Evaluating the link between DIO3-FA27 promoter methylation, biochemical indices, and heart failure progression

BACKGROUND

Heart failure (HF) is a disease that poses a serious threat to individual health, and DNA methylation is an important mechanism in epigenetics, and its role in the occurrence and development of the disease has attracted more and more attention. The aim of this study was to evaluate the link between iodothyronine deiodinase 3 promoter region fragment FA27 (DIO3-FA27) methylation levels, biochemical indices, and HF.

RESULTS

The methylation levels of DIO3-FA27_CpG_11.12 and DIO3-FA27_CpG_23.24 significantly differed in HF patients with different degrees. Multivariate logistic regression analysis indicated that the relative HF risk in the third and fourth quartiles of activated partial thromboplastin time and fibrin degradation products. The results of the restricted cubic spline model showed that the methylation levels of DIO3-FA 27_CpG_11.12 and DIO3-FA 27_CpG_23.24 were associated with coagulation indicators, liver function, renal function, and blood routine.

CONCLUSIONS

Based on the differential analysis of CpG methylation levels based on DIO3-FA27, it was found that biochemical indicators combined with DIO3-FA27 promoter DNA methylation levels could increase the risk of worsening the severity classification of HF patients, which provided a solid foundation and new insights for the study of epigenetic regulation mechanisms in patients with HF.

Rapid carbothermal shocking fabrication of iron-incorporated molybdenum oxide with heterogeneous spin states for enhanced overall water/seawater splitting

Molybdenum dioxide (MoO2) has been considered as a promising hydrogen evolution reaction (HER) electrocatalyst. However, the active sites are mainly located at the edges, resulting in few active sites and poor activity in the HER. Herein, we first reported on an efficient strategy to incorporate Fe into MoO2 nanosheets on Ni foam (Fe-MoO2/NF) using a rapid carbothermal shocking method (820 °C for 127 s). Notably, the different spin states between Fe and Mo atoms could lead to rich lattice dislocations in Fe-MoO2/NF, exposing abundant oxygen vacancies and the low-oxidation-state of Mo sites during the rapid Joule heating process. As tested, the catalyst exhibited superior activity with ultralow overpotentials (HER: 17 mV@10 mA cm-2; oxygen evolution reaction (OER): 310 mV@50 mA cm-2) and high OER selectivity in alkaline seawater splitting. Meanwhile, this catalyst was equipped in a home-made anion exchange membrane (AEM) seawater electrolyzer, which achieved a low energy consumption (5.5 kW h m-3). More importantly, Fe-MoO2/NF also coupled very well with a solar-driven electrolytic system and turned out a solar-to-hydrogen (STH) efficiency of 13.5%. Theoretical results also demonstrated that Fe incorporated and abundant oxygen vacancies in MoO2 can distort the distance of the Mo-O bonds and regulate the electronic structure, thus optimizing the binding energy of H*/OOH* adsorption. This method can be extended to other heterogeneous spin states in MoO2-based catalysts (e.g. Ni-MoO2/NF, Co-MoO2/NF) for seawater splitting, and provide a simple, efficient and universal strategy to prepare highly-efficient MoO2-based electrocatalysts.

Defects-Induced Single-Atom Anchoring on Metal-Organic Frameworks for High-Efficiency Photocatalytic Nitrogen Reduction

Aiming to improve the photocatalytic activity in N2 fixation to produce ammonia, herein, we proposed a photochemical strategy to fabricate defects, and further deposition of Ru single atoms onto UiO-66 (Zr) framework. Electron-metal-support interactions (EMSI) were built between Ru single atoms and the support via a covalently bonding. EMSI were capable of accelerating charge transfer between Ru SAs and UiO-66, which was favorable for highly-efficiently photocatalytic activity. The photocatalytic production rate of ammonia improved from 4.57 μmol g-1  h-1 to 16.28 μmol g-1  h-1 with the fabrication of defects onto UiO-66, and further to 53.28 μmol g-1  h-1 with Ru-single atoms loading. From the DFT results, it was found that d-orbital electrons of Ru were donated to N2 π✶-antibonding orbital, facilitating the activation of the N≡N triple bond. A distal reaction pathway was probably occurred for the photocatalytic N2 reduction to ammonia on Ru1 /d-UiO-66 (single Ru sites decorated onto the nodes of defective UiO-66), and the first step of hydrogenation of N2 was the reaction determination step. This work shed a light on improving the photocatalytic activity via feasibly anchoring single atoms on MOF, and provided more evidences to understand the reaction mechanism in photocatalytic reduction of N2 .

Hydrothermal preparation of C3N4 on carbonized wood for photothermal-photocatalytic water splitting to efficiently evolve hydrogen

Hydrogen generation by photocatalysis is one of the most effective approaches to rationally utilize solar energy. In this work, we designed a biphasic photothermal-photocatalytic system. Spherical g-C3N4 (HCN) was grown on the carbonized wood (CW) by a one-step hydrothermal method. The carbonization layer in carbonized wood/spherical g-C3N4 (CW-HCN) system was able to further enhance the photothermal conversion of water steam production by improving the absorption of solar radiation. In addition, the temperature was increased due to photothermal effect, which was beneficial for H2 evolution reaction. Moreover, the carbonized layer could act as a reservoir for photogenerated electrons on g-C3N4, which could accelerate the charge separation. Benefiting from all above-mentioned merits, the H2 evolution rate of CW-HCN system under simulated sunlight reached 2700.18 μmol/m2/h, which was 42.23 times higher than that of pristine g-C3N4 powder directly dispersed in water. In addition, the CW-HCN system exhibited broad applicability, maintaining the H2 evolution activity of 2013.29 μmol/m2/h with seawater as water resource. This work provided a new strategy for highly efficient H2 evolution.

TFAM Modulates Cardiomyocytes Pyroptosis Induced by Ionizing Radiation through mtDNA/TLR9/NF-kB Pathway

PURPOSE/OBJECTIVE(S)

Mitochondrial transcription factor A (TFAM) is a pivotal factor for regulating mitochondrial DNA (mtDNA) replication, transcription and biogenesis. Previous studies have reported that cytosolic mtDNA stress can lead to cardiomyocytes pyroptosis, which is characterized by inflammasome formation. In this study, we attempted to investigate the mechanism of TFAM regulate cardiomyocytes pyroptosis induced by ionizing radiation.

MATERIALS/METHODS

The peripheral blood serum of patients with esophageal cancer before and after definitive chemoradiotherapy was collected for Luminex multiplex cytokine assays. C57BL/6 mice were irradiated with the whole heart using small animal radiation research platform (SARRP) to construct a radiation-induced myocardial damage (RIMD) mouse model, and the ventricular function was evaluated using 9.4T Bruker magnetic resonance (MR) scanner. The function changes of cardiomyocytes exposed to radiation were observed in vitro and in vivo after knocking out GSDMD. Furthermore, the changes of mitochondrial function, the levels of cytosolic mtDNA, and the protein levels of NF-kB and pyroptosis pathway in irradiated cardiomyocytes were analyzed by knockdown and overexpression of TFAM in vitro and in vivo.

RESULTS

By multifactor cytokine assays we found that pyroptosis related IL-1β and IL-18 were significantly increased in patients with high mean heart dose (MHD) after radiotherapy, while those with low MHD were not significantly increased after radiotherapy. Next, we successfully constructed the RIMD mouse model using a single heart irradiation of 20 Gy. We found that the gene expression of pyroptosis pathway was significantly up-regulated after cardiac irradiation by myocardial tissue transcriptomic sequencing. Compared with wild-type (WT) mice, cardiac systolic function of Gsdmd-/- mice was significantly improved at 1, 2, 6, 12, and 24 weeks after heart irradiation. In vitro, we also demonstrated increased viability of irradiated cardiomyocytes by knocking out GSDMD. In vitro and in vivo experiments confirmed the expression of TFAM decreased after radiation. By overexpression of TFAM, we found that irradiated cardiomyocytes showed improved mitochondrial function, decreased release of mtDNA into cytoplasm through mitochondrial permeability transition pores (mPTPs), decreased binding of cytosolic mtDNA to TLR9, and decreased expression of NF-kB and pyroptosis pathway proteins. Dual luciferase gene reporter assays and Chromatin immunoprecipitation (CHIP) assay confirmed that p65 could bind the NLRP3 promoter region. In addition, we found that ventricular function deteriorated and improved in mice with knockdown and overexpression of TFAM through adeno-associated virus serotype 9 (AAV9), respectively.

