Anisotropic photoluminescence of nonpolar ZnO epilayers and ZnO/Zn1-xMgxO multiple quantum wells grown on LiGaO2 substrate

The temperature-dependent polarized photoluminescence spectra of nonpolar ZnO samples were investigated by 263 nm laser. The degree of polarization (DOP) of m-plane quantum wells changes from 76% at 10 K to 40% at 300 K, which is much higher than that of epilayer. The strong anisotropy was presumably attributed to the enhanced confinement effect of a one-dimension confinement structure formed by the intersection of quantum well and basal stacking fault. The polarization of laser beam also has an influence on the DOP. It is assumed that the luminescence polarization should be affected not only by the in-plane strains but also the microstructural defects, which do modify the electronic band structure.

Fulvestrant inhibits the glycolysis of prolactinoma GH3 cells by downregulating IRE1/XBP1 signaling pathway

OBJECTIVE

We aimed to evaluate the effects of fulvestrant on the glycolysis of prolactinoma GH3 cells, and reveal the potential regulatory mechanisms.

MATERIALS AND METHODS

Prolactinoma cell line GH3 was treated with different concentrations of fulvestrant (0, 0.12, 0.25, 0.5 and 1 ng/ml) for 4 h. siRNAs XBP1s and XBP1u were constructed to treat GH3 cells. The expression levels of XBP1s, XBP1u, IRE1, PKM2 and GRP78 of GH3 cells were detected by Western blot. Meanwhile, the glycolytic activity of GH3 cells, including the glucose uptake, ATP/ADP, and lactate production were detected.

RESULTS

The expression levels of XBP1s and XBP1u were significantly inhibited by fulvestrant in a dose-dependent manner. The glucose uptake, ATP/ADP and lactate production of GH3 cells were significantly inhibited by fulvestrant as well as siRNA XBP1s and XBP1u (p < 0.05). Western blot analysis suggested that the expression levels of IRE1, PKM2 and GRP78 were significantly decreased in GH3 cells treated by fulvestrant as well as siRNA XBP1s and XBP1u, compared with those in normal control (p < 0.05).

CONCLUSIONS

Fulvestrant could inhibit the glycolysis of GH3 cells by downregulating IRE1/XBP1 signaling pathway, and this process was closely related with the downregulation of PKM2.

µ-opioid receptor, β-endorphin, and cannabinoid receptor-2 are increased in the colonic mucosa of irritable bowel syndrome patients

BACKGROUND AND AIMS

The gut immune, cannabinoid, and opioid systems constitute an integrated network contributing to visceral sensation and pain modulation. We aimed to assess the expression of the µ-opioid receptor (MOR), its ligand β-endorphin (β-END), and cannabinoid receptor-2 (CB2 ) in patients with irritable bowel syndrome (IBS) and asymptomatic controls (AC) and their correlation with sex and symptom perception.

METHODS

Mucosal biopsies were obtained from the left colon of 31 IBS patients (45% women) with predominant constipation (IBS-C, 9) or diarrhea (IBS-D, 10) or with mixed bowel habits (IBS-M, 12) and 32 AC (44% women) and processed for qRT-PCR, Western blotting, and immunohistochemistry.

KEY RESULTS

µ-opioid receptor and CB2 mRNA and protein expression and β-END protein levels were increased in patients with IBS compared to AC (all Ps=0.021). A significant sex by IBS interaction was found in relation to CB2 mRNA expression (P = .003) with women showing a markedly higher expression to men (P = .035). In contrast, in AC, men had higher expression than women (P = .033). β-END, MOR, and CB2 immunoreactivities (IR) were localized to CD4+T cells including EMR-1+ eosinophils and CD31+ T cells but not to mast cells.

CONCLUSIONS

The increased expression of MOR, β-END, and CB2 in the mucosa of IBS patients, where they are localized to immune cells, suggests that opioid and cannabinoid systems play an immune-related compensatory role in visceral pain in IBS patients. Further work is necessary to support this hypothesis.

Purine Permease-Type Benzylisoquinoline Alkaloid Transporters in Opium Poppy

Although opiate biosynthesis has been largely elucidated, and cell-to-cell transport has been long postulated, benzylisoquinoline alkaloid (BIA) transporters from opium poppy (Papaver somniferum) have not been reported. Investigation of a purine permease-type sequence within a recently discovered opiate biosynthetic gene cluster led to the discovery of a family of nine homologs designated as BIA uptake permeases (BUPs). Initial expression studies in engineered yeast hosting segments of the opiate pathway showed that six of the nine BUP homologs facilitated dramatic increases in alkaloid yields. Closer examination revealed the ability to uptake a variety of BIAs and certain pathway precursors (e.g. dopamine), with each BUP displaying a unique substrate acceptance profile. Improvements in uptake for yeast expressing specific BUPs versus those devoid of the heterologous transporters were high for early intermediates (300- and 25-fold for dopamine and norcoclaurine, respectively), central pathway metabolites [10-fold for (S)-reticuline], and end products (30-fold for codeine). A coculture of three yeast strains, each harboring a different consecutive segment of the opiate pathway and BUP1, was able to convert exogenous Levodopa to 3 ± 4 mg/L codeine via a 14-step bioconversion process involving over a dozen enzymes. BUP1 is highly expressed in opium poppy latex and is localized to the plasma membrane. The discovery of the BUP transporter family expands the role of purine permease-type transporters in specialized metabolism, and provides key insight into the cellular mechanisms involved in opiate alkaloid biosynthesis in opium poppy.

