Potential mechanisms of exercise for relieving inflammatory pain: a literature review of animal studies

Inflammatory pain (IP) is one of the most prevalent and intractable human conditions, and it leads to progressive dysfunction and reduced quality of life. Additionally, IP is incredibly challenging to treat successfully with drugs or surgery. The development of IP is complex and multifactorial, and peripheral and central sensitization may influence chronicity and treatment resistance in IP. Understanding the mechanisms underlying IP is vital for developing novel therapies. Strong evidence suggests that exercise can be a first-line relief for patients with IP during rehabilitation. However, the mechanisms through which exercise improves IP remain unclear. Here, we reviewed the current animal experimental evidence for an exercise intervention in IP and proposed biological mechanisms for the effects of synaptic plasticity in the anterior cingulate cortex, endocannabinoids, spinal dorsal horn excitability balance, immune cell polarization balance, cytokines, and glial cells. This information will contribute to basic science and strengthen the scientific basis for exercise therapy prescriptions for IP in clinical practice.

One independent or many independent? The relationship among self-construal, number of brand endorsers, and brand attitudes

Introduction

It was common for brands to use different numbers of endorsers in marketing practice. Nevertheless, research on brand endorsers' quantity has not yielded a uniform consensus. The previous research about brand endorsers mainly focuses on the appeal of endorsement, brand category, and endorser characteristics, paying less attention to the impact of cultural factors, particularly self-construal. This study delves into selecting brand endorsers across diverse cultural regions for the same brand.

Methods

Drawing on the principles of self-consistency theory and self-construal theory, our research, conducted through three distinct experiments, reveals that consumers tend to hold more favorable opinions about brands endorsed by a single individual. Furthermore, self-consistency emerges as a crucial mediating factor in this phenomenon. Additionally, self-construal is an essential factor among consumers from various cultural backgrounds.

Results

Consumers with an independent self-construal exhibit more favorable brand perceptions when it comes to single-endorser brands compared to their counterparts with an interdependent self-construal. Conversely, individuals with an interdependent self-construal demonstrate a more positive disposition towards brands with multiple endorsers than those with an independent self-construal.

Discussion

This research not only enriches and extends our theoretical understanding of the impact of the number of brand endorsers on consumer brand attitudes but also provides valuable practical insights for optimizing the selection of brand endorsers for companies.

[Deep learning-based dose prediction in radiotherapy planning for head and neck cancer]

OBJECTIVE

To propose an deep learning-based algorithm for automatic prediction of dose distribution in radiotherapy planning for head and neck cancer.

METHODS

We propose a novel beam dose decomposition learning (BDDL) method designed on a cascade network. The delivery matter of beam through the planning target volume (PTV) was fitted with the pre-defined beam angles, which served as an input to the convolution neural network (CNN). The output of the network was decomposed into multiple sub-fractions of dose distribution along the beam directions to carry out a complex task by performing multiple simpler sub-tasks, thus allowing the model more focused on extracting the local features. The subfractions of dose distribution map were merged into a distribution map using the proposed multi-voting mechanism. We also introduced dose distribution features of the regions-of-interest (ROIs) and boundary map as the loss function during the training phase to serve as constraining factors of the network when extracting features of the ROIs and areas of dose boundary. Public datasets of radiotherapy planning for head and neck cancer were used for obtaining the accuracy of dose distribution of the BDDL method and for implementing the ablation study of the proposed method.

RESULTS

The BDDL method achieved a Dose score of 2.166 and a DVH score of 1.178 (P < 0.05), demonstrating its superior prediction accuracy to that of current state-ofthe-art (SOTA) methods. Compared with the C3D method, which was in the first place in OpenKBP-2020 Challenge, the BDDL method improved the Dose score and DVH score by 26.3% and 30%, respectively. The results of the ablation study also demonstrated the effectiveness of each key component of the BDDL method.

CONCLUSION

The BDDL method utilizes the prior knowledge of the delivery matter of beam and dose distribution in the ROIs to establish a dose prediction model. Compared with the existing methods, the proposed method is interpretable and reliable and can be potentially applied in clinical radiotherapy.

The rational design of nanozymes for imaging-monitored cancer therapy

Nanozymes are nanoscale materials that display enzyme-like properties, which have been improved to eliminate the limitations of natural enzymes and further broaden the use of conventional artificial enzymes. In the last decade, the research and exploration of nanozymes have attracted considerable attention in the chemical and biological fields, especially in the fields of biomedicine and tumor therapy. To date, plenty of nanozymes have been developed with the single or multiple activities of natural enzymes, including peroxidase (POD), catalase (CAT), superoxide dismutase (SOD), glucose oxidase (GOx). Tumor-characteristic metabolites can be transformed into toxic substances under the catalysis of nanozymes to kill tumor cells. However, the therapeutic effects of nanozymes greatly depend on their catalytic activity, which displays a lot of differences in vitro and in vivo. Moreover, the complex tumor environment (low pH, high H₂O₂ and GSH concentration, hypoxia, etc.) plays an important role in affecting their catalytic activity. Besides, the uncontrollable catalysis of nanozymes may lead to the destruction of normal tissues. To solve these problems, researchers have exploited several imaging methods to monitor the reaction processes during catalysis, including optical imaging methods (fluorescence and chemiluminescence), photoacoustic imaging, and magnetic resonance imaging. In this review, we have summarized the development of tumor treatment using nanozymes in recent years, along with the current imaging tools to monitor the catalyzing activity of nanozymes. Representative examples have been elaborated on to show the current development of these imaging tools. We hope this review will provide some instructive perspectives on the development of nanozymes and promote the applications of imaging-guided tumor therapeutics.

Neuroprotection of isookanin against MPTP-induced cell death of SH-SY5Y cells via BCL2/BAX and PI3K/AKT pathways

BACKGROUND AND PURPOSE

Isookanin, an important antioxidant component in Coreopsis tinctoria Nutt., has shown remarkable hypolipidemic, hypoglycemic, and hypotensive effects. However, the neuroprotective effect of isookanin has not been reported yet. Here, the neuroprotective effects and relevant molecular mechanisms of isookanin are explored for the first time.

METHODS

The SH-SY5Y cells were exposed to neurotoxic H₂O₂, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), and Aβ_25-35, respectively. Cell viability and apoptosis were evaluated by MTT, lactate dehydrogenase (LDH), and TUNEL assays. Intercellular ROS and mitochondrial membrane potential were assessed by DCFH-DA and JC-1 assay. Western blot and qRT-PCR were used to explore the perturbed signaling at the gene and protein levels. Molecular docking analysis and in vitro assay were further applied to confirm potential target.

RESULTS

Among the three in vitro models, isookanin showed the best neuroprotection against MPTP-induced damage. Isookanin attenuated the levels of LDH, intracellular ROS, and mitochondrial membrane potential. Isookanin upregulated phosphorylation of AKT and PI3K, and increased BCL2/BAX ratio. Isookanin possessed a powerful affinity toward AKT. Besides, the protective effects of isookanin disappeared when cells were co-treated with an AKT inhibitor (AZD5363).

CONCLUSION

Isookanin regulated BCL2/BAX and PI3K/AKT pathways to reduce mitochondrial damage and cellular apoptosis. Isookanin may be a new protector for neurodegenerative diseases.

Exercise for myocardial ischemia-reperfusion injury: A systematic review and meta-analysis based on preclinical studies

The main pathological manifestation of coronary artery disease is myocardial injury caused by ischemia-reperfusion (IR) injury. Regular exercise reduces the risk of death during myocardial IR injury. The aim of this study was to describe the effects of various types of exercise on myocardial IR injury. Four electronic databases PubMed, Web of Science, Embase, and Cochrane Library were comprehensively searched from inception until February 2022, to identify studies relevant to the current review, using the method of combining subject and free words. Finally, 16 articles were included in the meta-analysis. Results showed that exercise training decreases the Myocardial infarct size compared to the control group (SMD = -2.6, 95 % CI [-3.53 to -1.67], P < 0.01); increasing the coronary blood flow (MD = 2.93, 95 % CI [2.41 to 3.44], P < 0.01), left ventricular developed pressure (SMD = 2.28, 95 % CI [0.12 to 4.43], P < 0.05), cardiac output (SMD = 1.22, 95 % CI [0.61 to 1.83], P < 0.01) compared to the control group. According to the descriptive analysis results also showed that exercise training increases the left ventricular ejection fraction, superoxide dismutase, manganese superoxide dismutase, glutathione peroxidase, copper-zinc superoxide dismutase, glutathione peroxidase, and decrease the creatine kinase, creatine kinase-MB, lactate dehydrogenase, Malondialdehyde, cardiac troponins T. Exercise can improve myocardial function after myocardial IR injury; however, further research is needed in combination with specific issues such as exercise mode, intensity, duration, and model issues.

