Naive CD4 T cells activated by antigen-presenting cells (APCs) undergo terminal differentiation in the periphery. Multiple mechanisms determine their fates, that is, whether they differentiate into conventional T (Tconv) cells or regulatory T (Treg) cells. The key event during Treg generation is expression of the transcription factor Foxp3, which is the lineage-determining regulator for Treg differentiation and function. Here we show that the transcription factor Batf3 acts as a fate-decision factor with respect to Tconv versus Tregs by restraining Treg differentiation. Batf3 was preferentially expressed in effector CD4 T cells but not in Treg cells, and ectopic expression of Batf3 inhibited Foxp3 induction. Batf3-deficient CD4 T cells favorably differentiated into Treg cells in vitro and in colonic lamina propria. Batf3 KO mice also showed enhanced Treg function in gut-associated immune disease models (for example, ovalbumin tolerance and inflammatory bowel disease models). Batf3 bound to the CNS1 region of the Foxp3 locus and reduced expression of the gene. Thus, Batf3 is a transcriptional suppressor of Treg differentiation.
Animals ; Antigen-Presenting Cells ; Colon ; Ectopic Gene Expression ; Immune System Diseases ; In Vitro Techniques ; Inflammatory Bowel Diseases ; Mice ; Mucous Membrane ; Ovalbumin ; T-Lymphocytes ; T-Lymphocytes, Regulatory* ; Transcription Factors*

Th17 cells promote inflammatory reactions, whereas regulatory T (Treg) cells inhibit them. Thus, the Th17/Treg cell balance is critically important in inflammatory diseases. However, the molecular mechanisms underlying this balance are unclear. Here, we demonstrate that casein kinase 2 (CK2) is a critical determinant of the Th17/Treg cell balance. Both the inhibition of CK2 with a specific pharmacological inhibitor, CX-4945, and its small hairpin RNA (shRNA)-mediated knockdown suppressed Th17 cell differentiation but reciprocally induced Treg cell differentiation in vitro. Moreover, CX-4945 ameliorated the symptoms of experimental autoimmune encephalomyelitis and reduced Th17 cell infiltration into the central nervous system. Mechanistically, CX-4945 inhibited the IL-6/STAT3 and Akt/mTOR signaling pathways. Thus, CK2 has a crucial role in regulating the Th17/Treg balance.
Casein Kinase II* ; Casein Kinases* ; Caseins* ; Central Nervous System ; Encephalomyelitis, Autoimmune, Experimental ; In Vitro Techniques ; RNA, Small Interfering ; T-Lymphocytes, Regulatory* ; Th17 Cells

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma

TGF-beta-induced tolerogenic-antigen presenting cells (Tol-APCs) could induce suppression of autoimmune diseases such as collagen-induced arthritis (CIA) and allergic asthma. In contrast, many studies have shown that NKT cells are involved in the pathogenesis of Th1-mediated autoimmune joint inflammation and Th2-mediated allergic pulmonary inflammation. In this study, we investigated the effect of CD1d-restricted NKT cells in the Tol-APCs-mediated suppression of autoimmune disease using a murine CIA model. When CIA-induced mice were treated with Tol-APCs obtained from CD1d+/- or CD1d-/- mice, unlike CD1d+/- APCs, CD1d-/- Tol-APCs failed to suppress CIA. More specifically, CD1d-/- Tol-APCs failed to suppress the production of inflammatory cytokines and the induction of Th2 responses by antigen-specific CD4 T cells both in vitro and in vivo. Our results demonstrate that the presence of CD1d-restricted NKT cells is critical for the induction of Tol-APCs-mediated suppression of CIA.
Animals ; Antibodies/blood ; Antibody Formation/immunology ; Antibody Specificity/immunology ; Antigen-Presenting Cells/*immunology ; Antigens, CD1d/immunology ; Arthritis, Experimental/blood/*immunology/*prevention & control ; Collagen Type II/immunology ; Cytokines/blood ; Immune Tolerance/*immunology ; Inflammation Mediators/blood ; Mice ; Natural Killer T-Cells/*immunology ; Th1 Cells/immunology

This study was performed to investigate the effect of insight on the readiness to change in alcoholism. The subjects were 131 Korean male patients with alcohol dependence who were being hospitalized in a community-based alcohol treatment center. The patients' readiness to change was classified into precontemplation, contemplation, and action stage through the readiness to change questionnaire. The state of the patients' insight was measured through the Hanil alcohol insight scale. Fourteen patients (10.7%) were in the stage of precontemplation, 65 (49.6%) in contemplation and 52 (39.7%) in action stage. The insight score of the patients in precontemplation stage was significantly lower (p<0.001) than that of others. On the basis of the precontemplation stage, multinomial logistic regression analysis for the control of the differences in the patients' characteristics among each stage of the readiness to change showed that the possibility of contemplation and action stage went up 1.231 (p<0.01) and 1.249 (p<0.01) times higher as the insight score increased.
Adaptation, Psychological ; Adult ; Alcohol Drinking ; Alcoholism/*psychology/*therapy ; Awareness ; Health Behavior ; Humans ; Korea ; Male ; Middle Aged ; Motivation ; Psychometrics ; Questionnaires ; Regression Analysis ; Self Care

