A comparative study on the anti-inflammatory effects of single oral doses of naproxen and its hydrogen sulfide (H2S)-releasing derivative ATB-346 in rats with carrageenan-induced synovitis

BACKGROUND: Non-steroidal antiinflammatory drugs (NSAIDs) are the most commonly prescribed agents for arthritic patients, although gastric effects limit their long-term use. Considering the reported gastric safety of hydrogen sulfide (H2S)-releasing NSAIDs, in addition to the anti-inflammatory effects of H2S administration to rats with synovitis, we decided to evaluate the effects of the H2S-releasing naproxen derivative ATB-346 in this animal model. METHODS: Male Wistar rats were anesthetized with inhalatory halothane and pre-treated with equimolar oral doses of either naproxen (0.3, 1, 3 or 10 mg/kg) or ATB-346 (0.48, 1.6, 4.8, or 16 mg/kg) 30 min before the i.art. injection of 7.5 mg of carrageenan (CGN) into the right knee joint cavity. Joint swelling and pain score were assessed after 1, 3 and 5 h, and tactile allodynia after 2 and 4 h. After the last measurement, the joint cavity lavages were performed for counting of the recruited leukocytes. The drugs (at the highest doses) were also tested for their gastric effects by evaluating macroscopical damage score and neutrophil recruitment (measured as myeloperoxidase - MPO activity) in the stomachs 5 h after administration of the drugs. In addition, the serum naproxen pharmacokinetic profiles of both compounds, administered at the highest equimolar doses, were obtained during the first 6 h after dosing. RESULTS: At the two highest tested doses, both naproxen and ATB-346 reduced edema and pain score (measured 3 and 5 h after CGN; P < 0.001). Tactile allodynia was similarly inhibited by ~45% 4 h after CGN by both naproxen (at 1, 3 and 10 mg/kg) and ATB-346 (at 1.6 and 4.8 mg/kg; P < 0.001), as well as leukocyte infiltration. Naproxen (but not ATB-346) induced significant gastric damage and, despite the increased gastric MPO activity by ~130% in the naproxen-, but not in the ATB-346-treated rats, this effect was of no statistical significance. CONCLUSION: The presence of a H2S-releasing moiety in the ATB-346 structure does not impair the antiinflammatory activity of the parent compound in rats with CGN-induced synovitis. In addition, released H2S may account for the absence of deleterious gastric effects, thus making of ATB-346 a potentially useful therapeutic alternative to traditional naproxen for treatment of patients with arthritis.

Protocolo de anestesia y recuperación para estudio de morfometría de juveniles de caballito de mar, (Hippocampus hippocampus (Linnaeus, 1758)

Anaesthetic and Recovery Protocol for morfometric study of Atlantic seahorse, Hippocampus hippocampus (Linnaeus, 1758), juveniles. Some morphometric studies in marine organism need anaesthetics in order to avoid animal?s sacrifice and allow its recovery. In this study different natural clove essential concentrations has been tested in Atlantic seahorses, Hippocampus hippocampus (Linnaeus, 1758) aged 13 (trunk length 7,48 ± 1,14 mm) and 22 days (trunk length 9,09 ± 1,62 mm). An inversed relation was observed between anaesthetic concentration and effective time. The concentration allowing measures was 25 ppm. This procedure allowed 100% survival rate.

Organismi acquatici e ambiente: meccanismi biochimici di interazione, risposta e adattamento

