Phenotypic analysis of atopic dermatitis in children aged 1-12 months: elaboration of novel diagnostic criteria for infants in China and estimation of prevalence

BACKGROUND

Atopic dermatitis (AD) is the most common skin disorder in infancy. However, the diagnosis and definite significance of infantile AD remains a debated issue.

OBJECTIVE

To analyse the phenotypes of AD in infancy, to establish diagnostic criteria and to estimate the prevalence of this condition in China.

METHODS

This is a multicentric study, in which 12 locations were chosen from different metropolitan areas of China. Following careful and complete history-taking and skin examination, the definite diagnosis of AD was made and the severity based on the SCORAD index was determined by local experienced dermatologists. Based on the detailed phenotyping, the major and representative clinical features of infantile AD were selected to establish the diagnostic criteria and evaluate their diagnostic efficacy.

RESULTS

A total of 5967 infants were included in this study. The overall point prevalence of AD was 30.48%. The infantile AD developed as early as at the second month of life, and its incidence peaked in the third month of life at 40.81%. The proportion of mild, moderate and severe AD was 67.40%, 30.57% and 2.03%, respectively. The most commonly seen manifestations in the infantile AD were facial dermatitis (72.07%), xerosis (42.72%) and scalp dermatitis (27.93%). We established the novel diagnostic criteria of infants, which included: (i) onset after 2 weeks of birth; (ii) pruritus and/or irritability and sleeplessness comparable with lesions; and (iii) all two items above with one of the following items can reach a diagnosis of AD: (i) eczematous lesions distributed on cheeks and/or scalp and/or extensor limbs, and (ii) eczematous lesions on any other parts of body accompanied by xerosis.

CONCLUSIONS

In China, the prevalence of AD in infancy is 30.48% according to clinical diagnosis of dermatologists. The novel Chinese diagnostic criteria for AD in infants show a higher sensitivity and comparable specificity.

[Acceptability of pre-exposure HIV prophylaxis clinical trial among MSM in Shenyang city]

Objective: To investigate the acceptability and related factors of an "on-demand" pre-exposure prophylaxis (PrEP) to prevent HIV transmission among MSM in Shenyang. Methods: MSM recruited by non-probability sampling method and questionnaire survey conducted by investigators to collect information on social and behavioral characteristics, awareness of PrEP, Truvada and the acceptability of two different PrEP-based trials. Multivariate logistic regression was employed for statistical analysis. Results: Among the 292 respondents, 34.2% had heard of PrEP and 58.2% (170/292) reported were interested in participating a PrEP trial- "on-demand" use or 48.3% (141/292) interested on "daily" use (χ(2)=5.785, P=0.02). Factors independently associated with those "on-demand" would include: having more than 2 male sexual partners during the past 6 month (aOR=1.7, 95%CI: 1.1-2.7), concerning on the positive effect of PrEP (vs. side effects) (aOR=6.4, 95%CI:2.2-18.9), having an HIV-infected sexual partners (aOR=8.1, 95%CI: 1.0-63.3) and self-reported high risk for HIV (aOR=2.6, 95%CI: 1.2-6.0). The last two factors were only associated with the "on-demand" group. Conclusions: "On-demand" PrEP (as opposed to daily) seemed a more feasible prevention strategy on HIV and particularly in those having high risk behavior of HIV. For those who could not follow the daily medication or having HIV risk perception, "On-demand" basis PrEP trial should be recommended for them to follow.

[Bibliometric analysis on research hotspots on HIV post-exposure prophylaxis related articles in the world, 2000-2017]

Objective: To analyze and reveal the distribution, research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP), and provide information for related studies in China. Methods: CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017. Results: The average growth rate of international PEP-related papers was 10.78%,and number of published papers in 2016 was highest (n=34), relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk, such as MSM, in recent years. Clustering analysis classified research hotspots into three categories, including risk reduction through enhanced intervention, current status of global HIV PEP and German-Austrian Recommendation. Conclusions: Non-occupational HIV PEP in groups at high-risk, especially MSM, has received increasing attention in recent years, the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication. In the context of severe HIV epidemic in MSM without effective control in China, PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.

HIV incidence is rapidly increasing with age among young men who have sex with men in China: a multicentre cross-sectional survey

OBJECTIVES

The HIV epidemic is worsening among men who have sex with men (MSM) in China, especially among those who are younger than 25 years old [younger MSM (YMSM)]. The aim of the study was to compare the prevalences of HIV incidence and recent HIV infection as well as factors associated with recent HIV infection in YMSM and older MSM (OMSM).

METHODS

A multicentre cross-sectional survey was conducted among 4496 MSM recruited from seven Chinese cities. YMSM were defined as those aged < 25 years. Data on demographics and sexual behaviours were collected using structural questionnaires. Blood samples were tested for recent HIV infection and other sexually transmitted infections.

