Floating plastics as integrative samplers of organic contaminants of legacy and emerging concern from Western Mediterranean coastal areas

This study investigates the role of floating plastics as integrative samplers of organic contaminants. To this end, plastics items were collected in two Western Mediterranean coastal areas: the Mar Menor lagoon, and the last transect of Ebro river. Floating plastics were identified and characterized by attenuated total reflection Fourier-transform infrared spectrometry. Then, organic contaminants were extracted from plastic items by ultrasonic extraction with methanol, and the concentrations of 168 regulated and emerging contaminants were analysed. These compounds were analysed by stir bar sorptive extraction coupled to gas chromatography-mass spectrometry (GC-MS), except for bisphenol analogues, which were analysed with a ultraperformance liquid chromatography pump coupled to a triple quadrupole mass spectrometer (UHPLC-MS/MS), and pharmaceutical compounds, determined by UPLC coupled to hybrid triple quadrupole-linear ion trap mass spectrometer (UPLC-MS/MS). All the contaminants groups considered were detected in the samples, being particularly relevant the contribution of plastic additives. The most frequently detected contaminants were UV-filters, PAHs, pharmaceuticals and synthetic musks. Apart from plasticizers, the individual contaminants octocrylene, homosalate, galaxolide, salycilic acid and ketoprofen were frequently detected in plastics items. The results pointed out to urban and touristic activities as the main sources of pollution in the coastal areas investigated. The utility of floating plastics as integrative samplers for the detection of organic contaminants in aquatic ecosystems has been demonstrated.

Metal and metallothionein concentrations in mesozooplankton from an oligotrophic offshore area in the eastern Mediterranean Sea (Cretan Passage/Levantine Sea)

Spatial variability of Cd, Cu, Cr, Ni, Zn, Fe, Mn, Pb and metallothionein (MT) concentrations were determined in mesozooplankton samples along the west-east axis of the Cretan Passage in the western Levantine Sea (Eastern Mediterranean). Metal and MT values from the present study are proposed as background levels, due to the lack of substantial anthropogenic activities in the area, where only maritime traffic and atmospheric deposition could be potential sources. Higher concentrations, of both metals and MTs, were recorded mainly at the western stations indicating higher metal bioavailability than in the eastern part. An inverse relationship of the metal zooplankton levels with zooplankton biomass, abundance and vital rates (production, respiration and ingestion rates), as well as salinity, was evident. We discuss the hypothesis that physical and biological characteristics of the marine environment, affecting growth dynamics of phytoplankton and zooplankton communities, may also act on metal uptake in oligotrophic marine systems.

Interactive effects of palladium (Pd) and microplastics (MPs) on metal bioaccumulation and biological responses in the Mediterranean mussel, Mytilus galloprovincialis

This study investigates the potential of MPs as carriers of pollutants as they can strengthen bioaccumulation of toxic metals on marine organisms. For the first time, the interaction of the metal palladium (Pd) with the widespread MPs, both with increasing concentrations in water environments from anthropogenic sources, was tested. Mytilus galloprovincialis, an important seafood product, was exposed to Pd (24 h) in two ways: water-dissolved and MPs-adsorbed, with depuration followed for 144 h. Quantification of Pd in tissues shown an accumulation 2-3 times higher (59 % of initial Pd) for mussels exposed to MPs-adsorbed Pd and higher in digestive gland than when exposed to water-dissolved Pd (25 %; higher in gills). Additionally, it was demonstrated that Pd induced oxidative stress and altered the feeding behavior of mussels. Therefore, this work support MPs as being vectors of metals (i.e. Pd) to enhance their bioaccumulation on marine organisms which highlights ecological risk of these emerging pollutants.

Combined exposure of the bivalve Mytilus galloprovincialis to polyethylene microplastics and two pharmaceuticals (citalopram and bezafibrate): Bioaccumulation and metabolomic studies

Pharmaceuticals and microplastics constitute potential hazards in aquatic systems, but their combined effects and underlying toxicity mechanisms remain largely unknown. In this study, a simultaneous characterization of bioaccumulation, associated metabolomic alterations and potential recovery mechanisms was performed. Specifically, a bioassay on Mediterranean mussels (Mytilus galloprovincialis) was carried out with polyethylene microplastics (PE-MPLs, 1 mg/L) and citalopram or bezafibrate (500 ng/L). Single and co-exposure scenarios lasted 21 days, followed by a 7-day depuration period to assess their potential recovery. PE-MPLs delayed the bioaccumulation of citalopram (lower mean at 10 d: 447 compared to 770 ng/g dw under single exposure), although reaching similar tissue concentrations after 21 d. A more limited accumulation of bezafibrate was observed overall, regardless of PE-MPLs co-exposure (<MQL-3.2 ng/g dw). Metabolic profiles showed a strong effect of pharmaceuticals, generally independent of PE-MPLs co-exposure. Alterations of the citrate cycle (bezafibrate exposure) and steroid and prostaglandin metabolism (citalopram and bezafibrate exposures) were highlighted. PE-MPLs alone also impacted metabolic pathways, such as neurotransmitters or purine metabolism. After depuration, relevant latent or long-lasting effects were demonstrated as, for instance, the effect of citalopram on neurotransmitters metabolism. Altogether, the observed molecular-level responses to pharmaceuticals and/or PE-MPLs may lead to a dysregulation of mussels' reproduction, energy metabolism, and/or immunity.

Occurrence and distribution of contaminants of legacy and emerging concern in surface waters of two Western Mediterranean coastal areas: Mar Menor Lagoon and Ebro Delta

The occurrence and distribution of UV filters, plastic additives, synthetic musks, other personal care products (Other PCPs), triazines, polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides (OCPs), organophosphorus pesticides (OPPs), polychlorinated biphenyls (PCBs) and other current-use pesticides (Other CUPs) were characterised during summer 2018 and winter 2019 in surface waters of two sensitive areas of the Spanish coast located on the Mediterranean Sea (Mar Menor lagoon and Ebro Delta). Sixty-three organic contaminants out of a total of 100 compounds were detected, thus confirming the presence of all groups of pollutants studied in surface water at concentrations of ng/L. Both areas are affected by agricultural, urban and recreational activities, PCPs (mainly UV filters) being the predominant compounds found in both seasons which showed significant increases in concentrations in summer. The contaminants found at the highest concentrations were octocrylene, homosalate and ethylhexyl salicylate, which showed risk quotients higher than 1, indicating a potential risk to aquatic organisms, particularly in summer.

Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) occurrence in Sparus aurata exposed to microplastic enriched diets in aquaculture facilities

Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) are highly stable and bioaccumulative, and microplastics (MPs; plastics <5 mm) are ubiquitous in the marine environment. In this study we report the levels of a selection of pollutants in liver and muscle of juvenile gilthead seabream (Sparus aurata) exposed to virgin and weathered MP enriched diets during three months and followed by one month of MP depuration. In general, a major concentration of pollutants in liver was observed. According to OCPs, total DDTs was two or three times higher in liver. Levels in muscle suffer higher variability between treatments and sampling periods. The MP index was negatively correlated to HCB and positively to p,p'DDT in liver. Levels of pollutants are correlated to biological parameters such as total size and total weight. Our results suggest that the bioaccumulation is subjected to the molecular structure of the pollutants and that MPs are correlated with the detoxification system.

Sea snail (Hexaplex trunculus) and sea cucumber (Holothuria polii) as potential sentinel species for organic pollutants and trace metals in coastal ecosystems

The seasonal bioaccumulation of trace metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and organochlorinated pesticides (OCPs) in sea snail (Hexaplex trunculus) and sea cucumber (Holothuria polii) from Mar Menor lagoon were characterised. The highest concentrations of p,p'-DDE were detected in the central and south part of Mar Menor lagoon. However, the highest concentrations of metals in sea snail and holothurians were detected in the influence area of El Beal wadi. Biomagnification factors (BMF) in sea snail from cockle (sea snail-cockle concentration ratio) were higher than 5 for metal and organochlorinated compounds. However, similar concentrations were observed in both species for PAHs due to gastropods capability of metabolising these pollutants. Consequently, sea snail is proposed as a sentinel for trace metals, PCBs and OCPs in the coastal lagoons, not only due to its bioaccumulation and biomagnification capacity but also the easy sampling and amply distribution in many coastal areas.

Metal and metallothionein levels in zooplankton in relation to environmental exposure: spatial and temporal variability (Saronikos Gulf, Greece)

Metal and metallothionein (MT) in mixed zooplankton were investigated as means of monitoring metal availability regarding environmental exposure. Spatial and temporal variability of Cd, Cu, Ni, Zn, Fe, Mn and Pb in zooplankton and seawater were studied in Saronikos Gulf (Aegean Sea, Eastern Mediterranean), once every second month during an annual cycle (2011-2012). Particulate organic carbon and chlorophyll α were also measured in seawater samples. Median zooplankton metal concentrations were 0.65, 32.4, 7.1, 864, 1420, 40.2 and 26.8 μg g^-1 dw for Cd, Cu, Ni, Zn, Fe, Mn and Pb, respectively, and 109 μg g^-1 ww for MTs. Metal levels in zooplankton and MTs were higher at sites influenced by human-derived pressures. Additionally, metal concentrations in pelagic fish flesh from the Greek MED-POL data base were used for bioconcentration and biomagnification factors calculation. Bioconcentration from water to zooplankton was higher than metal transfer from either seston to zooplankton or zooplankton to fish.

Combining an effect-based methodology with chemical analysis for antibiotics determination in wastewater and receiving freshwater and marine environment

Two different methodologies were combined to evaluate the risks that antibiotics can pose in the environment; i) an effect-based methodology based on microbial growth inhibition and ii) an analytical method based on liquid-chromatography coupled to mass spectrometry (LC-MS). The first approach was adapted and validated for the screening of four antibiotic families, specifically macrolides/β-lactams, quinolones, sulfonamides and tetracyclines. The LC-MS method was applied for the identification and quantification of target antibiotics; then, the obtained results were combined with ecotoxicological data from literature to determine the environmental risk. The two methodologies were used for the analysis of antibiotics in water samples (wastewater, river water and seawater) and biofluids (fish plasma and mollusk hemolymph) in two monitoring campaigns undertaken in the Ebro Delta and Mar Menor Lagoon (both in the Mediterranean coast of Spain). Both approaches highlighted macrolides (azithromycin) and quinolones (ciprofloxacin and ofloxacin) as the main antibiotics in wastewater treatment plant (WWTP) effluents with potential risk for the environment. However, no risk for the aquatic life was identified in the river, lagoon and seawater as antibiotic levels were much lower than those in WWTP effluents. Fish from Ebro River were the organisms presenting the highest antibiotic concentration when compared with bivalves (mussels) from the Mediterranean Sea and gastropods (marine snails) from the Mar Menor Lagoon. The effect-based methodology successfully determined antibiotic risk in wastewater, but its applicability was less clear in environmental waters such as seawater, due to its high detection limits. Improving sample preconcentration could increase the method sensibility. Overall, combination of both methodologies provides comprehensive insights in antibiotic occurrence and risk associated in areas under study.

The hydrological regime of a large Mediterranean river influences the availability of pollutants to mussels at the adjacent marine coastal area: Implications for temporal and spatial trends

The present study reports the levels and trends (1993-2013) of DDTs, PCBs and metals in mussels collected at two coastal sites influenced by the River Ebro discharges. Results showed that levels of PCBs, DDTs, Cd and Hg were related to water inputs from the river, while these did not seem to be the main source for the Pb, Zn, Cu and As levels observed. Significant relationships were observed between PCBs and DDTs levels and the river flowrate in the fast-flowing months, suggesting that overflow periods promoted the mobilization of contaminants from sediments, and their subsequent discharge and spreading across the sea. Results indicated that PCBs were effectively southwestern transported, probably in relation to their soluble behavior in stream waters, while DDTs were limitedly spread in seawater, likely due to their particulate behavior. Significant declining trends observed for some metals, PCBs and p,p' DDE may reflect the reduction of pollutants inputs along the river basin. However, the results also showed significant relationships between the river's flowrate in the fast-flowing months and PCBs and DDTs levels, and significant decreases on the river flowrate in some fast-flowing months during the long-term series studies. Both facts suggested that the reduction on overflow periods influenced the decreasing pollutants trends observed in mussels. The present study advises that decreasing trends in contaminant levels in Mediterranean estuarine coastal areas may be related not only to successful remediation works/policies, but also to the fluctuations on the hydrological regime of the rivers, which are directly linked to current climatic trends.

