POS0724 RISK FACTORS FOR CORONARY ARTERY DISEASE IN CHINESE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTI-CENTER, RETROSPECTIVE, COHORT STUDY

Background

Coronary artery disease (CAD) not only has an increased prevalence but also is a major cause of premature mortality in systemic lupus erythematosus (SLE) [1, 2]. However, information is limited regarding the risk factors for CAD in Chinese patients with SLE.

Objectives

To assess the risk factors for CAD in Chinese patients with SLE.

Methods

This multi-center, retrospective, cohort study included 3778 consecutive SLE patients, with CAD (CAD group) or without a medical history of CAD (control group). CAD was defined as a coronary stenosis ≥50% in any major epicardial coronary vessel detected by coronary angiography or a history of myocardial infarction confirmed by medical records. General parameters, clinical features, laboratory tests and medical therapies were compared between groups, and the risk factors for CAD in SLE were analyzed by logistic regression analysis.

Results

The age at baseline was older, male ratio was higher and body mass index was greater in CAD group (all P<0.001). Traditional CAD risk factors including diabetes mellitus, hypertension, dyslipidemia, family history of CAD and smoking were more common in CAD group (all P<0.001) (Figure 1). SLE Disease Activity Index 2000 was greater (P=0.012), hyperuricemia and elevated C-reactive protein (CRP) were more prevalent (both P<0.001), and an increased corticosteroids’ usage (P=0.018) was detected in CAD group (Table 1). Binary logistic regression analysis showed hyperuricemia (odds ratio: 3.082, 95% confidence interval: 1.283-7.403; P=0.012) and CRP (odds ratio: 7.248, 95% confidence interval: 2.931-17.925; P<0.001) were independent risk factors for CAD in SLE patients.

Table 1.

Comparison of clinical features in SLE patients between CAD group and control group.

ParametersControl group (n=3732)CAD group (n=46)PAge at baseline [years, median (P25, P75)]35.00 (29.00, 45.00)59.50 (50.25, 67.75)<0.001Male, n (%)296 (7.94)11 (23.91)<0.001Disease duration [years, median (P25, P75)]8.00 (4.00, 12.00)10.00 (4.00, 19.00)0.173Body mass index [kg/m2, median (P25, P75)]21.77 (19.63, 24.16)23.50 (22.09, 25.36)<0.001Renal disorder, n (%)1737 (46.57)9 (19.57)<0.001Neurologic disorder, n (%)595 (15.95)3 (6.52)0.082Thrombocytopenia, n (%)859 (23.03)8 (17.39)0.366SLEDAI-2K [median (P25, P75)]3.00 (0.00, 8.00)5.50 (1.50, 14.00)0.012Elevated creatinine, n (%)295 (7.91)10 (21.74)0.002Hyperuricemia, n (%)209 (5.60)16 (34.78)<0.001Elevated ESR, n (%)951 (25.5)22 (47.83)0.001Elevated CRP, n (%)210 (5.63)15 (32.61)<0.001Positive aPL, n (%)734 (19.68)11 (23.91)0.474Corticosteroids, n (%)2752 (73.78)41 (89.13)0.018Immunosuppressants, n (%)2950(79.09)37 (80.43)0.823

Abbreviations: aPL, antiphospholipid antibody; CAD, coronary artery disease; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; SLE, systemic lupus erythematosus; SLEDAI-2K, SLE Disease Activity Index 2000. P <0.05 are shown as italics and bold.

Figure 1.

Comparison of traditional risk factors in SLE patients between CAD group and control group. Abbreviations: CAD, coronary artery disease; SLE, systemic lupus erythematosus. All P<0.001.

Conclusion

Hyperuricemia and CRP are independent risk factors for CAD in SLE patients. This study highlights the association between hyperuricemia, CRP and CAD burden in SLE, and might provide a modifiable perspective on improving SLE outcomes.

