Coronavirus disease 2019 among pregnant Chinese women: case series data on the safety of vaginal birth and breastfeeding

OBJECTIVE

To assess whether vaginal secretions and breast milk of women with coronavirus disease 2019 (COVID-19) contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

DESIGN

Single centre cohort study.

SETTING

Renmin Hospital of Wuhan University, Wuhan, Hubei province, China.

POPULATION

We studied 13 SARS-CoV-2-infected pregnant women diagnosed between 31 January and 9 March 2020.

METHODS

We collected clinical data, vaginal secretions, stool specimens and breast milk from SARS-CoV-2-infected women during different stages of pregnancy and collected neonatal throat and anal swabs.

MAIN OUTCOMES AND MEASURES

We assessed viral presence in different biosamples.

RESULTS

Of the 13 women with COVID-19, five were in their first trimester, three in their second trimester and five in their third trimester. Of the five women in their third trimester who gave birth, all delivered live newborns. Among these five deliveries, the primary adverse perinatal outcomes included premature delivery (n = 2) and neonatal pneumonia (n = 2). One of nine stool samples was positive; all 13 vaginal secretion samples, and five throat swabs and four anal swabs collected from neonates, were negative for the novel coronavirus. However, one of three samples of breast milk was positive by viral nucleic acid testing.

CONCLUSIONS

In this case series of 13 pregnant women with COVID-19, we observed negative viral test results in vaginal secretion specimens, suggesting that a vaginal delivery may be a safe delivery option. However, additional research is urgently needed to examine breast milk and the potential risk for viral contamination.

TWEETABLE ABSTRACT

New evidence for the safety of vaginal delivery and breastfeeding in pregnant women infected with SARS-CoV-2, positive viral result in a breast-milk sample.

[Clinicopathological features of de novo CD5-positive diffuse large B-cell lymphoma]

Objective: To investigate the relationship between the protein expression of C-MYC, bcl-2 and bcl-6 and the clinicopathological characteristics in patients with de novo CD5-positive diffuse large B cell lymphoma (CD5(+)DLBCL). Methods: Fifty seven cases of de novo CD5(+)DLBCL were collected at Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from February 2013 to September 2018. The hematoxylin-eosin stained slides were reviewed, and immunohistochemical (IHC) staining and FISH were used to analyze the relationship between C-MYC, bcl-2, bcl-6 expression and the clinicopathologic characteristics of patients. Results: Among these 57 cases, 27 were male and 30 were female. The age of onset was 35-99 years old. The IHC expression rates of C-MYC, bcl-2 and bcl-6 were 50.9% (29/57), 84.2% (48/57), and 75.4% (43/57) respectively; and co-expression rate of C-MYC and bcl-2 proteins was 40.4 (23/57). There was no significant correlation between protein expression and patients' genders, clinical stage, the level of serum LDH,β2 microglobulin, IPI,B symptoms, bone marrow involvement and central nervous system recurrence (P>0.05). Univariate analysis showed that the median OS of C-MYC negative patients was significantly longer than C-MYC positive patients (P<0.05); and the median OS of patients without double expression was significantly longer than that of patients with positive expression (P<0.05), and bcl-6 positive patients had longer median OS than bcl-6 negative patients (P<0.05). There was no significant correlation between prognosis and bcl-2 protein expression (P>0.05) . Cox multivariate analysis showed C-MYC protein expression was an independent predictor of OS in de novo CD5(+)DLBCL (P<0.05). Conclusions: Bcl-2 protein expression has no effect on the prognosis in de novo CD5(+)DLBCL whereas bcl-6 expression is correlated with good prognosis. C-MYC protein expression could be used as an independent and effective index to predict the prognosis of patients with de novo CD5(+)DLBCL.However, the relationship between protein expression and gene rearrangement of C-MYC, bcl-2 and bcl-6 needs to be further explored.

