Regardless, it is easy to appreciate

how the work from these two laboratories provides hope for millions of people with certain types of liver disease. Indeed, hepatocytes from iPS cells represent a giant leap forward for hepatology. “
“See article in J. Gastroenterol. Hepatol. 2011; 26: 1145–1150. Tuberculosis (TB) remains a major challenge to human health, affecting 9.4 million and killing Y-27632 mouse 1.7 million people each year.1 Intestinal tuberculosis (ITB) is one form of extra-pulmonary TB; it most often affects the ileocecal region, but can affect any part of the gastrointestinal tract. Making a clinical diagnosis is challenging, as its non-specific symptoms of abdominal pain, fever and weight loss often mimic other diseases, particularly Crohn’s disease, adenocarcinoma and other enteric infections. Ultrasound, barium studies, computed tomography (CT) and magnetic resonance imaging (MRI) may support the diagnosis, but

imaging is often relatively non-specific. Therefore endoscopic biopsy and histological examination are usually required to confirm the diagnosis, including smear for acid-fast bacilli and culture. In high burden regions, however, empirical treatment is often instituted even without bacteriological confirmation, followed by monitoring of the patient’s response to treatment. In this edition of the Journal, Lv et al. demonstrate an association between ITB and genetic variants BMS-777607 of the intracellular proteasome, which is involved in processing protein antigens

for MHC class I-restricted presentation to CD8+ T cells.2 Their population of 168 patients all had microbiologically proven ITB; 51% of patients also had concurrent pulmonary disease, but none had disease of the selleck chemical peritoneal cavity or other viscera. This study sheds further light on the role of CD8+ T cells in response to extra-pulmonary TB. T cells play a central role in the adaptive immune response to tuberculosis infection, and the essential role of CD4+ T-cells in controlling Mycobacterium tuberculosis is well established.3 Evidence from both murine and human studies indicates that CD8+ T cells are also important for effective immunity against M. tuberculosis, through the recognition of mycobacterial peptides and lipids presented by MHC Class I and non-classical MHC molecules, respectively, on infected macrophages.4,5 These CD8+ T cells contribute to the control of infection by cytolysis of infected macrophages, augmenting cytokine production and the direct activity of secreted anti-microbial peptides.6 The key insight provided by Lv et al. is that proteosome-mediated processing of mycobacterial peptides for MHC class I presentation has an important role in the immune response to extrapulmonary TB.2 LMP2 and LMP7 (also called PSMB9 and PSMB8) are protein subunits of the multimeric proteosome, which degrades intracellular proteins into peptides.