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Monocytes and macrophages are central players of the innate immune response and play a pivotal role in the regulation of inflammation. Thereby, they actively participate in all phases of the immune response, from initiating inflammation and triggering the adaptive immune response, through to the clearance of cell debris and resolution of inflammation. In this review, we described the mechanisms of monocyte and macrophage adaptation to rapidly changing microenvironmental conditions and discussed different forms of macrophage polarization depending on the environmental cues or pathophysiological condition. Therefore, special focus was placed on the tight regulation of the pro- and anti-inflammatory immune response, and the diverse functions of S100A8/S100A9 proteins and the scavenger receptor CD163 were highlighted, respectively. We paid special attention to the function of pro- and anti-inflammatory macrophages under pathological conditions.

Background Scavenger receptor CD163 is exclusively expressed on monocytes/macrophages and is widely used as a marker for alternatively activated macrophages. However, the role of CD163 is not yet clear. Objectives We sought to examine the function of CD163 in steady-state as well as in sterile and infectious inflammation. Methods Expression of CD163 was analyzed under normal and inflammatory conditions in mice. Functional relevance of CD163 was investigated in models of inflammation in wild-type and CD163−/− mice. Results We describe a subpopulation of bone marrow–resident macrophages (BMRMs) characterized by a high expression of CD163 and functionally distinct from classical bone marrow–derived macrophages. Development of CD163+ BMRMs is strictly dependent on IFN regulatory factor-8. CD163+ BMRMs show a specific transcriptome and cytokine secretion pattern demonstrating a specific immunomodulatory profile of these cells. Accordingly, CD163−/− mice show a stronger inflammation in allergic contact dermatitis, indicating a regulatory role of CD163. However, CD163−/− mice are highly susceptible to S aureus infections, demonstrating the relevance of CD163 for antimicrobial defense as well. Conclusions Our data indicate that anti-inflammatory and immunosuppressive mechanisms are not necessarily associated with a decreased antimicrobial activity. In contrast, our data define a novel macrophage population that controls overwhelming inflammation on one hand but is also necessary for an effective control of infections on the other hand.

Uncontrolled inflammation is a leading cause of many clinically relevant diseases. Current therapeutic strategies focus mainly on immunosuppression rather than on the mechanisms of inflammatory resolution. Glucocorticoids (GCs) are still the most widely used anti-inflammatory drugs. GCs affect most immune cells but there is growing evidence for cell type specific mechanisms. Different subtypes of monocytes and macrophages play a pivotal role both in generation as well as resolution of inflammation. Activation of these cells by microbial products or endogenous danger signals results in production of pro-inflammatory mediators and initiation of an inflammatory response. GCs efficiently inhibit these processes by down-regulating pro-inflammatory mediators from macrophages and monocytes. On the other hand, GCs act on “naïve” monocytes and macrophages and induce anti-inflammatory mediators and differentiation of anti-inflammatory phenotypes. GC-induced anti-inflammatory monocytes have an increased ability to migrate toward inflammatory stimuli. They remove endo- and exogenous danger signals by an increased phagocytic capacity, produce anti-inflammatory mediators and limit T-cell activation. Thus, GCs limit amplification of inflammation by repressing pro-inflammatory macrophage activation and additionally induce anti-inflammatory monocyte and macrophage populations actively promoting resolution of inflammation. Further investigation of these mechanisms should lead to the development of novel therapeutic strategies to modulate undesirable inflammation with fewer side effects via induction of inflammatory resolution rather than non-specific immunosuppression.

Myeloid-derived suppressor cells (MDSC) are a heterogeneous group of mononuclear and polymorphonuclear myeloid cells, which are present at very low numbers in healthy subjects, but can expand substantially under disease conditions. Depending on disease type and stage, MDSC comprise varying amounts of immature and mature differentiation stages of myeloid cells. Validated unique phenotypic markers for MDSC are still lacking. Therefore, the functional analysis of these cells is of central importance for their identification and characterization. Various disease-promoting and immunosuppressive functions of MDSC are reported in the literature. Among those, the capacity to modulate the activity of T cells is by far the most often used and best-established read-out system. In this review, we critically evaluate the assays available for the functional analysis of human and murine MDSC under in vitro and in vivo conditions. We also discuss critical issues and controls associated with those assays. We aim at providing suggestions and recommendations useful for the contemporary biological characterization of MDSC.

Background Rett syndrome is a rare developmental disorder with a genetic background, and scoliosis is one of its many complications. The aim of the present study was to assess the structure of the torso in the frontal plane in RTT. It was assumed that asymmetry of the structure of the torso in the frontal plane would be smaller in girls who are able to maintain a vertical body position. Material and methods The study included 14 girls previously diagnosed with RTT aged between 3 and 15 years, who were divided into 2 groups. Group 1 comprised 5 girls who were not able to maintain a vertical position. Group 2 comprised 9 girls who were able to maintain a vertical position. Body mass and weight were measured with an electronic scales and a height measuring device. The Body Mass Index was calculated. Photogrammetry was used to assess the structure of the torso in the frontal plane. The study results were subjected to a statistical analysis involving the calculation of the arithmetic mean (x), standard deviation (sd), coefficient of variation (v%) and significance of differences (p). Results Left-sided asymmetries were most common in both groups. All angles and linear values were higher in Group 1. 80% of the subjects in Group 1 demonstrated significant asymmetry of the pelvic tilt angle (PTA). There were no statistically significant differences between Group 1 and 2 regarding all study indices. Conclusions 1. The study demonstrated that asymmetry of the torso in the frontal plane was common in the girls with RTT. 2. Torso asymmetry was more pronounced in girls with a poorer functional status. 3. Analysis of BMI values demonstrated a poor nutritional status of the girls.

