Expansion of endogenous T cells in CSF of pediatric CNS tumor patients undergoing locoregional delivery of IL13R〿2-targeting CAR T cells: an interim analysis

Outcomes for pediatric brain tumor patients remain poor, and there is optimism that chimeric antigen receptor (CAR) T cell therapy can improve prognosis. Here, we present interim results from the first six pediatric patients treated on an ongoing phase I clinical trial (NCT04510051) of IL13BBζ-CAR T cells delivered weekly into the lateral cerebral ventricles, identifying clonal expansion of endogenous CAR-negative CD8+ T cells in the cerebrospinal fluid (CSF) over time. Additionally, of the five patients evaluable for disease response, three experienced transient radiographic and/or clinical benefit not meeting protocol criteria for response. The first three patients received CAR T cells alone; later patients received lymphodepletion before the first infusion. There were no dose limiting toxicities (DLTs). Aside from expected cytopenias in patients receiving lymphodepletion, serious adverse events possibly attributed to CAR T cell infusion were limited to one episode of headache and one of liver enzyme elevation. One patient withdrew from treatment during the DLT period due to a Grade 3 catheter-related infection and was not evaluable for disease response, although this was not attributed to CAR T cell infusion. Importantly, scRNA- and scTCR-sequence analyses provided insights into CAR T cell interaction with the endogenous immune system. In particular, clonally expanded endogenous CAR- T cells were recovered from the CSF, but not the peripheral blood, of patients who received intraventricular IL13BBζ-CAR T cell therapy. Additionally, although immune infiltrates in CSF and post-therapy tumor did not generally correlate, a fraction of expanded T cell receptors (TCRs) was seen to overlap between CSF and tumor. This has important implications for what samples are collected on these trials and how they are analyzed. These initial findings provide support for continued investigation into locoregionally-delivered IL13BBζ-CAR T cells for children with brain tumors.

OP0004 AUTOMATED RECOGNITION AND MONITORING OF DORSAL SKIN FOLDS BY A CONVOLUTIONAL NEURAL NETWORK AS A POTENTIAL DIGITAL BIOMARKER FOR JOINT SWELLING IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background

To monitor rheumatic diseases, digital biomarkers such as wearables are of increasing interest, but they lack disease specificity.

Objectives

In this study, we apply convolution neural networks (CNN) to real world hand photographs in order to automatically detect, extract and analyse dorsal finger folds lines as a correlate of proximal interphalangeal (PIP) joint swelling in patients with rheumatoid arthritis (RA).

Methods

Hand photographs from 190 RA patients were taken by a smartphone camera in a standardized manner. PIP joints were categorised as either swollen or not swollen based on clinical judgement and ultrasound. Images were automatically preprocessed by cropping PIP joints and extracting dorsal finger folds. Subsequently, metrical analysis of dorsal finger folds was performed and a CNN was trained to classify the dorsal finger lines into swollen versus non-swollen joints. Representative horizontal finger folds were also quantified in a subset of patients before and after resolution of PIP swelling and in patients with disease flares, respectively.

Results

In swollen joints, the number of automatically extracted double-contoured, deep skinfold imprints was significantly reduced compared to non-swollen joints (1.3, SD 0.8 vs. 3.3, SD 0.49). The joint diameter / deep skinfold ratio was significantly higher in swollen (4.1, SD 1.4) versus non-swollen joints (2.1 SD 0.6). The CNN model successfully differentiated swollen from non-swollen joints based on finger fold patterns with a validation accuracy of 0.84. A heatmap of the original images obtained by an extraction algorithm confirmed finger folds as the region of interest for correct classification. After significant response to DMARD +/- corticosteroid therapy, longitudinal metrical analysis of eight representative deep finger folds showed a decrease of the mean diameter/ finger fold length (finger fold index, FFl) from 3.03 (SD 0.68) to 2.08 (SD 0.57). Conversely, the FFI increased in patients with a flare of joint swelling.

Conclusion

Automated preprocessing and the application of CNN algorithms in combination with longitudinal metrical analysis of dorsal finger fold patterns extracted from real world hand photos might serve as a digital biomarker in RA.

Figure 1.

Automated finger fold recognition to monitor rheumatoid arthritis (RA). Hand photographs are taken by a smartphone (A). Hands, and subsequently proximal interphalangeal (PIP) joints, are automatically recognized and extracted. Finger fold lines are isolated from the images, measured and related to the joint diameter (B,C). A convolutional deep neural network was used to train a model for classification of extracted finger fold patterns into swollen vs. non swollen joints (D). On cropped PIP joint images, the heatmap of the same classification task confirms finger folds as the region of interest (E).

