Method for determination of elemental impurities in metronidazole benzoate using inductively coupled plasma mass spectrometry

The elemental impurities in pharmaceutical products have aroused widespread concern among respective supervising authorities and official pharmacopoeias since they are harmful and have no therapeutic effects. Metronidazole benzoate is used extensively to treat a variety of infections. However, impurities will inevitably be introduced in the manufacturing process of metronidazole benzoate. Hence, in this study, a sensitive method was developed for trace determination of elemental impurities in metronidazole benzoate active pharmaceutical ingredients by using inductively coupled plasma mass spectrometry in kinetic energy discrimination mode. The method was validated for system suitability, specificity, linearity, sensitivity, accuracy, and precision according to USP chapter <233> Elemental Impurities-Procedure. The method had good linearity with correlation coefficients > 0.99. The limits of detection were in the range of 0.0003-0.1411 μg/g, which was lower than the acceptable limit and indicated the high sensitivity of the method. The method was accurate with the recoveries in the range of 92%-107%. Moreover, the content of seven elemental impurities in the three batches of metronidazole benzoate active pharmaceutical ingredients by this method was originally below their limits and less than 30% of permitted daily exposure, meeting the requirement of International Council for Harmonization Q3D guidelines. Thus, this newly developed and validated method for estimating elemental impurities in metronidazole benzoate active pharmaceutical ingredients was within the permitted limit and suitable for routine use.

[Study of the predictive role of serum HBV RNA on HBeAg serological conversion in children with chronic hepatitis B]

Objective: To investigate the role of serum hepatitis B virus RNA (HBV RNA) in predicting HBeAg serological conversion in children with chronic hepatitis B. Methods: 175 children aged 1~17 years with chronic hepatitis B who received interferon α (IFNα) for 48 weeks were selected. Patients were divided into HBeAg seroconversion and non-conversion based on whether HBeAg seroconversion occurred at 48 weeks of treatment.T-test and Mann-Whitney U test were used to compare between groups; chisquare test or Fisher exact probability method was used to compare the frequency between groups of classified variables; and Pearson correlation was used to analyze the correlation between indicators. Univariate and multivariate logistic regression analyses were used to identify influencing factors associated with HBeAg serological conversion. The predictive effect of HBV RNA, HBV DNA, and HBsAg on HBeAg serological conversion was compared and analyzed by the receiver operating characteristic curve (ROC). Results: The seroconversion rate of HBeAg at 48 weeks was 36.0% (63/175). The reduction in HBVRNA levels from baseline to the 12th, 24th, 36th, and 48th weeks of antiviral therapy was significantly greater in the HBeAg serological conversion group than that in the non-conversion group, and the difference was statistically significant between the two groups (P < 0.05). Univariate and multivariate regression analyses showed that age and a decline in HBV RNA levels at week 12 were independent predictors of HBeAg serological conversion. The area under the ROC curve (AUROC) of HBV RNA decline at week 12 was 0.677(95% CI∶0.549-0.806, P = 0.012), which was significantly better than the same period of AUROC of HBV DNA (0.657, 95% CI∶0.527-0.788, P = 0.025) and HBsAg (0.660, 95% CI∶0.526-0.795, P = 0.023) decline. HBV RNA levels decreased (>1.385 log10 copies/ml) at week 12, with a positive predictive value of 53.2%, a negative predictive value of 72.2%, a sensitivity of 77.4%, and a specificity of 57.9% for HBeAg seroconversion. Conclusion: HBV RNA level lowering during the 12th week of antiviral therapy can serve as an early predictor marker for HBeAg serological conversion in children with chronic hepatitis B.

Enhancement Patterns of Metastatic Intrahepatic Cholangiocarcinoma and Outcomes after Chemotherapy and Radiation

PURPOSE/OBJECTIVE(S)

Patients with metastatic intrahepatic cholangiocarcinoma (M1-iCCA) have a poor prognosis with a 5-year survival rate of less than 20%. Definitive doses of radiation therapy (RT) after upfront chemotherapy (chemo/RT) in this patient population have shown to prolong survival by reducing the risk of tumor-related liver failure compared to chemotherapy alone. Our group has also identified a baseline radiographic feature, the arterial enhancement pattern, which has pathological and prognostic associations for iCCA. We tested the hypothesis that baseline arterial enhancement is independently associated with survival outcomes for patients who receive chemo/RT or chemo alone.

MATERIALS/METHODS

Patients with M1-iCCA from 2010 to 2021 were included in this retrospective study. Patients were grouped into those who underwent chemo alone and those who underwent chemo/RT. The inclusion criteria included confirmed diagnosis of M1-iCCA, availability of baseline multi-phasic computed tomography (CT), and follow-up for at least six months or until death. Tumor arterial enhancement patterns were categorized as previously described into hypovascular or hypervascular, where the tumors that were hypervascular had either peripheral enhancement or central enhancement. Mean tumor density in Hounsfield units was recorded for each patient. Survival was estimated using the Kaplan Meier method, and Cox proportional models were used to adjust for prognostic variables.

RESULTS

A total of 281 patients with iCCA were identified and 229 had evaluable CT scans. Demographic and baseline characteristics of patient groups are shown in the Table. On univariate analysis, patient age, ECOG performance status (PS) at diagnosis, treatment type, and arterial enhancement patterns associated with overall survival (OS). On multivariable analysis, the arterial enhancement pattern independently associated with OS after accounting for covariates. Patients with hypervascular tumors had prolonged OS compared to those with hypovascular tumors (HR = 0.72, [0.54 - 0.96], p = 0.02). Prolonged OS was also observed in the chemo/RT group compared to the chemo alone group (HR = 0.37, [0.25-0.54], p< 0.0001).

CONCLUSION

Baseline enhancement patterns of M1-iCCA were prognostic in the contexts of chemo alone and chemo/RT. This imaging-based biomarker may improve the ability to stratify patients for therapeutic management.

