Nanoparticle-hydrogel composite as dual-drug delivery system for the potential application of corneal graft rejection

Immune rejection remains the major cause of corneal graft failure. Immunosuppressants (such as rapamycin; RAPA) adjunctive to antibiotics (such as levofloxacin hydrochloride; Lev) are a clinical mainstay after corneal grafts but suffer from poor ocular bioavailability associated with severe side effects. In this study, we fabricated a Lev@RAPA micelle loaded cationic peptide-based hydrogel (NapFFKK) as a dual-drug delivery system by integrating RAPA micelles with Lev into a cationic NapFFKK hydrogel to potentially reduced the risk of corneal graft rejection. The properties of the resulting hydrogels were characterized using transmission electronmicroscopy and rheometer. Lev@RAPA micelles loaded NapFFKK hydrogel provided sustained in vitro drug release without compromising their inherent pharmacological activities. Topical instillation of Lev@RAPA micelles loaded NapFFKK hydrogel resulted in the great ocular tolerance and extended precorneal retention over 60 min, thus significantly enhancing the ocular bioavailability of both Lev and RAPA. Overall, such dual-drug delivery system might be a promising formulation for the suppression of corneal graft failure.

Subconjunctival injection of rapamycin-loaded polymeric microparticles for effective suppression of noninfectious uveitis in rats

Noninfective uveitis is a major cause of vision impairment, and corticosteroid medication is a mainstay clinical strategy that causes severe side effects. Rapamycin (RAPA), a potent immunomodulator, is a promising treatment for noninfective uveitis. However, because high and frequent dosages are required, it is a great challenge to implement its clinical translation for noninfective uveitis therapy owing to its serious toxicity. In the present study, we engineered an injectable microparticulate drug delivery system based on biodegradable block polymers (i.e., polycaprolactone-poly (ethylene glycol)-polycaprolactone, PCEC) for efficient ocular delivery of RAPA via a subconjunctival injection route and investigated its therapeutic efficacy in an experimental autoimmune uveitis (EAU) rat model. RAPA-PCEC microparticles were fabricated using the emulsion-evaporation method and thoroughly characterized using scanning electron microscopy, fourier transform infrared spectroscopy, X-ray diffraction, and differential scanning calorimetry. The formed microparticles exhibited slow in vitro degradation over 28 days, and provided both in vitro and in vivo sustained release of RAPA over 4 weeks. Additionally, a single subconjunctival injection of PCEC microparticles resulted in high ocular tolerance. More importantly, subconjunctival injection of RAPA-PCEC microparticles significantly attenuated the clinical signs of EAU in a dose-dependent manner by reducing inflammatory cell infiltration (i.e., CD45+ cells and Th17 cells) and inhibiting microglial activation. Overall, this injectable microparticulate system may be promising vehicle for intraocular delivery of RAPA for the treatment of noninfective uveitis.

[Application of optical coherence tomography in the evaluation of cervical lesions: a multicenter study]

Objective: To explore the value of optical coherence tomography (OCT) imaging system in evaluating cervical lesions in vivo. Methods: A total of 1 214 patients with cervical lesions were collected from January 2020 to December 2021 in the Third Affiliated Hospital of Zhengzhou University, Maternal and Chlid Heaith Hospital of Gushi County, Xinyang City, Henan Province, and Maternal and Chlid Heaith Hospital of Sui County, Shangqiu City, Henan Province. The age of the patients was (38.9±10.5) years (range: 16-77 years). All patients underwent in vivo cervical OCT examination and cervical biopsy pathology examination, and summarized the OCT image features of in vivo cervical lesions. Using the pathological diagnosis as the "gold standard", the accuracy, specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of OCT image interpretation results were evaluated, as well as the consistency of OCT image diagnosis and pathological diagnosis. At the same time, the in vivo cervical OCT imaging system, as a newly developed screening tool, was compared with the traditional combined screening of human papillomavirus (HPV) and Thinprep cytologic test (TCT), to assess the screening effect. Results: By comparing the OCT images of the cervix in vivo with the corresponding HE images, the OCT image characteristics of the normal cervix and various types of cervical lesions in vivo were summarized. The accuracy, sensitivity, specificity, PPV and NPV of OCT image in the diagnosis of high-grade squamous intraepithelial lesion (HSIL) and above (HSIL+) were 93.4%, 88.5%, 95.0%, 85.0% and 96.2%, respectively. The accuracy, sensitivity, specificity, PPV and NPV of OCT for low-grade squamous intraepithelial lesion (LSIL) were 84.7%, 61.7%, 96.3%, 89.3% and 83.2%, respectively. The consistency between OCT image diagnosis and pathological diagnosis was strong (Kappa value was 0.701).The accuracy, sensitivity and specificity of OCT screening, HPV and TCT combined screening were 83.7% vs 64.9% (χ²=128.82, P<0.001), 77.8% vs 64.5% (χ²=39.01, P<0.001), 91.8% vs 65.4% (χ²=98.12, P<0.001), respectively. The differences were statistically significant. Conclusions: OCT imaging system has high sensitivity and specificity in the evaluation of cervical lesions in vivo, and has the characteristics of non-invasive, real-time and high efficiency. OCT examination is expected to become an effective method for the diagnosis of cervical lesions and cervical cancer screening.

