Accuracy of interferon-γ-induced protein 10 for diagnosing latent tuberculosis infection: a systematic review and meta-analysis

BACKGROUND

Effective diagnostic methods for detecting latent tuberculosis infection (LTBI) are important for its eradication. A number of studies have evaluated the use of interferon-γ-induced protein 10 (IP-10), which is elevated after tuberculosis infection, as a biomarker for LTBI, but conclusive results regarding its effectiveness have not been reported.

OBJECTIVES

Our objective was to assess the diagnostic value of IP-10 for LTBI.

DATA SOURCES

We searched the PubMed, Embase, the Cochrane Library and Web of Science databases to find eligible studies.

STUDY ELIGIBILITY CRITERIA

We included cohort, case-control and cross-sectional studies that evaluated IP-10 in LTBI participants in comparison with tuberculin skin tests (TST) and interferon-γ release assays (IGRA).

PARTICIPANTS

Individuals with LTBI and uninfected participants.

INTERVENTIONS

IP-10 (index test) compared with TST and IGRA (reference standard) for diagnosing LTBI.

METHODS

PubMed, Embase, the Cochrane Library, and Web of Science databases were searched up to June 2018. A hierarchical summary receiver operating characteristic (HSROC) model was used to evaluate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and HSROC curve for the diagnostic efficiency of IP-10.

RESULTS

Twelve studies including 1023 participants and 1122 samples were included. The overall pooled sensitivity was 0.85 (95% CI 0.80-0.88), specificity was 0.89 (95% CI 0.84-0.92), PLR was 7.55 (95% CI 5.20-10.97), NLR was 0.17 (95% CI 0.13-0.22) and DOR was 44.23 (95% CI 28.86-67.79), indicating a high accuracy for diagnosing LTBI. Based on a meta-regression analysis, high-burden countries, study design, IP-10 method, reference standard and the IP-10 cut-off could not explain the heterogeneity (p >0.05).

CONCLUSIONS

Our results suggested that IP-10 is a promising biomarker for the diagnosis of LTBI.

Administration of activated lymphocyte-derived DNA accelerates and aggravates lupus nephritis in B6/lpr mice: a new approach to modify a lupus murine model

B6/lpr mouse strain is a well-known systemic lupus erythematosus murine model characterized by uncontrolled lymphoproliferation and autoantibody production. However, it displays a delayed and mild development of lupus nephritis (LN), which is not conducive to the research of the pathogenesis and therapeutic strategies of this condition. Our previous study demonstrated that activated lymphocyte-derived DNA (ALD-DNA) could induce high urine protein levels and severe glomerulonephritis (GN) in BALB/c mice. In the present study, we tried to remedy delayed urine protein production and mild GN in B6/lpr mice via ALD-DNA immunization. We found that urine protein levels were enhanced significantly in B6/lpr mice 4 weeks after ALD-DNA immunization compared with those in unactivated lymphocyte-derived (UnALD)-DNA- and phosphate-buffered saline (PBS)-treated controls. Moreover, more serious GN and glomerular immune complex were observed in ALD-DNA-immunized B6/lpr mice. We further explored the mechanism, and found that ALD-DNA immunization promoted T helper type 17 (Th17) cell enrichment remarkably, which enhanced the proportion of autoantibody-secreting plasma cells and promoted the production of anti-dsDNA autoantibodies, leading to accelerated and aggravated LN. Our data demonstrated that ALD-DNA immunization could remedy delayed urine protein production and mild GN in B6/lpr mouse, which makes it more suitable for studies on the pathogenesis of and therapeutic strategies against LN.

Pretreatment Predictors of Early Response Revealed by Quantitative Cerebral Blood Flow in Major Depressive Disorder

Objective

The potential pattern of regional cerebral blood flow (rCBF) in major depressive disorder (MDD) underlies different response to antidepressants medication remain unclear. This study aimed to investigate the differences of rCBF between patients with different treatment response.

Methods

Eighty MDD patients [(44 treatment-responsive depression (RD) and 36 non-responding depression (NRD)] and 42 healthy controls (HC) underwent pulsed arterial spin labeling (PASL) scans in magnetic resonance imaging and clinical estimates. The exact rCBF values of each groups were obtained via quantification evaluation.

Results

Compared to NRD, the RD patients showed decreased rCBF values in frontal sensorimotor network (i.e. left paracentral lobule, left medial frontal gyrus, right superior frontal gyrus and right middle frontal gyrus), and further receiver operating curve (ROC) analyses demonstrated that the altered rCBF in these four regions exhibited outstanding performance on distinguishing NRD from RD. The NRD also exhibited reduced rCBF in bilateral cerebellum posterior lobe and right middle occipital gyrus and elevated rCBF in right postcentral gyrus and right middle frontal gyrus as compared to HC.

