Influence of the Drying Process on the Volatile Profile of Different Capsicum Species

Chili is a globally significant spice used fresh or dried for culinary, condiment, and medicinal purposes. Growing concerns about food safety have increased the demand for high-quality products and non-invasive tools for quality control like origin tracing and safety assurance. Volatile analysis offers a rapid, comprehensive, and safe method for characterizing various food products. Thus, this study aims to assess the impact of the drying process on the aromatic composition of various Capsicum species and to identify key compounds driving the aromatic complexity of each genetic makeup. To accomplish these objectives, the aroma was examined in fruits collected from 19 different pepper accessions (Capsicum sp.) belonging to four species: one ancestral (C. chacoense) and three domesticated pepper species (C. annuum, C. baccatum and C. chinense). Fresh and dried samples were analyzed using a headspace PTR-TOF-MS platform. Our findings reveal significant changes in the composition and concentration of volatile organic compounds (VOCs) from fresh to dried Capsicum. Notably, chili peppers of the species C. chinense consistently exhibited higher emission intensity and a more complex aroma compared to other species (both fresh and dried). Overall, the data clearly demonstrate that the drying process generally leads to a reduction in the intensity and complexity of the aromatic compounds emitted. Specifically, fresh peppers showed higher volatile organic compounds content compared to dried ones, except for the two sweet peppers studied, which exhibited the opposite behavior. Our analysis underscores the variability in the effect of drying on volatile compound composition among different pepper species and even among different cultivars, highlighting key compounds that could facilitate species classification in dried powder. This research serves as a preliminary guide for promoting the utilization of various pepper species and cultivars as powder, enhancing product valorization.

Proposal of model for personalized early adapted cancer screening in people living with HIV: experience of "Gaetano Martino" Hospital University of Messina

Human immunodeficiency virus (HIV) infection has historically been related to the development of specific cancers, some of which are so closely linked to the infection, such as Kaposi's Sarcoma (KS), that they have earned the name Acquired Immuno-Deficiency Syndrome (AIDS)-defining cancers (ADCs). While the development of antiretroviral therapy (ART) has decreased the incidence of AIDS-defining cancers, the resulting aging of people living with HIV (PLWH) highlighted an increased occurrence of other forms of cancer. At the "Gaetano Martino" hospital in Messina, we developed a multidisciplinary approach by creating a bridge between the Oncology Unit and the Infectious Diseases Unit to carry out screening and a more rapid diagnostic and therapeutic journey for cancers in PLWH. The goal is to improve the diagnosis of various types of cancer by involving other professionals, such as gastroenterologists and gynecologists, to ensure faster access to treatment and, therefore, a greater chance of survival. In addition, our multidisciplinary approach has also included vaccine screening, offered by the "Gaetano Martino" hospital and useful for preventing the development of specific forms of cancer in the entire population and particularly in PLWH.

Changes in RDW according to prognostic predictors in newly diagnosed multiple myeloma

RDW is an erythrocyte index that increase in multiple myeloma, in which it appears to have an important role in predicting outcome. For this reason, we performed a retrospective analysis to evaluate the relationships of RDW with some important prognostic predictors. Specifically, in a cohort of 190 newly diagnosed multiple myeloma patients, we have examined the behaviour of RDW and its trend in relation to the ISS stage and other prognostic factors, such as albumin, beta-2 microglobulin, LDH and bone marrow plasma cell infiltration. We performed the analysis in the entire cohort of patients and in the three different disease isotypes (Light chain, IgA, and IgG multiple myeloma). The evaluation of RDW in the different isotypes was made with the Kruskal-Wallis test, integrated by the Dunn test. The comparison between the subgroups allocated above and below the median value of each prognostic factor, was made with the Mann-Whitney test. From our analysis, we observed that RDW is higher in the IgA multiple myeloma, and it increases significantly from ISS I to III. Moreover, RDW increases in the presence of lower albumin values, higher levels of beta2-microglobulin and LDH and in the presence of a greater bone marrow plasma cell infiltrate.

Does the Harvest Type Affect Olive Health? Influence of the Harvesting System and Storage Time on the Chemical, Volatile and Sensory Qualities of Extra Virgin Olive Oils

With the aim of investigating the effect of bruising and its development during the postharvest time, olive fruits (Frantoio and Moraiolo), manually and mechanically harvested, were stored in climatic chambers at two different temperatures (5 °C and 18 °C) for five days. Visual observations highlighted changes in the olive peel with discoloration in the damaged areas and tissue bruising. Olive fruit polyphenols, volatile organic compounds (VOCs) and other oil quality parameters (phenolic content, free acidity and peroxide index) and sensory assessment were evaluated. Analyses were carried out on fruits and experimental extra virgin oils at harvesting and after 5 days of fruit storage. The results highlight that low-temperature storage (5 °C for 5 days) may contribute to the maintenance of high olive oil quality, and the quality of olives stored at room temperature drastically decreases after 5 days of storage. Moreover, mechanical harvesting, compared to manual harvesting, does not seem to affect the final oil quality, at least at harvesting, but seems to determine differences in the long-term storage period. Finally, the samples stored at 18 °C showed a quality deterioration with the development of sensorial defects.

Can microplastics threaten plant productivity and fruit quality? Insights from Micro-Tom and Micro-PET/PVC

Solanum lycopersicum L., a crop grown worldwide with a high nutritional value for the human diet, was used to test the impact of microplastics on plant growth, productivity, and fruit quality. Two of the most represented microplastics in soils, polyethylene terephthalate (PET) and polyvinyl chloride (PVC), were tested. Plants were grown in pots with an environmentally realistic concentration of microplastics and, during the whole crop life cycle, photosynthetic parameters, number of flowers and fruits were monitored. At the end of the cultivation, plant biometry and ionome were evaluated, along with fruit production and quality. Both pollutants had negligible effects on shoot traits, with only PVC causing a significant reduction in shoot fresh weight. Despite an apparent low or no toxicity during the vegetative stage, both microplastics decreased the number of fruits and, in the case of PVC, also their fresh weights. The plastic polymer-induced decline in fruit production was coupled with wide variations in fruit ionome, with marked increases in Ni and Cd. By contrast there was a decline in the nutritionally valuable lycopene, total soluble solids, and total phenols. Altogether, our results reveal that microplastics can not only limit crop productivity but also negatively impact fruit quality and enhance the concentration of food safety hazards, thus raising concerns for their potential health risks for humans.

Metabolic Responses in Leaves of 15 Italian Olive Cultivars in Correspondence to Variable Climatic Elements

This study aims to evaluate the metabolic changes that occurred in olive leaves as responses over time to variations in climatic elements. Rainfall, temperature, and solar radiation data were collected over 4 months (August-November) to assess the impact of different climatic trends on the metabolism of the leaves of 15 Italian olive cultivars, cultivated at the experimental farm of the University of Florence. The net photosynthetic rate (AN) and stomatal conductance (gs), measured as main indicators of primary metabolism, were mainly influenced by the "cultivar" effect compared to the "climate" effect. The lowest AN value was showed by "Bianchera", while "Ascolana" recorded the highest (8.6 and 13.6 µmol CO2 m-2s-1, respectively). On the other hand, the secondary metabolism indicators, volatile organic compound (VOC) and oleuropein (OL) content, were much more influenced by climate trends, especially rainfall. A phase of high rainfall caused a significant increase in the VOCs emission from leaves, even with different behaviors among the genotypes. The highest differences were observed between "Maiatica di Ferrandina", with the highest average values (~85,000 npcs), and "Frantoio", which showed the lowest (~22,700 npcs). The OL content underwent considerable fluctuations in relation to the rainfall but also appeared to be controlled by the genotype. "Coratina" always showed the highest OL concentration (reaching the maximum ~98 mg g-1), indicating the great potential of this cultivar for the industrial recovery of OL.

The role of complexity for digital twins of cities

We argue that theories and methods drawn from complexity science are urgently needed to guide the development and use of digital twins for cities. The theoretical framework from complexity science takes into account both the short-term and the long-term dynamics of cities and their interactions. This is the foundation for a new approach that treats cities not as large machines or logistic systems but as mutually interwoven self-organizing phenomena, which evolve, to an extent, like living systems.

Intercropping Salt-Sensitive Lactuca sativa L. and Salt-Tolerant Salsola soda L. in a Saline Hydroponic Medium: An Agronomic and Physiological Assessment

Competition for freshwater is increasing, with a growing population and the effects of climate change limiting its availability. In this experiment, Lactuca sativa plants were grown hydroponically with or without a 15% share of seawater (12 dS m^-1) alone or intercropped with Salsola soda to demonstrate if L. sativa benefits from sodium removal by its halophyte companion. Contrary to the hypothesis, saline-grown L. sativa plants demonstrated reduced growth compared to the control plants regardless of the presence or absence of S. soda. Both limitations in CO₂ supply and photosystem efficiency may have decreased CO₂ assimilation rates and growth in L. sativa plants grown in the seawater-amended solutions. Surprisingly, leaf pigment concentrations increased in salt-treated L. sativa plants, and most notably among those intercropped with S. soda, suggesting that intercropping may have led to shade-induced increases in chlorophyll pigments. Furthermore, increased levels of proline indicate that salt-treated L. sativa plants were experiencing stress. In contrast, S. soda produced greater biomass in saline conditions than in control conditions. The mineral element, carbohydrate, protein, polyphenol and nitrate profiles of both species differed in their response to salinity. In particular, salt-sensitive L. sativa plants had greater accumulations of Fe, Ca, P, total phenolic compounds and nitrates under saline conditions than salt-tolerant S. soda. The obtained results suggest that intercropping salt-sensitive L. sativa with S. soda in a hydroponic system did not ameliorate the growing conditions of the salt-sensitive species as was hypothesized and may have exacerbated the abiotic stress by increasing competition for limited resources such as light. In contrast, the saline medium induced an improvement in the nutritional profile of S. soda. These results demonstrate an upper limit of the seawater share and planting density that can be used in saline agriculture when intercropping S. soda plants with other salt-sensitive crops.