A comprehensive review on traditional and modern research of the genus Bupleurum (Bupleurum L., Apiaceae) in recent 10 years

ETHNOPHARMACOLOGICAL RELEVANCE

The genus Bupleurum (family Apiaceae), comprising approximately 248 accepted species, is widely distributed and used in China, Japan, India, Central Asia, North Africa and some European countries as traditional herbal medicines. Certain species have been reported to have significant therapeutic effects in fever, inflammatory disorders, cancer, gastric ulcer, virus infection and other diseases.

AIM OF THE REVIEW

we performed a comprehensive review of the ten-year research progress in phytochemistry, pharmacology, toxicity, along with bibliometrics research of the genus Bupleurum, aiming to identify knowledge gaps for future research.

MATERIALS AND METHODS

All the literatures are retrieved from library and electronic sources including Web of Science, PubMed, Elsevier, Google Scholar, CNKI and Baidu Scholar. These papers cover studies of the traditional use, phytochemistry, pharmacology, and toxicology of the genus Bupleurum.

RESULTS

There is a long history of using the genus Bupleurum in traditional herbal medicine that dated back to over 2000 years ago. Twenty-five species and 8 varieties with 3 variants within this genus have been reported to be effective to treat fever, pain, liver disease, inflammation, thoracolumbar pain, irregular menstruation and rectal prolapse. The main phytochemicals found in these plants are triterpene saponins, volatile oil, flavonoid, lignans, and polysaccharides. Many of these compounds have also been shown to have anti-inflammatory, anti-tumor, antimicrobial, immunoregulation, neuroregulation, hepatoprotective and antidiabetic activities. Meanwhile, improper usage of Bupleurum may induce cytotoxic effects, and polyacetylenes may be the main poisonous compounds.

CONCLUSIONS

This article summarized recent findings about Bupleurum research from many different aspects. While a small number of Bupleurum species have been investigated through modern pharmacology methods, there are still major knowledge gaps due to inadequate studies and ambiguous findings. Future research could focus on more specific phytochemistry studies combined with mechanistic analysis to provide better guidance to utilize Bupleurum as medicinal resources.

"Four-In-One" Design of a Hemicyanine-Based Modular Scaffold for High-Contrast Activatable Molecular Afterglow Imaging

Afterglow luminescence (long persistent luminescence) holds great potential for nonbackground molecular imaging. However, current afterglow probes are mainly nanoparticles, and afterglow imaging systems based on organic small molecules are still lacking and have rarely been reported. Moreover, the lack of reactive sites and a universal molecular scaffold makes it difficult to design activatable afterglow probes. To address these issues, this study reports a novel kind of hemicyanine-based molecule scaffolds with stimuli-responsive afterglow luminescence, which is dependent on an intramolecular cascade photoreaction between ¹O₂ and the afterglow molecule to store the photoenergy for delayed luminescence after light cessation. As a proof of concept, three modular activatable molecular afterglow probes (MAPs) with a "four-in-one" molecular design by integrating a stimuli-responsive unit, ¹O₂-generating unit, ¹O₂-capturing unit, and luminescent unit into one probe are customized for quantification and imaging of targets including pH, superoxide anions, and aminopeptidase. Notably, MAPs show higher sensitivity in afterglow imaging than in fluorescence imaging because the responsive unit simultaneously controls the initiation of fluorescence (S₁ to S₀) and ¹O₂ generation (S₁ to T₁). Finally, MAPs are applied for high-contrast afterglow imaging of drug-induced hepatotoxicity, which is poorly evaluated in clinics and drug discovery. By reporting the sequential occurrence of oxidative stress and upregulation of aminopeptidase, such activatable afterglow probes allow noninvasive imaging of hepatotoxicity earlier than the serological and histology manifestation, indicating their promise for early diagnosis of hepatotoxicity.

LncRNA AC093850.2 predicts poor outcomes in patients with triple-negative breast cancer and motivates tumor progression by sponging miR-4299

BACKGROUND

Accumulating evidence displays that non-coding RNAs (ncRNAs) are involved in the progression of triple-negative breast cancer (TNBC). This study aimed to investigate the role of lncRNA AC093850.2 in TNBC.

METHODS

The AC093850.2 levels were compared using RT-qPCR in TNBC tissues and corresponding normal tissues. The Kaplan-Meier curve method was conducted to assess the clinical significance of AC093850.2 in TNBC. Bioinformatic analysis was used to predict potential miRNA. Cell proliferation and invasion assays were carried out to explore the function of AC093850.2/miR-4299 in TNBC.

RESULTS

lncRNA AC093850.2 expression is raised in TNBC tissues and cell lines, which is related to the shorter overall survival of patients. AC093850.2 is directly bound to miR-4299 in TNBC cells. Downregulation of AC093850.2 reduces tumor cell proliferation, migration, and invasion abilities, while miR-4299 silence attenuated AC093850.2 silencing induced inhibition of cellular activities in TNBC cells.

CONCLUSION

In general, the findings suggest that lncRNA AC093850.2 was closely related to the prognosis and progression of TNBC by sponging miR-4299, which might be a prognosis predictor and potential target for treating TNBC patients.

Effects of acupuncture combined with medication on patients with COVID-19 complicated with bipolar disorder: A protocol of systematic review and meta-analysis

BACKGROUND

There is growing evidence that coronavirus disease 2019 (COVID-19) can trigger acute episodes of mood disorders or psychotic symptoms. Reports on the treatment of COVID-19-related bipolar disorder (BD) are limited. Our study aimed to investigate the potential for new or recurrent BD due to COVID-19. We qualitatively evaluate clinical treatments (acupuncture combined with medication) and any potential pathophysiological links between infection and BD.

METHODS

We searched Embase, PubMed, Cochrane Library, Web of Science and MEDLINE (via Web of Science), Scopus, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database, and the Wanfang Database from December 1, 2019, to September 15, 2022, to identify all articles on acupuncture combined with drugs used to treat COVID-19 complicated with bipolar disorders. Two researchers will screen the articles and extract the relevant information.

RESULTS

The results will provide a systematic overview of the current evidence on the use of acupuncture combined with drug therapy to treat COVID-19 complicated with bipolar disorder.

CONCLUSION

The conclusions of this study will help clarify the effects of acupuncture combined with drug therapy on patients with COVID-19-related BD.

[The impact of the dosage of intraoperative opioids on postoperative survival outcomes in patients with pancreatic cancer]

Objective: To investigate the impact of the dosage of intraoperative opioids on postoperative survival of pancreatic cancer patients who underwent pancreatectomy. Methods: The clinical data of 95 patients with pancreatic cancer who underwent pancreatectomy at Harbin Medical University Cancer Hospital from September 2013 to August 2018 were retrospectively collected. Dosage of intraoperative opioid medications was converted to fentanyl equivalent dose. Patients were divided into high-dose group (fentanyl consumption ≥2.21 mg, n=46) and low-dose group (fentanyl consumption<2.21 mg, n=49) according to the median intra-operative fentanyl equivalents. The relapse-free survival (RFS) and overall survival (OS) between the two groups were compared. Cox proportional hazards regression model was used to analyze the impact of important covariates on RFS and OS. Results: RFS of patients in low-dose group at 1, 3 and 5 years was 75.5%, 26.5% and 15.2% respectively. OS of patients in low-dose group at 1, 3 and 5 years was 77.6%, 32.5% and 24.4% respectively. RFS of patients in high-dose group at 1, 3 and 5 years was 76.1%, 23.9% and 12.0% respectively. OS of patients in high-dose group at 1, 3 and 5 years was 76.1%, 37.0% and 15.0%. There was no significant difference in RFS and OS between the two groups (all P>0.05). Multivariate Cox analysis showed that dosage of intraoperative fentanyl was not associated with RFS (HR=1.205, 95%CI: 0.737-1.970, P=0.456) or OS (HR=1.062, 95%CI: 0.634-1.778, P=0.818). Conclusion: Dosage of intraoperative opioid has no effect on RFS and OS in pancreatic cancer patients undergoing pancreatectomy.

