Structural connections between the noradrenergic and cholinergic system shape the dynamics of functional brain networks

Complex cognitive abilities are thought to arise from the ability of the brain to adaptively reconfigure its internal network structure as a function of task demands. Recent work has suggested that this inherent flexibility may in part be conferred by the widespread projections of the ascending arousal systems. While the different components of the ascending arousal system are often studied in isolation, there are anatomical connections between neuromodulatory hubs that we hypothesise are crucial for mediating key features of adaptive network dynamics, such as the balance between integration and segregation. To test this hypothesis, we estimated the strength of structural connectivity between key hubs of the noradrenergic and cholinergic arousal systems (the locus coeruleus [LC] and nucleus basalis of Meynert [nbM], respectively). We then asked whether the strength of structural LC and nbM inter-connectivity was related to individual differences in the emergent, dynamical signatures of functional integration measured from resting state fMRI data, such as network and attractor topography. We observed a significant positive relationship between the strength of white-matter connections between the LC and nbM and the extent of network-level integration following BOLD signal peaks in LC relative to nbM activity. In addition, individuals with denser white-matter streamlines interconnecting neuromodulatory hubs also demonstrated a heightened ability to shift to novel brain states. These results suggest that individuals with stronger structural connectivity between the noradrenergic and cholinergic systems have a greater capacity to mediate the flexible network dynamics required to support complex, adaptive behaviour. Furthermore, our results highlight the underlying static features of the neuromodulatory hubs can impose some constraints on the dynamic features of the brain.

Brain charts for the human lifespan

Over the past few decades, neuroimaging has become a ubiquitous tool in basic research and clinical studies of the human brain. However, no reference standards currently exist to quantify individual differences in neuroimaging metrics over time, in contrast to growth charts for anthropometric traits such as height and weight1. Here we assemble an interactive open resource to benchmark brain morphology derived from any current or future sample of MRI data ( http://www.brainchart.io/ ). With the goal of basing these reference charts on the largest and most inclusive dataset available, acknowledging limitations due to known biases of MRI studies relative to the diversity of the global population, we aggregated 123,984 MRI scans, across more than 100 primary studies, from 101,457 human participants between 115 days post-conception to 100 years of age. MRI metrics were quantified by centile scores, relative to non-linear trajectories2 of brain structural changes, and rates of change, over the lifespan. Brain charts identified previously unreported neurodevelopmental milestones3, showed high stability of individuals across longitudinal assessments, and demonstrated robustness to technical and methodological differences between primary studies. Centile scores showed increased heritability compared with non-centiled MRI phenotypes, and provided a standardized measure of atypical brain structure that revealed patterns of neuroanatomical variation across neurological and psychiatric disorders. In summary, brain charts are an essential step towards robust quantification of individual variation benchmarked to normative trajectories in multiple, commonly used neuroimaging phenotypes.

The Inhibitory Effect of Curcumin Derivative J147 on Melanogenesis and Melanosome Transport by Facilitating ERK-Mediated MITF Degradation

The therapeutic use of curcumin and chemically modified curcumin (CMC) for suppressing melanogenesis and tyrosinase activity have been recognized. J147 is a modified version of curcumin with superior bioavailability and stability. However, there is no report about the effects of J147 on pigmentation in vitro and in vivo. In our studies, we investigated the hypopigmentary effects of J147 treatment on melanocytes and explored the underlying mechanism. The present studies suggested that J147 suppressed both basal and α-MSH-induced melanogenesis, as well as decreased melanocyte dendricity extension and melanosome transport. J147 played these roles mainly by activating the extracellular signal-regulated protein kinase (ERK) pathway. Once activated, it resulted in MITF degradation and further down-regulated the expression of tyrosinase, TRP-1, TRP-2, Myosin Va, Rab27a and Cdc42, ultimately inhibited melanin synthesis and melanosome transport. Furthermore, the hypopigmentary effects of J147 were demonstrated in vivo in a zebrafish model and UVB-induced hyperpigmentation model in brown guinea pigs. Our findings also suggested that J147 exhibited no cytotoxicity in vitro and in vivo. Taken together, these data confirmed that J147 may prove quite useful as a safer natural skin-whitening agent.

Clinical characteristics and outcomes in young patients with myocardial infarction

Background

Young people hold a stable or increasing percentage of patients with acute myocardial infarction in many countries. However, data on clinical characteristics and outcomes in young patients are lacking.

Purpose

To compare clinical characteristics and outcomes between patients aged ≤45 years and those aged >45 years with acute myocardial infarction.

