Epatite E: ruolo del suino nella trasmissione dell'infezione all'uomo, studio di prevalenza in aree rurali della Bolivia

L’infezione da virus dell’ epatite E (HEV) nei suini e nell’uomo è stata segnalata in diversi Paesi. Nei suini, il virus causa infezioni asintomatiche, mentre nell’uomo è responsabile di epidemie di epatite ad andamento acuto nei Paesi a clima tropicale o subtropicale con condizioni igieniche scadenti, di casi sporadici in quelli sviluppati. HEV è stato isolato anche in diversi animali e l’analisi nucleotidica degli isolati virali di origine animale ha mostrato un elevato grado di omologia con i ceppi di HEV umani isolati nelle stesse aree geografiche, avvalorando l’ipotesi che l'infezione da HEV sia una zoonosi. In America del Sud HEV suino è stato isolato per la prima volta in suini argentini nel 2006, mentre solo dal 1998 esistono dati sull’ infezione da HEV nell’uomo in Bolivia. In questa indagine è stato eseguito uno studio di sieroprevalenza in due comunità rurali boliviane e i risultati sono stati confrontati con quelli dello studio di sieroprevalenza sopra menzionato condotto in altre zone rurali della Bolivia. Inoltre, mediante Nested RT-PCR, è stata verificata la presenza di HEV nella popolazione umana e suina. La sieroprevalenza per anticorpi IgG anti-HEV è risultata pari al 6,2%, molto simile a quella evidenziata nello studio precedente. La prevalenza maggiore (24%) si è osservata nei soggetti di età compresa tra 41 e 50 anni, confermando che l’ infezione da HEV è maggiore fra i giovani-adulti. La ricerca di anticorpi anti HEV di classe IgM eseguita su 52 sieri ha fornito 4 risultati positivi. Il genoma virale è stato identificato in uno dei 22 pool di feci umane e l'esame virologico di 30 campioni individuali fecali e 7 individuali di siero ha fornito rispettivamente risultati positivi in 4/30 e 1/7. La Nested RT-PCR eseguita sui 22 pool di feci suine ha dato esito positivo in 7 pool. L’analisi delle sequenze genomiche di tutti gli amplificati ha consentito di stabilire che gli isolati umani appartenevano allo stesso genotipo III di quelli suini e presentavano con questi una elevata omologia aminoacidica (92%).

Klonierung und Charakterisierung eines Konsensusgenoms des Hepatitis C Virus als Grundlage der Etablierung eines Zellkultursystems

Das Hepatitis C Virus (HCV) ist der Haupterreger der parenteral übertragenen non-A non-B Hepatitis. Bisher wurde die Erforschung der Replikation und Pathogenese des HCV durch das Fehlen eines effizienten und verläßlichen Zellkultursystems behindert.Virale RNA aus infizierten humanen Leberzellen wurde isoliert und kloniert. Mit Hilfe eines Vergleichs mehrerer Klone wurde eine isolatspezifische Konsensussequenz bestimmt, auf deren Basis ein Konsensusgenom konstruiert wurde. Mit dem Konsensusgenom als Grundlage wurden subgenomische RNA-Moleküle, sogenannte „selektionierbare Replikons“ hergestellt. Nach Transfektion der Replikons in humane HuH-7 Hepatoma-Zellen konnte gezeigt werden, daß die Replikons autonom und in hohem Maße in den Wirtszellen replizierten.Die Arbeit definiert die Struktur von HCV-Replikons, die in Zellkultur funktionell sind. Damit wird die Basis für ein lange gesuchtes HCV-Zellkultursystem geschaffen, welches das Studium der HCV-Replikation im Detail und die Entwicklung antiviral wirksamer Substanzen ermöglicht.

