Anti-Aging Drugs and the Related Signal Pathways

Aging is a multifactorial biological process involving chronic diseases that manifest from the molecular level to the systemic level. From its inception to 31 May 2022, this study searched the PubMed, Web of Science, EBSCO, and Cochrane library databases to identify relevant research from 15,983 articles. Multiple approaches have been employed to combat aging, such as dietary restriction (DR), exercise, exchanging circulating factors, gene therapy, and anti-aging drugs. Among them, anti-aging drugs are advantageous in their ease of adherence and wide prevalence. Despite a shared functional output of aging alleviation, the current anti-aging drugs target different signal pathways that frequently cross-talk with each other. At present, six important signal pathways were identified as being critical in the aging process, including pathways for the mechanistic target of rapamycin (mTOR), AMP-activated protein kinase (AMPK), nutrient signal pathway, silent information regulator factor 2-related enzyme 1 (SIRT1), regulation of telomere length and glycogen synthase kinase-3 (GSK-3), and energy metabolism. These signal pathways could be targeted by many anti-aging drugs, with the corresponding representatives of rapamycin, metformin, acarbose, nicotinamide adenine dinucleotide (NAD+), lithium, and nonsteroidal anti-inflammatory drugs (NSAIDs), respectively. This review summarized these important aging-related signal pathways and their representative targeting drugs in attempts to obtain insights into and promote the development of mechanism-based anti-aging strategies.

Using CT imaging features to predict visceral pleural invasion of non-small-cell lung cancer

AIM

To examine the diagnostic performance of different models based on computed tomography (CT) imaging features in differentiating the invasiveness of non-small-cell lung cancer (NSCLC) with multiple pleural contact types.

MATERIALS AND METHODS

A total of 1,573 patients with NSCLC (tumour size ≤3 cm) were included retrospectively. The clinical and pathological data and preoperative imaging features of these patients were investigated and their relationships with visceral pleural invasion (VPI) were compared statistically. Multivariate logistic regression was used to eliminate confounding factors and establish different predictive models.

RESULTS

By univariate analysis and multivariable adjustment, surgical history, tumour marker (TM), number of pleural tags, length of solid contact and obstructive inflammation were identified as independent risk predictors of pleural invasiveness (p=0.014, 0.003, <0.001, <0.001, and 0.017, respectively). In the training group, comparison of the diagnostic efficacy between the combined model including these five independent predictors and the image feature model involving the latter three imaging predictors were as follows: sensitivity of 88.9% versus 77% and specificity of 73.5% versus 84.1%, with AUC of 0.868 (95% CI: 0.848-0.886) versus 0.862 (95% CI: 0.842-0.880; p=0.377). In the validation group, the sensitivity and specificity of these two models were as follow: the combined model, 93.5% and 74.3%, the imaging feature model, 77.4% and 81.3%, and their areas under the curve (AUCs) were both 0.884 (95% CI: 0.842-0.919). The best cut-off value of length of solid contact was 7.5 mm (sensitivity 68.9%, specificity 75.5%).

CONCLUSIONS

The image feature model showed great potential in predicting pleural invasiveness, and had comparable diagnostic efficacy compared with the combined model containing clinical data.

[Rac1 promotes the formation of heterotypic cell-in-cell structure]

Heterotypic cell-in-cell structures (heCICs) are closely related to tumor development and progression, and have become a new frontier in life science research. Ras-related C3 botulinum toxin substrate 1 (Rac1) belongs to the classic Rho GTPase, which plays a key role in regulating the cytoskeleton and cell movement. To investigate the role and mechanism of Rac1 in the formation of heCICs, tumor cells and immune killer cells were labeled with cell-tracker, respectively, to establish the heCICs model. Upon treatment with the Rac1 inhibitor NSC23766, the formation of heCICs between tumor and immune cells was significantly reduced. The plasmid pQCXIP-Rac1-EGFP constructed by gene cloning was packaged into pseudoviruses that subsequently infect tumor cells to make cell lines stably expressing Rac1. As a result, the formation of heCICs was significantly increased upon Rac1 overexpression. These results demonstrated a promotive role of Rac1 in heCICs formation, which may facilitate treating cell-in-cell related diseases, such as tumors, by targeting Rac1.

Subtype-based analysis of cell-in-cell structures in non-small cell lung cancer

Lung cancer is ranked as the leading cause of cancer-related death worldwide, and the development of novel biomarkers is helpful to improve the prognosis of non-small cell lung cancer (NSCLC). Cell-in-cell structures (CICs), a novel functional surrogate of complicated cell behaviors, have shown promise in predicting the prognosis of cancer patients. However, the CIC profiling and its prognostic value remain unclear in NSCLC. In this study, we retrospectively explored the CIC profiling in a cohort of NSCLC tissues by using the "Epithelium-Macrophage-Leukocyte" (EML) method. The distribution of CICs was examined by the Chi-square test, and univariate and multivariate analyses were performed for survival analysis. Four types of CICs were identified in lung cancer tissues, namely, tumor-in-tumor (TiT), tumor-in-macrophage (TiM), lymphocyte-in-tumor (LiT), and macrophage-in-tumor (MiT). Among them, the latter three constituted the heterotypic CICs (heCICs). Overall, CICs were more frequently present in adenocarcinoma than in squamous cell carcinoma (P = 0.009), and LiT was more common in the upper lobe of the lung compared with other lobes (P = 0.020). In univariate analysis, the presence of TiM, heCIC density, TNM stage, T stage, and N stage showed association with the overall survival (OS) of NSCLC patients. Multivariate analysis revealed that heCICs (HR = 2.6, 95% CI 1.25-5.6) and lymph node invasion (HR = 2.6, 95% CI 1.33-5.1) were independent factors associated with the OS of NSCLC. Taken together, we profiled the CIC subtypes in NSCLC for the first time and demonstrated the prognostic value of heCICs, which may serve as a type of novel functional markers along with classical pathological factors in improving prognosis prediction for patients with NSCLC.

