The purified proteins did not present cross-reactivity with sera from dogs infected with Trypanosoma caninum, Babesia canis and Ehrlichia canis. Cross-reaction was verified with sera from dogs infected with Leishmania brasiliensis (11·7% for rLci2B and 2·9% for rLci1A). Based on ELISA results, it is suggested the use of rLci2B and rLci1A as antigens in an alternative serological assay for diagnostic of canine leishmania. Leishmaniasis

is an endemic disease present in more than selleck chemicals 60 countries worldwide, including Southern Europe, North Africa, the Middle East, Central and South America, and the Indian subcontinent (1). Leishmaniasis comprises a group of diseases caused by protozoan parasites of the Leishmania genus that includes cutaneous, mucocutaneous and visceral leishmaniasis. Visceral leishmaniasis (VL) is provoked mainly by Leishmania chagasi (= syn. DMXAA in vivo Leishmania infantum),

and it is a relevant human disease prevalent in many American countries, including Brazil (2). This form has the greatest potential for lethality and affects 500 000 people worldwide (3). The VL symptoms include fever, weight loss, hepatosplenomegaly, lymphadenopathy, pancytopenia and hypergammaglobulinaemia (4). Skin pigmentation may also be a feature (kala-azar: black disease). It may be asymptomatic and self-resolving, but usually runs a chronic course and may be fatal if left without treatment (5). The dogs have all the characteristics of a good reservoir: they are present in the domestic and peridomestic environment (6), working as a powerful source for the vector, and they develop

high parasitic skin, allowing (-)-p-Bromotetramisole Oxalate a high rate of infection (7). These characteristics are important to maintain the domestic cycle vector-dog-vector-human (6), making diagnosis of L. chagasi infected dogs essential for VL surveillance programs. For the diagnosis of canine VL, the dog epidemiological origin and symptoms should be considered. Parasitological diagnosis based on visualization of the parasite is regarded as a ‘gold standard’ test. In contrast, the serologic diagnosis of VL is based on different methods of antibody detection that include the direct agglutination test, the indirect immunofluorescence test, immunoblotting analysis, the enzyme-linked immunoassay (ELISA) and rapid diagnostic tests (8,9). Nowadays, molecular approaches such as screening of Leishmania genes in cDNA libraries promote the identification of different antigens that are targets for vaccine development and diagnostics of leishmaniasis (10). Some protein antigens, lipids and carbohydrates such as GP63 (11), Leishmania-activated C kinase (12), lipophosphoglycan (13), D13 or p80 (14,15), K9 and K26 (16), Leif (Leishmania elongation initiation factor) (17) and protein A2 amastigote-specific (18), among others, present particular characteristics that allow their potential use in diagnosis (19).

Based on the imaging results and her clinical symptoms, she was finally diagnosed with non-herpetic limbic encephalitis

and treated with methyl-prednisolone pulse therapy (1 g/day for 3 days). Immediately after starting steroid treatment, her fever and headache disappeared, and her short-term memory loss subsequently improved. However, because her mild somnolence persisted, a second cycle of methyl-prednisolone pulse therapy (1 g/day for 3 days) was commenced on day 18 of the illness. After Metformin mouse this treatment, the patient recovered completely without any neurological sequelae. As HSV infections are commonly associated with encephalitis, PCR detection of viral DNA in CSF is a popular method for diagnosing encephalitis. In general, patients who are suspected to have encephalitis, including limbic encephalitis, undergo an examination to determine whether the diagnosis is herpes simplex encephalitis. Non-herpetic acute limbic encephalitis case, which has been determined to be HSV-negative by PCR analysis of the CSF, could be caused by any of the six other human herpesviruses. In order to investigate this possibility we used real-time PCR methods, which have been suggested to be valuable tools for diagnosing encephalitis (11–14), to measure the viral DNA load in CSF samples. The reliability of the previously established real-time PCR methods

is selleck products high, and the sensitivities of these methods (10 gene copies/reaction) were considered to be sufficient for detection of small amounts of viral DNA in CSF. None of the CSF samples collected from non-herpetic acute limbic D-malate dehydrogenase encephalitis patients contained DNA from the six herpesviruses, except for one patient who was EBV DNA-positive. Although HHV-6 is thought to be a causative agent for post-transplant acute limbic encephalitis (3–5), none of the CSF samples in this study contained HHV-6 DNA. Although in vitro examinations were not performed to evaluate the patients’ immunity, their medical records indicated that all of them appeared to be immunocompetent.

