The role of miRNAs in viral myocarditis, and its possible implication in induction of mRNA-based COVID-19 vaccines-induced myocarditis

BACKGROUND

Several reports of unheeded complications secondary to the current mass international rollout of SARS-COV-2 vaccines, one of which is myocarditis occurring with the FDA fully approved vaccine, Pfizer, and others.

MAIN BODY OF THE ABSTRACT

Certain miRNAs (non-coding RNA sequences) are involved in the pathogenesis in viral myocarditis, and those miRNAs are interestingly upregulated in severe COVID-19. We hypothesize that the use of mRNA-based vaccines may be triggering the release of host miRNAs or that trigger the occurrence of myocarditis. This is based on the finding of altered host miRNA expression promoting virus-induced myocarditis.

SHORT CONCLUSION

In conclusion, miRNAs are likely implicated in myocarditis associated with mRNA vaccines. Our hypothesis suggests the use of miRNA as a biomarker for the diagnosis of mRNA vaccine-induced myocarditis. Additionally, the interplay between viral miRNA and the host immune system could alter inflammatory profiles, hence suggesting the use of therapeutic inhibition to prevent such complications.

Learned lesson from COVID-19: can routine immunizations be the first line of defense against the next pandemic?

Background

Single-cell sequencing studies on the lung microenvironment have revealed that the outcome of COVID-19 depends largely on the immune system response rather than the viral load. A robust innate immune response and a regulated adaptive immunity can prevent the worst outcomes such as hospitalization and the need for mechanical ventilation.

Main body

Intriguingly, several vaccines pertaining to the routine vaccination schedule, not only BCG, can skew the immune response towards the aforementioned beneficial effects.

Short conclusion

This means that routine immunization not only can help in the current pandemic but can also offer a rapid rescue in the subsequent epidemics or pandemics until a vaccine is developed.

AB0076 THE ROLE OF MACROPHAGE MIGRATION INHIBITORY FACTOR IN ACTIVITY AND PROGRESSION OF ANKYLOSING SPONDYLITIS

Background:

Ankylosing Spondylitis (AS) is a chronic inflammatory form of arthritis that predominantly affects the axial joints and has a global prevalence of 1%. Disease progression is marked by osteoproliferation and bone fusion in the axial joints, causing considerable loss of mobility. Migration Inhibitory Factor (MIF) is a potent pro-inflammatory cytokine implicated in several diseases. Elevated serum MIF levels have been reported in AS the role of MIF in bone formation has been a subject of controversy.

Objectives:

Detection the level of Migration Inhibitory Factor in Ankylosing Spondylitis patients and correlate the level with disease activity and progression.

Methods:

This cross-sectional case-control study were concluded upon 70 randomly selected people from internal medicine department in Kobry El-kobba Military Hospital and from rheumatology and rehabilitation department in EL-Hussein university hospital. The population study were divided into two groups: Group A: (50) Patients with Ankylosing Spondylitis (AS) who met the European Spondyloarthropathy Study Group (ESSG) criteria for AS (30) and Group B: (20) Healthy controls. Serum MIF by ELISA were measured. X-rays cervical &lumbosacral vertebrae (dorsal, lateral) views were obtained. m-SASS score (based on radiographic findings to detect progression) were assessed. MSK U/S on Tendo Achilles affected in AS patients were done.

Results:

the mean age of all patients was (38.2 ± 8.4) years. Regarding gender of the patients, the majority (65.7%) of patients were males, while (34.3%) were females. (88%) of AS patients had cervical erosion or sclerosis, (46%) had dorsal erosion or sclerosis, (92%) had lumbosacral erosion or sclerosis, with m-SASS score of (11 ± 6.1). Regarding musculoskeletal U/S, (72%) had evidence of inflammation and erosion. Highly significant increase in ESR, CRP and MIF levels in A group; compared to control B group; with highly significant statistical difference (p < 0.01). the increase in smoking, ESR and MIF level; had an independent effect on increasing the probability of progression occurrence; with significant statistical difference (p < 0.05 respectively). MIF level at a cutoff point (>51) predicted patients with progression, with fair accuracy (74%), sensitivity= 53% and specificity= 94% (p = 0.0056).

