Infections With the Tick-Borne Bacterium "Candidatus Neoehrlichia mikurensis” Mimic Noninfectious Conditions in Patients With B Cell Malignancies or Autoimmune Diseases

We present a comprehensive study of a new infectious disease in immune compromised patients, neoehrlichiosis. The clinical picture of the disease can be misleading because the symptoms may be misinterpreted to be a worsening of the underlying diseas

Förändrad chefsstruktur. En fallstudie om Sjukhusets organisationsförändring

Organisationsförändringar har visat sig vara viktigt att genomföra för att företag ska överleva och vara konkurrenskraftiga. Alla förändringar som genomförs görs i förhoppningen att organisationens processer ska bli ännu bättre och ännu mer effektiva än de var tidigare, men alla organisationsförändringar lyckas inte alla gånger. Denna studie undersöker därför anledningar till att företag genomför organisationsförändringar, delvis i syftet att undersöka bakomliggande faktorer men också för att öka förståelsen för varför organisationerförändringar sker. Studien syftar även till att öka förståelsen för hur företag i praktiken kan genomföra organisationsförändringar och huruvida organisationsförändringar gällande chefsstrukturen kan påverka företag. Detta för att möjliggöra en ökad förståelse för hur organisationsförändringar i den formella strukturen kan påverka företag. För att studera detta har en fallstudie genomförts tillsammans med ett privat företag som i studien kallas för“Sjukhuset”. Organisationsförändringar har undersökts utifrån ledningens och chefernas perspektiv gällande den förändring som Sjukhuset genomgår gällande deras chefsstruktur. Det studien kom fram till är att externa påtryckningar och interna drivkrafter till att vilja förändras och förbättras är en förenklad bild av anledningen till varför organisationsförändringar genomförs - det kan istället handla om en vilja att ändra i den formella strukturen för att avlägsna vissa personer från en chefsposition. En ytterligare aspekt som framkom var att genomförandet av en organisationsförändring kräver tydlig kommunikation genom hela processen. För att lyckas med organisationsförändringen och genomförandet av den krävs det även att målet och syftet är tydlig och konkret, precis som kommunikationen kring det. Brister detta skapar det oro och rädsla för medarbetare då de är ovissa om vad framtiden inom företaget kommer att innebära. Vid förändring av befattningar, och med ett nyskapat delat ledarskap inom företaget, finns risken att konkurrens skapas mellan cheferna men även desorganisation gällande vem som är chef

Tetra­ammonium diaqua­diperoxidoocta­molybdate(VI) tetra­hydrate

The title compound (NH4)4[Mo8O24(O2)2(H2O)2]·4H2O, consists of an octa­molybdate cluster with a crystallographic centre of symmetry. The clusters pack in a cubic close packing arrangement defining channels containing water mol­ecules and ammonium cations, which exhibit hydrogen bonding with neighbouring clusters. Hydrogen bonding also exists between the coordinated water mol­ecules of one cluster with one of the O atoms of the peroxido fragment in a neighbouring cluster

Low-density granulocytes are related to shorter pregnancy duration but not to interferon alpha protein blood levels in systemic lupus erythematosus

BACKGROUND: An increased risk of pregnancy complications is seen in women with systemic lupus erythematosus (SLE), but the specific immunopathological drivers are still unclear. Hallmarks of SLE are granulocyte activation, type I interferon (IFN) overproduction, and autoantibodies. Here we examined whether low-density granulocytes (LDG) and granulocyte activation increase during pregnancy, and related the results to IFNα protein levels, autoantibody profile, and gestational age at birth. METHODS: Repeated blood samples were collected during pregnancy in trimesters one, two, and three from 69 women with SLE and 27 healthy pregnant women (HC). Nineteen of the SLE women were also sampled late postpartum. LDG proportions and granulocyte activation (CD62L shedding) were measured by flow cytometry. Plasma IFNα protein concentrations were quantified by single molecule array (Simoa) immune assay. Clinical data were obtained from medical records. RESULTS: Women with SLE had higher LDG proportions and increased IFNα protein levels compared to HC throughout pregnancy, but neither LDG fractions nor IFNα levels differed during pregnancy compared to postpartum in SLE. Granulocyte activation status was higher in SLE relative to HC pregnancies, and it was increased during pregnancy compared to after pregnancy in SLE. Higher LDG proportions in SLE were associated with antiphospholipid positivity but not to IFNα protein levels. Finally, higher LDG proportions in trimester three correlated independently with lower gestational age at birth in SLE. CONCLUSION: Our results suggest that SLE pregnancy results in increased peripheral granulocyte priming, and that higher LDG proportions late in pregnancy are related to shorter pregnancy duration but not to IFNα blood levels in SLE

