Graves' disease TSHR-stimulating antibodies (TSAbs) induce the activation of immature thymocytes: a clue to the riddle of TSAbs generation?

Graves' disease (GD) is an autoimmune thyroid disease defined by the production of stimulating autoantibodies to the thyroid-stimulating hormone receptor (TSHR) (TSAbs) that induce a sustained state of hyperthyroidism in patients. We previously demonstrated that TSHR, the target of this autoimmune response, is also a key susceptibility gene for GD, probably acting through thymic-dependent central tolerance. We also showed that TSHR is, unexpectedly, expressed in thymocytes. In this report, we confirm the expression of TSHR in thymocytes by protein immunoblotting and quantitative PCR, and show that expression is confined to maturing thymocytes. Using functional assays, we show that thymic TSHR is functional and that TSAbs can stimulate thymocytes through this receptor. This new activity of TSAbs on thymocytes may: 1) explain GD-associated thymic enlargement (hyperplasia), and 2) suggest the provocative hypothesis that the continuous stimulation of thymocytes by TSAbs could lead to a vicious cycle of iterative improvement of the affinity and stimulating capability of initially low-affinity antibacterial (e.g., Yersinia) Abs cross-reactive with TSHR, eventually leading to TSAbs. This may help to fill one of the gaps in our present understanding of unusual characteristics of TSAbs.

Lantana camara poisoning in cattle that took refuge during a storm in a forest invaded by this plant.

An outbreak of poisoning by Lantana camara occurred in cattle when a herd sought refuge in a Eucalyptus forest heavily infested by this plant. The animals showed apathy, elevated serum activities of hepatic enzymes, severe photosensitivity, jaundice, hepatomegaly and nephrosis. After a clinical manifestation period of 2-15 days, 74 out of 170 heifers died. The main histological changes were random hepatocellular necrosis, cholestasis, biliary proliferation and, in one animal, centrilobular necrosis. Immunostaining for Caspase 3 detected scattered apoptotic hepatocytes.

Revisiting the Tabanid Fauna (Diptera: Tabanidae) of Uruguay: Notes on the Species of the Genus Tabanus Linnaeus, with the Description of a New Species.

We describe a new species of Tabanus (for Uruguay, the first in more than 90 years) based on females from the Department of Tacuarembó, Uruguay. Tabanus tacuaremboensis sp. n. is the 15th species of the genus Tabanus recorded from Uruguay. The species description is accompanied by illustrations of the diagnostic external and internal characters. In addition, for comparison with the new species, we provide photographs of the regional species of Tabanus whose distributions are still poorly known. In view of the lengthy hiatus since the last new tabanid species was described from Uruguay, we offer a brief discussion of the importance of new and further sampling in areas where the tabanofauna is still poorly known.

Molecular of Anaplasma marginale Theiler (Rickettsiales: Anaplasmataceae) in horseflies (Diptera: Tabanidae) in Uruguay.

Anaplasma marginale is transmitted biologically by infected ticks or mechanically by biting flies and contaminated fomites. In tick-free areas, such as southern Uruguay, horseflies could be the principal vectors of this pathogen for bovines, causing anaplasmosis. The objective of this work was to detect the presence of A. marginale by MSP-5 PCR and Sanger sequencing in the most prevalent species of horseflies obtained using different collection methods in Colonia, Tacuarembó and Paysandú, Uruguay. Eight horsefly species were tested (Dasybasis missionum, Poeciloderas lindneri, Tabanus campestris, T. claripennis, T. fuscofasciatus, T. platensis, T. tacuaremboensis and T. triangulum); four species were found to be positive for A. marginale, with D. missionum and P. lindneri having the most frequent infections, while only one individual each of T. fuscofasciatus and T. tacuaremboensis was positive. Both D. missionum and P. lindneri were positive for A. marginale in tick-free areas, and the implications are discussed in this report.

Analysis of the cumulative changes in Graves' disease thyroid glands points to IFN signature, plasmacytoid DCs and alternatively activated macrophages as chronicity determining factors.

