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Cristóvão-Ferreira S, Navarro G, Brugarolas M, Pérez-Capote K, Vaz SH, Fattorini G, Conti F, Lluis C, Ribeiro JA, McCormick PJ, Casadó V, Franco R, Sebastião AM. Correction to: A 1R-A 2AR heteromers coupled to G s and G i/0 proteins modulate GABA transport into astrocytes. Purinergic Signal 2024:10.1007/s11302-024-10012-3. [PMID: 38671309 DOI: 10.1007/s11302-024-10012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Affiliation(s)
- Sofia Cristóvão-Ferreira
- Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal
- Unit of Neurosciences, Institute of Molecular Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal
| | - Gemma Navarro
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Marc Brugarolas
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Kamil Pérez-Capote
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Sandra H Vaz
- Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal
- Unit of Neurosciences, Institute of Molecular Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal
| | - Giorgia Fattorini
- Department of Neuroscience, Università Politecnica delle Marche, Ancona, Italy
- Center for Neurobiology of Aging, INRCA IRCCS, Ancona, Italy
| | - Fiorenzo Conti
- Department of Neuroscience, Università Politecnica delle Marche, Ancona, Italy
- Center for Neurobiology of Aging, INRCA IRCCS, Ancona, Italy
- Fondazione di Medicina Molecolare, Università Politecnica delle Marche, Ancona, Italy
| | - Carmen Lluis
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Joaquim A Ribeiro
- Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal
- Unit of Neurosciences, Institute of Molecular Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal
| | - Peter J McCormick
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Vicent Casadó
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Rafael Franco
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Laboratory of Cell and Molecular Neuropharmacology, Neurosciences Division, Centro de Investigación Médica Aplicada (CIMA), University of Navarra, Pamplona, Spain
| | - Ana M Sebastião
- Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal.
- Unit of Neurosciences, Institute of Molecular Medicine, University of Lisbon, Av. Professor Egas Moniz, Edificio Egas Moniz, 1649-028, Lisbon, Portugal.
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Gerbino A, Tamma G, Conti F, Valenti G. Editorial: 72nd annual meeting of the Italian society of physiology: new perspectives in physiological research. Front Physiol 2024; 15:1403715. [PMID: 38645695 PMCID: PMC11026701 DOI: 10.3389/fphys.2024.1403715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Affiliation(s)
- Andrea Gerbino
- Department of Biosciences, Biotechnologies and Environment, Università di Bari Aldo Moro, Bari, Italy
| | - Grazia Tamma
- Department of Biosciences, Biotechnologies and Environment, Università di Bari Aldo Moro, Bari, Italy
| | - Fiorenzo Conti
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Giovanna Valenti
- Department of Biosciences, Biotechnologies and Environment, Università di Bari Aldo Moro, Bari, Italy
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3
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Pietrobon D, Conti F. Astrocytic Na +, K + ATPases in physiology and pathophysiology. Cell Calcium 2024; 118:102851. [PMID: 38308916 DOI: 10.1016/j.ceca.2024.102851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
The Na+, K+ ATPases play a fundamental role in the homeostatic functions of astrocytes. After a brief historic prologue and discussion of the subunit composition and localization of the astrocytic Na+, K+ ATPases, the review focuses on the role of the astrocytic Na+, K+ pumps in extracellular K+ and glutamate homeostasis, intracellular Na+ and Ca2+ homeostasis and signaling, regulation of synaptic transmission and neurometabolic coupling between astrocytes and neurons. Loss-of-function mutations in the gene encoding the astrocytic α2 Na+, K+ ATPase cause a rare monogenic form of migraine with aura (familial hemiplegic migraine type 2). On the other hand, the α2 Na+, K+ ATPase is upregulated in spinal cord and brain samples from amyotrophic lateral sclerosis and Alzheimer disease patients, respectively. In the last part, the review focuses on i) the migraine relevant phenotypes shown by familial hemiplegic migraine type 2 knock-in mice with 50 % reduced expression of the astrocytic α2 Na+, K+ ATPase and the insights into the pathophysiology of migraine obtained from these genetic mouse models, and ii) the evidence that upregulation of the astrocytic α2 Na+, K+ ATPase in mouse models of amyotrophic lateral sclerosis and Alzheimer disease promotes neuroinflammation and contributes to progressive neurodegeneration.
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Affiliation(s)
- Daniela Pietrobon
- Department of Biomedical Sciences and Padova Neuroscience Center (PNC), University of Padova, Padova 35131, Italy.
| | - Fiorenzo Conti
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy; Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy.
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4
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Gioia C, Picchianti Diamanti A, Perricone R, Chimenti MS, Afeltra A, Navarini L, Migliore A, Massafra U, Bruzzese V, Scolieri P, Meschini C, Paroli M, Caccavale R, Scapato P, Scrivo R, Conti F, Laganà B, Di Franco M. Anti-tumor necrosis factor α: originators versus biosimilars, comparison in clinical response assessment in a multicenter cohort of patients with inflammatory arthropathies. Reumatismo 2023; 75. [PMID: 38115772 DOI: 10.4081/reumatismo.2023.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/25/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE To compare etanercept and adalimumab biosimilars (SB4 and ABP501) and respective bioriginators in terms of safety and efficacy in a real-life contest. METHODS We consequently enrolled patients affected by rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, treated with SB4, and ABP501, or with corresponding originators, belonging to the main biological prescribing centers in the Lazio region (Italy), from 2017 to 2020. Data were collected at recruitment and after 4, 8, 12, and 24 months of therapy. RESULTS The multicenter cohort was composed by 455 patients treated with biosimilars [SB4/ABP501 276/179; female/male 307/146; biologic disease-modifying anti-rheumatic drug (b-DMARD) naïve 56%, median age/ interquartile range 55/46-65 years] and 436 treated with originators (etanercept/adalimumab 186/259, female/ male 279/157, b-DMARD naïve 67,2%, median age/interquartile range 53/43-62 years). No differences were found about safety, but the biosimilar group presented more discontinuations due to inefficacy (p<0.001). Female gender, being a smoker, and being b-DMARD naïve were predictive factors of reduced drug survival (p=0.05, p=0.046, p=0.001 respectively). The retention rate at 24 months was 81.1% for bioriginators and 76.5% for biosimilars (median retention time of 20.7 and 18.9 months, respectively) (p=0.002). Patients with remission/low disease activity achievement at 4 months showed a cumulative survival of 90% to biosimilar therapy until 24 months (p=0.001); early adverse reactions instead represented a cause of subsequent drug discontinuation (p=0.001). CONCLUSIONS Real-life data demonstrated a similar safety profile between biosimilars and originators, but a reduced biosimilar retention rate at 24 months. Biosimilars could be considered a valid, safe, and less expensive alternative to originators, allowing access to treatments for a wider patient population.
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Affiliation(s)
- C Gioia
- Division of Rheumatology, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome.
| | - A Picchianti Diamanti
- Rheumatology, Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome.
| | - R Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - M S Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - A Afeltra
- Allergology, Clinical Immunology and Rheumatology, Bio-Medical Campus, University of Rome.
| | - L Navarini
- Allergology, Clinical Immunology and Rheumatology, Bio-Medical Campus, University of Rome.
| | - A Migliore
- San Pietro Fatebenefratelli Hospital, Rome.
| | - U Massafra
- San Pietro Fatebenefratelli Hospital, Rome.
| | - V Bruzzese
- Department of Internal Medicine, Rheumatology and Gastroenterology, Nuovo Regina Margherita Hospital, Rome.
| | - P Scolieri
- Department of Internal Medicine, Rheumatology and Gastroenterology, Nuovo Regina Margherita Hospital, Rome.
| | - C Meschini
- General Medicine, Belcolle Hospital, Viterbo.
| | - M Paroli
- Department of Medical-Surgical Sciences and Biotechnology, Polo Pontino, Sapienza University, Latina.
| | - R Caccavale
- Department of Medical-Surgical Sciences and Biotechnology, Polo Pontino, Sapienza University, Latina.
| | - P Scapato
- Rheumatology, Department of Medicine, S. Camillo de Lellis Hospital, Rieti.
| | - R Scrivo
- Division of Rheumatology, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome.
| | - F Conti
- Division of Rheumatology, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome.
| | - B Laganà
- Rheumatology, Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome.
| | - M Di Franco
- Division of Rheumatology, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome.
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Spinelli FR, Conti F, Caporali R, Iannone F, Cacciapaglia F, Steering Committee Of The Italian Society Of Rheumatology OBOT. Janus kinase inhibitors: between prescription authorization and reimbursability. Reumatismo 2023; 75. [PMID: 38115771 DOI: 10.4081/reumatismo.2023.1627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 12/21/2023] Open
Abstract
Following the restrictions on the reimbursability of Janus kinase inhibitors introduced by the Italian Medicines Agency, the Italian Society of Rheumatology has drafted this document to shed light on the clinical conditions and reimbursability criteria set out in the prescription forms.
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Affiliation(s)
- F R Spinelli
- Rheumatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome.
| | - F Conti
- Rheumatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome.
| | - R Caporali
- Rheumatology Unit, Department of Clinical and Community Sciences, University of Milan, ASST Gaetano Pini-CTO, Milan.
| | - F Iannone
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro.
| | - F Cacciapaglia
- Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro.
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Di Palma M, Catalano M, Serpe C, De Luca M, Monaco L, Kunzelmann K, Limatola C, Conti F, Fattorini G. Lipopolysaccharide augments microglial GABA uptake by increasing GABA transporter-1 trafficking and bestrophin-1 expression. Glia 2023; 71:2527-2540. [PMID: 37431178 DOI: 10.1002/glia.24437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023]
Abstract
Gamma-aminobutyric acid (GABA), the principal inhibitory neurotransmitter in the brain, affects numerous immune cell functions. Microglia, the brain's resident innate immune cells, regulate GABA signaling through GABA receptors and express the complete GABAergic machinery for GABA synthesis, uptake, and release. Here, the use of primary microglial cell cultures and ex vivo brain tissue sections allowed for demonstrating that treatment with lipopolysaccharide (LPS) increased microglial GABA uptake as well as GABA transporter (GAT)-1 trafficking. This effect was not entirely abolished by treatment with GAT inhibitors (GAT-Is). Notably, LPS also induced microglial upregulation of bestrophin-1 (BEST-1), a Ca2+ -activated Cl- channel permeable to GABA. Combined administration of GAT-Is and a BEST-1 inhibitor completely abolished LPS-induced microglial GABA uptake. Interestingly, increased microglial GAT-1 membrane turnover via syntaxin 1A was detected in LPS-treated cultures after BEST-1 blockade. Altogether, these findings provided evidence for a novel mechanism through which LPS may trigger the inflammatory response by directly altering microglial GABA clearance and identified the GAT-1/BEST-1 interplay as a potential novel mechanism involved in brain inflammation.
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Affiliation(s)
- Michael Di Palma
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, Università Politecnica delle Marche, Ancona, Italy
| | - Myriam Catalano
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Carmela Serpe
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Mariassunta De Luca
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Lucia Monaco
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Karl Kunzelmann
- Physiological Institute, University of Regensburg, Regensburg, Germany
| | - Cristina Limatola
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Fiorenzo Conti
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, Università Politecnica delle Marche, Ancona, Italy
- Center for Neurobiology of Aging, INRCA IRCCS, Ancona, Italy
- Fondazione di Medicina Molecolare, Università Politecnica delle Marche, Ancona, Italy
| | - Giorgia Fattorini
- Department of Experimental and Clinical Medicine, Section of Neuroscience and Cell Biology, Università Politecnica delle Marche, Ancona, Italy
- Center for Neurobiology of Aging, INRCA IRCCS, Ancona, Italy
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Matcaşu I, Haddad N, Barrou B, Conti F, Barete S. Biotherapies for chronic inflammatory dermatosis in organ transplant recipients: 3 case reports and a literature review. Ann Dermatol Venereol 2023; 150:219-222. [PMID: 36739220 DOI: 10.1016/j.annder.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/27/2022] [Accepted: 11/08/2022] [Indexed: 02/05/2023]
Affiliation(s)
- I Matcaşu
- Dermatology Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - N Haddad
- Dermatology Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - B Barrou
- Kidney Transplantation Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - F Conti
- Liver Transplantation Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - S Barete
- Dermatology Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France.
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Brockmann SJ, Buck E, Casoli T, Meirelles JL, Ruf WP, Fabbietti P, Holzmann K, Weishaupt JH, Ludolph AC, Conti F, Danzer KM. Mitochondrial genome study in blood of maternally inherited ALS cases. Hum Genomics 2023; 17:70. [PMID: 37507754 PMCID: PMC10375681 DOI: 10.1186/s40246-023-00516-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND ALS is a heterogeneous disease in which different factors such as mitochondrial phenotypes act in combination with a genetic predisposition. This study addresses the question of whether homoplasmic (total mitochondrial genome of a sample is affected) and/or heteroplasmic mutations (wildtype and mutant mitochondrial DNA molecules coexist) might play a role in familial ALS. Blood was drawn from familial ALS patients with a possible maternal pattern of inheritance according to their pedigrees, which was compared to blood of ALS patients without maternal association as well as age-matched controls. In two cohorts, we analyzed the mitochondrial genome from whole blood or isolated white blood cells and platelets using a resequencing microarray (Affymetrix MitoChip v2.0) that is able to detect homoplasmic and heteroplasmic mitochondrial DNA mutations and allows the assessment of low-level heteroplasmy. RESULTS We identified an increase in homoplasmic ND5 mutations, a subunit of respiratory chain complex I, in whole blood of ALS patients that allowed maternal inheritance. This effect was more pronounced in patients with bulbar onset. Heteroplasmic mutations were significantly increased in different mitochondrial genes in platelets of patients with possible maternal inheritance. No increase of low-level heteroplasmy was found in maternal ALS patients. CONCLUSION Our results indicate a contribution of homoplasmic ND5 mutations to maternally associated ALS with bulbar onset. Therefore, it might be conceivable that specific maternally transmitted rather than randomly acquired mitochondrial DNA mutations might contribute to the disease process. This stands in contrast with observations from Alzheimer's and Parkinson's diseases showing an age-dependent accumulation of unspecific mutations in mitochondrial DNA.
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Affiliation(s)
- Sarah J Brockmann
- Department of Neurology, University Clinic, University of Ulm, Ulm, Germany
| | - Eva Buck
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany
| | - Tiziana Casoli
- Center for Neurobiology of Aging, Scientific Technological Area, IRCCS INRCA, Ancona, Italy
| | - João L Meirelles
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany
| | - Wolfgang P Ruf
- Department of Neurology, University Clinic, University of Ulm, Ulm, Germany
| | - Paolo Fabbietti
- Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, Ancona, Italy
| | | | - Jochen H Weishaupt
- Department of Neurology, University Clinic, University of Ulm, Ulm, Germany
- Division for Neurodegenerative Diseases, Neurology Department, University Medicine Mannheim, Heidelberg University, Mannheim, Germany
| | - Albert C Ludolph
- Department of Neurology, University Clinic, University of Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany
| | - Fiorenzo Conti
- Center for Neurobiology of Aging, Scientific Technological Area, IRCCS INRCA, Ancona, Italy
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Karin M Danzer
- Department of Neurology, University Clinic, University of Ulm, Ulm, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany.
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Tamzali Y, Pourcher V, Azoyan L, Ouali N, Barrou B, Conti F, Coutance G, Gay F, Tourret J, Boutolleau D. Factors Associated With Genotypic Resistance and Outcome Among Solid Organ Transplant Recipients With Refractory Cytomegalovirus Infection. Transpl Int 2023; 36:11295. [PMID: 37398559 PMCID: PMC10307959 DOI: 10.3389/ti.2023.11295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023]
Abstract
Genotypically resistant cytomegalovirus (CMV) infection is associated with increased morbi-mortality. We herein aimed at understanding the factors that predict CMV genotypic resistance in refractory infections and disease in the SOTR (Solid Organ Transplant Recipients) population, and the factors associated with outcomes. We included all SOTRs who were tested for CMV genotypic resistance for CMV refractory infection/disease over ten years in two centers. Eighty-one refractory patients were included, 26 with genotypically resistant infections (32%). Twenty-four of these genotypic profiles conferred resistance to ganciclovir (GCV) and 2 to GCV and cidofovir. Twenty-three patients presented a high level of GCV resistance. We found no resistance mutation to letermovir. Age (OR = 0.94 per year, IC95 [0.089-0.99]), a history of valganciclovir (VGCV) underdosing or of low plasma concentration (OR= 5.6, IC95 [1.69-20.7]), being on VGCV at infection onset (OR = 3.11, IC95 [1.18-5.32]) and the recipients' CMV negative serostatus (OR = 3.40, IC95 [0.97-12.8]) were independently associated with CMV genotypic resistance. One year mortality was higher in the resistant CMV group (19.2 % versus 3.6 %, p = 0.02). Antiviral drugs severe adverse effects were also independently associated with CMV genotypic resistance. CMV genotypic resistance to antivirals was independently associated with a younger age, exposure to low levels of GCV, the recipients' negative serostatus, and presenting the infection on VGCV prophylaxis. This data is of importance, given that we also found a poorer outcome in the patients of the resistant group.