Conclusion:

MIF ply an important role in the pathogenesis of Ankylosing Spondylitis and has a link between chronic inflammation, new bone formation and disease progression and can be used as indicator for activity and disease progression.

Disclosure of Interests:

None declared

COVID-19 during pregnancy should we really worry from vertical transmission or rather from fetal hypoxia and placental insufficiency? A systematic review

Background

COVID-19 is the largest outbreak to strike humanity. The wide scale of fatalities and morbidities lead to a concurrent pandemic of uncertainty in scientific evidence. Conflicting evidences are released on daily basis about the neonatal outcomes of COVID-19-positive mothers. The aim of this study was to use the relevant case reports and series to determine the percentage of newborns who test positive for COVID-19 who are born to COVID-19-positive mothers. Secondary outcomes included examining laboratory abnormalities among COVID-19-positive neonates, and any depicted placental abnormalities in COVID-19-positive mothers. For this purpose, systematic review was performed on all studies reporting primary data on fetus-mother pairs with COVID-19. Data bases were searched for studies that met our inclusion and exclusion criteria.

Results

Final screening revealed 67 studies, from which the primary data of 1787 COVID-19 mothers were identified and had their pregnancy outcome analyzed. Only 2.8% of infants born to COVID-19-positive mothers tested positive, and this finding is identical to percentages reported in former Coronaviridae outbreaks, whereas 20% manifested with intrauterine hypoxia alongside placental abnormalities suggestive of heavy placental vaso-occlusive involvement.

Conclusions

These findings suggest that while vertical transmission is unlikely, there appears to be an underlying risk of placental insufficiency due to the prothrombotic tendency observed in COVID-19 infection. Guidelines for proper prophylactic anticoagulation in COVID-positive mothers need to be established.

PADI4 (rs2240340), PDCD1 (rs10204525), and CTLA4 (231775) gene polymorphisms and polyarticular juvenile idiopathic arthritis

BACKGROUND

Certain single nucleotide polymorphisms (SNPs) in genes such as PADI4 (coding for peptidyl arginine deiminase 4), PDCD1 (coding for programmed cell death 1), and CTLA4 (coding for cytotoxic T-lymphocyte-associated protein 4) are linked to rheumatoid arthritis (RA). However, links between SNPs rs2240340, rs10204525 and rs231775 in PADI4, PDCD1 and CTLA4 respectively, and juvenile idiopathic arthritis (JIA), the commonest type of childhood arthritis, are unclear. We aimed to determine whether any of these SNPs are associated with JIA, and to clinical indices disease activity score (JADAS 71) and functional disability score (CHAQ).

METHODS

We genotyped the three SNPs in 150 children with polyarticular JIA and 160 healthy children, recording standard health questionnaires, clinical features and laboratory markers.

RESULTS

The TT genotype of PADI4 rs2240340 (aOR/95%CI 2.64: 1.31-5.30, P = 0.006) and CT genotype of PDCD1 rs10204525 (aOR/95%CI 4.99: 2.98-8.36, P < 0.0001) were associated with JIA. The AG+GG genotype of CTLA4 rs231175 was modestly linked to disease activity (aOR/95%CI 2.44 (1.19-5.04), p = 0.015). PADI4 rs2240340 was linked to CHAQ score (genotypes p = 0.013, alleles p = 0.006), whilst PDCD1 rs10204525 was linked to anti-CCP antibodies (genotypes p = 0.004), RF (genotypes p = 0.01), and the CHAQ score (genotypes p = 0.005, alleles p = 0.013).

CONCLUSIONS

There are various roles for these SNPs in PADI4, CTLA4 and PDCD1 in the diagnosis and, potentially, in the management of JIA.

