scholarly journals General Anesthesia in Geriatric Dogs with Propofol-Isoflurane, PropofolSevoflurane, Alphaxalone-Isoflurane, Alphaxalone-Sevoflurane and Their Comparison of Biochemical, Hemodynamic and Cardiopulmonary Effects

2018 ◽  
Vol 46 (1) ◽  
pp. 9
Author(s):  
Zeynep Bilgen Şen ◽  
Nuh Kiliç
Keyword(s):  
Blood Collection ◽  
Anesthesia Induction ◽  
Isoflurane Anesthesia ◽  
Group 4 ◽  
Anesthetic Drugs ◽  
Group I ◽  
Organ Systems ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Geriatric is defined as the life-cycle in which the physical state, organ functions, sensory functions, mental function and immunity progressively regress. Aging causes progressive and irreversible changes in the functional capacities of organ systems, which in turn alter the response to stress and anesthetic drugs. Propofol is an anesthetic agent with sedative and hypnotic effects. Anesthesia induction with propofol is fast and smooth. Alphaxalone (3α-hydroxy-5α-pregnane11,20-dione) is a central nervous system depressant in the form of synthetic neuroactive steroids. This allows anesthesia and muscle relaxation by increasing the inhibition of gamma amino butyric acid type A (GABA) receptors. The aim of this study is to compare effects of propofol-isoflurane and propofol-sevoflurane with relatively a new anesthetic combination alphaxalone-isoflurane and alphaxalone-sevoflurane on hematological, biochemical and physiological parameters.Materials, Methods & Results: Dogs were randomly divided into 4 groups and anesthesia protocols were applied. After induction of anesthesia with 6 mg/kg propofol in groups 1 and 2, isoflurane anesthesia was continued in group 1 and sevoflurane in group 2. After induction of 3 mg/kg alphaxalone anesthesia in groups 3 and 4, isoflurane anesthesia was continued in group 3 whereas sevoflurane in group 4. Vena cephalica was catheterized for blood collection. At the preanesthetic period, 15, 30, 45, 60 min and 60 min after the anesthesia, complete blood counts were performed. Serum ALT, AST, urea, creatinine values were measured during preanesthesia, perianesthesia 15-30 min and 60 min after anesthesia. Cardiopulmonary parameters and reflexes were evaluated before anesthesia and recorded at perianesthetic 5, 10, 15, 30, 45, 60 min and 60 min after full recovery. Patients were monitored during anesthesia. The average age of the dogs in the study was 10.83. All of the dogs were anesthetized in a few seconds with intravenous injection of propofol or alphaxalone. During anesthesia the respiratory rate (fR) was recorded by counting the movements of the reservoir bag. A pulse oximeter was used to monitor pulse rate (fH) and haemoglobin oxygen saturation (SpO2). Body temperature was measured from rectum with a thermometer. Geriatric dogs were anesthetized for a variety of clinical reasons, concerning laparatomy (12.5%), orthopedic (7.5%), soft tissue (60%),  dental (10%) and ophthalmologic surgery (10%). Duration of anesthesia was 94.44 (± 12.6) for group I, 81(± 10.54) for group II, 93.88 (± 11.6) for group III and 64.5 (± 3.97) min for group IV. Serum urea and creatinine concentrations were not significantly different in the four groups.Discussion: The mean duration of anesthesia recovery was 6.0 ± 2.0 in group 1, 4.6 ± 1.45 in group 2, 3.7 ± 1.23 in group 3 and 9.7 ± 3.09 min in group 4. In group 4 recovery was longer than other groups and statistically significant (P < 0.05). In our research, the recovery is shorter in the isoflurane treated groups than in the sevoflurane treated groups. When the effect of different groups on heart rate was examined, the difference between them was not significant.  Duration and depth of the anesthesia with propofol-isoflurane, propofol-sevoflurane, alphaxalone–isoflurane and alphaxalone-sevoflurane were found to be satisfactory for surgery. Four anesthetic agents applied in geriatric dogs did not adversely affected the hematological and biochemical parameters. In conclusion anesthesia on geriatric dogs after induction of propofol and alphaxalone maintained with isoflurane or sevoflurane found to be safe. However, they did not provide analgesia in painful operations, so it would be appropriate to use analgesics in the pre or intraoperative period.

scholarly journals The effect of uncooked and roll-dried maize starch, alone and mixed in equal quantity with sucrose, on dental caries in the albino rat

