Takayasu arteritis is a rare large vessel vasculitis which has traditionally been treated with hi... more Takayasu arteritis is a rare large vessel vasculitis which has traditionally been treated with high-dose steroids. There have been a small number of publications where biological agents have been used to manage refractory cases. To the authors knowledge, there are no publications using biological agents in combination with steroids as a first-line treatment in Takayasu arteritis. In this publication, we document the case of Takayasu arteritis, in a 39-year-old woman, where rituximab was used in combination with steroids as a first-line agent in the setting of poorly controlled bipolar affective disorder.
Background Osteoporosis, characterised by deteriorating bone microarchitecture with a concomitant... more Background Osteoporosis, characterised by deteriorating bone microarchitecture with a concomitant increase in bone fragility, represents a growing public health concern. From an inflammatory arthropathy perspective, especially RA, it is a well-known extra-articular characteristic of concern. Fracture risk can be examined using the World Health Organization Fracture Risk Assessment Tool (FRAX®) which has been formulated to estimate a 10-year absolute risk of fracture using validated clinical risk factors. Objectives The aims of our study were to determine the fracture risk in patients receiving biologic therapies using the FRAX® tool and to determine if a care-gap exists in this cohort. Methods A cross-sectional telephone based questionnaire study, employing the FRAX® tool, was conducted on Inflammatory arthropathy patients (RA, PsA, SNA, AS), receiving biological therapies, attending our Rheumatology service. Patients received a letter informing them of the study and pending telephone call one week in advance. Those not contactable within two attempted telephone calls were excluded from the study. Patients were randomly selected from the Departments Biologics database. Following FRAX® assessment, patients were classified as low, intermediate or high fracture risk using The National Osteoporosis Guideline Group (NOGG) analysis. Results 182 patients were telephoned with 123 patients being contactable within two attempts. 101 patients partook in the study. 8 (8%) had a prior osteoporosis diagnosis. 93 (92%) were eligible for FRAX® assessment with a mean age was 55.5 years (range: 40-75) and 53% male. Of the untreated group 77% had RA, 14% PsA and 8% AS. FRAX® assessment gave a median 10-year hip osteoporotic fracture probability of 2.1% (mean =3.5%) and major osteoporotic fracture probability of 11% (mean =12.4%). NOGG analysis would advise offering treatment to 25%, DXA imaging to 56% and osteoporosis/fracture risk lifestyle advice to 19% of patients. Thus a potential 81% of untreated patients may require osteoporosis/risk fracture prevention measures. Conclusions A large care-gap was identified among this patient group. Results highlight the need to identify and modify fracture risk in patients with inflammatory arthropathies receiving biologic therapies. Disclosure of Interest None declared
With the recent influenza season, much concern existed among rheumatology patients and treating p... more With the recent influenza season, much concern existed among rheumatology patients and treating physicians regarding the impact of the seasonal influenza virus. Unfortunately, this year, we also faced the additional challenge and worry of the H1N1 virus, which was first ...
The experience with anti-TNF agents is relatively short; and with time, we are learning more abou... more The experience with anti-TNF agents is relatively short; and with time, we are learning more about the frequency of occurrence of different adverse events as the original trials were either too small or too brief. We report a case series of four patients who suffered from chronic inflammatory arthritis [rheumatoid arthritis (n = 3) and psoriatic arthritis (n = 1)]. Their inflammatory arthritis remained refractory to increasing doses of methotrexate up to 20 mg weekly and required an advance in treatment to TNF antagonists. However, within a few weeks of commencing these patients on adalimumab, they developed newly diagnosed recurring sinusitis. All these patients were assessed by otorhinolaryngologists, and had clinically confirmed diagnosis. The sinusitis remained refractory to standard medications; however, it resolved after the discontinuation of adalimumab. Although FDA and Irish Pharmaceutical Health Association describe that adalimumab use increases the risk of non-serious infections marginally and most of the patients continued on Humira (adalimumab) after the infection was resolved, however, our recent observation raises the concern of probable higher incidence.
The sequencing of over a thousand Saccharomyces cerevisiae genomes revealed a complex pangenome. ... more The sequencing of over a thousand Saccharomyces cerevisiae genomes revealed a complex pangenome. Over one third of the discovered genes are not present in the S. cerevisiae core genome but instead are often restricted to a subset of yeast isolates and thus may be important for adaptation to specific environmental niches. We refer to these genes as “pan‐genes,” being part of the pangenome but not the core genome.
Lignocellulosic biomass is a viable source of renewable energy for bioethanol production. For the... more Lignocellulosic biomass is a viable source of renewable energy for bioethanol production. For the efficient conversion of biomass into bioethanol, it is essential that sugars from both the cellulose and hemicellulose fractions of lignocellulose be utilised. We describe the development of a recombinant yeast system for the fermentation of cellulose and xylose, the most abundant pentose sugar in the hemicellulose fraction of biomass. The brewer's yeast Saccharomyces pastorianus was chosen as a host as significantly higher recombinant enzyme activities are achieved, when compared to the more commonly used S. cerevisiae. When expressed in S. pastorianus, the Trichoderma reesei xylose oxidoreductase pathway was more efficient at alcohol production from xylose than the xylose isomerase pathway. The alcohol yield was influenced by the concentration of xylose in the medium and was significantly improved by the additional expression of a gene encoding for xylulose kinase. The xylose redu...