Background The aim of the study was to compare the static and dynamic plantar pressure profiles of amateur marathon runners with sedentary cohorts. Research questions Are there differences in the plantar pressures of these two populations? Is there a correlation between body mass and BMI with plantar loading? Methods The study involved 43 runners involved in marathon training and 30 age-matched untrained individuals. Plantar pressure was measured using a baropodometric system. Results The marathon runners showed greater forefoot plantar pressure of the dominant extremity in the static condition and reduced medial plantar pressure of both extremities in the dynamic condition. A correlation was observed between body mass and BMI with mean plantar pressure only in the marathon group and only for the dominant extremity in the dynamic condition. Conclusions Marathon training may modify the forefoot plantar loading characteristics of the dominant extremity during static conditions and increase lateral plantar pressure of both extremities in a dynamic (gait) condition.

Objective The aim of this study was to assess existing differences in the isokinetic trunk muscle strength in males and females aged between 10 and 11 years depending on body posture. Methods The study included 145 children (67 males and 78 females) divided into 2 age groups: 10-year-old males ( x ¯ = 9.98 ± 2.34 years) and females ( x ¯ = 9.85 ± 2.94 years) and 11-year-old males ( x ¯ = 11.14 ± 2.22 years) and females ( x ¯ = 11.15 ± 2.32 years). Posture in the sagittal plane was assessed by photogrammetry using the moire projection technique. Based on a classification system, the participants were divided into subgroups of males and females with normal and abnormal postures. Trunk muscle strength was measured using isokinetic dynamometry. Results A high prevalence of abnormal posture in children aged between 10 and 11 years was observed, primarily represented by an excessive curvature of the spine in the sagittal plane. The males and females with poor posture recorded lower values in isokinetic trunk muscle strength. Conclusion The results of the study point to the need for the application of suitable physiotherapy treatment (corrective measures/exercises) to treat musculoskeletal disorders to compensate for the loss of trunk flexor muscle strength in children with improper posture.

Background Breast cancer treatment may be a cause of postural disorders. Objective Assessment of the effects of various forms of physical activity on body posture in the sagittal plane in women post breast cancer treatment. Study group Sixty women who had received breast cancer treatment. The study group was intentionally divided into three groups of 20 women who followed different exercise regimens: NordicWalking (NW), water resistance exercise (WE) or general fitness exercise (GE). Methods Photogrammetric examination of body posture using a Computer-Based Body Posture Diagnostics apparatus performed at baseline and after an 8-week regimen of appropriately selected physical exercise. Results A favourable tendency for the shallowing of thoracic kyphosis and the reduction of lumbar cu rvature of the spine was noted in the NW group. Reduced kyphosis was also noted in the WE group, however it was accompanied by more pronounced lumbar lordosis and a tendency for excessive forward bending of the trunk. In the GE group, on the other hand, no significant differences were observed in terms of the shape of anteroposterior spinal curvatures. Conclusions The diversity observed in the shape of anteroposterior spinal curvatures following physical training regimens of different type and nature demonstrates the need of appropriate exercise selection to attain the desired therapeutic outcome. Balanced postural changes were only identified among the women in the NW group. In the GE group, however, training only sustained the status existing prior to the initiation of the exercise regimen.

The aim of the study was to investigate the range of motion (ROM) of lumbar and thoracic articulations and static and dynamic plantar pressure in sport climbing athletes.The sample included 30 sport climbers with a minimum of 2 years training experience and 30 physical education students who served as an active untrained control. ROM was assessed by a Saunders digital inclinometer and plantar pressure by a baropodometric platform.Mean spinal ROMs were greater in the sport climbers with an exception of extension, rotation, and lateral thoracic flexion, with a high degree of statistical significance obtained in the majority of the analyzed ROMs. The climbers exhibited increased mean forefoot pressure (smaller rearfoot pressure) in both the dominant and nondominant extremities, with significant intergroup differences found in dominant forefoot/rearfoot pressure distribution.Sport climbers present increased lumbar and thoracic ROM. The characteristics of climbing may also affect transverse arch structure and plantar pressure distribution.

Evaluation of body posture and strength of spinal muscles in children during their progressive ontogenesis is significant for the evaluation of their physical health condition and physical fitness. It is also a reference point in a process of control and medical care.The aim if this study was to evaluate correlation between the selected features of somatic body structure, shape of anteroposterior spinal curves and force-velocity (FV) parameters of trunk muscles in school children.The sample involved 104 children aged 10-11 years, 60 females (10.74 ±0.7) and 44 males (10.50 ±0.9). Body posture was assessed using the Moiré photogrammetry while trunk muscles (flexors and extensors) strength was measured isokinetically.The results of the research revealed the existence of many average and strong correlations observed between the analysed somatic characteristics and forcevelocity (FV) parameters of trunk muscles. Correlation between the volume of the spinal curvatures in the sagittal plane and forcevelocity parameters of trunk extensors and flexors were average or weak for both groups of children.Somatic features indicated stronger correlation with trunk muscles' strength than with the size of the anteroposterior spinal curves.

