Distribution patterns of organic pollutants and microbial processes in marine sediments across a gradient of anthropogenic impact.

Marine sediments are part of the hydrological cycle and the ultimate storage compartment of land-derived organic matter, including pollutants. Since relevant microbially-driven processes occurring at benthic level may affect the quality of the overall aquatic system, the necessity for incorporating information about microbial communities functioning for ecosystem modelling is arising. The aim of this field study was to explore the links occurring between sediment contamination patterns by three selected class of organic pollutants (Polycyclic Aromatic Hydrocarbons, PAHs, Nonylphenols, NPs, Bisphenol A, BPA) and major microbial properties (Prokaryotic Biomass, PB; total living biomass, C-ATP; Prokaryotic C Production rate, PCP; Community Respiration rate, CR) across a gradient of anthropogenic pollution. Sediments were sampled from 34 sites selected along 700 km of the western coastline of the Adriatic Sea. Organic contamination was moderate (PAHs <830 ng g-1; NPs <350  ng g-1; BPA <38  ng g-1) and decreased southward. The amount of PAHs-associated carbon (C-PAHs) increased significantly with sediment organic carbon (OC), along with microbial functional rates. The negative relation between PCP/CR ratio and OC indicated the shift toward oxidative processes in response to organic pollution and potential toxicity, estimated as Toxic Equivalents (TEQs). Our outcomes showed that sediment organic contamination and benthic microbial processes can be intimately linked, with potential repercussions on CO2 emission rates and C-cycling within the detritus-based trophic web.

Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study.

OBJECTIVE: To compare the effectiveness and toxicity of cyclosporin A (CsA) vs low-dose methotrexate (MTX) over a period of one year in the treatment of psoriatic arthritis (PsA) with peripheral involvement. METHODS: Thirty-five patients with PsA were enrolled in a prospective, controlled, randomized trial. CsA was initially given in doses of 3 mg/kg/day to a maximum permitted dose of 5 mg/kg/day; MTX was given in oral doses of 2.5 mg every 12 hours for 3 consecutive doses each week up to a maximum dose of 15 mg/weekly. Clinical and laboratory evaluations were performed at entry and monthly thereafter. RESULTS: After 6 and 12 months the number of painful joints, the number of swollen joints, the Ritchie index, the duration of morning stiffness, grip strength, CRP, the patient's and the physician's assessment of PsA activity, as well as the PASI, were significantly improved in both treatment groups. ESR values were significantly reduced only in the MTX group (p < 0.01), which also showed a significantly increase of liver enzymes. The changes in the main clinical and laboratory parameters during the course of CsA or MTX treatment were not significantly different except for the AST and ALT levels (p < 0.05). After one year of therapy CsA and MTX were withdrawn in 41.2% and 27.8% of the patients respectively, but these differences were not statistically significant. CONCLUSION: Our one-year prospective trial shows that low-dose CsA and MTX are both effective in the treatment of PsA, but the differences in the tolerability of these drugs must be considered at the start of therapy.

Interleukin-6 and soluble interleukin-2-receptor in psoriatic arthritis: correlations with clinical and laboratory parameters.

OBJECTIVE: In this study we evaluated the relationships of IL-6 and sIL-2R levels with the main clinical and laboratory parameters in PsA patients with peripheral polyarthritis. METHODS: Serum levels of IL-6 and sIL-2R were measured by an enzyme immunoassay kit in patients with peripheral (< 4 joints) PsA (n = 47), with RA (n = 41), or with psoriasis (N = 15) and in healthy volunteers (n = 15) RESULTS: The patients with PsA had higher serum levels of IL-6 and sIL-2R than healthy volunteers and psoriatic patients, while they showed lower levels of IL-6 and sIL-2R than RA patients. We found abnormal values for IL-6 and sIL-2R in 63.8% and 57.4% of PsA patients, respectively. IL-6 levels correlated with the number of painful and swollen joints, RAI, physician's assessment, CRP and ESR, while sIL-2R levels correlated only with the number of swollen joints, the physician's assessment and ESR. IL-6 and sIL-2R correlated with each other. CONCLUSION: Our study shows that IL-6 and sIL-2R may play a role in the pathogenetic mechanism of psoriatic arthritis.

