Association Between T2-related Comorbidities and Effectiveness of Biologics in Severe Asthma

Rationale: Previous studies investigating the impact of comorbidities on the effectiveness of biologic agents have been relatively small and of short duration and have not compared classes of biologic agents. Objectives: To determine the association between type 2-related comorbidities and biologic agent effectiveness in adults with severe asthma (SA). Methods: This cohort study used International Severe Asthma Registry data from 21 countries (2017-2022) to quantify changes in four outcomes before and after biologic therapy-annual asthma exacerbation rate, FEV1% predicted, asthma control, and long-term oral corticosteroid daily dose-in patients with or without allergic rhinitis, chronic rhinosinusitis (CRS) with or without nasal polyps (NPs), NPs, or eczema/atopic dermatitis. Measurements and Main Results: Of 1,765 patients, 1,257, 421, and 87 initiated anti-IL-5/5 receptor, anti-IgE, and anti-IL-4/13 therapies, respectively. In general, pre- versus post-biologic therapy improvements were noted in all four asthma outcomes assessed, irrespective of comorbidity status. However, patients with comorbid CRS with or without NPs experienced 23% fewer exacerbations per year (95% CI, 10-35%; P < 0.001) and had 59% higher odds of better post-biologic therapy asthma control (95% CI, 26-102%; P < 0.001) than those without CRS with or without NPs. Similar estimates were noted for those with comorbid NPs: 22% fewer exacerbations and 56% higher odds of better post-biologic therapy control. Patients with SA and CRS with or without NPs had an additional FEV1% predicted improvement of 3.2% (95% CI, 1.0-5.3; P = 0.004), a trend that was also noted in those with comorbid NPs. The presence of allergic rhinitis or atopic dermatitis was not associated with post-biologic therapy effect for any outcome assessed. Conclusions: These findings highlight the importance of systematic comorbidity evaluation. The presence of CRS with or without NPs or NPs alone may be considered a predictor of the effectiveness of biologic agents in patients with SA.

Forage intake, digestibility and performance of cattle, horses, sheep and goats grazing together on an improved heathland

A mixed herd of five cows, five mares, 32 ewes and 32 goats was managed with their offspring during two consecutive years in a paddock (22.3 ha) with 76% of heathlands and 24% of improved pasture area, with the aim of studying their differences in ingestive behaviour and performance. Diet composition, dry matter intake (DMI) and digestibility (DMD) were estimated on three occasions using the alkane technique, and all animals were periodically weighed to calculate bodyweight (BW) changes per livestock unit (LU). Goats selected higher proportions of shrubs than the other herbivore species (P < 0.001). Overall, daily DMI was higher (P < 0.001) in equines (218 g/kg BW0.75) than in ruminants (174, 121 and 80 g/kg BW0.75 for cattle, goats and sheep, respectively), whereas DMD was lower (P < 0.001) in equines (569 g/kg DM) compared with ruminants (733–791 g/kg DM). During the first half of the grazing season (from late April to mid-July), dams’ BW changes per LU did not differ between species. However, during late summer–autumn lower (P < 0.001) BW losses per LU were observed in sheep and goats (–89 g/day) than in cattle (–534 g/day), being intermediate in horses (–254 g/day). For the overall grazing season, ewes and goats showed greater (P = 0.056) BW gains per LU (338 g/day) than cows and mares (178 g/day). Regarding the offspring, BW gains per LU were greater (P < 0.001) in lambs (3612 g/day) than in other species. Calves presented greater gains than kids (2647 vs 1909 g/day.LU), whereas foals showed intermediate gains (2385 g/day.LU). Therefore, under these conditions of partially improved heathlands, sheep was the most productive species. However, looking at the diet selection and digestibility, goats could complement sheep or cattle herds by achieving a more efficient utilisation of heathland vegetation, and increasing overall productivity per hectare. By contrast, horses, having high levels of grass intake, compete with cattle and sheep for pasture utilisation.

