CT phenotypes in mild-to-moderate chronic obstructive pulmonary disease: difference before and after the age of 60 years

AIM

To investigate the pulmonary phenotype of mild-to-moderate chronic obstructive pulmonary disease (COPD) using quantitative computed tomography CT analysis techniques.

MATERIALS AND METHODS

Sixty-three patients with stable-phase mild-to-moderate COPD and 78 healthy controls, categorised as those aged <60 (28 and 40 patients, respectively) and ≥60 years (35 and 38, respectively), underwent chest low-dose respiratory dual-phase CT and pulmonary function test. Automatic software was used to measure the proximal airway parameters, and the emphysema and air-trapping indices were recorded. The intergroup differences in each parameter were assessed by one-way analysis of variance.

RESULTS

At <60 years of age, the mean Pi10WA (Wall area of a hypothetical airway with an internal perimeter of 10 mm) was greater in the mild-to-moderate COPD group than in the healthy control group (17.04 ± 1.63 versus 16.03 ± 1.16 mm²; p=0.004). Mild or moderate air-trapping was observed in the mild-to-moderate COPD group aged <60 years. There was no significant difference in the proximal airway parameters and inspiratory VI_-950 (percent voxels less than -950 HU) between the two groups at age ≥60 years (all p>0.05); however, the expiratory VI_-856 (percent voxels less than -856 HU) and mean lung density expiratory/inspiratory ratio (MLD_E/I) were higher in the mild-to-moderate COPD group than those in the healthy control group (26.02 [30.23] versus 6.45 [11.16]; 0.88 ± 0.05 versus 0.84 ± 0.04; p<0.001 and p=0.024).

CONCLUSION

For patients with mild-to-moderate COPD, the CT phenotype was predominantly the "airway remodelling" type at <60 years of age, and the "air-trapping" type at ≥60 years of age. Thus, pulmonary CT phenotypes of mild-to-moderate COPD patients of different age groups are different.

Enhancement of immune responses by co-administration of bacterial ghosts-mediated Neisseria gonorrhoeae DNA vaccines

AIM

Gonorrhoea remains a leading public health burden and the development of vaccine against gonorrhoea becomes more urgent. Here, a novel Neisseria gonorrhoeae DNA vaccine delivered by Salmonella enteritidis ghosts was developed and the immune responses of the vaccine candidate were evaluated.

METHODS AND RESULTS

Neisseria gonorrhoeae nspA gene was cloned into the pVAX1 vector. The constructed recombinant plasmid pVAX1-nspA was loaded into the lyophilized SE ghosts to produce SE ghosts (pVAX1-nspA). Then, the immune responses induced by SE ghosts (pVAX1-nspA) alone and co-administrated with SE ghosts (pVAX1-porB) were evaluated in mouse model. Co-administered SE ghosts (pVAX1-nspA) and SE ghosts (pVAX1-porB) could elicited significantly higher levels of specific IgG antibody responses and lymphocyte proliferative responses than the control groups. Furthermore, the group co-administered SE ghosts (pVAX1-nspA) and SE ghosts (pVAX1-porB) had the highest bactericidal antibody titres.

CONCLUSIONS

Co-administration of SE ghosts (pVAX1-nspA) and SE ghosts (pVAX1-porB) elicited significant specific humoral and cellular immune responses.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrates the potential of co-administration of SE ghosts (pVAX1-nspA) and SE ghosts (pVAX1-porB) as an attractive vaccination regimen for gonorrhoea.

The relationship between circadian blood pressure variability and maternal/perinatal outcomes in women with preeclampsia with severe features

OBJECTIVE

To determine whether circadian blood pressure (BP) variation of women with preeclampsia (PE) with severe features was associated with adverse maternal/perinatal outcomes.

METHODS

173 women with PE with severe features were recruitedand categorized into three groups: dipper, non-dipper and reverse dipper type BP group.. Maternal and perinatal outcomes were compared among groups.

RESULTS

There were significant differences in gestational ages, premature delivery, retinopathy, HELLP syndrome, mean birth weight, rate of low birth weight infants and fetal growth restriction.

CONCLUSION

Aberrant circadian pattern of BP in women with PE with severe features was associated with several adverse maternal/perinatal outcomes.

LncRNA DARS-AS1 regulates microRNA-129 to promote malignant progression of thyroid cancer

OBJECTIVE

To investigate the expression of long non-coding RNA (lncRNA) DARS-AS1 in thyroid cancer, and to further investigate whether it can promote the development of thyroid cancer by regulating microRNA-129.

