Phase dependent encapsulation and release profile of ZIF-based biocomposites

Biocomposites composed of Zeolitic Imidazolate Frameworks (ZIFs) are generating significant interest due to their facile synthesis, and capacity to protect proteins from harsh environments. Here we systematically varied the composition (i.e. relative amounts of ligand (2-methylimidazole), metal precursor (Zn(OAc)2·2H2O), and protein) and post synthetic treatments (i.e. washes with water or water/ethanol) to prepare a series of protein@ZIF biocomposites. These data were used to construct two ternary phase diagrams that showed the synthesis conditions employed gave rise to five different phases including, for the first time, biocomposites based on ZIF-CO3-1. We examined the influence of the different phases on two properties relevant to drug delivery applications: encapsulation efficiency and release profile. The encapsulation efficiencies of bovine serum albumin and insulin were phase dependent and ranged from 75% to 100%. In addition, release profiles showed that 100% protein release varied between 40 and 300 minutes depending on the phase. This study provides a detailed compositional map for the targeted preparation of ZIF-based biocomposites of specific phases and a tool for the straightforward analysis of the crystalline phases of ZIF based materials (web application named "ZIF phase analysis"). These data will facilitate the progress of ZIF bio-composites in the fields of biomedicine and biotechnology.

Sensory Impairment and All-Cause Mortality Among the Oldest-Old: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

OBJECTIVES

To investigate the association between sensory impairment and all-cause mortality among the oldest-old (aged 80 and older) in China.

DESIGN

Prospective cohort study.

SETTING

Community-based setting in 22 provinces of China.

PARTICIPANTS

A total of 8788 older adults aged 80 and over at baseline with complete hearing and vision function data were included as the study population.

MEASUREMENTS

Sensory impairment was categorized as no sensory impairment, hearing impairment (HI) only, vision impairment (VI) only and dual sensory impairment (DSI) according to hearing and vision function. Deaths were identified through interviews by close family members. Cox proportion hazards regression models were used to examine the association of sensory impairment with mortality, adjusting for socio-demographic data, life style factors and health status.

RESULTS

The mean age was 92.3 ± 7.6 years old, and 60.1% of participants were female. Among 8788 participants, 9.8% were recognized as DSI, 9.7% were HI only and 10.4% with VI only. Comparing with participants with no sensory impairment, those with VI only (HR=1.10, 95% CI=1.01-1.20) and DSI (HR=1.21, 95% CI=1.09-1.35) were significantly associated with higher risk of all-cause mortality in the fully adjusted model.

CONCLUSION

Our results demonstrated that VI only and DSI were significantly associated with higher risk of mortality among Chinese older adults aged 80 and over. The finding advocated that it is necessary to identify and manage sensory impairments for the advanced ages to reduce mortality risks.

Ethnic Groups Differences in the Prevalence of Sarcopenia Using the AWGS Criteria

OBJECTIVES

To estimate the prevalence of sarcopenia in different ethnic groups and the association with cultural life styles in west China.

DESIGN

A cross-sectional study.

SETTINGS

The communities in Yunnan, Guizhou, Sichuan, and Xinjiang provinces.

PARTICIPANTS

4500 participants aged 50 years or older in west China were enrolled in this study. Sarcopenia was defined according to the diagnostic algorithm of the Asia Working Group for Sarcopenia (AWGS).

MEASUREMENTS

We measured gait speed, handgrip strength and muscle mass by using bioelectrical impedance analysis (BIA) for all eligible participants. Life-style information were collected by reviewers. Relationships between sarcopenia and ethnic groups were analyzed using univariate and multivariate analyses.

