Clinical Characteristics and Short-Term Outcomes of Acute Kidney Injury Missed Diagnosis in Older Patients with Severe COVID-19 in Intensive Care Unit

OBJECTIVES

Patients with severe or critical COVID-19 are at higher risk for developing acute kidney injury (AKI). However, whether AKI is diagnosed in all the patients and the correlation between the outcomes of COVID-19 are not well understood.

PATIENTS AND METHODS

This cohort study was conducted from February 4, 2020 to April 16, 2020 in Wuhan, China. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. AKI was defined according to the KDIGO 2012 criteria. The outcomes of patients with and without AKI and whether AKI was or was not recognized were compared.

RESULTS

A total of 107 elderly patients were included in the final analysis. The median age was 70 (64-78) years, and 69 (64.5%) were men. Overall, 48 of 107 patients (44.9%) developed AKI during hospitalization. Meanwhile, 22 (45.8%) cases with AKI was not recognized (missed diagnosis) in this cohort. The Kaplan-Meier curves showed that survival was better in the non-AKI group than in the AKI group (log-rank, all P < 0.001); in the subgroups of the patients with AKI, the hospital survival rate decreased when AKI was not recognized. The survival of patients with recognized AKI was better than that of patients with unrecognized AKI (log-rank, all P < 0.001). According to the multivariate regression analysis, the independent risk factors for in-hospital mortality were AKI (recognized AKI vs non-AKI: HR = 2.413; 95% CI = 1.092-5.333; P = 0.030 and unrecognized AKI vs non-AKI: HR = 4.590; 95% CI = 2.070-10.175; P <0.001), C-reactive protein level (HR = 1.004; 95% CI = 1.000-1.008; P = 0.030), lactate level (HR = 1.236; 95% CI = 1.098-1.391; P < 0.001), and disease classification (critical vs severe: HR = 0.019; 95% CI = 1.347-26.396; P = 5.963).

CONCLUSIONS

AKI is not an uncommon complication in elderly patients with COVID-19 who admitted to ICU. Extremely high rates of underdiagnosis and undertreatment of AKI have resulted in an elevated in-hospital mortality rate. Kidney protection is an important issue that cannot be ignored, and intensive care kidney specialists should take responsibility for leading the battle against AKI.

The clinical characteristics and prognosis of COVID-19 patients with cerebral stroke: A retrospective study of 113 cases from one single-centre

To explore the clinical characteristics and prognosis of COVID‐19 patients with cerebral stroke. A total of 2,474 COVID‐19 patients from February 10th to March 24th, 2020 were admitted and treated in two branches (Optic Valley and Sino‐French New City branch) of the Tongji Hospital. Data on the clinical characteristics, laboratory parameters and prognosis of COVID‐19 patients with or without cerebral stroke were collected and comparatively analysed. Of the 2,474 COVID‐19 patients, 113 (4.7%) patients had cerebral stroke and 25 (1.0%) patients had new‐onset stroke. Eighty‐eight (77.9%) patients in the previous‐stroke group had cerebral ischaemia, while 25 (22.1%) patients in the new‐onset stroke group had cerebral ischaemia. Most COVID‐19 patients with stroke were elderly with more comorbidities such as hypertension, diabetes and heart diseases than patients without stroke. Laboratory examinations showed hypercoagulation and elevated serum parameters such as IL‐6, cTnI, NT pro‐BNP and BUN. Consciousness disorders, a long disease course and poor prognosis were also more commonly observed in stroke patients. The mortality rate of stroke patients was almost double (12.4% vs. 6.9%) that of patients without stroke. In addition, age, male sex and hypertension were independent predictors for new cerebral stroke in COVID‐19 patients. In conclusion, the high risk of new‐onset stroke must be taken into consideration when treating COVID‐19 patients with an elderly age combined with a history of hypertension. These patients are more vulnerable to multiorgan dysfunction and an overactivated inflammatory response, in turn leading to an unfavourable outcome and higher mortality rate.

