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Type I interferon (IFN-I) strongly inhibits viral replication and is a crucial factor in controlling virus infections and diseases. Cellular activation through pattern recognition receptors induces interferon production in a wide variety of hematopoietic and nonhematopoietic cell types, including dendritic cells, fibroblasts, hepatocytes, and cells of neuronal origin. The relative contribution of hematopoietic and nonhematopoietic cells to the overall interferon response is an important issue which has not been fully addressed. Using irf7(-/-) and wild-type bone marrow chimeras we analyzed the contribution of IFN-I from bone marrow-derived sources in the control of viral infections and immunopathology in mice. We found that during systemic cytopathic virus infection, hematopoietic cells were essential for production of IFN-I, inhibition of viral spread to peripheral organs, and limiting cell damage. In a model of autoimmune diabetes induced by noncytopathic virus infection, hematopoietic cell-derived IFN-I was essential for CD8(+) T cell-dependent cytotoxicity in pancreatic beta-islet cells and induction of diabetes. These data suggest that during systemic viral infection primarily hematopoietic cell-derived IFN-I controls viral replication and viral-induced disease.

More than 500 million people worldwide are persistently infected with hepatitis B virus or hepatitis C virus. Although both viruses are poorly cytopathic, persistence of either virus carries a risk of chronic liver inflammation, potentially resulting in liver steatosis, liver cirrhosis, end-stage liver failure or hepatocellular carcinoma. Virus-specific T cells are a major determinant of the outcome of hepatitis, as they contribute to the early control of chronic hepatitis viruses, but they also mediate immunopathology during persistent virus infection. We have analyzed the role of platelet-derived vasoactive serotonin during virus-induced CD8(+) T cell-dependent immunopathological hepatitis in mice infected with the noncytopathic lymphocytic choriomeningitis virus. After virus infection, platelets were recruited to the liver, and their activation correlated with severely reduced sinusoidal microcirculation, delayed virus elimination and increased immunopathological liver cell damage. Lack of platelet-derived serotonin in serotonin-deficient mice normalized hepatic microcirculatory dysfunction, accelerated virus clearance in the liver and reduced CD8(+) T cell-dependent liver cell damage. In keeping with these observations, serotonin treatment of infected mice delayed entry of activated CD8(+) T cells into the liver, delayed virus control and aggravated immunopathological hepatitis. Thus, vasoactive serotonin supports virus persistence in the liver and aggravates virus-induced immunopathology.

This study demonstrates a unique and crucial role of plasmacytoid dendritic cells (pDCs) and pDC-derived type I interferons (IFNs) in the pathogenesis of mouse coronavirus infection. pDCs controlled the fast replicating mouse hepatitis virus (MHV) through the immediate production of type I IFNs. Recognition of MHV by pDCs was mediated via TLR7 ensuring a swift IFN-alpha production following encounter with this cytopathic RNA virus. Furthermore, the particular type I IFN response pattern was not restricted to the murine coronavirus, but was also found in infection with the highly cytopathic human severe acute respiratory syndrome (SARS) coronavirus. Taken together, our results suggest that rapid production of type I IFNs by pDCs is essential for the control of potentially lethal coronavirus infections.

We summarized most of the rheumatologic manifestations of tuberculosis (TB) and the occurrence of Mycobacterium tuberculosis disease associated with rheumatologic diseases. We established 4 different categories: (1) direct musculoskeletal involvement of M. tuberculosis, including spondylitis, osteomyelitis, septic arthritis, and tenosynovitis; (2) M. tuberculosis as an infectious pathogen in rheumatologic diseases, particularly with the use of newer agents such as tumor necrosis factor-alpha inhibitors; (3) antimycobacterial drug-induced rheumatologic syndromes, including tendinopathy, drug-induced lupus, and others; and (4) reactive immunologic phenomena caused by TB, such as reactive arthritis, erythema nodosum, and others. In addition, Bacille-Calmette-Guérin vaccination used for the prevention of TB or as a chemotherapeutic agent for bladder carcinoma also may be associated with musculoskeletal adverse events. We conclude that M. tuberculosis can directly or indirectly affect the musculoskeletal system.

Background: We tested the hypothesis that bougie-guided insertion of the ProSeal laryngeal mask airway (ProSeal LMA) has higher success rate than the digital technique in children., Methods: One hundred and twenty children (ASA I-II, aged 1-16 yr) were randomly allocated for ProSeal LMA insertion using the digital or bougie-guided technique. The digital technique was performed according to the manufacturer's instructions. The bougie-guided technique involved priming the drain tube with a bougie, placing the bougie in the oesophagus under direct vision and railroading the ProSeal LMA into position. Unblinded data were collected about ease of insertion (number of attempts and time taken to provide an effective airway), efficacy of seal, ease of gastric tube placement, haemodynamic responses and blood staining. Blinded data were collected about postoperative airway morbidity., Results: The first attempt success rate was higher for the bougie-guided technique (59/60 vs 52/60, P=0.015), but effective airway time was longer (37 vs 32 s, P<0.001). There were no differences in efficacy of seal, ease of gastric tube placement, haemodynamic responses, blood staining or postoperative airway morbidity., Conclusion: We conclude that bougie-guided insertion of the ProSeal LMA has a higher first attempt success rate than the digital technique in children.