Microplastic distribution in surface sediments along the Spanish Mediterranean continental shelf

Microplastics (MPs) are widely recognised as a contaminant of emerging concern in the marine environment. This work provides original data of the presence of MPs in coastal sediments along the Spanish Mediterranean continental shelf. Ten surface sediment samples were collected in order to document baseline microplastic distribution from Algeciras to Barcelona. Microplastics were extracted from bulk sediments by density separation. The number of microplastics per kilogramme of dry weight ranged from 45.9 ± 23.9 MPs/kg d.w. observed at Palma de Mallorca to 280.3 ± 164.9 MPs/kg d.w. noted at Málaga, with an average value of 113.2 ± 88.9 MPs/kg d.w. The lower limit is defined by the pore filter size used (1.2 μm). For all analysed locations, the dominant microplastic type was fibres (82.9%), followed by fragments, and the main colours were transparent and blue. Microplastic size distribution was presented; in the case of fragments, 85% was lower than 0.5 mm, and in the case of fibres, the three studied intervals (0.5-1, 1-2, 2-5 mm) had similar distribution (35, 34 and 31%, respectively). Attending to all available data, no statistically significant relationship (Spearman's correlation) was found between microplastic average size and distance to the coast, the depth, density population and sediment grain size. Neither relationship was observed between these variables and microplastic concentration using the non-parametric Kruskal-Wallis H test. This study has confirmed the widespread distribution of MPs in surface sediments from the Spanish Mediterranean continental shelf, and these data are useful to define baselines for MPs in the Western Mediterranean region.

Occurrence of selected endocrine disrupting compounds in Iberian coastal areas and assessment of the environmental risk

The spatial and temporal distribution of selected endocrine disrupting compounds (4-tert-octylphenol, 4-n-octylphenol, 4-n-nonylphenol, nonylphenol, and bisphenol A) in two coastal areas of the Iberian Peninsula (Ria de Vigo and Mar Menor lagoon) were evaluated for the first time. Seawater and sediment samples collected during spring and autumn of 2015 were analysed using greener extraction techniques and liquid chromatography-tandem mass spectrometry. The presence of branched isomers (4-tert-octylphenol and nonylphenol) and bisphenol A in almost all seawater and sediment samples demonstrated their importance as pollutants in the frame of water policy, while no concentrations of linear isomers (4-n-octylphenol and 4-n-nonylphenol) were found. Higher seawater levels were observed in Mar Menor lagoon, especially in spring, associated with wastewater treatment plant effluents and nautical, agricultural and industrial activities. Similar sediment concentrations were measured in both studied areas, being nonylphenol levels five times higher than those measured for the other EDCs. Experimental sediment-water partition coefficients showed a moderate sorption of target compounds to sediments. Risk quotients for water compartment evidenced a moderate risk posed by nonylphenol, considering the worst-case scenario. For sediments, moderate risk related to 4-tert-octylphenol and high risk to nonylphenol were estimated.

Effect of microplastics on the toxicity of chlorpyrifos to the microalgae Isochrysis galbana, clone t-ISO

It is highly likely that phytoplanktonic organisms will interact with MPs in the ocean, and consequently with the pollutants sorbed onto their surfaces. Microalgae play an essential role in maintaining the balance of the marine ecosystem due to the fact that they are a primary producer and the base of marine trophic chains. Therefore, their fitness represents an important index in the assessment of water quality. The objectives of this study were i) to assess the toxicity of MPs and the pesticide chlorpyrifos (CPF) to the microalgae, Isochrysis galbana, clone t-ISO and ii) to ascertain whether the presence of MPs affects the toxicity of CPF. Microalgae growth rate was selected as the endpoint and a commercial virgin PE micronized powder was chosen as a micro-plastic model, with mean size ranging from 2 to 6 µm, assayed until 25 mg L^-1. CPF was tested at concentrations ranging from 0 to 4 mg L^-1. A constant concentration of MPs (5 mg L^-1) was loaded with increasing doses of CPF (0-3 mg L^-1) with a 2 h incubation period. Bioassays were performed at 20 °C, in glass tubes of 50 ml, with air and constant light and an exposure time of 72 h. Cell counts were performed using a Coulter Counter Multisizer III and HPLC was used to quantify the partition of this pollutant among MPs and water. Although microalgae growth was not impacted by MPs, growth was clearly affected by exposure to CPF from 2 mg L^-1 and above, with a total growth inhibition at concentrations over 3 mg L^-1. Subsequent to incubation, 80% of CPF was sorbed onto MP surfaces. Two different dose-response curves resulted from CPF bioassays depending on the presence of MP, with lower percentages of inhibition when CPF was presented through MP. Thus, the adsorption of CPF onto MP surfaces modulates the toxicity of CPF on I. galbana growth through a reduction in its toxicity, as CPF is adsorbed onto MP surfaces which are less bio-available to the algal cells.

Report From the First and Second Spanish Killer Immunoglobulin-Like Receptor Genotyping Workshops: External Quality Control for Natural Killer Alloreactive Donor Selection in Haploidentical Stem Cell Transplantation

An important factor affecting the success in the setting of related haploidentical hematopoietic stem cell transplantation (HSCT) is the graft-versus-leukemia effect mediated by natural killer (NK) cells when the donor displays NK alloreactivity versus the recipient. NK cell function is regulated by killer immunoglobulin-like receptors (KIR) and it has been described that donor KIR genotype influences transplantation outcome. This has led to a requirement of laboratories to have a quality assurance program for validation and control of their KIR genotyping methods. The goal of the 1st and 2nd Spanish KIR Genotyping Workshops was to provide an external proficiency testing program in KIR genotyping for Spanish immunology and transplant laboratories. These workshops were conducted during the years 2014-2016 and consisted of 17 participating laboratories typing a set of 20 samples. The presence/absence of 16 mandatory KIR loci (2DL1, 2DL2, 2DL3, 2DL4, 2DL5, 2DS1, 2DS2, 2DS3, 2DS4, 2DS5, 2DP1, 3DL1, 3DL2, 3DL3, 3DS1, and 3DP1) was evaluated per sample. Methods for KIR genotyping included polymerase chain reaction with the use of sequence-specific primers and sequence-specific oligoprobes. Consensus typing was reached in all samples, and the performance of laboratories in external proficiency testing was satisfactory in all cases. The polymorphism detected in the small sample studied in both workshops is indicative of an ample variety of KIR gene profiles in the Spanish population.