1967 ◽  
Vol 21 (1) ◽  
pp. 225-230 ◽  
Author(s):  
R. M. Green ◽  
R. L. Hartles
Keyword(s):  
Dental Caries ◽  
Maize Starch ◽  
Albino Rat ◽  
Group 4 ◽  
Group I ◽  
Weanling Rats ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

1. One hundred and ten weanling rats were distributed between five dietary groups in randomized blocks. Each block was constructed from within a litter and each member of the block received a different diet.2. The main features of the diets were: group I (twenty-six rats) 72% sucrose, group 2 (sixteen rats) 72% uncooked maize starch, group 3 (sixteen rats) 72% roll-dried maize starch, group 4 (twenty-six rats) 36% sucrose and 36% uncooked starch, group 5 (twenty-six rats) 36% sucrose and 36% roll-dried starch.3. The animals were killed after 20 days on the diets and assessed for dental caries. The rats of group 1 (sucrose) had significantly more caries than all other groups, the rats of group 2 (uncooked starch) had significantly less caries than any of the other groups. Roll-dried starch (group 3) produced significantly more caries than uncooked starch (group 2). The mixture of uncooked starch and sucrose (group 4) was significantly more cariogenic than the mixture of roll-dried starch and sucrose (group 5).

scholarly journals Hematology of 2, 4 (Dinitrophenyl Hydrazine) Induced Anaemic Rat Administered with Ficus capensis Fruits and Leave Extract

2020 ◽  
pp. 41-49
Author(s):  
N. N. Umerah ◽  
J. I. Okoye ◽  
A. I. Asouzu
Keyword(s):  
Body Weight ◽  
Blood Cell ◽  
Blood Parameters ◽  
Haematological Parameters ◽  
Group 4 ◽  
Group I ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Anemia is regarded as public health challenge and is predominant in developing countries due to nutritional deficiencies. Aim/Objectives: The study was carried out to evaluate the biological properties of Ficus capensis fruits and vegetables on some haematological parameters in 2, 4 (dinitrophenyl hydrazine) induced anemic rat. Materials and Methods: Ficus capensis leaves and fruits were separately plucked, sorted cleaned. Twenty male adult rats were purchased from the Department of Veterinary Pathology, University of Nigeria, Nsukka. The animals were divided into 4 groups of 5 rats each on the basis of body weight. The rats in all the groups received 2, 4-DNPH (20 mg/kg body weight) once daily for 7 days to induce anaemia. Group I were fed rat chow alone, group 2 were fed rat chow with ferrous sulphate, group 3 were fed rat chow with Ficus capensis leaves extract and group 4 were fed rat chow with Ficus capensis seed extract. The aqueous extracts of the leaves and fruits were tested for haematinic effects in albino rats. Blood parameters such as Packed Cell Volume (PCV), Red Blood Cell (RBC) count, White Blood Cell (WBC) count and Haemoglobin concentration (Hb) were measured. Results: The result showed that the mean PCV baseline of the rats were (38.72-39.24%), mean PCV of anemic rats (33.01- 34.60%) and the mean PCV of the rats after test of recovery were group 1 (34.10%), group 2 (51.81%), group 3 (40.20%) and group 4 (38.20%).The result showed that the mean HB baseline of the rats were (9.67-10.47 g/dl), mean HB of anemic rats (6.50- 7.10 g/dl) and the mean HB of the rats after test of recovery were group 1 (6.51 g/dl), group 2 (12.32 g/dl), group 3 (9.73 g/dl) and group 4 (9.69 g/dl). The results of the effect of the extracts on the haematological parameters indicated that oral administration of the aqueous extract of Ficus capensis leaves and fruits after 22 days exhibited a significant (P < 0.05) increase in haematinic activity by increasing the blood parameters Hb, PCV, WBC and RBC.