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Affiliation(s)
- Yanis Tamzali
- Sorbonne Université, Paris, France
- Department of Infectious and Tropical Diseases, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Medicosurgical Unit of Kidney Transplantation, Paris, France
- INSERM UMR 1146, Paris, France
| | - V. Pourcher
- Sorbonne Université, Paris, France
- Department of Infectious and Tropical Diseases, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM UMR, Paris, France
| | - L. Azoyan
- Sorbonne Université, Paris, France
- Department of Infectious and Tropical Diseases, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - N. Ouali
- Department of Nephrology Unité SINRA, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - B. Barrou
- Sorbonne Université, Paris, France
- Department of Infectious and Tropical Diseases, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Medicosurgical Unit of Kidney Transplantation, Paris, France
- INSERM UMR 1038, Paris, France
| | - F. Conti
- Sorbonne Université, Paris, France
- Department of Hepatogastroenterlogy, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Liver Transplantation Unit, Paris, France
| | - G. Coutance
- Sorbonne Université, Paris, France
- Department of Cardiosurgery, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Fédération de Cardiologie, Paris, France
| | - F. Gay
- Sorbonne Université, Paris, France
- Department of Parasitology and Mycology, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - J. Tourret
- Sorbonne Université, Paris, France
- Department of Infectious and Tropical Diseases, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Medicosurgical Unit of Kidney Transplantation, Paris, France
- INSERM UMR 1146, Paris, France
| | - D. Boutolleau
- Sorbonne Université, Paris, France
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM UMR, Paris, France
- Department of Virology, Assistance Publique—Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Centre National de Référence Herpèsvirus (Laboratoire Associé), Paris, France
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Balietti M, Casoli T, Giorgetti B, Colangeli R, Nicoletti C, Solazzi M, Pugliese A, Conti F. Generation and Characterization of the First Murine Model of Alzheimer's Disease with Mutated AβPP Inserted in a BALB/c Background (C.B6/J-APPswe). J Alzheimers Dis 2023:JAD230195. [PMID: 37182890 DOI: 10.3233/jad-230195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Numerous mouse models of Alzheimer's disease (AD) are available, but all suffer from certain limitations, thus prompting further attempts. To date, no one model exists with amyloidopathy in a BALB/c strain. OBJECTIVE To generate and characterize the C.B6/J-APPswe mouse, a model of AD with a mutated human gene for the amyloid-β protein precursor (AβPP) inserted in a BALB/c background. METHODS We analyzed five groups at different ages (3, 6, 9, 12, and 16-18 months) of C.B6/J-APPswe and wild-type mice (50% males and 50% females) for the main hallmarks of AD by western blotting, amyloid-β (Aβ) ELISA, immunocytochemistry, electrophysiology, and behavioral tests. RESULTS The C.B6/J-APPswe mouse displays early AβPP and Aβ production, late amyloid plaques formation, high level of tau phosphorylation, synaptic deficits (reduced density and functional impairment due to a reduced post-synaptic responsiveness), neurodegeneration caused by apoptosis and necroptosis/necrosis, microgliosis, astrocytic abnormalities, and sex-related differences in explorative behavior, anxiety-like behavior, and spatial long-term and working memories. Social housing is feasible despite the intra-cage aggressiveness of male animals. CONCLUSION C.B6/J-APPswe mice develop most of the distinctive features of AD and is a suitable model for the study of brain atrophy mechanisms and of the differences between males and females in the onset of cognitive/non-cognitive deficits.
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Affiliation(s)
- Marta Balietti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Tiziana Casoli
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | | | - Roberto Colangeli
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Cristina Nicoletti
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Moreno Solazzi
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Arianna Pugliese
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Fiorenzo Conti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
- Fondazione di Medicina Molecolare e Terapia Cellulare, Università Politecnica delle Marche, Ancona, Italy
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11
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Requie LM, Gómez-Gonzalo M, Speggiorin M, Managò F, Melone M, Congiu M, Chiavegato A, Lia A, Zonta M, Losi G, Henriques VJ, Pugliese A, Pacinelli G, Marsicano G, Papaleo F, Muntoni AL, Conti F, Carmignoto G. Author Correction: Astrocytes mediate long-lasting synaptic regulation of ventral tegmental area dopamine neurons. Nat Neurosci 2023:10.1038/s41593-023-01330-7. [PMID: 37186120 DOI: 10.1038/s41593-023-01330-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Linda Maria Requie
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Marta Gómez-Gonzalo
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy.
| | - Michele Speggiorin
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Francesca Managò
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano di Tecnologia (IIT), Genova, Italy
| | - Marcello Melone
- Department of Experimental and Clinical Medicine, Section of Neuroscience & Cell Biology, Università Politecnica delle Marche, and Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Mauro Congiu
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, Università degli Studi di Cagliari, Cagliari, Italy
- Neuroscience Institute, Section of Cagliari, National Research Council (CNR), Cagliari, Italy
| | - Angela Chiavegato
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Annamaria Lia
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Micaela Zonta
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Gabriele Losi
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
- Nanoscience Institute, National Research Council (CNR), Modena, Italy
| | - Vanessa Jorge Henriques
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Arianna Pugliese
- Department of Experimental and Clinical Medicine, Section of Neuroscience & Cell Biology, Università Politecnica delle Marche, and Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Giada Pacinelli
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano di Tecnologia (IIT), Genova, Italy
- Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
| | - Giovanni Marsicano
- University of Bordeaux and Interdisciplinary Institute for Neuroscience (CNRS), Bordeaux, France
| | - Francesco Papaleo
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano di Tecnologia (IIT), Genova, Italy
| | - Anna Lisa Muntoni
- Neuroscience Institute, Section of Cagliari, National Research Council (CNR), Cagliari, Italy
| | - Fiorenzo Conti
- Department of Experimental and Clinical Medicine, Section of Neuroscience & Cell Biology, Università Politecnica delle Marche, and Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Giorgio Carmignoto
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy.
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12
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Conti F, Pietrobon D. Astrocytic Glutamate Transporters and Migraine. Neurochem Res 2023; 48:1167-1179. [PMID: 36583835 DOI: 10.1007/s11064-022-03849-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/07/2022] [Accepted: 12/17/2022] [Indexed: 12/31/2022]
Abstract
Glutamate levels and lifetime in the brain extracellular space are dinamically regulated by a family of Na+- and K+-dependent glutamate transporters, which thereby control numerous brain functions and play a role in numerous neurological and psychiatric diseases. Migraine is a neurological disorder characterized by recurrent attacks of typically throbbing and unilateral headache and by a global dysfunction in multisensory processing. Familial hemiplegic migraine type 2 (FHM2) is a rare monogenic form of migraine with aura caused by loss-of-function mutations in the α2 Na/K ATPase (α2NKA). In the adult brain, this pump is expressed almost exclusively in astrocytes where it is colocalized with glutamate transporters. Knockin mouse models of FHM2 (FHM2 mice) show a reduced density of glutamate transporters in perisynaptic astrocytic processes (mirroring the reduced expression of α2NKA) and a reduced rate of glutamate clearance at cortical synapses during neuronal activity and sensory stimulation. Here we review the migraine-relevant alterations produced by the astrocytic glutamate transport dysfunction in FHM2 mice and their underlying mechanisms, in particular regarding the enhanced brain susceptibility to cortical spreading depression (the phenomenon that underlies migraine aura and can also initiate the headache mechanisms) and the enhanced algesic response to a migraine trigger.
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Affiliation(s)
- Fiorenzo Conti
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy.
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy.
| | - Daniela Pietrobon
- Department of Biomedical Sciences and Padova Neuroscience Center (PNC), University of Padova, 35131, Padua, Italy.
- CNR Institute of Neuroscience, 35131, Padua, Italy.
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13
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Requie LM, Gómez-Gonzalo M, Speggiorin M, Managò F, Melone M, Congiu M, Chiavegato A, Lia A, Zonta M, Losi G, Henriques VJ, Pugliese A, Pacinelli G, Marsicano G, Papaleo F, Muntoni AL, Conti F, Carmignoto G. Astrocytes mediate long-lasting synaptic regulation of ventral tegmental area dopamine neurons. Nat Neurosci 2022; 25:1639-1650. [PMID: 36396976 DOI: 10.1038/s41593-022-01193-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
The plasticity of glutamatergic transmission in the ventral tegmental area (VTA) represents a fundamental mechanism in the modulation of dopamine neuron burst firing and phasic dopamine release at target regions. These processes encode basic behavioral responses, including locomotor activity, learning and motivated behaviors. Here we describe a hitherto unidentified mechanism of long-term synaptic plasticity in mouse VTA. We found that the burst firing in individual dopamine neurons induces a long-lasting potentiation of excitatory synapses on adjacent dopamine neurons that crucially depends on Ca2+ elevations in astrocytes, mediated by endocannabinoid CB1 and dopamine D2 receptors co-localized at the same astrocytic process, and activation of pre-synaptic metabotropic glutamate receptors. Consistent with these findings, selective in vivo activation of astrocytes increases the burst firing of dopamine neurons in the VTA and induces locomotor hyperactivity. Astrocytes play, therefore, a key role in the modulation of VTA dopamine neuron functional activity.
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Affiliation(s)
- Linda Maria Requie
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Marta Gómez-Gonzalo
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy.
| | - Michele Speggiorin
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Francesca Managò
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano di Tecnologia (IIT), Genova, Italy
| | - Marcello Melone
- Department of Experimental and Clinical Medicine, Section of Neuroscience & Cell Biology, Università Politecnica delle Marche, and Center for Neurobiology of Aging, Ancona, Italy
| | - Mauro Congiu
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, Università degli Studi di Cagliari, Cagliari, Italy.,Neuroscience Institute, Section of Cagliari, National Research Council (CNR), Cagliari, Italy
| | - Angela Chiavegato
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Annamaria Lia
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Micaela Zonta
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Gabriele Losi
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy.,Nanoscienze Institute, National Research Council (CNR), Modena, Italy
| | - Vanessa Jorge Henriques
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Arianna Pugliese
- Department of Experimental and Clinical Medicine, Section of Neuroscience & Cell Biology, Università Politecnica delle Marche, and Center for Neurobiology of Aging, Ancona, Italy
| | - Giada Pacinelli
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano di Tecnologia (IIT), Genova, Italy.,Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
| | - Giovanni Marsicano
- University of Bordeaux and Interdisciplinary Institute for Neuroscience (CNRS), Bordeaux, France
| | - Francesco Papaleo
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano di Tecnologia (IIT), Genova, Italy
| | - Anna Lisa Muntoni
- Neuroscience Institute, Section of Cagliari, National Research Council (CNR), Cagliari, Italy
| | - Fiorenzo Conti
- Department of Experimental and Clinical Medicine, Section of Neuroscience & Cell Biology, Università Politecnica delle Marche, and Center for Neurobiology of Aging, Ancona, Italy
| | - Giorgio Carmignoto
- Neuroscience Institute, Section of Padova, National Research Council (CNR) and Department of Biomedical Sciences, Università degli Studi di Padova, Padova, Italy.
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14
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La Barbera L, Nobili A, Cauzzi E, Paoletti I, Federici M, Saba L, Giacomet C, Marino R, Krashia P, Melone M, Keller F, Mercuri NB, Viscomi MT, Conti F, D’Amelio M. Upregulation of Ca 2+-binding proteins contributes to VTA dopamine neuron survival in the early phases of Alzheimer's disease in Tg2576 mice. Mol Neurodegener 2022; 17:76. [PMID: 36434727 PMCID: PMC9700939 DOI: 10.1186/s13024-022-00580-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Recent clinical and experimental studies have highlighted the involvement of Ventral Tegmental Area (VTA) dopamine (DA) neurons for the early pathogenesis of Alzheimer's Disease (AD). We have previously described a progressive and selective degeneration of these neurons in the Tg2576 mouse model of AD, long before amyloid-beta plaque formation. The degenerative process in DA neurons is associated with an autophagy flux impairment, whose rescue can prevent neuronal loss. Impairments in autophagy can be the basis for accumulation of damaged mitochondria, leading to disturbance in calcium (Ca2+) homeostasis, and to functional and structural deterioration of DA neurons. METHODS In Tg2576 mice, we performed amperometric recordings of DA levels and analysis of dopaminergic fibers in the Nucleus Accumbens - a major component of the ventral striatum precociously affected in AD patients - together with retrograde tracing, to identify the most vulnerable DA neuron subpopulations in the VTA. Then, we focused on these neurons to analyze mitochondrial integrity and Apoptosis-inducing factor (AIF) localization by electron and confocal microscopy, respectively. Stereological cell count was also used to evaluate degeneration of DA neuron subpopulations containing the Ca2+-binding proteins Calbindin-D28K and Calretinin. The expression levels for these proteins were analyzed by western blot and confocal microscopy. Lastly, using electrophysiology and microfluorometry we analyzed VTA DA neuron intrinsic properties and cytosolic free Ca2+ levels. RESULTS We found a progressive degeneration of mesolimbic DA neurons projecting to the ventral striatum, located in the paranigral nucleus and parabrachial pigmented subnucleus of the VTA. At the onset of degeneration (3 months of age), the vulnerable DA neurons in the Tg2576 accumulate damaged mitochondria, while AIF translocates from the mitochondria to the nucleus. Although we describe an age-dependent loss of the DA neurons expressing Calbindin-D28K or Calretinin, we observed that the remaining cells upregulate the levels of Ca2+-binding proteins, and the free cytosolic levels of Ca2+ in these neurons are significantly decreased. Coherently, TUNEL-stained Tg2576 DA neurons express lower levels of Calbindin-D28K when compared with non-apoptotic cells. CONCLUSION Overall, our results suggest that the overexpression of Ca2+-binding proteins in VTA DA neurons might be an attempt of cells to survive by increasing their ability to buffer free Ca2+. Exploring strategies to overexpress Ca2+-binding proteins could be fundamental to reduce neuronal suffering and improve cognitive and non-cognitive functions in AD.
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Affiliation(s)
- Livia La Barbera
- grid.9657.d0000 0004 1757 5329Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy ,grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy
| | - Annalisa Nobili
- grid.9657.d0000 0004 1757 5329Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy ,grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy
| | - Emma Cauzzi
- grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy ,grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Ilaria Paoletti
- grid.9657.d0000 0004 1757 5329Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Mauro Federici
- grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy
| | - Luana Saba
- grid.9657.d0000 0004 1757 5329Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy ,grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy
| | - Cecilia Giacomet
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Ramona Marino
- grid.9657.d0000 0004 1757 5329Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Paraskevi Krashia
- grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy ,grid.9657.d0000 0004 1757 5329Department of Sciences and Technologies for Humans and Environment, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Marcello Melone
- grid.7010.60000 0001 1017 3210Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche (UNIVPM), 60020 Ancona, Italy ,Center for Neurobiology of Aging, IRCCS Istituto Nazionale Ricovero e Cura Anziani (INRCA), 60020 Ancona, Italy
| | - Flavio Keller
- grid.9657.d0000 0004 1757 5329Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Nicola Biagio Mercuri
- grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy ,grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Maria Teresa Viscomi
- grid.8142.f0000 0001 0941 3192Department of Life Science and Public Health; Section of Histology and Embryology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy ,grid.414603.4Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy
| | - Fiorenzo Conti
- grid.7010.60000 0001 1017 3210Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche (UNIVPM), 60020 Ancona, Italy ,Center for Neurobiology of Aging, IRCCS Istituto Nazionale Ricovero e Cura Anziani (INRCA), 60020 Ancona, Italy ,grid.7010.60000 0001 1017 3210Foundation for Molecular Medicine, Università Politecnica delle Marche, 60020 Ancona, Italy
| | - Marcello D’Amelio
- grid.9657.d0000 0004 1757 5329Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy ,grid.417778.a0000 0001 0692 3437Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00143 Rome, Italy
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Ceccarelli F, Covelli V, Olivieri G, Natalucci F, Alessandri C, Conti F. Patients with systemic lupus erythematosus and their experience with vaccination against COVID-19: a descriptive and explanatory study. Reumatismo 2022; 74. [DOI: 10.4081/reumatismo.2022.1491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
Not available
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16
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Baccelli F, Ortolano R, Conti F, Soncini E, Baronio F, Masetti R, Cassio A, Pession A. Transplantation to save the life, TSH screening to save the brain: A report and brief literature review of autoimmune thyroid disease after HSCT for severe combined immunodeficiency. Clin Immunol 2022; 245:109142. [DOI: 10.1016/j.clim.2022.109142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/07/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
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17
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Roger C, Mazzola A, Lacaille F, Malvy J, de Lamballerie X, Conti F. Pre-emptive treatment of West Nile Virus after split liver transplantation. Clin Res Hepatol Gastroenterol 2022; 46:101972. [PMID: 35690357 DOI: 10.1016/j.clinre.2022.101972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/25/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Affiliation(s)
- C Roger
- Unité Médicale de Transplantation Hépatique, Service d'Hépato-Gastro-Entérologie, Hôpital Pitié Salpêtrière, APHP, 47-83 Boulevard de l'Hôpital 75013 Paris.
| | - A Mazzola
- Unité Médicale de Transplantation Hépatique, Service d'Hépato-Gastro-Entérologie, Hôpital Pitié Salpêtrière, APHP, 47-83 Boulevard de l'Hôpital 75013 Paris; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris
| | - F Lacaille
- Service de Gastroentérologie-Hépatologie-Nutrition Pédiatriques, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres 75015 Paris
| | - Jmd Malvy
- Service des Maladies Infectieuses et Tropicales, Hôpitaux de Bordeaux and Inserm, Université de Bordeaux, Bordeaux 1219, France
| | - X de Lamballerie
- Unité des Virus Émergents - (UVE), Faculté de Médecine de Marseille, Aix-Marseille Université, IRD 190 - Inserm 1207, EFS - IRBA, 27 Boulevard Jean Moulin, Marseille 13005 Cedex 05, France
| | - F Conti
- Unité Médicale de Transplantation Hépatique, Service d'Hépato-Gastro-Entérologie, Hôpital Pitié Salpêtrière, APHP, 47-83 Boulevard de l'Hôpital 75013 Paris; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris; Sorbonne Université, INSERM, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
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18
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Balietti M, Conti F. Environmental enrichment and the aging brain: is it time for standardization? Neurosci Biobehav Rev 2022; 139:104728. [PMID: 35691473 DOI: 10.1016/j.neubiorev.2022.104728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/01/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Abstract
Aging entails a progressive decline of cognitive abilities. However, since the brain is endowed with considerable plasticity, adequate stimulation can delay or partially compensate for age-related structural and functional impairment. Environmental enrichment (EE) has been reported to determine a wide range of cerebral changes. Although most findings have been obtained in young and adult animals, research has recently turned to aged individuals. Notably, EE can contribute identifying key lifestyle factors whose change can help extend the "mind-span", i.e., the time an individual lives in a healthy cognitive condition. Here we discuss specific methodological issues that can affect the outcomes of EE interventions applied to aged rodents, summarize the main variables that would need standardization (e.g., timing and duration, enrichment items, control animals and setting), and offer some suggestions on how this goal may be achieved. Reaching a consensus on EE experiment design would significantly reduce differences between and within laboratories, enable constructive discussions among researchers, and improve data interpretation.
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Affiliation(s)
- Marta Balietti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy.
| | - Fiorenzo Conti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy; Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy.
