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

Background

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

Objectives

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

Methods

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

Results

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

Figure 1.

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

Conclusion

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

References

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

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

Disclosure of Interests

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

Synthesis, structure and thermolysis of oxazagermines and oxazasilines

Nine new oxazasilines and oxazagermines were characterized and two of them were proven to be suitable precursors for porous Ge@C.

Evaluation of ear skin temperature as a cow-side test to predict postpartum calcium status in dairy cows

Subclinical hypocalcemia is considered a gateway disease that increases susceptibility to other metabolic and infectious diseases in transition dairy cows. In the absence of a cow-side test, however, it is difficult to identify hypocalcemic cows. The objective of this study was to evaluate ear skin temperature as a diagnostic predictor of serum calcium concentration. We conducted a cross-sectional study on 7 commercial dairy farms, involving 251 cows 0 to 48h after calving. Skin temperature of the ears (STEar) was scored manually by palpating both ears. An infrared thermometer was used to measure ear temperature, skin temperature on the coxal tuber (STCox), and ambient temperature. Rectal temperature was measured using a digital thermometer. A blood sample was drawn to determine serum calcium concentration. Hypocalcemia was defined as serum calcium below 2.0mmol/L, irrespective of clinical symptoms. Serum calcium concentration <2.0mmol/L in connection with clinical symptoms was defined as clinical milk fever; serum calcium concentration <2.0mmol/L without clinical symptoms was defined as subclinical hypocalcemia. Multivariate analysis using the GENLINMIXED procedure and receiver operating characteristic analysis were performed to evaluate whether serum calcium concentration could be predicted using ear temperature and other temperature estimates. The prevalence of hypocalcemia was 3.3, 27.3, 32.8, and 69.6% for cows in first, second, third, and fourth or greater lactation, respectively. None of the cows in first and second lactation had clinical milk fever. The prevalence of clinical milk fever was 6.0 and 20.3% for cows in their third and fourth or greater lactation, respectively. A decrease in ear temperature of 0.39°C [95% confidence interval (CI): 0.25-0.54] was associated with a decrease of 0.1mmol/L in serum calcium concentration. Ambient temperature, however, was a major confounder for ear temperature. With an increase in ambient temperature of 1°C, STEar rose by 0.78°C (95% CI: 0.67-0.90). Hypothermia was more pronounced in clinical milk fever (median 21.8°C; interquartile range 14.7-27.0°C) compared with subclinical hypocalcemia (median 27.6°C, interquartile range 22.1-30.8°C). All temperature estimates had only accurate test characteristics based on their area under the curve for prediction of subclinical hypocalcemia (area under the curve for STEar, STCox, and rectal temperature were 0.641, 0.668, and 0.606, respectively) when cows with clinical milk fever were excluded. Although ear temperature has been associated with serum calcium concentration, ear temperature cannot be recommended for diagnosis of subclinical hypocalcemia.

Smallest molecular chalcogenidometalate anions of the heaviest metals: syntheses, structures, and their interconversion

The syntheses of the first molecular meta-selenidomercurate(ii), ortho-telluridothallate(iii) and a hydrate of an ortho-selenidoplubate(iv) are presented alongside an improved and facile synthesis of the selenidobismuthate(iii) with almost quantitative yields. By means of quantum chemical calculations, the energetics of the interconversions of small metalate anions is discussed and the existence of the heaviest homologues of [NO2](-), [NO3](-), [PO4](2-) and [CO3](2-) are predicted.

