AB0083 RELATIONSHIP BETWEEN APOLIPOPROTEIN C-III AND ACTIVATED FACTOR VII-ANTITHROMBIN COMPLEXES IN PATIENTS WITH RHEUMATOID ARTHRITIS AND PSORIATIC ARTHRITIS

Background

Both rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are associated with increased cardiovascular risk and thrombosis. Alterations in plasma lipids levels, including apolipoproteins are recognized as the important risk factors of cardiovascular disorders. Activated Factor VII -anti- Thrombin complex (FVIIa-AT) is a marker of the extrinsic coagulation cascade activation, the pathway accelerated by interaction with plasma apolipoprotein C-III (Apo-CIII) (1).

Objectives

To investigate the associations between plasma FVIIa-AT concentration, lipid profile including apolipoprotein CIII, and markers of disease activity in patients with RA and PsA.

Methods

41 patients with RA, 38 with PsA, and 22 healthy controls, all not taking anticoagulant drugs were selected for the study. The lipid profile comprised triglycerides (TG), total cholesterol (TCh), low (LDL), and high-density lipoprotein (HDL). Serum levels of Apo C-III were measured using a Human ApoCIII ELISA kit CellBiolabs Inc.Austria. FVIIa–AT plasma concentrations were determined using ELISA test. C-reactive protein (CRP) level was measured using the immunoturbidimetric assay. All measurements were performed by a technician blinded to sample origin. The Mann-Whitney test and Kruskal Wallis tests were applied for intergroup comparisons, and correlations were assessed using Spearman’s rank tests, due to data non-normal distribution.

Results

The highest serum levels of Apo C-III were found in RA patients (median: 99.9μg/ml, min.-max. 8.7–199) compared to PsA (30.86μg/ml, 12.4–125.8) and controls (9.5 μg/ml, 3.7–29.2), p<0.001. RA and PsA patients revealed higher FVIIa-AT plasma levels than controls (RA median 153.8 pM, min.—max. 57.0–397.8, PsA 157.6 pM, 64.9– 323.8 vs controls 104.5 pM, 68.9–150.9, p<0.001). In RA and PsA patients ApoCIII correlated positively with TG levels (r=0.35, p=0.027 and r=0.38, p=0.018 respectively). In all patients and controls, Apo C-III levels correlated positively with FVIIa-AT concentrations (r=0.45 p<0.001). No significant differences were found in the serum concentrations of TCh, LDL, HDL, TG, and CRP, between the groups of RA and PsA patients.

Conclusion

Elevated concentrations of both, apolipoprotein CIII and activated FVII-AT complexes in rheumatic patients suggest associations between plasma lipoproteins and activation of coagulation cascade leading to a pro-thrombotic state in patients with RA and PsA. Further studies on these relationships are necessary taking into account various clinical conditions of patients and treatment.

References

[1]Martinelli N et al. Apolipoprotein C-III Strongly Correlates with Activated Factor VII-Anti-Thrombin Complex: An Additional Link between Plasma Lipids and Coagulation. Thromb Haemost. 2019; 119: 192-202.

Disclosure of Interests

None declared

AB0659 SECUKINUMAB PROVIDES SIGNIFICANT IMPROVEMENT OF SPINAL PAIN IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: RESULTS FROM THE 24-WEEK PHASE 3 SKIPPAIN STUDY

Background:

Spinal inflammation causing back pain is a hallmark of axial spondyloarthritis (axSpA) mainly affecting the sacroiliac joints and spine.1Spinal pain is the most burdensome symptom resulting in substantial functional limitations and impairment of health-related quality of life.

Objectives:

SKIPPAIN (NCT03136861) evaluated efficacy and safety of secukinumab (SEC) in reducing spinal pain in patients (pts) with axSpA who had an inadequate response to NSAIDs.