RESULTS

We found 869 (19.31%) adults aged 50 years old or older were sarcopenia. The mean age is 62.4±8.3 years. The main ethnic groups enrolled in this study is Han, Tibetan, Qiang, Yi and Hui. The crude prevalence of sarcopenia is 22.3% in Han, 18.2% in Tibetan, 11.8% in Qiang, 34.7% in Yi and 26.7% in Hui. Compared to Han, after adjusting sex and age, Qiang has a lower prevalence of sarcopenia (odds ratio [OR]: 0.44, 95% CI 0.35-0.55), Yi has a higher prevalence of sarcopenia (OR: 1.78, 95% CI 1.29-2.43). While adding adjusting other potential cofounders, sarcopenia is still less prevalent in Qiang (OR: 0.44, 95% CI 0.34-0.57).

CONCLUSIONS

The crude prevalence of sarcopenia is 22.3% in Han, 18.2% in Tibetan, 11.8% in Qiang, 34.7% in Yi and 26.7% in Hui. Sarcopenia was less prevalent in Qiang compared with Han. Further studies to determine related factors of sarcopenia among different ethnic groups are recommended.

Association Between Number of Teeth, Denture Use and Frailty: Findings from the West China Health and Aging Trend Study

OBJECTIVE

Frailty and poor oral health are both common age-related conditions. However, the association between oral health and frailty has not been explored thoroughly among older Chinese adults. We aimed to investigate the associations between number of teeth, denture use, and frailty among older adults in western China.

DESIGN

Cross-sectional study.

SETTING

Community-based.

PARTICIPANTS

Participants were 4037 community-dwelling individuals aged 60 and older from the West China Health and Aging Trend (WCHAT) study.

MEASUREMENTS

Frailty was assessed using the physical frailty phenotype (PFP) and categorized as non-frail, prefrail and frail. In addition, number of teeth and denture use were examined by calibrated dentists. Multinomial logistic regression models were performed to examine the association between number of teeth, denture use, and frailty.

RESULTS

The overall prevalence of frailty was 6.7% among 4037 participants aged 60 and older in western China. Participants with no more than 20 teeth were associated with higher odds of being prefrail or frail whether wearing dentures or not. Denture using could not help lower the odds of being prefrail or frail for older adults with fewer teeth.

CONCLUSIONS

This study suggested that frailty was associated with having fewer teeth (≤20 teeth) among older Chinese adults. Future research involving targeted interventions addressing number of teeth may help provide information to establish effective strategies for frailty prevention in older adults.

Sarcopenia, Obesity and Sarcopenia Obesity in Comparison: Prevalence, Metabolic Profile, and Key Differences: Results from WCHAT Study

OBJECTIVE

To identify the prevalence, lifestyle factors, chronic disease status, and assessing the metabolic profile, comparing key differences in a cohort of subjects with non-sarcopenia/non-obesity (H), sarcopenia/non-obesity (S), non-sarcopenia/obesity (O) and sarcopenia obesity (SO) in a multi-ethnic population in west China.

DESIGN

A cross-sectional study.

SETTING

The communities in Yunnan, Guizhou, Sichuan, and Xinjiang provinces.

PARTICIPANTS

We included 4,500 participants aged 50 years or older who did bioelectrical impedance in our analysis from West China Health and Aging Trend (WCHAT) study.

MEASUREMENTS

We measured gait speed, handgrip strength and muscle mass by using bioelectrical impedance analysis (BIA) for all participants. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia (AWGS). Obesity was defined as the highest sex-specific quintile of the percentage body fat. Different variables like anthropometry measures, life styles, chronic disease and blood test were collected. Analysis of variance and a multinomial logistic regression analysis adjusting for covariates were used to assess the differences of metabolic profiles among different groups.

