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Periodontal disease is more common in individuals with rheumatoid arthritis (RA) who have detectable anti-citrullinated protein antibodies (ACPAs), implicating oral mucosal inflammation in RA pathogenesis. Here, we performed paired analysis of human and bacterial transcriptomics in longitudinal blood samples from RA patients. We found that patients with RA and periodontal disease experienced repeated oral bacteremias associated with transcriptional signatures of ISG15 + HLADR hi and CD48 high S100A2 pos monocytes, recently identified in inflamed RA synovia and blood of those with RA flares. The oral bacteria observed transiently in blood were broadly citrullinated in the mouth, and their in situ citrullinated epitopes were targeted by extensively somatically hypermutated ACPAs encoded by RA blood plasmablasts. Together, these results suggest that (i) periodontal disease results in repeated breaches of the oral mucosa that release citrullinated oral bacteria into circulation, which (ii) activate inflammatory monocyte subsets that are observed in inflamed RA synovia and blood of RA patients with flares and (iii) activate ACPA B cells, thereby promoting affinity maturation and epitope spreading to citrullinated human antigens.

Osteoarthritis (OA) is the leading cause of joint failure, yet the underlying mechanisms remain elusive, and no approved therapies that slow progression exist. Dysregulated integrin function was previously implicated in OA pathogenesis. However, the roles of integrin α(V)β(3) and the integrin-associated receptor CD47 in OA remain largely unknown. Here, transcriptomic and proteomic analyses of human and murine osteoarthritic tissues revealed dysregulated expression of α(V)β(3), CD47, and their ligands. Using genetically deficient mice and pharmacologic inhibitors, we showed that α(V)β(3), CD47, and the downstream signaling molecules Fyn and FAK are crucial to OA pathogenesis. MicroPET/CT imaging of a mouse model showed elevated ligand-binding capacities of integrin α(V)β(3) and CD47 in osteoarthritic joints. Further, our in vitro studies demonstrated that chondrocyte breakdown products, derived from articular cartilage of individuals with OA, induced α(V)β(3)/CD47-dependent expression of inflammatory and degradative mediators, and revealed the downstream signaling network. Our findings identify a central role for dysregulated α(V)β(3) and CD47 signaling in OA pathogenesis and suggest that activation of α(V)β(3) and CD47 signaling in many articular cell types contributes to inflammation and joint destruction in OA. Thus, the data presented here provide a rationale for targeting α(V)β(3), CD47, and their signaling pathways as a disease-modifying therapy.

Objective Osteoarthritis (OA), the leading cause of joint failure, is characterized by breakdown of articular cartilage and remodeling of subchondral bone in synovial joints. Despite the high prevalence and debilitating effects of OA, no disease-modifying drugs exist. Increasing evidence, including genetic variants of the interleukin 4 (IL-4) and IL-4 receptor genes, implicates a role for IL-4 in OA, however, the mechanism underlying IL-4 function in OA remains unknown. Here, we investigated the role of IL-4 in OA pathogenesis. Methods Il4-, myeloid-specific-Il4ra-, and Stat6-deficient and control mice were subjected to destabilization of the medial meniscus to induce OA. Macrophages, osteoclasts, and synovial explants were stimulated with IL-4 in vitro, and their function and expression profiles characterized. Results Mice lacking IL-4, IL-4Ra in myeloid cells, or STAT6 developed exacerbated cartilage damage and osteophyte formation relative to WT controls. In vitro analyses revealed that IL-4 downregulates osteoarthritis-associated genes, enhances macrophage phagocytosis of cartilage debris, and inhibits osteoclast differentiation and activation via the type I receptor. Conclusion Our findings demonstrate that IL-4 protects against osteoarthritis in a myeloid and STAT6-dependent manner. Further, IL-4 can promote an immunomodulatory microenvironment in which joint-resident macrophages polarize towards an M2 phenotype and efficiently clear pro-inflammatory debris, and osteoclasts maintain a homeostatic level of activity in subchondral bone. These findings support a role for IL-4 modulation of myeloid cell types in maintenance of joint health and identify a pathway that could provide therapeutic benefit for osteoarthritis.

