Comparison of SGLT2 inhibitors vs. DPP4 inhibitors for patients with metabolic dysfunction associated fatty liver disease and diabetes mellitus

PURPOSE

This study aimed to examine the potential benefit of sodium-glucose cotransporter 2 (SGLT2) inhibitors for patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and diabetes mellitus (DM) using a real-world database.

METHODS

We analyzed individuals with MAFLD and DM newly initiated on SGLT2 or dipeptidyl peptidase 4 (DPP4) inhibitors from a large-scale administrative claims database. The primary outcome was the change in the fatty liver index (FLI) assessed using a linear mixed-effects model from the initiation of SGLT2 or DPP4 inhibitors. A propensity score-matching algorithm was used to compare the change in FLI among SGLT2 and DPP4 inhibitors.

RESULTS

After propensity score matching, 6547 well-balanced pairs of SGLT2 and 6547 DPP4 inhibitor users were created. SGLT2 inhibitor use was associated with a greater decline in FLI than DPP4 inhibitor use (difference at 1-year measurement, - 3.8 [95% CI - 4.7 to - 3.0]). The advantage of SGLT2 inhibitor use over DPP4 inhibitor use for improvement in FLI was consistent across subgroups. The relationship between SGLT2 inhibitors and amelioration of FLI was comparable between individual SGLT2 inhibitors.

CONCLUSIONS

Our analysis using large-scale real-world data demonstrated the potential advantage of SGLT2 inhibitors over DPP4 inhibitors in patients with MAFLD and DM.

Association between blood pressure classification using the 2017 American College of Cardiology/American Heart Association blood pressure guideline and hypertensive retinopathy

Purpose

We aimed to explore the association of blood pressure (BP) classification using the 2017 American College of Cardiology/ American Heart Association Guideline and the prevalence of hypertensive retinopathy using a nationwide epidemiological database.

Methods

This study is a retrospective observational cross-sectional analysis using the health claims database of the JMDC between 2005 and 2020. We analyzed 280,599 participants who did not take anti-hypertensive medications. Each participant was categorized as having normal BP (systolic BP [SBP] <120 mm Hg and diastolic BP [DBP] <80 mm Hg; n=159,524); elevated BP (SBP 120–129 mm Hg and DBP <80 mm Hg; n=35,603); stage 1 hypertension (SBP 130–139 mm Hg or DBP 80–89 mm Hg; n=54,795); or stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90 mm Hg; n=30,677). Retinal photography at health check-up was classified as normal, grade 1, grade 2, grade 3, or grade 4 according to the Keith-Wagener-Barker system.

Results

Median (interquartile range) age was 46 (40–53) years, and 50.4% were men. Hypertensive retinopathy which was defined as ≥ Keith-Wagener-Barker system grade 1, was observed in 16,836 participants (6.0%). Multivariable logistic regression analysis showed that, compared with normal BP, elevated BP (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.23–1.38), stage 1 hypertension (OR 1.71, 95% CI 1.64–1.79), and stage 2 hypertension (OR 4.10, 95% CI 3.93–4.28) were associated with higher prevalence of hypertensive retinopathy. Even among 92,121 participants without obesity, high waist circumference, diabetes mellitus, dyslipidemia, cigarette smoking, and alcohol drinking, multivariable logistic regression analysis showed that, compared with normal BP, elevated BP (odds ratio 1.34, 95% CI 1.19–1.51), stage 1 hypertension (OR 1.79, 95% CI 1.61–1.98), and stage 2 hypertension (OR 4.42, 95% CI 4.00–4.92) were associated with higher prevalence of hypertensive retinopathy. The association between BP category and hypertensive retinopathy was observed in all subgroups stratified by age or sex.

Conclusion

Our investigation showed that the prevalence of hypertensive retinopathy increased with the blood pressure category, suggesting that atherosclerotic change could start even in elevated BP and stage 1 hypertension.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (19AA2007 and H30-Policy-Designated-004) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (17H04141).

A novel three-dimensional visualization system revealed an essential adaptive angiogenic response during the early phase of pulmonary hypertension

Background

Pulmonary hypertension (PH) is characterized by increased pulmonary vascular resistance and right heart failure with progressive narrowing or occlusion of the pulmonary artery. However, the assessment of vascular remodeling is mostly limited to averaged increases in wall thickening, and even the role of vascular endothelial growth factor (VEGF), remains incompletely understood; Although abundantly expressed VEGF is expected to elicit angio-obliteration and the knockout of hypoxia inducible factor (HIF) prevents PH in mice, VEGF inhibitor Sugen exacerbates hypoxia (Hx)-induced PH model, which is referred to as VEGF paradox.

