The complexity of glucose time series is associated with short- and long-term mortality in critically ill adults: a multi-center, prospective, observational study

BACKGROUND

The wealth of data taken from continuous glucose monitoring (CGM) remains to be fully used. We aimed to evaluate the relationship between a promising new CGM metric, complexity of glucose time series index (CGI), and mortality in critically ill patients.

METHODS

A total of 293 patients admitted to mixed medical/surgical intensive care units from 5 medical centers in Shanghai were prospectively included between May 2020 and November 2021. CGI was assessed using intermittently scanned CGM, with a median monitoring period of 12.0 days. Outcome measures included short- and long-term mortality.

RESULTS

During a median follow-up period of 1.7 years, a total of 139 (47.4%) deaths were identified, of which 73 (24.9%) occurred within the first 30 days after ICU admission, and 103 (35.2%) within 90 days. The multivariable-adjusted HRs for 30-day mortality across ascending tertiles of CGI were 1.00 (reference), 0.68 (95% CI 0.38-1.22) and 0.36 (95% CI 0.19-0.70), respectively. For per 1-SD increase in CGI, the risk of 30-day mortality was decreased by 51% (HR 0.49, 95% CI 0.35-0.69). Further adjustment for HbA1c, mean glucose during hospitalization and glucose variability partially attenuated these associations, although the link between CGI and 30-day mortality remained significant (per 1-SD increase: HR 0.57, 95% CI 0.40-0.83). Similar results were observed when 90-day mortality was considered as the outcome. Furthermore, CGI was also significantly and independently associated with long-term mortality (per 1-SD increase: HR 0.77, 95% CI 0.61-0.97).

CONCLUSIONS

In critically ill patients, CGI is significantly associated with short- and long-term mortality.

Behavioral and biochemical responses of the marine polychaete Perinereis aibuhitensis to 2-ethylhexyl-4-methoxycinnamate (EHMC) exposure

2-ethylhexyl-4-methoxycinnamate (EHMC) is a commonly used UV filter, and is receiving increasing concerns due to its ubiquitous occurrence in a variety of environmental media and potential adverse effects. This study was aimed to assess the ecotoxicological potentials of EHMC on the marine polychaete Perinereis aibuhitensis. To this end, ragworms were exposed to 2, 20, 200 μg/L EHMC for 14 days and multiple toxicological endpoints were investigated. The results showed that EHMC significantly reduced burrowing rate, but did not affect AChE activity. Exposure to EHMC significantly elevated the activities of SOD and CAT and decreased the levels of lipid peroxidation. Besides, the induction of AKP activity indicated a stimulated immune response in the ragworms when exposed to high concentration of EHMC. Furthermore, the upregulated expression of caspase-8 suggested that EHMC might induce apoptosis in ragworms via the death receptor-mediated extrinsic pathway. Our findings highlight the potential environmental risks of EHMC to marine ecosystems.

Uptake and toxicity of micro-/nanoplastics derived from naturally weathered disposable face masks in developing zebrafish: Impact of COVID-19 pandemic on aquatic life

The unprecedented proliferation of disposable face masks during the COVID-19 pandemic, coupled with their improper disposal, threatens to exacerbate the already concerning issue of plastic pollution. This study evaluates the role of environmentally weathered masks as potential sources of microplastics (MPs) and nanoplastics (NPs) and assesses their adverse impact on the early life stages of zebrafish. Experimental findings revealed that a single disposable mask could release approximately 1.79 × 109 particles, with nearly 70% measuring less than 1 μm, following 60 days of sunlight exposure and subsequent sand-induced physical abrasion. Remarkably, the MPs/NPs (MNPs) emanating from face masks have the potential to permeate the outer layer (chorion) of zebrafish embryos. Furthermore, due to their minute size, these particles can be consumed by the larvae's digestive system and subsequently circulated to other tissues, including the brain. Exposure to mask-derived MNPs at concentrations of 1 and 10 μg/L led to significant cases of developmental toxicity, incited oxidative stress, and prompted cell apoptosis. A subsequent metabolomics analysis indicated that the accumulation of these plastic particles perturbed metabolic functions in zebrafish larvae, primarily disrupting amino acid and lipid metabolism. The outcomes of this research underscore the accelerating possibility of environmental aging processes and physical abrasion in the release of MNPs from disposable face masks. Most importantly, these results shed light on the possible ecotoxicological risk posed by improperly disposed of face masks.

Environmentally relevant concentrations of tris (2-chloroethyl) phosphate (TCEP) induce hepatotoxicity in zebrafish (Danio rerio): a whole life-cycle assessment

Tris (2-chloroethyl) phosphate (TCEP), a typical organophosphate flame retardant, is of increasingly great concern considering their ubiquitous presence in aquatic environments and potential ecotoxicity. The present work was aimed to investigate the potential growth inhibition and hepatic stress induced by whole life-cycle exposure to TCEP (0.8, 4, 20 and 100 μg/L) in zebrafish. The results revealed that the body length, body mass and hepatic-somatic index (HSI) of zebrafish were significantly declined after exposure to TCEP for 120 days. GPx activity and GSH content were increased in the liver of zebrafish treated with low concentrations (0.8 and 4 μg/L) of TCEP, while exposure to high concentrations (20 and 100 μg/L) of TCEP reduced antioxidative capacity and elevated lipid peroxidation (LPO) levels. Gene transcription analysis demonstrated that the mRNA levels of nrf2 were altered in a similar manner to the transcription of the downstream genes nqo1 and hmox1, suggesting that Nrf2-Keap1 pathway mediated TCEP-induced oxidative stress in zebrafish liver. In addition, TCEP exposure might alleviate inflammatory response through down-regulating transcription of inflammatory cytokines (il-1β, il-6 and inos), and induce apoptosis via activating the p53-Bax pathway. Moreover, whole life-cycle exposure to TCEP caused a series of histopathological anomalies in zebrafish liver. Overall, our results revealed that lifetime exposure to environmentally relevant concentrations of TCEP could result in growth retardation and induce significant hepatotoxicity in zebrafish.

Life-cycle exposure to tris (2-chloroethyl) phosphate (TCEP) causes alterations in antioxidative status, ion regulation and histology of zebrafish gills

Tris (2-chloroethyl) phosphate (TCEP) has been receiving great concerns owing to its ubiquitous occurrence in various environmental compartments and potential risks to wildlife and humans. Gill is structural basis for ion regulation and homeostasis in fish and susceptible to xenobiotics. However, current knowledge on the impacts of long-term exposure to TCEP on the structure and physiological function of fish gills are insufficient. In this work, zebrafish were exposed to environmental realistic concentrations (0.8, 4, 20 and 100 μg/L) of TCEP from 3 h post ferterlization (hpf) till 120 days post ferterlization (dpf). Our results demonstrated that life-cycle exposure to TCEP significantly decreased the activity of glutathione S-transferase (GST), but elevated the activities of antioxidative enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and increased malondialdehyde (MDA) content in zebrafish gills. Gene transcription analysis implied that the mRNA expressions of antioxidant-related genes (nrf2, cat and nqo1) were induced, while the transcription of gstα1, hmox1, keap1 were down-regulated, indicating that Nrf2-Keap1 pathway might be activated to defend the oxidative stress induced by TCEP. Additionally, the ion homeostasis was disrupted by TCEP exposure, evidenced by reduced activities of Na+/K+-ATPase (NKA), Ca2+-ATPase and Mg2+-ATPase and downregulated transcription levels of ncc, nkcc, cftr and clc-3. Besides, whole-life exposure to TCEP resulted in a series of structural damages to gills, including epithelial lifting, epithelial rupture, telangiectasis, vacuolation, edema and shortened gill lamellae. Overall, our results demonstrated that long-term TCEP exposure could induce oxidative stress, affect ion regulation and cause histological changes in zebrafish gills.

[Association between different treatment timings and adverse neonatal outcomes in pregnant women with syphilis during pregnancy]

Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.

