IL-10 dependent adaptation allows macrophages to adjust inflammatory responses to TLR4 stimulation history

During an infection, innate immune cells must adjust nature and strength of their responses to changing pathogen abundances. To determine how stimulation of the pathogen sensing TLR4 shapes subsequent macrophage responses, we systematically varied priming and restimulation concentrations of its ligand KLA. We find that different priming strengths have very distinct effects at multiple stages of the signaling response, including receptor internalization, MAPK activation, cytokine and chemokine production, and nuclear translocation and chromatin association of NFκB and IκB members. In particular, restimulation-induced TNF-α production required KLA doses equal to or greater than those used for prior exposure, indicating that macrophages can detect and adaptively respond to changing TLR4 stimuli. Interestingly, while such adaptation was dependent on the anti-inflammatory cytokine IL-10, exogenous concentrations of IL-10 corresponding to those secreted after strong priming did not exert suppressive effects on TNF-α without such prior priming, confirming the critical role of TLR4 stimulation history.

Patterns of Failure in Pediatric and Young Adult Rhabdomyosarcoma

PURPOSE/OBJECTIVE(S)

To characterize patterns of failure in pediatric and young adult patients with rhabdomyosarcoma (RMS) from a single institution with over 20 years of experience.

MATERIALS/METHODS

Patients diagnosed with RMS from 2000 to 2022 were identified retrospectively. Time to failure was calculated from diagnosis. Local only failure was defined as first failure at the primary site without distant failure. Distant failure was defined as first failure outside of the primary site with or without local failure. Cumulative incidence (CI) of failure was calculated using death as a competing risk. Fine-Gray regression was used to evaluate impact of prognostic factors.

RESULTS

Ninety-five patients were eligible. Median age was 7.28 years (range 0 - 35 years), 41% of patients were >10 years old. Median follow up was 33.3 months. Approximately half (n = 47, 49.5%) of the tumors demonstrated alveolar histology. FOXO1 fusion status was available in 76 (80%) patients, of which 7 out of 37 alveolar tumors (18.9%) were FOXO1 fusion negative. The majority of tumors presented with unfavorable primary site (n = 72, 75.8%) and advanced stage (Stage III and IV, n = 72, 75.8%). The 5-yr CI of local only failure and distant failure for the entire cohort was 19.0% (95% CI 11.3, 28.3) and 34.6% (24.0, 45.5%), respectively. The predominant pattern of failure by Group was: Groups 1&2: Local only (5yr CI 14.8%), Group 3: Distant (5yr CI: 25.9%), Group 4: Distant (5yr CI: 67.6%). CI of distant failure by primary site was higher in perianal/gluteal (n = 2/5, 5yr CI 60.0%) and extremity (n = 8/19, 5yr CI 45.9%) sites. Of the 28 distant failures, 10 (36%) also had a local failure component. CI of local only failure by primary site was higher in parameningeal head and neck (n = 6/25, 5yr CI 30%) and bladder/prostate (n = 2/12, 5yr CI 23%) sites. The following were associated with an increased CI of distant failures: increasing age (HR 1.08, p<0.01), alveolar vs. embryonal histology (HR 3.01, p = 0.0095), FOXO1 fusion positive vs. negative (HR 2.8, p = 0.02) and Group IV vs. Groups I/II (HR 7.7, p = 0.0007). FOXO1 fusion and alveolar histology were associated with older age and Group IV, both of which were independently associated with increased distant failure on multivariate analysis.

CONCLUSION

Failures were predominantly distant in older patients and patients with Group IV RMS, both of which were associated with FOXO1 fusion and alveolar histology, highlighting the need to improve therapies in this population. Local only failures were highest in parameningeal head and neck and bladder/prostate primaries, highlighting the need to improve local control strategies at these sites.

POS0993 RADIOLOGICAL CERVICAL INVOLVMENT IN ANKYLOSING SPONDYLITIS

Background

Cervical involvement in ankylosing spondylitis (AS) is particularly disabling and has been poorly studied yet. Actual radiologic scoring design to assess disease progression does not provide a comprehensive picture of the cervical involvement in AS. [1] Association with clinical features such as psoriasis are discussed.

Objectives

We aimed to assess radiographic features of cervical involvement in AS and clinico-biological parameters associated with this specific radiographic location.

Methods

Cross-sectional study based on radiographic analysis of a subgroup of patients included in the French BambooSpine cohort, originally designed to study the genetic risk factors of AS structural severity. The analysis was based on patients included in Parisian hospitals to have access to images of the entire spine on the Picture Archiving and Communication System (PACS) shared by all University Hospitals in Paris. A double reading of the images was performed by a rheumatologist/radiologist pair until consensus was reached, to identify syndesmophytes, zygapophyseal joint (ZJ) involvement and posterior ligament structures (PLS) at each cervical level, syndesmophytes in the thoracic region, and ZJ and PLS involvement in the lumbar region.