Conclusions

The decreased rCBF in frontal sensorimotor network appeared to be distinct characteristics for NRD, and might be severed as promising neuroimaging markers to differentiate depressed patients with weak early response to antidepressant medication. These findings expand our understanding of neural substrate underlying the antidepressant efficacy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

[The value of different antibodies detection in diagnosis of rheumatism with uveitis]

Objective: To investigate the value of HLA-B27 antigen, antinuclear antibody (ANA), anti-dsDNA and Anti-Neutrophil Cytoplasmic Antibodies (ANCA) detection in diagnosis of rheumatism with uveitis. Methods: Seven hundred and twenty four newly diagnosed patients with non-infection uveitis in Beijing Tongren Hospital from March 2012 to March 2016 who long-term lived in Beijing and its surrounding areas were continuously enrolled. HLA-B27 antigen expressions in peripheral blood lymphocytes and ANA, anti-dsDNA and ANCA levels in serum were tested. The detailed clinical data, imaging examinations and pathological examinations were recorded to define whether the patients had rheumatism and the types of rheumatism. Results: There were 285 patients were diagnosed with rheumatism in 724 patients (39.4%), with 135 male (47.4%) and 150 female (52.6%). The mean age of male (41±14) was lower than that of female (44±14), with statistically significant (t=2.18, P<0.05). There were 176 patients with Spondyloarthropathies, 48 patients with primary systemic vasculitis, 22 patients with systemic lupus erythematosus, 18 patients with primary Sjogren's syndrome, 16 patients with rheumatoid arthritis and 5 patients with juvenile idiopathic arthritis in 285 rheumatism patients. The positive rate of HLA-B27(57.2%), ANA(15.8%), anti-dsDNA (5.3%) and ANCA(9.1%) in rheumatic uveitis patients were obviously higher than those of non-rheumatic uveitis patients [HLA-B27(1.1%), ANA(1.6%), anti-dsDNA (0.0%) and ANCA(0.9%)], with statistically significant (Fisher's exact test, P<0.01). The HLA-B27 positive antigen were mainly in patients with Spondyloarthropathies, rate was 92.1%; the positive ANA were mainly in patients with systemic lupus erythematosus, rate was 95.5%; the positive anti-dsDNA were mainly in patients with systemic lupus erythematosus, rate was 59.1%; the positive ANCA were mainly in patients with primary systemic vasculitis (besides Behcet disease), rate was 57.1%. Conclusions: The detections of HLA-B27 antigen, ANA, anti-dsDNA and ANCA are valuable for primary screening of some rheumatic uveitis. There fore, clinicians should select targeted laboratory examination combine with the patients' clinical manifestations. This will be helpful in the auxiliary diagnosis of some types of rheumatic uveitis.

Celastrol inhibits inflammatory stimuli-induced neutrophil extracellular trap formation

Neutrophil extracellular traps (NETs) are web-like structures released by activated neutrophils. Recent studies suggest that NETs play an active role in driving autoimmunity and tissue injury in diseases including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The purpose of this study was to investigate if celastrol, a triterpenoid compound, can inhibit NET formation induced by inflammatory stimuli associated with RA and SLE. We found that celastrol can completely inhibit neutrophil oxidative burst and NET formation induced by tumor necrosis factor alpha (TNFα) with an IC50 of 0.34 µM and by ovalbumin:anti-ovalbumin immune complexes (Ova IC) with an IC50 of 1.53 µM. Celastrol also completely inhibited neutrophil oxidative burst and NET formation induced by immunoglobulin G (IgG) purified from RA and SLE patient sera. Further investigating into the mechanisms, we found that celastrol treatment downregulated the activation of spleen tyrosine kinase (SYK) and the concomitant phosphorylation of mitogen-activated protein kinase kinase (MAPKK/MEK), extracellular-signal-regulated kinase (ERK), and NFκB inhibitor alpha (IκBα), as well as citrullination of histones. Our data reveals that celastrol potently inhibits neutrophil oxidative burst and NET formation induced by different inflammatory stimuli, possibly through downregulating the SYK-MEK-ERK-NFκB signaling cascade. These results suggest that celastrol may have therapeutic potentials for the treatment of inflammatory and autoimmune diseases involving neutrophils and NETs.

