Changes in plasma levels of fat-derived hormones adiponectin, leptin, resistin and visfatin in patients with rheumatoid arthritis

BACKGROUND

Rheumatoid arthritis is a chronic autoimmune inflammatory condition characterised by polyarthritis and severe change in body mass and neuroendocrine environment.

OBJECTIVES

To investigate plasma levels of adipocytokines (leptin, adiponectin, visfatin and resistin) in patients with rheumatoid arthritis and to compare them with levels in healthy controls.

METHODS

Adiponectin, resistin, visfatin and leptin concentrations were measured in 31 patients with rheumatoid arthritis and 18 healthy controls by using specific enzyme-linked immunosorbent assays.

RESULTS

Patients with rheumatoid arthritis showed considerably higher plasma levels of leptin, adiponectin and visfatin than healthy controls. No marked difference was observed in resistin levels between patients and controls.

CONCLUSION

A marked increase in plasma levels of leptin, adiponectin and visfatin was noted in patients with rheumatoid arthritis, whereas resistin levels were similar to those observed in healthy controls. Coordinated roles for adiponectin, leptin and visfatin are suggested in the modulation of the inflammatory environment in patients with rheumatoid arthritis, whereas the lack of modulation in resistin levels is predictive of an irrelevant role for this peptide, suggesting that resistin level is probably not one of the main signals associated with the pathogenesis of this disease.

Activated carbons from sewage sludge and discarded tyres: production and optimization

This is a study about making use of two residual materials such as sludges from a sewage treatment plant and discarded tyres to generate activated carbons and later optimize the production process. H2SO4 and ZnCl2 were used as chemical activating agents. Liquid-phase adsorption tests were made using the produced carbons to retain methylene blue and iodine. The best precursor was sludge activated with ZnCl2. After optimization studies, the best production methodology involved a 1:1 ratio of sludge and ZnCl2, a heating rate of 5 degrees C/min up to 650 degrees C and a residence time of 5 min. The resulting materials adsorbed up to 139.4 mg/g of methylene blue and 1358.5 mg/g of iodine. Nevertheless these carbons may leach Zn while using. To avoid this two treatments were carried out: one consisting of a coating with a polymer and another involving an intensive washing, which was seen to be more efficient.

The endogenous growth hormone secretagogue (ghrelin) is synthesized and secreted by chondrocytes

Ghrelin, the endogenous ligand for the GH secretagogue receptor (GHS-R), is a recently isolated hormone, prevalently expressed in stomach but also in other tissues such as hypothalamus and placenta. This novel acylated peptide acts at a central level to stimulate GH secretion and, notably, to regulate food intake. However, the existence of further, as yet unknown, effects or presence of ghrelin in peripheral tissues cannot be ruled out. In this report, we provide clear evidence for the expression of ghrelin peptide and mRNA in human, mouse, and rat chondrocytes. Immunoreactive ghrelin was identified by immunohistochemistry in rat cartilage, being localized prevalently in proliferative and maturative zone of the epiphyseal growth plate, and in mouse and human chondrocytic cell lines. Moreover, ghrelin mRNA was detected by RT-PCR and confirmed by Southern analysis in rat cartilage as well as in mouse and human chondrocytes cell lines. Ghrelin mRNA expression has been studied in rat along early life development showing a stable profile of expression throughout. Although ghrelin expression in chondrocytes suggests the presence of an unexpected autocrine/paracrine pathway, we failed to identify the functional GH secretagogue receptor type 1A by RT-PCR. On the other hand, binding analysis with 125I ghrelin suggests the presence of specific receptors different from the 1A isotype. Scatchard analysis revealed the presence of two receptors with respectively high and low affinity. Finally, ghrelin, in vitro, was able to significantly stimulate cAMP production and inhibits chondrocytes metabolic activity both in human and murine chondrocytes. In addition, ghrelin is able to actively decrease both spontaneous or insulin-induced long chain fatty acid uptake in human and mouse chondrocytes. This study is the first to provide evidence for the presence of this novel peptide in chondrocytes and suggests novel potential roles for this newly recognized component of the GH axis in cartilage metabolism.

Conservation of purified protein derivative RT-23 tuberculin

OBJECTIVE

Recommendations that purified protein derivative (PPD) RT-23 tuberculin should not be kept and used more than 24 to 48 hours after opening are rarely complied with. The aim of this study was to determine whether using PPD RT-23 tuberculin from vials that had been open for a longer time could affect results of tuberculin tests and whether the solution could become contaminated.

