Application of StrucGP in medical immunology: site-specific N-glycoproteomic analysis of macrophages

The structure of N-glycans on specific proteins can regulate innate and adaptive immunity via sensing environmental signals. Meanwhile, the structural diversity of N-glycans poses analytical challenges that limit the exploration of specific glycosylation functions. In this work, we used THP-1-derived macrophages as examples to show the vast potential of a N-glycan structural interpretation tool StrucGP in N-glycoproteomic analysis. The intact glycopeptides of macrophages were enriched and analyzed using mass spectrometry (MS)-based glycoproteomic approaches, followed by the large-scale mapping of site-specific glycan structures via StrucGP. Results revealed that bisected GlcNAc, core fucosylated, and sialylated glycans (e.g., HexNAc₄Hex₅Fuc₁Neu5Ac₁, N₄H₅F₁S₁) were increased in M1 and M2 macrophages, especially in the latter. The findings indicated that these structures may be closely related to macrophage polarization. In addition, a high level of glycosylated PD-L1 was observed in M1 macrophages, and the LacNAc moiety was detected at Asn-192 and Asn-200 of PD-L1, and Asn-200 contained Lewis epitopes. The precision structural interpretation of site-specific glycans and subsequent intervention of target glycoproteins and related glycosyltransferases are of great value for the development of new diagnostic and therapeutic approaches for different diseases.

[Research advances on burn blister fluid]

Burns often cause the damaged tissue to produce a large amount of exudate and the formation of blisters on the wound. The burn blister fluid contains a large number of molecules related to wound healing, which can reflect the state of local tissue microenvironment of the burn wound. Analyzing relevant information such as cellular components, signal mediators, and protein molecules in burn blister fluid is helpful to understand the local reaction and tissue microenvironment of burn wounds, and then help clinical burn treatment. In this article, by understanding the production mechanism of burn blister fluid, discussing its role in wound evaluation, and integrating the research progress of burn blister fluid in proteomics, metabolomics, cellular components, and pharmacokinetics, we propose our thoughts and prospects on the research of burn blister fluid, in order to provide assistance for clinical evaluation and treatment of burn wounds, and also provide idea for the follow-up study of burn blister fluid.

Evaluation of absorbent cotton for glycopeptide enrichment

Selecting proper and efficient glycopeptide enrichment approaches are essential for mass spectrometry-based glycoproteomics since glycopeptides are usually with microheterogeneity and low abundance in most biological samples. Herein, we introduced a cotton hydrophilic interaction liquid chromatography (HILIC) approach for large-scale glycopeptide enrichment with 80% acetonitrile/1% trifluoroacetic acid as the optimal sample loading buffer. The comparison of cotton HILIC with Venusil HILIC and mixed anion-exchange (MAX) approaches indicated that cotton HILIC was superior in overall glycopeptide enrichment, whereas Venusil HILIC preferred in complex glycan structures and MAX performed better with high mannose glycans. Exploration of capacity and recovery rate of cotton HILIC illustrated that 5mg cotton packed in a 200μL tip achieved a reasonable glycopeptide enrichment performance (~6% recovery) from ~0.5mg peptides. In conclusion, cotton HILIC can be used as an optional glycopeptide enrichment approach in glycosylation analysis with its specific merit.

[Chaihu Guizhi Decoction plus or minus formula combined with capecitabine inhibits IL-6/STAT3 signaling to suppress triple-negative breast cancer xenografts in nude mice]

OBJECTIVE

To investigate the effect of Chaihu Guizhi Decoction (CHGZD) combined with capecitabine on growth and apoptosis of subcutaneous triple-negative breast cancer xenografts in nude mice and explore the possible mechanism.

METHODS

Nude mouse models bearing subcutaneous triple-negative breast cancer xenografts were randomized into 6 groups (n=10) for treatment with distilled water (model group), low (10.62 g/kg), medium (21.23 g/kg) and high (42.46 g/kg) doses of CHGZD, capecitabine (0.2 mg/kg), or the combination of CHGZD (42.46 g/kg) and capecitabine (0.2 mg/k) once daily for 21 consecutive days. The general condition of mice was observed, and after 21-day treatments, the tumors were dissected for measurement of tumor volume and weight and histopathological examination with HE staining. Serum IL-6 levels of the mice were determined with enzyme-linked immunosorbent assay (ELISA), and the expression levels of IL-6, STAT3, p-STAT3, Bax, Bcl-2 and cyclin D1 in the tumor tissues were detected using real-time PCR and Western blotting.