[Molluscicidal effect of spraying 5% niclosamide ethanolamine salt granules with drones against Oncomelania hupensis in hilly regions]

OBJECTIVE

To establish a snail control approach for spraying chemicals with drones against Oncomelania hupensis in complex snail habitats in hilly regions, and to evaluate its molluscicidal effect.

METHODS

The protocol for evaluating the activity of spraying chemical molluscicides with drones against O. hupensis snails was formulated based on expert consultation and literature review. In August 2022, a pretest was conducted in a hillside field environment (12 000 m2) north of Dafengji Village, Dacang Township, Weishan County, Yunnan Province, which was assigned into four groups, of no less than 3 000 m2 in each group. In Group A, environmental cleaning was not conducted and 5% niclosamide ethanolamine salt granules were sprayed with drones at a dose of 40 g/m2, and in Group B, environmental cleaning was performed, followed by 5% niclosamide ethanolamine salt granules sprayed with drones at a dose of 40 g/m2, while in Group C, environmental cleaning was not conducted and 5% niclosamide ethanolamine salt granules were sprayed with knapsack sprayers at a dose of 40 g/m2, and in Group D, environmental cleaning was performed, followed by 5% niclosamide ethanolamine salt granules sprayed with knapsack sprayers at a dose of 40 g/m2. Then, each group was equally divided into six sections according to land area, with Section 1 for baseline surveys and sections 2 to 6 for snail surveys after chemical treatment. Snail surveys were conducted prior to chemical treatment and 1, 3, 5, 7 days post-treatment, and the mortality and corrected mortality of snails, density of living snails and costs of molluscicidal treatment were calculated in each group.

RESULTS

The mortality and corrected mortality of snails were 69.49%, 69.09%, 53.57% and 83.48%, and 68.58%, 68.17%, 52.19% and 82.99% in groups A, B, C and D 14 days post-treatment, and the density of living snails reduced by 58.40%, 63.94%, 68.91% and 83.25% 14 days post-treatment relative to pre-treatment in four groups, respectively. The median concentrations of chemical molluscicides were 37.08, 35.42, 42.50 g/m2 and 56.25 g/m2 in groups A, B, C and D, and the gross costs of chemical treatment were 0.93, 1.50, 0.46 Yuan per m2 and 1.03 Yuan per m2 in groups A, B, C and D, respectively.

CONCLUSIONS

The molluscicidal effect of spraying 5% niclosamide ethanolamine salt granules with drones against O. hupensis snails is superior to manual chemical treatment without environmental cleaning, and chemical treatment with drones and manual chemical treatment show comparable molluscicidal effects following environmental cleaning in hilly regions. The cost of chemical treatment with drones is slightly higher than manual chemical treatment regardless of environmental cleaning. Spraying 5% niclosamide ethanolamine salt granules with drones is recommended in complex settings with difficulty in environmental cleaning to improve the molluscicidal activity and efficiency against O. hupensis snails.

Repeatability and agreement of AOCT-1000 M, RTVue XR and IOL master 500 in measuring corneal thickness mapping and axial length applying principle of optical coherence tomography

PURPOSE

To evaluate the repeatability and agreement of Fourier-domain optical coherence tomography (AOCT-1000 M and RTVue XR) and partial coherence interferometry biometer (IOL Master 500) in measuring corneal thickness mapping and axial length respectively.

