Development of MGUS in psoriatic patients: a possible undiagnosed event during anti-TNF-α-treatment.

BACKGROUND: Monoclonal gammopathies are haematological conditions characterized by the clonal proliferation of plasma cells which produce a monoclonal immunoglobulin that accumulates in the blood. They have already been reported during treatment with a range of drugs but never before during treatment with the anti-TNF-α treatments: adalimumab, etanercept and infliximab currently used in the therapy of moderate-severe psoriasis and psoriatic arthritis. OBJECTIVE: This is a case series describing the development of MGUS in psoriatic patients treated with anti-TNF-α. METHODS: Three hundred patients receiving an anti-TNF-α treatment for chronic plaque psoriasis or psoriatic arthritis in a clinical setting in Italy, These patients were screened through serum protein electrophoresis to investigate the possible development of MGUS. RESULTS: Eight patients were found to have developed monoclonal gammopathy of undetermined significance. The median treatment duration for the eight patients was 1 year with excessive IgG present in five patients, IgM accumulation in one patient and a double monoclonal component in two patients. CONCLUSION: Our data suggest that there may be an association between anti-TNF-α therapy and development of MGUS.

Exposure to 1.8 GHz electromagnetic fields affects morphology, DNA-related Raman spectra and mitochondrial functions in human lympho-monocytes.

Blood is a fluid connective tissue of human body, where it plays vital functions for the nutrition, defense and well-being of the organism. When circulating in peripheral districts, it is exposed to some physical stresses coming from outside the human body, as electromagnetic fields (EMFs) which can cross the skin. Such fields may interact with biomolecules possibly inducing non thermal-mediated biological effects at the cellular level. In this study, the occurrence of biochemical/biological modifications in human peripheral blood lympho-monocytes exposed in a reverberation chamber for times ranging from 1 to 20 h to EMFs at 1.8 GHz frequency and 200 V/m electric field strength was investigated. Morphological analysis of adherent cells unveiled, in some of these, appearance of an enlarged and deformed shape after EMFs exposure. Raman spectra of the nuclear compartment of cells exposed to EMFs revealed the onset of biochemical modifications, mainly consisting in the reduction of the DNA backbone-linked vibrational modes. Respirometric measurements of mitochondrial activity in intact lympho-monocytes resulted in increase of the resting oxygen consumption rate after 20 h of exposure, which was coupled to a significant increase of the FoF1-ATP synthase-related oxygen consumption. Notably, at lower time-intervals of EMFs exposure (i.e. 5 and 12 h) a large increase of the proton leak-related respiration was observed which, however, recovered at control levels after 20 h exposure. Confocal microscopy analysis of the mitochondrial membrane potential supported the respiratory activities whereas no significant variations in the mitochondrial mass/morphology was observed in EMFs-exposed lympho-monocytes. Finally, altered redox homeostasis was shown in EMFs-exposed lympho-monocytes, which progressed differently in nucleated cellular subsets. This results suggest the occurrence of adaptive mechanisms put in action, likely via redox signaling, to compensate for early impairments of the oxidative phosphorylation system caused by exposure to EMFs. Overall the data presented warn for health safety of people involved in long-term exposure to electromagnetic fields, although further studies are required to pinpoint the leukocyte cellular subset(s) selectively targeted by the EMFs action and the mechanisms by which it is achieved.

Correction: Exposure to 1.8 GHz electromagnetic fields affects morphology, DNA-related Raman spectra and mitochondrial functions in human lympho-monocytes.

[This corrects the article DOI: 10.1371/journal.pone.0192894.].

Effects of fludarabine and gemcitabine on human acute myeloid leukemia cell line HL 60: direct comparison of cytotoxicity and cellular Ara-C uptake enhancement.

