Cerebral Phospho-Tau Acts Synergistically with Soluble Aβ42 Leading to Mild Cognitive Impairment in AAV-AD Rats

BACKGROUND

Alzheimer's disease (AD) is a continuum of events beginning with an increase in brain soluble Aβ42 followed by the appearance of hyperphosphorylated tau (P-tau, asymptomatic stage). Mild Cognitive Impairment (MCI) then appears (prodromal stage). However, the individual contribution of these two soluble proteins in the onset of the first cognitive symptoms remains unclear.

OBJECTIVES

We sought to understand the specific impact of p-tau on the development of MCI in the AAV-AD rat model, a model of late-onset Alzheimer's disease (LOAD) predementia.

METHODS

We specifically reduced the phosphorylation level of tau while leaving Aβ42 levels unchanged using a DYRK1A protein kinase inhibitor, Leucettine L41, in an adeno-associated virus-based Alzheimer's disease (AAV-AD) rat model. Leucettine L41 was administered by intraperitoneal injection at 20 mg/kg per day in AAV-AD rats from 9 (late asymptomatic phase) to 10 (prodromal phase) months of age.

RESULTS

Decreased soluble forms of P-tau induced by chronic administration of Leucettine L41 did not change soluble Aβ42 levels but prevented MCI onset in 10-month-old AAV-AD rats.

CONCLUSIONS

The present study argues that P-tau is required to induce the development of MCI. Consistent with our previous findings that soluble Aβ42 is also required for MCI onset, the data obtained in the AAV-AD rat model confirm that the transition from the asymptomatic to the prodromal stage may be caused by the combined presence of both soluble brain forms of Aβ42 and p-tau, suggesting that the development of MCI may be the consequence of their synergistic action.

Definition of Environmental Variables and Critical Periods to Evaluate Heat Tolerance in Large White Pigs Based on Single-Step Genomic Reaction Norms

Properly quantifying environmental heat stress (HS) is still a major challenge in livestock breeding programs, especially as adverse climatic events become more common. The definition of critical periods and climatic variables to be used as the environmental gradient is a key step for genetically evaluating heat tolerance (HTol). Therefore, the main objectives of this study were to define the best critical periods and environmental variables (ENV) to evaluate HT and estimate variance components for HT in Large White pigs. The traits included in this study were ultrasound backfat thickness (BFT), ultrasound muscle depth (MDP), piglet weaning weight (WW), off-test weight (OTW), interval between farrowing (IBF), total number of piglets born (TNB), number of piglets born alive (NBA), number of piglets born dead (NBD), number of piglets weaned (WN), and weaning to estrus interval (IWE). Seven climatic variables based on public weather station data were compared based on three criteria, including the following: (1) strongest G×E estimate as measured by the slope term, (2) ENV yielding the highest theoretical accuracy of the genomic estimated breeding values (GEBV), and (3) variable yielding the highest distribution of GEBV per ENV. Relative humidity (for BFT, MDP, NBD, WN, and WW) and maximum temperature (for OTW, TNB, NBA, IBF, and IWE) are the recommended ENV based on the analyzed criteria. The acute HS (average of 30 days before the measurement date) is the critical period recommended for OTW, BFT, and MDP in the studied population. For WN, WW, IBF, and IWE, a period ranging from 34 days prior to farrowing up to weaning is recommended. For TNB, NBA, and NBD, the critical period from 20 days prior to breeding up to 30 days into gestation is recommended. The genetic correlation values indicate that the traits were largely (WN, WW, IBF, and IWE), moderately (OTW, TNB, and NBA), or weakly (MDP, BFT, and NBD) affected by G×E interactions. This study provides relevant recommendations of critical periods and climatic gradients for several traits in order to evaluate HS in Large White pigs. These observations demonstrate that HT in Large White pigs is heritable, and genetic progress can be achieved through genetic and genomic selection.

Utilising clinical data to personlaise boundary conditions significantly improves the accuracy of angiography based virtual FFR

Background

Angiography-derived computed (virtual) fractional flow reserve (vFFR) permits the assessment of coronary physiology without the need for a pressure wire or hyperaemia. However, accuracy is limited by assumptions made about coronary microvascular resistance (CMVR) [1]. We hypothesised that machine learning may allow us to “tune” our estimate of the CMVR to increase the accuracy of vFFR.

Purpose

To determine whether routine clinical data can personalise CMVR and improve the accuracy of vFFR on an individual case basis.

Methods

Patients with chronic coronary syndromes underwent coronary angiography with FFR assessment. Vessel-specific CMVR was computed using a 3D- computational fluid dynamics simulation with invasively measured proximal and distal pressures. Predictive models were created using non-linear autoregressing moving average with exogenous inputs (NARMAX) modelling with computed CMVR as the dependent variable. vFFR was computed using previously described methods [2]. Three simulations were run, using: 1) a generic CMVR value (Model A); 2) a NARMAX-predicted CMVR based upon a panel of simple clinical data (Model B); and 3) a NARMAX-predicted CMVR incorporating echocardiographic data (Model C). The diagnostic and quantitative accuracy of each model was compared with directly measured FFR.

Results

Eighty four patients underwent coronary angiography with FFR assessment in 157 vessels. Mean age was 64 (±0.1) years and 64 (76%) were male. Mean FFR was 0.79 (±0.15). Mean CMVR was 1.01e+10 Pa/m3 s–1. vFFR error with Model A was ±0.10, with Model B was ±0.07 (p<0.001) and with Model C was ±0.05 (p<0.001) (Table 1).

Conclusion

vFFR is dependent upon not only the epicardial stenosis, but also the CMVR, estimation of which can be personalised based upon clinical and echocardiographic data. This can be used to increase the accuracy of vFFR.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): British Heart Foundation Clinial Research Training FellowshipNIHR i4i grant Table 1

Maxillary molar root and canal morphology of Neolithic and modern Chinese

OBJECTIVE

This study aimed to characterize Neolithic human maxillary molars from archeological remains at the Jiaojia site, Shandong, China, and compare their ultrastructural features with sex and age-matched modern locals.

DESIGN

Maxillary first (n = 86) and second (n = 80) molars in 5000-year-old individuals (n = 50) from the Jiaojia site were scanned by cone-beam computed tomography (CBCT). Sex and age-matched control groups were assigned from oral surgical patients at Shandong University. Images were analyzed for crown size, root length, root morphology, canal inter-orifice distances, mesiobuccal canal morphology, and second mesiobuccal (MB2) canal prevalence and location. Neolithic and modern values were compared statistically using Chi-squared and Mann-Whitney test at p < .05.

RESULTS

Crown and root size were smaller, and canal inter-orifice distances were shorter in Neolithic maxillary molars than their modern counterparts. For mesiobuccal roots, Weine's Type I single canals were the most prevalent in Neolithic and modern first and second molars. MB2 canal prevalence were not significantly different (p > .05) in Neolithic (53.3%) or modern (60.5%) first molars, and Neolithic (11.3%) or modern (21.3%) second molars. But, MB2 prevalence was significantly higher for modern than ancient male first (p = .032) and second (p = .005) molars. Additionally, MB2 were located more mesially and closer to MB1 in Neolithic than modern molars.

CONCLUSIONS

Maxillary molar root and canal morphology of ancient 5000-year-old remains at the Jiaojia site resemble that of local patients. A trend towards larger tooth size, and more dispersed MB2 canals over this short evolutionary period warrants additional investigation.