RESULTS

Among the participants, 1313 were YMSM and 3183 were OMSM. Compared with OMSM, YMSM had a higher prevalence of recent HIV infection [5.4% (71 of 1313) for YMSM vs. 3.6% (115 of 3175) for OMSM; P = 0.006] and a higher HIV incidence [11.8 per 100 person-years (PY) (95% confidence interval (CI) 9.0-14.5) for YMSM vs. 7.6 per 100 PY (95% CI 6.3-9.0) for OMSM]. The incidence increased with age among YMSM, especially between the ages of 16 and 21 years. In contrast, the incidence declined with age among OMSM. Anal bleeding, recreational drug use, syphilis and herpes simplex virus 2 (HSV-2) infection were independent risk factors for recent HIV infection among YMSM. The prevalence of all these risk factors increased with age between the ages of 16 and 21 years. Anal bleeding (19.8%) and recreational drug use (19.5%) had the highest adjusted population attributable fractions (aPAFs) among YMSM. The highest aPAFs of anal bleeding (27.4%) and syphilis infection (25.5%) were found between the ages of 19 and 21 years.

CONCLUSIONS

The HIV incidence in Chinese YMSM was significantly higher than that in OMSM. YMSM aged 16-21 years had an extremely high risk of recent HIV infection.

Dietary pea fibre alters the microbial community and fermentation with increase in fibre degradation-associated bacterial groups in the colon of pigs

This study was attempted to investigate the influence of dietary pea fibre (PF) on the community and quantity of colonic bacteria of piglets and finisher pigs using pyrosequencing data and real-time PCR. The concentration of acetate in colonic digesta from PF-fed piglets was significantly higher than that from control (p < .05). Feeding PF diet to finisher pigs increased the ratio of acetate to total volatile fatty acids (VFAs) but decreased the ratio of butyrate, as compared with the control pigs (p < .05 in both cases). The lower ratio of butyrate in samples from finisher pigs receiving PF suggested that this dietary fibre did not favour butyrate production in the hindgut. Supplementation of PF to piglets reduced abundance of Bacteroidetes, as compared with control animals. However, PF had opposite effects in finisher pigs, higher abundance of Bacteroidetes but lower of Firmicutes. Lactobacillus and Prevotella were found as the predominant genera in PF piglets. Prevotella accounted for nearly half of the total bacteria in the colon of finisher pigs in the PF group, but only one-third in the control animals. Quantitative PCR showed that Firmicutes/Bacteroidetes were significantly increased in the colon of PF piglets (p < .05) as compared with control animals, but decreased in PF finisher pigs. Bacteroidetes-Prevotella-Porphyromonas and Desulfovibrio desulfuricans which are involved in degradation of dietary fibres were more abundant in the PF finisher pigs than in the controls (p < .05), suggesting mutualism between host and its gut microbes.

[Genes Expression in the Early Stage of Acute Renal Ischemia-reperfusion Injury in Rats]

OBJECTIVES

To study the differential genes expression in the early stage of acute renal ischemia-reperfusion injury and explore potential molecular mechanisms.

METHODS

The ischemia-reperfusion model was made via clamping renal artery of rat. The microarray detection and bioinformatics analyzing of the genes expression were performed. Differentially expressed genes were screened and related cellular activities and signaling pathways were analyzed in early stage of acute kidney injury. Meanwhile, molecules closely relative to acute kidney injury were explored by establishing a biological network of the differentially expressed genes, and the results were verified by real-time PCR.

RESULTS

A total of 151 genes showed differential expression in this study, including 132 up-regulated and 19 down-regulated genes. Cell proliferation, cytokines mediated signaling transduction and immune responses were greatly enriched by GO and KEGG analysis. The results of real-time PCR showed that compared with control groups, three selected genes （ANXA1, PHLDA1 and KLF6） which related to the acute kidney injury had an obvious differential expression in the early stage of disease. The multiple of increase was essentially the same as the multiple detected by microarray.

CONCLUSIONS

This study shows differential gene expression profile, related biological processes and signaling pathways involved in the early stage of acute kidney injury. ANXA1, PHLDA1 and KLF6 may play a role in the pathogenesis of acute kidney injury.

Anterior cingulate cortex γ-aminobutyric acid deficits in youth with depression

Abnormally low γ-aminobutyric acid (GABA) levels have been consistently reported in adults with major depressive disorder (MDD). Our group extended this finding to adolescents, and documented that GABA deficits were associated with anhedonia. Here we aimed to confirm our prior finding of decreased brain GABA in youth with depression and explore its associations with clinical variables. Forty-four psychotropic medication-free youth with MDD and 36 healthy control (HC) participants (12-21 years) were studied. Participants represent a combined sample of 39 newly recruited youth (MDD=24) and 41 youth from our previously reported study (MDD=20). GABA levels and the combined resonances of glutamate and glutamine (Glx) were measured in vivo in the anterior cingulate cortex using proton magnetic resonance spectroscopy. Youth with depression exhibited significantly lower GABA levels than HC in both the newly reported (P=0.003) and the combined (P=0.003) samples. When depressed participants were classified based on the presence of anhedonia, only the anhedonic MDD subgroup showed reduced GABA levels compared to HC (P=0.002). While there were no associations between any clinical measures and GABA or Glx levels in the new sample, GABA was negatively correlated with only anhedonia severity in the combined MDD group. Furthermore, in the combined sample, hierarchical regression models showed that anhedonia, but not depression severity, anxiety or suicidality, contributed significant variance in GABA levels. This report solidifies the evidence for a GABA deficit early in the course of MDD, which correlates specifically with anhedonia in the disorder.