Effects of tail docking on the expression of genes related to lipid metabolism in Lanzhou fat-tailed sheep

To evaluate stearoyl-CoA desaturase (SCD), hormone-sensitive lipase (HSL), lipoprotein lipase (LPL), and peroxisome proliferator-activated receptor (PPARγ) expression in Lanzhou fat-tailed sheep (with and without docked tails), 18 rams were randomly divided into two equal groups (docked group, LT; control group, LC). These data were also used to increase the understanding of sheep fat deposition and metabolism. All animals were harvested at the age of 18 months, and expression was determined for 10 tissues. The results indicated that the fat weight of each tissue in LT was higher than in LC (P < 0.05). SCD expression in semitendinosus, omentum majus fat (OF), subcutaneous fat, kidney fat (KF), and subcutaneous rump fat was higher in LT than in LC rams (P < 0.05). Trends (P < 0.10) associated with higher HSL expression of LC in comparison to that of LT rams in intestinal fat, OF, and KF tissues were detected. Numerically, LPL expression was the highest in KF, OF, and kidney tissues, but there were few differences (P > 0.10). PPARγexpression was greater in LT than in LC rams in liver tissues (P < 0.05), but there were few differences in other tissues. No significant differences were found with regard to the regression analysis of expression and adipose tissue weights, but the two indices exhibited the same trend. The results indicated that changes in fatty deposits may be due to the common control of docking management and the minor effects associated with the regulation of SCD, HSL, LPL, and PPARγexpression.

Prevalence and associated factors of myopia among primary and middle school-aged students: a school-based study in Guangzhou

PurposeTo estimate the prevalence of myopia among primary and middle school-aged students in Guangzhou and to explore the potentially contributing factors to myopia.MethodsThis cross-sectional study was based on a sample of students in grades 1-6 and grades 7-9. Data were collected from refractive error measurements and a structured questionnaire.ResultsA total of 3055 participants were involved in this analysis, and the overall prevalence of myopia was 47.4% (95% confidence interval (CI)= 45.6-49.2%). The prevalence of myopia in students increased along with the growth of grade level; the prevalence of myopia in students in grade 1 was only 0.2%, as it increased to 38.8% in students in grade 3, and the rate was the highest (68.4%) in students in grade 9. Girls were at a higher risk of myopia than boys (adjusted odds ratio=1.22, 95% CI=1.04-1.44). Both male and female students whose distance of reading was longer than 25 cm were less likely to have myopia and who have one or two myopic parents were at a higher risk of myopia. In addition, reading for pleasure more than 2 h per day (adjusted odds ratio=1.84, 95% CI=1.09-3.12) was only positively associated with myopia in boys and spending time watching television per week was only positively associated with myopia in girls.ConclusionMyopia in students is a significant public health problem in Guangzhou. Female gender, higher grade, longer time spent for near work, shorter distance of near work, and parental myopia were shown to be associated with the increasing risk of myopia in children.

Association analysis of imbalanced interhemispheric functional coordination and early therapeutic efficacy in major depressive disorder: Evidence from resting state fMRI

Introduction

Emerging evidences indicate that the alteration of interhemispheric functional coordination may be involved in the pathogenesis of major depressive disorder (MDD). In present study, we aim to explore the potential marker by using the voxel-mirrored homotopic connectivity (VMHC) approach, which may be contributing to predict the clinical prognosis in MDD.

Methods

Eighty-two MDD patients and 50 normal control (NC) subjects participated in this study. We divided the MDD group into unremitted and remitted group according to the reduction rate of Hamilton Rating Scale for Depression (HAMD) within 2 weeks.

Results

The study detected significantly decreased VMHC in bilateral precuneus (pCu), inferior temporal gyrus (ITG) and increased VMHC in middle frontal gyrus (MFG) and caudate nucleus when compared remitted depression (RD) group to unremitted depression (URD) group. Meanwhile, when compared with NC group, the URD group presented reduced VMHC in bilateral cerebellum anterior lobe, thalamus and postcentral gyrus. Furthermore, the VHMC in media frontal gyrus, postcentral gyrus and precentral gyrus were significantly decreased in RD group. Correlation analysis suggested that reduced VMHC in bilateral pCu was negatively correlated with the baseline HAMD score of URD (r = −0.325, P = 0.041). Receiver operating characteristic (ROC) curve indicated that three regional VMHC changes could identify depressed patient with poorer treatment response: ITG [area under curve (AUC) = 0.699, P = 0.002, 95% CI = 0.586–0.812], MFG (AUC = 0.692, P = 0.003, 95% CI = 0.580–0.805), pCu (AUC = 0.714, P = 0.001, 95% CI = 0.603–0.825).

