Lysine acetyltransferase 6A maintains CD4+ T cell response via epigenetic reprogramming of glucose metabolism in autoimmunity

Augmented CD4+ T cell response in autoimmunity is characterized by extensive metabolic reprogramming. However, the epigenetic molecule that drives the metabolic adaptation of CD4+ T cells remains largely unknown. Here, we show that lysine acetyltransferase 6A (KAT6A), an epigenetic modulator that is clinically associated with autoimmunity, orchestrates the metabolic reprogramming of glucose in CD4+ T cells. KAT6A is required for the proliferation and differentiation of proinflammatory CD4+ T cell subsets in vitro, and mice with KAT6A-deficient CD4+ T cells are less susceptible to experimental autoimmune encephalomyelitis and colitis. Mechanistically, KAT6A orchestrates the abundance of histone acetylation at the chromatin where several glycolytic genes are located, thus affecting glucose metabolic reprogramming and subsequent CD4+ T cell responses. Treatment with KAT6A small-molecule inhibitors in mouse models shows high therapeutic value for targeting KAT6A in autoimmunity. Our study provides novel insights into the epigenetic programming of immunometabolism and suggests potential therapeutic targets for patients with autoimmunity.

[The effect of Shendan Sanjie capsule on angiogenesis in mice with colitis associated cancer and mechanism]

Objective: To investigate the effects and the mechanism of Shendansanjie capsules on angiogenesis of colitis associated cancer(CAC) mice. Methods: Azoxymethane and dextran sulfact sodium were used to construct a mice model with CAC. Ten mice were divided into the normal group, model group, Shendan Sanjie capsule group, MK-2206 group, and Shendan Sanjie capsule + IGF-1 group, respectively. Immunohistochemistry was used to detect the microvessel density (MVD) in the colon tissue of each group of mice. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the mRNA levels of basic fibroblast growth factor (bFGF) and angiopoietin 2 (Ang2) in colon tissue. Western blot was used to detect the expressions of Akt, p-Akt, vascular endothelial growth factor A (VEGFA), hypoxia-inducible factor-1α (HIF-1α). Results: The number of MVD in the colon tissue of mice in the model group, Shendan Sanjie capsule group, MK-2206 group, Shendan Sanjie capsule + IGF-1 group were 63.3±3.3, 36.6±2.3, 36.6±2.2, 50.3±2.5, significantly higher than 2.0±0.1 in the normal group (P<0.05). The number of MVD in Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group are lower than that in model group (P<0.05), while Shendan Sanjie capsule+ IGF-1 group is higher than Shendan Sanjie Capsule group (P<0.05). The relative expressions of bFGF mRNA in the colon cancer tissue of mice in the model group, Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group were 4.55±0.31, 2.46±0.37, 2.49±0.33, 3.34±0.21, respectively, and the relative mRNA expressions of Ang2 were 5.78±0.19, 2.21±0.14, 2.26±0.17 and 3.67±0.32, respectively, which were significantly higher than 1.01±0.05 and 0.99±0.07 in the normal group (P<0.05). The mRNA levels of bFGF and Ang2 in Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group were lower than those in the model group (P<0.05), while Shendan Sanjie capsule+ IGF-1 group is higher than Shendan Sanjie capsule group (P<0.05). The relative expression levels of p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissues of the model group were 4.75±0.18, 4.64±0.22 and 4.84±0.12, respectively, which were significantly higher than 1.01±0.07, 0.95± 0.08 and 0.98±0.05 in the normal group (P<0.05). The relative expressions of p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissues in the Shendan Sanjie capsule group were 2.24±0.22, 3.15±0.26 and 2.07±0.18, respectively, which were significantly lower than those in the model group (P<0.05). However, compared with the MK-2206 group, the difference was not statistically significant (P>0.05). The relative expression levels p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissue of the Shendan Sanjie capsule+ IGF-1 group were 3.37±0.15, 4.02±0.11, 3.52±0.24, respectively, which were significantly higher than those in the Shendan Sanjie capsule group (P<0.05). Conclusion: Shendan Sanjie capsules may inhibit Akt/HIF-1α/VEGFA signaling pathway, and then reduce the expression of microvascular growth factors bFGF and Ang2, thereby inhibit the tumor angiogenesis of CAC.

