High consumption of coffee is associated with decreased multiple sclerosis risk; results from two independent studies

OBJECTIVE

Previous studies on consumption of caffeine and risk of multiple sclerosis (MS) have yielded inconclusive results. We aimed to investigate whether consumption of coffee is associated with risk of MS.

METHODS

Using two population-representative case-control studies (a Swedish study comprising 1620 cases and 2788 controls, and a US study comprising 1159 cases and 1172 controls), participants with different habits of coffee consumption based on retrospective data collection were compared regarding risk of MS, by calculating ORs with 95% CIs. Logistic regression models were adjusted for a broad range of potential confounding factors.

RESULTS

Compared with those who reported no coffee consumption, the risk of MS was substantially reduced among those who reported a high consumption of coffee exceeding 900 mL daily (OR 0.70 (95% CI 0.49 to 0.99) in the Swedish study, and OR 0.69 (95% CI 0.50 to 0.96) in the US study). Lower odds of MS with increasing consumption of coffee were observed, regardless of whether coffee consumption at disease onset or 5 or 10 years prior to disease onset was considered.

CONCLUSIONS

In accordance with studies in animal models of MS, high consumption of coffee may decrease the risk of developing MS. Caffeine, one component of coffee, has neuroprotective properties, and has been shown to suppress the production of proinflammatory cytokines, which may be mechanisms underlying the observed association. However, further investigations are needed to determine whether exposure to caffeine underlies the observed association and, if so, to evaluate its mechanisms of action.

[(11)C]Ascorbic and [(11)C]dehydroascorbic acid, an endogenous redox pair for sensing reactive oxygen species using positron emission tomography

Here we report the radiosynthesis of an endogenous redox pair, [(11)C]ascorbic acid ([(11)C]VitC) and [(11)C]dehydroascorbic acid ([(11)C]DHA), the reduced and oxidized forms of vitamin C, and their application to ROS sensing. These results provide the basis for in vivo detection of ROS using positron emission tomography (PET).

Pretreatment plasma fibrinogen as an independent prognostic indicator of prostate cancer patients treated with androgen deprivation therapy

BACKGROUND

Hyperfibrinogen is thought to be associated with a higher risk of invasion and metastasis, as well as a worse outcome for multiple types of cancer. However, the prognostic significance of plasma fibrinogen has not been investigated in prostate cancer with hormonal therapy. The objective of this study was to evaluate its roles in prostate cancer patients treated with androgen deprivation therapy (ADT).

METHODS

A total of 290 patients who underwent ADT as first-line therapy for prostate cancer were retrospectively analyzed. The fibrinogen level was measured at the time of diagnosis. Patients were categorized using a cutoff point of 3.225 g l(-1) according to a calculation by the receiver operating curve analysis. Correlations between the fibrinogen and clinical characteristics were analyzed. Meanwhile, univariable and multivariable cox regression analyses were performed to determine the associations of fibrinogen with progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). Prognostic accuracy was evaluated with the Harrell concordance index.

RESULTS

Compared with patients with a lower fibrinogen level (<3.225 g l(-1)), patients with a higher fibrinogen level were more likely to have higher PSA, Gleason score, risk stratification and incidence of metastasis (P<0.05). Multivariable analyses identified hyperfibrinogen as an independent prognostic factor for PFS (hazard ratio (HR)=2.000, P<0.001), CSS (HR=2.209, P=0.006) and OS (HR=1.965, P=0.009). The final models built by the addition of fibrinogen improved predictive accuracy (c-index: 0.750, 0.799 and 0.767) for PFS, CSS and OS compared with the clinicopathological base models (c-index: 0.730, 0.778 and 0.746), which included Gleason score and metastasis.

CONCLUSIONS

The pretreatment plasma fibrinogen level was associated with tumor progression and might have a significant role in the prognosis of the prostate cancer patients treated with ADT. Thus, we recommend adding fibrinogen to traditional prognostic model, which may improve its predictive accuracy.

