Pleomorphic hyalinizing angiectatic tumor originating in the nasal cavity: A CARE case report

INTRODUCTION

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare low-grade malignant mesenchymal neoplasm. It commonly occurs in the limbs and trunk, with limited occurrences in the head and neck region. Only five cases of PHAT occurring in the head and neck have been reported in the literature to date. The etiology of PHAT remains unclear. We described a case of nasal cavity PHAT following CARE guidelines.

CASE SUMMARY

A 32-year-old male with PHAT originating in the nasal cavity recurred after two surgeries. Adjuvant radiotherapy was performed after the third surgery. The patient has been regularly followed up for 36months, and no tumor recurrence or metastasis has been observed.

DISCUSSION

PHAT is a rare soft tissue tumor known for its local aggressiveness. Because of a high risk of recurrence, extensive resection should be implemented, possibly completed by radiotherapy if resection cannot be complete because of proximity to at-risk structures.

Deciphering the molecular nexus of BTG2 in periodontitis and diabetic kidney disease

OBJECTIVE

To investigate the role of BTG2 in periodontitis and diabetic kidney disease (DKD) and its potential underlying mechanism.

METHODS

Gene expression data for periodontitis and DKD were acquired from the Gene Expression Omnibus (GEO) database. Differential expression analysis identified co-expressed genes between these conditions. The Nephroseq V5 online nephropathy database validated the role of these genes in DKD. Pearson correlation analysis identified genes associated with our target gene. We employed Gene Set Enrichment Analysis (GSEA) and Protein-Protein Interaction (PPI) networks to elucidate potential mechanisms. Expression levels of BTG2 mRNA were examined using quantitative polymerase Chain Reaction (qPCR) and immunofluorescence assays. Western blotting quantified proteins involved in epithelial-to-mesenchymal transition (EMT), apoptosis, mTORC1 signaling, and autophagy. Additionally, wound healing and flow cytometric apoptosis assays evaluated podocyte migration and apoptosis, respectively.

RESULTS

Analysis of GEO database data revealed BTG2 as a commonly differentially expressed gene in both DKD and periodontitis. BTG2 expression was reduced in DKD compared to normal conditions and correlated with proteinuria. GSEA indicated enrichment of BTG2 in the EMT and mTORC1 signaling pathways. The PPI network highlighted BTG2's relevance to S100A9, S100A12, and FPR1. Immunofluorescence assays demonstrated significantly lower BTG2 expression in podocytes under high glucose (HG) conditions. Reduced BTG2 expression in HG-treated podocytes led to increased levels of EMT markers (α-SMA, vimentin) and the apoptotic protein Bim, alongside a decrease in nephrin. Lower BTG2 levels were associated with increased podocyte mobility and apoptosis, as well as elevated RPS6KB1 and mTOR levels, but reduced autophagy marker LC3.

CONCLUSION

Our findings suggest that BTG2 is a crucial intermediary gene linking DKD and periodontitis. Modulating autophagy via inhibition of the mTORC1 signaling pathway, and consequently suppressing EMT, may be pivotal in the interplay between periodontitis and DKD.

Ischemia/reperfusion-activated ferroptosis in the early stage triggers excessive inflammation to aggregate lung injury in rats

Objective

Lung ischemia/reperfusion injury (LIRI) is a clinical syndrome of acute lung injury that occurs after lung transplantation or remote organ ischemia. Ferroptosis and inflammation are involved in the pathogenesis of LIRI according to the results of several studies on animal models. However, the interactive mechanisms between ferroptosis and inflammation contributing to LIRI remain unclear.

Methods

HE staining and indicators of oxidative stress were used to evaluated the lung injury. The reactive oxygen species (ROS) level was examined by DHE staining. The quantitative Real-time PCR (qRT-PCR) and western blot analysis were employed to detect the level of inflammation and ferroptosis, and deferoxamine (DFO) was used to assess the importance of ferroptosis in LIRI and its effect on inflammation.