PATIENTS AND METHODS

Real-time quantitative polymerase chain reaction (qPCR) was used to detect the level of DARS-AS1 in tumor tissues and paracancerous tissues of 34 thyroid carcinomas. It was also used to analyze the relationship between the expression of DARS-AS1 and the clinical indicators of thyroid cancer and the prognosis of patients. qPCR was used to further verify the expression of DARS-AS1 in thyroid cancer cell lines. The DARS-AS1 knockdown model was constructed using lentivirus in thyroid cancer cell lines. Cell counting kit-8 (CCK-8), cell clone formation, and transwell migration assays were performed to evaluate the effects of DARS-AS1 on the biological function of thyroid cancer cells. Finally, the potential mechanism was explored by using recovery experiments and the interplay between DARS-AS1 and microRNA-129 was further studied.

RESULTS

qPCR results revealed that the level of DARS-AS1 in tumor tissues of thyroid cancer patients was remarkably higher than that in adjacent tissues, and the difference was statistically significant. Compared with patients with low expression of DARS-AS1, patients with high DARS-AS1 expression had a higher incidence of high tumor stage, distant metastasis, and a lower overall survival rate. Besides, compared with NC group, the proliferation and migration ability of shRNA-AS1 expression knockdown group sh-DARS-AS1 was remarkably decreased. qPCR results indicated that there was a negative correlation between the level of microRNA-129 and DARS-AS1 in thyroid cancer tissues. In addition, cell proliferation and migration ability in the microRNA-129 overexpression group were remarkably decreased. The recovery experiment also found that there was a mutual regulation between DARS-AS1 and microRNA-129, which together affected the malignant progression of thyroid cancer.

CONCLUSIONS

DARS-AS1 level in tumor tissues of thyroid cancer was remarkably increased and was correlated with the pathological stage, distant metastasis, and poor prognosis of thyroid cancer. Moreover, DARS-AS1 could promote the proliferation and migration capabilities of thyroid cancer cells by modulating microRNA-129.

Air temperature, carbon dioxide, and ammonia assessment inside a commercial cage layer barn with manure-drying tunnels

Understanding the air temperature distribution, ammonia (NH₃) and carbon dioxide (CO₂) levels in poultry housing systems are crucial to poultry health, welfare, and productivity. In this study, 4 Intelligent Portable Monitoring Units and 7 temperature sensors were installed inside and between the cages and above 2 minimum ventilation fans of a commercial stacked-deck cage laying hen house in the Midwest United States (425,000 laying hens) to continuously monitor the interior environment over a 6-month period. During cold conditions (March 12th–May 22nd), there was a variation noted, with barn center temperatures consistently being highest in the longitudinal and lateral direction (P < 0.001) and the top floor deck warmer than the bottom floor (P < 0.05). During hotter conditions (May 23rd–July 26th), the interior thermal environment was more uniform than during the winter, resulting in a difference only in the longitudinal direction. The daily CO₂ and NH₃ concentrations were 400 to 4,981 ppm and 0 to 42.3 ppm among the 4 sampling locations, respectively. Both CO₂ and NH₃ decreased linearly with increasing outside temperatures. The mean NH₃ and CO₂ concentrations varied with sampling locations and with the outside temperatures (P < 0.001). For CO₂, the minimum ventilation sidewall had lower values than those measured in the barn’s center (P < 0.05) during cold weather, while the barn center and the manure room sidewall consistently measured the highest concentrations during warmer weather (P < 0.05). For NH₃, the tunnel ventilation inlet end consistently had the lowest daily concentrations, whereas the in-cage and manure drying tunnel sidewall locations measured the highest concentrations (P < 0.001). Higher NH₃ and CO₂ concentrations were recorded within the cage than in the cage aisle (P < 0.05). The highest NH₃ concentration of 42 ppm was recorded above the minimum exhaust fan adjacent to the manure drying tunnel, which indicated that higher pressure (back pressure) in the manure drying tunnel allowed air leakage back into the production area through nonoperating sidewall fan shutters.