Purpose

To analyze three-dimensional (3D) spatiotemporal changes of pulmonary microstructure and function, which reflect the disease activity and lead to resolve the paradox.

Methods and results

We developed a novel 3D visualization system of microstructural networks in whole mouse organ with single-cell resolution, using combined tissue clearing technique called CUBIC and multiphoton excitation microscope. The system enabled the simultaneous 3D evaluation of microvascular structure, invaded macrophages and fibrosis with effective penetration of several mm (whole organ). Three-dimensional observations of PH mice models including Hx, Sugen/Hx, and human-like Alk1+/− hereditary PH models, revealed that not only inward (negative) microvessel remodeling with stenosis, but also marked elongation of microvascular ECs, was evident except Sugen/Hx model at the early phase, which had not been detected by 2D histological sections. Comparable transcriptome analysis revealed that PGC1α, which regulates HIF-independent VEGF expression and angiogenesis, plays an important role in the characteristic response for mitochondrial and microvascular maintenance. PGC1α was up-regulated in the early phage in Hx and Alk1+/− PH models with microvascular angiogenetic change, whereas Sugen/Hx-model did not increase PGC1α expression and did not show microvascular remodeling. Furthermore pulmonary ECs-specific PGC1α-deficient mice exacerbated Hx-PH model with decreased VEGF expression and microvessel density, and administration of Baicalin, a flavonoid enhancing PGC1α expression, ameliorated Hx-PH model with increased VEGF expression.

Conclusions

The 3D visualization system disclosed an unexpected change of angiogenic microvascular structure in the early phage of PH, which is regulated by EC PGC1α. Microvascular angiogenesis which is induced by up-regulation in PGC1α -VEGF pathway is a crucial factor for compensation of PH in the early phase, which provides a potential novel therapeutic target for PH.

Figure 1

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): JSJP

Characterization of porcine sapelovirus isolated from Japanese swine with PLC/PRF/5 cells

Porcine sapelovirus (PSV) is a causative agent of neurological disorders, fertility disorders and dermal lesions of swine. In this study, we isolated two PSV strains, Jpsv477 and Jpsv1315, from swine faecal specimens using a PLC/PRF/5 cell culture system. The PSV infection of PLC/PRF/5 cells induced a cytopathic effect (CPE). Two types of virus particles with identical diameter (~35 nm) but different densities (1.300 and 1.285 g/cm³ ) were observed in the cell culture supernatants. Analysis of the entire genome sequence of Jpsv477 and Jpsv1315 revealed that both strains possess 7,558 nucleotides and the poly (A) tail and have a typical PSV genome organization consisting of a 5' terminal untranslated region (5'UTR), a large open reading frame (ORF), and a 3' terminal untranslated region (3'UTR). The ORF encodes a single polyprotein that is subsequently processed into a leader protein (L), four structural proteins (VP1, VP2, VP3 and VP4) and seven functional proteins (2A, 2B, 2C, 3A, 3B, 3C and 3D). The structural proteins VP1, VP2, VP3 and VP4 have molecular masses of ~35, ~26, ~25 and ~6 kDa. The N-terminal amino acid sequence analysis of VP1, VP2, VP3 and VP4 confirmed that the cleavage sites between VP4 and VP2, VP2 and VP3, and VP3 and VP1 are K/A, Q/G and Q/G, respectively. We further confirmed that HepG2/C3A, Vero E6 and primary green monkey kidney cells (PGMKC) were also susceptible to PSV infection. The stability assay demonstrated that PSV was inactivated by heating at 60°C for 10 min or 65°C for 5 min. The virus also lost infectivity by incubation with 62.5 ppm of NaClO for 30 min.

Peripartum type B aortic dissection in patients with Marfan syndrome who underwent aortic root replacement: a case series study

OBJECTIVE

To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR).

DESIGN

Retrospective case series study.

SETTING

Tertiary perinatal care centre at a university hospital.

POPULATION

Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS who were managed at our institute.

METHODS

The pregnancy outcomes of all patients with MFS managed at our institute between 1982 and September 2016 were reviewed retrospectively based on medical records.

MAIN OUTCOME MEASURES

Obstetrical management and complication including the incidence of AD throughout the peripartum period.