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19
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Simoncelli E, Colafrancesco S, Spinelli FR, Gattamelata A, Giardina F, Truglia S, Garufi C, Izzo R, Cantarini L, Frediani B, Conticini E, Grazzini S, Priori R, Conti F. POS1266 MULTICENTER RETROSPECTIVE STUDY EVALUATING THE SAFETY OF ANTI-SARS-CoV-2 VACCINE IN A COHORT OF PATIENTS WITH SYSTEMIC VASCULITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundVaccinations against SARS-CoV-2 represent a fundamental tool in controlling the pandemic. To date, data on the safety of anti-SARS-CoV-2 vaccines in patients with rare rheumatic diseases, such as systemic vasculitis, are limited.ObjectivesIn this study we aimed at evaluating the safety of anti-SARS-CoV-2 vaccines in a multicentric cohort of patients with systemic vasculitis.MethodsPatients with systemic vasculitis from two Rheumatology centres who had received anti-SARS-CoV-2 vaccine were retrospectively examined. The primary outcome was to evaluate, in this multi-centric cohort, the occurence of a disease flare after the administration of the vaccine, defined as development of clinical manifestations related to vasculitis with a concomitant increase in serum inflammatory markers. As a secondary outcome we aimed at evaluating, in a monocentric cohort of patients with vasculitis, the occurrence of adverse events (AEs) following vaccine administration compared to healthy controls (HC).ResultsWe examined 111 patients with systemic vasculitis (n=69 female, n=42 male), with a mean age of 64.3 (± 13) years. Sixty had ANCA-associated vasculitis (AAV), fourty-two had Giant-Cell Arterities (GCA), five had Periarteritis Nodosa, four had Takayasu’s arteritis. One-hundred and five patients received a mRNA vaccine and six a viral vector one. A disease flare occurred in only 2 patients (1.8%) after the first dose of a mRNA vaccine: both had AAV (microscopic poliangioitis) and developed a pulmunary disease flare (respiratory failure requiring hospitalization and treatment with high-dose glucocorticoids). Of note, one of these patients had multiple previous comorbidities, including a severe COPD. Multivaried analysis, adjusted for age and sex, performed in a single monocentric cohort of patients with systemic vasculitis [n=60 (39 AAV, 21 GCA), 37 female, 23 male, mean age 71 (± 12.5) years] demonstrated a statistically significant higher frequency of AEs in vasculitis patients compared to HC (p=0.015) after the first dose of vaccination. No significant differences in the frequency of AEs in vasculitis patients compared to HC after the second dose were detected. All the AEs were mild in both groups (malaise was the most frequently reported); no serious AEs were reported.ConclusionOur data show a very low incidence of disease flares after the administration of anti-SARS-CoV-2 vaccines in patients with systemic vasculitis. Patients with systemic vasculitis seem more prone to develop mild AEs after the first dose of the vaccine. Taken together, this data suggest a good risk profile for anti-SARS-CoV-2 vaccine in patients with systemic vasculitis.Disclosure of InterestsNone declared
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Pellegrino G, Colasanti T, Bisconti I, Cadar M, DI Ciommo FR, Reza Beigi DM, Stefanantoni K, Gigante A, Rosato E, Conti F, Riccieri V. POS0475 ROLE OF IL-33/ST2 AXIS IN SYSTEMIC SCLEROSIS PATIENTS WITH ELECTROCARDIOGRAPHIC ABNORMALITIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundElectrocardiographic (EKG) abnormalities are described in 25-75% Systemic Sclerosis (SSc) patients and they are associated with other systemic manifestations1 as well as with a worse prognosis.2 There is an increasing need for clinical and laboratory biomarkers to ameliorate the diagnostic approaches to patients with EKG abnormalities.3In the last decade, many studies focused on the components of the interleukin (IL)-33/ST2 axis. Under physiological conditions, IL-33 is released by apoptotic cardiac cells, promoting a protective mechanism of cell survival, thanks to the binding with its transmembrane receptor ST2.4 During pathological cardiovascular events, an abnormal secretion of the IL-33 soluble receptor (sST2) by Th2 cells occurs. It binds IL-33 not allowing the physiological mechanism driven by the IL-33/ST2 binding previously described.4 For these reasons, sST2 has been proposed as a biomarker of cardiac injury in a variety of diseases.5ObjectivesAim of this study was to analyse clinical and demographical parameters in a group of SSc patients, trying to define any possible feature associated with EKG abnormalities. Furthermore, the role of IL-33/ST2 axis components as biomarkers of cardiac injury in patients with SSc-related EKG abnormalities was evaluated, also assessing the possible correlation with serum concentration of NT-pro-BNP, a well-known cardiac injury biomarker in SSc.MethodsData from 277 SSc patients, fulfilling the 2013 ACR/EULAR classification criteria,6 attending our Scleroderma Clinic were retrospectively analysed. We selected patients with EKG trace and a blood sample available, collected after the SSc diagnosis. The sera levels of sST2 (ELISA Kit, Abcam), IL-33 (ELISA kit, RayBiotech) and NT-pro-BNP (ELISA Kit, Abcam) were measured. Patients with a history of heart diseases occurring before the diagnosis of SSc or features of secondary cardiac involvement (pulmonary arterial hypertension, severe interstitial lung disease or renal disease) were excluded.ResultsForty-six SSc patients showed significant EKG abnormalities (rhythm and conduction disorders). Thirty-one SSc patients without pathologic finding at EKG traces were recruited as the control group.From the analysis of the clinical characteristic of the disease at the moment of serum collection, patients with EKG anomalies have more frequently both a diffuse form of disease (n°-%: 23-50 vs 7-23; p 0.01), with a mean value of mRSS higher than controls (11±9 vs 6±6; p 0.01), and a scleroderma “late” pattern at the nailfold capillaroscopy (n°-% 23-50 vs 6-19; p 0.027).Significantly higher median values of serum levels of sST2 in SSc patients with EKG disorders compared to the control group (4289pg/mL, IQR 2383 vs 2560 pg/mL, IQR 1455; p 0.0002) were detected, while opposite results were found analyzing serum levels of IL-33 (2.89 pg/mL IQR 101 vs 9 pg/mL IQR 277; p 0.032) (Graph 1). Serum NT-pro-BNP median values were significantly higher in the group of patients with EKG abnormalities than in the control group (149 pg/mL, IQR 354 vs 26 pg/mL, IQR 62; p 0.0007). These values correlated with sST2 serum levels (rho Spearman correlation 0.37; p 0.0006).ConclusionSSc patients with EKG abnormalities showed an increased skin and vascular involvement with respect to the control group. These associations could help clinicians in clinically stratifying SSc patients at risk of EKG abnormalities. To our knowledge, this is the first report evaluating the serum concentration of sST2 in SSc patients. Based on these results, we can speculate on the role of this molecule as potential biomarkers of early cardiac injury during SSc, although further studies involving a larger cohort of patients are needed.References[1]Vacca et al. Rheumatol 2014[2]Tyndall et al. Ann Rheum Dis 2010[3]Muresan et al. Clin Rheumatol 2018[4]Vianello et al. Int J Biochem Cell Biol 2019[5]Dudek et al. Adv Clin Exp Med 2020[6]van den Hoogen et al. Arthritis Rheum 2013Figure 1:Graph 1. Serum sST2 (a) and IL-33 (b) concentrations in patients with EKG abnormalities (EKG+) vs control group (EKG)Disclosure of InterestsNone declared.
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Castellani C, Terribili R, DI Sanzo L, Molteni E, Sciarra G, Bevignani G, DI Franco M, Riccieri V, Alessandri C, Scrivo R, Conti F. POS1253 THE COURSE OF COVID-19 IN A COHORT OF SPONDYLOARTHRITIS PATIENTS: A CASE-CONTROL PROSPECTIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundWith the outbreak of the SARS-CoV-2 pandemic, the rheumatologists’ attention was directed at understanding whether infected patients could have a less favorable outcome. Available data seem to indicate that the course in rheumatic patients is not dissimilar from that in the general population. However, data on the outcome of COVID-19 in patients with spondyloarthritis (SpA) are scant.ObjectivesTo describe the outcome of COVID-19 in patients with SpA in terms of hospitalization, need of oxygen therapy, and symptoms compared to a control group. The variation in disease activity before and after COVID-19 was also assessed.MethodsWe enrolled adult patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) classified according to standard criteria, that received a diagnosis of COVID-19 through molecular or rapid antigen swab tests between September 2020 and January 2022. Demographic and clinical data, including age, body mass index (BMI), smoking habit, comorbidities, rheumatic treatment at diagnosis of COVID-19, date of COVID-19 diagnosis, symptoms and additional therapy during the infection and vaccination status were collected through a questionnaire and recorded on an electronic database. Disease activity, assessed by DAPSA in PsA patients and by BASDAI and ASDAS in AS patients, was evaluated before and at the first visit after the infection. As controls, individuals with COVID-19 but with no known diagnosis of rheumatic/autoimmune disease were recruited using the “best friend” system.ResultsSixty-two patients were enrolled [43 with PsA and 19 with AS; F:M=40:22; median age 51 years, 25th-75th percentile 39.5-61; median BMI 25.5, 25th-75th percentile 21.75-28; median disease duration 90 months, 25th-75th percentile 36-192; 6 (9.7%) smokers, 37 (59.7%) non-smokers, 19 (30.6%) past smokers; 15 (24.2%) only treated with one conventional DMARD, 27 (43.5%) with bDMARDs and 20 (32.3%) with both; 44 (71%) had received no vaccine, 18 (29%) one or more doses of vaccine]. Forty-eight controls were also recruited [F:M=29:19; median age 48 years, 25th-75th percentile 41.5-57; median BMI 23.86, 25th-75th percentile 20.69-28.03; 10 (20.83%) smokers, 28 (58.33%) non-smokers, 10 (20.83%) past smokers; 43 (89.6%) had received no vaccine, 5 (10.4%) one or more doses of vaccine]. Among patients, 10 (16.1%) were hospitalized, of whom 8 (80%) required noninvasive oxygen therapy. Among controls, 7 (14.5%) were hospitalized, of whom 5 (71.4%) required noninvasive oxygen therapy. No differences were observed compared to the control group in terms of hospitalization and need for oxygen support. Likewise, the two groups did not bear any statistically significant difference in terms of symptoms (fever, dysgeusia, dyspnoea) and cardiovascular and respiratory comorbidities. BMI and smoking habit did not influence the outcome of COVID-19 in SpA patients, while a BMI of 25 or above was associated with hospitalization in the control group (p=0.0004, RR 3.417). Baseline treatment with immunosuppressants did not influence the disease outcome. DAPSA, ASDAS, and BASDAI did not significantly change after the infection (Table 1). We did not record any COVID-19-related death in either group.Table 1.Disease activity before and after COVID-19Last visit before COVID-19First visit after COVID-19*PsA (n=43)AS (n=19)PsA (n=43)AS (n=19)Remission/low disease activity, n (%)19 (44.2%)17 (89.5%)23 (53.5%)14 (73.7%)Moderate/high disease activity, n (%)11 (25.6%)0 (0%)7 (16.3%)1 (5.3%)NA 13 (30.2%)NA 2 (10.5%)NA 13 (30.2%)NA 4 (21%)* Reassessment of patients was performed 2 months (median) after COVID-19, 25th-75th percentile 1-4 monthsPsA, psoriatic arthritis; AS, ankylosing spondylitis; NA, not availableConclusionOur data show that patients with SpA do not face a worse prognosis of COVID-19 than subjects without rheumatic/autoimmune diseases and that demographic and clinical features did not influence the course of the disease.Disclosure of InterestsNone declared
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Bettiol A, Urban ML, Bello F, Fiori D, Mattioli I, Lopalco G, Iannone F, Egan A, Moroni L, Dagna L, Caminati M, Negrini S, Cameli P, Folci M, Toniati P, Padoan R, Flossmann O, Solans-Laqué R, Losappio L, Schroeder J, André M, Moi L, Parronchi P, Conti F, Sciascia S, Jayne D, Vaglio A, Emmi G. POS0246 SEQUENTIAL RITUXIMAB AND MEPOLIZUMAB IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRituximab (RTX) is an effective remission-induction treatment in ANCA-associated vasculitides (AAVs). Some reports have suggested that it might be effective also in Eosinophilic Granulomatosis with Polyangiitis (EGPA), to induce and maintain remission of vasculitic manifestations [1,2]. However, its effects for preventing respiratory relapses seem to be poor. Mepolizumab (Mepo) (both 100 and 300mg/month) is effective in improving respiratory manifestations and lung function, while partially controlling also systemic activity [3,4]. Isolated case reports further indicate that the sequential therapy with RTX and Mepo might be effective [5-7].ObjectivesThe study aimed to investigate the efficacy and safety of a therapeutic regimen based on sequential RTX and Mepo for the control of EGPA.MethodsA multicenter, retrospective, cohort study was conducted on adult patients diagnosed with EGPA according to the ACR classification criteria [8] or MIRRA trial criteria [3]. Only patients who received induction therapy with RTX (any dosage), and subsequent treatment with Mepo (100-300 mg/4 weeks) within 12 months from last RTX administration were included. Patients receiving other induction therapies between RTX and Mepo were excluded. The effectiveness of sequential RTX and Mepo was assessed in terms of disease activity (by the Birmingham Vasculitis Activity Score, BVAS) and daily corticosteroid dosage. Safety data were also collected.ResultsThirty-four EGPA patients treated with sequential RTX and Mepo were included (59% females, median age of 51 years (IQR 40-58); 41% ANCA positive).In most cases (26/34; 76%), RTX was started at the dosage of 1g q2w, and all except two patients had active disease at time of RTX beginning [median BVAS of 9 (IQR 6-14)]. Specifically, most patients started RTX for the control of systemic manifestations (19/34; 56%), or of both systemic and respiratory symptoms (11/34; 32%). All except one patient were receiving oral corticosteroids, at a median dosage of 25 mg/day (10-38).Mepo was started after a median of 14 months (6-23) from RTX initiation and after a median of 5 months (IQR 3-11) from the last RTX administration. Mepo was used at the dosage of 100mg/4 weeks in 32/34 (94%), mostly for the control of respiratory manifestations (25/34, 74%). At the time of starting Mepo, the median BVAS was 4 (2-8), and median prednisolone dose 10 mg/day (7-15). After a median follow-up of 28 months (IQR 23-33) from starting Mepo, the median BVAS decreased to 1.5 (IQR 0-4) and the median corticosteroid dosage to 5 mg/day (2.5-5), with 7/34 (21%) patients being off steroids. At last follow-up, most patients were off-RTX (28/34), typically due to stable disease remission (20/34; 59%).Both RTX and Mepo were well-tolerated; 5 patients had adverse events on RTX (none serious), and 5 on Mepo (including one serious infection).ConclusionSequential use of RTX and Mepo seems to be effective for remission induction and maintenance in EGPA.References[1]Emmi, Ann Rheum Dis, 2018[2]Teixeira, RMD Open, 2019 3. Wechsler, NEJM, 2017[4]Bettiol, Arthritis Rheumatol, 2021[5]Shiroshita, Respir Med Case Rep, 2018[6]Higashitani, Mod Rheumatol Case Rep, 2021[7]Afiari, Cureus 2020[8]Masi, Arthritis Rheum, 1990Table 1.Effectiveness of sequential RTX and Mepo in the 34 patients included in the studyRTX beginningMepo beginningLast follow-upMedian time elapsed (IQR)-14 months (6-23) from RTX beginning28 months (23-33) from Mepo beginningDosage1g q2w (26/34);100mg/4 weeks (32/34)6 patients off Mepo; 28 patients off RTX375mg/m2 for 4 weeks (8/34)300mg/4 weeks (2/34)Reason for treatment beginning (manifestations)Systemic (19/34);Respiratory (25/34);-Systemic + respiratory (11/34);Systemic (4/34);Only respiratory (3/34);Remission maintenance (5/34)Other (1/34)BVAS (median, IQR)9 (6-14)4 (2-8)1.5 (0-4)Prednisolone dosage (median, IQR), mg/day25 (10-38)10 (7-15)5 (2.5-5)Disclosure of InterestsAlessandra Bettiol: None declared, Maria Letizia Urban: None declared, Federica Bello: None declared, Davide Fiori: None declared, Irene Mattioli: None declared, Giuseppe Lopalco: None declared, Florenzo Iannone: None declared, Allyson Egan: None declared, Luca Moroni: None declared, Lorenzo Dagna Consultant of: Consultation honoraria from GSK outside the current work, Marco Caminati: None declared, Simone Negrini: None declared, Paolo Cameli: None declared, Marco Folci: None declared, Paola Toniati: None declared, Roberto Padoan: None declared, Oliver Flossmann: None declared, Roser Solans-Laqué: None declared, Laura Losappio: None declared, Jan Schroeder Consultant of: Advisory Board fees from AstraZeneca and GSK, Marc André: None declared, Laura Moi: None declared, paola parronchi Consultant of: Consultation honoraria from GSK and Novartis, Fabrizio Conti: None declared, Savino Sciascia: None declared, David Jayne Consultant of: Consultant for Astra-Zeneca, Aurinia, BMS, Boehringer-Ingelheim, Chemocentryx, Chugai, CSL, GSK, Infla-RX, Janssen, Novartis, Roche/Genentech, Takeda and Vifor, Augusto Vaglio Consultant of: Consultation honoraria from GSK outside the current work, Giacomo Emmi Consultant of: Consultation honoraria from GSK outside the current work
