Oncolytic immunotherapy: multiple mechanisms of oncolytic peptides to confer anticancer immunity

Oncolytic peptides are highly effective on remodeling the tumor microenvironment and potentiating the anticancer immunity through multiple mechanisms, particularly by inducing immunogenic cell death. Intriguingly, a recent study demonstrates that LTX-315, one of the most promising and extensively studied oncolytic peptides, inhibits PD-L1 expression via ATP11B, thus enhancing the effectiveness of cancer immunotherapy by targeting the PD-1/PD-L1 axis. Therefore, this commentary discusses the broad effects and perspectives of oncolytic peptides on anticancer immunity, further highlighting the potential issues and directions of oncolytic peptides in cancer immunotherapy.

Evidence of a Near-Threshold Resonance in ^{11}B Relevant to the β-Delayed Proton Emission of ^{11}Be

A narrow near-threshold proton-emitting resonance (E_{x}=11.4  MeV, J^{π}=1/2^{+}, and Γ_{p}=4.4  keV) was directly observed in ^{11}B via proton resonance scattering. This resonance was previously inferred in the β-delayed proton emission of the neutron halo nucleus ^{11}Be. The good agreement between both experimental results serves as a ground to confirm the existence of such exotic decay and the particular behavior of weakly bound nuclei coupled to the continuum. R-matrix analysis shows a sizable partial decay width for both, proton and α (Γ_{α}=11  keV) emission channels.

Behavioral Health Professionals' Perceptions on Patient-Controlled Granular Information Sharing (Part 2): Focus Group Study

BACKGROUND

Patient-directed selection and sharing of health information "granules" is known as granular information sharing. In a previous study, patients with behavioral health conditions categorized their own health information into sensitive categories (eg, mental health) and chose the health professionals (eg, pharmacists) who should have access to those records. Little is known about behavioral health professionals' perspectives of patient-controlled granular information sharing (PC-GIS).

OBJECTIVE

This study aimed to assess behavioral health professionals' (1) understanding of and opinions about PC-GIS; (2) accuracy in assessing redacted medical information; (3) reactions to patient rationale for health data categorization, assignment of sensitivity, and sharing choices; and (4) recommendations to improve PC-GIS.

METHODS

Four 2-hour focus groups and pre- and postsurveys were conducted at 2 facilities. During the focus groups, outcomes from a previous study on patients' choices for medical record sharing were discussed. Thematic analysis was applied to focus group transcripts to address study objectives.

RESULTS

A total of 28 health professionals were recruited. Over half (14/25, 56%) were unaware or provided incorrect definitions of granular information sharing. After PC-GIS was explained, all professionals demonstrated understanding of the terminology and process. Most (26/32 codes, 81%) recognized that key medical data had been redacted from the study case. A majority (41/62 codes, 66%) found the patient rationale for categorization and data sharing choices to be unclear. Finally, education and other approaches to inform and engage patients in granular information sharing were recommended.

CONCLUSIONS

This study provides detailed insights from behavioral health professionals on granular information sharing. Outcomes will inform the development, deployment, and evaluation of an electronic consent tool for granular health data sharing.

Behavioral Health Professionals' Perceptions on Patient-Controlled Granular Information Sharing (Part 1): Focus Group Study

BACKGROUND

Patient-controlled granular information sharing (PC-GIS) allows a patient to select specific health information "granules," such as diagnoses and medications; choose with whom the information is shared; and decide how the information can be used. Previous studies suggest that health professionals have mixed or concerned opinions about the process and impact of PC-GIS for care and research. Further understanding of behavioral health professionals' views on PC-GIS are needed for successful implementation and use of this technology.

OBJECTIVE

The aim of this study was to evaluate changes in health professionals' opinions on PC-GIS before and after a demonstrative case study.

