[Clinicopathological features of malignant mixed mesodermal tumor: analysis of 50 cases]

Objective: To investigate the clinicpathological, immunohistochemical and molecular genetic features of malignant mixed mesodermal tumor (MMMT) in the female reproductive system. Methods: To analyze its histopathological characteristics, we performed a retrospective review of the MMMT cases diagnosed at PLA General Hospital, Beijing, China during 2005-2019 using its surgical and pathological databases. EnVision immunohistochemical staining was used to detect the expression of ER, PR, p16, p53 and MMR proteins. Results: Fifty cases were conformed to the diagnosis, including 29 cases originated in the uterus, 16 cases in ovary, 4 cases of synchronous occurrence in uterus and ovary, 1 case in cervix. The tumor was histologically composed of two components, namely carcinoma and sarcoma ones, with clear borderline or blend mutually. The proportion of cancer component in the whole tumor ranged from 5%-90%. The proportion of carcinoma was more than 50% in 76% of the cases, and less than 50% in 24% of cases, including 2 cases with<10% of carcinoma. In the cases of primary uterine MMMT, the main carcinoma type was high grade endometrioid carcinoma (55%, 16/29). In ovarian MMMT, the main carcinoma type was serous carcinoma (12/16), while that of cervical MMMT was squamous cell carcinoma. The others were clear cell carcinoma or the undifferentiated carcinoma. There was one carcinoma type in most cases, only 7 cases had two carcinoma types. Homologous sarcomas, including stromal sarcoma, leiomyosarcoma and high-grade spindle cell sarcomas, were more commonly found in uterine MMMT (72.4%, 21/29). While heterogenic sarcomas, including chondrosarcoma, osteosarcoma and rhabdomyosarcoma, were more commonly noted in ovarian MMMT (12/16) than MMMT of other sites. There were 10 cases that consisted of two types of sarcomas. The synchronous MMMT of uterus and ovary had similar morphology and the types of carcinoma and sarcoma. The tumor cells that spread or metastasized to lymph node, omentum, intestinal wall or skin were all carcinoma cells, and were morphologically consistent with the original tumors. Immunohistochemically, ER and PR were both negative (23/25 in uterine, 8/10 in ovarian tumors). p16 was strongly positive (11/11 in uterine tumors, and 6/6 in ovarian tumors), with similar expression patterns in the carcinoma and sarcoma components. p53 showed mutant-type staining (64%, 21/33) and expressed synchronously in carcinoma and sarcoma components. p53 mutation was found in 35% cases of endometrial carcinoma and 46.7% cases of non-endometrial carcinoma. p53 mutation was also found in only 31.8% cases of heterogenic sarcomas, but in 50% of non-heterogenic sarcomas. Twenty-eight cases (28/33, 85%) presented intact mismatch repair proteins, while 5 cases (5/33, 15%) presented deficient mismatch repair proteins. Conclusions: MMMT in female reproductive system is a rare high-grade biphasic tumor with complex and diverse morphology. The immunohistochemical features are characterized by negative ER/PR and strongly positive p16, mostly mutant p53 and proficient mismatch repair proteins. The patients with a high FIGO stage have worse prognosis.

Compatible stealth design of infrared and radar based on plasmonic absorption structure

In this paper, a metamaterial structure with radar and infrared (IR) compatible stealth characteristics is designed based on the principle of plasmonic absorbing structure (PAS). Due to the lack of reports on PAS-based IR radar compatible stealth, this article combines PAS and IR frequency selective surfaces to achieve the desired purpose. Through mathematical modeling and dispersion engineering of the unit cell proposed, a PAS with ultra-wideband wave absorption is realized. The low emissivity of the IR atmospheric window band is realized by means of the simulation and analysis of the IR frequency selective surface with different indium tin oxide (ITO) occupation ratios. The absorptivity of designed structure is higher than 90% from 4GHz to 28.6GHz, and the emissivity of the IR atmospheric window is only 0.3. The experience of the fabricated sample is consistent with the theoretical analysis and the simulation. Our method enriches the implementation strategies of radar-IR compatibility and has reference significance for multi-spectrum compatible stealth.