Disclosure of Interests

Thomas Hügle Shareholder of: Atreon SA., Speakers bureau: Multiple. Not relevant for this work., Grant/research support from: Multiple. Not for this work., Leo Caratsch: None declared, Matteo Matteo Caorsi Employee of: MC is an employee of L2F., Jules Maglione: None declared, Diana Dan: None declared, Alexandre Dumusc Speakers bureau: Multiple. Not relevant for this work., Marc Blanchard Shareholder of: Atreon SA., Gabriel Kalweit: None declared, Maria Kalweit: None declared.

OP0199 EX VIVO BIOMARKER PROFILING IDENTIFIES ONCOSTATIN-M AS SPINE OSTEOARTHRITIS-SPECIFIC OSTEOIMMUNOLOGICAL TARGET

Background:

Disease heterogeneity, both clinically and molecularly, has been a major hurdle in the development of efficacious disease-modifying osteoarthritis drugs (DMOADs). Biomechanical, inflammatory, osteoporotic and metabolic OA have been proposed as clinically relevant subtypes for stratification of knee OA patients, yet this remains to be included in clinical trial design. Disease heterogeneity does not only occur within, but also between joint types. However, robust data on joint-specific pathomechanisms of OA are still lacking.

Objectives:

In this study, we performed ex vivo biomarker profiling of human osteochondral tissue of knee and spine OA to identify joint-specific pathomechanisms and DMOAD treatment responses.

Methods:

Facet joint and tibial plateaus were obtained from patients undergoing lumbar spinal fusion (n=11, mean age 72.8) and total joint arthroplasty (n=8, mean age 73.0) respectively. Osteochondral specimens were cut in equal-sized samples (100-300 mg wet weight) and randomly assigned to treatment groups: control (DMSO), inflammation (1 μg/mL LPS) or inflammation + DMOAD (TGF-beta

type I receptor inhibitor,10 μM SB-505124). Explant culture was conducted for one week and biomarkers of bone metabolism (Pro-Col-Ia, SOST, OPG, SPP1), inflammation (MCP-1, IL-6, MMP3, OSM, TIMP1, VEGFA) and cartilage metabolism (ACAN, COMP) were determined by ELISA. Normalized biomarker secretion was analysed using clusteranalyses and ANOVA. Cartilage proteoglycans were assessed by whole mount Alcian blue staining. Expression of Oncostatin-M (OSM) and its receptors OSMR and LIFR in joint tissues was assessed by RT-PCR and immunohistochemistry.

Results:

Clusteranalyses revealed that LPS stimulation increased IL-6 and MCP-1 secretion by both facet joint (FJ) and knee joint (KJ) tissues. Interestingly, Oncostatin-M (OSM) and its downstream mediators MMP3 and TIMP1 were increased in the majority of FJ, but not KJ specimens. Statistical analyses corroborated increased OSM, MMP3 and TIMP1 levels in a spine-specific fashion (Figure).

Whole mount Alcian blue staining revealed heterogeneous effects of LPS treatment on cartilage proteoglycans, which was negatively correlated with OSM (r=-0.54) and TIMP1 levels (r=-0.45) – yet poorly associated with ACAN (r=0.19). Inhibition of TGF-beta type I receptor signalling in osteochondral tissues led to a drastic reduction of Pro-Collagen-Ia and IL-6 secretion in both spine and knee OA specimens. Interestingly, DMOAD treatment significantly reduced OSM, TIMP1 and MMP3 levels in FJ specimens only. Vice versa, KJ tissues revealed a specific upregulation of monocyte chemoattractant protein-1 (MCP-1) and osteopontin (SPP1) upon inhibition of TGF-beta signalling. OSM was exclusively expressed in subchondral bone marrow macrophages. Isolated chondrocytes and osteoblasts expressed both LIFR and OSMR, yet intact cartilage only showed OSMR expression, while OSMR and LIFR was expressed in marrow tissue

Conclusion:

Oncostatin-M expression and signalling was uncovered as specific pathomechanism of spine OA. DMOAD treatment effects suggested interplay of OSM and TGF-beta signalling pathways in facet joint osteoarthritis. Known to be predominantly expressed by macrophages and immune cells, OSM may be an important osteoimmunological mediator of tissue damage and remodelling in spine, but not knee OA. This study also highlights the value of ex vivo human tissue models for OA phenotyping and preclinical evaluation of DMOADs.

Disclosure of Interests:

None declared

Outcome for bilateral cochlear implantation in patients with congenital Cytomegalovirus infection

OBJECTIVES

To analyze the impact of bilateral cochlear implantation (CI) on perceptual and linguistic development in hearing-impaired children with congenital Cytomegalovirus (CMV) infection.

PATIENTS AND METHOD

A retrospective study was performed for the period 1991-2016 in a pediatric CI reference center. Closed Set Word (CSW) recognition scores, Categories of Auditory Performance (CAP) and linguistic level on the MT Lenormand scale (MTL) were compared between bilateral (Bi) and unilateral (Uni) groups 12, 24 and 36 months after first CI (CI-1).

