Detection of Buckminsterfullerene emission in the diffuse interstellar medium.

Emission of fullerenes in their infrared vibrational bands has been detected in space near hot stars. The proposed attribution of the diffuse interstellar bands at 9577 and 9632 Å to electronic transitions of the buckminsterfullerene cation (i.e. [Formula: see text]) was recently supported by new laboratory data, confirming the presence of this species in the diffuse interstellar medium (ISM). In this letter, we present the detection, also in the diffuse ISM, of the 17.4 and 18.9 µm emission bands commonly attributed to vibrational bands of neutral C60. According to classical models that compute the charge state of large molecules in space, C60 is expected to be mostly neutral in the diffuse ISM. This is in agreement with the abundances of diffuse C60 we derive here from observations. We also find that C60 is less abundant in the diffuse ISM than in star-forming regions, supporting the theory that C60 can be formed in these regions.

ALMA Compact Array observations of the Fried Egg nebula: Evidence for large-scale asymmetric mass-loss from the yellow hypergiant IRAS 17163-3907.

Yellow hypergiants are rare and represent a fast evolutionary stage of massive evolved stars. That evolutionary phase is characterised by a very intense mass loss, the understanding of which is still very limited. Here we report ALMA Compact Array observations of a 50″-mosaic toward the Fried Egg nebula, around one of the few Galactic yellow hypergiants IRAS 17163-3907. The emission from the 12CO J=2-1 line, H30α recombination line, and continuum is imaged at a resolution of ~8″, revealing the morphology of the molecular environment around the star. The continuum emission is unresolved and peaks at the position of the star. The radio recombination line H30α shows unresolved emission at the star, with an approximately gaussian spectrum centered on a velocity of 21±3 km s-1 with a width of 57±6 km s-1. In contrast, the CO 2-1 emission is complex and decomposes into several components beyond the contamination from interstellar gas in the line of sight. The CO spectrum toward the star is a broad plateau, centered at the systemic velocity of +18 km s-1 and with an expansion velocity of 100±10 km s-1. Assuming isotropic and constant mass-loss, we estimate a mass-loss rate of 8±1.5 ×10-5 M⊙ yr-1. At a radius of 25″ from the star, we detect CO emission associated with the dust ring previously imaged by Herschel. The kinematics of this ring, however, is not consistent with an expanding shell, but show a velocity gradient of vsys ±20 km s-1. In addition, we find a puzzling bright feature radially connecting the star to the CO ring, at a velocity of +40 km s-1 relative to the star. This spur feature may trace a unidirectional ejection event from the star. Our ACA observations reveal the complex morphology around IRAS 17163 and illustrate the breakthroughs that ALMA will bring to the field of massive stellar evolution.

Polycyclic aromatic hydrocarbons and molecular hydrogen in oxygen-rich planetary nebulae: the case of NGC 6720.

Evolved stars are primary sources for the formation of polycyclic aromatic hydrocarbons (PAHs) and dust grains. Their circumstellar chemistry is usually designated as either oxygen-rich or carbon-rich, although dual-dust chemistry objects, whose infrared spectra reveal both silicate- and carbon-dust features, are also known. The exact origin and nature of this dual-dust chemistry is not yet understood. Spitzer-IRS mid-infrared spectroscopic imaging of the nearby, oxygen-rich planetary nebula NGC 6720 reveals the presence of the 11.3 µm aromatic (PAH) emission band. It is attributed to emission from neutral PAHs, since no band is observed in the 7-8 µm range. The spatial distribution of PAHs is found to closely follow that of the warm clumpy molecular hydrogen emission. Emission from both neutral PAHs and warm H2 is likely to arise from photo-dissociation regions associated with dense knots that are located within the main ring. The presence of PAHs together with the previously derived high abundance of free carbon (relative to CO) suggest that the local conditions in an oxygen-rich environment can also become conducive to in-situ formation of large carbonaceous molecules, such as PAHs, via a bottom-up chemical pathway. In this scenario, the same stellar source can enrich the interstellar medium with both oxygen-rich dust and large carbonaceous molecules.

Association of DRB1 shared epitope genotypes with early mortality in rheumatoid arthritis: results of eighteen years of followup from the early rheumatoid arthritis study.

