First Measurement of the Z→μ^{+}μ^{-} Angular Coefficients in the Forward Region of pp Collisions at sqrt[s]=13 TeV

The first study of the angular distribution of μ^{+}μ^{-} pairs produced in the forward rapidity region via the Drell-Yan reaction pp→γ^{*}/Z+X→ℓ^{+}ℓ^{-}+X is presented, using data collected with the LHCb detector at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 5.1  fb^{-1}. The coefficients of the five leading terms in the angular distribution are determined as a function of the dimuon transverse momentum and rapidity. The results are compared to various theoretical predictions of the Z-boson production mechanism and can also be used to probe transverse-momentum-dependent parton distributions within the proton.

The apparent metabolisable energy requirement of Sansui ducks from hatch to 21 days of age

A dose-response experiment was conducted to estimate optimal dietary apparent metabolisable energy requirement (AME) in Sansui ducks (Sansui Sheldrake duck) from hatch to 21 days of age. Three hundred thirty-six one-day-old male Sansui ducks were randomly assigned to six experimental treatments, each consisting of seven replicate pens with eight birds per pen. Birds were fed diets containing either 10.92, 11.38, 11.8, 12.26, 12.68 and 13.14 MJ AME/kg, respectively. At 21 d of age, the body weight, weight gain, feed intake, protein intake, energy intake and feed conversion ratio of ducklings from each pen were measured. Increasing AME content from 10.92 MJ/kg to 13.14 MJ/kg significantly improved body weight, weight gain, feed intake, feed conversion ratio and crude protein intake (P<0.05). No significant changes in energy intake were found among treatments (P>0.05). Based on broken-line regression analysis, the AME requirement of male Sansui ducks from hatch to 21 d of age was 11.49 and 11.59 MJ/kg for maximum body weight and best feed conversion ratio, respectively.

[Development of a nomogram for predicting the risk of colorectal advanced adenomas]

Objective: To explore the risk factors of colorectal advanced adenomas (AA) and construct a nomogram to predict the risk of colorectal AAs. Methods: Clinical data of patients were retrospectively collected who underwent their first colonoscopy from January 2017 to December 2020 in the First Affiliated Hospital of Nanjing Medical University and were pathologically confirmed harboring colorectal polyps. A credible random split-sample method was used to divide data into training and validation cohorts (split ratio=7∶3). Univariate and multivariate logistic regression analysis were used to identify the predictors of colorectal advanced adenomas, and a nomogram was developed based on the above results. The validation cohort was used for internal validation of the nomogram. The discriminatory value of the nomogram was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). The consistency between actual outcomes and predicted probabilities was evaluated by the calibration curve. The clinical validity of the model was evaluated by the decision analysis curve (DCA). Results: A total of 1 936 patients with colorectal polyps were eligible. Including 1 356 patients in the training cohort (840 males and 516 females), and 580 patients in the validation cohort (379 males and 201 females), with the mean ages of (57.4±9.8) and (57.6±9.7) years, respectively. There were 1 502 (77.6%) patients without AAs and 434 [22.4%,1-9 mm 73(16.8%) cases、>9-<20 mm 271(62.5%) cases、≥20 mm 90(20.7%) cases] patients with AAs. The regression analysis found that age (OR=1.018, 95%CI:1.003-1.033), fatty liver (OR=1.870, 95%CI:1.274-2.744), low-density lipoprotein (LDL) (OR=1.378, 95%CI:1.159-1.637), fecal occult blood test (FOBT) (OR=2.597, 95%CI:1.857-3.631), and location of adenomas [proximal (OR=2.869, 95%CI:1.727-4.764), distal (OR=2.791, 95%CI:1.721-4.527)] were identified as predictors of colorectal AAs. The AUC of the nomogram was 0.664 (95%CI:0.630-0.698) in the training cohort and 0.640 (95%CI:0.587-0.693) in the validation cohort. The calibration curve showed good consistency between the predicted and actual risk, and the Hosmer-Lemeshow (H-L) test P value was 0.830 and 0.150 in the training cohort and the validation cohort. DCA demonstrated that the nomogram had a better clinical application value. Conclusions: A nomogram with five predictors, including age, fatty liver, LDL, FOBT, and location of adenomas, helped predict the risk of colorectal AAs in patients with polyps and implemented colorectcal cancer stratified screening strategy for colonoscopy in the high-risk population.

Conceptual design and performance predictions for 2D beam emission spectroscopy turbulence measurements at Wendelstein 7-X

A conceptual design for a 2D beam emission spectroscopy diagnostic system to measure ion gyro-scale plasma turbulence at Wendeslstein 7-X is described. The conceptual design identifies field-aligned viewing geometries and ports for cross-field turbulence measurements in the neutral beam volume. A 2D sightline grid covers the outer plasma region, and the grid configuration provides sufficient k-space coverage in radial and poloidal directions for ion temperature gradient and trapped-electron mode turbulence measurements. Emission intensity estimates, optical transmission losses, and detector noise levels indicate that the measurements will be sensitive to plasma density fluctuations as small as δn/n ≈ 0.5% with a bandwidth of 1 MHz. Implementation challenges include a small beam emission Doppler shift due to nearly radial heating beams and reduced optical throughput due to collection aperture limitations.

Ultrafast soliton delivered by miniaturized mode-locker with MoTe2 and core-expanded fiber

Thermally expanded core (TEC) technology is an effective method of high-power fiber lasers. Miniaturization is also a major challenge for high-power lasers. We have proposed a miniaturized mode-locker based on TEC fiber and MoTe₂-polyvinyl alcohol (PVA) film. The proposed mode-locker is consisting of two TEC ferrules, a piece of MoTe₂-PVA film and a ceramic sleeve. The length of the proposed device is about 20 mm, and its outer diameter is about 2 mm. The relations between heating time, heating temperature, and mode field diameter (MFD) have been numerically simulated. The bending loss with respect to MFD has also been analyzed. The simulation results have revealed the trade-off relation between maximal tolerable intensity and low cavity loss, which means that there is an optimal MFD corresponding to optimal heating time and heating temperature. The proposed mode-locker has been applied in an integrated fiber laser, which has emitted ultrafast soliton with 3 times intensity larger than that of conventional sandwiched-type saturable absorber. The proposed mode-locker and fiber laser will find important applications in laser processing, laser ranging, and optical communication.

Study of the doubly charmed tetraquark [Formula: see text]

Quantum chromodynamics, the theory of the strong force, describes interactions of coloured quarks and gluons and the formation of hadronic matter. Conventional hadronic matter consists of baryons and mesons made of three quarks and quark-antiquark pairs, respectively. Particles with an alternative quark content are known as exotic states. Here a study is reported of an exotic narrow state in the D0D0π+ mass spectrum just below the D*+D0 mass threshold produced in proton-proton collisions collected with the LHCb detector at the Large Hadron Collider. The state is consistent with the ground isoscalar [Formula: see text] tetraquark with a quark content of [Formula: see text] and spin-parity quantum numbers JP = 1+. Study of the DD mass spectra disfavours interpretation of the resonance as the isovector state. The decay structure via intermediate off-shell D*+ mesons is consistent with the observed D0π+ mass distribution. To analyse the mass of the resonance and its coupling to the D*D system, a dedicated model is developed under the assumption of an isoscalar axial-vector [Formula: see text] state decaying to the D*D channel. Using this model, resonance parameters including the pole position, scattering length, effective range and compositeness are determined to reveal important information about the nature of the [Formula: see text] state. In addition, an unexpected dependence of the production rate on track multiplicity is observed.

Angular Analysis of D^{0}→π^{+}π^{-}μ^{+}μ^{-} and D^{0}→K^{+}K^{-}μ^{+}μ^{-} Decays and Search for CP Violation

The first full angular analysis and an updated measurement of the decay-rate CP asymmetry of the D^{0}→π^{+}π^{-}μ^{+}μ^{-} and D^{0}→K^{+}K^{-}μ^{+}μ^{-} decays are reported. The analysis uses proton-proton collision data collected with the LHCb detector at center-of-mass energies of 7, 8, and 13 TeV. The dataset corresponds to an integrated luminosity of 9  fb^{-1}. The full set of CP -averaged angular observables and their CP asymmetries are measured as a function of the dimuon invariant mass. The results are consistent with expectations from the standard model and with CP symmetry.

