Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A

The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10  TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60  TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.

[Genome sequence analysis of two SARS-CoV-2 virus infections in Inner Mongolia, 2022]

The target gene sequences of the novel coronaviruses obtained by sequencing were compared with the reference sequences to analyze the genetic variation of the two cases of the novel coronaviruses from Inner Mongolia Autonomous Region in 2022 and to explore the sources of infection. The results showed that the two sequences belonged to different evolutionary branches, Delta (AY.122) and Omicron (BA.1.1), respectively. hCoV-19/Inner Mongolia/IVDC-591/2022 had 48 single nucleotide polymorphisms on the genome sequences, sharing 40 nucleotide mutation sites with a Mongolian strain; hCoV-19/Inner Mongolia/IVDC-592/2022 genome shared 57 nucleotide mutation sites with a UK strain, and the nucleotide mutation site identity was 100% (57/57). Phylogenetic analysis showed that the target gene sequences were not directly related to domestic novel coronavirus sequences during the same period, but were related to isolates from Europe and Mongolia.

Develop a Deep Radiomics Model for Predicting the Response to Neoadjuvant Chemoradiotherapy (nCRT) in Patients with Locally Advanced Esophageal Cancer Using Three-Stage Longitudinal CT Images

PURPOSE/OBJECTIVE(S)

To develop a deep radiomics model for predicting the response to neoadjuvant chemoradiotherapy (nCRT) of patients with locally advanced esophageal cancer using three stage longitudinal CT images.

MATERIALS/METHODS

In this study, 189 patients were used to train our model, 80 patients were used to test the performance of the trained model. All patients enrolled in this study underwent nCRT followed by esophagectomy, and all patients underwent three stage longitudinal CT scans (before nCRT, after nCRT and before esophagectomy). The number of radiomics features for each CT images was 2153, the number of longitudinal radiomic features for each patient was 6459. Then, we used the least absolute shrinkage and selection operator regression for feature importance analysis. After this, the selected features of each stage were feed to the disentangled representation network to explore the relationship between the dynamic changes of tumors before and after nCRT and the pathological complete response (pCR). In addition, in order to further evaluate the effect of the time interval between nCRT and esophagectomy on the response to nCRT, we conducted subgroup analysis on different time frames. The performance of our model was evaluated by area under curve (AUC), accuracy, sensitivity and specificity.

RESULTS

Compared with only using single-stage CT images (the AUC of only using before nCRT CT images, after nCRT CT images, before esophagectomy CT images were 73.27%, 74.21%, and 74.95%, respectively), effectively exploring the dynamic changes of the tumor can achieve better performance in predicting the response to nCRT in the testing cohort (the AUC was 84.29%, 95% CI, 81.14%-87.44%). In addition, the performance of our proposed method outperforms any combinations of two stage CT images (the AUC using the CT images of before nCRT and after nCRT was 77.92%, the AUC using the CT images of before nCRT and before esophagectomy was 79.31%, the AUC using the CT images of after nCRT and before esophagectomy was 80.01%). Finally, the results showed that exploring the dynamic changes of the tumor using the three-stage CT images outperformed using single-stage CT images and any combinations of two-stage CT images in predicting the response to nCRT. The study also found that the time interval between nCRT and esophagectomy had some influence on the accuracy of pCR prediction, with the prediction accuracy tending to increase from 1 to 6 weeks and stabilizing after 6 weeks.

CONCLUSION

By exploring the dynamic changes of tumors, the designed disentangled representation network can effectively predict the response to nCRT of patients with esophageal cancer. In addition, the time interval between nCRT and esophagectomy also has a certain impact on the response to nCRT.

A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst

Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.

Pregnancy Loss in Relation to the Risks of Female-Specific Cancers in a Population-Based Cohort and Mendelian Randomization Study - China, 2004-2017

What is already known about this topic?

Limited evidence exists regarding the relationship between pregnancy loss and female-specific cancers within the Chinese population from prospective cohort studies.

What is added by this report?

Terminations were associated with a 13% lower risk of endometrial cancer, whereas stillbirths were related to an 18% higher risk of cervical cancer. Rural residents with a history of pregnancy loss experienced a 19% and 38% increased risk of breast and cervical cancers, respectively, compared to their urban counterparts. Moreover, a positive graded relationship between live births and pregnancy loss on cervical cancer was observed.