References

[1]Gonzalez LA, Alarcon GS. The evolving concept of SLE comorbidities [J]. Expert Rev Clin Immunol, 2017, 13(8): 753-768.

[2]Kostopoulou M, Nikolopoulos D, Parodis I, et al. Cardiovascular Disease in Systemic Lupus Erythematosus: Recent Data on Epidemiology, Risk Factors and Prevention [J]. Curr Vasc Pharmacol, 2020, 18(6): 549-565.

Disclosure of Interests

None declared

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

[The correlation of physical activity and sedentary leisure time with low muscle mass, strength, and quality in Chinese adults]

Objective: To explore the relationship of physical activity and sedentary leisure time with muscle mass, strength, and quality in Chinese adults. Methods: Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of physical activity and sedentary leisure time with low muscle mass, grip strength, and muscle quality. Results: A total of 24 245 participants were included in the analysis. The average daily physical activity level was (18.3±13.8) MET-h/d, and the sedentary leisure time was (4.4±1.9) hours. We took the lowest physical activity quartile as the reference and found that the participants' physical activity was negatively correlated to low muscle mass, strength, and quality. The ORs (95%CIs) of low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI), low grip strength and low arm muscle quality (AMQ) were 0.68 (0.60-0.77), 0.66 (0.58-0.75), 0.82 (0.72-0.94) and 0.84 (0.74-0.95), respectively. The subtypes of physical activity, including those related to work, transportation, housework, and leisure, also showed negative correlations with low muscle mass, strength, and quality to varying degrees. Compared with participants with the shortest sedentary leisure time, those who had the longest were more likely to have low TSMI (OR=1.13, 95%CI: 0.99-1.30). Conclusions: Physical activity was negatively correlated with a lower risk of low muscle mass and strength, while longer sedentary leisure time positively correlated with low muscle mass.

[The correlation of sleep duration and insomnia with low muscle mass, strength and quality in Chinese adults]

Objective: To explore the relationship of sleep duration and insomnia with muscle mass, strength, and quality in Chinese adults. Methods: Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of sleep duration, insomnia, and its duration with low muscle mass, handgrip strength, and muscle quality. Results: The average sleep duration of the study population was (7.4±1.5) hours. Morbidities of short sleep duration (<6 hours), long sleep duration (≥9 hours), and insomnia were 9.3%,17.4%,and 29.9%,respectively. Compared with those who slept for 7- hours, those who slept for ≥9 hours were more likely to have low muscle mass, low handgrip strength,and low arm muscle quality (AMQ), and the OR (95%CI) of low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI), low grip strength and low AMQ were 1.32 (1.18-1.48),1.26 (1.13-1.41), 1.33 (1.18-1.49) and 1.16 (1.03-1.30), respectively. Compared with participants without insomnia, insomnia patients were more likely to have low muscle mass,and the longer the duration of insomnia,the higher the risk (P for trend <0.001). Participants who reported <6 hours sleep duration and insomnia had a higher proportion of low ASMI and low TSMI,compared with those who slept for 7- hours and without insomnia, the OR (95%CI) were 1.26 (1.08-1.47) and 1.25 (1.07-1.46), respectively. Conclusions: Participants who reported ≥9 hours sleep duration were more likely to have low muscle mass,low handgrip strength,and low AMQ. Participants with insomnia had lower muscle mass, and the longer the duration of insomnia, the higher the proportion of low ASMI and low TSMI.

Sodium MRI at 7T for Early Response Evaluation of Intracranial Tumors following Stereotactic Radiotherapy Using the CyberKnife

BACKGROUND AND PURPOSE

Conventionally, early treatment response to stereotactic radiotherapy in intracranial tumors is often determined by structural MR imaging. Tissue sodium concentration is altered by cellular integrity and energy status in cells. In this study, we aimed to investigate the feasibility of sodium MR imaging at 7T for the preliminary evaluation of radiotherapeutic efficacy for intracranial tumors.