RESULTS

Among 22 patients (28 pregnancies) who had been managed as potential MFS or related disorders, 14 (17 pregnancies) fulfilled the revised Ghent nosology (2010) criteria for MFS and were enrolled in this study. Five patients (five pregnancies) had received ARR before conception: three (60%) developed type B aortic dissection [AD(B)] during the peripartum period, compared with only one of 10 patients (12 pregnancies) without ARR (P < 0.05, Chi-square test).

CONCLUSIONS

Our study results suggest that MFS patients after prophylactic ARR are still at high risk of AD(B) during the peripartum period. Careful pre-pregnancy counselling and multidisciplinary care throughout the peripartum period are essential for the management of MFS, even after surgical repair of an ascending aortic aneurysm.

TWEETABLE ABSTRACT

MFS patients after prophylactic ARR are still at high risk of type B aortic dissection during the peripartum period.

Abstract P1-11-12: Re-evaluating outcomes of partial-breast irradiation using multicatheter brachytherapy for Japanese patients with breast cancer by European brachytherapy phase 3 trial

[Purpose] The Groupe European de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) has reported the equivalent outcomes of partial-breast irradiation (PBI) using multicatheter interstitial brachytherapy (MCB) to whole-breast irradiation (WBI) in breast-conserving therapy, showing that the incidence of local recurrence was 1.44% with MCB-PBI and 0.92% with WBI. Based on the trial, MCB-PBI could be considered as an alternative method to WBI for low-risk breast cancer patients. However, it would be difficult to translate it directly into Japanese community practice. After categorization of Japanese patients using the inclusion and exclusion criteria of this trial, our databases were re-evaluated to validate the data for Japanese patients, and the possibility to extend the candidate for MCB-PBI was also investigated.

[Methods] Patients undergoing BCT were retrospectively examined between November 2007 and December 2015. The technique involved an open-cavity implant with a dose of 32 Gy in eight fractions. WBI was performed with a total dose of 50 Gy in fractions of 2 Gy. The 4-year clinical outcomes of MCB-PBI were evaluated in the two distinct categories, and comparisons of outcomes between MCB-PBI and WBI were performed in patients with unfavorable features.

[Results] Of a total of 501 lesions undergoing BCT, 301 lesions were treated with MCB-PBI and 200 lesions with WBI. At a median follow-up time of 52 months, the 4-year rate of ipsilateral breast tumor recurrence (IBTR)-free, disease-free, and overall survival in patients with MCB-PBI and WBI were 98.9% vs. 98.0% (p = 0.56), 97.0% vs. 95.3% (p = 0.78), and 99.6% vs. 98.2% (p = 0.38), respectively. In the exclusion cohort treated with MCB-PBI, IBTR-free and disease-free survival were significantly poorer than in the inclusion cohort.However, no significant differences in the outcomes between the two radiotherapy techniques were demonstrated with respect to either IBTR-FS (95.0% vs. 97.2%, p = 0.24), DFS (95.0% vs. 95.8%, p = 0.31), or OS (100% vs. 99.0%, p = 0.80) in patients with exclusion criteria

Univariate and multivariate analysis of prognostic factors for IBTR and breast cancer eventVariablesIBTR  Locoregional and distant recurrences   P-value  P-value   UnivariateMultivariateHR (95% CI)UnivariateMultivariateHR (95% CI)Age ≥ 40 vs &lt; 40years.25—2.49 (0.53–11.72) —0.90 (0.21–3.85)Axillary node negative vs. positive&lt;.05&lt;.054.09 (1.18–14.12)&lt;.05&lt;.052.75 (1.19–6.36)Margin negative vs. positive&lt;.01&lt;.015.58 (1.54–20.29).075.0682.55 (0.93–6.97)WBI vs. MCB-PBI.56—0.69 (0.20–2.39).78—0.89 (0.39–2.03).

ConclusionsTo our knowledge, this study includes the largest cohort of Asian patients undergoing MCB-PBI. Although the retrospective chart review with relatively short follow-up time and small number of patients does not allow reaching any definite conclusion, we could expect the same outcomes by MCB-PBI as those in the GEC-ESTRO trial with respect to the tumor control only for Japanese but for Asian patients with breast cancer. Moreover, no negative impact on the outcomes of MCB-PBI as compared to WBI was not found in patients with exclusion criteria.

Citation Format: Sato K, Mizuno Y, Fuchikami H, Takeda N, Kato M. Re-evaluating outcomes of partial-breast irradiation using multicatheter brachytherapy for Japanese patients with breast cancer by European brachytherapy phase 3 trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-11-12.

