Features Of The Clinical And Laboratory Course Of Tuberculosis Lymphadenopathy In Patients Without And With HIV Infection

Tuberculous lymphadenopathy without HIV infection, in comparison with those with HIV infection, was characterized by a more favorable clinical course, limited lesion and, especially important, limited caseous-necrotic changes. Analysis of the histological picture of the removed lymph nodes in patients with HIV-i made it possible to distinguish three activities of tuberculous lymphadenopathy: an inactive phase (with a predominance of a productive cellular reaction) - in 3 patients (5.3%), an active (with a predominantly productive-necrotic tissue reaction) - in 11 patients (19.3%), the phase of progression of the pathological process (mainly necrotic lesions, suppuration and formation of fistulas) - in 43 patients (75.4%). It was found that the inactive phase is 5.5 times more common in patients without HIV than in patients with HIV (29.3% and 5.3%, respectively, P˂0.001), while the active phase and the progression phase was 1.5 and 1.3 times more frequent in patients with HIV than in patients without HIV (19.3% and 13.1, respectively, P˃0.5; 75.4% and 57, 6%, respectively, P˂0.02).

Histopathological Aspects of Cutaneous Leishmaniasis due to Leishmania-Major in Libya

Aims: To describes the histopathological characteristics of skin lesions from patients with cutaneous leishmaniasis caused by Leishmania major in northwestern Libya and correlate with clinical presentation. Study Design: case series study. Place and Duration of Study: This study was carried on patients referred by the region's healthcare institutions and those presented at the Tripoli Central Hospital or the Libyan National Centre for Disease Control between July 2017 to January 2018. Methodology: The study included 38 patients, aged between 1-73 years, of both sexes, and came from 18 endemic areas in North-Western of Libya. The inclusion criteria were clinical symptoms and microscopic visualization of the parasite on a Giemsa-stained skin smear, in addition, clinical by the slit and smear technique, polymerase chain reaction for L. major. In addition, statistical analysis was conducted for the Histopathological examination. Results: The study found that 36 (94%) of the cases studied were positive by the slit and smear technique, and 32 (88.9%) were positive by PCR for L. major. Five histopathological patterns were observed: (i) diffuse cellular reaction without necrosis (25%); (ii) diffuse cellular reaction with necrosis (31.3%); (iii) exudative and necrotic granulomatous reaction (25%); (iv) exudative granulomatous reaction without necrosis (9.3%); (v) exudative-tuberculoid reaction with typical tuberculoid granuloma (organized) (9.3%). Inflammatory cellular infiltration ranged from mild to severe. Lymph plasmacytosis and lymph histiocytosis were predominant (34.4% and 21.7%, respectively). Necrosis was diffuse or local. The clinical features were correlated with this histological pattern. Epidermal changes included acanthosis, exocytosis, spongiosis, hyperkeratosis, and atrophy. Conclusion: The histopathological changes observed in CL caused by L. major in North-Western of Libya are characterized by an intense diffuse inflammatory reaction in the dermis with the predominance of lymphoplasmacytic infiltration. Overall, the granulomatous presentation was the main one. Various clinical forms, including papule, plaque, erythematous nodule with hemorrhagic crust, or violaceous nodule with adherent crust and ulcerated nodule, are significantly correlated with the histopathological stages, whereas disease progression could be related to age. The histopathological diagnosis of CL caused by L. major has a sensitivity of 78% relative to PCR.

Autophagy: A Novel Horizon for Hair Cell Protection

As a general sensory disorder, hearing loss was a major concern worldwide. Autophagy is a common cellular reaction to stress that degrades cytoplasmic waste through the lysosome pathway. Autophagy not only plays major roles in maintaining intracellular homeostasis but is also involved in the development and pathogenesis of many diseases. In the auditory system, several studies revealed the link between autophagy and hearing protection. In this review, we aimed to establish the correlation between autophagy and hair cells (HCs) from the aspects of ototoxic drugs, aging, and acoustic trauma and discussed whether autophagy could serve as a potential measure in the protection of HCs.

Immunohistochemical analysis of the inflammatory reaction within the implantation bed of a collagen hemostatic biomaterial

