lncRNA NORAD, soluble ICAM1 and their correlations may be related to the regulation of the tumor immune microenvironment in laryngeal squamous cell carcinoma (LSCC)

NORAD, non-coding RNA activated by DNA damage, is a Long non-coding RNA (lncRNA) transcript that modulates genome stability and has been reported to be dysregulated in different cancers. Although it has been reported to be upregulated in tumor cells mostly for solid organ cancers, it has also been reported to be downregulated in some cancers. Although the pathophysiological mechanism is not fully understood, a negative correlation between NORAD and intercellular cell adhesion molecule-1 (ICAM-1) has been shown in experimental models, but this situation has not been evaluated in terms of cancer. We aimed to evaluate the potential roles of these two biomarker candidates together and separately in the clinicopathological axis in Laryngeal squamous cell carcinoma (LSCC) in a case-control study setting. The interactions of NORAD and ICAM1 at the RNA level were evaluated interactively by the RIblast program. sICAM1 (soluble intercellular cell adhesion molecule-1) levels were determined by ELISA in one hundred and five individuals (forty-four LSCC, sixty-one control) and lncRNA NORAD expression in eighty-eight tissues (forty-four LSCC tumors, forty-four tumor-free surrounding tissues) was determined by Real-time PCR. While the energy treesholud was - 16 kcal/mol between NORAD and ICAM1, the total energy was 176.33 kcal/mol, and 9 base pair pairings from 4 critical points were detected. NORAD expression level was found to be higher in tumor surrounding tissue compared to tumor tissue, and sICAM1 was higher in the control group compared to LSCC (p = 0.004; p = 0.02). NORAD discreminte tumor surrounding tissue from tumor (AUC: 0.674; optimal sensitivity:87.50%; optimal specificity 54.55%; cut-off point as >1.58 fold change; P = 0.034). The sICAM1 level was found to be higher in the control (494,814 ± 93.64 ng/L) than LSCC (432.95 ± 93.64 ng/L) (p = 0.02). sICAM1 discreminte control group from LSCC (AUC: 0.624; optimal sensitivity 68,85%; optimal specificity 61,36%; cut-off point ≤115,0 ng/L; (p = 0.033). A very strong negative correlation was found between NORAD expression and patients' sICAM1 levels (r = -.967; n = 44; p = 0.033). sICAM1 levels were found to be 1.63 times higher in NORAD downregulated subjects compared to upregulated ones (p = 0.031). NORAD was 3.63 times higher in those with alcohol use, and sICAM 1 was 5.77 times higher in those without distant organ metastasis (p = 0.043; 0.004). The increased NORAD expression in the tumor microenvironment in LSCC, the activation of T cells via TCR signaling, and the decrease of sICAM in the control group in correlation with NORAD suggests that ICAM1 may be needed as a membrane protein in the tumor microenvironment. NORAD and ICAM1 may be functionally related to tumor microenvironment and immune control in LSCC.

Challenges of CYP21A2 genotyping in children with 21-hydroxylase deficiency: determination of genotype-phenotype correlation using next generation sequencing in Southeastern Anatolia

BACKGROUND/PURPOSE

Although it is known that there is generally a good correlation between genotypes and phenotypes, the number of studies reporting discrepancies has recently increased, exclusively between milder genotypes and their phenotypes due to the complex nature of the CYP21A2 gene and methodological pitfalls. This study aimed to assess CYP21A2 genotyping in children with 21-hydroxylase deficiency (21-OHD) and establish their predictive genotype-phenotype correlation features using a large cohort in Southeastern Anatolia's ethnically diverse population.

METHODS

The patients were classified into three groups: salt-wasting (SW), simple virilizing (SV) and non-classical (NC). The genotypes were categorized into six groups due to residual enzyme activity: null-A-B-C-D-E. CYP21A2 genotyping was performed by sequence-specific primer and sequenced with next generation sequencing (NGS), and the expected phenotypes were compared to the observed phenotypes.