Therefore, although there were a limited number of samples in this study, these results suggest that HHV-6 is not the main causative agent for non-herpetic acute limbic encephalitis in immunocompetent individuals. However, a limitation of this study is that only one CSF sample from each patient was tested. It is well known that repeat examination of CSF samples is useful to determine whether or not causative agents are present in the CSF. Large number of samples should be analyzed to further elucidate this question in a future study. Only one CSF sample contained EBV DNA, and this was at 1184 copies/ml. As the patient did not show typical clinical features of infectious mononucleosis, serological examination for EBV infection was not performed.

90–92 However, similar experiments, but using a different ST2-deficient mouse, indicated that Th2 cells developed normally in vitro and in vivo.93 These studies are open to broader interpretation if ST2 is shared by other ligands. One study has reported il33-deficient mice that develop milder airway inflammation following allergen challenge;94 however, a detailed analysis of Th2 cell development in vitro or in vivo was not reported. buy Gefitinib In addition to other cytokines, which most likely contribute to Th2 cell differentiation, so far IL-4, TSLP, IL-25 and IL-33 have all been associated

with differentiation, activation and/or recruitment of Th2 cells. Whether a context-specific hierarchy of importance for these molecules can be drawn up or not is unclear. There appears to be significant overlap and redundancy, from the current literature. Whether this is true redundancy, or a failure on our part to dissect Th2 cells at sufficient resolution is not clear. For example, are naive or differentiated Th2 cells that are exposed to IL-4, TSLP, IL-33 and or IL-25 similar? Adding one more dimension, such as variable TCR signal strength, are these cells still similar? Further still, adding a third dimension of co-stimulation, do these polarizing

cytokines still act in similar ways? And so on. We hypothesize that there is significant heterogeneity within the Th2 spectrum, so much so that there is overlap into what may www.selleckchem.com/products/midostaurin-pkc412.html appear to be Treg, Th9, Th17 or Th1 cells, depending on the signals received and lineage-defining markers used. As briefly mentioned above, T helper cell plasticity is slowly being unravelled and is smudging the lines between the current subsets. Current Th cell nomenclature, such as Th1 and Th2 will make a half-century but as we delve

deeper into the molecular machinery of Th cell biology unique properties aminophylline of Th cells in the context of disease are appearing. This has led to two schools of thought (i) fractionating the Th subsets further still into unique subsets, or (ii) grouping the Th cells together with an appreciation of plasticity depending upon the environment. As more data are reported, support for a plasticity model is gaining weight, but presumably this too has a limit. Can a fully polarized IFN-γ-producing cell with TCR re-arrangement, chromatin remodelling of the ifng gene and tissue-specific homing markers ever turn on IL-4, IL-5 and IL-13? Would it ever need to in vivo? The interactions between microorganisms and antigen-presenting cells, via pathogen-associated molecular patterns and pathogen recognition receptors leading to induction of Th1 responses are well documented.95,96 Progress is being made to elucidate helminth products, allergens and their cognate receptors expressed by DCs that lead to the induction of Th2 responses.

However, the relative contributions of each of these factors was uncertain,5 and a number of new and distinct trends

have emerged over the past decade. In this paper we examine the role of these factors in patterns of RRT in various demographic groups within Australia and New Zealand (NZ). The ANZDATA registry is a complete database Pifithrin-�� cost of patients who receive chronic RRT – either dialysis or kidney transplant – in Australia and NZ. All patients who commenced chronic RRT in Australia or NZ were included in analyses. We grouped patients into six primary kidney diseases: glomerulonephritis, analgesic nephropathy, vascular disease, cystic diseases, DN, and other causes. Comorbidities recorded were the presence (or suspected presence) of coronary artery disease, R788 mouse peripheral vascular disease, chronic lung disease,

cerebrovascular disease and diabetes. We generally combined type 1 and type 2 DN patients, in line with most of the published data.6 Race was coded as: Indigenous Australian (Aboriginal and Torres Strait Islanders), all other Australians, Māori, Pacific people in NZ and all other NZ residents. Late referral was defined as commencement of RRT within 3 months of nephrology referral and this was routinely collected after March 1997. We calculated body mass index (BMI) from weight at commencement of RRT for patients older than 19. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine at commencement