Prevalence of Metabolic Syndrome According to Absolute and Relative Values of Muscle Strength in Middle-Aged and Elderly Women

Metabolic syndrome (MetS) increases with age, obesity, low physical activity, and decreased muscle strength. Although many studies have reported on grip strength and MetS, few studies have been conducted on leg strength. The purpose of this study was to analyze the prevalence of MetS according to absolute and relative leg strength values in middle-aged and older women. The participants were 1053 women who visited the healthcare center: middle-aged (n = 453) and older (n = 601). MetS was diagnosed using the criteria established by the third report of the National Cholesterol Education Program Adult Treatment Panel III and the World Health Organization's Asia Pacific guidelines for waist circumference. For leg strength, knee flexion and extension were performed using isokinetic equipment. Grip strength was measured using a grip dynamometer and classified into quartiles. Analysis of prevalence using logistic regression showed that MetS was present in 21.2% of middle-aged and 39.4% of older women. The lowest relative leg extension increased 2.5 times in the middle-aged and 1.5 times in older women (p < 0.05). However, leg flexion did not have a significant prevalence in either age group. The prevalence of MetS in middle-aged and older women with the lowest relative grip strength increased 1.5 and 1.2 times, respectively. Conversely, the lower the absolute leg extension strength, the lower the MetS prevalence was at 0.520 in middle-aged and 0.566 in older women (p < 0.05). In conclusion, the prevalence of MetS increased in women with low relative grip and leg strengths. Specifically, the lower the relative leg extension muscle strength, the higher the prevalence of MetS. In addition, the prevalence of MetS increased in the high-frequency alcohol consumption and non-physical activity group.

P–420 uncomplicated oocyte donation pregnancies display elevated CD163 positive type 2 macrophage load in the decidua, which is associated with fetal-maternal HLA class II mismatches

Study question

Do quantity and composition of decidual macrophages differ between uncomplicated oocyte donation (OD) pregnancies and non-OD in vitro fertilization (IVF) pregnancies?

Summary answer

OD placentas show higher decidual CD163 positive fraction within the total macrophage population compared to non-OD IVF placentas.

What is known already

The embryo of an OD pregnancy is completely allogeneic to the mother, which may lead to a bigger challenge for the maternal immune system to tolerize the fetus compared to autologous pregnancies. Placental macrophages may be essential in maintaining a healthy pregnancy. Macrophages can be classified into different categories based on phenotype and characteristics, in which type 2 macrophages are thought to exhibit immune suppressive activity.

Study design, size, duration

This retrospective case-control study included patients who delivered in the Leiden University Medical Center between January 1st 2006 and July 1st 2016. A total of 42 pregnancies were enrolled in this study, conceived by uncomplicated singleton OD pregnancies (n = 25) or non-OD IVF pregnancies (n = 17). Medical records were reviewed and clinical data were collected. Placental tissue samples were collected for immunohistochemical staining and blood samples were collected for HLA typing.

Participants/materials, setting, methods

Placentas were collected and immunohistochemically stained for CD14 (pan-macrophage marker) and CD163 (type 2 macrophage marker). The extent of staining was quantitated by digital image analysis software. To assess mismatching, maternal and fetal DNA was typed for HLA-A, -B, C, -DRB1, and -DQB1.

Main results and the role of chance

A significantly lower percentage of CD14 positive staining was observed in the decidua basalis of OD pregnancies compared to non-OD IVF pregnancies (p = 0.030). Consequently, the CD163/CD14 ratio in OD group was higher than in non-OD IVF group (p = 0.243). In the parietalis, OD pregnancies demonstrated a significantly higher percentage of CD163+ staining (p = 0.040) and a significantly higher CD163/CD14 ratio (p = 0.032) compared to non-OD IVF group. The reproducibility of this quantitative analysis was found to be high. OD group was separated into a syngeneic group (number of mismatches lower than half of the antigens per HLA locus) and an allogeneic group (number of mismatches higher than half of the antigens per HLA locus). Significant differences of CD163+ and CD163/CD14 ratio were found in the decidua parietalis when comparing the HLA-classII-allogeneic OD group with the non-OD IVF group (p = 0.047). This difference was not found for the HLA-class-II-syngeneic OD group.

Limitations, reasons for caution

Our study only focused on decidua basalis and parietalis, no other locations in the placentas. Larger sample size might be needed to verify the association between macrophages and HLA mismatches.

Wider implications of the findings: To our knowledge, this study is the first to quantify a higher CD163 positive M2 macrophages load within the total decidual macrophages of uncomplicated OD pregnancy compared to non-OD IVF pregnancies.

Trial registration number

Not applicable

P-420 Pre-selected for an award: Uncomplicated oocyte donation pregnancies display elevated CD163 positive type 2 macrophage load in the decidua, which is associated with fetal-maternal HLA class II mismatches

Study question

Do quantity and composition of decidual macrophages differ between uncomplicated oocyte donation (OD) pregnancies and non-OD in vitro fertilization (IVF) pregnancies?

Summary answer

OD placentas show higher decidual CD163 positive fraction within the total macrophage population compared to non-OD IVF placentas.

What is known already

The embryo of an OD pregnancy is completely allogeneic to the mother, which may lead to a bigger challenge for the maternal immune system to tolerize the fetus compared to autologous pregnancies. Placental macrophages may be essential in maintaining a healthy pregnancy. Macrophages can be classified into different categories based on phenotype and characteristics, in which type 2 macrophages are thought to exhibit immune suppressive activity.

