The Effect of Prior Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Treatment on Coronavirus Disease 2019 (COVID-19) Susceptibility and Outcome: A Systematic Review and Meta-analysis

There have been arguments on whether angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) treatment alters the risk of COVID-19 susceptibility and disease severity. We identified a total of 102 eligible studies for systematic review, in which 49 studies adjusting for confounders were included in the meta-analysis. We found no association between prior ACEI/ARB use and risk of SARS-CoV-2 infection in general population (adjusted OR [aOR] 1.00, 95% confidence interval [CI] 0.94-1.05). The risk of mortality (aOR 0.87, 95%CI 0.66-1.04) and severe outcomes (aOR 0.95, 95%CI 0.73-1.24) are also unchanged among COVID-19 patients taking ACEI/ARB. These findings remain consistent in subgroup analyses stratified by populations, drug exposures and in other secondary outcomes. This systematic review provides evidence-based support to current medical guidelines and position statements that ACEI/ARB should not be discontinued. Additionally, there has been no evidence for initiating ACEI/ARB regimen as prevention or treatment of COVID-19.

Comparative analyses of aging-related genes in long-lived mammals provide insights into natural longevity

Extreme longevity has evolved multiple times during the evolution of mammals, yet its underlying molecular mechanisms remain largely underexplored. Here, we compared the evolution of 115 aging-related genes in 11 long-lived species and 25 mammals with non-increased lifespan (control group) in the hopes of better understanding the common molecular mechanisms behind longevity. We identified 16 unique positively selected genes and 23 rapidly evolving genes in long-lived species, which included nine genes involved in regulating lifespan through the insulin/IGF-1 signaling (IIS) pathway and 11 genes highly enriched in immune-response-related pathways, suggesting that the IIS pathway and immune response play a particularly important role in exceptional mammalian longevity. Interestingly, 11 genes related to cancer progression, including four positively selected genes and seven genes with convergent amino acid changes, were shared by two or more long-lived lineages, indicating that long-lived mammals might have evolved convergent or similar mechanisms of cancer resistance that extended their lifespan. This suggestion was further corroborated by our identification of 12 robust candidates for longevity-related genes closely related to cancer.

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Evolution analyses of 115 aging-related genes exploring natural longevity in mammals

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Positively selected genes & rapidly evolved genes enriched in IIS and immune pathways

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Convergent mutations in genes associated with cancer in long-lived species

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Evolution of longevity through cancer resistance in long-lived mammals

A Cross-sectional literature survey showed the reporting quality of multicenter randomized controlled trials should be improved

OBJECTIVE

To assess the reporting quality of randomized controlled trials (RCTs) with multicenter design, particularly whether necessary information related to multicenter characteristics was adequately reported.

STUDY DESIGN AND SETTING

Through a search of 4 international electronic databases, we identified multicenter RCTs published in English from 1975 to 2019. Reporting quality was assessed by the CONSORT (Consolidated Standards of Reporting Trials) checklist (37 items) and by a self-designed multicenter-specific checklist (27 items covering multicenter design, implement and analysis). The scores of trials published in three time periods (1975-1995; 1996-2009; and 2010-2019) were also compared.

RESULTS

A total of 2,844 multicenter RCTs were included. For the CONSORT checklist, the mean (standard deviation) reporting score was 24.1 (5.5), 12 items were assessed as excellent (>90%), 12 items as good (50%-90%), and 13 items as poor (<50%). For the multicenter checklist, the reporting score was 3.9 (2.2), only 3 items were excellent or good, and the remaining 24 items were poor. Time period comparison showed that reporting quality improved over time, especially after the CONSORT 2010 issued.

CONCLUSION

Although CONSORT appears to have enhanced the reporting quality of multicenter RCTs, further improvement is needed. A "CONSORT extension for multicenter trials" should be developed.

