Osteoporosis and Primary Biliary Cholangitis: A Trans-ethnic Mendelian Randomization Analysis

Osteoporosis is a major clinical problem in many autoimmune diseases, including primary biliary cholangitis (PBC), the most common autoimmune liver disease. Osteoporosis is a major cause of fracture and related mortality. However, it remains unclear whether PBC confers a causally risk-increasing effect on osteoporosis. Herein, we aimed to investigate the causal relationship between PBC and osteoporosis and whether the relationship is independent of potential confounders. We performed bidirectional Mendelian randomization (MR) analyses to investigate the association between PBC (8021 cases and 16,489 controls) and osteoporosis in Europeans (the UK Biobank and FinnGen Consortium: 12,787 cases and 726,996 controls). The direct effect of PBC on osteoporosis was estimated using multivariable MR analyses. An independent replication was conducted in East Asians (PBC: 2495 cases and 4283 controls; osteoporosis: 9794 cases and 168,932 controls). Trans-ethnic meta-analysis was performed by pooling the MR estimates of Europeans and East Asians. Inverse-variance weighted analyses revealed that genetic liability to PBC was associated with a higher risk of osteoporosis in Europeans (OR, 1.040; 95% CI, 1.016-1.064; P = 0.001). Furthermore, the causal effect of PBC on osteoporosis persisted after adjusting for BMI, calcium, lipidemic traits, and sex hormones. The causal relationship was further validated in the East Asians (OR, 1.059; 95% CI, 1.023-1.096; P = 0.001). Trans-ethnic meta-analysis confirmed that PBC conferred increased risk on osteoporosis (OR, 1.045; 95% CI, 1.025-1.067; P = 8.17 × 10-6). Our data supports a causal effect of PBC on osteoporosis, and the causality is independent of BMI, calcium, triglycerides, and several sex hormones.

MGAT5/TMEM163 variant is associated with prognosis in ursodeoxycholic acid-treated patients with primary biliary cholangitis

BACKGROUND

Primary biliary cholangitis (PBC) is a chronic immune-mediated liver disease. Previous genome-wide meta-analysis has identified the association between variants in TMEM163 with PBC. Here we aimed to evaluate the association between variants near the reported risk loci of TMEM163 at 2q21.3 and prognosis of PBC patients.

METHODS

We performed a retrospective analysis of 347 PBC patients treated with ursodeoxycholic acid (UDCA) for at least 1 year. We collected clinical data at diagnosis and 1 year after UDCA treatment. SNPs within 200 kb upstream and downstream of the lead variant were genotyped and screened.

RESULTS

We identified that rs661899 near MGAT5 and TMEM163 showed the strongest association with prognosis in PBC patients. Patients carrying the rs661899 T allele tended to respond incompletely to UDCA treatment and had worse performances in laboratory values including aspartate aminotransferase (53.5 vs 32 vs 28.5 U/L, p = 0.001), alkaline phosphate (157.25 vs 125 vs 113 U/L, p = 0.001), albumin (41.5 vs 42.3 vs 43.7 g/L, p = 0.008) and bilirubin (19.2 vs 14.9 vs 12.85 μmol/L, p = 0.001). GLOBE scores (p = 4.8 × 10-5) and UK-PBC risk scores (p = 4.6 × 10-4) were strongly correlated with rs661899 genotype. Patients with TT genotype had a higher risk for adverse events compared with CC genotype (p = 0.039) during the 1-year follow-up. Results were also verified in an independent cohort.

CONCLUSIONS

PBC patients carrying the rs661899 T allele are associated with poor prognosis and adverse outcomes after 1-year UDCA therapy.

Itaconate inhibits CD103 + T RM cells and alleviates hepatobiliary injury in mouse models of primary sclerosing cholangitis

BACKGROUND AND AIMS

Primary sclerosing cholangitis (PSC) is a chronic progressive liver disease characterized by the infiltration of intrahepatic tissue-resident memory CD8 + T cells (T RM ). Itaconate has demonstrated therapeutic potential in modulating inflammation. An unmet need for PSC is the reduction of biliary inflammation, and we hypothesized that itaconate may directly modulate pathogenic T RM .

APPROACH AND RESULTS

The numbers of intrahepatic CD103 + T RM were evaluated by immunofluorescence in PSC (n = 32), and the serum levels of itaconate in PSC (n = 64), primary biliary cholangitis (PBC) (n = 60), autoimmune hepatitis (AIH) (n = 49), and healthy controls (n = 109) were determined by LC-MS/MS. In addition, the frequencies and immunophenotypes of intrahepatic T RM using explants from PSC (n = 5) and healthy donors (n = 6) were quantitated by flow cytometry. The immunomodulatory properties of 4-octyl itaconate (4-OI, a cell-permeable itaconate derivative) on CD103 + T RM were studied in vitro. Finally, the therapeutic potential of itaconate was studied by the administration of 4-OI and deficiency of immune-responsive gene 1 (encodes the aconitate decarboxylase producing itaconate) in murine models of PSC. Intrahepatic CD103 + T RM was significantly expanded in PSC and was positively correlated with disease severity. Serum itaconate levels decreased in PSC. Importantly, 4-OI inhibited the induction and effector functions of CD103 + T RM in vitro. Mechanistically, 4-OI blocked DNA demethylation of RUNX3 in CD8 + T cells. Moreover, 4-OI reduced intrahepatic CD103 + T RM and ameliorated liver injury in murine models of PSC.

