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Background@#Recently, there has been a growing interest in stem cells for human medicine.Limited feline endometrial mesenchymal stem cell (fEM-MSC) research in veterinary medicine necessitates reporting for future feline disease research and therapy. @*Objectives@#This study aimed to isolate fEM-MSCs from feline endometrial tissues and evaluate their morphology, proliferative ability, differentiation ability, and immunophenotype. @*Methods@#Feline endometrial tissues were obtained from the ovariohysterectomies of healthy cats and isolated using an enzymatic method. The morphology and proliferative ability of the isolated cells were assessed using a doubling time (DT) assay from passages 3 to 6 (P3 − P6). We measured pluripotency gene expressions of cells in P2 using quantitative realtime polymerase chain reaction (qRT-PCR). To investigate MSC characteristics, a trilineage differentiation assay was conducted in P4, and cells in P4 were immunophenotyped using flow cytometry. @*Results@#fEM-MSCs showed a typical spindle-shaped morphology under a microscope, and the DT was maintained from P3 to P6. fEM-MSCs could differentiate into adipocytes, osteoblasts, and chondrocytes, and expressed three pluripotency markers (OCT4, SOX2, and NANOG) by qRT-PCR. Immunophenotypic analysis showed that the fEM-MSCs were CD14− , CD34− , CD45− , CD9+ , and CD44+ . @*Conclusions@#In this study, the feline endometrium was a novel source of MSCs, and to the best of our knowledge, this is the first report on the isolation method and characteristics of fEM-MSCs.
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Background@# : The purpose of this study was to identify the attributes of nursing students’ simulation practice experiences utilizing a patient simulator. @*Methods@# : Data collection was conducted through one-on-one in-depth interviews between March 10 and May 3, 2023. The participants were 15 fourth-year nursing students who had experienced simulation practice using a patient simulator. For analysis, all interviews were recorded and transcribed verbatim. The transcriptions were analyzed using Hsieh and Shannon’s (2005) qualitative content analysis method. @*Results@# : The following four themes were derived: ‘Replicated clinical environment in nursing practical room’, ‘Course requiring preparation’, ‘Learning that varies depending on the instructor’, and ‘Process of nurse development through teamwork’. These results show the characteristics of nursing students who engage in simulation practice using a patient simulator. @*Conclusion@# : For effective simulation practice for nursing students, a program that complements the contents and methods based on simulation practice experience is needed.
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Purpose@#This study was conducted to identify the effects of grit on the work engagement of nurses and to identify the mediating effects of positive psychological capital and burnout in the relationship between grit and work engagement. @*Methods@#The study subjects were 182 nurses who had been working in a general hospital for more than six months. The data were collected from July 12 to July 26, 2021. The collected 182 sets of data were analyzed by descriptive statistics, correlation analysis, and a hierarchical regression analysis using IBM SPSS statistics version 23.0 and also by bootstrapping using SPSS Process Macro. @*Results@#As a result of the analyses, it was found that higher work engagement was associated with higher grit, higher positive psychological capital, and lower burnout. The mediating effects of positive psychological capital and burnout in the relationship between grit and work engagement were found to be both direct and indirect. @*Conclusion@#This study provides basic data suggesting that an education program designed to reduce burnout and reinforce grit and positive psychological capital is necessary to promote the work engagement of nurses in clinical settings.
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Purpose@#The aim of this study was to investigate the educational status and needs of premature birth prevention, and to identify factors associated with preconception health behaviors. @*Methods@#The study design was a crosssectional descriptive study. Data were collected through an online questionnaire survey, and the subjects were 192 women of childbearing age in Korea. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation coefficients, and multiple regression. @*Results@#The proportion of subjects who received education on premature birth prevention was 8.9%, and 75.5% of subjects answered that they needed education on premature birth prevention. They demanded education through online media, small groups, cases, cartoons (webtoon) with stories, pictures, and videos. A related factor of preconception health behavior was self-efficacy for high-risk pregnancy health care (β=.20, p=.012), which accounted for 8.2% of the total variance related to preconception health behavior. @*Conclusion@#There was a need for more development of education programs to prevent premature birth for women of childbearing age. Its education programs should be applied with online, small group activities using various educational media. It is also required to promote preconception health behavior through self-efficacy for high-risk pregnancy health care.
