Multi-omics study reveals different pathogenesis of the generation of skin lesions in SLE and IDLE patients

Lupus erythematosus (LE) is a heterogeneous, antibody-mediated autoimmune disease. Isolate discoid LE (IDLE) and systematic LE (SLE) are traditionally regarded as the two ends of the spectrum, ranging from skin-limited damage to life-threatening multi-organ involvement. Both belong to LE, but IDLE and SLE differ in appearance of skin lesions, autoantibody panels, pathological changes, treatments, and immunopathogenesis. Is discoid lupus truly a form of LE or is it a completely separate entity? This question has not been fully elucidated. We compared the clinical data of IDLE and SLE from our center, applied multi-omics technology, such as immune repertoire sequencing, high-resolution HLA alleles sequencing and multi-spectrum pathological system to explore cellular and molecular phenotypes in skin and peripheral blood from LE patients. Based on the data from 136 LE patients from 8 hospitals in China, we observed higher damage scores and fewer LE specific autoantibodies in IDLE than SLE patients, more uCDR3 sharing between PBMCs and skin lesion from SLE than IDLE patients, elevated diversity of V-J recombination in IDLE skin lesion and SLE PBMCs, increased SHM frequency and class switch ratio in IDLE skin lesion, decreased SHM frequency but increased class switch ratio in SLE PBMCs, HLA-DRB1*03:01:01:01, HLA-B*58:01:01:01, HLA-C*03:02:02:01, and HLA-DQB1*02:01:01:01 positively associated with SLE patients, and expanded Tfh-like cells with ectopic germinal center structures in IDLE skin lesions. These findings suggest a significant difference in the immunopathogenesis of skin lesions between SLE and IDLE patients. SLE is a B cell-predominate systemic immune disorder, while IDLE appears limited to the skin. Our findings provide novel insights into the pathogenesis of IDLE and other types of LE, which may direct more accurate diagnosis and novel therapeutic strategies.

Human-multimodal deep learning collaboration in 'precise' diagnosis of lupus erythematosus subtypes and similar skin diseases

BACKGROUND

Lupus erythematosus (LE) is a spectrum of autoimmune diseases. Due to the complexity of cutaneous LE (CLE), clinical skin image-based artificial intelligence is still experiencing difficulties in distinguishing subtypes of LE.

OBJECTIVES

We aim to develop a multimodal deep learning system (MMDLS) for human-AI collaboration in diagnosis of LE subtypes.

METHODS

This is a multi-centre study based on 25 institutions across China to assist in diagnosis of LE subtypes, other eight similar skin diseases and healthy subjects. In total, 446 cases with 800 clinical skin images, 3786 multicolor-immunohistochemistry (multi-IHC) images and clinical data were collected, and EfficientNet-B3 and ResNet-18 were utilized in this study.

RESULTS

In the multi-classification task, the overall performance of MMDLS on 13 skin conditions is much higher than single or dual modals (Sen = 0.8288, Spe = 0.9852, Pre = 0.8518, AUC = 0.9844). Further, the MMDLS-based diagnostic-support help improves the accuracy of dermatologists from 66.88% ± 6.94% to 81.25% ± 4.23% (p = 0.0004).

CONCLUSIONS

These results highlight the benefit of human-MMDLS collaborated framework in telemedicine by assisting dermatologists and rheumatologists in the differential diagnosis of LE subtypes and similar skin diseases.

Development of terpenoid repellents against Aedes albopictus: a combined study of biological activity evaluation and computational modelling

To explore novel terpenoid repellents, 22 candidate terpenoid derivatives were synthesized and tested for their electroantennogram (EAG) responses and repellent activities against Aedes albopictus. The results from the EAG experiments revealed that 5-(2-hydroxypropan-2-yl)-2-methylcyclohex-2-en-1-yl formate (compound 1) induced distinct EAG responses in female Aedes albopictus. At concentrations of 0.1, 1, 10, 100, and 1000 mg/L, the EAG response values for compound 1 were 179.59, 183.99, 190.38, 193.80, and 196.66 mV, demonstrating comparable or superior effectiveness to DEET. Repellent activity analysis indicated significant repellent activity for compound 1, closest to the positive control DEET. The in silico assessment of the ADMET profile of compound 1 indicates that it successfully passed the ADMET evaluation. Molecular docking studies exhibited favourable binding of compound 1 to the active site of the odorant binding protein (OBP) of Aedes albopictus, involving hydrophobic forces and hydrogen bond interactions with residues in the OBP pocket. The QSAR model highlighted the influential role of hydrogen-bonding receptors, positively charged surface area of weighted atoms, polarity parameters of molecules, and maximum nuclear-nuclear repulsion force of carbon-carbon bonds on the relative EAG response values of the tested compounds. This study holds substantial significance for the advancement of new terpenoid repellents.

Erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum in a patient with myasthenia gravis: first case report and literature review

BACKGROUND

Dermatophytes are the most common causative pathogens of mycoses worldwide and usually cause superficial infections. However, they can enter deep into the dermis lead to invasive dermatophytosis such as deeper dermal dermatophytosis on rare occasions. Erythroderma is a severe dermatological manifestation of various diseases resulting in generalized skin redness, but erythroderma due to fungi infections is barely reported. In this article, we reported the first case of erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum (T. rubrum) in a patient with myasthenia gravis.

CASE PRESENTATION

A 48-year-old man was hospitalized because of erythema with scaling and nodules covering his body for a month. The patient had a history of myasthenia gravis controlled by regularly taking prednisolone for > 10 years and accompanied by onychomycosis and tinea pedis lasting > 8 years. Based on histopathological examinations, fungal cultures, and DNA sequencing results, the patient was finally diagnosed with dermatophyte-induced erythroderma combined with deeper dermal dermatophytosis caused by T. rubrum. After 2 weeks of antifungal treatment, the patient had recovered well.

CONCLUSIONS

This case report shows that immunosuppressed patients with long histories of superficial mycoses tend to have a higher risk of developing invasive dermatophytic infections or disseminated fungal infections. Dermatologists should be alert to this condition and promptly treat the superficial dermatophytosis.

Experimental evaluation and structure-activity relationship analysis of bridged-ring terpenoid derivatives as novel Blattella germanica repellent

Cockroaches are urban pests that are very difficult to control. Using repellents is a green, safe and effective strategy for their control. In order to find novel cockroach repellents, the repellent activity of 45 bridged-ring terpenoid derivatives synthesized from β-pinene against Blattella germanica was tested. The relationship between the molecular structure of these bridged-ring terpenoid derivatives and their repellent activity against Blattella germanica was also analysed. The results show that some of the bridged-ring terpenoid derivatives exhibit good repellent activity against Blattella germanica, and six compounds (RR = 60.44-87.32%) show higher repellent activity against Blattella germanica than DEET (RR = 54.77%), making them promising for development as new cockroach repellents. Quantitative structure-activity relationship (QSAR) analysis revealed that the HOMO-1 energy, Kier and Hall index (order 2), Balaban index, and relative positive charged surface area of bridged-ring terpenoid derivatives have effects on repellent activity against Blattella germanica. The present study may provide a theoretical basis for the high-value use of β-pinene and can be helpful to the development of novel repellents against Blattella germanica.

Effects of probiotic and Bidens pilosa on the performance and gut health of chicken during induced Eimeria tenella infection

AIM

In this study, we have examined the individual and combined protective mechanism of probiotic and Bidens pilosa on the performance and gut health of chickens during Eimeria tenella infection over a 29-day experimental trial.

METHODS AND RESULTS

A total of one hundred and fifty 1-day-old chickens were equally distributed into five treatment groups with three biological replicates: two groups were allocated as control groups (control group untreated unchallenged, CG and control positive untreated challenged, CPG) and three groups were fed diets with probiotic (PG), B. pilosa (BPG) and probiotic + B. pilosa (PG + BPG) and challenged with E. tenella. Birds of all groups were assessed for pre and post-infection body weights, oocysts shedding, caecal lesion scores and mRNA expression levels of apoptosis related proteins (Bcl-2, Bax and caspase-3), antioxidant enzymes (CAT and SOD 1), pro-inflammatory cytokines (IL-6 and IL-8) and tight junction proteins (CLDN 1 and ZO 1). Our results revealed that during infection (day 21-29), E. tenella challenged chickens significantly decreased the body weight compared with uninfected control chickens; however, there was no significant effect on body weight of chickens fed with probiotic, B. pilosa and probiotic + B. pilosa was observed. Eimeria tenella challenged untreated birds increased (P < 0·05) oocysts shedding, destructive ratio of caeca and mortality as compared to treated challenged birds. CPG group up-regulated the mRNA expression levels of anti-apoptosis protein Bcl-2 while down-regulated the pro-apoptosis protein Bax relative to PG, BPG and PG + BPG groups. Moreover chickens fed probiotic, B. pilosa and probiotic + B. pilosa diets enhanced the activities of antioxidant enzymes, pro-inflammatory cytokines and tight junction proteins with the comparison of control positive untreated challenged chickens.