The high risk of neonatal death from sepsis is thought to result from impaired responses by innate immune cells; however, the clinical observation of hyperinflammatory courses of neonatal sepsis contradicts this concept. Using transcriptomic, epigenetic and immunological approaches, we demonstrated that high amounts of the perinatal alarmins S100A8 and S100A9 specifically altered MyD88-dependent proinflammatory gene programs. S100 programming prevented hyperinflammatory responses without impairing pathogen defense. TRIF-adaptor-dependent regulatory genes remained unaffected by perinatal S100 programming and responded strongly to lipopolysaccharide, but were barely expressed. Steady-state expression of TRIF-dependent genes increased only gradually during the first year of life in human neonates, shifting immune regulation toward the adult phenotype. Disruption of this critical sequence of transient alarmin programming and subsequent reprogramming of regulatory pathways increased the risk of hyperinflammation and sepsis. Collectively these data suggest that neonates are characterized by a selective, transient microbial unresponsiveness that prevents harmful hyperinflammation in the delicate neonate while allowing for sufficient immunological protection.

BackgroundIn contrast to other chronic inflammatory diseases glucocorticoids alone do not maintain sufficient remission in primary vasculitis. The reasons for this therapeutic failure remain unclear.ObjectivesTo investigate the molecular effects glucocorticoids exert on endothelial cells (EC) and to elucidate the molecular pathways responsible.MethodsA comparative approach was used to treat human micro and macrovascular EC as well as monocytes long and short term with glucocorticoids or glucocorticoids and tumour necrosis factor alpha (TNFα). Gene expression changes were analysed applying microarray technology, sophisticated bioinformatic work-up and quantitative reverse transcription PCR. Glucocorticoid receptor translocation processes were traced by cell fractionation assays and immunofluorescence microscopy.ResultsIn EC glucocorticoids completely failed to inhibit the expression of immune response genes both after sole glucocorticoid exposure and glucocorticoid treatment of a TNFα-induced proinflammatory response. In contrast, an impressive downregulation of proinflammatory genes was seen in monocytes. The study demonstrated that the glucocorticoid receptor is comparably expressed in EC and monocytes, and demonstrated good translocation of ligand-bound glucocorticoid receptor allowing genomic glucocorticoid actions. Refined gene expression analysis showed that in EC transactivation takes place and causes glucocorticoid side effects on growth and metabolism whereas transrepression-mediated anti-inflammatory effects as in monocytes are missing. Insufficient induction of SAP30, an important constituent of the Sin3A-histone deacetylase complex, in EC suggests impairment of transrepression due to co-repressor absence.ConclusionsThe impressive unresponsiveness of EC to anti-inflammatory glucocorticoid effects is associated with deficiencies downstream of glucocorticoid receptor translocation not affecting transactivation but transrepression. The findings provide the first molecular clues to the poor benefit of glucocorticoid treatment in patients with primary vasculitis.

The aim of the work was to determine the activity of trunk muscles in the sagittal plane in relation to body posture type in women treated for breast cancer. Fifty women having undergone treatment for breast cancer, with an average age of 61, participated in the study. All patients were studied by application of the photogrammetric method in order to determine posture; on the basis of the compensation ratio (mu), the examined group was divided into three posture sub-groups: kyphotic (K), lordotic (L) and balanced (R). At Biodex Multi Joint 3 examination system for isokinetic tests, the functional evaluation of trunk flexor muscles and extensor muscles was performed. Women having undergone mastectomy who participate regularly in rehabilitation are characterized by diverse posture types: kyphotic, lordotic and balanced. Women with lordotic posture achieved the highest force-speed parameter values in the trunk muscles irrespective of the muscle group examined, while the lowest values were observed in women exhibiting kyphotic posture. The function of trunk muscles in women following mastectomy depends on body posture type.

Objectives In Poland, physiotherapy is offered at three types of school: medical universities, universities of physical education, and schools that do not specialise in either the medical sciences or physical education. This study explored the knowledge of students who were completing their physiotherapy studies about working in Poland and other countries of the European Union (EU), and about their vocational plans. Students were asked, through self-assessment, about aspects of the professional skills they had gained. Design Quantitative questionnaire-based study of students in three university settings. Setting Eleven university-level schools in Poland offering studies in physiotherapy and representing three orientations: medical sciences (MS), physical education (PE) and other universities (OU). Participants The study sample comprised of 954 third-year Bachelor programme students. Results The differences in university profiles did not influence the vocational plans of the students, with more than 70% (668/954) declaring that they would look for work outside Poland: 76% (725/954) in the UK and 69% (658/954) in Germany. Most students stated that finding work as a physiotherapist is difficult in Poland (686/954,72%) and easy in other EU countries (763/954, 80%). Differences in university profiles had an effect on the students’ assessments of their professional skills, as students from universities without a long-standing tradition of training in physiotherapy declared that they were less well prepared to work as physiotherapists; the difference was statistically significant for 12 of the 16 domains examined (P < 0.05). Conclusions In the light of these results, an increased influx of Polish physiotherapists, trained according to European standards, into EU countries, especially the UK and Germany, is to be expected in the near future. The physiotherapists will predominantly be graduates of medical and sports-oriented state universities. It appears advisable to launch, under the auspices of an EU programme, an integrated employment information system for physiotherapists that would offer updated information on current demand in individual EU countries.