Study design, size, duration

This retrospective case-control study included patients who delivered in the Leiden University Medical Center between January 1st 2006 and July 1st 2016. A total of 42 pregnancies were enrolled in this study, conceived by uncomplicated singleton OD pregnancies (n = 25) or non-OD IVF pregnancies (n = 17). Medical records were reviewed and clinical data were collected. Placental tissue samples were collected for immunohistochemical staining and blood samples were collected for HLA typing.

Participants/materials, setting, methods

Placentas were collected and immunohistochemically stained for CD14 (pan-macrophage marker) and CD163 (type 2 macrophage marker). The extent of staining was quantitated by digital image analysis software. To assess mismatching, maternal and fetal DNA was typed for HLA-A, -B, C, -DRB1, and -DQB1.

Main results and the role of chance

A significantly lower percentage of CD14 positive staining was observed in the decidua basalis of OD pregnancies compared to non-OD IVF pregnancies (p = 0.030). Consequently, the CD163/CD14 ratio in OD group was higher than in non-OD IVF group (p = 0.243). In the parietalis, OD pregnancies demonstrated a significantly higher percentage of CD163+ staining (p = 0.040) and a significantly higher CD163/CD14 ratio (p = 0.032) compared to non-OD IVF group. The reproducibility of this quantitative analysis was found to be high. OD group was separated into a syngeneic group (number of mismatches lower than half of the antigens per HLA locus) and an allogeneic group (number of mismatches higher than half of the antigens per HLA locus). Significant differences of CD163+ and CD163/CD14 ratio were found in the decidua parietalis when comparing the HLA-classII-allogeneic OD group with the non-OD IVF group (p = 0.047). This difference was not found for the HLA-class-II-syngeneic OD group.

Limitations, reasons for caution

Our study only focused on decidua basalis and parietalis, no other locations in the placentas. Larger sample size might be needed to verify the association between macrophages and HLA mismatches.

Wider implications of the findings

To our knowledge, this study is the first to quantify a higher CD163 positive M2 macrophages load within the total decidual macrophages of uncomplicated OD pregnancy compared to non-OD IVF pregnancies.

Trial registration number

not applicable

Ultra-wideband flexible transparent metamaterial with wide-angle microwave absorption and low infrared emissivity

Optically transparent metamaterials with the performance of infrared radar compatible stealth have been designed and manufactured on the basis of the continuous in-depth research on single-band stealth technology. In this paper, metamaterials are designed through theoretical calculations and modeling simulations. The designed structure can achieve higher than 90% broadband (8.7-32 GHz) absorption at wide-angle (45 degrees), emissivity of 0.3 in infrared atmospheric window, and optical transparency. In addition, the material can be bent, which greatly expands its application scenarios. The experimental results are consistent with the theoretical calculation and simulation results.

Asymmetric expression patterns of B- and C-class MADS-box genes correspond to the asymmetrically specified androecial identities of Canna indica

Canna indica is a common ornamental plant with asymmetric flowers having colourful petaloid staminodes. The only fertile stamen comprises a one-theca anther and a petaloid appendage and represents the lowest stamen number in the order Zingiberales. The molecular mechanism for the asymmetric androecial petaloidy remains poorly understood. Here, we studied the identity specification in Canna stamen. We observed four types of abnormal flower in terms of androecium identity transformation and analysed the corresponding floral symmetry changes. We further tested the expression patterns of B- and C-class MADS-box genes using in situ hybridization in normal Canna stamen. Homeotic conversions in the androecium were accompanied by floral symmetry changes, and the asymmetric stamen is key in contributing to the floral asymmetry. Both B- and C-class genes exhibited higher expression levels in the anther primordium than in other androecial parts. This asymmetric expression pattern precisely corresponded to the asymmetric identities of the Canna androecium. We identified C. indica as a model species for studying androecial organ identity and floral symmetry synthetically in Zingiberales. We hypothesized that homeotic genes specify floral organ identity in a putative dose-dependent manner. The results add to the current understanding of organ identity-related floral symmetry.

Effect of miR-132 on lung injury in sepsis rats via regulating Sirt1 expression

OBJECTIVE

The aim of this study was to explore the effects of the expressions of micro ribonucleic acid (miR)-132 and sirtuin1 (Sirt1) on lung injury in sepsis rats, and to elucidate the regulatory relation between miR-132 and Sirt1.

