Highly Adhesive Amyloid-Polyphenol Hydrogels for Cell Scaffolding

Rationally designing microstructures of soft hydrogels for specific biological functionalization is a challenge in tissue engineering applications. A novel and affordable soft hydrogel scaffold is constructed here by incorporating polyphenol modules with lysozyme amyloid fibrils (Lys AFs) via non-covalent self-assembly. Embedded polyphenols not only trigger hydrogel formation but also determine gel behavior by regulating the polyphenol gallol density and complex ratio. The feasibility of using a polyphenol-Lys AF hydrogel as a biocompatible cell scaffold, which is conducive to cell proliferation and spreading, is also shown. Notably, introducing polyphenols imparts the corresponding hydrogels a superior cell bioadhesive efficiency without further biofunctional decoration and thus may be successfully employed in both healthy and cancer cell lines. Confocal laser scanning microscopy also reveals that the highly expressed integrin-mediated focal adhesions form due to stimulation of the polyphenol-AF composite hydrogel, direct cell adhesion, proliferation, and spreading. Overall, this work constitutes a significant step forward in creating highly adhesive tissue culture platforms for in vitro culture of different cell types and may greatly expand prospects for future biomaterial design and development.

POS0650 THE IMPACT OF OLD AGE ON THE PERSISTENCE AND SAFETY OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS

Background

The effect of age on persistence and safety of treatment with biologic disease modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis has been a subject to research interest. Two recently published studies did not observe significantly different survival of treatment with bDMARDs among older age (≥ 65 years) individuals (1,2); incidence of serious adverse events was higher in these patients (2).

Objectives

to evaluate association of the age with treatment survival and overall safety among patients receiving one or multiple courses of bDMARDs or targeted synthetic (ts-) DMARDs.

Methods

BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment necessarily involving a bDMARD or tsDMARD (latest date, Nov 19, 2019). Treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. Primary outcome was the incidence treatment interruption for any reason (except for pregnancy or disease remission), while interruption due to adverse events (AEs; including death) and due to inefficacy served as secondary outcomes. Incidence of serious adverse events (SAEs) also served as a secondary outcome. Extended (frailty) multivariate Cox proportional hazards models and negative binomial regression with generalized estimating equations (to calculate incidence rate ratios [IRRs]) were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).

Results

In total, 1316 patients (2335 treatment courses, 6508 patient-years [PY]) were enrolled. Of these, 160 patients (643 PY; 237 treatment courses) were ≥ 65 years old, mean age at starting treatment = 71 ± 5 yrs (84% female). Old age was not significantly associated with treatment interruption for any reason, but presented higher risk of interruption due to adverse events (after multivariate adjustment) and lower risk of stopping because of inefficacy (see Table 1). Older patients presented higher incidence of SAEs than younger ones (16.0 vs 8.4/100 PY, respectively; multivariate IRR: 2.06, 95% CI: 1.51 to 2.80, P<0.001). Among old patients, tocilizumab (HR: 2.73, 95% CI: 1.13 to 6.64, P=0.026), etanercept (2.13, 1.12 to 4.07, P=0.022), and infliximab (2.39, 1.19 to 4.79, P=0.014) presented higher risk of treatment termination as compared with adalimumab. In this subgroup (age ≥65 yrs), there was no significant difference in the risk of SAEs between different bDMARDs/tsDMARDs.

Table 1.

Univariate and multivariate hazard ratios (HRs) of interruption of treatment course comparing older (≥65 years) versus younger patients (reference category). Results are HRs, 95% CIs, and P values.

Cause of interruption (n of events)Crude analysisAdjusted covariates*Interruption - any reason (1321)0.96 (0.75 to 1.23), P=0.7601.09 (0.82 to 1.43), P=0.550Interruption - adverse events (368)1.33 (0.75 to 0.89), P=0.1601.59 (1.07 to 2.35), P=0.020Interruption - inefficacy (680)0.56 (0.39 to 0.80), P=0.0020.57 (0.38 to 0.87), P=0.009

* Age, baseline DAS28, disease duration, gender, smoking, RF or anti-CCP, previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B,C, treatment sequence.

Conclusion

The overall risk of treatment interruption with biologic or targeted synthetic DMARDs is not higher in older patients. Higher risk of interruption due to AE was balanced by a lower risk of stopping treatment due to inefficacy. Older patients had a higher incidence of SAEs.

References

[1]Mathieu et al. Rheumatol Int 2021;41:879-85.

[2]Freitas et al. Drugs Aging 2020;37:899-907.

[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.

Disclosure of Interests

None declared

POS0676 SURVIVAL OF THE FIRST COURSE OF BIOLOGIC OR JAK INHIBITOR IN RHEUMATOID ARTHRITIS: ASSOCIATION WITH THE CHOICE OF AGENT AND CONCOMITANT CONVENTIONAL SYNTHETIC DMARDS

Background:

After failure of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in the therapy of rheumatoid arthritis (RA), treatment may be escalated to biologic (bDMARDs) or JAK inhibitors (JAKi) (1). Analysis of drug survival can provide useful information on the effectiveness of these therapeutic schemes.

Objectives:

to evaluate the association of the choice of therapeutic agent with the survival of treatment course in RA patients receiving their first bDMARD or JAKi.

Methods:

BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients starting their first bDMARD/JAKi (2). This analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over the first course of treatment with a bDMARD/JAKi until censoring (latest date, Nov 19, 2019) or occurrence of the outcome of interest. A treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. The primary outcome was the interruption of treatment course for any reason (except for pregnancy or disease remission); interruption of treatment due to adverse events (AEs) or death and due to inefficacy served as secondary outcomes. Multivariate Cox proportional hazards models were used for analyses.