Graves' disease (GD) is a chronic autoimmune process in the thyroid gland and involves IFN and IFN driven immune activation. Assuming the thyroid gland is the main site stimulating the autoimmune response, we investigated the role of IFNs and other factors in the chronic evolution of GD by comparing the transcriptomic profiles of thyroid glands from short clinical course (SC), long clinical course (LC) cases, and control glands (C). Over 200 differentially expressed genes of the immune system were identified. Results were extensively analyzed bioinformatically and validated by qPCR in 31 glands. The analysis indicated that GD involved a progressive accumulation of changes with clearly distinct profiles in the SC and LC glands. Humoral response, antigen presentation and chemokines & cytokines were overall the most represented gene ontology categories in LC cases. Ingenuity Pathway Analysis pointed to a few inflammatory pathways in SC cases whereas LC cases involved numerous complex pathways, such us "communication between innate and adaptive immune cells" and "autoimmune thyroid signaling". A broad IFN signature consisted of the over-expression of 74 and 84 type I and type II IFN responsive genes respectively (overall 96 out of 211, 45%), but many of these genes can also be directly activated through cytoplasmic viral receptors. For the first time, plasmocytoid dendritic cells were identified in GD thyroid, but surprisingly, the main producers of IFN-alpha were cells with a myeloid cell phenotype. In addition, cells with the phenotype of alternatively activated macrophages were detected in abundance in GD thyroids, confirming data from the transcriptomic analysis. Collectively, these results confirmed the role of IFNs, suggested other natural immunity triggers, identified new cell types in the local disease process, and expanded our knowledge of the processes that may determine the chronicity of GD.

Diversity and seasonality of horse flies (Diptera: Tabanidae) in Uruguay.

Horse flies (Diptera: Tabanidae) cause direct and indirect losses in livestock production and are important vectors of pathogens. The aim of this study was to determine the diversity and seasonality of horse fly species at an experimental farm in Tacuarembó and the diversity of species in different departments of Uruguay. For 20 months, systematic collections were performed in two different environments at the experimental farm using Nzi and Malaise traps. In addition, nonsystematic collections were performed at farms located in the departments of Paysandú, Tacuarembó and Colonia. A total of 3,666 horse flies were collected, and 16 species were identified. These species included three species that had not been previously recorded in Uruguay, namely, Dasybasis ornatissima (Brèthes), Dasybasis missionum (Macquart), and Tabanus aff. platensis Brèthes, and a species that had not been previously taxonomically described (Tabanus sp.1). Among the systematically captured samples, the most abundant species were Tabanus campestris Brèthes, T. aff. platensis and D. missionum, representing 77.6% of the collected specimens. The horse fly season in Tacuarembó started in September and ended in May. No horse flies were caught during winter. Variations in the prevalences of species in the different departments were observed, which indicates the need for new sampling efforts.

Hemorrhagic diathesis in cattle due to consumption of Adiantopsis chlorophylla (Swartz) Fée (Pteridaceae).

An outbreak of acute febrile syndrome associated with coagulopathy and severe pancytopenia occurred in cattle grazing in paddocks with high infestation by Adiantopsis chlorophylla. The administration of the plant to a calf reproduced the same signs and lesions seen in spontaneous cases. Similar syndromes are caused by ptaquiloside from bracken fern. Traces of the ptaquiloside-like molecule caudatoside were detected together with 0.03-0.24 mg/g of it's degradation product pterosin A, in dry fronds of the plant. In conclusion, A. chlorophylla is a cause of hemorrhagic diathesis in cattle.

Diagnosis and treatment of thyroid nodules in Spain. Results of a national survey. / Diagnóstico y tratamiento del nódulo tiroideo en España. Resultados de una encuesta nacional.

