Regulatory mechanisms underlying interleukin-6 expression in murine brown adipocytes

Three types of adipocytes, white, brown, and beige, regulate the systemic energy balance through the storage and expenditure of chemical energy. In addition, adipocytes produce various bioactive molecules known as adipokines. In contrast to white adipocyte-derived molecules, less information is available on the adipokines produced by brown adipocytes (batokine). This study explored the regulatory expression of interleukin (IL)-6 in cell culture studies. Norepinephrine or a nonselective β-adrenergic receptor agonist increased the expression of IL-6 in primary brown adipocytes and HB2 brown adipocytes. Treatment with forskolin (Fsk), an activator of the cAMP-dependent protein kinase (PKA) pathway (downstream signaling of the β-adrenergic receptor), efficiently stimulated IL-6 expression in brown adipocytes and myotubes. Phosphorylated CREB and phosphorylated p38 MAP kinase levels were increased in Fsk-treated brown adipocytes within 5 min. In contrast, a long-term (∼60 min and ∼4 h) treatment with Fsk was required for increase in STAT3 phosphorylation and C/EBPβ expression, respectively. The PKA, p38 MAP kinase, STAT3, and C/EBPβ pathways are required for the maximal IL-6 expression induced by Fsk, which were verified by use of various inhibitors of these signal pathways. Vitamin C enhanced Fsk-induced IL-6 expression through the extracellular signal-regulated kinase activity. The present study provides basic information on the regulatory expression of IL-6 in activated brown adipocytes.

Changes in metabolite content in the kidneys and skeletal muscles of rats fed magnesium-restricted diets

A metabolomic study was performed on the kidneys and skeletal muscles of rats fed diets containing varying contents of Mg for 4 weeks. The kidneys are divided into two parts, the aerobic cortex and the anaerobic medulla, that differ in metabolism. The relative contents of 3-phosphoglyceric acid, 2-phosphoglyceric acid, and phosphoenolpyruvic acid increased with Mg restriction in both renal regions. In contrast, pyruvic acid content decreased with Mg restriction in the diets, suggesting an inhibitory conversion of phosphoenolpyruvic acid to pyruvic acid. The lactic acid content increased in both regions of the kidneys of Mg-restricted rats, implying changes towards a more glycolytic metabolism, possibly resulting from the impairment of mitochondrial function. There are two types of muscle fibers: glycolytic fast and oxidative slow muscle fibers. The soleus muscle consists of slow muscle fibers, whereas the gastrocnemius muscle consists of a combination of fast and slow muscle fibers. Similar to the changes in the kidneys, the contents of 3-phosphoglyceric acid, 2-phosphoglyceric acid, phosphoenolpyruvic acid, and lactic acid increased in the soleus and gastrocnemius muscles with dietary Mg restriction. Unlike in the kidney, pyruvic acid content increased in the soleus muscle in response to Mg restriction. Severe Mg restriction decreased contents of carnosine and its constituent β-alanine and increased the levels of purine derivatives such as xanthine and uric acid in the gastrocnemius muscle. The present study suggests a region-dependent sensitivity to dietary restriction of Mg, which may lead to the onset of various metabolic disorders.

Weak response of bovine hepcidin induction to iron through decreased expression of Smad4

Hepcidin negatively regulates systemic iron levels by inhibiting iron entry into the circulation. Hepcidin production is increased in response to an increase in systemic iron via the activation of the bone morphogenetic protein (BMP) pathway. Regulation of hepcidin expression by iron status has been proposed on the basis of evidence mainly from rodents and humans. We evaluated the effect of iron administration on plasma hepcidin concentrations in calves and the expression of bovine hepcidin by the BMP pathway in a cell culture study. Hematocrit as well as levels of blood hemoglobin and plasma iron were lower than the reference level in calves aged 1-4 weeks. Although intramuscular administration of iron increased iron-related parameters, plasma hepcidin concentrations were unaffected. Treatment with BMP6 increased hepcidin expression in human liver-derived cells but not in bovine liver-derived cells. A luciferase-based reporter assay revealed that Smad4 was required for hepcidin reporter transcription induced by Smad1. The reporter activity of hepcidin was lower in the cells transfected with bovine Smad4 than in those transfected with murine Smad4. The lower expression levels of bovine Smad4 were responsible for the lower activity of the hepcidin reporter, which might be due to the instability of bovine Smad4 mRNA. In fact, the endogenous Smad4 protein levels were lower in bovine cells than in human and murine cells. Smad4 also confers TGF-β/activin-mediated signaling. Induction of TGF-β-responsive genes was also lower after treatment with TGF-β1 in bovine hepatocytes than in human hepatoma cells. We revealed the unique regulation of bovine hepcidin expression and the characteristic TGF-β family signaling mediated by bovine Smad4. The present study suggests that knowledge of the regulatory expression of hepcidin as well as TGF-β family signaling obtained in murine and human cells is not always applicable to bovine cells.

Protein-Ligand Interaction Analyses with Nuclear Magnetic Resonance Spectroscopy Enhanced by Dissolution Triplet Dynamic Nuclear Polarization

Solution-state nuclear magnetic resonance spectroscopy (NMR) is a powerful method for the analysis of intermolecular interactions within a biomolecular system. However, low sensitivity is one of the major obstacles of NMR. We improved the sensitivity of solution-state ¹³C NMR for the observation of intermolecular interactions between protein and ligand using hyperpolarized solution samples at room temperature. Eutectic crystals composed of ¹³C-salicylic acid and benzoic acid doped with pentacene were hyperpolarized by dynamic nuclear polarization using photoexcited triplet electrons, and a ¹³C nuclear polarization of 0.72 ± 0.07% was achieved after dissolution. The binding of human serum albumin and ¹³C-salicylate was observed with several hundred times sensitivity enhancement under mild conditions. The established ¹³C NMR was applied for pharmaceutical NMR experiments by observation of the partial return of the ¹³C chemical shift of salicylate by competitive binding with other non-isotope-labeled drugs.

Possibility of uncoupling protein 1 expression in bovine fast-twitch muscle fibers

Uncoupling protein 1 (UCP1) is responsible for non-shivering thermogenesis in brown/beige adipocytes in humans and rodents. Previously, we showed unexpected expression of UCP1 in bovine skeletal muscles. Here we evaluated Ucp1 mRNA levels in the muscle tissue of Japanese Black steers. Expression of Ucp1 was higher in 30-month-old cattle than in 26-month-old cattle. Levels of myosin heavy chain (Myh)1, an MYH predominantly expressed in fast-twitch muscles, were also significantly higher in cattle aged 30 months. A similar tendency was observed in the expression of other Myhs that are highly expressed in fast-twitch muscles, Myh2 and Myh4. Ucp1 expression was positively correlated with expression of Myh1, Myh2, and Myh4. Our results indicate the possibility of Ucp1 expression in fast-twitch muscle fibers.

Effectiveness of patient and staff cohorting to reduce the risk of vancomycin-resistant enterococcus (VRE) acquisition: a retrospective cohort study during a VRE outbreak in Japan

BACKGROUND

Patient and staff cohorting is part of a bundle approach in the response to multi-drug-resistant organisms, but its effectiveness is not fully clarified. This study compared the risks of acquiring vancomycin-resistant Enterococcus faecium (VREfm) at a hospital during a VREfm outbreak based on contact characteristics in order to better understand the effectiveness of cohorting.

