[Clinical analysis of 11 cases of sub-acute arsenic poisoning]

Objective: To investigate the clinical manifestations, treatments and prognosis of subacute arsenic poisoning. Methods: In January 2020, a retrospective analysis was carried out on 11 patients hospitalized with subacute arsenic poisoning caused by arsenic contaminated drinking water. We observed manifestations, treatments and prognosis. Results: The main clinical presentations of subacute arsenic poisoningin were gastroenteritis in early phase, some of them had other organ damage, such as skin, blood, liver, kidney, cardiovascular and so on. The later phase was mainly peripheral nervous system damage. The treatment was mainly to chelate arsenic, protect target organs and treat toxic peripheral neuropathy. Most were significantly recoveried, but the recovery of severe toxic peripheral neuropathy was tardy. Conclusion: Acute gastroenteritis is the mainly early manifestation of subacute arsenic poisoning caused by digestive tract, and toxic peripheral neuropathy in the later phase. The prognosis is good, but the recovery of severe toxic peripheral neuropathy is tardy.

Exploring the determinants of synergetic development of social organizations participating in home-based elderly care service: An SEM method

The current aging service industry has problems in meeting the ever-increasing demand for the home-based elderly care service (HECS). Social organizations participating in HECS seems to be a promising way to address these problems but also raises new challenges, like uncoordinated cooperation among stakeholders, which could lead to low management efficiency and low service quality. However, Synergetic development can be promising to enhance the participation of social organizations and to improve social welfare. This study introduces a conceptual model to explore relationships between five determinants and synergetic development of social organizations participating in HECS. A structural equation model (SEM) based on questionnaire survey is used as a test methodology. The results indicated that stakeholder engagement plays a critical role in synergetic development in HECS, resource allocation can only be improved by institutional climate, and supervision capacity cannot facilitate information sharing. This study provides effective strategies and directions for the improvement of home-based elderly care services.

Antecedents of safety behavior in construction: A literature review and an integrated conceptual framework

There has been no scarcity in the literature of suggested antecedents of employee safety behavior, and this paper brings together the disaggregated antecedents of safety behavior in the construction field. In total, 101 eligible empirical articles are obtained. Bibliometric and context analyses are combined to identify the influential journals, scholars, keywords, use of theory, research methods, and countries or regions of the empirical samples. The 83 factors that are identified are divided into five groups, namely (a) individual characteristics, (b) workgroup interactions, (c) work and workplace design, (d) project management and organization, and (e) family, industry, and society. This indicates that the causes of safety behavior are manifold. Various factors from different systems likely work in concert to create situations in which an individual chooses to comply with safety rules and participate voluntarily in safety activities. Given this, we propose that safety behavior is only an ostensible symptom of more complex "The Self-Work-Home-Industry/Society" systems and establish a safety behavior antecedent analysis and classification model. Based on this model, we develop a resource flow model, illustrating why, how, and when the flow of resources between the five systems-namely the self system, work system, home system, work-home interface system, and industry/society system-either promotes or inhibits safety behavior. The safety behavior antecedent analysis and classification model and resource flow model are based mainly on bioecological system theory and resources theories. Avenues for future theoretical development and method designs are suggested based on the reviewed findings and the two conceptual models. The intention with this systematic review together with the two integrated conceptual models is to advance theoretical thinking on how safety behavior can be promoted, or instead, inhibited.

[Epidemiological characteristics of imported COVID-19 cases in Guangzhou]

