Search

Environmental or social challenges can stimulate a cascade of coordinated physiological changes in stress response systems. Unfortunately, chronic activation of these adaptations under conditions such as low socioeconomic status (SES) can have negative consequences for long-term health. While there is substantial evidence tying low SES to increased disease risk and reduced life expectancy, the underlying biology remains poorly understood. Using pilot data on 120 older adults from the Health and Retirement Study (United States, 2002-2010), we examined the associations between SES and gene expression levels in adulthood, with particular focus on a gene expression program known as the conserved transcriptional response to adversity. We also used a bioinformatics-based approach to assess the activity of specific gene regulation pathways involved in inflammation, antiviral responses, and stress-related neuroendocrine signaling. We found that low SES was related to increased expression of conserved transcriptional response to adversity genes and distinct patterns of proinflammatory, antiviral, and stress signaling (e.g., sympathetic nervous system and hypothalamic-pituitary-adrenal axis) transcription factor activation. [ABSTRACT FROM AUTHOR]

This article presents a new adaptive framework for understanding children's growth in the past. Drawing upon the recent work on adaptive responses in relation to growth, it presents prenatal and postnatal adaptive mechanisms that affect the growth patterns of children. The most novel adaptive response to the historical literature is the prenatal predictive adaptive response where the metabolism and growth trajectory of a child is programmed to match predicted conditions later in life. Having discussed the framework in detail, a reinterpretation of the growth pattern of American slaves is then suggested. It seems likely that a mismatch between relatively good conditions in utero and absolutely appalling conditions in infancy and early childhood led slave children to become extremely stunted by the age of three or four. However, after this age, slave children experienced catch-up growth because their immune systems had become more developed and because their diet improved tremendously and hookworm exposure was reduced. Thus, it seems that American slave children may have experienced substantial catch-up growth because they were prenatally programmed for a higher metabolism and growth trajectory. The article concludes by setting out some stylized facts about children's growth in the past and pointing toward areas of future research. [ABSTRACT FROM AUTHOR]

The use of probiotics in the hospital setting is largely understudied and highly controversial. Probiotics are living organisms that, when taken internally, can produce an immunomodulating effect and improve the gastrointestinal (GI) mucosal barrier. Although used for centuries by healthy individuals for GI health, their use in the hospital setting is now gaining wide attention for the prevention of infectious complications such as antibiotic-associated diarrhea, Clostridium difficile infections, multiple-organ dysfunction syndrome, and ventilator-associated pneumonia. However, current understanding of the efficacy of probiotics in the acute care setting is confounded by the inconsistencies in the literature with regard to the strain of probiotic being studied, optimal dosage, and timing and duration of dosing, which make the formulation of clinical practice guidelines difficult. Although the safety of probiotics has been confirmed when used for the prevention and treatment of certain diseases, practitioners remain hesitant to administer them to their patients, citing the lack of high-quality studies clearly demonstrating efficacy and safety. Infection is a cause of late death in trauma patients, but only recently has research been conducted on the use of probiotics specifically for the prevention of hospital-acquired infections in trauma patients. In the face of such limited but promising research, is it reasonable to use probiotics for the prevention of infection in hospitalized trauma patients and improve outcomes? Use of the “precautionary principle” may be useful in this instance. [ABSTRACT FROM AUTHOR]

Athletes may be predisposed to low vitamin D concentrations, with studies reporting a high prevalence of athletes with a vitamin D concentration below 50 nmol/L across a range of sports and geographical locations, particularly over the winter months. It is well documented that vitamin D is important for osseous health by enhancing calcium absorption at the small intestine; however, emerging research suggests that vitamin D may also benefit a plethora of extra-skeletal target tissues and systems. There is strong evidence that vitamin D is capable of regulating both innate and adaptive immune processes via binding of active vitamin D to its complementary receptor. Supplementation with vitamin D may also enhance skeletal muscle function through morphological adaptations and enhanced calcium availability during cross-bridge cycling; however, an exact mechanism of action is yet to be elucidated. Such findings have prompted research into the importance of maintaining vitamin D concentrations over wintertime and the possible physiological and immunological benefits of vitamin D supplementation in athletes. The following review critically evaluates existing literature and presents novel perspectives on how vitamin D may enhance athletic performance. [ABSTRACT FROM AUTHOR]