Lager yeasts, Saccharomyces pastorianus, are interspecies hybrids between S. cerevisiae and S. eu... more Lager yeasts, Saccharomyces pastorianus, are interspecies hybrids between S. cerevisiae and S. eubayanus and are classified into Group I and Group II clades. The genome of the Group II strain, Weihenstephan 34/70, contains eight so-called 'lager-specific' genes that are located in subtelomeric regions. We evaluated the origins of these genes through bioinformatic and PCR analyses of Saccharomyces genomes. We determined that four are of cerevisiae origin while four originate from S. eubayanus. The Group I yeasts contain all four S. eubayanus genes but individual strains contain only a subset of the cerevisiae genes. We identified S. cerevisiae strains that contain all four cerevisiae 'lager-specific' genes, and distinct patterns of loss of these genes in other strains. Analysis of the subtelomeric regions uncovered patterns of loss in different S. cerevisiae strains. We identify two classes of S. cerevisiae strains: ale yeasts (Foster O) and stout yeasts with patterns...
Journal of immune based therapies and vaccines, Jan 8, 2006
The heat shock protein, Hsp70, has been shown to play an important role in tumour immunity. Vacci... more The heat shock protein, Hsp70, has been shown to play an important role in tumour immunity. Vaccination with Hsp70-peptide complexes (Hsp70-PCs), isolated from autologous tumour cells, can induce protective immune responses. We have developed a novel method to identify synthetic mimic peptides of Hsp70-PCs and to test their ability to activate T-cells. Peptides (referred to as "recognisers") that bind to Hsp70-PCs from the human breast carcinoma cell line, MDA-MB-231, were identified by bio-panning a random peptide M13 phage display library. Synthetic recogniser peptides were subsequently used as bait in a reverse bio-panning experiment to identify potential Hsp70-PC mimic peptides. The ability of the recogniser and mimic peptides to prime human lymphocyte responses against tumour cell antigens was tested by stimulating lymphocytes with autologous peptide-loaded monocyte-derived dendritic cells (DCs). Priming and subsequent stimulation with either the recogniser or mimic p...
Takayasu arteritis is a rare large vessel vasculitis which has traditionally been treated with hi... more Takayasu arteritis is a rare large vessel vasculitis which has traditionally been treated with high-dose steroids. There have been a small number of publications where biological agents have been used to manage refractory cases. To the authors knowledge, there are no publications using biological agents in combination with steroids as a first-line treatment in Takayasu arteritis. In this publication, we document the case of Takayasu arteritis, in a 39-year-old woman, where rituximab was used in combination with steroids as a first-line agent in the setting of poorly controlled bipolar affective disorder.
Background Osteoporosis, characterised by deteriorating bone microarchitecture with a concomitant... more Background Osteoporosis, characterised by deteriorating bone microarchitecture with a concomitant increase in bone fragility, represents a growing public health concern. From an inflammatory arthropathy perspective, especially RA, it is a well-known extra-articular characteristic of concern. Fracture risk can be examined using the World Health Organization Fracture Risk Assessment Tool (FRAX®) which has been formulated to estimate a 10-year absolute risk of fracture using validated clinical risk factors. Objectives The aims of our study were to determine the fracture risk in patients receiving biologic therapies using the FRAX® tool and to determine if a care-gap exists in this cohort. Methods A cross-sectional telephone based questionnaire study, employing the FRAX® tool, was conducted on Inflammatory arthropathy patients (RA, PsA, SNA, AS), receiving biological therapies, attending our Rheumatology service. Patients received a letter informing them of the study and pending telephone call one week in advance. Those not contactable within two attempted telephone calls were excluded from the study. Patients were randomly selected from the Departments Biologics database. Following FRAX® assessment, patients were classified as low, intermediate or high fracture risk using The National Osteoporosis Guideline Group (NOGG) analysis. Results 182 patients were telephoned with 123 patients being contactable within two attempts. 101 patients partook in the study. 8 (8%) had a prior osteoporosis diagnosis. 93 (92%) were eligible for FRAX® assessment with a mean age was 55.5 years (range: 40-75) and 53% male. Of the untreated group 77% had RA, 14% PsA and 8% AS. FRAX® assessment gave a median 10-year hip osteoporotic fracture probability of 2.1% (mean =3.5%) and major osteoporotic fracture probability of 11% (mean =12.4%). NOGG analysis would advise offering treatment to 25%, DXA imaging to 56% and osteoporosis/fracture risk lifestyle advice to 19% of patients. Thus a potential 81% of untreated patients may require osteoporosis/risk fracture prevention measures. Conclusions A large care-gap was identified among this patient group. Results highlight the need to identify and modify fracture risk in patients with inflammatory arthropathies receiving biologic therapies. Disclosure of Interest None declared
With the recent influenza season, much concern existed among rheumatology patients and treating p... more With the recent influenza season, much concern existed among rheumatology patients and treating physicians regarding the impact of the seasonal influenza virus. Unfortunately, this year, we also faced the additional challenge and worry of the H1N1 virus, which was first ...
