Identification of Circulating Tfh/Th Subsets as Biomarker of Hospital-acquired Pneumonia

BackgroundThe incidence rate of hospital-acquired pneumonia (HAP) is increasing in ICU patients, which is usually associated with dysregulated immune responses. Previous study has revealed Follicular helper T (Tfh) cells were essential for the formation and maintenance of geminal centers for anti-viral immune response, however, little is known about it during HAP.MethodsA total number of 62 patients with HAP and 10 healthy individuals were recruited. Lower respiratory tract secretion and blood samples were taken for microbiological examinations. Uncontrolled and controlled HAP patients were identified on the basis of its respiratory function or hemodynamics, according to the ATS guidelines of HAP. Circulating Tfh cells (CXCR5+Foxp3-CD4+) and Th cells (CXCR5-FoxP3-CD4+) in all individuals were analyzed by flow cytometry.ResultsClinically, 34 patients had uncontrolled HAP and 28 patients were controlled HAP. Patients were mainly infected with Klebsiella pneumoniae (K.p), Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa. It is noted that Tfh/Th ratio was increased in patients with uncontrolled HAP than controlled HAP (P<0.05). Especially, Tfh/Th ratio was also higher in K.p-infected than non-K.p-infected patients (P<0.05). Furthermore, Tfh/Th ratio was significantly elevated in patients with BSIs compared to those without BSIs (P<0.01). Furthermore, Tfh/Th ratio showed an association with PCT, and the combination of Tfh/Th and PCT could serve as a better predicting marker for deterioration of HAP. Accordingly, HAP patients with high Tfh/Th ratio had a lower rate of survival in 28 days.ConclusionTfh/Th ratio is useful for identifying the severity of the patients with HAP and increased Tfh/Th ratio indicates uncontrolled HAP. Circulating Tfh/Th subsets could be used as a prognostic biomarker and may provide novel insight for the pathogenesis of HAP.

Inhibition of Staphylococcus aureus by Lysostaphin-Expressing Lactobacillus plantarum WCFS1 in a Modified Genital Tract Secretion Medium

ABSTRACTLactobacillusspecies are a predominant member of the vaginal microflora and are critical in maintaining an acidic vaginal environment thought to contribute to the prevention of a number of urogenital diseases. However, during menstruation the pH of the vaginal environment increases to neutrality, a pH conducive forStaphylococcus aureusproliferation and the production of toxic shock syndrome toxin 1 (TSST-1) in susceptible women. In order to generateLactobacillusspecies capable of expressing lysostaphin (an endopeptidase that cleaves the cell wall ofS. aureus) in a modified genital tract secretion medium (mGTS) under neutral-pH conditions, six prominent proteins fromLactobacillus plantarumWCFS1 spent medium were identified by mass spectrometry. Sequences for promoters, signal peptides, and mature lysostaphin were used to construct plasmids that were subsequently transformed intoL. plantarumWCFS1. The promoter and signal sequences of Lp_3014 (putatively identified as a transglycosylase) or the promoter sequence of Lp_0789 (putatively identified as glyceraldehyde 3-phosphate dehydrogenase) with the signal sequence of Lp_3014 exhibited lysostaphin activity on buffered medium containing heat-killedS. aureus. The cassettes were integrated into the chromosome ofL. plantarumWCFS1, but only the cassette containing the promoter and signal sequence from Lp_3014 had integrated into the appropriate site. Coculture assays using buffered mGTS showed that lysostaphin expressed fromL. plantarumWCFS1 reduced the growth of TSST-1-producing strains ofS. aureusunder neutral-pH conditions. This study provides the basis for determining whether lysostaphin-producingLactobacillusstrains could potentially be used as a means to inhibit the growth ofS. aureusduring menstruation.

Chirurginių ligonių perioperacinis maitinimas: ar jis reikalingas?