OBJECTIVE: To investigate the clinical effectiveness of emergency cervical cerclage in pregnant women with advanced cervical incompetence in the second trimester. METHODS: This study analyzed retrospectively the pregnancy outcomes of 20 patients who were offered emergency cerclage between June 2000 and April 2004. Group I was defined as the patients cervical dilatation without membrane prolapse. Group II was the patients with membrane prolapse into vagina, who were underwent amniocentesis to decrease intraamniotic pressure. RESULTS: The mean+/-SD gestational age at cerclage was 21.6+/-2.4 weeks (Group I: 21.0+/-2.5, Group II: 22.1+/-2.3). The mean cervical dilatation was 2.5+/-0.9 cm (Group I: 1.8+/-0.5, Group II: 3.2+/-0.8) and mean effacement was 79.0+/-12.9% (Group I: 68.8+/-11.6, Group II: 87.3+/-6.4). The mean interval from cerclage to delivery was 9.4+/-5.3 weeks (Group I: 11.1+/-6.1, Group II: 7.9+/-3.7) and mean gestational age at delivery was 31.0+/-6.0 weeks (Group I: 32.2+/-7.4, Group II: 30.0+/-4.9). The birth weight was 1.9+/-1.1 kg (Group I: 2.4+/-1.4, Group II: 1.6+/-0.8) and the perinatal survival rate was 75% (Group I: 77%, Group II: 73%). Cervix dilatation and effacement were significantly more advanced in group II compared to the group I (p<0.05). However, the duration of pregnancy prolongation and birth weight, gestational age at the delivery were not significantly different between both groups. CONCLUSION: This results suggest that emergency cervical cerclage might be an effective treatment in advanced cervical incompetence, and that the concomitant amniocentesis could help the cerclage in the patients with membrane prolapse.
Amniocentesis ; Birth Weight ; Cerclage, Cervical* ; Cervix Uteri ; Dilatation ; Emergencies* ; Female ; Gestational Age ; Humans ; Labor Stage, First ; Membranes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnant Women ; Prolapse ; Retrospective Studies ; Survival Rate ; Vagina

Typhoid fever often manifests hepatic involvement but pleural involvement has rarely been reported to occur as a complication of typhoid fever. One case of typhoid pleurisy, in which Salmonella was isolated from the blood, is presented with the brief review of the literature. A 44 year old female was admitted to the hospital because of high fever, abdominal pain. Typhoid fever was diagnosed by blood culture, Widal test, and liver function test. Chest X-ray and pleural effusion examination demonstrated pleurisy. With the administration of ceftriaxone and pleural aspiration, she became afebrile with subsidence of pleural effusion.
Abdominal Pain ; Adult ; Ceftriaxone ; Female ; Fever ; Hepatitis* ; Humans ; Liver Function Tests ; Pleural Effusion ; Pleurisy* ; Salmonella ; Thorax ; Typhoid Fever*

Typhoid fever often manifests hepatic involvement but pleural involvement has rarely been reported to occur as a complication of typhoid fever. One case of typhoid pleurisy, in which Salmonella was isolated from the blood, is presented with the brief review of the literature. A 44 year old female was admitted to the hospital because of high fever, abdominal pain. Typhoid fever was diagnosed by blood culture, Widal test, and liver function test. Chest X-ray and pleural effusion examination demonstrated pleurisy. With the administration of ceftriaxone and pleural aspiration, she became afebrile with subsidence of pleural effusion.
Abdominal Pain ; Adult ; Ceftriaxone ; Female ; Fever ; Hepatitis* ; Humans ; Liver Function Tests ; Pleural Effusion ; Pleurisy* ; Salmonella ; Thorax ; Typhoid Fever*

We experienced a case of primary gastric tuberculosis presented with melena. A 61-year-old male was admitted with epigastric pain and melena. Upper endoscopy revealed an irregular shaped gastric ulcer on the posterior wall of the body. Histological examination of endoscopic specimen revealed chronic inflammation with fibrosis, granulomas and acid-fast bacilli. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. There was no evidence of the tuberculous lesion anywhere else. Primary gastric tuberculosis remains an extremely uncommon clinical entity; the definitive diagnosis is made by biopsy and positive culture for the organism. We report a case of primary gastric tuberculosis with review of the literature.
Biopsy ; Diagnosis ; Endoscopy ; Fibrosis ; Granuloma ; Humans ; Inflammation ; Male ; Melena* ; Middle Aged ; Mycobacterium tuberculosis ; Stomach Ulcer ; Tuberculosis*