The Subgingival Microbiome Relationship to Periodontal Disease in Older Women

Understanding of the oral microbiome in relation to periodontal disease in older adults is limited. The composition and diversity of the subgingival microflora and their oligotypes in health and levels of periodontal disease were investigated in this study on older postmenopausal women. The 16S rRNA gene was sequenced using the Illumina MiSeq platform in 1,206 women aged 53 to 81 y. Presence and severity of periodontal disease were defined by Centers for Disease Control and Prevention/American Academy of Periodontology criteria. Composition of the microbiome was determined by 16S rRNA amplicon sequencing and the abundance of taxa described by the centered log₂-ratio (CLR) transformed operational taxonomic unit (OTU) values. Differences according to periodontal disease status were determined by analysis of variance with Bonferroni correction. Bacteria oligotypes associated with periodontal disease and health were determined by minimum entropy decomposition and their functions estimated in silico using PICRUSt. Prevalence of none/mild, moderate, and severe periodontal disease was 25.1%, 58.3%, and 16.6%, respectively. Alpha diversity of the microbiome differed significantly across the 3 periodontal disease categories. β-Diversity differed between no/mild and severe periodontal disease, although considerable overlap was noted. Of the 267 bacterial species identified at ≥0.02% abundance, 56 (20.9%) differed significantly in abundance according to periodontal disease status. Significant linear correlations for pocket depth and clinical attachment level with bacterial amounts were observed for several taxa. Of the taxa differing in abundance according to periodontal disease status, 53% had multiple oligotypes appearing to differ between none/mild and severe periodontal disease. Among older women, taxonomic differences in subgingival microbiome composition and diversity were observed in relation to clinical periodontal disease measures. Potential differences in bacterial subspecies (oligotypes) and their function were also identified in periodontal disease compared with health.

FRI0003 ELEVATED HISTONE H4 IN NEUTROPHIL EXTRACELLULAR TRAPS PROMOTES MACROPHAGE ACTIVATION IN BEHÇET’S DISEASE

Background:

Neutrophil-released neutrophil extracellular traps (NETs) are upregulated and promote autoinflammation and thrombosis in Behçet’s disease (BD), a multi-system inflammatory disease with unknown etiology1,2. However, whether NETs promote macrophage activation in BD remains unclear.

Objectives:

To investigate the potential role of NETs in promoting aberrant macrophage activation in BD.

Methods:

We quantified NETs by measuring dsDNA using ELISA and immunofluorescence. Macrophages were stimulated with BD- and healthy controls (HC)-derived NETs, and IL-8 and TNF-α production were measured by ELISA. NETs-stimulated macrophages were incubated with naive CD4+T cells, and Th1 cell differentiation was examined on day 7 by flow cytometry. Histones H1, H2A, H2B, H3, H4, S100A8 and neutrophil elastase in NETs were analyzed by western blot. Macrophages were stimulated with anti-Histone 4 antibody-treated NETs, and IL-8 production was measured by ELISA.

Results:

Circulating NETs (2336±534 ng/ml vs. 1472±549 ng/ml,P=0.0008) and neutrophil-derived NETs (909.2±485.2 ng/ml vs. 582.4±199.2 ng/ml,P=0.0108) were significantly higher in BD patients compared with those in HC. BD NETs stimulated macrophages to produce a higher level of IL-8 (17±4 ng/ml vs. 13±4 ng/ml,P=0.0474) and TNF-α (166±61 pg/ml vs. 102±48 pg/ml,P=0.0132) than HC NETs. Moreover, BD NETs promoted macrophages to facilitate Th1 differentiation than HC NETs (33±10% vs. 24±7%,P=0.0398). Western blot analysis revealed more Histone H4 (289076 (144365, 544038) IOD values vs. 42121 (6958, 129625) IOD values,P=0.0286), but not Histones H1, H2A, H2B, H3, S100A8 or neutrophil elastase in BD NETs compared to HC NETs. Importantly, neutralizing Histone H4 abrogated the BD NETs-stimulated IL-8 overproduction by macrophages (9.99±2.07 ng/ml vs. 13.95±2.91 ng/ml,P=0.021).

Conclusion:

BD NETs promoted macrophages activation, which might be mediated by a higher level of Histone H4.

References:

[1]Safi R., Kallas R., Bardawil T., et al. Neutrophils contribute to vasculitis by increased release of neutrophil extracellular traps in Behçet’s disease. J. Dermatol. Sci. 2018;92:143–150.

[2]Le Joncour a, Martos r, Loyau s, et al. Critical role of neutrophil extracellular traps (NETs) in patients with Behcet’s disease. Ann Rheum Dis 2019;78:1274–1282.

Disclosure of Interests:

None declared

FRI0225 THE CLINICAL FEATURES AND OUTCOME OF VENA CAVA INVOLVEMENT IN BEHCET’S DISEASE

Background:

Behcet’s disease (BD) is a systemic disease that can affect vessels of any size and type. However, only limited cases of BD patients with vena cava involvement have been reported.