Methods

A total of 24125 patients with acute myocardial infarction between January 2013 and September 2014 from China Acute Myocardial Infarction (CAMI) registry were included in this study. Clinical characteristics, in-hospital and 2-year outcomes were compared between patients aged ≤45 years (young) and those aged >45 years (older). Gender disparity in prognosis of myocardial infarction was analyzed among young patients.

Results

Of 24125 patients, 2042 (8.5%, 116 female) were aged ≤45 years. Compared with patients aged >45 years, young patients were more often male, current smokers, having medical history of hyperlipidemia and family history of premature coronary artery disease. Young patients were significantly more likely to have clear trigger factor, present with persistent chest pain and suffer ST-segment elevation myocardial infarction. Symptom onset to admission time was shorter in patients aged ≤45 years. For patients undergoing emergency coronary angiography, those aged ≤45 years were more likely to suffer left anterior descending coronary artery related myocardial infarction. Young patients were significantly more likely to receive percutaneous coronary intervention and other medications at discharge, including dual antiplatelet therapy, statins, angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and β blockers. Compared with patients aged >45 years, young patients experienced significantly lower in-hospital and 2-year mortality and major adverse cardiac and cerebrovascular events (MACCE, a composite of death, reinfarction and stroke) rates (Table 1). Among young patients, women experienced higher in-hospital mortality and MACCE rates than men (Table 2). Women who survived at discharge experienced significantly higher 2-year mortality (1.4% vs 3.8%, Log-rank P=0.0412, Table 2).

Conclusions

Compared with the older patients, young patients were more likely to present with typical symptoms and receive guideline-recommended medications. Clinical outcomes of patients aged ≤45 years were significantly better than older patients. However, our results showed significant gender disparity in both short- and long-term outcomes of young patients. More efforts are needed to improve prognosis in young patients with acute myocardial infarction.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Twelfth Five-Year Planning Project of the Scientific and Technological Department of China

Phosphodiesterase-4D Knockdown in the Prefrontal Cortex Alleviates Memory Deficits and Synaptic Failure in Mouse Model of Alzheimer's Disease

Phosphodiesterase 4 (PDE4)-dependent cAMP signaling plays a crucial role in cognitive impairment associated with Alzheimer’s disease (AD). However, whether inhibition of PDE4 subtypes or their splice variants in the prefrontal cortex positively regulates synaptic plasticity and antioxidative stress, and reverses β-amyloid 1–42 (Aβ1–42, Aβ42)-induced cognitive impairment still need to be clarified. The present study determined whether and how PDE4D knockdown by microinjection of lenti-PDE4D-miRNA into the prefrontal cortex reversed Aβ1–42-induced cognitive impairment in behavioral, neurochemical, and molecular biology assays. The results suggested that PDE4D knockdown increased time to explore the novel object and decreased latency to leave the platform in novel object recognition and step-down passive avoidance tests. Further study suggested that PDE4D knockdown decreased the number of working memory errors in the eight-arm maze test. These effects were prevented by PKA inhibitor H89. The subsequent experiment suggested that inhibition of PDE4D in the prefrontal cortex rescued the long-term potentiation (LTP) and synaptic proteins’ expression; it also increased antioxidant response by increasing superoxide dismutase (SOD) and decreasing malondialdehyde (MDA) levels. PDE4D knockdown also increased phosphorylated cAMP response element-binding protein (pCREB), brain-derived neurotrophic factor (BNDF), and anti-apoptotic proteins’ expression, i.e., the ratio of Bcl-2/Bax, and decreased caspase-3 level in the prefrontal cortex. These findings extend the previous findings and support the hypothesis that RNA interference-mediated PDE4D knockdown in the prefrontal cortex ameliorated memory loss associated with synaptic failure in an AD mouse model by its antioxidant, anti-apoptotic, and neuroprotective properties.

Incidence and risk factors of female urinary incontinence: a 4-year longitudinal study among 24 985 adult women in China

OBJECTIVE

To estimate the incidence of urinary incontinence (UI), including its subtypes stress UI (SUI), urgency UI (UUI) and mixed UI (MUI), and to examine risk factors for de novo SUI and UUI in Chinese women.

DESIGN

Nationwide longitudinal study.

SETTING

Six geographic regions of China.

PARTICIPANTS

Women aged ≥20 years old were included using a multistage, stratified, cluster sampling method.

METHODS

This study was conducted between May 2014 and March 2016, with follow up in 2018. Data on demographics, medical history, lifestyle and physiological and anthropometric information were collected.

MAIN OUTCOME MEASUREMENTS

Incidence, rate ratio (RR).