Objective: To understand the epidemiological characteristics of imported COVID-19 cases in Guangzhou and provide scientific basis for the prevention and control of the disease. Methods: The data of imported COVID-19 in Guangzhou reported as of April 1, 2020 were collected from National Notifiable Disease Report System of China. The software Excel 2010 and SPSS 19.0 were applied for data cleaning and statistical analysis. Results: As of April 1, 2020, a total of 103 imported COVID-19 cases had been reported in Guangzhou, in which 92 were confirmed cases and 11 were asymptomatic infection cases. The number of the confirmed imported cases accounted for 11.4% (92/806) in of the total in China at the same time. The male to female ratio of the cases was 1.58∶1 (63∶40). The median age of the cases was 31 years (P(25)-P(75):22-40 years), range of age was 11-63 years. The main occupational distributions of the cases were business services (41/103, 39.8%) and students (36/103, 35.0%). The imported cases whose destinations were 19 provinces and municipalities rather than Guangdong after entering the country accounted for 43.7%. The main source countries of infections were the United Kingdom (27/103, 26.2%), the Philippines (13/103, 12.6%), the United States (13/103, 12.6%) and Nigeria (7/103, 6.8%). There were 34 inbound flights from which the imported COVID-19 cases were detected, in which 10 flights (10/34, 29.4%) were found to carry more than 3 cases, with an average voyage time of (11.14±0.53) hours. A total of 29 imported cases(28.2%) showed symptoms before entering the country, and 65 cases (63.1%) had been isolated before the onset of the disease. The mean free activity time of the isolated cases after the onset was (6.76±0.79) days. The average number of the imported cases' close contacts was 53. There were 13 clusters of COVID-19 caused by the imported cases, involving 36 cases (including 1 imported associated case). Conclusions: The sources of the imported COVID-19 cases in Guangzhou were widely distributed, and no cases had been found to be infected on the flights. In the early stage of the imported epidemic, there was high risk for the spread of the epidemic. Strengthened prevention and control of imported COVID-19 effectively reduced the of transmission risk of COVID-19 in communities.

Key Factors Influencing Low-Carbon Behaviors of Staff in Star-Rated Hotels-An Empirical Study of Eastern China

To guide sustainable development in the hospitality industry requires hotel staff engagement, so what causes and how to facilitate the implementation of low-carbon behaviors should be high priorities. However, most prior studies focused on hotel guest behavior or discussed, on an individual level, the psychological aspects of the factors of the low-carbon behavior of either managers or employees. Therefore, this research aims to examine the effect of influencing factors inside and outside of the hotel context on hotel staff’s low-carbon behaviors in star-rated hotels. A set of influencing factors were identified by using literature retrieval, ground theory and in-depth interviews. Structural equation modelling was then applied with 440 valid questionnaires collected from representative star-rated hotels in Eastern China. The results revealed that low-carbon managerial activities, strategic orientation, social norms, and perceived behavior control were four key factors affecting the low-carbon behavior adoption of staff from star-rated hotels. Among them, low-carbon managerial activities were found to be the strongest factor affecting hotel staff’s low-carbon behaviors. Consumer attitude, however, exerted no significant impact. Targeted strategies were finally proposed for the improvement of hotel staff’s low-carbon behavior from the perspectives of hoteliers and governments. This study contributes to the generation mechanism of low-carbon behavior among staff and, in practice, towards behavioral improvement by providing comprehensive insights about the attribution of factors belonging to multiple dimensions related to the low-carbon behavior of staff in the hotel industry.

[Risk prevention of plague and suggestions for coping in China]

Plague is listed by the WHO as one of 20 infectious diseases that have re-emerged. Plague was prevalent in the world, bringing great disaster to the people around the world. Nowadays, great achievements have been made in the prevention and control of plague in our country. Human plague in China is currently sporadic, but there are still risks of resurgence spread and importation. This paper reviews the incidence of human plague globally and in China in the past ten years, summarizes the characteristics of current plague epidemic globally and in China, analyzes the current risks of plague prevention in China, and puts forward relevant countermeasures.