CONCLUSIONS

Itaconate exerted immunomodulatory activity on CD103 + T RM in both in vitro and murine PSC models. Our study suggests that targeting pathogenic CD103 + T RM with itaconate has therapeutic potential in PSC.

Suppression of YTHDF2 attenuates autoimmune hepatitis by expansion of myeloid-derived suppressor cells

BACKGROUND & AIMS

The N6-methyladenosine (m⁶A) reader YTH domain-containing family protein 2 (YTHDF2) is critically involved in a multiplicity of biological processes by mediating the degradation of m⁶A modified mRNAs. Based on our current understanding of this process, we hypothesized that YTHDF2 will play a role in the natural history and function of myeloid-derived suppressor cells (MDSC) and in particular in AIH.

APPROACH & RESULTS

We took advantage of YTHDF2 conditional knock-out mice to first address the phenotype and function of MDSCs by flow cytometry. Importantly, the loss of YTHDF2 resulted in a gradual elevation of MDSCs including PMN-MDSCs both in liver and ultimately in the BM. Notably, YTHDF2 deficiency in myeloid cells attenuated concanavalin (ConA)-induced liver injury, with enhanced expansion and chemotaxis to liver. Furthermore, MDSCs from Ythdf2^CKO mice had a greater suppressive ability to inhibit the proliferation of T cells. Using multi-omic analysis of m⁶A RNA immunoprecipitation (RIP) and mRNA sequencing, we noted RXRα as potential target of YTHDF2. Indeed YTHDF2-RIP-qPCR confirmed that YTHDF2 directly binds RXRα mRNA thus promoting degradation and decreasing gene expression. Finally, by IHC and immunofluorescence, YTHDF2 expression was significantly upregulated in the liver of patients with AIH which correlated with the degree of inflammation.

CONCLUSION

Suppression of YTHDF2 enhances the expansion, chemotaxis and suppressive function of MDSCs and our data reveals a unique therapeutical target in immune mediated hepatitis.

[Current situation of screening, prevention and treatment of bleeding esophageal varices in cirrhotic portal hypertension in Tibet region: a multicenter study]

Objective: To investigate and analyze the current situation, screening, clinical characteristics, prevention and treatment of bleeding esophageal varices in cirrhotic patients with portal hypertension in Tibet region. Methods: Clinical data of cirrhotic patients with portal hypertension through March 2017 to February 2020 from Tibet region were collected and analyzed retrospectively. Results: 511 cases with liver cirrhosis were included in the study, of which 185 cases (36.20%) had compensated cirrhosis and 326 cases (63.80%) had decompensated cirrhosis. Further analysis of the etiological data of liver cirrhosis showed that 306 cases (59.88%) were of chronic hepatitis B, 113 cases (22.11%) of alcoholic liver disease, and 68 cases (13.31%) of chronic hepatitis B combined with alcoholic liver disease. Among patients with compensated liver cirrhosis, 48 cases (25.95%) underwent endoscopic examination of which 33 diagnosed as high-risk variceal bleeding. However, none of these 33 cases had received non-selective β-blocker therapy, and only four patients had received endoscopic variceal banding therapy. Among patients with decompensated liver cirrhosis, 83 cases (25.46%) had a history of upper gastrointestinal bleeding, 297 cases (91.10%) had ascites, 23 cases (7.05%) had hepatic encephalopathy, and 3 cases (0.92%) had hepatorenal syndrome. Among the patients with a history of upper gastrointestinal bleeding, 42 cases (50.60%) had received secondary preventive treatment for bleeding esophageal varices, including 39 cases of endoscopic treatment, 1 case of endoscopic combined drug treatment, 3 cases of interventional treatment, and 2 cases of surgical treatment. Conclusion: Chronic hepatitis B and alcoholic liver diseases are the main causes of liver cirrhosis in Tibet region. Moreover, this region lacks screening, prevention and treatment for bleeding esophageal varices in cirrhotic patients with portal hypertension. Therefore, it is necessary to increase the screening of high-risk groups to prevent and improve the first-time bleeding, and promote multidisciplinary team to prevent and treat re-bleeding.