RESULTS

84 patients with congenital CMV infection who underwent CI were included, in 2 groups: sequential or simultaneous bilateral CI (Bi) (N=20), and unilateral CI (Uni) (N=64). Twelve, 24 and 36 months after CI-1, CSW scores were 35.56%, 64.52% and 82.93% in Uni and 60.3%, 85% (P=0.0084*), and 100% (P=0.00085*) in Bi. CAP scores 12, 24 and 36 months after CI-1 were 2.57, 3.85 and 4.3 in Uni and 3.91 (P=0.0068*), 5.00 (p=0.029*) and 5.50 (P=0.051*) in Bi. MTL linguistic level scores at 12, 24 and 36 months were 0.72, 1.25 and 1.65 in Uni, and 1.72, 3 (P=0.033) and 3.11 (P=0.045) in Bi. These significantly better scores in Bi at 24 and 36 months after CI-1 were also found on analysis of subgroups with no associated neurologic disorder (P=0.046* and P=0.032*), no associated psychiatric pathology (P=0.0055* and P=0.0073*), and no other associated disorder (P=0.0018* and P=0.035*), and for all subgroups together (P=0.0036 and P=0.037).

CONCLUSION

Bilateral CI is a faster way than unilateral CI for patients with congenital CMV infection to achieve structured fluent oral language. 50% of the series showed cerebral abnormalities on MRI, without difference between groups. This was not in itself predictive of poor progression of oral communication, unless associated with major neurologic disorder. Some children made little or no use of their CI in the medium term.

The atypical Rho GTPase Rnd2 is critical for dentate granule neuron development and anxiety-like behavior during adult but not neonatal neurogenesis

Despite the central role of Rho GTPases in neuronal development, their functions in adult hippocampal neurogenesis remain poorly explored. Here, by using a retrovirus-based loss-of-function approach in vivo, we show that the atypical Rho GTPase Rnd2 is crucial for survival, positioning, somatodendritic morphogenesis, and functional maturation of adult-born dentate granule neurons. Interestingly, most of these functions are specific to granule neurons generated during adulthood since the deletion of Rnd2 in neonatally-born granule neurons only affects dendritogenesis. In addition, suppression of Rnd2 in adult-born dentate granule neurons increases anxiety-like behavior whereas its deletion in pups has no such effect, a finding supporting the adult neurogenesis hypothesis of anxiety disorders. Thus, our results are in line with the view that adult neurogenesis is not a simple continuation of earlier processes from development, and establish a causal relationship between Rnd2 expression and anxiety.

FC16-04 - The clinical effectiveness of individual cognitive behaviour therapy for depressed older people in primary care and the use of a talking control (TC)

Objective

To determine the clinical effectiveness of Cognitive Behaviour Therapy (CBT) delivered in primary care for older people with depression and evaluation of a talking control (TC).

Methods

A single-blind, randomized, controlled trial with 4- and 10-month follow-up. 204 people, aged 65 years or more, with a Geriatric Mental State diagnosis of depression were recruited from primary care. The interventions were: treatment as usual (TAU), TAU plus TC, or TAU plus CBT. The TC and CBT were offered over 4 months. The TC was to control for common effects in therapy. The Beck Depression Inventory-II (BDI-II) was the main outcome. Subsidiary measures were the Beck Anxiety Inventory, Social Functioning Questionnaire, and Euroqol. Intention to treat analysis (ITT) and Compliance Average Causal Effect (CACE) analyses was employed. The Cognitive therapy scale (CTS) evaluated common and specific factors in therapy.

Results

A mean of 7 sessions of TC or CBT were delivered. ITT analysis found improvements of −3.07 (95% confidence interval [CI], −5.73 to −0.42) and −3.65 (95% CI, −6.18 to −1.12) in BDI-II scores in favour of CBT vs TAU and TC respectively. CACE analysis found a benefit of 0.4 points (95% CI, 0.01 to 0.72) per therapy session of CBT over TC. Ratings for CBT on the CTS were high (mean [SD], 54.2 [4.1]) and showed no difference for nonspecific, but significant differences for specific factors in therapy.

Conclusion

CBT is an effective treatment for depressed older people. Improvement appears to be associated with specific factors in CBT.

Paroxysmal strabismus and stridor acquired in childhood: Do not overlook calcemia!

Hypocalcemia is known to induce stridor but was rarely reported to cause strabismus. We report the case of a 4-year-old girl who presented with paroxysmal stridor and strabismus with diplopia, persisting for several weeks. Severe hypocalcemia (1.25 mmol/L) was finally diagnosed and was related to hypoparathyroidism, which was the first manifestation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in this patient. Strabismus and stridor both resolved after normalization of calcemia. This case report is a rare observation of paroxysmal strabismus caused by hypocalcemia and it highlights the importance of calcium monitoring in any situation of atypical neurological symptoms.

