Physical and chemical properties of nabak (Zizyphus spina-christi) seed kernel and sweet pepper (Capsicum annuum L.) seed oils

BACKGROUND

Nabak seed kernels and sweet pepper seeds, which are separated from the fruits and discarded as waste after processing or consumption, contain high levels of oils (30.19% and 19.57%, respectively). The chemical and thermal characteristics of nabak seed kernel oil (NSO) and sweet pepper seed oil (PSO) were investigated in this study.

RESULTS

The NSO and PSO contained high levels of unsaturated fatty acids (84.1% and 86.5%, respectively), and the major fatty acid was oleic acid (57.3%) in NSO, but it was linoleic acid (69.4%) in PSO. The triacylglycerol (TAG) profiles show that NSO contained ten TAG species, three of which represented 87.1%, namely C54:3, C52:2 and C54:4, and triolein was the dominant (OOO, 47.0%). Pepper seed oil contained nine TAG molecular species, four of which represented 93.6%, namely C54:6, C52:4, C54:4 and C52:5, and trilinolein was dominant (LLL, 44.0%). The differential scanning calorimetry (DSC) analysis of NSO revealed that three exothermal peaks were detected during cooling, two endothermal peaks were detected during melting, and the major peak occurred at a low temperature. For PSO, three exothermal peaks were detected during cooling, three peaks were detected (one of them was exothermal) during melting, and the major peaks were observed at low temperatures. Fourier transform infrared (FTIR) spectra indicated that NSO and PSO did not contain peroxides or trans fatty acids, but they did contain low concentrations of free fatty acids.

CONCLUSION

This study offers a scientific basis for the use of NSO and PSO as new sources of edible oils for food applications. © 2021 Society of Chemical Industry.

Impact of perioperative interruption of antithrombotic therapy on thrombotic and bleeding events in non-cardiac surgery

Funding Acknowledgements

Type of funding sources: None.

Introduction

Antithrombotic therapy including antiplatelet agents and anticoagulants are prescribed for secondary prevention in patients with established cardiovascular disease. Although antithrombotic therapy is often interrupted before non-cardiac surgery with or without perioperative bridging anticoagulation, the impact on thrombotic and bleeding events remains uncertain. 

Purpose

The aim of this study was to clarify the impact of perioperative interruption of anticoagulants on thrombotic and bleeding events in patients with established CVD undergoing elective non-cardiac surgery. 

Methods

A total of 330 patients chronically treated with antithrombotic therapy for secondary prevention underwent elective non-cardiac surgery under general anesthesia, with the complete interruption of antithrombotic agents. The study endpoints included all-cause death, thrombotic events, and major bleeding complications after surgical procedures. 

Results

Of 330 patients, 171 (51.8%) and 159 (48.2%) received antiplatelet agents and anticoagulants perioperatively. Atrial fibrillation (31.8%) and coronary artery disease (20.3%) were the major indications for antithrombotic regimens. Antithrombotic therapy was interrupted from 5 [2, 7] days before the surgery to 4 [2, 7] days postoperatively. Perioperative bridging therapy with unfractionated heparin was employed in 99 (30.0%) patients. During the hospitalization, 3 (0.9%) patients died due to non-cardiovascular causes. Thrombotic events and major bleeding occurred in 2 (0.6%) and 9 (2.7%) patients. Bridging therapy with heparin was non-significantly associated with an increased risk of bleeding events (5.1% vs. 1.7%, p = 0.09). In univariable and multivariable analyses, pre-operative hemoglobin level and operative duration were significantly associated with bleeding complications.

Conclusions

In the present study, complete interruption of antithrombotic therapy resulted in a few thrombotic events with a numerically higher rate of bleeding events in patients undergoing elective non-cardiac surgery. Pre-operative hemoglobin level and operative duration were significantly associated with post-operative bleeding complications.

Combined use of baking soda and electric toothbrushing for removal of artificial extrinsic stain on enamel surface: An in vitro study

Background

This study aimed to investigate the combined effect of baking soda and electric toothbrushing on the removal of artificial extrinsic stain in vitro.

Material and Methods

Flat enamel surfaces of 15 bovine incisors were artificially stained with 10% citric acid / 3% ferric chloride solution followed by 1% tannic acid solution. These specimens were randomly divided into three groups (n = 5) – Group S+B: brushing with an electric toothbrush and baking soda, Group S+C: brushing with an electric toothbrush and fluoride dentifrice, Group S: brushing only with an electric toothbrush. Color values (L*, a*, and b*) and surface roughness were measured before and after brushing (after 1, 2, 3, and 5 min). The data were statistically analyzed using two-way analysis of variance and Tukey’s honest significant difference test as a post hoc test (p< 0.05).

Results

The L* value of Group S+B increased over time, and was significantly different between before brushing and at 5 min (p< 0.05). A significant difference in the ΔE* value of Group S+B was found at 5 min (p< 0.05). However, no significant difference was found in the ΔE* values of Group S+C and Group S. No significant differences in Ra were found in any of the groups.

Conclusions

The results of this study suggest that the combined use of baking soda and electric toothbrushing has an excellent stain-removing effect compared with electric toothbrushing with a fluoride dentifrice. Additionally, the changes in surface roughness were similar to the changes caused by the use of general dentifrices.

Key words:Baking soda, dentifrice, extrinsic stain removal, color change, surface roughness.