METHODS

Exposure came from contact with patients with VREfm (infectors), including existing patients with VREfm and patients who acquired VREfm during the study period. Contact was defined as length of contact time, degree of sharing space, and care by the same nurses as those caring for infectors between January and March 2018. The outcome was VREfm acquisition as determined through monthly stool or rectal screening cultures. Incidence rates were calculated based on contact patterns, and incidence rate ratios (IRRs) were compared.

FINDINGS

Among 272 inpatients (4038 patient-days), 43 patients acquired VREfm with the same or similar pulsotype. Incidence rates were 8.45 per 1000 patient-days when susceptible inpatients were on the same ward as an infector but cared for by different nurses (reference), 16.96 when susceptible inpatients were on the same ward as an infector and cared for by the same nurses [IRR 2.01, 95% confidence interval (CI) 0.62-10.28], and 52.91 when susceptible inpatients shared a room with an infector (IRR 6.26, 95% CI 1.61-35.40).

CONCLUSION

Compared with susceptible inpatients in a different room from infectors and not being cared for by the same nurses, the risk of VREfm acquisition could be six times higher for susceptible inpatients who are in the same room as infectors, and could be double for susceptible inpatients cared for by the same nurses as infectors.

Factors affecting the induction of uncoupling protein 1 in C2C12 myogenic cells

Brown/beige adipocytes, which are derived from skeletal muscle/smooth muscle-lineage cells, consume excess energy as heat through the expression of mitochondrial uncoupling protein 1 (UCP1). Previous studies have shown that forced expression of PR/SET domain (PRDM)-16 or early B-cell factor (EBF)-2 induced UCP1-positive adipocytes in C2C12 myogenic cells. Here, we explored the culture conditions to induce Ucp1 expression in C2C12 cells without introducing exogenous genes. Treatment with rosiglitazone (a peroxisome proliferator-activated receptor (PPAR)-γ agonist), GW501516 (a PPARδ agonist), and bone morphogenetic protein (BMP)-7 for 8 days efficiently increased Ucp1 expression in response to treatment with forskolin, an activator of the protein kinase A pathway. BMP7 dose-dependently increased forskolin-induced Ucp1 expression in the presence of rosiglitazone and GW501516; however, GW501516 was not required for Ucp1 induction. Additionally, the structurally related proteins, BMP6 and BMP9, efficiently increased forskolin-induced Ucp1 expression in rosiglitazone-treated cells. UCP1 protein was localized in cells with lipid droplets, but adipocytes were not always positive for UCP1. Continuous treatment with BMP7 was needed for the efficient induction of Ucp1 by forskolin treatment. Significant expression of Prdm16 was not detected, irrespective of the treatment, and treatment with rosiglitazone, GW501516, and BMP7 did not affect the expression levels of Ebf2. Fibroblast growth factor receptor (Fgfr)-3 expression levels were increased by BMP9 in rosiglitazone-treated cells, and molecules that upregulate Fgfr3 transcription partly overlapped with those that stimulate Ucp1 transcription. The present results provide basic information on the practical differentiation of myogenic cells to brown adipocytes.

AB1140 IMPACT OF COVID-19 NEWS SOURCES ON RHEUMATOID ARTHRITIS PATIENTS’ LIFESTYLE AND THEIR DISEASE ACTIVITY FROM NINJA 2020 COHORT STUDY

Background

One of the problems with the COVID-19 epidemic is infodemic. Insufficient and inaccurate information can be confusing and hinder treatment. In Japan, tabloid TV show might be an easily accessible source of information, but its reliability is low and it has a harmful effect on patients’ mental status and lifestyle. There are no reports to examine what is the source of COVID-19 news for patients with rheumatoid arthritis and how these information affect patients’ daily lives and disease activity. By using NinJa, Japanese largest database of rheumatoid arthritis, it may be possible to examine them in detail.

Objectives

To investigate the impact of the COVID—19 news sources on rheumatoid arthritis patients’ lifestyle and their disease activity using NinJa 2020 cohort study.

Methods

At the timing of collection of patients’ data of NinJa2020, questionnaire about their lifestyle and news source of COVID-19 was given. Questionnaire includes questions about frequency of scheduled visit, going out and exercise, weakness and news source.

Results

6677 patients out of 15553 patients answered questionnaire. Most patients did not change the interval of scheduled visit. The frequency of hospital visits was “unchanged” in 85.8%, “longer” in 13.6%, and “shortened” in 0.6%. The chances of going out were “unchanged” at 14.4%, “significantly decreased” at 57.5%, “slightly decreased” at 27.8%, and “increased” at 0.3%. 42.6% answered that the amount of exercise did not change, 30.2% answered that it decreased considerably, 26.1% answered that it decreased a little, and 1.1% answered that it increased. Regarding muscular strength and physical strength, 46.0% answered “no change”, 19.9% ​​answered “significantly dropped”, 33.5% answered “slightly dropped”, and 0.6% answered “increased”.

The media used as information sources are “newspaper (86.4%)”, “tabloid show (54.5%)”, “family, acquaintances and friends (43.7%)”, and “official web of Ministry of Health, Labor and Welfare and academic societies (9.4. %)”. Respondents often referred to multiple media and 30.6% of them listed three sources (Figure 1). There was a positive correlation between the decrease in frequency of going out and the number of information sources, and a negative correlation between age and the number of information sources. We also found a negative correlation with age for muscle weakness.

No correlation was found between the number of information sources and SDAI, CDAI, HAQ-DI, EQ-5D, HADS (A), HADS (D).

Figure 1.

Conclusion

The more sources of information, the less chance of going out. About 80% of the patients refrained from going out, the opportunity for exercise decreased in more than 50% of the patients, and the decrease in physical fitness was also noticed in nearly 50% of the patients. Newspapers, tabloid shows, and acquaintances were the most common sources of medical information, and relatively few patients used official sources.

He provision of accurate information about COVID-19 was important to avoid infodemic. From this questionnaire, more practical information delivery system was required in Japan.

Disclosure of Interests

None declared

AB0200 COMPARISON OF TREATMENT AND DISEASE ACTIVITY OF BETWEEN EORA AND YORA PATIENTS IN A NATIONWIDE DATABASE OF RHEUMATOID ARTHRITIS IN JAPAN “NINJA”

Background

Elderly-onset rheumatoid arthritis (EORA) has different characteristics from younger-onset RA (YORA), however, few reports have conducted large-scale and long-term comparisons of treatment and disease activity between EORA and YORA.

Objectives

To compare the changes in treatment and disease activity of between EORA and YORA patients and to examine the characteristics of patients who achieved remission between them using data of a real-world database in Japan.

Methods

Analysis was performed using data from 2010, 2013, 2016, and 2019 of the National Database of Rheumatic Diseases in Japan (NinJa). Patients were grouped according to age of disease onset into G1: <65 years (divided into G1a <65 years and G1b ≧65 years by the age at analysis), G2: 65-74 years, and G3:≧75 years.

