External Validation of a Nomogram and Risk Grouping System for Predicting Individual Prognosis of Patients With Medulloblastoma

Background: Medulloblastoma (MB) is one of the most malignant neuroepithelial tumors in the central nervous system. This study aimed to establish an effective prognostic nomogram and risk grouping system for predicting overall survival (OS) of patients with MB.

Materials and Methods: The nomogram was constructed based on data from the database of Surveillance, Epidemiology, and End Results (SEER). This database consisted of 2,824 patients with medulloblastoma and was used as the training cohort. The data of another additional 161 patients treated at the Sun Yat-sen University Cancer Center (SYSUCC) were used as the external validation cohort. Cox regression analysis was used to select independent prognostic factors. Concordance index (C-index) and calibration curve were used to predict the prognostic effect of the nomogram for overall survival.

Results: In the training cohort, Cox regression analyses showed that the prognostic factors included histopathology, surgery, radiotherapy, chemotherapy, tumor size, dissemination, and age at diagnosis. The internal and external validated C-indexes were 0.681 and 0.644, respectively. Calibration curves showed that the nomogram was able to predict 1-, 3-, and 5-year OS for patients with MB precisely. Using the training cohort, a risk grouping system was built, which could perfectly classify patients into four risk nomogroups with a 5-year survival rate of 83.9%, 76.5%, 64.5%, and 46.8%, respectively.

Conclusion: We built and validated a nomogram and risk grouping system that can provide individual prediction of OS and distinguish MB patients from different risk groups. This nomogram and risk grouping system could help clinicians making better treatment plan and prognostic assessment.

CTNI-76. PHASE 2 CLINICAL TRIAL OF VAL-083 IN NEWLY DIAGNOSED MGMT-UNMETHYLATED GBM

Approximately 60% of glioblastoma multiforme (GBM) patients possess an unmethylated methylguanine DNA-methyltransferase (MGMT) promoter region, which confers a limited response to standard-of-care treatment with temozolomide (TMZ), resulting in shorter median survival when compared to patients with methylated MGMT promoter. VAL-083 is a novel bi-functional DNA targeting agent that induces inter-strand cross-links at N7-guanine, leading to DNA double-strand breaks and ultimately cell death. VAL-083 circumvents MGMT-mediated TMZ resistance in vitro and in vivo. A Phase 2 study has been initiated for VAL-083 in newly diagnosed MGMT unmethylated GBM. The study has 2 stages: Stage 1 is a dose-escalation safety and tolerability phase to confirm the phase 2 dose of VAL-083 when administered concurrently with radiation therapy (RT). Patients received VAL-083 at 20, 30, or 40 mg/m2/day x 3 days every 21 days along with standard radiation treatment (RT) (2 Gy/day, 5 days/week). The dose escalation stage is complete, and 30 mg/m2/day of VAL-083 in combination with RT was generally safe and well-tolerated. Stage 2 comprises an expansion phase to enroll up to 20 additional patients at the 30 mg/m2/day of VAL-083 in combination with RT. As of June 2, 2020, all patients have been enrolled, with a total of 29 patients in the study, and 25 patients receiving 30 mg/m2/day VAL-083. Of the 29 patients enrolled, 27 have completed their prospectively planned MRI scans and had their initial assessment for tumor response. Two additional patients died prior to their post-cycle 3 MRI. Consistent with our prior experience, myelosuppression was the most common adverse event. Three patients have experienced dose-limiting toxicities - one (1/3; 33%) at the 40 mg/m2/day and two (2/25; 8%) at the 30 mg/m2/day dose. Further safety and efficacy updates will be presented at the meeting. Clinicaltrials.gov identifier: NCT03050736.

EPCO-34. CLINICAL AND GENETIC EVOLUTION OF EPENDYMOMA

Ependymomas are glial brain tumors accounting for approximately 2~3% of all primary tumors in central nervous system (CNS), and 12% of all pediatric intracranial tumors. To better understand the evolution process of ependymomas, we studied the clinical, pathological and genetic development of a rare girl case with repeatedly recurrent ependymoma. This girl was diagnosed as anaplastic ependymoma at age of 9 years old, and experienced 7 times tumor relapse and received 9 times surgeries but finally ceased at19 years old with multiregional recurrences. The pathological characteristics, radiographic images and therapeutic strategies of the patient were all retrieved. Molecular markers confirmed the diagnosis based on the updated WHO guideline for CNS tumors. Whole-genome sequencing (WGS) was performed to elucidate the landscape of mutation signatures and to identify potential driver mutations along the tumor progression. The seven tumor specimens showed a highly branched evolutionary pattern. There were six gene mutations found in 5 of the 7 specimens (PCDHA4, PCDHA8, SEC14L6, SETD2, RIOK2, and SLCO2A1) and three in 6 of 7 the samples (RYR1, SNX25, DSC2). Strikingly, there was one gene, ADGRL3, which was found to be consistently mutated in the entire disease progression process. Our findings therefore suggest that ADGRL3 might play roles in the disease progression of ependymoma patient.

Identification of a Twelve-Gene Signature and Establishment of a Prognostic Nomogram Predicting Overall Survival for Medulloblastoma

BACKGROUND

Medulloblastoma is the common pediatric malignant tumor with poor prognosis in cerebellum. However, MB is always with clinical heterogeneity. To provide patients with more clinically beneficial treatment strategies, there is a pressing need to develop a new prognostic prediction model as a supplement to the prediction outcomes of clinical judgment.

MATERIALS AND METHODS

Four datasets of mRNA expression and clinical data were downloaded from gene expression omnibus (GEO) database. Differentially expressed genes (DEGs) were identified and functionally enriched among GSE50161, GSE74195, GSE86574. Then we used STRING and Cytoscape to constructed and analyze protein-protein interaction network (PPI) and hub genes. Univariate cox regression analysis was performed to identify overall survival-related hub genes in an unique dataset from GSE85217 as train cohort. Lasso Cox regression model was used to construct the prognostic gene signature. Time-dependent receiver operating characteristic (ROC), Kaplan-Meier curve, univariate and multivariate Cox regression analysis were used to assess the prognostic capacity of the twelve-gene signature. A unique dataset from GSE85217 was downloaded to further validate the results. Finally, we established the nomogram by using the gene signature and validated it with ROC curve. Gene set enrichment analysis (GSEA) was carried out to further investigate its potential molecular mechanism. Besides, the twelve genes expression at the mRNA and protein levels was validated using external database such as Oncomine, cBioportal and HPA, respectively.

RESULTS

A twelve-gene signature comprising FOXM1, NEK2, CCT2, ACTL6A, EIF4A3, CCND2, ABL1, SYNCRIP, ITGB1, NRXN2, ENAH, and UMPS was established to predict overall survival of medulloblastoma. The ROC curve showed good performance in survival prediction in both the train cohort and the validation cohort. The twelve-gene signature could stratify patients into a high risk and low risk group which had significantly different survival. Univariate and multivariate Cox regression revealed that the twelve-gene signature was an independent prognostic factor in medulloblastoma. Nomogram, which included twelve-gene signatures, was established and showed some clinical benefit.

CONCLUSION

Our study identified a twelve-gene signature and established a prognostic nomogram that reliably predicts overall survival in medulloblastoma. The above results will help us to better analyze the pathogenesis and treatment of medulloblastoma in the future.

Microstructure Characteristics and Its Effect on the Fracture in the Triple Junction Region of Friction Stir Welded Mg Alloys Subjected to Tension

Because of the tensile strength decreasing of the friction stir welded wrought magnesium (Mg) alloy compared to the base material, the reasons for the failure of weld has been focused on. After the fracture in transverse tension, the crack went through the welded joint from the center of the weld to the transition zone between the thermal-mechanical affected zone and weld zone. In the present study, the microstructure characteristics and its effect on the facture in the triple junction region is investigated. Based on the metallography and the electron back-scattered diffraction (EBSD) technology, it was observed that a twin band extended from the triple junction region to the middle of weld. The profuse twinning in the twin band was considered to play an important role on the crack propagation from the stir zone edge to the crown zone.