CONCLUSION

These findings elaborated that feed supplementation of probiotic and B. pilosa (individually or in combination) appeared to be effective in inhibiting the occurrence of disease and decreasing the severity of Eimeria infection in chickens.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study explained the underlying anti-coccidial mechanism in which probiotic and B. pilosa (individually and/or in combination) improve the performance of chicken and protect against gut inflammatory responses caused by E. tenella.

Brain-specific monoallelic expression of bovine UBE3A is associated with genomic position

Genomic imprinting is a rare epigenetic process in mammalian cells that leads to monoallelic expression of a gene with a parent-specific pattern. The UBE3A (ubiquitin protein ligase E3A) gene is imprinted with maternal allelic expression in the brain but biallelically expressed in all other tissues in humans. The silencing of the paternal UBE3A allele is thought to be caused by the paternally expressed antisense RNA transcript of UBE3A-ATS. The aberrant imprinted expression of the UBE3A is associated with several neurodevelopmental syndromes and psychological disorders. Cattle are a valuable model species in determining the genetic etiology of sporadic human disorder, and maternal expression of UEB3A has been revealed by next-generation sequencing study in the bovine conceptus. In this study, we investigated the allelic expression of UBE3A and UBE3A-ATS in adult bovine somatic tissues. To confirm the splicing pattern of bovine UBE3A, five 5' alternative transcripts (MT210534-MT210538) were first obtained from bovine brain tissue by RT-PCR. Based on 10 SNP genotypes, we found that the brain-specific monoallelic expression of bovine UBE3A did not occur along the entire locus, and there was a shift from biallelic expression to monoallelic expression in exon 14 of the UBE3A gene. However, the brain-specific monoallelic expression of bovine UBE3A-ATS occurred in the entire gene. These observations demonstrated that the monoallelic expression did not occur along the bovine UBE3A entire locus and was associated with the genomic position.

Comparing Diagnostic Properties of the FRAIL-NH Scale and 4 Frailty Screening Instruments among Chinese Institutionalized Older Adults

OBJECTIVE

To examine the diagnostic test accuracy (DTA) of the FRAIL-NH and four frailty screening instruments among institutionalized older adults.

DESIGN

Cross-sectional study.

SETTING

Institutionalized setting, Jinan, China.

PARTICIPANTS

A total of 305 older adults (mean age 79.3 ± 8.4 years, 57.0% female) were enrolled from nursing homes.

MEASUREMENTS

Frailty was assessed by the FRAIL-NH, Physical Frailty Phenotype (PFP), FRAIL, Tilburg Frailty Indicator (TFI), and Groningen Frailty Indicator (GFI), respectively. The Comprehensive Geriatric Assessment (CGA) was used as a reference standard of frailty. The receiver operating characteristic (ROC) curve was plotted to examine the DTA of five frailty screening instruments against the CGA. The optimal cut-point was determined by the maximum value of the Youden index (YI, calculated as sensitivity + specificity - 1).

RESULTS

The prevalence of frailty ranged from 25.9% (FRAIL) to 56.4% (GFI). Areas under the curve (AUCs) against the CGA ranged from 0.80 [95% confidence interval (CI) 0.74 - 0.85: FRAIL] to 0.83 (95% CI 0.78 - 0.88: PFP). At their original cut-points, all five frailty screening instruments presented low sensitivity (32.9% - 69.3%) and high specificity (80.0% - 93.8%), as well as high positive predictive values (90.7% - 94.9%) and low negative predictive values (33.2% - 48.1%). At their optimal cut-points, the sensitivity and specificity of the FRAIL-NH, PFP, and FRAIL tended to be balanced, and their correctly classified rates (76.1% - 81.3%) and kappa values (0.465 - 0.523) increased a lot. ROC contrasts showed that all five frailty screening instruments had similarly good diagnostic accuracy (χ2: 0.0003 - 1.38, P > .05).

CONCLUSION

In the institutionalized setting, the specific FRAIL-NH, self-report FRAIL, TFI, and GFI as well as hybrid PFP, show similarly good diagnostic properties in identifying frailty against the CGA.

