[Study on the negative regulation of TIPE2 from peripheral blood mononuclear cells on tissue factor in patients with bronchial asthma]

Objective: To investigate the expression of tumor necrosis factor alpha-inducible protein 8 like-2 (TIPE2) and tissue factor (TF) in patients with bronchial asthma. And to explore the regulation of TIPE2 on TF. Methods: Sixty-five asthmatic patients and 40 healthy controls were selected from the First Affiliated Hospital of Zhengzhou University from July to November, 2017. The expression of TIPE2 and TF in peripheral blood mononuclear cells of asthmatic patients and healthy controls were detected by Western blot.The level of TF protein in plasma was detected by enzyme-linked immunosorbent assay. The changes of TIPE2 and TF mRNA expression in THP-1 cells stimulated by house dust mite extract were detected by real-time fluorescence quantitative PCR (RT-PCR). The recombinant adenovirus Adv-TIPE2 was constructed and transfected into THP-1 cells and the effect of over-expression TIPE2 on TF expression in THP-1 cells was detected by RT-PCR. Results: The relative level of TIPE2 protein in asthmatic patients and healthy controls was 0.025±0.010 and 0.087±0.070, while that of TF was 0.40±0.27 and 0.15±0.10, respectively. Compared with healthy controls, the levels of TIPE2 protein decreased and TF protein increased in asthmatic patients, the differences were statistically significant (t=-5.06, 9.04, P<0.05) . TIPE2 protein level was negatively correlated with TF protein level (r=-0.460 3, P<0.05). The house dust mite extract reduced the expression level of TIPE2 mRNA in THP-1 cells, but increased the level of TF mRNA expression. When the concentration was 1 μg/ml, the change of TIPE2 mRNA was the most obvious at 4 h (P<0.05). The recombinant adenovirus Adv-TIPE2 was successfully constructed. The level of TF mRNA expression in THP-1 cells over-expressing TIPE2 gene was reduced (P<0.05). Conclusion: TIPE2, a negative regulator of inflammation, has a negative control effect on TF, and may be involved in the hyper-coagulable state of bronchial asthma by regulating TF expression.

Extensive tinea capitis and corporis in a child caused by Trichophyton verrucosum

A 3-year-old boy presented with multiple lesions of tinea corporis with dermatophytids, and subsequent inflammatory lesions with alopecia on the scalp. At the beginning, topical clobetasone butyrate was prescribed. The infection was diagnosed as dermatophytosis on the basis of positive direct microscopy and fungal culture. The etiological agent was isolated from all sampled sites and identified as Trichophyton verrucosum. Clonal nature of the infection was confirmed by random amplified polymorphic DNA (RAPD) analysis. The child lived in close vicinity of cattle. He was successfully treated with itraconazole.

Magnesium supplementation improves diabetic mitochondrial and cardiac diastolic function

In heart failure and type 2 diabetes mellitus (DM), the majority of patients have hypomagnesemia, and magnesium (Mg) supplementation has improved cardiac function and insulin resistance. Recently, we have shown that DM can cause cardiac diastolic dysfunction (DD). Therefore, we hypothesized that Mg supplementation would improve diastolic function in DM. High-fat diet-induced diabetic mouse hearts showed increased cardiac DD and hypertrophy. Mice with DM showed a significantly increased E/e' ratio (the ratio of transmitral Doppler early filling velocity [E] to tissue Doppler early diastolic mitral annular velocity [e']) in the echocardiogram, left ventricular end diastolic volume (LVEDV), incidence of DD, left ventricular posterior wall thickness in diastole (PWTd), and ratio of heart weight to tibia length (HW/TL) when compared with controls. DM mice also had hypomagnesemia. Ventricular cardiomyocytes isolated from DM mice exhibited decreased mitochondrial ATP production, a 1.7- ± 0.2-fold increase of mitochondrial ROS, depolarization of the mitochondrial membrane potential, and mitochondrial Ca2+ overload. Dietary Mg administration (50 mg/ml in the drinking water) for 6 weeks increased plasma Mg concentration and improved cardiac function. At the cellular level, Mg improved mitochondrial function with increased ATP, decreased mitochondrial ROS and Ca2+ overload, and repolarized mitochondrial membrane potential. In conclusion, Mg supplementation improved mitochondrial function, reduced oxidative stress, and prevented DD in DM.

Association of BNP with Frailty in Elderly Population: Rugao Longevity and Ageing Study

OBJECTIVES

To explore the associations of B-type natriuretic peptide (BNP) with physical frailty status as well as each domain of frailty in a general elderly population.

DESIGN

Cross-sectional analysis of prospective cohort study.

SETTING

All of 31 communities in Jiang'an township.

PARTICIPANTS

Overall 1338 participants (aged 70-89 years, mean 77.42±4.08 years) without a history of cardiovascular diseases in the third-wave of the aging arm of the Rugao Longevity and Aging Study (RuLAS).

MEASUREMENTS

Frailty was defined as the presence of ≥3 domains among five modified Fried's criteria (unintentional weight loss, low physical activity level, weakness (low grip strength), exhaustion, and slowness (slow gait speed)) and pre-frailty as the presence of 1-2 domains.

RESULTS

The prevalence of frailty and pre-frailty was 10.4% and 53.3%, respectively, in this elderly population. Elevated BNP (≥100 pg/mL) was significantly associated with pre-frailty (OR: 1.61, 95% CI: 1.13-2.29) and frailty (OR: 2.63, 95% CI: 1.61-4.32) after adjustment for covariates. In addition, elevated BNP was associated with low grip strength (OR: 2.00, 95% CI: 1.41-2.82) and low gait speed (OR: 1.62, 95% CI: 1.15-2.28) after adjustment for multiple covariates. Log BNP was inversely associated with grip strength (r= -0.265, p<0.001) and gait speed (r= -0.189, p<0.001).

