Vitamin E–loaded dialyzer resets PBMC-operated cytokine network in dialysis patients

Vitamin E–loaded dialyzer resets PBMC-operated cytokine network in dialysis patients.BackgroundIn hemodialysis patients the activity of stimulated Th1 lymphocytes is depressed, while Th2 cells are constitutively primed. Such phenomena may depend on monocyte activation and altered release of interleukin (IL)-12 and IL-18, which regulate Th cell differentiation. Reactive oxygen species (ROS) activate monocytes; therefore, a hemodialyzer with antioxidant activity would contrast ROS, prevent monocyte activation, reset IL-12 and IL-18 release, and restore Th1/Th2 balance.MethodsTen patients on regular dialysis treatment (RDT) with cellulosic membrane (CM) were shifted to vitamin E–coated dialyzer (VE). During treatment with CM and after 3, 6, and 12months of treatment with VE, peripheral blood mononuclear cells (PBMC) and purified CD4+ cells were isolated, and cultured, resting, mitogen-stimulated, and interferon γ (IFNγ), IL-4, IL-10, IL-12, and IL-18 release was measured. Vitamin E and A plasma levels and the effects of a single dialysis session on peripheral blood NO levels were assayed.ResultsThe constitutive release of IL-4 and IL-10 by CD4+ cells was abated significantly by treatment with VE (nadir -77.8% and -55.3%, respectively, at 12months). INFγ release by mitogen-stimulated CD4+ recovered with VE (zenith +501% at 12months). PBMC constitutive production of IL-12 and IL-18 was significantly reduced by VE (nadir at 12months -64.7% and -51.3%, respectively). VE increased plasma levels of vitamins E and A. NO plasma levels fell after a single dialysis treatment with VE (-17%, P < 0.05) in contrast with CU (+27.1%, P < 0.05).ConclusionThe network of cytokines released by monocytes and Th cells is reset toward normality by treatment with vitamin E–coated dialyzer

The association between lifelong personality and clinical phenotype in the FTD-ALS spectrum

Introduction: Frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) are two phenotypes of the same neurodegenerative disease, the FTD-ALS spectrum. What determines the development of one rather than the other phenotype is still unknown. Based on the clinical observation that patients' personality seems to differ between the two phenotypes, i.e., ALS patients tend to display kind, prosocial behaviors whereas FTD patients tend to present anti-social behaviors, and that these traits are often reported as pre-existing the disease onset by caregivers, we set up to study experimentally patients' personality in their premorbid life.Methods: We first tested for differences between groups, then tested the association between premorbid personality and current functional organization of the brain. Premorbid personality of a cohort of forty patients, 27 FTD and 13 ALS, was explored through the NEO Personality Inventory 3 (NEO-PI-3), which analyses the five main personality factors, completed by the caregiver with reference to patient's personality 20 years before symptoms onset (premorbid). A subgroup of patients underwent a brain MRI including structural and resting-state functional MRI (rsfMRI).Results: A significant difference between FTD and ALS in premorbid personality emerged in the Openness (133.92 FTD vs. 149.84 ALS, p = 0.01) and Extraversion (136.55 FTD vs. 150.53 ALS, p = 0.04) factors. This suggests that ALS patients had been, in their premorbid life, more open to new experiences, more sociable and optimistic than FTD patients. They also showed greater functional connectivity than both FTD and a control group in the Salience resting state network, over and above differences in gray matter atrophy. Finally, there was a positive correlation between premorbid Openness and functional connectivity in the Salience network across all patients, suggesting a possible association between premorbid personality and current functional organization of the brain, irrespective of the degree of atrophy.Discussion: Our proof-of-concept results suggest that premorbid personality may eventually predispose to the development of one, rather than the other, phenotype in the FTD-ALS spectrum

Eficácia de Dietas Específicas no Manejo da Síndrome do Intestino Irritável

Irritable Bowel Syndrome (IBS) is a common gastrointestinal condition that significantly impacts patients' quality of life. This systematic review aims to evaluate the effectiveness of specific diets in managing IBS, focusing on diets such as low FODMAP, exclusive enteral nutrition, and gut microbiota modulation strategies. Studies published between 2010 and 2023, sourced from databases like PubMed, Scopus, Web of Science, and Cochrane Library, were reviewed. The results indicate that the low FODMAP diet is particularly effective in reducing IBS symptoms, while other interventions, such as enteral nutrition and fecal microbiota transplantation, also show promising benefits. Personalized diets and continuous nutritional guidance are essential to maximize therapeutic benefits. The review highlights the importance of personalized dietary approaches and suggests directions for future research.A síndrome do intestino irritável (SII) é uma condição gastrointestinal comum que afeta significativamente a qualidade de vida dos pacientes. Esta revisão sistemática visa avaliar a eficácia de dietas específicas no manejo da SII, com foco em dietas como a baixa em FODMAPs, nutrição enteral exclusiva e estratégias de modulação da microbiota intestinal. Foram revisados estudos publicados entre 2010 e 2023, extraídos de bases de dados como PubMed, Scopus, Web of Science e Cochrane Library. Os resultados indicam que a dieta baixa em FODMAPs é particularmente eficaz na redução dos sintomas da SII, enquanto outras intervenções, como a nutrição enteral e o transplante de microbiota fecal, também mostram benefícios promissores. A personalização das dietas e a orientação nutricional contínua são essenciais para maximizar os benefícios terapêuticos. A revisão destaca a importância de abordagens dietéticas personalizadas e sugere direções para pesquisas futuras

Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospectiveItalian P-RHEUM.it study

Objectives To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. Methods Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database. Results We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. Conclusions Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures

Comparison of the transcriptional response to T₁AM with the known genomic effects of thyroid hormone, Insulin and Cortisol (up-regulated = ↑, down-regulated = ↓, not regulated or no data available = -).

<p>Comparison of the transcriptional response to T₁AM with the known genomic effects of thyroid hormone, Insulin and Cortisol (up-regulated  = ↑, down-regulated  = ↓, not regulated or no data available  =  -).</p

Differentially expressed genes in the subcutaneous adipose tissue annotated by <i>Onto-Express</i>, <i>GeneCards</i> and <i>COREMINE</i>.

<p>Differentially expressed genes in the subcutaneous adipose tissue annotated by <i>Onto-Express</i>, <i>GeneCards</i> and <i>COREMINE</i>.</p

Changes in gene expression evidenced by microarrays were confirmed by RT-qPCR for four of the five genes tested in the subcutaneus adipose tissue (the differential expression of Cebpb was not statistically significant) and for all the seven genes tested in the liver.

<p>Data reported as: log2 fold-change ± SE; *: p≤0.05.</p