Results

Of the 113 assessed patients, 101 were men, mean age 53 years (+/- 11 years) with 27 years (+/- 13 years) of disease duration (Table 1). Of those whose HLA B27 status was known, 85% (70/82) were carriers. Among 86 patients with radiological cervical involvement, 83% had syndesmophytes, 86% had ZJ involvement and 24% had PLS involvement. In the cervical region, 13 patients (15%) had zygapophyseal fusion without syndesmophytes. 26/113 patients were completely free of any cervical involvement while 30/113 had a maximal cervical involvement (anterior and posterior). In univariate analyses, HLA-B27 was significantly associated with ZJ involvement at the cervical and lumbar level (p=0.016). Cervical involvement of any type was not associated with psoriasis. Low educational level (not beyond secondary school) was significantly associated with syndesmophytic involvement (p=0.035). There was a non-significant trend for an association between arthritis and ZJ involvement.

Table 1.

Clinical features

Men (n,%)101/11389,4%Age at diagnosis (mean, SD)31,211,68Duration of evolution (mean, SD)27,013,0Smoking ever (n,%)65/11258,0 %Chronic Back Pain (for > 3 months) (n,%)109/11396,5%Chest pain45/11040,9%Buttock pain78/10971,6%Arthritis36/11132,4%Enthesitis38/11233,9%Dactylitis6/1115,4%HLA B2770/8285,4%CRP87/10384,5%X ray sacro-iliitis112/112100%Personnal history -Uveitis41/11336,3% -Inflammatory bowel disease13/11311,5% -Reactive arthritis2/1121,8% -Psoriasis19/11117,1%

Conclusion

Cervical involvement was very frequent (76% of this severe AS population) but not associated with psoriasis, as usually thought. Zygapophyseal involvement was present in 86 % of cases and exclusive in 15 % of cases. This latter radiological form of the disease, i.e. without syndesmophytes, is usually more difficult to diagnose, and should be systematically assessed among AS patients with cervical pain and/or patients with reduced cervical mobility.

References

[1]Wanders AJB, Landewé RBM, Spoorenberg A, et al. What is the most appropriate radiologic scoring method for ankylosing spondylitis? Arthritis & Rheumatism 2004

Disclosure of Interests

None declared

MR Imaging Differences in the Circle of Willis between Healthy Children and Adults

BACKGROUND AND PURPOSE

Asymmetries in the circle of Willis have been associated with several conditions, including migraines and stroke, but they may also be age-dependent. This study examined the impact of age and age-dependent changes in cerebral perfusion on circle of Willis anatomy in healthy children and adults.

MATERIALS AND METHODS

We performed an observational, cross-sectional study of bright and black-blood imaging of the proximal cerebral vasculature using TOF-MRA and T2 sampling perfection with application-optimized contrasts by using different flip angle evolution (T2-SPACE) imaging at the level of the circle of Willis in 23 healthy children and 43 healthy adults (4-74 years of age). We compared arterial diameters measured manually and cerebral perfusion via pseudocontinuous arterial spin-labeling between children and adults.

RESULTS

We found that the summed cross-sectional area of the circle of Willis is larger in children than in adults, though the effect size was smaller with T2-SPACE-based measurements than with TOF-MRA. The circle of Willis is also more symmetric in children, and nonvisualized segments occur more frequently in adults than in children. Moreover, the size and symmetry of the circle of Willis correlate with cerebral perfusion.

CONCLUSIONS

Our results demonstrate that the circle of Willis is different in size and symmetry in healthy children compared with adults, likely associated with developmental changes in cerebral perfusion. Further work is needed to understand why asymmetric vasculature develops in some but not all adults.

Negative affect, affect regulation, and food choice: A value-based decision-making analysis

Introduction

Research has shown that negative affect leads to unhealthy eating, the top cause of death in the United States.

Objectives

This project examined whether AR (Affect Regulation) can be applied to incidental negative affect to improve eating behavior.

Methods

We conducted four studies.

