[Correlation analysis of anterior pituitary hormone and tumor size in patients with pituitary adenomas]

Objective: To summarize the correlation between anterior pituitary function and tumor size in patients with different hormone-secreting pituitary adenomas. Methods: This was a retrospective case series study. The clinical data of 1 946 patients with pituitary adenoma hospitalized in the First Medical Center of Chinese PLA General Hospital from January 1, 2005, to December 31, 2020, were collected. The correlation between tumor size and anterior pituitary hormone levels was analyzed using Spearman rank correlation analysis in different types of pituitary adenomas. Results: The median age of the 1 946 patients was 45.1 years, of which 857 (44.0%) were men. The maximum tumor diameter of the patients [M (Q₁, Q₃)] was 22 (14, 30) mm. Tumor size in nonfunctioning adenomas (n=1 191) was negatively correlated with adrenocorticotropic hormone (ACTH) (r=-0.11, P<0.001), growth hormone (r=-0.13, P<0.001), and luteinizing hormone (men: r=-0.26, P<0.001, women: r=-0.31, all P<0.001). The tumor size of somatotropic adenomas (n=297) was positively correlated with growth hormone (r=0.46, P<0.001), but negatively correlated with male testosterone (r=-0.41, P<0.001). The tumor size of ACTH-secreting pituitary adenomas (n=155) was positively correlated with the ACTH level at 8∶00 AM (r=0.25, P<0.001); however, no correlation was found with cortisol at 8∶00 AM (P>0.05). The tumor size of prolactinomas (n=303) was positively correlated with the prolactin level (men: r=0.34, P=0.001; women: r=0.13, P=0.070). Conclusions: The correlation between the function of the anterior pituitary and size of the tumor depends on the cellular origin of the pituitary adenoma and specific type of hormone secretion. In somatotroph adenomas, ACTH-secreting pituitary adenomas, and prolactinomas, there is a positive correlation between tumor size and level of hormones secreted by the corresponding tumors. In patients with nonfunctioning adenomas, the tumor size was negatively correlated with the hormone levels of the pituitary-adrenal and pituitary-growth hormone axes.

[Long-term outcome of EVAHEART I implantable ventricular assist device for the treatment of end stage heart failure: clinical 3-year follow-up results of 15 cases]

Objective: To evaluate the long-term efficacy and safety of the implantable ventricular assist system EVAHEART I in clinical use. Methods: Fifteen consecutive patients with end-stage heart failure who received left ventricular assist device therapy in Fuwai Hospital from January 2018 to December 2021 were enrolled in this study, their clinical data were retrospectively analyzed. Cardiac function, liver and kidney function, New York Heart Association (NYHA) classification, 6-minute walk distance and quality of life were evaluated before implantation and at 1, 6, 12, 24 and 36 months after device implantation. Drive cable infection, hemolysis, cerebrovascular events, mechanical failure, abnormally high-power consumption and abnormal pump flow were recorded during follow up. Results: All 15 patients were male, mean average age was (43.0±7.5) years, including 11 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 2 cases of valvular heart disease. All patients were hemodynamically stable on more than one intravenous vasoactive drugs, and 3 patients were supported by preoperative intra aortic balloon pump (IABP). Compared with before device implantation, left ventricular end-diastolic dimension (LVEDD) was significantly decreased ((80.93±6.69) mm vs. (63.73±6.31) mm, P<0.05), brain natriuretic peptide (BNP), total bilirubin and creatinine were also significantly decreased ((3 544.85±1 723.77) ng/L vs. (770.80±406.39) ng/L; (21.28±10.51) μmol/L vs. (17.39±7.68) μmol/L; (95.82±34.88) μmol/L vs. (77.32±43.81) μmol/L; P<0.05) at 1 week after device implantation. All patients in this group were in NYHA class Ⅳ before implantation, and 9 patients could recover to NYHA class Ⅲ, 3 to class Ⅱ, and 3 to class Ⅰ at 1 month after operation. All patients recovered to class Ⅰ-Ⅱ at 6 months after operation. The 6-minute walk distance, total quality of life and visual analogue scale were significantly increased and improved at 1 month after implantation compared with those before operation (P<0.05). All patients were implanted with EVAHEART I at speeds between 1 700-1 950 rpm, flow rates between 3.2-4.5 L/min, power consumption of 3-9 W. The 1-year, 2-year, and 3-year survival rates were 100%, 87%, and 80%, respectively. Three patients died of multiple organ failure at 412, 610, and 872 d after surgery, respectively. During long-term device carrying, 3 patients developed drive cable infection on 170, 220, and 475 d after surgery, respectively, and were cured by dressing change. One patient underwent heart transplantation at 155 d after surgery due to bacteremia. Three patients developed transient ischemic attack and 1 patient developed hemorrhagic stroke events, all cured without sequelae. Conclusion: EVAHEART I implantable left heart assist system can effectively treat critically ill patients with end-stage heart failure, can be carried for long-term life and significantly improve the survival rate, with clear clinical efficacy.