Darstellung, Charakterisierung und Normalkoordinatenanalyse von gemischtvalentem Dodekabromotriplatinat(IV,II,IV) [Pt3Br12]2- und Kristallstruktur von (Ph3P=N=PPh3)2[Pt3Br12] · 2 CH2C12 / Preparation, Characterization and Normal Coordinate Analysis of the Mixed Valence Dodecabromotriplatinat(IV,II,IV) [Pt3Br12]2- and Crystal Structure of (Ph3P=N=PPh3)2[Pt3Br12] · 2CH2Cl2

Heating a mixture (2:1) of the tetrabutylammonium salts (TBA)2[PtBr6] and (TBA)2[PtBr4] with trifluoroacetic acid leads to the mixed valence dodecabromotriplatinate(IV,II,IV) (TBA)2[Pt3Br12]. The X-ray structure determination of (Ph3P=N=PPh3)2[Pt3Br12] · 2 CH2Cl2 (triclinic, PĪ, Z = 1) shows trinuclear groups with nearly D2h symmetry for the anions, formed of two PtBr6 octahedra and one planar PtBr4 group sharing edges. Using the structural data a normal coordinate analysis based on a general valence force field for [Pt3Br12]2- has been performed, which gives good agreement of the calculated frequencies with the bands observed in the IR and Raman spectra.

Darstellung, Reaktionen und spektroskopische Charakterisierung von [Os2X8]2-, X = Cl, Br, I, und Kristallstruktur von (PPN)2[Os2I8] · 2 CH2Cl2 / Preparation, Reactions and Spectroscopic Characterization of [Os2X8]2-, X = Cl, Br, I, and Crystal Structure of (PPN)2[Os2I8] · 2 CH2Cl2

The triply bonded octahalogenodiosmate(III) anions [Os2X8]2-, previously known with X = Cl, Br, have now been extended to include the iodide with two staggered OsI4 units. This compound was prepared by treating [Os2Cl8]2- with Nal at room temperature in acetone solution. The structure determination by X-ray diffractometry on single crystals of (PPN)2[Os2I8] · 2 CH2Cl2, reveals crystallization in the monoclinic system, space group P21/c with Z = 4. The Os-Os triple bond is with 2.212(1) Å the longest within the three octahalogenodiosmates(III). The Raman spectra show ν(OsOs) at 285, [Os2Cl8]2-; at 287, [Os2Br8]2- and for the iodo compound at 270.1 cm-1 with up to three overtones. The spectroscopic constants are calculated to be ω1 = 270.9 cm-1; X11 = -0.50 cm-1. The 10 Κ UV-VIS spectra of solid [(n-C4H9)4N]2[Os2X8] exhibit δ-π* transitions with maxima at 723, 690 and 643 nm, superimposed by vibrational fine structures with long progressions of 195, 211 and 183 cm-1 for X = Cl, Br, I, respectively. Oxidation of [Os2X8]2-, X = Cl, Br with the corresponding halogen leads to the cleavage of the Os-Os bond, and the dekahalogenodiosmates(IV), [Os2X10]2-, are formed

[Efficacy of vaginal progesterone inserts (CIDR) to reduce early embryonic losses in dairy cows]

The OBJECTIVE of this study was to test the efficacy of a progesterone releasing device (CIDR®, Pfizer, Germany) inserted on day (d) 20 post insemination (p.i.) to reduce embryonic losses between d 27 and 39 p.i. Furthermore, we hypothesized that CIDR® increases blood progesterone levels during the application period, but does not affect the maintenance of pregnancy after removal.

MATERIAL AND METHODS

The study was conducted on a commercial dairy farm, randomly allocating 74 Holstein Friesian cows to one of two groups. These cows were non-pregnant after previous artificial insemination and treated with an Ovsynch protocol. Group 1 (n=36) received a CIDR® on d 20 p.i. (CIDR® group) while group 2 (n=38) remained untreated (control group). CIDR® was removed on d 39 p.i. Blood samples were drawn from all cows on d 20, 27, 39 and 55 p.i. for analysis of progesterone (P4) concentrations by immunoassay (ADVIA Centaur®, Siemens, Germany). Pregnancy diagnosis was conducted on d 27 p.i. with ultrasonography, and on d 39 and 55 p.i. by transrectal palpation.