Results

MTX usage rate decreased over time in G2 (58.3% in 2013→55.1% in 2016→54.4% in 2019) and G3 group (41.1→39.5→37.9%). Biologics/JAKi usage rate increased (G1b:24.4→28.2→ 33.3%, G2:19.1→20.3→23.7%, G3:12.3→14.5→19.1%) and steroid usage rate decreased (G1b:49.1→41.8→35.1%, G2:42.2→36.8→29.5%, G3:50.9→45.9→39.2%) in all groups. TNFi usage rate decreased (G1b:19.5→18.0→17.3%, G2:15.4→ 14.1→12.7%, G3:6.2→4.3→5.1%) but IL-6i usage rate increased (G1b:5.2→7.4→9.5%, G2:4.1→4.3→5.9%, G3:2.7→3.4→3.3%) except for the G3 group. CTLA-4Ig usage rate also increased (G1b:3.7→5.3→6.7%, G2:2.7→5.5→5.9%, G3:3.6→6.5→8.1%) in all groups.

The SDAI remission rate was increased over time in all groups (G1a:34.4→41.2→44.6%, G1b:25.1→31.4→35.2%, G2:33.1→37.1→42.2%, G3:30.0→35.9→39.3%) and EORA showed similar rate of remission with YORA. In the analysis stratified by SDAI using NinJa 2019, the positive rate of RF and ACPA decreased (ex RF. G3: 71.0→64.5→53.2%, ACPA. G3: 66.4→56.2→46.5%) and the proportion of male increased (ex G3: 23.0→30.3→35.1%) as the disease activity decreased (moderate / high → low → remission) in all groups. Also, the proportion of patients using two or more DMARDs decreased (ex G3: 43.8→35.2→22.4%) and the usage rate of steroid decreased (ex G3:52.5→37.9→30.2%). Furthermore, in a comparison of remission patients in each group, MTX usage rate (G1b:62.9→G2:61.7→G3:40.9%) and biologics/JAKi usage rate decreased (32.5→23.6→15.3%) as the age of onset increased, but the steroid usage rate increased (20.3→20.6→30.2%).

Conclusion

Disease activity improved over time, regardless of age of onset. EORA showed the same remission achievement rate as YORA, but the treatment content of those who achieved remission differed greatly depending on the age of onset.

Disclosure of Interests

Toshihiro Matsui Speakers bureau: Abbvie, Asahi Kasei, Ono, Chugai, Eli lilly, Pfizer, Grant/research support from: Abbvie, Asahi Kasei, Chugai, Shigeto Tohma: None declared

POS0614 THE RELATIONSHIP BETWEEN DISEASE ACTIVITY AND FINANCIAL TOXICITY IN PATIENTS WITH RHEUMATOID ARTHRITIS ON BIOLOGICS: A CROSS-SECTIONAL STUDY USING THE JAPANESE RHEUMATOID ARTHRITIS REGISTRY

Background

As the number of rheumatoid arthritis (RA) patients using biologics increases, the health financial issues posed by biologics become more important. The health financial issues posed by biologics have been discussed using health economic indicators such as incremental cost-effectiveness ratios (ICERs), but have not been evaluated using the financial burden of medical expenses (financial toxicity). In the field of malignancies, evaluations using financial burden have been conducted and have shown that the stage of malignancy is associated with financial toxicity. It is not known whether disease activity and financial toxicity are similarly associated in RA patients.

Objectives

This study aims to evaluate the relationship between RA activity and financial toxicity in RA patients using biologics, who are especially likely to feel the financial burdens.

Methods

We conducted a cross-sectional study of biologic users enrolled in NinJa2020, a database of rheumatoid arthritis patients in Japan collected from April 1, 2020 to March 31, 2021. We defined the users of TNF inhibitor, IL-6 receptor antagonists, T-cell costimulation blocker, Janus kinase inhibitor and biosimilar as biologic users. The main exposure was the disease activity of RA and was measured using DAS28-CRP. Outcome measure was a financial toxicity and was measured using COmprehensive Score for financial Toxicity (COST). This scale is a patient-reported outcome measure (PROM) consisting of 11 items. The responses are recorded on 5-point Likert Scales (ranging from 0 = strongly disagree to 4 = strongly agree). The score by domains ranges from 0 to 44. Higher scores indicated better results and lower financial toxicity. Multiple linear regression models adjusted for age, sex, disease duration, co-payments for anti-rheumatic drugs, work status, financial support systems were conducted to assess the relationship between the disease activity of RA and financial toxicity. As a secondary analysis, we excluded patients with zero copayments and performed the same analysis as in the main analysis. We used multiple imputation to deal with missing values.

Results

Among 15553 cases in the NinJa database, 649 cases for which RA disease activity and COST were available were included. The median age of the patients was 70 (interquartile range [IQR],56 -77), 83.7% were female. The median copayment amount was ¥12978 per month (IQR 637.2 to 24204.1). The median DAS28-CRP was 1.99 (IQR, 1. - 2.72). The median financial toxicity (COST score) was 21 (IQR 0-27) (Figure 1). In the main analysis using multiple linear regression, COST significantly decreased with disease activity of RA (per 1-pt DAS28-CRP, -1.16 [95% CI -2.04 - -0.28]). In the secondary analysis, COST significantly decreased with disease activity of RA (per 1-pt DAS28-CRP, -1.69 [95% CI -2.29 - -1.10]). Statistical significance was defined as a two-sided p-value < 0.05. All statistical analyses were conducted using STATA 17.0 (Stata Corp LP, College Station, TX). The National Hospital Organization’s research ethics committees evaluated and authorized the NinJa study.

Conclusion

High disease activity of RA was associated with high financial toxicity in biologic users. We reaffirmed the importance of financial considerations and empathy for RA patients using biologics, and suggested a potential demand for more financial support for RA patients who are refractory to treatment.

Disclosure of Interests

None declared

Large-Scale Prospective Genome-Wide Association Study of Oxaliplatin in Stage II/III Colon Cancer and Neuropathy

IMPORTANCE

The severity of oxaliplatin (L-OHP)-induced peripheral sensory neuropathy (PSN) exhibits substantial interpatient variability, and some patients suffer from long-term, persisting PSN.

OBJECTIVE

To identify single-nucleotide polymorphisms (SNPs) predicting L-OHP-induced PSN using a genome-wide association study (GWAS) approach.

DESIGN, SETTING, PARTICIPANTS

A large prospective GWAS including 1,379 patients with stage II/III colon cancer who received L-OHP-based adjuvant chemotherapy (mFOLFOX6/CAPOX) under the phase II (JOIN/JFMC41) or the phase III (ACHIVE/JFMC47) trial.

MAIN OUTCOMES AND MEASURES

First, GWAS comparison of worst grade PSN (grade 0/1 vs. 2/3) was performed. Next, to minimize the impact of ambiguity in PSN grading, extreme PSN phenotypes were selected and analyzed by GWAS. SNPs that could predict time to recovery from PSN were also evaluated. In addition, SNPs associated with L-OHP-induced allergic reactions (AR) and time to disease recurrence were explored.

RESULTS

No SNPs exceeded the genome-wide significance (p < 5.0 × 10^-8) in either GWAS comparison of worst grade PSN, extreme PSN phenotypes, or time to recovery from PSN. Association study focusing on AR or time to disease recurrence also failed to reveal any significant SNPs.

CONCLUSION AND RELEVANCE

Our results highlight the challenges of utilizing SNPs for predicting susceptibility to L-OHP-induced PSN in daily clinical practice.