Results

In Studies 1 and 2 (n=80), we developed a autobiographical negative affect induction, showed that it induces negative affect, and demonstrated that participants can learn to downregulate this negative affect. In Study 3 (n=40), participants completed a three-phase dietary food choice task. In phase 1, participants made food choices under neutral conditions. In phase 2, participants made food choices after receiving the negative affect induction from Studies 1 and 2. In phase 3, participants made food choices while downregulating the negative affect caused by the induction. In phase 2, participants placed less importance on health (b=-0.15, z=-5.99, p<.001) when making food choices than under neutral conditions (phase 1). In phase 3, participants successfully downregulated their negative affect (b=-1.2, t=-22.01, p<.001) and placed the same level of importance on health when making food choices as in phase 1, indicating that AR applied to incidental affect is an effective method for improving eating behavior. In Study 4 (n=120), we pre-registered and replicated our findings from Study 3. In addition, we fit drift-diffusion models to participants reaction time data and show that these results extent to the by-participant weights participants place on health when making food choices.

Conclusions

These results are a step towards scalable AR interventions to improve eating behavior.

Disclosure

No significant relationships.

Computer Retrieval of Mechanically - Indexed Articles

A program package offered by the Institute for Scientific Information, Philadelphia, for computer retrieval of machine-indexed scientific articles has been adapted for use on an IBM 360/30 system. Titles provided on magnetic tapes serve as input to the automatic retrieval programs; corresponding information from Current Contents is scanned manually for comparison.

Seven user interest profiles are matched against 45,000 titles, and the computer retrieval ratio is found to be 89% compared to 60% for manual search; computer relevance ratio is over 99%. The programs used are described and a simplified flow chart and a sample user profile are presented. Questions of computer running time and minimum configuration are considered, and reasons for non-retrieval are discussed. Future improvements being planned are indicated.

MEG sensor and source measures of visually induced gamma-band oscillations are highly reliable

High frequency brain oscillations are associated with numerous cognitive and behavioral processes. Non-invasive measurements using electro-/magnetoencephalography (EEG/MEG) have revealed that high frequency neural signals are heritable and manifest changes with age as well as in neuropsychiatric illnesses. Despite the extensive use of EEG/MEG-measured neural oscillations in basic and clinical research, studies demonstrating test-retest reliability of power and frequency measures of neural signals remain scarce. Here, we evaluated the test-retest reliability of visually induced gamma (30-100Hz) oscillations derived from sensor and source signals acquired over two MEG sessions. The study required participants (N=13) to detect the randomly occurring stimulus acceleration while viewing a moving concentric grating. Sensor and source MEG measures of gamma-band activity yielded comparably strong reliability (average intraclass correlation, ICC=0.861). Peak stimulus-induced gamma frequency (53-72Hz) yielded the highest measures of stability (ICCsensor=0.940; ICCsource=0.966) followed by spectral signal change (ICCsensor=0.890; ICCsource=0.893) and peak frequency bandwidth (ICCsensor=0.856; ICCsource=0.622). Furthermore, source-reconstruction significantly improved signal-to-noise for spectral amplitude of gamma activity compared to sensor estimates. Our assessments highlight that both sensor and source derived estimates of visually induced gamma-band oscillations from MEG signals are characterized by high test-retest reliability, with source derived oscillatory measures conferring an improvement in the stability of peak-frequency estimates. Importantly, our finding of high test-retest reliability supports the feasibility of pharma-MEG studies and longitudinal aging or clinical studies.

Cortical activation associated with asterixis in manifest hepatic encephalopathy

OBJECTIVES

Severe hepatic encephalopathy gives rise to asterixis, a striking motor symptom also called flapping tremor, which is characterized by a sudden ceasing of muscle tone in all muscles of a limb. In this study, we aimed at scrutinizing the cortical activation associated with asterixis and unraveling the underlying pathophysiological mechanisms.

MATERIAL AND METHODS

We recorded simultaneously neural activity with magnetoencephalography (MEG) and muscle activity with surface EMG in nine patients with manifest hepatic encephalopathy showing asterixis. Asterixis events were detected semiautomatically and served as triggers for averaging MEG signals. Evoked responses averaged time-locked to asterixis events were subjected to equivalent current dipole (ECD) modeling. Additionally, we localized the strongest cortico-muscular coherence in the frequency of the co-occurring tremulousness.

RESULTS

Evoked fields averaged time-locked to asterixis events were best explained by a single dipolar source in the contralateral primary motor cortex (M1, Talairach coordinates of mean localization: -40, -20, and 64; Brodmann area 4). This dipole showed a twofold field reversal, that is biphasic wave, with frontal dipole orientation at 49 ms before flap onset and 99 ms after flap onset. Conversely, two maxima with occipital dipole orientation were observed 2 ms and 160 ms after flap onset. Cortico-muscular coherence for the tremulousness was likewise localized in the contralateral M1 confirming earlier findings in the present patient cohort.

CONCLUSIONS

Our results reveal an involvement of M1 in the generation of asterixis. As also tremulousness, also called mini-asterixis, was shown to originate in M1, asterixis and mini-asterixis may share common pathophysiological mechanisms.