Impact of shift work on dementia: a systematic review and dose-response meta-analysis

OBJECTIVES

Although shift work has been reported as having a link to dementia, evidence remains inconsistent, and a comprehensive dose-response meta-analysis of the association is still lacking. We therefore conducted this meta-analysis to explore the association between shift work and the risk of dementia.

STUDY DESIGN

Systematic review and dose-response meta-analysis.

METHODS

PubMed, Embase, and Web of Science databases were systematically searched. Fixed or random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (95% CIs). Generalized least squares regression was used to estimate dose-response associations, and restricted cubic splines were used to examine possible linear or non-linear associations.

RESULTS

Five articles (10 studies) with 72,999 participants and 23,067 cases were eventually included in the meta-analysis. The summary RRs and 95% CIs of dementia risk with shift work and night shift work versus daytime work were 1.13 (95% CI: 1.05-1.21, I2 = 46.70%) and 1.13 (95% CI: 1.03-1.24, I2 = 9.20%), respectively. The risk of dementia increased by 1% (RR = 1.01, 95% CI: 1.01-1.02, I2 = 41.3%) with each 1-year increase in the duration of shift work. We found a non-linear dose-response association between the duration of shift work and the risk of dementia (Pnon-linearity = 0.006). Though the shape of the curve was steeper with the duration of shift work <7 years, the increase was more gradual after 7 years.

CONCLUSION

Our findings suggest that shift work may be a risk factor for future dementia and that controlling the length of shift work is a feasible measure that may contribute to prevent dementia.

A multibiomarker approach to assess the ecotoxicological effects of diclofenac on Asian clam Corbicula fluminea (O. F. Müller, 1774)

Diclofenac (DCF), one of the most current and widely used nonsteroidal anti-inflammatory drugs (NSAIDs), has been frequently detected in aquatic environments worldwide. However, the ecotoxicological effects of DCF on freshwater invertebrates remain largely unknown. In the present study, Corbicula fluminea were exposed to environmentally relevant concentrations of DCF (0, 2, 20, and 200 μg/L) for 28 days, and the potential adverse effects of DCF on siphoning behavior, antioxidant responses, and apoptosis were investigated. Our results showed that the siphon efficiencies of clams were significantly suppressed under DCF stress. DCF exerted neurotoxicity via reducing the activity of acetylcholinesterase (AChE) in gills and digestive gland of C. fluminea. Exposure to DCF induced antioxidant stress and increased malondialdehyde (MDA) levels in both gills and digestive gland of C. fluminea. Transcriptional alterations of apoptosis-related genes indicated that DCF might induce apoptosis by triggering mitochondrial apoptotic pathway. These findings can improve our understanding of the ecological risk of DCF in freshwater ecosystems.

Parental whole life-cycle exposure to tris (2-chloroethyl) phosphate (TCEP) disrupts embryonic development and thyroid system in zebrafish offspring

Tris (2-chloroethyl) phosphate (TCEP), an emerging environmental pollutant, has been frequently detected in natural waters. The objective of this study was to investigate possible parental transfer of TCEP and transgenerational effects on the early development and thyroid hormone homeostasis in F1 larvae following parental whole life-cycle exposure to TCEP. To this end, zebrafish (Danio rerio) embryos were exposed to environmentally relevant concentrations (0.8, 4, 20 and 100 μg/L) of TCEP for 120 days until sexual maturation. Parental exposure to TCEP resulted in significant levels of TCEP, developmental toxicity including decreased survival and final hatching rates, accelerated heart rate and elevated malformation rate, as well as induction of oxidative stress and cell apoptosis in F1 offspring. In F1 eggs, declined thyroxin (T4) levels were observed, consistent with those in plasma of F0 adult females, indicating the maternal transfer of thyroid endocrine disruption to the offspring. In addition, mRNA levels of several genes along the hypothalamic-pituitary-thyroid (HPT) axis were significantly modified in F1 larvae, which could be linked to transgenerational developmental toxicity and thyroid hormone disruption. For the first time, we revealed that the parental exposure to environmentally relevant levels of TCEP could cause developmental toxicity and thyroid endocrine disruption in subsequent unexposed generation.

Comparative transcriptome analysis reveals immunotoxicology induced by three organic UV filters in Manila clam (Ruditapes philippinarum)

Benzophenone-3 (BP-3), 4-methyl-benzylidene camphor (4-MBC) and 2-ethyl-hexyl-4-trimethoxycinnamate (EHMC) are commonly used organic ultraviolet (UV) filters and are frequently detected in water environments. In the present study, we studied the potential adverse impacts of UV filter exposures in Ruditapes philippinarum by investigating transcriptomic profiles and non-specific immune enzyme activities. Transcriptome analysis showed that more genes were differentially regulated in EHMC-treated group, and down-regulated genes (2009) were significantly more than up-regulated ones (410) at day 7. Function annotation revealed that pathways "immune system", "cell growth and death" and "infectious diseases" were significantly enriched. Generally, combined qPCR and biochemical analyses demonstrated that short-term exposure to low dose of UV filters could activate immune responses, whereas the immune system would be restrained after prolonged exposure. Taken together, the present study firstly demonstrated the immunotoxicology induced by BP-3, 4-MBC and EHMC on R. philippinarum, indicating their potential threats to the survival of marine bivalves.

Decreased Salinity Offsets the Stimulation of Elevated pCO2 on Photosynthesis and Synergistically Inhibits the Growth of Juvenile Sporophyte of Saccharina japonica (Laminariaceae, Phaeophyta)

The combined effect of elevated pCO₂ (Partial Pressure of Carbon Dioxide) and decreased salinity, which is mainly caused by freshwater input, on the growth and physiological traits of algae has been poorly assessed. In order to investigate their individual and interactive effects on the development of commercially farmed algae, the juvenile sporophytes of Saccharina japonica were cultivated under different levels of salinity (30, 25 and 20 psu) and pCO₂ (400 and 1000 µatm). Individually, decreased salinity significantly reduced the growth rate and pigments of S. japonica, indicating that the alga was low-salinity stressed. The maximum quantum yield, F_v/F_m, declined at low salinities independent of pCO₂, suggesting that the hyposalinity showed the main effect. Unexpectedly, the higher pCO₂ enhanced the maximum relative electron transport rate (rETR_max) but decreased the growth rate, pigments and soluble carbohydrates contents. This implies a decoupling between the photosynthesis and growth of this alga, which may be linked to an energetic reallocation among the different metabolic processes. Interactively and previously untested, the decreased salinity offset the improvement of rETR_max and aggravated the declines of growth rate and pigment content caused by the elevated pCO₂. These behaviors could be associated with the additionally decreased pH that was induced by the low salinity. Our data, therefore, unveils that the decreased salinity may increase the risks of future CO₂-induced ocean acidification on the production of S. japonica.

Andrographolide restored production performances and serum biochemical indexes and attenuated organs damage in Mycoplasma gallisepticum-infected broilers

1. This study aimed to study the preventive and therapeutic effects of andrographolide (Andro) during Mycoplasma gallisepticum HS strain (MG) infection in ArborAcres (AA) broilers.2. The minimum inhibitory concentration (MIC) of Andro against MG was measured. Broiler body weight, feed efficiency, morbidity, cure rate and mortality were recorded during the experiment. Air sac lesion scores and immune organ index were calculated. Expression of pMGA1.2 in lung tissue and serum biochemical indices were examined. Histopathological examinations of immune organs, liver, trachea and lung tissue were conducted by Haematoxylin and Eosin stain.3. MIC was 3.75 μg/mL and Andro significantly inhibited the expression of pMGA1.2 (P ≤ 0.05). Compared with control MG-infected group, Andro low-dose and high-dose prevention reduced the morbidity of chronic respiratory disease in 40.00% and 50.00%, respectively. Mortality of C, D and E group was 16.67%, 10.00% and 6.67%, respectively. Cure rate of E, F, G and H group was 92.00%, 92.86%, 93.33% and 100.0%, respectively. Compared with control MG-infected group, Andro treatment significantly increased average weight gain (AWG), relative weight gain rate (RWG) and feed conversion rate (FCR) at 18 to 24 days (P ≤ 0.05). Compared with control group, Andro alone treatment significantly increased AWG in broilers (P ≤ 0.05).4. Compared with control MG-infected group, Andro significantly attenuated MG-induced air sac lesion, immune organs, liver, trachea and lung damage in broilers. Andro alone treatment did not induce abnormal morphological changes in these organs in healthy broilers. Serum biochemical analysis results showed, comparing with control MG-infected group, Andro significantly decreased the content of total protein, albumin, globulin, alanine aminotransferase, aspartate aminotransferase, total bilirubin, urea, creatinine, uric acid, total cholesterol, and increased the albumin/globulin ratio and content of alkaline phosphatase, apolipoprotein B and apolipoprotein A-I in a dose-dependent manner (P ≤ 0.05).5. Andro could act as a potential agent against MG infection in broilers.