Impact of flash flood events on the distribution of organic pollutants in surface sediments from a Mediterranean coastal lagoon (Mar Menor, SE Spain)

The influence of flash flood events on the input and distribution of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and organochlorinated pesticides (OCPs) in surface sediments from the Mar Menor lagoon were characterized in this study. These contaminants were analyzed in surface water samples collected during two flash flood events in the main surface watercourse which flow into the Mar Menor lagoon. Surface sediments were sampled semiannually before and after flash flood events. The total input of PAHs, OCPs, and PCBs (sorbed + dissolved) during two flash flood events was estimated at 0.98, 1.32, and 0.34 kg, respectively, the main input corresponding to p,p'-DDE (1.00 kg). The distribution of organic contaminants in surface sediments was not homogeneous as a consequence of the presence of many simultaneous sources and different meteorological, hydrodynamic, and physicochemical conditions. As a consequence of flash flood events, p,p'-DDE concentrations in surface sediments increased significantly in the central and south zones of the lagoon. However, in the case of PCBs, a dilution effect was observed in the south zone after such events, reducing the environmental risk. These changes in the pollutant distribution persisted at least 1 year later (autumn 2010), showing that the impact of flood events in the distribution of persistent organic contaminants in Mediterranean coastal lagoons is of relevance according to the ecological risk assessment carried out. The impact of these events should be also considered in other coastal systems, especially in semiarid and semiconfined areas.

Pro- and anti-inflammatory cytokine gene single-nucleotide polymorphisms in inflammatory bowel disease

Anti-inflammatory cytokines have an important role in disease, tumour and transplant processes. Alterations in the regulation of several cytokines have been implicated in a variety of inflammatory disorders, including IBD (inflammatory bowel disease) [Crohn's disease (CD) and ulcerative colitis (UC)]. Cytokine polymorphisms are also known to affect the level of gene expression. Thus, the aim of this study was to determine the relationship between cytokine polymorphisms and the IBD pathologies in a Spanish population. Polymorphisms analysis was performed using PCR-SSOP using a microbeads luminex assay. The following polymorphisms were determined: TNFα [-238G/A (rs361525) and -308G/A (rs1800629)], IFNγ [+874A/T (rs62559044)], TGFβ [+869C/T (rs1982073) and +915G/C (rs1800471)], IL10 [-1082A/A (rs1800896), -592A/C (rs1800872), -819C/T (rs1800871)], IL6 [-174C/G (rs1800795)], IL12p40 [3'UTR -1188A/C (rs3212227)], IL1α [-889C/T (rs1800587)], IL1β [-511C/T (rs1143634) and +3962C/T (rs1143633)], IL1R [Pst-1 1970C/T] and IL1RA [Mspa-1 11100C/T]. No statistical differences in TNFα, IFNγ, TGFβ, IL10, IL6, IL1α, IL1β, IL1R and IL1Ra genotypes and allele distributions between the IBD groups and healthy controls were found. However, we observed significant differences in the 3'UTR -1188A/C polymorphism of IL12p40. So -1188A allele was increased in patients with UC and the -1188C allele (high IL12p40 production) was increased in patients with CD with respect to controls. These data are in concordance with the fact that CD has been shown to be associated with a Th1 T-cell-mediated inflammation model and high IL12/IFNγ production at histological affected sites. These data suggest that cytokine polymorphisms in TNFα, IFNγ, TGFβ, IL10, IL6 and IL1α, IL1β, IL1R and IL1Ra cytokine gene do not seem to be relevant in IBD susceptibility and IL12p40 3'UTR -1188A/C polymorphism seems to be associated with a differential IBD development.

Heterogeneous distribution of polycyclic aromatic hydrocarbons in surface sediments and red mullet along the Spanish Mediterranean coast

The spatial distribution of polycyclic aromatic hydrocarbon (PAH) concentrations was characterised in surface sediments and red mullet from eleven Iberian Mediterranean coastal areas. Mean PAH concentrations ranged from 28 to 1006 and from 3 to 40 μg kg(-1)d.w. in sediment and red mullet muscle, respectively. The highest PAH concentrations in sediments were detected close to main ports and urban nuclei. However, concentrations of PAHs in red mullet showed little correspondence with PAH concentrations of the sediments due to its metabolic capacity. Phenanthrene was the predominant homologue in red mullet, whereas fluoranthene, pyrene and benzo(b)fluoranthene were the most abundant ones in sediments. Significant correlations between PAHs and organic carbon or fine fraction in sediments were only found in some areas. PAH concentrations in sediments were lower than environmental criteria in the majority of cases, except for benzo(g,h,i)perylene in 25% of samples from the Barcelona coastal area and for several homologues close to the port of Sagunto.

Influence of an intensive agricultural drainage basin on the seasonal distribution of organic pollutants in seawater from a Mediterranean coastal lagoon (Mar Menor, SE Spain)

The seasonal distribution of polycyclic aromatic hydrocarbons, polychlorinated biphenyls, organochlorine pesticides, organophosphorus pesticides, triazines and other organic pollutants in surface seawater from the Mar Menor lagoon (SE Spain) was characterized from spring 2009 to winter 2010 by stir bar sorptive extraction and thermal desorption followed by capillary gas chromatography coupled to mass spectrometry (SBSE-GC-MS). The most ubiquitous pollutants were chlorpyrifos, chlortal-dimethyl, terbuthylazine, naphthalene and propyzamide throughout the year. Insecticides and herbicides were predominant in summer and spring, and fungicides were more abundant in autumn and winter. Chlorpyrifos was predominant in autumn and spring; herbicides (propyzamide, terbuthylazine and terbuthylazine-desethyl) in autumn and fungicides (flutolanil, boscalid, cyprodinil) in autumn and winter. The highest concentrations for the majority of pollutants were detected in autumn as consequence of air and surface/ground water inputs, and above all of desorption from terrigenous materials deposited in sediments by two intense flash flood events (September 2009).

Seasonal input of regulated and emerging organic pollutants through surface watercourses to a Mediterranean coastal lagoon

Seasonal input of organic pollutants through El Albujón Watercourse to the Mar Menor lagoon was estimated from Spring 2009 to Winter 2010, including regular periods and two flash flood events. 82 semivolatile organic pollutants (persistent organic pollutants, different groups of pesticides and others) were determined by stir bar sorptive extraction and thermal desorption followed by capillary gas chromatography coupled to mass spectrometry from surface waters with quantification limits of a few ngL(-1). Pesticide concentrations varied significantly along the watercourse due to the presence of different sources (groundwaters, wastewater effluent, tributary contributions, brackish waters, etc.) and physicochemical/biological processes that take place simultaneously. The most commonly detected analytes were propyzamide, triazine compounds and chlorpyrifos. A clear seasonal pattern has been detected, with a predominance of insecticides during Summer and of herbicides during Winter. The input of pesticides through this watercourse is particularly relevant during periods of heavy rain, representing more than 70% of total yearly input for many of them.

