Profile of Bioactive Components and Antioxidant Activity of Aronia melanocarpa Fruits at Various Stages of Their Growth, Using Chemometric Methods

Aronia (chokeberry, Aronia melanocarpa) is a valuable fruit that combines the health benefits of green tea and red wine and is gaining popularity worldwide. Aronia has a unique chemical composition with strong antioxidant properties, including anthocyanins and chlorogenic acids (CGAs). However, it remains unclear which specific compounds or groups are primarily responsible for the antioxidant properties of chokeberry. Therefore, an analysis of the antioxidant properties of aronia berries based on geographical region and their variability during ripening (from green to frostbitten fruit) was conducted. The fruits were collected from three locations for two years. The aim of our work was to identify the compounds responsible for the antioxidant properties of aronia berry extracts by using chemometric methods. The analyses of anthocyanins and CGAs were performed using HPLC-DAD, and the antioxidant capacity was assessed by FRAP and DPPH methods. The PCA analysis also considered variations in temperature and precipitation. The chemometric analysis revealed a strong correlation between radical-scavenging properties and the content levels of chlorogenic acids. The results obtained in this study show that unripe green chokeberry fruits exhibit the highest antioxidant properties, which can be attributed to the high content of CGAs at this stage.

Anti-Atherosclerotic Properties of Aronia melanocarpa Extracts Influenced by Their Chemical Composition Associated with the Ripening Stage of the Berries

The high content of bioactive compounds in Aronia melanocarpa fruit offers health benefits. In this study, the anti-atherosclerotic effect of Aronia extracts was assessed. The impact on the level of adhesion molecules and the inflammatory response of human umbilical vein endothelial cells (HUVECs) was shown in relation to the chemical composition and the stage of ripening of the fruits. Samples were collected between May (green, unripe) and October (red, overripe) on two farms in Poland, which differed in climate. The content of chlorogenic acids, anthocyanins, and carbohydrates in the extracts was determined using HPLC-DAD/RI. The surface expression of ICAM-1 and VCAM-1 in HUVECs was determined by flow cytometry. The mRNA levels of VCAM-1, ICAM-1, IL-6, and MCP-1 were assessed using the quantitative real-time PCR method. The farms' geographical location was associated with the quantity of active compounds in berries and their anti-atherosclerotic properties. Confirmed activity for green fruits was linked to their high chlorogenic acid content.

Re-visiting the six-item Stanford presenteeism scale (SPS-6) and its psychometric properties

Presenteeism has often been considered as the correlate of absenteeism and associated to productivity loss. This study sought to re-examine the psychometric properties of the 6-item Stanford Presenteeism Scale (SPS-6), a popular measure which has been translated in a number of languages. The study adopted a cross-sectional design with 268 participants aged 18 - 65 working in a multinational IT company with headquarters based in Poland. The respondents participated willingly in an online questionnaire on a presenteeism health-related productivity measure (SPS-6), job resources (peer support), job demands (work-to-family conflict), engagement and burnout. Their responses were subjected to statistical analyses. Confirmatory Factor Analysis revealed that the SPS-6 is better represented by two singular and independent components, namely completing work and avoiding distractions, rather than an aggregated measure of health-related productivity. In fact, the aggregated measure had convergent and discriminant validity issues. We also assessed, via Structural Equation Modeling (SEM), the explanatory role of the SPS-6 within the wider well-being discourse by subjecting its' factors as outcomes using the JD-R framework. Here, burnout was better at explaining its relationship to avoiding distractions and completing work compared to engagement, while avoiding distractions was more dominant than completing work in explaining indirect pathways. Given the convergent and discriminant validity of its two-dimensional measures, we argue that the SPS-6 is a better assessment of health-related productivity in the light of presenteeism when keeping both components separate rather than adding the scores from both dimensions to provide a global score as has been the practice so far. In addition, the SEM findings suggest that both SPS-6 components may require different theoretical explanations. This study supports a growing chorus of scholars who argue the need to look deeper into the presenteeism phenomenon, not least its measures.

Combination Treatment of Locoregionally Aggressive Granulomatosis with Polyangiitis and Cranial Base Infiltration

OBJECTIVES

To present a personalized approach in three cases of treatment-resistant, locoregionally aggressive forms of cANCA-positive granulomatosis with polyangiitis (GPA) and skull base involvement.

METHODS

Three patients with GPA and skull base involvement were described alongside a critical review of the current literature.

RESULTS

All presented patients suffered from GPA with an inflammatory tumor at the skull base, alongside cerebellopontine angle involvement, cranial nerve palsies, cerebellar disorders, concomitant hearing loss, and severe otalgia. Symptoms were associated with progressive granulomatous destruction of the temporal bone, laryngopharynx, and central nervous system infiltration. Treatment with cyclophosphamide and high doses of glucocorticoid steroids were ineffective but subsequent therapy with rituximab was successful in the presented cases. The literature review showed that the course of the disease with skull base involvement is associated with poorer clinical and radiological responses to standard pharmacotherapies.

CONCLUSION

Granulomatous inflammation localized in the skull base is associated with a more aggressive disease progression and is less likely to respond to pharmacotherapy. Standard induction therapy with cyclophosphamide and glucocorticoid steroids may be ineffective. A better response may be achieved by using rituximab and concomitant local treatment with glucocorticoid steroid injections.

