[Role of mitochondrial autophagy and the curative effect of rehmannia glutinosa leaves total glycoside capsules on nucleos(t)ide drug-induced renal injury]

Objective: To study the curative effect of rehmannia glutinosa leaves total glycoside capsules and the role of mitochondrial autophagy on nucleos(t)ide drug-induced renal injury. Methods: Adefovir dipivoxil (ADV) was used to construct a hepatitis B virus (HBV) transgenic mouse model for renal injury. Renal function was measured in each group at one and two weeks of modeling. Mitochondrial autophagy indicators were measured at two weeks of modeling in renal tissue. Transmission electron microscopy was used to detect mitochondrial autophagy phenomena in renal tissue. The model was established for two weeks. Mouse with renal injury were treated with rehmannia glutinosa leaves total glycoside capsules or isotonic saline for eight weeks by intragastric administration. Renal function was measured. Renal tissue morphology was observed. Mitochondrial autophagy indicators were detected in renal tissue. The protective effect of different concentrations of verbascoside (the main active ingredient of rehmannia glutinosa capsule) was observed on HK-2 cell damage induced by ADV. HK-2 cells were divided into control, ADV, and ADV plus verbascoside groups. The effects of verbascoside at different times and concentrations were observed on the HK-2 mitochondrial autophagy indicators. Fifty patients with chronic hepatitis B were collected who presented with renal injury after treatment with nucleos(t)ide analogs. The random number method was used to divide 29 cases into a control group that received conventional treatment. The treatment group of 21 cases was treated with rehmannia glutinosa leaves total glycoside capsules on the basis of the control group. Serum creatinine (Scr) and urinary protein were detected at eight weeks.The χ(2) test or t-test was used for statistical analysis. Results: Compared with the control group, two weeks of modeling in the ADV group induced renal function injury in HBV mice. The expression of autophagy indicators was higher in the renal tissue of the ADV group than that of the control group. Transmission electron microscopy had revealed mitochondrial autophagy in the renal tissue of the ADV group. Compared with the control group, the renal function of HBV mice treated with rehmannia glutinosa leaves total glycoside capsules improved for two months, and the expressions of autophagy indicators were down-regulated.Verbascoside promoted proliferation in ADV-damaged HK-2 cells, and the expression of autophagy indicators was down-regulated compared with the ADV alone group. In 50 patients with renal function injury, the urinary protein improvement was significantly superior in the treatment group than that in the control group, with eighteen and three cases being effective and ineffective in the treatment group and 12 and 17 cases being effective and ineffective in the control group, with a statistically significant difference (χ(2) = 9.975 0, P = 0.001 6). Serum creatinine was decreased in the treatment group compared with the control group, with 11 and 10 cases being effective and ineffective in the treatment group and 12 and 17 cases being effective and ineffective in the control group, with no statistically significant difference (χ(2) = 0.593 5, P = 0.441 1). Conclusion: Rehmannia glutinosa leaves total glycoside capsule can improve the nucleos(t)ide drug-induced renal function injury in chronic hepatitis B, possibly playing a role via inhibiting PINK1/Parkin-mediated mitochondrial autophagy.

Phase I study of peposertib and avelumab with or without palliative radiotherapy in patients with advanced solid tumors

INTRODUCTION

We report results from a phase I, three-part, dose-escalation study of peposertib, a DNA-dependent protein kinase inhibitor, in combination with avelumab, an immune checkpoint inhibitor, with or without radiotherapy in patients with advanced solid tumors.

MATERIALS AND METHODS

Peposertib 100-400 mg twice daily (b.i.d.) or 100-250 mg once daily (q.d.) was administered in combination with avelumab 800 mg every 2 weeks in Part A or avelumab plus radiotherapy (3 Gy/fraction × 10 days) in Part B. Part FE assessed the effect of food on the pharmacokinetics of peposertib plus avelumab. The primary endpoint in Parts A and B was dose-limiting toxicity (DLT). Secondary endpoints were safety, best overall response per RECIST version 1.1, and pharmacokinetics. The recommended phase II dose (RP2D) and maximum tolerated dose (MTD) were determined in Parts A and B.

RESULTS

In Part A, peposertib doses administered were 100 mg (n = 4), 200 mg (n = 11), 250 mg (n = 4), 300 mg (n = 6), and 400 mg (n = 4) b.i.d. Of DLT-evaluable patients, one each had DLT at the 250-mg and 300-mg dose levels and three had DLT at the 400-mg b.i.d. dose level. In Part B, peposertib doses administered were 100 mg (n = 3), 150 mg (n = 3), 200 mg (n = 4), and 250 mg (n = 9) q.d.; no DLT was reported in evaluable patients. Peposertib 200 mg b.i.d. plus avelumab and peposertib 250 mg q.d. plus avelumab and radiotherapy were declared as the RP2D/MTD. No objective responses were observed in Part A or B; one patient had a partial response in Part FE. Peposertib exposure was generally dose proportional.

CONCLUSIONS

Peposertib doses up to 200 mg b.i.d. in combination with avelumab and up to 250 mg q.d. in combination with avelumab and radiotherapy were tolerable in patients with advanced solid tumors; however, antitumor activity was limited.

CLINICALTRIALS

GOV IDENTIFIER

NCT03724890.

Expression of ICAM-1 and E-selectin in different metabolic obesity phenotypes: discrepancy for endothelial dysfunction

OBJECTIVES

Endothelial dysfunction, the earliest vascular alteration, is a consequence of metabolic disorders associated with obesity. However, it is still unclear whether a proportion of obese individuals without metabolic alterations associated with obesity, defined as "metabolically healthy obesity (MHO)", exhibit better endothelial function. We therefore aimed to investigate the association of different metabolic obesity phenotypes with endothelial dysfunction.

METHODS

The obese participants without clinical cardiovascular disease from the MESA (Multi-Ethnic Study of Atherosclerosis) were allocated to the different metabolic obesity phenotypes based on their metabolic status, including MHO and metabolically unhealthy obesity (MUO). Associations of metabolic obesity phenotypes with the biomarkers of endothelial dysfunction, including soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-selectin (sE-selectin), were evaluated using multiple linear regression models.

RESULTS

Plasma levels of sICAM-1 and sE-selectin were respectively measured in 2371 and 968 participants. Compared to the non-obese participants, those with MUO were associated with higher concentrations of sICAM-1 (β 22.04, 95% CI 14.33-29.75, P < 0.001) and sE-selectin (β 9.87, 95% CI 6.00-13.75, P < 0.001) after adjusting for confounders. However, no differences were found for the concentrations of sICAM-1 (β 0.70, 95% CI - 8.91 to 10.32, P = 0.886) and sE-selectin (β 3.69, 95% CI - 1.13 to 8.51, P = 0.133) in the participants with MHO compared to the non-obese participants.

CONCLUSIONS

Individuals with MUO were associated with elevated biomarkers of endothelial dysfunction, but the association with endothelial dysfunction was not found in those with MHO, indicating that the individuals with MHO might exhibit better endothelial function.

Effectiveness of Bladder Filling Control during Online MR-Guided Adaptive Radiotherapy for Rectum Cancer

PURPOSE/OBJECTIVE(S)

MR-guided adaptive radiotherapy (MRgART) treatment sessions at MR-Linac are time-consuming and changes in bladder filling during the session can impact the treatment dosimetry. In this work, we present the procedure implemented in the clinical workflow to stabilize bladder filling during the MR based adaptive radiotherapy sessions and evaluate its effectiveness and the resulting dosimetric impact on the adaptive plan.

MATERIALS/METHODS

Twenty-five rectum cancer patients treated at 1.5T MR-Linac with a short course radiotherapy (25 Gy in 5 fractions of 5 Gy each) were included in this retrospective study. Patients were treated with the adapt-to-shape workflow consisting of a plan adaptation based on the MRI acquired in each session and optimized on the corresponding MR-based synthetic CT. Considering the significant interval time between the acquisition of the first daily MRI used for plan adaptation, and the beam delivery, a bladder catheter was used to stabilize the bladder filling; the procedure consists of emptying the bladder and refilling it with a well-known amount of physiological solution before each MRI acquisition. Two MRIs were acquired at each session: the first was used for plan adaptation and the second was acquired while approving the adapted plan, to be rigidly registered with the first to ensure the appropriateness of the isodoses on the ongoing delivery treatment. A total of 125 sessions and 250 MRI images and bladder contours were analyzed; for each fraction, the time interval between the first and second MRI and the corresponding bladder volumes were recorded; the consistency of bladder volumes and shapes along each online session was assessed with the dice similarity index (DSC) and Hausdorff distance (HD); the impact on plan dosimetry was evaluated by comparing target and bladder DVH cut off points of the plan on the two different MRI datasets.

RESULTS

The time interval between the first and second MRI, averaged over the 125 sessions is 39.0 min, range (18.6-75.8) min. The changes in bladder volumes, DSC index, HD, and the differences between the bladder and target DVH cut-off points are shown in the table below. The DSC and HD are comparable to inter-observer variability in manual contour segmentation, with an average DSC of 0.91 and average HD of 2.13 mm; the average differences in bladder and target dosimetry remain under 0.63% and 0.10%, respectively.

CONCLUSION

The use of a procedure in the clinical workflow of MRgART to stabilize the bladder filling throughout the online session may be helpful to guarantee the accuracy of the ongoing delivered treatment.