AIM-CICs: an automatic identification method for cell-in-cell structures based on convolutional neural network

Edited by Luonan Chen Whereas biochemical markers are available for most types of cell death, current studies on non-autonomous cell death by entosis rely strictly on the identification of cell-in-cell structures (CICs), a unique morphological readout that can only be quantified manually at present. Moreover, the manual CIC quantification is generally over-simplified as CIC counts, which represents a major hurdle against profound mechanistic investigations. In this study, we take advantage of artificial intelligence technology to develop an automatic identification method for CICs (AIM-CICs), which performs comprehensive CIC analysis in an automated and efficient way. The AIM-CICs, developed on the algorithm of convolutional neural network, can not only differentiate between CICs and non-CICs (the area under the receiver operating characteristic curve (AUC) > 0.99), but also accurately categorize CICs into five subclasses based on CIC stages and cell number involved (AUC > 0.97 for all subclasses). The application of AIM-CICs would systemically fuel research on CIC-mediated cell death, such as high-throughput screening.

[Analysis of the application of radiotherapy facility construction project evaluation standard in health management institutions]

Objective: To investigate the application of GBZ/T 220.2-2009 "The Specification of Radiological Protection Assessment for Occupational Hazard in Construction Project-Part 2: Radiotherapy Facility" in health management institutions, and to understand the scientificity, practicability and problems existing in the implementation of the standard. Methods: The method of multistage stratified sampling and questionnaire survey were used to collect the standard application status among 96 radiological health managers who had participated in the evaluation of radiotherapy facility construction projects in 6 provinces and cities from November 2020 to April 2021. A descriptive statistical analysis method was used to analyze the basic information of the survey object, the knowledge of the standard, the publicity and implementation of the standard. Results: The radiological health management personnel mainly came from health supervision agencies (62.5%, 60/96) , and 86.5% (83/96) were engaged in the pre-evaluation of radiotherapy device construction project and the approval and supervision of control effect evaluation. The awareness rate and training rate of radiological health managers on GBZ/T 220.2-2009 were 88.5% (85/96) and 31.3% (30/96) , respectively. 89.6% (86/96) managers thought it could meet the needs of radiotherapy facility construction project approval or supervision. 49.0% (47/96) of managers believed that the standard needed to be revised. Conclusion: The content of GBZ/T 220.2-2009 is basically scientific and reasonable, but the publicity, implementation and training of radiological health administrator still need to be strengthened. It is suggested to revise some clauses in the standard that do not meet the requirements.

Long-range enhancement of N501Y-endowed mouse infectivity of SARS-CoV-2 by the non-RBD mutations of Ins215KLRS and H655Y

Background

Rodents, such as mice, are vulnerable targets, and potential intermediate hosts, of SARS-CoV-2 variants of concern, including Alpha, Beta, Gamma, and Omicron. N501Y in the receptor-binding domain (RBD) of Spike protein is the key mutation dictating the mouse infectivity, on which the neighboring mutations within RBD have profound impacts. However, the impacts of mutations outside RBD on N501Y-mediated mouse infectivity remain to be explored.

Results

Herein, we report that two non-RBD mutations derived from mouse-adapted strain, Ins215KLRS in the N-terminal domain (NTD) and H655Y in the subdomain linking S1 to S2, enhance mouse infectivity in the presence of N501Y mutation, either alone or together. This is associated with increased interaction of Spike with mouse ACE2 and mutations-induced local conformation changes in Spike protein. Mechanistically, the H655Y mutation disrupts interaction with N657, resulting in a less tight loop that wraps the furin-cleavage finger; and the insertion of 215KLRS in NTD increases its intramolecular interaction with a peptide chain that interfaced with the RBD-proximal region of the neighboring protomer, leading to a more flexible RBD that facilitates receptor binding. Moreover, the Omicron Spike that contains Ins214EPE and H655Y mutations confer mouse infectivity > 50 times over the N501Y mutant, which could be effectively suppressed by mutating them back to wild type.

Conclusions

Collectively, our study sheds light on the cooperation between distant Spike mutations in promoting virus infectivity, which may undermine the high infectiousness of Omicron variants towards mice.

Supplementary information

The online version contains supplementary material available at 10.1186/s13062-022-00325-x.

Immune response in COVID-19: what is next?

The coronavirus disease 2019 (COVID-19) has been a global pandemic for more than 2 years and it still impacts our daily lifestyle and quality in unprecedented ways. A better understanding of immunity and its regulation in response to SARS-CoV-2 infection is urgently needed. Based on the current literature, we review here the various virus mutations and the evolving disease manifestations along with the alterations of immune responses with specific focuses on the innate immune response, neutrophil extracellular traps, humoral immunity, and cellular immunity. Different types of vaccines were compared and analyzed based on their unique properties to elicit specific immunity. Various therapeutic strategies such as antibody, anti-viral medications and inflammation control were discussed. We predict that with the available and continuously emerging new technologies, more powerful vaccines and administration schedules, more effective medications and better public health measures, the COVID-19 pandemic will be under control in the near future.