Etablierung eines humanisierten Mausmodells zur In-vivo-Analyse von DC-adressierenden Nanopartikeln

In dieser Arbeit wurde zunächst ein humanisiertes Mausmodell entwickelt für die Analyse von humanen DCs in vivo. Darüber hinaus wurden erste Versuche mit Nanopartikelbeladenen DCs durchgeführt, mit der Intention, durch diese Kombination humane DCs zu untersuchen. Es wurden immunsupprimierte NOD/LtSz-scid IL2R (NSG) Mäuse verwendet und mit humanen CD34+ PBSCs transplantiert. Es wurden insgesamt 14 Modelle getestet, mit einer durchschnittlichen Humanisierungsrate von 76 %. In allen Modellen konnten ab Woche sechs nach Transplantation humane CD45+ Zellen sowie humane Bund NK-Zellen und CD14+ Monozyten gefunden werden. Darüber hinaus waren myeloide DC-Vorläuferzellen, konventionelle HLA DR CD11c DCs (cDCs) und plasmazytoide DCs (pDCs) vorhanden. Humane T-Zellen konnten nicht vor Woche 18 nach Transplantation beobachtet werden. Neben der Rekonstitution humaner DCs in peripheren Organen, wurde ebenfalls nach gewebsständigen DCs, insbesondere den Langerhans Zellen (LCs) der Epidermis geschaut. Waren humane LC vorhanden, konnten diese ab Woche zwölf nach Transplantation in der murinen Epidermis detektiert werden. Diese waren konstant bis in Woche 30 nach Transplantation nachweisbar. In Hinblick auf die Etablierung der DCs in diesem humanisierten Mausmodells wurden verschiedene Einflussgrößen getestet. IL-7 führte zu keiner veränderten Hämatopoese, wohingegen Flt3L zu einer Zunahme von CD14+ Monozyten und cDCs führte. Darüber hinaus konnte eine drastische Abnahmernhumaner B-Zellen beobachtet werden. Es zeigte sich, dass der Zeitpunkt der Flt3LrnApplikation einen entscheidenen Faktor für den Effekt von Flt3L auf die Rekonstitution humaner Zellen darstellt. Für die in dieser Arbeit durchgeführten funktionellen in vivo Studien, wurden humanisierten Mäusen alloreaktive CD8+ T-Zellen appliziert. Somit sollte die Funktionalität der rekonstituierten humanen APCs getestet werden. Es wurde deutlich, dass Monozyten und DCs ihre Funktionalität erst ab Woche 14 nach Transplantation zu entwickeln schienen,rnwohingegen B-Zellen bereits zu früheren Zeitpunkten als Zielzellen für die alloreaktiven T-Zellen dienten. Dies wurde durch den Rückgang der jeweiligen Zellen nach Applikation der T-Zellen sichtbar. Zu erwähnen ist, dass das Anwachsen einer humanen Hämatopoese stark spenderabhängig ist und somit keine allgemeingültigen Aussagen hinsichtlich der in vivo Funktion getroffen werden können. Um im Gewebe verbliebende APCs zu manipulieren gibt es verschiedene Möglichkeiten. Im Rahmen dieser Arbeit wurden auf Polystyren-basierende Nanopartikel getestet. Die verwendeten Partikel hatten eine Größe von 80 bis 160 nm und waren unfunktionalisiert oder mit Amino- bzw. Carboxy-Gruppen versehen. Zusätzlich wurden die Partikel mit BODIPY (Durchflusszytometrie und kLSM-Messungen), einem Infrarotnahem Farbstoff IR 780 (BFI-Messungen) und Platin (in vivo Messungen) beladen. Der Carboxy-funktionalisierte Partikel zeigte den geringsten Einfluss auf die Vitalität von humanen DCs, wohingegen der Amino-funktionalisierte Partikel bei steigender Konzentration toxisch wirkte. Bei unfunktionalisierten Partikeln stieg die Toxizität bei zunehmender Konzentration. Hinsichtlich der Expression diverser DC spezifischer Oberflächenmoleküle nach Beladung mit Nanopartikeln zeigte sich, dass allein der unfunktionalisierte, mit Lutensol AT50 hergestellte Partikel zu einer leichten Hochregulation von MHC-Klasse-II Molekülen führte. Die Expression von CD86 wurde im Gegenzug nur durch die Beladung mit den Amino-, bzw. Carboxy funktionalisierten Partikeln und dem unfunktionalisierten, mit SDS hergestellten Partikel leicht gesteigert. Trotz der teilweise leicht veränderten Expression von Oberflächenmarkern, konnte mit Hilfe von IFN-g ELISpots keine Beeinflussungrnder Funktion als APCs von Nanopartikel-beladenen DCs beobachtet werden. In den in vivo Untersuchungen zeigten alle vier Partikel eine konstante Zirkulation imrnOrganismus und konnten bis 96 h nach Applikation nachgewiesen werden. Alle Partikel konnten primär in der Leber detektiert werden, wobei der unfunktionalisierte, mit Lutensol AT50 hergestelle Partikel das weiteste Verbreitungsmuster zeigte. Erste Versuche im humanisierten Mausmodell zeigten keine Beeinflussung der Verteilung und Kinetik von Nanopartikeln durch die humane Hämatopoese. Mit dem in dieser Arbeit etablierten humanisierten Mausmodell ist es möglich, die Entwicklung, Differenzierung, Aktivierung und Funktionalität humaner DCs in vivo zu untersuchen. Darüber hinaus kann das gezielte Adressieren von DCs in vivo analysiert werden, was sowohl die Möglichkeit der Manipulation von DCs zur Vermeidung einer akuten GvHD bietet als auch Verwendung in anderen DC-vermittelten Therapien (z.B.Vakzinationsstudien) findet.

