OP0031 SEROLOGICAL COLLAGEN BIOMARKERS CAN DIFFERENTIATE PATIENTS WITH PSORIASIS FROM PSORIATIC ARTHRITIS

Background

Psoriasis is a common chronic immune-mediated skin disease. About 25% of psoriasis patients have psoriatic arthritis (PsA) which is a chronic inflammatory disease affecting the joints, enthesis, and axial skeleton. Delayed diagnosis of PsA is associated with joint damage and disability. Therefore, optimized screening methods including identifying predictors of arthritis in patients with psoriasis have become a medical priority. Collagens are major proteins in all tissues, including skin, bone, cartilage, and connective tissues, which are affected by inflammatory processes present in both psoriasis and PsA. Throughout degradation and remodelling of the extracellular matrix (ECM), proteases cleave collagens leading to protein breakdown products which are released into the circulation. These collagen fragments can be quantified in serum as biomarkers of tissue remodelling and may be helpful in screening patients with psoriasis that have or will develop PsA.

Objectives

Our aim is to identify serum biomarkers that can differentiate patients with psoriasis without PsA (PsC) from PsA

Methods

Patients with PsC (n=87, mean ±SD age 42.01 ±12.20, 44% female; underwent a full rheumatologic assessment to exclude PsA) and patients with PsA (n=99, mean ±SD age 45.94 ±12.47, 49% female) were recruited at the Toronto Western Hospital, Canada, after appropriate ethics approval. ECM remodelling was estimated using as indices serological anabolic biomarkers quantifying formation of type III, IV, and VI collagen (PRO-C3, PRO-C4, and PRO-C6 respectively), and catabolic biomarkers measuring degradation of type I, III, IV and VI collagen (C1M, C3M, C4M, C6M respectively). Data are presented as mean ± standard deviation (SD). Statistically significant difference between the two groups was calculated by Mann-Whitney U test and a p-value below 0.05 was considered significant. Area under the receiver operating characteristic (ROC) curve (AUC) analysis was performed to describe the discrimination accuracy of each biomarker between the two patient groups.

Results

Patients with PsA presented higher levels of C1M, C3M, C6M, and PRO-C6 compared to PsC (p<0.0460-p<0.0009, Figure 1 A, B, D, G), while biomarkers levels of C4M, PRO-C3, and PRO-C4 were not significantly different between PsC and PsA patients (Figure 1 C, E, F). Moreover, C1M and C6M were able to separate between PsC and PsA patients with an AUROC=0.6277 (p=0.0027) and AUROC=0.6446 (p=0.0010), respectively, indicating that these biomarkers may be markers of joint involvement (Figure 1 H, I).

Conclusion

This work provides evidence that serum degradation biomarkers of type I and VI collagen were able to differentiate patients with PsA from PsC and may be potential biomarkers of inflammatory systemic musculoskeletal involvement. These findings suggest that serological biomarkers may be used to identify the 25% of psoriasis patients that have PsA.

Disclosure of Interests

Solveig Skovlund Groen: None declared, Signe Holm Nielsen Employee of: Signe Holm Nielsen is employed by Nordic Bioscience, Anne-Christine Bay-Jensen Shareholder of: Anne C. Bay-Jensen holds stock in Nordic Bioscience, Employee of: Anne C. Bay-Jensen is employed by Nordic Bioscience, Mozhgan Rasti: None declared, Darshini Ganatra: None declared, Katerina Oikonomopoulou: None declared, Vinod Chandran: None declared.

POS1097 BIOMARKERS OF INFLAMMATION AND JOINT TISSUE TURNOVER CAN HELP IMPROVING THE DIFFERENTIATION BETWEEN OSTEOARTHRITIS AND PSORIATIC ARTHRITIS PATIENTS

Background

Osteoarthritis (OA) is a slow progressive disease characterized by degeneration within the joint cartilage, leading to destruction and dysfunction of the involved joints. Psoriatic arthritis (PsA) is a chronic inflammatory disease manifesting itself in skin lesions and progressive inflammatory changes within the musculoskeletal system, leading to joint damage and functional limitation. Although OA and PsA are considered to be distinct diseases, they share overlapping clinical and inflammatory features that can cause diagnostic challenges. Throughout these inflammatory and degenerative processes in the joint tissues, proteases hold a major role in remodelling of the extracellular matrix (ECM) which results in protein breakdown products released into the synovial fluid (SF). These protein fragments can be quantified in SF as biomarkers of tissue remodelling and may be helpful in characterizing disease-specific or overlapping pathologies between OA and PsA.

