Longitudinal ultrasound and clinical follow-up of Baker’s cysts injection with steroids in knee osteoarthritis

This study was conducted to assess ultrasound (US) and clinical changes of Baker's cyst (BC) of patients with knee osteoarthritis (OA) after steroid injection. Patients with knee OA complicated with symptomatic BC (40) were treated with US-guided direct (posterior) aspiration. The injection of 40 mg triamcynolone acetonide was in 20 patients direct into the BC and in other 20 subjects intra-articular (anterior). BC diameters (longitudinal, transverse, and thickness) were measured and followed up with US at baseline, 2, 4, and 8 weeks after injection. Swelling, pain, and range motion were scored at clinical examination with Rauschning and Lindgren classification (RLC, since 0 normal to 3 maximal signs). All US measures of BC and RLC significantly decreased after treatment, in comparison to baseline (p < 0.001) and during the follow-up, did not change through the time (no significant difference between 2, 4, and 8 weeks). At 4 and 8 weeks, diameters measured at US are lower when BC is directly infiltrated in comparison to intra-articular injection (p < 0.01). US steroid direct injection reduces US measures and clinics of BC in knee OA, in particular, when steroid is directly infiltrated into BC.     

Relationship of low-circulating "anti-aging" klotho hormone with disability in activities of daily living among older community-dwelling adults

The aging suppressor gene klotho encodes a single-pass transmembrane protein klotho that in mice is known to extend life span when overexpressed and to resemble accelerated aging, with skeletal muscle atrophy and decreased bone mineral density, when expression is disrupted. We sought to examine the relationship between plasma klotho and disability in activities of daily living (ADL) in older community-dwelling adults. In a cross-sectional study, plasma klotho was measured in a population-based sample of 802 adults, ≥ 65 years, who participated in the "Invecchiare in Chianti" (Aging in the Chianti Area) (InCHIANTI) study in Tuscany, Italy. The overall proportion of adults with ADL disability was 11.9%. Mean (standard deviation) klotho concentrations were 689 (238) pg/mL. From the lowest to the highest tertile of plasma klotho, 16.1%, 9.7%, and 5.6% of participants, respectively, had ADL disability (p=0.0004). Plasma klotho, per 1 standard deviation increase, was associated with ADL disability (odds ratio=0.57, 95% confidence interval 0.35-0.93, p=0.02) in a multivariate logistic regression model adjusting for age, education, cognition, physical activity, physical performance, total cholesterol, alcohol and tobacco use, and chronic diseases. Low plasma klotho concentrations were independently associated with ADL disability among older community-dwelling men and women.     

Human spleen cell generation of factors stimulating human pluripotent stem cell, erythroid, and myeloid progenitor cell growth

Mitogen-stimulated murine spleen cells produce humoral substances capable of supporting murine hematopoiesis and pluripotent stem cell proliferation in vitro. Thus, we evaluated conditioned media generated by human spleen cells (SCM) in the presence or absence of mitogens for factors stimulatory for human pluripotent (CFU-GEMM), erythroid (BFU- E), and myeloid (CFU-GM) precursors. Two and one half percent to 10% SCM stimulated proliferation of all three types of precursor cells from nonadherent buoyant human marrow target cells. Mitogen-stimulated SCM augmented CFU-GM (175% to 225%), whereas CFU-GEMM and BFU-E growth was essentially unchanged. Cell separation procedures used to determine which cells provided these microenvironmental stimuli indicated that nonadherent mononuclear spleen cells provided the bulk of the CSF-GM, whereas adherent cells (95% nonspecific esterase + monocyte- macrophages) and nonadherent cells provided similar proportions of CSF- mix and erythroid burst-promoting activity (BPA). The nonadherent cells generating high levels of CSF-mix, BPA, and CSF-GM were predominantly Leu-1-negative, ie, non-T, cells. In the presence or absence of mitogens, SCM was a more potent source (1.3- to 3.8-fold) than peripheral leukocyte CM of the growth factors for the three progenitor cell types. Specific in situ cytochemical stains for analyzing morphology of myeloid colonies demonstrated that SCM stimulated the proliferation of the same types and proportions of colonies as human placental CM, suggesting that these CMs may contain similar CSF-GMs. These data show the contribution of spleen cell subsets to the generation of hematopoietic growth factors and the responsiveness of these cells to various mitogenic stimuli.     

