Preliminary evidence that Merkel cells exert chemosensory functions in human epidermis

The mechanotransduction of light-touch sensory stimuli is considered to be the main physiological function of epidermal Merkel cells (MCs). Recently, however, MCs have been demonstrated to be also thermo-sensitive, suggesting that their role in skin physiologically extends well beyond mechanosensation. Here, we demonstrate that in healthy human skin epidermal MCs express functional olfactory receptors, namely OR2AT4, just like neighbouring keratinocytes. Selective stimulation of OR2AT4 by topical application of the synthetic odorant, Sandalore®, significantly increased Piccolo protein expression in MCs, as assessed by quantitative immunohistomorphometry, indicating increased vesicle trafficking and recycling, and significantly reduced nerve growth factor (NGF) immunoreactivity within MCs, possibly indicating increased neurotrophin release upon OR2AT4 activation. Live-cell imaging showed that Sandalore® rapidly induces a loss of FFN206-dependent fluorescence in MCs, suggesting OR2AT4-dependent MC depolarization and subsequent vesicle secretion. Yet, in contrast to keratinocytes, OR2AT4 stimulation by Sandalore® altered neither the number nor the proliferation status of MCs. These preliminary ex vivo findings demonstrate that epidermal MCs also exert OR-dependent chemosensory functions in human skin, and invite one to explore whether these newly identified properties are dysregulated in selected skin disorders, for example, in pruritic dermatoses, and if these novel MC functions can be therapeutically targeted to maintain/promote skin health.

OP0309-PARE REUMASUTRA: RETHINKING SEXUALITY IN RHEUMATIC AND MUSCULOSKELETAL DISEASES

Background:

Rheumatic and musculoskeletal diseases (RMDs) have a great impact on people’s quality of life affecting daily tasks. Research has shown that sexual relationships are also affected by RMDs. This occurs by one or a combination of: (1) the symptoms of the disease and (2) the side effects of the medication.

Although we are all here because of sex, talking about sex and sexuality remains taboo. Physicians themselves report that embarrassment, lack of time, lack of knowledge about the topic, or age are barriers that prevent them from starting a conversation about the subject. Consequently, the sexual sphere of people with RMDs is neglected; producing uncertainty in the people affected by them and their partners.

In 2016, we set ourselves the task of studying what has already been created. The only material we found was a book with drawings that showed several sexual positions. We realized that the existing material fell short and we knew that we could make an original contribution. That’s why using participatory action research (PAR) approach we decided to create Reumasutra (LLC): The kamasutra for people with rheumatic diseases.

Objectives:

To understand the complexities and the difficulties of sexuality in people with RMDs,

To offer a solution to the problems previously identified,

To (un)validate the proposed solution using the feedback of people with RMDs.

Methods:

PAR affirms that experience can be a basis of knowing and that experiential learning can lead to a legitimate form of knowledge that influences practice.

PAR differs from conventional research in three ways. Firstly, it focuses on research whose purpose is to enable action. Secondly, PAR pays careful attention to power relationships, advocating for power to be deliberately shared between the researcher and the researched: blurring the line between them until the researched become the researchers. Thirdly, PAR contrasts with less dynamic approaches that remove data and information from their contexts, by advocating that those being researched should be involved in the process actively.

Results:

Our project is divided into three phases.

In the first phase, interviews with people with RMDs were conducted. The interviewees expressed that sex remains a taboo topic, which is often ignored by physicians. Besides, we opened a suggestion box on the websitewww.reumaxxx.com. Last year, we received feedback from approximately >30.000 people. After evaluating the feedback, it was clear that the best way to educate in sex in RMDs was by showing real people practicing adapted sexual positions.

For that task, we asked a couple with RMDs to validate the sexual positions that appear as drawings on the only book we found on the topic. Also, the couple added new sexual positions that they have been using and adapting to be sexually active despite having RMDs.

In the second phase, we recruited sex surrogates with experience with people with functional diversity to recreate the sexual position previously validated. The sex surrogates received coaching in real-time from a person with RMDs. The positions were filmed in January 2020.

For the last phase, we expect to upload the audiovisual content to the website. Afterward, we will send out surveys so that the users themselves can determine the validity and usefulness of the solution created.

Conclusion:

Mobility in rheumatic diseases is affected. Sex is dynamic and a person cannot properly learn a new dynamic reality using static resources. We need to cross the taboo line to offer real solutions anchored to the reality of people with RMDs.