Recovery of stem cell proliferation by low intensity vibration under simulated microgravity requires LINC complex

Mesenchymal stem cells (MSC) rely on their ability to integrate physical and spatial signals at load bearing sites to replace and renew musculoskeletal tissues. Designed to mimic unloading experienced during spaceflight, preclinical unloading and simulated microgravity models show that alteration of gravitational loading limits proliferative activity of stem cells. Emerging evidence indicates that this loss of proliferation may be linked to loss of cellular cytoskeleton and contractility. Low intensity vibration (LIV) is an exercise mimetic that promotes proliferation and differentiation of MSCs by enhancing cell structure. Here, we asked whether application of LIV could restore the reduced proliferative capacity seen in MSCs that are subjected to simulated microgravity. We found that simulated microgravity (sMG) decreased cell proliferation and simultaneously compromised cell structure. These changes included increased nuclear height, disorganized apical F-actin structure, reduced expression, and protein levels of nuclear lamina elements LaminA/C LaminB1 as well as linker of nucleoskeleton and cytoskeleton (LINC) complex elements Sun-2 and Nesprin-2. Application of LIV restored cell proliferation and nuclear proteins LaminA/C and Sun-2. An intact LINC function was required for LIV effect; disabling LINC functionality via co-depletion of Sun-1, and Sun-2 prevented rescue of cell proliferation by LIV. Our findings show that sMG alters nuclear structure and leads to decreased cell proliferation, but does not diminish LINC complex mediated mechanosensitivity, suggesting LIV as a potential candidate to combat sMG-induced proliferation loss.

[Brain derived neurotrophic factor enhances the role of mesenchymal stem cells in inhibiting follicular helper T cells]

目的

探讨脑源性神经营养因子（BDNF）增强间充质干细胞（MSC）抑制滤泡辅助性T细胞（Tfh细胞）的作用及机制。

方法

ELISA法检测MSC培养上清中吲哚胺2,3-二加氧酶（IDO）、IL-10、TGF-β和IL-21的含量；采集健康志愿者的外周血标本，采用人淋巴细胞分离液分离外周血中的淋巴细胞；采用Transwell小室进行MSC和淋巴细胞共培养，流式细胞术检测CD4⁺CXCR5⁺ Tfh细胞及其亚群的比例。

结果

①BDNF组（BDNF刺激的MSC）培养上清IL-10、TGF-β、IDO浓度均高于对照组（加入等体积磷酸盐缓冲液）[IL-10：（42.1±4.4）ng/ml对（19.3±2.1）ng/ml，t=4.761，P=0.009；TGF-β：（13.9±1.7）ng/ml对（5.3±0.6）ng/ml，t=5.129，P=0.008；IDO：（441.3±56.9）ng/ml对（226.7±37.6）ng/ml，t=3.130，P=0.035]；②BDNF组（淋巴细胞与BDNF刺激的MSC共培养）与MSC组（淋巴细胞与MSC共培养）比较：CD4⁺CXCR5⁺Tfh细胞比例降低[（3.37±0.21）%对（6.51±0.27）%，t=9.353，P<0.001]，CD4⁺ CXCR5⁺ CXCR3⁺ CCR6⁻Tfh1细胞比例升高[（41.14±2.04）%对（26.72±2.57）%，t=4.383，P=0.012]，CD4⁺CXCR5⁺CXCR3⁻CCR6⁻Tfh2细胞和CD4⁺CXCR5⁺CXCR3⁻CCR6⁺Tfh17细胞比例降低[Tfh2：（30.16±5.38）%对（43.26±4.11）%，t=4.426，P=0.012；Tfh17：（15.61±1.52）%对（22.32±0.72）%，t=4.202，P=0.014]，CD4⁺CXCR5⁺Foxp3⁺ Tfr细胞比例升高[（4.95±0.22）%对（2.32±0.16）%，t=10.241，P<0.001]，淋巴细胞培养上清中IL-21浓度降低[（0.28±0.03）ng/ml对（0.85±0.08）ng/ml，t=6.675，P=0.003]。

结论

BDNF能够增强MSC抑制Tfh细胞的作用，机制是抑制淋巴细胞中Tfh细胞比例升高及其向Tfh2和Tfh17亚群的分化。

[Effect of emergency thoracic endovascular aortic repair in patients with acute traumatic thoracic aortic injury]

