Ring finger protein 126 promotes breast cancer metastasis and serves as a potential target to improve the therapeutic sensitivity of ATR inhibitors

BACKGROUND/AIMS

This study explores the relationship between the E3 ubiquitin ligase Ring finger protein 126 (RNF126) and early breast cancer metastasis and tests the hypothesis that RNF126 determines the efficacy of inhibitors targeting Ataxia telangiectasia mutated and Rad3-related kinase (ATR).

METHODS

Various metastasis-related genes were identified by univariable Cox proportional hazards regression analysis based on the GSE11121 dataset. The RNF126-related network modules were identified by WGCNA, whereas cell viability, invasion, and migration assays were performed to evaluate the biological characteristics of breast cancer cells with or without RNF126 knockdown. MTT, immunoblotting, immunofluorescence, and DNA fiber assays were conducted to determine the efficiency of ATR inhibitor in cells with or without RNF126 knockdown.

RESULTS

RNF126 was associated with early breast cancer metastasis. RNF126 promoted breast cancer cell proliferation, growth, migration, and invasion. ATR inhibitors were more effective at killing breast cancer cells with intact RNF126 due to replication stress compared with the corresponding cells with RNF126 knockdown. Cyclin-dependent kinase 2 (CDK2) was involved in regulating replication stress in breast cancer cells with intact RNF126.

CONCLUSION

A high level of expression of RNF126 in early breast cancer patients without lymph node metastases may indicate a high-risk type of metastatic disease, possibly due to RNF126, which may increase breast cancer cell proliferation and invasion. RNF126-expressing breast cancer cells exhibit CDK2-mediated replication stress that makes them potential targets for ATR inhibitors.

Mesoporous NiO@ZnO nanofiber membranes via single-nozzle electrospinning for urine metabolism analysis of smokers

A simple and efficient single-nozzle electrospinning strategy using polystyrene (PS) spheres and polyvinyl pyrrolidone (PVP) to construct a mesoporous NiO@ZnO nanofiber membrane was developed, which was used for the urine metabolism analysis of smokers.

5G-Enabled intelligent construction of a chest pain center with up-conversion lateral flow immunoassay

Acute myocardial infarction (AMI) has become a worldwide health problem because of its rapid onset and high mortality. Cardiac troponin I (cTnI) is the gold standard for diagnosis of AMI, and its rapid and accurate detection is critical for early diagnosis and management of AMI. Using a lateral flow immunoassay with upconverting nanoparticles as fluorescent probes, we developed an up-conversion fluorescence reader capable of rapidly quantifying the cTnI concentration in serum based upon the fluorescence intensity of the test and control lines on the test strip. Reliable detection of cTnI in the range 0.1-50 ng mL^-1 could be achieved in 15 min, with a lower detection limit of 0.1 ng mL^-1. The reader was also adapted for use on a 5th generation (5G) mobile network enabled intelligent chest pain center. Through Bluetooth wireless communication, the results achieved using the reader on an ambulance heading to a central hospital could be transmitted to a 5G smartphone and uploaded for real-time edge computing and cloud storage. An application in the 5G smartphone allows users to upload their medical information to establish dedicated electronic health records and doctors to monitor patients' health status and provide remote medical services. Combined with mobile internet and big data, the 5G-enabled intelligent chest pain center with up-conversion lateral flow immunoassay may predict the onset of AMI and save valuable time for patients suffering an AMI.

