Adalimumab dose tapering in patients with rheumatoid arthritis who are in long-standing clinical remission: results of the phase IV PREDICTRA study

Objective: To investigate the association between baseline disease activity and the occurrence of flares after adalimumab tapering or withdrawal in patients with rheumatoid arthritis (RA) in sustained remission. Methods: The PREDICTRA phase IV, randomised, double-blind (DB) study (ImPact of Residual Inflammation Detected via Imaging TEchniques, Drug Levels, and Patient Characteristics on the Outcome of Dose TaperIng of Adalimumab in Clinical Remission Rheumatoid ArThritis (RA) Patients) enrolled patients with RA receiving adalimumab 40 mg every other week who were in sustained remission ≥6 months. After a 4-week, open-label lead-in (OL-LI) period, patients were randomised 5:1 to DB adalimumab taper (every 3 weeks) or withdrawal (placebo) for 36 weeks. The primary endpoint was the association between DB baseline hand and wrist MRI-detected inflammation with flare occurrence. Results: Of 146 patients treated during the OL-LI period, 122 were randomised to taper (n=102) or withdrawal (n=20) arms. Patients had a mean 12.9 years of active disease and had received adalimumab for a mean of 5.4 years (mean 2.2 years in sustained remission). Overall, 37 (36%) and 9 (45%) patients experienced a flare in the taper and withdrawal arms, respectively (time to flare, 18.0 and 13.3 weeks). None of the DB baseline disease characteristics or adalimumab concentration was associated with flare occurrence after adalimumab tapering. Approximately half of the patients who flared regained clinical remission after 16 weeks of open-label rescue adalimumab. The safety profile was consistent with previous studies. Conclusions: Approximately one-third of patients who tapered adalimumab versus half who withdrew adalimumab experienced a flare within 36 weeks. Time to flare was numerically longer in the taper versus withdrawal arm. Baseline MRI inflammation was not associated with flare occurrence. Trial registration number: NCT02198651, EudraCT 2014-001114-26

Avaliação da solarização do solo para o controle de Ralstonia solanacearum.

O presente trabalho avaliou o emprego da solarização como uma alternativa para o controle da murcha bacteriana, causada por Ralstonia solanacearum, em amostras de solo infestado com o patógeno, dispostas em bolsas de náilon e enterradas em parcelas solarizadas ou não. Dois experimentos foram instalados, um em Campinas (SP), de fevereiro a abril de 2001, e o outro em Piracicaba (SP), de dezembro de 2001 a janeiro de 2002. Os ensaios foram efetuados em delineamento inteiramente casualizado, esquema fatorial, com quatro repetições, tendo cada parcela 4 x 4 m. Os fatores avaliados foram a solarização (com ou sem), efetuada com filme plástico transparente de 100 µm de espessura, o período de tratamento (30 e 60 dias e 37 e 60 dias para o primeiro e o segundo experimentos, respectivamente) e a profundidade de colocação das amostras (10 e 20 cm), fator verificado apenas no segundo ensaio. Após os períodos estipulados de solarização, o solo de cada bolsa foi colocado em vasos, para os quais foram transplantadas mudas de tomateiro (Lycopersicon esculentum). No solo não solarizado, em ambos os experimentos, 43 a 100% dos tomateiros murcharam. No segundo experimento, 6 a 22% dos tomateiros murcharam no solo solarizado por 37 dias. Entretanto não foram detectadas plantas murchas nas parcelas solarizadas do primeiro experimento e no segundo ensaio nenhum tomateiro murchou solo solarizado por 60 dias, nas duas profundidades estudadas. Os resultados indicam que a solarização é uma técnica promissora para o controle de R. solanacearum

MIGHTEE-HI: The relation between the HI gas in galaxies and the cosmic web

We study the 3D axis of rotation (3D spin) of 77 HI galaxies from the MIGHTEE-HI Early Science observations, and its relation to the filaments of the cosmic web. For this HI-selected sample, the alignment between the spin axis and the closest filament ($\lvert \cos \psi \rvert$) is higher for galaxies closer to the filaments, with $\langle\lvert \cos \psi \rvert\rangle= 0.66 \pm 0.04$ for galaxies $<5$ Mpc from their closest filament compared to $\langle\lvert \cos \psi \rvert\rangle= 0.37 \pm 0.08$ for galaxies at $5 < d <10$ Mpc. We find that galaxies with a low HI-to-stellar mass ratio ($\log_{10}(M_{\rm HI}/M_{\star}) < 0.11$) are more aligned with their closest filaments, with $\langle\lvert \cos \psi \rvert\rangle= 0.58 \pm 0.04$; whilst galaxies with ($\log_{10}(M_{\rm HI}/M_{\star}) > 0.11$) tend to be mis-aligned, with $\langle\lvert \cos \psi \rvert\rangle= 0.44 \pm 0.04$. We find tentative evidence that the spin axis of HI-selected galaxies tend to be aligned with associated filaments ($d<10$ Mpc), but this depends on the gas fractions. Galaxies that have accumulated more stellar mass compared to their gas mass tend towards stronger alignment. Our results suggest that those galaxies that have accrued high gas fraction with respect to their stellar mass may have had their spin axis alignment with the filament disrupted by a recent gas-rich merger, whereas the spin vector for those galaxies in which the neutral gas has not been strongly replenished through a recent merger tend to orientate towards alignment with the filament. We also investigate the spin transition between galaxies with a high HI content and a low HI content at a threshold of $M_{\mathrm{HI}}\approx 10^{9.5} M_{\odot}$ found in simulations, however we find no evidence for such a transition with the current data.Comment: 11 pages, 9 figures, 5 tables, accepted for publication in MNRA

