Allo-HLA Cross-Reactivities of Cytomegalovirus-, Influenza-, and Varicella Zoster Virus-Specific Memory T Cells Are Shared by Different Healthy Individuals.

Virus-specific T cells can recognize allogeneic HLA (allo-HLA) through TCR cross-reactivity. The allospecificity often differs by individual (private cross-reactivity) but also can be shared by multiple individuals (public cross-reactivity); however, only a few examples of the latter have been described. Because these could facilitate alloreactivity prediction in transplantation, we aimed to identify novel public cross-reactivities of human virus-specific CD8+ T cells directed against allo-HLA by assessing their reactivity in mixed-lymphocyte reactions. Further characterization was done by studying TCR usage with primer-based DNA sequencing, cytokine production with ELISAs, and cytotoxicity with 51 chromium-release assays. We identified three novel public allo-HLA cross-reactivities of human virus-specific CD8+ T cells. CMV B35/IPS CD8+ T cells cross-reacted with HLA-B51 and/or HLA-B58/B57 (23% of tetramer-positive individuals), FLU A2/GIL (influenza IMP[58-66] HLA-A*02:01/GILGFVFTL) CD8+ T cells with HLA-B38 (90% of tetramer-positive individuals), and VZV A2/ALW (varicella zoster virus IE62[593-601] HLA-A*02:01/ALWALPHAA) CD8+ T cells with HLA-B55 (two unrelated individuals). Cross-reactivity was tested against different cell types including endothelial and epithelial cells. All cross-reactive T cells expressed a memory phenotype, emphasizing the importance for transplantation. We conclude that public allo-HLA cross-reactivity of virus-specific memory T cells is not uncommon and may create novel opportunities for alloreactivity prediction and risk estimation in transplantation.

Virus-Specific CD8(+) T Cells Cross-Reactive to Donor-Alloantigen Are Transiently Present in the Circulation of Kidney Transplant Recipients Infected With CMV and/or EBV.

T cells play a dual role in transplantation: They mediate transplant rejection and are crucial for virus control. Memory T cells generated in response to pathogens can cross-react to alloantigen, a phenomenon called heterologous immunity. Virus-specific CD8(+) T cells cross-reacting to donor-alloantigen might affect alloimmune responses and hamper tolerance induction following transplantation. Here, we longitudinally studied these cross-reactive cells in peripheral blood of 25 kidney transplant recipients with a cytomegalovirus and/or Epstein-Barr virus infection. Cross-reactive T cells were identified by flow cytometry as virus-specific T cells that proliferate in response to donor cells in a mixed-lymphocyte reaction. In 13 of 25 patients, we found cross-reactivity to donor cells for at least 1 viral epitope before (n = 7) and/or after transplantation (n = 8). Cross-reactive T cells were transiently present in the circulation, and their precursor frequency did not increase following transplantation or viral infection. Cross-reactive T cells expressed interferon-γ and CD107a in response to both alloantigen and viral peptide and resembled virus-specific T cells in phenotype and function. Their presence was not associated with impaired renal function, proteinuria, or rejection. In conclusion, virus-specific T cells that cross-react to donor-alloantigen are transiently detectable in the circulation of kidney transplant recipients.

Increased cytotoxic capacity of tumor antigen specific human T cells after in vitro stimulation with IL21 producing dendritic cells.

Monocyte derived dendritic cells (moDC) electroporated with tumor associated antigen derived mRNA can elicit specific T cells against tumor cells in vivo. IL21 has been shown to enhance activation and cytotoxicity in CD8+ T cells. We therefore investigated in vitro effects on human CD8+ T-cells after stimulation with IL21 mRNA electroporated moDC. Codon modification of the IL21 gene significantly enhanced IL21 production upon electroporation of moDC. Tumor associated antigen specific CTL induction efficiency was significantly enhanced when codon modified IL21 mRNA was co-electroporated with tumor associated antigen mRNA. Tumor associated antigen specific T cells induced by codon modified IL21-DC demonstrated increased cytotoxic capacity and killing compared to control cultures. In conclusion, ectopic expression of codon modified IL21 by moDC enhances the priming efficiency of the DC as well as the cytotoxic potential of the induced CTL.