Preparation and Product Characterization of Microwaveable Food Using Lentinus edodes Protein through 3D Printing

The Lentinus edodes protein (LP) is a high-quality protein known for its well-balanced amino acid composition. In this study, we developed three-dimensional (3D)-printed microwaveable food using a combination of LP and potato flour, and optimized the formulation to achieve a ratio of LP: potato flour: xanthan gum: water = 2:8:1:23. The 3D-printed samples exhibited better shape, weight, and size compared to the molded samples after microwave treatment, with the most favorable microwave effect observed at a 90% filling ratio. The LP content affected the viscosity and retrogradation value of the LP-potato starch mixture. Microwave duration affected the surface hardness, interior softness, and moisture content of the product. The highest overall score of 8.295 points was obtained with a microwave processing duration of 2 min. This study lays a foundation for the development of LP-based 3D-printed food.

Unveiling the Therapeutic Potentials of Mushroom Bioactive Compounds in Alzheimer's Disease

Alzheimer's disease (AD) stands as a prevailing neurodegenerative condition (NDs), leading to the gradual deterioration of brain cells and subsequent declines in memory, thinking, behavior, and emotion. Despite the intensive research efforts and advances, an effective curative treatment for the disease has not yet been found. Mushrooms, esteemed globally for their exquisite flavors and abundant nutritional benefits, also hold a wealth of health-promoting compounds that contribute to improving AD health. These compounds encompass polysaccharides, proteins, lipids, terpenoids, phenols, and various other bioactive substances. Particularly noteworthy are the potent neuroprotective small molecules found in mushrooms, such as ergothioneine, erinacine, flavonoids, alkaloids, ergosterol, and melanin, which warrant dedicated scrutiny for their therapeutic potential in combating AD. This review summarizes such positive effects of mushroom bioactive compounds on AD, with a hope to contribute to the development of functional foods as an early dietary intervention for this neurodegenerative disease.

Method for trace determination of N-nitrosamines impurities in metronidazole benzoate using high-performance liquid chromatography coupled with atmospheric-pressure chemical ionization tandem mass spectrometry

Genotoxic impurity control has been a great concern in the pharmaceutical industry since the recall of the large round of sartans worldwide in 2018. In these sartans, N-nitrosamines were the main contaminants in active pharmaceutical ingredients and formulations. Numerous analytical methods have been developed to detect N-nitrosamines in food, drugs, and environmental samples. In this study, a sensitive method is developed for the trace determination of N-nitrosamine impurities in metronidazole benzoate pharmaceuticals using high-performance liquid chromatography/atmospheric-pressure chemical ionization tandem mass spectrometry in the multiple reaction monitoring mode. The method was validated regarding system suitability, selectivity, linearity, accuracy, precision, sensitivity, solution stability, and robustness. The method showed good linearity with R² ≥ 0.999 and F_Mandel  < F_tab(95%) ranging from 0.33 to 8.00 ng/ml. The low limits of detection of N-nitrosamines were in the range of 0.22-0.80 ng/ml (0.0014-0.0050 ppm). The low limits of quantification were in the range of 0.33-1.20 ng/ml (0.0021-0.0075 ppm), which were lower than the acceptable limits in metronidazole benzoate pharmaceuticals and indicated the high sensitivity of the method. The recoveries of N-nitrosamines ranged from 84% to 97%. Thus, this method exhibits good selectivity, sensitivity, and accuracy. Moreover, it is a simple, convenient, and scientific strategy for detecting N-nitrosamine impurities in pharmaceuticals to support the development of the pharmaceutical industry.

Compensating for gyroradius effects in beamlines with small Helmholtz coils

Measurements of lighter, low-energy charged particles in a laboratory beamline are complicated due to the influence of Earth's magnetic field. Rather than nulling out the Earth's magnetic field over the entire facility, we present a new way to correct particle trajectories using much more spatially limited Helmholtz coils. This approach is versatile and easy to incorporate in a wide range of facilities, including the existing ones, enabling measurements of low-energy charged particles in a laboratory beamline.

[Nontuberculous mycobacteria infection and pulmonary alveolar proteinosis in a patient with hematopoietic defects]

A 28-year-old male with a history of leukopenia was admitted with complaints of fever, cough, and dyspnea for 3 months. Initial work-up identified reduced circulating levels of granulocytes, monocytes, lymphocytes, and NK cells. Computed tomography revealed bilateral reticulonodular opacities and mediastinal lymph node enlargement. Peripheral blood culture and mediastinal lymph node aspiration yielded Mycobacterium avium. Genetic testing revealed a heterozygous germline GATA2 mutation (c.1187G>A, R396Q). Despite standard anti-mycobacterial therapy, the patient's dyspnea worsened and subsequent imaging studies revealed diffuse ground-glass opacification. A transbronchial lung biopsy confirmed the development of pulmonary alveolar proteinosis. Bone marrow transplantation had not been performed due to the unavailability of suitable donors. The disease progressed after whole lung lavage, and the patient died at the age of 31 years from respiratory failure. The current case report emphasized the importance of raising awareness about the rare GATA2 deficiency, which is characterized by hematologic abnormalities, primary immunodeficiency, and pulmonary alveolar proteinosis.

[Clinical and pathological features and differential diagnosis of fibro-osseous tumors and dysplasias]

Fibro-osseous lesions is a class of diseases with obvious similarities in clinical manifestations and pathological features, which has been attracting the attention of clinicians and pathologists. The latest WHO 2022 Classification (5th edition) included six of these diseases (cemento-osseous dysplasia, segmental odontomaxillary dysplasia, fibrous dysplasia, juvenile trabecular ossifying fibroma, psammomatoid ossifying fibroma and familial gigantiform cementoma) in the " fibro-osseous tumours and dysplasias ", and put forward new ideas on the diagnosis and treatment of these diseases. According to the latest WHO 2022 Classification (5th edition), the clinical and pathological features, diagnosis and differential diagnosis of these six diseases were described.