Abstract P3-07-22: RS1008805 polymorphism in CYP19A1 gene is related to the efficacy of hormone therapy in early breast cancer

Purpose It has been suggested that genetic polymorphisms in CYP19A1 gene were related to aromatase activity as well as circulating steroid hormone levels in postmenopausal women. Therefore, it is biologically reasonable that CYP19A1 rs1008805 (A/G) polymorphism may be associated with clinical outcome for hormone therapy.

Methods Genotyping for CYP19A1 polymorphism rs1008805 was performed on 287 women with HR-positive early breast cancer. Associations were evaluated between CYP19A1 rs1008805 genotypes and disease-free survival (DFS).

Results Based on the analysis of the whole cohort, no significant differences were observed between rs1008805 genotypes and DFS, 5-year DFS rate. However, in postmenopausal women, rs1008805 genotypes were significantly associated with DFS and 5-years DFS rate (AA versus AG versus GG: 89.2 months versus 58.2 versus 32.7 months; 55.9% versus 47.8% versus 0%; P = 0.019). In addition, when the population was subgrouped into two cohorts, women carrying GG variant have a poorer DFS, 5-years DFS rate (GG versus AA or AG: 32.7 months versus 70.6 months; 0% versus 52.1%; HR, 3.613; 95% CI,1.380-9.457; P = 0.005). Furthermore, being adjusted by patients features in multivariate analyses, GG genotype remained an independent prognostic factor for DFS (HR, 3.439; 95% CI, 1.251-9.456; P = 0.017). However, there was no significant differences in DFS and 5-years DFS rate between women harbor the minor allele and those with the homozygous common allele (AG or GG versus AA: 52.4 months versus 89.2 months; 41.0% versus 52.9%; HR, 1.288; 95% CI, 0.705-2.353; P = 0.408). In addition, there were no differences between rs1008805 polymorphisms and DFS among premenopausal women.

Conclusions The homozygous minor allele (GG) of CYP19A1 rs1008805 is significantly associated with worse clinical outcome of hormone therapy in postmenopausal HR-positive early breast cancer patients. If confirmed, genotyping for CYP19A1 polymorphisms rs1008805 may provide predictive information for better selection of endocrine treatment.

Citation Format: Wang X, Shao X, Zheng Y, Shi L, Huang Y. RS1008805 polymorphism in CYP19A1 gene is related to the efficacy of hormone therapy in early breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-22.

Baseline characteristics and management of patients with atrial fibrillation/flutter in the emergency department: results of a prospective, multicentre registry in China

BACKGROUND/AIM

There have been several studies of atrial fibrillation (AF) over the past decades; however, data from Chinese patients are scarce. The aim of the study was therefore to describe the patient characteristics, risk profile and management strategies for Chinese AF patients presenting to emergency department (ED).

METHODS

We conducted a prospective, multicentre registry of patients with AF or atrial flutter (AFL) in China. Participants were enrolled at 20 EDs, then data regarding baseline characteristics and treatment in EDs were collected.

RESULTS

Of the 2016 Chinese patients, 1104 (54.8%) were female. Six hundred eighteen (30.7%) had paroxysmal AF, 452 (22.4%) had persistent AF and 945 (46.9%) had permanent AF. The most common comorbidity was hypertension (55.5%), followed by coronary artery disease (41.8%) and heart failure (HF, 37.4%). The prevalence of concomitant cardiovascular risk factors, such as HF and valvular heart disease, increased as AF progressed. Among the patients with non-valvular AF, 110 (12.7%) of those with CHADS2 (congestive HF, hypertension, age of 75 years and greater, diabetes mellitus and history of stroke) ≥2 were prescribed oral anticoagulants (OAC), while 119 (15.6%) of those with CHADS2 <2 received such agents. Among the 324 patients with valvular AF, 134 (41.4%) actually were treated with OAC. The international normalised ratio value was within the target range (2.0-3.0) in 96 patients only (26.4%). Moreover, a total of 16.2% of the patients received ≥1 anti-arrhythmic agents, whereas rate control agents were used more frequently (68.4%).

CONCLUSIONS

According to the present study, the risk profile and management of Chinese patients with AF/AFL differed from that observed in previous studies. The use of OAC inadequately deviate from current guidelines.

