The underpinning factors affecting the classroom air quality, thermal comfort and ventilation in 30 classrooms of primary schools in London

The health and academic performance of children are significantly impacted by air quality in classrooms. However, there is a lack of understanding of the relationship between classroom air pollutants and contextual factors such as physical characteristics of the classroom, ventilation and occupancy. We monitored concentrations of particulate matter (PM), CO2 and thermal comfort (relative humidity and temperature) across five schools in London. Results were compared between occupied and unoccupied hours to assess the impact of occupants and their activities, different floor coverings and the locations of the classrooms. In-classroom CO2 concentrations varied between 500 and 1500 ppm during occupancy; average CO2 (955 ± 365 ppm) during occupancy was ∼150% higher than non-occupancy. Average PM10 (23 ± 15 μgm-3), PM2.5 (10 ± 4 μgm-3) and PM1 (6 ± 3 μg m-3) during the occupancy were 230, 125 and 120% higher than non-occupancy. Average RH (29 ± 6%) was below the 40-60% comfort range in all classrooms. Average temperature (24 ± 2 °C) was >23 °C in 60% of classrooms. Reduction in PM10 concentration (50%) by dual ventilation (mechanical + natural) was higher than for PM2.5 (40%) and PM1 (33%) compared with natural ventilation (door + window). PM10 was higher in classrooms with wooden (33 ± 19 μg m-3) and vinyl (25 ± 20 μgm-3) floors compared with carpet (17 ± 12 μgm-3). Air change rate (ACH) and CO2 did not vary appreciably between the different floor levels and types. PM2.5/PM10 was influenced by different occupancy periods; highest value (∼0.87) was during non-occupancy compared with occupancy (∼0.56). Classrooms located on the ground floor had PM2.5/PM10 > 0.5, indicating an outdoor PM2.5 ingress compared with those located on the first and third floors (<0.5). The large-volume (>300 m3) classroom showed ∼33% lower ACH compared with small-volume (100-200 m3). These findings provide guidance for taking appropriate measures to improve classroom air quality.

Heavy metal pollution in the aquatic environment: efficient and low-cost removal approaches to eliminate their toxicity: a review

Heavy metal contamination of water sources has emerged as a major global environmental concern, threatening both aquatic ecosystems and human health. Heavy metal pollution in the aquatic environment is on the rise due to industrialization, climate change, and urbanization. Sources of pollution include mining waste, landfill leachates, municipal and industrial wastewater, urban runoff, and natural phenomena such as volcanic eruptions, weathering, and rock abrasion. Heavy metal ions are toxic, potentially carcinogenic, and can bioaccumulate in biological systems. Heavy metals can cause harm to various organs, including the neurological system, liver, lungs, kidneys, stomach, skin, and reproductive systems, even at low exposure levels. Efforts to find efficient methods to remove heavy metals from wastewater have increased in recent years. Although some approaches can effectively remove heavy metal contaminants, their high preparation and usage costs may limit their practical applications. Many review articles have been published on the toxicity and treatment methods for removing heavy metals from wastewater. This review focuses on the main sources of heavy metal pollution, their biological and chemical transformation, toxicological impacts on the environment, and harmful effects on the ecosystem. It also examines recent advances in cost-effective and efficient techniques for removing heavy metals from wastewater, such as physicochemical adsorption using biochar and natural zeolite ion exchangers, as well as decomposition of heavy metal complexes through advanced oxidation processes (AOPs). Finally, the advantages, practical applications, and future potential of these techniques are discussed, along with any challenges and limitations that must be considered.

An evaluation of the risk of airborne transmission of COVID-19 on an inter-city train carriage

Experiments were conducted in an UK inter-city train carriage with the aim of evaluating the risk of infection to the SARS-CoV-2 virus via airborne transmission. The experiments included in-service CO₂ measurements and the measurement of salt aerosol concentrations released within the carriage. Computational fluid dynamics simulations of the carriage airflow were also used to visualise the airflow patterns, and the efficacy of the HVAC filter material was tested in a laboratory. Assuming an infectious person is present, the risk of infection for a 1-h train journey was estimated to be 6 times lower than for a full day in a well-ventilated office, or 10-12 times lower than a full day in a poorly ventilated office. While the absolute risk for a typical journey is likely low, in the case where a particularly infectious individual is on-board, there is the potential for a number of secondary infections to occur during a 1-h journey. Every effort should therefore be made to minimize the risk of airborne infection within these carriages. Recommendations are also given for the use of CO₂ sensors for the evaluation of the risk of airborne transmission on train carriages.

POS1423 CHARACTERISTICS OF CYTOMEGALOVIRUS-POSITIVE VERSUS NEGATIVE, AND CYTOMEGALOVIRUS-TREATED VERSUS UNTREATED PATIENTS DURING IMMUNOSUPPRESSIVE THERAPY FOR RHEUMATIC DISEASES

Background

Immunosuppressive treatment is a common cause of cytomegalovirus (CMV) reactivation.

Objectives

To elucidate the characteristics of CMV-positive and negative patients during the treatment for rheumatic diseases.

Methods

We retrospectively evaluated consecutive patients admitted to our department from January 2006 to October 2021 whose C7-HRP antigen were measured. We collected their age, sex, primary problem and its lesion, and test results within 3 months before C7-HRP measurement. We also investigated the use of immunosuppressants, and maximum and cumulative dose of administered prednisolone within 6 months before C7-HRP measurement. Maximum and cumulative dose of prednisolone contained methylprednisolone pulse, which was converted into prednisolone equivalent. We investigated the characteristics of CMV-positive and negative patients, and those of CMV-positive patients with or without anti-CMV drug use.

Results

Of a total of 472 patients, 85 were positive and 387 were negative for C7-HRP. The average age was 71.2 vs. 64.4 (p=0.0021). Their male-to-female ratio was 20/65 vs. 120/267 (p=0.0290). The following diseases were significantly common among CMV-positive patients: microscopic polyangiitis (21.2% vs. 3.9%, p<0.0001), adult-onset Still’s disease (7.1% vs. 1.3%, p=0.0002), and systemic sclerosis (4.7% vs. 2.1%, p=0.0273). Significantly common comorbidities of CMV-positive patients were interstitial lung disease (35.3% vs. 16.0%, p<0.0001), nephritis (23.5% vs. 11.6%, p=0.0005), peripheral nervous system disorders (11.8% vs. 5.7%, p=0.0070), alveolar hemorrhage (5.9% vs. 0.8%, p=0.0001), and peripheral circulatory disorders (4.7% vs. 1.6%, p=0.0111). Average neutrophil counts (7720 /μL vs. 6440 /μL, p=0.0001), serum creatinine (1.0 mg/dL vs. 0.9 mg/dL, p=0.0104), and hemoglobin A1c (6.3% vs. 5.7%, p=0.0030) were significantly higher among CMV-positive patients, whereas hemoglobin (10.1 g/dL vs. 11.1 g/dL, p<0.0001), lymphocyte counts (820 /μL vs. 1190 /μL, p<0.0001), platelet counts (233000 /μL vs. 259000 /μL, p<0.0001), and serum albumin (2.9 g/dL vs. 3.4 g/dL, p<0.0001) were lower. Higher maximum dose of prednisolone (534.9 mg/day vs. 135.5 mg/day, p<0.0001), intravenous cyclophosphamide (27.1% vs. 11.4%, p<0.0001), rituximab (9.4% vs. 2.1%, p<0.0001), azathioprine (23.5% vs. 14.2%, p=0.0053), cyclosporin (8.2% vs. 3.6%, p=0.0101) were significantly more often used among CMV-positive patients. Average cumulative dose of prednisolone was 3022.6 mg vs. 1408.7 mg (p<0.0001). We also performed multivariate analysis, including the patients’ age, sex, maximum and cumulative dose of prednisolone, and the use of intravenous cyclophosphamide, rituximab, azathioprine, and cyclosporin. Elderly (p=0.0006), female (p=0.0293), high cumulative dose of prednisolone (p=0.0155), and the use of cyclosporin (p=0.0479) were significantly associated with CMV-positivity. Anti-CMV drug was administered to 63.5% of CMV-positive patients. The average age was significantly higher in anti-CMV-drug-treated patients than untreated patients (73.7 vs. 67.1, p=0.0492). The CMV-treated patients had significantly higher neutrophil counts (8540 /μL vs. 6280 /μL, p<0.0001), erythrocyte sedimentation rate (57.6 mm/h vs. 40.5 mm/h, p<0.0001), and C-reactive protein (5.3 mg/dL vs. 2.6 mg/dL, p<0.0001) than the untreated patients while the other data such as complete blood counts and serum chemistry revealed no significant difference. Average maximum dose of prednisolone was significantly higher in CMV-treated patients (617.1 mg/day vs. 391.1 mg/day, p=0.0261) while average cumulative dose of prednisolone and the use of any other immunosuppressants revealed no significant difference.