RESULTS

Compared with those in the model group, the tumor-bearing mice receiving treatments with CHGZD showed significantly increased food intake with good general condition, sensitive responses, increased body weight, and lower tumor mass (P < 0.01). Compared with capecitabine treatment alone, treatment with CHGZD alone at the medium and high doses and the combined treatment all resulted in significantly higher tumor inhibition rates (P < 0.01), induced obvious tumor tissue degeneration and reduced the tumor cell density. Treatments with CHGZD, both alone and in combination with capecitabine, significantly decreased serum IL-6 level, lowered the mRNA expression levels of IL-6 and STAT3, the protein expressions of IL-6, STAT3 and P-STAT3 (P < 0.05), and the mRNA and protein expressions of Bcl-2 and cyclin D1 (P < 0.05), and increased the mRNA and protein expressions of Bax in the tumor tissues (P < 0.05).

CONCLUSION

CHGZD combined with capecitabine can significantly inhibit tumor growth in nude mice bearing triple-negative breast cancer xenografts, the mechanism of which may involve the inhibition of IL-6/STAT3 signaling pathway and regulation of Bax, Bcl-2 and cyclin D1 expressions to suppress tumor cell proliferation and differentiation and induce cell apoptosis.

Precision Structural Interpretation of Site-Specific N-Glycans in Seminal Plasma

N-Linked glycoproteins are rich in seminal plasma, playing various essential roles in supporting sperm function and the fertilization process. However, the detailed information on these glycoproteins, particularly site-specific glycan structures, is still limited. In this study, a precision site-specific N-glycoproteome map of human seminal plasma was established by employing the site-specific glycoproteomic approach and a recently developed glycan structure interpretation software, StrucGP. A total of 9567 unique glycopeptides identified in human seminal plasma were composed of 773 N-linked glycan structures and 1019 N-glycosites from 620 glycoproteins. These glycans were comprised of four types of core structures and 13 branch structures. The majority of identified glycoproteins functioned in response to stimulus and immunity. As we reported in human spermatozoa, heavy fucosylation (fucose residues ≥6 per glycan) was also detected on seminal plasma glycoproteins such as clusterin and galectin-3-binding protein, which were involved in the immune response of biological processes and reactome pathways. Comparison of site-specific glycans between seminal plasma and spermatozoa revealed more complicated glycan structures in seminal plasma than in spermatozoa, even on their shared glycoproteins. These present data will be greatly beneficial for the in-depth structural and functional study of glycosylation in the male reproduction system.

Proteomic characterization of four subtypes of M2 macrophages derived from human THP-1 cells

Macrophages are widely distributed immune cells that contribute to tissue homeostasis. Human THP-1 cells have been widely used in various macrophage-associated studies, especially those involving pro-inflammatory M1 and anti-inflammatory M2 phenotypes. However, the molecular characterization of four M2 subtypes (M2a, M2b, M2c, and M2d) derived from THP-1 has not been fully investigated. In this study, we systematically analyzed the protein expression profiles of human THP-1-derived macrophages (M0, M1, M2a, M2b, M2c, and M2d) using quantitative proteomics approaches. The commonly and specially regulated proteins of the four M2 subtypes and their potential biological functions were further investigated. The results showed that M2a and M2b, and M2c and M2d have very similar protein expression profiles. These data could serve as an important resource for studies of macrophages using THP-1 cells, and provide a reference to distinguish different M2 subtypes in macrophage-associated diseases for subsequent clinical research.

Transcription Regulation of Tceal7 by the Triple Complex of Mef2c, Creb1 and Myod

Simple Summary

We have previously reported a striated muscle-specific gene during embryogenesis, Tceal7. Our studies have characterized the 0.7 kb promoter of the Tceal7 gene, which harbors important E-box motifs driving the LacZ reporter in the myogenic lineage. However, the underlying mechanism regulating the dynamic expression of Tceal7 during skeletal muscle regeneration is still elusive. In the present work, we have defined a cluster of Mef2#3–CRE#3–E#4 motifs through bioinformatic analysis and transcription assays. Our studies suggested that the triple complex of Mef2c, Creb1 and Myod binds to the Mef2#3–CRE#3–E#4 cluster region, therefore driving the dynamic expression of Tceal7 during skeletal muscle regeneration. The novel mechanism may throw new light on understanding transcription regulation in skeletal muscle myogenesis.

Abstract

Tceal7 has been identified as a direct, downstream target gene of MRF in the skeletal muscle. The overexpression of Tceal7 represses myogenic proliferation and promotes cell differentiation. Previous studies have defined the 0.7 kb upstream fragment of the Tceal7 gene. In the present study, we have further determined two clusters of transcription factor-binding motifs in the 0.7 kb promoter: CRE#2–E#1–CRE#1 in the proximal region and Mef2#3–CRE#3–E#4 in the distal region. Utilizing transcription assays, we have also shown that the reporter containing the Mef2#3–CRE#3–E#4 motifs is synergistically transactivated by Mef2c and Creb1. Further studies have mapped out the protein–protein interaction between Mef2c and Creb1. In summary, our present studies support the notion that the triple complex of Mef2c, Creb1 and Myod interacts with the Mef2#3–CRE#3–E#4 motifs in the distal region of the Tceal7 promoter, thereby driving Tceal7 expression during skeletal muscle development and regeneration.