MATERIALS AND METHODS

Data were collected from 16 patients (12 men and 4 women, 24-75 years of age) with 22 intracranial tumors who were treated with stereotactic radiation therapy using CyberKnife at our institution between December 1, 2016, and August 15, 2019. Sodium MR imaging was performed at 7T before and 48 hours, 1 week, and 1 month after CyberKnife radiation therapy. Tissue sodium concentration (TSC) was calculated and analyzed based on manually labeled regions of tumors.

RESULTS

Ultra-high-field sodium MR imaging clearly showed the intratumoral signal, which is significantly higher than that of normal tissue (t = 5.250, P <.001)., but the edema zone has some influence. The average TSC ratios of tumor to CSF in the 22 tumors, contralateral normal tissues, edema zones, frontal cortex, and frontal white matter were 0.66 (range, 0.23-1.5), 0.30 (range, 0.15-0.43), 0.58 (range, 0.25-1.21), 0.25 (range, 0.17-0.42), and 0.30 (range, 0.19-0.49), respectively. A total of 12 tumors in 8 patients were scanned at 48 hours, 1 week, and 1 month after treatment. The average TSC at 48 hours after treatment was 0.06 higher than that before treatment and began to decrease at 1 week. The TSC ratios of 10 continued to decline and 2 tumors increased at 1 month, respectively. Tumor volume decreased by 2.4%-99% after 3 months.

CONCLUSIONS

Changes in the TSC can be quantified by sodium MR imaging at 7T and used to detect radiobiologic alterations in intracranial tumors at early time points after CyberKnife radiation therapy.

Classification of eCRS: Based on disease outcome or normal range?: Comment on Toro et al

Undoubtedly, there is a lack of unanimous histopathologic criteria to classify eosinophilic chronic rhinosinusitis (eCRS) worldwide. We read with great interest the recent constructive systematic review by Toro et al.(1). The authors stretched out the current knowledge on the methods of classifying eCRS to determine an optimal cut-off point. While the authors are to be congratulated for their comprehensive overview, a point regarding the disease recurrence as the most relevant parameter to divide eosinophilic and noneosinophilic inflammation in chronic rhinosinusitis (CRS) should be discussed. In order to contribute to an evidence-based standardization of cut-off point to classify eCRS, we would like to share our considerations and approaches in this comment.

Relationship between the amino acid release kinetics of feed proteins and nitrogen balance in finishing pigs

In current nutrition requirements of swine, although the protein diets are formulated based on the ileal digestibility of protein and amino acid (AA), there is a difference in nitrogen utilisation among various protein diets, which might be related to the AA release kinetics. To evaluate the relationship between AA release kinetics of feed proteins and nitrogen balance in finishing pigs, pigs were fed diets based on casein (CAS) or corn gluten meal (CGM) at normal or low-protein concentrations, and the AA release patterns were assessed. A 2 × 2 full factorial experimental design was used. 24 pigs (Duroc × Landrace × Yorkshire) with an initial weight of 67.0 ± 1.8 kg were randomly assigned to consume a normal-protein casein-based diet (N.CAS, 10% CP), normal-protein corn gluten meal-based diet (N.CGM, 10% CP), low-protein casein-based diet (L.CAS, 8.5% CP), or low-protein corn gluten meal-based diet (L.CGM, 8.5% CP) for 14 days (n = 6 per group; pigs housed and fed separately). The low-protein diets were associated with a more rapid release of AAs in the early stages of gastric digestion than the normal-protein diets. The N.CAS and L.CAS diets were associated with a peak AA release at approximately 4 h during trypsin digestion, whereas N.CGM and L.CGM were at approximately 16 h. The N.CAS diet was associated with the least dispersed release curves and lowest synchronisation indexes, implying that it was associated with the best AA release synchronism, whereas the L.CGM diet was on the contrary. The nitrogen intake (NI), faecal nitrogen, urine nitrogen (UN), total nitrogen, net protein utilisation and apparent biological value (ABV) of protein of pigs fed the L.CAS or L.CGM diets were lower than those fed the N.CAS or N.CGM diets (P < 0.05). Notably, there was a difference in NI (P < 0.05) and trends with respect to UN and ABV (0.05 < P < 0.1), but no differences in retained nitrogen or apparent nitrogen digestibility between pigs fed the N.CAS or L.CAS diets and those fed the N.CGM or L.CGM diets. Pigs fed the N.CAS or N.CGM diets had higher serum concentrations of UN than pigs fed the L.CAS or L.CGM diets (P < 0.05), but there were no differences in serum total protein, albumin, triglyceride, glucose, alanine transaminase, or aspartate aminotransferase between the groups. In addition, there was an interaction between protein level and protein source on serum globulin (P < 0.05). Therefore, the diet with a better AA release synchronism can improve protein utilisation efficiency in finishing pigs and to reduce environmental pollution.

