Search

AimsCharacterise T-cell receptor gene (TR) repertoires of small intestinal T cells of patients with newly diagnosed (active) coeliac disease (ACD), refractory CD type I (RCD I) and patients with CD on a gluten-free diet (GFD).MethodsNext-generation sequencing of complementarity-determining region 3 (CDR3) of rearranged T cell receptor β (TRB) and γ (TRG) genes was performed using DNA extracted from intraepithelial cell (IEC) and lamina propria cell (LPC) fractions and a small subset of peripheral blood mononuclear cell (PBMC) samples obtained from CD and non-CD (control) patients. Several parameters were assessed, including relative abundance and enrichment.ResultsTRB and TRG repertoires of CD IEC and LPC samples demonstrated lower clonality but higher frequency of rearranged TRs compared with controls. No CD-related differences were detected in the limited number of PBMC samples. Previously published LP gliadin-specific TRB sequences were more frequently detected in LPC samples from patients with CD compared with non-CD controls. TRG repertoires of IECs from both ACD and GFD patients demonstrated increased abundance of certain CDR3 amino acid (AA) motifs compared with controls, which were encoded by multiple nucleotide variants, including one motif that was enriched in duodenal IECs versus the PBMCs of CD patients.ConclusionsSmall intestinal TRB and TRG repertoires of patients with CD are more diverse than individuals without CD, likely due to mucosal recruitment and accumulation of T cells because of protracted inflammation. Enrichment of the unique TRG CDR3 AA sequence in the mucosa of patients with CD may suggest disease-associated changes in the TCRγδ IE lymphocyte (IEL) landscape.

Bartonella henselaeis a zoonotic gram-negative bacteria transmitted by kittens. Bartonellainfection causes Cat Scratch Disease (CSD) which commonly presents with fever, lymphadenopathy, and granulomas within the liver and spleen. In our cases, history and examination were critical in the diagnosis as CSD is diagnosed with serology, a modality of no utility in patients with XLA. Histopathology of affected tissue should demonstrate granulomatous inflammation in immunocompetent patients and those with XLA. Warthin Starry silver stain may identify the bacteria, but organisms are often sparse and may be missed.

This article surveys important developments in the field of international commercial transactions, franchising, and distribution during late 2010 and 2011. (1) I. U.N. Convention on the Use of Electronic Communications [...]

Most people assume that insurance is an essential part of the health-care system. Some think it should be provided through public programs like Medicare, while others prefer to see it [...]

I. EC Vertical Restraints Block Exemption Regulation and Guidelines on Vertical Restraints On June 1, 2010, new European Union ("EU") competition rules on supply and distribution agreements entered into force. [...]

I. New Secured Transactions Laws and Registries in Australia, China, Cambodia, Honduras, Guatemala, Solomon Islands, and Vanuatu; Developments in Private International Law Regarding Secured Transactions With the encouragement of the [...]

Arnold Harrison addresses some of the unique issues that arise in a workout situation when real estate has been acquired by investors in a Section 1031 Program when the program [...]

Annual seasonal influenza epidemics of variable severity caused by influenza A and B virus infections result in substantial disease burden worldwide. Seasonal influenza virus circulation declined markedly in 2020–21 after SARS-CoV-2 emerged but increased in 2021–22. Most people with influenza have abrupt onset of respiratory symptoms and myalgia with or without fever and recover within 1 week, but some can experience severe or fatal complications. Prevention is primarily by annual influenza vaccination, with efforts underway to develop new vaccines with improved effectiveness. Sporadic zoonotic infections with novel influenza A viruses of avian or swine origin continue to pose pandemic threats. In this Seminar, we discuss updates of key influenza issues for clinicians, in particular epidemiology, virology, and pathogenesis, diagnostic testing including multiplex assays that detect influenza viruses and SARS-CoV-2, complications, antiviral treatment, influenza vaccines, infection prevention, and non-pharmaceutical interventions, and highlight gaps in clinical management and priorities for clinical research.

The problems in the financial sector, increasing pressure on small banks and staffing problems all played a role in the downtrend and eventual crisis of Saambou Bank in South Africa. Saambou is compared theoretically with the US Enron Corporation and the analysis presents a need for functional corporate communication to target audiences, media coverage and media management.

Lymphangioleiomyomatosis (LAM) is a disease of unknown etiology that is characterized by the proliferation of abnormal smooth muscle cells (LAM cells) in the lung, which leads to cystic parenchymal destruction [...]

Influenza vaccination may reduce the rate of influenza-like symptoms among nursing home patients. During the 1989-1990 influenza outbreak, immunized older nursing home residents in 23 Michigan homes were less likely than non-immunized residents to develop influenza-like illness. Vaccination was more effective in those less than 84 years old than in the very old. The immunologic profile in very old patients may require prophylactic drugs or alternative vaccines.