Skin pigmentation is inversely associated with insulin resistance in healthy Japanese women

AIM

As a low-pigment skin type is prevalent in men and women with type 1 diabetes, it is possible that skin pigmentation may be associated with insulin resistance. This study aimed to cross-sectionally examine this association in healthy women.

METHODS

Study participants were 792 Japanese women who attended a health examination and were not taking any medication for diabetes. Skin pigmentation on the inner upper and lower arms and forehead was measured using a Mexameter^® skin colorimeter, a narrow-band reflective spectrophotometer. Data are expressed as a melanin index, which quantifies melanin content. Fasting blood glucose and insulin levels were also measured, and homoeostasis model assessment for insulin resistance (HOMA-IR) scores were calculated. Information on medical history and lifestyle factors were obtained by a self-administered questionnaire, while data on sun exposure were collected through interviews. Plasma 25-hydroxyvitamin D levels were measured in a subsample of women (n=464).

RESULTS

Melanin indices at the inner upper and lower arms were significantly and inversely associated with fasting insulin levels and HOMA-IR after controlling for age, body mass index, smoking status, indicators for rater effects, cumulative sun exposure and season at the time of measurement. Additional adjustment for plasma 25-hydroxyvitamin D levels did not alter the results.

CONCLUSION

These data suggest that skin pigmentation is associated with insulin resistance, and encourage future studies into the potential role of melanin and related factors in glucose homoeostasis.

Abstract P3-12-19: Impact of young age on local control after partial-breast irradiation in early-stage breast cancer

Background: Although the rate of breast-conserving surgery (BCS) increased, the receipt of adjuvant radiotherapy after BCS decreased especially for young patients. The long-term daily visit to radiation facilities must be the most relevant barriers to receiving radiation therapy. The use of partial-breast irradiation (PBI) is considered an alternative option. However, there are limited data to be seen how safe PBI is as an option of adjuvant radiation therapy in young patients compared with whole-breast irradiation (WBI). In this report, we reviewed our single-institution experience with PBI compared with WBI in young breast cancer patients.

Methods: We evaluated 443 consecutive patients with T≤3-cm N0–1 breast cancer who underwent breast-conserving therapy (BCT) between November 2007 and May 2015. 268 patients received PBI using interstitial multicatheter brachytherapy. The interstitial brachytherapy was performed in an accelerated fashion with a dose of 32 Gy in eight fractions over 5-6 days. 185 patients received WBI with a dose of 50 Gy in fractions of 2 Gy. Patients with risk factors such as positive margins and young age received a subsequent 10 Gy boost to the tumor bed, and the regional nodal irradiation was added in patients with ≥ 4 positive nodes. Patients who underwent neoadjuvant chemotherapy were excluded from the analysis. Our primary objective was to assess outcome rates of ipsilateral breast tumor recurrence (IBTR), disease-free survival (DFS), and overall survival (OS), and compare the patterns of treatment failures between the cohorts.

Results: Patients aged &lt;50 years with a minimum follow-up period of 6 months were selected for the analysis. Of those patients who could be completely followed, there were 95 women receiving PBI and 81 women receiving WBI. In PBI cohort, 4 patients also received WBI because of adverse histological features with positive nodes or positive margins by final pathology. Median follow-up was 4.0 years for PBI patients and 3.9 years for WBI patients. Median age was 43.9 years old for PBI and 42.1 years old for WBI cohort. Mean tumor size was equivalent for the cohorts (12 mm). Positive lymph nodes were seen more frequently in WBI cohort (9.5% and 29.6%, p &lt; 0.05). There was no significant difference in the 3-year probability of disease-free survival (97.4% and 98.1% for PBI and WBI, respectively; p = 0.95). No breast cancer related death was observed. With our follow-up period, there were 5 IBTR (2.8%). Of these IBTRs, 4 were true recurrences (2 were in PBI and 2 were in WBI). There was 1 elsewhere recurrence in PBI cohort. The actual rate of IBTR was 3.2% and 2.5% in PBI and WBI, respectively (p = 0.64).

Conclusions: We observed equivalent IBTR rates between PBI and WBI cohorts in young breast cancer patients. If there are no differences in survival between the two radiotherapy regimens, PBI may be a better option than WBI after BCS in such a population. To our knowledge, this is the first report describing that the efficacy of PBI after BCS is comparable with WBI in young breast cancer patients in Asia. However, our data are limited by our short median follow-up with small number of patients. The application of PBI should still be carefully considered until mature Phase III trial data are available.

Citation Format: Sato K, Mizuno Y, Fuchikami H, Takeda N, Kato M. Impact of young age on local control after partial-breast irradiation in early-stage breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-12-19.