Chiral zinc oxide functionalized quartz crystal microbalance sensor for enantioselective recognition of amino acids

Chiral transition metal oxides with tunable structures and multiple physicochemical features have been increasingly applied for chiral sensing and detection. In this work, chiral zinc oxide (ZnO) was first applied as selector to construct quartz crystal microbalance (QCM) sensor for enantioselective recognition of amino acids. The chiral ZnO was prepared by a methionine-induced self-assembly strategy and its high topological chirality was confirmed by several techniques such as circular dichroism spectrum. The chiral discrimination factors were calculated by frequency shifts in response to aspartic acid, phenylalanine, lysine and arginine on L-ZnO surface, achieving 1.89 ± 0.04, 1.76 ± 0.11, 1.66 ± 0.07 and 1.54 ± 0.09, respectively. Notably, L-enantiomers preferred stronger absorptions on L-ZnO surface as compared to D-forms. It was further found that this sensor was appropriate for quantitative analysis and enantiomer excess analysis and adsorption kinetics study. Furthermore, molecular docking revealed the recognition mechanism, where chiral distinction was caused by the different steric interactions between enantiomers and chiral ZnO. This method enjoyed merits of high enantioselectivity, simple preparation and low cost, offering newly chiral sensing method for other molecules.

NLRP3 Disturbs Treg/Th17 Cell Balance to Aggravate Apical Periodontitis

Apical periodontitis is an inflammatory condition that is considered an immunological reaction of the periapical tissue to invading bacteria and their pathogenic components. Recent research has revealed that NLR family pyrin domain containing 3 (NLRP3) is crucial to the pathogenesis of apical periodontitis and serves as a link between innate and adaptive immunity. The balance between regulatory T-cell (Treg) and T helper cell 17 (Th17 cell) determines the direction of the inflammatory response. Therefore, this study aimed to investigate whether NLRP3 exacerbated periapical inflammation by disturbing Treg/Th17 balance and the underlying regulatory mechanisms. In the present study, NLRP3 was raised in apical periodontitis tissues as opposed to healthy pulp tissues. Low NLRP3 expression in dendritic cells (DCs) increased transforming growth factor β secretion while decreasing interleukin (IL)-1β and IL-6 production. The Treg ratio and IL-10 secretion rose when CD4⁺ T cells were cocultured with DCs primed with IL-1β neutralizing antibody (anti-IL-1β) and specific small interfering RNA (siRNA) targeting NLRP3 (siRNA NLRP3), but the proportion of Th17 cells and IL-17 release dropped. Furthermore, siRNA NLRP3-mediated suppression of NLRP3 expression aided Treg differentiation and elevated Foxp3 expression as well as IL-10 production in CD4⁺ T cells. Inhibition of NLRP3 activity by MCC950 boosted the percentage of Tregs while decreasing the ratio of Th17 cells, leading to reduced periapical inflammation and bone resorption. Nigericin administration, however, exacerbated periapical inflammation and bone destruction with an unbalanced Treg/Th17 response. These findings demonstrate that NLRP3 is a pivotal regulator by regulating the release of inflammatory cytokines from DCs or directly suppressing Foxp3 expression to disturb Treg/Th17 balance, thus exacerbating apical periodontitis.

Effect of clay supplementation on growth performance of broiler chickens: a systematic review and meta-analysis

1. This review assessed the effect of dietary clay supplementation as a drug and toxin adsorbent on broiler growth performance as a meta-analysis.2. A total of 33 eligible studies were included in the present study after identification and evaluation from online databases. Standardised mean differences (SMD) with corresponding 95% confidence intervals were computed with a fixed-effects model.3. The results indicated that clay supplementation significantly improved broiler daily gain (P < 0.001) and feed conversion ratio (P < 0.001), but did not affect feed intake (P = 0.954). Results of subgroup analysis showed that zeolite clay had the most stable medium improvement effect on FCR, while kaolin had a large effect. In addition, male broilers and Cobb or Ross broilers were more sensitive to the addition of clay, and the best supplemental levels, in general, were 10 g/kg to 30 g/kg.4. Meta-regression analysis showed that clay supplemental level and sex of broilers may be important factors in the effect of clay on ADG and FCR of broilers, respectively. The sensitivity analysis showed high stability of the results and no significant publication bias was found with funnel plot analysis and Egger's or Begg's test (P > 0.05).5. In conclusion, an appropriate addition level is a prerequisite for effective clay application. Kaolin and zeolite clays seem to be more suitable for enhancing broiler growth performance, and the value of clay is amplified in specific broiler breeds.