RESULTS

A total of 118 unrelated children with 21-OHD were included in this study (61% SW, 24.5% SV and 14.5% NC). The pathogenic variants were found in 79.5% of 171 mutated alleles (60.2%, 22.2%, and 17.6% in SW, SV and NC, respectively). Patient distribution based on genotype groups was as follows: null-16.1%, A-41.4%, B-6.0%, C-14.4%, E-22%). In2G was the most common pathogenic variant (33.9% of all alleles) and the most common variant in the three phenotype groups (SW-38.8%, SV-22.2% and NC-23.3%). The total genotype-phenotype correlation was 81.5%. The correlations of the null and A groups were 100% and 76.1%, respectively, while it was lower in group B and poor in group C (71.4% and 23.5%, respectively).

CONCLUSION

This study revealed that the concordance rates of the severe genotypes with their phenotypes were good, while those of the milder genotypes were poor. The discrepancies could have resulted from the complex characteristics of 21-OHD genotyping and the limitations of using NGS alone without integrating with other comprehensive methods.

Immunophenotypic analysis of lymphocyte subsets in newborns with biotinidase deficiency

BACKGROUND/AIM

Biotin is a vital micronutrient that plays a role in metabolic homeostasis and the regulation of innate and adaptive immune system functions. Biotinidase deficiency (BTD) leads to impairment in biotin-dependent immune functions. This study focused on immunophenotypic analysis of lymphocyte subsets in newborns with BTD.

PATIENTS AND METHODS

A total of 181 (95 female and 86 male; 114 had BTD and 67 were healthy) newborns underwent biotinidase enzyme activity, molecular and lymphocyte immunophenotyping analyses. BTD is classified into four biochemical phenotypes: profound, partial, heterozygous and normal. The following lymphocyte subsets were studied in all participants: total B lymphocyte (CD19), total T lymphocyte (CD3), helper T lymphocyte (CD3/CD4), cytotoxic T lymphocyte (CTL) (CD3/CD8), natural killer T lymphocyte (CD16/56) and a T-lymphocyte activation marker (HLA-DR).

RESULTS

The percentages of lymphocyte subsets were similar in newborns with and without BTD. In all newborns with BTD, the mean CD3/CD4 levels were higher in females, while the CD3/CD8 levels were higher in males (P < .001 for each). In female and male newborns, the CD3/CD4 levels were 53.83 ± 9.46 and 16.82 ± 5.19, respectively, and the CD3/CD8 levels were 48.80 ± 8.65 and 21.48 ± 6.02, respectively. A moderate negative correlation was found between CD3/CD4 and CD3/CD8 in female and male newborns (r_female  = -0.488, r_male  = -0.574, P < .001).

CONCLUSION

This study showed that although there were no differences in the lymphocyte subsets in newborns with BTD, the CD3/CD4 levels were higher in females, and the CD3/CD8 levels were higher in males. In addition, there was a negative correlation between the CD3/CD4 and CD3/CD8 levels in both genders. Although these results indicate sexual dimorphism between CD3/CD4 and CD3/CD8 levels, whether this dissociation is unique to BTD in newborns is not fully clear.

Immunological interpretation of minipuberty: Minipuberty as the driving force of sexual dimorphism in the immune response

BACKGROUND/OBJECTIVE

Although the physiology of minipuberty is well established, it is not fully explained why it occurs. It has been suggested that minipuberty contributes to the development of reproductive organs, somatic growth, cognitive/behavioural and sex-specific brain development. Given the well-known trade-off between the reproductive/endocrine and immune systems in adults, the immunological approach to minipuberty, which is characterized by transient activation of the hypothalamo-pituitary gonadal (HPG) axis, seems to be ignored. This study focused on the relationship of the lymphocyte subsets with gonadotrophin and sex hormones during the minipuberty.

MATERIALS AND METHODS

A total of 121 newborns (58 male) were included in this cross-sectional study. The hormone and lymphocyte subsets studied were as follow: follicle-stimulating hormone (FSH), luteinizing hormone (LH) estradiol (E), testosterone (T), CD19, CD16/56, CD3, CD3/CD4, CD3/CD8 and HLA-DR as lymphocyte activation marker.

