Movements and spatial distribution of an endangered fish (Sciaena umbra) within a marine protected area.

The brown meagre (Sciaena umbra) is an endangered species, which requires specific protection measures to ensure its conservation. These measures need to be informed by high-quality scientific knowledge on their space use patterns. Here, we used acoustic telemetry to assess its seasonal movement patterns and habitat use within a marine protected area (MPA). Our results suggested that S. umbra is a highly sedentary species (home range < 1.0 km2) and, therefore, the MPA is extensive enough to protect the local population. Their population was discretely distributed in two main areas within the MPA, which was likely a result of habitat segregation and density-dependent movements. The temporal variability of their movements further uncovered when and where spawning occurs (mainly, but probably not only, in the fully protected area in June) and indicated that spillover of this species is limited but still possible. Overall, we highlight the importance of MPAs in the recovery of S. umbra, we advocate the need to perpetuate the current national fishing bans and extend it to other countries in the Mediterranean region, and we emphasize that considering the fine-scale movements of S. umbra in future management actions is key to achieving a successful recovery of their populations.

Seasonal influence on the bathymetric distribution of an endangered fish within a marine protected area.

The spatio-temporal variability of fish distribution is important to better manage and protect the populations of endangered species. In this sense, the vertical movements of a vulnerable and protected species, Sciaena umbra, were assessed in a marine protected area (the Réserve Naturelle Marine de Cerbère-Banyuls, south of France) to study the variability of their bathymetric distribution at different time scales. Twenty adults were marked with acoustic transmitters and acoustically monitored over 2.5 years. This revealed that some individuals remained at shallow waters (< 8 m) all year round, while others presented vertical segregation at deeper waters during the cold months (mean depth of 22.5 ± 0.04 m) and all aggregated in shallow waters during the warm months. The brown meagre was more active during the night, except in June and July when peaks of activity were observed at dusk. These patterns are likely associated with foraging and reproductive behavior during the cold and warm periods, respectively, and likely regulated by water temperature and the depth of the thermocline. Here, we provide valuable information on when and where in the water column critical periods of S. umbra life cycle are expected to occur, which should be considered in management and protection plans.

Solar drying in the vineyard: a sustainable technology for the recovery of nutrients from winery organic waste.

The present study describes a pilot-scale experimental validation of a forced-convection greenhouse solar dryer, combined with a biofilter, for controlled atmospheric emissions. This set-up was applied to the dewatering of sewage sludge from a biological plant that treated process wastewater in a commercial Mediterranean winery. Experiments were performed after the harvest, from September onwards, during the peak generation of sludge. The average drying rate during the first 10 days of operation ranged from 1.17 to 2.24 kg m-2 d-1, depending on the measurement method, during which the water content of the sludge was reduced from 90% down to 67%. Biofiltration was quite inefficient against greenhouse gases (methane and dinitrous oxide), and direct emissions during the drying process were on average 57 g CO2-eq m-2 d-1. Ammonia and volatile organic compounds were removed with average efficiencies of 71% and 35%, but ammonia losses through volatilization represented less than 2% of the initial nitrogen content. The sludge was dried further during November, to the lowest possible water content of 14%. Both the intermediate and final sludge dried materials were characterized for their agronomical value as organic fertilizers.

Does trophic level drive organic and metallic contamination in coral reef organisms?