Pickering emulsion-enhanced Vibrio fischeri assay for ecotoxicity assessment of highly hydrophobic polycyclic aromatic hydrocarbons

Accurate ecotoxicity assessment of contaminated soil is critical to public health, and the luminescent bacteria (Vibrio fischeri) method is the most commonly used. Hydrophobic compounds such as polycyclic aromatic hydrocarbons (PAHs) in soil cannot be in contact with luminescent bacteria due to their low water solubility so that the luminescence inhibitory effect cannot be observed. The underestimated biological toxicity makes the test unreliable and en-dangers public health and safety. The commonly adopted improved method of adding cosolvents has limited effect, it was only effective for low-hydrophobicity chemicals and could not be used for ecotoxicity evaluation of high-hydrophobicity chemicals. Therefore, we constructed Pickering emulsions using luminescent bacteria modified with n-dodecanol in which PAHs were dissolved in the oil phase, n-tetradecane. Then the luminescent bacteria could tightly adhere to the oil-water interface and contact PAHs. As a result, their bioluminescence was suppressed to varying degrees depending on the chemical species and concentrations. With no solubility limitation, highly hydrophobic PAHs could even completely inhibit bacterial bioluminescence, hence the toxicity information was accurately displayed and the median effect concentration (EC₅₀) values could be calculated. This Pickering emulsion-based method was successfully applied for the accurate ecotoxicity evaluation of highly hydrophobic PAHs and soil samples contaminated with them, which all previous methods could not achieve. This method overcomes the problem of ecotoxicity evaluation of hydrophobic compounds, and has great potential for practical application, whether it is pure chemicals or various real samples from the ecological environment.

Anticeramide Improves Sjögren's Syndrome by Blocking BMP6-Induced Th1

T-cell dysfunction has been shown to play an important role in the pathogenesis of Sjögren's syndrome (SS). In recent studies, the increased expression of BMP6 has been reported to be related to SS. However, the roles that BMP6 plays in immune homeostasis in the development of SS as well as the downstream signals activated by BMP6 remain unclear. In this study, we investigated the effects and molecular mechanisms of BMP6 on naive CD4⁺ T cells, showing that BMP6 could upregulate interferon (IFN)-γ secretion from CD4⁺ T cells through a ceramide/nuclear factor-κB pathway, with no effect on T-cell activation or proliferation. Moreover, an in vivo study showed that anticeramide treatment (myriocin) for an SS animal model (NOD/LtJ mice) could significantly decrease the IFN-γ expression and Th1 frequency in the salivary glands and suppress the inflammation infiltration in salivary glands and maintain the salivary flow rates, both of which reflect SS-like symptoms. This study identifies a promising target that could effectively attenuate the abnormal state of CD4⁺ T cells and reverse the progression of SS.

Plant-Based Diet and Risk of Frailty in Older Chinese Adults

OBJECTIVES

This study examined the relationship between the consumption of plant-based diet and frailty in older Chinese adults.

DESIGN

Prospective cohort study.

SETTING

Community-based setting in 22 provinces of China.

PARTICIPANTS

The final sample included data from 3990 older adults from 2011-2014 from the Chinese Longitudinal Healthy Longevity Survey.

MEASUREMENTS

A plant-based diet index (PDI) was calculated based on a qualitative food frequency questionnaire. Frailty was defined using modified Fried criteria. A Generalized Estimating Equation was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for frailty. We further performed subgroup analyses stratified by sex and lifestyle factors.

RESULTS

557 cases of frailty were observed. After adjustment for covariates, the RR for frailty of a high PDI was 0.792 (95% CI: 0.644-0.973), relative to a low PDI. During follow-up, compared with respondents with a continually low PDI, the respondents with a continually high PDI had a significantly reduced risk of frailty (RR = 0.683, 95% CI: 0.514-0.908). In further subgroup analysis, a consistently high PDI over time resulted in a significantly reduced risk of frailty for male (RR = 0.591, 95% CI: 0.391-0.893); for never smokers (RR = 0.670, 95% CI: 0.458-0.979); for people who did never consume alcohol (RR = 0.654, 95% CI: 0.454-0.941); and for people with current or former exercise habits (RR = 0.488, 95% CI: 0.313-0.762).

