The localization and function of p38α mitogen-activated protein kinase in rat oocytes

P38α mitogen-activated protein kinase (MAPK), which is a member of the canonical MAPK family, is activated in response to various extracellular stresses and plays a role in multiple cellular processes. In this study, we investigated the expression, subcellular localization and functional roles of p38α MAPK during the meiotic maturation of rat oocytes. We found that p38α MAPK phosphorylation (p-p38α MAPK, indicative of p38α MAPK activation) was low at the germinal vesicle (GV) stage, increased 3 hr after germinal vesicle breakdown (GVBD) and maintained its maximum at metaphase I (MI) or metaphase II (MII). The p-p38α MAPK mainly accumulated in the GV and had no obvious expression in the nucleus. From GVBD to MII, p-p38α MAPK was distributed in the cytoplasm around either the chromosomes or the spindle. We used SB203580, an inhibitor of p38α MAPK, to investigate the possible functional role of p38α MAPK during rat oocyte meiotic maturation. Treatment of GV stage oocytes with 20 μM SB203580 blocked p-p38α MAPK activity, and the spindles appeared abnormal. Additionally, the rate of GVBD after 3 hr of culture with 20 μM SB203580 (58.8%) was significantly inhibited compared with the control (82.5%, p < .05), and the polar body extrusion rate after 12 hr of culture with SB203580 was also significantly decreased compared with the control (40.1% vs 73.3%, p < .05). Taken together, these data indicate that p38α MAPK may play a vital role in rat oocyte meiotic maturation.

Vitamin D and gestational diabetes mellitus: a systematic review based on data free of Hawthorne effect

BACKGROUND

Gestational diabetes mellitus (GDM) is an increasingly prevalent disorder, associated with low blood vitamin D level.

OBJECTIVES

To evaluate the relationship between vitamin D and GDM.

SEARCH STRATEGY

EMBASE, MEDLINE, Cochrane Library and China Biology Medicine disc were searched up to May 2017. The references of previous studies were screened.

SELECTION CRITERIA

Observational studies on the relationship between vitamin D and GDM free from Hawthorne effect and randomised controlled trials of vitamin D supplementation during pregnancy for preventing or treating GDM were included.

DATA COLLECTION AND ANALYSIS

Data and information of included articles were extracted by duplicate using piloted tables. Newcastle-Ottawa Scale and Cochrane Handbook were used for quality assessment. Random-effects models were used for meta-analyses. Heterogeneity tests, sensitivity analysis and analysis of publication bias were conducted.

MAIN RESULTS

Eighty-seven observational studies and 25 randomised controlled trials involving 55 859 and 2445 women, respectively, were included. Low blood vitamin D level during pregnancy was associated with a higher risk of GDM (OR 1.850, 95% CI 1.471-2.328). Blood vitamin D level for women with GDM were lower than in the control women. Blood vitamin D level was associated with fasting plasma glucose (FPG) and homeostasis model of assessment for insulin resistance index (HOMA-IR) (r = -0.100 and r = -0.351), whereas the correlation between blood vitamin D level and fasting insulin (FINS) might be concealed by publication bias. Vitamin D intervention during pregnancy could change the blood levels of vitamin D, FINS, FPG, HOMA-IR, glutathione, C-reactive protein and lipid.

CONCLUSIONS

Low blood vitamin D level could increase the risk of GDM, and vitamin D supplementation during pregnancy could ameliorate the condition of GDM.

TWEETABLE ABSTRACT

Low blood vitamin D increases gestational diabetes mellitus (GDM) risk. Vitamin D supplementation ameliorates GDM condition.