MATERIALS AND METHODS

The model of sepsis-induced lung injury was successfully established in rats via injection of lipopolysaccharide (LPS) into the caudal vein (model group). Before modeling, the rats were infused with miR-132 antagomir via the trachea (miR-132 antagomir group) or intraperitoneally injected with the Sirt1 activator (SRT1720) (SRT1720 group). Meanwhile, the rats injected with an equal volume of normal saline via the caudal vein were enrolled in the control group. The expressions of the inflammatory factors interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α) were determined using enzyme-linked immunosorbent assay (ELISA). Quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) and Western blotting were applied to detect gene and protein expressions in lung tissues, respectively. Targeted relationship between miR-132 and Sirt1 was explored using Luciferase reporter assay. In addition, tissue sections of the right lung were stained with hematoxylin-eosin (HE) to observe the degree of lung injury.

RESULTS

The model of sepsis-induced lung injury was successfully established in rats by LPS. The results showed that the expressions of IL-6, IL-1β, TNF-α and miR-132 rose significantly in lung tissues (p<0.01), whereas the expression of Sirt1 significantly declined (p<0.01). Lung injury was alleviated by miR-132 antagomir and SRT1720. Both miR-132 antagomir and SRT1720 significantly reduced the expressions of miR-132, IL-6, IL-1β and TNF-α (p<0.01). However, the expression of Sirt1 was remarkably upregulated in rats with lung injury (p<0.01). Luciferase reporter gene assay indicated that miR-132 regulated Sirt1 in a targeted manner.

CONCLUSIONS

MiR-132 may cause lung injury in sepsis rats by regulating the expression of Sirt1.

Naphthalimide Derivative-Functionalized Metal-Organic Framework for Highly Sensitive and Selective Determination of Aldehyde by Space Confinement-Induced Sensitivity Enhancement Effect

Facile and sensitive determination of formaldehyde (FA) in indoor environments still remains challenging. Herein, a fluorescent probe, termed PHN@MOF, was synthesized by embedding the fluorescent molecule of N-propyl-4-hydrazine-naphthalimide (PHN) into a metal-organic framework (MOF) for sensitive and visual monitoring of FA. The hydrazine group of PHN acts as the specific reaction group with FA based on the condensation reaction. The host of MOF (UiO-66-NH₂) offers the surrounding confinement space required for the reaction. Owing to the enrichment effect and molecular sieve selection of UiO-66-NH₂ to FA, PHN@MOF, compared with free PHN, exhibits very high sensitivity and selectivity based on space confinement-induced sensitivity enhancement (SCISE). Moreover, the fluorescence of UiO-66-NH₂ offers a reference signal for FA detection. Using this ratiometric fluorescent PHN@MOF probe, a colorimetric gel plate and test paper were developed and used to visually monitor FA in air.

POS0754 DEVELOPMENT OF A RISK PREDICTION MODEL FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: THE SLE-VTE SCORE

Background:

Patients with systemic lupus erythematosus (SLE) have a substantially increased risk of venous thromboembolism (VTE). An individual VTE risk assessment is important to ensure that all patients are assessed and given adequate thromboprophylaxis.

Objectives:

We conducted this study to develop a risk score for VTE in patients with SLE.

Methods:

Patients with SLE who participated in the Chinese SLE Treatment and Research group were enrolled in this study. Patient baseline information and clinical laboratory indicators were obtained, and VTE events were recorded every 3-6 months during follow-up visits. The risk prediction model was created and internally validated using the bootstrap methods, and a scoring system was established (Figure 1).

Figure 1.

Flow chart of study design.

Results:

Out of 4,502 patients included in this study, 135 had a VTE event. After univariate analysis and Lasso regression, the following 11 variables were identified and included in the risk prediction model: male sex, age, BMI ≥25 kg/m2, hyperlipidemia, hypoalbuminemia, hsCRP>3 mg/L, renal involvement, nervous system involvement, anti-β2-glycoprotein I antibody positivity, lupus anticoagulant positivity, and no use of hydroxychloroquine. The AUC for the SLE-VTE score (Table 1) was 0.947 (95% CI, 0.9249-0.9694). The SLE-VTE score’s sensitivity and specificity with the optimal cutoff value of 13 were 0.919 and 0.881, respectively. The SLE-VTE score was superior to the GAPSS system in predicting the risk of VTE in patients with SLE (AUC= 0.947 vs. 0.680, P< 0.001; integrated discrimination improvement (IDI)= 0.6652, P< 0.001; net reclassification improvement (NRI)= 0.6652, P< 0.001).

Table 1.