Multimodal MRI staging for tracking progression and clinical-imaging correlation in sporadic Creutzfeldt-Jakob disease

Diffusion imaging is very useful for the diagnosis of sporadic Creutzfeldt-Jakob disease, but it has limitations in tracking disease progression as mean diffusivity changes non-linearly across the disease course. We previously showed that mean diffusivity changes across the disease course follow a quasi J-shaped curve, characterized by decreased values in earlier phases and increasing values later in the disease course. Understanding how MRI metrics change over-time, as well as their correlations with clinical deficits are crucial steps in developing radiological biomarkers for trials. Specifically, as mean diffusivity does not change linearly and atrophy mainly occurs in later stages, neither alone is likely to be a sufficient biomarker throughout the disease course. We therefore developed a model combining mean diffusivity and Volume loss (MRI Disease-Staging) to take into account mean diffusivity's non-linearity. We then assessed the associations between clinical outcomes and mean diffusivity alone, Volume alone and finally MRI Disease-Staging. In 37 sporadic Creutzfeldt-Jakob disease subjects and 30 age- and sex-matched healthy controls, high angular resolution diffusion and high-resolution T1 imaging was performed cross-sectionally to compute z-scores for mean diffusivity (MD) and Volume. Average MD and Volume were extracted from 41 GM volume of interest (VOI) per hemisphere, within the images registered to the Montreal Neurological Institute (MNI) space. Each subject's volume of interest was classified as either "involved" or "not involved" using a statistical threshold of ± 2 standard deviation (SD) for mean diffusivity changes and/or -2 SD for Volume. Volumes of interest were MRI Disease-Staged as: 0 = no abnormalities; 1 = decreased mean diffusivity only; 2 = decreased mean diffusivity and Volume; 3 = normal ("pseudo-normalized") mean diffusivity, reduced Volume; 4 = increased mean diffusivity, reduced Volume. We correlated Volume, MD and MRI Disease-Staging with several clinical outcomes (scales, score and symptoms) using 4 major regions of interest (Total, Cortical, Subcortical and Cerebellar gray matter) or smaller regions pre-specified based on known neuroanatomical correlates. Volume and MD z-scores correlated inversely with each other in all four major ROIs (cortical, subcortical, cerebellar and total) highlighting that ROIs with lower Volumes had higher MD and vice-versa. Regarding correlations with symptoms and scores, higher MD correlated with worse Mini-Mental State Examination and Barthel scores in cortical and cerebellar gray matter, but subjects with cortical sensory deficits showed lower MD in the primary sensory cortex. Volume loss correlated with lower Mini-Mental State Examination, Barthel scores and pyramidal signs. Interestingly, for both Volume and MD, changes within the cerebellar ROI showed strong correlations with both MMSE and Barthel. Supporting using a combination of MD and Volume to track sCJD progression, MRI Disease-Staging showed correlations with more clinical outcomes than Volume or MD alone, specifically with Mini-Mental State Examination, Barthel score, pyramidal signs, higher cortical sensory deficits, as well as executive and visual-spatial deficits. Additionally, when subjects in the cohort were subdivided into tertiles based on their Barthel scores and their percentile of disease duration/course ("Time-Ratio"), subjects in the lowest (most impaired) Barthel tertile showed a much greater proportion of more advanced MRI Disease-Stages than the those in the highest tertile. Similarly, subjects in the last Time-Ratio tertile (last tertile of disease) showed a much greater proportion of more advanced MRI Disease-Stages than the earliest tertile. Therefore, in later disease stages, as measured by time or Barthel, there is overall more Volume loss and increasing MD. A combined multiparametric quantitative MRI Disease-Staging is a useful tool to track sporadic Creutzfeldt-Jakob- disease progression radiologically.

0840 Sleep Quality in Clinically Indicated In-Laboratory Polysomnography

Introduction

Few studies have explored how patients sleep or what characteristics might be predictive of poor sleep during clinically-indicated polysomnography (PSG) in an in-laboratory setting.

Methods

We reviewed clinically indicated diagnostic PSG studies completed over a 10-year period in a single academic sleep center. Total sleep time (TST) and sleep efficiency (SE) were used as proxies for sleep quality. Patients were categorized as normal or poor sleepers based on TST &lt;4 hours or SE &lt;50%. Multivariate linear and logistic regression analyses were performed to determine factors associated with sleep quality while controlling for demographics, medications, comorbidities and measures of sleep.

Results

We included 4957 patients, who were mostly female (58.9%), middle-aged (52.9 y), Caucasian (69.3%), and overweight or obese (91.3%). 3682 patients (74.2%) were diagnosed with sleep apnea (Apnea Hypopnea Index(AHI)&gt;5/hr).