Results:

In total, 1177 patients (3800 patient-years [PY]) were enrolled. The overall incidence of treatment interruption was 17.5/100 PY. Adalimumab was the most frequently prescribed agent, followed by infliximab (n= 267). The hazards ratios (HR) of the primary and secondary outcomes are presented in Table 1. Figure 1 compares the survival of treatment curves of different bDMARDs/JAKi.

Table 1.

Hazard ratios (HR) of interruption of therapy course of each therapeutic agent (the reference category for bDMARDs/ JAKi is infliximab). Results are HR, 95% CIs, and P values*.

Agent (number of patients)Interruption for any reason (665 events)Interruption due to adverse events or death (196 events)Interruption due to inefficacy (319 events)Adalimumab (354)0.83 (0.68 to 1.01), P= 0.0620.68 (0.48 to 0.96), P=0.0291.08 (0.80 to 1.44), P=0.621Etanercept (257)0.81 (0.66 to 1.01), P=0.0630.56 (0.37 to 0.83), P=0.0040.93 (0.68 to 1.29), P=0.674Certolizumab (80)0.74 (0.47 to 1.16), P=0.1850.33 (0.13 to 0.86), P=0.0241.32 (0.74 to 2.35), P=0.350Golimumab (53)0.86 (0.53 to 1.38), P=0.5300.46 (0.18 to 1.19), P=0.1111.07 (0.53 to 2.15), P=0.849JAKi (tofacitinib) (59)0.54 (0.30 to 0.99), P=0.0470.19 (0.04 to 0.82), P=0.0260.89 (0.41 to 1.96), P=0.779Rituximab (48)0.87 (0.55 to 1.37), P=0.5400.48 (0.20 to 1.18), P=0.1090.58 (0.26 to 1.34), P=0.205Abatacept (30)0.52 (0.25 to 1.07), P=0.0770.46 (0.14 to 1.56), P=0.2150.46 (0.14 to 1.52), P=0.203Tocilizumab (29)0.29 (0.14 to 0.63), P=0.0020.40 (0.12 to 1.30), P=0.1260.28 (0.09 to 0.90), P=0.033Methotrexate (792)0.95 (0.79 to 1.14), P=0.5610.86 (0.62 to 1.19), P=0.3620.98 (0.75 to 1.28), P=0.860Leflunomide (497)1.17 (0.99 to 1.39), P=0.0611.44 (1.06 to 1.96), P=0.0201.02 (0.80 to 1.30), P=0.856Sulfasalazine (48)1.18 (0.80 to 1.75), P=0.4011.94 (1.07 to 3.54), P=0.0300.85 (0.45 to 1.59), P=0.605Antimalarials (230)0.80 (0.65 to 0.98), P=0.0270.67 (0.45 to 0.99), P=0.0430.67 (0.50 to 0.92), P=0.011

* All tests adjusted for other variables presented in the table and for age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF/anti-CCP), previous malignancy, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, use of corticosteroids, starting year, hypercholesterolemia, osteoporosis, hepatitis B and C.

Conclusion:

In our study, infliximab was related to an overall higher hazard of treatment course interruption than tolicizumab and tofacitinib, and higher hazard of interruption due to AEs than most other anti-TNF agents and tofacitinib. Maintaining antimalarials in patients receiving advanced therapies for RA may reduce interruption of treatment due to inefficacy and AEs.

Disclosure of Interests:

None declared

Influence of Partial Acid Hydrolysis on Size, Dispersity, Monosaccharide Composition, and Conformation of Linearly-Branched Water-Soluble Polysaccharides

The effect of partial acid hydrolysis on the physical and chemical properties of galactomannan, arabinoxylan, and xyloglucan was investigated. Polysaccharides were treated at 50 °C with hydrochloric acid for 3-48 h. Portions of isopropanol (i-PrOH) were added sequentially to the hydrolyzates, resulting in fractions that were collected by centrifugation. As expected, a significant reduction of weight-average molecular weight (Mw) was observed with increasing hydrolysis time. Fractional precipitation was successfully applied to collect at least one polymer fraction with dispersity (Đ) close to one for each polysaccharide. The monosaccharide composition analysis showed that the partial hydrolysis usually lowered the relative amount of side chains, with the exception of galactomannan, where the composition remained largely unaffected. Estimation of the polymer conformation in solution, through evaluation of the Mark-Houwink parameter coefficient (α), confirmed that acid hydrolysis influenced the polysaccharides' conformation. It was demonstrated that acid treatment in dilute solution followed by fractional isopropanol precipitation is a method, extendible to a variety of polysaccharides, to obtain materials of decreased molecular weight and low dispersity with slightly altered overall composition and conformation.

Electrospun Patch Functionalized with Nanoparticles Allows for Spatiotemporal Release of VEGF and PDGF-BB Promoting In Vivo Neovascularization

The use of nanomaterials as carriers for the delivery of growth factors has been applied to a multitude of applications in tissue engineering. However, issues of toxicity, stability, and systemic effects of these platforms have yet to be fully understood, especially for cardiovascular applications. Here, we proposed a delivery system composed of poly(dl-lactide- co-glycolide) acid (PLGA) and porous silica nanoparticles (pSi) to deliver vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF). The tight spatiotemporal release of these two proteins has been proven to promote neovascularization. In order to minimize tissue toxicity, localize the release, and maintain a stable platform, we conjugated two formulations of PLGA-pSi to electrospun (ES) gelatin to create a combined ES patch releasing both PDGF and VEGF. When compared to freely dispersed particles, the ES patch cultured in vitro with neonatal cardiac cells had significantly less particle internalization (2.0 ± 1.3%) compared to free PLGA-pSi (21.5 ± 6.1) or pSi (28.7 ± 2.5) groups. Internalization was positively correlated to late-stage apoptosis with PLGA-pSi and pSi groups having increased apoptosis compared to the untreated group. When implanted subcutaneously, the ES patch was shown to have greater neovascularization than controls evidenced by increased expression of α-SMA and CD31 after 21 days. Quantitative reverse transcription-polymerase chain reaction results support increased angiogenesis by the upregulation of VEGFA, VEGFR2, vWF, and COL3A1, exhibiting a synergistic effect with the release of VEGF-A164 and PDGF-BB after 21 days in vivo. The results of this study proved that the ES patch reduced cellular toxicity and may be tailored to have a dual release of growth factors promoting localized neovascularization.