Myocarditis in patients treated with anti–programmed death-1/programmed death ligand 1 therapy

e14579

Background: We retrospectively analysed the cases of immune checkpoint inhibitor(ICI) -associated myocarditis managed in PUMCH. We aim to investigate the clinical characteristics of myocarditis and the risk factors affecting the prognosis. Methods: Medical records of all checkpoint inhibitor-related myocarditis were reviewed retrospectively. Descriptive statistics were used for the report of clinical outcomes. Univariate and multivariate Logistic analyses were performed to establish a prognostic model. Results: The median age of 19 patients was 64 years old (range 39̃80 years). The median time of onset from the iniatial of ICIs was 21 days (ranging from 2 to 375 days). Seven cases were grade 4 (36.8%), 2 cases were grade 3 (10.5%), 8 cases were grade 2 (42.1%), and 2 cases were grade 1 (10.5%). Clinical symptoms included dyspnea (13/19, 68.4%), fatigue (11/19, 57.9%), myalgia/myasthenia (9/19, 47.4%), sweating (6/19, 31.6%) and palpitation (6/19, 31.6%) et al. 47.4% (9/19) of the patients showed cardiac insufficiency/hemodynamic instability at first, and 52.6% (10/19) of the patients showed symptoms related to myositis first. cTnI and CK increased in all patients. The level of cTnI was significantly higher in grade 3̃4 than that in grade 1-2. NTproBNP was elevated in all grade 4 cases and one grade 3 case. The LVEF decreased only in 4 patients with grade 4 myocarditis (4/19, 22.2%). The electrocardiogram showed ventricular arrhythmia in 4 cases and complete atrioventricular block (3°AVB) in 3 cases. All patients were treated with corticosteroids (GCS). Grade 4 (6 cases), grade 3 (1 case) and grade 2 (2 cases) were given GCS pulse dose. The median total duration of GCS treatment was 42 days (range: 14-60 days). Three patients were treated with tocilizumab and one patient with infliximab. All patients with grade 3-4 and 2 patients with grade 2 were also treated with IVIG. Pacemakers were implanted in 3 patients with 3°AVB. The mortality rate of 19 cases was 21.1% (4/19), and the mortality rate of grade 4 myocarditis was 42.9%(3/7). The longer course before GCS therapy (p = 0.023), the higher NTproBNP (p = 0.030) and the lower LVEF value (p = 0.014) were found in the death group compared to the survival group. Logistic regression analysis showed that LVEF is an independent risk factor. The myocarditis prognostic model was condstructed as follows: Y = 8.794-18.002*LVEF, the prognostic critical value of LVEF was 57.5%, the area under the ROC curve of the prognostic model was 0.894 (95%CI: 0.735̃1.000), the sensitivity was 0.769, and the specificity was 1.000. Conclusions: We describe the largest single-center immune myocarditis cohort to date. Paying attention to the symptoms related to myositis is helpful to find more grade 1-2 myocarditis. cTnI is sensitive to myocarditis, and NTproBNP is of great significance to grade 3 ̃ 4 cases. LVEF < 57% may be an independent risk factor for poor prognosis.

Long-term patency and comparisons of venous outflow in hemodialysis forearm arteriovenous grafts

INTRODUCTION

This retrospective study investigated the factors and the effects of different venous outflows on forearm arteriovenous graft patency.

METHODS

The venous outflow sites included basilic, cephalic, median antecubital, and deep veins. Comparisons among multiple groups were analyzed.

FINDINGS

A total of 179 patients with forearm loop arteriovenous grafts met the inclusion criteria. Of these, 72 were basilic, 48 were cephalic, 44 were median antecubital, and 15 were deep. The median observation period was 19 months. The survival rate was 84.9% at 24 months and 78.2% at 48 months. Primary, secondary, and assisted primary patency rates for all arteriovenous grafts were 48.9%, 72.4%, and 68.4% at 12 months; 13.8%, 33.9%, and 23.6% at 24 months; and 0.6%, 4.6%, and 2.3% at 48 months, respectively. Differences in primary patency were statistically significant compared with those of secondary and assisted primary patency (P < 0.05). Primary patency rates for cephalic, median antecubital, basilic, and deep were 47.9%, 48.6%, 47.7%, and 40.0% at 12 months and 12.5%, 13.9%, 22.7%, and 0% at 24 months, respectively. Secondary patency rates for cephalic, median antecubital, basilic, and deep were 75.0%, 69.4%, 75.0%, and 73.3% at 12 months and 39.6%, 30.6%, 38.6%, and 13.3% at 24 months, respectively. There was no significant difference in primary thrombosis among basilic, cephalic, median antecubital and deep. There were no significant differences observed in primary or secondary patency rates among all the groups. Stenoses in the venous anastomosis and outflow vein were frequently observed in all types of arteriovenous grafts. Central venous stenosis was most commonly seen in deep (26.67%). On average, 1.9 interventions per patient were performed on the graft to maintain function.