Study on the Clinical Use of a Respiratory Navigator Combined with Breath-Hold for MRI- Guided Liver SBRT

PURPOSE/OBJECTIVE(S)

Respiratory movement strongly affects the accuracy of stereotactic body radiation therapy (SBRT) of liver malignancies treated without the use of a respiratory gating system. This study investigates the feasibility and advantages of using a respiratory navigator-guided combined with patient breath-hold for liver SBRT in an adaptive magnetic-resonance guided workflow.

MATERIALS/METHODS

Clinical datasets of 10 liver cancer patients treated with 1.5T MR-Linac with respiratory navigator-guided SBRT combined with patient breath-hold were retrospectively analyzed. All patients underwent simulation CT with and without contrast, and 4D-CT and 3D-T2w MRI without contrast. Patients received a prescription dose ranging from 36 to 50 Gy in 5 to 8 fractions and followed the adapt to shape (ATS) workflow including contours adjustment and a subsequent MR-based synthetic CT (sCT) calculation on the online MRI acquired. The reference treatment plan was optimized on the expiratory phase of the 4D-CT, and during the online session the contours and the adapted plans were performed using the 3D-T2w navigator MRI of the patient's end-expiratory signal; 2D-T2w real-time monitoring MRI was also used as support for the contour's definition. The radiation therapist instructed the patients to hold their breath at the end of the breathing cycle for the time of the beam on. A total of 59 fractions were analyzed. For each fraction the dosimetric parameters of the target and normal liver of the adaptive and reference plans were compared; particularly the volume, the conformity index (CI) and gradient index (GI) for the target, and V5, V10 and Dmean for the normal liver. T-student statistical analysis was performed; a p-value less than 0.05 was considered statistically significant.

RESULTS

In the free breathing state, the 3D-T2w navigator MRI images enable a clear visualization of the tumor and its boundaries. The average target CI of the adaptive and reference plans is not significantly different (p = 0.448), while the GI is significantly higher (p = 0.043). Normal liver V10 and Dmean are lower and V5 is slightly increased, but without statistical differences. The mean values and standard deviation of the dosimetric parameters of the reference and adapted plans are shown in the Table below.

CONCLUSION

The use of a respiratory navigator combined with the breath-hold for MRI- guided liver SBRT allows clear visualization of the tumor, ensures the accuracy of the delivered dose and may be considered an alternative when the respiratory gating system is not available during MRgART sessions.

Study on Lattice Radiotherapy Treatments (LRT) for Head and Neck Bulky Tumors

PURPOSE/OBJECTIVE(S)

Lattice radiotherapy (LRT) exploits various effects of radiation, such as the bystander effect and the abscopal effect, and consists on the administration of high dose fraction in small areas with large tumor masses, helping to solve the problem of treating bulky disease, especially if it is located in a critical anatomical area. The optimization of LRT treatment plans is challenging due to the difficulty to generate spots of high dose within the tumor with consequent high gradient. This study compares the plan dosimetry and delivery time of two delivery techniques VMAT and CyberKnife for LRT treatments of bulky head and neck lesions.

MATERIALS/METHODS

Six patients with giant head and neck tumors who received LRT at our institution were included in this study. Target and OARs were contoured following international guidelines; to allow easy identification of the desired high gradient zones, an artificial geometrical lattice structure with spherical vertices was arranged inside the target volume (GTV), and the vertices of the lattice representing the high dose boost volumes (GTVboost) were delineated. The GTVboost and GTV were prescribed to receive 12 Gy and 3 Gy, respectively in a single fraction. Separate VMAT and CyberKnife LRT plans were optimized for each patient with lattice vertex of 0.5 diameter and center-to-center distances of 1.5 cm (LRT1.5) and 3 cm (LRT3). The dose heterogeneity was measured as the peak-to-valley dose ratio (PVDR), with the traditional definition being replaced by the D10/D90 ratio, where D10 and D90 represent the doses covering 10% and 90% of the GTV, respectively. For each plan generated, the treatment delivery time, the monitor units (MU), and the PVDR were assessed. Pre-treatment plan verifications were performed with ArcCheck array and Gafchromics film for VMAT and CyberKnife, respectively, using gamma analysis criteria of 3%-3mm.

RESULTS

The mean PVDR obtained for VMAT LRT plans were 2.0 and 2.6 for LRT1.5 and LRT3, respectively, and 3.2 and 4.7, respectively for CyberKnife LRT plans. For each pre-treatment plan dose verification, the gamma passing rate (GPR) was higher than 95.0 %; CyberKnife delivery time and MU were more than 10 times higher than that of VMAT, nevertheless, VMAT had a lower PVDR. The detailed results are shown in the table below.

CONCLUSION

CyberKnife LRT has a strong ability to place the peak dose within the target, generating a higher peak-to-valley dose ratio, however its use is partially invalidated by the long beam delivery times and the resulting high MU number; the use of the VMAT LRT technique allows clinically adequate dosimetry with acceptable delivery times.

[A control study of steroid withdrawal protection strategy after kidney transplantation in children]

Objective: To study the influence of steroid withdrawal protection strategy on height growth in pediatric patients after kidney transplantation. Methods: The prospective cohort study enrolled 40 stage 5 chronic kidney disease children receiving kidney transplantation from July 2017 to September 2022 at Guangzhou Women and Children's Medical Center. Based on the primary preoperative disease, patients with immune abnormality-associated glomerular diseases or unknown causes were assigned to the steroid maintenance group, in which patients received steroid tapering within 3 months after surgery to a maintenance dose of 2.5 to 5.0 mg/d. While patients with hereditary kidney disease or congenital urinary malformations were assigned to the steroid withdrawal group, in which patients had steroids tapered off within 3 months. The characteristics of height catch-up growth and clinical data were compared between the 2 groups at baseline, 6, 12, 18 and 24 months after kidney transplantation. T-test, repeated measurement of variance analysis, Mann-Whitney U test, and Fisher exact test were used for the comparison between the 2 groups. Results: Among the 40 children, 17 were males, 23 were females, 25 were in the steroid withdraw group ((7.8±2.8) years old when receiving kidney transplantation) and 15 cases were in the steroid maintenance group ((7.6±3.5) years old when receiving kidney transplantation). The study population was followed up for (26±12) months. The total dose per unit body weight of steroids in the steroid withdrawal group was lower than that in the steroid maintenance group ((0.13±0.06) vs. (0.36±0.19) mg/(kg·d), t=5.83, P<0.001). The height catch-up rate (ΔHtSDS) in the first year after kidney transplantation in the steroid withdraw and steroid maintenance groups was 1.0 (0.7, 1.4) and 0.4 (0.1, 1.0), respectively; in the second year, the ΔHtSDS in the steroid withdraw group was significantly higher than that in the steroid maintenance group (1.1 (0.2, 1.7) vs. 0.3 (0, 0.8), U=28.00, P=0.039). The HtSDS in the steroid withdrawal group at the five follow-up time points was -2.5±0.8, -2.0±0.8, -1.5±0.8, -1.3±0.9 and -0.5±0.3, respectively, while in the steroid maintenance was -2.4±1.3, -2.2±1.1, -2.0±1.0, -1.8±1.0 and -1.6±1.0, respectively. There were statistically significant differences in HtSDS at different follow-up time points in both 2 groups (F=19.81, P<0.01), but no statistical differences in overall impact between the 2 groups (F=1.13, P=0.204). The steroid treatment was interaction with the increase of follow-up time (F=3.62, P=0.009). At the 24th month after transplantation, the HtSDS in the steroid withdrawal group was significantly higher than that in the steroid maintenance group (P=0.047). Six patients in the steroid withdrawal group experienced antibody-mediated immune rejection (AMR), while 3 did in the steroid maintenance group. Moreover, there was no significant difference in AMR between the two groups (χ2=0.06, P=0.814). Conclusion: The steroid withdrawal protection strategy favors the height catch-up growth in pediatric patients after kidney transplantation and does not increase the risk of postoperative antibody-mediated immune rejection.

Synergistic Adsorption and In Situ Catalytic Conversion of SO2 by Transformed Bimetal-Phenolic Functionalized Biomass

SO2 removal is critical to flue gas purification. However, based on performance and cost, materials under development are hardly adequate substitutes for active carbon-based materials. Here, we engineered biomass-derived nanostructured carbon nanofibers integrated with highly dispersed bimetallic Ti/CoOx nanoparticles through the thermal transition of metal-phenolic functionalized industrial leather wastes for synergistic SO2 adsorption and in situ catalytic conversion. The generation of surface-SO32- and peroxide species (O22-) by Ti/CoOx achieved catalytic conversion of adsorbed SO2 into value-added liquid H2SO4, which can be discharged from porous nanofibers. This approach can also avoid the accumulation of the adsorbed SO2, thereby achieving high desulfurization activity and a long operating life over 6000 min, preceding current state-of-the-art active carbon-based desulfurization materials. Combined with the techno-economic and carbon footprint analysis from 36 areas in China, we demonstrated an economically viable and scalable solution for real-world SO2 removal on the industrial scale.

The transmission of hepatitis B virus (HBV) infection from mother-to-infant (MTI) and the susceptibility of offspring to hepatitis B under intrauterine exposure to HBsAg

OBJECTIVE

Hepatitis B virus (HBV) causes long-term injury to the liver in patients with chronic hepatitis B. It was reported that nearly half of this disease's cases now result from mother-to-infant (MTI) transmission. Therefore, intervention during this period of transmission of HBV could effectively prevent HBV infection in infants.