A candidate gene study of the type I interferon pathway implicates IKBKE and IL8 as risk loci for SLE

Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease in which the type I interferon pathway has a crucial role. We have previously shown that three genes in this pathway, IRF5, TYK2 and STAT4, are strongly associated with risk for SLE. Here, we investigated 78 genes involved in the type I interferon pathway to identify additional SLE susceptibility loci. First, we genotyped 896 single-nucleotide polymorphisms in these 78 genes and 14 other candidate genes in 482 Swedish SLE patients and 536 controls. Genes with P<0.01 in the initial screen were then followed up in 344 additional Swedish patients and 1299 controls. SNPs in the IKBKE, TANK, STAT1, IL8 and TRAF6 genes gave nominal signals of association with SLE in this extended Swedish cohort. To replicate these findings we extracted data from a genomewide association study on SLE performed in a US cohort. Combined analysis of the Swedish and US data, comprising a total of 2136 cases and 9694 controls, implicates IKBKE and IL8 as SLE susceptibility loci (Pmeta=0.00010 and Pmeta=0.00040, respectively). STAT1 was also associated with SLE in this cohort (Pmeta=3.3 × 10−5), but this association signal appears to be dependent of that previously reported for the neighbouring STAT4 gene. Our study suggests additional genes from the type I interferon system in SLE, and highlights genes in this pathway for further functional analysis

Anti-α-Internexin Autoantibody from Neuropsychiatric Lupus Induce Cognitive Damage via Inhibiting Axonal Elongation and Promote Neuron Apoptosis

Neuropsychiatric systemic lupus erythematosus (NPSLE) is a major complication for lupus patients, which often leads to cognitive disturbances and memory loss and contributes to a significant patient morbidity and mortality. The presence of anti-neuronal autoantibodies (aAbs) has been identified; as examples, anti-NMDA receptors and anti-Ribsomal P aAbs have been linked to certain pathophysiological features of NPSLE.In the current study, we used a proteomic approach to identify an intermediate neurofilament alpha-internexin (INA) as a pathogenetically relevant autoantigen in NPSLE. The significance of this finding was then validated in an expanded of a cohort of NPSLE patients (n = 67) and controls (n = 270) by demonstrating that high titers of anti-INA aAb was found in both the serum and cerebrospinal fluid (CSF) of ∼50% NPSLE. Subsequently, a murine model was developed by INA immunization that resulted in pronounced cognitive dysfunction that mimicked features of NPSLE. Histopathology in affected animals displayed cortical and hippocampal neuron apoptosis. In vitro studies further demonstrated that anti-INA Ab mediated neuronal damage via inhibiting axonal elongation and eventually driving the cells to apoptosis.Taken together, this study identified a novel anti-neurofilament aAb in NPSLE, and established a hitherto undescribed mechanism of aAb-mediated neuron damage that could have relevance to the pathophysiology of NPSLE

Cerebral inflammation and degeneration in systemic lupus erythematosus

PURPOSE OF REVIEW: This review deals with new information related to central nervous system lupus, with special emphasis on mechanisms engaged in inflammation and neurodegeneration. RECENT FINDINGS: We report the very recent findings related to neuropsychiatric lupus in areas of (1) neuroimaging, (2) immunology and genetics, (3) biochemistry, and (4) neuropsychological tests. The relation between treatment of central nervous system lupus and immunologic/biochemical parameters as an outcome variable is also reported. SUMMARY: The recent advances in the field of neuropsychiatric lupus allow better understanding of the pathogenesis of the disease and follow-up of disease activity during immunosuppressive treatment