Metallic and organic pollutants constitute a serious threat for coral reef ecosystems, potentially affecting a great number of species interacting within complex trophodynamic processes. Pesticides, PCBs and trace elements were measured on coral reef communities of three Pacific islands (Moorea, Wallis and New Caledonia) in relation with δ15N values, a proxy of trophic level. Several potential sources of organic matter, benthic invertebrates and fish belonging to various trophic strategies were sampled at each island. Wallis and New Caledonia displayed, respectively, the highest concentrations of pesticides and trace elements. In the three islands, most trace element concentrations (Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, and V) decreased when δ15N was rising (i.e. bioreduction), whereas Hg and Se biomagnified with increasing δ15N values. Only few trace elements in some islands did not show any significant trend in relation with δ15N (i.e., Ag in New Caledonia, Zn in Wallis and As plus Zn in Moorea). PCBs concentrations showed a significant bioreduction in New Caledonia and in Moorea, but a significant biomagnification in Wallis. Aldrin and heptachlor were the only pesticides to show a similar significant bioreduction in the three islands. Other pesticides, such as chlordecone, diazinon, endosulfan I and II, heptachlor-epoxide A and B, lindane and pp'-DDE displayed contrasted patterns (e.g. chlordecone significantly biomagnified in New Caledonia, significantly bioreduced in Wallis and did not displayed any significant trend in Moorea). Finally, for unclear reasons, Moorea displayed only negative significant correlations between δ15N and all pesticides (except pp'-DDT). Our results highlight that trophic level, here assessed through δ15N values, is a good predictor of metallic trace elements biomagnification or bioreduction in coral reef organisms. However, at large spatial scale, trophic level relevance to predict pesticides and PCBs biomagnification or bioreduction should be considered with caution and studied in close relation with local characteristics.

Sí: un error es un tesoro, pues nos permite aprender; pero en el informe radiológico, ¿no sería mejor hablar de discrepancias? / Certainly: an error is a gift, so we can learn from it. Nevertheless, related to the radiological report, should we not consider talking about discrepancies?

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Protective effect of cyclodextrins on the quality parameters of roast preserved pepper.

Total phenolics (TP), vitamin C, antioxidant activity and colour of preserved peppers were evaluated at 4, 25 and 50 ℃ storage during 30-day intervals. Except for 4 ℃, TP decreased during storage at 25 ℃ and 50 ℃, being softer for fortified samples with ß-CDs. The protective effect was evident, since 50 ℃ samples containing ß-CDs exhibited lower TP loss (19%) than control samples (38%) for 5 months storage. A decrease in the vitamin C content was observed for both samples as time and temperature progressed. In samples stored at 50 ℃ the protective effect of ß-CD only was evident at the first month, since fortified samples showed lower vitamin C loss (10%) than control samples. The fortified samples with ß-CDs exhibited lowest antioxidant activity loss (40%) during 90-day storage at 50 ℃, than control samples (64%). The colour changes were in line with those observed for total phenolics and at the end of study, the presence of 1% ß-CDs delayed the darkening of samples at both (25 and 50 ℃) storage conditions.

Impact of a training course on the quality of chest radiography to diagnose pulmonary tuberculosis.

SETTING: Socio-economically underprivileged urban areas in the Philippines. OBJECTIVE: To assess the performance of radiological technicians (RTs) 3 years after their participation in a training course to improve the quality of chest X-ray (CXR) and to test a monitoring visit after the course. DESIGN: A cross-sectional and observational study including on-site monitoring of X-ray facilities in Manila and Quezon City and assessment of CXR films taken by 23 RTs who previously attended a training course in 2009 or 2010. The sum of the assessment scores for each of six assessment factors at four points, i.e., before and after the training course that had been previously analysed, and before and after the monitoring visits that were currently analysed, were compared. RESULTS: Two assessment sum scores, identification mark or patient positioning, did not show significant differences. However, assessment of density, contrast, sharpness and artefact significantly improved after the training course, and before and after the monitoring visit, compared with before the training. There were no significant differences in any of the assessment factors before and after the monitoring visits. CONCLUSION: The training course appears to have had a long-term effect on maintaining CXR quality. The post-training monitoring visit did not significantly improve CXR quality.