METHODS

Four focus groups were conducted at two integrated health care facilities: one serious mental illness facility and one general behavioral health facility. A total of 28 participants were given access to outcomes of a previous study where patients had control over medical record sharing. Participants were surveyed before and after focus groups on their views about PC-GIS. Thematic analysis of focus group output was paired with descriptive statistics and exploratory factor analysis of surveys.

RESULTS

Behavioral health professionals showed a significant opinion shift toward concern after the focus group intervention, specifically on the topics of patient understanding (P=.001), authorized electronic health record access (P=.03), patient-professional relationship (P=.006), patient control acceptance (P<.001), and patient rights (P=.02). Qualitative methodology supported these results. The themes of professional considerations (2234/4025, 55.5% of codes) and necessity of health information (260/766, 33.9%) identified key aspects of PC-GIS concerns.

CONCLUSIONS

Behavioral health professionals agreed that a trusting patient-professional relationship is integral to the optimal implementation of PC-GIS, but were concerned about the potential negative impacts of PC-GIS on patient safety and quality of care.

Oncolytic peptide LTX-315 induces anti-pancreatic cancer immunity by targeting the ATP11B-PD-L1 axis

Background

LTX-315 is an oncolytic peptide deriving from bovine lactoferrin, with the ability to induce cancer immunogenic cell death. However, the mechanism used by LTX-315 to trigger the antitumor immune response is still poorly understood. The expression of programmed cell death ligand 1 (PD-L1) largely determines the efficacy and effectiveness of cancer immunotherapies targeting this specific immune checkpoint. This study aimed to demonstrate the potential effect and mechanism of LTX-315 in PD-L1 inhibition-induced anti-pancreatic cancer immunity.

Methods

Both immunodeficient and immunocompetent mouse models were used to evaluate the therapeutic efficacy of monotherapy and combination therapy. Flow cytometry and immunohistochemistry were used to assess the immune microenvironment. Multiomic analysis was used to identify the potential target and down-streaming signaling pathway. Both in-house tissue microarray and open accessed The Cancer Genome Atlas data sets were used to evaluate the clinical relevance in pancreatic cancer prognosis.

Results

LTX-315 treatment inhibited PD-L1 expression and enhanced lymphocyte infiltration in pancreatic tumors. ATP11B was identified as a potential target of LTX-315 and a critical regulator in maintaining PD-L1 expression in pancreatic cancer cells. As regards the mechanism, ATP11B interacted with PD-L1 in a CKLF-like MARVEL transmembrane domain containing 6 (CMTM6)-dependent manner. The depletion of ATP11B promoted CMTM6-mediated lysosomal degradation of PD-L1, thus reactivating the immune microenvironment and inducing an antitumor immune response. The significant correlation among ATP11B, CMTM6, and PD-L1 was confirmed in clinical samples of pancreatic cancer.

Conclusions

LTX-315 was first identified as a peptide drug inducing PD-L1 downregulation via ATP11B. Therefore, LTX-315, or the development of ATP11B-targeting drugs, might improve the efficacy of cancer immunotherapy.

An imaging-based artificial intelligence model for non-invasive grading of hepatic venous pressure gradient in cirrhotic portal hypertension

The hepatic venous pressure gradient (HVPG) is the gold standard for cirrhotic portal hypertension (PHT), but it is invasive and specialized. Alternative non-invasive techniques are needed to assess the hepatic venous pressure gradient (HVPG). Here, we develop an auto-machine-learning CT radiomics HVPG quantitative model (aHVPG), and then we validate the model in internal and external test datasets by the area under the receiver operating characteristic curves (AUCs) for HVPG stages (≥10, ≥12, ≥16, and ≥20 mm Hg) and compare the model with imaging- and serum-based tools. The final aHVPG model achieves AUCs over 0.80 and outperforms other non-invasive tools for assessing HVPG. The model shows performance improvement in identifying the severity of PHT, which may help non-invasive HVPG primary prophylaxis when transjugular HVPG measurements are not available.