CONCLUSION

Different venous outflow selections were not associated with long-term patency and the occurrence of thrombosis in hemodialysis forearm loop arteriovenous grafts.

Gut microbiota dysbiosis in stable coronary artery disease combined with type 2 diabetes mellitus influences cardiovascular prognosis

BACKGROUND AND AIMS

Host-microbiota interactions involving metabolic pathways have been linked to the pathogenesis of atherosclerotic disease and type 2 diabetes. As stable coronary artery disease (SCAD) patients combined with type 2 diabetes have significantly increased risk for cardiac event, we focused on elucidating the role of microbiota affecting cardiometabolic disease development.

METHODS AND RESULTS

We used multi-omics analyses (metagenomics and metabolomics) of fecal and serum samples from a prospective cohort including stable coronary artery disease combined with diabetes mellitus (SCAD + T2DM, n = 38), SCAD (n = 71), and healthy control (HC, n = 55). We linked microbiome features to disease severity in a three-pronged association analysis and identified prognostic bacterial biomarkers. We identified that bacterial and metabolic signatures varied significantly between SCAD and SCAD + T2DM groups. SCAD + T2DM individuals were characterized by increased levels of aromatic amino acids and carbohydrates, which correlate with a gut microbiome with enriched biosynthetic potential. Our study also addressed how metformin may confound gut dysbiosis and increase the potential for nitrogen metabolism. In addition, we found that specific bacterial taxa Ruminococcus torques [HR: 2.363 (08-4.56), P = 0.03] was predictive of cardiac survival outcomes.

CONCLUSION

Overall, our study identified relationships between features of the gut microbiota (GM) and circulating metabolites, providing a new direction for future studies aiming to understand the host-GM interplay in atherosclerotic cardiovascular pathogenesis.

Restoration of NRF2 attenuates myocardial ischemia reperfusion injury through mediating microRNA-29a-3p/CCNT2 axis

Accumulated studies have been implemented for comprehending the mechanism of myocardial ischemia reperfusion injury (MI/RI). Nuclear factor erythroid-2 related factor 2 (NRF2)-mediated transcription activity in MI/RI has not been completely interpreted from the perspective of microRNA-29a-3p (miR-29a-3p) and cyclin T2 (CCNT2). Therein, this study intends to decode the mechanism of NRF2/miR-29a-3p/CCNT2 axis in MI/RI. Rat MI/RI models were established by left anterior descending artery ligation. Rats were injected with NRF2 or CCNT2 overexpression plasmids or miR-29a-3p agomir to explore their effects on MI/RI. Hypoxia/reoxygenation (H/R) cardiomyocytes were established and transfected with restored NRF2 or miR-29a-3p or CCNT2 for further exploration of their roles. NRF2, miR-29a-3p, and CCNT2 expression in myocardial tissues in rats with MI/RI and in cardiomyocytes in H/R injury were detected. ChIP assay verified the relationship between miR-29a-3p and NRF2, and the bioinformatics software and dual-luciferase reporter experiment verified the interaction between miR-29a-3p and CCNT2. NRF2 and miR-29a-3p were down-regulated while CCNT2 was up-regulated in myocardial tissues in rats with MI/RI and in H/R-treated cardiomyocytes. Restoration of NRF2 or miR-29a-3p improved hemodynamics and myocardial injury and suppressed serum inflammation and cardiomyocyte apoptosis via CCNT2 in rats with MI/RI. Upregulation of NRF2 or miR-29a-3p inhibited LDH and CK-MB activities, oxidative stress, and apoptosis and promoted viability of cardiomyocytes with H/R injury. NRF2 bound to the promoter of miR-29a-3p and CCNT2 was targeted by miR-29a-3p. This study elucidates that up-regulating NRF2 or miR-29a-3p attenuates MI/RI via inhibiting CCNT2, which may renew the existed knowledge of MI/RI-related mechanism and provide a novel guidance toward MI/RI treatment.