Salt stress in olive tree shapes resident endophytic microbiota

Olea europaea L. is a glycophyte representing one of the most important plants in the Mediterranean area, both from an economic and agricultural point of view. Its adaptability to different environmental conditions enables its cultivation in numerous agricultural scenarios, even on marginal areas, characterized by soils unsuitable for other crops. Salt stress represents one current major threats to crop production, including olive tree. In order to overcome this constraint, several cultivars have been evaluated over the years using biochemical and physiological methods to select the most suitable ones for cultivation in harsh environments. Thus the development of novel methodologies have provided useful tools for evaluating the adaptive capacity of cultivars, among which the evaluation of the plant-microbiota ratio, which is important for the maintenance of plant homeostasis. In the present study, four olive tree cultivars (two traditional and two for intensive cultivation) were subjected to saline stress using two concentrations of salt, 100 mM and 200 mM. The effects of stress on diverse cultivars were assessed by using biochemical analyses (i.e., proline, carotenoid and chlorophyll content), showing a cultivar-dependent response. Additionally, the olive tree response to stress was correlated with the leaf endophytic bacterial community. Results of the metabarcoding analyses showed a significant shift in the resident microbiome for plants subjected to moderate salt stress, which did not occur under extreme salt-stress conditions. In the whole, these results showed that the integration of stress markers and endophytic community represents a suitable approach to evaluate the adaptation of cultivars to environmental stresses.

Stalk cell polar ion transport provide for bladder-based salinity tolerance in Chenopodium quinoa

Chenopodium quinoa uses epidermal bladder cells (EBCs) to sequester excess salt. Each EBC complex consists of a leaf epidermal cell, a stalk cell, and the bladder. Under salt stress, sodium (Na⁺ ), chloride (Cl^- ), potassium (K⁺ ) and various metabolites are shuttled from the leaf lamina to the bladders. Stalk cells operate as both a selectivity filter and a flux controller. In line with the nature of a transfer cell, advanced transmission electron tomography, electrophysiology, and fluorescent tracer flux studies revealed the stalk cell's polar organization and bladder-directed solute flow. RNA sequencing and cluster analysis revealed the gene expression profiles of the stalk cells. Among the stalk cell enriched genes, ion channels and carriers as well as sugar transporters were most pronounced. Based on their electrophysiological fingerprint and thermodynamic considerations, a model for stalk cell transcellular transport was derived.

Bacterial Communities in the Fruiting Bodies and Background Soils of the White Truffle Tuber magnatum

Tuber magnatum Picco is a greatly appreciated truffle species mainly distributed in Italy. Its price and characteristics mostly depend on its geographical origin. Truffles represent a fundamental step of the life cycle of Tuber species promoting spore dissemination. They consist of two main parts, gleba, the inner part, and peridium, which is in direct contact with ground soil. Within the truffle and around in the growing soil, both the occurrence and abundance of different microbial species seem to play an essential role in truffle production. The development of the next-generation sequencing (NGS) based technology has greatly improved to deepen the role of the composition of microbial communities, thus improving the knowledge of the existing relationships between microbial taxa in a specific condition. Here, we applied a metabarcoding approach to assess the differences in T. magnatum samples collected from three areas in Tuscany (Italy). Peridium and gleba were analyzed separately with the aim to distinguish them based on their microbial composition. Also, soil samples were collected and analyzed to compare productive and unproductive truffle grounds to confirm the presence of specific patterns linked to truffle production. Results indicate that differences occurred between truffle compartments (gleba and peridium) as well as between analyzed soils (productive and unproductive), with distinctive taxa associated. Furthermore, findings also demonstrated specific characteristics associated with truffle collection areas, thus indicating a degree of microbial selection related to different environments.

POS0120 NEUROLOGICAL INVOLVEMENT IN A MONOCENTRIC COHORT OF PATIENTS WITH SERONEGATIVE ANTIPHOSPHOLIPID SYNDROME

Background

The 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.

Objectives

The 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.

Methods

We 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).

Results

From 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)

Conclusion

The 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 Interests

None declared

The Physiological Response of Different Brook Willow (Salix acmophylla Boiss.) Ecotypes to Salinity

Few phytoremediation studies have been conducted under semi-arid conditions where plants are subjected to drought and/or salinity stress. Although the genus Salix is frequently used in phytoremediation, information regarding its tolerance of drought and salinity is limited. In the present study, Salix acmophylla Boiss. cuttings from three sites (Adom, Darom and Mea She'arim) were tested for tolerance to salinity stress by growing them hydroponically under either control or increasing NaCl concentrations corresponding to electrical conductivities of 3 and 6 dS m^-1 in a 42-day greenhouse trial. Gas exchange parameters, chlorophyll fluorescence and concentration, and water-use efficiency were measured weekly and biomass was collected at the end of the trial. Root, leaf and stem productivity was significantly reduced in the Adom ecotype, suggesting that Darom and Mea She'arim are the more salt-tolerant of the three ecotypes. Net assimilation and stomatal conductance rates in salt-treated Adom were significantly reduced by the last week of the trial, coinciding with reduced intrinsic water use efficiency and chlorophyll a content and greater stomatal aperture. In contrast, early reductions in stomatal conductance and stomatal aperture in Darom and Mea She'arim stabilized, together with pigment concentrations, especially carotenoids. These results suggest that Darom and Mea She'arim are more tolerant to salt than Adom, and provide further phenotypic support to the recently published data demonstrating their genetic similarities and their usefulness in phytoremediation under saline conditions.

Modelling botanical biofiltration of indoor air streams contaminated by volatile organic compounds

Botanical filtration is a biological-based treatment method suitable for removing hazardous volatile organic compounds (VOCs) from air streams, based on forcing an air flow through a porous substrate and foliage of a living botanical compartment. The pathways and removal mechanisms during VOC bioremediation have been largely investigated; however, their mathematical representation is well established only for the non-botanical components of the system. In this study, we evaluated the applicability of such a modelling scheme to systems which include a botanical compartment. We implemented a one-dimensional numerical model and performed a global sensitivity analysis to measure the input parameters influence on the transient and steady biofilter responses. We found that the most sensitive parameters on the transient-state behaviour were the mass transfer coefficient between gas and solid surfaces, and the fraction of solid surfaces covered by the biofilm; the steady-state response was primarily influenced by the biofilm specific surface area and the fraction of surfaces covered by the biofilm. We calibrated the identified set of parameters and successfully validated the model against data from a pilot-scale installation. The results showed that the application of the model to systems with a botanical compartment is feasible, although under a strict set of assumptions.

Early signalling processes in roots play a crucial role in the differential salt tolerance in contrasting Chenopodium quinoa accessions

Significant variation in epidermal bladder cell (EBC) density and salt tolerance (ST) exists amongst quinoa accessions, suggesting that salt sequestration in EBCs is not the only mechanism conferring ST in this halophyte. In order to reveal other traits that may operate in tandem with salt sequestration in EBCs and whether these additional tolerance mechanisms acted mainly at the root or shoot level, two quinoa (Chenopodium quinoa) accessions with contrasting ST and EBC densities (Q30, low ST with high EBC density versus Q68, with high ST and low EBC density) were studied. The results indicate that responses in roots, rather than in shoots, contributed to the greater ST in the accession with low EBC density. In particular, the tolerant accession had improved root plasma membrane integrity and K+ retention in the mature root zone in response to salt. Furthermore, superior ST in the tolerant Q68 was associated with faster and root-specific H2O2 accumulation and reactive oxygen species-induced K+ and Ca2+ fluxes in the root apex within 30 min after NaCl application. This was found to be associated with the constitutive up-regulation of the membrane-localized receptor kinases regulatory protein FERONIA in the tolerant accession. Taken together, this study shows that differential root signalling events upon salt exposure are essential for the halophytic quinoa; the failure to do this limits quinoa adaptation to salinity, independently of salt sequestration in EBCs.

Bone damage after chemotherapy for lymphoma: a real-world experience

BACKGROUND

Despite recent improvements in survival due to advances in treatment, the quality of life of patients with lymphoma may be compromised by the long-term complications of chemotherapy and steroid therapy. Among these, a potentially relevant problem is bone loss and the development of fragility fractures.

AIM

To provide further evidence of clinical or subclinical skeletal complications in correlation with biological variables and markers of bone disease in patients with complete response to therapy.

METHOD

A cross-sectional observational study was conducted on subjects diagnosed with lymphoma with subsequent antineoplastic treatment, disease status after therapy defined as complete response disease for at least a year now. We performed: blood chemistry tests, imaging techniques and screening tools for the assessment of functional status and quality of life (SARC-F and mini-Osteoporosis Quality of Life).

RESULTS

Approximately 50% of patients had osteoporosis, with a prevalence of vertebral fractures of 65.5%. In most patients, we found hypovitaminosis D and high levels of parathyroid hormone (PTH). Furthermore, a statistically significant association was observed between high PTH levels and previous lymphoma treatment. Finally, the Mini-Osteoporosis Quality of life (mini-OQLQ) questionnaire demonstrated a loss of quality of life as a consequence of the change in bone status.

CONCLUSIONS

Patient treatment design for personalized chemotherapy would be desirable to reduce late effects on bone. Also, early prevention programs need to be applied before starting treatment. The most benefited subpopulations could be not only elderly but also young patients.

Our sisters the plants? notes from phylogenetics and botany on plant kinship blindness

Before the upheaval brought about by phylogenetic classification, classical taxonomy separated living beings into two distinct kingdoms, animals and plants. Rooted in 'naturalist' cosmology, Western science has built its theoretical apparatus on this dichotomy mostly based on ancient Aristotelian ideas. Nowadays, despite the adoption of the Darwinian paradigm that unifies living organisms as a kinship, the concept of the "scale of beings" continues to structure our analysis and understanding of living species. Our aim is to combine developments in phylogeny, recent advances in biology, and renewed interest in plant agency to craft an interdisciplinary stance on the living realm. The lines at the origin of plant or animal have a common evolutionary history dating back to about 3.9 Ga, separating only 1.6 Ga ago. From a phylogenetic perspective of living species history, plants and animals belong to sister groups. With recent data related to the field of Plant Neurobiology, our aim is to discuss some socio-cultural obstacles, mainly in Western naturalist epistemology, that have prevented the integration of living organisms as relatives, while suggesting a few avenues inspired by practices principally from other ontologies that could help overcome these obstacles and build bridges between different ways of connecting to life.

Early responses to salt stress in quinoa genotypes with opposite behavior

Soil salinity is among the major abiotic stresses that plants must cope with, mainly in arid and semiarid regions. The tolerance to high salinity is an important agronomic trait to sustain food production. Quinoa is a halophytic annual pseudo-cereal species with high nutritional value that can secrete salt out of young leaves in external non-glandular cells called epidermal bladder cells (EBC). Previous work showed high salt tolerance, but low EBC density was associated with an improved response in the early phases of salinity stress, mediated by tissue-tolerance traits mainly in roots. We compared the transcript profiling of two quinoa genotypes with contrasting salt tolerance patterning to identify the candidate genes involved in the differentially early response among genotypes. The transcriptome profiling, supported by in vitro physiological analyses, provided insights into the early-stage molecular mechanisms, both at the shoot and root level, based on the sensitive/tolerance traits. Results showed the presence of numerous differentially expressed genes among genotypes, tissues, and treatments, with genes involved in hormonal and stress response upregulated mainly in the sensitive genotype, suggesting that tolerance may be correlated to restricted changes in gene expression, at least after a short salt stress. These data, showing constitutive differences between the two genotypes, represent a solid basis for further studies to characterize the salt tolerance traits. Additionally, new information provided by this work might be useful for the development of plant breeding or genome engineering programs in quinoa.