Abstract CT273: Phase 2 trial of dianhydrogalactitol (VAL-083) in patients with newly diagnosed MGMT-unmethylated glioblastoma

Glioblastoma (GBM) is the most common and aggressive primary brain cancer. Current standard-of-care includes surgery followed by chemoirradiation and temozolomide (TMZ). An unmethylated promoter for O6-methylguanine DNA methyltransferase (MGMT) is a validated biomarker for TMZ-resistance and is strongly correlated with poor outcomes. The majority of glioblastoma multiforme (GBM) patients have an unmethylated MGMT promoter status, leading to limited response to TMZ and decreased survival. Dianhydrogalactitol (VAL-083) is a novel bi-functional DNA targeting agent that induces interstrand cross-links at N7-guanine, leading to DNA double-strand breaks and ultimately cell death. VAL-083 circumvents MGMT-mediated drug-resistance and has demonstrated cytotoxicity in MGMT-unmethylated GBM cell lines, cancer stem cells (CSCs) and in vivo models. Furthermore, VAL-083 acts as a radiosensitizer in GBM CSCs and non-CSCs. A Phase 2, open-label, biomarker-driven, study has been initiated to evaluate the tolerability and efficacy of VAL-083 in combination with radiation therapy (RT) in newly diagnosed MGMT-unmethylated GBM patients. A treatment regimen, consisting of a 6-week induction period of VAL-083 given IV at 20, 30, or 40 mg/m2/day x 3 days every 21 days and concurrent radiation (2 Gy daily, 5 days/week) followed by up to 24 weeks of maintenance therapy with single-agent VAL-083, is being evaluated. The study has 2 stages: Stage 1 is a dose-escalation and induction format to establish a recommended dose of VAL-083 when administered concurrently with RT based on safety and tolerability. The dose escalation stage has been completed and we identified a recommended dose of 30 mg/m2/day of VAL-083 in combination with RT as generally safe and well-tolerated. Stage 2 comprises an expansion stage to enroll up to 20 additional patients at 30 mg/m2/day IV infusion on days 1, 2, and 3 of 21-day cycles and is currently ongoing. Tumor response will be assessed by MRI, according to RANO criteria. Efficacy endpoints include progression-free survival (PFS) and overall survival (OS). Additional endpoints include safety evaluations and pharmacokinetic assessments of plasma and CSF samples. As of 21st January 2020, 19 subjects have initiated treatment in stage 2. The enrollment, safety data and primary results update will be provided at the meeting. Clinicaltrials.gov identifier: NCT03050736.

Citation Format: Zhong-ping Chen, Cheng-cheng Guo, Qun-ying Yang, Jia-Wei Lei, Shao-xiong Wu, Gregory Johnson, John Langlands, Claire Kwan, Sarath Kanekal, Richard Schwartz, Jeffrey A. Bacha, Anne Steino, Dennis M. Brown. Phase 2 trial of dianhydrogalactitol (VAL-083) in patients with newly diagnosed MGMT-unmethylated glioblastoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT273.

[Current status and prospects of population exposure assessment of nanomaterials consumer products]

With the wide application of nanomaterials in consumer products in the market, it is necessary to understand the existence and release of nanomaterials in consumer products, as well as the current situation of exposure assessment of consumers. China has been a large industrial producer with a huge consumer market, but the supervision of consumer goods with nanomaterials is almost blank. This article summarized and classified the existing consumer products of nanomaterials in the international market, and discussed the release of key nanomaterials in consumer products and the exposure assessment methods of consumers, in order to provide a scientific basis for the establishment of a regulatory system for consumer products of nanomaterials in China in the future.

[Clinical and immunological characteristics of a case with activated phosphoinositide 3-kinase δ syndrome 2]

Objective: To analyze the clinical and immunological characteristics of a patient with activated phosphoinositide 3-kinase δ syndrome 2 (APDS2). Methods: A retrospective analysis of clinical data, immune-related gene sequencing, imaging and laboratory findings of a patient with APDS2 admitted to Children's Hospital of Chongqing Medical University was performed. The absolute and relative numbers of peripheral lymphocyte subsets, immune cell subsets and phenotypes were detected by flow cytometry with the age matched healthy child or the patient's father as a control. Results: A female patient aged 6 years and 4 months old was firstly admitted due to paleness over one month and cough for 7 days in June 2017. The IgA (<0.067 g/L) decreased while the IgM (2.55 g/L) increased. The abdominal ultrasound found hepatomegaly (subcostal 1.7 cm) and splenomegaly (subcostal 3.6 cm), and gene sequencing revealed a heterozygous mutation in the PIK3R1 gene c.1425+1G>A. After the treatment with prednisone which was initiated with a dose of 10 mg/times, 3 times/d and continued and tapered over 7 months, the IgM decreased to normal (1.72 g/L), and the hepatomegaly (subcostal 0 cm) and splenomegaly (subcostal 0.5 cm) were improved. The patient was readmitted due to pale and sallow complexion for half a month in July 2019. The percentage of naive CD4(+)T (0.386) and naive CD8(+)T cells (0.271) were decreased while the percentage of terminally differentiated effector memory CD8(+)T cells (0.377) and transitional B cells (0.223) were increased. The mean fluorescence intensity (MFI) of phosphorylated protein kinase B (AKT) in CD3(+)T, CD4(+)T and CD8(+)T cells were higher in the patient (4 125, 5 213, 3 497) than those in her father (3 434, 3 312, 3 058). The percentage of follicular helper T cell (Tfh) (0.299), Th1 (0.491) and Th1-like cells (0.438) in the patient were higher than those in the healthy control (0.156,0.313,0.303), while the percentage of Th17 (0.126) and Th17-like cells (0.188) were lower than those in the healthy control (0.198, 0.315). And the percentage of CD57 in the patient (0.306) was also higher than that in the healthy control (0.246). Conclusions: The humoral immunity and cellular immunity of APDS2 patient are impaired to varying degrees. The steroid can improve the lymphoproliferation and autoimmune hemolytic anemia in this case.

ACTR-06. CLINICAL TRIAL OF VAL-083 IN NEWLY DIAGNOSED MGMT-UNMETHYLATED GBM: HALF-WAY REPORT

Approximately 60% of glioblastoma multiforme (GBM) patients possess an unmethylated methylguanine DNA-methyltransferase (MGMT gene, which confers a limited response to standard of care treatment with temozolomide (TMZ) resulting in a lower survival. VAL-083 is a novel bi-functional DNA targeting agent that induces interstrand cross-links at N7-guanine, leading to DNA double-strand breaks and ultimately cell death. VAL-083 circumvents MGMT-mediated repair of the O6 guanine alkylator TMZ. A Phase 2 study has been initiated for VAL-083 in newly diagnosed MGMT unmethylated GBM. The study has 2 stages: Stage 1 is a dose-escalation and induction format to confirm the recommended dose of VAL-083 when administered concurrently with radiation therapy (RT) based on safety and tolerability. The subjects received VAL-083 at 20, 30, or 40 mg/m2/day x 3 days every 21 days along with standard radiation treatment. Stage 2 comprises an expansion phase to enroll up to 30 patients. The dose escalation stage is complete and 30 mg/m2/day of VAL-083 in combination with RT was generally safe and well-tolerated. As of 17 May, 2019, 18 patients have been enrolled. Fifteen patients have completed their prospectively planned MRI scans and had their initial assessment for tumor progression. Of these 15 patients, seven were assessed as a complete response (CR), and eight patients as having stable disease (SD). Of the remaining three patients, one died prior to their post-cycle 3 MRI and two have not been on study long enough to reach their planned post-cycle 3 MRI. As of the data cutoff, 14 of the 18 patients were still alive. Consistent with our prior experience, myelosuppression was the most common adverse event. Three dose-limiting toxicities have been reported - one at the 40 mg/m2/day and two at the 30 mg/m2/day dose. Further enrollment, safety & study updates will be presented at the meeting. Clinicaltrials.gov identifier: NCT03050736.

DRES-07. TMZ-LEV- IFN COCKTAIL REGIMEN SIGNIFICANTLY INHIBITED THE GROWTH OF GLIOMA IN VIVO

OBJECTIVE

Temozolomide (TMZ), is the first line chemotherapeutic drug for glioma. Previous studies have suggested that interferon (IFN) and levetiracetam (LEV) could respectively reverse the resistance of TMZ by down-regulating MGMT expression. This study, we aim to investigate the therapeutic effect of a cocktail chemotherapy regimen combining TMZ, LEV, IFN in vivo.

METHODS

Glioma cell lines U251 and SKMG-4 (MGMT protein expression positive), U138 and GSC-1(MGMT protein expression negative) were used for producing xenograft tumors. The xenograft tumors were established by subcutaneously injecting 1×106 glioma cells into female BALB/C nude mice and divided into 5 treatment groups: Control, TMZ, TMZ+IFN, TMZ+LEV, TMZ+LEV+IFN. The treatment with TMZ (50 mg/kg, i.p.), IFN (2×105 IU, s.c.), LEV (150 mg/kg, i.p.) once a day for five consecutive days and xenograft tumors were measured every two days.