[Clinical characteristics of non-invasive ventilation treatment in children with spinal muscular atrophy and sleep disordered breathing]

Objective: To study the short-term and long-term efficacy of the non-invasive ventilation treatment in children with spinal muscular atrophy (SMA) and sleep-disordered breathing. Methods: This was a prospective research to study the effect of night-time non-invasive ventilation in children with SMA and moderate to severe sleep-disordered breathing during March 2016 to January 2018, from the Pulmonary Department of Capital Institute of Pediatrics Affiliated Children's Hospital. Patients were divided into the treated group (with night-time non-invasive ventilation) and the control group (without ventilator). Sleep breathing pressure titration was suggested to the patients who were prepared to receive non-invasive ventilation. All cases were followed up for one year. Parameters'changes in polysomnography were assessed (paired t-test) in titration patients. Frequency of respiratory tract infection during the next year in the patients with and without ventilation was collected and compared (Mann-Whitney U-test). Results: Seventeen cases were recruited. The average age was (5.1±2.9) years, 10 cases were boys and 7 cases were girls. In the titration group (8 patients), after non-invasive ventilation, the average apnea hypopnea index was (3.8±2.5) times/h (t=4.086, P=0.005), hypopnea index was (2.4±1.2) times/h (t=2.779, P=0.027), average oxygen saturation during total sleep time was 0.966±0.007 (t=-5.292, P=0.001), and the minimum oxygen saturation was 0.906±0.023 (t=-3.938, P=0.006). All the above parameters were significantly improved after treatment. Than before, which was (16.6±9.7) times/h, (7.2±4.7) times/h, 0.946±0.015, 0.786±0.092 respectively. Ventilator mode for the 9 children with long time non-invasive ventilation at home was Bi-level positive airway pressure S/T. The positive airway pressure was set at 8-14 cmH(2)O (1 cmH(2)O=0.098 kPa) in inspiratory phase and 4-6 cmH(2)O in expiratory phase. In the treated group (9 patients), the average frequency of upper respiratory tract infection was 1.0 (0, 3.0) times/year (Z=-2.245, P=0.023), the lower respiratory tract infection was 0 (0, 0) times/year (Z=-3.189, P=0.001), hospitalization was 0 (0, 0) times/year (Z=-3.420, P<0.01), and admission to intensive care unit was 0 (0, 0) times/year (Z=-3.353, P=0.029). All the above indexes were significantly decreased compared with the control group (8 patients), which was 3.0 (2.3, 7.0) times/year, 2.0 (1.3, 4.5) times/year, 1.0 (1.0, 4.3) times/year, 0.5 (0, 1.0) times/year respectively. Conclusion: Non-invasive ventilation is efficient to SMA children with sleep-disordered breathing, and also can reduce the incidence of respiratory tract infections for children with SMA.

History of early life adversity is associated with increased food addiction and sex-specific alterations in reward network connectivity in obesity

BACKGROUND

Neuroimaging studies have identified obesity-related differences in the brain's resting state activity. An imbalance between homeostatic and reward aspects of ingestive behaviour may contribute to obesity and food addiction. The interactions between early life adversity (ELA), the reward network and food addiction were investigated to identify obesity and sex-related differences, which may drive obesity and food addiction.

METHODS

Functional resting state magnetic resonance imaging was acquired in 186 participants (high body mass index [BMI]: ≥25: 53 women and 54 men; normal BMI: 18.50-24.99: 49 women and 30 men). Participants completed questionnaires to assess ELA (Early Traumatic Inventory) and food addiction (Yale Food Addiction Scale). A tripartite network analysis based on graph theory was used to investigate the interaction between ELA, brain connectivity and food addiction. Interactions were determined by computing Spearman rank correlations, thresholded at q < 0.05 corrected for multiple comparisons.

RESULTS

Participants with high BMI demonstrate an association between ELA and food addiction, with reward regions playing a role in this interaction. Among women with high BMI, increased ELA was associated with increased centrality of reward and emotion regulation regions. Men with high BMI showed associations between ELA and food addiction with somatosensory regions playing a role in this interaction.

CONCLUSIONS

The findings suggest that ELA may alter brain networks, leading to increased vulnerability for food addiction and obesity later in life. These alterations are sex specific and involve brain regions influenced by dopaminergic or serotonergic signalling.

