Background We previously reported abnormalities in circulating B cells in patients with chronic granulomatous disease (CGD) and those with HIV infection. Gastrointestinal complications are common to both diseases and likely involve perturbation of immune cells, including plasma cells (PCs). IgA is the most abundant immunoglobulin in the human body, with roles in protection and maintenance of intestinal homeostasis. IgA is produced primarily by PCs residing in mucosal tissues that are also thought to circulate in the blood. Objective We sought to characterize and compare PCs in patients with infectious (HIV) and noninfectious (CGD and Crohn disease) diseases that have been associated with intestinal inflammation. Methods Phenotypic and transcriptional analyses were performed on cells isolated from the blood and colon. Results IgA-secreting CCR10-expressing PCs predominated in the guts of healthy subjects, whereas in patients with HIV, CGD, and Crohn disease, there was a significant increase in the proportion of IgG-secreting PCs. Where intestinal inflammation was present, IgG-secreting PCs expressed reduced levels of CCR10 and increased levels of CXCR4. The intensity of CXCR4 expression correlated with the frequency of IgG-expressing PCs and the frequency of CXCR4+/IgG+ PCs was associated with the severity of intestinal inflammatory disease yet distinct from PCs and plasmablasts circulating in the blood. Conclusions These findings suggest that regardless of the underlying disease, the presence of CXCR4+/IgG+ PCs in the gut is a strong yet localized indicator of intestinal inflammation. Furthermore, our findings suggest that CXCR4+/IgG+ PCs might play a role in immune cell homeostasis during inflammatory processes of the gut.

The present investigation examined the potential benefits and costs of optimistic expectations about future events through the lens of Error Management Theory (EMT). Decades of evidence have shown that optimism about the likelihood of future events is pervasive and difficult to correct. From an EMT perspective, this perpetuation of inaccurate beliefs is possible because optimism offers benefits greater than the costs. The present investigation examined this possibility for controllable important life events with a known time at which they would occur.College students taking their first exam (n = 1,061) and medical students being matched with residency placements (n = 182) reported their expectations and emotions weeks before the event and their responses after they knew the outcome of the event. There was evidence that optimistic expectations predicted the quality of effort investment before an event occurred -students were more satisfied with their studying and medical students were more satisfied with their decision making, and both groups performed better when optimistic. Optimistic expectations also predicted less emotional distress before the event occurred. There was no evidence that optimistic expectations related to longer-term greater distress when participants experienced an unexpected negative outcome; the valence of the outcome itself predicted distress. Consistent with EMT, optimistic expectations appear to have benefits for effort and emotion before an event occurs, with little cost after the outcome occurs.

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Disseminated gonococcal infection (DGI) often manifests as gonococcal arthritis and may carry significant morbidity. However, diagnosis remains elusive due to limited sensitivity of available diagnostic tests. We used metagenomic next-generation sequencing to detect Neisseria gonorrhoeae from culture-negative joint aspirates of 2 patients with clinically diagnosed DGI.

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