Results

In the present study, the link of ferroptosis with inflammation was evaluated at reperfusion 30-, 60- and 180-minute time points, respectively. As the results at reperfusion 30-minute point shown, the pro-ferroptotic indicators, especially cyclooxygenase (COX)-2 and acyl-CoA synthetase long-chain family member 4 (ACSL4), were upregulated while the anti-ferroptotic factors glutathione peroxidase 4 (GPX4), cystine-glumate antiporter (XCT) and ferritin heavy chain (FTH1) were downregulated. Meanwhile, the increased level of interleukin (IL)-6, tumor necrosis factor alpha (TNF-α) and IL-1β were observed beginning at reperfusion 60-minute point but mostly activated at reperfusion 180-minute point. Furthermore, deferoxamine (DFO) was employed to block ferroptosis, which can alleviate lung injury. Expectedly, the survival rate of rats was increased and the lung injury was mitigated containing the improvement of type II alveolar cells ultrastructure and ROS production. In addition, at the reperfusion 180-minute point, the inflammation was observed to be dramatically inhibited after DFO administration as verified by IL-6, TNF-α and IL-1β detection.

Conclusion

These findings suggest that ischemia/reperfusion-activated ferroptosis plays an important role as the trigger for inflammation to further deteriorate lung damages. Inhibiting ferroptosis may have therapeutic potential for LIRI in clinical practice.

Neuroprotective Effects of IVIG against Alzheimer' s Disease via Regulation of Antigen Processing and Presentation by MHC Class I Molecules in 3xTg-AD Mice

BACKGROUND

The results of clinical trials for Alzheimer's disease (AD) patients treated with Intravenous immunoglobulin (IVIG) revealed inconsistency in efficacy.

OBJECTIVE

To explore the neuroprotective effects and possible mechanisms of different IVIG in 3xTg-AD mice.

METHODS

3-month-old 3xTg-AD mice were administered intraperitoneally with different IVIG (A/B/C) for 3 months and then the therapeutic effects were observed and tested at 9 months of age. The bioavailability of IVIG and Aβ40/42 concentrations in parietotemporal cortex was measured by ELISA. Behavioral tests were performed to examine cognitive functions. Immunohistochemistry was utilized to examine the deposition of Aβ, the phosphorylation of tau, the levels of GFAP and Iba-1 in the hippocampus. Proteomics, Luminex assay and parallel reaction monitoring were performed to identify and verify the proteins that showed a marked change in the hippocampus.

RESULTS

IVIG-C was more effective than IVIG-A and IVIG-B in counteracting cognitive deficits, ameliorating Aβ deposits and tau phosphorylation, attenuating the activation of microglia and astrocytes in the hippocampus and inhibiting the secretion of pro-inflammatory factors. IVIG-C affected innate immunity and suppressed the activation of antigen processing and presentation by MHC class I molecule (APP-MHC-I).

CONCLUSION

The efficacy of different IVIG on AD was significantly different, and only IVIG-C has been confirmed to possess significant neuroprotective effects, which are related to the inhibition of APP-MHC-I. IVIG may be a potential therapeutic for AD but further research is needed to evaluate the functional of IVIG before clinical trials of AD treatment.

Analgesic dorsal root ganglion field stimulation blocks both afferent and efferent spontaneous activity in sensory neurons of rats with monosodium iodoacetate-induced osteoarthritis

OBJECTIVES

Chronic joint pain is common in patients with osteoarthritis (OA). Non-steroidal anti-inflammatory drugs and opioids are used to relieve OA pain, but they are often inadequately effective. Dorsal root ganglion field stimulation (GFS) is a clinically used neuromodulation approach, although it is not commonly employed for patients with OA pain. GFS showed analgesic effectiveness in our previous study using the monosodium iodoacetate (MIA) - induced OA rat pain model. This study was to evaluate the mechanism of GFS analgesia in this model.

METHODS

After osteoarthritis was induced by intra-articular injection of MIA, pain behavioral tests were performed. Effects of GFS on the spontaneous activity (SA) were tested with in vivo single-unit recordings from teased fiber saphenous nerve, sural nerve, and dorsal root.

RESULTS

Two weeks after intra-articular MIA injection, rats developed pain-like behaviors. In vivo single unit recordings from bundles teased from the saphenous nerve and third lumbar (L3) dorsal root of MIA-OA rats showed a higher incidence of SA than those from saline-injected control rats. GFS at the L3 level blocked L3 dorsal root SA. MIA-OA reduced the punctate mechanical force threshold for inducing AP firing in bundles teased from the L4 dorsal root, which reversed to normal with GFS. After MIA-OA, there was increased retrograde SA (dorsal root reflex), which can be blocked by GFS.

CONCLUSIONS

These results indicate that GFS produces analgesia in MIA-OA rats at least in part by producing blockade of afferent inputs, possibly also by blocking efferent activity from the dorsal horn.