Final multivariable analysis for venous thromboembolism risk in patients with SLE

β coefficientsOdds ratio* (95% CI)P-valuePoints in scoring systemMale0.6211.86(0.953-3.503)0.0612Age at study entry(≥50)0.8372.308(1.339-3.915)0.0023BMI02(kg/m20.7922.209(1.333-3.627)0.0023Hyperlipemia0.8382.313(1.246-4.166)0.0063Hypoalbuminemia2.1638.697(5.185-14.794)< 0.0017hsCRP>3 mg/L1.4524.272(2.618-6.968)< 0.0015Anti β2GPI1.0132.754(1.543-4.853)0.0013LA1.5594.752(2.799-8.072)< 0.0015Nervous system2.38210.832(6.163-18.998)< 0.0018Lupus nephritis0.8352.305(1.414-3.756)0.0013No use of hydroxychloroquine1.7715.876(3.722-9.401)< 0.0016

BMI: body mass index; hsCRP: Hypersensitive c-reactive protein; ACL: anticardiolipin, antiβ2GPI: anti-β2-glycoprotein I, LA: lupus anticoagulantm;

Values in bold are statistically significant at p <0.05.

Conclusion:

Various factors are related to the occurrence of VTE in patients with SLE. The proposed SLE-VTE risk score can accurately predict the risk of VTE and help identify SLE patients with a high risk of VTE who may benefit from thromboprophylaxis.

References:

[1]Ramirez GA, Efthymiou M, Isenberg DA, Cohen H. Under crossfire: thromboembolic risk in systemic lupus erythematosus. Rheumatology. 2018;58:940-952.

[2]Chung WS, Lin CL, Chang SN, Lu CC, Kao CH. Systemic lupus erythematosus increases the risks of deep vein thrombosis and pulmonary embolism: a nationwide cohort study. J Thromb Haemost. 2014;12:452-458.

[3]Liew NC, Alemany GV, Angchaisuksiri P, et al. Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. Int Angiol. 2017;36:1.

[4]Savino S, Giovanni S, Veronica M, Dario R, Khamashta MA, Laura BM. GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology. 2013:8.

[5]Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543-603.

[6]Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Nguyen NT, Stamos MJ. A Nationwide Analysis of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Colon and Rectal Surgery. J Gastrointest Surg. 2014;18:2169-2177.

Disclosure of Interests:

None declared

OP0290 CLINICAL CHARACTERISTICS AND PROGNOSIS OF ANTIPHOSPHOLIPID SYNDROME PATIENTS BASED ON CLUSTER ANALYSIS: A 10-YEAR COHORT STUDY

Background:

APS is an autoimmune disease characterized by persistent antiphospholipid antibodies (aPLs) positivity, leading to thrombotic events or pregnancy morbidity. High-risk aPLs profiles included positive lupus anticoagulant (LA) and multiple aPLs positivity1. Association was also found between aPLs and a variety of manifestations beyond thrombosis, referred to “non-criteria manifestations” (i.e. thrombocytopenia, hemolytic anemia, heart valve disease and aPL-related nephropathy)2, of which the role in APS risk stratification is poorly understood. The manifestation spectrum of APS is wide, ranging from asymptomatic aPLs positivity to life-threatening catastrophic APS, and patients other than confirmed APS also need proper management. Therefore, a risk stratification integrating demographic data, aPL-related manifestations, aPLs profiles, coexisting cardiovascular risk factors and SLE is needed for management guidance and prognosis assessment.

Objectives:

Using cluster analysis, to identify phenotypes among aPL-positive patients and assess the prognosis of each phenotype.

Methods:

This is a single-center, prospective cohort study of aPL-positive patients who presented to Peking Union Medical College Hospital from 2004 to 2020. Demographic characteristics, aPL-related manifestations, cardiovascular risk factors, antibodies profile and follow-up data were recorded. The primary end point was defined as a combination of newly onset arterial thrombosis (AT) or deep venous thrombosis (DVT), major bleeding events, non-criteria manifestations and all-cause death. Hierarchical cluster analysis with the Euclidean distance and the Ward method was applied to identify clusters of patients and variables separately. Multiple comparison and Kaplan-Meier survival analysis were performed among clusters.

Results:

Four clusters among 383 patients (70.2% female; mean age 37.7 years) were identified (Figure 1A). Cluster 1 (n=138): female patients with SLE, non-criteria manifestations, triple aPLs positivity, high AT rate and moderate DVT rate. Cluster 2 (n=112): male patients with obesity, smoking history, hypertension, hyperhomocysteinemia, triple aPLs positivity and the highest rate of AT and DVT. Cluster 3 (n=83): female patients with the highest pregnancy morbidity rate and the lowest thrombosis rate. Cluster 4 (n=50): 62% male patients with isolated LA positivity, high AT rate and moderate DVT rate. Four clusters of variables were also identified (Figure 1A). From Kaplan-Meier survival analysis, 1-, 5- and 10-year event-free survival rates were 92.6%, 79.8% and 66.8%, respectively. Cluster 3 showed lowest incidence of primary endpoint (Figure 1B), while Cluster 1 and 2 showed higher newly-onset AT risk compared with other clusters (P=0.028 for 2 vs 3 and P=0.049 for 2 vs 4).