Objectives

Our aim of this study is to measure biomarkers of inflammation and joint tissue turnover in SF to explore the distinct and overlapping pathologies between OA and PsA.

Methods

SF samples were collected from patients with OA (n=54, mean ±SD age 62.1 ±11.9, 48% female) and patients with PsA (n=59, mean ±SD age 47.8±13.3, 37% female) recruited through Toronto Western Hospital, Canada. Study was approved by the local ethics committee. Biomarkers of inflammation reflecting macrophage activity (VICM) and neutrophil activity (CPa9-HNE) were measured in the SF samples. Moreover, ECM remodelling was assessed in the SF samples by biomarkers quantifying type II collagen formation (PRO-C2), fibronectin turnover (FBN-C), and aggrecan degradation (ARGS). Data were log-transformed and presented as mean ± standard deviation (SD). An ANCOVA corrected for age was applied to test the difference between biomarker levels across the two patient groups and a p-value below 0.05 was considered significant. Area under the receiver operating characteristic (ROC) curve (AUC) analysis was performed to describe the discrimination accuracy of each biomarker between the two patient groups.

Results

PsA patients presented significantly higher levels of macrophage; VICM, activity compared to OA (p<0.001, Figure 1A). On the other hand, OA patients demonstrated increased type II collagen formation and aggrecan degradation compared to PsA (p<0.001, Figure 1C, E). Interestingly, no significant difference in biomarkers levels of neutrophil activity and fibronectin remodelling was observed between the two disease groups. Moreover, VICM, PRO-C2, and ARGS showed high distributional difference between OA and PsA patients with an AUROC=0.915 (p<0.001, Figure 1F), AUROC=0.737 (p<0.001, Figure 1G), and AUROC=0.725 (p<0.001, Figure 1H), respectively.

Conclusion

PsA patients demonstrated higher macrophage activity in the SF compared to the OA patients, while higher levels of cartilage formation and degradation were observed in OA patients compared to PsA. No differences between OA and PsA were observed in neutrophil activity and fibronectin turnover, which may mirror the clinical difficulty in telling the two arthritides apart. Identifying the unique characteristics of the pathological processes underlying the two diseases may improve diagnosis and allow for the precise management of both OA and PsA patients.

Disclosure of Interests

Solveig Skovlund Groen: None declared, Signe Holm Nielsen Employee of: Signe is employed by Nordic Bioscience, Anne-Christine Bay-Jensen Shareholder of: Anne C. Bay-Jensen holds stock in Nordic Bioscience, Employee of: Anne C. Bay-Jensen is employed by Nordic Bioscience, Mozhgan Rasti: None declared, Darshini Ganatra: None declared, Katerina Oikonomopoulou: None declared, Vinod Chandran: None declared

Quercetin potentiates transdifferentiation of bone marrow mesenchymal stem cells into the beta cells in vitro

PURPOSE

Type 1 diabetes is an autoimmune disease caused by the destruction of β-cells in the pancreas. Bone marrow mesenchymal stem cells are multipotent and easy accessible adult stem cells that may provide options in the treatment of type 1 diabetes. Injured pancreatic extract can promote the differentiation of rat bone marrow mesenchymal stem cells into β-cells. We aimed to observe the effect of quercetin in differentiation and insulin secretion in β-cells.

METHODS

Bone marrow mesenchymal stem cells were obtained from the tibiae of rats. Cell surface markers were analyzed by flow cytometry. The cells were treated with rat injured pancreatic extract and quercetin for 2 weeks. Insulin secretion was measured by ELISA. Insulin expression and some islet factors were evaluated by RT-PCR. PDX1, a marker for β-cell function and differentiation, was evaluated by both immunocytochemistry and Western blot. β-cell count was determined by stereology and cell count assay.