Win Big with Small: The Influence of Organic Food Packaging Size on Purchase Intention

People pay much attention to food and health issues, more so these days. Organic food brings its own “organic” aura as soon as it is produced. Despite the many studies on organic food packaging at present, they mainly focus on packaging design, materials, and colors and pay less attention to packaging size. In view of this gap in the literature, this study explores the influence of organic food packaging size on consumer purchase intention. This article conducted two experiments with 755 participants to examine the effect of organic food packaging size on purchase intention. The results show that the packaging size of organic food has a significant influence on consumer purchase intention. Specifically, the small size of organic food packaging (vs. large) can improve consumer purchase intention, and the green perceived value plays an intermediary role (Study 1). In addition, the consumers’ construal level moderates the influence of organic food packaging size on their purchase intention. For consumers with a high construal level, the small size of organic food packaging (vs. large) can improve their purchase intention. For consumers with a low construal level, large packaging size (vs. small) of organic food can improve their purchase intention (Study 2). This study reveals the psychological mechanism and boundary conditions of organic food packaging size on consumer purchase intention and provides practical enlightenment for enterprises in formulating the size of organic food packaging.

Efficacy of Traditional Chinese Exercise in Improving Gait and Balance in Cases of Parkinson's Disease: A Systematic Review and Meta-analysis

Background

The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of motor function in patients with Parkinson's disease (PD) is controversial. The present study aimed to assess the effects of TCE on balance and gait outcomes, as well as motor symptoms in individuals with PD, and evaluate potential discrete moderators such as TCE dosage-related variables.

Method

PubMed, Embase, Cochrane's Library, Web of Science, Medline, and Scopus were systematically searched from their dates of inception to February 2022. All studies were randomized controlled trials (RCTs) of TCE-based interventions for PD. The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges' g). The Physiotherapy Evidence Database was used to evaluate the methodological quality of the study.

Result

Fifteen studies involving a total of 873 participants were included in the final analysis. The meta-analytic findings revealed significant improvements in balance outcomes [Berg Balance Scales (BBS) (g = 0.83, 95% CI = 0.37–1.29, p = 0.000, I² = 84%), time up and go (TUG) (g = −0.80, 95% CI = −1.13– −0.47, p = 0.000, I² = 81%), and the one legged blind balance test (g = 0.49, 95% CI = 0.13–0.86, p = 0.01, I² = 10%)], as well as gait outcomes [gait velocity (g = 0.28, 95% CI = 0.02–0.54, p = 0.04, I² = 64%), 6-min walking test (6MWT) (g = 0.32, 95% CI 0.01–0.62, p = 0.04, I²= 15%), stride length (g = 0.25, 95% CI = 0.08–0.41, p = 0.003, I² = 42%)], and motor symptoms [Unified Parkinson's Disease Rating Scale part III (UPDRS-III) (g = −0.77, 95% CI = −1.06– −0.48, p = 0.000, I² = 76%)]. However, cadence (g = −0.03) and step length (g = 0.02) did not differ significantly. The moderator shows that the effects of TCE on BBS and gait velocity were moderated by Pedro score, exercise type, control group type, and number of sessions. Meta-regression found that TCE (exercise duration, number of sessions, and session duration) was significantly associated with improved UPDRS-III and BBS scores.

Conclusion

These findings provide evidence for the therapeutic benefits of TCE as an adjunct therapy for patients with PD. TEC dosage (high-intensity long sessions) may moderate some favorable effects.

Systematic Review Registration

PROSPERO, identifier CRD42022314686.

Ratiometric afterglow luminescent nanoplatform enables reliable quantification and molecular imaging

Afterglow luminescence is an internal luminescence pathway that occurs after photo-excitation, holds great promise for non-background molecular imaging in vivo, but suffer from poor quantitative ability owing to luminescent attenuation over time. Moreover, the inert structure and insufficient reactive sites of current afterglow materials make it hard to design activatable afterglow probes for specific detection. Here, we report a ratiometric afterglow luminescent nanoplatform to customize various activatable afterglow probes for reliable quantification and molecular imaging of specific analytes, such as NO, ONOO⁻ or pH. Notably, these afterglow probes can not only address the attenuation of afterglow intensity and eliminate the interference of factors (e.g., laser power, irradiation time, and exposure time), but also significantly improve the imaging reliability in vivo and signal-to-background ratios (~1200-fold), both of which enable more reliable quantitative analysis in biological systems. Moreover, as a proof-of-concept, we successfully design an NO-responsive ratiometric afterglow nanoprobe, RAN1. This nanoprobe can monitor the fluctuations of intratumoral NO, as a biomarker of macrophage polarization, making it possible to real-time dynamically evaluate the degree cancer immunotherapy, which provides a reliable parameter to predict the immunotherapeutic effect.

Afterglow luminescence is promising for non-background molecular imaging in vivo. Here the authors report a ratiometric afterglow luminescent nanoplatform to generate activatable afterglow probes for quantification of specific analytes including NO.

Prebiotics and probiotics for autism spectrum disorder: a systematic review and meta-analysis of controlled clinical trials

Introduction. Autism spectrum disorder (ASD) is a neurodevelopmental disorder. The discovery of the influence of gut microbiota on mental illness opens up new research avenues for the role of gut microbiota modifiers, such as probiotics or prebiotics, as a potential course of treatment. Potential treatments have received considerable attention in recent years.Aim. The meta-analysis only included clinical controlled trials to explore whether probiotics and prebiotics can improve the overall severity of ASD symptoms in children, the severity of gastrointestinal (GI) problems and the comorbid psychopathlology in ASD.Gap statement. Although systematic reviews have been conducted in this area in the past, most of them are mixed experimental designs, and the reliability of the conclusions remains to be determined. To the best of our knowledge, no systematic review of randomized controlled trials (RCTs) has been conducted.Methodology. A meta analysis used a combination of subject terms and free words, or used keywords, titles, and abstracts to conduct in PubMed, Web of Science, Embase, and Cochrane Library to identify studies relevant to the current review.Result. The results of the meta-analysis showed that probiotics and prebiotics did not significantly improve the severity of ASD patients, GI problems and comorbid psychopathlology in ASD, and the result is contradictory to the previous literatures.Conclusion. Since there are relatively few clinical controlled trials that can be included, the results of this study still need to be further verified in the clinic. In the future, more randomized controlled studies, more research populations, and the use of more professional clinicians may provide more robust research results.

Site-specific therapy in cancers of unknown primary site: a systematic review and meta-analysis

Background

Cancer of unknown primary site (CUP) is a term applied to characterize pathologically confirmed metastatic cancer with unknown primary tumor origin. It remains uncertain whether patients with CUP benefit from site-specific therapy guided by molecular profiling.

Patients and methods

A systematic search in PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov, and of conference abstracts from January 1976 to January 2021 was performed to identify studies investigating the efficacy of site-specific therapy on patients with CUP. The quality of included studies was evaluated using the Cochrane risk of bias tool and Newcastle–Ottawa scale. Eligible studies were weighted and pooled for meta-analysis. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were assessed to compare the efficacy of site-specific therapy with empiric therapy in patients with CUP. In addition, subgroup analyses were conducted.