Contexte : Zones urbaines de bas niveau socio-économique aux Philippines.Objectif : Evaluer la performance des manipulateurs radio (RT) dans les 3 années suivant leur participation à un cours de formation destiné à améliorer la qualité des radiographies pulmonaires (CXR) ainsi que l'effet d'une visite de suivi après le cours.Schéma : Etude transversale et d'observation incluant le suivi sur place des structures de radiographie à Manille et Quezon et l'évaluation des clichés de CXR pris par 23 RT qui avaient assisté au cours de formation en 2009 ou 2010. Les sommes des scores d'évaluation de chacun des six facteurs d'évaluation à quatre moments, c'est-à-dire avant et après le cours de formation qui avaient été évalués précédemment et avant et après les visites de suivi qui étaient en cours d'analyse, ont été comparées.Résultats : Deux sommes de scores d'évaluation­identification du cliché ou positionnement du patient­n'ont pas mis en évidence de différence significative. Cependant, en ce qui concerne la densité, le contraste, la définition et les artefacts, une amélioration significative a été constatée après le cours de formation et avant et après la visite de suivi, par comparaison avec les résultats préalables à la formation. Par contre, il n'y a eu de différence significative dans aucun des facteurs d'évaluation avant et après les visites de suivi.Conclusion : Le cours de formation a démontré un effet à long terme en termes de maintien de la qualité des RP. Par contre, la visite de suivi après la formation n'a pas significativement amélioré la qualité des RP.

Marco de referencia: Zonas urbanas en situación socioeconómica desfavorable en las Filipinas.Objetivo: Evaluar el desempeño de los auxiliares técnicos de radiología (RT) 3 años después de haber participado en un curso de capacitación destinado a mejorar la calidad de la radiografía de tórax (CXR) y la utilidad de una visita de supervisión después del curso.Métodos: Se llevó a cabo un estudio transversal y de observación, en el cual se realizó una supervisión directa de las instalaciones de radiología en Manila y Ciudad Quezón y se evaluaron las CXR realizadas por 23 auxiliares RT que habían atendido a un curso de capacitación en el 2009 o el 2010. Se calificaron seis criterios de calidad de las CXR y la suma de las puntuaciones de cada criterio se categorizó en cuatro niveles; se compararon las sumatorias de las puntuaciones en cada momento de evaluación antes y después de la capacitación y antes y después de las visitas de supervisión realizadas durante el estudio.Resultados: Las sumatorias de las puntuaciones de dos criterios­la marca de identificación y el posicionamiento del paciente­no exhibieron diferencias significativas en los diferentes momentos de evaluación. Sin embargo, las puntuaciones sobre la densidad, el contraste, la nitidez y la presencia de artefactos revelaron una mejoría significativa después de la capacitación y también antes y después de la visita de supervisión, comparadas con las calificaciones obtenidas antes del curso de capacitación. No se observaron diferencias significativas en los criterios de calidad evaluados antes y después de las visitas de supervisión.Conclusión: El curso de capacitación ofrece un efecto a largo plazo sobre el mantenimiento de la calidad de las CXR. Las visitas de supervisión posteriores al entrenamiento no tuvieron una repercusión importante sobre la calidad.

Effectiveness of a training course on the quality assurance of chest radiography in the Philippines.

SETTING: Socio-economically underprivileged areas in urban settings in the Philippines. OBJECTIVE: To determine the effectiveness of a training course in quality chest radiography (CXR). METHODS: A descriptive, observational intervention study in which a questionnaire was administered to X-ray facility staff before training, and CXRs were reviewed before and after a training course for radiological technologists in Manila and Quezon City in the Philippines from 2009 to 2010. Course participants submitted six CXRs, each taken before and after training. Two senior radiological technologists blinded to the CXR profiles assessed the CXRs independently, using an assessment sheet developed by the Tuberculosis Coalition for Technical Assistance. RESULTS: Forty radiological technologists from 10 facilities in Manila City and nine in Quezon City participated in the training. A total of 36 participants submitted the required set of CXRs. The assessment indicated that the training effectively improved the quality of CXRs in terms of identification marking (Wilcoxon matched-pairs signed-rank sum test, P = 0.00), contrast (P = 0.00), sharpness (P = 0.01), artefacts (P = 0.00), and the total score of the factors (P = 0.00). CONCLUSION: The significant improvement in the total score of assessment factors strongly suggests a positive impact of the training course on improving the quality of CXRs.