Cell-in-cell structure mediates in-cell killing suppressed by CD44

Penetration of immune cells into tumor cells was believed to be immune-suppressive via cell-in-cell (CIC) mediated death of the internalized immune cells. We unexpectedly found that CIC formation largely led to the death of the host tumor cells, but not the internalized immune cells, manifesting typical features of death executed by NK cells; we named this “in-cell killing” which displays the efficacy superior to the canonical way of “kiss-killing” from outside. By profiling isogenic cells, CD44 on tumor cells was identified as a negative regulator of “in-cell killing” via inhibiting CIC formation. CD44 functions to antagonize NK cell internalization by reducing N-cadherin-mediated intercellular adhesion and by enhancing Rho GTPase-regulated cellular stiffness as well. Remarkably, antibody-mediated blockade of CD44 signaling potentiated the suppressive effects of NK cells on tumor growth associated with increased heterotypic CIC formation. Together, we identified CIC-mediated “in-cell killing” as a promising strategy for cancer immunotherapy.

Thinopyrum intermedium TiAP1 interacts with a chitin deacetylase from Blumeria graminis f. sp. tritici and increases the resistance to Bgt in wheat

The biotrophic fungal pathogen Blumeria graminis f. sp. tritici (Bgt) is a crucial factor causing reduction in global wheat production. Wild wheat relatives, for example Thinopyrum intermedium, is one of the wild-used parents in wheat disease-resistant breeding. From T. intermedium line, we identified the aspartic protease gene, TiAP1, which is involved in resistance against Bgt. TiAP1 is a secreted protein that accumulates in large amounts at the infection sites of Bgt and extends to the intercellular space. Yeast two-hybrid, luciferase complementation imaging and bimolecular florescent complimentary analysis showed that TiAP1 interacted with the chitin deacetylase (BgtCDA1) of Bgt. The yeast expression, purification and in vitro test confirmed the chitin deacetylase activity of BgtCDA1. The bombardment and VIGS-mediated host-induced gene silencing showed that BgtCDA1 promotes the invasion of Bgt. Transcriptome analysis showed the cell wall xylan metabolism, lignin biosynthesis-related and defence genes involved in the signal transduction were up-regulated in the transgenic TiAP1 wheat induced by Bgt. The TiAP1 in wheat may inactivate the deacetylation function of BgtCDA1, cause chitin oligomers expose to wheat chitin receptor, then trigger the wheat immune response to inhibit the growth and penetration of Bgt, and thereby enhance the resistance of wheat to pathogens.

A Methodology for Reconstructing Source Properties of a Conical Piezoelectric Actuator Using Array-Based Methods

We investigated the force produced by a conical piezoelectric (PZT, lead zirconate titanate) transducer actuated by high voltage pulses (HVP) in contact with a steel transfer plate. Using elastic wave propagation theory in a semi-infinite plate, we aimed to quantify the magnitude and estimate the shape of the force-time function via the body waves produced in the transfer plate using the displacement field recorded on an array of 20 absolutely calibrated PZT receivers. We first calibrated the receiver array using glass capillary fracture. We proceeded to use a conical PZT transducer to actively produce a source at the origin, allowing us to study the displacement field produced on the now calibrated PZT receiver array. We studied two types of HVP: An impulsive and step source. The calibrated receiver array was used to estimate the general shape of the force-time functions for each type of HVP. From our hypothesized force-time functions we were able to estimate the peak force produced by the PZT actuator: The impulsive source generated a force of f peak = 2.90 ± 0.42 N and the step source generated f peak = 1.79 ± 0.30 N, respectively, for a peak applied voltage of 273 V. This translates to an applied force of ∼ 0.011 N/V and 0.007 N/V for the impulse and step force-time functions, respectively, which is similar to estimates found in the literature for other conical transducers in contact with metallic transfer media. This measurement was verified directly by independent measurements of the peak force f peak using a dynamic force transducer. We found that our methodology correctly estimated the magnitude of the force but is limited to transducers with incident angles θ < 53 ∘ . Beyond this angle, overestimates of the force were observed due to the lack of body wave energy produced by the source. These results allow us to quantitatively determine the forces produced by active PZT techniques using only the measurement of the displacement field captured on a calibrated conical PZT array. Quantitative understanding of active PZT sources additionally constrains the transfer functions approach, which is commonly used in the non-destructive testing of materials and in other fields, such as rock physics and laboratory seismology.

Senescence as a dictator of patient outcomes and therapeutic efficacies in human gastric cancer

Senescence is believed to be a pivotal player in the onset and progression of tumors as well as cancer therapy. However, the guiding roles of senescence in clinical outcomes and therapy selection for patients with cancer remain obscure, largely due to the absence of a feasible senescence signature. Here, by integrative analysis of single cell and bulk transcriptome data from multiple datasets of gastric cancer patients, we uncovered senescence as a veiled tumor feature characterized by senescence gene signature enriched, unexpectedly, in the noncancerous cells, and further identified two distinct senescence-associated subtypes based on the unsupervised clustering. Patients with the senescence subtype had higher tumor mutation loads and better prognosis as compared with the aggressive subtype. By the machine learning, we constructed a scoring system termed as senescore based on six signature genes: ADH1B, IL1A, SERPINE1, SPARC, EZH2, and TNFAIP2. Higher senescore demonstrated robustly predictive capability for longer overall and recurrence-free survival in 2290 gastric cancer samples, which was independently validated by the multiplex staining analysis of gastric cancer samples on the tissue microarray. Remarkably, the senescore signature served as a reliable predictor of chemotherapeutic and immunotherapeutic efficacies, with high-senescore patients benefited from immunotherapy, while low-senescore patients were responsive to chemotherapy. Collectively, we report senescence as a heretofore unrecognized hallmark of gastric cancer that impacts patient outcomes and therapeutic efficacy.