Relationship between Leachate Pollution Index and growth response of two willow and poplar hybrids: Implications for phyto-treatment applications

Phytoremediation is a potentially suitable technique for the reclamation of toxic landfill leachate (LL) by decreasing its volume through water uptake and improving its composition by uptake, accumulation and amelioration of pollutants. We investigated the use of two parameters, the LL concentration and the Leachate Pollution Index (LPI), a method used to determine the phytotoxicity potential of a leachate source based on a weighted sum of its components, to set the best LL dilution to apply when poplar clone 'Orion' and willow clone 'Levante' are selected for phytoremediation. Cuttings were watered with five LL concentrations ranging from 0 to 100%. The poplar clone showed significantly higher values than the willow clone for lowest effective concentration index (LOEC) for leaf (i.e. 11.3% vs 10.5%; p = 0.0284) and total biomass (i.e. 10.9% vs 10.6%; p = 0.0402) and for lowest effective LPI for leaf (i.e. 12.3 vs 12.1; p = 0.0359) and total biomass (i.e. 12.8 versus 12.2; p = 0.0365), respectively, with effectiveness demonstrating the LOEC or LPI value at which the parameter is negatively affected. Photosynthetic rates were higher in poplar than willow in both control and the lowest LL dilution, but rapidly declined in both at higher LL dilutions. Although a direct translation of data from bench trials to field conditions should be investigated, we concluded that in the establishment phase, the poplar hybrid is more tolerant than the willow hybrid to LL. We also provide evidence for LPI as a potential predictor for setting LL irrigation levels in the initial phase of a phyto-treatment approach.

Barbara G. Pickard - Queen of Plant Electrophysiology

Barbara Gillespie Pickard (1936-2019) studied plant electrophysiology and mechanosensory biology for more than 50 y. Her first papers on the roles of auxin in plant tropisms were coauthored with Kenneth V. Thimann. Later, she studied plant electrophysiology. She made it clear that plant action potentials are not a peculiar feature of so-called sensitive plants, but that all plants exhibit these fast electric signals. Barbara Gillespie Pickard proposed a neuronal model for the spreading of electric signals induced by mechanical stimuli across plant tissues. In later years, she studied the stretch-activated plasma membrane channels of plants and formulated the plasma-membrane control center model. Barbara Pickard summarized all her findings in a new model of phyllotaxis involving waves of auxin fluxes and mechano-sensory signaling.

AB0704 TELEMEDICINE AT THE TIME OF COVID-19: THE EXPERIENCE WITH RA PATIENTS TREATED WITH JAK-INHIBITORS

Background:

The spread of COVID-19, the lockdown, the limited access to care reevaluated the role of tele-consultation and self-assessment.

Objectives:

Our aim was to evaluate in a cohort of Rheumatoid Arthritis (RA) patients treated with JAK-inhibitors (JAKi): the self-assessed disease activity during lockdown, the lockdown impact on fatigue, anxiety, depression and the prevalence of Covid-19.

Methods:

We enrolled RA patients treated with baricitinib or tofacitinib. At baseline (BL) and follow-up we collected: patients’ demographic data, composite disease activity indices (CDAI, DAS28CRP), global assessment (PGA), pain visual analogue scale (VAS), FACIT (functional assessment of chronic illness therapy) and a self-rating scale for disease impact on anxiety and depression (Zung-A/D). Patients were instructed on how to perform self-assessment through video-material and fulfilled the online form of “Rheumatoid Arthritis Impact of Disease” (RAID)1 and “RA Disease Activity Index” (RADAI). To capture the pandemic effect, we compared patients in different status (remission, low, moderate and high-disease activity) at the last in-person visit (preCoV) through the DAS28CRP and CDAI, to the tele-health visit (THV), measured by the RAID. BL and pre-CoV ZUNG-A, ZUNG-D, FACIT questionnaires were compared with the online results during the pandemic. Exposure, tests and symptoms of Covid-19 were recorded. Data were expressed as mean±standard deviation or median(IQR) according to distribution.

Results:

Twenty patients (median age 58.2±11.9 and mean disease duration 153.5 ± 112.7 months) were treated with tofacitinib and 27 with baricitinib. The median time-lapse between the pre-CoV visit and the THV was 12 (IQR 4) weeks. DAS28CRP and CDAI significantly decreased from BL to pre-CoV visit. During the last in-person visit, 21 patients (48.83%) were in remission, 9 (20.93%) in low disease activity; according to the RAID, 15 (31.91%) and 7 (14.89%) patients were respectively in remission and low disease activity during the THV (Table A). PGA and pain significantly decreased from BL to pre-Cov visit but worsened during the lockdown (Table A). FACIT remaining stable during THV. At THV, we detected a significant improvement of anxiety from BL (Zung-A) and a tendency to lower depression scores compared to BL (Table A). JAKi showed a good safety profile considering Covid-19 symptoms, none of the patients was diagnosed with SarsCoV2 infection.

Conclusion:

This is the first study on virtual assessment in RA patients treated with JAKi. The unique social experiment of the pandemic impaired the clinical response already achieved before the lockdown, without a collateral worseling of FACIT, anxiety and depression.

References:

[1]Gossec L, et al. Ann Rheum Dis. 2009

[2]Stucki G, et al. Arthritis Rheum. 1995

Table A.

DAS28, CDAI, RAID scores and patient-reported outcomes assessment at baseline and during the follow-up

BLpre-CoVTHVDISEASE ACTIVITYN (%)N (%)N (%)REMISSIONDAS280 (0%)21 (48.8%)CDAI0 (0%)10 (22.7%)RAID15 (31.9%)LOW DISEASEDAS281(2.1%)9 (20.9%)CDAI7(14.8%)23 (52.2%)RAID7 (14.9%)MODERATEDAS2833 (70.2%)12 (27.9%)CDAI17 (37.1%)8 (18.1%)RAID13 (27.6%)HIGHDAS2813 (27.6%)1 (2.3%)CDAI23 (48.9%)3 (6.8%)RAID12 (25.5%)GH70 (30)20 (49.5)*45 (45)*#Pain70 (28)25 (45.5)*40 (48.5)*#Zung A37 (9)37 (10.2)35 (14)*Zung-D39 (17)39 (13)*38 (12)FACIT11.5 (17.2)8 (19.5)7(15)

* p≤0.001 vs BL

# p ≤0.04vs preCoV

Data expressed as median (IQR)

Disclosure of Interests:

Cristina Garufi: None declared, Francesca Romana Spinelli Speakers bureau: Abbvie, Eli Lilly, Consultant of: Gilead/Galapagos, Eli Lilly, Grant/research support from: Pfizer, Silvia Mancuso: None declared, Fulvia Ceccarelli: None declared, Fabrizio Conti Speakers bureau: Abbvie, Eli Lilly, Sanofi, Pfizer, Consultant of: Gilead/Galapagos

POS1240 HYDROXYCHLOROQUINE CARDIOTOXICITY: A CASE-CONTROL STUDY COMPARING PATIENTS WITH COVID19 AND PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Background:

Antimalarials have been associated with QT prolongation in COVID19 patients but are generally safe in patients with rheumatologic disease.

Objectives:

Aim of the study was to compare the prevalence of QTc prolongation between COVID19 and Systemic Lupus Erythematosus (SLE) patients treated with hydroxychloroquine (HCQ).

Methods:

We included consecutive patients with SARS-CoV-2 infection confirmed by nasopharyngeal swab and patients taking HCQ for SLE. A prolonged QTc was defined as an increase in QTc intervals >60 ms (compared with baseline) or as a QTc of ≥500 ms.

Results:

We enrolled 58 COVID19 patients (median age 70.5 years, IQR 25). HCQ, without or with azithromycin, was given to 26 (44.8%) and 15 patients (25.9%), respectively; 17 (29.3%) had not received either drug. The median baseline QTc was 432 (IQR 36) and prolonged QTc was observed in 15 (26%) patients (12 QTc≥500 ms and 3 patients ΔQTc>60 ms). We didn’t find significant differences in QTc prolongation among the three treatment groups. Baseline QTc (OR 111.5) and D-dimer (OR 78.3) were independently associated to QTc prolongation.

Compared to the 50 SLE patients (median age of 38.5 years, IQR 22), chronically treated with HCQ, patients with COVID19 showed significantly longer QTc (p < 0.001) (Table 1).

Conclusion:

This is the first study demonstrating that, differently from COVID19 patients, patients with SLE are not susceptible to HCQ-induced long QT syndrome and arrhythmia. The combined arrhythmogenic effect of SARS-CoV-2 infection and HCQ could account for the excess of QTc prolongation and fatal arrhythmias described in patients with COVID19.

Table 1.

Difference in clinical and demographic features between Systemic Lupus Erythematosus and COVID19 patients.

Demographic FeaturesSLE patientsCovid-19 patientsp-ValueN°5058Female4323< 0.001Age (years)45 (17)70.5 (25)< 0.001Comorbidities N %Hypertension15 (30)24 (48)0.2Cardiovascular diseses8 (16)13 (22.4)0.4COPD1 (2)9 (15.5)0.016Thyroid disease8 (16)8 (13.8)0.75Chronic kidney disease4 (8)5 (8.6)0.91Population characteristics Median (IQR)HCQ (mg/die)400 (125)400< 0.001HCQ Time (days)3255 (5790)7< 0.001QTc (ms)SLEDAI-2KSDI432 (36.25)0 (4)0395 (80)--< 0.001--

Disclosure of Interests:

None declared

AB0269 ARE INTERFERON-GAMMA RELEASE ASSAYS RELIABLE TO DETECT TUBERCULOSIS INFECTION IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH JANUS KINASE INHIBITORS?

Background:

The therapeutic armamentarium for patients with rheumatoid arthritis (RA) has recently been enriched with the family of Janus kinase (JAK) inhibitors. Because the risk of reactivation of latent tuberculosis infection (LTBI) following the use of these drugs seems to be similar to that seen with anti-TNF agents, screening for LTBI is recommended in patients with RA before starting treatment with JAK inhibitors. Interferon(IFN)-gamma release assays (IGRAs) are increasingly used for this purpose. However, JAK inhibitors tend to decrease the levels of IFNs, questioning the reliability of IGRAs during treatment with this novel class of drugs.