Targeting STING attenuates ROS induced intervertebral disc degeneration

OBJECTIVE

DNA damage induced by ROS is considered one of the main causes of nucleus pulposus (NP) cells degeneration during the progression of intervertebral disc degeneration (IVDD). cGAS-STING pathway acts as DNA-sensing mechanism for monitoring DNA damage. Recent studies have proved that cGAS-STING contributes to the development of various diseases by inducing inflammation, senescence, and apoptosis. This work explored the role of STING, the main effector of cGAS-STING signaling pathway, in NP degeneration.

METHOD

Immunohistochemistry was conducted to measure STING protein levels in the nucleus pulposus tissues from human and puncture-induced IVDD rat models. TBHP induces degeneration of nucleus pulposus cells in vitro. For in vivo experiments, lv-NC or lv-STING were injected into the central intervertebral disc space. The degeneration level of IVDD was assessed by MRI, X-ray, HE, and Safranin O staining.

RESULTS

We found that the expression of STING was upregulated in human and rat degenerated NP tissue as well as in TBHP-treated NP cells. Overexpression of STING promoted the degradation of extracellular matrix; it also promoted apoptosis and senescence of TBHP-treated and untreated NP cells. Knock-down of STING significantly reversed these effects. Mechanistically, STING activated IRF3, whereas blockage of IRF3 attenuated STING-induced apoptosis, senescence and ECM degradation. In vivo experiments revealed that STING knock-down alleviated puncture-induced IVDD development.

CONCLUSION

STING promotes IVDD progress via IRF3, while suppression of STING may be a promising treatment for IVDD.

Pharmacokinetic studies of [68 Ga]Ga-PSMA-11 in patients with biochemical recurrence of prostate cancer: detection, differences in temporal distribution and kinetic modelling by tissue type

Purpose

[⁶⁸ Ga]Ga-PSMA-11 is a promising radiopharmaceutical for detecting tumour lesions in prostate cancer, but knowledge of the pharmacokinetics is limited. Dynamic PET-CT was performed to investigate the tumour detection and differences in temporal distribution, as well as in kinetic modelling of [⁶⁸ Ga]Ga-PSMA-11 by tissue type.

Methods

Dynamic PET-CT over the lower abdomen and static whole-body PET-CT 80–90 min p.i. from 142 patients with biochemical recurrence were retrospectively analysed. Detection rates were compared to PSA levels. Average time-activity curves were calculated from tumour lesions and normal tissue. A three-compartment model and non-compartment model were used to calculate tumour kinetics.

Results

Overall detection rate was 70.42%, and in patients with PSA > 0.4 ng/mL 76.67%. All tumour lesions presented the steepest standardised uptake value (SUV) incline in the first 7–8 min before decreasing to different degrees. Normal tissue presented with a low uptake, except for the bladder, which accumulated activity the steepest 15–16 min. p.i.. While all tumour lesions continuously increased, bone metastases showed the steepest decline, resulting in a significantly lower SUV than lymph node metastases (60 and 80–90 min). Transport rate from the blood and tracer binding and internalisation rate were lower in bone metastases. Heterogeneity (fractal dimension) and vascular density were significantly lower in bone metastases.