Detection of inflammatory bowel disease (IBD)-associated microRNAs by two color DNA-templated silver nanoclusters fluorescent probes

Researches demonstrated that circulating miRNAs could be used as novel diagnostic and prognostic potential markers for patients with inflammatory bowel diseases (IBD). It is of great significance in clinical to develop rapid and specific detection methods for miRNAs. Herein, we established a fluorescent probe for ulcerative colitis (UC) activity-associated two serum biomarkers (miR-23a and miR-223) simultaneous detection, which used multi-color fluorescent DNA-stabilized silver nanoclusters (DNA-AgNC) illuminated by a close guanine (G)-rich sequence as a signal transducer and two split DNA probes as recognition units. In principle, the two DNA probe sequences containing AgNC nucleation sequence and G-rich sequence respectively, formed a ternary complex when in the presence of target miRNA through base pairing, so as to induce enhancement of fluorescence emission of AgNC by shortening the distance from G-rich sequence. The combined probes for miR-23a and miR-223 detection generated increased fluorescence signals at 460 nm ex/545 nm em and at 560 nm ex/630 nm em, respectively. With this technique, we successfully quantified the two target miRNAs with high selectivity. Furthermore, the potential clinic applicability of this method was verified by testing the spiked standard miRNAs in human serum. Thus, this one-step, low-cost, and homogenous method offers a great opportunity for disease-associated multiplex miRNAs simultaneous detection.

POS1259 AXIAL SPONDYLOARTHRITIS, AGE AND MALE GENDER IMPACT COVID VACCINATION AEs MORE THAN RHEUMATOID ARTHRITIS

Background

Rheumatologists recommend vaccination in rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) patients, but there are few studies on the occurrence of adverse events (AEs), particularly worsening disease related activity and unrelated immune reactions in these groups.

Objectives

To evaluate the uptake of COVID vaccination in RA and axSpA patients, compare the frequency of AEs, and identify risk factors associated with vaccine AEs in two prospective cohorts comprised of these patients.

Methods

The IMPACT study is a monthly survey of two prospective cohorts of established RA and axSpA patients in northern Alberta, Canada from November 2020-2021 who answered at least one or more Redcap surveys through de-identified email link surveying demographics, disease characteristics, COVID symptoms, treatment of RA and axSpA, health care utilization, vaccination status, vaccine AEs and use of cannabis. Univariate analyses evaluated independent variables associated with the dependent variables of (1) any AE, (2) any severe AE, (3) any arthritis flare, and (4) any severe arthritis flare, followed by multivariate analyses of these four dependant variables using all clinically relevant variables from the univariate analysis.

Results

773/2167 patients (RA 574, axSpA 197) responded to at least one survey. 32/663 (5%) were single vaccinated, 631 (95%) double vaccinated and 230 (54%) triple vaccinated with 80% receiving Pfizer, 24% Moderna, 28% AstraZeneca and 30% “other”. 456 (69%) reported at least one AE (Figure 1) with 21 (3%) patients seeing a physician for their AE. Increased age was associated with all AEs. RA patients had lower reported AEs versus axSpA patients for all AE definitions except for severe arthritis flares. Generally, males reported worse AEs (Table 1). “Any arthritis flare” was lower in patients reporting cannabis use.

Table 1.

Summary of Multivariate Level Mixed-Effect Logistic Regression Models Evaluating the IMPACT of RA and axSpA Disease Characteristics on Vaccine AEs