Safety, pharmacokinetics, and efficacy of BPI-15086 in patients with EGFR T790M-mutated advanced non-small-cell lung cancer: results from a phase I, single-arm, multicenter study

Background

Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) resistance frequently occurs in patients with non-small-cell lung cancer (NSCLC). EGFR Thr790Met mutation (T790M+) is seen in ∼50% of patients. We assessed the safety, tolerability, and pharmacokinetics (PK) of BPI-15086, a novel, ATP-competitive, irreversible, third-generation, mutation-selective EGFR-TKI in patients with EGFR T790M-mutated NSCLC.

Patients and methods

This two-center, phase I, dose-escalation study included patients who were 18-65 years old, with an Eastern Cooperative Oncology Group performance status of 0-2, with histologically or cytologically confirmed locally advanced or metastatic T790M+ NSCLC who were not surgical or radiotherapy candidates, and had imaging-identified disease progression after prior EGFR-TKIs. This dose-escalation study enrolled patients using a 3 + 3 study design. Patients received 25, 50, 100, 200, and 300 mg/day orally in 21-day cycles. The primary endpoints were safety, tolerability, and PK. Secondary endpoints were objective response rate (ORR) and disease control rate (DCR). The dose-expansion study was not conducted.

Results

We enrolled 17 patients from 29 December 2016 to 16 May 2018, in the safety and full analysis sets. All patients completed a single dosing trial, and no adverse events (AEs) causing drug discontinuation were seen. Grade 1-2 nausea, hypoalbuminemia, and decreased appetite were the most common treatment-related AEs. Grade 3 hyperglycemia was seen in one patient dosed at 300 mg/day. The ORR and DCR were 17.7% [95% confidence interval (CI) 3.8% to 43.4%] and 47.1% (95% CI 23.0% to 72.2%), respectively.

Conclusion

BPI-15086 is a safe and tolerable third-generation EGFR-TKI with a rationale for further clinical studies.

•

BPI-15086 is safe and has partial effectiveness in patients with advanced T790M+ NSCLC after previous EGFR-TKI therapy.

•

A different safety profile for BPI-15086 compared with other third-generation EGFR-TKIs.

•

The modest efficacy in this study is still deemed important and should be added to the literature of third-generation TKIs.

POS0413 IGURATIMOD AMELIORATES BLEOMYCIN-INDUCED PULMONARY FIBROSIS VIA INHIBITINGEMT PROCESS AND NLRP3 INFLAMMASOME ACTIVATION

Background

Interstitial pulmonary fibrosis is the deadliest manifestation of rheumatoid arthritis (RA), and its pathogenesis is complicated. As a new drug for controlling RA, clinical studies have found that iguratimod (IGU) has certain advantages in improving lung function and shows great potential for pulmonary fibrosis therapy[1]. However, the specific mechanism of IGU in treating pulmonary fibrosis is not clear.

Objectives

This study was designed to observe and investigate the therapeutic effects of IGU on bleomycin-induced pulmonary fibrosis in mice and further investigate its underlying mechanism, aiming to provide a further theoretical basis for clinical rational drug use.

Methods

A mouse model of pulmonary fibrosis was induced by intratracheal injection of bleomycin (BLM)[2]. Model mice were randomly assigned to receive Sodium carboxymethyl cellulose (CMC) or different concentrations of IGU. HE staining and immunohistochemical staining were performed to observe the therapeutic effects of IGU on mouse fibrosis. TGF-β induced A549 EMT cell model was utilized to investigate the effects of IGU on EMT in vitro[3]. NLRP3 inflammasome was activated by the co-stimulation of TGF-β+LPS+ATP (TLA) to evaluate the effects of IGU in vitro[4].

Results

We found that IGU resulted in favorable therapeutic outcomes by affecting the inflammation infiltration (Figure 1A) and collagen deposition (Figure 1B). Immunohistochemical results showed that IGU downregulated the levels of α-SM and NLRP3. Additionally, the markers of BLM-mediated EMT (Figure 1C) phenotype and NLRP3-activated (Figure 1D) phenotype in the lung were also attenuated after IGU administration. In vitro experiments, the results confirmed its anti-EMT effects of reducing the expression of interstitial proteins Vimentin and α-SMA and restoring the content of epithelial protein E-cadherin. Besides, IGU could inhibit NLRP3 activation by downregulating NLRP3 related marker proteins, reducing the secretion of IL-1β, and attenuating caspase-1 activity. We then found that IGU anti-EMT and anti-NLRP3 effect was accompanied by decreased ROS production.

Figure 1.

IGU ameliorates BLM-induced pulmonary inflammation and pulmonary fibrosis. (A) Representative lung micrographs of lung tissues stained with HE. Magnification, × 200. (B) Representative photographs of lung tissues stained with Masson’s trichrome staining. Magnification, × 200. (C) Representative results of western blot for E-cadherin, Vimentin, α-SMA expression in lung tissues. GAPDH was used as the endogenous control. (D) Representative results of western blot for NLRP3, caspase-1, cleaved-caspase-1 p20, IL-1β expression in lung tissues. GAPDH was used as the endogenous control.

Conclusion

IGU can inhibit the EMT process and NLRP3 inflammasome activation, reduce ROS production to ameliorate pulmonary fibrosis, which may provide new insights into the further application of IGU in Interstitial pulmonary fibrosis.

References

[1]Shu P, et al. Eur Rev Med Pharmacol Sci 2021, 25(4):4687 v Med

[2]Philipp K, et al. Eur Respir J 2020, 55(6):1901105.

[3]Justin C. H, et al. Matrix Biol 2018, 71-72:112-127.

[4]Anita A P, et al. Front Pharmacol 2020, 11:1201.

Disclosure of Interests

None declared.

Persistent influence of precession on northern ice sheet variability since the early Pleistocene

Prior to ~1 million years ago (Ma), variations in global ice volume were dominated by changes in obliquity; however, the role of precession remains unresolved. Using a record of North Atlantic ice rafting spanning the past 1.7 million years, we find that the onset of ice rafting within a given glacial cycle (reflecting ice sheet expansion) consistently occurred during times of decreasing obliquity whereas mass ice wasting (ablation) events were consistently tied to minima in precession. Furthermore, our results suggest that the ubiquitous association between precession-driven mass wasting events and glacial termination is a distinct feature of the mid to late Pleistocene. Before then (increasing), obliquity alone was sufficient to end a glacial cycle, before losing its dominant grip on deglaciation with the southward extension of Northern Hemisphere ice sheets since ~1 Ma.

Tests of Lepton Universality Using B^{0}→K_{S}^{0}ℓ^{+}ℓ^{-} and B^{+}→K^{*+}ℓ^{+}ℓ^{-} Decays

Tests of lepton universality in B^{0}→K_{S}^{0}ℓ^{+}ℓ^{-} and B^{+}→K^{*+}ℓ^{+}ℓ^{-} decays where ℓ is either an electron or a muon are presented. The differential branching fractions of B^{0}→K_{S}^{0}e^{+}e^{-} and B^{+}→K^{*+}e^{+}e^{-} decays are measured in intervals of the dilepton invariant mass squared. The measurements are performed using proton-proton collision data recorded by the LHCb experiment, corresponding to an integrated luminosity of 9  fb^{-1} . The results are consistent with the standard model and previous tests of lepton universality in related decay modes. The first observation of B^{0}→K_{S}^{0}e^{+}e^{-} and B^{+}→K^{*+}e^{+}e^{-} decays is reported.

Observation of the Decay Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ}

The first observation of the semileptonic b-baryon decay Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ}, with a significance of 6.1σ, is reported using a data sample corresponding to 3  fb^{-1} of integrated luminosity, collected by the LHCb experiment at center-of-mass energies of 7 and 8 TeV at the LHC. The τ^{-} lepton is reconstructed in the hadronic decay to three charged pions. The ratio K=B(Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ})/B(Λ_{b}^{0}→Λ_{c}^{+}π^{-}π^{+}π^{-}) is measured to be 2.46±0.27±0.40, where the first uncertainty is statistical and the second systematic. The branching fraction B(Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ})=(1.50±0.16±0.25±0.23)% is obtained, where the third uncertainty is from the external branching fraction of the normalization channel Λ_{b}^{0}→Λ_{c}^{+}π^{-}π^{+}π^{-}. The ratio of semileptonic branching fractions R(Λ_{c}^{+})≡B(Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ})/B(Λ_{b}^{0}→Λ_{c}^{+}μ^{-}ν[over ¯]_{μ}) is derived to be 0.242±0.026±0.040±0.059, where the external branching fraction uncertainty from the channel Λ_{b}^{0}→Λ_{c}^{+}μ^{-}ν[over ¯]_{μ} contributes to the last term. This result is in agreement with the standard model prediction.