[Epidemiological characteristics of adenovirus infection in hospitalized children with acute respiratory tract infection in Kunming during 2019]

Objective: To investigate the epidemiology and clinical characteristics of adenovirus (ADV)-caused acute respiratory tract infection among hospitalized children in Kunming, China. Methods: Clinical and laboratory data were collected from 467 children with adenovirus infection who were hospitalized from January 1, 2019 to December 31, 2019 in 6 grade A class Ⅲ hospitals in Kunming area. The basic characteristics, epidemiology, mixed infection and adenovirus genotypes of the patients were retrospectively analyzed. The patients diagnosed with adenovirus pneumonia (AP) were divided into two groups, severe AP (SAP) group and general AP(GAP) group according to the severity of illness. Mann-Whitney U test or χ² test was used for comparison between groups, while multivariate regression was applied to analyze the risk factors of SAP. Results: Among 15 635 hospitalized children with respiratory tract infection, 467 cases were adenovirus positive, with a detection rate of 2.99%. Of the 467 patients with adenovirus infection, 284 were male and 183 female, the age was 2.4 (1.1,3.9) years, including 44 cases (9.4%) < 0.5 years, 59 cases (12.6%) of 0.5 to<1.0 years, 176 cases (37.7%) of 1.0 to <3.0 years, 150 cases (32.1%) of 3.0 to <7.0 years, and 38 cases (8.1%) of 7.0 to 14.0 years. Adenovirus infection was common in autumn and winter, and the high incidence months were October to December, which accounted for 51.6% (241/467) of the whole year cases. Co-infection was detected in 226 cases (48.4%) out of 467 patients, in which one pathogen co-infection was the most frequent form (172 cases, 76.1%). Of the 262 pathogen detected 108 (41.2%) were Mycoplasma pneumoniae. In 144 of ADV-positve cases (30.8%) were taken geno-typing was done by PCR amplification, the results showed that 74 cases (51.4%) were ADV 3, 7 subtypes and 65 cases (45.1%) of ADV 1, 2,6 subtypes. Of the 467 cases of ADV infection, 320 (68.5%) were diagnosed with pneumonia, 82 (17.6%) with upper respiratory tract infection and pharyngeal tonsillitis, and 65 (13.9%) with bronchitis, laryngeal bronchitis, and asthmatic bronchitis. Among the 320 patients with AP, 56 cases were severe and 264 cases were general. Two cases (3.6%) in severe group died. Compared with the GAP group, the age was young [17 (11,42) months vs. 24 (14,44) months, Z=2.222, P=0.026], the fever duration was long [8 (5,14) days vs. 6 (3,9) days, Z=3.380, P<0.01], and the proportions of preterm birth and having underlying diseases were high [respectively 19.6% (11/56) vs. 6.1% (16/264), 26.8% (15/56) vs. 10.2% (27/264), χ²=8.965,11.109, P<0.05] in SAP group. Referring to laboratory markers, white blood cell count, C-reactive protein, creatine kinase-MB and lactate dehydrogenase were significantly increased in SAP group as compared to GAP group(all P<0.05). Multivariate Logistic regression analysis showed that preterm birth (OR=3.284, 95%CI 1.079-9.993, P=0.036), underlying disease (OR=3.284, 95%CI 1.079-9.993, P=0.036), fever duration ≥10 d (OR=2.523,95%CI 1.195-5.328, P=0.015) and C-reactive protein ≥50 mg/L (OR=3.156, 95%CI 1.324-7.524, P=0.010) were positively correlated with the risk of SAP. Conclusions: The incidence of adenovirus infection among hospitalized children in Kunming was lower than the national level, and no outbreak occurred in 2019. Subtype 3 and 7 of ADV are the predominant strains for infection, which usually occurs in autumn and winter and mainly causes pneumonia. Premature birth, underlining diseases, long fever duration and markedly increased C-reactive protein are the risk factors for developing into severe pneumonia. This paper presents the prevalence and clinical characteristics of adenovirus infection in children at high altitude area.

Differences in growth and vascularization of ectopic menstrual and non-menstrual endometrial tissue in mouse models of endometriosis

STUDY QUESTION

Is there a difference in the growth and vascularization between murine endometriotic lesions originating from menstrual or non-menstrual endometrial fragments?

SUMMARY ANSWER

Endometriotic lesions developing from menstrual and non-menstrual tissue fragments share many similarities, but also exhibit distinct differences in growth and vascularization, particularly under exogenous estrogen stimulation.

WHAT IS KNOWN ALREADY

Mouse models are increasingly used in endometriosis research. For this purpose, menstrual or non-menstrual endometrial fragments serve for the induction of endometriotic lesions. So far, these two fragment types have never been directly compared under identical experimental conditions.

STUDY DESIGN, SIZE, DURATION

This was a prospective experimental study in a murine peritoneal and dorsal skinfold chamber model of endometriosis. Endometrial tissue fragments from menstruated (n = 15) and non-menstruated (n = 21) C57BL/6 mice were simultaneously transplanted into the peritoneal cavity or dorsal skinfold chamber of non-ovariectomized (non-ovx, n = 17), ovariectomized (ovx, n = 17) and ovariectomized, estrogen-substituted (ovx+E2, n = 17) recipient animals and analyzed throughout an observation period of 28 and 14 days, respectively.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The engraftment, growth and vascularization of the newly developing endometriotic lesions were analyzed by means of high-resolution ultrasound imaging, intravital fluorescence microscopy, histology and immunohistochemistry.

MAIN RESULTS AND THE ROLE OF CHANCE

Menstrual and non-menstrual tissue fragments developed into peritoneal endometriotic lesions without differences in growth, microvessel density and cell proliferation in non-ovx mice. Lesion formation out of both fragment types was markedly suppressed in ovx mice. In case of non-menstrual tissue fragments, this effect could be reversed by estrogen supplementation. In contrast, endometriotic lesions originating from menstrual tissue fragments exhibited a significantly smaller volume in ovx+E2 mice, which may be due to a reduced hormone sensitivity. Moreover, menstrual tissue fragments showed a delayed vascularization and a reduced blood perfusion after transplantation into dorsal skinfold chambers when compared to non-menstrual tissue fragments, indicating different vascularization modes of the two fragment types. To limit the role of chance, the experiments were conducted under standardized laboratory conditions. Statistical significance was accepted for a value of P < 0.05.

LARGE SCALE DATA

N/A.

LIMITATIONS, REASONS FOR CAUTION

Endometriotic lesions were induced by syngeneic tissue transplantation into recipient mice without the use of pathological endometriotic tissue of human nature. Therefore, the results obtained in this study may not fully relate to human patients with endometriosis.

WIDER IMPLICATIONS OF THE FINDINGS

The present study significantly contributes to the characterization of common murine endometriosis models. These models represent important tools for studies focusing on the basic mechanisms of endometriosis and the development of novel therapeutic strategies for the treatment of this frequent gynecological disease. The presented findings indicate that the combination of different experimental models and approaches may be the most appropriate strategy to study the pathophysiology and drug sensitivity of a complex disease such as endometriosis under preclinical conditions.

STUDY FUNDING/COMPETING INTEREST(S)

There was no specific funding of this study. The authors have no conflicts of interest to declare.

P–568 Homozygous Pathogenic Variants in ACTL9 Cause Fertilization Failure and Male Infertility in Human and Mouse

Study question

What are the other male factors that cause total fertilization failure (TFF) excepting for variants in PLCZ1?

Summary answer

Homozygous variants in ACTL9 (actin like 9) cause abnormal localization of PLCζ in a loosened perinuclear theca (PT) structure and leads to TFF.

What is known already

In previous studies, investigators have reported that the female factors in TFF after intracytoplasmic sperm injection (ICSI) include pathogenic variants in WEE2, TLE6, and TUBB8, whereas for male factors, pathogenic variants in PLCZ1 were reported to be the primary cause of TFF, which account for approximately 30% of couples with male factors in TFF excluding globozoospermia. Most recently, it was reported that pathogenic variants in ACTL7A led to reduced expression and abnormal localization of PLCζ, thereby identifying this genetic variant as a potential cause of TFF.

Study design, size, duration

Fifty-four infertile couples with TFF or poor fertilization (fertilization rate of &lt; 20%) at the Reproductive and Genetic Hospital of CITIC-Xiangya during January 2014 to June 2020 were recruited into this study.

Participants/materials, setting, methods

Male factors were identified in (MOAT). WES analysis was used to analyze the genetic factors of individuals with male factors. Sperm morphological study was conducted by H&E staining and TEM. Immunostaining of PLCζ was used to analyze the status of sperm-borne activation factor. A knock-in mouse model was generated by CRISPER-Cas9 technology. Sperm from homozygous Actl9 variant mice were analyzed by TEM and ICSI. ICSI with AOA was performed in couples with ACTL9 variants.