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aHVPG is an automated HVPG quantitative estimation model based on CT

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aHVPG has the potential to assess HVPG and outperforms other non-invasive tools

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Non-invasive tools may help PHT monitoring when invasive HVPG is not available

Development of an atmospheric plasma jet device for versatile treatment of electron microscope sample grids

Atmospheric-pressure plasmas have been widely applied for surface modification and biomedical treatment because of their ability to generate highly reactive radicals and charged particles. In negative-stain electron microscopy (Neg-EM) and cryogenic electron microscopy (cryo-EM), plasmas have been used to generate hydrophilic surfaces and eliminate surface contaminants to embed specimens onto grids. In addition, plasma treatment is a prerequisite for negative-stain and Quantifoil grids, whose surfaces are coated with hydrophobic amorphous carbon. Although the conventional glow discharge system has been used successfully in this purpose, there has been no further effort to take an advantage from the recent progress in the plasma field. Here, we developed a nonthermal atmospheric plasma jet system as an alternative tool for treatment of surfaces. The low-temperature plasma is a nonequilibrium system that has been widely used in biomedical area. Unlike conventional glow discharge systems, the plasma jet system successfully cleans and introduces hydrophilicity on the grid surface in the ambient environment without a vacuum. Therefore, we anticipate that the plasma jet system will have numerous benefits, such as convenience and versatility, as well as having potential applications in surface modification for both negative-stain and cryo-EM grid treatment.

ISP-Net: Fusing features to predict ischemic stroke infarct core on CT perfusion maps

BACKGROUND

Acute ischemic stroke is one of the leading death causes. Delineating stoke infarct core in medical images plays a critical role in optimal stroke treatment selection. However, accurate estimation of infarct core still remains challenging because of 1) the large shape and location variation of infarct cores; 2) the complex relationships between perfusion parameters and final tissue outcome.

METHODS

We develop an encoder-decoder based semantic model, i.e., Ischemic Stroke Prediction Network (ISP-Net), to predict infarct core after thrombolysis treatment on CT perfusion (CTP) maps. Features of native CTP, CBF (Cerebral Blood Flow), CBV (Cerebral Blood Volume), MTT (Mean Transit Time), Tmax are generated and fused with five-path convolutions for comprehensive analysis. A multi-scale atrous convolution (MSAC) block is firstly put forward as the enriched high-level feature extractor in ISP-Net to improve prediction accuracy. A retrospective dataset which is collected from multiple stroke centers is used to evaluate the performance of ISP-Net. The gold standard infarct cores are delineated on the follow-up scans, i.e., non-contrast CT (NCCT) or MRI diffusion-weighted image (DWI).

RESULTS

In clinical dataset cross-validation, we achieve mean Dice Similarity Coefficient (DSC) of 0.801, precision of 81.3%, sensitivity of 79.5%, specificity of 99.5%, Area Under Curve (AUC) of 0.721. Our approach yields better outcomes than several advanced deep learning methods, i.e., Deeplab V3, U-Net++, CE-Net, X-Net and Non-local U-Net, demonstrating the promising performance in infarct core prediction. No significant difference of the prediction error is shown for the patients with follow-up NCCT and follow-up DWI (P >0.05).

CONCLUSION

This study provides an approach for fast and accurate stroke infarct core estimation. We anticipate the prediction results of ISP-Net could offer assistance to the physicians in the thrombolysis or thrombectomy therapy selection.

Heritability of abnormalities in limbic networks of autism spectrum disorder children: Evidence from an autism spectrum disorder twin study