Conclusion

Intense immunosuppression, especially with higher dose of glucocorticoids, seemed to be the major risk factor of CMV reactivation. These medications may often require anti-CMV therapy.

Disclosure of Interests

None declared

AB0298 THE RISK OF SULPHA ALLERGY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background

Sulpha drugs have been used such as sulfasalazine for the treatment of rheumatoid arthritis (RA), and trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment or prevention of pneumocystis pneumonia. However, some patients with RA delay treatment because of allergy to sulpha drugs[1]. We reported that 16.7% of RA patients presented drug allergies[2]. It was not clear what is a risk factor for drug allergies in patients with RA.

Objectives

The aim of this study was to evaluate the clinical features with sulpha allergy in patients with RA.

Methods

We prospectively examined consecutive patients diagnosed with RA in our hospital from March 2021 to January 2022. The patients with RA met the EULAR/ACR 2010 criteria. We included patients with RA with other rheumatic diseases. A careful allergic history was obtained from patients with RA and physical examination performed.

The first analysis was performed on patient baseline laboratory data at diagnosis of patients with RA with or without sulpha allergy. Sulpha allergy (rash, angioedema and anaphylaxis after drug exposure) was allergy to sulfasalazine or TMP-SMX. The second analysis was performed on seven types of allergic reactions: (1) drug allergies other than sulpha drugs (rash, angioedema and anaphylaxis after drug exposure), (2) food allergy (rash, angioedema and anaphylaxis after foods exposure), (3) allergic contact dermatitis such as metals, and other cosmetics, (4) seasonal allergic rhinitis and/or conjunctivitis (AR and/or AC), and AR and/or AC associated with house dust, (5) asthma, and (6) atopic dermatitis.

Results

There were 513 patients with RA in our study. In the first analysis, 17 patients with sulpha allergy and 496 patients without sulpha drugs were enrolled (Table 1). The median ages (with supha allergy and without sulpha allergy) were 66.0 and 72.0 years old (p=0.40). Females were 82.3% and 77.0%(p=0.4). The median observation period was 97.0 and 69.0 months (p=0.20). Patients with other rheumatic diseases were 11.6 and 6.8% (p=0.34).

Table 1.

Characteristics of RA patients at diagnosis of RA

With sulpha allergy (n = 17)Without sulpha allergy (n = 496)PFemale83.4%76.9%0.77Age, year, y66.0 (56.0-78.5)72.0 (60.0-80.0)0.40Observation period, m97.0 (45.5-182.0)69.0 (31.0-123.8)0.20Patients with other rheumatic diseases11.8%6.8%0.34ANA-positive patients(>1:80)52.9%28.2%0.052Anti-SSA antibody-positive patients46.2%18.2%0.02RF-positive patients40.0%66.8%0.049

The RA patients with sulpha allergy had higher positivity rate of anti-nuclear antibody (ANA) (>1:80) (52.9%, 28.2%: p=0.052), higher positivity rate of anti–Sjögren’s-syndrome-related antigen A autoantibody (anti-SSA antibody) than those without sulpha allergies (46.2%, 18.2%: p = 0.02) and lower positivity rate of rheumatoid factor(RF) than those without sulpha allergies (40.0%, 66.8%: p = 0.049).

In the second analysis drug allergies other than sulpha allergy were more frequent in patients with sulpha allergy. Drug allergies other than sulpha allergy were such as antibiotics and nonsteroidal anti-inflammatory drugs. There were no significant differences in other allergies.

Conclusion

Among patients with RA, patients with sulpha allergy had higher positivity rate of ANA and anti-SSA antibody, and lower positivity rate of RF than those without sulpha allergy. RA patients with sulpha allergy had a higher prevalence of the other drug allergies than those other than sulpha allergy.

References

[1]Konishi MH et al. Allergic diseases in adult-onset Still’s disease and rheumatoid arthtitis. Arerugi. 2021; 70: 965-975.

[2]Konishi MH et al. Allergic Disorders and Drug Allergies in Primary Sjögren’s Syndrome and Rheumatoid Arthritis. EULAR 2021.

Disclosure of Interests

None declared

In-kitchen aerosol exposure in twelve cities across the globe

Poor ventilation and polluting cooking fuels in low-income homes cause high exposure, yet relevant global studies are limited. We assessed exposure to in-kitchen particulate matter (PM_2.5 and PM₁₀) employing similar instrumentation in 60 low-income homes across 12 cities: Dhaka (Bangladesh); Chennai (India); Nanjing (China); Medellín (Colombia); São Paulo (Brazil); Cairo (Egypt); Sulaymaniyah (Iraq); Addis Ababa (Ethiopia); Akure (Nigeria); Blantyre (Malawi); Dar-es-Salaam (Tanzania) and Nairobi (Kenya). Exposure profiles of kitchen occupants showed that fuel, kitchen volume, cooking type and ventilation were the most prominent factors affecting in-kitchen exposure. Different cuisines resulted in varying cooking durations and disproportional exposures. Occupants in Dhaka, Nanjing, Dar-es-Salaam and Nairobi spent > 40% of their cooking time frying (the highest particle emitting cooking activity) compared with ∼ 68% of time spent boiling/stewing in Cairo, Sulaymaniyah and Akure. The highest average PM_2.5 (PM₁₀) concentrations were in Dhaka 185 ± 48 (220 ± 58) μg m^-3 owing to small kitchen volume, extensive frying and prolonged cooking compared with the lowest in Medellín 10 ± 3 (14 ± 2) μg m^-3. Dual ventilation (mechanical and natural) in Chennai, Cairo and Sulaymaniyah reduced average in-kitchen PM_2.5 and PM₁₀ by 2.3- and 1.8-times compared with natural ventilation (open doors) in Addis Ababa, Dar-es-Salam and Nairobi. Using charcoal during cooking (Addis Ababa, Blantyre and Nairobi) increased PM_2.5 levels by 1.3- and 3.1-times compared with using natural gas (Nanjing, Medellin and Cairo) and LPG (Chennai, Sao Paulo and Sulaymaniyah), respectively. Smaller-volume kitchens (<15 m³; Dhaka and Nanjing) increased cooking exposure compared with their larger-volume counterparts (Medellin, Cairo and Sulaymaniyah). Potential exposure doses were highest for Asian, followed by African, Middle-eastern and South American homes. We recommend increased cooking exhaust extraction, cleaner fuels, awareness on improved cooking practices and minimising passive occupancy in kitchens to mitigate harmful cooking emissions.

