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Min Y, Xiong W, Shen W, Liu X, Qi Q, Zhang Y, Fan R, Fu F, Xue H, Yang H, Sun X, Ning Y, Tian T, Zhou X. Developing nucleoside tailoring strategies against SARS-CoV-2 via ribonuclease targeting chimera. SCIENCE ADVANCES 2024; 10:eadl4393. [PMID: 38598625 PMCID: PMC11006213 DOI: 10.1126/sciadv.adl4393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/06/2024] [Indexed: 04/12/2024]
Abstract
In response to the urgent need for potent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) therapeutics, this study introduces an innovative nucleoside tailoring strategy leveraging ribonuclease targeting chimeras. By seamlessly integrating ribonuclease L recruiters into nucleosides, we address RNA recognition challenges and effectively inhibit severe acute respiratory syndrome coronavirus 2 replication in human cells. Notably, nucleosides tailored at the ribose 2'-position outperform those modified at the nucleobase. Our in vivo validation using hamster models further bolsters the promise of this nucleoside tailoring approach, positioning it as a valuable asset in the development of innovative antiviral drugs.
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Zhou G, Xie D, Fan R, Yang Z, Du J, Mai S, Xie L, Wang Q, Mai T, Han Y, Lai F. Comparison of Pulmonary and Extrapulmonary Models of Sepsis-Associated Acute Lung Injury. Physiol Res 2023; 72:741-752. [PMID: 38215061 PMCID: PMC10805253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/09/2023] [Indexed: 01/14/2024] Open
Abstract
To compare different rat models of sepsis at different time points, based on pulmonary or extrapulmonary injury mechanisms, to identify a model which is more stable and reproducible to cause sepsis-associated acute lung injury (ALI). Adult male Sprague-Dawley rats were subjected to (1) cecal ligation and puncture (CLP) with single (CLP1 group) or two repeated through-and-through punctures (CLP2 group); (2) tail vein injection with lipopolysaccharide (LPS) of 10mg/kg (IV-LPS10 group) or 20 mg/kg (IV-LPS20 group); (3) intratracheal instillation with LPS of 10mg/kg (IT-LPS10 group) or 20mg/kg (IT-LPS20 group). Each of the model groups had a sham group. 7-day survival rates of each group were observed (n=15 for each group). Moreover, three time points were set for additional experimental studying in each model group: 4 hours, 24 hours and 48 hours after modeling (every time point, n=8 for each group). Rats were sacrificed to collect BALF and lung tissue samples at different time points for detection of IL-6, TNF-alpha, total protein concentration in BALF and MPO activity, HMGB1 protein expression in lung tissues, as well as the histopathological changes of lung tissues. More than 50 % of the rats died within 7 days in each model group, except for the IT-LPS10 group. In contrast, the mortality rates in the two IV-LPS groups as well as the IT-LPS20 group were significantly higher than that in IT-LPS10 group. Rats received LPS by intratracheal instillation exhibited evident histopathological changes and inflammatory exudation in the lung, but there was no evidence of lung injury in CLP and IV-LPS groups. Rat model of intratracheal instillation with LPS proved to be a more stable and reproducible animal model to cause sepsis-associated ALI than the extrapulmonary models of sepsis.
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Dong SY, Deng SY, Fan R, Chen JZ, Cheng X, Hao X, Dai WC. [Predictive value of aMAP risk score for early recurrence of small hepatocellular carcinoma after microwave ablation]. ZHONGHUA NEI KE ZA ZHI 2023; 62:1329-1334. [PMID: 37935500 DOI: 10.3760/cma.j.cn112138-20221108-00835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Objective: To explore the value of the aMAP risk score (age, male, albumin-bilirubin, and platelets) to predict early recurrence within one year after microwave ablation in patients with small hepatocellular carcinoma. Methods: This was a retrospective study that enrolled 142 patients diagnosed with hepatocellular carcinoma who were treated with microwave ablation in the Department of Hepatology Unit of Nanfang Hospital, Southern Medical University from July 2016 to July 2021. The cohort enrolled 121 male and 21 female patients, including 110 patients that were <60 years old. All the patients were followed-up after microwave ablation to evaluate residual tumor and recurrence of tumor by computed tomography or magnetic resonance imaging. The observation indices mainly included general data and imaging data of patients. Using the X-tile tools, patients were divided into two groups: a high aMAP score group and a low aMAP score group. Multivariate Cox regression analysis was conducted for comparison of independent risk factors. Results: Multivariate Cox regression showed that high aMAP score, maximum tumor diameter >20 mm, and high AFP were the independent risk factors of early recurrence (all P<0.05). Kaplan-Meier survival curves showed that the median recurrence-free survival was 25.5 months in the low aMAP score group and 6.1 months in the high aMAP score group (P=0.001). Conclusions: The aMAP score could predict the early recurrence within 1 year of small hepatocellular carcinoma after microwave ablation. Patients with high aMAP score should undergo rigorous postoperative follow-up evaluations..