The physiological, biochemical and transcriptional responses to sulfamethoxazole in the Asian clam, Corbicula fluminea (O. F. Müller, 1774)

Sulfamethoxazole (SMX), a broad-spectrum antibiotic, has been widely used in the treatment and prevention of infection caused by bacteria in recent years. The present study was aimed to evaluate the response mechanisms to SMX stress in gills and digestive gland of Corbicula fluminea (O. F. Müller, 1774). To this end, clams were exposed to environmentally relevant concentrations of SMX (0, 1, 10 and 100 μg/L) for 7 and 28 days, and siphon behavior, tissue-specific enzymatic and transcriptional changes were assayed. Our results showed that exposure to SMX significantly suppressed filtration rate and acetylcholinesterase (AChE) activity, activated antioxidant defense system and elevated transcription of several genes related to cell apoptosis in gills and digestive gland of clams. In general, SMX at environmentally relevant concentrations exhibited a negative impact on siphon behavior and induced neurotoxicology, oxidative stress and cell apoptosis in C. fluminea. The current study will help broaden our understanding of the ecotoxicity of SMX on freshwater bivalves.

OS10.7.A Activation of the CCR8-ACP5 axis by human microglia/macrophage derived CCL18 promotes glioma growth

Background

Glioblastoma multiforme is a highly malignant primary brain tumor with an average survival of 14 months and very limited therapeutic options. Glioma associated microglia and macrophages (GAMs) foster tumor growth by releasing several cytokines, which have only partly been identified. Here, we studied the chemokine (C-C motif) ligand 18 (CCL18), a chemokine which is only expressed in human, but not rodent GAMs, in a novel ex-vivo brain slice model including transplantation of human induced pluripotent stem cells (iPSC) derived human microglia (iMGL) and human glioma cells in to murine brain slices, which had been depleted of intrinsic murine microglia before.

Material and Methods

After establishing the humanized ex-vivo brain slice model, we performed immunohistochemical analysis (IHC) of growth and invasiveness, qrtPCR on glioma cells isolated by magnetic-activated cell sorting (MACS), functional assays measuring invasiveness, proliferation, migration and colony formation of glioma cells in vitro and in slice experiments. Corresponding studies on tumor growth and invasiveness were performed after treatment with a CCL18 neutralizing antibody, a CCR8 neutralizing antibodies and knockdown of CCR8, ACP5 (Acid Phosphatase 5) and PITPNM3 with small interfering RNA (siRNA) and short hairpin RNA (shRNA). QrtPCR, IHC and Westernblot analysis were performed on primary glioma specimens. We also conducted bioinformatic analyses, based on the TCGA GBM, GLIOVIS and GEPIA databases.

Results

We observed that CCL18 was highly expressed in GAMs, whereas CCR8 was only expressed in glioma cells. We identified the chemokine (C-C motif) receptor 8 (CCR8) as a functional receptor for CCL18 and ACP5 as an important down-stream signaling component in glioma cells. Activation of the CCL18/CCR8/ACP5 signaling pathway in human glioblastoma was associated with enhanced tumor growth and invasiveness.

Conclusion

GAMs derived CCL18 promoted glioma growth by activation of the CCR8/ACP5 axis in human glioma cells and therefore is a potential therapeutic target.

Exposure to diclofenac alters thyroid hormone levels and transcription of genes involved in the hypothalamic-pituitary-thyroid axis in zebrafish embryos/larvae

Diclofenac (DCF), one of typical non-steroidal anti-inflammatory drugs (NSAIDs), has been frequently detected in various environmental media. Nevertheless，the potential endocrine disrupting effects of DCF on fish were poorly understood. In the present study, zebrafish embryos/larvae were used as a model to evaluate the adverse effects of DCF on development and thyroid system. The results demonstrated that DCF only significantly decreased the heart rate at 72 h post-fertilization (hpf), exhibiting limited influence on the embryonic development of zebrafish. Treatment with DCF significantly reduced whole-body thyroxine (T4) levels, and changed transcriptional levels of several genes related to the hypothalamic-pituitary-thyroid (HPT) axis. These findings provide important information regarding to the mechanisms of DCF-induced developmental toxicity and thyroid disruption in fish.

Insights into the mechanisms of tris(2-chloroethyl) phosphate-induced growth inhibition in juvenile yellow catfish Pelteobagrus fulvidraco

With the gradual elimination of brominated flame retardants (BFRs), the production and application of tris (2-chloroethyl) phosphate (TCEP), as a substitute of BFRs, has increased greatly. The objective of the present study was to comprehensively explore the potential adverse effects of TCEP on fish growth and the possible underlying mechanisms. To this end, juvenile yellow catfish (Pelteobagrus fulvidraco) were exposed to environmentally relevant concentrations of TCEP (0, 1, 10 and 100 µg/L) for 30 days. The results showed that exposure to high concentrations of TCEP (10 and 100 µg/L) significantly decreased body weight, body length and specific growth rate (SGR). Plasma IGF-I levels and hepatic mRNA levels of igf1 and igf1r were all reduced, while the transcriptional levels of IGFBPs (igfbp2, igfbp3, igfbp5) were significantly up-regulated in the liver of yellow catfish under exposure to 10 and 100 µg/L TCEP. TCEP-induced growth inhibition might be related to somatostatin (SS) signaling system, as evidenced by elevated mRNA transcriptions of ss in brain and its receptors (sstr2, sstr3, sstr5) in liver. In addition, fish exposed to high concentrations of TCEP displayed multiple histological alterations in liver. Taken together, these findings suggested that TCEP (>10 µg/L) might exert its inhibitory effect on fish growth through interfering with the GH/IGF axis and SS signaling system, and by impairing hepatic structures.

AB0058 SERUM ANTIGENOME PROFILING REVEALS DIAGNOSTIC MODELS FOR RHEUMATOID ARTHRITIS

Background

Rheumatoid arthritis (RA) is a chronic autoimmune disease that leads to joint damage, systemic inflammation and early mortality. Though the precise molecular mechanism in the triggering immune response are not fully understood, the emergence of antibodies against self-antigens can serve as diagnostic biomarker. Multiple antigens have been confirmed. However, the profiling of serum antigen, antigenome, remains poorly known.

Objectives

The study aimed to investigate the serum antigenomic profiling and determine potential diagnostic biomarkers using label-free proteomic technology implemented with machine-learning algorithm.

Methods

We captured serum antigens from a cohort consisting of 60 RA patients (45 ACPA-positive RA patients and 15 ACPA-negative RA patients), sex- and age-matched 30 osteoarthritis patients and 30 healthy controls. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed. We then trained a machine learning model to classify RA, ACPA-positive RA and ACPA-negative RA based on proteomic data and validated in the cohort.

Results

We identified 62, 71 and 49 differentially expressed proteins (DEPs) in RA, ACPA-positive RA and ACPA-negative RA respectively, compared to OA and healthy controls. Among these DEPs, the pathway enrichment analysis and protein-protein interactions networks were conducted. Three panels were constructed to classify RA, ACPA-positive RA and ACPA-negative RA using random forest models algorithm based on the molecular signature of DEPs, whose area under curve (AUC) were calculated as 0.9949 (95% CI = 0.9792-1), 0.9913 (95%CI = 0.9653-1) and 1.0 (95% CI = 1-1).