MATERIALS AND METHODS

This study employed bioinformatics methods to analyze the datasets of MTI hepatitis B transmission obtained from the Gene Expression Omnibus (GEO) database. Through this analysis, we extracted valuable information to identify genes exhibiting differential expression and uncover the associated signal pathways. Ultimately, our investigations into alterations in immune function shed light on the underlying mechanisms of MTI HBV transmission.

RESULTS

There were 593 genes that were significantly differentially expressed (512 up-regulated genes and 81 down-regulated genes) in the offspring CD8+T cells with Hepatitis B surface antigen (HBsAg) intrauterine exposure. The pathways enriched for differentially expressed genes have been revealed. Furthermore, we performed a correlation analysis between differentially expressed genes and maternal hepatitis B inheritance via the weighted gene co-expression network analysis (WGCNA) and eventually found a high correlation between the cyan module and the shape. Among them, there were 166 genes in the cyan module, which were mainly enriched in the phosphatidylinositol signaling system, glycerolipid metabolism, and other types of O-Glycan biosynthesis.

CONCLUSIONS

Therefore, we speculated that these signaling pathways and the genes within may be closely related to hepatitis B susceptibility and maternal hepatitis B inheritance. In this study, we showed that differentially expressed genes and signaling pathways may be valuable in preventing MTI transmission of HBV.

[Prevalence of parasitic infections in human stool samples from a hospital in Chenzhou City of Hunan Province]

OBJECTIVE

To investigate the prevalence of parasitic infections in human stool samples from a hospital in Chenzhou City, Hunan Province, so as to provide insights into the management of intestinal parasitic diseases.

METHODS

Stool samples were collected from patients admitted to a hospital in Chenzhou City from September 2020 to March 2021, subjected to physiological saline smearing and microscopy for detection of intestinal parasites. The prevalence of parasitic infections and the species of parasites were descriptively analyzed.

RESULTS

The overall prevalence of intestinal parasitic infections was 1.61% in the 10 728 stool samples, and there were 3 samples with mixed infections of two parasite species. A total of seven parasite species were identified, including Blastocystis hominis (162 cases, 1.55%), Giardia lamblia (5 cases, 0.05%), Dientamoeba fragilis (5 cases, 0.05%), Endolimax nana (one case, 0.01%), Iodamoeba bütschlii (one case, 0.01%), Strongyloides stercoralis (one case, 0.01%) and Trichomonas hominis (one case, 0.01%). The prevalence of intestinal parasitic infection was significantly higher among women than in men (2.14% vs. 1.25%; χ² = 13.01, P < 0.01), and a high prevalence rate was seen among patients at ages of 20 to 30 years (2.99%) and 80 years and older (2.86%); however, no age-specific prevalence of intestinal parasitic infection was detected (χ² = 12.45, P > 0.05).

CONCLUSIONS

The overall prevalence of intestinal parasitic infection was low among patients admitted to a hospital in Chenzhou City, and gender-specific prevalence was found. Food-borne and opportunistic parasites were predominant intestinal parasites, including B. hominis, G. lamblia and D. fragilis.

Potassium assisted pyrolysis of Chinese Baijiu distillers' grains to prepare biochar as controlled-release K fertilizer

A novel K-loaded biochar as controlled-release K fertilizer was prepared through K assisted pyrolysis of distillers' grains (DGs, typical solid-byproducts of Chinese Baijiu) under different atmospheres (N₂ and CO₂) and temperatures (400 and 800 °C). The fabricated DGs-based biochar exhibited high K loading (200.20-232.33 mg/g), and the release kinetics and column leaching experiments suggested that K-loaded biochar exhibited excellent controlled release performance in a long term. Compared with other biochar, the K-loaded biochar prepared at CO₂ and 400 °C has lower cumulative release ratio of 82.35 %, and could retain the durative K release at ~0.5 % for 25 d. The release kinetics suggested that the K release behavior was dominated by dissolution, electrostatic attraction, adsorption, confinement effect, and chemical interaction. Furthermore, pot experiments revealed that K-loaded biochar could promote the growth of Komatsuna, in which the fresh weight and chlorophyll relative content of Komatsuna cultivated with biochar prepared at CO₂ and 400 °C reached 0.146 g and 41.95 after 25 d growth, respectively. The above results suggested that the K-loaded biochar exhibited excellent utilization potential as a controlled-release K fertilizer, facilitating the sustainable development and resource valorization of Baijiu industry.

Effect of pulmonary function on bone mineral density in the United States: results from the NHANES 2007-2010 study

The relationship between pulmonary function (PF) and bone mineral density (BMD) remains controversial. In the US population, we found a positive association between PF and BMD. Mixed variables such as age, gender, and race may influence this association.

INTRODUCTION

Based on the data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2010, this study explored whether there is a correlation between PF (1st second forceful expiratory volume as a percentage of expected value (FEV1(% predicted)), (one-second rate (FEV1/FVC)), and bone mineral density.

METHODS

We evaluated the relationship between PF and BMD in 6327 NHANES subjects (mean age 44.51 ± 15.64 years) from 2007 to 2010. The bone mineral density of the whole femur was measured by dual-energy X-ray absorptiometry (DXA). After adjusting for a wide range of confounders, we examined the relationship between PF and total femur BMD using a multiple linear regression model.

RESULTS

Correction of race, age, alcohol consumption, body mass index (BMI), height, poor income ratio (PIR), total protein, serum calcium, serum uric acid, cholesterol, serum phosphorus, blood urea nitrogen, FEV1(% predicted), and femur BMD were positively correlated (β = 0.032, 95% CI: 0.010-0.054, P = 0.004). FEV1/FVC was positively correlated with spine BMD (β = 0.275 95%CI: 0.102-0.448, P = 0.002).

CONCLUSIONS

Our study shows that PF is positively associated with BMD in the US population. A variety of factors such as race and age influence this relationship. the relationship between PF and BMD needs to be further investigated, including specific regulatory mechanisms and confounding factors.

A sustainable thermochemical conversion of animal biomass to N-heterocycles

The production of high-valued organonitrogen chemicals, especially N-heterocycles, requires artificial N2 fixation accompanied by the consumption of fossil resources. To avoid the use of these energy- and resource-intensive processes, we develop a sustainable strategy to convert nitrogen-rich animal biomass into N-heterocycles through a thermochemical conversion process (TCP) under atmospheric pressure. A high percentage of N-heterocycles (87.51%) were obtained after the TCP of bovine skin due to the abundance of nitrogen-containing amino acids (e.g., glycine, proline, and l-hydroxyproline). Animal biomass with more diverse amino acid composition (e.g., muscles) yielded higher concentrations of amines/amides and nitriles after TCP. In addition, by introducing catalysts (KOH for pyrrole and Al2O3 for cyclo-Gly–Pro) to TCP, the production quantities of pyrrole and cyclo-Gly–Pro increased to 30.79 mg g−1 and 38.88 mg g−1, respectively. This approach can be used to convert the significant animal biomass waste generated annually from animal culls into valued organonitrogen chemicals while circumventing NH3-dependent and petrochemical-dependent synthesis routes.

Graphical Abstract

Polyethyleneimine/hydrated titanium oxide-functionalized fibrous adsorbent for removing cobalt: Adsorption performance and irradiation stability

Radionuclides of ⁶⁰Co often encountered in the fields of radiation therapy, medical preparation, and equipment sterilization, which have been considered fatal. Therefore, developing efficient and irradiation-stable adsorbents for the removal of ⁶⁰Co in wastewater is urgently needed. An irradiation-stable fibrous adsorbent was fabricated through the surface functionalization of collagen fibers (CFs) by polyethyleneimine (PEI) and hydrated titanium oxide (TiO) (PEI-TiO-CFs). PEI-TiO-CFs, including their adsorption performance and irradiation stability, were systematically investigated. Results showed that PEI-TiO-CFs exhibit a maximum adsorption capacity of 0.5575 mmol g^-1. In addition, the adsorption capacity of PEI-TiO-CFs only demonstrated a slight decrease in the selectivity investigation of Co²⁺ mixed with another coexisting ion, such as Na⁺, K⁺, and NO^3-, Cl^-. Furthermore, breakthrough point of PEI-TiO-CFs in column is high at 80 BV (bed volume) and the PEI-TiO-CF column can be mostly regenerated using 12 BV of Na₂EDTA solution. Excellent irradiation stability of PEI-TiO-CFs was confirmed by the maintained morphology and adsorption capacity after irradiation at 350 kGy of ⁶⁰Co γ-ray. Results indicated that PEI-TiO-CFs are an effective adsorbent for radioactive cobalt removal from aqueous solutions.