METHODS

Corneal thickness was measured by AOCT-1000 M and RTVue XR. Axial lengths were measured by AOCT-1000 M and IOL Master 500. The repeatability and agreement of corneal thickness and axial length were calculated in two groups of devices. The intraclass correlation coefficient (ICC) was used to verify the repeatability of the device. The 95% confidence interval of the difference compared to the set cut-off value was used to verify the agreement between the two devices.

RESULTS

A total of 60 subjects with 58 eyes were included. The central corneal thickness measured by AOCT-1000 M and RTVue XR were 504.46 ± 42.53 μm and 504.43 ± 42.89 μm respectively. The average difference between groups was 0.03 ± 4.58 μm, and the 95% confidence interval was (-1.17, 1.24), which was far less than the set threshold value of 15 μm (P < 0.001). Both RTVue XR and AOCT-1000 M had very good ICC values of central corneal thickness (0.998 and 0.994, respectively). The average axial lengths measured by AOCT-1000 M and IOL Master 500 were 24.28 ± 1.25 mm and 24.29 ± 1.26 mm respectively and the 95% confidence interval was (-0.02, 0.01), which was less than the set threshold value of 0.15 mm (P < 0.001). The ICC for both devices were 1.000.

CONCLUSION

Good repeatability and agreement were seen in measurements of central corneal thickness and axial length by AOCT-1000 M.

17β-estradiol regulates adenosine triphosphate-binding cassette transporters A1 expression via estrogen receptor A to increase macrophage cholesterol efflux

The liver is the focus of research on the effects of estrogen on cholesterol metabolism. Few studies have investigated the effects of estrogen on macrophages despite the significance of cells in atherosclerosis. The purpose of this study is to examine the effect of estrogen on macrophage cholesterol efflux. Macrophage cholesterol efflux, oil red O staining, RT-qPCR, Western blotting analyses were used to determine cholesterol metabolize and the expressions of adenosine triphosphate (ATP)-binding cassette transporter G1 (ABCG1) and ATP-binding cassette transporter A1 (ABCA1) in J774A.1 cells, and the effect of these treatments was compared to without adding 17β-estradiol (E2). Gain and loss of estrogen receptor alpha (ERα), liver X receptor α (LXRα) were conducted to study interactions between E2, ERα, LXRα and ABCA. Finally, in mice, we validate the relationship between ERα and ABCA1. E2 increases cholesterol efflux from macrophages and decreases the formation of lipid droplets and positively regulates the expression of ABCA1. This suggests that estrogen receptors (ERs) directly regulate ABCA1 translation. We suppressed ERα, which decreased the mRNA and protein expression of ABCA1. At the mRNA level, E2 treatment could partially counteract these phenomena, but not at the protein level. ABCA1 expression decreased after LXRα was inhibited. This suggests that ABCA1 translation is directly regulated by ERα. In the ovariectomized mouse model of ABCA1 protein expression was significantly reduced in the peritoneal macrophages of the ovariectomy (OVX) group. ABCA1 protein expression was greater in the E2+OVX group than in the OVX group. E2 contributes to the positive regulation of ABCA1 expression and promotes cholesterol efflux in macrophages by binding to ERα. The effect is independent of ABCA1 transcription regulation by LXRα.

Changes in Shape Discrimination Sensitivity Under Glare Conditions After Orthokeratology in Myopic Children: A Prospective Study

Purpose

To investigate changes in shape discrimination under mesopic conditions with and without glare after orthokeratology in myopic children.

Methods

This prospective study included 79 eyes of 79 myopic children (ages: 8-16 years). Shape discrimination thresholds (SDTs) were measured using radial frequency patterns, with a radial frequency of 4 cycles/360°, a peak spatial frequency of 3 cycles per degree, a contrast of 20%, and a mean radius of 1.5 degrees. SDT under mesopic conditions with and without glare was measured before orthokeratology and again at 1 week and 1 month after orthokeratology. Changes in the SDTs and their relationships to baseline ocular parameters were analyzed.