VariableAny Adverse EventOR (95 % CI) p valueSevere Adverse Event* OR 95 % CI) p valueAny Arthritis Flare or Joint Ache Adverse Event OR (95 % CI) p valueAny Severe Arthritis Flare or Joint Ache* OR (95 % CI) p valueGenderMale1.47 (0.89 – 2.43)p=0.132.10 (1.30-3.41)p=0.0032.05 (1.20 – 3.50) p=0.013.97 (1.84 – 8.57)p=0.0004FemaleAge1.06 (1.04 – 1.08)p<0.011.05 (1.03 – 1.06)p<0.011.03 (1.01 – 1.04)p=0.0031.03 (1.01 – 1.06)p=0.004Rheumatic Disease TypeRA0.42 (0.23 – 0.76)p=0.050.55 (0.31 – 0.98)p=0.040.52 (0.28 – 0.98)p=0.040.78 (0.34 – 1.78)p=0.55axSpASteroidsYes0.85 (0.40 – 1.83) P=0.680.66 (0.32 – 1.35) p=0.250.84 (0.36 – 1.95) p=0.690.38 (0.15 – 0.97)p=0.04NoNSAIDSYes1.11 (0.81 – 1.52) p=0.511.03 (0.75 – 1.41)p=0.861.05 (0.74 – 1.48)p=0.801.17 (0.73 – 1.89)p=0.52NoCurrent Disease Activity0.95 (0.88 – 1.03) p=0.230.90 (0.83 – 0.97)p=0.190.92 (0.85 – 1.00)p=0.060.82 (0.74 – 0.92)p=0.001HAQ1.08 (0.73 – 1.61) p=0.700.77 (0.52 – 1.14)p=0.010.74 (0.48 – 1.13)p=0.170.65 (0.38 – 1.11)p=0.12Nicotine productsYes1.33 (0.75 – 2.37) p=0.341.42 (0.80 – 2.52)p=0.241.15 (0.60 – 2.01)p=0.760.97 (0.43 – 2.17)p=0.94NoCannabis productsYes0.78 (0.49 – 1.25) p=0.300.87 (0.55 – 1.38)p=0.550.51 (0.31 – 0.83)p=0.070.66 (0.35 – 1.26)p=0.21NoDMARDsYes1.98 (1.28 – 3.06)p=0.0021.52 (1.01 – 2.28)p=0.051.43 (0.91 – 2.23) p=0.121.86 (1.03 – 3.36)p=0.04NoBiologic DMARDYes0.72 (0.42 – 1.25) p=0.240.79 (0.45 – 1.41) p=0.431.20 (0.66 – 2.18 p=0.541.39 (0.63 – 3.08)p=0.42No

*Severe = Any of the following: ranked moderate to severe and/or lasting more than 7 days and/or saw physician

Conclusion

RA and axSpA patients showed high uptake of COVID vaccination with largely minor AEs. Older age and male gender were associated with more general and arthritis specific AEs. The association of any AE and/or arthritis-specific AEs in SpA versus RA patients is a novel finding which may correlate with the male predominance of SpA. The association of cannabis with fewer arthritis AEs may reflect the nociceptive properties of cannabis.

Acknowledgements

Epidemiology Coordinating and Research (EPICORE) Centre provided support for the REDCAP survey and biostatistical analyses.

Disclosure of Interests

Stephanie Keeling Speakers bureau: Pfizer, Abbvie, GSK, UCB, Consultant of: Abbvie, GSK, UCB, AstraZeneca, Sandoz, Pfizer, Grant/research support from: Abbvie, Sandoz, Merck, UCB, Bo Pan: None declared, Edna Hutchings Shareholder of: BMS, Stephanie Wichuk: None declared, Mohammed Osman Speakers bureau: Boehringer Ingelheim, Takeda Pharmaceuticals, Grant/research support from: Boehringer Ingelheim and CSL-Behring, Ameeta Singh: None declared, Ashlesha Sonpar Speakers bureau: Novartis, Ilan Swartz: None declared, Walter P Maksymowych Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, UCB, Consultant of: Abbvie, Boehringer Ingelheim, Celegene, Eli-Lilly, Galapagos, Novartis, Pfizer, UCB, Grant/research support from: Abbvie, Novartis, Pfizer, UCB

POS1258 LESS THAN EXPECTED IMPACT OF RHEUMATOID ARTHRITIS AND AXIAL SPONDYLOARTHRITIS DISEASE ON COVID SEVERITY

Background

Throughout the pandemic, there has been ongoing concern that people with autoimmune diseases such as rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) will have more severe COVID-19 disease due to immune dysfunction associated with autoimmune diseases and their treatment.

Objectives

We aimed to compare the severity of COVID-19 in patients with RA versus axSpA and characterize the predictors of COVID-19 severity during the pre-Omicron pandemic phases.

Methods

The IMPACT (IMPact of inflammatory Arthritis on COVID Outcomes STudy) study is a monthly survey of two established northern Alberta, Canada prospective cohorts of RA and axSpA patients from November 2020-2021 who answered Redcap surveys through de-identified email link surveying patient demographics, disease characteristics, COVID-19 symptoms, treatment of RA and axSpA, health care utilization, vaccination status and vaccine adverse events. Descriptive and univariate analyses (dependent variable = severe COVID-19) were performed followed by multivariate analyses of all significant and clinically relevant independent variables from the univariate analysis. Infection severity was defined as any patient with COVID-19 symptoms who visited a doctor, ER or required hospital admission.