Preparation and characterization of 3D-printed antibacterial hydrogel with benzyl isothiocyanate

Benzyl isothiocyanate (BITC) is an isothiocyanate of plant origin, especially the mustard family, which has good antibacterial properties. However, its applications are challenging due to its poor water solubility and chemical instability. We used food hydrocolloids, including xanthan gum, locust bean gum, konjac glucomannan, and carrageenan as three-dimensional (3D)-printing food ink base and successfully prepared 3D-printed BITC antibacterial hydrogel (BITC-XLKC-Gel). The characterization and fabrication procedure of BITC-XLKC-Gel was studied. The results show that BITC-XLKC-Gel hydrogel has better mechanical properties by low-field nuclear magnetic resonance (LF-NMR), mechanical properties, and rheometer analysis. The strain rate of BITC-XLKC-Gel hydrogel is 76.5%, which is better than that of human skin. Scanning electron microscope (SEM) analysis showed that BITC-XLKC-Gel has uniform pore size and provides a good carrier environment for BITC carriers. In addition, BITC-XLKC-Gel has good 3D-printing performance, and 3D printing can be used for customizing patterns. Finally, inhibition zone analysis showed that the BITC-XLKC-Gel added with 0.6% BITC had strong antibacterial activity against Staphylococcus aureus and the BITC-XLKC-Gel added with 0.4% BITC had strong antibacterial activity against Escherichia coli. Antibacterial wound dressing has always been considered essential in burn wound healing. In experiments that simulated burn infection, BITC-XLKC-Gel showed good antimicrobial activity against methicillin-resistant S. aureus. BITC-XLKC-Gel is a good 3D-printing food ink attributed to strong plasticity, high safety profile, and good antibacterial performance and has great application prospects.

[Research progress of tunneling nanotube in bone biology]

Tunneling nanotube (TNT) is a newly discovered communication mode between animal cells in recent years, which have important physiological and pathological significance. However, the role of TNT in bone biology is still unclear. At present, there are many reports about tunneling nanotubes in bone marrow mesenchymal stem cells, osteoclast precursor cells, osteoblasts and immune cells. This review describes the research advances of TNT and its research progress in bone biology. It looks forward to the research direction of TNT in oral and maxillofacial bone development and bone biology, to provide new strategies for the maintenance of bone homeostasis and the treatment of bone diseases.

Response of sugar metabolism in the cotyledons and roots of Ricinus communis subjected to salt stress

Ricinus communis is an important oilseed crop worldwide and is also considered one of the best potential plants for salt-affected soil improvement in northeast China. However, little is known about photosynthesis and carbohydrate metabolism in this plant, nor the distribution of carbohydrates in cotyledons and roots under salinity stress. In the present study, seedling growth, gas exchange parameters (P_N , E, g_s and C_i ), carbohydrate (fructose, sucrose, glucose, soluble sugar and starch) metabolism and related enzymes and genes were measured in Ricinus plants. Under salt stress, P_N of cotyledons decreased significantly (P < 0.05), resulting in weak photosynthetic capacity. Furthermore, salt stress increased sucrose and glucose content in cotyledons, but decreased soluble sugar and starch content. However, sucrose increased and starch decreased in roots. This may be correlated with the increasing sugar metabolism under salinity, including notable changes in sugar-related enzyme activities (SPS, SuSy, α-amylase and β-amylase) and gene expression of RcINV, RcSUS, RcAmY, RcBAM and RcGBE1. The results suggest that salinity reduces photosynthesis of cotyledons, alters carbohydrate allocation between cotyledons and roots and also promotes starch utilization in cotyledons and starch biosynthesis in roots, leading to a functional imbalance between cotyledons and roots. Together, these findings provide insights into the crucial role of sugar metabolism in improving salt-tolerance of Ricinus during the early seedling growth stage.

Relationship between Social Support, Sarcopenia, and Cognitive Impairment in Chinese Community-Dwelling Older Adults

BACKGROUND

Cognitive impairment and sarcopenia have become important challenges for the growing aging population. Social support has been shown to protect against cognitive impairment, but its impact on sarcopenia remains unknown. The purpose of this study was to explore the correlation between social support, sarcopenia, and cognitive impairment in Chinese older adults.

METHOD

A multi-stage whole group sampling method was used to conduct a cross-sectional survey of 720 community-dwelling older people in Shanghai. The definition of sarcopenia was in accordance with the criteria of the Asian Working Group for Sarcopenia (AWGS) 2019. Cognitive impairment was evaluated using a computerized neuropsychological assessment device that had been previously validated. Social support was assessed using the Social Support Rate Scale. Logistic regression analyses were conducted to explore the relationship between social support cognitive impairment and sarcopenia, fully adjusting for all potential confounding factors.

RESULTS

Our study found that 230 (31.94%) of the participants had cognitive impairment and 97 (13.47%) of the participants had sarcopenia. The mean social support score was 35.10 ± 7.54. Besides, the results showed that cognitive impairment was associated with sarcopenia (OR:1.650, 95% CI: 1.048, 2.596, P=0.030) after adjusting for confounding factors. Older adults with high level social support had the lowest risk of cognitive impairment (OR: 0.297, 95% CI: 0.115, 0.680, P=0.021) and sarcopenia (OR: 0.113, 95% CI: 0.031, 0.407, P=0.001), respectively.

CONCLUSION

Our analysis revealed that high level social support was negatively associated with sarcopenia and cognitive impairment. These findings provide strong support for the health promotion effect of social networks against sarcopenia and cognitive impairment in Chinese community-dwelling older adults, with important implications for healthcare policy makers.

[Changes of the World Health Organization 2022 classification (5th edition) of salivary glands tumors]

Pathological diagnosis of salivary gland tumors is one of the most challenging areas in all head and neck surgical pathology. The classification of salivary gland tumors was updated in the 5th edition of the World Health Organization Classification of Head and Neck Tumours, most of which were based on their molecular pathological characteristerics. This new classification features a description of several new entitiesamong benign and malignant neoplasms, salivary gland tumors with updated naming or diagnostic criteria, and lesions deleted from this section, etc.This present review focuses on the updates and changes in the new classification of salivary gland tumors, and provides some reference for head and neck surgeons and pathologists.

Activation of PI3K/Akt prevents hypoxia/reoxygenation-induced GnRH decline via FOXO3a

Recent studies have suggested that the hypothalamus has an important role in aging by regulating nuclear factor-κB (NF-κB)-directed gonadotropin-releasing hormone (GnRH) decline. Moreover, our previous study has shown that ischemia-reperfusion (IR) injury activates NF-κB to reduce hypothalamic GnRH release, thus suggesting that IR injury may facilitate hypothalamic programming of system aging. In this study, we further examined the role of phosphoinositide 3-kinase (PI3K)/Protein kinase B (Akt) pathway, a critical intracellular signal pathway involved in the repair process after IR, in hypoxia-reoxygenation (HR)-associated GnRH decline in vitro. We used GT1-7 cells and primarily-cultured mouse GnRH neurons as cell models for investigation. Our data revealed that the activation of the PI3K/Akt/Forkhead box protein O3a (FOXO3a) pathway protects GnRH neurons from HR-induced GnRH decline by preventing HR-induced gnrh1 gene inhibition and NF-κB activation. Our results further the understanding of the regulatory mechanisms of HR-associated hypothalamic GnRH decline.

