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A crucial role for B cells in neuroinvasive scrapie.

Although prion proteins are most efficiently propagated through intracerebral inoculation, peripheral administration has caused the diseases kuru, iatrogenic Creutzfeldt-Jakob disease (CJD), bovine spongiform encephalopathy (BSE) and new-variant CJD. The development of neurological disease after peripheral inoculation depends on prion expansion within cells of the lymphoreticular system. Here we investigate the identity of these cells by using a panel of immune-deficient mice inoculated with prions intraperitoneally: we found that defects affecting only T lymphocytes had no apparent effect, but that all mutations that disrupted the differentiation and response of B lymphocytes prevented the development of clinical scrapie. As an absence of B cells and of antibodies correlates with severe defects in follicular dendritic cells, a lack of any of these three components may prevent the development of clinical scrapie. However, we found that scrapie developed after peripheral inoculation in mice expressing immunoglobulins that were exclusively of the M subclass and without detectable specificity for the normal form of the prion PrPC, and in mice which had differentiated B cells but no functional follicular dendritic cells. We conclude that differentiated B cells are crucial for neuroinvasion by scrapie, regardless of the specificity of their receptors.

Animals↗

Chemotactic and chemokinetic properties of topical ophthalmic preparations.

PURPOSE: Chronic ocular inflammation can be due to a disease process or to iatrogenic factors that attract inflammatory cells to the anterior chamber. This study was conducted to investigate the effect of commonly used ophthalmic preparations on leukocyte migration. METHODS: A modified multi-well Boyden chamber was used to study the chemotactic and chemokinetic effects of 33 commercial ophthalmic preparations. To determine whether the chemotactic effect was a property of the commercial ophthalmic preparation or other chemicals present in the products, experiments were also done with some common preservatives and excipients. RESULTS: Of the drugs, 14 (42.4%) showed chemokinetic and/or chemotactic activity and 19 (57.6%) had either no effect or decreased neutrophil migration. Of the preservatives and excipients, 5 (62.5%) were found to be chemotactic. Eleven of 14 chemotactic drugs (78.6%) and 8 of 19 non-chemotactic drugs (42.1%) were positive for at least one chemotactic excipient. The correlation between chemotactic ophthalmic preparations and the presence of a chemotactic excipient in their composition was significant (p < 0.05). CONCLUSIONS: Chemotactic activity was commonly found in commercial ophthalmic preparation. Furthermore, the presence of certain chemotactic preservatives and/or excipients was a contributing factor enhancing this property. Avoiding known chemotactic compounds or adjusting the intervals of the treatment may help to eliminate this iatrogenic component of the inflammatory process especially in patients with chronic ocular inflammation.

Administration, Topical↗

Molecular and clinical classification of human prion disease.

While rare in humans, the prion diseases have become an area of intense clinical and scientific interest. The recognition that variant Creutzfeldt-Jakob disease is caused by the same prion strain as bovine spongiform encephalopathy in cattle has dramatically highlighted the need for a precise understanding of the molecular biology of human prion diseases. Detailed clinical, pathological and molecular data from a large number of human prion disease cases have shown that distinct abnormal isoforms of prion protein are associated with prion protein gene polymorphism and neuropathological phenotypes. A molecular classification of human prion diseases seems achievable through characterisation of structural differences of the infectious agent itself.

Adult↗

Radiation-related pericardial effusions in patients with Hodgkin's disease.

Pericardial effusions following radiotherapy for Hodgkins Disease have previously been described as infrequent and related to the total dose of radiation received. Analysis of all chest x-rays on 81 patients who received upper-mantle radiotherapy for Hodgkins Disease at the Baltimore Cancer Research Center between 1968 and 1972 disclosed an incidence of pericardial effusions of 30.9% (25 of 81), with 13.6% (11 of 81) requiring limitation of activity (5) or pericardiectomy (6). Clinical presentation of radiation-related percardial effusions was subtle, with signs and symptoms a late finding if they occurred. Radiotherapy data was reviewed and no difference in total dose (rads) or time-dose relationships (rets) was found between the groups who did or did not develop effusions. Analysis of multiple pre-treatment clinical and pathological characteristics disclosed four parameters that were felt to be related to the development of pericardial effusions; elevated ESR, normal absolute lymphocyte count, initial presence of extensive mediastinal adenopathy and the addition of adjuvant chemotherapy. The presence of increasing combinations of these pretreatment 'risk factors' led to an increasing likelihood of developing a radiation-related pericardial effusion such that six of seven patients with all four 'risk factors' developed a pericardial effusion. Nine of 13 clinically significant effusions were associated with the addition of adjuvant chemotherapy. Possible pathogenetic mechanisms that include factors other than radiation dosage and the clinical management of radiation-related pericardial effusions are discussed.

Adult↗

The medical management of eight horses with grade 3 rectal tears.

Eight horses with Grade 3b rectal tears of the peritoneal part of the rectum or small colon were treated by a combination of medical therapy and dietary manipulation. All of the horses developed septic peritonitis during the course of treatment. Medical therapy consisted of a combination of penicillin, gentamicin and flunixin meglumine administered parenterally, metronidazole administered orally and liquid paraffin administered by nasogastric tube. Some horses also received fluid and electrolyte therapy i.v., plasma and heparin i.v. All horses were maintained on a laxative diet. Six of the 8 horses recovered. Duration of therapy in the horses that survived was between 2 and 7 weeks. Three of the 6 horses that recovered developed a rectal diverticulum, which did not appear to cause any subsequent medical problems. In the 2 horses that died, the Grade 3 rectal tear progressed to a Grade 4 tear with subsequent faecal contamination of the abdomen. Manual evacuation of the cavity of the rectal tears during treatment and size of the tears were identified as possible causes for the progression of the disease in these 2 horses.

Animals↗