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Advanced or metastatic breast cancer affects multiple organs and is a leading cause of cancer-related death. Cancer metastasis is associated with epithelial-mesenchymal metastasis (EMT). However, the specific signals that induce and regulate EMT in carcinoma cells remain unclear. PRR16/Largen is a cell size regulator that is independent of mTOR and Hippo signalling pathways. However, little is known about the role PRR16 plays in the EMT process. We found that the expression of PRR16 was increased in mesenchymal breast cancer cell lines. PRR16 overexpression induced EMT in MCF7 breast cancer cells and enhances migration and invasion. To determine how PRR16 induces EMT, the binding proteins for PRR16 were screened, revealing that PRR16 binds to Abl interactor 2 (ABI2). We then investigated whether ABI2 is involved in EMT. Gene silencing of ABI2 induces EMT, leading to enhanced migration and invasion. ABI2 is a gene that codes for a protein that interacts with ABL proto-oncogene 1 (ABL1) kinase. Therefore, we investigated whether the change in ABI2 expression affected the activation of ABL1 kinase. The knockdown of ABI2 and PRR16 overexpression increased the phosphorylation of Y412 in ABL1 kinase. Our results suggest that PRR16 may be involved in EMT by binding to ABI2 and interfering with its inhibition of ABL1 kinase. This indicates that ABL1 kinase inhibitors may be potential therapeutic agents for the treatment of PRR16-related breast cancer.
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Melanogenesis is the production of melanin from tyrosine by a series of enzyme-catalyzed reactions, in which tyrosinase and DOPA oxidase play key roles. The melanin content in the skin determines skin pigmentation. Abnormalities in skin pigmentation lead to various skin pigmentation disorders. Recent research has shown that the expression of EMP2 is much lower in melanoma than in normal melanocytes, but its role in melanogenesis has not yet been elucidated. Therefore, we investigated the role of EMP2 in the melanogenesis of MNT1 human melanoma cells. We examined TRP-1, TRP-2, and TYR expression levels during melanogenesis in MNT1 melanoma cells by gene silencing of EMP2. Western blot and RT-PCR results confirmed that the expression levels of TYR and TRP-2 were decreased when EMP2 expression was knocked down by EMP2 siRNA in MNT1 cells, and these changes were reversed when EMP2 was overexpressed. We verified the EMP2 gene was knocked out of the cell line (EMP2 CRISPR/Cas9) by using a CRISPR/Cas9 system and found that the expression levels of TRP-2 and TYR were significantly lower in the EMP2 CRISPR/Cas9 cell lines. Loss of EMP2 also reduced migration and invasion of MNT1 melanoma cells. In addition, the melanosome transfer from the melanocytes to keratinocytes in the EMP2 KO cells cocultured with keratinocytes was reduced compared to the cells in the control coculture group. In conclusion, these results suggest that EMP2 is involved in melanogenesis via the regulation of TRP-2 expression.
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Purpose@#This study considers the variables related to self-leadership of Korean nursing students and verifies the results of precedent studies through meta-analysis. @*Methods@#This study selected a total of 48 precedent studies regarding the investigation of the correlation between variables related to self-leadership of nursing students conducted between 2009 and 2019 and carried out a meta-analysis. @*Results@#For the effect size of variables related to self-leadership of nursing students, individual characteristics had a medium effect size (ESr=.49) and the effect size was larger for meta-cognition (ESr=.65), emotional intelligence (ESr=.58), and self-efficacy (ESr=.54). The characteristics of nursing competency (ESr=.45) also had a medium effect size and the effect size was larger for professional self-concept (ESr=.60), social support (ESr=.58), and critical thinking (ESr=.56). This result shows that individual characteristics were highly correlated with self-leadership compared to the characteristics of nursing competency. @*Conclusion@#This study is significant in that it verified the effect of variables related to self-leadership and presented the direction and preliminary data for a follow-up study. It is necessary to include variables considering individual characteristics in the development of an educational program for improving self-leadership in the future.
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Purpose@#This study aimed to determine the mediating effect of emotional intelligence on the relationship between the social support and job satisfaction of general hospital nurses. @*Methods@#The data of 197 nurses in general hospitals located in three different cities were collected for analysis. Collected data were analyzed using the t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and hierarchical multiple regression with SPSS/WIN 23.0. @*Results@#The social support of the subjects showed positive correlations with job satisfaction (r=.56, p<.001) and emotional intelligence (r=.42, p<.001). Emotional intelligence and job satisfaction were positively correlated (r=.54, p<.001). Emotional intelligence was found to perform the partial mediation in the relationship between social support and job satisfaction. @*Conclusion@#To improve job satisfaction, an organizational culture which enhances social support may be required as an intervention strategy, and programs should be developed to induce positive emotional intelligence.