RESULTS

Of 4500 participants aged 50 years old or older, the proportions of H, O, S, SO were 63.0%, 17.7%, 16.7% and 2.6%, respectively. And the prevalence of S subjects in men was 18.3% and 15.7% in women, while the prevalence of SO was 3.7% in men and 2.0% in women. Data showed that the prevalence of S and SO has an aging increase pattern which was opposite with O. Both S and SO tends to be older, lower educational level, without spouse, smoking, comorbidity of chronic disease, poor nutrition status, depression and cognitive decline compared to H and S seems to be worse than SO. Compared to H, S cohort showed a decrease in Vitamin D, triglyceride, albumin, fasting glucose, insulin, creatinine, ALT, nutrition scores and increase in HDL. SO cohort were observed for an increase in cholesterol, LDL, total protein and decrease in vitamin D. While O cohort showed an increase in triglyceride, cholesterol, LDL, total protein, glucose, insulin, WBC, uric acid, ALT and nutrition scores, but a decrease in HDL and vitamin D level.

CONCLUSIONS

Among individuals aged 50 years old or older in West China. S, O and SO participants demonstrate distinct differences in the life-styles, chronic disease profile, and metabolic profiles. The prevalence of S and SO has an aging increase pattern contrary to O. Both S and SO tend to be older, lower educational level, without spouse, smoking, comorbidity of chronic disease, poor nutrition status, depression and cognitive decline compared to H and S looks like to be worse than SO. Besides, the S subjects seem to have more metabolic index changes than SO compared to H. While O subjects have some contrary metabolic index to S subjects.

Prevalence and Its Associated Factors of Physical Frailty and Cognitive Impairment: Findings from the West China Health and Aging Trend Study (WCHAT)

OBJECTIVES

Previous literature has reported that physical frailty (PF) closely associated with cognitive impairment (CI). In this study, we aim to describe and evaluate the prevalence and associated factors with different patterns of PF and cognitive impairment.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

Community-dwelling older adults aged ≥60 from the West China Health and Aging Trend (WCHAT) study were included in this study.

MEASUREMENTS

Participants were assessed the PF and cognitive impairment. PF was assessed using the physical phenotype as defined by Fried's criteria. Cognitive impairment was identified using the Short Portable Mental Status Questionnaire (SPMSQ). According different patterns of PF and cognitive impairment, participants were divided into 4 groups: not-PF and cognitive intact ( "neither" group), not-PF and cognitive impairment ("CI only" group), PF and cognitive intact ("PF only" group), and PF and cognitive impairment ("both" group). Multinomial logistic regression was used to explore the association between medical conditions and different patterns of PF and cognitive impairment after adjusting the demographic characteristics.

RESULTS

Among 4,103 participants (age 67.8 + 5.9 years, female 58.3%), 78.8%, 3.9%, 14.5% and 2.9% were "neither", "PF only", "CI only", and "both", respectively. The prevalence of "PF only", "CI only" and "both" were associated with age, lower education level and single status. In addition, there was substantial ethnicity heterogeneity in the prevalence of different patterns of PF and cognitive impairment. Comparing with "neither", PF and/or cognitive impairment had higher association with depression, ADLs impairment, and malnutrition. Of note, obesity was only significantly associated with "PF only", but not associated with "CI only" or "both".

CONCLUSIONS

We found the substantial demographic and medical conditions disparities in different patterns of PF and cognitive impairment. Further research should focus on the efficient and practical screen to predict the risk of "PF only", "CI only" and "both".

SMPDL3b modulates insulin receptor signaling in diabetic kidney disease

Sphingomyelin phosphodiesterase acid-like 3b (SMPDL3b) is a lipid raft enzyme that regulates plasma membrane (PM) fluidity. Here we report that SMPDL3b excess, as observed in podocytes in diabetic kidney disease (DKD), impairs insulin receptor isoform B-dependent pro-survival insulin signaling by interfering with insulin receptor isoforms binding to caveolin-1 in the PM. SMPDL3b excess affects the production of active sphingolipids resulting in decreased ceramide-1-phosphate (C1P) content as observed in human podocytes in vitro and in kidney cortexes of diabetic db/db mice in vivo. Podocyte-specific Smpdl3b deficiency in db/db mice is sufficient to restore kidney cortex C1P content and to protect from DKD. Exogenous administration of C1P restores IR signaling in vitro and prevents established DKD progression in vivo. Taken together, we identify SMPDL3b as a modulator of insulin signaling and demonstrate that supplementation with exogenous C1P may represent a lipid therapeutic strategy to treat diabetic complications such as DKD.