Objectives:

To investigate the clinical features and outcome of vena cava involvement in BD patients.

Methods:

We retrospectively reviewed the clinical data of BD patients with vena cava involvement in our institute from August 2001 to October 2019. The treatment and outcome of these patients were also analyzed.

Results:

Fifty BD patients with vena cava involvement were included. The median interval between BD onset and diagnosis of vena cava involvement was 2.8 (range 0-19.4) years. Superior vena cava (SVC) involvement was detected in 22 (44.0%) patients, and 21 patients had typical manifestations of SVC syndrome. Inferior vena cava (IVC) was detected in 35 (70.0%) patients, including 7 patients diagnosed with Budd-Chiari syndrome. Seven patients had both superior and inferior vena cava involvement. Forty-five (90.0%) patients had venous involvement other than vena cava, including 19 patients with common iliac thrombosis, 12 patients with common femoral vein thrombosis, 11 patients with external iliac vein thrombosis, etc. For the other BD manifestations, oral ulceration was presented in all patients, followed by genital ulceration (35, 70.0%), Erythema nodosum (27, 54.0%) and pathergy reaction (25, 50.0%). Thirteen (26%) patients had eye involvement. Ten (20%) patients had pleural and/or pericardial effusions. Eleven (22.0%) patients had pulmonary thromboembolism, and 4 (8.0%) patients had arterial involvement. Inflammatory markers were significantly elevated in 41 (82.0%) patients when the vena cava involvement developed, the mean ESR was 34.0±29.2mm/hr, and the median CRP level was 19.9(0.2-177.0) mg/L. The mean BDCAF2006 score of all patients was 4.6±1.6. Glucocorticoid was used in 47 (94.0%) patients after vena cava involvement was diagnosed, and cyclophosphamide was the first-choice immunosuppressant. Forty-one (82.0%) patients received anticoagulation treatment. Five patients had received placement of IVC filter, and 3 patients had taken balloon dilation of IVC. With a mean follow up of 4.1±3.8 years, 45 patients (90.0%) achieved clinical improvements, 6 patients (12.0%) had relapse of vascular involvement, 5 patients (10.0%) died. The respective estimated cumulative 1- and 5- years relapse-free rates were 90.9% and 83.1%, and the respective estimated 1- and 5- years survival rates were 95.9% and 90.1%.

Conclusion:

Vena cava involvement is a rare complication in BD patients. The prognosis of these patients is relatively optimistic after proper treatment. To the best of our knowledge, our study is the largest cohort of BD patients with vena cava involvement.

References:

[1]Y. Fei, X. Li, S. Lin et al. Major vascular involvement in Behçet’s disease: a retrospective study of 796 patients. Clinical Rheumatology, 2013, 32 (6): 845–852.

[2]Seyahi E, Caglar E, Ugurlu S et al. An outcome survey of 43 patients with Budd-Chiari syndrome due to Behçet’s syndrome followed up at a single, dedicated center. Semin Arthritis Rheum, 2015, 44(5):602-609.

Acknowledgments:

We gratefully thank all the patients who participated in our study.

Disclosure of Interests:

None declared

AB0531 GOLIMUMAB IN THE TREATMENT OF SEVERE AND/OR REFRACTORY VASCULO-BEHÇET’S DISEASE: A SINGLE-CENTRE EXPERIENCE IN CHINA

Background:

Vascular involvement is one of the leading causes of mortality and morbidity in Behcet’s Disease (BD)1. Surgical treatments are difficult for Vaculo-BD (VBD) patients due to the high risk of serious postoperative complications without effective and promptly perioperative immunotherapy2, 3. Anti-tumor necrosis factor alpha (TNF-α) therapy has been reported as a potential treatment in severe VBD, e.g. infliximab (IFX) and adalimumab (ADA). However, only few case reports are available regarding the fully humanized monoclonal antibody to TNF-α, golimumab (GOL), in the management of VBD4.

Objectives:

The objective of this study was to report the efficacy and safety of GOL for the treatment of severe and/or refractory VBD.

Methods:

We retrospectively analyzed the efficacy and safety profile of patients with severe and/or refractory VBD treated with GOL in our medical center between 2018 to 2020.