Results

773 of 2167 (36%) patients (RA n=574, axSpA n=197) registered in both cohorts answered at least one baseline survey, 28 (4%) reporting positive COVID-19 tests (24 positive once). Of 442 reporting COVID-19 symptoms during the survey, 11 (3%) were admitted for a mean of 4 days, 2 requiring ICU or blood clot treatment and 1 requiring advanced therapy. 116 (26%) visited a physician for Covid symptoms. Univariate analysis showed that the use of steroids, NSAIDs and increased disease activity were associated with having less severe infection but these associations were not significant in the multivariate analysis (Table 1). There were no significant impacts of RA vs axSpA, age, gender, treatment, disease activity, or smoking.

Table 1.

Multivariate Level Mixed-Effect Logistic Regression Model: IMPACT of RA and axSpA Disease Characteristics on COVID Infection Severity Defined as Patients with COVID Symptoms Requiring Visit to Doctor, Emergency Room and/or Hospital Admission.

VariableCoefficient (S.E)Odds Ratio (95 % Confidence Interval)P-valueGenderMale0.17 (0.34)1.18 (0.61 – 2.31)0.6193FemaleReferenceAge-0.01 (0.01)0.99 (0.97 – 1.01)0.2543Rheumatic Disease TypeRA0.18 (0.40)1.20 (0.58 – 2.48)0.6213SpAReferenceSteroidsYes-0.40 (0.56)0.67 (0.23 – 2.01)0.4757NoReferenceNSAIDSYes-0.20 (0.26)0.82 (0.49 – 1.37)0.4508NoReferenceCurrent Disease Activity-0.04 (0.06)0.96 (0.85 – 1.09)0.5275HAQ-0.03 (0.29)0.97 (0.55 – 1.70)0.9041Nicotine productsYes-0.67 (0.37)0.51 (0.25 – 1.06)0.0714NoReferenceCannabis productsYes-0.45 (0.31)0.64 (0.35 – 1.18)0.1510NoReferenceDMARDsYes0.26 (0.30)1.30 (0.72 – 2.35)0.3860NoReferenceBiologic DMARDYes-0.46 (0.43)0.63 (0.27 – 1.46)0.2813NoReference

Conclusion

Possible disease related risk factors for increased COVID-19 severity in RA and axSpA patients preceding the onset of the Omicron variant including use of steroids or DMARDs were not associated with severe infection. These findings are consistent with other international studies whereby other non-rheumatic disease comorbidities played a greater role in infection severity.

Acknowledgements

Epidemiology Coordinating and Research (EPICORE) Centre provided support for the REDCAP survey and biostatistical anayses.

Disclosure of Interests

Stephanie Keeling Speakers bureau: Abbvie, GSK, Pfizer, UCB, Consultant of: Abbvie, GSK, Pfizer, Sandoz, UCB, Eli-Lilly, Galapagos, Novartis, Grant/research support from: Abbvie, UCB, Sandoz, Pfizer, Merck, Bo Pan: None declared, Edna Hutchings Shareholder of: BMS, Stephanie Wichuk: None declared, Mohammed Osman Speakers bureau: Boehringer Ingelheim, Takeda Pharmaceuticals, Grant/research support from: Yes, Boehringer Ingelheim and CSL-Behring, Ameeta Singh: None declared, Ashlesha Sonpar Speakers bureau: Novartis, Ilan Swartz: None declared, Walter P Maksymowych Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, UCB

, Consultant of: Abbvie, Boehringer Ingelheim, Celegene, Eli-Lilly, Galapagos, Novartis, Pfizer, UCB, Grant/research support from: Abbvie, Novartis, Pfizer, UCB

Efficacy of probiotics against dental caries in children: a systematic review and meta-analysis

Dental caries causes serious consequences and the financial burden of society especially in children with high morbidity rate. Here we carried out a meta-analysis to systematically evaluate the efficacy of probiotics against dental caries in children. Forty-three RCTs were eligible for this meta-analysis after searching the PubMed, Cochrane and Web of Science from the inception through October 2021. Pooled estimates demonstrated that treatment with probiotics significantly reduced noncavitated (dicdas2-6mft) (SMD = -0.18, 95% CI: -0.3 to -0.06, p = 0.002) and cavitated (dicdas5-6mft) carious lesions in children (SMD = -0.32, 95% CI: -0.5 to 0.14, p = 0.0004). Probiotics also reduced prevalence of noncavitated (dicdas2-6mft) carious lesions (RR = 0.8, 95% CI: 0.67 to-0.97, p = 0.02). Salivary Streptococcus mutans was declined after intervention (SMD = -1.17, 95% CI: -1.85 to -0.5, p = 0.0007), while Lactobacillus counts were upregulated (SMD = 1.19, 95% CI: 0.46-1.92, p = 0.001). However, no significant effects in total bacteria counts and salivary pH were observed. Our findings suggest that probiotics especially Lactobacillus could be a promising therapeutic strategy for clinical applications in children dental caries.