Stimulation of myogenesis by ascorbic acid and capsaicin

Myogenesis is a complex process regulated by several factors. This study evaluated the functional interaction between vitamin C and a high dose of capsaicin (a potential endoplasmic reticulum (ER) stress inducer) on myogenesis. After the induction of differentiation, treatment with ascorbic acid or ascorbic acid phosphate (AsAp) alone had minimal effects on myogenesis in C2C12 cells. However, treatment with capsaicin (300 μM) in undifferentiated C2C12 cells increased the expression levels of genes related to ER stress as well as oxidative stress. Myogenesis was effectively enhanced in C2C12 cells treated with a combination of capsaicin (300 μM) for one day before differentiation stimulation and AsAp for four days post-differentiation; subsequently, thick and long myotubes formed, and the expression levels of myosin heavy chain (MYH) 1/2 and Myh1, Myh4, and Myh7 increased. Considering that mild ER stress stimulates myogenesis, AsAp may elicit myogenesis through the alleviation of oxidative stress-induced negative effects in capsaicin-pretreated cells. The enhanced expression of Myh1 and Myh4 coincided with the expression of Col1a1, a type I collagen, suggesting that the fine-tuning of the myogenic cell microenvironment is responsible for efficient myogenesis. Our results indicate that vitamin C is a potential stimulator of myogenesis in cells, depending on the cell context.

POS0286 INCIDENCE OF MALIGNANCIES IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS: DATA FROM A LARGE JAPANESE NATIONAL REGISTRY

Background:

Patients (pts) with rheumatoid arthritis (RA) have an increased risk of some malignancies vs the general population, and this can vary by region/race.1,2 Data on the epidemiology and impact of biological (b)DMARDs and targeted synthetic (ts)DMARDs, such as Janus kinase (JAK) inhibitors, on the incidence of malignancies in Japanese pts with RA are limited. The National Database of Rheumatic Diseases in Japan (NinJa) is one of the largest RA registries in Japan.

Objectives:

To evaluate the incidence of malignancies in Japanese pts with RA using NinJa registry data.

Methods:

This retrospective observational study analysed NinJa registry data for Japanese pts with RA aged ≥18 years with ≥1 data entry between 2013 (first JAK inhibitor approval for RA in Japan) and 2018. The overall cohort included all pts with RA, and two sub-cohorts were analysed: pts exposed and unexposed to bDMARDs (exposure defined as ≥1 bDMARD reported in database). Crude incidence rates (IRs) for malignancies (including non-melanoma skin cancer) were calculated as the number of events per 100 pt-years of follow-up (time between start of follow-up or the date of first bDMARD exposure [for bDMARD-exposed pts] and end of observation period, or withdrawal from database). The most recent data for incidence of malignancy in the Japanese general population (2013–2017 data from the National Cancer Center, Japan) were used to calculate standardised incidence ratios (SIRs) and age- and sex-adjusted standardised rates (ASRs) for malignancies. Cross-sectional (per calendar year) and cumulative analyses were performed for the overall cohort. Cumulative rates were calculated for sub-cohorts, and all cumulative analyses were repeated excluding pts exposed to JAK inhibitors (ie ≥1 JAK inhibitor reported in database).

Results:

Data were collected for 26 607 Japanese pts with RA from 2013–2018. In the cross-sectional analysis (Table 1), the SIR and ASR for malignancies in all pts with RA were generally consistent from 2013–2018. In the cumulative analysis, the SIR (95% CI) for malignancies from 2013–2018 was 0.97 (0.91, 1.03) in all pts with RA, and 0.93 (0.82, 1.04) and 0.99 (0.92, 1.07) in pts exposed and unexposed to bDMARDs, respectively (Figure 1). Adjusting for age/sex, the cumulative ASR (95% CI) for malignancies from 2013–2018 was 0.83 (0.76, 0.90) in all pts with RA, and 0.82 (0.69, 0.95) and 0.86 (0.77, 0.96) in pts exposed and unexposed to bDMARDs, respectively (Figure 1). In all cohorts, the cumulative SIR and ASR were similar when pts exposed to JAK inhibitors were excluded (Figure 1).

Table 1.

Cross-sectional analysis of the incidence of malignancies in Japanese pts with RA from 2013–2018

All RA2013 (N=13 423)2014 (N=15 584)2015 (N=15 751)2016 (N=16 107)2017 (N=15 994)2018(N=15 003)Total follow-up, PY13 35314 86614 82914 97014 74814 898Pts with events, n140164174168161211Crude IRa(95% CI)1.05(0.89, 1.24)1.10(0.95, 1.29)1.17(1.01, 1.36)1.12(0.97, 1.31)1.09(0.94, 1.27)1.42(1.24, 1.62)ASRa,b(95% CI)0.76(0.60, 0.93)0.76(0.62, 0.90)0.90(0.68, 1.11)0.88(0.68, 1.07)0.80(0.62, 0.98)0.88(0.74, 1.01)SIRb(95% CI)0.97(0.82, 1.14)1.01(0.86, 1.17)1.02(0.87, 1.18)0.88(0.75, 1.02)0.86(0.73, 1.00)1.10(0.95, 1.25)

aIR/ASR were calculated as number of events per 100 PY of follow-up

bData from a Japanese general population database of malignancy incidence from 2013–2017, provided by the Center for Cancer Control and Information Services, National Cancer Center, Japan

PY, pt-years

Conclusion:

The incidence of malignancies in Japanese pts with RA, registered in the NinJa database from 2013–2018, was similar to that in the Japanese general population. The SIR and ASR for malignancies were comparable in pts exposed and unexposed to bDMARDs. In all cohorts, rates did not increase when pts exposed to JAK inhibitors were included.

References:

[1] Dougados et al. Ann Rheum Dis 2014; 73: 62-68.

[2] Parikh-Patel et al. Cancer Causes Control 2009; 20: 1001-1010.

Acknowledgements:

Study sponsored by Pfizer Inc. Medical writing support was provided by Christina Viegelmann, CMC Connect, and funded by Pfizer Inc.

Disclosure of Interests:

Toshihiro Matsui Speakers bureau: Astellas, Ayumi, Chugai, Daiichi-Sankyo, Eli Lilly, Ono, Pfizer Inc, Takeda, Tanabe-Mitsubishi, Consultant of: Pfizer Inc, Grant/research support from: Chugai, Naonobu Sugiyama Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Shigeyuki Toyoizumi Employee of: Pfizer R&D Japan, Fujio Matsuyama Consultant of: Pfizer Inc, Employee of: CRECON Medical Assessment Inc, Tatsunori Murata Consultant of: Pfizer Inc, Employee of: CRECON Medical Assessment Inc, Yukitomo Urata Speakers bureau: Asahi Kasei, Chugai, Eli Lilly, Pfizer Inc, Consultant of: AbbVie, Asahi Kasei, Chugai, Pfizer Inc, Kimito Kawahata Speakers bureau: Pfizer Inc, Consultant of: Pfizer Inc, Grant/research support from: Pfizer Inc, Shigeto Tohma Speakers bureau: Astellas, Ayumi, Chugai, Ono, Pfizer Inc, Takeda, Consultant of: Pfizer Inc

Magnesium bioavailability of dried and thinly shaved kombu in rats

BACKGROUND

Magnesium (Mg) is highly bioavailable in kombu compared with other edible seaweeds. However, a considerable amount of Mg is lost during industrial processing and cooking of kombu. We hypothesized that thinly shaved kombu (TSK), a traditional Japanese kombu product, is a suitable Mg source for daily diets because TSK hardly loses Mg during processing. Rats were fed diets containing TSK or magnesium oxide (MgO) to satisfy 25%, 50%, 75%, or 100% of their Mg requirements. We determined the relative Mg bioavailability of TSK compared to MgO and examined factors affecting Mg bioavailability in TSK.