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Malarial infection induces tissue hypoxia in the host through destruction of red blood cells. Tissue hypoxia in malarial infection may increase the activity of HIF1α through an intracellular oxygen-sensing pathway. Activation of HIF1α may also induce vascular endothelial growth factor (VEGF) to trigger angiogenesis. To investigate whether malarial infection actually generates hypoxia-induced angiogenesis, we analyzed severity of hypoxia, the expression of hypoxia-related angiogenic factors, and numbers of blood vessels in various tissues infected with Plasmodium berghei. Infection in mice was performed by intraperitoneal injection of 2×10⁶ parasitized red blood cells. After infection, we studied parasitemia and survival. We analyzed hypoxia, numbers of blood vessels, and expression of hypoxia-related angiogenic factors including VEGF and HIF1α. We used Western blot, immunofluorescence, and immunohistochemistry to analyze various tissues from Plasmodium berghei-infected mice. In malaria-infected mice, parasitemia was increased over the duration of infection and directly associated with mortality rate. Expression of VEGF and HIF1α increased with the parasitemia in various tissues. Additionally, numbers of blood vessels significantly increased in each tissue type of the malaria-infected group compared to the uninfected control group. These results suggest that malarial infection in mice activates hypoxia-induced angiogenesis by stimulation of HIF1α and VEGF in various tissues.
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Animais , Camundongos , Indutores da Angiogênese , Hipóxia , Vasos Sanguíneos , Western Blotting , Eritrócitos , Imunofluorescência , Imuno-Histoquímica , Injeções Intraperitoneais , Malária , Mortalidade , Parasitemia , Plasmodium , Plasmodium berghei , Fator A de Crescimento do Endotélio VascularRESUMO
PURPOSE: This paper reports the results of a massage therapy on transcutaneous bilirubin (TcB) in the forehead and inguinal regions, feeding intake, urine amount, and defecation frequency for neonates with jaundice who are receiving phototherapy. METHODS: A non-equivalent control group, pre-post, quasi-experimental design was used. Participants were 33 neonates with jaundice admitted for phototherapy and were randomly assigned to one of two groups—an experimental group (n=16), which received 3 days of routine plus 15 minutes of massage three times a day, and a control group (n=17), which received the routine care only. Data were analyzed using χ²-test and Mann-Whitney U test with SPSS 21.0 Win program. RESULTS: On the second day of hospitalization, the experimental group showed significantly lower TcB in the inguinal region (Z=−2.12, p=0.017); on the third day, the experimental group showed significantly lower TcB in the inguinal region (Z=−2.31, p=0.011) and higher defecation frequency (Z=−2.22, p=0.013) compared with the control group. CONCLUSIONS: The study findings suggest that massage for jaundice neonates receiving phototherapy is an effective intervention to reduce TcB in the inguinal region and to increase defecation frequency.
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Humanos , Lactente , Recém-Nascido , Bilirrubina , Defecação , Testa , Hospitalização , Icterícia , Massagem , FototerapiaRESUMO
PURPOSE: This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. METHODS: A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. RESULTS: Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. CONCLUSION: These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.
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Idoso , Humanos , Glicemia , Colesterol , Diabetes Mellitus , Jejum , Educação em Saúde , Modelos Lineares , Mentores , Atividade Motora , Autocuidado , Estatística como Assunto , Triglicerídeos , Populações VulneráveisRESUMO
Breast cancer remains the second leading cause of cancer death among woman, worldwide, despite advances in identifying novel targeted therapies and the development of treating strategies. Classification of clinical subtypes (ER+, PR+, HER2+, and TNBC (Triple-negative)) increases the complexity of breast cancers, which thus necessitates further investigation. Mouse models used in breast cancer research provide an essential approach to examine the mechanisms and genetic pathway in cancer progression and metastasis and to develop and evaluate clinical therapeutics. In this review, we summarize tumor transplantation models and genetically engineered mouse models (GEMMs) of breast cancer and their applications in the field of human breast cancer research and anti-cancer drug development. These models may help to improve the knowledge of underlying mechanisms and genetic pathways, as well as creating approaches for modeling clinical tumor subtypes, and developing innovative cancer therapy.