Recurrent symptoms of low back pain and its transition to a chronic state are associated with specific motor strategies used by people to avoid pain. The aim of the study was to determine the impact of chronic pain intensity on sit-to-stand (STS) strategy in chronic low back pain (CLBP) patients with herniated disks.Vertical ground reaction forces (counter, peak, and postpeak rebound) and their respective times of occurrence were measured on 2 Kistler force plates. Thirty-two healthy persons served as a control group. People with CLBP (n = 40) were divided into 2 subgroups according to the reported pain intensity at rest as measured by the numeric pain rating scale (NRS): low pain (NRS ≤ 3) and high pain (HP; NRS3).Both CLBP subgroups achieved shorter time to counter force but longer time to postpeak rebound force (P.01). The time to peak force was extended in HP on the right side (P.01). HP presented lower peak force on the right and lower postpeak rebound force on the left side (P.001) compared with controls.Patients with CLBP were characterized by an individual, compensatory STS movement strategy with shorter preparation and longer stabilization times. Avoidance behavior in STS execution was presented in HP individuals only, indicating that intensity of chronic pain was a significant factor in decreasing ground reaction peak force and increasing time to peak force.

In patients with juvenile idiopathic arthritis (JIA), increased release of IFN-γ and GM-CSF in cells infiltrating synovial tissue can be a potent driver of monocyte activation. Given the fundamental role of monocyte activation in remodeling the early phases of inflammatory responses, here we analyze the GM-CSF/IFN-γ induced activity of human monocytes in such a situation in vitro and in vivo. Monocytes from healthy donors were isolated and stimulated with GM-CSF ± IFN-γ. Monocyte activation and death were analyzed by flow cytometry, immunofluorescence microscopy, ELISA, and qPCR. T-cell GM-CSF/IFN-γ expression and monocyte function were determined in synovial fluid and peripheral blood from 15 patients with active JIA and 21 healthy controls. Simultaneous treatment with GM-CSF and IFN-γ induces cell death of monocytes. This cell death is partly cathepsin B-associated and has morphological characteristics of necrosis. Monocytes responding to costimulation with strong proinflammatory activities are consequently eliminated. Monocytes surviving this form of hyperactivation retain normal cytokine production. Cathepsin B activity is increased in monocytes isolated from synovial fluid from patients with active arthritis. Our data suggest GM-CSF/IFN-γ induced cell death of monocytes as a novel mechanism to eliminate overactivated monocytes, thereby potentially balancing inflammation and autoimmunity in JIA.

Activated phagocytes express considerable amounts of MRP8 and MRP14, 2 calcium-binding S100 proteins forming stable heterodimers that are specifically secreted at inflammatory sites in many diseases. We previously reported that treatment of human microvascular endothelial cells with purified MRP8/MRP14 leads to loss of endothelial cell contacts. In this study, we demonstrate that MRP8/MRP14 complexes furthermore trigger cell death of endothelial cells after the onset of cell detachment. Morphologic analysis of dying endothelial cells revealed characteristic features of both apoptosis and necrosis. Furthermore, MRP8/MRP14 induced apoptotic caspase-9 and caspase-3 activation, DNA fragmentation, and membrane phosphatidylserine exposure in target cells. These events were independent of death receptor signaling and in part controlled by a mitochondrial pathway. Consistently, overexpression of antiapoptotic Bcl-2 abrogated caspase activation and externalization of phosphatidylserine; however, MRP8/MRP14 still induced plasma membrane damage and even DNA fragmentation. Thus, our results demonstrate that MRP8/MRP14 triggers cell death via caspase-dependent as well as -independent mechanisms. Excessive release of cytotoxic MRP8/MRP14 by activated phagocytes might therefore present an important molecular pathomechanism contributing to endothelial damage during vasculitis and other inflammatory diseases.

Binding to fibronectin (FN) is a crucial pathogenic factor of Staphylococcus aureus mediated by fibronectin-binding protein A (FnBP-A) and extracellular adherence protein (Eap). Recently, we have shown that binding of soluble CD163 (sCD163) to FN linked to these molecules exhibits anti-microbial effects by enhancing phagocytosis and killing activity of S. aureus-infected monocytes. However, it remained unclear whether sCD163 also influences the monocytic activation status. Using genetically modified staphylococcal strains we now identified FnBP-A, but not Eap, as activator of the inflammatory response of monocytes to infection. FnBP-A-mediated inflammatory activation was masked by sCD163 binding to S. aureus promoting efficient pathogen elimination. Thus, sCD163 protects monocytes from overwhelming activation upon staphylococcal infection by dampening the secretion of pro-inflammatory cytokines TNFα, IL-1β, IL-6 and IL-8 and DAMP molecule MRP8/14. Moreover, sCD163 limited expression of pro-apoptotic transcription factor NR4A1 induced during S. aureus infection and inhibited induction of chemokine CXCL2promoting survival of staphylococci in vivo. sCD163-mediated effects were not due to general immunosuppression since MAP kinase activation and ROS production were unaltered during infection of monocytes with sCD163-bound bacteria. Thus, sCD163 promotes a specific defence of the immune system against FnBP-A-mediated inflammatory activation enabling successful pathogen elimination, tissue recovery and resolution of inflammation.