The article presents a scientific statement from the American Society for Nutrition (ASN) which focuses on the nutritional impacts of processed foods. Topics discussed include an introduction to how processed foods contribute to the health of populations, the part they play to "nutrients to encourage" and "constituents to limit" in the American diet as recommended by the Dietary Guidelines for Americans, and the responsibilities of various stakeholders in improving the American diet.

Vaccines are one of the greatest achievements of biomedical science and public health. Proper vaccination plays a critical role in the reduction of vaccine-preventable disease and related morbidity and mortality. Despite levels of vaccine-preventable diseases being at or near record lows, many still persist due to numerous underimmunized children, adolescents, and adults. In addition to morbidity and premature deaths, vaccine-preventable diseases impose a high societal and economic burden, including decreased school and work productivity, increased doctor's visits, and hospitalizations. The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention releases updated immunization schedules annually. In the 12 months that span schedule updates, new evidence becomes available and product changes occur. New products are approved by FDA and existing products may obtain approval for additional formulations or further indications. This article reviews certain recommendations and product changes that have occurred during 2011 since publication of the immunization schedules in January/February 2011. The covered vaccines include influenza intradermal and high-dose, herpes zoster, human papillomavirus, quadrivalent meningococcal conjugate, and tetanus toxoid. ACIP guidance affects vaccine practices; pharmacists' knowledge of the most current recommendations can enhance patient education, improve patient care, and potentially result in increased vaccination rates. [ABSTRACT FROM AUTHOR]

Objectives: To expand the understanding of potential pathways through which food insecurity is associated with adverse health outcomes, we investigated whether food insecurity is associated with nutritional levels, inflammatory response, and altered immune function., Methods: We performed a cross-sectional analysis of the National Health and Nutrition Examination Survey (1999-2006) with 12,191 participants. We assessed food insecurity using the US Department of Agriculture food security scale module and measured clinical biomarkers from blood samples obtained during participants' visits to mobile examination centers., Results: Of the study population, 21.5% was food insecure. Food insecurity was associated with higher levels of C-reactive protein (adjusted odds ratio [AOR]=1.21; 95% confidence interval [CI]=1.04, 1.40) and of white blood cell count (AOR=1.36; 95% CI=1.11, 1.67). White blood cell count partly mediated the association between food insecurity and C-reactive protein., Conclusions: These findings show that food insecurity is associated with increased inflammation, a correlate of chronic diseases. Immune response also appears to be a potential mediator in this pathway.

There are no unique boxing diseases but certain factors contributing to the spread of illnesses apply strongly to the boxer, coach, and the training facility. This article examines the nature of the sport of boxing and its surrounding environment, and the likelihood of spread of infection through airborne, contact, or blood-borne routes of transmission. Evidence from other sports such as running, wrestling, and martial arts is included to help elucidate the pathophysiologic elements that could be identified in boxers.

Aging is associated with declines in immune system function, or 'immunosenescence', leading to progressive deterioration in both innate and adaptive immunity. These changes contribute to the decreased response to vaccines seen in many older adults, and morbidity and mortality from infection. Infections (e.g., influenza, pneumonia and septicemia) appear among the top ten most-common causes of death in adults in the USA aged 55 years and older. As immunosenescence has gathered more attention in the scientific and healthcare communities, investigators have demonstrated more links between immunosenescent changes and morbidity and mortality related to infections and declining vaccine responses. This review summarizes the recent literature on age-dependent defects in adaptive and innate immunity, data linking these defects to poor vaccine response and morbidity and mortality, current recommendations for vaccinations and potential strategies to improve vaccine efficacy in older adults.

