Use of a short-term whole blood intracellular staining assay to study the T-cell response in respiratory syncytial virus-infected pediatric patients.

The aim of the present study was the development of a reliable method to evaluate the pattern of the ongoing T-cell response in young infants affected by respiratory infection. To this purpose, we enrolled 44 infants hospitalized with a diagnosis of respiratory syncytial virus bronchiolitis. After a short-term stimulation of whole blood samples, intracellular IFN-g and IL-4 cytokines were measured in CD4+ and CD8+ T-cell subsets by flow cytometry. A stringent staining and gating strategy was used in order to maximize the reduction of background noise and to exclude false positives. The frequencies of cytokine-producing T-cell subsets, albeit low, were easily quantifiable. Cytokine responses were higher in infants sampled > 7 days from the onset of symptoms. The use of a rigorous strategy for cell staining and gating, coupled with a short-term stimulation of whole blood and a careful evaluation of time elapsed from the onset of symptoms constitutes a convincing approach for future clinical studies.

Infants hospitalized for Bordetella pertussis infection commonly have respiratory viral coinfections.

BACKGROUND: Whether viral coinfections cause more severe disease than Bordetella pertussis (B. pertussis) alone remains unclear. We compared clinical disease severity and sought clinical and demographic differences between infants with B. pertussis infection alone and those with respiratory viral coinfections. We also analyzed how respiratory infections were distributed during the 2 years study. METHODS: We enrolled 53 infants with pertussis younger than 180 days (median age 58 days, range 17­109 days, 64. 1% boys), hospitalized in the Pediatric Departments at "Sapienza" University Rome and Bambino Gesù Children's Hospital from August 2012 to November 2014. We tested in naso-pharyngeal washings B. pertussis and 14 respiratory viruses with real-time reverse-transcriptase-polymerase chain reaction. Clinical data were obtained from hospital records and demographic characteristics collected using a structured questionnaire. RESULTS: 28/53 infants had B. pertussis alone and 25 viral coinfection: 10 human rhinovirus (9 alone and 1 in coinfection with parainfluenza virus), 3 human coronavirus, 2 respiratory syncytial virus. No differences were observed in clinical disease severity between infants with B. pertussis infection alone and those with coinfections. Infants with B. pertussis alone were younger than infants with coinfections, and less often breastfeed at admission. CONCLUSIONS: In this descriptive study, no associations between clinical severity and pertussis with or without co-infections were found. TRIAL REGISTRATION: Policlinico Umberto I: protocol 213/14, 3085/13.02.2014, retrospectively registered. Bambino Gesù Children's Hospital: protocol n. RF-2010-2317709.

Difficult diagnosis of atypical kawasaki disease in an infant younger than six months: a case report.

BACKGROUND: Kawasaki disease (KD) is an acute inflammatory vasculitis of unknown origin. CASE PRESENTATION: We report the case of a 5-month-old child with an atypical form of KD, characterized by undulating symptoms, who developed an aneurysm of the right coronary artery and an ectasia of the left anterior descending coronary artery. CONCLUSION: This case report underlines the difficulties in recognizing incomplete forms of the illness in young infants, who are at higher risk of cardiac complications.

[Prevalence of Mood Disorders in a university students population]. / Prevalenza dei Disturbi dell'Umore in una popolazione distudenti universitari.

