CT-based radiomics for prediction of pulmonary haemorrhage after percutaneous CT-guided transthoracic lung biopsy of pulmonary nodules

AIM

To evaluate the feasibility of intranodular and perinodular computed tomography (CT) radiomics features for predicting the occurrence of pulmonary haemorrhage after percutaneous CT-guided transthoracic lung biopsy (PCTLB) in pulmonary nodules.

MATERIALS AND METHODS

The data for 332 patients with pulmonary nodules who underwent PCTLB were reviewed retrospectively. Pulmonary haemorrhage after PCTLB was evaluated using CT (144 cases occurred). Radiomics features based on gross nodular (GNV) and perinodular volumes (PNV) were extracted from pre-biopsy CT images and features selection using least absolute shrinkage and selection operator (LASSO) regression, and three radiomics scores (rad-scores) were built. Rad-scores, clinical, and clinical-radiomic models were developed and evaluated to predict the occurrence of pulmonary haemorrhage.

RESULTS

Five, five, and six significant features were selected for prediction of pulmonary haemorrhage based on GNV, PNV, and GNV + PNV, respectively. Lesion depth was the only clinical characteristics related to pulmonary haemorrhage. Lesion depth and rad-score based on GNV, PNV, and GNV + PNV for predicting the pulmonary haemorrhage achieved areas under the curves (AUCs) of 0.656, 0.645, 0.651, and 0.635 in the validation group, respectively. Three clinical-radiomic models improved the AUCs to 0.743, 0.723, and 0.748. The performance of rad-score_GNV + PNV combined with lesion depth outperformed the clinical model (p=0.024) and the radiomics signature (p=0.038). In addition, the radiomics signatures were significantly associated with higher-grade pulmonary haemorrhage (p<0.05).

CONCLUSIONS

Radiomics features from intranodular and perinodular regions of pulmonary nodules have good predictive ability for pulmonary haemorrhage after PCTLB, which may provide additional predictive value for clinical practice.

Recent progress in carbon dots for anti-pathogen applications in oral cavity

Background

Oral microbial infections are one of the most common diseases. Their progress not only results in the irreversible destruction of teeth and other oral tissues but also closely links to oral cancers and systemic diseases. However, traditional treatment against oral infections by antibiotics is not effective enough due to microbial resistance and drug blocking by oral biofilms, along with the passive dilution of the drug on the infection site in the oral environment.

Aim of review

Besides the traditional antibiotic treatment, carbon dots (CDs) recently became an emerging antimicrobial and microbial imaging agent because of their excellent (bio)physicochemical performance. Their application in treating oral infections has received widespread attention, as witnessed by increasing publication in this field. However, to date, there is no comprehensive review available yet to analyze their effectiveness and mechanism. Herein, as a step toward addressing the present gap, this review aims to discuss the recent advances in CDs against diverse oral pathogens and thus propose novel strategies in the treatment of oral microbial infections.

Key scientific concepts of review

In this manuscript, the recent progress of CDs against oral pathogens is summarized for the first time. We highlighted the antimicrobial abilities of CDs in terms of oral planktonic bacteria, intracellular bacteria, oral pathogenic biofilms, and fungi. Next, we introduced their microbial imaging and detection capabilities and proposed the prospects of CDs in early diagnosis of oral infection and pathogen microbiological examination. Lastly, we discussed the perspectives on clinical transformation and the current limitations of CDs in the treatment of oral microbial infections.

Development of ε-poly(L-lysine) carbon dots-modified magnetic nanoparticles and their applications as novel antibacterial agents

Magnetic nanoparticles (MNPs) are widely applied in antibacterial therapy owing to their distinct nanoscale structure, intrinsic peroxidase-like activities, and magnetic behavior. However, some deficiencies, such as the tendency to aggregate in water, unsatisfactory biocompatibility, and limited antibacterial effect, hindered their further clinical applications. Surface modification of MNPs is one of the main strategies to improve their (bio)physicochemical properties and enhance biological functions. Herein, antibacterial ε-poly (L-lysine) carbon dots (PL-CDs) modified MNPs (CMNPs) were synthesized to investigate their performance in eliminating pathogenic bacteria. It was found that the PL-CDs were successfully loaded on the surface of MNPs by detecting their morphology, surface charges, functional groups, and other physicochemical properties. The positively charged CMNPs show superparamagnetic properties and are well dispersed in water. Furthermore, bacterial experiments indicate that the CMNPs exhibited highly effective antimicrobial properties against Staphylococcus aureus. Notably, the in vitro cellular assays show that CMNPs have favorable cytocompatibility. Thus, CMNPs acting as novel smart nanomaterials could offer great potential for the clinical treatment of bacterial infections.