13C CPMAS NMR as an Alternative Method to Verify the Quality of Dietary Supplements Containing Curcumin

Turmeric is a traditional Indian spice that has recently become very popular worldwide because it contains a powerful ingredient called curcumin, which has strong anti-inflammatory properties. Hence, dietary supplements containing extracts rich in curcumin have gained great popularity. The main problems related to curcumin-containing dietary supplements are poor water solubility and the fact that they are often faked by using synthetic curcumin instead of the plant extract. In this article, we propose the use of the ¹³C CPMAS NMR method to control the quality of dietary supplements. The analysis of ¹³C CPMAS NMR spectra supported by GIPAW computations allowed us to identify a polymorphic form present in dietary supplements (which affected the solubility of curcumin) and to point out a dietary supplement that could be faked by using synthetic curcumin. Further PXRD and HPLC investigations confirmed that the examined supplement contained synthetic curcumin instead of the genuine extract. Our method can be used for routine control, especially because the investigation is performed directly from the capsule/tablet content and does not require any special sample preparation.

AB0083 RELATIONSHIP BETWEEN APOLIPOPROTEIN C-III AND ACTIVATED FACTOR VII-ANTITHROMBIN COMPLEXES IN PATIENTS WITH RHEUMATOID ARTHRITIS AND PSORIATIC ARTHRITIS

Background

Both rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are associated with increased cardiovascular risk and thrombosis. Alterations in plasma lipids levels, including apolipoproteins are recognized as the important risk factors of cardiovascular disorders. Activated Factor VII -anti- Thrombin complex (FVIIa-AT) is a marker of the extrinsic coagulation cascade activation, the pathway accelerated by interaction with plasma apolipoprotein C-III (Apo-CIII) (1).

Objectives

To investigate the associations between plasma FVIIa-AT concentration, lipid profile including apolipoprotein CIII, and markers of disease activity in patients with RA and PsA.

Methods

41 patients with RA, 38 with PsA, and 22 healthy controls, all not taking anticoagulant drugs were selected for the study. The lipid profile comprised triglycerides (TG), total cholesterol (TCh), low (LDL), and high-density lipoprotein (HDL). Serum levels of Apo C-III were measured using a Human ApoCIII ELISA kit CellBiolabs Inc.Austria. FVIIa–AT plasma concentrations were determined using ELISA test. C-reactive protein (CRP) level was measured using the immunoturbidimetric assay. All measurements were performed by a technician blinded to sample origin. The Mann-Whitney test and Kruskal Wallis tests were applied for intergroup comparisons, and correlations were assessed using Spearman’s rank tests, due to data non-normal distribution.

Results

The highest serum levels of Apo C-III were found in RA patients (median: 99.9μg/ml, min.-max. 8.7–199) compared to PsA (30.86μg/ml, 12.4–125.8) and controls (9.5 μg/ml, 3.7–29.2), p<0.001. RA and PsA patients revealed higher FVIIa-AT plasma levels than controls (RA median 153.8 pM, min.—max. 57.0–397.8, PsA 157.6 pM, 64.9– 323.8 vs controls 104.5 pM, 68.9–150.9, p<0.001). In RA and PsA patients ApoCIII correlated positively with TG levels (r=0.35, p=0.027 and r=0.38, p=0.018 respectively). In all patients and controls, Apo C-III levels correlated positively with FVIIa-AT concentrations (r=0.45 p<0.001). No significant differences were found in the serum concentrations of TCh, LDL, HDL, TG, and CRP, between the groups of RA and PsA patients.

Conclusion

Elevated concentrations of both, apolipoprotein CIII and activated FVII-AT complexes in rheumatic patients suggest associations between plasma lipoproteins and activation of coagulation cascade leading to a pro-thrombotic state in patients with RA and PsA. Further studies on these relationships are necessary taking into account various clinical conditions of patients and treatment.

References

[1]Martinelli N et al. Apolipoprotein C-III Strongly Correlates with Activated Factor VII-Anti-Thrombin Complex: An Additional Link between Plasma Lipids and Coagulation. Thromb Haemost. 2019; 119: 192-202.

Disclosure of Interests

None declared

Associations of IL-18 with Altered Cardiovascular Risk Profile in Psoriatic Arthritis and Ankylosing Spondylitis

Objective: To investigate the associations of IL-18 serum levels with serum lipids, cardiovascular risk, and disease activity in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) with axial (axPsA) and peripheral (perPsA) joint involvement. Methods: 155 adult patients (PsA 61/AS 94) were enrolled in the study. Standard disease activity indices, BASDAI, and ASDAS, were calculated for AS and PsA and DAPSA for PsA. Sera from peripheral blood samples were obtained after night fasting. Serum concentrations of cytokines (IL-18, IL-17) were measured by ELISA, while lipid profile with total cholesterol (TC), triglycerides (TG), low-density cholesterol-(LDL), high-density cholesterol (HDL), and C-reactive protein (CRP) concentrations were determined using routine procedures. The atherogenic index was calculated using the standard formula AI = TC/HDL. Results: Patients with PsA and peripheral joint involvement (perPsA) had significantly higher IL-18 serum levels than axial PsA and AS patients (medians 160 vs. 116 vs. 80 pg/mL). In patients with PsA and in the subgroup with PsA+ ischemic heart disease (IHD), IL-18 positively correlated with atherogenic index (AI) (rho = 0.46 and rho = 0.67, respectively) and TG serum concentrations (rho = 0.4 and rho = 0.675), while negatively with HDL levels (rho = −0.37 and rho = −0.608). In PsA + IHD subgroup IL-18 serum levels correlated positively also with disease activity (DAPSA) (rho = 0.613). Importantly, in patients with perPsA, characterized by the highest IL-18 serum levels, cardiovascular risk, and frequency of both hypertriglyceridemia and IHD, positive correlations between IL-18 and IL-17 (rho = 0.47, p = 0.002), TG (rho = 0.45 p = 0.01) levels and AI (rho = 0.63 p = 0.021) were found. Whereas linear regression models revealed that IL-17, TG concentrations and the tender joint count had an impact on IL-18 Conclusions: We confirmed that patients with perPsA are characterized by a more pronounced proinflammatory and proatherogenic cardiovascular risk profile than patients with axPsA and AS. Importantly our study indicates that in PsA, but not in AS, elevated serum concentration of IL-18 is associated with higher disease activity and proatherogenic lipid profile, leading to a higher cardiovascular risk. Thus, our results point out IL-18 as a critical contributor in these pathological processes and possible therapeutic targets.