Observation of Two New Excited Ξ_{b}^{0} States Decaying to Λ_{b}^{0}K^{-}π^{+}

Two narrow resonant states are observed in the Λ_{b}^{0}K^{-}π^{+} mass spectrum using a data sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the LHCb experiment and corresponding to an integrated luminosity of 6  fb^{-1}. The minimal quark content of the Λ_{b}^{0}K^{-}π^{+} system indicates that these are excited Ξ_{b}^{0} baryons. The masses of the Ξ_{b}(6327)^{0} and Ξ_{b}(6333)^{0} states are m[Ξ_{b}(6327)^{0}]=6327.28_{-0.21}^{+0.23}±0.12±0.24 and m[Ξ_{b}(6333)^{0}]=6332.69_{-0.18}^{+0.17}±0.03±0.22  MeV, respectively, with a mass splitting of Δm=5.41_{-0.27}^{+0.26}±0.12  MeV, where the uncertainties are statistical, systematic, and due to the Λ_{b}^{0} mass measurement. The measured natural widths of these states are consistent with zero, with upper limits of Γ[Ξ_{b}(6327)^{0}]<2.20(2.56) and Γ[Ξ_{b}(6333)^{0}]<1.60(1.92)  MeV at a 90% (95%) credibility level. The significance of the two-peak hypothesis is larger than nine (five) Gaussian standard deviations compared to the no-peak (one-peak) hypothesis. The masses, widths, and resonant structure of the new states are in good agreement with the expectations for a doublet of 1D Ξ_{b}^{0} resonances.

Measurement of the Nuclear Modification Factor and Prompt Charged Particle Production in p-Pb and pp Collisions at sqrt[s_{NN}]=5 TeV

The production of prompt charged particles in proton-lead collisions and in proton-proton collisions at the nucleon-nucleon center-of-mass energy sqrt[s_{NN}]=5  TeV is studied at LHCb as a function of pseudorapidity (η) and transverse momentum (p_{T}) with respect to the proton beam direction. The nuclear modification factor for charged particles is determined as a function of η between -4.8<η<-2.5 (backward region) and 2.0<η<4.8 (forward region), and p_{T} between 0.2<p_{T}<8.0  GeV/c. The results show a suppression of charged particle production in proton-lead collisions relative to proton-proton collisions in the forward region and an enhancement in the backward region for p_{T} larger than 1.5  GeV/c. This measurement constrains nuclear PDFs and saturation models at previously unexplored values of the parton momentum fraction down to 10^{-6}.

Enhancing Wheat Disease Diagnosis in a Greenhouse Using Image Deep Features and Parallel Feature Fusion

Since the assessment of wheat diseases (e.g., leaf rust and tan spot) via visual observation is subjective and inefficient, this study focused on developing an automatic, objective, and efficient diagnosis approach. For each plant, color, and color-infrared (CIR) images were collected in a paired mode. An automatic approach based on the image processing technique was developed to crop the paired images to have the same region, after which a developed semiautomatic webtool was used to expedite the dataset creation. The webtool generated the dataset from either image and automatically built the corresponding dataset from the other image. Each image was manually categorized into one of the three groups: control (disease-free), disease light, and disease severity. After the image segmentation, handcrafted features (HFs) were extracted from each format of images, and disease diagnosis results demonstrated that the parallel feature fusion had higher accuracy over features from either type of image. Performance of deep features (DFs) extracted through different deep learning (DL) models (e.g., AlexNet, VGG16, ResNet101, GoogLeNet, and Xception) on wheat disease detection was compared, and those extracted by ResNet101 resulted in the highest accuracy, perhaps because deep layers extracted finer features. In addition, parallel deep feature fusion generated a higher accuracy over DFs from a single-source image. DFs outperformed HFs in wheat disease detection, and the DFs coupled with parallel feature fusion resulted in diagnosis accuracies of 75, 84, and 71% for leaf rust, tan spot, and leaf rust + tan spot, respectively. The methodology developed directly for greenhouse applications, to be used by plant pathologists, breeders, and other users, can be extended to field applications with future tests on field data and model fine-tuning.

Study of Z Bosons Produced in Association with Charm in the Forward Region

Events containing a Z boson and a charm jet are studied for the first time in the forward region of proton-proton collisions. The data sample used corresponds to an integrated luminosity of 6  fb^{-1} collected at a center-of-mass energy of 13 TeV with the LHCb detector. In events with a Z boson and a jet, the fraction of charm jets is determined in intervals of Z-boson rapidity in the range 2.0<y(Z)<4.5. A sizable enhancement is observed in the forwardmost y(Z) interval, which could be indicative of a valencelike intrinsic-charm component in the proton wave function.

A2 MUCUS DEFICIENCY IMPACTS INTESTINAL EPITHELIAL CELL PROLIFERATION INDEPENDENT OF THE MICROBIOTA

Background

Intestinal homeostasis is highly dependent on the proliferation and differentiation of intestinal epithelial cells (IEC). IEC arise from intestinal stem cells (ISCs) that reside at the bottom of intestinal crypts. Following proliferation, the IEC migrate up as transient amplifying (TA) cells, and differentiate into mature IEC subtypes. When this process is disrupted, it can lead to aberrant IEC proliferation and differentiation. Mucus production by secretory goblet cells is also crucial for intestinal homeostasis, as mucus separates the IEC from luminal microbiota. Surprisingly, mice lacking Muc2, the main protein component of mucus, display increased distal colonic IEC proliferation and crypt hyperplasia at baseline, suggesting a relationship between Muc2 production and IEC proliferation.

Aims

We investigated how mucus production impacts IEC proliferation and differentiation in the intestinal crypt.

Methods

We used wildtype (Muc2^+/+) and Muc2 deficient (Muc2^-/-) littermates to measure distal colon crypt length and IEC proliferation pattern via microscopy. Organoids were also derived from distal colons of Muc2^+/+ and Muc2^-/- mice, and quantified for size, density and proliferation for 7 days to test whether the hyper-proliferation phenotype was also seen in vitro, thus epithelial-intrinsic. Crypts and organoids were collected for RNA sequencing to examine changes in IEC proliferation pathways. Proliferation assessments were repeated in germ-free (GF) Muc2^+/+ and Muc2^-/- mice. Muc2^-/- mice were also cross-bred with Lgr5^{-EGFP-IRES-CreERT2} mice to investigate the contribution of ISCs to IEC hyperproliferation resulting from Muc2 deficiency.

Results

Significant crypt hyperplasia was observed in the distal colons of Muc2^-/- mice in concert with a > twofold increase in Ki67⁺ TA cells as compared to Muc2^+/+ mice. Similarly, Muc2^-/- organoids also displayed significantly greater size, density and an increased number of Ki67⁺ cells than Muc2^+/+ organoids. Hyperproliferation was also seen in GF mice and organoids, suggesting that mucus impacts IEC proliferation independent of the microbiome. Muc2^-/- Lgr5-EGFP⁺ mice showed no significant increase in numbers of Lgr5⁺ cells, indicating that Muc2 deficiency does not directly impact ISC number, but rather their proliferation and differentiation reflected in increased numbers of TA cells. RNA-sequencing results suggested that changes in lipid metabolism may underlie the increased IEC proliferation seen in Muc2^-/- mice.

Conclusions

Mucus not only promotes IEC homeostasis by separating luminal bacteria from the intestinal epithelium, but also intrinsically modifies IEC proliferation independent of the microbiota. Taken together, our results emphasize the importance of mucus in controlling gut health through mechanisms independent of its role in barrier function.

