POS0506 DIFFERENT BIOACTIVE LIPID PROFILES PREDICT RESPONSE TO TNF OR IL6 INHIBITORS IN RHEUMATOID ARTHRITIS: RESULT OF THE CorEvitas CERTAIN COMPARATIVE EFFECTIVENESS STUDY

Background

Circulating bioactive lipids can provide information about the pathogenesis of specific diseases and potentially help predict therapeutic response. Choosing the right biological therapy earlier in the course of rheumatoid arthritis (RA) could help reach the goal of remission.

Objectives

We hypothesized that circulating bioactive lipids at baseline would identify specific metabolic profiles that predict patient response to therapy and define elements of metabolic pathobiology in arthritis.

Methods

Bioactive lipids were measured in plasma from two cohorts of RA patients from the CorEvitas (formerly known as Corrona) CERTAIN registry (1) at baseline prior to treatment with TNF inhibitors (all biologic naïve, N=102) or anti-IL6 (all previously exposed to biologics, N=114). Response to treatment was categorized by minimal clinically important difference (MCID) in Clinical Disease Activity Index (CDAI) (2) at 6 months after treatment initiation. Patients had to have a 6 month follow up visit and plasma available at both the baseline and the f/u time points. Liquid chromatography (LC) system coupled with high resolution QExactive orbitrap mass spectrometer (LC/MS) was used for bioactive lipids profiling. Around 300 spectral features were identified as potential oxylipins by searching against an in-house MS/MS library. Logistic regression analyses adjusted for gender, age and BMI was perfomed using R software.

Results

102 patients (average age 54, standard deviation [SD] 12.6, 82% female [83], average BMI 29.7, SD 6.7, average CDAI 27.1, SD 13.7) starting anti-TNF therapy and 114 patients (average age 57, SD 13, 90% female [102], average BMI 30.5, SD 7.4, average CDAI 28.7, SD 13.8) starting tocilizumab were analyzed. Twenty-five bioactive metabolites discriminated between RA patients classified as anti-TNF responders (R, n = 74) and non-responders (NR, n = 28). Among these, the anti-inflammatory oxylipin maresin 2 was higher in R while the pro-inflammatory oxylipins 15d PGJ2 and 5,6-diHETE were higher in NR. Twenty different metabolites discriminated anti-IL6 R (n=73) and NR (n=41) as shown in Figure 1. The anti-inflammatory oxylipin 14-15EET was higher in R while the pro-inflammatory oxylipins 16-HETE and 5S-HpETE were higher in NR.

Figure 1.

Volcano plots visualizing baseline metabolites associated with responders vs. non responders in a) anti-TNF and b) anti IL-6 therapy groups. Results are derived from multivariate logistic regression analysis of baseline metabolites and response to treatment categorized by MCID. Data plotted as the metabolite against its statistical significance, respectively reported as odds ratio (OR) and -log10(pvalue).

Conclusion

Circulating bioactive lipid analysis using LC/MS provided a rapid analysis of a wide range of metabolites and can be used to describe metabolic signatures that predict response to therapies. These results lay the groundwork for more deliberate investigations novel metabolic-based interventions to predict response to therapy and reduce arthritis morbidity.

References

[1]Pappas DA, Kremer JM, Reed G, Greenberg JD, Curtis JR. Design characteristics of the CORRONA CERTAIN study: a comparative effectiveness study of biologic agents for rheumatoid arthritis patients. BMC Musculoskeletal Disord 2014; 15: 113

[2]Curtis JR, Yang S, Chen L, Pope JE, Keystone EC, Haraoui B, Boire G, Thorne JC, Tin D, Hitchon CA, Bingham CO 3rd, Bykerk VP. Determining the Minimally Important Difference in the Clinical Disease Activity Index for Improvement and Worsening in Early Rheumatoid Arthritis Patients. Arthritis Care Res (Hoboken). 2015 Oct;67(10):1345-53. doi: 10.1002/acr.22606. PMID: 25988705; PMCID: PMC4580563.