A two-step hybrid technique for accurately localizing acoustic source in anisotropic structures without knowing their material properties

Acoustic source localization techniques generally assume straight line propagation of waves from the acoustic source to the sensor. However, it is well-known that in anisotropic plates the acoustic energy does not always propagate in straight lines. Even for isotropic plates containing a cavity or an inclusion between the acoustic source and the sensor the straight line propagation assumption is violated. In such cases only options available in localizing acoustic source is to use relatively expensive distributed sensor systems, or to follow time reversal techniques based on the impulse response functions which is labor intensive and computationally demanding. A two-step hybrid technique is proposed in this paper for predicting acoustic source in anisotropic plates. During the first step it was assumed that the waves propagated along straight lines from the acoustic source to the sensor. The source was localized with this simplifying assumption. Then this first prediction was improved in the second step by solving an optimization problem. Experimental results showed that the second step always moved the estimates towards the actual source location. Thus it always reduced the prediction error irrespective of whether the final prediction coincided with the actual source location or not.

Chalcone Tetramers, Lophirachalcone and Alatachalcone, fromLophira alataas Possible Anti-tumor Promoters

Two chalcone tetramers were isolated as inhibitors of Epstein-Barr virus (EBV)-activation induced by a tumor promoter, teleocidin B-4, from a medicinal plant in tropical west Africa, Lophira alata (Ochnaceae). One of them was identified as lophirachalcone. The other, named alatachalcone, was new, and the structure was determined by spectral properties. Both compounds also showed potent inhibitory activities against teleocidin B-4-induced inflammation on mouse ear. In an initiation-promotion experiment on mouse skin, alatachalcone (16 nmol) significantly inhibited tumor promotion caused by 12-O-tetradecanoylphorbol-13-acetate (TPA, 1.6 nmol).

Magnetic phase diagram of clathrate compound Ce3Pd20Si6 with quadrupolar ordering

We present results of specific heat measurements on a Ce3Pd20Si6 single crystal and construct the magnetic phase diagram for the three cubic principal directions [100], [110] and [111]. The highly anisotropic phase diagram is discussed and can be qualitatively explained by the Zeeman splitting at the 8c-site. For B ‖ [100], the present study found two different quadrupolar ordered phases, which meet the paramagnetic phase at a tri-critical point and establish the new phase boundaries.

Study on biological monitoring of fenpropathrin exposure in application by utilizing urinary 3-phenoxybenzoic acid level

To estimate pesticide exposure faced by applicators, an investigation of exposure-absorption was conducted on two applicators under routine working conditions and using regular procedures during pesticide spraying of greenhouse strawberries with fenpropathrin. The authors hypothesized that 3-phenoxybenzoic acid (3-PBA) is a urinary excreted metabolite of fenpropathrin, a synthetic pyrethroid pesticide with 3-phenoxybenzyl moiety, and its determination would help to improve the assessment of fenpropathrin exposure-absorption in applicators. The extent of exposure-absorption was evaluated by the determination of urinary level of 3-PBA (biological monitoring), the amount of the chemical adhered to clothes and permeated to the skin surface, and its concentration in the air of the greenhouse. The results showed that the fenpropathrin concentration in the air was less than 0.1 μg/m(3). The amount of adhesion was less than 0.001 to 10.25 μg/cm(2), and there was very little permeation. However, the urinary 3-PBA concentration by biological monitoring appeared to be approximately twice that of pre-exposure levels in both applicators. This finding demonstrates that the applicators were exposed to fenpropathrin and absorbed it during spraying. We conclude that the fenpropathrin exposure-absorption in application could be estimated by the determination of urinary 3-PBA. This method of biological monitoring may be more useful indicator to accurately evaluate the working conditions in application.

Identification of Hic-5 as a novel regulatory factor for integrin αIIbβ3 activation and platelet aggregation in mice

BACKGROUND

Integrin αIIbβ3 plays key roles in platelet aggregation and subsequent thrombus formation. Hydrogen peroxide-inducible clone-5 (Hic-5), a member of the paxillin family, serves as a focal adhesion adaptor protein associated with αIIbβ3 at its cytoplasmic strand.

OBJECTIVES

Hic-5 function in αIIbβ3 activation and subsequent platelet aggregation remains unknown. To address this question, platelets from Hic-5(-/-) mice were analyzed.