[Endoscopic reconstruction of the posterior nares for the treatment of 46 children with congenital posterior atresia]

Objective:The aim of this study is to explore the influencing factors of the posterior nostril re-atresia by analyzing the clinical data of endoscopic posterior nostril reconstruction in the children with posterior nostril atresia. Method:Retrospectively reviewed 46 pediatric patients with congenital choanal atresia who underwent endoscopic posterior nostril reconstruction. Randomly divided the cases into the atresia group（19 cases） and the non-atresia group（27 cases） according to whether the new posterior nostril re-atresia again. Compared the difference of the clinical data between the two groups and observed the influencing factors of the posterior nostril re-atresia. Result:The gender, age, unilateral/bilateral atresia or U-shaped stent had no significant differences between the two groups. However, the nature of the atresia and granulation hyperplasia were significant differences between the two groups. Further analysis of the nature of the atresia revealed osseous atresia had higher rate of re-atresia than membranous atresia. Conclusion:Endoscopic posterior nostril reconstruction was a good method for the treatment of the children with congenital posterior nostril atresia. However, the children with osseous atresia had higher re-atresia rate.

[The efficacy of sublingual specific immunotherapy in children with allergic rhinitis]

Objective:To investigate the efficacy of single-allergen sublingual immunotherapy (SLIT) in children with allergic rhinitis and the potential relationship between sensitization status and efficacy and analyze the possible relationships between sensitized state and clinical efficacy. Method:One hundred and thirty children, aged 4-15 years old, with mites-induced respiratory allergic diseases had been arranged into the treatment group (n=70) or control group (n=50) and received SLIT with standardized dermatophagoides farinae extracts and pharmacotherapy for 1 year. Rhinitis and asthma symptoms and medications, visual analogue scale (VAS), skin prick test (SPT) and peak expiratory flows (PEF) were evaluated. After treatment, patients in the poly-sensitized group who completed the study had been analyzed as subgroup 1 (n=33) and subgroup 2 (n=37) according to the number of coexist allergens. Result:The global clinical parameters had been significantly improved after treatment. The treatment and control group rhinitis symptom score, symptomatic medication score and VAS scores were significantly reduced after 52 weeks treatment (all P<0.05). SLIT group dust mite grade skin reactions decreased after 52 weeks treatment (P<0.05). Dust mite skin reactions grade was greater than before treatment in the control group (P>0.05). Between the two groups, SLIT group rhinitis symptom score at 24 weeks, 36 weeks, 52 weeks were lower than the control group, the difference was statistically significant (P<0.05). SLIT group symptomatic medication score and VAS scores at 36 weeks and 52 weeks compared with the control group, the difference was statistically significant (P<0.05). Dust mite SLIT group grade skin reactions grade was lower than the control group at 52 weeks, the difference was statistically significant (P<0.05). In addition to the 36 weeks poly-sensitized group symptoms of allergic rhinitis score was lower than mono-sensitized group (P＜0.05) and at 24 weeks poly-sensitized group VAS score was lower than single allergy group (P<0.05), the comparison between subgroup 1 and subgroup 2 indicated that, there was no significant difference in symptoms scores, SPT, PEF and VAS at each scheduled follow-up visit. Conclusion:This study shows that SLIT can significantly reduce rhinitis symptoms and drug use, and improve the children with allergies. An equivalent efficacy of single-allergen SLIT is found in poly-sensitized and mono-sensitized children. The number of coexist positive allergens has a limited impact on the efficacy from a long-term perspective.

