Citrate high volume on-line hemodiafiltration modulates serum Interleukin-6 and Klotho levels: the multicenter randomized controlled study \u201cHephaestus

Background: Studies addressing the anti-inflammatory properties of citrate dialysate enrolled patients in both hemodialysis (HD) and hemodiafiltration (HDF), the latter not adjusted for adequate convective exchange. This is a potential source of confounding in that HDF itself has anti-inflammatory effects regardless of the buffer, and optimal clinical outcomes are related to the amount of convection. Methods: To distinguish the merits of the buffer from those of convection, we performed a 6-month, prospective, randomized, crossover AB-BA study. Comparisons were made during the 3-month study period of on-line HDF with standard dialysate containing three mmol of acetic acid (OL-HDFst) and the 3-month of OL-HDF with dialysate containing one mmol of citric acid (OL-HDFcit). Primary outcome measure of the study was interleukin-6 (IL-6). Klotho, high sensitivity C-reactive protein (hsCRP), fetuin and routine biochemical parameters were also analyzed. Results: We analyzed 47 patients (mean age 64 years, range 27-84 years) enrolled in 10 participating Nephrology Units. Convective volumes were around 25 L/session with 90 percent of sessions > 20 L and f2-microglobulin reduction rate 76% in both HDFs. Baseline median IL-6 values in OL-HDFst were 5.6 pg/ml (25:75 interquartile range IQR 2.9:10.6) and in OL-HDFcit 6.6 pg/ml (IQR 3.4:11.4 pg/ml). The difference was not statistically significant (p 0.88). IL-6 values were lower during OL-HDFcit than during OL-HDFst, both when analyzed as the median difference of overall IL-6 values (p 0.02) and as the median of pairwise differences between the baseline and the 3-month time points (p 0.03). The overall hsCRP values too, were lower during OL-HDFcit than during OL-HDFst (p 0.01). Klotho levels showed a time effect (p 0.02) and the increase was significant only during OL-HDFcit (p 0.01). Conclusions: Citrate buffer modulated IL-6, hsCRP and Klotho levels during high volume OL-HDF. These results are not attributable to differences in the dialysis schedule and may suggest a potential anti-inflammatory and anti-senescent effect of citrate even in dialysis patients with low grade inflammatio

Citrate anion improves chronic dialysis efficacy, reduces systemic inflammation and prevents Chemerin-mediated microvascular injury

Systemic inflammation and uremic toxins (UT) determine the increased cardiovascular mortality observed in chronic hemodialysis (HD) patients. Among UT, the adipokine Chemerin induces vascular dysfunction by targeting both endothelial and vascular smooth muscular cells (EC and VSMC). As Citrate anion modulates oxidative metabolism, systemic inflammation and vascular function, we evaluated whether citrate-buffered dialysis improves HD efficiency, inflammatory parameters and chemerin-mediated microvascular injury. 45 patients were treated in sequence with acetate, citrate and, again, acetate-buffered dialysis solution (3 months per interval). At study admission and after each treatment switch, we evaluated dialysis efficacy and circulating levels of chemerin and different inflammatory biomarkers. In vitro, we stimulated EC and VSMC with patients' plasma and we investigated the role of chemerin as UT. Citrate dialysis increased HD efficacy and reduced plasma levels of CRP, fibrinogen, IL6 and chemerin. In vitro, patients' plasma induced EC and VSMC dysfunction. These effects were reduced by citrate-buffered solutions and paralleled by the decrease of chemerin levels. Consistently, chemerin receptor knockdown reduced EC and VSMC dysfunction. In conclusion, Switching from acetate to citrate improved dialysis efficacy and inflammatory parameters; in vitro, chemerin-induced EC and VSMC injury were decreased by using citrate as dialysis buffer

Comunicazione e produzione culturale di un centro culturale con al suo interno i servizi di una biblioteca contemporanea. Il caso studio di Ginestra Fabbrica della Conoscenza

Ginestra è un centro culturale, un luogo fisico adesso in ristrutturazione ma che ospiterà la nuova Biblioteca Comunale di Montevarchi, spazi per laboratori artistici e didattici votati alla creazione di produzioni originali, presentazioni e performance dal vivo. È un organismo di produzione di idee, arte e cultura: una rete multidisciplinare di soggetti, un centro di attività creative, dove sperimentare processi di apprendimento basati sull’imparare facendo. Luogo di antica memoria, è stata ..