Recent progress of inertial microfluidic-based cell separation

Cell separation has consistently been a pivotal technology of sample preparation in biomedical research. Compared with conventional bulky cell separation technologies applied in the clinic, cell separation based on microfluidics can accurately manipulate the displacement of liquid or cells at the microscale, which has great potential in point-of-care testing (POCT) applications due to small device size, low cost, low sample consumption, and high operating accuracy. Among various microfluidic cell separation technologies, inertial microfluidics has attracted great attention due to its simple structure and high throughput. In recent years, many researchers have explored the principles and applications of inertial microfluidics and developed different channel structures, including straight channels, curved channels, and multistage channels. However, the recently developed multistage channels have not been discussed and classified in detail compared with more widely discussed straight and curved channels. Therefore, in this review, a comprehensive and detailed review of recent progress in the multistage channel is presented. According to the channel structure, the inertial microfluidic separation technology is divided into (i) straight channel, (ii) curved channel, (iii) composite channel, and (iv) integrated device. The structural development of straight and curved channels is discussed in detail. And based on straight and curved channels, the multistage cell separation structures are reviewed, with a special focus on a variety of latest structures and related innovations of composite and integrated channels. Finally, the future prospects for the existing challenges in the development of inertial microfluidic cell separation technology are presented.

Prognostic Significance of Ultrasound Findings of Acute Acalculous Cholecystitis for Elderly Long-Term Bedridden Patients

Background: Acute acalculous cholecystitis (AAC) is characterized by the development of cholecystitis in the gallbladder without gallstones or with small gallstones unrelated to inflammatory diseases. This disease is not rare in the elderly bedridden patients with co-morbidities and prone to develop life-threatening gangrene or perforation of gallbladder. Early imaging is essential for detecting and effectively treating AAC. This study aimed to evaluate the use of ultrasound diagnostic criteria for the diagnosis and prognosis of elderly long-term bedridden patients with suspected AAC.

Methods: We retrospectively studied 374 elderly bedridden patients with clinical manifestations of AC at the acute stage of the disease. Gallbladder anomalies were found in 92 patients by ultrasound examination, which correlated with the duration time of clinical manifestations, complications, as well as therapeutic prognosis. The major and minor ultrasound criteria of AAC were made according to the Tokyo Guidelines 2018. Ultrasound results were thought to be AAC positive when they met two major criteria or one major and two minor criteria.

Results: Forty-three (46.7%) of the 92 patients presented with AAC (+) test results based on the ultrasound criteria, with a higher incidence of complications (27.9%) than AAC (–) patients (0%; P < 0.001). The median length of symptoms (8 vs. 4 days, P < 0.001) and duration of antibiotic therapy (13 vs. 5 days, P < 0.001) were longer in the AAC (+) group.

Conclusions: The ultrasound-based AAC (+) group often had a worse prognosis than the AAC (–) group. Therefore, patients from the AAC (+) group should receive a follow-up ultrasound examination to detect disease progression early.

Double-layer capsule of mesoporous ZnO@SnO2 for sensitive detection of triethylamine

To overcome obstacles such as low response and poor selectivity of pure ZnO and SnO₂ gas sensors, the ZnO@SnO₂ sensor was synthesized by hydrothermal synthesis. The samples were characterized by XRD, XPS, SEM, HRTEM, N₂ adsorption-desorption and other techniques. The results show that ZnO@SnO₂ forms an n-n-type heterostructure and presents a double-layer capsule with a size of 0.5-4 μm. The results show that compared with pure ZnO and SnO₂, the ZnO@SnO₂ sensor exhibits a higher response (138.9) to 50 ppm triethylamine (TEA) at 152°C, which is 19.56 times that of the pure ZnO sensor and 21.7 times that of the SnO₂ sensor. It has a short response/recovery time (11/11 s), excellent selectivity and cycling stability. Compared with other volatile organic compounds or gases, it has higher selectivity for TEA detection.

Can situations awaken emotions? The compilation and evaluation of the Emotional Situation Sentence System (ESSS)

We aimed to establish and evaluate a standardized emotional situation sentence system (ESSS) relevant to the lives of college students to supplement prior literature and adapt to the needs of emotional research. Two studies were designed for this research; study 1 examined the effect of words in the ESSS and study 2 involved the use of pictures. For Study 1, 778 items were selected by 607 college students and 15 experts. We then tested the scale with 80 undergraduate participants. The ESSS sentences were rated on their degree of valence, arousal, and dominance using a 9-point scale. Cronbach's α (greater than 0.986) of the overall score as well as each sub-score in the three components confirmed the scale's reliability. As seen on a scatter plot, the results suggest that negative emotions (fear, disgust, anger, sadness, anxiety) are convergent and different from the distribution of positive (happiness) and neutral emotions. Study 2 included 30 participants to compare the difference in valence and arousal between the ESSS and emotional pictures. The results indicate that the ESSS is a standardized, situational, and ecological emotional contextual text system, well-suited to invoke emotion in college students. The ESSS has significantly better arousal and potency than pictures; moreover, it can be applied to experimental studies of anxiety-related emotions. However, emotion pictures have shorter response times, and wider application ranges, and they can include more cross-cultural characteristics compared to words.