Conclusion

This study presented serum antigen profiling of RA. Among them, three panels of antigens were identified to classify RA, ACPA-positive and ACPA-negative RA patients as diagnostic biomarkers.

References

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[3]Kampstra ASB, Dekkers JS, Volkov M, Dorjée AL, Hafkenscheid L, Kempers AC, et al. Different classes of anti-modified protein antibodies are induced on exposure to antigens expressing only one type of modification. Ann Rheum Dis. (2019) 78: 908-16. doi: 10.1136/annrheumdis-2018-214950

[4]Liao W, Li Z, Li T, Zhang Q, Zhang H, Wang X. Proteomic analysis of synovial fluid in osteoarthritis using swath‑mass spectrometry. Mol Med Rep. (2018) 17: 2827-36. doi: 10.3892/mmr.2017.8250

[5]Peffers MJ, Smagul A, Anderson JR. Proteomic analysis of synovial fluid: current and potential uses to improve clinical outcomes. Expert Rev Proteomic. (2019) 16: 287-302. doi:10.1080/14789450.2019.1578214

[6]Swan AL, Mobasheri A, Allaway D, Liddell S, Bacardit J. Application of machine learning to proteomics data: classification and biomarker identification in postgenomics biology. Omics: a journal of integrative biology. (2013) 17: 595-610. doi: 10.1089/omi.2013.0017

[7]Mahler M, Martinez-Prat L, Sparks JA, Deane KD. Precision medicine in the care of rheumatoid arthritis: focus on prediction and prevention of future clinically-apparent disease. Autoimmun Rev. (2020) 19: 102506. doi: 10.1016/j.autrev.2020.102506

[8]Mun S, Lee J, Park A, Kim HJ, Lee YJ, Son H, et al. Proteomics approach for the discovery of rheumatoid arthritis biomarkers using mass spectrometry. Int J Mol Sci. (2019) 20. doi: 10.3390/ijms20184368

[9]Li K, Mo W, Wu L, Wu X, Luo C, Xiao X, et al. Novel autoantibodies identified in acpa-negative rheumatoid arthritis. Ann Rheum Dis. (2021). doi: 10.1136/annrheumdis-2020-218460

Figure 1.

Study overview and antigenome characterization

Disclosure of Interests

None declared

Adherence to antihypertensive medication and cardiovascular disease events in hypertensive patients: a dose-response meta-analysis of 2 769 700 participants in cohort study

BACKGROUND

Recently, many studies have investigated the association between adherence to antihypertensive medication (AHM) and risk of cardiovascular disease (CVD) events for hypertensive patients; however, the results varied by different studies.

AIMS

The purpose of our meta-analysis was to explore the comprehensively summarized association between AHM adherence and risk of CVD events in hypertensive patients from cohort studies.

DESIGN

A dose-response meta-analysis.

METHODS AND RESULTS

We conducted a systematic search in two databases (PubMed and Embase) from 1974 to 15 December 2019 to identify English-language reports that assessed the association of AHM adherence with risk of CVD events in cohort studies. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated by using a fixed- or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear association.

RESULTS

We included 16 cohort studies with 2 769 700 participants in the present meta-analysis. The pooled RR of CVD events was 0.66 (95% CI, 0.56-0.78, I2 = 98.6%) for the highest versus lowest AHM adherence categories. We found a linear dose-response association of AHM adherence and CVD events (Pnonlinearity = 0.887), each 20% increase in AHM adherence was associated with a 13% reduced risk of CVD events (RR 0.87, 95% CI 0.83-0.92, I2 = 98.2%) in hypertensive patients.

CONCLUSION

High AHM adherence has a protective effect on CVD events for hypertensive patients, and improving medication adherence may provide long-term CVD benefits.

Association between Sedentary Time and 6-Year All-Cause Mortality in Adults: The Rural Chinese Cohort Study

OBJECTIVES

This study aims to prospectively explore the association between sedentary time and the risk of all-cause mortality in adults based on a cohort from rural areas of China.

METHODS

The study population included 20,194 adults at baseline (2007-2008) who participated in the Rural Chinese Cohort Study. Cox's proportional hazard regression model was used to analyze the hazard ratios (HRs) and 95% confidence intervals (CIs) of sedentary time and all-cause mortality, and a restricted cubic spline was used to model the dose-response relation. We also carried out a series of sensitivity analyses to verify the robustness of our main results.

RESULTS

The median follow-up duration was 6 years, with a total of 17,265 participants (response rate 85.5%) followed up, and 1,106 deaths observed. Data for 17,048 participants were analyzed, with the mean age of participants being 52.00. Compared with sedentary time <4 h/day group, the risk of all-cause mortality was significantly increased in the 8-11 h/day (HR=1.27, 95%CI:1.03-1.56) and ≥11 h/day groups (HR=1.48, 95%CI:1.20-1.84). With increases in sedentary time, the risk of all-cause mortality increased gradually (Ptrend <0.001). For each 1 h/day increase in sedentary time, the risk of all-cause mortality increased by 3% (HR=1.03, 95%CI: 1.01-1.05). Sensitivity analyses showed our main results were consistent.

CONCLUSIONS

Prolonged sedentary time increases the risk of all-cause mortality in the adult rural Chinese population. Reducing sedentary time may have important implications for reducing mortality risk.

Integrating genome-wide association and transcriptome prediction model identifies novel target genes for osteoporosis

In this study, we integrated large-scale GWAS summary data and used the predicted transcriptome-wide association study method to discover novel genes associated with osteoporosis. We identified 204 candidate genes, which provide novel clues for understanding the genetic mechanism of osteoporosis and indicate potential therapeutic targets.

INTRODUCTION

Osteoporosis is a highly polygenetic disease characterized by low bone mass and deterioration of the bone microarchitecture. Our objective was to discover novel candidate genes associated with osteoporosis.

METHODS

To identify potential causal genes of the associated loci, we investigated trait-gene expression associations using the transcriptome-wide association study (TWAS) method. This method directly imputes gene expression effects from genome-wide association study (GWAS) data using a statistical prediction model trained on GTEx reference transcriptome data. We then performed a colocalization analysis to evaluate the posterior probability of biological patterns: associations characterized by a single causal variant or multiple distinct causal variants. Finally, a functional enrichment analysis of gene sets was performed using the VarElect and CluePedia tools, which assess the causal relationships between genes and a disease and search for potential gene's functional pathways. The osteoporosis-associated genes were further confirmed based on the differentially expressed genes profiled from mRNA expression data of bone tissue.

RESULTS

Our analysis identified 204 candidate genes, including 154 genes that have been previously associated with osteoporosis, 50 genes that have not been previously discovered. A biological function analysis found that 20 of the candidate genes were directly associated with osteoporosis. Further analysis of multiple gene expression profiles showed that 15 genes were differentially expressed in patients with osteoporosis. Among these, SLC11A2, MAP2K5, NFATC4, and HSP90B1 were enriched in four pathways, namely, mineral absorption pathway, MAPK signaling pathway, Wnt signaling pathway, and PI3K-Akt signaling pathway, which indicates a causal relationship with the occurrence of osteoporosis.

CONCLUSIONS

We demonstrated that transcriptome fine-mapping identifies more osteoporosis-related genes and provides key insight into the development of novel targeted therapeutics for the treatment of osteoporosis.