This study was designed to compare the effects of fludarabine and gemcitabine on cytosine arabinoside (Ara-C) uptake and retention, and their specific cytotoxicity on HL 60 human acute myeloid leukemia cells. The leukemic blasts were exposed to either drug at equimolar concentrations (10 microM) for 3 h and further incubated with Ara-C (5 microM), added immediately (day 0) or after an interval of 24 h in cells were kept in a drug free medium (day 1). On day 0, leukemic cells exposed to fludarabine 10 microM had a significant (P<0.01) increase in Ara-C uptake (297 +/- 11 pmol/10(7) cells) with respect to control cells (not pre-treated: 195 +/- 10 pmol/10 (7) cells). After treatment of leukemic cells with fludarabine, cytoplasmic Ara-C peaked after 180 min of exposure, as well as nuclear bound Ara-C. At the same time, a significant decrease in the number of S-phase leukemic cells, consistent with depressed [3 H]TdR uptake was observed. Although on day 0 gemcitabine 10 microM did not have potentiating effects on Ara-C uptake, it showed a high degree of intrinsic cytotoxicity as a single agent(clear from cell cycle distribution, [3H]TdR uptake, plating efficiency (PE) data and percentage of apoptotic cells). Cells exposed to gemcitabine, on the other hand, showed on day 1 a significant increase in Ara-C uptake (2.4 x control values in the cytoplasmic and 3x in the nuclear fractions) and a reduced number of S-phase blasts, [3H]TdR uptake and PEs, as well as an increased apoptotic cell death. Evidently, it is possible to modulate Ara-C uptake by leukemic cells with gemcitabine. Although this effect is similar to that demonstrated with fludarabine, its kinetics and time of efficacy are different and also, because of its intrinsic higher cytoxicity and lack of important side effects, gemcitabine could be considered a suitable candidate for Ara-C association therapy in acute leukemia.

Effect of (dl)-5-methyltetrahydrofolate on acute non-lymphocytic leukemia cells in primary culture.

High doses of (dl)-5-methyltetrahydrofolate (mTHF) cause strong inhibition of growth of leukemic cell lines. We studied the effect of mTHF, at concentrations ranging from 10(-3) M to 10(-4) M, on peripheral leukemic cells obtained from 15 acute non-lymphocytic leukemia (ANLL) patients, by [3H]-thydimidine uptake inhibition. Unlike leukemic cell lines, mTHF exerts a variable effect on ANLL cells in primary culture. While about 33% of cases are strongly inhibited, 55% are only slightly affected, showing a reduction in growth comparable to normal cell populations tested (unstimulated and PHA-stimulated lymphocytes, day 7 and day 14 colony forming units-granulocyte/monocyte (CFU-GM), normal blast colonies). In a minority of cases we observed stimulation of growth. This study reflects the metabolic variability of single-case leukemic cell populations, possibly in relationship to folate transport and accumulation.

Metabolism of 5-hydroxytryptophan in the isolated perfused rat lung.

The metabolism of 5-hydroxytryptophan (5-HTP) and tryptophan (TRP) in a single pass across the pulmonary circulation was studied in the isolated ventilated perfused rat lung and by high pressure liquid chromatography. The metabolism of 5-HTP was dependent on the rate of lung perfusion and the duration of infusion of 5-HTP, and was a saturable process with an apparent Km of 1.8 mM and Vmax of 0.14 mumol/g/3 min. The indoles found in the lung were 5-HTP, 5-hydroxytryptamine (5-HT) and 5-hydroxyindole acetic acid (5-HIAA); only 5-HIAA was detected in the lung effluent. The efflux of 5-HTP from the lung had two exponential components with half-lives of 0.15 and 3.65 min. After an infusion of 3H-5-HTP, the radiolabel that accumulated in lung was located mainly in the soluble fraction. An infusion of TRP resulted in the synthesis of 5-HTP, 5-HT and 5-HIAA in the lung, and 5-HTP was detected in the lung effluent. The results suggest that 5-HT can be synthesized in the intact lung from circulating TRP and 5-HTP. Since the rate of lung metabolism is low and no 5-HT is released into the lung effluent, the contribution of the lung to circulating levels of 5-HT is likely to be insignificant. Synthesis of 5-HT in intact lung suggests an intrapulmonary role for 5-HT.