Results

SDTs with glare decreased significantly at 1 week (-0.08 ± 0.15 log(arcsec), P < 0.001) and 1 month (-0.09 ± 0.15 log(arcsec), P < 0.001) after orthokeratology. SDTs without glare remained stable (P = 0.81 and P = 1.00, respectively). The difference between SDTs with and without glare also decreased significantly at 1 week (-0.10 ± 0.17 log(arcsec), P < 0.001) and at 1 month (-0.08 ± 0.18 log(arcsec), P = 0.001) after orthokeratology. Based on a multivariate analysis, the greater decrease in SDT with glare after 1 month of orthokeratology was associated with a higher baseline spherical equivalent refraction.

Conclusions

Orthokeratology resulted in improved shape discrimination in myopic children under mesopic conditions but only when measured in the presence of glare.

An injectable thermosensitive hydrogel for dual delivery of diclofenac and Avastin® to effectively suppress inflammatory corneal neovascularization

Corneal neovascularization (CNV) is a sequela of anterior segment inflammation, which could lead to vision impairment and even blindness. In the present study, the dual delivery of anti-inflammatory agent (i.e., diclofenac; DIC) and anti-VEGF antibody (i.e., Avastin®; Ava) by the thermosensitive hydrogel (Poly(dl-lactide)-poly(ethylene glycol)-poly(dl-lactide); PDLLA-PEG-PDLLA) is expected to effectively inhibit CNV via their synergistic effects. The optimal DIC micelles were formulated and then mixed with Ava and PDLLA-PEG-PDLLA aqueous solution to generate various DIC@Ava-loaded hydrogels. The co-encapsulation of DIC micelles and Ava did not influence the gelling behavior of the system, and the resulting DIC@Ava-loaded hydrogel provided sustained drug release of both DIC and Ava without compromising their pharmacological activity over 19 days. As indicated by in vitro cytotoxicity and in vivo ocular biocompatibility test, the proposed PDLLA-PEG-PDLLA hydrogel caused minimal cytotoxicity against all tested cell lines at a polymeric concentration ranging from 0.05 mg/mL to 0.8 mg/mL and demonstrated good ocular biocompatibility after a single subconjunctival injection. Using the rabbit CNV model, we documented the superior anti-angiogenic effects of the DIC@Ava-loaded hydrogel over Ava alone medication (treatment with Ava solution and Ava-loaded hydrogel) due to synergistic effects of anti-VEGF and anti-inflammatory action. Overall, the proposed DIC@Ava-loaded hydrogel might be a powerful strategy to reduce CNV.

Biofunctional peptide-click PEG-based hydrogels as 3D cell scaffolds for corneal epithelial regeneration

Poly(ethylene glycol) (PEG)-based hydrogels as highly promising 3D cell scaffolds have been widely implemented in the field of tissue regrowth and regeneration, yet the functionalized PEG hydrogel providing dynamic, cell-instructive microenvironments is inherently difficult to obtain. Here, we have exploited the specificity of click reaction to develop a set of hydrogels based on 4-arm PEG tetraazide (4-arm-PEG-N₃) and di-propargylated peptides (GRGDG and GRDGG) with tunable physicochemical properties applicable for 3D cell scaffolds. The azide groups of PEG were reacted with the alkynyl groups of peptides, catalyzed by copper to form triazole rings, thus generating a cross-linked hydrogel. The gelation time and mechanical strength of the hydrogels varied according to the PEG/peptide feed ratio. The resulting hydrogel exhibited a typical porous microstructure and suitable swelling behavior. The in vitro cytotoxicity test indicated that the resulting hydrogels did not cause apparent cytotoxicity against human corneal epithelial cells (HCECs). After co-incubation with HCECs, the density of RGD as well as peptide sequence in the hydrogels remarkably affected the cell attachment, spreadability, and proliferation. Additionally, the proposed hydrogel showed high ocular biocompatibility after being embedded subconjunctivally into rabbit eyes. Overall, these findings highlighted that the biofunctional hydrogels formed by PEG and RGD motifs via a controllable click reaction might be promising 3D cell scaffolds for corneal epithelial regeneration.

High expression of ACE2 in the human lung leads to the release of IL6 by suppressing cellular immunity: IL6 plays a key role in COVID-19

OBJECTIVE

The pathogenesis of coronavirus disease 2019 (COVID-19) remains clear, and no effective treatment exists. SARS-CoV-2 is the virus that causes COVID-19 and uses ACE2 as a cell receptor to invade human cells. Therefore, ACE2 is a key factor to analyze the SARS-CoV-2 infection mechanism.

