Clinical and Immunological Characteristics of Patients With Adenovirus Infection at Different Altitude Areas in Tibet, China

BackgroundThe severities of human adenovirus (HAdV) infection are diverse in different areas of Tibet, China, where a large altitude span emerges. Serious consequences may be caused by medical staff if the clinical stages and immunological conditions of patients in high-altitude areas are misjudged. However, the clinical symptoms, immunological characteristics, and environmental factors of HAdV infection patients at different altitude areas have not been well described.MethodsIn this retrospective, multicenter cohort study, we analyzed the data of patients who were confirmed HAdV infection by PCR tests in the General Hospital of Tibet Military Command or CDC (the Center for Disease Control and Prevention) of Tibet Military Command from January 1, 2019, to December 31, 2020. Demographic, clinical, laboratory, radiological, and epidemiological data were collected from medical records system and compared among different altitude areas. The inflammatory cytokines as well as the subsets of monocytes and regulatory T cells of patients were also obtained and analyzed in this study.ResultsSix hundred eighty-six patients had been identified by laboratory-confirmed HAdV infection, including the low-altitude group (n = 62), medium-altitude group (n = 206), high-altitude group (n = 230), and ultra-high-altitude group (n = 188). Referring to the environmental factors regression analysis, altitude and relative humidity were tightly associated with the number of infected patients (P < 0.01). A higher incidence rate of general pneumonia (45.7%) or severe pneumonia (8.0%) occurred in the ultra-high-altitude group (P < 0.05). The incubation period, serial interval, course of the disease, and PCR-positive duration were prolonged to various extents compared with the low-altitude group (P < 0.05). Different from those in low-altitude areas, the levels of IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, G-CSF, GM-CSF, IFN-γ, IP-10, MCP-1, TNF-α, TNF-β, and VEGF in the plasma of the ultra-high-altitude group were increased (P < 0.05), while the proportion of non-classical monocytes and regulatory T cells was decreased (P < 0.05).ConclusionsThe findings of this research indicated that patients with HAdV infection in high-altitude areas had severe clinical symptoms and a prolonged course of disease. During clinical works, much more attention should be paid to observe the changes in their immunological conditions. Quarantine of patients in high-altitude areas should be appropriately extended to block virus shedding.

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Environmental and Occupational Risk Factors Associated with Chronic Kidney Disease of Unknown Etiology in West Javanese Rice Farmers, Indonesia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124521 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4521 ◽

Cited By ~ 3

Author(s):

Laila Fitria ◽

Nurhayati Adnan Prihartono ◽

Doni Hikmat Ramdhan ◽

Tri Yunis Miko Wahyono ◽

Pornpimol Kongtip ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Environmental Factors ◽

High Altitude ◽

Unknown Etiology ◽

West Java ◽

Occupational Factors ◽

Rice Farmers ◽

Low Altitude

Chronic kidney disease of unknown etiology (CKDu) in agricultural population is an increasing issue. This study aims to obtain a prevalence estimate of CKDu in male rice farmers in West Java, Indonesia; and analyze the relationship between CKDu and environmental and occupational factors. The study design was cross-sectional. This study included 354 healthy male farmers in two rice agriculture areas in West Java with different altitudes (low altitude and high-altitude location). This research included blood and urine sampling from the farmers for serum creatinine (SCr) level and proteinuria; questionnaire on demographic information, occupational factors and other risk factors for CKDu. We measured ambient temperature and humidity in both study locations for environmental factors. From SCr level and proteinuria, we categorized the farmers into five stages of CKD; then we distinguished CKDu from CKD if the farmers had stage 1–4 of CKD but without diabetes, hypertension and other traditional causes. Data were analyzed with multivariate logistic regression to get prevalence odd ratios of CKDu and its relationship with environmental and occupational factors, adjusted with other risk factors of CKDu. The overall prevalence of CKD was 24.9% and CKDu was 18.6%. For the environmental factors, farm location (high altitude versus low altitude location) was associated with CKDu (Prevalence Odds Ratio (POR): 2.0; 95% CI: 1.2–3.5). For the occupational factors, although not significant, the risk of CKDu increased with the longer use of insecticide and with the more frequent of insecticide use. We suggested that there was a need to conduct future research to investigate more on the association of those environmental and occupational factors with CKDu.

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Aspirin ameliorates experimental autoimmune encephalomyelitis through interleukin-11–mediated protection of regulatory T cells

Science Signaling ◽

10.1126/scisignal.aar8278 ◽

2018 ◽

Vol 11 (558) ◽

pp. eaar8278 ◽

Cited By ~ 11

Author(s):

Susanta Mondal ◽

Malabendu Jana ◽

Sridevi Dasarathi ◽

Avik Roy ◽

Kalipada Pahan

Keyword(s):