CONCLUSION

Plant-based diet was associated with low risk of frailty in men and in older adults with healthy lifestyle. These findings stress that plant-based diet should be recommended as a dietary strategy to prevent and reduce frailty in older adults; in addition, more dietary interventions along with lifestyle modification should be adopted to promote successful ageing, especially for women.

[Study on nomograph predicting the risk of type 2 diabetes mellitus in Beijing community adults]

Objective: Development and validation of a nomogram for predicting the 4-year incidence of type-2 diabetes mellitus (T2DM) in a Chinese population was attempted. Methods: This prospective cohort study was conducted in Shijingshan District Pingguoyuan Community (Beijing, China) from December 2011 to April 2012 among adults aged≥40 years not suffering from T2DM. Finally, 8 058 adults free of T2DM were included with a median duration of follow-up of 4 years. Participants were divided into a modeling group and verification group using simple random sampling at a ratio of 7∶3. Univariate and multivariate Cox proportional risk models were applied to identify the independent risk predictors in the modeling group. A nomogram was constructed to predict the 4-year incidence of T2DM based on the results of multivariate analysis. The Concordance Index and calibration plots were used to evaluate the differentiation and calibration of the nomogram in both groups. Results: A total of 5 641 individuals were in the modeling group and 2 417 people were in the validation group, of which 265 and 106 had T2DM, respectively, at 4-year follow-up. In the modeling group, age (HR=1.349, 95%CI 1.011-1.800), body mass index (HR=1.347, 95%CI 1.038-1.746), hyperlipidemia (HR=1.504, 95%CI 1.133-1.996), fasting blood glucose (HR=4.189, 95%CI 3.010-5.830), 2-h blood glucose level according to the oral glucose tolerance test (HR=3.005, 95%CI 2.129-4.241), level of glycosylated hemoglobin (HR=3.162, 95%CI 2.283-4.380), and level of γ-glutamyl transferase (HR=1.920, 95%CI 1.385-2.661) were independent risk factors for T2DM. Validation of the nomogram revealed the Concordance Index of the modeling group and validation group to be 0.906 (95%CI 0.888-0.925) and 0.844 (95%CI 0.796-0.892), respectively. Calibration plots showed good calibration in both groups. Conclusion: These data suggest that our nomogram could be a simple and reliable tool for predicting the 4-year risk of developing T2DM in a high-risk Chinese population.

[A meta-analysis of risk factors for multidrug-resistant tuberculosis in China]

Objective: To explore the main risk factors of multidrug-resistant tuberculosis (MDR-TB) in China and to provide evidence-based evidence for MDR-TB preventon and control. Methods: All relevant literatures were searched in thedatabases, such as Pubmed, Web of Science and CNKI, Wanfang, VIP and SinoMed from 2000 to 2021. Quality evaluation and data extraction were carried out, and then a meta-analysis was performed using Stata 16.0 software. Results: A total of 59 literatures (36 cross-sectional and 23 case-control) including 75 793 participants were included in this study, and meta-analysis results showed age (OR=1.27, 95%CI: 1.05-1.54), education level (OR=1.29, 95%CI: 1.02-1.65), positive sputum smear (OR=2.56, 95%CI: 1.09-6.04), pulmonary cavity (OR=1.99, 95%CI: 1.57-2.52), course of disease (OR=4.25, 95%CI: 1.95-9.30), history of tuberculosis treatment (OR=6.42,95%CI:5.40-7.63), treatment interruption (OR=2.81, 95%CI: 1.50-5.29), irregular medication (OR=5.02, 95%CI: 2.95-8.54), adverse drug reactions (OR=4.27, 95%CI: 2.22-8.19), combined chronic obstructive pulmonary disease (COPD) (OR=2.21, 95%CI: 1.45-3.37), tuberculosis exposure history (OR=1.99, 95%CI: 1.36-2.91), smoking history (OR=1.35, 95%CI: 1.09-1.66) and floating population (OR=1.60, 95%CI: 1.04-2.44) were associated with the occurrence of MDR-TB. Conclusions: The high risk groups were farmer, low education level, pulmonary cavity, long course of disease, history of tuberculosis treatment, treatment interruption, irregular medication, adverse drug reaction, co-COPD, contact history of tuberculosis, smoking history, rural residence, and floating population. We should pay attention to high-risk groups, strengthen management and take effective measures such as early screening, knowledge education on tuberculosis, standardized and personalized treatment and whole-course supervision.