STRATEGY FORMULATION FOR THE SUSTAINABLE DEVELOPMENT OF SMART CITIES: A CASE STUDY OF NANJING, CHINA

Smart cities possess huge potential in future urban development. However, the critical problems in developing sustainable smart cities in China are the lack of clear strategies and effective strategy planning tools. Therefore, reasonable plans and strategies play important roles in helping the government develop sustainable smart cities. In this study, 16 SWOT (Strength, Weakness, Opportunity, and Threat) factors were identified. According to a structured questionnaire survey about SWOT factors, an integrated method, composed of SWOT and AHP (analytic hierarchy process) was conducted. A case study was conducted in Nanjing, China. The most powerful facilitators (strengths and opportunities) and the most powerful obstacles (weaknesses and threats) for developing Smart Nanjing City (SNC) were identified. The strategic intensity and value of the elements were confirmed. Moreover, proactive strategies were proposed including strengthening intelligent clusters, establishing governance ecosystem, and providing integrated services for SNC, which can be considered as policy suggestions for SNC, providing hybrid strategies for a planning approach integrating bottom-up and top-down design to develop smart cities, as a reference for other global cities. Moreover, the proposed AHP-SWOT hybrid method can be used as an effective quantitative strategy planning tool to help other authorities determine appropriate strategies for developing smart cities.

MicroRNA-579-3p promotes the progression of osteoporosis by inhibiting osteogenic differentiation of mesenchymal stem cells through regulating Sirt1

OBJECTIVE

To explore whether microRNA-579-3P was involved in the development of osteoporosis, and to investigate the possible molecular mechanisms.

PATIENTS AND METHODS

The messenger RNA (mRNA) expression levels of microRNA-579-3P, alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2) and bone sialoprotein (BSP) in serum samples of osteoporosis patients and normal controls were detected by quantitative Real-time polymerase chain reaction (qRT-PCR), respectively. Meanwhile, the expressions of the above genes during osteogenic differentiation of human bone marrow mesenchymal stem cells (hMSCs) were examined as well. To investigate the effect of microRNA-579-3P on osteogenesis, microRNA-579-3P was overexpressed and knocked down in hMSCs. Subsequently, the mRNA and protein expression levels of osteogenesis-related genes, such as ALP, RUNX2 and BSP, were detected by qRT-PCR and Western blot, respectively. In addition, ALP activity and mineralization forming ability were evaluated by ALP staining and alizarin red staining. Bioinformatics predicted that Sirt1 was the target gene of microRNA-579-3P. Subsequent luciferase reporter gene assay was performed to verify the binding relationship of microRNA-579-3P to Sirt1. Meanwhile, qRT-PCR and Western blot were used to detect the changes in the mRNA and protein expression levels of Sirt1, respectively. After overexpression of microRNA-579-3P and Sirt1, qRT-PCR, Western blot, ALP staining and alizarin red staining assays were performed to detect the osteogenic differentiation of hMSCs.

RESULTS

The expression of microRNA-579-3P in serum of patients with osteoporosis was significantly higher than that of normal controls. Meanwhile, the expression of microRNA-579-3P decreased gradually during osteogenic differentiation of hMSCs. Overexpression of microRNA-579-3P significantly reduced the expressions of osteogenic related genes, including ALP, RUNX2 and BSP. Besides, ALP activity and mineralized nodule formation ability decreased obviously as well. Luciferase reporter gene assay showed that microRNA-579-3P could bind to Sirt1. After overexpression of microRNA-579-3P, the mRNA and protein expression levels of Sirt1 were significantly reduced, which were reversed after silence of microRNA-579-3P. Simultaneous overexpression of microRNA-579-3P and Sirt1 could reverse the inhibition of osteogenic differentiation of hMSCs caused by overexpression of microRNA-579-3P alone.

CONCLUSIONS

MicroRNA-579-3P could inhibit osteogenic differentiation of hMSCs by regulating Sirt1, thereby promoting the development of osteoporosis.

[Comparison of epidemic characteristics between severe acute respiratory syndrome and coronavirus disease 2019]