RESULTS

The overall prevalence rate of early embryonic losses between d 27 and 39 p.i. was 37.1% (CIDR® group 35.3%, control group 38.9%; p=0.83). On d 39 p.i. 30.5% of all cows were pregnant and the percentage of pregnant cows did not differ between the study groups (p=0.83). Progesterone levels on d 20 p.i. did not differ among cows which were pregnant on d 39 p.i. (p=0.57). On d 27 p.i. progesterone levels in pregnant cows were higher in the CIDR® group (16.2 ± 9.9 ng/ml) compared to the control group (11.2 ± 3.4 ng/ml; p=0.04). Progesterone concentrations were lower on d 39 p.i., but still differed between study groups (p=0.05). After removal of CIDR®, blood progesterone levels did not differ between pregnant cows of both study groups on d 55 p.i. (p=0.36).

CONCLUSION

The application of a progesterone releasing device led to increased blood progesterone levels during the application period, but did not affect maintenance of pregnancy after its removal.

CLINICAL RELEVANCE

Supplementation with progesterone at d 20 p.i. does not decrease early embryonic losses between d 27 and 39 p.i. or increase the number of cows pregnant on d 39 p.i.

Wirksamkeit einer vaginalen Progesteronspange zur Verringerung embryonaler Verluste in der Frühträchtigkeit bei Milchkühen

Ziel der Studie war, den Einfluss einer intravaginalen Progesteronspange (CIDR®, Pfizer) auf embryonale Verluste zwischen Tag 27 und 39 post inseminationem (p. i.) zu testen. Geprüft wurden ferner die Hypothesen, dass die Progesteronspange die Serum-Progesteronkonzentration während der Anwendung beeinflusst und sich nach ihrer Entfernung keine negativen Auswirkungen auf das Fortbestehen der Trächtigkeit ergeben. Material und Methoden: Bei 74 Kühen eines Milchviehbetriebs in Brandenburg erfolgte eine zufällige Zuordnung zu zwei Gruppen. Diese Tiere waren nach Besamung als nichttragend diagnostiziert worden und wurden daraufhin hormonell in einem Ovsynch-Programm behandelt und terminiert besamt. Kühe der CIDR®-Gruppe (n = 36) erhielten an Tag 20 p. i. eine Progesteronspange, die an Tag 39 p. i. entfernt wurde. Kühe der Kontrollgruppe (n = 38) blieben unbehandelt. Blutproben zur Messung der Progesteronkonzentration mittels Immunoassay wurden an den Tagen 20, 27, 39 und 55 p. i. entnommen. Trächtigkeitsuntersuchungen fanden an Tag 27 p. i. mittels Ultraschall und an den Tagen 39 und 55 p. i. mittels rektaler Palpation statt. Ergebnisse: Die embryonalen Verluste zwischen Tag 27 und 39 p. i. betrugen insgesamt 37,1% (CIDR®-Gruppe: 35,3%; Kontrollgruppe: 38,9%; p = 0,83). Die Progesteronkonzentrationen unterschieden sich an Tag 20 p. i. zwischen den an Tag 39 p. i. trächtigen Tieren beider Gruppen nicht. An Tag 27 p. i. lag die Konzentration in der CIDR®-Gruppe mit 16,2 ± 9,9 ng/ ml höher als in der Kontrollgruppe mit 11,2 ± 3,4 ng/ml (p = 0,04). Nach Präparatentfernung zeigten Kühe der CIDR®-Gruppe an Tag 55 p. i. keine höheren Progesteronwerte als Kontrolltiere. Schlussfolgerung: Die Progesteronspange steigerte die Progesteron konzentration während der Anwendung und ihre Entfernung hatte keinen negativen Einfluss auf das Fortbestehen der Trächtigkeit . Klinische Relevanz: Die Supplementierung mit Progesteron an Tag 20 p. i. kann die embryonalen Verluste zwischen Tag 27 und 39 p. i. nicht verringern oder den Anteil tragender Tiere erhöhen.

