One-year Results of Health-related and Vision-related Quality of Life After Clear Lens Extraction and Multifocal Intraocular Lens Implantation.

PURPOSE: Multifocal intraocular lenses (MIOLs) are effective in treating presbyopia before cataracts develop. This study measured health-related quality of life (HRQoL) and vision-related quality of life (VRQoL) after clear lens extraction (CLE) and MIOL implantation. DESIGN: Before-and-after study METHODS: Patients were treated in Medilaser Coronaria, CorGroup, Oulu, Finland. HRQoL was measured by a generic 15-dimension (15D) instrument. VRQoL was measured with Visual Function Index-14 (VF-14) questionnaire. RESULTS: CLE and MIOL implantation was performed in 137 patients. The patient age was 57 ± 6.2 years (mean ± standard deviation), and 58% were women. The near add was 2.1±0.3 diopters (D). The overall HRQoL 15D score increased from 0.938±0.058 to 0.955±0.057 at 6 months (P < .0001 vs baseline) and to 0.948±0.060 at 1 year (P = .02 vs baseline). The VRQoL VF14 score increased from 85.32±15.57 to 96.57±5.07 at 6 months (P < .0001 vs baseline) and to 96.61±6.48 at 1 year (P < .0001 vs baseline). The increase of HRQoL was correlated with the increase of VRQoL (P < .04). CONCLUSIONS: CLE and MIOL implantation improved HRQoL and VRQoL compared to spectacles in this 1-year follow-up study. Improvement of HRQoL was correlated with VRQoL.

Loss of Pax5 promotes plasma cell differentiation.

Pax5 is indispensable for the commitment of early lymphoid progenitors to the B cell lineage as well as for the development of B cells. To better understand the functional importance of Pax5 at the later stages of B cell differentiation, we established a Pax5-deficient DT40 B cell line. The Pax5(-/-) cells exhibited slower growth, decreased surface IgM expression, and total loss of B cell receptor signaling. Moreover, the expression of the plasma cell-characteristic transcription factors Blimp-1 and XBP-1 were significantly upregulated and the expression of Bcl-6 diminished in the Pax5(-/-) cells, and this alteration was normalized by restored Pax5 expression. The Pax5-deficient cells further manifested substantially elevated secretion of IgM into the supernatant, another characteristic of plasma cells. These results indicate that downregulation of Pax5 function promotes the plasma cell differentiation of B cells.

Identification of a novel cytokine-like transcript differentially expressed in avian gammadelta T cells.

Chicken represents a species with a high frequency of gammadelta T cells in peripheral blood, suggesting an important function. To elucidate the genes specific for the avian gammadelta T cells, the suppression subtractive hybridization (SSH) between gammadelta and alphabeta T cells was used. The SSH library, which was successfully enriched for the TCR gamma and delta (both V and C region) sequences, provided gammadelta T-cell-specific genes, including, for example, the ribosomal proteins, signaling and structural molecules, and molecules related to transcription and translation. Among these genes, a clone named KK34 was shown to match the PFAM profile for IL-5 and to have 19.5% amino acid identity to the human interleukin 5 protein. Clone KK34 had lower sequence homology, from 5.4% to 15.6%, to other short-chain four-helix bundle superfamily members IL-3, IL-4, IL-13 and GM-CSF. The hydrophobic signal peptide sequence and the presence of cysteines needed for the interchain disulfide bonds were found to be conserved between clone KK34 and mammalian IL-5 proteins. Clone KK34 transcript expression was studied by RT-PCR, Northern blotting and in situ hybridization and it was confirmed to be expressed in avian gammadelta T cells. We propose that this clone, KK34, may represent the first nonmammalian IL-5, supporting the findings that gammadelta T cells are important in the development of allergy.

Insight into lymphoid development by gene expression profiling of avian B cells.

The avian immune system provides an excellent model to track B-cell development from prebursal stem cells throughout B-cell differentiation and maturation. Bursal B cells are uniquely positioned at the crossroads of B-cell development, having properties of both stem cells and of mature B cells, as demonstrated by their ability to reconstruct the bursal B-cell compartment and to express and diversify the B-cell receptor at their cell surface. To understand avian B-cell development better, we determined the gene expression profile of different B-cell stages using a bursal expressed sequence tag array. The expression profile of bursal B cells reveals the presence of factors associated with B-cell signaling and defines novel B-cell-specific genes. Genes associated with proliferation, apoptosis, DNA repair and recombination are abundantly expressed. The expression profile of the DT40 cell line is most similar to bursal B cells rather than to other stages of B-cell development, confirming the suitability of DT40 for studies of B-cell physiology. Interestingly, prebursal stem cells express genes involved in B-cell receptor signaling, although they express only low levels of immunoglobulin genes. This suggests that B-cell receptor-mediated selection is present before bursal colonization. The gene expression signatures of germinal centers and cells of the Harderian gland indicate that evolutionarily conserved genetic programs regulate B-cell activation and terminal differentiation.