Immune changes following 2 h of intensive cycling with or without rest intervals were measured in trained cyclists (n = 12) who functioned as their own controls during two test sessions that were separated by two weeks. Subjects cycled for 2.0 h at approximately 64 % Watts(max) continuously (C) or with 3-min rest intervals (R) interspersed every 10 min (2.6 h total time), with the order of the sessions randomized. Blood samples were collected 30-min pre-exercise, and immediately and 1-h postexercise, and assayed for blood leukocyte subset counts, plasma IL-6, IL-10, IL-1ra, IL-8, PHA-induced lymphocyte proliferation, and natural killer cell activity (NKCA). Significant time effects were measured for all immune measures, but no significant differences in the pattern of change were found between C and R exercise trials. In conclusion, immune changes induced by 2 h of intense and prolonged exercise paralleled those measured when athletes rested 3 min every 10 min of exercise.

Accidental trauma and heavy endurance exercise, both induce a kind of systemic inflammatory response, also called systemic inflammatory response syndrome (SIRS). Exercise-related SIRS is conditioned by hyperthermia and concomitant heat shock responses, whereas trauma-induced SIRS manifests concomitantly with tissue necrosis and immune activation, secondarily followed by fever. Inflammatory cytokines are common denominators in both trauma and exercise, although there are marked quantitative differences. Different anti-inflammatory cytokines may be involved in the control of inflammation in trauma- and exercise-induced stress. Exercise leads to a balanced equilibrium between inflammatory and anti-inflammatory responses. Intermittent states of rest, as well as anti-oxidant capacity, are lacking or minor in trauma but are high in exercising individuals. Regular training may enhance immune competence, whereas trauma-induced SIRS often paves the way for infectious complications, such as sepsis.

In recent years, there has been increasing regulatory pressure to protect the health of children, with the basic tenet being that children differ significantly from adults in their biological or physiological responses to chemical exposures. In a regulatory context, this has been translated to mean a requirement for an additional 10-fold safety factor for environmental contaminants, specialized tests, or both. Much of the initial focus has been on the developing endocrine and nervous systems; but increasingly, the developing immune system has been identified as a potential target organ for chemically mediated toxicity. More recently, the question has been raised regarding whether the current state of science supports the creation of developmental immunotoxicology (DIT) test guidelines. What is needed is a risk-based evaluation of the biology associated with the proposed differential sensitivity between children and adults and the impact of that assessment on additional regulatory measures to protect children in risk assessment analyses. Additionally, an understanding of whether the developing immune system shows greater susceptibility, either qualitatively or quantitatively, to chemical perturbation is critical. To address the question "What's so special about the developing immune system?" a symposium was organized for the 2003 Society of Toxicology annual meeting that brought together risk assessors, clinicians, immunologists, and toxicologists.

The prototype autoimmune disorder SLE is a highly variable disease characterized by episodic exacerbations, some of which are severe enough to require admission to the ICU. Infection, disease activity, and cardiovascular complications are among the major reasons for admission. Drugs, particularly the immunosuppressants used to treat SLE, often cause as much injury to the immune system as the disease itself, and intensive treatments are often required to combat the side effects of these drugs. Studies indicate that sex, age, and race affect both morbidity and mortality in SLE. Despite well-documented patterns of morbidity and mortality and episodic exacerbations requiring admission to the ICU, the specific nursing care needs of patients with SLE admitted to the ICU have not been investigated.

There have been numerous studies in the mouse illustrating the dichotomy of T cell responses, with the common classification orchestrated around Th1 vs. Th2 responses. This classification is now widely applied to human disease as well and the generic conclusion is that the Th1 responses are more likely to occur secondary to specific microbiologic insult but also inflammatory responses. In contrast, the Th2 response is the prevalent response in subjects with atopy and allergic disease but is also the mechanism for protection against helminthic infections. Unfortunately, the paradigm of Th1 vs. Th2 is not as clear in the human as it is in mouse models. Even so, the immunological mechanisms responsible for IgE production that are protective in helminthic infections, i.e. Schistosoma, are similar to those for the production of specific IgE against allergens. In fact, there also appear to be associations in the memory T cell subpopulation CD4+CD45RO+ and the elicitation of IgE against both parasites and allergens. In this review, we present the overall contemporary scheme on the role of parasites in genetic susceptibility to allergic IgE, helminthic infections with specific discussion of its implications for the evolution of the human immune system.