Methods:

SKIPPAIN, a 24 week (wk), randomised, double-blind, multicentre trial, enrolled axSpA pts (aged ≥18 years) with active disease defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥4 and average spinal pain numerical rating scale (NRS) score >4 at baseline (BL) and inadequate response to ≥2 NSAIDs ≥4 wks. The trial had a PBO-controlled period from BL to Wk 8 and a SEC 150/300 mg period from Wk 8 to Wk 24. Primary and key secondary endpoints were superiority of SEC 150 mg compared to PBO in achieving average spinal pain score <4 on a 0–10 NRS and BASDAI score <4 at Wk 8, respectively.

Results:

380 axSpA pts (269 (70.8%) AS and 111 (29.2%) nr-axSpA) were randomised to SEC 150 mg (N=285) or PBO (N=95). Demographic and BL characteristics are presented inTable 1. Proportion of responders, in terms of average spinal pain, was 31.9% vs. 20.0% for SEC vs PBO (p<0.05) and proportion of pts with BASDAI score of <4 was 33.3% vs. 23.2% for SEC vs PBO (p<0.05), respectively at Wk 8 (Table 2). After Wk 8, responder rates increased with SEC treatment. No unexpected safety events were reported.

Conclusion:

Secukinumab provided significant improvement of spinal pain in pts with axSpA. SEC was well tolerated with a safety profile consistent with previous reports.2

References:

[1]Danve A & Deodhar A.Clin Rheumatol. 2019;38:625-34.

[2]Deodhar A, et al.Arthritis Res Ther. 2019;21(1):111.

Table 1.

Patient Demographics and BL Characteristics

CharacteristicSEC 150 mgN = 285PBON = 95Age (years)142.3 (11.9)40.9 (12.2)Female2106 (37.2)39 (41.1)Time since onset of back pain (years)113.2 (10.1)12.3 (9.6)HLA-B27 positive2233 (81.8)76 (80.0)hsCRP (mg/L)113.0 (21.5)13.2 (23.5)Elevated hsCRP (>5 mg/L)2140 (49.1)49 (51.6)Previous exposure to TNF-α inhibitors234 (11.9)11 (11.6)Spinal pain NRS Score, 0-10 (average)17.27 (1.37)7.31 (1.31)Spinal pain NRS Score, 0-10 (nocturnal)17.31 (1.42)7.40 (1.35)Spinal pain NRS Score, 0-10 (total)17.23 (1.51)7.22 (1.48)BASDAI17.09 (1.22)6.91 (1.38)ASDAS13.75 (0.89)3.67 (0.84)Peripheral arthritis2104 (36.5)30 (31.6)

1mean (Standard Deviation),2n (%).

hsCRP, high-sensitivity CRP; N, number of randomized pts; n, number of evaluable pts; NRS, numerical rating scale

Table 2.

Inferential Analysis of Achieving Spinal Pain and BASDAI Score <4.0 Using Logistic Regression Model at Wk 8

VariableTreatment Groupn/N (%)Odds ratio versus PBO95% CIP-valueSpinal Pain NRS Score (Average)SEC 150 mg91/285(31.9)1.89(1.08, 3.33)0.0264PBO19/95(20.0)Spinal Pain NRS Score (Nocturnal)SEC 150 mg77/285(27.0)1.72(0.95, 3.10)0.0720PBO17/95(17.9)Spinal Pain NRS Score (Total)SEC 150 mg92/285(32.3)2.38(1.31, 4.31)0.0043PBO16/95(16.8)BASDAI scoreSEC150 mg95/285(33.3)1.75(1.01, 3.04)0.0466PBO22/95(23.2)

P-values are from a Logistic regression model with treatment as the principle factor and prior exposure to TNF inhibitors and naïve/inadequate responders to TNF inhibitors as stratification factors.

Missing values were imputed as non-responders. N, Number of randomised pts; n, Number of pts who are responders/evaluable pts.