Antioxidant activity, color, carotenoids composition, minerals, vitamin C and sensory quality of organic and conventional mandarin juice, cv. Orogrande.

The effects of organic farming on antioxidant activity, CIE L*a*b* color, carotenoids composition, minerals contents, vitamin C and sensory quality of Orogrande mandarin juices were studied. Independent of the farming type, mandarin juices can be considered as good source of some important nutrients, such as potassium and antioxidant chemicals, for example, ß-cryptoxanthin. Organic farming of mandarin resulted in juices with higher antioxidant activity, total carotenoids concentrations, minerals (Ca, K and Fe) contents, vitamin C content, more appealing and intense orange color and better sensory quality. For instance, organic Orogrande juice contained significantly (p < 0.001) higher total carotenoids content (22.7 ± 0.3 mg/L) than conventional juice (15.7 ± 0.4 mg/L); a similar pattern was observed for the antioxidant activity, with values being 0.076±0.004 and 0.053 ± 0.003 mM Trolox m/L in organic and conventional juices, respectively. A trained panel stated that organic Orogrande juices had higher intensities of orange color, fresh mandarin and floral aromas than conventional juices.

Acute complications of electrophysiology and pacing procedures: identification and management.

Non-pharmacologic interventional techniques for treatment and management of almost all cardiac arrhythmias have greatly expanded over the past decade. These newer interventional electrophysiologic techniques continue to demonstrate increasing success at achieving their targeted goals, and enhancing the patient's quality of life. However, like all interventional procedures, complications may result. In this article we provide the reader with an overview of the more common and significant adverse events that may follow electrophysiologic and pacing procedures, and how best to recognize and manage these complications. After providing the reader with an overview of the complications inherent to all electrophysiologic procedures, we will detail the adverse events intrinsic to specific therapeutic electrophysiologic interventions (DC cardioversion, pharmacologic-based cardioversion, antitachycardia pacing, and ablation of specific arrhythmias). In the last part of the review, we will delineate complications associated with pacing procedures (pacemaker and defibrillator implantation, biventricular pacing and pacing lead extraction).

[Idiopathic thrombocytopenic purpura as an extraintestinal manifestation of Crohn's disease]. / Púrpura trombocitopénica idiopática como manifestación extraintestinal de la enfermedad de Crohn.

Idiopathic thrombocytopenic purpura is an infrequent extraintestinal manifestation of inflammatory bowel disease. It is particularly rare in association with Crohn's disease. In these cases it presents certain peculiarities with respect to its normal clinical features, occurring more frequently when Crohn's disease is mainly colonic and usually appearing after the diagnosis of Crohn's disease has been made. Moreover, it usually complicates the clinical course of both diseases. We present a case of idiopathic thrombocytopenic purpura in a 14-year-old girl in whom the two diseases first presented simultaneously. The clinical course was poor and both diseases were refractory to habitual treatment.

[Health professionals' opinion of the Catalan Health Plan. Basis for a reflexion on the future]. / La opinión de los profesionales sanitarios sobre el Plan de Salud de Cataluña. Punto de partida para una reflexión orientada al futuro.

