The addition of albumin improves Schwann cells viability in nerve cryopreservation

Construction and validation of a nomogram model for predicting diabetic peripheral neuropathy

Objective

Diabetic peripheral neuropathy (DPN) is a chronic complication of diabetes that can potentially escalate into ulceration, amputation and other severe consequences. The aim of this study was to construct and validate a predictive nomogram model for assessing the risk of DPN development among diabetic patients, thereby facilitating the early identification of high-risk DPN individuals and mitigating the incidence of severe outcomes.

Methods

1185 patients were included in this study from June 2020 to June 2023. All patients underwent peripheral nerve function assessments, of which 801 were diagnosed with DPN. Patients were randomly divided into a training set (n =711) and a validation set (n = 474) with a ratio of 6:4. The least absolute shrinkage and selection operator (LASSO) logistic regression analysis was performed to identify independent risk factors and develop a simple nomogram. Subsequently, the discrimination and clinical value of the nomogram was extensively validated using receiver operating characteristic (ROC) curves, calibration curves and clinical decision curve analyses (DCA).

Results

Following LASSO regression analysis, a nomogram model for predicting the risk of DPN was eventually established based on 7 factors: age (OR = 1.02, 95%CI: 1.01 - 1.03), hip circumference (HC, OR = 0.94, 95%CI: 0.92 - 0.97), fasting plasma glucose (FPG, OR = 1.06, 95%CI: 1.01 - 1.11), fasting C-peptide (FCP, OR = 0.66, 95%CI: 0.56 - 0.77), 2 hour postprandial C-peptide (PCP, OR = 0.78, 95%CI: 0.72 - 0.84), albumin (ALB, OR = 0.90, 95%CI: 0.87 - 0.94) and blood urea nitrogen (BUN, OR = 1.08, 95%CI: 1.01 - 1.17). The areas under the curves (AUC) of the nomogram were 0.703 (95% CI 0.664-0.743) and 0.704 (95% CI 0.652-0.756) in the training and validation sets, respectively. The Hosmer-Lemeshow test and calibration curves revealed high consistency between the predicted and actual results of the nomogram. DCA demonstrated that the nomogram was valuable in clinical practice.

Conclusions

The DPN nomogram prediction model, containing 7 significant variables, has exhibited excellent performance. Its generalization to clinical practice could potentially help in the early detection and prompt intervention for high-risk DPN patients.

Development of Chitosan/Gelatin-Based Hydrogels Incorporated with Albumin Particles

The research subject of this paper are natural polymer-based hydrogels modified with albumin particles. The proteins were obtained via the salt-induced precipitation method, and next characterized using dynamic light scattering (DLS), UV-Vis spectroscopy and FT-IR spectroscopy. The most favorable composition showing monodispersity and particles with a size lower than 40 nm was selected for modification of hydrogels. Such systems were obtained via the photopolymerization performed under the influence of UV radiation using diacrylate poly(ethylene glycol) as a crosslinking agent and 2-hydroxy-2-methylpropiophenone as a photoinitiator. Next, the hydrogels' swelling ability, mechanical properties, wettability and surface morphology were characterized. Moreover, FT-IR spectroscopy, incubation studies in simulated physiological liquids, pro-inflammatory activity analysis and MTT reduction assay with L929 murine fibroblasts were performed. The release profiles of proteins from hydrogels were also verified. Materials modified with proteins showed higher swelling ability, increased flexibility even by 50% and increased surface hydrophilicity. Hydrogels' contact angles were within the range 62-69° while the tensile strength of albumin-containing hydrogels was approx. 0.11 MPa. Furthermore, the possibility of the effective release of protein particles from hydrogels in acidic environment (approximately 70%) was determined. Incubation studies showed hydrogels' stability and lack of their degradation in tested media. The viability of fibroblasts was 89.54% for unmodified hydrogel, and approx. 92.73% for albumin-modified hydrogel, and such an increase indicated the positive impact of the albumin on murine fibroblast proliferation.

Serum albumin was negatively associated with diabetic peripheral neuropathy in Chinese population: a cross-sectional study

BACKGROUND

Previous studies that explored the relationship of serum albumin with diabetic peripheral neuropathy (DPN) have indicated inconsistent results. Thus, the present study aimed to evaluated the association between serum albumin and DPN, defined as vibration perception threshold (VPT) values ≥ 25 V and/or inability to feel the monofilament, in Chinese patients with type 2 diabetes mellitus (T2DM).

METHODS

1465 T2DM patients aged ≥ 16 years, who completed the measurement of serum albumin and DPN screening between 2012 and 2015, were included in the cross-sectional study. Correlation and multivariate logistic regression analysis models were used to evaluate the possible relationship between serum albumin and DPN.

RESULTS

Patients with higher quartiles of serum albumin had significantly lower VPT values and prevalence of DPN compared with those with lower quartiles (P for trend < 0.01), and there was an inverse relationship between serum albumin and VPT values and prevalence of DPN (all P < 0.01). Multivariate logistic regression analysis demonstrated that the risk of DPN was progressively decreased across serum albumin quartiles (P for trend < 0.01), and participants in the highest quartile of serum albumin were at a significantly decreased risk of DPN compared to those in the lowest quartile (odds rate: 0.311, 95% confidence intervals 0.134-0.724, P < 0.01). ROC analysis revealed that the optimal cutoff point of serum albumin for the prevalence of DPN was 39.95 g/L in patients with T2DM, with a sensitivity of 65.88% and a specificity of 66.7%.

CONCLUSIONS

Decreased levels of serum albumin might be correlated with increased risk of DPN in Chinese patients with T2DM. Future longitudinal studies with large samples are warranted to confirm our findings, and elucidate putative mechanisms for the association.

Construction of transplantable artificial vascular tissue based on adipose tissue-derived mesenchymal stromal cells by a cell coating and cryopreservation technique

Prevascularized artificial three-dimensional (3D) tissues are effective biomaterials for regenerative medicine. We have previously established a scaffold-free 3D artificial vascular tissue from normal human dermal fibroblasts (NHDFs) and umbilical vein-derived endothelial cells (HUVECs) by layer-by-layer cell coating technique. In this study, we constructed an artificial vascular tissue constructed by human adipose tissue-derived stromal cells (hASCs) and HUVECs (ASCVT) by a modified technique with cryopreservation. ASCVT showed a higher thickness with more dense vascular networks than the 3D tissue based on NHDFs. Correspondingly, 3D-cultured ASCs showed higher expression of several angiogenesis-related factors, including vascular endothelial growth factor-A and hepatic growth factor, compared to that of NHDFs. Moreover, perivascular cells in ASCVT were detected by pericyte markers, suggesting the differentiation of hASCs into pericyte-like cells. Subcutaneous transplantation of ASCVTs to nude mice resulted in an engraftment with anastomosis of host's vascular structures at 2 weeks after operation. In the engrafted tissue, the vascular network was surrounded by mural-like structure-forming hASCs, in which some parts developed to form vein-like structures at 4 weeks, suggesting the generation of functional vessel networks. These results demonstrated that cryopreserved human cells, including hASCs, could be used directly to construct the artificial transplantable tissue for regenerative medicine.