Abstract 2981: Establishment and validation of humanized murine modeling platforms to facilitate immuno-oncology research

Immuno-oncology (I/O) space is proven to be one of the fast-moving areas with numeral blockbuster drugs delivered to the market. However, lacking of more clinically relevant preclinical models appeared to hinder this process as the I/O field is getting more established and the therapeutic modalities becomes more complex. The traditional testing systems such as transplantable xenograft tumor models can no longer meet the requirements of I/O novel drug evaluation and the mouse models with tumor-immune microenvironment interactions are urgently needed. At Simcere, in order to overcome those technical barriers and to accommodate our fast-paced pipeline development, we attempted to establish our own I/O in vivo testing platforms. These platforms were tailored to Simcere's dynamic progress of the research programs. To date, a variety of humanized mouse model-based in vivo modalities have been established in house. These testing systems fall into 4 categories: the human immune system reconstitution mouse tumor model (either using hPBMC or hCD34 stem cell approach), the hTreg focused humanized mouse model, the hTreg interfered GVHD mouse model, and the transgenic mouse model with modified immune targets (I/O targeted model; co-developed with a patterner). Each of these model systems were characterized to gain a comprehensive understanding before they were applied to any programs. The model characterization data showed that, 1) A large population of hCD4 and hCD8 T cells was maintained in peripheral blood of the hPBMC reconstructed mice,and significant percentage of human T,B and other type of immune cells were maintained in the human stem cell reconstituted mice.Anti-PD-L1 or anti-TIGIT antibodies showed significant anti-tumor efficacy in these humanized tumor models; 2) In the hTreg focused humanized mice axis, the proportion and functions of hTregs in the spleen of the hTreg reconstituted mice treated with the Treg modulated drugs were significantly amended, indicating that the system can be used to dissect out drugs with Treg modulating functions; 3) A hTreg interfered mouse GVHD model was proven to be a useful tool to assess effects of exogenous or endogenous Tregs on progression of the disease in a chronic setting; 4) Collaborating with a business patterner, we generated genetically modified mouse models in which selected murine immune targets were replaced with human counterparts. One of these models have been used to evaluate our IND candidate molecules, where significant anti-tumor effects and meaningful PD modulation were observed. To conclude, we have developed four types of I/O in vivo platforms to facilitate development process of immune modulatory and cancer immunotherapy agents. A majority of these modalities have been validated and utilized to drive our internal I/O programs. Optimization and expansion of these platforms are currently ongoing.

Citation Format: Yang Liu, Hai Huang, Danni Hao, Ran Pang, Mi Ye, Guojing Wu, Wenjing Li, Liting Xue, Zhenchuan Miao, Ming Yin, Wenqing Yang. Establishment and validation of humanized murine modeling platforms to facilitate immuno-oncology research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2981.

Human pluripotent stem cell-derived eosinophils reveal potent cytotoxicity against solid tumors

Eosinophils are attractive innate immune cells to use to potentiate T cell antitumor efficacy because they are capable of infiltrating tumors at early stages and modulating the tumor microenvironment. However, the limited number of functional eosinophils caused by the scarcity and short life of primary eosinophils in peripheral blood has greatly impeded the development of eosinophil-based immunotherapy. In this study, we established an efficient chemically defined protocol to generate a large quantity of functional eosinophils from human pluripotent stem cells (hPSCs) with nearly 100% purity expressing eosinophil peroxidase. These hPSC-derived eosinophils transcriptionally resembled their primary counterpart. Moreover, hPSC-derived eosinophils showed competent tumor killing capacity in established solid tumors. Furthermore, the combination of hPSC-derived eosinophils with CAR-T cells exhibited potential synergistic effects, inhibiting tumor growth and enhancing mouse survival. Our study opens up new avenues for the development of eosinophil-based immunotherapies to treat cancer.