Comparison of feed intake, digestion and rumen function among domestic ruminant species grazing in upland vegetation communities

This study aimed to compare feed intake, digestion, rumen fermentation parameters and bacterial community of 5 beef cows, 12 crossed ewes and 12 goats grazing together in spring-early summer on heather-gorse vegetation communities with an adjacent area of improved pasture. Organic matter intake (OMI) and digestibility (OMD) were estimated using alkane markers. Ruminal fluid samples were collected for measuring fermentation parameters, and studying the bacterial community using terminal restriction fragment length polymorphism (T-RFLP). Spot samples of urine were taken to determine purine derivative (PD) and creatinine concentrations to estimate microbial protein synthesis in the rumen. Herbaceous species were the main dietary component in all animal species. Cattle had higher (p < 0.05) daily OMI (g/kg LW^0.75 ) and OMD, whereas sheep and goats showed similar values. The highest ammonia concentration was observed in sheep. Total VFA, acetate and butyrate concentrations were not influenced by animal species, while propionate concentrations in goats were 1.8 times lower (p < 0.05) than in sheep. Acetate:propionate ratio was greater (p < 0.05) in goats, whereas cattle excreted more allantoin (p < 0.05). Estimated supply of microbial N was higher in cows (p < 0.01), whereas the efficiency of microbial protein synthesis was lower (p < 0.01) in this animal species. Hierarchical clustering analysis indicated a clear effect of animal species on rumen bacterial structure. Differences among animal species were also observed in the relative frequency of several T-RFs. Certain T-RFs compatible with Lachnospiraceae, Proteobacteria and Clostridiales species were not found in goats, while these animals showed high relative frequencies of some fragments compatible with the Ruminococcaceae family that were not detected in sheep and cattle. Results suggest a close relationship between animals' grazing behaviour and rumen bacterial structure and its function. Goats seem to show a greater specialization of their microbial populations to deal with the greater fibrous and tannin content of their diet.

Anthelmintic effect of heather in goats experimentally infected with Trichostrongylus colubriformis

The effects of heather (composed primarily of Calluna vulgaris with a smaller content of Erica umbellata and Erica cinerea) consumption on the establishment of incoming infective larvae (experiment 1, preventive treatment) and an adult worm population (experiment 2, curative treatment) were investigated in Cashmere goats experimentally infected with Trichostrongylus colubriformis. In experiment 1, 12 castrated male goats were divided into two groups: heather-supplemented vs. non-supplemented animals. After 2 weeks of adaptation to the diet, all goats were experimentally infected per os with 6,000 T. colubriformis third-stage larvae. Three weeks post-infection, the goats were slaughtered, and worm counts as well as female worm fecundity and development were determined. Heather consumption was associated with a close to significant (P=0.092) reduction (mean 14 %) in larvae establishment. No effect on fecundity was observed, but the length of female worms in supplemented goats was greater (P<0.001). In experiment 2, 15 non-lactating does were experimentally infected with 6,000 T. colubriformis third-stage larvae. At 6 weeks post-infection, three groups were established: control, heather-supplemented and heather-supplemented with polyethylene glycol. Individual faecal nematode egg output was measured twice weekly to assess gastrointestinal nematode egg excretion. The goats were slaughtered 5 weeks after heather administration (11 weeks post-infection), and worm counts as well as female worm fecundity and development were subsequently determined. Heather administration was associated with a significant (P<0.001) decrease (between 47 and 66 % compared with control group) in egg excretion from 45 to 76 days post-infection. Although worm counts and female fecundity were lower in supplemented goats, no significant differences were observed. Overall, the results showed a reduction in T. colubriformis larvae establishment and a decrease in nematode egg excretion when heather was administered in experimentally infected goats. The heather plus polyethylene glycol treatment reduced nematode egg excretion levels at the same proportion as heather, thereby suggesting that the threshold of tannins required for an anthelmintic effect is most likely quite low.