A key question in studies of mass extinctions is whether the extinction was a sudden or gradual event. This question may be addressed by examining the locations of fossil occurrences in a stratigraphic section. However, the fossil record can be consistent with both sudden and gradual extinctions. Rather than being limited to rejecting or not rejecting a particular scenario, ideally we should estimate therangeof extinction scenarios that is consistent with the fossil record. In other words, rather than testing the simplified distinction of “sudden versus gradual,” we should be asking, “How gradual?”In this paper we answer the question “How gradual could the extinction have been?” by developing a confidence interval for the duration of a mass extinction. We define the duration of the extinction as the time or stratigraphic thickness between the first and last taxon to go extinct, which we denote by Δ. For example, we would like to be able to say with 90% confidence that the extinction took place over a duration of 0.3 to 1.1 million years, or 24 to 57 meters of stratigraphic thickness. Our method does not deny the possibility of a truly simultaneous extinction; rather, in this framework, a simultaneous extinction is one whose value of Δ is equal to zero years or meters.We present an algorithm to derive such estimates and show that it produces valid confidence intervals. We illustrate its use with data from Late Permian ostracodes from Meishan, China, and Late Cretaceous ammonites from Seymour Island, Antarctica.

Osteoarthritis (OA), the most common form of arthritis in the world, is characterized by articular cartilage breakdown in synovial joints. There is evidence of low-grade inflammatory responses in OA, but their contribution to OA pathogenesis is unclear. Studies have demonstrated that dysregulated complement activity is involved in OA pathogenesis. The complement component, C1q, is known to regulate inflammation via mechanisms involving apoptotic cell clearance and macrophage activation. Thus, we hypothesized that C1q is a key negative regulator of inflammatory mechanisms in OA. Using a combination of NanoString-based mRNA quantification and Luminex-based analyses for cytokine profiling, we found that differentiation of human monocyte-derived macrophages in C1q-depleted serum followed by stimulation with cartilage debris resulted in enhanced pro-inflammatory (e.g., IL1β) and reduced anti-inflammatory (e.g,. IL10) cytokine expression and secretion compared to cells grown in normal human serum. To definitively establish a regulatory role for C1q in OA, we used a well-established destabilization of the medial meniscus (DMM) model of knee OA in genetically-deficient mice. We found that knees of C1q-deficient mice subjected to DMM developed worse OA pathologies including exacerbated cartilage damage, osteophyte formation and synovitis relative to C1q-sufficient mice. Our data suggest that C1q deficiency exacerbates inflammation and cartilage damage through mechanisms involving dysregulated macrophage activation. Understanding the precise mechanisms underlying C1q-mediated regulation of inflammation may lead to the identification of novel targets for the treatment of inflammatory diseases including OA.

M ediopatellar plica syndrome is an uncommon diagnosis in the rheumatology clinic. Medial plica is an embryologic synovial remnant that originates from the medial wall of the knee and inserts obliquely into the fat pad. Although the medial plica is a common arthroscopic finding in adults, it only causes discomfort once it becomes irritated. We do not have knowledge of previous reports of an acute painful effusion attributable to mediopatellar plica after protracted travel sitting.

A micro inertial measurement unit (muIMU) which is based on MEMS accelerometers and gyro sensors is developed for real-time recognition of human hand motions, which when combined with appropriate filtering and transformation algorithms, becomes a digital writing system that can be used to record handwriting on any surface. The overall size of our muIMU is less than 25 mm times 70 mm times 20 mm, including the micro sensors, processor, and wireless interface components. We present our progress on using this muIMU based on Kalman filtering algorithm to filter the noise of sensors, which has allowed the system to successfully transform hand motions into recognizable and recordable English characters. Our goal is to implement this system to a digital hand-writing system that can interface with PC and mobile computing devices