Biomarkers of Good EULAR Response to the B Cell Depletion Therapy in All Seropositive Rheumatoid Arthritis Patients: Clues for the Pathogenesis

Objective

To find out whether a high number of auto-antibodies can increase the probability of a “good-EULAR response” and to identify the possible biomarkers of response in seropositive rheumatoid arthritis (RA) patients undergoing the B cell depletion therapy (BCDT).

Patients and Methods

One hundred and thirty-eight patients with long standing RA (LSRA), 75% non or poorly responsive to one or more TNFα blockers, all seropositive for at least one autoantibody (AAB) (RF-IgM, RF-IgA, RF-IgG, anti-MCV, ACPA-IgG, ACPA-IgA, ACPA-IgM) received one full course of BCDT. The major outcomes (moderate or good-EULAR response) were assessed after 6 months of therapy. The IL6 and BAFF levels were also determined.

Results

At a 6-month follow-up, 33 (23.9%) of the RA patients achieved a good EULAR response. Having up to 5-AABs positivity increased the chances for treatment response. After a logistic regression analysis, however, only 4 baseline factors arose as associated with a good-EULAR response: no steroid therapy (OR = 6.25), a lymphocyte count <1875/uL (OR = 10.74), a RF-IgG level >52.1 IU/ml (OR = 8.37) and BAFF levels <1011 pg/ml (OR = 7.38). When all the AABs, except for RF-IgM and ACPA-IgG, were left in the analysis, the two final predictors were no-steroid therapy and low lymphocyte count.

Discussion

The number of AABs increased the chances of being a “good-EULAR” responder. The only predictors, however, at the baseline of a good response in this seropositive cohort of RA patients were 2 simple variables – no steroids and lymphocyte count – and two laboratory assays – IgG-RF and BAFF.     

Human chorionic villus mesenchymal stromal cells reveal strong endothelial conversion properties

Chorion, amnion and villi are reservoirs of mesenchymal stromal cells (StC) and the hypothesis that StC from fetal tissues retain higher plasticity compared to adult StC has been suggested. Aimed at investigating this aspect, a series of in vitro experiments were performed with StC isolated from first trimester human chorionic villi (CVStC). CVStC were cultured in: (i) standard mesenchymal medium (MM) and (ii) AmniomaxII? (AM), specifically designed to grow amnion-derived cells in prenatal diagnostic procedures. Cells were then exposed to distinct differentiation treatments and distinguished according to morphology, immunophenotype and molecular markers. Human StC obtained from adult bone marrow (BMStC) were used as control. CVStC cultured either in MM or AM presented stromal morphology and immunophenotype, were negative for pluripotency factors (Nanog, Oct-4 and Sox-2), lacked detectable telomerase activity and retained high genomic stability. In AM, however, CVStC exhibited a faster proliferation rate compared to BMStC or CVStC kept in MM. During differentiation, CVStC were less efficient than BMStC in acquiring adipocytes and osteocytes features; the cardiomyogenic conversion occurred at low efficiency in both cell types. Remarkably, in the presence of pro-angiogenic factors, CVStC reprogrammed toward an endothelial-like phenotype at significantly higher efficiency than BMStC. This effect was particularly evident in CVStC expanded in AM. Mechanistically, the reduced CVStC expression of anti-angiogenic microRNA could support this process. The present study demonstrates that, despite of fetal origin, CVStC exhibit restricted plasticity, distinct from that of BMStC and predominantly directed toward the endothelial lineage.     

Altitudinal Change in the Photosynthetic Capacity of Tropical Trees: A Case Study from Ecuador and a Pantropical Literature Analysis

In tropical mountains, trees are the dominant life form from sea level to above 4,000-m altitude under highly variable thermal conditions (range of mean annual temperatures: <8 to >28°C). How light-saturated net photosynthesis of tropical trees adapts to variation in temperature, atmospheric CO₂ concentration, and further environmental factors, that change along elevation gradients, is not precisely known. With gas exchange measurements in mature trees, we determined light-saturated net photosynthesis at ambient temperature (T) and [CO₂] (A _sat) of 40 tree species from 21 families in tropical mountain forests at 1000-, 2000-, and 3000-m elevation in southern Ecuador. We tested the hypothesis that stand-level averages of A _sat and leaf dark respiration (R _D) per leaf area remain constant with elevation. Stand-level means of A _sat were 8.8, 11.3, and 7.2?μmol?CO₂?m^?2?s^?1; those of R _D 0.8, 0.6, and 0.7?μmol?CO₂?m^?2?s^?1 at 1000-, 2000-, and 3000-m elevation, respectively, with no significant altitudinal trend. We obtained coefficients of among-species variation in A _sat and R _D of 20–53% (n?=?10–16 tree species per stand). Examining our data in the context of a pan-tropical A _sat data base for mature tropical trees (c. 170 species from 18 sites at variable elevation) revealed that area-based A _sat decreases in tropical mountains by, on average, 1.3?μmol?CO₂?m^?2?s^?1?per?km altitude increase (or by 0.2?μmol?CO₂?m^?2?s^?1 per K temperature decrease). The A _sat decrease occurred despite an increase in leaf mass per area with altitude. Local geological and soil fertility conditions and related foliar N and P concentrations considerably influenced the altitudinal A _sat patterns. We conclude that elevation is an important influencing factor of the photosynthetic activity of tropical trees. Lowered A _sat together with a reduced stand leaf area decrease canopy C gain with elevation in tropical mountains.     