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Gatto M, Depascale R, Tincani A, Emmi G, Scarpato S, Conti F, Govoni M, Mosca M, Gerosa M, Bozzolo E, Canti V, Gabrielli A, Gremese E, De Vita S, Ciccia F, Salvarani C, Rossini M, Faggioli P, Laria A, De Paulis A, Gerli R, Brunetta E, Mathieu A, Selmi C, De Angelis R, Negrini S, Zen M, Doria A, Iaccarino L. AB0441 PREDICTORS OF CLASI RESPONSE OVER TIME IN A MULTICENTRIC REAL LIFE COHORT OF SLE PATIENTS TREATED WITH BELIMUMAB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundOver 80% of patients affected with SLE experience skin involvement. The anti-BLyS drug belimumab was shown effective in ameliorating mucocutaneous SLE manifestations in clinical trials and real-life studies. Cutaneous response is quantified through the CLASI (cutaneous lupus erythematosus area and severity index). Clinically relevant improvements are defined as decreases of ≥50% (CLASI50) or 70% (CLASI70) from baseline values.ObjectivesTo assess rates and predictors of CLASI50 and CLASI70 in the Berliss multicentric SLE cohort1 of patients treated with belimumab.MethodsBaseline and ongoing features of patients with baseline active skin involvement (CLASI>0) were assessed in relationship to the chosen outcomes CLASI50 and CLASI70 at 24 and 52 weeks. A subanalysis on patients with CLASI≥5 was as well conducted. Logistic regression was employed to identify predictors of response.Results172 patients displayed skin involvement at baseline (CLASI>0). Of those, 124 displayed at least a 12-month-follow-up and were included in the analysis. Seventy-seven (62.1%) patients reached CLASI50 at 24 weeks and 91 (77.8%) at 52 weeks; 87 (70.2%) reached CLASI70 at 24 and 99 (79.8%) at 52 weeks. Baseline predictors of CLASI50 at 24 weeks were CLASI-damage (CLASI-d) (OR [95%CI], p; 0.79 [0.65-0.98] 0.03) and disease duration (0.93[0.86-0.99], 0.011). No baseline predictors of CLASI70 at 24 weeks emerged, however having achieved a CLASI50 response at 24 weeks portended CLASI50 and 70 response through week 52 (p<0.01, Table 1). In the subgroup of patients with CLASI≥5, longer disease and increased CLASI-d at baseline confirmed as negative predictors of CLASI50 at 24 weeks. In this subset, use of antimalarials and active smoking at baseline predicted CLASI70 at 24 weeks (Table 1).Table 1.Predictors of CLASI-A Response at Week 24 and 52 by Baseline CLASI-A at 50% and 70% Response ThresholdsTimepointOutcomeVariableOR[95%CI] pCLASI>024 weeksCLASI50CLASI-d0.79 [0.65-0.98] 0.030Disease duration0.93[0.86-0.99], 0.011CLASI70CLASI-d0.93 [0.74-1.16], 0.51Disease duration0.97 [0.97-1.02], 0.1852 weeksCLASI50CLASI50 at 24 weeks14.3[4.88-44.42], <0.001CLASI70CLASI50 at 24 weeks6.22 [2.00-19.34], 0.002CLASI≥524 weeksCLASI50CLASI-d0.72 [0.53-0.98], 0.037Disease duration0.93 [0.66-1.00], 0.071CLASI70Antimalarials6.61 [1.20-36.29] 0.032Smoking0.15 [0.03-0.83], 0.03452 weeksCLASI50CLASI50 at 24 weeks22.0 [2.47-196.05], 0.006CLASI70CLASI50 at 24 weeks1.24 [0.06-25.08], 0.88CLASI, cutaneous lupus erythematosus area and severity index; CLASI-d, CLASI damage; CLASI50 and CLASI70: decrease ≥50% or ≥70% in CLASI from baseline. OR and 95%CIs are estimated using a logistic regression model with stratification factors as covariates (SLEDAI-2K at baseline, baseline prednisone dosage).ConclusionEarlier use of belimumab favors achievement of skin response among SLE patients and attainment of a prompt response predicts further response. Use of antimalarials reinforces while smoking hampers a more profound CLASI improvement over time.References:[1]Gatto M, et al. Arthritis Rheumatol. 2020 Aug;72(8):1314-1324Disclosure of InterestsMariele Gatto Speakers bureau: GSK, Grant/research support from: GSK, Roberto Depascale: None declared, Angela Tincani: None declared, Giacomo Emmi: None declared, Salvatore Scarpato: None declared, Fabrizio Conti: None declared, Marcello Govoni: None declared, Marta Mosca: None declared, Maria Gerosa: None declared, Enrica Bozzolo: None declared, Valentina Canti: None declared, Armando Gabrielli: None declared, Elisa Gremese: None declared, Salvatore De Vita: None declared, francesco ciccia: None declared, Carlo Salvarani: None declared, Maurizio Rossini: None declared, Paola Faggioli: None declared, Antonella Laria: None declared, Amato De Paulis: None declared, Roberto Gerli: None declared, Enrico Brunetta: None declared, Alessandro Mathieu: None declared, Carlo Selmi: None declared, Rossella De Angelis: None declared, Simone Negrini: None declared, Margherita Zen: None declared, Andrea Doria Speakers bureau: GSK, Eli Lilly, Roche, Grant/research support from: GSK, Luca Iaccarino Speakers bureau: GSK, Grant/research support from: GSK
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Olivieri G, Ceccarelli F, Pirone C, Picciariello L, Natalucci F, Ciccacci C, Perricone C, Spinelli FR, Alessandri C, Borgiani P, Conti F. AB0455 DRUGS, AUTOANTIBODIES AND GENES CONTRIBUTE TO THE DEVELOPMENT OF CHRONIC DAMAGE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundGenetic contribution to development of chronic damage have been scarcely investigated in systemic lupus erythematosus (SLE). In fact, whereas most studies have looked for an association between genetic variants and SLE susceptibility or disease phenotypes, only few have focused on the relationship between these biomarkers and damage development.ObjectivesMoving from these premises, we firstly analyzed the distribution of organ damage in a cohort of SLE patients and secondly we evaluate the role of clinical and genetic factors in determining the development of chronic damage.MethodsCaucasian SLE patients, diagnosed according with 1997 ACR criteria, were enrolled, and clinical and laboratory data were collected. Based on literature data, we selected a panel of 17 SNPs of following genes STAT4, IL10, IRAK1, HCP5, MIR146a, ATG16L1, IRGM, ATG5, MIR124, MIR1279, TNFSF4, CD40. Genotyping was performed by allelic discrimination assays. A phenotype-genotype correlation analysis was performed by evaluating specific domains of SLICC Damage Index (SDI).ResultsAmong 175 Caucasian SLE patients, 105 (60%) exhibited damage (SDI ≥1) with a median value of 1.0 (IQR 3.0). The musculoskeletal (26.2%), neuropsychiatric (24.6%) and ocular domains (20.6%) were involved most frequently. The presence of damage was associated with higher age, longer disease duration, neuropsychiatric (NP) manifestations, anti-phospholipid syndrome and the positivity of anti-dsDNA antibodies. Concerning therapies cyclophosphamide, mycophenolate mofetil and glucocorticoids resulted associated with the development of damage. The genotype/phenotype correlation analysis showed an association between renal damage, identified in 6.9% of patients, and rs2205960 of TNFSF4 (p=0.001; OR 17.0). This SNP resulted significantly associated with end-stage renal disease (p= 0.018, OR 9.68) and estimated GFR<50% (p=0.025, OR 1.06, Figure 1). The rs1463335 of MIR1279 gene was associated with the development of NP damage (p=0.029; OR 2.783). The multivariate logistic regression analysis confirmed the associations between TNFSF4 rs2205960 SNP and renal damage (p=0.020, r=2.53) and between NP damage and rs1463335 of MIR1279 gene (p=0.013, r=1.26)].Figure 1.Association between renal damage and rs2205960 of TNFSF4 (p=0.001). In addition, this SNP resulted significantly associated with the development of two specific items of SDI renal domain: estimated glomerular filtration rate (GFR) <50% and end-stage renal disease (ESRD) (p=0.025, p=0.018 respectively).ConclusionWe showed the role of age, drugs, and autoantibody profile in determining chronic damage.Our data suggest a possible role of genetic background in determining the development of renal and neuropsychiatric damage, as demonstrated by the association with polymorphisms of TFNSF4 and MIR1279, respectively. These results agree with previous studies suggesting the involvement of TNFSF4 in Lupus nephritis and microRNA in neuroinflammation.Disclosure of InterestsNone declared
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Ucci FM, Barbati C, Colasanti T, Balbinot E, Speziali M, Celia AI, Ciancarella C, Tripdi G, Buonocore G, Ceccarelli F, Spinelli FR, Riitano G, Recalchi S, Longo A, Manganelli V, Sorice M, Conti F, Alessandri C. POS0428 PATHOGENETIC ROLE OF MICROPARTICLES IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMicroparticles (MPs) are fragments of surface membranes of activated eukaryotic cells. They are characterized by different dimensions (from 0.1 to 1μm) and expression of surface antigens, depending on their origin. MPs are important mediators of cell-to-cell communication as they can be internalized in a dose-dependent manner by macrophages, endothelial cells and other cell types, influencing both functional and phenotypic characteristics of the target cells. Even if MPs formation is enhanced by cell activation or apoptosis, constitutive exocytosis is a continuous ongoing process in vivo for many cells, and MPs originating from different cells can be always found in the plasma. In various autoimmune diseases, it has been found an increased number of MPs derived from activated platelets, leukocytes, vascular endothelium cells and other cell types. In Rheumatoid Arthritis (RA) an excessive production of MPs may predispose to autoimmune manifestations. Moreover, it has been speculated that MPs can stimulate the production, secretion, and transport of inflammatory factors in RA.ObjectivesWe investigated the presence on the surface of RA-MPs of antigens derived from post-translationally modified proteins (citrullinated peptides and carbamylated peptides). We assumed that these specific antigens carried on the surface of RA-MPs could participate in RA pathogenetic process.MethodsWe enrolled 20 RA patients naïve for biological therapy fulfilling the 2010 American College of Rheumatology RA criteria and 20 healthy controls (HC), matched for age and sex. For each patient, laboratory and clinical data were recorded and clinical indexes were measured (TJ, SJ, CDAI, VAS pain, CDAI, SDAI, DAS28). A fasting blood sample, obtained from RA patients and HC, was centrifugated in order to obtain platelet-poor plasma (PPP), rich in MPs. Thereafter, MPs in RA patients and HC were measured using nanoparticle tracking analysis. Later on, MPs were incubated with unconjugated anti-citrullinated/carbamylated proteins antibodies and processed by flow cytometry and western blot to evaluate the surface expression of citrullinated/carbamylated antigens.ResultsNanoparticle tracking analysis revealed a significant increase of number of MPs in RA compared to HC. Moreover, densitometric analysis showed a significative higher expression of citrullinated antigens on MPs’ surface in RA than controls (p < 0.0001), while no substantial difference was found in the expression of carbamylated antigens. The data obtained were confirmed with the western blot which identified the cytoskeletal protein vimentin, the cytoplasmatic glycolytic enzyme alpha-enolase1 and type II collagen as the main citrullinated and carbamylated proteins carried by MPs. Finally, a relevant correlation between the expression of citrullinated and carbamylated antigens and disease activity was found (Figure 1).Figure 1.The figure shows: (A) concentration of MPs in RA patients and HC (nanoparticle tracking analysis); (B) expression of citrullinated and carbamylated antigens on MPs’ surface in RA patients (flow cytometry analysis); (C) expression of citrullinated antigens in RA patients and HC and correlation between expression of citrullinated and carbamylated antigens on MPs’ surface in RA patients and DAS28, CDAI, SDAI; (D) cytoskeletal protein vimentin, cytoplasmatic glycolytic enzyme alpha-enolase1 and collagen type II (western blot).ConclusionThe results of this study confirm an important role of MPs in the pathogenesis of RA not only as markers of disease activity but also as possible inducers of autoimmunity.Disclosure of InterestsNone declared.
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Celia AI, Barbati C, Colasanti T, Speziali M, Pellegrino G, Natalucci F, Ucci FM, Balbinot E, Ciancarella C, Tripodi G, Buoncuore G, Ceccarelli F, Conti F, Alessandri C. POS0410 THE ROLE OF IL-6 IN ENDOTHELIAL DYSFUNCTION: RHEUMATOID ARTHRITIS AND COVID-19, TWO PATHOGENIC MODELS IN COMPARISON. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is the most common systemic autoimmune disease that primarily affects joints but is also often characterized by extra-articular involvement1. Cardiovascular diseases are the most important causes of sudden death in these patients, which present a risk of developing cardiovascular events increased by 48%2. The causes of increased cardiovascular risk are several and not completely understood, but recent evidence supports the key role of endothelial dysfunction in pathogenesis. In this complex scenario, it is known that IL-6 receptors are present at the endothelial level and can be activated leading to endothelial dysfunction. SARS-Cov-2 is a coronavirus responsible for the disease called ‘coronavirus disease 2019’ (CoViD-19) characterized by clinical manifestations ranging from a flu-like syndrome up to severe lung damage associated with systemic hyper cytokine syndrome that can lead to multiple organ failure and death. Therefore, both RA and Covid-19 are associated with an increased pro-thrombotic and cardiovascular risk and IL-6 might be crucial in the pathophysiological mechanisms of both diseases.ObjectivesThe main hypothesis of this study was to evaluate the possible role of IL-6 as a promoter of endothelial dysfunction in RA and CoViD-19.MethodsIn vitro experiments were conducted on the endothelial cell line EA. hy926. Cells were treated for 24 h with fetal bovine serum (FBS), a pool of RA patients’ sera or a pool of CoViD-19 patients’ sera. The expression levels of adhesion molecules (V-CAM1/CD-106, I-CAM/CD-54, p-selectine/CD-62, tissue factor/CD-142) and apoptosis were analyzed using cytofluorimetric technique. In addition, the autophagy level, using the autophagy markers p62 and LC3II, were evaluated through a western-blot analysis. The same experiments were conducted co-treating cells with the same pool of sera in addition to tocilizumab (TCZ), an anti-IL-6 drug, to verify the reversibility of the process and test the role of the aforementioned cytokine. Data are reported as interquartile median values. The Kruskal Wallis test was used for unpaired samples and the Mann-Whitney test for paired samples. P<0.05 values were considered statistically significant.ResultsEA. hy926 cells, when treated with both RA and CoViD-19 patients’ sera, showed increased levels of activation molecules and apoptosis compared to FBS treated cells. In addition, we observed increased levels of both p62 and LC3 proteins after both rheumatoid arthritis and CoViD-19 patients’ sera treatment. All these findings were reversible in the presence of TCZ. The results are presented in Figure 1.Figure 1.Figures show the adhesion molecules levels (A), apoptosis levels (B), p62 and LC3II levels (C), in all experimental conditions. FBS 10% (cells treated with FBS at 10% concentration), S AR (cells treated with a pool of RA patients’ sera); S Covid (cells treated with a pool of COVID-19 patients’ sera); FBS 10%+toci (cells co-treated with FBS at 10% concentration and TCZ); S AR+toci (cells co-treated with a pool of RA patients’ sera and TCZ); S Covid+toci (cells co-treated with a pool of CoViD-19 patients’ sera and TCZ).ConclusionOur data showed that treatment with RA and CoViD-19 patients’ sera increase the activation and death of endothelial cells in vitro. The increased level of cells death is possibly due to a block of autophagy. The reversibility of the process after blocking IL-6 with TCZ co-treatment confirms the hypothesis that IL-6 can play a key role in the pathogenesis of endothelial damage in patients with RA and CoViD-19.References[1]Bordy R et al. Microvascular endothelial dysfunction in rheumatoid arthritis. Nat Rev Rheumatol. 2018 Jul;14(7):404-420.[2]Avina-Zubieta et al. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann. Rheum. Dis. 2012; 71:1524–1529.Disclosure of InterestsNone declared.