CONCLUSION

Elevated plasma BNP was associated with increased risks of frailty, pre-frailty, and low levels of grip strength and gait speed in the elderly community people.

Abstract 536: Increased O-linked Glycosylation in Diabetic Myocardium of Mice and Human

Objectives: The modification of serine and threonine residues of nuclear and cytoplasmic proteins by O-linked β-N-acetylglucosamine (O-GlcNAc) has emerged as a highly dynamic post-translational modification that plays a critical role in regulating numerous biological processes. Our focus was to establish the difference of O-linked glycosylation in diabetic (DM) and Non-diabetic (ND) heart of mouse and human in the presence or absence of cardioplegic ischemia and cardiopulmonary bypass (CP/CPB).

Methods and results: Right atrial tissue was harvested pre- and post-CP/CPB from the ND patients and patients with type-2 DM undergoing cardiac surgery (n = 4/group).The post-CP/CPB tissue samples were from a atrial tissue segment exposed to cold, hyperkalemic blood cardioplegia (ischemia) and a brief period (10 minutes) of reperfusion. Ventricular tissue samples were also obtained from mice with and without type-2 DM (n =3/group). Thin Layer Chromatography (TLC) was used to measure the contents of acetyl coenzyme A (acetyl-CoA) in the tissue lysates of mouse and human myocardium. Western blotting and immunohistochemistry analysis were employed to determine the expression/localization of O-Linked β-N-acetylglucosamine (O-GlcNAc) in the tissue lysates and paraffin-embedded tissue sections. Diabetes tends to increase the amounts of acetyl-CoA and O-GlcNAc (20% increase vs. ND, P<0.05) in the myocardium compared with ND. Post-CP/CPB further induced more acetyl-CoA and this effect was more pronounced in the diabetic atrial myocardium than that of ND. Immunofluorescence experiments with O-GlcNAc-specific antibody and paraffin-embedded tissue sections from human atria and mouse heart show a significant number of cells stain positively with the antibody in the diabetes sections (3 folds increases in optical density vs. ND, P <0.01). The protein oxidation and ratio of NADH/NAD in the DM myocardium were significantly increased compared with ND (P<0.05).

Conclusion: Diabetes and cardioplegic ischemia are associated with an increase in O-linked glycosylation in the mouse and human myocardium, suggesting that diabetes and cardioplegic ischemia affect myocardial metabolism via hexosamine biosynthetic pathway.

Abstract 540: Magnesium Improves Cardiac Diastolic Function by Modulating Mitochondria

Rationale: A diet rich in saturated fat has been found to induce diabetes mellitus (DM) accompanied by myocardial mitochondrial dysfunction, insulin resistance, and magnesium (Mg) deficiency. The most prominent characteristic of diabetic cardiomyopathy is cardiac diastolic dysfunction (DD). Mg supplementation improves the heart rate variability and arterial elasticity in chronic heart failure. Recently, we have reported that mitochondrial reactive oxygen species (mitoROS) play a critical role in the progress of DD and diastolic heart failure. Therefore, we hypothesized that Mg supplementation would benefit diastolic function by improving mitochondrial function.

Methods and Results: High fat diet (HFD)-induced diabetic mouse hearts showed cardiac DD with increased E/e’ (45±2 in DM mice vs. 32±2 in control mice), increased left ventricular diastolic volume (LVDV, 80±1 μL in DM vs. 61±4 μL in control), and increased incidence of DD (9 of 10 mice in DM vs 1 of 10 mice in control; P<0.05 for all). DM mice also showed decreased plasma Mg concentration (0.80±0.04 mmol/L in DM vs. 0.98±0.03 mmol/L in control, P<0.05). Ventricular cardiomyocytes isolated from DM mice exhibited decreased mitochondrial ATP production (75±11% of control), a 1.7±0.2-fold increase in mitoROS, significantly depolarized mitochondrial membrane potential, and mitochondrial Ca 2+ overload (3.7±1.3-fold; P<0.05 vs. control for all). Dietary Mg administration (50 mg/mL, ≈6-8 g/kg/day) for 6 weeks corrected all these parameters with increased plasma Mg concentration (1.5±0.1 mmol/L), improved cardiac diastolic function (E/e’ 37±1; LVDV 54±5 μL; LVPWT 0.77±0.02 mm; the incidence of DD, 2 of 10 mice; P<0.05 vs. DM for all). Mitochondrial function was improved significantly by Mg with increased ATP production, decreased mitoROS, repolarized mitochondrial membrane potential, and decreased mitochondrial Ca 2+ overload in DM mice.

Conclusion: These results indicate that Mg supplementation improved mitochondrial function, reduced oxidative stress, and prevented diastolic dysfunction in DM.

Mitochondrial Ca2+ flux modulates spontaneous electrical activity in ventricular cardiomyocytes

Introduction

Ca²⁺ release from sarcoplasmic reticulum (SR) is known to contribute to automaticity via the cytoplasmic Na⁺-Ca²⁺ exchanger (NCX). Mitochondria participate in Ca²⁺ cycling. We studied the role of mitochondrial Ca²⁺ flux in ventricular spontaneous electrical activity.