Effects of long-term cadmium exposure on growth, antioxidant defense and DNA methylation in juvenile Nile tilapia (Oreochromis niloticus)

Cadmium (Cd) is a ubiquitous environmental contaminant, posing serious threats to aquatic organisms. The aims of the present study were to investigate the effects of long-term Cd exposure on the growth, GH/IGF axis, antioxidant defense and DNA methylation in juvenile Nile tilapia (Oreochromis niloticus). To this end, juvenile Nile tilapia were exposed to 0, 10 and 50 µg∙L^-1 Cd for 45 and 90 days. The obtained results revealed that exposure to high concentrations of Cd significantly decreased body mass and body length, and down-regulated mRNA levels of GHRs, IGF-I and IGF-II in the liver of Nile tilapia. Cd exposure induced oxidative stress including the reduction of antioxidant activities and increases of malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) contents. Beside, the global DNA methylation levels significantly decreased with increasing Cd concentration and exposure time, which might result from increased oxidative DNA damage, the down-regulated expression of DNMT3a and DNMT3b and up-regulated expression of TET1 and TET2. In conclusion, long-term Cd exposure could inhibit growth, reduce antioxidant capacity and lead to oxidative damages to lipid and DNA, and decrease global DNA methylation level in juvenile Nile tilapia.

Effects of tris (2-chloroethyl) phosphate (TCEP) on survival, growth, histological changes and gene expressions in juvenile yellow catfish Pelteobagrus fulvidraco

Tris (2-chloroethyl) phosphate (TCEP) is an emerging aquatic environmental pollutant. In the present study, juvenile yellow catfish (Pelteobagrus fulvidraco) were exposed to environmentally relevant concentrations of TCEP for 30 days. The results showed that TCEP exposure decreased the survival rate (100 μg/L), body weight (10 and 100 μg/L) and specific growth rate (10 and 100 μg/L) of juvenile yellow catfish. Exposure to TCEP resulted in pronounced damages of gill structures. Gene transcription analysis showed that the antioxidant capacity of the liver and gills was affected; CYP1A1 might contribute to phase I metabolism of TCEP in the liver rather than CYP1B1; TCEP stress might increase the demand of ion transport in fish gill; TCEP could stimulate the immune response and might induce apoptosis via a p53-Bax pathway and caspase-dependent pathway in gills. Collectively, these findings provide new insights into the toxic effects of TCEP on fish.

P16.05 Implementation of a novel ex-vivo brain slice model to study human glioblastoma and glioma-associated microglia

BACKGROUND

Glioblastoma multiforme is a highly malignant brain tumor with a devastating prognosis. Resection followed by radio-chemotherapy leads to an overall survival of only 15 months. Up to 40% of the tumor mass consist of tumor-associated microglia and macrophages (TAMs). These cells were shown to promote tumor growth and invasiveness in many murine glioma models. The interaction between TAMs and tumor cells is crucial for tumor progression and includes several known pathways. Still, murine glioma models only partially mirror the human tumor microenvironment. Several known genes, which are highly upregulated in human glioma and TAMs are only expressed in human tissue and not in mice. To further investigate some of these genes, we aimed at establishing a humanized ex-vivo brain slice model, in which human TAMs and human glioma cells can be studied in a standardized manner.

MATERIAL AND METHODS

We used 250 micrometer thick murine brain slices, which were depleted of intrinsic microglia by applying clodoronated liposomes. Next, we inoculated human glioma cells (originating from the cell lines mCherryU87, mCherryU251MG, mCherryLN229 and several patient derived cells lines) with or without human microglia derived from induced pluripotent stem cells (iPSCs). Slices were cultivated for 7 to 14 days. Next, we performed a detailed analysis of microglia morphology (sphericity, cell body volume, process length and branching pattern) and tumor volume.

RESULTS

Clodronation efficacy was high, depending on duration of treatment and length of cultivation. iPSCs and tumor cells integrated into the slice very well. The presence of tumor cells led to an increased sphericity of iPSC-dervied microglia and to an increased cell body volume. Branching pattern and process length did not differ between both conditions. Tumor volume was significantly larger when iPSC-derived microglia were present. This was found in various glioma cells lines and also in patient derived cells.

CONCLUSION

The newly established humanized ex-vivo brain slice system was shown to be feasible. The method successfully allows to study the interaction between human TAMs and tumor cells. Microglia foster tumor growth not only in murine glioma models, but also in a human paradigm. The humanized ex-vivo brain slice model therefore is the optimal basis to study the role human-specific genes in TAM-glioma interaction.

Adherence to antihypertensive medications for secondary prevention of cardiovascular disease events: a dose-response meta-analysis

OBJECTIVES

The aim of the study was to explore the association between adherence to antihypertensive medications (AHMs) and the risk of recurrence of cardiovascular disease (CVD) events in patients with a history of CVD events from cohort studies.

STUDY DESIGN

This is a dose-response meta-analysis.

METHODS

PubMed and Embase databases were searched up to March 4, 2021, to identify English-language reports of cohort studies that assessed the association of AHM adherence with risk of recurrence of CVD events. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated by using a fixed- or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear association.

RESULTS

We included nine cohort studies (54,349 patients) in the present meta-analysis. The pooled RR of CVD events was 0.66 (95% CI, 0.54-0.78) for the highest versus lowest AHM adherence category. We did not find any evidence of non-linearity association between AHM adherence and risk of CVD events (P_{non-linearity} = 0.534); for patients with a history of CVD events, the risk of CVD events was reduced by 9% for each 20% increase in AHM adherence (RR, 0.91; 95% CI, 0.85-0.97). The results of sensitivity analysis and subgroup analysis were virtually unchanged.

CONCLUSIONS

The high level of adherence to AHM is an effective strategy for preventing recurrence of CVD events. Patients with a history of CVD events should adhere to AHM.

AB0046 THE EXPRESSION AND CLINICAL SIGNIFICANCE OF TAM RECEPTOR TYROSINE KINASE ON MONOCYTE SUBSETS IN RHEUMATOID ARTHRITIS

Background:

The TAM receptor tyrosine kinases (Tyro3/Axl/Mer TK) are a subfamily of receptor tyrosine kinases, the role of which in autoimmune diseases such as systemic lupus erythematosus has been well explored, while their functions in rheumatoid arthritis (RA) remain largely unknown [1].

Objectives:

The study aimed to investigate the expression and clinical significance of Tyro3, Axl and MerTK on monocyte subsets in rheumatoid arthritis (RA).

Methods:

The expression of Tyro3, Axl and MerTK on CD14+ monocytes, nonclassical monocytes (NCM, CD14+CD16++), intermediate monocytes (IM, CD14++CD16+), and classical monocytes (CM, CD14++CD16-) were evaluated in peripheral blood of RA by flow cytometry and qPCR. And the correlation between the expression of Tyro3TK and MerTK on NCM, IM, and CM with RA patient clinical feature were further analyzed.

Results:

The results revealed that the expression of Tyro3TK on CD14+ monocytes was significantly upregulated in RA patients (F = 9.18, P < 0.0001), while there was no significant difference of the expression MerTK on HC, OA, and RA, and the expression of AxlTK was minimal (Fig 1). The expression of Tyro3TK on CM was significantly upregulated in RA patients as compared with HC and osteoarthritis (OA) patients (P < 0.05, Fig 2-3), and positively correlated with the disease manifestations, such as swollen joint count (SJC), tender joint count (TJC) and the disease activity score (Fig 4).

Figure 1.

The expression of Tyro3, Axl and MerTK on CD14+ monocytes is increased in RA. (a) Gating strategy for flow cytometry of Tyro3, Axl and MerTK on CD14+ monocytes. (b) The expression of Tyro3, Axl and MerTK on CD14+ monocytes were compared between HC (n = 40), OA (n = 27), and RA patients (n = 40). *P < 0.05, **P < 0.01, ns, not significant.

Figure 2.

The expression of Tyro3TK on IM and CM were increased in RA. (a) Gating strategy for flow cytometry of TAMTK on monocyte subsets. The expression of (b) Tyro3TK and (c) MerTK on NCM, IM, and CM were compared between HC (n = 40), OA (n = 27), and RA patients (n = 40). *P < 0.05, **P < 0.01, ***P < 0.001, ns, not significant.

Figure 3.

The mRNA expression of Tyro3TK on CM is increased in RA. (a) The mRNA expression of Tyro3TK on NCM, IM, and CM in HC (n = 3) and RA (n = 3) patients. (b) The mRNA expression of MerTK on NCM, IM, and CM in HC (n = 3) and RA (n = 3) patients. **P < 0.01.