RESULTS

We identified that U138, U251, SKMG-4 tumor growth among TMZ, TMZ+IFN, TMZ+LEV, TMZ+LEV+IFN were all significantly inhibited (P< 0.05), compared with the control. As for U251 and SKMG-4, tumor killing effect of all 4 treatment groups were not different (P > 0.05). In the treatment of mice bearing U138 glioma, the tumor weight of TMZ+LEV+IFN (0.2688±0.1169 g) group was the lowest and significantly lower than that of TMZ+LEV (0.6574±0.08174g, P=0.0261), TMZ+IFN(0.6108±0.07317 g, P=0.0381), and TMZ (0.9054±0.07154 g, P=0.0017) group. Glioma stem cells GSC-1 was highly resistant to TMZ, tumor volume of TMZ group was not different from control group (P >0.05). While compared with TMZ (1.993±0.1274 g) group, in TMZ+IFN (1.506±0.1223g, P=0.0203), TMZ+LEV (1.178±0.1807g, P=0.0042), and TMZ+LEV+IFN (1.049±0.2171 g, P=0.0038) groups, GSC-1 tumor growth were significantly inhibited(P< 0.05).

CONCLUSION

Our data demonstrate that both IFN and LEV can sensitize TMZ effect on glioma in vivo, even for MGMT(+) tumors, and TMZ-LEV-IFN cocktail regimen seems the best. Key words: glioma, TMZ, LEV, IFN

[Spatial distribution of cancer-related burden in Guangzhou from 2010 to 2013]

Objective: To evaluate the burden and to describe the characteristics of spatial distribution caused by malignant tumors among different administrative areas in Guangzhou from 2010- 2013. Methods: Based on data from the Cancer Registry system and population in Guangzhou in 2010- 2013, disability-adjusted life year (DALY) was assessed on the disease burden of cancer, in accordance with the method used in the Global Burden of Disease study. Results: The crude incidence rates of cancer appeared as 256.22/10(5) in 2010-2011 and 270.04/10(5) in 2012-2013, with the crude mortality rates as 143.17/10(5) and 148.01/10(5), respectively, in Guangzhou. Cancers caused 606 238.95 DALYs in 2010-2011 and 623 763.80 DALYs in 2012-2013 for both sexes and 37.63 and 37.81 person year per 1 000 persons, with the standardized DALY rates as 34.51‰, 34.00‰ respectively. Three administrative districts (Yuexiu, Haizhu and Liwan) were with the largest disease burden of cancers that accounted for 45% of the DALYs for the whole Conghua district, with liver cancer was the leading cancer on DALYs, and tracheal, bronchus and lung cancer ranked the first in the other districts. Conclusions: In Guangzhou, disease burden caused by cancers was both prominently seen in the newly developed urban area and the old districts. It remains an arduous task to continue programs on control and prevention of cancers in this city.

[Association between interleukin-17A and 17F single nucleotide polymorphisms and knee osteoarthritis]

Objective: To investigate the association between single nucleotide polymorphisms (SNP) of IL-17A (rs2275913) and IL-17F (rs763780) genes and susceptibility to knee osteoarthritis (KOA) in Chinese Han and Tibetan populations. Methods: A case-control study was conducted. Total of 122 Han KOA patients and 124 Han healthy controls and 76 Tibetan KOA patients and 68 Tibetan healthy controls in Qinghai Province were selected between 2015 and 2017. SNP typing was performed on four groups of rs2275913 and rs763780 polymorphisms by polymerease chain reaction (PCR)-sequencing to detect IL-17A and IL-17 F genotype frequencies and allele frequencies. The t test was used to compare data between groups. Results: The genotype AA frequency of IL-17A (rs2275913) was significantly different between the Han KOA and the control group (OR=2.625, P=0.016). Compared with the frequency of allele A in healthy control group, the allele A frequency in Han KOA group was significantly higher(OR=1.445, P=0.047); the genotype frequency of IL-17A,however,was comparable between the KOA and the healthy control in Tibetan population (OR=1.696, 1.355, both P>0.05); there were also not difference in the IL-17F (rs763780) genotype frequency and allele frequency between the Han KOA and Tibetan KOA groups and two control groups,respectively (OR=1.346, 1.126, both P>0.05). Conclusion: It is highly likely that the pathogenesis of KOA in Chinese Han population is positively related to the genotype AA and allele A of IL-17A (rs2275913).

[Effects of percutaneous nephrolithotomy in the treatment of medullary sponge kidney with calculi]

Objective: To evaluate the effects of percutaneous nephrolithotomy (PNL) in the treatment of medullary sponge kidney with calculi. Methods: A total of 77 patients (91 renal units) of medullary sponge kidney with calculi (MSK group) and 77 patients (77 renal units) with common kidney stone (control group) received PNL at Department of Urology in Peking University People's Hospital from September 2006 to February 2016 were analyzed retrospectively. The MSK group included 33 males and 44 females with a mean age of (42.1±13.2) years, the mean stone burden was (3.9±1.8) cm. The control group included 36 males and 41 females with a mean age of (45.3±13.0) years, the mean stone burden was (3.6±1.5) cm. The numbers of tracts, the time of operation, the drop of hemoglobin, the change of creatine, the time of hospitalization, the stone free rate and major complications were compared between the two groups. The measurement data and numeration data were compared with t test and χ(2) test. Results: There were no significant differences in sex, age, preoperative urinary tract infection, stone type, and stone burden between the two groups (all P>0.05). The proportion of bilateral renal calculus in MSK group was higher (18.2% vs. 0, χ(2)=15.400, P=0.000). There were 159 percutaneous channels were established in MSK group while 90 percutaneous channels were established in control group. Compared with the control group, the operation time ((88.1±37.5) minutes vs. (68.5±30.1) minutes, t=3.543, P=0.000) and hospitalization time ((15.1±8.3) days vs. (10.1±3.6) days, t=4.816, P=0.000) were longer, the creatinine level increased ((101.2±62.6) μmol/L vs. (71.3±23.6) μmol/L, t=3.777, P=0.000), the rate of stone free decreased (27.5% vs. 83.1%, χ(2)=51.840, P=0.000) and the rate of complications increased (29.9% vs. 11.7%, χ(2)=8.114, P=0.004) in MSK group. There was no statistically difference in hemoglobin drop ((12.5±13.2) g/L vs. (13.0±10.9) g/L, t=-0.260, P=0.795). Conclusions: Using PNL for patients of MSK with calculi has a lower stone free rate and a higher complications. It is an effective method for patients of MSK with large and complex calculi.

Belimumab promotes negative selection of activated autoreactive B cells in systemic lupus erythematosus patients

Belimumab has therapeutic benefit in active systemic lupus erythematosus (SLE), especially in patients with high-titer anti-dsDNA antibodies. We asked whether the profound B cell loss in belimumab-treated SLE patients is accompanied by shifts in the immunoglobulin repertoire. We enrolled 15 patients who had been continuously treated with belimumab for more than 7 years, 17 matched controls, and 5 patients who were studied before and after drug initiation. VH genes of sort-purified mature B cells and plasmablasts were subjected to next-generation sequencing. We found that B cell-activating factor (BAFF) regulates the transitional B cell checkpoint, with conservation of transitional 1 (T1) cells and approximately 90% loss of T3 and naive B cells after chronic belimumab treatment. Class-switched memory B cells, B1 B cells, and plasmablasts were also substantially depleted. Next-generation sequencing revealed no redistribution of VH, DH, or JH family usage and no effect of belimumab on representation of the autoreactive VH4-34 gene or CDR3 composition in unmutated IgM sequences, suggesting a minimal effect on selection of the naive B cell repertoire. Interestingly, a significantly greater loss of VH4-34 was observed among mutated IgM and plasmablast sequences in chronic belimumab-treated subjects than in controls, suggesting that belimumab promotes negative selection of activated autoreactive B cells.

A combustion method to synthesize nanoporous graphene

In this paper, we introduce a combustion method which is rapid, low cost, mass-producing and environmentally friendly to produce nanoporous graphene. After loading a graphene oxide aerogel (GOA)/paper (GOP) on a preheated hot plate (as the heat source, with a temperature as low as 200 °C) under an ambient environment, in a few seconds, the GOA/GOP would self-combust and change into reduced graphene oxide (RGO) with nanopores mainly concentrated in the 0.4-2.0 nm range and a large specific surface area of 536 m2 g-1. Supercapacitors fabricated with the synthesized porous RGO (P-RGO) showed a high specific capacitance of 245 F g-1 at 0.1 A g-1, and a retention rate of about 96.9% after 12 000 cycle tests with respect to the initial specific capacitance with a scan rate of 10.0 A g-1. The production yield of this method was as high as 77.0%.

