New Insight into the Pathogenesis of Erythema Nodosum Leprosum: The Role of Activated Memory T-Cells.

Memory T-cells, particularly, effector memory T cells are implicated in the pathogenesis of inflammatory diseases and may contribute to tissue injury and disease progression. Although erythema nodosum leprosum (ENL) is an inflammatory complication of leprosy, the role of memory T cell subsets has never been studied in this patient group. The aim of this study was at investigate the kinetics of memory T cell subsets in patients with ENL before and after prednisolone treatment. A case-control study design was used to recruit 35 untreated patients with ENL and 25 non-reactional lepromatous leprosy (LL) patient controls at ALERT Hospital, Ethiopia. Venous blood samples were obtained before, during, and after treatment from each patient. Peripheral blood mononuclear cells (PBMCs) were isolated and used for immunophenotyping of T cell activation and memory T-cell subsets by flow cytometry. The kinetics of these immune cells in patients with ENL before and after treatment were compared with LL patient controls as well as within ENL cases at different time points. The median percentage of CD3+, CD4+, and CD8+ T-cells expressing activated T-cells were significantly higher in the PBMCs from patients with ENL than from LL patient controls before treatment. The median percentage of central and activated memory T-cells was significantly increased in patients with ENL compared to LL patient controls before treatment. Interestingly, patients with ENL had a lower percentage of naïve T cells (27.7%) compared to LL patient controls (59.5%) (P < 0.0001) before treatment. However, after prednisolone treatment, patients with ENL had a higher median percentage of naïve T-cells (43.0%) than LL controls (33.0%) (P < 0.001). The median percentage of activated T-cells (effector memory and effector T-cells) was significantly increased in patients with ENL (59.2%) before treatment compared to after treatment with prednisolone (33.9%) (P < 0.005). This is the first work which has shown T-cell activation and the different subsets of memory T cells in untreated patients with ENL. Consequently, this study delineates the role of T-cell activation in the pathogenesis of ENL reaction and challenges the long-standing dogma of immune complex as a sole etiology of ENL reaction

The Effects of Prednisolone Treatment on Cytokine Expression in Patients with Erythema Nodosum Leprosum Reactions.

Erythema nodosum leprosum (ENL) is a systemic inflammatory complication occurring mainly in patients with lepromatous leprosy (LL) and borderline lepromatous leprosy. Prednisolone is widely used for treatment of ENL reactions but clinical improvement varies. However, there is little good in vivo data as to the effect of prednisolone treatment on the pro-inflammatory cytokines in patients with ENL reactions. As a result, treatment and management of reactional and post-reactional episodes of ENL often pose a therapeutic challenge. We investigated the effect of prednisolone treatment on the inflammatory cytokines TNF, IFN-γ, IL-1β, IL-6, and IL-17 and the regulatory cytokines IL-10 and TGF-β in the skin lesion and blood of patients with ENL and compared with non-reactional LL patient controls. A case-control study was employed to recruit 30 patients with ENL and 30 non-reactional LL patient controls at ALERT Hospital, Ethiopia. Blood and skin biopsy samples were obtained from each patient before and after prednisolone treatment. Peripheral blood mononuclear cells from patients with ENL cases and LL controls were cultured with M. leprae whole-cell sonicates (MLWCS), phytohemagglutinin or no stimulation for 6 days. The supernatants were assessed with the enzyme-linked immunosorbent assay for inflammatory and regulatory cytokines. For cytokine gene expression, mRNA was isolated from whole blood and skin lesions and then reverse transcribed into cDNA. The mRNA gene expression was quantified on a Light Cycler using real-time PCR assays specific to TNF, IFN-γ, IL-β, TGF-β, IL-17A, IL-6, IL-8, and IL-10. The ex vivo production of the cytokines: TNF, IFN-γ, IL-1β, and IL-17A was significantly increased in untreated patients with ENL. However, IL-10 production was significantly lower in untreated patients with ENL and significantly increased after treatment. The ex vivo production of IL-6 and IL-8 in patients with ENL did not show statistically significant differences before and after prednisolone treatment. The mRNA expression in blood and skin lesion for TNF, IFN-γ, IL-1β, IL-6, and IL-17A significantly reduced in patients with ENL after treatment, while mRNA expression for IL-10 and TGF-β was significantly increased both in blood and skin lesion after treatment. This is the first study examining the effect of prednisolone on the kinetics of inflammatory and regulatory cytokines in patients with ENL reactions before and after prednisolone treatment. Our findings suggest that prednisolone modulates the pro-inflammatory cytokines studied here either directly or through suppression of the immune cells producing these inflammatory cytokines

Al2O3/Fe3O4/ZrO2 ternary oxide sorbent: Synthesis, characterization and sorption behavior to fluoride and phosphate ions from aqueous solution