A single-arm pilot of a web-based intervention to improve itch-related quality of life

BACKGROUND

Many patients with chronic itch and atopic dermatitis (AD) or psoriasis do not receive/use available medical and psychosocial treatments properly due to system, provider and/or patient factors.

OBJECTIVE

An educational website (ITCH-RELIEF) to improve itch-related quality of life (QoL) for adults with AD or psoriasis and chronic itch was developed and assessed. ITCH RELIEF stands for Interactive Toolbox of Comprehensive Health Resources to Enhance Living with Itch - Educational Facilitation (for Adults).

METHODS

Single-arm pre- and post-test design with 1-month follow-up (N = 137 at baseline).

RESULTS

There was statistically and clinically significant improvement in the primary outcome of itch-related QoL impairment as assessed by the ItchyQoL from baseline [M = 78.9, 95% confidence interval (CI) = 75.9, 81.9] to follow up (M = 75.4, CI = 72.4, 78.5), P = 0.007, as well as statistically significant improvement in several itch-related secondary outcomes (all Ps < 0.05).

CONCLUSIONS

This study demonstrated initial effectiveness of an online intervention to improve itch-related QoL among individuals with AD or psoriasis and chronic itch. Future studies should address limitations by randomizing more heterogeneous participants, utilizing a longer follow-up and assessing medication use.

The virological impacts of SARS-CoV-2 D614G mutation

The coronavirus diseases 2019 (COVID-19) caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 has caused more than 140 million infections worldwide by the end of April 2021. As an enveloped single-stranded positive-sense RNA virus, SARS-CoV-2 underwent constant evolution that produced novel variants carrying mutation conferring fitness advantages. The current prevalent D614G variant, with glycine substituted for aspartic acid at position 614 in the spike glycoprotein, is one of such variants that became the main circulating strain worldwide in a short period of time. Over the past year, intensive studies from all over the world had defined the epidemiological characteristics of this highly contagious variant and revealed the underlying mechanisms. This review aims at presenting an overall picture of the impacts of D614G mutation on virus transmission, elucidating the underlying mechanisms of D614G in virus pathogenicity, and providing insights into the development of effective therapeutics.

Psychosocial adjustment mediates impacts of playmate positive support on body mass index and overweight risk in adolescents

OBJECTIVES

We examined the mediation effects of psychosocial adjustment on the impact of playmate positive support throughout childhood and early adolescence (from age 54 months to 11 years) on later body mass index (BMI) and overweight risk in middle adolescence (age 15 years).

STUDY DESIGN

This was a prospective cohort study.

METHODS

Among 844 children and their families, positive support between child-playmate dyads was repeatedly assessed from child's age 54 months to Grade 5. Long-term positive support between child-playmate dyads throughout childhood and early adolescence was prospectively linked to child's BMI and overweight/obesity status at age 15 years. The average scores of repeated assessments of internalizing and externalizing behavior problems from Grades 3 to 6 were used as mediators.

RESULTS

Significant mediations of internalizing and externalizing behavior problems were observed on pathways from positive support between child-playmate dyads to later BMI and overweight/obesity status at age 15 years. The observed mediations were mainly sustained with pronounced magnitudes in girls, but not in boys.

CONCLUSIONS

Our findings demonstrated a significant mediating role of psychosocial adjustment. Future research efforts are highly encouraged to replicate our findings and further explore this underlying mediation mechanism.

Subtype-Based Analysis of Cell-in-Cell Structures in Esophageal Squamous Cell Carcinoma

Cell-in-cell (CIC) structures are defined as the special structures with one or more cells enclosed inside another one. Increasing data indicated that CIC structures were functional surrogates of complicated cell behaviors and prognosis predictor in heterogeneous cancers. However, the CIC structure profiling and its prognostic value have not been reported in human esophageal squamous cell Carcinoma (ESCC). We conducted the analysis of subtyped CIC-based profiling in ESCC using "epithelium-macrophage-leukocyte" (EML) multiplex staining and examined the prognostic value of CIC structure profiling through Kaplan-Meier plotting and Cox regression model. Totally, five CIC structure subtypes were identified in ESCC tissue and the majority of them was homotypic CIC (hoCIC) with tumor cells inside tumor cells (TiT). By univariate and multivariate analyses, TiT was shown to be an independent prognostic factor for resectable ESCC, and patients with higher density of TiT tended to have longer post-operational survival time. Furthermore, in subpopulation analysis stratified by TNM stage, high TiT density was associated with longer overall survival (OS) in patients of TNM stages III and IV as compared with patients with low TiT density (mean OS: 51 vs 15 months, P = 0.04) and T3 stage (mean OS: 57 vs 17 months, P=0.024). Together, we reported the first CIC structure profiling in ESCC and explored the prognostic value of subtyped CIC structures, which supported the notion that functional pathology with CIC structure profiling is an emerging prognostic factor for human cancers, such as ESCC.