Conclusion

Even at low PSA between 0.51 and 0.99 ng/mL, detection rate was 57%. Dynamic imaging showed a time window in the first 10 min where tumour uptake is high, but no bladder activity is measured, aiding accuracy in distinction of local recurrence. Kinetic modelling provided additional information for tumour characterisation by tissue type.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00259-021-05420-1.

Rapid postglacial rebound amplifies global sea level rise following West Antarctic Ice Sheet collapse

Geodetic, seismic, and geological evidence indicates that West Antarctica is underlain by low-viscosity shallow mantle. Thus, as marine-based sectors of the West Antarctic Ice Sheet (WAIS) retreated during past interglacials, or will retreat in the future, exposed bedrock will rebound rapidly and flux meltwater out into the open ocean. Previous studies have suggested that this contribution to global mean sea level (GMSL) rise is small and occurs slowly. We challenge this notion using sea level predictions that incorporate both the outflux mechanism and complex three-dimensional viscoelastic mantle structure. In the case of the last interglacial, where the GMSL contribution from WAIS collapse is often cited as ~3 to 4 meters, the outflux mechanism contributes ~1 meter of additional GMSL change within ~1 thousand years of the collapse. Using a projection of future WAIS collapse, we also demonstrate that the outflux can substantially amplify GMSL rise estimates over the next century.

Predicting difficult-to-treat chronic rhinosinusitis by noninvasive biological markers

BACKGROUND

Previous studies have been limited to the utility of clinical features and invasive nasal mucosal biomarkers in the prediction of chronic rhinosinusitis (CRS) outcomes. This study aimed to identify noninvasive biomarkers associated with difficult- to-treat CRS, enabling physicians to subgroup patients into risk groups for poor outcome before surgery.

METHODS

Three hundred and nine CRS patients undergoing endoscopic sinus surgery were finally enrolled. Patients treated with oral or intranasal glucocorticoids within 3 months or 1 month before surgery, respectively, were excluded. Baseline clinical charac- teristics, nasal secretions and peripheral blood samples were collected before surgery. The protein levels of 39 biological mar- kers were detected by the Bio-Plex suspension chip method. Classification and regression tree analysis was applied to establish prediction model for difficult-to-treat CRS determined one year after surgery. A random forest algorithm was used to confirm the discriminating factors that formed the classification tree.

RESULTS

In the cohort with nasal secretion sample (n = 189), 21% of CRS patients were diagnosed as difficult-to-treat after 1 year of follow-up. Nasal secretion CCL17 level, hyposmia score, allergic rhinitis comorbidity, and nasal secretion MIP-1β level were found important predictors of difficult-to-treat CRS. A classification tree separated patients into 5 subgroups leading to an overall predictive accuracy of 94%. However, none of the plasma biological markers were associated with difficult-to-treat CRS in the cohort with blood sample (n = 128).

CONCLUSIONS

Patients with difficult-to-treat-CRS were characterized by higher nasal secretion levels of CCL17 and MIP-1β severe hyposmia and concomitant allergic rhinitis. The classification tree could be useful to identify patients with high risk of poor outcome prior to surgery and offer more personalized interventions. However, since only patients without preoperative steroid treatments were included in this study, the generalization of our predictive model in other patient populations should be conside- red with caution.

[Role of institutional cultural building in the schistosomiasis control program of Jiangsu Province]

Jiangsu Province was once one of the provinces that are hyperendemic for schistosomiasis in China. Following the concerted efforts for nearly 70 years, the transmission of schistosomiasis was interrupted in the province in 2019, which is the first province to achieve the national criteria of interruption of schistosomiasis transmission among the 5 provinces locating in the marshland and lake regions. In addition to political, economic and scientific and technical factors that greatly contribute to the huge achievements from schistosomiasis control in Jiangsu Province, the spiritual implication of Jiangsu schistosomiasis control culture that is mainly characterized by dedication, rigorousness, truth-seeking and innovation play a vital role in the schistosomiasis control program of Jiangsu Province, which encourages generations of schistosomiasis control professionals working in Jiangsu Province to fight against the "God of plague".