The diacylglycerol kinase α/Atypical PKC/β1 integrin pathway in SDF-1α mammary carcinoma invasiveness

Diacylglycerol kinase α (DGKα), by phosphorylating diacylglycerol into phosphatidic acid, provides a key signal driving cell migration and matrix invasion. We previously demonstrated that in epithelial cells activation of DGKα activity promotes cytoskeletal remodeling and matrix invasion by recruiting atypical PKC at ruffling sites and by promoting RCP-mediated recycling of α5β1 integrin to the tip of pseudopods. In here we investigate the signaling pathway by which DGKα mediates SDF-1α-induced matrix invasion of MDA-MB-231 invasive breast carcinoma cells. Indeed we showed that, following SDF-1α stimulation, DGKα is activated and localized at cell protrusion, thus promoting their elongation and mediating SDF-1α induced MMP-9 metalloproteinase secretion and matrix invasion. Phosphatidic acid generated by DGKα promotes localization at cell protrusions of atypical PKCs which play an essential role downstream of DGKα by promoting Rac-mediated protrusion elongation and localized recruitment of β1 integrin and MMP-9. We finally demonstrate that activation of DGKα, atypical PKCs signaling and β1 integrin are all essential for MDA-MB-231 invasiveness. These data indicates the existence of a SDF-1α induced DGKα - atypical PKC - β1 integrin signaling pathway, which is essential for matrix invasion of carcinoma cells

Adherence to Gluten-Free Diet Restores Alpha Diversity in Celiac People but the Microbiome Composition Is Different to Healthy People

Celiac disease (CD) is an autoimmune disease with the destruction of small intestinal villi, which occurs in genetically predisposed individuals. At the present moment, a gluten-free diet (GFD) is the only way to restore the functionality of gut mucosa. However, there is an open debate on the effects of long-term supplementation through a GFD, because some authors report an unbalance in microbial taxa composition. Methods: For microbiome analysis, fecal specimens were collected from 46 CD individuals in GFD for at least 2 years and 30 specimens from the healthy controls (HC). Data were analyzed using an ensemble of software packages: QIIME2, Coda-lasso, Clr-lasso, Selbal, PICRUSt2, ALDEx2, dissimilarity-overlap analysis, and dysbiosis detection tests. Results: The adherence to GFD restored the alpha biodiversity of the gut microbiota in celiac people but microbial composition at beta diversity resulted as different to HC. The microbial composition of the CD subjects was decreased in a number of taxa, namely Bifidobacterium longum and several belonging to Lachnospiraceae family, whereas Bacteroides genus was found to be more abundant. Predicted metabolic pathways among the CD bacterial communities revealed an important role in tetrapyrrole biosynthesis. Conclusions: CD patients in GFD had a non-dysbiotic microbial composition for the crude alpha diversity metrics. We found significant differences in beta diversity, in certain taxon, and pathways between subjects with inactive CD in GFD and controls. Collectively, our data may suggest the development of new GFD products by modulating the gut microbiota through diet, supplements of vitamins, and the addition of specific prebiotics

Glycoprotein Ib activation by thrombin stimulates the energy metabolism in human platelets

<div><p>Thrombin-induced platelet activation requires substantial amounts of ATP. However, the specific contribution of each ATP-generating pathway <i>i</i>.<i>e</i>., oxidative phosphorylation (OxPhos) versus glycolysis and the biochemical mechanisms involved in the thrombin-induced activation of energy metabolism remain unclear. Here we report an integral analysis on the role of both energy pathways in human platelets activated by several agonists, and the signal transducing mechanisms associated with such activation. We found that thrombin, Trap-6, arachidonic acid, collagen, A23187, epinephrine and ADP significantly increased glycolytic flux (3–38 times <i>vs</i>. non-activated platelets) whereas ristocetin was ineffective. OxPhos (33 times) and mitochondrial transmembrane potential (88%) were increased only by thrombin. OxPhos was the main source of ATP in thrombin-activated platelets, whereas in platelets activated by any of the other agonists, glycolysis was the principal ATP supplier. In order to establish the biochemical mechanisms involved in the thrombin-induced OxPhos activation in platelets, several signaling pathways associated with mitochondrial activation were analyzed. Wortmannin and LY294002 (PI3K/Akt pathway inhibitors), ristocetin and heparin (GPIb inhibitors) as well as resveratrol, ATP (calcium-release inhibitors) and PP1 (Tyr-phosphorylation inhibitor) prevented the thrombin-induced platelet activation. These results suggest that thrombin activates OxPhos and glycolysis through GPIb-dependent signaling involving PI3K and Akt activation, calcium mobilization and protein phosphorylation.</p></div

ACYLATED AND UNACYLATED GHRELIN IMPAIR SKELETAL MUSCLE ATROPHY IN MICE.

