[Clinical follow-up analysis of multidisciplinary treatment of children with spinal muscular atrophy]

Objective: To analyze the follow-up and clinical effect of multidisciplinary treatment on the children with spinal muscular atrophy (SMA). Methods: The clinical data including nutritional status, respiratory function, bone health and motor function of 45 children with SMA who received multidisciplinary management 1-year follow-up in the Children's Hospital, Zhejiang University School of Medicine from July 2019 to October 2021 were retrospectively collected. Comparisons before and after management were performed using paired-samples t-test or Wilcoxon rank-sum test, etc. Results: The age of 45 patients (25 boys and 20 girls) was 50.4 (33.6, 84.0) months at the enrollment, with 6 cases of type 1, 22 cases of type 2, and 17 cases of type 3 respectively. After the multidisciplinary management, the cases of SMA patients with malnutrition decreased from 22 to 12 (P=0.030), the level of vitamin D were significantly increased ((45±17) vs. (48±14) nmol/L, t=-4.13, P<0.001). There was no significant difference in the forced vital capacity %pred, the forced expiratory volume at 1 second %pred, and the peak expiratory flow %pred ((76±19)% and (76±21)%, (81±18)% and (79±18)%, (81±21)% and (78±17)%; t=-0.24, 1.36, 1.21; all P>0.05). The Cobbs angle of scoliosis also improved significantly (8.0°(0°, 13.0°) vs. 10.0°(0°, 18.5°), Z=-3.01, P=0.003). The Hammersmith functional motor scale expanded scores of children with SMA type 2 and type 3 both showed significant elevation (11.0 (8.0, 18.0) vs. 11.0 (5.0, 18.5) scores, 44.0 (36.5, 53.0) vs. 44.0 (34.0, 51.5) scores, Z=2.44, 3.11, P=0.015, 0.002). Conclusion: Multidisciplinary management is beneficial for delaying the progression of the multi-system impairments of SMA patients, such as malnutrition, restrictive ventilation dysfunction and scoliosis.

Nomograms based on sonographic and clinicopathological characteristics to predict lateral lymph node metastasis in classic papillary thyroid carcinoma

BACKGROUND

Lateral lymph node metastasis (LLNM) has been considered a risk factor of recurrence in papillary thyroid cancer (PTC). Preoperative detecting LLNM accurately is difficult. Solitary lateral lymph node metastasis is a special type of LLNM. We aimed to develop nomograms for predicting LLNM and multiple lateral lymph node metastasis (MLLNM).

METHODS

We retrospectively retrieved 528 classic PTC patients that underwent surgery between March 2019 and May 2020. Sonographic and clinicopathological features were collected. Risk factors of LLNM and MLLNM were determined by univariate and multivariate analysis. Nomograms for predicting LLNM and MLLNM were developed.

RESULTS

LLNM was independently associated with tumor size, the number of foci, location, margin, central lymph node metastasis, and lymph node ratio. Independent predictors of MLLNM were age, margin, and the number of metastatic lymph nodes in central compartment. By using above variables, we constructed nomograms for predicting LLNM and MLLNM, with area under curves of 0.864 and 0.748, respectively.

CONCLUSION

Through these accurate and easy-to-use nomograms, we can detect the risk of residual LLNM postoperatively for classic PTC patients who did not receive lateral neck dissection and provide an individualized plan for postoperative management of classic PTC patients.

Observation of an a_{0}-like State with Mass of 1.817 GeV in the Study of D_{s}^{+}→K_{S}^{0}K^{+}π^{0} Decays

Using e^{+}e^{-} annihilation data corresponding to an integrated luminosity of 6.32  fb^{-1} collected at center-of-mass energies between 4.178 and 4.226 GeV with the BESIII detector, we perform the first amplitude analysis of the decay D_{s}^{+}→K_{S}^{0}K^{+}π^{0} and determine the relative branching fractions and phases for intermediate processes. We observe an a_{0}-like state with mass of 1.817 GeV in its decay to K_{S}^{0}K^{+} for the first time. In addition, we measure the ratio {B[D_{s}^{+}→K[over ¯]^{*}(892)^{0}K^{+}]/B[D_{s}^{+}→K[over ¯]^{0}K^{*}(892)^{+}]} to be 2.35_{-0.23stat}^{+0.42}±0.10_{syst}. Finally, we provide a precision measurement of the absolute branching fraction B(D_{s}^{+}→K_{S}^{0}K^{+}π^{0})=(1.46±0.06_{stat}±0.05_{syst})%.

Symptom burden, psychological distress, and symptom management status in hospitalized patients with advanced cancer: a multicenter study in China

BACKGROUND

The management of physical symptoms and psychological distress of cancer patients is an important component of cancer care. The purpose of this study was to evaluate the symptom burden, psychological distress, and management status of hospitalized patients with advanced cancer in China and explore the potential influencing factors of undertreatment and non-treatment of symptoms.

PATIENTS AND METHODS

A total of 2930 hospitalized patients with advanced cancer (top six types of cancer in China) were recruited from 10 centers all over China. Patient-reported MD Anderson Symptom Inventory, Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9) scales and symptom management-related information were collected and linked with the patient's clinical data. The proportion of patients reporting moderate-to-severe (MS) symptoms and whether they were currently well managed were examined. Multivariable logistic regression models were applied to explore the factors correlated to undertreatment and non-treatment of symptoms.

RESULTS

About 27% of patients reported over three MS symptoms, 16% reported over five, and 9% reported over seven. Regarding psychological distress, the prevalence of HADS-anxiety was 29% and that of PHQ-9 depression was 11%. Sixty-one percent of patients have at least one MS symptom without any treatment. Sex [odds ratio (OR) = 2.238, 95% confidence interval (95% CI) 1.502-3.336], Eastern Cooperative Oncology Group (ECOG; OR = 0.404, 95% CI 0.241-0.676), and whether currently undergoing anticancer treatment (OR = 0.667, 95% CI 0.503-0.886) are the main factors correlated with the undertreatment of symptoms. Age (OR = 1.972, 95% CI 1.263-3.336), sex (OR = 0.626, 95% CI 0.414-0.948), ECOG (OR = 0.266, 95% CI 0.175-0.403), whether currently undergoing anticancer treatment (OR = 0.356, 95% CI 0.249-0.509), and comorbidity (OR = 0.713, 95% CI 0.526-0.966) are the main factors correlated with the non-treatment of symptoms.

CONCLUSIONS

This study shows that hospitalized patients with advanced cancer had a variety of physical and psychological symptoms but lacked adequate management and suggests that a complete symptom screening and management system is needed to deal with this complex problem.

[Association between the awareness of Nutrition Facts Panel and prepackaged food purchase behavior among residents]

Objective: To explore the association between the cognition of Nutrition Facts Panel and prepackaged food purchase behavior among residents in six provinces in China. Methods: Using a multi-stage sampling method, 3 002 adults aged 18-70 were selected from the western region (Sichuan), eastern region (Guangdong, Jiangsu, Beijing), central region (Henan), and northeastern region (Heilongjiang) of China from July 2020 to March 2021. Socio-demographic characteristics of participants and their cognition of Nutrition Facts Panel and prepackaged food purchase behavior were collected through questionnaire. A multivariate binary logistic regression model was used to analyze the association between cognition of Nutrition Facts Panel and prepackaged food purchase behavior. Results: The age of 3 002 subjects was (42.3±13.4) years, among which 63.8% (1 914) were female, 66.7% knew the Nutrition Facts Panel, 49.8% would read it when purchasing, 30.7% could understand it, and 56.6% (1 699) bought prepackaged food more than once a week. The results of multivariate analysis showed that after adjusting for relevant confounding factors, compared with the participants knowing but not reading the Nutrition Facts Panel, the group knowing and reading was more likely to buy 11 types of prepackaged food at least once a week (all P<0.05). Compared with the participants reading but not understanding the Nutrition Facts Panel, the group reading and understanding was less likely to buy 11 types of prepackaged food at least once a week (all P<0.05). Conclusion: There was a correlation between cognition of Nutrition Facts Panel and prepackaged food purchase behavior among residents.