Allele-specific expression and chromatin accessibility contribute to heterosis in tea plants (Camellia sinensis)

Heterosis is extensively used to improve crop productivity, yet its allelic and chromatin regulation remains unclear. Based on our resolved genomes of the maternal TGY and paternal HD, we analyzed the contribution of allele-specific expression (ASE) and chromatin accessibility of JGY and HGY, the artificial hybrids of oolong tea with the largest cultivated area in China. The ASE genes (ASEGs) of tea hybrids with maternal-biased were mainly related to the energy and terpenoid metabolism pathways, whereas the ASEGs with paternal-biased tend to be enriched in glutathione metabolism, and these parental bias of hybrids may coordinate and lead to the acquisition of heterosis in more biological pathways. ATAC-seq results showed that hybrids have significantly higher accessible chromatin regions (ACRs) compared with their parents, which may confer broader and stronger transcriptional activity of genes in hybrids. The number of ACRs with significantly increased accessibility in hybrids was much greater than decreased, and the associated alleles were also affected by differential ACRs across different parents, suggesting enhanced positive chromatin regulation and potential genetic effects in hybrids. Core ASEGs of terpene and purine alkaloid metabolism pathways with significant positive heterosis have greater chromatin accessibility in hybrids, and were potentially regulated by several members of the MYB, DOF and TRB families. The binding motif of CsMYB85 in the promoter ACR of the rate-limiting enzyme CsDXS was verified by DAP-seq. These results suggest that higher numbers and more accessible ACRs in hybrids contribute to the regulation of ASEGs, thereby affecting the formation of heterotic metabolites.

[Study of transmissibility of 2019-nCoV Omicron variant in Beijing]

Objective: To evaluate the transmissibility of 2019-nCoV Omicron variant under the current prevention and control strategy in Beijing, and provide evidence for the prevention and control of COVID-19. Methods: The information of 78 Omicron variant infection cases involved in clear transmission chains in Beijing during 7-25 March, 2022 were collected, the incubation period and serial interval of the disease were fitted by using Gamma and Weibull distribution. Markov Chain Monte Carlo approach was used to estimate the time-varying reproduction number (R_t). Results: The median of the incubation period (Q₁, Q₃) of Omicron variant infection was 4.0 (3.0, 6.0) days, and the serial interval was 3.0 (2.0, 5.0) days. The median of the serial interval (Q₁, Q₃) was 2.0 (1.0, 4.0) days in unvaccinated cases and 4.0 (2.0, 6.0) days in vaccinated cases (Z=-2.12, P=0.034), and 2.0 (1.5, 3.0) days in children and 4.0 (2.0, 6.0) days in adults, respectively (Z=-2.02,P=0.044), the differences were significant. The mean of R_t was estimated to be 4.98 (95%CI: 2.22-9.04) for Omicron variant in this epidemic. Conclusion: Omicron variant has stronger transmissibility compared with Delta variant. It is necessary to strengthen the routine prevention and control COVID-19, promote the vaccination and pay close attention to susceptible population, such as children.

[Application of immunohistochemical staining of PRAME in differential diagnosis between melanoma and melanocytic nevus]

Objective: To investigate the diagnostic value of preferentially expressed antigen in melanoma (PRAME) in differential diagnosis of benign and malignant cutaneous melanocytic lesions. Methods: Fifty-nine cases of melanoma (50 cases of skin primary melanoma, and 9 cases of metastatic melanoma) and 48 cases of melanocytic nevus (40 cases of common nevus and 8 cases of dysplastic nevus) were subject to PRAME immunohistochemistry staining.The difference of PRAME expression between melanoma and melanocytic nevus was analyzed. Results: Among the 50 patients with primary cutaneous melanoma, there were 23 males and 27 females ranging in age from 33 to 87 years (average age 62.4 years, median age 64.5 years). Among the 9 metastatic melanoma there were 7 males and 2 females ranging in age from 40 to 82 years (average age 64 years, median age 65 years). Twenty-six cases (26/50, 52.0%) of cutaneous primary melanoma and 4 cases (4/9) of metastatic melanoma showed diffuse positive PRAME staining. 40 cases (40/40, 100%) of common nevus and 8 (8/8) cases of dysplastic nevus were PRAME negative. Compared with melanocytic nevus group, the melanoma group included more cases with diffuse positive PRAME staining (P<0.05). The sensitivity and specificity of using PRAME to differentiate primary cutaneous melanoma from melanocytic nevus in the cohort is 52.0% and 100%. Conclusions: There is a significant difference in the expression of PRAME between melanoma and melanocytic nevus.Thus, PRAME can be used as an auxiliary diagnostic tool for differentiating benign from malignant cutaneous lesions.