Hierarchical collagen fibers complexed with tannic acid and Fe3+ as a heterogeneous catalyst for enhancing sulfate radical-based advanced oxidation process

Efficient sulfate radical-based advanced oxidation processes (SR-AOPs) are important for treating organic contaminants of industrial wastewater. To achieve this goal, tannic acid (TA)-modified skin collagen fibers (CFs) were prepared for the enhanced immobilization of Fe³⁺ based on multiple complexation interactions, resulting in a heterogeneous catalyst with more catalytic sites (defined as TA-Fe-CFs) for activating peroxymonosulfate (PMS). During the removal of an organic dye (rhodamine B, RhB) from water, the hierarchical TA-Fe-CFs exhibited excellent adsorption capacity at the early stage before the introduction of PMS, which can be ascribed to the π-π interaction between TA and aromatic RhB. Such improved mass transfer of target contaminants into the catalytic support was proved to be beneficial for improving the utilization efficiency of sulfate radicals in subsequent SR-AOPs. After introducing PMS, the reductive TA moieties of the heterogeneous catalyst were able to accelerate the redox cycle of Fe³⁺/Fe²⁺ in Fenton reactions, facilitating the activation of PMS to generate sulfate radicals for the degradation of organic RhB.

[Comparative study of decentration, tilt and visual quality after implantation of aspherical intraocular lenses]

Objective: To compare the difference of decentration and tilt among 4 kinds of aspherical intraocular lenses (IOLs), and to analyze their objective visual quality. Methods: Prospective non-randomized controlled clinical trial. Age-related cataract patients who planned to undergo phacoemulsification and IOL implantation in the Affiliated Hospital of North Sichuan Medical College from April to June in 2020 were divided into ZCB00 group, SN60WF group, A1-UV group, and AO group according to IOL types. Thirty right eyes and thirty left eyes were selected in each group. Before operation and at 1 day, 1 week and 1 month postoperatively, decentration and tilt values were measured by a new swept-source anterior-segment optical coherence tomography device (CASIA2), and wavefront aberrations, objective scatter index (OSI), modulation transfer function cut off frequency (MTF cut off) and Strehl ratio (SR) were also examined. Values of decentration, tilt and visual quality compared among 4 groups were took from the right eye. One-way analysis of variance was used for inter-group comparison, and repeated measurement one-way analysis of variance was used for intra-group comparison. Data between right eyes and left eyes from all the individuals were compared by independent sample t-test. Results: A total of 181 patients (240 eyes) were enrolled, and 169 patients (224 eyes) completed the follow-up (114 right eyes and 110 left eyes). There were 77 males and 92 females, with an age of (69±9) years. There was no significant difference in gender, age, axial length, decentration and tilt of crystalline lens and IOL power among 4 groups (all P>0.05). At 1 day, 1 week and 1 month postoperatively, there was significant difference in decentration value among 4 groups (F=7.11, 6.12, 4.66; all P<0.05). For further pairwise comparison, the decentration value of SN60WF group was higher than that of the other 3 groups at 1 day and 1 week postoperatively, and the decentration value of SN60WF group was (0.259±0.101) mm at 1 month postoperatively, which was higher than that of ZCB00 group (0.177±0.099) mm and AO group (0.163±0.122) mm, and the differences were statistically significant (using SNK-q test, both P<0.05). The IOL tilt value in the ZCB00 group, SN60WF group, A1-UV group, and AO group at 1 month postoperatively were (4.806±1.129)°, (5.080±1.309)°, (4.586±1.338)°, (5.112±1.406)°, respectively. No significant difference in tilt value among 4 groups was found at any time after surgery (all P>0.05). In each group, there was no significant difference in decentration and tilt value at different postoperative time points (all P>0.05). At 1 month postoperatively, there was no significant difference in decentration and tilt at horizontal and vertical directions respectively among 4 groups (all P>0.05), and in each group, there was no significant difference in decentration and tilt value between right eyes and left eyes (all P>0.05), and IOLs tended to tilt towards the inferonasal or inferotemporal direction in both eyes. With 4-mm and 6-mm pupil diameter, there was significant difference in internal (F=131.32, 85.17) and ocular (F=46.64, 47.55) spherical aberration among 4 groups (all P<0.01). For further pairwise comparison, the spherical aberration of AO group was higher than that of the other 3 groups, and the difference was statistically significant (using SNK-q test, all P<0.05). There was no significant difference in OSI, MTF cut off and SR among 4 groups (all P>0.05). Conclusions: The four types of IOLs show decentration and tilt in varying degrees after implantation in the capsular bag, but this difference do not lead to clinical significance. Human eyes have tolerance to mild decentration and tilt of aspheric IOLs, showing good visual quality.

Polyphenol modified natural collagen fibrous network towards sustainable and antibacterial microfiltration membrane for efficient water disinfection

Because of their low-cost and high bacterial interception efficiency, large-scale membrane separation technologies like microfiltration (MF) have been widely implemented for water disinfection. However, lack of antibacterial ability and low sustainability are two major drawbacks of most petroleum-based MF membranes, which are normally associated with hazardous issues including biofouling and nonbiodegradable waste. In this work, abundant animal hides, which are by-products of the meat processing industry, were proposed as raw materials to fabricate a sustainable MF membrane due to their natural, hierarchical, and renewable collagen fibrous network (CFN) with inherent biodegradability. After the removal of non-collagen compositions from animal hides, such as hair and fat, through a facile pretreating process base on green chemistry principles, a thin CFN based membrane (CFN-M) with a similar micropore size to that of commercial MF membranes could be produced. Furthermore, inspired by conventional leather tanning technology, tannic acids (TA) were selected as plant polyphenol tanning agent to modify collagen fibers based on tanning chemistry to improve the thermal stability of CFN-M. Moreover, the TA cross-linked CFN-M (TA@CFN-M) exhibited excellent antibacterial properties due to the production of reactive oxygen species (ROS) by the catechol functional group. The resulting TA@CFN-M achieved >99.9% water disinfection efficiency with a flux of ∼150 L m^-2 h^-1 via gravity-driven operation, while simultaneously showing admirable anti-biofouling ability. Different from the commercial MF membrane, based on the green chemistry principle, this work may shed light on designing new sustainable and antibacterial membranes for anti-biofouling water disinfection.

Natural leather based gamma-ray shielding materials enabled by the coordination of well-dispersed Bi3+/Ba2+ ions and RE2O3 coating

Gamma rays is widely used in modern science and technology, but it may cause health damage to practitioners. In the present study, natural composites based on leather and high-Z elements (atomic number ≥ 56) were fabricated and used as gamma rays shielding materials. These shielding materials were prepared by coating rare earth nanoparticles (Er2O3 or La2O3) onto the surface of natural leather, which was first impregnated with Bi3+ and Ba2+. Results show that the attenuation efficiency of the prepared Er1.31Bi5.46-NL (1.31 and 5.46 mmol cm−3 loaded elements) with thickness of 3.2 mm was 61.57% for incident rays at 121.78 keV (152Eu) and reached 96.4% in the incident of 59.5 keV (241Am), which is comparable to that of 0.25-mm lead plate (54.54 mmol cm−3). In addition, these natural-leather-based shielding materials exhibited low density (approximately 1/10 of Pb), high strength and wearable behaviors.

Graphical abstract

POS0349 DECOY RECEPTOR 3 AND ITS SIGNAL PATHWAY CONTRIBUTE TO PATHOGENESIS IN PRIMARY GOUTY ARTHRITIS

Background

Gouty arthritis (GA) is an autoinflammatory disease caused by the deposition of monosodium urate crystal (MSU) in the joints and surrounding tissues, which lead to a series of complex inflammatory cascade amplification reactions.The clinical symptoms of acute GA attack rapidly, but often alleviate spontaneously within 7 ~ 10 days, which is one of the significant characteristics different from other joint diseases or autoimmune diseases. However, the exact molecular mechanism of its inflammatory self limitation is still unclear. The phenotypic imbalance of Th1 / Th2 cells and the M1/ M2 polarization of macrophages may be involved in the inflammatory self limitation of gout[1].Decoy receptor 3 (DCR3) can differentiate T cells into Th2 phenotype, promote M2 polarization of macrophages, and play the functions of immune regulation and repair[2].DCR3 and its Signal Pathway are involved in the pathogenesis of tumors and a variety of autoimmune diseases, and have become an important research target of tumors and immune related diseases.However, studies on DcR3 related molecular pathway and GA are scarce, and the specific regulatory mechanism is unknown.

Objectives

To assess the contribution of DcR3 and its signal pathway to gout and the clinical importance of these genes in primary gouty arthritis.

Methods

The mRNA expression levels of DCR3 and its signal pathway(DR3, TL1A, Fas, FasL, Ligth, LigthR, LTgthRNA expression levels of DCR3 and its signal pathway(DR3gout and the clinical importance of these genes in primary gouty arthritis.nt research target of tumors and immune related diseases.However, studies on DcR3 related moathway expression levels and laboratory features was analyzed in GA patients.

Results

The expression levels of DCR3, FasL were much lower in the AG and IG group than in the HC groups (p<0.05), and no significant difference was detected between AG and IG groups(P>0.05)(a,e). The expression levels of DR3 were much lower in the AG and IG group than in the HC groups (p<0.05), and much lower in the AG group than in the IG groups (p<0.05)(b). The expression levels of TL1A were much higher in the AG group than in the IG and HC groups (p<0.05), and no significant difference was detected between IG and HC groups(P>0.05)(c).The expression levels of Light, LightR were much lower in the AG group than in the HC groups (p<0.05), and no significant difference was detected between AG and IG groups, IG and HC groups(P>0.05)(f,g).The expression levels of LTlower in the AG and IG group than in the HC groups (p<0.05(p<0.05), and no significant difference was detected between AG and IG groups, IG and HC groups(P>0.05)(h).In GA patients, the levels of DcR3 related molecular pathway gene correlated with laboratory inflammatory and metabolic indexes.

