Deep Learning-Based Automatic Segmentation of Lumbosacral Nerves on CT for Spinal Intervention: A Translational Study

BACKGROUND AND PURPOSE

3D reconstruction of a targeted area ("safe" triangle and Kambin triangle) may benefit the viability assessment of transforaminal epidural steroid injection, especially at the L5/S1 level. However, manual segmentation of lumbosacral nerves for 3D reconstruction is time-consuming. The aim of this study was to investigate the feasibility of deep learning-based segmentation of lumbosacral nerves on CT and the reconstruction of the safe triangle and Kambin triangle.

MATERIALS AND METHODS

A total of 50 cases of spinal CT were manually labeled for lumbosacral nerves and bones using Slicer 4.8. The ratio of training/validation/testing was 32:8:10. A 3D U-Net was adopted to build the model SPINECT for automatic segmentations of lumbosacral structures. The Dice score, pixel accuracy, and Intersection over Union were computed to assess the segmentation performance of SPINECT. The areas of Kambin and safe triangles were measured to validate the 3D reconstruction.

RESULTS

The results revealed successful segmentation of lumbosacral bone and nerve on CT. The average pixel accuracy for bone was 0.940, and for nerve, 0.918. The average Intersection over Union for bone was 0.897 and for nerve, 0.827. The Dice score for bone was 0.945, and for nerve, it was 0.905. There were no significant differences in the quantified Kambin triangle or safe triangle between manually segmented images and automatically segmented images (P > .05).

CONCLUSIONS

Deep learning-based automatic segmentation of lumbosacral structures (nerves and bone) on routine CT is feasible, and SPINECT-based 3D reconstruction of safe and Kambin triangles is also validated.

[Submucosal tunneling endoscopic resection for submucosal tumors originating from muscularis propria layer at esophagogastric junction]

Objective: To evaluate the short-term outcomes and safety of submucosal tunneling endoscopic resection (STER) for submucosal tumors (SMT) originating from muscularis propria (MP) layer at esophagogastric junction. Methods: The clinical data of 31 patients with SMT originating from MP layer at esophagogastric junction underwent STER were collected and retrospectively analyzed. Results: The success rate of STER of the thirty-one patients was 100%. The mean tumor size was (2.5±1.3) cm and the average operative time was (95.9±56.7) min. Perforation occurred in 3 patients and was successfully clipped by endo-clips during operation. One patient developed delayed bleeding and the bleeding was stopped by endoscopic hemostasis. Twenty-nine leiomyomas and two stromal tumors (GIST) were finally pathologically diagnosed. No local recurrence and distant metastasis were noted during the mean 15.4 months follow-up of 20 cases. According to the lesion size, 31 patients who received STER were divided into two groups. The operation time of maximum diameter ≥3.5 cm group was (134.0±70.6) min, significantly longer than (80.3±42.6) min of maximum diameter <3.5 cm group (P=0.014). However, the en bloc removal rate, postoperative hospital stay and the complication incidence between the two groups had no obvious differences (P>0.05). Univariate analysis showed that the piecemeal removal group had longer tumor diameter, higher incidence of irregular tumor morphology, and longer operative time than the en bloc removal group (all P<0.05). Stepwise logistic regression analysis showed that irregular shape was a risk factor for failure of en bloc removal (OR=18.000, 95% CI: 1.885~171.88, P=0.012). Conclusion: As a new method of minimally invasive treatment, STER technology appears to be a safe and effective option for patients with SMT originating from MP layer at esophagogastric junction.

Abstract P4-13-02: Selective androgen receptor modulator RAD140 inhibits the growth of endocrine-resistant breast cancer models with defined genetic backgrounds