METHODS

A prospective cross-sectional study was carried out. Two tuberculin tests were simultaneously administered, one in each forearm, to adult contacts of patients with active tuberculosis, one test using a recently opened vial of tuberculin (control) and the other using tuberculin that had been opened a week before (first phase) or a month before (second phase) (study tuberculin). Leftover tuberculin from several of the vials was cultured.

RESULTS

For the 127 patients in the first group (tuberculin opened 1 week), the mean (SD) diameter of the induration was 6.2 (6.9) mm for the study tuberculin and 6.3 (6.9) mm for the control (P=.3). For the 83 patients in the second group (tuberculin opened 1 month), the mean diameter of the induration was 5.5 (7.3) mm for the study tuberculin and 5.7 (7.3) mm for the control (P=.5). There were no differences between the number of positive tests found. None of the cultured tuberculins produced bacterial growth.

CONCLUSIONS

PPD RT-23 tuberculin does not appear to lose potency or sterility when vials have been opened for a week or a month.

Characterization of self-assembled redox polymer and antibody molecules on thiolated gold electrodes

Multilayer immobilization of antibody and redox polymer molecules on a gold electrode was achieved, as a strategy for the potential development of an amperometric immunosensor. The step-by-step assembly of antibiotin IgG on Os(bpy)(2)ClPyCH(2)NH poly(allylamine) redox polymer (PAH-Os) adsorbed on thiolated gold electrodes was proved by quartz crystal microbalance (QCM) and atomic force microscopy (AFM) experiments, confirming the electrochemical evidence. The increase of redox charge during the layer-by-layer deposition demonstrated that charge propagation within the layers is feasible. The multilayer structure proved to be effective for the molecular recognition of horseradish peroxidase-biotin conjugate (HRP-biotin), as confirmed by the QCM measurements and the electrocatalytic reduction current obtained upon H(2)O(2) addition. The catalytic current resulting from PAH-Os mediation was shown to increase with the number of assembled layers. Furthermore, the inventory of IgG molecules on the supramolecular self-assembled structure and the specific and non-specific binding of HRP-biotin conjugate were confirmed by the QCM transient studies, giving information on the kinetics of IgG deposition and HRP-biotin conjugate binding to the IgG.

Chronic inflammation modulates ghrelin levels in humans and rats

OBJECTIVES

The aim of this work was to investigate whether changes in plasma ghrelin, the recently discovered 28-amino acid gastric hormone that regulates growth hormone (GH) secretion and energy homeostasis, occur during inflammation in adjuvant-induced arthritis (AA) in rats. For completeness, ghrelin plasma levels were measured in rheumatoid arthritis (RA) patients.

METHODS

AA was induced in male Lewis rats using Freund's complete adjuvant. Animals were monitored for weight and food intake, every 2 or 3 days, along all time-course experiments. Plasma ghrelin concentrations in 31 RA patients and 18 healthy controls, as well as in rats, were determined by a specific double-antibody radioimmunoassay. Gastric ghrelin mRNA expression was evaluated by northern blot analysis. Human GH and insulin-like growth factor (IGF)-1 were determined by quantitative chemiluminescence assay.

RESULTS

Compared with controls, arthritic rats gained significantly (P < 0.01) less body weight than controls until the end of the study, when a partial recovery occurred. Ghrelin plasma levels were significantly lower at day 7 after arthritis induction than in controls (AA 7 = 91.2 +/- 5.6 pg/ml vs controls = 124.75 +/- 5.9 pg/ml), but they recovered to control levels by day 15. RA patients had ghrelin plasma levels significantly lower than healthy controls (RA = 24.54 +/- 2.57 pg/ml vs 39.01 +/- 4.47 pg/ml of healthy controls; P = 0.0041).

CONCLUSION

In AA, there is a compensatory variation of ghrelin levels that relates to body weight adjustments. Recovery of ghrelin levels in the latter stage suggests an adaptive response and may represent a compensatory mechanism under catabolic conditions. In RA patients, chronic imbalance in ghrelin levels suggests that this gastric hormone may participate, together with other factors, in alterations of metabolic status during inflammatory stress.

[Adult nesidioblastosis]

In adults, endogenous hyperinsulinemic hypoglycaemia is almost invariably due to insulinoma. The authors describe a 29 year old patient with repeated postprandial symptomatic hypoglycaemias and negative prolonged fast test. Distal pancreatectomy was performed, directed by positive arteriographic testing. Histological examination revealed pancreatic nesidioblastosis and no tumoral lesion. Distinct pathogenetic, clinical, diagnostic and therapeutic aspects of this rare disease in the adult are reviewed.