Results

Five studies comprising 1114 patients were identified, of which 454 patients received site-specific therapy, and 660 patients received empiric therapy. Our meta-analysis revealed that site-specific therapy was not significantly associated with improved PFS [HR 0.93, 95% confidence interval (CI) 0.74-1.17, P = 0.534] and OS (HR 0.75, 95% CI 0.55-1.03, P = 0.069), compared with empiric therapy. However, during subgroup analysis significantly improved OS was associated with site-specific therapy in the high-accuracy predictive assay subgroup (HR 0.46, 95% CI 0.26-0.81, P = 0.008) compared with the low accuracy predictive assay subgroup (HR 0.93, 95% CI 0.75-1.15, P = 0.509). Furthermore, compared with patients with less responsive tumor types, more survival benefit from site-specific therapy was found in patients with more responsive tumors (HR 0.67, 95% CI 0.46-0.97, P = 0.037).

Conclusions

Our results suggest that site-specific therapy is not significantly associated with improved survival outcomes; however, it might benefit patients with CUP with responsive tumor types.

•

Studies evaluating the role of site-specific therapy guided by molecular profiling in CUP provided contradictory results.

•

Site-specific therapy is not significantly associated with improved survival outcomes in the overall CUP population.

•

Molecularly defined site-specific therapy may improve OS only when high-accuracy assays assign CUP to responsive tumor types.

Chemical Design of Activatable Photoacoustic Probes for Precise Biomedical Applications

Photoacoustic (PA) imaging technology, a three-dimensional hybrid imaging modality that integrates the advantage of optical and acoustic imaging, has great application prospects in molecular imaging due to its high imaging depth and resolution. To endow PA imaging with the ability for real-time molecular visualization and precise biomedical diagnosis, numerous activatable molecular PA probes which can specifically alter their PA intensities upon reacting with the targets or biological events of interest have been developed. This review highlights the recent developments of activatable PA probes for precise biomedical applications including molecular detection of the biotargets and imaging of the biological events. First, the generation mechanism of PA signals will be given, followed by a brief introduction to contrast agents used for PA probe design. Then we will particularly summarize the general design principles for the alteration of PA signals and activatable strategies for developing precise PA probes. Furthermore, we will give a detailed discussion of activatable PA probes in molecular detection and biomedical imaging applications in living systems. At last, the current challenges and outlooks of future PA probes will be discussed. We hope that this review will stimulate new ideas to explore the potentials of activatable PA probes for precise biomedical applications in the future.

Smart Nanozyme Platform with Activity-Correlated Ratiometric Molecular Imaging for Predicting Therapeutic Effects

Nanozymes with intrinsic enzyme-like characteristics have attracted enormous research interest in biological application. However, there is a lack of facile approach for evaluating the catalytic activity of nanozymes in living system. Herein, we develop a novel manganese-semiconducting polymer-based nanozyme (MSPN) with oxidase-like activity for reporting the catalytic activity of itself in acid-induced cancer therapy via ratiometric near-infrared fluorescence (NIRF)-photoacoustic (PA) molecular imaging. Notably, MSPN possess oxidase-like activity in tumor microenvironment, owing to the mixed-valent MnOx nanoparticles, which can effectively kill cancer cells. Because the semiconducting polymer (PFODBT) is conjugated with oxidase-responsive molecule (ORM), the catalytic activity of nanozyme can be correlated with the ratiometric signals of NIRF (FL₆₉₅ /FL₈₂₅ ) and PA (PA₆₈₀ /PA₇₈₀ ), which may provide new ideas for predicting anticancer efficacy of nanozymes in living system.

Comparison of lorlatinib, alectinib and brigatinib in ALK inhibitor-naive/untreated ALK-positive advanced non-small-cell lung cancer: a systematic review and network meta-analysis

Because of lacking of head-to-head comparison among lorlatinib, alectinib and brigatinib for patients with ALK inhibitor-naive or untreated (ALK inhibitor-naive and chemotherapy-naive) ALK-positive advanced non-small-cell lung cancer (NSCLC), the optimal option for these patients still remains undefined. We searched published reports that described the activity and safety of those novel ALK inhibitors (lorlatinib, alectinib and brigatinib) for ALK inhibitor-naive or untreated (ALK inhibitor-naive and chemotherapy-naive) ALK-positive advanced NSCLC. Five randomized controlled trials were identified, covering 1111 subjects. In the network meta-analysis, lorlatinib seemed to prolong progression free survival than brigatinib (Hazard Ratio: 0.57, P = 0.03) and alectinib (Hazard ratio: 0.65, P = 0.05) for previously untreated patients with ALK-positive advanced NSCLC as assessed by the independent review committee. Meanwhile, lorlatinib significantly improved significant progression free survival than brigatinib (Hazard ratio: 0.57, P = 0.03) and alectinib (Hazard ratio: 0.59, P = 0.03) for ALK inhibitor-naive patients. Among lorlatinib, alectinib, brigatinib, and crizotinib, lorlatinib had the highest probability to reach the best overall confirmed response rates (probability of 48%) and intracranial confirmed response rates (probability of 44%). No significant difference was found among them in overall survival and adverse events analysis. In terms of progression free survival, our results indicated that lorlatinib was the best treatment choice for patients with ALK inhibitor-naive or untreated (ALK inhibitor-naive and chemotherapy-naive) ALK-positive advanced NSCLC. The future head-to-head trials assessing the relative efficacy of lorlatinib, alectinib and brigatinib were warranted.

AB0552 PROBABILITY OF ACHIEVING TREATMENT TARGETS WITH APREMILAST MONOTHERAPY IN BIOLOGIC-NAIVE PSORIATIC ARTHRITIS PATIENTS IN ACTIVE WITH MODERATE AND HIGH BASELINE DISEASE ACTIVITY

Background:

Patients with psoriatic arthritis (PsA) in moderate disease activity (ModDA) who are naive to disease-modifying antirheumatic drugs (DMARDs) have a higher probability of achieving the Clinical Disease Activity Index for PsA (cDAPSA) treatment targets after receiving apremilast 30 mg BID (APR) than those in high disease activity (HDA). In Europe, APR is indicated for the treatment of active PsA in adult patients who had an inadequate response or were intolerant to a prior DMARD therapy. Achievement of cDAPSA treatment targets with APR monotherapy in biologic-naive patients with PsA who had previously taken a maximum of 1 conventional synthetic DMARD (csDMARD) has not been evaluated.

Objectives:

To assess the predictive value of baseline clinical disease status on achieving long-term cDAPSA treatment targets at Week 52 among biologic-naive patients with PsA in the phase 3b, randomized, placebo-controlled Assessing Apremilast Monotherapy in a Clinical Trial of Biologic-Naive Patients With PsA (ACTIVE).

Methods:

ACTIVE enrolled adults with PsA who had ≥3 swollen and ≥3 tender joints and were biologic naive with prior failure of a maximum of 1 csDMARD. In this post hoc analysis, we assessed the probabilities of achieving cDAPSA treatment targets of remission (REM; ≤4) or low disease activity (LDA; >4 to ≤13) at Week 52 in patients randomized to APR and stratified by cDAPSA ModDA (>13 to ≤27) or HDA (>27) at baseline. Patients with enthesitis at baseline in each stratum were analyzed separately.

Results:

Of the 109 patients randomized to APR, 35 were in ModDA (32.1%) and 71 were in HDA (65.1%) at baseline (Table 1). For patients with ModDA vs HDA at baseline, swollen (4.6 vs 10.8) and tender (6.7 vs 21.7) joint counts were lower, and the prevalence of enthesitis was lower (42.9% vs 57.7%) (Table 1). Patients in ModDA at baseline were estimated to be more than twice as likely to achieve treatment targets at Week 52 vs patients in HDA at baseline (Figure 1). Consistent with these results, a higher proportion of patients with ModDA + enthesitis at baseline achieved treatment targets at Week 52 than patients with HDA + enthesitis at baseline (58.9% vs 32.8%).

Table 1.