Results:

Nine VBD patients (8 male and 1 female) were enrolled, with a mean age and median course of 37±8.6 years and 72 months (range 12 to 300), respectively. Cardiac involvements (severe aortic regurgitation secondary to BD) were presented in 7 patients, including 2 patients with post-operative paravalvular leakage (PVL) after aortic valve replacement surgery. Multiple vascular lesions were documented in the other 2 patients, including one patient with life-threatening multiple pulmonary aneurysms, pulmonary thromboembolism and recurrent deep vein thrombosis, and another patient with abdominal aortic pseudoaneurysm and multiple artery stenosis and occlusion. Prior to GOL therapy, all patients experienced disease progression despite high-dose glucocorticoids combined with multiple immunosuppressants. Moreover, seven patients required effective and fast control of inflammation and a decrease of glucocorticoid dose during the perioperative period. They were treated with GOL, 50mg every 4 weeks, in combination with background low-or medium-dose glucocorticoids and immunosuppressants, for a median of 6 (range 3-15) months. After a mean duration of follow-up of 10 (range 2-6) months, all patients achieved improvement both in clinical symptoms and serum inflammation markers. The ESR level [4.88±4.94 mm/h vs 31.13±31.78mm/h, P<0.01] and CRP level [1.9 (0.11-3.73)mg/L vs 24.3 (0.4-85.57)mg/L, P<0.01] significantly decreased. The dosage of glucocorticoid[10 (0-15) vs 40 (0-100)mg/d, P<0.01] effectively tapered, indicating a potential steroid-sparing effect. No newly-onset aneurysm and recurrent venous thrombosis were observed. Also, one patient had a marked reduction in size and number of pulmonary aneurysms. No post-operative PVL was observed in the five patients after Bentall operation with a median follow-up of 10 months. One patient with severe aortic regurgitation remained stable and without surgical intervention with the treatment of GOL for 16 months. No severe complication occurred in one patient after underwent endovascular repair of abdominal aorta for 8 months. GOL was well-tolerated, and no serious adverse event was observed.

Conclusion:

Our results suggested that GOL is safe and effective for the treatment of patients with severe and / or refractory VBD. Further controlled studies are warranted to confirm the therapeutic potential of GOL in VBD patients.

Disclosure of Interests:

None declared

THU0326 TOFACITINIB IN THE TREATMENT OF SEVERE AND REFRACTORY BEHÇET’S DISEASE: A SINGLE-CENTRE EXPERIENCE IN CHINA

Background:

Small-molecule JAK inhibitors have succeeded in the treatment of rheumatoid arthritis, psoriasis, and inflammatory bowel disease1. Tofacitinib is under investigation for various autoimmune diseases2, but its effectiveness on Behçet’s disease(BD) has not been demonstrated.

Objectives:

We aimed to investigate the efficacy and safety of Tofacitinib in the treatment of severe and refractory BD.

Methods:

We retrospectively analyzed the efficacy and safety profile of Tofacitinib in treating severe and refractory BD patients in our hospital from 2017 to 2020.

Results:

Thirteen BD patients (7 males and 6 females) were enrolled, with a mean age and median course of 40.6±14.7 years and 84 months (60, 132). Vascular/cardiac, gastrointestinal, and articular involvement were presented in 5, 6, and 2 patients, respectively. Three patients had multiple arterial stenosis or occlusion, two presented with aortic root dilation with aortic valve regurgitation, and one experienced perivalvular leakage (PVL). All the six patients with gastrointestinal involvement had multiple episodes of ileocecal and colon ulcers, intestinal bleed, and three had anastomotic ulcers or leaks.

All the patients had received high-dose glucocorticoids and immunosuppressants before tofacitinib therapy, they displayed poor response with evidence of disease progression; furthermore, three patients with gastrointestinal involvement and one patient with polyarthritis had failed anti-TNF antibody treatment. They were then treated with Tofacitinib, 5mg twice daily, with background glucocorticoids and immunosuppressants, for a median of 6 months (range 4 to 19).

After a median follow-up of 7 (5, 19) months, the ESR and CRP level decreased significantly (21(8, 50) mm/h vs 8(3, 19.5) mm/h, P<0.01, and 25(5.85, 49.5) mg/L vs 1.89(0.44, 6.65) mg/L, P<0.01, respectively). All patients with vascular/cardiac and articular involvement achieved clinical improvement. Vascular lesions of three patients were radiologically stable, no progressive aneurysm or PVL was observed. Two patients with intestinal ulcers revealed complete mucosal healing; the other three had sustained elevation of ESR and CRP, active mucosal ulcers, recurrent bleeding, or fistula formation. The dose of corticosteroids was tapered in six cases (46.2%), furthermore, the number of immunosuppressants lessened in seven cases. However, two patients had herpes zoster infection during follow up, while being treated with five to six immunosuppressants in addition to Tofacitinib for refractory intestinal ulcers.

