Assessment of the effectiveness of golimumab 50-mg and 100-mg regimens in patients with rheumatoid arthritis in daily practice

Abstract

Objectives. To assess the effectiveness of the golimumab (GLM) 50-mg and 100-mg regimens in patients with rheumatoid arthritis (RA) in daily practice. Methods. We retrospectively analyzed RA patients who started GLM between September 2011 and July 2012. Patients were divided into three groups: a 50-mg group; a 50/100-mg group (had a dose increase to 100 mg); and a 100-mg group (started GLM at 100 mg). We assessed Disease Activity Score 28 (DAS28) and treatment continuation rate. Risk factors associated with time to discontinuation of the 50-mg regimen were determined with proportional hazards analysis. Results. We analyzed 74 patients: 43 in the 50-mg group, 23 in the 50/100-mg group, and 8 in the 100-mg group. DAS28 improved from 4.0 ± 1.0, 4.8 ± 1.0, and 4.7 ± 1.9, respectively, at baseline to 2.4 ± 1.2, 3.3 ± 1.5, and 2.5 ± 0.7, respectively, at week 52. Treatment continuation rates at week 52 were 73.7%, 60.9%, and 87.5%, respectively. In the 50/100-mg group, the mean DAS28 improved significantly from 4.4 ± 1.2 before to 3.6 ± 1.3 12 weeks after the dose increase. Oral corticosteroid therapy ≥ 5 mg/day, previous use of two biologic agents, and DAS28 > 5.1 at initiation of GLM were significantly associated with discontinuation of the 50-mg regimen. Conclusions. Both GLM 50-mg and 100-mg regimens are effective in patients with RA in daily practice.     

Caspase-dependent and -independent DNA fragmentation in Sertoli and germ cells from men with primary testicular failure: relationship with histological diagnosis

BACKGROUND: Germ cell elimination and sperm DNA fragmentationin men with primary testiculopathies involve apoptosis-relatedprocesses whose mechanisms are poorly understood. This studyexamines the participation of typical (caspase-dependent) andatypical (caspase-independent) pathways in these processes.METHODS: Caspase activity and DNA fragmentation were evaluatedin Sertoli and germ cells from 63 men with non-obstructive azoospermiaand with different histological diagnoses who were undergoingtesticular biopsy for an assisted reproduction attempt. In eightof these men, phosphatidylserine externalization was also examined.RESULTS: The percentage of Sertoli cells showing caspase activityand DNA fragmentation was low and uniform in all diagnoses.In germ cells that remained tightly associated with Sertolicells despite vigorous mechanical treatment, the incidence ofboth caspase activity and DNA fragmentation was high, particularlyin men with maturation arrest. In Sertoli cell-free germ cells,high incidence of DNA fragmentation contrasted with low incidenceof caspase activity and phosphatidylserine externalization.CONCLUSIONS: In men with primary testicular failure, apoptosisof Sertoli cells is insignificant. Some germ cells undergo caspase-dependentapoptosis, show phosphatidylserine externalization and are tightlyassociated with Sertoli cells. Other germ cells show caspase-independentDNA fragmentation, do not externalize phosphatidylserine andlack a tight association with Sertoli cells.     

CpG ODN增强乙肝疫苗在老年小鼠中的免疫应答

目的：探讨CpG ODN对老年小鼠的体液和细胞免疫应答的增强作用。方法：选用老年C57BL／6小鼠，将乙肝疫苗和10μg、20μg CpG ODN同时或单独肌注到小鼠体内，两周后以同样剂量加强免疫一次，再过3周后摘除眼球取血，用EILSA方法检测抗HBs16；抗体和IL-12；无菌取脾脏作HE染色，观察脾脏淋巴细胞变化。结果：10μg和20μg CpG ODN与疫苗同时注射组产生的抗体绝对量分别是单独注射疫苗组的3倍和4倍；产生的IL-12水平较对照组有明显升高，且20μg比10μCpG组产生的IL-12水平更高。光镜下各组的脾脏淋巴细胞的变化如下：正常老年鼠组脾脏淋巴细胞较正常青年鼠组明显稀少；老年鼠 10μgCpG组脾脏淋巴细胞较正常老年鼠组有了明显增加，且细胞核也明显增大；20μgCpG组增加的更加明显。结论：CpG ODN能增强乙肝疫苗在老年小鼠中的体液和细胞免疫应答。     

IgA‐ and SIgA anti‐PR3 antibodies in serum versus organ involvement and disease activity in PR3‐ANCA‐associated vasculitis

