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Objective: To investigate the effect of infliximab treatment on anti-cyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) in patients with rheumatoid arthritis. Methods: 43 patients with rheumatoid arthritis not responding to disease modifying anti-rheumatic drugs (DMARD) received intravenous infliximab at a dose of 3 mg/kg at baseline and after two and six weeks, and subsequently bimonthly, in combination with methotrexate. Serum samples were collected at baseline and at week 24. A commercial enzyme linked immunosorbent assay was used to test for anti-CCP antibodies; RF were detected using a quantitative nephelometric assay. Results: At baseline, 38 of the 43 patients (88%) were positive for anti-CCP antibodies, and 41 (95%) were positive for RF. The serum titre of anti-CCP and RF decreased significantly after six months of treatment (p = 0.0001 and p Conclusions: Anti-TNFα treatment in rheumatoid arthritis results in a decrease in the serum titres of RF and anti-CCP antibodies in patients showing clinical improvement, suggesting that these measurements may be a useful adjunct in assessing treatment efficacy.

Background Migrants from developing to Western countries tend to become more sensitised to host than to origin country allergens, although substantial changes in migration patterns have occurred in recent decades. Methods We investigated adult immigrants with respiratory allergy, first tested for allergic sensitisation between 1985 and 2012 in a highly industrialised area in Italy. A comparison was made of the sensitisation pattern between immigrants and a random sample of native-born subjects affected by a respiratory allergy, and among immigrants according to macro-region of origin and time period. Results Between 1985 and 2012, 480 immigrants with respiratory allergy had a first positive allergy test. Immigrants were sensitised mainly to grass (67.1%), house dust mites (HDM) (38.5%) and birch (27.5%), with a pattern of sensitisation very similar to that observed in Italians (native-born). An increase in the proportion of subjects with asthma and of subjects with polysensitisation was observed from the first (1985–2002) to the middle (2003–2007) and the most recent period (2008–2012). In recent years, the proportion of subjects with polysensitisation in immigrants is higher than in Italians (native-born) (53.3% vs. 40.1%). Among immigrants, the risk of sensitisation to grass was higher in those from Sub-Saharan Africa (odds ratio, OR = 2.76) and Latin America (OR = 2.49), whereas risk of sensitisation to HDM was higher among immigrants from South Asia (OR = 2.71), compared to immigrants from Eastern Europe. Conclusions Immigrants develop multiple sensitisations more frequently than native-born people, and are especially sensitised to local allergens; the country of origin seems to play a role.

SummaryDespite the widely recognized practical importance of anticardiolipin (aCL) ELISA, the reliability of this test has been recently discussed. In order to investigate this area on European scale, we sent to 30 experienced centers a questionnaire focusing on the diagnostic procedures applied to patients with antiphospholipid syndrome (APS) and on the detailed protocols used to perform aCL. Anticardiolipin ELISA was found to be the most frequently performed test in patients with suspected APS, but significant difference was shown among the various protocols. The cross-laboratory multiple examination of ten serum samples evaluated independently by the 24 centers pointed out the difficulty in getting comparable results. Therefore a “consensus” protocol was derived from the aCL methods giving the best performance. The materials and reagents necessary to perform the “consensus” method, including, as putative standards, one IgG and one IgM monoclonal antibody (HCAL and EY2C9) were distributed to 19 Centers. The results of one IgG and one IgM aCL high positive sera measured in serial dilutions were compared. A progressive decrease in the variability of the values obtained for a given sample appeared evident when all the laboratories used the same standard, in their own in-house ELISA and even more in the “consensus” ELISA.Our data show that aCL ELISA standardization is necessary in order to obtain comparable results in different laboratories.

Summary Background. Urticarial vasculitis (UV) is an uncommon type of chronic urticaria (CU), which exhibits leucocytoclastic vasculitis. Painful and long-lasting (> 24 h) weals associated with purpura or bruising are considered indicative of UV. It is often responsive to oral corticosteroids and poorly to oral antihistamines. Hypocomplementaemia and systemic involvement are also commonly reported. Aims. To diagnose patients with UV histologically and then compare their clinical features and response to various treatment regimens. Methods. Biopsies were taken from 312 subjects with CU unresponsive to oral antihistamines; of these, 47 were histologically diagnosed as having UV. Biopsies were taken irrespective of the clinical features of weal eruption. Other diseases known to be associated with small-vessel vasculitis had previously been excluded. Results. Individual weals lasted

A short stereoselective synthesis of the acetoxy azetidinone (1), an important precursor of several biologically active beta-lactam antibiotics, has been accomplished in seven steps and 32.8% overall yield from the easily available and inexpensive (R) ethyl 3-hydroxybutanoate.

Highly stereoselective C[sbnd]C bond forming reactions can be performed with a variety of optically active sulfinyl derivatives to afford, after desulfurization, optically active sulfur-free products.

The enantiomeric composition of derivatives of new classes of optically active sulphur compounds (variously substituted sulphoxides, sulphoximes, sulphilimines) has been readily determined with the aid of chiral europium shift reagents.

The sulfinyl group is characterized by the presence of ligands very different from each other from the stereoelectronic point of view: the lone-pair, the oxygen and two aryl or alkyl groups. This accounts for the generally high stereoselectivity met with in reactions involving chiral or prochiral groups α or β to the sulfur moiety. Transmission of chirality from sulfur to carbon has been observed i) in the α-hologenation of sulfoxides, ii) in the addition of nucleophiles and electrophiles to α, β unsaturated sulfoxides, iii) in the formation of allenic sulfoxides, and iv) in the reduction of alkylidensulfinamides and of β-ketosulfoxides. The high degree of asymmetric induction allows in most cases to rationalize the absolute configuration of the reaction products in terms of mechanism and steric factors.

Reaction of sulphoxides with (dichloroiodo)benzene or with bromine in the presence of pyridine affords the corresponding α-halogeno-sulphoxides. Some reactions of α-halogeno-sulphoxides are here described.

Synthese de p-toluenesulfinyl-1 alcanones-2, -alcanenitriles, -alcanols-2, -acide alcanoique. Reactions d'alkylation, d'additions nucleophile et electrophile, d'halogenation et de transposition, a partir de sulfoxydes

The sulfoxide (I) is efficiently used as a synthon for the insertion of an allylic alcohol moiety into the title aldehydes (II).