Tapahtuman Herra : Kristuksen läsnäolo ehtoollisessa Euroopan protestanttisten kirkkojen yhteisön Zur Lehre und Praxis des Abendmahls -asiakirjassa

Vuosina 1989 1993 Euroopan protestanttisten kirkkojen yhteisö (EPKY) jatkoi sisäistä ehtoollisteologista keskusteluaan. Tämän keskustelun tuloksena syntyi asiakirja Zur Lehre und Praxis des Abendmahls (ZLPA), joka hyväksyttiin kirkkoyhteisön yleiskokouksessa Wienissä vuonna 1994. Asiakirja on viimeisin ehtoollista käsittelevä teksti EPKY:ltä. Tämän pro gradu -tutkielman tavoitteena on selvittää asiakirjan käsitys Kristuksen läsnäolon tavasta ehtoollisessa. Tehtävän toteuttamiseksi tutkielma tarkastelee ZLPA:n teologisia taustoja valmisteluasiakirjojen valossa ja tarkastelee asiakirjaa lyhyesti myös suhteessa viimeisimpään ekumeeniseen luterilais-reformoituun keskusteluun ehtoollisesta. Valmisteluasiakirjoissa hajonta ehtoollista koskevissa käsityksissä näkyy etenkin liturgisissa seikoissa. Luterilaisten esitelmissä on piirteitä, jotka viestivät käsitystä Kristuksen ruumiillisesta läsnäolosta ehtoollisessa sekä asetussanojen ymmärtämistä konsekraationa. Reformoitujen kirkkojen liturgiaa kuvaavissa esitelmissä asetussanat eivät saa vastaavaa painotusta. Tarkasteltaessa ZLPA:n käsitystä Kristuksen läsnäolosta kolmen eri osa-alueen (Kristuksen ruumiin ja leivän suhde, manducatio impiorum ja liturgian ja käytännön ohjeet) kautta näyttää siltä, ettei ZLPA tue käsitystä Kristuksen ruumiillisesta läsnäolosta leivässä ja viinissä, joskaan se ei sitä suoraan torju. Kristuksen läsnäolo sijoitetaan sen sijaan ehtoollisen tapahtumaan. Leuenbergin konkordian kristologiasta käsin ilmenee, että Kristus on kuitenkin kokonaisena ylösnousseena vapahtajana läsnä Pyhän Hengen kautta. Asiakirjan sisäinen logiikka näyttäisi siten tukevan käsitystä, jonka mukaan Kristus on koko persoonansa puolesta läsnä ehtoollisen tapahtumassa, mutta ei kuitenkaan ruumiillisesti. ZLPA näyttäytyy Arnoldshainin ehtoollisteesejä eksplikoivana asiakirjana. Samalla se ei kuitenkaan yhtä eksplisiittisesti kiellä konsekraatioteologiaa tai substanssiajattelua kuin Arnoldshainin teesit. Näin ollen on mahdollista tulkita ZLPA:n toisaalta jättävän tilaa luterilaiselle käsitykselle Kristuksen ruumiillisesta läsnäolosta ehtoollisaineissa, joskin asiakirjan sisäisen logiikan näkökulmasta luterilaista tulkintaa on vaikea sovittaa yhteen sen kanssa. Kaikki tulokset yhteen kerättynä näyttää siltä, että on mahdollista piirtää selkeä kaari valmisteluasiakirjoista lopulliseen Zur Lehre und Praxis des Abendmahls -asiakirjaan Kristuksen läsnäolon osalta. Aktualismi ja personalismi näkyvät lopullisessa asiakirjassa. Vaikka ZLPA:ssa ei oteta avoimen kielteistä kantaa Kristuksen ruumiilliseen läsnäoloon elementeissä, asiakirjan sisäinen logiikka sisältää paljon samaa ajattelua kuin joissakin valmisteluasiakirjoissa. Asiakirjassa eivät näy ne luterilaiset Kristuksen läsnäoloon ja liturgiaan liittyvät painotukset, jotka ovat läsnä valmisteluasiakirjoissa. Niiden sijasta liturgisissa seikoissa tuodaan esille vain minimaalinen yksimielisyys siitä, mikä on välttämätöntä ja toisaalta, mikä on protestanttisesta konsensuksesta käsin hyväksyttävissä. Tämä minimikonsensusajattelu näkyy halki asiakirjan ja se palautuu käsitykseen Kristuksesta, joka on läsnä ehtoollistapahtumassa seurakunnan Herrana