Conclusion

The current study combined with previous evidence indicates that the subdued intrinsic interhemispheric functional connectivity might represents a novel neural trait involved in the pathophysiology of MDD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Decreased interhemispheric functional coordination underlying the cognitive impairment in late-onset depression

Background

The intuitive association between cognitive dysfunction in late onset depression (LOD) and the aberrant functional activity in the brain's default-mode network (DMN) has prompted interest in exploring the role of the DMN in LOD. The altered pattern of resting state voxel-mirrored homotopic connectivity (VMHC) in cognitive processes is not yet well understood in LOD.

Methods

The study was designed to examine the implicit coupling between the alteration of interhemispheric functional coordination and cognitive impairment in LOD. Thirty-one LOD patients and 37 matched healthy controls (HC) underwent neuropsychological tests and functional magnetic resonance imaging (fMRI) in this study.

Results

Compared to HC group, attenuated VMHC in superior frontal gyrus, superior temporal gyrus, posterior cerebellar lobe, postcentral and precentral gyrus was observed in LOD. Neuro-behavioral relevancy approach revealed that the imbalanced interhemispheric functional coordination in bilateral cerebellum was positively correlated with the performance of trail making test in LOD (r = 0.367, P = 0.040).

Conclusion

Altered linkage pattern of intrinsic homotopic connectivity and cognition was firstly investigated in LOD, and it would provide a novel clue to reveal the neural substrates underlying the cognitive dysfunction in LOD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Abstract P5-01-03: Stratifying triple-negative breast cancer prognosis using 18F-FDG-PET/CT imaging

Introduction: Triple-negative breast cancer (TNBC) is a highly diverse group of cancers, and may benefit from molecular-targeted therapies. This study aims to stratify prognosis of TNBC patients using pre-treatment 18F-FDG PET/CT, alone and with correlation to immunohistochemistry biomarkers.

Method: 200 consecutive TNBC breast cancer patients treated between 2008 and 2012 who received lumpectomy or mastectomy as primary treatment were retrieved. Among the full cohort, 79 patients had pre-treatment 18F FDG PET/CT scans. Immunostaining status (percentage and intensity) of basal biomarkers (EGFR, CK5/6), Ki-67, P53, and other clinicopathological variables (age, tumor size, pathological T/N stage, nuclear grade, and lymph node metastasis) were obtained. Three PET image features were evaluated: maximum uptake values (SUVmax), mean uptake (SUVmean) and target volume (SUVvol) defined by SUV&gt;2.5. The relationships among tumor metabolic activities and clinicopathological factors were evaluated. All variables were analyzed versus disease-free survival (DFS) using univariate and multivariate Cox analysis, Kaplan-Meier curves and log-rank tests. The optimal cutoff points of variables were estimated using time-dependent survival receiver operating characteristic (ROC) analysis.

Results: All PET features significantly correlated with proliferation marker Ki-67 (all p&lt;0.010). SUVmax stratified the prognosis of TNBC patients with optimal cutoff derived by ROC analysis (≤3.5 vs &gt;3.5, AUC=0.654, p=0.006). Basal biomarkers EGFR and CK5/6 and image features SUVmax, SUVmean, SUVvol were significant associated with DFS in univariate Cox analysis, whereas SUVmax (p=0.001) and EGFR (p=0.001) were also significant in multivariate Cox analysis. To integrate prognosis of biological and imaging markers, patients were first stratified by EGFR into low (≤15%) and high (&gt;15%) risk groups. Further, SUVmax was used as a variable to stratify the two EGFR groups. In the high EGFR group, patients with high FDG uptake (SUVmax&gt;3.5) had worse survival outcome (median DFS=7.6 months) than those patients with low FDG uptake (SUVmax≤3.5, median DFS=11.6 months). In the low EGFR group, high SUVmax also indicated worse survival outcome (17.2 months) than low SUVmax (22.8 months). The risk stratification with integrative EGFR and PET was statistically significant with log-rank p&lt;&lt;0.001.