Dose- and type-dependent effects of long-chain fatty acids on adipogenesis and lipogenesis of bovine adipocytes

Differentiation and lipid metabolism of adipocytes have a great influence on milk performance, health, and feed efficiency of dairy cows. The effects of dietary long-chain fatty acids (FA) on adipogenesis and lipogenesis of dairy cows are often confounded by other nutritional and physiological factors in vivo. Therefore, this study used an in vitro approach to study the effect of dose and type of long-chain FA on adipogenesis and lipogenesis of bovine adipocytes. Stromal vascular cells were isolated from adipose tissue of dairy cows and induced into mature adipocytes in the presence of various long-chain FA including myristic, palmitic, stearic, oleic, or linoleic acid. When concentrations of myristic, palmitic, and oleic acids in adipogenic mediums were 150 and 200 μM, the induced mature adipocytes had greater lipid content compared with other concentrations of FA. In addition, mature adipocytes induced at 100 μM stearic acid and 300 μM linoleic acid had the greatest content of lipid than at other concentrations. High concentrations of saturated FA were more toxic for cells than the same concentration of unsaturated FA during the induction. When commitment stage was solely treated with FA, the number of differentiated mature adipocytes was greater for oleic and linoleic acids than other FA. When the maturation stage was treated with FA, the number of mature adipocytes was not affected, but the lipid content in adipocytes was affected and ranked oleic > linoleic > myristic > stearic > palmitic. In summary, this study showed that adipogenesis and lipogenesis of bovine adipocytes were differentially affected by long-chain FA, with unsaturated FA more effective than saturated FA.

[A cross-sectional study of seroepidemiology of viral hepatitis among Uighurs in Shufu of Xinjiang]

Objective: To explore the status of seroepidemiology on hepatitis A, B and C among students and residents aged equal or greater than 18 years in south Xinjiang, and to provide scientific evidence for prevention and control of viral hepatitis. Methods: Uyghur students in four towns and villages were selected by cluster random sampling from Feb to May, 2015, and Uyghur residents aged 18 to 69 years were selected by stratified cluster sampling from May to September, 2016. 4 507 middle and primary Uygur students and 4 833 Uyghur resides equal or greater than 18 years attended this survey. Self-designed questionnaire was used to collect the demographic information. And Elisa test was adopted to detect HAV-IgG, HBsAg, HBsAb and HCV-IgG. Chi-square test was used to calculate the difference on antibody positive rate of three types of hepatitis among the participants. Results: The overall HAV-IgG positive rate was 99.45% (9 289/9 340). The positive rates were 99.70% (4 006/4 018) in male and 99.27% (5 283/5 322) in female (χ(2)=7.95, P=0.005). The HAV-IgG positive rate among people aged 10 to 14 years was the highest (99.91%, 2 233/2 235), and the difference between the age specific HAV-IgG positive rates was statistical significant (χ(2)=38.21, P<0.001). The overall HBsAg positive rate was 4.11% (384 cases), with 4.55% (183 cases) for male and 3.78% (201 cases) for female. The HBsAg positive rate among participants 19 to 24 years old was the highest (9.46%, 21/222) and the differences between the age specific HBsAg was statistically significant (χ(2)=116.22, P<0.001). The HBsAb positive rate was 35.03% (3 272 cases), with 35.59% (1 430 cases) for male and 34.61% (1 842 cases) for female, and the HBsAb positive rate among participants aged 15 to 18 years was the highest, which was 69.12% (696/1 007). The differences between the age specific HBsAb rates appeared statistically significant (χ(2)=671.80, P<0.001). The overall HCV-IgG positive rate was 0.65%(61 cases). The HCV-IgG positive rate in female was 0.86% (46 cases) and 0.37% (15 cases) in male (χ(2)=8.51, P=0.004).The HCV-IgG positive rate among participants aged over 70 years was the highest (3.78%,9/238) , and the difference between the age specific HCV-IgG positive rates had statistic significance (χ(2)=70.30, P<0.001). The HAV-IgG positive rate in hepatitis A vaccinees (100%, 876/876) was higher than that among the non-vaccinees (99.40%, 8 413/8 464) (χ(2)=4.26, P=0.039). The HBsAb positive rate in hepatitis B vaccinees was 39.32% (1 816/4 619) which was higher than that among the non-vaccinees (30.84%, 1 456/4 721) (χ(2)=73.68, P<0.001). Conclusion: The positive rate of overall HAV-IgG was high, male and participants aged between 10 to 14 had higher probability to be infected. But the infection rates of hepatitis B and C were low, with the low vaccination rate and the poor protective effectiveness of hepatitis B.

AMPK-autophagy inhibition sensitizes icaritin-induced anti-colorectal cancer cell activity

The current research studied the potential effect of autophagy on icaritin-induced anti-colorectal cancer (CRC) cell activity. Treatment of icaritin in both primary and established (HT-29) CRC cells induced feedback activation of autophagy, evidenced by p62 degradation, Beclin-1 and autophagy-related gene-5 (ATG-5) upregulation, as well as light chain 3B (LC3B)-GFP puncta formation. Pharmacological inhibiting of autophagy dramatically potentiated icaritin-induced CRC cell death and apoptosis. Meanwhile, shRNA-mediated knockdown of Beclin-1 or ATG-5 also sensitized icaritin-induced CRC cell death and apoptosis. Icaritin activated AMP-activated protein kinase (AMPK) signaling in CRC cells, functioning as the upstream signaling for autophagy activation. shRNA/siRNA-mediated knockdown of AMPKα1inhibited icaritin-induced autophagy activation, but exacerbated CRC cell death. On the other hand, the AMPK activator compound 13 (C13) or the autophagy activator MHY1485 attenuated icaritin-induced cytotoxicity. In nude mice, icaritin (oral administration)-induced HT-29 tumor growth inhibition was potentiated when combined with AMPKα1 shRNA knockdown in tumors. We conclude that feedback activation of AMPK-autophagy pathway could be a primary resistance factor of icaritin.

[Status of seroepidemiology of hepatitis A, B and C in primary and middle school students in Shufu county, Xinjiang Uygur Autonomous Region of China]

Objective: To explore the status of seroepidemiology on hepatitis A, B and C in primary and middle school students in Shufu county, Xinjiang Uygur Autonomous Region of China (Xinjiang) and to evaluate the effect of related immunization. Methods: Students in four towns and villages were selected by cluster random sampling method. HAV-IgG, HBsAg, HBsAb and HCV-IgG were detected in Feb to May, 2015. Results: The overall HAV-IgG positive rate was 99.75%, among 4 830 primary and middle school students. The positive rates were seen 99.92% in boys and 99.57% in girls, with difference statistically significant (χ²=5.798, P=0.016). The overall HBsAg positive rate appeared as 3.02%, with 3.55% for boys and 2.47% for girls, with difference statistically significant (χ²=4.782, P=0.029). The difference between age specific HBsAg positive rates also showed statistically significant (χ²=71.990,P=0.000). HBsAg positive rate in the students in rural area (3.28%) was higher than that in the students in urban area (1.61%, χ²=6.019, P=0.014). HBsAb positive rate was 38.84%, and the differences between the age specific HBsAb positive rates appeared statistically significant (χ²=837.699, P=0.000). HBsAg positive rate in students from the urban area (42.36%) was higher than those from the rural area (38.20%, χ²=4.598, P=0.032). 2 815 students, accounting for 58.28% of the total students, showed negative on both HBsAg and HBsAb. The overall HCV-IgG positive rate was 0.19%, and all appeared in students from the rural areas, with ethnicity solely as Uygur. Conclusions: The effect of hepatitis A vaccine was satisfactory in primary and middle school students in Shufu county but quiet a number of the students missed the vaccination. The infection rate of hepatitis C was low. Publicity and health education on hepatitis immunization and control should be revved up. Programs regarding primary and supplementary immunization on hepatitis, should be carried out timely for children of school age.

[Dynamic maternal measles antibody level in infants: a longitudinal study]

OBJECTIVE

To understand the dynamic maternal measles antibody level in infants in Guangzhou.

METHOD

Women who delivered babies in a maternal and child health care hospital in Guangzhou and their infants who were never affected by measles were included in our study. All the serum samples collected from mothers and infants were tested by using enzyme linked immunosorbent assay(ELISA)for the quantitative measurement of measles IgG antibodies. A longitudinal sero-epidemiological study was conducted to investigate the duration of the presence of measles maternal antibodies in infants based on the measurement at different time points(0, 3, 5, 7 month).

RESULT

A total of 689 mothers and their 691 infants(two pairs of twins)were included in the study. The concentration and the sero-positivity rate of measles antibody in mothers was 513.8 mIU/ml and 81.6% respectively. The concentration and the sero-positivity rate of measles antibody in infants was 732.8 mIU/ml and 87.3%, respectively. The measles antibody levels of newborns were positively associated with those of mothers(r=0.917 5, P<0.001), which declined rapidly at 3 months after birth and mostly turned to be negative at 7 months after birth. Measles antibody turned be negative at 3 months after birth in low, middle level groups, but remained to be positive in high level group at 5 months after birth.

CONCLUSION

The maternal measles antibody could rarely protect infants at age of 8 months even though mother had been vaccinated or acquired natural immunity. It is suggested to adjust the time of the first dose measles vaccination in infants and increase the measles antibody level of child bearing aged women to reduce the incidence of measles in infants.

