Age and low levels of circulating vitamin D are associated with impaired innate immune function

This study investigated in vivo the influence of age and vitamin D status on innate immune function in HC. Serum 25OHD was measured in 71 HC. TLR expression on various subpopulations of PBMCs, as well as TLR function by stimulating PBMCs with specific ligands, was assessed by flow cytometry. Circulating cathelicidin levels were determined by ELISA. Serum 25OHD levels decreased with age, and there was a significant inverse correlation between 25OHD levels and age. There was a negative correlation between serum 25OHD levels and MFI expression of TLR7 on B cells, T cells, and monocytes. TLR7 function, addressed by in vitro stimulation with a specific agonist, was significantly correlated with serum 25OHD levels, and this was especially a result of the results in HC older than 60 years. MFI expression of TLR5 on T cells and TLR2 on monocytes was also negatively correlated with serum 25OHD levels. TLR1 (monocytes) and TLR2 (monocytes) expression was positively correlated with age. Furthermore, TLR4 and TLR8 function was negatively correlated with age. Circulating cathelicidin levels decreased with age and were positively correlated with 25OHD levels. Aging is accompanied by changes in expression and function of several TLRs. Serum 25OHD levels decrease with age and are also associated with a change in expression and defective function of certain TLRs, especially those involved in viral response.

Cytokine gene considerations in giant cell arteritis: IL10 promoter polymorphisms and a review of the literature

Polymorphisms of cytokine genes have been investigated as susceptibility markers of giant cell arteritis (GCA). Here, we have reviewed the evidence to date and especially addressed the functional consequences of IL10 (-592C/A and -1082A/G) gene polymorphisms and their association with susceptibility to and disease phenotype in GCA. A total number of 71 patients with GCA and 124 age-matched controls were genotyped using allele-specific primers and restriction fragment length polymorphism analysis. As previous studies in GCA showed inconsistent results, a meta-analysis of the existing studies was also conducted by using both fixed and random-effects models. The levels of circulating IL10 and the production of IL10 by peripheral blood mononuclear cells after in vitro stimulation were studied by Cytometric Bead Array. Data showed no significant differences in genotype or allele frequency distribution between patients and controls. The clinical characteristics and prognosis of these patients were also unrelated to the presence of these polymorphisms. However, the meta-analysis found a significant association of IL10 -592C/A polymorphism with susceptibility to GCA (odds ratio 2.205 (95% confidence interval 1.074-4.524); p = 0.031). In both patients and age-matched controls, no differences in circulating IL10 levels or IL10 production were observed depending on the genotypes of the IL10 gene. In conclusion, although our cohort results do not support the impact of IL10 variants in susceptibility or clinical phenotype of GCA patients, the meta-analysis revealed a significant association of -592C/A polymorphism with susceptibility to GCA. In this population, no functional association was found between IL10 gene variants and IL10 production.

Toll-like receptor 4 gene polymorphisms in polymyalgia rheumatica and elderly-onset rheumatoid arthritis

OBJECTIVES

Coding variants in TLR4 gene have been reported to be associated with inflammatory diseases. The aim of this study was to determine whether two of these polymorphisms (Asp299Gly and Thr399Ile) of TLR4 contribute to the genetic background of polymyalgia rheumatica (PMR) and elderly-onset rheumatoid arthritis (EORA). Furthermore, we have attempted to correlate the functional consequences of these polymorphisms.

METHODS

164 patients with PMR, 93 with EORA and 126 unrelated age-matched controls were genotyped. The TLR4 genotypes were determined using allele-specific primers and restriction fragment length polymorphism analysis. Association of genotypes and alleles with disease susceptibility and disease phenotypes were studied. TLR4 expression was assessed on PBMCs by flow cytometry and TLR4 function was assessed by stimulating PBMCs in vitro with LPS.

RESULTS

No significant difference in allele frequency or genotype between patients with elderly-onset inflammatory conditions and controls was observed. The Thr399Ile CC genotype was associated with a higher cumulative dose of corticosteroids in patients with PMR (p=0.031). We found no association with TLR4 expression on B cells, T cells or monocytes or a distinct phenotype of TLR4 response with the Asp299Gly or Thr399Ile genotypes.

CONCLUSIONS

These results do not support the association of these TLR4 variants with two age-related inflammatory conditions. The value of determining Thr399Ile genotypes for disease prognosis in PMR should be confirmed in different populations.