Funding Agencies

CCC, CIHRC.H.I.L.D Foundation

A40 IDENTIFYING NOVEL ROLES FOR TLR2 SIGNALING IN THE INTESTINAL EPITHELIUM USING ORGANOIDS

Background

Inflammatory bowel disease (IBD) is thought to result from an imbalance between protective and damaging immune responses to the resident microbiota and other luminal antigens. Increasing evidence suggests that toll-like-receptor (TLR)-mediated innate immune dysfunction contributes to the pathogenesis of IBD. Among the receptors in the TLR family, TLR2 and its signalling pathway appears to play an important protective role in the gastrointestinal (GI) tract. Notably, our group previously discovered that Tlr2 expression by nonhematopoietic cells played an important protective role in the Citrobacter rodentium model of infectious colitis.

Aims

To determine if intestinal epithelial cells (IECs) control Tlr2 dependent tissue protective responses, we sought to characterize the role of Tlr2 signalling in intestinal organoids. In addition, to better define the role of Tlr2 during C. rodentium infection, we developed a novel in vitro model of C. rodentium infection using organoid-derived monolayers.

Methods

Organoids were derived from the colonic tissue of wild type (C57BL/6J) and Tlr2 deficient (-/-) mice and then stimulated with Tlr2 agonists, and their responses were evaluated by qPCR, ELISA, Western blot and immunostaining. In addition, 2D monolayers were grown from organoids, and infected with C. rodentium to explore whether Tlr2 signaling regulates other protective IEC functions such as barrier proteins and cell death in response to noxious stimuli.

Results

Stimulation of WT, but not Tlr2-/- mouse orgnaoids led to increased transcription of chemokine and cytokine genes Ccl20, Mcp-1, Cxcl1 and Tnf-α. This was accompanied by increased protein secretion through a NF-κB and p38 MAP kinase dependent mechanism. Interestingly, organoids derived from the distal colon displayed stronger Tlr2 responses than organoids from the proximal colon. During C. rodentium infection of monolayers, Tlr2 signaling had no effect on the distribution of tight junction proteins such as ZO-1 or Claudin3, however, Tlr2 did regulate levels of IEC apoptosis upon C. rodentium infection.

Conclusions

Our study demonstrates that colonic organoids express functional Tlr2, which upon stimulation, leads to pro-inflammatory responses as well as control over cell death. Our novel C. rodentium infection model enables us to further study the role of IEC in promoting host defense during bacterial infection. Futher work will examine how interactions with Tlr2 dependent cytokines (ie. IL-6, IL-22) impact IEC responses to C. rodentium.

Funding Agencies

CCC, CIHRCH.I.L.D

A9 SIALIC ACID METABOLISM PLAYS A KEY ROLE IN INTESTINAL FITNESS AND VIRULENCE OF AN ATTACHING/ EFFACING BACTERIAL PATHOGEN

Background

The gastrointestinal (GI) mucus barrier acts as an important interface between the host and luminal gut microbes, beyond its role in limiting direct contact between noxious luminal agents and the underlying intestinal epithelium. Mucus is comprised of highly glycosylated mucin proteins, modified by O-glycan side chains, formed by five sugar monomers, including sialic acid. Sialic acid frequently occupies the terminal position of O-glycans and can be cleaved by microbial sialidases. We hypothesize that upon entering their hosts, enteric pathogens, such as the attaching and effacing (A/E) family (EHEC, EPEC and Citrobacter rodentium) metabolically adapt to their intestinal environment, and express key virulence factors by sensing and metabolizing mucin sugars, such as sialic acid.

Aims

Investigate the role of sialic acid in regulating the fitness and virulence strategies of the A/E pathogen C. rodentium within the GI environment.

Methods

C57Bl/6 mice were orally infected with either wildtype (WT) or mutant strains of C. rodentium to study bacterial pathogenicity in vivo. Sialic acid was localized in mouse colonic tissue sections through lectin staining, and quantified in mouse feces and mucus scrapings using a commercial kit. Protein secretion by C. rodentium, in the presence or absence of sialic acid was analyzed by SDS-PAGE and mass spectrometry. Intestinal epithelial cell lines were infected with enteropathogenic E. coli (EPEC) or C. rodentium to examine bacterial adherence.

Results

Sialic acid was expressed widely in the GI tracts of mice, primarily in the colonic mucus layer and by intestinal goblet cells. Both EPEC and C. rodentium were found to take up and metabolize sialic acid through the transporter NanT. A C. rodentium strain deficient in sialic acid uptake ( ΔnanT) was dramatically impaired in colonizing the intestines of mice and was rapidly cleared. Sialic acid also impacted C. rodentium’s virulence by inducing the secretion of two key virulence factors, which significantly enhanced the pathogen’s adhesion to intestinal epithelial cells. Moreover, sialic acid increased C. rodentium’s ability to degrade mucus, due to the increased production of these two secreted virulence factors.

Conclusions

We demonstrate that sialic acid, a mucin-derived sugar, is an essential nutrient for A/E pathogens to thrive and expand within their host’s intestines. Moreover, sialic acid enhances pathogen virulence by inducing secretion of two important virulence factors, which increase adhesion to the epithelium and promote the degradation of mucus.

Funding Agencies

CCC, CIHRCH.I.L.D. Fdn

Evidence for a New Structure in the J/ψp and J/ψp[over ¯] Systems in B_{s}^{0}→J/ψpp[over ¯] Decays

An amplitude analysis of flavor-untagged B_{s}^{0}→J/ψpp[over ¯] decays is performed using a sample of 797±31 decays reconstructed with the LHCb detector. The data, collected in proton-proton collisions between 2011 and 2018, correspond to an integrated luminosity of 9  fb^{-1}. Evidence for a new structure in the J/ψp and J/ψp[over ¯] systems with a mass of 4337_{-4}^{+7} _{-2}^{+2}  MeV and a width of 29_{-12}^{+26} _{-14}^{+14}  MeV is found, where the first uncertainty is statistical and the second systematic, with a significance in the range of 3.1 to 3.7σ, depending on the assigned J^{P} hypothesis.

Analysis of Neutral B-Meson Decays into Two Muons

Branching fraction and effective lifetime measurements of the rare decay B_{s}^{0}→μ^{+}μ^{-} and searches for the decays B^{0}→μ^{+}μ^{-} and B_{s}^{0}→μ^{+}μ^{-}γ are reported using proton-proton collision data collected with the LHCb detector at center-of-mass energies of 7, 8, and 13 TeV, corresponding to a luminosity of 9  fb^{-1}. The branching fraction B(B_{s}^{0}→μ^{+}μ^{-})=(3.09_{-0.43-0.11}^{+0.46+0.15})×10^{-9} and the effective lifetime τ(B_{s}^{0}→μ^{+}μ^{-})=2.07±0.29±0.03  ps are measured, where the first uncertainty is statistical and the second systematic. No significant signal for B^{0}→μ^{+}μ^{-} and B_{s}^{0}→μ^{+}μ^{-}γ decays is found and upper limits B(B^{0}→μ^{+}μ^{-})<2.6×10^{-10} and B(B_{s}^{0}→μ^{+}μ^{-}γ)<2.0×10^{-9} at the 95% C.L. are determined, where the latter is limited to the range m_{μμ}>4.9  GeV/c^{2}. The results are in agreement with the standard model expectations.

Genomic landscape and immune-related gene expression profiling of epithelial ovarian cancer after neoadjuvant chemotherapy

Platinum-based neoadjuvant chemotherapy followed by interval debulking surgery is an accepted treatment for patients with stage III or IV epithelial ovarian cancer who are not suitable for primary debulking surgery. The identification of suitable adjuvant treatments in these patients is an unmet need. Here, we explore potential genomic characteristics (mutational and immune-associated expression profiles) in a series of patients undergoing neoadjuvant chemotherapy. Tumor samples from biopsy and interval debulking surgery were analyzed for mutational landscape and immune profiling, together with detailed immunohistochemistry using different immune cell markers, and correlated with clinicopathological characteristics and potential response to neoadjuvant chemotherapy. No major differences in the mutational landscape were observed in paired biopsy and surgery samples. Genomic loss of heterozygosity was found to be higher in patients with total/near-total tumor response. The immune gene expression profile after neoadjuvant chemotherapy revealed activation of several immune regulation-related pathways in patients with no/minimal or partial response. In parallel, neoadjuvant therapy caused a significant increase of tumor-infiltrating lymphocyte population abundance, primarily due to an augmentation of the CD8+ T cell population. Remarkably, these changes occurred irrespective of potential homologous recombination defects, such as those associated with BRCA1/2 mutations. Our study strengthens the use of loss of heterozygosity as a biomarker of homologous repair deficiency. The changes of immune states during neoadjuvant chemotherapy reveal the dynamic nature of tumor-host immune interactions and suggest the potential use of immune checkpoint inhibitors or their combination with poly-ADP polymerase inhibitors in high stage and grade epithelial ovarian cancer patients undergoing neoadjuvant therapy.