The research is focused on the relationship between some Mg2+-dependent ATPase activities of plasma- and mitochondrial membranes from tissues of cultured marine bivalve molluscs and potentially stressful environmental conditions, such as the exposure to contaminants both of natural origin (ammonia nitrogen, the main contaminant of aquaculture plants) and of anthropic source (alkyltins). The two filter-feeding bivalve species selected colonize different habitats: the common mussel Mytilus galloprovincialis binds to hard substrates and the Philippine clam Tapes philippinarum burrows into sea bottom sandy beds. The choice of typical species of coastal waters, extremely suitable for environmental studies due to their features of poor motility, resistance to transport and great filtering efficiency, may constitute a model to evaluate responses to contaminants of membrane-bound enzyme activities involved in key biochemical mechanisms, namely cell ionic regulation and mitochondrial energy production. In vitro and in vitro approaches have been pursued. In vitro assays were carried out by adding the contaminants (NH4Cl and alkyltins) directly to the ATPase reaction media. In vivo experiments were carried out by exposing mussels to various tributyl tin (TBT) concentrations under controlled conditions in aquaria. ATPase activities were determined spectrophotometrically according to the principles of the method of Fiske and Subbarow (1925). The main results obtained are detailed below. In Tapes philippinarum the interaction of NH4 +, the main form of ammonia nitrogen at physiological and seawater pHs, with the Na,K-ATPase and the ouabaininsensitive Na-ATPase was investigated in vitro on gill and mantle microsomal membranes. The proven replacement by NH4 +of K+ in the activation of the Na,KATPase and of Na+ in the activation of the ouabain-insensitive ATPase displayed similar enzyme affinity for the substituted cation. on the one hand this finding may represent one of the possible mechanisms of ammonia toxicity and, on the other, it supports the hypothesis that NH4 + can be transported across the plasma membrane through the two ATPases. In this case both microsomal ATPases may be involved and co-operate, at least under peculiar circumstances, to nitrogen excretion and ammonia detoxification mechanisms in bivalve molluscs. The two ATPase activities stimulated by NH4 + maintained their typical response to the glycoside ouabain, specific inhibitor of the Na,K-ATPase, being the Na++ NH4 +-activated ATPase even more susceptive to the inhibitor and the ouabain-insensitive ATPase activity activated indifferently by Na+ or NH4 + unaffected by up to 10-2 M ouabain. In vitro assays were carried out to evaluate the response of the two Na-dependent ATPases to organotins in clams and mussels and to investigate the interaction of TBT with mussel mitochondrial oligomycin-sensitive Mg-ATPase. Since no literature data were available, the optimal assay conditions and oligomycin sensitivity of mussel mitochondrial MgATPase were determined. In T. philippinarum the ouabain-insensitive Na-ATPase was found to be refractory to TBT both in the gills and in the mantle, whereas the Na,K-ATPase was progressively inhibited by increasing TBT doses; the enzyme inhibition was more pronounced in the gills than in the mantle. In both tissues of M. galloprovincialis the Na,K-ATPase inhibition by alkyltins decreased in the order TBT>DBT(dibutyltin)>>MBT(monobutyltin)=TeET(tetraethyltin) (no effect). Mussel Na-ATPase confirmed its refractorimess to TBT and derivatives both in the gills and in the mantle. These results indicate that the Na,K-ATPase inhibition decreases as the number of alkyl chains bound to tin decreases; however a certain polarity of the organotin molecule is required to yield Na,K-ATPase inhibition, since no enzyme inhibition occurred in the presence of tetraalkyl-substituted derivatives such as TeET . Assays carried out in the presence of the dithioerythritol (DTE) pointed out that the sulphhydrylic agent is capable to prevent the Na,K-ATPase inhibition by TBT, thus suggesting that the inhibitor may link to -SH groups of the enzyme complex.. Finally, the different effect of alkyltins on the two Na-dependent ATPases may constitute a further tool to differentiate between the two enzyme activities. These results add to the wealth of literature data describing different responses of the two enzyme activities to endogenous and exogenous modulators . Mussel mitochondrial Mg-ATPase was also found to be in vitro inhibited by TBT both in the gills and in the mantle: the enzyme inhibition followed non competitive kinetics. The failed effect of DTE pointed out that in this case the interaction of TBT with the enzyme complex is probably different from that with the Na,K-ATPase. The results are consistent with literature data showing that alkyltin may interact with enzyme structures with different mechanisms. Mussel exposure to different TBT sublethal doses in aquaria was carried out for 120 hours. Two samplings (after 24 and 120 hrs) were performed in order to evaluate a short-term response of gill and mantle Na,K-ATPase, ouabain-insensitive Na-ATPase and Mg-ATPase activities. The in vivo response to the contaminants of the enzyme activities under study was shown to be partially different from that pointed out in the in vitro assays. Mitochondrial Mg-ATPase activity appeared to be activated in TBTexposed mussels with respect to control ones, thus confirming the complexity of evaluating in vivo responses of the enzyme activities to contaminants, due to possible interactions of toxicants with molluscan metabolism. Concluding, the whole of data point out that microsomal and mitochondrial ATPase activities of bivalve molluscs are generally responsive to environmental contaminants and suggest that in some cases membrane-bound enzyme activities may represent the molecular target of their toxicity. Since the Na,K-ATPase, the Na-ATPase and the Mg-ATPase activities are poorly studied in marine bivalves, this research may contribute to enlarge knowledge in this quite unexplored field.