Multivariate Cox analysis for disease-free survivalVariablesHR (95% CI)p-valuePathology, T stage, ≤ 3 vs &gt;32.337(0.428-7.384)0.148EGFR, ≤15% vs &gt; 15%9.109(1.997-41.55)0.004CK5/6, ≤ 50% vs &gt; 50%1.471(0.598-3.614)0.401SUVmax, ≤3.5 vs &gt; 3.53.883(1.13-13.32)0.031

TNBC patient risk groups stratified by EGFR and SUVmax (with the median values of variables)Risk groups (EGFR&gt;15, SUVmax&gt;3.5)patient#DFS monthsEGFR %SUVmaxSUVmeanSUVvolKi-67%1 (-, -)1222.852.00.60.2342 (-, +)1517.258.94.37.2673 (+, -)1311.6502.72.60.9354 (+, +)377.66011.35.210.960

Conclusions: Pre-treatment 18F-FDG PET/CT imaging has significant prognostic value for predicting survival outcome of TNBC patients. Integrated with basal-biomarker EGFR, PET imaging can further stratify patient risks in the pre-treatment stage, and help select appropriate treatment strategies for individual patients.

Citation Format: Yue Y, Cui X, Bose S, Audeh W, Zhang X, Fraass B. Stratifying triple-negative breast cancer prognosis using 18F-FDG-PET/CT imaging. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-01-03.

Abstract P3-12-13: Radiation enhancement with cysteine coated platinum nanoparticles

Background: Radiation is the current choice treatment for non-operable metastatic breast-brain cancer. When cancer lesions are located in sensitive areas like the brain or have excessive amounts of metastatic sites, radiation usually proves to be a more viable option than excision. Ionizing (X-ray and gamma) radiation is non-selective and affects all the tissue it penetrates. In order to concentrate the dose on tumors, high energy radiation from multiple directions is typically used, reaching the highest dose where the radiation crosses. This type of multiple angle treatment minimizes the dose to normal tissue by increasing overall normal tissue irradiation. The objective is to achieve sufficient radiation in the tumor tissue to cause the DNA strands to break and to disrupt the reproduction and maintenance of cancer cells while keeping the damage to normal tissue in a reasonable range for tissue preservation.

Metal nanoparticles have shown promising results for reinforcing the radiation dose effect. High atomic number (Z) elements absorb a greater amount of radiation because the higher density raises the probability of interaction. The metal nanoparticles interact with the energy of the ionizing radiation by either scattering or absorbing, or accumulating the energy, thus increasing the number of DNA strand breaks in the nucleus of cells.

Methods: Four breast cancer cell lines (BT-474, MDA-231, BT-549 and MCF-7) were incubated with 1-2 nm platinum nanoparticles (0-1000 μg/mL) produced with a cysteine coating. 24 hours later cells were exposed to 2 Gy radiation with a C-arm (Toshiba Infinix VF-i/SP) using 125 KVP to deliver a spectrum of KeV low energy X-rays. After 24 hours the cells were washed and analyzed using a bioluminescence assay to assess cell proliferation based on ATP production.

Results: Of the four cell lines tested the BT-474 and BT-549 demonstrated limited reduction in cell proliferation at up to the highest treatment concentration 1000 μg/mL with no radiation exposure. As a result of the limited toxicity of the platinum nanoparticles the effect from increased radiation can be more readily observe when 2 Gy radiation is added resulting a in platinum nanoparticle dose dependent decrease in proliferation in the BT-474 cell line.

Nanoparticle Toxicity Concentration of Platinum Nanoparticles (μ/mL) 02505007501000MDA-2311.000±0.0050.995±0.0120.974±0.0130.979±0.0140.777±0.014BT-5491.000±0.0131.003±0.0091.003±0.0170.969±0.0170.894±0.009MCF-71.000±0.0140.960±0.0150.927±0.0220.851±0.0220.769±0.032BT-4741.000±0.0240.961±0.0290.957±0.0330.965±0.0630.985±0.065Table 1: Indexed values for cell proliferation for the BT-474 cell

Radiation Toxicity Concentration of Platinum Nanoparticles (μ/mL) 02505007501000*0 Gy1.000±0.0240.961±0.0290.957±0.0330.965±0.0630.985±0.0652 Gy1.027±0.0380.966±0.0230.908±0.0340.870±0.0310.799±0.037Table 2: Indexed values for cell proliferation for the BT-474 cell line 0 and 2 Gy radiation doses, 6 averages. * Student T-TEST P&lt;0.05

Conclusions: At moderate doses of low energy radiation, a reduction in cell proliferation can be detected. This data supports follow-up experiments to add a targeting protein to facilitate uptake by cancer cells based on cell receptor expression. Experiments are current being done to utilize the HER2+ cell receptor upregulation to increase internalization of the particles to achieve a greater effect.

Citation Format: Wagner S, Yue Y, Cui X, Zhang G, Bingchen H, Li D, Medina-Kauwe L. Radiation enhancement with cysteine coated platinum nanoparticles. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-12-13.