Precision glycoproteomics reveals distinctive N-glycosylation in human spermatozoa

Spermatozoon represents a very special cell type in human body, and glycosylation plays essential roles in its whole life including spermatogenesis, maturation, capacitation, sperm–egg recognition, and fertilization. In this study, by mapping the most comprehensive N-glycoproteome of human spermatozoa using our recently developed site-specific glycoproteomic approaches, we show that spermatozoa contain a number of distinctive glycoproteins, which are mainly involved in spermatogenesis, acrosome reaction and sperm:oocyte membrane binding, and fertilization. Heavy fucosylation is observed on 14 glycoproteins mostly located at extracellular and cell surface regions in spermatozoa but not in other tissues. Sialylation and Lewis epitopes are enriched in the biological process of immune response in spermatozoa, while bisected core structures and LacdiNAc structures are highly expressed in acrosome. These data deepen our knowledge about glycosylation in spermatozoa and lay the foundation for functional study of glycosylation and glycan structures in male infertility.

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A precision site-specific glycoproteome is documented in human spermatozoa.

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Distinctive glycoproteins and heavy fucosylation are detected in spermatozoa.

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Sialylation and Lewis epitopes are related to immune response of spermatozoa.

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Bisected core structures and LacdiNAc are enriched on acrosome of spermatozoa.

Plasma C-type lectin-like receptor 2 as a predictor of death and vascular events in patients with acute ischemic stroke

BACKGROUND AND PURPOSE

C-type lectin-like receptor 2 (CLEC-2) has prominent involvement in platelet activation, which is increased in coronary heart disease and acute ischaemic stroke (AIS) and is associated with stroke progression and stroke prognosis. Here, the aim was to examine the prognostic value of CLEC-2 in death and vascular event recurrence in AIS patients.

METHODS

In all, 352 patients with AIS were studied prospectively. All patients were followed up for 1 year. Death for all vascular events and a combination of death and vascular diseases (recurrent stroke, myocardial infarction, hospitalized and treated angina, hospitalized and treated peripheral arterial disease) were recorded.

RESULTS

During 1 year of follow-up, 46 patients (14.2%) experienced death or combined end-points (23 death and 46 combined end-points). Plasma CLEC-2 (pCLEC-2) was significantly associated with an increased risk of death and combined events of death and vascular diseases after adjusting for age, sex, history of hypertension, diabetes mellitus and coronary artery disease, and National Institutes of Health Stroke Scale scores. Each 1 SD higher log-transformed pCLEC-2 was associated with a 4.27-fold (hazard ratio 4.27, 95% confidence interval 1.71-10.65) increased risk for death and a 2.42-fold increased risk for combined end-points (hazard ratio 2.42, 95% confidence interval 1.52-3.86). The optimal cut-off point of pCLEC-2 for predicting death was 184.38 pg/ml.

CONCLUSIONS

Higher pCLEC-2 levels at admission were associated with increased risk of death and combined events of death and vascular diseases in patients with AIS, which indicated that pCLEC-2 is an important prognostic factor for AIS.

Correlations Among Ultrasound-Guided Diffuse Optical Tomography, Microvessel Density, and Breast Cancer Prognosis

OBJECTIVES

To investigate the correlation among ultrasound-guided diffuse optical tomography (DOT), microvessel density, and breast cancer prognosis.

METHODS

Before surgery, the total hemoglobin (Hb) concentrations of 184 female patients with breast cancer with only a single lesion were measured. During follow-up, 23 patients had recurrence or metastatic disease after surgery. Among these patients, 18 with recurrence or metastatic disease within 3 years after surgery were paired with 18 patients without recurrence or metastatic disease. We retrospectively reviewed the pathologic sections of those 36 patients, conducted immunohistochemical staining, and counted the microvessel densities. Then we analyzed the correlation between microvessel density and total Hb, compared total Hb and microvessel density among breast cancers with different prognoses, and tested the value of DOT in predicting the prognosis of breast cancer.

RESULTS

Microvessel density and total Hb were linearly correlated (r = 0.584; P < .001). Total Hb and microvessel density were significantly increased in the metastasis group (P = .001 and .027, respectively). A receiver operating characteristic curve analysis showed that at a total Hb cutoff value of 221.7 μmol/L, the sensitivity, specificity, and area under the curve of DOT for predicting recurrence or metastasis were 0.826, 0.516, and 0.660, respectively.

CONCLUSIONS

The total Hb concentration can reflect a tumor's blood supply. Patients with a high total Hb concentration and microvessel density have a higher risk for a poorer prognosis. Total Hb can be used as an indicator of breast cancer prognosis. Diffuse optical tomography can help physicians identify patients with a high risk of metastasis and make clinical decisions.