[The progress on post-exposure prophylaxis of tetanus immunological preparation in adults]

The tetanus has been eliminated in the pregnancy women and newborns in China. However, there is a gap for adult tetanus immunization, and the risk of tetanus infection cannot be ignored. In order to clearly understand the effect of the tetanus to human beings and the current use of tetanus immunological preparation for adult post-exposure prophylaxis, the incidence of the tetanus, the use status of tetanus immunological preparation and recommendations for post-exposure prophylaxis at home and abroad were reviewed and summarized, which may provide academic evidence for post-exposure prophylaxis procedures and use of tetanus immunological preparation.

P-524 Bi-allelic CFAP61 variants cause male infertility in humans and mice with severe oligoasthenoteratozoospermia

Study question

Are mutations in cilia and flagella-associated protein 61 (CFAP61) associated with human male infertility?

Summary answer

Bi-allelic variants ([NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in CFAP61 were identified as contributory genetics factor in severe oligoasthenoteratozoospermia (OAT).

What is known already

Cfap61 knockout mice were infertile due to multiple morphological abnormalities of the sperm flagella (MMAF). However, so far there is no direct evidence that mutations of CFAP61 cause OAT and male infertility.

Study design, size, duration

Variant screening was performed by whole-exome sequencing (WES) from 325 infertile patients with OAT and 392 fertile individuals. A knockout mouse model was generate to confirm the candidate disease-causing gene, intracytoplasmic sperm injection (ICSI) was used to evaluate the efficiency of clinical treatment.

Participants/materials, setting, methods

A total 325 OAT-affected patients and 392 men with normal fertility were recruited from China. WES was performed, followed by Sanger sequencing validation. In silico bioinformatics predictions and in vitro functional analyses were performed to evaluate the impacts of candidate disease-causing variants. Hematoxylin and eosin (H&E) staining, electron microscopy, and immunofluorescence assays were performed to evaluate the sperm morphology. Two OAT-affected men with CFAP61 variants were treated by ICSI, and pregnancy outcomes were followed.

Main results and the role of chance

We identified bi-allelic CFAP61 variants [NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in two (0.62%) of the 325 OAT-affected men. In silico bioinformatics analysis predicted that all four variants were deleterious, and in vitro functional analysis confirmed the deleterious effects of the mutants. Notably, H&E staining and electron microscopy analyses of the spermatozoa revealed multiple morphological abnormalities of sperm flagella, the absence of central pair microtubules, and mitochondrial sheath malformation in sperm flagella from man with CFAP61 variants. Further immunofluorescence assays revealed markedly reduced CFAP61 staining in the sperm flagella. In addition, Cfap61-deficient mice showed the OAT phenotype, suggesting that loss of function of CFAP61 was the cause of OAT. Two individuals accepted ICSI therapy using their own ejaculated sperm, and one of them succeeded in fathering a healthy baby.

Limitations, reasons for caution

Limitations include the lack of in vivo data from the one of patients, and the exact molecular mechanism should be further investigated.

Wider implications of the findings

Our findings indicate that CFAP61 is essential for spermatogenesis and that bi-allelic CFAP61 variants lead to OAT and male infertility in humans and mice. In addition, our results show that ICSI treatment can be recommended for CFAP61-related OAT.

Trial registration number

not applicable

[Study of the effect of liraglutide on the correlation between NLRP3 inflammasome and non-alcoholic fatty liver disease]