Efficacy of a treatment with hCG 4 days after AI to reduce pregnancy losses in lactating dairy cows after synchronized ovulation

Content The objective of the study was to investigate whether a treatment with hCG 4 days after AI could reduce pregnancy losses in lactating dairy cows. Cows of a dairy herd presented to the veterinarian in a fixed reproductive management protocol were treated with an Ovsynch protocol if no corpus luteum (CL) could be palpated per rectum (Group OV). Cows with a CL received cloprostenol (0.15 mg). After 2 days, these cows were treated with buserelin (0.01 mg) and received timed AI 16-20 h later (Group PG). In both treatment protocols, cows were assigned to two groups to receive 2500 IU of hCG i.v. 4 days after AI or to serve as untreated controls (Groups OV-hCG, OV-Control, PG-hCG and PG-Control). Pregnancy diagnosis was carried out 27 days after AI via ultrasonography and 39 days after AI by rectal palpation. Pregnancy losses were defined as cows being pregnant on day 27 but not pregnant on day 39 after AI. Pregnancy rate (PR) by day 27 did not differ among the four groups (35.4, 35.0, 37.0 and 38.0% for Groups OV-hCG, OV-Control, PG-hCG and PG-Control, respectively). Pregnancy losses between day 27 and day 39 after AI were smaller in hCG treated animals in summer but not in autumn and spring. Pregnancy rate by day 39 after AI was higher in PG than in OV groups, but independent of hCG-treatment. In conclusion, treatment with hCG 4 days after AI did not significantly increase PR on 39 days after AI. A positive effect of hCG on pregnancy losses during the summer months warrants further investigation.

Rapid determination of short DNA sequences by the use of MALDI-MS

We have developed a protocol for rapid sequencing of short DNA stretches (15-20 nt) using MALDI-TOF-MS. The protocol is based on the Sanger concept with the modification that double-stranded template DNA is used and all four sequencing reactions are performed in one reaction vial. The sequencing products are separated and detected by MALDI-TOF-MS and the sequence is determined by comparing measured molecular mass differences to expected values. The protocol is optimized for low costs and broad applicability. One reaction typically includes 300 fmol template, 10 pmol primer and 200 pmol each nucleotide monomer. Neither the primer nor any of the nucleotide monomers are labeled. Solid phase purification, concentration and mass spectrometric sample preparation of the sequencing products are accomplished in a few minutes and parallel processing of 96 samples is possible. The mass spectrometric analyses and subsequent sequence read-out require only a few seconds per template.

HLA-DRB1 typing in rheumatoid arthritis: predicting response to specific treatments

OBJECTIVE

To determine the predictive value of shared epitope alleles for response to treatment in patients with rheumatoid arthritis.

METHODS

Patients from our previously published triple DMARD study were tested for the presence of shared epitope alleles (DRB1 *0401, 0404/0408, 0405, 0101, 1001, and 1402). Patients who were shared epitope positive were then compared with those who were negative to see if there was a differential effect on therapeutic response.

RESULTS

Shared epitope positive patients were much more likely to achieve a 50% response if treated with methotrexate-sulphasalazine-hydroxychloroquine compared with methotrexate alone (94% responders versus 32%, p < 0.0001). In contrast shared epitope negative patients did equally well regardless of treatment (88% responders for methotrexate-sulphasalazine-hydroxychloroquine versus 83% for methotrexate). Additionally, a trend toward an inverse relation of the gene dose was seen for response to methotrexate treatment (p = 0.05).

CONCLUSIONS

These data suggest that determining shared epitope status may provide clinical information useful in selecting among treatment options.

Pressure-Induced Changes in the Structure and Band Gap of CsGeX(3) (X = Cl, Br) Studied by Electronic Band Structure Calculations

Tight-binding electronic band structures of cesium trihalometalates CsGeX(3) (X = Cl, Br) were calculated to examine the pressure-dependence of their crystal structures and band gaps as well as their primitive cubic to rhombohedral structural phase transitions. In agreement with experiment, our calculations show that an increase in the applied pressure decreases the band gap and the stability of CsGeX(3), and the band gap is larger for CsGeCl(3) than for CsGeBr(3). CsGeCl(3) has a much stronger second-order Jahn-Teller instability than does CsGeBr(3) and therefore can adopt a disordered cubic phase unlike CsGeBr(3).