The morphological and physiological basis of delayed pollination overcoming pre-fertilization cross-incompatibility in Nicotiana

Delayed pollination is widely used to overcome pre-fertilization incompatibility, but its regulatory mechanisms are unclear. When Nicotiana tabacum was cross-pollinated with pollen of N. alata, the incompatibility occurring in the basal 1/4 region of the style (pollinated at anthesis: 0-day-old pistil) was overcome by delayed pollination (of 6-day-old pistil), and the morphological changes and corresponding physiological basis are explored here. The structure and ultrastructure of the pistil were observed under fluorescence microscopy and transmission electron microscopy. Differentially expressed proteins were screened with a monoclonal antibody chip for Nicotiana, and protein expression and distribution were analysed by immunofluorescence. Cellulase and pectinase activities were tested using enzyme-linked immunosorbent assay kits. The style of Nicotiana is solid in the basal region and pollen tubes grow in the extracellular spaces (ECM) of the transmitting tissue (TTS) cells. Seven of the 22 identified proteins were cell wall-associated proteins and were expressed at higher levels during pistil senescence. Cellulase and pectinase activities increased. The TTS cells in the basal 1/4 region of the 0-day-old style were polygonal and tightly arranged, with narrow ECM, but these were oval or partially dissolved in the 6-day-old pistil, leading to wider ECM and richer secretions. The increased expression of cell wall proteins and enhanced enzyme activity during pistil senescence might partially be responsible for the cells becoming oval and the ECM enlarged, providing the morphological basis for delayed pollination overcoming the pre-fertilization incompatibility between N. tabacum and N. alata.

[Antiviral treatment for hepatitis C among injecting drug users in the era of direct-acting antiviral agents]

HCV prevalence among people who inject drugs (PWID) is up to 67%. PWID is a population that needs priority attention to achieve the World Health Organization's goal of eliminating viral hepatitis as a public health threat by 2030. Although the SVR of HCV patients treated with direct-acting antiviral drugs (DAAs) can reach over 95%, especially in medical practice, there are still major obstacles to PWID treatment, because PWID is usually accompanied with concurrent infection, multiple-genotype infections, low compliance, substance abuse, methadone maintenance therapy, and risky behavior and re-infection conditions. Therefore, physicians often concern that these factors will affect the treatment efficacy, and refuse to provide hepatitis C treatment in PWID. This article reviews the relevant studies status and effects of hepatitis C treatment in PWID with different infection states and special behavior characteristics, and further highlights that the multidisciplinary cooperation for hepatitis C treatment in PWID is safe and effective, and can ensure treatment compliance.

Effects of feeding a Lactobacillus plantarum JL01 diet on caecal bacteria and metabolites of weaned piglets

Currently, knowledge is limited concerning the impact of a Lactobacillus plantarum JL01 diet for weaned piglets on caecal bacteria and metabolite profiles. In our experiments, 24 weaned piglets were randomly divided into two groups; each piglet in the treatment groups (Cec-Lac) was fed a basic diet and administered 10 ml of L. plantarum JL01 (1·0 × 10⁹  CFU per ml) every day. The control group (Cec-Con) was fed a basic diet. After feeding for 28 days, we analysed the parameters of the caecal digesta of weaned piglets. We used 16S rDNA gene sequencing and mass spectrometry (MS)-based metabolomics techniques to investigate the effect of a L. plantarum JL01 diet on intestinal microbial composition and its metabolite profiles in the caecum contents of weaned piglets. The results showed that the richness estimators (ACE and Chao indices) in the caecal bacteria increased in the Cec-Lac group. Prevotella_2 and Desulfovibrio decreased significantly, while Pantoea and Rectale_group increased in the caecum of weaned piglets in the Cec-Lac group. Furthermore, Pearson's correlation analysis revealed that the genus Rectale_group was positively correlated with indole-3-acetic acid (P < 0·05), and the genus Pantoea had the same correlation with 1-palmitoyl lysophosphatidic acid. The metabolomics analysis revealed that the L. plantarum JL01 diet supplementation had significant effects on tryptophan metabolism and fat digestion and absorption. The results indicated that the L. plantarum JL01 dietary supplementation not only altered the microbial composition but also mediated tryptophan metabolism and fat digestion and absorption in the caecum, factors that may further affect the health of the host.