CD163 is a multi-ligand scavenger receptor exclusively expressed by monocytes and macrophages, which is released after their activation during sepsis (sCD163). The biological relevance of sCD163, however, is not yet clear. We now demonstrate that sCD163 exhibits direct antimicrobial effects by recognizing a specific subfragment ((6) F1(1) F2(2) F2(7) F1) of fibronectin (FN) bound to staphylococcal surface molecules. Moreover, contact with staphylococci promotes sCD163-shedding from monocyte surface via induction of metalloproteinases ADAM10 and ADAM17. sCD163 subsequently binds to Staphylococcus aureus via FN peptides and strongly amplifies phagocytosis as well as killing by monocytes and to a lesser extend by neutrophils. This mechanism exhibits additional paracrine effects because staphylococci additionally opsonized by sCD163 induce higher activation and more efficient killing activity of non-professional phagocytes like endothelial cells. Targeting pathogen-bound FN by sCD163 would be a very sophisticated strategy to attack S. aureus as any attempt of the pathogen to avoid this defence mechanism will automatically bring about loss of adherence to the host protein FN, which is a pivotal patho-mechanism of highly invasive staphylococcal strains. Thus, we report a novel function for sCD163 that is of particular importance for immune defence of the host against S. aureus infections.

Glucocorticoids (GC) are the most widely used immunosuppressive agents in clinical medicine. Recently we showed that GC enhance survival of human monocytes and induce a specific anti-inflammatory monocyte subtype which actively induces resolution of inflammation. We now investigated if cytokines IL-4, IL-6 and IL-10, which, like GC, have mostly anti-inflammatory effects on macrophages, would have GC-like effects also on monocytes. Human monocytes were stimulated with either cytokine, GC or combination thereof, and resulting effects on apoptosis, adherence, migration, phagocytosis, ROS production and cell surface phenotype were determined. We found that IL-4, IL-6, and IL-10 had either less or different effects on various anti-inflammatory functions of monocytes compared to GC. As such, IL-4 and IL-6 alone did not delay apoptosis while IL-10 even enhanced it. However, IL-6 or IL-10 increased GC-mediated protection from apoptosis when applied together with GC. Thus, the potential of GC to induce anti-inflammatory human monocytes is unique and not mimicked by the investigated cytokines. However, IL-6 and IL-10 amplify GC-induced anti-inflammatory and pro-resolution mechanisms by enhancing survival of GC-induced monocytes and thus sustaining their function. This combined effect of GC and cytokines could be important for the physiological switch from amplification towards resolution phase of inflammation.

BACKGROUND Treatment of breast cancer can lead to abnormally shaped anteroposterior spinal curvatures, which consequently leads to functional disturbances of trunk muscles. The aim of the paper was to investigate the correlation between trunk muscle function and type of body posture in women receiving treatment for breast cancer. MATERIAL AND METHODS Fifty women following treatment of breast cancer were included in the study. The average age of the women was 61 years (± 8.67), average body height was 157.5 cm (± 5.49) and average body weight was 74 kg (± 13.10). 84% of the women underwent a modified radical mastectomy, while 16% underwent a breast-sparing procedure. The average time since surgery was 6.4 years (± 5.15). Additionally 90% of women were subjected to adjuvant treatment. The force and velocity parameters of the flexor and extensor muscles of trunk were assessed in all participants at angular velocities of 60 degrees/s and 120 degrees/s in an isokinetic examination unit. A photogrammetric evaluation of the anteroposterior curvatures of the spine was also carried out. On the basis of the value of a compensation index (μ), the participants were divided into three body posture subgroups: kyphotic (K), lordotic (L) and balanced (R. RESULTS 40% of the women (20 patients) demonstrated a balanced body posture with equal thoracic and lumbar curvatures, 30% (15 patients) demonstrated a kyphotic body posture with a dominance of the kyphotic curvature over the lordotic one, and another 30% (15 patients) demonstrated a dominance of the lordotic over kyphotic curvature. Women with a lordotic body posture had the highest correlation between the activity of trunk muscles at loads of 60 degrees/s and 120 degrees/s and body posture in the sagittal plane. Minimal correlation, in turn, was observed in the women with a balanced body posture. CONCLUSIONS 1. The most marked involvement of trunk muscles was observed in women with a lordotic body posture. 2. Women with a balanced posture did not show any correlation between muscle activity and the parameters characterizing this posture.

Objective: Playing an instrument often requires a certain posture and asymmetric position that may affect the anteroposterior spinal curvatures and may lead to postural asymmetry. The aim of the study was to evaluate the spinal curvatures in the sagittal plane and the magnitude of asymmetries in the trunk in the frontal plane in a group of music students in comparison with a control group. Methods: The group of 67 students aged 20 to 26 years was made up of 2 subgroups: the musicians (violin playing students of the Academy of Music in Wroclaw) and the control group (physical therapy students who played no instruments). The examination included an interview, measuring of somatic characteristics, and evaluation of body posture by means of the photogrammetric method. Results: The spinal curvatures of the instrumentalists in the sagittal plane differ from the control group mainly in terms of length and depth parameters. Compared with the control group, the musicians were characterized by statistically more significantly longer and deeper thoracic kyphosis (P b .01) and more shallow lumbar lordosis (P b .05), a greater angle of thoracic kyphosis (P b .005), and a smaller inclination angle of the thoracolumbar and lumbosacral section of the spine (P b .01). Conclusion: In the group of musicians, the asymmetries in the area of shoulders and waist triangles as well as the distance of the spinous processes from the C7 to S1 line were more frequent. (J Manipulative Physiol Ther 2012;35:319-326) Key Indexing Terms: Music; Posture; Moire Topography