What are the implications for public health practice?

This study has significant implications for identifying women at an increased risk for breast and genital cancers and contributes to the development of effective public health strategies for female cancer prevention. Future research on reproductive history, particularly in rural areas, should be given priority in efforts to improve female cancer screening and early detection.

Pre-pregnancy body mass index and risk of maternal or infant complications with gestational diabetes mellitus as a mediator: A multicenter, longitudinal cohort study in China

AIMS

We explored the complex relationships between pre-pregnancy body mass index (pBMI) and maternal or infant complications and the mediating role of gestational diabetes mellitus (GDM) in these relationships.

METHODS

Pregnant women from 24 hospitals in 15 different provinces of China were enrolled in 2017 and followed through 2018. Propensity score-based inverse probability of treatment weighting, logistic regression, restricted cubic spline models, and causal mediation analysis were utilized. In addition, the E-value method was used to evaluate unmeasured confounding factors.

RESULTS

A total of 6174 pregnant women were finally included. Compared to women with a normal pBMI, obese women had a higher risk for gestational hypertension (odds ratio [OR] = 5.38, 95% confidence interval [CI]: 3.48-8.34), macrosomia (OR = 2.65, 95% CI: 1.83-3.84), and large for gestational age (OR = 2.05, 95% CI: 1.45-2.88); 4.73% (95% CI: 0.57%-8.88%), 4.61% (95% CI: 0.51%-9.74%), and 5.02% (95% CI: 0.13%-10.18%) of the associations, respectively, were mediated by GDM. Underweight women had a high risk for low birth weight (OR = 1.42, 95% CI: 1.15-2.08) and small for gestational age (OR = 1.62, 95% CI: 1.23-2.11). Dose-response analyses indicated that 21.0 kg/m² may be the appropriate tipping point pBMI for risk for maternal or infant complications in Chinese women.

CONCLUSION

A high or low pBMI is associated with the risk for maternal or infant complications and partly mediated by GDM. A lower pBMI cutoff of 21 kg/m² may be appropriate for risk for maternal or infant complications in pregnant Chinese women.

Constraints on Heavy Decaying Dark Matter from 570 Days of LHAASO Observations

The kilometer square array (KM2A) of the large high altitude air shower observatory (LHAASO) aims at surveying the northern γ-ray sky at energies above 10 TeV with unprecedented sensitivity. γ-ray observations have long been one of the most powerful tools for dark matter searches, as, e.g., high-energy γ rays could be produced by the decays of heavy dark matter particles. In this Letter, we present the first dark matter analysis with LHAASO-KM2A, using the first 340 days of data from 1/2-KM2A and 230 days of data from 3/4-KM2A. Several regions of interest are used to search for a signal and account for the residual cosmic-ray background after γ/hadron separation. We find no excess of dark matter signals, and thus place some of the strongest γ-ray constraints on the lifetime of heavy dark matter particles with mass between 10^{5} and 10^{9}  GeV. Our results with LHAASO are robust, and have important implications for dark matter interpretations of the diffuse astrophysical high-energy neutrino emission.

The effect of driving pressure-guided ventilation strategy on the patients with mechanical ventilation: a meta-analysis of randomized controlled trials

OBJECTIVE

The aim of this study was to evaluate the effect of driving pressure (DP) guided ventilation strategy on the patients with mechanical ventilation in the hospital.

MATERIALS AND METHODS

The articles published in PubMed, the Cochrane Library, the China National Knowledge Information (CNKI), Wei Pu, Wan Fang database and Web of Science from inception to September 2021 were retrieved. The Q test and the I² statistic were used to assess statistical heterogeneity. Risks ratios (RR) with 95% confidence intervals (CI) were calculated for mortality.

