ABSTRACT
Regulatory T lymphocytes (Treg) play a fundamental importance in modulating the relative balance between inflammation and immune tolerance, and alterations of these cells are observed in inflammatory diseases. To better characterize the neuroinflammatory processes suggested to be associated with Alzheimer's disease (AD) and to clarify the possible role of Treg cells in this process, we extensively analyzed these cells (CD4 + CD25highFoxp3+) in patients with either severe AD (n=25) or mild cognitive impairment (MCI) (n=25), comparing the results with those of two groups of healthy controls (HC) (n=55). Because the intra- or extracellular expression of programmed death receptor 1 (PD1) identifies functionally diverse subsets of Treg we also analyzed such subpopulations. Results showed that, whereas both Treg and PD1pos Treg are increased in MCI and AD patients compared to HC, PD1neg Treg, the subpopulation of Treg cells endowed with the strongest suppressive ability, are significantly augmented in MCI patients alone. In these patients amyloid-ß-stimulated-T cells proliferation was reduced and Treg-mediated suppression was more efficient compared to both AD and HC. The observation that PD1neg Treg, cells are increased in MCI patients reinforces the inflammatory origin of AD and supports a possible beneficial role of these cells in MCI that is lost in patients with full-blown AD.
Subject(s)
Alzheimer Disease/immunology , Antigens, CD/metabolism , Apoptosis Regulatory Proteins/metabolism , Cognition Disorders/immunology , T-Lymphocyte Subsets/metabolism , T-Lymphocytes, Regulatory/metabolism , Aged , Alzheimer Disease/metabolism , Cell Proliferation , Cognition Disorders/metabolism , Forkhead Transcription Factors/metabolism , Humans , Immune Tolerance/immunology , Middle Aged , Neuropsychological Tests , Programmed Cell Death 1 Receptor , Severity of Illness Index , Statistics, Nonparametric , T-Lymphocyte Subsets/immunology , T-Lymphocytes, Regulatory/immunologyABSTRACT
BACKGROUND: Nutrition support is an important aspect of multidisciplinary approaches in cardiology rehabilitation. However, little is known about the impact of a patient's nutrition status on recovery after elective heart surgery. The authors assessed changes in nutrition markers in patients undergoing postsurgical rehabilitation, and tested their correlation with systemic inflammatory responses and clinical outcomes to determine the adequacy of the prescribed dietary regimen. METHODS: Plasma concentrations of nutrition biomarkers were measured in 50 nondiabetic patients upon admission to a cardiology rehabilitation unit after coronary artery bypass grafting or mitral and/or aortic valve replacement (D0), and again 16 days later (D16). RESULTS: On D16, low plasma albumin increased, anemia improved, and high levels of inflammation markers declined. Vitamins remained stable within normal values, with the exception of vitamin B12, which decreased significantly from 516 +/- 341 to 445 +/- 212 ng/mL (P = .007). Blood glucose was >110 mg/dL in 51% of the patients at baseline; this proportion did not decline after rehabilitation. Overweight patients (body mass index >25 kg/m(2)) were prevalent (58%). They showed a slightly but not significantly greater inflammatory response and had a higher incidence of infective complications than the normal-weight group, but similar levels of nutrition markers. CONCLUSIONS: The standard dietary regimen followed during cardiological rehabilitation after major cardiovascular surgery aids recovery from surgical insult, but fails to normalize high glucose levels. Vitamin B12 supplementation should be encouraged because of its substantial reduction during the rehabilitation period.
Subject(s)
Anemia/blood , Diet/standards , Heart Diseases/blood , Inflammation/blood , Nutritional Status , Postoperative Complications/blood , Serum Albumin/metabolism , Aged , Anemia/etiology , Biomarkers/blood , Blood Glucose/metabolism , Coronary Artery Bypass , Female , Heart Diseases/complications , Heart Diseases/surgery , Heart Valve Prosthesis Implantation , Humans , Hyperglycemia/blood , Hyperglycemia/etiology , Inflammation/etiology , Male , Middle Aged , Nutritional Support , Overweight/blood , Overweight/complications , Vitamin B 12/blood , Vitamin B 12/therapeutic use , Vitamins/blood , Vitamins/therapeutic useABSTRACT
In order to investigate the possible involvement of viruses in Multiple Sclerosis (MS), the study evaluated the presence of viral genomic sequences in cerebrospinal fluid (CSF), as markers of viral replication within the central nervous system (CNS). A total of 85 CSF samples were collected from 38 MS patients, 28 patients with other neurological diseases and 19 subjects without neurological diseases. Using nested-PCR, the investigation focused on the presence of human herpes virus DNA, including herpes simplex virus 1 (HSV-1) and 2 (HSV-2), the Epstein-Barr virus (EBV), varicella zoster virus (VZV), human cytomegalovirus (HCMV), human herpes virus 6 (HHV-6) and JC virus (JCV). All the CSF samples from the individuals without neurological diseases were negative for viral DNA. Genomic sequences of HSV-1, HCMV, EBV, HHV6, and JCV were found in patients with MS and other neurological diseases without significant differences between the two groups. VZV DNA was detected more frequently (P < 0.05) in the MS group (31.6%), particularly among the relapsing-remitting MS patients (43.5%), compared with patients with other neurological diseases (10.7%). In addition, the results indicated that JCV and HHV-6 were replicating actively in the CNS of a small, but significant number of patients with MS and other neurological diseases. Most importantly, the study revealed a high frequency of VZV DNA in the CSF of patients with MS, suggesting a possible role of this virus in the pathogenesis of MS.