A Phytocannabinoid Formula Containing Palmitoylethanolamide, Acmella Oleracea Extract, and Bovine Colostrum Filtrate Inhibited Cytokine and Chemokine Production in Human Peripheral Blood Mononuclear Cells Stimulated Ex Vivo

A phytocannabinoid formula containing copaiba essential oil, palmitoylethanolamide, Sichuan pepper extract, Acmella oleracea extract, cruciferous vegetable extracts blend, and bovine colostrum filtrate was tested for its ex vivo effect on inhibiting stimulated cytokine release in human peripheral blood mononuclear cells. Effects of the phytocannabinoid formula on the peripheral blood mononuclear cells viability were measured by alamarBlue™ to confirm no obvious cytotoxicity. The phytocannabinoid formula was compared to reference compounds for its ability to inhibit both the phytohemagglutinin-stimulated release of the cytokines from T-cells and the lipopolysaccharide-stimulated release of the cytokines from macrophages/monocytes in human peripheral blood mononuclear cells. The T cell cytokine responses measured were those of interleukins (interleukin-1β, interleukin-2, interleukin-4, interleukin-5, interleukin-6, interleukin-8, interleukin-10, and interleukin-13) and interferon-gamma, interferon gamma-induced protein 10, macrophage inflammatory protein-1α, and tumor necrosis factor-α. The macrophage and monocyte cytokine responses measured were of interleukin-1β, interleukin-6, interleukin-8, macrophage inflammatory protein-1α, and tumor necrosis factor-α. For the phytohemagglutinin-stimulated T cell production of cytokines, the peripheral blood mononuclear cells treated with the Phytocannabinoid formula at 2 μg/mL and 20 μg/mL showed significant inhibition of interleukin-2, interleukin-6, interleukin-5, interleukin-8, interleukin-10, interleukin-13, and interferon gamma-induced protein 10 production. The phytocannabinoid formula also significantly reduced the macrophage/monocyte production of interleukin-1β and interleukin-6. Results from the present study showed that the phytocannabinoid formula inhibited cytokines and chemokines production in ex vivo stimulated human peripheral blood mononuclear cells, suggesting a potential immunomodulatory effect.

Branching Fraction Measurements of the Rare B_{s}^{0}→ϕμ^{+}μ^{-} and B_{s}^{0}→f_{2}^{'}(1525)μ^{+}μ^{-} Decays

The branching fraction of the rare B_{s}^{0}→ϕμ^{+}μ^{-} decay is measured using data collected by the LHCb experiment at center-of-mass energies of 7, 8, and 13 TeV, corresponding to integrated luminosities of 1, 2, and 6  fb^{-1}, respectively. The branching fraction is reported in intervals of q^{2}, the square of the dimuon invariant mass. In the q^{2} region between 1.1 and 6.0  GeV^{2}/c^{4}, the measurement is found to lie 3.6 standard deviations below a standard model prediction based on a combination of light cone sum rule and lattice QCD calculations. In addition, the first observation of the rare B_{s}^{0}→f_{2}^{'}(1525)μ^{+}μ^{-} decay is reported with a statistical significance of 9 standard deviations and its branching fraction is determined.

[Effectiveness and safety of ultrasound-guided microwave ablation for the treatment of primary hyperparathyroidism in 12 patients with parathyroid adenoma]

To investigate the effectiveness and safety of ultrasound-guided microwave ablation (MWA) in treatment of primary hyperparathyroidism (PHPT). A total of 12 PHPT patients with parathyroid adenoma were treated with MWA in Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to February 2021. The patients were followed up once every 3 months for 3-12 months. Levels of serum parathyroid hormone (PTH), calcium and phosphorus were detected before and 20 min, 4h and 1day after ablation, and during follow-up period. The volume and volume reduction rate of parathyroid lesion were compared before the treatment and at the end of follow-up. The technical and clinical success of MWA were assessed as well. At the end of follow-up, median serum PTH [66.60 (42.21,80.03) ng/L vs.169.90 (89.01,396.50) ng/L] and calcium [2.39 (2.32,2.49) mmol/L vs. 2.75 (2.57,2.96) mmol/L] levels in 12 patients decreased significantly (all P<0.05). A complete response in terms of PTH and calcium levels was achieved in 6 of the 12 patients, while 4 of the patients had slightly elevated PTH levels just above the upper limit of normal reference range, and 2 of the patients remained abnormal PTH and calcium levels. The clinical cure rate was 50%. The volumes of all lesion after ablation were significantly decreased (P<0.05), with the technical success rate reaching 92.3%. No serious complications were observed. Ultrasound-guided MWA, thus, is safe and effective in the treatment of PHPT.

Anti-biofilm potential of kefir-derived Lactobacillus paracasei L10 against Vibrio parahaemolyticus

Vibrio parahaemolyticus, a kind of biofilm-forming foodborne bacterium, presents formidable challenges to the effectiveness of antimicrobial agents. Increasingly, the safety of chemical antimicrobials has aroused the widespread attention of the public. The development of the novel nature antimicrobial agents has become critical for controlling biofilm-related pollution and infections. In this paper, we investigated the antibacterial activity of Lactobacillus paracasei L10, and evaluated the inhibition and eradication effects of the cell-free supernatant (CFS) of the strain on V. parahaemolyticus biofilms in detail. We found that the CFS exhibited marked antibacterial activity against all tested pathogenic bacteria. In co-cultural assay, L. paracasei L10 could notably reduce cell viability in both plankton and biofilm of V. parahaemolyticus and this antagonism effect in biofilm was greater than that in planktonic state. Meanwhile, the growth of V. parahaemolyticus was completely inhibited when 6% (v/v) of the CFS was added, and the supernatant also showed a concentration-dependent manner to inhibit and eradicate the biofilms of V. parahaemolyticus while decreased the metabolic activity of the biofilm in the same way. Moreover, the fluorescence microscopic and confocal laser scanning microscopy images confirmed the anti-biofilm activity of the CFS. This study elucidates that L. paracasei L10 displays a significant anti-biofilm effect on V. parahaemolyticus and the mechanism of its antagonism merits further study, which provides theoretical support for further development and application of L. paracasei L10 as anti-biofilm agents.

Observation of the Mass Difference between Neutral Charm-Meson Eigenstates

A measurement of mixing and CP violation in neutral charm mesons is performed using data reconstructed in proton-proton collisions collected by the LHCb experiment from 2016 to 2018, corresponding to an integrated luminosity of 5.4  fb^{-1}. A total of 30.6 million D^{0}→K_{S}^{0}π^{+}π^{-} decays are analyzed using a method optimized for the measurement of the mass difference between neutral charm-meson eigenstates. Allowing for CP violation in mixing and in the interference between mixing and decay, the mass and decay-width differences are measured to be x_{CP}=[3.97±0.46(stat)±0.29(syst)]×10^{-3} and y_{CP}=[4.59±1.20(stat)±0.85(syst)]×10^{-3}, respectively. The CP-violating parameters are measured as Δx=[-0.27±0.18(stat)±0.01(syst)]×10^{-3} and Δy=[0.20±0.36(stat)±0.13(syst)]×10^{-3}. This is the first observation of a nonzero mass difference in the D^{0} meson system, with a significance exceeding seven standard deviations. The data are consistent with CP symmetry and improve existing constraints on the associated parameters.

