Neuropsychiatric systemic lupus erythematosus: where are we now?

When dealing with neuropsychiatric Systemic Lupus Erythematosus (NPSLE) there are still many controversial topics. In 1999 the American College of Rheumatology gave classification criteria for 19 clinical syndromes. However major problems are still related to low specificity of some of them such as headache, cognitive impairment or mood disorders. Even though a frequency of CNS involvement from 14 to 75% has been described, depending on both the population studied and the methodology of assessment, a lower frequency ranging from 21 to 28 % derived by larger case series seems more realistic. The introduction of the concept of "borderline cases", proposed by Italian Study Group for NP-SLE, is based both on clinical and instrumental evaluation and could represent a useful tool when dealing with conditions which do not fulfil ACR classification. Also the relationship between SLE activity and NP involvement is a debated issue. Concerning pathogenesis, it seems reasonable to consider multifactorial mechanisms related to antibody-mediated damage, antiphospholipid pro-thrombotic effect, non-inflammatory vasculopathy and cytokines mediated cytotoxycity. However, direct and unequivocal evidence for the implication of any of the above-mentioned mechanisms is still lacking. Although a wide range of neuroimaging tools have been used to evaluate CNS involvement, no single technique has proven to be definitive and, when dealing with a patient with suspected NPSLE, it is important to combine different diagnostic techniques. Due to the lack of effective imaging along with limitation in knowledge of underlying pathogenetic mechanisms and paucity of histopathologic findings, therapeutic approach in NPSLE remains a difficult issue and is currently based on personal experience. Italian Study Group for NP-SLE proposes the creation of a national registry on NPSLE to validate ACR classification criteria. Furthermore, the possibility to collect large series and stratifying them for each of the included neuro-psychiatric syndromes seems a good strategy for planning multicentric controlled therapeutic trials in the near future

Efficient CO2 electroreduction on tin modified cuprous oxide synthesized via a one-pot microwave-assisted route

Bimetallic copper-tin catalysts are considered cost-effective and suitable for large-scale electrochemical conversion of CO2 to valuable products. In this work, a class of tin (Sn) modified cuprous oxide (Cu2O) is simply synthesized through a one-pot microwave-assisted solvothermal method and thoroughly characterized by various techniques. Sn is uniformly distributed on the Cu2O crystals showing a cube-within-cube structure, and CuSn alloy phase emerges at high Sn contents. The atomic ratio of Cu to Sn is found to be crucially important for the selectivity of the CO2 reduction reaction, and a ratio of 11.6 leads to the optimal selectivity for CO. This electrode shows a high current density of 47.2 mA cm−2 for CO formation at −1.0 V vs. the reversible hydrogen electrode and also displays good CO selectivity of 80–90% in a wide potential range. In particular, considerable CO selectivity of 72–81% is achieved at relatively low overpotentials from 240 mV to 340 mV. During the long-term tests, satisfactory stability is observed for the optimal electrode in terms of both electrode activity and CO selectivity. The relatively low price, the fast and scalable synthesis, and the encouraging performance of the proposed material implies its good potential to be implemented in large-scale CO2 electrolyzers

The soluble terminal complement complex (SC5b-9) up-regulates osteoprotegerin expression and release by endothelial cells: Implications in rheumatoid arthritis

Objective. Complement activation products contribute to a large number of inflammatory diseases, including RA. We have investigated whether osteoprotegerin (OPG) may concur with the soluble terminal complement complex (SC5b-9) to the inflammatory cascade characterizing RA. Methods. Levels of SC5b-9 and OPG in the plasma and SF of patients with active RA were determined by ELISA. The presence of SC5b-9 and OPG in RA synovial lesions was analysed by immunohistochemistry. Cultured endothelial cells were used for in vitro leucocyte/endothelial cell adhesion assays. In addition, endothelial cells were exposed to SC5b-9 in order to evaluate the effects on the production of OPG protein, as well as the activation of the OPG promoter. Results. Patients affected by active RA are characterized by elevated levels of both SC5b-9 and OPG in plasma and/or SF. Of note, we have observed a co-localization of SC5b-9 and OPG in endothelial cells of post-capillary venules of RA synovial lesions. Data on endothelial cell cultures showed that exposure to SC5b-9 induced the up-regulation of OPG expression/release, stimulating the transcriptional activity of the OPG promoter, and synergized with TNF-α in up-regulating OPG production. Conclusions. Our findings demonstrate that SC5b-9 induces OPG production by endothelial cells and we propose that the SC5b-9-mediated up-regulation of OPG may be an important mechanism whereby complement contributes in promoting and/or enhancing the inflammation in RA. © The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved

Electrochemical Reduction of {CO}2 With Good Efficiency on a Nanostructured Cu-Al Catalyst

Carbon monoxide (CO) and formic acid (HCOOH) are suggested to be the most convenient products from electrochemical reduction of CO2 according to techno-economic analysis. To date, tremendous advances have been achieved in the development of catalysts and processes, which make this research topic even more interesting to both academic and industrial sectors. In this work, we report nanostructured Cu-Al materials that are able to convert CO2 to CO and HCOOH with good efficiency. The catalysts are synthesized via a green microwave-assisted solvothermal route, and are composed of Cu2O crystals modified by Al. In KHCO3 electrolyte, these catalysts can selectively convert CO2 to HCOOH and syngas with H-2/CO ratios between 1 and 2 approaching one unit faradaic efficiency in a wide potential range. Good current densities of 67 and 130 mA cm(-2) are obtained at -1.0 V and -1.3 V vs. reversible hydrogen electrode (RHE), respectively. When switching the electrolyte to KOH, a significant selectivity up to 20% is observed for C2H4 formation, and the current densities achieve 146 and 222 mA cm(-2) at -1.0 V and -1.3 V vs. RHE, respectively. Hence, the choice of electrolyte is critically important as that of catalyst in order to obtain targeted products at industrially relevant current densities