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Wang L, Fan R, Ma H, Sun Y, Huang Y, Wang Y, Guo Q, Ren X, Xu L, Zhao J, Zhang L, Xu Y, Jin L, Dong Y, Quan C. Genomic and metabolomic insights into the antimicrobial compounds and plant growth-promoting potential of Bacillus velezensis Q-426. BMC Genomics 2023; 24:589. [PMID: 37794314 PMCID: PMC10548584 DOI: 10.1186/s12864-023-09662-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/08/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The Q-426 strain isolated from compost samples has excellent antifungal activities against a variety of plant pathogens. However, the complete genome of Q-426 is still unclear, which limits the potential application of Q-426. RESULTS Genome sequencing revealed that Q-426 contains a single circular chromosome 4,086,827 bp in length, with 4691 coding sequences and an average GC content of 46.3%. The Q-426 strain has a high degree of collinearity with B. velezensis FZB42, B. velezensis SQR9, and B. amyloliquefaciens DSM7, and the strain was reidentified as B. velezensis Q-426 based on the homology analysis results. Many genes in the Q-426 genome have plant growth-promoting activity, including the secondary metabolites of lipopeptides. Genome mining revealed 14 clusters and 732 genes encoding secondary metabolites with predicted functions, including the surfactin, iturin, and fengycin families. In addition, twelve lipopeptides (surfactin, iturin and fengycin) were successfully detected from the fermentation broth of B. velezensis Q-426 by ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS/MS), which is consistent with the genome analysis results. We found that Q-426 produced indole-3-acetic acid (IAA) at 1.56 mg/l on the third day of incubation, which might promote the growth of plants. Moreover, we identified eighteen volatile compounds (VOCs, including 2-heptanone, 6-methylheptan-2-one, 5-methylheptan-2-one, 2-nonanone, 2-decanone, 2-undecanone, 2-dodecanone, 2-tridecanone, 2-tetradecanone, 2-nonadecanone, pentadecanoic acid, oleic acid, dethyl phthalate, dibutyl phthalate, methyl (9E,12E)-octadeca-9,12-dienoate), pentadecane, (6E,10E)-1,2,3,4,4a,5,8,9,12,12a-decahydro-1,4-methanobenzo[10]annulene, and nonanal) based on gas chromatograph-mass spectrometer (GC/MS) results. CONCLUSIONS We mined secondary metabolite-related genes from the genome based on whole-genome sequence results. Our study laid the theoretical foundation for the development of secondary metabolites and the application of B. velezensis Q-426. Our findings provide insights into the genetic characteristics responsible for the bioactivities and potential application of B. velezensis Q-426 as a plant growth-promoting strain in ecological agriculture.
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Zhang X, Wang Y, Fan R, Zhang L, Li Z, Zhang Y, Zheng W, Wang L, Liu B, Quan C. Quantitative Proteomic Analysis of Outer Membrane Vesicles from Fusobacterium nucleatum Cultivated in the Mimic Cancer Environment. Microbiol Spectr 2023; 11:e0039423. [PMID: 37341631 PMCID: PMC10434195 DOI: 10.1128/spectrum.00394-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/25/2023] [Indexed: 06/22/2023] Open
Abstract
Fusobacterium nucleatum is a Gram-negative bacterium that has been identified as an important pathogenic gut bacterium associated with colorectal cancer. Compared with the normal intestine, the pH value of the tumor microenvironment is weakly acidic. The metabolic changes of F. nucleatum in the tumor microenvironment, especially the protein composition of its outer membrane vesicles, remain unclear. Here, we systematically analyzed the effect of environmental pH on the proteome of outer membrane vesicles (OMVs) from F. nucleatum by tandem mass tag (TMT) labeling-high-resolution liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. A total of 991 proteins were identified in acidic OMVs (aOMVs) and neutral OMVs (nOMVs), including known virulence proteins and putative virulence proteins. Finally, 306 upregulated proteins and 360 downregulated proteins were detected in aOMVs, and approximately 70% of the expression of OMV proteins was altered under acidic conditions. A total of 29 autotransporters were identified in F. nucleatum OMVs, and 13 autotransporters were upregulated in aOMVs. Interestingly, three upregulated autotransporters (D5REI9, D5RD69, and D5RBW2) show homology to the known virulence factor Fap2, suggesting that they may be involved in various pathogenic pathways such as the pathway for binding with colorectal cancer cells. Moreover, we found that more than 70% of MORN2 domain-containing proteins may have toxic effects on host cells. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses demonstrated that a number of proteins were significantly enriched in multiple pathways involving fatty acid synthesis and butyrate synthesis. Seven metabolic enzymes involved in fatty acid metabolism pathways were identified in the proteomic data, of which 5 were upregulated and 2 were downregulated in aOMVs, while 14 metabolic enzymes involved in the butyric acid metabolic pathway were downregulated in aOMVs. In conclusion, we found a key difference in virulence proteins and pathways in the outer membrane vesicles of F. nucleatum between the tumor microenvironment pH and normal intestinal pH, which provides new clues for the prevention and treatment of colorectal cancer. IMPORTANCE F. nucleatum is an opportunistic pathogenic bacterium that can be enriched in colorectal cancer tissues, affecting multiple stages of colorectal cancer development. OMVs have been demonstrated to play key roles in pathogenesis by delivering toxins and other virulence factors to host cells. By employing quantitative proteomic analysis, we found that the pH conditions could affect the protein expression of the outer membrane vesicles of F. nucleatum. Under acidic conditions, approximately 70% of the expression of proteins in OMVs was altered. Several virulence factors, such as type 5a secreted autotransporter (T5aSSs) and membrane occupation and recognition nexus (MORN) domain-containing proteins, were upregulated under acidic conditions. A large number of proteins showed significant enrichments in multiple pathways involving fatty acid synthesis and butyrate synthesis. Proteomics analysis of the outer membrane vesicles secreted by pathogenic bacteria in the acidic tumor microenvironment is of great significance for elucidating the pathogenicity mechanism and its application in vaccine and drug delivery vehicles.