INTRODUCTION: Thyroid nodule (TN) is a common reason for consultation in daily practice. The purpose of this study was to evaluate the diagnosis and treatment of TNs in our environment and to assess the current status regarding the existence and structure of high-resolution TN clinics. MATERIAL AND METHODS: Members of the Spanish Society of Endocrinology and Nutrition were invited in 2018 to participate in an online survey on the diagnostic and therapeutic processes of TN. RESULTS: A total of 211 valid surveys were received. Of all respondents, 30.8% stated that there were high-resolution TN clinics in their environment, with the endocrinologist being the main person responsible for performing ultrasonography (87.7%) and fine needle aspiration (FNA) (69.2%). For ultrasound classification of TNs, 32.7% used the ATA criteria, 32.2% the TI-RADS criteria, and 22.7% no classification. In situ verification of sample suitability was performed in 35.5% of the cases, and molecular analysis in 8.1%. With regard to clinical discharge, 65.4% would consider it after 5 years of follow-up and with a benign FNA. In the event of a Bethesda III result, 50.2% of respondents would repeat FNA and 35.5% would opt for surgery; if a Bethesda IV result was found, 95.8% would opt for surgery. CONCLUSIONS: High-resolution TN clinics are structures increasingly implemented in our environment where the endocrinologist is the main person responsible for performing ultrasonography and FNA. The standard clinical practice in our specialty is consistent with most recommendations concerning clinical practice guidelines for TNs.

Poorer Quality of Life and Treatment Satisfaction is Associated with Diabetic Retinopathy in Patients with Type 1 Diabetes without Other Advanced Late Complications.

Diabetic retinopathy (DR) may potentially cause vision loss and affect the patient's quality of life (QoL) and treatment satisfaction (TS). Using specific tools, we aimed to assess the impact of DR and clinical factors on the QoL and TS in patients with type 1 diabetes. This was a cross-sectional, two-centre study. A sample of 102 patients with DR and 140 non-DR patients were compared. The Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) and Diabetes Treatment Satisfaction Questionnaire (DTSQ-s) were administered. Data analysis included bivariate and multivariable analysis. Patients with DR showed a poorer perception of present QoL (p = 0.039), work life (p = 0.037), dependence (p = 0.010), and had a lower average weighted impact (AWI) score (p = 0.045). The multivariable analysis showed that DR was associated with a lower present QoL (p = 0.040), work life (p = 0.036) and dependence (p = 0.016). With regards to TS, DR was associated with a higher perceived frequency of hypoglycaemia (p = 0.019). In patients with type 1 diabetes, the presence of DR is associated with a poorer perception of their QoL. With regard to TS, these subjects also show a higher perceived frequency of hypoglycaemia.

Regulation of TSHR Expression in the Thyroid and Thymus May Contribute to TSHR Tolerance Failure in Graves' Disease Patients via Two Distinct Mechanisms.

Graves' disease (GD) involves the presence of agonistic auto-antibodies against the thyrotropin receptor (TSHR), which are responsible for the clinical symptoms. While failure of TSHR tolerance is central to GD pathogenesis, the process leading to this failure remains poorly understood. Two mechanisms intimately linked to tolerance have been proposed to explain the association of SNPs located in TSHR intron 1 to GD: (1) differential alternative splicing in the thyroid; and (2) modulation of expression in the thymus. To elucidate the relative contribution to these two mechanisms to GD pathogenesis, we analyzed the level of full-length and ST4 and ST5 isoform expression in the thyroid (n = 49) and thymus (n = 39) glands, and the influence of intron 1-associated SNPs on such expression. The results show that: (1) the level of flTSHR and ST4 expression in the thymus was unexpectedly high (20% that of the thyroid); (2) while flTSHR is the predominant isoform, the levels are similar to ST4 (ratio flTSHR/ST4 = 1.34 in the thyroid and ratio flTSHR/ST4 in the thymus = 1.93); (3) next-generation sequencing confirmed the effect of the TSHR intron 1 polymorphism on TSHR expression in the thymus with a bias of 1.5 ± 0.2 overexpression of the protective allele in the thymus compared to the thyroid; (4) GD-associated intron 1 SNPs did not influence TSHR alternative splicing of ST4 and ST5 in the thyroid and thymus; and (5) three-color confocal imaging showed that TSHR is associated with both thymocytes, macrophages, and dendritic cells in the thymus. Our findings confirm the effect of intron 1 polymorphisms on thymic TSHR expression and we present evidence against an effect on the relative expression of isoforms. The high level of ST4 expression in the thymus and its distribution within the tissue suggest that this would most likely be the isoform that induces central tolerance to TSHR thus omitting most of the hinge and transmembrane portion. The lack of central tolerance to a large portion of TSHR may explain the relatively high frequency of autoimmunity related to TSHR and its clinical consequence, GD.