Mechanical Ring Interfaces between Adherens Junction and Contractile Actomyosin to Coordinate Entotic Cell-in-Cell Formation

Entosis is a cell-in-cell (CIC)-mediated death program. Contractile actomyosin (CA) and the adherens junction (AJ) are two core elements essential for entotic CIC formation, but the molecular structures interfacing them remain poorly understood. Here, we report the characterization of a ring-like structure interfacing between the peripheries of invading and engulfing cells. The ring-like structure is a multi-molecular complex consisting of adhesive and cytoskeletal proteins, in which the mechanical sensor vinculin is highly enriched. The vinculin-enriched structure senses mechanical force imposed on cells, as indicated by fluorescence resonance energy transfer (FRET) analysis, and is thus termed the mechanical ring (MR). The MR actively interacts with CA and the AJ to help establish and maintain polarized actomyosin that drives cell internalization. Vinculin depletion leads to compromised MR formation, CA depolarization, and subsequent CIC failure. In summary, we suggest that the vinculin-enriched MR, in addition to CA and AJ, is another core element essential for entosis.

p53-dependent elimination of aneuploid mitotic offspring by entosis

Entosis was proposed to promote aneuploidy and genome instability by cell-in-cell mediated engulfment in tumor cells. We reported here, in epithelial cells, that entosis coupled with mitotic arrest functions to counteract genome instability by targeting aneuploid mitotic progenies for engulfment and elimination. We found that the formation of cell-in-cell structures associated with prolonged mitosis, which was sufficient to induce entosis. This process was controlled by the tumor suppressor p53 (wild-type) that upregulates Rnd3 expression in response to DNA damages associated with prolonged metaphase. Rnd3-compartmentalized RhoA activities accumulated during prolonged metaphase to drive cell-in-cell formation. Remarkably, this prolonged mitosis-induced entosis selectively targets non-diploid progenies for internalization, blockade of which increased aneuploidy. Thus, our work uncovered a heretofore unrecognized mechanism of mitotic surveillance for entosis, which eliminates newly born abnormal daughter cells in a p53-dependent way, implicating in the maintenance of genome integrity.

Role and dynamics of vacuolar pH during cell-in-cell mediated death

The nonautonomous cell death by entosis was mediated by the so-called cell-in-cell structures, which were believed to kill the internalized cells by a mechanism dependent on acidified lysosomes. However, the precise values and roles of pH critical for the death of the internalized cells remained undetermined yet. We creatively employed keima, a fluorescent protein that displays different excitation spectra in responding to pH changes, to monitor the pH dynamics of the entotic vacuoles during cell-in-cell mediated death. We found that different cells varied in their basal intracellular pH, and the pH was relatively stable for entotic vacuoles containing live cells, but sharply dropped to a narrow range along with the inner cell death. In contrast, the lipidation of entotic vacuoles by LC3 displayed previously underappreciated complex patterns associated with entotic and apoptotic death, respectively. The pH decline seemed to play distinct roles in the two types of inner cell deaths, where apoptosis is preceded with moderate pH decline while a profound pH decline is likely to be determinate for entotic death. Whereas the cancer cells seemed to be lesser tolerant to acidified environments than noncancerous cells, manipulating vacuolar pH could effectively control inner cell fates and switch the ways whereby inner cell die. Together, this study demonstrated for the first time the pH dynamics of entotic vacuoles that dictate the fates of internalized cells, providing a rationale for tuning cellular pH as a potential way to treat cell-in-cell associated diseases such as cancer.

SARS-CoV-2 Targets by the pscRNA Profiling of ACE2, TMPRSS2 and Furin Proteases

The cellular targets of SARS-CoV-2, the novel coronavirus causing the COVID-19 pandemic, is still rudimentary. Here, we incorporated the protein information to analyze the expression of ACE2, the SARS-CoV-2 receptor, together with co-factors, TMPRSS2 and Furin, at single-cell level in situ, which we called protein-proofed single-cell RNA (pscRNA) profiling. Systemic analysis across 36 tissues revealed a rank list of candidate cells potentially vulnerable to SARS-CoV-2. The top targets are lung AT2 cells and macrophages, then cardiomyocytes and adrenal gland stromal cells, followed by stromal cells in testis, ovary, and thyroid, whereas the kidney proximal tubule cells, cholangiocytes, and enterocytes are less likely to be the primary SARS-CoV-2 targets. Actually, the stomach may constitute a physical barrier against SARS-CoV-2 as the acidic environment (pH < 2.0) could completely inactivate SARS-CoV-2 pseudo-viruses. Together, we provide a comprehensive view on the potential SARS-CoV-2 targets by pscRNA profiling.

Diagnostic efficacy of contrast-enhanced ultrasound versus MRI Liver Imaging Reporting and Data System (LI-RADS) for categorising hepatic observations in patients at risk of hepatocellular carcinoma

AIM

To investigate the diagnostic efficacy of the contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for categorising hepatic observations in patients at risk of hepatocellular carcinoma (HCC) compared with magnetic resonance imaging (MRI) LI-RADS.