Human body posture changes in the course of ontogenesis. The changes are brought about by both internal factors (illness) and external factors (injury). The negative consequences of a medical condition such as breast cancer, together with the treatment process, undoubtedly contribute to disturbance of body posture. The aim of this paper was to evaluate the type of body posture in women after treatment of breast cancer on the basis of anteroposterior spinal curves.The study involved a group of 51 (Group 1) women following treatment of breast cancer and a group of 37 healthy women (Group 2). The average age of the women in Group 1 was 61 years, and the average age of the healthy women was 58 years. All participants underwent a photogrammetric examination of body posture. Postural types were defined on the basis of the value of a compensation index (μ) as kyphotic, balanced, and lordotic. The following subtypes were distinguished within these three categories, depending on the shape of the spinal curves: kyphotic subtype I, II, III; balanced subtype I, II, III; and lordotic subtype I, II, III.The post-mastectomy group and the control group did not differ with regard to age (p=0.09), making it possible to continue the analysis of postural differences, which revealed significant differences at p=0.00008. In the group of women after treatment of breast cancer, 82.3% demonstrated a faulty body posture, compared to only 35.1% of the controls. There was no significant relationship between the quality of body posture and oncological treatment.A significantly higher incidence of faulty body postures was observed among women after treatment of breast cancer.

Active resolution of inflammation is a previously unrecognized process essential for tissue homeostasis. Monocytes play a pivotal role in the generation as well as resolution of inflammation. Glucocorticoids (GCs) are widely used anti-inflammatory agents. We demonstrate that GCs exhibit antiapoptotic effects in monocytes resulting in differentiation to an anti-inflammatory phenotype. The molecular basis of this novel antiapoptotic effect is a prolonged activation of the extracellular signal regulated kinase/mitogen-activated protein kinase (ERK/MAPK) pathway resulting in inhibition of caspase activities and expression of antiapoptotic genes via activation of c-Myc. We identified up-regulation and activation of A3 adenosine receptor (A3AR) as the initial trigger of this antiapoptotic pathway. In summary, we deciphered a novel molecular pathway promoting survival of anti-inflammatory monocytes. Specific activation of A3AR or its downstream signaling pathways may thus be a novel strategy to modulate inflammation in autoimmune disorders with fewer side effects via induction of inflammatory resolution rather than immunosuppression.

Objective The etiology and pathology of pain in the lumbosacral region and pelvis of pregnant women during and after pregnancy have not been fully determined. This study evaluated if lower back pain during pregnancy and after childbirth is connected with static alterations in the alignment of the pelvis, dysfunction of sacroiliac joints, and irritation of the pelvic ligaments and spine in the lumbosacral region. Methods This study was carried out on a group of 30 women in their eighth month of pregnancy and through 3 months after childbirth. Techniques of manual examination were used to determine the strain. Static alteration of the pelvis was evaluated in both the sitting and standing positions on the basis of alignment of the posterior superior iliac spines. Irritation of the iliolumbar ligaments, sacrotuberous, sacroiliac, and interspinous ligaments was evaluated by means of pressure palpation. Disorders of sacroiliac joint function were evaluated with the Patrick FABERE test, the standing Gillet test, and the standing and sitting flexion tests. Results The most frequently irritated ligaments in the lumbar region are interspinous (60%), iliolumbar (40%), and sacroiliac (36%). Conclusions In women, in their eighth month of pregnancy and after childbirth, disorders of static alterations in pelvis alignment and sacroiliac joint dysfunction may occur. The state of pregnancy may result in strain symptoms in the lumbosacral region and pelvis with variable pain intensifying in various static positions.

There has been a growing interest in studies examining the importance of the aquatic environment in non-invasive treatment of scoliosis. The water environment is an important element in the correction of body posture abnormalities. The aim of this paper is to evaluate the influence of corrective exercises in a water environment on the shape of the antero-posterior curves of the spine and on the functional status of the locomotor system of children with Io scoliosis.The study involved a group of 94 children aged 8-13 years with Cobb Io scoliosis. Computer-aided photogrammetry was used to analyse the shape of the antero-posterior curves of the spine. The functional evaluation of the children's musculoskeletal system involved several functional tests: the Dega wall test, Thomas test, Lasegue test, and Kraus-Weber test. The tests were carried out twice: before a 6-month programme of corrective exercises in a water environment, and immediately on completion of the rehabilitation programme. The programme included swimming and corrective exercises in water.A statistical analysis of the dimensions of the anterio-posterior curves of the spine revealed a significant increase in the total length of the spine and the length of thoracic kyphosis. Besides, the bending angle of the trunk, the angle of thoracic kyphosis and the angle of lumbar lordosis were reduced. The analysis also showed an increase in the bending angle of the upper spine. Shoulder mobility also increased significantly following the programme of corrective aquatic exercises.1. The programme of corrective exercises had an influence on the length and angle of thoracic kyphosis. 2. The muscle strength of the lower part of the erector spinae also increased, as did shoulder mobility measured by the Dega test.