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Ceccarelli F, Natalucci F, Olivieri G, Galasso G, Pirone C, Orefice V, Garufi C, Spinelli FR, Scrivo R, Alessandri C, Conti F. POS1058 BIOLOGICAL DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS IN PSORIATIC ARTHRITIS: PREDICTORS OF TREATMENT SURVIVAL IN A REAL-LIFE SETTING. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) is a chronic, immune-mediated, inflammatory arthropathy, distinctively involving joints and enthesis. The improved understanding of PsA pathogenesis has enabled the development of biological disease-modifying anti-rheumatic drugs (bDMARDS) targeting specific cytokines and signalling pathways. The availability of these drugs deeply modified PsA history, by preventing disease progression and by improving quality of life. Nevertheless, bDMARDS are not effective in all the patients who may experience primary or secondary inefficacy or adverse events development.ObjectivesIn a real-life scenario, we evaluated the bDMARDs retention rate in a large PsA cohort. In detail, we compared drug survival of the first and second biological drug and we investigated the presence of factors associated with the bDMARDs treatment withdrawal.MethodsWe longitudinally evaluated adult PsA patients (2016 CASPAR criteria) treated with at least one bDMARD during disease history. For each PsA patient, the clinical and laboratory data, including demographics, past medical history with the date of diagnosis and treatments, clinical disease phenotypes, were collected in a standardized, computerized and electronically filled form. The retention rate was estimated by using the Kaplan-Meier method. Predictors for bDMARDs withdrawal were investigated in univariate and multivariate Cox proportional hazards analysis, adjusted for relevant variables.ResultsThe present analysis included 223 PsA patients [M/F 91/132; median age 57 years (IQR 17); median disease duration 120 months (IQR 132)]. Adalimumab and Etanercept were the most frequently prescribed bDMARDs (41.5% and 41.0%, respectively). The retention rate of the first prescribed bDMARD as reported in Figure 1A: in detail, we found a 12-months retention rate of 79.8%. The comparison between etanercept and adalimumab showed a similar 12-months retention rate, but significantly higher for etanercept at 24 months (82.4% versus 69.5%, p=0.0034, Figure 1B). Out of 223 enrolled PsA patients, 109 (48.9%) received only one bDMARDs, while the remaining 114 (51.1%) received at least 2 drugs. When comparing these two groups of patients, drug survival at 24 months was significantly higher in patients treated with one bDMARD in comparison with those treated with at least two drugs (67.7% versus 52.2%, p=0.03, Figure 1C). Finally, female sex and anxiety-depressive disorders were significantly associated with the treatment with at least two dDMARDs (p=0.005 and p=0.01, respectively).ConclusionThe results of the present study demonstrated a higher retention rate in the first-line bDMARDs treatment in comparison with second-line. Female sex and anxiety-depressive disorders may negatively affect drug retention rate.Disclosure of InterestsNone declared
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Lini D, Nalli C, Andreoli L, Crisafulli F, Fredi M, Lazzaroni MG, Bitsadze V, Calligaro A, Canti V, Caporali R, Carubbi F, Chighizola C, Conigliaro P, Conti F, De Carolis C, Del Ross T, Favaro M, Gerosa M, Iuliano A, Khizroeva J, Makatsariya A, Meroni PL, Mosca M, Padovan M, Perricone R, Rovere-Querini P, Sebastiani GD, Tani C, Tonello M, Truglia S, Zucchi D, Franceschini F, Tincani A. POS0721 ASSOCIATION BETWEEN PRECONCEPTION COMPLEMENT LEVELS AND USE OF HYDROXYCHLOROQUINE WITH PREGNANCY OUTCOME IN PATIENTS WITH PRIMARY ANTIPHOSPHOLIPID SYNDROME AND CARRIERS OF ANTIPHOSPHOLIPID ANTIBODIES: AN INTERNATIONAL MULTICENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAntiphospholipid Syndrome (APS) is a rare autoimmune disease characterized by thrombotic events and/or pregnancy morbidities in the presence of confirmed positivity for antiphospholipid antibodies (aPL). Complement was demonstrated to be involved in aPL-related pregnancy loss in animal models and several groups investigated the significance of complement levels in human disease. C3 and C4 serum levels were assessed in several cohorts of pregnant patients with APS and/or aPL positivity in order to relate complement consumption with adverse pregnancy outcome (APO).According to some authors, hydroxychloroquine (HCQ) can control the activation of the complement system, improve pregnancy outcome and reduce aPL title.ObjectivesThis study was designed to verify the effect of HCQ in addition to low dose aspirin (LDA) + low molecular weight heparin (LMWH) treatment in a multicenter cohort of primary APS (PAPS) and aPL carriers pregnant women and the possible correlation with preconception serum C3/C4 levels.MethodsMedical records of pregnant women with confirmed positivity for aPL antibodies attending twelve referral centers from January 2010 to December 2020 were retrospectively evaluated. We considered as aPL-related APO: spontaneous abortions (<10 weeks of gestation), fetal loss (≥10 weeks of gestation), neonatal death (death of a formed fetus alive at birth in the first 28 days of life), preterm delivery before 37 weeks of gestation, preeclampsia, eclampsia or HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet).ResultsWe have analyzed 164 singleton PAPS/aPL carrier pregnancies (22 aPL carriers - 13%) in 128 patients: all were treated with combination therapy (LDA+LMWH), and in 30 HCQ was added. 58 pregnancies (43%) had low levels of preconception C3/C4. A triple aPL positivity was observed in 54 pregnancies, 14 of them were treated with combination therapy + HCQ. When considering the whole cohort, the addition of HCQ had not significantly improved the gestational outcome. Further stratification was performed on the basis of complement consumption. In the group of patients with preconception low C3/C4 levels the addition of HCQ had not significantly improved pregnancy outcome. We have lastly evaluated 40 pregnancies with a high-risk profile (triple aPL positivity and complement consumption), in which we have found that HCQ significantly improved gestational outcome (p=0.018, Table 1).Table 1.Relationship between APO, therapy during pregnancy and risk profile.All pregnancies (n=164)Reduced C3/C4 (n=58)Triple aPL+ and reduced C3/C4 (n=40)LDA+LMWH (n, %)LDA+LMWH+HCQ (n, %)pLDA+LMWH (n, %)LDA+LMWH+HCQpLDA+LMWHLDA+LMWH+HCQp(n, %)(n, %)(n, %)APO62 (46%)16 (53%)ns32 (68%)4 (36%)ns23 (77%)3 (30%)0.018No APO72 (54%)14 (47%)15 (32%)7 (64%)7 (23%)7 (70%)Total1343047113010This observation could not be confirmed in patients with single or double aPL positivity.ConclusionThe study shows that administering HCQ in addition to combination therapy can improve gestational outcome in aPL/PAPS high-risk patients. This observation confirms that HCQ exerts a beneficial effect on aPL pregnancies by complement inhibition as it was shown in animal models. In addition, our results provide the clinicians a useful tool to implement conventional treatment in patients at high risk of pregnancy complication or loss.References[1]De Carolis S, et al. Is there any role for the hydroxychloroquine (HCQ) in refractory obstetrical antiphospholipid syndrome (APS) treatment? Autoimmun Rev 2015;14:760-2.[2]Mekinian A, et al. The efficacy of hydroxychloroquine for obstetrical outcome in antiphospholipid syndrome: data from a European multicenter retrospective study. Autoimmun Rev 2015;40:498-502.[3]Mekinian A et al. Obstetrical APS: is there a place for hydroxychloroquine to improve the pregnancy outcome? Autoimmun Rev 2015;14:23-9.Disclosure of InterestsNone declared
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Molteni E, Pellegrino G, Castellani C, Reza Beigi DM, Conti F, Scrivo R, Riccieri V. AB1355 NAILFOLD CAPILLAROSCOPY CHANGES IN PATIENTS WITH PSORIATIC ARTHRITIS AND RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIn psoriatic arthritis (PsA) and rheumatoid arthritis (RA) systemic inflammation is known to cause endothelial dysfunction(1). Nailfold videocapillaroscopy (NVC) analyzes in vivo blood vessels, looking for alterations due to microvascular damage, and its application in these pathologies often highlights interesting abnormalities. PsA is characterized by lower mean capillary length and density and abnormal morphology, such as tight terminal convolutions. In RA typically elongated and dilated capillaries and prominent subpapillary plexus are described(2, 3). Differences between RA and PsA NCV patterns are known but not well defined yet(3).ObjectivesAim of our study was to evaluate the microvascular features circulation by NVC in patients affected by PsA and RA, looking for possible differences that may characterize the two diseases.MethodsWe recruited outpatients affected by PsA or RA classified according to standard criteria(4, 5) referring to the Rheumatology Unit at Sapienza University of Rome. Healthy controls (HCs) without known risk factors for nailfold capillary alterations(6) were also recruited. Patients and HCs underwent NVC with a 200x magnification lens. The following morphological parameters were considered: number of capillaries per square millimeter, alterations in length, dimension, morphology and distribution of the capillary; presence of ectatic loops, hemorrhages, flux abnormalities(7, 8). A semi-quantitative rating scale was adopted to score these changes, according to previous studies(9). The mean score for each subject was obtained by analyzing all fingers, except the thumbs.For the statistical analysis, Chi-square and Mann-Whitney tests were used. All tests were two-sided with a significance level set at p<0.05.ResultsWe recruited 34 patients (20 with PsA and 14 with RA) and 30 HCs. For patients, the mean age was 61,7 years (SD 15,4), median disease duration was 184 months (SD 204) and males were 18 (53%). Active or past smokers were 11 (18%), 9 (15%) suffered from arterial hypertension and 2 (0.03%) from type 2 diabetes mellitus. Raynaud’s phenomenon was present in 4 patients with PsA (20%) and 6 with RA (43%).The most frequent morphological changes were tortuous capillaries (90% in PsA and 100% in RA), single-crossing shape (90% and 86%) and bizarre capillaries (30% in both groups) while multiple crossing and ramified capillaries were present in 50% and 21 % RA patients only.With respect to HCs, we found significantly more frequent changes concerning morphology, ectatic loops, presence of hemorrhages and capillary plexus visibility in both PsA and RA patients. Moreover, patients with RA showed significantly more frequent abnormalities of the blood flow with respect to HCs. These results are shown in Table 1.Table 1.Comparison of the main NVC changes in patients and HCs.NVC ChangesHCPsARAN (%)N (%)P value vs HCsN (%)P value vs HCsMorphology3 (10%)14 (70%)p<0.000112 (86%)p<0.0001Ectatic loops0 (0%)11 (55%)p<0.00018 (57%)p<0.0001Hemorrhages2 (0.07%)1 (5%)p<0.016 (43%)p<0.0058Plexus19 (63%)10 (50%)p<0.027 (50%)p<0.02Flux abnormalities3 (10%)6 (30%)p>0.055 (36%)p<0.026The presence of hemorrhages was significantly higher in RA rather than in PsA patients (p<0.01). No significant differences were found in number, length, and distribution of capillaries between PsA/RA cases and HCs.ConclusionOur study confirms and completes the frame of NCV alterations in PsA and RA. We described for the first time alterations in the capillary morphology and the presence of hemorrhages in both groups of patients with respect to HCs. It remains to evaluate how these findings can reflect the microvascular environment of chronic arthritis.References[1]Fromm, S et al. Arthritis Res Ther 2019[2]Lambova SN, Müller-Ladner U. Microvasc Res 2012[3]Graceffa D, et al. Arthritis 2013[4]Taylor W, et al. Arthritis Rheum 2006[5]Aletaha D, et al. Ann Rheum Dis 2010[6]Ciaffi J, et al. Microvasc Res 2020[7]Maricq HR. Arthritis Rheum 1981[8]Smith V, et al. Autoimmun Rev. 2020[9]Cutolo M, et al. J Rheumatol 2000Disclosure of InterestsNone declared
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Colafrancesco S, Barbati C, Priori R, Giardina F, Gattamelata A, Izzo R, Cerbelli B, Giordano C, Scarpa S, Fusconi M, Spinelli FR, Cavalli G, Alessandri C, Conti F. OP0236 JAK-STAT INHIBITION RESTORES EPITHELIAL CELLS’ HOMEOSTASIS IN PRIMARY SJOGREN’S SYNDROME. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAlthough salivary gland epithelial cells (SGECs) are key players in the pathogenesis of autoimmune epithelitis that characterizes primary Sjӧgren’s Syndrome (pSS), the mechanisms sustaining SGECs activation in pSS remain largely undetermined. Therefore, therapeutic strategies to counteract SGECs activation in pSS are also lacking. In previous studies, we revealed that maladaptive autophagy sustains survival and pro-inflammatory activation of SGECs in pSS (1).ObjectivesTo determine the therapeutic potential of JAK/STAT inhibition with baricitinib to restore homeostatic regulation of SGECs in pSS, by reducing autophagy, survival, and expression of adhesion molecules.MethodsPrimary SGECs were isolated from minor salivary glands (SG) of large cohort of patients with pSS or sicca syndrome and subjected to mechanistic and functional studies including flow-cytometry, immunoblotting, and immunofluorescence to assess autophagy (autophagic-flux, LC3IIB, p62, LC3B+/LAMP1+ staining), apoptosis (annexin V/PI, Caspase-3) and activation (ICAM, VCAM). Focus score and germinal centers were determined in homologous SG biopsies to assess correlations of findings with histological disease severity. Primary SGECs of patients with pSS were treated with Baricitinib (1 mM) for 24 prior to assessment of autophagy, apoptosis and activation.ResultsSGECs from pSS patients (n=29) exhibited increased autophagy (as determined by autophagic-flux p=0.001; LC3IIB p=0.02; p62 p=0.064; LC3IIB/LAMP1+ staining), increased expression of anti-apoptotic molecules (Bcl2 p=0.006), and reduced apoptosis (Annexin-V/PI p=0.002, Caspase-3 p=0.057) compared to sicca (n=16). Induction of autophagy in pSS SGECs correlated with histologic disease severity. Treatment of pSS SGECs with baricitinib ex vivo suppressed autophagy, increased apoptosis, and reduced expression of adhesion molecules.ConclusionSGECs in the inflammatory milieu of pSS are characterized by induction of autophagy and pro-survival mechanisms, and by expression of adhesion molecules. These changes correlate with SG infiltration with immune cells and with histologic disease severity. Among clinically available therapies, the JAK/STAT inhibitor baricitinib effectively reduced autophagy, countered the state of maladaptive activation of SGECs, and restored epithelial cell homeostasis. Transcriptomics and metabolomics studies are ongoing to dissect the specific mechanisms responsible for these beneficial effects.References[1]Colafrancesco S, et al. Maladaptive autophagy in the pathogenesis of autoimmune epithelitis in Sjӧgren’s Syndrome. Arthritis Rheumatol 2021.Disclosure of InterestsSerena Colafrancesco Speakers bureau: NovartisSobi, Grant/research support from: Eli Lilly, cristiana barbati: None declared, Roberta Priori: None declared, Federico Giardina: None declared, angelica gattamelata: None declared, raffaella izzo: None declared, Bruna Cerbelli: None declared, Carla Giordano: None declared, Susanna Scarpa: None declared, Massimo Fusconi: None declared, Francesca Romana Spinelli Speakers bureau: Eli LillyPfizerAbbvie, Giulio Cavalli: None declared, cristiano alessandri: None declared, Fabrizio Conti: None declared
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Foddai SG, Sciascia S, Alessandri C, Alunno A, Andreoli L, Barinotti A, Calligaro A, Canti V, Carubbi F, Cecchi I, Chighizola C, Conti F, Emmi G, Fioravanti A, Fischetti F, Franceschini F, Gerosa M, Hoxha A, Larosa M, Lazzaroni MG, Nalli C, Pazzola G, Radin M, Raffeiner B, Ramoni V, Roccatello D, Rubini E, Sebastiani G, Truglia S, Urban ML, Tincani A. POS0741 REPORT FROM THE APS STUDY GROUP OF THE ITALIAN SOCIETY FOR RHEUMATOLOGY (SIR-APS) ON aPL NEGATIVIZATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe rate of antiphospholipid antibodies (aPL)negativization in antiphospholipid syndrome (APS) patients is uncertain, but it is estimated to be as high as 8%. aPL disappearance seems to be more frequent in patients positive for one single aPL test and appears to be related with the immunosuppressant/immunomodulatory treatment undertaken by the patient. Currently, a consensus definition of aPL negativization is lacking, as well as international recommendations on how to approach treatment in patients with a persistent aPL negative seroconversion.ObjectivesThe aim of our work was to evaluate the clinical approach and the level of consensus among experts from the APS Study Group of the Italian Society for Rheumatology (SIR-APS) in different clinical scenario addressing aPL negativization and its definition.MethodsExperts of SIR-APS were contacted using a survey methodology.ResultsA structured survey was circulated among 30 experts.Up to 90% of the interviewed experts agreed on defining aPL negativization as the presence of two negative determinations, one year apart (90%).Almost ful lconsensus exist among experts in some clinical settings, including: a) the role of aPL negativitation in the management of a thrombotic event determined by concomitant presence of cardiovascular risk factors, both modifiable and not modifiable (90%): b) approach to young patients with triple aPL positivity who experienced pulmonary arterial thrombotic event and tested negative for aPL detection after five year of vitamin K antagonist (VKA) treatment (90%); c)the use of “extra criteria” aPL antibodies testing before pondering VKA suspension (93%).ConclusionConsensus is needed to support the management of patients with APS in areas where controlled data are missing. A substantial agreement exists among expert in defying aPL negativization as the presence of two negative determinations, one year apart. On the contrary, VKA suspension should be embraced with extreme caution when it comes to APS patients, particularly if they experienced arterial thrombotic events and/or tested positive for triple aPL. Nevertheless, VKA cessation might be considered when risk factors are carefully monitored/treated and the presence for “extra criteria” aPL is ruled out.References[1]Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RHWM, DE, Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.[2]Coloma Bazán E, Donate López C, Moreno Lozano P, Cervera R, Espinosa G.Discontinuation of anticoagulation or antiaggregation treatment may be safe in patients with primary antiphospholipid syndrome when antiphospholipid antibodies became persistently negative. Immunol Res Immunol Res; 2013; 56: 358–61.[3]Radin M, Schreiber K, Sciascia S, Roccatello D, Cecchi I, Aguirre Zamorano MÁ, Cuadrado MJ. Prevalence of Antiphospholipid Antibodies Negativisation in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Multicentre Study. Thromb Haemost 2019; 119: 1920–6.AcknowledgementsItalian Society of RheumatologyDisclosure of InterestsNone declared
