Objective. To determine the influence of prostaglandins on the production of interleukins 2, 4, and 5 (IL-2, IL-4, and IL-5), interferon-y ( m y ) , granulocytemacrophage colony-stimulating factor, and transforming growth factor pl by CD4+ T cells.
Methods. THO, TH1, and TH2 T cell clones were stimulated in the presence and absence of the prostaglandin El (PGE,) analog misoprostol and PGE,. Lymphokine production was analyzed by using a semiquantitative polymerase chain reaction with lymphokine-specific primer sets andlor by determining lymphokine activity in bioassays.Results. PGE, and misoprostol have distinct effects on different functional T helper cells. TH1 cells, which predominantly produce IL-2 and IFNy, are completely inhibited, while TH2 cells, which preferentially produce IL-4 and IL-5, are largely unaffected. Misoprostol and PGE, are equivalent in their ability to modulate T cell function. In the presence of prostaglandins, THO-like helper cells, which are characterized by the coproduction of multiple lymphokines, function as TH2 cells; however, they do not differentiate into TH2 T cells.Conclusion. Prostaglandins that are produced in inflamed tissue can regulate the functional capabilities of infiltrating T cells. In the presence of PGE,, TH1-like responses are suppressed and THO-like responses are shifted toward a TH2-like pattern dominated by the production of IL-4 and IL-5.
This article focuses on the difficulties facing the neophyte trainee in the field of psychotherapy. Three areas of such difficulties are identified, defined, and discussed: feelings of inadequacy and incompetence, anxieties concerning supervisors, and confusion concerning multiple theoretical views of clinical work. Two vignettes from the early training of the paper's junior authors illustrate and discuss these problems and their resolution in applied contexts. A conclusion is offered which emphasizes the value of supervisory recognition of these dimensions of trainees' experience, as well as their potential for modeling processes of growth that are likely to help supervisees' patients as well.
Objective. To evaluate the efficacy of an antLCD5 ricin-linked immunoconjugate (CD5-IC) in patients with rheumatoid arthritis (RA).Methods. A total of 104 evaluable patients were enrolled in a multicenter, double-blind, multiple-dose, placebo-controlled study of CDS-IC.Results. Treatment with CDS-IC in doses up to 8 mg/m2/day for 4 days in 1 month failed to produce marked or prolonged T cell depletion and was no more effective than placebo in ameliorating disease manifestations. An unexpectedly high placebo response was observed in 48% of the patients. Adverse events were correlated with the dose of CDS-IC, but the treatment was generally well-tolerated.Conclusion. At the doses used in this study, CDS-IC was ineffective for treating RA.
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