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BIOL10008 Clinical Immunology Question 1. What rationale has been provided by the authors for conducting this study?  2. What is the aim of this study? 3. Comment, in detail, on the study participants – n numbers, patients’ status and recruitment. 4. Critically analyse the results presented in this paper, including a description of the methods used at each stage. 5. How does this study build upon previous studies? What does it add to the field of research? 6. Provide a critical reflection of what you have learned from this study and how you could improve it. Answer Immunology 1. It is important to note that research plays a critical role in understanding various issues or concepts in the medical field. It helps the health care professionals to find out, for example, the effects of diseases or drugs on human body so that they can establish ways to curb adverse impacts. The authors of have conducted the study to ascertain or affirm that Homeostatic chemokines CCL21 as well as CCL19 promote or enhance inflammation in human immune-deficiency virus-infected patients with continuing viral replication (Moser et al., 2014). The authors state that Chemokines are well-known as regulatory molecules in the development of lymphoid tissues, lymphocyte homing, and leucocyte maturation, and some chemokines might be protective in human immune-deficiency virus in infected people due to their ability or capability to block Human Immune Virus entry into macrophages and T cells via the HIV co-receptor (Damas et al., 2009). Since chemokines have potent inflammatory properties which can have toxic impacts in HIV-infected people, the authors opted to establish the effects of chemokines.  The authors were also influenced by the past contradicting studies, with some suggesting or establishing that chemokines can promote inflammatory responses whereas others stating that chemokines lead to obstinate HIV infection in secondary lymphoid tissues through the promotion of viral replications in activated T-cells. Additionally, the authors opted to establish the link between chemokines and HIV replication. 2. The aim of the study was to examine the role of CCL19 and CCL21 in human immune-deficiency virus (HIV) infections through the promotion of inflammation. It aimed at examining the expression of both CCL21 and CCL19 in bone marrow mono-nuclear cells as well as mono-nuclear cells from peripheral blood mono-nuclear in HIV-infected patient before as well as during extremely active anti-retroviral therapies (Allen et al., 2017). It also aimed at examining the ability of CCL21 and CCL19 to promote or enhance inflammatory response in HIV patients. 3. The study involved 29 HIV-infected patients who were recruited in a cross-sectional study where none of the patients had received highly active anti-retroviral therapy. Notably, 14 HIV-infected patients or participants were categorized as asymptomatic. Blood samples were collected from 21 sex-and-age matched healthy control for comparison. A sub-group of 9 patients from the cross-sectional study was also trailed during highly active anti-retroviral therapy with samples taken before and four and twenty-six weeks after the therapy’s initiation. Examination of CCR7 expressions and the impacts of CCL21 and CCL19 blood samples were collected from nine HIV-infected patients afore the highly active anti-retroviral therapy initiation. 4. The study established that HIV infected patients having high viral load were had a characteristic of increased proportions of CD8+CCR7-CD45RA-T Cells. The study found that CCR7 expressing monocyte can result in a potential of inflammatory upon activation. Additionally, the study established that dysregulated CCR7, CCL19, and CCL21 system plays a pathogenic role in HIV contraction or infection through the contribution of an inappropriate inflammation. The results were analyzed using SSPS, chi-square, and t-test. Rationally, the critical review of the authors’ methodology based on hypothesis testing and the overall research design demonstrates a well-organized, appropriate presentation of ideas and results. 5. This study is an improvement of the previous studies. It extends the findings of enhanced levels of serum of CCL21 and CCL19 among HIV infected individuals in linkage to disorder severity in untreated HIV infections by indicating that highly active anti-retroviral therapy-naïve HIV infected individuals are characterized by decreased stimulated and increased spontaneous secretion of CCL19 in mono-nuclear cells (Damas et al., 2009). The past researches on CCR7, CCL21, and CCL19 in HIV infection focused on their roles in lymphocyte. However, this study goes ahead to report on impaired CCR7 regulation on plasmacytoids DC among the HIV infected adolescents as well as children. It also shows untreated HIV infected individuals with immune-deficiency are characterized by spontaneous secretion of CCL19 due to reverse of highly active anti-retroviral therapy, which had not been established by the previous studies. 6. Generally, critical and creative analysis and evaluation of the article background indicate a well-organized as well as logical presentation, which meets the authors’ intended aim or purpose. The study draws its strength from a coherent and consistent summary, matching up the introduction as well as conclusion. It demonstrates strong convincing power in the findings, discussion, integral text, and interpretation (Mertens, 2014). Moreover, the stated aims of the article are rational and consistent. Reasonably, the critical review of the authors’ methodology based on hypothesis testing and the overall research design also demonstrates a well-organized, appropriate presentation of ideas and results. Additionally, the results are duly interpreted to support the aims. I can improve the research by involving more participants and experienced researchers or professionals in the medical industry. References Allen SJ, Crown SE, & Handel TM. (2017) Chemokine: receptor structure, interactions, and antagonism. Annu Rev Immunol; 25:787–820. Damas et al. (2009) Homeostatic chemokines CCL19 and CCL21 promote inflammation in human immunodeficiency virus-infected patients with ongoing viral replication. Clin. Exp. Immunol. 157: 400-407 Mertens, D.M., (2014). ”Research and evaluation in education and psychology: Integrating diversity with quantitative, qualitative, and mixed methods”. Oxford: Oxford University. Sage Publications.pp.123-136. Moser B, Wolf M, & Walz A., (2014) Chemokines: multiple levels of leukocyte migration control. Trends Immunol; 25:75–84.

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