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Fornaro M, Franceschini F, Gremese E, Cauli A, Sebastiani M, Montecucco C, Conti F, Rossini M, Foti R, Cantatore FP, Fusaro E, Lomater C, Frediani B, Govoni M, Atzeni F, Ramonda R, D’angelo S, Ferraccioli G, Lapadula G, Caporali R, Iannone F. POS0634 SAFETY PROFILE OF b/tsDMARD IN RHEUMATOID ARTHRITIS PATIENTS WITH IMPAIRED GLOMERULAR FILTRATION RATE. AN ANALYSIS FROM THE GISEA REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIn real-life setting, a greater number of elderly rheumatoid arthritis (RA) patients with impaired glomerular filtration rate (GFR) needs treatment with biologic or target synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD) to achieve disease control and reduce NSAIDs intake. Long-term observational data from the real-life on the use of b/tsDMARD in these patients are scarce.ObjectivesThe aim of this study was to evaluate the retention rate of b/tsDMARD in RA patients with impaired GFR in real-life setting.MethodsData of RA patients treated with at least one b/tsDMARD were retrospectively analyzed form the national Italian GISEA registry from January 2016 to December 2021. Estimated-GFR (eGFR) was calculated with the Cockcroft-Gault equation at the time of any b/tsDMARD prescription. For the purpose of this study, patients were divided in two groups, patients with impaired GFR (eGFR ≤60) and patients with normal GFR (eGFR >60). The retention rate was calculated by the Kaplan-Meier method and compared between these two groups by a log-rank test.ResultsThe study population included 2443 treatment-line with b/tsDMARD from 1888 patients (female 80.4%, age 57±12 years, mean baseline CDAI 17±12, FR/ACPA+ 69.5%) who started a new b/tsDMARD. Disease characteristics are shown in Table 1. 288 treatments with b/tsDMARD were started in patients with impaired eGFR and 2155 in patients with normal eGFR. Compared to patients with eGFR >60, patients with eGFR ≤60 showed higher HAQ-DI (1.3±0.8 vs 1±0.8, p<0.001) at the start of b/tsDMARD treatment. Glucocorticoids were more prescribed in patients with impaired eGFR (80.2% vs 72.8%, p<0.01), while csDMARDs were more prescribed in association with b/tsDMARD in patients with normal eGFR (83.1% vs 76.4%, p<0.01). Of note, CTLA4-Ig treatment was more prescribed in patients with impaired eGFR (26% vs 17.1%, p<0.05), while no difference in b/tsDMARD prescription was observed for other mechanism of actions. Drug survival was similar between RA patients with impaired eGFR [58.2%, mean survival time 35 months (CI95% 31-39)]and RA patients with normal eGFR [55%, mean survival time 34.4 months (CI95% 33-36), log rank: 0.88] (Figure 1). Cox regression model adjusted for age, sex and b/tsDMARD showed no impact of eGFR on drug survival [HR: 0.9 (CI95%: 0.7-1.2).ConclusionOur data show that impaired eGFR seems to not influence the persistence of b/tsDMARD treatment in RA patients.Disclosure of InterestsNone declared
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Pacucci VA, Spinelli FR, Garufi C, Ceccarelli F, Colafrancesco S, Leopizzi M, Alessandri C, Conti F. AB0499 LYMPHOID ORGANIZATION IN LUPUS NEPHRITIS: EVALUATING POSSIBLEAUTO ANTIGENS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundLupus nephritis (LN) represent one of the most frequent organ manifestations and one the major cause of morbidity in Systemic Lupus Erythematosus (SLE) patients. Tubule-interstitial infiltrate (TII) represents an independent prognostic factors of renal outcome1.ObjectivesThe aim of the study was to evaluate the inflammatory infiltrates organization in kidney biopsies obtained from LN patients and to investigate possible autoantigens for in situ immune response.MethodsParaffin embedded kidney specimens collected since 2017 from SLE patients who underwent a renal biopsy for diagnostic purpose were re-evaluated2. Clinical, laboratory and histological data were collected in a standardized, computerized and electronically filled form, including demographics and past medical history. Disease activity was assessed by using SLEDAI-2K and remission in response to therapy was defined as a score 0 of renal item of the SLEDAI3. The cellular infiltrate were assessed by hematoxylin-eosin and by immunohistochemistry with a staining of sequential sections for monoclonal antibodies to CD3, CD20, CD21. Staining for detections of LL-37, vimentin and citrulline was made4. Serological levels of CXCL13 and anti-vimentin antibodies (AVAs) were evaluated in a subgroup of patients.ResultsEighteen paraffin embedded renal specimens with TII, from LN patients were re-evaluated (F:M = 17:1, median age at biopsy-SD years 37-23; median disease duration at date of biopsy-IQR 3-4 years). A histo-morphologic grading score was performed based on the total count of TI lymphocytes and the presence of ectopic lymphoid structures-ELSs (grade 3-G3) (Figure 1). A correlation was found between G3 structures and the absence of renal remission with conventional immunosuppressive therapy (P=0.0026). Samples with G3 foci showed significantly higher intensity of LL37 (P=0.013) and LL37 co-localization (P=0.006) compared to the other lymphocytic infiltrates. No correlation was found among the intensity of vimentin and citrulline and the grade of lymphoid aggregates. A statistically significant inverse correlation between AVAs serum levels and response to therapy was found (P=0.0048). Moreover, higher level of AVAs and CXCL13 were found in patients with G3 structures. To note, two patients underwent anti-CD20 therapy but renal remission was achieved only in the patients displaying G3 structure.Figure 1.ConclusionThe study demonstrated that tubule-interstitium involvement is associated with the presence of lymphoid aggregation and poor renal outcome. For the first time we demonstrated that patients with G3 structures had a significant decreased response to immunosuppressant conventional therapies compared to those without ELSs. These results suggest a possible phatogenetic, prognostic and therapeutical role of lymphocytic aggregates. In addiction, LL37, thus NETosis, could have a possible role in inducing the formation of lymphocytic structures. Moreover, patients with a G3 foci showed high serological levels of AVAs and CXCL13, thus, promoting their possible role as circulating biomarkers of the presence of ELSs.References[1]Bajema, I. M. et al. Revision of the International Society of Nephrology/Renal Pathology Society classification for lupus nephritis: clarification of definitions, and modified National Institutes of Health activity and chronicity indices. Kidney Int. 93,789–796 (2018).[2]Weening JJ et al. International Society of Nephrology Working Group on the Classification of Lupus Nephritis; Renal Pathology Society Working Group on the Classification of Lupus Nephritis. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int. 2004 Feb;65(2):521-30.[3]Gladman DD et al. Systemic lupus erythematosus disease activity index 2000. J Rheumatol 2002; 29:288-91.[4]Bombardieri M et al. Ectopic lymphoid neogenesis in rheumatic autoimmune diseases. Nat Rev Rheumatol. 2017 Mar;13(3):141-154.Disclosure of InterestsNone declared
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Picciariello L, Ceccarelli F, Natalucci F, Olivieri G, Pirone C, Orefice V, Garufi C, Spinelli FR, Priori R, Alessandri C, Conti F. AB0436 EFFECTIVENESS OF BELIMUMAB IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS: A REAL-LIFE ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundEfficacy and safety of belimumab (BLM) in Systemic Lupus Erythematosus (SLE) patients with active disease have been demonstrated by RCTs [1,2] and confirmed by several observational studies [3-8]. Most of these data have been obtained by the use of BLM intravenous formulation (IV); on the contrary, very few findings are available on the use of the drug subcutaneous formulation (SC).ObjectivesEfficacy and drug survival of BLM have been assessed in a monocentric cohort of SLE patients, exploring any difference between the two routes of administration, IV or SC.MethodsA longitudinal study on SLE patients (according to ACR 1997 classification criteria [9]) candidates for treatment with BLM has been performed. Demographic, clinical-laboratory and therapeutic data - including glucocorticoid dosage in prednisone-equivalent - have been collected. Disease activity has been assessed by SLEDAI-2k [10]; in patients with inflammatory articular involvement, DAS28-PCR [11] has been used. In compliance with the study protocol, patients were assessed at baseline and at 3 and 12 months after starting treatment.ResultsA total of 85 patients treated with BLM were enrolled, most of whom were female (male/female 2/83), with a median age of 48 years (IQR 13) and a median disease duration of 127 months (IQR 151). Fifty-one patients (60%) were treated with IV formulation and the remaining 34 (40%) with SC route. BLM was prescribed due to the following clinical manifestations: joint involvement (61.2%), cutaneous manifestations (20.0%), renal involvement (for residual proteinuria, 5.9%), haematological modifications (5.9%), constitutional involvement (3.5%), pericarditis (1.2%), headache (1.2%). In both the formulations, joint involvement was the most frequent indication of BLM (IV: 64.7%, SC: 58.8%). Median treatment duration was 15 months (IQR 24). Moving on drug efficacy, after 3 and 12 months of follow-up BLM has determined a significant reduction of SLEDAI-2k median values (p=0.001, p<0.001 respectively, Figure 1A) as well as of daily prednisone dose (p=0.009, p<0.0001 respectively, Figure 1B). In patients treated because of musculoskeletal manifestations, DAS28-PCR reduced significantly at 3 and 12 months after treatment (p<0.0001). Drug survival at 12 months was 70% in the total cohort (Figure 1C) and was higher in patients treated with SC formulation than with IV route (75.8% versus 66.5%, p=ns). During the period of follow-up, 39 patients (45.9%) discontinued BLM: 38.4% of patients due to adverse events, 41% for primary or secondary inefficacy, 15% lost to follow-up, 5.1% for pregnancy. BLM withdrawal for adverse events was more frequent in the group of patients treated with IV formulation than SC one (25.9% versus 5.9%, p=0,0001). 11 patients switched from IV formulation to SC one after a median period of 40 months (IQR 20) without loss of efficacy or adverse events.ConclusionOur results confirm BLM efficacy also in a real-life setting. Notably, our data highlight a better drug survival in patients treated with SC formulation, mainly secondary to a less frequency of adverse events.References[1]Furie R et al. Arthritis Rheum. 2011;63(12):3918-3930.[2]Navarra SV et al. Lancet. 2011;377(9767):721-731.[3]Andreoli L et al. Isr Med Assoc J. 2014;16(10):651-653.[4]Hui-Yuen JS et al. J Rheumatol. 2015;42(12):2288-2295.[5]Collins CE et al. Lupus Sci Med. 2016;3(1):e000118.[6]Touma Z et al. Rheumatol Int. 2017;37(6):865-873.[7]Iaccarino L et al. Arthritis Care Res (Hoboken). 2017;69(1):115-123.[8]Gatto M et al. Arthritis Rheumatol. 2020;72(8):1314-1324.[9]Hochberg M.C. Arthritis Rheum. 1997;40:1725.[10]Gladman DD et al. J Rheumatol. 2002;29(2):288-291.[11]Prevoo ML et al. Arthritis Rheum. 1995;38(1):44-48.Disclosure of InterestsNone declared
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Reza Beigi DM, Pellegrino G, Loconte M, Paone G, DI Ciommo FR, Cadar M, Bisconti I, Stefanantoni K, Conti F, Riccieri V. POS0879 LUNG ULTRASOUND FOR INTERSTITIAL LUNG DISEASE DETECTION IN A COHORT OF SYSTEMIC SCLEROSIS PATIENTS: ROLE OF B-LINE AND PLEURAL LINE MODIFICATIONS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundLung ultrasound (LUS) is a technique that showed a high diagnostic accuracy for interstitial lung disease (ILD) detection in systemic sclerosis (SSc) patients and currently in progress of standardization. Traditionally, B-lines represented the finding of ILD, with the ≥10 total cut-off reported by Tardella et al. resulting to be closely related to moderate ILD detected on high resolution chest computed tomography (HRCT). Recently, Fairchild et al. proposed novel LUS criteria for the evaluation of pleural line, disclosing high accuracy and reproducibility.ObjectivesTo compare B lines cut-off with novel pleural line criteria and the respectively associated variables.MethodsWe enrolled 55 consecutive patients affected by SSc according to ACR/EULAR 2013 criteria who underwent respiratory functional tests (RFTs) during 2021, excluding smokers and those with arterial pulmonary hypertension. Twenty-four of them carried out a HRCT during a ± 6-months’ time. In the same day of RFTs, two certified blinded operators performed LUS for each patient applying the 14-areas technique proposed by Gutierrez et al., looking for the presence of total ≥10 cumulative B lines and the fulfilling of Fairchild’s criteria for pleural line. A 3-13 MHz operating linear probe was used. Clinical-demographic data and ongoing therapies were collected.ResultsAmong 55 total SSc patients, the agreement between the two operators for Fairchild’s criteria was almost perfect (Cohen’s kappa (k) =0.81) and substantial for ≥10 cumulative B-lines count (k=0.74). Fairchild’s criteria showed a higher diagnostic accuracy compared with ILD detected on HRCT, with an overall specificity (SP) and a positive predicted value (PPV) of 100% (Table 1). A negative correlation emerged between total lung capacity values (TLC%) and both B lines cut-off [first operator (IO): p 0.04, r -0.27; second operator (IIO): p 0.042, r-0.28] and pleural line criteria (IO: p 0.009, r -0.35; IIO: p 0.08, r – 0.36), but only the latter negatively correlated also with forced vital capacity values (FVC%) (IO: p 0.04, r – 0.27; IIO p 0.03, r -0.28). The ≥10 total B lines amount correlated positively with concurrent mycophenolate therapy (IO: p 0.09, r 0.28; IIO: p 0.005, r 0.37) and negatively with anti-centromere antibodies (IO: p 0.002, r -0.3; IIO p 0.009, r -0.34). The presence of digital ulcers showed a positive correlation with pleural line criteria (IO: p 0.03, r 0.29; IIO: p 0.005, r 0.37), with a significant association on multivariate analysis (IO: p 0.03, IIO: p 0.01).Table 1.Overall sensitivity, specificity, positive predictive value, negative predictive value of LUS compared to ILD detected on HRCT. C.I. 95% confidence interval.SE (C.I.)SP (C.I.)PPV (C.I.)NPV (C.I.)Fairchild’s criteria fulfilling0.91 (0.76 - 0,97)1 (0.78 – 1.000)1 (0.88 -1.00)0.82 (0,59 – 0.94)≥10 cumulative B-lines count0.73 (0.56 – 0.85)0.8 (0.55 – 0.93)0.89 (0.72 – 0.96)0.57 (0.36 – 0.75)ConclusionWe confirmed the feasibility and reliability of Fairchild’s recently proposed pleural line LUS criteria, that showed a higher diagnostic accuracy versus ≥10 cumulative B-lines count for ILD detected on HRCT, presenting SP and PPV values of 100% in SSc. Furthermore, these LUS features seem to differently associate with other aspects of the disease such as autoantibody specificity and vascular lesions, thus deserving future deeper evaluations. For the first time, we found that Fairchild’s criteria were associated with a clinical variable such as digital ulcers. Our results highlight the relevance of pleural line evaluation for ILD detection in SSc on LUS and its possible role towards a standardization of this diagnostic technique.References[1]Gutierrez M et al., Radiol Med, 2019.[2]Xie, H.Q et al. Arthritis Res Ther, 2019.[3]Tardella M et al., Medicine (Baltimore), 2018.[4]Fairchild R et al. Arthritis Care Res, 2021.Disclosure of InterestsNone declared
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Gioia C, Picchianti-Diamanti A, Perricone R, Chimenti MS, Afeltra A, Navarini L, Migliore A, Massafra U, Bruzzese V, Scolieri P, Meschini C, Scapato P, Paroli M, Scrivo R, Conti F, Laganà B, Di Franco M. AB0380 ANTI-TNFα: ORIGINATORS vs BIOSIMILARS, COMPARISON IN CLINICAL RESPONSE ASSESSMENT IN A MULTICENTER COHORT OF PATIENTS WITH INFLAMMATORY ARTHROPATHIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTumor necrosis factor (TNF)-α is one of principal proinflammatory cytokines involved in pathogenesis of different inflammatory arthropathies as Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS). Biotechnological drugs, represented among others by monoclonal antibodies directed against TNF-α, lead to a revolution in RA and spondylarthritis treatment. They were the first biological drugs used to treat these diseases, with good results in terms of safety and efficacy. Also because of high cost of these drugs, for some years biosimilars have been introduced in clinical practice. Biosimilars are less expensive (in Italy, less of 30% than bioriginators); they underwent to a severe process of “comparability” to assess safety and efficacy like their originators. In Italy, AIFA authorized SB4 (etanercept biosimilar), SB5 and ABP501 (adalimumab biosimilars) after passing III-phase randomized clinical trials; but real-life data and registers are lacking.ObjectivesAim of this study is to compare biosimilars and bioriginators in terms of safety and efficacy in a real-life contest.MethodsWe consequently enrolled patients, affected by inflammatory arthropathies (RA, PsA, AS) and treated with biosimilars (SB4, ABP501), belonging to any of the main biological prescribing centers in the Lazio region, from 2017 to 2020. Moreover, we enrolled patients, affected by same inflammatory diseases, but treated with corresponding originator. Clinical and laboratory data as well as disease activity indices, were collected at recruitment (T0) and after 4 (T1), 8 (T2), 12 (T3) and 24 (T4) months of therapy. Adverse events were registered.ResultsThe multicenter cohort was composed by 455 patients treated with biosimilars (SB4/ABP501 276/179; F/M 307/146; naïve 56%, median age/IQR 55/46-65) and 436 treated with originators (etanercept/adalimumab 186/259, F/M 279/157, naïve 67,2%, median age/IQR 53/43-62). No differences were found about safety, but biosimilar group presented a higher number of discontinuations due to inefficacy (p<0.001), observed at all time-points. Female gender, to be smoker and b-DMARDs naïve, the initial non-response to the drug were predictive factors of reduced drug survival (p=0,05, p=0,046, p=0,001 respectively). Retention rate at 24 months was 81.1% for bioriginators and 76.5% for biosimilars (with a median retention time of 20.7 and 18.9 months, respectively) (p=0.002). Patients with remission/low disease activity achievement at T1 showed a cumulative survival of 90% to biosimilar therapy until at T4 (p=0.001); early adverse reactions instead represented an important cause of subsequent drug discontinuation (p=0.001).ConclusionReal-life data demonstrated the same safety between biosimilars and originators but a reduced biosimilar retention rate at 24 months, about 76%. Despite their loss efficacy, biosimilars could be considered valid and safe, and a good and less expensive alternative to the originators, allowing access to these innovative treatments to a wider patient population.References[1]Feldmann, M. & Maini, R. N. Anti-TNFα therapy of rheumatoid arthritis: what have we learned? Annu. Rev. Immunol. 2001;19, 163–196.[2]McInnes IB, Schett G (2007) Cytokines in the pathogenesis of rheumatoid arthritis. Nat Rev Immunol 7:429–442[3]Velayudhan J, Chen YF, Rohrbach A, Pastula C, Maher G, Thomas H, et al. Demonstration of functional similarity of proposed biosimilar ABP 501 to adalimumab. BioDrugs. 2016;30(4):339– 51.[4]Emery P, Vencovsky ́ J, Sylwestrzak A et al. Long-term safety and efficacy of SB4 (etanercept biosimilar) in patients with rheumatoid arthritis: comparison between continuing SB4 and switching from etanercept reference product to SB4. Ann Rheum Dis 2016; 75:236.Figure 1.Disclosure of InterestsNone declared