Pediatric cochlear reimplantation: Decision-tree efficacy

OBJECTIVES

The context leading to pediatric cochlear reimplantation (CreI) can be complex. The objectives of this study were to define initial CreI indications, analyze final diagnosis and draw up a decision-tree.

METHODS

A retrospective study included patients undergoing CreI between 2005 and 2015. Demographic characteristics, CreI circumstances and technical reports were collected. Circumstances indicating CreI were classified in 3 groups: performance decrement, suspected device failure, or medical. After CreI, final diagnoses were classified in 2 groups: confirmed failure (DFail) or medical (DMed).

RESULTS

69 out of 734 cochlear implantation surgeries were for CreI (8%). Manufacturers' reports were available in 64 cases (93%). Two principal causes were found: trauma and infection. Initial indications were: performance decrement: 27%; device failure: 56%; and medical: 17%. Final diagnoses were: DFail: 72%; and DMed: 28%. Initial indication and final diagnosis were similar in 86% of cases. The majority of the 14% initial indication errors belonged to the "performance decrement" group. Traumatic causes correlated with risk of initial indication error (P=0.039).

CONCLUSION

Apart from spontaneous device failure, the two causes of CreI were infection and trauma. Using the present decision algorithm, half of the complex cases were resolved after CreI.

Measurement and comparison of individual external doses of high-school students living in Japan, France, Poland and Belarus-the 'D-shuttle' project

Twelve high schools in Japan (of which six are in Fukushima Prefecture), four in France, eight in Poland and two in Belarus cooperated in the measurement and comparison of individual external doses in 2014. In total 216 high-school students and teachers participated in the study. Each participant wore an electronic personal dosimeter 'D-shuttle' for two weeks, and kept a journal of his/her whereabouts and activities. The distributions of annual external doses estimated for each region overlap with each other, demonstrating that the personal external individual doses in locations where residence is currently allowed in Fukushima Prefecture and in Belarus are well within the range of estimated annual doses due to the terrestrial background radiation level of other regions/countries.

[Recurrent laryngeal papillomatosis complicated by decompensated respiratory failure in two children]

Laryngeal papillomatosis is a rare, potentially severe cause of recurrent laryngeal dyspnea. It should be known as a cause of laryngeal dyspnea resistant to the usual treatments. We report on two pediatric cases of severe laryngeal papillomatosis with respiratory distress and failure. These observations illustrate the importance of early adequate treatment.

Determination of phthalates and their by-products in tissues of roach (Rutilus rutilus) from the Orge river (France)

Seven phthalate by-products were investigated for the first time, in target tissues of roach from a contaminated river of the Ile-de-France district. All parent phthalates were bioaccumulated in liver and muscle and liver contents were correlated with river concentrations (p < 0.01). All metabolites were found in liver, plasma and bile. The mono-iso-butyl phthalate (MiBP; 1.6 μg g(-1) dw of liver), followed by mono-n-butyl phthalate (MnBP; 1.5 μg g(-1) dw of liver) were the most abundant ones. Among the three metabolites of di-ethylhexyl phthalate (DEHP), mono (2-ethylhexyl) phthalate (MEHP) predominated in bile (15.5 ng ml(-1)) and liver (0.237 μg g(-1) dw), whereas in plasma, it was mono (2-ethyl-5-hydroxyhexyl) phthalate - MEHHP (214 ng ml(-1)). In liver, MEHP/DEHP ratios ranged from 0.04 to 0.2. Among the oxidized metabolites, only mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) was correlated (p < 0.05) with parent DEHP and appeared to be a more reliable marker of DEHP impact than the monoester.

Atypical failure after cochlear implantation in children

We report a case of intermittent dysfunction in a 10-years-old boy, implanted with MedEL(®) cochlear implant. Few weeks after the surgery the boy described short and intermittent episodes of implant dysfunction with rapid return to a normal function. No evidence for any electric or neural dysfunction was found. After few weeks, a clinical link was discovered to episodes of sneeze or nose blowing. Clinical and surgical implications are discussed.

Resting-state connectivity deficits associated with impaired inhibitory control in non-treatment-seeking adolescents with psychotic symptoms

OBJECTIVE

Psychotic symptoms are common in the population and index risk for a range of severe psychopathological outcomes. We wished to investigate functional connectivity in a community sample of adolescents who reported psychotic symptoms (the extended psychosis phenotype).

METHOD

This study investigated intrinsic functional connectivity (iFC) during resting-state functional magnetic resonance imaging (fMRI; rs-fMRI). Following screening in schools, 11 non-treatment seeking, youth with psychotic symptoms (aged 11-13) and 14 community controls participated in the study. Seed regions of interest comprised brain regions previously shown to exhibit aberrant activation during inhibitory control in adolescents with psychotic symptoms.