AB0596 AORTIC MANIFESTATIONS IN GIANT CELL ARTERITIS: SINGLE CENTRE 10-YEAR EXPERIENCE

Background

Disease stratification in GCA is an urgent need, with patients categorised into cranial and large-vessel GCA (LV-GCA) subgroups. LV-GCA may have worse outcomes with regards relapsing disease, poor response to glucocorticoids (GC) and aortic involvement.

Objectives

We report a single centre experience using clinical, imaging and treatment outcomes from a specialist clinic.

Methods

134 patients with LV-GCA were identified over a 10-year period at Southend University Hospital (2012-2022). Medical records were reviewed retrospectively for baseline demographics, clinical presentation, inflammatory markers, imaging (vascular ultrasound, PET-CT, echocardiography), vascular damage and treatment.

Results

There was a female predominance (female n=91). Age at presentation ranged from 46 to 86 years (median 70 years). Co-morbidities implicated in aortic disease included hypertension (n=60), hypercholestrolaemia (n=29), diabetes (n=14), aortic valvular disease (n=5) and atherosclerotic disease including coronary and carotid artery disease (n=19). Constitutional disturbance was most frequently observed presentation (70%, n=94), and the only feature for 11 patients. This was followed by cranial symptoms (62%, n=83), polymyalgia (53%, n=71), ischaemic symptoms i.e., visual disturbance or tongue/jaw claudication (24%, n=32) and cardiovascular presentations (7%, n=9). The latter included limb claudication, stroke, and aortic aneurysm. Although LV-GCA refers to extra-cranial disease, 12 patients (9%) had isolated cranial and/or ischaemic symptoms at initial presentation.

Inflammatory markers were typically elevated at presentation, C-reactive protein ranged from 1-425mg/L and ESR 1-130mm. Vascular ultrasound was used at diagnosis in 93 patients, with positive temporal artery findings in 50% (n=38) and positive axillary findings in 75% (n=57). PET-CT data was available for 125 patients, of which 113 were positive for LV-GCA. Thoracic aorta FDG-uptake was seen in 77%, with 7 ascending and 1 abdominal aortic aneurysm observed. Transthoracic echocardiogram was available for 46% (n=62). Four (6.5%) patients had a dilated aortic root when indexed to height as per British Society of Echocardiography (BSE) guidelines1 (SOV (mm/m) > 21.8mm in males and > 20.7mm in females). Values for our patients were 22.6 and 21.2 mm/m for the female patients and 29.2 and 25.2 mm/m for the male patients. Furthermore, 32 patients showed some extent of diastolic dysfunction as per BSE criteria (52%).

All patients received GC as part of their treatment, 60% (n=82) needing one or more DMARDs and 17% (n=23) Tocilizumab for relapsing disease. DMARDs used included Leflunomide (n=63), Methotrexate (n=18), Mycophenolate mofetil (n=3) and Azathioprine (n=1). One patient received cyclophosphamide.

Conclusion

By combined imaging modalities, 11 patients (8%) had evidence of ascending aortic damage. Grade 1 diastolic dysfunction can be age related, so this may be association rather than causation2,3. Over half of patients had not undergone echocardiogram evaluation, so there may be a hidden burden of disease. Many patients required GC-sparing therapy, showing GC alone are often not enough to halt disease progression, and vascular damage was relatively reduced compared to historical reports. The authors feel GCA services should include standardised protocols for early DMARDs, continuing thorough assessment for LV-GCA and vascular damage, including echocardiography, progressing to cross-sectional imaging if indicated.

References

[1]Harkness A. et al. Normal reference intervals for cardiac dimensions and function for use in echocardiographic practice: a guideline from the British Society of Echocardiography”. Echo Research and Practice 7.1 (2020): G1-G18.

[2]Sanders, D et al. Diastolic dysfunction, cardiovascular aging, and the anesthesiologist. Anesthesiology clinics vol. 27,3 (2009): 497-517.

[3]Jakovljevic and Djordje G. Physical activity and cardiovascular aging: Physiological and molecular insights. Experimental gerontology vol. 109 (2018): 67-74.