A novel method of literature mining to identify candidate COVID-19 drugs

Summary

COVID-19 is a serious infectious disease that has recently emerged and continues to spread worldwide. Its spreading rate is too high to expect that new specific drugs will be developed in sufficient time. As an alternative, drugs already developed for other diseases have been tested for use in the treatment of COVID-19 (drug repositioning). However, to select candidate drugs from a large number of compounds, numerous inhibition assays involving viral infection of cultured cells are required. For efficiency, it would be useful to narrow the list of candidates down using logical considerations prior to performing these assays. We have developed a powerful tool to predict candidate drugs for the treatment of COVID-19 and other diseases. This tool is based on the concatenation of events/substances, each of which is linked to a KEGG (Kyoto Encyclopedia of Genes and Genomes) code based on a relationship obtained from text mining of the vast literature in the PubMed database. By analyzing 21 589 326 records with abstracts from PubMed, 98 556 KEGG codes with NAME/DEFINITION fields were connected. Among them, 9799 KEGG drug codes were connected to COVID-19, of which 7492 codes had no direct connection to COVID-19. Although this report focuses on COVID-19, the program developed here can be applied to other infectious diseases and used to quickly identify drug candidates when new infectious diseases appear in the future.

Availability and implementation

The programs and data underlying this article will be shared on reasonable request to the corresponding authors.

Contact

atmuramatsu@g.ecc.u-tokyo.ac.jp, amtanok@mail.ecc.u-tokyo.ac.jp.

Supplementary information

Supplementary data are available at Bioinformatics Advances online.

Crystallization and melting properties studied by DSC and FTIR spectroscopy of goldenberry (Physalis peruviana) oil

The chemical and thermal characteristics of goldenberry pomace oil (GPO) and goldenberry seed oil (GSO) were investigated. GPO and GSO contained high levels of unsaturated fatty acids (90.1% and 85.1%, respectively), and the major fatty acid was linoleic (62.0% and 72.8%, respectively). Additionally, GPO contained eleven triacylglycerol (TAG) species, three of which represented 82.7%, namely C54:6, C54:4 and C52:4, and trilinolein was the dominant one (35.5%). GSO contained nine TAG species, two of which represented 80.3%, namely C54:6 and C52:4, and trilinolein was dominant (53.3%). The DSC analysis of GPO and GSO revealed that three exothermal peaks were detected during cooling. Three endothermal peaks (one of which is exothermal for GSO) were detected during melting, and the most significant peaks occurred at low temperatures. FTIR spectra indicated that GPO and GSO did not contain peroxides or trans fatty acids, but they did contain low concentrations of free fatty acids.

Development of multiband optical sensing method for phenotyping of tomatoes in cultivation site

For the development of a smart food chain, it is necessary to produce stable high-quality agricultural products in the agricultural sector which is the starting point of the food system, and it is important to accumulate and analyse the phenotypic information of agricultural products during cultivation. An easy, rapid, non-destructive and quantitative evaluation method of tree vigor is desirable. This study aimed to develop an X-ray fluorescent (XRF) spectroscopy of fresh leaves and infrared (IR) spectroscopy of fruit juice using a portable device. In addition, the relationship between the spectroscopic information and the surface color of agricultural products was studied. The results showed that the changes in leaf element were in balance and organic matters in the fruits due to slight differences in cultivation conditions were grasped as the XRF and IR spectroscopic information. Furthermore, such changes could be reflected as the differences in the surface color information obtained using the digital camera. Therefore, it was experimentally suggested that the multiband optical sensing could be a powerful and important tool for realizing smart food chains and phenomics research starting from agricultural production.

Prospective validation of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I in Japanese patients presenting to emergency department

Background

The diagnostic performance of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I (hsTnI) for non-ST-segment elevation myocardial infarction (NSTEMI) has not been evaluated in an Asian population.

Purpose

We aimed to prospectively validate the 0-hour/1-hour algorithm using hsTnI in a Japanese population.

Method

We enrolled 754 Japanese patients (mean age of 70 years, 395 men) presenting to our emergency department with symptoms suggestive of NSTEMI. The hsTnI concentration was measured using the Siemens ADVIA Centaur hsTnI assay at presentation and after 1 hour. Patients were divided into three groups according to the algorithm: hsTnI below 3 ng/L (only applicable if chest pain onset &gt;3 hours) or below 6 ng/L and delta 1 hour below 3 ng/L were the “rule-out” group; hsTnI at least 120 ng/L or delta 1 hour at least 12 ng/L were in the “rule-in” group; the remaining patients were classified as the “observe” group. Based on the Fourth Universal Definition of Myocardial Infarction, the final diagnosis was adjudicated by 2 independent cardiologists using all available information, including coronary angiography, coronary computed tomography, and follow-up data. Safety of rule-out was quantified by the negative predictive value (NPV) for NSTEMI, accuracy of rule-in by the positive predictive value (PPV), and overall efficacy by the proportion of patients triaged towards rule-out or rule-in within 1 hour.

Results

Prevalence of NSTEMI was 6.5%. The safety of rule-out (NPV 100%), accuracy of rule-in (PPV 26%), and overall efficacy (54%) were shown in Figure.

Conclusion

The 0-hour/1-hour algorithm using hsTnI is very safe and effective in triaging Japanese patients with suspected NSTEMI.

Funding Acknowledgement

Type of funding source: None

Comparison between optical frequency domain imaging and intravascular ultrasound in PCI guidance for Biolimus A9 eluting stent implantation

Background

It has been reported that intravascular ultrasound (IVUS) guided PCI reduced a risk of major adverse cardiac event compared to conventional angiography guided PCI, while comparison between IVUS-guided and optical frequency domain imaging (OFDI)-guided PCI specifically in long-term clinical outcomes (&gt;1 year) has been unexplored.