Association between tachyarrhythmia and mortality in a cohort of critically ill patients with coronavirus disease 2019 (COVID-19)

Background

Cardiovascular involvement manifesting as arrhythmias has been confirmed in patients with coronavirus disease 2019 (COVID-19), so we aimed to explore the association between primary tachyarrhythmia and death in critically ill patients with COVID-19 in this retrospective study.

Methods

A total of 79 critically ill patients with COVID-19 were included. Demographic characteristics, clinical data (past history, vital signs, therapeutic management, and outcomes), and results of laboratory findings and cardiac investigations were collected. All statistical analyses were performed using SPSS 23.0 software (IBM, Armonk, NY, USA).

Results

The median age was 65±12 years, and 53 patients (67%) were male. A total of 57 (72%) patients died, and compared with survivors, these patients were older and had significantly higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score and fewer lymphocytes as well as higher heart rate (P<0.05). Autopsy findings did not suggest severe myocarditis. A total of 19 (24%) patients had tachyarrhythmias, including 10 (13%) with atrial fibrillation (AF) and 9 (11%) with ventricular tachycardia or fibrillation. The incidence of tachyarrhythmias in non-survivor was much higher than in survivors (P=0.04). In a Cox regression model, older patients with ventricular tachyarrhythmias (VTAs) age were at a higher risk of death, with hazard ratio (HR) of 3.302 [95% confidence interval (CI), 1.524-7.154, P=0.002] and 1.045 (95% CI, 1.020-1.071, P=0.000), respectively. The use of beta-blockers [HR, 0.219 (95% CI, 0.066-0.722); P=0.013] was associated with a lower risk of death.

Conclusions

Critically ill patients with COVID-19 had a poor prognosis. VTA and older age were independent prognostic factors of death. Beta-blockers might be an effective therapy to improve survival.

Drug-resistant cancer cell-derived exosomal EphA2 promotes breast cancer metastasis via the EphA2-Ephrin A1 reverse signaling

Tumor metastasis induced by drug resistance is a major challenge in successful cancer treatment. Nevertheless, the mechanisms underlying the pro-invasive and metastatic ability of drug resistance remain elusive. Exosome-mediated intercellular communications between cancer cells and stromal cells in tumor microenvironment are required for cancer initiation and progression. Recent reports have shown that communications between cancer cells also promote tumor aggression. However, little attention has been regarded on this aspect. Herein, we demonstrated that drug-resistant cell-derived exosomes promoted the invasion of sensitive breast cancer cells. Quantitative proteomic analysis showed that EphA2 was rich in exosomes from drug-resistant cells. Exosomal EphA2 conferred the invasive/metastatic phenotype transfer from drug-resistant cells to sensitive cells. Moreover, exosomal EphA2 activated ERK1/2 signaling through the ligand Ephrin A1-dependent reverse pathway rather than the forward pathway, thereby promoting breast cancer progression. Our findings indicate the key functional role of exosomal EphA2 in the transmission of aggressive phenotype between cancer cells that do not rely on direct cell-cell contact. Our study also suggests that the increase of EphA2 in drug-resistant cell-derived exosomes may be an important mechanism of chemotherapy/drug resistance-induced breast cancer progression.

An efficient delivery of photosensitizers and hypoxic prodrugs for a tumor combination therapy by membrane camouflage nanoparticles

Photodynamic therapy (PDT) is an oxygen-dependent, non-invasive cancer treatment. The hypoxia in the tumor environment limits the therapeutic effects of PDT. The combined delivery of photosensitizers and hypoxic prodrugs is expected to improve the efficacy of tumor treatment. In this paper, an erythrocyte and tumor cell membrane camouflage nanocarrier co-loaded with a photosensitizer (indocyanine green) and a hypoxic prodrug (tirapazamine) were used to combine PDT with chemotherapy. The system achieved less macrophage clearance through erythrocyte membranes and tumor-targeted tumor cell membranes, thereby inducing cell death and increasing tumor environment hypoxia by NIR irradiation of photosensitizers. Furthermore, the hypoxic environment activated TPZ to kill more tumor cells. In vivo results showed that the tumor inhibition rate of the drug-loaded nanoparticles increased from 34% to 64% after membrane modification. Moreover, the tumor inhibition rate of the photodynamic treatment group alone was only 47%, and the tumor inhibition rate after the combination was 1.3 times that of photodynamic therapy alone. Our platform is expected to contribute to the further application of cancer combination therapy.