Main results and the role of chance

A total of 54 couples with TFF or poor fertilization were screened, with 21 couples determined to have a male infertility factor by MOAT. Whole-exome sequencing of these 21 male individuals identified three homozygous pathogenic variants in ACTL9 in three individuals. ACTL9 variations led to abnormal ultrastructure of the PT, with PLCζ absent in the head and present in the neck of the mutant sperm, which contributed to failed normal calcium oscillations in oocytes and subsequent TFF. The key roles of ACTL9 in the PT structure and TFF after ICSI were further confirmed in Actl9-mutated mouse model. Furthermore, assisted oocyte activation by calcium ionophore exposure successfully overcame TFF and achieved live births in a couple with an ACTL9 variant.

Limitations, reasons for caution

The mechanism of how ACTL9 regulate PLCζ remains unknown.

Wider implications of the findings: It provided a genetic marker and a therapeutic option for individuals who have undergone ICSI without successful fertilization.

Trial registration number

not applioable

The effect of dispatch of national medical teams to Wuhan on its control and prevention of COVID-19

Objectives

As a unique prevention and control measure, the dispatch of national medical teams to Wuhan has played a key role in protecting Wuhan against COVID-19. This study aimed to quantitatively evaluate the effect of this key measure in reducing infections and fatalities.

Study design

A scenario analysis is used in this study, where the forming of scenarios is on the basis of the stages of medical to Wuhan. We divided the evaluation into 4 scenarios: Scenario Ⅰ—no dispatch, Scenario Ⅱ—dispatch of 4599 medical staff, Scenario Ⅲ—dispatch of 16,000 staff, and Scenario Ⅳ—dispatch of 32,000 staff.

Methods

The extended Susceptible-Exposed-Infectious-Recovered-Death model was adopted to quantify the effect of the dispatch of national medical teams to Wuhan on COVID-19 prevention and control.

Results

The dispatch dramatically cuts the channels for the transmission of the virus and succeeds in raising the cure rates while reducing the fatality rates. If there were no dispatch at all, a cumulative total of 158,881 confirmed cases, 18,700 fatalities and a fatality rate of 11.77% would have occurred in Wuhan, which are 3.2 times, 4.8 times and 1.5 times the real figures respectively. The dispatch has avoided 108,541 confirmed cases and 14,831 fatalities in this city.

Conclusions

The proven successful measure provides valuable experience and enlightenment to international cooperation on prevention and control of COVID-19, as well as a similar outbreak of new emerging infectious diseases.

Accurate diagnosis of colorectal cancer based on histopathology images using artificial intelligence

BACKGROUND

Accurate and robust pathological image analysis for colorectal cancer (CRC) diagnosis is time-consuming and knowledge-intensive, but is essential for CRC patients' treatment. The current heavy workload of pathologists in clinics/hospitals may easily lead to unconscious misdiagnosis of CRC based on daily image analyses.

METHODS

Based on a state-of-the-art transfer-learned deep convolutional neural network in artificial intelligence (AI), we proposed a novel patch aggregation strategy for clinic CRC diagnosis using weakly labeled pathological whole-slide image (WSI) patches. This approach was trained and validated using an unprecedented and enormously large number of 170,099 patches, > 14,680 WSIs, from > 9631 subjects that covered diverse and representative clinical cases from multi-independent-sources across China, the USA, and Germany.

RESULTS

Our innovative AI tool consistently and nearly perfectly agreed with (average Kappa statistic 0.896) and even often better than most of the experienced expert pathologists when tested in diagnosing CRC WSIs from multicenters. The average area under the receiver operating characteristics curve (AUC) of AI was greater than that of the pathologists (0.988 vs 0.970) and achieved the best performance among the application of other AI methods to CRC diagnosis. Our AI-generated heatmap highlights the image regions of cancer tissue/cells.

CONCLUSIONS

This first-ever generalizable AI system can handle large amounts of WSIs consistently and robustly without potential bias due to fatigue commonly experienced by clinical pathologists. It will drastically alleviate the heavy clinical burden of daily pathology diagnosis and improve the treatment for CRC patients. This tool is generalizable to other cancer diagnosis based on image recognition.

[Correlation between midpalatal suture stage on cone-beam CT images and its cervical vertebral maturation stage for 1 076 Chinese children and youth]

Objective: To investigate the correlation between cone-beam CT (CBCT) morphological stage of midpalatal suture (MPS) and cervical vertebral maturation stage (CS) of Chinese children and youth. Methods: This study was a retrospective observational study. A total of 1 076 CBCT images (male: 401, female: 675, age≥ 6.0 years old and<21.0 years old) taken from January 2013 to April 2018 in Peking University School and Hospital of Stomatology were included. MPS and CS of each sample were recorded according to previous studies. MPS included five stages: MPS 1, MPS 2, MPS 3, MPS 4s1 (substage), MPS 4s2 (substage), and MPS 5. CS included six stages: CS 1-6. Correlation between MPS and CS (ordinal categorical variables) was investigated by Spearman correlation coefficient and diagnostic test analysis. Results: Spearman coefficient between CS and MPS was 0.803. Diagnostic pairs with the best diagnostic performance include: CS 6-MPS 5, CS 5-MPS 4s2, CS 1-MPS 1, CS 4-MPS 4s1, CS 2-MPS 1, CS 3-MPS 3. The 90.9% (309/340) of individuals at CS 1-3 were at MPS 1-3 and 9.1% (31/340) were at MPS 4s1. The 33.0% (107/324) of individuals at CS 4 were at MPS 3 and 46.6% (151/324) were at MPS 4s1. Conclusions: CS has a close relationship with MPS. Individuals at CS 4 are recommended to take pre-treatment CBCT, so as to estimate feasibility of skeletal expansion with traditional tooth-borne rapid maxillary expansion.

Cell Therapy for Critical Limb Ischemia: Advantages, Limitations, and New Perspectives for Treatment of Patients with Critical Diabetic Vasculopathy

PURPOSE OF REVIEW

To provide a highlight of the current state of cell therapy for the treatment of critical limb ischemia in patients with diabetes.

RECENT FINDINGS

The global incidence of diabetes is constantly growing with consequent challenges for healthcare systems worldwide. In the UK only, NHS costs attributed to diabetic complications, such as peripheral vascular disease, amputation, blindness, renal failure, and stroke, average £10 billion each year, with cost pressure being estimated to get worse. Although giant leaps forward have been registered in the scope of early diagnosis and optimal glycaemic control, an effective treatment for critical limb ischemia is still lacking. The present review aims to provide an update of the ongoing work in the field of regenerative medicine. Recent advancements but also limitations imposed by diabetes on the potential of the approach are addressed. In particular, the review focuses on the perturbation of non-coding RNA networks in progenitor cells and the possibility of using emerging knowledge on molecular mechanisms to design refined protocols for personalized therapy. The field of cell therapy showed rapid progress but has limitations. Significant advances are foreseen in the upcoming years thanks to a better understanding of molecular bottlenecks associated with the metabolic disorders.

Comparative two-dimensional GPC3 overexpressing SK-Hep1 cell membrane chromatography /C18/ time-of-flight mass spectrometry for screening selective GPC3 inhibitor components from Scutellariae Radix

Screening active components targeting membrane proteins is important for drug discovery from traditional Chinese medicine. Cell membrane chromatography (CMC) has achieved a wide application in screening active components on pathological cells due to its high sensitivity and effectiveness. However, it is hard to clarify the specific target protein through simply using pathological and normal cells. In this study, a novel comparative two-dimensional (2D) cell membrane chromatography system was established. Based on the construction of hepatocellular carcinoma cell line SK-Hep1-GPC3 with high expression of protein Glypican-3 (GPC3), SK-Hep1-GPC3/CMC column was loaded to screen selective antitumor components from Scutellariae Radix according to the retention behaviors on column. Viscidulin I was retained on SK-Hep1-GPC3/CMC column, and showed 4.33 μM affinity to GPC3 according to surface plasmon resonance (SPR). The IC₅₀ of viscidulin I on SK-Hep1-GPC3 cells was 18.01 μM in cell proliferation assay. Thus, this method can be applied to screen complex herbal medicines for ligands bound to specific target protein receptor related to hepatic carcinoma.