Average TST was 5.75±1.43 hours (Interquartile range [IQR] = 4.94 - 6.73) and average SE was 75.1%±16.1% (IQR=66.9 - 87.2). TST and SE were lower for males compared to females (5.48 vs 5.93 hr, p&lt;0.001; 73% vs 77%, p&lt;0.001). In multivariable analysis, older age (TST: OR = 1.04, 95% CI:[1.03,1.05]; SE: OR = 1.04, 95% CI:[1.04,1.05]), male sex (TST: 1.38,[1.14,1.68]; SE: 1.34,[1.07,1.68]), normal body habitus (TST: 1.47,[1.02,2.08]; SE: 1.51,[1.01,2.27]) and a higher AHI (TST: 1.02,[1.02,1.03]; SE: 1.02,[1.003,1.03]) were significantly associated with being a poor sleeper for both TST and SE. Antidepressant use was associated with poor sleep for TST (0.77, [0.59,1]), but not for SE (0.98, [0.73,1.3]).

Conclusion

Sleep quality during the in-laboratory PSG differed by sex, age and presence of sleep apnea. Sleep quality during in-lab PSG is thought to be compromised by obtrusive monitoring and an unfamiliar environment, but average sleep quality may be higher than expected for patients in the laboratory. Future studies should consider examining in-lab sleep quality in different patient populations.

Support

N/A

[Relationship between serum brain-derived neurotrophic factor and clinical stage and dysmenorrhoea of enodmetriosis]

Objective: To explore the association between serum brain-derived neurotrophic factor and clinical stage and dysmenorrhoea of endometriosis. Methods: A total of 82 patients were studied with laparoscopically diagnosed endometriosis between June 2017 and June 2019, and 75 healthy women with reproductive age were selected as the control group during the same period. The endometriosis patients were scored by visual analogue scale(VAS)according to their preoperative dysmenorrhoea.And endometriosis was staged and scored according to the score of Revised American Fertility Society(r-AFS).Enzyme-linked immunosorbent assay (ELISA) was used to determine preoperative BDNF level in serum, and the correlation between BDNF level with clinical stage as well as dysmenorrhea of endometriosis were analysed. Results: The serum BDNF level in endometriosis patients was (1 082±43) ng/L, significantly higher than that in the normal control [(649±30) ng/L], there was statistical difference between the two groups(P<0.001). The BDNF expression in patients with r-AFS stage Ⅲ-Ⅳ was higher than that in patients with Ⅰ-Ⅱ stage [(1 164±389) ng/L vs (791±218)ng/L, P<0.001]. BDNF level in serum was closely correlated with the degree of dysmenorrhea (r=0.682), and the BDNF level in patients with moderate or severe dysmenorrhea was significantly higher than that in patients without dysmenorrhea and patients with mild dysmenorrhea [(1 292±43) ng/L vs(718±36) ng/L, P<0.001]. Conclusions: The serum BDNF level in endometriosis patients is positively correlated with clinical stage and dysmenorrhea.

Targeted therapy for advanced salivary gland carcinoma based on molecular profiling: results from MyPathway, a phase IIa multiple basket study

BACKGROUND

Systemic therapy options for salivary cancers are limited. MyPathway (NCT02091141), a phase IIa study, evaluates targeted therapies in non-indicated tumor types with actionable molecular alterations. Here, we present the efficacy and safety results for a subgroup of MyPathway patients with advanced salivary gland cancer (SGC) matched to targeted therapies based on tumor molecular characteristics.

PATIENTS AND METHODS

MyPathway is an ongoing, multiple basket, open-label, non-randomized, multi-center study. Patients with advanced SGC received pertuzumab + trastuzumab (HER2 alteration), vismodegib (PTCH-1/SMO mutation), vemurafenib (BRAF V600 mutation), or atezolizumab [high tumor mutational burden (TMB)]. The primary endpoint is the objective response rate (ORR).

RESULTS

As of January 15, 2018, 19 patients with SGC were enrolled and treated in MyPathway (15 with HER2 amplification and/or overexpression and one each with a HER2 mutation without amplification or overexpression, PTCH-1 mutation, BRAF mutation, and high TMB). In the 15 patients with HER2 amplification/overexpression (with or without mutations) who were treated with pertuzumab + trastuzumab, 9 had an objective response (1 complete response, 8 partial responses) for an ORR of 60% (9.2 months median response duration). The clinical benefit rate (defined by patients with objective responses or stable disease >4 months) was 67% (10/15), median progression-free survival (PFS) was 8.6 months, and median overall survival was 20.4 months. Stable disease was observed in the patient with a HER2 mutation (pertuzumab + trastuzumab, n = 1/1, PFS 11.0 months), and partial responses in patients with the PTCH-1 mutation (vismodegib, n = 1/1, PFS 14.3 months), BRAF mutation (vemurafenib, n = 1/1, PFS 18.5 months), and high TMB (atezolizumab, n = 1/1, PFS 5.5+ months). No unexpected toxicity occurred.