Objective: To investigate the effect of emergency thoracic endovascular aortic repair (TEVAR) in patients with acute traumatic thoracic aortic injury. Method: From January 2014 to December 2016, a total of 35 patients with acute traumatic thoracic aortic injuries were treated with emergency TEVAR in our hospital, their clinical data were analyzed retrospectively in this study. Results: The patients were 42 (34, 55) years old,and there were 31 males.All cases were diagnosed by emergency aorta computed tomography angiography (CTA),and 5 cases were diagnosed as aortic transaction, 13 cases were diagnosed as aortic pseudoaneurysm, 7 cases were diagnosed as aortic dissection, and 10 cases were diagnosed as aortic intramural hematoma combined hemothorax.The concomitant injuries included cerebral contusion (3 cases, 8.6%), pulmonary contusion with rib fracture (31 cases, 88.5%), long bone fracture (7 cases, 22.5%), contusion of viscera or internal organs (3 cases, 8.6%).Emergency TEVAR were performed with vascular suture system preset under local anesthesia after diagnosis,and combined injury was treated in related departments.CTA was repeated after 1, 3 and 6 months and yearly thereafter. One patient died before transferring to catheter room,and 34 (97.1%) patients underwent TEVAR procedure successfully.Time from door to operating room was (88.6±26.6) minutes,and the procedure time was (52.0±9.4) minutes. A total of 69 Perclose Proglide vascular suture system were used,and 2 cases underwent surgical suture because of hematoma and pseudoaneurysm formation in femoral arteries.The involved length of thoracic aorta was (44.5±7.4)mm. A total of 46 stent-grafts were implanted, the length of stent-graft was (164.3±15.2)mm,and the proximal oversize rate was (22.3±8.6)%. The follow-up time was 24 (12,24) months, and there were no procedure related complication such as endoleak and paraplegia. Complete aortic remodeling was observed in 14 cases. Fully thrombolization at stent segments were observed in 7 cases. Fully thrombalization of pseudoaneurysms were observed in 13 cases. One patient complained mild left upper limb weakness due to left subclavian artery occlusion. Conclusion: Emergency TEVAR is safe and effective procedure for the treatment of patients with acute traumatic thoracic aortic injury.

Immunoproteomics to identify Staphylococcus aureus antigens expressed in bovine milk during mastitis

Staphylococcus aureus is an opportunistic pathogen affecting both human and animal species. An effective vaccine to prevent S. aureus bovine disease and transmission would have positive effects on animal well-being, food production, and human health. The objective of this study was to identify multiple antigens that are immunoreactive during udder colonization and disease for exploration as vaccine antigens to prevent bovine mastitis. Staphylococcus aureus produces several cell wall-anchored and surface-associated virulence factors that play key roles in the pathogenesis of mastitis. Many of these proteins are conserved between different strains of S. aureus and represent promising vaccine candidates. We used an immunoproteomics approach to identify antigenic proteins from the surface of S. aureus. The expression of cell wall and surface proteins from S. aureus was induced under low iron conditions, followed by trypsin extraction and separation by 2-dimensional electrophoresis. The separated proteins were blotted with antibodies from mastitic bovine milk and identified by liquid chromatography-mass spectrometry. Thirty-eight unique proteins were identified, of which 8 were predicted to be surface exposed and involved in S. aureus virulence. Two surface proteins, iron-regulated surface determinant protein C (IsdC) and ESAT-6 secretion system extracellular protein (EsxA), were cloned, expressed, and purified from Escherichia coli for confirmation of immune reactivity by ELISA. A PCR of 37 bovine S. aureus isolates indicated that the presence of esxA and isdC is conserved, and amino acid alignments revealed that IsdC and EsxA sequences are highly conserved. The immunoproteomics technique used in this study generated reproducible results and identified surface exposed and reactive antigens for further characterization.

[Feasibility and efficacy of transcatheter closure of anastomotic leakage after aortic surgery using Amplatzer Vascular Plug Ⅲ]

Objective: To investigate the feasibility and efficacy of transcatheter closure of anastomotic leakage after aortic surgery using Amplatzer Vascular Plug Ⅲ (AVP Ⅲ). Methods: A retrospective analysis was performed in 5 patients with anastomotic leakage after aortic surgery, who underwent transcatheter closure in our hospital from January to June 2017 using AVP Ⅲ. Surgeries were performed in 3 cases of Standford type A dissection, 1 case of ascending aortic aneurysm and 1 case of persistent truncus.There were 3 males,and age was (43.8±13.1) years old. Anastomotic leakages located at the ascending aorta in 4 patients, and the other one located between the aortic arch and the stent-graft.Three of them had aorta-right atrium fistula and patients suffered from progressive heart failure. False aneurysm between aorta and pulmonary artery was formed in 1 patient, and patent aortic false lumenwas found in the other patient. All the AVP Ⅲ were deployed based on a femoral arteriosus loop. Patients were followed up after transcatheter closure to observe the clinical results. Results: Six AVP Ⅲ were successfully implanted in the 5 patients. Trivial residual shunt was seen in 1 patient after closure. The patients were followed up 6 (1, 6) months. The cardiac function improved from NYHA class Ⅱ-Ⅳ to class Ⅰ-Ⅱ after the procedure in 3 congestive heart failure patients.The right atrium systolic pressure was significantly reduced after the procedure((8.7±1.8) mmHg (1 mmHg=0.133 kPa) vs. (24.3±2.3) mmHg, P=0.03). The diameter of the false aneurysm reduced in 1 patient after the procedure. Complete thrombosis formation of the thoracic false lumen was observed in 1 patient. Conclusion: Transcatheter closure of anastomotic leakage after aortic surgery using AVP Ⅲ is feasible and effective according to our primary experience.