Immune response to influenza vaccination in children treated with methotrexate or/and tumor necrosis factor-alpha inhibitors

In children treated with immunosuppressive medication such as methotrexate and tumor necrosis factor-alpha (TNF-α) inhibitors, additional immunizations are recommended because of increased susceptibility to infections. However, it is unclear if adequate antibody response to vaccinations can be established in children receiving methotrexate and/or TNF-α inhibitors. In a prospective open label study, we assessed seroprotection and seroconversion following influenza vaccination during 2 seasons (6 strains) in 36 children with autoimmune disease treated either with methotrexate (n=18), TNF-α inhibitors (n=10) or both (n=8) and a control group of 16 immunocompetent children. Influenza antibody titers were determined by hemagglutinin inhibition assay, before and 4-8 weeks after vaccination. Post-vaccination seroprotection (defined as a titer ≥1:40) did not significantly differ between immunosuppressed and immunocompetent subjects. Seroconversion, defined as the change from a nonprotective (< 1:40) to a protective titer (≥1:40) with at least a 4-fold titer increase, was less likely to occur in immunosuppressed patients, although no significant difference from the control group was established. Safety evaluation of vaccination showed no serious adverse events. Children receiving methotrexate and/or TNF-α inhibitors can be safely and effectively immunized against influenza, with a seroprotection after vaccination comparable to immunocompetent children.

Time course based artifact identification for independent components of resting-state FMRI

In functional magnetic resonance imaging (fMRI) coherent oscillations of the blood oxygen level-dependent (BOLD) signal can be detected. These arise when brain regions respond to external stimuli or are activated by tasks. The same networks have been characterized during wakeful rest when functional connectivity of the human brain is organized in generic resting-state networks (RSN). Alterations of RSN emerge as neurobiological markers of pathological conditions such as altered mental state. In single-subject fMRI data the coherent components can be identified by blind source separation of the pre-processed BOLD data using spatial independent component analysis (ICA) and related approaches. The resulting maps may represent physiological RSNs or may be due to various artifacts. In this methodological study, we propose a conceptually simple and fully automatic time course based filtering procedure to detect obvious artifacts in the ICA output for resting-state fMRI. The filter is trained on six and tested on 29 healthy subjects, yielding mean filter accuracy, sensitivity and specificity of 0.80, 0.82, and 0.75 in out-of-sample tests. To estimate the impact of clearly artifactual single-subject components on group resting-state studies we analyze unfiltered and filtered output with a second level ICA procedure. Although the automated filter does not reach performance values of visual analysis by human raters, we propose that resting-state compatible analysis of ICA time courses could be very useful to complement the existing map or task/event oriented artifact classification algorithms.