RESULTS

The relative bioavailability of Mg in TSK compared with MgO was calculated as 92.3%, 111.4%, and 87.2% from apparent absorption, urinary excretion, and femoral concentration of Mg, respectively. The ultrafiltrable Mg concentration was lower in the cecal content of rats given TSK than those given MgO. However, the mRNA expression of TRPM6, an Mg channel responsible for Mg absorption, was higher in the cecum of rats given TSK than those given MgO.

CONCLUSION

Enhancement of TRPM6 expression in the large intestine negates the low bioaccessibility of Mg in TSK, and thus TSK shows Mg bioavailability comparable with MgO. © 2020 Society of Chemical Industry.

Factors affecting expression and transcription of uncoupling protein 2 gene

Previous studies suggest a negative relationship between hepatic oxidative stress and productivity in beef cattle. Uncoupling protein 2 (UCP2) is involved in the disappearance of reactive oxygen species, suggesting the defensive role of UCP2 against oxidative stress. The present study examined the relationship between oxidative stress and expression levels of UCP2/Ucp2 in cultured human and mouse liver-derived cells. We also explored factors regulating bovine Ucp2 transcription. As oxidative stress inducers, hydrogen peroxide, ethanol, and cumene hydroperoxide (CmHP) were used. Expression levels of hemoxygenase 1 (HMOX1), a representative gene induced by oxidative stress, were not affected by any oxidative stress inducers in HepG2 human liver-derived cells. The levels of UCP2 mRNA were also unaffected by the oxidative stress inducers. Treatment with CmHP increased expression of Hmox1 in Hepa1-6 mouse liver-derived cells, but Ucp2 expression was not changed. Stimulus screening for regulator of transcription (SSRT) revealed that expression of p50 or p65, transcription factors conferring response to oxidative stress, did not stimulate bovine Ucp2 transcrition in HepG2 cells. SSRT also showed 11 molecules that induced Ucp2 transcription more than 4-fold; among them, endoplasmic reticulum (ER) stress-related transcription factors such as XBP1, c-JUN, JUNB, and C/EBPβ were identified. However, treatment with ER stress inducers did not increase Ucp2 expression in HepG2 and Hepa1-6 cells. The present results suggest that 1) neither oxidative stress nor ER stress induces Ucp2 expression in liver-derived cells, and 2) Ucp2 transcription is stimulated by several transcription factors.

Regulatory expression of uncoupling protein 1 and its related genes by endogenous activity of the transforming growth factor-β family in bovine myogenic cells

Uncoupling protein 1 (UCP1) is responsible for non-shivering thermogenesis, with restricted expression in brown/beige adipocytes in humans and rodents. We have previously shown an unexpected expression of UCP1 in bovine skeletal muscles. This study evaluated factors affecting Ucp1 gene expression in cultured bovine myogenic cells. Myosatellite cells, which were isolated from the bovine musculus longissimus cervicis, were induced to differentiate into myotubes in the presence of 2% horse serum. Previous studies using murine brown/beige adipocytes revealed that Ucp1 expression levels are directly increased by forskolin and all-trans retinoic acid (RA). The transforming growth factor-β (TGF-β)/activin pathway negatively regulated Ucp1 expression, whereas activation of the bone morphogenetic protein (BMP) pathway indirectly increases Ucp1 expression through the stimulation of brown/beige adipogenesis. Neither forskolin nor RA significantly affected Ucp1 mRNA levels in bovine myogenic cells. A-83-01, an inhibitor of the TGF-β/activin pathway, stimulated myogenesis in these cells. A-83-01 significantly increased the expression of some brown fat signature genes such as Pgc-1α, Cox7a1, and Dio2, with a quantitative but not significant increase in the expression of Ucp1. Treatment with LDN-193189, an inhibitor of the BMP pathway, did not affect the differentiation of bovine myosatellite cells. Rather, LDN-193189 increased Ucp1 mRNA levels without modulating the levels of other brown/beige adipocyte-related genes. The current results indicate that the regulation of Ucp1 expression in bovine myogenic cells is distinct from that in murine brown/beige adipocytes, which has been more intensely characterized. SIGNIFICANCE OF THE STUDY: We previously reported unexpected expression of Ucp1 in bovine muscle tissues; Ucp1 expression has been known to be detected predominantly in brown/beige adipocytes. This study examined regulatory expression of bovine Ucp1 in myogenic cells. Consistent with the changes in expression levels of brown/beige adipocyte-selective genes, Ucp1 expression tended to be increased by inhibition of endogenous TGF-β activity. In contrast, inhibition of endogenous BMP significantly increased Ucp1 expression without affecting brown/beige adipocyte-selective gene expression. The current results indicate that regulatory expression of Ucp1 in bovine myogenic cells is distinct from that in murine brown/beige adipocytes that is more intensely characterized.

SAT0124 RISK OF SERIOUS INFECTION, MALIGNANCY, OR DEATH IN JAPANESE RHEUMATOID ARTHRITIS PATIENTS TREATED WITH A COMBINATION OF ABATACEPT AND TACROLIMUS: A RETROSPECTIVE COHORT STUDY

Background:

Both Abatacept (ABT) and Tacrolimus (Tac) suppress T cell immunity, but it is unknown whether combinations of these will increase the risk of adverse events.

Objectives:

To evaluate whether combining ABT and Tac increases the risk of infection and malignancy compared to their individual use in Japanese rheumatoid arthritis (RA) patients.

Methods:

We conducted a retrospective cohort study of RA patients using the multicenter database in Japan (NinJa). The dataset was clinical information at a certain point within each year, and the point was any point selected by a registered physician. RA was clinically diagnosed in the dataset. (1)

We analyzed the data from RA patients registered in NinJa during the period from April 2010 to March 2019. In this study, we compared three groups who received Tac, ABT or a combination of both. We included patients who had just begun initiating treatment with ABT or Tac, and we excluded patients who used TNF inhibitors, IL-6 inhibitors, and Jak inhibitors in the first year. The primary outcome was defined the composite events including infections that require hospitalization, newly diagnosed malignancy, and death from any cause after initiation of ABT or Tac. We assessed whether the combination contributed to increase the risk of outcome by performing a Cox regression analysis.

Results:

Among the 27032 RA patients in the registry, 2009 patients were included. The Tac, ABT and combination groups consisted of 1328, 563 and 118 patients, respectively. (Figure 1) (Table 1) Primary outcomes occurred in 149 (13.4%), 62 (13.5%), 14 (13.9%) patients, of the Tac, ABT and combination groups, respectively. The incidence between groups was not significantly different (p= 0.638). (Figure 2) A Cox regression analysis was adjusted for the following parameters: age, sex, disease duration, modified health assessment questionnaire, disease activity score 28-CRP, CRP, use of prednisolone, and use of methotrexate. The analysis revealed no significant differences between groups. The hazard ratio (95% confidence interval) was as follows: Tac 1.00 (Ref), ABT 1.02 (0.74-1.40), and combination 1.15 (0.65-2.05).