Sensing morphogenesis of bone cells under microfluidic shear stress by holographic microscopy and automatic aberration compensation with deep learning

We present sensing time-lapse morphogenesis of living bone cells under micro-fluidic shear stress (FSS) by digital holographic (DH) microscopy. To remove the effect of aberrations on quantitative measurements, we propose a numerical and automatic method to compensate for aberrations based on a convolutional neural network (CNN). For the first time, the aberration compensation issue is considered as a regression task where optimal coefficients for constructing the phase aberration map act as responses corresponding to the input aberrated phase image. We adopted tens of thousands of living cells' phase images reconstructed from digital holograms for training the CNN. The experiments demonstrate that, based on the trained network, phase aberrations can be totally removed in real-time without any hypothesis of object and aberration phase, knowledge of the setup's physical parameters, and the operation of selecting background regions; hence, the morphogenesis of the bone cells under FSS is accurately detected and quantitatively analyzed. The results show that the proposed method could provide a highly efficient and versatile way to investigate the effects of micro-FSS on living biological cells in microfluidic lab-on-chip platforms thanks to the combination of phase-contrast label-free microcopy with artificial intelligence.

Displacement and strain mapping for osteocytes under fluid shear stress using digital holographic microscopy and digital image correlation

Osteocytes, as the mechano-sensors in bone, are always subjected to fluid shear stress (FSS) from the surrounding matrix. Quantification of FSS-induced cellular deformation is significant for clarifying the "perceive and transmit" process of cellular mechanotransduction. In this research, a label-free displacement and strain mapping method based on digital holographic microscopy (DHM) and digital image correlation (DIC) is introduced. The method, which is termed DHM-DIC, innovatively utilizes surface features extracted from holographic phase images instead of speckles as the metric for DIC searching. Simulation results on a hemisphere validate the feasibility of DHM-DIC. Displacement and strain maps of living osteocytes under 1.5 Pa FSS are evaluated from DHM-DIC and present good agreement with our previous finite element modeling results.

Recent advances in waste water treatment through transition metal sulfides-based advanced oxidation processes

With the ever-growing water pollution issues, advanced oxidation processes (AOPs) have received growing attention due to their high efficiency in the removal of refractory organic pollutants. Transition metal sulfides (TMSs), with excellent optical, electrical, and catalytical performance, are of great interest as heterogeneous catalysts. These TMSs-based heterogeneous catalysts have been demonstrated to becapable and adaptable in water purification through advanced oxidation processes. The aim of this review is to conduct an exhaustive analysis and summary of recent progress in the application of TMSs-based AOPs for water decontamination. Firstly, the commonly used tuning strategies for TMSs-based catalysts are concisely introduced, including artificial size and shape control, composition control, doping, and heterostructure manufacturing. Then, a comprehensive overview of the current state-of-the-art progress on TMSs-based AOPs (i.e., Fenton-like oxidation, photocatalytic oxidation, and electro chemical oxidation processes) for wastewater treatment is discussed in detail, with an emphasis on their catalytic performance and involved mechanism. In addition, influencing factors of water chemistry, namely, pH, temperature, dissolved oxygen, inorganic species, and natural organic matter on the catalytic performance of established AOPs are analyzed. Furthermore, the reusability and stability of TMSs-based catalysts in these AOPs are also outlined. Finally, current challenges and future perspectives related to TMSs-based catalysts and their applications for AOPs wastewater treatment are proposed. It is expected that this review would shed some light on the future development of TMSs-based AOPs towards water purification.