A nanofibrous electrospun patch to maintain human mesenchymal cell stemness

Mesenchymal stem cells (MSCs) have been extensively investigated in regenerative medicine because of their crucial role in tissue healing. For these properties, they are widely tested in clinical trials, usually injected in cell suspension or in combination with tridimensional scaffolds. However, scaffolds can largely affect the fates of MSCs, inducing a progressive loss of functionality overtime. The ideal scaffold must delay MSCs differentiation until paracrine signals from the host induce their change. Herein, we proposed a nanostructured electrospun gelatin patch as an appropriate environment where human MSCs (hMSCs) can adhere, proliferate, and maintain their stemness. This patch exhibited characteristics of a non-linear elastic material and withstood degradation up to 4 weeks. As compared to culture and expansion in 2D, hMSCs on the patch showed a similar degree of proliferation and better maintained their progenitor properties, as assessed by their superior differentiation capacity towards typical mesenchymal lineages (i.e. osteogenic and chondrogenic). Furthermore, immunohistochemical analysis and longitudinal non-invasive imaging of inflammatory response revealed no sign of foreign body reaction for 3 weeks. In summary, our results demonstrated that our biocompatible patch favored the maintenance of undifferentiated hMSCs for up to 21 days and is an ideal candidate for tridimensional delivery of hMSCs. The present work reports a nanostructured patch gelatin-based able to maintain in vitro hMSCs stemness features. Moreover, hMSCs were able to differentiate toward osteo- and chondrogenic lineages once induces by differentiative media, confirming the ability of this patch to support stem cells for a potential in vivo application. These attractive properties together with the low inflammatory response in vivo make this patch a promising platform in regenerative medicine.

Enhanced surveillance of shellfish mortality to improve early detection and investigation of outbreaks of exotic or emerging infectious diseases: An example of a mass mortality outbreak of mussels, France 2014

This paper explores the relevance and feasibility of enhanced surveillance of mussel-related mortality based on regular telephone interviews of a key informant in a farming community. Based on qualitative analyses of data collected through semi-structured interviews, this method of participatory disease surveillance enabled the retrieval of high quality data during an outbreak of mussel mortality which occurred in Pertuis Charentais, France, in 2014. The findings illustrated that such an enhanced surveillance approach compared with the institutional shellfish health surveillance system could improve the early detection of outbreaks of mussel mortality by one week. This approach enabled a detailed description of the outbreak, showing higher incidence proportion in the Northern water bodies. It also captured relevant data for hypothesis generation for further outbreak investigations, integrating a global view of the health and disturbance of the coastal marine ecosystem. However, to be effective and sustainable, this flexible approach requires a pre-existing knowledge of the structure of the information network of the farmers' community. Such a community-based enhanced surveillance could increase the reactivity of the entire system to enable the earliest possible and most appropriate interventions to protect shellfish populations against exotic or emerging infectious diseases. This would also help to improve the vigilance of mussel farmers and foster their commitment, which is an essential element for sustainable shellfish health surveillance.

Hippocampal cholineacetyltransferase activity, agonistic behaviour and social stress in male rabbits

Agonistic behaviour was observed in pairs of unfamiliar male rabbits living in an outdoor enclosure. Attack, Chase, Follow and Cross-over were scored. On the basis of their frequencies the subjects in the pair were assigned a first or second rank-position. Hippocampal cholineacetyltransferase (ChAT) and plasma levels of corticosterone were considered in relation to rank. ChAT levels in the dorsal hippocampus varied in relation to agonistic behaviour. Second-ranking subjects had significantly higher levels of ChAT than the first-ranking animals and had levels of corticosterone which were markedly higher at the end of the experimental period than at the beginning. A negative correlation was found between Attack and ChAT levels in the dorsal hippocampus. These results suggest the presence of social stress in the second-ranking animals and indicate a state of activation of the hippocampus in relation to agonistic behaviour.

Carbonate hydroxyapatite functionalization: a comparative study towards (bio)molecules fixation

Different methods for the functionalization of carbonate hydroxyapatite granules with free amine groups by reaction with (3-aminopropyl)triethoxysilane (APTES) have been compared in order to improve the potential for tethering of bioactive molecules to bioceramics. The combined use of tetraethoxyorthosilicate and APTES with acid catalysis resulted in an evident increase in amine surface grafting.

Amino and carboxyl plasma functionalization of collagen films for tissue engineering applications

Type I collagen films have been functionalized on their surfaces by plasma treatment with carboxyl and amino groups to improve their potential for grafting bioactive molecules. The physico-chemical properties of the plasma-treated films were evaluated and compared to the untreated materials by water contact angle, SEM and AFM. The presence of new functional groups on the film surfaces has been assessed by ATR-FTIR spectra after chemical derivatization. Moreover, the biocompatibility of the plasma-treated films was studied with MG-63 human osteoblast-like cells, evaluating cell proliferation, viability and morphology at 1, 3 and 7 days.

