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Extrapulmonary TB (EPTB) occurs with increased frequency in persons with underlying immunodeficiency. Even after recovery from acute illness, differences in immune phenotype and activation persist. Studies defining characteristics of immune responses after recovery from extrapulmonary TB may provide insights into factors that increase TB risk. We performed two case-control studies (in the United States and Brazil) among HIV-seronegative adults with previous EPTB (n = 9; 25), previous pulmonary TB (n = 7; 25), latent M. tuberculosis (Mtb) infection (n = 11; 25), and uninfected TB contacts (n = 10; 25). We assessed the frequency of dual CD4+ interferon-γ and tumor necrosis factor-α responses after stimulation with overlapping Mtb peptides from ESAT-6 or CFP-10, or gamma-irradiated Mtb H37Rv, proliferative responses to Mtb antigens, T-regulatory cell (Treg) frequency and phenotype. In both study populations, individuals with prior EPTB had the highest frequency of intracellular cytokine-producing cells in response to Mtb antigens (p < 0.05; p

For much of the twentieth century, the United States led the world in both the production of lead products AND the study of lead’s risks. Having brought its own exposures to its lowest levels in a century, America has not taken the lead in continuing that environmental cleansing to the rest of the world. This talk surveys the history of lead and lead poisoning in America and Europe from the late 19th century to the early 21st , focusing on the changing nature of exposures, the creation of knowledge about the health effects of lead, and the regulatory efforts to minimize those health consequences. A century ago, the United States overtook other nations in the production and consumption of lead, but it lagged far behind Europe in keeping its workers safe. The unique dangers of tetraethyl lead, introduced in the mid-1920s, forced America to take a leadership role in the industrial toxicology, and eventually the public health epidemiology of lead. The decades since the 1960s saw a revolution in the definition...

aLate in 1935, Alice Hamilton, who a generation earlier had done more than any other government-sponsored researcher to expose and ameliorate industrial lead poisoning, wrote to Martha May Eliot, assistant chief of the U.S. Children’s Bureau. 1 A young friend of Hamilton’s, a new mother married to a third-year medical student at Harvard, had asked Hamilton how to be sure that paint on baby furniture was lead-free. Although Hamilton had always assumed “that furniture and toys were painted with enamel paint, lead-free,” the Bureau of Standards informed her that in fact many enamel paints contained lead. Hamilton’s purpose in writing Eliot, then, was to urge “that tests would have to be made of furniture paints and toy paints,” and to suggest who should take on this task: “Do not you think that it is an important question and that it lies within the field of the Children’s Bureau?” No such investigation was ever undertaken by the Children’s Bureau, the federal agency charged with advocating for “the welfare of children and child life among all classes of our people.” 2