Liquid repellency enabled antipathogen coatings

Currently, Coronavirus Disease 2019 (COVID-19)-a respiratory contagion spreading through expiratory droplets-has evolved into a global pandemic, severely impacting the public health. Importantly, the emerging of immune evasion SARS-CoV-2 variants and the limited effect of current antivirals against SARS-CoV-2 in clinical trials suggested that alternative strategies in addition to the conventional vaccines and antivirals are required to successfully control the COVID-19 pandemic. Here, we propose to use liquid-repellent coatings to prevent the spread of the disease in the absence of effective vaccines, antimicrobial agents, or therapeutics, wherein the deposition and penetration of pathogen droplets are prohibited. We use SARS-CoV-2 as a model pathogen and find that SARS-CoV-2 remnants are reduced by seven orders of magnitude on coated surfaces, yielding a repelling efficacy far outperforming the inactivation rate of disinfectants. The SARS-CoV-2 remnant scales exponentially with the liquid/solid adhesion, uncovering the mechanism and effective means for minimizing pathogen attachment. The antipathogen coating that both repels and inactivates pathogens is demonstrated by incorporating the super-liquid-repellent coating with antipathogen additives. Together with its versatility over a wide range of substrates and pathogens, the novel antipathogen coating is of considerable value for infection control in everyday life as well as during pandemics.

Observation of New Resonances Decaying to J/ψK^{+} and J/ψϕ

The first observation of exotic states with a new quark content cc[over ¯]us[over ¯] decaying to the J/ψK^{+} final state is reported with high significance from an amplitude analysis of the B^{+}→J/ψϕK^{+} decay. The analysis is carried out using proton-proton collision data corresponding to a total integrated luminosity of 9  fb^{-1} collected by the LHCb experiment at center-of-mass energies of 7, 8, and 13 TeV. The most significant state, Z_{cs}(4000)^{+}, has a mass of 4003±6_{-14}^{+4}  MeV, a width of 131±15±26  MeV, and spin parity J^{P}=1^{+}, where the quoted uncertainties are statistical and systematic, respectively. A new 1^{+}  X(4685) state decaying to the J/ψϕ final state is also observed with high significance. In addition, the four previously reported J/ψϕ states are confirmed and two more exotic states, Z_{cs}(4220)^{+} and X(4630), are observed with significance exceeding 5 standard deviations.

[Association between pulse pressure and new-onset diabetes in hypertensive patients]

Objective: To determine the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Methods: In this prospective cohort study, hypertensive patients from the Kailuan Study, who were diagnosed in 2006-2007 check-up, were screened for enrollment. Participants who finished the biennial follow-up until December 31, 2017 were finally included in this analysis. The primary outcome was incident diabetes development. The pulse pressure variables were divided into quartiles (Q1-Q4), and the Kaplan-Meier curve was used to examine and estimate the cumulative incidence of new-onset diabetes among quartiles. Cox proportional hazards regression model was performed to explore the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Results: During an average follow-up of 8.17 years, 6 617 new-onset diabetes were identified out of the 32 917 hypertensive patients with no history or evidence of diabetes in 2006-2007 check-up. Participants were classified into quartiles according to pulse pressure levels as follows: Q1 group(<41 mmHg (1mmHg=0.133kPa))(n=7 995); Q2 group(41-<51 mmHg) (n=8 196); Q3 group (51-<61 mmHg) (n= 8 270); Q4 group (≥61 mmHg) (n=8 456). The cumulative incidences of new-onset diabetes across the quartiles were 16.94%, 19.61%, 21.07%, and 22.33%, respectively, with the incidence density was 20.27, 23.20, 24.92, and 26.10 per 1 000 person-years, respectively. The cumulative incidence of new-onset diabetes increased in proportion with increasing pulse pressure levels (P<0.01 by the Log-rank test). After multivariate adjustment, compared with the first quartile, the hazard ratios for new-onset diabetes in the third and fourth quartiles were 1.13 (95%CI 1.04-1.22, P<0.01) and 1.14 (95%CI 1.05-1.24, P<0.01), respectively. The risk of new-onset diabetes increased 5%(HR=1.05, 95%CI 1.02-1.08, P<0.01) with the fractional pulse pressure increased per 1 SD (0.13). Findings from the three sensitivity analyses were consistent with the main results in this cohort. Conclusions: Pulse pressure at baseline is positively associated with the incidence of new-onset diabetes among hypertensive individuals, and pulse pressure is an independent risk factor for the development of diabetes in hypertensive patients.

MicroRNA-543 inhibits the proliferation, migration, invasion, and epithelial-mesenchymal transition of triple-negative breast cancer cells via down-regulation of ACTL6A gene

PURPOSE

To investigate the effect of microRNA-543 (miR-543) on the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of triple-negative breast cancer (TNBC) cells, and the associated mechanism.

METHODS

Human breast cancer cells (MDA-MB-231, HCC1937, and MCF-7, ZR-75-1) and normal human breast epithelial cell line (MCF10A) were transfected with miR-543 mimics or inhibitor using lipofectamine 2000. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blotting were used to determine the mRNA and protein expression levels of miR-543, actin-like protein 6A (ACTL6A), vimentin, Snail, and E-cadherin in breast cancer cells/tissue. Cell counting kit-8 (CCK-8), wound-healing, and Transwell assays were used to measure the effect of miR-543 on TNBC cell proliferation, invasion, and migration. Overall survival was determined using data from Gene Expression Omnibus (GEO) and Cancer Genome Atlas (TCGA) databases. Bioinformatics analysis and luciferase reporter gene assay were used to determine the regulatory effect of miR-543 on ACTL6A.

RESULTS

The level of expression of miR-543 was significantly lower in breast cancer cells/tissue than in normal human breast epithelial cell/tissue (p < 0.05). MicroRNA-543 expression level was significantly reduced in TNBC cells/tissue, relative to the other breast cancer cells/normal breast tissue (p < 0.05). MicroRNA-543 significantly suppressed tumor growth and the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of TNBC cells, in mouse xenograft model (p < 0.05).

CONCLUSIONS

miR-543 influences the biological behavior of TNBC cells by directly targeting ACTL6A gene. miR-543 could serve as a novel diagnostic and therapeutic target for TNBC.

Sex-specific associations of serum insulin-like growth factor-1 with bone density and risk of fractures in Chinese patients with type 2 diabetes

We evaluated the associations of serum insulin-like growth factor-1 (IGF-1) with bone mineral density (BMD) and risk of fractures in Chinese patients with type 2 diabetes (T2D). We found positive associations between IGF-I and BMD and negative associations between IGF-I and all three modified 10-year probabilities of MOFs and HFs in men, but not in women.

INTRODUCTION

The objective was to investigate the associations of serum insulin-like growth factor-1 (IGF-1) with bone mineral density (BMD) and risk of fractures in Chinese patients with type 2 diabetes (T2D) in each gender.

METHODS

This was a cross-sectional, retrospective study that included men over 50 years and postmenopausal women with T2D without medical conditions or medications known to significantly affect BMD or serum IGF-I levels. Data of IGF-1, bone metabolism markers, lumbar spine (LS), femoral neck (FN), and total hip (TH) BMD were obtained; 10-year probability of major osteoporotic fractures (MOFs) and hip fractures (HFs) was calculated and modified with rheumatoid arthritis, femoral neck T-score, and age. Correlations of IGF-1 levels with bone metabolism and risk of fractures were statistically analyzed in men and women, respectively.

RESULTS

A total of 391 patients, including 226 men and 165 women, were included. The age, serum fasting C-peptide, glycosylated hemoglobin (HbA1c), bone formation marker, and all three modified 10-year probabilities of MOFs and HFs were higher in women than those in men (all p < 0.05). The levels of 25 hydroxyvitamin D (25OHD), IGF-1, and BMD were lower in women than those in men (all p < 0.05). In men, IGF-1 was positively correlated with FN and TH BMD (FN BMD: r = 0.267, p < 0.001; TH BMD: r = 0.235, p < 0.001) and negatively correlated with all three modified 10-year probabilities of MOFs (RA-modified MOFs: r = - 0.289, p < 0.001; age-modified MOFs: r = - 0.237, p < 0.001; FN T-score-modified MOFs: r = - 0.280, p < 0.001) and HFs (RA-modified HFs: r = - 0.291, p < 0.001; age-modified HFs: r = - 0.271, p < 0.001; FN T-score-modified HFs: r = - 0.270, p < 0.001), while no significant correlations were found between serum IGF-I and BMD and three modified 10-year probability in women.