Objectives:

To compare the performance of the QuantiFERON-TB Gold Plus (QFT-Plus) test with that of QuantiFERON-TB Gold In-tube (QFT-GIT) assay in RA patients before and during treatment with JAK inhibitors.

Methods:

A longitudinal, prospective study has been performed in RA patients (ACR/EULAR 2010 criteria) candidates for tofacitinib or baricitinib treatment. All patients underwent QFT-Plus and QFT-GIT at baseline (T0), and after 3 (T3) and 9/12 months (T9/12) of treatment with JAK inhibitors. The agreement of the two tests was calculated at all timepoints. The agreement between IGRAs and tuberculin skin test (TST) or chest radiography at baseline was also determined. Lastly, the variability of QTF-Plus results was assessed during follow-up.

Results:

Twenty-nine RA patients (F/M 23/6; median age/IQR 63/15.5 years; median disease duration/IQR 174/216 months) were enrolled: among them, 22 were to start baricitinib (75.9%) and 7 tofacitinib (24.1%). A perfect agreement was found between QFT-Plus and QFT-GIT at all times of observation (κ=1). At baseline, no agreement was recorded between IGRAs and TST (κ=-0.08) and between TST and chest radiography (κ=-0.07), while a low agreement was found between QFT-Plus and chest radiography (κ=0.17). A variation of 33.3% in the results of the QFT-Plus test was recorded at T3 compared to T0, of 29.4% at T9/12 compared to T0, and of 11.8% at T9/12 compared to T3. The median levels of IFN-γ produced by lymphocytes in response to the mitogen of QFT-Plus decreased after 3 months of treatment (1.59/4.72 IU/ml vs 3.08/7.68 IU/ml at baseline), followed by an increase after 9/12 months (2.25/4.61 IU/ml), but these differences were not significant. No significant change in the median number of circulating lymphocytes such as to explain the variation of the QFT-Plus results after 3 months of JAK inhibitor therapy was documented (1815/690/mm3 vs 2140/750/mm3 at baseline). At baseline, both QFT-Plus and QFT-GIT showed positive results in 5 patients (17.2%), negative in 19 (65.5%), and indeterminate in 5 (17.2%). Glucocorticoids intake was associated with a higher probability of negative or indeterminate result of IGRAs at baseline (p<0.0001).

Conclusion:

Our data show that a response to IGRAs is detectable in the course of treatment with JAK inhibitors. However, similarly to what has been observed during treatment with TNF antagonists, the results of QFT-GIT and QFT-Plus show some variability when longitudinally repeated. These fluctuations occur in the absence of correlation with clinical outcome, thus challenging their interpretation. Since we do not have a sufficiently sensitive test capable of detecting TB infection, an integrated evaluation of risk factors, clinical manifestations and multiple diagnostic tests should be considered for a proper evaluation of the risk of TB infection in immunosuppressed patients.

Disclosure of Interests:

None declared

POS1238 ANTIPHOSPHOLIPID ANTIBODIES AND COVID-19: TREND OVER TIME

Background:

Since the beginning of the SARS-CoV-2 outbreak, antiphospholipid antibodies (aPL), a known thrombotic risk factor, have been studied in COVID-19 patients, in whom thromboembolic events have been associated with poor prognosis. To date, the pathogenetic role of aPL and the trend over time is still unknown.

Objectives:

Aim of the study was to investigate whether aPL positivity was correlated with thrombosis in COVID-19 patients and whether it was a transient or persistent.

Methods:

We included all consecutive COVID-19 patients hospitalized at Policlinico Umberto I, Sapienza University of Rome from April 1, 2020 to June 7, 2020. In these patients, serum levels of anti-cardiolipin (aCL) IgM, IgG, IgA, anti-β2glycoprotein I (aβ2GPI) IgM, IgG were measured by enzyme-linked immunosorbent assay (ELISA) and Lupus Anticoagulant (LA) was detected with coagulatory tests in patients not in treatment with anticoagulant drugs.

Results:

Five out of 73 (6.8%) patients resulted positive for aCL IgM, 3 of them also tested positive for aβ2GPI IgM. aCL IgA were tested positive in 14 out of 46 patients (30.4%). Overall 18 patients resulted positive for at least one test. Seven (9.6%) patients developed thrombotic events during hospitalization, 3 of them resulting positive for aPL (Table 1. below).

Table 1.

Clinical and demographic features of the 7 Covid-19 patients that presented thrombotic events

FeaturesPatient 1Patient 2Patient 3Patient 4Patient 5Patient 6Patient 7Age - yr67788343707495SexfemalefemalefemalemalemalefemalemaleMedical HistoryMalignancy, HypertensionStrokeChronic obstructive pulmonary diseaseNo medical historyChronic obstructive pulmonary disease, HypertensionMalignancy,HypertensionInitial findingsSigns and symptomsDyspneaDyspneaDyspneaFever, ageusia/anosmia, chest painFever, coughDyspneaDyspneaHRCT chest: Bilateralground glass opacityyesyesyesyesyesyesyesBaseline laboratory valuesLymphocytecount, cells x 106/L2202102330158016806001390Lactatedehydrogenase, U/L223321199227226349199Ferritin mcg/L6143172133874622455197D-dimer mcg/L7301213291228268812981097PaO2:FIO2, mm Hg132120442534348493314Anticoagulant therapy at the time of the thrombotic eventTherapeutic dosageProphylactic dosageProphylactic dosageNot administeredTherapeutic dosageTherapeutic dosageTherapeutic dosageThrombotic eventsStrokePulmonary embolismPeripheral venous thrombosisMyocardial infarctionPulmonary embolismMyocardial infarction, peripheral arterial thrombosis, peripheral venous thrombosisPeripheral venous thrombosisAntiphospholipid antibodiesnegativeAnti-cardiolipin IgM low title, anti-β2glicoprotein I IgM low titlenegativenegativenegativeAnti-cardiolipin IgM low title, anti-β2glicoprotein I IgM low titleAnti-cardiolipin IgA low titleOutcomeExitusExitusSuicideDischargedDischargedDischargedExitusAntiphospholipid antibodies tested after at least 12 weeksNPNPNPNPNPNegativeNP

We observed that patients showing double positivity for aCL IgM and aβ2GPI IgM had a likelihood positive ratio of 6.3 for thrombotic events (p=0.012) and a likelihood positive ratio of 4.9 for increased D-dimer levels (p=0.027). aCL IgA, the most prevalent aPL in this cohort, was not associated with thrombosis. Of the 18 aPL positive patients, 5 died, 3 were lost to follow-up, and 10 were tested on a second occasion at least 12 weeks, two patients confirmed positivity without clinical signs suggestive of APS.

Conclusion:

These results suggest that double positivity for aCL and aβ2GPI IgM increases the risk of thrombosis in COVID-19 patients, unlike aCL IgA. APL positivity may be persistent and it is advisable to monitor it over time.

Disclosure of Interests:

None declared

POS0677 THE ROLE OF MUSCULOSKELETAL ULTRASOUND IN PREDICTING THE RESPONSE TO JAK INHIBITORS: RESULTS FROM A LARGE MONOCENTRIC COHORT

Background:

In the management of chronic arthritis, such as Rheumatoid Arthritis (RA), Ultrasound (US) assessment can provide relevant information about the joint inflammatory status in the diagnostic phase and even more in the monitoring of disease activity and structural damage1,2.

Objectives:

In this longitudinal study, we aimed to assesse the role of US in predicting the efficacy of JAK-inhibitors (JAKi) in RA patients.

Methods:

We enrolled RA patients starting baricitinib or tofacitinib. All patients were evaluated at baseline and after 4, 12, 24, 48 weeks. Disease activity was calculated by DAS28CRP. US examination in 22 joints (I–V MCPs and PIPs, wrists) aimed at evaluating inflammatory features (synovial effusion and hypertrophy, power Doppler-PD), through a semi-quantitative scale (0-3). The total US (0-198) and PD (0-66) scores were calculated. We scanned bilateral flexor (I–V fingers of hands) and extensor compartments (1-6) tendons: tenosynovitis was scored as absent/present (0/1), resulting in a total score (0-22).

Results:

We studied 102 patients (M/F 15/87; median age 59.2 years, IQR 17.75; median disease duration 144 months, IQR 126), 61 treated with baricitinib and 41 with tofacitinib. At baseline, the median total US score was 18 (IQR 19) and the median PD score 2 (4). We observed a significant reduction in both total and PD US scores at all time-points (p<0.0001) (Figure 1). At baseline, 75.4% of patients showed tenosynovitis involving at least one tendon, with a median score of 2 (IQR 3.5) significantly decreasing after 24 weeks (p=0.02). Multivariate analysis, adjusted for baseline DAS28CRP and other concomitant treatments (including glucocorticoids and methotrexate treatment), confirmed the independent association between baseline US (PD and tenosynovitis) scores and the reduction of disease activity at follow-up evaluations.

Conclusion:

The present study confirmed the early efficacy of JAKi in RA patients by using US evaluation. Furthermore, power doppler and tenosynovitis scores could play a predictive role in response to treatment.

References:

[1]MUELLER RB, HASLER C, POPP F, et al. Effectiveness, Tolerability, and Safety of Tofacitinib in Rheumatoid Arthritis: A Retrospective Analysis of Real-World Data from the St. Gallen and Aarau Cohorts. J Clin Med. 2019;8(10):1548.

[2]COLEBATCH AN, EDWARDS CJ, ØSTERGAARD M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804-14.

Figure 1.

Ultrasound inflammatory score (a) and Ultrasound Power Doppler (PD) score (b) at baseline and follow-up.

Table 1.

Baseline characteristics of 414 RA patients.

WEEKS04122448US inflammatory score18 (19)11 (15.5)9.5 (11.7)7.5 (8)6 (11)US PD score2 (4)0 (2)0 (1)0 (1)0 (0.7)

Disclosure of Interests:

Cristina Garufi: None declared, Fulvia Ceccarelli: None declared, Francesca Romana Spinelli Speakers bureau: Abbvie, Eli Lilly, Consultant of: Gilead/Galapagos, Eli Lilly, Grant/research support from: Pfizer, Silvia Mancuso: None declared, Carmelo Pirone: None declared, Fabrizio Conti Speakers bureau: Abbvie, Eli Lilly, Sanofi, Pfizer, Consultant of: Gilead/Galapagos

Are Peach Cultivars Used in Conventional Long Food Supply Chains Suitable for the High-Quality Short Markets?