Flow-injection spectrophotometric determination of phenolic drugs and carbamate pesticides by coupling with diazotized 2,4,6-trimethylaniline

A flow-injection (FI) spectrophotometric system is proposed for the determination of phenols and carbamates. In the FI manifolds, the solutions of phenols or carbamates (the latter after hydrolysis with NaOH) were injected into a diazonium ion carrier stream at pH 9.5 (buffered with tetrahydroborate), which was formed by mixing 2,4,6-trimethylaniline (TMA) with nitrate in a sodium dodecyl sulfate aqueous micellar medium. Absorbance was measured at 550 nm. The system combines the advantages derived from the use of TMA for the coupling of phenols in basic micellar media, because of the inhibition of the self-coupling reaction of the reagent, with the precision and speed of the FI procedures. Other diazotized reagents produced excessive blank signals. The procedures were successfully applied to the determination of phenolic drugs (epinephrine, acetaminophen, and gualacol) in pharmaceuticals and carbamates (bendiocarb, benfuracarb, carbaryl, carbofuran, methiocarb, promecarb, and propoxur) in pesticide products and water samples.

Interleukin-12 gene polymorphisim in patients with giant cell arteritis, polymyalgia rheumatica and elderly-onset rheumatoid arthritis

OBJECTIVE

The cytokine profile suggests that giant cell arteritis (GCA) is a Th1-driven disease, in which local IFN-gamma plays a critical role in the development of a systemic arteritis. IL-12 is a potent inducer of IFN-gamma and is critically involved in biasing an immune response towards a Th1 pathway. The purpose of this study was to investigate whether there was an association between an IL-12 gene polymorphism (-1188 A/C 3UTR) and disease susceptibility for GCA and two other age-related inflammatory conditions, such as polymyalgia rheumatica (PMR) and elderly-onset rheumatoid arthritis (EORA). Furthermore, we attempted to correlate such polymorphism with in vitro IL-12 production.

MATERIALS AND METHODS

We analyzed genotypes at -1188 in the 3UTR of the IL-12 promoter by PCR-RFLP in 68 GCA, 138 PMR, and 72 EORA patients as well as in 465 healthy controls (HC). IL-12p70 levels in culture supernatants after stimulation with PMA+Ionomycin was assessed by ELISA.

RESULTS

All groups were in Hardy-Weinberg equilibrium. Allelic and gen-omic distribution was not significantly different among the study groups. None of the genetic variants was associated with disease severity. Although the differences were not statistically significant, HC genotypes were associated with distinct IL-12 p70 production.

CONCLUSIONS

The IL-12 (-1188 A/C 3UTR) gene polymorphism is not associated with disease susceptibility or severity in three age-related chronic inflammatory syndromes. The production of IL-12 p70 is dependent on the genetic background in HC, although in patients such association may be biased by other unknown factors.

Comparative study of the glistening between four intraocular lens models assessed by OCT and deep learning

PURPOSE

To evaluate the glistening in 4 different models of intraocular lenses (IOLs) using optical coherence tomography (OCT) and deep learning (DL).

SETTING

Centro Internacional de Oftalmología Avanzada (Madrid, Spain).

DESIGN

Cross-sectional study.

METHODS

325 eyes were assessed for the presence and severity of glistening in 4 IOL models: ReSTOR+3 SN6AD1 (n = 41), SN60WF (n = 110), PanOptix TFNT (n = 128) and Vivity DFT015 (n = 46). The presence of glistening was analyzed using OCT, identifying the presence of hyperreflective foci (HRF) in the central area of the IOL. A manual and an original DL-based quantification algorithm designed for this purpose was applied.

RESULTS

Glistening was detected in 22 (53.7%) ReSTOR SN6AD1, 44 (40%) SN60WF, 49 (38.3%) PanOptix TFNT, and 4 (8.7%) Vivity DFT015 IOLs, when any grade was considered. In the comparison of the different types of IOLs, global glistening measured as total HRF was 17.3 ± 25.9 for the ReSTOR+3; 9.3 ± 15.7 for the SN60WF; 6.9 ± 10.5 for the PanOptix; and 1.2 ± 2.6 for the Vivity ( P < .05). There was excellent agreement between manual and DL-based quantification (≥0.829).

CONCLUSIONS

It is possible to quantify, classify and compare the glistening severity in different IOL models using OCT images in a simple and objective manner with a DL algorithm. In the comparative study, the Vivity presented the lowest severity of glistening.

P6554Utility of accelerometer programmation in leadless pacemaker regardind location. CARDIOCHUS registry

Background

Real-world data reinforce positive results in different implant locations of leadless pacemaker (LPM). LPM have special characteristics regarding accelerometer programmation.