C1q-fixing human leukocyte antigen assay in immunized renal patients: correlation between Luminex SAB-C1q and SAB-IgG

BACKGROUND

There is no consensus about the impact of thresholds of complement-fixing antibody assays. Recently, a C1q-SAB assay has been developed to identify complement-fixing HLA antibodies with high sensitivity and specificity. Our aim was to determine the correlation between IgG single antigens beads (SAB) and C1q-SAB assay results among patients on the renal waiting list.

PATIENTS AND METHODS

Serum samples from immunized renal waiting list patients as well as negative and positive controls were valided by Luminex (LMX). These sera, which were positive for 166 antibody specificities, were tested for HLA class I in parallel by LMX-IgG and LMX-C1q.

RESULTS

Comparison of antibody detection revealed no correlation based on median fluorescent intensity (MFI), levels between the IgG SAB and the C1qSAB assay (P > .05). IgG-positive sera with MFIs as low as 700 were able to fix C1q, whereas other sera with MFIs as high 14,500 did not. Furthermore, there appeared to be disparities in the profiles of class I antigens able to fix C1q-SAB. In our series, only 34% class I IgG SAB antibodies were also C1qSAB+. In several patients, we detected C1qSAB+ against IgGSAB- that was surely due to IgM antibodies. So, the C1qSAB assay detected IgM antibodies that fix complement.

CONCLUSION

These data suggested that the C1q-SAB assay could be an important method to evaluate pretransplant virtual crossmatch and to define nonpermitted specificities (C1q-fixing) in kidney transplantation.

Genetic polymorphisms of tumour necrosis factor alpha (TNF-α) promoter gene and response to TNF-α inhibitors in Spanish patients with inflammatory bowel disease

Tumour necrosis factor alpha (TNF-α) has an important role in inflammatory response. Alterations in the regulation of TNF-α have been implicated in a variety of inflammatory disorders, including Inflammatory bowel disease (IBD). Indeed, a common treatment for IBD is the use of TNF-α inhibitors. Polymorphisms in the TNF-α promoter region are known to affect the level of gene expression. Our aim was to investigate the influence of these single nucleotide polymorphisms (SNPs) in TNF-α promoter gene play in the risk of IBD in a Spanish population and their individual response to anti-TNF-α treatment. DNA samples from patients with IBD and controls were screened for TNF-α -238G/A (rs361525) and -308G/A (rs1800629) SNPs by PCR-SSOP using a microbeads luminex assay and compared with response to TNF-α inhibitors. There were not statistical differences in -238G/A and -308G/A allele and genotype frequencies between patients. However, we found an increased frequency of -308A allele and -308GA genotype in these nonresponders patients to TNF-α inhibitors with respect to responders patients (Pc < 0.05). This -308GA genotype has been classified as high producer of this cytokine. This fact could actually be interesting to explain the different response of patients with IBD with respect to TNF-α inhibitors. TNF-α promoter gene polymorphism does not seem to play a role in IBD susceptibility, but particular TNF-α genotypes may be involved in the different responses to TNF-α inhibitor treatment in Spanish patients with IBD.

Spatial distribution and temporal trends of polycyclic aromatic hydrocarbons in Mytilus galloprovincialis from the Iberian Mediterranean coast

Polycyclic aromatic hydrocarbons (PAHs) have been determined in blue mussels (Mytilus galloprovincialis) from several Iberian Mediterranean coastal areas through the implementation of a monitoring programme from Spain in the framework of the Mediterranean Pollution Programme (MED POL). The selected areas correspond to sites with differing degrees of exposure to the main pollution sources (hot spots, coastal and reference areas). The sampling campaigns were performed from 2004 to 2009, with samples being taken from May to June, the non-spawning period for mussels in this area. Thirteen PAHs were determined by high-performance liquid chromatography with specific fluorescence detection. In general, total PAHs concentration was lower than 50 μg kg(-1) d.w., except in areas close to the principal ports and cities (Barcelona, Tarragona, Valencia and Algeciras) where it varies from 75 to 390 μg kg(-1) d.w. Background concentrations have been proposed for PAHs in mussels (23.8 μg kg(-1) d.w.) from Western Mediterranean area. Temporal trends were not statistically significant for PAHs concentrations from 2004 to 2009. Longer monitoring periods would be required to detect a continuous tendency, especially for PAHs because although the efficiency of combustion engines has reduced PAHs emissions, their increasing use could alter this potential reduction. The predominant PAHs were three and four ring congeners in all cases, with the predominance of phenanthrene in mussels sited far from the main PAHs sources. The phenanthrene/anthracene (lower than 10) and fluoranthene/pyrene (higher than 1) ratios indicate that PAHs detected in Spanish Mediterranean coastal mussels are mainly of pyrolytic origin.

Health status of red mullets from polluted areas of the Spanish Mediterranean coast, with special reference to Portmán (SE Spain)

A suite of general physiological indicators and hepatic biomarker responses were determined in red mullet (Mullus barbatus) from priority pollution areas of W Mediterranean Sea, including the highly metal polluted area of Portmán (Cartagena, SE Spain). Concentrations of metals and persistent organic pollutants in fish muscle tissue and sediment samples were also analysed. Our results showed that fish from Portmán accumulated the highest concentrations of mercury, lead and arsenic and also of some polycyclic aromatic hydrocarbons and polychlorinated biphenyls congeners. In addition, they had significantly lower condition factor, muscle lipid content and gonadosomatic index, as well as the lowest levels of DNA integrity and the highest ethoxyresorufin-O-deethylase (EROD) activity in liver of the areas investigated. Contaminant body burden in fish only partly corresponded to chemical characteristics of the sediments in the areas in which they were collected. Our findings indicate that red mullets from Portmán had suboptimal health status that warrant further study.