Mechanisms of cognitive-behavioral therapy for obsessive-compulsive disorder involve robust and extensive increases in brain network connectivity

Cognitive-behavioral therapy (CBT) is effective for obsessive compulsive disorder (OCD); however, little is understood about its mechanisms related to brain network connectivity. We examined connectivity changes from resting-state functional magnetic resonance imaging data pre-to-post-CBT in 43 OCD participants, randomized to receive either 4 weeks of intensive CBT or 4 weeks waitlist followed by 4 weeks of CBT, and 24 healthy controls before and after 4 weeks of no treatment. Network-based-statistic analysis revealed large-magnitude increases in OCD connectivity in eight networks. Strongest increases involved connectivity between the cerebellum and caudate/putamen, and between the cerebellum and dorsolateral/ventrolateral prefrontal cortices. Connectivity increases were associated with increased resistance to compulsions. Mechanisms of CBT may involve enhanced cross-network integration, both within and outside of classical cortico-striatal-thalamo-cortical regions; those involving cerebellar to striatal and prefrontal regions may reflect acquisition of new non-compulsive goal-directed behaviors and thought patterns. Our findings have implications for identifying targets for enhancing treatment efficacy and monitoring treatment progress.

Influence of tumor size on outcomes following pelvic exenteration

OBJECTIVE

Pelvic exenteration (PE) is often the only curative option for locally advanced or recurrent pelvic malignancies. Despite radical surgery, recurrence risk and morbidity remain high. In this study, we sought to determine tumor size effect on perioperative outcomes and subsequent survival in patients undergoing PE.

METHODS

Retrospective chart review was performed for female patients who underwent PE at two comprehensive cancer centers from 2000 to 2015. Demographics, complications and outcomes were recorded. Statistical analyses were performed using chi-square, student's t-test, logistic regression, non-parametric tests, log-rank test, and Cox proportional hazards.

RESULTS

Of 151 women who underwent PE, 144 had available pathologic tumor size. Gynecologic oncology, surgical oncology, and urology performed 84, 29, and 31 exenterations, respectively. Tumor dimensions ranged from 0 to 25.5cm. Perioperative complications, 30-day mortality, reoperation, and readmission rates were not associated with tumor size. Obesity and prior radiation increased risk for major perioperative complication while anterior exenterations decreased risk. Larger tumors were more likely to undergo total pelvic exenteration (OR 1.14; 95%CI 1.03-1.27), have positive margins (OR 1.11; 95%CI 1.02-1.22), and recur (65%, 42% and 20% for tumors >4cm, ≤4cm and no residual tumor respectively, p=0.016). Tumor size >4cm and positive margins were associated with worse overall survival amongst gynecologic oncology patients.

CONCLUSION

Tumor size was not associated with perioperative morbidity. Larger tumors were associated with positive margins, more extensive resection, and worse survival in gynecologic oncology patients. Larger studies are needed to further understand tumor size impact on PE outcomes within specific tumor types.

Withasteroid B from D. metel L. regulates immune responses by modulating the JAK/STAT pathway and the IL-17+ RORγt+ /IL-10+ FoxP3+ ratio

Datura metel L. is a medicinal herb that contains withasteroids and has a wide range of biological activities. We isolated seven withasteroids from the flowers of D. metel L and examined their ability to inhibit immune responses in vitro and in vivo. Among the withasteroids, withasteroid B2 exhibited the strongest inhibitory effect on immune responses comparing B2 with other isolated compounds from D. metel L., including suppressing the differentiation of CD4⁺ T cells by inhibiting the expression and production of T cell lineage-specific master regulators and cytokines and directly suppressing the cytokine-induced Janus kinase/signal transducer and activator of transcription (JAK/STAT) signalling pathways. In the interleukin (IL)-23-induced mouse ear model of skin disease, B2 repressed disease development by inhibiting the expression of proinflammatory mediators in murine ear skin. Moreover, B2 affected the maturation of dendritic cells (DCs) in vitro which, in turn, induced T cell differentiation with an increased regulatory T cell (T_reg ) phenotype and decreased T helper type 17 (Th17) phenotype. This study provides new evidence that B2 might ameliorate chronic inflammatory skin diseases by suppressing pathogenic CD4⁺ T cell differentiation and the IL-17⁺ retinoic-acid-receptor-related orphan receptor gamma t (RORγt)⁺ /IL-10⁺ forkhead box protein 3 (FoxP3)⁺ ratio. These findings suggest that B2 might mediate the therapeutic effects observed in psoriasis patients following treatment with D. metel L.