Precise Measurements of Decay Parameters and CP Asymmetry with Entangled Λ-Λ[over ¯] Pairs

Based on 10 billion J/ψ events collected at the BESIII experiment, a search for CP violation in Λ decay is performed in the difference between CP-odd decay parameters α_{-} for Λ→pπ^{-} and α_{+} for Λ[over ¯]→p[over ¯]π^{+} by using the process e^{+}e^{-}→J/ψ→ΛΛ[over ¯]. With a five-dimensional fit to the full angular distributions of the daughter baryon, the most precise values for the decay parameters are determined to be α_{-}=0.7519±0.0036±0.0024 and α_{+}=-0.7559±0.0036±0.0030, respectively. The Λ and Λ[over ¯] averaged value of the decay parameter is extracted to be α_{avg}=0.7542±0.0010±0.0024 with unprecedented accuracy. The CP asymmetry A_{CP}=(α_{-}+α_{+})/(α_{-}-α_{+}) is determined to be -0.0025±0.0046±0.0012, which is one of the most precise measurements in the baryon sector. The reported results for the decay parameter will play an important role in the studies of the polarizations and CP violations for the strange, charmed and beauty baryons.

Factors associated with depression in residents in the post-epidemic era

OBJECTIVE

To explore the factors associated with depression in residents in the post-epidemic era of COVID-19.

METHODS

A multi-stage stratified random sampling method was used to conduct a questionnaire survey among community residents through self-designed questionnaires and self-rating depression scale (SDS). Multivariate logistic regression analysis was performed on the influencing factors of depressive symptoms.

RESULTS

A total of 1993 residues completed the survey of depression status. The incidence of depressive symptoms was 27.04%. The multivariate logistic regression analysis showed that female (odds ratio (OR): 6.239, 95% confidence interval (CI): 2.743-10.698), body mass index (BMI) > 24 (OR: 2.684, 95% CI: 1.059-3.759) and drinking (OR: 1.730, 95% CI: 1.480-3.153) were the risk factors for developing depressive symptoms. Married (OR: 0.417, 95% CI: 0.240-0.652), monthly income (3001-5000 yuan, OR: 0.624, 95% CI: 0.280-0.756; >5000 yuan, OR: 0.348, 95% CI: 0.117-0.625), ordinary residents (OR: 0.722, 95% CI: 0.248-0.924) and urban residents (OR: 0.655, 95% CI: 0.394-0.829) were the protective factors of depressive symptoms.

CONCLUSIONS

Under the post-epidemic era of COVID-19, depressive symptoms are still common among community residents in China. Gender, BMI, drinking, marriage, monthly income and nature of personnel and residential area are associated with the incidence of depressive symptoms.

First Observation of the Direct Production of the χ_{c1} in e^{+}e^{-} Annihilation

We study the direct production of the J^{PC}=1^{++} charmonium state χ_{c1}(1P) in electron-positron annihilation by carrying out an energy scan around the mass of the χ_{c1}(1P). The data were collected with the BESIII detector at the BEPCII collider. An interference pattern between the signal process e^{+}e^{-}→χ_{c1}(1P)→γJ/ψ→γμ^{+}μ^{-} and the background processes e^{+}e^{-}→γ_{ISR}J/ψ→γ_{ISR}μ^{+}μ^{-} and e^{+}e^{-}→γ_{ISR}μ^{+}μ^{-} is observed by combining all the data samples. The χ_{c1}(1P) signal is observed with a significance of 5.1σ. This is the first observation of a C-even state directly produced in e^{+}e^{-} annihilation. The electronic width of the χ_{c1}(1P) resonance is determined to be Γ_{ee}=(0.12_{-0.08}^{+0.13})  eV, which is of the same order of magnitude as theoretical calculations.

Evidence for a Neutral Near-Threshold Structure in the K_{S}^{0} Recoil-Mass Spectra in e^{+}e^{-}→K_{S}^{0}D_{s}^{+}D^{*-} and e^{+}e^{-}→K_{S}^{0}D_{s}^{*+}D^{-}

We study the processes e^{+}e^{-}→K_{S}^{0}D_{s}^{+}D^{*-} and e^{+}e^{-}→K_{S}^{0}D_{s}^{*+}D^{-}, as well as their charge conjugated processes, at five center-of-mass energies between 4.628 and 4.699 GeV, using data samples corresponding to an integrated luminosity of 3.8  fb^{-1} collected by the BESIII detector at the BEPCII storage ring. Based on a partial reconstruction technique, we find evidence of a structure near the thresholds for D_{s}^{+}D^{*-} and D_{s}^{*+}D^{-} production in the K_{S}^{0} recoil-mass spectrum, which we refer to as the Z_{cs}(3985)^{0}. Fitting with a Breit-Wigner line shape, we find the mass of the structure to be (3992.2±1.7±1.6)  MeV/c^{2} and the width to be (7.7_{-3.8}^{+4.1}±4.3)  MeV, where the first uncertainties are statistical and the second are systematic. The significance of the Z_{cs}(3985)^{0} signal is found to be 4.6σ including both the statistical and systematic uncertainty. We report the Born cross section multiplied by the branching fraction at different energy points. The mass of the Z_{cs}(3985)^{0} is close to that of the Z_{cs}(3985)^{+}. Assuming SU(3) symmetry, the cross section of the neutral channel is consistent with that of the charged one. Hence, we conclude that the Z_{cs}(3985)^{0} is the isospin partner of the Z_{cs}(3985)^{+}.

Observation of Resonance Structures in e^{+}e^{-}→π^{+}π^{-}ψ_{2}(3823) and Mass Measurement of ψ_{2}(3823)

Using a data sample corresponding to an integrated luminosity of 11.3  fb^{-1} collected at center-of-mass energies from 4.23 to 4.70 GeV with the BESIII detector, we measure the product of the e^{+}e^{-}→π^{+}π^{-}ψ_{2}(3823) cross section and the branching fraction B[ψ_{2}(3823)→γχ_{c1}]. For the first time, resonance structure is observed in the cross section line shape of e^{+}e^{-}→π^{+}π^{-}ψ_{2}(3823) with significances exceeding 5σ. A fit to data with two coherent Breit-Wigner resonances modeling the sqrt[s]-dependent cross section yields M(R_{1})=4406.9±17.2±4.5  MeV/c^{2}, Γ(R_{1})=128.1±37.2±2.3  MeV, and M(R_{2})=4647.9±8.6±0.8  MeV/c^{2}, Γ(R_{2})=33.1±18.6±4.1  MeV. Though weakly disfavored by the data, a single resonance with M(R)=4417.5±26.2±3.5  MeV/c^{2}, Γ(R)=245±48±13  MeV is also possible to interpret data. This observation deepens our understanding of the nature of the vector charmoniumlike states. The mass of the ψ_{2}(3823) state is measured as (3823.12±0.43±0.13)  MeV/c^{2}, which is the most precise measurement to date.

Role of synovial lymphatic function in osteoarthritis

BACKGROUND

Osteoarthritis (OA) affects the entire joint, initially with a low degree of inflammation. Synovitis is correlated with the severity of OA clinical symptoms and cartilage degradation. The synovial lymphatic system (SLS) plays a prominent role in clearing macromolecules within the joint, including the pro-inflammatory cytokines in arthritic status. Scattered evidence shows that impaired SLS drainage function leads to the accumulation of inflammatory factors in the joint and aggravates the progression of OA, and the role of SLS function in OA is less studied.

DESIGN

This review summarizes the current understanding of synovial lymphatic function in OA progression and potential regulatory pathways and aims to provide a framework of knowledge for the development of OA treatments targeting lymphatic structure and functions.

RESULTS

SLS locates in the subintima layer of the synovium and consists of lymphatic capillaries and lymphatic collecting vessels. Vascular endothelial growth factor C (VEGF-C) is the most critical regulating factor of lymphatic endothelial cells (LECs) and SLS. Nitric oxide production-induced impairment of lymphatic muscle cells (LMCs) and contractile function may attribute to drainage dysfunction. Preclinical evidence suggests that promoting lymphatic drainage may help restore intra-articular homeostasis to attenuate the progression of OA.

CONCLUSION

SLS is actively involved in the homeostatic maintenance of the joint. Understanding the drainage function of the SLS at different stages of OA development is essential for further design of therapies targeting the function of these vessels.