scholarly journals Evaluation of the Effect of Hydroxyzine on Preoperative Anxiety and Anesthetic Adequacy in Children: Double Blind Randomized Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Esther Aleo ◽  
Amanda López Picado ◽  
Belén Joyanes Abancens ◽  
Carmen Soto Beauregard ◽  
Nuria Tur Salamanca ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Preoperative Anxiety ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Group 4 ◽  
Formula Group ◽  
Secondary Objective ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Surgical procedures can generate significant preoperative anxiety (POA) in as much as 70% of the paediatric population. The role of hydroxyzine and distractive techniques such as clowns in the management of anxiety is controversial. Our main objective was to evaluate the effect of hydroxyzine on the control of POA. The secondary objective was to assess the potential additive effect of hydroxyzine and distracting techniques. We performed a randomized double-blind, controlled clinical trial in children aged 2–16 years undergoing outpatient surgery ( n = 165 ). Subjects were randomized to hydroxyzine (group 1) or placebo (group 2). For the secondary objective, two further groups were made by allocation by chance to hydroxyzine plus accompaniment with clowns (group 3) and placebo plus clowns (group 4). All patients were accompanied by their parents as the standard procedure. POA was determined by a modified Yale scale of POA (m-YPAS). Compliance of children during induction of anesthesia (Induction Compliance Checklist (ICC)) was also assessed. No differences ( p = 0.788 ) were found in POA control at the time of induction measured by m-YPAS (group 1: 39.2 ± 27.9 ; group 2: 37.0 ± 26.1 ; group 3: 34.7 ± 25.5 ; group 4: 32.4 ± 20.5 ). No differences were found in the level of ICC between the different treatment arms (group 1: 1.8 ± 3.4 ; group 2: 1.5 ± 3.0 ; group 3: 1.2 ± 2.4 ; group 4: 1.5 ± 2.7 ). The combination of all treatments (group 3) was the only effective strategy to contain the progression of anxiety. In conclusion, hydroxyzine was not effective to control POA in children. The combination of hydroxyzine and clowns avoided the progression of POA in our patients. This trial is registered with ClinicalTrials.gov identifier: NCT03324828 (registered 21 September 2017, subject recruitment started on 12th January 2018).

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?

2019 ◽  
Vol 17 (4) ◽  
pp. 354-364
Author(s):  
Hassan Al-Thani ◽  
Moamena El-Matbouly ◽  
Maryam Al-Sulaiti ◽  
Noora Al-Thani ◽  
Mohammad Asim ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Lower Extremity ◽  
Hazard Ratio ◽  
Lower Extremity Amputation ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Extremity Amputation ◽  
Group 1

Background: We hypothesized that perioperative HbA1c influenced the pattern and outcomes of Lower Extremity Amputation (LEA). Methods: A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17.7%, Group 3: 15.0%, Group 4: 13.5% and Group 5: 34.9%). Major amputation was performed in 35%, 32%, 22%, 10.8% and 13.6%, respectively. Results: The overall mortality was 36.5%; of that one quarter occurred during the index hospitalization. Mortality was higher in Group 1 (57.4%) compared with Groups 2-5 (46.9%, 38.3%, 36.1% and 31.2%, respectively, p=0.001). Cox regression analysis showed that poor glycemic control (Group 4 and 5) had lower risk of mortality post-LEA [hazard ratio 0.57 (95% CI 0.35-0.93) and hazard ratio 0.46 (95% CI 0.31-0.69)]; this mortality risk persisted even after adjustment for age and sex but was statistically insignificant. The rate of LEA was greater among poor glycemic control patients; however, the mortality was higher among patients with tight control. Conclusion: The effects of HbA1c on the immediate and long-term LEA outcomes and its therapeutic implications need further investigation.

Association between cervical disc disease and lesions of multiple sclerosis

2021 ◽  
pp. 197140092098356
Author(s):  
Marwan Alkrenawi ◽  
Michael Osherov ◽  
Azaria Simonovich ◽  
Jonathan Droujin ◽  
Ron Milo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Disc ◽  
Cervical Disc Disease ◽  
Disc Disease ◽  
Group 4 ◽  
Demyelinating Lesions ◽  
Grade Ii ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background Cervical discopathy and demyelinating lesions often co-exist in patients with multiple sclerosis (MS). Our study examines the possible association between these two pathologies. Methods Medical records and cervical magnetic resonance imaging scans of MS patients with cervical discopathy who were seen at our MS clinic during 2018 were retrospectively reviewed. The severity of the disc disease was classified as grade I (no compression), grade II (compression of the dural sac) and grade III (cord compression). The spinal cord in each scan was divided into six segments corresponding to the intervertebral space of the spine (C1–C6). Each segment was defined as containing demyelinating lesion and disc pathology (group 1), demyelinating lesion without disc pathology (group 2), disc pathology without demyelinating lesion (group 3) and no demyelinating lesion or disc pathology (group 4). Fisher’s exact test was used to test the association between demyelinating lesions and disc pathology. Results Thirty-four MS patients with cervical discopathy were included in the study (26 females; average age 42.9 ± 13.7 years; average disease duration 8.4 ± 5.4 years). A total of 204 spinal cord segments were evaluated. Twenty-four segments were classified as group 1, 27 segments as group 2, 52 segments as group 3 and 101 segments as group 4. There was no association between demyelinating lesions and the grade of disc disease ( p = 0.1 for grade I, p = 0.3 for grade II and p = 1 for grade III disc disease). Conclusion Our study did not find any association between cervical disc disease and demyelinating spinal cord lesion.