A comparison of lipase and amylase in the diagnosis of acute pancreatitis in patients with abdominal pain

The clinical value of amylase and lipase measurement for the diagnosis of acute pancreatitis was evaluated in 253 patients presenting with acute abdominal pain. Acute pancreatitis was detected in 32 patients by computed tomography or ultrasound. In the serum samples collected on days 0-1 after the onset of symptoms, lipase was elevated in 100% and amylase in 95%. A 95% sensitivity/specificity was reached at a lipase cutoff near twofold above normal. The receiver-operating characteristics (ROC) showed similar curves for both enzymes, lipase being slightly superior to amylase. The ROC curves from days 2-3 demonstrated a much lower sensitivity/specificity of both enzymes. Lipase, however, was notably superior to amylase: at a sensitivity of 85% the specificity of lipase (amylase) was 82% (68%). In samples from days 4-5 the accuracy of the enzyme assays was even worse; at a sensitivity of 60% the specificity did not increase above 70%. The diagnostic value of simultaneous measurement of amylase and lipase was tested at different cutoffs in two groups: the OR group, in which one of the two parameters had to be elevated, and the AND group, in which both parameters had to be above normal. Combination of both parameters mainly improved the specificity of the assay (from 91 to 98% on days 2-3 and from 93 to 97% on day 4-5) but only when, in the OR group, twofold elevated amylase was combined with lipase. We conclude that the simultaneous determination of serum lipase and amylase marginally improved the diagnosis of acute pancreatitis in patients with acute abdominal pain, however, the sensitivity of the assay with samples collected 4-5 days after onset of the disease remained low.

Dual-task performance in space: results from a single-case study during a short-term space mission

During spaceflights, astronauts are exposed to many stressors (e.g., microgravity, confinement) that may impair human information-processing capabilities. In order to analyze the possible effects of the space environment on human time-sharing efficiency, a single-case experiment was conducted in which the time course of dual-task performance (unstable tracking with concurrent memory search) of one space crew member was monitored repeatedly (13 times) throughout an 8-day space mission. Tasks were taken from the Advisory Group for Aerospace Research and Development battery of Standardized Tests for Research with Environmental Stressors. Comparisons of in-flight, preflight, and postflight performance revealed no decrements in single-task memory search performance but did reveal clear impairments in single-task tracking and dual-task performance. From these results we conclude that psychomotor processes and higher attentional functions are particularly prone to disturbance effects in space.

Immunologic effects of levamisole in mice and humans: evidence for augmented antibody response without modulation of cellular cytotoxicity

Selected immunomodulatory effects of levamisole were studied in patients with asymptomatic metastatic colon cancer and in a preclinical model (CF1 female mice treated with methyl-azoxymethanol acetate) for colon tumors. In the patient population studied, there was no augmentation of cellular cytotoxicity or alteration in lymphocyte subpopulations that participate in these functions. An increase in Fc receptor binding on circulating monocytes was apparent at the 4-week timepoint; however, a corresponding increase in antibody-dependent cellular cytotoxicity was observed in only one of the six patients studied. In most patients, cellular cytotoxicity diminished with time. No significant effects on cellular immunity or carcinogenesis were observed in our murine studies. However, treatment with levamisole did increase circulating immunoglobulin levels and IgM response in mice immunized with the T-dependent antigen keyhole limpet hemocyanin. This parameter was not tested in the human trial. Failure to demonstrate antitumor effects on cellular immunity by levamisole in both human and murine studies suggests that these effects, if they do exist, may involve immunological parameters that were not tested using our methods or that may not be apparent in patients with more advanced malignancy.