[The associations of cyclin-dependent kinase inhibitor 2B antisense RNA 1 gene polymorphisms with the risk of Crohn's disease in Chinese patients]

Objectives: The present study aimed to investigate the associations of cyclin-dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1) gene polymorphisms with the risk of Crohn's disease (CD) in Chinese patients. Methods: From January 2012 to January 2021, a total of 207 CD patients and 545 age-and gender-matched healthy controls were collected from the Department of Gastroenterology, the Second Affiliated Hospital of Wenzhou Medical University. The genotypes of CDKN2B-AS1 (rs1063192, rs10757274, rs10757278, rs1333048, rs2383207) were determined by matrix-assisted laser desorption ionization time-of-flight mass spectrometry technique. Unconditional logistic regression analysis was used to analyze the differences of CDKN2B-AS1 polymorphisms between CD patients and healthy controls, as well as their influences on the clinicopathologic characteristics of CD patients. The analyses for linkage disequilibrium and haplotype were further performed by Haploview 4.2 software. Results: The variant genotype (AG+GG) and variant allele (G) of rs1063192 were more prevalent in CD patients than in healthy controls (32.4% vs 24.8%, P=0.036; 18.8% vs 13.6%, P=0.011). The same conclusions were also drawn for homozygous variant genotype (GG) and variant allele (G) of rs10757274 when CD patients were compared with healthy controls (19.8% vs 12.8%, P=0.017; 45.2% vs 38.1%, P=0.012). According to the Montreal Classification Standards, CD patients were stratified into different subgroups. The homozygous variant genotype (GG) and variant allele (G) of rs10757278 were less frequent in the patients with stricturing CD or penetrating CD than in those with non-stricturing and non-penetrating CD (13.7% vs 29.9%, P=0.015; 37.7% vs 50.4%, P=0.022). However, all the correlations above were no longer significant after Bonferroni's correction (all P>0.05). The polymorphic loci of rs10757274, rs2383207, rs10757278, and rs1333048 were in close linkage disequilibrium with each other in CDKN2B-AS1 gene. Compared with healthy controls, the frequency of haplotype AGAC was decreased in CD patients (1.5% vs 4.5%, χ²=7.61, P=0.006), whereas the frequency of haplotype GGAC was obviously increased in CD patients (3.0% vs 0.6%, χ²=14.25, P<0.001). The stratified analysis further showed that the frequency of haplotype AGAC was higher in the patients with stricturing CD or penetrating CD than in those with non-stricturing and non-penetrating CD (3.1% vs 0.4%, χ²=5.31, P=0.021). Conclusions: The variations of CDKN2B-AS1 (rs1063192, rs10757274, rs10757278, rs1333048, rs2383207) may not independently affect the risk of CD. Among the haplotypes constructed by rs10757274, rs2383207, rs10757278, and rs1333048, the haplotype AGAC may reduce the risk of CD, whereas it may increase the risk of stricturing or penetrating in CD patients. In addition, the haplotype GGAC may increase the risk of CD.

[Proteomic-driven precision medicine research in hepatocellular carcinoma]

Proteomics is the study of proteins-the direct executor of life activities. Protein plays a vital role in the development and growth of human body and the genesis and development of diseases. It is the most widely used clinical marker type and the direct drug target. In recent years, the advance of proteomic core technology with chromatography and mass spectrometry has promoted the rapid development in the depth and breadth of proteomic research, and its application in the large cohort of hepatocellular carcinoma opens a new era of proteomics-driven precision medicine (PDPM). This review highlights the proteomic research in new techniques, directions and discoveries of hepatocellular carcinoma research in recent years, providing new ideas and references for clinicians to understand proteomics, and to use proteomics to assist in the diagnosis of diseases and the development of personalized therapies.

[Assessment of quality of systematic reviews and Meta-analyses on efficacy and safety of COVID-19 vaccines]

Objective: To evaluate the methodology of the published systematic reviews and Meta-analyses (SR/MA) on efficacy and safety of coronavirus disease 2019 (COVID-19) vaccines. Methods: We conducted a retrieval for literatures published as of December 10, 2021 in English databases (Medline, Embase, Cochrane Library, Web of science) and Chinese databases (CNKI, Wanfang data, VIP, Sinomed). Two reviewers independently screened literatures and extracted data. The methodology of included SR/MA papers was assessed by A MeaSurement Tool to Assess systematic Review-2 (AMSTAR-2) tool in 16 items. Results: A total 22 SR/MA papers were included, in which 3 (13.6%) had low quality and 19 (86.4%) had very low quality. The main problems of these SR/MA included having no definite PICO (Participants, intervention, control and outcome), providing no preliminary research protocol, no list of excluded studies and justify the exclusions, making no evaluation and explanation or discussion of the risk of bias of original studies, no adequate evaluation of publication bias and discuss its likely impact on the results, etc. Conclusion: SR/MA for the efficacy and safety of COVID-19 vaccines had varied methodological deficiencies, further improvements are needed.

Observation of WWW Production in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

This Letter reports the observation of WWW production and a measurement of its cross section using 139  fb^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. Events with two same-sign leptons (electrons or muons) and at least two jets, as well as events with three charged leptons, are selected. A multivariate technique is then used to discriminate between signal and background events. Events from WWW production are observed with a significance of 8.0 standard deviations, where the expectation is 5.4 standard deviations. The inclusive WWW production cross section is measured to be 820±100 (stat)±80 (syst)  fb, approximately 2.6 standard deviations from the predicted cross section of 511±18  fb calculated at next-to-leading-order QCD and leading-order electroweak accuracy.

Effect of pharmaceutical care on the treatment of community-acquired pneumonia in the elderly: a case report

OBJECTIVE

Elderly patients with community-acquired pneumonia (CAP) have more comorbidities, decreased organ function, and weakened immune function, which can easily lead to various adverse reactionsduring anti-infection treatment. Comprehensive geriatric assessment is a commonly used method to optimize the management of the clinical treatment of the elderly, of which the clinical pharmacists are the core member. However, few studies have focused on the participation of relevant clinical pharmacists of comprehensive geriatric assessment (CGA) of elderly CAP patients.

CASE PRESENTATION

A case where the clinical pharmacist participated in the entire process of medical treatment of an elderly patient with CAP. From the first day of admission to the hospital, anti-infective drugs were selected based on the condition combined with the distribution and drug-resistance of common local pathogens, paying attention to the changes of various indicators during treatment, the drug dose was adjusted in time, and targeted anticoagulation, cardiotonic, diuretic, potassium supplementation, intestinal flora regulation and anti-fungal treatment were carried out, as well as the prevention and treatment of antibiotic-related diarrhea. After 24 days of hospitalization, the patient was in a stable condition after treatment and was discharged from the hospital.

CONCLUSIONS

The participation of clinical pharmacists in CGA had positive significance for the clinical treatment of elderly CAP, and it was worthy of further improvement and clinical promotion.

[The preference for Front-of-Pack Labeling and its association with the understanding of Nutrition Facts Panel among residents aged 18 to 70: results of a survey in 6 provinces of China]

Objective: To investigate the preference for Front-of-Pack Labeling (FOP) and its association with the understanding of the Nutrition Facts Panel among Chinese residents. Methods: A multi-stage sampling strategy was adopted to select 3 002 people aged between 18 and 70 years old from the eastern region of China (Beijing, Jiangsu Province, Guangdong Province), the northeast region (Heilongjiang Province), the central region (Henan Province) and the western region (Sichuan Province) from July 2020 to March 2021. Socio-demographic characteristics of participants and their understanding of the Nutrition Facts Panel and preference for FOP were collected. The χ² test was conducted to compare the preference for FOP in different groups of population, and multivariate logistic regression was used to analyze the association between the preference for FOP and the understanding of the Nutrition Facts Panel. Results: The mean age of 3 002 participants was (42.3±13.4) years, of which 1 914 (63.8%) were females and 69.3% could not understand the Nutrition Facts Panel. About 2 458 respondents (81.9%) suggested that FOP could be promoted. The top three nutrients that should be labeled were sugar (68.4%), salt (68.2%) and total fat (62.4%). The number of participants who believed that the Multiple Traffic Lights (MTL) could be easier to help consumers to quickly choose healthy food, attract attention and provide the most needed information was 1 064 (35.4%), 1 026 (34.2%) and 1 140 (38.0%), respectively. The multivariate logistic regression analysis showed that, compared with the Guideline Daily Amount (GDA) system, participants who could not understand the Nutrition Facts Panel preferred (1) Nutri-Score, Warning labels, and Health logos: Smart Choice in terms of"Which format of FOP could quickly help you choose food more easily?"[OR (95%CI): 2.21 (1.62-3.02), 1.64 (1.22-2.22), 1.79 (1.31-2.45), respectively]; (2) Nutri-Score, Warning labels, and Health logos: Smart Choice in terms of"Which format of FOP could attract your attention the most?"[OR (95%CI): 2.62 (1.92-3.59), 1.96 (1.45-2.66), 2.25 (1.66-3.04), respectively]; and (3) Nutri-Score, Warning labels, and Health logos: Smart Choice in terms of"Which format of FOP could provide you with the most needed information?"[OR (95%CI): 2.33 (1.70-3.21), 2.21 (1.66-2.95), 2.01 (1.50-2.71), respectively]. Conclusion: The residents from six provinces in China have a supportive attitude towards FOP. The interpretive FOP with color information, specific nutrient information and summary indicator can be launched. The nutrition information of sugar, salt and total fat could be prioritized to be labeled on the FOP.