MATERIALS AND METHODS

CEUS and MRI data were analysed retrospectively according to the LI-RADS scheme. Follow-up results and pathological findings served as the reference standard. Receiver operating characteristic (ROC) curve analysis was used to reveal the area under the curve (AUC). The sensitivity, specificity, accuracy, and positive (PPV) and negative predictive values (NPV) of LR-5 for determining HCC were calculated. The intra-observer agreement of CEUS LI-RADS was also evaluated.

RESULTS

Eighty-four patients with 86 liver observations were enrolled. Forty-two observations were classified as LR-5 by CEUS and MRI, respectively. Based on the reference standard, 53 nodules were HCC. The AUCs were 0.876 for CEUS and 0.873 for MRI, without a significant difference (Z=0.050, p=0.960). The sensitivity, specificity, PPV, NPV, and accuracy of LR-5 was 75.47%, 93.94%, 95.24%, 70.45%, 82.56% with CEUS and 73.58%, 90.9%, 92.86%, 68.18%, 80.23% with MRI, respectively. There was a significant difference in specificity between CEUS and MRI (p=0.006). There was almost perfect agreement for arterial phase hyperenhancement (k=0.870), substantial agreement for washout (k=0.765) and CEUS LI-RADS category (k=0.787).

CONCLUSION

The CEUS LI-RADS scheme is an effective diagnostic tool for HCC with substantial intra-observer reliability. The diagnostic performance of CEUS LI-RADS for determining HCC was comparable to MRI LI-RADS, and the specificity of CEUS LR-5 was significantly higher.

PCDH7 Inhibits the Formation of Homotypic Cell-in-Cell Structure

Though homotypic cell-in-cell (hoCIC) structures are implicated in the development and progression of multiple human tumors, the molecular mechanisms underlying their formation remain poorly understood. We found that the expression of Protocadherin-7 (PCDH7), an integral membrane protein, was negatively associated with the formation of hoCIC structures. Overexpression of PCDH7 efficiently inhibits, while its depletion significantly enhances, hoCIC formation, which was attributed to its regulation on intercellular adhesion and contractile actomyosin as well. Via directly interacting with and inactivating PP1α, a protein phosphatase that dephosphorylates pMLC2, PCDH7 increases the level of pMLC2 leading to enhanced actomyosin at the intercellular region and compromised hoCIC formation. Remarkably, PCDH7 enhanced anchorage-independent cell growth in a hoCIC-dependent manner. Together, we identified PCDH7 as the first trans-membrane protein that inhibits hoCIC formation to promote tumor growth.

High Frequency of Cell-in-Cell Formation in Heterogeneous Human Breast Cancer Tissue in a Patient With Poor Prognosis: A Case Report and Literature Review

Cell cannibalism is a unique pathological phenomenon that has been observed at low frequency in a variety of human tumor samples (<0.5%), including breast cancer. Cannibalistic cells typically form cell-in-cell (CIC) structures characterized by enclosure of one cell or more by another, mediating a novel type of cell death "entosis," which was proposed as the type IV cell death. A large number of CIC structures are generally associated with malignant transformation and progression, and they are believed to be primed by and form among heterogeneous cells. However, there is currently no in vivo evidence from human tumor samples. In this case report, covering a 37-year-old female breast cancer patient, we observed considerable heterogeneity and proliferative activity (>70% Ki-67 positivity) in her breast cancer cells, accompanied by high frequency of CIC formation (~6%) and poor prognosis. We consider this a typical example of cell cannibalism, supporting a role of heterogeneity in cell-in-cell formation and malignant progression. It may serve as a pretest basis for further investigations of cell-in-cell biology and breast cancer treatment.

Subtype-Based Prognostic Analysis of Cell-in-Cell Structures in Early Breast Cancer

Though current pathological methods are greatly improved, they provide rather limited functional information. Cell-in-cell structures (CICs), arising from active cell–cell interaction, are functional surrogates of complicated cell behaviors within heterogeneous cancers. In light of this, we performed the subtype-based CIC profiling in human breast cancers by the “EML” multiplex staining method, and accessed their values as prognostic factors by Cox univariate, multivariate, and nomogram analysis. CICs were detected in cancer specimens but not in normal breast tissues. A total of five types of CICs were identified with one homotypic subtype (91%) and four heterotypic subtypes (9%). Overall CICs (oCICs) significantly associated with patient overall survival (OS) (P = 0.011) as an independent protective factor (HR = 0.423, 95% CI, 0.227–0.785; P = 0.006). Remarkably, three CICs subtypes (TiT, TiM, and MiT) were also independent prognostic factors. Among them, higher TiT, from homotypic cannibalism between tumor cells, predicted longer patient survival (HR = 0.529, 95% CI, 0.288–0.973; P = 0.04) in a way similar to that of oCICs and that (HR = 0.524, 95% CI, 0.286–0.962; P = 0.037) of heterotypic TiM (tumor cell inside macrophage); conversely, the presence of MiT (macrophage inside tumor cell) predicted a death hazard of 2.608 (95% CI, 1.344–5.063; P = 0.05). Moreover, each CIC subtype tended to preferentially affect different categories of breast cancer, with TiT (P < 0.0001) and oCICs (P = 0.008) targeting luminal B (Her2⁺), TiM (P = 0.011) targeting HR⁻ (Her2⁺/HR⁻ and TNBC), and MiT targeting luminal A (P = 0.017) and luminal B (Her⁻) (P = 0.006). Furthermore, nomogram analysis suggested that CICs impacted patient outcomes in contributions comparable (for oCICs, TiT, and TiM), or even superior (for MiT), to TNM stage and breast cancer subtype, and incorporating CICs improved nomogram performance. Together, we propose CICs profiling as a valuable way for prognostic analysis of breast cancer and that CICs and their subtypes, such as MiT, may serve as a type of novel functional markers assisting clinical practices.