CONCLUSIONS

Overall, 12 of 19 patients (63%) with advanced SGC, treated with chemotherapy-free regimens matched to specific molecular alterations, experienced an objective response. Data from MyPathway suggest that matched targeted therapy for SGC has promising efficacy, supporting molecular profiling in treatment determination.

Ultrafast Transient Spectroscopy of Trans-Polyacetylene in the Midinfrared Spectral Range

Trans-polyacetylene [t-(CH)_{x}] possesses twofold ground state degeneracy. Using the Su-Schrieffer-Heeger Hamiltonian, scientists predicted charged solitons to be the primary photoexcitations in t-(CH)_{x}; this prediction, however, has led to sharp debate. To resolve this saga, we use subpicosecond transient photomodulation spectroscopy in the mid-IR spectral range (0.1-1.5 eV) in neat t-(CH)_{x} thin films. We show that odd-parity singlet excitons are the primary photoexcitations in t-(CH)_{x}, similar to many other nondegenerate π-conjugated polymers. The exciton transitions are characterized by two photoinduced absorption (PA) bands at 0.38 and 0.6 eV, and an associated photoluminescence band at ∼1.5  eV having similar polarization memory. The primary excitons undergo internal conversion within ∼100  fs to an even-parity (dark) singlet exciton with a PA band at ∼1.4  eV. We also find ultrafast photogeneration of charge polarons when pumping deep into the polymer continuum band, which are characterized by two other PA bands in the mid-IR and associated photoinduced IR vibrational modes.

MiR-200a improves respiratory distress syndrome in newborn rabbits via the Wnt/β-catenin signaling pathway

OBJECTIVE

The aim of this study was to investigate the effect of micro-ribonucleic acid (miR)-200a on respiratory distress syndrome (RDS) in newborn rabbits by regulating the Wnt/β-catenin signaling pathway.

MATERIALS AND METHODS

In this work, newborn rabbits aged three days were selected from our laboratory as research objects. The messenger RNA (mRNA) and protein expression levels of miR-200a, β-catenin and interleukin-10 (IL-10) in blood samples of healthy newborn rabbits and newborn rabbits with RDS were determined by fluorescence quantitative Polymerase Chain Reaction (PCR) and Western blotting, respectively. Lentivirus-packaged plasmids containing miR-200a were then injected into newborn rabbits suffering from RDS. After 2 d, the mRNA and protein expression levels of miR-200a, β-catenin and IL-10 in blood samples of newborn rabbits in different treatment groups were measured. Meanwhile, lung sections were collected from newborn rabbits in different treatment groups. After that, the sections were observed via hematoxylin and eosin (H&E) staining. At the same time, lung coefficient of newborn rabbits in different treatment groups was also measured.

RESULTS

Compared with healthy newborn rabbits, the mRNA and protein expression levels of miR-200a and IL-10 in the blood of newborn rabbits with RDS decreased significantly (p<0.05), while β-catenin increased markedly (p<0.05). The mRNA and protein expression levels of β-catenin and IL-10 in newborn RDS rabbits with miR-200a over-expression and knockout were detected as well. The results revealed that lowly expressed miR-200a could remarkably promote the expression level of β-catenin, whereas inhibiting the expression of IL-10. However, highly expressed miR-200a could significantly inhibit the expression level of β-catenin and promote the expression level of IL-10. H&E staining results manifested that miR-200a knockout markedly promoted the increase of pulmonary alveoli with increased lung coefficients. However, the up-regulation of miR-200a could reduce lung coefficients and remarkably improve RDS.

CONCLUSIONS

MiR-200a regulates RDS in newborn rabbits by regulating the Wnt/β-catenin signaling pathway.

Comparison of DSSP and tSSS algorithms for removing artifacts from vagus nerve stimulators in magnetoencephalography data

OBJECTIVE

Large-amplitude artifacts from vagus nerve stimulator (VNS) implants for refractory epilepsy affect magnetoencephalography (MEG) recordings and are difficult to reject, resulting in unusable data from this important population of patients who are frequently evaluated for surgical treatment of epilepsy. Here we compare the performance of two artifact removal algorithms for MEG data: dual signal subspace projection (DSSP) and temporally extended signal space separation (tSSS).