Sleep status of psychiatric nurses: A survey from China

Aim

Our study aimed to evaluate the sleep status of psychiatric nurses in Chinese population and analyse the influencing factors.

Design

Cross‐sectional, correlation design with logistic regression analysis.

Methods

We investigated 1,044 psychiatric nurses from seven psychiatric hospitals in China. Pittsburgh Sleep Quality Index and Maslach Burnout Inventory General Survey were used as main measures.

Results

The average Pittsburgh Sleep Quality Index score of 1,044 psychiatric nurses was 7.00 ± 3.59, and 38.63% of nurses had a total Pittsburgh Sleep Quality Index score >7. Our study found that middle‐night shift nurses had poor sleep quality and sleep disorders are positively correlated with emotional exhaustion and cynical disregard for job burnout. Middle‐night shift nurses showed 1.586 times more likely to suffer from sleep disorders than those non‐middle‐night shift. The higher the score of emotional exhaustion, the greater the risk of sleep disorders.

Novel Thin Film Nanocomposite Forward Osmosis Membranes Prepared by Organic Phase Controlled Interfacial Polymerization with Functional Multi-Walled Carbon Nanotubes

Novel high-quality thin film nanocomposite (TFN) membranes for enhanced forward osmosis (FO) were first synthesized through organic phase controlled interfacial polymerization by utilizing functional multi-walled carbon nanotubes (MWCNTs). As 3-aminopropyltriethoxysilane (APTES) grafted MWCNTs via an amidation reaction significantly promoted the dispersion in organic solution, MWCNTs-APTES with better compatibility effectively restricted the penetration of trimesoyl chloride (TMC), thus adjusting the morphology and characters of TFN membranes. Various techniques such as Fourier transform infrared spectra (FTIR), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), scanning electron microscope (SEM), sessile droplet analysis and FO experiments and reverse osmosis (RO) operation were taken to characterize and evaluate the performance of nanocomposites and membranes. The prepared TFN FO membranes exhibited good hydrophilicity and separation efficiency, in which water flux was about twice those of thin film composite (TFC) membranes without MWCNTs-APTES in both AL-DS and AL-FS modes. Compared with the original TFC membrane, the membrane structural parameter of the novel TFN FO membrane sharply was cut down to 60.7%. Based on the large number of low mass-transfer resistance channels provided by functional nanocomposites, the progresses may provide a facile approach to fabricate novel TFN FO membranes with advanced selectivity and permeability.

Circ_0000615 promotes high glucose-induced human retinal pigment epithelium cell apoptosis, inflammation and oxidative stress via miR-646/YAP1 axis in diabetic retinopathy

BACKGROUND

Diabetic retinopathy (DR), a common complication of diabetes mellitus, is the major cause of visual impairment and blindness. Circ_0000615 was found to be elevated in retina samples of diabetic patients. Hence, the detailed effects and molecular mechanisms of circ_0000615 in DN progression were explored.

METHODS

The levels of circ_0000615, microRNA (miR)-646 and YAP1 (yes-associated protein 1) were detected using quantitative real-time polymerase chain reaction and Western blot assays. Cell viability, apoptosis, inflammation and reactive oxygen species (ROS) generation were determined using cell counting kit-8 assay, flow cytometry, caspase3 activity analysis, Western blot, enzyme-linked immunosorbent assay (ELISA) and Dichlorofluorescein diacetate (DCFH-DA) assay, respectively. The binding interaction between miR-646 and circ_0000615 or YAP1 was determined using dual-luciferase reporter, RNA immunoprecipitation (RIP), and RNA pull-down assays.