Objective: To observe the effect of liraglutide on the correlation between nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) infl ammasome and nonalcoholic fatty liver disease (NAFLD). Methods: Thirty-nine NAFLD cases (group N) and thirty-nine healthy subjects (group C) were selected from the physical examination center, and their general data were collected to determine the serum levels of NLRP3, IL-1β, and IL-18. The differences and correlations were analyzed between the two sets of indicators. Thirty male SD rats were randomly divided into normal (NC, n=10) and high-fat diet group (HF, n=20). The normal group were fed with normal diet and high-fat diet group were fed with high-fat diet. After 12 weeks of feeding, HF group was randomly divided into HF group (n=10) and liraglutide group (100L, n=10), and were given 0.5 ml/kg sterile isotonic saline and 100 g/kg liraglutide subcutaneously twice a day, respectively. Four weeks later, serum biochemical indicators, liver NLRP3 infl ammasome protein expression, and infl ammatory cytokine conditions were detected in each group. Statistical analysis was performed using t test, oneway analysis of variance (ANOVA) or χ² test. Results: There were no statistically signifi cant differences between N and C group in terms of age, gender, diastolic blood pressure, glycosylated hemoglobin, mean platelet volume, erythrocyte distribution width, serum low-density lipoprotein cholesterol (HDL-Ch), total cholesterol, and total bileacid. Compared with group C, group N had elevated systolic blood pressure, body mass index (BMI), fasting blood glucose, blood creatinine, alkaline phosphatase (ALP), NLRP3, interleukin (IL)-1β, IL-18, TG, blood uric acid, γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and white blood cell counts, while HDL-Ch and total bilirubin were depleted than group C, and the difference was statistically significant (P< 0.05). NLRP3 was positively correlated with systolic blood pressure, BMI, fasting blood glucose, serum creatinine, IL-1β, IL-18, triglycerides, serum uric acid, GGT, ALT, AST, but negatively correlated with total bilirubin and HDL-Ch, and the difference was statistically signifi cant. Compared with NC group, HF group had significantly increased body mass, liver mass, serum biochemical indicators (triglycerides, AST, ALT), liver NLRP3 inflammasome protein expression, and inflammatory cytokines. After treatment with liraglutide, 100L group indicators were signifi cantly decreased when compared to HF group. Conclusion: Compared with healthy subjects, the infl ammation-related indicators, body mass, blood lipids and liver function-related indicators are signifi cantly changed in patients with NAFLD, which is also consistent with the results of rat model study. Liraglutide treatment had improved NAFLD to certain extent in NAFLD rats, so NLRP3 regulation may be one of the mechanisms to improve liver inflammation and steatosis.

AB0598 ASSOCIATION OF PROLONGED DISEASE DURATION AND TG/HDL-C RATIO IN ACCELERATING ATHEROSCLEROSIS IN PATIENTS WITH TAKAYASU’S ARTERITIS

Background

Takayasu’s arteritis (TA) is an autoimmune vasculitis that frequently occur in young women.Multiple previous studies have demonstrated that accelerated atherosclerotic changes were commonly found in TA patients[1-4].More specifically, data indicated that as much as 27% of all TA patients developed carotid artery plaque, while which was only 2% in the age- and sex-matched healthy individuals[1]. In addition, up to 20% of TA patients developed stroke and/or transient ischemic attack(TIA), which both have been known to be associated with atherosclerotic lesions[1-3]. Inflammation of the vascular wall may promotes atherosclerosis (As) in TA,which accelerates the development of As.Higher triglyceride (TG)/HDL-C ratio was found to be associated with presence of endothelial dysfunction and As[5].

Objectives

This study aimed to identify the risk factors associated with the development of atherosclerosis in TA.

Methods

This retrospective study enrolled a total of 101 TA patients. All patients were divided into two groups according to the absence or presence of atherosclerosis(43 vs 58). Baseline demographic features and clinical characteristics were compared between two groups. A logistic model was applied to determine the risk factors associated with the development of atherosclerosis.

Results

Our data suggested that the disease duration of patients in the atherosclerosis group was significantly longer than that of patients in the non-atherosclerosis group [96(18.00,180.00) vs 48.00(12.00,111.00) months] (p=0.015). In addition, the average age of patients with atherosclerosis was significantly older compared to patients without atherosclerosis [44.00（38.00，48.00）vs 28.50（24.00，37.00）years] (p<0.001). Logistic regression analysis showed that the risk of developing atherosclerosis increased by 9.2% per 1 year increase in thedisease duration(p=0.005, OR 1.092,95%CI:1.027-1.162).Patients with TG/HDL-C ratio more than 0.8875 were associated with a 5.861fold increase of risk developing atherosclerosis(p<0.001, 95%CI:2.299-14.939).

Conclusion

Our study indicated that prolonged disease duration and elevated TG/HDL-C ratio are associated with the development of atherosclerosis in TA patients.

References

[1]Seyahi E, Ugurlu S, Cumali R, Balci H, Seyahi N, Yurdakul S, et al. Atherosclerosis in Takayasu arteritis. Ann Rheum Dis. 2006;65(9):1202-7.

[2]Numano F, Okawara M, Inomata H, Kobayashi Y. Takayasu’s arteritis. Lancet. 2000;356(9234):1023-5.

[3]Park KC, Kim JH, Yoon SS, Heo SH. Takayasu’s disease presenting with atherothrombotic ischaemic stroke. Neurol Sci. 2008;29(5):363-6.