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Li Z, Shi X, Fan R, Wang L, Bu T, Zheng W, Zhang X, Quan C. [Expression, purification, and characterization of the histidine kinase CarS from Fusobacterium nucleatum]. SHENG WU GONG CHENG XUE BAO = CHINESE JOURNAL OF BIOTECHNOLOGY 2023; 39:1596-1608. [PMID: 37154325 DOI: 10.13345/j.cjb.220779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Fusobacterium nucleatum is an opportunistic pathogenic bacterium that can be enriched in colorectal cancer tissues, affecting multiple stages of colorectal cancer development. The two-component system plays an important role in the regulation and expression of genes related to pathogenic resistance and pathogenicity. In this paper, we focused on the CarRS two-component system of F. nucleatum, and the histidine kinase protein CarS was recombinantly expressed and characterized. Several online software such as SMART, CCTOP and AlphaFold2 were used to predict the secondary and tertiary structure of the CarS protein. The results showed that CarS is a membrane protein with two transmembrane helices and contains 9 α-helices and 12 β-folds. CarS protein is composed of two domains, one is the N-terminal transmembrane domain (amino acids 1-170), the other is the C-terminal intracellular domain. The latter is composed of a signal receiving domain (histidine kinases, adenylyl cyclases, methyl-accepting proteins, prokaryotic signaling proteins, HAMP), a phosphate receptor domain (histidine kinase domain, HisKA), and a histidine kinase catalytic domain (histidine kinase-like ATPase catalytic domain, HATPase_c). Since the full-length CarS protein could not be expressed in host cells, a fusion expression vector pET-28a(+)-MBP-TEV-CarScyto was constructed based on the characteristics of secondary and tertiary structures, and overexpressed in Escherichia coli BL21-Codonplus(DE3)RIL. CarScyto-MBP protein was purified by affinity chromatography, ion-exchange chromatography, and gel filtration chromatography with a final concentration of 20 mg/ml. CarScyto-MBP protein showed both protein kinase and phosphotransferase activities, and the MBP tag had no effect on the function of CarScyto protein. The above results provide a basis for in-depth analysis of the biological function of the CarRS two-component system in F. nucleatum.
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Lei H, Zeng T, Ye X, Fan R, Xiong W, Tian T, Zhou X. Chemical Control of CRISPR Gene Editing via Conditional Diacylation Crosslinking of Guide RNAs. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2206433. [PMID: 36737854 PMCID: PMC10074079 DOI: 10.1002/advs.202206433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Conditional control of RNA structure and function has emerged as an effective toolkit. Here, a strategy based on a one-step introduction of diacylation linkers and azide groups on the 2'-OH of RNA is advance. Selected from eight phosphine reagents, it is found that 2-(diphenylphosphino)ethylamine has excellent performance in reducing azides via a Staudinger reduction to obtain the original RNA. It is demonstrated that the enzymatic activities of Cas13 and Cas9 can be regulated by chemically modified guide RNAs, and further achieved ligand-induced gene editing in living cells by a controllable CRISPR/Cas9 system.