Disclosure of Interests

Mona Alotaibi: None declared, Roxana Coras: None declared, Dimitrios A Pappas Speakers bureau: Sanofi, Novartis, Paid instructor for: Novartis, Consultant of: Roche, Sanofi, Joel M Kremer Speakers bureau: Pfizer, Consultant of: BMS, Geoffrey Thiele: None declared, Ted Mikuls Consultant of: Pfizer, Gilead, BMS, Sanofi, Mohit Jain Employee of: Sapient Bio, Monica Guma Grant/research support from: Pfizer, Novartis.

Detection of Raillietina saudiae from the domestic pigeon in Saudi Arabia through 18S and 28S rDNA genes

Raillietina saudiae is a well-studied avian gastrointestinal parasite belonging to the family Davaineidae and is the most prevalent cyclophyllid tapeworm infecting pigeon in Saudi Arabia. The present study considered as a complementary analysis of Al-Quraishy et al. (2019; Parasitol Int 71, 59-72) with molecular studies for two ribosomal DNA genes employed for precise recognition of this Raillietina species. The annotated partial 18S and 28S rDNA gene regions were found to be 888 and 900 bp long that utilized further to elucidate their genetic relationships at species level using maximum likelihood method. The query sequence of R. saudiae is well aligned and placed within the Davaineidae family, with the same clade of all species of Raillietina that well separated from other cyclophyllidean cestodes especially taeniid and hymenolepid species. Sequence data recorded the monophyly of Raillietina species. The current phylogeny supports the usage of the partial 18S and 28S rDNA genes as reliable markers for phylogenetic reconstructions.

Electroactive Amphiphiles for Addressable Supramolecular Nanostructures

In this focus review we aim to highlight an exciting class of materials, electroactive amphiphiles (EAAs). This class of functional amphiphilic molecules has been the subject of sporadic investigations over the last few decades, but little attempt has been made to date to gather or organise these investigations into a logical fashion. Here we attempted to gather the most important contributions, provide a framework in which to discuss them, and, more importantly, point towards the areas where we believe these EAAs will contribute to solving wider scientific problems and open new opportunities. Our discussions cover materials based on low molecular weight ferrocenes, viologens and anilines, as well as examples of polymeric and supramolecular EAAs. With the advances of modern analytical techniques and new tools for modelling and understanding optoelectronic properties, we believe that this area of research is ready for further exploration and exploitation.

Membrane potential oscillations are not essential for spontaneous firing generation in L4 Aβ-afferent neurons after L5 spinal nerve axotomy and are not mediated by HCN channels

NEW FINDINGS

What is the central question of this study? Is spontaneous activity (SA) in L4 dorsal root ganglion (DRG) neurons induced by L5 spinal nerve axotomy associated with membrane potential oscillations in these neurons, and if so, are these membrane oscillations mediated by HCN channels? What is the main finding and its importance? Unlike injured L5 DRG neurons, which have been shown to be incapable of firing spontaneously without membrane potential oscillations, membrane potential oscillations are not essential for SA generation in conducting 'uninjured' L4 neurons, and they are not mediated by HCN channels. These findings suggest that the underlying cellular mechanisms of SA in injured and 'uninjured' DRG neurons induced by spinal nerve injury are distinct.

ABSTRACT

The underlying cellular and molecular mechanisms of peripheral neuropathic pain are not fully understood. However, preclinical studies using animal models suggest that this debilitating condition is driven partly by aberrant spontaneous activity (SA) in injured and uninjured dorsal root ganglion (DRG) neurons, and that SA in injured DRG neurons is triggered by subthreshold membrane potential oscillations (SMPOs). Here, using in vivo intracellular recording from control L4-DRG neurons, and ipsilateral L4-DRG neurons in female Wistar rats that had previously undergone L5 spinal nerve axotomy (SNA), we examined whether conducting 'uninjured' L4-DRG neurons in SNA rats exhibit SMPOs, and if so, whether such SMPOs are associated with SA in those L4 neurons, and whether they are mediated by hyperpolarization-activated cyclic nucleotide gated (HCN) channels. We found that 7 days after SNA: (a) none of the control A- or C-fibre DRG neurons showed SMPOs or SA, but 50%, 43% and 0% of spontaneously active cutaneous L4 Aβ-low threshold mechanoreceptors, Aβ-nociceptors and C-nociceptors exhibited SMPOs, respectively, in SNA rats with established neuropathic pain behaviors; (b) neither SMPOs nor SA in L4 Aβ-neurons was suppressed by blocking HCN channels with ZD7288 (10 mg kg^-1 , i.v.); and (c) there is a tendency for female rats to show greater pain hypersensitivity than male rats. These results suggest that SMPOs are linked to SA only in some of the conducting L4 Aβ-neurons, that such oscillations are not a prerequisite for SA generation in those L4 A- or C-fibre neurons, and that HCN channels are not involved in their electrogenesis.