Potential health risks due to in-car aerosol exposure across ten global cities

Car microenvironments significantly contribute to the daily pollution exposure of commuters, yet health and socioeconomic studies focused on in-car exposure are rare. This study aims to assess the relationship between air pollution levels and socioeconomic indicators (fuel prices, city-specific GDP, road density, the value of statistical life (VSL), health burden and economic losses resulting from exposure to fine particulate matter ≤2.5 µm; PM_2.5) during car journeys in ten cities: Dhaka (Bangladesh); Chennai (India); Guangzhou (China); Medellín (Colombia); São Paulo (Brazil); Cairo (Egypt); Sulaymaniyah (Iraq); Addis Ababa (Ethiopia); Blantyre (Malawi); and Dar-es-Salaam (Tanzania). Data collected by portable laser particle counters were used to develop a proxy of car-user exposure profiles. Hotspots on all city routes displayed higher PM_2.5 concentrations and disproportionately high inhaled doses. For instance, the time spent at the hotspots in Guangzhou and Addis Ababa was 26% and 28% of total trip time, but corresponded to 54% and 56%, respectively, of the total PM_2.5 inhaled dose. With the exception of Guangzhou, all the cities showed a decrease in per cent length of hotspots with an increase in GDP and VSL. Exposure levels were independent of fuel prices in most cities. The largest health burden related to in-car PM_2.5 exposure was estimated for Dar-es-Salam (81.6 ± 39.3 μg m^-3), Blantyre (82.9 ± 44.0) and Dhaka (62.3 ± 32.0) with deaths per 100,000 of the car commuting population per year of 2.46 (2.28-2.63), 1.11 (0.97-1.26) and 1.10 (1.05-1.15), respectively. However, the modest health burden of 0.07 (0.06-0.08), 0.10 (0.09-0.12) and 0.02 (0.02-0.03) deaths per 100,000 of the car commuting population per year were estimated for Medellin (23 ± 13.7 μg m^-3), São Paulo (25.6 ± 11.7) and Sulaymaniyah (22.4 ± 15.0), respectively. Lower GDP was found to be associated with higher economic losses due to health burdens caused by air pollution in most cities, indicating a socioeconomic discrepancy. This assessment of health and socioeconomic parameters associated with in-car PM_2.5 exposure highlights the importance of implementing plausible solutions to make a positive impact on peoples' lives in these cities.

Chemical source profiles of fine particles for five different sources in Delhi

Increasing emissions from sources such as construction and burning of biomass from crop residues, roadside and municipal solid waste have led to a rapid increase in the atmospheric concentrations of fine particulate matter (≤2.5 μm; PM_2.5) over many Indian cities. Analyses of their chemical profiles are important for receptor models to accurately estimate the contributions from different sources. We have developed chemical source profiles for five important pollutant sources - construction (CON), paved road dust (PRD), roadside biomass burning (RBB), solid waste burning (SWB), and crop residue burning (CPB) - during three intensive campaigns (winter, summer and post-monsoon) in and around Delhi. We obtained chemical characterisations of source profiles incorporating carbonaceous material such as organic carbon (OC) and elemental carbon (EC), water-soluble ions (F^-, Cl^-, NO₂^-, NO₃^-, SO₄^2-, PO₄^3-, Na⁺ and NH₄⁺), and elements (Mg, Al, Si, P, S, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Br, Rb, Sr, Ba, and Pb). CON was dominated by the most abundant elements, K, Si, Fe, Al, and Ca. PRD was also dominated by crustal elements, accounting for 91% of the total analysed elements. RBB, SWB and CPB profiles were dominated by organic matter, which accounted for 94%, 86.2% and 86% of the total PM_2.5, respectively. The database of PM emission profiles developed from the sources investigated can be used to assist source apportionment studies for accurate quantification of the causes of air pollution and hence assist governmental bodies in formulating relevant countermeasures.

AB0442 CLINICAL FEATURES OF POLYMYOSITIS AND DERMATOMYOSITIS PATIENTS WITH SEVERE DYSPHAGIA

Background:

Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases characterized by proximal myositis. Dysphagia has been reported to develop in 35 to 62% of PM/DM patients and known as poor prognosis factor.

Objectives:

The purpose of this study is to determine the clinical characteristics of PM/DM patients who present with deglutition disorder.

Methods:

Consecutive patients with PM/DM who visited National Hospital Organization Tokyo Medical Center between April 2010 and January 2021 are included in this study. We compared clinical features between the patients with and without dysphagia. The diagnosis of dysphagia was based on videofluorography swallow study, and dysphagia requiring gastrostomy was defined as severe dysphagia. The clinical characteristics compared in this study were following: age of onset, levels of serum creatine kinase (CK) and lactate dehydrogenase(LDH), sense of dysphagia, manual muscle test (MMT) score, and complication of malignancy or interstitial pneumonia.

Results:

A total of 73 patients with PM/DM were identified. Among them, 12 patients were diagnosed with dysphagia, and 5 patients developed severe dysphagia. Patients with dysphagia had the following characteristics compared to patients without dysphagia: higher levels of serum LDH (833.7 ± 500.1 U/L vs 471.9 ± 321.0 U/L, p = 0.0088), higher levels of serum CK at initial examination (6070.3 ± 7184.8 IU/L vs 1534.7 ± 2978.8 IU/L, p = 0.0086) and more frequent sense of dysphagia (90.9% vs 10.6%, p< 0.0001), lower MMT score(3.18 ± 1.07 vs 4.31 ± 0.75, p = 0.0017). In addition to those, patients with severe dysphagia presented older age of onset (mean age 69.4 ± 12.0 vs 51.7 ± 14.8, p = 0.014), more frequent complication of malignancy (80.0% vs 14.8%, p= 0.0048) and less frequent complication of interstitial pneumonia (0.0% vs 55.5%, p= 0.023).

Conclusion:

These results indicate that dysphagia develops frequently in PM/DM patients with higher levels of serum LDH or CK, sense of dysphagia and low MMT score. Among them, patients with elderly onset or malignancy are at risk for sever dysphagia, and should be treated carefully.

Disclosure of Interests:

None declared.

AB0324 ALLERGIC DISORDERS AND DRUG ALLERGIES IN PRIMARY SJÖGREN’S SYNDROME AND RHEUMATOID ARTHRITIS

Background:

Allergic disorders have been reported in a variety of rheumatic diseases. A high prevalence of allergic disorders was found in patients with Sjoegren’s syndrome [1]. Nevertheless, it was not clear what is a risk factor for allergic disorders and drug allergies in patients with primary Sjögren’s syndrome (pSS). Drug allergies may lead to delayed treatment and unnecessary clinical tests.

Objectives:

The primary aim of this study was to compare the prevalence of allergic disorders and drug allergies in patients with pSS and rheumatoid arthritis (RA). The secondary aim was to compare the clinical features with and without drug allergies in patients with pSS.

Methods:

We retrospectively examined consecutive patients diagnosed with pSS or RA in our hospital from 2010 to 2020. The patients with SS met the criteria of the 1999 revised Japanese Ministry of Health criteria[2]. We included patients with pSS without RA or other rheumatic diseases. The patients with RA met the EULAR/ACR 2010 criteria. We included patients with RA without other rheumatic diseases.

The first analysis was performed on six types of allergic reactions: (1) food allergy (exanthema, angioedema and anaphylaxis after foods exposure), (2) drug allergy (exanthema, angioedema and anaphylaxis after drug exposure), (3) allergic contact dermatitis such as metals, alcohol swab, and other cosmetics, (4) seasonal allergic rhinitis and/or allergic conjunctivitis, and allergic rhinitis and/or allergic conjunctivitis associated with house dust, (5) asthma, and (6) atopic dermatitis.

The secondary analysis was performed on patient baseline laboratory data at diagnosis of pSS and RA patients with or without drug allergies.

Results:

In the first analysis, 292 patients with pSS and 413 patients with RA were enrolled (Table 1). The mean ages (pSS, RA) were 57.3±15.8, 66.0±14.6 years old. Females were 94.2%, 78.2%. The mean observation period was 82.7±70.8, 65.6±37.0 months. 54.8% of pSS patients and 34.9% of RA patients presented at least one type of allergic disorders or drug allergies. These included food allergy, drug allergy, allergic rhinitis/conjunctivitis, asthma, and atopic dermatitis. Allergic disorders and drug allergies were more frequent in patients with pSS.

In the second analysis, 77 patients with drug allergies and 215 patients without drug allergies were enrolled. The mean ages with drug allergies and without drug allergies were 56.0±15.8 and 57.8±15.8 years old, respectively; females were 96.1% and 93.5%; the mean observation period was 90.9±72.4 and 79.8±70.2 months. The pSS patients with drug allergies had higher levels of Immunoglobulin G (IgG) (2028±1409 mg/dL, 1726±587 mg/dL: p = 0.01), higher levels of eosinophils (220±247/μL, 126±112/μL: p<0.019), and higher positivity rate of anti–Sjögren’s-syndrome-related antigen A autoantibody (anti-SSA antibody) than those without drug allergies (89.6%, 79.7%: p = 0.06).