Dye adsorption by sewage sludge-based activated carbons in batch and fixed-bed systems

The present research work deals with the production of activated carbons by chemical activation and pyrolysis of sewage sludges. The adsorbent properties of these sewage sludges based activated carbons were studied by liquid-phase adsorption tests. Dyes removal from colored wastewater being a possible application for sludge based adsorbents, methylene blue and saphranine removing from solution was studied. Pure and binary adsorption assays were performed in batch and fixed bed systems. In all cases studied, the adsorbents produced from sewage sludges were able to adsorb both the compounds considered here. Nevertheless, time required for reaching equilibrium, adsorptive capacity and fixed bed characteristic parameters were different for these two compounds. Methylene blue adsorption occurred faster than that of saphranine, and it was preferably adsorbed when treating binary solutions. It could be concluded that the sewage sludge-based activated carbons may be promising for dyes removal from aqueous streams.

Upgrading sewage sludges for adsorbent preparation by different treatments

Addressing the adequate management of sludges produced at sewage plants is becoming a fundamental need as a consequence of the high production volumes, both current and forecasted, of this byproduct. European waste-treatment policies consider reuse of sludges as one of the preferred actions; along those lines this study proposes using sewage sludges as adsorbents for pollutants contained in wastewaters. As potential adsorbents, sludges dried at 105 degrees C, dried and pyrolyzed, or dried and chemically activated were tried. As adsorbate, methylene blue was used in order to characterize the adsorption capacity of the different materials. Although surface areas corresponding to pyrolyzed and chemically activated sludges were around 80 and 390 m2/g, respectively, both these materials exhibited poor levels of methylene blue adsorption which may have been due to their high proportions of micropores. Sludges only dried, on the contrary, showed significant methylene blue adsorption capacities.

[Anesthesia for the patient with cancer]

Surgery and radiotherapy provide the basis for local and regional control of cancer. The cancer patient has special characteristics that have implications for anesthesia. Tumors may involve the airways and affect ventilation, hemodynamics and intracranial pressure. Remote tumors can occur in endocrine cancer and in paraneoplastic syndromes. Other systemic complications of the cancer patient include hemostatic changes, immunosuppressant anemia and altered metabolism. Radiotherapy causes changes with anesthetic implications when treatment is directed at the head and neck, mediastinum, lung or surgical area. Chemotherapy is associated with non-specific toxic effects such as mucositis, aplasia and immunosuppression, alopecia and vascular injury; in addition, each chemical has other more specific toxic effects. Chemicals that are toxic for the heart and lungs have the greatest implications for anesthesia. Preoperative assessment should ascertain the effects caused by both the tumor and its treatment. Preparation for surgery includes improving nutrition and possibly inserting a venous port. Management during surgery depends on type of intervention and the patient's physical status, as they will determine the need for invasive monitoring and vessel access. The patient can be given antiemetic and antithrombotic prophylaxis. Important issues in postoperative care are the need for adequate analgesia; provision of early nutrition; antibiotic, antithrombotic and antiemetic prophylaxis; and prevention of ulcers caused by pressure.

Layer-by-layer electrostatic deposition of biomolecules on surfaces for molecular recognition, redox mediation and signal generation

Layer-by-layer supramolecular structures composed of alternate layers of negatively charged enzymes and cationic redox polyelectrolyte have been assembled. Glucose oxidase (GOx), lactate oxidase (LOx) and soybean peroxidase (SBP) have been electrically wired to the underlying electrode by means of poly(allylamine) with [Os(bpy)2ClPyCOH]+ covalently attached (PAA-Os) in organized structures with high spatial resolution. Biotinylated glucose oxidase has also been used to assemble step-by-step on antibiotin goat immunoglobulin (IgG) layers and the enzyme was electrically wired by PAA-Os. These spatially organized multilayers with mono- and bienzymatic schemes can work efficiently in molecular recognition, redox mediation and generation of an electrical signal. The concentration of redox mediator integrated into the multilayers, obtained from the voltammetric charge and an estimation of the layer thickness, exceeds by 100-fold the amount of deposited enzyme assessed by quartz crystal microbalance. Differences in GOx electrical wiring efficiency have been detected with the different assembling strategies. The surface concentration of electrically wired enzyme represents a small proportion of all the enzyme molecules present in the multilayers which can be oxidized by the soluble mediator [Os(bpy)2Cl PyCOOH]Cl. This proportion, as well as the rate of FADH2 oxidation by PAA-Os, increases with the number of electrically wired enzyme layers and with the spatial accessibility of the Os moiety to the enzyme active center.