of RRT, 3-oxoacyl-(acyl-carrier-protein) reductase using the four variable Modification of Diet in Renal Disease Study (MDRD) formula7 for patients older than 18. We did not apply any correction factors for racial groups for eGFR or BMI. We used age and sex-stratified population estimates of the five demographic groups.8–12 Population data were only available for 1996, 2001 and 2006 for Pacific people, so we interpolated and extrapolated numbers for each age group to all years from 1990 to 2009. We used modified Poisson regression to calculate adjusted relative risks (RR) between groups of patients.13 Sandwich robust standard error estimates allowed for clustering (overdispersion) by initial hospital, except when comparing between countries. Where appropriate, RR were calculated with adjustments for age (four categories: 0–49, 50–59, 60–69 and 70+ years), sex, race and year of treatment, and interactions with treatment year when meaningful. Comparisons of pre-emptive transplants also involved adjustments for weight, height, serious comorbidities (confirmed or suspected chronic lung, coronary artery, peripheral and cerebrovascular diseases and diabetes), and data limitations mean that only patients who started after 2000 were included. All RR values presented are adjusted, and are only presented when significantly different to 1.0 (P < 0.05). Continuous variables such as eGFR were analyzed with linear regression using the covariates listed above.

Thus, it would be unreasonable to expect a stronger effect (in other words, after onset of diabetes) in humans. Secondly, no preclinical study ever tested the clinical GAD-Alum preparation, and no efficacy was noted in our recent studies in NOD and B6 diabetes models (Pagni, Boettler and von Herrath, unpublished). selleckchem Again, it is probably unreasonable to expect an antigenic formulation to work in humans when it does

not even prevent diabetes in otherwise permissive animal models. Several other theories have been proposed to account for the failure of GAD-Alum in humans, including the lack of GAD expression in β cells; this is a controversial area, as many studies have demonstrated expression of GAD-65 and 67 proteins in murine and human β cells [36]. Lastly, one could ask whether the dose of GAD-Alum was sufficient – as most patients mounted a clearly detectable immune response, this appears less likely. However, alum might have been a suboptimal adjuvant for an ASI, as the resulting mixed but T helper type 2 (Th2)-dominated cytokine response of induced GAD-reactive T cells (Arif, CHIR-99021 Roep and Peakman, unpublished) did not result in protective cell populations. In the absence of a functional mouse model of GAD-Alum preventing diabetes, it will be difficult at this point to clarify these issues. The question of the antigenic dose might have more bearing on the

issue of efficacy with oral insulin [15]. As predicted from animal models [37], prophylactic oral GNE-0877 insulin given at a daily dose of 7·5 mg had a very marginal effect in preventing diabetes in individuals at high risk (exhibiting multiple autoantibodies [38-41]), but not in any other patient groups. However, as has been evident from multiple studies in different mouse models, oral insulin dosages have to be comparatively

much higher to induce optimal disease preventive effects, which are seen at a dose of 1 mg given twice per week [42]. This dose would equate to approximately 1 g of oral insulin twice per week in humans. In addition, it is likely to be necessary to provide the drug in enteric-coated capsules, without which > 99·99% of the insulin is lost through digestion in the stomach and only minimal amounts of intact antigen or some peptides will reach the lower gut and the Peyer’s patches, the location at which oral insulin has been shown to induce its desired immune-regulatory response. Therefore, more precise dose calculations should have probably preceded the oral insulin trial and its current follow-up study. A further human/mouse mismatch relates to the overall management of expectations when devising trials for ASI. In rodent studies most, if not all, ASI is effective only for early and, at best, late prevention of disease, but never after onset of hyperglycaemia. Thus, we should not expect antigens to reverse human diabetes or even preserve C-peptide after onset (at least with effects detectable in reasonably sized studies); and this has indeed been the case.