Peaches are climacteric and highly perishable fruits, with a short shelf life, and are prone to rapid deterioration after harvest. In this study, the chemical proprieties, aroma profile and a sensory evaluation were conducted to: (1) characterize and compare fruits of 13 different peach and nectarine cultivars, harvested at physiological maturation; and (2) assess the suitability of these cultivars, that are successfully used in long food supply chains (LFSCs), for their use in short food supply chains (SFSCs). Through statistical analysis clear differences were found among the studied cultivars, and in particular between cultivars suited to SFSCs compared to those suited for LFSCs. Results indicate that, despite all cultivars being planted in the same orchards and with the same pre-harvest management and practices, their post-harvest performances were mainly influenced by the cultivar genetic makeup. Therefore, cultivars conventionally used in SFSCs, such as “Guglielmina” and “Regina di Londa”, had the best aroma, sweetness and juiciness compared to LSCPs ones. In contrast, the LSCPs varieties showed interesting values for firmness and crunchiness.

Quali-quantitative monitoring of chemocatalytic cellulose conversion into lactic acid by FT-NIR spectroscopy

Chemocatalytic conversion of cellulose into lactic acid is a valuable alternative to simple sugar fermentation. Nevertheless, the procedures still need optimization to be translated to the industrial scale. Such translation would benefit by on-line monitoring of reaction parameters by fast, inexpensive, direct spectroscopic techniques. In this work, we propose the application of FT-NIR spectroscopy as a suitable analytical tool for monitoring the chemocatalytic conversion of cellulose into lactic acid. Comparison between different FT-NIR spectra at different reaction temperatures and times was exploited to qualitatively indicate the feasibility of the reaction. Besides, an FT-NIR prediction model was proposed for rapidly estimating the molar distribution of cellulose catalytic degradation components in the reaction mixtures. The calibration model was based on reference samples analysed by HPLC. The model was validated by an external validation set. Relevant statistical values of Ratio Performance to Deviations (RPD) referred to both calibration and external validation were obtained, thus demonstrating the potential of such analytical technique in process monitoring.

Biphasic activation of survival and death pathways in Arabidopsis thaliana cultured cells by sorbitol-induced hyperosmotic stress

Hyperosmotic stresses represent some of the most serious abiotic factors that adversely affect plants growth, development and fitness. Despite their central role, the early cellular events that lead to plant adaptive responses remain largely unknown. In this study, using Arabidopsis thaliana cultured cells we analyzed early cellular responses to sorbitol-induced hyperosmotic stress. We observed biphasic and dual responses of A. thaliana cultured cells to sorbitol-induced hyperosmotic stress. A first set of events, namely singlet oxygen (¹O₂) production and cell hyperpolarization due to a decrease in anion channel activity could participate to signaling and osmotic adjustment allowing cell adaptation and survival. A second set of events, namely superoxide anion (O₂^-) production by RBOHD-NADPH-oxidases and SLAC1 anion channel activation could participate in programmed cell death (PCD) of a part of the cell population. This set of events raises the question of how a survival pathway and a death pathway could be induced by the same hyperosmotic condition and what could be the meaning of the induction of two different behaviors in response to hyperosmotic stress.

Individuality, self and sociality of vascular plants

Vascular plants are integrated into coherent bodies via plant-specific synaptic adhesion domains, action potentials (APs) and other means of long-distance signalling running throughout the plant bodies. Plant-specific synapses and APs are proposed to allow plants to generate their self identities having unique ways of sensing and acting as agents with their own goals guiding their future activities. Plants move their organs with a purpose and with obvious awareness of their surroundings and require APs to perform and control these movements. Self-identities allow vascular plants to act as individuals enjoying sociality via their self/non-self-recognition and kin recognition. Flowering plants emerge as cognitive and intelligent organisms when the major strategy is to attract and control their animal pollinators as well as seed dispersers by providing them with food enriched with nutritive and manipulative/addictive compounds. Their goal in interactions with animals is manipulation for reproduction, dispersal and defence. This article is part of the theme issue 'Basal cognition: multicellularity, neurons and the cognitive lens'.

Willow and poplar for the phyto-treatment of landfill leachate in Mediterranean climate

Phytotechnological approaches using living plants are currently being proposed to address a wide range of environmental purposes including the treatment of landfill leachate (LL). Despite their popularity, few studies have investigated this possibility under actual Mediterranean conditions using fast-growing trees. This research reports the results of a two-year project where poplar and willow grown in mesocosm were tested for their ability to withstand and remove specific pollutants from different [Low: 7% (1st year) and 15% (2nd year); High: 15% (1st year) and 30% (2nd year)] amounts of LL. Results indicate that both species were able to treat 340 (Low) and 680 (High) m³ ha^-1 in the establishment year (70 days) and 2470 (Low) and 4950 (High) m³ ha^-1 in the second year (150 days). Both species yielded the same aboveground biomass, but under high LL treatment, poplar performed better than willow. Poplar showed on average significantly higher extraction rates for Cd, Cu, P, and N than willow. Moreover, under high LL treatment, poplar also seemed more efficient than willow in decreasing the concentration of specific pollutants (BOD₅, COD and As) in output effluent. However, with low LL loads both species were able to significantly reduce other compounds (i.e. NH₄-N, Cu and Ni). By contrast, Cl, surfactants, and NO₃-N, had a tendency to accumulate over time in the effluent and could still represent an actual constraint to large-scale application of the technique. The fate of such pollutants should be investigated with further research to better inform strategies used to manage low amounts of high-concentrated effluent.

Semi-synthesis as a tool for broadening the health applications of bioactive olive secoiridoids: a critical review

Covering: 2005 up to 2020Olive bioactive secoiridoids are recognized as natural antioxidants with multiple beneficial effects on human health. Nevertheless, the study of their biological activity has also disclosed some critical aspects associated with their application. Firstly, only a few of them can be extracted in large amounts from their natural matrix, namely olive leaves, drupes, oil and olive mill wastewater. Secondly, their application as preventive agents and drugs is limited by their low membrane permeability. Thirdly, the study of their biological fate after administration is complicated by the absence of pure analytical standards. Accordingly, efficient synthetic methods to obtain natural and non-natural bioactive phenol derivatives have been developed. Among them, semi-synthetic protocols represent efficient and economical alternatives to total synthesis, combining efficient extraction protocols with efficient catalytic conversions to achieve reasonable amounts of active molecules. The aim of this review is to summarize the semi-synthetic protocols published in the last fifteen years, covering 2005 up to 2020, which can produce natural olive bioactive phenols scarcely available by extractive procedures, and new biophenol derivatives with enhanced biological activity. Moreover, the semi-synthetic protocols to produce olive bioactive phenol derivatives as analytical standards are also discussed. A critical analysis of the advantages offered by semi-synthesis compared to classical extraction methods or total synthesis protocols is also performed.

SAT0555 MUSCULOSKELETAL ULTRASOUND IN MONITORING RESPONSE TO JAKi IN RHEUMATOID ARTHRITIS PATIENTS: RESULTS FROM A LONGITUDINAL STUDY

Background:

Therapeutic approach of rheumatoid arthritis (RA) patients has been enriched by the introduction of small molecules. In particular Jak inhibitors (JAKi), baricitinib and tofacitinib, demonstrated their efficacy in patients naïve or resistant to biological treatments in randomized controlled trials. Moreover, these drugs seem to be able to prevent radiographic progression. To date few data are available from the real life context. Ultrasonographic (US) assessment has became a valid imaging tool in the management of RA patients in clinical practice, allowing the evaluation of joint inflammatory status. Together with clinimetric assessment, US could provide a comprehensive assessment of drug response.

Objectives:

In the present study we aimed at assessing the early response to JAKi treatment by using musculoskeletal US.

Methods:

In this prospective longitudinal study, we collected data about all consecutive active RA patients starting treatment with JAKi. RA was diagnosed according to the 2010 ACR/EULAR criteria. At each visit, clinical and laboratory data were collected in a standardized and computerized form, including demographics, past medical history, co-morbidities, previous and concomitant treatments. According with study protocol, all patients underwent clinical and US assessment at the following time-points: baseline (T0), 4 weeks (T1) and 12 weeks (T2). Clinical evaluation included tender and swollen joint counts (0-28), patients global health assessment. C-reactive protein (CRP) levels were registered and disease activity was calculated by disease activity score (DAS) in 28 joints by using CRP (DAS28-CRP). A systematic multiplanar grey-scale and power Doppler (pD) US examination was performed by using MyLab Eight Exp Machine (Esaote, Florence, Italy) at level of 22 joints (bilateral I-V metacarpophalangeal, I-V proximal interphalangeal, wrist). According with OMERACT definitions (1) we assessed the presence of synovial effusion, hypertrophy and pD, that were scored according to a semi-quantitative scale (0-3). A total US inflammatory score (0-198) was obtained by their sum.

Results:

We enrolled 91 patients [F/M 77/14; median age 60.0 years (IQR 15.5); median disease duration 144 months (IQR 126)]. Of these patients, 54 (59.3%) were treated by baricitinib and the remaining 37 by tofacitinib. At baseline we found a median US inflammatory score of 20 (IQR 18.7) and a median DAS28-CRP of 5.0 (IQR 1.56). US assessment demonstrated significant reduction in the median values of inflammatory score already at T1 [median 13 (IQR 14.7), p<0.0001], that was maintained at T2 [median 10 (IQR 11), p<0.0001]. These results are represented in figure 1. Similar to US inflammatory score, a significant reduction was registered for DAS28-CRP median values [T1 3.5 (IQR 1.73), p<0.0001; T2 3.3 (IQR 1.8), p<0.0001]. No significant differences were found when subgrouping patients according with different JAKi drug, in terms US and clinimetric assessment.

Conclusion:

In the present study, specifically designed to evaluate the US-detected efficacy of JAKi in RA patients, we demonstrated in a real life setting a significant, early and sustained improvement of inflammatory joint status.

References:

[1]Wakefield et al, J Rheumatol 2005

Disclosure of Interests:

enrica cipriano: None declared, Fulvia Ceccarelli: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Consultant of: Novartis, Gilead, Lilly, Sanofi, Celgene, Speakers bureau: Lilly, Cristina Garufi: None declared, Ilaria Duca: None declared, Silvia Mancuso: None declared, cristiano alessandri Grant/research support from: Pfizer, Manuela Di Franco: None declared, Roberta Priori: None declared, Valeria Riccieri: None declared, Rossana Scrivo: None declared, Carlo Perricone: None declared, Guido Valesini: None declared, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

FRI0134 EFFECT OF JAK INHIBITORS ON PAIN AND QUALITY OF LIFE IN RHEUMATOID ARTHRITIS PATIENTS

Background:

Pain control is considered a treatment priority from most patients with Rheumatoid Arthritis (RA). Despite the treat to target approach, residual pain is commonly reported by patients with RA. Treatment with JAK inhibitors (JAKi) has been associated to a rapid control of pain.