Transport of various substances through human enamel and dentine

The penetration of 14C-labelled alcohols (methanol, ethanol, n-butanol), 14C-labelled carbonic acids (formic, acidic, propionic, valerianic, octanoic, malonic, succinic and lactic acid), 14C-drugs (procain, barbital), and 14C-sugars (saccharose, xylose) into about 800 human deciduous or permanent teeth, both healthy and carious, was investigated. Dental enamel up to the cemento-enamel junction was incubated at a pH-value of 5.0 or 6.8 for 1 or 24 hours. For measurement of radioactivity, the dentine of the root was obtained by trepanation. Between intact and carious permanent teeth only slight differences were observed in case of the diffusion of methanol and ethanol (2% of the incubation medium), while n-butanol penetrated the dentine to an extent of 4.2% at a pH of 5.0. The monocarbonic acids penetrated the enamel of healthy teeth within 24 hours to an extent of 6.6-19.2% of the content of the incubation medium, while the dicarbonic (succinic and malonic) acids reached amounts of 3.6 and 9.2%, and the percentage of lactid acid which penetrated the enamel reached 2.9%, respectively. Under all conditions tested, saccharose penetration was higher in carious than in healthy teeth (3.8 vs 6.5%). The highest uptake was found in experiments with barbital; it was more pronounced in deciduous than permanent teeth (16.2 vs 12.4%). The data could be of interest in the therapy of inflammatory and other processes of the pulp.

Behavioral aspects of human adaptation to space: analyses of cognitive and psychomotor performance in space during an 8-day space mission

Living in the space environment and exposure to microgravity induce a number of effects that may interfere with human cognitive and psychomotor performance. However, up to now very few attempts have been made to monitor possible impairments of human performance during space missions. In the present single-case study several cognitive and psychomotor functions were monitored during an 8-day space mission to an orbital station using a computerized performance monitoring device. This device included four different tasks, which were selected from a battery of Standardized Tests for Research with Environmental Stressors published recently by the NATO Advisory Group for Aerospace Research and Development, and which demanded logical reasoning and decision-making functions, memory retrieval functions, and fine manual control. Each task was performed 23 times (6 preflight, 13 inflight, 4 postflight sessions). By means of single-subject statistics inflight performance was compared with baseline performance during pre- and postflight sessions. In accordance with the few previous performance studies conducted during space flights, speed and accuracy of short-term memory retrieval and logical reasoning functions remained unimpaired during the stay in space. However, clear decrements in tracking performance were found, showing to increased difficulties in fine manual control. These results suggest that performance decrements in space may arise primarily in psychomotor functions due to alterations requiring an effortful accommodation of motor skills which had been acquired under 1-g conditions to the new conditions of microgravity.

[Isovolemic hemodilution--an adjuvant treatment principle in patients with chronic cor pulmonale caused by chronic obstructive lung disease]

On the basis of 10 patients with chronic cor pulmonale due to chronic obstructive lung disease and secondary polyglobulia in a clinical and experimental study could be made evident that by limited isovolaemic haemodilution (haematocrit value of 0.58 +/- 0.03 reduced to 0.36 +/- 0.01) are to be expected a decrease of the total pulmonary-arterial resistance, a reduction of the mean pulmonary arterial pressure, an increase of the partial O2-pressure as well as an increase of the heart index. Analogically to this as a consequence of the improved rheologic conditions a clear involution of the clinical signs of a heart insufficiency developed. Complications were not observed. The technique of the limited haemodilution should find a broader use in the medical practice, taking into consideration the isovolaemia as adjuvant treatment principle for patients with the indication mentioned.

Construction and use of a template block for radial immunodiffusion

Details for design and construction of template blocks for the increased sensitivity of radial immunodiffusion (RID) assays are described. The sensitivity of the template RID was 10-fold higher for quantifying albumin and 5-fold higher for IgG than the conventional RID with wells cut into the agarose. The system described in this communication resulted from the unit which provided the most consistent results from a variety of trials with different block thicknesses, chamber sizes and depths, and chamber arrangements.

