Background and Purpose:Multiple studies have suggested an association between Chlamydia pneumoniae and Mycoplasma pneumoniae infectio n and cardiovascular disease. We investigated whether the risk of cerebrovascula r ...Background and Purpose:Multiple studies have suggested an association between Chlamydia pneumoniae and Mycoplasma pneumoniae infectio n and cardiovascular disease. We investigated whether the risk of cerebrovascula r disease is associated with Legionella pneumophila infection and the aggregate number/infectious burden of these atypical respiratory pathogens.Methods:One hu ndred patients aged >65 years admitted with acute stroke or transient ischemic a ttack (TIA) and 87 control patients admitted concurrently with acute noncardiopu lmonary,noninfective conditions were recruited prospectively. Using enzyme-link ed immunosorbent assay (ELISA) kits, we previously reported the seroprevalences of C pneumoniae and M pneumoniae in these patients. We have now determined these roprevalences of L pneumophila IgG and IgM in this cohort of patients using ELI SA. Results:The seroprevalences of L pneumophila IgG and IgM were 29%(n=91) an d 12%(n=81) in the stroke/TIA group and 22%(n=86) and 10%(n=72) in the contro ls, respectively. Using logistic regression to adjust for age, sex, hypertension , smoking, diabetes, ischemic heart disease, and ischemic ECG, the odds ratios f or stroke/TIA in relation to L pneumophila IgG and IgM were 1.52 (95%CI,0.70 to 3.28; P=0.29) and 1.49 (95%CI, 0.45 to 4.90; P=0.51),respectively. The odds ra tios in relation to IgG seropositivity for 1, 2, or 3 atypical respiratory patho gens after adjustment were 3.89 (95%CI, 1.13 to 13.33), 2.00 (95%CI, 0.64 to 6 .21), and 6.67 (95%CI, 1.22 to 37.04), respectively (P=0.06).Conclusions:L pne umophila seropositivity is not significantly associated with stroke/TIA. However , the risk of stroke/TIA appears to be associated with the aggregate number of c hronic infectious burden of atypical respiratory pathoeens such as C pneumoniae, M pneumoniae, and L pneumophila.展开更多
Context: The “ hygiene hypothesis" has implicated sibship as a marker of infection load during early life and suggests that exposure or reexposure to infections can influence the developing immune system. Viral ...Context: The “ hygiene hypothesis" has implicated sibship as a marker of infection load during early life and suggests that exposure or reexposure to infections can influence the developing immune system. Viral infection has also been implicated in the pathogenesis of multiple sclerosis (MS). Abstract:Objectives: To evaluate whether exposure to infant siblings in early life is associated with the risk of MS, and to explore the possible mechanism for any apparent protective effect, including altered Epstein- Barr virus (EBV) infection patterns. Design, Setting, and Patients: Population- based case- control study in Tasmania, Australia, from 1999 to 2001 based on 136 cases of magnetic resonance imaging- confirmed MS and 272 community controls, matched on sex and year of birth. Main Outcome Measure: Risk of MS by duration of contact with younger siblings aged less than 2 years in the first 6 years of life. Results: Increasing duration of contact with a younger sibling aged less than 2 years in the first 6 years of life was associated with reduced MS risk (adjusted odds ratios [AORs]: < 1 infant- year, 1.00 [reference]; 1 to < 3 infant- years, 0.57 [95% confidence interval {CI}, 0.33- 0.98]; 3 to < 5 infant- years, 0.40 [95% CI, 0.19- 0.92]; ≥ 5 infantyears, 0.12 [95% CI, 0.02- 0.88]; test for trend, P=.002). A history of exposure to infant siblings was associated with a reduced IgG response to EBV among controls. Controls with at least 1 infant- year contact had a reduced risk of infectious mononucleosis and a reduced risk of very high composite EBV IgG titers (AOR, 0.33; 95% CI, 0.11- 0.98) compared with other controls. The inverse association between higher infant contact and MS was independent of EBV IgG titer. Conclusion: Higher infant sibling exposure in the first 6 years of life was associated with a reduced risk of MS, possibly by altering childhood infection patterns and related immune responses.展开更多