[Clinical follow-up analysis of nusinersen in the disease-modifying treatment of pediatric spinal muscular atrophy]

Objective: To explore the clinical efficacy of disease-modifying drug nusinersen on children with spinal muscular atrophy. Methods: The baseline and longitudinal clinical data of 15 children who were treated with nusinersen in the Children's Hospital, Zhejiang University School of Medicine from October 2019 to October 2021 were retrospectively collected. The general data (gender, age, genotype, and clinical classification, etc.), motor function, nutritional status, scoliosis and respiratory function were analyzed. Wilcoxon rank-sum test was used for comparing multi-system conditions before and after treatment. Results: The age of 15 cases (7 males, 8 females) was 6.8 (2.8, 8.3) years, with 2 cases of type 1, 6 cases of type 2, and 7 cases of type 3 respectively, and the course of disease was 55.0 (21.0, 69.0) months. After 9.0 (9.0, 24.0) months of treatment, the motor function scale evaluations of the Hammersmith neurological examination section 2 (13.0 (7.0, 23.0) vs. 18.0 (10.0, 25.0) scores, Z=-2.67, P=0.018) of 15 children, the Hammersmith functional motor scale expanded (38.0 (18.5, 45.5) vs. 42.0 (23.0, 51.0) scores, Z=-2.38, P=0.018), and the revised upper limb module (27.0 (19.5, 32.0) vs. 33.0 (22.5, 35.5) scores, Z=-2.52, P=0.012) of children with type 2 and 3 had significantly improved. Thirteen patients achieved clinically significant motor function improvement, and 2 of them had kept stable scale scores. Subjective reports also indicated that the muscle strength and daily exercise ability of these children improved after treatment, and no serious adverse reactions were reported. Supplemented by the multi-disciplinary team management, the levels of some indicators such as Cobbs angle of scoliosis and forced vital capacity all had significantly improved (all P<0.05). Conclusions: Nusinersen can improve the motor function of patients with 5q spinal muscular atrophy, which is also proved safe to be used in children. The drug treatment supplemented by the multi-disciplinary team management is helpful to improve the multi-system function of the children with spinal muscular atrophy.

Enabling ultra-low-voltage switching in BaTiO3

Single crystals of BaTiO₃ exhibit small switching fields and energies, but thin-film performance is considerably worse, thus precluding their use in next-generation devices. Here, we demonstrate high-quality BaTiO₃ thin films with nearly bulk-like properties. Thickness scaling provides access to the coercive voltages (<100 mV) and fields (<10 kV cm^-1) required for future applications and results in a switching energy of <2 J cm^-3 (corresponding to <2 aJ per bit in a 10 × 10 × 10 nm³ device). While reduction in film thickness reduces coercive voltage, it does so at the expense of remanent polarization. Depolarization fields impact polar state stability in thicker films but fortunately suppress the coercive field, thus driving a deviation from Janovec-Kay-Dunn scaling and enabling a constant coercive field for films <150 nm in thickness. Switching studies reveal fast speeds (switching times of ~2 ns for 25-nm-thick films with 5-µm-diameter capacitors) and a pathway to subnanosecond switching. Finally, integration of BaTiO₃ thin films onto silicon substrates is shown. We also discuss what remains to be demonstrated to enable the use of these materials for next-generation devices.

[A preliminary study on the improved efficacy of mesalazine combined with vitamin D3 in ulcerative colitis]

Objective: To analyze the influence of vitamin D₃ supplementation on the clinical efficacy of mesalazine in patients with ulcerative colitis (UC). Methods: From January 2015 to December 2020, patients with mild-to-moderate active UC were retrospectively and continuously enrolled, who accepted mesalazine treatment for at least 12 months at the Second Affiliated Hospital of Wenzhou Medical University. According to simultaneous supplement of vitamin D₃ (125 IU/d), the patients were divided into study group and control group. Demographic and disease characteristics, serum 25-hydroxyvitamin D[25(OH)D] levels and other information were collected through retrieving hospital database. Student's t-test, Mann-Whitney U test and Chi-square test were applied for comparison of disease characteristics. The changes of modified Mayo scores[ΔMayo] and 25(OH)D[Δ25(OH)D] were compared before and after treatment by paired t-test, Wilcoxon signed rank test and Chi-square test. Multiple linear regression model was used to analyze the independent factors affecting ΔMayo and Δ25(OH)D, and variables with P-values less than 0.20 in the univariate analysis were allowed for further multivariate analysis. Results: A total of 74 UC patients (44 males, 30 females), with median age (range) 39.5 (20-76) years old, were analyzed and respectively assigned into study group (n=36) and control group (n=38). In study group, the average level of serum 25(OH)D was significantly increased at month 12 compared with that at baseline [(22.87±7.30) μg/L vs. (18.15±7.48) μg/L,P<0.001]. However, no significant elevation of serum 25(OH)D was found in control group [(19.17±8.49) μg/L vs. (19.82±9.47) μg/L,P=0.466]. Furthermore, there was a significant decrease of modified Mayo score [-3(-4.75, -1.25) vs.-2(-3.25, 0), P=0.034] and a higher clinical remission rate (55.6% vs. 28.9%, P=0.020) at month 12 in study group than those in control group. In addition, according to the baseline level of serum 25(OH)D before mesalazine treatment, 74 UC patients were divided into vitamin D deficiency group (n=38, serum 25(OH)D<20 μg/L) and non-deficiency group (n=36, serum 25(OH)D≥20 μg/L). At month 12 in vitamin D deficiency group, patients with vitamin D3 supplementation had a greater decline in modified Mayo score [-4(-5.75, -2) vs.-2(-4, 0), P=0.048] and a higher clinical remission rate (60.0% vs. 22.2%, P=0.019) compared with those without. Conclusions: In patients with mild-to-moderate active UC receiving mesalazine treatment, vitamin D3 supplementation may improve the clinical efficacy, especially in patients with vitamin D deficiency.

A detailed map of Higgs boson interactions by the ATLAS experiment ten years after the discovery

The standard model of particle physics1-4 describes the known fundamental particles and forces that make up our Universe, with the exception of gravity. One of the central features of the standard model is a field that permeates all of space and interacts with fundamental particles5-9. The quantum excitation of this field, known as the Higgs field, manifests itself as the Higgs boson, the only fundamental particle with no spin. In 2012, a particle with properties consistent with the Higgs boson of the standard model was observed by the ATLAS and CMS experiments at the Large Hadron Collider at CERN10,11. Since then, more than 30 times as many Higgs bosons have been recorded by the ATLAS experiment, enabling much more precise measurements and new tests of the theory. Here, on the basis of this larger dataset, we combine an unprecedented number of production and decay processes of the Higgs boson to scrutinize its interactions with elementary particles. Interactions with gluons, photons, and W and Z bosons-the carriers of the strong, electromagnetic and weak forces-are studied in detail. Interactions with three third-generation matter particles (bottom (b) and top (t) quarks, and tau leptons (τ)) are well measured and indications of interactions with a second-generation particle (muons, μ) are emerging. These tests reveal that the Higgs boson discovered ten years ago is remarkably consistent with the predictions of the theory and provide stringent constraints on many models of new phenomena beyond the standard model.

Observation of supersymmetry and its spontaneous breaking in a trapped ion quantum simulator

Supersymmetry (SUSY) helps solve the hierarchy problem in high-energy physics and provides a natural groundwork for unifying gravity with other fundamental interactions. While being one of the most promising frameworks for theories beyond the Standard Model, its direct experimental evidence in nature still remains to be discovered. Here we report experimental realization of a supersymmetric quantum mechanics (SUSY QM) model, a reduction of the SUSY quantum field theory for studying its fundamental properties, using a trapped ion quantum simulator. We demonstrate the energy degeneracy caused by SUSY in this model and the spontaneous SUSY breaking. By a partial quantum state tomography of the spin-phonon coupled system, we explicitly measure the supercharge of the degenerate ground states, which are superpositions of the bosonic and the fermionic states. Our work demonstrates the trapped-ion quantum simulator as an economic yet powerful platform to study versatile physics in a single well-controlled system.