Transcriptome-wide analysis of N6-methyladenosine uncovers its regulatory role in gene expression in the lepidopteran Bombyx mori

N6-methyladenosine (m6A) methylation is the most common form of RNA modification in eukaryotes and has been shown to act as an important epitranscriptomic marker, which can regulate gene expression, messenger RNA stability, alternative splicing and translation efficiency. Recent progress on determining insect m6A function has been limited to the dipteran Drosophila melanogaster, in which m6A is involved in neuronal functions and sex determination. Methylation and function of m6A in other insects, however, remain unknown. Here, we investigated a transcriptome-wide profile of m6A in the lepidopteran Bombyx mori and identified the methyltransferase subunits B. mori methyltransferase-like 3 (BmMETTL3) and BmMETTL14 in the m6A methylation pathway. Strikingly, loss of BmMETTL3 and BmMETTL14 in cultured B. mori cells led to arrest of cell cycle progression and caused deficiency of chromosome alignment and segregation. Specifically, we identified 2853 m6A peaks representing transcripts of 2043 genes, and the target genes with m6A methylation were shown to be involved in gene expression and translation. It was interesting that we found that the highly expressed genes tended to be methylated by m6A, and comparative analysis of RNA m6A and DNA N6-methyladenine (6mA) revealed two distinct regulatory mechanisms for gene expression. Overall, our work suggests RNA m6A and DNA 6mA play important roles in RNA and DNA epigenetic regulation in B. mori.

miR-375 inhibits the proliferation and invasion of glioblastoma by regulating Wnt5a

The aberrant expression of microRNA-375 (miR-375) has been proved to be associated with carcinogenesis. However, the role of miR-375 in glioblastoma (GBM) remains unknown. The aim of this study was to investigate biological functions and its molecular mechanisms of miR-375 in GBM cells. In this study, real-time PCR results showed that the level of miR-375 expression in GBM tissues and GBM cell lines (U87 and U251) was decreased. Using MTT assay, Transwell migration and invasion assay, we demonstrated that miR-375 overexpression significantly suppress cell proliferation, cell migration and cell invasion capacity in U87 and U251 cells. However, downregulation of miR-375 had reverse effects on cell proliferation, migration and invasion. Targeting association analysis, dual luciferase assay, RT-PCR and western blot analysis results confirmed that miR-375 could target the 3'UTR of Wnt5a mRNA and regulated its protein expression. Further studies also find overexpression of Wnt5a could significantly reverse miR-375-mediated proliferation, migration and invasion on U87 and U251 cells. Therefore, we concluded that miR-375 inhibited the proliferation and invasion of GBM by regulating Wnt5a and might be a possible therapeutic agent for GBM.

Role of spinal cyclooxygenase-2 and prostaglandin E2 in fentanyl-induced hyperalgesia in rats

BACKGROUND

Accumulated evidence suggests that spinal cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) may be implicated in the development of opioid-induced hyperalgesia.

METHODS

Rats received subcutaneous fentanyl injections at different doses (20-80 μg kg^-1), four separate times at 15-min intervals. Some rats only received fentanyl (60 μg kg^-1 × 4 doses) with or without surgical incision. Fentanyl-induced hyperalgesia was evaluated via a tail-pressure or paw-withdrawal test. The concentrations of spinal COX-2, EP-1 receptor (EP-1R) mRNA, and PGE2 were measured. The effects of the COX-2 inhibitor, parecoxib (intraperitoneal 10 mg kg^-1), or the EP-1R antagonist, SC51089 (intraperitoneal 100 μg kg^-1), on hyperalgesia and spinal PGE2 were examined.

RESULTS

Acute repeated injections of fentanyl dose-dependently induced mechanical hyperalgesia, which reached a peak at the 1^st day and persisted for 1-4 days postinjection. This hyperalgesia could be partly or totally prevented by the pretreatment of either parecoxib or SC51089. Consistently, the levels of spinal COX-2 mRNA and PGE2 were also dose-dependently increased, reaching a peak at the first day and persisting for 2 days postinjection. Pretreatment with parecoxib could block the increase in spinal PGE2 and had no effects on spinal COX-2 and EP-1R mRNA. Fentanyl injection enhanced incision-induced mechanical and thermal hyperalgesia.

CONCLUSIONS

Acute repeated fentanyl administration dose-dependently produced mechanical hyperalgesia and augmented surgery induced postoperative hyperalgesia. This behavioural change was paralleled with an increase in spinal COX-2 mRNA and PGE2 after fentanyl administration. Inhibition of COX-2 or blockade of EP-1R can partly or totally prevent hyperalgesia.

Codeinone reductase isoforms with differential stability, efficiency and product selectivity in opium poppy

Codeinone reductase (COR) catalyzes the reversible NADPH-dependent reduction of codeinone to codeine as the penultimate step of morphine biosynthesis in opium poppy (Papaver somniferum). It also irreversibly reduces neopinone, which forms by spontaneous isomerization in aqueous solution from codeinone, to neopine. In a parallel pathway involving 3-O-demethylated analogs, COR converts morphinone to morphine, and neomorphinone to neomorphine. Similar to neopine, the formation of neomorphine by COR is irreversible. Neopine is a minor substrate for codeine O-demethylase (CODM), yielding morphine. In the plant, neopine levels are low and neomorphine has not been detected. Silencing of CODM leads to accumulation of upstream metabolites, such as codeine and thebaine, but does not result in a shift towards higher relative concentrations of neopine, suggesting a mechanism in the plant for limiting neopine production. In yeast (Saccharomyces cerevisiae) engineered to produce opiate alkaloids, the catalytic properties of COR lead to accumulation of neopine and neomorphine as major products. An isoform (COR-B) was isolated from opium poppy chemotype Bea's Choice that showed higher catalytic activity than previously characterized CORs, and it yielded mostly neopine in vitro and in engineered yeast. Five catalytically distinct COR isoforms (COR1.1-1.4 and COR-B) were used to determine sequence-function relationships that influence product selectivity. Biochemical characterization and site-directed mutagenesis of native COR isoforms identified four residues (V25, K41, F129 and W279) that affected protein stability, reaction velocity, and product selectivity and output. Improvement of COR performance coupled with an ability to guide pathway flux is necessary to facilitate commercial production of opiate alkaloids in engineered microorganisms.