Non-invasive brain stimulation in neglect rehabilitation: an update

Here, we review the effects of non-invasive brain stimulation such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) in the rehabilitation of neglect. We found 12 studies including 172 patients (10 TMS studies and 2 tDCS studies) fulfilling our search criteria. Activity of daily living measures such as the Barthel Index or, more specifically for neglect, the Catherine Bergego Scale were the outcome measure in three studies. Five studies were randomized controlled trials with a follow-up time after intervention of up to 6 weeks. One TMS study fulfilled criteria for Class I and one for Class III evidence. The studies are heterogeneous concerning their methodology, outcome measures, and stimulation parameters making firm comparisons and conclusions difficult. Overall, there are however promising results for theta-burst stimulation, suggesting that TMS is a powerful add-on therapy in the rehabilitation of neglect patients.

Repeated measurements of cerebral blood flow in the left superior temporal gyrus reveal tonic hyperactivity in patients with auditory verbal hallucinations: a possible trait marker

Background: The left superior temporal gyrus (STG) has been suggested to play a key role in auditory verbal hallucinations (AVH) in patients with schizophrenia. Methods: Eleven medicated subjects with schizophrenia and medication-resistant AVH and 19 healthy controls underwent perfusion magnetic resonance (MR) imaging with arterial spin labeling (ASL). Three additional repeated measurements were conducted in the patients. Patients underwent a treatment with transcranial magnetic stimulation (TMS) between the first 2 measurements. The main outcome measure was the pooled cerebral blood flow (CBF), which consisted of the regional CBF measurement in the left STG and the global CBF measurement in the whole brain. Results: Regional CBF in the left STG in patients was significantly higher compared to controls (p < 0.0001) and to the global CBF in patients (p < 0.004) at baseline. Regional CBF in the left STG remained significantly increased compared to the global CBF in patients across time (p < 0.0007), and it remained increased in patients after TMS compared to the baseline CBF in controls (p < 0.0001). After TMS, PANSS (p = 0.003) and PSYRATS (p = 0.01) scores decreased significantly in patients. Conclusions: This study demonstrated tonically increased regional CBF in the left STG in patients with schizophrenia and auditory hallucinations despite a decrease in symptoms after TMS. These findings were consistent with what has previously been termed a trait marker of AVH in schizophrenia.

Gaze perception in social anxiety and social anxiety disorder

Clinical observations suggest abnormal gaze perception to be an important indicator of social anxiety disorder (SAD). Experimental research has yet paid relatively little attention to the study of gaze perception in SAD. In this article we first discuss gaze perception in healthy human beings before reviewing self-referential and threat-related biases of gaze perception in clinical and non-clinical socially anxious samples. Relative to controls, socially anxious individuals exhibit an enhanced self-directed perception of gaze directions and demonstrate a pronounced fear of direct eye contact, though findings are less consistent regarding the avoidance of mutual gaze in SAD. Prospects for future research and clinical implications are discussed.

A new methodical approach in neuroscience: assessing inter-personal brain coupling using functional near-infrared imaging (fNIRI) hyperscanning

Since the first demonstration of how to simultaneously measure brain activity using functional magnetic resonance imaging (fMRI) on two subjects about 10 years ago, a new paradigm in neuroscience is emerging: measuring brain activity from two or more people simultaneously, termed "hyperscanning". The hyperscanning approach has the potential to reveal inter-personal brain mechanisms underlying interaction-mediated brain-to-brain coupling. These mechanisms are engaged during real social interactions, and cannot be captured using single-subject recordings. In particular, functional near-infrared imaging (fNIRI) hyperscanning is a promising new method, offering a cost-effective, easy to apply and reliable technology to measure inter-personal interactions in a natural context. In this short review we report on fNIRI hyperscanning studies published so far and summarize opportunities and challenges for future studies.