Conclusion

Altered DCR3 and its signal pathway expression suggests that DCR3 related molecular pathway is involved in the pathogenesis of GA and participates in regulating inflammation and metabolism.

References

[1]Desai J, Steiger S, Anders HJ. Molecular Pathophysiology of Gout[J]. Trends Mol Med. 2017 Aug;23(8):756-768. DOI:10.1016/j.molmed.2017.06.005.

[2]Pan YG, Huang MT, Sekar P, et al. Decoy Receptor 3 Inhibits Monosodium Urate-Induced NLRP3 Inflammasome Activation via Reduction of Reactive Oxygen Species Production and Lysosomal Rupture[J]. Front Immunol. 2021 Mar 3;12:638676.DOI:10.3389/fimmu.2021.638676.

Figure 1.

Relative Expression of DcR3 related molecular pathway gene in the PBMCs of Patients.The expression levels of DCR3, FasL were much lower in the AG and IG group than in the HC groups (p<0.05)(a,e). The expression levels of DR3 were much lower in the AG and IG group than in the HC groups (p<0.05), and much lower in the AG group than in the IG groups (p<0.05)(b). The expression levels of TL1A were much higher in the AG group than in the IG and HC groups (p<0.05)(c).The expression levels of Light, LightR were much lower in the AG group than in the HC groups (p<0.05)(f,g).The expression levels of LTβR were much higher in the AG group than in the HC groups (p<0.05)(h).

Acknowledgements

Institute of Research Center of Gout and Hyperuricemia of the Affiliated Hospital, North Sichuan Medical College

Disclosure of Interests

None declared

AB0702 Coexistence of systemic sclerosis and microscopic polyangitis associated with pulmonary renal syndrome: a case report and literature review

Background

Systemic sclerosis is a chronic immune disease characterized by varying degrees of fibrosis of skin and internal organs. Microscopic polyangitis, as a subtype of ANCA associated vasculitis, mainly involves small blood vessels, often manifested as necrotizing glomerulonephritis and pulmonary capillary vasculitis. Pulmonary renal syndrome is characterized by diffuse alveolar hemorrhage based on pulmonary capillary vasculitis and rapidly progressive glomerulonephritis, which can be derived from a variety of autoimmune diseases, of which ANCA associated vasculitis accounts for about 60%[1]. The cases of coexistence of systemic sclerosis and microscopic polyangitis associated with pulmonary renal syndrome in clinic are rare, which is often dangerous and is easy to miss diagnosis or misdiagnosis.

Objectives

To investigate the clinical characteristics, diagnosis and treatment of coexistence of systemic sclerosis (SSC) and microscopic polyangitis（MPA）associated with pulmonary renal syndrome (PRS).

Methods

The clinical data, diagnosis and treatment process of a patient who has SSC combined with MPA and PRS were summarized and analyzed. And the literature was reviewed to explore the correlation of the pathogenesis and clinical experience of SSC complicated with MPA and PRS.

Results

The case is a middle-aged male who was diagnosed as SSc due to the hardening of the skin of both hands，Reynolds phenomenon, the anti-scl-70 antibody are positive. The patient suffered from repeated hemoptysis, progressive dyspnea, severe anemia and renal insufficiency, so he was diagnosed as MPA with PRS. After giving glucocorticoid, immunosuppressant and anti-infection treatment, his condition has improved. A total of 7 case reports were retrieved by reviewing the relevant literature.A total of 7 patients were reported.They were first diagnosed as SSc and then MPA with PRS, of which 4 cases improved after treatment and 3 cases died. Among the dead patients, 1 case was treated with penicillamine for 3 years, and the remaining 2 cases were only treated with steroids without immunosuppressants.In SSc, P-ANCA is closely related to vasculitis, and the prognosis of PRS secondary to P-ANCA may be very poor. Most of the diagnosis of MPA is only after patients have kidney or lung diseases.There is a certain correlation between them in pathogenesis. Glucocorticoids, immunosuppressants, biological agents, hemodialysis and plasma exchange are the main treatments.

Conclusion

Although the cases of SSc combined with MPA and PRS are rare, there are still many cases reported,which reminds us: ①When SSc patients have new symptoms such as renal insufficiency or lungs, they should be alert to new entities that may be combined with other autoimmune diseases to avoid missed diagnosis or misdiagnosis.②ANCA should be detected in SSc patients at baseline, which may be related to disease activity.③PRS has rapid progress and high mortality, whcih is an emergency that needs urgent treatment. Such patients should be treated with glucocorticoid, immunosuppression and plasma exchange immediately. However, if patients are complicated with SSc, they need to be extra careful when using high-dose steroids, which increases the risk of renal crisis.

References

[1]de Groot K, Schnabel A. Das pulmorenale Syndrom [Pulmonary-renal syndrome]. Internist (Berl). 2005;46(7):769-782. doi:10.1007/s00108-005-1423-8.

Figure 1.

The contrast of chest CT before and after treatment showed that the exudative lesions of both lungs were significantly absorbed

Figure 2.

Clinical data of systemic sclerosis combined with microscopic polyangitis and pulmonary renal syndrome

Acknowledgements

Institute of Research Center of Gout and Hyperuricemia of the Affiliated Hospital, North Sichuan Medical College

Disclosure of Interests

None declared

AB0112 DECOY RECEPTOR 3 AND ITS SIGNAL PATHWAY CONTRIBUTE TO PATHOGENESIS IN ANKYLOSING SPONDYLITIS

Background

Ankylosing spondylitis (AS) is a chronic progressive disease with invasion of spine and sacroiliac joint as the main clinical manifestation, which can be combined with systemic inflammation or abnormalities in multiple parts at the same time. There are complex changes of immune function in patients with AS, and its immune and genetic pathogenesis is still unclear. Decoy receptor 3 (DcR3), as a new immune molecule discovered in recent years, plays an important role in regulating T cell activation, proliferation, differentiation and apoptosis.Studies have confirmed that DcR3 is involved in the immune disorder process of rheumatoid arthritis, SLE, AS and other autoimmune diseases, so that the role of DcR3 in AS has attracted attention. However, the expression of DcR3 related pathway genes[1-3].However, studies evaluating the DcR3 related pathway genes in AS are scarce.

Objectives

To assess the contribution of DcR3 and its signal pathway to AS and the clinical importance of these genes in AS.

Methods

The mRNA expression levels of DCR3 and its signal pathway(DR3、TL1A、Fas、FasL、Ligth、LigthR、LTgthRNA expresured in peripheral blood mononuclear cells (PBMCs) from 50 AS patients and 50 healthy subjects. The relationship between DCR3 related molecular pathway expression levels and laboratory features was analyzed in AS patients.

Results

The expression levels of DCR3、DR3、Fas、Light were much lower in the AS group than in the HC groups (p<0.05)(a,b,c,d), and the expression levels of LT The relationship between DCR3 related molecular pathway expression l

Conclusion

Compared with HC group, DCR3 and its signal pathway in PBMCs of AS patients are differentially expressed. It is speculated that DcR3 related molecular pathway gene may be involved in the pathogenesis of AS.

Figure 1.

Relative Expression of DcR3 related molecular pathway gene in the PBMCs of Patients. The mRNA levels in PBMCs from AS patients(n=50) and HCs(n=50) were measured by RT-qPCR. The expression levels of DCR3ˎDR3ˎFasˎLight were much lower in the AS group than in the HC groups (p<0.05)(a,b,c,d), and the expression levels of LTβR was much higher in the AS group than in the HC groups (p<0.05)(e).

References

[1]Lee CS, Hu CY, Tsai HF, et al. Elevated serum decoy receptor 3 with enhanced T cell activation in systemic lupus erythematosus. Clin Exp Immunol. 2008;151(3):383-390. doi:10.1111/j.1365-2249.2007.03579.x

[2]Hayashi S, Miura Y, Tateishi K, Takahashi M, Kurosaka M. Decoy receptor 3 is highly expressed in patients with rheumatoid arthritis. Mod Rheumatol. 2010;20(1):63-68. doi:10.1007/s10165-009-0240-7.

[3]Chen MH, Chen WS, Tsai CY, Liao HT, Chen CH, Chou CT. Overexpression of decoy receptor 3 in synovial tissues of inflammatory arthritis. Clin Exp Rheumatol. 2012;30(2):171-177.

Acknowledgements

Institute of Research Center of Gout and Hyperuricemia of the Affiliated Hospital, North Sichuan Medical College

Disclosure of Interests

None declared

Natural polyphenol-based nanoengineering of collagen-constructed hemoperfusion adsorbent for the excretion of heavy metals

Designing a hemoperfusion adsorbent for the excretion therapy of toxic heavy metals still remains a great challenge due to the biosafety risks of non-biological materials and the desired highly efficient removal capacity. Herein, inspired from the homeostasis mechanism of plants, natural polyphenols are integrated with collagen matrix to construct a polyphenol-functionalized collagen-based artificial liver (PAL) for heavy metals excretion and free radicals scavenging therapy. PAL presents high adsorption capacities for Cu²⁺, Pb²⁺, and UO₂²⁺ ions, up to 76.98 μmol g^-1, 106.70 μmol g^-1, and 252.48 μmol g^-1, respectively. Remarkably, PAL possesses a high binding affinity for UO₂²⁺, Pb²⁺, and Cu²⁺ ions even in the complex serum environment with the presence of biologically-relevant ions (e.g., Mg²⁺, Ca²⁺ ions). Low hemolysis ratio (1.77%), high cell viability (> 85%), high plasma recalcification time (17.4 min), and low protein adsorption (1.02 μmol g^-1) indicate outstanding biocompatibility of this material. This natural polyphenol/collagen-based fully bio-derived hemoperfusion adsorbent provides a novel and potentially applicable strategy for constructing a hemoperfusion adsorbent for heavy metal ions excretion therapy with efficiency and biosafety.