Disclosure of Interests:

Denis Poddubnyy Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Effie Pournara Shareholder of: Novartis, Employee of: Novartis, Agnieszka Zielińska Consultant of: Novartis, Pfizer, Asta Baranauskaite Consultant of: AbbVie, Speakers bureau: Novartis, AbbVie, Amgen, Roche, KRKA, Alejandro Muñoz Jimenez.: None declared, Preeti Kumari Employee of: Novartis Healthcare Pvt. Ltd., Barbara Schulz Employee of: Novartis, Michael Rissler Shareholder of: Novartis, Employee of: Novartis, Chiara Perella Shareholder of: Novartis, Employee of: Novartis, Helena Marzo-Ortega Grant/research support from: Janssen, Novartis, Consultant of: Abbvie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, UCB, Speakers bureau: Abbvie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Takeda, UCB

Evaluation of reference genes for quantitative real-time PCR in Wharton's Jelly-derived mesenchymal stem cells after lentiviral transduction and differentiation

Quantitative real time reverse transcription PCR, qRT-PCR, is one of the most important techniques for assessing the level of gene expression. Selecting the correct reference gene to normalize the results is a key step in this method. Inaccurate data can be generated if the correct reference gene is not selected. The level of the expression of reference genes is tissue-variable, and in the case of mesenchymal stem cells (MSC), it can be different depending on the source of their origin. The aim of this study was to select the reference gene for Wharton's Jelly-derived MSC (WJ- MSC) that were undergoing transduction and differentiation. In this work, the expression of 32 genes was analyzed, of which two (RPS17 and 18S rRNA), which had the most stable expression level, were selected. A comparative analysis of the expression stability of the selected genes was then performed with the genes that are most commonly used in the literature, i.e. β-actin and GAPDH. Next, it was determined that a false picture of the expression level of the studied genes can be obtained when a reference gene with variable expression level is used for normalization. RPS17 and 18S rRNA proved to be the most stable reference genes for the WJ-MSC that had been subjected to the lentiviral transfection procedure followed by differentiation. The expression of β-actin and GAPDH was highly unstable and therefore these genes are not suitable for use as reference genes in studies involving WJ- MSC.

Effect of macroalgae enriched with microelements on egg quality parameters and mineral content of eggs, eggshell, blood, feathers and droppings

This study presents results obtained from feeding experiment on laying hens, which were fed with the diet supplemented with two marine macroalgae: Enteromorpha prolifera and Cladophora sp., enriched with microelements [Cu(II), Zn(II), Co(II), Mn(II), Cr(III)]. The applicability of the preparation was tested on five experimental groups of laying hens and one control group. In the control group, microelements were supplemented in the inorganic form, whereas in experimental groups, Cu, Zn, Co, Mn and Cr were replaced by macroalgae enriched with a given microelement ion. During feeding experiment, weight of laying hens, weight of eggs, eggshell thickness and mineral content of blood, feathers, droppings, eggs content (separately yolk and egg white) and eggshell were measured. Also egg number was counted and microclimate (temperature and relative humidity) was monitored. Supplementing bio-metallic feed additives to the diet of laying hens resulted in higher microelement transfer to eggs and enhanced the colour of yolk. It was also found that the presence of Enteromorpha prolifera and Cladophora sp. in laying hens diet influenced advantageously eggs weight, eggshell thickness as well as body weight of hens. On the basis of these results, it could be concluded that Enteromorpha prolifera and Cladophora sp. enriched with microelement ions could be potentially used as mineral feed additives in laying hens feeding.

Youth's knowledge and attitude to epilepsy

PURPOSE

The aim of this research is to assess youth's knowledge and attitude towards their epileptic peers.

MATERIAL AND METHODS

The present study concerned 181 students of two secondary schools in Poznań, including 107 girls and 74 boys. The tool used was a self-made questionnaire. The criterion of including a questionnaire into data was the answer to the following question: "Have you heard about epilepsy?"

RESULTS

The questionnaire has shown that 46% of secondary school students had already known a person with epilepsy. 91% of students knew that epilepsy was not a contagious disease, but 12% of pupils thought that epilepsy was a mental illness. Almost 23% of respondents claimed they knew what could cause epilepsy. Only 2% of the students knew how to provide first aid during an epileptic fit. 92% of the respondents accepted a person with epilepsy among their friends.