Estrogen receptor α-positive (ER+) breast cancer is routinely treated with therapies targeting the ER axis. However, de novo and acquired resistance to the standard-of-care treatment occur in a significant subset of patients. Multiple mechanisms have been proposed for the resistance, among which genetic alterations to the coding gene of ERα, ESR1, have been extensively studied. Notably, ESR1 hotspot mutations within the ligand binding domain (LBD), novel fusion proteins consisting of the N-terminal domain of ER and the C-terminal domain of a partner gene, and ESR1 gene amplification have been found to be enriched in endocrine-resistant, metastatic breast cancers. Together these ER gene alterations present new challenges in the management of ER+ breast cancer and call for the development of new agents to supplement the current standard-of-care. Around 90% of the ER+ breast cancer cases are also androgen receptor (AR) positive (AR+). Mounting preclinical evidence has demonstrated that AR agonists suppress AR and ER positive (AR/ER+) breast cancer cell growth, in line with clinical activity of androgens. We recently reported the oral selective androgen receptor modulator (SARM) RAD140 is a potent, tissue-selective AR agonist in breast cancer cells which significantly inhibited the growth of AR/ER+ patient-derived xenograft (PDX) models, partly via inhibiting ESR1 gene expression and ER signaling. It also elicited enhanced tumor growth inhibition when combined with a CDK4/6 inhibitor.

Here we further examine the activity of RAD140 in AR/ER+ breast cancer models that are endocrine-independent with a spectrum of ESR1 genetic alterations. In PDX models harboring ESR1 amplification or fusion, RAD140 inhibited tumor growth to a greater degree than fulvestrant, a standard-of-care selective ER degrader (SERD). These results are consistent with the clinical history of the donor patients whose diseases relapsed from or progressed rapidly on fulvestrant. In PDX models with ESR1 Y537S mutation, RAD140 showed anti-tumor activity comparable to that of fulvestrant. Notably, RAD140 treatment also led to substantial reduction of proliferation and colony formation in cell line models recapitulating resistance to the combination of estrogen deprivation and CDK4/6 inhibition.

In summary, RAD140 showed marked anti-tumor activity in AR/ER+, endocrine-resistant breast cancer models with defined genetic background. Importantly, in models with ESR1 amplification and fusion, the AR-targeting RAD140 exhibited more profound inhibitory activity compared with fulvestrant. In models with an ESR1 mutation, the efficacy of RAD140 and fulvestrant was comparable. These results lend support to a clinical hypothesis that AR/ER+, endocrine-resistant tumors with these genetic backgrounds may benefit from AR agonist-based treatment. RAD140 is currently being evaluated in hormone receptor positive (HR+) breast cancer patients (NCT03088527).

Citation Format: Yu Z, He S, Miller C, Saeh J, Hattersley G, O'Neill A. Selective androgen receptor modulator RAD140 inhibits the growth of endocrine-resistant breast cancer models with defined genetic backgrounds [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-13-02.

Negative Association of Serum URIC Acid with Peripheral Blood Cellular Aging Markers

OBJECTIVES

We aimed to explore the association between serum UA and cellular aging markers.

DESIGN

The current cross-sectional analysis was based on data collected within a type 2 diabetes project.

SETTINGS

Serum uric acid (UA), which has both antioxidant and pro-oxidant properties, is thought to be involved in cellular aging processes.

PARTICIPANTS

There are 536 participants included in total, 65.3% of which are women. The average serum UA in women was 267.8 umol/l, lower than in men of 337.7 umol/l (P<0.001).

MEASUREMENTS

Serum UA, blood lipid profile, HbA1c, plasma glucose and insulin were determined. The peripheral blood leukocyte telomere length (LTL) and mitochondrial DNA copy number (mtDNAcn) were assessed using a real-time PCR assay. Logistic regressions were used to analyze the associations between serum UA and cellular aging markers.

RESULTS

In Spearman's correlation analysis, there were significantly negative correlations between serum UA and LTL in both women and men (r=-0.162, P=0.006; and r=-0.232, P=0.004, respectively). The logistic regression adjusted for age, BMI, WC, daily energy intake, HbA1c, TG, and LDL-C revealed that the ORs of shorter LTL comparing the extreme serum UA quintiles was 5.52 (95% CI 1.69-18.02; P for trend =0.025) in women and 6.49 (95% CI 1.38-30.45; P for trend =0.108) in men. Furthermore, the OR (95% CI) for shorter LTL per 1 SD increment in serum UA was 1.51(1.10-2.07) in women and 1.64(1.01-2.65) in men. In regard to mtDNAcn, the association between elevated serum UA and lower mtDNAcn only reached significance in men when comparing the second and fifth quintiles with reference quintile (OR=3.73(1.07-13.04) and 3.76(1.01-14.09) , separately, and P for trend=0.066).