Although the limbic system is closely related to emotion and social behaviors, little is known about the integrity of limbic pathways and how genetics influence the anatomical abnormalities of limbic networks in children with autism spectrum disorder (ASD). Therefore, we used an ASD twin study design to evaluate the microstructural integrity and autism-related differences in limbic pathways of young children with ASD and to estimate the heritability of limbic tracts microstructure variance. We obtained diffusion tensor imaging scans from 33 pairs of twins with ASD aged 2-9 years and 20 age-matched typically developing children. The ACE model was used to estimate the relative effects of additive genetic factors (A), shared environmental factors (C) and specific environmental factors (E) on the variability of diffusivity measurements. We found a significant decrease in fractional anisotropy (FA) in the bilateral fornix and uncinate fasciculus (UF), as well as increased mean diffusivity (MD) and radial diffusivity (RD) in the bilateral fornix and right UF of ASD children. Correlation analysis showed that FA, MD, and lateralization indices of UF were correlated with autism diagnostic observation schedule scores. The ACE model revealed that genetic effects may drive some of the variability of microstructure in the bilateral fornix, cingulum, and left UF. In conclusion, in children with ASD, there are abnormalities in the white matter microstructure of the limbic system, which is related to the core symptoms; these abnormalities may be related to the relative contribution of genetic and environmental effects on specific tracts. LAY SUMMARY: Autism spectrum disorder (ASD) children have abnormal white matter structure in limbic system related to ASD symptoms, and genetic factors play an important role in the development of limbic tracts.

One shoot, three birds: Targeting NEK2 orchestrates chemoradiotherapy, targeted therapy, and immunotherapy in cancer treatment

Combinational therapy has improved the cancer therapeutic landscape but is associated with a concomitant increase in adverse side reactions. Emerging evidence proposes that targeting one core target with multiple critical roles in tumors can achieve combined anti-tumor effects. This review focuses on NEK2, a member of serine/threonine kinases, with broad sequence identity to the mitotic regulator NIMA of the filamentous fungus Aspergillus nidulans. Elevated expression of NEK2 was initially found to promote tumorigeneses through abnormal regulation of the cell cycle. Subsequent studies report that NEK2 is overexpressed in a broad spectrum of tumor types and is associated with tumor progression and therapeutic resistance. Intriguingly, NEK2 has recently been revealed to mediate tumor immune escape by stabilizing the expression of PD-L1. Targeting NEK2 is thus becoming a promising approach for cancer treatment by orchestrating chemoradiotherapy, targeted therapy, and immunotherapy. It represents a novel strategy for inducing combined anti-cancer effects using a mono-agent.

Risk stratification of lung adenocarcinoma using a nomogram combined with ferroptosis-related LncRNAs and subgroup analysis with immune and N6-methyladenosine modification

Background

Determining the prognosis of lung adenocarcinoma (LUAD) is challenging. The present study aimed to identify prognostic ferroptosis-related long noncoding RNAs (FRLs) and construct a prognostic model. Moreover, differential analysis of immune and N6-methyladenosine (m6A)-related genes was systematically conducted.

Methods

A total of 504 patients selected from a dataset from The Cancer Genome Atlas were included. The patients with LUAD were randomly divided into a training group and a test group at a ratio of 1:1. Pearson correlation analysis and univariate Cox regression analysis were used to identify the prognostic FRLs. Then, a prognostic model was constructed from the optimized subset of prognostic FRLs based on the least absolute shrinkage and selection operator (LASSO) algorithm. Subsequently, the receiver operating characteristic (ROC) curve and survival analysis were used to evaluate the performance of the model. The risk score based on the prognostic model was analyzed using Cox regression analysis. Moreover, gene set enrichment analysis and differential analysis of immune- and m6A-related genes were conducted.

Results

After univariate Cox regression analysis and LASSO algorithm analysis, a total of 19 prognostic FRLs were selected to construct the final model to obtain the risk score. The area under the ROC curve of the prognostic model for 1-year, 3-year, and 5-year overall survival (OS) was 0.763, 0.745, and 0.778 in the training set and 0.716, 0.724, and 0.736 in the validation set, respectively. Moreover, the OS of the high-risk group was significantly worse than that of the low-risk group in the training group (P < 0.001) and in the test group (P < 0.001). After univariate and multivariate Cox regression analysis, the risk score [hazard ratio (HR) = 1.734; P < 0.001] and stage (HR = 1.557; P < 0.001) were both considered significant prognostic factors for LUAD. A nomogram was constructed based on clinical features and risk score. The expression of 34 checkpoint genes and 13 m6A-related genes varied significantly between the two risk groups.