Saulius Bradulskis1, Kęstutis Adamonis21 Kauno medicinos universiteto Bendrosios chirurgijos klinika,Josvainių g. 2, LT-3021 Kaunas.2 Kauno medicinos universiteto Gastroenterologijos klinika,Eivenių g. 2, LT-3007 Kaunas.El paštas: [email protected] Įvadas / tikslas Straipsnyje aptariama chirurginių ligonių mitybos nepakankamumo problema. Rezultatai Mitybos nepakankamumas nustatomas nuo 27 iki 50 % šių ligonių. Jis gali būti viena iš svarbiausių pooperacinių komplikacijų, ilgesnio buvimo stacionare pooperaciniu laikotarpiu, papildomų gydymo išlaidų priežastimi. Mitybos korekcija, o ypač maitinimas imuniniais mišiniais, akivaizdžiai padeda spręsti šias problemas. Bereikalingas badavimas prieš operaciją sukelia neigiamų padarinių: sumažėja seilių ir virškinimo trakto sulčių sekrecija, slopinama žarnyno motorika, blogėja kraujo cirkuliacija, padidėja sąlyginai patogeninės žarnų floros virulentiškumas, atrofuojasi gleivinė, padidėja bakterinės translokacijos iš žarnos galimybė, sumažėja antioksidantų, flavonoidų, fitoestrogenų kiekis, slopinamas imunitetas. Badavimas prieš operaciją yra susijęs su pooperaciniu atsparumu insulinui, tiksliau – jo intensyvumu. Prieš operaciją skiriant ligoniui lengvai pasisavinamų angliavandenių, pavyzdžiui, gliukozės, galima sumažinti šio reiškinio intensyvumą pooperaciniu laikotarpiu. Išvados Prieš operaciją ir po jos būtina griežtai laikytis mitybos korekcijos indikacijų, nes kitu atveju ši gydymo procedūra gali būti ne tik nenaudinga, bet ir sukelti komplikaciju, padidinti gydymo išlaidas. Prasminiai žodžiai: perioperacinis laikotarpis, enterinis maitinimas. Perioperative nutrition of surgical patiens: is it necessary? Saulius Bradulskis1, Kęstutis Adamonis2 Background / objective Problems of surgical patients nutrition, pre- and postoperative nutritional problems are discussed. Results Nutrition disorders among surgical patients are frequent – from 50 to 27%. Nutritional disorders may be one of the reasons for complications and long in-hospital stay and additional expenses. Nutritional correction, especially immunonutrition, is beneficial to surgical patients, as it decreases septic complications, in-hospital stay and it helps to save, money. Lack of nutrition has negative consequences: inhibition of digestive tract secretion, motility, splanchnic circulation, increased virulence of pathogenic flora, atrophy of the mucosae, microbial translocation. Data that have become available show that the preoperative administration of carbohydrates to patients undergoing surgery has metabolic benefits postoperatively by reducing postoperative insulin resistance. Conclusions Pre- and postoperative nutritional correction has strong indications, and nonobservance of this indication prolongs in-hospital stay and the preoperative period, as well as increases expenses, and first of all it has no influence on the postoperative complications. Keywords: perioperative period, enteral nutrition.

SPECIFIC SECRETORY PROTEIN OF THE FEMALE GENITAL TRACT

ABSTRACT Investigations on the biochemical composition of genital tract secretions during oestrus and early reproductive stages reveal a spectrum of different substrate and time specific patterns, particularly of secretory proteins. Results are presented on the biochemistry, immunological specificity, and endocrinological regulation of rabbit female genital tract secretion proteins. Special attention is drawn upon uteroglobin, which is one of the genital tract specific proteins presumably involved in preimplantational blastocyst development. Since analytical data on rabbit genital tract secretion proteins accumulate, there is consequently a necessity for an approach to comparable studies in the human uterus. Discelectrophoretical patterns and immunochemical test results are presented in this paper which encourage further studies on human genital tract specific proteins with regard to human reproduction, particularly with its contraceptive and fertility problems.