Stress-related hormonal and psychological changes to official youth Taekwondo competitions

The aim of this study was to evaluate the effects of an official Taekwondo competition on the heart rate (HR), salivary α-amylase (sA-A), salivary free cortisol (sC), and Profile of Mood States (POMS) in 10 young male (14±0 years) and six female (13±1 years) athletes. POMS and hormones were measured 15 min before and directly after the competition. During the recovery phase (30 and 90 min), sA-A and sC were also measured. HR measured during the competition was expressed as a percentage of individual's maximal heart rate (%HR(max) ) to evaluate the intensity of exercise. During the competition, athletes spent 65% of the time working at HR>90% of individuals HR(max). A significant increase (P<0.0001) in sA-A (115%) was observed at the end of the match. At 30 min of recovery, sA-A returned to the pre-competition level. The peak sC values were observed at 30 min of recovery (P<0.001), returning to the pre-competition level at 90 min of recovery. A gender difference (P=0.01) emerged only for sC, although a similar trend was observed for female and male athletes. Significantly higher post-match scores emerged for Anger-hostility (pre: 6.1±1.1, post: 11.2±1.9; P=0.03) and Depression-dejection (pre: 4.5±0.5, post: 10.2±1.9; P=0.006), whereas the reverse picture was observed for Vigour-activity (pre: 23.2±1.2, post: 16.3±1.7; P=0.0006). Taekwondo competition results in temporary changes in the stress-related parameters measured in this study. The present findings suggest that this experimental paradigm can represent a useful model for further research on the effects of various stressors (i.e., training and competition) in Taekwondo athletes of different levels (i.e., novice, international).

Risk and indicators of condemnation of male turkey broilers in western France, February-July 2006

A field study was conducted to estimate the sanitary condemnation proportion in male turkey broiler flocks, to describe the reasons for condemnation and the related macroscopic lesions, and to investigate whether primary production information would predict the risk of condemnation. Male turkey standard broiler flocks (117) were randomly selected in the 13 slaughterhouses located in Western France, from February to July 2006. The flocks were monitored from their arrival at the slaughterhouse until the results of the post mortem sanitary inspection. Information about rearing conditions, health history, catching and loading conditions, transportation to the slaughterhouse and slaughtering was also collected. Sampling design was considered in the calculations and the condemnation proportion was modelled using a negative binomial regression, accounting for clustering within slaughterhouse. The within-flock weighted average condemnation proportion was 1.8% (95% confidence interval, 1.3-2.3%). Emaciation, arthritis-polyarthritis and congestion were the main reported official reasons for condemnation, representing 76% of the condemned carcases. Three variables were significantly associated with increased risk of condemnation: observed locomotor disorders on the farm, high cumulative mortality 2 weeks before slaughter, and clinical signs observed by the Veterinary Services during the ante mortem inspection at the slaughterhouse. The final model explained 35% of the total variation in condemnation risk. Half of this explained variation could be attributed to locomotor disorders observed during rearing. The sensitivity and specificity of the model to predict a high flock condemnation risk were 80% and 74%, respectively, when using an optimum threshold of 0.95% to define high risk. The results of this study suggested that the variables found to be associated with condemnation proportion were markers of increased risk and could be used as indicators. These risk indicators can easily be retrieved from the pre-existing regulatory document transmitted before flock arrival at the slaughterhouse and could be used to screen flocks before slaughter, according to their expected risk of condemnation.

Skin lesions in broiler chickens measured at the slaughterhouse: relationships between lesions and between their prevalence and rearing factors

1. This slaughterhouse-based study was to evaluate correlations between cutaneous lesions which are linked to animal welfare. The relationships between these lesions and various rearing factors were investigated. 2. The percentage of lesions in each flock was determined by observation at the slaughterhouse. Fifty-five flocks slaughtered between May 2005 and May 2006 in 8 slaughterhouses were investigated. 3. Data relating to farm management and housing factors during the rearing period were collected retrospectively from 36 of the 55 flocks scored for lesions. 4. A negative correlation was observed between (i) presence of breast blisters and deep hock burns, (ii) presence of breast blisters and deep footpad dermatitis, and (iii) presence of breast burns and scratches. 5. We proposed an assessment of broiler chicken welfare at the slaughterhouse on the basis of several criteria: (i) footpad dermatitis, hock burns and breast burns, (ii) scratches, and (iii) breast blisters. 6. The presence of contact dermatitis was related to litter quality and several management factors. Only scratches and breast blisters were related to high stocking density. The type of lesion was related to genotype. Genotype A (fast-growing) had fewer breast blisters but deeper footpad lesions than B (slower-growing).

Effects of simulated firefighting on the responses of salivary cortisol, alpha-amylase and psychological variables

The aim of this study was to evaluate the effects of a simulated firefighting intervention on salivary alpha-amylase (sA-A), free cortisol (sC), anxiety (STAI), and profile of mood states (POMS) in 20 male firefighters (age 32 +/- 1 years, VO(2peak): 43 +/- 5 ml/kg per min). During the 12-min firefighting intervention (ambient temperature: 13 +/- 1 degrees C; relative humidity: 63 +/- 1%), individuals spent 63 +/- 28% of the time working at heart rate (HR) >85% of individual HR(max), [La] (peak) 9.2 +/- 2.9 mM and ratings of perceived exertion 16 +/- 2. At 30 min post-intervention significant (p < 0.001) increases in sA-A (174%) and sC (109%) were found with regard to values recorded before and after 90 min of the firefighting intervention. Since no differences emerged between pre-intervention and post intervention for STAI and POMS values, the hormonal changes were attributable to the intense physical stress of the simulated intervention. Further research is needed during real firefighting activities, where high emotional stress may also be present.