Assessment of the mechanisms of detoxification of chemical compounds and antioxidant enzymes in the digestive gland of mussels, Mytilus galloprovincialis, from Mediterranean coastal sites

In this study the effects of the main marine pollutants (metals, PAHs, PCBs and DDTs) were assessed in native mussels from the Mediterranean coast of Spain. For this purpose several biomarkers such as benzo[a]pyrene hydroxylase (BPH), DT-diaphorase (DTD), glutathione S-transferase (GST), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidases (GPs), glutathione reductase (GR), metallothionein (MT) and lipid peroxidation (LPO) were measured in the digestive gland. Results showed increased LPO levels in mussels which accumulated high loads of organic compounds and arsenic in their tissues. BPH levels correlated to the concentrations of organic compounds in mussel tissues, though the range of BPH response was low in relation to the high gradient of accumulation of organic pollutants. Increased BPH levels, concomitant to low DTD and GST activities, were detected in mussels which presented high levels of organic pollutants in their tissues. This suggests that signs of LPO present in these organisms are related to the imbalance between phase I and phase II biotransformation processes. Furthermore, the increased levels of MT and CAT detected in mussels which showed high levels of Cd in their tissues appear to reflect a coordinated response which protects against the toxicity of this metal. The application of these biomarkers in environmental assessment is discussed.

Micronuclei and other nuclear abnormalities in mussels (Mytilus galloprovincialis) as biomarkers of cyto-genotoxic pollution in mediterranean waters

Environmental genotoxicity and cytotoxicity along the Spanish Mediterranean coast was investigated through the determination of levels of micronuclei (MN) and other nuclear abnormalities (NAs) such as nuclear buds (NB) and binucleated cells (BN) in gills of wild mussels, Mytilus galloprovincialis, from 17 study sites. The results obtained were studied in relation to the exposure to main pollutants (metals, PAHs, PCBs and DDTs), gill antioxidant enzyme activities and environmental variables (temperature and salinity). The highest MN and NB levels were found in mussels from metal-polluted sites, such as Cartagena (MN: 11.6‰, NB: 4.6‰) and Portman (MN: 8.0‰, NB: 3.5‰), where genotoxicity seemed to be related to the oxidative stress generated by exposure to metals. High frequencies of MN and NB in mussels from Algeciras 1 (MN: 8.6‰, NB: 4‰) and of MN (7.2‰) in mussels from Manilva also indicated genotoxicity, though not attributable to the pollutants analysed. In contrast, MN levels at sites highly polluted by organic contaminants such as Barcelona, Vallcarca, Tarragona and Valencia, were lower than expected (ranging from 3.8 to 5.8‰). On the other hand, evidences of cytotoxicity indicated by the high frequencies of BN found in mussels from Vallcarca, Barcelona, and Cartagena (3.9, 3.4, and 2.3‰, respectively) appeared to be specifically related to the accumulation of organic pollutants. Positive correlations found between MN and NB frequencies, and also between both NAs and water temperature, suggested that they were related genotoxic events, and that this environmental factor is able to influence their levels and has to be taken into account in the application of these biomarkers in field studies.

CD28 and KIR2D receptors as sensors of the immune status in heart and liver transplantation

Viral infections and cellular acute rejection (AR) condition immunosuppressive therapy and compromise the evolution of allografts. Immune monitoring can be useful for ascertaining rejection and for differentiating allo-reaction from activation induced by infections. This work analyzes the usefulness of monitoring the expression of CD28 and KIR2D receptors in peripheral blood T lymphocytes by flow cytometry, to ascertain the immune response in heart and liver transplant recipients. In both types of transplant, the up-regulation of CD28 in CD4(+) lymphocytes in the periods of greatest AR frequency indicates an effective allo-response, whereas the post-transplantation emergence of circulating CD8(+)CD28(-) and CD8(+)CD28(-)KIR2D(+) T cells correlates with better early clinical results. Cytomegalovirus (CMV) infection, but not hepatitis C virus (HCV) or other infections, abrogated both CD28 up-regulation and CD8(+)CD28(-)KIR2D(+) T-cell expansion. Our results show that monitoring the expression of CD28 and KIR2D receptors on T lymphocytes might be considered as sensors of the immune status of heart and liver recipients.

Antioxidant responses in gills of mussel (Mytilus galloprovincialis) as biomarkers of environmental stress along the Spanish Mediterranean coast

Antioxidant response was used to assess the effects of the main pollutants in wild mussels (Mytilus galloprovincialis) along the Mediterranean coast of Spain. Antioxidant enzyme activities - those of catalase, superoxide dismutase, glutathione peroxidases, glutathione reductase, glutathione S-transferase and DT-diaphorase - as well as lipid peroxidation and metallothionein concentrations were measured in gills of mussels from 16 selected sites. Furthermore, concentrations of the main contaminants (Hg, Pb, Cd, Cu, Zn, As, PAH, PCB, and DDT) were quantified in mussel tissue, and environmental parameters were measured in water samples collected at each site. Results showed that the glutathione-dependent antioxidant enzymes offered an increased and coordinated response against metal (Hg, Pb and Cd) contamination. These enzymatic activities correlated positively to temperature, suggesting the influence of this environmental parameter on antioxidant responses in gill tissues. Furthermore, although temperature did not reach stressful levels in the study area, it seemed to add a synergistic effect to that produced by metals to induce antioxidant enzymes in the most metal-polluted sites. Catalase activity appeared to be involved in a different antioxidant pathway, more related to organic pollutant bioaccumulation, offering an efficient protection mechanism against reactive oxygen species generation due both to organic exposure and high physiological activity, reflected by high condition indices. In general terms, increased levels of antioxidant enzymes at some sites suffering from metal and organic pollution indicated a situation of oxidative stress that nevertheless did not appear to be harmful, since lipid peroxidation levels showed no peroxidative damage in gill tissues of mussels collected from even the most heavily polluted sites. On the other hand, metallothionein and DT-diaphorase did not reflect pollutant exposure and seemed to be more influenced by environmental variables than by the pollutants.

Integrated use of antioxidant enzymes in mussels, Mytilus galloprovincialis, for monitoring pollution in highly productive coastal areas of Galicia (NW Spain)

In the present work, we investigated the potential use of several antioxidant enzymes in wild mussels (Mytilus galloprovincialis) as biomarkers of marine pollution. The enzymatic activity levels of glutathione S-transferase (GST), glutathione peroxidase (GPx) and catalase (CAT) were measured in gills and digestive gland. Those enzymes participate in the cellular defense system that is involved in the adaptive response of organisms to chemical pollution. Adult mussels were collected at five sampling sites located at the Ría de Pontevedra and Ría de Vigo. Seasonal variations in the control site were observed for the CAT activity, but no significant variability was found for GST and GPx. Mussels from the most polluted sites exhibited a significantly greater GST activity compared to the control site (p<0.05) during the sampling period, whereas GPx and CAT activities have not such a marked pattern. Trace metals, PAHs, PCBs and DDT contents in mussels at sampling sites showed highly significant positive correlations with the GST activity. This study supports the use of GST as a useful biomarker for long-term pollution monitoring in marine coastal ecosystems, whilst more research is needed for GPx and CAT.