Objectives:

To investigate the effect of JAKi on pain and quality of life in a mono-centric real-life clinical setting.

Methods:

Patients candidate to baricitinib or tofacitinib were evaluated at baseline and after 12 and 24 weeks of treatment. Disease activity was assessed by Disease Activity Score (DAS)28 with C reactive protein (CRP). A reduction of ≥ 50% of pain visual-analogue scale (VAS) 0-100 mm was recorded as “very much improved, substantially improved” (1). Pain VAS score ≤ 10 mm was considered “no/limited pain” (2). Patients’ satisfaction was assessed by the Patient Acceptable Symptom State question (3). Data were expressed as mean (SD) or median (interquartile range) according to the variables’ distribution. Mann Witney test was use and p values <0.05 were considered statistically significant.

Results:

Overall 108 patients started a JAK inhibitor (baricitinib n=67, tofacitinib n=41). Eighty-four patients (baricitinib n=51; tofacitinib n=33) were followed-up for at least 3 months and were included in the analysis. Table 1 summarizes demographic and clinical characteristic of the cohort. After 12 and 24 weeks of treatment we detected a significant reduction of DAS28 compared with baseline [from 4.7 (1.5) to 3.2 (1.7) 2.9 (1.5) and 2.7 (1.1), respectively; p<0.001; p<0.00001 and p<0.00001). At week 4, 27% and 51.8% of patients achieved remission and low disease activity, respectively; the percentages increase to 32.1% and 60.7% at week 12 and 42.2% and 70.3% at week 24. When evaluating the extent of reduction of the single items included in the DAS28 composite index we found that number of tender (TJ) and swollen joints (SJ) decreased from 9 (7.8) to 5 (3.5) to 4 (5) and 1 (3) at week 4, 2 (4) and 1 (3) at week 12, and 2 (4) and 1 (3) at week 24, respectively (p<0.00001 for all); the median reduction of TJC and SJC at week 4, 12 and 24 was 60%, 77% and 88%, and 81%, 86% and 100%, respectively. GH decreased from 70(30) to 40(40) at week 4, 40(30) at week 12 and 37(40) at week 24 (p<0.00001) with a median reduction of 37.5%, 44% and 46%. C reactive protein decreased by 54.5% at week 4, 47% at week 12 and 55% at week 24. VAS pain was significantly reduced at week 4, 12 and 24 [from 70(25) to 40(40,)30(40) at the three timepoints, p<0.00001] decreasing by 37.5%, 50% and 54%, respectively. A substantial reduction (≥50%) in VAS pain was reported by 41.3%, 54.4% and 53.9% of patients after 4, 12 and 24 weeks, respectively. Limited/no pain was reported by 21.3%, 24.7% and 36.5% at weeks 4, 12 and 24, respectively. Overall, 81.8% of patients achieved the PASS after a median time of 10 (7-15) days.

Conclusion:

JAK inhibitors baricitinib and tofacitinib induce a rapid improvement of disease activity driven both by pain and inflammation control. Even if no/limited pain was described only by one third of the patients, most of them reported a rapid and sustained reduction of pain accounting for the achievement of a satisfactory health condition.

References:

[1]Dworkin RH et al. Pain 2008; 9:105–121.

[2]Well GA et al. J Rheumatol 2005; 32:2016–2024.

[3]Heiber T et al. Ann Rheum Dis 2008; 67:967-71.

Baricitinib (n=51)Tofacitinib (n=33)PF:M43: 826:7nsAge, mean (SD)59±1260±12nsDisease duration, mean (SD)163±101170±112nsBaseline DAS28(PCR), median (IQR)4.7 (4-5.6)4.7 (4.3-5.4)nsConcomitant methotrexate, n (%)27 (52.9)8 (24.2)<0.001Daily prednisone dose, median (IQR)5 (2.5-9.5)5 (1.88-9.9)nsN° of previous csDMRADs, median (IQR)3 (1-4)2.5 (2-3)nsN° of previous bDMRADs, median (IQR)2 (1-4)1 (0-2.5)ns

Disclosure of Interests:

Francesca Romana Spinelli Grant/research support from: Pfizer, Speakers bureau: Lilly, BMS, Celgene, Cristina Garufi: None declared, Fulvia Ceccarelli: None declared, Silvia Mancuso: None declared, Ilaria Duca: None declared, cristiano alessandri Grant/research support from: Pfizer, Manuela Di Franco: None declared, Roberta Priori: None declared, Valeria Riccieri: None declared, Rossana Scrivo: None declared, Guido Valesini: None declared, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

AB0355 EFFECT OF TOFACITINIB IN TREG /TH17 BALANCE IN RHEUMATOID ARTHRITIS

Background:

Rheumatoid arthritis (RA) is a systemic chronic autoimmune disease that can cause progressive articular destruction (1). The imbalance between Tregs and Th17-cells - an effector T-cell subset acting as Treg antagonists – is closely linked to autoimmunity (2). A shift in the Th17/Treg balance towards the pro-inflammatory Th17 side has been reported in many autoimmune disorders including RA (4-5). Tofacitinib is the first janus kinases (JAK) inhibitor (JAKi) approved for the treatment of RA and it binds to and competitively inhibits the kinase domain of JAK3, JAK1 and, to a lesser degree, JAK2. Data on JAKi and Th17 cells/regulatory T cells (Tregs) are only available for ruxolitinib, a JAKi registered for myeloproliferative diseases (6).

Objectives:

Our project aimed at investigate the possible effect of Tofacitinib on the Treg/Th17 balance in RA patients.

Methods:

We isolated Peripheral Blood Mononuclear Cells (PBMCs) from patients affected by RA at baseline (T0) and after one month of Tofacitinib therapy (T1). By flow cytometry we characterized Treg and Th17 at T0 and T1. Clinical and laboratory data of the patients were collected in a standardized, computerized and electronically filled form. We assessed the disease activity by using DAS-28 (CRP). Data were expressed as mean(SD) or median (interquartile range, IQR) according to the variables’ distribution. Mann-Whitney and Spearman test were used. The values of P < 0.05 were considered statistically significant.

Results:

We isolated PBMCs from 9 patients with RA (F:M = 7:2, mean age±SD 60±17.4 years; mean disease duration±SD 20±6.6 years, DAS-28 median at T0 4.14 IQR 1.6; at T1 3.08 IQR 1.3). The median percentage of Treg and Th17 at T0 and T1 were respectively: T0 1.85 IQR 0.98 T1 3.12 IQR 1.37; T0 1.64 IQR 1.4, T1 0.6 IQR 1.1. Treg significantly increased after tofacitinib treatment while Th17 showed a tendency in decreasing without achieving a statistical difference (p= 0.003 and p=0.8, respectively) (figure 1). DAS-28 was negatively correlated with Treg number (r = -0.76565, p = 0.00021) and positively with Th17 numbers (r = 0.5816, p = 0.01135).

Conclusion:

This is the first study that investigated the role of JAKi on the Treg/Th17 balance in RA showing and increase in Treg cells with a concurrent tendency in decrease of Th17 cell population. The restore of the Treg/Th17 balance was associated with the reduction of DAS-28 (CRP).

References:

[1]McInnes IB et al. Lancet 2017

[2]Fasching P et al. Molecules 2017

[3]Han L et al. Front. Med. 2015

[4]Beringer A et al. Med. 2016

[5]Lippert E et al. Blood 2006

Disclosure of Interests:

viviana antonella pacucci: None declared, cristiana barbati: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Speakers bureau: Lilly, BMS, Celgene, Fulvia Ceccarelli: None declared, Silvia Mancuso: None declared, Cristina Garufi: None declared, cristiano alessandri Grant/research support from: Pfizer, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

FRI0121 STEROID-SPARING EFFECT OF JAK INHIBITORS IN RHEUMATOID ARTHRITIS PATIENTS FOLLOWED UP IN A REAL LIFE SETTING

Background:

Glucocorticoids (GCs) are a milestone of Rheumatoid Arthritis (RA) treatment; EULAR recommendations on the management of medium to high dose glucocorticoids remind to evaluate comorbidities and risk factors for adverse events when planning GCs treatment. Tofacitinib and Baricitinib are Janus kinases inhibitors (JAKi) registered for RA treatment. About 60% of patients enrolled in randomized clinical trials with JAKi were co-treated with GCs; however, little is known about tapering and percentage of withdrawal both in clinical trials and real life.

Objectives:

To evaluate the steroid-sparing effect of JAKi in patients with RA.

Methods:

We prospectively enrolled consecutive adult patients with RA starting JAKi. At baseline and after 4, 12 and 24 weeks we calculated C-Reactive Protein based Disease Activity score 28 (DAS28CRP). Daily dose of GCs was recorded at each visit as prednisone (PDN)-equivalent dose. Data are expressed as median (IQR). Continuous variables were compared by Mann Whitney test while dichotomous ones by Chi-square test. P values < 0.05 were considered statistically significant.

Results:

Between January 2018 and January 2020, 108 patients started JAKi: 67 patients Baricitinib, 41 patients Tofacitinib. The analysis was restricted to 64 RA patients (50 female, 14 male) who had at least 6 months of follow-up. Table 1 shows the demographic, clinical and clinimetric characteristics of the cohort. Patients treated with baricitinib and tofacitinib were comparable for age, disease duration, PDN dose and previous number of csDMARDS and bDMARDS; 30 patients (47.6%) were treated with JAKi in monotherapy. At baseline, the median daily PDN dose was 5 (7.25) mg; after 4, 12 and 24 weeks the median daily dose significant decreased to 5 (6.25) mg, 2.5 (5) mg and 0 (5) mg, respectively (p<0.0001). The percentage of patients treated with GC decreased from 81.5% to 63.5% at week 4, and to 48.4% at week 12 and 24. After 4, 12 and 24 weeks we detected a significant reduction of DAS28 (p<0.00001 compared to baseline). A similar percentage of patients who withdrew PDN compared to those who were still on PDN achieved remission after 12 and 24 months. Similarly, the reduction in DAS28 was comparable between the two groups at week 4 [4.8 (4.2) in those who withdrew vs 4.1 (1) in those who did not] at week 12 [4.8(1.6) for both] and at week 24 [3.7 (1.4) in those who withdrew vs 2.3 (0.7) in those who did not].

Table 1.