Chemerin/chemR23 association with endothelial-mesenchymal transition in diabetic nephropathy

This study was aimed to analyze the association of chemerin/chemR23 with endothelial-mesenchymal transition (EndMT) in the kidney of rats during the progression of diabetic nephropathy (DN). Eighty male Sprague-Dawley rats were randomly distributed to age-matched control and diabetic nephropathy model groups. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ). Morphological changes in the renal tissues were observed after periodic acid-Schiff staining. Chemerin and chemR23 expression was determined by immunohistochemistry. Co-expression of α-smooth muscle actin (α-SMA) and CD31 was determined by immunofluorescence double-labeling. Expression of all these markers was analyzed by Western blotting. Expression of chemerin, chemR23, and transforming growth factor-β1 (TGF-β1) genes at mRNA level was determined by qRT-PCR. Mild glomerular hypertrophy was observed at 4 weeks and mild glomerular basement membrane thickening and mesangial matrix proliferation at 12 weeks. Immunohistochemistry showed much higher levels of chemerin and chemR23 in diabetic rats compared with the control group. Expression of chemerin, chemR23, and α-SMA proteins increased with disease progression, while CD31 protein expression decreased. Expression of chemerin, chemR23, and TGF-β1 mRNAs also increased. α-SMA and CD31 co-expression increased with disease progression from 4 weeks. Spearman correlation analysis showed that chemerin mRNA levels correlated positively with Chem R23, TGF-β1, α-SMA expression, and CD31 and α-SMA double-positive cell numbers, but negatively with CD31 protein expression. In conclusion, chemerin expression correlates with EndMT in DN model rats.

The influence of connective tissue growth factor on rabbit ligament injury repair

Objectives

The injured anterior cruciate ligament (ACL) is thought to exhibit an impaired healing response, and attempts at surgical repair have not been successful. Connective tissue growth factor (CTGF) is reported to be associated with wound healing, probably through transforming growth factor beta 1 (TGF-β1).

Methods

A rabbit ACL injury model was used to study the effect of CTGF on ligament recovery. Quantitative real-time PCR (qRT-PCR) was performed for detection of changes in RNA levels of TGF-β1, type 1 collagen (COL1), type 2 collagen (COL2), SRY-related high mobility group-box gene9 (SOX9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and matrix metallopeptidase 13 (MMP-13). Expression of related proteins was detected by Western blotting.

Results

The current study showed that CTGF could promote the recovery of an injured anterior cruciate ligament. It can upregulate mRNA and expression of TGF-β1, COL1, COL2, SOX9, and tissue inhibitor of TIMP-1, and downregulate mRNA and expression of MMP-13, suggesting that the curative effect of CTGF on injured rabbit ligaments is through regulation of these cellular factors.

Conclusions

This finding revealed the healing role of CTGF in injured tissues and provides new possibilities of treating injured tissues and wound healing by using CTGF.

Cite this article: X. Sun, W. Liu, G. Cheng, X. Qu, H. Bi, Z. Cao, Q. Yu. The influence of connective tissue growth factor on rabbit ligament injury repair. Bone Joint Res 2017;6:399–404. DOI: 10.1302/2046-3758.67.BJR.2016-0255.R1.

IL-6 promotes epithelial-to-mesenchymal transition of human peritoneal mesothelial cells possibly through the JAK2/STAT3 signaling pathway

Long-term peritoneal dialysis (PD) therapy results in functional and structural alteration of the peritoneal membrane, including epithelial-to-mesenchymal transition (EMT). Interleukin 6 (IL-6) is a local pleiotropic cytokine, hypothesized to play an important role in EMT. This study was designed to investigate the role of IL-6 in EMT and peritoneal membrane dysfunction in long-term PD patients by assessing the level of IL-6 in dialysate and exploring the relationship between IL-6, the related signaling pathway JAK2/STAT3, and EMT, using in vitro cellular and molecular techniques. Plasma and dialysate levels of IL-6 were significantly higher in PD ultrafiltration failure patients compared with patients without ultrafiltration failure and were negatively correlated with measures of PD adequacy. In vitro IL-6 treatment changed human peritoneal mesothelial cell phenotype from a typical cobblestone-like to a fibroblast-like appearance and increased cell viability. IL-6 treatment increased α-smooth muscle actin and vascular endothelial growth factor expression but decreased E-cadherin expression. IL-6 treatment activated the JAK/STAT signaling pathway. However, the JAK2/STAT3 inhibitor WP1066 prevented IL-6-induced activation of the JAK2/STAT3 pathway and EMT. We conclude that IL-6 promotes the EMT process, possibly by activating the JAK2/STAT3 signaling pathway. IL-6 may serve as a novel therapeutic target for preventing EMT, and preservation of the peritoneal membrane may arise from these studies.