Evaluation of three-year monitoring with biomarkers in fish following the Prestige oil spill (N Spain)

A previous study using a suite of hepatic enzymatic biomarker in two demersal fish species (Lepidorhombus boscii and Callionymus lyra) indicated exposure of the fish to the hydrocarbons in the oil spilled by the Prestige five months after the accident. The main objective of this follow-up study is to determine whether the same biomarkers in both fish species show any significant variations in responses over the years following the Prestige oil spill. Detoxification and antioxidant enzyme measurements--of ethoxyresorufin-O-deethylase (EROD), glutathione-S-transferase (GST), glutathione reductase (GR) and catalase (CAT)--were taken from immature specimens. The results show significant lowering of biomarker activity two and three-years after the oil spill, indicating a decreasing level of exposure of the fish to residual hydrocarbons associated with the spillage (p < 0.01) and a recovery to baseline levels existing before the accident. Overall, spatial biomarker patterns over time are in agreement with the oil slick trajectories and the spatial distribution of tar aggregates found on the bottom shelf after the accident. The results also indicate that the Prestige oil spill had an impact on sublethal responses in fish not only in inshore areas, but also in offshore areas along the middle/outer northern Iberian shelf. In both species, EROD activity was found to be the most discriminating biomarker.

Expression of HLA Molecules on Peripheral Blood Lymphocytes: A Useful Monitoring Parameter in Cardiac Transplantation

During the rejection process of cardiac allografts, the expression of HLA antigens increases on various graft tissues, ie, the myocardium and the interstitial structures. However, in this type of transplant there is a paucity of knowledge about HLA expression on recipient cells, such as peripheral blood mononuclear cells. In the present study expression of HLA class I and class II antigens was monitored on peripheral blood lymphocytes prior to and during a 12-month follow-up, using flow cytometry. In our series, the frequency of acute rejection episodes was greater from the fourth to the ninth month after transplantation, coinciding with a reduction in cyclosporine blood levels. At the same time, expression of HLA class I and class II antigens significantly increased among recipients suffering from more severe acute rejection episodes compared with those showing acceptance of their grafts (P < .01). In conclusion, acute rejection episodes in cardiac transplantation were associated with up-regulation of HLA molecules on recipient peripheral blood cells. Monitoring the expression of HLA molecules on peripheral blood lymphocytes may represent an easy, noninvasive practice to individualize immunosuppressive therapy.

Involvement of IFNβ on IFNγ and nitric oxide (NO) production by bone marrow (BM) cells in response to lipopolysaccharide

Bone marrow (BM) cells fractioned in Percoll gradients yield a low-density fraction (Fr3) highly enriched in suppressor activity. Previously, it has been demonstrated that BM associated suppressor activity was mediated by early myeloid cells, through a mechanism dependent on endogenous IFNgamma and nitric oxide production after bacterial stimuli, e.g. lipopolysaccharide (LPS). However, the mechanism(s) through which the IFNgamma is produced in BM has not yet been fully elucidated. Therefore, in the present study we investigated the involvement of IL-12, IL-18 and IFNbeta on the production of IFNgamma and nitric oxide in cultures of BM Fr3 cells, and characterized the IFNgamma-producing cells, in response to LPS. The results show that both IL-12 and IFNbeta, but not IL-18, are involved on IFNgamma production. However, only IFNbeta appears to be critical on nitric oxide production. Furthermore, we found that cells of the Thy1.2+CD3+ phenotype produce IFNgamma and are tightly involved on nitric oxide production by BM Fr3 cells. In conclusion, IFNbeta appears to be critical on IFNgamma- and nitric oxide production by BM cells in response to LPS, through a mechanism that is dependent on Thy1.2+CD3+ IFNgamma-producing cells.

Monitoring biomarkers in fish (Lepidorhombus boscii and Callionymus lyra) from the northern Iberian shelf after the Prestige oil spill

Hepatic biomarker responses were measured in two demersal fish species (Lepidorhombus boscii and Callionymus lyra) from the northern Iberian shelf associated with the massive Prestige oil spill (POS), five months after the accident. The biomarkers selected were 7-ethoxyresorufin-O-deethylase (EROD), glutathione-S-transferase (GST), glutathione reductase (GR), catalase (CAT), and DNA integrity. Interspecies differences and spatial variations in biomarker responses were observed along the shelf. GST, GR and CAT activities were significantly elevated in L. boscii in the most oil impacted area (Finisterre) and positively correlated (p<0.05) with POS tar aggregate densities. The lack of previous data from the area together with the existence of chronic background pollution of the shelf implies that the observed biomarker responses cannot be solely attributed to the petroleum hydrocarbon components of the spilled oil. This first biological effect assessment showed that L. boscii is a potentially suitable target species to be used in future biomonitoring programmes along the northern Iberian shelf.

Cyclophosphamide Induces the Development of Early Myeloid Cells Suppressing Tumor Cell Growth by a Nitric Oxide-Dependent Mechanism

Adoptive immunotherapy with cyclophosphamide (Cy) increases the host resistance against tumor growth. The precise mechanism(s) by which this therapy enhances tumor suppression is unclear. Cy induces the development of early myeloid cells that may be strongly antiproliferative through NO production. These cells are similar to the natural suppressor cells found in normal bone marrow with a potential antitumor effect. Here we have addressed whether the development of NO-producing cells may be involved in this tumor resistance in Cy-treated mice. The results show a synergism between Cy treatment and tumor-specific lymphocytes transferred systemically (i.v.) or locally (Winn's assay) that results in a strong tumor suppression. Inhibition of NO production by N(G)-monomethyl-L-arginine at the site of tumor inoculation results in a loss of the protection achieved by the combined therapy. Cy-treated mice develop splenic early myeloid (CD11b, Gr-1, CD31 (ER-MP12), ER-MP20, ER-MP54) cells producing large amounts of NO upon T cell-derived signals (IFN-gamma plus CD40 ligation) able to inhibit tumor cell growth in vitro. Early myeloid cells (ER-MP54(+)) and cells expressing inducible NO synthase are increased at the site of tumor challenge in mice treated with the combined therapy, but not in those treated with Cy or immune cell transfer alone. Thus, Cy induces the expansion of early myeloid cells, inhibiting tumor cell growth by a mechanism involving NO. Both the recruitment and the activation of these myeloid cells at the site of tumor challenge appear to be dependent on the presence of tumor-specific lymphocytes.