The aim of this study was to assess the changes of the bioelectric activity of the selected muscles and their impact on the functioning of the shoulder joint in people with impingement syndrome. The study covered 58 subjects aged between 24 and 85, who were treated for impingement syndrome in the years 2004-2006. The average duration of the disease was 40 months. The following muscles were tested for bioelectric activity using surface myography: deltoid, supraspinatus, infraspinatus, latissimus dorsi, greater pectoral and biceps brachii on the healthy and the diseased sides. A significant drop in activity of the deltoid and the infraspinatus muscles on the diseased side was observed. The following muscles showed comparable activity on both sides: the supraspinatus, latissimus dorsi and the greater pectoral muscle. The activity of the biceps brachii muscles grew during resisted movements. The drop in the activity of the deltoid and the infraspinatus muscles on the affected side is an important factor responsible for changes of the active mobility of the shoulder and for the development of instability of the shoulder joint. A similar activity of the latissimus dorsi, greater pectoral and biceps brachii muscles on both sides indicates a development of the compensatory mechanisms and the role of those muscles in the dynamic stabilisation of the shoulder joint.

Impingement syndrome (IS) is one of the most common causes of progressive dysfunctions of the shoulder joint. The aim of the study was to evaluate the changes in the joint's mobility in patients with IS and to find correlations between the angular values of particular motion ranges.The study involved 58 people aged 24-85 years, treated for IS from 2004 to 2006. The average duration of the disease was 40 months. A comparative examination of active mobility on the healthy and affected side was carried out according to the SFTR method.A comparison of mean values of the motion ranges indicated significant limitations of active mobility in the affected shoulder. The greatest mobility deficit was found in the external rotation range. Moreover, there was a statistically significant correlation between the angular values of internal rotation and the values of the remaining motion ranges.Impingement syndrome.

The study aimed to assess changes in shoulder joint mobility and symmetry as well as changes in the bioelectrical activity of selected muscles important for the functioning of the shoulder complex in order to determine optimal physiotherapeutic management in patients with shoulder impingement syndrome.The study involved 58 persons aged 24-85 years treated for shoulder impingement syndrome from 2004 to 2006. Symptoms had been present for 40 months on average. The examination of patients included in each case measurement of active mobility ranges using the SFTR method, photogrammetry-based assessment of shoulder symmetry and an examination of the bioelectrical activity of muscles using surface electromyography.The results demonstrated that the degree of limitation of external rotation, which considerably affects the other motion ranges, is the most important index of shoulder joint dysfunction. The decrease in the bioelectrical activity of the deltoid muscle is caused by pain avoidance, with high activity of the pectoralis major and latissimus dorsi muscles indicating the development of compensatory mechanisms. A spatial displacement of the scapula referred to as a wing-like position impairs the scapulobrachial rhythm.Therapeutic management should firstly aim to eliminate pain, then to restore shoulder joint stability by instructing the patient on how to properly centre the humeral head, and, subsequently, to restore normal movement patterns and the scapulobrachial rhythm, and finally to gradually increase the range of active mobility, in particular of external rotation.

The posture of people with shoulder impingement syndrome (SIS) is a result of adaptive defensive posturing to decrease the intensity of pain in the affected joint. The aim of this work is to characterise trunk and shoulder girdle positioning in patients with SIS.The study involved 58 patients treated for SIS in the years 2004-2006. Symptoms had been present for 40 months on average. A photogrammetric study was performed with the use of a MORA 4G system. It consisted in measuring lordosis and kyphosis, as well as the symmetry of some selected anthropometric points in the frontal plane.Changes in posture presenting as an increased angle of trunk inclination in the sagittal plane and in the frontal plane were observed in all patients. There was asymmetry of bony points as regards the position of the scapula and the waist triangles.The impingement syndrome is associated with displacement of all bony points analysed. Changes in posture are a result of adaptive mechanisms. Trunk asymmetry is secondary to changes in the spatial position of the scapula.

Monocytes and macrophages may either promote or down-regulate inflammatory reactions depending on their state of activation. The effects of glucocorticoids (GCs), the most widely used immunosuppressive drugs, on monocytes are currently not well defined. By analyzing the GC-induced expression pattern in human monocytes by microarray technology, we identified for the first time GC-dependent regulation of 133 genes, including anti-inflammatory molecules such as adenosine A3 receptor, CD1d, and IL-1 receptor II. The results were independently confirmed by real-time polymerase chain reaction (PCR) and flow cytometry. Functional clustering of GC-regulated genes indicated induction of monocytic properties such as phagocytosis and motility as well as repression of adhesion, apoptosis, and oxidative burst. These predictions were confirmed by independent functional assays. GCs up-regulate fMLP receptors and specifically promote chemotaxis to this chemoattractant. Furthermore, GCs promote survival of an anti-inflammatory monocytic phenotype in inflammatory reactions, probably by inhibition of apoptosis because of oxidative stress. GCs limit tissue damage because of induction of antioxidative properties and high capacity for phagocytosis of proinflammatory agents. Thus, GC treatment did not cause a global suppression of monocytic effector functions but results in differentiation of a specific anti-inflammatory phenotype which seems to be actively involved in resolution of inflammatory reactions.

