Effect of the PA-MSHA vaccine on septic serum-induced inflammatory response

Regulatory effect of Pseudomonas aeruginosa mannose-sensitive hemagglutinin on inflammation and immune function in percutaneous nephrolithotomy patients with upper urinary tract calculi complicated with infection

Objective

To study the effect of an injection of Pseudomonas aeruginosa mannose-sensitive hemagglutinin (PA-MSHA) on inflammation and immune function in patients with upper urinary tract calculi complicated by infection who have undergone percutaneous nephrolithotomy.

Methods

We retrospectively recorded the clinical data of patients with upper urinary tract calculi complicated by infection who have undergone Percutaneous nephrolithotomy(PCNL) in the Department of Urology, 2nd Affiliation Hospital of Kunming Medical University, from March to December 2021. Clinical data include general condition, laboratory index, CT, postoperative body temperature, heart rate, respiration, SIRS, sepsis, etc. Patients were divided into treated and control groups according to whether they had received a preoperative PA-MSHA injection. The two groups were compared for indices of inflammation and complications of infection after PCNL. Pre- and post-operative lymphocyte subsets and immunoglobulin changes were compared.

Results

115 patients were included in the study, including 43 in the treatment group and 72 in the control group. After Propensity Score Matching, 90 patients were divided into treatment (n=35) and control (n=55) groups. The postoperative inflammation index was higher in the treatment group than in the control group (P<0.05). The incidence of postoperative SIRS was higher in the treatment group than control (P<0.05). There were no cases of sepsis in either group. The double-positive T cells lymphocyte subsets were higher in the treatment group than in the control group ((P<0.05). Pre- and post-operative changes in immune function: total T lymphocyte count reduced, NK and NKT cell count increased in the control group, double-positive T cell count increased in the treatment group, IgG, IgA, IgM, complement C3 and C4 count reduced in both groups post-operatively.

Conclusion

This study found that patients with upper urinary tract calculi and infection treated with antibiotic-based PA-MSHA before percutaneous nephrolithotomy had an increased inflammatory response after surgery, which may play a role in the prevention and treatment of sepsis. The percentage of double-positive T cells in the peripheral blood was increased after PA-MSHA treatment, which may have an immunomodulatory and protective effect in PCNL patients with stones complicated by infection.

Pseudomonas aeruginosa injection decreases drainage in lateral neck dissection for metastatic thyroid cancer

Background

Pseudomonas aeruginosa injection (PAI) has been proven effective against chylous fistula but not in decreasing drainage after lateral neck dissection (LND). To verify the safety of spraying PAI onto the surface of the traumatic cavity after total thyroidectomy with LND and to evaluate whether its application can reduce the drainage volume.

Methods

A total of 85 patients with metastatic papillary thyroid cancer (PTC) who agreed to total thyroidectomy with unilateral LND were recruited from March 2016 to September 2017. During the operation, PAI was applied in 44 patients, while 41 remaining patients served as the control group. The thyroid function and parathyroid function, drainage volume, hospital stay, and incidence of complications were compared between the two groups.

Results

The groups had few differences in age, gender, BMI, thyroid function, parathyroid function, diameter of tumor, and the number of the harvested lymph nodes. The median total drainage volume was significantly smaller and the mean hospital stay was obviously shorter in the PAI group compared to the non-PAI group. But the median volumes of peak 24-hour drainage which appeared during the first day after operation had few differences in the two groups. Postoperative fever in the PAI group was higher than in the non-PAI group. None of the patients had permanent recurrent laryngeal nerve paralysis and tumor recurrence on the 12^th month after operation.

Conclusions

The application of PAI to the wound cavity after LND is safe and effective for reducing the drainage volume and hospital stay.

Effect of PA-MSAH preprocessing on the expression of TLR-4-NF-κB pathway and inflammatory factors in the intestinal tract of rats with septic shock

Effects of Pseudomona blank s aeruginosa-mannose sensitive hemagglutini (PA-MSHA) preprocessing on toll like receptor (TLR)-4-NF-κB pathway and inflammatory factors expression in the intestinal tract of rats with septic shock were investigated. A total of 30 rats were randomly divided into 3 groups (n=10): Blank control, septic shock, and PA-septic shock group. After the model was successfully established, the average arterial pressure in rats was monitored. The concentration of cytokine interleukin-l (IL-1), IL-6 and tumor necrosis factor-α (TNF-α) were determined by ELISA method. Flow cytometry was performed to detect TLR-4 expression. Number of in vitro chemotaxised neutrophils was detected by Transwell chamber. The expression of TLR-4, NF-κB and ICAM-1 and VCAM-1 was detected by western blot analysis. The concentration of cytokine IL-1, IL-6, TNF-α in the peritoneal lavage fluid and the intestinal tissue significantly increased in the septic shock group and the PA-septic shock group (P<0.05), and the concentration in the PA-septic shock group was significantly lower than that of the septic shock group (P<0.05). Compared to the control group, the expression of TLR-4, NF-κB and ICAM-1 and VCAM-1 increased in the septic shock and PA-septic shock group (P<0.05), and the expression level of PA-septic shock group was lower than the septic shock group (P<0.05). The expression of TLR-4 in the PA-septic shock group was lower than the septic shock group (P<0.05). PA-MSHA pretreatment reduced inflammation, thus preventing the intestinal injury caused by septic shock.

The Effective Regulation of Pro- and Anti-inflammatory Cytokines Induced by Combination of PA-MSHA and BPIFB1 in Initiation of Innate Immune Responses

PA-MSHA and BPIFB1 play especially important roles in triggering innate immune responses by inducing production of pro- or anti-inflammatory cytokines in the oral cavity and upper airway. We found that PA-MSHA had a strong ability to activate pro-inflammatory cytokines such as IL-1β, IL-6 and TNF-α. However, BPIFB1 alone did not express a directly inductive effect. With incubation of PA-MSHA and BPIFB1, the combination can activate the CD14/TLR4/MyD88 complex and induce secretion of subsequent downstream cytokines. We used a proteome profiler antibody array to evaluate the phosphokinases status with PA-MSHA and BPIFB1 treatment. The results showed that the activation of MAPK, STAT, and PI-3K pathways is involved in PA-MSHA-BPIFB1 treatment, and that the related pathways control the secretion of targeting cytokines in the downstream. When we assessed the content changes of cytokines, we found that PA-MSHA-BPIFB1 treatment increased the production of pro-inflammatory cytokines in the early phase of treatment and induced the increase of IL-4 in the late phase. Our observations suggest that PA-MSHA-BPIFB1 stimulates the release of pro-inflammatory cytokines, and thereby initiates the innate immune system against inflammation. Meanwhile, the gradual release of anti-inflammatory cytokine IL-4 by PA-MSHA-BPIFB1 can also regulate the degree of inflammatory response; thus the host can effectively resist the environmental risks, but also manipulate inflammatory response in an appropriate and adjustable manner.