CONCLUSIONS

Our results indicate a significant negative association between serum UA and peripheral blood cellular aging markers. Serum UA might play a role in promoting cellular aging.

[Resting metabolic rate estimated by bioelectrical impedance analysis and its determinants in maintenance hemodialysis patients]

Objective: To explore the level of resting energy expenditure (REE) estimated by bioelectrical impedance analysis and the association of resting metabolic rate (RMR) with clinical related factors, and provide new ideas for improving protein energy wasting (PEW) in maintenance hemodialysis (MHD) patients. Methods: Seven hundred and sixty-five subjects receiving MHD between July 2015 and September 2016 in 11 hemodialysis centers in Guizhou province were enrolled in this cross-sectional study. Bioelectrical impedance analysis was used to measure RMR and body composition, such as lean body mass, fat mass and body cell mass (BCM). Baseline characteristics, routine blood test indexes and biochemical data of hemodialysis patients were collected. The level of RMR and body composition in hemodialysis patients was compared by gender grouping. Then the patients were divided into four groups according to the cutoff value of RMR quartile. Spearman correlation analysis and multiple linear regression analysis were used to analyze the relationships between RMR and clinical related factors. Results: The average age of MHD patients was (54.96±15.78) years and the duriation of dialysis was (42.3±9.0) months. The level of RMR in male patients (474 cases, 61.96%) was significantly higher than that in female patients [1 591(1 444, 1 764) kcal/d vs 1 226 (1 104, 1 354) kcal/d, P<0.001]. However, this significant difference of RMR between different genders disappeared after adjusting for lean body mass (P=0.193). Multiple linear regression analysis showed that RMR was positively correlated with body surface area (β=0.817) and lactate dehydrogenase (LDH) (β=0.198), and negatively correlated with age (β=-0.141), all P<0.05. Conclusion: RMR levels in patients with maintenance hemodialysis are associated with lactate dehydrogenase level, which may become a new index to evaluate energy consumption.

[The application of cineMRI in evaluation of upper airway obstruction levels in complicated pediatric OSAS]

Objective:The aim of this study is to explore the role of cineMRI in the localization of upper airway obstruction in complicated pediatric OSAS. Method:Eleven persistent OSAS and 11 complex OSAS patients underwent cineMRI. Each patient was imaged midline sagittal and axial magnetic resonance cine image. The obtained sagittal and axial images were displayed in cine format, creating a real time "movie" of airway motion, to make a personalized treatment for each child. Polysomnography was performed to evaluate the effectiveness of cineMRI directed treatment for pediatric OSAS. Result:cineMRI could effectively define the upper airway obstruction level. There was a significant improvement in AHI (P=0.019) and saturation nadir (P<0.01). Conclusion:cineMRI is an effective method for assessing the level of airway obstruction on persistent or complex pediatric OSAS.

[Functional rhinoplasty under nasal endoscope]

Objective:At different times and cultural background,people have different definition of beauty.With the improvement of economic level and culture quality,people are becoming more and more recognition of nasal appearance and function are equally important.Even the importance of the function of the nasal is higher than the importance of shape of the nose. Concurrent rhinoplasty (nasal dorsum and lateral nasal wall reduction) and functional sinus surgery (nasal septum reconstructory, middle turbinate,inferior turbinate surgery even extended to the nasal cavity expansion tecunhnique, sinusitis surgery) with endoscopic surgical surgical methods were discussed.Method:The study included 20 patients with deformed functional endoscopic rhinoplasty, 2010-2015 in Beijing Tongren Hospital,of ages 16-53, male 14 cases,female 6 cases, 11cases had history of trauma, all of 20 patients have unilateral nasal plugging. Operating methods, 17 patients were performed nasal endoscopic septoplasty and rhinoplasty at the same time. One case cocurrent endoscopic rhinodacryocystostomy.Two cases were performed Nasal endoscopic sinus operation. Only 5 cases use silica gel prosthesis, 15 cases use autologous cartilage in functional rhinoplasty.Result:Twenty patients compared with performed rhinoplasty,nasal septum reconstructory,middle turbinate,inferior turbinate surgery,nasal cavity expansion,sinusitis surgery separately,surgery is better,no other complicationgs occurred.Actually decredsed the number of surgical treatment and hospitalization expenses.Conclusion:Functional endoscopic rhinoplasty,over the same period it solved the nasal shape and nasal ventilation function.To avoid impact on ventilation function in the process of the rhinoplasty.Implements the unification of beauty and function.Reduce the surgical treatment of times and cost.No other complication compared to convertional surgery,high feasibility.