Disclosure of Interests

None declared

Comparative Outcomes for Trauma Patients in Prison and the General Population

BACKGROUND

Prisoners are a vulnerable population, and there are few contemporary studies that consider trauma patient outcomes within the prisoner population. Therefore, we sought to provide a descriptive analysis of prisoners involved in trauma and evaluate whether a healthcare disparity exists. We hypothesized that prisoners and non-prisoners have a similar risk of mortality and in-hospital complications after trauma.

METHODS

The Trauma Quality Improvement Program (2015-2016) was queried for trauma patients based upon location inside or outside of prison at the time of injury. A multivariable logistic regression analysis was performed to compare these groups for risk of mortality-the primary outcome.

RESULTS

From 593,818 trauma patients, 1115 were located in prison. Compared to non-prisoners, prisoner trauma patients had no significant difference in mortality (5.1 vs 6.0%, P = .204). However, after adjusting for covariates, prisoners had a shorter length of stay (LOS) (mean days, 6.3 vs 7.8, P < .001), shorter intensive care unit (ICU) LOS (mean days, 5.44 vs 5.89, P = .004), and fewer complications, including lower rates of drug/alcohol withdrawal (.4% vs 1.1%, P = .030), pneumonia (.5 vs 1.6%, P = .004), and urinary tract infections (.0 vs 1.1%, P < .001). Upon performing a multivariable logistic regression model, prisoner trauma patients had a similar associated risk of mortality compared to non-prisoners (OR 1.61, CI .52-4.94, P = .409).

DISCUSSION

Our results suggest that prisoner trauma patients at least receive equivalent treatment in terms of mortality and may have better outcomes when considering some complications. Future prospective studies are needed to confirm these results and explore other factors, which impact prisoner patient outcomes.

Regional variations in discrete collagen fibre mechanics within intact intervertebral disc resolved using synchrotron computed tomography and digital volume correlation

Many soft tissues, such as the intervertebral disc (IVD), have a hierarchical fibrous composite structure which suffers from regional damage. We hypothesise that these tissue regions have distinct, inherent fibre structure and structural response upon loading. Here we used synchrotron computed tomography (sCT) to resolve collagen fibre bundles (∼5μm width) in 3D throughout an intact native rat lumbar IVD under increasing compressive load. Using intact samples meant that tissue boundaries (such as endplate-disc or nucleus-annulus) and residual strain were preserved; this is vital for characterising both the inherent structure and structural changes upon loading in tissue regions functioning in a near-native environment. Nano-scale displacement measurements along >10,000 individual fibres were tracked, and fibre orientation, curvature and strain changes were compared between the posterior-lateral region and the anterior region. These methods can be widely applied to other soft tissues, to identify fibre structures which cause tissue regions to be more susceptible to injury and degeneration. Our results demonstrate for the first time that highly-localised changes in fibre orientation, curvature and strain indicate differences in regional strain transfer and mechanical function (e.g. tissue compliance). This included decreased fibre reorientation at higher loads, specific tissue morphology which reduced capacity for flexibility and high strain at the disc-endplate boundary.

Statement of significance

The analyses presented here are applicable to many collagenous soft tissues which suffer from regional damage. We aimed to investigate regional intervertebral disc (IVD) structural and functional differences by characterising collagen fibre architecture and linking specific fibre- and tissue-level deformation behaviours. Synchrotron CT provided the first demonstration of tracking discrete fibres in 3D within an intact IVD. Detailed analysis of regions was performed using over 200k points, spaced every 8 μm along 10k individual fibres. Such comprehensive structural characterisation is significant in informing future computational models. Morphological indicators of tissue compliance (change in fibre curvature and orientation) and fibre strain measurements revealed localised and regional differences in tissue behaviour.

[Chaihu Guizhi decoction produces antidepressant-like effects via sirt1-p53 signaling pathway]

OBJECTIVE

To investigate the mechanism of the antidepressant-like effects of Chaihu Guizhi decoction (CGD).

OBJECTIVE

Chaihu Guizhi decoction at the daily dose of 17 g/kg and solvent vehicle were administered by gavage in 12 and 14 male C57BL/6J mice for 7 consecutive days, respectively. Forced swimming test (FST), elevated plus maze (EPM) test, open field test (OFT) and novelty-suppressed feeding test (NSF) were performed to assess the depression- and anxiety-like behaviors and motor ability of the mice. We further used chronic social defeat stress (CSDS) and social interaction test to evaluate the antidepressant-like effects of CGD in comparison with the solvent vehicle. Western blotting and RT-qPCR were performed to detect the expressions of sirt1, p53, acetylated p53, and the neuron plasticity-related genes including synapsin I (Syn1), Rab4B, SNAP25 and tubulin beta4b in the hippocampus of the mice.