Rapid improvement in spinal pain in patients with axial spondyloarthritis treated with secukinumab: primary results from a randomized controlled phase-IIIb trial

BACKGROUND

This study aimed to evaluate the efficacy and safety of secukinumab 150 mg compared with placebo in the management of spinal pain and disease activity in patients with axial spondyloarthritis (axSpA) at Week 8 and up to Week 24.

METHODS

Patients (n = 380) with active axSpA were randomized (3:1) to secukinumab 150 mg (Group A) or placebo (Group B). At Week 8, patients from Group A with an average spinal pain score <4 were defined as responders and were re-assigned to secukinumab 150 mg (Arm A1); whereas non-responders were re-randomized to secukinumab 150/300 mg (Arm A2/A3). Patients from Group B were re-randomized (1:1) to secukinumab 150/300 mg (Arm B1/B2).

RESULTS

At Week 8, the odds of achieving an average spinal pain score of <4 were significantly higher for patients on secukinumab 150 mg than for patients on placebo (odds ratio (OR): 1.89; 95% confidence interval (CI): 1.08-3.33; p = 0.0264). Further reductions in spinal pain were observed across treatment groups up to Week 24. Pronounced improvements were also observed in other disease activity measurements, such as Bath Ankylosing Spondylitis Disease Activity Index and Ankylosing Spondylitis Disease Activity Score. Responders from Group A showed the highest improvements for all measured parameters of spinal pain compared with the other arms. No new or unexpected safety signals were observed.

CONCLUSION

Secukinumab provided rapid and significant improvement in spinal pain at Week 8 which was sustained or increased further up to Week 24 in patients with axSpA.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03136861. Registered May 2, 2017.

P188 Secukinumab provides significant improvement of spinal pain and lowers disease activity in patients with axial spondyloarthritis: 24-week results from a randomised controlled Phase 3b trial

Background/Aims 

SKIPPAIN (NCT03136861) is the first randomised controlled study involving a biological disease-modifying anti-rheumatic drug, with a primary endpoint of spinal pain at Week 8 in patients with axial spondyloarthritis (axSpA; ankylosing spondylitis [AS] and non-radiographic [nr]-axSpA). We present the 24-week results of secukinumab in reducing spinal pain and disease activity following step-up dosing.

Methods 

This double-blind, placebo-controlled Phase 3b study enrolled patients (aged ≥18 years) with active disease (BASDAI ≥4; average spinal pain numerical rating scale [NRS] score &gt;4 at baseline; inadequate response to ≥ 2 non-steroidal anti-inflammatory drugs ≥4 weeks). Patients were randomised (3:1) to subcutaneous secukinumab 150 mg or placebo weekly followed by every 4 weeks (Q4W) from Week 4. At Week 8, placebo patients were re-randomised to secukinumab 150 or 300 mg Q4W. Patients originally randomised to secukinumab 150 mg were classified as responders or non-responders (spinal pain NRS score &lt;4 or ≥ 4, respectively) at Week 8. Responders were re-assigned to continue doubleblind secukinumab 150 mg Q4W (Arm A1). Non-responders were re-randomised to double-blind secukinumab 150 mg (Arm A2) or a step-up dose of 300 mg (Arm A3) Q4W. Treatment was up to Week 24. Primary endpoint: proportion of patients achieving an average spinal pain score &lt;4 on a 0-10 NRS with secukinumab vs placebo at Week 8.

Results 

380 axSpA patients (269/380 [70.8%] AS; 111/380 [29.2%] nr-axSpA) were randomised to secukinumab 150 mg (N = 285) or placebo (N = 95). The primary endpoint was met (proportion of spinal pain NRS [average] score responders: 32% vs 20%; odds ratio [95% confidence interval] 1.9 [1.1-3.3] favouring secukinumab vs placebo; P &lt; 0.05). Further reductions in spinal pain occurred at Week 24, especially in those initially randomised to placebo and switched to active drug. Pronounced improvements were observed in other disease activity measurements (Table 1). Numerically, more patients achieved ASDAS low disease activity at Week 24 post-secukinumab dose escalation (Arm A3) vs those remaining on the same dose (Arm A2).