APPROACH

Each algorithm's performance was first evaluated in simulations. We then tested the performance of each algorithm on resting-state MEG data from patients with VNS implants. We also examined how each algorithm improved source localization of somatosensory evoked fields in patients with VNS implants.

MAIN RESULTS

DSSP and tSSS algorithms have a similar ability to reject interference in both simulated and real MEG data if the origin location for tSSS is appropriately set. If the origin set for tSSS is inappropriate, the signal after tSSS can be distorted due to a mismatch between the internal region and the actual source space. Both DSSP and tSSS are able to remove large-amplitude artifacts from outside the brain. DSSP might be a better choice than tSSS when the choice of origin location for tSSS is difficult.

SIGNIFICANCE

Both DSSP and tSSS algorithms can recover distorted MEG recordings from people with intractable epilepsy and VNS implants, improving epileptic spike identification and source localization of both functional activity and epileptiform activity.

Evaluating RANKL and OPG levels in patients with Duchenne muscular dystrophy

RANKL-OPG should be explored in DMD patients to potentially provide targeted therapy. We quantified RANKL and OPG levels in DMD patients compared with controls. RANKL, OPG, and RANKL:OPG significantly declined with age in DMD patients suggesting some bone turnover markers are difficult to assess or use as therapeutic indicators.

INTRODUCTION

Osteoporosis in Duchenne muscular dystrophy (DMD) is multi-factorial in nature with high prevalence of fractures. RANKL-OPG should be explored to potentially provide targeted therapy for these patients. We quantified RANKL, OPG, and RANKL:OPG levels in DMD patients compared with controls and analyzed the influence of age, glucocorticoid use, ambulatory status, bone density, and fracture history.

METHODS

DMD patients were enrolled at CHLA. Controls were recruited from general pediatric clinic and in collaboration with samples from a previously completed study. Free soluble RANKL and OPG levels were quantified using a sandwich ELISA.

RESULTS

Fifty DMD patients and 50 controls were enrolled. DMD patients had a significant decline in RANKL, OPG, and RANKL:OPG with age (p = < 0.0001, p = 0.026, and p = 0.002, respectively) while healthy controls showed no significant change. RANKL trended lower in patients on glucocorticoids (p = 0.05), attributed to the significantly older age in the treatment group. RANKL and RANKL:OPG levels were significantly lower in the non-ambulatory group compared with the ambulatory group (p = 0.010 and 0.036 respectively), again likely due to their older age. There was no correlation of RANKL, OPG, or RANKL:OPG with DXA Z-score or presence of vertebral fractures.

CONCLUSION

There was significant decline in RANKL, OPG, and RANKL:OPG with age in DMD patients compared with controls, potentially due to disease severity or worsening osteoblastic function. This suggests some bone turnover markers may be difficult to assess or use as therapeutic indicators in DMD patients. Larger studies are needed to evaluate the role of RANKL-OPG in DMD patients to provide better targeted therapy.

Association of Blood and Cerebrospinal Fluid Tau Level and Other Biomarkers With Survival Time in Sporadic Creutzfeldt-Jakob Disease

IMPORTANCE

Fluid biomarkers that can predict survival time in sporadic Creutzfeldt-Jakob disease (sCJD) will be critical for clinical care and for treatment trials.

OBJECTIVE

To assess whether plasma and cerebrospinal fluid (CSF) biomarkers are associated with survival time in patients with sCJD.

DESIGN, SETTING, AND PARTICIPANTS

In this longitudinal cohort study, data from 193 patients with probable or definite sCJD who had codon 129 genotyping referred to a tertiary national referral service in the United States were collected from March 2004 to January 2018. Participants were evaluated until death or censored at the time of statistical analysis (range, 0.03-38.3 months). We fitted Cox proportional hazard models with time to event as the outcome. Fluid biomarkers were log-transformed, and models were run with and without nonfluid biomarkers of survival. Five patients were excluded because life-extending measures were performed.