Recupero della funzione renale in pazienti con acute kidney injury (AKI) sottoposti a terapia sostitutiva renale

L’insufficienza renale acuta(AKI) grave che richiede terapia sostitutiva, è una complicanza frequente nelle unità di terapia intensiva(UTI) e rappresenta un fattore di rischio indipendente di mortalità. Scopo dello studio é stato valutare prospetticamente, in pazienti “critici” sottoposti a terapie sostitutive renali continue(CRRT) per IRA post cardiochirurgia, la prevalenza ed il significato prognostico del recupero della funzione renale(RFR). Pazienti e Metodi:Pazienti(pz) con AKI dopo intervento di cardiochirurgia elettivo o in emergenza con disfunzione di due o più organi trattati con CRRT. Risultati:Dal 1996 al 2011, 266 pz (M 195,F 71, età 65.5±11.3aa) sono stati trattati con CRRT. Tipo di intervento: CABG(27.6%), dissecazione aortica(33%), sostituzione valvolare(21.1%), CABG+sostituzione valvolare(12.6%), altro(5.7%). Parametri all’inizio del trattamento: BUN 86.1±39.4, creatininemia(Cr) 3.96±1.86mg/dL, PAM 72.4±13.6mmHg, APACHE II score 30.7±6.1, SOFAscore 13.7±3. RIFLE: Risk (11%), Injury (31.4%), Failure (57.6%). AKI oligurica (72.2%), ventilazione meccanica (93.2%), inotropi (84.5%). La sopravvivenza a 30 gg ed alla dimissione è stata del 54.2% e del 37.1%. La sopravvivenza per stratificazione APACHE II: <24=85.1 e 66%, 25-29=63.5 e 48.1%, 30-34=51.8 e 31.8%, >34=31.6 e 17.7%. RFR ha consentito l’interruzione della CRRT nel 87.8% (86/98) dei survivors (Cr 1.4±0.6mg/dL) e nel 14.5% (24/166) dei nonsurvivors (Cr 2.2±0.9mg/dL) con un recupero totale del 41.4%. RFR è stato osservato nel 59.5% (44/74) dei pz non oligurici e nel 34.4% dei pz oligurici (66/192). La distribuzione dei pz sulla base dei tempi di RFR è stata:<8=38.2%, 8-14=20.9%, 15-21=11.8%, 22-28=10.9%, >28=18.2%. All’analisi multivariata, l’oliguria, l’età e il CV-SOFA a 7gg dall’inizio della CRRT si sono dimostrati fattori prognostici sfavorevoli su RFR(>21gg). RFR si associa ad una sopravvivenza elevata(78.2%). Conclusioni:RFR significativamente piu frequente nei pz non oligurici si associa ad una sopravvivenza alla dimissione piu elevata. La distribuzione dei pz in rapporto ad APACHE II e SOFAscore dimostra che la sopravvivenza e RFR sono strettamente legati alla gravità della patologia.