A Meta-Analysis of Microbial Therapy Against Metabolic Syndrome: Evidence From Randomized Controlled Trials

Background and aims: Metabolic syndrome (MetS), accompanied with significant intestinal dysbiosis, causes a great public health burden to human society. Here, we carried out a meta-analysis to qualify randomized controlled trials (RCTs) and to systematically evaluate the effect of microbial therapy on MetS. Methods and results: Forty-two RCTs were eligible for this meta-analysis after searching the PubMed, Cochrane, and Embase databases. Pooled estimates demonstrated that treatment with microbial therapy significantly reduced the waist circumference (WC) (SMD = -0.26, 95% CI -0.49, -0.03), fasting blood glucose (FBG) (SMD = -0.35, 95% CI -0.52, -0.18), total cholesterol (TC) (SMD = -0.36, 95% CI -0.55, -0.17), low-density lipoprotein cholesterol (LDL-C) (SMD = -0.42, 95% CI -0.61, -0.22), and triacylglycerol (TG)(SMD = -0.38, 95% CI -0.55, -0.20), but increased the high-density lipoprotein cholesterol (HDL-C) (SMD = 0.28, 95% CI.03, 0.52). Sensitivity analysis indicated that after eliminating one study utilizing Bifidobacteriumlactis, results became statistically significant in diastolic blood pressure (DBP) (SMD = -0.24, 95% CI -0.41, -0.07) and in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (SMD = -0.28, 95% CI -0.54, -0.03), while the body mass index (BMI) showed significant difference after eliminating one study utilizing oat bran (SMD = -0.16, 95% CI -0.31, -0.01). There was still no significant effect in systolic blood pressure (SBP) and in hemoglobin A1c (HbA1c%). Conclusion: In patients with MetS, the conditioning with microbial therapy notably improves FBG, TC, TG, HDL-C, LDL-C, WC, BMI (except for the study using oat bran), HOMA-IR, and DBP (except for the Study using Bifidobacteriumlactis), however, with no effect in SBP and in HbA1c%.

Effectiveness of Probiotics and Prebiotics Against Acute Liver Injury: A Meta-Analysis

Background and Aims: Acute liver injury (ALI) is a clinical syndrome characterized by rapid loss of liver function, which may progress to life-threatening liver failure. We conducted this meta-analysis to examine the evidence on the effects of probiotics or prebiotics on ALI.

Methods and Results: Several databases, including PubMed, EMBASE, and Cochrane Library, were scrutinized from the inception through February 2021 by combining key search terms, yielding 26 eligible studies, which concluded that modulation of gut microbiota significantly decreased aspartate transaminase [standardized mean difference (SMD): −1.51, 95% confidence interval (CI): −2.03 to −1.00], alanine aminotransferase (SMD: −1.42, 95% CI: −1.85 to −0.98), and bilirubin (SMD: −0.91, 95% CI: −1.33 to −0.49). In addition, administration of probiotics or prebiotics also promoted proliferation of Bifidobacterium (SMD: 1.21, 95% CI: −0.18 to 2.60) and inhibited Enterococcus (SMD: −1.00, 95% CI: −1.39 to −0.61), contributing to lower levels of endotoxin (SMD: −2.14, 95% CI: −2.91 to −1.37). Tight junction protein ZO-1 (SMD: 1.95, 95% CI: 0.14 to 3.76) was upregulated after intervention, thereby reducing bacterial translocation to the liver [odds ratio (OR) = 0.23, 95% CI: 0.13–0.44] and mesenteric lymph node (OR = 0.14, 95% CI: 0.08 to 0.26), with decreased tumor necrosis factor-α (SMD: −2.84, 95% CI: −3.76 to −1.93) and interleukin-6 (SMD: −2.62, 95% CI: −4.14 to −1.10). Oxidative stress was also relieved by reducing malondialdehyde (SMD: −1.83, 95% CI: −2.55 to −1.10) while elevating superoxide dismutase (SMD: 1.78, 95% CI: 1.00–2.55) and glutathione (SMD: 1.83, 95% CI: 0.76–2.91).