S100A8 and S100A9 are two proinflammatory molecules belonging to the S100 family of calcium-binding proteins. Common to all S100 proteins S100A8 and S100A9 form non-covalently associated complexes which have been shown to exhibit different functional properties. Besides dimerization, recent research is focused on the importance of higher oligomeric structures of S100 proteins induced by bivalent cations. While S100A8/S100A9-heterodimers are formed in the absence of calcium, tetramerization is strictly calcium-dependent. Heterodimer formation is not a simple process and our biophysical analyses (FRET, ESI-MS) demonstrate that simply mixing both subunits is not sufficient to induce complex formation. Steps of denaturation/renaturation are necessary for the recombinant complex to show identical biophysical properties as S100A8/S100A9 obtained from granulocytes. In addition to calcium both proteins are able to bind zinc with high affinity. Here we demonstrate for the first time by different biophysical methods (MALDI-MS, ESI-MS, fluorescence spectroscopy) that zinc-binding, like calcium, induces (S100A8/S100A9) 2 -tetramers. Using mass spectrometric investigations we demonstrate that zinc triggers the formation of (S100A8/S100A9) 2 -tetramers by zinc-specific binding sites rather than by interactions with calcium-specific EF-hands. The zinc-induced tetramer is structurally very similar to the calcium-induced tetramer. Thus, like calcium, zinc acts as a regulatory factor in S100A8/S100A9-dependent signaling pathways.

Despite significant progress in cancer therapy, the outcome of the treatment is often unfavorable. Better treatment monitoring would not only allow an individual more effective, patient-adjusted therapy, but also it would eliminate some of the side effects. Using a cytochrome c ELISA that was modified to increase sensitivity, we demonstrate that serum cytochrome c is a sensitive apoptotic marker in vivo reflecting therapy-induced cell death burden. Furthermore, increased serum cytochrome c level is a negative prognostic marker. Cancer patients whose serum cytochrome c level was normal 3 years ago have a twice as high probability to be still alive, as judged from sera samples collected for years, analyzed recently and matched with survival data. Moreover, we show that serum cytochrome c and serum LDH-activity reflect different stages and different forms of cell death. Cellular cytochrome c release is specific for apoptosis, whereas increased LDH activity is an indicator of (secondary) necrosis. Whereas serum LDH activity reflects the "global" degree of cell death over a period of time, the sensitive cytochrome c-based method allows confirmation of the individual cancer therapy-induced and spontaneous cell death events. The combination of cytochrome c with tissue-specific markers may provide the foundation for precise monitoring of apoptosis in vivo, by "lab-on-the-chip" technology. (c) 2005 Wiley-Liss, Inc.

During acute inflammation, leukocyte infiltration is mostly neutrophilic, but later monocytes prevail. The majority of inflammatory cells, particularly neutrophilic polymorphonuclear leukocytes (PMNs), become apoptotic at later stages of inflammation and are phagocytosed by neighboring cells, mostly by macrophages. Recently, it has been found that human peripheral blood monocytes also recognize apoptotic cells, which primes them to increased production of interleukin (IL)-10--a cytokine known to reduce phagocytes' ability to engulf and kill pathogens. Based on the above, we studied monocytes' ability to phagocytose and kill Staphylococcus aureus while in contact with apoptotic cells.Monocytes isolated by elutriation were co-cultured with apoptotic PMNs or Jurkat cells and exposed to viable, human serum-opsonized S. aureus. To induce apoptosis PMNs were cultured overnight while Jurkat cells were UV-treated. Apoptosis, phagocytosis of bacteria and intracellular superoxide production were measured by flow cytometry. Production of reactive oxygen species was also followed by measurement of chemiluminescence. The bactericidal effect was determined by standard colony forming units method.Data presented show that contact of monocytes with apoptotic neutrophils and Jurkat cells had no influence on monocyte phagocytosis of S. aureus, the generation of reactive oxygen species, or the killing of bacteria.The data obtained suggest that monocytes attracted to the inflammatory site are not deficient in their ability to cope with pathogens after contact with apoptotic cells despite increased production of IL-10.

Monocytes/macrophages undergo apoptosis and are in contact with apoptotic cells both in vitro and in vivo. The data show that monocytes undergoing spontaneous apoptosis in vitro change their cytokine production profile. We demonstrate that the lipopolysaccharide (LPS)-induced production of interleukin-10 (IL-10) is up-regulated, while production of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) is either not affected or reduced. These differences seen both at the protein and mRNA level directly correlate with the appearance of apoptotic cells in the culture. Flow cytometry analysis using double staining, surface with annexin V and intracellular with anti-IL-10, suggested that annexin V-negative monocytes are the predominant source of IL-10. Analysis of sorted populations of monocytes indicated that the increase in IL-10 synthesis appears to result from direct interactions between non-apoptotic and apoptotic cells at the time of stimulation. Also non-apoptotic, freshly isolated monocytes produced more IL-10 upon stimulation with LPS, Staphylococcus aureus or zymosan when apoptotic neutrophils were added to the culture. In contrast, monocyte-derived macrophages did not produce more IL-10 in the presence of apoptotic neutrophils. Finally, we found that the presence of apoptotic monocytes in the culture may influence specific immune responses. The data show that in the presence of annexin V-positive monocytes CD4-positive memory T cells produce less IFN-gamma upon stimulation with purified protein derivative of tuberculin, which could be partially reversed by anti-IL-10 neutralizing antibodies. We conclude that these findings might illustrate the mechanisms operating within an inflammatory site and play an important immunoregulatory role during the resolution of inflammation and specific immune responses.