OP0113 FUNCTIONAL GENOMICS IN PRIMARY T CELLS AND MONOCYTES IDENTIFIES MECHANISMS BY WHICH GENETIC SUSCEPTIBILITY LOCI INFLUENCE SYSTEMIC SCLEROSIS RISK

Background

Systemic sclerosis (SSc) is a complex autoimmune disease with a strong genetic component. However, the underlying mechanism by which genetics increase disease risk is still unknown. The most recent GWAS studies have identified 27 independent signals associated to SSc [1]. However, the majority of these signals affect regulatory elements that can regulate genes often located hundreds of kilobases away.

The challenge in the post-GWAS era is to use functional genomics to translate genetic findings into patients’ benefit, particularly in disease-relevant cell types.

Objectives

In this study we use chromatin conformation and gene expression analysis in patient derived primary cells and healthy individuals to assess potential mechanisms by which GWAS variants increase disease risk. We identify the potentially affected genes in a cell type specific manner and potential drug targets already in use or with potential for re-purposing.

Methods

Promoter capture Hi-C (pCHi-C) and RNA sequencing experiments were performed in a total of 15 CD4+ T cells and CD14+ monocytes samples each isolated from peripheral blood from SSc patients and healthy controls. We linked SSc-associated variants with their target genes and performed differential expression and differential interaction analyses between both cell types. Potential drug targets were identified using a protein-protein interaction model and queried against the OpenTargets database.

Results

We linked SSc-associated loci to 39 new potential target genes, confirming 7 previously assigned genes. We highlight novel causal genes, such as CXCR5 as the most probable candidate gene for the DDX6 locus (Figure 1). We confirm some previously linked SSc genes such as IRF8, STAT4, or CD247 which interestingly showed cell type specific interactions. We also identified 15 potential drug targets already in use in other similar immune-mediated diseases that could be repurposed for SSc treatment. Furthermore, we observed that interactions are directly related with the expression of important genes implicated in cell type specific pathways.

Figure 1.

Promoter Capture Hi-C interactions linking the DDX6 GWAS loci with the promoter of CXCR5 in CD4+ T cells and CD14+ monocytes. CD4+ T cells show significantly stronger interactions as well as CXCR5 gene expression.

Conclusion

Our study reveals potential causal genes for SSc-associated loci, some of them acting in a cell type specific manner, suggesting novel drug targets and biological mechanisms that may mediate SSc pathogenesis.

References

[1]López-Isac E, Acosta-Herrera M, Kerick M, et al (2019) GWAS for systemic sclerosis identifies multiple risk loci and highlights fibrotic and vasculopathy pathways. Nat Commun 10:. https://doi.org/10.1038/s41467-019-12760-y

Acknowledgements

This work was supported by the Spanish Ministry of Science and Innovation (grants RTI2018101332-B-100 and SAF2015-66761-P), the Cooperative Research Thematic Network (RETICS) programme (RD16/0012/0013) (RIER) from Instituto de Salud Carlos III (ISCIII, Spanish Ministry of Economy, Industry and Competitiveness), the Wellcome Trust (award references 207491/Z/17/Z and 215207/Z/19/Z), Versus Arthritis (award reference 21754), and the NIHR Manchester Biomedical Research Centre. DGS was supported by the Spanish Ministry of Economy and Competitiveness through the FPI programme (SAF2015-66761-P).

Disclosure of Interests

None declared

POS0035 GENE REGULATION IN T-CELLS FROM PsA PATIENTS DIFFERS BETWEEN PERIPHERAL BLOOD AND THE INFLAMED JOINTS: IMPLICATIONS FOR THE INTERPRETATION OF GWAS SIGNALS

Background

Genome-wide association studies (GWAS) have identified variants that are associated with complex diseases such as Psoriatic Arthritis (PsA). The majority of these variants do not affect the coding sequence of proteins but rather regulatory elements which are highly cell type and state specific, and can affect distally located genes via chromatin interaction mechanisms.

We and others have previously analysed GWAS loci for multiple conditions (including PsA and Rheumatoid Arthrtitis) in cell lines using functional genomics techniques, providing putative mechanisms to many loci with previously unknown function [1].

However, multiple studies have identified large differences in gene regulatory mechanisms between cell lines and primary cells, which could significantly alter the proposed mechanisms. Differences between between samples from healthy volunteers and patients, in particular from the affected tissue, have although not been exhaustively investigated.

Objectives

To assess the impact of using primary cells derived from PsA patients compared to healthy volunteers in functional genomics studies.

Methods

CD4+ and CD8+ T cells were isolated from peripherial blood from 10 healthy controls and 48 PsA patients and from 6 PsA synovial fluid samples.

We performed RNA-seq and ATAC-seq on these two cell types to analyse the global patterns of gene expression and chromatin activity.

Results

We find subtle differences between PsA patients and healthy controls in cells isolated from blood. RNA-seq analysis identified only a handful of differentially expressed genes whilst ATAC-seq analysis identified only 28 differential loci.

On the other hand, T cells isolated from synovial fluid showed significant differences compared to T cells isolated from patient’s blood. Interestingly, we find that CD4+ T cells show substantially more differentially expressed genes compared to CD8+ T cells (1168 vs 346 Log2FoldChange > 1, FDR < 0.01). Genes overexpressed in synovial CD4+ T cells are more strongly enriched for immune pathways such as cytokine signaling and T cell proliferation compared to synovial CD8+ T cells

We also find that synovial CD4+ T cells highly overexpress MHC class II genes (Figure 1).

Figure 1.

Normalized counts of the alpha chains of MHC class 2 genes in CD4+ and CD8+ T cells purified from blood from healthy subjects and patients and synovial fluid.

Conclusion

This preliminary analysis suggests that T cells isolated from peripherial blood do not seem to differ significantly between PsA patients and healthy controls. In contrast, cells isolated from synovial fluid are highly specialized and activated. Moreover, these cells do not resemble canonically activated T cells which means that this state can not be easily emulated in vitro.