RESULTS

Seven studies (n=1,405 patients) were included. Five studies reported an adjusted Risk Ratio (RR) of mortality. Compared with the control group, the DP guided ventilation group was associated with a decreased mortality (RR 0.56; 95% confidence interval [CI], 0.39-0.79; p=0.001; I2 = 23%) using a fixed-effects model without significant heterogeneity. The control group had significantly higher driving pressure level than DP guided group (MD -3.03, 95%CI, -5.72 - -0.34, I2=100%, p=0.03); PaO2/FiO2 was significantly higher in DP guided group than in control group (MD 43.37; 95%CI, 12.58-74.15; I2=97%, p=0.006). There was no statistically significant difference in respiratory compliance, complications, platform pressure, duration of mechanical ventilation and the length of hospital stay between the DP guided group and the control group.

CONCLUSIONS

The results suggested that the driving pressure guided ventilation strategy could decrease the mortality and increase oxygenation index (OI). However, further high-quality randomized controlled trials (RCTs) are needed to verify the impact of driving pressure on mechanically ventilated patients.

Longitudinal association of maternal dietary patterns with antenatal depression: Evidence from the Chinese Pregnant Women Cohort Study

BACKGROUND

Limited evidence to show the longitudinal associations between maternal dietary patterns and antenatal depression (AD) from cohort studies across the entire gestation period.

METHODS

Data came from the Chinese Pregnant Women Cohort Study. The qualitative food frequency questionnaire (Q-FFQ) and Edinburgh Postnatal Depression Scale (EPDS) were used to collect diet and depression data. Dietary patterns were derived by using factor analysis. Generalized estimating equation models were used to analyze the association between diet and AD.

RESULTS

A total of 4139 participants finishing 3-wave of follow-up were finally included. Four constant diets were identified, namely plant-based, animal-protein, vitamin-rich and oily-fatty patterns. The prevalence of depression was 23.89%, 21.12% and 22.42% for the first, second and third trimesters. There were reverse associations of plant-based pattern (OR:0.85, 95%CI:0.75-0.97), animal-protein pattern (OR:0.85, 95%CI:0.74-0.99) and vitamin-rich pattern (OR:0.58, 95%CI:0.50-0.67) with AD, while a positive association between oily-fatty pattern and AD (OR:1.47, 95%CI:1.29-1.68). Except for the plant-based pattern, other patterns had linear trend relationships with AD (P_trend < 0.05). Moreover, a 1-SD increase in vitamin-rich pattern scores was associated with a 20% lower AD risk (OR:0.80, 95%CI:0.76-0.84), while a 1-SD increase in oily-fatty pattern scores was associated with a 19% higher risk (OR:1.19, 95%CI:1.13-1.24). Interactions between dietary patterns and lifestyle habits were observed.

LIMITATIONS

The self-reported Q-FFQ and EPDS may cause recall bias.

CONCLUSIONS

There are longitudinal associations between maternal dietary patterns and antenatal depression. Our findings are expected to provide evidence for a dietary therapy strategy to improve or prevent depression during pregnancy.

POS0833 DIFFERENCES BETWEEN AVACOPAN AND PREDNISONE FOR THE TREATMENT OF ANCA-ASSOCIATED VASCULITIS AT DIFFERENT THRESHOLDS OF GLUCOCORTICOID TOXICITY

Background

Treatment with glucocorticoids (GCs) for ANCA-associated vasculitis (AAV) is associated with substantial toxicity. The Glucocorticoid Toxicity Index (GTI) was developed to measure change in GC toxicity over time.1 Data from the composite GTI domains provide both an Aggregate Improvement Score (AIS) and a Cumulative Worsening Score (CWS) of GC toxicity, permitting the instrument to compare both improvement and worsening of GC toxicity across treatment groups. The GTI was a pre-specified secondary outcome in ADVOCATE, a randomized, double-blind, placebo-controlled trial in patients with AAV that aimed to replace a GC taper with avacopan, a complement C5a receptor inhibitor. Patients were randomized to either avacopan or a prednisone taper on a background of either cyclophosphamide or rituximab.2 In ADVOCATE, the median GC exposure was 400 mg vs. 2939 mg in the avacopan and prednisone groups, respectively, which is an 86% median reduction in GC exposure from all sources. Remission rates were comparable in the two groups at 26 weeks (72.3% vs. 70.1%, respectively), and avacopan was superior at 52 weeks (sustained remission in 65.7% vs. 54.9%).2

Objectives

To compare GC toxicity between the treatment groups at three different thresholds of GC toxicity, beginning with the minimum detectable difference (MDD) of the GTI.