Anthelmintic and nutritional effects of heather supplementation on Cashmere goats grazing perennial ryegrass-white clover pastures1

To investigate anthelmintic and nutritional effects of heather supplementation in goats grazing perennial ryegrass-white clover pastures, 40 dry Cashmere goats were randomly assigned to 4 treatments in a 2 x 2 factorial arrangement: 2 grazing management treatments (supplementation with heather vs. nonsupplementation) and 2 anthelmintic treatments (treatment vs. nontreatment). Goats grazed continuously from May to September 2004. At the end of the grazing period, the number of dead goats due to gastrointestinal parasitism was 1 in the group supplemented with heather and dosed with anthelmintic, 4 in the group that received neither supplementation nor anthelmintic, and 0 in the other 2 groups. For goats that did not receive anthelmintic treatment, the percentage of heather in the diet was negatively correlated with fecal egg count in August (r = -0.59, P < 0.05) and September (r = -0.49, P < 0.1) and positively correlated (r = 0.54, P < 0.05) with BW changes during the grazing season. Therefore, the correlation coefficient between BW change and fecal egg count was negative (r = -0.62, P < 0.05). Rumen ammonia concentrations were always lower in supplemented goats (P < 0.05). However, VFA concentrations were greater in goats consuming heather (58.9 vs. 50.9 mmol/L), which suggests that ruminal fermentation was not adversely affected by consumption of tannins. Heather availability in the vegetation might represent a valuable opportunity and sustainable method to control gastrointestinal nematode infections in a goat production system based on grazing perennial ryegrass-white clover pastures.

Application of n-alkanes as diet composition markers in grazing/browsing goats and sheep: effect of using different faecal recovery corrections and plant species grouping approaches

The present study aimed to test the effect of applying different sets of n-alkane faecal recoveries and different plant species grouping approaches on the estimates of the diet selected by goats and sheep when grazing/browsing complex vegetation communities composed of mosaics of heather-gorse vegetation interspersed with patches of perennial ryegrass. The use of different sets of n-alkane faecal recoveries significantly affected the estimated proportions of most vegetation components in both animal species. The diet estimates were also significantly affected by the calculation approach: A1 (using all individual plant species); A2 (grouping plant species with similar n-alkane profile, with equal weighting within the group); and A3 (grouping plant species with similar n-alkane profile, with different weighting according to the botanical composition of the plot). There was a significant interaction between calculation approach (A) and faecal recovery sets (FR) on the resulting estimates of the Ericaceae species in the diet of goats and of all diet components in sheep. When using A1 approach, the estimated proportion of Agrostis capillaris in the diets was high and seemed to be overestimated, compared with its low availability (1.1% of total cover) in the field. However, the application of calculation approaches A2 and A3 gave lower dietary proportions of component D2 (Agrostis capillaris and Ulex gallii) and higher proportions of components D1 (Lolium perenne and Pseudarrhenatherum longifolium), D3 (Erica umbellata, Erica cinerea, Erica australis, Calluna vulgaris) and Erica arborea. These results indicate that the application of the n-alkane technique for estimation of the diet composition in field with complex vegetation conditions is sensitive to the use of faecal recovery corrections and to the grouping of possible dietary components.

Serotonin activates a Ca(2+)-dependent K(+) current in identified peptidergic neurons from the crayfish