METHODS AND RESULTS

Hic-5(-/-) mice displayed a significant hemostatic defect and resistance to thromboembolism, which were explained in part by weaker thrombin-induced aggregation in Hic-5(-/-) platelets. Mechanistically, Hic-5(-/-) platelets showed limited activation of αIIbβ3 upon thrombin treatment. Morphological alteration in Hic-5(-/-) platelets after thrombin stimulation on fibrinogen plates was also limited. As a direct consequence, the quantity of actin co-immunoprecipitating with the activated αIIbβ3 was smaller in Hic-5(-/-) platelets than in wild-type platelets.

CONCLUSION

We identified Hic-5 as a novel and specific regulatory factor for thrombin-induced αIIbβ3 activation and subsequent platelet aggregation in mice.

Preseasonal prophylactic treatment with antihistamines suppresses nasal symptoms and expression of histamine H₁ receptor mRNA in the nasal mucosa of patients with pollinosis

Administration of antihistamines 2-4 weeks before the pollen season showed a greater inhibitory effect on nasal allergy symptoms in patients with seasonal allergic rhinitis. However, the mechanism of slow-onset effects of preseasonal treatment with antihistamines remains unclear. Here, we investigated the effect of preseasonal prophylactic treatment with antihistamines on nasal symptoms and the expression of histamine H₁ receptor (H1R) mRNA of the nasal mucosa in patients with cedar pollen pollinosis. During the peak pollen period, the expression of H1R mRNA in the nasal mucosa and the scores of sneezing and watery rhinorrhea in patients receiving preseasonal prophylactic treatment with antihistamines were significantly suppressed in comparison with those in the patients without treatment. Moreover, there was a significant correlation between the nasal symptoms and the expression of H1R mRNA in both patients with or without preseasonal prophylactic treatment. These findings suggest that preseasonal prophylactic treatment with antihistamines is more effective than on-seasonal administration to patients with pollinosis in reducing nasal symptoms during the peak pollen period by suppressing H1R gene expression in the nasal mucosa.

Interferon-gamma release assay for diagnosing Mycobacterium tuberculosis infections in patients with systemic lupus erythematosus

Our aim was to analyze the performance of an interferon-gamma release assay, QuantiFERON-TB Gold (QFT-2G), for diagnosing Mycobacterium tuberculosis (MTB) infection in patients with systemic lupus erythematosus (SLE). We performed the QFT-2G and tuberculin skin test (TST) in 71 SLE patients. The QFT-2G results of 279 patients with other connective tissue diseases (CTD) and 35 healthy controls were analyzed. Of the 71 SLE patients, two (2.8%) were positive and 46 (64.8%) were negative by QFT-2G. All SLE patients had no evidence of active MTB infection, apart from one. QFT-2G produced a significantly higher number of indeterminate results in patients with SLE (23/71, 32.4%) compared with those with other CTD (5.7%) or healthy controls (0%) ( p < 0.0001 and p < 0.0001). Decreased lymphocyte counts and high SLEDAI scores in SLE patients were shown to be risk factors for indeterminate results by multivariate analysis ( p = 0.02 and p = 0.04). Among all patients with CTD, SLE itself and lymphocytopenia were found to be independent risks for indeterminate results ( p = 0.00000625 and p = 0.000107). In conclusion, QFT-2G may have more potential to assist in the diagnosis of active and latent MTB infection than TST in SLE patients. However, because of the high frequency of indeterminate results, caution must be used when interpreting the results of QFT-2G among SLE patients, especially those who have parallel or subsequent flares.

Thickness Effect on Cracking Phenomena and Mechanical Properties of Submicron Glass Thin Films Deposited on a Polymer Substrate

The multiple cracking progress in thin SiOx films deposited on polyethylene terephthalate (PET) substrates during tensile tests were investigated. Five kinds of specimens with different SiOx film thicknesses of 43, 67, 90, 120 and 320 nm were prepared. With the appropriate estimation of the residual strain in the film, the crack onset stress was found to be nearly proportional to the minus one-half power of the thickness. After the cracking is sufficiently developed, on the other hand, thinner specimens showed higher crack density than thicker ones. In order to predict the multiple cracking progress, stress distributions in the cracked films were calculated both by the elastic-plastic finite element analysis and modified shear lag analysis. The prediction, under the assumption of the unique stress criterion, explained reasonably well the multiple cracking progress obtained in the experiments.