Methods

The MDD for the GTI (10 points) was calculated in the initial validation phase of the instrument. Thus, any GTI score > 10 points may be considered to represent a true change in GC toxicity. We compared the two groups at GTI thresholds of 10, 20, and 30 points for both the CWS and AIS. The CWS comprises a total of all GC-related toxicities that have occurred in the GTI between baseline and 26 weeks (time of primary outcome). The AIS, in contrast, allows toxicities to be added if they are new or subtracted if they improve. Higher CWS and AIS values indicate greater severity of GC toxicity. The two scores together capture the nuances of longitudinal GC toxicity across multiple domains. We compared the percentages of those in the two treatment groups who exceeded GTI threshold values of 10, 20, and 30 points in the CWS or AIS.

Results

The percentages of patients exceeding the specified AIS thresholds differentiated the avacopan group from the prednisone group (48.2% vs. 60.4%, respectively, at the 10-point threshold, p=0.02; 29.5% vs. 45.1% at the 20-point threshold, p=0.003; and 18.1% vs. 33.5% at the 30-point threshold, p=0.001) (Table 1). The CWS differentiated avacopan from prednisone at the 20- and 30-point thresholds (57.8% vs 73.2%, respectively, at 20 points, p=0.002; 41.0% vs 55.5% at 30 points, p=0.007).

Table 1.

Percentages of Patients in ADVOCATE Exceeding Selected GTI Thresholds at Week 26

GTI threshold/study groupn (%) exceeding CWS thresholdp-valuen (%) exceeding AIS thresholdp-valueGTI worsening > 10 points Avacopan (N = 164)138 (83.1%)0.14780 (48.2%)0.022 Prednisone (N = 166)144 (87.8%)99 (60.4%)GTI worsening > 20 points Avacopan (N = 164)96 (57.8%)0.00249 (29.5%)0.003 Prednisone (N = 166)120 (73.2%)74 (45.1%)GTI worsening > 30 points Avacopan (N = 164)68 (41.0%)0.00730 (18.1%)0.001 Prednisone (N = 166)91 (55.5%)55 (33.5%)

AIS, Aggregate Improvement Score; CWS, Cumulative Worsening Score; GTI, Glucocorticoid Toxicity Index

Conclusion

Among patients with AAV, treatment with avacopan was associated with lower GC toxicity across multiple GTI thresholds compared to treatment with prednisone, consistent with the substantial reduction in total GC exposure associated with avacopan. The GTI scores differentiated the two treatment groups effectively through a composite of GC toxicity domains.

References

[1]McDowell PJ, Stone JH, Zhang Y, et al. Quantification of Glucocorticoid-Associated Morbidity in Severe Asthma Using the Glucocorticoid Toxicity Index. J Allergy Clin Immunol Pract. 2021; 9:365-72.

[2]Jayne DRW, Merkel PA, Schall TJ, et al. Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med. 2021;384:599-609.

Disclosure of Interests

Naomi Patel: None declared, Yuqing Zhang: None declared, David Jayne Speakers bureau: Amgen, Vifor, Consultant of: Astra-Zeneca, BMS, Boehringer-Ingelheim, Chemocentryx, GSK, Novartis, Otsuka, Roche/Genentech, Takeda, UCB & Vifor, Grant/research support from: GSK, Roche/Genentech, Peter A Merkel Consultant of: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, Immagene, InflaRx, Jannsen, Kiniksa, Kyverna, Magenta, MiroBio, Novartis, Pfizer, Regeneron, Sparrow, Takeda, Talaris, Grant/research support from: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Sanofi, Takeda, Huibin Yue Shareholder of: ChemoCentryx, Employee of: ChemoCentryx, Pirow Bekker Shareholder of: ChemoCentryx, Consultant of: ChemoCentryx, Employee of: ChemoCentryx, John H. Stone Shareholder of: Steritas, Consultant of: ChemoCentryx, Roche/Genentech, Sanofi, Bristol-Myers Squib, AbbVie, InflaRx, Kyverna, Novartis, Q32Bio, Zenas, Horizon, Grant/research support from: Roche/Genentech, Horizon, Sanofi, Bristol-Myers Squib

