Mechanisms of preventative and therapeutic role of probiotics in different allergic and autoimmune disorders

The prevalence of allergic and autoimmune diseases has been increasing from the last decades of 20th century. Intestinal microflora contributes to antigen exposure in early life and is one of the most abundant sources of early immune stimulation as well as adaptation. Because allergic and autoimmune responses manifest early in life, there has been obvious interest in the potential benefits of modifying the gastrointestinal flora by using probiotic supplementation. So far, there have been several studies to address the role of probiotics in primary prevention and therapy, with a reported suspicious reduction in the incidence of atopic and autoimmune diseases. Here, our aim is to evaluate the available knowledge of mechanisms of preventative and therapeutic role of probiotics in different allergic and autoimmune disorders. Promising mechanisms of probiotic effects may be categorized as local and systemic effects. Local influences of probiotics potentially include reduction of gut permeability and systemic penetration of antigens, increased local immunoglobulin A production, and alteration of local inflammation or tolerance induction. Some possible systemic effects consist of anti-inflammatory effects mediated by Th17 cells and Toll-like receptors, Th1 skewing of responses to allergens, activation of tolerogenic dendritic cells, in addition to T-regulatory cell production.

The roles of bone remodeling in normal hematopoiesis and age-related hematological malignancies

Prior research establishing that bone interacts in coordination with the bone marrow microenvironment(BMME)to regulate hematopoietic homeostasis was largely based on analyses of individual bone-associated cell populations.Recent advances in intravital imaging has suggested that the expansion of hematopoietic stem cells(HSCs)and acute myeloid leukemia cells is restricted to bone marrow microdomains during a distinct stage of bone remodeling.These findings indicate that dynamic bone remodeling likely imposes additional heterogeneity within the BMME to yield differential clonal responses.A holistic understanding of the role of bone remodeling in regulating the stem cell niche and how these interactions are altered in age-related hematological malignancies will be critical to the development of novel interventions.To advance this understanding,herein,we provide a synopsis of the cellular and molecular constituents that participate in bone turnover and their known connections to the hematopoietic compartment.Specifically,we elaborate on the coupling between bone remodeling and the BMME in homeostasis and age-related hematological malignancies and after treatment with bone-targeting approaches.We then discuss unresolved questions and ambiguities that remain in the field.

DiGeorge综合征伴SAPHO性骨髓炎和类肉瘤样皮炎1例

We report the development and spontaneous resolution of annular erythematous skin lesions consistent with sarcoid dermatitis in a child with DiGeorge syndrome (DGS) carrying the 22q11.2 microdeletion. The skin lesion developed after she was treated with isoniazid (INH) following exposure to active tuberculosis (TB). After resolution of the skin lesions, this child developed sterile hyperplastic osteomyelitis consistent with SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) osteomyelitis in her right mandible triggered by an odontogenic infection. This child had congenital heart disease, dysmorphic facies, recurrent sinopulmonary infection, gastroesophgeal re- flux disease, scoliosis, reactive periostitis, and developmental delay. She had a low CD4 and CD8 T cell count with a normal 4/8 ratio, but normal cell proliferation and T cell cytokine production in response to mitogens. When she was presented with sterile osteomyelitis of right mandible, she revealed polyclonal hypergammaglobulinemia with elevated erythrocyte sedimentation rate (ESR)/ angiotensin converting enzyme (ACE) levels, but negative CRP. Autoimmune and sarcoidosis workup was negative. Inflammatory parameters gradually normalized following resolution of odontogenic infection and with the use of non- steroidal anti- inflammatory drugs (NSAIDs). The broad clinical spectrum of DGS is further expanded with the development of autoimmune and inflammatory complications later in life. This case suggests that patients with the DGS can present with unusual sterile inflammatory lesions triggered by environmental factors, further broadening the clinical spectrum of this syndrome.

腺苷脱氨酶缺陷重症联合免疫缺陷伴疫苗接种后播散性水痘感染一例

目的提高对腺苷脱氨酶（ADA）缺陷重症联合免疫缺陷（SCID）及疫苗接种后播散性水痘感染的认识。方法结合1例ADA缺陷SCID伴疫苗接种后播散性水痘感染的临床资料和文献复习，探讨ADA缺陷SCID背景知识、临床表现、诊断和治疗。结果患儿存在生长停滞情况，以发热、皮疹3周余入院，出皮疹前两周曾接种水痘疫苗，水痘直接免疫荧光试验阳性，血液常规检查淋巴细胞比例和绝对值（105×10^6／L）明显降低，IgG（1520mg／L）、IgM（250mg／L）和IgA（102mg／L）显著降低，淋巴细胞亚群CD3、CIM、CD8和CD19的相对比例和绝对值均显著降低，CD56比例升高，但其绝对值显著降低。红细胞ADA值明显降低，脱氧核苷酸腺苷明显升高。结论ADA缺陷SCID存在特征性改变，目前的治疗方法包括造血干细胞移植、酶替代治疗和基因治疗。对生长发育停滞儿童需重视免疫功能评估，对免疫缺陷病患儿需加强疫苗接种管理。

Racial differences in pet ownership in families of children with asthma

Background:Exposure to household domestic animals such as cats and dogs in early life may have some role in pathogenesis of asthma.Racial differences exist in the prevalence of asthma.We hypothesized that there may also be racial differences in pet ownership in families with asthma.Methods:A cross sectional study was conducted from June 2011 to December 2014 on 823 of 850(97%)families of children with asthma for pet ownership.Comparisons among racial groups were done using chi square analysis and one-way analysis of variance.Results:The mean age of the cohort was 6.9±4.4 years.A total of 540(65.62%)patients were Caucasian,195(23.7%)African American,42(5.1%)hispanics,and 26(3.2%)biracial with one Caucasian parent.Pets in the home were reported by 470(58.5%)households.Signifi cantly fewer African American and hispanic families had pets in the home(26.9% and 44.7%)than biracial and Caucasian families(72% and 69.9%,P<0.001).Likewise,significantly more biracial and Caucasian families were noted to have dogs(52% and 54.4%)or cats(25.4%and 40%)or both cats and dogs(28% and 18%)than African Americans families(20.3%,P<0.001;7.1%,P<0.001)and(4.6%,P<0.001),respectively.Conclusion:Among families with asthmatic children,pet ownership is significantly more likely in Caucasian families compared with African-American and Hispanic families,thus there is a racial diversity in pet ownership among families of children with asthma.