Implementation of the multi-channel monolith reactor in an optimisation procedure for heterogeneous oxidation catalysts based on genetic algorithms.

A multi-criteria optimisation procedure based on genetic algorithms is carried out in search of advanced heterogeneous catalysts for total oxidation. Simple but flexible software routines have been created to be applied within a search space of more then 150,000 individuals. The general catalyst design includes mono-, bi- and trimetallic compositions assembled out of 49 different metals and depleted on an Al2O3 support in up to nine amount levels. As an efficient tool for high-throughput screening and perfectly matched to the requirements of heterogeneous gas phase catalysis - especially for applications technically run in honeycomb structures - the multi-channel monolith reactor is implemented to evaluate the catalyst performances. Out of a multi-component feed-gas, the conversion rates of carbon monoxide (CO) and a model hydrocarbon (HC) are monitored in parallel. In combination with further restrictions to preparation and pre-treatment a primary screening can be conducted, promising to provide results close to technically applied catalysts. Presented are the resulting performances of the optimisation process for the first catalyst generations and the prospect of its auto-adaptation to specified optimisation goals.

From Barley Straw to Valuable Polyols: A Sustainable Process Using Ethanol/Water Mixtures and Hydrogenolysis over Ruthenium-Tungsten Catalyst.

Organosolv fractionation of barley straw followed by a hydrogenolysis reaction of the resulting organosolv pulp over a heterogeneous catalyst containing ruthenium and tungsten on activated carbon (Ru-W/AC) is a potential pathway to produce valuable chemicals from lignocellulose-based feedstock in a future biorefinery. Polyols, such as ethylene glycol, propylene glycol, or 1,2-butanediol, can be obtained with a very high yield of 70 % using organosolv barley pulp pretreated in a 50:50 wt % ethanol/water solution at 200 °C and a processing time of one hour. Moreover, we investigated the influence of several pretreatment parameters (e.g., solvent/water ratio, reaction temperature, and reaction time) on the pulp composition and product distribution obtained during the hydrogenolysis reaction to reduce the production of undesired side molecules. Finally, the optimal organosolv pretreatment conditions for straw were successfully transferred to other lignocellulose-based feedstock, namely bamboo foliage and hemp shives.

Susceptibility of field populations of Haematobia irritans to fipronil in Uruguay

ABSTRACT: Fipronil was registered in Uruguay in 1997, and, since then, it has been used for the control of Haematobia irritans irritans and Rhipicephalus microplus. The susceptibility of H. irritants to this drug has not been evaluated. Therefore, the goal of the present study was to evaluate the resistance of H. irritans to fipronil. Additionally, a survey was carried out with the farmers to evaluate the use of fipronil for H. irritans control in the ranches where the flies came from. For the bioassays, 31 field populations of H. irritans were exposed to 10 concentrations of fipronil (3.2-16.0g.cm2), and their LC50 values were calculated using probit analysis. A bioassay was performed with horn flies from the susceptible colony maintained at the USDA-ARS Knipling-Bushland U.S. Livestock Insects Research Laboratory for comparison and calculation of resistance ratios (RRs). All 31 field populations surveyed in the study were susceptible to fipronil, with resistance ratios ranging from 0.5 to 2.2. Four populations with RRs >1 did not differ significantly from the susceptible strain. A single population showed an RR >2.2. Overall, the survey shows that fipronil was mostly used for R. microplus control, and in only three ranches, which were free of R. microplus, was fipronil used for horn fly control. Seventeen farmers did not use fipronil at all in the last three years. It is concluded that, in Uruguay, field populations of horn flies remain susceptible to fipronil.