OP0180 EFFECT OF AVACOPAN ON RELAPSE RATES AND RELAPSE-FREE TIME IN PATIENTS WITH ANCA-ASSOCIATED VASCULITIS, RESULTS OF THE PHASE 3 ADVOCATE STUDY

Background

For patients with ANCA-associated vasculitis, both failure to achieve remission and relapse after achieving remission are associated with worse long-term outcomes. Avacopan, an oral selective inhibitor of the C5a receptor, is approved for the treatment of ANCA-associated vasculitis. The phase 3 ADVOCATE study tested daily avacopan as a substitute for a standard oral glucocorticoid taper regimen. At week 26, the avacopan group achieved a remission rate (72.3%) comparable to the prednisone group (70.1%) and superior sustained remission at Week 52 (65.7% avacopan vs. 54.9% prednisone groups, respectively [1]). The median (mean) total glucocorticoid dose from all sources was 400 mg (1349 mg) in the avacopan group versus 2939 mg (3655 mg) in the prednisone group, representing 86% (63%) lower glucocorticoid exposure in the avacopan group. Compared with the prednisone group, the avacopan group showed a reduction in the proportion of patients who relapsed after achieving remission and, among patients who achieved remission, a longer time to relapse (1).

Objectives

To further characterize efficacy, additional post-hoc analyses compared the avacopan and prednisone groups regarding i) failure to achieve remission and ii) relapse after achieving remission.

Methods

ADVOCATE, a phase 3, randomized, double-blind, controlled trial in 330 patients, evaluated the efficacy and safety of avacopan. Patients with ANCA-associated vasculitis (new-onset or relapsing disease) were randomized to receive avacopan 30 mg twice daily, or a standard 20-week oral prednisone taper, plus matching placebos, in addition to background immunosuppressant therapy. For the purpose of these analyses, remission was defined as the first timepoint when a BVAS of 0 was achieved. Relapse was defined as worsening of disease, after having previously achieved remission, that involved one or more major or three or more minor items in the BVAS, or one or two minor items in the BVAS recorded at two consecutive study visits.

Two post-hoc sensitivity analyses of patients in the intent-to-treat population examined: i) the proportion of patients who failed to achieve remission, or achieved remission and subsequently relapsed after achieving that remission, and ii) relapse-free time. For patients who achieved remission, relapse-free time was calculated as the number of days from the initial remission achieved to relapse. For patients who failed to achieve remission, relapse-free time was imputed as one day (remission and relapse on the same day). Patients who did not relapse were censored at the time of the last BVAS assessment.

Results

Baseline characteristics and time to achieve initial remission were similar between groups, and the incidence of BVAS 0 at any point in the study occurred approximately equally in both groups (158 avacopan vs. 157 prednisone). In the first sensitivity analysis, the avacopan group showed a reduction in the proportion of patients who failed to achieve remission, or relapsed after remission, compared with the prednisone group (24 [14.5% vs 40 [24.4%], p=0.011). In the second sensitivity analysis that included all patients in the trial, the hazard ratio of relapse-free time for avacopan vs prednisone was 0.57, 95% CI (0.35, 0.96), p=0.029 (log-rank test) (Figure 1).

Figure 1.

Relapse-free time among patients with ANCA-associated vasculitis in ADVOCATE (intention-to-treat population).

Conclusion

In the phase 3 ADVOCATE study of ANCA-associated vasculitis, more patients in the avacopan group compared to the prednisone group achieved remission, and fewer in the avacopan group relapsed after achieving remission. Patients receiving avacopan had a longer relapse-free time compared to the prednisone group. These post-hoc sensitivity analyses provide additional evidence of the efficacy of avacopan for the treatment of ANCA-associated vasculitis.

References

[1]Jayne D et al., Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med 2021 384(7):599-609.

Disclosure of Interests

Peter A. Merkel Consultant of: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, CSL Behring, Dynacure, EMDSerono, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, Immagene, InflaRx, Jannsen, Kiniksa, Kyverna, Magenta, MiroBio, Neutrolis, Novartis, Pfizer, Regeneron, Sparrow, Takeda, Talaris.