OBJECTIVE

In FST, the immobility time of CGDtreated mice was decreased significantly (P < 0.05); no significant differences were found in the performances in EPM, NSF and OFT tests between the two groups. In social interaction test, the mouse models of CSDS treated with CGD showed significantly increased time in the interaction zone (P < 0.05). Compared with those in the vehicle group, the CGD-treated mouse models exhibited significantly increased protein level of SIRT1 and decreased p53 acetylation (P < 0.05) with up-regulated synapsin I mRNA expression in the hippocampus (P < 0.05); no significant difference were found in Rab (P=0.813), SNAP (P=0.820), or Tubb mRNA expressions (P=0.864) between the two groups.

OBJECTIVE

CGD produces antidepressant-like effects in mice possibly through the sirt1-p53 signaling pathway and synaptic plasticity.

Second-order QCD corrections to event shape distributions in deep inelastic scattering

We compute the next-to-next-to-leading order (NNLO) QCD corrections to event shape distributions and their mean values in deep inelastic lepton-nucleon scattering. The magnitude and shape of the corrections varies considerably between different variables. The corrections reduce the renormalization and factorization scale uncertainty of the predictions. Using a dispersive model to describe non-perturbative power corrections, we compare the NNLO QCD predictions with data from the H1 and ZEUS experiments. The newly derived corrections improve the theory description of the distributions and of their mean values.

An in-situ thermally regenerated air purifier for indoor formaldehyde removal

Formaldehyde is a common indoor pollutant that is an irritant and has been classified as carcinogen to humans. Adsorption technology is safe and stable and removes formaldehyde efficiently, but its short life span and low adsorption capacity limit its indoor application. To overcome these limitations, we propose an in-situ thermally regenerated air purifier (TRAP) which self-regenerates as needed. This purifier has four working modes: cleaning mode, regeneration mode, exhaust mode, and outdoor air in-take mode, all of which are operated by valve switching. We developed a real-scale TRAP prototype with activated carbon as adsorbent. The experimental testing showed that the regeneration ratios for formaldehyde of TRAP were greater than 90% during 5 cycles of adsorption-regeneration and that through the 5 cycles, there was no damage to the adsorption material as confirmed by scanning electron microscope (SEM) and Brunauer-Emmett-Teller (BET) tests. The total energy consumption by the prototype for purifying 1000 m³ indoor air was 0.26 kWh. This in-situ thermal-regeneration method can recover the purifier's adsorption ability through at least five cycles.

Voriconazole and squamous cell carcinoma after lung transplantation: A multicenter study

This study evaluated the independent contribution of voriconazole to the development of squamous cell carcinoma (SCC) in lung transplant recipients, by attempting to account for important confounding factors, particularly immunosuppression. This international, multicenter, retrospective, cohort study included adult patients who underwent lung transplantation during 2005-2008. Cox regression analysis was used to assess the effects of voriconazole and other azoles, analyzed as time-dependent variables, on the risk of developing biopsy-confirmed SCC. Nine hundred lung transplant recipients were included. Median follow-up time from transplantation to end of follow-up was 3.51 years. In a Cox regression model, exposure to voriconazole alone (adjusted hazard ratio 2.39, 95% confidence interval 1.31-4.37) and exposure to voriconazole and other azole(s) (adjusted hazard ratio 3.45, 95% confidence interval 1.07-11.06) were associated with SCC compared with those unexposed after controlling for important confounders including immunosuppressants. Exposure to voriconazole was associated with increased risk of SCC of the skin in lung transplant recipients. Residual confounding could not be ruled out because of the use of proxy variables to control for some confounders. Benefits of voriconazole use when prescribed to lung transplant recipients should be carefully weighed versus the potential risk of SCC. EU PAS registration number: EUPAS5269.