RESULTS

Relative to controls, adolescents with psychotic symptoms exhibited reduced iFC between regions supporting inhibitory control. Specifically, they showed weaker iFC between the right inferior frontal gyrus (IFG) and the cingulate, IFG and the striatum, anterior cingulate and claustrum, and precuneus and supramarginal gyrus. Conversely, the psychotic symptoms group exhibited stronger iFC between the superior frontal gyrus and claustrum and IFG and lingual gyrus.

CONCLUSION

The present findings are the first to reveal aberrant functional connectivity in resting-state networks in a community sample of adolescents with psychotic symptoms and suggest that disruption in integration between distributed neural networks (particularly between prefrontal, cingulate and striatal brain regions) may be a key neurobiological feature of the extended psychosis phenotype.

Occupational engagement among community dwelling older people: A time-geographic perspective†

How older people spend their time in different occupations could contribute to our understanding of everyday life in healthy ageing. This study adopted a time-geographic method and occupational perspective to explore the occupational engagement of community dwelling older people. The term occupational engagement encompasses what people do, where and with whom they spend their time and the perceived level of competence and meaningfulness of their time use. Nineteen volunteers born between 1932 and 1933, living alone in an urban area in northern Sweden and receiving no home care services, completed open time-geographic diaries for 5 days in May 2010. The diary data were analyzed using Daily Life software program. The study revealed the complexity and the diversity of the older people's occupational engagement and that most of their time was spent alone in their home. The older people reported they were very good at doing almost half of the occupations in which they engaged and that their occupations were primarily either very meaningful or meaningful. While some methodological limitations were identified, time-geographic studies of community dwelling older people living independently are considered to have potential to contribute to community and social planning for older people as they can provide interesting insights to older persons' time use and occupational needs.

[Genetic aspects of congenital sensorineural hearing loss]

Hearing loss is the most common sensory disability with an incidence of one over 1000 newborns. Hearing loss may be caused by environmental and genetic factors; inherited causes are assumed in two thirds of cases. There is a great clinical and genetic heterogenicity. All inheritance modes have been described. Mutations in the GJB2 gene, which encodes connexin 26, are mainly responsible for sensorineural deafness resulting in prelingual non syndromic autosomal recessive phenotypes DFNB1. The 35 delG mutation of this gene is very frequent (70% of the cases). Thus, 35 delG is, with the delta F508 mutation of the CFTR gene, the most frequent human pathogenic mutation known. Hearing loss might also be associated with other clinical features. Some of these syndromes, including hearing loss, have to be looked for systematically because of their frequency, of their possible clinical presentation as an isolated hearing loss and of the possibility of a medical treatment.

Sperm morphology assessment using David's classification: time to switch to strict criteria? Prospective comparative analysis in a selected IVF population

The aim of this study was to compare assessment of sperm morphology by using David's classification (DC), a method of manual analysis most common in France, with a computer-assisted method (Integrated Visual Optical System) based on the strict criteria (CASA SC) for their ability to predict fertilization in a selected in vitro fertilization (IVF) population. A total of 120 couples engaged in IVF protocols were prospectively included in the study. To focus mainly on sperm morphology, couples were excluded in cases of abnormalities of sperm concentration and/or motility and immunological factors and when a low number of oocytes were collected. Sperm morphology analysis was performed on the day of oocyte retrieval by the same trained biologist. Our results showed a moderate correlation between the two techniques (r = 0.49). The DC sperm morphology analysis was less indicative of fertilization than CASA SC (r = 0.07, p = 0.47 vs. r = 0.22, p = 0.014). Using receiver-operating characteristics analysis, we showed that DC was not discriminating in the prediction of fertilization (AUC = 0.572). DC seemed less appropriate for the prediction of fertilization success or failure. In contrast, with CASA SC, the previously determined cut-off value of around 14% was confirmed (AUC = 0.735, cut-off = 6%). Our results argue in favour of the replacement of DC by SC to tend towards worldwide standardization.

Abusive behaviour experienced by family carers from people with dementia: the CARD (caring for relatives with dementia) study

BACKGROUND

The authors report the first study of abusive behaviour by people with dementia towards their family carers. The authors hypothesised that while abusive behaviour would be associated with the carer reporting a less rewarding relationship, this could be mediated by the carer's coping style.

METHODS

The authors interviewed 220 consecutively referred family dementia carers from five UK Community Mental Health Teams, using the revised Modified Conflict Tactics Scale to measure abuse, and the Relationship Rewards Scale.