Ontogenic evolution of behavioural and electrophysiological responses to the serotonergic agents, quipazine and harmaline, was studied in the maturing rabbit in normal and pretreated conditions. As regards behavioural effects, tremor induced by quipazine was present from the first postnatal day and was antagonized by methysergide, but not by p-chlorophenylalanine (PCPA) or pretreatment with 5,7-dihydroxytryptamine (5,7-DHT). In contrast, tremor induced by harmaline could not be elicited before the second postnatal week and was partially antagonized by methysergide and 5,7-DHT, but not by PCPA. Electrophysiological studies of cell activity in the inferior olivary nucleus revealed a similar dependency on age since rhythmic activation of the inferior olivary nucleus could be registered from the first postnatal day with quipazine and only from the 8th postnatal day with harmaline; drug interactions with methysergide, PCPA and 5,7-DHT were the same as for the behavioural observations. It is suggested that quipazine directly activates serotonin receptors which are already present at birth, whereas harmaline requires the presence of serotonergic fibres for such activation.

It has been informed in cases with epithelial neoplasias an increased level of secretory immunoglobulin A (IgAS) in bronchial secretions: IgAS, IgG and IgM were measured in bronchial secretions and sera in four groups: bronchogenic carcinoma (Brc), lung metastasis, chronic bronchitis (CB) and voluntary subjects without respiratory disease. It was employed radial immunodiffusion method (RID) with a control from human colostrum for IgAS and commercial controls with the same method for IgG and IgM. To avoid dilutional factor it was established the relation between IgAS, IgA and IgM with total proteins in the samples of bronchial lavage (Ig/tp). Using ANOVA it was found a significative difference (p less than .002) in IgAS/tp among the four groups in the bronchial samples. With Mann-Whitney there was a p less than .05 comparing the healthy control group with any of the others. There was no statistical differences among the BrC and the metastasis or CB groups; IgG and IgM did not showed differences. The seric values of the immunoglobulins has normal levels. It was detected low levels of IgAS in the groups with pulmonary pathology in comparison with the healty controls. The present results are different with the previously reported in the revised literature.

To determine if gastric A-cells are a major source of the glucagonemia of insulin-deprived depancreatized dogs and to examine their secretory behavior, immunoreactive glucagon (IRG) was measured simultaneously in plasma from the inferior vena cava (VC) and from a gastric vein (GV) draining the fundus. Basal GV IRG averaged 205 +/- 35 pg/ml, significantly above the VC level of 71 +/- 30 (P less than 0.001) and rose to 1417 +/- 498 1.5 minutes after the start of an arginine infusion, exceeding VC IRG at all points (P less than 0.01). Measurement of IRG in gastric, jejunal, and ileal veins and vena cava revealed an IRG gradient only across the stomach. Measurement of glucagon-like immunoreactivity (GLI) revealed no gradient across the stomach, jejunum, or ileum, thus excluding cross-reaction with GLI as the cause of the GV hyperglucagonemia. Intragastric arginine elicited a near doubling of GV IRG within 1.5 minutes and this persisted for at least 120 minutes, ranging from 142 to 623 pg/ml above the VC level. Infusion of insulin at a physiologic rate lowered GV IRG from 665 +/- 66 to 151 +/- 49 pg/ml in 20 minutes and abolished the GV-VC gradient within 60 minutes, whereas intravenous and intragastric glucose administration without insulin did not alter GV IRG. It is concluded that: 1) in the insulin-deprived depancreatized dog, the stomach is a major source of IRG; 2) gastric IRG secretion is somehow stimulated by intravenous and intragastric arginine administration; 3) it is not influenced by intravenous or intragastric glucose administration; and 4) its release is suppressed by physiologic levels of insulin.

The contribution of the gastric fundus to the hyperglucagonemia of poorly controlled diabetes was studied in insulin-deprived alloxan-diabetic dogs by simultaneously measuring plasma glucagon in the venous effluents of the fundus and the pancreas, and the inferior vena cavae plasma. In the basal state, mean glucagon averaged 411 +/- 45 pg./ml. in the gastric vein and 941 +/-161 in the pancreaticoduodenal vein; both values were significantly above the vana caval level of 281 +/-35 (p less than 0.01). Intravenous arginine infusion to 1,180 +/- 432 after 1.5 minutes; this was significantly above the mean vena caval glucagon concentration which reached a peak of only 352 +/- 74 (p less than 0.01 to 0.05). Intragastric instillation of arginine was followed by a doubling of gastric vein glucagon within 10 minutes, and the increases in the gastric vein were significantly greater than in the peripheral plasms at several points. The infusion of insulin at a rate of 0.0015 u./kg./min. rapidly lowered glucagon in the gastric and pancreaticoduodenal veins, abolishing the gradient across the stomach and reducing the transpancreatic gradient. The studies raise the possibility that extrapancreatic glucagon may contribute to the hyperglucagonemia of insulin deficiency.

To determine if glucagon-containing cells could be identified in the human fundus, stomachs attained at autopsy within 4-hours of death from persons previously considered to be in good health were examined by the indirect immunoperoxidase technique using antiglucagon serum 30K. Glucagon-containing cells were demonstrated in one of eight gastric fundi examined. The glucagon content of acid alcohol extracts of the fundi examined. The glucagon content of acid alcohol extracts of the funci was low in all cases. Glucagon content was also low in canine stomach removed 4-hours after death. It is concluded that glucagon-containing cells, demonstrable by immunocytochemical techniques, may be present in the gastric fundus of humans.