[Effects of tetrandrine on proliferation and activation of cardiac fibroblasts]

OBJECTIVE

To investigate the effects of tetrandrine (Tet) on proliferation and activation of rat cardiac fibroblasts.

METHODS

Firstly, the cell counting kit-8 (cck-8) assay was applied to detect the effects of Tet with different concentrations on proliferation of cardiac fibroblasts. Secondly, transforming growth factor (TGF-β)with a concentration of 5 μg/L was used to induce the cardiac fibroblast activation, and Western blot was performed to measure the expression variation of β-catenin, vimentin (Vm), fibronectin (Fn) and smooth muscle α-actin (SMA). At last, the real-time PCR was conducted to measure the expression change of collagen-1(Col-1) and collagen-3(Col-3).

RESULTS

The cck-8 assay showed that the Tet with different concentrations respectively, which were 0.5 μmol/L, 1 μmol/L, 2 μmol/L, 4 μmol/L, and 8 μmol/L, significantly inhibited the proliferation of cardiac fibroblasts. The viability was decreased to 94.4%,84.9%,74.9%,63.8%and 50.3% respectively of the control group when the Tet concentration changed, and the difference was statistically significant, P=0.043, P<0.001, P<0.001, P<0.001, P<0.001 respectively. Western blot revealed that the expressions of β-catenin, Fn, SMA and Vm, were up-regulated by TGF-β(5 μg/L), the result showed that the difference was statistically significant, and the P values were 0.001,0.008,0.010,0.001 respectively. Then, the up-regulation of β-catenin, Fn and SMA was attenuated by pre-treatment of Tet, and the result also displayed that the difference was statistically significant, and the P values were 0.009, 0.005, 0.019,respectively. While there was no significant change in the expression of Vm, according to Western blotting, and P>0.05,at the same time, real-time PCR indicated that the up-regulations of Col-1 and Col-3 which were induced by TGF-β were blocked by pre-treatment of Tet, the result showed that the difference was statistically significant, P<0.001.

CONCLUSION

According to the experimental results, we can draw the conclusion that: the Tet can significantly inhibit the proliferation of cardiac fibroblasts, meanwhile, it can block the activation of cardiac fibroblasts, which is induced by TGF-β. It is supposed that the Tet may probably have anti myocardial fibrosis, which indicates that it may probably be a medicine which is used to block the cardiac remodeling.

Abstract P2-02-06: Biomarker analysis by next generation circulating tumor DNA (ctDNA) sequencing in patients with advanced breast cancer

Background: Next-generation sequencing is of increasing interest to identify specific targets for both drug development and treatment. The study of metastatic cancer is complicated by lack of tissue and the potential for change in biology over treatment. We evaluated ctDNA in patients with advanced breast cancer to explore the relationship between specific DNA mutations and prognosis as well as therapeutic decision making.

Methods:Peripheral blood was collected in EDTA at the time of diagnosis of advanced disease. Samples were sent to Geneplus-Beijing for sequencing. Indexed Illumina libraries were prepared from germline and circulating DNA using the KAPA Library Preparation Kit; the capture probe was designed based on genomic regions selected with 1021 genes, covering the most frequently mutated genes and exons in solid tumors. Clinical characteristics, treatment and outcome data were collected. We analyzed progression free survival (PFS) from first-line therapy and overall survival (OS), endpoints were correlated with observed gene mutations.

Results: 54 patients were enrolled; 27 (50%) HER2+, 22 (41%) hormone receptor + (HR+)/HER2-, and 5 (9%) triple negative (TNBC). Median age was 48 (range 26-74). The median follow-up was 8 years (range 12-180 months). First-line therapy included chemotherapy with trastuzumab for HER2+ disease, chemotherapy with endocrine maintenance (17) or endocrine therapy alone (5) for HR+/HER2- disease, and chemotherapy for TNBC. Mutations were found in TP53, PIK3CA, PIK3CA 3140 A&gt;G(p.H1047R) and ERBB (including ERBB1-4), at 40.7%, 35.2%, 20.4% and 25.9%, respectively. In univariate analysis, patients with tumor mutations in TP53 had a shorter OS (median 64 vs 121 months, p=0.006). The PIK3CA 3140 A&gt;G mutation was more frequent in HER2+ (7/27, 25.9%) than HR+/HER2- (4/22 (18.2%) or TNBC (0/5), and was associated with shorter median PFS in HER2+ disease (mutant vs. wild type: 4 (range 2-9) vs. 8 (range 2-22) months, p=0.006). The frequency of ERBB mutation was similar in HER2- 7/27(25.9%) (p=0.707) or HER2+ 7/27(25.9%) disease (p=0.066); there was no significant impact on PFS in any subset. Multivariate analysis for HER2+ disease including age, ER, Ki67, TP53, PIK3CA, PIK3CA 3140 A&gt;G and ERBB), demonstrated that the PIK3CA 3140 A&gt;G mutation was the only factor associated with shorter PFS (p=0.025); further analysis by receiver operating characteristic (ROC) curve showed that the PIK3CA 3140 A&gt;G mutation and the mutation in PIK3CA 3140 A&gt;G and ERBB combination pathway had a large area under the curve (AUC), with AUC of 0.789, and 0.734 respectively.