The effects of 5-hydroxytryptamine (5-HT) were investigated in red pigment concentrating hormone (RPCH)-containing neurons isolated from the X-organ of the crayfish (Procambarus clarkii). Under current-clamp conditions and using the gramicidin-perforated-patch configuration, 5-HT elicited a prolonged hyperpolarization that suppressed neuronal firing concomitant with an increase in membrane conductance. Under voltage-clamp conditions, 5-HT evoked an outward current at a holding potential of −50 mV. This current reversed at an E(K) of −90 mV, which shifted by 30 mV when the extracellular K(+) concentration was increased from 5.4 to 19 mmol l(−1). The effect of 5-HT was dose-dependent within the range 1–100 micromol l(−1) and followed simple Michaelis-Menten kinetics, with a half-maximal response being elicited at 10 micromol l(−1). Preincubation with charybdotoxin (100 nmol l(−1)), tetraethylammonium (500 micromol l(−1)) or methysergide (100 micromol l(−1)) was effective in blocking the response to 5-HT. These results suggest that 5-HT is an inhibitory mediator of the release of red pigment concentrating hormone by acting on a Ca(2+)-dependent K(+) current.

Regulation of crustacean neurosecretory cell activity

1. The X organ-sinus gland system is a conglomerate of 150-200 neurosecretory cells in the eyestalk of crustaceans. It is the source of a host of peptide neurohormones which partake in the control of a wide range of physiological functions. Distinct families of X organ peptides have been chemically characterized: (a) two chromatophorotropic hormones of small sizes, one of 8 residues and the other of 15-20 residues; and (b) three metabotropic hormones of high molecular weight (70-80 residues), related to the control of blood sugar levels, molting, and gonad activity. Some of these hormones have been identified only in crustaceans; others are common to various arthropod groups. A number of peptides orginally described in other zoological groups are also present in the X organ-sinus gland system; such is the case for members of the FMRF-amide family, enkephalins, and other peptides. 2. Cells specifically containing each hormone have been located in the X organ and some information is available on the cellular and molecular substrate of the biosynthesis, transport, storage, and release of various hormones. The electrical activity of X organ neurons has been recorded at the cell soma, arborizations, axons, and neurosecretory terminals. Conspicuous regional differences have been defined for the various patterns of activity, as well as the distribution of their underlying ion currents. 3. The release of hormones and the electrical activity of X organ neurons are regulated by environmental and endogenous influences, such as light and darkness, stress, and circadian rhythms. These influences appear to be mediated by a host of neurotransmitters/modulators, most noticeably, gamma-aminobutyric acid, 5-hydroxytryptamine and other amines, and enkephalins. Each of these mediators acts upon a definite ionic substrate(s) and exerts specific regulatory effects on X organ cell activity. A given neuron may be under the control of more than one neurotransmitter, and a transmitter may mediate different and even opposite influences on different neurons.

Modulation of electrical activity by 5-hydroxytryptamine in crayfish neurosecretory cells

The effect of 5-hydroxytryptamine (5-HT) was tested in a population of X organ neurosecretory cells in the eyestalk of the crayfish Procambarus clarkii. Tests were conducted both in situ and on isolated neurones kept in culture. The application of 5-HT induced action potentials in silent cells. In spontaneously active neurones, 5-HT increased the firing rate and either induced firing or enhanced bursting activity. The effect of 5-HT was dose-dependent within the range 1-100 micromol l-1 in cells of the intact organ. The effect persisted for 20-30 min after 5-HT had been removed from the bathing solution. Successive applications of 5-HT onto the same neurone reduced responsiveness, suggesting that desensitization had occurred. The effects of 5-HT were blocked by prior incubation with the 5-HT antagonist methysergide. In X organ cells whose axons and branches in the neuropile had been severed, 5-HT induced a depolarisation associated with a slow inward current. In X organ neurones isolated from the eyestalk and kept in culture, 5-HT was capable of evoking bursts of action potentials and elicited a slow inward current. This effect was also blocked by methysergide (10(-4 )mol l-1). These results suggest a direct modulatory effect of 5-HT on the pattern of electrical activity in the X organ cells.

