ABSTRACT
Mortality in individuals with trisomy 18 has significantly decreased over the past 20 years, but there is scant literature addressing the prognosis and cause of death in individuals with trisomy 18 and survival past the first year of life (YOL). This study analyzed factors associated with mortality and cause of death in a retrospective cohort of 174 individuals with trisomy 18 and survival past the first YOL, the largest such series to date. Data were collected via retrospective survey of parents of affected individuals. Prenatal diagnosis of trisomy 18; postnatal respiratory distress; maternal age > 35 years; birthweight <2000 g; brain and spinal cord defect(s); atrial and/or ventricular septal defect(s); inability to feed orally without medical assistance; and failure to meet sitting and rolling milestones were associated with mortality in this sample. Cause of death was compared between our cohort of individuals with trisomy 18 and existing literature on those with mortality before the first YOL. Individuals with trisomy 18 with mortality after the first YOL demonstrated a predominance of infectious (n = 10/22) and postoperative (n = 6/22) contributing causes of death, in contrast to the existing literature, which shows a predominance of cardiopulmonary causes of death (e.g., cardiopulmonary arrest, pulmonary hypertension). These findings demonstrate that individuals with trisomy 18 and survival past the first YOL have unique medical needs, but further research is needed to develop clinical guidelines for this growing population.
Subject(s)
Heart Septal Defects, Ventricular , Pregnancy , Female , Humans , Adult , Trisomy 18 Syndrome/diagnosis , Trisomy 18 Syndrome/genetics , Cause of Death , Retrospective Studies , Prenatal Diagnosis , Trisomy/geneticsABSTRACT
This study reviewed the methodology and findings of 44 peer-reviewed studies on psychosocial risk factors associated with mental health outcomes among undocumented immigrants (UIs) in the United States. Findings showed a considerable advancement over the past seven years in the methods and measures used in the included studies. Nonetheless, there is a need for continued methodological rigor, innovative study designs, greater diversity of samples, and in-depth exploration of constructs that facilitate resilience. Identifying avenues to reduce risk in this population is essential to inform intervention and advocacy efforts aimed at overcoming distress from the current U.S. anti-immigrant and socio-political climate.
ABSTRACT
Class-switched antibodies to double-stranded DNA (dsDNA) are prevalent and pathogenic in systemic lupus erythematosus (SLE), yet mechanisms of their development remain poorly understood. Humans and mice lacking secreted DNase DNASE1L3 develop rapid anti-dsDNA antibody responses and SLE-like disease. We report that anti-DNA responses in Dnase1l3-/- mice require CD40L-mediated T cell help, but proceed independently of germinal center formation via short-lived antibody-forming cells (AFCs) localized to extrafollicular regions. Type I interferon (IFN-I) signaling and IFN-I-producing plasmacytoid dendritic cells (pDCs) facilitate the differentiation of DNA-reactive AFCs in vivo and in vitro and are required for downstream manifestations of autoimmunity. Moreover, the endosomal DNA sensor TLR9 promotes anti-dsDNA responses and SLE-like disease in Dnase1l3-/- mice redundantly with another nucleic acid-sensing receptor, TLR7. These results establish extrafollicular B cell differentiation into short-lived AFCs as a key mechanism of anti-DNA autoreactivity and reveal a major contribution of pDCs, endosomal Toll-like receptors (TLRs), and IFN-I to this pathway.
Subject(s)
B-Lymphocytes/immunology , B-Lymphocytes/metabolism , Cell Communication , DNA/immunology , Dendritic Cells/immunology , Dendritic Cells/metabolism , Interferon Type I/metabolism , Animals , Antibodies, Antinuclear/immunology , Autoantigens/immunology , Autoimmunity , Biomarkers , CD40 Ligand/deficiency , Cell Communication/genetics , Cell Communication/immunology , Disease Models, Animal , Disease Susceptibility , Endodeoxyribonucleases/deficiency , Fluorescent Antibody Technique , Germinal Center/immunology , Germinal Center/metabolism , Germinal Center/pathology , Lupus Erythematosus, Systemic/etiology , Lupus Erythematosus, Systemic/metabolism , Mice , Mice, Knockout , Toll-Like Receptor 7/metabolism , Toll-Like Receptor 9/metabolismABSTRACT
The optimization of engineered metabolic pathways requires careful control over the levels and timing of metabolic enzyme expression. Optogenetic tools are ideal for achieving such precise control, as light can be applied and removed instantly without complex media changes. Here we show that light-controlled transcription can be used to enhance the biosynthesis of valuable products in engineered Saccharomyces cerevisiae. We introduce new optogenetic circuits to shift cells from a light-induced growth phase to a darkness-induced production phase, which allows us to control fermentation with only light. Furthermore, optogenetic control of engineered pathways enables a new mode of bioreactor operation using periodic light pulses to tune enzyme expression during the production phase of fermentation to increase yields. Using these advances, we control the mitochondrial isobutanol pathway to produce up to 8.49 ± 0.31 g l-1 of isobutanol and 2.38 ± 0.06 g l-1 of 2-methyl-1-butanol micro-aerobically from glucose. These results make a compelling case for the application of optogenetics to metabolic engineering for the production of valuable products.