Figure 1.

Conclusion:

We identified 4 clinical phenotypes of aPL-positive patients. APS secondary to SLE was always aggregated with non-criteria manifestations. Clinicians should be alert to the possibility of SLE in aPL-positive patients with coexisting non-criteria manifestations, for whom immunosuppressive therapy besides anticoagulation may be necessary. Cluster 4 represented patients with isolated LA positivity and shared similar prognosis with secondary APS and male patients, which confirmed that LA represented a high-risk antibody spectrum. Additionally, cardiovascular risk factors (i.e. male, smoking history and obesity) played an important role in thrombosis events, and led to poor prognosis. Therefore, more attention should be paid to male patients, and the screening and management of cardiovascular risk factors should not be ignored.

References:

[1]Tektonidou MG, Andreoli L, Limper M et al. EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis 2019;78:1296–304.

[2]Miyakis S, Lockshin MD, Atsumi T et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295–306.

Disclosure of Interests:

None declared.

POS0775 APLS-ASSOCIATED RETINAL VASCULOPATHY AS A PRESENTATION OF THROMBOTIC MICROANGIOPATHY

Background:

Persistent antiphospholipid antibodies (aPL) positivity was a recognized risk factor for thrombotic events, obstetric morbidity and a variety of manifestations beyond thrombosis. The presence of some non-criteria manifestations including thrombocytopenia, hemolytic anemia, and APS nephropathy should prompt consideration for thrombotic microangiopathy (TMA).1 Patients with APS can also present with a variety of ocular and neuro-ophthalmic manifestations, such as retinal artery/vein occlusion, retinal arteritis, optic neuritis and ischemic optic neuropathy, with underlying mechanisms remained elusive. Retinal vasculopathy including retinal artery occlusion (RAO) or retinal vein occlusion (RVO) was recently found occurred more frequently in APS patients with thrombocytopenia2, suggested other possible mechanisms besides thromboembolism.

Objectives:

To explore risk factors and possible mechanisms of retinal vasculopathy among APS patients.

Methods:

In this single-center case-control study among APS patients, we evaluated patients who fulfilled 2006 Sapporo APS Classification Criteria3 with or without retinal vasculopathy during 2018-2020 at Peking Union Medical College Hospital. Demographic data, aPL-related manifestations, cardiovascular risk factors and antibodies profile were compared and a logistical regression model was built. Hierarchical cluster analysis with the Euclidean distance and the Ward method was applied to identify clusters of variables.

Results:

A total of 310 APS patients (67.4% female, mean age 38.1 years) were included, of whom 18 patients were diagnosed with retinal vasculopathy (9 with RVO and 9 with RAO). No significant differences was found among most demographic characteristics, clinical manifestations, or antibody profile. However, APS-related heart valve disease (OR 13.66, 95% confidence interval [CI] 4.55-40.98), APS nephropathy (OR 12.77, 95% CI 4.04-40.35), thrombocytopenia (OR 2.63, 95% CI 1.01-6.89) and high serum IgM (OR 3.67, 95% CI 1.30-10.40) were predictive of retinal vasculopathy (Figure 1 A). APS-related heart valve disease and nephropathy were also found statistical significant in multivariate logistical regression (Figure 1 B). They and other non-criteria manfestations were aggregated with retinal vasculopathy from cluster analysis of variables (Figure 1 C).

Conclusion:

Patients with APS-related heart valve disease and nephropathy suffered a higher risk of retinal vasculopathy including RAO and RVO. The underlying mechanisms of aPLs-associated retinal vasculopathy may involve TMA, leading to a poor prognosis and therapeutic changes.

References:

[1]Kotzen ES, Roy S, Jain K. Antiphospholipid Syndrome Nephropathy and Other Thrombotic Microangiopathies Among Patients With Systemic Lupus Erythematosus. Adv Chronic Kidney Dis. 2019 Sep;26(5):376-386.

[2]Ermakova NA, Alekberova ZS, Reshetniak TM, Kalashnikova LA, Kosheleva NM. [Retinal vascular lesions in systemic lupus erythematosus and secondary antiphospholipid syndrome]. Vestn Oftalmol. 2005 Sep-Oct;121(5):31-6.

[3]Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006 Feb;4(2):295-306.

Figure 1. A) Forest plot of univariate analysis; B) Forest plot of multivariate logistic regression; C) Cluster analysis of variables.

Disclosure of Interests:

None declared

Hydrogen gas (XEN) inhalation ameliorates airway inflammation in asthma and COPD patients

BACKGROUND

Hydrogen was proven to have anti-oxidative and anti-inflammation effects to various diseases.