[An analysis of medical X-ray examination frequency in ten hospitals in Tianjin, China]

Objective: To investigate the usage frequency of radiological diagnosis devices in ten hospitals in Tianjin, China, and to provide a basis for the survey of medical radiation frequency in Tianjin. Methods: Ten hospitals from the ten districts in Tianjin were enrolled as subjects by a convenient sampling method. A survey was conducted to assess the general information and radiological diagnosis device information and usage frequency in those hospitals in 2016. The radiological examination frequency in Tianjin was estimated. Results: A total of 610 458 patients received radiological examinations in the sampled hospitals in 2016. In those patients, 371 882 received X-ray examinations for imaging and 238 576 for computed tomography (CT) ; there were slightly more female patients than male patients, suggesting a relatively equal gender distribution; patients older than 40 years accounted for 65.53%, which was the highest among all the age groups. Different types of radiological diagnosis devices were mostly used in tertiary and secondary hospitals. In Tianjin, the estimated frequency of X-ray examination for imaging and CT scanning was 451 and 188 per thousand people, respectively, in 2016. Conclusion: The frequency of radiological diagnosis is relatively high in the ten hospitals in Tianjin. The investigation of medical radiation in Tianjin needs to be improved.

Expression profiling identified IL-8 as a regulator of homotypic cell-in-cell formation

Homotypic cell-in-cell (CIC) structures forming between cancer cells were proposed to promote tumor evolution via entosis, a nonapoptotic cell death process. However, the mechanisms underlying their formation remained poorly understood. We performed a microarray analysis to identify genes associated with homotypic CIC formation. Cancer cells differing in their ability to form homotypic CIC structures were selected for the study. Association analysis identified 73 probe sets for 62 candidate genes potentially involved in CIC formation. Among them, twenty-one genes were downregulated while 41 genes were upregulated. Pathway analysis identified a gene interaction network centered on IL-8, which was upregulated in high CIC cells. Remarkably, CIC formation was significantly inhibited by IL-8 knockdown and enhanced upon recombinant IL-8 treatment, which correlated with altered cell-cell adhesion and expression of adhesive molecules such as P-cadherin and γ-catenin. Together, our work identified IL-8 as a positive regulator of homotypic CIC formation via enhancing intercellular adhesion. [BMB Reports 2018; 51(8): 412-417].

CDKN2A inhibits formation of homotypic cell-in-cell structures

Cell-in-cell (CIC) structures, characterized by enclosure of one or more cells within another cell, were extensively documented in human cancers. Although elevated CIC formation was found in cancers with CDKN2A inactivation, a causal link between them remains to be established. We reported here that inhibiting CDKN2A expression effectively promoted homotypic CIC formation, whereas ectopic overexpression of p16INK4a or p14ARF, two proteins encoded by CDKN2A gene, significantly suppressed CIC formation in MCF7 cells. The regulation of CIC formation by CDKN2A was tightly correlated with subcellular redistribution of E-cadherin, F-actin rearrangement and reduced phosphorylation of myosin light chain 2 (p-MLC2), consistent with which, CDKN2A expression imparted cells winner/outer identity in competition assay. Moreover, CIC formation negatively correlates with p16INK4a expression in human breast cancers. Thus, our work identifies CDKN2A as the first tumor suppressor whose inactivation promotes homotypic CIC formation in human cancer cells.

Studies of Adsorbents for Hemoperfusion in Artificial Liver Support. I. Preparation and in Vitro Studies of Cross-Linked Agarose Beads Entrapped Activated Charcoal (CAAC)

A new method for the preparation of the cross-linked agarose beads entrapped activated charcoal (CAAC) is reported. Since the agarose-encapsulated adsorbents reported elsewhere cannot stand high temperature for sterilization, the CAAC has the advantage of thermal stability to withstand autoclave at 121°C. for ½ hour without breaking up or melting. A further advantage of CAAC is that the adsorbent has a much better consistency with good mechanical strength and elasticity, so that it can be formed into beads of a diameter less than 1 mm. This will not only give a better adsorption capacity than larger beads, but can also assure a better blood flow than soft beads which usually interfere in hemoperfusion due to compacting and sludging. Preliminary investigations indicate that the CAAC is relatively hemocompatible.

Rhabdomyolysis and fluctuating asymptomatic hyperCKemia associated with CACNA1S variant

BACKGROUND AND PURPOSE

CACNA1S encodes Ca_v 1.1, a voltage sensor for muscle excitation-contraction coupling, which activates the ryanodine receptor 1 (RYR1) leading to calcium release from the sarcoplasmic reticulum. CACNA1S mutations cause hypokalemic periodic paralysis, malignant hyperthermia and congenital myopathy. RYR1 mutations result in congenital myopathy, malignant hyperthermia and rhabdomyolysis.

METHODS

The aim was to describe a novel phenotype associated with a CACNA1S variant at a site previously linked to hypokalemic periodic paralysis.