MATERIALS AND METHODS

We included 9,783 sequencing results of different organs, analyzed the effects of different ACE2 expression patterns in organs and immune regulation.

RESULTS

We found that ACE2 expression was significantly increased in the lungs and digestive tract. The cellular immunity of individuals with elevated ACE2 expression is activated, whereas humoral immunity is dampened, leading to the release of many inflammatory factors dominated by IL6. Furthermore, by studying the sequencing results of SARS-CoV-2-infected and uninfected cells, IL6 was found to be an indicator of a significant increase in the number of infected cells. However, although patients with high expression of ACE2 will release many inflammatory factors dominated by IL6, cellular immunity in the colorectum is significantly activated. This effect may explain why individuals with SARS-CoV-2 infection have severe lung symptoms and digestion issues, which are important causes of milder symptoms.

CONCLUSIONS

This finding indicates that ACE2 and IL6 inhibitors have important value in COVID-19.

Glycol chitosan/oxidized hyaluronic acid hydrogel film for topical ocular delivery of dexamethasone and levofloxacin

In the present study, we fabricated a glycol chitosan/oxidized hyaluronic acid hydrogel film with promising potential for the dual ophthalmic delivery of dexamethasone (Dex) and levofloxacin (Lev). Utilizing different oxidation degrees of oxidized hyaluronic acid (OHA), several blank hydrogel films and Lev-loaded hydrogel films were successfully fabricated. With an increase in the oxidation degree of OHA, the swelling ratio of the hydrogel films decreased accordingly. The hydrogel films displayed a stepwise release of Lev and Dex, with Lev rapidly released from the hydrogel film, followed by a sustained release of Dex. Lev-loaded hydrogel films revealed a potent capacity to inhibit bacterial growth in different bacterial strains. In lipopolysaccharide-activated RAW264.7 macrophages, the formulated hydrogel films displayed potent in vitro anti-inflammatory activity by significantly downregulating various inflammatory cytokines. Overall, the fabricated hydrogel film acting as a dual drug delivery system might be a promising vehicle for the treatment of postoperative endophthalmitis.

Evaluation of microvasculature alterations in convalescent Vogt-Koyanagi-Harada disease using optical coherence tomography angiography

PURPOSE

To evaluate the microvasculature alterations in convalescent Vogt-Koyanagi-Harada (VKH) disease using optical coherence tomography angiography (OCTA), and to explore the association between microvasculature and the presence of sunset glow fundus (SGF).

METHODS

A cross-sectional study was conducted with 28 VKH patients at convalescent stage and 25 healthy individuals. Both eyes of each participant were enrolled. The VKH patients were classified into two subgroups based on the existence of SGF. OCTA images (3 × 3 mm) were assessed for the data of superficial capillaris plexus (SCP), deep capillaris plexus (DCP), choriocapillaris, and foveal avascular zone (FAZ).

RESULTS

Compared with healthy control eyes and eyes without SGF, the vessel densities of the SCP and DCP decreased significantly in most regions of eyes with SGF (p < 0.0167). No significant difference of vascular perfusion was found between eyes without SGF and control eyes (p > 0.05). VKH patients with SGF had slightly increased FAZ area (p = 0.067) and decreased choroid flow area (p = 0.427) than those in the control group.

CONCLUSION

Convalescent VKH patients with SGF showed decreased macular capillary perfusion. OCTA could serve as a sensitive tool to assess the microvasculature alterations of VKH disease.

Associations of Preoperative Irisin Levels of Paired Cerebrospinal Fluid and Plasma with Physical Dysfunction and Muscle Wasting Severity in Residents of Surgery Wards

BACKGROUND

Myokine Irisin has been proposed to regulate metabolic homeostasis, which is related to chronic diseases or physical activity. However, whether irisin levels in paired cerebrospinal fruid (CSF), plasma and their ratio of inpatients, could use as biomarkers, and be independently related to the varying physical dysfunction, muscle wasting severity and chronic diseases with varying severe degrees, remain largely elusive.