RESUMO: O fipronil foi registrado no Uruguai em 1997 e, desde então, tem sido utilizado no controle de Haematobia irritans irritans e Rhipicephalus microplus. O objetivo do presente estudo foi avaliar a susceptibilidade de populações de campo de H. irritans ao fipronil. Além disso, foi realizada uma pesquisa para avaliar a utilização de fipronil e as práticas de controle de H. irritans nas fazendas de onde provinham as moscas. Para os bioensaios, 31 populações de campo de H. irritans foram expostas a 10 concentrações de fipronil (3,2-16,0g.cm2), e seus valores de CL50 foram calculados usando análise probit. Um bioensaio foi realizado com H. irritans da colônia suscetível mantida no USDA-ARS Knipling-Bushland U.S. Livestock Insects Research Laboratory para comparação e cálculo das razões de resistência (RRs). Todas as 31 populações de campo pesquisadas no estudo eram suscetíveis ao fipronil, com taxas de resistência variando de 0,5 à 2,2. Quatro populações com Rrs >1 não diferiram significativamente da cepa suscetível. Uma única população apresentou RR >2,2. No geral, o fipronil tinha sido usado principalmente para o controle de R. microplus, e em apenas três fazendas, que estavam livres de R. microplus, o fipronil era utilizado para o controle da H. irritans. Em 17 fazendas não tinha sido utilizado fipronil nos últimos três anos. Conclui-se que no Uruguai as populações de H. irritans no campo permanecem suscetíveis ao fipronil.

Susceptibility of field populations of Haematobia irritans to fipronil in Uruguay / Suscetibilidade de populações de campo de Haematobia irritans ao fipronil no Uruguai

Fipronil was registered in Uruguay in 1997, and, since then, it has been used for the control of Haematobia irritans irritans and Rhipicephalus microplus. The susceptibility of H. irritants to this drug has not been evaluated. Therefore, the goal of the present study was to evaluate the resistance of H. irritans to fipronil. Additionally, a survey was carried out with the farmers to evaluate the use of fipronil for H. irritans control in the ranches where the flies came from. For the bioassays, 31 field populations of H. irritans were exposed to 10 concentrations of fipronil (3.2-16.0μg.cm2), and their LC50 values were calculated using probit analysis. A bioassay was performed with horn flies from the susceptible colony maintained at the USDA-ARS Knipling-Bushland U.S. Livestock Insects Research Laboratory for comparison and calculation of resistance ratios (RRs). All 31 field populations surveyed in the study were susceptible to fipronil, with resistance ratios ranging from <0.5 to 2.2. Four populations with RRs >1 did not differ significantly from the susceptible strain. A single population showed an RR >2.2. Overall, the survey shows that fipronil was mostly used for R. microplus control, and in only three ranches, which were free of R. microplus, was fipronil used for horn fly control. Seventeen farmers did not use fipronil at all in the last three years. It is concluded that, in Uruguay, field populations of horn flies remain susceptible to fipronil.(AU)

O fipronil foi registrado no Uruguai em 1997 e, desde então, tem sido utilizado no controle de Haematobia irritans irritans e Rhipicephalus microplus. O objetivo do presente estudo foi avaliar a susceptibilidade de populações de campo de H. irritans ao fipronil. Além disso, foi realizada uma pesquisa para avaliar a utilização de fipronil e as práticas de controle de H. irritans nas fazendas de onde provinham as moscas. Para os bioensaios, 31 populações de campo de H. irritans foram expostas a 10 concentrações de fipronil (3,2-16,0μg.cm2), e seus valores de CL50 foram calculados usando análise probit. Um bioensaio foi realizado com H. irritans da colônia suscetível mantida no USDA-ARS Knipling-Bushland U.S. Livestock Insects Research Laboratory para comparação e cálculo das razões de resistência (RRs). Todas as 31 populações de campo pesquisadas no estudo eram suscetíveis ao fipronil, com taxas de resistência variando de <0,5 à 2,2. Quatro populações com Rrs >1 não diferiram significativamente da cepa suscetível. Uma única população apresentou RR >2,2. No geral, o fipronil tinha sido usado principalmente para o controle de R. microplus, e em apenas três fazendas, que estavam livres de R. microplus, o fipronil era utilizado para o controle da H. irritans. Em 17 fazendas não tinha sido utilizado fipronil nos últimos três anos. Conclui-se que no Uruguai as populações de H. irritans no campo permanecem suscetíveis ao fipronil.(AU)

Breaking Therapeutic Inertia in Type 2 Diabetes: Active Detection of In-Patient Cases Allows Improvement of Metabolic Control at Midterm.

