NOD2 signaling in CD11c + cells is critical for humoral immune responses during oral vaccination and maintaining the gut microbiome.

Nucleotide-binding oligomerization domain containing 2 (NOD2) is a critical regulator of immune responses within the gastrointestinal tract. This innate immune receptor is expressed by several cell types, including both hematopoietic and nonhematopoietic cells within the gastrointestinal tract. Vaccination targeting the gastrointestinal mucosal immune system is especially difficult due to both physical and mechanistic barriers to reaching inductive sites. The use of lactic acid bacteria is appealing due to their ability to persist within harsh conditions, expression of selected adjuvants, and manufacturing advantages. Recombinant Lactobacillus acidophilus (rLA) has shown great promise in activating the mucosal immune response with minimal impacts on the resident microbiome. To better classify the kinetics of mucosal vaccination with rLA, we utilized mice harboring knockouts of NOD2 expression specifically within CD11c + cells. The results presented here show that NOD2 signaling in CD11c + cells is necessary for mounting a humoral immune response against exogenous antigens expressed by rLA. Additionally, disruption of NOD2 signaling in these cells results in an altered bacterial microbiome profile in both control mice and mice receiving L. acidophilus strain NCK1895 and vaccine strain LaOVA.

Use of high dose chloral hydrate for ophthalmic exams in children: a retrospective review of 302 cases.

Although chloral hydrate sedation has been proposed as an alternative to evaluation under anesthesia for pediatric patients who are unable to cooperate with routine test procedures, a careful study of the drug's safety and effectiveness is lacking. This study reports the effectiveness and safety of high-dose chloral hydrate for ophthalmic examination in 302 patients between the ages of 1 month and 5 years. The patients had nothing to eat or drink for 4 hours prior to drug administration. The patients were monitored during sedation and until fully awake. Eighty-eight percent of the patients (266/302) were successfully sedated without a supplemental dose. There were no reports of any complications including emesis, respiratory distress or depression, behavioral problems, changes in vital signs, patient injury, or hospital admission. The high-dose chloral hydrate protocol described, results in safe and generally successful sedation of pediatric patients for ophthalmic examination.

PVEP evidence of true suppression in adult onset strabismus.

Customarily, it is taught that strabismus acquired in childhood results in suppression of the diplopic image, whereas strabismus acquired in adulthood causes diplopia or conscious image ignoring, but not true cortical suppression. The pattern visual evoked potential (PVEP) was recorded from strabismic patients, three with childhood onset, two adult onset with diplopia, and three with longstanding adult onset strabismus "ignored" diplopia. Patients with childhood onset and adult onset "ignored" diplopia similarly showed essentially no response under haploscopic stimulation, whereas patients with diplopia and normal control subjects showed a 50% decrease (rivalry). These results suggest that adults with acquired strabismus who "ignore" the diplopic image actually have a suppressed cortical visual activity, as evidenced by the pattern visual evoked potential.