Conclusion: Our findings suggest that probiotics and prebiotics could be a promising therapeutic strategy in ALI and possess a potential for clinical applications.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=255888, CRD42021255888.

Hybrid Nanoparticles Modified by Hyaluronic Acid Loading an HSP90 Inhibitor as a Novel Delivery System for Subcutaneous and Orthotopic Colon Cancer Therapy

Background

As a therapeutic target for cancer treatment, HSP90 has been explored extensively. However, the significant side effects of the HSP90 inhibitor 17AAG have limited its clinical use.

Methods

In this study, we used hyaluronic acid (HA)–decorated DOTAP–PLGA hybrid nanoparticles (HA-DOTAP-PLGA NPs) as 17AAG-delivery carriers for targeted colon cancer therapy.

Results

Different methods were used to characterize the successful fabrication of these hybrid PLGA NPs. Our results demonstrated that internalization of HA-NPs in colon cancer cells was governed by CD44receptor–mediated endocytosis. Annexin V–propidium iodide staining experiments revealed that cell apoptosis induced by HA-NPs-17AAG in colon cancer cells was more efficient than free 17AAG. In two animal models used to screen anticancer efficacy (Luc-HT29 subcutaneous xenograft and AOM/DSS-induced orthotopic tumor model), HA-NPs-17AAG significantly inhibited xenograft and orthotopic tumor growth, demonstrating HA-NPs-17AAG had much better therapeutic efficiency than free 17AAG. It is worth noting that great biocompatibility of HA-DOTAP-PLGA NPs was observed both in vitro and in vivo.

Conclusion

Our research offers a preclinical proof of concept for colon cancer therapy with DOTAP-PLGA NPs as a creative drug-delivery system.

VENTHEART is required for cardiomyocyte specification and function

Background

Long noncoding RNAs (lncRNAs) control early stages of cardiac differentiation, however their role in later specification and maturation is still not well explored.

Methods and results

We performed single cell RNA-seq for 2, 6 and 12 week-old hESC-CM. Weighted correlation network analysis (WGCNA) identified core genes significantly upregulated, along with a subset of lncRNAs. Importantly, these lncRNAs are highly abundant and unique to human heart. Through independent integrative analysis of genome-wide association studies (GWAS) and expression quantitative trait locus (eQTL) data using human hearts, we also identified a long intergenic noncoding RNA (we call VENTHEART, VHRT) as co-regulated with core cardiac contractile genes, and strongly associated with heart failure. VHRT was highly expressed in MYL2+ hESC-CMs in our single cell dataset, and its locus is antisense and downstream of MYL2. VHRT knockdown (KD) in 6-weeks old hESC-CMs downregulated MYL2 and other key cardiac genes. Patch clamp recordings with VHRT KD cells showed a loss of the ventricular-like action potential. Concordantly, CRISPR-mediated excision of the VHRT locus led to impaired CM sarcomere formation, and loss of CM specification gene programs. VHRT transcript replacement in VHRT-KO cells was however insufficient to rescue the phenotype. Instead, we established by 3C assay, that the VHRT locus loops and interacts with the MYL2 promoter, bearing histone marks characteristic of a super-enhancer.

Conclusion

Thus, we conclude that both the VHRT lncRNA transcript and its genomic locus are required for proper CM specification and function, and may play a role in heart failure progression.

Funding Acknowledgement

Type of funding source: Other. Main funding source(s): EMBO, Singapore National Research Council

Elevated aspartate aminotransferase and monocyte counts predict unfavorable prognosis in patients with malignant pleural mesothelioma

Limited biomarkers predicting prognosis of malignant pleural mesothelioma (MPM) have been identified. The present study aims to assess potential laboratory prognostic factors of MPM. We retrospectively reviewed the clinical data of 105 patients with MPM. The overall survival and prognostic factors were assessed by Kaplan-Meier curves and Cox regression analysis. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values. The mean age of the 105 patients (62 men, 43 women) was 56.0 years. The major clinical presentations were dyspnea, cough and chest pain. The most common laboratory abnormalities were thrombocytosis and elevated monocyte count. Significant prognostic factors on univariate analysis were performance status (PS), serum albumin, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), monocyte, platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and treatment strategy. Multivariate analysis showed PS, AST, monocyte, and treatment strategy were statistically significant (p<0.05). Higher AST level and monocyte count were both related to the presence of anemia (p=0.001 and 0.010, respectively) and higher ALP level (p=0.049 and 0.001, respectively). A higher AST level was also associated with higher alanine aminotransferase (ALT) and LDH level (p<0.05). A higher monocyte count was also correlated with male patients, higher white blood cell (WBC), platelet, neutrophil counts, lower red blood cell (RBC) and LMR counts (p<0.05). In conclusion, our data show that PS<2, normal AST level, lower monocyte count, and multimodality treatment are independent positive prognostic factors of MPM. The elevated AST and monocyte levels represent unfavorable prognostic biomarkers of MPM.