Genetic analysis of a hybrid sterility gene that causes both pollen and embryo sac sterility in hybrids between Oryza sativa L. and Oryza longistaminata

Oryza longistaminata originates from African wild rice and contains valuable traits conferring tolerance to biotic and abiotic stress. However, interspecific crosses between O. longistaminata and Oryza sativa cultivars are hindered by reproductive barriers. To dissect the mechanism of interspecific hybrid sterility, we developed a near-isogenic line (NIL) using indica variety RD23 as the recipient parent and O. longistaminata as the donor parent. Both pollen and embryo sac semi-sterility were observed in F₁ hybrids between RD23 and NIL. Cytological analysis demonstrated that pollen abortion in F₁ hybrids occurred at the early bi-nucleate stage due to a failure of the first mitosis in microspores. Partial embryo sacs in the F₁ hybrids were defective during the functional megaspore formation stage. Most notably, nearly half of the male or female gametes were aborted in heterozygotes S40ⁱS40^l, regardless of their genotypes. Thus, S40 was indicated as a one-locus sporophytic sterility gene controlling both male and female fertility in hybrids between RD23 and O. longistaminata. A population of 16 802 plants derived from the hybrid RD23/NIL-S40 was developed to fine-map S40. Finally, the S40 locus was delimited to an 80-kb region on the short arm of chromosome 1 in terms with reference sequences of cv. 93-11. Eight open reading frames (ORFs) were localized in this region. On the basis of gene expression and genomic sequence analysis, ORF5 and ORF8 were identified as candidate genes for the S40 locus. These results are helpful in cloning the S40 gene and marker-assisted transferring of the corresponding neutral allele in rice breeding programs.

Abstract P5-02-05: Biology and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014)

Background: Milestone studies showed that ultrasound (US) was an effective primary screening test for breast cancer both in the western world and in China [PMID: 26712110, 26715161, and 25668012]. Ultrasound has been officially designated to be the initial imaging test for breast cancer screening in Beijing and several other cities in China, due to its improved sensitivity in Chinese women who usually have denser breasts and develop breast cancer earlier than Caucasian counterparts. Study showed that it would take 40 years to screen each woman in the target age group once [PMID: 26808342].The mainstay modality of breast cancer screening in China is the hospital-based opportunistic screening among asymptomatic self-referred women. However, there is little data about the tumor biology and long-term survival of the US-detected non-palpable breast cancer (NPBC) in hospital-based Chinese population.

Methods: From January 2001 to December 2014, 3,786 asymptomatic women with positive (BI-RADS 4 and 5) initial screening US underwent biopsies in Peking Union Medical College Hospital, and 572 NPBC in 556 women were diagnosed. Women without dense breasts (defined as BI-RADS category C and D) also received screening mammography (MG) after physical examination and ultrasound. 788 patients with positive (BI-RADS 4 and 5) mammogram (MG) and normal US (BI-RADS 1, 2 and 3) underwent MG-guided biopsies and another 127 NPBC were diagnosed in 126 women. The clinicopathological features, treatment choice, 10-year disease-free survival (DFS) and overall survival (OS) were reviewed and compared between the US-detected and MG-detected NPBC. Prognostic factors of NPBC were identified.

Results: Overall, US could detect more invasive NPBC (83.4% vs 54.3%, p&lt;0.001), lymph node positive cancer (19.1% vs 10.2%, p&lt;0.001)and multifocal cancer (19.2% vs 6.3%, p&lt;0.001). In invasive NPBC, US detected more low grade cancer (21.4% vs 10.2%, p=0.001), multifocal cancer (20.7% vs 2.9%, p&lt;0.001), Her2 negative cancer (77.6% vs 62.3%, p=0.001) and larger tumor (pT1c+pT2, 53.3% vs 37.6%, p&lt;0.001). There was no significant difference in immunophenotype/subtype, treatment methods, DFS or OS between US- and MG-NPBC among ductal carcinoma in situ (DCIS), invasive and all NPBC. For all NPBC and the US-NPBC, the common DFS-factors included pT, pN and p53 whereas OS-predictors were pN and immunophenotype/subtype.

Table 1. Kaplan-Meier estimates of DFS and OS between US-NPBC and MG-NPBC§.Patients (No.)10-year DFS (%)P value10-year OS (%)P valueAllUS-NPBC (572)90.60.73896.10.142 MG-NPBC (127)92.7 100.0 DCISUS-NPBC (94)100.00.060100.0- MG-NPBC (58)93.8 100.0 InvasiveUS-NPBC (478)88.60.68095.20.239 MG-NPBC (69)92.0 100.0 § Kaplan-Meier survival curves between each two subgroups would be displayed in the poster.

Conclusion: Compared to MG, US detected more invasive NPBC with positive lymph node in hospital-based asymptomatic self-referred Chinese women, who could achieve comparable 10-year DFS and OS as MG-detected NPBC. US could serve as the feasible initial imaging modality in hospital-based opportunistic screening Chinese women.