Conclusion:

Patients with pSS had a higher prevalence of allergic disorders and drug allergies than patients with RA. Among patients with pSS, patients with drug allergies had higher levels of IgG, higher levels of eosinophils, and higher positivity rate of anti-SSA antibody than those without drug allergies.

Table 1.

Allergic Disorders and Drug Allergies in pSS and RA

pSS (n = 292)RA (n = 413)Pat least one type of allergy, n (%)160 (54.8)144 (34.9)<0.01food allergy, n (%)35 (12.0)27 (6.7)0.02drug allergy, n (%)76 (26.1)69 (16.7)<0.01allergic contact dermatitis, n (%)10 (3.4)19 (4.6)0.6allergic rhinitis and/or conjunctivitis, n (%)99 (33.9)35 (8.5)<0.01asthma, n (%)29 (9.9)25 (6.1)0.06atopic dermatitis, n (%)15 (5.1)0 (0)<0.01

References:

[1]Hama et al. Clinical features of patients with Sjoegren syndrome associated with adult onset Still’s disease. Japan College of Rheumatology Annual Congress 2020.

[2]Fujibayashi et al. Revised Japanese criteria for Sjögren’s syndrome (1999): availability and validity. Mod Rheumatol. 2004; 14: 425-34.

Disclosure of Interests:

None declared

In-car particulate matter exposure across ten global cities

Cars are a commuting lifeline worldwide, despite contributing significantly to air pollution. This is the first global assessment on air pollution exposure in cars across ten cities: Dhaka (Bangladesh); Chennai (India); Guangzhou (China); Medellín (Colombia); São Paulo (Brazil); Cairo (Egypt); Sulaymaniyah (Iraq); Addis Ababa (Ethiopia); Blantyre (Malawi); and Dar-es-Salaam (Tanzania). Portable laser particle counters were used to develop a proxy of car-user exposure profiles and analyse the factors affecting particulate matter ≤2.5 μm (PM_2.5; fine fraction) and ≤10 μm (PM_2.5-10; coarse fraction). Measurements were carried out during morning, off- and evening-peak hours under windows-open and windows-closed (fan-on and recirculation) conditions on predefined routes. For all cities, PM_2.5 and PM₁₀ concentrations were highest during windows-open, followed by fan-on and recirculation. Compared with recirculation, PM_2.5 and PM₁₀ were higher by up to 589% (Blantyre) and 1020% (São Paulo), during windows-open and higher by up to 385% (São Paulo) and 390% (São Paulo) during fan-on, respectively. Coarse particles dominated the PM fraction during windows-open while fine particles dominated during fan-on and recirculation, indicating filter effectiveness in removing coarse particles and a need for filters that limit the ingress of fine particles. Spatial variation analysis during windows-open showed that pollution hotspots make up to a third of the total route-length. PM_2.5 exposure for windows-open during off-peak hours was 91% and 40% less than morning and evening peak hours, respectively. Across cities, determinants of relatively high personal exposure doses included lower car speeds, temporally longer journeys, and higher in-car concentrations. It was also concluded that car-users in the least affluent cities experienced disproportionately higher in-car PM_2.5 exposures. Cities were classified into three groups according to low, intermediate and high levels of PM exposure to car commuters, allowing to draw similarities and highlight best practices.

Temporary reduction in fine particulate matter due to 'anthropogenic emissions switch-off' during COVID-19 lockdown in Indian cities

The COVID-19 pandemic elicited a global response to limit associated mortality, with social distancing and lockdowns being imposed. In India, human activities were restricted from late March 2020. This 'anthropogenic emissions switch-off' presented an opportunity to investigate impacts of COVID-19 mitigation measures on ambient air quality in five Indian cities (Chennai, Delhi, Hyderabad, Kolkata, and Mumbai), using in-situ measurements from 2015 to 2020. For each year, we isolated, analysed and compared fine particulate matter (PM2.5) concentration data from 25 March to 11 May, to elucidate the effects of the lockdown. Like other global cities, we observed substantial reductions in PM2.5 concentrations, from 19 to 43% (Chennai), 41-53% (Delhi), 26-54% (Hyderabad), 24-36% (Kolkata), and 10-39% (Mumbai). Generally, cities with larger traffic volumes showed greater reductions. Aerosol loading decreased by 29% (Chennai), 11% (Delhi), 4% (Kolkata), and 1% (Mumbai) against 2019 data. Health and related economic impact assessments indicated 630 prevented premature deaths during lockdown across all five cities, valued at 0.69 billion USD. Improvements in air quality may be considered a temporary lockdown benefit as revitalising the economy could reverse this trend. Regulatory bodies must closely monitor air quality levels, which currently offer a baseline for future mitigation plans.

FRI0205 CLINICAL FEATURES OF MONONEURITIS MULTIPLEX ASSOCIATED WITH ANCA-ASSOCIATED VASCULITIS

Background:

ANCA-associated vasculitis sometimes presents mononeuritis multiplex which worsens the prognosis and activity of daily living in patients.

Objectives:

This study aimed to determine the clinical feature of mononeuritis multiplex associated with AAV.

Methods:

Consecutive patients with AAV who visited Tokyo Medical Center between April 2006 and December 2019 were included in this study. We examined the following clinical features: prevalence of neuropathy, age of onset, sex, the worst blood test values before the initial therapy (white blood cell count (WBC), eosinophil count (Eo), MPO-ANCA, PR3-ANCA, and C-reactive protein(CRP) levels), manual muscle testing (MMT)score of 20 muscles (Max 100 points), and time (days) from the initial symptoms to the initial induction therapies.

Results:

A total of 89 patients with AAV were identified. Among them, 19 patients had eosinophilic granulomatosis with polyangiitis (EGPA) (8 males and 11 females, mean age 63.3 ± 2.7), 9 patients had granulomatosis with polyangiitis (GPA) (0 males, 9 females, mean age 75.6 ± 3.9), and 61 patients had microscopic polyangiitis (MPA) (17 males, 44 females, mean age 78.2 ± 1.5). Of the 89 AAV patients, 26 had sensory neuropathy (15/19 EGPA (78.9%), 11/61 MPA (18.0%), and 0/9 GPA (0%)). Motor neuropathy was observed in 19 patients (EGPA 14/19 (73.7%), MPA 5/61 (8.2%), GPA 0/9 (0%)). 15 patients had both sensory and motor neuropathies (EGPA 12/19 (63.2%), MPA 3/61 (4.9%), GPA 0 (0%)). In patients with both sensory and motor neuropathy, sensory impairment preceded in all cases. Among patients with neuropathy, the time from initial symptoms to initial induction therapy in patients with and without motor neuropathy was 34 ± 10.1 days and 30 ± 10.8 days (p = 0.776), respectively. Also, when comparing those who were treated within 7 days from the onset of movement disorders with those who were treated later, MMT score two weeks after the start of treatment were 92.15 ± 1.47 vs. 91.25 ± 2.65 (p = 0.77).

Between the patients with EGPA with and without sensory neuropathy, there were no significant differences in the following: highest WBC(19620.0 ± 2082.6 vs. 19350.0 ± 4033.5 cells/uL (p = 0.953)), highest Eo(10790.6 ± 1774.8 vs 12440.8 ± 3436.9 cells/uL (p = 0.6750)), and highest CRP levels (4.467 ± 0.96 vs 2.70 ± 1.85 mg/dL (p = 0.41)) before the initial therapy. On the other hand, comparing the EGPA patients with and without motor neuron disorder, CRP levels were significantly higher in those with motor impairment than those without(WBC 20978.6 ± 2049.8 vs. 15600.0 ± 3429.9 cells/uL (p = 0.20); Eo 12213.4 ± 1775.5 vs. 8127.0 ± 2971.0 cells/uL (p = 0.25); CRP 5.13 ± 0.89 vs. 1.20 ± 1.48 mg/dL (p = 0.04)). And in patients with motor neuropathy, the decrease in MMT score was significantly correlated with the worst levels of CRP(p = 0.001)while the decrease was not correlated with the other blood tests. ANCA levels were not associated with sensory or motor neuropathy. In similar analyses of patients with MPA and GPA, there were no significant findings.

