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  • JAMA July 18, 2017

    Figure 4: Contrasting Standard vs Biologic Therapies in Asthma

    Standard asthma therapy is commonly delivered via the airway, by therapeutic aerosols of inhaled corticosteroids (ICSs) or bronchodilators, and by design have effects largely limited to the environment of the airway. The cysteinyl leukotriene receptor (type 1) antagonist montelukast (and others) is delivered to the airway by the systemic circulation and reduces smooth muscle contraction and inflammation, particularly that due to activated eosinophils. Biologic therapy in asthma acts upstream of the inflammatory process in the airway. Omalizumab reduces mast cell activation and release of mediators of bronchoconstriction (principally histamine and cysteinyl leukotrienes) and reduces production of proinflammatory cytokines, including IL-5. IL-5 is produced by several types of cells, including TH2 lymphocytes and type 2 innate lymphoid cells (ILC2), and by activated mast cells. IL-5 has protean effects on eosinophil poesis, maturation in the bone marrow, emigration into the circulation, migration to sites of inflammation, and activation to produce oxidative damage and toxic eosinophil granule protein release. Mepolizumab and reslizumab reduce the activity of IL-5 at all these sites and reduce eosinophilic inflammatory responses. Individually and collectively, airway inflammation, airway hyperresponsiveness, and bronchoconstriction may produce structural airway changes of increased smooth muscle mass, thickened lamina reticularis, and mucus gland hypertrophy, collectively known as airway wall remodeling. It has not been proven than that any asthma therapy reduces or eliminates airway wall remodeling.
  • B Cells Fuel Inflammation in Multiple Sclerosis

    Abstract Full Text
    JAMA. 2015; 314(21):2226-2226. doi: 10.1001/jama.2015.16086
  • JAMA June 9, 2015

    Figure 1: Histological Subtypes of NAFLD and Their Implications for Disease Progression

    Nonalcoholic fatty liver disease is broadly divided into those with NAFL (isolated steatosis with or without nonspecific inflammation) and NASH, with varying degrees of hepatic fibrosis. A, Isolated steatosis is characterized by macrovesicular fatty change in the absence of cellular injury (ballooning) (hematoxylin-eosin, original magnification × 10). B, Steatosis with nonspecific inflammation (hematoxylin-eosin, original magnification × 20). C, NASH is characterized by the additional presence of cellular ballooning (inset) (hematoxylin-eosin, original magnification × 20). D, NASH with early fibrosis in a typical pericellular pattern (arrowhead) (Trichrome, original magnification × 20). E, NASH cirrhosis is characterized by the development of broad collagen bands that form nodules (arrowhead) (Trichrome, original magnification × 10). Other characteristic features of NASH may or may not be present once cirrhosis has developed. ALT indicates alanine aminotransferase; AST, aspartate aminotransferase; AST:ALT, ratio of AST to ALT.
  • JAMA April 7, 2015

    Figure: Nanoparticle Delivery Approach Targets Atherosclerotic Plaques

    Nanoparticles loaded with peptides that help suppress inflammation may offer a new strategy for treating atherosclerosis.
  • JAMA April 7, 2015

    Figure: Painful Rash in a Patient With Bronchiectasis

    Left, Axial computed tomography scan of the chest revealing mild bronchiectasis and ground glass inflammation. Right, Purpuric plaque on the right medial ankle and dorsal foot, with central vesicles.
  • Research on Psychiatric Disorders Targets Inflammation

    Abstract Full Text
    JAMA. 2014; 312(5):474-476. doi: 10.1001/jama.2014.8276
  • Mucus’ Effects on Inflammation May Be Used to Treat Gut Diseases

    Abstract Full Text
    JAMA. 2013; 310(17):1785-1785. doi: 10.1001/jama.2013.281695
  • Fetal Growth Restriction, Inflammation Linked to Cerebral Palsy

    Abstract Full Text
    JAMA. 2013; 310(16):1666-1666. doi: 10.1001/jama.2013.281119
  • Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among Overweight and Obese Adults With Knee Osteoarthritis: The IDEA Randomized Clinical Trial

    Abstract Full Text
    free access
    JAMA. 2013; 310(12):1263-1273. doi: 10.1001/jama.2013.277669

    To determine the effects of weight loss on patients with knee osteoarthritis, Messier and coauthors conducted a 18-month randomized clinical trial comparing 3 interventions—intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, and exercise—among 454 overweight and obese older community-dwelling adults.