scholarly journals Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Liu ◽  
Jing Li ◽  
Wanyu Zhang ◽  
Yihong Guo
Keyword(s):  
Birth Weight ◽  
Ovarian Stimulation ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
The Impact ◽  
Ivf Et ◽  
Group 1

AbstractOestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

scholarly journals Control of Vulval Competence and Centering in the Nematode Oscheius sp. 1 CEW1

Genetics ◽  
2003 ◽  
Vol 163 (1) ◽  
pp. 133-146 ◽  
Author(s):  
Sophie Louvet-Vallée ◽  
Irina Kolotuev ◽  
Benjamin Podbilewicz ◽  
Marie-Anne Félix
Keyword(s):  
Germ Line ◽  
Specific Mechanism ◽  
C Elegans ◽  
Group 4 ◽  
Cell Ablation ◽  
Group 3 ◽  
Group 2 ◽  
P Cells ◽  
Large Category ◽  
Group 1

Abstract To compare vulva development mechanisms in the nematode Oscheius sp. 1 to those known in Caenorhabditis elegans, we performed a genetic screen for vulva mutants in Oscheius sp. 1 CEW1. Here we present one large category of mutations that we call cov, which affect the specification of the Pn.p ventral epidermal cells along the antero-posterior axis. The Pn.p cells are numbered from 1 to 12 from anterior to posterior. In wild-type Oscheius sp. 1 CEW1, the P(4-8).p cells are competent to form the vulva and the progeny of P(5-7).p actually form the vulva, with the descendants of P6.p adopting a central vulval fate. Among the 17 mutations (defining 13 genes) that we characterize here, group 1 mutations completely or partially abolish P(4-8).p competence, and this correlates with early fusion of the Pn.p cells to the epidermal syncytium. In this group, we found a putative null mutation in the lin-39 HOM-C homolog, the associated phenotype of which could be weakly mimicked by injection of a morpholino against Osp1-lin-39 in the mother’s germ line. Using cell ablation in a partially penetrant competence mutant, we show that vulval competence is partially controlled by a gonadal signal. Most other mutants found in the screen display phenotypes unknown in C. elegans. Group 2 mutants show a partial penetrance of Pn.p competence loss and an abnormal centering of the vulva on P5.p, suggesting that these two processes are coregulated by the same pathway in Oscheius sp. 1. Group 3 mutants display an enlarged competence group that includes P3.p, thus demonstrating the existence of a specific mechanism inhibiting P3.p competence. Group 4 mutants display an abnormal centering of the vulval pattern on P7.p and suggest that a specific mechanism centers the vulval pattern on a single Pn.p cell.

scholarly journals Hypertrophy of unaffected cardiomyocytes correlates with severity of cardiomyopathy in female patients with Fabry disease

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Cristina Chimenti ◽  
Romina Verardo ◽  
Andrea Frustaci
Keyword(s):  
Fabry Disease ◽  
Wall Thickness ◽  
Left Ventricular ◽  
Female Patients ◽  
Maximal Wall Thickness ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Aim To investigate the contribution of unaffected cardiomyocytes in Fabry disease cardiomyopathy. Findings Left ventricular (LV) endomyocardial biopsies from twenty-four females (mean age 53 ± 11 ys) with Fabry disease cardiomyopathy were studied. Diagnosis of FD was based on the presence of pathogenic GLA mutation, Patients were divided in four groups according with LV maximal wall thickness (MWT): group 1 MWT ≤ 10.5 mm, group 2 MWT 10.5–15 mm, group 3 MWT 16–20 mm, group 4 MWT > 20 mm. At histology mosaic of affected and unaffected cardiomyocytes was documented. Unaffected myocytes’ size ranged from normal to severe hypertrophy. Hypertrophy of unaffected cardiomyocytes correlated with severity of MWT (p < 0.0001, Sperman r 0,95). Hypertrophy of unaffected myocytes appear to concur to progression and severity of FDCM. It is likely a paracrine role from neighboring affected myocytes.