The mechanisms governing the body's response to physical exercise have been investigated from various perspectives including metabolism, nutrition, age and sex. Increased attention to the immune system during recent decades is reflected by a rapidly growing number of publications in the field. This article highlights the most recent findings and only briefly summarises more basic concepts already reviewed by others. Topics include Th1/Th2 cytokine balance, inoculation time, age and immune compensation. Some less investigated areas are discussed including studies in children, the environment and dendritic cells. Because physical exercise enhances some aspects and suppresses other aspects of immunity, the biological significance of alterations in the immune system are unknown. So far, no link between immunological alterations and infection rate has been established and infection after strenuous physical exercise is equally likely to be the result of exercising with an already established rather than a new infection. If there is an increased risk for infections with increased exercise duration and intensity, why do overtrained athletes not display the greatest risk for upper respiratory tract infections? Increased knowledge on immune system modulations with physical exercise is relevant both from a public health and elite athlete's point of view.

The hazards of long-duration space flight are real and unacceptable. In order for humans to participate effectively in long-duration orbital missions or continue the exploration of space, we must first secure the health of the astronaut and the success of such missions by assessing in detail the biomedical risks of space flight and developing countermeasures to these hazards. Acquiring the understanding necessary for building a sound foundation for countermeasure development requires an integrated approach to research in physiology and medicine and a level of cooperative action uncommon in the biomedical sciences. The research program of the National Space Biomedical Research Institute (NSBRI) was designed to accomplish just such an integrated research goal, ameliorating or eliminating the biomedical risks of long-duration space flight and enabling safe and productive exploration of space. The fruits of these labors are not limited to the space program. We can also use the gained understanding of the effects and mechanisms of the physiological changes engendered in space and the applied preventive and rehabilitative methods developed to combat these changes to the benefit of those on Earth who are facing similar physiological and psychological difficulties. This paper will discuss the innovative approach the NSBRI has taken to integrated research management and will present some of the successes of this approach., (c2003 International Astronautical Federation. Published by Elsevier Science Ltd. All rights reserved.)

Vitamin C is an essential dietary nutrient required as a co-factor for many enzymes, and humans are among the few animals that lack the ability to synthesize the compound from glucose. The reduced form of the vitamin, ascorbic acid, is an especially effective antioxidant owing to its high electron-donating power and ready conversion back to the active reduced form. Concentrations of the vitamin in body tissues and fluids are regulated through interactions of intestinal absorption, cellular transport, and excretion. The amount of vitamin C needed to prevent scurvy is very small and easily obtained in nearly all Western diets. There is great interest in the clinical roles of vitamin C because of evidence that oxidative damage is a root cause of, or at least associated with, many diseases. Population studies show that individuals with high intakes of vitamin C have lower risk of a number of chronic diseases, including heart disease, cancer, eye diseases, and neurodegenerative conditions. However, these results may simply reflect a more healthful diet or lifestyle for individuals with a high vitamin C intake. At present, data from controlled clinical trials have not established that higher intakes of vitamin C alone will help prevent chronic degenerative diseases. However, the evidence that ascorbic acid acts as an important antioxidant in many body tissues is convincing. The new higher Recommended Dietary Allowance (RDA) for vitamin C of 75 mg for women and 90 mg for men is, for the first time, based on the vitamin's role as an antioxidant as well as protection from deficiency. In healthy people, amounts greater than the RDA do not appear to be helpful. Vitamin C nutriture may be more important for people with certain diseases or conditions. High intakes of the vitamin are generally well tolerated; a Tolerable Upper Level was recently set at 2 g based on gastrointestinal upset that sometimes accompanies excessive intakes.