Untersuchungen zur autoimmunen Genese der thrombotisch thrombozytopenischen Purpura

Untersuchungen zur autoimmunen Genese der thrombotisch thrombozytopenischen Purpura. rnEinführung: Die idiopathische thrombotisch thrombozytopenische Purpura (TTP) ist eine lebensbedrohliche Mikroangiopathie und wird durch ein Autoantikörper-induziertes Defizit der ADAMTS13-Protease ausgelöst. Eine Assoziation zwischen Krankheitsprädisposition und Vorliegen bestimmter humaner Leukozytenantigene (HLA) wird vermutet. Untersuchungen zu diesem Zusammenhang stellen einen Teil dieser Arbeit dar. rnAutoimmunkrankheiten tendieren zum gemeinsamen Auftreten innerhalb eines Individuums. Im zweiten Teil dieser Arbeit wird untersucht, ob eine solche Kookkurrenz verschiedener Autoimmunkrankheiten auch bei Patienten mit idiopathischer TTP beobachtet werden kann.rnMethodik: Zur Untersuchung der ersten Fragestellung werden die HLA-Klasse I und II-Merkmale von 54 deutschen TTP-Patienten bestimmt. Alle Patienten weisen Autoantikörper gegen ADAMTS13 und eine Protease-Aktivität <5% vor. Die Blutproben werden mittels Sequence Specific Primer-Polymerase Chain Reaction (PCR) und Sequence Specific Oligonucleotid-PCR auf HLA-DRB1, -DRB3-5 und –DQB1 untersucht. Als Referenz dienen die Werte deutscher Knochenmark- und Blutspender, erhalten über www.allelefrequencies.net. Die statistische Auswertung erfolgt mittels zweiseitigem Binomialtest und die resultierenden p-Werte werden nach Benjamini-Hochberg korrigiert.rnZur Beantwortung der zweiten Fragestellung werden 76 deutsche TTP-Patienten anhand eines standardisierten Fragebogens nach Begleiterkrankungen befragt. Als Vergleichswerte dient die Prävalenz der jeweiligen Erkrankung in der Allgemeinbevölkerung. Die statistische Auswertung erfolgt mittels zweiseitigem Binomialtest. Da die p-Werte nicht korrigiert werden, sind die Ergebnisse nur deskriptiv zu verstehen.rnErgebnis: Der Vergleich der HLA-Frequenzen ergibt ein signifikant gehäuftes Vorkommen von HLA-DQB1*02:02 (p<0,001) und -DRB1*11 (p=0,003) innerhalb des Patientenkollektivs. 20% (DQB1*02:02) bzw. 48,1% (DRB1*11) der TTP-Patienten sind im Gegensatz zu nur 1,2% (DQB1*02:02) bzw. 23,5% (DRB1*11) innerhalb der Vergleichsgruppe für das jeweilige HLA-Merkmal positiv.rnDie Befragung der TTP-Patienten bezüglich weiterer Erkrankungen ergab im Vergleich mit der Allgemeinbevölkerung fünf auffällig häufig im Patientenkollektiv vorkommende Autoimmunkrankheiten: Hashimoto Thyreoiditis (23,5% in der Patientengruppe zu 0,7% in der Allgemeinbevölkerung; p<0,001), systemischer Lupus erythematodes (6,5% der Patienten im Gegensatz zu 0,025% in der Allgemeinbevölkerung, p<0,001), Immunthrombozytopenie (6,3% der Patienten zu 0,02% in der Allgemeinbevölkerung; p<0,001), Psoriasis (9,4% der Patienten zu 2,5% in der Allgemeinbevölkerung; p=0,005) und glutensensitive Enteropathie (3,1% der Patienten zu 0,2% in der Allgemeinbevölkerung; p=0,007). rnSchlussfolgerung: Das vermehrte Vorkommen bestimmter HLA-Merkmale im Patientenkollektiv spricht für eine prädisponierende Wirkung dieser Antigene im Krankheitsgeschehen. Eine mögliche HLA-vermittelte Assoziation zwischen TTP und den genannten Autoimmunkrankheiten wird vermutet, kann jedoch nicht in allen Fällen die beobachtete Kookkurrenz ausreichend erklären. Insgesamt bestätigt die vorliegende Arbeit die Assoziation verschiedener Autoimmunkrankheiten untereinander und spricht für eine genetische Prädisposition zur Ausbildung autoimmuner Störungen. rn

In vitro detection of cytotoxic T and NK cells in peripheral blood of patients with various drug-induced skin diseases