Citation Format: Yao R, Pan B, Zhu Q, Xu Q, Zhou Y, Zhang J, Mao F, You S, Lin Y, Shi J, Guan J, Wang X, Zhang Y, Zhang X, Shen S, Zhong Y, Xu Y, Liang Z, Jiang Y, Sun Q. Biology and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014) [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 P5-02-05.

Rapid Detection and Characterisation of Triterpene Saponins from the Root of Pulsatilla chinensis (Bunge) Regel by HPLC-ESI-QTOF-MS/MS

INTRODUCTION

Triterpene saponins are the major bioactive components in the root of Pulsatilla chinensis (Bunge) Regel (RPC), and have been reported to possess antitumor and immunological adjuvant activities. However, the isolation, purification and elucidation procedures of triterpene saponins from RPC are difficult and time consuming due to high polarity and structural similarity.

OBJECTIVES

To develop an analytical strategy for discovering and elucidating triterpene saponins in RPC.

METHODS

Methanolic extract of RPC is analysed by high-performance liquid chromatography coupled to electrospray ionisation and quadrupole time-of-flight-mass spectrometry (HPLC-ESI-QTOF-MS/MS). The MS and MS/MS experiments are conducted using the negative-ionisation mode, in order to provide molecular-mass information and production spectra for the structural elucidation of compounds.

RESULTS

Based on retention times, accurate mass and mass spectrometric fragmentation, 24 triterpene saponins are identified or tentatively elucidated from RPC, of which nine triterpene saponins were not reported previously.

CONCLUSION

The HPLC-ESI-QTOF-MS/MS could be employed as a rapid, effective technique to screen and identify triterpene saponins in RPC without tedious and time-consuming isolation of pure constituents. Copyright © 2016 John Wiley & Sons, Ltd.

Control of Immune Response to Allogeneic Embryonic Stem Cells by CD3 Antibody-Mediated Operational Tolerance Induction

Implantation of embryonic stem cells (ESCs) and their differentiated derivatives into allogeneic hosts triggers an immune response that represents a hurdle to clinical application. We established in autoimmunity and in transplantation that CD3 antibody therapy induces a state of immune tolerance. Promising results have been obtained with CD3 antibodies in the clinic. In this study, we tested whether this strategy can prolong the survival of undifferentiated ESCs and their differentiated derivatives in histoincompatible hosts. Recipients of either mouse ESC-derived embryoid bodies (EBs) or cardiac progenitors received a single short tolerogenic regimen of CD3 antibody. In immunocompetent mice, allogeneic EBs and cardiac progenitors were rejected within 20-25 days. Recipients treated with CD3 antibody showed long-term survival of implanted cardiac progenitors or EBs. In due course, EBs became teratomas, the growth of which was self-limited. Regulatory CD4(+)FoxP3(+) T cells and signaling through the PD1/PDL1 pathway played key roles in the CD3 antibody therapeutic effect. Gene profiling emphasized the importance of TGF-β and the inhibitory T cell coreceptor Tim3 to the observed effect. These results demonstrate that CD3 antibody administered alone promotes prolonged survival of allogeneic ESC derivatives and thus could prove useful for enhancing cell engraftment in the absence of chronic immunosuppression.

Evaluation of lymph node status after neoadjuvant chemotherapy in breast cancer patients: comparison of diagnostic performance of ultrasound, MRI and ¹⁸F-FDG PET/CT

Objective:

To evaluate the diagnostic performance of ultrasound, MRI and fluorine-18 fludeoxyglucose positron emission tomography (¹⁸F-FDG PET)/CT for the diagnosis of metastatic axillary lymph node (ALN) after neoadjuvant chemotherapy (NAC) and to find out histopathological factors affecting the diagnostic performance of these imaging modalities.

Methods:

From January 2012 to November 2014, 191 consecutive patients with breast cancer who underwent NAC before surgery were retrospectively reviewed. We included 139 patients with ALN metastasis that was confirmed on fine needle aspiration or core needle biopsy at initial diagnosis.

Results:

After NAC, 39 (28%) patients showed negative conversion of ALN on surgical specimens of sentinel lymph node (LN) or ALN. The sensitivity of ultrasound, MRI and PET/CT was 50% (48/96), 72% (70/97) and 22% (16/73), respectively. The specificity of ultrasound, MRI and PET/CT was 77% (30/39), 54% (21/39) and 85% (22/26), respectively. The Az value of combination of ultrasound and PET/CT was the highest (0.634) followed by ultrasound (0.626) and combination of ultrasound, MRI and PET/CT (0.617). The size of tumour deposit in LN and oestrogen receptor was significantly associated with the diagnostic performance of ultrasound (p < 0.001 and p = 0.009, respectively) and MRI (p = 0.045 and p = 0.036, respectively). The percentage diameter decrease, size of tumour deposit in LN, progesterone receptor, HER2 and histological grade were significantly associated with the diagnostic performance of PET/CT (p = 0.023, p = 0.002, p = 0.036, p = 0.044 and p = 0.008, respectively). On multivariate logistic regression analysis, size of tumour deposit within LN was identified as being independently associated with diagnostic performance of ultrasound [odds ratio, 13.07; 95% confidence interval (CI), 2.95–57.96] and PET/CT (odds ratio, 6.47; 95% CI, 1.407–29.737).