A central issue that must be addressed by phytonutrient research is how to assess the effects of phytonutrients on long-term health. Proper assessment of these effects requires the measurement of biomarkers of long-term health in people consuming any particular phytonutrient. This is a brief review of what is known about biomarkers of cancer risk, immune function, and aging. Relatively few biomarkers of long-term health have been even partially validated in experimental animals or people.

As home care looks to alternative programs to serve the community and generate income, one service that is beginning to attract more attention is music therapy. As a means to relaxation and healing, this therapy can help patients heal from within and even strengthens the immune system.

Interleukin-6, an inflammatory cytokine, is characterized by pleiotropy and redundancy of action. Apart from its hematologic, immune, and hepatic effects, it has many endocrine and metabolic actions. Specifically, it is a potent stimulator of the hypothalamic-pituitary-adrenal axis and is under the tonic negative control of glucocorticoids. It acutely stimulates the secretion of growth hormone, inhibits thyroid-stimulating hormone secretion, and decreases serum lipid concentrations. Furthermore, it is secreted during stress and is positively controlled by catecholamines. Administration of interleukin-6 results in fever, anorexia, and fatigue. Elevated levels of circulating interleukin-6 have been seen in the steroid withdrawal syndrome and in the severe inflammatory, infectious, and traumatic states potentially associated with the inappropriate secretion of vasopressin. Levels of circulating interleukin-6 are also elevated in several inflammatory diseases, such as rheumatoid arthritis. Interleukin-6 is negatively controlled by estrogens and androgens, and it plays a central role in the pathogenesis of the osteoporosis seen in conditions characterized by increased bone resorption, such as sex-steroid deficiency and hyperparathyroidism. Overproduction of interleukin-6 may contribute to illness during aging and chronic stress. Finally, administration of recombinant human interleukin-6 may serve as a stimulation test for the integrity of the hypothalamic-pituitary-adrenal axis.

Cutaneous T-cell lymphomas define a spectrum of disorders associated with T-lymphocytic proliferation with clinical manifestations occurring in the skin during the course of the disease. This review has dealt with two rather uncommon disorders, namely mycosis fungoides and Sezary syndrome which are indolent malignant lymphomas, occurring primarily in the fifth decade, and affecting males most frequently. Historically, mycosis fungoides and Sezary syndrome have been described for a relatively short time. As witnessed by Table 2, little was known concerning these disorders, other than clinical and pathologic features, until the application of immunologic, cell biologic, and cytogenetic technology which burgeoned a multitude of questions. The discovery of TCGF has allowed for both continuous growth of normal and neoplastic T cells and for the clonal expansion of some malignant clones. The establishment of these continuous cultures allowed for: (1) investigation of the mechanism of TCGF production and stimulation of T-cell growth, and (2) identification of HTLV, a retrovirus found in cell cultures from two patients with CTCL, and subsequently from patients with Japanese adult T-cell lymphoma. In addition, the HTLV has been related to a more virulent form of T-cell malignancy. The exact etiologic role of this virus in the CTCL is presently the subject of intense investigation. Through the use of immunologic methods the malignant cell of CTCL has been pheno-typically and functionally characterized as a "helper/inducer" subtype (E rosette+, anti-T-cell antisera+, T11+, T1+, T3+, 3A1-, T6-, T8-) and usually Ia-, HLADR-. Clinical manifestations of the phenotype may be clinically apparent in the serologic abnormalities present in these disorders. Utilizing these methods to investigate these disorders may provide a key to the understanding of T-cell function and cellular immunity much as myeloma provided a model for the understanding of B cells and immunity. Clinically and pathologically, these disorders behave as malignant indolent lymphomas with spread from localized cutaneous lesions to extracutaneous involvement of the blood, lymph nodes, and viscera culminating in the death of the patient from either organ dysfunction or infectious complications. At autopsy, this extracutaneous involvement is more pronounced than what was expected ante-mortem. Application of prospective staging techniques employing such special procedures as E-rosette cytology, cytogenetics, and electron microscopy in addition to usual light microscopy studies has demonstrated a greater percentage of extracutaneous involvement than otherwise expected.(ABSTRACT TRUNCATED AT 400 WORDS)