Early myeloid cells are high producers of nitric oxide upon CD40 plus IFN-gamma stimulation through a mechanism dependent on endogenous TNF-alpha and IL-1alpha

Bone marrow contains nonadherent low-density wheat germ agglutinin-positive (Fr3-WGA(+)) cells that release large amounts of NO and show natural suppressor activity if stimulated with activated T cells. We have assessed the involvement of CD40-derived signals in NO production and their cytokine requirements. Production of NO by Fr3-WGA(+) cells in co-culture with activated T cells is inhibited by a competing CD40 soluble fusion protein. Fr3-WGA(+) cells express the inducible NO synthase (iNOS) and release NO following CD40 plus IFN-gamma activation. Production of NO through CD40 is strictly dependent on endogenous TNF-alpha and / or IL-1alpha, since it is inhibited by neutralizing these cytokines or blocking the TNF receptor (p55). Both cytokines are transcribed when Fr3-WGA(+) cells are stimulated by CD40 signaling plus IFN-gamma, although TNF-alpha remains below detection limits in stimulated Fr3-WGA(+) cell cultures. Phenotypic studies combined with data on intracellular iNOS expression and cell sorting indicate that NO-producing cells are CD40, CD31 (ER-MP12), CD11b (Mac-1)low, ER-MP20 (Ly-6C) and Gr-1 (Ly-6G) positive, consistent with myeloid progenitors. The results point to early myeloid cells as an important cell source of NO once triggered by activated T cells through CD40 and IFN-gamma-derived signals, in a mechanism involving the production of TNF-alpha and / or IL-1alpha.

Combined effect of HLA-DRB1*1501 and interleukin-1 receptor antagonist gene allele 2 in susceptibility to relapsing/remitting multiple sclerosis

Susceptibility to multiple sclerosis (MS) is associated with HLA-DRB1*1501. Many reports have suggested associations with other loci but these results remain unconfirmed. We studied the IL-1 receptor antagonist (IL-1ra) gene polymorphism and the HLA-DR and DQ allele frequencies by DNA-based methods in both the primary chronic progressive form (PP MS) and the relapsing/remitting form (R/R MS). The frequency of DRB1*1501 and IL-1ra allele 2 were significantly higher in R/R MS. Association was more marked in the female sex and in patients with benign forms of R/R MS. On the other hand DR4 subtypes carrying a Val at position 86 in the DR beta chain were increased in PP MS. The present study indicates that MS is genetically heterogeneous and shows a combined effect of HLA-DR and IL-1ra genes in susceptibility to the R/R form of the disease.

Disposition of Dibekacin in patients undergoing haemodialysis

The pharmacokinetics of Dibekacin were studied in 10 patients with terminal renal impairment (creatinine clearance < 5 ml/min) undergoing haemodialysis sessions lasting 4 h. The dialyzers were either the Gambro Lundia Major 13.5 or the Ultra Flo II 1.4., and the patients were divided into two groups according to the dialyzer used. Blood flow varied between 250 and 280 ml/min and dialyzate flow between 450 and 600 ml/min. All patients received a single i. v. dose of Dibekacin 1.5 mg/kg at the beginning of the dialysis session. The concentration of the antibiotic at the input and the output of the dialyzer were determine microbiologically by a plate diffusion method using B. subtilis as the test organism. The intravenously administered antibiotic followed an open two-compartment kinetic model. The type of dialyzer used did not influence the dialysis of Dibekacin. Haemodialysis significantly increased the elimination rate of the antibiotic with respect to the interdialysis periods. The plasma half-life in the slow disposition phase fell from 30 h in the interdialysis period to 4.0 h during dialysis sessions. From the calculated pharmacokinetic parameters, a dosage regimen for this kind of patient is proposed.

Pharmacokinetics of cefamandole in rabbits with experimentally induced renal impairment

The pharmacokinetics of cefamandole have been studied in rabbits with normal renal function and varying degrees of renal impairment caused experimentally, by uranyl nitrate, after i.v. administration of a single dose of 30 mg/kg of the antibiotic. The plasma concentrations of cefamandole 80 minutes after administration were 3 micrograms/ml in normal rabbits reaching 90 micrograms/ml at 9 hours in the case of terminal renal impairment. With respect to the pharmacokinetic parameters established in rabbits with normal renal function, the following modifications may be observed in the case of rabbits with renal impairment: alpha, beta, K12, K21, K13, Vc and Vp are decreased, while there is an increase in t 1/2 alpha, t 1/2 beta and (AUC)infinity 0. Linear relationships have been established between log alpha and log beta, respectively, and serum creatinine. Biliary excretion of cefamandole is increased parallel to the increase in the degree of renal impairment, there being a linear relationship between the percentage excreted of the antibiotic and serum creatinine. The values of KB fall from 0.57 h-1 in rabbits with normal renal function, to 0.26 h-1 in rabbits with severe renal impairment.

Pharmacokinetics of cefamandole in patients undergoing hemodialysis

The pharmacokinetics of Cefamandole was studied in 17 patients with terminal renal impairment, 10 of which were undergoing sessions of hemodialysis while 7 were in the period between dialysis sessions. An open two-compartment kinetic model was used to describe the bi-phasic decrease of the plasma concentrations of Cefamandole thus establishing the amounts of the antibiotic in the peripheral and central compartments together with the amount eliminated. All patients received an i.v. bolus injections of 15 mg/kg body weight. During the hemodialysis sessions, the pharmacokinetic parameters of Cefamandole were the following: alpha = 5.006 hr-1 beta = 0.182 hr-1 K12 = 2.598 hr-1 K21 = 2.147 hr-1 K13 = 0.441 hr-1 Vc = 5.700 l Vp = 6.190 l Vdss = 11.94 l It may be seen that there is a decrease in the overall elimination constant compared with that obtained during the periods between the dialysis sessions. A dosage regimen of multiple doses is established as a function of the pharmacokinetic parameters of the antibiotic for patients with terminal renal impairment undergoing periodic sessions of hemodialysis.