Conclusion 

Secukinumab provided rapid, significant improvement in spinal pain and led to low disease activity in axSpA patients. Secukinumab dose escalation might be beneficial for patients not responding fully to the starting dose. P188 Table 1:Spinal pain and ASDAS-CRP scores at Weeks 8 and 24Week 8SEC 150 mg (N = 285)PBO (N = 95)Change from baseline in spinal pain NRS score (total), mean (SD) [n]-2.6 (2.5) [279]-1.5 (2.2) [92]Change from baseline in ASDAS-CRP score, mean (SD) [n]-1.2 (1.0) [271]-0.5 (0.8) [89]Week 24Active treatment group (SEC treatment starting at baseline)PBO switchers group (SEC treatment starting at Week 8)Arm A1 (SEC 150 R-150) N = 90Arm A2 (SEC 150 NR-150) N = 94Arm A3 (SEC 150 NR-300) N = 94Arm B1 (PBO-SEC 150) N = 45Arm B2 (PBO-SEC 300) N = 44Change from Week 8 in spinal pain NRS score (total), mean (SD) [n]-0.4 (1.5) [88]-2.1 (2.2) [93]-1.9 (2.2) [91]-2.5 (2.6) [45]-2.9 (2.6) [43]Change from baseline in ASDAS-CRP score, mean (SD) [n]-2.2 (1.0) [86]-1.2 (1.0) [93]-1.5 (1.0) [92]-1.5 (1.1) [44]-1.8 (0.9) [43]Arm A1=SEC responder to SEC 150 mg at Week 8 (SEC 150 R-150); Arm A2=SEC non-responder to SEC 150 mg at Week 8 (SEC 150 NR-150); Arm A3=SEC non-responder to SEC 300 mg at Week 8 (SEC 150 NR-300); Arm B1=Placebo patients to SEC 150 mg (PBO-SEC 150); Arm B2=Placebo patients to SEC 300 mg (PBO-SEC 300). ASDAS-CRP, Ankylosing Spondylitis Disease Activity Score using C-reactive protein; N, total number of patients randomised; n, number of evaluable patients; NR, non-responders; NRS, numerical rating scale; PBO, placebo; R, responders; SD, standard deviation; SEC, secukinumab.

Disclosure 

H. Marzo-Ortega: Consultancies; AbbVie, Celgene, Janssen, Lilly, Novartis, Pfizer, UCB. Member of speakers’ bureau; AbbVie, Celgene, Janssen, Lilly, Novartis, Pfizer, Takeda, UCB. Grants/research support; Janssen, Novartis. C. Perella: Corporate appointments; Employee of Novartis. Shareholder/stock ownership; Novartis Stock. D. Poddubnyy: Consultancies; Consultant/speaker for: AbbVie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB. Grants/research support; AbbVie, MSD, Novartis, Pfizer. E. Pournara: Corporate appointments; Employee of Novartis. Shareholder/stock ownership; Novartis Stock. A. Zielińska: Consultancies; Novartis, Pfizer. A. Baranauskaite: Consultancies; AbbVie. Member of speakers’ bureau; Novartis, AbbVie, Amgen, Roche, KRKA. S. Sadhu: Corporate appointments; Employee of Novartis. B. Schulz: Corporate appointments; Employee of Novartis. M. Rissler: Corporate appointments; Employee of Novartis. Shareholder/stock ownership; Novartis Stock.

Aronia melanocarpa Fruits as a Rich Dietary Source of Chlorogenic Acids and Anthocyanins: 1H-NMR, HPLC-DAD, and Chemometric Studies

Aronia melanocarpa (Michx.) Elliott's (chokeberry) besides anthocyanins contains significant amounts of hydroxycinnamic acids: Chlorogenic and its isomer neochlorogenic acid. They exhibit antioxidant, anti-inflammatory, antidiabetic, and antibacterial activities, thus they can have a significant impact on the health-promoting properties of Aronia. The aim of our research was to determine the changes in the content of chlorogenic acids (CGAs) and anthocyanins during fruit development and ripening, with a particular emphasis on acids. Aronia fruit samples were collected from July to October on two organic farms in Poland. The chemical composition of the extracts was determined by NMR spectroscopy and HPLC-DAD. ¹H-NMR and HPLC data were analyzed using chemometric analysis and multivariate statistics (PCA). The results showed that the content of chlorogenic acids and anthocyanins changes during ripening and depends on the time of harvest and the region of cultivation. A correlation between the time of CGAs reduction and the appearance of anthocyanins was also noticed. The result of our research was also a database in the form of NMR parameters, which allows analysis of the metabolite profile and tracking of its changes. The ¹H-NMR spectrum showing anthocyanin and CGA resonance can be considered the Aronia berry fingerprint.

AB0659 SECUKINUMAB PROVIDES SIGNIFICANT IMPROVEMENT OF SPINAL PAIN IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: RESULTS FROM THE 24-WEEK PHASE 3 SKIPPAIN STUDY

Background:

Spinal inflammation causing back pain is a hallmark of axial spondyloarthritis (axSpA) mainly affecting the sacroiliac joints and spine.1Spinal pain is the most burdensome symptom resulting in substantial functional limitations and impairment of health-related quality of life.

Objectives:

SKIPPAIN (NCT03136861) evaluated efficacy and safety of secukinumab (SEC) in reducing spinal pain in patients (pts) with axSpA who had an inadequate response to NSAIDs.

Methods:

SKIPPAIN, a 24 week (wk), randomised, double-blind, multicentre trial, enrolled axSpA pts (aged ≥18 years) with active disease defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥4 and average spinal pain numerical rating scale (NRS) score >4 at baseline (BL) and inadequate response to ≥2 NSAIDs ≥4 wks. The trial had a PBO-controlled period from BL to Wk 8 and a SEC 150/300 mg period from Wk 8 to Wk 24. Primary and key secondary endpoints were superiority of SEC 150 mg compared to PBO in achieving average spinal pain score <4 on a 0–10 NRS and BASDAI score <4 at Wk 8, respectively.

Results:

380 axSpA pts (269 (70.8%) AS and 111 (29.2%) nr-axSpA) were randomised to SEC 150 mg (N=285) or PBO (N=95). Demographic and BL characteristics are presented inTable 1. Proportion of responders, in terms of average spinal pain, was 31.9% vs. 20.0% for SEC vs PBO (p<0.05) and proportion of pts with BASDAI score of <4 was 33.3% vs. 23.2% for SEC vs PBO (p<0.05), respectively at Wk 8 (Table 2). After Wk 8, responder rates increased with SEC treatment. No unexpected safety events were reported.