Circulating immunoglobulin (Ig)A class anti‐neutrophil cytoplasm antibodies (ANCA) directed against proteinase 3 (PR3) have been reported in ANCA‐associated vasculitis (AAV) with mucosal involvement. However, secretory IgA (SIgA) PR3‐ANCA has not been reported previously. In this study we compared serum levels of SIgA PR3‐ANCA and IgA PR3‐ANCA with IgG PR3‐ANCA in relation to disease characteristics. Among 73 patients with AAV and PR3‐ANCA at diagnosis, 84% tested positive for IgG PR3‐ANCA, 47% for IgA‐ANCA and 36% for SIgA PR3‐ANCA at the time of sampling for the present study. IgA and IgG PR3‐ANCA were represented similarly among patients with different organ manifestations, i.e. upper airway, lung or kidney at time of sampling. However, SIgA PR3‐ANCA was significantly less represented among patients with upper airway involvement. During active disease, the proportions of IgA PR3‐ANCA and SIgA PR3‐ANCA‐positive patients were significantly higher compared to inactive disease. Eight patients were sampled prospectively during 24 months from onset of active disease. In these patients, IgA PR3‐ANCA and SIgA PR3‐ANCA turned negative more often after remission induction compared to IgG PR3‐ANCA. Our findings suggest that serum IgA PR3‐ANCA and SIgA PR3‐ANCA are related more closely to disease activity in AAV compared to IgG PR3‐ANCA. Further studies are required to reveal if this has implications for disease activity monitoring. The mean number of PR3‐ANCA isotypes increased along with disease activity, suggesting a global B cell activation during active disease.     

Neonatal exposure to monosodium glutamate induces morphological alterations in suprachiasmatic nucleus of adult rat

Neonatal exposure to monosodium glutamate (MSG) induces circadian disorders in several physiological and behavioural processes regulated by the suprachiasmatic nucleus (SCN). The objective of this study was to evaluate the effects of neonatal exposure to MSG on locomotor activity, and on morphology, cellular density and expression of proteins, as evaluated by optical density (OD), of vasopressin (VP)‐, vasoactive intestinal polypeptide (VIP)‐ and glial fibrillary acidic protein (GFAP)‐immunoreactive cells in the SCN. Male Wistar rats were used: the MSG group was subcutaneously treated from 3 to 10 days of age with 3.5 mg/g/day. Locomotor activity was evaluated at 90 days of age using ‘open‐field’ test, and the brains were processed for immunohistochemical studies. MSG exposure induced a significant decrease in locomotor activity. VP‐ and VIP‐immunoreactive neuronal densities showed a significant decrease, while the somatic OD showed an increase. Major axes and somatic area were significantly increased in VIP neurons. The cellular and optical densities of GFAP‐immunoreactive sections of SCN were significantly increased. These results demonstrated that newborn exposure to MSG induced morphological alterations in SCN cells, an alteration that could be the basis for behavioural disorders observed in the animals.     

Resting posterior versus frontal delta/theta EEG activity is associated with extraversion and the COMT VALMET polymorphism

Recent studies suggest that resting posterior versus frontal EEG delta/theta activity (delta/theta Pz–Fz) is both sensitive to pharmacological manipulations of neural dopamine and associated with the agency facet of extraversion (i.e., a motivational disposition comprising enthusiasm, energy, assertiveness, achievement striving and social dominance). These observations suggest that posterior versus frontal resting EEG delta/theta activity may represent a useful marker for investigating the molecular genetic basis of extraversion. The present study aimed to test the novel hypothesis of an association between delta/theta Pz–Fz and a functional polymorphism of the enzyme catechol-O-methyltransferase (COMT VAL¹⁵⁸MET) involved in dopamine catabolism. This was conducted in a large EEG data set from the Brain Resource International Database (BRID; resting EEG from N = 1093 healthy individuals, 382 of which also genotyped for COMT VAL¹⁵⁸MET). In summary, we (1) showed for the first time that the VAL allele is associated with increased delta/theta Pz–Fz; (2) replicated the association between extraversion and delta/theta Pz–Fz in a large, heterogeneous sample including both genders; and (3) documented that the VAL allele of the COMT VAL¹⁵⁸MET is associated with increased extraversion scores, as previously reported for an overlapping BRID sample. This coherent pattern of findings adds further support to the suggestion that the posterior–anterior distribution of resting EEG slow wave activity in the delta/theta range represents a useful tool for probing the dopaminergic basis of extraversion.     