Methods

Spontaneously contracting mouse embryonic stem cells (ESC)-derived ventricular cardiomyocytes (CMs) were differentiated from wild type and ryanodine receptor type 2 (RYR2) knockout mouse ESCs and differentiated for 19–21 days. Automaticity was also observed in human induced pluripotent stem cell (hiPSC)-derived ventricular CMs differentiated for 30 days, and acute isolated adult mouse ventricular cells in ischemic simulated buffer. Action potentials (APs) were recorded by perforated whole cell current-clamp. Cytoplasmic and mitochondrial Ca²⁺ transients were determined by fluorescent imaging.

Results

In mouse ESC-derived ventricular CMs, spontaneous beating was dependent on the L-type Ca²⁺ channel, cytoplasmic NCX and mitochondrial NCX. Spontaneous beating was modulated by SR Ca²⁺ release from RYR2 or inositol trisphosphate receptors (IP₃R), the pacemaker current (I_f) and mitochondrial Ca²⁺ uptake by the mitochondrial Ca²⁺ uniporter (MCU). In RYR2 knockout mouse ESC-derived ventricular CMs, mitochondrial Ca²⁺ flux influenced spontaneous beating independently of the SR Ca²⁺ release from RYR2, and the mitochondrial effect was dependent on IP₃R SR Ca²⁺ release. Depolarization of mitochondria and preservation of ATP could terminate spontaneous beating. A contribution of mitochondrial Ca²⁺ flux to automaticity was confirmed in hiPSC-derived ventricular CMs and ischemic adult mouse ventricular CMs, confirming the findings across species and cell maturity levels.

Conclusions

Mitochondrial and sarcolemma NCX fluxes are required for ventricular automaticity. Mitochondrial Ca²⁺ uptake plays a modulatory role. Mitochondrial Ca²⁺ uptake through MCU is influenced by IP₃R-dependent SR Ca²⁺ release.

Pure red cell aplasia with t-cell large granular lymphocytic leukemia

Pure red cell aplasia (PRCA) develops as a result of erythroid precursors failing to reach maturity in the bone marrow, which eventually leads to anemia. Here we present a case of a 64-year-old Asian male with a medical history of colorectal adenocarcinoma who had been treated with 6 cycles of oxaliplatin and capecitabine four years ago. The patient was diagnosed with PRCA and T-cell large granular lymphocyte leukemia.

RNA Binding Protein, HuR, Regulates SCN5A Expression Through Stabilizing MEF2C transcription factor mRNA

BACKGROUND

Although transcription is the initial process of gene expression, posttranscriptional gene expression regulation has also played a critical role for fine-tuning gene expression in a fast, precise, and cost-effective manner. Although the regulation of sodium channel α-subunit (SCN5A) mRNA expression has been studied at both transcriptional and pre-mRNA splicing levels, the molecular mechanisms governing SCN5A mRNA expression are far from clear.

METHODS AND RESULTS

Herein, we show that, as evidenced by ribonucleoprotein immunoprecipitation assay, RNA binding protein Hu antigen R/ELAV like RNA binding protein 1 (HuR/ELAVL1) and myocyte enhancer factor-2C (MEF2C) transcription factor mRNA are associated. HuR positively regulated transcription factor MEF2C mRNA expression by protecting its mRNA from degradation. As demonstrated by both chromatin immunoprecipitation-quantitative polymerase chain reaction assay and an electrophoretic mobility shift assay, MEF2C enhanced SCN5A transcription by binding to a putative MEF2C binding site within SCN5A promoter region. Overexpression of HuR increased the expression of SCN5A mRNA, and this effect was attenuated by the presence of MEF2C small interfering RNA in cardiomyocytes.

CONCLUSIONS

In conclusion, our results suggested that HuR participates in a combined network at the DNA and RNA levels that regulates SCN5A mRNA expression. HuR upregulates MEF2C mRNA expression by protecting MEF2C mRNA from degradation, and consequently, the elevated MEF2C enhances SCN5A mRNA transcription.

Mitochondrial Ca2+ Influx Contributes to Arrhythmic Risk in Nonischemic Cardiomyopathy

Background

Heart failure (HF) is associated with increased arrhythmia risk and triggered activity. Abnormal Ca²⁺ handling is thought to underlie triggered activity, and mitochondria participate in Ca²⁺ homeostasis.

Methods and Results

A model of nonischemic HF was induced in C57BL/6 mice by hypertension. Computer simulations were performed using a mouse ventricular myocyte model of HF. Isoproterenol‐induced premature ventricular contractions and ventricular fibrillation were more prevalent in nonischemic HF mice than sham controls. Isolated myopathic myocytes showed decreased cytoplasmic Ca²⁺ transients, increased mitochondrial Ca²⁺ transients, and increased action potential duration at 90% repolarization. The alteration of action potential duration at 90% repolarization was consistent with in vivo corrected QT prolongation and could be explained by augmented L‐type Ca²⁺ currents, increased Na⁺‐Ca²⁺ exchange currents, and decreased total K⁺ currents. Of myopathic ventricular myocytes, 66% showed early afterdepolarizations (EADs) compared with 17% of sham myocytes (P<0.05). Intracellular application of 1 μmol/L Ru360, a mitochondrial Ca²⁺ uniporter–specific antagonist, could reduce mitochondrial Ca²⁺ transients, decrease action potential duration at 90% repolarization, and ameliorate EADs. Furthermore, genetic knockdown of mitochondrial Ca²⁺ uniporters inhibited mitochondrial Ca²⁺ uptake, reduced Na⁺‐Ca²⁺ exchange currents, decreased action potential duration at 90% repolarization, suppressed EADs, and reduced ventricular fibrillation in nonischemic HF mice. Computer simulations showed that EADs promoted by HF remodeling could be abolished by blocking either the mitochondrial Ca²⁺ uniporter or the L‐type Ca²⁺ current, consistent with the experimental observations.