[Study on the risk of mortality and associated factors among HIV-exposed children in Henan province, 2002-2014]

Objective: To investigate the status of survival and related risk factors among HIV-exposed children in Henan province from 2002 to 2014. Methods: A follow-up program was set up when infants as 1, 3, 6, 9, 12, 18 month olds. Data regarding the HIV-exposed children and their mothers were collected, including service of PMTCT, antiviral therapy, incidence of infectious disease and survival status of infants. Univariate and multivariate logistic regression models were used to explore the risk factors. Results: A total number of 1 705 HIV-infected infants were reported from 2002 to 2014. Among them, 1 536 infants (90.09%) were still alive when they were at one and a half years old, with another 58 (3.40%) lost to follow up and 111 (6.51%) infants were dead. The cumulative mortality rates in HIV-exposed children, newborn, and HIV-exposed infants were 67.39‰, 23.07‰, and 57.01‰, respectively. No statistical significance was found on the decreasing tendency of mortality in different years. The leading cause of death was noticed as pneumonia, with a proportion of 32.43%, followed by suspected AIDS. Early diagnosis had not been made in infants. Low-birth weight (OR=4.97, 95%CI: 3.12-7.92) seemed to be a risk factor. Early detection in pregnancy (OR= 0.46, 95%CI: 0.26-0.80) and HARRT provided to children (OR=0.25, 95%CI: 0.15-0.42) were recognized as protective factors. Conclusions: The mortality of HIV-exposed children were high, which called for the development of programs on early infant diagnosis and HARRT. Measures should be taken to prevent pneumonia and other infectious diseases, together with nutrition support and monitor program on growth.

[Effectiveness of prevention of mother to child HIV transmission in Henan province, 2002-2013]

Objective: To evaluate the effectiveness of the intervention on preventing mother to child transmission of HIV and identify the influencing factors. Methods: The data regarding the pregnant women and their infants were collected, including demographic characteristics, pregnancy and delivery, access to antiviral therapy, HIV infection status at age 18 months and survival of infants between 2002 and 2013 through follow-up, Multivariate logistic regression model were used to identify the influencing factors. Results: By the end of 2013, a total of 8 621 554 pregnant women received HIV test, among them 2 264 were infected with HIV. The positive rate of HIV is 0.03%. The HIV positive rate decreased year by year (χ(2) =4.871, P=0.027). A total of 1 530 infants were born from 2002 to 2013, among them 1 384 survived and 92 died at age of 18 months, and 54 were lost for follow up. Sixty infants were tested to be HIV-positive, 1 324 infants were tested to be HIV-negative. The mother to child transmission rate was 4.34%, the corrective mother to child transmission rate was 6.33%. Receiving HIV prevention service in early pregnancy (OR=0.26, 95% CI: 0.09-0.77), standardized antiviral therapy (OR=0.42, 95% CI: 0.21-0.82), artificial feeding (OR=0.06, 95% CI: 0.02-0.21) might be the main protective factors, episiotomy on delivery (OR=3.91, 95% CI: 1.74-8.80) might be the risk factors. Conclusion: The HIV tested positive rate remained to be low and decreased year by year in pregnant women in Henan, but the mother to child HIV transmission rate was high. It is necessary to improve the prevention of mother to child HIV transmission.

A full subtraction approach for finite element method based source analysis using constrained Delaunay tetrahedralisation

A mathematical dipole is widely used as a model for the primary current source in electroencephalography (EEG) source analysis. In the governing Poisson-type differential equation, the dipole leads to a singularity on the right-hand side, which has to be treated specifically. In this paper, we will present a full subtraction approach where the total potential is divided into a singularity and a correction potential. The singularity potential is due to a dipole in an infinite region of homogeneous conductivity. The correction potential is computed using the finite element (FE) method. Special care is taken in order to evaluate the right-hand side integral appropriately with the objective of achieving highest possible convergence order for linear basis functions. Our new approach allows the construction of transfer matrices for fast computation of the inverse problem for anisotropic volume conductors. A constrained Delaunay tetrahedralisation (CDT) approach is used for the generation of high-quality FE meshes. We validate the new approach in a four-layer sphere model with a highly conductive cerebrospinal fluid (CSF) and an anisotropic skull compartment. For radial and tangential sources with eccentricities up to 1 mm below the CSF compartment, we achieve a maximal relative error of 0.71% in a CDT-FE model with 360 k nodes which is not locally refined around the source singularity and therefore useful for arbitrary dipole locations. The combination of the full subtraction approach with the high quality CDT meshes leads to accuracies that, to the best of the author's knowledge, have not yet been presented before.