Conclusions: Using NGS in ctDNA, we found that the PIK3CA 3140A&gt;G mutation was more frequent in HER2+ disease, and was the only mutation associated with shorter PFS on multivariate analysis. The presence of a TP53 mutation was associated with worse OS. Evaluation of ctDNA is feasible in a general breast cancer population and has prognostic impact; further correlation of these findings with tumor samples is ongoing.

Citation Format: Li H, Wang J, Rugo HS, Zhang Y, Yang L, Liu X, Shao B, Xu Y, Yang L, Zhang R, Ran R, Chang L. Biomarker analysis by next generation circulating tumor DNA (ctDNA) sequencing in patients with advanced breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-02-06.

Cardiolipin synthase A colocalizes with cardiolipin and osmosensing transporter ProP at the poles of Escherichia coli cells

Osmosensing by transporter ProP is modulated by its cardiolipin (CL)-dependent concentration at the poles of Escherichia coli cells. Other contributors to this phenomenon were sought with the BACterial Two-Hybrid System (BACTH). The BACTH-tagged variants T18-ProP and T25-ProP retained ProP function and localization. Their interaction confirmed the ProP homo-dimerization previously established by protein crosslinking. YdhP, YjbJ and ClsA were prominent among the putative ProP interactors identified by the BACTH system. The functions of YdhP and YjbJ are unknown, although YjbJ is an abundant, osmotically induced, soluble protein. ClsA (CL Synthase A) had been shown to determine ProP localization by mediating CL synthesis. Unlike a deletion of clsA, deletion of ydhP or yjbJ had no effect on ProP localization or function. All three proteins were concentrated at the cell poles, but only ClsA localization was CL-dependent. ClsA was shown to be N-terminally processed and membrane-anchored, with dual, cytoplasmic, catalytic domains. Active site amino acid replacements (H224A plus H404A) inactivated ClsA and compromised ProP localization. YdhP and YjbJ may be ClsA effectors, and interactions of YdhP, YjbJ and ClsA with ProP may reflect their colocalization at the cell poles. Targeted CL synthesis may contribute to the polar localization of CL, ClsA and ProP.

Colonic immune cells in irritable bowel syndrome: A systematic review and meta-analysis

BACKGROUND & AIMS

Increases in mucosal immune cells have frequently been observed in irritable bowel syndrome (IBS) patients. However, this finding is not completely consistent between studies, possibly due to a combination of methodological variability, population differences and small sample sizes. We performed a meta-analysis of case-control studies that compared immune cell counts in colonic biopsies of IBS patients and controls.

METHODS

PubMed and Embase were searched in February 2017. Results were pooled using standardized mean difference (SMD) and were considered significant when zero was not within the 95% confidence interval (CI). Heterogeneity was assessed based on I² statistics where I²  ≤ 50% and I²  > 50% indicated fixed and random effect models, respectively.

KEY RESULTS

Twenty-two studies on 706 IBS patients and 401 controls were included. Mast cells were increased in the rectosigmoid (SMD: 0.38 [95% CI: 0.06-0.71]; P = .02) and descending colon (SMD: 1.69 [95% CI: 0.65-2.73]; P = .001) of IBS patients. Increased mast cells were observed in both constipation (IBS-C) and diarrhea predominant IBS (IBS-D). CD3⁺ T cells were increased in the rectosigmoid (SMD: 0.53 [95% CI: 0.21-0.85]; P = .001) and the descending colon of the IBS patients (SMD: 0.79, 95% CI [0.28-1.30]; P = .002). This was possibly in relation to higher CD4⁺ T cells in IBS (SMD: 0.33 [95% CI: 0.01-0.65]; P = .04) as there were no differences in CD8⁺ T cells.

CONCLUSIONS & INFERENCES

Mast cells and CD3⁺ T cells are increased in colonic biopsies of patients with IBS vs non-inflamed controls. These changes are segmental and sometimes IBS-subtype dependent. The diagnostic value of the quantification of colonic mucosal cells in IBS requires further investigation.

Decline of insulin therapy and delays in insulin initiation in people with uncontrolled diabetes mellitus

AIMS

To design and validate a natural language processing algorithm to identify insulin therapy decline from the text of physician notes, and to determine the prevalence of insulin therapy decline and its impact on insulin initiation.