RESULTS

82 (37.3%) carers reported abuse from the care recipient 'at least sometimes' over the last 3 months. 80 (36.4%) reported psychologically, and 13 (5.9%) physically abusive behaviour. On average, current carer relationship rewards had decreased from premorbid levels (mean difference -1.5 (95% CI 1.8 to 1.2); p<0.001). The association between higher abuse score and lower current relationship rewards was mediated by dysfunctional coping use. In our final model, current relationship rewards were predicted by reporting a better past relationship (beta=0.66 (95% CI 0.55 to 0.77)), less abuse from the care recipient (beta=-0.39 (-0.65 to -0.13)) and fewer dysfunctional coping strategies (beta=-0.98 (-1.50 to-0.46)).

CONCLUSION

Over a third of family carers reported significant abuse from the people they cared for. Carers who reported more abuse also reported a greater deterioration in their relationship with the person with dementia. The extent to which carers used dysfunctional coping strategies partially explained this, suggesting that interventions to change the carers' coping styles might alleviate the impact of abusive behaviour.

Short-term associations between fine and coarse particles and hospital admissions for cardiorespiratory diseases in six French cities

OBJECTIVES

Little is known about the potential health effects of the coarse fraction of ambient particles. The aim of this study is to estimate the links between fine (PM(2.5)) and coarse particle (PM(2.5-10)) levels and cardiorespiratory hospitalisations in six French cities during 2000-2003.

METHODS

Data on the daily numbers of hospitalisations for respiratory, cardiovascular, cardiac and ischaemic heart diseases were collected. Associations between exposure indicators and hospitalisations were estimated in each city using a Poisson regression model, controlling for confounding factors (seasons, days of the week, holidays, influenza epidemics, pollen counts, temperature) and temporal trends. City-specific findings were combined to obtain excess relative risks (ERRs) associated with a 10 mug/m(3) increase in PM(2.5) and PM(2.5-10 )levels.

RESULTS

We found positive associations between indicators of particulate pollution and hospitalisations for respiratory infection, with an ERR of 4.4% (95% CI 0.9 to 8.0) for PM(2.5-10 )and 2.5% (95% CI 0.1 to 4.8) for PM(2.5). Concerning respiratory diseases, no association was observed with PM(2.5), whereas positive trends were found with PM(2.5-10), with a significant association for the 0-14-year-old age group (ERR 6.2%, 95% CI 0.4 to 12.3). Concerning cardiovascular diseases, positive associations were observed between PM(2.5) levels and each indicator, although some did not reach significance; trends with PM(2.5-10 )were weaker and non-significant except for ischaemic heart disease in the elderly (ERR 6.4%, 95% CI 1.6 to 11.4).

CONCLUSIONS

In accordance with other studies, our results indicate that the coarse fraction may have a stronger effect than the fine fraction on some morbidity endpoints, especially respiratory diseases.

Persistent toxic substance inputs to the river Seine basin (France) via atmospheric deposition and urban sludge application

Paris constitutes a major direct and indirect source of persistent toxic substances (PTS) to the river Seine, its tributaries and its basin, by atmospheric depositions and sewage sludge land-filling. The contaminant cycle and transfer pathways were investigated from 1999 to 2003 at local and inter regional scales in order to determine the respective importance of the main input and diffusion processes (wastewater, rainwater and runoff) from urban to rural areas. Paris constitutes an atmospheric emission hot spot for PAHs and PCBs. For example, for 2002, atmospheric concentrations ranged from 0.5 to 3 ng m(-3) for PAHs (Sigma 6 WHO) and from 0.06 to 0.69 ng m(-3) for PCBs (Sigma 7, EEC) and concentrations in bulk deposition ranged from 6.6 to 647 ng L(-1) for PAHs (Sigma 14) and from 0.6 to 8.1 ng L(-1) for PCBs. At Paris, annual atmospheric deposition inputs of PAHs (Sigma 6) and PCBs (Sigma 7) reached 104 g km(-2) and 35 g km(-2), respectively. PAHs followed a marked seasonal cycle in relation with winter domestic heating and bulk deposition concentrations were 5 to 15 times lower in remote areas. No seasonal cycle was observed for PCBs which varied little according to the area considered. PCB deposition fluxes were ruled by the rainfall amount, while for PAHs, the fluxes depended on local anthropogenic characteristics. At the scale of the Seine-Aval treatment plant comparison of annual inputs of PTS in wet period indicated that PCBs essentially come from atmospheric sources whereas PAHs are derived from both atmospheric and urban runoff sources. At the scale of the sub-basin, atmospheric inputs to the soil (Sigma 3 PAHs: 14-25 g km(-2), Sigma 7 PCBs: 5.6-25 g km(-2)) represent the prevailing source for PAHs and PCBs, as compared to that from the disposal of urban sludge on agricultural plots (Sigma 3 PAHs: 3-8 g km(-2), Sigma 7 PCBs: 0.5-2 g km(-2)).