POS1035 LOW RATES OF RADIOGRAPHIC PROGRESSION WITH 2 YEARS OF GUSELKUMAB, A SELECTIVE INHIBITOR OF THE INTERLEUKIN-23p19 SUBUNIT: RESULTS FROM A PHASE 3, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF BIOLOGIC-NAÏVE PATIENTS WITH ACTIVE PSORIATIC ARTHRITIS

Background

In the phase 3 DISCOVER-2 (D2) study, guselkumab (GUS) 100 mg every 4/8 weeks (Q4W/Q8W) significantly improved joint and skin symptoms in patients (pts) with active psoriatic arthritis (PsA); GUS-treated pts had smaller mean changes in radiographic progression vs placebo (PBO) at W24.1 Clinical response rates and favorable safety profile were durable through W100.2, 3

Objectives

To report details of radiographic assessments comprising Reading Session 3 through W100 of D2, including relationships between radiographic changes and measures of clinical outcomes.

Methods

Biologic-naïve adults with active PsA (≥5 swollen + ≥5 tender joint count; CRP ≥0.6 mg/dL) were randomized (1:1:1) to GUS 100 mg Q4W; GUS 100 mg at W0, W4, then Q8W; or PBO with crossover to GUS 100 mg Q4W (PBO→Q4W) at W24, all through W100. Radiographic Reading Session 3 included assessments at W0/24/52/100 (or at discontinuation after W52) from pts ontinuing study treatment at W52; readers were blinded to treatment group and timepoint. Observed mean changes in total PsA-modified van der Heijde-Sharp (vdH-S), joint space narrowing (JSN), and erosion scores were reported. Changes in total vdH-S scores from W0-100 were determined in pts who did and did not achieve clinical response at W100, assessed by ACR20/50/70, low disease activity (LDA) based on Disease Activity in Psoriatic Arthritis score (DAPSA; ≤14) or Psoriatic Arthritis Disease Activity Score (PASDAS; ≤3.2), minimal disease activity (MDA), and normalized Health-Assessment Questionnaire-Disability Index (HAQ-DI) score (<0.5).

Results

Of 739 randomized pts, 664 had evaluable data from Reading Session 3; 629 had evaluable data from W52-100. Mean total baseline vdH-S scores were: Q4W, 28.0; Q8W, 23.9; PBO→Q4W, 25.6. Mean progression of joint damage from W0-24 was numerically lower in GUS- than PBO-treated pts for erosion, JSN, and total vdH-S scores (Table 1), consistent with the results from Reading Session 1.1 Mean changes in radiographic scores from W52-100 indicated low rates of radiographic progression across GUS groups. Among GUS-randomized pts, mean changes in vdH-S score from W0-100 were numerically lower for pts achieving clinical response assessed using ACR20/50/70, DAPSA LDA, PASDAS LDA, MDA, and HAQ-DI vs pts not achieving response at W100 (Figure 1).

Table 1.

Observed erosion, joint space narrowing, and total PsA-modified vdH-S scores through W100 of DISCOVER-2

GUS Q4WGUS Q8WPBO→GUS Q4WBaseline PsA-modified vdH-S score, n221228215Erosion14.2 (23.3)12.0 (21.9)12.1 (21.9)Joint space narrowing13.8 (21.8)11.9 (19.5)13.5 (21.6)Total28.0 (43.6)23.9 (40.4)25.6 (42.4)Mean (SD) change in PsA-modified vdH-S scoreW0-24 N=221W24-52 N=221W52-100 N=211W0-24 N=228W24-52 N=228W52-100 N=216W0-24 N=215W24-52 N=213W52-100 N=202Erosion0.27 (1.91)0.36 (1.77)0.45 (2.90)0.51 (1.96)0.20 (1.24)0.26 (1.75)0.73 (2.20)0.25 (1.85)0.09 (1.98)Joint space narrowing0.21 (1.17)0.21 (1.11)0.30 (1.32)0.17 (0.69)0.12 (0.66)0.20 (0.92)0.39 (1.72)0.09 (1.11)0.04 (1.90)Total0.48 (2.70)0.57 (2.66)0.75 (4.02)0.68 (2.36)0.31 (1.57)0.46 (2.42)1.12 (3.80)0.34 (2.79)0.13 (3.74)

Data presented as mean (SD).

GUS, guselkumab; PBO, placebo; PsA, Psoriatic Arthritis; Q4W, every 4 weeks; Q8W, every 8 weeks; SD, standard deviation; vdH-S, van der Heijde-Sharp; W, week

Conclusion

In biologic-naïve pts with active PsA enriched for greater risk of radiographic progression, GUS 100 mg (Q4W or Q8W) was associated with low rates of radiographic progression through 2 years. Pts achieving clinical response across several global measures of disease activity or normalized physical function at W100 had lower mean changes in total PsA-modified vdH-S scores compared with nonresponders.

References

[1]Mease PJ. Lancet. 2020;395:1126-1136

[2]McInnes IB. Arthritis Rheumatol. 2021;73:604-616

[3]McInnes IB. Innovations in Dermatology. Presentation: March 16-20, 2021

Disclosure of Interests

Philip J Mease Consultant of: AbbVie, Aclaris, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, Grant/research support from: AbbVie, Aclaris, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, Alice B Gottlieb Shareholder of: Xbiotech (stock options only), Consultant of: Anaptyps Bio, Avotres Therapeutics, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Dermavant, Eli Lilly, Incyte, Janssen, LEO Pharma, Novartis, Pfizer, Sun Pharmaceuticals, UCB, Grant/research support from: Boehringer Ingelheim, Janssen, Novartis, Sun Pharmaceuticals, UCB, and Xbiotech, Iain McInnes Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Proton Rahman Speakers bureau: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB, Grant/research support from: Janssen and Novartis, Alexa Kollmeier Shareholder of: Johnson & Johnson, Employee of: Janssen Research and Development, LLC, Xie L Xu Shareholder of: Johnson & Johnson, Employee of: Janssen Research and Development, LLC, Yusang Jiang Employee of: Cytel, Inc., Shihong Sheng Shareholder of: Johnson & Johnson, Employee of: Janssen Research and Development, LLC, May Shawi Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, Soumya D Chakravarty Shareholder of: Johnson & Johnson, Employee of: Janssen Scientific Affairs, LLC, Frederic Lavie Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, Désirée van der Heijde Consultant of: AbbVie, Amgen, Astellas, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, and UCB Pharma, Employee of: Director of Imaging and Rheumatology BV

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusion

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

References

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

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

Figure 1.

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

Acknowledgements

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

Disclosure of Interests

None declared

The efficacy and safety of different doses of calcitriol combined with neutral phosphate in X-linked hypophosphatemia: a prospective study

The present study was the first prospective cohort evaluated the efficacy and safety of different doses of calcitriol in XLH children. The results suggested that a dose of 40 ng/kg/day calcitriol, compared with 20 ng/kg/day, was more effective in relieving the rickets, with similar safety outcomes. Further investigations were expected to set more dose groups.

INTRODUCTION

Dose recommended for calcitriol in X-linked hypophosphatemia (XLH) varies in different studies. Therefore, we aimed to compare the efficacy as well as the safety of 20 ng/kg/d and 40 ng/kg/d calcitriol in Chinese XLH pediatrics population.

METHODS

A 2-year, randomized, open-label, prospective study recruited 68 XLH children, which were randomized to receive either 40 ng/kg/day or 20 ng/kg/day calcitriol. Efficacy endpoints were the total Thacher ricket severity score (RSS) change from baseline to month 12 and 24, the difference in serum TALP level, fasting serum phosphate level, body height Z-score, and frequency of dental abscess. Safety assessments were done using renal ultrasound nephrocalcinosis grades (0-4), fasting serum and 24 h urine calcium level, and the occurrence of hyperparathyroidism.

RESULTS

The decrease in the total RSS from baseline was more significant in the high-dose group at 12 (difference 0.87, p = 0.049) and 24 month (difference 1.23, p = 0.011). The serum TALP level was significantly lower in the high-dose group at 6 months. Pi level, height Z-score change, frequency of dental abscess and ratio of de novo nephrocalcinosis were comparable. A lower incidence of secondary hyperparathyroidism was seen in the high-dose group (p < 0.0001).

CONCLUSION

For the first time in this prospective cohort, 40 ng/kg/d calcitriol was shown to be the more effective therapy in XLH children than the 20 ng/kg/d. Moreover, 40 ng/kg/d calcitriol was not associated with increasing adverse events.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT 03,820,518.

AB1043 IDENTIFICATION OF UNUSUAL TOPHI ANTERIOR TO THE THYROID CARTILAGE USING DIFFERENT IMAGING METHODS

Background

Inadequately treated gout patients could develop tophi. However, tophi could appear as atypical mass, leading to difficulty in differential diagnosis.