STAT6 and STAT1 Pathway Activation in Circulating Lymphocytes and Monocytes as Predictor of Treatment Response in Rheumatoid Arthritis

Objective To find novel predictors of treatment response to disease-modifying antirheumatic drugs (DMARDs), we studied activation of STAT (signal transducers and activators of transcription) 6 and 1 in circulating leukocytes of patients with rheumatoid arthritis (RA). Methods 19 patients with untreated recent-onset RA, 16 patients with chronic RA irresponsive to synthetic DMARDs and 37 healthy volunteers provided blood samples for whole blood flow cytometric determination of intracellular STAT6 and STAT1 phosphorylation, expressed as relative fluorescence units, in response to IL-4 and IFN-gamma, respectively. Phosphorylation was restudied and treatment response (according to European League Against Rheumatism) determined after 1-year treatment with synthetic DMARDs in recent-onset RA and with biological DMARD in synthetic DMARD-irresponsive RA. Estimation-based exact logistic regression was used to investigate relation of baseline variables to treatment response. 95% confidence intervals of means were estimated by bias-corrected bootstrapping and the significance between baseline and follow-up values was calculated by permutation test. Results At baseline, levels of phosphorylated STAT6 (pSTAT6) induced by IL-4 in monocytes were higher in those who achieved good treatment response to synthetic DMARDs than in those who did not among patients with untreated RA (OR 2.74, 95% CI 1.05 to 9.47), and IFN-gamma-stimulated lymphocyte pSTAT1 levels were higher in those who achieved good treatment response to a biological drug than in those who did not among patients with chronic RA (OR 3.91, 95% CI 1.12 to 20.68). During follow-up, in recent-onset RA patients with good treatment response to synthetic DMARDS, the lymphocyte pSTAT6 levels decreased (p = 0.011), and, consequently, the ratio of pSTAT1/pSTAT6 in lymphocytes increased (p = 0.042). Conclusion Cytokine-stimulated STAT6 and STAT1 phosphorylation in circulating leukocytes was associated with treatment response to DMARDs in this pilot study. The result, if confirmed in larger studies, may aid in developing personalized medicine in RA.Peer reviewe

Autumn cold acclimation of shoots does not explain the northern distribution limit of three southern exotic tree species in Finland

Frost hardiness (FH) is one of the key traits that limits the distribution of tree species in the north. Different species and ecotypes respond differently to the drivers of frost hardening and may therefore have different survival capacities, especially in their northern distribution range. Several southern tree species such as pedunculate oak (Quercus robur L.), Norway maple (Acer platanoides L.), and mountain elm (Ulmus glabra Hudson) have their natural northern distribution limit in Southern Finland. Here, we examined whether insufficient frost hardening in the autumn limits the northwards distribution of these three species. To that end, we monitored phenological events and frost hardening in the autumn in these exotic species in Central Finland, further north from the natural distribution range of the three exotic species, and for the sake of comparison, in the native silver birch (Betula pendula Roth.). In all species, a timely growth cessation was observed. The water content of the stem decreased, and its dry mass content increased rapidly in August before the onset of frost hardening, after which no major changes were observed in these two traits. In the early phase of hardening, there were differences in leaf colouring between the four species. The values of the electrical impedance parameters of the stem changed during frost hardening, with a clear turning point after the first night frosts at the end of September. Depending on the species and hardening phase, the high temperature exotherm (HTE) of the stem was observed between -3 °C and -10 °C, but HTE did not indicate differences between the species in frost hardening. In all four species, frost hardening started at the beginning of September and proceeded first at equal rates, but the hardening was more rapid later in birch than in the other species. The damaging temperature range assessed by the controlled freezing tests became wider with increasing FH. The occurrence rate of the low temperature exotherm (LTE) varied between the species, and the LTE was observed at around -35 °C in the last sampling at the beginning of December (no LTE was observed in birch). We conclude that the hardening of all four species took place in a timely manner so that in each, the frost hardiness was sufficient to survive the autumn frosts at the experimental site in Central Finland. Further studies are needed to examine whether the exotic three species also tolerate temporarily occurring extreme winter conditions such as temperatures below -35 °C, and the high short-term temperature variations in winter and especially in spring.202