Conclusion:

Secukinumab provided significant improvement of spinal pain in pts with axSpA. SEC was well tolerated with a safety profile consistent with previous reports.2

References:

[1]Danve A & Deodhar A.Clin Rheumatol. 2019;38:625-34.

[2]Deodhar A, et al.Arthritis Res Ther. 2019;21(1):111.

Table 1.

Patient Demographics and BL Characteristics

CharacteristicSEC 150 mgN = 285PBON = 95Age (years)142.3 (11.9)40.9 (12.2)Female2106 (37.2)39 (41.1)Time since onset of back pain (years)113.2 (10.1)12.3 (9.6)HLA-B27 positive2233 (81.8)76 (80.0)hsCRP (mg/L)113.0 (21.5)13.2 (23.5)Elevated hsCRP (>5 mg/L)2140 (49.1)49 (51.6)Previous exposure to TNF-α inhibitors234 (11.9)11 (11.6)Spinal pain NRS Score, 0-10 (average)17.27 (1.37)7.31 (1.31)Spinal pain NRS Score, 0-10 (nocturnal)17.31 (1.42)7.40 (1.35)Spinal pain NRS Score, 0-10 (total)17.23 (1.51)7.22 (1.48)BASDAI17.09 (1.22)6.91 (1.38)ASDAS13.75 (0.89)3.67 (0.84)Peripheral arthritis2104 (36.5)30 (31.6)

1mean (Standard Deviation),2n (%).

hsCRP, high-sensitivity CRP; N, number of randomized pts; n, number of evaluable pts; NRS, numerical rating scale

Table 2.

Inferential Analysis of Achieving Spinal Pain and BASDAI Score <4.0 Using Logistic Regression Model at Wk 8

VariableTreatment Groupn/N (%)Odds ratio versus PBO95% CIP-valueSpinal Pain NRS Score (Average)SEC 150 mg91/285(31.9)1.89(1.08, 3.33)0.0264PBO19/95(20.0)Spinal Pain NRS Score (Nocturnal)SEC 150 mg77/285(27.0)1.72(0.95, 3.10)0.0720PBO17/95(17.9)Spinal Pain NRS Score (Total)SEC 150 mg92/285(32.3)2.38(1.31, 4.31)0.0043PBO16/95(16.8)BASDAI scoreSEC150 mg95/285(33.3)1.75(1.01, 3.04)0.0466PBO22/95(23.2)

P-values are from a Logistic regression model with treatment as the principle factor and prior exposure to TNF inhibitors and naïve/inadequate responders to TNF inhibitors as stratification factors.

Missing values were imputed as non-responders. N, Number of randomised pts; n, Number of pts who are responders/evaluable pts.

Disclosure of Interests:

Denis Poddubnyy Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Effie Pournara Shareholder of: Novartis, Employee of: Novartis, Agnieszka Zielińska Consultant of: Novartis, Pfizer, Asta Baranauskaite Consultant of: AbbVie, Speakers bureau: Novartis, AbbVie, Amgen, Roche, KRKA, Alejandro Muñoz Jimenez.: None declared, Preeti Kumari Employee of: Novartis Healthcare Pvt. Ltd., Barbara Schulz Employee of: Novartis, Michael Rissler Shareholder of: Novartis, Employee of: Novartis, Chiara Perella Shareholder of: Novartis, Employee of: Novartis, Helena Marzo-Ortega Grant/research support from: Janssen, Novartis, Consultant of: Abbvie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, UCB, Speakers bureau: Abbvie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Takeda, UCB

Antibacterial and Antioxidant Activity of Extracts from Rose Fruits (Rosa rugosa)

The aim of the present study was to determine the antioxidant and antimicrobial properties in freeze-dried extracts of rose fruits (Rosa rugosa) obtained using various extraction techniques and to determine the effect of a selected extract on bacterial survival in model fluids imitating protein food. Ethanolic extracts from rose fruits showed higher antioxidant activity compared to other tested extracts. The rose fruits aqueous extract showed the highest inhibitory activity against most of the 10 bacterial strains tested. From the group of Gram-positive bacteria, the Bacillus cereus strain proved to be the most sensitive to the action of the rose extract. From the Gram-negative bacteria: Escherichia coli and Klebsiella pneumoniae were the most sensitive. The reduction in the number of bacterial cells in matrices imitating protein food depended on the concentration of the aqueous extract used. However, at none of the concentrations used was a complete inhibition of bacterial growth observed. We have confirmed that the traditional extraction and freeze-drying of rose fruits is still suitable for the food industry due to obtaining extracts with good antibacterial and antioxidant properties and the use of bio-solvents, such as water or ethanol, which are easily available in high purity and completely biodegradable.

Evaluation of reference genes for quantitative real-time PCR in Wharton's Jelly-derived mesenchymal stem cells after lentiviral transduction and differentiation

Quantitative real time reverse transcription PCR, qRT-PCR, is one of the most important techniques for assessing the level of gene expression. Selecting the correct reference gene to normalize the results is a key step in this method. Inaccurate data can be generated if the correct reference gene is not selected. The level of the expression of reference genes is tissue-variable, and in the case of mesenchymal stem cells (MSC), it can be different depending on the source of their origin. The aim of this study was to select the reference gene for Wharton's Jelly-derived MSC (WJ- MSC) that were undergoing transduction and differentiation. In this work, the expression of 32 genes was analyzed, of which two (RPS17 and 18S rRNA), which had the most stable expression level, were selected. A comparative analysis of the expression stability of the selected genes was then performed with the genes that are most commonly used in the literature, i.e. β-actin and GAPDH. Next, it was determined that a false picture of the expression level of the studied genes can be obtained when a reference gene with variable expression level is used for normalization. RPS17 and 18S rRNA proved to be the most stable reference genes for the WJ-MSC that had been subjected to the lentiviral transfection procedure followed by differentiation. The expression of β-actin and GAPDH was highly unstable and therefore these genes are not suitable for use as reference genes in studies involving WJ- MSC.