Conclusion:

These findings indicate that Tyro3TK on CM was elevated in RA patients and correlated positively with disease activity, which may serves as an important participant in RA pathogenesis.

References:

[1]Rothlin CV, Lemke G, TAM receptor signaling and autoimmune disease. Curr Opin Immunol, 2010. 22(6): p. 740-6.

Footnotes:

The study was supported by grants from the National Natural Science Foundation of China (81671609 and 81871290 to Dr. Y. Su, 82001718 to Dr. L. Xu), the Beijing Science and Technology Planning Project (Z191100006619111 to Dr. Y. Su), the Beijing Municipal Natural Science Foundation (7194329 to Dr. L. Xu).

Figure 4.

Correlation analysis of Tyro3TK on IM and CM with RA patient clinical manifestations. The associations of Tyro3TK on IM (r = 0.492, *P = 0.001) (a) and CM (r = 0.577, *P = 0.0001) (b) with RA patient swollen joint counts (SJC) were analyzed, respectively. The expression of Tyro3TK on IM and CM were also compared between different RA patient groups: (c) RA with high disease activity (DAS28-ESR > 3.2) and non-high disease activity (DAS28-ESR ≤ 3.2), (d) RA with and without swollen joints, (e) tender joints. *P < 0.05, **P < 0.01.

Disclosure of Interests:

None declared

Abstract 034: A Healthy Lifestyle Score Including Sleep Duration And Risk Of Cardiovascular Disease

Objectives: The aim of this study was to evaluate the relationship between a lifestyle score including sleep duration and CVD risk, and to estimate whether adding sleep duration into a traditional lifestyle score improved CVD risk prediction.

Methods: A prospective analysis was conducted among 67250 women in the Nurses’ Health Study and 29279 men in the Health Professionals Follow-up Study who were followed from 1986 to 2016. The traditional lifestyle score was defined as not smoking, normal BMI(18.5-24.9 kg/m 2 ), ≥30 min/d of moderate physical activity, higher diet quality (top 40% of AHEI), moderate alcohol intake (women:5-15g/day; men:5-30g/day). Low-risk sleep duration, defined as sleeping ≥6 to <8 hours/day, was included as an additional component. Cox proportion hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of CVD, CHD, and stroke. We used the likelihood ratio test and C-statistics to compare the predictive value of the two scores.

Results: A total of 11826 incident CVD cases were documented. In multivariable-adjusted models, each low-risk factor was independently and significantly associated with lower risk of CVD, CHD, and stroke. The multivariable-adjusted HRs (95% CIs) comparing six with zero low-risk factors in the healthy lifestyle score were 0.17(0.12, 0.23) for CVD, 0.15(0.10, 0.22) for CHD, and 0.19(0.12, 0.33) for stroke. Approximately 67% of CVD and CHD cases, and 62% stroke cases were attributable to poor adherence to a healthy lifestyle. P- value for likelihood ratio test comparing nested models including the traditional lifestyle score vs traditional lifestyle score plus sleep duration was <0.001. Adding sleep duration to the traditional score prediction model increased the C-statistics from 0.63 (95% CI: 0.62, 0.63) to 0.64 (95% CI: 0.63, 0.65)( P <0.001).

Conclusions: Incorporating sleep duration into traditional lifestyle scores improves prediction of CVD risk and warrants consideration for inclusion in lifestyle recommendations.

Effects of environmentally relevant concentrations of tris (2-chloroethyl) phosphate (TCEP) on early life stages of zebrafish (Danio rerio)

Tris (2-chloroethyl) phosphate (TCEP) has been received great concerns because of its increasing presence in various environmental compartments and toxicity. In the present study, zebrafish embryos were exposed to environmentally relevant concentrations of TCEP (0.2, 2, 20, 200 μg/L) from 3 to 120 h post-fertilization (hpf). The results showed that TCEP exposure (20, 200 μg/L) led to developmental toxicity including decreased body length and delay of hatching. Treatment with TCEP significantly decreased whole-body thyroxine (T4) levels and mRNA level of thyroglobulin (tg), and enhanced transcriptions of genes sodium/iodide symporter (nis), thyroid hormone receptor α (trα) and ugt1ab involved in thyroid synthesis and metabolism, respectively. Additionally, TCEP altered the transcription of α1-tubulin, gap43 and mbp related to nervous system development, even at relatively low concentrations. Overall, our results revealed that TCEP exposure can lead to developmental toxicity, thyroid endocrine disruption and neurotoxicity on early developmental stages of zebrafish.

Associations of Body Mass Index, Visceral Fat Area, Waist Circumference, and Waist-to-Hip Ratio with Cognitive Function in Western China: Results from WCHAT Study

OBJECTIVES

This study examined the relationship between cognitive performance and obesity parameters, such as body mass index (BMI), visceral fat area (VFA), waist circumference (WC), and waist-to-hip ratio (WHR) in western China.

STUDY DESIGN

A cross-sectional study.

METHODS

3914 participants, aged ≥50 years, were recruited in this study. Anthropometrics measurements, life-style factors, chronic disease comorbidities, and sleep qualities were recorded for each participant. Among the anthropometrics, BMI, WC, and WHR were assessed using standard procedures, while VFA was calculated using bioelectrical impedance analysis. Cognitive performance was estimated using the Short Portable Mental Status Questionnaire (SPMSQ). Finally, relationships between cognitive abilities and BMI, VFA, WC, and WHR were evaluated using univariate and multivariate regression analyses.

RESULTS

Cognitive decline (CD) occurred at a rate of 13.29% among the 3914 participants. A strong correlation was observed between cognitive abilities and BMI of male patients aged 50-59 yrs (OR 1.116,95% CI1.002-1.242), in the adjusted model. Alternately, WHR was shown to be significantly related to CD in females aged ≥70 years (OR 0.041, 95% CI0.002-0.671). WC was shown to have a strong association with CD in males (OR 1.023,95% CI1.003-1.024). Lastly, WHR was closely connected to CD in participants with BMI < 25 kg/m2 (OR 0.022,95% CI0.002-0.209).

CONCLUSIONS

Our findings suggest that a higher middle age BMI is associated with CD, whereas, in the elderly population, a higher WHR is related to improved cognitive performance. Further investigation is warranted to elucidate a relationship between VFA and CD.

Inactivation of TMEM106A promotes lipopolysaccharide-induced inflammation via the MAPK and NF-κB signaling pathways in macrophages

Pattern recognition receptors, such as Toll-like receptors (TLRs), play an important role in the host defense against invading microbial pathogens. Their activation must be precisely regulated, as inappropriate activation or overactivation of TLR signaling pathways may result in inflammatory disorders, such as septic shock or autoimmune diseases. TMEM106A is a type II transmembrane protein constitutively expressed in macrophages. Our current study demonstrated that TMEM106A levels were increased in macrophages upon lipopolysaccharide (LPS) stimulation, as well as in the peripheral monocytes of patients with sepsis. Tmem106a knockout mice were more sensitive to lipopolysaccharide (LPS)-induced septic shock than wild-type mice. Further experiments indicated that Tmem106a ablation enhanced the expression of CD80, CD86 and major histocompatibility complex (MHC)-II in mouse macrophages upon LPS stimulation, accompanied with up-regulation of tumor necrosis factor (TNF)-α, interleukin (IL)-6, interferon (IFN)-β and inducible nitric oxide synthase (iNOS), indicating the activation of macrophages and polarization towards the M1 inflammatory phenotype. Moreover, elevated mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-κB) signaling were found to be involved in the LPS-induced inflammatory response in Tmem106a^-/- macrophages. However, this effect was largely abrogated by macrophage deletion in Tmem106a^-/- mice. Therefore, deficiency of Tmem106a in macrophages may enhance the M1 polarization in mice, resulting in inflammation. This suggests that TMEM106A plays an important regulatory role in maintaining macrophage homeostasis.