AIM

We wish to investigate the acute effects of inhaled hydrogen on airway inflammation in patients with asthma and chronic obstructive pulmonary disease (COPD).

DESIGN

Prospective study.

METHODS

In total, 2.4% hydrogen containing steam mixed gas (XEN) was inhaled once for 45 min in 10 patients with asthma and 10 patients with COPD. The levels of granulocyte-macrophage colony stimulating factor, interferon-γ, interleukin-1β (IL-1β), IL-2, IL-4, IL-6 and so on in peripheral blood and exhaled breath condensate (EBC) before and after 'XEN' inhalation were measured.

RESULTS

45 minutes 'XEN' inhalation once decreased monocyte chemotactic protein 1 level in both COPD (564.70-451.51 pg/mL, P = 0.019) and asthma (386.39-332.76 pg/mL, P = 0.033) group, while decreased IL-8 level only in asthma group (5.25-4.49 pg/mL, P = 0.023). The level of EBC soluble cluster of differentiation-40 ligand in COPD group increased after inhalation (1.07-1.16 pg/mL, P = 0.031), while IL-4 and IL-6 levels in EBC were significantly lower after inhalation in the COPD (0.80-0.64 pg/mL, P = 0.025) and asthma (0.06-0.05 pg/mL, P = 0.007) group, respectively.

CONCLUSIONS

A single inhalation of hydrogen for 45 min attenuated inflammatory status in airways in patients with asthma and COPD.

Effects of grazing mixed-grass pastures on growth performance, immune responses, and intestinal microbiota in free-range Beijing-you chickens

There is an increasing interest in free-range poultry with the increasing focus on food safety and animal welfare. This study was conducted to evaluate the effects of grazing mixed-grass pastures on growth performance, immune responses, and intestinal microbiota in free-range laying chickens. Ten-week-old female Beijing-you chickens were blocked by the BW and randomly assigned to 3 free-range systems in poplar plantations for 120 d: forage-removed paddocks with a high stocking density of 5 m²/hen (control [CK]); mixed-grass pastures with a low stocking density of 6 m²/hen ;or mixed-grass pastures with a high stocking density of 5 m²/hen. Intestinal microbial community analysis was performed by 16S rRNA gene sequencing using Illumina MiSeq. The results revealed that no differences (P > 0.05) were found between the 3 raising systems for the BW and ADG. Chickens grazing mixed-grass pastures exhibited decreased (P > 0.05) mortality and improved immune responses as evidenced by increased T-lymphocyte proliferation (P > 0.05) and immunoglobulin A (P > 0.05) and immunoglobulin M concentrations (P < 0.05) compared with those raised in forage-removed paddocks. Metagenomic analysis indicated that grazing mixed-grass pastures regulated the intestinal microbiota by increasing the prevalence of beneficial bacteria, such as Lactobacillus, Bacteroides, and Faecalibacterium, and reducing potentially pathogenic bacteria population, such as the Rikenellaceae_RC9_gut_group compared with the CK. Therefore, this study indicated that grazing mixed-grass pastures could positively influence intestinal microbiota that may contribute to the overall growth and immunity of free-range chickens and that a low stocking density of 6 m²/hen was optimal to Beijing-you chickens grazing mixed-grass pastures.

LncRNA DARS-AS1 regulates microRNA-129 to promote malignant progression of thyroid cancer

OBJECTIVE

To investigate the expression of long non-coding RNA (lncRNA) DARS-AS1 in thyroid cancer, and to further investigate whether it can promote the development of thyroid cancer by regulating microRNA-129.

PATIENTS AND METHODS

Real-time quantitative polymerase chain reaction (qPCR) was used to detect the level of DARS-AS1 in tumor tissues and paracancerous tissues of 34 thyroid carcinomas. It was also used to analyze the relationship between the expression of DARS-AS1 and the clinical indicators of thyroid cancer and the prognosis of patients. qPCR was used to further verify the expression of DARS-AS1 in thyroid cancer cell lines. The DARS-AS1 knockdown model was constructed using lentivirus in thyroid cancer cell lines. Cell counting kit-8 (CCK-8), cell clone formation, and transwell migration assays were performed to evaluate the effects of DARS-AS1 on the biological function of thyroid cancer cells. Finally, the potential mechanism was explored by using recovery experiments and the interplay between DARS-AS1 and microRNA-129 was further studied.