METHODS

We conducted an observational study to assess the independent associations between irisin levels in paired cerebrospinal fruid (CSF), plasma and their ratio, and the independence in activities of daily life (ADLs), muscle wasting severity and chronic diseases with varying severe degrees among elderly Chinese in-patient subjects.

RESULTS

Among 217 inpatients in surgery wards with a mean age of 68.07 years (±15.94years), 31.3% of women and 68.7% of men were included in the study. Bivariate correlation analysis showed that Log transformed CSF and plasma irisin levels and their ratio were potential associated with age, fat%, muscle wasting time, ADLs, number of multimorbidity, the severity of bone mass loss and anemia. Regression models analysis indicated that CSF and plasma irisin levels and their ratio in inpatient individuals were independently associated with the independence in ADLs. Plasma irisin levels were independently related to the change of muscle wasting use.

CONCLUSIONS

Collectively, the evaluation of paired plasma and CSF irisin levels, and their ratio in in-patient individuals is intriguing candidates for the susceptibility of the independence in ADLs. Plasma irisin levels were positively associated with indepedence in ADLs, negatively related to muscle wasting severity, and could use as biomarkers for muscle wasting severity.

Identification and characterisation of a novel FT orthologous gene in London plane with a distinct expression response to environmental stimuli compared to PaFT

FLOWERING LOCUS T (FT) is a key integrator of environmental signals and internal cues, and codes for florigen-like activity which regulates the transition from vegetative to reproductive growth in flowering plants. Unlike annual plants, perennial tree species undergo several years of vegetative growth prior to the transition to the reproductive stage, as characterised by the ability to form flower buds. Thereafter, trees in temperate regions typically display an annual growth cycle involving distinct vegetative growth, flowering and dormancy stages. In London plane (Platanus acerifolia Willd.), a FT-like gene has previously been identified. Here, we report the isolation of a novel FT orthologous gene, PaFTL, and investigate the functions of PaFT and PaFTL through the analysis of expression profiles and transgenic phenotypes. PaFT displayed the highest levels of expression during tree dormancy, and similarly elevated expression levels were seen under conditions of low temperature and short days (LT/SD). In contrast, PaFTL transcripts were up-regulated during the floral transition phase, the early stages of inflorescence development and throughout the main flowering period, whereas expression levels were low and variable during dormancy and in response to LT/SD treatments. Ectopic expression of 35s::PaFTL in tobacco produced a phenotype similar to that with PaFT, namely, advanced floral initiation. Overall, the results suggest that PaFT and PaFTL have both conserved and diverse functions in floral initiation, floral development and dormancy regulation.

Identification of a Good-Prognosis IDH-Mutant-Like Population of Patients with Diffuse Gliomas

BACKGROUND

Isocitrate dehydrogenase (IDH) mutation is the initiating event that defines major clinical and prognostic classes of gliomas, but the potential mechanisms have not been well interpreted yet. The main objective of the current study was to better understand the underlying biology of IDH mutant gliomas as captured by gene expression profiles.

METHODS

RNA sequencing data of WHO grade II-IV gliomas from the Chinese Glioma Genome Atlas (CGGA, N=325) were used to assess differentially expressed genes between IDH mutant and wild type gliomas and to construct a gene expression-based classifier to detect IDH mutant samples with high sensitivity and specificity. The classifier was validated in independent RNA sequencing data from the Cancer Genome Atlas (TCGA, N=699), and the prognostic value of the classifier was also assessed in the two datasets.

RESULTS

A 58-gene-pair IDH mutation signature was developed by using the top scoring pairs algorithm. In CGGA dataset, 98.5% and 100% IDH mutant samples were also predicted to be mutant by gene expression based IDH status in grade II-III and grade IV gliomas, respectively. In TCGA dataset, the proportions were 99.8% and 100%, respectively. The signature remained to be a prognostic marker in multivariate cox analysis both in CGGA and TCGA datasets.

CONCLUSION

A characteristic gene expression signature is associated with and accurately predicts IDH mutation status. This suggests a common biology between these tumors and adds prognostic and biologic information that is not captured by the mutation status alone. These results may help in population stratification for clinical trials. As RNA-seq is more and more prevalent and cost-effective in glioma molecular diagnosis, this gene signature would provide a precise method to predict IDH mutation status with RNA-seq data.