RESULTS

ELISA showed significant differences in insulin secretion in the cells treated with RIPE + 20 μM quercetin (0.55 ± 0.01 µg/L) compared with the cells treated with RIPE alone (0.48 ± 0.01 µg/L) (P = 0.026). RT-PCR results confirmed insulin expression in both groups. PDX1 protein was detected in both groups by Western blot and immunocytochemistry. Stereology results showed a significant increase in β-cell number in the RIPE + quercetin-treated cells (47 ± 2.0) when compared with RIPE treatment alone (44 ± 2.5) (P = 0.015).

CONCLUSIONS

Quercetin has a strengthening effect on the differentiation of rat bone marrow mesenchymal stem cells into β-cells and increases insulin secretion from the differentiated β-cells in vitro.

Detection of Hepatitis C virus RNA in peripheral blood mononuclear cells of patients with abnormal alanine transaminase in Ahvaz

PURPOSE

Hepatitis C virus (HCV) is an important agent for chronic and acute hepatitis. Occult hepatitis C remains a major health problem worldwide. Patients with chronic occult HCV may progress to cirrhosis and hepatocellular carcinoma. The aim of this study was to determine prevalence of occult hepatitis C by IS-PCR-ISH (in situ PCR in situ hybridisation) in the patients with abnormal ALT.

MATERIALS AND METHODS

The blood samples were taken from 53 patients including 17 females (32.1%) and 36 (67.9%) males who had abnormal alanine transaminase (ALT) for more than 1 year. The mean ALT and aspartate transaminase (AST) level were 41.02±9.3 and 24.17±7.3, respectively. The patients' age were between 4 and 70-years old with mean age 38±13. All the patients were negative for HCV antibody, HCV RNA and HBs Ag. The peripheral blood mononuclear cells (PBMC) were separated with ficoll gradient from each blood sample, then the cells were fixed on slides by cold acetone and followed by IS-PCR-ISH for HCV RNA detection.

RESULTS

Seventeen (32%) patients including 6 (11.3%) females and 11 (20.7%) males showed positive results for HCV RNA by in situ-PCR in situ hybridisation. Ten (18.8%) positive cases were between 20 and 40-years old and 6 (11.3%) positive patients were between 40 and 60 years old. Ten (19.6%) patients who were positive for IS-PCR-ISH also had positive anti-HBc IgG and 7 (13.2%) patients were negative for HBc-IgG.

CONCLUSION

In the present study high rate of 32% occult hepatitis C were found among the patients with elevated ALT.

Expression and Purification of Recombinant Mycobacterium Tuberculosis (TB) Antigens, ESAT-6, CFP-10 and ESAT- 6/CFP-10 and Their Diagnosis Potential for Detection of TB Patients

BACKGROUND

One of the most widely used methods to detect tuberculosis (TB) infection is the tuberculin skin test (TST). The completion of Mycobacterium tuberculosis (M. tuberculosis) genome sequence has led to identification of several antigens that can be utilized for accurate diagnosis and control of TB. The aim of this study was to purify the recombinant M. tuberculosis antigens for the evaluation of their potential in TB diagnosis.

METHODS

The recombinant secretory antigens, ESAT-6, CFP-10 and ESAT-6/CFP-10 were produced by PCR and cloning methods. To investigate antigen specific responses of these recombinant antigens in detection of TB, ex vivo enzyme linked immunospot (ELISPOT) test in 30 clinically diagnosed TB patients was evaluated.

RESULTS

The selected M. tuberculosis antigens were cloned, expressed and purified in Escherichia coli (BL21). ELISPOT assay for detection of TB showed the sensitivity of 93, 90 and 100% for recombinant ESAT-6, CFP-10 and ESAT-6/CFP-10 proteins respectively, which is significantly higher than conventional TST.

CONCLUSION

The recombinant antigens of ESAT-6, CFP-10 and ESAT-6/CFP-10 can be used as an accurate means of detecting TB in Iran.