[Investigation into the relationship between mitochondrial 12 S rRNA gene, tRNA gene and cytochrome oxidase Ⅱ gene variations and the risk of noise-induced hearing loss]

Objective: To explore the relationship between mitochondrial 12 S rRNA gene variation, tRNA gene variation and cytochrome oxidase Ⅱ gene point mutations and the risk of noise-induced hearing loss (NIHL). Methods: A nested case-control study was performed that followed a cohort of 7 445 noise-exposed workers in a steel factory in Henan province, China, from January 1, 2006 to December 31, 2015. Subjects whose average hearing threshold was more than 40 dB(A) in high frequency were defined as the case group, and subjects whose average hearing threshold was less than 35 dB(A) in high frequency and less than 25 dB (A) in speech frequency were defined as the control group. Subjects was recruited into the case group (n=286) and the control group (n=286) according to gender, age, job category and time of exposure to noise, and a 1∶1 case-control study was carried out. We genotyped eight single nucleotide polymorphisms in the mitochondrial 12 S rRNA gene, the mitochondrial tRNA gene and the mitochondrial cytochrome oxidase Ⅱ gene using SNPscan high-throughput genotyping technology from the recruited subjects. The relationship between polymorphic sites and NIHL, adjusted for covariates, was analyzed using conditional logistic regression analysis, as were the subgroup data. Results: The average age of the recruited subjects was (40.3±8.1) years and the length of service exposure to noise was (18.6±8.9) years. The range of noise exposed levels and cumulative noise exposure (CNE) was 80.1- 93.4 dB (A) and 86.8- 107.9 dB (A) · year, respectively. For workers exposed to noise at a CNE level<98 dB (A) · year, smokers showed an increased risk of NIHL of 1.88 (1.16-3.05) compared with non-smokers; for workers exposed to noise at a CNE level ≥98 dB(A) · year, smokers showed an increased risk of NIHL of 2.53 (1.49- 4.30) compared with non-smokers. For workers exposed to noise at a CNE level<98 dB (A) · year, the results of univariate analysis and multifactor analysis, adjusted by smoking and CNE, suggested that the risk of NIHL in workers exposed to noise carrying the GG genotype (G827A) was lower than that of NIHL workers exposed to noise carrying the AA genotype (G827A) [OR (95% CI) were 0.18 (0.04- 0.82) and 0.19 (0.04- 0.88), respectively]. Conclusion: Smoking increased the risk of NIHL in the present study. For workers subjected to a CNE<98 dB(A)·year, the mitochondrial genetic variant G827A was found to be significantly associated with the risk of NIHL.

[Correlation between EGLN1 gene, protein express in lung tissue of rats and pulmonary artery pressure at different altitude]

OBJECTIVE

To investigate the correlation between pulmonary artery pressure (PAP) and the expression level of Egl nine homologue 1 (EGLN1) gene or its protein in lung tissue of rats at different altitudes.

METHODS

Totally 121 male Wistar rats were randomly divided into low altitude group (n=11), moderate altitude group and high altitude group, the rats in moderate altitude and high altitude group were further divided into 1(st) day, 3(rd) days, 7(th) days, 15(th) day and 30(th) day group according to the exposure time to hypoxic environment, each group 11 rats. The low altitude group, the PAP of rats were determined by physiological signal acquisition system, and tissue samples were collected in liquid nitrogen container for storage at an altitude of 498 m area. Moderate altitude group rats were placed in altitude of 2 260 meters of natural environment, 5 high altitude groups rats were placed in the hypobaric hypoxic chamber, simulating altitude of 4 500 meters. The PAP of rats in moderate altitude group and high altitude group were also determined by physiological signal acquisition system, and tissue samples were collected when rats were exposed to hypoxia at 1(st), 3(rd), 7(th), 15(th) and 30(th) day; Western blot was used to determine expression levels of EGLN1 protein, and person correlation analysis was used to analyze whether the protein was related to the formation of pulmonary arterial hypertension (PH) under hypoxia. Real-time quantitive PCR method determined expression levels of EGLN1 mRNA in lung tissues, and the relative expression method was used to analyze PCR data, and finally assess whether the EGLN1 gene was the initial cause of the formation of PH during hypoxia.

RESULTS

The mean PAP of rats was (20.0±3.2) mmHg (1 mmHg=0.133 kPa) in low altitude group; in moderate altitude group, mean PAP began to increase slightly when rats were exposed to hypoxia on the 15(th) day and reached at (22.7±4.1) mmHg on hypoxic 30(th) day, but compared with the low altitude group, there was no statistical difference (P> 0.05); the mean PAP of rats in high altitude group began to rise on the 7(th) day (28.7±7.7) mmHg, which was higher than that in low altitude group (P<0.05), and significantly increased to (42.3±9.1) mmHg (P<0.001) on hypoxic 30(th) day; it was significantly proportional with exposure to hypoxic time, and compared to low altitude group and moderate altitude group, there was significant difference (P<0.05). EGLN1 protein expression in the lung tissue of rats had no significant difference between the low altitude group and moderate altitude group, and its expression level in the high altitude group were significantly decreased, furthermore, the expression level decreased with the increase of hypoxia exposure time (P<0.05); PAP and EGLN1 protein expression levels showed a negative correlation (r=-0.662). The transcription level of mRNA EGLN1 in high altitude group was significantly increased under hypobaric hypoxia, it was 72 times more than that of the moderate altitude group, and nearly 300 times than that of the low altitude group, respectively (both P<0.001=.

CONCLUSION

EGLN1 gene expression in lung tissue of rat is affected by hypoxia, the expression level increases with the increase of the altitude; but the protein expression level, in contrast with gene expression level, is decreased with the increase of altitude and is significantly negatively correlated with mean PAP.

[Risk factor analysis of systemic inflammatory response syndrome in type 2 diabetics after percutaneous nephrolithotomy]

OBJECTIVE

To evaluate the risk factors of systemic inflammatory response syndrome (SIRS) in the patients with type 2 diabetes diagnosed with kidney stone after percutaneous nephrolithotomy (PCNL).

METHODS

In this study, 461 patients with type 2 diabetes who received PCNL in Peking University People's Hospital from June 2006 to December 2015 were reviewed. There were 281 males and 180 females with an average age of 57 years were included, of whom, 137 were diagnosed with SIRS after PCNL. The demographic data, clinical features, and test results were compared between the patients with SIRS and without SIRS, trying to identify the correlation between their clinical characters and the occurrence of SIRS.

RESULTS

The SIRS was significantly correlated with the patients' preoperative white blood cell counting (×10⁹/L) [7.76 (4.00-17.96) vs. 6.31 (2.00-17.40), P<0.001], preoperational blood glucose level (mmol/L) [7.30 (3.08-19.90) vs. 6.40 (3.42-16.78), P<0.001], operative time (min) [75 (20-270) vs. 60 (20-200), P<0.001], length of stay (d) [12 (2-46) vs. 11 (3-29), P=0.019], staghorn stones [38.8% (33/85) vs. 27.7% (104/376), P=0.042], and preoperational urinary tract infection [36.8% (50/136) vs. 26.6% (81/304), P=0.032]. There was no significant correlation between the SIRS and the patients' age, body mass index, preoperative hemoglobin level, preoperative serum creatinine, and transfusion. In multivariate analysis, abnormal preoperative white blood cell counting (OR=3.194, 95% CI: 1.531-6.666, P=0.002), operative time longer than 60 min (OR=1.635, 95% CI: 1.088-2.456, P=0.018), and preoperational blood glucose level higher than normal 7.1 mmol/L were significantly correlated with the presence of SIRS.

CONCLUSION

The high level of preoperational blood glucose, abnormal preoperative white blood cell counting, and long operative time were significantly correlated with the presence of SIRS in patients with type 2 diabetes after PCNL.

[Association between grainyhead-like 2 gene polymorphisms and noise-induced hearing loss]

OBJECTIVE

To investigate association between genetic polymorphism in the grainyhead-like 2 gene (GRHL2) and noise-induced hearing loss (NIHL) in the Chinese population.

METHODS

A matched case-control association study was employed, In which, 3 790 workers exposed to continuous and steady-state occupational noise in a steel factory participated. The questionnaires were adopted to collect individual features and audiometry tests performed. In the sstudy, 286 subjects were diagnosed as cases, Which were each designated on the basis of the matched criterion, and 286 paired samples were selected finally. Noise intensity was measured according to the standards given in 'Measurement of Noise in the Workplace'(Occupational Health Standard of the People's Republic of China, GBZ/T189.8-2007). Cumulative noise exposure (CNE) was calculated, according to monitoring data on A-weighed sound pressure level and employment time. Genomic DNA was obtained from peripheral blood samples using 2 mL DNA extraction Kit following the manufacturer's protocol. Five single nucleotide polymorphisms (SNPs) of GRHL2 were genotyped by multiplex SNP genotyping kit. The continuous variables and categorical variables were analyzed by t-test and chi-square test respectively. Multivariate Logistic regression was used to test the association between genetic frequency and disease status, with adjustments for the possible confounding variables. The haplotypes were established and their frequencies in the two groups were assessed by haploview and phase softwares.