Demographic, clinic and clinimetric characteristics of the 64 patients

Baricitinib= 41Tofacitinib=23P valueFemale:male33:817:6P=nsAge, median (IQR), years58 (15)66 (14.5)P=nsDisease duration, median (IQR), months144 (144)150 (120)P=nsN° of previous csDMARDS3 (3)3 (1)P= nsN° of previous bDMARDs2 (3)1 (3)P= nsDAS28CRPat baseline4.7 (1.6)4.8 (2)P=nsPDN dose at baseline, median (IQR), mg5 (7.5)5 (5)P=nsPDN dose at 4 weeks, median (IQR), mg5 (7.5)5 (5)P=nsPDN dose at 12 weeks, median (IQR), mg2 (5)2.5 (4.7)P=nsPDN dose at 24 weeks, median (IQR), mg0 (5)2.5 (0)P=ns

IQR: interquartile range; DAS28CRP: Disease Activity Score 28 using C-Reactive Protein, csDMARDS: conventional synthetic Disease Modyfing anti-rheumatics drugs, bDMARDS: biotheconological Disease Modifying anti-rheumatics drugs PDN= prednisone

Conclusion:

The rapid reduction of disease activity determined by JAK inhibitors allows a fast tapering of PDN, as suggested by the last EULAR recommendations for the management of RA.

Disclosure of Interests:

Ilaria Duca: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Speakers bureau: Lilly, BMS, Celgene, Fulvia Ceccarelli: None declared, Cristina Garufi: None declared, Silvia Mancuso: None declared, cristiano alessandri Grant/research support from: Pfizer, Rossana Scrivo: None declared, Roberta Priori: None declared, Valeria Riccieri: None declared, Manuela Di Franco: None declared, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

AB0340 EFFECT OF BARICITINIB ON RANKL SERUM CONCENTRATION IN RHEUMATOID ARTHRITIS PATIENTS

Background:

RANKL (receptor activator of nuclear factor κB ligand) and osteoprotegerin, the main regulators of bone metabolism, are involved in osteoblasts/osteoclasts balance in inflammatory disease, such as Rheumatoid Arthritis (RA). Janus kinase (JAK) inhibitors (baricitinib and tofacitinib) can reduce the progression of structural damage in patients with moderate to severe RA. Previous studies suggest a link between JAK inhibition, production of RANKL and osteoclastogenesis1,2.

Objectives:

to investigate the effect of baricitinib on RANKL serum concentration in unselected RA patients.

Methods:

Patients affected by RA according to 2010 ACR criteria, starting treatment with baricitinib as clinically indicated, were consecutively enrolled. Demographic, clinical and laboratory data were collected at baseline (T0) and after three months of therapy (T3). RANKL serum concentration was analyzed by ELISA at the same timepoints. All patients underwent ultrasound (US) examination at T0 and T3. According with OMERACT definitions, the presence of synovial effusion, hypertrophy and power Doppler were assessed and scored on a semi-quantitative scale (0=absent, 1=mild, 2=moderate, 3=severe), obtaining a total US score (0-198), representing the joint inflammatory status (15); erosions were registered. Data were expressed as median (interquartile range); Mann-Whitney and Spearman tests were performed for comparisons and p values < 0.05 were considered statistically significant.

Results:

We prospectively followed up 33 RA patients starting treatment with baricitinib [M/F 8/25; age 58(9) years; disease duration 165(150) months; 22/33 (67%) ACPA-anti-citrullinated protein antibody positive; 24/33 patients (73%) RF-rheumatoid factor positive]. After three months of therapy we observed a significant reduction of DAS28CRP, CDAI and SDAI compared to baseline (p<0.0001). The US inflammatory score showed a significant improvement at T3 (p<0.0001). The serum concentration of RANKL showed a significant decrease after three months of therapy from 44 (25.9) to 27.5 (35.3) pg/ml,p=0.0256 (Figure 1). While in 67% of patients RANKL decreased after treatment, in 33% of patients no decrease or an increase of RANKL was detected. Those patients showing an increase of RANKL had similar DAS28CRP, CDAI, SDAI, but had significantly less swollen joints, compared to those in which RANKL decreased (p=0.0364). At baseline, the concentration of RANKL significantly correlated with the swollen joint count (p=0.0117) and ESR (p=0.0482), but not with DAS28CRP, CDAI, SDAI nor with the US inflammatory score. Nevertheless, the reduction of RANKL was not significantly associated with the achievement of low disease/remission after three months of treatment, with ACPA/RF positivity or the presence of erosions detected by US.

Conclusion:

This is the first study demonstrating that baricitinib reducesin vivothe serum levels of RANKL, regardless the correlation with disease activity indices. The discrepancy between the levels of RANKL and the clinical response is in line with previous data in the literature, demonstrating that, under treatment with anti-TNF and anti-IL1, the decrease of RANKL did not influence the local or systemic inflammatory parameters, even if still preventing bone loss3.

References:

[1]LaBranche T P et al. JAK inhibition with tofacitinib suppresses arthritic joint structural damage through decreased RANKL production. Arthritis Rheum 2012

[2]Murakami, KA Jak1/2 inhibitor, baricitinib, inhibits osteoclastogenesis by suppressing RANKL expression in osteoblasts in vitro. PLOS ONE 2017

[3]Stolina M et al. RANKL inhibition by osteoprotegerin prevents bone loss without affecting local or systemic inflammation parameters in two rat arthritis models: comparison with anti-TNFalpha or anti-IL-1 therapies. Arthritis Res Ther 2009

Disclosure of Interests:

Cristina Garufi: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Consultant of: Novartis, Gilead, Lilly, Sanofi, Celgene, Speakers bureau: Lilly, Fulvia Ceccarelli: None declared, Silvia Mancuso: None declared, cristiana barbati: None declared, Tania Colasanti: None declared, cristiano alessandri Grant/research support from: Pfizer, Fabrizio Conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

OP0204 LUPUS COMPREHENSIVE DISEASE CONTROL IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS: APPLICATION OF A NEW INDEX

Background:

The main outcomes in SLE patients management are represented by the remission achievement and chronic damage prevention. Even though activity and damage are intimately connected, to date indices including both these outcomes are not available.

Objectives:

In the present study, we aimed at assessing the application of a new index, the Lupus comprehensive disease control (LupusCDC), including disease activity and chronic damage progression.

Methods:

We performed a longitudinal analysis, including SLE patients according to ACR 1997 criteria, followed-up in the period between January 2014 and December 2018, and with at least one visit per year. Disease activity was assessed by SLE Disease Activity Index 2000 (SLEDAI-2K) and three different remission levels were evaluated, as reported in Table 1 (1).

Table 1.

Remission levels considered in the study (1).

Remission levelDefinitionComplete Remission(CR)No clinical and serological activity (SLEDAI-2K=0) in corticosteroid-free and immunosuppressant-free patients (antimalarials allowed)Clinical remission off-corticosteroids(ClR-GCoff)Serological activity with clinical quiescent disease according to SLEDAI-2K in corticosteroid-free patients (stable immunosuppressive therapy and antimalarials allowed)clinical remission on-corticosteroids(ClR-GCon)Clinical quiescent disease according to SLEDAI-2K in patients on prednisone 1–5 mg/day (stable immunosuppressants and antimalarials allowed)

Chronic damage was registered according to SLICC damage index (SDI). All the patients were evaluated at baseline (T0) and every 12 months (T1, T2, T3, T4). At each time-point, we calculated the prevalence of LupusCDC, defined as remission achievement plus absence of chronic damage progression in the previous one year. We calculated this outcome including separately the different remission levels.

Results:

According with inclusion criteria, 172 SLE patients were evaluated in the present analysis [M/F 16/156, median age 49 years (IQR 16.7), median disease duration 180 months (IQR 156)]. At first assessment, we observed a mean±SD SDI value of 0.7±1.1. In details, 56 patients (32.5%) showed damage in at least one organ/system and the presence of damage was significantly associated with age (p<0.0001, r=0.3) and disease duration (p=0.0003, r=0.3). During the follow-up, we observed a significant increase in SDI values compared with T0 (T1: mean±DS 0.8±1.3, p<0.0001; T2: 0.8±1.4, p<0.0001; T3: 0.9±1.4 p=0.0001; T4: 1.0±1.5 p<0.0001).

In figure 1A and 1B we reported the proportion of patients achieving the different levels of remission and LupusCDC, respectively. In particular, the LupusCDC definition including CR was the most frequently detected in all time-points evaluated (T1: 18.0%; T2: 31.9%; T3: 27.9%; T4: 24.4%), with a significant difference at T2 [LupusCDC(CR)versusLupusCDC(ClR-GCoff), p=0.0002; LupusCDC(CR)versusLupusCDC(ClR-GCon) p=0.0002)], T3 [LupusCDC(CR)versusLupusCDC(ClR-GCoff), p=0.03; LupusCDC(CR)versusLupusCDC(ClR-GCon) p=0.006], T4 [LupusCDC(CR)versusLupusCDC(ClR-GCon), p=0.002]. No significant differences were found when comparing the prevalence of different remission levels and the prevalence of LupusCDC including the corresponding remission.

Conclusion:

In the present analysis we proposed for the first time a new index including disease activity and chronic damage, in order to evaluate the proportion of SLE patients reaching a comprehensive disease control. We found that CR is most frequently associated with the absence of damage progression.

References:

[1]Zen M et al. Ann Rheum Dis 2017.

Disclosure of Interests:

Fulvia Ceccarelli: None declared, Giulio Olivieri: None declared, Lorenzo Dominici: None declared, Alessandra Ida Celia: None declared, enrica cipriano: None declared, Cristina Garufi: None declared, Silvia Mancuso: None declared, Francesco Natalucci: None declared, Valeria Orefice: None declared, Carlo Perricone: None declared, Carmelo Pirone: None declared, viviana antonella pacucci: None declared, Francesca Morello: None declared, Simona Truglia: None declared, Francesca Miranda: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Consultant of: Novartis, Gilead, Lilly, Sanofi, Celgene, Speakers bureau: Lilly, cristiano alessandri Grant/research support from: Pfizer, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

FRI0145 FOLLOW-UP OF A MONOCENTRIC COHORT OF SERONEGATIVE ANTIPHOSPHOLIPID SYNDROME

Background:

Seronegative antiphospholipid syndrome (SN-APS) is the term proposed to describe patients with clinical signs highly suggestive of APS but persistently negative for conventional antiphospholipid antibodies (aPL) assays. Therefore, new antigenic targets or different methodological approaches have been investigated to detect aPL in SN-APS [1].

Objectives:

The aim of this study was to describe the clinical follow-up of a monocentric cohort of SN-APS patients.

Methods:

The study included all consecutive SN-APS patients examined from 2014 to 2018. In all patients other possible causes of thrombosis or obstetric morbidity were ruled out. APL were investigated through two tests: 1. anti-cardiolipin/vimentin antibodies (aCL/Vim) by enzyme-linked immunosorbent assay (ELISA) 2. anti-cardiolipin antibodies (aCL) by thin-layer chromatography (TLC)-immunostaining.