CONCLUSION

Our study indicated that TFAM regulate irradiated cardiomyocytes pyroptosis through mtDNA/TLR9/NF-kB pathway. We provide a novel mechanism of RIMD, revealing an underappreciated intervention target for RIMD.

Safety and Efficacy Analysis of Patients with Extensive-Stage Small Cell Lung Cancer (ES-SCLC) Treated with SHR-1316 Plus Chemotherapy and Sequential Chest Radiotherapy as First-Line Therapy from a Phase II Trial

PURPOSE/OBJECTIVE(S)

CAPSTONE-1, a phase 3 trial, showed that SHR-1316 (PD-L1 antibody) combined with standard first-line chemotherapy could prolong overall survival (OS) in patients (pts) with ES-SCLC. The CREST trial reported consolidative thoracic radiotherapy (TRT) of 30 Gy in 10 fractions provided a 10% 2-year OS benefit and more intensive TRT should be investigated in ES-SCLC. In the era of immunotherapy, the role of TRT also needs further exploration. Therefore, we designed this clinical trial to investigate the efficacy and safety of SHR-1316 plus first-line chemotherapy followed by TRT combined with SHR-1316.

MATERIALS/METHODS

Key inclusion criteria were pts aged 18-75 years, with previously untreated histologically or cytologically confirmed ES-SCLC, and an ECOG performance status of 0-1. Eligible pts would receive 4∼6 cycles of SHR-1316 (20mg/kg, D1, q3w) combined with EP/EC (etoposide, 100mg/m2, D1-5, q3w and cisplatin, 75mg/m², D1-3, q3w or carboplatin, AUC = 5, D1, q3w), followed by SHR-1316 combined with TRT (≥3 Gy*10 f or ≥2 Gy*25 f, involved-field irradiation), and then the maintenance therapy with SHR-1316 until disease progression or intolerable adverse events (AEs). The main endpoints included ORR, PFS and safety.

RESULTS

From October 2020 to January 2023, 33 pts received SHR-1316 and sequential consolidative TRT. Among them, 19 pts received high-dose TRT (>3 Gy*10 f or ≥2 Gy*25 f) and 14 pts received low-dose TRT (≤3 Gy*10 f or<2 Gy*25 f). The median age was 62 (range: 38-73). Most pts were male (28, 84.8%), former smokers (22, 66.7%) with an ECOG performance status 1 (32, 97%). Ten (30.3%) pts were diagnosed with brain metastasis and 10 (30.3%) pts had liver metastasis at baseline. At the data cutoff date, 9 pts remained on treatment, the average number of treatment cycles was 9.2. 33 pts had at least one 1 post-treatment tumor assessment. The confirmed ORR and DCR were 90.9% (30/33) and 100% (33/33) in all pts, were 89.5% (17/19) and 100% (19/19) in high-dose TRT group, and were 92.9% (13/14) and 100% (14/14) in low-dose TRT group. The median PFS was 10.2(CI: 5.8∼14.7) months in all pts, was 7 (CI: 3.8∼10.2) months in high-dose TRT group and 10.4 (CI: 8.4∼12.3) months in low-dose TRT group. AEs occurred in 27 (81.8%) pts and grade 3 or 4 AEs occurred in 20 (60.6%) pts. The most common grade 3 or 4 AEs included neutropenia (15, 45.5%), leukopenia (8, 24.2%), lymphocytopenia (5, 15.2%), pneumonia (3, 9.1%), anemia (3, 9.1%) and thrombocytopenia (2, 6.1%).

CONCLUSION

SHR-1316 plus chemotherapy and sequential TRT as first-line therapy for ES-SCLC showed promising efficacy and acceptable safety. There is no significant difference between high-dose and low-dose TRT groups in terms of safety and efficacy according to current data.

Performance Evaluation in Automatic Plan Generation for Ethos Intelligent Optimization Engine

PURPOSE/OBJECTIVE(S)

To evaluate the automatic optimization performance and clinical feasibility of the Intelligent Optimization Engine (IOE) of Ethos online adaptive radiotherapy platform.

MATERIALS/METHODS

Eleven patients with cervical cancer treated with Halcyon accelerator were retrospectively selected. All the patients manually planned with four full arc volume rotating intensity modulated radiotherapy (VMAT) (Manual-4Arc), and the prescription dose was 45 Gy/25F. All patient images and structures were imported into Ethos simulator, and clinical goals were added appropriately based on clinical requirements. The target coverage was normalized to 95%. 7F, 9F, 12F IMRT plans and 2Arc, 3Arc VMAT plans were automatically generated by IOE. Dosimetric index comparisons were made among the Manual-4Arc plans and five group IOE generated plan to evaluate the automatic optimization performance of IOE.

RESULTS

In terms of hot dose area, for PTV, D1% of IMRT-12F plans was the lowest, and there were significant differences between IMRT-12F plans and Manual-4Arc plans (46.936 ± 0.241 vs 48.639 ± 2.395, p = 0.004); In terms of target coverage, the CTVs of all groups meet clinical requirements. Although the Ethos online adaptive plans have been normalized during planning, the PTV coverage is slightly insufficient (12F: 94.913 ± 0.154; 9F: 94.585 ± 1.148). For OARs close to target, such as bladder, V30Gy, V40Gy and Dmean have significant differences among the six group plans. The order of bladder dose is basically followed by IMRT-12F

CONCLUSION

The plans automatically generated by Ethos IOE can achieve similar performance as the manual plan, and the automatically generated IMRT-12F and 9F plans are preferred for clinical use.

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Affiliation(s)

Z Wang Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
B Yang Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
X Meng Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Y Liang Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
T Pang Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
J Qiu Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

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Dose DIBH Really Reduce the Subclinical Cardiac Acute Injury? Analysis of Clinical Real World from Our Institute

PURPOSE/OBJECTIVE(S)

The study is aim to investigate whether Deep-inspirational breath-hold (DIBH), compared with free breathing (FB), could provide a short-term cardiac benefit in patients with early left breast cancer after breast-conserving surgery combined whole breast radiotherapy.

MATERIALS/METHODS

A total of 78 patients with early stage left breast cancer treated with radiotherapy between 2021-2022 after breast-conserving surgery were enrolled. Among them, 32 cases were treated with DIBH technique and 46 cases were treated with free breathing. Patients with previous cardiac disease such as coronary artery disease were excluded. We performed myocardial enzymes, ECG, and ECHO in all patients within 2 weeks before, during, and 6 months after radiotherapy. The results of the two groups were compared using nonparametric tests and chi-square tests, and P < 0.05 indicated statistical significance. Where subclinical acute cardiac injury was defined as new above-normal myocardial enzymes and/or electrocardiographic ST-T or T-wave changes and/or ECHO abnormalities after the start of radiotherapy.

RESULTS

The median follow-up of patients was 6 months and the mean age of patients was 52.3 years for FB and 44.9 years for DIBH. There were no significant differences in staging, molecular subtype, chemotherapy and endocrine therapy history. The proportion of subclinical acute cardiac injury was smaller in the DIBH group compared to the FB group (DIBH = 31/46 and FB = 28/32, p = 0.042). The most sensitive of the subclinical acute cardiac injury events were detected by myocardial enzymes rising, with cTnI (p = 0.034) and NT-proBNP (p = 0.023) appearing significantly lower in the DIBH patients during radiotherapy. The difference of cTnI between 2 groups at 6 months after radiotherapy became non-significant. In contrast, CK-MB was higher in DIBH compared with FB only 6 months after radiotherapy (p = 0.006). The differences in ECG and ECHO were not significant between the two groups.

CONCLUSION

After breast-conserving surgery combined with radiotherapy for left early breast cancer, DIBH compared to FB reduces the proportion of acute subclinical cardiac injury that occurs with the most sensitive changes in myocardial enzymes. Subsequent studies will explore the relationship between the short-term subclinical injury and irradiated dose, as well as long term cardiac injury.

The Predictive Value of Changes in Basal Myocardial F-18 Fluorodeoxyglucose Uptake for Cardiotoxicity in Locally Advanced Esophageal Cancer Patients Receiving Definitive Radiotherapy

PURPOSE/OBJECTIVE(S)

To investigate the predictive value of changes in myocardial 18F-FDG uptake for major adverse cardiac events (MACEs) in locally advanced esophageal cancer patients receiving definitive radiotherapy.