Conclusion:

Worst CRP levels before the initial therapy can be a poor prognosis factor for motor neuropathy in patients with EGPA. Therefore, EGPA patients with high CRP levels need to be paid more attention to because of possible development of motor neuropathy.

Disclosure of Interests:

satoshi hama: None declared, Yutaro Hayashi: None declared, Keisuke Izumi Grant/research support from: Asahi Kasei Pharma, Takeda Pharmaceutical Co., Ltd., Speakers bureau: Asahi Kasei Pharma Corp, Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Misako Higashida-Konishi: None declared, mari ushikubo: None declared, kumiko akiya: None declared, yutaka okano: None declared, Hisaji Oshima: None declared

FRI0488 CLINICAL AND LABORATORY FEATURES OF PATIENTS WITH REMITTING SERONEGATIVE SYMMETRICAL SYNOVITIS WITH PITTING EDEMA COMPARED TO PATIENTS WITH SERONEGATIVE RHEUMATOID ARTHRITIS

Background:

In the case of seronegative arthritis, it was difficult to make a differential diagnosis between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (seronegative RA) because the distribution of affected joints was similar and the patients with RS3PE or seronegative RA may have edema.

Objectives:

To compare the clinical characteristics of RS3PE and seronegative RA

Methods:

We retrospectively examine consecutive patients diagnosed with RS3PE or seronegative RA in our hospital from 2007 to 2019. Patients in whom both ACPA and RF were negative were included. The patients with RS3PE met the criteria of McCarty et al.: (1) pitting edema of the dorsum of both hands and both feet, (2) sudden onset of polyarthritis, (3) seronegative for ACPA and RF. (4)no radiologically evident erosions developed. The patients with seronegative RA met the EULAR/ACR 2010 criteria. The patients who were diagnosed with RS3PE at first and then diagnosed with seronegative RA afterward were included in seronegative RA group. The first analysis was performed on the affected joints, CRP, ESR, Hb, LDH, edema, the history of malignancy 2 years before and after the diagnosis, treatment, and the history of infection requiring hospitalization after the start of treatment. The affected joints were shoulders, elbows, wrists, finger joints (the MCP, and PIP joints), hips, knees, ankles, and toe joints (the MTP and PIP joints). The secondary analysis was performed on the above evaluations with a propensity score (PS) matching for age.

Results:

In the first analysis, 20 patients with RS3PE and 122 patients with seronegative RA were enrolled. The mean ages (RS3PE, seronegative RA) were 81.1, 67.4 years old. Females were 60.0%, 63.1%. The mean observation period was 25.4, 63.6 months. The proportion of affected joints were shoulders (25.0%, 42.6%), elbows (10.0%, 29.5%: p=0.06), wrists (85.0%, 73.8%), finger joints (80.0%, 95.1%: p=0.01), hips (0%, 9.8%), knees (40.0%, 37.7%), ankles (65.0%, 39.3%: p=0.03) and toe joints (40.0%, 32.8%). Edema at diganosis was observed in 100%, 17.21% (p <0.0001). The mean levels of the following blood tests at diagnosis were noted: CRP, 9.0 and 4.8 mg/dL (p=0.02); ESR, 87.6 and 60.7 mm/1h (p=0.003); Hb, 10.4 and 11.8 mg/dl (p=0.001); LDH, 198.3 and 177.9 U/L (p = 0.12); MMP-3, 742.5 and 633.8 ng/mL (p = 0.14). The proportion of patients with high LDH levels (>222 U/L) was 13.6% and 9.0% (p=0.0269). The proportion of patients having the history of malignancy was 20.0%, 8.2% (p=0.10). The patient treated with prednisolone as the initial treatment was 100% and 41.0%; the mean dose was 14.3 and 9.9 mg/d. After the start of treatment, the proportion of infection requiring hospitalization was 20.0 and 3.28% (p=0.002).

In the secondary analysis with PS, 17 patients with RS3PE and 17 patients with seronegative RA were enrolled. The mean ages were 80.4, 78.9 years old. Females were 52.9, 76.4%. The affected joints with difference were elbows (11.8, 35.3%: p=0.10), wrists (82.4, 100%: p=0.06), and finger joints (82.4, 100%: p=0.06). The mean levels of Hb at diagnosis was 10.4, 11.4 mg/dL (p=0.01). The proportion of patients having the history of malignancy was 23.5% and 0% (p=0.03). After the start of treatment, the proportion of infection requiring hospitalization was 23.5% and 0% (p=0.03).

Conclusion:

When the ankles are affected and edema is observed, RS3PE is more likely than seronegative RA. RS3PE had higher levels of CRP, ESR, and LDH. The proportion of anemia was higher in RS3PE. The proportions of infection requiring hospitalization and the history of malignancy were higher in RS3PE.

References:

[1]McCarty DJ, O’Duffy JD et al. Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE Syndrome). JAMA 1985; 254: 2763–2767. DOI:10.1001/jama.1985.03360190069027

Disclosure of Interests:

Misako Higashida-Konishi: None declared, Keisuke Izumi Grant/research support from: Asahi Kasei Pharma, Takeda Pharmaceutical Co., Ltd., Speakers bureau: Asahi Kasei Pharma Corp, Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Satoshi Hama: None declared, Yutaro Hayashi: None declared, Yutaka Okano: None declared, Hisaji Oshima: None declared

The nexus between air pollution, green infrastructure and human health

Cities are constantly evolving and so are the living conditions within and between them. Rapid urbanization and the ever-growing need for housing have turned large areas of many cities into concrete landscapes that lack greenery. Green infrastructure can support human health, provide socio-economic and environmental benefits, and bring color to an otherwise grey urban landscape. Sometimes, benefits come with downsides in relation to its impact on air quality and human health, requiring suitable data and guidelines to implement effective greening strategies. Air pollution and human health, as well as green infrastructure and human health, are often studied together. Linking green infrastructure with air quality and human health together is a unique aspect of this article. A holistic understanding of these links is key to enabling policymakers and urban planners to make informed decisions. By critically evaluating the link between green infrastructure and human health via air pollution mitigation, we also discuss if our existing understanding of such interventions is sufficient to inform their uptake in practice. Natural science and epidemiology approach the topic of green infrastructure and human health very differently. The pathways linking health benefits to pollution reduction by urban vegetation remain unclear and the mode of green infrastructure deployment is critical to avoid unintended consequences. Strategic deployment of green infrastructure may reduce downwind pollution exposure. However, the development of bespoke design guidelines is vital to promote and optimize greening benefits, and measuring green infrastructure's socio-economic and health benefits are key for their uptake. Greening cities to mitigate pollution effects is on the rise and these need to be matched by scientific evidence and appropriate guidelines. We conclude that urban vegetation can facilitate broad health benefits, but there is little empirical evidence linking these benefits to air pollution reduction by urban vegetation, and appreciable efforts are needed to establish the underlying policies, design and engineering guidelines governing its deployment.

Noninvasive delivery of siRNA into the epidermis by iontophoresis using an atopic dermatitis-like model rat

Topical application of siRNA to the skin should be an effective treatment for serious skin disorders, such as atopic dermatitis. However, it is difficult to introduce hydrophilic macromolecules, including siRNA, into the skin by conventional methods. For efficient delivery of siRNA, we examined an iontophoretic technique, since it is suitable for the delivery of charged molecules. Naked siRNA effectively accumulated in the epidermis (and not in the dermis) after iontophoretic delivery. In contrast, siRNA did not penetrate tape-stripped skin by passive diffusion. In a rat model of atopic dermatitis, skin was sensitized with ovalbumin to stimulate IL-10 mRNA expression as observed in skin lesions. Iontophoretic delivery of anti-IL-10 siRNA significantly reduced (73%) the level of IL-10 mRNA. In conclusion, we successfully delivered naked siRNA into the epidermis and concomitantly suppressed the expression of an endogenous immuno-regulatory cytokine.