OBJECTIVES: To know health professional's opinion of the Health Plan for Catalonia (Spain) in order to get news elements for the formulation and management of new plans. DESIGN: Combination of quantitative and qualitative methodologies. Postal survey to doctors and nurses (multistage randomised sample). 3.223 questionnaires were obtained (response rate: 34,1%). Interview to a selected sample of 41 health care professionals and managers. MEASUREMENTS AND MAIN RESULTS: 78,8% (IC95%: 1,4) of health professionals are familiar with the Health Plan, and for most of them it is valued as important. 28,9% (IC95%: 1,7) of the professionals who know the Plan consider that it has repercussions in their daily work and 51,8% (IC95%: 1,9) declare that it doesn't have any repercussions. Different issues such as the planning process, the contents, the dissemination strategy, as well as a the poor impact on the health budget are critised. Differences by age group and sex, care setting and type of health professional are observed. CONCLUSIONS: The implication of health professionals in the discussion, formulation and implementation of the Health Plan proposals needs to be improved. It will be necessary to make progress in identifying health problems and needs, in setting priorities and in the allocation of resources. To increase the multisectorial involvement and to develop marketing strategies directed to politicians, managers and health professionals will also be needed in order to increase the impact of the Health Plan on both the Health System and the other sectors involved in health. The role to be played by the Health Plan in the health system must be redefined and this will lead to redesigning the planning process and the implementation of health strategies.

La opinión de los profesionales sanitarios sobre el Plan de Salud de Cataluña. Punto de partida para una reflexión orientada al futuro / Health professionals' opinion of the Catalan Health Plan. Basis for a reflexion on the future

Objetivos: Conocer la opinión de los profesionales sanitarios sobre el Plan de Salud (PS) de Cataluña y obtener nuevos elementos para la formulación y gestión de nuevos planes. Diseño: Combinación de metodología cuantitativa y cualitativa. Encuesta postal a personal médico y de enfermería, por muestreo aleatorio polietápico con estratificación. Se obtuvieron 3.223 cuestionarios (tasa de respuesta del 34,1 per cent). Entrevista a una muestra de conveniencia formada por 41 profesionales asistenciales y de la gestión. Mediciones y resultados principales: El PS es conocido por el 78,8 per cent (intervalo de confianza del 95 per cent: ñ 1,4) de los profesionales y es valorado positivamente por la mayoría de los consultados. Según el 28,9 per cent (IC del 95 per cent: ñ 1,7) de los encuestados que lo conocen, el PS ha tenido repercusiones favorables en su labor diaria, y el 51,8 per cent (IC del 95 per cent: ñ 1,9) opina que no ha tenido repercusiones. Se critican aspectos de su elaboración, contenido, difusión y la escasa asignación de recursos específicos. Se observan diferencias por edad, sexo, ámbito asistencial y colectivo profesional. Conclusiones: Es necesaria una mayor implicación de los profesionales en la discusión, diseño e implementación de las propuestas del PS. Se debe avanzar en la identificación de problemas, en el establecimiento de prioridades y en la asignación de recursos. También hay que lograr un mayor compromiso intersectorial y desarrollar estrategias de comunicación específicas para políticos, gestores y profesionales que permitan mejorar la proyección de los objetivos del PS en el sistema sanitario y otros sectores con responsabilidad en el ámbito de la salud. En definitiva, es necesario replantearse el papel del PS en el sistema y, de acuerdo con él, rediseñar los procesos para el establecimiento y aplicación de estrategias de salud (AU)

Objectives: To know health professional's opinion of the Health Plan for Catalonia (Spain) in order to get news elements for the formulation and management of new plans. Design: Combination of quantitative and qualitative methodologies. Postal survey to doctors and nurses (multistage randomised sample). 3.223 questionnaires were obtained (response rate: 34,1%). Interview to a selected sample of 41 health care professionals and managers. Measurements and main results: 78,8% (IC95%: ± 1,4) of health professionals are familiar with the Health Plan, and for most of them it is valued as important. 28,9% (IC95%: ± 1,7) of the professionals who know the Plan consider that it has repercussions in their daily work and 51,8% (IC95%: ± 1,9) declare that it doesn't have any repercussions. Different issues such as the planning process, the contents, the dissemination strategy, as well as a the poor impact on the health budget are critised. Differences by age group and sex, care setting and type of health professional are observed. Conclusions: The implication of health professionals in the discussion, formulation and implementation of the Health Plan proposals needs to be improved. It will be necessary to make progress in identifying health problems and needs, in setting priorities and in the allocation of resources. To increase the multisectorial involvement and to develop marketing strategies directed to politicians, managers and health professionals will also be needed in order to increase the impact of the Health Plan on both the Health System and the other sectors involved in health. The role to be played by the Health Plan in the health system must be redefined and this will lead to redesigning the planning process and the implementation of health strategies (AU)

New insights into the mechanism of neurally mediated syncope.