However, except for HIV and EBV, the other human viral pathogens have often only been tested in one or two studies in mice with human immune system components. The obtained information is often too sparse to judge whether these infections faithfully recapitulate pathogenesis in patients. Moreover, the low number of

animals analyzed in the respective experiments begs for further characterization, in greater detail. Although the reconstitution of human immune system components has been catalogued in detail and the T cells as well as B cells arising in these systems have been PKC412 purchase shown to possess a highly diversified antigen receptor repertoire [8, 57-59], the characterization of the Lapatinib supplier immune competence of the reconstituted immune system lags behind. While primary lymphoid tissues such as thymus and BM are populated with human cells and support the development of B-cell and T-cell compartments [60, 61], the development of secondary lymphoid tissues is compromised, with only few lymph nodes developing and a disorganized white pulp structure in the spleen [62]. Given that isotype switching and affinity maturation of B-cell responses depend much more on these secondary lymphoid structures than T-cell responses [63], isotype-switched B-cell responses

are difficult to achieve in these models. This is in contrast to T-cell responses, which develop readily in response to pathogen challenge in mice with reconstituted human immune system components. Accordingly, specific antibody responses to HIV, HSV-2, JC Docetaxel virus, dengue virus, and EBV were mostly IgM after infection and only a minor subset of reconstituted mice developed IgG responses against viral antigens [22, 40, 49, 50, 52, 53, 64]. Improved interactions of human B cells with CD4+ follicular helper T cells might overcome this

shortcoming [65], but currently no protocol that would consistently ensure these interactions has been established. Moreover, no studies have so far addressed the protective value of the observed B-cell responses by B-cell depletion, for example. Thus, it remains unclear to which extent protective anti-viral humoral immune responses can be modeled in mice with reconstituted human immune system compartments. Partly due to this limitation, the protective value of antibodies is starting to be assessed by passive immunization in these in vivo models. It was recently documented that HIV was able to escape neutralizing antibody monotherapy during infection of reconstituted mice, but that a pool of five HIV neutralizing antibodies controlled HIV viral load [66]. This protection lasted 60 days after cessation of therapy. Taking it one step further, a HIV-neutralizing IgA antibody was expressed in human hematopoietic progenitors by lentiviral transduction and following reconstitution, a protective effect was observed against mucosal transmission of HIV [67].

Qi Cao USE OF STENTS IN HAEMODIALYSIS FISTULAE: SUCCESS AND LONG TERM FOLLOW-UP Brendon Neuen NUTRITIONAL STATUS IS ASSOCIATED WITH THE FUTURE TREATMENT CHOICE – RENAL REPLACEMENT THERAPY VS. CONSERVATIVE CARE IN END STAGE KIDNEY DISEASE PATIENTS

ATTENDING THE MULTIDISCIPLINARY PRE-DIALYSIS ASSESSMENT CLINIC Maria Chan SELECTIVE EPITHELIAL POTENTIAL Roscovitine mw OF A RENAL MESENCHYMAL STEM CELL-LIKE POPULATION DERIVED FROM MATURE COLLECTING DUCT EPITHELIUM Joan Li UPPER ARM FISTULAE AND MULTIPLE STENOSES INFLUENCE HAEMODIALYSIS ARTERIOVENOUS FISTULAE PATENCY AFTER BALLOON ANGIOPLASTY?

Brendon Neuen UREMIC TOXINS AND INFLAMMATION IN CHRONIC KIDNEY DISEASE Megan Rossi FMS-LIKE TYROSINE KINASE 3 LIGAND (FLT3-L) INDUCES REGULATORY T CELLS (TREGS), BUT DOES NOT PROTECT MICE FROM EXPERIMENTAL CRESCENTIC GLOMERULONEPHRITIS (GN) Joanna Ghali CLINICAL OUTCOMES AFTER ARTERIOVENOUS FISTULA CREATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE Mardiana Lee I Don’t Like What I Read About Chronic Kidney Disease, I Might As Well Just Go Get A Gun And Shoot Myself”: Focus Group Study of Patients with Early Stage Chronic Kidney Disease Pamela A Lopez-Vargas LOSS OF CRIM1 RESULTS LEE011 IN RENAL PAPILLARY HYPOPLASIA VIA PERTURBATIONS