Nitric oxide attenuates vascular endothelial cadherin-mediated vascular integrity in human chronic inflammation

In this study, we examined the role of nitric oxide (NO) in controlling vascular integrity mediated by vascular endothelial (VE)-cadherin in chronic inflammation. Periapical granulomas were analysed for the expression of inducible NO synthase (iNOS) and VE-cadherin, and more iNOS expression than VE-cadherin was shown. Human umbilical vein endothelial cells (HUVECs) were stimulated with proinflammatory cytokines and lipopolysaccharide extracted from Porphyromonas gingivalis and it induced iNOS expression, whereas it reduced VE-cadherin expression, compared with negative controls. On the other hand, pre-incubation with 1400W, an iNOS-specific inhibitor, markedly reduced iNOS expression in stimulated HUVECs and restored VE-cadherin expression to its control level, suggesting that vascular integrity was modulated in conjunction with the reduction of NO. Immunocytochemistry confirmed the functional role of NO in cultured HUVEC monolayers with or without 1400W. These data are consistent with a hypothesis suggesting that NO could attenuate VE-cadherin-mediated vascular integrity in human chronic inflammation.

Centrosome amplification induced by survivin suppression enhances both chromosome instability and radiosensitivity in glioma cells

Glioblastoma is characterised by invasive growth and a high degree of radioresistance. Survivin, a regulator of chromosome segregation, is highly expressed and known to induce radioresistance in human gliomas. In this study, we examined the effect of survivin suppression on radiosensitivity in malignant glioma cells, while focusing on centrosome aberration and chromosome instability (CIN). We suppressed survivin by small interfering RNA transfection, and examined the radiosensitivity using a clonogenic assay and a trypan blue exclusion assay in U251MG (p53 mutant) and D54MG (p53 wild type) cells. To assess the CIN status, we determined the number of centrosomes using an immunofluorescence analysis, and the centromeric copy number by fluorescence in situ hybridisation. As a result, the radiosensitisation differed regarding the p53 status as U251MG cells quickly developed extreme centrosome amplification (=CIN) and enhanced the radiosensitivity, while centrosome amplification and radiosensitivity increased more gradually in D54MG cells. TUNEL assay showed that survivin inhibition did not lead to apoptosis after irradiation. This cell death was accompanied by an increased degree of aneuploidy, suggesting mitotic cell death. Therefore, survivin inhibition may be an attractive therapeutic target to overcome the radioresistance while, in addition, proper attention to CIN (centrosome number) is considered important for improving radiosensitivity in human glioma.

Octaarginine-modified multifunctional envelope-type nanoparticles for gene delivery

This study describes a multifunctional envelope-type nano device (MEND) that mimics an envelope-type virus based on a novel packaging strategy. MEND particles contain a DNA core packaged into a lipid envelope modified with an octaarginine peptide. The peptide mediates internalization via macropinocytosis, which avoids lysosomal degradation. MEND-mediated transfection of a luciferase expression plasmid achieved comparable efficiency to adenovirus-mediated transfection, with lower associated cytotoxicity. Furthermore, topical application of MEND particles containing constitutively active bone morphogenetic protein (BMP) type IA receptor (caBmpr1a) gene had a significant impact on hair growth in vivo. These data demonstrate that MEND is a promising non-viral gene delivery system that may provide superior results to existing non-viral gene delivery technologies.

Co-production of vascular endothelial cadherin and inducible nitric oxide synthase by endothelial cells in periapical granuloma

AIM

To clarify the mechanisms of inflammatory cell migration in human periapical granulomas by examining vascular endothelial (VE) cadherin and inducible nitric oxide synthase (iNOS)-producing cells.

METHODOLOGY

Periapical tissues were obtained from patients during endodontic surgery and were divided into two portions. After fixing the tissues with acetone or 4% paraformaldehyde in phosphate-buffered saline, 5-microm-thick paraffin or cryostat sections were prepared, respectively. The paraffin sections of the inflamed tissues were evaluated histologically with haematoxylin-eosin stains. Cryostat sections of the tissue, diagnosed as periapical granulomas, were then examined by either immunohistochemistry using anti-human VE-cadherin or iNOS antibodies (Abs) for the characterization of infiltrating cells. In addition, co-localization of VE-cadherin and iNOS production was also analysed by two-colour immunofluorescence image analysis.

RESULTS

Endothelial cells were strongly stained with iNOS Abs. Macrophages, lymphocytes, polymorphonuclear leucocytes and fibroblasts also exhibited iNOS production. These iNOS-positive cells accumulated around the blood vessels. On the other hand, VE-cadherin production was exhibited in only endothelial cells. Two-colour immunofluorescence image analysis using VE-cadherin and iNOS Abs demonstrated that iNOS-producing endothelial cells also showed VE-cadherin production.

CONCLUSIONS

Vascular endothelial-cadherin produced by endothelial cells could be regulated by iNOS-producing cells in periapical granulomas and might play a pivotal role in vascular permeability.

Enhancement of nitric oxide and superoxide generations by alpha-tocopheryl succinate and its apoptotic and anticancer effects

Tocopheryl succinate (TS), a succinyl ester of alpha-tocopherol (alpha-T), has been reported to have various biological activities. In this communication, we review the current findings about TS including our recent studies of its effects on nitric oxide (NO) and superoxide (O2-) generations implicated in cancer and atherosclerosis. First, we investigated the effect of TS on NO production in vascular smooth muscle cells (VSMC) under atherosclerosis-like conditions using lipopolysaccharide (LPS) and interferon-gamma (IFN). TS enhanced LPS/IFN-dependent NO production, but alpha-T itself did not. The enhancement by TS of NO production was inhibited by alpha-T but not by antioxidants such as ascorbic acid and 2[3]-t-butyl-4-hydroxyanisole (BHA). TS enhanced the amount of protein kinase Calpha (PKCalpha) in VSMC, and PKC inhibitors inhibited TS-enhanced NO production, suggesting that the enhancing effect of TS on NO production is caused by up-regulation of PKC. Second, we found that TS induced apoptosis in VSMC associated with increase in O2- generation via NADPH-dependent oxidase. We further observed that a mouse breast cancer cell line C127I was more susceptible for TS-induced apoptosis than a mouse breast normal cell line NmuMG, and that superoxide dismutase, alpha-T, and BHA inhibited TS-caused morphological cell damage in C127I. From these results, O2- itself and/or other reactive oxygen species are assumed to associate with TS-induced cell toxicity, and antioxidative defense systems are supposed to be lowered in cancer cells. Finally, we found that intravenous injection of TS vesicles completely inhibited the growth of melanoma cells B16-F1 inoculated on the back of hairless mice and enhanced their survival time.

Method for large scale isolation, culture and cryopreservation of human monocytes suitable for chemotaxis, cellular adhesion assays, macrophage and dendritic cell differentiation

This paper presents an improved method of isolating, culturing and cryopreserving human monocytes in large quantity with high purity using standard laboratory centrifuges. Monocytes were isolated from 300 to 360 ml of heparinized human blood using a Double Density technique employing Ficoll Isopaque and 46% iso-osmotic Percoll. Yields of monocytes ranged from 75 to 205 million (from 300 to 360 ml of blood) with an average purity of 90.6%. The ability of fresh or frozen monocytes to adhere to endothelial cells in the presence of oxidized L-alpha-1-palmitoyl-2-arachidonosyl-sn-glycero-3-phosphocholine (oxPAPC) or lipopolysaccharide (LPS) did not differ and no significant difference in response to the chemotactic stimulant N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP) was observed. We define a useful method for the culture and differentiation of fresh or frozen monocytes isolated by this method, into macrophages as judged by morphology, expression of the macrophage marker SRA-1 and induction of inflammatory genes TNF-alpha, IL-6 and COX-2. Also, fresh or frozen Double Density isolated cells can be successfully differentiated into dendritic cells in the presence of GM-CSF and IL-4 as judged by the expression of the hallmark surface proteins CD1a and DC-sign and the absence of CD14. This method also yields a pure population of lymphocytes.