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Garufi C, Tucci G, Pacella I, Zagaglioni M, Pinzon Grimaldos A, Ceccarelli F, Piconese S, Spinelli FR, Conti F. AB0087 THE EFFECT OF BARICITINIB ON STAT1 PHOSPHORYLATION IN MONOCYTES FROM RHEUMATOID ARTHRITIS PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundBaricitinib is a Janus kinase (JAK)1/JAK2 inhibitor approved for the treatment of rheumatoid arthritis (RA)1-2. STAT proteins bind JAK kinase dimers coupled with cytokine receptors and regulate gene transcription. The JAK/STAT system is responsible for the intracellular signaling of different cytokines contributing to the activation process of the monocyte lineage, therefore the use of JAK inhibitors can affect cell functionality3-6.ObjectivesThe aim of the present study was to verify the effects of baricitinib on STAT phosphorylation in peripheral mononuclear cells (PBMCs) of RA patients and to evaluate any correlation between STAT phosphorylation and response to therapy.MethodsAt baseline (BL) and after 4 weeks (w4) of treatment, we evaluated patients’ disease activity (DAS28PCR, CDAI and SDAI), dividing them into responders and non-responders according to the Minimal Clinically Important Difference for DAS28PCR (1.2 points) at w4. The phosphorylation of STAT1, STAT4 and STAT5 was analyzed at BL and w4 in gated monocytes, Treg, CD8 + and CD4 + lymphocytes from 4 responder and 4 non-responder patients through flow cytometry, at basal conditions and after IL2, IFNα and IL6 stimulation.ResultsBaseline clinical and demographic characteristics of patients are reported in Table 1. We showed that monocyte count decreased from BL to w4 mostly in responders. Basal pSTAT1 phosphorylation tent to be higher in monocytes of non-responder patients; after 4 weeks of treatment, the reduction of the cytokine-induced pSTAT1 was significantly greater in monocytes from responders compared to non-responders (Figure 1). The phosphorylation of STAT4 and STAT5 was not affected by treatment in any cell type and at any time point. We further studied the STAT1 phosphorylation pathway isolating the effect of stimulation with IFNα and stratifying monocytes according to their surface marker expression of CD14 and CD16 in classical, intermediate and non-classical. We observed the same pattern with a significant greater reduction of pSTAT1 in monocytes from responder patients, compared to non-responders, after the treatment with baricitinib.Table 1.Clinical and demographic characteristics of Rheumatoid Arthritis patients.Clinical and demographic characteristicsN=8Age (years), median (IQR)59 (8)Female:Male7:1Etnicity-Caucasian n (%)6 (75)-Hispanic n (%)2 (25)Disease duration (months), median (IQR)156 (201)Rheumatoid Factor, n (%)3 (37.5)ACPA, n (%)4 (50)Number of previous csDMARDs, n (%)-12 (25)-21 (12.5)-31 (12.5)-≥ 44 (50)Number of previous bDMARDs, n (%)-12 (25)-22 (25)-31 (12.5)-≥ 43 (37.5)Baricitinib in monoterapy, n (%)5 (62.5)Daily PDN dose, median (IQR)5 (6)ACPA: anti-citrullinated protein antibodies; csDMARDs: conventional syntetic disease-modifying antirheumatic drugs; bDMARDs: biological disease-modifying antirheumatic drugs; PDN: prednisone.Figure 1.STAT1 phosphorylation in responder (R) and non-responder (NR) patients at basal conditions (before stimulation) (a), and after cytokine (IL2, IFNα and IL6) stimulation (b) at baseline and at T1 (week 4).ConclusionThese results may suggest that monocyte count and STAT1 phosphorylation in circulating monocytes could represent early markers of response to baricitinib therapy.References[1]Gadina M, et al. Janus kinases to jakinibs: from basic insights to clinical practice. Rheumatology (Oxford). 2019[2]Gadina M, et al. Translating JAKs to Jakinibs. J Immunol. 2020[3]Kubo S, et al. The JAK inhibitor, tofacitinib, reduces the T cell stimulatory capacity of human monocyte-derived dendritic cells. Ann Rheum Dis. 2014[4]Kubo S, et al. Janus Kinase Inhibitor Baricitinib Modulates Human Innate and Adaptive Immune System. Front Immunol. 2018[5]Ikari Y, et al. Peficitinib Inhibits the Chemotactic Activity of Monocytes via Proinflammatory Cytokine Production in Rheumatoid Arthritis Fibroblast-Like Synoviocytes. Cells. 2019[6]Yang X, et al. Tofacitinib inhibits ox-LDL-induced adhesion of THP-1 monocytes to endothelial cells. Artif Cells Nanomed Biotechnol. 2019Disclosure of InterestsCristina Garufi Consultant of: Lilly, Gloria Tucci: None declared, Ilenia Pacella: None declared, Marta Zagaglioni: None declared, Alessandra Pinzon Grimaldos: None declared, Fulvia Ceccarelli: None declared, Silvia Piconese: None declared, Francesca Romana Spinelli Consultant of: Lilly, Fabrizio Conti Consultant of: Lilly
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Rapino L, Truglia S, Mancuso S, De Michele M, Toni D, Berto I, Sorice M, Misasi R, Capozzi A, Alessandri C, Conti F. POS0120 NEUROLOGICAL INVOLVEMENT IN A MONOCENTRIC COHORT OF PATIENTS WITH SERONEGATIVE ANTIPHOSPHOLIPID SYNDROME. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe nervous system is affected in a relevant number of patients with antiphospholipid syndrome (APS), being responsible for high morbidity and mortality rates. The identification of neurological manifestations is crucial since those symptoms may benefit from anticoagulation treatment. Noteworthy, the prevalence and the characteristics of neurological manifestations in the subset of patients with “seronegative APS” (SN-APS) still need to be investigated.ObjectivesThe aim of this study was to assess the neurological involvement in patients with SN-APS. Secondly, association between non-conventional antiphospholipid antibodies (aPL) and clinical characteristics were investigated.MethodsWe included all consecutive patients referred to the Lupus Clinic and to the Stroke Unit of our Hospital, presenting clinical features consistent with a diagnosis of APS despite the evidence of persistently negative tests for anti-cardiolipin antibodies (aCL), anti-β2 glycoprotein I, and lupus anticoagulant. Patients with an identified cause of thrombosis and/or pregnancy morbidity were excluded. Patients’ sera were analyzed for the detection of aCL using thin layer chromatography (TLC), while ELISA test was used to detect antibodies directed against the anti-vimentin/cardiolipin complex (aVim/CL).ResultsFrom January 2015 to October 2019, 40 patients with SN-APS and neurological involvement were enrolled. Clinical and demographic characteristics are reported in Table 1. Thirty-three patients (82.5%) resulted positive for at least one non-conventional test (62.5% positive on two occasions) while 17.5% were negative. The occurrence of aCL by TLC immunostaining was 33/40 (82.5%), while a Vim/CL were found in 10/40 (25%). Double positivity for aCL by TLC-immunostaining and aVim/CL was observed in 8/40 patients (20%). Patients who tested positive for non-conventional aPL on two occasions had a five-fold increased risk of developing venous thrombosis (LR 5.24; p=0.022). The positivity for aCL by TLC immunostaining determined an augmented risk of sinus vein thrombosis (LR 5.49; p=0.019) while positivity for aVim/CL raised the likelihood of epilepsy (LR 4.133; p=0.042). Almost all (16/18, 88%) patients with ischemic stroke resulted positive at least one test, 15 tested positive for aCL by TLC-immunostaining and 3 for aVim/CL. In this subset of patients, the positivity for non-conventional aPL on two occasions determined an increased risk of venous thrombosis (LR 8.905; p=0.003) and recurrent stroke (LR 6.321; p=0.012). In particular, those who tested positive for aVim/CL were at higher risk of developing recurrent stroke (LR 6.659; p=0.01).Table 1.CharacteristicsPatients N= 40 (%)Female/Male35/5Mean age in years (S.D.)48 (12.5)Thrombosis34 (85) Arterial23 (57.5) Venous17 (42.5) Recurrent13 (32.5)Pregnancy morbidity12 (34.3) Recurrent miscarriage11 (31.4) Foetal deaths2 (5.7) Premature births2 (5.7)Thrombosis + Pregnancy morbidity6 (17.1)Neurological manifestations Stroke18 (45) Recurrent stroke7 (17.5) Transient ischemic attack4 (10) Venous sinus thrombosis5 (12.5) Headache18 (45) Epilepsy7 (17.5) Transverse myelitis2 (5)Other manifestations Livedo reticularis5 (12.5) Low platelets3 (7.5)ConclusionThe nervous system is one of the most frequently affected in APS, however only few data exist about prevalence, characteristics and outcome of its involvement in SN-APS patients. In this work, using TLC immunostaining and ELISA for aVim/CL, we identified non-conventional aPL antibodies in 62,5% SN-APS patients. This subset of patients presented a wide spectrum of neurological manifestations, with frequencies and features that resemble those observed in APS patients. Furthermore, we demonstrated the association between non-conventional aPL and neurological manifestations, such as sinus vein thrombosis, recurrent stroke and epilepsy. In conclusion, testing for non-conventional aPL antibodies may contribute to the evaluation of the stratification of risk for neurological manifestations in SN-APS.Disclosure of InterestsNone declared
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Orefice V, Ceccarelli F, Barbati C, Putro E, Pirone C, Spinelli FR, Alessandri C, Conti F. AB0507 IMPACT OF CAFFEINE CONSUMPTION ON ENDOTHELIAL PROGENITOR CELLS SURVIVAL IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundCirculating endothelial progenitor cells (EPCs) are widely demonstrated biomarkers of endothelial function. Their frequency and function varied in systemic lupus erythematosus (SLE) patients, with a significant association with subclinical atherosclerosis1. Caffeine, one of the most widely consumed products in the world, seems to interact with multiple components of the immune system by acting as a non-specific phosphodiesterase inhibitor, and it seems to be able to activate autophagy2-3. In terms of cardiovascular disease (CVD), data from the literature showed a U-shaped association between habitual coffee intake and CVD4. In this view, Spyridopoulos et al. demonstrated a significant improvement in endothelial cells and EPCs migration after coffee consumption in coronary artery disease both in mouse models and in patients5. Finally, we demonstrated the impact of caffeine on SLE disease activity, in terms of SLEDAI2k values and serum cytokine levels. Moreover, patients with a low caffeine intake seemed to have a more severe disease phenotype6.ObjectivesThe aim of this study was to evaluate the role of caffeine intake on endothelial function in SLE patients, by assessing its effect on number and function of EPCs both ex vivo in SLE patients and in vitro in healthy donors (HD) treated with SLE sera.MethodsWe performed a cross-sectional study enrolling consecutive SLE patients (revised 1997 ACR criteria), referring to the Sapienza Lupus Clinic. Patients with history of traditional CV risks factors were excluded. Caffeine intake was evaluated using a 7-day food frequency questionnaire. At the end of questionnaire filling circulating EPCs were detected by using a flow cytometry analysis defined as CD34+KDR+ cells. Subsequently, EPCs pooled from 6 HD were co-cultured with caffeine at 0.5 mM and 1 mM with and without SLE sera. After 7 days, we evaluated the cells morphology and the ability to form colonies. Moreover, we analyzed for the percentage of annexin V-positive (AV) apoptotic cells by flow cytometry analysis and for levels of autophagy and apoptotic markers LC3-II, p62 and Bcl2 by western blot.ResultsWe enrolled 31 SLE patients (F:M 30:1, median age 43 years, IQR 18; median disease duration 144 months, IQR 180). The median intake of caffeine was 166 mg/day (IQR 194). We found a EPCs median percentage of 0.03% (IQR 0.04) observing a positive correlation between caffeine intake and EPCs percentage (p=0.03, r=0.4). Moving on in vitro experiments, after 7 days of cell cultures, HD EPCs treated with SLE sera and caffeine showed an improvement in morphology and in number of EPCs-CFU in comparison with those incubated with SLE sera without caffeine (p=0.0003). Moreover, the colonies treated with SLE sera were poorly organized in comparison with HD; the addition of caffeine restored the colony structure. After treated HD-EPCs with SLE sera we observed an increase in AV positive cells and p62 and LC3-II values and a reduction of Bcl2 values; the addition of caffeine was able to significantly reduce AV positive cells and p62 and LC3-II values and to significantly increased Bcl2 values, without any significant differences between caffeine 0.5 mM and 1 mM treatment (Figure 1A-D).ConclusionOur data demonstrated the ability of caffeine in increasing the number of circulating EPCs in SLE patients. Moreover, in vitro experiments seem to suggest a protective role of caffeine on EPCs survival and vitality through the promotion of autophagy and the inhibition of apoptosis.References[1]Westerweel et al. Ann Rheum Dis 2007;[2]Aronsen et al. Europ Joul of Pharm 2014;[3]Li et al. Theranostics 2018;[4]Ding et al. Circulation 2015;[5]Spyridopoulos et al. Art. Thromb Vasc Biol. 2008;[6]Orefice et al. Lupus 2020.Disclosure of InterestsNone declared
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Speziali M, Ceccarelli F, Natalucci F, Celia AI, Colasanti T, Barbati C, Olivieri G, Balbinot E, Ciancarella C, Ucci FM, Buoncuore G, Tripdi G, Spinelli FR, Conti F, Alessandri C. POS0553 NEW BIOMARKERS IN RHEUMATOID ARTHRITIS: ROLE OF HOMOCYSTEINYLATED ANTI-ALPHA1 ANTITRYPSIN ANTIBODIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRheumatoid Arthritis (RA) is a multifactorial, chronic, systemic, inflammatory disease that can lead to progressive joint destruction (Alamanos et al, Autoimmun Rev 2005). Positivity for Rheumatoid Factor (RF) and antibodies against citrullinated proteins (ACPA) is useful for diagnostic and prognostic purposes. Nevertheless, in about 20% of patients, it is not possible to detect the presence of these autoantibodies. This has led to the identification of new antibody specificities, such as antibodies directed against carbamylated proteins (Mastrangelo A et al, J Immunol Res 2015) and, more recently, against homocysteinylated alpha 1 antitrypsin (anti-HATA) (Colasanti T et al, J Autoimmun 2020).ObjectivesTo evaluate the prevalence of anti-HATA in a large cohort of patients with RA and their correlation with serological, clinical and erosive bone damage assessed by musculo-skeletal ultrasound (US).MethodsConsecutive outpatients with RA, diagnosed according to the 2010 ACR/EULAR criteria, were enrolled. Demographic and clinical-laboratory data were recorded, including FR and ACPA determination. Disease activity was assessed by DAS28. The presence of anti-HATA antibodies was investigated by homemade ELISA using native alpha 1 antitrypsin modified in vitro to obtain homocysteinylated alpha 1 antitrypsin. US assessment was performed at the level of bilateral metacarpophalangeal and proximal interphalangeal joints; the presence of erosions and inflammatory features was identified according to OMERACT definitions (Wakefield RJ et al, J Rheumatol 2005).ResultsThe present analysis included 91 RA patients (M/F 22/69; mean age 62 years; mean disease duration 12.5 years). Overall, the prevalence of anti-HATA was 69.2%. Anti-HATA antibodies were found in 63/91 (69.2%) of the entire patient cohort, whereas 68/91 (74.3%) patients were positive for ACPA and 63/91 (69.4%) for FR. 41.4% of patients had concomitant positivity for the three autoantibodies (FR, ACPA, anti-HATA). The analysis of patients with triple positivity for related arthritis antibodies (FR, ACPA, anti-HATA) was particularly interesting: indeed, in this subgroup, 80% of patients presented erosive damage, compared to 42.1% of patients who did not present simultaneously the three autoantibodies (p=0.0001). Patients with simultaneous positivity for RF, ACPA and anti-HATA showed a more aggressive disease phenotype (p=0.0001). Finally, a positive correlation was also found between disease activity (expressed by DAS28) and total inflammatory and erosive ultrasonographic score (p=0.005 and p=0.001, respectively).ConclusionThe results of the present study confirm a high prevalence of anti-HATA in RA patients; furthermore, patients with concomitant presence of anti-HATA, ACPA and RF showed a more aggressive disease phenotype, in terms of erosive damage. Our analysis underlines as the characterization of new antibody specificities in RA could help in the early diagnosis of this disease and in the characterization of the different severity degrees.References[1]Alamanos Y, Drosos AA. Epidemiology of adult rheumatoid arthritis. Autoimmun Rev. 2005 Mar;4(3):130-6.[2]Mastrangelo A, Colasanti T, Barbati C, Pecani A, Sabatinelli D, Pendolino M, Truglia S, Massaro L, Mancini R, Miranda F, Spinelli FR, Conti F, Alessandri C. The Role of Posttranslational Protein Modifications in Rheumatological Diseases: Focus on Rheumatoid Arthritis. J Immunol Res. 2015;2015:712490;[3]Colasanti T, Sabatinelli D, Mancone C, Giorgi A, Pecani A, Spinelli FR, Di Giamberardino A, Navarini L, Speziali M, Vomero M, Barbati C, Perricone C, Ceccarelli F, Finucci A, Celia AI, Currado D, Afeltra A, Schininà ME, Barnaba V, Conti F, Valesini G, Alessandri C. Homocysteinylated alpha 1 antitrypsin as an antigenic target of autoantibodies in seronegative rheumatoid arthritis patients. J Autoimmun. 2020 Sep;113:102470.[4]Wakefield RJ, Balint PV, Szkudlarek M, et al. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol 2005; 32: 2485-2487.Disclosure of InterestsNone declared.