BACKGROUND: Cytotoxic cells are involved in most forms of drug-induced skin diseases. Till now, no in vitro test addressed this aspect of drug-allergic responses. Our report evaluates whether drug-induced cytotoxic cells can be detected in peripheral blood of nonacute patients with different forms of drug hypersensitivity, and also whether in vitro detection of these cells could be helpful in drug-allergy diagnosis. METHODS: GranzymeB enzyme-linked immunosorbent spot-forming (ELISPOT) and cell surface expression of the degranulation marker CD107a were evaluated on peripheral blood mononuclear cells from 12 drug-allergic patients in remission state and 16 drug-exposed healthy controls. RESULTS: In 10/12 allergic patients culprit but not irrelevant drug elicited granzymeB release after 48-72 h stimulation. It was clearly positive in patients with high proliferative response to the drug, measured in lymphocyte transformation tests. In patients, who showed moderate or low proliferation and low drug-response in granzymeB ELISPOT, overnight preincubation with interleukin (IL)-7/IL-15 enhanced drug-specific granzymeB release and allowed to clearly identify the offending agent. CD107a staining was positive on CD4+/CD3+, CD8+/CD3+ T cells as well as CD56+/CD3- natural killer cells. None of the drug-exposed healthy donors reacted to the tested drugs and allergic patients reacted only to the offending, but not to tolerated drugs. CONCLUSION: GranzymeB ELISPOT is a highly specific in vitro method to detect drug-reacting cytotoxic cells in peripheral blood of drug-allergic patients even several years after disease manifestation. Together with IL-7/IL-15 preincubation, it may be helpful in indentifying the offending drug even in some patients with weak proliferative drug-response.

Progression of coronary artery disease during long-term follow-up of the Swiss Interventional Study on Silent Ischemia Type II (SWISSI II)

Background: This study evaluates cardiovascular risk factors associated with progression of coronary artery disease (CAD) in patientswith silent ischemia followingmyocardial infarction. Hypothesis: Coronary artery disease only progresses slowly with comprehensive risk factor intervention. Methods: A total of 104 of 201 patients (51.7%) of the Swiss Interventional Study on Silent Ischemia Type II (SWISSI II) with baseline and follow-up coronary angiography were included. All patients received comprehensive cardiovascular risk factor intervention according to study protocol. Logistic regression was used to evaluate associationsbetween baseline cardiovascular risk factors and CAD progression. Results: The mean duration of follow-upwas 10.3 ± 2.4 years. At baseline, 77.9% of patients were smokers, 45.2% had hypertension, 73.1% had dyslipidemia, 7.7% had diabetes, and 48.1% had a family history of CAD. At last follow-up, only 27 patients of the initial 81 smokers still smoked, only 2.1% of the patients had uncontrolled hypertension, 10.6%of the patientshad uncontrolled dyslipidemia, and 2.1%of the patientshad uncontrolled diabetes. Coronary artery disease progression was found in up to 81 (77.9%) patients. Baseline diabetes and younger age were associatedwith increased odds of CAD progression.The time intervalbetween baseline and follow-up angiography was also associatedwith CAD progression. Conclusion: Coronary artery disease progressionwas highly prevalent in these patients despite comprehensive risk factor intervention. Further research is needed to optimize treatment of known risk factors and to identify other unknown and potentiallymodifiable risk factors.

All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study

Objective To examine all cause and disease specific mortality in patients with osteoarthritis of the knee or hip. Design Population based cohort study. Setting General practices in the southwest of England. Participants 1163 patients aged 35 years or over with symptoms and radiological confirmation of osteoarthritis of the knee or hip. Main outcome measures Age and sex standardised mortality ratios and multivariable hazard ratios of death after a median of 14 years’ follow-up. Results Patients with osteoarthritis had excess all cause mortality compared with the general population (standardised mortality ratio 1.55, 95% confidence interval 1.41 to 1.70). Excess mortality was observed for all disease specific causes of death but was particularly pronounced for cardiovascular (standardised mortality ratio 1.71, 1.49 to 1.98) and dementia associated mortality (1.99, 1.22 to 3.25). Mortality increased with increasing age (P for trend <0.001), male sex (adjusted hazard ratio 1.59, 1.30 to 1.96), self reported history of diabetes (1.95, 1.31 to 2.90), cancer (2.28, 1.50 to 3.47), cardiovascular disease (1.38, 1.12 to 1.71), and walking disability (1.48, 1.17 to 1.86). However, little evidence existed for increased mortality associated with previous joint replacement, obesity, depression, chronic inflammatory disease, eye disease, or presence of pain at baseline. The more severe the walking disability, the higher was the risk of death (P for trend <0.001). Conclusion Patients with osteoarthritis are at higher risk of death compared with the general population. History of diabetes, cancer, or cardiovascular disease and the presence of walking disability are major risk factors. Management of patients with osteoarthritis and walking disability should focus on effective treatment of cardiovascular risk factors and comorbidities, as well as on increasing physical activity.