Abstract P1-03-05: Long term survival and tumor biology of screen-detected small non-palpable breast cancer in Chinese women: The smaller, the better?

Background: Tumor biology would reflect the prognosis and potentially the lead time and over-diagnosis rate of screen-detected small breast cancer [PMID: 28591529, 21452022 and 24888816]. Chinese women had earlier peak age of breast cancer incidence and used ultrasound as the primary screening imaging test on a hospital-basis [2016 SABCS P5-02-05, PMID: 27689334]. In our previous work, we showed that US detected non-palpable breast cancer (NPBC) had higher percentage of invasive and lymph node positive cancer, yet still could be regarded as low-risk cancer [PMID:27689334, 28412736]. This study was performed to investigate the prognostic impact of immunohistochemical subtypes and tumor size: the smaller the NPBC, the better the tumor biology and prognosis?

Methods: From January 2001 to December 2017, 6,423 consecutive asymptomatic women underwent mammography (MG) or ultrasound (US) guided biopsy in Peking Union Medical College Hospital. Among them, 159 T1a, 239 T1b, 377 T1c and 72 T2 NPBC were diagnosed and treated. The clinicopathological features, treatment choice, 10-year disease-free survival (DFS) and overall survival (OS) of the small NPBC (defined as≤1.0cm, T1a+b) were reviewed and compared with T1c and T2 NPBC. Prognostic factors of these subgroups of invasive NPBC were identified.

Results: Compared to big NPBC, the T1a+b small NPBC showed more lymph node negative (p&lt;0.001) and low Ki67 (&lt;14%, p&lt;0.001) cancers with earlier TNM stage (p&lt;0.001), more luminal A subtype (p=0.003) and significantly improved 10-year DFS and OS (p=0.004). T1c+T2 NPBC had more triple-negative subtype and received more chemotherapy (p&lt;0.001) and targeted therapy (p=0.008). Breast conserving rate and the use of radiation and endocrine therapy showed no significant difference.

Table 1.Comparison of clinicopathological factors and long term survival of small vs big screen-detected NPBCScreen-detected NPBC(2001-2017    Clinical&prognostic factors T1a+T1b(n=398)T1c+T2(n=449)P valueScreening methodUS-NPBC(n,%)336(84.4)406(90.4)0.008 MG-NPBC(n,%)62(15.6)43(9.6) Lymph node statusNegative(n,%)343(86.2)315(70.2)&lt;0.001 Positive(n,%)55(13.8)134(29.8) TNM stageI(n,%)344(86.4)277(61.7)&lt;0.001 II(n,%)37(9.3)134(29.8)  III(n,%)17(4.3)38(8.5) Ki67&lt;14%(n,%)208(52.2)168(37.4)&lt;0.001 ≥14%(n,%)183(46.0)274(61.0) SubtypeLuminal A(n,%)164(41.3)135(30.1)0.003 Luminal B(n,%)155(38.9)218(48.6)  Her2(n,%)28(7.0)27(6.0)  TNBC(n,%)31(7.8)52(11.6)  Unknown(n,%)20(5.0)17(3.7) 10-year survivalDFS(%)94.688.80.004 OS(%)100.096.4 

Conclusion: Small asymptomatic NPBCs were detected when small because they were good in terms of low Ki67 index, favorable subtype, tumor biology and long term prognosis. On the contrary, T1c and T2 NPBCs were screened when already big or even with positive nodes without clinical symptoms indicating that they might have larger chance of becoming interval cancers.

Citation Format: Xu Y, Pan B, Yao R, Zhou Y-D, Mao F, Zhu Q-L, Wu H-W, Lin Y, Shen S-j, Sun Q. Long term survival and tumor biology of screen-detected small non-palpable breast cancer in Chinese women: The smaller, the better? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-03-05.