RESULTS

Circ_0000615 was elevated in high glucose (HG)-induced human retinal pigment epithelium (HRPE) cells. Knockdown of circ_0000615 attenuated HG-triggered HRPE cell apoptosis, inflammation, and ROS generation. Mechanistically, miR-646 was confirmed to be a target of circ_0000615, inhibition of miR-646 reversed the protective effects of circ_0000615 knockdown on HG-evoked HRPE cell dysfunction. MiR-646 was verified to target YAP1, overexpression of YAP1 abolished the impairment induced by miR-646 on HG-induced HRPE cell damage. Besides that, we confirmed that circ_0000615 could regulate YAP1 expression via miR-646.

CONCLUSION

Circ_0000615 contributed to HG-induced HRPE cell dysfunction via miR-646/YAP1 axis, suggesting a novel insight into the pathogenesis of DR and a potential candidate for DR treatment.

Salvage immune checkpoint inhibitor (ICI) plus tyrosine kinase inhibitor (TKI) combination therapy for metastatic renal cell carcinoma (mRCC)

e16567

Background: ICI/TKI combinations are a new standard of care for the initial treatment (tx) of mRCC. Efficacy and toxicity of such combination regimens beyond the first-line (1L) setting remain unknown. Methods: We retrospectively reviewed charts for adult patients (pts) receiving an ICI/TKI combination in any line of tx for mRCC of any histology at one of two academic centers as of May 1, 2020. ICIs included pembrolizumab (Pm), nivolumab (Ni), ipilimumab (Ip), or avelumab (Av); TKIs included sunitinib (Su), axitinib (Ax), pazopanib (Pz), lenvatinib (Ln), or cabozantinib (Ca). Clinical data including pt demographics, histology, International mRCC Database Consortium (IMDC) risk group, tx history, and ICI/TKI tx and toxicity details were recorded. Outcomes included objective response rate (ORR), median progression-free survival (mPFS), and safety, analyzed via descriptive statistics and the Kaplan-Meier method. Results: Of 85 pts, 69 (81%) were male and 67 (79%) had clear cell histology. IMDC risk was favorable (24%), intermediate (54%), poor (20%), and unknown (2%). 39% had ICI/TKI tx in the 1L setting. ICI/TKI regimens included Pm/Ax (33%), Ni/Ca (25%), Ni/Ax (20%), Av/Ax (11%), Ni/Ip/Ca (8%), Ni/Su (2%), and Ni/Ln (1%). ORR and mPFS stratified by line of tx and prior tx are shown in the table. Of 52 pts who received ICI/TKI tx as salvage (after 1L), 52% had a grade 3 or higher (≥G3) adverse event (AE), of which the most common were anorexia (13.5%), diarrhea and hypertension (11.5% each), and fatigue (9.6%). 65% of pts on salvage ICI/TKI tx stopped tx for progression/death, while 16% stopped tx for ≥G3 AE. ≥G3 AE rates by line of tx were 62.5% (2L), 50% (3L), and 45% (≥4L). Conclusions: ICI/TKI combination therapy is effective and safe beyond the 1L setting. Prior tx history appears to impact efficacy but has less of an effect on safety/tolerability. These observations will need to be confirmed in prospective studies.[Table: see text]

Identifying the Potential Therapeutic Targets for Atopic Dermatitis Through the Immune Infiltration Analysis and Construction of a ceRNA Network

Purpose

This study was meant to analyze immune infiltration and construct a ceRNA network to explore the new therapeutic targets for atopic dermatitis (AD) through bioinformatics way.

Patients and Methods

We downloaded the AD patients’ RNA expression profile datasets (GSE63741, GSE124700) from the Gene Expression Omnibus (GEO) database, which were analyzed through the GEO2R. We explored the hub genes by the enrichment analysis and the protein–protein interaction (PPI) analysis. Moreover, we estimated immune cell types and their proportions by ImmucellAI. GSE121212 dataset validation was performed to verify the robustness of the hub genes. Then, a ceRNA network was constructed by the miRWalk, miRNet, miRDB, DIANA, TargetScan, and starbase database. Finally, gene expression analysis was performed by using RT-qPCR.