Objectives

The objectives of the study were to describe an unusual case with tophi anterior to the Thyroid Cartilage using different imaging methods.

Methods

Clinical information of the case was presented. Ultrasound, dual energy Computed Tomography (DECT) and CT scan were compared to describe the tophi.

Results

A 66-year-old man with a 30-year history of gout was admitted. He had received urate-lowering drugs intermittently over the past few years. Physical examination revealed multiple tophi on the hands, feet, and other auricular surfaces. Moreover, there was a subcutaneous mass above the thyroid cartilage (Figure 1A). Ultrasound revealed hyperechoic nodule anterior to the thyroid cartilage, 11*7cm in size, with uneven internal echo, no blood flow signal inside, and a close relationship between the barrier of the nodule and the thyroid cartilage (Figure 1B). DECT of the neck confirmed that the mass anterior to the thyroid cartilage were tophi (Figure 1C-D). A plain radiographic evaluation demonstrated soft-tissue swellings and para-articular erosions involving hands (Figure 1E-F). The serum creatinine and uric acid levels were elevated as follows, creatinine, 562 μmol per liter (normal range, 31.8 to 116); and uric acid, 621 μmol per liter (normal range, 90 to 420).

Figure 1.

Tophi detected by different imaging methods. A.A picture of the mass anterior to the thyroid cartilage; B. A mass anterior to the thyroid cartilage detected by ultrasound; C. The mass anterior to the thyroid cartilage detected by dual energy CT; D. The mass anterior to the thyroid cartilage detected by CT scan; E. a picture of tophi in the hands; F. a plain radiograph of tophi in the hands.

Conclusion

DECT has more advantages over ultrasound and CT for detection of atypical tophi in gout patients.

Disclosure of Interests

Yutong Jiang Grant/research support from: Scientific and Technological Planning Project of Guangzhou City [grant number 202102020150], Xinyu Wu: None declared, Zetao Liao: None declared, Jun Qi: None declared, Jieruo Gu: None declared

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusion

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

References

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

Figure 1.

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

Figure 2.

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

Acknowledgements

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

Disclosure of Interests

None declared

AB1520 EFFECTIVE TREATMENT OF TOCILIZUMAB IN PATIENTS WITH REFRACTORY ADULT-ONSET STILL’S DISEASE

Background

Pro-inflammatory cytokines such as interleukin 6 (IL-6) are involved in the pathogenesis of adult-onset Still’s disease (AOSD). Anti-IL-6 agents such as tocilizumab have been tried to treat AOSD successfully.

Objectives

To access the efficacy of tocilizumab in the treatment of AOSD patient refractory to,or with initial treatment.

Methods

We reviewed three cases with refractory AOSD treated with tocilizumab. All patients fulfill the Cush criteria for AOSD. All patients performed blood culture, auto-antibodies test and bone marrow test to exclude infectious diseases, other rheumatic diseases and tumors. All patients received broad-spectrum antibiotics and had no response. All patients received glucocorticoid therapy and at least one kind of anti-cytokine therapies but didn’t have full response. Then the three patients received intravenous tocilizumab treatment of 8mg/kg every 2 weeks or 4 weeks.

Results

The first patient, a 21-year-old woman, performed positron emission tomography (PET-CT) and lymphoglandula pathology in addition to routine tests. She received high dose methylprednisolone (500mg per day for 3 days and followed by 80mg per day), gamma globulin injection (20g per day for 3 days) and baricitinib 4mg per day for 12 days, but had no response to the treatment. Then she received tocilizumab of 8mg/kg every 2 weeks and stopped baricitinib. And the symptoms and blood tests improved gradually, and the methylprednisolone dose reduced to 16mg per day at the last follow-up.

The second patient is a 52-year-old man, and performed bone marrow cytology and PET-CT to excluded hematological diseases. He received methylprednisolone 80mg per day, adalimumab and tofacitinib treatment. But the patients still got recurrent fever, high ESR, CRP and serum ferritin. Then he stopped adalimumab and tofacitinib, and received tocilizumab of 8mg/kg every 2 weeks and reduced to 8mg/kg every 4 weeks because of economic factors. The patient did not develop fever and the inflammatory indexes such as ESR/CRP gradually decreased to normal range. And methylprednisolone dose reduced to 32mg nowadays.

The third patient is a 30-year-old woman and has recurrent AOSD for 15 years. She had tried glucocorticoids, methotrexate, iguratimod, baritinib and entanercept successively. Yet she still had recurrent arthritis on hand and knee, and elevated ESR/CRP/serum ferritin. Additionally she suffered femoral head necrosis because of excessive doses of glucocorticoid. The patient received tocilizumab 8mg/kg every 4 weeks, then joint symptoms and inflammatory indicators improved significantly. The methylprednisolone dose was also successfully reduced to 4mg/d.

The Figure 1 showed the main course of disease evolution.

Figure 1.

Conclusion

Tocilizumab may be an effective candidate in refractory AOSD despite no response to other treatments.

Disclosure of Interests

None declared

OP0114 IDENTIFICATION AND FUNCTIONAL PREDICTION OF LONG NONCODING RNA RELATED TO CONNECTIVE TISSUE DISEASE-ASSOCIATED INTERSTITIAL LUNG DISEASES

Background

Recently, the role of long noncoding RNA (lncRNA) in rheumatic immune diseases has attracted widespread attention1. However, knowledge of lncRNA in connective tissue disease-associated interstitial lung disease (CTD-ILD) is limited.

Objectives

To explore the expression profile of lncRNA in peripheral blood mononuclear cells (PBMCs) of CTD-ILD patients and the possible mechanisms of significantly differentially expressed lncRNA involved in CTD-ILD, especially systemic sclerosis (SSc)-ILD and rheumatoid arthritis (RA)-ILD.

Methods

LncRNA microarray analysis was used to identify the pattern of lncRNA dysregulation between CTD-ILD and connective tissue disease without associated interstitial lung disease (CTD-NILD). Differential genes were identified by bioinformatic analysis. Relative expression levels of five differentially expressed lncRNAs in 120 SSc and RA patients with or without ILD were detected by quantitative reverse-transcription PCR (qRT-PCR).

Results

The differential gene expression analysis revealed 46 lncRNAs were upregulated while 194 lncRNAs were downregulated in the CTD-ILD group compared to the CTD-NILD group (Figure 1). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses identified several significant biological processes and signaling pathways, including NF-kappa B signaling pathway, IL-17 signaling pathway, Toll-like receptor signaling pathway, B cell receptor signaling pathway. QRT-PCR confirmed that the selected target genes were differentially expressed in different groups. In particular, the ENST00000604692 expression level was significantly higher in the ILD than the NILD group (p<0.05, Figure 1); T311354 and arginase-1were significantly higher in SSc than RA group; Furthermore, the area under receiver operating characteristic curve for ENST00000604692 in predicting ILD from NILD was 0.797 (Figure 1).

Conclusion

This research has demonstrated, for the first time, the specific profile of lncRNA in PBMCs of CTD-ILD patients and the potential signal pathways related to the pathogenesis of CTD-ILD. ENST00000604692 can effectively distinguish ILD group from NILD group,which may be a diagnostic indicator of CTD-ILD, especially SSc-ILD and RA-ILD.

References

[1]Guo CJ, Xu G, Chen LL. Mechanisms of Long Noncoding RNA Nuclear Retention. Trends Biochem Sci (2020) 45(11):947-60. doi: 10.1016/j.tibs.2020.07.001.

Disclosure of Interests

None declared

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusion

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

Figure 1.

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

References

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

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

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

Acknowledgements

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

Disclosure of Interests

None declared

POS0136 COMPLEMENT C1q PROMOTES MITOCHONDRIA RESPIRATION AND SECRETION OF IL-6 and IL-1β BUT NOT TNF-α BY SYNOVIAL MACROPHAGE IN RHEUMATOID ARTHRITIS

Background

Complement C1q (C1q), predominantly synthesized by myeloid cells such as macrophages, has elusive functions in the pathogenesis of rheumatic arthritis (RA). Binding to its receptor gC1qR, C1q can activate mitochondria, the dysfunction of which may result in tissue inflammatory disease [1]. Bone marrow derived macrophages in RA patients have elevated OXPHOS activity [2], while the reason remains to be discovered.

Objectives

The objectives of the study were to explore the expression of C1q and its receptor gC1qR in synovial macrophages in RA and whether C1q contributes to tissue inflammation via affecting pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α) and mitochondria respiration in synovial macrophages.

