Identification of Reg3β-producing cells using IL-22-stimulated enteroids

Reg3β, a lectin, displays antibacterial activity. This study investigated Reg3β-expressing cells using IL-22-stimulated enteroids. IL-22 stimulation elevated the mRNA and protein levels of Reg3β. IL-22 also increased the mRNA levels of CD133 (a transit-amplifying cell marker) and lysozyme (a Paneth cell marker). Immunohistochemistry showed partial colocalization of Reg3β- and lysozyme-positive cells, suggesting that Paneth cells are one of Reg3β-producing cells.

Pyogenic spondylitis with acute course caused by Corynebacterium simulans

Corynebacterium simulans was first reported in 2000. Although it is a member of the normal skin flora, some cases of C. simulans infection have been reported. Other Corynebacterium spp. rarely cause chronic pyogenic spondylitis, and pyogenic spondylitis caused by C. simulans has not been reported at all. Here we report a case of acute pyogenic spondylitis due to C. simulans. A 78-year-old man with diabetes mellitus visited our hospital with a 3-day history of lower back pain and fever. Blood culture revealed C. simulans and magnetic resonance images of lumbar vertebrae showed pyogenic spondylitis. He recovered after treatment by vancomycin for 9 weeks and was discharged home. No recurrence has been observed for half a year. This is likely the first reported case of pyogenic spondylitis by C. simulans. In general, Corynebacterium spp. cause chronic pyogenic spondylitis, but this case showed an acute course.

P6337Prognostic impacts of serum uric acid levels in patients with chronic heart failure: insights from the CHART-2 Study

Background

Prognostic impact of serum uric acid (UA) levels in patients with heart failure (HF) remains to be fully elucidated, as previous studies were inconclusive with small study sample sizes. Furthermore, although the J-curve relationship between serum UA levels and cardiovascular events has been suggested in patients with hypertension and those with diabetes, it is still unclear whether this is also the case for patients with HF.

Purpose

We examined the prognostic impacts of serum UA levels in HF patients, using the database of our Chronic Heart Failure Registry and Analysis in the Tohoku district (CHART)-2 Study, the largest multicenter, prospective, observational cohort study for cardiovascular patients with HF or those at risk of HF in Japan (N=10,219).

Methods

First, we determined the cut-off value of serum UA levels at baseline by the Classification and Regression Tree (CART). Then, we divided 4,652 consecutive HF patients in the CHART-2 Study into 4 groups; G1 (<3.8 mg/dL, N=313), G2 (3.8–7.1 mg/dL, N=3,070), G3 (7.2–9.2 mg/dL, N=1,018), and G4 (≥9.3 mg/dL, N=251). Among the 4 groups, we compared clinical characteristics and incidence of all-cause death, HF hospitalization, and a composite of all-cause death and HF hospitalization.

Results

Mean age in G1, G2, G3, and G4 was 71±12, 69±12, 68±13, and 69±15 years, respectively (P<0.001). G1 was characterized by a significantly high prevalence of women as compared with G2, G3 and G4 (59, 32, 24 and 23%, respectively). Serum creatinine levels (0.8±0.4, 0.9±0.4, 1.2±0.6 and 1.4±0.8 mg/dL, respectively), prevalence of atrial fibrillation (34, 39, 45 and 50%, respectively), and diuretics use (36, 45, 67, 89%, respectively) increased from G1, G2, G3 to G4 (all P<0.001), while left ventricular ejection fraction decreased from G1, G2, G3 to G4 (59±15, 58±15, 54±15, and 52±17%, respectively, P<0.001). Median BNP levels were comparably low in G1 and G2 and then increased to G3 and G4 (94.4, 91.5, 130 and 192.5 pg/mL, respectively, P<0.001). As a HF etiology, prevalence of ischemic heart disease was highest in G2 and lowest in G4 (48, 52, 48, 38%, respectively, P<0.001), while that of dilated cardiomyopathy increased from G1, G2, G3 to G4 (11, 12, 16 and 20%, respectively, P<0.001). During the median follow-up period of 6.3 years, in G1, G2, G3 and G4, 111 (35%), 905 (29%), 370 (36%) and 139 (55%) patients died and 79 (25%), 729 (24%), 300 (29%) and 115 (46%) experienced HF hospitalization, respectively (both P<0.001). Cox proportional hazard models adjusted for clinical backgrounds showed that, as compared with G2, both G1 and G4 had increased risk for all-cause death, HF hospitalization and a composite of all-cause death, and HF hospitalization, indicating the J-curve relationship between serum UA levels and prognosis (Figure).

Prognostic impacts of serum UA levels

Conclusions

Both decreased and increased UA levels were associated with increased incidence of death and HF hospitalization in HF patients.

Probiotic Lactobacillus gasseri SBT2055 improves insulin secretion in a diabetic rat model

The probiotic Lactobacillus gasseri SBT2055 (LG2055) has a protective effect against metabolic syndrome in rats and humans. Metabolic syndrome increases the risk of type 2 diabetes mellitus. In this study, Goto-Kakizaki rats were used as a diabetic model and fed diets containing LG2055-fermented or nonfermented skim milk for 4 wk. Indices of diabetes such as blood glucose levels, serum glucagon levels, plasma levels of insulin, C-peptide, and glucagon-like peptide-1, tissue glycogen contents, and pancreatic mRNA levels were measured. The plasma C-peptide levels and pancreatic mRNA levels of insulin genes (Ins1 and Ins2) and Pdx1 (a transcriptional factor of insulin genes) were increased in LG2055 diet-fed rats. The increase in insulin secretion corresponded to an improvement in serum and pancreatic inflammatory status, associated with decreases in serum levels of serum amyloid P and pancreatic levels of granulocyte colony-stimulating factor. Insulin resistance in Goto-Kakizaki rats was ameliorated by increased glycogen storage in the liver and quadriceps femoris muscles and decreased serum free fatty acid levels. This improvement may be related to the increased cecal production of short-chain fatty acids. In conclusion, dietary LG2055 improved insulin secretion in diabetic rats by improving the inflammatory status in the pancreas and serum.