Isolation of human herpesvirus-6 from clinical specimens using human fibroblast cultures

The isolation and characterization of human herpesvirus-6 (HHV-6) has been hindered by the lack of cell lines useful for its rapid propagation. Recently, we have reported that the MRC-5 cell line (human diploid lung fibroblasts) was susceptible for HHV-6 infection. In this study, we report on the isolation of HHV-6 from the peripheral blood or buffy coat of three chronic fatigue syndrome patients, one post-liver transplant patient, and one severe chronic active Epstein-Barr virus syndrome patient using the MRC-5 cell line. Additionally, it was observed by Southern blot hybridization studies that four of five isolates had different restriction enzyme fragment patterns than the isolate obtained from the National Institutes of Health with Eco RI. These data suggest the usefulness of the MRC-5 cell line in the isolation and characterization of HHV-6 from various patients.

Action spectra of the lateral eyes recorded from mammalian pineal glands

Single neuronal units from the pineal stalk and the pineal body of hamsters, guinea pigs and rats were recorded during photic stimulation of the lateral eyes in order to identify the retinal photoreceptor that mediates the environmental control of the mammalian pineal. Two cell types could be distinguished: one type was characterized by spontaneous spike discharges that were irresponsive to light stimulation of the eyes and the pineal body; the other, also spontaneously active, responded to flash stimulation of the lateral eye with On- and Off-discharges. With increasing light intensity, the spike frequency of the second response type followed a sigmoidal function up to a saturation level. Spectral sensitivity curves of all dark-adapted animals peaked at 500 nm. During light adaptation (18 microW/cm2) action spectra exhibited an additional maximum in the red (560 nm, rats and hamsters) and in the blue (450 nm, guinea pigs) light, respectively. Chromatic adaptation to orange light diminished the sensitivity at longer wavelengths, whereas adaptation to blue-green light enhanced the sensitivities at longer wavelengths. Thus, the spectral sensitivity recorded from pineal units of hamsters, guinea pigs and rats corresponds to those described for retinal ganglion cells, which indicates that both rods and cones contribute to the light-sensitivity of the mammalian pineal gland. Direct illumination of the pineal gland did not influence the activity of pineal units.

Antibody reactivity to a synthetic peptide (P62) of the Epstein-Barr nuclear antigen in sera of patients with X-linked lymphoproliferative syndrome

An enzyme-linked immunosorbent assay (ELISA) was used to measure IgG antibody titers against a synthetic peptide whose sequence was derived from the glycine-alanine repeating region of Epstein-Barr virus nuclear associated antigen 1 (EBNA-1). Antibody titers were determined in sera from 15 normal subjects, sera from 21 normal male siblings of X-linked lymphoproliferative syndrome (XLP) patients, from 20 XLP patients comprising a total of 42 samples, and ten samples before and ten samples after gamma-globulin therapy in ten patients with XLP. Data analysis demonstrated that while there are differences between the ELISA and ACIF, they appear to measure a similar response as demonstrated by their correlation coefficient (0.77) and the GMT to EBNA observed by both methods. No cross-reactivity of cytomegalovirus antibodies to the EBNA-1 peptide was observed by immunoblotting, ELISA or ACIF using adsorption against AD-169 infected MRC-5 cells. However, non-specific binding was observed if samples were not pre-incubated in a 10% goat serum PBS-Tween 20 solution. This pre-treatment removed the non-specific binding that falsely elevated the GMT in approximately 15% of both normal and XLP samples in ELISA. The ELISA system appears to be a sensitive, reproducible and objective test that may be useful for assessing the antibody response of patients to the EBNA-1 protein.

[Significance of macrocytosis as an indicator of chronic alcohol abuse]

On the basis of a retrospective study the importance of the haematological parameter MCV (mean corpuscular volume) for the recognition of chronic alcohol addicts was investigated. It was shown that in males a macrocytosis of the erythrocytes (MCV greater than or equal to 100 fl) refers to a daily alcohol abuse of more than 80 to 100 g, when diseases disturbing the blood formation and medicamentous injuries have been excluded. The sensitivity of this haematological screening method lies in the same order of magnitude as the sensitivity in the determination of the gamma-glutamyl transpeptidase. The daily abuse of high per cent spirits seems to have a larger effect on the development of a macrocytosis than the daily abuse of equivalent quantities of beer.