Type 2 diabetes (T2D) exists in 25-40% of hospitalized patients. Therapeutic inertia is the delay in the intensification of a treatment and it is frequent in T2D. The objectives of this study were to detect patients admitted to surgical wards with hyperglycaemia (HH; fasting glycaemia > 140 mg/dL) as well as those with T2D and suboptimal chronic glycaemic control (SCGC) and to assess the midterm impact of treatment modifications indicated at discharge. A total of 412 HH patients were detected in a period of 18 months; 86.6% (357) had a diagnosed T2D. Their preadmittance HbA1c was 7.7 ± 1.5%; 47% (189) had HbA1c ≥ 7.4% (SCGC) and were moved to the upper step in the therapeutic algorithm at discharge. Another 15 subjects (3.6% of the cohort) had T2D according to their current HbA1c. Ninety-four of the 189 SCGC patients were evaluated 3-6 months later. Their HbA1c before in-hospital-intervention was 8.6 ± 1.2% and 7.5 ± 1.2% at follow-up (P < 0.004). Active detection of hyperglycaemia in patients admitted in conventional surgical beds permits the identification of T2D patients with SCGC as well as previously unknown cases. A shift to the upper step in the therapeutic algorithm at discharge improves this control. Hospitalization is an opportunity to break therapeutic inertia.

Occurrence of thyrocyte HLA class II expression in a wide variety of thyroid diseases: relationship with lymphocytic infiltration and thyroid autoantibodies.

The proteins of the major histocompatibility system (HLA in humans) play an essential role in the regulation of immune responses due to their involvement in the presentation of antigen to T lymphocytes. Thyroid follicular cells (thyrocytes) from patients with Graves' disease and Hashimoto's thyroiditis demonstrate increased expression of HLA class I and aberrantly or inappropriately express class II antigens, a phenomenon that may play an important role in the pathogenesis of these autoimmune diseases. To establish if these changes in the expression of HLA molecules are characteristic of thyroid autoimmune disease, the immunopathological features (including class I and class II antigen expression) of 100 thyroidectomy specimens from patients with nonautoimmune thyroid disease were studied by indirect immunofluorescence, and the results compared with the findings in specimens from 14 patients with Graves' disease and 12 subjects undergoing laryngectomies for carcinoma. Increased class I product expression was found in 61% of all tissues studied, with maximal occurrence in papillary carcinomas (100%) and Graves' disease (86%), but it was also detected in 50% of the glands containing nodular lesions and in 16% of the control glands. Inappropriate class II molecule expression was found in Graves' disease (71%), hyperplastic nodules (53%), multinodular glands (44%), papillary carcinomas (38%), and 16% of the control glands. In summary, an increase in inappropriate HLA class I and class II expression was very common in nonautoimmune thyroid glands, but it generally occurred in the context of lymphocytic infiltration and thyroid autoantibodies (i.e. focal thyroiditis). Multiple correlation analyses of these 4 phenomena indicated heterogeneity in the mechanism leading to the inappropriate expression of thyrocyte class II antigens in the different conditions studied.

A one-tube polymerase chain reaction protocol demonstrates CC chemokine overexpression in Graves' disease glands.

An adaptation of mixed oligonucleotide primed amplification of complementary DNA to detect the profile of CC chemokines in biological samples is presented. By introducing normalization, two correction coefficients, performing a single amplification reaction, and five parallel hybridizations, intrasample and intersample comparisons can be reliably made. This protocol of single tube PCR CC chemokine profiling was applied to tissue samples from an autoimmune thyroid condition, Graves' disease, and from a nonautoimmune condition, multinodular goiter. Results demonstrate overexpression of CC chemokines in Graves' disease, statistically significant for macrophage inflammatory protein-1alpha and -1beta, which correlated with the aberrant human leukocyte antigen class II expression by thyrocytes, as assessed by flow cytometry. Overexpression of CC chemokines probably plays a major role in determining the characteristics of the lymphocytes migrating to the thyroid gland and influences the course of the disease. The study of chemokine profile should be more informative than the study of isolated chemokines and cytokines, and as it can be applied to fine needle aspiration biopsies, it may be useful to clinical research.