Relationships among Cortical Glutathione Levels, Brain Amyloidosis, and Memory in Healthy Older Adults Investigated In Vivo with 1H-MRS and Pittsburgh Compound-B PET

BACKGROUND AND PURPOSE

Oxidative stress has been implicated as an important pathologic mechanism in the development of Alzheimer disease. The purpose of this study was to assess whether glutathione levels, detected noninvasively with proton MR spectroscopy, are associated with brain amyloidosis and memory in a community-dwelling cohort of healthy older adults.

MATERIALS AND METHODS

Fifteen cognitively healthy subjects were prospectively enrolled in this study. All subjects underwent 1H-MR spectroscopy of glutathione, a positron-emission tomography scan with an amyloid tracer, and neuropsychological testing by using the Repeatable Battery for the Assessment of Neuropsychological Status. Associations among glutathione levels, brain amyloidosis, and memory were assessed by using multivariate regression models.

RESULTS

Lower glutathione levels were associated with greater brain amyloidosis in the temporal (P = .03) and parietal (P = .05) regions, adjusted for apolipoprotein E ε4 carrier status. There were no significant associations between glutathione levels and cognitive scores.

CONCLUSIONS

This study found an association between cortical glutathione levels and brain amyloidosis in healthy older adults, suggesting a potential role for 1H-MR spectroscopy measures of glutathione as a noninvasive biomarker of early Alzheimer disease pathogenesis.

Genome-wide association studies of growth traits in three dairy cattle breeds using whole-genome sequence data

Male calves and culled cows of dairy cattle are used for beef production. However, unlike beef breeds, the genetics of growth performance traits in dairy breeds have not been extensively studied. Here, we performed a genome-wide association study (GWAS) on Holsteins ( = 5,519), Jerseys ( = 1,231), and Red Dairy Cattle ( = 4,410) to identify QTL for growth traits. First, a GWAS was performed within breeds using whole-genome sequence variants. Later, a meta-analysis was performed to combine information across the 3 breeds. We have identified several QTL that have large effects on growth traits in Holsteins and Red Dairy Cattle but with little overlap across breeds. Only 1 QTL located on chromosome 10 was shared between Holsteins and Red Dairy Cattle. The most significant variant (BTA10:59,164,533, rs43636323; -value = 2.8 × 10) in this QTL explained 2.4% of the total additive genetic variance in Red Dairy Cattle. The gene is a strong candidate for the underlying gene of this QTL. In Red Dairy Cattle, a QTL near 25 Mb on chromosome 14 was very significantly associated with growth traits, consistent with the previously reported gene , which affects growth in beef cattle and humans. No QTL for growth performance was statistically significant in Jerseys, possibly due to the low power of detection with the small sample size. The meta-analysis of the 3 breeds increased the power to detect QTL.

Temporally controlled B cell depletion with universal chimeric antigen receptor (CAR) T cells for pemphigus vulgaris (PV) therapy

Therapy of PV relies on chronic immunosuppression, which results in significant morbidity. Complete, transient B cell depletion should cure PV, since autoreactive clones do not recur upon regeneration of the B cell repertoire. Engineered CAR T cells (CARTs) are the most potent means for total B cell depletion, but for therapy of autoimmunity, temporal control of CART activity is necessary to prevent lasting immunosuppression. Here we validate 3 novel strategies to control CART survival and function. We combined a B cell targeting CAR with an inducible caspase 9 suicide gene (sCAR), a reverse (constitutively active) suicide gene (revCAR), or a molecular on-switch that permits CAR surface expression (onCAR). sCAR, revCAR and onCARTs showed potent in vitro killing equivalent to conventional CARTs. Activation of the respective regulatory system resulted in in vitro depletion of &gt;95% of sCART and revCARTs and loss of CAR expression in onCARTs. In an in vivo leukemia model, &gt;90% of sCARTs were eliminated (p&lt;0.01) as compared to vehicle treated mice, while preserving their efficacy before suicide gene activation (p&lt;0.001). RevCARTs showed complete loss of leukemia control in vivo in the absence of a suicide-preventing compound (p&lt;0.01), indicating their functional depletion in vivo. Finally, to allow universal (allogeneic) CART therapy, we used CRISPR genome editing to disrupt endogenous T cell receptor and MHCI expression. Universal sCARTs caused total B cell depletion in a humanized allogeneic BLT mouse model (p&lt;0.05) with complete in vivo depletion of sCARTs. In summary, we present 3 novel strategies to regulate CARTs, which provide a platform for curative, universal, and large-scale applications in PV and other autoimmune diseases.