Two-photon microperimetry: sensitivity of human photoreceptors to infrared light

Microperimetry is a subjective ophthalmologic test used to assess retinal function at various specific and focal locations of the visual field. Historically, visible light has been described as ranging from 400 to 720 nm. However, we previously demonstrated that infra-red light can initiate visual transduction in rod photoreceptors by a mechanism of two-photon absorption by visual pigments. Here we introduce a newly designed and constructed two-photon microperimeter. We provide for the first time evidence of the presence of a nonlinear process occurring in the human retina based on psychophysical tests using newly developed instrumentation. Since infra-red light penetrates the aged front of the eye better than visible light, it has the potential for improved functional diagnostics in patients with age-related visual disorders.

Usability and safety of SB5 (an adalimumab biosimilar) prefilled syringe and autoinjector in patients with rheumatoid arthritis

OBJECTIVE

To demonstrate comparability between administration of the adalimumab biosimilar, SB5, via prefilled syringe (PFS) and autoinjector (AI) pen based on injection site pain, patient preference, and safety in rheumatoid arthritis (RA) patients.

METHODS

In this phase 2, open-label study (NCT02565810; EudraCT Number 2014-004887-39), adult RA patients self-administered 40 mg SB5 subcutaneously via PFS at weeks 0 and 2, followed by AI at weeks 4, 6, 8, and 10. Patients rated injection site pain from 0 (no pain) to 10 (severe pain) using a visual numeric scale immediately and 15-30 min post-injection at weeks 0, 2, 4, and 6. Equivalence between PFS and AI was concluded if the 97.5% confidence interval (CI) of the difference in the injection site pain scores at weeks 2 and 6 was contained within the equivalence margin of ±5. Overall impression and preference for PFS and AI were also evaluated. Safety was assessed up to 20 weeks after the first injection.

RESULTS

Of 49 patients enrolled, 48 completed the study. Mean injection site pain scores were equivalent between PFS and AI immediately (2.3 vs 2.0; 97.5% CI = -0.99-0.30) and 15-30 min post-injection (0.8 vs 0.7; 97.5% CI = -0.47-0.25). The overall impression of both devices was comparable. The overall preference of AI was higher than PFS. Treatment-emergent adverse events (TEAE) were mild-to-moderate. There were no severe or serious TEAEs reported during the study.

CONCLUSIONS

In RA patients, SB5 showed equivalent injection site pain and comparable safety when administered via PFS and AI.

Distinct Secretory Activity and Clinical Impact of Subcutaneous Abdominal Adipose Tissue in Women with Rheumatoid Arthritis and Osteoarthritis

In the general population, low-grade inflammation of adipose tissue accompanies obesity and contributes to cardiovascular disease (CVD) development, but the implication of this tissue in rheumatic disease pathology is unclear. Therefore, we characterized the secretory activity of subcutaneous abdominal adipose tissue (SAAT) of females with rheumatoid arthritis (RA) and osteoarthritis (OA) and searched for its relationship with intensity of systemic inflammation, body composition and comorbidity. The secretion of classical adipokines (leptin, adiponectin), pro- and anti-inflammatory factors, i.e. interleukin (IL)-6, IL-8, IL-10, tumour necrosis factor (TNF), macrophage migration inhibitory factor (MIF) and hepatocyte growth factor (HGF), from SAAT explants was measured by specific enzyme-linked immunosorbent assays. Patients' body composition was evaluated by bioelectric impendence technique. Rheumatoid SAAT secreted more adiponectin, IL-6, IL-10, TNF and MIF but less leptin than respective osteoarthritis tissues. In RA patients, TNF secretion correlated with cachectic body composition, HGF release was linked to secondary amyloidosis and visceral fat rating was an independent risk factor for CVD. In OA, secretion of leptin and HGF positively, while adiponectin inversely, correlated with systemic inflammation markers, and the release of MIF was an independent risk factor for CVD. This study reveals differences between RA and OA patients in SAAT secretory activity and suggests its different clinical impact in these diseases, characterized by high- and low-grade systemic inflammation, respectively. In RA, SAAT may directly or via an effect on body composition contribute to amyloidosis, cachexia or CVD co-occurring, while in OA SAAT-derived adipocytokines may rather regulate intensity of systemic inflammation and redound to CVD emergence.

Assessment of the exposure to elements from silver jewelry by hair mineral analysis

The aim of the present article was to assess the effect of wearing silver jewelry on mineral composition of human scalp hair. To investigate the possible effect of gender, a group of females and males was distinguished. Subjects, who declared in the questionnaire wearing silver jewelry, constituted 55% of the whole population. It was found that individuals wearing jewelry had increased levels of Ag (~3 times), Ba (30%), Ca (33%), La (40%), Li (25%), and Zn (27%) in hair and lowered level of: Al (34%), K (79%), and Na (32.5%) in comparison with the group that did not wear jewelry. Those differences were statistically significant. Lower levels of K and Na in hair of subjects wearing jewelry was probably related with an antagonism between Ag-K and Ag-Na found in the present work. Analyzing the effect of two grouping variables-gender and wearing silver jewelry-on hair composition, it was observed that statistically significant differences were determined for the following elements: As, Ba, Ca, and Se. Female hair contained two times more Ca, four times Ba, 36% less As, and five times less Se. It was found that 34% of the population wearing silver jewelry had higher Ag content in hair than the upper value of the reference range (0.567 mg/kg) determined for subjects who did not wear jewelry. Ag and other metals (especially Cu and Zn) from jewelry could be absorbed through the skin and therefore hair mineral analysis is useful in the assessment of this exposure. The study was carried out on Poles, among which silver jewelry is particularly popular. The population can be thus considered as exposed.