C-terminal-binding protein interacting protein binds directly to adenovirus early region 1A through its N-terminal region and conserved region 3

C-terminal-binding protein interacting protein (CtIP) was first isolated as a binding partner of C-terminal-binding protein (CtBP). It is considered to contribute to the transcriptional repression and cell cycle regulatory properties of the retinoblastoma (Rb) family of proteins and to have a role in the cellular response to DNA damage. Here, we have shown that CtIP is a novel target for the adenovirus oncoprotein early region 1A (AdE1A). AdE1A associates with CtIP in both Ad5E1-transformed cells and Ad5-infected cells and binds directly in glutathione-S-transferase pull-down assays. Two binding sites have been mapped on Ad5E1A - the N-terminal alpha-helical region (residues 1-30) and conserved region 3 (CR3) - the transcriptional activation domain. CtIP can bind AdE1A and CtBP independently, raising the possibility that ternary complexes exist in Ad-transformed and -infected cells. Significantly, reduction of CtIP expression with small interfering RNAs results in reduction of the ability of a Gal4 DNA-binding domain-CR3 construct to transactivate a Gal 4-responsive luciferase reporter and this effect is reversed by reduction of CtBP expression. Therefore, in this model, CtIP acts as a transcriptional co-activator of AdE1A when dissociated from CtBP, through the action of AdE1A. These data are consistent with observations that CtIP expression is induced by AdE1A during viral infection and that reduction of CtIP expression with RNA interference can retard virus replication. In addition, AdE1A causes disruption of the CtIP/Rb complex during viral infection by its interaction with CtIP, possibly contributing to transcriptional derepression.

Analysis of arylsulfatases A and B, acid phosphatase, lactate dehydrogenase, and aspartate transaminase in chronic periapical lesions of endodontic origin

Attempts were made to detect and measure the activities of arylsulfatases. A&B acid phosphatase, lactate dehydrogenase, and glutamate oxaloacetate transaminase (aspartate transaminase) enzymes in human chronic lesions of endodontic origin. Thirteen periapical lesions of endodontic origin and 11 noninflamed control periapical tissues were obtained. The specimens were carried to the laboratory on liquid nitrogen and kept at -70 degrees C. Samples were thawed, homogenized, and then assayed for enzyme activities. The specific activities of arylsulfatase A (nmol/hr/mg protein) were 55.0+/-10.7 (chronic lesions) vs. 3.4+/-2.2 (controls) (p < 0.01). Arylsulfatase B specific activities (nmol/hr/mg protein) were 50.3+/-6.4 (chronic lesions) vs 91.8+/-18.4 (controls). Total acid phosphatase activities (mU/mg protein) were 45.8+/-6.6 (chronic lesions) vs. 26.8+/-3.1 (controls). Lactate dehydrogenase activities (Berger-Broida units/mg protein) of the chronic periapical lesions were significantly higher than the control group (362+/-63.2) vs. (140+/-46.0) (p < 0.05). There was no significant difference between the specific activities of aspartate transaminase in chronic lesions and the control group (68.0+/-14.5) vs. (53.0+/-10.4) mU/mg protein).

Modulation of the pituitary and basomedial hypothalamic lysyl-aminopeptidase activities be beta-estradiol and/or an aqueous extract of Physalis alkekengi fruits

Injections of an aqueous extract of winter cherry fruits (Physalis alkekengi) to adult female cycling rats by an intraperitoneal route resulted in the diminution of the pituitary lysyl-aminopeptidase (Lys-AP) activity by 50% and that of the basomedial hypothalamus (BMH) by 45%. Administration of daily doses of 3.75, 7.5, and 15 micrograms beta-estradiol for a period of 5-8 days to such animals increased pituitary Lys-AP activity from 31% to 61.5% and that of BMH from 20% to 87%, respectively. Administration of the same doses of beta-estradiol along with a given dose of the aqueous extract for 7-8 days diminished Lys-AP inhibitory effect of the extract in both the pituitary and BMH and eventually, at the highest dose of beta-estradiol, increased the pituitary enzyme activity by 9% and that of BMH by 5%. It is concluded that Lys-AP enzymes of both tissues, being estrogen-induced proteins, are inhibited by the estrogen antagonistic principle of the winter cherry aqueous extract. It is further suggested that BMH Lys-AP activity may be used as an enzyme marker for the action of beta-estradiol in hypothalamus.