CCAAT enhancer binding protein β promotes tumor growth and inhibits apoptosis in prostate cancer by methylating estrogen receptor β

The CCAAT enhancer binding protein β (C/EBPβ) is overexpressed at late stages in carcinogenesis of prostate cancer (PCa), suggesting that it could potentially contribute to progression of PCa. Estrogen receptor beta (ERβ) is a tumor suppressor gene in PCa. However, whether C/EBPβ could regulate ERβ by promoter methylation is still poorly understood.In this study, expression levels of C/EBPβ and ERβ in two PC lines (LNCap and PC-3), prostatic epithelial cell line (RWPE-1), forty-eight paired non-cancerous and cancerous peripheral blood samples were examined via qRT-PCR, western blotting and methylation-specific PCR. In addition, PCa cell line was infected with pCDH-C/EBPβ and pLKO.1-C/EBPβ and expression levels of C/EBPβ, ERβ and DNA methyltransferases were detected. Finally, the role of C/EBPβ in proliferation and apoptosis of PCa cell lines was examined by MTT and flow cytometer assay. Our results show a higher frequency of promoter methylation of ERβ levels in blood samples from PCa patients (16 of 48 cases) compared with that from healthy controls (3 of 48). Besides, elevated expression levels of C/EBPβ were found in PCa patients and two PCa lines (LNCap and PC-3) compared to non-cancerous cases or prostatic epithelial cell line (RWPE-1), while opposite expression levels of ERβ were found. Overexpression of C/EBPβ could regulate ERβ expression, DNA methyltransferases expression, cell proliferation and apoptosis. Our results support the conclusion that C/EBPβ down-regulated ERβ expression through increasing its promoter methylation, and then regulated proliferation and apoptosis in PCa.

Enhanced surface ozone during the heat wave of 2013 in Yangtze River Delta region, China

Under the background of global warming, occurrence of heat waves has increased in most part of Europe, Asia and Australia along with enhanced ozone level. In this paper, observational air temperature and surface ozone in the Yangtze River Delta (YRD) region of China during summer of 2013, and the regional chemistry-climate model (RegCM-CHEM4) were applied to explore the relationship between heat wave and elevated ground-level ozone. Observations indicated that YRD experienced severe heat waves with maximum temperature up to 41.1°C, 6.1°C higher than the definition of heat wave in China, and can last for as long as 27days. Maximum ozone reached 160.5ppb, exceeding the national air quality standard (secondary level) as 74.7ppb. Moreover, ozone was found to increase at a rate of 4-5ppbK^-1 within the temperature range of 28-38°C, but decrease by a rate of -1.3~-1.7ppbK^-1 under extremely high temperature. A typical heat wave case (HW: 24/7-31/7) and non-heat wave case (NHW: 5/6-12/6) were selected to investigate the mechanism between heavy ozone and heat waves. It was found that chemical reactions play the most important role in ozone formation during HW days, which result in 12ppb ozone enhancement compared to NHW days. Chemical formation of ozone can be influenced by several factors. During heat waves, a more stagnant condition, controlled by anti-cyclone with sink airflow, led to less water vapor in YRD from south and contributed to less cloud cover, which favored a strong solar radiation environment and ozone significantly increasing. High temperature also slightly promote the effect of vertical turbulence and horizontal advection, which beneficial to ozone remove, but the magnitude is much smaller than chemical effect. Our study suggests that the chemical reaction will potentially lead to substantial elevated ozone in a warmer climate, which should be taken into account in future ozone related issues.

Inflammation-related genetic variants predict toxicity following definitive radiotherapy for lung cancer

Definitive radiotherapy improves locoregional control and survival in inoperable non-small cell lung cancer (NSCLC) patients. However, radiation-induced toxicities (pneumonitis/esophagitis) are common dose-limiting inflammatory conditions. We therefore conducted a pathway-based analysis to identify inflammation-related SNPs associated with radiation-induced pneumonitis or esophagitis. 11,930 SNPs were genotyped in 201 stage I-III NSCLC patients treated with definitive radiotherapy. Validation was performed in an additional 220 NSCLC cases. After validation, 19 SNPs remained significant. A polygenic risk score (PRS) was generated to summarize the effect from validated SNPs. Significant improvements in discriminative ability were observed by adding the PRS into the clinical/epidemiological variable-based model. We then used 277 lymphoblastoid cell-lines to assess radiation sensitivity and eQTL relationships of the identified SNPs. Three genes (PRKCE,DDX58 and TNFSF7) were associated with radiation sensitivity. We concluded that inflammation-related genetic variants could contribute to the development of radiation-induced toxicities. These loci could assist in predicting those unfavorable events.