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Lei H, Fan R, Ye X, Xiong W, Cui S, Zeng T, Tian T, Zhou X. A Novel Nucleobase Modification Strategy for Controlling RNA-Guided Nucleic Acid Cleavage. CCS CHEMISTRY 2023. [DOI: 10.31635/ccschem.023.202202604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Wang M, Wang Y, Zhang Y, Zhang W, Wang Y, Fan R, Wen Y. High Intake of Dietary Cholesterol Decreases the Risk of All-Cause Dementia and AD Dementia: A Results from Framingham Offspring Cohort. J Prev Alzheimers Dis 2023; 10:748-755. [PMID: 37874096 DOI: 10.14283/jpad.2023.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Dietary cholesterol has been confirmed to be associated with high risks of diabetes, hypertension, and stroke, but whether it is detrimental to cognitive health is highly debated. This study aimed to investigate the associations between dietary cholesterol and all-cause dementia and AD dementia. METHODS This prospective study analyzed Framingham Offspring Study cohort (FOS) participants who were dementia-free at baseline and had detailed information on daily diet (measured by food frequency questionnaires) and demographic characteristics. Surveillance for incident dementia commenced at examination 5 (1991-1995) through 2018 and continued for approximately 30 years. RESULTS A total of 3249 subjects were included with a mean age of 54.7 years (SD: 9.8). During a median follow-up of 20.2 years (interquartile range: 14.2-24.8), a total of 312 incident dementia events occurred, including 211 (67.7%) cases of AD dementia. After multivariate adjustments for established dementia risk factors, participants with the highest intake of dietary cholesterol had a lower risk of all-cause dementia (HR: 0.70; 95% CI: 0.57-0.93) and AD dementia (HR: 0.68; 95% CI: 0.60-0.88) relative to individuals with the lowest intake. However, the associations were not significant for the group with a medium intake of dietary cholesterol. CONCLUSION High intake of dietary cholesterol was associated with a decreased risk of all-cause dementia and AD dementia. The findings of this observational study need to be confirmed by other studies to highlight the role of dietary cholesterol in the development of neurodegenerative diseases.
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Liu JJ, Xu XX, Sun LJ, Yuan CX, Kaneko K, Sun Y, Liang PF, Wu HY, Shi GZ, Lin CJ, Lee J, Wang SM, Qi C, Li JG, Li HH, Xayavong L, Li ZH, Li PJ, Yang YY, Jian H, Gao YF, Fan R, Zha SX, Dai FC, Zhu HF, Li JH, Chang ZF, Qin SL, Zhang ZZ, Cai BS, Chen RF, Wang JS, Wang DX, Wang K, Duan FF, Lam YH, Ma P, Gao ZH, Hu Q, Bai Z, Ma JB, Wang JG, Wu CG, Luo DW, Jiang Y, Liu Y, Hou DS, Li R, Ma NR, Ma WH, Yu GM, Patel D, Jin SY, Wang YF, Yu YC, Hu LY, Wang X, Zang HL, Wang KL, Ding B, Zhao QQ, Yang L, Wen PW, Yang F, Jia HM, Zhang GL, Pan M, Wang XY, Sun HH, Xu HS, Zhou XH, Zhang YH, Hu ZG, Wang M, Liu ML, Ong HJ, Yang WQ. Observation of a Strongly Isospin-Mixed Doublet in ^{26}Si via β-Delayed Two-Proton Decay of ^{26}P. PHYSICAL REVIEW LETTERS 2022; 129:242502. [PMID: 36563237 DOI: 10.1103/physrevlett.129.242502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/10/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
β decay of proton-rich nuclei plays an important role in exploring isospin mixing. The β decay of ^{26}P at the proton drip line is studied using double-sided silicon strip detectors operating in conjunction with high-purity germanium detectors. The T=2 isobaric analog state (IAS) at 13 055 keV and two new high-lying states at 13 380 and 11 912 keV in ^{26}Si are unambiguously identified through β-delayed two-proton emission (β2p). Angular correlations of two protons emitted from ^{26}Si excited states populated by ^{26}P β decay are measured, which suggests that the two protons are emitted mainly sequentially. We report the first observation of a strongly isospin-mixed doublet that deexcites mainly via two-proton decay. The isospin mixing matrix element between the ^{26}Si IAS and the nearby 13 380-keV state is determined to be 130(21) keV, and this result represents the strongest mixing, highest excitation energy, and largest level spacing of a doublet ever observed in β-decay experiments.
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Aslam F, Al-Sadawi MA, Aleem S, Ijaz H, Jacob R, Cao K, Santore L, Almasry I, Singh A, Fan R, Rashba E. Outcomes of additional substrate modification in de novo atrial fibrillation ablation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. Data regarding additional substrate modification has been conflicting, both in paroxysmal and persistent atrial fibrillation.
Purpose
To assess the effect of additional linear substrate modification during de novo AF ablation on AF recurrence.
Methods
We reviewed 1575 AF ablations in 1254 patients from January 2013 to June 2021 at a single academic medical center. There were 1096 de novo ablations. We defined substrate modification as linear ablations including cavotricuspid isthmus (CTI), superior vena cava isolation, intercaval line, mitral isthmus, and left atrial roof and floor lines. We evaluated clinical and procedural characteristics to identify risk factors for AF recurrence and complications. Patients were followed for a minimum of 6 months.
Results
The 1096 de novo ablations included 65.5% males with mean age 61.1 years, mean BMI 31.3, 81.8% paroxysmal AF and 18.2% persistent AF. There were four AF ablation subgroups: PVI alone (41.6%), PVI and CTI ablation (37.1%), PVI with CTI and additional substrate modification (15.6%), and PVI with substrate modification without CTI ablation (5.7%). Overall, AF recurred in 36.9% cases. AF recurrence with PVI only ablation was 41% compared to 32.7% in patients with PVI and CTI ablation (p=0.02). When looking at patients with paroxysmal and persistent AF, results were similar, with decreased AF recurrence with the addition of CTI ablation in both paroxysmal (37.3% v. 29.2%, p=0.03) and persistent AF (58.1% v. 40.0%, p=0.02). Additional substrate modification did not result in significant difference in outcome in either paroxysmal or persistent AF (Figure 1).