RESULTS

Analyses included 24 985 women (mean age 41.9 years).The follow-up response rate was 55.5%, median follow-up time was 3.7 years. The standardised incidences of UI, SUI, UUI and MUI were 21.2, 13.1, 3.0 and 5.1 per 1000 person-years, respectively. Risk factors for de novo SUI included delivery pattern (vaginal spontaneous delivery RR 2.12, 95% CI 1.62-2.78 and instrumental delivery RR 3.30, 95% CI 1.99-5.45), high body mass index (BMI) (overweight RR 1.52, 95% CI 1.33-1.74 and obesity RR 1.67, 95% CI 1.32-2.11), cigarette smoking (RR 1.54, 95% CI 1.12-2.12), chronic cough (RR 1.44, 95% CI 1.17-1.76), diabetes (RR 1.33, 95% CI 1.10-1.60) and older age (50-59 years RR 1.49, 95% CI 1.16-1.90 and 60-69 years RR 1.61, 95% CI 1.22-2.13).The risk factors significantly associated with de novo UUI were age (RR increased from 1.21, 95% CI 0.74-1.99, at 30-39 years to 6.3, 95% CI 3.85-10.30, at >70 years) and diabetes (RR 1.48, 95% CI 1.05-2.09).

CONCLUSIONS

The incidence of female UI is 21.2 per 1000 person-years in China. Delivery (vaginal spontaneous delivery, instrumental delivery), high BMI, cigarette smoking, chronic cough, diabetes and older age were risk factors.

TWEETABLE ABSTRACT

The incidence of female urinary incontinence was 21.2 per 1000 person-years in China. Delivery, BMI, diabetes and old age are risk factors.

P–583 Differential lipidomic characteristics of children born to women with polycystic ovary syndrome

Study question

To describe lipidomic characteristics of offspring born to polycystic ovary syndrome (PCOS-off) women and assess the associations of clinical phenotypes changes with differential lipids.

Summary answer

PCOS-off showed specific changes in lipidomics and some differential lipids (e.g., phosphatidylcholines, lysophosphatidylcholine and sphingomyelin) may be the potential markers of aberrant cardiometabolic health.

What is known already

Polycystic ovary syndrome (PCOS), the most prevalent endocrine disorder characterized by ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology, affects about 8–13% of women of fertile age. Aberrant metabolic pathophysiological changes and increased pregnancy complications associated with PCOS predispose PCOS patients to have suboptimal intrauterine environments and that may produce a detrimental impact on the cardiometabolic health of their children.

Study design, size, duration

A total of 141 blood plasma samples from 70 children born to PCOS women (43 girls, 27 boys) and 71 healthy control children (44 girls, 27 boys) were obtained for lipidomics.

Participants/materials, setting, methods

Blood samples were centrifuged at 2000 rpm, 4 °C for 20 min, and the upper plasma was collected and used for lipid extraction. Then the waters ACQUITY UPLC I-Class system and The Xevo G2-S Q-TOF with an electrospray ionization (ESI) source (Waters, Manchester, UK) was used for chromatographic analysis and mass spectrometry analysis separately.

Main results and the role of chance

In total, 44 metabolites were found to be significantly altered in PCOS-off, including 8 up-regulated and 36 down-regulated metabolites. After stratified by sex, 44 metabolites were found to express differently in girls born to PCOS women (PCOS-g). 13 metabolites were up-regulated, and 31 metabolites were down-regulated, most of which belong to glycerolipids species. While 46 metabolites were found to express differently in boys born to PCOS women (PCOS-b) with 9 increased metabolites and 35 decreased ones, most of which were glycerophospholipids metabolites. Additionally, significant associations between metabolites changes and weight Z-score as well as high density lipoprotein level were found in PCOS-off. In PCOS-g, triglyceride, low density lipoprotein and high density lipoprotein level were found to be correlated with some metabolites, whereas in PCOS-b, thyroid stimulating hormone and high density lipoprotein were correlated with some lipids.

Limitations, reasons for caution

Other species of metabolites except lipids are not included in this study. Besides, some potential confounding maternal factors, such as smoking, drinking, breastfeeding etc. were not included due to the lack of data.

Wider implications of the findings: The results had broadened our understanding of PCOS-off’s cardiometabolic status and emphasized monitor and special management in this susceptible group of population.