[Prevalence and risk factors of pterygium in Han and Yugur populations in Gansu Province, China]

Objective: To investigate the prevalence and risk factors of pterygium in Han and Yugur populations aged 40-79 years in Gansu Province, China. Methods: This was a cross-sectional study. A multistage cluster sampling method with urbanization level-based stratification was employed. Multiple logistic regression analysis was performed to evaluate the risk factors of pterygium. Results: A total of 4 193 people (1 840 males, 2 353 females; 3 035 Hans, 1 158 Yugurs) aged over 40 in Gansu Province were included in the study. Among them, 391 patients (9.3%) were found to have pterygium. The prevalence of pterygium adjusted for age and sex was 9.3%. The prevalence rates of Han and Yugur participants were 8.8% (267 patients) and 10.7% (124 patients), respectively, and there was no significant difference between them (χ²=3.629, P=0.057). Multivariate regression analysis showed that the risk factors of pterygium included age (OR=3.66, 95%CI: 2.26-5.92), length of residence in the countryside (OR=2.18, 95%CI: 1.41-3.38), and education level (OR=0.49, 95%CI: 0.29-0.83). In the Han group, the risk factors of pterygium were age (OR=3.84, 95%CI: 2.18-6.78) and length of rural residence (OR=2.02, 95%CI: 1.23-3.33), and a higher level of education (OR=0.36, 95%CI: 0.20-0.66) was a protective factor. Older age (OR=3.11, 95%CI: 1.13-8.59) and rural residential length ratio (OR=3.28, 95%CI: 1.09-9.88) were risk factors for pterygium in Yugur population. Conclusions: The overall prevalence of pterygium in Han and Yugur populations aged over 40 in Gansu Province, China was 9.3%, with no significant difference between the two nationalities. Older age and rural residency increased the incidence of pterygium, and a higher education level was a protective factor for pterygium.(Chin J Ophthalmol, 2020, 56:600-607).

[Value of magnetic resonance imaging texture analysis in evaluating renal allograft injury]

Objective: To explore the value of magnetic resonance imaging (MRI) texture analysis in evaluating renal allograft injury. Methods: A retrospective review was performed on sixty-six patients who underwent allograft renal transplantation (42 males, 24 females; age range, 22-63 years; mean age, (40±10) years) between November 2013 and December 2016. All the patients were divided into three groups according to their eGFR on the day of MRI examination: normal renal allograft function (nRAF) group (n=15), mild to moderate renal allograft injury (mRAI) group (n=18), and severe renal allograft injury (sRAI) group (n=33). All the patients underwent conventional T(2) weighted image (T(2)WI), susceptibility weighted imaging (SWI), and blood-oxygen level dependent (BOLD) MRI examination. MRI texture features of renal allograft were extracted. The texture features based on T(2)WI, SWI, and BOLD with absolute correlation coefficient of eGFR greater than or equal to 0.3 (P<0.05)and also with the highest Z value for Boruta algorithmwere selected. The diagnostic performance of the selected texture features in differentiating the three groups was assessed by receiver operating characteristic (ROC) curve analysis. Results: T(2)WI_Perc.50%, SWI_Perc.01%, BOLD_S(4,4)Contrast, and BOLD_S(5,5)Correlat with absolute correlation coefficient of eGFR greater than or equal to 0.3 (P<0.05) and also with the highest Z value for Boruta algorithm were selected. The AUC for T(2)WI_Perc.50%, SWI_Perc.01%, and BOLD_S(5,5)Correlat in differentiating the nRAF group with the mRAI group was 0.785, 0.720, and 0.700. The AUC for T(2)WI_Perc.50%, SWI_Perc.01%, BOLD_S(4,4)Contrast, and BOLD_S(5,5)Correlat in differentiating the nRAF group with the sRAI group was 0.687, 0.733, 0.784, and 0.737.The AUC for BOLD_S(4,4) Contrast in differentiating the mRAI group with the sRAI group was 0.667. Conclusion: MRI texture analysis can provide valuable information for evaluating renal allograft injury.