Objective: To compare epidemic characteristics between severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19). Methods: The general information, including epidemiological and clinical data of the confirmed cases during the epidemic period of the two infectious diseases was collected. The data of SARS in Guangzhou was derived from the technical files of Guangzhou Center for Disease Control and Prevention (GZCDC), including the statistical report and brief report of the epidemic situation (from January 2 to May 11, 2003);The data of COVID-19 in Wuhan was derived from the epidemic data published by Wuhan health and Health Committee's official website and other publicly reported documents (from December 9, 2019 to March 11, 2020). Descriptive analysis was used for a comparativeanalysis of the time and age characteristics, the number of cases, basic reproduction number (R0), proportion of medical staff in confirmed cases (%), crude mortality, etc. Results: A total of 1 072 cases of SARS in Guangzhou were included in the study. The incidence ratio of male to female was 1∶1.26. 43 cases of death were reported with a mortality rate of 4.01%. The median age was 36 years old. The proportion of medical staff in the early stage of the epidemic was 29.04% (88 cases). As to COVID-19 in Wuhan, a total of 49 978 cases were included, The incidence ratio of male to female was 1.04∶1. The 2 423 cases of death were reported with a mortality rate of 4.85%. The median age was 56 years old. The proportion of medical staff in the early stage of the epidemic was 30.43% (42 cases). Conclusion: The COVID-19 in Wuhan has the characteristics of high incidence and wide population. However, the epidemic situation is falling rapidly, and the prevention and control strategy needs to be adjusted timely. The prevention and control of nosocomial infection should be addressed in future.

Assessing the Safety Risks of Civil Engineering Laboratories Based on Lab Criticity Index: A Case Study in Jiangsu Province

With the rapid development of the construction industry, an increasing amount of attention were paid by universities to the development of civil engineering experiment courses so as to improve the practical research abilities of students. In recent years, due to the frequent occurrence of civil engineering laboratory accidents, it has become an urgent issue regarding on what factors influencing safety risks and how to assess and reduce the safety risks in civil engineering laboratories. Based on the lab criticity index (LCI) model, the research specificities of civil engineering laboratories were analyzed through literature review and expert interviews and 13 risk factors of civil engineering laboratories, from the four aspects of man, object, management, and environment, identified. The data for each parameter in the LCI model was obtained through a questionnaire survey, and finally the LCI value was calculated to evaluate priority. Among them, insufficient safety awareness of operators, danger due to equipment failure, imperfect management policies, and complex floor conditions were listed as the most common risk factors. Based on the LCI model, the worsening factors of these four risk factors were further analyzed. The LCI model is applied to the new research field of safety risk assessment in civil engineering laboratories that few researchers have studied before and a risk list for civil engineering laboratories was created. We revealed the safety status of civil engineering laboratories in Jiangsu Province and provided feasible suggestions for improving the management and supervision of civil engineering laboratories at universities. It can strengthen operator awareness of the risks in civil engineering laboratories and improve the social group's attention to the safety risks of the laboratories, thus reducing the accidents' possibility and seriousness of civil engineering laboratories.

Developing Key Safety Management Factors for Construction Projects in China: A Resilience Perspective

It is acknowledged that construction safety is pivotal to the project management objectives. Meanwhile, the concept of resilience provides an effective and pragmatic countermeasure to improve the safety management level of construction projects. However, the “resilience” has not gained considerable attention in the construction safety management system. In this context, the paper aims to develop the key safety management factors for construction projects from the resilience perspective. Firstly, the theoretical framework and key safety management factors of construction safety management system based on the resilience theory are proposed. The importance of each factor is then obtained by using the method of structural equation modeling (SEM). The results indicate that information management, material and technology management, organization management and personnel management would improve the safety and resilience of the project. Specifically, improving the resilience of information flow to strengthen the interaction among elements of the system can enhance the safety management level. These findings can be used as references for construction safety managers to improve the abilities of preventing safety accidents and recovering after safety accidents.

[Analysis of clinicopathological features of clear cell tumor of the lung]