High-Performance Aqueous Zinc-Ion Batteries Realized by MOF Materials

Rechargeable aqueous zinc-ion batteries (ZIBs) have been gaining increasing interest for large-scale energy storage applications due to their high safety, good rate capability, and low cost. However, the further development of ZIBs is impeded by two main challenges: Currently reported cathode materials usually suffer from rapid capacity fading or high toxicity, and meanwhile, unstable zinc stripping/plating on Zn anode seriously shortens the cycling life of ZIBs. In this paper, metal-organic framework (MOF) materials are proposed to simultaneously address these issues and realize high-performance ZIBs with Mn(BTC) MOF cathodes and ZIF-8-coated Zn (ZIF-8@Zn) anodes. Various MOF materials were synthesized, and Mn(BTC) MOF was found to exhibit the best Zn2+-storage ability with a capacity of 112 mAh g-1. Zn2+ storage mechanism of the Mn(BTC) was carefully studied. Besides, ZIF-8@Zn anodes were prepared by coating ZIF-8 MOF material on Zn foils. Unique porous structure of the ZIF-8 coating guided uniform Zn stripping/plating on the surface of Zn anodes. As a result, the ZIF-8@Zn anodes exhibited stable Zn stripping/plating behaviors, with 8 times longer cycle life than bare Zn foils. Based on the above, high-performance aqueous ZIBs were constructed using the Mn(BTC) cathodes and the ZIF-8@Zn anodes, which displayed an excellent long-cycling stability without obvious capacity fading after 900 charge/discharge cycles. This work provides a new opportunity for high-performance energy storage system.

AB0131 RESPIRATORY TRACT POLY(I:C) STIMULATION ACCELERATES SALIVARY GLAND IMMUNE DYSFUNCTION IN SPONTANEOUS SJOGREN’S SYNDROME ANIMAL MODEL

Background:

Sjogren’s syndrome is one of the most common autoimmune diseases, with a prevalence of 0.33% to 0.77% in Chinese people, characterized by focal infiltration of lymphocytes in glands and the production of multiple autoantibodies. Studies have shown that virus infection may play a crucial role in the occurrence and development of this disease.

Objectives:

It has been shown that airway stimulation with poly(I:C) can mimic respiratory tract viral infection to some extent. Thus, this study was aimed to investigate the dynamic immune responses in salivary gland after respiratory tract poly(I:C) stimulation in NOD mice.

Methods:

The 5-week-old NOD mice were given respiratory tract poly(I:C) stimulation to mimic the respiratory virus infection once every other day for a total of 5 times (the total dose is 100μg), and the control group were given the same dose of sterile PBS. After 8 weeks, the mice were sacrificed to obtain and analyze the salivary gland tissues.

Results:

We found that the salivary gland flow rate was decreased and the blood glucose was influenced by the Viroid stimulation during the early stage in poly(I:C) stimulated group compared with that in PBS group. Accordingly, the pathological injury of salivary gland tissues in poly(I:C) stimulated group was more serious, including decreased volumes of the salivary glands, increased number of pathological focus score and the increased area of lymphocyte infiltration. Furthermore, we found that the expression of IL-33 in salivary glands of poly(I:C) stimulated NOD mice was increased, especially the expression of IL-33 in the acini and ducts. Moreover, the expression of IFN-I and IFN-II is up-regulated in salivary glands.

Conclusion:

The results of this study suggest that respiratory tract poly(I:C) stimulation accelerates salivary gland immune dysfunction in spontaneous sjogren’s syndrome NOD mice, which mechanisms need to be further investigated.

References:

[1] Pathogenetic mechanisms in the initiation and perpetuation of Sjogren’s syndrome. Nat Rev Rheumatol 2010; 6: 529-537.

[2]Primary Sjögren’s Syndrome. N Engl J Med.2018 378(10):931-939.

[3]Epidemiology of primary Sjögren’s syndrome: a systematic review and meta-analysis. Ann Rheum Dis 2015; 74: 1983-9.