Low Wall Shear Stress Is Associated with Local Aneurysm Wall Enhancement on High-Resolution MR Vessel Wall Imaging

BACKGROUND AND PURPOSE

Some retrospective studies have found that the aneurysm wall enhancement on high-resolution MR vessel wall postgadolinium T1WI has the potential to distinguish unstable aneurysms. This study aimed to identify hemodynamic characteristics that differ between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.

MATERIALS AND METHODS

TOF-MRA and high-resolution MR vessel wall T1WI of 25 patients were fused to localize the enhanced area of the aneurysm wall. Using computational fluid dynamics, we studied the aneurysm models. Mean static pressure, mean wall shear stress, and oscillatory shear index were compared between the enhanced and nonenhanced areas.

RESULTS

The aneurysmal enhanced area had lower wall shear stress (P < .05) and a lower oscillatory shear index (P = .021) than the nonenhanced area. In addition, the whole aneurysm had lower wall shear stress (P < .05) and a higher oscillatory shear index (P = .007) than the parent artery.

CONCLUSIONS

This study suggests that there are hemodynamic differences between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.

[Imaging charateristics of bony erosion and fungal culture analysis in allergic fungal rhinosinusitis]

Objective:To investigate the imaging characteristics of bony erosion, fungal culture and related factors in allergic fungal rhinosinusitis (AFRS). Method:Sixty cases of AFRS were reviewed in this study. The characteristics of Computed Tomography and Magnetic Resonance Imaging including positive rate of bony erosion, eroded sites, disease extension and sinus expansion were summarized. Fungal culture and identification of nasal secretion were done. The correlation between the degree of sinus expansion, species of fungi and bony erosion was evaluated by statistical analysis. Result:Of the 60 patients, 18 (30%) had bony erosion. There was a significant difference in the proportion of bone erosion among the sinuses (P<0.05). The most commonly eroded site was the ethmoid sinus. The orbit were the most common adjacent anatomic spaces to exhibit disease extension, and anterior cranial fossa is the second most common. Statistical analysis revealed a significant association(P<0.05)of bone erosion with sinus expansion. The positive rate of fungal culture was 51.3%, among which the most common is Aspergillus. Statistical analysis shows no association(P>0.05)of bone erosion with specific fungi. Conclusion:Bone erosion is an important imaging feature of AFRS. Bone erosion may cause by sinus expansion. Extension of disease into the orbit or intracranial cavity results from a natural progression of disease after erosion occurs. Specific fungal species that can cause bone erosion was found.

[Epidemiological investigation on 1 946 hospitalized pediatric patients with burns]