This study indicates the importance of not only studying GWAS loci in relevant primary cells from patients, but also that attention needs to be given to cells isolated from the affected site.

References

[1]Shi C, Ray-Jones H, Ding J, et al (2021) Chromatin Looping Links Target Genes with Genetic Risk Loci for Dermatological Traits. J Invest Dermatol 141:1975–1984. https://doi.org/10.1016/J.JID.2021.01.015

Acknowledgements

This work was funded by the Wellcome Trust (award references 207491/Z/17/Z and 215207/Z/19/Z), the Versus Arthritis (award reference 21754), the NIHR Manchester Biomedical Research Centre, and the Medical Research Council (award reference MR/N00017X/1).

Disclosure of Interests

None declared

OP0222 IDENTIFICATION OF CAUSAL GENES AND MECHANISMS BY WHICH GENETIC VARIATION MEDIATES JUVENILE IDIOPATHIC ARTHRITIS SUSCEPTIBILITY USING FUNCTIONAL GENOMICS AND CRISPR-CAS9

Background

We recently performed the largest juvenile idiopathic arthritis (JIA) genome-wide association study (GWAS) to date 1. Disease-associated loci contain multiple single nucleotide polymorphism (SNPs), and the majority map to non-coding enhancers, making it challenging to define causal variants and genes.

Functional genomics datasets in disease-relevant tissues have shown to be essential for the functional interpretation of GWAS loci. In particular, capture Hi-C (CHi-C) has been successful in detecting chromosomal interactions linking GWAS loci to their target genes. However, such datasets are lacking in JIA.

Objectives

The aim of this study is to bridge this gap and advance the knowledge of the biological mechanisms that underpin susceptibility to JIA, by integrating GWAS with public epigenomics datasets and in-house generated CHi-C from JIA patients. We focus on CD4+ T-cells, which have been shown to be one of the most relevant cell types in JIA. In addition, we use CRISPR-Cas9 to validate the regulatory effect of prioritised variants on their predicted target genes.

Methods

Credible SNP sets for the top JIA risk loci (P < 5x10-6) were annotated using EpiMap data 2. Low input whole genome promoter CHi-C (PCHi-C) was performed on CD4+ T-cells isolated from blood from 3 JIA oligoarthritis patients, and data was analysed using CHiCAGO 3. GWAS and PCHi-C data were combined to prioritise causal genes using the Capture Hi-C Omnibus Gene Score (COGS) pipeline 4. We subsequently employed CRISPR activation (CRISPRa) and CRISPR interference (CRISPRi) in Jurkats to assess whether prioritized JIA variants were capable of regulating the expression of the interacting genes.

Results

614 credible SNPs (out of 735) were found to overlap active enhancers in CD4+ T-cells, and were prioritized for further analysis.

We identified numerous significant chromatin interactions in 19 out of 44 non-MHC JIA associated loci, linking JIA SNPs mapping to T-cell enhancers to a total of 61 target genes and revealing potential novel disease pathways. Moreover, COGS prioritised a total of 7 genes (RGS14, ERAP2, HIPK1, CCR4, CCRL2, CCR2, CCR3).

A JIA associated locus on chromosome 3 contains 39 SNPs. It maps to an intergenic region and the causal gene/s are unclear. Our PCHi-C data revealed that this JIA locus presents chromatin interactions with the promoters of several genes, such as CCRL2, CCR2, CCR3 and CCR5, three of which were prioritised by COGS. Two variants were selected for further analysis: rs79815064, which had the highest posterior probability, and rs8005404,the only variant within a CD4+ T-cell enhancer linked to surrounding gene activity.

When both SNPs were targeted with CRISPRa and CRISPRi, we observed an increased and decreased expression, respectively, of CCRL2, CCR2, CCR3 and CCR5, confirming their role in disease. These genes belong to the chemokine receptor family and are important regulators of the inflammatory response.

Conclusion

Our work shows how functional genomics can help identify biological mechanisms by which GWAS variants increase risk of JIA, which in turn will benefit patients through personalised medicine and the identification of therapeutic targets.

References

[1]López-Isac, E. et al. Combined genetic analysis of juvenile idiopathic arthritis clinical subtypes identifies novel risk loci, target genes and key regulatory mechanisms. Ann. Rheum. Dis.80, 321–328 (2021).

[2]Boix, C. A., James, B. T., Park, Y. P., Meuleman, W. & Kellis, M. Regulatory genomic circuitry of human disease loci by integrative epigenomics. Nat. 2021 5907845590, 300–307 (2021).

[3]Cairns, J. et al. CHiCAGO: Robust detection of DNA looping interactions in Capture Hi-C data. Genome Biol.17, 1–17 (2016).

[4]Javierre, B. M. et al. Lineage-Specific Genome Architecture Links Enhancers and Non-coding Disease Variants to Target Gene Promoters. Cell167, 1369 (2016).

Disclosure of Interests

Antonio Frantzesko: None declared, Valeriya Malysheva: None declared, Chenfu Shi: None declared, James Ding: None declared, John Bowes: None declared, Wendy Thomson: None declared, Stephen Eyre: None declared, Mikhail Spivakov Shareholder of: co-founder and shareholder of Enhanc3D Genomics Ltd, Gisela Orozco: None declared

A High Energy X-ray Diffraction Study of Amorphous Indomethacin

Amorphous pharmaceuticals often possess a wide range of molecular conformations and bonding arrangements. The x-ray pair distribution function (PDF) method is a powerful technique for the characterization of variations in both intra-molecular and inter-molecular packing arrangements. Here, the x-ray PDF of amorphous Indomethacin is shown to be particularly sensitive to the preferred orientations of the chlorobenzyl ring found in isomers in the crystalline state. In some cases, the chlorobenzyl ring has no preferred torsional angle in the amorphous form, while in others evidence of distinct isomer orientations are observed. Amorphous samples with no preferred torsion angles of the chlorobenzyl ring are found to favor enhanced inter-molecular hydrogen bonding, and this is reflected in the intensity of the first sharp diffraction peak. These significant variations in structure rule out amorphous Indomethacin as a possible standard for x-ray PDF measurements. At high humidity, time resolved PDF's for >40 h reveal water molecules forming hydrogen bonds with Indomethacin molecules. A simple linear hydrogen bond model indicates that water molecules in the wet amorphous form have similar hydrogen bond strengths to those found between Indomethacin dimers or chains in the dry amorphous form.