MATERIALS/METHODS

Between August 2012 and January 2018, 400 patients with stage II-III esophageal cancer receiving definitive radiotherapy at two institutions were divided into the training (n = 240) and external validation cohorts (n = 160). All patients underwent FDG-PET imaging within 1 week before treatment and 3 months after treatment. Myocardium delineation was performed by Carimas software (version 2.10) based on the AHA 17-segment model. When contouring the left ventricle, the myocardium was automatically divided into basal (segments 1-6), middle (segments 7-12), and apical (segments 13-16) regions, and the mean dose and FDG uptake parameters of each region were obtained by Carimas. Our primary endpoint was MACEs. Patient clinicopathologic factors, dosimetric parameters for the whole heart and cardiac substructures, and myocardial changes within the three regions on 18F-FDG PET were utilized to seek the best predictive models for cardiotoxicity. To avoid multicollinearity between dose-volume histogram (DVH) parameters, we selected the variables with the lowest Akaike Information Criterion (AIC) value from the DVH parameters of the same cardiac structure for the actual modeling procedure. Competing risk analysis and Cox regressions analysis were performed. The predictive performance of the models was evaluated using the area under the receiver operating characteristic curve (AUC) and Brier score.

RESULTS

At a median follow-up interval of 78 months, 28 patients (11.7%) developed MACEs. The basal region of the myocardium received the highest radiation dose, followed by the middle and the apex region. The basal myocardial SUVmax and SUVmean significantly increased after radiotherapy while the apical and middle myocardial SUVmax and SUVmean not significantly increased. In univariate analysis, age, pre-existing cardiac disease, changes in pre- and post-treatment basal myocardial SUVmax and SUVmean (∆SUVmax and ∆SUVmean), and dosimetric parameters for MHD, mean LCX, mean LAD, and mean LV dose were associated with an increased hazard of MACEs. Multivariate analysis showed that basal ∆SUVmean retained significance after adjusting for age, pre-existing cardiac disease, and dosimetric parameters for whole heart and cardiac substructures. The AUCs and Brier scores demonstrated favorable predictive accuracies of the model's integrating variables with significant difference in multivariate analysis when predicting MACEs in the training and validation cohorts.

CONCLUSION

∆SUVmean was an independent indicator of MACE in locally advanced esophageal cancer patients receiving definitive radiotherapy. Changes in basal myocardial FDG uptake is a promising biomaker for predicting radiation-induced cardiotoxicity.

PD-L1 Inhibitors Combined with Thoracic Radiotherapy in First-Line Treatment of Extensive Stage Small Cell Lung Cancer: A Propensity Score-Matched, Real-World Study

PURPOSE/OBJECTIVE(S)

The CREST study showed that the addition of thoracic radiotherapy (TRT) could improve the survival of extensive stage small cell lung cancer (ES-SCLC), but whether TRT can bring survival benefit in the era of immunotherapy is controversial. This study aims to explore the efficacy and safety of adding TRT to the combination of PD-L1 inhibitors and chemotherapy.

MATERIALS/METHODS

Thepatients who received PD-L1 inhibitors combined with platinum-based chemotherapy as the first-line treatment of ES-SCLC from January 2019 to December 2021 were retrospectively collected. According to whether they received TRT, they were divided into two groups, and the follow-up analysis was performed. Propensity score matching (PSM) in with a 1:1 ratio was performed to balance the baseline characteristics of the two cohorts. The endpoints were progression-free survival (PFS) and OS.

RESULTS

A total of 211 patients with ES-SCLC were enrolled, of whom 70 (33.2%) patients received standard therapy plus TRT as first-line treatment, and 141 (66.8%) patients in the control group received PD-L1 inhibitors plus chemotherapy. After PSM, a total of 65 pairs of patients were enrolled in the analysis. There were no significant differences in baseline characteristics between the two groups of patients who received TRT and those who did not. In all patients, the median PFS (mPFS) in the TRT group and the non-TRT groupwere 9.5 months and 7.2 months, respectively, with HR = 0.60 (95% CI 0.41-0.87, p = 0.007). The median OS (mOS) in the TRT group was also significantly longer than that in the non-TRT group (24.1 months vs. 18.5 months, HR = 0.53, 95% CI 0.32-0.85, p = 0.009). Multivariable analysis showed that baseline liver metastasis and bone metastasis were independent prognostic factors for OS. In terms of safety, immunotherapy combined with thoracic radiotherapy increased the incidence of treatment-related pneumonia (p<0.001), most of which were grade 1-2.

CONCLUSION

This real-world study shows that adding TRT to durvalumab or atezolizumab plus chemotherapy significantly improves survival in ES-SCLC. It leads to more treatment-related pneumonia, but most of them can be relieved after symptomatic treatment. This treatment model deserves to be explored in prospective clinical trials.

Enhanced Radiosensitivity of Esophagus Cancer through Loss of ADAR1 and Cell Apoptosis via NF-kB Signaling Pathway

PURPOSE/OBJECTIVE(S)

RNA editing is a common posttranslational mechanism for generating genomic diversity by modifying selected RNA sequences without altering the genome. A new understanding of cancer therapy can be enhanced by the discovery of ADAR1 in the control of signal transduction pathways. However, the study of the biological effects of ADAR1 in radioresistance of esophageal cancer is not very deep.

MATERIALS/METHODS

The TCGA data sets were used to explore the correlations between ADAR1 and prognosis in esophageal cancer. Two pairs of ADAR1 gene siRNA fragments (siADAR1-1 and siADAR1-2) were designed and transiently transfected into KYSE410 cells and KYSE410-RT cells. The expression of ADAR1 was detected by RT-PCR and WB. Colony formation assay was used to evaluate the radiosensitivity. Apoptosis was measured using a flow cytometric apoptosis assay. Furthermore, transcriptome sequencing was performed to elucidate the pathways regulated by ADAR1.

RESULTS

In this study, we found that ADAR1 is overexpressed in esophageal tumors and is associated with poor prognosis in bioinformatics analysis. Colony formation experiment showed that siRNA-mediated depletion of ADAR1 in KYSE410 cells could inhibit cell proliferation and reduce radiosensitivity significantly. Consistently results were showed in KYSE410-RT cells. Mechanism studies revealed loss of ADAR1 induced cell apoptosis and radiotherapy could enhance this process. Transcriptomic data indicated that ADAR1 could regulate apoptosis through the NF-kB pathway.

CONCLUSION

RNA editing was found to be involved in the regulation of radiosensitivity of esophageal cancer and loss of ADAR1 can cause cell apoptosis though NF-kB pathway. A better understanding of A-to-I RNA editing and its oncogenic mechanisms may facilitate the development of radiotherapy in esophageal cancer.

Highly Efficient Solar-Driven Dry Reforming of Methane on a Rh/LaNiO3 Catalyst through a Light-induced Metal-To-Metal Charge Transfer Process

As an energy-saving and green method, solar-driven dry reforming of methane (DRM) is expected to introduce new activation processes and prevent sintering and coking of the catalysts. However, it still lacks an efficient way to coordinate the regulation of activation of reactants and lattice oxygen migration. In this study, Rh/LaNiO3 is designed as a highly efficient photothermal catalyst for solar-driven DRM, which performs production rates of 452.3 mmol h-1  gRh -1 for H2 and 527.6 mmol h-1  gRh -1 for CO2 under a light intensity of 1.5 W cm-2 , with an excellent stability. Moreover, a remarkable light-to-chemical energy efficiency (LTCEE) of 10.72% is achieved under a light intensity of 3.5 W cm-2 . The characterizations of surface electronic and chemical properties and theoretical analysis demonstrate that strong adsorption for CH4 and CO2 , light-induced metal-to-metal charge transfer (MMCT) process and high oxygen mobility together bring Rh/LaNiO3 excellent performance for solar-driven DRM.

Energetic Electron Precipitation Driven by Electromagnetic Ion Cyclotron Waves from ELFIN's Low Altitude Perspective

We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or Δ L ∼ 0.56 ) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L ∼ 5 - 7 at dusk, while a smaller subset exists at L ∼ 8 - 12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L -shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼ 1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.