METHODS

We designed the algorithm using the publicly available natural language processing platform Canary. We evaluated the accuracy of the algorithm on 1501 randomly selected primary care physicians' notes from the electronic medical record system of a large academic medical centre. Using the validated language model, we then studied the prevalence of insulin therapy decline between 2000 and 2014.

RESULTS

The algorithm identified documentation of insulin therapy decline with a sensitivity of 100% (95% CI 82.4-100), a positive predictive value of 95% (95% CI 74.4-99.9), and a specificity of 99.9% (95% CI 99.6-100.0). We identified 3295 insulin-naïve adults with Type 2 diabetes who were recommended insulin therapy; 984 of them (29.9%) initially declined insulin. People with HbA_1c ≥ 75 mmol/mol (9.0%) were more likely [766/2239 (34.2%)] to have declined insulin than people with HbA_1c 53-63 mmol/mol (7.0-7.9%) and 64-74 mmol/mol (8.0-8.9%; P < 0.0001). Among the people who initially declined but ultimately started insulin [374/984 (38.0%)], mean time to insulin initiation was 790 days.

CONCLUSIONS

Insulin therapy decline is common, potentially leading to progression of hyperglycaemia and a delay in achievement of glycaemic control. Further investigation is needed to determine the reasons, risk factors and long-term outcomes of this important clinical phenomenon.

[A case report: Ramsay Hunt syndrome with throat as starting place merger ipsilateral cranial nerver involvement]

The clinical data of a case of Ramsay Hunt syndrome concurrent with ipsilateral Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, Ⅺ cranial nerves paralysis with throat as starting place was retrospectively analyzed, and the relevant literatures were also reviewed. The case is rare, so the relevant clinical reports are less. It is important to take the objective data as well as subjective symptoms of the patients into consideration to make a definite diagnosis, so that we can treat it as soon as possible to achieve better curative effect.

Observation of whispering gallery modes through electron beam-induced deposition

Surprisingly intense spectra of whispering gallery modes were observed in polymer microbeads after illumination with electrons in a scanning electron microscope and subsequent laser illumination and spectral analysis. It will be proposed that whispering gallery mode resonances became visible after local deposition of hydrocarbon material through electron beam-induced deposition. The illumination of deposited material with a near infrared laser generates a broad light spectrum, acting as a local "white light" source that couples, for favorable wavelengths, with the WGM sustained by the sphere. This facilitates a spectroscopic analysis of the WGM and provides the Q-factor and free spectral range for all investigated particles. The analysis by an integrated SEM and Raman micro-spectrometer offers a direct approach to the analysis of WGM resonators as they are, for instance, used in sensing.

Abstract P1-10-02: A signature predictive of early vs. late recurrence after radiation treatment (RT) for breast cancer that may inform the biology of early, aggressive recurrences

Purpose: Unmet clinical needs in breast cancer (BC) management include the identification of patients (pts) at high risk to fail locally despite standard local therapy including RT and understanding the biology of these recurrences. We previously reported1 a RT response signature and here extend those studies to identify a signature predictive of timing of recurrence after completion of RT (before or after 3 years).

Methods: Two independent patient cohorts (treated with BCS) from non-randomized clinical trials were used for training and validation. The training cohort included 119 pts with in-breast tumor recurrence and the validation cohort had 25 pts with recurrences. Initial feature selection used Spearman's rank correlation correlating gene expression (14,806 genes) to recurrence time. Genes with sig. correlation (FDR &lt;0.1) and large expression range (fold change &gt;2) were used to train an elastic net penalized Poisson regression model. This model was locked and then applied to the validation dataset. Cox regression was used for both univariate and multivariable analyses (UVA and MVA). To identify biological-related concepts, Spearman's corr. coefficients of recurrence time to gene expression within the training cohort were used to generate a pre-ranked list upon which GSEA pathway analysis was performed.

Results: Spearman's correlation identified 485 genes whose expression was significantly associated with recurrence time (early vs. late). Feature reduction further refined the gene list to 41 genes, which were retained within the signature and locked for further validation. In the training dataset the Spearman's correlation of the continuous score to recurrence time was 0.852 with a P-value of 1.3x10-34 and an AUC of 0.92. Application of this early vs late signature to an independent BC validation set accurately identifies pts with early vs. late recurrences (Spearman's corr.=0.537, p-value&lt;0.007, AUC=0.74, sensitivity=0.71, specificity=0.73, PPV=0.77, NPV=0.67). In UVA and MVA the early vs. late recurrence signature remained the most significant factor associated with recurrence time. Although independent of intrinsic subtype, GSEA analysis of the 41 genes retained within the signature identifies proliferation and EGFR concepts associated with early recurrences and luminal and ER-signaling pathways associated with late recurrences. Knockdown of genes associated with the early and late recurrences is currently underway to assess phenotypic changes (proliferation and clonogenic survival as a measure of early and durable RT response) associated with the early and late recurrence-associated genes.