Conclusion

This study constructed a prognostic model to effectively predict the OS of patients with LUAD, and these OS-related FRLs might serve as potential therapeutic targets of LUAD.

Noncontrast-enhanced MRI-based Noninvasive Score for Portal Hypertension (CHESS1802): An International Multicenter Study

BACKGROUND AND AIMS

This study aimed to determine the performance of the non-invasive score using noncontrast-enhanced MRI (CHESS-DIS score) for detecting portal hypertension in cirrhosis.

METHODS

In this international multicenter, diagnostic study (ClinicalTrials.gov, NCT03766880), patients with cirrhosis who had hepatic venous pressure gradient (HVPG) measurement and noncontrast-enhanced MRI were prospectively recruited from four university hospitals in China (n=4) and Turkey (n=1) between December 2018 and April 2019. A cohort of patients was retrospectively recruited from a university hospital in Italy between March 2015 and November 2017. After segmentation of the liver on fat-suppressed T1-weighted MRI maps, CHESS-DIS score was calculated automatically by an in-house developed code based on the quantification of liver surface nodularity.

RESULTS

A total of 149 patients were included, of which 124 were from four Chinese hospitals (training cohort) and 25 were from two international hospitals (validation cohort). A positive correlation between CHESS-DIS score and HVPG was found with the correlation coefficients of 0.36 (p<0.0001) and 0.55 (p<0.01) for the training and validation cohorts, respectively. The area under the receiver operating characteristic curve of CHESS-DIS score in detection of clinically significant portal hypertension (CSPH) was 0.81 and 0.9 in the training and validation cohorts, respectively. The intraclass correlation coefficients for assessing the inter- and intra-observer agreement were 0.846 and 0.841, respectively.

CONCLUSIONS

A non-invasive score using noncontrast-enhanced MRI was developed and proved to be significantly correlated with invasive HVPG. Besides, this score could be used to detect CSPH in patients with cirrhosis.

Enhancing capacity and transport kinetics of C@TiO2core-shell composite anode by phase interface engineering

In nanocomposite electrodes, besides the synergistic effect that takes advantage of the merits of each component, phase interfaces between the components would contribute significantly to the overall electrochemical properties. However, the knowledge of such effects is far from being well developed up to now. The present work aims at a mechanistic understanding of the phase interface effect in C@TiO₂core-shell nanocomposite anode which is both scientifically and industrially important. Firstly, amorphous C, anatase TiO₂and C@anatse-TiO₂electrodes are compared. The C@anatase-TiO₂shows an obvious higher specific capacity (316.5 mAh g^-1at a current density of 37 mA g^-1after 100 cycles) and Li-ion diffusion coefficient (4.0 × 10^-14cm²s^-1) than the amorphous C (178 mAh g^-1and 2.9 × 10^-15cm²s^-1) and anatase TiO₂(120 mAh g^-1and 1.6 × 10^-15cm²s^-1) owing to the C/TiO₂phase interface effect. Then, C@anatase/rutile-TiO₂is obtained by a heat treatment of the C@anatase-TiO₂. Due to an anatase-to-rutile phase transformation and diffusion of C along the anatase/rutile phase interface, additional abundant C/TiO₂phase interfaces are created. This endows the C@anatase/rutile-TiO₂with further boosted specific capacity (409.4 mAh g^-1at 37 mA g^-1after 100 cycles) and Li-ion diffusion coefficient (3.2 × 10^-13cm²s^-1), and excellent rate capability (368.6 mAh g^-1at 444 mA g^-1). These greatly enhanced electrochemical properties explicitly reveal phase interface engineering as a feasible way to boost the electrochemical performance of nanocomposite anodes for Li-ion batteries.