Purpose

We sought to compare imaging surrogates at 8 months and clinical outcomes beyond 1 year after drug-eluting stent implantation between IVUS and OFDI guidance.

Methods

The MISTIC-1 is a prospective, multi-centre, single-blinded, randomised-controlled, non-inferiority trial comparing OFDI-guided and IVUS-guided PCI using Biolimus A9 eluting Nobori stent. We enrolled patients with stable coronary artery disease who have symptoms or clinically relevant myocardial ischemia. Stent landing zones were selected in the most normal looking sites with largest lumen and without percentage plaque area &gt;50% in IVUS group while without lipidic plaque of &gt;2 quadrants or suggestive thin-cap fibroatheroma in OFDI group. Stent sizing was based on external elastic lamina (EEL) in IVUS group, while by taking 10% or 0.25mm larger than mean lumen diameter at reference sites in OFDI group. Stent optimisation with in-stent minimum lumen area ≥80% of the average lumen area at proximal and distal reference sites was encouraged in both groups. Primary efficacy endpoint is in-segment minimum lumen area (MLA) assessed by OFDI at 8 months. Secondary safety endpoint is a composite of cardiovascular death, target vessel myocardial infarction, or target lesion revascularisation. Based on the assumption that mean in-segment MLA at follow-up was 4.5mm2 with a standard deviation of 2.0mm2 in the control (IVUS) group and a non-inferiority limit of 1.2mm2 for OFDI group, sample size was estimated as 48 cases in each group with 5% type I error and 90% statistical power.

Results

Since June-2014 and August-2016, we prospectively enrolled 109 patients (mean age 70 years, male 78%) with 126 lesions. Baseline patient and lesion characteristics were well balanced and average nominal size and length of stent used did not differ between OFDI-guided and IVUS-guided PCI (3.0 and 19.1mm vs. 3.1 and 19.3mm, respectively). Post-procedural minimum stent area was 6.24mm2 in OFDI group and 6.72mm2 in IVUS group (p=0.20). At 8-month follow-up, in-segment MLA was 4.56mm2 in OFDI group and 4.13mm2 in IVUS group (P for non-inferiority &lt;0.001). During the follow-up (median 4.5 years [1654 days]), incidence rates of major adverse cardiac event were comparable between the two groups (7.4% in OFDI group and 7.3% in IVUS group, hazard ratio 0.96, 95% CI 0.24–3.83, p=0.95). No definite or probable stent thrombosis were documented in both groups.

Conclusion

OFDI-guided PCI demonstrated comparable results in achieving satisfactory imaging surrogates as well as long-term clinical outcomes after newer generation DES implantation as compared to IVUS-guided PCI.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): Suzuken Memorial Foundation

Five-year major adverse cardiac and cerebrovascular events of patients with lipid core abutting lumen (LCAL) on integrated-backscatter intravascular ultrasound undergoing PCI with current DES

Background

Percutaneous Coronary Intervention (PCI) using the new generation drug-eluting stent (DES) has been extremely reduced target lesion revascularization (TLR) in recent years. However, a high incidence of non-target lesion-related cardiovascular events in patients undergoing PCI is an important problem to be solved. According to the previous findings, patients with vulnerable plaques particularly have a high recurrence of cardiovascular events. Little studies, however, has been done to examine the relationship between plaque characteristics on intravascular imaging in a target lesion and non-target lesion-related cardiovascular events.

Purpose

The main objective of this study is to investigate the five-year major adverse cardiac and cerebrovascular events (MACCE) of patients with lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound (IB-IVUS) in a target lesion undergoing PCI with current DES.

Methods and results

Between February 2010 and September 2013, in total 780 patients with ischemic heart disease undergoing PCI, 166 target lesions in 166 consecutive patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) and stable angina pectoris (SAP) undergoing IVUS-guided PCI were studied.

Plaque characteristics in all target lesions were analyzed by three-dimensional IB-IVUS system using the mechanical IVUS catheter. Our previous study has found that LCAL which is defined as a lipid pool directly in contact with the lumen visualizes the thin fibrous cap of less than 75μm on optical coherence tomography (OCT). On the basis of this data, LCAL at minimal lumen area (MLA) site was identified.

In total, 39 patients had lesions with LCAL at MLA site (LCAL(+)), and 127 patients had those without LCAL (LCAL(−)).

The primary endpoint was defined as MACCE, including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke and non-TLR for the new lesion during a median follow up of five years. The MACCE occurred significantly higher in the LCAL(+) than in the LCAL(−) (38.5% vs. 17.3%; p&lt;0.005). And the Kaplan-Meier estimates have shown that the cumulative incidence of MACCE was significantly higher in the LCAL(+) than in the LCAL(−) (log rank test, p=0.041). Additionally, after adjustment for confounders, gender, prior PCI and LCAL was the independent predictors for the MACCE of patients undergoing PCI with current DES.

Furthermore, after adding LCAL to a baseline model with established factors consisting of age, gender, diabetes mellitus, prior PCI and percentage lipid volume on IB-IVUS, the net reclassification (p&lt;0.002) and integrated discrimination improvement (p&lt;0.004) significantly improved compared to baseline model alone.

Conclusions

In this study, it has become clear that LCAL on IB-IVUS is likely to be a surrogate marker of MACCE in patients undergoing PCI with current DES.