Collaborative Learning and Style-Adaptive Pooling Network for Perceptual Evaluation of Arbitrary Style Transfer

Although the research of arbitrary style transfer (AST) has achieved great progress in recent years, few studies pay special attention to the perceptual evaluation of AST images that are usually influenced by complicated factors, such as structure-preserving, style similarity, and overall vision (OV). Existing methods rely on elaborately designed hand-crafted features to obtain quality factors and apply a rough pooling strategy to evaluate the final quality. However, the importance weights between the factors and the final quality will lead to unsatisfactory performances by simple quality pooling. In this article, we propose a learnable network, named collaborative learning and style-adaptive pooling network (CLSAP-Net) to better address this issue. The CLSAP-Net contains three parts, i.e., content preservation estimation network (CPE-Net), style resemblance estimation network (SRE-Net), and OV target network (OVT-Net). Specifically, CPE-Net and SRE-Net use the self-attention mechanism and a joint regression strategy to generate reliable quality factors for fusion and weighting vectors for manipulating the importance weights. Then, grounded on the observation that style type can influence human judgment of the importance of different factors, our OVT-Net utilizes a novel style-adaptive pooling strategy guiding the importance weights of factors to collaboratively learn the final quality based on the trained CPE-Net and SRE-Net parameters. In our model, the quality pooling process can be conducted in a self-adaptive manner because the weights are generated after understanding the style type. The effectiveness and robustness of the proposed CLSAP-Net are well validated by extensive experiments on the existing AST image quality assessment (IQA) databases. Our code will be released at https://github.com/Hangwei-Chen/CLSAP-Net.

[Advances in clinical characteristics of talaromycosis combined with other opportunistic infections]

Talaromycosis (TSM) is an opportunistic deep mycosis prevalent in southeast Asia and southern China, affecting HIV-positive, anti-interferon-gamma autoantibody-positive and other immunodeficiency hosts. These hosts are often co-infected with mycobacterium tuberculosis, non-tuberculosis mycobacteria, bacteria, fungi, viruses and other opportunistic infections. The clinical characteristics and the pathogenic spectrum of TSM with opportunistic infections vary with different immune states. The rates of misdiagnosis, missed diagnosis and mortality are high. This review summarized the clinical characteristics of TSM with opportunistic infections in order to improve the level of clinical diagnosis and treatment.

[Persistence follow-up of immune memory to hepatitis B vaccine among infants with non- and low-response to primary vaccination after revaccination with three doses]

This study followed up the immune memory after 3-dose revaccination among infants with non-and low-response following primary hepatitis B (HepB) vaccination. About 120 children without self-booster doses were finally included who had anti-HBs<10 mIU/ml (anti-HBs negative) at the time of follow-up, of whom 86 children completed blood sampling and anti-HBs testing. Before the challenge dose, all 86 children were negative for anti-HBs, and the GMC of anti-HBs was<10 mIU/ml. The seropositive conversion rate of anti-HBs was 100% and the GMC of anti-HBs was 886.11 (95%CI: 678.15-1 157.84) mIU/ml after the challenge dose. Compared with those with GMC<7 mIU/ml before the challenge dose, infants with GMC>7 mIU/ml had a higher anti-HBs level after the challenge dose. The β value (95%CI) was 0.82 (0.18-1.46) (P=0.012). Compared with those with GMC<1 000 mIU/ml at primary vaccination, infants with GMC≥1 000 mIU/ml had a higher anti-HBs level after the challenge dose. The β value (95%CI) was 0.78 (0.18-1.38)(P=0.012). The results showed a stronger immune memory was found at 9 years after revaccination among infants with non-and low-response to HepB.

Ti3C2 MXene supporting platinum nanoparticles as rapid electrons transfer channel and active sites for boosted photocatalytic water splitting over g-C3N4

Two-dimension (2D) MXene materials have increasingly attracted attentions in improving the photocatalytic conversion of solar-to-chemical energy over graphitic carbon nitride (g-C₃N₄). In this work, Pt nanoparticles modified few-layer Ti₃C₂ MXene sheet (MXene@Pt) was successfully prepared by chemical reduction, which was used as efficient co-catalysts to enhance the photocatalytic hydrogen evolution over porous g-C₃N₄ (PCN). The high work function of MXene@Pt and the tight 2D/2D interfacial contact between MXene@Pt and PCN significantly promoted the transfer and separation of photogenerated electron-hole. Besides, the MXene@Pt could enhance the light-harvesting of PCN and provide plentiful active sites for hydrogen evolution reaction. The hydrogen evolution activity of optimum 2D/2D MXene@Pt modified PCN (PCN/MPt-5) composite was dramatically enhanced, even higher than that of equal Pt mass modified PCN. Besides, overall water splitting was realized via a two-electron pathway with H₂O₂ and H₂ generation. This work may provide the fabrication strategy for developing MXene-based co-catalyst in photocatalysis.

Bismuth-based semiconductors applied in photocatalytic reduction processes: fundamentals, advances and future perspectives

Bismuth-based semiconductors (BBSs) with their typical layered structures and unique electronic properties are considered an attractive visible light-responsive photocatalysts. Recently, BBS exhibited promising properties and was rapidly developed in photoreduction reactions. In this review, we firstly focus on the photoreduction reactions of BBS with a description of the basic principles. Specifically, the restrictive factors of the photoreduction reactions and the design directions of the catalysts are addressed. BBS photocatalysts, such as bismuth oxide, bismuth halide oxide and bismuth-based oxygenates, are presented in terms of the catalyst material design, crystal structure and other features. Furthermore, the primary applications of BBS in photoreduction reactions are described, including CO₂ reduction, N₂ reduction, H₂ evolution, and nitrate reduction. Additionally, the advances and shortages of BBS applied in these processes are summarized and comprehensively discussed. Future works for BBS applied in photoreduction processes are also proposed.

Experimental analysis of a slant perforated mesh-plate photoreactor for water detoxification

A novel slant perforated mesh-plate photoreactor (SPPR) was designed and fabricated. The central assembly of SPPR was an array of slant perforated mesh-plate coated with TiO₂ (P25). The performance of SPPR in water detoxification was evaluated with regard to the degradation of phenol as the target pollutant. The effects of slant plate tilt angle (α) and perforated plate opening aperture diameter on SPPR performance were investigated and analyzed. The photocatalytic performance of SPPR increased with decreasing α. The SPPR with an α of 15° and a pore size of 1 mm showed the best performance with 9.17 h required to reach 80% of phenol degradation (4-L, initial concentration: 15 mg/L). The mass transfer was introduced into the kinetic reaction model, and mass transfer coefficients were calculated for SPPRs with different structures. Flow rate and initial pollutant concentration were investigated for their effects on degradation efficiency. In addition, the activity of SPPR under natural sunlight has also been tested to explore its potential to be applied in practice.

Detection of marine oil spills from radar satellite images for the coastal ecological risk assessment

Coastal ecosystems offer substantial support and space for the sustainable development of human society, and hence the ecological risk evaluation of coastal ecosystems is of great significance. In this article, we propose an innovative framework for evaluating coastal ecological risk by considering oil spill risk information and environmental vulnerability information. Specifically, a deep learning based marine oil spill monitoring method is presented to obtain the oil spill risk information from Sentinel-1 polarimetric synthetic aperture radar (PolSAR) images. The environmental vulnerability information is then obtained from biological sample data and habitat information. Finally, a weighted probability model is introduced to utilize the oil spill risk and environmental vulnerability information, to evaluate the coastal ecological risk. In the experimental part, the proposed oil spill monitoring method shows its reliability in global ocean areas, and the proposed model is adopted to evaluate the ecological risk in Jiaozhou Bay, China. The results show that the ecological situation of more than half of the areas in Jiaozhou Bay is unstable, and the areas with high risk are mainly concentrated in the ports, shipping channels, and those areas with high biodiversity. This study provides some new perspectives on ecological risk assessment for coastal ecosystems, facilitating the planning process and the actions to be taken in response to the accidents that occur in the ocean, especially oil spill accidents.

Recent review of BixMOy (M=V, Mo, W) for photocatalytic CO2 reduction into solar fuels

The utilization of solar energy for CO₂ conversion not only enables a green and low-carbon recycling of CO₂ with renewable energy, but also solves ecological problems. Bi_xMO_y (M = V, Mo, W) materials have typical layered structures and unique electronic properties that provide suitable band gaps and potential to meet the basic conditions for CO₂ reduction. However, pristine Bi_xMO_y faces with problems such as small specific surface area, insufficient active sites, low charge carriers' separation and utilization efficiency. This review comprehensively described the basic principles and reaction pathways of photocatalytic CO₂ reduction, and further presented the research progress of Bi_xMO_y catalysts in CO₂ conversion reactions. In this perspective, we further focus on the design concepts and modification strategies to improve the photocatalytic CO₂ reduction activity of Bi_xMO_y, such as morphology control, constructing surface vacancies and heterojunction fabrication. Finally, based on representative researches, the present review will be expected to provide updated information and insights for developing advanced Bi_xMO_y materials to further improve CO₂ reduction activity and selectivity.