Evolution of sensory complexity recorded in a myxobacterial genome

Myxobacteria are single-celled, but social, eubacterial predators. Upon starvation they build multicellular fruiting bodies using a developmental program that progressively changes the pattern of cell movement and the repertoire of genes expressed. Development terminates with spore differentiation and is coordinated by both diffusible and cell-bound signals. The growth and development of Myxococcus xanthus is regulated by the integration of multiple signals from outside the cells with physiological signals from within. A collection of M. xanthus cells behaves, in many respects, like a multicellular organism. For these reasons M. xanthus offers unparalleled access to a regulatory network that controls development and that organizes cell movement on surfaces. The genome of M. xanthus is large (9.14 Mb), considerably larger than the other sequenced delta-proteobacteria. We suggest that gene duplication and divergence were major contributors to genomic expansion from its progenitor. More than 1,500 duplications specific to the myxobacterial lineage were identified, representing >15% of the total genes. Genes were not duplicated at random; rather, genes for cell-cell signaling, small molecule sensing, and integrative transcription control were amplified selectively. Families of genes encoding the production of secondary metabolites are overrepresented in the genome but may have been received by horizontal gene transfer and are likely to be important for predation.

Atmospheric fate of phthalate esters in an urban area (Paris-France)

The atmospheric fate of six phthalate esters was investigated in the urban area of Paris (France). Total atmospheric levels (ng m-3) were as follows: DMP, 0.5; DEP, 10.7; DnBP, 22.2; BBP, 4.6; DEHP, 18.9; and DnOP, 0.5 ng m-3, showing a predominance of DnBP and next, DEHP. They are mainly present in the vapour phase, from 93.8% to 64.9%, particularly for the esters with alkyl chain length of less than six C. An inverse correlation was found between the vapour phase concentrations and the molecular weight and also a direct correlation between the vapour phase concentrations and the log [vapour pressure] of the compounds. Seasonal variations were displayed by principal component analysis (PCA), due to significant correlation between phthalate concentrations and air temperature. Rain water concentrations (ng L-1) were as follows: DMP, 116; DEP, 333; DnBP, 592; BBP, 81; DEHP, 423; and DnOP, 10. PCA analysis showed a seasonal variation of these concentrations correlated to the air temperature. The experimental water/air scavenging ratio was calculated and was in accordance with the theoretical one obtained from the vapour pressure and the Henry's law constant for each phthalate ester. The global trend was a decrease of the washout coefficient in relation with the rise of alkyl chain length. Yearly balances for rainwater and bulk deposition allowed the estimation of dry deposits that represented about half of total. Our findings highlight the major part played by particles in atmospheric deposition processes.

Immunological response to long-term transport stress in mature horses and effects of adaptogenic dietary supplementation as an immunomodulator

REASONS FOR PERFORMING STUDY

Little information exists on the immunological effects of transport or the use of supplements to minimise transport stress.

OBJECTIVES

To establish baseline ranges and evaluate immunophenotypic and functional changes associated with transport and a nutritional 'adaptogen' supplement.

METHODS

Horses received either supplement (n = 10) or placebos (n = 9) during the 30 day study. After 28 days in stalls, 12 horses (6 supplement; 6 placebo) were transported for 24 h, then unloaded and recovered. Venous blood samples were collected on Days 1, 14 and 28 to establish baselines, and on Days 28, 29 and 30 to examine changes during transport and recovery.

RESULTS

Transport prompted elevations (P<0.05) in cortisol concentration, neutrophil count and white blood cell counts, while lymphocyte subpopulation counts (CD3+, CD4+, CD8+, CD21+) decreased (P<0.05). Normal phenotypic lymphocyte profiles returned within 24 h of recovery. Supplement effects on immunophenotype (CD21+ and CD8+) were observed in stabled horses (P<0.05), but not in transported horses.

CONCLUSIONS

These results provide insights into the immunological mechanisms associated with long-term transport.

POTENTIAL RELEVANCE

The existence of a small window of immunological uncertainty follows long-term transportation, enhancing the potential risk of infectious disease in susceptible individuals.

Virulence and antibiotic susceptibility of Staphylococcus aureus strains isolated from various origins

We looked for links between the antibiotic susceptibility pattern of Staphylococcus aureus strains, their source and their virulence genes. Forty-four methicillin-sensitive and -resistant S. aureus strains from four antibiogroups were studied by SmaI macrorestriction and PCR detection of ea, eb, tst, lukS-PV and lukF-PV. Genes encoding virulence factors were most prevalent (i) in S. aureus strains originated from skin, (ii) in methicillin-sensitive, quinolone-resistant strains or in methicillin-sensitive multiresistant strains (EMSSA strains), and (iii) in strains with decreased susceptibility or resistance to fusidic acid. This is consistent with the hypothesis that S. aureus antibiotic resistance promoted by local antibiotic treatment also contributes to the emergence of virulence strains.