AIM： To characterize the peripheral T-cell subpopulation profiles and their correlation with hepatitis B virus （HBV） replication in different dinical stages of chronic HBV infection. METHODS： A total of 422 patien...AIM： To characterize the peripheral T-cell subpopulation profiles and their correlation with hepatitis B virus （HBV） replication in different dinical stages of chronic HBV infection. METHODS： A total of 422 patients with chronic HBV infection were enrolled in this study. The patients were divided into three stages： immune-tolerant stage, immune active stage, and immune-inactive carrier stage. Composition of peripheral T-cell subpopulations was determined by flow cytometry. HBV markers were detected by enzyme-linked immunosorbent assay. Serum HBV DNA load was assessed by quantitative real-time poiymerase chain reaction.RESULTS： CD8^＋ T-cells were significantly higher in patients at the immune-tolerant stage than in patients at the immune-active and -inactive carrier stages （36.87 ± 7.58 vs 34.37 ± 9.07, 36.87 ± 7.58 vs 28.09 ± 5.64, P 〈 0.001）. The peripheral blood in patients at the immune-tolerant and immune active stages contained more CD8^＋ T-cells than CD4^＋ T-cells （36.87 ± 7.58 vs 30.23 ± 6.35, 34.37 ± 9.07 vs 30.92 ± 7.40, P 〈 0.01）, whereas the peripheral blood in patients at the immune- inactive carrier stage and in normal controls contained less CD8^＋ T-cells than CD4^＋ T-cells （28.09 ± 5.64 vs 36.85 ±6.06, 24.02 ± 4.35 vs 38.94 ± 3.39, P 〈 0.01）. ANOVA linear trend test showed that CD8^＋ T-cells were significantly increased in patients with a high viral load （39.41 ± 7.36, 33.83 ± 7.50, 31.81 ± 5.95 and 26.89 ± 5.71, P 〈 0.001）, while CD4^＋ T-cells were significantly increased in patients with a low HBV DNA load （37.45 ± 6.24, 33.33 ± 5.61, 31.58 ± 6.99 and 27.56 ± 5.49, P 〈 0.001）. Nultiple regression analysis displayed that log copies of HBV DNA still maintained its highly significant coefficients for T-cell subpopulations, and was the strongest predictors for variations in CD3^＋, CD4^＋ and CD8^＋ cells and CD4^＋/CD8^＋ ratio after adjustment for age at HBV-infection, maternal HBV-infection status, presence of hepatitis B e antigen and HBV mutation.CONCLUSION： Differences in peripheral T-cell subpopulation profiles can be found in different clinical stages of chronic HBV infection. T-cell impairment is significantly associated with HBV load.展开更多
文摘Background and Purpose:Multiple studies have suggested an association between Chlamydia pneumoniae and Mycoplasma pneumoniae infectio n and cardiovascular disease. We investigated whether the risk of cerebrovascula r disease is associated with Legionella pneumophila infection and the aggregate number/infectious burden of these atypical respiratory pathogens.Methods:One hu ndred patients aged >65 years admitted with acute stroke or transient ischemic a ttack (TIA) and 87 control patients admitted concurrently with acute noncardiopu lmonary,noninfective conditions were recruited prospectively. Using enzyme-link ed immunosorbent assay (ELISA) kits, we previously reported the seroprevalences of C pneumoniae and M pneumoniae in these patients. We have now determined these roprevalences of L pneumophila IgG and IgM in this cohort of patients using ELI SA. Results:The seroprevalences of L pneumophila IgG and IgM were 29%(n=91) an d 12%(n=81) in the stroke/TIA group and 22%(n=86) and 10%(n=72) in the contro ls, respectively. Using logistic regression to adjust for age, sex, hypertension , smoking, diabetes, ischemic heart disease, and ischemic ECG, the odds ratios f or stroke/TIA in relation to L pneumophila IgG and IgM were 1.52 (95%CI,0.70 to 3.28; P=0.29) and 1.49 (95%CI, 0.45 to 4.90; P=0.51),respectively. The odds ra tios in relation to IgG seropositivity for 1, 2, or 3 atypical respiratory patho gens after adjustment were 3.89 (95%CI, 1.13 to 13.33), 2.00 (95%CI, 0.64 to 6 .21), and 6.67 (95%CI, 1.22 to 37.04), respectively (P=0.06).Conclusions:L pne umophila seropositivity is not significantly associated with stroke/TIA. However , the risk of stroke/TIA appears to be associated with the aggregate number of c hronic infectious burden of atypical respiratory pathoeens such as C pneumoniae, M pneumoniae, and L pneumophila.