ABSTRACT. Excess quantities of fluoride and phosphate in water bodies can lead to fluorosis and eutrophication problems, respectively. In search of a promising adsorbent targeting these ions, Fe3O4/Al2O3/ZrO2 ternary oxide was synthesized via co-precipitation method and characterized by X-ray diffraction (XRD), Fourier transform-infrared (FTIR) and Brunauer-Emmer-Teller (BET). Its specific surface area was found to be 205 m2/g. The effects of solution pH, adsorbent dose, contact time, agitation speed and initial fluoride and phosphate concentrations were also investigated and the optimum values were 4, 0.5 g, 12 h, 100 rpm and 20 mg/L, respectively, for fluoride and 5, 0.1 g, 8 h, 100 rpm and 10 mg/L, respectively, for phosphate. Fluoride and phosphate adsorptions fitted well with Freundlich and Langmuir isotherm models, respectively and their kinetic data correlated well with the pseudo-second order model. Desorbability study revealed that maximum desorption was achieved at pH 12. Thermodynamics study on the other hand showed that adsorption of fluoride was nonspontaneous and endothermic whereas that of phosphate was spontaneous and exothermic. Application on real water sample decreased the concentration of fluoride from 4.92 to 1.97 mg/L in ground water and phosphate from 1.7 to 0.35 mg/L lake water showing its potential as a promising adsorbent. &nbsp; KEY WORDS: Adsorption, Fluoride, Phosphate, Ternary oxide sorbent, Isotherm models &nbsp; Bull. Chem. Soc. Ethiop. 2022, 36(3), 555-569.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; DOI: https://dx.doi.org/10.4314/bcse.v36i3.6&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp

Preparation and sorption property study of Fe3O4/Al2O3/ZrO2 composite for the removal of cadmium, lead and chromium ions from aqueous solutions

Fe-Al-Zr ternary mixed oxides composite was synthesized via co-precipitation method for the removal Pb(II), Cd(II) and Cr(VI) ions from aqueous solutions. The as-synthesized materials were characterized by X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET), scanning electron microscope hyphenated with energy dispersive X-ray diffraction (SEM-EDX) and Fourier transform infrared (FTIR) techniques. The pH at the point of zero charge (pHpzc) of the sorbent and effect of ionic strength on sorption were also determined. The batch tests were conducted to optimize the various sorption parameters such as pH, adsorbent dose, contact time, speed of agitation and initial metal concentration. The experimental results showed that the adsorbed amounts of Pb(II), Cd(II) and Cr(VI) tend to decrease with increase in pH. Freundlich isotherm model fits better the equilibrium data for the adsorbent. Kinetic data correlated better with both pseudo first order and pseudo second order kinetic models. The spontaneous nature of the adsorption process was also confirmed from thermodynamic grounds. The nanosized adsorbent exhibited an adsorption efficiency of 96.65%, 96.55% and 97.2% for Cd(II), Cr(VI) and Pb(II), respectively, at optimum condition. Experimental results showed that the nanocomposite was effective for the removal of the title heavy metals from aqueous solution. &nbsp; Bull. Chem. Soc. Ethiop. 2020, 34(1), 105-121. DOI: https://dx.doi.org/10.4314/bcse.v34i1.1

Barriers and drivers to stakeholder engagement in global mental health projects

Background Engagement with diverse stakeholders, including policy makers, care providers and service users and communities, is essential for successful implementation of global mental health interventions. Despite being a fundamental factor in the implementation process, evidence about challenges and drivers to stakeholder engagement is limited in the global mental health literature. Methods We conducted semi-structured qualitative interviews with 29 recipients of Grand Challenges Canada Global Mental Health funding to assess barriers and drivers to global mental health implementation across a portfolio of projects. We used framework analysis to identify key themes related to implementation barriers and drivers. This paper reports on barriers and drivers to stakeholder engagement, with results related to capacity development and service delivery reported elsewhere in this journal. Results Barriers and drivers to stakeholder engagement were identified across four themes: (1) Contextual Considerations, (2) Resources, (3) Participation, Uptake and Empowerment, and (4) Stigma. While complex contextual challenges create barriers, mechanisms such as formative research can facilitate a deeper contextual understanding that supports effective implementation planning. Limited financial and human resources and competing priorities can lead to substantial challenges. Investing in and leveraging existing local resources and expertise can help to mitigate these barriers. The challenge of achieving active participation from stakeholders and diverging expectations about the nature of participation were identified as barriers, while providing opportunities for meaningful participation and empowerment acted as drivers. Stigma at the institutional, community and individual level was also identified as a substantial barrier to engagement. Conclusion The findings of this study are relevant to implementers in global mental health. They also have implications for global mental health funding agencies and policy organizations, who can support improved stakeholder engagement by investing in high-quality formative research, supporting capacity building for policy engagement, investing in longer-term funding schemes to support sustainable partnerships and scale-up, thus fostering successful engagement and supporting effective implementation of global mental health innovations

People who once had 40 cattle are left only with fences: Coping with persistent drought in Awash, Ethiopia

How to support those responding to environmental change in resource-constrained environments is central to literature on climate change adaption. Our research explores a gap in this literature relating to the negotiation of intra-household relations and resource access across different types of household in contexts of social and environmental transition. Using the example of the semi-arid Awash region in North-Eastern Ethiopia, which has experienced drought and alien plant invasion over the past decade, we explore how men and women use changes in household structures and relationships to adapt more effectively. We draw evidence from life histories with 35 pastoralists across three rural, peri-urban and urban communities. Using Dorward et al’s taxonomy, we find Afar people are not only ‘stepping up’, but also ‘stepping out’: shifting from pastoralism into agriculture and salaried employment. As this often involves splitting households across multiple locations, we look at how these reconfigured households support pastoralists’ wellbeing