Objective: To analyze the clinicopathological features of clear cell tumor of the lung (CCTL). Methods: A total of 9 cases were collected from August 2008 to August 2019 in the Department of Pathology of the First Medical Center of PLA General Hospital and Hainan Hospital of PLA General Hospital. Their clinical data, pathological characteristics, immunohistochemical staining and special staining results were summarized and analyzed. Results: There were 3 males and 6 females, aged from 28 to 70 years (average 52.2 years). All tumors were located in the peripheral part of the lung, and were solitary in 8 cases, and multiple (24 nodules) in 1 case. The lesion was round or oval, with clear boundary. The diameter of the nodule was 0.5-5.5 cm. Histologically, the tumor cells were oval, short fusiform or polygonal, with obvious nucleoli. The tumor cells were mostly distributed in sheet around thin-walled vessels, and there was hyaline degeneration around the blood vessels. Neither necrosis nor mitosis could be seen. Immunohistochemical staining showed tumor cells were diffusely positive for Vimentin, and CD34, Melan-A, specific monoclonal antibody against melanoma (HMB45) and S-100 were positive with different degrees. Broad spectrum cytokeratin (CK), epithelial membrane antigen (EMA), smooth muscle actin (SMA), desmin, CD10, paired box gene 8 (PAX-8) or myomodulatory protein (Myo-D1) were all negative. The positive index of the proliferating cell nuclear antigen (Ki-67) was low. Schiff dyeing with periodate (PAS) staining was positive, PAS staining of glycogen digested by amylase (d-PAS) staining was negative. All the tumors in the nine cases were resected and patients were followed up for 5-137 months. Except 1 case was lost for follow-up, the other 8 cases survived without recurrence or metastasis of the disease. Conclusions: CCTL is a rare benign tumor, most of which are single, few of which can be multiple; histopathological characteristics and immunohistochemical staining are helpful for diagnosis and differentiated diagnosis. After complete resection, the prognosis was good. However, when histological features indicating malignancy, intense follow-up should be considered.

Predicting pungency and understanding the pungency mechanism of capsaicinoids using TOPS-MODE approach

Quantitative structure-property relationship (QSPR) models were developed for predicting the pungency of a set of capsaicinoids. Multiple linear regression (MLR) coupled with topological substructural molecular descriptor (TOPS-MODE) approach was used. The best MLR model based on only five orthogonalized TOPS-MODE variables allowed us to obtain a coefficient of determination of 0.954 on the training set. The predictive power of the model was validated through a test set and several external validation parameters. This showed that the TOPS-MODE descriptors weighted by bond dipole moments, van der Waals atomic radii, and the total solute hydrogen bond basicity affected pungency. The contributions of certain bonds and fragments to pungency were used to understand the pungency mechanism of capsaicinoids. The selected model can more accurately predict pungency of capsaicinoids compared than those found in the literature, and especially bring insights into the structural features and chemical factors related to pungency.

[Comparison of islet autoantigen-specific T cell response detected by direct enzyme-linked immunospot (ELISPOT) assay and accelerated co-cultured dendritic cells (acDCs) assay]

Objective: To investigate the effect of enzyme-linked immunospot (ELISPOT) on accelerated co-cultured dendritic cells (acDCs) and direct detection of islet full-length antigen-specific T cell response in peripheral blood of patients with type 1 diabetes mellitus (T1DM). Methods: Sixteen patients with T1DM[9 males, 7 females, mean age(28.5±9.4)years] and 12 age-and sex-matched healthy controls were selected in the Department of Metabolism and Endocrinology, the Second Xiangya Hospital between March 2012 and August 2014. The numbers of IFN-γ secreting CD4(+)T cells responding to glutamic acid decarboxylase 65 (GAD(65)), C-peptide (CP) and insulin (INS) were detected by ELISPOT-acDCs and ELISPOT-direct assays, respectively. The positive rate of islet autoantigen and associated antigen reactive T cells under different detection assays were compared. Results: The positive rate for GAD(65), INS, and CP antigen reactive T cells detected by ELISPOT-acDCs was 1/16, 6/16 and 4/16, respectively, and T cells positive for INS in T1DM patients were higher than that in the controls (0/12) (P=0.024). Combining GAD(65), CP and INS-ELISPOT-acDCs detection, the positive rate for CD4(+) T cells in T1DM patients was higher than that in the controls (9/16 vs 1/12, P=0.016). The positive rate for GAD(65), INS, and CP antigen reactive T cells detected by ELISPOT-direct detection was 2/16, 1/16 and 7/16, respectively, and T cells positive for CP was higher than that in the controls (1/12), but the difference was not statistically significant (P=0.088). Likewise, the positive rate for CD4(+) T cells was higher in T1DM patients than that in the controls by combined GAD(65), CP and INS-ELISPOT-direct detection (8/16 vs 1/12, P=0.039). Compared with the ELISPOT-direct assay, the positive rate of INS antigen specific T cell response detected by ELISPOT-acDCs was higher (P=0.041). No statistical differences of other antigens were found between the two groups (all P>0.05). Conclusions: Both multiple islet antigens-combined CD4(+)-ELISPOT-acDCs and direct assays could provide diagnostic value of cellular immunology for T1DM patients. The ELISPOT-acDCs assay is superior to the ELISPOT-direct assay in the detection of INS antigen-specific T cell response.