Results

In total, we detected 22 differentially expressed genes (DEGs), which contained 8 downregulated genes and 14 upregulated genes. There were 5 hub genes confirmed as key genes through PPI network analysis and the ROC curves. KEGG pathway analysis revealed that they were significantly enriched in the IL-17 signaling pathway and GO analysis showed mainly in the immune cell chemotaxis. The immune infiltration profiles were different between normal controls and AD, and each of the key genes (S100A7, S100A8, S100A9, and LCE3D) was significantly correlated with the main infiltration cell of AD. A lncRNA–miRNA–mRNA ceRNA network containing the key genes was constructed, and NEAT1 and XIST, the core of ceRNA network, were significantly overexpressing verified by RT-qPCR in AD patients.

Conclusion

Altogether, the key genes and their ceRNA network provided a novel perspective to the immunomodulation of AD, which may be potential and new therapeutic targets for AD.

Artificial intelligence (AI) for medical imaging to combat coronavirus disease (COVID-19): a detailed review with direction for future research

Since early 2020, the whole world has been facing the deadly and highly contagious disease named coronavirus disease (COVID-19) and the World Health Organization declared the pandemic on 11 March 2020. Over 23 million positive cases of COVID-19 have been reported till late August 2020. Medical images such as chest X-rays and Computed Tomography scans are becoming one of the main leading clinical diagnosis tools in fighting against COVID-19, underpinned by Artificial Intelligence based techniques, resulting in rapid decision-making in saving lives. This article provides an extensive review of AI-based methods to assist medical practitioners with comprehensive knowledge of the efficient AI-based methods for efficient COVID-19 diagnosis. Nearly all the reported methods so far along with their pros and cons as well as recommendations for improvements are discussed, including image acquisition, segmentation, classification, and follow-up diagnosis phases developed between 2019 and 2020. AI and machine learning technologies have boosted the accuracy of Covid-19 diagnosis, and most of the widely used deep learning methods have been implemented and worked well with a small amount of data for COVID-19 diagnosis. This review presents a detailed mythological analysis for the evaluation of AI-based methods used in the process of detecting COVID-19 from medical images. However, due to the quick outbreak of Covid-19, there are not many ground-truth datasets available for the communities. It is necessary to combine clinical experts' observations and information from images to have a reliable and efficient COVID-19 diagnosis. This paper suggests that future research may focus on multi-modality based models as well as how to select the best model architecture where AI can introduce more intelligence to medical systems to capture the characteristics of diseases by learning from multi-modality data to obtain reliable results for COVID-19 diagnosis for timely treatment .

Calcitriol-mediated hypercalcemia as an immune-related adverse event in a patient receiving nivolumab and ipilimumab for metastatic renal cell carcinoma, case report

BACKGROUND

Severe hypercalcemia is often associated with uncontrolled malignancy through several mechanisms. However, calcitriol-mediated hypercalcemia is a rare etiology for advanced solid tumors.

CASE PRESENTATION

We report a case of calcitriol-mediated hypercalcemia secondary to immune checkpoint inhibition in a responder with metastatic clear cell renal cell carcinoma (ccRCC). In this case, a 68 year old male with metastatic ccRCC to the liver within 4 months of right radical nephrectomy went on to develop hypercalcemia (12.8 mg/dL) shortly following 2 cycles of nivolumab and ipilimumab. Additional testing showed an elevated calcitriol level (142 pg/mL), low parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP) levels, and a normal 25-hydroxyvitamin D level. FDG-PET imaging showed hypermetabolic mediastinal, hilar, and intra-abdominal lymphadenopathy, however the subsequent lymph node biopsy only showed reactive lymphoid cells without malignancy or granuloma. The hypercalcemia was resistant to initial therapy with calcitonin, hydration, and zoledronic acid but quickly responded to high-dose prednisone (1 mg/kg), followed by normalization of calcitriol levels. The patient was rechallenged with nivolumab and ipilimumab which provided a partial response after 4 cycles. He was maintained on low dose prednisone (10 mg daily) leading to a sustained resolution of his hypercalcemia.

CONCLUSION

This case suggests calcitriol-mediated hypercalcemia as a novel immune-related adverse event.