The shape of a bone scraper: an in vitro pilot study using porcine bone chips.

Bone scrapers are commonly used to harvest autologous bone in oral and implant surgery. The angle of the cutting blade is a variable that distinguishes bone scrapers. In the present study, the impact of the angle of the cutting blade on the in vitro characteristics of harvested bone was determined. Bone scrapers with blade angles of 15°, 25°, 35°, 45°, and 55° were used to harvest porcine cortical mandibular bone. The number and characteristics of the cells that grew out from the bone chips were examined. The data showed that, independent of the angle of the cutting blade, viable cells were barely detectable in fresh bone grafts. However, cells with a fibroblastic morphology appeared within 1 week in the culture dishes. After 21 days, the number of cells did not differ significantly between the five preparations. Moreover, cells responded to incubation with bone morphogenetic protein 7 (BMP-7) with an increased alkaline phosphatase activity, irrespective of the preparation. The data suggest that bone scrapers with different cutting angles produce bone chips with comparable in vitro characteristics.

Varying expectancies and attention bias in phobic and non-phobic individuals.

Phobic individuals display an attention bias to phobia-related information and biased expectancies regarding the likelihood of being faced with such stimuli. Notably, although attention and expectancy biases are core features in phobia and anxiety disorders, these biases have mostly been investigated separately and their causal impact has not been examined. We hypothesized that these biases might be causally related. Spider phobic and low spider fearful control participants performed a visual search task in which they specified whether the deviant animal in a search array was a spider or a bird. Shorter reaction times (RTs) for spiders than for birds in this task reflect an attention bias toward spiders. Participants' expectancies regarding the likelihood of these animals being the deviant in the search array were manipulated by presenting verbal cues. Phobics were characterized by a pronounced and persistent attention bias toward spiders; controls displayed slower RTs for birds than for spiders only when spider cues had been presented. More important, we found RTs for spider detections to be virtually unaffected by the expectancy cues in both groups, whereas RTs for bird detections showed a clear influence of the cues. Our results speak to the possibility that evolution has formed attentional systems that are specific to the detection of phylogenetically salient stimuli such as threatening animals; these systems may not be as penetrable to variations in (experimentally induced) expectancies as those systems that are used for the detection of non-threatening stimuli. In sum, our findings highlight the relation between expectancies and attention engagement in general. However, expectancies may play a greater role in attention engagement in safe environments than in threatening environments.

Visual avoidance in phobia: particularities in neural activity, autonomic responding, and cognitive risk evaluations.

We investigated the neural mechanisms and the autonomic and cognitive responses associated with visual avoidance behavior in spider phobia. Spider phobic and control participants imagined visiting different forest locations with the possibility of encountering spiders, snakes, or birds (neutral reference category). In each experimental trial, participants saw a picture of a forest location followed by a picture of a spider, snake, or bird, and then rated their personal risk of encountering these animals in this context, as well as their fear. The greater the visual avoidance of spiders that a phobic participant demonstrated (as measured by eye tracking), the higher were her autonomic arousal and neural activity in the amygdala, orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and precuneus at picture onset. Visual avoidance of spiders in phobics also went hand in hand with subsequently reduced cognitive risk of encounters. Control participants, in contrast, displayed a positive relationship between gaze duration toward spiders, on the one hand, and autonomic responding, as well as OFC, ACC, and precuneus activity, on the other hand. In addition, they showed reduced encounter risk estimates when they looked longer at the animal pictures. Our data are consistent with the idea that one reason for phobics to avoid phobic information may be grounded in heightened activity in the fear circuit, which signals potential threat. Because of the absence of alternative efficient regulation strategies, visual avoidance may then function to down-regulate cognitive risk evaluations for threatening information about the phobic stimuli. Control participants, in contrast, may be characterized by a different coping style, whereby paying visual attention to potentially threatening information may help them to actively down-regulate cognitive evaluations of risk.