AB0784 Symptoms compatible with Rome IV functional bowel disorder in patients with ankylosing spondylitis

Background

Clinical manifestations of gut problems except for inflammatory bowel disease (IBD) have not been well-established in patients with ankylosing spondylitis (AS). One study investigated that 30% patients with axial spondyloarthritis (axSpA) had irritable bowel syndrome (IBS) symptoms meeting Rome III criteria.[1]

Objectives

To determine the frequency of symptoms meeting Rome IV functional bowel disorder (FBD) in patients with AS, investigate factors associated with FBD symptoms, and assess whether having FBD symptoms might influence AS disease activity.

Methods

In this cross-sectional study, we consecutively enrolled 153 AS patients without known colonic ulcer and 56 sex- and age-matched controls to evaluate FBD (or its subtypes) symptoms.[2] In AS group, logistic regression models were used to explore whether demographic data, disease activity, level of gut inflammation, drug use, and fibromyalgia [3] were associated with presence of gut symptoms. Finally, potential impacts of gut symptoms on AS disease status were assessed in linear regression models.

Results

Sixty (39.2%) of 153 AS patients had FBD symptoms, which was more prevalent than controls (23.2%). Besides, symptoms compatible with IBS and chronic diarrhea were detected in 18 and 43 AS patients respectively. For AS group, multivariable logistic regression analyses showed that symptoms of FBD, IBS, and chronic diarrhea were negatively associated with using non-steroidal anti-inflammatory drug (NSAID), and positively associated with comorbid fibromyalgia, respectively. In exploration about effects of FBD (or its subtypes) symptoms on AS disease activity by multivariable linear regression analyses, FBD symptoms and chronic diarrhea had positive associations with assessments of AS respectively.

Conclusion

Patients with AS had frequent symptoms compatible with FBD, IBS, and chronic diarrhea, proportions of which were lower in those with NSAID-use. The improvement of FBD symptoms, especially chronic diarrhea, might be conducive to disease status of AS patients.

References

[1]Wallman JK, et al. Ann Rheum Dis. 2020;79:159-61.

[2]Mearin F, et al. Gastroenterology. 2016;18:S0016-5085(16)00222-5.

[3]Wolfe F, et al. J Rheumatol. 2011;38:1113-22.

Figure 1.

Frequencies with symptoms meeting FBD criteria

Table 1.

Univariable and multivariable associations between gut symptoms and assessments of AS

Gut symptomsUnivariableMultivariableβpβpASDAS-CRPaFBD symptoms0.2340.1120.294< 0.001IBS symptoms0.0390.863Chronic diarrhea0.2170.1720.3010.002BASDAIbFBD symptoms0.747< 0.0010.764< 0.001IBS symptoms0.2020.560Chronic diarrhea0.7610.0020.845< 0.001BAS-GcFBD symptoms0.936< 0.0010.979< 0.001IBS symptoms0.0590.889Chronic diarrhea0.9030.0030.9490.001ASAS HIdFBD symptoms1.941< 0.0011.6730.003IBS symptoms2.2630.0081.7690.046Chronic diarrhea1.5000.0151.3430.030BASFIeFBD symptoms0.4330.0490.4280.048IBS symptoms0.2960.376Chronic diarrhea0.4480.0600.4250.069BASMIfFBD symptoms-0.3730.190-0.4930.075IBS symptoms-0.4420.304Chronic diarrhea-0.1790.564　　

Besides gut symptoms, other clinical variables (Block-1) being chosen into hierarchical multivariable models were as follows: aHLA-B27, lnCRP, and lnESR; bHLA-B27 and lnESR; cHLA-B27 and lnCRP; dsex and TNFi; eHLA-B27, lnESR, and TNFi; fage and lnESR. Missing data ranging from 1-7%.

Disclosure of Interests

None declared

Observation of Spin Splitting Torque in a Collinear Antiferromagnet RuO_{2}

Current-induced spin torques provide efficient data writing approaches for magnetic memories. Recently, the spin splitting torque (SST) was theoretically predicted, which combines advantages of conventional spin transfer torque (STT) and spin-orbit torque (SOT) as well as enables controllable spin polarization. Here we provide the experimental evidence of SST in collinear antiferromagnet RuO_{2} films. The spin current direction is found to be correlated to the crystal orientation of RuO_{2} and the spin polarization direction is dependent on (parallel to) the Néel vector. These features are quite characteristic for the predicted SST. Our finding not only presents a new member for the spin torques besides traditional STT and SOT, but also proposes a promising spin source RuO_{2} for spintronics.

The role of Trithorax family regulating osteogenic and Chondrogenic differentiation in mesenchymal stem cells

Mesenchymal stem/stromal cells (MSCs) hold great promise and clinical efficacy in bone/cartilage regeneration. With a deeper understanding of stem cell biology over the past decade, epigenetics stands out as one of the most promising ways to control MSCs differentiation. Trithorax group (TrxG) proteins, including the COMPASS family, ASH1L, CBP/p300 as histone modifying factors, and the SWI/SNF complexes as chromatin remodelers, play an important role in gene expression regulation during the process of stem cell differentiation. This review summarises the components and functions of TrxG complexes. We provide an overview of the regulation mechanisms of TrxG in MSCs osteogenic and chondrogenic differentiation, and discuss the prospects of epigenetic regulation mediated by TrxG in bone and cartilage regeneration.