Acknowledgments:

To Dr. Anne Campbell, John Campbell, Miss Estigia, Ivy de Luna, Sylvan, and Sally Fenaux and her crew.

Disclosure of Interests:

None declared

An osteopontin-derived peptide inhibits human hair growth at least in part by decreasing fibroblast growth factor-7 production in outer root sheath keratinocytes

BACKGROUND

Given that unwanted hair growth (hirsutism, hypertrichosis) can cause major psychological distress, new pharmacological treatment strategies with safe and effective hair growth inhibitors that do not destroy the hair follicle (HF) and its stem cells need to be developed.

OBJECTIVES

To establish if osteopontin-derived fragments may modulate human hair growth given that human HFs express the multifunctional, immunomodulatory glycoprotein, osteopontin.

METHODS

Our hypothesis was tested ex vivo and in vivo by using a newly generated, toxicologically well-characterized, modified osteopontin-derived peptide (FOL-005), which binds to the HF.

RESULTS

In organ-cultured human HFs and scalp skin, and in human scalp skin xenotransplants onto SCID mice, FOL-005 treatment (60 nmol L^-1 to 3 μmol L^-1 ) significantly promoted premature catagen development without reducing the number of keratin 15-positive HF stem cells or showing signs of drug toxicity. Genome-wide DNA microarray, quantitative reverse-transcriptase polymerase chain reaction and immunohistochemistry revealed decreased expression of the hair growth promoter, fibroblast growth factor-7 (FGF7) by FOL-005, while cotreatment of HFs with recombinant FGF7 partially abrogated FOL-005-induced catagen promotion.

CONCLUSIONS

With caveats in mind, our study identifies this osteopontin-derived peptide as an effective, novel inhibitory principle for human hair growth ex vivo and in vivo, which deserves systematic clinical testing in hirsutism and hypertrichosis. What's already known about this topic? The treatment of unwanted hair growth (hypertrichosis, hirsutism) lacks pharmacological intervention, with only few and often unsatisfactory treatments available. Osteopontin is prominently expressed in human HFs and has been reported to be elevated during catagen in the murine hair cycle. What does this study add? We tested the effects on hair growth of a novel, osteopontin-derived fragment (FOL-005) ex vivo and in vivo. In human hair follicles, high-dose FOL-005 significantly reduces hair growth both ex vivo and in vivo. What is the translational message? High-dose FOL-005 may provide a new therapeutic opportunity as a treatment for unwanted hair growth.

Filgotinib (GLPG0634/GS-6034), an oral selective JAK1 inhibitor, is effective as monotherapy in patients with active rheumatoid arthritis: results from a randomised, dose-finding study (DARWIN 2)

Objectives

To evaluate the efficacy and safety of different doses of filgotinib, an oral Janus kinase 1 inhibitor, as monotherapy in patients with active rheumatoid arthritis (RA) and previous inadequate response to methotrexate (MTX).

Methods

In this 24-week phase IIb study, patients with moderately to severely active RA were randomised (1:1:1:1) to receive 50, 100 or 200 mg filgotinib once daily, or placebo, after a ≥4-week washout from MTX. The primary end point was the percentage of patients achieving an American College of Rheumatology (ACR)20 response at week 12.

Results

Overall, 283 patients were randomised and treated. At week 12, significantly more patients receiving filgotinib at any dose achieved ACR20 responses versus placebo (≥65% vs 29%, p<0.001). For other key end points at week 12 (ACR50, ACR70, ACR-N, Disease Activity Score based on 28 joints and C reactive protein, Clinical Disease Activity Index, Simplified Disease Activity Index and Health Assessment Questionnaire-Disability Index) significant differences from baseline in favour of filgotinib 100 and 200 mg versus placebo were seen; responses were maintained or improved through week 24. Rapid onset of action was observed for most efficacy end points. Dose-dependent increases in haemoglobin were observed. The percentage of patients with treatment-emergent adverse events (TEAE) was similar in the placebo and filgotinib groups (∼40%). Eight patients on filgotinib and one on placebo had a serious TEAE, and four patients, all of whom received filgotinib, experienced a serious infection. No tuberculosis or opportunistic infections were reported.

Conclusions

Over 24 weeks, filgotinib as monotherapy was efficacious in treating the signs and symptoms of active RA, with a rapid onset of action. Filgotinib was generally well tolerated.

Trial registration number

NCT01894516.

The 1985 central chile earthquake: a repeat of previous great earthquakes in the region?