Formation of chlorinated aromatics in model fly ashes using various copper compounds

Various copper compounds found in fly ash are related to the formation of chlorinated aromatics. The formation potentials of chlorinated aromatics in different model fly ashes containing various copper compounds and the chemical behavior of such copper compounds were investigated. In model fly ash with copper metal, hydroxide, carbonate, or oxides, the generated amounts of chlorobenzene (CBz) and polychlorinated biphenyls (PCBs) and the average chlorination numbers were low and at the same level, respectively. The maximum generated amounts of chlorinated aromatics were observed at 300 degrees C. Although X-ray absorption near edge structure (XANES) spectra indicated that the chemical form of copper compounds changed little, they were found to promote the formation of chlorinated aromatics. Therefore, these copper compounds play the same role as CuO. On the other hand, in model fly ash with copper chloride, the generated amounts of CBz and PCBs were quite high and the average chlorination numbers was high. Dynamic changes were observed in XANES spectra, and the pre-edge peak attributed to monovalent copper compounds appeared at around 300 degrees C. A large difference was observed between these two groups in the amount of CuCl generated and the homologs of chlorinated aromatics present, indicating that CuCl played an important role in the formation of chlorinated aromatics.

Sero-epidemiology of sporadic acute hepatitis in Bangladesh: high prevalences of infection with type-B, type-E and multiple types of hepatitis virus

In a recent investigation of hepatitis in Bangladesh, the sera from 74 adult patients (aged 15-67 years) who had been clinically diagnosed as cases of sporadic acute hepatitis were collected at various hospitals in and around Dhaka. Five cases were positive for IgM antibody against the hepatitis A virus and 30 were positive both for the surface antigen of the hepatitis B virus (HBV) and for IgM antibody against the HBV core (HBc). The six cases found positive for antibodies against the hepatitis D virus were all also positive for the HBV surface antigen but negative for anti-HBc IgM. Thirteen patients harboured hepatitis C virus RNA and 29 were positive for IgM antibody against the hepatitis E virus (HEV). There were 14 non-A-to-E subjects, whose illness was of unknown aetiology. Of the 83 infections with hepatitis viruses detected in the other 60 patients, 6%, 36%, 16%, 7% and 35% were of types A, B, C, D and E, respectively. Each of 28 of the patients (47% of those confirmed to have viral hepatitis) had concomitant infection with more than one type of hepatitis virus. The predominance of HBV and HEV infections and the high prevalence of multiple infection seen among these Bangladeshi cases have not been observed among hepatitis cases in developed countries.

Behaviour and adsorptive removal of siloxanes in sewage sludge biogas

We investigated the behaviour of siloxanes, which adversely affect biogas engines, as well as their concentration levels in sewage sludge biogas in Japan. We also performed experiments on the absorptive removal of siloxanes using various adsorbents and determined the main adsorbent characteristics required for the removal of siloxanes. The results of our study on the concentration and composition of siloxanes in biogas were similar to previous reports. Moreover, we found that the concentration of siloxanes changes in relation to the outside air temperature based on real-time measurements of siloxanes using a continuous analyser. We further speculated that the continuous analyser would accurately indicate the siloxane concentration in model biogas but overestimate the siloxane concentration in actual biogas because of positive interference by VOCs and other biogas components. In the siloxane adsorption experiment, the equilibrium uptake of both cyclic siloxanes, D4 and D5, was positively related to the BET-specific surface area of the adsorbents and the fraction of the external surface area taken up by relatively large diameter pores. We attributed the adsorption results to the fact that the siloxane molecules are generally larger than micropores; therefore, they are less susceptible to adsorption to micropores. Based on these results, we concluded that adsorbents with large BET-specific surface areas, especially those with a high external specific surface area and pores of relatively large diameters, are desired for the removal of siloxanes.

Epithelium-derived chemokines induce airway smooth muscle cell migration

BACKGROUND

The remodelling of airway smooth muscle (ASM) associated with asthma severity may involve the migration of ASM cells towards the epithelium. However, little is known about the mechanisms of cell migration and the effect of epithelial-derived mediators on this process.

OBJECTIVE

The main objective of the current study is to assess the effects of epithelial-derived chemokines on ASM cell migration.

METHODS

Normal human ASM cells were incubated with supernatants from cells of the bronchial epithelial cell line BEAS-2B and normal human bronchial epithelial (NHBE) cells. To induce chemokine production, epithelial cells were treated with TNF-alpha. Chemokine expression by epithelial cells was evaluated by quantitative real-time PCR, ELISA and membrane antibody array. To identify the role of individual chemokines in ASM cell migration, we performed migration assays with a modified Boyden chamber using specific neutralizing antibodies to block chemokine effects.