Idle time in the washing and iron concentration in leachate removed: two basic parameters in the desulphurization of coal in a packed column

Column biodesulphurization of coal is at the experimental stage and is influenced by many variables including temperature, pH, particle size, concentration of iron in solution, among others. Idle time in the washing process and the concentration of dissolved iron in the purged leachate are two variables with a definite effect on the yield of the desulphurization system. In the laboratory, several trials were run with columns packed with coal for different idle times: 1, 2, 3, 5, 6 and 7 days, and for different concentrations of iron in the purged leachate: 500 to 4,000 mg/l. The optimal values for the two variables; that is, those allowing for the highest desulphurization yields, were idle times of 3 and 5 days, which give an elimination of 56% and 49% of pyritic sulphur, respectively, and 3,000 mg/l of iron concentration in the purged leachate, giving a decrease in pyritic sulphur in coal of 57%.

Mechanisms of agonist-dependent and -independent desensitization of a recombinant P2Y2 nucleotide receptor

UTP activates P2Y, receptors in both 1321N1 cell transfectants expressing the P2Y2 receptor and human HT-29 epithelial cells expressing endogenous P2Y, receptors with an EC50 of 0.2-1.0 microM. Pretreatment of these cells with UTP diminished the effectiveness of a second dose of UTP (the IC50 for UTP-induced receptor desensitization was 0.3-1.0 microM for both systems). Desensitization and down-regulation of the P2Y2 nucleotide receptor may limit the effectiveness of UTP as a therapeutic agent. The present studies investigated the phenomenon of P2Y2 receptor desensitization in human 1321N1 astrocytoma cells expressing recombinant wild type and C-terminal truncation mutants of the P2Y2 receptor. In these cells, potent P2Y2 receptor desensitization was observed after a 5 min exposure to UTP. Full receptor responsiveness returned 5-10 min after removal of UTP. Thapsigargin, an inhibitor of Ca2+-ATPase in the endoplasmic reticulum, induced an increase in the intracellular free calcium concentration, [Ca2+]i, after addition of desensitizing concentrations of UTP, indicating that P2Y2 receptor desensitization is not due to depletion of calcium from intracellular stores. Single cell measurements of increases in [Ca2+]i induced by UTP in 1321N1 cell transfectants expressing the P2Y2 receptor indicate that time- and UTP concentration-dependent desensitization occurred uniformly across a cell population. Other results suggest that P2Y2 receptor phosphorylation/dephosphorylation regulate receptor desensitization/resensitization. A 5 min preincubation of 1321N1 cell transfectants with the protein kinase C activator, phorbol 12-myristate 13-acetate (PMA), reduced the subsequent response to UTP by about 50%, whereas co-incubation of PMA with UTP caused a greater inhibition in the response. The protein phosphatases-1 and -2A inhibitor, okadaic acid, partially blocked resensitization of the receptor. Furthermore, C-terminal truncation mutants of the P2Y2 receptor that eliminated several potential phosphorylation sites including two for PKC were resistant to UTP-, but not phorbol ester-induced desensitization. Down regulation of protein kinase C isoforms prevented phorbol ester-induced desensitization but had no effect on agonist-induced desensitization of wild type or truncation mutant receptors. These results suggest that phosphorylation of the C-terminus of the P2Y2 receptor by protein kinases other than protein kinase C mediates agonist-induced receptor desensitization. A better understanding of the molecular mechanisms of P2Y2 nucleotide receptor desensitization may help optimize a promising cystic fibrosis pharmacotherapy based on the activation of anion secretion in airway epithelial cells by P2Y, receptor agonists.

[Comparison between penicillin and amoxicillin-clavulanic acid for the treatment of recurrent tonsillopharyngitis in childhood]

Fifty-one children aged 2-14 years with recurrent tonsillopharyngitis, presenting dysphagia, fever and lymphadenitis, with more than two similar episodes in the last three years and showing a beta-hemolytic group A streptococci in the pharyngeal smear, were studied. They underwent random treatment for ten days with phenoxymethylpenicillin (40-60 mg/kg/day) (n = 28) or amoxicillin-clavulanic acid (20-40 mg/kg/day) (n = 23) taken orally three times a day. Clinical and bacteriological tests were carried out at 10 days and 2, 6 and 12 months post-treatment. The clinical and bacteriological results showed the superiority of the amoxicillin-clavulanic acid treatment both in the short term (disappearance of symptoms) and in the long term (decrease in recurrence). These results support the idea that betalactamases produced by the pharyngeal flora play an important role in the failures of penicillin.