LncRNA MALAT1 expression inhibition suppresses tongue squamous cell carcinoma proliferation, migration and invasion by inactivating PI3K/Akt pathway and downregulating MMP-9 expression

OBJECTIVE

LncRNA MALAT1 has been proved to be involved in the development of various types of human cancers while the involvement of MALAT1 in tongue squamous cell carcinoma has not been reported. In view of this, our study aimed to investigate the functionality of MALAT1 in tongue squamous cell carcinoma.

PATIENTS AND METHODS

The expression of MALAT1 in tumor tissues and adjacent healthy tissues of tongue cancer patients, and the serum from tongue cancer patients as well as healthy controls, were detected by quantitative Real Time-PCR (qRT-PCR). ROC curve analysis was performed to analyze the diagnostic value of plasma MALAT1 for tongue cancer. Survival curves were plotted using the Kaplan-Meier method to evaluate the prognostic value of plasma MALAT1 for tongue cancer. CCK-8 assay, transwell migration and invasion assay were performed to investigate the effects of MALAT1 knockdown on the proliferation, migration and invasion of tongue cancer cells, respectively. The effects of MALAT1 overexpression on the PI3K/Akt pathway and MMP-9 expression were detected by Western blot.

RESULTS

The expression level of MALAT1 was remarkably higher in tumor tissues than that in adjacent healthy tissues. Serum MALAT1 was significantly higher in tongue cancer patients than in healthy controls. MALAT1 knockdown markedly inhibits the proliferation, migration and invasion of tongue cancer cells. MALAT1 knockdown also reduced the phosphorylation level of Akt as well as the expression level of MMP-9. It showed no significant effects on Akt expression, while PI3K activator treatment reduced the inhibitory effects of MALAT1 knockdown on the proliferation, migration and invasion of tongue cancer cells.

CONCLUSIONS

LncRNA MALAT1 expression inhibition can inhibit the proliferation, migration and invasion of tongue cancer cells by inactivating the PI3K/Akt pathway and downregulating MMP-9. MALAT1 may serve as a target for the treatment of tongue squamous cell carcinoma.

ZNF295-AS1 inhibits autophagy via the ZNF295-AS1/miR-508-5p/ATG7 axis in AS

OBJECTIVE

As a result of gene-environment interactions, the incidence of atherosclerosis (AS) is rapidly increasing worldwide. Autophagy in endothelial cells is a key process of AS and is difficult to control when it becomes excessive in the end stage of AS.

MATERIALS AND METHODS

In this study, we found increased expression levels of ZNF295-AS1 in the serum of AS patients, as well as in ox-LDL-treated HUVECs. The autophagy level was also upregulated in both samples. We demonstrated that ZNF295-AS1 may interact directly with miR-508-5p to act as a miR-508-5p sponge. The negative relationship between ZNF295-AS1 and miR-508-5p indicated that ZNF295-AS1 may be an upstream suppressor of miR-508-5p.

RESULTS

ATG7 plays a critical role in autophagy and was predicted to be a target of miR-508-5p. Therefore, we overexpressed miR-508-5p, which reduced the expression level of ATG7, enhanced cell proliferation and prevented autophagy. These data indicated that the ZNF295-AS1/miR-508-5p/ATG7 axis may participate in autophagy regulation in ox-LDL-treated HUVECs. The subsequent rescue experiments revealed the specificity of the ZNF295-AS1/miR-508-5p/ATG7 axis in the contribution of ZNF295-AS1 to autophagy.