Conclusions
In de novo AF ablations, addition of CTI ablation to de novo PVI ablation is associated with lower AF recurrence in both paroxysmal and persistent AF. Additional linear substrate modification did not impact outcomes.
Funding Acknowledgement
Type of funding sources: None.
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Ijaz H, Al-Sadawi M, Aslam F, Aleem S, Jacob R, Cao K, Santore L, Almasry I, Singh A, Fan R, Rashba E. Safety of same day discharge after atrial fibrillation ablation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) ablation is an outpatient procedure with traditionally an overnight hospital observation (OHO). Recently, there has been a trend towards same day discharge (SDD).
Purpose
Compare AF ablation procedure safety outcomes with SDD vs. OHO.
Methods
We reviewed consecutive AF procedures performed from January 2013 to June 2021 at a single academic center. Patients underwent OHO until June 2020, after which patients had SDD whenever feasible. Adverse events were assessed at three months, which included pericardial effusion, pericarditis, post-procedure hypotension, embolic events, and vascular complications. We also assessed emergency department (ED) visits and procedure-related hospital admissions.
Results
There were 1254 patients who underwent 1575 AF ablations. 1440 patients underwent OHO and 135 had SDD. Mean age was 62.2 years, BMI 33 kg/m2, 65% were male, and 27.6% had persistent AF, without significant differences in baseline characteristics between OHO and SDD. We found that SDD was not associated with increased complications (OHO 0.20% v. SDD 0.49%; p>0.05), ED visits, or hospital admissions (2% v. 5%; p>0.05) (Figure 1, 2). There were no gender or age-related disparities in all outcomes (p>0.05).
Conclusion
SDD protocol after AF ablation is feasible and not associated with higher incidence of complications, ED visits, and procedure-related hospitalizations.
Funding Acknowledgement
Type of funding sources: None.
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Aslam F, Al-Sadawi M, Aleem S, Alsaiqali M, Almasry I, Singh A, Rashba E, Fan R. Effect of defibrillator on long term all-cause mortality in patients with chronic kidney disease: an updated meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The beneficial role of implantable defibrillator (ICD) in patients with chronic kidney disease (CKD) is less understood as this population is often not well represented in clinical trials.
Purpose
Evaluate the effect of ICD use in patients with CKD on long term outcomes.
Methods
Literature search was conducted for studies reporting the effect of ICD on all-cause mortality in patients with CKD, which is defined as glomerular filtration rate (GFR) <60 mL/min. The search was not restricted to time or publication status. The search included the following databases: Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL. The minimum duration of follow-up required for inclusion was one year.
Results
The literature search identified 834 studies, of which 14 studies with 70,661 patients were included. Mean follow up was 39 months (12–81 months). For all patients with CKD, ICD was associated with lower all-cause mortality (log HR −0.247, SE 0.101, p=0.015); Heterogeneity: df=13 (P<0.01), I2=97.057; Test for overall effect: Z=−2.431 (Figure 1). When further stratified based on dialysis, CKD patients without the need for dialysis had favorable outcome (log HR −0.211, SE 0.095, p=0.026); Heterogeneity: df=6 (P<0.01), I2=70.146; Test for overall effect: Z=−2.225, whereas ICD implantation in CKD patients requiring dialysis was not associated with mortality benefit (log HR −0.262, SE 0.134, p=0.051) (Figure 2A, B).
Conclusion
ICD implantation is associated with mortality benefit in patients with CKD, but this association is not present for patients requiring dialysis.
Funding Acknowledgement
Type of funding sources: None.
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Aslam F, Al-Sadawi M, Tao M, Aleem S, Almasry I, Singh A, Rashba E, Fan R. Association of late-gadolinium enhancement in cardiac magnetic resonance with ventricular arrhythmias and mortality in patients with non-ischemic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Late-gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) is a predictor of adverse events such as cardiovascular mortality, cardiovascular related hospitalization and defibrillation shocks in patients with non-ischemic cardiomyopathy (NICM). The correlation between LGE and ventricular arrhythmia and mortality has not been completely established.
Purpose
This meta-analysis assessed the relationship between LGE in CMR with ventricular arrhythmias: sustained, non-sustained and ICD therapy; and mortality in patients with NICM.
Methods
Databases were queried for studies reporting the association between LGE in CMR in NICM and ventricular arrhythmias and mortality, including Ovid MEDLINE, EMBASE, Web of Science, and Google Scholar. The search was not restricted to time or publication status. The minimal follow up duration was one year.
Results
A total of 46 studies and 10,548 patients (4,610 with LGE vs 5,938 without LGE) were included; mean follow up was 3 years (ranging between 13 to 71 months) and mean left ventricular ejection fraction 33%. LGE in NICM was associated with increased risk of ventricular arrhythmias and sudden cardiac death (odds ratio 4.595, 95% confidence interval 3.54–5.97; P<0.01) and mortality (odds ratio 2.949, 95% confidence interval 2.285–3.806; P<0.01). Heterogeneity is low to moderate: χ2=82.2, df =45 (P=0.001), I2=45% (Figures 1, 2).