Table 1.

baseline characteristics

TacrolimusAbataceptCombinationp valueN (person-year)1328 (2505)563 (944)118 (193)age (median [IQR])69.00 [60.00, 76.00]70.00 [61.00, 76.00]67.00 [59.00, 74.00]0.169*sex female (%)1038 (78.2)468 (83.1)97 (82.2)0.039†disease duration (yr) (median [IQR])9.00 [4.00, 18.00]11.00 [5.00, 21.00]11.00 [7.00, 20.00]0.002*Steinbrocker stage (%)I285 (23.5)82 (15.6)12 (12.1)<0.001†II361 (29.8)125 (23.8)25 (25.3)III232 (19.1)150 (28.5)31 (31.3)IV334 (27.6)169 (32.1)31 (31.3)mHAQ (median [IQR])0.25 [0.00, 0.75]0.38 [0.00, 1.00]0.50 [0.00, 1.13]<0.001*DAS28CRP (median [IQR])2.58 [1.88, 3.40]2.77 [2.09, 3.62]3.01 [2.27, 3.98]<0.001*CRP (mg/dL) (median [IQR])0.30 [0.10, 1.02]0.35 [0.13, 1.10]0.30 [0.14, 0.82]0.590*RF positivity (%)708/895 (79.1)331/400 (82.8)57/71 (80.3)0.314†Tacrolimus (mg/d) (median [IQR])1.50 [1.00, 2.00]0.00 [0.00, 0.00]2.00 [1.00, 2.50]<0.001*MTX use (%)619 (46.6)264 (46.9)32 (27.1)<0.001†PSL use (%)749 (56.4)299 (53.1)71 (60.2)0.253†

Abbreviations: anti-CCP, anti-cyclic citrullinated peptide; mHAQ, modified Health Assessment Questionnaire; MTX, methotrexate; PSL, prednisolone; RF, rheumatoid factor * Kruskal-Wallis test; † chi square test; ‡ analysis of variance (ANOVA)

Conclusion:

The combination of ABT and Tac does not increase the risk of adverse events in patients with rheumatoid arthritis in Japan when compared to the use ABT or Tac alone. Further evaluation is needed.

References:

[1]Matsui T, et al. Ann Rheum Dis 2007;66:1221–6.

Disclosure of Interests:

Kenichiro Tokunaga: None declared, Kunihiko Matsui: None declared, Hideto Oshikawa: None declared, Toshihiro Matsui Paid instructor for: Chugai Pharmaceutical Co., LTD., Janssen Pharmaceutical K,K,, Shigeto Tohma: None declared

Expression levels of brown/beige adipocyte-related genes in fat depots of vitamin A-restricted fattening cattle1

Brown/beige adipocytes dissipate energy as heat. We previously showed that brown/beige adipocytes are present in white adipose tissue (WAT) of fattening cattle. The present study examined the effect of vitamin A restriction on mRNA expression of brown/beige adipocyte-related genes. In Japan, fattening cattle are conventionally fed a vitamin A-restricted diet to improve beef marbling. Twelve Japanese Black steers aged 10 mo were fed control feed (n = 6) or vitamin A-restricted feed (n = 6) for 20 mo. Subcutaneous WAT (scWAT) and mesenteric WAT (mesWAT) were collected, and mRNA expression levels of molecules related to the function of brown/beige adipocytes (Ucp1, Cidea, Dio2, Cox7a, and Cox8b) as well as transcriptional regulators related to brown/beige adipogenesis (Zfp516, Nfia, Prdm16, and Pgc-1α) were evaluated. The vitamin A restriction significantly increased or tended to increase expression levels of Cidea and Pgc-1α in scWAT, and Cidea, Dio2, and Nfia in mesWAT. Previous studies revealed that the bone morphogenetic protein (Bmp) pathway was responsible for commitment of mesenchymal stem cells to brown/beige adipocyte-lineage cells. The vitamin A restriction increased expression of Bmp7 and some Bmp receptors in WAT. The interrelationship between gene expression levels indicated that expression levels of Nfia, Prdm16, and Pgc-1α were closely related to those of genes related to the function of brown/beige adipocytes in scWAT. Also, expression levels of Nfia, Prdm16, and Pgc-1α were highly correlated with those of Alk3 in scWAT. In summary, the present results suggest that the vitamin A restriction increases the number or activity of brown/beige adipocytes through regulatory expression of transcriptional regulators to induce brown/beige adipogenesis, especially in scWAT of fattening cattle, which may be governed by the Bmp pathway.

Distribution and evolution of the serine/aspartate racemase family in plants

Previous studies have shown that several d-amino acids are widely present in plants, and serine racemase (SerR), which synthesizes d-serine in vivo, has already been identified from three plant species. However, the full picture of the d-amino acid synthesis pathway in plants is not well understood. To clarify the distribution of amino acid racemases in plants, we have cloned, expressed and characterized eight SerR homologous genes from five plant species, including green alga. These SerR homologs exhibited racemase activity towards serine or aspartate and were identified on the basis of their maximum activity as SerR or aspartate racemase (AspR). The plant AspR gene is identified for the first time from Medicago truncatula, Manihot esculenta, Solanum lycopersicum, Sphagnum girgensohnii and Spirogyra pratensis. In addition to the AspR gene, three SerR genes are identified in the former three species. Phylogenetic tree analysis showed that SerR and AspR are widely distributed in plants and form a serine/aspartate racemase family cluster. The catalytic efficiency (k_cat/K_m) of plant AspRs was more than 100 times higher than that of plant SerRs, suggesting that d-aspartate, as well as d-serine, can be synthesized in vivo by AspR. The amino acid sequence alignment and comparison of the chromosomal gene arrangement have revealed that plant AspR genes independently evolved from SerR in each ancestral lineage of plant species by gene duplication and acquisition of two serine residues at position 150 to 152.

Randomized clinical trial of extensive intraoperative peritoneal lavage versus standard treatment for resectable advanced gastric cancer (CCOG 1102 trial)

BACKGROUND

A survival benefit of extensive intraoperative peritoneal lavage (EIPL) has been reported in patients with gastric cancer with positive peritoneal cytology. The hypothesis of this study was that EIPL may reduce peritoneal recurrence in patients with advanced gastric cancer who undergo surgery with curative intent.

METHODS

This was an open-label, multi-institutional, randomized, phase 3 trial to assess the effects of EIPL versus standard treatment after curative gastrectomy for resectable gastric cancer of T3 status or above. The primary endpoint was disease-free survival (DFS); secondary endpoints were overall survival, peritoneal recurrence-free survival and incidence of adverse events.