An alternative technique for stabilisation of the carpometacarpal joint of the thumb after dislocation or subluxation

We report a new surgical technique for the treatment of traumatic dislocation of the carpometacarpal (CMC) joint of the thumb. This is a tenodesis which uses part of the flexor carpi radialis.

Between January 2010 and August 2013, 13 patients with traumatic instability of the CMC joint of the thumb were treated using this technique. The mean time interval between injury and ligament reconstruction was 13 days (0 to 42). The mean age of the patients at surgery was 38 years: all were male.

At a mean final follow-up of 26 months (24 to 29), no patient experienced any residual instability. The mean total palmar abduction of the CMC joint of the thumb was 61° and the mean radial abduction 65° The mean measurements for the uninjured hand were 66° (60° to 73°) and 68° (60° to 75°), respectively. The mean Kapandji thumb opposition score was 8.5° (8° to 9°). The mean pinch and grip strengths of the hand were 6.7 kg (3.4 to 8.2) and 40 kg (25 to 49), respectively. The mean Disabilities of the Arm, Shoulder, and Hand questionnaire score was 3 (1 to 6). Based on the Smith and Cooney score, we obtained a mean score of 85 (75 to 95), which included four excellent, seven good, and two fair results.

Our technique offers an alternative method of treating traumatic dislocation of the CMC joint of the thumb: it produces a stable joint and acceptable hand function.

Cite this article: Bone Joint J 2015;97-B:1533–8.

Antifungal modes of action of tea tree oil and its two characteristic components against Botrytis cinerea

AIMS

The essential oil of Melaleuca alternifolia (tea tree) has been evaluated as a potential eco-friendly antifungal agent against Botrytis cinerea. In this study, we investigated the antifungal activity and mode of action of tea tree oil (TTO) and its components against B. cinerea.

METHODS AND RESULTS

Of the components we tested in contact phase, terpinen-4-ol had the highest antifungal activity, followed by TTO, α-terpineol, terpinolene, then 1,8-cineole. As one of characteristic components of TTO, terpinen-4-ol treatment led to pronounced alterations in mycelial morphology, cellular ultrastructure, membrane permeability under scanning electron microscope, transmission electron microscope and fluorescent microscope, and also reduced the ergosterol content of fungi. As another characteristic component, 1,8-cineole caused serious intracellular damage but only slightly affected B. cinerea otherwise. When terpinen-4-ol and 1,8-cineole were used together, the synergistic antifungal activity was significantly higher than either component by itself.

CONCLUSIONS

The results of our study confirmed that terpinen-4-ol and 1,8-cineole act mainly on the cell membranes and organelles of B. cinerea, respectively, and when combined are similar to TTO in antifungal activity due to their differences.

SIGNIFICANCE AND IMPACT OF THE STUDY

Understanding the mechanism of terpinen-4-ol and 1,8-cineole antifungal action to B. cinerea is helpful for investigation on their synergistic effect and explaining antifungal action modes of TTO.

Association between metabolically unhealthy overweight/obesity and chronic kidney disease: the role of inflammation

AIM

Our study explored the association between subtypes of increased fat mass (with or without associated metabolic alterations) and the presence of chronic kidney disease (CKD).

METHODS

In this cross-sectional survey in China, body mass index (BMI) was used to assess fat mass. Metabolically healthy was defined as no insulin resistance or any metabolic syndrome components except abdominal obesity. We also used two previous definitions of metabolically healthy. Multiple logistic regression models were used. Normal weight with metabolic health was designated the reference group. Three other subgroups included normal weight with metabolic unhealthiness, overweight/obesity with metabolic health and overweight/obesity with metabolic unhealthiness.

RESULTS

Of the 2324 subjects, 11.77% overweight/obese subjects were metabolically healthy. Compared with normal-weight subjects who were metabolically healthy, overweight/obese subjects who were metabolically healthy did not have an increased risk of CKD (OR: 0.79, 95% CI: 0.29–2.14; P = 0.64), whereas overweight/obese subjects who were metabolically unhealthy had a significantly higher risk of CKD (OR: 2.47, 95% CI: 1.5–3.95; P < 0.001). Normal-weight subjects who were metabolically unhealthy also had a higher risk of CKD, but the P value was of borderline significance. On further adjusting for C-reactive protein (CRP) levels, ORs were much attenuated, but did not alter the associations observed. Using two other definitions of metabolically healthy resulted in similar results.