Baseline Demographics and Disease Characteristics

Baseline cDAPSA CategoryModDA (n = 35)HDA (n = 71)Age, mean (SD), years48.5 (12.9)51.6 (11.8)Women, n (%)20 (57.1)36 (50.7)White, n (%)34 (97.1)71 (100.0)PsA duration, mean (SD), years4.5 (4.6)3.8 (4.5)Enthesitis, n (%)15 (42.9)41 (57.7)SJC (0-66), mean (SD)4.6 (1.6)10.8 (4.3)TJC (0-68), mean (SD)6.7 (2.2)21.7 (11.5)PtGA (0-10 NRS), mean (SD)4.9 (1.4)6.5 (2.0)PhGA (0-10 NRS), mean (SD)5.4 (1.2)6.6 (1.5)

The n represents the total sample. The number of patients with data available may vary. Not included are 3 patients in LDA at baseline. NRS = Numeric Rating Scale; PhGA = Physician’s Global Assessment of Disease Activity; PtGA = Patient’s Global Assessment of Disease Activity; SJC = swollen joint count; TJC = tender joint count.

Figure 1.

Conclusion:

Similar to observations in DMARD-naive patients with PsA, patients who were biologic naive but may have had experience with a maximum of 1 csDMARD, including those with enthesitis, and who were in ModDA at baseline had a higher probability of achieving treatment targets (cDAPSA REM or LDA) at Week 52 with continued APR treatment compared with those with HDA.

Acknowledgements:

This study was funded by Celgene. Additional analyses were funded by Amgen Inc. Writing support was funded by Amgen Inc. and provided by Kristin Carlin, RPh, MBA, of Peloton Advantage, LLC, an OPEN Health company.

Disclosure of Interests:

Peter Nash Consultant of: AbbVie, BMS, Celgene, Gilead/Galapagos, GSK, Janssen, Lilly, MSD, Novartis, Pfizer, and Samsung, Grant/research support from: AbbVie, BMS, Celgene, Gilead/Galapagos, GSK, Janssen, Lilly, MSD, Novartis, Pfizer, and Samsung, Sven Richter Employee of: Amgen Inc., Shauna Jardon Employee of: Amgen Inc., Lichen Teng Employee of: Amgen Inc., Jessica A. Walsh Consultant of: AbbVie, Amgen Inc., Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen Inc., Janssen, Lilly, Merck, Novartis, Pfizer, and UCB.

[Effects of protein disulfide isomerase on hyperglycemia and hypoxia/reoxygenation injury in H9c2 cardiomyocytes]

Objective: To explore the effect of protein disulfide isomerase (PDI) in diabetic ischemic heart disease. Methods: We established an in vitro model of high glucose and hypoxia/reoxygenation in H9c2 rat myocardial cells. Cultured cells were divided into four groups: Control, high glucose (HG), hypoxia/reoxygenation (H/R) and HG+H/R. Changes in PDI expression mediated by PDI adenovirus(Ad-PDI) infection and siRNA(PDI-siRNA) transfection in myocardial cells were observed by inverted fluorescence microscopy. We also measured lactate dehydrogenase(LDH) activity and malondialdehyde(MDA) and high molecular weight(HMW)-APN concentrations. PDI, APN, cleaved caspase-3, and glucose regulated protein 78 (Grp78) protein expression were detected. Results: PDI expression was significantly decreased in the HG, H/R and HG+H/R groups compared to the Control group; however, LDH activity[(179.7±10.4) U/L、(218.4±18.4) U/L、(328.2±5.3) U/L vs (91.0±11.0) U/L], MDA concentration[(7.0±0.4) μmol/L、(10.0±1.0) μmol/L、(11.7±1.0) μmol/L vs (4.2±1.8) μmol/L], cleaved caspase-3, and Grp78 expression were increased. Interestingly, APN and HMW-APN expression were decreased [(2.01±0.21) μg/L、(1.64±0.27) μg/L、(1.20±0.14) μg/L vs (2.62±0.12) μg/L, all P<0.05]. Over expression of PDI attenuated high glucose and hypoxia/reoxygenation induced apoptosis and oxidative stress in H9c2 cardiomyocytes(all P<0.05), and simultaneously increased APN and HMW-APN expression [(2.86±0.03) μg/L vs (3.03±0.10) μg/L、(2.06±0.05) μg/L vs (2.31±0.06) μg/L、(1.83±0.07) μg/L vs (1.96±0.11) μg/L、(1.20±0.06) μg/L vs (1.39±0.09) μg/L]. PDI-siRNA transfection increased LDH activity, MDA concentration, and cleaved caspase-3 and Grp78 expression, and decreased APN and HMW-APN expression [(0.75±0.09) μg/L vs (0.59±0.09) μg/L、(0.62±0.04) μg/L vs (0.53±0.05) μg/L、(0.55±0.14) μg/L vs (0.51±0.12) μg/L、(0.48±0.12) μg/L vs (0.35±0.08) μg/L] in response to different treatments in cultured H9c2 cardiomyocytes (all P<0.05). Conclusion: PDI may regulate the expression of APN and HMW-APN, and play an important role in the function of diabetic ischemia-reperfusion cardiomyocytes.

AB0553 BASELINE DISEASE ACTIVITY AS A PREDICTOR FOR ACHIEVING cDAPSA TREATMENT TARGETS WITH APREMILAST IN DMARD-NAIVE PATIENTS WITH MANIFESTATIONS OF ACTIVE PSORIATIC ARTHRITIS

Background:

In PALACE 4, DMARD-naive patients (pts) with moderately active (ModDA) psoriatic arthritis (PsA) at baseline (BL) were more likely to achieve Clinical Disease Activity Index for PsA (cDAPSA) treatment targets (cDAPSA remission [REM] or low disease activity [LDA]) at Week 52 with continued apremilast 30 mg BID (APR) treatment than pts with high disease activity (HDA) at BL. Pts who achieved cDAPSA treatment targets also had no or mild articular and extra-articular disease activity by Week 52. Whether specific PsA manifestations other than arthritis impact the achievement of cDAPSA treatment targets in this population is unknown.

Objectives:

To assess the predictive value of BL clinical disease status on achieving cDAPSA treatment targets in DMARD-naive pts in PALACE 4 with PsA in ModDA or HDA who exhibited manifestations of skin involvement, enthesitis, and/or dactylitis at BL.

Methods:

This post hoc analysis included APR-treated pts in ModDA or HDA with available cDAPSA data at BL and Week 52 who exhibited any of the PsA manifestations at BL, including skin-involved body surface area (BSA) ≥3%, Maastricht Ankylosing Spondylitis Entheses Score (MASES) >0, or dactylitis count >0. Pts were divided into 4 subgroups based on number of manifestations: ≥1, only 1, any 2, or all 3. The proportions of pts who shifted across ModDA (>13 to ≤27) and HDA (>27) cDAPSA categories at BL to REM (≤4) and LDA (>4 to ≤13) treatment targets at Week 52 were calculated (data as observed).

Results:

In 176 PALACE 4 pts with PsA receiving APR, 165 had involvement in ≥1 PsA manifestation in addition to peripheral arthritis (ie, skin/enthesitis/dactylitis) at BL. This population had a mean age of 48.8 years, PsA duration of 3.6 years, Psoriasis Area and Severity Index (PASI) score of 6.6, MASES of 3.8, and dactylitis count of 3.5 (Table 1). Within this subgroup, 32.7% had only 1 of these non-arthritic PsA manifestations, 50.9% had any 2, and 16.4% had all 3. In pts with ≥1 manifestation, a greater proportion in ModDA achieved REM/LDA at Week 52 than those in HDA (66.7% vs 32.2%; risk difference: 0.34) (Figure 1). Similarly, greater rates of treatment target achievement were observed in subgroups of pts in ModDA vs HDA and only 1 (72.2% vs 39.1%; risk difference: 0.33), any 2 (57.1% vs 28.6%; risk difference: 0.29), or all 3 (75.0% vs 33.3%; risk difference: 0.42) PsA manifestations (Figure 1).

Conclusion:

In DMARD-naive pts exhibiting various non-arthritic manifestations of active PsA (ie, skin/enthesitis/dactylitis), those in ModDA at BL were more likely to achieve cDAPSA REM or LDA at Week 52 of APR treatment than pts in HDA. This observation was consistent whether pts had only 1 or multiple manifestations. These findings are consistent with the probability of achieving treatment targets demonstrated in the overall population in PALACE 4 (61.7% ModDA vs 28.2% HDA).

Table 1.

