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Plasmodium falciparum–infected individuals in a malaria-endemic region have an abundance of adaptive NK cells that correlates with resistance to malaria. Adaptive NK cells dominate antibody-dependent responses to P. falciparum–infected red blood cells and may contribute to acquired immunity to malaria.

A role for tumour necrosis factor-a, complement C5 and interleukin-6 in the initiation and development of the mycobacterial cord factor trehalose 6,69-dimycolate induced granulomatous response

Hypothyroidism is a very common disorder worldwide, for which the usual treatment is monotherapy with levothyroxine (L-T4). However, a number of patients treated with L-T4 continue to report symptoms of hypothyroidism despite seemingly normal levels of thyroid stimulating hormone (TSH), free-T3 (FT3), and free-T4 (FT4) measured by immunoassay. This review summarizes the limitations of the immunoassays commonly used to measure thyroid hormones and emphasizes the advantages of the role of liquid chromatography-tandem mass spectrometry (LC-MSMS). Immunoassays for free thyroid hormone are affected by alterations in serum binding proteins that occur in many physiologic and disease states. Multiple studies show falsely normal values for T3, FT3, and FT4 by immunoassay that are below the reference interval when measured by (ultrafiltration) LC-MSMS, a reference method. We suggest evaluation of thyroid hormone levels by ultrafiltration LC-MSMS for patients who continue to experience hypothyroid symptoms on LT-4. This may help identify the approximately 20% subset of patients who would benefit from addition of T3 to their treatment regimen (combination therapy).

Postprimary tuberculosis occurs in immunocompetent people infected with Mycobacterium tuberculosis. It is restricted to the lung and accounts for 80% of cases and nearly 100% of transmission. Little is known about the immunopathology of postprimary tuberculosis due to limited availability of specimens. Tissues from 30 autopsy cases of pulmonary tuberculosis were located. Sections of characteristic lesions of caseating granulomas, lipid pneumonia, and cavitary stages of postprimary disease were selected for immunohistochemical studies of macrophages, lymphocytes, endothelial cells, and mycobacterial antigens. A higher percentage of cells in lipid pneumonia (36.1%) and cavitary lesions (27.8%) were positive for the dendritic cell marker DEC-205, compared to granulomas (9.0%, P < .05). Cavities contained significantly more T-regulatory cells (14.8%) than found in lipid pneumonia (5.2%) or granulomas (4.8%). Distribution of the immune cell types may contribute to the inability of the immune system to eradicate tuberculosis.

Vancomycin is the first-line therapy for methicillin-resistant