RESULTS

Between July 2011 and January 2014, 314 patients were enrolled from 15 institutions and 295 patients were analysed (145 and 150 in the EIPL and no-EIPL groups respectively). The 3-year DFS rate was 63·9 (95 per cent c.i. 55·5 to 71·2) per cent in the EIPL group and 59·7 (51·3 to 67·1) per cent in the control group (hazard ratio (HR) 0·81, 95 per cent c.i. 0·57 to 1·16; P = 0·249). The 3-year overall survival rate was 75·0 (67·1 to 81·3) per cent in the EIPL group and 73·7 (65·9 to 80·1) per cent in the control group (HR 0·91, 0·60 to 1·37; P = 0·634). Peritoneal recurrence-free survival was not significantly different between the two groups (HR 0·92, 0·62 to 1·36; P = 0·676). No intraoperative complications related to EIPL were observed.

CONCLUSION

EIPL did not improve survival or peritoneal recurrence in patients who underwent gastrectomy for advanced gastric cancer. Registration number: 000005907 (http://www.umin.ac.jp/ctr/index.htm).

Relationships between expression levels of genes related to adipogenesis and adipocyte function in dogs

There are three kinds of adipocytes; white adipocytes accumulate excess energy as fat, whereas brown/beige adipocytes dissipate energy through expression of uncoupling protein 1 (UCP1). Obesity, a feature of excess accumulation of white adipocytes in a body, is one of the risk factors for onset of various diseases in dogs. As the first step to explore adipose genes related to dog obesity, we examined relationships among mRNA levels of putative molecules related to adipogenesis and function of adipocytes in fat of hospitalized dogs. Gonadal adipose tissues were collected from a total of 29 dogs, and the gene expression levels were examined by quantitative RT-PCR analysis. The multicollinearity analysis revealed that body condition score (BCS), which reflects adiposity, did not correlate with expression levels of any genes but correlated with age of dog. Bone morphogenetic protein (BMP) pathway stimulates not only commitment of mesenchymal stem cells to white adipocyte-lineage cells but also brown/beige adipogenesis. Some relationships between expression levels of BMP receptors were significant; especially, expression levels of activin receptor-like kinase (Alk) 3 (a BMP type I receptor) positively related to those of Alk2 (another BMP type I receptor), activin receptor type II (ActRII) A (a type II receptor to transmit BMP signal), ActRIIB (another type II receptor to transmit BMP signal) and BMP receptor type 2 (Bmpr2). PR domain containing 16 (Prdm16) expression levels strongly correlated with expression levels of ActRIIB. Although PRDM16 is known to stimulate brown/beige adipogenesis, expression levels of Ucp1 did not correlate with those of Prdm16. On the other hand, expression levels of Ucp1 correlated with those of Alk6. The present study suggests close relationships among adipose expressions of BMP signal components, and the relationships of expression levels of BMP receptor and those of Prdm16 or Ucp1 in dogs. Further studies using more dogs with various BCS potentially lead to identification of adipose factors to relate with adiposity in dogs.

Chronic retinoic acid treatment induces differentiation and changes in the metabolite levels of brown (pre)adipocytes

Dietary vitamin A status affects energy metabolism. The present study explored the effect of all-trans retinoic acid (ATRA) on the expression levels of molecules and metabolites of brown adipocytes. Chronic ATRA treatment was initiated during the early stage (days 0-8) or late stage (days 8-12) of adipogenesis. Treatment with ATRA during the early and late stage of adipogenesis resulted in an increase in the expression level of Ucp1 and Cidea, genes highly expressed in brown adipocytes, on day 8 and day 12, respectively, whereas expression of Pgc-1α, another gene expressed during brown adipogenesis, was unaffected by ATRA. Non-targeted metabolomic analyses indicated that the pathways related to the glucose metabolism were affected by ATRA, irrespective of the differentiation stage. Cellular levels of glucose 6-phosphate, fructose 6-phosphate, citric acid, and succinic acid decreased after ATRA treatment on days 8 and 12. In contrast, glucose level was higher in ATRA-treated cells on day 8, but it was lower on day 12. ATRA decreased the cellular level of aconitic acid, fumaric acid, and malic acid on day 12 but not on day 8. Furthermore, ATRA increased the expression level of Hxk2 and downregulated the expressions of G6pdh and Pfkl/Pfkp on day 8 but not on day 12. Together, the results indicate that the chronic treatment with ATRA stimulated the formation of activated brown adipocytes, eventually leading to alterations in the levels of cellular metabolites related to glucose metabolism. SIGNIFICANCE OF THE STUDY: Significance of the study treatment with all-trans retinoic acid (ATRA) during the early and late stage of adipogenesis increased the expression of Ucp1 and Cidea, genes highly expressed in brown adipocytes, on day 8 and day 12. Cellular levels of glucose 6-phosphate, fructose 6-phosphate, citric acid, and succinic acid decreased after ATRA treatment on days 8 and 12. In contrast, glucose level was higher in ATRA-treated cells on day 8, but it was lower on day 12. The present results indicate that ATRA stimulated the formation of activated brown adipocytes, eventually leading to alterations in the levels of cellular metabolites related to glucose metabolism.

Hepcidin and IL-1β

Hepcidin expression is determined through transcriptional regulation by systemic iron status. However, acute or chronic inflammation also increases the expression of hepcidin, which is associated with the dysregulation of iron metabolism in pathological conditions. Interleukin (IL)-6 has been suggested to be a principal molecule to confer inflammation-related hepcidin transcription, which is mediated via signal transducer and activator of transcription (STAT)-binding site on the hepcidin promoter. Recently, it has been uncovered that another pro-inflammatory cytokine IL-1β stimulates hepcidin expression through the distinct mechanism underlying IL-6-mediated hepcidin transcription. In addition to IL-6 induction, IL-1β stimulates expression of CCAAT-enhancer-binding protein (C/EBP)δ, a transcription factor, leading to transcriptional activation of hepcidin via C/EBP-binding site on the hepcidin promoter. Thus, hepcidin transcription is stimulated through multiple elements in response to proinflammatory cytokines. Relationships between increased production of IL-1β and dysregulated iron metabolism have been suggested in various diseases, which may be linked to overproduction of hepcidin.

A Standard Nomenclature for Referencing and Authentication of Pluripotent Stem Cells

Unambiguous cell line authentication is essential to avoid loss of association between data and cells. The risk for loss of references increases with the rapidity that new human pluripotent stem cell (hPSC) lines are generated, exchanged, and implemented. Ideally, a single name should be used as a generally applied reference for each cell line to access and unify cell-related information across publications, cell banks, cell registries, and databases and to ensure scientific reproducibility. We discuss the needs and requirements for such a unique identifier and implement a standard nomenclature for hPSCs, which can be automatically generated and registered by the human pluripotent stem cell registry (hPSCreg). To avoid ambiguities in PSC-line referencing, we strongly urge publishers to demand registration and use of the standard name when publishing research based on hPSC lines.