Conclusion:

Our study suggests that Tofacitinib is effective for the treatment of vascular and articular BD; given the limited data, its therapeutic effect on gastrointestinal BD could not be validated. We have to be cautious of infectious risk for severely immunocompromised patients. Further large-scale prospective studies are warranted to confirm the therapeutic potential of JAK inhibitors in BD patients.

References:

[1]Banerjee, S., Biehl, A., Gadina, M., Hasni, S. & Schwartz, D. M. JAK–STAT Signaling as a Target for Inflammatory and Autoimmune Diseases: Current and Future Prospects. Drugs 77, 521–546 (2017).

[2]Fragoulis, G. E., Mcinnes, I. B. & Siebert, S. JAK-inhibitors. New players in the field of immune-mediated diseases, beyond rheumatoid arthritis. Rheumatol. (United Kingdom) 58, i43–i54 (2019).

Disclosure of Interests:

None declared

[Analysis of population attributable risk of large for gestational age]

Objective: To examine the association of pre-pregnancy obesity, excessive gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with the risk of large for gestational age (LGA), and assess the dynamic changes in population attributable risk percent (PAR%) for having these exposures. Methods: A retrospective cohort study was conducted to collect data on pregnant women who received regular health care and delivered in Beijing Obstetrics and Gynecology Hospital from January to December in 2011, 2014 and 2017, respectively. Information including baseline characteristics, metabolic indicators during pregnancy, pregnancy complications, and pregnancy outcomes were collected. Multivariate logistic regression model was constructed to assess their association with LGA delivery. Adjusted relative risk and prevalence of these factors were used to calculate PAR%and evaluate the comprehensive risk. Results: (1)The number of participants were 11 132, 13 167 and 4 973 in 2011, 2014 and 2017, respectively. Corresponding prevalence of LGA were 15.19% (1 691/11 132), 14.98% (1 973/13 167) and 16.21% (806/4 973). No significant change in the prevalence of LGA was observed across all years investigated (all P>0.05). (2)According to results from multivariate logistic regression model, advanced maternal age, multiparity, pre-pregnancy overweight or obesity, GWG,GDM and serum triglyceride level≥1.7 mmol/L in the first trimester were associated with high risk of LGA (all P<0.05). Among these factors, pre-pregnancy overweight or obesity, excessive GWG and multiparity were common risk factors of LGA. GDM was not associated with risk of LGA in 2017 database. (3) Dynamic change of PAR% in these years were notable. PAR% of GWG for LGA decreased (32.6%, 27.2% and 22.2% in 2011, 2014 and 2017, respectively), while PAR% of pre-pregnancy overweight or obesity showed an upward trend (4.2%, 3.3% and 8.4%). In addition, PAR% of multiparity increased as well (3.5%, 6.3% and 15.9%). (4) Further analysis showed that excessive GWG in the first and second trimesters contributed the most (20.2% and 19.0% in 2014 and 2017). Conclusions: Excessive GWG, pre-pregnancy overweight or obesity and multiparity are the important risk factors what contribute to LGA. PAR% of excessive GWG for LGA decrease in recent years. However, GWG in the first and second trimesters is a critical factor of LGA. Appropriate weight management in pre-pregnancy, the first or second trimester is the key point to reduce the risk of LGA.

P-Band Induced Self-Organization and Dynamics with Repulsively Driven Ultracold Atoms in an Optical Cavity

We investigate a Bose-Einstein condensate strongly coupled to an optical cavity via a repulsive optical lattice. We detect a stable self-ordered phase in this regime, and show that the atoms order through an antisymmetric coupling to the P band of the lattice, limiting the extent of the phase and changing the geometry of the emergent density modulation. Furthermore, we find a nonequilibrium phase with repeated intense bursts of the intracavity photon number, indicating nontrivial driven-dissipative dynamics.

Evaluation of common variants in the CNR2 gene and its interaction with abdominal obesity for osteoporosis susceptibility in Chinese post-menopausal females

Objectives

The objective of this study was to investigate the association of four single-nucleotide polymorphisms (SNPs) of the cannabinoid receptor 2 (CNR2) gene, gene-obesity interaction, and haplotype combination with osteoporosis (OP) susceptibility.