Effector memory T-cell frequencies in relation to tumour stage, location and HPV status in HNSCC patients.

BACKGROUND: The immune system plays an important role in tumour immune surveillance. Head and neck squamous cell carcinoma patients are often immune compromised. OBJECTIVE: To chart the baseline levels of T-cell subpopulation frequencies in patients with cancer prior to treatment. SUBJECTS AND METHODS: Blood samples of patients were taken at the time of diagnosis, analysed with flowcytometry and compared with blood samples of healthy donors. RESULTS: Compared to healthy donors, a significant shift from naive to effector memory T cells was observed. This effect was most prominent in stage II patients. A similar shift from naive to effector memory T cells was noted in patients with oropharynx or larynx squamous cell carcinomas. Furthermore, the percentage of effector memory and effector T cells was higher in the group of patients with human papillomavirus-positive oropharyngeal squamous cell carcinomas, compared with patients with human papillomavirus-negative tumours, suggestive of virus-induced T-cell activation. CONCLUSION: Here, we provide a simple and easily implementable tool to document T lymphocyte subsets in the peripheral blood of head and neck cancer patients, which might be useful for prognosis and/or therapy response prediction.

General practice--reflection on five years of multidisciplinary training at Medical Centre Gütersloh.

BACKGROUND: Medical Centre Gütersloh is a primary care setting which provides the full range of general practice care for British Forces Germany Health Service (BFG HS). The aim of this article is to evaluate the multidisciplinary training organised by the author there, to exchange information and to provide suggestions for improvement and development. METHODS: Description of the training scheme and analysis of routinely collected management data. RESULTS: The training scheme is based on adult education principles with a focus on interactive learning. Over the period November 2005-July 2010 a total of 1201 members of staff from various disciplines participated in 86 documented training sessions. The majority of the attending staff considered the training to be relevant, interesting and well presented. A substantial proportion indicated that they would change their practice as a result of the training. These views remained stable over time. The majority of facilitators consisted of medical centre employees. CONCLUSIONS: This article provides an overview onfive years of multidisciplinary training in a general practice setting. Overall feedback from staff suggests that the training has been highly valued over those years. However, it is recognised that this evaluation has its limitations and suggestions are made regarding how these types of training schemes can be improved and developed further.

The general practitioner trainer exchange as an innovative approach to peer review.

There are various formal peer review schemes to assess the quality of primary care practices and several special approval and re-approval programmes exist for General Practitioner (GP) trainers and primary care training practices. The Defence Postgraduate Medical Deanery (DPMD) has its own General Practice Education Committee (GPEC) approval and re-approval programme. Part of this programme is related to the New Membership of the Royal College of Practitioners (nMRCGP). There is limited published information related to GP trainer exchanges as a means of peer review and as such as preparation for GPEC in the British Forces. This paper provides a review of a GP trainer exchange involving a visit of a GP trainer from British Forces Germany (BFG) to the practices of Dhekelia and Ay Nik on Cyprus in January 2010. It concludes that a GP trainer exchange is cost neutral and may be a valuable experience for both the host and visiting GP trainer, the local GP trainers' group, the practice teams and above all, for the GP trainee.

Which quality and outcomes framework (QOF) clinical indicators are applicable for British Forces Germany Health Service (BFG HS) primary care?