Trial registration number

Not applicable

Lipidomics of Serum and Hippocampus Reveal the Protective Effects of Fermented Soybean Lipid on Rats of Microwave-Induced Cognitive Damage

Fermented soybean lipids (FSE-C) is an extract enriched in active lipid classes. To explore whether FSE-C can alleviate cognitive damage triggered by the exposure to microwave radiation through regulating lipid metabolism, we employed lipidomic profiling based on a UPLC-MS to investigate differential lipid metabolites in the serum and hippocampus of rats. The results showed that orally administered FSE-C could protect from cognitive damage in microwave-induced rats. Serum lipidomics indicated that FSE-C effectively facilitated the recovery of 43 differential lipid metabolites including 6 phosphatidylcholines (PCs), 5 phosphatidylethanolamines (PEs), 1 phosphatidylinositol, 3 lysophosphatidylcholines (LPCs), 6 lysophosphatidylethanolamines (LPEs), and 22 triglycerides (TGs), which was consistent with the analysis of serum TG levels. Moreover, FSE-C positively coordinated hexacosanoic acid, 2 PCs, 4 sphingomyelins (SMs), and 11 TGs, through the hippocampal lipidomics. Collectively, these findings suggested that phospholipid and TG metabolisms were significantly modified in microwave-exposed rats. TGs may be regarded as potential biomarkers to further investigate and evaluate the roles and functions of FSE-C on the attenuation of cognitive damage induced by microwave radiation.

Effects of medicine food Fructus Gardeniae on liver and kidney functions after oral administration to rats for 12 weeks

Fructus Gardeniae (FG) is medicine food widely used for the treatment and prevention of various diseases. However, in recent years, research has suggested that high doses of FG can cause hepatotoxicity and nephrotoxicity. To assess this potential toxicity in more depth, this study investigated the effects of decocted FG and two of its bioactive constituents (geniposide and genipin) on liver and kidney function in rats. Rats were intragastrically administered FG (330 mg/kg body weight), geniposide (50 mg/kg body weight), or genipin (50 mg/kg body weight) for 12 weeks. Changes in body weight, liver and kidney indices, biochemical indices, and inflammatory factors were monitored. In addition, pathological sections were assessed and the expression of caspase-3, NF-κBp65, COX-2, and iNOS was detected by immunohistochemistry and Western blot. It was found that the levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, creatinine, and urea nitrogen increased following administration of FG, geniposide, and genipin. Furthermore, the activities of superoxide dismutase and reduced glutathione decreased following treatment, while malondialdehyde levels increased. Pathological and immunohistochemical evaluations further confirmed that FG and its constituents may cause damage to the liver and kidneys. The mechanism study revealed that the protein level of inflammatory pathway increased and further promoted apoptosis, suggesting that it should not be taken orally for extended periods of time. PRACTICAL APPLICATIONS: Chinese medicine and food safety have always been public health concerns. Fructus Gardeniae (FG) is a plant with a dual-purpose as it is used as both a medicine and food. Medicinally, it has the effects of heat-clearing and detoxification. However, its adverse effects and related mechanisms are not clear, and this has potential safety implications. In this study, rats were treated with FG for 12 weeks and found that the long-term administration of FG or high dosing can lead to damage to liver and kidney function. Therefore, close attention must be paid to the dosage of FG in order to achieve a therapeutic effect and avoid adverse reactions. Thus, this study lays a foundation for the safety evaluation and clinical application of FG.

Circ-ABCB10 acts as an oncogene in glioma cells via regulation of the miR-620/FABP5 axis

OBJECTIVE

This study aims to investigate the biological function of circular RNA ABCB10 (circ-ABCB10) in regulating the progression of glioma and to study the possible underlying mechanisms.

PATIENTS AND METHODS

The expression levels of circ-ABCB10, miR-620 and FABP5 mRNA in glioma tissues, normal surrounding tissues and glioma cell lines were measured by Real-time PCR (RT-PCR). Circ-ABCB10 was silenced by siRNA in glioma cell lines (U87, T98G). The proliferation, migration and invasion of glioma cells were measured by MTT, wound healing and transwell assays, respectively. The relationship between circ-ABCB10, miR-620 and FABP5 was tested by Dual-Luciferase assay. The expression of proteins was measured by Western blot. The cell cycle distribution and apoptosis were measured by flow cytometry.

RESULTS

The expression levels of circ-ABCB10 and FABP5 in glioma tissues and cells were significantly higher than those in their normal counterparts. Moreover, the expression of miR-620 was lower in glioma tissues. Silencing of circ-ABCB10 in glioma cells significantly inhibited the proliferation, migration and invasion of glioma cells. Moreover, downregulation of circ-ABCB10 induced cell cycle arrest and apoptosis in glioma cells. Furthermore, inhibition of miR-620 showed the opposite effects to silencing circ-ABCB10 on glioma cells. Dual-Luciferase reporter assays demonstrated that circ-ABCB10 could bind to miR-620 and that FABP5 was a direct target of miR-620. Western blot results showed that circ-ABCB10 could stabilize the expression of FABP5, while miR-620 decreased the expression of FABP5. Furthermore, overexpression of FABP5 abrogated the silencing effects of circ-ABCB10 in glioma cells.

CONCLUSIONS

These data suggest that circ-ABCB10 affects glioma progression by regulating the miR-620/FABP5 axis, and circ-ABCB10 might be used as a potential target for the treatment of glioma.