Effects of gonadectomy and pain on interferon-gamma production in splenocytes of male and female rats

The role of gonadal hormones and persistent pain (formalin test) in the regulation of interferon-gamma (IFN-gamma) production in splenocytes was investigated in male and female rats. Animals were either sham-operated (Intact) or gonadectomized (GDX) and, 3 weeks later, were subcutaneously injected with formalin (50 microl, 10%) or only pricked with a syringe needle in the dorsal hind paw. Sixty minutes after treatment the animals were deeply anesthetized and the spleens were dissected under aseptic conditions. Blood was collected from the abdominal aorta for measurement of plasma steroids. IFN-gamma production was determined in vitro in the splenocytes after Con A stimulation. Splenocytes of Intact females showed higher IFN-gamma production than those of Intact males. This sex difference disappeared in GDX animals because of the lower levels in GDX females. Formalin decreased IFN-gamma in both Intact and GDX groups. In females, there was a positive correlation between IFN-gamma production in splenocytes and plasma estradiol levels. The present data demonstrate a sex difference in IFN-gamma production (due to the immunostimulating effect of estradiol in females) and an immunodepressive role of pain in both sexes.

Glucocorticoid receptors in human peripheral blood mononuclear cells in relation to explosive performance in elite handball players

Ten handball players, members of the Italian National Team (aged 20-25 years), were studied in two sessions corresponding to different performance levels. The first session occurred one week after the end of the regular season of the Italian Handball Federation: it corresponded to the beginning of the training cycle for the European Handball Championship. The second session occurred ten weeks after the first session. During this period, training consisted of 3 weeks of active recovery and 7 weeks of increasing workload. For each session, jumping performances (maximal height in a single jump, average mechanical power for a 15-s set of consecutive jumps) were evaluated. Venous blood samples were collected in resting conditions immediately before jumping performances to assess cortisol and testosterone plasma concentrations and glucocorticoid receptors (GcR) binding capacity and affinity in peripheral blood mononuclear cells (PBMCs). All the parameters, except GcR binding affinity, increased in the second session. The trends of variation in jumping performances, steroid hormone levels and GcR binding capacity were similar. For testosterone, this agrees with the hypothesis that an adequate level of this hormone is a prerequisite for improvement in explosive performances. For cortisol, higher GcR binding capacity after 10 weeks of training (with respect to initial values) indicated an up-regulation of GcR concomitant with the increase in hormone levels and performances. These findings suggest that the adaptation to training, confirmed by the improvement in performance, is characterized by a high value of GcR binding capacity and that it is mediated, among other factors, by the hormone levels and up-regulation of the receptors.

Immunoreactivity for thyroid transcription factor-1 in stage I non-small cell carcinomas of the lung

Thyroid transcription factor-1 (TTF-1) is a nuclear protein regulating the transcriptional activity of lung-specific genes in the normal and neoplastic bronchioloalveolar cells. It has been implicated in the normal growth and development of the lung, and the disruption of the TTF-1 locus leads to neonatal death with pulmonary hypoplasia. We evaluated retrospectively the prevalence and clinical significance of TTF-1 immunoreactivity in 222 patients with stage I non-small cell lung carcinoma (NSCLC) with a follow-up time of at least 5 years, and we investigated its relationship with other markers of tumor growth, namely cell proliferation and angiogenesis. TTF-1 immunoreactivity was documented by using the commercially available monoclonal antibody 8G7G3/1 in 72% of 97 adenocarcinomas, 5% of 119 squamous cell carcinomas, and in the glandular component of two adenosquamous carcinomas. Four large cell carcinomas were completely unreactive. In adenocarcinomas, but not squamous cell carcinomas, TTF-1 immunoreactivity correlated significantly with microvessel density (p = 0.04) and inversely with the tumor proliferation fraction assessed by Ki-67 immunostaining (p = 0.03). Also, TTF-1-immunoreactive adenocarcinomas showed a trend for a size less than 3 cm (p = 0.08). TTF-1 expression was not related to specific growth patterns, tumor grade, or tumor cell typing. TTF-1 immunoreactivity did not significantly affect patient survival, although patients with more than 75% immunoreactive neoplastic cells showed a trend for longer overall and disease-free survival. Our findings suggest that TTF-1 could be involved in the development of small pulmonary adenocarcinomas, but it has not prognostic implications in patients with stage I NSCLC.

Preparatory versus main competitions: differences in performances, lactate responses and pre-competition plasma cortisol concentrations in elite male swimmers

Two groups of elite male swimmers were studied using a similar protocol during the winter training seasons of two consecutive years. In the first season (September 1997-January 1998), eight male swimmers (age 19-25 years) of the Italian National Team participated, after 12 weeks of increased training volume, in a preparatory national competition (PWC) and then, after a further 6 weeks of specific training, in the World Championships (WC, both competitions in a 50-m pool), which represented the main competition at the end of the 18-week-long winter season. In the second season (September 1998-December 1998), a group of ten high-level male swimmers (18-22 years) participated, after 8 weeks of increased training volume, in a preparatory national competition (PIC) and then, after a further 6 weeks of specific training, in the Italian Championships (IC, both competitions in a 25-m pool), the main competition at the end of the 14-week-long winter season. A tapering period lasting 1-3 weeks was observed before the main competition in both seasons. All swimmers were competing at distances of up to 400 m; two of them participated in the study in both seasons. The swimming velocities and post-competition blood lactate concentrations were higher in the main competitions than in the preparatory competitions in both seasons. Pre-competition plasma cortisol (CORT) concentrations were higher than the initial values at the beginning of the season, reaching maximal values at the preparatory competitions and then decreasing before the main competitions in both seasons. The percentage increase in individual swimming velocity from the preparatory to the main competition was positively correlated with the corresponding increase in post-competition blood lactate (r = 0.63, P = 0.046) in the 1997 season (WC), and negatively correlated with the corresponding decrease in pre-competition CORT concentration (r = -0.66, P = 0.019) in the 1998 season (IC). Our results indicate that a decrease in pre-competition CORT could be a prerequisite for an improvement in swimming performance.