OBJECTIVES: To determine which QOF clinical indicators are applicable for BFG HS primary care. METHOD: In depth cross-sectional survey of BFG HS general practitioners. Participants were requested to assess all 19 QOF clinical domains (80 clinical indicators) and to indicate to what extent these were applicable for BFG HS (Likert scale 1-5). Response rate was documented. Cronbach's alpha reliability was calculated and a comparison of the mean responses of training and non-training practices was made. RESULTS: The response rate was 80% (28/35). Cronbach's alpha was 0.91.The mean score for both training practices and non-training practices was 3.9. Based on the mean score the applicable indicators were (in descending order): Hypothyroidism (mean 4.6, 95% confidence interval 4.5-4.8), Hypertension (4.6, 4.5-4.8), Asthma (4.3, 4.2-4.5), Diabetes mellitus (4.3, 4.2-4.3), Obesity (4.1, 4.0-4.2), Chronic Heart Disease (4.1, 3.9-4.2), Epilepsy (4.0, 3.9-4.2) and Smoking (4.0, 3.7-4.2). Problematic were (descending means): Cancer (3.9, 3.6-4.2), Stroke and TIA (3.8, 3.7-4.0), Atrial fibrillation (3.6, 3.3-3.8), Learning disabilities (3.5, 3.1- 4.0), Chronic kidney disease (3.5, 3.3-3.8), Chronic Obstructive Pulmonary Disease (3.5, 3.3-3.7), Mental health (3.5, 3.3-3.6), Heart failure (3.4, 3.1-3.7), Depression (3.2, 2.8-3.5) and Palliative care (3.2, 2.7-3.6). Not applicable was Dementia (2.4, 2.0-2.8). CONCLUSION: This study shows that several but not all QOF clinical indicators are applicable in BFG HS. Therefore QOF cannot be directly transferred to BFH HS and an adapted quality framework is required.

Differential responses of biomarkers in tissues of a freshwater mussel, Dreissena polymorpha, to the exposure of sediment extracts with different levels of contamination.

In this study, zebra mussels, D. polymorpha, were exposed to extracts of sediments obtained from two sites, a contaminated lake (Ketelmeer, Km) and a relatively clean lake (Drontenmeer, Dm). The main objective of this work was to investigate whether six selected biomarkers could discriminate between the two sediments. The selected biomarkers included phase I enzymes such as DT-diaphorase, NADPH-cytochrome c reductase, NADH-cytochrome c reductase, a phase II enzyme (glutathione S-transferase, GST), an antioxidant enzyme, catalase, and the total glutathione, reduced (GSH) and oxidized (GSSG). After a short (24 h) and a long-term (7 days) exposure, the levels of these biomarkers were measured in gills and the rest of soft mussel tissues (soft mussel tissue minus gills) and compared with control values. A decrease of GST level by 20% (P = 0.004) and a 4-fold decrease of total glutathione concentration relative to the control, were observed in the gills of mussels exposed to the more contaminated Km extract. No significant differences in the GST activities were observed in the gills of control and Dm extract-treated mussels (P = 0.23). Although the levels of catalase and NADH-cytochrome c reductase were, in the short-term exposure, unaffected, both activities were, in the long-term exposure, reduced in the gills of the mussels exposed to the contaminated Km extract, compared with control values, by 43% and 20%, respectively. The activities of DT-diaphorase and NADPH-cytochrome c reductase remained unaffected in all exposure conditions. However, the level of NADPH-cytochrome c reductase was found higher in gills than in the rest of soft mussel tissues. This difference in the ratio of the two reductases between the two tissues could account for the observed differential responses of the biomarkers.

Mass spectrometric methods for the characterisation and differentiation of isomeric O-diglycosyl flavonoids.

Tandem mass spectrometric methods have been evaluated for the characterisation of the type and the differentiation of the interglycosidic linkage of isomeric flavonoid O-diglycosides. Based on the occurrence of internal monosaccharide residue loss and the relative abundances of Y-type ions formed by fragmentation at glycosidic bonds, four pairs of isomeric flavonoid O-diglycosides can be unambiguously differentiated. The different techniques used, i.e. linked scanning at constant B/E without collisional activation and low-energy collision-induced dissociation using methane or helium as collision gas, have been shown to be useful for distinguishing the two most common (1, 2- and 1, 6-) interglycosidic linkages, e.g. flavonoid O-neohesperidosides and O-rutinosides.