Enantioselective transesterification using immobilized Aspergillus oryzae overexpressing lipase

In the present study, we used gene manipulation to construct a recombinant Aspergillus oryzae strain overexpressing lipase and investigated its application to the optical resolution of chiral compounds. A. oryzae niaD300, which was derived from the wild-type strain RIB40, was used as the host strain. The tglA gene, which encodes a triacylglycerol lipase, was cloned from the A. oryzae niaD300 chromosomal genome, then reintroduced, with and without a secretion-signal sequence, into the genome and expressed under the control of the improved glaA promoter of plasmid pNGA142. The resulting recombinant strain overexpressing A. oryzae lipase was immobilized within biomass-support particles and used as a whole-cell biocatalyst. The immobilized lipase-overexpressing strain with secretion-signal sequence showed high activity and was used to selectively synthesize (R)-1-phenylethyl acetate from (RS)-1-phenylethanol and vinyl acetate. After 48 h reaction at 30 degrees C with molecular sieve 4A, the yield and enantiomeric excess (%ee) of (R)-1-phenylethyl acetate reached approximately 90 and 95%ee, respectively. The whole-cell biocatalyst for optical resolution of chiral compounds produced in this study maintained its activity over 25 batch-reaction cycles.

p16 Gene transfer increases cell killing with abnormal nucleation after ionising radiation in glioma cells

It is well established that cells synchronised at the G1–S phase are highly radiosensitive. In this study, p16-null human glioma cell lines were induced into G1 cell cycle arrest by adenovirus-mediated p16 gene transfer, and examined for radiation-induced cell killing. Clonogenic analysis and trypan blue extraction test showed that the p16 gene transfer enhanced radiation-induced cell killing in p16-null glioma cell lines. TUNEL assays and pulse-field gel electrophoresis confirmed that the radiation-induced cell killing of p16-transfected cells could be caused by a nonapoptotic mechanism. Gimsa staining demonstrated that irradiation alone or Ax-mock infection plus irradiation results in a slight increase in the frequency of cells with abnormal nucleus, compared to unirradiated uninfected or Ax-mock infected cells. However, Ax-hp16 or Ax-hp21 infection alone modestly increased the frequency of cells with abnormal nucleus (especially bi- and multinucleation), and 4-Gy irradiation of Ax-hp16 or Ax-hp21 infected cells substantially enhanced this frequency. These results suggest that there exists some unknown interaction between radiation and p16 in cytoplasm/membranes, which decreases cytokinesis and promotes abnormal nucleation. Thus, p16 expression prevented radiation-induced apoptosis by promoting abnormal nucleation, thereby leading to another mode of cell death.

Paraoxonase-2 is a ubiquitously expressed protein with antioxidant properties and is capable of preventing cell-mediated oxidative modification of low density lipoprotein

The oxidation of apolipoprotein B-containing lipoproteins and cell membrane lipids is believed to play an integral role in the development of fatty streak lesions, an initial step in atherogenesis. We have previously shown that two antioxidant-like enzymes, paraoxonase (PON)-1 and PON3, are high density lipoprotein-associated proteins capable of preventing the oxidative modification of low density lipoprotein (LDL) (Reddy, S. T., Wadleigh, D. J., Grijalva, V., Ng, C., Hama, S., Gangopadhyay, A., Shih, D. M., Lusis, A. J., Navab, M., and Fogelman, A. M. (2001) Arterioscler. Thromb. Vasc. Biol. 21, 542-547). In the present study, we demonstrate that PON2 (i) is not associated with high density lipoprotein; (ii) has antioxidant properties; and (iii) prevents LDL lipid peroxidation, reverses the oxidation of mildly oxidized LDL (MM-LDL), and inhibits the ability of MM-LDL to induce monocyte chemotaxis. The PON2 protein was overexpressed in HeLa cells using the tetracycline-inducible ("Tet-On") system, and its antioxidant capacity was measured in a fluorometric assay. Cells that overexpressed PON2 showed significantly less intracellular oxidative stress following treatment with hydrogen peroxide or oxidized phospholipid. Moreover, cells that overexpressed PON2 were also less effective in oxidizing and modifying LDL and, in fact, were able to reverse the effects of preformed MM-LDL. Our results suggest that PON2 possesses antioxidant properties similar to those of PON1 and PON3. However, in contrast to PON1 and PON3, PON2 may exert its antioxidant functions at the cellular level, joining the host of intracellular antioxidant enzymes that protect cells from oxidative stress.

Pulsatile flow regulates monocyte adhesion to oxidized lipid-induced endothelial cells

Oxidized 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine (ox-PAPC), a component of minimally modified low density lipoprotein, induces monocyte adhesion to endothelial cells. It is not known whether the upstroke slopes of pulsatile flow, defined as shear stress slew rates (tau(r)/tauT)), can regulate monocyte binding to ox-PAPC-treated bovine aortic endothelial cells (BAECs). At 60 cycles per minute, ox-PAPC-treated BAECs were exposed to 3 conditions representing known vascular conditions: (1) high shear stress slew rates (tau(r)/tau(T)=293 dyne. cm(-2). s(-1)), with time-averaged shear stress=50 dyne/cm(2); (2) low shear stress slew rate (tau(r)/tau(t)=71 dyne. cm(-2). s(-1)), with identical time-averaged shear stress; and (3) reversing oscillating flow (0+/-2.6 mm Hg). Reverse transcription-polymerase chain reaction and quantification were performed for monocyte chemoattractant protein-1 (MCP-1) mRNA expression. High tau(r)/tau(t) reduced monocyte binding to ox-PAPC-treated BAECs by 64+/-3.2% compared with static conditions, and low tau(r)/tau(t) reduced monocyte binding by 31+/-3.4%, whereas oscillating flow increased monocyte binding by 22+/-1.7% (P<0.005). High partial tau(r)/tau(t) downregulated MCP-1 expression by 33+/-8%, and low partial tau(r)/tau(t) downregulated MCP-1 expression by 15+/-4%, but oscillating flow upregulated MCP-1 by 13+/-5%. These results suggest that shear stress slew rates regulate monocyte binding by modulating the expression of a potent monocyte chemoattractant.

Superoxide is responsible for apoptosis in rat vascular smooth muscle cells induced by alpha-tocopheryl hemisuccinate

We investigated the mechanism of cell toxicity of alpha-tocopheryl hemisuccinate (TS). TS concentration- and time-dependently induced the lactate dehydrogenase release and DNA fragmentation of rat vascular smooth muscle cells (VSMC). Exogenous addition of superoxide dismutase, but not catalase, significantly inhibited the cell toxicity of TS. The NADPH-dependent oxidase activity of VSMC was stimulated by TS treatment. The cell toxicity of TS was inhibited by NADPH oxidase inhibitor 4-(2-aminoethyl)-benzenesulfonyl fluoride. Consequently, TS-induced apoptosis of VSMC was suggested to be caused by exogenous O(2)(-) generated via the oxidase system activated with TS.