The experience with anti-TNF agents is relatively short; and with time, we are learning more abou... more The experience with anti-TNF agents is relatively short; and with time, we are learning more about the frequency of occurrence of different adverse events as the original trials were either too small or too brief. We report a case series of four patients who suffered from chronic inflammatory arthritis [rheumatoid arthritis (n = 3) and psoriatic arthritis (n = 1)]. Their inflammatory arthritis remained refractory to increasing doses of methotrexate up to 20 mg weekly and required an advance in treatment to TNF antagonists. However, within a few weeks of commencing these patients on adalimumab, they developed newly diagnosed recurring sinusitis. All these patients were assessed by otorhinolaryngologists, and had clinically confirmed diagnosis. The sinusitis remained refractory to standard medications; however, it resolved after the discontinuation of adalimumab. Although FDA and Irish Pharmaceutical Health Association describe that adalimumab use increases the risk of non-serious infections marginally and most of the patients continued on Humira (adalimumab) after the infection was resolved, however, our recent observation raises the concern of probable higher incidence.
The sequencing of over a thousand Saccharomyces cerevisiae genomes revealed a complex pangenome. ... more The sequencing of over a thousand Saccharomyces cerevisiae genomes revealed a complex pangenome. Over one third of the discovered genes are not present in the S. cerevisiae core genome but instead are often restricted to a subset of yeast isolates and thus may be important for adaptation to specific environmental niches. We refer to these genes as “pan‐genes,” being part of the pangenome but not the core genome.
Lignocellulosic biomass is a viable source of renewable energy for bioethanol production. For the... more Lignocellulosic biomass is a viable source of renewable energy for bioethanol production. For the efficient conversion of biomass into bioethanol, it is essential that sugars from both the cellulose and hemicellulose fractions of lignocellulose be utilised. We describe the development of a recombinant yeast system for the fermentation of cellulose and xylose, the most abundant pentose sugar in the hemicellulose fraction of biomass. The brewer's yeast Saccharomyces pastorianus was chosen as a host as significantly higher recombinant enzyme activities are achieved, when compared to the more commonly used S. cerevisiae. When expressed in S. pastorianus, the Trichoderma reesei xylose oxidoreductase pathway was more efficient at alcohol production from xylose than the xylose isomerase pathway. The alcohol yield was influenced by the concentration of xylose in the medium and was significantly improved by the additional expression of a gene encoding for xylulose kinase. The xylose redu...
Lager yeasts, Saccharomyces pastorianus, are interspecies hybrids between S. cerevisiae and S. eu... more Lager yeasts, Saccharomyces pastorianus, are interspecies hybrids between S. cerevisiae and S. eubayanus and are classified into Group I and Group II clades. The genome of the Group II strain, Weihenstephan 34/70, contains eight so-called 'lager-specific' genes that are located in subtelomeric regions. We evaluated the origins of these genes through bioinformatic and PCR analyses of Saccharomyces genomes. We determined that four are of cerevisiae origin while four originate from S. eubayanus. The Group I yeasts contain all four S. eubayanus genes but individual strains contain only a subset of the cerevisiae genes. We identified S. cerevisiae strains that contain all four cerevisiae 'lager-specific' genes, and distinct patterns of loss of these genes in other strains. Analysis of the subtelomeric regions uncovered patterns of loss in different S. cerevisiae strains. We identify two classes of S. cerevisiae strains: ale yeasts (Foster O) and stout yeasts with patterns...
Journal of immune based therapies and vaccines, Jan 8, 2006
The heat shock protein, Hsp70, has been shown to play an important role in tumour immunity. Vacci... more The heat shock protein, Hsp70, has been shown to play an important role in tumour immunity. Vaccination with Hsp70-peptide complexes (Hsp70-PCs), isolated from autologous tumour cells, can induce protective immune responses. We have developed a novel method to identify synthetic mimic peptides of Hsp70-PCs and to test their ability to activate T-cells. Peptides (referred to as "recognisers") that bind to Hsp70-PCs from the human breast carcinoma cell line, MDA-MB-231, were identified by bio-panning a random peptide M13 phage display library. Synthetic recogniser peptides were subsequently used as bait in a reverse bio-panning experiment to identify potential Hsp70-PC mimic peptides. The ability of the recogniser and mimic peptides to prime human lymphocyte responses against tumour cell antigens was tested by stimulating lymphocytes with autologous peptide-loaded monocyte-derived dendritic cells (DCs). Priming and subsequent stimulation with either the recogniser or mimic p...
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