[Intratympanic methylprednisolone perfusion remedy refractory sudden sensorineural hearing loss]

Objective:To observe the clinical efficacy and characteristics of intratympanic methylprednisolone perfusion (IMP) as a salvage treatment in sudden sensorineural hearing loss（SSNHL） patients who failed in conventional treatments.Method:One hundred and ten SSNHL patients who failed to respond to conventional therapies were recruited. And a 10-day IMP was adopted as a salvage treatment to improve their hearing. Twenty five SSNHL patients who failed to respond to conventional therapies and without any other treatment were recruited as control group. The pure tone average(PTA) before and after IMP treatment was observed by pure tone audiometry. Data analysis was performed using SPSS13.0 and test level was set α=0.05. Result:The total effective rate of IMP was 49.09%, significantly higher than control group 16.00%. Significant hearing improvement was observed at all frequencies after IMP treatment. Especially PTA gain at the low frequencies was (13.45±18.10) dB, obviously higher than high frequency. An obvious improvement of PTA were detected in profound group(15.62±13.95)dB compared with in moderate group(7.97±14.90) dB and in severe group［PTA gain(5.59±13.88) dB］. However, there was no significant difference between the two latter groups. PTA gain was(12.26±14.69) dB,(13.37±17.11) dB and (3.21±10.51) dB respectively in patients who suffer from SSNHL within 2 weeks, >2-4 weeks and over 4 weeks. Whether accompanied with vertigo or tinnitus had no significant influence on the efficacy of IMP treatment in SSNHL patients who failed investigated. Conclusion:IMP treatment could improve the hearing in SSNHL patients who failed to respond to conventional therapies. The gain was closely related to the onset time and the severity of hearing loss before IMP treatment.

[Experience in children airway foreign bodies: an analysis of 220 cases]

Objective:To observe the clinical characteristics, pathogen infection and the diagnostic reliability of CT multiplanar reconstruction(CT MPR) in the children with airway foreign bodies.Method:We retrospectively reviewed 220 pediatric patients suspected with respiratory foreign bodies who were simultaneously examined by CT MPR, bronchoscopy and secretion culture.Then we summarized their characteristics from treatment process, age distribution, foreign body kinds, examination results of CT MPR, bronchoscopy and secretion culture. Result:Only 108 cases(49.09%) accepted bronchoscopy in 48 hours and the most risk age was 1 to 2 years old. We observed the commonest foreign bodies were peanuts, melon seeds and nuts. In addition, we found CT MPR was accurate in diagnostic airway foreign body with accuracy ratio was 94.09%. Furthermore, our secretion culture showed negative(64.09%) in 141 cases and positive(35.91%) in 79 patients. And the commonest pathogenic bacteria were staphylococcus aureus, streptococcus pneumoniae, haemophilus influenzae, pseudomonas aeruginosa,klebsiella pneumonia.Conclusion:Pediatric airway foreign bodies had its own clinical characteristics.When the medical units had no conditions to carry out bronchoscopy,CT MPR would be a good choice to rule out airway foreign body.Besides,most case only needed symptomatic treatment other than antibiotics after bronchoscopy.

The serological profiles of subgroup of primary Sjögren's syndrome correlation with the clinical features of parotid glands

OBJECTIVE

To investigate the difference of serological profile in pSS and their correlation with the clinical characteristics of parotid glands.

METHODS

This retrospective study includes 289 patients who fulfilled the 2002 American-European Consensus Group Criteria for pSS. The patients were categorized by the clinical features of parotid glands: Group 1 (massive group), Group 2 (infection group), Group 3 (swelling group) and Group 4 (others). The demographic data and serological profiles among these groups were compared. Statistical analyses of the results between groups were performed using the Student t test, Fisher's exact test, chi-square and analysis of variance.

RESULTS

There was a difference of serological profile in the different clinical characteristics of parotid glands of pSS. Serum Ig G value of Group 1 was the greatest, and complement C4 was lowest in the four groups. Serum Ig E value of Group 2 was the greatest and ESR of Group 3 was the greatest in the four groups.

CONCLUSION

This study has determined the differences of serological profile in the different clinical features of parotid glands of pSS patients, which may help advance our understanding of the disease and improve patient management.