Is there a Minimum Caseload that Achieves Acceptable Operative Mortality in Abdominal Aortic Aneurysm Operations?

BACKGROUND

Studies have shown correlation between operative workload and mortality for major operations. Is there a threshold for case volume that predicts an acceptable mortality for abdominal aortic aneurysm surgery?

METHODS

Hospital Episode Statistics (HES) Data for England between 1997-2002 was analysed using ICD-10 codes I71.x and OPCS-4 codes L16.x-L26.x. Mortality was identified by the method of discharge.

RESULTS

31,078 operations on abdominal aortic aneurysms were studied in 223 NHS Trusts. 6,007 in-hospital deaths were identified in both elective and emergency cases (overall mortality rates 7.7% and 40%, respectively). Trusts with large elective workloads had reduced mortality for both elective and emergency operations. Using parabolic regression and logarithmic transformation, 14 elective operations per Trust per year was identified as a cut-off point above which the decrease in mortality rate with increasing case volume was relatively small. A similar effect was not seen with increasing emergency workload alone.

CONCLUSION

HES data analysis suggests increasing elective workload correlates with lower in-hospital mortality for elective and emergency operations on abdominal aortic aneurysm. Data suggests a range of hospital caseload that correlate with an acceptable elective and emergency mortality rate.

Confirmation of FWT1 as a Wilms' tumour susceptibility gene and phenotypic characteristics of Wilms' tumour attributable to FWT1

A susceptibility gene for Wilms' tumour (WT), designated FWT1, was previously mapped to chromosome 17q12-q21 by linkage analysis of a single family. We now confirm the existence of this gene by analysis of additional cases in the original family (3-point LOD score=5.69), and by detecting strong evidence of linkage to this region in an unrelated pedigree with seven cases of WT (3-point LOD score=2.56). Analysis of 11 smaller WT families confirms that there is genetic heterogeneity in familial WT, as three families exhibit strong evidence against linkage to FWT1. One of these was subsequently found to have a predisposing WT1 mutation. However, the other two families show evidence against both FWT1 and WT1, suggesting that at least one further familial WT gene exists. Analysis of the phenotype of 16 WT cases from the families linked to FWT1 demonstrates that they present at a significantly older age and a significantly later stage than both sporadic WT and the six cases from two families unlinked to either FWT1 or WT1. The results confirm the role of FWT1 in susceptibility to WT, provide strong evidence for genetic heterogeneity in familial WT and suggest there are phenotypic differences between familial WT due to FWT1, familial WT due to other genes and non-familial WT.

Comparison of iliofemoral and femorofemoral crossover bypass in the treatment of unilateral iliac arterial occlusive disease

Between 1981 and 1988, 74 synthetic crossover bypass grafts were inserted for unilateral iliac arterial occlusive disease. In 32 patients the bypass procedure was iliofemoral and in 42 femorofemoral. The cumulative patency rate at a mean of 2.7 years was 79 per cent in both groups. There was no significant difference in either postoperative mortality rate or duration of hospital stay. Iliofemoral bypass may offer significant advantages over the femorofemoral approach. In particular it avoids a groin incision in the donor limb, leaving the common femoral artery intact for subsequent angioplasty or reconstruction should proximal stenotic disease develop in the donor iliac vessel.

The influence of calcium and beta-sympathomimetics on force-frequency relationship and resting potentiation in guinea pig papillary muscle

The influence of various calcium concentrations and of the beta-sympathomimeticum orciprenaline (Alupent) on the force-frequency relationship and on the resting potentiation of isolated isometrically contracting papillary muscles of the guinea pig heart was studied. Elevation of Ca concentration and/or addition of orciprenaline augment the amplitudes of contractions elicited by rhythmical stimulation, but they diminish the amplitudes of test contractions elicited after a test interval of 1-2 s. It is suggested that calcium and orciprenaline strengthen the calcium loss from the sarcoplasmic reticulum out of the cell during a prolonged interval.