A37 EFFICACY AND SAFETY OF RISANKIZUMAB AS MAINTENANCE THERAPY IN PATIENTS WITH CROHN’S DISEASE: 52 WEEK RESULTS FROM THE PHASE 3 FORTIFY STUDY

Background

Risankizumab (RZB), an anti-IL-23 p19 inhibitor, was well-tolerated and superior to placebo (PBO) in inducing clinical remission and endoscopic response in patients (pts) with moderate-to-severe Crohn’s disease (CD) in two phase 3 studies at 12 weeks.

Aims

FORTIFY (NCT03105102), was a 52-week (wk) phase 3 double-blind, re-randomized responder withdrawal study that evaluated the efficacy and safety of continuing RZB as subcutaneous (SC) maintenance therapy versus withdrawal to placebo in pts achieving induction response to RZB

Methods

Week 12 IV RZB responders were re-randomized 1:1:1 to: RZB SC 360mg (N=141), RZB 180mg (N=157), or PBO (withdrawal from IV RZB; N=164) every 8wks for 52wks. Co-primary endpoints were clinical remission (per CD Activity Index [CDAI] (US); or stool frequency/abdominal pain score [SF/APS] (OUS) and endoscopic response at wk52. Other clinical and endoscopic endpoints, inflammatory biomarkers, RZB serum levels, and safety were assessed over time.

Results

Rates of clinical remission (CDAI, SF/APS) and clinical response were similar for RZB and PBO groups through wk24, with rates lower for PBO thereafter. At wk52, clinical remission (CDAI, SF/APS) and endoscopic response rates were significantly higher with RZB 360mg than PBO ( P<0.01); RZB 180mg was superior to PBO for clinical remission per CDAI and endoscopic response ( P<0.01). Endoscopic remission and deep remission rates increased over time with 360mg, remained steady with 180mg, and decreased with PBO. Mean fecal calprotectin (FCP) and C-reactive protein (CRP) levels decreased with SC RZB, but increased with PBO, over 52wks. Exposure-adjusted event rates (per 100 pts-years) of serious adverse event (AE) were generally similar among groups (360mg, 21.0 E/100PY and 180mg, 19.5 E/100PY vs PBO, 19.3 E/100PY), as were AEs leading to drug discontinuation (4.8 E/100PY and 2.4 E/100PY vs 3.7 E/100PY), and serious infections (6.0 E/100PY and 3.0 E/100PY vs 5.0 E/100PY).

Conclusions

In pts with moderate-to-severe CD, a robust pharmacodynamic effect on the IL-23 pathway after 12wks RZB IV induction was maintained with RZB SC maintenance therapy. The durability of RZB was demonstrated with high rates of efficacy over the 52-wk study. RZB was superior to PBO for achieving clinical remission and endoscopic response at wk52. Results for the more stringent endpoints (endoscopic remission\deep remission) and persistent improvements in inflammatory biomarkers are consistent with a dose response relationship. Continued RZB SC maintenance treatment was generally safe and well-tolerated.

Funding Agencies

AbbVie

[Distribution and metabolism of toxicants in rats with phenol burn]

Objective: To study the distribution and metabolism of toxicants in rats after phenol burn. Methods: In February 2019, SPF-grade healthy SD male rats were transdermally exposed to 6 mg/kg phenol to create a 5% body surface burn model of rats. High performance liquid chromatography was used to determine phenol content in rat plasma and kidney tissues after 0.25, 0.75, 2, 4, 8, 16, and 32 h, respectively. The kinetic parameters of phenol were calculated by DAS 2.0 software, and the kidney targeting of phenol was evaluated. Results: The area under the blood concentration-time curve at 0-8 h (AUC(0-8)) of the rat after phenol burn was (28.741±6.485) μg/ml·h, and the area under the blood concentration-time curve from 0 to infinite time (AUC(0-∞)) was (30.354±6.424) μg/ml·h, half-life (t(1/2)) was (2.111±0.632) h, peak concentration (C(max)) was (16.287±4.870) μg/ml, mean residence time (MRT) was (1.854±0.148) h. The target efficiency (DTE) of rat kidney was 2.91. Conclusion: Phenol burn rats have fast percutaneous absorption, rapid elimination of phenol, and have high clearance rate, short MRT, and weak substance accumulation. Phenol has relatively obvious selectivity to the kidneys.

Interaction mechanism of collagen peptides with four phenolic compounds in the ethanol-water solution

This study demonstrated the interaction mechanism of collagen peptides (CPs) with 4-ethylphenol (4-EP), phenol, guaiacol, and 4-ethylguaiacol (4-EG) in the ethanol-water solution. The ultraviolet visible spectroscopy, zeta potential tests and hydrogen nuclear magnetic spectroscopy manifested that CPs interacted with the phenolic compounds. Meanwhile, Isothermal titration calorimetry determination indicated that the CPs was hydrogen bonded with 4-EP in 52 %(v/v) ethanol-water solution, while the hydrophobic forces played a major role in the interaction of CPs with guaiacol and 4-EG, respectively. Moreover, hydrogen and hydrophobic bonds were involved in the interaction between CPs and phenol. Finally, Head Space-solid Phase Microextraction Gas Chromatography Mass Spectrometry analysis indicated that the content of phenolic compounds in model solution efficiently decreased with the presence of CPs. In the real liquor, it was found that the content of volatile compounds (including phenolic compounds) was obviously decreased after CPs added.

Collagen peptide provides Streptomyces coelicolor CGMCC 4.7172 with abundant precursors for enhancing undecylprodigiosin production

Abstract

Effective and ecofriendly converting biomass to chemicals is important for sustainable engineering based on the foreseeable shortage of fossil resources. Undecylprodigiosin (UP) is a promising antibiotic, but the direct feeding of pure precursor amino acids makes it costly for large-scale production. Here, collagen peptide (CP), a renewable animal-derived biomass contains abundant precursor amino acids of UP. CP can act as carbon and nitrogen source for the growth of Streptomyces coelicolor CGMCC 4.7172. The plant biomasses including soybean meal, wheat bran, and malt extract were unsuitable for UP prodution. However, 365.40 µg/L UP was detected after 24 h in the media containing CP, and its highest concentration reached 1198.01 µg/L. UP was also detected in the media containing meat hydrolysates of domestic animals, but its initial production time was delayed, and final concentration was lower than that in the medium containing CP only. Compared the fermentation performances of CP and other proteins, CP has a special superiority for UP production. These results revealed that UP biosynthesis may be dependent on amino acid availability of substrates and CP is beneficial for UP production because of its specific amino acid composition.

Graphical abstract

AB0197 EFFICACY AND SAFETY OF HLX01 COMBINED WITH METHOTREXATE IN CHINESE PATIENTS WITH MODERATELY TO SEVERELY ACTIVE RHEUMATOID ARTHRITIS WHO HAD INADEQUATE RESPONSES TO METHOTREXATE: RESULTS OF A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED PHASE 3 STUDY

Background:

Rituximab is an effective therapy for rheumatoid arthritis (RA) patients with inadequate responses to methotrexate (MTX)1, 2. However, it has not been registered or approved in China for the treatment of RA by far. HLX01, an approved rituximab biosimilar (demonstrated in Chinese patients with diffuse large B-cell lymphoma)3, is thus evaluated in this study for the benefits of Chinese RA patients.

Objectives:

This study aimed to evaluate the efficacy and safety of HLX01 plus MTX versus placebo plus MTX in Chinese patients with active RA who had inadequate responses to MTX.

Methods:

This was a randomised, double-blind, placebo-controlled phase 3 study conducted in China (NCT03522415). Eligible patients were randomised 2:1 to receive intravenous infusion of 2×1000 mg HLX01 or placebo on day 1 and day 15. Patients with inadequate responses at week 16 and 20 were allowed to receive rescue treatments. Patients were retreated with or switched to receive (if initially assigned to placebo) 2×1000 mg rituximab at the first day of week 24 and 26. The primary endpoint of this study was the American College of Rheumatology criteria (ACR) 20 response at week 24. Secondary efficacy endpoints were evaluated at week 12, 24, 36 and 48. The safety, pharmacokinetics, pharmacodynamics and immunogenicity of HLX01 were observed and analyzed throughout the study.

Results:

Between May 28, 2018 and Sep 11, 2020, a total of 275 patients (ITT set) were randomised and 263 patients without major protocol deviations were included in per-protocol set (PPS). At week 24, HLX01 showed statistically superior efficacy (p <0.001) to placebo (ACR20: 60.7% vs 35.9% in ITT set, 60.3% vs 37.1% in PPS). Secondary efficacy endpoints were also significantly improved in HLX01 group compared with placebo (Table 1). The overall incidence of serious treatment emergent adverse events (TEAEs), adverse drug reactions (ADRs), and TEAEs leading to drug discontinuation were similar among treatment groups, with the most common TEAE been upper respiratory tract infection before (18.1% vs 18.5%) or after (13.0% vs 12.3%) week 24. Serum concentrations, immunogenicity and pharmacodynamics were similar between HLX01 and placebo groups.