Cinnamic Acid Increased the Incidence of Fusarium Wilt by Increasing the Pathogenicity of Fusarium oxysporum and Reducing the Physiological and Biochemical Resistance of Faba Bean, Which Was Alleviated by Intercropping With Wheat

BACKGROUND

Continuous cropping has resulted in the accumulation of self-toxic substances in faba beans which has restricted their global production. Intercropping is widely used to alleviate these problems.

AIMS

To explore the role of cinnamic acid stress in faba bean physiology and disease resistance, and the potential mitigating effects of intercropping the faba bean with wheat.

METHODS

Faba bean seedlings were grown with or without wheat in both field and hydroponic conditions in the presence of different cinnamic acid concentrations and Fusarium oxysporum (FOF), the occurrence of. Fusarium-mediated wilt and oxidative stress, as well as plant growth indices and the anti-pathogen defense system were analyzed.

RESULTS

Cinnamic acid significantly increased Fusarium pathogenicity, inhibited the activity of defense enzymes and reduced the ability of plants to resist pathogens, indicating the importance of cinnamic acid in the promotion of Fusarium wilt resulting in reduced seedling growth. Intercropping with wheat improved plant resistance by alleviating cinnamic acid-induced stress, which promoted crop growth and decreased the incidence and disease index of Fusarium wilt.

CONCLUSION

Cinnamic acid promotes Fusarium wilt by stimulating pathogen enzyme production and destroying the defense capability of faba bean roots. Intercropping reduces Fusarium wilt by alleviating the damage caused by cinnamic acid to the defense system of the faba bean root system.

FGIN-1-27 Inhibits Melanogenesis by Regulating Protein Kinase A/cAMP-Responsive Element-Binding, Protein Kinase C-β, and Mitogen-Activated Protein Kinase Pathways

FGIN-1-27 is a synthetic mitochondrial diazepam binding inhibitor receptor (MDR) agonist that has demonstrated pro-apoptotic, anti-anxiety, and steroidogenic activity in various studies. Here we report, for the first time, the anti-melanogenic efficacy of FGIN-1-27 in vitro and in vivo. FGIN-1-27 significantly inhibited basal and α-melanocyte-stimulating hormone (α-MSH)-, 1-Oleoyl-2-acetyl-sn-glycerol (OAG)- and Endothelin-1 (ET-1)-induced melanogenesis without cellular toxicity. Mushroom tyrosinase activity assay showed that FGIN-1-27 did not directly inhibit tyrosinase activity, which suggested that FGIN-1-27 was not a direct inhibitor of tyrosinase. Although it was not capable of modulating the catalytic activity of mushroom tyrosinase in vitro, FGIN-1-27 downregulated the expression levels of key proteins that function in melanogenesis. FGIN-1-27 played these functions mainly by suppressing the PKA/CREB, PKC-β, and MAPK pathways. Once inactivated, it decreased the expression of MITF, tyrosinase, TRP-1, TRP-2, and inhibited the tyrosinase activity, finally inhibiting melanogenesis. During in vivo experiments, FGIN-1-27 inhibited the body pigmentation of zebrafish and reduced UVB-induced hyperpigmentation in guinea pig skin, but not a reduction of numbers of melanocytes. Our findings indicated that FGIN-1-27 exhibited no cytotoxicity and inhibited melanogenesis in both in vitro and in vivo models. It may prove quite useful as a safer skin-whitening agent.

Beta amyloid-induced time-dependent learning and memory impairment: involvement of HPA axis dysfunction

Aβ aggregation is one of the pathological biomarkers of Alzheimer's disease (AD). However, the possible mechanism related to Aβ-induced pathological signaling pathway is still unknown. In the present study, Aβ1-42-induced time-dependent memory impairment and its possible relationship to hypothalamic-pituitary-adrenal (HPA) axis hyperactivity were examined. Aβ1-42-treated mice significantly impaired acquisition activity in the learning curve at 10 days, 1 and 4 months in the Morris water-maze (MWM) task. This learning activity was back to normal at 8 months after Aβ1-42 treatment. In the probe trial test, Aβ1-42-treated mice needed longer latencies to touch the precious platform location and fewer numbers of crossing from 10 days to 4 months after microinjection. This Aβ1-42 induced memory loss was consistent with the results of the step-down passive avoidance test. The HPA axis related parameters, such as corticosterone (CORT) level in the serum, glucocorticoid receptor (GR) and corticotropin-releasing factor receptor (CRF-R) expression in the frontal cortex and hippocampus increased in Aβ1-42-treated mice from 10 days to 4 months. While the downstream molecules phosphorylation of cyclic AMP response element binding (pCREB) and brain-derived neurotrophic factor (BDNF) expression decreased during this time. These effects were back to normal 8 months after treatment with Aβ1-42. Altogether, our results suggested that Aβ1-42 induced significant learning and memory impairment, which is involved in HPA axis dysfunction.