TO WNT/β-CATENIN SIGNALLING Yu Leng Phua OUTCOME OF PREDIALYSIS EDUCATION IN WESTERN SYDNEY: EARLY REFERRAL IS ASSOCIATED WITH REDUCED RATE OF LINE USE AT FIRST DIALYSIS Tatiana Smolonogov IMPROVED PATIENT ACCESS TO DIETETIC SERVICES IN CHRONIC KIDNEY DISEASE USING A CATEGORISED REFERRAL TOOL Belinda Mason INNATE IMMUNE CELLS PRODUCE INTERLEUKIN-17A, WHICH DRIVES AUTOIMMUNITY AND LUPUS NEPHRITIS Shaun Summers FACTORS selleck products INFLUENCING HAEMODIALYSIS ARTERIOVENOUS FISTULA PATENCY AFTER BALLOON ANGIOPLASTY; A SYSTEMATIC REVIEW Brendon Neuen IDIOPATHIC MEMBRANOUS NEPHROPATHY (IMN) TREATMENT AND OUTCOMES: A RETROSPECTIVE CASE REVIEW STUDY Danielle Wu INCREASED TUBULOINTERSTITIAL RECRUITMENT OF HUMAN CD141hi CLEC9A+ AND CD1C+ MYELOID DENDRITIC CELLS IN FIBROTIC KIDNEY DISEASE Ray Wilkinson IMPROVING VASCULAR ACCESS OUTCOMES AT GOLD COAST Samuel Thokala ALPORT SYNDROME AND THIN BASEMENT MEMBRANE NEPHROPATHY IN THE QUEENSLAND CHRONIC KIDNEY DISEASE (CKD) REGISTRY Andrew Mallett DIRECTING THE DIFFERENTIATION OF HUMAN ES CELLS TOWARDS A RENAL FATE.

Thus, immunological approaches against hCG have potential of use not only for control of fertility, but also as new therapeutic options for advanced stage, invariably drugs refractory, hCG expressing tumors. hCG has a role not only in initiation but also in sustenance of pregnancy. It is no doubt critical for implantation even though the precise mechanism is not fully clear. Leukemia

inhibitory factor is up-regulated by hCG.16 hCG inhibits IL-2 in peripheral blood mononuclear cells (PBMC) and modulates the immune response during pregnancy.17 hCG exercises an inhibitory effect on blast transformation of lymphocytes to mitogens and allogenic cells.18,19 hCG also elicits immunoregulatory properties by suppressing mitogen-induced responses of T18,20,21 and B lymphocytes.19 Regulatory T cells (Treg) present at the fetal–maternal interface are believed to provide immune tolerance favoring the fetus. Moreover, Z-VAD-FMK in vitro hCG is reported to attract macrophages to the fetal–maternal interface, which prevent the exposure of maternal immune system to paternal antigens in the placenta.22,23 Human gonadotropins promote the decidualization of stromal cells, noticeable not only by the morphology of the stromal cells to get transformed to the decidual phenotype, but also evident from the expression of prolactin.24 Both

in selleck vivo and in vitro evidence point out to the formation of syncytium from cytotrophoblasts by the action of hCG.25 A recombinant chimeric antibody cPiPP Clomifene against hCG prevents the fusion of cytotrophoblasts into syncytium.26 Administration of hCG causes an increase in endothelial cell proliferation.27 Treatment with hCG increases the levels of vascular endothelial growth factor (VEGF) and metaloproteinase-924 and hence promotes angiogenesis. Many actions of hCG in promoting pregnancy may also be operative in its support to cancers. hCG or its subunits enhance the proliferation

of tumor cells. Bladder cancer cell line T24, which does not produce hCG or its subunits, after treatment with βhCG showed a marked increase in proliferation.28 This action may be a result of its counteracting the apoptotic effect of TGFβ-1; TGFβ-1-induced apoptosis is dose dependently inhibited by co-incubation with βhCG.29 hCG also causes the down-regulation of Fas, Fas ligand, and BAX and p53, which are major apoptotic factors.30 Reduction in βhCG subunit expression in cervical cancer cell lines by silencing RNA led to apoptosis of the HeLa cells.31 Another important action of hCG or its subunits is on promotion of angiogenesis by stimulating the migration and capillary sprout formation of uterine endothelial cells. High levels of hCG and its subunits is associated with high microvessel density in hCG expressing cancers.15βhCG has also a profound effect on metastasis and invasion of cancer cells via its regulation of E-Cadherin.