Conclusions

Mitochondrial Ca²⁺ handling plays an important role in EADs seen with nonischemic cardiomyopathy and may represent a therapeutic target to reduce arrhythmic risk in this condition.

Interpretation of liver stiffness measurement-based approach for the monitoring of hepatitis B patients with antiviral therapy: A 2-year prospective study

Liver biopsy is not routinely performed in treated chronic hepatitis B. Liver stiffness measurement has been validated for noninvasive liver fibrosis assessment in pretreatment chronic hepatitis B but has not been assessed for fibrosis monitoring during antiviral therapy. Liver stiffness was systemically monitored by Fibroscan^® every 6 months in a cohort of patients with hepatitis B receiving antiviral therapy and compared with liver biopsies at baseline and week 104. A total of 534 hepatitis B e antigen-positive treatment-naive patients receiving telbivudine-based therapy with qualified liver stiffness measurement at baseline and week 104 were analyzed, 164 of which had adequate paired liver biopsies. Liver stiffness decreased rapidly (-2.2 kPa/24 weeks) in parallel with alanine aminotransferase (ALT) from 8.6 (2.6-49.5) kPa at baseline to 6.1 (2.2-37.4) kPa at week 24. Interestingly, liver stiffness decreased slowly (-0.3 kPa/24 weeks) but continually from week 24 to week 104 (6.1 vs 5.3 kPa, P < .001) while ALT levels remained stable within the normal range. More importantly, liver stiffness declined significantly irrespective of baseline ALT levels and liver necroinflammation grades. From baseline to week 104, the proportion of patients with no or mild fibrosis (Ishak, 0-2) increased from 74.4% (122/164) to 93.9% (154/164). Multivariate analysis revealed that percentage decline of 52-week liver stiffness from baseline was independently associated with 104-week liver fibrosis regression (odds ratio, 3.742; P = .016). Early decline of 52-week liver stiffness from baseline may reflect the remission of both liver inflammation and fibrosis and was predictive of 104-week fibrosis regression in treated patients with chronic hepatitis B.

Activation of the unfolded protein response downregulates cardiac ion channels in human induced pluripotent stem cell-derived cardiomyocytes

RATIONALE

Heart failure is characterized by electrical remodeling that contributes to arrhythmic risk. The unfolded protein response (UPR) is active in heart failure and can decrease protein levels by increasing mRNA decay, accelerating protein degradation, and inhibiting protein translation.

OBJECTIVE

Therefore, we investigated whether the UPR downregulated cardiac ion channels that may contribute to arrhythmogenic electrical remodeling.

METHODS

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) were used to study cardiac ion channels. Action potentials (APs) and ion channel currents were measured by patch clamp recording. The mRNA and protein levels of channels and the UPR effectors were determined by quantitative RT-PCR and Western blotting. Tunicamycin (TM, 50 ng/mL and 5 μg/mL), GSK2606414 (GSK, 300 nmol/L), and 4μ8C (5 μmol/L) were utilized to activate the UPR, inhibit protein kinase-like ER kinase (PERK) and inositol-requiring protein-1 (IRE1), respectively.

RESULTS

TM-induced activation of the UPR caused significant prolongation of the AP duration (APD) and a reduction of the maximum upstroke velocity (dV/dt_max) of the AP phase 0 in both acute (20-24 h) and chronic treatment (6 days). These changes were explained by reductions in the sodium, L-type calcium, the transient outward and rapidly/slowly activating delayed rectifier potassium currents. Na_v1.5, Ca_v1.2, K_v4.3, and K_vLQT1 channels showed concomitant reductions in mRNA and protein levels under activated UPR. Inhibition of PERK or IRE1 shortened the APD and reinstated dV/dt_max. The PERK branch regulated Na_v1.5, K_v4.3, hERG, and K_vLQT1. The IRE1 branch regulated Na_v1.5, hERG, K_vLQT1, and Ca_v1.2.

CONCLUSIONS

Activated UPR downregulates all major cardiac ion currents and results in electrical remodeling in hiPSC-CMs. Both PERK and IRE1 branches downregulate Na_v1.5, hERG, and K_vLQT1. The PERK branch specifically downregulates K_v4.3, while the IRE1 branch downregulates Ca_v1.2. Therefore, the UPR contributed to electrical remodeling, and targeting the UPR might be anti-arrhythmic.

Di-2-ethylhexyl phthalate (DEHP) exposure disturbs lipid metabolism in juvenile yellow catfish Tachysurus fulvidraco

This study was conducted to determine the mechanism by which di-2-ethylhexyl phthalate (DEHP) exposure influences lipid metabolism of juvenile yellow catfish Tachysurus fulvidraco. Fish were exposed to three DEHP concentrations (0, 0·1 and 0·5 mg l^-1 DEHP) for 8 weeks. Fatty acid synthase (FAS) activity significantly decreased with increasing DEHP concentrations, the highest value was in the Tween control group, whereas the lowest activities of carnitine palmitoyltransferase (CPT) and lipoprotein lipase (LPL) were in this group. The messenger (m)RNA levels of 6-phospho-gluconate dehydrogenase (6PGD), FAS and acetyl-CoA carboxylase a (ACCa) significantly increased with increasing DEHP concentration, the highest values were in the 0·5 mg l^-1 DEHP group. The mRNA level of peroxisome proliferator-activated receptor γ (PPARγ) was lower in Tween control than in fish exposed to 0·1 and 0·5 mg l^-1 DEHP. The highest mRNA level of ACCb was in the 0·1 mg l^-1 DEHP group. These results indicate that DEHP exposure can disturb lipid metabolism at the enzymatic and mRNA levels in Pelteobagrus fulvidraco.