[Treatment experience of cardiac rupture in patients with acute myocardial infarction]

Objective: To analyze the treatment results of cardiac rupture in patients with acute myocardial infarction (AMI) . Method: Clinical data of 6 with cardiac rupture after AMI, who were hospitalized in our hospital from June 2015 to June 2017, were retrospectively analyzed,and the clinical manifestations, methods of treatment and outcomes were investigated. Results: Cardiac function classification was Killip class Ⅱin all patients. There were 3 massive anterior wall myocardial infarction, 2 anterior wall myocardial infarction,and 1 inferior myocardial infarction. There were 4 patients with ventricular septal defect, 1 patient with rupture of papillary muscle,and 1 patient with left ventricular free wall rupture.All patients received continuous infusion of vasoactive medicines and treated with intra-aortic balloon pump(IABP), 2 patients (1 patient accepted operative treatment,and 1 patient received conservative treatment) were treated with extracorporeal membrane oxygenation (ECMO), mechanical ventilation,and continuous renal replacement therapy(CRRT).Three patients received surgical repair,1 case was supported by IABP, 1 case supported by ECMO,CRRT,and IABP,and 1 case did not use IABP or ECMO post operation. All 3 surgically treated patients recovered successfully and were discharged from hospital.Meanwhile, in the other 3 patients treated conservatively, 2 patients died in the hospital and 1 patient was discharged according to own will. Conclusion: On the basis of vasoactive medicines and IABP, surgery repair is a feasible option for cardiac rupture patients secondary to AMI,and ECMO may improve the perioperative state in these patients.

[Clinical features and diagnosis of childhood leukoencephalopathy with cerebral calcifications and cysts in four cases]

Objective: To investigate the clinical features and diagnostic bases of childhood leukoencephalopathy with cerebral calcifications and cysts (LCC). Methods: The clinical data involving manifestations and laboratory examinations of 4 children with LCC admitted to Beijing Children's Hospital Affiliated to Capital Medical University from 2012 to 2017 were retrospectively summarized. Each patient had a follow-up visit ranging from 4 months to 5 years and 9 months after initial examination. Results: Patients consisted of 2 males and 2 females, whose age of onset was respectively 2 years and 9 months, 6 years and 2 months, 7 years and 10 months, and 5 years and 1 month. The main clinical symptoms of these cases included headache, dizziness, partial seizure and claudication, and two of these cases had insidious onset. Cerebral calcifications and cysts with leukoencephalopathy were detected by neuroimaging in all patients. In addition, multifocal microhemorrhages and calcifications were observed by magnetic susceptibility-weighted imaging (SWI) series in 3 patients. Brain biopsy performed on 1 case disclosed a neuronal reduction in the cerebral cortex, loosening of focal white matter, multifocal lymphocyte infiltration, fresh hemorrhages, and gliosis, as well as angiomatous changes of blood vessels with hyalinized thicken-wall, stenotic or occlusive lumina and calcification deposits. The compound heterozygous mutations of n.*10G>A and n.82A>G in SNORD118 were identified in 1 case by target-capture next-generation sequencing. Sanger sequencing verified that the variant n.*10G>A was a novel mutation and it was of paternal-origin, while the variant n.82A>G was of maternal-origin, which had already been reported to be pathogenic to LCC. Follow-up study had shown continued partial seizure in 1 case and remissive claudication in another, while the remaining 2 cases had a relatively favorable outcome without obvious neurological symptoms at present time. Conclusions: The clinical manifestations of LCC are nonspecific, and the onset of the disease tends to be insidious. The triad neuroimaging findings of cerebral calcifications, cysts and leukoencephalopathy are essential to the diagnosis of the disease, and the signals of microhemorrhages revealed by SWI series provide another eloquent reference for the diagnosis. As biopsy is invasive and usually unavailable in the early stage, gene assessment, instead of pathological data, should be the gold standard in the diagnosis of LCC.