AIMS: To evaluate (i) the incidence of psychiatric disorders and (ii) the frequency of Mood Disorders diagnoses in a sample of 115 university students afferent to Sportello Counseling-Accoglienza Studenti "Fatti vivo!" of "Sapienza" University of Rome, between November 2008 and December 2010; to point out correlations with socio-demographic variables. MATERIALS AND METHODS: The prevalence of Mood Disorders was evaluated with the Structured Clinical Interview for DSM IV Axis I Disorders Clinical Version (SCID-I cv), drawn up by the counselor at first meeting. Each student completed a data collection from which investigates socio-demographic characteristics. A descriptive analysis was conducted and the associations between variables and Axis I diagnoses were investigated. RESULTS: The overall mean age is 24.7 years. A DSM IV-TR Axis I Disorder was diagnosed in 26.9%, of which 45.2% is constituted by Mood Disorders (mean age of 25.7 years). Male students, the highest family members' mean age and the lowest regular studies (64% pursue a course of regular studies) seem to be characteristics of the subgroup of students with Mood Disorders diagnoses compared to the subgroups with other Axis I Disorders diagnoses. Moreover, the same subgroup most frequently recognizes as pathological its condition (78.6%) compared to the subgroup with other Axis I Disorders diagnoses (53.3%). Those differences, however, aren't statistically significant. CONCLUSIONS: The discovered percentage of Axis I diagnoses in general and Mood Disorders in particular could be considered representative of perceived unease degree in a population of university students. At the same time, the difficulty in identifying the early signs of uneasiness and in recognizing as pathological own condition interferes with and delays the awareness of the need of a psychological/psychiatric support and the expression of the help-seek.

Psychological factors in childhood asthma.

OBJECTIVES: The aim of this study is to evaluate psychological aspects of childhood asthma and the connections between the illness and behavioral disturbances in asthmatic children. STUDY DESIGN: We selected a group of 47 asthmatic children and a control group of 47 healthy children. The only criterion for inclusion was that the children be between 4 and 10 years of age; criteria for exclusion were neurological pathologies, cognitive retardation, and serious or chronic systemic disease. The collaboration of a psychologist and a comparative examination of questionnaires used in medical literature helped us prepare a calibrated questionnaire for our study. RESULTS: In our study, the asthmatic children show significantly more behavioral and psychological disturbances than the children in the control group. CONCLUSIONS: Within the group of asthmatic children the boys and the children whose illness has lasted less than 4 years, are at greater risk of such disturbances; stressful situations connected to the birth or previous pregnancies can be seen more often in the group of asthmatic children than in the control group; before the onset of the illness the asthmatic children had significant sleep disturbances.

Characterization of beta-keratins and associated proteins in adult and regenerating epidermis of lizards.

Reptilian epidermis contains two types of keratin, soft (alpha) and hard (beta). The biosynthesis and molecular weight of beta-keratin during differentiation of lizard epidermis have been studied by autoradiography, immunocytochemistry and immunoblotting. Tritiated proline is mainly incorporated into differentiating and maturing beta-keratin cells with a pattern similar to that observed after immunostaining with a chicken beta-keratin antibody. While the antibody labels a mature form of beta-keratin incorporated in large filaments, the autoradiographic analysis shows that beta-keratin is produced within the first 30 min in ribosomes, and is later packed into large filaments. Also the dermis incorporates high amount of proline for the synthesis of collagen. The skin was separated into epidermis and dermis, which were analyzed separately by protein extraction and electrophoresis. In the epidermal extract proline-labeled proteic bands at 10, 15, 18-20, 42-45, 52-56, 85-90 and 120 kDa appear at 1, 3 and 5 h post-injection. The comparison with the dermal extract shows only the 85-90 and 120 kDa bands, which correspond to collagen. Probably the glycine-rich sequences of collagen present also in beta-keratins are weakly recognized by the beta-1 antibody. Immunoblotting with the beta-keratin antibody identifies proteic bands according to the isolation method. After-saline or urea-thiol extraction bands at 10-15, 18-20, 40, 55 and 62 kDa appear. After extraction and carboxymethylation, weak bands at 10-15, 18-20 and 30-32 kDa are present in some preparations, while in others also bands at 55 and 62 kDa are present. It appears that the lowermost bands at 10-20 kDa are simple beta-keratins, while those at 42-56 kDa are complex or polymeric forms of beta-keratins. The smallest beta-keratins (10-20 kDa) may be early synthesized proteins that are polymerized into larger beta-keratins which are then packed to form larger filaments. Some proline-labeled bands differ from those produced after injection of tritiated histidine. The latter treatment does not show 10-20 kDa labeled proteins, but tends to show bands at 27, 30-33, 40-42 and 50-62 kDa. Histidine-labeled proteins mainly localize in keratohyalin-like granules and dark keratin bundles of clear-oberhautchen layers of lizard epidermis, and their composition is probably different from that of beta-keratin.