Conclusion:

Combination of three imaging modalities showed the highest sensitivity, and PET/CT showed the highest specificity for the evaluation of ALN metastasis after NAC. Ultrasound alone or combination of ultrasound and PET/CT showed the highest positive-predictive value. The size of tumour deposit within ALN was significantly associated with diagnostic performance of ultrasound and PET/CT.

Advances in knowledge:

This study is about the diagnostic performance of ultrasound, MRI, PET/CT and combination of each imaging modality for the evaluation of metastatic ALN after NAC. Of many histopathological factors, only the size of tumour deposit within ALN was an independent factor associated with the diagnostic performance of ultrasound and PET/CT.

Local Recurrent Phyllodes Tumors of the Breast: Clinical and Sonographic Features

OBJECTIVES

The purpose of this study was to investigate the clinical, pathologic, and sonographic features of local recurrent phyllodes tumors of the breast and provide evidence for diagnosing tumor recurrence.

METHODS

A total of 127 patients with phyllodes tumors who underwent surgery from 1993 to 2012 were followed. The clinical, pathologic, and sonographic features of local recurrent tumors were analyzed.

RESULTS

Of the 127 patients, pathologic diagnoses were benign, borderline, and malignant in 75 (59.1%), 41 (32.3%), and 11 (8.7%) patients, respectively. The patients were followed for a mean duration ± SD of 50.9 ± 42.1 months (range, 2-225 months). Twenty-one patients had local recurrence, for a recurrence rate of 16.5%. The benign, borderline, and malignant recurrence rates were 14.7%, 17.1%, and 27.3%. The local recurrence in the 21 patients occurred after a mean interval of 19.4 ± 13.4 months. The mean times to local recurrence were 20.2 ± 12.1, 16.9 ± 10.8, and 20.3 ± 19.0 months for benign, borderline, and malignant tumors. The histologic characteristics of the recurrent tumors were similar to those of the initial tumors in 14 patients (66.7%), whereas the characteristics changed in 7 (33.3%). The sonographic features of the recurrent tumors were as follows: 69.4% were lobulated; 88.9% appeared as well-defined lesions; 41.7% had posterior acoustic enhancement; 11.1% had intramural cystic areas; and 83.4% had moderate or marked blood flow.

CONCLUSIONS

The recurrence rate for phyllodes tumors is high. One to 2 years after surgery is the key time for follow-up. The sonographic features contribute to recurrence diagnosis.

Diffuse optical tomography of breast carcinoma: can tumor total hemoglobin concentration be considered as a new promising prognostic parameter of breast carcinoma?

RATIONALE AND OBJECTIVES

Diffuse optical tomography (DOT) is an emerging functional modality, which can reflect tumor metabolic activity and angiogenesis. The purpose of this exploratory study was to correlate the total hemoglobin concentration (THC) measured by noninvasive DOT with prognostic factors in breast carcinomas.

MATERIALS AND METHODS

We prospectively imaged 251 breast carcinomas in 229 consecutive women (mean age, 51.18 ± 12.32 years) using DOT from 2007 to 2010. Tumor angiogenesis and metabolic activity were assessed based on quantitatively measured THC. The THC was correlated with prognostic factors, including tumor size, histopathologic classification, histologic grade, estrogen receptor (ER), progesterone receptor (PR), c-erbB-2, and p53.

RESULTS

In univariate analysis, THC was significantly correlated with the following prognostic factors: tumor size (P < .001), histologic grade (P < .001), ER (P < .05), PR (P < .001), and c-erbB-2 (P < .05). THC was not associated with histopathologic classification (P = .170) or p53 (P = .463). On the basis of a stepwise multiple regression analysis, THC of invasive ductal carcinoma was significantly correlated with tumor size (P < .001), histologic grade (P < .001), and PR (P < .05).

CONCLUSIONS

THC was associated with prognostic factors of breast carcinoma. THC may be considered as a new prognostic parameter of breast carcinoma and a prediction of tumor behavior and biological activity.

Analysis of underlying causes of inter-expert disagreement in retinopathy of prematurity diagnosis. Application of machine learning principles

OBJECTIVE

Inter-expert variability in image-based clinical diagnosis has been demonstrated in many diseases including retinopathy of prematurity (ROP), which is a disease affecting low birth weight infants and is a major cause of childhood blindness. In order to better understand the underlying causes of variability among experts, we propose a method to quantify the variability of expert decisions and analyze the relationship between expert diagnoses and features computed from the images. Identification of these features is relevant for development of computer-based decision support systems and educational systems in ROP, and these methods may be applicable to other diseases where inter-expert variability is observed.