Absolute CBV for the differentiation of recurrence and radionecrosis of brain metastases after gamma knife radiotherapy: a comparison with relative CBV

AIM

To investigate the efficiency of absolute cerebral blood volume (CBV) in the differentiation of tumour recurrence (TR) and radionecrosis (RN) in brain metastases (BM) and to evaluate the performance of absolute CBV compared to relative CBV (rCBV).

MATERIALS AND METHODS

Between March 2015 and June 2017, 46 patients with BM underwent quantitative dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) because new enhancement had been demonstrated in irradiated lesions after gamma knife radiotherapy. The patients were assigned to either the TR group or RN group on the basis of MR perfusion follow-up or histopathological outcome. Absolute CBV of lesions (CBVlesion) and contralateral normal appearing white matter (CBVNAWM) in both groups were obtained. Mean rCBV were calculated as CBVlesion/CBVNAWM, which was equal to rCBV using traditional DSC-PWI.

RESULTS

CBVlesion of TR alone was significantly higher than the other parameters in both groups (p<0.001, separately). CBVlesion had smaller interobserver difference than CBVNAWM and rCBV (p<0.001, separately). Although CBVlesion significantly correlated with rCBV (r=0.914, p<0.001) and both had a similar specificity (96%) in differential diagnosis, CBVlesion had a higher sensitivity (96.9% versus 90.9%) to predict the treatment outcome. The best cut-off value of CBVlesion was 21.8 ml/100 g.

CONCLUSION

Quantitative DSC-PWI is a powerful method for the assessment of radiosurgically treated brain metastases. Absolute CBV has higher diagnostic efficiency than rCBV, which enables an absolute quantification of the regional CBV and prediction of tumour response. These advantages promote the intra- and inter-patient quantitative image comparison across different institutions.

Association of sarcopenia and fractures in community-dwelling older adults: a systematic review and meta-analysis of cohort studies

To our knowledge, no comprehensive meta-analysis has examined the association between sarcopenia and the risk of fractures. This systematic review and meta-analysis of prospective cohort studies aims to summarize whether sarcopenia is a risk factor for fractures among community-dwelling older adults. We searched four electronic literature databases (Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PubMed) for relevant publications from inception to December 2017, using relevant keywords. We conducted a pooled analysis of the association between sarcopenia and the risk of fractures by employing a random-effects model. Subgroup analyses were conducted based on definitions of sarcopenia and gender. In total, nine studies were included in our systematic review and meta-analysis. The prevalence of sarcopenia ranged from 4.3 to 33.1%. The pooled RR of fractures for the sarcopenic versus the nonsarcopenic was 1.34 (95% CI = 1.13-1.58, P = 0.001, I² = 5.5%, P-heterogeneity = 0.391). Subgroup analyses showed that associations between sarcopenia and fractures were significant when using the AWGS definition (combined effect size = 1.78, 95% CI = 1.25-2.54, P = 0.001), and studies in males (combined effect size = 1.39, 95% CI = 1.13-1.71, P = 0.002). In conclusion, we found that compared to nonsarcopenic, the association between sarcopenia and fractures among community-dwelling older people was significant when using the AWGS definition, and only for males. Future studies are needed to establish a possible association between sarcopenia definitions and risk of fractures of different sites.

Postcontrast T1 Mapping for Differential Diagnosis of Recurrence and Radionecrosis after Gamma Knife Radiosurgery for Brain Metastasis

BACKGROUND AND PURPOSE

The differential diagnosis of radionecrosis and tumor recurrence in brain metastases is challenging. We investigated the diagnostic efficiency of postcontrast T1 mapping in solving this problem.