To what extent do social support and mastery mediate the association between childhood maltreatment and depression? A sequential causal mediation analysis

AIMS

This study aimed to examine the independent roles of various childhood maltreatment (CM) subtypes in the development of depression; quantify the joint mediation effect of social support and mastery in the association between subtypes of CM and depression and examine the additional contribution of mastery beyond the effect that is operating through social support to this relationship.

METHODS

Data analysed were from the Zone d'Épidémiologie Psychiatrique du Sud-Ouest de Montréal, an ongoing longitudinal population-based study. In total, 1351 participants with complete information on the studied variables were included. The propensity score matching and inverse-probability weighted regression adjustment estimation methods were used to minimise the potential confounding in the relationship between CM and major depression. We then used inverse odds ratio-weighted estimation to estimate the direct effects of maltreatment and indirect effects of social support and mastery.

RESULTS

We found that exposures to all maltreatment subtypes increased the risk of subsequent depression. The joint mediating effect of social support and mastery explained 37.63-46.97% of the association between different maltreatment subtypes and depression. The contribution of these two mediators differed by maltreatment subtypes, with social support being the major contributor to the mediating effect.

CONCLUSIONS

The findings of the study not only provide scientific evidence on the importance of psychosocial attributes in the development of major depression but also suggest that prevention and invention strategies should focus on these psychosocial attributes to effectively break the vicious cycle of CM on major depression.

Surgical treatment of secondary hyperparathyroidism combined with Sagliker syndrome caused by chronic renal failure: a case report

Background

Case Description

Conclusions

3D printing polylactic acid polymer-bioactive glass loaded with bone cement for bone defect in weight-bearing area

The treatment of bone defects in weight-bearing areas is mainly to transplant filling materials into the defect area, to provide immediate and strong support for weight-bearing. At present, the commonly used filling material is bone cement, which can only provide physical support without bone regeneration effect. The long-term stress at the interface may cause the loosening of bone cement. The ideal filling material should provide not only strong mechanical support but also promote bone regeneration. We introduce a 3D printing frame-filling structure in this study. The structure was printed with polylactic acid/bioactive glass as the frame, and bone cement as the filler. In this system, bone cement was used to provide immediate fixation, and the frame provided long-term fixation by promoting osteogenic induction and conduction between the interface. The results showed that the degradation of bioactive glass in the frame promoted osteogenic metabolism, induced M2 polarization of macrophages, and inhibited local inflammatory response. The in vivo study revealed that implantation of the frame-filling structure significantly promoted bone regeneration in the femoral bone defect area of New Zealand white rabbits. For a bone defect in a weight-bearing area, long-term stability could be obtained by bone integration through this frame-filling structure.

Photocatalytic Reduction of CO2 on a Bi2MoxW1-xO6 Solid Solution with Enhanced Activity

This paper reports on a Bi₂Mo_xW_1-xO₆ solid solution with excellent photocatalytic activity in CO₂ reduction. Under simulated sunlight, the Bi₂Mo_0.25W_0.75O₆ solid solution achieved a CO generation yield of ≤298.2 μmol g^-1 over 3 h, which was 2.1 and 1.5 times larger than those of pristine Bi₂WO₆ and Bi₂MoO₆, respectively. Via an in-depth study of the mechanism, this excellent photocatalytic activity was determinied to be probably due to two major contributions: (1) the formation of oxygen vacancies on the Bi₂Mo_0.25W_0.75O₆ solid solution, which provided more reactive sites for adsorption and activation of CO₂, and (2) modulation of the electronic band structure, which facilitated charge separation. Mechanistic and reaction pathways have been deeply explored and proposed.

[Anti-HBs persistence after primary vaccination with three doses of 5 μg recombinant hepatitis B vaccine among normal and high-responder infants: 10-year of follow-up]

Objective: Assess the 10-year Immune persistence and the predictors after primary vaccination hepatitis B vaccine (HepB) among normal and high-responder infants. Methods: A total of 1 838 Infants of 7-12 months old located in Jinan, Weifang, Yantai and Weihai of Shandong Province who were induced normal or high antibody response (anti-HBs titer ≥ 100 mIU/ml) after primary vaccination (three dose with 0-1-6 procedure) with 5 μg recombinant HepB among newborns were included in the study, in 2009. 3 ml of venous blood samples were collected at baseline survey (T₀) and antibodies against hepatitis B surface antigen (anti-HBs), antibody against hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were detected using chemiluminescence microparticle immunoassay (CMIA) method. A self-designed questionnaire was used to collect information including the infant's age, sex, birth weight, premature birth, birth number, delivery location and mother's HBV infection status. In 2014 (followed up for 5 years) and in 2019 (followed up for 10 years) (T₁), 2 ml of venous blood samples were collected. Anti HBS and anti HBC were detected by CMIA method. Those with anti HBS<10 mIU/ml were detected by CMIA method. Multivariate unconditional logistic and linear regression models were used to analyze the influencing factors of anti-HBs positive rate and geometric mean concentration (GMC) at T₁. Results: After 10 years follow-up, 73.94% of the subjects (1 359/1 835) finished the follow-up. 51.15% of the subjects, a total of 625 were boys. The positive rate of anti-HBs was 100% at T₀ and decreased to 53.44% (95%CI: 50.59%-56.26%) at T₁. The average annual decline rate of anti-HBs positive rate from T₀ to T₁ was 6.07%. The GMC of anti-HBs decreased from 607.89 (95%CI: 579.01-642.62) mIU/ml to 16.44 (95%CI: 15.06-18.00) mIU/ml. The average annual decline rate of anti-HBs GMC in 10-year follow-up was 30.30%. Multivariate logistic analysis showed that the positive rate of anti-HBs at T₁ was lower in those who did not vaccinate the first dose in time (OR=0.25, 95%CI:0.07-0.71). Compared with those with GMC<1 000 mIU/ml at T₀, those with GMC ≥ 1 000 mIU/ml had a higher positive rate of anti-HBs at T₁ (OR=2.29, 95%CI:1.76-2.97). Multivariate regression analysis showed that the GMC of anti-HBs at T₁ was lower in those who did not vaccinate the first dose in time (β=-0.50, 95%CI:-1.24-0.24). Compared with those with GMC<1 000 mIU/ml at T₀, those with GMC ≥ 1 000 mIU/ml had a higher GMC of anti-HBs at T₁ (β=0.81, 95%CI: 0.62-1.05). Conclusion: Anti-HBs GMC decreased in 10 years after primary vaccination of 5 μg recombinant hepatitis B vaccine among normal and high-responders. The anti-HBs persistence was mainly associated with whether the first dose was vaccinated in time and the level of anti-HBs at the end of primary vaccination.

The efficacy and safety of different doses of calcitriol combined with neutral phosphate in X-linked hypophosphatemia: a prospective study

The present study was the first prospective cohort evaluated the efficacy and safety of different doses of calcitriol in XLH children. The results suggested that a dose of 40 ng/kg/day calcitriol, compared with 20 ng/kg/day, was more effective in relieving the rickets, with similar safety outcomes. Further investigations were expected to set more dose groups.

INTRODUCTION

Dose recommended for calcitriol in X-linked hypophosphatemia (XLH) varies in different studies. Therefore, we aimed to compare the efficacy as well as the safety of 20 ng/kg/d and 40 ng/kg/d calcitriol in Chinese XLH pediatrics population.

METHODS

A 2-year, randomized, open-label, prospective study recruited 68 XLH children, which were randomized to receive either 40 ng/kg/day or 20 ng/kg/day calcitriol. Efficacy endpoints were the total Thacher ricket severity score (RSS) change from baseline to month 12 and 24, the difference in serum TALP level, fasting serum phosphate level, body height Z-score, and frequency of dental abscess. Safety assessments were done using renal ultrasound nephrocalcinosis grades (0-4), fasting serum and 24 h urine calcium level, and the occurrence of hyperparathyroidism.

RESULTS

The decrease in the total RSS from baseline was more significant in the high-dose group at 12 (difference 0.87, p = 0.049) and 24 month (difference 1.23, p = 0.011). The serum TALP level was significantly lower in the high-dose group at 6 months. Pi level, height Z-score change, frequency of dental abscess and ratio of de novo nephrocalcinosis were comparable. A lower incidence of secondary hyperparathyroidism was seen in the high-dose group (p < 0.0001).