Adjuvant Abemaciclib Combined with Endocrine Therapy for High Risk Early Breast Cancer: Safety and Patient-Reported Outcomes From the monarchE Study

BACKGROUND

In monarchE, abemaciclib plus endocrine therapy (ET) as adjuvant treatment of hormone receptor-positive, human epidermal growth factor 2-negative, high risk, early breast cancer demonstrated a clinically meaningful improvement in invasive disease-free survival versus ET alone. Detailed safety analyses conducted at a median follow-up of 27 months and key patient-reported outcomes (PRO) are presented.

PATIENTS AND METHODS

The safety population included all patients who received at least one dose of study treatment (n=5591). Safety analyses included incidence, management, and outcomes of common and clinically relevant adverse events (AEs). Patient-reported health-related quality-of-life, ET symptoms, fatigue, and side effect burden were assessed.

RESULTS

The addition of abemaciclib to ET resulted in higher incidence of Grade≥3 AEs (49.7% vs 16.3% with ET alone), predominantly laboratory cytopenias (e.g., neutropenia [19.6%]) without clinical complications. Abemaciclib-treated patients experienced more serious adverse events (SAEs; 13.3% vs 7.8%). Discontinuation of abemaciclib and/or ET due to AEs occurred in 18.5% of patients, mainly due to Grade1/2 AEs (66.8%). AEs were managed with comedications (e.g., antidiarrheals), abemaciclib dose holds (61.7%), and/or dose reductions (43.4%). Diarrhea was generally low grade (Grade1/2: 77%); Grade2/3 events were highest in the first month (20.5%), most short-lived (≤7 days) and did not recur. Venous thromboembolic events (VTE) were higher with abemaciclib+ET (2.5%) vs ET (0.6%); in the abemaciclib arm, increased VTE risk was observed with tamoxifen vs AIs (4.3% vs 1.8%). PROs were similar between arms, including being 'bothered by side effects of treatment', except for diarrhea. At ≥3 months, most patients reporting diarrhea reported "a little bit" or "somewhat".

CONCLUSION

In patients with high risk EBC, adjuvant abemaciclib+ET has an acceptable safety profile and tolerability is supported by PRO findings. Most AEs were reversible and manageable with comedications and/or dose modifications, consistent with the known abemaciclib toxicity profile.

Modification of PVC/CPE Blends with Coupling Agent and its Mechanism

In this thesis, the modification of PVC/CPE blends was investigated. Addition of aromatic diamines into PVC/CPE blends as a coupling agent, greatly increases the impact strength of the blends. At the same time, other mechanical properties such as the tensile and bending strength can be improved as well.

With the aid of solvent etching, the multiphase microstructure of the blends has been studied using a scanning electron microscope. The relationship between the microstructure and mechanical properties of the blends has been discussed.

It was shown that there were coupling and crosslinking reactions in the blends with coupling agents. The concentration of the reacted coupling agent was related to the mechanical properties of the blends quantitatively.

Using probability methods, the concentration of the coupled molecules formed in the blends can be calculated. The influence of the ratio of PVC to CPE on the coupling effectiveness can be predicted.

[C-reactive protein is associated with impaired working capacity in Chinese patients with ankylosing spondylitis in paid employment: the real-world evidence from Smart-phone SpondyloArthritis Management System]

To investigate the relationship between serum C-reactive protein (CRP) levels and work impairment in patients with ankylosing spondylitis (AS) based on real-world evidence. Outpatients with confirmed AS at Chinese PLA General Hospital were recruited consecutively by Smart-phone SpondyloArthritis Management System (SpAMS) from April 2016 to April 2018. The relationship between CRP and work productivity and activity impairment questionnaire (WPAI) were evaluated. Five hundred and fifty-one outpatients with AS in paid employment were recruited. The presenteeism, overall work impairment, and activity impairment rates increased by 1.4% (1.1%, 1.8%), 1.1% (0.5%, 1.6%), and 1.7% (1.3%, 2.1%), respectively, for every 10 mg/L increase in the CRP level (all P value<0.01). However, the CRP level was not associated with absenteeism after adjusting for covariates [0.5%(-0.4%, 1.0%),P>0.05]. There is a significant association between increased serum CRP levels at baseline and the previous 7-day work impairment in patients with AS. Higher CRP levels contribute to worse presenteeism, overall work impairment, and activity impairment rates, which suggests the necessity of monitoring CRP on treatment, and also indicates that anti-inflammatory therapy may be effective for improving work productivity.