RESULTS

The mean FSH levels were higher in females (15.15 ± 10.12 mIU/ml vs, 2.61 ± 1.74 mIU/ml) and LH in males (5.80 ± 2.51 mIU/ml vs. 1.91 ± 12.89 mIU/ml) (P < .001 for each). The mean percentages of the CD3/CD4 levels were higher in females (54.61 ± 6.70% vs. 51.17 ± 6.77%) and CD3/CD8 in males (21.49 ± 4.82% vs. 17.31 ± 3.66%) (P < .001 for each). In the females, the mean FSH levels negatively correlated with CD3/CD4 (r_FSH-CD3/CD4  = -0.423, P = .001) and positively correlated with CD3/CD8 (r_FSH-CD3/CD8  = 0.311, P = .013). In the males, LH positively correlated with CD3/CD4 (r_LH-CD3/CD4  = 0.406, P < .001) and negatively correlated with CD3/CD8 (_rLH-CD3/CD8  = -0.486, P < .001).

CONCLUSION

This study showed that the mean CD3/CD4 levels were higher in female and CD3/CD8 in male newborns, indicating that there was a sexual dimorphism in favour of immunostimulant in females and immunosuppressor components of immune response in males during the minipuberty. These interactions point to sex-specific trade-off between reproductive/endocrine and immune systems, which it reflects the an investment favouring in the reproductive system against the immune response during minipuberty, which is critical period for adult fertility, especially in males.

Clinical and laboratory clues of maturity-onset diabetes of the young and determination of association with molecular diagnosis

BACKGROUND/AIM

Maturity-onset diabetes of the young (MODY) is often misdiagnosed as other types of diabetes because it is overlooked due to atypical clinical presentations. This study aims to reveal the clinical and laboratory clues and examine their compatibility with MODY genotypes.

METHODS

Participants consisted of 230 children with atypical presentations for type1(T1DM) and type2 diabetes mellitus (T2DM). MODY-causing mutations were screened in the following genes:GCK-HNF1A-HNF4A-HNF1B-PDX1-NEUROD1-KLF11-CEL-PAX4-INS-BLK. Clinical and laboratory features were compared between children with MODY and children without MODY.

RESULTS

The most common reasons for MODY screening were as follows (n/%):low daily dose of insulin (DDI) requirement (122/53%), absence of beta-cell antibodies(58/25.3%), coincidental hyperglycemia(26/11.3%), family history of diabetes (12/5.2%), hypoglycemia/hyperglycemia episodes(7/3%), hyperglycemia related to steroids(3/1.4%) and renal glycosuria(2/0.8%). The markers with the most likelihood to distinguish MODY from T1DM were determined as follows: measurable C-peptide in follow-up, family history of early-onset diabetes and low DDI requirement (odds ratio:12.55, 5.53 and 3.43, respectively). The distribution of the most common causative genes in children with MODY(n = 24) is as follows (n/%):GCK(15/62.5%), HNF4A(7/29.1%), HNF1A(1/9.2%) and PDX1(1/9.2%).All children(n = 12) with GCK-MODY(MODY2) were screened for low DDI requirement, while beta-cell negativity was more common in HNF4A-MODY(MODY1).

CONCLUSION

The study shows that measurable C-peptide in follow-up, family history of early-onset diabetes, and low DDI are still remarkable clues to predict MODY in children with misdiagnosed T1DM. In addition, the most common mutations were found in the GCK and HNF4A genes. Among children misdiagnosed with T1DM, a low DDI requirement was found more frequently in MODY2, whereas beta-cell antibody negativity was more common in MODY1.

Chronotypical characteristics and related miR-142-3p levels of children with attention deficit and hyperactivity disorder

To compare children with Attention Deficit and Hyperactivity Disorder (ADHD) and a healthy control group in terms of chronotype characteristics and miRNA-142-3p/miRNA-378 levels. 50 children with ADHD and 44 healthy children were included in the study. Childhood Chronotype Questionnaire was used to identify the chronotype preferences of children. Serum miR-142-3p and miR- 378 levels were determined. Preference for nighttime was higher in children with ADHD. Additionally, a night preference was found to be associated with attention deficit in both groups. While a significant correlation was found between the psychopathology rate in mothers and the presence of ADHD, there was no such correlation in fathers. In the comparison between children with ADHD and the control group, no significant difference was found between miRNA levels. Both the miR-142-3p and miR-378 values of the children with ADHD that have immediate relatives with a psychiatric disorder were lower, compared to control group. We found that shift to night preference in the circadian rhythm was higher and this preference was associated with attention deficit in the children with ADHD. In addition, the presence of psychopathology in the family and the mother's psychopathology affected the miR-142-3p and miR378 levels.