Therapeutic use of IL-2 can generate antitumor immunity; however, a variety of different mechanisms have been reported. We injected IL-2 intratumorally (i.t.) at different stages of growth, using our unique murine model of mesothelioma (AE17; and AE17 transfected with secretory OVA (AE17-sOVA)), and systematically analyzed real-time events as they occurred in vivo. The majority of mice with small tumors when treatment commenced displayed complete tumor regression, remained tumor free for >2 mo, and survived rechallenge with AE17 tumor cells. However, mice with large tumors at the start of treatment failed to respond. Timing experiments showed that IL-2-mediated responses were dependent upon tumor size, not on the duration of disease. Although i.t. IL-2 did not alter tumor Ag presentation in draining lymph nodes, it did enhance a previously primed, endogenous, tumor-specific in vivo CTL response that coincided with regressing tumors. Both CD4+ and CD8+ cells were required for IL-2-mediated tumor eradication, because IL-2 therapy failed in CD4+-depleted, CD8+-depleted, and both CD4+- and CD8+-depleted C57BL/6J animals. Tumor-infiltrating CD8+ T cells, but not CD4+ T cells, increased in association with a marked reduction in tumor-associated vascularity. Destruction of blood vessels required CD8+ T cells, because this did not occur in nude mice or in CD8+-depleted C57BL/6J mice. These results show that repeated doses of i.t. (but not systemic) IL-2 mediates tumor regression via an enhanced endogenous tumor-specific CTL response concomitant with reduced vasculature, thereby demonstrating a novel mechanism for IL-2 activity.

ObjectivesWe have undertaken a clinic-based survey of neuromyelitis optica spectrum disorders (NMOSD) in Australia and New Zealand in order to establish incidence and prevalence across the region and in populations of differing ancestry.Background NMOSD is a recently defined demyelinating disease of the central nervous system. The incidence and prevalence of NMOSD in Australia and New Zealand has not been established. European ancestry. We found NMOSD to be more common in the population with Asian ancestry. Methods

A prospective, 12-month study of 975 non-Aboriginal children with diarrhea and age- and sex-matched children without diarrhea, in Perth, Western Australia, was designed to investigate the significance of enterotoxigenic Aeromonas species as a cause of diarrhea. Enterotoxigenic Aeromonas species were found in the fecal specimens of 10.8% of the patients with diarrhea but in only 0.7% of those without diarrhea. Most Aeromonas species were isolated during the summer. Other important bacterial pathogens included Campylobacter, Salmonella, Shigella, and enterotoxigenic Escherichia coli; rotavirus infections appeared to be much less important in the Western Australian environment. Most of the patients were younger than two years of age and about one-quarter had mixed bacterial and/or viral intestinal infections. Enterotoxigenic Aeromonas species can be identified with 97% accuracy using a simple hemolysin assay which should be considered for use by routine diagnostic laboratories, particularly in children's hospitals.

Cross-presentation of exogenous Ags via the MHC class I pathway is now recognized for its role in self-tolerance, tumor immunity, and vaccine development. However, little is known about the in vivo distribution and kinetics of cross-presented protein Ags, nor the subsequent development of CTL effector responses to dominant or subdominant epitopes. We examined the location and duration of cross-presented Ag by using 5,6-carboxy-succinimidyl-fluorescein ester-labeled T cells from class I-restricted Ag-specific TCR mice. Comparisons of results from an in vitro 51Cr release CTL assay with an in vivo CTL assay provided physiologically relevant insights into the functional capacities of CTL specific for epitopes with differing affinities. These data demonstrate that efficient cross-presentation of a dominant class I-restricted Ag is dose related and remains largely localized, but not limited to the draining lymph nodes for up to 3 wk following a single injection of soluble protein. Within this period, dominant peptide-specific CTL are fully functional in vivo throughout the secondary lymphoid system. However, no in vivo responses are seen to a subdominant or cryptic epitope. Prolonging Ag cross-presentation via use of IFA promoted persisting in vivo dominant epitope-specific CTL activity and revealed dose-responsive precursor CTL to the subdominant, but not to a cryptic epitope. Analysis of functional in vivo CTL responses demonstrated that, in the presence of strong ongoing responses to the dominant peptide, lytic activity of CTL directed at weaker epitopes is undetectable.