Conclusions
Our results suggest that LGE is associated with increased risk of ventricular arrhythmias, sudden cardiac death and mortality in long-term follow up. These results further substantiate the need for larger prospective randomized trials using LGE to decide ICD indication regardless of EF. There are two ongoing trials testing this indication: CMR-ICD and CMR-GUIDE.
Funding Acknowledgement
Type of funding sources: None.
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Aleem S, Al-Sadawi M, Aslam F, Ijaz H, Cao K, Jacob R, Santore L, Almasry I, Fan R, Rashba E, Singh A. Does body mass index affect atrial fibrillation ablation outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There are conflicting reports in the literature regarding whether body-mass index (BMI) influences the success and procedural complication rates of atrial fibrillation (AF) ablation.
Purpose
To determine if differences in BMI affect AF ablation outcomes
Methods
At a single academic center, AF ablation procedures were reviewed from 2013 to 2021. Primary outcomes were AF recurrence (after a 90 day blanking period), procedure-related complications, emergency department visits or hospital admission (ED/HOSP). Patients had a minimum of 6 months follow-up
Results
We analyzed 1569 AF ablation consecutive procedures (1093 de novo, 476 repeat ablation) using either radiofrequency or cryoablation. The study population was 65% male with a mean age 62 years, with 28% persistent AF. BMI was separated into three cohorts: <25 kg/m2 (N=218), 25–30 kg/m2 (N=547), and >30 kg/m2 (N=804). There were no significant differences in the type of AF, left atrial diameter, or left ventricular ejection fraction in the BMI subgroups. There was a direct relationship between the prevalence of co-morbid conditions and increasing BMI: hypertension (49.1%, 59.9%, 60.2%; p 0.04), diabetes (6.4%, 13.5%, 21.3%; p 0.01), and obstructive sleep apnea (5.5%, 10.8%, 26.7%; p<0.01). There were no significant differences in AF recurrence, procedural complications or ED/HOSP among the BMI cohorts (p>0.05) (Figure 1). No gender related disparities were noted in outcomes (p>0.05).
Conclusion
Higher BMI was not associated with AF recurrence, complications, or ED/HOSP after AF ablation despite a higher prevalence of comorbid medical conditions
Funding Acknowledgement
Type of funding sources: None.
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Wang C, Liu J, Fan R, Xiao L. Promotion strategies for environmentally friendly packaging: a stochastic differential game perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL SCIENCE AND TECHNOLOGY : IJEST 2022; 20:7559-7568. [PMID: 36093339 PMCID: PMC9440469 DOI: 10.1007/s13762-022-04453-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/07/2022] [Accepted: 07/26/2022] [Indexed: 06/12/2023]
Abstract
With the evolution of the e-commerce and express delivery industry, the consumption of packaging materials is increasing rapidly. Many members of society encourage using environmentally friendly packaging. However, due to the attitude-behavior gap, i.e., expressing concerns about environmental issues does not necessarily lead to green consumption, promoting the use of green packaging remains a challenge. This paper considers a stochastic differential game between green packaging manufacturers and e-commerce platforms. The optimal promotion strategies are derived for scenarios involving cooperation as well as non-cooperation. In addition, a welfare allocation mechanism for attaining stable cooperation is also discussed under the bargaining model. Numerical simulations and a sensitivity analysis were conducted to demonstrate the results. This paper finds that the cooperation between manufacturers and platforms can expand the actual market demand and promote the consumption of green packaging. The proposed model provides an effective tool for manufacturers and platforms to devise optimal strategies for promoting the use of green packaging.
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Wang LD, Li X, Song XK, Zhao FY, Zhou RH, Xu ZC, Liu AL, Li JL, Li XZ, Wang LG, Zhang FH, Zhu XM, Li WX, Zhao GZ, Guo WW, Gao XM, Li LX, Wan JW, Ku QX, Xu FG, Zhu AF, Ji HX, Li YL, Ren SL, Zhou PN, Chen QD, Bao SG, Gao HJ, Yang JC, Wei WM, Mao ZZ, Han ZW, Chang YF, Zhou XN, Han WL, Han LL, Lei ZM, Fan R, Wang YZ, Yang JJ, Ji Y, Chen ZJ, Li YF, Hu L, Sun YJ, Chen GL, Bai D, You D. [Clinical characteristics of 272 437 patients with different histopathological subtypes of primary esophageal malignant tumors]. ZHONGHUA NEI KE ZA ZHI 2022; 61:1023-1030. [PMID: 36008295 DOI: 10.3760/cma.j.cn112138-20210929-00668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT). Methods: A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results: A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment. Conclusion: ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.