Funding Acknowledgement

Type of funding source: None

Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units

Background

Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known.

Objective

We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality.

Methods

We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] &lt;15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death.

Results

During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P&lt;0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P&lt;0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P&lt;0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P&lt;0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P&lt;0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P&lt;0.0001) and left ventricular ejection fraction (46% vs. 52%, P&lt;0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P&lt;0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P&lt;0.0001). Quartiles of presepsin levels were significantly (P&lt;0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone.

Conclusions

Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs.

Presepsin quartiles and mortality

Funding Acknowledgement

Type of funding source: None

Improved preparation of group-specific component (Gc) protein to derive macrophage activating factor

Cancer immunotherapy has recently attracted attention as an approach for cancer treatment through the activation of the immune system. Group-specific component (Gc) protein is a precursor for macrophage activating factor (GcMAF), which has a promising immunomodulatory effect on the suppression of tumor growth and angiogenesis. In this study, we successfully purified Gc protein from human serum using anion-exchange chromatography combined with affinity chromatography using a 25-OH-D₃-immobilized column. The purity of Gc protein reached 95.0% after anion-exchange chromatography. The known allelic variants of Gc protein are classified into three subtypes-Gc1F, Gc1S and Gc2. The fragment sequence of residues 412-424 determined according to their MS/MS spectra is available to evaluate the subtypes of Gc protein. The data showed that the Gc protein purified in this study consisted of the Gc1F and Gc2 subtypes. Our method improved the purity of Gc protein, which was not affected by the treatment to convert it into GcMAF using β-galactosidase- or neuraminidase-immobilized resin, and will be useful for biological studies and/or advanced clinical uses of GcMAF, such as cancer immunotherapy.

DNA methylation of GJA1, BMP2 and BMP4 in a human cementoblast cell line induced by lipopolysaccharide

AIM

To examine DNA methylation of GJA1, BMP2 and BMP4 in human cementoblasts (HCEM) induced by lipopolysaccharide (LPS).

METHODOLOGY

HCEM were cultured in osteoinduction medium. After 24 h, Escherichia coli LPS (1 μg/mL) was added to the medium, which was changed every 2-3 days. Untreated samples were used as controls. Messenger RNA was extracted after 4 weeks, and quantitative real-time polymerase chain reaction (qRT-PCR) for GJA1, BMP2, BMP4 and DNMT1 was performed. Genomic DNA was extracted after 4 weeks, and quantitative methylation-specific polymerase chain reaction was carried out for GJA1, BMP2 and BMP4. To detect mineralization, alizarin red and alkaline phosphatase staining were performed. The cells were also treated with the DNA methyltransferase inhibitor 5-Aza-2'-deoxycytidine (5Aza) and examined. The significance of differences amongst groups was assessed using a two-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test with P < 0.05 being significant.

RESULTS

Decreased expression of mRNA was seen in GJA1, BMP2 and BMP4 after 4 weeks (P < 0.05). DNA hypermethylation was detected in GJA1, BMP2 and BMP4 (P < 0.05). Alizarin red staining and alkaline phosphatase staining revealed decreased mineralization levels in HCEM stimulated with LPS. 5Aza abolished the effects of DNA methylation in HCEM stimulated with LPS.

CONCLUSIONS

These results suggest that long-term LPS stimulation induces DNA methylation of GJA1, BMP2 and BMP4 in HCEM.

NMR-based metabolic profiling and comparison of Japanese persimmon cultivars

Persimmons are a traditional, autumnal, and healthy fruit commonly consumed in Japan and East Asia based on the saying, "a persimmon a day keeps the doctor away." The differences in metabolites among five major Japanese persimmon cultivars were investigated using a nuclear magnetic resonance (NMR)-based metabolomics approach. By using a broadband water suppression enhanced through T₁ effects (WET) method for the sensitive detection of minor metabolites, better discrimination among cultivars and more informative details regarding their metabolic differences have been achieved compared to those achieved in conventional ¹H NMR sequences. Among the nonastringent cultivars analyzed, the Taishu cultivar has the highest abundance of amino acids. The Matsumotowase-Fuyu cultivar contains ethyl-β-glycosides as characteristic components, which may relate to fruit softening. Citric acid concentration is higher in Maekawa Jiro than in other nonastringent cultivars. Among the two astringent cultivars analyzed, ethanol was significantly higher in Hiratanenashi than in Yotsumizo, which indicates different reactivity during deastringency treatments. The present study proposes an efficient and relatively quantitative metabolomics approach based on broadband WET NMR spectra.

P6178The optimal point of CT-FFR measurement in comparison with invasive FFR

Background

Currently, invasive fractional flow reserve (FFR), has become a gold standard to select patients requiring revascularization. Coronary computed tomography angiography (CTA) -derived FFR (FFRCT/CT-FFR) can be used for the management of coronary artery disease, which would be a gatekeeper of invasive coronary angiography. In most of the previous report to evaluate the diagnostic performance of FFRCT/CT-FFR, FFRCT/CT-FFR value was measured at the same point as the invasive FFR. Clinically, FFRCT/CT-FFR should be measured without the information of invasive FFR. However, optimal measurement point for CT-FFR has not been established yet.

Purpose

To assess the optimal measurement point of CT-FFR in comparison with invasive FFR as a gold standard.

