Explanatory models and help-seeking for symptoms of PTSD and depression among Syrian refugees.

OBJECTIVE: This study investigates how Syrian refugees explain and prefer to seek help for symptoms of post-traumatic stress disorder (PTSD) and depression. METHODS: We conducted five semi-structured focus group interviews based on a vignette-technique with Syrian refugees (n = 21 men, n = 10 women). The vignettes describe a fictional person suffering from symptoms of PTSD or depression in line with DSM-5 and ICD-10 criteria. RESULTS: Despite never mentioning PTSD, participants in the PTSD-interviews recognized the symptoms. They perceived them as a common reaction to extreme situations, mainly the war, the flight, and post-migratory stressors. Depression was labeled as either depression or feelings caused by social problems, and the participants were more hesitant to identify with these symptoms. Despite some differences, both the PTSD and depression vignettes were explained in terms of situational explanatory models and externally caused stress. The main finding is how participants described changing stressors resulting from migration and resettlement leading to a difference in how they would seek help in Syria and in Norway. Specifically, we found that preferred help-seeking and coping strategies are contextual. CONCLUSIONS: These findings point to the need to consider transformations following forced migration when studying aspects of explanatory models, preferred help-seeking, and coping strategies in refugee groups.

Receptor localization, native tissue binding and ex vivo occupancy for centrally penetrant P2X7 antagonists in the rat.

BACKGROUND AND PURPOSE: The P2X7 receptor is implicated in inflammation and pain and is therefore a potential target for therapeutic intervention. Here, the development of a native tissue radioligand binding, localization and ex vivo occupancy assay for centrally penetrant P2X7 receptor antagonists is described. EXPERIMENTAL APPROACH: Autoradiography studies using the P2X7 antagonist radioligand [³H]-A-804598 were carried out in rat brain and spinal cord. Subsequent in vitro binding and ex vivo occupancy assays were performed using rat cortex homogenate. KEY RESULTS: P2X7 expression was shown to be widespread throughout the rat brain, and in the grey matter of the spinal cord. In binding assays in rat cortex homogenate, ∼60% specific binding was achieved at equilibrium. In kinetic binding assays, k(on) and k(off) values of 0.0021·min⁻¹·nM⁻¹ and 0.0070·min⁻¹ were determined, and the K(d) derived from kinetic measurements was consistent with that derived from saturation analysis. Novel P2X7 antagonists inhibited the binding of [³H]-A-804598 to rat cortex P2X7 receptors with K(i) values of <40 nM. In an ex vivo occupancy assay, a P2X7 antagonist dosed orally to rats caused a concentration-dependent inhibition of the specific binding of [³H]-A-804598 to rat cortex. CONCLUSIONS AND IMPLICATIONS: The present study describes the development of an assay that allows localization of P2X7 receptors, the measurement of the binding affinity of P2X7 receptor antagonists in native tissue, and provides a means of determining central P2X7 receptor occupancy. These assays could form an important part of a P2X7 drug discovery programme.

Remarkable attachment of lactoferrin to Streptococcus pyogenes during acute pharyngotonsillitis.

The purpose of this study was to establish whether lactoferrin (hLf) attached to Streptococcus pyogenes, one causative agent of acute pharyngotonsillitis (AT), during the course of the disease. Bacterial samples were obtained from the tonsillar surfaces of 7 patients (6 females, 1 male; median age 26 years; range 16-50 years) suffering from AT who were culture-positive for S. pyogenes and from 5 healthy adult controls who were culture-negative for this pathogen. Using gold-labelled antiserum against S. pyogenes and hLf, this pathogen and other bacteria on the tonsillar surfaces coated with hLf could be identified by tracing the gold particles in a transmission electron microscope. In healthy adults, 8% (median value; range 6-12%) of the surface tonsillar bacteria were coated with hLf. In AT patients, 59% (median value; range 42 67%) of S. pyogenes were coated with hLf, in contrast to 9% (median value; range 0-26%) of all other bacteria (p < 0.01). This study hints that hLf might participate in recovery from AT in several ways, e.g. by binding to the S. pyogenes pathogens, in addition to its well-known virtue of iron-binding capacity.

Bacterial coating with immunoglobulins on the palatine tonsils during infectious mononucleosis: immunocytochemical study with gold markers.

Epithelial cells and bacteria were sampled from the tonsillar surfaces of seven patients (six males, one female; median age 16 years, range 10 to 21 years) suffering from acute infectious mononucleosis with concomitant pharyngotonsillitis. By using gold-labelled antiserum to human IgG and secretory IgA (sIgA), micro-organisms on the tonsillar surfaces coated with these immunoglobulins could be identified by tracing the gold particles in the transmission electron microscope. The patients harboured significantly fewer bacteria coated with immunoglobulins than did healthy controls. More bacteria were coated with IgG immunoglobulins than with sIgA. Reduced immunoglobulin-coating of the bacteria on the tonsillar surfaces during infectious mononucleosis can explain their tendency to immense local colonization and proneness to penetrate into the epithelial cells.

Bacterial penetration into tonsillar surface epithelium during infectious mononucleosis.

Bacterial penetration into epithelial cells, scraped from the palatine tonsils of 14 patients (10 males, four females; median age 16 years) with current infectious mononucleosis and concomitant membranous tonsillitis, was studied using the transmission electron microscopic (TEM) technique. Bacteria were seen to adhere to and penetrate the epithelial cells, some of which were completely filled with bacteria. This finding suggests intracellular proliferation of bacteria. Epstein-Barr virus, the causative agent of infectious mononucleosis, especially when associated with growth of beta-haemolytic streptococci on the palatine tonsils, induces bacterial penetration into tonsillar tissue, that in turn might be a causative mechanism in the development of peritonsillar abscess.

SIgA- and IgG-coated Streptococcus pyogenes on the tonsillar surfaces during acute tonsillitis.

Bacterial swabs were collected from the tonsillar surfaces of eight patients with current acute tonsillitis, culture-positive for Streptococcus pyogenes. Using gold-labelled antiserum to S. pyogenes, these micro-organisms could be localized in the samples by transmission electron microscopy. S. pyogenes pathogens were further characterized with gold-labelled antiserum to human IgG and SIgA antibodies. Roughly 90% of the pathogens were found coated with IgG antibodies, irrespective of the duration of the disease, whereas the proportion of SIgA-coated pathogens increased with disease duration. Insufficient IgA coating of pathogens might well be a contributory cause of the induction of tonsillar infection, probably due to inadequate prevention of the attachment of the S. pyogenes bacteria to the tonsillar surface epithelium.