Conclusion: In this study we derive a BC-specific RT signature predictive of early vs. late recurrence with biologic relevance and validate this signature for prediction of timing of recurrence in an independent clinical dataset. By identifying pts with tumors likely to recur sooner vs. later this signature has the potential to allow for a furthered understanding of the biology underlying early and late recurrences and has a potential to personalize RT, particularly in patients for whom treatment intensification is needed.

1. Clin Cancer Res. 2015 Aug 15;21(16):3667-77.

Citation Format: Speers C, Chang L, Santola A, Liu M, Zhao SG, Chandler B, Olsen E, Bartelink H, Feng FY, Pierce LJ. A signature predictive of early vs. late recurrence after radiation treatment (RT) for breast cancer that may inform the biology of early, aggressive recurrences [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-10-02.

miR-26a-5p suppresses tumor metastasis by regulating EMT and is associated with prognosis in HCC

OBJECTIVE

To determine the role of miR-26a-5p in tumor invasion and metastasis in hepatocellular carcinoma (HCC).

METHODS

We evaluated miR-26a-5p expression in HCC tissues by quantitative PCR and then analyzed its clinical significance using a Cox regression model. Transwell and nude mouse models were used to examine tumor metastasis in vitro and in vivo, respectively. The relationship between miR-26a-5p and epithelial-mesenchymal transition was also investigated by q-PCR and western blot.

RESULTS

Strong downregulation of miR-26a-5p was observed in tumor tissues compared to paired adjacent normal tissues. Moreover, patients with low miR-26a-5p expression had a significantly poorer prognosis than those with high expression. The multivariate analysis indicated that miR-26a-5p expression was an independent prognostic indicator. The experimental transwell model and athymic mouse model revealed that miR-26a-5p depressed tumor metastasis in vitro and in vivo, respectively. In addition, the decreased miR-26a-5p level observed in HCC was associated with reduced E-cadherin expression and upregulation of vimentin, which affects the molecular mechanism of EMT.

CONCLUSION

Downregulation of miR-26a-5p promotes tumor metastasis by targeting EMT and influences the prognosis of HCC patients. Therefore, miR-26a-5p has potential as a new biomarker and therapeutic target.

[Effects of oral interventions on carotid artery, serum C-reactive protein and interleukin 6 in chronic periodontitis rats with atherosclerosis]

Objective: To explore the effect of variousoral interventions on the development of atherosclerosis in SD rats with chronic periodontitis and atherosclerosis. Methods: Forty-four male SD rats were randomly divided into three groups, Group A(healthycontrol), Group B(atherosclerosis, As) and Group C(chronic periodontitis with atherosclerosis, CP+As). Rats in Group C were further divided randomly into Subgroup C1(natural process, n=7), Subgroup C2(mechanical therapy, n=7), Subgroup C3(systemic antibiotic treatment, n=7) and Subgroup C4(tooth extraction, n=7). Rats in each subgroup of Group C received one of the appropriate oral interventions. The pathological lesions of carotid artery plaque were stained with hematoxylin and eosin(HE) and observed under a light microscope. The serum levels of C-reactive protein(CRP) and interleukin-6(IL-6) were detected by enzyme-linked immunosorbent assay (ELISA) in five different time points. Results: Pathological results showed that increased foam cells and inflammatory cells were found in Group B. Irregular vessel wall, inflammatory cell, the foam cells, disordered elastic fibers were observed in Group C. While fewer in flammatory cells were found in Subgroup C2 than that in other subgroups. The changing trends of the serum levels of CRP and IL-6 were consistant with time went by. The levels of serum CRP, IL-6 in Groups B and C were significantly higher than that in Group A at all time points(P<0.01). The levels of serum CRP, IL-6 in Subgroup C1 became higher gradually(P<0.05) with time being. The serum levels after oral interventions changed significantly compared with the baseline levels(P<0.05). One week after the second round of intervention, the serum levels of CRP(C2: [9.43 ± 1.28] μg/L, C3: [12.38±0.81] μg/L, C4: [15.76±1.03] μg/L) and IL-6 (C2: [94.71±16.09] μg/L, C3: [112.89± 40.16] μg/L, C4: [175.11 ± 50.79] μg/L) in intervention subgroups reached the peaksand were significantly higher than that of Group B(CRP: [6.96±1.30] μg/L, IL-6: [43.36±7.46] μg/L) and Subgroup C1(CRP: [8.41± 0.46] μg/L, IL-6: [73.59±27.89] μg/L)(P<0.05). The changes of serum levels then declined with time beingin each group/subgroupand level in Subgroup C2 was the lowest(P<0.01). Conclusions: In chronic periodontitis of rats with atherosclerosis, permanent periodontitis mightsignificantly raise the risk of the development of atherosclerosis. Oral interventions increased the risk of atherosclerosis in a short period of time because of increased levels of serum inflammatory factors, but effective improvement could be observed on the As lesions after oral interventions in along term, especially after the periodontal mechanical therapy.

Effects of baseline abdominal pain and bloating on response to lubiprostone in patients with irritable bowel syndrome with constipation

BACKGROUND

Lubiprostone (8 μg b.d.) received US Food and Drug Administration (FDA) approval in 2008 for the treatment of constipation-predominant irritable bowel syndrome (IBS-C) in women aged ≥18 years. In 2012, the FDA issued new guidance for IBS-C clinical trials, recommending a composite endpoint incorporating both abdominal pain and stool frequency.