MAIN OUTCOMES AND MEASURES

Biomarkers of survival included sex, age, codon 129 genotype, Barthel Index, Medical Research Council Prion Disease Rating Scale, 8 CSF biomarkers (total tau [t-tau] level, phosphorylated tau [p-tau] level, t-tau:p-tau ratio, neurofilament light [NfL] level, β-amyloid 42 level, neuron-specific enolase level, 14-3-3 test result, and real-time quaking-induced conversion test), and 3 plasma biomarkers (t-tau level, NfL level, and glial fibrillary acidic protein level).

RESULTS

Of the 188 included participants, 103 (54.8%) were male, and the mean (SD) age was 63.8 (9.2) years. Plasma t-tau levels (hazard ratio, 5.8; 95% CI, 2.3-14.8; P < .001) and CSF t-tau levels (hazard ratio, 1.6; 95% CI, 1.2-2.1; P < .001) were significantly associated with survival after controlling for codon 129 genotype and Barthel Index, which are also associated with survival time. Plasma and CSF t-tau levels were correlated (r = 0.74; 95% CI, 0.50-0.90; P < .001). Other fluid biomarkers associated with survival included plasma NfL levels, CSF NfL levels, t-tau:p-tau ratio, 14-3-3 test result, and neuron-specific enolase levels. In a restricted subset of 23 patients with data for all significant biomarkers, the hazard ratio for plasma t-tau level was more than 40% larger than any other biomarkers (hazard ratio, 3.4; 95% CI, 1.8-6.4).

CONCLUSIONS AND RELEVANCE

Cerebrospinal fluid and plasma tau levels, along with several other fluid biomarkers, were significantly associated with survival time in patients with sCJD. The correlation between CSF and plasma t-tau levels and the association of plasma t-tau level with survival time suggest that plasma t-tau level may be a minimally invasive fluid biomarker in sCJD that could improve clinical trial stratification and guide clinical care.

Stromal fibroblast-derived MFAP5 promotes the invasion and migration of breast cancer cells via Notch1/slug signaling

BACKGROUND

The tumor microenvironment (TME) regulates tumor progression, and cancer-associated fibroblasts (CAFs) are the primary stromal components of the TME, with the potential to drive tumor metastasis via the secretion of paracrine factors, but the specific mechanisms driving this process have not been defined.

METHODS

Proteins secreted from CAFs and normal fibroblasts (NFs) were analyzed via proteomic analysis (fold change > 2, p < 0.05) to identify tumor-promoting proteins secreted by CAFs.

RESULTS

Proteomic analysis revealed that microfibrillar-associated protein 5 (MFAP5) is preferentially expressed and secreted by CAFs relative to NFs, which was confirmed by Western blotting and RT-qPCR. Transwell and wound healing assays confirmed that MFAP5 is secreted by CAFs, and drives the invasion and migration of MCF7 breast cancer cells. We further found that in MCF7 cells MFAP5 promoted epithelial-mesenchymal transition, activating Notch1 signaling and consequently upregulating NICD1 and slug. When Notch1 was knocked down in MCF7 cells, the ability of MFAP5 to promote invasion and migration decreased.

CONCLUSION

CAFs promote cancer cells invasion and migration via MFAP5 secretion and activation of the Notch1/slug signaling. These data highlight this pathway as a therapeutic target to disrupt tumor progression through the interference of CAF-tumor crosstalk.

Improving genomic prediction for two Yorkshire populations with a limited size using the single-step method

In this study, we conducted genomic prediction for two Yorkshire purebred populations (Yichun and Chifeng) from two different provinces of China that both had a limited population size. Two growth traits (age adjusted to 100 kg weight, AGE; back-fat thickness adjusted to 100 kg weight, BF) and one reproduction trait (total number of piglets born, TNB) were analyzed with four prediction strategies: one-population BLUP, joint two-population BLUP, one-population single-step BLUP (SSBLUP) and joint two-population SSBLUP. Our results illustrate that accuracies of genomic estimated breeding values were improved for BF and TNB for the Yichun population and for BF for the Chifeng population by genomic prediction (one-population SSBLUP and joint two-population SSBLUP). The accuracy of TNB for the Yichun population was increased two fold when comparing the one-population SSBLUP to the one-population BLUP prediction. Meanwhile, prediction biases were dramatically reduced for AGE for the Yichun population and for TNB for the Chifeng population. The conclusions of this study are as follows: first, genomic prediction is useful for improving prediction accuracy for purebred pig breeding farms with a limited population size; second, joint genomic prediction for different populations of the same breed with certain genetic links has the trend to further improve prediction accuracy.