OBJECTIVE: To determine the role of the cerebral cortex in neurally mediated syncope, the electroencephalograms (EEG) of patients recorded during head up tilt table test were analysed. DESIGN: Retrospective study. SETTING: University hospital. PATIENTS: 18 patients with syncope or near syncope underwent head up tilt table test with simultaneous ECG and EEG monitoring. METHODS: Standard 70 degrees tilt table test was done with simultaneous ECG and EEG monitoring. EEG waveforms were analysed by both visual inspection and spectral analysis. RESULTS: 6 of 18 patients (33%) had a positive tilt table test. Before syncope slow waves increased in patients with a positive test. In addition, five of six tilt positive patients (83%) had slow wave activity that lateralised to the left side of the brain (mean (SD) 822 (724) v 172 (215) micro V(2), p < 0.05), while none of the tilt negative patients exhibited lateralisation (24 (15) v 26 (19) micro V(2), NS). Spectral analysis showed that the lateralisation occurred in the delta frequency. The lateralisation preceded the event by 5-56 seconds (18 (21) seconds). CONCLUSIONS: EEG activity lateralises to the left hemisphere of the brain before syncope. The lateralisation precedes syncope and is associated with the onset of bradycardia, hypotension, and clinical symptoms. These findings suggest that the central nervous system may have a role in neurally mediated syncope.

T cell infiltration of the prostate induced by androgen withdrawal in patients with prostate cancer.

Manipulations capable of breaking host tolerance to induce tissue-specific T cell-mediated inflammation are of central importance to tumor immunotherapy and our understanding of autoimmunity. We demonstrate that androgen ablative therapy induces profuse T cell infiltration of benign glands and tumors in human prostates. T cell infiltration is readily apparent after 7-28 days of therapy and is comprised predominantly of a response by CD4+ T cells and comparatively fewer CD8+ T cells. Also, T cells within the treated prostate exhibit restricted TCR Vbeta gene usage, consistent with a local oligoclonal response. Recruitment/activation of antigen-presenting cells in treated prostate tissues may contribute to local T cell activation. The induction of T cell infiltration in prostate tissues treated with androgen ablation may have implications for the immunotherapeutic treatment of prostate cancer as well as other hormone-sensitive malignancies, including breast carcinoma.

Injection of human herpesvirus-8 in human skin engrafted on SCID mice induces Kaposi's sarcoma-like lesions.

Kaposi's sarcoma-associated herpesvirus (KSHV) or human herpesvirus 8 (HHV-8) has been implicated in the development of Kaposi's sarcoma (KS) and several B-cell lymphoproliferative diseases. Serologic and molecular genetic association data has implicated HHV-8 as the causal agent of KS, but its role in the development of KS lesions is not understood. To examine the etiology of KS, HHV-8 was injected into normal human skin transplanted onto SCID mice. Injection of HHV-8 induced lesion formation that is morphologically and phenotypically consistent with KS, including the presence of angiogenesis and spindle-shaped cells latently infected with HHV-8. These findings suggest that HHV-8 is indeed the etiologic agent of KS, and that the virus plays an important role in initiation of this disease.

Induction of human immunodeficiency virus 1 replication by human herpesvirus 8.