Table 1.

Results of secondary efficacy endpoints at week 12, 24, 36 and 48 in ITT set.

DurationSecondary efficacy endpointsACR20 (%)ACR50 (%)ACR70 (%)DAS28-CRP(mean)HAQ-DI(mean)HLX01PlaceboHLX01PlaceboHLX01PlaceboHLX01PlaceboHLX01PlaceboBaseline5.495.431.401.45Week 1248.132.621.910.94.45.43.894.471.021.22Week 2460.735.936.618.515.312.03.394.370.871.22Week 3660.148.946.431.532.217.42.883.510.710.97Week 4873.862.055.240.239.927.22.823.510.721.03

Conclusion:

Comparing with placebo plus MTX, HLX01 plus MTX showed significantly improved clinical outcomes and comparable safety profiles in Chinese patients with moderately to severely active RA who had inadequate responses to MTX, demonstrating HLX01 in combination with MTX as a well-tolerated, safe and efficient treatment option.

References:

[1]Emery P, Deodhar A, Rigby WF, et al. Efficacy and safety of different doses and retreatment of rituximab: a randomised, placebo-controlled trial in patients who are biological naive with active rheumatoid arthritis and an inadequate response to methotrexate (Study Evaluating Rituximab’s Efficacy in MTX iNadequate rEsponders (SERENE)). Ann Rheum Dis. Sep 2010;69(9):1629-35. doi:10.1136/ard.2009.119933.

[2]Rubbert-Roth A, Tak PP, Zerbini C, et al. Efficacy and safety of various repeat treatment dosing regimens of rituximab in patients with active rheumatoid arthritis: results of a Phase III randomized study (MIRROR). Rheumatology (Oxford). Sep 2010;49(9):1683-93. doi:10.1093/rheumatology/keq116.

[3]Shi Y, Song Y, Qin Y, et al. A phase 3 study of rituximab biosimilar HLX01 in patients with diffuse large B-cell lymphoma. J Hematol Oncol. Apr 16 2020;13(1):38. doi:10.1186/s13045-020-00871-9.

Acknowledgements:

The authors would like to thank participants in this study and their families. They would also like to acknowledge other investigators and staff at all clinical sites and the members of the Independent Data Monitoring Committee.

Disclosure of Interests:

None declared

High pressure homogenization inactivation of Escherichia coli and Staphylococcus aureus in phosphate buffered saline, milk and apple juice

High pressure homogenization (HPH) offers new opportunities for food pasteurization/sterilization. Escherichia coli and Staphylococcus aureus suspended in phosphate buffered saline (PBS) buffer, milk and apple juice at initial concentration of ~10⁶ log₁₀ CFU per ml were subjected to HPH treatments up to 200 MPa with inlet temperatures at 4-40°C. After HPH at 200 MPa with the inlet temperature at 40°C, the count of E. coli suspended in PBS, milk and apple juice reduced by 3·42, 3·67 and 3·19 log₁₀ CFU per ml respectively while the count of S. aureus decreased by 2·21, 1·02 and 2·33 log₁₀ CFU per ml respectively suggesting that S. aureus was more resistant. The inactivation data were well fitted by the polynomial equation. Milk could provide a protective effect for S. aureus against HPH. After HPH at 200 MPa with the inlet temperature at 20°C, the cell structure of E. coli was destroyed, while no obvious damages were found for S. aureus.

Irradiation-stable hydrous titanium oxide-immobilized collagen fibers for uranium removal from radioactive wastewater

Developing efficient adsorbents with radiation stability for uranium removal from nuclear wastewater is greatly important for resource sustainability and environmental safety in manufacturing nuclear fuel. A novel adsorbent of hydrous titanium oxide-immobilized collagen fibers (HTO/CFs) with good radiation stability for UO₂²⁺ removal was developed. Results showed that the adsorption capacity of HTO/CFs for UO₂²⁺ was 1.379 mmol g^-1 at 303 K and pH 5.0 when the initial concentration of UO₂²⁺ was 2.5 mmol L^-1. Moreover, HTO/CFs showed high selectivity for U(VI) in bilateral mixed solution including UO₂²⁺ with another coexisting ion, such as Cl^-, NO₃^-, Zn²⁺, and Mg²⁺. The adsorption behavior of UO₂²⁺ from radioactive wastewater on HTO/CF column was also investigated, and the breakthrough point was approximately 250 BV (bed volume). Notably, the HTO/CFs column can be rapidly regenerated by using only 4.0 BV of 0.1 mol L^-1 HNO₃ solution. The regenerated HTO/CFs column exhibited slight change in the breakthrough curve, suggesting its excellent reapplication ability. Furthermore, after irradiation under ⁶⁰Co γ-ray at total doses of 10-350 kGy, HTO/CFs still preserved fibrous morphology and adsorption capacity, indicating significant radiation stability. These results demonstrate that HTO/CFs are industrial scalable adsorbents for the adsorptive recovery of uranium.

Collagen Peptide Provides Saccharomyces cerevisiae with Robust Stress Tolerance for Enhanced Bioethanol Production

Efficient production of bioethanol is desirable for bioenergy large-scale applications, but it is severely challenged by ethanol and sugar stresses. Here, collagen peptide (CP), as a renewable nitrogen-containing biomass, remarkably enhanced the stress resistance of Saccharomyces cerevisiae SLL-510 against ethanol challenge, based on its unique amino acid composition. Transcriptome analysis showed that the energy, lipid, cofactor, and vitamin metabolism may involve in stress tolerance provided by CP. When CP was added into the media containing 249.99 mg/mL glucose, the bioethanol yield increased from 8.03 to 12.25% (v/v) and 11.35 to 12.29% (v/v) at 43 and 120 h, respectively. Moreover, at 286.79 mg/mL glucose, the highest yield reached 14.48% (v/v), with 99.58% glucose utilization rate. The protection and promotion effects of CP were also shown by four other industrial S. cerevisiae strains. These results coupled with the advantages of abundant reserves, cleanliness, and renewability revealed that CP is a promising economically viable and industrially scalable enhancer for bioethanol fermentation.

Lightweight and Flexible Bi@Bi-La Natural Leather Composites with Superb X-ray Radiation Shielding Performance and Low Secondary Radiation

A high-shielding, low secondary radiation, lightweight, flexible, and wearable X-ray protection material was prepared by coimpregnating La₂O₃ and Bi₂O₃ nanoparticles in natural leather (NL) with an additional Bi₂O₃ coating at the bottom surface of the leather. The prepared Bi_28.2@Bi_3.48La_3.48-NL (28.2 and 3.48 mmol·cm^-3 are the loading contents of elements) showed excellent X-ray shielding ability (65-100%) in a wide energy range of 20-120 keV with reduced scattered secondary radiation (30%). The bottom surface coating played a critical role in enhancing the X-ray attenuation and reducing the scattered secondary radiation by reflecting and deflecting incident X-ray photons. Excellent mechanical property with superb bending resistance of the NL matrix was properly maintained, and its tensile strength and tearing load were 15.39 MPa and 25.81 N·mm^-1, respectively. This lightweight and wearable high-performance protection material can facilitate safety and comfortability during intensive activities of practitioners in the health care industry.

Research on X-ray shielding performance of wearable Bi/Ce-natural leather composite materials

Natural leather (NL) based composite protection materials with lightweight, flexibility, wearability and high shielding efficiency will remarkably innovate the current research on X-ray protection materials. A co-doped Bi/Ce-NL composite with outstanding X-ray attenuation in the energy range of 20-120 keV is successfully fabricated. The uniform distribution of Bi₂O₃ and CeO₂ nanoparticles in the hierarchical structure of natural leather significantly promotes the X-ray attenuation by improving the weak absorption region of Bi with Ce via synergistic effects of the two elements. The fabricated Bi/Ce-NL loading with 0.755 mmol cm^-3 Bi₂O₃ and 1.51 mmol cm^-3 CeO₂ achieves approximately 100% X-ray shielding when the energy below 40 keV. Thus, the fabricated Bi/Ce-NL with superb X-ray attenuation can safely and comfortably protect human from the risk of X-ray exposure with low bulk density, high water vapor permeability, exceptional mechanical properties and excellent bending resistance, presenting significant advantages in wearability and flexibility compared to both traditional lead-based and polymer-based protection materials.

Prevention of Bacterial Colonization Based on Self-Assembled Metal-Phenolic Nanocoating from Rare-Earth Ions and Catechin

Clinically related infection is a critical risk for human health and is usually caused by biofilm formation on medical devices. Herein, typical polyphenols, catechin (Cat), and rare-earth ions (Re³⁺) were used for self-assembled Cat-Re nanoparticles that can be facilely coated on the surface of a polyamide (PA) membrane to synergistically prevent bacterial adhesion and subsequent biofilm formation. The antibacterial adhesion feature of the assembled Cat-Re nanoparticles coated on the PA membrane surface was assessed using Pseudomonas aeruginosa, one of the most common pathogenic bacteria, as probe bacteria under static and dynamic simulation flow conditions. The Cat-Re nanocoating showed excellent antibacterial and anti-adhesion activities against P. aeruginosa and successfully prevented biofilm formation on the material's surface. Regardless of the conditions, the Cat-Re nanocoating significantly suppressed the growth and attachment of P. aeruginosa and maintained >90% inhibition activity with favorable reusability and long-term stability. The results suggest that the self-assembled rare-earth-phenolic nanocoating has promising application potential in the prevention of medical device-related biofilm formation.