Objective: To investigate the epidemiological characteristics of hospitalized pediatric patients with burns and explore the prevention and treatment strategy of pediatric burns. Methods: Medical records of pediatric burn patients hospitalized in multiple departments of Children's Hospital of Chongqing Medical University from January 2012 to December 2016 were retrospectively analyzed. Data including gender, age, residence, ways of paying, total burn area, burn severity, cause, time, and place of burns, prehospital treatment ways, clinical outcome, length of hospital stay were collected and processed with chi-square test, Kruskal-Wallis H test, and Bonferroni correction. The factors which influence wound healing were processed with multivariate logistic regression analysis. Results: (1) A total of 1 946 pediatric burn patients with complete medical records were hospitalized in Children's Hospital of Chongqing Medical University during the 5 years, with 1 127 boys (57.91%), which were more than 819 girls (42.09%). Pediatric patients≤3 years old were with the highest incidence of burns of 87.15% (1 696/1 946). There was no significantly statistical difference in gender composition ratio among pediatric patients of different ages (χ²=2.294, P= 0.318). (2) The residence of 1 536 pediatric patients (78.93%) were in town, and most of them used urban resident essential medical insurance for medical cost. Most of the pediatric patients living in rural areas paid the medical cost at their own expense. There was significantly statistical difference in way of paying between pediatric patients living in urban and those in rural areas (χ²=658.324, P<0.05). (3) The pediatric patients with total burn surface area≥5% total body surface area (TBSA) and<15% TBSA were the most (1 200 cases, accounting for 61.66%). The pediatric patients with moderate burns were the most (1 225 cases, accounting for 62.95%), followed by mild burns (494 cases, accounting for 25.39%), severe burns (124 cases, accounting for 6.37%), and extremely severe burns (46 cases, accounting for 2.36%). (4) The pediatric patients with scald caused by hot water were the most (1 801 cases, accounting for 92.55%), followed by flame burns (69 cases, accounting for 3.55%), chemical burns (44 cases, accounting for 2.26%), and electrical burns (32 cases, accounting for 1.64%). There was significantly statistical difference in cause of injury among pediatric patients of different ages (χ²=85.471, P<0.05). (5) The incidence of burns of pediatric patients in Spring was 27.95% (544/1 946), which was slightly higher than those in other seasons. There was significantly statistical difference in the burn season among pediatric patients admitted to the hospital in different years (χ²= 23.172, P< 0.05). As to burn place, most of burns of pediatric patients happened at home (1 776 cases, accounting for 91.26%). (6) There was significantly statistical difference in clinical outcome among pediatric patients with different prehospital treatments (H=16.005, P<0.05). There was significantly statistical difference in clinical outcome between pediatric patients with reasonable prehospital treatments and those with unreasonable prehospital treatments (H=-64.990, P<0.05), and between pediatric patients with reasonable prehospital treatments and those without any treatment (H=-74.775, P<0.05). There was no significantly statistical difference in clinical outcome between pediatric patients with unreasonable prehospital treatments and those without any prehospital treatment (H=-9.785, P>0.05). (7) The median of length of hospital stay of pediatric patients was 8 days. The pediatric patients with length of hospital stay≤7 days were the most (834 cases, accounting for 42.86%), and the pediatric patients with length of hospital stay>30 days were the least (39 cases, accounting for 2.00%). (8) The way of prehospital treatment and cause of injury were independent risk factors influencing wound healing (χ²=7.946, 12.977, P<0.05). With no prehospital treatment as benchmark, reasonable prehospital treatments promoted wound healing (odds ratio=1.662, 95% confidence interval=1.129-2.447, P<0.05). With chemical burns as benchmark, electrical burn wounds were harder to heal (odds ratio=0.144, 95% confidence interval=0.028-0.734, P<0.05). Conclusions: Pediatric burn patients hospitalized in Children's Hospital of Chongqing Medical University were mainly boys≤3 years old with moderate scald caused by hot water at home in urban areas. Timely and reasonable prehospital treatments are beneficial to wound healing.

Termite soldiers contribute to social immunity by synthesizing potent oral secretions

The importance of soldiers to termite society defence has long been recognized, but the contribution of soldiers to other societal functions, such as colony immunity, is less well understood. We explore this issue by examining the role of soldiers in protecting nestmates against pathogen infection. Even though they are unable to engage in grooming behaviour, we find that the presence of soldiers of the Darwin termite, Mastotermes darwiniensis, significantly improves the survival of nestmates following entomopathogenic infection. We also show that the copious exocrine oral secretions produced by Darwin termite soldiers contain a high concentration of proteins involved in digestion, chemical biosynthesis, and immunity. The oral secretions produced by soldiers are sufficient to protect nestmates against infection, and they have potent inhibitory activity against a broad spectrum of microbes. Our findings support the view that soldiers may play an important role in colony immunity, and broaden our understanding of the possible function of soldiers during the origin of soldier-first societies.

An increased tendency in fibrinogen activity and its association with a hypo-fibrinolytic state in early stages after injury in patients without acute traumatic coagulopathy (ATC)