A Comprehensive Analysis of Genomics and Metagenomics in a Heterozygote Familial Hypercholesterolemia Family

Familial hypercholesterolemia (FH) is an inherited rare disease leading to markedly elevated low-density lipoprotein cholesterol (LDL-C) levels and increased risk for cardiovascular event. Gut microbiota has been implicated as a pivotal contributing factor in hyperlipidemia, however, its role in FH remains elusive. We performed whole-exome and metagenomics sequencing on a family with 22 members in which myocardial infarctions occurred at a young age with unclear etiology. We confirmed the missense mutation of LDLR c.1723C>T accounted for the abnormal cholesterol metabolism in the family through co-segregation analysis. In addition, Prevotella dentalis was found elevated and strongly associated with LDL-C level in FH family members with mutation of LDLR c.1723C>T compared to unaffected members with hyperlipidemia. Overall, our work suggests that whole-exome sequencing can facilitate identification of disease-causing variants and enable preventive treatment of FH. Our metagenomics analysis provides early insights into potential contributions of host-microbe interactions in genetic and common hypercholesterolemia.

The Promise of Aggregation-Induced Emission Luminogens for Detecting COVID-19

The long-term pandemic of coronavirus disease 2019 (COVID-19) requires sensitive and accurate diagnostic assays to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and SARS-CoV-2 antibodies in infected individuals. Currently, RNA of SARS-CoV-2 virus is mainly detected by reverse transcription-polymerase chain reaction (RT-PCR)-based nucleic acid assays, while SARS-CoV-2 antigen and antibody are identified by immunological assays. Both nucleic acid assays and immunological assays rely on the luminescence signals of specific luminescence probes for qualitative and quantitative detection. The exploration of novel luminescence probes will play a crucial role in improving the detection sensitivity of the assays. As innate probes, aggregation-induced emission (AIE) luminogens (AIEgens) exhibit negligible luminescence in the free state but enhanced luminescence in the aggregated or restricted states. Moreover, AIEgen-based nanoparticles (AIE dots) offer efficient luminescence, good biocompatibility and water solubility, and superior photostability. Both AIEgens and AIE dots have been widely used for high-performance detection of biomolecules and small molecules, chemical/biological imaging, and medical therapeutics. In this review, the availability of AIEgens and AIE dots in nucleic acid assays and immunological assays are enumerated and discussed. By building a bridge between AIE materials and COVID-19, we hope to inspire researchers to use AIE materials as a powerful weapon against COVID-19.

Citric acid promotes disulfide bond formation of whey protein isolate in non-acidic aqueous system

Impacts of citric acid (CA) treatment under non-acidic conditions (pH 7.0, 8.0 and 9.0) on whey protein isolate (WPI) were examined in this study. Size exclusion chromatography and SDS-PAGE indicated that molecular size and weight of WPI-CA became larger at pH 7.0, 8.0 and 9.0 with CA ranged from 0 to 15 mg/mL, but the protein aggregates disappeared after β-mercaptoethanol was added. The free SH groups of WPI-CA gradually decreased. This could be deduced that CA could promote disulfide bond formation of WPI at the non-acidic pH values. Furthermore, fourier transform infra-red (FTIR) spectroscopy and fluorescence spectroscopy data confirmed the conformational changes of secondary and tertiary structures of CA-modified WPI, respectively. Therefore, these results suggested that disulfide bond formation of WPI occurred at citric acid treatment under non-acidic conditions, being contributed to production of its larger molecular size substances and alteration of its structural characteristics.

Rapid evolution and molecular convergence in cryptorchidism-related genes associated with inherently undescended testes in mammals

BACKGROUND

The mammalian testis is an important male exocrine gland and spermatozoa-producing organ that usually lies in extra-abdominal scrotums to provide a cooler environment for spermatogenesis and sperm storage. Testicles sometimes fail to descend, leading to cryptorchidism. However, certain groups of mammals possess inherently ascrotal testes (i.e. testes that do not descend completely or at all) that have the same physiological functions as completely descended scrotal testes. Although several anatomical and hormonal factors involved in testicular descent have been studied, there is still a paucity of comprehensive research on the genetic mechanisms underlying the evolution of testicular descent in mammals and how mammals with ascrotal testes maintain their reproductive health.

RESULTS

We performed integrative phenotypic and comparative genomic analyses of 380 cryptorchidism-related genes and found that the mammalian ascrotal testes trait is derived from an ancestral scrotal state. Rapidly evolving genes in ascrotal mammals were enriched in the Hedgehog pathway-which regulates Leydig cell differentiation and testosterone secretion-and muscle development. Moreover, some cryptorchidism-related genes in ascrotal mammals had undergone positive selection and contained specific mutations and indels. Genes harboring convergent/parallel amino acid substitutions between ascrotal mammals were enriched in GTPase functions.