The associations between serum 25-hydroxyvitamin D level and the risk of total fracture and hip fracture

In this meta-analysis, we evaluated the association between serum 25-hydroxyvitamin D (25(OH) vitamin D) level and the risk of total fractures and hip fractures. Low serum 25(OH) vitamin D level is associated with an increased risk of total and hip fractures.

INTRODUCTION

Data on the association between serum 25(OH) vitamin D level and the risk of fractures are conflicting. This study aimed to provide a summary of prospective cohort or nested case-control studies on the association between serum 25(OH) vitamin D level and the risk of total fractures and hip fractures.

METHODS

We identified relevant studies by searching the PubMed, EMBASE, and OVID databases from their inception to June 1, 2016. We included published prospective cohort or nested case-control studies evaluating the associations of serum 25(OH) vitamin D level with the fracture risk. Two reviewers abstracted the data independently. Relative risks (RRs) with 95% confidence intervals (CIs) were derived throughout the whole analysis.

RESULTS

Sixteen prospective cohort studies and three nested case-control studies were included. We found that low serum 25(OH) vitamin D level was significantly associated with the risk of total fractures (RR 1.25, 95% CI 1.06-1.43; I ² = 31.3%, p for heterogeneity = 0.15) and hip fractures (RR 1.48, 95% CI 1.29-1.68; I ² = 0%, p for heterogeneity = 0.51). The hip fracture risk was increased by 40% for each SD decrease in serum 25(OH) vitamin D level (RR 1.40, 95% CI 1.20-1.61; I ² = 0%, p for heterogeneity = 0.51). The per SD decrease in serum 25(OH) vitamin D level was not associated with the increased risk of total fractures (RR 1.14, 95% CI 0.93-1.35; I ² = 63.2%, p for heterogeneity = 0.04).

CONCLUSIONS

Our study suggests that low serum 25(OH) vitamin D level is associated with increased risks of total and hip fractures. In the analyzed studies, the per SD decrease in serum 25(OH) vitamin D level was associated with the hip fracture risk but not with the total fracture risk.

Accuracy of glomerular filtration rate equations for chronic kidney disease patients at the G3a stage: a single-center cross-sectional study

Background

Kidney disease improving global outcomes provided a new classification for chronic kidney disease (CKD) by subdividing the G3 stage into G3a and G3b stages based on glomerular filtration rate (GFR) in 2012. Currently, a few methods are used to evaluate GFR, including measured GFR (mGFR) and estimated GFR (eGFR). One of the mGFR was ^99mTc-DTPA scintigraphy method and eGFR using GFR equations were used clinically. Equations were modification of diet in renal disease (MDRD), chronic kidney disease epidemiology collaboration (CKD-EPI), and Chinese adapted MDRD (C-MDRD). This study assessed the accuracy of three different equations for estimated glomerular filtration rate (eGFR) with mGFR using DTPA scintigraphy method as the standard in a population of Chinese chronic kidney disease patients at the G3a stage.

Results

One hundred and twenty-two patients (age 52.0 ± 15.6 years, 69 were male) were determined as CKD stage 3 based on mGFR. Patients were divided into G3a (47 patients) and G3b (75 patients) subgroups. Bias between eGFR for CKD-EPI and reference mGFR was 0.92 mL/min and 95% limits of agreement was −38.82 to 40.67 mL/min. Bias between eGFR for C-MDRD and mGFR was 3.76 and 95% limits of agreement was −39.32 to 46.85 mL/min. Bias between eGFR for MDRD and mGFR was 3.53 and 95% limits of agreement was −43.35 to 50.4 mL/min. The CKD-EPI equation showed better diagnostic value with a greater area under the receiver operating characteristic curve (AUC: 0.763). AUC for MDRD and C-MDRD were 0.75 and 0.757, respectively.