Antiviral Activities of Peptides with Sequences Related to the Cytoplasmic Domain of the Respiratory Syncytial Virus Glycoproteins

A set of peptides from 6–10 amino acids in length with sequences corresponding to the respiratory syncytial virus (RSV) attachment glycoprotein, G, has been found to inhibit secretion of virus particles from two human cell lines infected with RSV. Peptides of similar lengths with sequences related to the fusion (F) protein were not effective. A modified assay for syncytia formation was used to measure infectious particles and we found that cell-free infectious RSV was inhibited by those same peptides that blocked particle release. However, only about 5–20% of the total infectious virus formed in the cultured cells was released from the cells – the remaining was assayable only after lysis of the infected cells. Formation of this major fraction of infectious, cell-associated RSV was not affected by the peptides. The inhibitory peptides were ineffective in blocking release of infectious virus from cells infected with influenza, vesicular stomatitis and Semliki Forest viruses. Only a set of specific amino acids in these peptides were inhibitory and they consisted of a very hydrophobic sequence that also required a cysteine residue.

Understanding and controlling airborne organic compounds in the indoor environment: mass transfer analysis and applications

Mass transfer is key to understanding and controlling indoor airborne organic chemical contaminants (e.g., VVOCs, VOCs, and SVOCs). In this study, we first introduce the fundamentals of mass transfer and then present a series of representative works from the past two decades, focusing on the most recent years. These works cover: (i) predicting and controlling emissions from indoor sources, (ii) determining concentrations of indoor air pollutants, (iii) estimating dermal exposure for some indoor gas-phase SVOCs, and (iv) optimizing air-purifying approaches. The mass transfer analysis spans the micro-, meso-, and macroscales and includes normal mass transfer modeling, inverse problem solving, and dimensionless analysis. These representative works have reported some novel approaches to mass transfer. Additionally, new dimensionless parameters such as the Little number and the normalized volume of clean air being completely cleaned in a given time period were proposed to better describe the general process characteristics in emissions and control of airborne organic compounds in the indoor environment. Finally, important problems that need further study are presented, reflecting the authors' perspective on the research opportunities in this area.

Depth-resolved model-based reconstruction of attenuation coefficients in optical coherence tomography

We present a method, based on a single scattering model, to calculate the attenuation coefficient of each pixel in optical coherence tomography (OCT) depth profiles. Numerical simulations were used to determine the model's response to different depths and attenuation coefficients. Experiments were performed on uniform and layered phantoms with varying attenuation coefficients. They were measured by a 1300 nm OCT system and their attenuation coefficients were evaluated by our proposed method and by fitting the OCT slope as the gold standard. Both methods showed largely consistent results for the uniform phantoms. On the layered phantom, only our proposed method accurately estimated the attenuation coefficients. For all phantoms, the proposed method largely reduced the variability of the estimated attenuation coefficients. The method was illustrated on an in-vivo retinal OCT scan, effectively removing common imaging artifacts such as shadowing. By providing localized, per-pixel attenuation coefficients, this method enables tissue characterization based on attenuation coefficient estimates from OCT data.

Expression of interleukin-18 in a rat model of deep vein thrombosis

AIM

Interleukin-18 (IL-18) is an important proinflammatory cytokine. However, little is known about the roles of IL-18 in the process of venous thrombosis. This study aimed to investigate the roles of IL-18 during deep vein thrombosis (DVT).

METHODS

Fifty rats were randomly divided into 0 (control group), 12, 24, 36 and 48 h groups (10 rats in each group) by observation time. The inferior vena cava (IVC) was ligated to establish the DVT model. Serum samples were extracted to determine the levels of IL-18, tumor necrosis factor-alpha (TNF-α), thromboxane B2 (TXB2) and 6-keto-prostaglandin Fl alpha (6-keto-PG Flα) by enzyme-linked immunosorbent assay (ELISA). The weight and length of IVC was also measured.

RESULTS

The DVT model was successfully established by ligating IVC. The injury of vein endothelium was observed in the model groups. IL-18, TNF-α, TXB2, TXB2/6-keto-PG Flα levels and thrombus weight were significantly increased in the model groups as compared with the control group, and peaked at 24 h after IVC ligation. 6-keto-PG F1α slightly decreased in the model groups comparing with the control group. IL-18 was positively correlated with TNF-α, TXB2, TXB2/6-keto-PG Flα ratio and thrombus weight. However, IL-18 was negatively correlated with 6-keto-PG Flα. There was a positive correlation between TXB2/6-keto-PG Flα ratio and thrombus weight.

CONCLUSION

Serum IL-18 level increased in the process of DVT, which might impair venous endothelial cells and result in venous thrombosis. IL-18 might be a new potential therapeutic target of DVT prevention.