Butylated caffeic acid: An efficient novel antioxidant

A novel antioxidant, butylated caffeic acid (BCA) was rationally designed by adding a tert-butyl group to caffeic acid, which was synthesized at a high yield (36.2%) from 2-methoxy-4-methylphenol by a four-step reaction including Friedel-Crafts alkylation, bromine oxidation, ether bond hydrolysis and Knoevenagel condensation. Its antioxidant capacity was much stronger than common commercial antioxidant tert-butyl hydroquinone (TBHQ) and its mother compound, caffeic acid, in both rancimat and deep frying tests. When investigated via the DPPH method, the antioxidant capacity of BCA was almost equal to TBHQ, but lower than caffeic acid. BCA could be a potentially strong antioxidant, especially for food processing at high temperatures such as deep frying and baking.

A systematic review on delayed absorption of subretinal fluid after scleral buckling for rhegmatogenous retinal detachment

Rhegmatogenous retinal detachment is a vision-threatening disease and is treated by either scleral buckling or pars planar vitrectomy. Rapid absorption of the subretinal fluid (SRF) helps in the early recovery of the vision. The absorption of SRF after the scleral buckling procedure is rapid, provided that the retinal break or breaks are closed at or after surgery. However, in some patients with rhegmatogenous retinal detachment, complete absorption of the SRF occur several weeks or months after the surgery. In this review, we discuss the factors influencing the rate of SRF absorption and the role of delayed absorption on visual recovery. We also discuss the therapeutic options for delayed SRF absorption and the available additional therapeutic options. Knowledge of the factors that influence the rate of SRF absorption, would enable the surgeon to predict the outcomes more accurately.

Abstract P6-07-31: Molecular mechanism of alcohol-associated breast cancer

Epidemiological studies have indicated that alcohol consumption is an established risk factor for breast cancer. The association of alcohol consumption and breast cancer is more pronounced in ER+ cases than in ER- cases. However, this molecular mechanism remains to be determined. Deregulation of RNA polymerase III (Pol III) transcription enhances cellular tRNAs and 5S rRNA production, increasing translational capacity to promote cell transformation and tumor formation. Our results reveal that alcohol increases Pol III gene transcription in both normal and cancer breast cell lines. The induction of Pol III genes by alcohol in ER+ breast cancer cells is significantly higher than in ER- normal breast cells and ER- breast cancer cells. E2 causes slight increase in Pol III gene transcription. The addition of ethanol to this system produces a marked increase. Alcohol increases ERa expression to enhance the cellular levels of Brf1 protein and mRNA. In addition, ethanol markedly stimulates phosphorylation of JNK1. Inhibition of JNK1 decreases ERE-Luc reporter activity and represses expression of ERa, Brf1 and Pol III genes. Reduction of ERa by its siRNA represses Brf1 and Pol III gene transcription. Ethanol with E2 produces larger and more numerous colonies. Repression of ERa or Brf1 inhibits alcohol-induced cell transformation. More interestingly, human biopsies studies show that Brf1 expression is significantly increased in nuclei of breast cancer cells, compared to tissue adjacent to the carcinoma. Together, these results support the idea that alcohol increases ERa expression through JNK1 pathway to elevate Brf1 expression and Pol III gene transcription, leading to greater phenotypic changes. ERa mediates Pol III gene transcription through Brf1, suggesting that ERa play a critical role in alcohol-induced deregulation of Pol III genes in ER+ breast cancer development.

*: The project is supported by NIAAA/NIH grants: AA017288, AA021114 and AA02324 to S Zhong.

Citation Format: Zhong S, Zhang Y, Lei J, Li W, Wu Z, Shi G. Molecular mechanism of alcohol-associated breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-31.

Role of protein kinase C in metabolic regulation of the cardiac Na+ channel

BACKGROUND

The reduced form of nicotinamide adenine dinucleotide (NADH) increases in cardiomyopathy, activates protein kinase C (PKC), up-regulates mitochondrial reactive oxygen species (mitoROS), and down-regulates the cardiac Na⁺ channel (Na_V1.5).

OBJECTIVE

The purpose of this study was to determine how NADH signals down-regulation of Na_V1.5.

METHODS

Isolated mouse cardiomyocytes were used for patch-clamp recording and for monitoring mitoROS with MitoSOX Red. HEK293 cells were used for transient transfections. HEK293 cells stably expressing human Na_V1.5 were used for single channel recording, whole-cell patch-clamp recording, activity measurements of phospholipase C and phospholipase D (PLD), channel protein purification, and co-immunoprecipitation with PKC isoforms. HL-1 cells were used for mitochondria isolation.

RESULTS

NADH enhanced PLD activity (1.6- ± 0.1-fold, P <.01) and activated PKCδ. Activated PKCδ translocated to mitochondria and up-regulated mitoROS (2.8- ± 0.3-fold, P <.01) by enhancing the activities of mitochondrial complexes I, II, and IV (1.1- to 1.5-fold, P <.01). PKCδ also interacted with Na_V1.5 to down-regulate Na⁺ current (I_Na). Reduction in I_Na by activated PKCδ was prevented by antioxidants and by mutating the known PKC phosphorylation site S1503. At the single channel level, the mechanism of current reduction by PKC and recovery by protein kinase A was a change in single channel conductance.