CONCLUSIONS

Overall, our findings demonstrate a novel mechanism by which ZNF295-AS1 silencing regulates ATG7 reduction and inhibits autophagy, which may delay the progression of AS. The ZNF295-AS1/miR-508-5p/ATG7 axis may be of therapeutic significance in AS.

FRI0261 DIFFERENTIAL EXPRESSION OF PERIPHERAL CD4+ T CELLS IN PATIENTS WITH SYSTEMIC SCLEROSIS AND MIXED CONNECTIVE TISSUE DISEASE

Background:

The CD4+T cell subsets plays an important role in its pathogenesis, and its new research are constantly being published, but its specific changes between SSc and MCTD are still unclear.

Objectives:

The aim of the present study was to explore the absolute numbers of CD4+T subsets in peripheral blood(PB) of patients with SSc and MCTD using our modified flow cryometric method and investigate the role in the pathogenesis of both.

Methods:

The PB samples from 54 patients with SSc, 51 patients with MCTD as well as 30 healthy control subjects were analyzed for lymphocyte subsets using flow cytometry. Of these patients, 19 had pulmonary involvement, including 9 patients with SSc and 10 patients with MCTD. Using directly the percentages from flow cytometry combined with internal standard beads calculated absolute number of peripheral lymphocyte subsets from the subjects in each group.

Results:

Although there were some changes among CD4+T cell subsets in PB from these SSc patients and MCTD patients, the major alteration was the reductions of Treg cells. Compared with the normal controls, the absolute number of CD4+CD25+FOXP3+Treg cells were significantly decreased in SSc patients and MCTD patients, and the absolute number of Th1 cells in MCTD patients is also significantly reduced. Notably, the absolute numbers of Th17 and Th2 cells were not different from those of normal controls, but the ratios of Th17/Treg in SSc patients and MCTD patients were significantly higher, causing by insufficient number of Treg cells (Fig 1). In addition, in patients with pulmonary involvement, we found that the absolute number of Treg cells was significantly reduced in patients with MCTD, while the absolute number of Th2 cells and Th17 cells was significantly reduced in patients with SSc(Fig 2).

Fig 1.

Comparison of the levels of CD4+T lymphocyte subsets in SSc patients, MCTD patients and healthy controls: (A) The absolute number of peripheral Th1 cells in patients with MCTD was significantly reduced; (B and C) There was no significant difference in the absolute number of Th2 cells in peripheral blood of different subjects; (D and E) The ratio of Th17/Treg cells in PB of patients with SSc and MCTD were significantly higher.*P< 0.05; **P< 0.01; ***P< 0.001.

Conclusion:

The number of peripheral Treg cells in patients with SSc and MCTD was significantly reduced, suggesting that that SSc and MCTD progression is associated with the imbalances between pro-inflammation cells to anti-inflammation Treg cells. In addition, we also found that the decrease in peripheral numbers of Treg cells may contribute to the development of MCTD-associated lung disease, whereas in SSc patients who had lung involvement, the reduce in peripheral number of Th17 cells may result in a severe imbalance of Th17/Treg cells, thereby promoting disease progression.

Fig 2.

Comparison of the levels of CD4+T lymphocyte subsets in patients who had pulmonary involvement and healthy controls: (A) There was no significant difference in the absolute number of Th1 cells in peripheral blood of different subjects; (B and C) The absolute number of peripheral Th2 cells and Th17 cells in patients with SSc were significantly reduced; (D and E) The ratio of Th17/Treg cells in PB of patients with MCTD were higher.*P< 0.05; **P< 0.01; ***P< 0.001.

References:

[1]Liu M, Wu W, Sun X, et al. New insights into CD4(+) T cell abnormalities in systemic sclerosis. Cytokine Growth Factor Rev. 2016 Apr; 28:31-6. doi: 10.1016/j.cytogfr.2015.12.002.

Acknowledgments:

None

Disclosure of Interests:

None declared