T Cells ◽

Regulatory T Cells ◽

Experimental Autoimmune Encephalomyelitis ◽

Clinical Symptoms ◽

Interleukin 4 ◽

T Helper 17 ◽

Autoimmune Encephalomyelitis ◽

Relapsing Remitting ◽

The Central Nervous System ◽

Experimental Autoimmune

Multiple sclerosis (MS) is a human disease that results from autoimmune T cells targeting myelin protein that is expressed within the central nervous system. In MS, the number of FoxP3-expressing regulatory T cells (Tregs) is reduced, which facilitates the activation of autoreactive T cells. Because aspirin (acetylsalicylic acid) is the most widely used nonsteroidal anti-inflammatory drug, we examined its immunomodulatory effect in mice with experimental autoimmune encephalomyelitis (EAE), an animal model of MS. We found that low-dose aspirin suppressed the clinical symptoms of EAE in mouse models of both relapsing-remitting and chronic disease. Aspirin reduced the development of EAE driven by myelin basic protein (MBP)–specific T cells and the associated perivascular cuffing, inflammation, and demyelination. The effects of aspirin required the presence of CD25+FoxP3+ Tregs. Aspirin increased the amounts of Foxp3 and interleukin-4 (IL-4) in T cells and suppressed the differentiation of naïve T cells into T helper 17 (TH17) and TH1 cells. Aspirin also increased the transcription of Il11 mediated by the transcription factor CREB, which was necessary for the generation of Tregs. Neutralization of IL-11 negated the effects of aspirin on Treg development and exacerbated EAE. Furthermore, we found that IL-11 alone was sufficient to maintain the percentage of FoxP3+ Tregs and protect mice from EAE. These results identify a previously uncharacterized mode of action of aspirin.

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High-altitude is associated with better short-term survival in critically ill COVID-19 patients admitted to the ICU

10.1101/2021.01.22.21249811 ◽

2021 ◽

Author(s):

Pablo R. Morocho Jaramillo ◽

Katherine Simbaña-Rivera ◽

Javier V. Velastegui Silva ◽

Lenin Gómez-Barreno ◽

Ana B. Ventimilla Campoverde ◽

...

Keyword(s):

Clinical Outcome ◽

High Altitude ◽

Sea Level ◽

Critically Ill ◽

Clinical Laboratory ◽

Chronic Kidney Failure ◽

Disease Classification ◽

Term Survival ◽

Altitude Exposure ◽

Low Altitude

AbstractBackgroundThe novel human coronavirus, SARS-CoV-2, has affected at least 218 countries worldwide. Some geographical and environmental factors are positively associated with a better or worse prognosis concerning COVID-19 disease and with lower or higher SARS-CoV-2 transmission. High altitude exposure has been associated with lower SARS-CoV-2 attack rates; nevertheless, the role of chronic high-altitude exposure on the clinical outcome of critically ill COVID-19 patients has not been studied.ObjectiveTo compare the clinical course and outcomes of critically ill patients with COVID-19 hospitalized in two intensive care units (ICU) located at low and high altitude.Exposure and OutcomeTo explore the effect of two different elevations (10 m vs 2,850 m above sea level) on COVID-19 clinical outcome and survival.MethodsA prospective cohort, two-center study in confirmed COVID-19 adult patients admitted to a low altitude (Sea level) and high altitude (2,850 m) ICU units in Ecuador was conducted. Two hundred and thirty confirmed COVID-19 patients were enrolled from March 15th to July 15th, 2020. Sociodemographic, clinical, laboratory and imaging parameters including supportive therapies, pharmacological treatments and medical complications were reported and compared between the low and high-altitude groups.ResultsThe median age of all the patients was 60 years, 64.8% were men and 35.2% were women. A total of 105 (45.7%) patients had at least one underlying comorbidity, the most frequent being chronic diseases, such as hypertension (33.5%), diabetes (16.5%), and chronic kidney failure (5.7%). The APACHE II scale at 72 hours was especially higher in the low-altitude group with a median of 18 points (IQR: 9.5-24.0), compared to 9 points (IQR: 5.0-22.0) obtained in the group of high altitude. There is evidence of a difference in survival in favor of the high-altitude group (p = 0.006), the median survival being 39 days, compared to 21 days in the low altitude group.ConclusionThere has been a substantial improvement in survival amongst people admitted to the high-altitude critical care unit. High altitude living was associated with improved survival, especially among patients with no comorbidities. COVID-19 patients admitted to the high-altitude ICU unit have improved severity-of-disease classification system scores at 72 hours and reported better respiratory and ventilatory profiles than the low altitude group.

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Evaluation of Clinical and Immunological Responses: A 2-Year Follow-Up Study in Children with Allergic Rhinitis due to House Dust Mite

Mediators of Inflammation ◽

10.1155/2013/345217 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Heleen Moed ◽

Roy Gerth van Wijk ◽

Rudi W. Hendriks ◽

J. C. van der Wouden

Keyword(s):

T Cells ◽

Allergic Rhinitis ◽

T Cell ◽

Regulatory T Cells ◽

Clinical Symptoms ◽

Cell Activity ◽

Skin Tests ◽

Large Trial ◽

Immunological Responses ◽

Immunological Changes

Background. Allergic rhinitis is a disease with polarization towards Th2and a defect of regulatory T cells. Immunological changes have been reported after immunotherapy treatment. However, there is not much known about the natural course of allergic rhinitis with respect to clinical manifestation and the relation with immunological responses.Objective. To evaluate clinical symptoms of allergic rhinitis, in relation toin vivoallergen-specific skin responses andin vitroallergen-specific effector and regulatory T cells determined at baseline and after two years.Methods. From a large trial, 59 children were randomly selected. The following variables were compared: clinical symptoms, allergen skin tests, specific IgE, T-cell proliferation, IL-5, IL-13, IFN-gamma, IL-10, TGF-beta,CD4+CD25hicells, and Foxp3 expression.Results. Allergic symptoms had decreased after two years. Whereas skin test reactions correlated between years 0 and 2, there was no change in the size of the reaction. Also, proinflammatory reactions did not change after two years, with a positive correlation between years 0 and 2. No relevant changes were observed with respect to regulatory cells.Conclusion. Whereas, comparable to immunotherapy, allergic complaints decrease, the immunological changes of specific T-cell activity (both effector cells and regulator cells) which are observed after immunotherapy, do not change.

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