文摘Context: The “ hygiene hypothesis" has implicated sibship as a marker of infection load during early life and suggests that exposure or reexposure to infections can influence the developing immune system. Viral infection has also been implicated in the pathogenesis of multiple sclerosis (MS). Abstract:Objectives: To evaluate whether exposure to infant siblings in early life is associated with the risk of MS, and to explore the possible mechanism for any apparent protective effect, including altered Epstein- Barr virus (EBV) infection patterns. Design, Setting, and Patients: Population- based case- control study in Tasmania, Australia, from 1999 to 2001 based on 136 cases of magnetic resonance imaging- confirmed MS and 272 community controls, matched on sex and year of birth. Main Outcome Measure: Risk of MS by duration of contact with younger siblings aged less than 2 years in the first 6 years of life. Results: Increasing duration of contact with a younger sibling aged less than 2 years in the first 6 years of life was associated with reduced MS risk (adjusted odds ratios [AORs]: < 1 infant- year, 1.00 [reference]; 1 to < 3 infant- years, 0.57 [95% confidence interval {CI}, 0.33- 0.98]; 3 to < 5 infant- years, 0.40 [95% CI, 0.19- 0.92]; ≥ 5 infantyears, 0.12 [95% CI, 0.02- 0.88]; test for trend, P=.002). A history of exposure to infant siblings was associated with a reduced IgG response to EBV among controls. Controls with at least 1 infant- year contact had a reduced risk of infectious mononucleosis and a reduced risk of very high composite EBV IgG titers (AOR, 0.33; 95% CI, 0.11- 0.98) compared with other controls. The inverse association between higher infant contact and MS was independent of EBV IgG titer. Conclusion: Higher infant sibling exposure in the first 6 years of life was associated with a reduced risk of MS, possibly by altering childhood infection patterns and related immune responses.
文摘AIM： To characterize the peripheral T-cell subpopulation profiles and their correlation with hepatitis B virus （HBV） replication in different dinical stages of chronic HBV infection. METHODS： A total of 422 patients with chronic HBV infection were enrolled in this study. The patients were divided into three stages： immune-tolerant stage, immune active stage, and immune-inactive carrier stage. Composition of peripheral T-cell subpopulations was determined by flow cytometry. HBV markers were detected by enzyme-linked immunosorbent assay. Serum HBV DNA load was assessed by quantitative real-time poiymerase chain reaction.RESULTS： CD8^＋ T-cells were significantly higher in patients at the immune-tolerant stage than in patients at the immune-active and -inactive carrier stages （36.87 ± 7.58 vs 34.37 ± 9.07, 36.87 ± 7.58 vs 28.09 ± 5.64, P 〈 0.001）. The peripheral blood in patients at the immune-tolerant and immune active stages contained more CD8^＋ T-cells than CD4^＋ T-cells （36.87 ± 7.58 vs 30.23 ± 6.35, 34.37 ± 9.07 vs 30.92 ± 7.40, P 〈 0.01）, whereas the peripheral blood in patients at the immune- inactive carrier stage and in normal controls contained less CD8^＋ T-cells than CD4^＋ T-cells （28.09 ± 5.64 vs 36.85 ±6.06, 24.02 ± 4.35 vs 38.94 ± 3.39, P 〈 0.01）. ANOVA linear trend test showed that CD8^＋ T-cells were significantly increased in patients with a high viral load （39.41 ± 7.36, 33.83 ± 7.50, 31.81 ± 5.95 and 26.89 ± 5.71, P 〈 0.001）, while CD4^＋ T-cells were significantly increased in patients with a low HBV DNA load （37.45 ± 6.24, 33.33 ± 5.61, 31.58 ± 6.99 and 27.56 ± 5.49, P 〈 0.001）. Nultiple regression analysis displayed that log copies of HBV DNA still maintained its highly significant coefficients for T-cell subpopulations, and was the strongest predictors for variations in CD3^＋, CD4^＋ and CD8^＋ cells and CD4^＋/CD8^＋ ratio after adjustment for age at HBV-infection, maternal HBV-infection status, presence of hepatitis B e antigen and HBV mutation.CONCLUSION： Differences in peripheral T-cell subpopulation profiles can be found in different clinical stages of chronic HBV infection. T-cell impairment is significantly associated with HBV load.