[4]Vitamin D insufficiency in a large MCTD population. Autoimmun Rev 10:317–324.

[5]Epstein-Barr virus persistence and infection of autoreactive plasma cells in synovial lymphoid structures in rheumatoid arthritis. Ann Rheum Dis 72:1559–1568

[6]Liew, F., Girard, J. & Turnquist, H. Interleukin-33 in health and disease. Nat Rev Immunol 16, 676–689 (2016) doi:10.1038/nri.2016.95

[7]Interleukin-33 and the function of innate lymphoid cells. Trends in Immunology, August 2012, Vol. 33, No. 8

[8]Increased Levels of Interleukin 33 in Sera and Synovial Fluid from Patients with Active Rheumatoid Arthritis YASUSHI MATSUYAMA et al The Journal of Rheumatology January 2010, 37 (1) 18-25

[9]Potential involvement of the IL-33-ST2 axis in the pathogenesis of primary Sjogren’s syndrome, Ann Rheum Dis, 2014, 73(6): 1259-1263.

[10]The Interleukin 33/ST2 axis in patients with primary Sjogren syndrome: expression in serum and salivary glands, and the clinical association, J Rheumatol, 2015, 42(2): 264-271.

[11]Kok MR, Baum BJ, Tak PP, et al Use of localised gene transfer to develop new treatment strategies for the salivary component of Sjögren’s syndrome Annals of the Rheumatic Diseases 2003;62:1038-1046.

Acknowledgments:

NO

Disclosure of Interests:

None declared

SAT0250 CLINICAL CHARACTERISTICS AND THE DISEASE ACTIVITY OF BEHCET’S DISEASE IN CHINA: A STUDY BASED ON SMART SYSTEM OF DISEASE MANAGEMENT (SSDM)

Background:

Behcet´s disease (BD) is a systemic autoimmune disease that affects multiple organ systems with recurrent oral ulcers, genital ulcers and skin lesions. Behcet´s Disease Current Activity Form (BDCAF) and Electronic Medical Record-based Activity Index (EMRAI) are commonly used internationally to evaluate the disease activity of BD.

Objectives:

This study aimed to analyze the clinical characteristics, the level of disease activity, and the incidence of anxiety and depression for Chinese BD patients. Patients can perform self-management of disease with SSDM.

Methods:

SSDM is a series of doctor-patient interactive applications for self-management of patients with chronic diseases. Patients can perform self-assessment with SSDM and upload the data to their authorized doctors. The SSDM patients’ application system integrates the BDCAF and EMRAI into one scoring system. Patients could obtain scores of BDCAF and EMRAI by responding to one questionnaire through SSDM.

Results:

From Apr 2017 to Jan 2020, 719 BD patients from 166 hospitals used SSDM, with a mean age of 38.97±12.71 (14~81) years old, and median disease duration of 20.8 months. 719 patients performed BDCAF and EMRAI self-assessment 1321 times, 252 patients repeat assessments for 855 times. The mean score of BDCAF and EMRAI are 3.57±2.17 and 3.44±1.90, respectively. The matching degree of the two score was 0.8747.

The most common clinical characteristics were oral ulcers (83.73%), ocular symptoms (62.03%), joint pain (50.07%). The comparative study between males and females revealed significant difference in the aspects of epididymitis (10.94% vs 0, p<0.001), genital ulcer (35.09% vs 44.93%, p=0.01), headache (24.15% vs 33.92%, p=0.01) and superficial thrombophlebitis (24.15% vs 33.92%, p=0.01). Table 1.

Table 1.

Clinical Characteristics of different systems in Chinese BD patients.