RESULTS

Supernatants from BEAS-2B cells treated with TNF-alpha increased ASM cell migration; migration was increased 1.6 and 2.5-fold by supernatant from BEAS-2B cells treated with 10 and 100 ng/mL TNF-alpha, respectively. Protein levels in supernatants and mRNA expression by BEAS-2B cells of regulated on activation, normal T cell expressed and secreted (RANTES) and IL-8 were significantly increased by 100 ng/mL TNF-alpha treatment. The incubation of supernatant with antibodies to RANTES or IL-8 significantly reduced ASM cell migration, and the combined antibodies further inhibited the cell migration. The migratory effects of supernatants and inhibiting effects of RANTES and/or IL-8 were confirmed also using NHBE cells.

CONCLUSION

The results show that chemokines from airway epithelial cells cause ASM cell migration and might potentially play a role in the process of airway remodelling in asthma.

Flattening of sagittal spinal curvature as a predictor of vertebral fracture

In a 12-year prospective study of 100 adult volunteers, incident vertebral fractures were analyzed for potential predictors. Decreased sagittal spinal curvature and pre-existing fractures were identified as independent predictors. The risk of vertebral fracture increased to 8.6-fold with a 1 SD decrease in both thoracic and lumbar curves.

INTRODUCTION

Physiological spinal curvature acts as a shock absorber: however, it has not been demonstrated whether reduced spinal curvature is a risk of vertebral fracture. The aim of this prospective study is to assess the relationship between the extent of sagittal spinal curvature and incidence of vertebral fractures.

METHODS

One hundred community-based volunteers aged 50+ years were followed radiologically for at least 10 years. Entire spine radiograms of volunteers in erect position were used for evaluating sagittal spinal curvatures, grade of osteoporosis, and incident vertebral fractures.

RESULTS

Mean baseline age was 61.9 years and mean follow-up period was 12.0 years. In multivariate analysis, preexisting vertebral fracture (relative risk [RR] 3.70, 95% confidence interval [CI] 1.22-11.20), and a decrease in either thoracic or lumbar curvature by 1-SD (RR 3.06, 95% CI 1.04-9.00) were independent predictors. The fracture risk even increased in the presence of a 1-SD decrease in both thoracic and lumbar curvature (RR 8.64, 95% CI 1.39-53.78).

CONCLUSIONS

Reduction of physiological curvatures in both thoracic and lumbar spine led to the increased risk of vertebral fracture by more than eightfold. The importance of evaluating sagittal spinal alignment should be emphasized, because it might indicate the risk of the first vertebral fracture, which is another strong predictor of subsequent fractures.

Chemical states of trace elements in sewage sludge incineration ash by using x-ray absorption fine structure

In this study, the chemical states of chromium (Cr), arsenic (As), and selenium (Se) in sewage sludge incineration ash were determined by X-ray absorption fine structure (XAFS) spectroscopy. Sewage sludge incineration ash was sampled from several facilities, and XAFS measurements were carried out with a beam line BL01B1 at the SPring-8 facility. Cr K-edge X-ray absorption near-edge structure (XANES) spectra suggested that Cr compounds were predominantly speciated as Cr(III) and the fraction of Cr(VI) was very minor. Compared to the reference materials, Cr XANES spectra of the incineration ashes were similar to those of FeCr2O4, Cr(OH)3, and CaCr2O4. As K-edge XANES spectra indicated that As(V) compounds were present in incineration ashes. Because the chemical state of As in sewage sludge was As3+ in our previous study, we speculated that the chemical state of As changed into As(V) during the incineration process. According to Se K-edge XANES spectra, Se compounds were predominantly Se(IV), and a slight difference was observed in the chemical states amongst facilities using inorganic or organic coagulants in the dewatering process.

Emergence of panniculitis and haemophagocytic syndrome in a patient with chronic systemic lupus erythematosus

Panniculitis rarely occurs in the course of systemic lupus erythematosus (SLE). When it occurs, it is thought to be mainly lupus erythematosus panniculitis (LEP). Here we describe a 32-year old Japanese woman with chronic SLE, who simultaneously presented facial lymphocytic lobular panniculitis and pancytopenia due to haemophagocytic syndrome. She showed several auto-antibodies against trilineage haematopoetic cells, an anti-cardiolipin antibody, and no evidence of viral infection, indicating that her haemophagocytic syndrome might be autoimmune-associated haemophagocytic syndrome. The panniculitis and haemophagocytic syndrome presented simultaneously, and these manifestations were dramatically improved with corticosteroid therapy; therefore, the lymphocytic lobular panniculitis could be linked to autoimmune-associated haemophagocytic syndrome in this case.