An auto-perfusing umbilical cord blood collection instrument

In this paper, the development of an automated umbilical cord blood (UCB) collection instrument, comprising of mechanical, electronics and control components, is provided in detail. UCB from the placenta provides a rich source of highly proliferative cells for many clinical uses as it contains rich Hematopoietic Stem Cells (HSCs) which yield many benefits over traditional sources such as the bone marrow and periphery blood. Current collection of UCB uses a syringe to extract blood from placenta, which is highly limited in volume and cell numbers. This paper will present the development of an automated UCB collection instrument to yield improved performance which comprised four subsystems. First, a placenta handling system is designed to produce air pressure which can realize the emulation of the uterus compression on the placenta. Second, an auto-medium injector system is presented to enable perfusion automatically. Third, a time window widening system is developed which generates vibrations during the perfusion phase and helps the exposed end of the cord cool down to a low temperature. Finally, a control platform is used to integrate all systems working together, hosting the control algorithms which operate the instrument automatically.

Examination of TIMP-1 Levels and Relapse-Free Survival for Patients in NCIC CTG MA.14 Who Received Adjuvant Tamoxifen +/- Octreotide LAR

Background: Tissue inhibitor of metalloproteinase-1 (TIMP-1) has been shown to have diverse multifunctional roles in tumorigenesis. AL/KL/SA postulated from first line metastatic endocrine therapy that elevated pre-treatment serum TIMP-1 required additional therapy. NCIC CTG MA.14 adjuvant endocrine trial permitted examination of whether TIMP-1 serum levels post-chemotherapy was associated with RFS. Methods: NCIC CTG MA.14 is a trial where 667 postmenopausal patients were randomized to receive adjuvant tamoxifen +/- octreotide LAR with a stratification factor of no, concurrent or sequential chemotherapy. For the purposes of this work, this was simplified to whether a patient had or had not received adjuvant chemotherapy prior to the serum draw. Serum TIMP-1 was assessed on &gt;90% of the trial patients. We examined the effect of baseline TIMP-1 levels on relapse-free survival (RFS) of 1) all types, 2) bone only, 3) all types of bone, and 4) non-bone, by timing of chemotherapy before the serum draw utilizing continuous TIMP (ng/ml) and categorical TIMP (&lt;454, &gt;454 ng/ml, based on 95% non-parametric cut-point for healthy post-menopausal females). Data were available on patient and tumour characteristics of age (years), pathologic tumour size (cm), pathologic lymph node status (# nodes), IGF-1, C-peptide, IGFBP-3. Step-wise forward Cox multivariate models were used where a factor was added if p&lt;=0.05, and interaction terms were added for TIMP-1 level and timing of chemotherapy. Results: High (categorical) TIMP-1 was significantly associated with longer RFS (p=0.04) in the non-bone RFS multivariate model in the subgroup of patients who had prior chemotherapy, but not in those who did not. The interaction between TIMP-1 and administration of chemotherapy before serum draw was significant (p=0.02). High (continuous) TIMP-1 was significantly associated with longer bone only RFS (p=0.04) in subgroup who had no chemotherapy before the serum draw, but not in those who may or may not have had it after. There was no significant interaction effect. Categorical and continuous TIMP-1 were not associated with any other type of RFS. Conclusions: We found a predictive benefit with the assessment of serum TIMP-1 in hormone receptor positive patients, that high TIMP-1 levels after adjuvant chemotherapy were predictive of a reduction in non-bone RFS.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3022.

Prognostic value of different B symptoms in upper aerodigestive tract NK/T-cell lymphoma

e19544

Background: Extranodal NK/T-cell lymphoma (ENKL) is a rare disease originated from NK or toxic T cells. ENKL arising from the upper aerodigestive tract (UNKTL) is a newly recognized subtype and commonly presents with B symptoms. This study is to investigate the prognostic value of different B symptoms in UNKTL. Methods: UNKTL cases with detailed clinical, pathological and prognostic data in our center since 2001 to 2007 were retrospectively analyzed with the major study endpoint of overall survival (OS). Central pathological review was performed. Survival curves were estimated by Kaplan-Meier method and tested by Log Rank method. Statistically significant factors in univariate analysis were then included in multivariate analysis. B symptoms were defined as fever, night sweat and weight loss according to the Ann Arbor Cotswolds meeting. The predictive values of survival for each type of B symptoms were studied independently. Results: 172 cases of UNKTL with a median follow-up duration of 27.4 months were included. 45 ladies and 127 gentlemen had a median age of 43 years. 98 cases were Ann Arbor stage I, 54 were stage II and the remaining 20 cases were stage III or IV. About half of the patients present B symptoms: 82 had fever, 5 had night sweat and 6 present weight loss. Totally 18 patients had ECOG PS larger than 1. The 5-year OS rate of the whole group is 41.8%. Patients with persistent fever before treatment indicated a poor outcome in the univariate analysis (p=.033) and its prognostic value was also confirmed by the Cox regression (p=.030) whereas those of night sweat and weight loss were not (p= .960 and .824 respectively). Conclusions: B symptoms were common in UNKTL patients. Our data suggested that only fever among the three types of B symptoms was independent prognostic factor for UNKTL but it still needs further confirmation.

No significant financial relationships to disclose.