MATERIALS AND METHODS

Between March 2016 and June 2017, fifty-six patients with brain metastases who underwent contrast-enhanced cerebral T1 mapping were recruited for this prospective study. The findings revealed new enhancement after gamma knife radiosurgery. The subjects were assigned to radionecrosis and recurrence groups based on follow-up (median, 11.5 months) and histopathologic results. T1 values of lesions 5 (T1_5min) and 60 (T1_60min) minutes after administration of contrast agent and their difference (T1_differ) were compared between the 2 groups with the 2-tailed Mann-Whitney U test. Receiver operating characteristic curves were used to determine the optimum cutoff values for differential diagnosis.

RESULTS

There were significant differences between the 2 groups in T1_5min, T1_60min, and T1_differ values (P = .012, P = .004, and P < .001, respectively). Relative to T1_5min and T1_60min, T1_differ exhibited greater sensitivity and specificity (P < .001, respectively) in identifying radionecrosis. The optimum T1_differ value for differential diagnosis was 71.1 ms (area under the curve = 0.97; 95% CI, 0.93-1.00), with sensitivity and specificity of 81.5% and 96.5%, respectively.

CONCLUSIONS

Postcontrast T1 mapping is optimal for the differential diagnosis of radionecrosis and tumor recurrence. Among T1 parameters, T1_differ is the most powerful parameter for differential diagnosis. Advantages in terms of quantitative analysis and high resolution portend the wide use of postcontrast T1 mapping in the future.

Topological nature of the node-arc semimetal PtSn4 probed by de Haas-van Alphen quantum oscillations

Dirac node arc semimetal state is a new topological quantum state which is proposed to exist in PtSn₄ (Wu et al 2016 Dirac node arcs in PtSn₄ Nat. Phys. 12 667-71). We present a systematic de Haas-van Alphen quantum oscillation study on this compound. Two intriguing oscillation branches, i.e. F ₁ and F ₂, are detected in the fast Fourier transformation spectra, both of which are characterized to possess tiny effective mass and ultrahigh quantum mobility. And the F ₂ branch exhibits an angle-dependent nontrivial Berry phase. The features are consistent with the existence of the node arc semimetal state and shed new light on its complicated Fermi surfaces and topological nature.

[Small vessel-childhood primary angiitis of the central nervous system: a case report and literature review]

Objective: To summarize the clinical and pathological features of small vessel-childhood primary angiitis of the central nervous system (SV-cPACNS), discuss the immune therapy and increase the attention to brain biopsy in SV-cPACNS. Methods: The clinical data, pathology of brain biopsy, treatment and outcome of an SV-cPACNS patient hospitalized in Beijing Children's Hospital in February 2016 were analyzed retrospectively. The cases reported at Pubmed, CNKI and Wanfang databases from 2007 to 2017 were searched, the clinical and pathological features, immunotherapy and prognosis of the disease were summarized according to the literature review. Results: A 70 months old girl had 6 times relapses during 5 months' disease course. Symptoms included convulsions, limb paralysis, blurred vision and speech difficulty. Multiple cortical lesions were found successively in brain MRI but CT angiography was negative. The pathology of brain biopsy revealed thickening of small vessel walls together with lymphocytic infiltration. After the treatment with rituximab, remission was achieved and remained stable without recurrence in 1 year follow up. A total of 44 pathologically confirmed cases reported in nearly 10 years were retrieved. Male to female ratio was 1∶3.5. The average onset age was 9.8 years. Clinical manifestations included seizures (37/45, 82%), headache (35/45, 78%), cognitive decline (28/45, 62%), speech regression(20/45, 44%), paralysis (15/45, 33%), and so on; 70% (19/27) patients experienced relapses. Erythrocyte sedimentation rate and C-reactive protein slightly elevated, antinuclear antibody and other autoimmune antibodies were mostly negative. Mild lymphocytosis in cerebrospinal fluid was found in 67%(29/43) patients. 53%(23/43) patients had elevated CSF protein level, several had elevated IgG and positive oligoclonal band. Bilateral multifocal lesions were revealed in 80% (36/45) brain MRIs, meanwhile all angiographies were unremarkable. The pathology showed small angiitis and immunohistochemistry positive for CD3 and CD20. Twenty-seven patients had detailed therapeutic information; 25 of them received immunosuppressive agents, including cyclophosphamide, mycophenolate mofetil and rituximab. One patient died, 26 patients achieved remission with 54% (22/44) had neurological sequelae. Conclusions: SV-cPACNS had varied clinical manifestations, there was no specificity in laboratory and imaging examination and angiography was often negative. The definite diagnosis relied on brain biopsy, which showed lymphocytic inflammation of small vessels. SV-cPACNS tended to relapse and induce neurologic deterioration. Treatment required long-term use of steroids and immunosuppressive agents. Rituximab could be an effective agent.