Inflammation and immunosuppression in severe acute pancreatitis

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Activated Protein C Does Not Alleviate the Course of Systemic Inflammation in the APCAP Trial

The study aimed to determine the effect of the activated protein C on the course of systemic inflammation in the APCAP (activated protein C in acute pancreatitis) trial where we randomized 32 patients with severe acute pancreatitis to receive either recombinant activated protein C (drotrecogin alfa activated) (n = 16) or placebo (n = 16) for 96 hours. In the present study, we present the time course of the patients' plasma or serum levels of soluble markers (IL-8, IL-6, IL-10, IL-1ra, sE-selectin, PCT) and monocyte and neutrophil cell surface (CD11b, CD14, CD62L, HLA-DR) markers of systemic inflammatory response during the first 14 days after the randomization. The results of the intervention and placebo groups were comparable showing that recombinant APC treatment did not alter the course of systemic inflammation in severe acute pancreatitis. Our finding is in accordance with the clinical findings in the APCAP trial indicating that the intervention did not affect evolution of multiple organ dysfunctions

Circulating nucleosomes as predictive markers of severe acute pancreatitis

Abstract Background The components of nucleosomes, which contain DNA and histones, are released into the circulation from damaged cells and can promote inflammation. We studied whether the on-admission levels of circulating nucleosomes predict the development of severe acute pancreatitis (AP), in particular among the patients who present without clinical signs of organ dysfunction. Methods This is a prospective study of 74 AP patients admitted to Helsinki University Hospital from 2003 to 2007. Twenty-three patients had mild, 27 moderately severe, and 24 severe AP as defined by the revised Atlanta criteria. 14/24 severe AP patients had no sign of organ dysfunction on admission (modified marshall score <2). Blood samples were obtained on admission and the plasma levels of nucleosomes were measured using enzyme-linked immunosorbent assay. Results The on-admission levels of nucleosomes were significantly higher in severe AP than in mild or moderately severe AP (p < 0.001 for all), higher in non-survivors (n = 8) than in survivors (p = 0.019), and correlated with the on-admission levels of C-reactive protein (p < 0.001) and creatinine (p < 0.001). Among the AP patients who presented without organ dysfunction, the on-admission nucleosome level was an independent predictor of severe AP (p = 0.038, gender-adjusted forward-stepping logistic regression). Conclusions Circulating nucleosome levels may be helpful in identifying, on admission to hospital, the AP patients who present without clinical signs of organ dysfunction, and, yet, are bound to develop organ dysfunction during hospitalization

Circulating cytokines in predicting development of severe acute pancreatitis

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Constitutive STAT3 Phosphorylation in Circulating CD4(+) T Lymphocytes Associates with Disease Activity and Treatment Response in Recent-Onset Rheumatoid Arthritis

The aim of the present study was to examine constitutive signal transducer and activator of transcription 3 (STAT3) phosphorylation in circulating leukocytes as a candidate biomarker in rheumatoid arthritis (RA). 25 patients with recent-onset, untreated RA provided samples for whole blood flow cytometric determination of intracellular STAT3 phosphorylation, expressed as relative fluorescence units. The occurrence of constitutive STAT3 phosphorylation was evaluated by determining proportion of STAT3-phosphorylated cells among different leukocyte subtypes. Plasma levels of interleukin (IL)-6, IL-17 and IL-21 were measured by immunoassay, radiographs of hands and feet were examined and disease activity score (DAS28) was determined. Biomarkers were restudied and treatment response (according to European League Against Rheumatism) was determined after 12 months of treatment with disease-modifying antirheumatic drugs. At baseline, constitutive phosphorylation of STAT3 occurred in CD4(+) T cells of 14 (56%) patients, CD8(+) T cells of 13 (52%) patients, in CD19+ B cells of 7 (28%) patients, and in CD14(+) monocytes of 12 (48%) patients. STAT3 phosphorylation levels of CD4(+) T cells associated with DAS28, and those of all leukocyte subtypes studied associated with erosive disease. The presence of constitutive STAT3 phosphorylation in CD4(+) T lymphocytes, pSTAT3 fluorescence intensity of CD4(+) and CD8(+) T cells and C-reactive protein (CRP) levels at baseline associated with good treatment response. In conclusion, constitutive STAT3 phosphorylation in circulating CD4(+) T cells is common in recent-onset untreated RA and associates with good treatment response in patients characterized by high disease activity and the presence of systemic inflammation.Peer reviewe