BACKGROUND: Human immunodeficiency virus 1 (HIV-1)-infected individuals are commonly infected with herpesviruses, including cytomegalovirus, herpes simplex virus, varicella-zoster virus, and human herpesvirus 8 (HHV-8, also known as Kaposi sarcoma-associated herpesvirus [KSHV]). Previous studies have demonstrated that coinfection with herpesviruses can modulate HIV-1 replication. This can occur either through direct interaction between the 2 viruses or through secondary effects resulting from the release of cellular factors in response to infection. OBJECTIVE: To investigate HIV-1 replication in the presence and absence of HHV-8. DESIGN AND METHODS: HIV-1 replication was analyzed following culture of HIV-1-infected CD4(+) T cells in the presence of HHV-8 infected B-cell lines or control, uninfected B-cell lines. To confirm and extend the results of these in vitro studies, HIV-1-infected T cells were injected into human skin transplanted onto severe combined immunodeficient mice. The human skin was also injected with purified HHV-8 or phosphate-buffered saline as a control and HIV replication measured in biopsy specimens taken 5 to 8 days later. RESULTS AND CONCLUSIONS: The results demonstrated a significant increase in HIV-1 replication in the presence of HHV-8 in both the in vitro and in vivo model systems. Although the mechanism responsible for HHV-8 induction of HIV-1 replication remains to be identified, the results indicate that these 2 viruses may interact at the molecular level in coinfected patients, resulting in increased HIV-1 viral load.

Conceptualizing and applying a minimum basic needs approach in southern Philippines.

This study, a collaboration between Canadian and Filipino researchers, focuses on how the national government's Minimum Basic Needs (MBN) Approach has been implemented at the local level in some selected sites in Region XI on the Philippine island of Mindanao. This case study of MBN implementation focuses on the experiences of three municipalities and three barangays (villages) within them. The research explores, through interviews and group discussions, what the mayors, technical working groups and volunteer health workers in these areas thought about MBN and how they participated in the initiative. The objectives of the study were: to explore models of MBN data utilization at the municipal and barangay levels; to understand how the MBN data guided decision-making about community priorities and resource allocation; to examine the role that community volunteers played in promoting the use of MBN data, and in community health and development activities which ensued; and to determine what factors challenged or encouraged the use of MBN data for social development at the barangay level. In all the sites, MBN had some impact, most often due to methods of concentrating information on unmet basic needs locally and making use of it in planning and project development processes. The findings show that although there is still some way to go before MBN is effectively integrated into local planning and project development, some responses to problems have been implemented and innovative projects were undertaken or being considered.

Induction of HHV-8 lytic cycle replication by inflammatory cytokines produced by HIV-1-infected T cells.

Human herpesvirus 8 (HHV-8) is a gamma2-herpesvirus consistently identified in Kaposi's sarcoma (KS), primary effusion lymphoma, and multicentric Castleman's disease. Although HHV-8 infection appears to be necessary, it may not be sufficient for development of KS without the involvement of other cofactors. One potentially important cofactor is HIV-1. HIV-1-infected cells produce HIV-1-related proteins and cytokines, both of which have been shown to promote growth of KS cells in vitro. Though HIV-1 is not absolutely necessary for KS development, KS is the most frequent neoplasm in AIDS patients, and AIDS-KS is recognized as a particularly aggressive form of the disease. To determine whether HIV-1 could participate in the pathogenesis of KS by modulating HHV-8 replication (rather than by inducing immunodeficiency), HIV-1-infected T cells were cocultured with the HHV-8-infected cell line, BCBL-1. The results demonstrate soluble factors produced by or in response to HIV-1-infected T cells induced HHV-8 replication, as determined by production of lytic phase mRNA transcripts, viral proteins, and detection of progeny virions. By focusing on cytokines produced in the coculture system, several cytokines known to be important in growth and proliferation of KS cells in vitro, particularly Oncostatin M, hepatocyte growth factor/scatter factor, and interferon-gamma, were found to induce HHV-8 lytic replication when added individually to BCBL-1 cells. These results suggest specific cytokines can play an important role in the initiation and progression of KS through reactivation of HHV-8. Thus, HIV-1 may participate more directly than previously recognized in KS by promoting HHV-8 replication and, hence, increasing local HHV-8 viral load.