BL Demographics and Disease Characteristics in Pts With ≥1 Manifestations of PsA (Skin Involvement, Enthesitis, and/or Dactylitis) Treated With APR (N = 165)

Age*, years48.8 (12.5)Women, n (%)87 (52.7)BMI*, kg/m229.9 (6.5)Duration of PsA*, years3.6 (5.0)Duration of psoriasis*, years15.5 (13.3)cDAPSA (0-154)*39.4 (19.7)Swollen joint count (0-66)*10.3 (7.7)Tender joint count (0-68)*18.5 (12.9)Pt’s Assessment of Pain (VAS 0-100 mm)*52.8 (21.5)Pt’s Global Assessment (VAS 0-100 mm)*53.8 (20.1)Physician’s Global Assessment (VAS 0-100 mm)*52.2 (17.6)PASI score (0-72)*,†6.6 (5.1)MASES (0-13)*,‡3.8 (3.0)Dactylitis count (0-20)*,§3.5 (3.3)Corticosteroid use, n (%)13 (7.9)NSAID use, n (%)126 (76.4)

*Mean (SD).†In pts with BSA ≥3% at BL.‡In pts with enthesitis at BL.§In pts with dactylitis at BL.

Acknowledgements:

This study was funded by Celgene. Additional analyses were funded by Amgen Inc. Writing support was funded by Amgen Inc. and provided by Kristin Carlin, RPh, MBA, of Peloton Advantage, LLC, an OPEN Health company.

Figure 1.

Disclosure of Interests:

Philip J Mease Speakers bureau: AbbVie, Amgen Inc., Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen Inc., Boehringer Ingelheim, BMS, Celgene, Eli Lilly, Galapagos, GSK, Novartis, Pfizer, Sun, and UCB, Grant/research support from: AbbVie, Amgen Inc., Boehringer Ingelheim, BMS, Celgene, Eli Lilly, Galapagos, GSK, Novartis, Pfizer, Sun, and UCB, Arthur Kavanaugh Grant/research support from: AbbVie, Amgen Inc., AstraZeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, and UCB, Alexis Ogdie Consultant of: AbbVie, Amgen Inc., BMS, Celgene, Corrona, Eli Lilly, Gilead, Novartis, Pfizer, and UCB, Grant/research support from: Novartis and Pfizer, Alvin F. Wells Speakers bureau: AbbVie, Alexion, Amgen Inc., BMS, Celgene, Horizon, Lilly, Novartis, and UCB, Consultant of: AbbVie, Alexion, Amgen Inc., BMS, Celgene, Horizon, Lilly, Novartis, and UCB, Grant/research support from: AbbVie, Celgene, and Lilly, Martin Bergman Shareholder of: Johnson & Johnson, Speakers bureau: AbbVie, Amgen Inc., Novartis, Pfizer, and Sanofi, Consultant of: AbbVie, BMS, Celgene, Genentech, Janssen, Merck, Novartis, Pfizer, and Sanofi, Dafna D Gladman Consultant of: AbbVie, Amgen, BMS, Celgene Corporation, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, BMS, Celgene Corporation, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB, Frank Behrens Speakers bureau: AbbVie, Biotest, Boehringer Ingelheim, Celgene, Chugai, Eli Lilly, Genzyme, Janssen, Novartis, Pfizer, Roche, and UCB, Grant/research support from: AbbVie, Chugai, Janssen, Roche, and Pfizer, Yuri Klyachkin Employee of: Amgen Inc., Sven Richter Employee of: Amgen Inc., Lichen Teng Employee of: Amgen Inc., Josef S. Smolen Speakers bureau: AbbVie, Amgen Inc., AstraZeneca, Astro, Celgene, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, Medimmune, MSD, Novartis, Pfizer, Roche, Samsung, Sanofi, and UCB, Consultant of: AbbVie, Amgen Inc., AstraZeneca, Astro, Celgene, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, Medimmune, MSD, Novartis, Pfizer, Roche, Samsung, Sanofi, and UCB, Grant/research support from: AbbVie, Eli Lilly, Janssen, MSD, Medimmune, Pfizer, and Roche.

Precipitated Fluorophore-Based Molecular Probe for In Situ Imaging of Aminopeptidase N in Living Cells and Tumors

Aminopeptidase N (APN) is capable of cleaving N-terminal amino acids from peptides with alanine in the N-terminal position and plays a key role in the growth, migration, and metastasis of cancer. However, reliable in situ information is hard to be obtained with the current APN-responsive molecular probes because the released fluorophores are cytoplasmic soluble and thus rapidly depart from the enzymatic reaction sites and spread out all over the cytoplasm. Here, we report a de novo precipitated fluorophore, HBPQ, which is completely insoluble in water and shows strong yellow solid emission when excited with a 405 nm laser. Owing to the controllable solid fluorescence of HBPQ by the protection-deprotection of phenolic hydroxyl, we further utilized HBPQ to design an APN-responsive fluorogenic probe (HBPQ-A) for the imaging of intracellular APN. Importantly, HBPQ-A can not only perform in situ imaging of APN in different organelles (e.g., lysosomes, mitochondria, endoplasmic reticula, and so forth) but also display a stable and indiffusible fluorescent signal for reliable mapping of the distribution of APN in living cells. In addition, through real-time imaging of APN in 4T1 tumors, we found that the fluorescent signal with high fidelity generated by HBPQ-A could remain constant even after 12 h, which further confirmed its diffusion-resistant ability and long-term reliable imaging ability. We believe that the precipitated fluorophore may have great potential for long-term in situ imaging.

Mitochondrial ND1 T4216C and ND2 C5178A mutations are associated with maternally transmitted diabetes mellitus

Mutations in mitochondrial DNA (mtDNA) are important causes for type 2 diabetes mellitus (T2DM). To investigate the association between mtDNA mutations/variants and diabetes, we reported here clinical, genetic and biochemical characterization of a Chinese pedigree with maternally transmitted T2DM. Using PCR and direct sequencing analysis of mitochondrial genomes from the matrilineal relatives, we identified two potential pathogenic mutations, m.T4216C (p.Y304H) and m.C5178A (p.L237M) in the ND1 and ND2 genes, respectively, together with a set of genetic polymorphisms belonging to the human mitochondrial haplogroup D4b. Moreover, by isolating and analyzing polymononuclear leukocytes generated from the T2DM patients and controls, we identified lower levels of mitochondrial membrane potential and ATP production in T2DM patients than in the controls, in contrast, a significantly higher level of reactive oxygen species was observed in the T2DM patients carrying both of the m.T4216C and m.C5178A mutations (p < 0.05 for all). In addition, the plasma levels of malondialdehyde and 8-hydroxydeoxyguanosine in the T2DM patients markedly increased, while the level of superoxide dismutase decreased (p < 0.05 for all). Taken together, our data indicated that the ND1 T4216C and ND2 C5178A mutations may lead to oxidative stress and impair the mitochondrial function, and this, in turn, might have been involved in the pathogenesis and progression of T2DM in this pedigree. Thus, our study provides novel insight into the pathophysiology of T2DM that is manifested by mitochondrial dysfunction.

FRI0352 PROBABILITY OF ACHIEVING LOW DISEASE ACTIVITY OR REMISSION WITH APREMILAST TREATMENT AMONG DMARD-NAIVE SUBJECTS WITH ACTIVE PSORIATIC ARTHRITIS

Background:

Apremilast (APR) is associated with comparable ACR response rates in DMARD-naive vs DMARD-experienced patients (pts) with psoriatic arthritis (PsA).1,2A question that remains is if DMARD-naive pts treated with APR have greater chances of achieving treatment targets than DMARD-experienced pts. cDAPSA is a commonly used treatment target.

Objectives:

To assess the predictive value of baseline (BL) clinical disease status on achieving long-term cDAPSA treatment targets at Wk 52 among DMARD-naive subjects in PALACE 4; to compare these findings vs those recently reported from the PALACE 1-3 studies in subjects with prior exposure to DMARDs; and to provide further evidence that at a group level, achievement of cDAPSA disease targets with APR is associated with no or mild articular and extra-articular disease activity by Wk 52.

