Omalizumab efficacy in cases of chronic spontaneous urticaria is not explained by the inhibition of sera activity in effector cells

Omalizumab (OmAb) is a humanized anti-IgE antibody approved for the treatment of chronic spontaneous urticaria (CSU). OmAb's mechanism of action is known to include actions on free IgE and on pre-bound IgE. However, OmAb is equally and rapidly effective against autoimmune and non-autoimmune urticaria where IgE involvement is not clear, suggesting the involvement of additional mechanisms of action. In this study, we sought to investigate the ability of OmAb to inhibit mast cell and basophil degranulation induced by sera from CSU patients. For this purpose, we performed a comparison between the in vitro incubation of sera from CSU patients treated with OmAb and the in vivo administration of OmAb in a clinical trial. We found that OmAb added in vitro to sera from CSU patients did not modify the ability of the sera to induce cell degranulation. Similarly, the sera from patients treated with OmAb in the context of the clinical trial who had a good clinical outcome maintained the capacity to activate mast cells and basophils. Thus, we conclude that the beneficial activity of OmAb does not correlate with the ability of patient sera to induce cell degranulation

Advancing the application of systems thinking in health: managing rural China health system development in complex and dynamic contexts

Background: This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. It argues that the evolution of these schemes has been the outcome of the response of a large number of agents to a rapidly changing context and of efforts by the government to influence this adaptation process and achieve public health goals. Methods:The study draws on several sources of data including a review of official policy documents and academic papers and in-depth interviews with key policy actors at national level and at a sample of localities. Results: The study identifies three major transition points associated with changes in broad development strategy and demonstrates how the adaptation of large numbers of actors to these contextual changes had a major impact on the performance of the health system. Further, it documents how the Ministry of Health viewed its role as both an advocate for the interests of health facilities and health workers and as the agency responsible for ensuring that government health system objectives were met. It is argued that a major reason for the resilience of the health system and its ability to adapt to rapid economic and institutional change was the ability of the Ministry to provide overall strategy leadership. Additionally, it postulates that a number of interest groups have emerged, which now also seek to influence the pathway of health system development. Conclusions: This history illustrates the complex and political nature of the management of health system development and reform. The paper concludes that governments will need to increase their capacity to analyze the health sector as a complex system and to manage change processes.UKaid: DFI

Roles of Electrostatics and Conformation in Protein-Crystal Interactions

In vitro studies have shown that the phosphoprotein osteopontin (OPN) inhibits the nucleation and growth of hydroxyapatite (HA) and other biominerals. In vivo, OPN is believed to prevent the calcification of soft tissues. However, the nature of the interaction between OPN and HA is not understood. In the computational part of the present study, we used molecular dynamics simulations to predict the adsorption of 19 peptides, each 16 amino acids long and collectively covering the entire sequence of OPN, to the {100} face of HA. This analysis showed that there is an inverse relationship between predicted strength of adsorption and peptide isoelectric point (P<0.0001). Analysis of the OPN sequence by PONDR (Predictor of Naturally Disordered Regions) indicated that OPN sequences predicted to adsorb well to HA are highly disordered. In the experimental part of the study, we synthesized phosphorylated and non-phosphorylated peptides corresponding to OPN sequences 65–80 (pSHDHMDDDDDDDDDGD) and 220–235 (pSHEpSTEQSDAIDpSAEK). In agreement with the PONDR analysis, these were shown by circular dichroism spectroscopy to be largely disordered. A constant-composition/seeded growth assay was used to assess the HA-inhibiting potencies of the synthetic peptides. The phosphorylated versions of OPN65-80 (IC50 = 1.93 µg/ml) and OPN220-235 (IC50 = 1.48 µg/ml) are potent inhibitors of HA growth, as is the nonphosphorylated version of OPN65-80 (IC50 = 2.97 µg/ml); the nonphosphorylated version of OPN220-235 has no measurable inhibitory activity. These findings suggest that the adsorption of acidic proteins to Ca2+-rich crystal faces of biominerals is governed by electrostatics and is facilitated by conformational flexibility of the polypeptide chain

Observation of finite-wavelength screening in high-energy-density matter

A key component for the description of charged particle systems is the screening of the Coulomb interaction between charge carriers. First investigated in the 1920s by Debye and Hückel for electrolytes, charge screening is important for determining the structural and transport properties of matter as diverse as astrophysical and laboratory plasmas, nuclear matter such as quark-gluon plasmas, electrons in solids, planetary cores and charged macromolecules. For systems with negligible dynamics, screening is still mostly described using a Debye–Hückel-type approach. Here, we report the novel observation of a significant departure from the Debye–Hückel-type model in high-energy-density matter by probing laser-driven, shock-compressed plastic with high-energy X-rays. We use spectrally resolved X-ray scattering in a geometry that enables direct investigation of the screening cloud, and demonstrate that the observed elastic scattering amplitude is only well described within a more general approach

Tracking the density evolution in counter-propagating shock waves using imaging X-ray scattering

We present results from time-resolved X-ray imaging and inelastic scattering on collective excitations. These data are then employed to infer the mass density evolution within laser-driven shock waves. In our experiments, thin carbon foils are first strongly compressed and then driven into a dense state by counter-propagating shock waves. The different measurements agree that the graphite sample is about twofold compressed when the shock waves collide, and a sharp increase in forward scattering indicates disassembly of the sample 1 ns thereafter. We can benchmark hydrodynamics simulations of colliding shock waves by the X-ray scattering methods employed

Tracking the density evolution in counter-propagating shock waves using imaging X-ray scattering

We present results from time-resolved X-ray imaging and inelastic scattering on collective excitations. These data are then employed to infer the mass density evolution within laser-driven shock waves. In our experiments, thin carbon foils are first strongly compressed and then driven into a dense state by counter-propagating shock waves. The different measurements agree that the graphite sample is about twofold compressed when the shock waves collide, and a sharp increase in forward scattering indicates disassembly of the sample 1 ns thereafter. We can benchmark hydrodynamics simulations of colliding shock waves by the X-ray scattering methods employed