Emotional behavior in female rabbits: hippocampal EEG and neuroendocrine aspects

Behavior, hippocampal electrical activity, plasma hormones and hippocampal choline acetyltransferase (ChAT) were considered in two groups of female rabbits, different in age and condition of breeding, both in the presence and absence of emotional stimuli. In the two groups of female rabbits (4 and 18 months old), permanent electrodes were implanted bilaterally in the two dorsal hippocampi and, one week later, the animals were exposed for three consecutive days to the following tests: Day 1, novel environment (NE); Day 2, object with odor (O); Day 3, sparrow hawk (SP). Behavior: in comparison with Day 1, exploration was decreased by the object and by the sparrow hawk in the older females and increased in the younger ones. Quiet and alert immobility was higher during the SP test, while freezing and pointing were lower in the older females than in the young ones. Electrical activity: peak frequency was lower in younger females than in the older ones. The frequency band distribution corresponding to exploration and immobility showed that in the older females the % of high frequency band increased from the first to the third day of testing, while an opposite trend was present in the younger females. In the case of freezing the hippocampal electric activity showed a more rhythmical component in younger females than in the older ones. Hormones: increased corticosterone levels after the SP test were directly correlated with exploration and inversely correlated with freezing. Dorsal hippocampal ChAT was directly correlated with quiet immobility. These data indicate a relationship between the responses to the anxious/fearful stimuli and the age and/or breeding experience of the female rabbits; this is shown by both the hippocampal electrical activity and the behavioral differences between the two groups.

Neuroendocrine and behavioral effects of CRH blockade and stress in male rats

Our previous data have shown that restraint (RT), a mild nonpainful stressor, acutely impairs nonsocial and social behavior in male rats. Corticotropin-releasing hormone (CRH) is a regulator of these behavioral responses. To evaluate whether CRH mediates the neuroendocrine and behavioral alterations present 24 h after restraint stress, we administered the CRH antagonist alpha-helical CRH(9-41) (alpha-hCRH) intracerebroventricularly to male rats and we compared its effects with those of saline. Twenty-four hours after treatment, nonsocial behaviors were significantly decreased by alpha-hCRH, this effect being independent of RT. Among social behaviors, only introductory activity showed significant differences as a result of both RT and alpha-hCRH. The concentrations of ACTH in the plasma and those of beta-endorphin in the anterior and neurointermediate lobes of the pituitary were affected by alpha-hCRH treatment. The effect on ACTH was simply related to the administration of the alpha-hCRH, while for beta-endorphin, significant interactions between alpha-hCRH and RT were found. On the whole, these results point to the role played by CRH in the control of neuronal mechanisms involved in the stress-induced effects.

Influence of training on the response to exercise of adrenocorticotropin and growth hormone plasma concentrations in human swimmers

The aim of the present study was to evaluate the response of adrenocorticotropin ([ACTH]) and growth hormone ([GH]) concentrations to a typical aerobic swimming set during a training season. Nine top-level male endurance swimmers (age range 17-23 years) were tested during three training sessions occurring 6, 12 and 18 weeks after the beginning of the season. During each session, after a standard warm-up, the swimmers performed a training set of 15 x 200-m freestyle, with 20 s of rest between repetitions, at a predetermined individual speed. Blood samples were collected before warm-up and at the end of the training set. A few days before each session, the individual swimming velocity corresponding to the 4 mmol x 1(-1) blood lactate concentration (nu4) was assessed as a standard of aerobic performance. Aerobic training affected nu4 levels, which were highest 18 weeks after the beginning of the season; at the same time, while [ACTH] response was attenuated, [GH] response was enhanced. These results could be considered as adaptations to the exercise intensity. In our training programme, these adaptations seemed to have occurred between the 12th and 18th weeks of the training season.

Behavioural and hormonal effects of restraint stress and formalin test in male and female rats

The formalin test was used to measure the analgesia induced by restraint in male and female rats. Animals were restrained for 30 min or left undisturbed in their cage and then (1) killed immediately to collect blood for hormonal determinations; or (2) subcutaneously injected with formalin in the hind paw (or sham-injected), introduced to an open field for recording of behaviour, and killed at the end of this procedure. In both experiments, corticosterone was found to be higher in females. In Experiment 1, the ability of restraint to be stressful was confirmed by the increase in corticosterone in both sexes and by the decrease of testosterone in males. In Experiment 2, restraint-treatment induced a reduction in licking and flexing that was limited to the second phase. The reduction occurred in different periods and to a different degree in the two sexes; it was greater in females. Spontaneous behaviours showed sex differences in restraint-treated but not in formalin-treated animals. The results show that the hormonal effects observed after restraint are not present after the formalin test and that the marked analgesia observed with phasic painful stimuli does not occur with a longer-lasting one such as that induced by formalin, after which only partial and short-lasting effects were observed.

Sexually selected vigilance behaviour of the grey partridge is affected by plasma androgen levels

In the grey partridge, Perdix perdixvigilance and calling activity are two sex-dimorphic behaviours that are critical for mate choice. To ascertain whether circulating levels of testosterone directly affect vigilance (i.e. the occurrence of upright alert posture), we compared vigilance scores of testosterone-implanted versus control males both during the normal activity of the flock and after the passage of a raptor silhouette; in the latter case, the calling activity was also recorded. Hormone-treated males were more vigilant than controls in both experimental situations. Vigilance was correlated with calling rate. Testosterone seems to act as a link, relating conspicuous behaviours involved in sexual selection to male quality and physical condition, because of the costs of having high levels of both signalling and androgens.Copyright 1997 The Association for the Study of Animal Behaviour1997The Association for the Study of Animal Behaviour

Glucocorticoid receptors in human peripheral blood mononuclear cells in relation to age and to sport activity