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Animais , Feminino , Humanos , Camundongos , Neoplasias da Mama , Mama , Classificação , Metástase NeoplásicaRESUMO
PURPOSE: The purpose of this study was to investigate the influence of social support, self - esteem, hope, and health conservation of the vulnerable elderly people with diabetes. METHODS: Participants were 100 vulnerable elderly people with diabetes living in D or K cities. Data collection was done through interviews from February to March, 2016. Social support was measured with the MOS-SSS (Medical Outcomes Study Social Support Survey), self-esteem with Self-Esteem Scale, hope with the Nowotny Hope Scale, and health conservation with the Sung's Health Conservation Scale. IBM SPSS 20.0 was used to analyze descriptive statistics, one-way ANOVA, independent t-test, Pearson correlation, and stepwise multiple regression. RESULTS: Factors affecting the health conservation of the vulnerable elderly people were social support, hope, education level and subjective health status. These factors explained 64.9% of the health conservation. CONCLUSION: It is necessary to construct a comprehensive nursing classification system for elderly people with diabetes in vulnerable class and to develop integrated health conservation program and nursing care as a new social support resource.
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Idoso , Humanos , Classificação , Coleta de Dados , Autoavaliação Diagnóstica , Educação , Esperança , Enfermagem , Cuidados de Enfermagem , Autoimagem , Populações VulneráveisRESUMO
Sphingosylphosphorylcholine (SPC) is one of the bioactive phospholipids that has many cellular functions such as cell migration, adhesion, proliferation, angiogenesis, and Ca²⁺ signaling. Recent studies have reported that SPC induces invasion of breast cancer cells via matrix metalloproteinase-3 (MMP-3) secretion leading to WNT activation. Thrombospondin-1 (TSP-1) is a matricellular and calcium-binding protein that binds to a wide variety of integrin and non-integrin cell surface receptors. It regulates cell proliferation, migration, and apoptosis in inflammation, angiogenesis and neoplasia. TSP-1 promotes aggressive phenotype via epithelial mesenchymal transition (EMT). The relationship between SPC and TSP-1 is unclear. We found SPC induced EMT leading to mesenchymal morphology, decrease of E-cadherin expression and increases of N-cadherin and vimentin. SPC induced secretion of thrombospondin-1 (TSP-1) during SPC-induced EMT of various breast cancer cells. Gene silencing of TSP-1 suppressed SPC-induced EMT as well as migration and invasion of MCF10A cells. An extracellular signal-regulated kinase inhibitor, PD98059, significantly suppressed the secretion of TSP-1, expressions of N-cadherin and vimentin, and decrease of E-cadherin in MCF10A cells. ERK2 siRNA suppressed TSP-1 secretion and EMT. From online PROGgene V2, relapse free survival is low in patients having high TSP-1 expressed breast cancer. Taken together, we found that SPC induced EMT and TSP-1 secretion via ERK2 signaling pathway. These results suggests that SPC-induced TSP-1 might be a new target for suppression of metastasis of breast cancer cells.
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Humanos , Apoptose , Neoplasias da Mama , Caderinas , Movimento Celular , Proliferação de Células , Transição Epitelial-Mesenquimal , Inativação Gênica , Inflamação , Metástase Neoplásica , Fenótipo , Fosfolipídeos , Fosfotransferases , Receptores de Superfície Celular , Recidiva , RNA Interferente Pequeno , Trombospondina 1 , VimentinaRESUMO
Sphingosylphosphorylcholine (SPC) is one of the bioactive phospholipids that has many cellular functions such as cell migration, adhesion, proliferation, angiogenesis, and Ca²⁺ signaling. Recent studies have reported that SPC induces invasion of breast cancer cells via matrix metalloproteinase-3 (MMP-3) secretion leading to WNT activation. Thrombospondin-1 (TSP-1) is a matricellular and calcium-binding protein that binds to a wide variety of integrin and non-integrin cell surface receptors. It regulates cell proliferation, migration, and apoptosis in inflammation, angiogenesis and neoplasia. TSP-1 promotes aggressive phenotype via epithelial mesenchymal transition (EMT). The relationship between SPC and TSP-1 is unclear. We found SPC induced EMT leading to mesenchymal morphology, decrease of E-cadherin expression and increases of N-cadherin and vimentin. SPC induced secretion of thrombospondin-1 (TSP-1) during SPC-induced EMT of various breast cancer cells. Gene silencing of TSP-1 suppressed SPC-induced EMT as well as migration and invasion of MCF10A cells. An extracellular signal-regulated kinase inhibitor, PD98059, significantly suppressed the secretion of TSP-1, expressions of N-cadherin and vimentin, and decrease of E-cadherin in MCF10A cells. ERK2 siRNA suppressed TSP-1 secretion and EMT. From online PROGgene V2, relapse free survival is low in patients having high TSP-1 expressed breast cancer. Taken together, we found that SPC induced EMT and TSP-1 secretion via ERK2 signaling pathway. These results suggests that SPC-induced TSP-1 might be a new target for suppression of metastasis of breast cancer cells.