CONCLUSION

Metabolically unhealthy overweight/obesity, but not metabolically healthy overweight/obesity, is associated with an increased risk of CKD. Inflammation might mediate at least part of the association between metabolic changes and CKD prevalence.

Does nerve repair influence the outcome of reconstruction of a digital nail defect using a free composite flap taken from the great toe?

We describe reconstruction of a nail unit defect in the finger using a free composite flap taken from the great toe, comparing the outcome in patients in whom neurorrhaphy between the dorsal digital nerve of the great toe and the dorsal branch of the proper digital nerve of the injured finger was performed to those in which no nerve repair was made. From January 2002 to March 2009, 47 patients with traumatic fingernail defects were treated. Twenty-two patients before February 2005 had no nerve repair and subsequently 25 patients had nerve repair. The mean size of the germinal matrix and sterile matrix defects was 9 × 8 mm, and the mean size of the nail bed flaps was 9 × 9 mm. The mean length of the arteries used for the flap was 2.2 cm. Outcomes were rated. In the nerve repair group, full flap survival was achieved in 24 patients. At the mean follow-up period of 25 months, there were 12 excellent, seven very good, four good, and two fair results. In the comparison group without nerve repair, there were seven excellent, four very good, four good, five fair, and two poor results. Donor site morbidities were similar in both groups. The use of a free composite flap taken from the great toe is a useful technique for reconstructing nail unit defects in the finger. Innervated nail flap reconstructions tended to show better outcomes than those in which no nerve repair was performed. There is no difference in function or donor site between those in whom the nerve was repaired compared with those in whom it was not repaired.

Carpal tunnel release with subneural reconstruction of the transverse carpal ligament compared with isolated open and endoscopic release

We report a new surgical technique of open carpal tunnel release with subneural reconstruction of the transverse carpal ligament and compare this with isolated open and endoscopic carpal tunnel release.

Between December 2007 and October 2011, 213 patients with carpal tunnel syndrome (70 male, 143 female; mean age 45.6 years; 29 to 67) were recruited from three different centres and were randomly allocated to three groups: group A, open carpal tunnel release with subneural reconstruction of the transverse carpal ligament (n = 68); group B, isolated open carpal tunnel release (n = 92); and group C, endoscopic carpal tunnel release (n = 53).

At a mean final follow-up of 24 months (22 to 26), we found no significant difference between the groups in terms of severity of symptoms or lateral grip strength. Compared with groups B and C, group A had significantly better functional status, cylindrical grip strength and pinch grip strength. There were significant differences in Michigan Hand Outcome scores between groups A and B, A and C, and B and C. Group A had the best functional status, cylindrical grip strength, pinch grip strength and Michigan Hand Outcome score.

Subneural reconstruction of the transverse carpal ligament during carpal tunnel decompression maximises hand strength by stabilising the transverse carpal arch.

Cite this article: Bone Joint J 2015;97-B:221–8

Repair of a palmar soft tissue defect of the proximal interphalangeal joint with a transposition flap from the dorsum of the proximal phalanx

This article describes the use of a transposition flap raised from the dorsum of the proximal phalanx for coverage of the volar defects at the proximal interphalangeal joint. The flap was based on the first dorsal branch of the proper digital artery. From January 2007 to March 2009, 14 digits in 14 patients (10 males and 4 females) were treated. There were 5 index, 6 middle, 2 ring, and 1 little finger. All patients underwent surgery 2-9 hours (mean 5 hours) after injury. Soft tissue defects ranged in size from 1.2 × 1.7 cm to 2.1 × 2.3 cm (mean 1.7 × 2 cm). Flap size ranged from 1.5 × 1.7 cm to 2.4 × 2.7 cm (mean 2 × 2.4 cm). Mean pedicle length was 1.1 cm (range 0.8-1.4 cm). All flaps completely survived. At final follow-up from 24-29 months (mean 26 months), mean active motion arcs of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 84° (range 75-91°), 86° (range 65-100°) and 54° (range 32-80°), respectively. Our technique is useful and reliable for coverage of a palmar defect over the proximal interphalangeal joint.