Presence of clinical characteristicsTotalMalesFemalesP valueOral ulcer83.73% (602)86.42% (229)82.16% (373)0.14Genital ulcer41.31% (297)35.09% (93)44.93% (204)0.01*Epididymitis4.03% (29)10.94% (29)0 (0)<0.001**Erythema29.49% (212)29.43% (78)29.52% (134)0.98Skin lesions26.84% (193)28.68% (76)25.77% (117)0.4Superficial thrombophlebitis30.32% (218)24.15% (64)33.92% (154)0.01*Headache30.32% (218)24.15% (64)33.92% (154)0.01*Joint pain50.07% (360)51.32% (136)49.34% (224)0.61Arthritis14.60% (105)14.72% (39)14.54% (66)0.95Gastrointestinal involvement24.90% (179)27.92% (74)23.13% (105)0.15Ocular symptoms62.03% (446)62.64% (166)61.67% (180)0.79Nervous involvement23.78% (171)25.66% (68)22.69% (103)0.37Vascular involvement15.72% (113)18.11% (48)14.32% (65)0.18

*P values are for the comparison between the males and females.

Conclusion:

Chinese BD patients can effectively perform BDCAF and EMRAI self-assessment with SSDM. The results of the assessment conducted by the two scoring systems are similar. The clinical characteristics of Chinese BD were different depending on gender.

Acknowledgments: :

Smart system of disease management (SSDM) was developed by Shanghai Gothic Internet Technology Co., Ltd.

Disclosure of Interests:

None declared

SAT0294 IL33 ACTIVATES FIBROBLASTS AND INDUCES SKIN FIBROSIS IN SYSTEMIC SCLEROSIS

Background:

Systemic sclerosis (SSc) is a chronic immune-mediated autoimmune disease that is characterized by fibrotic changes of the skin and internal organs, which in turn leads to distortion of tissue structure and gradual loss of organ function. So far, there is still no treatment allows full recovery from this severe disorder. Therefore, it is of great social significance to study the pathogenesis of this disease and find new targets for treatment. Interleukin 33 (IL-33), which is a potent inducer of type 2 immune response, has been confirmed to be involved in the development and progression of multiple fibrotic diseases. However, the role and mechanism of IL-33 in SSc-related fibrosis remains unclear.

Objectives:

To clarify the role of interleukin 33 (IL-33) and its receptor Suppression of tumorigenicity 2 (ST2) in the skin fibrosis of SSc, so to provides a new target for the treatment of fibrosis in patients with SSc.

Methods:

The levels of IL-33 and ST2 was analysed in human samples, murine models of SSc and in cultured fibroblasts by immunohistochemistry and immunofluorescence. The functional role of IL-33 was evaluated by detecting changes in proliferation, migration, and activation of fibroblasts stimulated with recombinant IL-33 protein. MAPK and NF-κB signallings of fibroblasts were assessed by western blotting and analyses of target genes. The role of IL-33 in skin fibrosis was analysed in IL-33 deficient mice (il33−/−) and wild-type controls injected with bleomycin or NaCl.

Results:

The expression of IL-33 and its receptor ST2 were up-regulated in skin lesions of SSc patients (Fig 1 A-C) and bleomycin-treated mice(Fig1 D-F). Compared to the healthy skin, the skin from SSc patients expressed more ST2 on fibroblasts membrane(Fig 1 B-C). IL33 induces MAPK and IκBα activation in human dermal fibroblast(Fig 2 A), and promote proliferation, migration and production of collagen of human dermal fibroblasts, but not the release of inflammatory factors(IL-6, MCP-1)(Fig2 B-G). Mice deficient for IL33 are protected from bleomycin-induced dermal fibrosis (Fig3).

Fig 1.

Increased expression of IL33, ST2 in SSc patients and bleomycin-treated mice.

Fig 2.

IL33 induces MAPK and IκBα activation in human dermal fibroblast, and and promote proliferation, migration and production of collagen of human dermal fibroblasts.

Fig 3.

Mice deficient for IL33 are protected from bleomycin-induced dermal fibrosis.

Conclusion:

IL33 promotes skin fibrosis by activating fibroblasts, and IL33/ST2 may be an important target for the treatment of fibrosis in patients with SSc.