CONCLUSION

NADH activated PKCδ by enhancing PLD activity. PKCδ modulated both mitoROS and Na_V1.5. PKCδ elevated mitoROS by enhancing mitochondrial oxidative phosphorylation complex activities. PKCδ-mediated channel phosphorylation and mitoROS were both required to down-regulate Na_V1.5 and alter single channel conductance.

The common CARD14 gene missense polymorphism rs11652075 (c.C2458T/p.Arg820Trp) is associated with psoriasis: a meta-analysis

Recent genetic evidence suggests a robust association of the CARD14 single nucleotide polymorphism rs11652075 (c.C2458T/p.Arg820Trp) and other rare mutations in this gene with psoriasis. To assess whether combined data support the relationship between CARD14 rs11652075 and susceptibility to this disease, we conducted a meta-analysis. PubMed (MEDLINE), EMBASE, Web of Science, and the Cochrane Library were searched for relevant papers published in English. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effect models. Heterogeneity between studies was assessed using the Cochran's Q and I² statistics. A total of five published studies, including 32,807 psoriasis patients and 45,458 controls, met our inclusion criteria and were included in the meta-analysis. The pooled OR of the association between the minor allele of this polymorphism and psoriasis was 0.877 (95%CI = 0.834-0.922; P < 0.001). In a stratified analysis, pooled ORs relating to European and Asian ancestry were 0.883 (95%CI = 0.822-0.948) and 0.872 (95%CI = 0.812-0.936), respectively. Those calculated for studies with case sample sizes above and below 1000 were 0.912 (95%CI = 0.870- 0.956) and 0.824 (95%CI = 0.734-0.924), respectively. No publication bias was present, and the exclusion of any single dataset did not substantially alter the corresponding pooled ORs. Due to the limited data available regarding clinical classification of cases and genotypes, subgroup stratification by clinical type was not performed. Our results demonstrate a significant association between the CARD14 rs11652075 polymorphism and psoriasis.

Obstructive Sleep Apnea and Circulating Potassium Channel Levels

Background

Cardiac arrhythmias and sudden cardiac death are more frequent in patients with obstructive sleep apnea (OSA). OSA is associated with QT prolongation, and QT prolongation is an independent risk factor for sudden cardiac death. Because QT prolongation can be mediated by potassium channel loss of function, we tested whether OSA or continuous positive airway pressure therapy altered mRNA expression of circulating white blood cell potassium channels.

Methods and Results

In total, 28 patients with OSA newly diagnosed by polysomnogram and 6 participants without OSA were enrolled. Potassium channel levels in white blood cells at baseline and at a 4‐week follow‐up visit were compared. There was a significant inverse correlation between the severity of the OSA stratified by apnea–hypopnea index and mRNA expression of the main potassium channels assessed: KCNQ1 (r=−0.486, P=0.007), KCNH2 (r=−0.437, P=0.016), KCNE1 (r=−0.567, P=0.001), KCNJ2 (r=−0.442, P=0.015), and KCNA5 (r=−0.468, P=0.009). In addition, KCNQ1, KCNH2, and KCNE1 inversely correlated with the oxygen desaturation index 4. After 4 weeks of continuous positive airway pressure therapy, circulating KCNQ1 and KCNJ2 were increased 1.4±0.4‐fold (P=0.040) and 2.1±1.4‐fold (P=0.046) in the moderate OSA group. Compared with patients with mild or moderate OSA, patients with severe OSA had a persistently higher apnea–hypopnea index (mild 2.0±1.8, moderate 1.0±0.9, severe 5.8±5.6; P=0.015), perhaps explaining why the potassium channel changes were not seen in the severe OSA group.

Conclusions

The mRNA expression of most potassium channels inversely correlates with the severity of OSA and hypoxemia. Continuous positive airway pressure therapy improves circulating KCNQ1 and KCNJ2 in patients with moderate OSA.

High preoperative and postoperative levels of carcinoembryonic antigen and CYFRA 21-1 indicate poor prognosis in patients with pathological Stage I nonsmall cell lung cancer

BACKGROUND

Serum carcinoembryonic antigen (CEA) and the soluble fragment of cytokeratin 19 (CYFRA 21-1) are supposed to have a prognostic role in patients with nonsmall cell lung cancer (NSCLC) after surgery, but it has not been used as an adjunct to the tumor-node-metastasis (TNM) staging system to provide therapy options for patients with pathological Stage I NSCLC. This study was designed to investigate the effect of serum levels of CEA and CYFRA 21-1 before and after surgery on the prognosis of patients with Stage I NSCLC.

MATERIALS AND METHODS

A retrospective review was performed regarding the medical records and follow-ups of 169 patients with Stage I NSCLC before and after surgery. The patients were divided into three groups based on levels of serum CEA and CYFRA 21-1 before and after surgery: (1) continuously normal-level groups (CEA [NN] and CYFRA 21-1 [NN] groups); (2) declined to normal-level groups (CEA [HN] and CYFRA 21-1 [HN] groups); and (3) continuously high-level groups (CEA [HH] and CYFRA 21-1 [HH] groups). Survival analysis was conducted using the Kaplan-Meier method for each group. The Chi-square or Fisher exact test was employed to compare clinical and pathologic factors at the level of P < 0.05. The prognostic factor was evaluated by the Cox proportional hazards model.