Properties of soil particle size separates after 40 years of continuous corn

Changes in chemical and mineralogical characteristics associated with different particle size fractions in soil after 40 years of continuous production of corn by the conventional tillage method (CC) as compared with those of an adjacent native grassland site (NG) are investigated. Results indicate that corn cropping in a soil previously supporting native vegetation produces a decline in total and humified organic matter, phenolic compounds, enzymatic activities, cation exchange capacity (CEC), and hydrosoluble ions, both in the whole soil and in its particle-size separates. The largest losses in organic carbon (C) and nitrogen (N) contents of the cultivated soil were observed in the sandy fractions, the lowest in the silt+clay separates. The humification index (HI) indicates a higher degree of humification of the organic matter in NG than in CC samples. For both NG and GC sites the finest fraction (silt+clay) resulted to be enriched in organic C, total N, humus, phenolic compounds, enzyme activity, CEC, and hydrosoluble ions with the only exception of mineral N forms and sulphates (SO4). Slight differences were observed in the mineralogical composition of NG and CC soils. The sandy fractions of NG showed greater amounts of phyllosilicates while a lower content was found in the silt+clay fraction of CC as a consequence of a crumbling of parent rock into small pieces induced by repeated tillage practices

Skarn formation at the walls of the 79AD magma chamber of Vesuvius (Italy): Mineralogical and isotope constraints

This work presents the results of a mineralogical and isotopic (18O, 13C, 87Sr/86Sr) study on xenoliths ejected during the famous 79AD Plinian eruption of Vesuvius. They are considered to be representative of the upper parts of the crystallizing margins of the magma chamber and also of the associated skarn shell. The aim of this study is to describe the thermometamorphic and metasomatic processes which took place at the 79AD magma chamber/wall-rock interface. The results of our research indicate that metasomatism of carbonate wall rocks of the 79AD Vesuvius magma chamber took place due to the infiltration of magmatic fluids, which were exsolved from the peripheral parts of the magma chamber itself. These fluids drive Fe, K, Si, Al and trace elements such as REE, Nb, U, Th, Zr, W, Sb, Pb extracted from the magma into the carbonate host-rocks, thus producing exoskarn. No evidence of later re-equilibrium with low temperature external fluids of meteoric origin was observed. This indicates that only the prograde early stage of skarn formation is recorded in these xenoliths

Dimethylarginine levels and nutritional status in hemodialysis patients

Background: Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) originate from hydrolysis of methylated proteins, including dietary proteins, and are retained in end-stage renal disease (ESRD). This study aimed to detect the correlation of ADMA and SDMA to nutritional parameters in dialysis patients. Methods: Before and after a single dialysis session, L-arginine, ADMA and SDMA plasma levels were measured in 38 hemodialysis patients by HPLC-tandem mass spectrometry. Biochemistry, protein intake, anthropometry and bioelectric impedance analysis were evaluated Results: Predialysis plasma levels of ADMA were higher than in normal controls (n=20) (1.14 +/- 0.27 mu mol/L vs. 0.56 +/- 0.09 mu mol/L, p<0.001), as were SDMA levels (3.49 +/- 1.00 mu mol/L vs. 0.44 +/- 0.13 mu mol/L, p<0.001). On univariate analysis, predialysis ADMA levels were inversely related to BMI and albumin levels, whereas SDMA was directly related to nPNA, phase angle, prealbumin and creatinine serum levels. ADMA/SDMA ratio was inversely related to prealbumin and albumin, creatinine, urea and phosphorus serum levels, as well as nPNA, but positively to C-reactive protein. On multiple regression analysis, serum albumin and BMI were the stronger predictors of ADMA, whereas prealbumin serum levels followed by dietary protein intake were the stronger predictors of SDMA. Prealbumin followed by C-reactive protein was predictive of the ADMA/SDMA molar ratio. Conclusions: Our results confirm that ADMA and SDMA levels are increased in ESRD patients and suggest that a link may exist with inflammation and nutritional status. High ADMA levels associated with reduced SDMA may be a predictive marker of malnutrition-inflammation-atherosclerosis syndrome

Tree pathogens and their insect-mediated transport: Implications for oak tree die-off in a natural park area

Successful infection by a tree pathogen depends both on species-specific traits, related to its infection biology, and on external factors, i.e. the biotic and abiotic components of the ecosystem. Among species-specific traits, virulence, biomass (propagule) production and dispersal ability all contribute to pathogen establishment and spread. Among the external factors, two crucial roles are played by an environment conducive to disease and by vector occurrence. We investigated the endophytic fungi and xylophagous beetles associated with declining oaks in a natural stand of central Italy, particularly focusing on the fungi isolated from insects’ body. This paper extends and reinterprets the outcome of a previous study, which looked into the whole mycota (pathogenic/neutral/beneficial) found on these oaks. A rich assemblage of fungi was found on declining trees on which a number of wood-boring beetles (Buprestidae and Cerambycidae) also occurred. In the laboratory two-thirds of the insects proved to convey propagules of prominent fungal pathogens (Botryosphaeriaceae, Pestalotiopsidaceae, Plectosphaerellaceae, Pleosporaceae); this confirms pathogen pervasiveness in oak stands is enhanced by their association with xylophagous insects. The outcome of this research will benefit forest manager and other stakeholder efforts to manage stands and species invasions, also in the light of climate change. Keywords: Oak decline, Endophytic fungi, Xylophagous beetle

Citrate high volume on-line hemodiafiltration modulates serum Interleukin-6 and Klotho levels: the multicenter randomized controlled study "Hephaestus"

Studies addressing the anti-inflammatory properties of citrate dialysate enrolled patients in both hemodialysis (HD) and hemodiafiltration (HDF), the latter not adjusted&nbsp;for adequate convective exchange. This is a potential source of confounding in that HDF itself has anti-inflammatory effects regardless of the buffer, and optimal clinical outcomes are related to the amount of convection