Syringa microphylla Diels: A comprehensive review of its phytochemical, pharmacological, pharmacokinetic, and toxicological characteristics and an investigation into its potential health benefits

BACKGROUND

Syringa microphylla Diels is a plant in the family Syringa Linn. For hundreds of years, its flowers and leaves have been used as a folk medicine for the treatment of cough, inflammation, colds, sore throat, acute hepatitis, chronic hepatitis, early liver cirrhosis, fatty liver, and oesophageal cancer.

PURPOSE

For the first time, we have comprehensively reviewed information on Syringa microphylla Diels that is not included in the Pharmacopoeia, clarified the pharmacological mechanisms of Syringa microphylla Diels and its active ingredients from a molecular biology perspective, compiled in vivo and in vitro animal experimental data and clinical data, and summarized the toxicology and pharmacokinetics of Syringa microphylla Diels. The progress in toxicology research is expected to provide a theoretical basis for the development of new drugs from Syringa microphylla Diels, a natural source of compounds that are potentially beneficial to human health.

METHODS

The PubMed, Google Scholar, China National Knowledge Infrastructure, Web of Science, SciFinder Scholar and Thomson Reuters databases were utilized to conduct a comprehensive search of published literature as of July 2021 to find original literature related to Syringa microphylla Diels and its active ingredients.

RESULTS

To date, 72 compounds have been isolated and identified from Syringa microphylla Diels, and oleuropein, verbascoside, isoacteoside, echinacoside, forsythoside B, and eleutheroside B are the main active components. These compounds have antioxidant, antibacterial, anti-inflammatory, and neuroprotective effects, and their safety and effectiveness have been demonstrated in long-term traditional applications. Molecular pharmacology experiments have indicated that the active ingredients of Syringa microphylla Diels exert their pharmacological effects in various ways, primarily by reducing oxidative stress damage via Nrf2/ARE pathway regulation, regulating inflammatory factors and inducing apoptosis through the MAPK and NF-κB pathways.

CONCLUSION

This comprehensive review of Syringa microphylla Diels provides new insights into the correlations among molecular mechanisms, the importance of toxicology and pharmacokinetics, and potential ways to address the limitations of current research. As Syringa microphylla Diels is a natural low-toxicity botanical medicine, it is worthy of development and utilization and is an excellent choice for treating various diseases.

[Value of the application of enhanced CT radiomics and machine learning in preoperative prediction of microvascular invasion in hepatocellular carcinoma]

Objective: To explore the value of machine learning models in preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on dual-phase contrast-enhanced CT radiomics features. Methods: The data of 148 patients [106 males and 42 females, with an average age of (58±11) years] with HCC confirmed by pathology in the First Affiliated Hospital of Soochow University from January 2015 to May 2020 were retrospectively analyzed, including 88 cases of positive MVI and 60 cases of negative MVI. According to the ratio of 7∶3, the patients were randomly divided into the training and validation sets, respectively. The three-dimensional (3D) radiomics features of HCC in arterial phase (AP) and portal venous phase (PP) were extracted by MaZda software, and the optimal feature subset was obtained by combining three feature selection methods (FPM method) and Lasso regression. Then, six machine learning methods were used to build the prediction models. Receiver operating characteristic (ROC) curves were drawn to evaluate the prediction ability of the aforementioned models, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated. Results: Radiomics features of HCC in AP and PP were extracted by MaZda software, with 239 in each phase. There were 7 optimal features in AP and 14 optimal features in PP selected by FPM method and Lasso regression, respectively. The AUCs of decision tree, extreme gradient boosting, random forest, support vector machine (SVM), generalized linear model, and neural network based on the 7 optimal features in AP in the validation set were 0.736, 0.910, 0.913, 0.915, 0.897, 0.648, respectively. The SVM had the highest AUC in the validation set, with the accuracy, sensitivity and specificity of 95.35%, 95.83% and 94.74%, respectively. Likewise, the AUCs of machine learning models in prediction of MVI in HCC based on the 14 optimal features in PP in the validation set were 0.873, 0.876, 0.913, 0.859, 0.877, 0.834, respectively, and there were no significant differences (all P>0.05). The random forest had the highest AUC in the validation set, with the accuracy, sensitivity and specificity of 90.70%, 87.50% and 94.74%, respectively. Conclusion: Machine learning models based on dual-phase enhanced CT radiomics features can be used in preoperative prediction of MVI in HCC, particularly the SVM and random forest models have high prediction efficiency.

LncRNA OTUD6B-AS1 inhibits many cellular processes in colorectal cancer by sponging miR-21-5p and regulating PNRC2

Accumulating evidence has revealed that long noncoding RNAs (lncRNAs) play essential roles in regulating cellular process of various cancers. There have been many studies on the biological functions of lncRNAs in colorectal cancer (CRC). In this research, we explored the role and mechanism of lncRNA ovarian tumor domain containing 6B antisense RNA1 (OTUD6B-AS1) in CRC. Here, we detected OTUD6B-AS1 expression in CRC tissues and cells by RT-qPCR. Functional experiments were performed to test alterations in different cellular processes. Moreover, to verify the binding ability among the indicated RNA molecules, we carried out RIP, RNA pull-down and luciferase reporter assays. According to our data, OTUD6B-AS1 expression was low in CRC tissues and cells. Functionally, overexpression of OTUD6B-AS1 inhibited cell proliferation, migration, invasion and EMT, and promoted cell apoptosis. Bioinformatic analysis and mechanistical experiments confirmed that OTUD6B-AS1 could act as a competitive endogenous RNA (ceRNA) to upregulate Proline-Rich Nuclear Receptor Coactivator 2 (PNRC2) expression by sequestering miR-21-5p. Further rescue experiments validated the inhibitory function of the OTUD6B-AS1/miR-21-5p/PNRC2 axis in cellular process of CRC. Overall, OTUD6B-AS1 inhibits cellular development in CRC by sponging miR-21-5p and upregulating PNRC2, providing a novel insight into the exploration on CRC treatment.

