Low dose endoluminal photodynamic therapy improves murine T cell-mediated colitis.

BACKGROUND AND STUDY AIMS: Low dose photodynamic therapy (LDPDT) may modify the mucosal immune response and may thus provide a therapy for Crohn's disease. We evaluated the efficacy and safety of this technique in a murine T cell-mediated colitis model. METHODS: The safety of LDPDT was first tested in BALB/c mice. Naïve T cells were used to induce colitis in mice with severe combined immunodeficiency, which were followed up endoscopically, and a murine endoscopic index of colitis (MEIC) was developed. The efficacy of LDPDT (10 J/cm (2); delta-aminolevulinic acid, 15 mg/kg bodyweight) was then tested on mice with moderate colitis, while a disease control group received no treatment. The MEIC, weight, length, and histology of the colon, cytokine expression indices, number of mucosal CD4 (+) T cells, percentage of apoptotic CD4 (+) T cells, body weight, and systemic side effects were evaluated. RESULTS: LDPDT improved the MEIC ( P = 0.011) and the histological score ( P = 0.025), diminished the expression indices of the proinflammatory cytokines, interleukin-6 ( P = 0.042), interleukin-17 ( P = 0.029), and interferon-gamma ( P = 0.014), decreased the number of mucosal CD4 (+) T cells, and increased the percentage of apoptotic CD4 (+) T cells compared with the disease control group. No local or systemic side effects occurred. CONCLUSION: LDPDT improves murine T cell-mediated colitis, decreases the proinflammatory cytokines interleukin-6, interleukin-17, and interferon-gamma, and decreases the number of CD4 (+) T cells. No adverse events were observed. Therefore, this technique is now being evaluated in patients with inflammatory bowel disease.

Blood glucose and prognosis in children with presumed severe malaria: is there a threshold for 'hypoglycaemia'?

OBJECTIVES: Hypoglycaemia (glucose <2.2 mmol/l) is a defining feature of severe malaria, but the significance of other levels of blood glucose has not previously been studied in children with severe malaria. METHODS: A prospective study of 437 consecutive children with presumed severe malaria was conducted in Mali. We defined hypoglycaemia as <2.2 mmol/l, low glycaemia as 2.2-4.4 mmol/l and hyperglycaemia as >8.3 mmol/l. Associations between glycaemia and case fatality were analysed for 418 children using logistic regression models and a receiver operator curve (ROC). RESULTS: There was a significant difference between blood glucose levels in children who died (median 4.6 mmol/l) and survivors (median 7.6 mmol/l, P < 0.001). Case fatality declined from 61.5% of the hypoglycaemic children to 46.2% of those with low glycaemia, 13.4% of those with normal glycaemia and 7.6% of those with hyperglycaemia (P < 0.001). Logistic regression showed an adjusted odds ratio (AOR) of 0.75 (0.64-0.88) for case fatality per 1 mmol/l increase in baseline blood glucose. Compared to a normal blood glucose, hypoglycaemia and low glycaemia both significantly increased the odds of death (AOR 11.87, 2.10-67.00; and 5.21, 1.86-14.63, respectively), whereas hyperglycaemia reduced the odds of death (AOR 0.34, 0.13-0.91). The ROC [area under the curve at 0.753 (95% CI 0.684-0.820)] indicated that glycaemia had a moderate predictive value for death and identified an optimal threshold at glycaemia <6.1 mmol/l, (sensitivity 64.5% and specificity 75.1%). CONCLUSIONS: If there is a threshold of blood glucose which defines a worse prognosis, it is at a higher level than the current definition of 2.2 mmol/l.

[Archives de la Parole]. , [Parable of the prodigal son] : récit en dravidien, telugu, Province de Madras / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Présidence de Madras [i.e. Chennai]. Ceded Districts]

[Archives de la Parole]. , [Parable of the prodigal son] : récit en télougou / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]]

[Archives de la Parole]. , [Parable of the prodigal son] : récit en télougou [sic] / [Sir George Grierson], éd. ; Linguistic survey of India ; [Ranga], voix

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]. Etat du Tamil Nadu]

[Archives de la Parole]. , Pombada Songs / [Sir George Grierson], éd. ; Linguistic survey of India ; [Tyampa Pombada et Venku], voix

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]. Région de Kanara]

[Archives de la Parole]. , [Cowardice of the Bania class] : récit shindi [i.e. sindhi] / [Sir George Grierson], éd. ; Linguistic survey of India ; [Mulshankar Somjimal], voix

[Traditions. Asie. Inde. Présidence de Bombay. Pakistan. Province du Sind. Tharparkar]

[Archives de la Parole]. , [Parable of the prodigal son] : récit en hindoustani [mēwātī] / [Sir George Grierson], éd. ; Linguistic survey of India ; [Jainti Pershad], voix

[Traditions. Asie. Inde. Province de Delhi]

[Archives de la Parole]. , Récit en hindoustani [urdū] / [Sir George Grierson], éd. ; Linguistic survey of India ; [Baqir Ali], voix

[Traditions. Asie. Inde. Province de Delhi]

[Archives de la Parole]. , [Parable of the prodigal son] : Récit en hindoustani / [Sir George Grierson], éd. ; Linguistic survey of India ; [Jainti Pershad], voix

[Traditions. Asie. Inde. Province de Delhi]