Sequence variation of hepatitis B virus precore-core open reading frame isolated from serum and liver of children with chronic hepatitis B before and after interferon treatment

DNA and amino acid sequences of the hepatitis B virus (HBV) genome were studied in serum and liver samples taken from 12 children with chronic hepatitis B before and after interferon (IFN) therapy. The purpose was to discover whether the persistence of low levels of viral replication with normal alanine aminotransferases after the response to IFN treatment is due to the appearance of mutations in the sequence of HB core antigen T and B cell epitopes. The existence of mutants was studied by amplification of precore-core region of the HBV genome by polymerase chain reaction (PCR) and direct sequencing of the PCR products. In addition to the wild type sequence, mutation 1896 in the precore region was detected in the baseline serum and liver samples of five children. No changes in the distribution were found in the final samples, except one case. In the core region, both the wild type sequence and amino acid substitutions were observed in the basal serum and/or liver samples of six patients and most of these remained detectable in the samples after treatment. Sixteen (67%) of 24 changes in the core amino acid sequences were found in the T- or B-cell epitopes. The results suggest that viral persistence after response to IFN therapy in children is not due to the appearance of mutants in the HBV core T- and B-cell epitopes and that the host immune response can control the viral replication.

Clinical and histological outcome after hepatitis B e antigen to antibody seroconversion in children with chronic hepatitis B

Data regarding the outcome of children with chronic hepatitis B after seroconversion are scarce. We describe the long-term evolution of these patients. One hundred and three children with antibody against hepatitis B e antigen and normal alanine aminotransferase (ALT) levels were followed for 0.6 to 12.5 years (mean, 6.3 years). Paired liver biopsies (before and after seroconversion) were available in 83 cases. Final biopsies were obtained 0.5 to 12.5 years (mean, 4.5 years) after seroconversion. ALT levels remained normal in most of the children (79%) throughout the follow-up. All children, except five who lost hepatitis B surface antigen, had serum viral DNA detected by polymerase chain reaction. When comparing baseline and final liver biopsies, a significant improvement (P <.001) was found in the histological activity index and in the necrosis, cytolysis, inflammation, and fibrosis scores. The histological diagnosis improvement in the final biopsy was significantly related (P <.001) to the time from seroconversion to the biopsy performance. All children had viral DNA on their final liver biopsy. In summary, seroconversion and ALT normalization are quite stable findings in children, and no differences in the long-term outcome between treated and untreated children were found. In light of the histological outcome, it seems unnecessary to perform a follow-up liver biopsy in these cases.

Perineurioma (storiform perineurial fibroma) of the kidney in a child

Perineurioma is an extremely rare benign tumor of the peripheral nervous system composed exclusively of perineurial cells. Imaging findings of this tumor are non-specific and the diagnosis is based on histologic studies. We report a case of perineurioma of the kidney in a 7-year-old girl discovered incidentally during the evaluation of a urinary tract infection. This is the first case of renal perineurioma reported in a child. We present the ultrasound and computed tomography findings of this histologically confirmed neoplasm.

Detection of hepatitis GB virus type C RNA in serum and liver from children with chronic viral hepatitis B and C

The aim of this work was to study the presence of the hepatitis GB virus type C (HGBV-C) in liver and serum samples of children with chronic viral hepatitis, the time course of changes in viral RNA, and the possible acquisition routes of infection. Frozen serum and liver samples from 58 children with chronic hepatitis B (n = 33) or C (n = 25) were analyzed using polymerase chain reaction. Twenty-seven children had been included in different interferon trials. Two additional serum samples from the HGBV-C-positive children as well as serum samples from 29 of their relatives were also analyzed. HGBV-C RNA was detected in serum and liver samples from 9 of 58 (15%) of children as well as in serum samples from 3 of 29 of the relatives of the HGBV-C-infected children: the mother and the brother of one child (index case A) and the mother of another child (index case B). The homologies of the HGBV-C RNA sequences were 93% between index case A and his mother, 88% between index case A and his brother, and 94% between index case B and his mother. In the 3 children receiving alpha-interferon, HGBV-C RNA became undetectable during treatment although it reappeared in 2 of them after therapy. In conclusion, we found that 15% of children with chronic viral hepatitis were coinfected with HGBV-C. HGBV-C RNA was simultaneously present in serum and liver samples and tended to remain detectable even after alpha-interferon therapy. Our results suggest that vertical transmission of HGBV-C may occur.