AB0050 EXTENDED POLYDIMENSIONAL IMMUNOME CHARACTERISATION (EPIC) PLATFORM AS A TOOL FOR TRANSLATIONAL RESEARCH

Background:

We created a high dimensionality healthy human Immunome atlas by interrogating the peripheral blood mononuclear cells (PBMC) of >200 healthy subjects (cord blood to adult) with 63 unique mechanistic and phenotypic markers per cell by mass cytometry (CyTOF). This database is built with an open source, web-based bioinformatics toolkit, enabling its mining and uploading of datasets for comparison with the EPIC healthy database.

Objectives:

Here, we demonstrate the platform’s ability to identify the immunological differences of mechanistically important cell subsets in the uploaded data in comparison with EPIC.

Methods:

CyTOF data from 37 healthy elderly (>60 years old) was uploaded onto the EPIC Discovery tool where down-sampling, normalising and FlowSOM (Flow analysis with Self-Organising Maps) clustering were done with the EPIC database for comparison. Online visualisation outputs include cluster frequency boxplots, correspondence analysis (CA) plot and markers expression heat-map. The CA 2-dimensional plot depicts the global differences in immune cells composition between subjects with proximity between points (subjects) denoting similarity. Kruskal-Wallis test was done to identify age groups differences.

Results:

Increasing distances on the CA plot with age were observed with the elderly being farthest from the new-borns. Notably, we observed significant changes in naive CD4+IL8+T cells (p<1×10-20), memory CD4+IL17A+T cells (p<1×10-20) and type 2 innate lymphoid cells (ILC2) (Lin-CD7+CD25+CD127+CD161+, p<1×10-17) with increasing age. The naive CD4+IL8+T cells (median: 0.68%, interquartile range: 0.415 to 1.055% of CD45+ PBMC) and ILC2 (0.09%, 0.065 to 0.12%) were lowest and memory IL17A+T cells (0.58%, 0.41 to 0.905%) highest in the elderly. Significantly, the memory IL17A+T cells and ILC2 have been implicated in the pathogenesis of auto-immune conditions1,2.

Conclusion:

With EPIC, we have created an online tool enabling data uploading for comparison to a healthy database, allowing the holistic characterisation of immunological changes in different clinical scenarios. Using it, we were able to identify mechanistically important differences in immune cells composition in a distinct clinical cohort (elderly) compared to the younger ages. Translationally, the EPIC platform can be utilised similarly to catalyse the discovery process in auto-immune diseases interrogated with the EPIC antibody panels.

References:

[1]Fasching P, Stradner M, Graninger W, Dejaco C, Fessler J. Therapeutic Potential of Targeting the Th17/Treg Axis in Autoimmune Disorders. Molecules. 2017 Jan 14;22(1). pii: E134.

[2]Klose CS, Artis D. Innate lymphoid cells as regulators of immunity, inflammation and tissue homeostasis. Nat Immunol. 2016 Jun 21; 17(7): 765-74.

Disclosure of Interests:

None declared