Methods

Chinese patients with OP were recruited between March 2011 and December 2015 from our hospital. In this study, a total of 1267 post-menopausal female patients (631 OP patients and 636 control patients) were selected. The mean age of all subjects was 69.2 years (sd 15.8). A generalized multifactor dimensionality reduction (GMDR) model and logistic regression model were used to examine the interaction between SNP and obesity on OP. For OP patient-control haplotype analyses, the SHEsis online haplotype analysis software (http://analysis.bio-x.cn/) was employed.

Results

The logistic regression model revealed that the C allele of rs2501431 and the G allele of rs3003336 were associated with increased OP risk, compared with those with wild genotype. However, no significant correlations were found when analyzing the association of rs4237 and rs2229579 with OP risk. The GMDR analysis suggested that the interaction model composed of two factors, rs3003336 and abdominal obesity (AO), was the best model with statistical significance (p-value from sign test (P_sign) = 0.012), indicating a potential gene-environment interaction between rs3003336 and AO. Overall, the two-locus models had a cross-validation consistency of 10/10 and had a testing accuracy of 0.641. Abdominally obese subjects with the AG or GG genotype have the highest OP risk, compared with subjects with the AA genotype and normal waist circumference (WC) (odds ratio (OR) 2.23, 95% confidence interval (CI) 1.54 to 3.51). Haplotype analysis also indicated that the haplotype containing the rs3003336-G and rs2501431-C alleles was associated with a statistically increased OP risk.

Conclusion

Our results suggested that the C allele of rs2501431 and the G allele of rs3003336 of the CNR2 gene, interaction between rs3003336 and AO, and the haplotype containing the rs3003336-G and rs2501431-C alleles were all associated with increased OP risk.

Cite this article: Bone Joint Res 2019;8:544–549.

CD82/KAI1 inhibits invasion and metastasis of esophageal squamous cell carcinoma via TGF-β1

OBJECTIVE

Previous studies have found that CD82/KAI1 is a tumor suppressor gene. However, the role of CD82/KAI1 in esophageal squamous cell carcinoma (ESCC) has not been reported. This study aims to investigate the specific role of CD82/KAI1 in ESCC, so as to further explore the relationship between CD82/KAI1 expression and clinical characteristics of ESCC.

PATIENTS AND METHODS

The expression of CD82/KAI1 in 96 pairs of ESCC tissues and adjacent normal tissues was detected by Real-time quantitative polymerase chain reaction (qRT-PCR). The relationship between CD82/KAI1 expression and the pathological indicators of ESCC patients was analyzed by Kaplan-Meier method. QRT-PCR further validated the expression level of CD82/KAI1 in ESCC cells. In addition, the CD82/KAI1 knockdown expression model was constructed using small interfering RNA in ESCC cell lines TE-1 and EC-109 cells. Cell counting kit-8 (CCK-8) and transwell assay were performed to detect cell viability, invasion and migration. Finally, the potential mechanism of CD82/KAI1 in regulating ESCC was explored using Western blot.

RESULTS

QRT-PCR results showed that the expression level of CD82/KAI1 in ESCC was significantly lower than that of normal tissues, and the difference was statistically significant. Higher rates of lymph node metastasis and distant metastasis, as well as shorter overall survival were observed in ESCC patients with lower expression of CD82/KAI1 compared with those with higher expression. CD82/KAI1 overexpression decreased cell proliferation, invasion and metastasis in ESCC cells. Western blot results showed that the expressions of TGF-β1, Smad2/3, MMP-2 and MMP-9 were regulated by CD82/KAI1. In addition, rescue experiments demonstrated an interaction between CD82/KAI1 and TGF-β1, indicating that CD82/KAI1 inhibits the malignant progression of ESCC via regulating TGF-β1.

CONCLUSIONS

Lowly expressed CD82/KAI1 in ESCC was significantly associated with the pathological stage, distant metastasis and poor prognosis of ESCC patients. CD82/KAI1 may inhibit the malignant progression of ESCC by interacting with TGF-β1.