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Liao XM, Zhao SR, Dai WC, Fan R. [Research advances of metabolomics in early diagnosis of hepatocellular carcinoma]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2022; 30:803-808. [PMID: 36207936 DOI: 10.3760/cma.j.cn501113-20220624-00346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Primary liver cancer is the second leading cause of death from malignant tumors in China, and hepatocellular carcinoma (HCC) is the main type. The disease stage at the time of HCC diagnosis largely determines the efficacy of subsequent treatment. Due to the HCC screening among high-risk population has not yet popularized, and the current diagnose method of early HCC is not satisfactory, the early HCC diagnosis rate is less than 30% in China. Metabolomics research emerging in recent years has promoted the research progress of HCC in many fields, such as elaborating the mechanism of occurrence and development, early prevention and diagnosis, exploring drug treatment targets. At the same time, a large number of serum metabolites with excellent sensitivity and specificity were discovered, which made up for the deficiency of traditional serological indicators and helped the early screening and early diagnosis of HCC. This review will summarize the studies on serum metabolomic markers of HCC in recent 5 years, explore the role of metabolomics in the early prediction and diagnosis of HCC and its application prospect.
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Dai WC, Fan R, Sun AH, He FC, Hou JL. [Multi-omics research contributes to early screening, diagnosis and treatment of liver cancer]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2022; 30:793-796. [PMID: 36207934 DOI: 10.3760/cma.j.cn501113-20220628-00357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In 2016, the World Health Organization set an ambitious goal of reducing viral hepatitis-related deaths by 65% by 2030. The key to this goal is to reduce viral hepatitis-related HCC deaths. Liver cancer is the fourth most common malignant tumor and the second leading cause of cancer death in China. The onset of HCC is insidious, and most patients are already in the middle and late stage when diagnosed. Despite the great progress on management of HCC, the therapeutic effect and prognosis of HCC are still unsatisfactory. Therefore, multi-dimensional and comprehensive analysis of the mechanism of liver cancer, improving the early screening, diagnosis and treatment rate of liver cancer are the key points of reducing the harm of liver cancer in China. In recent years, multi-omics studies have been widely applied in the field of liver cancer, providing a basis for the pathogenesis of liver cancer, early detection and diagnosis, development of individual treatment strategies and prognosis assessment. This issue will focus on the application of genomics, proteomics, metabolomics and imaging omics in early screening, diagnosis and treatment of liver cancer.
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Fan R, Leasure A, Damsky W, Cohen J. 187 Mental health comorbidities and alcohol use disorder in atopic dermatitis: A case-control study in the All of Us research program. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Sun Q, Marukian N, Cheraghlou S, Paller A, Larralde M, Bercovitch L, Levinsohn J, Ren I, Hu R, Zhou J, Zaki T, Fan R, Tian C, Saraceni C, Nelson-Williams C, Loring E, Craiglow B, Milstone L, Lifton R, Boyden L, Choate K. 502 The genomic and phenotypic landscape of ichthyosis: An analysis of 1000 kindreds. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang F, Zhang SX, Wang Y, An J, Fan R, Liu YQ, Hu XR, Chen J. AB0005 INTEGRATED ANALYSIS OF lncRNAs AND mRNAs EXPRESSION PROFILING IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by over-activity of lymphocytes, production of autoantibodies and effects on multiple organs 1. Growing evidences suggest long noncoding RNAs (lncRNAs) and mRNAs widely participate in physiological and pathological processes. However, knowledge of related lncRNAs and mRNAs in SLE remains limited.ObjectivesThe aim of our study is to investigate the levels of differential expression of lncRNAs and mRNAs in the peripheral blood mononuclear cells (PBMCs) of SLE patients and their correlation with disease activity, clinical features and cell differentiation.MethodsPeripheral venous blood 4ml were collected from 11 patients with SLE before and after treatment and 11 sex-and age-matched healthy individuals and saved in EDTA tubes. PBMCs were isolated from peripheral blood samples by Ficoll-Histopaque density gradient centrifugation. Total RNA was extracted from PBMCs with TRIzol reagent. RNAs amount and quality were quantified by using a NanoDrop ND-1000. Peripheral blood samples were sent to Novogene Co. Ltd (Beijing, China) for sequencing. The DESeq package in R language was used to analyze the differential expression of lncRNAs and mRNAs in the two groups. GO and KEGG databases analyze the potential biological functions and signal transduction and disease pathways affected by abnormal expression of lncRNAs and mRNAs2.ResultsAccording to the RNAs expression profiles, 338 lncRNAs (173 upregulated and 165 downregulated) and 2020 mRNAs (1292 upregulated and 728 downregulated) were differentially expressed between SLE patients and control groups. In addition, 17 lncRNAs were significantly downregulated and 66 mRNAs (47 upregulated and 19 downregulated) were