MiR-221 affects the proliferation and apoptosis of laryngeal cancer cells through the PI3K/AKT signaling pathway

OBJECTIVE

To investigate the effect of MiR-221 on proliferation and apoptosis of laryngeal carcinoma cells through the PI3K/AKT signaling pathway.

MATERIALS AND METHODS

LipofectamineTM 2000 liposomes were used to transfer MiR-221 analogue, MiR-221 NC into Hep-2 cells of laryngeal carcinoma. Real-time fluorescence quantitative polymerase chain reaction (PCR) method was used to detect the expression of MiR-221, MTT method was used to detect the proliferation of cells, flow cytometry was used to detect cell cycle, Western blotting was used to detect the expression of apoptosis proteinase-1 (Apaf-1) and cyclin-dependent kinase (CDK1, CDK2) protein and the activation of phosphatidylinositol 3 kinase (PI3K)/protein kinase B (AKT).

RESULTS

Compared with MiR-221 NC group, the expression of MiR-221 in MiR-221 analogue group was up-regulated (p<0.01), the cell proliferation rate was decreased (p<0.01), the cell cycle was stagnated in the G1 phase (p<0.01), the expression levels of Cyclin A, CDK1, CDK2, PI3K, and p-AKT were significantly down-regulated (p<0.01), and the expression levels of Bax and Apaf-1 were significantly up-regulated (p<0.01).

CONCLUSIONS

MiR-221 analogues can significantly inhibit the proliferation and induce apoptosis of Hep-2 cells in laryngeal cancer, and this is achieved by blocking the PI3K/AKT signaling pathway, which also indicates that MiR-221 affects the proliferation and apoptosis of laryngeal cancer cells through the PI3K/AKT signaling pathway.

Construction of porous carbon for the highly efficient visible light-driven degradation methyl violet

A series of nanoporous carbons (NPC) Fe-C/N-900 and C/N-900 have been synthesized from one-step carbonization of 5,10,15,20-tetrakis(4-carboxyphenyl)porphyrin-Fe (Fe-TCPP) and TCPP, respectively and employed as photocatalyst for the degradation of organic dye methyl violet (MV) under UV irradiation. The optimized Fe-C/N-900 (carbonized at 900 oC for 2 h) exhibited an optimal performance in MV degradation. The photodegradation capacity of Fe-C/N-900 has been observed to be higher than that of C/N-900. The photodegradation ability of Fe-C/N-900 as a function of initial MV concentration, catalysis dosage, and pH has been also investigated. The Fe-C/N-900 material showed no apparent loss in MV degradation after four cycles. These features reveal that Fe-C/N-900 may be a promising degradant for dyes removal from water.                     KEY WORDS: Photocatalysis, Nanoporous carbons, Methyl violet, carbonization   Bull. Chem. Soc. Ethiop. 2020, 34(2), 277-284 DOI: https://dx.doi.org/10.4314/bcse.v34i2.6

[A summary of China's 70 years of development in optometric technology]

Since the founding of the People's Republic of China, the optometric technology has developed rapidly. Our peers have created breakthroughs in the field exploration and technology evolution, which have made the optometric technology in China reach the highest level in the world. We review the development and driving force of optometric technology in our country. We would like to send congratulations on the 70th anniversary of Chinese Journal of Ophthalmology with this article. (Chin J Ophthalmol, 2020, 56:721-725).

Tumour biomarkers: association with heart failure outcomes

BACKGROUND

There is increasing recognition that heart failure (HF) and cancer are conditions with a number of shared characteristics.

OBJECTIVES

To explore the association between tumour biomarkers and HF outcomes.

METHODS

In 2,079 patients of BIOSTAT-CHF cohort, we measured six established tumour biomarkers: CA125, CA15-3, CA19-9, CEA, CYFRA 21-1 and AFP.

RESULTS

During a median follow-up of 21 months, 555 (27%) patients reached the primary end-point of all-cause mortality. CA125, CYFRA 21-1, CEA and CA19-9 levels were positively correlated with NT-proBNP quartiles (all P < 0.001, P for trend < 0.001) and were, respectively, associated with a hazard ratio of 1.17 (95% CI 1.12-1.23; P < 0.0001), 1.45 (95% CI 1.30-1.61; P < 0.0001), 1.19 (95% CI 1.09-1.30; P = 0.006) and 1.10 (95% CI 1.05-1.16; P < 0.001) for all-cause mortality after correction for BIOSTAT risk model (age, BUN, NT-proBNP, haemoglobin and beta blocker). All tumour biomarkers (except AFP) had significant associations with secondary end-points (composite of all-cause mortality and HF hospitalization, HF hospitalization, cardiovascular (CV) mortality and non-CV mortality). ROC curves showed the AUC of CYFRA 21-1 (0.64) had a noninferior AUC compared with NT-proBNP (0.68) for all-cause mortality (P = 0.08). A combination of CYFRA 21-1 and NT-proBNP (AUC = 0.71) improved the predictive value of the model for all-cause mortality (P = 0.0002 compared with NT-proBNP).

CONCLUSIONS

Several established tumour biomarkers showed independent associations with indices of severity of HF and independent prognostic value for HF outcomes. This demonstrates that pathophysiological pathways sensed by these tumour biomarkers are also dysregulated in HF.

Intracapsular carcinoma ex basal cell adenoma of the parotid gland

Malignant transformation of basal cell adenoma is extremely rare. We report the case of a 63-year-old Chinese woman, who had noticed a slowing growing mass in her right parotid gland with slight pain for 1 month. Based on physical and ultrasound examinations, a diagnosis of benign salivary gland tumour was made before the surgery. A frozen biopsy was performed, and the diagnosis was basal cell adenoma, with the tumour cells infiltrating the capsule. Routine histopathological examination was performed after the surgery, and a final diagnosis of intracapsular basal cell adenocarcinoma ex basal cell adenoma was made. The patient received a further total parotidectomy and recovered well without any evidence of facial nerve palsy. This case suggests that during frozen biopsy, adequate sectioning including the capsule should be made. With regard to the treatment, we suggest a complete excision of the tumour with tumour-free margins, without any additional auxiliary therapy.

0638 Evaluation of an Oral Drug Pyridostigmine Bromide in Patients with Mild to Moderate Obstructive Sleep Apnea

Introduction

A randomized, double-blind, cross-over, placebo-controlled clinical study with pyridostigmine bromide (PYD) in obstructive sleep apnea (OSA) patients ranging from mild to moderate disease was conducted to evaluate its clinical efficacy and safety.