JAB1 Promotes High Glucose-Induced Inflammation and Extracellular Matrix Deposition in Glomerular Mesangial Cells by Regulating Angiopoietin-Like Protein 2

Diabetic or hyperglycaemic conditions stimulate the inflammatory response, excessive accumulation of extracellular matrix, and result in glomerulosclerosis, a scarring process of diabetic nephropathy. c-Jun activation domain-binding protein 1 (JAB1) functions as a regulator of pathways involved in cellular apoptosis and proliferation. The role of JAB1 in diabetic nephropathy was investigated in this study. Firstly, glomerular mesangial cells (GMCs) were treated with high glucose, and high glucose conditions induced up-regulation of JAB1 in the GMCs. Moreover, IL-6, TNF-α, MCP-1, and IL-1β were also elevated in high glucose-induced GMCs. Secondly, silencing of JAB1 reduced the levels of IL-6, TNF-α, MCP-1, and IL-1β in high glucose-induced GMCs. In addition, silencing of JAB1 attenuated the high glucose-induced decrease of superoxide dismutase (SOD) and the increase of reactive oxygen species (ROS) and malondialdehyde (MDA). The increased TGF-β1, collagen I, collagen IV, and fibronectin levels in high glucose-induced GMCs were restored by knockdown of JAB1. Thirdly, angiopoietin-like protein 2 (ANGPTL2) expression was reduced by JAB1. Over-expression of ANGPTL2 weakened the JAB1 silence-induced decrease of IL-6, TNF-α, MCP-1, IL-1β, TGF-β1, collagen I, collagen IV, and fibronectin. In conclusion, silencing of JAB1 reduced extracellular matrix deposition and suppressed inflammation in high glucose-induced GMCs through down-regulation of ANGPTL2.

Intratumoral interleukin-9 delineates a distinct immunogenic class of gastric cancer patients with better prognosis and adjuvant chemotherapeutic response

Interleukin-9 (IL-9) is a T cell cytokine that is associated with inflammation and allergy, but the expression level of IL-9 in gastric cancer and its clinical significance are less well established. Our study aims to uncover the critical role of IL-9 in the progression of gastric cancer. Here, a total of 453 patients with gastric cancer undergoing curative resection were enrolled for immunohistochemical analyses, and Kaplan-Meier analysis was conducted to compare overall survival of patients in different subgroups. We further investigated the correlation between IL-9 expression and functional status of intratumoral CD8⁺ T cells by means of Flow cytometry. Moreover, in vitro study was preformed to further explore the influence of IL-9 on anti-tumor immunity. Results indicated that gastric cancer patients with high IL-9 expression showed improved overall survival and gained more benefit from 5-fluorouracil-based adjuvant chemotherapy (ACT). High IL-9 expression was associated with increased numbers and elevated function of intratumoral CD8⁺ T cells. In vitro study revealed that recombinant human IL-9 (rhIL-9) exhibit anti-tumor activity via enhancing the function of intratumoral CD8⁺ T cells. Moreover, we found rhIL-9 could augment the efficacy of Pembrolizumab in gastric cancer. In summary, these results suggest that IL-9 expression could act as an independent predictor for overall survival and ACT response and enhancing IL-9 signaling might represent an important therapeutic strategy in gastric cancer.

A stop-flow comprehensive two-dimensional HK-2 and HK-2/CIKI cell membrane chromatography comparative analysis system for screening the active ingredients from Pyrrosia calvata (Bak.) Ching against crystal-induced kidney injury

Crystal-induced kidney injury (CIKI) is the fundamental pathological change during nephrolithiasis, although the molecular mechanism is still unclear. Pyrrosia calvata (Bak.) Ching has been used in folk medicine to treat urolithiasis for years. To clarify the pharmacodynamic substances and the mechanism of its antiurolithiasis effects, in this study, a novel, stop-flow, comprehensive, two-dimensional (2D) HK-2 and HK-2/CIKI cell membrane chromatography (CMC) comparative analysis system was developed to screen for the potential active ingredients from Pyrrosia calvata (Bak.) Ching against CIKI. The comprehensive 2D CMC comparative analysis system showed satisfactory selectivity, and eight ingredients were screened and identified by this system. Among them, mangiferin exhibited higher affinity for the HK-2/CIKI CMC column than the HK-2 CMC column and was selected for further efficacy verification. Cell proliferation assays showed that mangiferin could protect HK-2 cell viability after stimulation with sodium oxalate (NaOX). Additionally, in a rodent model of CIKI, mangiferin decreased the deposition of calcium oxalate (CaOX) crystals in mouse kidneys, alleviated the pathological damage to kidney tissue, and inhibited the upregulation of OPN, MCP1, and CD44 expression caused by CaOX crystals. The established comprehensive 2D CMC comparative analysis system can be applied to screen active ingredients with disease specificity from traditional Chinese medicine (TCM) and is suitable for other cell models.

Exercise stress global longitudinal strain echocardiography can detect subclinical cardiac dysfunction and assist in risk stratification in children with Kawasaki disease: a 3-year follow-up study

Background

Global longitudinal strain (GLS) echo has been regarded as a sensitive and reproducible indicator for detection of subclinical cardiac dysfunction in children with Kawasaki disease (KD), but whether it can assist in differentiating KD patients with different severity of coronary artery lesions (CALs) has been rarely reported. The purpose of this study was to determine the feasibility of GLS derived from rest and exercise stress echo in risk stratification in patients with KD.

Methods

43 children with KD and 50 healthy controls were enrolled. KDs was divided into 3 groups according to the severity of CALs based on Z score, which was measured at the 3-year follow-up, G1 = KD without CALs (Z&lt;2), G2 = KD with mild CALs (2≤Z&lt;5), G3 = KD with severe CALs (Z≥5). Both group underwent echo at the onset of KD diagnosis and at the 3 years' follow-up, including: diameter of LA and LV, thickness of LVPW and IVS, LVFS, LVEF, and rest GLS (GLSrest). Both group also accomplished the exercise stress echo at the 3 years' follow-up, who squatted quickly to reach target heart rate and stress GLS (GLSstress) was recorded. Patients in G3 underwent a CMR examination, including LGE, to detect myocardial ischemia or infarction.

Results

38 KDs and 50 HCs had normal exercise tolerance. There were 18, 8, and 12 patients in G1, G2, and G3, respectively. LA, LV, LVPW, IVS and LVEF, were not significantly different in the KDs at the onset and 3-year follow-up, and so did that between KDs and HCs (all p&gt;0.05). Both GLSrest and GLSstress in the KDs were significantly decreased compared with HCs (GLSrest: −17.2±9.1% vs. −22.3±0.7%, p&lt;0.01; GLSstress: −20.7±3.5% vs. −27.7±0.7%, p&lt;0.01, seen in Fig.1A, B). However, there were no significant difference in GLSrest among 3 subgroups of KDs (G1: −18.0±10.0%; G2: −19.7±1.2%; G3: 14.4±10.4%; all p&gt;0.05, seen in Fig.1C). GLSstress in the G3 decreased significantly compared with that in G1 and G2 (G3 vs. G1: −16.8±2.6% vs. −22.8±1.9%, p&lt;0.01; G3 vs. G2: −16.8±2.6% vs. −22.1±2.5%, p&lt;0.01, seen in Fig. 1D). GLSrest had no correlation with Z score (r=0.08, p=0.62), but GLSstress correlated well with Z score (r=0.70, p&lt;0.01). 8 of 12 (67%) patients in the G3 underwent CMR and 6 of 8 (75%) were found endomyocardial enhancement on LGE, which indicated myocardial infarction corresponding to the territory of abnormal coronary arteries (seen in Fig. 2).