Purpose

The purpose of the study was to describe our experience with LPM different implantation location and its programmation according the vector accelerometer.

Methods

We performed a prospective observational one center study including all patients with LPM implantation within 3 years (June 2015-December 2018). Location of deployment was classified as apicalseptal, midseptal or right ventricle outflow tract (RVOT). Vector programmation was performed from the second visit in patients with acceptable mobility and heart rate below 80 bpm, with the abbreviated protocol recommended by the brand. Clinical evaluation according to vector programmed was performed 3 to 6 months later.

Results

We include a total of 144 LPM, and exercise test was performed in 86 patients. There were 86 men (59.7%) with a mean age of 79.1±6.9 years-old (54 to 89). Location of deployment was distributed as follows: 32.4% in apicalseptal, 54.5% in midseptal and 13.1% in RVOT. Vector 1 was the more frequent programmation, specially in apicalseptal position. Correlation between location and vector of programmation could not be predicted (p=0.2381), but there was a non-significant tendency (p=0.08) between patients with LPM in RVOT location and Vector 3 programmation. Table 1 and Figure 1.

Table 1. Micra Location and Activity Vector Apicalseptal Midseptal RVOT P Value Test Vector 39 (84.8%) 40 (58.5%) 7 (46.7%) NS Vector 1 22 (56.4%) 26 (65.0%) 2 (28.6%) NS Vector 2 8 (20.5%) 4 (10.0%) 1 (14.3%) NS Vector 3 9 (23.1%) 10 (25.0%) 4 (57.1%) 0.08

Figure 1

Conclusions

In our series, Vector 1 was the predominant accelerometer programmation specially in apicalseptal LPM position and Vector 3 in RVOT position.

P6549Conventional single lead ventricular pacemaker against leadless pacemaker system in real-world patients: prospective one center study. CARDIOCHUS Registry

Background

As more experience is obtained with leadless pacemakers systems (LPM), a great group of patients is considered for its implantation. There are issues that cannot be completely avoided with conventional transvenous pacemaker (VVI-PM) such as infectious or pocket related complications in which LPM are clearly superior.

Purpose

The aim of the study was to compare the clinical and device performance between LPM and VVIPM in the same period of time in a “real-world” population.

Methods

We performed a prospective, observational, one center study, including all patients with a single chamber pacemaker implantation within 3 years (June 2015-December 2018) and its mid-term follow-up. All clinical, electrical and echocardiographic characteristics, as well as implantation characteristics and complications, were described.

Results

We included a total of 339 patients with transvenous pacemakers, 195 patients with VVI-PM and 144 LPM. There were no significant differences in mortality between both groups during the follow-up (12,3±10 months), Figure 1. Although there were no significant differences in major complications (P-value 0,54), the number of total complications was lower in the LPM group (P-value 0,01) at the expense of fewer minor ones (P-value 0,02), Table 1.

Table 1. Complications TVP (195) LPM (144) P value Major complications 11 (5.6%) 6 (4.2%) 0.54 Minor complications 10 (5.1%) 0 (0.0%) 0.01 Total Complications 21 (10.7%) 6 (4,2%) 0.02

Figure 1

Conclusions

In our study, during the med-term follow-up, there were no significant differences in terms of mortality and the major complications between LMP and VVI-PM. Although, the number of minor complications were less with the LMP.

Influence of interleukin 10 promoter polymorphisms in polymyalgia rheumatica: disease susceptibility and functional consequences

OBJECTIVES

To investigate the functional consequences of IL10 (-592C/A and -1082A/G) gene polymorphisms and their association with susceptibility to, and disease phenotype, in patients with polymyalgia rheumatica (PMR).

METHODS

A total number of 168 with PMR and 124 age-matched controls were genotyped using allele-specific primers and restriction fragment length polymorphism analysis. The levels of circulating IL10 and the production of IL10 by PBMCs after in vitro stimulation were studied by Cytometric Bead Array.

RESULTS

No significant differences were observed in genotype or allele frequency distribution between patients and controls. The clinical characteristics and prognosis of these patients were also unrelated to the presence of these polymorphisms. No significant differences between PMR patients with low ESR (<40 mm/hr) and classic PMR (>40 mm/hr) were found. Furthermore, we did not observe any influence of circulating IL10 with the intensity of the acute phase response. In both, PMR patients and age-matched controls, no differences in circulating IL10 levels or IL10 production were observed depending on the genotypes of the IL10 gene.

CONCLUSIONS

These results do not support the impact of IL10 variants in susceptibility or clinical phenotype of PMR patients. In this aged population no functional association was found between IL10 gene variants and IL10 production.