RESULTS

Compared with the continuously normal-level groups, the CEA [HN] group was significantly correlated to tumor size (P = 0.011), and the CYFRA 21-1 [HN] group was significantly correlated to tumor type and pathological TNM in addition to tumor size. Five-year survivals were significantly lower (P = 0.004) in the CEA [HH] group (67.3%) and the CEA [HN] group (86.5%) than in the CEA [NN] group (85.7%) and were significantly lower (P < 0.001) in the CYFRA 21-1 [HH] group (47.2%) and the CYFRA 21-1 [HN] group (70.1%) than in the CYFRA 21-1 [NN] group (90.1%). Multivariate analysis demonstrated that tumor size (21-50 mm), CEA [HH], and CYFRA 21-1 [HH] were independent unfavorable prognostic factors for overall survival (OS), whereas tumor size (21-50 mm), CEA [HH], CYFRA 21-1 [HN], and CYFRA 21-1 [HH] were independent significant prognostic factors for progression-free survival (PFS).

CONCLUSION

Patients with a persistently high serum CEA or CYFRA 21-1 before and after surgery had shortest OS and PFS. These patients had worst prognosis. Adjuvant chemotherapy was likely to improve survival for these patients.

Abstract 285: Endoplasmic Reticulum Stress Induces Mitochondrial ROS Overproduction and Contributes to Electrical Remodeling in Heart Failure

Introduction: Heart failure (HF) is associated with endoplasmic reticulum (ER) stress and activation of the unfolded protein response (UPR), which has three branches (PERK, IRE1 and ATF6α). UPR inhibits protein translation, and we hypothesized UPR contributes to electrical remodeling in HF.

Methods: HF was induced in C57BL/6 mice 6-7 weeks after unilateral nephrectomy, deoxycorticosterone acetate pellet implantation, and salt water substitution. Sham operated mice were used as controls. Isolated ventricular myocytes were utilized for whole-cell patch clamp recording and ROS measurement by DCFDA with confocal imaging. Heart tissue was used for mRNA and protein measurements. GSK2606414, a specific inhibitor of PERK, was applied to myocytes at 4-30 nM for 6-20 h.

Results: The action potential duration was prolonged in HF myocytes (204±26 vs. 100±16 ms of sham, P<0.05). The mRNA and protein levels of the UPR effectors indicated that the PERK and IRE1 branches were activated in HF heart tissue. The peak I Na , I to , I K1 , and I Kslow were decreased significantly in HF group, while I CaL and other K + currents were not affected. A PERK inhibitor, GSK2606414, restored I Na and I K,slow . Current changes were similar to those observed in myocytes under tunicamycin-induced ER stress. Significant reduction of channel protein levels were observed for K v 4.3, Kir2.1, K v 1.5, and Ca v 1.2, but not Na v 1.5, suggesting that I Na reduction was mediated by PERK but not by translational downregulation. Significant ROS production was observed in mouse cardiomyocytes under ER stress, which was suppressed by GSK2606414. Confocal imaging of ROS indicates the source to be mitochondria.

Conclusions: TM-treated cardiomyocyte changes indicated that reductions of I Na , I to , I K1 and I K,slow were mediated by ER stress. Proportionally decreased protein and current levels of K v 4.3, Kir2.1, and K v 1.5 suggested direct effects of ER stress. The downregulation of Na v 1.5 and K v 1.5 could be prevented by PERK inhibition. Nevertheless, the effect of PERK inhibition on I Na was indirect and mediated by a PERK-dependent elevation in mitochondrial ROS. In conclusion, the UPR contributes to electrical remodeling in HF by direct and indirect means. Targeting the UPR may be a novel antiarrhythmic strategy.

Changes in T-lymphocytes in lung cancer patients after hyperthermic intraperitoneal chemotherapy or radiotherapy

We investigated dynamic changes in T-lymphocyte subsets after hyperthermic intraperitoneal chemotherapy (HIPEC) or radiotherapy using flow cytometry. A total of 1423 lung cancer patients admitted to our hospital between October 2012 and July 2015 were enrolled, and age-matched healthy individuals served as controls. Peripheral blood mononuclear cells (PBMCs) were purified using standard Ficoll density gradient centrifugation, based on which CD3+, CD4+, and CD8+ T-cells were isolated. A surface marker was identified by flow cytometry. Immunohistochemical analysis determined the distribution of the cells in the tumor mass or adjacent tissues. A total of 957 patients (male: 555; female: 402; median age: 49.3 years) with lung cancer who had received only HIPEC or radiotherapy were enrolled. The patients were followed-up until death. No statistical difference was noticed between the patients who had received chemotherapy compared with the baseline levels. A remarkable elevation was noticed in the CD3+ T-cells in the patients three months after radiotherapy (78.71 ± 9.36 vs 68.15 ± 9.65, P < 0.05). The level of CD8+ in the patients who had received chemotherapy or radiotherapy was remarkably elevated in the post-treatment period (P < 0.05). The CD3+ and CD8+ T-cells were mainly expressed in the cytoplasm rather than in the adjacent tissues. The expression of CD3+ and CD4+ was correlated to tumor infiltration and metastasis. Remarkable elevation was noticed in the CD3+ T-cells in the patients three months after radiotherapy. The expression of CD3+ and CD4+ was negatively correlated to tumor infiltration and metastasis in non-small-cell lung cancer patients.