CONCLUSIONS

The level of the knowledge about epilepsy among pupils is insufficient. The youth do not know the causes of epilepsy, provocative factors of convulsions, and symptoms and the rules of giving first aid during an epileptic fit. The main source of information about the disease were television programs. The majority of the school - graduates expressed willingness to make friends with epileptic people and acceptance of the ill.

Peripheral blood lymphocyte population in children infected with Helicobacter pylori

PURPOSE

Helicobacter pylori infection in children is associated with a chronic inflammatory process of gastric and duodenal mucosa, which may have a various clinical course ranging from asymptomatic and chronic inflammatory condition to gastric ulceration. The immune system may contribute especially to chronic gastric mucosa inflammation. The aim of our study was to assess the levels of peripheral blood T (CD3+, CD4+, CD8+) and B lymphocyte subpopulation (CD19+) in children with Helicobacter pylori infection and to evaluate their relation to degree of antrum mucosa inflammation.

MATERIAL AND METHODS

The study was performed in 32 children aged 7-18 years, hospitalized due to dyspeptic symptoms. The endoscopic examination of upper gastrointestinal tract was performed and gastric and duodenal mucosa was estimated in all patients. The endoscopic and histological evaluation of gastric mucosa was performed according to the Sydney System [4]. The urease test (CLO-test-H. pylori) was made to estimate the severity of the infection.

RESULTS

Moderate antrum mucosa inflammation was found in 41.2% of the examined. The highest percentage of children (58.8%) presented marked inflammation. No mild inflammation was found in children examined.

CONCLUSIONS

No correlation was found between lymphocyte levels and the degree of the inflammatory changes in antrum mucosa. The evaluation of peripheral blood lymphocytes performed in children with Helicobacter pylori infection suggests that T lymphocytes may play a predominant role in this infection.

Nitrogen-15 fractionation in the thermal decomposition of nitrous oxide of natural isotopic composition

The 15N fractionation in the thermal decomposition of nitrous oxide (N2O) of natural isotopic composition has been investigated in quartz reaction vessel in the temperature interval 888-1073 K. The formulas relating the observed experimentally 15N fractionations with the primary 15N kinetic isotope effect, (k14/k15)p for 14N15N16O, and secondary 15N kinetic isotope effect, (k14/k15)s for 15N14N16O, have been derived. The experimentally estimated 15N kinetic isotope effects have been compared with the primary and secondary 15N kinetic isotope effects calculated with the absolute rate theory formulations applied to linear three atom molecules. A good agreement was found for the primary 15N kinetic isotope effect, (k14/k15)p, in the temperature interval 888-1007 K. But at 1073 K the decompositions of N2O, accompanied by NO (nitric oxide) formation proceed with a twice times smaller primary kinetic isotope effect, (k14/k15)p of 1.0251 +/- 0.0009, only, suggesting the nonlinear transition state structures with participation of the fourth external atom at high temperature decompositions of nitrous oxide. The nitrogen isotope effects determined in this study correlate well with nitrogen isotope fractionations observed in the natural biological, earth and atmospheric processes.

Carbon isotope fractionation in the decarboxylation of phenylpropiolic acid in hydrogen donating media

13C kinetic isotope effect (KIE) in the decarboxylation of phenylpropiolic acid (PPA) in tetralin medium (Tn) has been determined at 409-432 K and found to be of magnitude similar to the 13C KIE observed in the decarboxylation of malonic acid where the rupture of the C-C bond is the rate determining step. 13C KIE equals 1.0318/at 136 degrees C in the decarboxylation of PPA in Tn medium. Intramolecular 13C KIE in the decarboxylation of malonic acid equals 1.0316 at this temperature. Thus it has been shown that the nearly "full" 13C KIE can be achieved by providing the excess hydrogen to Calpha of PPA (or to triple acetylene bond) using not only strong mineral acids as the source of protons but also by carrying out the decarboxylation in organic medium like tetralin. A mechanism of decarboxylation of PPA in Tn is suggested.