Expanding the phenotype of SLC25A42-associated mitochondrial encephalomyopathy

SLC25A42 gene encodes an inner mitochondrial membrane protein that imports Coenzyme A into the mitochondrial matrix. A mutation in this gene was recently reported in a subject born to consanguineous parents who presented with mitochondrial myopathy with muscle weakness and lactic acidosis. In this report, we present 12 additional individuals with the same founder mutation who presented with variable manifestations ranging from asymptomatic lactic acidosis to a severe phenotype characterized by developmental regression and epilepsy. Our report confirms the link between SLC25A42 and mitochondrial disease in humans, and suggests that pathogenic variants in SLC25A42 should be interpreted with the understanding that the associated phenotype may be highly variable.

Robot-assisted surgical approach to bladder cancer: a decade of progress!

Robot-assisted radical cystectomy (RARC) has gained popularity and proven its efficacy, safety and reproducibility in the last decade. RARC has resulted in less blood loss, enhanced recovery, and shorter hospital stay. RARC has proven to have similar or better postoperative morbidity, mortality and equal oncologic, outcomes. Limiting factors to the acceptance of this surgical approach have included its steep learning curve and the lack of both long-term outcome data. This article systematically reviews the literature comparing the outcomes for RARC (comparisons with open radical cystectomy when performed at the same institution) with a focus on operative, complications, oncologic, functional and survival outcomes.

Factors affecting nurses? decisions to join their professional association

BACKGROUND

Many nursing associations in the world are facing difficulties in increasing nurses' membership. Many researchers have identified possible causes for this decline.

AIM

To explore factors that influence nurses' decision to join or not to join the Kuwait Nursing Association (KNA).

METHODS

A Professional Association Membership Questionnaire (PAMQ) developed by Yeager (1981) was used. A short demographic questionnaire and two open-ended questions developed by the researcher were added at the end of the questionnaire to gather the data sought in this study. The participants were 40 nurses who are current members of KNA and 100 nurses who had been members of KNA in the past and did not renew their membership in 2005.

RESULTS

This study showed that all 29 reported benefits were not very important to both groups. However, nine benefits strongly influenced the current members' decisions to join KNA, namely social activities, relief from boredom, fun, travel, improvement of health care, Something new, friendship, group benefit plans and peer group contact. The former members valued five benefits, namely education, programmes, support, professionalism and self-improvement.

CONCLUSION

Current and former members differ in their reasons to join or not to join the KNA. All the benefits provided by an association may not necessarily attract members and the philosophical differences between them are one of the reasons not join an association.

A centrifugation-based method for extraction of norovirus from raspberries

A method was developed for extraction of noroviruses from raspberries. The method consists of removal of virus from fruit surfaces by alkaline extraction, then removal of residual food debris by centrifugation, followed by concentration of virus particles by ultracentrifugation. The efficiency of the extraction was estimated by comparison of reverse transcription PCR signals obtained from fruit extracts and the norovirus suspension that was used to contaminate the fruit. Noroviruses were recovered with at least 10% efficiency from 60-g raspberry samples (n = 10). The sample treatment reported here should be applicable for harnessing to any norovirus reverse transcription PCR and form the basis of a dependable method to detect noroviruses in raspberries.