Down-regulation of cell adhesion molecules LFA-1 and ICAM-1 after in vitro treatment with the anti-TNF-alpha agent thalidomide.

The tumor necrosis factor-alpha (TNF-alpha) inhibitor thalidomide is known to be a potent modulator of host immunity, a potential treatment for autoimmune disorders such as rheumatoid arthritis (RA) and a treatment for complications of HIV-1 infection. RA is an autoimmune disease of the joints that has been associated with hyperactivity of lymphocytes and other leukocytes, over-expression of pro-inflammatory cytokines (TNF-alpha and IL-1) and chronic debilitating inflammation. Thalidomide may play a role in RA treatment by altering leukocyte function through down-modulation of cell adhesion molecules necessary for leukocyte migration to inflammatory sites. The present study investigates down-regulation of cell adhesion molecules (ICAM-1 and LFA-1) and decreases in cell-cell contacts between human T leukemic (CEM) cells and human umbilical vein endothelial cells (HUVEC) after thalidomide exposure. CEM cells were cultured in RPMI 1640 medium with 0, 10 or 50 microg/ml thalidomide, stained with fluorescent monoclonal antibodies specific to ICAM-1 and LFA-1 and expression was measured with flow cytometry. For cell-cell adhesion measurements, monolayers of HUVEC cultured in Kaign's F-12 medium were incubated with thalidomide treated CEM cells stained with calcein AM. Specific cell adhesion between the two cell types was visualized with fluorescence microscopy. Thalidomide treatment significantly reduced cell adhesion molecule expression in a dose-dependent fashion and inhibited HUVEC/CEM cell adhesion. These data support the hypothesis that thalidomide has modulatory actions on leukocyte functions through expression of cell adhesion molecules.

Effects of children's disabilities on parental time use.

An interview technique was used to collect data on the amount of time used in primary physical care of family members and in self-care of the mother. The amount of time that the mother was relieved of child care was also recorded, as was the frequency that families participated in certain activities. Children were first classified functionally according to their scores on the Vineland Scales of Social Maturity. The sample of 59 Delaware families interviewed was a subsample of an ongoing project currently being carried out at the University of Delaware. Analysis of the data included the analysis of variance and computation of Pearson's product-moment correlation and the chi-square test of independence. Although no difference was found between families with and without a disabled child as a member, families with a disabled child participated in fewer family activities than did families without a disabled child. Furthermore, significant correlations were found between the child's score on the Vineland Scales of Social Maturity and the amount of time the mother had for her self-care. Significant differences were found in the amount of personal care time available to the primary care giver and the disability classification of the child.

Measuring the cost of caring for a foster child.

The problem of determining this cost is complex. Total costs include the direct or out-of-pocket costs and indirect costs, or the value of time devoted to rearing foster children. The use of secondary data for estimating coses in local areas is recommended.