CONCLUSIONS

Our results suggest that the scrotal testis is an ancestral state in mammals, and the ascrotal phenotype was derived multiple times in independent lineages. In addition, the adaptive evolution of genes involved in testicular descent and the development of the gubernaculum contributed to the evolution of ascrotal testes. Accurate DNA replication, the proper segregation of genetic material, and appropriate autophagy are the potential mechanisms for maintaining physiological normality during spermatogenesis in ascrotal mammals. Furthermore, the molecular convergence of GTPases is probably a mechanism in the ascrotal testes of different mammals. This study provides novel insights into the evolution of the testis and scrotum in mammals and contributes to a better understanding of the pathogenesis of cryptorchidism in humans.

Risk factors for mortality due to COVID-19 in intensive care units: a single-center study

Background

Many studies have revealed several risk factors associated with the prognosis of patients with coronavirus disease 2019 (COVID-19), but the risk factors associated with death in critically ill COVID-19 patients still needs to be fully elucidated. Therefore, we analyzed clinical characteristics and laboratory data of ICU patients to identify risk factors associated with COVID-19 death.

Methods

Patients with COVID-19 from the ICU in the Sino-French New City Branch of Tongji Hospital Wuhan, China, between February 4 and February 29, 2020, were enrolled in this study. The final date of follow-up was April 4, 2020. Clinical manifestations, laboratory tests, treatment, and outcome of participants before and during the ICU stay were retrospectively collected and analyzed.

Results

A total of 92 patients were admitted or transferred to the ICU from February 4 to February 29, 2020. Compared to survivors, the majority of non-survivors (73.8%) presented with dyspnea. A random forest classifier and ROC curve were used to develop a predictive model. IL-6, D-dimer, lymphocytes, and albumin achieved good performance with AUCs of 0.9476, 0.9165, 0.8994, and 0.9251, respectively, which were consistent with clinical observations, such as inflammation, lymphopenia, and coagulation dysfunction. Combining IL-6 and D-dimer improved the performance of this model with an excellent AUC (0.997).

Conclusions

Mortality in COVID-19 was not rare in critically ill patients. The model that combined IL-6 and D-dimer was valuable for predicting the mortality of patients with COVID-19 with excellent performance. This model needs to be further optimized by adding more indicators and then evaluated with a multicenter study.

Oxidative stress drives divergent evolution of the glutathione peroxidase (GPX) gene family in mammals

The molecular basis for adaptations to extreme environments can now be understood by interrogating the ever-increasing number of sequenced genomes. Mammals such as cetaceans, bats, and highland species can protect themselves from oxidative stress, a disruption in the balance of reactive oxygen species, which results in oxidative injury and cell damage. Here, we consider the evolution of the glutathione peroxidase (GPX) family of antioxidant enzymes by interrogating publicly available genome data from 70 mammalian species from all major clades. We identified 8 GPX subclasses ubiquitous to all mammalian groups. Mammalian GPX gene families resolved into the GPX4/7/8 and GPX1/2/3/5/6 groups and are characterized by several instances of gene duplication and loss, indicating a dynamic process of gene birth and death in mammals. Seven of the eight GPX subfamilies (all but GPX7) were under positive selection, with the residues under selection located at or close to active sites or at the dimer interface. We also reveal evidence of a correlation between ecological niches (e.g. high oxidative stress) and the divergent selection and gene copy number of GPX subclasses. Notably, a convergent expansion of GPX1 was observed in several independent lineages of mammals under oxidative stress and may be important for avoiding oxidative damage. Collectively, this study suggests that the GPX gene family has shaped the adaption of mammals to stressful environments.