METHODS

The experiments were carried out on a dataset of 34 retinal images, each with diagnoses provided independently by 22 experts. Analysis was performed using concepts of Mutual Information (MI) and Kernel Density Estimation. A large set of structural features (a total of 66) were extracted from retinal images. Feature selection was utilized to identify the most important features that correlated to actual clinical decisions by the 22 study experts. The best three features for each observer were selected by an exhaustive search on all possible feature subsets and considering joint MI as a relevance criterion. We also compared our results with the results of Cohen's Kappa [36] as an inter-rater reliability measure.

RESULTS

The results demonstrate that a group of observers (17 among 22) decide consistently with each other. Mean and second central moment of arteriolar tortuosity is among the reasons of disagreement between this group and the rest of the observers, meaning that the group of experts consider amount of tortuosity as well as the variation of tortuosity in the image.

CONCLUSION

Given a set of image-based features, the proposed analysis method can identify critical image-based features that lead to expert agreement and disagreement in diagnosis of ROP. Although tree-based features and various statistics such as central moment are not popular in the literature, our results suggest that they are important for diagnosis.

Reduced expression of regeneration associated genes in chronically axotomized facial motoneurons

Chronically axotomized motoneurons progressively fail to regenerate their axons. Since axonal regeneration is associated with the increased expression of tubulin, actin and GAP-43, we examined whether the regenerative failure is due to failure of chronically axotomized motoneurons to express and sustain the expression of these regeneration associated genes (RAGs). Chronically axotomized facial motoneurons were subjected to a second axotomy to mimic the clinical surgical procedure of refreshing the proximal nerve stump prior to nerve repair. Expression of α1-tubulin, actin and GAP-43 was analyzed in axotomized motoneurons using in situ hybridization followed by autoradiography and silver grain quantification. The expression of these RAGs by acutely axotomized motoneurons declined over several months. The chronically injured motoneurons responded to a refreshment axotomy with a re-increase in RAG expression. However, this response to a refreshment axotomy of chronically injured facial motoneurons was less than that seen in acutely axotomized facial motoneurons. These data demonstrate that the neuronal RAG expression can be induced by injury-related signals and does not require acute deprivation of target derived factors. The transient expression is consistent with a transient inflammatory response to the injury. We conclude that transient RAG expression in chronically axotomized motoneurons and the weak response of the chronically axotomized motoneurons to a refreshment axotomy provides a plausible explanation for the progressive decline in regenerative capacity of chronically axotomized motoneurons.

Melanocyte-specific CD8+ T cells are associated with epidermal depigmentation in a novel mouse model of vitiligo

In the present study, we established a novel murine model of vitiligo by sequential prime/boost immunizations into the hind footpad and tail dermis with tyrosinase-related protein 2 (TRP2)-180 (SVYDFFVWL) peptide, lipopolysaccharides and cytosine-phosphate-guanosine (CpG) oligodeoxynucleotides. Immunized mice developed epidermal depigmentation in the tail skin without hair depigmentation, thereby differentiating this approach from established models of vitiligo. Following intradermal tail immunization, activated CD8(+) interferon (IFN)-γ(+) T cells were recruited locally to the tail skin. In-vivo cytotoxicity assays demonstrated specific lysis of TRP2-180-presenting cells in immunized mice. Furthermore, the extent of skin depigmentation correlated with the frequency of TRP2-180-specific splenic CD8(+) T cells, as determined by IFN-γ and tumour necrosis factor (TNF)-α production, and cytotoxic degranulation evidenced by CD107a staining. These findings suggest a correlation between the presence of TRP2-180-specific CD8(+) effector T cells and the development of depigmented skin lesions in our vitiligo model. This new model of vitiligo, characterized by skin depigmentation without hair depigmentation, is more similar to human disease than previous murine models. Therefore, this model is well suited to future studies on the pathogenesis of vitiligo and the development of novel therapeutics for vitiligo.

Delayed anti-CD3 therapy results in depletion of alloreactive T cells and the dominance of Foxp3+ CD4+ graft infiltrating cells

The engineered Fc-nonbinding (crystallizable fragment-nonbinding) CD3 antibody has lower mitogenicity and a precise therapeutic window for disease remission in patients with type 1 diabetes. Before anti-CD3 can be considered for use in transplantation, the most effective timing of treatment relative to transplantation needs to be elucidated. In this study anti-CD3F(ab')2 fragments or saline were administered intravenously for 5 consecutive days (early: d1-3 or delayed: d3-7) to mice transplanted with a cardiac allograft (H2(b)-to-H2(k); d0). Survival of allografts was prolonged in mice treated with the early protocol (MST = 48 days), but most were rejected by d100. In contrast, in mice treated with the delayed protocol allografts continued to survive long term. The delayed protocol significantly inhibited donor alloreactivity at d30 as compared to the early protocol. A marked increase in Foxp3(+) T cells (50.3 ± 1.6%) infiltrating the allografts in mice treated with the delayed protocol was observed (p < 0.0001 vs. early (24.9 ± 2.1%)) at d10; a finding that was maintained in the accepted cardiac allografts at d100. We conclude that the timing of treatment with anti-CD3 therapy is critical for inducing long-term graft survival. Delaying administration effectively inhibits the alloreactivity and promotes the dominance of intragraft Foxp3(+) T cells allowing long-term graft acceptance.