Methods

CTA images scanned at 70–99% of R-R interval with 320 slice CT were screened. In the de-novo lesions with invasive FFR data were included in this study. Since calcified lesions could affect CT-FFR value, severe calcified lesions on CTA were excluded from the analysis. The CT-FFR analysis was performed by 2 cardiologists blinded to the results of the invasive FFR using a standard desktop computer and dedicated software. CT-FFR values could be provided at any point from ostium of coronary artery to the distal with vessel diameter of 1.8mm. To determine the optimal point for measurement of CT-FFR, CT-FFR values were obtained at 3 points in each coronary artery; 1) at the same point as invasive FFR; 2) lowest CT-FFR at distal point of coronary artery; 3) at 2.0 cm distal to the lesion. The diagnostic performance at each point was compared with invasive FFR.

Results

Fifty vessels of 44 patients (average age 68 years, male were 32) were included. Average Agatston score was 279.4. There was significant correlation between CT-FFR at each point and invasive FFR. CT-FFR at the same point as invasive FFR showed the good correlation with invasive FFR (R=0.641, 95% CI= 0.041–0.127, p<0.0001). Compared to the lowest CT-FFR at distal (R=0.608, 95% CI= 0.069–0.160, p<0.0001), CT-FFR at 2.0 cm distal to the lesion (R=0.604, 95% CI= 0.007–0.061, p<0.0001) revealed better correlation with invasive FFR. Sensitivity, specificity, positive and negative predictive value at each point were 92.8 / 93.3 / 81.8; 75.0 / 57.1 / 94.2; 61.9 / 48.2 / 60.0; and 96.0 / 95.2 / 84.6, respectively. Diagnostic accuracy showed that CT-FFR at 2cm distal to the lesion (0.84) was similar to CT-FFR at the same point as invasive FFR (0.80), and it was better than far distal (0.68) to detect invasive FFR derived ischemia.

Conclusions

CT-FFR was feasible to detect invasive FFR derived ischemia at the same point.

CT-FFR at 2.0 cm distal to the lesion showed higher diagnostic performance compared with CT-FFR measured at the far distal. CT-FFR measurement at 2.0 cm distal to the lesion would be a optimal position clinically.

P6171Role of myocardial mass for identifying FFR-verified ischemia and determining therapeutic strategy

Background

Conventional noninvasive approach using coronary CT angiography (CTA) focusing on only coronary artery lesions remains mismatch in identifying functional ischemia and determining indication for coronary revascularization.

Purpose

We aimed to assess the usefulness of CT-verified myocardial mass for identifying FFR-verified myocardial ischemia and determining the indication of coronary revascularization after FFR examination.

Methods

We examined 244 vessels with intermediate stenoses (50 to 90% stenosis visually on CTA) in 216 patients (mean age 69.2±9.2, 166 men) who underwent both coronary CTA and invasive FFR. In addition to coronary stenosis severity and plaque characteristics on visual, minimal lumen diameter (MLD), minimal lumen area (MLA), plaque volume, the entire myocardial volume of the target vessel (MTV) and that exposed to ischemia (FFR ≤0.80) (myocardial volume of ischemia: MVI) were evaluated. Additionally, therapeutic strategy after FFR was recorded.

Results

Of 244 vessels, myocardial ischemia (FFR ≤0.80) was shown in 99 (40.6%). MTV was larger in the patients with FFR-verified ischemia than those without (53.3±19.2 vs. 41.5±21.6, P<0.001); MLA, plaque burden (PB) and percentage of aggregated plaque volume (%APV) were also associated with ischemia. The area under the curves (AUCs) of MLA, PB, %APV, and MTV were 0.69, 0.67, 0.64, and 0.71, respectively. Addition of MTV to a model with coronary stenosis on visual, MLA, PB, and %APV improved C-index (from 0.72 to 0.79, P<0.01), net reclassification improvement (NRI) (0.71, P<0.01), and integrated discrimination improvement (IDI) (0.10, P<0.01). Of 99 vessels with FFR ≤0.80, MVI was larger in the vessels with early revascularization after FFR than those without (38.8 vs. 29.1, P=0.01).

Conclusions

The measurement of myocardial mass improves the diagnostic performance of coronary CTA for the identification of coronary arteries with FFR-verified ischemia. Furthermore, it is associated with therapeutic strategy for the diseased vessels after FFR examination.

P5750Manipulation strategy for crossing coronary chronic total occlusion: an update from the Japanese CTO-PCI expert registry

Background

The percutaneous coronary intervention (PCI) strategy for chronic total occlusion (CTO) based on the guidewire manipulation time remains infrequent.

Purpose

We aimed to assess CTO-PCI strategy on the basis of guidewire manipulation time.

Methods

A total of 5843 patients undergoing CTO PCI between January 2014 and December 2017 and enrolled in the Japanese CTO-PCI expert registry were assessed. Their CTO-PCI strategies, procedural outcomes, and guidewire manipulation time were analysed.

Results

The primary retrograde approach was performed on 1562 patients (26.7%). The overall guidewire and technical success rates were 92.8% and 90.6%, respectively. Median guidewire manipulation time of guidewire success and failure were 56 (interquatile range [IQR]: 22 to 111) min and 176 (IQR: 130 to 229) min, respectively. The average Japanese CTO score of the primary antegrade approach with the antegrade alone, the primary antegrade approach with the retrograde approach, and the primary retrograde approach were 1.7±1.1, 2.1±1.2, and 2.3±1.1, respectively (p<0.001). Median successful guidewire crossing time of single wiring in the antegrade alone was 23 (IQR: 11 to 44) min, and that of the primary retrograde approach was significantly shorter than that of the primary antegrade approach with the retrograde approach (107 [IQR: 70 to 161] min vs. 126 [IQR: 87 to 174] min; p<0.001). Reattempt, CTO length ≥20 mm, and proximal cap ambiguity were the predictors of guidewire failure in the primary antegrade approach with antegrade alone, but were not those in the primary retrograde approach.