Exposure to metals from orthodontic appliances by hair mineral analysis

The aim of the present work was to investigate the exposure of patients to metals released from orthodontic appliances in situ. The paper reports the results of biocompatibility studies of orthodontic appliances by an in vivo method using hair sampled from the group of patients (N = 28) and a control group (N = 18). The mean content of metals (Ni, Cr, Mn, Fe) in hair that were hypothesized to be systemically absorbed from stainless steel, was provided. The highest difference between the groups was found for Ni (39% higher level in hair of patients), Mn (18%), Fe (4.1%), Cr (2.5%), as calculated by a new dimensionless metal release coefficient (α). The second coefficient defined in the present work (β) corresponded to the difference in the mean content of elements between the groups. The coefficient was the highest for Fe, subsequently Ni, Mn and Cr. None of the differences was statistically significant. For each group and a given element, ranges between 10th and 90th percentile were determined. The upper value of the range differed the mostly between the groups for Ni (82.5%) showing that stainless steel of orthodontic appliance can be the source of exposure to this element. The difference was also identified for Mn (26.5%). For Cr and Fe, the lower value of the range was elevated. It was noted that 22% of patients undergoing orthodontic treatment had elevated levels of Ni in hair. A correlation matrix between the content of the elements in hair was calculated. Statistically significant correlations were found between Cr and Fe, showing similar sources of exposure. Multiple regression analysis showed the dependence of Ni content (dependent variable) on the level of Co and Mg (synergism) and V (antagonism).

Inter-relationship between elements in human hair: The effect of gender

The aim of the present work was to examine the inter-relationship between elements in human hair depending on gender. In the whole population, the following groups of correlated elements were identified: alkaline earth metals (Ba, Ca, Mg, Sr), major microelements (Cu, Mn, Si, Zn) and La, Ti. In the subpopulation of males, the (Ag, Al, As, Fe) group was additionally included, whereas in the group of females (Ag, Al, Fe, Zr) was included. The group of alkali metals (Li, Na, K) and P was particularly visible in the group of males. In the group of females correlations among (Al, Co, Fe, K, Ti) were stronger than in males. In both sexes correlations between Mo, B and V (in females additionally Bi was present) and Bi-Co were found. Only in hair of males (Cd, Fe, Mn) and (Cu, Na, P) were detected, and the group of (As, Co, Cr, Fe, K, Ti) was detected only in females.

Effect of macroalgae enriched with microelements on egg quality parameters and mineral content of eggs, eggshell, blood, feathers and droppings

This study presents results obtained from feeding experiment on laying hens, which were fed with the diet supplemented with two marine macroalgae: Enteromorpha prolifera and Cladophora sp., enriched with microelements [Cu(II), Zn(II), Co(II), Mn(II), Cr(III)]. The applicability of the preparation was tested on five experimental groups of laying hens and one control group. In the control group, microelements were supplemented in the inorganic form, whereas in experimental groups, Cu, Zn, Co, Mn and Cr were replaced by macroalgae enriched with a given microelement ion. During feeding experiment, weight of laying hens, weight of eggs, eggshell thickness and mineral content of blood, feathers, droppings, eggs content (separately yolk and egg white) and eggshell were measured. Also egg number was counted and microclimate (temperature and relative humidity) was monitored. Supplementing bio-metallic feed additives to the diet of laying hens resulted in higher microelement transfer to eggs and enhanced the colour of yolk. It was also found that the presence of Enteromorpha prolifera and Cladophora sp. in laying hens diet influenced advantageously eggs weight, eggshell thickness as well as body weight of hens. On the basis of these results, it could be concluded that Enteromorpha prolifera and Cladophora sp. enriched with microelement ions could be potentially used as mineral feed additives in laying hens feeding.

The effect of dietary habits on mineral composition of human scalp hair

In the present work, hair mineral analysis of 117 individuals was carried out. The subjects were asked to fill a questionnaire concerning their dietary habits. The content of minerals in hair was determined by ICP-OES (macroelements) and ICP-MS technique (micro-, toxic and other trace elements). The results were elaborated statistically by Statisticaver. 8.0. It was found that consuming highly processed food causes increased levels of e.g. Na and P in hair, intake of slimming preparation resulted in increased content of Al, Cr, Ti, taking in laxative agents caused lower level of Pb (this element was probably eliminated by other excretory routes). Individuals which declared the use of analgesic agents had more Si in their hair. Drinking coffee was related with higher level of Al, Ni, S and Ti and lower Pb in hair. Drinking tea caused reduction in the level of Hg. These results show that hair mineral content reflects exposure of elements from the diet.