Dent’s disease: identification of a novel mutation in the renal chloride channel CLCN5

Dent's disease is an inherited tubulopathy caused by a mutation in the CLCN5 chloride channel gene. It is characterized by low-molecular weight proteinuria, hypercalciuria, nephrolithiasis or nephrocalcinosis, rickets and eventual-progressive renal failure. Onset of clinical symptoms show a great variability, making a diagnosis at an early stage of the disease often difficult. Given the variably clinical picture, genetic analysis can provide a reliable method to confirm the diagnosis. Here, we report on the case of a patient with progressive renal failure showing signs of a tubular lesion and symptoms of Dent's disease. Although this rare disease was suspected by means of the clinical features, it was genetic analysis that confirmed the diagnosis and revealed a novel mutation in the CLCN5 gene.

[Study on the physicochemical properties of Campylobacter jejuni enterotoxin]

Precipitate of Campylobacter jejuni cytotonic enterotoxin(CE) performed in an 80% saturated solution of ammonium sulfateit indicated that there were some little molecular proteins except the 68 kD main band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE), whereas the eluate from GM1 ganglioside affinity column chromatography exhibited only one 68 kD band on SDS-PAGE. The results suggest that CE mainly be consisted of 68 kD protein. The toxin is heat-labile, pH dependent and resistant to trypsin, It could be completely inactivated by heating at either 56 degrees C and 60 degrees C for 30 min or 100 degrees C for 15 min. The activity was maximum at pH 6.0 and was completely inactivate at pH 3.0 and pH 9.0, and rapidly reduced after storage over 3 d at 4 degrees C. The anti-LT serum could completely inhibited the activity of CE.

B7-1 antigen expression in tumor cells from cancerous human tissues

OBJECTIVE

To explore the expression of B7-1 antigen (Ag), the most important costimulatory molecule for T-lymphocyte activation, on tumor cells from cancerous human tissues.

STUDY DESIGN

The study group consisted of 82 biopsies taken from a variety of cancerous human tissues. Ten normal cervical specimens, used as controls, were taken from uteri removed for leiomyomas or leiomyomatosis. B7-1 molecule expression was identified using monoclonal antibody (Ab) with CD80 and the SABC technique.

RESULTS

In most cases (50/82), the tumor cells were totally or partially B7-1 Ag positive. The positive products were distributed mainly on the cell surface and, in some cases, also in the cytoplasm. Although in transitional cell carcinoma of the bladder, all tumor cells in all three cases stained strongly with CD80, in squamous cell carcinoma and adnocarcinoma, the B7-1 expression in cancer cells was detected in 3/56 and 15/23 cases, respectively. The intensity and distribution of B7-1 expression from case to case were heterogeneous: half the cases had relatively homogeneous and stronger B7-1 expression in cancer cells. Additionally, there were B7-1+ dendritic cells and lymphocytes scattered or densely infiltrating interstitial tissue. In some cases, the endothelia of small vessels were proved to be B7-1+. There was one esophageal cancer specimen containing normal-looking mucosa in which B7-1 molecule expression was also demonstrated in the squamous and glandular epithelia.

CONCLUSION

Our findings demonstrate that the tumor cells in cancerous human tissues do not all fail to express B7-1. The mechanism of the failure of hosts to reject tumors can be attributed not only to the lack of costimulatory molecules in tumor cells but also to events after the Ag-presenting process.

[Types of flowering branch of Magnolia denudata Desr. under high yield conditions]

The types of flowering branch of Magnolia denudata under high yield conditions were investigated. The action of axillary flowering branches on yield increase and the cultural techniques of promoting axillary flowering branch formation were evaluated. Under the same culturing conditions M. denudata var. dilutipurpurascens has hardly any axillary flowering branches.

[Differentiation of Magnolia denudata Desr. flower buds]

The article gives the results of an observation on the differentiation of Magnolia denudata buds. In Huaining County, Anhui Province, differentiation of the buds starts at the beginning of May. By the end of June the differentiation of various parts of the flower is completed. The process takes about 50 days. The differentiation of buds goes on at a fairly fast speed and in a fairly uniform way. Based on the results of the observation, the authors advise that application of fertilizer, especially the top application should not be late. The beginning of March is a very important time for the development of buds in length and size, and for the final harvest as well. The proper time to pick the flower buds comes when they are fully developed before the perianth appears.