Conclusions

Although successful guidewire crossing time of the primary antegrade approach with the antegrade alone is short, that of the primary retrograde approach can be shorter than that of the primary antegrade approach with the retrograde approach. Choosing an appropriate CTO-PCI strategy leads to shortening of successful guidewire crossing time.

P3388Five year outcomes of patients with lipid rich plaque detected three-dimensional Integrated-Backscatter intravascular ultrasound (IB-IVUS) in target lesion after second generation DES implantation

Background

Elective percutaneous coronary intervention (PCI) using second generation drug-eluting stent (DES) has been dramatically reduced restenosis rate. Recently, it has been reported that plaque characterization in nontarget lesion is associated with cardio-vascular events in ischemic heart disease patients undergoing elective PCI. However, it is unclear whether plaque characterization in target lesion is predictor of MACEs (major adverse cardiac events) after elective PCI.

Purposes

The aim of this study is whether plaque characterization detected integrated-backscatter intravascular ultrasound (IB-IVUS) in the target lesion is associated with MACEs in patients with PCI after second generation DES implantation.

Methods and results

Of 700 patients with ischemic heart disease, 552 patients were excluded for chronic totally occlusion, severe calcification hindering precise intracoronary imaging, tortuous lesions, ostial or left main stem lesions and ST-elevated myocardial infarction patients. Finally, 148 consecutive patients who consented to repeated IB-IVUS prior to undergoing elective PCI were recruited in the study.Plaque characterization in target lesion was identified for three-dimensional IB-IVUS technology using the mechanical IVUS catheter (ViewIT, 40 MHz, 2.5 Fr; Terumo, Tokyo, Japan). The median of percentage lipid volume in all target lesions was 47.6%. Furthermore, lipid rich plaque (LRP) group was defined as the lesions consisting of percentage lipid volume greater than the median. And, non-lipid rich plaque (non-LRP) group was defined as the lesions consisting of percentage lipid volume less than the median. MACEs were defined as cardiovascular death, target vessel myocardial infarction, target lesion revascularization and stent thrombosis. The median of follow up period was 60 months. Of the 148 patients, 106 patients had stable angina pectoris. The remaining 42 patients are acute coronary syndrome (NSTE-ACS). 74 patients were classified LRP groups and 74 patients were non-LRP groups. No significant differences were observed between the two groups with respect to age, sex and coronary risk factors. While plaque and vessel volume were greater in the LRP group (216.9±116.3mm3, p<0.001) than non-LRP group (322.5±144.0mm3, p p<0.001). Remodeling index was greater in LRP group (1.02±0.18) than non-LRP group (0.93±0.18, p<0.003). Although MACEs were no significant differences between the two groups, the number of MACEs tend to be more in patients with LRP group (8.1±27.4%) than small lipid group (2.7±16.3, p<0.147). Especially, cardiac death tend to be more in LRP group (6.7±25.2% than non-LRP group (1.3±11.6, p<0.096).

Conclusions

In conclusion, lipid rich plaque detected by three dimensional IB-IVUS system in target lesion with patients undergoing elective PCI may be associated with clinical outcomes for five years after second generation DES implantation.

Acknowledgement/Funding

None

P2240CTA derived plaque characteristics and cardiac events in deferred lesions by invasive FFR

Background

Fractional flow reserve (FFR) based strategy for coronary artery disease (CAD) is widely accepted. However, cardiac events could occur at deferred lesions after FFR. We previous reported that CT derived high risk plaque (HRP) and residual stenosis were the independent predictors of cardiac events.

Purpose

The purpose of this study was to investigate if plaque characteristics on CTA could predict cardiac events in deferred lesions after FFR.

Methods

We included 211 vessels of 193 patients who were deferred revascularization after CTA and invasive FFR. The presence of HRP and the stenosis grading on CTA were analyzed.

Results

Median follow-up period after CTA was 623 days (IQR 302–945). HRP and obstructive stenosis were detected in 58 (27.5%) and 87 (41.2%) lesions, respectively. Cardiac events were occurred in 10 lesions at 440±167 days in average (range: 150–770 days). Multivaliate cox hazard regression analysis revealed that HRP (HR8.01, p=0.0032) and obstructive stenosis with ≥70% (HR 34.93, p<0.0001) were the independent predictors of cardiac events after adjusted for age, sex, and FFR≤0.8. Of 21 lesions with both HRP and obstructive stenosis, 29% lesions resulted in cardiac events in 2 years.

Conclusions

Even in the deferred lesions by invasive FFR, lesions with HRP and obstructive stenosis showed high rate of cardiac events. These lesions should be treated with intensive medical therapy to prevent cardiac events.

P4620Circulating concentration of presepsin improves early prediction of short-term mortality in patients treated at medical cardiac intensive care units

Background

Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocytic activation. Presepsin appears to be an accurate diagnostic marker of sepsis, but its clinical significance remains unclear in cardiovascular disease.

Purpose

This prospective study aimed to investigate the predictive value of plasma presepsin levels on admission to medical (non-surgical) cardiac intensive care units (MCICUs) for short-term mortality.