The decision-making of treatment and outcome in elderly patients with symptomatic severe aortic stenosis

Background

The prevalence of aortic stenosis (AS) steadily increases with age. There is a consensus that intervention should be advised in patients with symptomatic severe AS. However, decision to operate raises complex issues in the elderly due to the increasing operative comorbidity and mortality. There is limited information regarding the characteristics and outcome of elderly patients with symptomatic severe AS who were denied intervention and the reasons leading to the denial.

Purpose

To analyze the decision-making and the prognosis in elderly patients with symptomatic severe AS.

Methods

In a cohort of 8929 patients aged ≥60 years with significant valvular heart disease, we divided patients with severe (valve area ≤1 cm2 or peak velocity ≥4.0 m/s or mean gradient ≥40 mmHg), symptomatic (angina or NYHA II-IV or syncope) AS into three groups by final treatment decision: intervention group, doctor-deny group, patient-deny group. The impact of characteristics on decision-making was evaluated and 1-year mortality among three groups were compared.

Results

Among 546 patients with severe symptomatic AS, the interventional decision was taken in 338 patients (61.9%), 134 patients (24.5%) were denied intervention by doctor after evaluation and 74 patients (13.5%) refused intervention due to personal preference. In multivariable analysis, age [OR=1.104, 95% CI (1.068–1.142)], multi-comorbidities [OR=4.706, 95% CI (2.355–9.403)] and left ventricular end-diastolic diameter (LVEDD) [OR=1.021, 95% CI (1.001–1.042)] were markedly associated with the conservative decision made by doctor, while LVEF >50% [OR=0.260, 95% CI (0.082–0.823)] was significantly linked with the interventional decision. Lower mortality was observed in intervention group during 1-year follow-up compared with either doctor-deny group or patient-deny group (both P<0.001 after adjustment). Further, diabetes [HR=2.513, 95% CI (1.243–5.084)], syncope [HR=2.856, 95% CI (1.338–6.098)], atrial fibrillation (AF) [HR=2.764, 95% CI (1.305–5.855)], stroke [HR=2.921, 95% CI (1.252–6.851)] and multi-comorbidities [HR=3.120, 95% CI (1.363–7.142)] were strong 1-year mortality predictors, whereas interventional treatment [HR=0.195, 95% CI (0.091–0.417)] and LEVF >50% [HR=0.960, 95% CI (0.938–0.984)] were related to lower mortality.

Conclusions

Intervention was denied in about forty percent of elderly patients with symptomatic severe AS. Patients with advanced age, multi-comorbidities and increased LVEDD tended to be denied intervention by doctors, whereas interventions were more likely to be performed on patients with normal LVEF. Diabetes, syncope, AF, stroke and multi-comorbidities were the predictive factors of 1-year mortality. Elderly patients with symptomatic severe AS could benefit from intervention. Patient education needs to be strengthened, to encourage more patients accept the appropriate intervention.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Twelfth Five-year Science and Technology Support Projects by Ministry of Science and Technology of China

Optimal timing of delayed percutaneous coronary intervention in stable patients with ST-segment elevation myocardial infarction

Background

There is ongoing controversy and limited data about the optimal timing to perform delayed percutaneous coronary intervention (PCI) in stable ST-segment elevation myocardial infarction (STEMI) patients who have missed opportunities for acute reperfusion therapy and are in absence of ongoing ischemia.

Purpose

To evaluate the effects of timing of delayed PCI on short- and long-term safety outcomes in stable STEMI patients.

Methods

A cohort of 3,048 stable STEMI patients without acute reperfusion therapy who underwent delayed PCI were included in the study. Procedural timing was stratified into three groups: <3d, 3–7d, >7d. Primary outcomes were 30-day and 12-month major adverse cardiac events (MACE), a composite of death and reinfarction. Multivariate logistic and Cox regression models were performed.

Results

After multivariate adjustment, restricted cubic splines revealed a monotonic decrease in the risk of MACE with prolonged procedural timing (Figure-1). Delayed PCI on 3–7d and >7d were strongly associated with lower risks of MACE at 30 days (3–7d: Hazard ratio (HR) 0.43 [95% Confidence interval (CI) 0.18–0.99], P=0.046; >7d: HR 0.40 [95% CI 0.19–0.87], P=0.020) and 12 months (3–7d: HR 0.49 [95% CI 0.25–0.95], P=0.036; >7d: HR 0.42 [95% CI 0.22–0.77], P=0.006) compared with that on <3d. Delayed PCI on >7d also showed improvement in 12-month mortality (HR 0.45 [95% CI 0.22–0.91], P=0.026) over that on <3d, whereas procedure on 3–7d did not (HR 0.52 [95% CI 0.24–1.11], P=0.091). MI location and cardiac function had significant interactions with procedural timing for 12-month MACE (P-interaction=0.141 and 0.137). Procedural timing had more significant effects on MACE in patients with anterior MI or cardiac insufficiency.