Methods

Tissue transcriptome analysis for C1q(C1qA, C1qB and C1qC), C1q receptors (including gC1qR) in rheumatoid synovium and and pro-inflammatory cytokines (IL-6, IL-1β and TNF-α) in rheumatoid synovium and synovium macrophages were quantified by RT-PCR. Concentrations of C1q in the plasma of RA and healthy controls (HC) were analyzed by ELISA and the correlation between plasma C1q and disease activty measured by DAS28 were calculated. gC1qR protein expression was detected by flow cytometric analysis and immunoblotting. Synovial macrophages were isolated and stimulated with or without C1q for 24 h. Function of gC1qR was analysed by knockdown experiment using siRNA. Transcripts for inflammatory cytokines were quantified by RT-PCR. Mitochondrial respirometer was evaluated with Seahorse Bioscience XF96 analyzer after C1q treatment or gC1qR knockdown.

Results

C1qA, C1qB,C1qC and gC1qR were all upregulated in both rheumatoid synovium and synovial macrophages compared to healthy controls. Meanwhile, RA patients had a higher level of C1q concentration in plasma, which positively correlated with DAS28. Moreover, an increased expression of gC1qR protein was confirmed by flow cytometric analysis and immunoblotting. Besides, C1q could increase the expression of IL-6 and IL-1β but not TNF-α in synovial macrophages. We also found that C1q could increase basal OCR, ATP-coupled OCR, max respiration and reserve capacity of healthy macrophages. Comparatively, gC1qR knockout could down-regulate mitochondria respiration of RA macrophages.

Conclusion

Synovial macrophages in RA patients have significantly elevated expression of C1q and its receptor gC1qR. C1q could promote mitochondria respiration through gC1qR, thus leading to hyper-metabolism in macrophages from RA patients. C1q could promote synovitis through enhanced pro-inflammatory cytokines IL-6 and IL-1β but not TNF-α secreted by synovial macrophages, which represents a novel therapeutic target in RA.

References

[1]Weyand CM, Goronzy JJ. A Mitochondrial Checkpoint in Autoimmune Disease. Cell Metab 2018; 28: 185-186.

[2]M. Zeisbrich, R.E. Yanes, H. Zhang, R. Watanabe, Y. Li, L. Brosig, et al., Hypermetabolic macrophages in rheumatoid arthritis and coronary artery disease due to glycogen synthase kinase 3b inactivation. Ann Rheum Dis 2018; 77: 1053-1062.

Figure 1.

The expression and function of C1q in RA macrophage. A.Transcripts for gC1qR, C1qA, C1qB and C1qC and pro-inflammatory cytokines were quantified by RT-PCR in synovial macrophage of RA and healthy control (HC), n=6; B. Concentrations of C1q in the plasma of RA and HC were measured by ELISA, n=8; C-D. Transcripts for pro-inflammatory cytokines were quantified by RT-PCR after C1q treatment, n=9; E-I. Mitochondrial respirometer was evaluated with Seahorse Bioscience XF96 analyzer by adding test agents in order of 1, oligomycin; 2, FCCP; 3, anti-mycin A/rotenone. Total trend and each segmentation of oxygen consumption rates (OCR) were shown after treated with C1q, n=6. *P < 0.05; **P < 0.01; ***P < 0.001.

Disclosure of Interests

Yutong Jiang Grant/research support from: Basic and Applied Basic Research Fund Project of Guandong Province [2021A1515111172]., Bowen Wu: None declared, Tao Huang: None declared, Yan Liu: None declared, Zhaolan Hu: None declared, Tuantuan Zhao: None declared, Yunfeng Pan: None declared, Weyand Cornelia: None declared

POS1028 GUSELKUMAB MAINTAINS RESOLUTION OF DACTYLITIS AND ENTHESITIS IN PATIENTS WITH ACTIVE PSORIATIC ARTHRITIS: RESULTS THROUGH 2 YEARS FROM A PHASE 3 STUDY

Background

Guselkumab (GUS), a selective inhibitor of IL-23, significantly improved the diverse manifestations of active psoriatic arthritis (PsA), including dactylitis and enthesitis, in DISCOVER (D)-1 & 2 trials of patients (pts) with active PsA1,2, with maintenance of response rates through 1 year (yr).3,4 Dactylitis and enthesitis, extra-articular manifestations of PsA, can be difficult to treat and cause significant disease burden.5,6

Objectives

To evaluate the ability of GUS to provide long-term resolution of dactylitis and enthesitis in pts with PsA through 2 yrs of D-2.

Methods

D-2 biologic naïve pts with active PsA were randomized 1:1:1 to GUS 100 mg every 4 weeks (Q4W); GUS 100 mg at W0, W4, Q8W; or placebo (PBO). At W24, PBO pts crossed over to GUS Q4W. Independent assessors evaluated dactylitis (total score: 0-60) and enthesitis (Leeds Enthesitis Index [LEI]; total score 0-6). These post hoc analyses assessed baseline (BL) frequency and severity of enthesitis in pts with dactylitis and dactylitis frequency in pts with enthesitis. Post BL, changes in dactylitis and LEI scores over time (least squares [LS] mean changes; analysis of covariance [ANCOVA]) and rates of resolution of dactylitis and enthesitis (Chi square correlation test) were determined in pts with these manifestations at BL (missing data imputed as no change/response).

Results

At BL, more D-2 pts had enthesitis (68%) than dactylitis (45%). At BL, 78% of pts with dactylitis vs 61% without (w/o) dactylitis had enthesitis and 51% of pts with enthesitis vs 32% w/o enthesitis had dactylitis. Among pts with enthesitis at BL, a higher percentage of pts with dactylitis (52%) had severe enthesitis (LEI score ≥3) vs pts w/o dactylitis (44%). Among those with the condition at BL, resolution rates of dactylitis (57%, Q4W; 64%, Q8W) and enthesitis (44%, Q4W; 54%, Q8W) at W24 increased through W52 (dactylitis: 74%, Q4W; 78%, Q8W; enthesitis: 57%, Q4W; 61%, Q8W) and were maintained at W100 (dactylitis: 72%, Q4W; 83%, Q8W; enthesitis: 62%, Q4W; 70%, Q8W). Consistent results were observed when evaluating mean changes in dactylitis and LEI scores and in pts who crossed over from PBO to GUS Q4W at W24 (Table 1). In pts with dactylitis and enthesitis at BL, GUS-treated pts showed significant correlations between resolution of enthesitis and dactylitis at W24 (p=0.004), W52 (p<0.001) and W100 (p=0.039), with nearly 90% of pts with enthesitis resolution also achieving dactylitis resolution at W52 and W100 (Figure).

Table 1.

LS mean change from baseline over time in dactylitis and LEI scores in pts with manifestation at baseline

GUS 100 mg Q4WGUS 100 mg Q8WPBO → GUS 100 mg Q4WDactylitis score (0-60)Pts, N12111199W24a-5.9 (-6.7, -5.0)-6.0 (-6.8, -5.1)-4.0 (-5.0, -3.1)W52a-6.5 (-7.2, -5.8)-7.2 (-7.9, -6.5)-6.9 (-7.6, -6.2)W100a-6.5 (-7.1, -5.8)-7.5 (-8.1, -6.8)-6.9 (-7.6, -6.2)LEI score (1-6)Pts, N170158178W24a-1.5 (-1.8, -1.3)-1.6 (-1.8, -1.4)-1.0 (-1.3, -0.8)W52a-1.8 (-2.0, -1.6)-1.9 (-2.1, -1.7)-2.0 (-2.2, -1.8)W100a-1.9 (-2.1, -1.7)-2.1 (-2.3, -1.8)-2.1 (-2.3, -1.9)

aResults are LS mean change (95% confidence interval [CI]); LS mean change determined by ANCOVA; missing data was imputed as no change for pts who discontinued treatment and using multiple imputation for remaining missing data

GUS, guselkumab; LEI, Leeds Enthesitis Index; LS, least squares; PBO, placebo; pts, patients; Q4W, every 4 weeks; Q8W, every 8 weeks; W, week

Conclusion

Pts with PsA often present with concurrent enthesitis and dactylitis, both of which can be recalcitrant to treatment. GUS resolved enthesitis and dactylitis in substantial proportions of pts through W100. GUS-treated pts who achieved enthesitis resolution were more likely to achieve dactylitis resolution and vice versa.