CONCLUSION

For the first time in this prospective cohort, 40 ng/kg/d calcitriol was shown to be the more effective therapy in XLH children than the 20 ng/kg/d. Moreover, 40 ng/kg/d calcitriol was not associated with increasing adverse events.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT 03,820,518.

POS1016 RELATIONSHIPS BETWEEN DISEASE DURATION AND RADIOGRAPHIC PROGRESSION AMONG PATIENTS WITH PSORIATIC ARTHRITIS TREATED WITH SECUKINUMAB IN FUTURE 5

Background

For patients with psoriatic arthritis (PsA), delays in diagnosis and treatment can lead to permanent radiographic damage, even early in the course of disease.1 In the phase 3 FUTURE 5 study (NCT02404350), treatment with secukinumab (SEC) was shown to inhibit progression of structural damage through Week 104 in patients with PsA.2 However, the effect of disease duration on inhibition of radiographic progression by SEC has not been characterized.

Objectives

This post hoc analysis explored relationships between time since diagnosis (TSD) of ≤1 year vs >1 year and radiographic progression among patients with PsA receiving SEC over 2 years in FUTURE 5.

Methods

Patient data from FUTURE 5 were stratified by TSD ≤1 year vs >1 year and analyzed by treatment arm. Through Week 24, patients received SEC 300 or 150 mg with subcutaneous loading dose (LD), SEC 150 mg without LD, or placebo (PBO) (period 1). After Week 24, patients receiving PBO were switched to SEC 300 or 150 mg (period 2), and a protocol amendment allowed those with suboptimal clinical response to SEC 150 mg to escalate to SEC 300 mg after Week 52 per investigator judgment.2 The proportion of patients with no radiographic progression, defined as change from baseline in van der Heijde total modified Sharp score ≤0.0, was analyzed at Weeks 24, 52, and 104. Mean total Sharp score was evaluated at baseline, and mean change from baseline was determined at Weeks 24, 52, and 104.

Results

Of 996 patients with PsA included here, 217 (21.8%) had a TSD ≤1 year and 779 (78.2%) had a TSD >1 year. At baseline, patients with TSD >1 year had greater radiographic damage than patients with TSD ≤1 year as determined by mean total Sharp score (Table 1). As early as Week 24, patients receiving SEC had less radiographic progression than those receiving PBO, regardless of TSD. From Week 24 to Week 104, radiographic progression remained low among all patients receiving SEC, with a trend of least progression among patients randomized to SEC 300 mg at baseline. Regardless of treatment, patients with TSD >1 year had numerically greater radiographic progression than those patients with TSD ≤1 year. Overall, the proportion of patients receiving SEC who did not have any radiographic progression was higher than that of placebo at Week 24 irrespective of TSD, with a trend towards a higher number of non-progressors among those treated with SEC 300 mg (Figure). Patients randomized to SEC 300 mg were the least likely to experience radiographic progression through 52 weeks.

Table 1.

Baseline Total Sharp Score and Change From Baseline at Weeks 24, 52, and 104 by TSD

Total Sharp scoreTSD ≤1 yearTSD >1 yearPeriod 1SEC 300 mg n = 54SEC 150 mg n = 46SEC 150 mg NL n = 43PBO n = 74SEC 300 mg n = 168SEC 150 mg n = 174SEC 150 mg NL n = 179PBO n = 258Baseline, mean (SD)8.02 (20.77)8.82 (12.06)12.74 (33.67)8.84 (20.42)14.37 (24.17)14.67 (28.01)15.56 (37.52)17.34 (41.21)Week 24 change from baseline, mean (SD)0.05 (0.72)−0.08 (1.40)−0.61 (5.25)0.76 (2.05)0.09 (1.37)0.23 (1.24)0.03 (2.05)0.42 (1.56)Period 2SEC 300 mg* n = 54SEC 150 mg†n = 46SEC 150 mg NL†n = 43PBO ‒ 300 mg n = 40PBO ‒ 150 mg†n = 30SEC 300 mg* n = 168SEC 150 mg†n = 174SEC 150 mg NL†n = 179PBO ‒ 300 mg n = 113PBO ‒ 150 mg†n = 123Week 52 change from baseline, mean (SD)0.05 (0.48)−0.03 (1.22)0.35 (2.25)0.22 (0.70)0.18 (0.75)−0.07 (1.16)0.26 (1.96)0.26 (1.05)0.16 (0.94)0.40 (2.00)Week 104 change from baseline, mean (SD)0.06 (0.63)0.11 (0.99)0.20 (2.71)0.11 (0.68)−0.07 (0.50)0.11 (2.00)0.62 (2.94)0.46 (2.08)0.12 (0.90)0.81 (2.66)

NL, no loading dose; PBO, placebo; SEC, secukinumab; TSD, time since diagnosis.

* One outlier in the 300-mg dose group was excluded.

† Includes patients who received dose escalation to SEC 300 mg after Week 52.

Conclusion

SEC resulted in low rates of radiographic progression through 2 years of treatment among patients in FUTURE 5, regardless of time since PsA diagnosis.

References

[1]Haroon M, et al. Ann Rheum Dis. 2015;74:1045-50.

[2]Mease P, et al. RMD Open. 2021;7:e001600.

Acknowledgements

This study was funded by Novartis Pharmaceuticals Corporation. Medical writing support was provided by Richard Karpowicz, PhD, CMPP, of Health Interactions, Inc, and was funded by Novartis Pharmaceuticals Corporation. This abstract was developed in accordance with Good Publication Practice (GPP3) guidelines. Authors had full control of the content and made the final decision on all aspects of this publication.

Disclosure of Interests

Christopher T. Ritchlin Consultant of: AbbVie, Amgen, Eli Lilly, Janssen, Pfizer, Novartis, Gilead, and UCB, Ana-Maria Orbai Consultant of: Bristol Myers Squibb, Janssen, Lilly, Novartis, Pfizer, and UCB, Grant/research support from: to Johns Hopkins University from AbbVie, Amgen, Celgene, Horizon, Janssen, Lilly, and Novartis, Bhumik Parikh Employee of: Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Corine Gaillez Employee of: Novartis Pharma AG, Basel, Switzerland, Xiangyi Meng Employee of: Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Philip J Mease Speakers bureau: AbbVie, Amgen, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Galapagos, Gilead, GlaxoSmithKline, Janssen, Eli Lilly, Novartis, Pfizer, Sun Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, Sun Pharma, and UCB

OP0076 L-ARGININE REPROGRAMS OSTEOCLAST PURINE METABOLISM AMELIORATING BONE LOSS IN RHEUMATOID ARTHRITIS

Background

Bone erosion is a clinical feature of rheumatoid arthritis related to disease severity and poor functional prognosis. Excessive osteoclast differentiation and insufficient osteoblast function are the main reasons for the erosive process in RA. Our previous investigation indicated that L-arginine supplementation not only diminished arthritic inflammation in the serum-induced arthritis (K/BxN) model but also decreased inflammatory joints osteoclast numbers (1).

Objectives

In the present study, we aim to investigate the metabolic action of L-arginine supplementation in RA, especially on periarticular bone erosion and systemic bone loss. We plan to depict the metabolic features of TNFα induced inflammatory osteoclasts after in vitro L-arginine supplementation.

Methods

Three murine arthritis models (serum-induced arthritis (K/BxN) model, collagen-induced arthritis model, and hTNFtg mice model) were analysed in this study. L-arginine was supplemented within the drinking water after the onset of arthritis. Bone parameters for axial skeleton (spine) and peripheral skeleton (tibia) from the respective group were quantified by μCT. HE and TRAP staining were performed to address further the erosion area and osteoclast numbers in periarticular sites. In vitro osteoclast differentiation was conducted with or without L-arginine treatment, in the presence or not of TNFα activation. Seahorse and SCENITH analyses were adopted to delineate the metabolic features. JC-1 staining and transmission electron microscopy (TEM) were used to depict the mitochondria metabolism. RNA-seq and mass spectrometry (MS) were performed to investigate the underlying molecular mechanism.

Results

Inflammation was diminished in all three arthritis models after L-arginine supplementation with a significant reduction in arthritic score. Moreover, an amelioration of periarticular bone erosion, systemic bone loss, and decreased osteoclast numbers in periarticular sites were observed in arthritic mice after L-arginine treatment. L-arginine also inhibited osteoclastogenesis in vitro, particularly under TNFα activation. Seahorse and SCENITH analyses indicated TNFα promoted glycolysis while blocking mitochondria-driven oxidative phosphorylations (OXPHOS) in pre-osteoclasts. Meanwhile, JC-1 staining and TEM images also showed that TNFα decreased mitochondria membrane potential and prompted damage of mitochondria. Surprisingly, L-arginine rescued the TNFα inhibition of OXPHOS while promoting ATP production.