A wealth of information has been amassed regarding the localization of signalling molecules, their kinetics and the transcription factors AUY-922 mouse they activate. We continue to discover mechanisms that cause receptors and signalling molecules to compartmentalize in the cell; however, the emerging challenge lies

in understanding how the immunological synapse contributes to differentiation. Here, we review some of the transcription factors activated downstream of T-cell receptor signalling and discuss mechanisms by which antigen dose and affinity may influence differentiation. Antigen affinity might change the kind of transcription factors that are activated whereas antigen dose is likely to influence the temporal dynamics of the transcription factors. The immunological synapse is therefore likely to influence differentiation find more by modulating the trafficking of transcription factors and by promoting asymmetric cell division, an emerging concept. The term immunological synapse was first proposed by Paul and Seder as a cognate interaction of a T cell and an antigen-presenting B cell which the T cell uses to secrete effector cytokines in the synaptic cleft to cause humoral responses.1 Kupfer and colleagues were first to define the compartmentalization of interactions at

the interface of T and B cells as the central accumulation of T-cell receptor–major histocompatibility complex–peptide (TCR-MHCp) interactions surrounded by a peripheral ring of adhesion molecule interactions. They called these zones central and peripheral supra-molecular activation clusters, respectively (c-SMAC

or p-SMAC). In the context of the synapse they found that protein kinase C-θ (PKC-θ) was localized to the c-SMAC whereas Talin, a molecule known to modulate adhesion, was localized to the p-SMAC.2 The kinetics of synapse formation was first demonstrated by Grakoui et al.3 Using glass-supported planar lipid membranes incorporated with lipid-anchored peptide–MHC complexes and intercellular adhesion molecule 1, it was demonstrated that immediately after contact initiation TCR-MHCp interactions are largely in the periphery many and the adhesion interactions are in the centre. Within a few minutes, there is a re-organization of these interactions to form the mature synapse. The impacts of antigen dose, affinity and the role of the co-receptor CD4 were also examined in these studies.3 The immunological synapse is also the site for signal initiation and integration.4–6 This paradigm has been effective in conveying an understanding of the spatial and temporal dynamics of proximal signalling (see Fig. 1) components over short time-scales of minutes to an hour. Differentiation of T cells, however, takes place over days, and although several distinct environmental signals contribute to differentiation, TCR signals remain central to this differentiation process.

Cytokine secretion assays work by building an antibody matrix on the cell surface to capture secreted cytokine. The captured cytokines thus become a surface antigen and can be detected and used for cell isolation with anti-cytokine antibodies [7,8]. The cytokine-producing cells isolated are the small number

of precursors fated to be grown out through repeat stimulation to produce T cell lines. By isolating these cells without any influence of long-term culture or the need to induce a phenotype with other stimuli, it is possible to work with these specific T cell subsets in their most natural state, whether for simple phenotyping or generation of T cell lines. In this technology focus we present examples of how cytokine secretion can be used to identify and isolate different T cell subsets rapidly, and the subsequent behaviour of these T cells when used

to generate T click here cell lines. We present a highly detailed methodology for the use of this technique. In the specimen results section we focus upon specific examples of how this technology can be applied: Identification and isolation of Th17 T cells – human and mouse. The cytokine secretion assay involves the following GW 572016 steps (Fig. 1): (i) T cells are stimulated with specific antigen or polyclonal T cell receptor (TCR)-stimulus; (ii) a cytokine-specific catch reagent is added to the cells. This is composed of the cytokine-specific ‘catch’ antibody, conjugated with a CD45-specific monoclonal antibody, labelling all leucocytes evenly with the catch reagent; (iii) the cells are incubated for 45 min at 37°C to allow cytokine secretion, and the secreted

cytokine binds to the catch reagent on the secreting cells; and (iv) bound cytokine is labelled subsequently with a second cytokine-specific fluorochrome-conjugated antibody for sensitive analysis by flow cytometry. Optionally, the caught cytokine is magnetically labelled further with specific antibody conjugated to super-paramagnetic particles for enrichment by magnetic cell sorting (MACS®). Human blood was collected following informed consent under local ethical guidelines, and mouse spleen cells were harvested from animals licensed under appropriate local regulations. Human peripheral blood selleck kinase inhibitor mononuclear cells (PBMC) were stimulated variously with CytoStim for 3 h (Miltenyi Biotec GmbH, Bergisch Gladbach, Germany); Candida albicans extract (Greer Source Materials, Lenoir, NC, USA) 16 h; cytomegalovirus (CMV) lysate (Dade-Behring, Marburg, Germany) for 16 h; PepTivator CMV pp65 (Miltenyi Biotec) for 4 h and pp65 NLV(495–503) human leucocyte antigen (HLA)-A2-restricted peptide (Miltenyi Biotec) for 3 h. CD40 monoclonal antibody (mAb) functional grade (Miltenyi Biotec) was added to cultures if CD154 expression was analysed (has no T cell stimulatory effect).