RESULTS

All the five SNPs (rs3735713, rs3824090, rs3735714, rs3735715 and rs611419) were in Hardy-Weinberg equilibrium (HWE) (P>0.05). The subjects carrying rs3735715 GG genotype had a higher NIHL risk than those carrying the GA genotype under the co-dominant model (OR=0.644, 95% CI: 0.442-0.939, P=0.022) after adjustment for height, blood pressure, drinking status and smoking status. After being stratified by CNE, in the CNE ≥ 98 dB (A) group, rs3735715 polymorphism was associated with the NIHL under the co-dominant model (OR=0.509, 95% CI: 0.281-0.923, P=0.026) after adjustment for height, blood pressure, drinking status and smoking status as well. However, no statistical significant difference was found in variant genotypes of the other SNPs between the case and control subjects. Four-locus (rs3735713, rs3824090, rs3735714 and rs3735715) haplotypes were constructed, and no risk or protective haplotypes was identified.

CONCLUSION

It is suggested that GRHL2 polymorphisms may be associated with development of NIHL.

[Risk factor analysis of systemic inflammatory response syndrome in type 2 diabetics after percutaneous nephrolithotomy]

OBJECTIVE

To evaluate the risk factors of systemic inflammatory response syndrome (SIRS) in the patients with type 2 diabetes diagnosed with kidney stone after percutaneous nephrolithotomy (PCNL).

METHODS

In this study, 461 patients with type 2 diabetes who received PCNL in Peking University People's Hospital from June 2006 to December 2015 were reviewed. There were 281 males and 180 females with an average age of 57 years were included, of whom, 137 were diagnosed with SIRS after PCNL. The demographic data, clinical features, and test results were compared between the patients with SIRS and without SIRS, trying to identify the correlation between their clinical characters and the occurrence of SIRS.

RESULTS

The SIRS was significantly correlated with the patients' preoperative white blood cell counting (×10(9)/L) [7.76 (4.00-17.96) vs. 6.31 (2.00-17.40), P<0.001], preoperational blood glucose level (mmol/L) [7.30 (3.08-19.90) vs. 6.40 (3.42-16.78), P<0.001], operative time (min) [75 (20-270) vs. 60 (20-200), P<0.001], length of stay (d) [12 (2-46) vs. 11 (3-29), P=0.019], staghorn stones [38.8% (33/85) vs. 27.7% (104/376), P=0.042], and preoperational urinary tract infection [36.8% (50/136) vs. 26.6% (81/304), P=0.032]. There was no significant correlation between the SIRS and the patients' age, body mass index, preoperative hemoglobin level, preoperative serum creatinine, and transfusion. In multivariate analysis, abnormal preoperative white blood cell counting (OR=3.194, 95% CI: 1.531-6.666, P=0.002), operative time longer than 60 min (OR=1.635, 95% CI: 1.088-2.456, P=0.018), and preoperational blood glucose level higher than normal 7.1 mmol/L were significantly correlated with the presence of SIRS.

CONCLUSION

The high level of preoperational blood glucose, abnormal preoperative white blood cell counting, and long operative time were significantly correlated with the presence of SIRS in patients with type 2 diabetes after PCNL.

Icaritin activates JNK-dependent mPTP necrosis pathway in colorectal cancer cells

The colorectal cancer (CRC) is one leading contributor of cancer-related mortality worldwide. The search for effective anti-CRC agents is valuable. In the current study, we showed that icaritin (ICT), an active natural ingredient from the Chinese plant Epimedium, potently inhibited proliferation and survival of established (HT-29, HCT-116, DLD-1, and SW-620) and primary (patient-derived) CRC cells. Significantly, ICT mainly induced necrosis, but not apoptosis, in CRC cells. The necrosis inhibitor necrostatin-1 attenuated ICT-mediated cytotoxicity in CRC cells. We showed that ICT treatment in CRC cells induced mitochondrial permeability transition pore (mPTP) opening, which was evidenced by mitochondrial membrane potential (MMP) decrease and mitochondrial adenine nucleotide translocator-1 (ANT-1)-cyclophilin-D (CyPD) association. On the other hand, mPTP blockers, including sanglifehrin A, cyclosporin A, and bongkrekic acid, as well as siRNA-mediated knockdown of mPTP component (CyPD or ANT-1), significantly alleviated ICT-mediated cytotoxicity against CRC cells. We suggested that Jun-N-terminal kinase (JNK) activation by ICT mediated mPTP opening and subsequent CRC cell necrosis. JNK pharmacological inhibition, dominant negative mutation, or shRNA downregulation suppressed ICT-induced MMP reduction and subsequent HT-29 cell necrosis. In vivo, oral gavage of ICT dramatically inhibited HT-29 xenograft growth in nude mice. The in vivo activity by ICT was largely attenuated by co-administration with the mPTP blocker CsA. Collectively, our results showed that ICT exerts potent inhibitory effect against CRC cells in vitro and in vivo. JNK-dependent mPTP necrosis pathway could be key mechanism responsible for ICT's actions.

Distinct mechanisms define murine B cell lineage immunoglobulin heavy chain (IgH) repertoires

Processes that define immunoglobulin repertoires are commonly presumed to be the same for all murine B cells. However, studies here that couple high-dimensional FACS sorting with large-scale quantitative IgH deep-sequencing demonstrate that B-1a IgH repertoire differs dramatically from the follicular and marginal zone B cells repertoires and is defined by distinct mechanisms. We track B-1a cells from their early appearance in neonatal spleen to their long-term residence in adult peritoneum and spleen. We show that de novo B-1a IgH rearrangement mainly occurs during the first few weeks of life, after which their repertoire continues to evolve profoundly, including convergent selection of certain V(D)J rearrangements encoding specific CDR3 peptides in all adults and progressive introduction of hypermutation and class-switching as animals age. This V(D)J selection and AID-mediated diversification operate comparably in germ-free and conventional mice, indicating these unique B-1a repertoire-defining mechanisms are driven by antigens that are not derived from microbiota.

DOI:http://dx.doi.org/10.7554/eLife.09083.001

Our immune system protects us by recognizing and destroying invading viruses, bacteria and other microbes. B cells are immune cells that produce protective proteins called antibodies to stop infections. These cells are activated by ‘antigens’, which are fragments of molecules from the microbes or from our own cells. When an antigen binds to a B cell, the cell matures, multiplies and produces proteins called antibodies. These antibodies can bind to the antigen, which marks the microbe for attack and removal by other cells in the immune system.

Each antibody consists of two ‘heavy chain’ and two ‘light chain’ proteins. B cells are able to produce a large variety of different antibodies due to the rearrangement of the gene segments that encode the heavy and light chains. In mice, there are two kinds of B cells – known as B-1a and B-2 cells – that play different roles in immune responses. B-1a cells have long been known to produce the ‘natural’ antibodies that are present in the blood prior to an infection. On the other hand, B-2 cells produce antibodies that are specifically stimulated by an infection and are better adapted to fighting it. Previous studies have shown that both types of antibodies are required to allow animals to successfully fight the flu virus.

Here, Yang, Wang et al. used a technique called fluorescence-activated cell sorting (or FACS) and carried out extensive genomic sequencing to study how the B-1a and B-2 populations rearrange their genes to produce heavy chains. This approach made it possible to separate the different types of B cells and then sequence the gene for the heavy chain within the individual cells. The experiments show that the “repertoire” of heavy chains in the antibodies of the B-1a cells is much less random and more repetitive than that of B-2 populations.

Furthermore, Yang, Wang et al. show that B-1a cells produce and maintain their repertoire of heavy chains in a different way to other B-2 populations. B-1a cells develop earlier and the major genetic rearrangements in the gene that encodes the heavy chain occur within the first few weeks of life. Although the gene rearrangements have mostly stopped by adulthood, the B-1a antibody repertoire continues to evolve profoundly as the B-1a cells divide over the life of the animal. On the other hand, the gene rearrangements that make the heavy chains in the B-2 cells continue throughout the life of the animal to produce the wider repertoire of antibodies found in these cells. In addition, the processes that continue to change the antibody reperotire in the B-1a cells during adulthood do not occur in the B-2 populations.

Importantly, the these reperotire-changing processes in B-1a cells also occur in mice that have been raised in germ-free conditions, which demonstrates that – unlike other B cells – the repertoire of heavy chains in B-1a cells is not influenced by antigens from microbes. Instead, it is mainly driven by antigens that are expressed by normal cells in the body. These findings open the way to future work aimed at understanding how B-1a cells help to protect us against infection, and their role in autoimmune diseases, where immune cells attack the body’s own healthy cells.