Association between isolated diastolic hypertension and cardiovascular events: a systematic review and meta-analysis of prospective cohorts

Background

Isolated diastolic hypertension (IDH) is a subtype of hypertension, which is defined as systolic blood pressure (SBP) &lt;140 mmHg and diastolic blood pressure (DBP) ≥90 mmHg by 2018 European Society of Cardiology (ESC) guideline and 2019 National Institute for Health and Care Excellent (NICE). Whereas some previous studies have demonstrated the significant association between IDH and cardiovascular (CV) events, some have not.

Purpose

To assess the association between IDH and the risk of CV events, CV mortality, and all-cause mortality.

Methods

We conducted a systematic search for publications using Medline, Embase, and the Cochrane Library from inception through March 2021 for prospective cohort studies exploring the association between IDH and CV events, CV mortality, and all-cause mortality. Relative risks (RR) or hazard ratios were extracted from the selected studies. Random effect models with inverse variance weighting were used to calculate the pooled RR and 95% confidence interval (CI). The primary outcome was a composite of total CV events including CV mortality. The secondary outcomes were CV mortality and all-cause mortality. We defined the IDH as SBP &lt;140 mmHg and DBP ≥90 mmHg, reference group as BP less than 140/90mmHg.

Results

Overall, 15 studies were identified including 1049587 participants (5.5% IDH). For the primary outcome, IDH was significantly associated with risk of CV events (RR, 1.40 [95% CI, 1.18–1.66], p&lt;0.001). The increased risk of CV events was also observed in subgroup analyses based on age (less or more than 50) and sex. However, in further stratified analysis based on geographical region, only the Asia population showed a significant association with increased risk of CV events, whereas results were null in Europe and North America populations. For the secondary outcomes, IDH was significantly associated with increased CV mortality (RR [95% CI], 1.41 [1.12–1.78], p&lt;0.001) but not with all-cause mortality (RR [95% CI], 1.13 [0.86–1.48], p=0.378). The sensitivity analysis showed the overall results did not vary significantly after exclusion of any one study.

Conclusions

IDH is associated with increased risk of CV events and CV mortality. Further, more large-scale prospective epidemiological cohorts are needed to confirm our conclusion.

Funding Acknowledgement

Type of funding sources: None. Primary outcomeSecondary outcomes

Multimode Operation of Organic-Inorganic Hybrid Thin-Film Transistors Based on Solution-Processed Indium Oxide Films

Solution-processed metal oxide (MO) thin films have been extensively studied for use in thin-film transistors (TFTs) due to their high optical transparency, simplicity of fabrication methods, and high electron mobility. Here, we report, for the first time, the improvement of the electronic properties of solution-processed indium oxide (InO_x) films by the subsequent addition of an organic p-type semiconductor material, here 6,13-bis(triisopropylsilylethynyl)pentacene (TIPS-pentacene), yielding organic-inorganic hybrid TFTs. The addition of TIPS-pentacene not only improves the electron mobility by enhancing the charge carrier percolation pathways but also improves the electronic and temporal stability of the I_DS(V_G) characteristics as well as reduces the number of required spin-coating steps of the InO_x precursor solution. Very interestingly, the introduction of 10 nm TIPS-pentacene films on top of 15 nm InO_x layers allows the fabrication of either enhancement- or depletion-mode devices with only minimal changes to the fabrication process. Specifically, we find that when the TIPS-pentacene layer is added on top of the source/drain electrodes, resulting in devices with embedded source/drain electrodes [embedded electrode TFTs (EETFTs)], the devices exhibit an enhancement-mode behavior with an average mobility (μ) of 6.4 cm² V^-1 s^-1, a source-drain current ratio (I_on/I_off) of around 10⁵, and a near-zero threshold voltage (V_TH). When on the other hand the TIPS-pentacene layer is added before the source-drain electrodes, i.e., in top-contact electrode TFTs (TCETFTs), a very clear depletion mode behavior is observed with an average μ of 6.3 cm² V^-1 s^-1, an I_on/I_off ratio of over 10⁵, and a V_TH of -80.3 V. Furthermore, a logic inverter is fabricated combining the enhancement (EETFTs)- and depletion (TCETFTs)-mode transistors, which shows a potential for the construction of organic-inorganic hybrid electronics and circuits.