Maturation of firing pattern in chick vestibular nucleus neurons

The principal cells of the chick tangential nucleus are vestibular nucleus neurons participating in the vestibuloocular and vestibulocollic reflexes. In birds and mammals, spontaneous and stimulus-evoked firing of action potentials is essential for vestibular nucleus neurons to generate mature vestibular reflex activity. The emergence of spike-firing pattern and the underlying ion channels were studied in morphologically-identified principal cells using whole-cell patch-clamp recordings from brain slices of late-term embryos (embryonic day 16) and hatchling chickens (hatching day 1 and hatching day 5). Spontaneous spike activity emerged around the perinatal period, since at embryonic day 16 none of the principal cells generated spontaneous action potentials. However, at hatching day 1, 50% of the cells fired spontaneously (range, 3 to 32 spikes/s), which depended on synaptic transmission in most cells. By hatching day 5, 80% of the principal cells could fire action potentials spontaneously (range, 5 to 80 spikes/s), and this activity was independent of synaptic transmission and showed faster kinetics than at hatching day 1. Repetitive firing in response to depolarizing pulses appeared in the principal cells starting around embryonic day 16, when <20% of the neurons fired repetitively. However, almost 90% of the principal cells exhibited repetitive firing on depolarization at hatching day 1, and 100% by hatching day 5. From embryonic day 16 to hatching day 5, the gain for evoked spike firing increased almost 10-fold. At hatching day 5, a persistent sodium channel was essential for the generation of spontaneous spike activity, while a small conductance, calcium-dependent potassium current modulated both the spontaneous and evoked spike firing activity. Altogether, these in vitro studies showed that during the perinatal period, the principal cells switched from displaying no spontaneous spike activity at resting membrane potential and generating one spike on depolarization to the tonic firing of spontaneous and evoked action potentials.     

Multilevel modelling of somatotype components: the Portuguese sibling study on growth,fitness, lifestyle and health

Background: Somatotype is a complex trait influenced by different genetic and environmental factors as well as by other covariates whose effects are still unclear.

Aims: To (1) estimate siblings’ resemblance in their general somatotype; (2) identify sib-pair (brother–brother (BB), sister–sister (SS), brother–sister (BS)) similarities in individual somatotype components; (3) examine the degree to which between and within variances differ among sib-ships; and (4) investigate the effects of physical activity (PA) and family socioeconomic status (SES) on these relationships.

Subjects and methods: The sample comprises 1058 Portuguese siblings (538 females) aged 9–20 years. Somatotype was calculated using the Health-Carter method, while PA and SES information was obtained by questionnaire. Multi-level modelling was done in SuperMix software.

Results: Older subjects showed the lowest values for endomorphy and mesomorphy, but the highest values for ectomorphy; and more physically active subjects showed the highest values for mesomorphy. In general, the familiality of somatotype was moderate (ρ?=?0.35). Same-sex siblings had the strongest resemblance (endomorphy: ρ_SS > ρ_BB > ρ_BS; mesomorphy: ρ_BB = ρ_SS > ρ_BS; ectomorphy: ρ_BB > ρ_SS > ρ_BS). For the ectomorphy and mesomorphy components, BS pairs showed the highest between sib-ship variance, but the lowest within sib-ship variance; while for endomorphy BS showed the lowest between and within sib-ship variances.

Conclusions: These results highlight the significant familial effects on somatotype and the complexity of the role of familial resemblance in explaining variance in somatotypes.     

Telomerase activity,telomere length and hTERT DNA methylation in peripheral blood mononuclear cells from monozygotic twins with discordant smoking habits

Increased telomerase expression has been implicated in the pathogenesis of lung cancer and, since the primary cause of lung cancer is smoking, an association between telomerase reactivation and tobacco smoke has been proposed. In this work an investigation has been performed to assess the relationship between tobacco smoke exposure and telomerase activity (TA) in peripheral blood mononuclear cells of healthy smokers. The methylation status of the catalytic subunit of telomerase hTERT was concurrently investigated to assess the possible association between epigenetic modifications of hTERT and TA. Besides, the association between smoke and telomere length (TL) has been evaluated. Healthy monozygotic twins with discordant smoking habits were selected as study population to minimize inter‐individual differences because of demographic characteristics and genetic heterogeneity. Statistically significant higher values of TA and TL were observed in smokers compared to nonsmoker co‐twins. The multivariate analysis of data showed, besides smoking habits (P = 0.02), an influence of gender (P = 0.006) and BMI (P = 0.001) on TA and a borderline effect of gender (P = 0.05) on TL. DNA methylation analysis, focused on 100 CpG sites mapping in hTERT, highlighted nine CpG sites differentially methylated in smokers. When co‐twins were contrasted, selecting as variables the intra‐twin difference in TA and hTERT DNA methylation, a statistically significant inverse correlation (P = 0.003) was observed between TA and DNA methylation at the cg05521538 site. In conclusion, these results indicate an association of tobacco smoke with TA and TL and suggest a possible association between smoke‐induced epigenetic effects and TA in healthy smokers. Environ. Mol. Mutagen. 58:551–559, 2017. © 2017 Wiley Periodicals, Inc.