scholarly journals THU0227 CAFFEINE INTAKE MODULATES DISEASE ACTIVITY AND CYTOKINES LEVELS IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 340.2-341
Author(s):  
V. Orefice ◽  
F. Ceccarelli ◽  
C. Barbati ◽  
R. Lucchetti ◽  
G. Olivieri ◽  
...  
Keyword(s):  
Disease Activity ◽  
Lupus Erythematosus ◽  
Caffeine Intake ◽  
Caffeine Consumption ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Background:Systemic lupus erythematosus (SLE) is an autoimmune disease mainly affecting women of childbearing age. The interplay between genetic and environmental factors may contribute to disease pathogenesis1. At today, no robust data are available about the possible contribute of diet in SLE. Caffeine, one of the most widely consumed products in the world, seems to interact with multiple components of the immune system by acting as a non-specific phosphodiesterase inhibitor2.In vitrodose-dependent treatment with caffeine seems to down-regulate mRNA levels of key inflammation-related genes and similarly reduce levels of different pro-inflammatory cytokines3.Objectives:We evaluated the impact of caffeine consumption on SLE-related disease phenotype and activity, in terms of clinimetric assessment and cytokines levels.Methods:We performed a cross-sectional study, enrolling consecutive patients and reporting their clinical and laboratory data. Disease activity was assessed by SLE Disease Activity Index 2000 (SLEDAI-2k)4. Caffeine intake was evaluated by a 7-day food frequency questionnaire, including all the main sources of caffeine. As previously reported, patients were divided in four groups according to the daily caffeine intake: <29.1 mg/day (group 1), 29.2-153.7 mg/day (group 2), 153.8-376.5 mg/day (group 3) and >376.6 mg/day (group 4)5. At the end of questionnaire filling, blood samples were collected from each patient to assess cytokines levels. These were assessed by using a panel by Bio-Plex assays to measure the levels of IL-6, IL-10, IL-17, IL-27, IFN-γ, IFN-α and Blys.Results:We enrolled 89 SLE patients (F/M 87/2, median age 46 years, IQR 14; median disease duration 144 months, IQR 150). The median intake of caffeine was 195 mg/day (IQR 160.5). At the time of the enrollment, 8 patients (8.9%) referred a caffeine intake < 29.1 mg/day (group 1), 27 patients (30.3%) between 29.2 and 153.7 mg/day (group 2), 45 patients (51%) between 153.8 and 376.5 mg/day (group 3) and 9 patients (10.1%) >376.6 mg/day (group 4). A negative correlation between the levels of caffeine and disease activity, evaluated with SLEDAI-2K, was observed (p=0.01, r=-0.26). By comparing the four groups, a significant higher prevalence of lupus nephritis, neuropsychiatric involvement, haematological manifestations, hypocomplementemia and anti-dsDNA positivity was observed in patients with less intake of caffeine (figure 1 A-E). Furthermore, patients with less intake of caffeine showed a significant more frequent use of glucocorticoids [group 4: 22.2%,versusgroup 1 (50.0%, p=0.0001), group 2 (55.5%, p=0.0001), group 3 (40.0%, p=0.009)]. Moving on cytokines analysis, a negative correlation between daily caffeine consumption and serum level of IFNγ was found (p=0.03, r=-0.2) (figure 2A); furthermore, patients with more caffeine intake showed significant lower levels of IFNα (p=0.02, figure 2B), IL-17 (p=0.01, figure 2C) and IL-6 (p=0.003, figure 2D).Conclusion:This is the first report demonstrating the impact of caffeine on SLE disease activity status, as demonstrated by the inverse correlation between its intake and both SLEDAI-2k values and cytokines levels. Moreover, in our cohort, patients with less caffeine consumption seems to have a more severe disease phenotype, especially in terms of renal and neuropsychiatric involvement. Our results seem to suggest a possible immunoregulatory dose-dependent effect of caffeine, through the modulation of serum cytokine levels, as already suggested byin vitroanalysis.References:[1]Kaul et alNat. Rev. Dis. Prim.2016; 2. Aronsen et alEurop Joul of Pharm2014; 3. Iris et alClin Immun.2018; 4. Gladman et al J Rheumatol. 2002; 5. Mikuls et alArth Rheum2002Disclosure of Interests:Valeria Orefice: None declared, Fulvia Ceccarelli: None declared, cristiana barbati: None declared, Ramona Lucchetti: None declared, Giulio Olivieri: None declared, enrica cipriano: None declared, Francesco Natalucci: None declared, Carlo Perricone: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Consultant of: Novartis, Gilead, Lilly, Sanofi, Celgene, Speakers bureau: Lilly, cristiano alessandri Grant/research support from: Pfizer, Guido Valesini: None declared, Fabrizio Conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi

Sign in / Sign up

Export Citation Format

Share Document