Conclusions

GLS derived from rest and exercise stress speckle-tracking echo can detect subclinical cardiac dysfunction in KD patients with normal LV systolic function by conventional measurements, but rest GLS could not assist in differentiating KD patients with different severity of CALs. Exercise stress GLS, which correlated well with Z score, has the potential in risk stratification in children with KD, and thus may provide prognostic value in multidisciplinary treatment strategy.

Statistics and echo, CMR imaging

Funding Acknowledgement

Type of funding source: None

PHACTR1, a pro-atherosclerotic mechanosensitive PPARgamma corepressor in endothelial cells

Background

Numerous genome-wide association studies revealed that SNPs at phosphatase and actin regulator 1 (PHACTR1) locus are strongly correlated with coronary artery disease (CAD). However, the mechanism linking these variants to CAD remains uncertain.

Purpose

We studied the biological functions and molecular mechanisms of PHACTR1 in atherosclerosis.

Methods and results

Analysis of GTEx database showed that CAD-related SNPs in PHACTR1 are cis-eQTLs for PHACTR1 in arteries. Therefore, we generated Phactr1 knockout mice and crossed them with apolipoprotein E-deficient (ApoE−/−) mice to induce atherosclerosis by high-fat/high-cholesterol (HF-HC) diet. Phactr1 deficiency significantly inhibited atherosclerosis with decreased inflammatory cell infiltration. Western blot showed that PHACTR1 was restricted to endothelial cells (ECs) in mice. Mechanistically, RNAseq of aortic ECs revealed that the major molecular function of PHACTR1 was transcriptional regulation. PPARγ/RXRα was the top transcription factor, and PPARγ target gene expression substantially increased in Phactr1−/− mice. Moreover, we generated endothelial cell specific Phactr1−/−, ApoE−/− mice and found decreased atherosclerotic plaque area in aortic sinus. In vitro, PHACTR1 associated with PPARγ and inhibited PPARγ transcriptional activity. The inhibitory effect of PHACTR1 on PPARγ required its shuttling from cytosol to nucleus triggered by disturbed flow, a well-established pro-atherosclerotic stimulus.

Conclusion

Our results identified PHACTR1 as a mechanosensitive corepressor of PPARγ in ECs to promote atherosclerosis. Endothelial PHACTR1 is a potential therapeutic target for atherosclerosis treatment.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China (NSFC), China Postdoctoral Science Foundation (CPSF)

Rescue of cardiac function in obese type-2 diabetic mice by transfer of a human longevity gene

Background

Healthy longevity is the result of the interaction between favourable environment and unique genetic makeup. We showed that horizontal transfer of a longevity-associated gene variant (LAV-BPIFB4) improves endothelial function and accelerates the recovery from ischemia.

Purpose

To determine if the benefit of LAV-BPIFB4 gene therapy can be extended to diabetic cardiomyopathy.

Methods and results

We confirmed that human diabetic patients with heart failure (n=13) show a decreased cardiac expression of BPIFB4 compared with healthy subjects (n=10). Obese db/db mice received a systemic injection of adeno-associated viral vector (AAV9)-LAV-BPIFB4, AAV9-wild type (WT)-BPIFB4 (both 100 μL at 1×1012 GC/mL) or vehicle before the onset of cardiomyopathy, and were euthanised four weeks later for histological, metabolic and transcriptional analyses. Echocardiographic evaluation (n=8/group), performed at baseline and after gene therapy, showed that LAV-BPIFB4 treatment, despite not resolving hyperglycaemia, improved left ventricular function compared with the other groups. Histological analyses of the hearts (n=5 to 10/group) revealed that LAV-BPIFB4 reduced myocardial fibrosis and increased angiogenesis compared with vehicle and WT-hearts; moreover, LAV increased the expression of the alpha-isoform of the cardiac myosin heavy chain, which is associated with a superior cardiomyocyte contractility. Interestingly, LAV-BPIFB4 treatment induced an increase in cardiac SDF1 expression compared with WT and vehicle, despite the mechanism linking the two events is still unknown. The oral administration of the CXCR4 antagonist AMD-070, given at 2 mg/kg/day for four weeks, abolished several of the beneficial effects exerted by the LAV-BPIFB4 therapy in the obese diabetic mice, as assessed by echocardiography and histology (n=7/group).

At the molecular level, next-generation RNA sequencing (n=3 to 4 /group) showed 8 genes were differentially expressed by LAV-BPIFB4-hearts compared with vehicle-hearts. These genes are associated with mitochondrial and metabolic functions. Among them, changes in the UCP3, HMGCS2, CS, ATPB and TOMM20 expression were also validated at the protein level by western blotting. Lipidomics using ultrahigh-performance liquid chromatography-mass spectrometry (n=6 or 7/group) showed 63 metabolites differentially expressed by LAV-BPIFB4- compared with vehicle-hearts, with only 3 (two cardiolipins and one glycerophospholipid) returning close to the non-diabetic phenotype following LAV-BPIFB4 treatment.

Conclusions

This study newly shows the possibility of transferring the benefit of salutary polymorphic gene variants to protect the cardiovascular system from metabolic pressure. Rather than combating pathogenic mechanisms, the strategy activates alternative pathways overriding disease risk factors.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation project grant “Longevity-associated BPIFB4 gene therapy for treatment of ischemic disease”

Targeting actin-bundling protein L-plastin as an anabolic therapy for bone loss

The actin-bundling protein L-plastin (LPL) mediates the resorption activity of osteoclasts, but its therapeutic potential in pathological bone loss remains unexplored. Here, we report that LPL knockout mice show increased bone mass and cortical thickness with more mononuclear tartrate-resistant acid phosphatase-positive cells, osteoblasts, CD31^hiEmcn^hi endothelial vessels, and fewer multinuclear osteoclasts in the bone marrow and periosteum. LPL deletion impeded preosteoclasts fusion by inhibiting filopodia formation and increased the number of preosteoclasts, which release platelet-derived growth factor-BB to promote CD31^hiEmcn^hi vessel growth and bone formation. LPL expression is regulated by the phosphatidylinositol 3-kinase/AKT/specific protein 1 axis in response to receptor activator of nuclear factor-κB ligand. Furthermore, we identified an LPL inhibitor, oroxylin A, that could maintain bone mass in ovariectomy-induced osteoporosis and accelerate bone fracture healing in mice. In conclusion, we showed that LPL regulates osteoclasts fusion, and targeting LPL serves as a novel anabolic therapy for pathological bone loss.

A nomogram to predict recurrence of RA patients in clinical remission within one year

OBJECTIVE

Some patients with rheumatoid arthritis (RA) will recur despite they have achieved clinical remission after treatment. The subclinical synovitis detected by ultrasonography (US) may be one of the main causes of the RA recurrence. The aim of this study is to establish a nomogram for predicting the outcome of RA patients with disease in clinical remission.

PATIENTS AND METHODS

One hundred and sixty-seven RA patients who achieved clinical remission and were willing to receive a 1-year follow-up were included in this study. Their demographic, clinical, and laboratory characteristics were recorded at baseline. 7-joints ultrasound (US7) synovitis score (simplified from US7 score) were evaluated at baseline and at the end of follow-up (or when RA recurrence confirmed). All patients were divided into recurrence group and non-recurrence group after the follow-up. Multivariable regression was applied to link the predictors that were significant at p < 0.05 in the univariate analysis and the recurrence of RA patients in clinical remission, which was served as the basis of the nomogram.

RESULTS

Fifty-one RA patients were included in the recurrence group and 116 patients in the non-recurrence group. All US7 synovitis scores in this study showed excellent reproducibility. Multivariable analysis revealed that high-titer positive anti-cyclic citrullinated peptide (anti-CCP), simplified clinical disease activity index (SDAI), baseline grayscale ultrasound (GSUS) score, and baseline power Doppler ultrasound (PDUS) score were the independent predictors for RA recurrence within 1 year. A nomogram incorporating the independent predictors was constructed to predict the risk of RA recurrence. The nomogram showed good discrimination (C-index=0.826) and good calibration.

