POS1315 USEFULNESS OF SYNOVIAL BIOPSY IN THE DIFFERENTIAL DIAGNOSIS AND AS POSSIBLE PREDICTOR OF RESPONSE TO TREATMENT IN JUVENILE IDIOPATHIC ARTHRITIS

Background:While synovial biopsy is an invasive procedure and is not required for the diagnosis of juvenile idiopathic arthritis (JIA), it may be useful in doubtful cases.Objectives:Aims of the study were i.to verify the role of synovial biopsy in the differential diagnosis of JIA and ii. to review the pathology slides in order to evaluate possible associations of a histologic pattern with response to treatment.Methods:We reviewed data from medical records of patients under the age of 18 years who underwent a synovial biopsy requested by our Pediatric Rheumatology Unit over the last 10 years. We collected information on demographic, clinical, laboratory, radiological, histopathological characteristics, as well as treatment response (in particular, remission at the last visit and number of examination, number of biologic drugs used). Among variables in the histologic score, number of layers in the synovial lining and inflammatory infiltrate (0-5) were compared to clinical status at last visit. Potential differences in variables between responders and non responders were assessed by unpaired t-test or non-parametric Mann-Whitney test, as appropriate.Results:We identified 64 patients (40F, 24M) with a median age at disease onset of 9 years (range 1-15) and a median follow-up time of 161 months (range 8-1160). We recognized two groups of interest: patients with a known JIA diagnosis (28/64) and patients with unknown diagnosis (36/64) at the moment of synovial biopsy. In the group with known JIA, most underwent the procedure during orthopedic surgery, and in all cases the histology was consistent with JIA. Among the unknown diagnosis group, in 19 cases results were consistent with a chronic synovitis, while among the other 17 histology could lead to a diagnosis of other conditions in 6 cases (foreign body and villonodular synovitis n=2 each, sarcoidosis and osteochondromatosis n=1 each). In the remaining 11 the final diagnoses were varied (mostly genetic forms eg skeletal dysplasia, CACP, Thiemann disease).Between the two groups we identified 46 patients with a definite JIA diagnosis. At the last follow-up visit 29 of them were in clinical remission, albeit on medication. The remaining 17 had a severe course of disease, with persistent activity and use of at least two biologic drugs. In 26 cases we could evaluate the correlation between status at last visit and number of layers/inflammatory infiltrate, but no statistical significant correlation was found.Conclusion:Despite its limited use nowadays, synovial biopsy may still be a useful tool in patients whose diagnosis is unclear. In our study, while it confirmed the suspicion in most cases, in other instances it allowed the diagnosis of rare conditions that would have been otherwise missed. No association between disease course and histological features in a small JIA cohort was found. We are currently expanding the study with a larger series.Disclosure of Interests:None declare

Arsenic movement and fractionation in agricultural soils which received wastewater from an adjacent industrial site for 50 years

Arsenic (As) is an element with important environmental and human health implications due to its toxic properties. It is naturally occurring since it is contained in minerals, but it can also be enriched and distributed in the environment by anthropogenic activities. This paper reports on the historic As contamination of agricultural soils in one of the most important national relevance site for contamination in Italy, the so-called SIN Brescia-Caffaro, in the city of Brescia, northern Italy. These agricultural areas received As through the use of irrigation waters from wastewater coming from a factory of As-based pesticides (lead and calcium arsenates, sodium arsenite). Pesticide production started in 1920 and ended in the '70. Concentrations in the areas are generally beyond the legal threshold values for different soil uses and are up to >200 mg/kg. Arsenic contamination was studied to assess the long-time trend and the dynamics related to the vertical movement of As down to 1 m depth and its horizontal diffusion with surface irrigation in the entire field. Arsenic fractionation analysis (solid phase speciation by sequential extraction procedure) was also performed on samples collected from these areas and employed in greenhouse experiments with several plant species to evaluate the long-term contamination and the role of plant species in modifying As availability in soil. The results of this work can help in the evaluation of the conditions controlling the vertical transfer of As towards surface aquifers, the bioaccumulation likelihood in the agricultural food chain and the selection of sustainable remediation techniques such as phytoextraction

Increased p21 expression in chondrocytes of achondroplasic children independently from the presence of the G380R FGFR3 mutation

Background. Achondroplasia (ACH) represents the major cause of dwarfi sm and is due to mutations in the fi broblast growth factor receptor 3 (FGFR3) gene. The cellular mechanisms involved in the reduced growth have been mainly described for in vitro or in vivo models, but few data have been obtained for humans. Methods. Thirteen children with ACH were enrolled in the study; the presence of FGFR3 mutations was determined by restriction fragment length polymorphism analysis and sequencing, whereas protein expression in cartilage biopsy was assessed by immunohistochemistry. Results. Chondrocytes in cartilage biopsies of ACH children were characterized by the presence of growth arrest mediated by STAT activation (both STAT1 and STAT5) and increased expression of p21 and cyclin D1, whereas no expression of either p53 or cyclin D3 could be detected. This mechanism was present in ACH children carrying the G380R mutation but also in a patient in whom no mutation could be detected in the entire coding region of the FGFR3 gene. Conclusions. These data thus demonstrate the presence of a common fi nal mechanism involving p21 and possibly leading to a block in chondrocyte proliferation

Habitats Directive in northern Italy: a series of proposals for habitat definition improvement