Fine structure of the human retina defined by confocal microscopic immunohistochemistry

INTRODUCTION

Research in to the pathophysiology of the complex layers of retinal and sub-retinal cells is hampered by inadequate recognition of particular cells and tissues. A comprehensive panel of antibodies recognising retinal tissues is lacking. Our purpose was to determine the value of a panel of antibodies labelling various cells in the human retina.

METHOD

Five groups of antibodies labelled frozen sections of retinas: (1) protein kinase C-α, Glutamine Synthetase (GS) and ionized calcium-binding adapter molecule 1 (Iba1); (2) Parvalbumin, Calretinin and glial fibrillary acidic protein (GFAP); (3) Thy1, GS and Iba1; (4) Rhodopsin, GS and Iba1; and (5) Brn3a, Rhodopsin and protein kinase C-α. The distribution of these antigens were determined by confocal microscopy and calculated grey value of each antibody in each layer of the retina by Image J.

RESULTS

Different antibodies determined certain retinal layers. Thy 1 is a good determinant of the ganglion cell layer, whilst GS is present in all layers except the photoreceptor layer. Brn3a is specific for the ganglion cell layer whilst parvalbumin marks the ganglion cell layer and the outer plexiform layer. Rhodopsin strongly marks the photoreceptor layer, but this is also marked weakly by GFAP.

CONCLUSION

The multiple labelling of human retinal cells brings further understanding of the biological characteristics and functions of these cells, and provides a theoretical basis for their possible role in diseases. In the growing field of human retina research, our data may provide a point of reference for future studies of the human retina.

Bioaccumulation and oxidative damage of polycyclic aromatic hydrocarbon mixtures in Manila clam Ruditapes philippinarum

The aim of this study was to investigate the bioaccumulation and oxidative damage of Manila clam, Ruditapes philippinarum, exposed to four selected mixtures of polycyclic aromatic hydrocarbons (PAHs; benzo (a) pyrene (BaP), benzo (a) anthracene (BaA), benzo (b) fluoranthene (BbF), and chrysene (Chr) in equal proportion. For this purpose, clams were exposed to PAHs (BaP:BbF:BaA:Chr = 1:1:1:1) at different concentrations (0.05, 0.5, and 5 μg/L) for 21 days, followed by a 15-day depuration period. All four PAHs accumulated in the gill, digestive gland, adductor muscle, and soft tissue of Manila clams, and all PAH treatment groups showed clear time and dose dependence. The decreasing order of bioaccumulation for the four PAHs in the exposure experiment was Chr > BaA > BaP > BbF. Moreover, the order of PAH bioaccumulation for the four tissues during the whole experiment was digestive gland > gill > soft tissues > adductor muscles. Although the initial concentrations of the four PAHs were the same, the final accumulated contents were different. Therefore, we also determined the detoxification processes of the four PAH mixtures in gills and digestive glands. The bioaccumulation of Chr was higher than the other three PAHs, probably because clams have a lower metabolic capacity for Chr than for BaP, BbF, and BaA. Exposure to PAH mixtures can result in oxidative damage, as indicated by the fact that DNA strand breaks, lipid peroxidation (LPO), and protein carbonyl (PC) were induced significantly (P < 0.05), except in the low-dose groups of PAHs, and different trends were detected with time of exposure. According to the correlation analysis, aryl hydrocarbon hydroxylase, glutathione s-transferase, superoxide dismutase, DNA strand break, PC, and LPO in both the gill and digestive gland are potential early indicators of PAH mixtures. We investigated the accumulation rules of R. philippinarum exposed to the selected PAHs and screened the potential biomarkers. The results of our study provide important scientific information for the purpose of monitoring marine pollution.

Seroprevalence of Toxoplasma gondii infection in people in southeast Hubei province, China

Toxoplasma gondii is a world-widely spread zoonotic parasite. However, scarce knowledge is known about the prevalence of T. gondii infection in people in Hubei province, China. This study herein was to perform epidemiological investigation of T. gondii infection in people in this region. A total 12527 blood samples were obtained during 2015-2018, and were assayed for T. gondii antibodies of IgG and IgM, respectively by employing an indirect hemagglutination test (IHA). The results discovered that the prevalence of T. gondii in people was 2.44% and 6.1%, respectively based on antibodies of IgG and IgM, respectively. The prevalence was ranged from 0.3% to 5.4% during 2015-2018 based on IgM antibodies. For genders, the prevalence was 0.7% and 2.6% in males and females, respectively based on IgM antibodies. In different years, the prevalence was ranged from 4.9% to 14.0% based on IgG antibodies. The prevalence of T. gondii was 4.9% and 6.6% in males and femalesy based on IgG antibodies. The current results may be helpful for the implementation of preventive measures against Toxoplasma infection among people living in this region.

Effect of air pre-exposure on Tetrabromobisphenol A resistance in the clam Ruditapes philippinarum

The present study was conducted to evaluate how air pre-exposure influences the responses in gills and digestive gland of Ruditapes philippinarum on subsequent Tetrabromobisphenol A (TBBPA) exposure. Firstly, clams were maintained in seawater or pre-exposed to air for 24 h, and then exposed to 0 or 100 μg/L TBBPA. Clam tissues were sampled after 1 day (T1) and 7 days (T7) of exposure to TBBPA. The results showed that in comparison with TBBPA exposure alone, air pre-exposure following TBBPA exposure reduced TBBPA accumulation in both tissues, up-regulated mRNA levels of CAT, Hsp70 and pi-GST in gills, and induced GST activity and P-glycoprotein (Pgp) mRNA level in digestive gland of clams at T1, whereas increased lipid peroxidation at T7. Overall, the findings indicate that 24-h exposure to air can activate a priming mechanism withstanding the subsequent TBBPA exposure, which is transient and may change after prolonged subsequent exposure.

Antibodies against carbamylated vimentin exist in systemic lupus erythematosus and correlate with disease activity

OBJECTIVES

Antibodies against carbamylated protein (anti-CarP) were found to be a promising marker to evaluate joint damage and disease activity in patients with rheumatoid arthritis (RA). However, whether anti-CarP antibodies were present in systemic lupus erythematosus (SLE) remained ambiguous. We have therefore undertaken this study to assess the levels of serum anti-CarP antibodies and to evaluate their clinical value in SLE.

METHODS

Serum levels of antibodies against carbamylated-vimentin (anti-Carp) were measured by enzyme immunosorbent assay in 100 patients with SLE, 76 with RA, 17 with primary Sjögren syndrome (pSS), and 68 healthy controls. Data analyses between anti-Carp antibodies and other laboratory measures were performed using SPSS 24 software for Windows.

RESULTS

The levels of serum anti-CarP antibodies in patients with SLE were significantly higher than those in healthy controls. In addition, anti-CarP antibodies were present in SLE patients lacking the disease-specific antibodies, including anti-Smith-negative patients (24.4%, 21/86), anti-dsDNA-negative patients (29.3%, 12/41), anti-nucleosome-negative patients (21.4%, 9/42), and antiribosomal P protein antibody-negative patients (23.7%, 18/76). There were significant differences between the anti-CarP-positive and anti-CarP-negative SLE patients in clinical and laboratory features, such as age, erythrocyte sedimentation rate (ESR), C-reactive protein, rheumatoid factor, third-generation cyclic citrullinated peptide (CCP3), anticardiolipin, D-dipolymer, complement 3, immunoglobulin G (IgG), red blood cell count (RBC) and hemoglobin. After adjusting for age and disease duration, the high levels of anti-CarP antibodies were still correlated with low RBC, hemoglobin and high ESR, IgG and CCP3. Active SLE patients demonstrated higher anti-CarP IgG than inactive patients. Moreover, the levels of anti-CarP were significantly higher in SLE patients with arthralgia and/or arthritis than in those without joint involvement.

CONCLUSIONS

Anti-CarP antibodies were present in SLE patients and associated with the disease severity. These might provide a potential supplement to other specific autoantibodies for diagnosis of SLE and serve as a promising marker for measuring joint damage in the disease.