RNA-seq and MS data confirmed the boost of OXPHOS after L-arginine treatment under TNFα activation. To interfere with OXPHOS, L-arginine inhibited cJun thus altered arginase-1 and arginase-2 expression. Moreover, the increased ATP in L-arginine treated cells facilitated purine metabolism, especially the production of inosine and hypoxanthine, contributing to the inhibition of osteoclastogenesis. Increasing Adenosine deaminase (ADA) is essential for the production of inosine and hypoxanthine due to the decreased inhibitory regulation of the transcription factor c-Jun.

Conclusion

These data strongly demonstrated that L-arginine ameliorates bone erosion in RA through metabolic reprogramming and perturbation of purine metabolism in osteoclasts. L-arginine might therefore benefit RA therapy by reducing joint inflammation and also ameliorating bone destruction.

References

[1]Hannemann, Nicole, et al. “Transcription factor Fra-1 targets arginase-1 to enhance macrophage-mediated inflammation in arthritis.” The Journal of clinical investigation 129.7 (2019): 2669-2684.

Disclosure of Interests

Shan Cao: None declared, Rui Song: None declared, Xianyi Meng: None declared, Katerina Kachler: None declared, Maximilian Fuchs: None declared, Xinyu Meng: None declared, Yixuan Li: None declared, Verena Taudte: None declared, Meik Kunz: None declared, Ursula Schloetzer-Schrehardt: None declared, Ulrike Schleicher: None declared, Xiaoxiang Chen Speakers bureau: AbbVie, Roche and Novartis, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB, Aline Bozec: None declared.

POS0409 INTESTINAL HIF1α EXPRESSION PROTECTS AGAINST EPITHELIAL CELL DEATH IN ARTHRITIS

Background

While a so-called gut-joint axis is supported by many clinical observations, the current knowledge on such axis is mostly confined to descriptive and correlative data, e.g. showing the microbiota changes are associated with arthritis. In contrast, mechanistic data on how molecular changes in the intestinal epithelium influence the development of arthritis are scarce.

Objectives

To investigate, whether the mucosal barrier in the intestine dependent of the epithelial cell survival maintenance, influences the development of arthritis.

Methods

Intestinal hypoxia inducible factor (HIF)-1α expression was assessed before, at onset and during experimental arthritis and human rheumatoid arthritis (RA). Intestinal epithelial cell-specific HIF1α conditional knock-out mice were generated (HIF1αΔIEC) and subjected to collagen-induced arthritis (CIA). Clinical and histological courses of arthritis were recorded, and T and B cell subsets were analyzed in the gut and secondary lymphatic organs, and intestinal epithelial cells were subjected to molecular mRNA sequencing in HIF1αΔIEC and littermate control mice. Furthermore, pharmacologic HIF1α stabilization by PHD inhibitor was used for the treatment of arthritis.

Results

Intestinal HIF1α expression peaked at onset and remained high in experimental arthritis and RA. Conditionally deletion of HIF1α in gut epithelial cells strongly exacerbate arthritis and was associated with increased gut epithelial cell death, intestinal and lymphatic Th1 and Th17 activation. Mechanistically, HIF1α inhibits the transcription of necroptotic and apoptotic markers, which leads to a defect in the intestinal barrier integrity. Furthermore, treatment with HIF1α stabilization reinforced the gut epithelial cell survival and inhibited arthritis.

Conclusion

These findings show that the HIF1α regulating epithelial cells survival is critical for the breakdown of the intestinal barrier function in arthritis highlighting the functional link between intestinal homeostasis and arthritis.

Disclosure of Interests

None declared.

POS1022 RELATIONSHIPS BETWEEN INHIBITION OF RADIOGRAPHIC PROGRESSION AND ACHIEVEMENT OF LOW DISEASE ACTIVITY OR REMISSION AND THEIR CORE COMPONENTS IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED WITH SECUKINUMAB IN FUTURE 5 DURING THE FIRST 24 WEEKS

Background

Patients with active psoriatic arthritis (PsA) experience inflammation that may result in structural damage and disability. In the phase 3 FUTURE 5 study, treatment with secukinumab (SEC) inhibited radiographic progression and led to sustained remission and low disease activity (LDA) through Week 104.1,2

Objectives

This post hoc analysis of FUTURE 5 explored relationships between radiographic progression status and achievement of LDA or remission in patients treated with SEC.

Methods

Patients were randomized 2:2:2:3 to receive SEC 300 mg with loading dose (LD), 150 mg LD, SEC 150 mg without LD, or placebo (PBO) at Baseline, Weeks 1, 2, 3, 4, and every 4 weeks thereafter until Week 24. In this post hoc analysis, patients were grouped by radiographic progression status at Week 24 (non-radiographic progressors: change from baseline in modified total Sharp score [mTSS] ≤0.0; radiographic progressors: change from baseline in mTSS >0.0). Efficacy (achievement of Minimal Disease Activity [MDA] or Very Low Disease Activity [VLDA] and their individual components, and Disease Activity Index for Psoriatic Arthritis [DAPSA] LDA or remission) was assessed at Week 24.

Results

Of 933 patients with available data, 675 (72.3%) were classified as non-radiographic progressors and 258 (27.7%) were radiographic progressors at Week 24. Non-progressors at Week 24 were more likely than progressors to achieve DAPSA LDA and remission at Week 24 across all treatment arms (Figure 1A). In addition, non-progressors were more likely to achieve MDA and VLDA at Week 24 than progressors across all treatment arms (Figure 1B). Similar trends were observed for all of the individual MDA/VLDA criteria at Week 24 among patients treated with SEC 300 mg or SEC 150 mg LD (Table 1). Notably, non-progressors were more likely to achieve improvements in physical function, pain, and patient global assessment of disease activity than progressors across all treatment arms.

Table 1.

Proportion of Patients Achieving MDA/VLDA Components at Week 24 Grouped by Radiographic Progression Status at Week 24

Week 24 non-progressorsWeek 24 progressorsOutcome, n/N (%)SEC 300 mg n = 166SEC 150 mg n = 150SEC 150 mg NL n = 159PBO n = 200SEC 300 mg n = 51SEC 150 mg n = 63SEC 150 mg NL n = 51PBO n = 93TJC78 ≤152/161 (32.3)46/146 (31.5)37/150 (24.7)38/196 (19.4)15/50 (30.0)13/62 (21.0)13/49 (26.5)11/90 (12.2)SJC76 ≤1105/160 (65.6)85/146 (58.2)83/150 (55.3)88/196 (44.9)32/50 (64.0)28/62 (45.2)20/49 (40.8)30/90 (33.3)PASI ≤1 or BSA ≤3%99/128 (77.3)90/128 (70.3)69/109 (63.3)64/153 (41.8)29/38 (76.3)27/47 (57.4)28/40 (70.0)26/70 (37.1)Patient pain VAS ≤1557/144 (39.6)50/133 (37.6)50/141 (35.5)33/179 (18.4)14/42 (33.3)15/60 (25.0)13/43 (30.2)7/82 (8.5)PtGA VAS ≤2063/145 (43.4)47/125 (37.6)50/135 (37.0)39/173 (22.5)13/41 (31.7)14/61 (23.0)13/41 (31.7)7/81 (8.6)HAQ-DI ≤0.572/135 (53.3)55/118 (46.6)54/122 (44.3)47/158 (29.7)13/39 (33.3)18/58 (31.0)17/39 (43.6)19/77 (24.7)Tender entheseal points ≤170/87 (80.5)44/63 (69.8)42/76 (55.3)45/88 (51.1)13/18 (72.2)17/31 (54.8)11/19 (57.9)23/38 (60.5)

BSA, body surface area; HAQ-DI, Health Assessment Questionnaire Disability Index; MDA, Minimal Disease Activity; NL, no loading dose; PASI, Psoriasis Area and Severity Index; PBO, placebo; PtGA, patient global assessment of disease activity; SEC, secukinumab; SJC, swollen joint count; TJC, tender joint count; VAS, visual analog scale; VLDA, Very Low Disease Activity.

Conclusion

Patients who did not have radiographic progression over 6 months of SEC treatment were more likely to achieve LDA or remission and improvement in physical function at Week 24. Additional analyses will explore relationships between radiographic progression and additional clinical and patient-reported outcomes over longer time periods.