Methods

We examined 1560 patients hospitalized in MCICUs and measured the baseline plasma presepsin levels at admission.

Results

Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Before MCICUs admission, emergent coronary angiography or percutaneous coronary intervention was performed in 36%, mechanical ventilation was required for respiratory insufficiency in 2.1%, and intraaortic balloon pumps were needed for hemodynamic instability in 8.9%. During 6 months after admission, there were 113 (7.2%) deaths. Patients who died were older (median: 77 vs. 71 years, P<0.0001); had higher levels of presepsin (263 vs. 119 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 696 vs. 186 pg/mL, P<0.0001), high-sensitivity troponin T (hsTnT: 81 vs. 47 pg/mL, P=0.004), and high-sensitivity C-reactive protein (13.8 vs. 2.2 mg/L, P<0.0001); and had lower levels of estimated glomerular filtration rate (50 vs. 65 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (43% vs. 51%, P<0.0001) than those of the survivors. In the multivariate Cox regression analysis, higher levels of presepsin (P=0.0002), BNP (P=0.04), and hsTnT (P=0.009) were all independent predictors of 6-month deaths. Quartiles of presepsin levels were associated with higher mortality rates within 6 months after admission (Table). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsTnT further enhanced reclassification (P=0.004) and discrimination (P=0.003) beyond that of the baseline model.

Mortality rates according to presepsin Presepsin quartile 1st 2nd 3rd 4th P value ≤80 pg/mL 81–124 pg/mL 125–232 pg/mL >232 pg/mL 1-month mortality 0.8% 2.0% 3.3% 8.0% <0.0001 6-month mortality 0.8% 3.8% 8.2% 16.3% <0.0001

Conclusions

Presepsin levels at admission could improve the prediction of short-term mortality in patients hospitalized at MCICUs.

Alkaline extracellular conditions promote the proliferation and mineralization of a human cementoblast cell line

AIM

To investigate the proliferation and mineralization of a human cementoblast cell line under alkaline conditions.

METHODOLOGY

A human cementoblast cell line was cultured in alkaline media with several pHs (pH 7.6, 8.0 and 8.4) without CO₂ . Cell numbers, phospho-p44/42 expression, alkaline phosphatase (ALP) activity and mineralization were evaluated. The significance of differences between groups was assessed using two-way analysis of variance 15 (ANOVA) followed by Bonferroni's multiple comparison test (α = 0.01).

RESULTS

Cell numbers increased in a time-dependent manner in the high pH medium groups. Western blot analysis revealed the upregulated expression of phospho-p44/42 under alkaline conditions. ALP activity was also increased at pH 8.0 and 8.4. Alizarin red staining revealed increased mineralization in the high pH medium groups. The incorporation of the transient receptor potential ankyrin subfamily member 1 (TRPA1) antagonist HC030031 markedly negated the effect on proliferation and mineralization.

CONCLUSIONS

Extracellular alkaline conditions promoted the proliferation and mineralization of human cementoblasts in vitro via TRPA1.

Response of porcine epithelial rests of Malassez to stimulation by interleukin-6

AIM

To investigate the proliferation and migration of epithelial cell rests of Malassez (ERM) after stimulation with IL-6.

METHODOLOGY

Porcine-derived ERM were seeded on Dulbecco's modified Eagle's Medium, and IL-6 (100 pg mL^-1 ) was incorporated into the culture medium. The WST-1 assay was performed to evaluate cell proliferation, and absorption was measured at 450 nm. A wound-healing assay and immunofluorescence assay for integrin α₃ were conducted to investigate migration. The Kruskal-Wallis test and the Mann-Whitney U-test with Bonferroni correction were used to analyse data of WST-1 and wound-healing assays.

RESULTS

Cell proliferation following the stimulation by IL-6 increased over time, with a significant increase being observed at 6 h (P < 0.05), but not in a concentration-dependent manner. Cell proliferation was significantly greater in IL-6-treated ERM than in nontreated ERM (P < 0.05). The results of the wound-healing assay revealed earlier closure in IL-6-treated ERM (P < 0.05). In the immunofluorescence assay, integrin α₃ was detected at the edge of cell processes adjacent to the wound area. A neutralized antibody abrogated the effects of the IL-6 stimulation in cell proliferation and migration.

CONCLUSION

IL-6 promoted the proliferation and migration of porcine ERM in vitro.

Distribution of Glycoconjugates in the Kidney Studied by Use of Labeled Lectins

Distribution of glycoconjugates in different areas of the rat kidney was studied by light and electron microscopy using six different horseradish peroxidase-labeled lectins. Glomeruli and brush borders of the proximal tubules reacted differently to these lectins, which indicated differences in the carbohydrate compositions of those regions. The ascending limb of Henle's loop (ALH) had strong binding sites for peanut agglutinin (PNA) and soybean agglutinin (SBA). Dolichos biflorus agglutinin (DBA) did not stain the cells of ALH but did stain those of distal convoluted tubules (DCT). DBA is a good marker for distinguishing ALH from DCT. DBA, PNA, and SBA were also good markers of the collecting duct. Ricinus communis agglutinin (RCA-1) and wheat germ agglutinin (WGA) diffusely stained the various components of different parts of the kidney.

Actin stabilization induces apoptosis in cultured porcine epithelial cell rests of Malassez

AIM

To test whether actin stabilization by jasplakinolide induces inhibition of cell viability and apoptosis in epithelial cell rests of Malassez (ERM).