Genomewide analysis of sperm whale E2 ubiquitin conjugating enzyme genes

Marine mammals are exposed to the oxidative stress induced by hypoxia/reoxygenation cycles yet resist cellular damage. The availability of high-quality genomes promises to provide insights on how this is achieved. In this study, we considered the ubiquitinconjugating enzymes (E2) gene family, UBE2 genes, which encodes enzymes with critical roles in cellular physiology, including the oxidative stress response. The sperm whale was the first marine mammal with a chromosome-level genome, allowing the study of gene family repertories, phylogenetic relationships, chromosome gene organization, and other evolutionary patterns on a genomewide basis. Here, 39 UBE2 genes (similar to human, including 32 intact genes, one partial gene, six pseudogenes) were identified in sperm whale genome. These genes were found on 17 chromosomes and were assigned into 23 subfamilies, 16 subgroups, and four classes based on structural characteristics and functions, phylogeny and conserved domains, respectively. Although the gene structure and motif distribution of sperm whale UBE2 genes are conserved in each subfamily, motif variation and intron gain/loss may contribute to functional divergence. Segmental duplications were detected in six gene pairs, which could drive UBE2 gene innovation in the sperm whale. Contrasting seven cetaceans and five terrestrial taxa, we found that cetaceans have experienced shifts in selective constraint on UBE2 genes, which may contribute to oxidative stress tolerance during the adaptation to aquatic life. Our results provide the first comprehensive survey of cetacean UBE2 genes.

The mitochondrial genome of the black-tailed dusky antechinus (Antechinus arktos)

In this study, we report the mitochondrial genome of the black-tailed antechinus (Antechinus arktos), a recently-discovered, endangered carnivorous marsupial inhabiting a caldera that straddles the border of Australia’s mid-east coast. The circular A. arktos genome is 17,334 bp in length and has an AT content of 63.3%. Its gene content and arrangement are consistent with reported marsupial mitogenome assemblies.

miR-330-5p inhibits NLRP3 inflammasome-mediated myocardial ischaemia-reperfusion injury by targeting TIM3

BACKGROUND/AIMS

The Nod-like receptor protein-3 (NLRP3) inflammasome signalling pathway is involved in the inflammatory reaction of myocardial ischaemia-reperfusion (I/R) injury. Our previous study showed that miR-330-5p was differentially expressed in both cerebral and myocardial I/R injury, and thus might be a biomarker for I/R injury-related diseases. Another study also indicated that miR-330-5p could promote NLRP3 inflammasome activation in renal IRI. However, the role of miR-330-5p in myocardial I/R injury-induced inflammatory responses is unknown. This study aimed to investigate the role of miR-330-5p in NLRP3 inflammasome-mediated myocardial I/R injury.

METHODS

Myocardial I/R injury was induced in mice by occlusion of the left anterior descending coronary artery for 45 min followed by reperfusion. For NLRP3 inflammasome stimulation in vitro, cardiomyocytes were treated with 2 h of oxygen and glucose deprivation (OGD) or LPS (100 ng/ml). Myocardial miR-330-5p expression was examined by PCR at different treatment times. A miR-330-5p antagomir and an agomir were used to regulate miR-330-5p expression. To evaluate the role of miR-330-5p in myocardial I/R injury, 2,3,5-triphenyltetrazolium chloride (TTC) staining, echocardiography, and immunoblotting were used to assess infarct volume, cardiac function, and NLRP3 inflammasome activation respectively. A luciferase binding assay was used to examine whether miR-330-5p could directly bind to the T cell immunoglobulin domain and mucin domain-containing molecule-3 (TIM3). Finally, the role of the miR-330-5p/TIM3 axis in regulating apoptosis and NLRP3 inflammasome formation was evaluated with flow cytometry assays and immunofluorescence staining.

RESULTS

Compared to that in the model group, the inhibition of miR-330-5p significantly aggravated myocardial I/R injury, resulting in increased infarct volume and more severe cardiac dysfunction. Moreover, inhibition of miR-330-5p significantly increased the levels of NLRP3 inflammasome-related proteins, including caspase-1, IL-1β, IL-18 and TNF-α, in both in-vivo and in-vitro models. Furthermore, TIM3 was confirmed as a potential target of miR-330-5p. As predicted, suppression of TIM3 by siRNA ameliorated the anti-miR-330-5p-mediated activation of the NLRP3 inflammasome induced by OGD and LPS, thus decreasing cardiomyocyte apoptosis.

CONCLUSIONS

Our study indicated that the miR-330-5p/TIM3 axis was involved in the regulatory mechanism of NLRP3 inflammasome-mediated myocardial inflammation.