Effects of miR-195 on diabetic nephropathy rats through targeting TLR4 and blocking NF-κB pathway

OBJECTIVE

The aim of this study was to explore the effects of micro ribonucleic acid (miR)-195 on diabetic nephropathy (DN) rats through targeting Toll-like receptor 4 (TLR4) and inhibiting the nuclear factor-κB (NF-κB) signaling pathway.

MATERIALS AND METHODS

The model of DN was first successfully established in rats. All rats were randomly divided into six groups, including control group (n=20), model group (n=20), 25 nM miR-195 mimics group (25 nM M group, n=20), 50 nM M group (n=20), 25 nM miR-195 inhibitor group (25 nM I group, n=20), and 50 nM I group (n=20). Urine volume, proteins and inflammatory factors were detected in each group, respectively. Subsequently, macrophages were cultured and transfected in vitro. The mRNA expressions of miR-195 and TLR4 in control group and model groups were determined using fluorescence quantitative polymerase chain reaction (qPCR). The protein expressions of TLR4 and NF-κB in macrophages were determined using Western blotting. Furthermore, the proliferation of macrophages was detected via cell counting kit-8 (CCK-8) assay.

RESULTS

Compared with model group, 24-h urine volume, urine protein, creatinine, urea nitrogen, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-6 levels declined significantly in 25 nM M group and 50 nM M group (p<0.05). However, they increased significantly in 25 nM I group and 50 nM I group (p<0.05). It could be suggested that miR-195 mimics might relieve the symptoms of DN rats. In kidney tissues in DN, miR-195 was lowly expressed, whereas TLR4 was highly expressed (p<0.01). This suggested that there was a negative correlation between the mRNA expressions of miR-195 and TLR4 (r2=0.4836, p=0.0007). After overexpression of miR-195, the protein expression of TLR4 was significantly reduced (p<0.01), indicating that miR-195 could negatively regulate the protein expression of TLR4. Besides, the protein expressions of TLR4 and NF-κB in si-TLR4 group were evidently lower than those in NC group (p<0.01). Meanwhile, they also had significant differences in si-TLR4 group compared with si-TLR4 + miR-195 inhibitor group (p<0.05). The above results demonstrated that the protein expressions of TLR4 and NF-κB in macrophages could be markedly inhibited by si-TLR4, but be promoted by si-TLR4 + miR-195 inhibitor. CCK-8 assay demonstrated that the proliferation ability of macrophages was remarkably weaker in miR-195 mimics group than NC group (p<0.001). Furthermore, it was also significantly weaker in si-TLR4 + miR-195 inhibitor group than si-TLR4 group (p<0.05).

CONCLUSIONS

MiR-195 reduces the release of inflammatory factors and inhibits the proliferation of macrophages through targeting TLR4 and blocking the NF-κB pathway, thereby alleviating the symptoms of DN rats.

Joint prediction of solitary pulmonary module malignant probability based on logistic regression and malignant tendency comprehensive score

PURPOSE

We analyzed the relationship between clinical data, tumor markers, chest high-resolution CT(HRCT) and pathology in patients with solitary pulmonary nodules (SPN) and explored the joint discrimination scheme to improve the accuracy of noninvasive diagnosis.

METHODS

242 SPNs with the largest diameter D<2cmwere divided into training set (161 cases) and test set (81 cases). We screened the risk factors by single factor analysis. Then, we established the prediction equation model (PE model) based on logistic regression and malignant tendency comprehensive score model (MTCS model) based on the evaluation criteria of SPN. The weight of the two sub models was used to determine the joint evaluation model (JE model).