The possible mechanism of antifungal action of tea tree oil on Botrytis cinerea

AIMS

Tea tree oil (TTO) has been confirmed in previous study as a potential natural antifungal agent to control Botrytis cinerea and grey mould in fresh fruit. However, the mechanism of its action has not been clearly revealed, and some hypotheses mainly depended on the results obtained from the bacterial test. For the antifungal mechanism, the effect of TTO on the mycelium morphology and ultrastructure, cell wall and membrane, and membrane fatty acid composition of B. cinerea was investigated in vitro experiments.

METHODS AND RESULTS

Tea tree oil in vapour or contact phase exhibited higher activity against the mycelial growth of B. cinerea. Observations using scanning electron microscope and transmission electron microscope revealed that the mycelial morphology and ultrastructure alternations caused by TTO are the markedly shriveled or flatted empty hyphae, with thick cell walls, ruptured plasmalemma and cytoplasmic coagulation or leakage. Furthermore, TTO caused significantly higher alkaline phosphatase activity after 4-h treatment and markedly higher absorbance at 260 nm and electric conductivity in the external hyphae of fungi after 16-h treatment. Moreover, decreased unsaturated/saturated fatty acid ratio of the fungal membrane was also observed after TTO treatment.

CONCLUSIONS

The methodology used in this study confirmed that the cell wall destroyed firstly in the presence of TTO, and then the membrane fatty acid composition changed, which resulted in the increasing of membrane permeability and releasing of cellular material. The above findings may be the main reason for TTO's antifungal ability to B. cinerea.

SIGNIFICANCE AND IMPACT OF THE STUDY

Understanding the mechanism of TTO antifungal action to B. cinerea is helpful for its commercial application on the preservation of fresh fruit and vegetables.

¹H NMR-based metabonomics in brain nucleus accumbens and striatum following repeated cocaine treatment in rats

Studies have shown a few cerebral metabolites modified by cocaine in brain regions; however, endogenous metabolic profiling has been lacking. Ex vivo (1)H NMR (hydrogen-1 nuclear magnetic resonance) spectroscopy-based metabonomic approach coupled with partial least squares was applied to investigate the changes of cerebral metabolites in nucleus accumbens (NAc) and striatum of rats subjected to cocaine treatment. Our results showed that both single and repeated cocaine treatment can induce significant changes in a couple of cerebral metabolites. The increase of neurotransmitters glutamate and gamma-amino butyric acid (GABA) were observed in NAc and striatum from the rats repeatedly treated with cocaine. Creatine and taurine increased in NAc whereas taurine increased and creatine decreased in striatum after repeated cocaine treatment. Elevation of N-acetylaspartate in NAc and striatum and decrease of lactate in striatum were observed, which may reflect the mitochondria dysregulation caused by cocaine; moreover, alterations of choline, phosphocholine and glycerol in NAc and striatum could be related to membrane disruption. Moreover, groups of rats with and without conditioned place preference (CPP) apparatus are presenting difference in metabolites. Collectively, our results provide the first evidence of metabonomic profiling of NAc and striatum in response to cocaine, exhibiting a regionally-specific alteration patterns. We find that repeated cocaine administration leads to significant metabolite alterations, which are involved in neurotransmitter disturbance, oxidative stress, mitochondria dysregulation and membrane disruption in brain.

Increment of 30-min post-challenge plasma glucose is associated with urine albumin excretion in men with normal glucose regulation

AIMS

The overwhelming majority of subjects with normal glucose regulation have the highest plasma glucose concentration at 30 minutes during oral glucose tolerance. We aimed to examine the association between increment of 30-min post-challenge glucose and albuminuria in participants with normal glucose regulation.

METHODS

A population-based cross-sectional study was conducted in six communities in Shanghai between 2007 and 2008. A total of 3508 subjects with normal glucose regulation had complete data and were enrolled into the analysis. Among the selected subjects, only 1525 individuals (581 men, 944 women) were examined for their serum insulin levels. We assessed post-challenge blood glucose and insulin at 0, 30 and 120 min, urinary albumin and creatinine. The 30-min post-challenge glucose increment (Δ) was calculated as 30-min post-challenge glucose minus fasting plasma glucose, and albumin/creatinine ratio was used to reflect urinary albumin excretion.