METHODOLOGY

ERM derived from porcine were spread in a 96-well dish (5 × 10(4) /well) using Dulbecco's modified Eagle's medium. The actin-specific stabilization reagent, jasplakinolide, was incorporated into the culture medium and incubated for 24 h. To evaluate cell viability, the WST-1 assay was carried out and absorption (450 nm) was measured. To detect apoptotic cells, monoclonal antibody to single-strand DNA (ssDNA) was used and absorption (405 nm) was measured. Actin stabilization and apoptosis induced by jasplakinolide were morphologically investigated by staining with Alexa Fluor 568 phalloidin and observed under a fluorescent microscope. As a negative control, DMSO was used instead of jasplakinolide. Differences between the jasplakinolide-treated group and the control group were analysed statistically using the Student's t-test.

RESULTS

Cell viability decreased in a concentration-dependent manner, and cell viability in the jasplakinolide-treated ERM was lower than that in nontreated ERM (n = 16, P < 0.01). Apoptotic cells in the jasplakinolide-treated ERM were more frequently detected compared to that in nontreated ERM (n = 16, P < 0.01). Morphologically, shrinkage, irregular forms and fragmentation of nuclei suggesting apoptotic bodies were observed in jasplakinolide-treated ERM, whilst actin filaments were extended in non-treated ERM.

CONCLUSION

Actin stabilization by jasplakinolide inhibited cell viability and induced apoptosis in epithelial cell rests of Malassez.

A redox switch shapes the Lon protease exit pore to facultatively regulate proteolysis

The Lon AAA+ protease degrades damaged or misfolded proteins in its intramolecular chamber. Its activity must be precisely controlled, but the mechanism by which Lon is regulated in response to different environments is not known. Facultative anaerobes in the Enterobacteriaceae family, mostly symbionts and pathogens, encounter both anaerobic and aerobic environments inside and outside the host's body, respectively. The bacteria characteristically have two cysteine residues on the Lon protease (P) domain surface that unusually form a disulfide bond. Here we show that the cysteine residues act as a redox switch of Lon. Upon disulfide bond reduction, the exit pore of the P-domain ring narrows by ∼30%, thus interrupting product passage and decreasing activity by 80%; disulfide bonding by oxidation restores the pore size and activity. The redox switch (E°' = -227 mV) is appropriately tuned to respond to variation between anaerobic and aerobic conditions, thus optimizing the cellular proteolysis level for each environment.

Structure and function of midkine as the basis of its pharmacological effects

Midkine (MK) is a heparin-binding growth factor or cytokine and forms a small protein family, the other member of which is pleiotrophin. MK enhances survival, migration, cytokine expression, differentiation and other activities of target cells. MK is involved in various physiological processes, such as development, reproduction and repair, and also plays important roles in the pathogenesis of inflammatory and malignant diseases. MK is largely composed of two domains, namely a more N-terminally located N-domain and a more C-terminally located C-domain. Both domains are basically composed of three antiparallel β-sheets. In addition, there are short tails in the N-terminal and C-terminal sides and a hinge connecting the two domains. Several membrane proteins have been identified as MK receptors: receptor protein tyrosine phosphatase Z1 (PTPζ), low-density lipoprotein receptor-related protein, integrins, neuroglycan C, anaplastic lymphoma kinase and Notch-2. Among them, the most established one is PTPζ. It is a transmembrane tyrosine phophatase with chondroitin sulfate, which is essential for high-affinity binding with MK. PI3K and MAPK play important roles in the downstream signalling system of MK, while transcription factors affected by MK signalling include NF-κB, Hes-1 and STATs. Because of the involvement of MK in various physiological and pathological processes, MK itself as well as pharmaceuticals targeting MK and its signalling system are expected to be valuable for the treatment of numerous diseases.

LINKED ARTICLES

This article is part of a themed section on Midkine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-4.

Autoprocessing mechanism of severe acute respiratory syndrome coronavirus 3C-like protease (SARS-CoV 3CLpro) from its polyproteins

Like many other RNA viruses, severe acute respiratory syndrome coronavirus (SARS‐CoV) produces polyproteins containing several non‐structural proteins, which are then processed by the viral proteases. These proteases often exist within the polyproteins, and are excised by their own proteolytic activity (‘autoprocessing’). It is important to investigate the autoprocessing mechanism of these proteases from the point of view of anti‐SARS‐CoV drug design. In this paper, we describe a new method for investigating the autoprocessing mechanism of the main protease (M^pro), which is also called the 3C‐like protease (3CL^pro). Using our method, we measured the activities, under the same conditions, of the mature form and pro‐forms with the N‐terminal pro‐sequence, the C‐terminal pro‐sequence or both pro‐sequences, toward the pro‐form with both N‐ and C‐terminal pro‐sequences. The data indicate that the pro‐forms of the enzyme have proteolytic activity, and are stimulated by the same proteolytic activity. The stimulation occurs in two steps, with approximately eightfold stimulation by N‐terminal cleavage, approximately fourfold stimulation by C‐terminal cleavage, and 23‐fold stimulation by the cleavage of both termini, compared to the pro‐form with both the N‐ and C‐terminal pro‐sequences. Such cleavage mainly occurs in a trans manner; i.e. the pro‐form dimer cleaves the monomeric form. The stimulation by N‐terminal pro‐sequence removal is due to the cis (intra‐dimer and inter‐protomer) effect of formation of the new N‐terminus, whereas that by C‐terminal cleavage is due to removal of its trans (inter‐dimer) inhibitory effect. A numerical simulation of the maturation pathway is presented.