Clinical and laboratory assessment of distal peripheral nerves in Gulf War veterans and spouses

BACKGROUND

The prevalence of symptoms suggesting distal symmetric polyneuropathy (DSP) was reported to be higher among deployed veterans (DV) to the Persian Gulf in 1990-1991 than to control non-deployed veterans (NDV). The authors therefore compared the prevalence of DSP by direct examination of DV and their spouses to control NDV and spouses.

METHODS

The authors performed standardized neurologic examinations on 1,061 DV and 1,128 NDV selected from a cohort of veterans who previously participated in a national mail and telephone survey. Presence of DSP was evaluated by history, physical examination, and standardized electrophysiologic assessment of motor and sensory nerves. Similar examinations were performed without electrophysiologic tests in 484 DV spouses and 533 NDV spouses. Statistical analyses were performed with appropriate adjustments for the stratified sampling scheme.

RESULTS

No differences between adjusted population prevalence of DSP in DV and NDV were found by electrophysiology (3.7% vs 6.3%, p = 0.07), by neurologic examination (3.1% vs 2.6%, p = 0.60), or by the methods combined (6.3% vs 7.3%, p = 0.47). Excluding veterans with non-military service related diseases that may cause DSP did not alter outcomes. DV potentially exposed to neurotoxins from the Khamisiyah ammunition depot explosion did not significantly differ in DSP prevalence compared to non-exposed DV. The prevalence of DSP in DV spouses did not differ from NDV spouses (2.7% vs 3.2%, p = 0.64).

CONCLUSIONS

Neither veterans deployed during the Gulf War era nor their spouses had a higher prevalence of DSP compared to NDV and spouses.

Polycyclic aromatic hydrocarbons and polychlorobiphenyls in wastewaters and sewage sludges from the Paris area (France)

Polycyclic aromatic hydrocarbons (PAHs) and polychlorobiphenyls (PCBs) were investigated during 1999-2000 in the sewerage system to the Seine Aval treatment plant which drains the Paris area (France). Contamination of sludges from storage chambers indicated a local origin typical of motor car traffic with PAH concentrations (Sigma16) ranging from 14 to 31 mg kg(-1) of dry weight, pyrene/fluoranthene ratios ranging between 1.12 and 1.48 and PCB concentrations (Sigma7) ranging from 0.07 to 0.65 mg kg(-1) of dry weight. In the same way, sludges from sand removal tanks displayed PAH values related to the importance of traffic whereas PCBs were rather characteristic of a diffuse origin. Among the five sewers entering the Seine Aval treatment plant, Clichy Argenteuil, which drains a large industrial area, was the most polluted one (PAHs as Sigma3, 10 kg year(-1); PCBs as Sigma7, 3.5 kg year(-1)). Seasonal variations were observed for PAHs with higher levels in winter in relation with the occurrence of combustion processes. Ninety-eight percent of the PAHs and 76% of the PCBs were extracted during the treatment plant processes, the primary clarifier of which retained 50% of the pollutants. Fluoranthene and PCB concentrations in the final dehydrated sludge (mean values) were 1.07 and 0.623 mg kg(-1) of dry weight, respectively. For PCBs, a significant correlation was found (r=0.668, P<0.001) between wastewater and dehydrated sludge concentrations. Yearly measured amounts of PAHs (Sigma3) were twice higher in sludges (76.3 kg) than in precipitations (37.7 kg) whereas those of PCBs (Sigma7) brought by total atmospheric fallout (17.6 kg) and sludges (21.1 kg) did not differ significantly.

Characterization of F21.A, a monoclonal antibody that recognize a leucocyte surface antigen for killer whale homologue to beta-2 integrin

The specificity of F21.A, a monoclonal antibody raised against bottlenose dolphin leucocytes, was characterized in killer whale on the basis of immunoprecipitation of a protein of 94 kDa, as well as flow cytometric analysis. While minimally expressed on resting cells, F21.A labeled a homologue to beta-2 integrin in 89-97% of PMA-activated neutrophils, 53-66% of activated monocytes, and activated B cells but not T cells. Activation of neutrophils reached its maximum 10 min after PMA stimulation. F21.A did not label intracellular stores as did both cross-reacting anti-canine CD11b and CD18, suggesting that an activation-induced conformational change would expose a neoepitope recognized by F21.A. F21.A labeling was largely inhibited by pre-incubation with plasma, suggesting a binding site closely related to that for fibrinogen. In vitro phagocytosis and respiratory burst were almost fully inhibited upon pre-incubation with F21.A, demonstrating its functional importance. This antibody is foreseen as a possible valuable diagnostic and research tool in cetacean immunology.