Habitats Directive (92/43/EEC) is the cornerstone of nature conservation in Europe and is at the core of the EU Biodiversity Strategy for 2030. There is room, however, for its improvement, at least for northern Italy, where ambiguities in the definition of habitat types of Annex I of the Habitats Directive are not novel and interpretation difficulties have been highlighted. Sharpening the characterization of habitat types represents an opportunity for lowering classification uncertainties and improving conservation success. With the aim to refine the definitions of habitat types and associated typical species of the Habitats Directive, a group of vegetation scientists of the Italian Society of Vegetation Science based in northern Italy made the exercise of finding viable proposals for those habitat types having a problematic interpretation in the Alpine biogeographical region of Italy. Such proposals arise from group discussions among scientists, and professionals, thus offering a shared view. We prepared 9 habitat proposals important for this geographic area. They include new habitat types at the European level, new subtypes within pre-existing habitat types, including some adjustments of the recently proposed subtypes with respect to northern Italy, and recognition of priority criteria for a pre-existing habitat type. With a vision of tailored conservation, our proposals represent a starting point in view of a future update of Annex I. Furthermore, the list of typical species could be useful for preparing expert systems for automatic classification. Irrespective of legally binding solutions in place, we caution these proposals represent relevant baseline conservation indications that local and regional administrations of the Alpine Arch should consider

Global and regional IUCN Red List assessments: 7

In this contribution, the conservation status assessment of four vascular plants according to IUCN categories and criteria are presented. It includes the assessments of Aurinia leucadea (Guss.) K.Koch, Chondrilla chondrilloides (Ard.) H.Karst., Daphne cneorum L., and Ophioglossum azoricum C.Presl at regional level (Italy)

The invasion history of Elodea canadensis and E. nuttallii (Hydrocharitaceae) in Italy from herbarium accessions, field records and historical literature

We analysed the invasion history of two North American macrophytes (Elodea canadensis and E. nuttallii) in Italy, through an accurate census of all available herbarium and field records, dating between 1850 and 2019, and a rich literature collection describing the initial introduction and naturalisation phase that supports the results obtained by the occurrence records. Elodea canadensis arrived in Italy before 1866 and had two invasion phases, between the 1890s and 1920s and between the 1990s and 2000s; E. nuttallii, probably arrived in the 1970s, started invading in 2000 and the invasion is still ongoing. Botanical gardens and fish farming played a crucial role in dispersal and naturalisation of both species. The current invasion range of both species is centred in northern Italy, with scattered occurrences of E. canadensis in central and southern regions. River Po represents a dispersal barrier to the Mediterranean region and a strategic monitoring site to prevent the invasion in the peninsula. The study detects differences in the niches of the two species during the introduction and naturalisation phase and a habitat switch occurred after 1980 in E. canadensis and after 2000 in E. nuttallii, during their expansion phases. For E. canadensis the switch corresponds to the second invasion round. Further research can clarify whether the second invasion round is due to confusion of the recently introduced E. nuttallii with E. canadensis, to a cryptic introduction of a new genotype, to post-introduction evolution, or just to an increased scientific interest in biological invasions

Invasion trends of aquatic Ludwigia hexapetala and L. peploides subsp. montevidensis (Onagraceae) in Italy based on herbarium records and global datasets

Identifying areas susceptible to invasion by an alien species is a strategy of prevention. We used national herbaria and global databases to assess the invasion trends of the two aquatic invasive species Ludwigia hexapetala and Ludwigia peploides subsp. montevidensis in Italy. We defined the invasion status with invasion curves and predicted potentially suitable areas with Species Distribution Models based on WorldClim variables and the human footprint index. Low seasonal variation in temperature and precipitation, temperature ≥ 20 °C in the driest period of the year and low precipitation in the coldest period are the bioclimatic factors that most account for the potential distribution of the two species. The human footprint has a lower relative importance than bioclimatic variables. All Italian peninsula appears as a suitable bioclimatic environment for the invasion of the two Ludwigia species, with over 90% of areas with high suitability lying below 600 m altitude. Only mountain regions and the islands appear less suitable. The agricultural land at the foothill of the Appennine in the Mediterranean region is the most vulnerable to the invasion. Considering the trend of the invasion curves, which have been sharply rising for the latest decades, there are reasons to expect that the alien Ludwigia species will continue their expansion, if no timely and effective actions are taken. Informative campaigns, accurate monitoring and prompt management are fundamental preventive tools in areas predicted as vulnerable to invasion by this study

Invasion trends of aquatic Ludwigia hexapetala and L. peploides subsp. montevidensis (Onagraceae) in Italy based on herbarium records and global datasets

Identifying areas susceptible to invasion by an alien species is a strategy of prevention. We used national herbaria and global databases to assess the invasion trends of the two aquatic invasive species Ludwigia hexapetala and Ludwigia peploides subsp. montevidensis in Italy. We defined the invasion status with invasion curves and predicted potentially suitable areas with Species Distribution Models based on WorldClim variables and the human footprint index. Low seasonal variation in temperature and precipitation, temperature ≥ 20 °C in the driest period of the year and low precipitation in the coldest period are the bioclimatic factors that most account for the potential distribution of the two species. The human footprint has a lower relative importance than bioclimatic variables. All Italian peninsula appears as a suitable bioclimatic environment for the invasion of the two Ludwigia species, with over 90% of areas with high suitability lying below 600 m altitude. Only mountain regions and the islands appear less suitable. The agricultural land at the foothill of the Appennine in the Mediterranean region is the most vulnerable to the invasion. Considering the trend of the invasion curves, which have been sharply rising for the latest decades, there are reasons to expect that the alien Ludwigia species will continue their expansion, if no timely and effective actions are taken. Informative campaigns, accurate monitoring and prompt management are fundamental preventive tools in areas predicted as vulnerable to invasion by this study