Advanced X-ray Shielding Materials Enabled by the Coordination of Well-Dispersed High Atomic Number Elements in Natural Leather

Nowadays, X-rays are playing increasingly important roles in daily life and industrial manufacture, which calls for effective and mobile shielding materials. However, it seems to be a paradox to prepare shielding materials simultaneously achieving excellent X-ray attenuation properties and superior mechanical strength. Here, an advanced leather-based X-ray shielding material containing bismuth and iodine (BiINP-LM) is prepared, and the stable and well-dispersed loading of high-Z element components is enabled by favorable interactions between bismuth iodide and leather, i.e., coordination, hydrogen bonds, and electrostatic attractions. A piece of BiINP-LM with 1.00 mm thickness displays an excellent X-ray attenuation efficiency of more than 90% in the photon energy range below 50 keV and 65% at 83 keV, which averagely exceeds ∼3% than that of the 0.25 mm lead plate and ∼5% than that of the 0.65 mm commercial lead apron. Additionally, the coordination between bismuth and leather provides an enhanced tensile and tear strength of ∼10-fold and 3-fold compared with the lead apron. It is worth mentioning that BiINP-LM also displays extra high water-vapor permeability, which is ∼50-fold more than the lead apron. Overall, this work opens up a new prospect for preparing advanced X-ray shielding materials with both excellent X-ray attenuation and outstanding physiomechanical performances.

Synthesis of Catechin-Rare Earth Complex with Efficient and Broad-Spectrum Anti-Biofilm Activity

Biofilm is the crucial reason of clinical infections. Herein, green tea based polyphenol (catechin) and rare earth (RE) metal ions were employed for the preparation of catechin-RE complexes with significant anti-biofilm properties. The complexes were characterized by FT-IR, Raman spectroscopy, X-ray photoelectron spectroscopy (XPS) and dynamic light scattering (DLS), which suggested that catechin coordinated with RE³⁺ through its ortho phenolic hydroxy groups. The prepared catechin-RE showed significant effects in anti-biofilm growth against P. aeruginosa (Gram-negative bacteria), S. sciuri (Gram-positive bacteria), and A. niger (fungi), which significantly exceeded the utilization of catechin or RE³⁺ . Morphological observations indicated that catechin supplied cell affinity to transfer RE³⁺ and helped to damage cell membrane, which act as a carrier to exert cytotoxicity of RE³⁺ to realize anti-biofilm. Differential gene expression analysis described gene expression changes induced by catechin-RE, including 56, 272 and 2160 downregulated genes for P. aeruginosa, S. sciuri and A. niger, respectively, which suggested critical changes in cellular metabolism, growth and other processes. These results illustrate the outstanding superiority of catechin-RE complexes in anti-infection aspect, i. e., the green tea based rare earth complexes are promising candidates for anti-biofilm applications to address serious challenges in the prevention of multiple infections.

[Clinical analysis of seven cases with primary hyperoxaluria type 1 in children]

Objective: To investigate the clinical, imaging and molecular characteristics of primary hyperoxaluria type 1 (PH1) in children and to sum up existing evidence for further understanding the phenotype-genotype correlation of infantile PH1. Methods: This retrospective analysis was based on the medical records of children with PH1 diagnosed by gene test in the Department of Nephrology, Guangzhou Women and Children's Medical Center from June 2016 to May 2019. Targeted exome sequencing was performed on tubular disease-related genes of the probands and Sanger sequencing was conducted to validate suspected pathogenic variants of family members. Logistic regression analysis of NC and CCr was adopted to show the relation between NC and renal function. The literature review was conducted, and the clinical, imaging and molecular biogenetic characteristics of the disease were analyzed and summarized. Results: A total of 7 children from 6 families were enrolled. The median age of onset was 5 months. The median age of diagnosis was 8 months. Five cases had progressed to end-stage renal disease (ESRD), one case had chronic kidney disease (CKD) stage 1, and the other one had CKD stage 2. Four cases died, one case maintained on hemodialysis, and the other two non-dialysis cases were followed up. Among the 7 cases, 4 patients had infantile PH1, 1 patient had child and adolescent type, 1 patient had family type and the other one had unknown classification. There were two siblings (the younger brother had uremia and the sister had normal renal function) who had the delayed diagnosis for 5 and 3 years respectively. All patients in this cohort had proteinuria and microscopic hematuria, but no patients had gross hematuria. Three cases had hypercalciuria. Comprehensive diagnostic imaging evaluation include CT scan, MR scan, radiography and ultrasound led to the diagnosis of nephrocalcinosis (NC) in 5 cases, including 4 cases of simple NL and 1 case of NC with nephrolithiasis (NL), 1 case of multiple NL and 1 case of microcrystal deposition in renal medulla. However, only one case of NC was identified by ultrasound, the other 4 cases of NC were identified by radiograph examination. In the logistic regression analysis involving NC and creatinine clearnce rate (CCr), the results showed that NC was an independent risk factor for renal dysfunction (OR 2.5, 95%CI 0.7-1.2, P<0.05). All the 7 cases had AGXT gene variant, including homozygous variant in 4 cases and compound heterozygous variant in 3 cases. A total of 9 variant genotypes were found, and exon 6 variants were found in 4 children. Among them, there were 3 cases with c.679_680delAA. To our knowledge, both c.679_680delAA and c.190A>T in the cohort have not been reported previously. Conclusions: Infantile PH1 is the most common type of PH1 in children, which progresses rapidly or even begins with renal failure, with poor prognosis. It is also highly heterogeneous in phenotype and genotype. NC is an independent risk factor leading to renal failure. Radiograph examination showed high specificity for the diagnosis of NC. At present, the misdiagnosis and delayed diagnosis of PH1 are still common in China. It is of great significance to carry out quantitative determination of uric oxalate in order to reduce the misdiagnosis rate and enhance follow-up technologies for evaluating the therapeutic effect.

Radionuclide tolerance mechanism of plants for ultraselective enrichment of low content of thorium with exceptional selectivity coefficient

Selective enriching low content of radionuclides from radioactive wastewater is a critical issue for environmentally benign utilization of nuclear power. Inspired by the tolerance mechanism of plants to radionuclides, we developed a pH-triggered ultraselective coordinative adsorption (CA) membrane. The as-prepared CA membrane featured the advantages of both coordinative adsorption and membrane separation, including ultrahigh selectivity coefficient of 1242, large capacity (80 L m^-2) and short mass transfer distance. The adsorption isotherms of Th⁴⁺ on the CA membrane were well described by the Freundlich model (R² > 0.99), and the adsorption kinetics have a good fitting by using the pseudo-second-order kinetic model (R² > 0.99). In a continuous separation under gravity, the CA membrane was able to selectively enrich the low content of Th⁴⁺ (0.05 mmol L^-1) in the presence of 700 folds (35 mmol L^-1) of co-existing ions (Na⁺, Mg²⁺, K⁺, Ca²⁺, Sr²⁺, Cs⁺ and Ba²⁺). The exceptional extraction efficiency to Th⁴⁺ was 100%, superior to that (3.7%) of all co-existing ions. Notably, the Th⁴⁺ enriched on the CA membrane was facilely eluted by diluted HNO₃ (0.1 mol L^-1). The Th⁴⁺ in the eluents was enriched by up to 54 folds. The eluted CA membrane was further reused for selective enrichment of Th⁴⁺, which showed no obvious loss of selectivity and enrichment capability. Our strategy might open up a new strategy for realizing ultraselective and recyclable enrichment of low content of irradiation contaminants from wastewater.

Dysregulation of miR-195-5p/-218-5p/BIRC5 axis predicts a poor prognosis in patients with gastric cancer

MicroRNAs (miRNAs) function by negatively regulating their target genes. Aberrant expression of baculoviral IAP repeat containing 5 (BIRC5) is associated with the tumor growth and metastasis, however, the clinical significance of miRNAs/BIRC5 axis in gastric cancer (GC) remains unknown. The association of BIRC5 or miR-195-5p/-218-5p expression levels with the clinicopathological characteristics and prognosis in patients with GC was analysed by using a tissue microarray and TCGA dataset. Pearson correlation analysis was used for analysing the correlation of BIRC5 with miR-195-5p/-218-5p expression in GC tissues. Cox proportional hazard regression model was conducted to assess whether BIRC5 or miR-195-5p/-218-5p was an independent prognostic factor in patients with GC. We found that BIRC5 expression levels were increased in GC tissues as compared with the adjacent normal tissues, and acted as an independent prognostic factor of tumor recurrence in patients with GC. Increased expression of BIRC5 was traceable to the dysregulation of miR-195-5p/-218-5p rather than its genetic and epigenetic alterations in GC tissues. MiR-195-5p/-218-5p displayed a negative correlation with BIRC5 expression, and acted as independent prognostic factors of poor prognosis in patients with GC. In conclusion, dysregulation of miR-195-5p/-218-5p/BIRC5 axis predicts a poor prognosis in patients with gastric cancer.