RESULTS

qPCR results revealed that the level of DARS-AS1 in tumor tissues of thyroid cancer patients was remarkably higher than that in adjacent tissues, and the difference was statistically significant. Compared with patients with low expression of DARS-AS1, patients with high DARS-AS1 expression had a higher incidence of high tumor stage, distant metastasis, and a lower overall survival rate. Besides, compared with NC group, the proliferation and migration ability of shRNA-AS1 expression knockdown group sh-DARS-AS1 was remarkably decreased. qPCR results indicated that there was a negative correlation between the level of microRNA-129 and DARS-AS1 in thyroid cancer tissues. In addition, cell proliferation and migration ability in the microRNA-129 overexpression group were remarkably decreased. The recovery experiment also found that there was a mutual regulation between DARS-AS1 and microRNA-129, which together affected the malignant progression of thyroid cancer.

CONCLUSIONS

DARS-AS1 level in tumor tissues of thyroid cancer was remarkably increased and was correlated with the pathological stage, distant metastasis, and poor prognosis of thyroid cancer. Moreover, DARS-AS1 could promote the proliferation and migration capabilities of thyroid cancer cells by modulating microRNA-129.

Serum soluble ST2 is a potential long-term prognostic biomarker for transient ischaemic attack and ischaemic stroke

BACKGROUND AND PURPOSE

Soluble ST2 (sST2) is a promising biomarker in inflammation, atherosclerosis and cardiovascular diseases. We investigated the association between serum sST2 and poor outcome in patients with transient ischaemic attack (TIA)/ischaemic stroke.

METHODS

Patients within 24 h after onset and with measured serum sST2 were prospectively enrolled in this study. Poor outcome was a combination of a new stroke event (ischaemic or haemorrhagic) and all-cause death within 90 days and 1 year. The associations of serum sST2 with poor outcome were analysed by Cox proportional hazards.

RESULTS

Among the 430 patients included, the median (interquartile range) sST2 was 17.72 (9.31-28.84) ng/mL. A total of 19 (4.4%) and 38 (8.8%) patients experienced poor outcome within 90 days and 1 year, respectively. Compared with the lowest sST2 tertile, hazard ratios (HRs) [95% confidence intervals (CI)] for the highest tertile were 5.14 (1.43-18.51) for poor outcome within 90 days and 3.00 (1.29-6.97) at 1 year after multivariate adjustments. Adding sST2 to a prediction model significantly improved risk stratification of poor outcome in TIA/ischaemic stroke, as observed by the continuous net reclassification improvement of 60.98% (95% CI, 15.37-106.6%, P = 0.009) and integrated discrimination improvement of 2.63% (95% CI, 0.08-5.18%, P = 0.043) at 90 days and the continuous net reclassification improvement of 41.68% (95% CI, 8.74-74.61%, P = 0.013) at 1 year.

CONCLUSIONS

Increased serum sST2 levels in TIA/ischaemic stroke were associated with increased risks of poor outcome within 90 days and 1 year, suggesting that serum sST2 may be a potential long-term prognostic biomarker for TIA/ischaemic stroke.

MiR-601 inhibits the proliferation and metastasis of esophageal squamous cell carcinoma (ESCC) by targeting HDAC6

OBJECTIVE

The aim of this study was to explore the role of microRNA-601 (miR-601) in the proliferation and invasion of esophageal squamous cell carcinoma (ESCC) cells, thereby providing new thoughts for prognosis evaluation and targeted therapy of ESCC.

PATIENTS AND METHODS

23 pairs of ESCC tissue samples and adjacent normal tissues were collected, and the expression level of miR-601 was detected. Biological information analysis and Luciferase report gene assay were used to verify the potential target genes of miR-601. Then, three groups were established in ESCC cell line (TE-1) to perform similar experiments, including the miR-NC group, the miR-601 mimics group and the mimics + HDAC6 group. Cell counting kit-8 (CCK-8) assay was used to detect cell proliferation ability. Meanwhile, transwell assay and scratch-wound assay were applied to observe the effect of miR-601 on cell invasion and migration. Quantitative reverse transcription Polymerase Chain Reaction (qPCR) and Western blot assay were applied to determine the mRNA and protein expression changes after transfection.

RESULTS

Compared with normal adjacent tissues and normal esophageal epithelial cells, the expression of miR-601 was significantly decreased in ESCC tissues and cells. HDAC6 was identified as a target gene of miR-601. The expression of HDAC6 in esophageal carcinoma cells transfected with miR-601 mimics was significantly down-regulated. The negative correlation between miR-601 and HDAC6 expression was assessed by qPCR and Western blot (WB) assay. Furthermore, miR-601 remarkably suppressed the proliferation of ESCC cells. Meanwhile, cell invasion and migration were also found markedly restricted after transfection of miR-601 mimics. However, the overexpression of HDAC6 significantly counteracted the effects of miR-601.

CONCLUSIONS

MiR-601 suppressed the proliferation, invasion and migration of esophagus carcinoma cells by down-regulating HDAC6 expression.