Conclusions

There were no obvious advantages in accuracy, sensitivity, and specificity for the diagnosis of patients at the G3a stage using the CKD-EPI equation.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-017-2400-8) contains supplementary material, which is available to authorized users.

Proton pump inhibitor monotherapy and the risk of cardiovascular events in patients with gastro-esophageal reflux disease: a meta-analysis

BACKGROUND AND PURPOSE

Proton pump inhibitors (PPIs) are commonly used as potent gastric acid secretion antagonists for gastro-esophageal disorders and their overall safety in patients with gastro-esophageal reflux disease (GERD) is considered to be good and they are well-tolerated. However, recent studies have suggested that PPIs may be a potential independent risk factor for cardiovascular adverse events. The aim of our meta-analysis was to examine the association between PPI monotherapy and cardiovascular events in patients with GERD.

METHODS

A literature search involved examination of relevant databases up to July 2015 including PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov, as well as selected randomized controlled trials (RCTs) reporting cardiovascular events with PPI exposure in GERD patients. In addition, the pooled risk ratio (RR) and heterogeneity were assessed based on a fixed effects model of the meta-analysis and the I² statistic, respectively.

KEY RESULTS

Seventeen RCTs covering 7540 patients were selected. The pooled data suggested that the use of PPIs was associated with a 70% increased cardiovascular risk (RR=1.70, 95% CI: [1.13-2.56], P=.01, I² =0%). Furthermore, higher risks of adverse cardiovascular events in the omeprazole subgroup (RR=3.17, 95% CI: [1.43-7.03], P=.004, I² =25%) and long-term treatment subgroup (RR=2.33, 95% CI: [1.33-4.08], P=.003, I² =0%) were found.

CONCLUSION & INFERENCES

PPI monotherapy can be a risk factor for cardiovascular adverse events. Omeprazole could significantly increase the risk of cardiovascular events and, so, should be used carefully.

Efficacy of statins for osteoporosis: a systematic review and meta-analysis

Our meta-analysis assessed the efficacy of statins on the risk of fracture, bone mineral density (BMD), and the markers of bone metabolism by collecting data from 33 clinical trials. We found that statin treatment was associated with bone metabolism. And statins seemed to be more effective on male patients with osteoporosis. The efficacy of statins for the treatment of osteoporosis has been controversial in previous studies and meta-analyses. Our meta-analysis was conducted to examine in detail the efficacy of statins on osteoporosis. We searched PubMed, Embase, and the Cochrane Library databases for clinical trials from inception to May 2016. We included studies that described the effect of statins on the risk of fracture, BMD, or bone turnover markers. Moreover, we also conducted subgroup analyses according to the skeleton site, patient gender, and length of follow-up. A total of 33 studies which included 23 observational studies (16 cohort studies and 7 case-control studies) and 10 randomized controlled trials (RCTs) were evaluated. These 33 studies included 314,473 patients in statin group and 1,349,192 patients in control group. Statins decreased the risk of overall fractures (OR = 0.81, 95% CI 0.73-0.89) and hip fractures (OR = 0.75, 95% CI 0.60-0.92). Furthermore, the use of statins was associated with increased BMD at the total hip (standardized mean difference (SMD) = 0.18, 95% CI 0.00-0.36) and lumbar spine (SMD = 0.20, 95% CI 0.07-0.32) and improved the bone formation marker, osteocalcin (OC) (SMD = 0.21, 95% CI 0.00-0.42). However, there was no positive effect on vertebral fractures, upper extremity fractures, BMD at the femoral neck, bone-specific alkaline phosphatase (BALP), and serum C-terminal peptide of type I collagen (S-CTX). Also, compared with male subgroups, the effect on female subgroups was only slightly positive or of no statistical significance. Our meta-analysis indicates that statin treatment may be associated with a decreased risk of overall fractures and hip fractures, an increased BMD at the total hip, BMD at the lumbar spine, and OC. Moreover, our results also show that statin treatment may have a greater effect on male patients than on female patients.