Altilix\uae Supplement Containing Chlorogenic Acid and Luteolin Improved Hepatic and Cardiometabolic Parameters in Subjects with Metabolic Syndrome: A 6 Month Randomized, Double-Blind, Placebo-Controlled Study

The objective was to evaluate the eects of 6 months of supplementation with Altilix\uae, containing chlorogenic acid and its derivatives, and luteolin and its derivatives, on cardiovascular risk and hepatic markers in subjects with metabolic syndrome (MetS). A randomized, double-blind, placebo-controlled study was performed in 100 subjects with MetS with a follow-up period of 6 months; 50 subjects were randomized to Altilix\uae (26 men and 24 women, mean age 63 8 years) and the other 50 to placebo (28 men and 22 women, mean age 63 11 years). Anthropometric, cardiometabolic, and hepatic parameters were assessed at baseline and at the end of follow-up. Carotid intima-media thickness and endothelial function were assessed by doppler ultrasound and by flow-mediated dilation of the brachial artery, respectively. The presence and degree of non-alcoholic fatty liver disease (NAFLD) was assessed by the fatty liver index (FLI), and subjects were divided into three subgroups: (1) without NAFLD; (2) with borderline NAFLD; and (3) with NAFLD. After 6 months of Altilix\uae supplementation, we found a significant improvement vs. placebo in most of the evaluated parameters, including body weight (2.40% (95% CI 3.79, 1.01); p < 0.001), waist circumference (2.76% (95% CI 4.55, 0.96); p = 0.003), HbA1c (0.95% (95% CI 1.22, 0.67); p < 0.001), plasma lipids, FLI (21.83% (95% CI 27.39, 16.27); p < 0.001), hepatic transaminases, flow-mediated dilation (10.56% (95% CI 5.00, 16.12); p < 0.001), and carotid intima-media thickness (39.48% (95% CI 47.98, 30.97); p < 0.001). Further, the improvement in cardiometabolic variables was independent of the degree of hepatic steatosis. Altilix\uae supplementation improved hepatic and cardio-metabolic parameters in MetS subjects. Altilix\uae supplementation was a beneficial approach in the management of hepatic and cardiometabolic alterations in MetS subjects

Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy: 13-year update of the prospective, multicenter randomized GITMO-IIL trial

Aprospective trial conducted in the period 2000-2005 showed no survival advantage for high-dose chemotherapy with rituximab and autograft (RHDS) versus conventional chemotherapy with rituximab (CHOP-R) as firstline therapy in 134 high-risk follicular lymphoma patients aged <60 years. The study has been updated at the 13-year median follow up. As of February 2017, 88 (66%) patients were alive, with overall survival of 66.4% at 13 years, without a significant difference between R-HDS (64.5%) and CHOP-R (68.5%). To date, 46 patients have died, mainly because of disease progression (47.8% of all deaths), secondary malignancies (3 solid tumor, 9 myelodysplasia/acute leukemia; 26.1% of all deaths), and other toxicities (21.7% of all deaths). Complete remission was documented in 98 (73.1%) patients and associated with overall survival, with 13- year estimates of 77.0% and 36.8% for complete remission versus no-complete remission, respectively. Molecular remission was documented in 39 (65%) out of 60 evaluable patients and associated with improved survival. In multivariate analysis, complete remission achievement had the strongest effect on survival (P<0.001), along with younger age (P=0.002) and female sex (P=0.013). Overall, 50 patients (37.3%) survived with no disease recurrence (18 CHOP-R, 32 R-HDS). This follow up is the longest reported on follicular lymphoma treated upfront with rituximab-chemotherapy and demonstrates an unprecedented improvement in survival compared to the pre-rituximab era, regardless of the use of intensified or conventional treatment. Complete remission was the most important factor for prolonged survival and a high proportion of patients had prolonged survival in their first remission, raising the issue of curability in follicular lymphoma

Biochar/Zinc Oxide Composites as Effective Catalysts for Electrochemical CO2 Reduction

Novel electrocatalysts based on zinc oxide (ZnO) and biochars are prepared through a simple and scalable route and are proposed for the electrocatalytic reduction of CO2 (CO2RR). Materials with different weight ratios of ZnO to biochars, namely, pyrolyzed chitosan (CTO) and pyrolyzed brewed waste coffee (CBC), are synthesized and thoroughly characterized. The physicochemical properties of the materials are correlated with the CO2RR to CO performance in a comprehensive study. Both the type and weight percentage of biochar significantly influence the catalytic performance of the composite. CTO, which has pyridinic- and pyridone-N species in its structure, outperforms CBC as a carbon matrix for ZnO particles, as evidenced by a higher CO selectivity and an enhanced current density at the ZnO_CTO electrode under the same conditions. The study on various ZnO to CTO weight ratios shows that the composite with 40.6 wt % of biochar shows the best performance, with the CO selectivity peaked at 85.8% at -1.1 V versus the reversible hydrogen electrode (RHE) and a CO partial current density of 75.6 mA cm-2 at -1.3 V versus RHE. It also demonstrates good stability during the long-term CO2 electrolysis, showing high retention in both CO selectivity and electrode activity