A phytoplasma related to 'Candidatus phytoplasma asteri' detected in citrus showing Huanglongbing (yellow shoot disease) symptoms in Guangdong, P. R. China

Citrus huanglongbing (HLB) or yellow shoot disease (i.e., greening disease) is highly destructive to citrus production worldwide. Understanding the etiology of HLB is critical for managing the disease. HLB is currently associated with infection by 'Candidatus Liberibacter spp.' around the world, including China. However, Koch's postulates have not been fulfilled. In addition, other plant pathogens also may be involved in HLB. In a survey performed in Guangdong Province, P. R. China in 2006 and 2007, 141 citrus samples showing typical symptoms of HLB from 11 different cities were collected. Polymerase chain reaction (PCR) using phytoplasma-specific primer sets fU5/rU3 nested with primer set P1/P7 identified 110 (78.0%) positive samples. A 1,785-bp amplicon was obtained with primer set P1/P7. Analysis showed a 100% identity of this sequence in the region of 16S rDNA and 16S-23S rRNA intergenic transcribed spacer to three strains of 'Candidatus Phytoplasma asteri' (onion yellows [Japan], aster yellows 'watercress' [Hawaii], and valeriana yellows [Lithuania]). Of the 141 samples, 89 (63.1%) samples were positive for 'Ca. Liberibacter asiaticus'. When mixed infection was considered, 69 (48.9%) samples were positive for both 'Ca. P. asteri' and 'Ca. L. asiaticus'. Transmission electron microscopy (TEM) showed low titers of both walled and wall-less bodies in the phloem sieve tubes of HLB citrus. When transmission from symptomatic citrus to periwinkle (Catharanthus roseus) via dodder (Cuscuta campestris) was conducted, both phytoplasma and 'Ca. L. asiaticus' were detected from the affected periwinkle. In addition to yellowing/mottling, the infected periwinkle showed symptoms of virescence and phyllody which are commonly associated with phytoplasmal diseases. TEM analysis of affected periwinkle revealed pleomorphic and wall-less organisms, characteristic of phytoplasmas, filling some phloem sieve tubes. In contrast, walled bacteria were at low titer. This study showed that in addition to 'Ca. L. asiaticus', a phytoplasma related to 'Ca. P. asteri' could also be detected in citrus showing HLB symptoms in Guangdong.

Trace amines: identification of a family of mammalian G protein-coupled receptors

Tyramine, beta-phenylethylamine, tryptamine, and octopamine are biogenic amines present in trace levels in mammalian nervous systems. Although some "trace amines" have clearly defined roles as neurotransmitters in invertebrates, the extent to which they function as true neurotransmitters in vertebrates has remained speculative. Using a degenerate PCR approach, we have identified 15 G protein-coupled receptors (GPCR) from human and rodent tissues. Together with the orphan receptor PNR, these receptors form a subfamily of rhodopsin GPCRs distinct from, but related to the classical biogenic amine receptors. We have demonstrated that two of these receptors bind and/or are activated by trace amines. The cloning of mammalian GPCRs for trace amines supports a role for trace amines as neurotransmitters in vertebrates. Three of the four human receptors from this family are present in the amygdala, possibly linking trace amine receptors to affective disorders. The identification of this family of receptors should rekindle the investigation of the roles of trace amines in mammalian nervous systems and may potentially lead to the development of novel therapeutics for a variety of indications.

Polymorphism of human platelet alloantigen in Chinese patients with acute myocardial infarction and acute ischemic stroke

OBJECTIVE

To investigate the gene frequencies of 5 major human platelet alloantiqens (HPA 1-5) in Chinese population and to assess if polymorphism of HPA was associated with Chinese acute myocardial infarction (AMI) and acute ischemic stroke (AIS).

METHODS

HPA 1-5 genotyping was performed by PCR using allele specific primers and restriction enzyme digestion based on PCR products in 95 AMI cases, 188 AIS cases and 270 normal controls. Gene frequency distribution was tested by Hardy-Weinberg equilibrium and comparison of HPA gene frequencies between the patient and control groups by chi 2 test.

RESULTS

The gene frequencies of HPA 1-5 were the followings: HPA1a: 91%; 1b: 9%; HPA 2a: 94%; 2b: 6%; HPA 3a: 83%; 3b: 17%; HPA 4a: 98%; 4b: 2%; HPA5a: 97%; 5b: 3%. We found there were no significant differences in HPA 1-5 gene frequencies between AMI patients and normal controls. In AIS patients group HPA-2a allele frequency was significant higher than in controls, but this allele gene frequency in two groups (0.94 and 0.99) was very close and too many subjects in these two groups were overlapped. Otherwise no differences was found in other 4 HPA systems between cases and controls.

CONCLUSION

Polymorphism of HPA were not inherited risky factors and not associated with chinese arterial thrombotic diseases such as AMI and AIS.