Mechanical Behaviors of Microalloyed TRIP-Assisted Annealed Martensitic Steels under Hydrogen Charging

Transformation Induced Plasticity (TRIP)-assisted annealed martensitic (TAM) steel sheets with various microalloying additions such as niobium, vanadium, or titanium were prepared on laboratory scale and subjected to a double-quenching and austempering heat treatment cycle. Slow strain rate tensile (SSRT) was tested on the investigated TAM steels with and without hydrogen charging to reveal their tensile behaviors and hydrogen induced embrittlement effects. Microstructure observations by scanning electron microscope (SEM) are composed of a principal annealed martensitic matrix and 11.0-13.0% volume fraction of retained austenite, depending on the type of microalloying addition in the different steels. SSRT results show that these TRIP-assisted annealed martensitic steels under air media conditions combine high tensile strength (>1000 MPa) and good ductility (~25%), while under hydrogen charging condition, both tensile strength and ductility decrease where tensile strength ranges between 680 and 760 MPa, down from 1000-1100 MPa, and ductility loss ratio is between 78.8% and 91.1%, along with a total elongation of less than 5%. Hydrogen charged into steel matrix leads to the appearance of cleavage fractures, implying the occurrence of hydrogen induced embrittlement effect in TAM steels. Thermal hydrogen desorption results show that there are double-peak hydrogen desorption temperature ranges for these microalloyed steels, where the first peak corresponds to a high-density dislocation trapping effect, and the second peak corresponds to a hydrogen trapping effect exerted by microalloying precipitates. Thermal desorption analysis (TDS) in combination with SSRT results demonstrate that microalloying precipitates act as irreversible traps to fix hydrogen and, thus, retard diffusive hydrogen motion towards defects, such as grain boundaries and dislocations in microstructure matrix, and eventually reduce the hydrogen induced embrittlement tendency.

The Effects of Bletilla striata Polysaccharides on Antioxidant and Immunomodulatory Activities of Mice In Vivo

Bletilla striata polysaccharide is a well-known antioxidant and immunomodulatory ingredient used in a variety of traditional Chinese medicine applications. A mouse aging model was constructed by intraperitoneal injection of D-galactose to explore the antioxidant and immunomodulatory effects of B. striata polysaccharides. B. striata polysaccharide was found to boost antioxidant capacity and retard aging in a subacutely aged mouse. In comparison to the cyclophosphamide alone group, the groups given 80 mg/kg and 160 mg/kg of B. striata polysaccharide showed considerably higher levels of total antioxidant capacity, superoxide dismutase, and catalase, with significantly lower malondialdehyde levels. To investigate the moderating effect of B. striata polysaccharide on immunological deficit, cyclophosphamide was injected into the abdominal cavity to create an immunocompromised mouse model. B. striata polysaccharide attenuated immunosuppressive effects of cyclophosphamide. The histological staining demonstrated that both liver and spleen cells in the control group were densely packed, with distinct nuclei and qualitative characteristics. The liver and spleen of the immunocompromised mice benefited significantly from 450 mg/kg B. striata polysaccharide. Taken together, B. striata polysaccharide exhibits an antioxidant and immunomodulatory effects in vivo.

Spatiotemporal distribution, source apportionment and combined pollution of antibiotics in natural waters adjacent to mariculture areas in the Laizhou Bay, Bohai Sea

The spatiotemporal distribution, source apportionment and combined pollution of 14 antibiotics in natural waters adjacent to mariculture farms of Laizhou Bay in the Bohai Sea were studied. The contribution proportion and quantity of each potential pollution source to antibiotics in natural water bodies were quantitatively described. The correlations between heavy metals and antibiotics and their underlying mechanisms in natural and aquaculture water environment were analyzed. Fourteen antibiotics were detected in natural water and sediment in the coastal area of Laizhou Bay. The maximum concentrations of sulfamethazine and trimethoprim in water reached tens or even hundreds of μg/L in winter. Trimethoprim was the main antibiotic in natural water bodies in winter and summer, and enrofloxacin was the principal antibiotic in sediments. Enrofloxacin, ciprofloxacin and oxytetracycline were detected in all underground water samples; thus, control of these antibiotics needs to be made a priority to mitigate groundwater contamination. PCA-MLR revealed that the potential sources of antibiotics in natural waters of Laizhou Bay include the mariculture wastewater (18.3%), the domestic sewage (63.3%) and the livestock wastewater (18.4%). Therefore, the antibiotic burden of Laizhou Bay was principally from the domestic sewage. In natural water, the concentration of Cu was positively correlated with antibiotics, which might be related to the common sources, the competitive adsorption in sediments and the easy complexation characteristic of Cu and antibiotics. Positive correlations among antibiotics and heavy metals were observed in mariculture sediments, while negative relationships were observed in natural sediments.

Epigenetic Control of Autophagy Related Genes Transcription in Pulpitis via JMJD3

Autophagy is an intracellular self-cannibalization process delivering cytoplasmic components to lysosomes for digestion. Autophagy has been reported to be involved in pulpitis, but the regulation of autophagy during pulpitis progression is largely unknown. To figure out the epigenetic regulation of autophagy during pulpitis, we screened several groups of histone methyltransferases and demethylases in response to TNFα treatment. It was found JMJD3, a histone demethylase reducing di- and tri-methylation of H3K27, regulated the expression of several key autophagy genes via demethylation of H3K27me3 at the gene promoters. Our study highlighted the epigenetic regulation of autophagy genes during pulpitis, which will potentially provide a novel therapeutic strategy.