Glucocorticoid receptors (GR) are ubiquitous molecules and are present also in the hippocampus and in several other nervous and immune tissues. Peripheral blood mononuclear cells (PBMCs) are a good model for studies of GR in humans. Glucocorticoids are important for maintaining cellular and humoral homeostasis and are key mediators of neuroendocrine-immune regulatory interactions. The increase of cortisol is immunosuppressive and reduces GR concentration both in nervous and immune systems. Variation of glucocorticoids in healthy aged subjects and athletes has been shown. Prompted by these results, we have investigated in man a possible relationship between GR binding capacity in the PBMCs and age, in relation also to plasma testosterone and cortisol. The same parameters have been examined in a group of soccer players for comparison with the sedentary group. GR binding capacity was higher in younger subjects than in older ones, and lower in the group of athletes than in the younger and older sedentary subjects. In the sedentary group a negative correlation was present between GR binding capacity and age. Plasma cortisol was higher and testosterone lower in the athletes; they were negatively correlated in athletes and positively correlated in the sedentary subjects. The results for athletes agree with their lower anabolic/catabolic balance. The mechanism of reduced GR levels in relation to age and sport activity could involve a loss or an involution of receptor synthesis. However other possibilities, such as altered distribution of lymphocyte subpopulations with different receptor concentrations and with different cytokine production, cannot be excluded. Several neuroendocrine-immune interactions could be responsible for reduced GR levels with age and sport activity in man.

Differential effects of exercise on sex hormone-binding globulin and non-sex hormone-binding globulin-bound testosterone

The response of total testosterone (T), free testosterone (fT), sex hormone-binding globulin (SHBG) and non-SHBG-bound testosterone (NST) to the same exercise protocol was evaluated in two different experiments on long distance runners. The first experiment was performed in the morning at 0900 hours with nine athletes, while the second was carried out in the afternoon at 1500 hours with seven athletes. During each experiment, each athlete ran for 1 h at the previously determined speed corresponding to 2 mmol.l-1 blood lactate concentration. Three venous blood samples were collected in each experiment: before exercise, at the end of running and after 1 h of recovery. Total T and SHBG showed similar responses: in the first experiment they had decreased after exercise, while in the second they had increased at the end of running. A positive correlation between total T and SHBG concentrations was found at the end of exercise. In both experiments, NST and fT had increased after exercise and decreased to initial concentrations during recovery. The results would suggest the existence of a compensatory mechanism which maintains adequate concentrations of biologically active T when total T concentrations decrease.

Immune and endocrine aspects of social and territorial behavior in male rabbits

Although there have been some studies of the relation between behavior and mitogen-induced lymphocyte proliferation and immunoglobulin synthesis, few data are available about the effect of behavior on specific lymphokine production. In this study, we describe the effect of social and territorial behaviors on interferon-gamma (IFN-gamma) production by concanavalin A-stimulated peripheral blood mononuclear cells (PBMCs) in pairs of socially naive male rabbits living in a seminatural open-air environment. We also assayed PBMC glucocorticoid receptors (GcRs) and plasma corticosterone (C). Three groups of behaviors were identified: agonistic (Mount and Follow), affiliative (Groom) and territorial (Mark and Dig). Mount was correlated with Follow, while Mark was correlated with Dig. Groom was correlated with all the other behaviors. Groom, Mark, Mount and Follow were all positively correlated with PBMC GcRs. Groom and PBMC GcRs were each negatively correlated with plasma C. The two rabbits in each pair could be distinguished in terms of territorial behavior, since one animal always had a higher score. The animals with the higher level of territorial behavior within the pairs exhibited a significant increase in IFN-gamma production at the end of the experimental period. They also showed a positive correlation between the percentage variations of IFN-gamma production and PBMC GcRs. It is suggested that social factors, especially territorial behavior, affect adrenocortical activity and IFN-gamma production.

Influence of training on the response of androgen plasma concentrations to exercise in swimmers

In eight top-level male endurance swimmers the aerobic performance and the response to exercise of total testosterone (T), free testosterone (fT), sex hormone binding globulin (SHBG), non-SHBG-bound testosterone (NST) and cortisol (C) were evaluated during a training season. The swimmers participated in three test sessions which occurred 6, 12 and 24 weeks after the beginning of the season. During each session, after a standard warm-up, the swimmers performed a set of 15 x 200-m freestyle, with a 20-s rest between repititions, at a predetermined individual speed. Three blood samples were collected: before warm-up, at the end of the set, and after 1 h of recovery. A few days before each session, the individual swimming velocity associated with a 4 mmol.l-1 blood lactate concentration (v4) was assessed as a standard of aerobic performance. The values of v4 were lower in the second session than in the third one. The concentrations of C. which increased after the exercise, showed the highest values in the second session. The values of T and the T:SHBG ratio increased after the exercise but returned to their initial concentrations during the recovery period. The values of fT and NST increased after the exercise in the first and third sessions. In the initial two sessions, when the aerobic performance was still low, the concentrations of NST decreased to below the initial values after recovery. In session III, when the adaptation to the training workload was complete, NST returned to resting concentrations after recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Responses of atrial natriuretic peptide and other fluid regulating hormones to long distance swimming in the sea

The plasma hormonal response following a swimming competition in the sea (18 km) was evaluated in 12 top level male endurance swimmers. At the end of the effort, while plasma renin activity (PRA) and aldosterone concentration (ALDO) were unchanged, a significant increase in plasma atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) concentrations were recorded. These changes were associated with a decrease in haematocrit and an increase in Na+ and Cl- plasma concentrations. The individual variations of ANP (difference between the final and initial concentrations) were inversely correlated with the corresponding individual variations of PRA and ADH. The results suggest that, during prolonged swimming, ANP may exert an inhibitory effect on the PRA-ALDO axis and have a modulatory role with regard to ADH secretion.