[4]Seyahi E, Ucgul A, Cebi Olgun D, Ugurlu S, Akman C, Tutar O, et al. Aortic and coronary calcifications in Takayasu arteritis. Semin Arthritis Rheum. 2013;43(1):96-104.

[5]Keles N, Aksu F, Aciksari G, et al. Is triglyceride/HDL ratio a reliable screening test for assessment of atherosclerotic risk in patients with chronic inflammatory disease?:[J]. Northern Clinics of Istanbul, 2016, 3(1):39-45.

Figure 1.

Disclosure of Interests

None declared

AB0600 ANALYSIS OF RISK FACTORS AND PROGNOSIS IN PATIENTS OF TAKAYASU’S ARTERITIS WITH CORONARY ARTERY LESIONS

Background

Takayasu’s arteritis（TA）can involve coronary artery lesions. The pathogenesis is complex and lacks the best treatment strategy.The coronary artery lesions were typical seen in the ostia of the left and right coronary arteries which were major risk factors for sudden death and ischemia heart failure[1-2].Coronary artery lesions is an important predictor of poor prognosis in TA patients.The incidences of coronary artery lesions were more common in type V TA patients [3-4].The prevalence of metabolic syndrome and its related characteristics (including dyslipidemia, diabetes and hyperinsulinemia) in TA patients are higher compared with healthy people[5].Thus，under the action of vascular inflammation and traditional risk factors, coronary artery stenosis or even occlusion occurs earlier, which can lead to MACE events.

Objectives

The aim of our study is to investigate the risk factors and prognosis of coronary artery lesions in TA patients.

Methods

This retrospective study enrolled a total of 120 TA patients.All patients were divided into two groups according to the absence or presence of coronary artery lesions in TA patients (61 vs 59). A logistic model was applied to determine the risk factors associated with the incidence of coronary artery lesions in TA patients.According to the before and after imaging comparison of TA with coronary artery lesions, the influencing factors of improving TA with coronary artery lesions were analyzed.

Results

The incidence of coronary artery lesions in TA patients increased by 1.618 times for each additional year (p=0.034, OR1.618,95%CI: 1.036-2.529). History of hyperlipidemia indicated 10.124 fold higher risk of coronary artery lesions in TA patients(p=0.003, OR10.124,95%CI: 2.159-47.483).In the follow-up of TA with coronary artery lesions, 27 patients had coronary CTA results before and after comparison. It was found that 11 patients had remission of coronary artery lesions and 16 patients had no remission of coronary artery lesions. The age in the group with improved coronary imaging was significantly younger than that in the group without improved coronary imaging[（39.00±9.81 vs (47.44±10.06) years,p=0.041)].TNF-α and interleukin-6 were significantly higher in the group with improved coronary imaging than in the group without improved coronary imaging[（26.40(10.08，165.90) vs 7.80(6.73，21.70)pg/dl,p=0.047;12.50(5.83，19.30) vs3.71(2.80，4.40)pg/dl,p<0.001].Numano type V (75.00% vs 27.27%, p = 0.022) and vascular calcification (56.25% vs 9.09%, p= 0.018) were significantly higher than those in the group without improved coronary imaging, while numano type IIb in the group with improved coronary imaging was significantly higher than that in the group without improved coronary imaging(45.45% vs 6.25%，p=0.027).

Conclusion

Hyperlipidemia and age are the risk factors of coronary artery lesions in Takayasu arteritis.Numano type V and vascular calcification are not conducive to the improvement of TA with coronary artery lesions.All patients with TA of numano type IIb should be screened for coronary artery. Early control of inflammation is more conducive to the imaging improvement of arteritis coronary lesions.

References

[1]Matsubara, O, Kuwata, T, Nemoto, T, et al., Coronary artery lesions in Takayasu arteritis: pathological considerations, Heart and vessels. Supplement, 1992;7:26-31.

[2]Wang H, Liu Z, Shen Z, et al. Impact of coronary involvement on long-term outcomes in patients with Takayasu’s arteritis. Clin Exp Rheumatol 2020;38:1118-26.

[3]LiJ,et al.. (2017) Clinical characteristics of heart involvement in Chinese patients with Takayasu arteritis. J Rheumatol 44:1867–1874.

[4]Li T, Du J, Gao N, et al. Numano type V Takayasu arteritis patients are more prone to have coronary artery involvement. Clin Rheumatol 2020;39:3439-47.

[5]Soto ME, et al..(2011) Coronary CT angiogra- phy in Takayasu arteritis. JACC Cardiovasc Imaging 4(9):958–966

Figure 1.

Disclosure of Interests

None declared