Guinea pig 11beta-hydroxysteroid dehydrogenase type 1: primary structure and catalytic properties

The 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) enzyme is responsible for the interconversion of glucocorticoids and their inactive metabolites, and thus modulates the intracellular level of bioactive glucocorticoids. The present study was designed to clone and characterize 11beta-HSD1 in the guinea pig, a laboratory animal known for resistance to glucocorticoids. The cDNA encoding guinea pig 11beta-HSD1 was cloned by a modified 3'-RACE (rapid amplification of cDNA ends) protocol using the hepatic RNA as template. The cloned cDNA encodes a protein of 300 amino acids that shares 71 to 74% sequence identity with other known mammalian 11beta-HSD1 proteins. Sequence comparison analysis revealed that the deduced guinea pig 11beta-HSD1 was longer, by eight amino acids at the C terminus, than those of other mammals. Moreover, one of the two absolutely conserved consensus sites for N-glycosylation was absent. To examine the functional significance of these structural changes, we also characterized 11beta-HSD1 activity in the hepatic microsomes. Although the guinea pig hepatic enzyme was NADP(H)-dependent and reversible, it displayed equal affinity for cortisol and cortisone (apparent K(m) for both substrates was 3 microM). This is in marked contrast to 11beta-HSD1 in other mammals whose affinity for cortisone is approximately 10 times higher than that for cortisol (apparent K(m) of 0.3 vs. 3.0 microM). The apparent lower affinity of the guinea pig enzyme for cortisone would suggest that the intracellular bioformation of cortisol from circulating cortisone may be less efficient in this species. Northern blot analysis and RT-PCR revealed that the mRNA for 11beta-HSD1 was widely expressed in the adult guinea pig but at low amounts. In conclusion, the present study has identified distinct features in the deduced primary structure and catalytic function of 11beta-HSD1 in the guinea pig. Thus, the guinea pig provides a useful model in which the structural determinants of catalytic function of 11beta-HSD1 may be studied.

[An extensive matrilineal nonsyndromic sensorineural deafness family and mtDNA 12SrRNA gene mutation]

OBJECTIVE

To investigate the possible cause and molecular genetic mechanism of matrilineal nonsyndromic sensorineural deafness, the authors analyzed an extensive matrilineal nonsyndromic sensorineural deafness family.

METHODS

PCR amplification of the nt1555 and nt7445 of the mitochondrial DNA, combined with PCR-SSCP, PCR-RFLP and sequence to analyze the family.

RESULTS

The authors found a homoplasmic A to G transition at position 1555(A1555G) of the mitochondrial 12SrRNA gene from all the patients, and four matrilineal relatives of this family, but the mutation was not found in the normal spouses of the family and controls (100 normal persons).

CONCLUSION

The A1555G mutation may be one of the major factors that cause deafness in this family.

[Calculation for Franck-Condon factors of the two band systems beta(B2pi(r) - X2pi(r)) and gamma(A2sigma+ - X2Pi(r)) of NO in the air at high temperature]

From the nuclear Schrödinger equation of a diatomic molecule with vibration-rotation interaction term involved in it, we derive the wavefunction relevant not only to vibrational quantum number, but also to rotational one. The Franck-Condon factors of the two band systems beta(B2pi(r) - X2pi(r)) and gamma(A2sigma+ - X2Pi(r)) of NO in the air at high temperature are calculated in this paper, using the derived wavefunction. In the calculation, the rotational quantum number J takes values from 0 up to 200. The results apply to both low or high temperature conditions.

[The theoretical study of Raman imaging for pendent drop adsorbed by uniaxial orientated molecules]

In this paper, Raman imaging method used to determine molecular orientation of LB film on pendent drop is proposed. For the molecules which is of uniaxial orientation, all of Raman activity matrix elements have been calculated. The intensity distribution of Raman imaging for pendent drop and the ratio distribution of polarized Raman intensity used to determining molecular orientation have also been calculated and drawn out.

[Studies on precipitate of Huanglian-Huangqin couples in decoction]

OBJECTIVE

Chemical composition of precipitate was researched when Huanglian-Huangqin was decocted.

METHOD

Ployamide column chromatography, TLC and TOF-MS were used.

RESULT

The precipitate contains berberine, palmatine, jalrorrhizing, epiberberine, copticine, baicaling and wogonoside.

CONCLUSION

The precipitate is effective composition in Chinese medical decoction. The research provides new data on medical effects of Huanglian-Huangqin couples.

[Early revascularization by percutaneous transluminal coronary angioplasty in acute myocardial infarction]

Twelve patients with acute myocardial infarction (AMI) underwent percutaneous transluminal coronary angioplasty (PTCA). The reperfusion blood flow of the infarct-related arteries (IRA) in eleven patients was TIMI Grade 3 with residual stenosis of 15.5 +/- 8.8%. Vascular endothelial dissection complicated by angioplasty was observed in one case and the patient died after emergency coronary artery bypass graft. It is suggested that early primary PTCA in AMI may create stable and effective revascularization which will favor reducing infarct size, improving myocardial pump function, and lowering restenosis and mortality rate.