Decrease of hippocampal choline acetyltransferase activity induced by formalin pain

The involvement of the hippocampal choline acetyltransferase (ChAT) activity in the response to tonic pain was investigated in rats injected with formalin, either 50 microliters 10% or 50 microliters 0.1%. Hippocampal ChAT activity was found to be reduced both 30 and 60 min after injection of the higher concentration of formalin but only 30 min after the lower one. Results indicate that the decrease in ChAT activity depends upon the presence of the nociceptive input rather than its magnitude. The hippocampal formation is involved in the specific behavioural response to pain, namely licking.

Effects of formalin-induced pain on exploratory behaviour in rabbits

We have used formalin to assess the long-term behavioural and hormonal effects of persistent pain in rabbits. Behaviour has been recorded over 10 min sessions both before and after 10 min, 4 and 24 hours after injection of formalin. A low dose of formalin (0.1 ml at 5%) elicited licking of the injected paw which lasted only a few minutes. Exploratory behaviour was greater than in the control (sham-injected) animals in all post-injection sessions. Following a larger dose of formalin (0.5 ml at 8%) licking occurred in all post-injection sessions, while exploration was lower than the controls only immediately after injection. Twenty-four hours after the formalin injection, testosterone levels were unaffected. Corticosterone levels increased over the course of the experiment but this increase was equal for the experimental and the control groups. Results suggest that different pain intensities and durations have opposite effects on exploratory behaviour in rabbits.

Immune and neuroendocrine response to restraint in male and female rats

A parallel study of the modification in the opioid and immunological systems induced by acute restraint (RT) was carried out in male and female rats 24 hr after the treatment. beta-Endorphin-like immunoreactivity (beta-ELI) was measured in two brain areas (ventral hypothalamus [HYP] and periaqueductal gray matter [PAG]) and in the pituitary (anterior and neurointermediate lobes), together with plasma corticosterone (C) and ACTH. Immune function was measured as mitogen-induced Interferon-gamma (IFN-gamma) production by splenocytes. RT reduced beta-ELI levels in the PAG in males and females. Plasma levels of C and ACTH did not differ from the basal levels in restrained animals. RT reduced IFN-gamma production in both sexes, but this effect was more marked in females than in males. The possible relationship between the immune and opioid system is discussed.

Changes in the exercise-induced hormone response to branched chain amino acid administration

It was the aim of the present experiment to detect possible effects of branched-chain amino acids (BCAA) on the endocrine response to 1 h of continuous running. Blood samples were collected from 14 long-distance runners (age 24-42 years) in two different trials performed at 1-week intervals. In both trials (E and P) blood samples were collected at the following times: 9 a.m. (basal values sample), 10.30 a.m. (sample 90), 11.30 a.m. (sample 150), 12.30 p.m. (sample 210); the athletes performed 1 h of running at a constant predetermined speed between samples 90 and 150. Following the basal sample a mixture containing BCAA (E trial), or not containing BCAA (P trial) was ingested. In both trials no hormone basal concentrations, except insulin, were changed before exercise. In P trial, following exercise (sample 150), human growth hormone (HGH), prolactin (PRL), adrenocorticotropic hormone (ACTH) and cortisol (C) increased, while testosterone (T) decreased. In sample 210, after 1 h of rest, while ACTH, PRL and HGH had recovered to basal concentrations, C remained elevated and T displayed a further decrease. In the E trial a similar pattern of change was observed in sample 150 for HGH, PRL, ACTH and C; in sample 210 HGH and PRL displayed significantly lower values than in the corresponding P trial samples. The T was not modified by the running exercise and increased during the recovery period. It is, therefore, suggested that BCAA administration before exercise affects the response of some anabolic hormones, mainly HGH and T.

[Perforation of the esophagus during attempted endotracheal intubation]

A case is reported of oesophageal perforation which occurred during an attempt to carry out endotracheal intubation. A 54-year-old female patient was scheduled for mastectomy. She had no clinical features likely to predict a difficult endotracheal intubation. After induction with thiopentone, phenoperidine and suxamethonium, three attempts were made to carry out tracheal intubation with a Mallinckrodt Lo-pro tube, internal diameter 7.5 mm. During the third attempt, the oesophagus was accidentally intubated. The diagnosis was made before any insufflation was carried out. Another anaesthetist took over, and intubated the patient. At that time, there was left-sided cervical emphysema which quickly spread. An oesophageal perforation was suspected, and the patient was given 500 mg of metronidazole and 1 g of cefotetan. Postoperatively, the antibiotics were continued, and the patient had nothing by mouth. Oesophagography showed a posterior fistula in the upper third. Conservative treatment was continued until the seventh day, when another oesophagography was carried out. This showed that the perforation had completely healed. This rather rare complication of endotracheal intubation may have a poor prognosis if it results in mediastinitis. The diagnosis and prognosis of this complication and its treatment, whether conservative or surgical, are discussed.

Time-course of opioid and pituitary-adrenal hormone modifications during the immobility reaction in rabbits

A series of experiments in male rabbits examined the influence of tonic immobility (animal hypnosis) on the opioid and pituitary-adrenal hormones. The aims of the experiments were to follow the temporal modifications in hormone parameters and to discriminate the effects of immobility from those of the manipulative procedure to induce the reaction. Results show that immobility elicits increases in plasma ACTH and beta-EP, but no modifications in pituitary beta-EP. The effects of induction procedure were dissociable from those of immobility, the most marked effect being a prolonged, sustained increase of corticosterone plasma levels. Results support the hypothesis of the opioid involvement in the physiological control of immobility reaction and indicate different mechanisms underlying the immobility response and the procedure of induction.