RESULTS

The patient presented with fluctuating asymptomatic creatine kinase elevation after an episode of rhabdomyolysis but has no history of periodic paralysis. His muscle biopsy showed core-like structures occurring mainly in type 2 fibers. He carries a novel Ca_v 1.1 variant (p.Arg528Leu) affecting a highly conserved amino acid. Different mutations at the same location cause hypokalemic periodic paralysis.

CONCLUSION

This case underscores the similarity between the phenotypes caused by mutations in two functionally linked proteins, RYR1 and Ca_v 1.1.

Cholesterol inhibits entotic cell-in-cell formation and actomyosin contraction

Cell-in-cell structure is prevalent in human cancer, and associated with several specific pathophysiological phenomena. Although cell membrane adhesion molecules were found critical for cell-in-cell formation, the roles of other membrane components, such as lipids, remain to be explored. In this study, we attempted to investigate the effects of cholesterol and phospholipids on the formation of cell-in-cell structures by utilizing liposome as a vector. We found that Lipofectamine-2000, the reagent commonly used for routine transfection, could significantly reduce entotic cell-in-cell formation in a cell-specific manner, which is correlated with suppressed actomyosin contraction as indicated by reduced β-actin expression and myosin light chain phosphorylation. The influence on cell-in-cell formation was likely dictated by specific liposome components as some liposomes affected cell-in-cell formation while some others didn't. Screening on a limited number of lipids, the major components of liposome, identified phosphatidylethanolamine (PE), stearamide (SA), lysophosphatidic acid (LPA) and cholesterol (CHOL) as the inhibitors of cell-in-cell formation. Importantly, cholesterol treatment significantly inhibited myosin light chain phosphorylation, which resembles the effect of Lipofectamine-2000, suggesting cholesterol might be partially responsible for liposomes' effects on cell-in-cell formation. Together, our findings supporting a role of membrane lipids and cholesterol in cell-in-cell formation probably via regulating actomyosin contraction.

MiR-216b increases cisplatin sensitivity in ovarian cancer cells by targeting PARP1

Cisplatin resistance hinders the efficacy of chemotherapy in ovarian cancer. MicroRNAs (miRs) have been implicated in drug resistance in anti-cancer chemotherapy. We compared the expression profiles of miRs between cisplatin-resistant and cisplatin-sensitive ovarian cancer cells, and found that miR-216b was significantly downregulated in cisplatin-resistant ovarian cancer cells. To investigate its molecular mechanism, we performed cell viability and apoptosis assays in cisplatin-resistant ovarian cells, and found that miR-216b reduced cell viability and promoted apoptosis. Although 4 potential targets were obtained through bioinformatics, only the mRNA level of poly(ADP-ribose) polymerase (PARP)-1 was significantly regulated by miR-216b. Disruption of the complementary binding sequence of miR-216b on the 3'-untranslated region (3'-UTR) of the PARP1 led to the loss of miR-216b targeting. Spearman's correlation coefficient of the levels of miR-216b and PARP1 mRNA from 51 human ovarian cancer specimens also showed a significantly negative correlation between them. Importantly, the improved cisplatin sensitivity induced by miR-216b was markedly reversed by PARP1 overexpression. Tumor formation assay in nude mice further provided an evidence on the suppressive role of miR-216b in tumor growth. Taken together, this study demonstrated that a new miRNA, miR-216b, was involved in cisplatin resistance in ovarian cancer, which could be regarded as a potential sensitizer in cisplatin chemotherapy.

High Free Fatty Acid Levels Are Associated with Stroke Recurrence and Poor Functional Outcome in Chinese Patients with Ischemic Stroke

BACKGROUND

The aim of this study is to investigate whether serum and cerebrospinal fluid (CSF) free fatty acid (FFA) levels are associated with outcome and recurrence in a cohort of patients with an acute ischemic stroke (AIS).

METHODS

From December 2013 to May 2015, patients with first-ever AIS were included. FFA level and NIH stroke scale (NIHSS) were measured at the time of admission. Logistic regression analysis was used to evaluate the stroke outcome and recurrence according to FFA level. Clinical follow-up was performed at 6 month.

RESULTS

In our study, we studied 296 patients (52.7% male). We have found a positive correlation between serum and CSF levels of FFA. Patients with a poor outcome and recurrence had significantly increased FFA serum and CSF levels on admission (all p<0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that FFA was an independent predictor of poor functional outcome and recurrence. Odds ratios (OR) values were more significant for the higher levels of FFA.

CONCLUSION

In summary, baseline serum and CSF FFA level were associated with stroke poor function outcome and recurrence, suggesting an effect of FFA on disease course in AIS.

Roles of Hippo signaling in lung cancer

Lung cancer is the leading cause of cancer-related mortality in the world, with more than 1 million deaths/year. Over the past years, lung cancer treatment has been based on cytotoxic agents and an improvement in the outcome and quality of life for patients has been observed. However, it has become clear that additional therapeutic strategies are urgently required to provide an improved survival benefit for patients. A major intracellular signaling pathway, the Hippo signaling pathways have been extensively studied in neoplasia, including lung cancer. Furthermore, the study of constitutively activated receptor and their downstream signaling mediators has become a promising new field of investigation for lung cancer treatment. Nevertheless for lung cancer, this approach has not been successful yet. Here, we will review the molecular basis of Hippo signaling in lung cancer and further discuss the therapeutic potential of multi-targeted strategies involving Yes-associated protein inhibitors.