The differential reactivity of cells of the melanocytic lineage with four monoclonal antibodies against IFN-gamma inducible molecules.

The reactivity of four monoclonal antibodies (MAbs) directed against IFN-gamma inducible antigens with melanocytic cells was investigated in the course of local and systemic tumor progression of human malignant melanoma. Frozen sections of histologically defined melanocytic tissues at different stages of progression were stained with these MAbs using an indirect immunoperoxidase technique. The reactivity of MAbs Me15/B3 and Me15/F9, directed against two different epitopes of a 90-kDa molecule, was found to correlate with melanoma progression. Indeed, a significantly lower percentage of small than of advanced primary melanomas or metastases stained positively. A differential staining of nevocytic and dysplastic nevi was further observed for these two MAbs, which were also non-reactive with normal skin melanocytes. The reactivity of MAb Me14/D12, which identifies the intercellular adhesion molecule ICAM-1 and MAb Mel14/F12, directed against a 40-kDa molecule, was found to be independent of the Breslow thickness of primary melanomas. Both the latter MAbs stained a high proportion of nevocytic and dysplastic nevi. The co-expression of the surface molecules defined by MAbs Me14/D12, Me15/B3 and Me15/F9 in the course of melanoma progression was also analyzed. The frequency of this co-expression increased according to the Breslow thickness of primary melanomas. In addition, up to 100% of metastases, as opposed to 20% of dysplastic nevi, were found to be simultaneously stained by these three MAbs. It is therefore conceivable that high-risk melanocytic lesions might be identified by the use of a combination of MAbs directed against IFN-gamma regulated antigens.

A disturbance of the IL-2/IL-2 receptor system parallels the activity of multiple myeloma.

The IL-2/IL-2 receptor (IL-2R) system has been investigated in 64 patients with multiple myeloma (MM), 31 with monoclonal gammopathies of undetermined significance (MGUS) and 20 normal controls. The MM data were related to clinical status by comparing active disease, i.e. at diagnosis and at relapse, and stable disease, i.e. complete remission and off-treatment plateau phase. Serum and urinary values of the soluble IL-2R (sIL-2R) were significantly increased in MM patients compared with normal controls and this increase was related to activity. MM patients with active disease gave significantly higher values than those with stable disease. Compared with normal controls, enriched B cell (but not T cell) preparations from peripheral blood mononuclear cells (PBMC) showed significantly increased proportions of IL-2R+ cells in MM and MGUS. However, the highest proportions were detected in active MM compared with stable MM and MGUS. Also, 16% of all MM patients, as opposed to 9% of MGUS, had well-defined bone marrow IL-2R+ plasma cell populations. The lowest serum IL-2 values were found in active MM. Serial follow up of serum sIL-2R suggested that this peptide can be used as an additional marker of active malignancy. The data indicate that a disturbance of IL-2/IL-2R system is most pronounced in active MM. These findings may provide clues as to the T cell abnormalities in MM.

Chloride dependence of the sodium-dependent glycine transport in pig kidney cortex brush-border membrane vesicles.

The Na+-dependent glycine uptake in pig kidney cortex brush-border membrane vesicles is specifically enhanced by the presence of Cl-. The Na+-independent glycine uptake is not affected by Cl-. Various anions tested could not substitute Cl- in the activation of the Na+-dependent glycine transport. Cl- is specifically required on the outer membrane side. The Na+-dependent glycine uptake is higher in the presence of an inwardly directed Cl- gradient than the one measured in the presence of equilibrated Cl-. The Na+-dependent glycine uptake depends on, and is saturable at increasing Cl- concentrations. By studying the activation of glycine uptake by Na+ in the presence and in the absence of Cl-, evidence was found that two different Na+-dependent glycine transport pathways are present in pig kidney cortex brush-border membrane vesicles. The kinetics of the glycine uptake measured in the presence of an inwardly directed NaCl gradient show the presence of two glycine transport systems, a low-affinity, high-capacity one and a high-affinity, low capacity one. In the absence of Cl- the high-affinity, low-capacity transport is almost suppressed, thus indicating the presence of a high-affinity glycine transport system simultaneously dependent on both Na+ and Cl- ions.