Conclusion

Delayed PCI over a week after symptom onset had significant improvement in short- and long-term safety in stable STEMI patients especially with anterior MI or cardiac insufficiency. Decision-making on optimal timing should identify the high-risk individuals and balance between ischemic benefits and safety.

Figure 1

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Twelfth Five-year Science and Technology Support Projects by Ministry of Science and Technology of China.

Protoporphyrin IX Stimulates Melanogenesis, Melanocyte Dendricity, and Melanosome Transport Through the cGMP/PKG Pathway

Protoporphyrin IX (PPIX) is a heterocyclic organic compound that is the last intermediate in the heme biosynthetic pathway. PPIX, due to its photodynamic effects, is utilized in the treatment of skin diseases. Furthermore, PPIX has been utilized as a melanogenesis-stimulating agent in various studies. However, the exact function and mechanism underlying PPIX action in melanocytes remain to be elucidated. In the present study, we sought to further investigate how PPIX affects melanocyte melanogenesis, and whether PPIX is involved in melanin transport. Our findings demonstrated that PPIX increased melanocyte dendricity and melanosome transport, in addition to increasing melanogenesis. PPIX functions primarily by activating the guanylate cyclase (GC) and cyclic guanosine 3’, 5’-monophosphate/protein kinase G (cGMP/PKG) signaling pathways. Once activated, these pathways increase tyrosinase activity and the expression of microphthalmia-associated transcription factor (MITF), tyrosinase, tyrosinase-related protein-1 and -2 (TRP-1 and TRP-2), myosin Va, melanophinin, Ras-related protein Rab-27A (Rab27a), and cell division cycle 42 (Cdc42), promoting melanogenesis, melanocyte dendricity, and melanosome transport. Furthermore, the melanogenic effects of PPIX were confirmed in vivo in a zebrafish model system. Our results indicate that PPIX is not cytotoxic and may, thus, be utilized as a pigmentation enhancer.

Circ-CCDC66 accelerates proliferation and invasion of gastric cancer via binding to miRNA-1238-3p

OBJECTIVE

The aim of this study was to examine the expression of circ-CCDC66 in gastric cancer (GC) tissues and cell lines, as well as its correlation with the prognosis of GC. Moreover, the regulatory effects of circ-CCDC66 on biological behaviors of GC cells and its molecular mechanism were explored.

PATIENTS AND METHODS

The relative expression level of circ-CCDC66 in GC tissues and cell lines was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The correlation between the circ-CCDC66 level and overall survival of GC patients was analyzed as well. The potential influences of circ-CCDC66 on proliferative and invasive abilities of GC cells were evaluated through 5-Ethynyl-2'-deoxyuridine (EdU), colony formation and transwell assay, respectively. Meanwhile, the cell cycle progression and apoptosis of GC cells affected by circ-CCDC66 were determined. In addition, the direct target miRNA of circ-CCDC66 was predicted and verified by bioinformatics method and Dual-Luciferase reporter gene assay, respectively.

RESULTS

Circ-CCDC66 was significantly up-regulated in GC tissues and cell lines. Up-regulation of circ-CCDC66 indicated markedly worse prognosis of GC patients. Transfection of circ-CCDC66-siRNA remarkably attenuated proliferative and invasive abilities of BGC-823 and MGC-803 cells. Besides, GC cells were arrested in the G0/G1 phase, and the apoptotic rate was remarkably elevated after circ-CCDC66 knockdown. The Dual-Luciferase reporter gene assay verified that circ-CCDC66 bind to miRNA-1238-3p by competing with LHX2 (LIM-homeobox domain 2). MiRNA-1238-3p was significantly down-regulated in GC cells, whereas LHX2 was up-regulated. Furthermore, overexpression of miRNA-1238-3p in GC cells markedly suppressed the LHX2 level.

CONCLUSIONS

Circ-CCDC66 is highly expressed in GC tissues and cell lines. Knockdown of circ-CCDC66 attenuates proliferative and invasive abilities of GC cells. Our results indicate that circ-CCDC66/miRNA-1238-3p/LHX2 axis may be a promising target for GC treatment.