AIM

In a post hoc analysis, similar criteria were applied to data from two pivotal, phase 3, double-blind, randomised trials of lubiprostone in patients with IBS-C.

METHODS

Included patients had a baseline spontaneous bowel movement (SBM) frequency <3/week and abdominal pain or bloating ratings ≥1.36 on a 5-point scale [0 (absent) to 4 (very severe)]. Responders (composite endpoint) had a mean pain reduction ≥30% compared with baseline, and an increase from baseline of ≥1 SBM/week for ≥6 of the 12 treatment weeks. Lubiprostone effects on abdominal pain alone were also evaluated, as were bloating alone and in a composite endpoint with stool frequency.

RESULTS

In pooled data, 325 patients received lubiprostone and 180 received placebo. Rates of response were higher with lubiprostone vs. placebo for the composite endpoint of improved pain and stool frequency (26.3% vs. 15.3%, respectively; P = 0.008) and the composite endpoint of improved bloating and stool frequency (23.8% vs. 12.6%, respectively; P = 0.012). Response rates were also higher with lubiprostone vs. placebo for abdominal pain alone (P = 0.005) and bloating alone (P = 0.012).

CONCLUSION

Lubiprostone was significantly more effective than placebo in improving abdominal pain or bloating, and also in composite endpoints that included stool frequency.

Cardiac damage and dysfunction in diabetic cardiomyopathy are ameliorated by Grx1

Glutaredoxin 1 (Grx1) has been found to be an important endogenous antioxidant enzyme closely related to the pathogenesis of diabetes and cardiovascular diseases caused by oxidative stress. In this study, the functional changes of the Grx1 redox system in blood of hyperglycemic patients were examined. Furthermore, using a rat model of streptozotocin (STZ)- and high-fat-diet-induced type 2 diabetes, we explored the correlation between functional changes of the Grx1 redox system in the left ventricular tissue and blood of the diabetic rats. Moreover, we studied the protective effect of Grx1 against cardiac toxicity caused by the high-glucose-induced expression of cardiac matrix metalloproteinases (MMPs) in primary cultured cardiac fibroblasts. Finally, we investigated the protective effects and signaling regulatory mechanism of Grx1 against diabetic cardiomyopathy (DCM) in terms of oxidative stress and NF-kB-mediated fibrosis-associated signaling pathways. In the serum of hyperglycemic patients, Grx1 levels were elevated, total/protein thiol or sulfhydryl (Total-SH/P-SH) levels were decreased, glutathione was downregulated, and oxidized glutathione was upregulated. In addition, in the left ventricular myocardium and blood of the diabetic rats, Grx1 levels were significantly increased and glutathione reductase and P-SH levels were decreased. Moreover, endogenous Grx1 was highly expressed in cardiac fibroblasts during high-glucose treatment, and exogenous Grx1 can prevent DCM by controlling oxidative damage and MMP expression. These findings are suggestive of changes in the Grx1 redox system, and Grx1-regulated protein oxidative modifications may serve as molecular markers for diabetes caused by high-glucose-induced oxidative stress.

Adverse childhood experiences are associated with irritable bowel syndrome and gastrointestinal symptom severity

BACKGROUND

Early adverse life events (EALs) are associated with irritable bowel syndrome (IBS). Exposure to EALs as assessed by the Adverse Childhood Experiences (ACE) questionnaire is associated with greater disease prevalence, but ACE has not been studied in gastrointestinal disorders. Study aims were to: (i) Estimate the prevalence of EALs in the IBS patients using the ACE questionnaire; (ii) Determine correlations between ACE and Early Trauma Inventory Self Report-Short Form (ETI-SR) scores to confirm its validity in IBS; and (iii) Correlate ACE scores with IBS symptom severity.

METHODS

A total of 148 IBS (73% women, mean age = 31 years) and 154 HCs (59% women, mean age = 30 years) completed the ACE and ETI-SR between June 2010 and April 2015. These surveys measured EALs before age 18 in the domains of physical, sexual, and emotional abuse, and general trauma. IBS and abdominal pain severity was measured by a 20-point scale (0 = none, 20 = worst symptoms).

KEY RESULTS

The ACE score increased the odds of having IBS (odds ratio [OR] = 2.05, 95% confidence interval [CI]: 1.21-3.48, p = 0.008). Household mental illness (p < 0.001), emotional abuse (p = 0.004), and incarcerated household member (p = 0.019) were significant predictors of IBS. Adverse childhood experiences and ETI-SR scores were strongly correlated (r = 0.59, p < 0.001). ACE, but not ETI-SR, modestly correlated with IBS severity (r = 0.17, p = 0.036) and abdominal pain (r = 0.20, p = 0.015).

CONCLUSIONS & INFERENCES

The ACE questionnaire is a useful instrument to measure EALs in IBS based on its use in large studies, its ability to measure prevalence across different EAL domains, and its correlation with symptom severity.