DOI:http://dx.doi.org/10.7554/eLife.09083.002

iRock 2.0 and the iR-Processor: an automated immune repertoire library preparation platform for NGS (TECH2P.919)

Immune repertoire amplification of T and B cell receptors coupled to Next Generation Sequencing (NGS) provides detailed sequence-level insight into the immune system. Previously, we described the automation of a patented, nested multiplex PCR method (arm-PCR) to amplify an immune repertoire, inclusively and semi-quantitatively, on the iR-Processor, an instrument developed by iCubate, Inc. The iR-Processor is an open development platform for diagnostic panels consisting of a closed-cassette and the iR-Processor. The cassette is pre-loaded with the reagents necessary for library preparation, and the iR-Processor instructs the cassette to perform the necessary liquid handling steps and PCR for library generation. Template RNA is added to the cassette with the RT enzyme. iRock 2.0 represents an improved method in which all of the first round cDNA is rescued prior to library generation with a pair of universal primers. Once PCR is complete, residual primer-dimers are removed by magnetic selection of the primary product in the cassette. The amplified library is eluted from the magnetic beads by the user and is directly ready for sequencing using the Illumina MiSeq. The sequencing results from repeat amplification experiments of the TCRβ chain from the same individual and between individuals are compared. The results demonstrate high repeatability among shared CDR3 sequences and an improvement in the percentage of shared CDR3 discovery upon repetition.

Outcome of surgical resection for brain metastases and radical treatment of the primary tumor in Chinese non-small-cell lung cancer patients

Purpose

Brain metastasis is the most common complication of brain cancer; nevertheless, primary lung cancer accounts for approximately 20%–40% of brain metastases cases. Surgical resection is the preferred treatment for brain metastases. However, no studies have reported the outcome of surgical resection of brain metastases from non–small-cell lung cancer (NSCLC) in the People’s Republic of China. Moreover, the optimal treatment for primary NSCLC in patients with synchronous brain metastases is hitherto controversial.

Patients and methods

We retrospectively analyzed the cases of NSCLC patients with brain metastases who underwent neurosurgical resection at the Sun Yat-sen University Cancer Center, and assessed the efficacy of surgical resection and the necessity of aggressive treatment for primary NSCLC in synchronous brain metastases patients.

Results

A total of 62 patients, including 47 men and 15 women, with brain metastases from NSCLC were enrolled in the study. The median age at the time of craniotomy was 54 years (range 29–76 years). At the final follow-up evaluation, 50 patients had died. The median OS time was 15.1 months, and the survival rates were 70% and 37% at 1 and 2 years, respectively. The median OS time of synchronous brain metastases patients was 12.5 months. Univariate analysis revealed that radical treatment of primary NSCLC was positively correlated with survival, and it was an independent prognostic factor in the multivariate analysis.

Conclusion

Surgical resection is an effective treatment for brain metastases. Besides craniotomy, radical therapy is necessary for the management of primary NSCLC in patients with synchronous brain metastases.

The association between BMP4 gene polymorphism and its serum level with the incidence of LVH in hypertensive patients

Background

Bone morphogenic proteins 4 (BMP4) is associated with cardiac remodeling under different conditions. However, the role of BMP4 and its gene polymorphism in the incidence of left ventricular hypertrophy (LVH) in hypertensive patients remains unknown.

Methods

A total of 1265 patients diagnosed with essential hypertension (EH) were recruited. Patients were assigned to LVH+ (n = 420) and LVH- (n = 845) groups. serum BMP4 level was measured and two single nucleotide polymorphism (SNPs) polymorphisms, 6007C > T and -5826G > A of BMP4 gene were genotyped. We also inhibited the BMP4 by small interfering RNA (siRNA). The effect of BMP4 on the hypertrophic response in Human Cardiomyocytes AC16 cells was studied.

Results

We found that the 6007C > T polymorphism of the BMP4 gene and the serum BMP4 level were significantly associated with the risk to develop LVH. With TT as reference, multivariate logistic regression analysis showed the 6007CC genotype carriers had a higher susceptibility to LVH incidence (adjusted OR = 2.65, 95% CI: 1.63-4.31, adjusted P < 0.001). Our in vitro study shows that the BMP4 inhibition in cardiomyocyte by si-RNA technique significantly decreased the Ang II induced cardiomyocyte size and protein content per cell, indicating the importance of BMP4 in the cardiomyocyte hypertrophy.

Conclusion

Collectively, our data suggest that both the 6007C > T of the BMP4 gene and the serum BMP4 level may be used as potential marker for LVH incidence among the EH patients.

Electronic supplementary material

The online version of this article (doi:10.1186/s12967-014-0368-x) contains supplementary material, which is available to authorized users.

MTA1 promotes cell proliferation via DNA damage repair in epithelial ovarian cancer

We examined whether metastasis-associated gene 1 (MTA1) promotes cell proliferation via DNA damage repair in ovarian cancer. MTA1 was successfully down-regulated using small interfering RNA in the epithelial ovarian cancer cell lines SKOV-3 and OVCAR-3. Cell growth was evaluated through MTT and colony formation assays. Fluorescence-activated cell sorting analysis was used to evaluate the distribution of cells in the cell cycle, and cytotoxicity assays were performed to study cell sensitivity to cisplatin. A neutral comet assay was used to measure levels of ionizing radiation-induced DNA damage in SKOV-3 cells, and Western blot analyses were carried out to examine the expression of key proteins involved in DNA damage repair pathways. MTA1 knockdown markedly inhibited cell growth and led to S phase cell cycle arrest. In addition, MTA1 depletion conferred sensitivity of ovarian cancer cells to cisplatin. Moreover, MTA1 depletion increased the level of ionizing radiation-induced DNA damage and caused irreparable damage, which was illustrated by a remarkable increase and persistent existence of a comet tail as well as protein expression levels of γH2AX, pRPA, and pChk1, all of which play critical roles in DNA repair. Thus, MTA1 promotes the proliferation of epithelial ovarian cancer cells by enhancing DNA repair.

MiR-181b sensitizes glioma cells to teniposide by targeting MDM2

BACKGROUND

Although the incidence of glioma is relatively low, it is the most malignant tumor of the central nervous system. The prognosis of high-grade glioma patient is very poor due to the difficulties in complete resection and resistance to radio-/chemotherapy. Therefore, it is worth investigating the molecular mechanisms involved in glioma drug resistance. MicroRNAs have been found to play important roles in tumor progression and drug resistance. Our previous work showed that miR-181b is involved in the regulation of temozolomide resistance. In the current study, we investigated whether miR-181b also plays a role in antagonizing the effect of teniposide.

METHODS

MiR-181b expression was measured in 90 glioma patient tissues and its relationship to prognosis of these patients was analyzed. Cell sensitivity to teniposide was tested in 48 primary cultured glioma samples. Then miR-181b stably overexpressed U87 cells were generated. The candidate genes of miR-181b from our previous study were reanalyzed, and the interaction between miR-181b and target gene MDM2 was confirmed by dual luciferase assay. Cell sensitivity to teniposide was detected on miR-181b over expressed and MDM2 down regulated cells.

RESULTS

Our data confirmed the low expression levels of miR-181b in high-grade glioma tissues, which is related to teniposide resistance in primary cultured glioma cells. Overexpression of miR-181b increased glioma cell sensitivity to teniposide. Through target gene prediction, we found that MDM2 is a candidate target of miR-181b. MDM2 knockdown mimicked the sensitization effect of miR-181b. Further study revealed that miR-181b binds to the 3'-UTR region of MDM2 leading to the decrease in MDM2 levels and subsequent increase in teniposide sensitivity. Partial restoration of MDM2 attenuated the sensitivity enhancement by miR-181b.

CONCLUSIONS

MiR-181b is an important positive regulator on glioma cell sensitivity to teniposide. It confers glioma cell sensitivity to teniposide through binding to the 3'-UTR region of MDM2 leading to its reduced expression. Our findings not only reveal the novel mechanism involved in teniposide resistance, but also shed light on the optimization of glioma treatment in the future.