References

[1]Mease P, et al. RMD Open. 2021;7:e001600.

[2]Coates LC, et al. Ann Rheum Dis. 2021;80:803-4.

Acknowledgements

This study was funded by Novartis Pharmaceuticals Corporation. Medical writing support was provided by Eric Deutsch, PhD, CMPP, of Health Interactions, Inc, and was funded by Novartis Pharmaceuticals Corporation. This abstract was developed in accordance with Good Publication Practice (GPP3) guidelines. Authors had full control of the content and made the final decision on all aspects of this publication.

Disclosure of Interests

Philip J Mease Speakers bureau: AbbVie, Amgen, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Galapagos, Gilead, GlaxoSmithKline, Janssen, Eli Lilly, Novartis, Pfizer, Sun Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, Sun Pharma, and UCB, Ana-Maria Orbai Consultant of: Bristol Myers Squibb, Janssen, Lilly, Novartis, Pfizer, and UCB, Grant/research support from: To Johns Hopkins University from AbbVie, Amgen, Celgene, Horizon, Janssen, Lilly, and Novartis, Bhumik Parikh Employee of: Novartis Pharmaceuticals Corporation, Corine Gaillez Employee of: Novartis Pharma AG, Xiangyi Meng Employee of: Novartis Pharmaceuticals Corporation, Christopher T. Ritchlin Consultant of: AbbVie, Amgen, Eli Lilly, Janssen, Pfizer, Novartis, Gilead, and UCB

ZnO nanoparticles attenuate polymer-wear-particle induced inflammatory osteolysis by regulating the MEK-ERK-COX-2 axis

Background/Objectives

Advanced thermoplastic materials, such as polyether-ether-ketone (PEEK) and highly cross-linked polyethylene (HXLPE), have been increasingly used as orthopaedic implant materials. Similar to other implants, PEEK-on-HXLPE prostheses produce debris from polymer wear that may activate the immune response, which can cause osteolysis, and ultimately implant failure. In this study, we examined whether the anti-inflammatory properties of zinc oxide nanoparticles (ZnO NPs) could attenuate polymer wear particle-induced inflammation.

Methods

RAW264.7 ​cells were cultured with PEEK or PE particles and gradient concentrations of ZnO NPs. Intracellular mRNA expression and protein levels of pro-inflammatory factors TNF-α, IL-1β, and IL-6 were detected. An air pouch mouse model was constructed to examine the inflammatory response and expression of pro-inflammatory factors in vivo. Furthermore, an osteolysis rat model was used to evaluate the activation of osteoclasts and destruction of bone tissue induced by polymer particles with or without ZnO NPs. Protein expression of the MEK-ERK-COX-2 pathway was also examined by western blotting to elucidate the mechanism underlying particle-induced anti-inflammatory effects.

Results

ZnO NPs (≤50 ​nm, 5 ​μg/mL) showed no obvious cytotoxicity and attenuated PEEK or PE particle-induced inflammation and inflammatory osteolysis by reducing MEK and ERK phosphorylation and decreasing COX-2 expression.

Conclusion

ZnO NPs (≤50 ​nm, 5 ​μg/mL) attenuated polymer wear particle-induced inflammation via regulation of the MEK-ERK-COX-2 axis. Further, ZnO NPs reduced bone tissue damage caused by particle-induced inflammatory osteolysis.

The translational potential of this article

Polymer wear particles can induce inflammation and osteolysis in the body after arthroplasty. ZnO NPs attenuated polymer particle-induced inflammation and inflammatory osteolysis. Topical use of ZnO NPs and blended ZnO NP/polymer composites may provide promising approaches for inhibiting polymer wear particle-induced inflammatory osteolysis, thus expanding the range of polymers used in joint prostheses.

3D printed porous sulfonated polyetheretherketone scaffold for cartilage repair: Potential and limitation

Objective

The treatment of cartilage lesions has always been a difficult problem. Although cartilage tissue engineering provides alternative treatment options for cartilage lesions, biodegradable tissue engineering scaffolds have limitations.

Methods

In this study, we constructed a porous PEEK scaffold via 3D printing, surface-engineered with concentrated sulfuric acid for 15 s (SPK-15), 30 s (SPK-30), and 60 s (SPK-60). We systematically evaluated the physical and chemical characteristics and biofunctionalities of the scaffolds, and then evaluated the macrophage polarization modulating ability and anti-inflammatory effects of the sulfonated PEEK, and observed the cartilage-protective effect of SPK using a co-culture study. We further evaluated the repair effect of PEEK and SPK by implanting the prosthetic scaffold into a cartilage defect in a rabbit model.

Results

Compared to the PEEK, SPK-15 and SPK-60 scaffolds, SPK-30 has a good micro/nanostructure, appropriate biomechanical properties (compressive modulus, 43 ± 5 MPa; Shaw hardness, 20.6 ± 1.3 HD; close to native cartilage, 30 ± 8 MPa, 17.8 ± 0.8 HD), and superior biofunctionalities. Compared to PEEK, sulfonated PEEK can favor macrophage polarization to the M2 phenotype, which increases anti-inflammatory cytokine secretion. Furthermore, SPK can also prevent macrophage-induced cartilage degeneration. The in-vivo animal experiment demonstrates that SPK can favor new tissue ingrowth and integration, prevent peri-scaffold cartilage degeneration and patellar cartilage degeneration, inhibit inflammatory cytokine secretion, and promote cartilage function restoration.

Conclusion

The present study confirmed that the 3D printed porous sulfonated PEEK scaffold could promote cartilage functional repair, and suggests a new promising strategy for treating cartilage defects with a functional prosthesis that spontaneously inhibits nearby cartilage degeneration.

Translational potential of this article

In the present study, we propose a new cartilage repair strategy based on a porous, non-biodegradable polyetheretherketone (PEEK) scaffold, which may bring up a new treatment route for elderly patients with cartilage lesions in the future.

Selective reduction of nitrate into N2 by novel Z-scheme NH2-MIL-101(Fe)/BiVO4 heterojunction with enhanced photocatalytic activity

Nitrate and its metabolites as common pollutants in water had attracted widespread attentions. Converting nitrate to nontoxic and harmless nitrogen via photocatalysis was a promising approach. In this study, a novel Z-scheme NH₂-MIL-101(Fe)/BiVO₄ heterojunction was successfully prepared. As-prepared Z-scheme heterojunction along with built-in electric field facilitated the charge separation and enhanced the photocatalytic activity in nitrate reduction. The results showed that 0.10-MBiVO photocatalyst exhibited the highest nitrate removal rate of 94.8% (initial concentration 100 mgN/L) and final selectivity to N₂ of 93.4% in 50 min under ultraviolet irradiation. Moreover, formic acid was proved as better hole scavenger compared with methanol and oxalic acid. And the concentration of formic acid had significant influence on the process of nitrate photocatalytic reduction. 0.10-MBiVO photocatalyst exhibited excellent reusability in the recycling tests, indicating its great potential in practical application of nitrate photocatalytic removal. The mechanism of the enhancement as well as reaction pathways for nitrate photocatalytic reduction on NH₂-MIL-101(Fe)/BiVO₄ were comprehensively explored and described at the end.

Bismuth chromate (Cr2Bi3O11): a new bismuth-based semiconductor with excellent photocatalytic activity

A novel bismuth chromate material (Cr₂Bi₃O₁₁) was synthesized by a direct mixing method with higher photocatalytic activity in both organic pollutant detoxification and oxygen evolution. Cr₂Bi₃O₁₁ with a band gap of 2.20 eV could be activated by photons with a wavelength below 561 nm. This work not only provides an approach for the controllable synthesis of Cr₂Bi₃O₁₁, but also experimentally and theoretically shows its excellence and potential when applied in photocatalysis.

In-situ synthesis of N-doped TiO2 onto Ti3C2 MXene with enhanced photocatalytic activity in selective reduction of nitrate to N2

Photocatalysis exhibited promises in the reduction of nitrates into harmless dinitrogen. Herein, the synthesis of N-doped TiO2/Ti3C2 at low calcination temperature using NH4Cl and Ti3C2 was reported for the first...

A novel Bismuth hydroxide (Bi(OH)3) semiconductor with highly-efficient photocatalytic activity

Herein, a novel Bi(OH)3 photocatalyst was successfully synthesized. Benefiting from the suitable band positions, abundant alkaline groups and oxygen vacancies, the as-prepared semiconductor exhibits efficient activity in both photocatalytic CO2...