  • JAMA September 11, 2013

    Figure 2: Scalp Pustules in a Patient Receiving Chemotherapy

    Skin biopsy from the scalp revealing diffuse inflammatory cell infiltration around hair follicles and in the dermis, consisting of predominant lymphoplasmacytic cells and focal neutrophils (hematoxylin-eosin, original magnification ×40).
  • Systemic Inflammation in Predicting COPD Exacerbations

    Abstract Full Text
    JAMA. 2013; 309(22):2390-2391. doi: 10.1001/jama.2013.5733
  • Inflammation and Atherosclerosis

    Abstract Full Text
    JAMA. 2012; 308(17):1729-1729. doi: 10.1001/jama.2012.14656
  • JAMA September 19, 2012

    Figure: Studies Probe Mechanisms That Have a Role in Obesity-Associated Morbidities

    Researchers are investigating the relationship between obesity and associated metabolic disorders, including the role of chronic low-grade inflammation and inflammatory mediators in adipose tissue.
  • JAMA August 8, 2012

    Figure 2: Assessment of Nonalcoholic Steatohepatitis (NASH) Severity in Patients With Nonalcoholic Fatty Liver Disease (NAFLD) and Examples of Histological Features

    Right, The severity of NASH is estimated by the NAFLD Activity Score. Left, A, Low-power view showing extensive macrovesicular steatosis throughout liver (hematoxylin-eosin; original magnification ×50). B, High-power view showing macrovesicular fat and balloon degeneration consistent with NASH (hematoxylin-eosin; original magnification ×200). C, High-power view showing macrovesicular fat and lobular inflammation with neutrophils and lymphocytes consistent with NASH (hematoxylin-eosin; original magnification ×200). D, Liver showing steatosis and fine perisinusoidal fibrosis around hepatocytes (blue) consistent with NASH (trichrome stain; original magnification ×100).
  • Inflammation, Immune Activation, and CVD Risk in Individuals With HIV Infection

    Abstract Full Text
    JAMA. 2012; 308(4):405-406. doi: 10.1001/jama.2012.8488
  • Association Between Changes in Air Pollution Levels During the Beijing Olympics and Biomarkers of Inflammation and Thrombosis in Healthy Young Adults

    Abstract Full Text
    free access
    JAMA. 2012; 307(19):2068-2078. doi: 10.1001/jama.2012.3488
    Taking advantage of air pollution restrictions for the 2008 Olympics, Rich and colleagues compared blood serum levels in 125 medical students living in Beijing before, during, and after the games to determine whether cardiovascular disease biomarkers respond to variations in air pollution. In an editorial, Dominici and Mittleman discuss reconciling economic growth with environmental protections.
  • JAMA January 4, 2012

    Figure: Ulcer Insights

    A recent study suggests a new target for treating serious inflammation caused by the bacterium Helicobacter pylori.
  • JAMA October 12, 2011

    Figure 2: Antigen Presentation and Production of Antibodies to Gluten Peptides and Tissue Transglutaminase (tTG)

    In the subepithelium of the small intestine, native (partially digested) gluten peptides are deamidated by the enzyme tTG. While tTG is ubiquitous, it is predominantly stored intracellularly in an inactive state and released in the presence of inflammation and activated by higher levels of extracellular calcium ions. Deamidation leads to change in shape and charge of the gluten peptides, permitting high-affinity binding to HLA-DQ2 and -DQ8 on APCs such as dendritic cells and macrophages. Only HLA-DQ2 and -DQ8 are able to bind gluten peptides strongly enough to trigger an inflammatory reaction, so the presence of at least 1 of these molecules is a prerequisite for development of celiac disease. Naive T cells that have been activated by deamidated gluten presented by APCs are then able to stimulate both a TH1 cytotoxic and TH2 humoral antibody response. The TH2 response leads to production of antibodies against native gluten peptide, deamidated gluten peptide, and tTG. Antibodies to the self-protein tTG are produced because tTG is often still complexed with deamidated gluten peptides during presentation by APCs. This directed anti-self immune response is the major autoimmune component of celiac disease. TCR indicates T-cell receptor; IFN, interferon.
  • JAMA July 20, 2011

    Figure 1: Histopathology Results From Case Patient’s Percutaneous Liver Biopsy Specimens

    A, From a biopsy in 2008, hematoxylin-eosin stain demonstrates moderate portal inflammation, moderate interface hepatitis, and mild steatosis, and Masson stain shows bridging fibrosis (blue). B, Repeat biopsy in 2010 shows hematoxylin-eosin stain demonstrating decreased inflammation and decreased steatosis, and Masson stain showing fibrosis (blue), which is unchanged. Original magnification ×200.