References:

[1]Ingegnoli F, Ughi N, Mihai C. Update on the epidemiology, risk factors, and disease outcomes of systemic sclerosis. Best practice & research. Clinical rheumatology. 2018;32(2):223-240.

[2]Schmitz J, Owyang A, Oldham E, et al. IL-33, an interleukin-1-like cytokine that signals via the IL-1 receptor-related protein ST2 and induces T helper type 2-associated cytokines. Immunity. 2005;23(5):479-490.

[3]Molofsky AB, Savage AK, Locksley RM. Interleukin-33 in Tissue Homeostasis, Injury, and Inflammation.Immunity.2015;42(6):1005-1019.

Disclosure of Interests:

None declared

[Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]

Objective: To study the effect of COVID-19 on pregnancy outcomes and neonatal prognosis in Hubei Province. Method: s A retrospective comparison of the pregnancy outcomes was done between 16 women with COVID-19 and 45 women without COVID-19. Also, the results of laboratory tests, imaging examinations, and the 2019 novel coronavirus (2019-nCoV) nucleic acid test were performed in 10 cases of neonatal delivered from women with COVID-19. Result: s (1) Of the 16 pregnant women with COVID-19, 15 cases were ordinary type and 1 case was severe type. No one has progressed to critical pneumonia.The delivery method of the two groups was cesarean section, and the gestational age were (38.7±1.4) and (37.9±1.6) weeks,there was no significant difference between the two groups (P>0.05). Also, there wee no significant differences in the intraoperative blood loss and birth weight of the newborn between the two groups (all P>0.05). (2) Ten cases of neonates delivered from pregnant women with COVID-19 were collected. The 2019-nCoV nucleic acid test were all negative.There were no significant differences in fetal distress, meconium-stained amniotic fluid, preterm birth, and neonatal asphyxia between the two groups (all P>0.05).(3) In the treatment of uterine contraction fatigue, carbetocin or carboprost tromethamine was used more in cesarean section for pregnant women with COVID-19 (1.3±0.6), compared with Non-COVID-19 group (0.5±0.7),the difference was statistically significant (P=0.001). Conclusions: If there is an indication for obstetric surgery or critical illness of COVID-19 in pregnant women, timely termination of pregnancy will not increase the risk of premature birth and asphyxia of the newborn, but it is beneficial to the treatment and rehabilitation of maternal pneumonia. Preventive use of long-acting uterotonic agents could reduce the incidence of postpartum hemorrhage during surgery. 2019-nCoV infection has not been found in neonates delivered from pregnant women with COVID-19.

Evidence for undoped Weyl semimetal charge transport in Y2Ir2O7

Weyl fermions scattering from a random Coulomb potential are predicted to exhibit resistivity versus temperature [Formula: see text] in a single particle model. Here we show that, in closed-environment-grown polycrystalline samples of Y₂Ir₂O₇, [Formula: see text] over four orders of magnitude in [Formula: see text]. While the measured prefactor, [Formula: see text], is obtained from the model using reasonable materials parameters, the [Formula: see text] behavior extends far beyond the model's range of applicability. In particular, the behavior extends into the low-temperature, high-resistivity region where the Ioffe-Regel parameter, [Formula: see text]. Strong on-site Coulomb correlations, instrumental for predicting a Weyl semimetal state in Y₂Ir₂O₇, are the possible origin of such 'bad' Weyl semimetal behavior.

Effects of early nutritional intervention on oral mucositis in patients with radiotherapy for head and neck cancer

BACKGROUND

To observe the effect of early nutritional intervention on radiation-induced oral mucositis and nutritional status in patients with head and neck cancer (HNC).

METHODS

A total of 54 HNC patients were divided into early (28 cases) and late (26 cases) nutritional intervention groups. The early group received enteral nutrition at the beginning of radiotherapy (RT), while the late group received enteral nutrition after restricted feeding. Operators reported and assessed the timing and extent of oral mucositis and nutritional status during treatment. The nutritional status assessment indicators included body weight; body mass index (BMI); Patient-Generated-Subjective Global Assessment (PG-SGA) score; levels of albumin, hemoglobin and pre-albumin and total lymphocyte count.