CONCLUSIONS

The nomogram incorporating anti-CCP, SDAI, and subclinical synovitis helps to achieve complete remission and reduces the risk of short-term recurrence of RA patients.

Development of 3-mercaptopropyltrimethoxysilane (MPTS)-modified bone marrow mononuclear cell membrane chromatography for screening anti-osteoporosis components from Scutellariae Radix

Osteoporosis is a bone metabolic disease caused by the imbalance between osteoblasts and osteoclasts due to excess osteoclastogenesis, manifesting in the decrease of bone density and bone strength. Scutellariae Radix shows good anti-osteoporosis activity, but the effective component is still unclear. Cell membrane chromatography (CMC) is a biological affinity chromatography with membrane immobilized on a silica carrier as the stationary phase. It can realize a dynamical simulation of interactions between drugs and receptors on cell membrane, which is suitable for screening active compounds from complex systems. In this study, the components of Scutellariae Radix with potential anti-osteoporosis activity through inhibiting the differentiation from bone marrow mononuclear cells (BMMCs) to osteoclast were screened by a BMMC/CMC analytical system. Firstly, a new 3-mercaptopropyltrimethoxysilane (MPTS)-modified BMMC/CMC stationary phase was developed to realize covalent binding with cell membrane fractions. By investigating the retention time (t_R) of the positive drug, the life span of the MPTS-modified CMC columns was significantly improved from 3 to 12 days. Secondly, 6 components of Scutellariae Radix were screened to show affinity to membrane receptors on BMMCs by a two-dimensional BMMC/CMC–TOFMS analytical system. Among them, tectochrysin demonstrated the best anti-osteoporosis effect in vitro, which has never been reported. We found that tectochrysin could inhibit the differentiation of BMMCs into osteoclasts induced by receptor activator of nuclear factor-κΒ ligand (RANKL) and macrophage colony-stimulating factor (M-CSF) in a concentration-dependent manner in vitro. In vivo, it significantly reduced the loss of bone trabeculae in ovariectomized mice, and decreased the level of C-terminal cross-linking telopeptides of type 1 collagen (CTX-1), tartrate-resistant acid phosphatase 5b (TRAP-5b), interleukin 6 (IL-6) in serum. In conclusion, tectochrysin serves as a potential candidate in the treatment of osteoporosis. The proposed two-dimensional MPTS-modified BMMC/CMC-TOFMS analytical system shows the advantages of long-life span and fast recognition ability, which is very suitable for infrequent cell lines.

Quality assessment of randomized controlled trial abstracts on drug therapy of periodontal disease from the abstracts published in dental Science Citation Indexed journals in the last ten years

Background

Randomized controlled trials (RCTs) provide the highest level of evidence and are likely to influence clinical decision-making. This study evaluated the reporting quality of RCT abstracts on drug therapy of periodontal disease and assessed the associated factors.

Material and Methods

The Pubmed database was searched for periodontal RCTs published in Science Citation Indexed (SCI) dental journals from 2010/01/01 to 2019/07/17. Information was extracted from the abstracts according to a modified Consolidated Standards of Reporting Trials (CONSORT) guideline checklist. The data was analyzed using descriptive statistical analysis and the statistical associations were examined using the linear regression analysis (P <0.05).

Results

This study retrieved 1715 articles and 249 of them were finally included. The average overall CONSORT score was 15.6 ± 3.4, which represented 40.9% (±0.6) of CONSORT criteria filling. The reporting rate of some items (trial design, numbers analyzed, confidence intervals, intention-to-treat analysis or per-protocol analysis, harms, registration) was less than 30%. The adequate reporting rate of some items (participants, randomization, numbers analyzed, confidence intervals, intention-to-treat analysis or per protocol analysis) was no more than 4%. None of the abstracts reported funding. According to the multivariable linear regression results, number of authors (P=0.030), word count (P <0.001), continent (P=0.003), structured format (P <0.001), type of periodontal disease (P <0.001) and international collaboration (P=0.023) have a significant association with reporting quality.

Conclusions

The quality of RCT abstracts on drug therapy of periodontal disease in SCI dental journals remained suboptimal. More efforts should be made to improve RCT abstracts reporting quality.

Key words:Abstracts, RCT, drug therapy, periodontal disease, CONSORT, reporting quality assessment.

Development of quantitative HPTLC methods for dolutegravir, lamivudine, and tenofovir disproxil fumarate in a combination pharmaceutical product using a model process published earlier for transfer of minilab TLC screening methods to HPTLC-densitometry

High-performance thin-layer chromatography (HPLTC)–densitometry methods are described for the analysis of the anti(retro)virals dolutegravir (D), lamivudine (L), and tenofovir disoproxil fumarate (TDF) in a pharmaceutical tablet product. To the best of our knowledge, no previous quantitative planar chromatography method has been reported in the literature for this combination formulation. The method for L was transferred from a thin-layer chromatography (TLC) screening method published in the Global Pharma Health Fund (GPHF) Minilab Manual designed for identification of counterfeit and substandard drug products using a model process published earlier. D and TDF are not included in the list of drugs for which TLC screening methods are published for the Minilab, but HPTLC–densitometry procedures were developed for them using the transfer process guidelines. L was analyzed simultaneously with TDF on Merck Premium Purity silica gel 60 F plates using the mobile phase ethyl acetate–methanol–acetone–concentrated ammonium hydroxide (30:7:3:1) and densitometric scanning at 254 nm. D was analyzed on a second plate by scanning at 366 nm after chromatography with the chloroform–methanol–formic acid (32:8:2) mobile phase. Data for all three drugs are shown to meet the requirements of the model transfer process for calibration curve r values, assay of tablets relative to their label values, peak purity/peak identity tests, and validation by standard addition analysis of samples spiked at 50%, 100%, and 150% of the label value of active ingredients. A TLC screening method for TDF in the combination product was developed and published online with open access.

Covalent Design of Cell Membrane Stationary Phase with Enhanced Stability for Fast Screening P-Glycoprotein Inhibitors

Cell membrane chromatography (CMC) has been widely used for characterizing the interaction between drugs and membrane receptors to screen target components from herbal medicines. However, the column life, stability, and the efficiency cannot meet the needs of high-throughput screening purpose. In this study, a P-glycoprotein immobilized cell membrane stationary phase (P-gp/CMSP) was prepared with a simple and mild two-step aldehyde modification, realizing the covalent bonding between cell membrane and stationary phase. The column life and stability were significantly enhanced compared with the unmodified columns. The P-gp/CMC column was equipped into a comprehensive 2D P-gp/CMC/Capcell-C18/TOFMS system, which actualizes the automated and high-throughput analytical process and rapid identification of complex chemical samples with no data loss. Five compounds with significant retention were screened out and unambiguously identified by the comprehensive 2D analytical system. Baicalin was confirmed as a P-gp inhibitor with ATP depletion inhibition ratio of 83.4%. Moreover, the reversal index of baicalin on DOX significantly increased to 11.13 when its concentration reached 25 μM, revealing that baicalin could effectively reverse the MDR cell model induced by DOX. The integrated system is a practical drug discovery platform and could be applied to other transmembrane protein models.

Neobavaisoflavone inhibits osteoclastogenesis through blocking RANKL signalling-mediated TRAF6 and c-Src recruitment and NF-κB, MAPK and Akt pathways

Psoralea corylifolia (P corylifolia) has been popularly applied in traditional Chinese medicine decoction for treating osteoporosis and promoting fracture healing since centuries ago. However, the bioactive natural components remain unknown. In this study, applying comprehensive two-dimensional cell membrane chromatographic/C18 column/time-of-flight mass spectrometry (2D CMC/C18 column/TOFMS) system, neobavaisoflavone (NBIF), for the first time, was identified for the bioaffinity with RAW 264.7 cells membranes from the extracts of P corylifolia. Here, we revealed that NBIF inhibited RANKL-mediated osteoclastogenesis in bone marrow monocytes (BMMCs) and RAW264.7 cells dose dependently at the early stage. Moreover, NBIF inhibited osteoclasts function demonstrated by actin ring formation assay and pit-formation assay. With regard to the underlying molecular mechanism, co-immunoprecipitation showed that both the interactions of RANK with TRAF6 and with c-Src were disrupted. In addition, NBIF inhibited the phosphorylation of P50, P65, IκB in NF-κB pathway, ERK, JNK, P38 in MAPKs pathway, AKT in Akt pathway, accompanied with a blockade of calcium oscillation and inactivation of nuclear translocation of nuclear factor of activated T cells cytoplasmic 1 (NFATc1). In vivo, NBIF inhibited osteoclastogenesis, promoted osteogenesis and ameliorated bone loss in ovariectomized mice. In summary, P corylifolia-derived NBIF inhibited RANKL-mediated osteoclastogenesis by suppressing the recruitment of TRAF6 and c-Src to RANK, inactivating NF-κB, MAPKs, and Akt signalling pathways and inhibiting calcium oscillation and NFATc1 translocation. NBIF might serve as a promising candidate for the treatment of osteoclast-associated osteopenic diseases.