Native associations of early hematopoietic stem cells and stromal cells isolated in bone marrow cell aggregates

In suspensions of murine bone marrow, many stromal cells are tightly entwined with hematopoietic cells. These cellular aggregations appear to exist normally within the marrow. Previous studies showed that lymphocytes and stem cells adhered to stromal cells via vascular cell adhesion molecule 1 (VCAM1). Injection of anti-VCAM1 antibody into mice disrupts the aggregates, showing the importance of VCAM1 in the adhesion between stromal cells and hematopoietic cells in vivo. Early hematopoietic stem cells were shown to be enriched in aggregates by using a limiting-dilution culture assay. Myeloid progenitors responsive to WEHI-3CM in combination with stem cell factor (c-kit ligand) and B220- B-cell progenitors responsive to insulin-like growth factor-1 in combination with interleukin-7 are not enriched. We propose a scheme of stromal cell-hematopoietic cell interactions based on the cell types selectively retained within the aggregates. The existence of these aggregates as native elements of bone marrow organization presents a novel means to study in vivo stem cell-stromal cell interaction.     

Relationship between use of proton pump inhibitors and IGF system in older subjects

Objectives

to investigate the effects of proton pump inhibitors (PPIs) on the insulin-like-growth factor 1(IGF-1) system in the elderly.

Design

cross-sectional.

Setting

InCHIANTI study.

Participants

938 older subjects (536 women, 402 men, mean age 75.7±7.4 years).

Measurements

complete data on age, sex, BMI, liver function, medications, dietary intake, IGF-1, IGF-binding protein-1 and -3 (IGFBP-1, IGFBP-3).

Results

Participants were categorized by PPI use, identifying 903 PPI non users and 35 users. After adjusting for age, male PPI users (107.0 ± 69.6 vs 127.1 ± 55.8, p<0.001) and female PPI users (87.6 ± 29.1 vs 107.6 ± 52.3, p=0.03) had lower IGF-1 levels than non-users. IGFBP-1 levels were similar in the two groups in both sexes. In whole population, after adjustment for age and sex, PPI users had lower IGF-1 levels 81.9 [61.1–113.8] than nonusers 110 [77.8–148.6], p=0.02. After further adjustment for BMI, albumin, liver function, C-reactive protein, Interleukin-6, number of medications, ACE-inhibitors use, caloric intake, protein intake, physical activity, glycemia, and IGFBP-1, the use of PPIs remained significantly and negatively associated with IGF-1 levels (β±SE=?19.60±9.83, p=0.045).

Conclusion

Use of PPIs was independently and negatively associated with IGF-1 levels.     

Adipocytokines and the metabolic syndrome among older persons with and without obesity: the InCHIANTI study

Objectives Adipose tissue‐derived inflammation may contribute to metabolic alterations and eventually to the metabolic syndrome (MetS). The purpose of this study was to: (1) examine the role of adipocytokines in the association between obesity and the MetS and (2) to determine whether the association is different in obese and non‐obese persons. Design Cross‐sectional population‐based InCHIANTI study. Subjects A total of 944 community‐dwelling adults aged 65 years and older living in Tuscany, Italy. Measurements Obesity was defined as body mass index ≥30 kg/m² and MetS as ≥3 of the ATP‐III criteria. Circulating levels of C‐reactive protein, interleukin (IL)‐6, IL‐1 receptor antagonist (IL‐1ra), IL‐18, tumour necrosis factor (TNF)‐α R1, adiponectin, resistin and leptin were measured. Additionally, insulin resistance was determined using the homeostasis model assessment (HOMA‐IR). Results The prevalence of the MetS was 32%. Both overall and abdominal obesity were significantly associated with the MetS after adjusting for inflammatory cytokines, adipokines and lifestyle factors. After adjusting for multiple confounders and HOMA‐IR, IL‐1ra, TNF‐α R1 and adiponectin (P < 0·05) remained significantly associated with the MetS. Having multiple cytokines in the highest tertile increased the likelihood of having the MetS in both obese (P for trend 0·002) and non‐obese persons (P for trend 0·001) independent of insulin resistance. Conclusions Non‐obese and obese individuals who develop an intense pro‐inflammatory state may be more prone to develop the MetS than those with lower levels of inflammation.