Cachexia is a wasting syndrome associated with cancer, AIDS, and multiple sclerosis, and several other disease states. It is characterized by weight loss, fatigue, loss of appetite and skeletal muscle atrophy and is associated with poor patient prognosis, making it an important treatment target. Ghrelin is a peptide hormone that stimulates growth hormone (GH) release and positive energy balance through binding to the receptor GHSR-1a. Only acylated ghrelin (AG), but not the unacylated form (UnAG), can bind GHSR-1a; however, UnAG and AG share several GHSR-1aindependent biological activities. Here we investigated whether UnAG and AG could protect against skeletal muscle atrophy in a GHSR-1a-independent manner. We found that both AG and UnAG inhibited dexamethasone-induced skeletal muscle atrophy and atrogene expression through PI3K\u3b2-, mTORC2-, and p38-mediated pathways in myotubes. Up-regulation of circulating UnAG in mice impaired skeletal muscle atrophy induced by either fasting or denervation without stimulating muscle hypertrophy and GHSR-1a-mediated activation of the GH/IGF-1 axis. In Ghsrdeficient mice, both AG and UnAG induced phosphorylation of Akt in skeletal muscle and impaired fasting-induced atrophy. These results demonstrate that AG and UnAG act on a common, unidentified receptor to block skeletal muscle atrophy in a GH-independent manner

Patients&#8217;, physicians&#8217;, nurses&#8217;, and pharmacists&#8217; preferences on the characteristics of biologic agents used in the treatment of rheumatic diseases

Objective: To estimate preferences in relevant treatment characteristics evaluated by different groups involved in the management of patients with rheumatic diseases. Subjects and methods: We surveyed patients with rheumatic diseases, and rheumatologists, nurses, and pharmacists with experience in treatment with/provision of biologic drugs for these patients. Through a discrete choice experiment, participants evaluated 16 possible scenarios in which pairs of similarly efficacious treatments were described with six characteristics: 1) frequency of administration; 2) mode and place of administration; 3) manner, helpfulness, efficiency, and courtesy of health personnel; 4) frequency of reactions at the site of drug administration; 5) severity of generalized undesired/allergic reactions; and 6) additional cost. The direction and strength of preferences toward each characteristic level and the relative importance of each characteristic were estimated through a random-effects conditional logistic regression model. Results: In total, 513 patients, 110 rheumatologists, 51 nurses, and 46 pharmacists from 30 centers in Italy participated. Characteristics 3, 4, and 6 were the most important for every subgroup; 1 was least important for patients and rheumatologists, 2 was least important for pharmacists, and 2 and 5 were least important for nurses. For characteristic 2, pharmacists preferred subcutaneous self-injection with a syringe; nurses preferred assisted infusion at an infusion center close to the patient\u2019s home; patients and rheumatologists preferred subcutaneous self-injection with a pen. Conclusion: The different preferences for some characteristics shown by the different groups can play an important role, together with purely clinical aspects, in the choice and consequent benefit of treatments, contributing also to a more satisfactory use of resources

MIGHTEE-H I: the MH I – M* relation over the last billion years

We study the MHI−M⋆ relation over the last billion years using the MIGHTEE-H i sample. We first model the upper envelope of the MHI−M⋆ relation with a Bayesian technique applied to a total number of 249 H i-selected galaxies, without binning the datasets, while taking account of the intrinsic scatter. We fit the envelope with both linear and non-linear models, and find that the non-linear model is preferred over the linear one with a measured transition stellar mass of log10 (M⋆M⊙) = 9.15±0.87, beyond which the slope flattens. This finding supports the view that the lack of H i gas is ultimately responsible for the decreasing star formation rate observed in the massive main-sequence galaxies. For spirals alone, which are biased towards the massive galaxies in our sample, the slope beyond the transition mass is shallower than for the full sample, indicative of distinct gas processes ongoing for the spirals/high-mass galaxies from other types with lower stellar masses. We then create mock catalogues for the MIGHTEE-H i detections and non-detections with two main galaxy populations of late- and early-type galaxies to measure the underlying MHI−M⋆ relation. We find that the turnover in this relation persists whether considering the two galaxy populations as a whole or separately. We note that an underlying linear relation could mimic this turnover in the observed scaling relation, but a model with a turnover is strongly preferred. Measurements on the logarithmic average of H i masses against the stellar mass are provided as a benchmark for future studies