Developmental expression and subcellular distribution of synaptotagmin 11 in rat hippocampus

Synaptotagmins are required for Ca(2+)-dependent membrane-trafficking in either neuronal synaptic vesicles or cellular membranes. Previous reports suggested that the synaptotagmin 11 (syt11) gene is involved in the development of schizophrenia based on the genomic analysis of patients. Parkin protein binds to the C2 domains of Syt11 which leads to the polyubiquitination of Syt11. However, where and how Syt11 performs its role in the brain is largely unknown. Here, we report that Syt11 is expressed mainly in the brain. In addition, exogenously expressed Syt11 in HEK293 cells can form higher molecular weight complex via its transmembrane domain. Also, Syt11 is targeted to both dendrite and axon compartments. Immunocytochemistry showed that Syt11 is juxtaposed to postsynaptic markers in both excitatory and inhibitory synapses. Both neuroligin 1 and 2, which are postsynaptic cell adhesion molecules and differentially induce excitatory and inhibitory presynapses, respectively, recruit Syt11 in neuron coculture. Immunogold electron microscopy analysis revealed that Syt11 exists mainly in presynaptic neurotransmitter vesicles and plasma membrane, and rarely in postsynaptic sites. These results suggest that Syt11 may contribute to the regulation of neurotransmitter release in the excitatory and inhibitory presynapses, and postsynapse-targeted membrane trafficking in dendrites.

Delta15N of soil N and plants in a N-saturated, subtropical forest of southern China

We investigated the delta(15)N profile of N (extractable NH(4)(+), NO(3)(-), and organic N (EON)) in the soil of a N-saturated subtropical forest. The order of delta(15)N in the soil was EON > NH(4)(+) > NO(3)(-). Although the delta(15)N of EON had been expected to be similar to that of bulk soil N, it was higher than that of bulk soil N by 5 per thousand. The difference in delta(15)N between bulk soil N and EON (Delta(15)N(bulk-EON)) was correlated significantly with the soil C/N ratio. This correlation implies that carbon availability, which determines the balance between N assimilation and dissimilation of soil microbes, is responsible for the high delta(15)N of EON, as in the case of soil microbial biomass delta(15)N. A thorough delta(15)N survey of available N (NH(4)(+), NO(3)(-), and EON) in the soil profiles from the organic layer to 100 cm depth revealed that the delta(15)N of the available N forms did not fully overlap with the delta(15)N of plants. This mismatch in delta(15)N between that of available N and that of plants reflects apparent isotopic fractionation during N uptake by plants, emphasizing the high N availability in this N-saturated forest.

5-HT 3 receptors mediate the time-dependent vagal afferent modulation of nociception during chronic food allergen-sensitized visceral hyperalgesia in rats

Converging lines of evidence demonstrate a vagally mediated antinociceptive pathway in animals undergoing acute visceral insults, the contribution of this system to visceral pain following chronic noxious stimuli is unknown. 5-HT(3) receptor (5-HT(3)Rs) on spinal afferents are crucially involved in nociceptive processing, the role of 5-HT(3)Rs on vagal afferents is unclear. The aim of the present study was to determine the contribution of vagal afferents to visceral nociception in rats undergoing chronic luminal allergen stimulation and whether it involves vagal 5-HT(3)Rs. Sensitized rats received chicken egg albumin (EA, 1 mg mL(-1)) in drinking water for 2 weeks (day 1-14). Visceromotor response (VMR) to colorectal distension [colorectal distension (CRD), 60 mmHg] and the levels of mRNA encoding 5-HT(3)R (including 3A and 3B subunits) in the nodose ganglia (NG) were evaluated on day 2, 4, 8 and 15. Chronic EA challenge induced gradually increased visceral nociception, with a peak on day 15. Subdiaphragmatic vagotomy or functional deafferentation with capsaicin abolished this time-dependent manner, inducing hyperalgesia from day 2, lasting to day 15. Intraluminal infusion of a 5-HT(3)R antagonist (granisetron), whether alone or infused after local mucosa anaesthetic with 1% lidocaine, mimicked the effects of vagotomy. The mRNA levels for 5-HT(3B) or 5-HT(3A) subunit in the NG showed an opposite time-course to that of visceral pain, which increased from day 2, then decreased gradually to levels lower than those of controls. Our results demonstrate a time-dependent vagal afferent modulation of chronic allergen-sensitized visceral hyperalgesia, which may involve a 5-HT(3)R pathway.