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Title: Contralateral responses to an inflammatory stimulus in man
Author: Shenker, Nicholas
Awarding Body: University of Bath
Current Institution: University of Bath
Date of Award: 2005
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Two observations are made. Firstly, many chronic inflammatory diseases manifest a bilateral symmetry far greater than expected by chance. This observation is supported by examining the distribution of erosions in the hands and wrists of 42 patients with rheumatoid arthritis using a microfocal radiographic technique. This demonstrated that particular areas were predisposed to erosions and that these areas contributed most to the symmetry seen in this disease. Secondly, from published literature afferent neural pathways that cross through the spinal cord, or via higher order connections, are anatomically identifiable, physiologically active and implicated in the distant transmission of inflammation in several animal models. The f thesis is that local inflammation can be neurally reflected to the topographically precise contralateral region in man. This can then explain the symmetrical phenotype of chronic inflammatory diseases and expose new targets for anti-inflammatory treatments. The first hypothesis is that the skin blood flow in the area of the contralateral arm, precisely topographical to an active immunisation given 2-4 days prior, will be different to that of control areas in a group of healthy volunteers. Using a laser Doppler imager to semi-quantify the skin blood flow there were no differences seen between the experimental and control contralateral regions. The second hypothesis is that there is greater expression of endothelial E-selectin in skin biopsies taken from the exact contralateral area to an MMR immunisation (given 1-3 days prior) when compared to the control biopsy taken from a different contralateral dermatomal area. Using a supraoptimal dilutional immunohistochemical technique there were no differences in E-selectin expression between the experimental and control groups contralateral to the MMR immunisation. The null hypothesis is again supported. Further work should consider a different stimulus or extending the timing of the observations before the thesis can be rejected.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available