Interannual fluctuations in copepod abundance and contribution of small forms in the Drake Passage during austral summer

The relative importance of small forms of copepods has been historically underestimated by the traditional use of 200?C300-??m mesh nets. This work quantified the distribution and abundance of copepods, considering two size fractions (<300???m and >300???m), in superficial waters (9?m deep) of the Drake Passage and contributed to the knowledge of their interannual fluctuations among three summers. Four types of nauplii and eleven species of copepods at copepodite and adult stages were identified, with abundance values of up to 13 ind L^?1 and 28,300???g C m^?3. The <300-??m fraction, composed of Oithona similis, small cyclopoids and nauplii, dominated the copepod communities in the 3?years; it accounted for more than 77% of the total number and for between 40 and 63% of the total biomass. Changes in density and biomass values among the three cruises differed according to copepod size fraction and water mass; the >300-??m fraction showed no changes among the 3?years, both in Antarctic (density and biomass) and in Subantarctic waters (density), whereas the <300-??m fraction showed higher (density and biomass) values in 2001 both in Subantarctic and in Antarctic waters. Sea surface temperature and its anomaly accounted for the largest proportion of variability in copepod density and biomass, particularly for the <300-??m fraction.     

DENV Inhibits Type I IFN Production in Infected Cells by Cleaving Human STING

Dengue virus (DENV) is a pathogen with a high impact on human health. It replicates in a wide range of cells involved in the immune response. To efficiently infect humans, DENV must evade or inhibit fundamental elements of the innate immune system, namely the type I interferon response. DENV circumvents the host immune response by expressing proteins that antagonize the cellular innate immunity. We have recently documented the inhibition of type I IFN production by the proteolytic activity of DENV NS2B3 protease complex in human monocyte derived dendritic cells (MDDCs). In the present report we identify the human adaptor molecule STING as a target of the NS2B3 protease complex. We characterize the mechanism of inhibition of type I IFN production in primary human MDDCs by this viral factor. Using different human and mouse primary cells lacking STING, we show enhanced DENV replication. Conversely, mutated versions of STING that cannot be cleaved by the DENV NS2B3 protease induced higher levels of type I IFN after infection with DENV. Additionally, we show that DENV NS2B3 is not able to degrade the mouse version of STING, a phenomenon that severely restricts the replication of DENV in mouse cells, suggesting that STING plays a key role in the inhibition of DENV infection and spread in mice.     

Cretaceous/Paleogene Floral Turnover in Patagonia: Drop in Diversity,Low Extinction,and a Classopollis Spike

Nearly all data regarding land-plant turnover across the Cretaceous/Paleogene boundary come from western North America, relatively close to the Chicxulub, Mexico impact site. Here, we present a palynological analysis of a section in Patagonia that shows a marked fall in diversity and abundance of nearly all plant groups across the K/Pg interval. Minimum diversity occurs during the earliest Danian, but only a few palynomorphs show true extinctions. The low extinction rate is similar to previous observations from New Zealand. The differing responses between the Southern and Northern hemispheres could be related to the attenuation of damage with increased distance from the impact site, to hemispheric differences in extinction severity, or to both effects. Legacy effects of the terminal Cretaceous event also provide a plausible, partial explanation for the fact that Paleocene and Eocene macrofloras from Patagonia are among the most diverse known globally. Also of great interest, earliest Danian assemblages are dominated by the gymnosperm palynomorphs Classopollis of the extinct Mesozoic conifer family Cheirolepidiaceae. The expansion of Classopollis after the boundary in Patagonia is another example of typically Mesozoic plant lineages surviving into the Cenozoic in southern Gondwanan areas, and this greatly supports previous hypotheses of high latitude southern regions as biodiversity refugia during the end-Cretaceous global crisis.     

Etk/BMX, a Btk family tyrosine kinase, and Mal contribute to the cross-talk between MyD88 and FAK pathways

MyD88 and focal adhesion kinase (FAK) are key adaptors involved in signaling downstream of TLR2, TLR4, and integrin alpha5beta1, linking pathogen-associated molecule detection to the initiation of proinflammatory response. The MyD88 and integrin pathways are interlinked, but the mechanism of this cross-talk is not yet understood. In this study we addressed the involvement of Etk, which belongs to the Tec family of tyrosine kinases, in the cross-talk between the integrin/FAK and the MyD88 pathways in fibroblast-like synoviocytes (FLS) and in IL-6 synthesis. Using small interfering RNA blockade, we report that Etk plays a major role in LPS- and protein I/II (a model activator of FAK)-dependent IL-6 release by activated FLS. Etk is associated with MyD88, FAK, and Mal as shown by coimmunoprecipitation. Interestingly, knockdown of Mal appreciably inhibited IL-6 synthesis in response to LPS and protein I/II. Our results also indicate that LPS and protein I/II induced phosphorylation of Etk and Mal in rheumatoid arthritis FLS via a FAK-dependent pathway. In conclusion, our data provide support that, in FLS, Etk and Mal are implicated in the cross-talk between FAK and MyD88 and that their being brought into play is clearly dependent on FAK.