Charge-remote fragmentation characteristics of functionalized alkanes in high-energy collision-induced dissociation

In this study we report on high-energy, collision-induced dissociation processes leading to charge-remote fragmentations, using three alkyl cations, namely n-hexadecylpyridinium, n-hexadecyltriphenylphosphonium and n-hexadecyltriethylammonium, each with and without (2)H(2)-labelling at the C(9) position of the hexadecyl chain. The characteristic patterns corresponding to the formal elimination of alkane elements were observed, and the (2)H(2)-labelling at C(9) clearly affected only one charge-remote fragment ion of the homologous series. However, in addition to the expected fragment ion containing only one deuterium atom, a significant ion retaining two deuterium atoms was observed. MS/MS/MS experiments demonstrated clearly that the latter ion showed partial deuteration around the charge site, the level of deuteration depending on the structure of the original precursor cation. These results can be interpreted in terms of two novel, distinct mechanisms, one of which involves an excited state in an aromatic ring. Mixed-site fragmentation (MSF) ions were also observed from the phosphonium and ammonium ion precursors. We believe that the observation of the MSF process occurring at an sp(2)-hybridized center in the phosphonium series has not been reported previously. It thus becomes apparent that high-energy collisions leading to charge-remote reactions in fact lead to a broad range of pathways. Copyright 2000 John Wiley & Sons, Ltd.

A chemostat system for investigating pesticide biodegradation in continuous mixed bacteria cultures originating from surface water.

To be able to predict the degradation (rate) of organic chemicals (e.g. pesticides) in the field, knowledge of the environmental conditions that are of influence on the degradation process are of importance. In the present study an experimental system is described which is used to study the degradation of organic pollutants in mixed bacteria cultures originating from surface water With this system the degradation of compounds can be followed for relatively long experimental periods (months). In addition, it is possible to vary different environmental parameters in order to investigate their influences on the degradation of the chemical. These preliminary experiments show that growth and 'composition' of the bacteria culture have comparable patterns in parallel experiments. The first order degradation rate constant for the test compound dichloran, as calculated from these experiments under these circumstances, is about 0.002 h(-1).

Steroids from Harrisonia abyssinica.

In addition to the known sterols and ketosteroids beta-sitosterol (24 alpha-ethylcholest-5-en-3 beta-ol), stigmasterol (24 alpha-ethylcholesta-5,22-dien-3 beta-ol), campesterol (24 alpha-methylcholest-5-en-3 beta-ol), beta-sitostenone (stigmast-4-en-3-one, 24 alpha-ethylcholest-4-en-3-one), stigmastenone (stigmasta-4,22-dien-3-one, 24 alpha-ethylcholesta-4,22-dien-3-one), campestenone (24 alpha-methylcholest-4-en-3-one), and stigmasta-3,5-dien-7-one (24 alpha-ethylcholesta-3,5-dien-7-one), the new steroids stigmasta-3,5,22-trien-7-one (24 alpha-ethylcholesta-3,5,22-trien-7-one), and campesta-3,5-dien-7-one (24 alpha-methylcholesta-3,5-dien-7-one) were isolated from the stem bark of Harrisonia abyssinica and identified by NMR and mass spectrometry.

Internal glucose residue loss in protonated O-diglycosyl flavonoids upon low-energy collision-induced dissociation.

The low-energy collision-induced dissociation of protonated flavonoid O-diglycosides, i.e., flavonoid O-rutinosides and O-neohesperidosides, containing different aglycone types has been studied. The results indicate that the unusual [M + H - 162]+ ion formed by internal glucose residue loss, which in a previous study was shown to be a rearrangement ion, is strongly dependent upon the aglycone type. For 7-O-diglycosides, the internal glucose loss is very pronounced for aglycones of the flavanone type, but is completely absent for aglycones of the flavone and flavonol types. Internal glucose residue loss was found to correspond to a minor fragmentation pathway for flavonol 3-O-diglycosides. A plausible mechanism is proposed based on proton mobilization from the aglycone to the disaccharidic part of the flavonoid O-diglycosides which is supported by theoretical calculations and model building.

Oumarone, bissaone, and aissatone, unusual prenylated polyketides from harrisonia abyssinica

Fractionation of the n-hexane extract of the leaves of Harrisonia abyssinica, collected in Guinea, afforded three novel and unusual prenylated polyketides, which were named oumarone (1), bissaone (2), and aissatone (3). Their structures were elucidated by spectroscopic methods, mainly 1D and 2D NMR spectroscopy.

Perceived antecedents of emotional reactions in inter-ethnic relations.