RESULTS

The incidence of high-grade oral mucositis was significantly lower in the early group than that in the late group (P < 0.05). Nutritional status assessments showed more significant weight and BMI losses in the late group than in the early group at weeks 4 and 7 after RT (P < 0.01). The albumin decreased in the late group at week 7 after RT was more significant than that in the early group (P < 0.05). Albumin, hemoglobin and pre-albumin levels and total lymphocyte count decreased significantly in both groups (P > 0.05). During therapy, more patients in the early group were well-nourished and fewer were malnourished according to PG-SGA scores (P < 0.05).

CONCLUSION

Early nutritional intervention can reduce the incidence of high-grade oral mucositis during RT in patients with HNC and improve the nutritional status during treatment, which has important clinical significance.

K2 Ti2 O5 @C Microspheres with Enhanced K+ Intercalation Pseudocapacitance Ensuring Fast Potassium Storage and Long-Term Cycling Stability

Benefiting from the natural abundance and low standard redox potential of potassium, potassium-ion batteries (PIBs) are regarded as one of the most promising alternatives to lithium-ion batteries for low-cost energy storage. However, most PIB electrode materials suffer from sluggish thermodynamic kinetics and dramatic volume expansion during K⁺ (de)intercalation. Herein, it is reported on carbon-coated K₂ Ti₂ O₅ microspheres (S-KTO@C) synthesized through a facile spray drying method. Taking advantage of both the porous microstructure and carbon coating, S-KTO@C shows excellent rate capability and cycling stability as an anode material for PIBs. Furthermore, the intimate integration of carbon coating through chemical vapor deposition technology significantly enhances the K⁺ intercalation pseudocapacitive behavior. As a proof of concept, a potassium-ion hybrid capacitor is constructed with the S-KTO@C (battery-type anode material) and the activated carbon (capacitor-type cathode material). The assembled device shows a high energy density, high power density, and excellent capacity retention. This work can pave the way for the development of high-performance potassium-based energy storage devices.

Enhanced Hydrogenation Performance over Hollow Structured Co-CoOx@N-C Capsules

It is desirable to design nonprecious metal nanocatalysts with high stability and catalytic performance for fine chemicals production. Here, a method is reported for the preparation of cobalt metal and cobalt oxide cores confined within nanoporous nitrogen-doped hollow carbon capsules. Core-shell structured Zn/Co-ZIF@polymer materials are fabricated through a facile coating polymer strategy on the surface of zeolitic imidazolate frameworks (ZIF). A series of hollow carbon capsules with cobalt metal and cobalt oxide are derived from a facile confined pyrolysis of Zn/Co-ZIF@polymer. The hollow Co-CoOx@N-C capsules can prevent sintering and agglomeration of the cobalt nanoparticles and the nanoporous shell allows for efficient mass transport. The specific surface area and Co particle size are optimized through finely tuning the original Zn content in ZIF particles, thus enhancing overall catalytic activity. The yolk-shell structured Zn4Co1Ox@carbon hollow capsules are shown to be a highly active and selective catalyst (selectivity >99%) for hydrogenation of nitrobenzene to aniline. Furthermore, Zn4Co1Ox@carbon hollow particles show superior catalytic stability, and no deactivation after 8 cycles of reaction. The hollow Co-CoOx@N-C capsules may shed light on a green and sustainable catalytic process for fine chemicals production.