MiR-34a-5p/PD-L1 axis regulates cisplatin chemoresistance of ovarian cancer cells

Ovarian cancer is the most lethal gynecologic malignancy in women with an increasing number of cases worldwide. Chemoresistance is the main obstacle for ovarian cancer treatment during clinical therapy. Previous studies found that programmed cell death 1 ligand 1 (PD-L1) was associated with chemoresistance of cancer. However, there were little reports about the function of PD-L1 involved in chemoresistance of ovarian cancer. In our study, cisplatin (DDP)-resistant SKOV3 and A2780 ovarian cancer cell lines (SKOV3/DDP and A2780/DDP) were established. We found that the expression of PD-L1 was increased and miR-34a-5p was decreased in DDP-resistant cells. PD-L1 silencing inhibited chemoresistance of DDP-resistant ovarian cancer cells to DDP, as evidenced by decreased proliferation, G1-phase cell cycle arrest and increased apoptosis. Western blot assay showed that in the presence of DDP, PD-L1 silencing decreased multidrug resistance protein 1 and Cyclin D1 protein levels, whereas increased cleaved-caspase-3 and cleaved-PARP protein levels in these cells. Moreover, we demonstrated that miR-34a-5p negatively regulated the expression of PD-L1 by targeting its 3'-untranslated region. The effects of miR-34a-5p mimic on DDP-treated SKOV3/DDP cells were reversed by the overexpression of PD-L1. Moreover, the tumorigenicity of DDP-resistant ovarian cancer cells in nude mice treated with DDP was attenuated by miR-34a-5p in vivo. The combined data indicate that miR-34a-5p/PD-L1 axis regulates DDP chemoresistance of ovarian cancer cells, providing a deeper insight into the treatment for ovarian cancer.

Association between depression subtypes and response to repeated-dose intravenous ketamine

OBJECTIVE

About half or more of treatment-resistant depressed patients do not respond to ketamine, and few clinical predictors to gauge the most likely antidepressant response have been proposed. We explored whether depression subtypes are associated with response to ketamine.

METHOD

Ninety-seven participants with depression were administered six repeated-dose intravenous ketamine and assessed for depression (Montgomery-Åsberg Depression Rating Scale, MADRS), anxiety (Hamilton Anxiety Rating Scale, HAMA), and suicidal ideation (Beck Scale for Suicidal Ideation, SSI) at baseline, 24 h after each infusion, and 2 weeks after the whole treatment. Participants were classified by melancholic/anxious subtype. Individuals who met criteria for neither or both subtypes were classified separately, resulting in four mutually exclusive groups.

RESULTS

Patients with melancholic or melancholic-anxious features were less likely to respond (e.g., day 13, melancholic-anxious vs. anxious, OR 0.138, 95% CI 0.032-0.584, P = 0.007) or remit (e.g., day 26, melancholic vs. no subtype, OR 0.182, 95% CI 0.035-0.960, P = 0.045) and took longer to achieve response/remission than those with anxious or no subtype features. Faster HAMA score reductions were observed in patients with anxious or melancholic-anxious features, and faster SSI score reductions were observed among those with melancholic-anxious features.

CONCLUSION

Our study shows promising results for ketamine as a novel antidepressant preferentially for the treatment of non-melancholic or anxious depression.

Lipopolysaccharide induces epithelial-mesenchymal transition of alveolar epithelial cells cocultured with macrophages possibly via the JAK2/STAT3 signaling pathway

Epithelial-mesenchymal transition (EMT) plays a key role in the process of pulmonary fibrosis (PF). Increasing evidences have shown that exaggerated EMT in recurrent pulmonary injury mediates the early pathogenesis of PF. This study aimed to evaluate EMT of human alveolar epithelial cells (A549) when cocultured with human macrophages Tohoku hospital pediatrics-1 (THP-1) induced by lipopolysaccharide (LPS) and investigate the role of Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway. Firstly, we detected the inflammatory and EMT biomarkers in A549 cells monoculture and A549/THP-1 cells coculture in the presence or absence of LPS. Then, the activation of JAK2/STAT3 signaling pathway was determined in coculture. Interestingly, inflammatory markers, such as interleukin (IL)-6, matrix metalloproteinase (MMP)-9, transforming growth factor (TGF)-β, and collagen type 1 (COL-1), were enhanced in LPS treated coculture. Besides, the expression of E-cadherin decreased but α-smooth muscle actin expression increased, indicating the presence of EMT in A549 cells when cocultured with THP-1 macrophages. However, these phenotypes could not be observed in LPS-treated A549 cells monoculture. Meanwhile, JAK2/STAT3 signaling pathway was activated, and the STAT3 DNA-binding and inflammatory markers were inhibited by Stattic. Together, these findings demonstrate the key role of JAK2/STAT3 signaling pathway in LPS promoted EMT of A549 in the presence of THP-1 macrophages as an in vitro PF model.