[Bivariate heritability estimation of resting heart rate and common chronic disease based on extended pedigrees]

OBJECTIVE

To estimate the univariate heritability of resting heart rate and common chronic disease such as hypertension, diabetes, and dyslipidemia based on extended pedigrees in Fujian Tulou area and to explore bivariate heritability to test for the genetic correlation between resting heart rate and other relative phenotypes.

METHODS

The study was conducted in Tulou area of Nanjing County, Fujian Province from August 2015 to December 2017. The participants were residents with Zhang surname and their relatives from Taxia Village, Qujiang Village, and Nanou Village or residents with Chen surname and their relatives from Caoban Village, Tumei Village, and Beiling Village. The baseline survey recruited 1 563 family members from 452 extended pedigrees. The pedigree reconstruction was based on the family information registration and the genealogy booklet. Univariate and bivariate heritability was estimated using variance component models for continuous variables, and susceptibility-threshold model for binary variables.

RESULTS

The pedigree reconstruction identified 1 seven-generation pedigree, 2 five-generation pedigrees, 23 four-generation pedigrees, 186 three-generation pedigrees, and 240 two-generation pedigrees. The mean age of the participants was 57.2 years and the males accounted for 39.4%. The prevalence of hypertension, diabetes, dyslipidemia in this population was 49.2%, 10.0%, and 45.2%, respectively. The univariate heritability estimation of resting heart rate, hypertension, and dyslipidemia was 0.263 (95%CI: 0.120－0.407), 0.404 (95%CI: 0.135－0.673), and 0.799 (95%CI: 0.590－1), respectively. The heritability of systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol was 0.379, 0.306, 0.393, 0.452, 0.568, 0.852, and 0.387, respectively. In bivariate analysis, there were phenotypic correlations between resting heart rate with hypertension, diabetes, diastolic blood pressure, fasting glucose, and triglyceride. After taking resting heart rate into account, there were strong genetic correlations between resting heart rate with fasting glucose (genetic correlation 0.485, 95%CI: 0.120－1, P<0.05) and diabetes (genetic correlation 0.795, 95%CI: 0.181－0.788, P<0.05).

CONCLUSION

Resting heart rate was a heritable trait and correlated with several common chronic diseases and related traits. There was strong genetic correlation between resting heart rate with fasting glucose and diabetes, suggesting that they may share common genetic risk factors.

Sub-Acute Treatment of Curcumin Derivative J147 Ameliorates Depression-Like Behavior Through 5-HT1A-Mediated cAMP Signaling

Background

Major depressive disorder (MDD) is a severe mental disorder related to the deficiency of monoamine neurotransmitters, particularly to abnormalities of 5-HT (5-hydroxytryptamine, serotonin) and its receptors. Our previous study suggested that acute treatment with a novel curcumin derivative J147 exhibited antidepressant-like effects by increasing brain derived neurotrophic factor (BDNF) level in the hippocampus of mice. The present study expanded upon our previous findings and investigated the antidepressant-like effects of sub-acute treatment of J147 for 3 days in male ICR mice and its possible relevancy to 5-HT_1A and 5-HT_1B receptors and downstream cAMP-BDNF signaling.

Methods

J147 at doses of 1, 3, and 9 mg/kg (via gavage) was administered for 3 days, and the anti-immobility time in the forced swimming and tail suspension tests (FST and TST) was recorded. The radioligand binding assay was used to determine the affinity of J147 to 5-HT_1A and 5-HT_1B receptor. Moreover, 5-HT_1A or 5-HT_1B agonist or its antagonist was used to determine which 5-HT receptor subtype is involved in the antidepressant-like effects of J147. The downstream signaling molecules such as cAMP, PKA, pCREB, and BDNF were also measured to determine the mechanism of action.

Results

The results demonstrated that sub-acute treatment of J147 remarkably decreased the immobility time in both the FST and TST in a dose-dependent manner. J147 displayed high affinity in vitro to 5-HT_1A receptor prepared from mice cortical tissue and was less potent at 5-HT_1B receptor. These effects of J147 were blocked by pretreatment with a 5-HT_1A antagonist NAD-299 and enhanced by a 5-HT_1A agonist 8-OH-DPAT. However, 5-HT_1B receptor antagonist NAS-181 did not appreciably alter the effects of J147 on depression-like behaviors. Moreover, pretreatment with NAD-299 blocked J147-induced increases in cAMP, PKA, pCREB, and BDNF expression in the hippocampus, while 8-OH-DPAT enhanced the effects of J147 on these proteins’ expression.

Conclusion

The results suggest that J147 induces rapid antidepressant-like effects during a 3-day treatment period without inducing drug tolerance. These effects might be mediated by 5-HT_1A-dependent cAMP/PKA/pCREB/BDNF signaling.