[Hepatic veno-occlusive disease associated with ingestion of Senecio tephrosioides]

A case of hepatic veno-occlusive disease (HVOD) in a 38 year-old woman is reported. She had occasionally consumed "Huamanrripa" (Senecio tephrosioides) as a cough remedy for many years. She was hospitalized because she had presented abdominal pain, jaundice and anasarca during 10 weeks. The histological studies of hepatic biopsy showed pronounced congestion to centrilobulillar predominance, focus of necrosis and a reversed lobulation pattern in some areas. In the next 13 months she was hospitalized four times due to complications of portal hypertension. This is the first reported case of HVOD associated with S tephrosioides ingestion. It is very probable that this plant used in peruvian traditional medicine contains pyrrolizidine alkaloids, hepatic and nephrotoxic substances that are present in other species of Senecio genus. Due to present popularity of alternative medicine, an increment in HVOD incidence is expected.

Excitatory action of gamma-aminobutyric acid (GABA) on crustacean neurosecretory cells

1. Intracellular and voltage-clamp recordings were obtained from a selected population of neurosecretory (ns) cells in the X organ of the crayfish isolated eyestalk. Pulses of gamma-aminobutyric acid (GABA) elicited depolarizing responses and bursts of action potentials in a dose-dependent manner. These effects were blocked by picrotoxin (50 microM) but not by bicuculline. Picrotoxin also suppressed spontaneous synaptic activity. 2. The responses to GABA were abolished by severing the neurite of X organ cells, at about 150 microns from the cell body. Responses were larger when the application was made at the neuropil level. 3. Topical application of Cd2+ (2 mM), while suppressing synaptic activity, was incapable of affecting the responses to GABA. 4. Under whole-cell voltage-clamp, GABA elicited an inward current with a reversal potential dependent on the chloride equilibrium potential. The GABA effect was accompanied by an input resistance reduction up to 33% at a -50 mV holding potential. No effect of GABA was detected on potassium, calcium, and sodium currents present in X organ cells. 5. The effect of GABA on steady-state currents was dependent on the intracellular calcium concentration. At 10(-6) M [Ca2+]i, GABA (50 microM) increased the membrane conductance more than threefold and shifted the zero-current potential from -25 to -10 mV. At 10(-9) M [Ca2+]i, GABA induced only a 1.3-fold increase in membrane conductance, without shifting the zero-current potential. 6. These results support the notion that in the population of X organ cells sampled in this study, GABA acts as an excitatory neurotransmitter, opening chloride channels.

Ionic currents in crustacean neurosecretory cells

1. The patterns of electrical activity and membrane characteristics of a population of neurosecretory-cell somata in the X-organ of the crayfish were investigated with microelectrodes and whole-cell, voltage-clamp techniques. Some neurons (56%) were silent but could be excited by intracellular current injection: other cells showed spontaneous tonic activity (35%), and some had spontaneous bursting activity (9%). The spiking activity was abolished by tetrodotoxin (TTX) exposure and by severing the axon near the cell body. After axotomy, only a small, slow, regenerative depolarization remained that could be blocked by Cd2+. 2. Under voltage clamp the steady-state I-V curve in low [Ca2+]i (9 X 10(-9) M) showed a slope conductance of 16.7 +/- 3.9 (SD) nS (n = 10) at -50 mV and zero current potential of -50.1 +/- 7.7 mV. In current-clamp mode these neurons were either silent or fired tonically. With high [Ca2+]i (1.7 X 10(-6) M) both the slope conductance and inward and outward currents were reduced. In some neurons high [Ca2+]i reveals a negative slope resistance in the range of -46 to -41 mV. It could be supressed by removing [Na+]o, but it was TTX insensitive. These are the neurons that under current clamp showed bursting activity. 3. The main inward current in cell somata was a Ca2+ current of 2 +/- 0.6 nA (n = 18), activated at -40 mV and peaking at 20 mV. It showed relaxation with prolonged pulses. No Na(+)-dependent, TTX-sensitive inward currents were recorded with short (100-ms) pulses in axotomized neurons. 4. Two outward currents could be distinguished.(ABSTRACT TRUNCATED AT 250 WORDS)