Dimethyl fumarate-induced lymphocyte count drop is related to clinical effectiveness in relapsing-remitting multiple sclerosis.

BACKGROUND AND PURPOSE: Dimethyl fumarate (DMF) causes a mean lymphocyte count drop of approximately 30% in relapsing-remitting multiple sclerosis (RRMS) patients. The relationship between this reduction and DMF effectiveness is controversial. The objective was to investigate if the decrease in absolute lymphocyte count (ALC) from baseline during DMF treatment is associated with clinical and magnetic resonance imaging (MRI) disease activity. A secondary aim was to evaluate ALC variations over time in a real-life cohort of DMF-treated patients. METHODS: Demographic, laboratory, clinical and MRI data were collected in this observational multicentre study, conducted on RRMS patients treated with DMF for at least 6 months. Multivariate Cox models were performed to evaluate the impact of 6-month ALC drop on time to no evidence of disease activity (NEDA-3) status loss. NEDA-3 is defined as absence of clinical relapses, MRI disease activity and confirmed disability progression. RESULTS: In all, 476 patients (312 females, age at DMF start 38.4 ± 9.97 years) were analysed up to 5-year follow-up. A greater lymphocyte decrease was associated with a lower risk of NEDA-3 status loss (hazard ratio 0.87, P = 0.01). A worse outcome in patients with lower ALC drop (<11.5%), compared with higher tertiles (11.5%-40.5% and >40.5%), was observed (P = 0.008). The nadir of ALC drop (-33.6%) and 35% of grade III lymphopaenia cases occurred after 12 months of treatment. CONCLUSION: A higher lymphocyte count drop at 6 months is related to better outcomes in DMF-treated patients. A careful ALC monitoring should be pursued up to 24 months of treatment.

Trace element accumulation in Pseudevernia furfuracea (L.) Zopf exposed in Italy's so called Triangle of Death.

Trace element accumulation in the lichen Pseudevernia furfuracea (L.) Zopf was studied in the district of Acerra (province of Naples, southern Italy), one of the points forming Italy's Triangle of Death. P. furfuracea thalli, collected from Mt. Faito (province of Naples), were transplanted and exposed in bags at different sites in Acerra district, classified into three different site types (urban, rural and industrial). We aimed to test the hypothesis that P. furfuracea, when transplanted in the district of Acerra, would respond to air pollution accumulating trace elements and that element concentrations in the exposed lichens were different in relation to the three different environments, characterised by different pollution sources. Samples were exposed for six months, periodically collected and examined by ICP MS spectrometer assays to measure concentrations of 10 trace elements (Al, As, Cd, Cr, Cu, Fe, Mn, Pb, V and Zn). The exposed samples showed increases in concentrations of all the examined elements; the trace element concentrations were evaluated by calculating exposed to control (EC) ratios, for each site and each trace element, to better understand the accumulation rates. EC ratios were evaluated after 3 and 6 month exposures, at the end of spring and summer respectively: 6 month EC values were the highest. The urban sites showed EC ratios generally higher than industrial and rural; the most accumulated elements were Pb and Cu (at the urban sites), Cu and Zn (at the industrial sites), and Cu and As (at the rural sites). The chemical data were then processed using a multivariate approach (ordination, PCA) to better understand environmental gradients. Bioaccumulation data and PCA analysis showed the sampling sites separated by different trace element abundance. Trace element abundance patterns in the three site types are discussed in relation to the land use and the pollution sources.

Plants as a source of salt.

Ecological and ethnobotanical aspects of some halophylous plants are presented. These plants possess several morphophysiological adaptations to face salinity in their habitats. They are a source of salt and could represent new potential crops in saline environments.

Efficacy of lamotrigine in idiopathic generalized epilepsy syndromes: a video-EEG-controlled, open study.

PURPOSE: This prospective, open, video-EEG-controlled study examined the efficacy of lamotrigine (LTG) as add-on and monotherapy in idiopathic generalized epilepsy (IGE). METHODS: 47 patients received LTG either because of insufficient seizure control (n = 35) or serious side effects of prior antiepileptic drugs (AED). Long-term video-EEG recordings were performed before and after the introduction of LTG. The mean follow-up time was 25.5 months. RESULTS: Of 12 patients with refractory childhood absence epilepsy, 9 became seizure free; in one child with absences with eyelid myoclonia, absence frequency was reduced > 50%; in 2 children with absences with a mild atonic component, seizure reduction was only transient. Of 12 patients with juvenile absence epilepsy, 10 became seizure-free and, in 2, a > 50% reduction was obtained. In 15 patients with juvenile myoclonic epilepsy, complete seizure control was achieved in 7 patients, in 6 patients myoclonia persisted. In one patient generalized tonic-clonic seizures also persisted and another patient developed a rash, LTG was therefore stopped. Of 5 patients with grand-mal on awakening, 3 became seizure-free, and a reduction of > 50% was obtained in one patient; LTG was stopped in one patient because of poor compliance. Three patients with pure photosensitive epilepsy became seizure-free. At the end of the study, 11 patients were seizure-free on LTG monotherapy, and in most other patients concomitant AED dosage could be substantially reduced. CONCLUSIONS: Lamotrigine was effective and well tolerated in patients with various IGE syndromes, although differences were observed between individual syndromes and seizure types.

Inhibition of radish germination and root growth by coumarin and phenylpropanoids.

Thirteen natural and synthetic phenylpropanoids as well as coumarin (2×10(4)M) were tested for their biological activity on radish germination and subsequent root growth in light and darkness. Coumarin was the most potent inhibitor. With some exceptions, phenylpropanoids with a carboxylic group in the side chain inhibited root growth. Coumarin was formed spontaneously by photooxidation of 2-hydroxycinnamic acid. Microscopic observations of root treated with coumarin suggest that this substance inhibits the elongation of cells of the differentiating zone of the root.

Joseph Jacob Plenck (1735-1807).

Joseph Jacob Plenck (1735-1807) is considered to be the forerunner of modern European dermatology, who also compiled a list of about 800 plants with medicinal uses. Of these about 115 have diuretic properties and are currently included in various pharmacopeias. They were traditionally used to cure ascites of various causes, in urolithiasis, nephritis, cystitis, bladder ulcers, strangury, urinary retention and incontinence. Few of these plants have been fully investigated by modern medicinal chemists, and many are worthy of further study.