Metabolic changes in adipose tissues in response to β3 -adrenergic receptor activation in mice

Brown and beige adipocytes dissipate energy as heat. Thus, the activation of brown adipocytes and the emergence of beige adipocytes in white adipose tissue (WAT) are suggested to be useful for preventing and treating obesity. Although β₃ -adrenergic receptor activation is known to stimulate lipolysis and activation of brown and beige adipocytes, fat depot-dependent changes in metabolite concentrations are not fully elucidated. The current study examined the effect of treatment with CL-316,243, a β₃ -adrenergic receptor agonist, on the relative abundance of metabolites in interscapular brown adipose tissue (iBAT), inguinal WAT (ingWAT), and epididymal WAT (epiWAT). Intraperitoneal injection of CL-316,243 (1 mg/kg) for 3 consecutive days increased the relative abundance of several glycolysis-related metabolites in all examined fat depots. The cellular concentrations of metabolites involved in the citric acid cycle and of free amino acids were also increased in epiWAT by CL-316,243. CL-316,243 increased the expression levels of several enzymes and transporters related to glucose metabolism and amino acid catabolism in ingWAT and iBAT but not in epiWAT. CL-316,243 also induced the emergence of more beige adipocytes in ingWAT than in epiWAT. Furthermore, adipocytes surrounded by macrophages were detected in the epiWAT of mice given CL-316,243. The current study reveals the fat depot-dependent modulation of cellular metabolites in CL-316,243-treated mice, presumably resulting from differential regulation of cell metabolism in different cell populations.

Effect of niacin supplementation in long-distance transported steer calves

Long-distance transportation has negative impacts on production and health in cattle. Feed and water are routinely deprived from cattle during transportation. We investigated whether niacin supplementation could improve niacin nutrition and mitigate the adverse effect of transportation with feed and water deprivation in steer calves. We also studied the adverse effect of feed and water deprivation in nontransported steer calves. Twelve calves were assigned to feed and water deprivation for 2 days, or full access to feed and water in experiment 1. Ten calves were assigned to 2-day transportation with feed and water deprivation, or the transportation with feed and water deprivation, but with supplementation of rumen-protected niacin at 100 g/day per head in experiment 2. Bodyweight was measured and blood was collected for 32 days in each experiment. Feed and water deprivation temporarily decreased serum glucose concentrations and bodyweight gain. Transportation with deprivation of feed and water caused a temporal decrease in bodyweight gain and serum albumin concentration, and a continuous decrease in serum glucose and total cholesterol concentrations, which was suppressed by niacin supplementation. Niacin supplementation increased blood niacin concentration. These results suggest that niacin supplementation mitigates adverse effects of transportation with feed and water deprivation in steer calves.

Si-based Mach-Zehnder wavelength/mode multi/demultiplexer for a WDM/MDM transmission system

We propose and experimentally demonstrate a low-loss and low-crosstalk Mach-Zehnder mode/wavelength multi/demultiplexer for WDM/MDM transmission based on a Si-photonics platform. A broadband 3-dB mode divider, which is also newly devised here, makes it possible to compose a Mach-Zehnder filter for "mode" and "wavelength" simultaneously. Transmission characteristics of fabricated 3-dB mode dividers are in excellent agreement with theoretical results. Mach-Zehnder filters using the 3-dB mode divider with a free spectral range (FSR) of 20 and 1 nm are also fabricated and the modal crosstalk is less than -24 dB in the 40-nm wavelength range for the MZ filter with an FSR of 20 nm. The tuning of the peak wavelength position by the TiN heater is also demonstrated.

Honeycomb micro-textures for light trapping in multi-crystalline silicon thin-film solar cells

The liquid phase crystallization (LPC) of silicon is an emerging technology for fabricating 10 - 20 µm thin multi-crystalline silicon layers on glass. LPC silicon solar cells exhibit similar electronic performance to multi-crystalline wafer-based devices. Due to the reduced absorber thickness, however, effective measures for light trapping have to be taken. We present tailor-made micro-structures for light trapping at the LPC silicon back-side, whereby a nano-imprinted resist layer serves as a three-dimensional etching mask in subsequent reactive ion etching. Contrary to state-of-the-art random pyramid textures produced by wet-chemical etching, this method allows to produce tailor-made textures independent of grain orientation. Differently shaped micro-textures were replicated in LPC silicon. Absorptance and external quantum efficiency of periodic honeycomb patterns and random pyramids were found to be equivalent. Thus, the method enables the potential to further optimize light trapping in LPC silicon solar cells.

Pathophysiological characteristics of non-alcoholic steatohepatitis-like changes in cholesterol-loaded type 2 diabetic rats

Spontaneously Diabetic Torii (SDT) fatty rats, a new obese diabetic model, reportedly presented with features of non-alcoholic steatohepatitis (NASH) after 32 weeks of age. We tried to accelerate the onset of NASH in SDT fatty rats using dietary cholesterol loading and noticed changes in the blood choline level which is expected to be a NASH biomarker. Body weight and biochemical parameters were measured from 8 to 24 weeks of age. At 16, 20, 24 weeks, pathophysiological analysis of the livers were performed. Hepatic lipids, lipid peroxides, and the expression of mRNA related to triglyceride (TG) synthesis, inflammation, and fibrosis were evaluated at 24 weeks. Hepatic fibrosis was observed in SDT fatty rats fed cholesterol-enriched diets (SDT fatty-Cho) from 16 weeks. Furthermore, hepatic lipids and lipid peroxide were significantly higher in SDT fatty-Cho than SDT fatty rats fed normal diets at 24 weeks. Hepatic mRNA expression related to TG secretion decreased in SDT fatty-Cho, and the mRNA expression related to inflammation and fibrosis increased in SDT fatty-Cho at 24 weeks. Furthermore, SDT fatty-Cho presented with increased plasma choline, similar to human NASH. There were no significant changes in the effects of feeding a cholesterol-enriched diet in Sprague-Dawley rats. SDT fatty-Cho has the potential to become a valuable animal model for NASH associated with type 2 diabetes and obesity.

Early results of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of cisplatin/S-1 and docetaxel/cisplatin/S-1 as neoadjuvant chemotherapy for locally advanced gastric cancer

Background

Neoadjuvant chemotherapy (NAC) is a promising method of improving the survival of resectable gastric cancer. Cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) are both effective against metastatic gastric cancer. This report clarified the impact of these regimens on early endpoints, including the pathological responses, chemotherapy-related toxicities, and surgical results.

Methods

Patients with M0 and either T4 or T3 in case of junctional cancer or scirrhous type received two or four courses of cisplatin (60 mg/m2 at day 8)/S-1 (80 mg/m2 for 21 days with 1 week rest) or docetaxel (40 mg/m2 at day 1)/cisplatin (60 mg/m2 at day 1)/S-1 (80 mg/m2 for 14 days with 2 weeks rest) as NAC. Patients then underwent D2 gastrectomy and adjuvant S-1 chemotherapy for 1 year. The primary endpoint was the 3-year overall survival.

Results

Between October 2011 and September 2014, 132 patients were assigned to receive CS (n = 66; 33 in 2 courses and 33 in 4 courses) or DCS (n = 66; 33 in 2 courses and 33 in 4 courses). The respective major grade 3 or 4 hematological toxicities (CS/DCS) were leukocytopenia (14.1%/26.2%), neutropenia (29.7%/47.7%), anemia (14.1%/12.3%), and platelet reduction (3.1%/1.5%). The rate of pathological response, defined as a complete response or < 10% residual cancer remaining, was 19.4% in the CS group and 15.4% in the DCS group, and 15.6% in the two-course group and 19.0% in the 4-course group. The R0 resection rate was 72.7% in the CS group and 81.8% in the DCS group and 80.3% in the two-course group and the 74.2% in the four-course group. No treatment-related deaths were observed.

Conclusions

Our results do not support three-drug therapy with a taxane over two-drug therapy, or any further treatment beyond two cycles as an attractive candidate for the test arm of NAC.