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Giardina F, Curcio G, Gioia C, Izzo R, Simoncelli E, Gattamelata A, Colafrancesco S, Mastromanno L, Villa M, Iannuccelli C, Di Franco M, Conti F, Priori R. AB1487 VALIDATION AND CULTURAL ADAPTATION OF THE QUALISEX QUESTIONNAIRE IN WOMEN WITH SJÖGREN’S SYNDROME IN ITALY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe quality of sexual life (QSL) is a complex and multimodal experience influenced by endogenous and external factors, including age, gender, and cultural environment. Rheumatic diseases, with their burden of pain, fatigue, organ damage, and disability, can severely impair sexual life and this is true also for Sjögren’s Syndrome, where simple tools to assess the QSL in everyday clinical practice are needed.ObjectivesTo translate ad adapt into Italian the Qualisex, a new brief questionnaire originally created for Rheumatoid Arthritis patients, for women with primary Sjögren’s Syndrome (pSS) and evaluate the impact of the disease on their sexuality.MethodsConsecutive sexually active pSS (according to ACR/EULAR 2016 criteria) patients aged >18 were asked to participate in this study approved by the local bioethics committee. With the permission of the developer, the French original version of the Qualisex questionnaire (consisting of 10 items, the higher the score, the greater the negative impact of the disease on the QSL) was translated and adapted into Italian according to current guidelines. In the absence of a gold standard assessment for sexuality in pSS, face and content validity was assessed cross-sectionally by correlations with other disease aspects such as anxiety and depression measured by Hospital Anxiety and Depression Scale (HADS), EULAR SS patient-reported index (ESSPRI), and quality of the relationship. As a measure of reliability, internal consistency was assessed through Cronbach’s Alpha coefficient. A Cronbach’s value >0.7 is generally regarded as satisfactory. The feasibility of the scale was indirectly assessed through missing data. To assess the factorial structure of the Italian version of the questionnaire an Exploratory Factor Analysis (EFA) was carried out. Moreover we also assessed the level of redundancy by means of intra-item correlation of the Qualisex questionnaire. ESSDAI (EULAR Sjögren’s Syndrome Disease Activity Index), and SSDDI (Sjogren’s Syndrome Disease Damage Index) were assessed as well. Analyses were carried out with IBM SPSS Statistics for Macintosh, version 22.0 (IBM Corp., Armonk, NY, USA).Results40 sexually active women with pSS and a median age of 53 (IQR 45.25-57.25) were enrolled. The EFA showed that the model with a single factor appeared to be highly significant (Chi235= 2943.10; p<0.05); the average inter-item correlation was found to be 0.392 (Min -0.479; Max 0.834) which is an acceptable value as for redundancy. There were no missing answers. Cronbach’s alpha coefficient resulted to be 0.86 which indicates an adequate internal consistency. The median Qualisex score was 4.65 (IQR 2.13–6.2). As far as correlations, age (Rho=0.39; p<0.05), menopause (Rho=0.41; p<0.05), relationship quality (Rho=0.55; p<0.05), anxiety (HADS-A; Rho=0.38; p<0.05), and depression (HADS-D; Rho=0.47; p<0.05) appeared to be positively correlated with Qualisex score. Also, a positive correlation with ESSPRI (Rho=0.43; p<0.05), and drug use (Rho=0.37; p<0.05) was demonstrated. On the contrary no significant correlation was found with education (Rho=-0.07; p=0.64), systemic disease activity (Rho=0.14; p=0.39), and damage (Rho=0.06; p=0,74).ConclusionThe Italian version of the Qualisex questionnaire is a valid, reliable and useful tool to assess the quality of sexual life in pSS. QSL in pSS women has an inverse relationship with age, menopause, drug use, ESSPRI, mood disorders, and dissatisfaction with the partner, while, as previously reported, no correlation was found with disease activity, damage, and educational status. This further highlights the impact of subjective symptoms such as dryness, pain, fatigue, and the overall psychological well-being on patients’ life. Thus, it is critical for the physician to consider patients’ perspective.Disclosure of InterestsNone declared
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Ceccarelli F, Saccucci M, Natalucci F, Olivieri G, Bruni E, Iacono R, Colasanti T, Di Carlo G, Alessandri C, Uccelletti D, Russo P, Pilloni A, Conti F, Polimeni A. AB0118 PORPHYROMONAS GINGIVALIS AMOUNT IN THE TONGUE BIOFILM IS ASSOCIATED WITH EROSIVE ARTHRITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSeveral data have demonstrated the occurrence of erosive arthritis in Systemic Lupus Erythematosus (SLE) patients. However, few studies have focused on the pathogenic mechanisms involved in this feature. The implication of oral pathogens has been proved in Rheumatoid Arthritis: in particular, Porphyromonas gingivalis (Pg), by inducing citrullination, could trigger autoimmune response.ObjectivesWe evaluated amount of Pg of the tongue in a cohort of SLE patients with arthritis, focusing on the association with the erosive phenotype.MethodsSLE patients with arthritis were enrolled. We evaluated the presence of ACPA and RF by using commercially enzyme-linked immunosorbent assay kits. SLEDAI-2k was applied to assess disease activity and DAS28 to assess joint inflammatory status. Erosive damage was evaluated by ultrasound at level of metacarpophalangeal and proximal interphalangeals joints. All subjects underwent a tongue cytologic swab in order to quantify the amount of Pg (real-time PCR). The bacterium expression was obtained from the ratio between the patient’s DNA amount and that obtained from healthy subjects.ResultsThe present analysis included 33 SLE patients (M/F 3/30; median age 47 years, IQR 17; median disease duration 216 months, IQR 180). Concerning activity at the time of the enrollment, we found a median DAS28 value of 3.8 (IQR 2.8) and a median SLEDAI-2k of 4 (IQR 5). Twelve patients (36.4%) showed US-detected erosive damage in at least one joint, significantly associated with ACPA positivity (p<0.0001). Furthermore, patients with erosive damage showed significantly higher median DAS28 values in comparison with those without [4 (IQR 3.1) versus 3.2 (IQR 2.1), p=0.03]. Moving on the oral pathogen analysis, we found a mean Pg ratio of 19.7±31.1 (median 6.6, IQR 22.3). When dividing patients according to the presence of erosive damage, we found higher Pg amount in SLE patients with this phenotype in comparison with those without (31.4±44.3 versus 12.9±19.2, p=ns; Figure 1A). Thus, we used Pg mean values as threshold, identifying two groups of patients, namely highPg and lowPg. In a receiver operating characteristic curve analysis (ROC), this threshold resulted in the most sensitive and specific one (sensitivity of 85%; specificity of 50%). As reported in Figure 1B, erosive damage was significantly more frequent in highPg patients in comparison with lowPg (60.0% versus 26.0%, p=0.001). Furthermore, highPg patients showed higher prevalence of skin manifestations, serositis and neurological involvement compared to lowPg patients (p=0.005, p=0.03, p=0.0001, respectively).ConclusionThe possible contribution of oral microbiota in SLE erosive arthritis was here evaluated for the first time, finding a significant association between erosive damage and higher expression of Pg at tongue level.Disclosure of InterestsNone declared
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Natalucci F, Di Filippo A, Ceccarelli F, Zizzari I, Olivieri G, Orefice V, Pirone C, Spinelli FR, Alessandri C, Nuti M, Conti F. AB0119 ROLE OF COSTIMULATORY MOLECULES IN SYSTEMIC LUPUS ERYTHEMATOSUS: FOCUS ON CD137. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSystemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by a wide autoantibodies production. The traditionally concept of a B-cell driven disease has been changed in the last years due to the evidence demonstrating the crucial role of T cells in SLE pathogenesis. In particular, regulatory (Treg) and memory T cells seem act through co-stimulatory and co-inhibitory molecules, such as CD137, PD1-1 and CTLA4. The over-expression of this molecules on lymphocytes may contribute to immune system dysregulation.ObjectivesThe primary objective of the present case-control study was to evaluate the expression of CD137, PD1-1 and CTLA4 on T cell surface of SLE patients by using flow-cytometry. Secondly, we evaluated the percentage of Treg and memory T cells.MethodsWe enrolled patients SLE patients (2019 ACR/EULAR criteria) and sex/age-matched healthy subjects (HS). Demographic, clinical, and laboratory data were collected in a standardized computerized electronically filled form. Disease activity was assessed by SLEDAI-2k. Each subject underwent peripheral blood sample collection. By using flow-cytometry we evaluated the expression of FOXP3, CD137, PD1-1 and CTLA4, CD45, CD25, CCR7 to determine the percentage of Treg and memory T cells.ResultsThe present analysis included 21 SLE patients [M/F 1/20 median age 48 years (IQR 17), median disease duration 144 months (IQR 204)]. The Treg percentage was significantly lower in SLE compared to HS [median 4.2 (IQR 0.32) versus 2.5 (IQR 2.44); p=0.001, Figure 1A]. Moving on effector Treg (eTreg), SLE patients with high disease activity (SLEDAI > 4) showed a significantly higher prevalence for these cells compared to patients with SLEDAI ≤ 4 [1.16 (IQR 0.51) versus 0.53 (IQR 0.8), p=0.014, Figure 1B]. Moreover, inverse correlation was found between eTreg percentage and SLEDAI-2k [p=0.029, r=-0.47 (CI 0.75 – 0.04) Figure 1C]. The evaluation of CD137 expression was significantly higher in SLE patients compared to HS on CD3+ cells [median 5.32 (IQR 6.11) versus 3.3 (IQR 1.7), p=0.001, Figure 1F]. On CD4+ cells, CD137 expression positively correlated with disease activity [p=0.0082, r=0.58 (CI 0.15-0.82)]. Finally, when analysing memory T cells subpopulations, inverse correlation has been found between effector memory T cells (TEM, CD45RA-CCR7-) and SLEDAI-2k when considering CD3+ [p=0.029, r=-0.56 (CI 0.81 – 0.12)] and CD4+ cells [p=0.016, R=-0.54 (CI -0.80 - -0.1)]. Of note, CD137 expression on T central memory cells (TCM, CD45RA-CCR7+) positively correlated with SLEDAI-2k [(p=0.019, r=0.52 (CI 0.09 – 0.79)].Figure 1.A) Comparison of the percentage of Treg in HS and SLE patients. B) Comparison of the percentage of eTreg in SLE patients with high disease activity and low disease activity C) Correlation between % eTreg and SLEDAI-2k. D) Comparison of the percentage of CD3+CD137+ cells in HS and SLE patients. E) Comparison of % of CD4+CD137+ cells in SLE patients with high disease activity and low disease activity F) Correlation between % of CD4+CD137+ cells and SLEDAI-2k.ConclusionOur results suggest a possible role of CD137-CD137L axis in SLE pathogenesis. The stimulatory role of this molecule is indicated by the positive correlation between SLEDAI-2k values and surface expression of CD137. Moreover, inverse correlation between SLEDAI-2k and eTreg percentage suggests a possible Treg dysregulation in SLE.Table 1.SLE cohort featuresClinical and Laboratory FeaturesMucocutaneous80.9%Articular76.1%Serositis19.0%Kidney23.8%Haematological48.2%CNS/PNS9.5%Thrombotic events4.7%anti-dsDNA68.4%anti-SSA/anti-SSB47.6%anti-RNP19.0%anti-Sm33.0%Antiphospholipid antibodies14.2%Low C3/C457.1%Previous TherapyGlucocorticoid90.5%Hydroxychloroquine95.2%Methotrexate23.8%Mofetil Mycophenolate33.3%Ciclosporin28.5%Cyclophosphamide9.5%Azathioprine33.3%Rituximab14.3%Antiplatelet23.8%Anticoagulant therapy4.7%Disclosure of InterestsNone declared
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Conti F, Marzollo A, Moratti M, Lodi L, Ricci S. Inborn Errors of Immunity underlying a susceptibility to pyogenic infections: from innate immune system deficiency to complex phenotypes. Clin Microbiol Infect 2022; 28:1422-1428. [DOI: 10.1016/j.cmi.2022.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/29/2022] [Accepted: 05/14/2022] [Indexed: 12/26/2022]
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Narkis J, Conti F, Beg FN. Material effects on dynamics in triple-nozzle gas-puff Z pinches. Phys Rev E 2022; 105:045205. [PMID: 35590572 DOI: 10.1103/physreve.105.045205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/15/2022] [Indexed: 06/15/2023]
Abstract
The gas-puff Z pinch has a long history with myriad applications as an efficient neutron or x-ray source. Its simplicity as a load configuration makes it suitable for studying fundamental plasma physics phenomena such as instabilities and energy transport. For example, the implosion of cylindrical shells onto a fusion fuel are inherently susceptible to instability growth on their external surfaces; if such instabilities are unmitigated, then the consequences in terms of degraded performance can be substantial. Similarly, mitigating heat transport from a hot fuel to its colder surrounding container can make fusion conditions more easily achievable. Here we have conducted a systematic study of triple-nozzle (outer liner, inner liner, fuel) gas puffs using two-dimensional (2D) magnetohydrodynamic simulations to investigate the effect of load material on the relevant dynamics. Analogous to past studies on spherical blast waves and converging shock waves, a trend emerges linking increased radiative cooling, lower adiabatic index, and increased magneto-Rayleigh-Taylor instability growth. Notably, our results suggest that, for the present configuration, Ar radiates less than both Ne and Kr during the early stages of the implosion while mass is being swept up and perturbations begin to seed instability growth. Consequently, pinches with Ar on the outer surface exhibit more stable 2D behavior. Here we also present a parameter scan of thermonuclear neutron yield, Y, as a function of peak current, I_{pk} and dopant concentration with Ne or Ar, depending on the inner liner material. Above 6 MA, our results suggest Y∝I_{pk}^{5} and even substantial mixing (10% by volume) of Ne into the fuel does not drastically reduce yield, suggesting an Ar/Ne/fuel configuration may reliably achieve DD thermonuclear yields of 10^{13}-10^{14}/cm in the 10-20 MA range.
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Affiliation(s)
- J Narkis
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
| | - F Conti
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
| | - F N Beg
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
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Vomero M, Caliste M, Barbati C, Speziali M, Celia AI, Ucci F, Ciancarella C, Putro E, Colasanti T, Buoncuore G, Corsiero E, Bombardieri M, Spinelli FR, Ceccarelli F, Conti F, Alessandri C. Tofacitinib Decreases Autophagy of Fibroblast-Like Synoviocytes From Rheumatoid Arthritis Patients. Front Pharmacol 2022; 13:852802. [PMID: 35308233 PMCID: PMC8928732 DOI: 10.3389/fphar.2022.852802] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 01/18/2023] Open
Abstract
The pathway of Janus tyrosine kinases (JAKs) has a central role in the pathogenesis of Rheumatoid Arthritis (RA) by regulating multiple immune functions and cytokine production. The JAK inhibitor tofacitinib is effective in RA patients not responding to methotrexate or TNF-inhibitors. Since hyperactive autophagy has been associated with impaired apoptosis of RA fibroblast-like synoviocytes (FLS), we aimed to investigate the role of tofacitinib in modulating autophagy and apoptosis in these cells. FLS isolated from RA biopsies were cultured with tofacitinib in presence of autophagy inducer rapamycin and in serum deprivation condition. Levels of autophagy, apoptosis, and citrullinated proteins were analyzed by western blot, flow cytometry, immunocytofluorescence, and Real-Time PCR. Rapamycin induced an increase in RA-FLS autophagy while the levels of autophagy marker LC3-II were reduced after in vitro treatment with tofacitinib. The analysis of autophagic flux by specific fluorescence dye confirmed the reduction of autophagy in RA FLS. The treatment with tofacitinib did not influence apoptosis of RA FLS. Modulation of the autophagic process by tofacitinib did not significantly change citrullination. The results of this study demonstrate that tofacitinib is able to modulate autophagy of FLS contributing to its effectiveness in RA patients.
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Affiliation(s)
- M. Vomero
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
- Rheumatology, Immunology and Clinical Medicine Unit, Università Campus Bio-Medico di Roma, Rome, Italy
| | - M. Caliste
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - C. Barbati
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
- *Correspondence: C. Barbati,
| | - M. Speziali
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - A. I. Celia
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - F. Ucci
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - C. Ciancarella
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - E. Putro
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - T. Colasanti
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - G. Buoncuore
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - E. Corsiero
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - M. Bombardieri
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - F. R. Spinelli
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - F. Ceccarelli
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - F. Conti
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - C. Alessandri
- Arthritis Center, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
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Cattaneo D, Pasina L, Conti F, Giacomelli A, Oreni L, Pezzati L, Bonazzetti C, Piscaglia M, Carrozzo G, Antinori S, Gervasoni C. Risks of potential drug-drug interactions in COVID-19 patients treated with corticosteroids: a single-center experience. J Endocrinol Invest 2021; 44:2849-2851. [PMID: 34053008 PMCID: PMC8164688 DOI: 10.1007/s40618-021-01604-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023]
Affiliation(s)
- D Cattaneo
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli-Sacco University Hospital, Milan, Italy
- Unit of Clinical Pharmacology, ASST Fatebenefratelli-Sacco University Hospital, Milan, Italy
| | - L Pasina
- Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - F Conti
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - A Giacomelli
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - L Oreni
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - L Pezzati
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - C Bonazzetti
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - M Piscaglia
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - G Carrozzo
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - S Antinori
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy
| | - C Gervasoni
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli-Sacco University Hospital, Milan, Italy.
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milano, Italy.
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Colafrancesco S, Barbati C, Priori R, Putro E, Giardina F, Gattamelata A, Monosi B, Colasanti T, Celia AI, Cerbelli B, Giordano C, Scarpa S, Fusconi M, Cavalli G, Berardicurti O, Gandolfo S, Nayar S, Barone F, Giacomelli R, De Vita S, Alessandri C, Conti F. Maladaptive autophagy in the pathogenesis of autoimmune epithelitis in Sjӧgren's Syndrome. Arthritis Rheumatol 2021; 74:654-664. [PMID: 34748286 DOI: 10.1002/art.42018] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/06/2021] [Accepted: 11/02/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE Salivary gland epithelial cells (SGECs) are key cellular drivers in the pathogenesis of primary Sjӧgren's Syndrome (pSS); however, the mechanisms sustaining SGECs activation in pSS remain undetermined. The aim of this study is to determine the role of autophagy in the survival and activation of SGECs in pSS. METHODS Primary SGECs isolated from minor salivary glands (SG) of patients with pSS or sicca syndrome were evaluated by flow-cytometry, immunoblotting, and immunofluorescence to assess autophagy (autophagic-flux, LC3IIB, p62, LC3B+/LAMP1+ staining), apoptosis (annexin V/PI, Caspase-3) and activation (ICAM, VCAM). Focus score and germinal centers presence was assessed in SG from the same patients to correlate with histological severity. Human salivary gland (HSG) cells were stimulated in vitro with PBMCs and serum from pSS patients in the presence or absence of autophagy inhibitors to determine changes in autophagy and epithelial cell activation. RESULTS SGECs from pSS patients (n=24) exhibited increased autophagy (autophagic-flux p=0.001; LC3IIB p=0.02; p62 p=0.064; LC3IIB/LAMP1+ staining), increased expression of anti-apoptotic molecules (Bcl2 p=0.006), and reduced apoptosis (Annexin-V/PI p=0.002, Caspase-3 p=0.057) compared to sicca (n=16). Autophagy correlated with histologic disease severity. In vitro experiments on HSG cells stimulated with serum and PBMCs from pSS patients confirmed activation of autophagy and expression of adhesion molecules, which was reverted upon pharmacologic inhibition of autophagy. CONCLUSIONS In pSS SGECs, inflammation induces autophagy and pro-survival mechanisms, which promote SGEC activation and mirror histological severity. These findings indicate that autophagy is a central contributor to the pathogenesis of pSS and a new therapeutic target.
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Affiliation(s)
- S Colafrancesco
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - C Barbati
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - R Priori
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy.,Saint Camillus International University of Health Science, UniCamillus, Rome, Italy
| | - E Putro
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - F Giardina
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - A Gattamelata
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - B Monosi
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - T Colasanti
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - A I Celia
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - B Cerbelli
- Department of Radiological, oncological and anatomo-pathological sciences, Sapienza University, Rome, Italy
| | - C Giordano
- Department of Radiological, oncological and anatomo-pathological sciences, Sapienza University, Rome, Italy
| | - S Scarpa
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - M Fusconi
- Department Organs of Sense, Sapienza University of Rome, Italy
| | - G Cavalli
- Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - O Berardicurti
- Division of Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - S Gandolfo
- Clinic of Rheumatology, DAME, University Hospital of Udine, Udine, Italy
| | - S Nayar
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - F Barone
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - R Giacomelli
- Unit of Allergology, Immunology and Rheumatology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
| | - S De Vita
- Clinic of Rheumatology, DAME, University Hospital of Udine, Udine, Italy
| | - C Alessandri
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - F Conti
- Division of Rheumatology, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy
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Conti F, Poujet L, Delverdier M, Lallemand EA, Benoit J. High dose rate interstitial 192‐Ir brachytherapy for the treatment of a recurrent dermal vascular hamartoma in a horse. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- F. Conti
- ONCOVET Villeneuve d'Ascq France
| | | | - M. Delverdier
- IHAP Université de Toulouse INRAE ENVT Toulouse France
| | - E. A. Lallemand
- InTheRes UMR1436 Université de Toulouse INRAE ENVT Toulouse France
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50
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Narkis J, Conti F, Velikovich AL, Beg FN. Mitigation of magneto-Rayleigh-Taylor instability growth in a triple-nozzle, neutron-producing gas-puff Z pinch. Phys Rev E 2021; 104:L023201. [PMID: 34525596 DOI: 10.1103/physreve.104.l023201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/28/2021] [Indexed: 11/07/2022]
Abstract
The gas-puff Z-pinch is a well-known source of x-rays and/or neutrons, but it is highly susceptible to the magneto-Rayleigh-Taylor instability (MRTI). Approaches to MRTI mitigation include density profile tailoring, in which nozzles are added or modified to alter the acceleration trajectory, and axial pre-magnetization, in which perturbations are smoothed out via magnetic field line tension. Here, we present two-dimensional magnetohydrodynamic simulations of loads driven by an 850 kA, 160 ns driver that suggest these mitigation strategies can be additive. The initial axial magnetic field, B_{z0}, to stabilize a 2.5-cm-radius Ne gas liner imploding onto an on-axis deuterium target can be reduced from 0.7 T to 0.3 T by adding a second liner with a radius of 1.25 cm. Because MRTI mitigation tends to increasingly lower yield with higher B_{z0}, the use of a lower field is advantageous. Here, we predict a reduction in yield penalty from >100× with the single liner to <10× with a double liner. A premagnetized, triple nozzle gas puff could therefore be an attractive source for intense neutrons or other fusion applications.
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Affiliation(s)
- J Narkis
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
| | - F Conti
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
| | - A L Velikovich
- Plasma Physics Division, Naval Research Laboratory, Washington, District of Columbia 20375, USA
| | - F N Beg
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
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