Glutamate Receptor Interacting Protein 1 Regulates CD4(+) CTLA-4 Expression and Transplant Rejection

PDZ domains are common 80- to 90-amino-acid regions named after the first three proteins discovered to share these domains: postsynaptic density 95, discs large, and zonula occludens. PDZ domain-containing proteins typically interact with the C-terminus of membrane receptors. Glutamate receptor interacting protein 1 (GRIP1), a seven-PDZ domain protein scaffold, regulates glutamate receptor surface expression and trafficking in neurons. We have found that human and mouse T cells also express GRIP1. T cell-specific GRIP1(-/-) mice >11 weeks old had prolonged cardiac allograft survival. Compared with wild-type T cells, in vitro stimulated GRIP1(-/-) T cells had decreased expression of activation markers and increased apoptotic surface marker expression. Surface expression of the strong T cell inhibitory molecule cytotoxic T lymphocyte antigen-4 (CTLA-4) was increased on GRIP1(-/-) T cells from mice >11 weeks old. CTLA-4 increases with T cell stimulation and its surface expression on GRIP1(-/-) T cells remained high after stimulation was removed, indicating a possible internalization defect in GRIP1-deficient T cells. CTLA-4-blocking antibody treatment following heart transplantation led to complete rejection in T cell GRIP1(-/-) mice, indicating that increased CTLA-4 surface expression contributed to the extended graft survival. Our data indicate that GRIP1 regulates T cell activation by regulating CTLA-4 surface expression.

Laparoscopic subtotal hysterectomy due to giant uterine fibroids: a case report

The laparoscopic subtotal hysterectomy (LSH) was given to a patient whose uterus was about seven-month pregnanacy because of fibroids. The biggest problem was the operation space and visual field was too narrow. Different from the usual procedure we do, we morcellated the uterus at the beginning to expand the space. Loop ligature of the uterine isthmus was adopted to block uterine ateries before morcellating the uterus. After the adnexa exposed totally, we started to cut off the round ligaments, proper ligaments and fallopian tubes like usual. It was the first time we did LSH for so giant uterus in our hospital, although which was usually suitable for the uterus smaller than four-month pregnancy. But if the uterine ateries can be blocked effectively at the beginning, the uterus can be morcellated and the space will be enlarged. The laparoscopic subtotal hysterectomy will also be completed successfully.

Expression of G protein αq Subunit is Decreased in Lymphocytes from Patients with Rheumatoid Arthritis and is Correlated with Disease Activity

Gαq, the alpha subunit of Gq, a member of the Gq/11 sub-family, was reported to inhibit phosphatidylinositol-3-Kinase (PI3K) activation and prevent the activation of Akt. Previous studies demonstrated that mice losing Gαq in their immune system could spontaneously develop inflammatory arthritis. In this study, we showed that the Gαq expressions at mRNA and protein levels in the peripheral blood lymphocytes (PBLs) from patients with rheumatoid arthritis (RA) were significantly decreased in comparison of which in healthy individuals. The expression levels of Gαq mRNA in PBLs from patients with RA were correlated with RA disease activity (DAS28), anti-cyclic citrullinated protein antibodies, C-reactive protein and rheumatoid factor. We also demonstrated that Gαq controlled the apoptosis of RA PBLs through regulating the activity of Mcl-1 and caspase-3. These data suggested that Gαq might be involved in the pathogenesis of RA by regulating PBLs apoptosis.

The role of autoreactive T cell in the pathogenesis of rheumatoid arthritis and implications for T cell targeted vaccine therapy

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterised by chronic inflammation of joint synovial tissue and subsequent destruction of associated bone, cartilage and soft tissues. RA is commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs), traditional disease-modifying antirheumatic drugs (DMARDs), glucocorticoids and biologic inhibitors of TNF, IL-1, IL-6, T cells and B cells. The use of these drugs especially biological agents has greatly improved the treatment of RA. Although the pathogenesis of RA remains unclear, T-cell mediated immune response is considered as a critical contributor in RA initiation and progression. It has been hypothesized that arthritogenic T cells (autoreactive T cells) escaping negative selection can recognize arthritogenic antigens and lead to autoimmunity and tissue destruction. Due to the important role of autoreactive T cells in the mechanisms of RA, they might be a novel therapeutic target. Many vaccines targeting autoreactive T cells which can establish immunological self tolerance have been developed. The efficacy of these vaccines has been justified in experimental models of RA and clinical trials. Inhibition of autoreactive T cell response by vaccination might provide a new treatment opinion in RA.

High cytoplasmic expression of SALL4 predicts a malignant phenotype and poor prognosis of breast invasive ductal carcinoma

Sal-like 4(SALL4) is significant for maintaining self-renewal and pluripotency in embryonic stem cells, cancer cells and perhaps even cancer stem cells. The expression of SALL4 has been recorded in various kinds of cancers and is deemed to have a clinical value for diagnosis. However, little information on SALL4 expression has been illustrated in breast cancer. In this study, the expression of SALL4 was scrutinized by immunohistochemical analysis in breast invasive ductal carcinoma in a large cohort of 160 patients. High cytoplasmic expression of SALL4 was detected in breast cancer tissues compared with normal adjacent tissues. High SALL4 expression was associated with advanced tumor invasion (p = 0.019), lymph node stage (p = 0.027), ER (p = 0.030), PR (p = 0.037), HER2 (p = 0.019) and TNBC (p = 0.007) in overall patients. Interestingly, in Kaplan-Meier analysis, breast cancer patients with high expression of SALL4 demonstrated a worse OS. Both univariate and multivariate analysis illustrated that examination of SALL4 was of great prognostic value in OS. Thus, our data showed that high cytoplasmic expression of SALL4 was considered to be an independent prognostic indicator for breast invasive ductal carcinoma.