Effect of rituximab combined with chemotherapy on the expression of serum exosome miR-451a in patients with diffuse large b-cell lymphoma

OBJECTIVE

The aim of this study was to investigate the influence of rituximab combined with chemotherapy on the expression of serum exosome micro ribonucleic acid 451a (miR-451a) in patients with diffuse large B-cell lymphoma (DLBCL), and to explore the possible underlying mechanism.

PATIENTS AND METHODS

89 DLBCL patients (DLBCL group) receiving rituximab combined with chemotherapy were enrolled in this study. Meanwhile, 48 healthy controls (control group) were enrolled as well. Serum samples were collected from all patients before and after treatment, respectively. At the same time, blood samples of healthy people were collected, and serum exosome was extracted. Real-Time fluorescence-quantitative Polymerase Chain Reaction (qRT-PCR) was applied to measure the expression level of serum exosome miR-451a. Receiver operating characteristics (ROC) curve was used to evaluate the diagnostic efficiency of miR-451a. Statistical Product and Service Solutions (SPSS) 22.0 was employed for statistical analysis. Two-sided 95% confidence interval (CI) was used for all tests, and p<0.05 was considered statistically significant.

RESULTS

The expression level of miR-451a in the DLBCL group was significantly lower than that of the control group. The area under the ROC curve (AUC) for the diagnostic efficacy of serum exosome miR-451a for DCBCL was 0.7147. After treatment, the level of serum exosome miR-451a in patients was significantly increased, whereas was still lower than the normal level. The AUC of ROC for evaluating the effect of serum exosome miR-451a in DCBCL was 0.8038.

CONCLUSIONS

Serum exosome miR-451a has moderate diagnostic efficiency for DLBCL. Moreover, miR-451a can act as an indicator for evaluating the efficacy of rituximab combined with chemotherapy in the DLBCL treatment.

Dietary fatty acids and risk of Alzheimer's disease and related dementias: Observations from the Washington Heights-Hamilton Heights-Inwood Columbia Aging Project (WHICAP)

Introduction:

High dietary intake of long chain, polyunsaturated fatty acids is associated with lower Alzheimer’s disease (AD) risk.

Methods:

Washington Heights-Hamilton Heights-Inwood Columbia Aging Project is a multiethnic, prospective observational study of aging and dementia among elderly (≥ 65 years). Dietary intake was measured using a food frequency questionnaire. Dietary short-, medium-, and long-chain fatty acid intakes were categorized by number of carbons and double bonds. Consensus AD diagnoses were made. Associations between AD risk and dietary fatty acid and cholesterol intakes were estimated using multivariable Cox proportional hazards regression models.

Results:

Of 2612 multiethnic women (67%) and men (baseline age 76.3 [6.4] years), 380 developed AD over an average 4.5 years follow-up. Lower risk of AD was associated with increasing intakes of docosahexaenoic acid (DHA; hazard ratio [HR] = 0.73, 95% confidence interval [CI]: 0.57 to 0.95, P = 0.018) and eicosapentaenoic acid (EPA; HR = 0.74, 95% CI: 0.57 to 0.95, P = 0.021), and longer AD-free survival (P < 0.05).

Discussion:

Higher intake of DHA and EPA are protective for AD.

Characterization of CD19+ CD24hi CD38hi B cells in Chinese adult patients with atopic dermatitis

BACKGROUND

Atopic dermatitis (AD) is a chronic inflammatory skin disease. Human interleukin-10⁺ B cells (B10 cells) is one of regulatory B cells and is enriched in CD19⁺ CD24^hi CD38^hi B cells. A little is known about these cells in atopic dermatitis.

OBJECTIVE

To study CD19⁺ CD24^hi CD38^hi B cells and their clinical significance in Chinese adult patients with atopic dermatitis.

METHODS

Thirty-two adult patients with AD and nineteen healthy controls were enrolled. Peripheral blood mononuclear cells (PBMCs) were isolated and stained with fluorescein-conjugated monoclonal antibodies for CD19, CD24, CD27, CD38 and Annexin V. The stained PBMCs were analysed by flow cytometry. B10 cells were prepared by stimulating PBMCs with CpG, LPS and CD40L followed by restimulation with phorbol12-myristate 13-acetate (PMA) and ionomycin. Serum IL-10, B-cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL) levels were measured by using the ELISA. Apoptosis and proliferation of CD19⁺ CD24^hi CD38^hi B cells were measured by flow cytometry. 4/P-signal transducer and activator of transcription 3 (STAT3) and extracellular signal-regulated kinase 1/2 (Erk) phosphorylation were also studied.

RESULTS

The number of CD19⁺ CD24^hi CD38^hi B cells in patients with AD was similar to that in healthy controls. However, B10 cells were decreased in patients with AD. The proportion of B10 cells was negatively associated with blood basophil counts but not associated with disease activity. CD19⁺ CD24^hi CD38^hi B cells from AD patients were more susceptible to apoptosis upon stimulation with CpG, LPS and CD40L. B cells from AD patients showed lower STAT3 and Erk phosphorylation.

CONCLUSIONS

CD19⁺ CD24^hi CD38^hi B cells were unchanged in atopic dermatitis while B10 cells were decreased. The increased B-cell apoptosis, decreased STAT3 and Erk phosphorylation might contribute to these changes.

[Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study]

Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34 ~ 21.15) μmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31 ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) μmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) μmol/L, respectively. Conclusion: The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

Akt2 Affects Periodontal Inflammation via Altering the M1/M2 Ratio

Periodontitis is a bacteria-driven inflammatory destructive disease that leads to attachment loss, bone resorption, and even tooth loss. Accumulating studies revealed that macrophages might play an nonnegligible role during the processes of periodontitis. However, the underlying mechanism remains largely unknown. In this study, we found novel Akt2/JNK1/2/c-Jun and Akt2/miR-155-5p/DET1/c-Jun signaling pathways that regulated the polarization of macrophages and altered periodontal inflammatory status. Through hematoxylin and eosin, immunostaining, and immunofluorescence staining of clinical specimens, a higher number of M1 phenotype macrophage infiltration was found in periodontitis than in normal controls. Flow cytometry and immunofluorescence showed that overexpression of Akt2 in RAW 264.7 cells induced M1 macrophage polarization and decreased M2 polarization, while knockdown of Akt2 exerted an opposite effect. Furthermore, overexpression of Akt2 activated the JNK pathway and then increased the release of proinflammatory mediators, while knockdown of Akt2 downregulated the above genes accordingly. Importantly, the macrophage polarization and the subsequent alteration of pathway molecules induced by overexpression of Akt2 could be rescued by Akt2 and JNK inhibitors. Moreover, JNK inhibition could facilitate M2 polarization of macrophages. In a mouse periodontitis model, the novel signaling pathway as well as clinical phenotype was further verified. Inhibition of Akt2 facilitated macrophage M2 polarization and rescued the bone loss due to periodontitis. Collectively, we identified novel Akt2/JNK1/2/c-Jun and Akt2/miR-155-5p/DET1/c-Jun signaling pathways that regulate macrophage polarization and highlight that Akt2 inhibition promotes M2 polarization of macrophages and can be a novel potential candidate in the treatment of periodontitis.