Current research on medical biomaterials have shown that the physical and chemical characteristics of biomaterials determine the body inflammatory cellular reaction after their implantation. The aim of this study was to evaluate the individual effects of the physical characteristics over the initial biomaterial-cellular interaction and the inflammatory cellular reaction. For this purpose, an equine-derived collagen hemostatic sponge (E-CHS) was modified by pressing and evaluated using ex vivo, in vitro and in vivo methods. The E-CHS was pressed by applying constant pressure (6.47± 0.85 N) for 2 min using a sterile stainless-steel cylinder and cut in segments of 1cm2. Subsequently, E-CHS and the pressed equine-derived collagen hemostatic sponge (P-E-CHS) were studied as two independent biomaterials and compared to a control group (CG). A blood concentrate containing inflammatory cells known as platelet rich fibrin (PRF) was used to mimic the initial biomaterial-cell interaction and to measure the absorption coefficient of the biomaterials to liquid PRF (iPAC). Additionally, the biomaterials were cultivated together with PRF for 3 and 6 days to measure the induction of pro-inflammatory cytokines (TNF-α and IL-8). The results were obtained through enzyme-linked immunosorbent assay (ELISA) and histological methods. PRF cultivated without biomaterials served as the CG. Additionally, the biomaterials were evaluated in vivo using a subcutaneous model in Wistar rats and compared to sham operated animals (CG) representing physiologic wound healing. After 3, 15 and 30 days, the explanted samples were evaluated using histochemical and immunohistochemical (IHC) staining using the following markers: CD68 (pan macrophages), CCR7 (pro-inflammatory macrophages, M1), CD206 (pro-wound healing macrophages, M2) and α-Smooth Muscle Actin (α-SMA; vessel identification). After the mixture of liquid PRF with both biomaterials for 15 minutes, the ex vivo results showed that E-CHS was penetrated by cells, whereas P-E-CHS was cell-occlusive. Additionally, P-E-CHS induced a higher release of pro-inflammatory cytokines compared to liquid PRF alone (CG) and E-CHS after 3 days (P< 0.05). Although the biomaterial was pressed, the difference of the iPAC value did not show statistical differences. In vivo, the CG induced at day 3 a higher inflammatory response compared to the experimental groups (EG) (P< 0.05). The intergroup comparison showed that P-E-CHS induced a higher presence of macrophages (CD68+/CC7+) compared to E-CHS at day 3 (P< 0.05). Only CD68+/CCR7+ mononuclear cells (MNCs) were observed without multinucleated giant cells (MNGCs). After 15 days, the presence of macrophages (CD68+ P<0.01 /CCR7+ P<0.001 /CD206+ P<0.05) reduced considerably in the CG. On the contrary, the inflammatory response increased in the EGs (CD68+/CCR7+). The intergroup comparison showed that this increment was statistically significant when comparing E-CHS and P-E-CHS to the CG at day 15 (P<0.01 and P< 0.05 respectively). At this time point, a reduced number of MNGCs were observed in the EGs. In the CG no MNGCs were observed. Furthermore, E-CHS showed a faster degradation rate and was fully invaded by cells and vessels formed in its interior region. On the other hand, P-E-CHS remained occlusive to cell penetration and vessels were formed only in the periphery. After 30 days, the cellular reaction shifted to a higher number of M2 macrophages (CD260+) in all groups and a reduced presence of CD68+ and CCR7+ MNCs. Both biomaterials degraded and only small fragments were found in the implantation bed surrounded by MNGCs (CCR7+). These results are of high clinical relevance and show that changes in biomaterial properties have a significant impact on their interaction with the body. They also serve as insight into the possibility to develop versatile biomaterials with different applications. For example, E-CHs can be applied to support hemostasis in a bleeding alveolar socket and P-E-CHs by being cell occlusive and having a delayed degradation rate can be applied for guided bone and tissue regeneration.

The Biomaterial-Induced Cellular Reaction Allows a Novel Classification System Regardless of the Biomaterials Origin

Several different biomaterials are being introduced for clinical applications. However, no current material-specific systematic studies define parameters for evaluating these materials. The aim of this retrospective animal study is to classify biomaterials according to the in vivo induced cellular reaction and outline the clinical consequence of the biomaterial-specific cellular reaction for the regeneration process. A retrospective histologic analysis was performed for 13 polymeric biomaterials and 19 bone substitute materials (BSMs) (of various compositions and origins) that were previously implanted in a standardized subcutaneous model. Semiquantitative analyses were performed at days 3, 15, and 30 after implantation according to a standardized score for the induction of multinucleated giant cells (MNGCs) and vascularization rate. The induced cellular reaction in response to different polymeric materials allowed their classification according to the MNGC score in the following groups: class I induced no MNGCs at any time point, class II induced and maintained a constant number of MNGCs over 30 days, and class III induced MNGCs and provided an increasing number over 30 days. All BSMs induced MNGCs to varying extents. Therefore, the resultant BSM classifications are as follows: class I induced MNGCs with a decreasing number, class II induced and maintained constant MNGCs over 30 days, and class III induced MNGCs with increasing number over 30 days. These observations were mostly related to the biomaterial physicochemical properties and were independent of the biomaterial origin. Consequently, the induction of MNGCs and their increase over 30 days resulted in disintegration of the biomaterial. By contrast, the absence of MNGCs resulted in an integration of the biomaterial within the host tissue. This novel classification provides clinicians a tool to assess the capacity and suitability of biomaterials in the intended clinical indication for bone and soft tissue implantations.

Immunohistochemistry of Lymphocytes Subsets in Subclinical Experimental Paratuberculosis in Goats

The present experiment was carried out to find out the lymphocytes subsets reactions in experimentally induced subclinical paratuberculosis in goats. Twelve goats of 8-12 weeks age were infected with 4.23 x 109 Mycobacterium avium paratuberculosis on 8 occasions. Seven goats were kept as in-contact controls and 4 as uninfected controls. Immunohitochemistry for detection of cellular reaction of CD2+, CD4+, CD8+, CD25+, MHC I and MHCII in the lymphocytes present in the intestine and lymph node revealed more reactive cells in the infected goats as compared with the in-contact and infected control goats.