A great earthquake (surface-wave magnitude, 7.8) occurred along the coast of central Chile on 3 March 1985, causing heavy damage to coastal towns. Intense foreshock activity near the epicenter of the main shock occurred for 11 days before the earthquake. The aftershocks of the 1985 earthquake define a rupture area of 170 by 110 square kilometers. The earthquake was forecast on the basis of the nearly constant repeat time (83 +/- 9 years) of great earthquakes in this region. An analysis of previous earthquakes suggests that the rupture lengths of great shocks in the region vary by a factor of about 3. The nearly constant repeat time and variable rupture lengths cannot be reconciled with time- or slip-predictable models of earthquake recurrence. The great earthquakes in the region seem to involve a variable rupture mode and yet, for unknown reasons, remain periodic. Historical data suggest that the region south of the 1985 rupture zone should now be considered a gap of high seismic potential that may rupture in a great earthquake in the next few tens of years.

Tight junction proteins ZO-1, ZO-2, and occludin along isolated renal tubules

BACKGROUND

Tight junctions play a critical role in tubular function. In mammalian kidney, the transepithelial electrical resistance and the complexity of the tight junction increase from the proximal to the collecting tubule. The differential expression of three tight junction proteins, ZO-1, ZO-2, and occludin, along isolated rabbit renal tubules is examined in this article.

METHODS

Microdissected rabbit renal tubules were processed for immunofluorescence detection of ZO-1, ZO-2, and occludin. The quantitation of these proteins was done by Western blot determinations in Percoll isolated tubules.

RESULTS

ZO-1 stained cell boundaries independently of the identity of the tubule. However, the amount found in distal segments was significantly higher than that expressed in proximal regions. ZO-2 in the proximal region was found diffusely distributed in the cytoplasm, with faint staining at cell borders, while a clear signal at cell perimeters was detectable from the Henle's loop to collecting tubules. Nuclear staining of ZO-2 was found along the whole nephron. The presence of occludin at the proximal region was faint and discontinuous, while its expression in the more distant portions was conspicuous. The quantity of ZO-2 and occludin present at the distal region was significantly higher compared with the proximal segment.

CONCLUSIONS

The distribution of ZO-1, ZO-2, and occludin follows the increase in junction complexity encountered in renal tubules. The amount of the three proteins found in proximal and distal segments is significantly higher in the latter.

Intimal thickening involves transdifferentiation of embryonic endothelial cells

Morphological studies have hypothesized different origins for the precursors of the vascular smooth muscle cells (SMCs). The intriguing possibility that intimal SMCs may arise from the endothelium has newly emerged. As a first step towards understanding of the possible mechanisms involved in the transdifferentiation of endothelium into smooth muscle cells, we characterized the in vivo phenotype of the cells located in the aortic wall (distal to the aortic arches). This was accomplished using advanced stages of chicken embryo development. Furthermore, we investigated whether the cells present at the intimal thickening derive from the endothelial cell transdifferentiation. Immunolabeling of serial cryosections suggested that mesenchymal cells observed in the intimal thickening may arise from the endothelium. These cells may persist either as non-muscle throughout the development or possibly convert to cells expressing smooth muscle alpha-actin (SM alpha-actin). To determine whether endothelial cells may actually transdifferentiate into mesenchymal cells, aortic explants from 14-day-old chicken embryos (stage 40) were used. We found that explanted endothelial cells lose their cobblestone-appearance and migrate toward cell-free area. Some of these cells maintain the vWf immunoreactivity, whereas other cells coordinately lose vWf and gain SM alpha-actin expression (transitional cells). Taken together these findings strongly support the possibility that embryonic aortic endothelial transdifferentiate into mesenchymal cells, some of which express SM alpha-actin. Since TGFbeta-3 is considered an essential factor during epithelial to mesenchymal transitions in earlier chicken heart development, we also investigated the distribution of this growth factor at day 14. Our observations indicated that the immunoreactivity for TGFbeta-3 in this stage may be associated with migrating mesenchymal cells and that this immunoreactivity appears to decrease as cell differentiation advances. Therefore, the present study provides evidence that could help to explain 1) the presence of cells displaying a phenotype reminiscent of fetal-like cells in the normal chicken aorta and in the intimal region of the human aorta; 2) the SM lineage diversity in the chicken embryo reported by others; 3) a subpopulation of immature cells in the subendothelial region of the main pulmonary arteries of fetal, neonatal and adult bovines; and 4) the presence of intimal cushions, intimal pads, eccentric and diffuse intimal thickening that are observed in mammalian and avian vessels at birth.