Life-table analysis of cyclosporin A treatment in psoriatic arthritis: comparison with other disease-modifying antirheumatic drugs.

OBJECTIVES: The aim of this study was to determine the cumulative probability of taking CsA in comparison to other DMARDs, as well as the reason for discontinuation of each DMARD, in a large cohort of PsA patients. METHODS: We prospectively studied 172 consecutive patients with a diagnosis of PsA who had been admitted to our rheumatological unit since 1984. We collected information about treatment with DMARDs including: number, dose, duration and causes of withdrawal, including side effects or inefficacy. Cumulative survival analysis was performed by the Kaplan-Meier test and the differences between these survival curves were determined by the Mantel-Hanszel test. RESULTS: The probability curve of continuing to take CsA was significantly lower than that of MTX (p < 0.046). The rate of adverse effects responsible for stopping DMARD therapy was higher in the CsA group, especially with respect to the antimalarial group (p < 0.014). The most common cause of CsA withdrawal was hypertension. The rate of withdrawal due to inefficacy in the CsA group was not significantly different from those observed in the other groups. Nevertheless, the total frequency of discontinuation due to toxicity and inefficacy in the MTX group was significantly lower compared to the gold salts (p < 0.05) and CsA groups (p < 0.01). CONCLUSION: Life-table analysis suggests that PsA patients taking CsA are less likely than patients on MTX to continue long term treatment. Therefore CsA, which seems to be less safe than the antimalarials, could be considered a useful drug in the treatment of PsA, but does seem to represent the drug of first choice, particularly when compared to MTX.

Effects of cyclosporin on joint damage in rheumatoid arthritis. The Italian Rheumatologists Study Group on Rheumatoid Arthritis.

According to the most recent literature, few antirheumatic drugs can claim disease-controlling properties over the anatomical joint damage in rheumatoid arthritis (RA). A small number of studies have favored one or another of the available agents, in particular parenteral gold salts, sulphasalazine and methotrexate, but the evidence regarding their efficacy is not convincing when analysed using methodological criteria known to be important in evaluating radiologic evidence of joint damage. The radiologic results in long-standing RA patients have shown that CsA may be of benefit in reducing disease progression. Data from the second year of a clinical trial designed to compare the disease-controlling, anti-rheumatic properties of CsA with those of conventional disease-modifying anti-rheumatic drugs (DMARDs) in early RA support the hypothesis that CsA may be useful in delaying the appearance of new joint erosion.

Lupus erythematosus panniculitis: an immunohistochemical study.

An immunohistochemical study on a case of lupus erythematosus panniculitis (LEP), without discoid lupus erythematosus (DLE) or systemic lupus erythematosus (SLE) signs, showed that the cells in skin infiltrates were immunologically committed lymphocytes (OKT4, OKT8, OKT11 and HLA-DR positive cells) and elements of the monocyte-macrophage lineage (Leu M3 and Leu M5 positive). No immunophenotypically identifiable B-lymphocytes were seen. Immunofluorescent IgG, IgM, C3 and C4 deposits were found in blood vessel walls of the deep dermis. These findings, similar to that described in the skin changes of SLE and DLE, suggest that immunological mechanisms are operative in localized LEP, where the dermal lesions are the only expression of the disease.

One year treatment with low dose methotrexate in rheumatoid arthritis: effect on class specific rheumatoid factors.

We evaluated the effect of a one-year treatment of low dose methotrexate (MTX) on class specific rheumatoid factors in 27 patients with rheumatoid arthritis (RA). Enzyme-linked immunosorbent assay (ELISA) showed after 6 and 12 months a significant reduction of IgM-RF, IgA-RF and IgG-RF levels from the baseline values. During MTX treatment, changes of each RF isotype were not correlated with any other isotype and its corresponding immunoglobulin changes. Moreover, immunological changes were not related to the improvement of clinical parameters. Our results showed that low dose MTX can specifically affect levels of RF isotypes, which are involved in the immune pathogenesis of RA.