Acute traumatic coagulopathy (ATC) diagnosed by prolongation of APTT and/or PT/INR involves alterations in platelet activity, coagulation and fibrinolysis. However, data showing the haemostatic situation in injured patients without ATC are scarce. To assess whether haemostatic impairment is also present in injured patients without ATC, ten injured patients without ATC and ten normal individuals were examined. The patients were sampled on arrival at the emergency department 0, 2, 12 h after surgical or other intervention. Thrombin generation, fibrin formation and fibrin proteolysis were determined via several laboratory methods, using tissue factor as the coagulation trigger. Thrombograms demonstrated that trauma accelerated both thrombin generation and decay. In the presence of unaffected peak thrombin levels, these two contradictory effects cancelled each other out, leading to the global endogenous thrombin potential (ETP) remaining normal. Under the mediation of normal ETP, fibrin network permeability (Ks) kept the reference levels in the two groups of subjects. Fibrinogen (FBG) activity (Clauss) rose with time from 0 to 2 h and 12 h, which significantly slowed down Clot Lysis Potential as determined by an in vitro method with exogenous t-PA. Summary: the main haemostatic impairment in the present patients concerned an increased tendency in FBG activity. Since an increase in FBG is a biomarker of acute inflammation and also predicts greater fibrin production which down-regulates fibrinolysis, we suggest that during early stages after injury, patients without ATC may suffer from worsening inflammation and confront enhancement of thrombosis risk due to dysfunction of fibrinolysis.

The clinical features in Chinese patients with PRNP D178N mutation

BACKGROUND AND PURPOSE

Fatal familial insomnia (FFI) is an autosomal dominant disease due to the D178N mutation of PRNP gene coupling with homozygous methionine (Met) at codon 129. It is generally considered that D178N mutation cases with 129 M/M homozygotes present as FFI, and 129 V/V as genetic CJD. However, the frequency of 129 Met alleles in Chinese population is much higher than that in Caucasians. This study aims to investigate the clinical features and genetic characteristics of Chinese D178N mutants in this genetic context.

METHODS

We reviewed the clinical and genetic features of seven D178N patients. The clinical data, genetic data, electroencephalogram (EEG), brain magnetic resonance imaging (MRI), polysomnography (PSG), CSF 14-3-3 protein examinations of the seven patients were analyzed.

RESULTS

The genotypes at codon 129 were all M/M. Four of the seven cases reported positive family history. Four patients were more likely the CJD phenotype and three were FFI phenotype according to the core clinical features. No major differences were found on the EEG, CSF 14-3-3 protein, and PSG presentations between this study and western studies. Novel neuroimaging findings were two patients had typical neuroimaging abnormalities of CJD and frontotemporal dementia, respectively.

CONCLUSIONS

Unlike the western populations, the diverse phenotypical presentations of D178N mutants were not simply determined by the 129 genotypes in Chinese. The underlying modifying factors for phenotypical variations warrant further investigations. For those with atypical clinical and imaging features, genetic testing was important for final diagnosis.

Type 1 innate lymphoid cell aggravation of atherosclerosis is mediated through TLR4

ILC populations elaborate a similar cytokine expression pattern with helper T cell subsets Th1, Th2 and Th17. Recent studies indicate that CD25+ILC2 could alleviate atherosclerosis by altering lipid metabolism, whereas the depletion of CD90-expressing ILCs had no influence on atherosclerosis. Thus, these findings raise the question of whether ILC1 cells react on atherosclerosis. Hence, our group attempted to explore the role of ILC1 cells in atherosclerosis. We found that ILC1 cells have a high Th1-like gene expression of T-bet and IFN-γ, which is distinct from ILC2, ILC3 or conventional NK (cNK) cells. Moreover, atherosclerotic lesions were greatly reduced in ApoE-/-Rag1-/- mice treated with anti-NK1.1 mAbs for depleting ILC1 cells (ILC1+cNK cells), compared to ApoE-/-Rag1-/- mice treated with anti-IL-15R mAbs for depleting cNK cells, and these effects could be fully rescued through the adoptive transfer of ILC1 cells sorted from the spleen of ApoE-/-TLR4+/+ mice into ApoE-/-Rag1-/- mice treated with anti-NK1.1 mAbs. However, the adoptive transfer of ILC1 cells sorted from the spleen of ApoE-/-TLR4-/- mice into ApoE-/-Rag1-/- mice treated with anti-NK1.1 mAbs blocked the progression of atherosclerosis, indicating that the pro-atherosclerotic role of ILC1 cells is dependent on TLR4. Furthermore, oxLDL-induced increase in IFN-γ expression from ApoE-/- ILC1 cells was correlated with the decrease in BACH2 expression. Taken together, ILC1 cells exist in atherosclerosis and aggravate atherosclerosis via increasing pro-inflammatory cytokine expression in a TLR4/BACH2-dependent manner.