Reference values for hair minerals of Polish students

In the present work, reference values for the content of elements in human hair were elaborated. The population chosen for the study was a group of students in Polish urban area, which served as a representative group of a population of 20 years old individuals living in Europe. The content of 36 elements (essential (B, Ca, Co, Cr, Cu, Fe, K, Mg, Mn, Mo, Na, P, S, Si, Sn, V, Zn), toxic (Al, As, Cd, Hg, Ni, Pb, Sb, Tl) elements and others (Ag, Ba, Bi, Ce, La, Li, Rb, Sr, Ti, Y, Zr)) was determined in hair sampled from 117 subjects. Hair were digested with nitric acid in microwave oven in closed Teflon bombs and underwent multielemental analysis for the content of macroelements by ICP-OES and for micro- and trace elements by ICP-MS. Reference ranges were determined and considered as the values between 10th and 90th percentile. It was assumed that the values of the extreme low and high 10% in the population reflected mineral imbalance. In the population, a group of females and males was distinguished, and also a group of women which tinted their hair was separated. This enabled to point out the differences in hair mineral content between genders and for tinted and non-tinted hair. Statistical significance of differences was found for several elements, for which separate reference values were elaborated. This concerned the following elements: Ba, Ca, Cu, K, La, Mg, Mn, Si, Sr and Ti. In the interpretation of the level of these elements it is necessary to take into consideration both sex and artificial coloring. Also ratios between elements were evaluated - between nutritive (Ca/Mg, Ca/P, Na/K, Zn/Cu) and nutritive vs. toxic (Zn/Cd, Zn/Pb). In this case the differences were detected only for Ca/P ratio. This shows that perhaps in the future, inter-element ratios rather than the absolute levels of elements would be considered for the interpretation of the results of mineral analysis of hair.

Youth's knowledge and attitude to epilepsy

PURPOSE

The aim of this research is to assess youth's knowledge and attitude towards their epileptic peers.

MATERIAL AND METHODS

The present study concerned 181 students of two secondary schools in Poznań, including 107 girls and 74 boys. The tool used was a self-made questionnaire. The criterion of including a questionnaire into data was the answer to the following question: "Have you heard about epilepsy?"

RESULTS

The questionnaire has shown that 46% of secondary school students had already known a person with epilepsy. 91% of students knew that epilepsy was not a contagious disease, but 12% of pupils thought that epilepsy was a mental illness. Almost 23% of respondents claimed they knew what could cause epilepsy. Only 2% of the students knew how to provide first aid during an epileptic fit. 92% of the respondents accepted a person with epilepsy among their friends.

CONCLUSIONS

The level of the knowledge about epilepsy among pupils is insufficient. The youth do not know the causes of epilepsy, provocative factors of convulsions, and symptoms and the rules of giving first aid during an epileptic fit. The main source of information about the disease were television programs. The majority of the school - graduates expressed willingness to make friends with epileptic people and acceptance of the ill.

Peripheral blood lymphocyte population in children infected with Helicobacter pylori

PURPOSE

Helicobacter pylori infection in children is associated with a chronic inflammatory process of gastric and duodenal mucosa, which may have a various clinical course ranging from asymptomatic and chronic inflammatory condition to gastric ulceration. The immune system may contribute especially to chronic gastric mucosa inflammation. The aim of our study was to assess the levels of peripheral blood T (CD3+, CD4+, CD8+) and B lymphocyte subpopulation (CD19+) in children with Helicobacter pylori infection and to evaluate their relation to degree of antrum mucosa inflammation.

MATERIAL AND METHODS

The study was performed in 32 children aged 7-18 years, hospitalized due to dyspeptic symptoms. The endoscopic examination of upper gastrointestinal tract was performed and gastric and duodenal mucosa was estimated in all patients. The endoscopic and histological evaluation of gastric mucosa was performed according to the Sydney System [4]. The urease test (CLO-test-H. pylori) was made to estimate the severity of the infection.

RESULTS

Moderate antrum mucosa inflammation was found in 41.2% of the examined. The highest percentage of children (58.8%) presented marked inflammation. No mild inflammation was found in children examined.

CONCLUSIONS

No correlation was found between lymphocyte levels and the degree of the inflammatory changes in antrum mucosa. The evaluation of peripheral blood lymphocytes performed in children with Helicobacter pylori infection suggests that T lymphocytes may play a predominant role in this infection.

Nitrogen-15 fractionation in the thermal decomposition of nitrous oxide of natural isotopic composition

The 15N fractionation in the thermal decomposition of nitrous oxide (N2O) of natural isotopic composition has been investigated in quartz reaction vessel in the temperature interval 888-1073 K. The formulas relating the observed experimentally 15N fractionations with the primary 15N kinetic isotope effect, (k14/k15)p for 14N15N16O, and secondary 15N kinetic isotope effect, (k14/k15)s for 15N14N16O, have been derived. The experimentally estimated 15N kinetic isotope effects have been compared with the primary and secondary 15N kinetic isotope effects calculated with the absolute rate theory formulations applied to linear three atom molecules. A good agreement was found for the primary 15N kinetic isotope effect, (k14/k15)p, in the temperature interval 888-1007 K. But at 1073 K the decompositions of N2O, accompanied by NO (nitric oxide) formation proceed with a twice times smaller primary kinetic isotope effect, (k14/k15)p of 1.0251 +/- 0.0009, only, suggesting the nonlinear transition state structures with participation of the fourth external atom at high temperature decompositions of nitrous oxide. The nitrogen isotope effects determined in this study correlate well with nitrogen isotope fractionations observed in the natural biological, earth and atmospheric processes.

Carbon isotope fractionation in the decarboxylation of phenylpropiolic acid in hydrogen donating media

13C kinetic isotope effect (KIE) in the decarboxylation of phenylpropiolic acid (PPA) in tetralin medium (Tn) has been determined at 409-432 K and found to be of magnitude similar to the 13C KIE observed in the decarboxylation of malonic acid where the rupture of the C-C bond is the rate determining step. 13C KIE equals 1.0318/at 136 degrees C in the decarboxylation of PPA in Tn medium. Intramolecular 13C KIE in the decarboxylation of malonic acid equals 1.0316 at this temperature. Thus it has been shown that the nearly "full" 13C KIE can be achieved by providing the excess hydrogen to Calpha of PPA (or to triple acetylene bond) using not only strong mineral acids as the source of protons but also by carrying out the decarboxylation in organic medium like tetralin. A mechanism of decarboxylation of PPA in Tn is suggested.