Objective: The purpose of this study was to determine the incidence of ultrasonographically detected cerebral white matter lesions (WMLs) in preterm twins at birth in relation to chorionicity, discordant weight and tw...Objective: The purpose of this study was to determine the incidence of ultrasonographically detected cerebral white matter lesions (WMLs) in preterm twins at birth in relation to chorionicity, discordant weight and twin- twin transfusion syndrome (TTTS). Methods: In this retrospective study, perinatal, neonatal, and cranial scan data of 85 monochorionic (MC) and 94 dichorionic (DC) twin pregnancies (341 infants) delivered between 24 and 34 weeks of gestation were collected. Data were analysed according to chorionicity, discordant birth weight (>20% ), single intrauterine death and TTTS. Results: The cerebral WML was seen in 14% of preterm twins. Monochorionic infants had higher risks of WML than DC twin (odds ratio 7.1; 95% CI 3.28- 15.8). In MC group, discordant weight (37% )- , TTTS (38% ), single intrauterine death (67% ) had higher incidence of cerebral WML than concordant weight infants (7% ). Similarly, incidence of WML was higher in DC discordant compared with concordant weight infants (13% versus 2% ; P <.0.05). Conclusion: Monochorionic infants had a seven- fold higher incidence of cerebral WML than DC infants. Discordant birth weight, TTTS and survivor of co- twin demise are an independent risk of cerebral white matter lesion.展开更多
Virus-specific CD8+T cell responses play an important role in the natural course of infection;however,the impact of certain CD8+T cell responses in determining clinical outcome has not been fully defined.A well-define...Virus-specific CD8+T cell responses play an important role in the natural course of infection;however,the impact of certain CD8+T cell responses in determining clinical outcome has not been fully defined.A well-defined cohort of women inoculated with HCV from a single source showed that HLAB27 has a strong association with spontaneous clearance.The immunological basis for this association is unknown.However,the finding is especially significant because HLA-B27 has also been shown to have a protective role in HIV infection.We report the identification of an HLA-B27 restricted hepatitis C virus(HCV)specific CD8+T cell epitope that is recognized in the majority of recovered HLA-B27 positive women.In chronically HCV-infected individuals,analysis of the corresponding viral sequence showed a strong association between sequence variations within this epitope and expression of HLA-B27,indicating allele-specific selection pressure at the population level.Functional analysis in 3 chronically HCV-infected patients showed that the emerging variant viral epitopes represent escape mutations.In conclusion,our results suggest a dominant role of HLA-B27 in mediating spontaneous viral clearance as well as viral evolution in HCV infection and mechanistically link both associations to a dominant novel CD8+T cell epitope.These results support the central role of virus-specific CD8+T cells and the genetically determined restriction of the virus-specific T cell repertoire in HCV infection.展开更多
文摘Objective: The purpose of this study was to determine the incidence of ultrasonographically detected cerebral white matter lesions (WMLs) in preterm twins at birth in relation to chorionicity, discordant weight and twin- twin transfusion syndrome (TTTS). Methods: In this retrospective study, perinatal, neonatal, and cranial scan data of 85 monochorionic (MC) and 94 dichorionic (DC) twin pregnancies (341 infants) delivered between 24 and 34 weeks of gestation were collected. Data were analysed according to chorionicity, discordant birth weight (>20% ), single intrauterine death and TTTS. Results: The cerebral WML was seen in 14% of preterm twins. Monochorionic infants had higher risks of WML than DC twin (odds ratio 7.1; 95% CI 3.28- 15.8). In MC group, discordant weight (37% )- , TTTS (38% ), single intrauterine death (67% ) had higher incidence of cerebral WML than concordant weight infants (7% ). Similarly, incidence of WML was higher in DC discordant compared with concordant weight infants (13% versus 2% ; P <.0.05). Conclusion: Monochorionic infants had a seven- fold higher incidence of cerebral WML than DC infants. Discordant birth weight, TTTS and survivor of co- twin demise are an independent risk of cerebral white matter lesion.
文摘Virus-specific CD8+T cell responses play an important role in the natural course of infection;however,the impact of certain CD8+T cell responses in determining clinical outcome has not been fully defined.A well-defined cohort of women inoculated with HCV from a single source showed that HLAB27 has a strong association with spontaneous clearance.The immunological basis for this association is unknown.However,the finding is especially significant because HLA-B27 has also been shown to have a protective role in HIV infection.We report the identification of an HLA-B27 restricted hepatitis C virus(HCV)specific CD8+T cell epitope that is recognized in the majority of recovered HLA-B27 positive women.In chronically HCV-infected individuals,analysis of the corresponding viral sequence showed a strong association between sequence variations within this epitope and expression of HLA-B27,indicating allele-specific selection pressure at the population level.Functional analysis in 3 chronically HCV-infected patients showed that the emerging variant viral epitopes represent escape mutations.In conclusion,our results suggest a dominant role of HLA-B27 in mediating spontaneous viral clearance as well as viral evolution in HCV infection and mechanistically link both associations to a dominant novel CD8+T cell epitope.These results support the central role of virus-specific CD8+T cells and the genetically determined restriction of the virus-specific T cell repertoire in HCV infection.