Endothelial extracellular vesicles modulate the macrophage phenotype: Potential implications in atherosclerosis

Endothelial cells (ECs) and macrophages engage in tight and specific interactions that play critical roles in cardiovascular homeostasis and the pathogenesis of atherosclerosis. Extracellular vesicles (EVs) are circular membrane fragments released from the endosomal compartment as exosomes or shed from the surfaces of the membranes of most cell types. Increasing evidence indicates that EVs play a pivotal role in cell-to-cell communication. However, the contribution of EVs, as determine by oxidized low-density lipoprotein (ox-LDL)-exposed and/or Kruppel-like factor 2 (KLF2)-transduced ECs in the interaction between vascular ECs and monocytes/macrophages, which is a key event in atherosclerotic plaque development, has remained elusive. This study demonstrates the characteristic impact of EVs from ox-LDL-treated and/or KLF2-transduced ECs on the monocyte/macrophage phenotype in vitro and in vivo.Q-PCR showed that both the atherosclerosis inducer ox-LDL and atheroprotective factor KLF2 regulated inflammation-associated microRNA-155 (miR-155) expression in human umbilical vein endothelial cells (HUVECs). Moreover, coculture, immunofluorescence and flow cytometry revealed that miR-155 was enriched in ox-LDL-induced ECs-EVs and subsequently transferred to human monocytic THP1 cells, in which these vesicles enhance monocyte activation by shifting the monocytes/macrophages balance from anti-inflammatory M2 macrophages towards proinflammatory M1 macrophages; EVs from KLF2-expressing ECs suppressed monocyte activation by enhancing immunomodulatory responses and diminishing proinflammatory responses, which indicate the potent anti-inflammatory activities of these cells. Furthermore, oil red staining showed that atherosclerotic lesions were reduced in mice that received EVs from KLF2-transduced ECs with decreased proinflammatory M1 macrophages and increased anti-inflammatory M2 macrophages, and this effect is at least partly due to the decreased expression of inflammation-associated miR-155, confirming our in vitro findings. In summary, this study provides novel insights into the pathophysiological effects of altered EV secretion and/or microRNA content and their influence on modulating monocyte activation depending on the environment surrounding EVs-releasing ECs.

Danshen (Salvia miltiorrhiza) protects ovariectomized rats fed with high-saturated fat-sucrose diet from bone loss

Dietary patterns may interfere with the efficacy of herbal intervention. Our results demonstrated the protective effects of Salvia miltiorrhiza aqueous extract (SMA) on bone metabolism were influenced by levels of dietary fat and sucrose in ovariectomized (OVX) rats through its actions on attenuating lipid deposition and oxidative stress in rats.

INTRODUCTION

Salvia miltiorrhiza (SM), also known as Danshen, has been tested as an osteoporosis treatment in a series of small, short human trials that generally report improvements in bone property. However, dietary patterns may interfere with the effects of herbal intervention. We hypothesized that dietary fat and sucrose levels could influence the effects of SM supplementation on bone in estrogen-deficient animals.

METHODS

Six-month-old Sprague-Dawley sham or OVX rats were fed either a low-saturated fat-sucrose (LFS, a diet that was similar in composition to normal rat chow) or a high-fat-sucrose (HFS) diet and OVX rats were treated (8 rats/group) with SM aqueous extract (SMA, 600 mg/kg/day), 17β-estradiol (1 mg/kg/day), or vehicle for 12 weeks.

RESULTS

SMA significantly improved bone properties as revealed by the increase in trabecular bone mineral density and decrease in trabecular separation at proximal metaphysis of the tibia (PT) in HFS-fed OVX rats, but not in LFS-fed OVX rats. SMA greatly reduced lipid deposition and malondialdehyde levels, improved the activities of superoxide dismutase, catalase, and glutathione peroxidase in the livers of HFS-fed OVX rats. SMA could directly improve the proliferation and differentiation in vitro in an H₂O₂-induced preosteoblast cell model by attenuating cellular reactive oxygen species levels.

CONCLUSIONS

The protective effects of SMA on bone metabolism were influenced by dietary fat and sucrose levels in OVX rats. The ability of SMA to reduce bone loss in HFS-fed OVX rats was associated with the attenuation of lipid deposition and oxidative stress levels.