Association of circulating calprotectin with lipid profile in axial spondyloarthritis

Calprotectin (CPT) is released during inflammation, also in the context of atherosclerosis. The link between CPT and the atherosclerotic process was evaluated in several diseases. However, studies in axial spondyloarthritis (axSpA), associated with a high incidence of subclinical atherosclerosis, are scarce. Therefore, we assessed the association of CPT with subclinical atherosclerosis and metabolic risk factors in axSpA. CPT serum levels were measured by enzyme-linked immunosorbent assay in 163 axSpA patients and 63 controls. Subclinical atherosclerosis was determined in patients by carotid ultrasonography (assessing the presence/absence of carotid plaques and carotid intima-media thickness [cIMT]). Data on inflammation, disease activity, lipid profile and treatment were collected to evaluate its relationship with CPT. axSpA patients evidenced lower CPT levels than controls. CPT showed no association with plaques or cIMT in axSpA. CPT and HDL-cholesterol negatively correlated, while a positive association of CPT with the atherogenic index was disclosed. Additionally, axSpA patients with C-reactive protein values at diagnosis higher than 3?mg/L displayed higher CPT levels. Our study shows no relationship between CPT and markers of subclinical atherosclerosis in axSpA. Nevertheless, it demonstrates an association of CPT with adverse lipid profiles and inflammatory biomarkers, which could further influence on the development of atherosclerosis.We wish to thank all the patients and controls that participated in this study and Begoña Ubilla for technical assistance. FG is a recipient of a Sara Borrell post-doctoral fellowship from the Instituto de Salud Carlos III (ISCIII) (Spain), co-funded by the European Social Fund (ESF, “Investing in your future”) (grant CD15/00095). SR-M is supported by funds of the RETICS Program (RIER) RD16/0012/0009 (ISCIII, co-funded by the European Regional Development Fund, ERDF). VM is supported by funds of a Miguel Servet type I programme (grant CP16/00033) (ISCIII, co-funded by ERDF). RL-M is a recipient of a Miguel Servet type I programme fellowship from the ISCIII, co-funded by the ESF (grant CP16/00033). This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Climate change impact modelling needs to include cross-sectoral interactions

Climate change impact assessments often apply models of individual sectors such as agriculture, forestry and water use without considering interactions between these sectors. This is likely to lead to misrepresentation of impacts, and consequently to poor decisions about climate adaptation. However, no published research assesses the differences between impacts simulated by single-sector and integrated models. Here we compare 14 indicators derived from a set of impact models run within single-sector and integrated frameworks across a range of climate and socio-economic scenarios in Europe. We show that single-sector studies misrepresent the spatial pattern, direction and magnitude of most impacts because they omit the complex interdependencies within human and environmental systems. The discrepancies are particularly pronounced for indicators such as food production and water exploitation, which are highly influenced by other sectors through changes in demand, land suitability and resource competition. Furthermore, the discrepancies are greater under different socio-economic scenarios than different climate scenarios, and at the sub-regional rather than Europe-wide scale

Right drug, right patient, right time: aspiration or future promise for biologics in rheumatoid arthritis?

Individualising biologic disease-modifying anti-rheumatic drugs (bDMARDs) to maximise outcomes and deliver safe and cost-effective care is a key goal in the management of rheumatoid arthritis (RA). Investigation to identify predictive tools of bDMARD response is a highly active and prolific area of research. In addition to clinical phenotyping, cellular and molecular characterisation of synovial tissue and blood in patients with RA, using different technologies, can facilitate predictive testing. This narrative review will summarise the literature for the available bDMARD classes and focus on where progress has been made. We will also look ahead and consider the increasing use of ‘omics’ technologies, the potential they hold as well as the challenges, and what is needed in the future to fully realise our ambition of personalised bDMARD treatment

Socio-economic scenario development for the assessment of climate change impacts on agricultural land use: A pairwise comparison approach

Assessment of the vulnerability of agriculture to climate change is strongly dependent on concurrent changes in socio-economic development pathways. This paper presents an integrated approach to the construction of socio-economic scenarios required for the analysis of climate change impacts on European agricultural land use. The scenarios are interpreted from the storylines described in the intergovernmental panel on climate change (IPCC) special report on emission scenarios (SRES), which ensures internal consistency between the evolution of socio-economics and climate change. A stepwise downscaling procedure based on expert-judgement and pairwise comparison is presented to obtain quantitative socio-economic parameters, e.g. prices and productivity estimates that are input to the ACCELERATES integrated land use model. In the first step, the global driving forces are identified and quantified for each of the four SRES scenario families. In the second step, European agricultural driving forces are derived for each scenario from global driving forces. Finally, parameters for the agricultural land use model are quantified. The stepwise procedure is appropriate when developing socio-economic scenarios that are consistent with climate change scenarios used in climate impact studies. Furthermore, the pairwise comparison approach developed by Saaty [Saaty, T.L., 1980. The Analytic Hierarchy Process. McGraw Hill, New York] provides a useful tool for the quantification from narrative storylines of scenario drivers and model parameters. Descriptions of the narratives are, however, helpful at each step to facilitate the discussion and communication of the resulting scenarios