differentially expressed between active and treated SLE patients. There were 1645 RNAs up-expression in active SLE patients and 36 RNAs under-expression in treated SLE patients, and total 14 RNAs changed direction of expression. GO and KEGG pathway analysis showed most of mRNAs were related to transcription, inflammation and immunity. The relativity between aberrantly expressed RNAs and clinical characteristics of active and treated SLE patients were shown in Table 1.ConclusionDysregulation of lncRNAs and mRNAs involves in molecular regulation of SLE, which may support for diagnosis or determination of the susceptibility of individuals of SLE.References[1]Tsokos GC. Systemic lupus erythematosus. N Engl J Med 2011;365(22):2110-21. doi: 10.1056/NEJMra1100359 [published Online First: 2011/12/02][2]Zhang Y, Xu YZ, Sun N, et al. Long noncoding RNA expression profile in fibroblast-like synoviocytes from patients with rheumatoid arthritis. Arthritis Res Ther 2016;18(1):227. doi: 10.1186/s13075-016-1129-4 [published Online First: 2016/10/08]Figure 1.(A-C) Analysis of DElncRNAs and DEmRNAs of pre-treated SLE and cotrols. (A) The volcano plot with the DElncRNAs. (B) The volcano plot with the DEmRNAs. (C) The hierarchical clustering heatmap of DElncRNAs and DEmRNAs. (D-F) Analysis of DElncRNAs and DEmRNAs between pre-treated and treated SLE. (D) Volcano plot with the DElncRNAs. (E) Volcano plot with the DEmRNAs. (F) The hierarchical clustering heatmap of DElncRNAs and DEmRNAs. (G1-G5) Partial RNAs expression changed in active and treated SLE patients. Table 1 showed specific changed RNAs. (H1-H4) The top 20 GO and KEGG terms related to the up-regulated and down-regulated DEmRNAs. (I1-I3) GO and KEGG analyses of DEmRNAs between active and treated SLE patients.Table 1:The relativity between aberrantly expressed mRNA and LncRNA and clinical characteristics of active and treated SLE patients.AcknowledgementsThis work was supported by the National Natural Science Foundation of China (No. 82001740) and the Natural Science Research Project of Shanxi Province (No.20210302123275).Disclosure of InterestsNone declared
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Liu YN, Fan R, Yang RF, Liu S, Wang J, Liao H, Qiu C, Deng R, Huang HX, Hu P, Zheng SJ, Zhang WH, Chen XM, Chen H, Sun J, Lu F. [Expert consensus on measurement and clinical application of serum HBV RNA in patients with chronic HBV infection]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2022; 30:505-512. [PMID: 35764542 DOI: 10.3760/cma.j.cn501113-20220420-00214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Since the discovery of circulating hepatitis B virus (HBV) RNA in the peripheral blood of patients with chronic hepatitis B in 1996, a growing number of studies have focused on clarifying the biological characteristics and clinical application value of serum HBV RNA. This consensus mainly summarizes the research progress of serum HBV RNA existing profiles, quantitative detection methods, and current clinical applications. In order to better apply this indicator for the clinical management of patients with chronic HBV infection, recommendations on quantitative detection target regions, detection results, and clinical applications are put forward.
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Zhu S, Pan Y, Li K, Fan R, Xiang L, Huang S, Jia S, Niu X, Li C, Chen Y. Complete Genome Sequence of Xanthomonas phaseoli pv. manihotis Strain CHN01, the Causal Agent of Cassava Bacterial Blight. PLANT DISEASE 2022; 106:1039-1041. [PMID: 35259300 DOI: 10.1094/pdis-09-21-2016-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Zhu S, Fan R, Xiong X, Li J, Xiang L, Hong Y, Ye Y, Zhang X, Yu X, Chen Y. MeWRKY IIas, Subfamily Genes of WRKY Transcription Factors From Cassava, Play an Important Role in Disease Resistance. FRONTIERS IN PLANT SCIENCE 2022; 13:890555. [PMID: 35720572 PMCID: PMC9201764 DOI: 10.3389/fpls.2022.890555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/02/2022] [Indexed: 05/20/2023]
Abstract
Cassava (Manihot esculenta Crantz) is an important tropical crop for food, fodder, and energy. Cassava bacterial blight (CBB) caused by Xanthomonas axonopodis pv. manihotis (Xam) occurs in all cassava growing regions and threatens global cassava production. WRKY transcription factor family plays the essential roles during plant growth, development, and abiotic or biotic stress. Particularly, previous studies have revealed the important role of the group IIa WRKY genes in plant disease resistance. However, a comprehensive analysis of group IIa subfamily in cassava is still missing. Here, we identified 102 WRKY members, which were classified into three groups, I, II, and III. Transient expression showed that six MeWRKY IIas were localized in the nucleus. MeWRKY IIas transcripts accumulated significantly in response to SA, JA, and Xam. Overexpression of MeWRKY27 and MeWRKY33 in Arabidopsis enhanced its resistance to Pst DC3000. In contrast, silencing of MeWRKY27 and MeWRKY33 in cassava enhanced its susceptibility to Xam. Co-expression network analysis showed that different downstream genes are regulated by different MeWRKY IIa members. The functional analysis of downstream genes will provide clues for clarifying molecular mechanism of cassava disease resistance. Collectively, our results suggest that MeWRKY IIas are regulated by SA, JA signaling, and coordinate response to Xam infection.
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