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Bactrim dosing cystic fibrosis (CF). Although it is believed that the human immunodeficiency virus (HIV) interacts with cytotoxic T lymphocyte (CTL) activity in the thymus, and possibly also lungs, there are no data directly linking this effect to the cystic fibrosis clinical course. role of Adderal 60 pills $277.47 $4.62 the virus in lung as an immunopathogonal agent is supported by two findings. First, there is evidence that CTLs are recruited during inflammation in the lungs, a process involving both innate and adaptive immune responses (25,26). Second, the cytokines, including interleukins (IL-2, IL-4, and IL-13), tumor necrosis factor (TNF), interferon, and IL-22, are all increased in experimental CF lung transplantation models and are all upregulated in response to infection (27,28). While the data to support role of CTL infection in CF is mixed, we propose a model in which infection with a cystic fibrosis virus produces an innate immune response in the lungs that initiates CTL activation. It is possible that the cystic fibrosis cytotoxic T cells can then induce an adaptive response that may be further enhanced during inflammation. Cytotoxic T (CTL)-expressing Thymic Cells are Recruited by Intriguing Cytotic Cytokine Production Cytotoxic T cell (CTL) expression in thymuses is not as well studied relative to the lungs. As we have previously shown (25), in Th1-positive lung explants, the thymic epithelium produces more IL-12 and IL-18 a large more diverse cytokine repertoire than does Th2 cells (23,29). We therefore investigated whether induction of CTL by the thymus would stimulate a cytokine production cascade in the human airway epithelium (HAE) that might result in an airway-immune response. Although CTL expression in non-cystic fibrosis lung explants can be induced from an HAE explant on day 1 (30), induction in a HAE explant that had been treated with the cystic fibrosis virus in its serum was delayed comparison with a noncystic fibrosis explant (23); the delay appeared to be related a reduction in IL-12 production the CTL-expressing HAE explants (23). These observations have lead us to conclude that the cytokine production during CTL-expressing HAE is regulated by the Th1 phenotype of HAE cell. It has also been suggested that CTLs recruited by IL-12 on the spleens of cystic fibrosis (CF) patients from both the lungs and spleen promote antigen presentation to thymus (31), although whether the Th1 or Th2 phenotype determines recruitment of CTLs by circulating cells remains to be determined. It is interesting that two human CTL-expressing HAE cells cultured in culture also express the CD4 receptor (31). While this expression does not appear to be essential for CD4 T-cell production, the CTL cells that are expressed here may play roles in stimulating the production of cytokines in airway epithelial cells that have a Th2 phenotype. possible mechanism to explain IL-18 production from the CTL cells could be related to Th17 cell differentiation, which results in production or secretion of IL-17 from spleen and peripheral blood lymphoid tissues upon transplantation to CF patients (32). CTL-Expressing HAE Proliferates a Th2 Cell Line that is Pro-Inflammatory Human HAE cells exhibit a thymic phenotype during infection with cystic fibrosis virus or IL-12 and are capable of proliferating to high numbers during the latter phases of viral replication. These observations indicate that human Th2 cells may contribute to the cystic fibrosis inflammatory response. One potential mechanism by which CTL may support this response is through its role as an antigen presenting cell that can stimulate antigen-specific T-cell responses. CTL-expressing human HAE also expresses both CD4 and IL-2 receptors is able to produce IFN-γ and IL-17 cytokines (17). Interestingly, it was shown recently in human CTL-depleted epithelial cells that these can produce antigen-specific IL-22 that was associated with an increase in interferon-γ and IFN-γ production Th1-competent but not Th2-competent cultures (33). Therefore, although CTL is not a major player in human lung development, it may be involved in initiating and stimulating Th2 Th17 cell differentiation and production of IL-22. Cytotoxic T cells of the CTL-expressing Thymus May Increase Th17 Cell Proliferation in the Lung Cytotoxic T cells from the CTL-expressing thymus are known to.

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