CONCLUSIONS

According to this study, we found sex differences in the associations of serum IGF-1 with BMD and risk of fractures in Chinese patients with T2D. These results suggested that increasing serum IGF-1 might be a clinical target for protecting fractures in T2D, especially in men.

AB0202 IMPROVEMENT IN CLINICAL DISEASE ACTIVITY AND PATIENT-REPORTED OUTCOMES AFTER 6 MONTHS OF TREATMENT WITH ABATACEPT, STRATIFIED BY LINE OF THERAPY, IN PATIENTS WITH RA: RESULTS FROM A LARGE, US, NATIONAL OBSERVATIONAL STUDY

Background:

RA is more responsive to treatment in the early stages of disease, and early treatment may lead to better long-term outcomes.1,2 Data on the effectiveness of specific drugs as first or later lines of therapy will help inform treatment sequencing.

Objectives:

Data from patients enrolled in the Corrona RA Registry were used to compare the effectiveness of abatacept across lines of therapy overall (primary cohort) and in a subset of patients who were anti-citrullinated protein antibody positive (ACPA+).

Methods:

Patients with RA who initiated abatacept (January 2006 to October 2020), had 6 months’ follow-up (within 4−9 months of starting abatacept), had baseline (BL) and follow-up CDAI scores available, and had BL CDAI >2.8 were included. Outcomes were compared for first-, second- and third or higher-line therapy: 0, 1 or ≥2 prior biologic DMARDs or Janus kinase inhibitors, respectively. Continuous outcomes included change from BL to 6 months in mean CDAI and patient-reported pain, fatigue, and HAQ. Binary outcomes included rate of achieving minimal clinically important difference (MCID) in CDAI or modified ACR20/50/70 at 6 months. Continuous and binary outcomes were analysed using multiple linear and logistic regression, respectively. The models included line of therapy, age, sex, disease duration, work status, SC nodules, history of hypertension and depression, BL CDAI, BL patient-reported pain and BL fatigue. Additional subgroup analyses were carried out in patients with moderate/high disease activity (CDAI >10) at BL.

Results:

In total, 2876 patients (2327 with BL CDAI >10; 890 ACPA+) were included; 442, 911, and 1523 patients initiated first-, second- or third/higher-line abatacept, respectively. Compared with patients on second/third/higher-line abatacept therapy, those on first-line abatacept were significantly older, had shorter disease duration, and had lower BL CDAI, pain and fatigue (all p<0.001). In adjusted analyses, patients receiving abatacept as earlier lines of therapy had significantly greater improvement from BL in mean CDAI and in patient-reported fatigue and HAQ (Table 1). There was no significant difference between lines of therapy in change in patient-reported pain. Patients receiving first-line abatacept had significantly higher odds of achieving a MCID in CDAI or modified ACR20/50/70 response (Figure 1). Similar patterns were seen when the sample was limited to patients with moderate/high disease activity or in patients who were ACPA+.

Conclusion:

There were significant differences in improvement in clinical disease activity and patient-reported outcomes across lines of therapy. Better treatment responses were observed with earlier lines of abatacept therapy in the overall population, in patients who were ACPA+ and in those with moderate/high BL disease activity.

References:

[1]Harrold LR, et al. Clin Rheumatol 2017;36:1215−1220.

[2]Monti S, et al. RMD Open 2015;1(Suppl 1):e000057.

Table 1.

Adjusted mean change in CDAI and patient-reported outcomes from BL to 6 months after initiation of abatacept by line of therapy (primary cohort)

Adjusted outcome, mean change (SE)First-line (n=440)Second-line (n=898)Third/higher-line (n=1515)p valueaCDAI−7.96 (0.33)−7.49 (0.27)−5.74 (0.19)<0.001Patient-reported pain (VAS 0–100)−9.43 (0.69)−7.98 (0.47)−7.70 (0.35)0.074Patient-reported fatigue (VAS 0–100)−7.49 (0.71)−5.87 (0.51)−4.81 (0.36)0.002Patient-reported HAQ−0.16 (0.01)−0.12 (0.01)−0.08 (0.01)<0.001

aEstimated by multiple linear regression model adjusted for age, sex, disease duration, work status, SC nodules, history of hypertension and depression, BL CDAI, BL patient-reported pain and BL fatigue (factors that were identified a priori based on clinical experience or that differed significantly by line of therapy); p values reflect ANOVA overall test of differences across lines of therapy.

VAS=visual analogue scale.

Acknowledgements:

Professional medical writing and editorial assistance was provided by Claire Line, PhD, at Caudex and was funded by Bristol Myers Squibb. The poster was a collaborative effort between Corrona and Bristol Myers Squibb, with financial support provided by Bristol Myers Squibb. This study was sponsored by Corrona, LLC. Corrona is supported through contracted subscriptions with multiple pharmaceutical companies.

Disclosure of Interests:

Leslie Harrold Consultant of: AbbVie, Bristol Myers Squibb, Genentech/Roche, Grant/research support from: Pfizer, Keith Wittstock Employee of: Bristol Myers Squibb, Sheila Kelly Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Sang Hee Park Employee of: Bristol Myers Squibb, Xue Han Employee of: Bristol Myers Squibb, Ying Shan: None declared, Carla Roberts-Toler: None declared, Nicole Middaugh: None declared, Vadim Khaychuk Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb

POS0344 RISK OF ACPA POSITIVITY BY MOTIF-BASED CLASSIFICATION OF HLA-DRB1 SHARED EPITOPE ALLELES IN RA

Background:

The shared epitope (SE) is the strongest known genetic risk factor for rheumatoid arthritis (RA) and is associated with an amino acid motif at positions 70-74 in HLA-DRB1. It is linked to anti-citrullinated protein antibody (ACPA) positivity, a specific serological marker for RA. In 2005, a new classification of HLA-DRB1 alleles was proposed, in which each allele is sorted into one of five classes (S1, S2, S3P, S3D, or X).1 The method was subsequently validated for predicting risk of developing RA2 and was described as “a major advance and a template for future studies.”3 However, there have been relatively few studies utilizing this classification.

Objectives:

To characterize the prevalence of each SE genotype from the 2005 classification and their association with ACPA positivity in a cohort of individuals with RA.

Methods:

Participants in FORWARD, The National Databank for Rheumatic Diseases, with RA and donated serum (collected 2010-2019) were analyzed to obtain ACPA status and high-resolution HLA-DRB1 type. Alleles were classified based on the presence (S2, S3P) or absence (S1, S3D, X; collectively L) of the SE motif, and individuals were classified by allele pair. Logistic regression models (adjusted for age, sex, and race/ethnicity) to determine risk of ACPA positivity by class were generated using L/L as the reference.

Results:

Characteristics of the 855 participants at the time of sample collection are presented in Table 1. Overall, 67% of participants were SE positive and 51% were ACPA positive. Of the 1,710 total alleles, X was the most common (29%) followed by S3P (24%), S1 (18%), S2 (18%), and S3D (9%). Adjusted models showed that the risk of ACPA positivity was highest among those with the genotype S2/S3P, followed by S2/S2, S2/S3D, S2/X, S3P/S3D, S1/S2, S3P/S3P, S3P/X, and S1/S3P (Figure 1).

Table 1.

Characteristics of study population by SE status and allele count (mean [SD] or n [%]). Significance was assessed by Student’s t-test or Χ2 test, as appropriate.

SE negativeSE positiveP (SE- vs SE+)0 allelesAll1 allele2 allelesn=286n=569n=407n=162Age, years57.4 (12.3)58.1 (11.8)58.0 (11.9)58.5 (11.5)0.42RA duration, years15.2 (12.8)17.0 (13.9)16.8 (14.1)17.6 (13.4)0.07Female259 (90.6)500 (87.9)359 (88.2)141 (87.0)0.24White260 (90.9)525 (92.3)372 (91.4)153 (94.4)0.49History of smoking117 (40.9)223 (39.2)166 (40.8)57 (35.2)0.63RDCI, 0-92.4 (1.8)2.0 (1.7)2.1 (1.7)1.9 (1.7)<0.01ACPA positive74 (25.9)365 (64.1)241 (59.2)124 (76.5)<0.001RF positive84 (29.4)333 (58.5)219 (53.8)114 (70.4)<0.001Pain VAS, 0-104.2 (2.7)3.6 (2.7)3.7 (2.6)3.5 (2.9)<0.01Patient global severity, 0-104.0 (2.5)3.3 (2.5)3.4 (2.4)3.1 (2.6)<0.001HAQ-II, 0-31.0 (0.7)0.8 (0.6)0.8 (0.6)0.8 (0.6)<0.001csDMARD use204 (71.3)433 (76.1)302 (74.2)131 (80.9)0.13bDMARD use165 (57.7)351 (61.7)244 (59.95)107 (66.0)0.26Corticosteroid use98 (34.3)165 (29.0)121 (29.7)44 (27.2)0.12Figure 1.