Effect of volatile anesthetics on endogenous tryptophan, 5-hydroxytryptophan and 5-hydroxytryptamine in rat lung.

Volatile anesthetics inhibit the pulmonary inactivation of 5-hydroxytryptamine (5-HT) possibly via an effect on endogenous lung 5-HT. The consequent higher systemic arterial 5-HT concentrations may predispose the heart to dysrhythmias. The direct effect of the anesthetics on endogenous 5-HT, its metabolites, and precursors in the isolated ventilated perfused rat lung was determined by high-pressure liquid chromatography. Halothane (0.45, 1.4, and 2.3 minimum alveolar concentration (MAC] and 35% nitrous oxide (N2O) increased lung 5-HT (11, 70, 94, and 54% respectively). The effect of 0.45 MAC halothane and 35% N2O on 5-HT was synergistic. Isoflurane (2.9 MAC) had no effect on lung 5-HT. The lung concentration of tryptophan (TRP) was increased 51% by 2.9 MAC isoflurane, but the rate of efflux of TRP from the lung was unchanged. There was no effect of the anesthetics on 5-hydroxytryptophan (5-HTP). The ratio of 5-HT:5-HTP was significantly increased by 2.3 MAC halothane and 0.5 MAC halothane +35% N2O. The 5-HTP:TRP ratio was unchanged. The metabolite of 5-HT, 5-hydroxyindole acetic acid (5-HIAA), was not always detected. The results suggest that the increase in lung 5-HT by halothane reflects an increase in 5-HTP decarboxylase activity and that halothane and isoflurane exert selective effects on lung 5-HT synthesis. The results do not support the hypothesis that lung 5-HT controls the inactivation of 5-HT in the pulmonary circulation.

Reticulocytes and reticulated platelets: simultaneous measurement in whole blood by flow cytometry.

Reticulated platelets are a fraction of newly released circulating elements characterized by a residual amount of RNA. It has been suggested that the reticulated platelet count, providing an estimate of thrombopoiesis in the same way as erythrocyte reticulocyte count is a measure of erythropoiesis, may be useful in the study of thrombocytopenic disorders. Reticulated red cells and platelets can be analyzed by flow cytometry using specific stains for nucleic acids such as Thiazole Orange and Auramine-O. The aim of our work was to perform the simultaneous evaluation of reticulated elements in whole blood using a standard flow cytometer and to correlate the results obtained with a dedicated cytometer. A group of 14 patients with abnormal absolute reticulocyte counts (range 1.1-11%) and a group of 41 patients showing a platelet discrimination error when analyzed with a dedicated flow cytometer (Sysmex R1000) were enrolled. Linear amplification of both scatter and fluorescence was used to perform reticulocyte count. A gate was set on platelet dimensions, and logarithmic amplification of scatter and fluorescence was used to count reticulated platelets. A good correlation was obtained both for results of reticulocyte count (r2 = 0.9825) and for reticulated platelets (r2 = 0.8717) between our method and those using dedicated instruments. These data show that reticulated platelet count may be easily introduced in clinical laboratories that routinely perform reticulocyte count by flow cytometry.

Anomalies in geophysical and geochemical parameters revealed on the occasion of the Spitak (M=6.9) earthquake

On the ocasion of the Spitak earthquake (December 7, 1988) irregularities in several geophysical and geochemical parameters were revealed. In this paper data on anomalies in the water level in deep wells and in the helium content in thermal waters are presented. Data were collected from sites located in Georgia. The presented anomalies can be attributed to the processes that preceded and accompanied the earthquake; the presence of a time delay in the onset of the helium content anomalies at different sites could be an indication of the stress propagation.(AU)