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Humanos , Apoptose , Neoplasias da Mama , Caderinas , Movimento Celular , Proliferação de Células , Transição Epitelial-Mesenquimal , Inativação Gênica , Inflamação , Metástase Neoplásica , Fenótipo , Fosfolipídeos , Fosfotransferases , Receptores de Superfície Celular , Recidiva , RNA Interferente Pequeno , Trombospondina 1 , VimentinaRESUMO
PURPOSE: This study was conducted to identify the factors influencing health promotion behaviors. METHODS: The subjects were 200 students sampled from the population that attend four universities in G and J city. Data were collected with a questionnaire and were analyzed by t-test, ANOVA, correlation, and stepwise multiple regression. RESULTS: The mean age of subjects was 21. Family function and self-efficacy were identified as determinants of health promotion behaviors, which explained 53% of the total variances of health promotion behavior. CONCLUSION: The findings provide evidence to help health assessment and activity related to the health promotion behavior of university students.
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Humanos , Promoção da SaúdeRESUMO
PURPOSE: The purpose of this study was to develop a breastfeeding empowerment program and to investigate the effects of the breastfeeding empowerment program on self-efficacy, adaptation and continuation of breastfeeding for primiparous women. METHODS: The 5 session breastfeeding empowerment program was developed and a non-equivalent control group non-synchronized quasi-experiment design was used. Fifty-five participants were assigned to either the experimental group (n=27) or the control group (n=28). Effects were tested using repeated measures ANOVA and χ²-test. RESULTS: Scores for self-efficacy, adaptation and continuation of breastfeeding of in the experimental group after program were significantly higher than 1 week, 4 weeks, 8 weeks scores in control group. CONCLUSION: The effects of the breastfeeding empowerment program for elevating self-efficacy, adaptation and continuation of breastfeeding in primiparous women were validated. Therefore, this program can be recommended for vigorous use in clinical practice.
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Feminino , Humanos , Aleitamento Materno , Poder Psicológico , AutoeficáciaRESUMO
BACKGROUND: We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes. METHODS: The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin. RESULTS: The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002). CONCLUSION: As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.
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Humanos , Glicemia , Peso Corporal , Colesterol , Hemoglobinas Glicadas , Lipoproteínas , Metformina , TiazolidinedionasRESUMO
To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.
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Adolescente , Animais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Enterobíase/epidemiologia , Enterobius/genética , Higiene , Infestações por Piolhos/epidemiologia , Orfanatos/estatística & dados numéricos , Pediculus/genética , Prevalência , República da Coreia/epidemiologiaRESUMO
In Trichinella spiralis infection, type 2 helper T (Th2) cell-related and regulatory T (T(reg)) cell-related immune responses are the most important immune events. In order to clarify which Toll-like receptors (TLRs) are closely associated with these responses, we analyzed the expression of mouse TLR genes in the small intestine and muscle tissue during T. spiralis infection. In addition, the expression of several chemokine- and cytokine-encoding genes, which are related to Th2 and T(reg) cell mediated immune responses, were analyzed in mouse embryonic fibroblasts (MEFs) isolated from myeloid differentiation factor 88 (MyD88)/TIR-associated proteins (TIRAP) and Toll receptor-associated activator of interferons (TRIF) adapter protein deficient and wild type (WT) mice. The results showed significantly increased TLR4 and TLR9 gene expression in the small intestine after 2 weeks of T. spiralis infection. In the muscle, TLR1, TLR2, TLR5, and TLR9 gene expression significantly increased after 4 weeks of infection. Only the expression of the TLR4 and TLR9 genes was significantly elevated in WT MEF cells after treatment with excretory-secretory (ES) proteins. Gene expression for Th2 chemokine genes were highly enhanced by ES proteins in WT MEF cells, while this elevation was slightly reduced in MyD88/TIRAP-/- MEF cells, and quite substantially decreased in TRIF-/- MEF cells. In contrast, IL-10 and TGF-beta expression levels were not elevated in MyD88/TIRAP-/- MEF cells. In conclusion, we suggest that TLR4 and TLR9 might be closely linked to Th2 cell and T(reg) cell mediated immune responses, although additional data are needed to convincingly prove this observation.