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Objective: Vascular stiffness has long been linked with the ageing process. However, it is only since the development of accurate methods for measuring arterial compliance that unravelling this relationship has become possible. Arterial stiffening over time appears to differ between ethnic groups and/or geographic areas. We investigated how the cardio-ankle vascular index (CAVI) varied with chronological age to make initial comparisons of its change with age between this European study and published data from Japanese and Korean patient populations. Method: 312 participants (180 men, 132 women), age 63.7±12.9 (mean±SD), range 25–92 years. The following were measured: CAVI using VaSera VS-1500N® (Fukuda Denshi, Japan); brachial BP using OMRON705-IT; baseline characteristics and physical examination of cardiovascular health. These data are from current UK studies of healthy volunteers with approximately 20% having two or more cardiovascular risk factors. Results: CAVI was significantly correlated with age (r = 0.63, p < 0.001), more closely in men (r = 0.71, p < 0.001) than women (r = 0.54, p < 0.001). These data were used to create a preliminary set of ‘usual’ average CAVI values for each age category (Table) and compared against data from Japan [1] and Korea [2] (plot 1 & 2). Korean men had lower CAVI values at each age. Age category (years) CAVI mean (SD)

Cryoglobulinaemic mononeuritis multiplex (MNM) is an extrahepatic manifestation of chronic hepatitis C virus (HCV) infection for which interferon-based antiviral therapy is currently the treatment of choice. Rarely MNM can be associated with HCV treatment though generally in the setting of pre-existing cryoglobulinaemia and detectable HCV viraemia. We report an unusual case of de novo MNM occurring late during the course of pegylated interferon and ribavirin therapy for chronic HCV infection, following a prolonged period of viral suppression. The patient had no evidence of cryoglobulinaemia prior to HCV treatment and undetectable HCV RNA levels at the time of presentation with MNM. The case raises the possibility that MNM could develop as an adverse immunomodulatory effect of pegylated interferon therapy.

Objective: To investigate the effects of soluble uric acid (UA) on expression and activation of the NOD-like receptor (NLR) pyrin domain containing protein 3 (NLRP3) inflammasome in human monocytes to elucidate the role of hyperuricemia in the pathogenesis of gout., Methods: Primary human monocytes and the THP-1 human monocyte cell line were used to determine the effects of short- and longterm exposure to UA on activation of the NLRP3 inflammasome and subsequent interleukin 1β (IL-1β) secretion by ELISA and cell-based assays. Expression of key NLRP3 components in monocytes from patients with a history of gout were analyzed by quantitative PCR., Results: Precipitation of UA was required for activation of the NLRP3 inflammasome and subsequent release of IL-1β in human monocytes. Neither monosodium urate (MSU) crystals nor soluble UA had any effect on activation of the transcription factor, nuclear factor-κB. Prolonged exposure of monocytes to soluble UA did not alter these responses. However, both MSU crystals and soluble UA did result in a 2-fold increase in reactive oxygen species. Patients with gout (n = 15) had significantly elevated serum UA concentrations compared to healthy individuals (n = 16), yet secretion of IL-1β and expression of NLRP3 inflammasome components in monocytes isolated from these patients were not different from those of healthy controls., Conclusion: Despite reports indicating that soluble UA can prime and activate the NLRP3 inflammasome in human peripheral blood mononuclear cells, precipitation of soluble UA into MSU crystals is essential for in vitro NLRP3 signaling in primary human monocytes.