Methods:

This post hoc analysis included subjects assigned to APR 30 mg twice daily at BL who had available cDAPSA data at BL. We calculated the probabilities of shifting across different cDAPSA categories (remission [REM]: ≤4; low disease activity [LDA]: >4 to ≤13; moderate disease activity [Mod]: >13 to ≤27; high disease activity [HDA]: >273) from BL to Wk 52. Mean values of articular and non-articular variables (e.g., PASI, SJC/TJC, MASES, dactylitis) from BL to Wk 52 were assessed by cDAPSA category achieved at Wk 52 to determine the association between achievement of targets and control of articular and non-articular manifestations. Results from the current analyses were compared with the previously reported results from PALACE 1-3.

Results:

A total of 175 subjects receiving APR were included; at BL, 66.3% were in HDA, 31.4% in Mod, and 2.3% were in LDA. Overall, subjects who achieved treatment targets (LDA or REM) by Wk 52 had lower levels of disease activity at BL, as shown by a lower number of swollen and tender joints and lower presence of enthesitis and dactylitis. Higher prevalence of psoriasis-involved body surface area ≥3% at BL was observed. Subjects in Mod at BL were estimated to be more than twice as likely to achieve REM or LDA at Wk 52 vs subjects in HDA at BL; for subjects in LDA at BL, the estimated probability of achieving cDAPSA treatment targets was 100% (Figure). PALACE 4 subjects with LDA and Mod at BL exhibited higher estimated probabilities of achieving treatment targets (100.0% and 61.7%, respectively) than those observed in the DMARD-experienced population of PALACE 1-3 (71.1% and 46.9%). Subjects in PALACE 4 who achieved REM or LDA by Wk 52 showed no or mild articular and extra-articular disease activity by Wk 52, similar to what was observed in the PALACE 1-3 population.4

Conclusion:

DMARD-naive subjects in PALACE 4 who had LDA or Mod at BL had the highest likelihood of achieving treatment targets (cDAPSA REM or LDA) by Wk 52 with continued APR treatment. Results from the current probability analyses revealed higher probability rates than those observed in the DMARD-experienced PALACE 1-3 population; control of articular and extra-articular manifestations was observed in the DMARD-naive and DMARD-experienced populations.

References:

[1]Wells AF, et al. Rheumatology. 2018;57:1253-63. 2. Kavanaugh A, et al. Arthritis Res Ther. 2019;21:118. 3. Machado PM. Ann Rheum Dis. 2016;75:787-90. 4. Mease PJ, et al. Arthritis Care Res. 2020 Jan 7.

Disclosure of Interests:

Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, Arthur Kavanaugh Grant/research support from: Abbott, Amgen, AstraZeneca, BMS, Celgene Corporation, Centocor-Janssen, Pfizer, Roche, UCB – grant/research support, Alexis Ogdie Grant/research support from: Novartis, Pfizer – grant/research support, Consultant of: AbbVie, BMS, Eli Lilly, Novartis, Pfizer, Takeda – consultant, Alvin F. Wells Grant/research support from: AbbVie, Celgene Corporation, Lilly – grant/research support, Consultant of: AbbVie, Alexion, Amgen, BMS, Celgene Corporation, Horizon, Lilly, Novartis, UCB – consultant, Speakers bureau: AbbVie, Alexion, Amgen, BMS, Celgene Corporation, Horizon, Lilly, Novartis, UCB – speakers bureau, Martin Bergman Shareholder of: Johnson & Johnson – stockholder, Consultant of: AbbVie, BMS, Celgene Corporation, Genentech, Janssen, Merck, Novartis, Pfizer, Sanofi – consultant, Speakers bureau: AbbVie, Celgene Corporation, Novartis, Pfizer, Sanofi – speakers bureau, Dafna D Gladman Grant/research support from: AbbVie, Amgen Inc., BMS, Celgene Corporation, Janssen, Novartis, Pfizer, UCB – grant/research support, Consultant of: AbbVie, Amgen Inc., BMS, Celgene Corporation, Janssen, Novartis, Pfizer, UCB – consultant, Frank Behrens Grant/research support from: AbbVie, Chugai, Janssen, Roche, Pfizer – grant/research support, Consultant of: AbbVie Biotest, Boehringer Ingelheim, Celgene Corporation, Chugai, Eli Lilly, Genzyme, Janssen, Novartis, Pfizer, Roche, UCB – consultant, Speakers bureau: AbbVie, Biotest, BMS, Celgene Corporation, Chugai, Eli Lilly, Genzyme, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sandoz, UCB - speaker, Sven Richter Employee of: Amgen Inc. – employment; Celgene Corporation – employment at the time of study conduct, Michele Brunori Employee of: Amgen Inc. – employment; Celgene Corporation – employment at the time of study conduct, Lichen Teng Employee of: Amgen Inc. – employment; Celgene Corporation – employment at the time of study conduct, Benoit Guerette Employee of: Amgen Inc. – employment; Celgene Corporation – employment at the time of study conduct, Josef S. Smolen Grant/research support from: AbbVie, Eli Lilly, Janssen, Merck Sharp & Dohme, Pfizer, Roche – grant/research support, Consultant of: AbbVie, Amgen Inc., AstraZeneca, Astro, Celgene Corporation, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, Medimmune, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Samsung, Sanofi, UCB – consultant, Speakers bureau: AbbVie, Amgen Inc., AstraZeneca, Astro, Celgene Corporation, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, Medimmune, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Samsung, Sanofi, UCB – speaker

Racial disparity of Crouzon syndrome in maxilla and mandible

The racial disparity of facial features in craniosynostosis patients is not fully understood. The aim of this study was to explore the difference in maxillary and mandibular morphology and spatial position in Asian and Caucasian Crouzon syndrome patients. Ninety-one computed tomography scans were included (12 Asian Crouzon syndrome patients, 22 Asian controls; 16 Caucasian Crouzon syndrome patients, 41 Caucasian controls) and measured using Materialise software. The maxillary and mandibular volumes of Asian patients were both reduced by 19% (P=0.102 and P=0.187), and those of Caucasian patients were reduced by 15% (P=0.142) and 14% (P=0.211) when compared to the respective race-specific controls. Maxilla length of Asian patients was reduced by 6.36mm (14%, P=0.003), while the reduction in Caucasian patients was 4.88mm (10%, P=0.038). ANS was retracted 11.99mm (P<0.001) in Asian patients and 11.54mm (P<0.001) in Caucasian patients. The ANB angle was narrowed by 13.17° (P<0.001) in Asian patients compared to Asian controls, and by 7.02° (P<0.001) in Caucasian patients compared to Caucasian controls. The retrusive midface profiles of Asian and Caucasian Crouzon syndrome look similar; both result from the combined effect of hypoplastic size and backward displacement. However, the insufficiency was found to be more a failure of the anteroposterior maxillary length in Asian patients, and more due to posterior maxillary positioning in Caucasian patients. Therefore, prognathism in Crouzon syndrome patients is more likely caused by displacement rather than elongation of mandibular length in both races. Crouzon syndrome results in the same extent of overall volume deficiency of the maxilla and mandible in these races.

Learning from Artemisinin: Bioinspired Design of a Reaction-Based Fluorescent Probe for the Selective Sensing of Labile Heme in Complex Biosystems

Labile heme (LH) is an important signaling molecule in virtually all organisms. However, specifically detecting LH remains an outstanding challenge. Herein, by learning from the bioactivation mechanism of artemisinin, we have developed the first LH-responsive small-molecule fluorescent probe, HNG, based on a 4-amino-1,8-naphthalimide (NG) fluorophore. HNG showed high selectivity for LH without interference from hemin, protein-interacting heme, and zinc protoporphyrin. Using HNG, the changes of LH levels in live cells were imaged, and a positive correlation of LH level with the degree of hemolysis was uncovered in hemolytic mice. Our study not only presents the first molecular probe for specific LH detection but also provides a strategy to construct probes with high specificity through a bioinspired approach.