[Analysis of differences in epidemiology and clinical features of Guillain-Barré syndrome between rural and urban areas of southern China]

Objective: To explore the differences in epidemiology and clinical features of Guillain- Barré syndrome (GBS) between rural and urban areas of southern China. Methods: The clinical data of 759 hospitalized GBS patients from 31 hospitals of 13 provinces/cities in southern China, between January 1st, 2013 and September 30th, 2016, were collected and analyzed retrospectively. Results: The risk of GBS was higher for males than females in rural and urban areas and the median age was 49 and 48 years, respectively. Seasonal clustering in winter and spring was noted in both rural and urban areas, and the seasonal trend was more markedly in rural areas, but the differences showed no statistical significance. There were 70.37% of patients in rural areas and 73.69% in urban areas who had antecedent respiratory infection. The median time from onset to nadir was 7 days, and Hughes Disability Scale at admission, nadir and discharge were (2.95±1.10 vs 2.84±1.15), (3.25±1.11 vs 3.14±1.21), (2.02±1.24 vs 2.00±1.31) in rural and urban areas respectively. Albuminocytologic dissociation was present in 84.34% of patients in rural areas and 84.62% of cases in urban areas. There were 8.65% and 10.94% of cases in rural and urban areas who required mechanical ventilation during hospitalization, respectively. Demyelinating GBS accounted for 53.29% and 48.77%, respectively, in patients with findings of nerve conduction studies available in rural and urban areas. Conclusions: GBS in rural areas of southern China showed male predominance and a peak of spring and winter occurrence, with respiratory infection as the predominated preceding events and demyelinating GBS being main clinical subtype. Winter and spring showed a higher incidence of GBS in rural and urban areas. There were no significant differences of sex, age, preceding events, season trend, progression of disease, clinical subtypes and cerebrospinal fluid investigations in GBS patients between rural and urban areas.

[Survey of Schistosoma japonicum infections in wild animals in hilly transmission-controlled areas of Jiangxi Province]

OBJECTIVE

To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis.

METHODS

Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay.

RESULTS

A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m² in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village.

CONCLUSIONS

The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.

A rare case of association between Budd-Chiari syndrome and sea-blue histiocytosis

Budd-Chiari syndrome (BCS) is a rare disease characterized by obstruction of hepatic venous outflow tract with diversified etiologies. Sea-blue histiocytosis (SBH) is a kind of storage diseases defined by the deposition of abundant sea-blue histiocytes in various organs and can lead to hepatosplenomegaly, cirrhosis, or even liver failure. The association between BCS and SBH has never been reported before. Here, we report a patient with BCS presenting with hepatosplenomegaly, portal hypertension, and pancytopenia who was later confirmed to also have SBH.

Tailored Plasmons in Pentacene/Graphene Heterostructures with Interlayer Electron Transfer

van der Waals (vdW) heterostructures, which are produced by the precise assemblies of varieties of two-dimensional (2D) materials, have demonstrated many novel properties and functionalities. Here we report a nanoplasmonic study of vdW heterostructures that were produced by depositing ordered molecular layers of pentacene on top of graphene. We find through nanoinfrared (IR) imaging that surface plasmons formed due to the collective oscillations of Dirac Fermions in graphene are highly sensitive to the adjacent pentacene layers. In particular, the plasmon wavelength declines systematically but nonlinearly with increasing pentacene thickness. Further analysis and density functional theory (DFT) calculations indicate that the observed peculiar thickness dependence is mainly due to the tunneling-type electron transfer from pentacene to graphene. Our work unveils a new method for tailoring graphene plasmons and deepens our understanding of the intriguing nano-optical phenomena due to interlayer couplings in novel vdW heterostructures.

[Influence of antiretroviral prophylaxis on growth of HIV-exposed uninfected infants]

Objective: To evaluate the influence of antiretroviral prophylaxis on the growth and development of HIV-exposed uninfected infants in Guangzhou. Methods: Data were from the national information system for prevention of mother-to-child transmission of HIV infection, syphilis and hepatitis B. After excluding death and perinatal HIV infection cases, 564 HIV-exposed uninfected infants were included. The infants were divided into three groups, nevirapine (NVP) group, zidovudine (AZT) group and untreated group. The influences of antiretroviral prophylaxis on the body weight and height of the HIV-exposed uninfected infants were analyzed by using generalized estimating equations. Results: The HIV-exposed uninfected infants at 1-month old had lower Z scores of body weight-for-age and body height-for-age than the World Health Organization's reference standard. The prevalence of wasting in AZT group (17.5%) was higher than that in NVP group (6.2%) for 1-month old infants. Taking NVP or AZT was a protective factor for Z score of body length-for-age (P<0.05). Intrauterine exposure to triple antiviral drugs was a risk factor for the Z scores of body weight-for-age and body length-for-age (P<0.05). Conclusion: The physical growth and development of HIV-exposed uninfected infants at 1-month old was not well, and HIV-exposed uninfected infants who taking AZT had a higher incidence of wasting. Attention should be paid to these infants.

[Association between both maternal pre-pregnancy body mass index/gestational weight gain and overweight/obesity children at preschool stage]

Objective: To investigate the association of both maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity in preschool children. Methods: A total of 4 303 preschool children aged 3-5 years were enrolled in our study during June and November 2016 in Guangzhou. Children defined as overweight and obesity were according to the criteria of WHO while weight status during maternal pre-pregnancy was using the China Adult Reference. Gestational weight gain was defined according to the Institute of Medicine guidelines. Results: After adjusting the possible confounding factors, results from the logistic regression analysis showed that both maternal pre-pregnancy overweight and obesity would increase the risk for both childhood overweight and obesity (OR=1.820, 95%CI: 1.368-2.422). The analysis of covariance results also showed that both maternal overweight and obesity before pregnancy and excessive maternal weight gain during pregnancy increased the BMI Z-score in children. Maternal GWG over the recommended level were associated with both the childhood overweight and obesity (OR=1.296, 95%CI: 1.007-1.667). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study. Stratified analysis was conducted in three groups according to the pre-pregnancy BMI of the mothers. Result showed that there was no statistical difference in the risks of either overweight or obesity in children (P>0.05). However, when compared to mothers with adequate pre-pregnancy higher BMI and adequate GWG, under the combination of high pre-pregnancy BMI and excessive GWG, their adverse effects on childhood overweight and obesity were much higher (OR=1.574, 95%CI: 1.029-2.409). Conclusions: Both high pre-pregnancy BMI and inappropriate GWG were associated with greater BMI of their offspring. Pregnant women should follow the appropriate weight gain program and help their children to prevent from becoming obese.

FOXA1 promotes proliferation, migration and invasion by transcriptional activating KRT7 in human gastric cancer cells

Gastric cancer (GC) is the fourth leading cause of gynecological malignancies worldwide. 5-fluorouracil (5-FU)-mediated chemotherapy is the adjuvant treatment for patients with GC following surgical resection. Many studies have indicated the cancer-type specific roles of forkhead box protein A1 (FOXA1) and keratin 7 (KRT7) in human malignancies. However, the potential mechanism underlying the involvement of FOXA1 and KRT7 in the pathogenesis and chemoresistance of GC are still not entirely clear. In our study, gain- and loss-of-function experiments proved that FOXA1 promoted cell proliferation, migration and invasion in AGS and SGC-7901 cells. Consequently, KRT7 was identified to be transcriptional activated by FOXA1 using Dual luciferase reporter assay. Our results also indicated that FOXA1 exerted its functions in enhancing viability and invasion of AGS and SGC-7901 cells through activating KRT7. Finally, interference of FOXA1 or KRT7 increased the chemosensitivity of AGS and SGC-7901 cells to 5-fluorouracil (5-Fu) treatment by suppressing cell proliferation. In conclusion, these data indicate that FOXA1 promoted proliferation, migration, invasion, and decreased chemosensitivity of GC cells to 5-Fu treatment through transcriptional activator KRT7. The present study provides a novel therapeutic strategy for the enhancement of efficacy in GC treatment and provides important insights into the molecular mechanism underlying 5-FU-mediated chemoresistance.