Rob J. Rentenaar

Expression of Granzyme B during Primary Cytomegalovirus Infection after Renal Transplantation

CD8+ T cells employ granzyme B (GrB) to induce apoptosis in target cells. Increased expression of GrB has been put forward as a diagnostic marker in transplant rejection and viral infection. Three-color flow cytometric analysis revealed that peripheral blood CD8+ T lymphocytosis during primary cytomegalovirus infection after renal transplantation resulted from expansion of a CD8+GrB+CD62L+ T cell subset that was almost absent during stable transplant function or acute rejection. This expansion coincided with a temporary increase in systemic soluble GrB (sGrB) levels. No such increase was observed during stable transplant function or acute rejection. Thus, the primary immune response to cytomegalovirus infection is accompanied by appearance of CD8+GrB+CD62L+ T cells and increased sGrB levels in the peripheral blood compartment. Determination of the latter may provide a novel approach for monitoring viral infections.

Systemic Treatment with Either Cyclosporin A or Methotrexate Does Not Influence the T Helper 1/T Helper 2 Balance in Psoriatic Patients

Cyclosporin A and methotrexate are highly effective drugs in the treatment of psoriasis. It was hypothesized that these therapies might modulate T helper cell cytokine secretion patterns or T cell migration patterns. Flow cytometric determination of interferon-gamma (IFNγ) and interleukin 4 (IL4) producing T helper cell frequencies, as well as of cutaneous lymphocyte associated antigen (CLA) expressing T cell frequencies was performed in patients suffering from severe psoriasis, before, during, and after a scheduled immunosuppressive regimen with either cyclosporin A or methotrexate. Both cyclosporin A and methotrexate treatment reduced the psoriasis area severity index score after 12 weeks of treatment. Cyclosporin A treatment reduced the frequencies of IL4-producing CD4pos T cells, without significantly affecting the T helper 1 to T helper 2 (Th1/Th2) balance but in conjunction with the decreasing number of peripheral blood eosinophil counts. In methotrexate-treated patients, the Th1/Th2 balance was unaffected. Cessation of both therapies resulted in increased numbers of IFNγ- as well as IL4-producing CD4pos T cells as compared to before initiation of oral therapy. Methotrexate, but not cyclosporin A, treatment reduced the frequencies of circulating skin-homing CLApos T cells. This effect was reversed by 4 weeks after withdrawal of methotrexate therapy. We conclude that (1) neither cyclosporin A nor methotrexate affects the balance between Th1 and Th2 cells; (2) exaggerated cytokine production by T helper cells after cessation of oral cyclosporin A or methotrexate drug treatment may contribute to the reappearance of psoriatic skin lesions; and (3) decrease of circulating skin-homing T cells may be responsible for part of the therapeutic effect of methotrexate in severe psoriasis.

Differentiation of human alloreactive CD8+ T cells in vitro

Expansion and differentiation of alloantigen‐reactive CD8+ T cells in mixed lymphocyte cultures was followed by measurement of the loss of carboxyfluorescein diacetate succinimidyl ester (CFSE) fluorescence of responder cells. Proliferation of CD8+ T cells became detectable on day 4 of culture and, 2 days later, > 60% of the CD8+ T cells in culture were dividing alloreactive lymphocytes. In parallel with expansion, CD8+ T‐cell differentiation was initiated, as evidenced by an increase in the number of CD45RA− and CD27− T cells and acquisition of the ability to produce interferon‐γ after restimulation with the specific alloantigen. Finally, although short‐term stimulation and measurement of intracellular cytokine production allowed visualization of alloreactive CD8+ T cells expanded in vitro, this procedure did not detect circulating alloreactive CD8+ T cells activated in vivo in recipients of allogeneic kidney grafts.

Predominant association of Raoultella bacteremia with diseases of the biliary tract.

Abstract A case series of 14 patients with Raoultella bacteremia was compared with 28 Klebsiella oxytoca and 28 Klebsiella pneumoniae bacteremia cases. Forty-three percent of Raoultella bacteremia cases were associated with biliary tract disease, compared to 32% and 22% of patients with K. oxytoca and K. pneumoniae bacteremia, respectively.

Ground Steel Target Plates in Combination with Direct Transfer of Clinical Candida Isolates Improves Frequencies of Species-Level Identification by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Comparison with Polished Steel Target Plates

MALDI-TOF MS identification of yeast isolates is fast and reliable, but the optimal workflow is debated (1, 2).…Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) identification (ID) of Candida yeast isolates is fast and reliable, but the optimal workflow is debated ([1][1], [2][2]). Two different steel target plates are available for the Microflex system (Bruker