OBJECTIVE: To determine whether the HLA-DRB1 shared epitope (SE) is associated with early mortality and specific causes of death in rheumatoid arthritis (RA). METHODS: HLA-DRB1 genotyping was carried out on blood samples from 767 patients recruited for the Early RA Study (ERAS), a multicenter, inception cohort study with followup over 18 years. Dates and causes of death (n = 186) were obtained from the Office of National Statistics. The association of HLA-DRB1 alleles with risk of mortality was assessed using Cox proportional hazards regression analyses. Multivariate stepwise models were used to assess the predictive value of HLA-DRB1 genotypes compared with other potential baseline risk factors. RESULTS: The SE was not significantly associated with overall mortality. However, the presence of 2 SE alleles was associated with risk of mortality from ischemic heart disease (hazard ratio [HR] 2.02 [95% confidence interval 1.04-3.94], P = 0.04), and malignancy (HR 2.18 [95% confidence interval 1.17-4.08], P = 0.01). Analysis of specific SE genotypes (corrected for age and sex) revealed that the HLA-DRB1*0101/*0401 and 0404/*0404 genotypes were the strongest predictors of mortality from ischemic heart disease (HR 5.11 and HR 7.55, respectively), and DRB1*0101/*0401 showed a possible interaction with smoking. Male sex, erythrocyte sedimentation rate, and Carstairs Deprivation Index were also predictive, but the Health Assessment Questionnaire score, rheumatoid factor, nodules, and swollen joint counts were not. Mortality due to malignancy was particularly associated with DRB1*0101 genotypes. CONCLUSION: The risk of mortality due to ischemic heart disease or cancer in RA is increased in patients carrying HLA-DRB1 genotypes with particular homozygous and compound heterozygous SE combinations.

Class II MHC antigens in early rheumatoid arthritis in Bath (UK) and Madrid (Spain).

OBJECTIVE: A number of studies have indicated that rheumatoid arthritis (RA) is a less severe disease in Mediterranean countries than in Northern Europe. We investigated whether differences in the frequency of class II MHC antigens might contribute to this variation in disease severity. METHODS: Typing at HLA-DR and -DQ loci was carried out at low and high resolutions by polymerase chain reaction amplification in patients with early RA of less than 6 months' duration (68 patients in Madrid and 68 in Bath) and in control subjects (929 in Madrid and 226 in Bath). Only ethnic Spanish and British individuals were included as patients and controls. RESULTS: Shared epitope (SE) alleles represented 19.8 and 28.9% of the total number of class II MHC alleles in controls from Madrid and Bath respectively (P: = 0.00001), this difference being largely due to increased numbers of DRB1*0401 individuals in the British subjects (P: = 0.0000001). Analysis of the patients showed the expected increase in SE alleles when compared with their respective control groups (Madrid, 31.6 vs 19.8%; Bath, 42.6 vs 28. 9%). In Bath the SE was mainly encoded by HLA-DR4 alleles (74.1%), while in Madrid it was encoded almost equally by DR4 (51.1%) and DR1 (44.7%) alleles. The risk of developing RA in carriers of SE alleles was similar in the two cities (Bath, odds ratio 1.83, 95% confidence interval 1.23-2.78; Madrid, odds ratio 1.87, 95% confidence interval 1.25-2.77), and was largely accounted for by HLA-DRB1*0401 alleles. CONCLUSION: We conclude that rheumatoid patients in Bath differ from their Spanish counterparts in class II antigen expression and allele frequency. This may be explained partly by genetic differences between the control populations in the two centres, and may help to explain the greater incidence of more severe rheumatoid disease expression seen in RA patients in the UK.

Inactivation of antithrombin III in synovial fluid from patients with rheumatoid arthritis.

OBJECTIVE: To investigate the thrombin inhibitory capacity of antithrombin III in the inflamed human joint. METHODS: Thrombin inhibitory capacity was measured, using a kinetic spectophotometric method, in matched plasma and synovial fluid samples of patients with rheumatoid arthritis (n = 22) and osteoarthritis (n = 16), together with normal control plasma samples (n = 13). In the same samples, the concentration of antithrombin III was also determined by the method of radial immunodiffusion. The combination of these measurements allowed the calculation of the specific thrombin inhibitory capacity of these samples. RESULTS: An increased concentration of antithrombin III in rheumatoid compared with osteoarthritic synovial fluid was noted (p < 0.05). However, there was a significant depression in the specific activity of antithrombin III in rheumatoid synovial fluid when compared with matched plasma samples (p < 0.001) or with osteoarthritic synovial fluid (p < 0.05). CONCLUSION: In rheumatoid synovial fluid the thrombin inhibitory capacity of antithrombin III is disproportionately depressed relative to the concentration of antithrombin III, indicating the inactivation of antithrombin III in the rheumatoid joint.

Antibody responses to gut bacteria in ankylosing spondylitis, rheumatoid arthritis, Crohn's disease and ulcerative colitis.