Risk of ACPA positivity by the motif-based classification and prevalence of SE by binary status, allele count, and class. The area within each circle is proportionate to the sample size of that group.

Conclusion:

The ranking by risk of ACPA positivity among this RA cohort is similar to the order of risk for developing RA, as determined in the 2006 validation paper for this classification method. A notable trend among the classes with one SE positive allele is the consistent ranking of S3D as higher risk, X in the middle, and S1 as the lowest, suggesting a potential protective effect from S1 alleles. Future work should examine clinical associations with these allele classes, including disease progression and treatment effects.

References:

[1]du Montcel, ST et al. New classification of HLA-DRB1 alleles supports the shared epitope hypothesis of rheumatoid arthritis susceptibility. Arthritis Rheum52, 1063–1068 (2005).

[2]Michou, L et al. Validation of the reshaped shared epitope HLA-DRB1 classification in rheumatoid arthritis. Arthritis Res Ther8, R79 (2006).

[3]Winchester, R. Reshaping Cinderella’s slipper: the shared epitope hypothesis. Arthritis Res Ther8, 109 (2006).

Acknowledgements:

This study was sponsored by Bristol Myers Squibb.

Disclosure of Interests:

Kristin Wipfler: None declared, Xue Han Employee of: Bristol Myers Squibb, Sarah (Sang Hee) Park Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Keith Wittstock Employee of: Bristol Myers Squibb, Kaleb Michaud: None declared

Application of contrast-enhanced dual-energy spectral CT for differentiating borderline from malignant epithelial ovarian tumours

AIM

To investigate the value of contrast-enhanced dual-energy spectral computed tomography (CT) in differentiating borderline epithelial ovarian tumours (BEOTs) from malignant epithelial ovarian tumours (MEOTs).

MATERIALS AND METHODS

Sixty patients who underwent pelvic contrast-enhanced spectral CT were divided into two groups for analysis based on the tumour types confirmed at histopathological examination (26 BEOTs and 34 MEOTs). The regions of interest (ROIs) were selected on solid tumour components to measure attenuation values on monochromatic image sets (40-140 keV) in all imaging phases and tumour iodine concentrations (IC) on material decomposition images. Differences in the attenuation value between the unenhanced and contrast-enhanced phases (enhancement degree) and between energy strengths (slope k, k = [attenuation at 40 keV- attenuation at 140 keV]/100) were calculated. All measurements between the two groups were compared with independent t-test. Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity, specificity and area under the ROC curve (AUC). Logistic regression analysis was used to evaluate the diagnostic efficacy of using combined parameters in two-phase contrast-enhanced images.

RESULTS

In the arterial phase (AP) and venous phase (VP), the BEOTs had significantly lower enhancement than MEOTs from 40 to 100 keV (p<0.05). The k values and IC values both showed significant differences in the AP and VP (p<0.05). Combining parameters in two contrast-enhanced phases provided 80.8% sensitivity and 82.4% specificity in differentiating MEOTs from BEOTs with an AUC of 0.844.

CONCLUSION

Dual-energy spectral CT provides a multiparametric approach in differentiating BEOTs from MEOTs with the best diagnostic efficacy using combined parameters in the AP and VP images.

[PD-1/PD-L1 expression and its interaction with interferon-γ in Toxoplasma gondii-infected mice at middle and late pregnancy]

OBJECTIVE

To explore the dynamic expression of programmed cell death-1 (PD-1) and its ligand PD-L1 at the maternal-fetal interface of mice post-infection with Toxoplasma gondii at early pregnancy and examine its interaction with interferon-γ (IFN-γ).

METHODS

A total of 20 mice at day 0 of pregnancy were randomly assigned into 4 groups, including the 12-day pregnancy control group (12 dpn group), 12-day pregnancy and infection group (12 dpi group), 18-day pregnancy control group (18 dpn group) and 18-day pregnancy and infection group (18 dpi group), respectively. On the 6th day of the pregnancy, mice in the 12 dpi and 18 dpi groups were injected intraperitoneally with 150 tachyzoites of the T. gondii PRU strain, while mice in the 12 dpn and 18 dpn groups were injected with the same volume of PBS. All mice in the four groups were sacrificed on 12th and 18^th day of the pregnancy, and the number of placenta and fetus was counted and the weight of placenta and fetus was measured. Then, the placental and uterine tissues of the pregnant mice in each group were sampled for pathological examinations. The mRNA expression of PD-1, PD-L1, T. gondii surface antigen SAG-1 and IFN-γ genes was quantified using a quantitative real-time PCR (qPCR) assay, and the correlation between PD-1 and IFN-γ expression was examined. In addition, the 12 dpn group, 12 dpi group, 18 dpn group, 18 dpi group, PBS negative control of the 12 pdi group and PBS negative control of the 18 dpi group were assigned, and the PD-1 expression was determined in the uterine and placenta tissues of the pregnant mice.

RESULTS

Adverse pregnant outcomes were seen in mice in the 12 dpi and 18 dpi groups, including placental dysplasia and fetal maldevelopment, and the placental weights and fetal body weights were significantly lower in mice in the 12 dpi and 18 dpi groups than those in the 12 dpn and 18 dpn groups (t = 5.52, 11.44, 12.63 and 11.67, all P < 0.01). The histopathological examinations showed that the decidua and junctional regions of the placental tissues were loosely connected in the 12 dpi and 18 dpi groups, and a large number of inflammatory cells infiltration and congestion were seen in the placental and uterine tissues. qPCR assay detected significant differences in PD-1, PD-L1, IFN-γ and SAG-1 expression in the placental and uterine tissues among the 12 dpn, 12 dpi, 18 dpn and 18 dpi groups (F = 22.48, 51.23, 9.61, 47.49, 16.08, 21.52, 28.66 and 238.90, all P < 0.05), and the PD-1, PD - L1, IFN - γ and SAG - 1 expression was all significantly higher in the placental and uterine tissues of mice in the 12 dpi group than in the 12 dpn group (all P values < 0.05). The PD-1 and PD-L1 expression was significantly lower in the placental tissues of mice in the 18 dpi group than in the 18 dpn group (all P values < 0.05), and the IFN-γ and SAG-1 expression was significantly higher in the placental and uterine tissues of mice in the 18 dpi group than in the 18 dpn group (all P values < 0.05), while the PD-1 and PD-L1 expression was significantly lower in the placental and uterine tissues of mice in the 18 dpi group than in the 12 dpi group (all P values < 0.05). Immunohistochemical staining showed PD-1 expression in the inflammatory cells of the placental tissues of mice in the 12 dpi group, and no apparent PD-1 expression in the 18 dpi group, while strongly positive PD-1 expression was found in the uterine epithelium of mice in the 12 dpi group, and mildly strong expression was in the 18 dpi group. In addition, the IFN-γ mRNA expression was positively correlated with the PD-1 mRNA expression in placental (r_s = 0.99, P < 0.01) and uterine tissues of mice in the 12 dpi group (r_s = 0.97, P < 0.01) and in placental (r_s = 0.82, P < 0.01) and uterine tissues of mice in the 18 dpi group (r_s = 0.81, P < 0.01).

CONCLUSIONS

Following T. gondii infection at early pregnancy, the PD-1 and PD-L1 expression shows a remarkable rise at middle pregnancy and a reduction at late pregnancy in placental and uterine tissues of mice, which appears the same tendency with IFN-γ expression during the same time period, and PD-1 expression positively correlates with IFN-γ expression. The dynamic expression of PD-1 and PD-L1 on the maternal-fetal interface of mice may be mutually mediated by IFN-γ induced by T. gondii infection.