ABSTRACT
Normal ageing is associated with an impaired systemic immune response contributing to an increased susceptibility to infectious diseases. The aim of this study was to compare the lymphocyte phenotype in human skin from old and young healthy subjects. Skin samples from donors were used for explant cultures before flow cytometric analysis. Our results depicted a higher proportion of CD4+ and a lower proportion of CD8+ among CD3+ T cells, a decreased proportion of CD45RA+ naive T cells (3.5 ± 1.9% vs 22.9 ± 11.1%, P ≤ 0.007) and an upregulation of the expression of CD39 and PD1 on CD3+ CD4+ T cells (25.1 ± 8.5% vs 12.5 ± 8.5%, P ≤ 0.003, 68.8 ± 11.6% vs 50.0 ± 11.3%, P ≤ 0.01, respectively) in the skin of old subjects. These findings could explain a reduced generation of long-lived memory T cells and an impaired antitumoral response in the skin of the elderly.
Subject(s)
Aging/metabolism , Apyrase/metabolism , CD4-Positive T-Lymphocytes/metabolism , Programmed Cell Death 1 Receptor/metabolism , Skin/immunology , Adolescent , Adult , Age Factors , Aged , CD3 Complex/metabolism , CD4-CD8 Ratio , CD8-Positive T-Lymphocytes/metabolism , Female , Healthy Volunteers , Humans , Leukocyte Common Antigens/metabolism , Male , Middle Aged , Phenotype , Skin/cytology , Young AdultSubject(s)
Cytokines/blood , Still's Disease, Adult-Onset/blood , Still's Disease, Adult-Onset/pathology , Adult , Age Factors , Biomarkers/blood , Case-Control Studies , Chronic Disease , Disease Progression , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment , Severity of Illness Index , Sex FactorsABSTRACT
The role of autoimmunity targeting epithelial antigens in asthma has been suggested, in particular in non-atopic and severe asthma. Periplakin, a desmosomal component, is involved in epithelial cohesion and intracellular signaling. We detected anti-periplakin IgG antibodies in 47/260 (18 %) patients with asthma, with no association with severity or atopy. In addition, anti-periplakin IgE antibodies were detected in 12 of 138 tested patients (8.7 %) and were more frequently observed in patients with than without nasal polyposis. This study identifies a new autoimmune epithelial target in asthma. Whether periplakin autoimmunity (both IgG and IgE auto-antibodies) is involved in asthma pathogenesis remains to be studied during the disease course of these patients.
Subject(s)
Asthma/immunology , Autoantibodies/blood , Autoimmunity , Immunoglobulin E/blood , Immunoglobulin G/blood , Plakins/immunology , Adult , Asthma/blood , Asthma/diagnosis , Asthma/epidemiology , Biomarkers/blood , Case-Control Studies , Female , France/epidemiology , Humans , Male , Middle Aged , Nasal Polyps/blood , Nasal Polyps/epidemiology , Nasal Polyps/immunology , Prevalence , Prospective Studies , Risk Factors , Seroepidemiologic Studies , Serologic Tests , Severity of Illness IndexABSTRACT
AIM: To investigate the safety and potential savings of decreasing medication use in low-risk patients with ocular hypertension (OH). METHODS: Patients with OH receiving pressure-lowering medication identified by medical record review at a university hospital underwent examination by a glaucoma specialist with assessment of visual field (VF), vertical cup-to-disc ratio (vCDR), central corneal thickness and intraocular pressure (IOP). Subjects with estimated 5-year risk of glaucoma conversion <15% were asked to discontinue ≥1 medication, IOP was remeasured 1â month later and risk was re-evaluated at 1 year. RESULTS: Among 212 eyes of 126 patients, 44 (20.8%) had 5-year risk >15% and 14 (6.6%) had unreliable baseline VF. At 1 month, 15 patients (29 eyes, 13.7%) defaulted follow-up or refused to discontinue medication and 11 eyes (5.2%) had risk >15%. The remaining 69 patients (107 eyes, 50.7%) successfully discontinued 141 medications and completed 1-year follow-up. Mean IOP (20.5±2.65â mmâ Hg vs 20.3±3.40, p=0.397) did not change, though mean VF pattern SD (1.58±0.41â dB vs 1.75±0.56â dB, p=0.001) and glaucoma conversion risk (7.31±3.74% vs 8.76±6.28%, p=0.001) increased at 1â year. Mean defect decreased (-1.42±1.60 vs -1.07±1.52, p=0.022). One eye (0.47%) developed a repeatable VF defect and 13 eyes (6.1%) had 5-year risk >15% at 1â year. The total 1-year cost of medications saved was US$4596. CONCLUSIONS: Nearly half (43.9%) of low-risk OH eyes in this setting could safely reduce medications over 1â year, realising substantial savings.