References

[1]Deodhar A et al. Lancet. 2020;395:1115

[2]Mease PJ et al. Lancet. 2020;395:1126

[3]Ritchlin C et al. RMD Open. 2021;7(1):e001457

[4]McInnes IB et al. Arthritis Rheumatol. 2021;73:604

[5]Kaeley GS et al. Semin Arthritis Rheum. 2018;48:35

[6]McGonagle D et al. Nat Rev Rheumatol. 2019;15:113

Disclosure of Interests

Proton Rahman Speakers bureau: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB, Grant/research support from: Janssen and Novartis, Iain McInnes Consultant of: AbbVie, Bristol Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB, Grant/research support from: AstraZeneca, Bristol Myers Squibb, Celgene, Janssen, Eli Lilly, Novartis, and UCB, Atul Deodhar Speakers bureau: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, GlaxoSmithKline, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer, and UCB, Georg Schett Speakers bureau: Abbvie, Janssen, and Novartis, Philip J Mease Speakers bureau: AbbVie, Aclaris, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, Consultant of: AbbVie, Aclaris, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, Grant/research support from: AbbVie, Aclaris, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, May Shawi Shareholder of: Janssen Global Services, LLC, Employee of: Janssen Global Services, LLC, Daniel Cua Shareholder of: Janssen Research & Development, LLC, Employee of: Janssen Research & Development, LLC, Jonathan Sherlock Shareholder of: Janssen Research & Development, LLC, Employee of: Janssen Research & Development, LLC, Alexa Kollmeier Shareholder of: Janssen Research & Development, LLC, Employee of: Janssen Research & Development, LLC, Xie L Xu Shareholder of: Janssen Research & Development, LLC, Employee of: Janssen Research & Development, LLC, Yusang Jiang Consultant of: Janssen, Employee of: Cytel Inc, Shihong Sheng Shareholder of: Janssen Research & Development, LLC, Employee of: Janssen Research & Development, LLC, Christopher T. Ritchlin Consultant of: AbbVie, Amgen, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, and UCB Pharma, Grant/research support from: AbbVie, Amgen, and UCB Pharma, Dennis McGonagle Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB

Effects of residual feed intake divergence on growth performance, carcass traits, meat quality, and blood biochemical parameters in small-sized meat ducks

Feed efficiency (FE) is a major economic trait of meat duck. This study aimed to evaluate the effects of residual feed intake (RFI) divergence on growth performance, carcass traits, meat quality, and blood biochemical parameters in small-sized meat ducks. A total of 500 healthy 21-day-old male ducks were housed in individual cages until slaughter at 63 d of age. The growth performance was determined for all the ducks. The carcass yield, meat quality, and blood biochemical parameters were determined for the selected 30 high-RFI (HRFI) and 30 low-RFI (LRFI) ducks. In terms of growth performance, the RFI, feed conversion ratio (FCR), and average daily feed intake (ADFI) were found to be significantly lower in the LRFI group (P < 0.01), whereas no differences were observed in the BW and body weight gain (P > 0.05). For slaughter performance, no differences were observed in the carcass traits between the LRFI and HRFI groups (P > 0.05). For meat quality, the shear force of breast muscle was significantly lower in the LRFI group (P < 0.05), while the other meat quality traits of breast and thigh muscles demonstrated no differences (P > 0.05). For blood biochemical parameters, the serum concentrations of triglycerides (TG) and glucose (GLU) were significantly lower in the LRFI group (P < 0.05), while the other parameters showed no differences (P > 0.05). The correlation analysis demonstrated a high positive correlation between RFI, FCR, and ADFI (P < 0.01). The RFI demonstrated a negative effect on the breast muscle and lean meat yields, but a positive effect on the shear force of breast muscle (P < 0.05). Further, the RFI demonstrated a positive effect on the TG and GLU levels (P < 0.05). These results indicate that the selection for low RFI could improve the FE of small-sized meat ducks without affecting the production performance. This study provides valuable insight into the biological processes underlying the variations in FE in small-sized meat ducks.

AB0102 GPX4 - ASSOCIATED FERROPTOSIS OF MACROPHAGE EXACERBATES IMMUNE IMBALANCE IN RHEUMATOID ARTHRITIS

Background

Reactive oxygen species accumulation and iron overload are involved in the pathogenesis of rheumatoid arthritis (RA). Ferroptosis, as a non-apoptotic form of programmed cell death, characteristically depends on iron and lipid peroxidation. However, the role of ferroptosis in RA has not been explored.

Objectives

To explore the role of ferroptosis in immune imbalance of rheumatoid arthritis.

Methods

Iron content in synovial fluid was determined by colorimetry. Lipid peroxidation was assessed by flow cytometry and immunofluorescence. MDA and GSH were used as markers to assess iferroptosis. K/BxN spontaneous arthritis mice and serum-induced arthritis mice were used as in vivo animal models of ferroptosis.

Results

Iron overload and hyperlipid peroxidation of mononuclear-macrophages were found in the synovial fluid of RA patients. Liproxstatin-1, the specific inhibitor of ferroptosis, alleviated the progression of arthritis mice model by increasing M2-like macrophage numbers. Mechanistically, iron overload in arthritis lesion induced anti-inflammatory macrophage ferroptosis by promoting glutathione peroxidase 4 (GPX4, a classical anti-ferroptosis molecule) to undergo P62 - dependent autophagy degradation.

Conclusion

Our results provide compelling evidence that macrophages ferroptosis plays a major role in RA. M2-like macrophages are more sensitive to ferroptosis than M1-like macrophages under iron overload circulation. This finding heavily contributes to the immune imbalance of rheumatoid arthritis.

References

[1]Xin Chen, et al. Cellular degradation systems in ferroptosis. Cell Death & Differentiation, (2021) 28:1135–1148.

[2]Pengchong Li,et al. Glutathione peroxidase 4-regulated neutrophil ferroptosis induces systemic autoimmunity. Nat Immunol, 2021 Sep;22(9):1107-1117.

[3]Alexandr A Kapralov, et al. Redox lipid reprogramming commands susceptibility of macrophages and microglia to ferroptotic death. Nat Chem Biol, 2020 Mar;16(3):278-290.

Disclosure of Interests

Yan Liu Grant/research support from: the National Natural Science Foundation of China (82101899), China Postdoctoral Science Foundation Grant (2021M693658), Yutong Jiang Grant/research support from: Basic and Applied Basic Research Fund Project of Guandong Province [2021A1515111172], yunfeng pan: None declared

Quantum Simulation of the Two-Dimensional Weyl Equation in a Magnetic Field

Quantum simulation of 1D relativistic quantum mechanics has been achieved in well-controlled systems like trapped ions, but properties like spin dynamics and response to external magnetic fields that appear only in higher dimensions remain unexplored. Here we simulate the dynamics of a 2D Weyl particle. We show the linear dispersion relation of the free particle and the discrete Landau levels in a magnetic field, and we explicitly measure the spatial and spin dynamics from which the conservation of helicity and properties of antiparticles can be verified. Our work extends the application of an ion trap quantum simulator in particle physics with the additional spatial and spin degrees of freedom.

[Dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy]

Objective: To analyze the dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture, Yunnan province, and provide information support for the clinical use of HIV-1 DNA quantitative detection. Methods: The HIV infection cases in recent infection cohort from Dehong Center for Disease Control and Prevention during 2009-2018 were selected as study subjects. The dynamic curve of HIV-1 DNA load varrying with time was generated and logistic regression analysis was conducted to identify the risk factors for HIV-1 load in the recent follow up after ART and statistical analysis was performed by using SPSS 17.0. Results: Among the 113 HIV infection cases detected from the recent infection cohort, the recent HIV infection rate were 49.6%(56/113) males, sexual transmission cases and drug injection transmission cases accounted for 53.1% (60/113), 80.5% (91/113) and 19.5% (22/113), respectively. The dynamic changes curve showed that HIV-1 DNA load was relatively high (>800 copies /10⁶ PBMCs) before ART, and droped rapidly (<400 copies /10⁶ PBMCs) after ART for 1 year. However, HIV-1 DNA load decreased insignificantly from the second year of ART, and remained to be 269 copies/10⁶ PBMCs after ART for 6 years. Univariable logistic regression analysis indicated that OR (95%CI) of CD8, CD4/CD8 and HIV-1 DNA load were 1.00 (1.00-1.00), 0.30 (0.09-1.05) and 1.01 (1.00-1.01), respectively. Multivariable logistic regression analysis showed that OR value of HIV-1 DNA load base was 1.00 (1.00-1.01). Conclusions: HIV-1 DNA load decreased significantly in the first year of ART, then remained stable for years. HIV-1 DNA load base was the key factor associated with the decrease of HIV-1 DNA load, the lower the HIV-1 DNA load base, the lower HIV-1 DNA load. Therefore, earlier ART can contribute to the decrease of HIV-1 DNA load.