Effects of increasing hydrophobicity on the physical-chemical and biological properties of a class A amphipathic helical peptide

We have recently shown that a class A amphipathic peptide 5F with increased amphipathicity protected mice from diet-induced atherosclerosis (Garber et al. J. Lipid Res. 2001. 42: 545-552). We have now examined the effects of increasing the hydrophobicity of a series of homologous class A amphipathic peptides, including 5F, on physical and functional properties related to atherosclerosis inhibition by systematically replacing existing nonpolar amino acids with phenylalanine. The peptides, based on the sequence Ac-D-W-L-K-A-F-Y-D-K-V-A-E-K-L-K-E-A-F-NH(2) (Ac-18A-NH(2) or 2F) were: 3F(3)(Ac-F(3)18A-NH(2)), 3F(14)(Ac-F(14)18A-NH(2)), 4F(Ac-F(3,14)18A-NH(2)), 5F(Ac-F(11,14,17) 18A-NH(2)), 6F(Ac-F(10,11,14,17)18A-NH(2)), and 7F(Ac-F(3,10,11,14,17) 18A-NH(2)). Measurements of aqueous solubility, HPLC retention time, exclusion pressure for penetration into an egg phosphatidylcholine (EPC) monolayer, and rates of EPC solubilization revealed an abrupt increase in the hydrophobicity between peptides 4F and 5F; this was accompanied by increased ability to associate with phospholipids. The peptides 6F and 7F were less effective, indicating a limit to increased hydrophobicity for promoting lipid interaction in these peptides. Despite this marked increase in lipid affinity, these peptides were less effective than apoA-I in activating the plasma enzyme, lecithin:cholesterol acyltransferase, with 5F activating LCAT the best (80% of apoA-I). Peptides 4F, 5F, and 6F were equally potent in inhibiting LDL-induced monocyte chemotactic activity. These studies suggest that an appropriate balance between peptide-peptide and peptide-lipid interactions is required for optimal biological activity of amphipathic peptides. These studies provide a rationale for the design of small apoA-I-mimetics with increased potency for atherosclerosis inhibition.

Adenovirus-mediated p16 gene transfer changes the sensitivity to taxanes and Vinca alkaloids of human ovarian cancer cells

BACKGROUND

Deletions and point mutations of the p16 gene are detectable in more than 50% of ovarian cancer cells. In this study, we examined the effect of p16 gene transduction on the growth of ovarian cancer cells and on the effect of anti-cancer agents.

MATERIALS AND METHODS

p16-null human ovarian cancer cell lines, SKOV-3 and OVCAR-5, were used in this study. We transduced the full-length human p16 gene using recombinant adenovirus (AxCA-hp16).

RESULTS

The spontaneous growth of these cells was significantly inhibited by hp16 transduction. MTT assay revealed that AxCA-hp16 infection induced chemoresistance in both cell lines. Flow cytometric analysis revealed that only hp16 -transduced SKOV-3, were arrested at the G1-phase for 3 days whereas those infected with AxCA-mock and OVCAR-5 infected with both recombinant viruses did not. Western blot analysis showed increased microtubule-associated proteins 4 (MAP4) in both cell lines.

CONCLUSION

These results suggest that in SKOV-3 cells, G1-arrest induced by p16-transduction prevents paclitaxel- and vindesine-induced cell death, and in OVCAR-5 cells, the other unknown mechanisms play a role of chemoresistance.

Mitogen-activated protein kinase phosphatase 1 activity is necessary for oxidized phospholipids to induce monocyte chemotactic activity in human aortic endothelial cells

Entrapment and oxidation of low density lipoproteins (LDL) in the sub-endothelial space is a key process in the initiation of atherosclerotic lesion development. Functional changes induced by oxidized lipids in endothelial cells are early events in the pathogenesis of atherosclerosis. Oxidized-l-alpha-1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (ox-PAPC), a major component of minimally modified/oxidized-LDL (MM-LDL) mimics the biological activities assigned to MM-LDL both in vitro in a co-culture model as well as in vivo in mice. We hypothesized that ox-PAPC initiates gene expression changes in endothelial cells that result in enhanced endothelial/monocyte interactions. To analyze the gene expression changes that oxidized lipids induce in endothelial cells, we used a suppression subtractive hybridization procedure to compare mRNA from PAPC-treated human aortic endothelial cells (HAEC) with that of ox-PAPC-treated cells. We report here the identification of a gene, mitogen-activated protein kinase phosphatase 1 (MKP-1), that is rapidly and transiently induced in ox-PAPC-treated HAEC. Inhibition of MKP-1 using either the phosphatase inhibitor sodium orthovanadate or antisense oligonucleotides prevents the accumulation of monocyte chemotactic activity in ox-PAPC-treated HAEC supernatants. Furthermore, we show that decreased monocyte chemotactic activity in HAEC treated with sodium orthovanadate or MKP-1 antisense oligonucleotides is due to decreased MCP-1 protein. Our results implicate a direct role for MKP-1 in ox-PAPC-induced signaling pathways that result in the production of MCP-1 protein by ox-PAPC-treated HAEC.

High-density lipoprotein loses its anti-inflammatory properties during acute influenza a infection

BACKGROUND

Viruses have been identified as one of a variety of potential agents that are implicated in atherogenesis.

METHODS AND RESULTS

C57BL/6J mice were killed before or 2, 3, 5, 7, or 9 days after intranasal infection with 10(5) plaque-forming units (pfu) of Influenza A strain WSN/33. Peak infectivity in lungs was reached by 72 hours, and it returned to baseline by 9 days. No viremia was observed at any time. The activities of paraoxonase and platelet-activating factor acetylhydrolase in HDL decreased after infection and reached their lowest levels 7 days after inoculation. The ability of HDL from infected mice to inhibit LDL oxidation and LDL-induced monocyte chemotactic activity in human artery wall cell cocultures decreased with time after inoculation. Moreover, as the infection progressed, LDL more readily induced monocyte chemotaxis. Peak interleukin-6 and serum amyloid A plasma levels were observed at 2 and 7 days after inoculation. HDL apoA-I levels did not change. ApoJ and ceruloplasmin levels in HDL peaked 3 days after infection. Ceruloplasmin remained elevated throughout the time course, whereas apoJ levels decreased toward baseline after the third day.

CONCLUSIONS

We conclude that alterations in the relative levels of paraoxonase, platelet-activating factor acetylhydrolase, ceruloplasmin, and apoJ in HDL occur during acute influenza infection, causing HDL to lose its anti-inflammatory properties.

Overcoming multi-drug resistance using an intracellular anti-MDR1 sFv

We made an intracellular single-chain variable fragment (sFv) from the C219 monoclonal antibody that recognized the intracellular domain of the multidrug resistance (MDR) gene product, P-glycoprotein (P-gp). Immuno-cytochemistry using the FITC conjugated anti-C-myc tag antibody showed that the sFv protein was expressed in the cytoplasm of the cells. Although transfection of the sFv did not result in the down-regulation of P-gp expression in P-gp positive MDR cells as determined by flow cytometry analysis, Adriamycin (ADM) uptake and Rhodamine123 (Rh123) retention were increased by the C219 intra-cellular sFv transfection. The transfected cells exhibited a higher sensitivity to ADM using a 10-day colony formation assay. The conventional 3-day MTT assay showed the drug resistant tendency in C219 sFv transfected cell we tested. The growth rate of C219 sFv transfected cells was delayed in all non-MDR and MDR cells that might be the reason why C219 transfected cells exhibited the drug resistant tendency in the MTT assay. Despite this unexpected effect of C219 sFv on growth rate, our data suggest that the intra-cellular sFv technique could knockout MDR functionally and may offer a means of increasing the effectiveness of tumor chemotherapy.

Human paraoxonase-3 is an HDL-associated enzyme with biological activity similar to paraoxonase-1 protein but is not regulated by oxidized lipids

Paraoxonase-1 (PON1) is a secreted protein associated primarily with high density lipoprotein (HDL) and participates in the prevention of low density lipoprotein (LDL) oxidation. Two other paraoxonase (PON) family members, namely, PON2 and PON3, have been identified. In this study, we report the cloning and characterization of the human PON3 gene from HepG2 cells. Tissue Northern analysis identifies an approximately 1.3-kb transcript for PON3 primarily in the liver. PON3-specific peptide antibodies detect an approximately 40-kDa protein associated with HDL and absent from LDL. Pretreatment of cultured human aortic endothelial cells with supernatants from HeLa Tet On cell lines overexpressing PON3 prevents the formation of mildly oxidized LDL and inactivates preformed mildly oxidized LDL. In contrast to PON1, PON3 is not active against the synthetic substrates paraoxon and phenylacetate. Furthermore, PON3 expression is not regulated in HepG2 cells by oxidized phospholipids and is not regulated in the livers of mice fed a high-fat atherogenic diet.