Reactive Oxygen Correlated Chemiluminescent Imaging of a Semiconducting Polymer Nanoplatform for Monitoring Chemodynamic Therapy

In chemodynamic therapy (CDT), real-time monitoring of reactive oxygen species (ROS) production is critical to reducing the nonspecific damage during CDT and feasibly evaluating the therapeutic response. However, CDT agents that can emit ROS-related signals are rare. Herein, we synthesize a semiconducting polymer nanoplatform (SPN) that can not only produce highly toxic ROS to kill cancer cells but also emit ROS-correlated chemiluminescent signals. Notably, the efficacy of both chemiluminescence and CDT can be significantly enhanced by hemin doping (∼10-fold enhancement for luminescent intensity). Such ROS-dependent chemiluminescence of SPN allows ROS generation within a tumor to be optically monitored during the CDT process. Importantly, SPN establishes an excellent correlation of chemiluminescence intensities with cancer inhibition rates in vitro and in vivo. Thus, our nanoplatform represents the first intelligent strategy that enables chemiluminescence-imaging-monitored CDT, which holds potential in assessing therapeutic responsivity and predicting treatment outcomes in early stages.

Imaging of peroxynitrite in drug-induced acute kidney injury with a near-infrared fluorescence and photoacoustic dual-modal molecular probe

A FRET-based probe for mapping the fluctuation of OONO⁻ in cisplatin-induced acute kidney injury was constructed.

pH stimulus-disaggregated BODIPY: an activated photodynamic/photothermal sensitizer applicable to tumor ablation

A pH activated photodynamic/photothermal sensitizer applicable to tumor ablation.

LncRNA DANCR promotes proliferation and metastasis in pancreatic cancer by regulating miRNA-33b

Increasing evidence indicates that long noncoding RNAs (lncRNAs) function as important regulators in biological processes and are dysregulated in various tumors. The lncRNA DANCR functions as an oncogene in various cancers, but elucidation of its role in pancreatic cancer (PC) requires further investigation. In the current study, we demonstrate that DANCR was increased in PC tissues and cell lines. Knockdown of DANCR significantly suppressed cell proliferation, migration, and invasion and influenced the levels of epithelial‐to‐mesenchymal transition‐associated proteins, as demonstrated by the observation of enhanced E‐cadherin levels and reduced N‐cadherin levels in PC cells. In addition, we identified direct binding to the predicted miR‐33b binding site on DANCR. We also showed that there is reciprocal repression between DANCR and miR‐33b. Furthermore, a miR‐33b inhibitor partially abrogated knockdown of DANCR and caused inhibitory effects. We also demonstrated that DANCR functions as a miR‐33b sponge to positively regulate MMP16 expression in PC cells. Collectively, the data reveal that DANCR exerts its function by regulating miR‐33b/MMP16 expression, implying an important role for a lncRNA–miRNA–mRNA functional network and suggesting a novel potential therapeutic target for PC.

A "Double-Locked" and enzyme-activated molecular probe for accurate bioimaging and hepatopathy differentiation

Molecular probes activated by a single enzyme have been extensively used in bioimaging and disease diagnosis; however, imaging and identification in an accurate manner remains a challenge for such probes. Here, based on the specificity of enzyme recognition, we engineered a "double-locked" and enzyme-activated molecular probe (NML) for accurate bioimaging and hepatopathy differentiation. Triggered by the successive reactions with leucine aminopeptidase (LAP, first "key") and monoamine oxidase (MAO, second "key"), the emissive fluorophore (NF) was released. NML can be activated only in the presence of both LAP and MAO and can be silenced when either enzyme is inhibited. Benefiting from the "double-locked" strategy, NML showed higher accuracy for imaging of drug-induced liver injury (DILI) than the "single-locked" probe. With serum testing, NML showed significant differences in mouse models of both CCl₄-induced liver cirrhosis and DILI. Significantly, NML can be applied to accurately distinguish serum samples from clinical patients with different hepatopathies. Our smart molecular probe may hold great potential for hepatopathy diagnosis and clinical transformation.

Effects of 25-hydroxyvitamin D on bone microstructure in T2MD rats

OBJECTIVE

This study aims to explore the effects of 25-hydroxyvitamin D on the bone microstructure of rats with type 2 diabetes mellitus (T2MD).

METHODS

40 male Wistar rats were randomly selected for T2MD modeling and injected with streptozotocin solution. The rats in the control group (n=19) were fed with common feed. 25-hydroxyvitamin D was injected into rats with successful modeling results (Treatment group, n=15). The remaining rats were considered as the model group (n=16). The enzyme-linked immunosorbent assay was adopted to determine bone gla protein (BGP) and tartrate-resistant acid phosphatase (TRACP), and an X-ray bone densitometer were applied to observe the vertebral sections.

RESULTS

The activity levels of blood glucose, triglyceride, total cholesterol and TRACP in the model group were higher than those in the treatment group and the control group (p⟨0.01), while serum calcium, phosphorus, BGP, ALP, and glycosylated hemoglobin, various indicators of rats in the model group were lower than those in the treatment group and the control group (p⟨0.05).

CONCLUSIONS

It is feasible to treat rats with T2MD with 25-hydroxyvitamin D, which can maintain the integrity of bone microstructure and increase the bone health.

Ultrathin two-dimensional covalent organic framework nanoprobe for interference-resistant two-photon fluorescence bioimaging

A two-photon fluorescent covalent organic framework nanopore is designed for the first time for H₂S interference-resistant bioimaging.

The complex environment of living organisms significantly challenges the selectivity of classic small-molecule fluorescent probes for bioimaging. Due to their predesigned topological structure and engineered internal pore surface, covalent organic frameworks (COFs) have the ability to filter out coexisting interference components and help to achieve accurate biosensing. Herein, we propose an effective interference-resistant strategy by creating a COF-based hybrid probe that combines the respective advantages of COFs and small-molecule probes. As a proof of concept, a two-photon fluorescent COF nanoprobe, namely TpASH-NPHS, is developed for targeting hydrogen sulfide (H₂S) as a model analyte. TpASH-NPHS exhibits limited cytotoxicity, excellent photostability and long-term bioimaging capability. More importantly, compared with the small-molecule probe, TpASH-NPHS achieves accurate detection without the interference from intracellular enzymes. This allows us to monitor the levels of endogenous H₂S in a mouse model of cirrhosis.

Engineering of a near-infrared fluorescent probe for real-time simultaneous visualization of intracellular hypoxia and induced mitophagy

A near-infrared fluorescent probe has been developed for real-time simultaneous visualization of intracellular hypoxia and the subsequent induced mitophagy.

Mitophagy induced by hypoxia plays an important role in regulating cellular homeostasis via the removal of dysfunctional mitochondria in the lysosomal degradation pathway, which results in physiological changes in the mitochondria, such as the pH, polarity and viscosity. However, the lack of an effective method for imaging of both the hypoxic microenvironment and the resulting variable mitochondria limits the visualization of hypoxia-induced mitophagy. Based on the specific mitochondrial pH changes during the hypoxia-induced mitophagy process, we have reported a near-infrared fluorescent probe (NIR-HMA) for real-time simultaneous visualization of the hypoxic microenvironment and the subsequent mitophagy process in live cells. NIR-HMA selectively accumulated in the hypoxic mitochondria in the NIR-MAO form, emitting at 710 nm, and then transformed into NIR-MAOH, emitting at 675 nm, in the acidified mitochondria-containing autolysosomes. Importantly, by smartly tethering the hypoxia-responsive group to the hydroxyl group of the NIR-fluorochrome, which shows ratiometric pH changes, NIR-HMA can differentiate between different levels of the hypoxic microenvironment and mitophagy. Furthermore, using NIR-HMA, we could track the complete mitophagy process from the mitochondria to the autolysosomes and visualize mitophagy caused only by hypoxia both in cancer cells and normal cells. Finally, NIR-HMA was applied to investigate the role that mitophagy plays in the hypoxic microenvironment via the cycling hypoxia-reoxygenation model. We observed a decreased fluorescence ratio after reoxygenation and a further increased mitophagy level after hypoxia was induced again, suggesting that mitophagy might be a self-protective process that allows cells to adapt to hypoxia. Our work may provide an attractive way for real-time visualization of relevant physiological processes in hypoxic microenvironments.