It is argued that the aspects of intergroup relations that potentially can arouse emotions in the perceiver are likely to become central and motivationally relevant elements of group stereotypes. Asking participants to report on the perceived antecedents of their emotional reactions to in-group and out-group members should therefore be an especially useful method to reveal the content of stereotypes. Native Dutch participants reported both the frequencies with which different emotions were felt in different intergroup relations and the perceived causes of these emotions. Analysis of self-reported antecedents of emotional reactions revealed that (a) despite a general in-group favourability bias, both the in-group and the two out-groups employed arouse different kinds of negative and positive emotions; and (b) differences in emotional reactions to the two out-groups are related to salient differences in perceived antecedents between these groups. Theoretical and practical implications of the present emphasis on the cognitive foundation of emotion in intergroup relations are discussed.

Triterpenoid saponins from Maesa lanceolata.

Six new homologous triterpenoid saponins were isolated from the methanol extract of the leaves of Maesa lanceolata and characterized as 3 beta-O-[alpha-L-rhamnopyranosyl(1 --> 2)-beta-D-galactopyranosyl (1 --> 3)]-[beta-D-galactopyranosyl(1 --> 2)]-beta-D-glucuronopyranosides alpha-diol, 22 alpha-angeloyloxy-16 alpha-butanoyloxy-13 beta,28-oxydoolean-21 beta,28 alpha-diol, 16 alpha,22 alpha-diangeloyloxy-13 beta,28-oxydoolean-21 beta,-28 alpha-diol, 22 alpha-angeloyloxy-13 beta,28-oxydo-16 alpha-(2-methyl-butanoyloxy)-olean-21 beta,28 alpha-diol, 21 beta-acetoxy-22 alpha-angeloyloxy-13 beta,28-oxydo-16 alpha-propanoyloxyolean-28 alpha-ol, 21 beta-acetoxy-22 alpha-angeloyloxy-16 alpha-butanoyloxy-13 beta,28-oxydoolean-28 alpha-01. The structures were established on the basis of chemical and spectral evidence.

Comparison of high- and low-energy collision-induced dissociation tandem mass spectrometry in the analysis of glycoalkaloids and their aglycons.

Four aglycons (tomatidine, demissidine, solanidine, and solasodine) and three glycoalkaloids (α-tomatine, α-chaconine, and α-solanine) have been analyzed by positive ion liquid secondary ion high-energy and low-energy collision-induced dissociation (CID) tandem mass Spectrometry, performed on a four-sector (EBEB) and a hybrid (EBQQ) instrument, respectively. Both high- and low-energy collision-induced dissociation mass spectra of [M+H](+) ions of these compounds provided structural information that aided the characterization of the different aglycons and of the carbohydrate sequence and linkage sites in the glycoalkaloids. Low-energy CID favors charge-driven fragmentation of the aglycon rings, whilst high-energy CID spectra are more complex and contain additional ions that appear to result from charge-remote fragmentations, multiple cleavages, or complex charge-driven rearrangements. With respect to the structural characterization of the carbohydrate part, low-energy CID fragmentations of sugar residues in the glycoalkaloids generate Y n (+) ions and some low intensity Z n (+) ions; the high-energy spectra also exhibit strong (1,5)X n (+) ions, formed by multiple cleavage of the sugar ring, and significant Z n (+) ions.

Fragmentation characteristics of neuropeptides related to chromogranin B and proenkephalin B using fast atom bombardment and collision-induced dissociation.

This study deals with the mass spectral characterization of selected neuropeptides related to chromogranin B and proenkephalin B precursor proteins using fast atom bombardment (FAB) ionization in combination with low- and high-energy collision-induced dissociation. Fragmentation pathways were investigated using linked scan and tandem mass spectrometric techniques. First-order FAB mass spectra and product ion spectra of [M+H]+ ions are discussed and analysed for structure-specific information. In the high-energy product ion spectra, abundant y and c ions are found to be indicative of the presence of proline and threonine residues, respectively. With regard to side chain specific ions, diagnostic d and w ions are found, which support the presence of leucine, glutamic acid and glutamine at specific positions in the amino acid sequence.