Results:

We enrolled 121 patients (all Caucasian except one Asian and one Hispanic women). Clinical and demographic characteristics are reported in Table 1.

Table 1.

Clinical and demographic characteristics

FeaturesSN-APSn= 121 (%)Male/Female14/107Mean age in years (from-to)42.58 (16-78)PAPS/SAPS78/43 (64.5/35.5)SLE28 (23.1)Others autoimmune diseases15 (12.4)Pregnancy morbidity56/107 (52.3) Spontaneous abortions49 (45.8) Normal fetus deaths22 (20.6) Premature births7 (6.54)Thrombosis72 (59.5) Arterial thrombosis36 (29.8) Venous thrombosis48 (39.7) Recurrent thrombosis28 (23.1)Thrombosis + Pregnancy morbidity8 (6.6)Non-criteria APS features45 (37.2) Livedo reticularis18 (14.9) Thrombocytopenia12 (9.9) Migraine19 (15.7) Seizures5 (4) Others11 (9)Cardiovascular risk factors50 (41.3) Hypercholesterolemia8 (6.6) Smoking22 (18.2) Hypertension22 (18.2) OC/HRT7 (5.8) Diabetes4 (3.3)

Sixty-nine out 121 patients (57%) resulted positive for at least one non-conventional test in two occasions more than 12 weeks apart (Figure 1). The agreement between first and second test resulted respectively of K=0,703 e K=0,655 (Cohen’s K test). Figure 2 shows the prevalence of aCL (TLC-immunostaining) and aCL/Vim. We found a significant correlation between aCL (by TLC-immunostaining) and aCL/Vim (p= 0.027), brain MRI ischemic changes (p= 0.012) and age (p= 0.023). ACL/Vim was significantly correlated with livedo reticularis (p = 0.015).

Patients with double positivity showed a higher prevalence of mixed thrombotic and obstetrical features than patients with single positivity (p < 0.001, likelihood positive ratio 8.2).

Non-conventional aPL positivity better supported the diagnosis of APS and, following the therapeutic changes implemented, in a median follow up of 41 months (IQR 39.5) only 3 cases of recurrent thrombosis (2 cases of arterial thrombosis during treatment with antiaggregant therapy and one case of venous thrombosis in treatment with new oral anticoagulant therapy) were observed. During the follow-up, 35 patients with obstetric morbidity who resulted positive for the tests had 20 pregnancies; 12 of them (60%) experienced a good outcome under conventional treatment for classical APS.

Conclusion:

The results demonstrate that new methods – TLC-immunostaining – or new antigens - CL/Vim – allow to detect aPL in so-called “SN-APS” patients and, consequently, to prescribe the most appropriate therapy.

References:

[1]Conti F et al. The Mosaic of “Seronegative” Antiphospholipid Syndrome. J Immunol Res. 2014;2014:389601

Disclosure of Interests:

Silvia Mancuso: None declared, Simona Truglia Speakers bureau: Lilly, BMS, Serena Recalchi: None declared, Gloria Riitano: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Speakers bureau: Lilly, BMS, Celgene, Fulvia Ceccarelli: None declared, Maurizio Sorice: None declared, cristiano alessandri Grant/research support from: Pfizer, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

Tuberomics: a molecular profiling for the adaption of edible fungi (Tuber magnatum Pico) to different natural environments

BACKGROUND

Truffles are symbiotic fungi that develop underground in association with plant roots, forming ectomycorrhizae. They are primarily known for the organoleptic qualities of their hypogeous fruiting bodies. Primarily, Tuber magnatum Pico is a greatly appreciated truffle species mainly distributed in Italy and Balkans. Its price and features are mostly depending on its geographical origin. However, the genetic variation within T. magnatum has been only partially investigated as well as its adaptation to several environments.

RESULTS

Here, we applied an integrated omic strategy to T. magnatum fruiting bodies collected during several seasons from three different areas located in the North, Center and South of Italy, with the aim to distinguish them according to molecular and biochemical traits and to verify the impact of several environments on these properties. With the proteomic approach based on two-dimensional electrophoresis (2-DE) followed by mass spectrometry, we were able to identify proteins specifically linked to the sample origin. We further associated the proteomic results to an RNA-seq profiling, which confirmed the possibility to differentiate samples according to their source and provided a basis for the detailed analysis of genes involved in sulfur metabolism. Finally, geographical specificities were associated with the set of volatile compounds produced by the fruiting bodies, as quantitatively and qualitatively determined through proton transfer reaction-mass spectrometry (PTR-MS) and gas-chromatography-mass spectrometry (GC-MS). In particular, a partial least squares-discriminant analysis (PLS-DA) model built from the latter data was able to return high confidence predictions of sample source.

CONCLUSIONS

Results provide a characterization of white fruiting bodies by a wide range of different molecules, suggesting the role for specific compounds in the responses and adaptation to distinct environments.

Preliminary evaluation of HER-2/neu oncogene and epidermal growth factor receptor expression in normal and neoplastic human ovaries

The HER-2/neu oncogene (a member of the Erb-like oncogene family) is distinct from but closely related to the c-erb B gene which encodes the epidermal growth factor receptor (EGFr). HER-2/neu gene amplification was found in a large number of mammary carcinomas and there was a strong correlation between this phenomenon and poor prognosis. In our study HER-2/neu oncogene expression was determined in 16 malignant ovarian tumors, 2 ovarian lymphomas and 5 normal ovaries. The HER-2/neu gene was found both in normal ovaries and malignant tumors, without any apparent difference among the various histological types. In all the specimens examined, HER-2/neu expression did not seem to be related to EGF binding capacity.

Trace element partitioning in a poplar phytoextraction stand in relation to stem size

At an Italian field test site the efficiency of phytoextraction of toxic trace elements (TEs) from the soil is determined by uptake capacity, bioavailability of TEs in the soil and biomass yield of the plants involved. Altering the quantity and type of biomass produced, especially among fast-growing trees, may be one method of increasing phytoextraction efficiency. In poplar bark and wood show different TE concentration. Poplar also shows changing proportions of bark and wood with increasing diameter at breast height (DBH). Though it is often thought that the amount of TE accumulated in the biomass increases with the size of the plant, in the current study we show that this is only partially true. In fact while Zn is highly accumulated by the largest (60 mm DBH) poplar plants, Cd, Cu, and Ni were more concentrated in slightly smaller plants (50 mm DBH), and Pb in even smaller (40 mm DBH). These findings could open new strategies for managing a poplar phytoextraction stand in terms of coppicing techniques and planting cycles in order to address specific targeted TEs and enhance the overall performance of this green technology.

Root vacuolar Na+ sequestration but not exclusion from uptake correlates with barley salt tolerance

Soil salinity is a major constraint for the global agricultural production. For many decades, Na⁺ exclusion from uptake has been the key trait targeted in breeding programs; yet, no major breakthrough in creating salt-tolerant germplasm was achieved. In this work, we have combined the microelectrode ion flux estimation (MIFE) technique for non-invasive ion flux measurements with confocal fluorescence dye imaging technique to screen 45 accessions of barley to reveal the relative contribution of Na⁺ exclusion from the cytosol to the apoplast and its vacuolar sequestration in the root apex, for the overall salinity stress tolerance. We show that Na⁺ /H⁺ antiporter-mediated Na⁺ extrusion from the root plays a minor role in the overall salt tolerance in barley. At the same time, a strong and positive correlation was found between root vacuolar Na⁺ sequestration ability and the overall salt tolerance. The inability of salt-sensitive genotypes to sequester Na⁺ in root vacuoles was in contrast to significantly higher expression levels of both HvNHX1 tonoplast Na⁺ /H⁺ antiporters and HvVP1 H⁺ -pumps compared with tolerant genotypes. These data are interpreted as a failure of sensitive varieties to prevent Na⁺ back-leak into the cytosol and existence of a futile Na⁺ cycle at the tonoplast. Taken together, our results demonstrated that root vacuolar Na⁺ sequestration but not exclusion from uptake played the main role in barley salinity tolerance, and suggested that the focus of the breeding programs should be shifted from targeting genes mediating Na⁺ exclusion from uptake by roots to more efficient root vacuolar Na⁺ sequestration.

Comparison between thrombotic risk scores in essential thrombocythemia and survival implications

The conventional thrombotic risk stratification in essential thrombocythemia (ET) distinguishes patients in two risk groups based on previous thrombosis and age (< or >60). The IPSET-thrombosis takes into account four risk factors: age greater than 60 years and the presence of CV risk factors, thrombosis history and JAK2 V617F presence. The revised IPSET-thrombosis uses three adverse variables to delineate four risk categories: age greater than 60, thrombosis history, and JAK2 V617F presence. We compared different risk models in the estimation of thrombotic risk in 191 patients with ET and the role of specific driver mutations affecting overall survival, according to thrombotic risk. We also evaluated the mutational status of patients showing history of thrombosis or cardiovascular events versus patients who did not. Finally, we verified whether the thrombotic risk had a significant impact on survival in our ET patients. The data analysis has been performed through the conventional statistics and overall survival estimated by using the Kaplan-Meyer method. Interestingly, either using the traditional system for thrombotic risk or the IPSET-t prognostic score or the current stratification for the thrombotic risk, high-risk patients are always highly represented. This evidence is of note, being the high-risk category indicated for cytoreduction, affecting quality of life, despite the good overall prognosis of patients with ET diagnosis in general. The analysis of overall survival in our patients, according to different models for thrombotic risk, highlighted the poor prognosis of high-risk patients compared with those with a lower thrombotic risk, in particular when using traditional stratification and current stratification. In conclusion, the occurrence of thrombotic or cardiovascular events represents one of the most severe complications at diagnosis or during follow-up of ET despite current recommendations, having a significant impact on morbidity and survival.

Activation of plasma membrane H+-ATPases participates in dormancy alleviation in sunflower seeds

Using various inhibitors and scavengers we took advantage of the size of sunflower (Helianthus annuus) seeds to investigate in vivo the effects of hormones, namely abscisic acid (ABA) and ethylene (ET), and reactive oxygen species (ROS) on the polarization of dormant (D) and non-dormant (ND) embryonic seed cells using microelectrodes. Our data show that D and ND seed cells present different polarization likely due to the regulation of plasma membrane (PM) H⁺-ATPase activity. The data obtained after addition of hormones or ROS scavengers further suggest that ABA dependent inhibition of PM H⁺-ATPases could participate in dormancy maintenance and that ET-and ROS-dependent PM H⁺-ATPase stimulation could participate in dormancy release in sunflower seeds.