High-Power and Ultralong-Life Aqueous Zinc-Ion Hybrid Capacitors Based on Pseudocapacitive Charge Storage

Rechargeable aqueous zinc-ion hybrid capacitors and zinc-ion batteries are promising safe energy storage systems. In this study, amorphous RuO2·H2O for the first time was employed to achieve fast and ultralong-life Zn2+ storage based on a pseudocapacitive storage mechanism. In the RuO2·H2O||Zn zinc-ion hybrid capacitors with Zn(CF3SO3)2 aqueous electrolyte, the RuO2·H2O cathode can reversibly store Zn2+ in a voltage window of 0.4-1.6 V (vs. Zn/Zn2+), delivering a high discharge capacity of 122 mAh g-1. In particular, the zinc-ion hybrid capacitors can be rapidly charged/discharged within 36 s with a very high power density of 16.74 kW kg-1 and a high energy density of 82 Wh kg-1. Besides, the zinc-ion hybrid capacitors demonstrate an ultralong cycle life (over 10,000 charge/discharge cycles). The kinetic analysis elucidates that the ultrafast Zn2+ storage in the RuO2·H2O cathode originates from redox pseudocapacitive reactions. This work could greatly facilitate the development of high-power and safe electrochemical energy storage.

Rapid selection of analytical lines for SAF-LIBS based on the doublet intensity ratios at the initial and final stages of plasma

Self-absorption-free laser-induced breakdown spectroscopy (SAF-LIBS) can directly obtain the applicable quasi-optically thin lines by determining the optimal acquisition delay time according to the intensity ratio of doublet lines at specific transition wavelength of the analyzed elements, thus eliminating the influence of self-absorption on quantitative results. In quantitative analysis of samples with a certain content range, the key to the convenient application of this technique is to rapidly select the suitable doublet lines for the element to be analyzed. The theoretical analysis shows that the evolution trend of doublet intensity ratio is monotonous under the assumptions that the plasma is uniform and in local thermal equilibrium (LTE) and the area density (Nl) is a constant, which is also confirmed by the experimental results of Cu and Al. Thus, a rapid spectral line selection criterion for SAF-LIBS applications is derived: only when the doublet intensity ratios measured at the initial and final stages of plasma induced by the boundary sample with the highest element content lie on both sides of the theoretical ratio, the doublet lines can reach quasi-optically thin during plasma evolution and are suitable for SAF-LIBS measurements. This new criterion is helpful to promote the practicality and industrial application of SAF-LIBS technology.

Kidney injury enhances renal G-CSF expression and modulates granulopoiesis and human neutrophil CD177 in vivo

Kidney injury significantly increases overall mortality. Neutrophilic granulocytes (neutrophils) are the most abundant human blood leukocytes. They are characterized by a high turnover rate, chiefly controlled by granulocyte colony stimulating factor (G‐CSF). The role of kidney injury and uremia in regulation of granulopoiesis has not been reported. Kidney transplantation, which inherently causes ischemia–reperfusion injury of the graft, elevated human neutrophil expression of the surface glycoprotein CD177. CD177 is among the most G‐CSF‐responsive neutrophil genes and reversibly increased on neutrophils of healthy donors who received recombinant G‐CSF. In kidney graft recipients, a transient rise in neutrophil CD177 correlated with renal tubular epithelial G‐CSF expression. In contrast, CD177 was unaltered in patients with chronic renal impairment and independent of renal replacement therapy. Under controlled conditions of experimental ischemia–reperfusion and unilateral ureteral obstruction injuries in mice, renal G‐CSF mRNA and protein expression significantly increased and systemic neutrophilia developed. Human renal tubular epithelial cell G‐CSF expression was promoted by hypoxia and proinflammatory cytokine interleukin 17A in vitro. Clinically, recipients of ABO blood group‐incompatible kidney grafts developed a larger rise in neutrophil CD177. Their grafts are characterized by complement C4d deposition on the renal endothelium, even in the absence of rejection. Indeed, complement activation, but not hypoxia, induced primary human endothelial cell G‐CSF expression. Our data demonstrate that kidney injury induces renal G‐CSF expression and modulates granulopoiesis. They delineate differential G‐CSF regulation in renal epithelium and endothelium. Altered granulopoiesis may contribute to the systemic impact of kidney injury.