Avascular necrosis of the femoral head in long-term follow-up of systemic sclerosis: report of two cases.

A long-term follow-up of two patients with scleroderma (SS) who developed a polyarthritis with bilateral femoral head osteonecrosis is reported. The severe parallel evolution of the small and large joint lesions and the late appearance of osteonecrotic changes in our patients suggest that avascular osteonecrosis is related to the osteoarticular progression of the longstanding SS.

Long-term follow-up of low-dose methotrexate therapy in one case of idiopathic retroperitoneal fibrosis.

Idiopathic retroperitoneal fibrosis (RPF) is characterized by the development of a fibrotic mass surrounding the abdominal aorta and its branches, of unknown aetiology. Several immunological mechanisms can be operative in the pathogenesis of RPF. Based on this assumption we treated a patient affected by idiopathic RPF with low-dose methotrexate (MTX) therapy. To our knowledge this is the first example of the effectiveness and safety of a long-term low-dose MTX treatment in the post-surgical management of RPF.

Rheumatoid nodules and cyclosporin A treatment.

The authors describe the appearance of rheumatoid nodules during cyclosporin A (CsA) therapy for RA. Their course was evaluated by sonography that revealed an increase in number and size of rheumatoid nodules. The relationship between CsA treatment and the onset of nodulosis is not clear and further studies are needed to assess the role of CsA treatment in the extra-articular manifestations of rheumatoid arthritis such as rheumatoid nodules.

[Immunohistochemical analysis of the expression of main adhesion molecules and tumor necrosis factors in the synovial membrane of psoriatic arthritis]. / Analisi immunoistochimica dell'espressione delle principali molecole di adesione e dei fattori di necrosi tumorale a livello della membrana sinoviale nell'artrite psoriasica.

OBJECTIVE: To define the expression and pattern of the synovial distribution of adhesion molecules such as E-selectin, ICAM-1 and VCAM-1 and of TNFalpha and TNFbeta cytokines in psoriatic arthritis (PsA), according to the synovitis duration. METHODS: Cryostatic sections of the synovial membrane tissue samples were stained for the different antibodies using a standard three-stage-immunoperoxidase-labeling technique. RESULTS: E-selectin grade of staining was higher in those patients with a shorter disease duration compared to longstanding synovitic specimens, as well as ICAM-1 expression. On the contrary a higher VCAM-1 positivity was mainly found in longstanding PsA patients. Anti-TNFalpha positivity was found almost in all the specimens with no difference among the two groups, while the intensity of anti-TNFbeta positivity was globally higher in longstanding cases. CONCLUSIONS: Different adhesion molecules may separately participate to the synovitic process in the different phases of PsA, leading to the hypothesis of their different involvement during the disease evolution. Moreover the upregulation of TNFalpha and TNFbeta gives evidence to their local proinflammatory effect within the synovium and to their role in perpetuating the PsA synovitis.

Groundwater geochemistry and microbial community structure in the aquifer transition from volcanic to alluvial areas.

Groundwaters may act as sinks or sources of organic and inorganic solutes, depending on the relative magnitude of biochemical mobilizing processes and groundwater-surface water exchanges. The objective of this study was to link the lithological and hydrogeological gradients to the aquatic microbial community structure in the transition from aquifer recharge (volcanic formations) to discharge areas (alluvial deposits). A field-scale analysis was performed along a water table aquifer in which volcanic products decreased in thickness and areal extension, while alluvial deposits became increasingly important. We measured the main groundwater physical parameters and the concentrations of major and trace elements. In addition, the microbial community structure was assessed by estimating the occurrence of total coliforms and Escherichia coli, the prokaryotic abundance, the cytometric and phylogenetic community composition. The overall biogeochemical asset differed along the aquifer flow path. The concentration of total and live prokaryotic cells significantly increased in alluvial waters, together with the percentages of Beta- and Delta-Proteobacteria. The microbial propagation over a theoretical groundwater travel time allowed for the identification of microbial groups shifting significantly in the transition between the two different hydrogeochemical facies. The microbial community structure was intimately associated with geochemical changes, thus it should be further considered in view of a better understanding of groundwater ecology and sustainable management strategies.