First Report of Rust of Plumeria rubra Caused by Coleosporium plumeriae in Guangdong Province, China

Plumeria spp. are ornamental trees commonly planted in parks and gardens, and Plumeria rubra cultivars (Frangipani) is most common in Guangdong Province, China. A rust disease of P. rubra was observed on leaves of susceptible plants from August to December 2013. Ten nurseries were surveyed in September 2013, and 91% (220 of 240) of the plumeria plants were infected with rust. Symptoms first appeared as chlorotic spots (about 1 mm in diameter) appearing on adaxial leaf surfaces and then spread to whole leaf, and infection further resulted in leaf necrosis and abscission. Therefore, the ornamental value of diseased trees was greatly diminished. Bright yellow or yellow-orange uredinia were hypophyllous and produced under the epidermis. Urediniospores were catenulate, globose, ovoid or ellipsoid, and sometimes angular in appearance, ranging from 20.0 to 42.0 μm in length by 14.1 to 25.6 μm in width. Their walls were verrucose and 1.3 to 3.2 μm thick. No teliospores were observed. The rust was identified as Coleosporium plumeriae Pat. based on urediniospore morphology (2). Species identity was confirmed with a 1,551-bp sequence (GenBank Accession No. KF879087) of ITS rDNA amplified with rust-specific primers Rust2inv and LR6 (1). The amplicon had a 100% similarity to C. plumeriae (GU145555). Pathogenicity was confirmed by spraying a urediniospores suspension (15,000 spores ml^-1) on five plants of P. rubra cultivar. Five leaves of each plant were inoculated and sealed in plastic bags, while five control plants were applied with sterile water. Plants were held at 28°C for 36 h in a dew chamber. All inoculated leaves developed typical rust symptoms with the uredinia appearing after 9 days, no symptoms developed on any control plants. Urediniospores were produced on infected leaves and pathogen identity was confirmed by morphology and re-sequencing of the ITS rDNA. Plumeria rust was first found in Hong Kong (4) and then in Hainan and Yunnan Provinces, China (3). However, this is the first report of plumeria rust in Guangdong Province, China. Frangipani has large, colorful flowers in the summer, and this rapidly spreading disease causes severe damage and affects their aesthetic value in the second half of the year. References: (1) M. C. Aime. Mycoscience 47:112, 2006. (2) N. Patouillard. Bull. Soc. Mycol. Fr. 18:171, 1902. (3) Q. Wang et al. New Dis. Rep. 23, doi:10.5197/j.2044-0588.2011.023.010, 2011. (4) J. Yan et al. Mycosystema 25:327, 2006 (in Chinese).

Automation of immune repertoire amplification on the iC-Processor (TECH1P.851)

Immune repertoire amplification of T and B cell receptors coupled to Next Generation Sequencing (NGS) provides detailed sequence-level insight into the immune system. Previously, we developed a patented, nested multiplex PCR method (arm-PCR) to amplify an immune repertoire, inclusively and semi-quantitatively. Here, we describe the automation of this process in cassette format on the iC-system (iCubate, Inc.) and compare the sequencing results from repeat amplification experiments of the TCRβ and human Ig heavy chains from the same individual. The iC-system is an open, nested multiplex PCR diagnostic development platform, which allows for the development of automated diagnostic panels in a closed cassette format. In addition to the automation, the closed format helps to reduce contamination of the laboratory environment with multiplex primers. Template RNA is added to the cassette at the appropriate concentration with RT enzyme. After two sets of PCR, residual primer-dimers are removed by magnetic selection of the primary product in the cassette. The cassette is then removed from the iC-Processor, and the amplified library is eluted from the magnetic beads. The amplified immune library is directly ready for pooling, QC, and sequencing using the Illumina MiSeq NGS platform. Repeat amplification experiments from the same individual using this automated approach demonstrated high repeatability among shared CDR3 sequences for both the TCRβ and Ig heavy chains.

Breast cancer diagnosis by high throughput sequencing of T cell receptors from peripheral blood samples (TUM2P.905)

T cells play vital roles in the identification and elimination of transformed cells. It might be possible to diagnose cancer by reading imprints on the immune system made by cancer cells. High-throughput immune repertoire sequencing allows the depiction of T cell repertoire details at a nucleotide resolution and enables us to search for cancer-specific biomarkers. RNA was isolated from whole blood in breast cancer and matched controls and the CDR3 region of the TCR beta chain amplified and sequenced by Illumina next-generation sequencing platform. Initial studies showed around 200 breast cancer-specific CDR3 sequences. Two thirds of those CDR3 sequences show a pattern of convergent evolution, i.e., the same CDR3 peptide sequence is coded by different sequences. To leverage those disease-specific CDR3’s for diagnostics, we developed a novel metric called immune repertoire sharing index (SI) to measure the similarity between a repertoire and the disease library. With SI, we were able to predict breast cancer cases with both the sensitivity and the specificity around 90%. The diagnostics process requires only 10ml peripheral blood. We hypothesized that the immune repertoire sequencing and sharing index method could be generalized to other diseases. An ‘ultimate diagnostics’ may be emerged where taking one sample, with one procedure; hundreds of diseases can be diagnosed by evaluating immune repertoires.

Biomarker: long term study of breast cancer specific CDR3s in peripheral blood (TUM2P.894)

We have identified a group of T cell receptors, represented by their unique CDR3 sequences, that are closely associated with breast cancer. Multiplex PCR was used to amplify the T cell receptor beta (TCRβ) inclusively and semi-quantitatively; the amplicons were sequenced with the Illumina HiSeq platform. Here, we report a longitudinal study where one patient’s peripheral blood samples were evaluated for repertoire changes before and after the treatment. At regular intervals over four years, we collected five peripheral blood samples from the patient. The blood samples were sorted into Tc, Tr, Th, and NKT cell subsets, and the TCRβ genes were amplified and sequenced. We have also sequenced the TCRβ from the patient’s surgically removed breast cancer tissue. We have identified two kinds of biomarkers for breast cancer: public and private biomarkers. The public biomarkers are those CDR3s that are shared with other patients who were also diagnosed with breast cancer; the private biomarkers are expressed exclusively within a particular patient and are also found in the disease tissue. The study has shown that a group of CDR3s can be used as breast cancer-specific biomarkers because they are tightly associated with breast cancer patients, and their expression level can be quantitatively measured from peripheral blood. The discovery of this new class of cancer specific biomarkers will facilitate the development of new drugs and also improve the utility of existing therapies.

Congenital sucrase-isomaltase deficiency: an under-diagnosed disease in Chinese children

Background

Congenital sucrase-isomaltase deficiency (CSID) is a rare genetic disorder. The prevalence of CSID in Chinese population is unknown and no single case has been reported.

Methods

Sucrose tolerance tests were performed in three children suspected of CSID. Glucose tolerance tests were performed to exclude glucose malabsorption. Blood glucose was measured at fasting and at 30 min, 60 min, 120 min, and 180 min of the study. Gastrointestinal symptoms were recorded up to 4 hours after the study.

Results

From December 2008 to June 2011, three children, ranging from 16 to 19 months old, were referred to our tertiary children’s hospital due to chronic watery diarrhea and failure to thrive. Laboratory investigations including complete blood counts, ESR, CRP, and serum immunoglobulins were normal. Routine stool culture for bacteria and exam for parasites were negative. Upper endoscopy, colonoscopy and histology were unremarkable. All children failed lactose-free and amino acid-based formulas. All three children had flat sucrose tolerance tests and began to have watery stool 2–4 hours after feeding sucrose test solution. The glucose tolerance tests were normal and no children developed watery stools up to 4 hours after feeding glucose test solution.

Conclusions

This is the first case series of CSID in Chinese children. The diagnosis of CSID can be made based on clinical suspicion and sucrose tolerance test. CSID is probably an under-diagnosed or misdiagnosed disease in Chinese children and should be considered in children with chronic watery diarrhea.

Elevated serum uric acid levels are independent risk factors for diabetic foot ulcer in female Chinese patients with type 2 diabetes

BACKGROUND

To investigate the relationship between elevated serum uric acid levels and the presence of diabetic foot ulcer (DFU) in Chinese patients with type 2 diabetes (T2D).

METHODS

A retrospective study was performed on 829 outpatients with T2D (478 men, 351 women) who visited the Diabetes Clinic (Nanfang Hospital, Southern Medical University) from January 2007 to December 2009. Information regarding their clinical history, anthropometric measurements, and laboratory data were collected. Potential confounding variables with P < 0.10 were adjusted for in multivariate logistic regression analysis.

RESULTS

In univariate analyses, there was a significant difference in serum uric acid levels between female patients with and without DFU (370 ± 128 vs. 313 ± 107 μmol/L, respectively; P < 0.05), but not between male patients with and without DFU (317 ± 100 vs. 348 ± 111 μmol/L, respectively; P = 0.643). The prevalence of DFU among quintiles of uric acid levels (from 1-20% to 80-100%) was 5.3%, 3.9%, 7.7%, 5.5%, and 16.7%, respectively. Using uric acid level as a continuous variable, the multivariate-adjusted odds ratio for diabetic foot ulcer in female patients was 1.004 (95% confidence interval 1.001-1.008; P < 0.05).

CONCLUSIONS

Elevated uric acid levels are a significant and independent risk factor for diabetic foot ulcer in female Chinese patients with T2D. Whether serum uric acid is involved in the pathogenesis of DFU in female patients remains to be investigated.