Specific immunoreactive anti-Klebsiella antibodies are found in patients with ankylosing spondylitis (AS), a significant proportion of whom have occult inflammatory bowel disease. Molecular mimicry between Klebsiella or other bacterial antigens and HLA-B27 has been suggested in the pathogenesis of AS. The specificity of increased immunoreactivity against Klebsiella remains to be assessed against the abundant anaerobic bacterial flora, present either in healthy controls or in patients with ulcerative colitis (UC) and Crohn's disease (CD). Total immunoglobulin (Ig; IgG, IgA, IgM) immunoreactivity was measured by ELISA against Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli and ten anaerobic isolates of the predominant normal bowel flora in 35 patients with active AS, 60 patients with inflammatory bowel disease (30 CD, 30 UC), 60 patients with active rheumatoid arthritis (RA) and 60 healthy controls. Ig immunoreactivity to K. pneumoniae was significantly elevated in AS (P < 0.001), CD (P < 0.001) and UC (P < 0.001) patients compared with RA patients and healthy controls. Furthermore, Ig immunoreactivity to P. mirabilis was significantly elevated only in RA patients, compared with the other inflammatory groups (P < 0.001) and controls (P < 0.001). There was no significant antibody response against E. coli or the ten obligate anaerobes in any of the test groups. The data suggested an increased immune response to Klebsiella in patients with AS, UC, CD and to Proteus in patients with RA. The specificity of these responses in some patients supported a possible role for enteric Klebsiella in the pathogenesis of AS and Proteus in RA. The role of Klebsiella in inflammatory bowel disease requires further study.

Exercise induced release of von Willebrand factor: evidence for hypoxic reperfusion microvascular injury in rheumatoid arthritis.

Experimental evidence suggests that rheumatoid synovitis may be perpetuated by the generation of reactive oxygen species during hypoxic reperfusion injury. The latter occurs because increased intra-articular pressure during exercise exceeds synovial capillary perfusion pressure, impairing blood flow. The object of this study was to establish a marker for and the mechanism of synovial hypoxic reperfusion injury. Von Willebrand factor (vWF) is only released from endothelial cells and platelets and is an in vivo and in vitro marker of endothelial injury. In vivo exercise induced changes in plasma vWF were therefore investigated in patients with rheumatoid arthritis (RA) compared with controls and in vitro vWF release by human umbilical vein endothelial cells subjected to hypoxia reperfusion. Pre-exercise plasma vWF levels were 1001 and 817 IU/l, increasing after exercise to 1658 and 845 IU/l in patients with RA and controls respectively. Von Willebrand factor release from human umbilical vein endothelial cells followed a biphasic pattern, occurring during both hypoxia and reperfusion. Hypoxia reperfusion induced vWF release by human umbilical vein endothelial cells in vitro suggests that exercise induced vWF release in patients with RA is best explained by synovial hypoxic reperfusion injury. This study supports evidence that generation of reactive oxygen species plays a principal part in synovial hypoxic reperfusion injury and suggests vWF as a useful marker of this phenomenon.

Treatment of early rheumatoid arthritis with rifampicin.

Following a report that seven of 20 patients with rheumatoid arthritis (RA) had come into clinical and laboratory remission after treatment with rifampicin, and that six of the seven responders had a disease duration of less than three years, 21 patients with classical or definite RA of recent onset were treated with 600 mg rifampicin and 300 mg isoniazid daily for six months. Fourteen of 21 patients completed six months' treatment, but there was no significant improvement in the mean values of the clinical and laboratory parameters measured. The improvement suggested by preliminary studies in patients with early RA is not seen in this larger group. In patients with a disease duration of less than 18 months, however, there was a significant decrease in the erythrocyte sedimentation rate and the serum concentrations of C reactive protein after treatment for six months, although there was no significant clinical improvement. Future studies of this drug in patients with RA should concentrate on this group.

Klebsiella antibodies in ankylosing spondylitis and Proteus antibodies in rheumatoid arthritis.

Antibodies to Klebsiella, but not to other bacteria, have been shown to be present in patients with active ankylosing spondylitis (AS) by seven different techniques. Antibodies to Proteus, but not to E. coli or Klebsiella, have been shown to be present in patients with active rheumatoid arthritis (RA) by three different techniques. It is suggested AS and RA are forms of reactive arthritis, to Klebsiella and Proteus respectively, probably mediated by cross-reactivity to HLA antigens.

Fatal cardiac tamponade complicating anticoagulant therapy in rheumatoid arthritis.

Haemopericardium with tamponade is a rare complication of anticoagulant therapy. A case of fatal haemopericardium is described in a patient with rheumatoid pericarditis in whom the precipitating factor appeared to be intravenous anticoagulant therapy.

Indices of disease activity in psoriatic arthritis.

Psoriatic arthritis (PA) may respond to disease-modifying antirheumatic therapy. The value of assessing disease activity with indices devised for rheumatoid arthritis (RA) was investigated in 72 patients with seronegative PA. Thirty patients had a peripheral polyarthritis including the distal interphalangeal joints (DIPJs) and 15 a symmetrical arthritis sparing DIPJs (RA-like). Significant correlations (Spearman rank test) were seen between the clinical variables (pain score, grip strength, Ritchie articular index and a summated index of disease activity) in these two groups. Ten patients with a markedly asymmetrical arthritis showed a poor correlation between clinical variables. Although the objective indices - erythrocyte sedimentation rate (ESR) and C-reactive protein - correlated together in the first two groups, the ESR correlated solely with clinical indices, and then only in RA-like patients. These results cast some doubt on the value of assessment methods based on RA when evaluating subgroups of PA other than RA-like disease.