Weight gain with add-on second-generation antipsychotics in bipolar disorder: a naturalistic study.

OBJECTIVE: Our aim was to investigate the prevalence and magnitude of weight gain in-patients with bipolar disorder when treated with a second-generation antipsychotic as an add-on treatment to a mood stabilizer in routine clinical practice. METHODS: Data were derived from the quality register for bipolar disorder in Sweden (BipoläR). Patients with bipolar disorder who started add-on treatment with a SGA (n = 575) were compared at next yearly follow-up with age and sex matched patients who were only treated with a mood stabilizer (n = 566). The primary outcome measure was change in body weight and body mass index (BMI). We also assessed the prevalence of clinically significant weight gain defined as ≥7% gain in body weight. RESULTS: The group that received add-on treatment with antipsychotics neither gained more weight nor were at higher risk for a clinically significant weight gain than the reference group. Instead, factors associated with clinically significant weight gain were female sex, young age, low-baseline BMI, and occurrence of manic/hypomanic episodes. CONCLUSION: We found no evidence of an overall increased risk of weight gain for patients with bipolar disorder after receiving add-on SGA to a mood stabilizer in a routine clinical setting.

Adenosine and its derivatives control human monocyte differentiation into highly accessory cells versus macrophages.

Human peripheral blood monocytes have been found to undergo a transitory state of high accessory activity before they fully become macrophages. Time kinetics were done to follow this accessory potential. Studying the regulation of accessory activity, we have found that monocyte-derived accessory cells (m-AC) pass through two phases of development, which both are adversely controlled by cyclic nucleotides. Phase I is positively correlated by intracellular cAMP increase and can be arrested by adenosine 3';5' cyclic monophosphate (cAMP) and synergystic agents. In addition to cAMP, non-cyclic adenine nucleotides and adenosine also mimic all cAMP effects. This behavior is explained by the known presence of surface 5' nucleotidase and adenosine receptor, which in turn leads to activation of adenylate cyclase. At phase II serum is required to convert m-AC into macrophages. In the absence of serum, cells were arrested in the m-AC state. Adenine nucleotides effectively counteract the serum induction leading to the development of m-AC even in the presence of serum. Monocyte/macrophage markers such as Fc receptors and non-specific esterase strictly correlate negatively with the expression of accessory activity. Morphologically, the appearance of veils positively correlates with all experimental situations of high accessory activity. Therefore, it is evident that serum contains regulatory factors that strongly modify the accessory potency of the m-AC via the cyclic nucleotide system, thus presenting a potent immunoregulatory principle at the beginning of the immune cascade.

Differentiation of human monocytes into accessory cells at serum-free conditions.

Human peripheral blood monocytes (HPBM) cultured in the absence of serum were found to convert into a state of high accessory function which was expressed by their ability to support lymphocyte proliferation. After a prolonged culture in serum-free media, the monocyte-derived cells were highly viable, increased in size, and had developed veils and dendritiform elongations. Paralleling the increase in accessory function, we found a decrease in the expression of markers typical of monocytes and macrophages (Mø), approaching the phenotype of lymphoid dendritic cells. We here define conditions for reproducibly generating these monocyte-derived accessory cells (m-AC) in various serum-free media, thus offering a novel differentiation model at highly defined culture conditions.

Effect of thallium fractions in the soil and pollution origins on Tl uptake by hyperaccumulator plants: a key factor for the assessment of phytoextraction.

Phytoremediation is often discussed as a means of extracting trace metals in excess in the soil, but to increase its efficiency a better understanding of the factors controlling plant uptake is required. The main objective of this study was to examine the effect of origin (anthropogenic vs. geogenic) and mobility of thallium (Tl) in the rhizosphere on Tl uptake. Two Tl-hyperaccumulating Brassicaceae species, kale (Brassica oleracea acephala L. cv. Winterbor F1) and candytuft (Iberis intermedia Guers.), were grown in a rhizobox system to investigate the dynamics of Tl in the rhizosphere soil. Four different soils were used. Two soils contained high Tl amounts due to anthropogenic sources (emissions from a cement plant and mining activities). High Tl content in the two other soils was due to a high rock content (geogenic origin). On completion of growth in the rhizoboxes, the depletion of Tl in seven different chemical fractions, determined by sequential extraction, was compared to the plant uptake. Most of the Tl taken up was derived from the so-called "easily accessible" fractions in both soils with geogenic Tl as well as in the soils polluted by mining activities. Due to the small amounts of easily accessible Tl in the geogenic soils, Tl uptake by Brassicaceae was low. On the other hand, for the air emission-polluted soil, a high depletion of Tl from "less accessible" fractions was observed in addition to depletion of the easily accessible fractions. Hence, the latter soil demonstrated the highest potential for effective soil decontamination by phytoextraction within an appropriate time frame.

Differentiation of human monocytes into CD14 negative accessory cells: do dendritic cells derive from the monocytic lineage?

Human peripheral-blood monocytes, when cultured in the absence of serum, are prevented to differentiate to macrophages (M phi). Instead, they develop into accessory cells which by various properties resemble dendritic cells. Signals that control development either into M phi or monocyte-derived accessory cells (m-AC) have been investigated by us. By applying such triggers, m-AC phenotypes and functions approached those known from lymphoid dendritic cells. Only the monocyte marker CD14, which is absent from dendritic cells, remained positive on m-AC as a last indicator of the monocytic origin of the cells. We now report that this most stable marker of the monocyte/M phi lineage can completely be down-regulated by combining tissue culture techniques with the inductive property of interleukin-4. Evidence has also been obtained by us that the conversion of monocytes into both m-AC and M phi represents a true differentiation, as demonstrated by the expression of the nuclear marker lamin A/C.