Role of vitamin D receptor gene polymorphisms in aplastic anemia: a case-control study from China

INTRODUCTION

Vitamin D receptor (VDR) gene and its polymorphisms are highlighted as candidate components for susceptibility to various autoimmune diseases. The aim of this study was to investigate the role of VDR polymorphisms (rs2228570, rs1544410, rs7975232, and rs731236) in aplastic anemia (AA).

METHODS

In this case-control study, the genotyping of VDR rs1544410 (c.1024 + 283G>A), rs7975232 (c.1025-49G>T), and rs731236 (c.1056T>C) polymorphisms was conducted using polymerase chain reaction (PCR)-ligase detection reaction, while the genotyping of rs2228570 (c.2T>C) was detected by PCR-restriction fragment length polymorphism.

RESULTS

The frequencies of GG genotype and G allele of rs1544410 were significantly higher in patients with AA than in controls. Further analysis indicated that rs1544410 and rs7975232 polymorphisms were correlated with the risk to nonsevere AA, while rs2228570 was relevant to severe AA. Moreover, TT carriers of rs2228570 were closely associated with a poor response to treatment and a higher risk of myelodysplastic syndrome/acute leukemia transformation, while CT carriers more easily evolved to overt paroxysmal nocturnal hemoglobinuria.

CONCLUSIONS

VDR polymorphisms may contribute to susceptibility to AA and influence the severity and prognosis of AA in a Chinese population.

Role of vitamin D receptor gene polymorphisms in aplastic anemia: a case-control study from China

INTRODUCTION

Vitamin D receptor (VDR) gene and its polymorphisms are highlighted as candidate components for susceptibility to various autoimmune diseases. The aim of this study was to investigate the role of VDR polymorphisms (rs2228570, rs1544410, rs7975232, and rs731236) in aplastic anemia (AA).

METHODS

In this case-control study, the genotyping of VDR rs1544410 (c.1024 + 283G>A), rs7975232 (c.1025-49G>T), and rs731236 (c.1056T>C) polymorphisms was conducted using polymerase chain reaction (PCR)-ligase detection reaction, while the genotyping of rs2228570 (c.2T>C) was detected by PCR-restriction fragment length polymorphism.

RESULTS

The frequencies of GG genotype and G allele of rs1544410 were significantly higher in patients with AA than in controls. Further analysis indicated that rs1544410 and rs7975232 polymorphisms were correlated with the risk to nonsevere AA, while rs2228570 was relevant to severe AA. Moreover, TT carriers of rs2228570 were closely associated with a poor response to treatment and a higher risk of myelodysplastic syndrome/acute leukemia transformation, while CT carriers more easily evolved to overt paroxysmal nocturnal hemoglobinuria.

CONCLUSIONS

VDR polymorphisms may contribute to susceptibility to AA and influence the severity and prognosis of AA in a Chinese population.