Mesoproterozoic Deposition, Regional Metamorphism and Deformation in North-Central New Mexico: Evidence from Metamorphic Monazite and Detrital Zircon Geochronology in the Picuris Mountains

Detrital zircon and metamorphic monazite ages from the Picuris Mountains, north central New Mexico, were used to confirm the depositional age of the Marquenas Formation, to document the depositional age of the Vadito Group, and to constrain the timing of metamorphism and deformation in the region. Detrital zircon 207Pb/206Pb ages were obtained with the LA-MC-ICPMS from quartzites collected from the type locality of the Marquenas Formation exposed at Cerro de las Marquenas, and from the lower Vadito Group in the southern and eastern Picuris Mountains. The Marquenas Formation sample yields 113 concordant ages including a Mesoproterozoic age population with four grains ca. 1470 Ga, a broad Paleoproterozoic age peak at 1695 Ma, and minor Archean age populations. Data confirm recent findings of Mesoproterozoic detrital zircons reported by Jones et al. (2011), and show that the Marquenas Formation is the youngest lithostratigraphic unit in the Picuris Mountains. Paleoproterozoic and Archean detrital grains in the Marquenas Formation are likely derived from local recycled Vadito Group rocks and ca. 1.75 Ga plutonic complexes, and ca. 1.46 detrital zircons were most likely derived from exposed Mesoproterozoic plutons south of the Picuris. Ninety-five concordant grains from each of two Vadito Group quartzites yield relatively identical unimodal Paleoproterozoic age distributions, with peaks at 1713-1707 Ma. Eastern exposures of quartzite mapped as Marquenas Formation yield detrital zircon age patterns and metamorphic mineral assemblages that are nearly identical to the Vadito Group. On this basis, I tentatively assigned the easternmost quartzite to the Vadito Group. Zircon grains in all samples show low U/Th ratios, welldeveloped concentric zoning, and no evidence of metamorphic overgrowth events, consistent with an igneous origin. North-directed paleocurrent indicators, such as tangential crossbeds (Soegaard & Eriksson, 1986) and other primary sedimentary structures, are preserved in the Marquenas Formation quartzite. Together with pebble-toboulder metaconglomerates in the Marquenas, these observations suggest that this formation was deposited in a braided alluvial plain environment in response to syntectonic uplift to the south of the Picuris Mountains. Metamorphic monazite from two Vadito Group quartzite samples were analyzed with an electron microprobe (EMP). Elemental compositional variation with respect to Th and Y define core and rim domains in monazite grains, and show lower concentrations of Th (1.46-1.52 wt%) and Y (0.67 wt%) in the cores, and higher concentrations of Th (1.98 wt%) and Y (1.06 wt%) in the rims. Results show that Mesoproterozoic core and rim ages from five grains overlap within uncertainty, ranging from 1395-1469 Ma with an average age of 1444 Ma. This 1.44 Ga average age is the dominant timing of metamorphic monazite growth in the region, and represents the timing of metamorphism experienced by the region. An older 1630 Ma core observed in sample CD10-12 may be interpreted as a result of low temperature metamorphism in lower Vadito Group rocks due to heat from ca. 1.65 Ga granitic intrusions. Core ages ca. 1.5 Ga are likely due to a mixing age of two different age domains during analyses. Confirmed sedimentation at 1.48-1.45 Ga and documented mid-crustal regional metamorphism in northern New Mexico ca. 1.44-1.40 are likely associated with a Mesoproterozoic orogenic event.