Issue link: https://viewer.e-digitaledition.com/i/147494
SPecIal clInIcal SecTIon: peDiatRics exposing an elusive Virus The moST common InTRauTeRIne vIRal InFecTIon In The unITed STaTeS, cyTomegalovIRuS (cmv) IS ReSPonSIBle FoR moRe deaThS and long-TeRm PRoBlemS In chIldRen Than doWn SyndRome, FeTal alcohol SyndRome and neuRal TuBe deFecTS. a BReakThRough In The undeRSTandIng oF hoW cmv ThWaRTS noRmal Immune SySTem ReSPonSe IS a STeP FoRWaRd In The develoPmenT oF a vaccIne. iN a papeR Recently published in Cell Host & Microbe, researchers from the La Jolla Institute for Allergy and Immunology and Cardiff University identified the mechanism that allows CMV to evade detection by the immune system. In the study, researchers found that a CMV gene The American Academy of Pediatric Dentistry recommends the first dental visit should occur shortly after the first tooth erupts or around the age of one. Tooth decay can begin as soon as teeth emerge in an infant's mouth. It can progress rapidly, causing pain and even harming the permanent teeth that are developing under the gums. Left untreated, decay can destroy the teeth of an infant or young child and can affect a child's general health. A dental visit lets parents discuss: •How to care for their infant's or toddler's mouth •Appropriate use of fluoride for their child •Ways to prevent trauma to the face, teeth and gums •Teething and development milestones •The relationship between diet and oral health Creating Healthy Teeth & Happy Smiles Edina 952-831-4400 Burnsville 952-435-4102 & Gentle, enjoyable, quality dental care for infants, children & teens Minnetonka 952-932-0920 Dr. Kurt King Dr. David Elgethun Dr. Mark Greenwood Dr. Sally Schuette Dr. Pamela Erickson Dr. Gayathri Sambasivan Dr. Thekla Swanson Dr. Lisa Abadeer Dr. Daniel Fallon www.childrensdent.com 16 | Twin Cities MD News ■ mDnews.com (UL141) blocks two TNF-related apoptosisinducing ligand (TRAIL) death receptors (DRs). By interfering with these immune pathways, CMV inhibits TRAIL's ability to selectively kill infected cells. The TRAIL protein is normally able to induce death, or apoptosis, in targeted cells by binding to certain DRs, primarily in tumor cells. For this reason, TRAIL has been the focus of anti-cancer therapeutics since the mid-1990s. The importance of TRAIL and its receptors in regulating antiviral immune defenses is only recently becoming more widely known. "Among scientists who study CMV, it is well-known as a 'clever' virus that has evolved a number of strategies to trick the immune system," says study author Chris A. Benedict, PhD, Associate Professor, Division of Immune Regulation at La Jolla Institute. "The novelty and importance of our work is the discovery that one of these strategies is to target the TRAIL DRs." cmV Vaccine presents challenges Currently under investigation, the development of a CMV vaccine may be more complex than conventional attenuated or killed virus, as an antibody-only approach may not provide sufficient protection from congenital infection. "I believe strongly that inducing robust cellular immune responses in combination with good antibody responses will be critical to the success of a CMV vaccine," says Benedict. "So, this is where our discovery fits into the picture — I propose that a strategy that boosts the contribution of TRAIL-mediated cellular immunity, and/ or commensurately inhibits the ability of CMV UL141 to block TRAIL DR signaling, will yield a better vaccine." ■