Induction of allograft tolerance by monoclonal CD3 antibodies: a matter of timing

Despite remarkable progress in organ transplantation through the development of a wealth of immunosuppressive drugs highly effective at controlling acute rejection, two major problems still remain, the loss of transplants due to chronic rejection and the growing number of sensitized recipients due to previous transplants, transfusions or pregnancies. Induction of immune tolerance appears to be the only way to curb this complex situation. Here we describe that a therapy, already successfully used to restore immune tolerance to self-antigens in overt autoimmunity, is effective at promoting transplant tolerance. We demonstrate that a short low-dose course with CD3 antibodies started after transplantation, at the time of effector T cell priming to alloantigens, induces permanent acceptance of fully mismatched islet allografts. Mechanistic studies revealed that antigen-specific regulatory and effector T cells are differentially affected by the treatment. CD3 antibody treatment preferentially induces apoptosis of activated alloreactive T cells which is mandatory for tolerance induction. In contrast, regulatory T cells are relatively spared from CD3 antibody-induced depletion and can transfer antigen-specific tolerance thus arguing for their prominent role in sustaining long-term graft survival.

OBSERVER AND FEATURE ANALYSIS ON DIAGNOSIS OF RETINOPATHY OF PREMATURITY

Retinopathy of prematurity (ROP) is a disease affecting low-birth weight infants and is a major cause of childhood blindness. However, human diagnoses is often subjective and qualitative. We propose a method to analyze the variability of expert decisions and the relationship between the expert diagnoses and features. The analysis is based on Mutual Information and Kernel Density Estimation on features. The experiments are carried out on a dataset of 34 retinal images diagnosed by 22 experts. The results show that a group of observers decide consistently with each other and there are popular features that have a high correlation with labels.

Principal curve based semi-automatic segmentation of organs in 3D-CT

Radiation therapy plays an important and effective role in the treatment of cancer. A main goal in radiation therapy is to deliver high radiation doses to the perceived tumors while minimizing radiation to surrounding normal tissues. Manual delineation of tumors and organs-at-risk(OARs) on three-dimensional computed tomography (3D-CT) is both a time-consuming and labor intensive task, and there maybe variability between manual delineations by different radiation oncologists. In this paper, we present a semi-supervised method to segment the contours of organs represented by piecewise linear segments connected with a small number of points given the user's input in one or more slices as an approximate initialization. This method detects ridge samples from the kernel interpolation of the edge map and approximates the shape of organs using piecewise linear segments among those sample points based on the principal curve score. Results are provided in two 3D-CT scans. Evaluation of the efficacy of our semiautomatic segmentation method is based on the overlapping ratio between the manually delineated contours and the semiautomatic segmented contours represented by a small number of points. The preserved points can be as low as 10 percent of the initial manual points, and the Dice Coefficients are approximately 0.93 for lung segmentation.

In vitro study of enhanced osteogenesis induced by HIF-1α-transduced bone marrow stem cells

OBJECTIVES

Hypoxia-inducible factor 1α (HIF-1α) is a pivotal regulator of hypoxic and ischaemic vascular responses that drives transcriptional activation of hundreds of genes involved in vascular reactivity, angiogenesis and arteriogenesis. Previous reports based on gene knockout technology have demonstrated that HIF-1α can promote osteogenesis. However, this protein is easily degraded in a normoxic state, which makes in vitro studies of HIF-1α-induced mesenchymal stem cell (MSC) osteogenesis difficult. For better understanding of HIF-1α promoting osteogenesis, the role of HIF-1α-induced MSC osteogenesis in the normoxic state has been investigated here.

MATERIALS AND METHODS

HIF-1α was made to overexpress using a lentiviral vector, and its effects on bone marrow-derived mesenchymal stem cell (BMSC) osteogenesis were investigated. Real-time quantitative and western blotting (to assess expression levels of angiogenic and osteogenic related genes regulated by Lenti-HIF-1α), alkaline phosphatase (ALP) and alizarin red-S staining analyses, were performed.

RESULTS

In HIF-1α gene-transfected BMSCs, expression levels of angiogenic, cartilaginous and osteogenic genes were all increased significantly compared to Lenti LacZ-transfected cells, at both mRNA and protein levels. ALP activity and alizarin red-S staining were significantly enhanced in HIF-1α transduced cells compared to control cells, on day 21.

CONCLUSIONS

These results indicate that Lenti-HIF-1α can induce BMSC overexpression levels of angiogenic and osteogenic genes in vitro in the normoxic state. Further study will be focused on whether HIF-1α can also improve bone repair in vivo.