Gp38k, a protein synthesized by vascular smooth muscle cells, stimulates directional migration of human umbilical vein endothelial cells

Gp38k is a 383-amino-acid secreted glycoprotein expressed by cultured vascular smooth muscle cells during the time of transition from a proliferating monolayer culture to a nonproliferating multilayered (differentiated) culture. Expression continues as the cell culture forms multicellular nodules. Because this transition period involves active cell migration, we evaluated the effects of exogenously added gp38k on vascular endothelial cell (HUVEC) migration and chemotaxis. Here we demonstrate that gp38k acts as a chemoattractant for HUVECs and stimulates cell migration in Boyden chambers at a level comparable to that achieved with the known endothelial cell chemoattractant bFGF. The migration effect is neutralized by the presence of a polyclonal anti-gp38k antibody. Because gp38k expression is also correlated with changes in culture morphology, we also assessed its ability to act as an agonist of HUVEC morphology using cultures growing on Matrigel. We report that gp38k stimulates endothelial cell tubulogenesis in this assay system. These results provide the first evidence that gp38k may function in angiogenesis by stimulating the migration and reorganization of vascular endothelial cells.

[Anticardiolipin antibodies in rheumatic autoimmune diseases. Correlation with clinical and laboratory findings]

The prevalence of anticardiolipin antibodies (ACA) was determined using an Elisa method in sera of 60 patients with autoimmune diseases. ACA were correlated with clinical manifestations of the antiphospholipid syndrome and other serological markers of autoimmunity. Sixty three percent of sera had ACA IgG (+) and 50% ACA IgM (+). Nine patients, five of them with systemic lupus erythematosus, had a history of arterial or venous thrombosis and all had positive ACA (IgG (+) in 7 and IgM (+) in 2). In patients with rheumatoid arthritis, no association was found between the presence of ACA and thrombosis. Patients with a history of spontaneous abortion had non significantly higher levels of ACA. There was a significant correlation between ACA levels and rheumatoid factor (ACA IgG r = 0.374, ACA IgM r = 0.676), no other association was found between ACA and other autoantibodies. It is concluded that ACA are found frequently in patients with autoimmune diseases and its clinical significance may be different in patients with lupus than in patients with rheumatoid arthritis or other connective tissue diseases.

[X syndrome. Angiographic findings]

Coronary artery spasm is the most frequent cause of ischemic heart disease without coronary atherosclerosis once other causes such as cardiomyopathy, arteritis, coronary ectasia, valvular heart disease or hypertensive heart disease are eliminated. We report 23 patients, 15 males and 8 females, whose ages ranged from 34 to 63 years, with a mean age of 47 years, with demonstrated angina pectoris and myocardial ischemia, whose cardiac cineangiography showed no signs of atherosclerosis. Nevertheless, a significant retardation in the progression speed of the contrast medium was observed, as indirect evidence of the increment in coronary resistance at the arteriole level. Coronary spasm was ruled out by administration of intracoronary ergonovine, and other causes of myocardial ischemia, such as muscular bridges, were also discarded. The clinical presentation of the ischemic heart disease was unstable angina (UA) in 21 patients and myocardial infarction (MI) in 2. In the UA group, 14 patients showed ischemic changes in the ECG while the pain lasted, and in 8 patients the changes were present during the stress test. In all of them, the stress test perfusion scan with thallium 201 showed myocardial ischemia. In the IM group, the diagnosis was based on the clinical findings, the ECG, the enzyme curve, and the technetium 99 cardiac scintigram. In the two-year follow-up the prognosis has been favorable with treatment based on calcium antagonists. Nowadays 18 patients are asymptomatic, four have stable angina and only one has unstable angina.

The Oaxaca, Mexico, Earthquake of 29 November 1978: A Preliminary Report on Aftershocks

Aftershocks of the 29 November 1978 Oaxaca, Mexico, earthquake (surface-wave magnitude Ms = 7.8) define a rupture area of about 6000 square kilometers along the boundary of the Cocos sea-plate subduction. This area had not ruptured in a large (Ms >/= 7), shallow earthquake since the years 1928 and 1931 and had been designated a seismic "gap." The region has also been seismically quiet for small to moderate (M >/= 4), shallow (depth </= 60 kilometers) earthquakes since 1966; this quiet zone became about six times larger in 1973. A major earthquake (Ms = 7.5 +/- 0.25) was forecast at this location on the basis of the quiescence that began in 1973. The aftershock data indicate that an area approximately equivalent in size to the seismic gap has now broken.