Guaiacol suppresses osteoclastogenesis by blocking interactions of RANK with TRAF6 and C-Src and inhibiting NF-κB, MAPK and AKT pathways

Angelica sinensis (AS; Dang Gui), a traditional Chinese herb, has for centuries been used for the treatment of bone diseases, including osteoporosis and osteonecrosis. However, the effective ingredient and underlying mechanisms remain elusive. Here, we identified guaiacol as the active component of AS by two‐dimensional cell membrane chromatography/C18 column/time‐of‐flight mass spectrometry (2D CMC/C18 column/TOFMS). Guaiacol suppressed osteoclastogenesis and osteoclast function in bone marrow monocytes (BMMCs) and RAW264.7 cells in vitro in a dose‐dependent manner. Co‐immunoprecipitation indicated that guaiacol blocked RANK‐TRAF6 association and RANK‐C‐Src association. Moreover, guaiacol prevented phosphorylation of p65, p50, IκB (NF‐κB pathway), ERK, JNK, c‐fos, p38 (MAPK pathway) and Akt (AKT pathway), and reduced the expression levels of Cathepsin K, CTR, MMP‐9 and TRAP. Guaiacol also suppressed the expression of nuclear factor of activated T‐cells cytoplasmic 1(NFATc1) and the RANKL‐induced Ca²⁺ oscillation. In vivo, it ameliorated ovariectomy‐induced bone loss by suppressing excessive osteoclastogenesis. Taken together, our findings suggest that guaiacol inhibits RANKL‐induced osteoclastogenesis by blocking the interactions of RANK with TRAF6 and C‐Src, and by suppressing the NF‐κB, MAPK and AKT signalling pathways. Therefore, this compound shows therapeutic potential for osteoclastogenesis‐related bone diseases, including postmenopausal osteoporosis.

Prediction and Visualisation of Bony Impingement for Subject Specific Total Hip Arthroplasty

Bony impingement (BI) may contribute to restricted hip joint motion, and recurrent dislocation after total hip arthroplasty (THA), and therefore, should be avoided where possible. However, BI risk assessment is generally performed intra-operatively by surgeons, which is partially subjective and qualitative. Therefore, the aim of the study was to develop a method for identifying subject-specific BI, and subsequently, visualising BI area on native bone anatomy to highlight the amount of bone should be resected. Activity definitions and subject-specific bone geometries, constructed from CT scans, with planned implants were used as inputs for the method. For each activity, a conical clearance angle (CCA) was checked between femur and pelvis through simulation. Simultaneously, BI boundary and area were automatically calculated using ray intersection and region growing algorithm respectively. The potential use of the developed method was explained through a case study using an anonymised pre-THA patient data. Two pure (flexion, and extension) and two combined hip joint motions (internal and external rotation at flexion and extension respectively) were considered as activities. BI area were represented in two ways: (a) CCA specific where BI area for each activity with different CCAs was highlighted, (b) activity specific where BI area for all activities with a particular CCA was presented. Result showed that BI area between the femoral and pelvic parts was clearly identified so that the pre-operative surgical plan could be adjusted to minimise impingement. Therefore, this method could potentially be used to examine the effect of different preoperative plans and hip motion on BI, and to guide bony resection during THA surgery.

Sitagliptin improves cardiac function after myocardial infarction through activation of autophagy in streptozotocin-induced diabetic mice

OBJECTIVE

The aim of this study was to investigate the protective effect of sitagliptin on cardiac function in mice with diabetes and myocardial infarction (MI), and to explore its possible mechanism using the mouse models of diabetes and MI.

MATERIALS AND METHODS

The models of diabetes and MI were established using C57BL/6 mice. All mice were randomly divided into 5 groups, including the control sham (CS) group, the control MI (CMI) group, the diabetes sham (DS) group, diabetes + MI (DMI) group and the DMI + sitagliptin (DMI+SGL) group. After modeling, mice in the DMI+SGL group were intragastrically administrated with sitagliptin (10 mg/kg/day) for 21 d and the survival rate of mice was recorded. Before and 7, 14, 21 days after MI, the cardiac function of mice in each group was detected via ultrasound. 21 days after MI, the area of MI was measured via 2,3,5-triphenyl tetrazolium chloride (TTC). Meanwhile, the degree of fibrosis in the peripheral region of MI was determined via Masson staining. Moreover, myocardial autophagosomes of mice in each group were observed by transmission electron microscope (TEM). 7 days after MI, the expressions of autophagy-related proteins LC3II and P65 were detected via Western blotting. The expressions of myocardial inflammatory factors, interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) were detected via enzyme-linked immunosorbent assay (ELISA). In addition, the expression of nuclear factor-κB (NF-κB) was also detected via Western blotting.

RESULTS

Sitagliptin increased survival rate, improved cardiac function, reduced infarction area, alleviated myocardial fibrosis, enhanced autophagy in the peripheral region and inhibited inflammation in the peripheral region in mice with diabetes after MI.

CONCLUSIONS

Sitagliptin can improve cardiac function and reduce the mortality rate in diabetic rats after MI. The possible underlying mechanism may be related to the fact that sitagliptin activates autophagy and inhibits inflammatory response in diabetes after MI.

Hematopoietic and lymphatic cancers in patients with periodontitis: a systematic review and meta-analysis

Background

Numerous studies have explored the correlation of periodontal disease (PD) with risk of hematopoietic and lymphatic cancers, but the findings were inconsistent. Therefore, we did a meta-analysis to ascertain the correlation of PD with risk of incident hematopoietic and lymphatic cancers.

Material and Methods

The authors searched relevant studies in databases (PubMed, Web of Science, and MEDLINE). The summary relative risk (RR) along with 95% confidence interval (CI) was calculated by use of random or fixed effects models.

Results

Six studies were included in qualitative synthesis. The pooled analysis revealed that PD was significantly associated with an increased risk of hematopoietic and lymphatic cancers (RR = 1.17; 95% CI = 1.07–1.27; P = 0). Stratified analysis showed the association of PD with hematopoietic and lymphatic cancers remained significant in the never smokers (RR = 1.28; 95% CI = 1.07–1.54; P = 0.007), and in the American population (RR = 1.17; 95% CI = 1.05–1.30; P = 0.003), respectively.

Conclusions

Never smokers population and the American population with PD have a higher risk of developing hematopoietic and lymphatic cancers. PD might be considered as a risk factor for hematopoietic and lymphatic cancers.

Key words:Periodontal disease, hematopoietic and lymphatic cancer, meta-analysis, systematic review.

Characterization of peripheral blood mononuclear cells isolated using two kinds of leukocyte filters

OBJECTIVE

The objective of this study was to compare the activity and biological function of leukocytes isolated using apheresis platelet leukoreduction system chambers (LRSC), whole blood leukoreduction filters (LRF), and leukocytes in unfiltered peripheral whole blood (WB).

METHODS

Peripheral blood mononuclear cells (PBMCs) and granulocytes were obtained by density gradient centrifugation using recovery filters and WB. Flow cytometry was used to detect the activity, phenotype, and apoptosis ratio of each cell subtype.

RESULTS

The proportion of lymphocytes obtained from PBMCs was similar when using the two different filters as compared to traditional isolation; however, there were significant differences between the monocytes and granulocytes. The phenotypic frequency of lymphocytes was similar, but the apoptosis rate of lymphocytes from the two filters was slightly higher. Additionally, monocytes isolated via the three sources were able to be induced into dendritic cells expressing specific molecules; Granulocytes isolated from the LRF showed a lower purity and a higher level of apoptosis than granulocytes isolated from the WB.

CONCLUSION

Compared with WB, the PBMCs isolated from the filters used in our blood center had no statistical difference in their activity and biological function, but they did differ in the proportion and quantity of monocytes and granulocytes. Our results show that the two filters can be used as an alternative method to collect leukocytes, which solves the problem of an insufficient blood supply for clinical and basic science research. Thus, these filters have significant value beyond their practical use in clinics.