Abstract P6-07-02: The CARMA3-Bcl10-MALT1 signalosome mediates pro-angiogenic IL-6 and IL-8 paracrine signaling in GPCR+ breast cancer

Background: The overexpression of selected G-protein coupled receptors (GPCRs) has been linked to the pathogenesis of multiple cancer subtypes. We recently demonstrated that overexpression of two such GPCRs, the angiotensin II receptor type I (AGTR1) and protease-activated receptor type 1 (PAR1), occurs in a substantial fraction of luminal breast cancers and is associated with treatment resistance and poor prognosis. Further, experimental models demonstrate that overexpression of these receptors in breast cancer cell lines promotes aggressive features that include EMT, invasion, migration, and loss of ER expression. In addition to these cell intrinsic effects, we find that GPCR overexpression in breast cancer cells can impact the tumor microenvironment. Specifically, we recently reported that conditioned media from angiotensin II-stimulated AGTR1+ breast cancer cells induces endothelial chemotaxis in vitro and tumor angiogenesis in vivo. We also demonstrated that this pro-angiogenic phenotype requires the CARMA3-Bcl10-MALT1 (CBM) signalosome, a signaling complex that links upstream GPCR stimulation with downstream NF-κB activation. We hypothesized that stimulation of either AGTR1 or PAR1 induces CBM-dependent secretion of NF-κB responsive, pro-angiogenic factors from these GPCR+ breast cancer cells which then exert proangiogenic effects on neighboring endothelial cells through paracrine signaling.

Methods: To identify CBM-dependent secreted factors, we evaluated the AGTR1+ BT549 cell line, +/- Bcl10 or MALT1 siRNA knockdown, for expression of 770 genes of significance to solid tumor pathogenesis using the NanoString PanCancer Progression Panel followed by Ingenuity Pathway Analysis (IPA). RT-PCR and ELISA were used to validate hits and determine if the CBM signalosome controls expression of the same genes in the PAR1+ cell lines, MCF7-N55 and MDA-MB-231.

Results: We identified IL-6 and IL-8 signaling pathways as the two most significantly downregulated angiogenesis pathways following either Bcl10 or MALT1 knockdown. Using quantitative RT-PCR and ELISA, we confirmed that IL-6 and IL-8 gene expression and protein secretion are significantly induced in response to stimulation of BT549 cells by angiotensin II and MCF7-N55 and MDA-MB-231 cells by TRAP6, a PAR1 agonist. siRNA-mediated MALT1 knockdown in BT549 cells led to a significant reduction of IL-6 and IL-8 gene expression upon angiotensin II stimulation; similarly, CRISPR/Cas9-mediated MALT1-deletion in MCF7-N55 cells resulted in failure of these cells to secrete IL-8 upon TRAP6 stimulation.

Conclusions: The GPCR-CBM-cytokine signaling pathway provides a common druggable target to curb pro-angiogenenic paracrine signaling in GPCR+ breast cancers. Importantly, the CBM signalosome has also been shown to be required for IL-8 dependent upregulation of VEGF in endothelial cells, indicating that inhibition of the signalosome could exert complementary effects on both cancer cells and endothelial cells to effectively limit the pro-angiogenic phenotype driven by GPCR overexpression. Several small-molecule MALT1 inhibitors are now available and can be tested for their efficacy as angiogenesis inhibitors in the setting of GPCR+ breast cancer.

Citation Format: Kang H, Ekambaram P, McAllister-Lucas LM, Lucas PC. The CARMA3-Bcl10-MALT1 signalosome mediates pro-angiogenic IL-6 and IL-8 paracrine signaling in GPCR+ breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-07-02.

Revealing Color Forces with Transverse Polarized Electron Scattering

The Spin Asymmetries of the Nucleon Experiment measured two double spin asymmetries using a polarized proton target and polarized electron beam at two beam energies, 4.7 and 5.9 GeV. A large-acceptance open-configuration detector package identified scattered electrons at 40° and covered a wide range in Bjorken x (0.3<x<0.8). Proportional to an average color Lorentz force, the twist-3 matrix element, d[over ˜]_{2}^{p}, was extracted from the measured asymmetries at Q^{2} values ranging from 2.0 to 6.0  GeV^{2}. The data display the opposite sign compared to most quark models, including the lattice QCD result, and an unexpected scale dependence. Furthermore, when combined with the neutron data in the same Q^{2} range the results suggest a flavor independent average color Lorentz force.