RESULTS

Multivariable logistic regression analysis revealed that the Δ30-min post-challenge glucose was independently associated with increased albumin/creatinine ratio in men with normal glucose regulation (OR = 1.08, P = 0.025), but not in women. Furthermore, multivariable linear regression analysis revealed that early-phase glucose disposition index was the main factor responsible for Δ30-min post-challenge glucose and explained 14-20% of the variance of Δ30-min post-challenge glucose in the two subgroups (P < 0.05). Notably, men had higher Δ30-min post-challenge glucose and lower early-phase glucose disposition index than women (all P < 0.001).

CONCLUSIONS

The 30-min post-challenge plasma glucose increment is associated with urine albumin excretion in men with normal glucose regulation.

Pharmacological characterization of cis-nitromethylene neonicotinoids in relation to imidacloprid binding sites in the brown planthopper, Nilaparvata lugens

Neonicotinoid insecticides, such as imidacloprid, are selective agonists of the insect nicotinic acetylcholine receptors (nAChRs) and extensively used in areas of crop protection and animal health to control a variety of insect pest species. Here we describe that two cis-nitromethylene neonicotinoids (IPPA152002 and IPPA152004), recently synthesized in our laboratory, discriminated between the high and low affinity imidacloprid binding sites in the brown planthopper, Nilaparvata lugens, a major insect pest of rice crops in many parts of Asia. [(3)H]imidacloprid has two binding sites with different affinities (Kd value of 0.0035 +/- 0.0006 nM for the high-affinity site and 1.47 +/- 0.22 nM for the low-affinity site). Although the cis-nitromethylene neonicotinoids showed low displacement ability (Ki values of 0.15 +/- 0.03 microM and 0.42 +/- 0.07 microM for IPPA152002 and IPPA152004, respectively) against [(3)H]imidacloprid binding, low concentrations (0.01 microM) of IPPA152002 completely inhibited [(3)H]imidacloprid binding at its high-affinity site. In Xenopus oocytes co-injected with cRNA encoding Nlalpha1 and rat beta2 subunits, obvious inward currents were detected in response to applications of IPPA152002 and IPPA152004, although the agonist potency is reduced to that of imidacloprid. The previously identified Y151S mutation in Nlalpha1 showed significant effects on the agonist potency of IPPA152002 and IPPA152004, such as a 75.8% and 70.6% reduction in Imax, and a 2.4- and 2.1-fold increase in EC(50). This data clearly shows that the two newly described cis-nitromethylene neonicotinoids act on insect nAChRs and like imidacloprid, discriminated between high and low affinity binding sites in N. lugens native nAChRs. These compounds may be useful tools to further elucidate the pharmacology and nature of neonicotinoid binding sites.

The lupus-susceptibility gene kallikrein downmodulates antibody-mediated glomerulonephritis

Sle3 is a NZM2410/NZW-derived lupus-susceptibility interval on murine chromosome 7, which is associated with spontaneous lupus nephritis (SLN), and also anti-GBM-induced glomerulonephritis (GN). The tissue kallikrein gene cluster is located within the Sle3 interval and constitutes potential candidate genes for this locus. We have recently reported that renal kallikrein expression was upregulated by anti-GBM antibody challenge in a strain-specific manner and that it was significantly underexpressed in the anti-GBM-sensitive strains, including B6.Sle3. Further sequencing and functional studies reported earlier provided evidence that kallikreins could constitute disease genes in lupus. In this report, we have used an adenoviral vector to deliver the klk1 gene to B6.Sle3 congenics to directly test if kallikreins might have a protective effect against anti-GBM-induced nephritis. Our data show that klk1 gene delivery ameliorated anti-GBM-induced nephritis in B6.Sle3 congenics. Taken together with earlier studies, these findings indicate that kallikreins play an important protective role in autoantibody-initiated GN and could constitute potential candidate genes for anti-GBM-induced GN and SLN.