Methods

Six diagnosed male patients with averages of age 48 yr (38 - 57 yr), BMI 28 (26 - 33), AHI 19.2 (15 - 26.2), minimum oxygen saturation (Min SaO2) 81% (75 - 87%) were enrolled to the study. The study consisted one-night acclimatization period followed immediately by a 2-night double-blind treatment period when subjects received either a single dose of PYD (a cholinesterase inhibitor, 90 mg) or placebo before sleep. Subjects were required to maintain in a supine position, and monitored by a standard polysomnography all the time. Sleep questionnaires (The SMH Sleep Questionnaire and ESS) were taken daily immediately after sleep and at the evening to evaluate the sleep satisfaction and the day-time quality, respectively. Safety of the drug was monitored and evaluated.

Results

Reductions of AHI (28.1%, p &lt; 0.01), apnea index (37.2%, p &lt; 0.05), % of total apnea/hypopnea time (36.4%, p &lt; 0.05) were observed in the treatment group compared with the placebo between 2-7 hours of sleep. Min SaO2 was increased, no change, or decreased by PYD in 3, 2, or 1 subject(s), respectively. PYD was generally well tolerated with minimum minor incidents. Subjects reported to have more satisfied sleep and more clear-headed in the treatment night, and more energy, more concentrated and less sleepy during the daytime following the treatment night.

Conclusion

This study demonstrated the initial effectiveness of the PYD treatment for OSA, indicating that it may provide a new treatment option if the efficacy can be maintained in a large-scale clinical trial.

Support

N/A

P3623Integrating depression and acute coronary syndrome care in low-resource hospitals in china: primary results from the I-Care randomised clinical trial

Background

Depression and acute coronary syndromes (ACS) are significant public health challenges. Patients with ACS often experience depression, which adversely affects prognosis. Low-cost, sustainable, and effective service models that integrate depression care into the management of ACS patients to reduce depression and improve ACS outcomes are critically needed.

Purpose

I-CARE study is a multi-center, randomised clinical trial (RCT) to evaluate the efficacy of an 11-month integrated care (IC) intervention compared to usual care (UC) in the management of ACS patients.

Methods

The I-CARE RCT was conducted between October 2014 and March 2018 in 16 rural Chinese hospitals. A total of 4041 patients with ACS were consecutively enrolled and randomly assigned in a 1:1 ratio to an IC intervention consisting of nurse-led risk factor management, group-based counseling supplemented by individual problem solving therapy and antidepressant medications as needed, or UC. The primary outcome was change in Patient Health Questionnaire-9 (PHQ-9) scores from baseline to 6 and 12 months. Secondary outcomes included incidence of major adverse events (MAEs) after discharge, quality of life (EQ5D), and adherence to ACS secondary prevention medications. Data analysis used a multilevel mixed-effects model with hospital-level and subject-level random-effect intercepts and hospital-level random slope incorporated to adjust for clustering effect. Primary analyses followed the intent-to-treat principle.

Results

The mean age of the patients was 61±10 years and 63% were men; however, only 3.3% were classified as depressed based upon a cutoff of ≥10 on the PHQ-9, and 26.9% had PHQ-9 scores between 5 to 9 at the baseline. There were no significant differences in patients' clinical characteristics between IC and UC groups. Changes in PHQ-9 scores from baseline to 6- and 12-months did not differ between treatment groups (−1.47 in IC group vs −1.40 in UC group; adjusted mean difference, −0.04; 95% CI, −0.17 to 0.08 at 6-months; −1.62 in IC group vs −1.54 in UC group; adjusted mean difference, −0.06; 95% CI: −0.19 to 0.06 at 12-months).The risk of MAEs after discharge between IC and UC groups also did not differ significantly (42.1% vs 43.1%; p=0.307).

Conclusions

Results from the I-CARE trial showed that a nurse-coordinated ACS and depression IC intervention did not reduce depression or improve clinical outcomes among patients with ACS compared to usual care controls. The low prevalence of depression was unexpected and may have minimized the potential added benefits of the IC intervention on depression and clinical outcomes compared to UC.

Acknowledgement/Funding

This study is supported by a grant from the National Institute of Mental Health (R01MH100332).

Identification of key pathways and genes changes in pancreatic cancer cells (BXPC-3) after cross-talk with primary pancreatic stellate cells using bioinformatics analysis

Pancreatic ductal adenocarcinoma (PDAC) is one of the most malignant tumors with poor prognosis, and the interaction between activated pancreatic stellate cells (PSCs) and PDAC cells plays an important role in the development of PDAC. The aim of this study was to identify gene changes in BXPC-3 after cross-talk with PSCs and reveal their potential mechanisms. The gene expression profiling analysis of BXPC-3 was completed after co-culture with primary PSCs for 48 h. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) enrichment analyses were performed, and the differentially expressed genes (DEGs) were identified by Agilent GeneSpring GX software. In total, 3657 DEGs were identified in BXPC-3, including 1881 up-regulated genes and 1776 downregulated genes. GO analysis results showed that upregulated DEGs were significantly enriched in biological processes (BP), including peptide metabolic process, response to stress and electron transport chain; the downregulated DEGs were significantly enriched in biological processes, including signaling, multicellular organism development and anatomical structure development. KEGG pathway analysis revealed that 19 pathways were upregulated and 32 pathways were downregulated, and that upregulated DEGs were enriched in protein export and glutathione metabolism, while the downregulated DEGs were enriched in axon guidance and focal adhesion. The top 10 upregulated genes and the top 10 downregulated genes were identified. By constructing PPI network, we selected out 10 key genes (TP53, SRC, IL6, JUN, ISG15, CAD, STAT1, OAS3, OAS1, VIM) and significant pathways. The associated survival analysis was performed and the SRC, IL-6, ISG15, STAT1, OAS3, OAS1 and VIM were proved to be related to worse overall survival time of PDAC patients. In conclusion, the present study indicated that the identified DEGs promote our understanding of the molecular mechanisms underlying the interaction between pancreatic cancer cells and PSCs and might be used as molecular targets in the future to study the role of tumor microenvironment in the progression of PDAC.