RESULTS

Age, CEA content, maximum diameter, pleural adhesions, spicule sign, and ground glass component were independent factors of malignant prediction (p<0.05) recorded as x1~x6, and PE model was established as P1=ex/(1+ex),x=0.052x1+0.0327x2+0.212x3+1.849x4+ 1.066x5+1.769x6-7.582.According to the different performance of different manifestations of the corresponding score, we could get each score S of SPN. The MTCS model was S/8.5. The JE model was P=0.76P1+0.24S/8.5. The results of test set showed the AUC values of JE, PE, MTCS, Mayo, VA and Li Yun model for D≤2cm SPN were 0.930(95% CI:0.877-0.983), 0.922(95% CI:0.870-0.974), 0.900(95% CI:0.879-0.921), 0.782(95% CI:0.749-0.815), 0.744(95% CI:0.731-0.756) and 0.801(95% CI:0.739-0.863). The sensitivity of JE, PE, MTCS model were 87.2%, 79.2%, 73.3%, the specificity was 90.1%, 89.2%, 82.2%, and the accuracy was 89.9%, 85.5%, 81.2%.

CONCLUSIONS

The joint evaluation model has better diagnostic efficiency and can provide reference for the diagnosis of SPN with D≤2cm.

NEK2 inhibition triggers anti-pancreatic cancer immunity by targeting PD-L1

Despite the substantial impact of post-translational modifications on programmed cell death 1 ligand 1 (PD-L1), its importance in therapeutic resistance in pancreatic cancer remains poorly defined. Here, we demonstrate that never in mitosis gene A-related kinase 2 (NEK2) phosphorylates PD-L1 to maintain its stability, causing PD-L1-targeted pancreatic cancer immunotherapy to have poor efficacy. We identify NEK2 as a prognostic factor in immunologically "hot" pancreatic cancer, involved in the onset and development of pancreatic tumors in an immune-dependent manner. NEK2 deficiency results in the suppression of PD-L1 expression and enhancement of lymphocyte infiltration. A NEK binding motif (F/LXXS/T) is identified in the glycosylation-rich region of PD-L1. NEK2 interacts with PD-L1, phosphorylating the T194/T210 residues and preventing ubiquitin-proteasome pathway-mediated degradation of PD-L1 in ER lumen. NEK2 inhibition thereby sensitizes PD-L1 blockade, synergically enhancing the anti-pancreatic cancer immune response. Together, the present study proposes a promising strategy for improving the effectiveness of pancreatic cancer immunotherapy.

Automatic Pancreas Segmentation in CT Images With Distance-Based Saliency-Aware DenseASPP Network

Pancreas identification and segmentation is an essential task in the diagnosis and prognosis of pancreas disease. Although deep neural networks have been widely applied in abdominal organ segmentation, it is still challenging for small organs (e.g. pancreas) that present low contrast, highly flexible anatomical structure and relatively small region. In recent years, coarse-to-fine methods have improved pancreas segmentation accuracy by using coarse predictions in the fine stage, but only object location is utilized and rich image context is neglected. In this paper, we propose a novel distance-based saliency-aware model, namely DSD-ASPP-Net, to fully use coarse segmentation to highlight the pancreas feature and boost accuracy in the fine segmentation stage. Specifically, a DenseASPP (Dense Atrous Spatial Pyramid Pooling) model is trained to learn the pancreas location and probability map, which is then transformed into saliency map through geodesic distance-based saliency transformation. In the fine stage, saliency-aware modules that combine saliency map and image context are introduced into DenseASPP to develop the DSD-ASPP-Net. The architecture of DenseASPP brings multi-scale feature representation and achieves larger receptive field in a denser way, which overcome the difficulties brought by variable object sizes and locations. Our method was evaluated on both public NIH pancreas dataset and local hospital dataset, and achieved an average Dice-Sørensen Coefficient (DSC) value of 85.49±4.77% on the NIH dataset, outperforming former coarse-to-fine methods.