Royalties: UpToDate., Grant/research support from: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Eicos, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Sanofi, Takeda, Huibin Yue Shareholder of: ChemoCentryx, Employee of: ChemoCentryx, Emil deGoma Shareholder of: ChemoCentryx, Employee of: ChemoCentryx, Pirow Bekker Shareholder of: ChemoCentryx, Consultant of: ChemoCentryx, David Jayne Paid instructor for: Lecture Fees: Amgen, Vifor, Consultant of: Astra-Zeneca, BMS, Boehringer-Ingelheim, Chemocentryx, GSK, NICE, Novartis, Otsuka, Roche/Genentech, Takeda, UCB & Vifor. Board Member: Aurinia., Grant/research support from: Commercial: GSK, Roche/Genentech; Non-commercial: EU, MRC, NIHR, Versus Arthritis

Cohort profile: the Chinese Pregnant Women Cohort Study and Offspring Follow-up (CPWCSaOF)

PURPOSE

A multicentre prospective cohort study, known as the Chinese Pregnant Women Cohort Study (CPWCS), was established in 2017 to collect exposure data during pregnancy (except environmental exposure) and analyse the relationship between lifestyle during pregnancy and obstetric outcomes. Data about mothers and their children's life and health as well as children's laboratory testing will be collected during the offspring follow-up of CPWCS, which will enable us to further investigate the longitudinal relationship between exposure in different periods (during pregnancy and childhood) and children's development.

PARTICIPANTS

9193 pregnant women in 24 hospitals in China who were in their first trimester (5-13 weeks gestational age) from 25 July 2017 to 26 November 2018 were included in CPWCS by convenience sampling. Five hospitals in China which participated in CPWCS with good cooperation will be selected as the sample source for the Chinese Pregnant Women Cohort Study (Offspring Follow-up) (CPWCS-OF).

FINDINGS TO DATE

Some factors affecting pregnancy outcomes and health problems during pregnancy have been discovered through data analysis. The details are discussed in the 'Findings to date' section.

FUTURE PLANS

Infants and children and their mothers who meet the criteria will be enrolled in the study and will be followed up every 2 years. The longitudinal relationship between exposure (questionnaire data, physical examination and biospecimens, medical records, and objective environmental data collected through geographical information system and remote sensing technology) in different periods (during pregnancy and childhood) and children's health (such as sleeping problem, oral health, bowel health and allergy-related health problems) will be analysed.

TRAIL REGISTRATION NUMBER

CPWCS was registered with ClinicalTrials.gov on 18 January 2018: NCT03403543. CPWCS-OF was registered with ClinicalTrials.gov on 24 June 2020: NCT04444791.

Keratinocytes: innate immune cells in atopic dermatitis

The skin is a unique immune organ that constitutes a complex network of physical, chemical and microbiological barriers against external insults. Keratinocytes are the most abundant cell type in the epidermis. These cells form the physical skin barrier and represent the first line of the host defense system by sensing pathogens via innate immune receptors, initiating anti-microbial responses and producing various cytokines, chemokines and anti-microbial peptides, which are important events in immunity. A damaged epidermal barrier in atopic dermatitis allows the penetration of potential allergens and pathogens to activate keratinocytes. Among the dysregulation of immune responses in atopic dermatitis, activated keratinocytes play a role in several biological processes that contribute to the pathogenesis of atopic dermatitis. In this review, we summarize the current understanding of the innate immune functions of keratinocytes in the pathogenesis of atopic dermatitis, with a special emphasis on skin-derived anti-microbial peptides and atopic dermatitis-related cytokines and chemokines in keratinocytes. An improved understanding of the innate immunity mediated by keratinocytes can provide helpful insight into the pathophysiological processes of atopic dermatitis and support new therapeutic efforts.

Cholesterol 24S-Hydroxylase overexpression increases the lipid droplet formation of human umbilical cord mesenchymal stem cells but does not affect adipocyte differentiation

Dysregulation of the adipo-osteogenic differentiation balance of mesenchymal stem cells (MSCs), which are common progenitor cells of adipocytes and osteoblasts, has been associated with many pathophysiologic diseases, such as obesity, osteopenia, and several neurodegenerative disorders. Growing evidence suggests that lipid metabolism is crucial for maintaining stem cell homeostasis and cell differentiation, however, the detailed underlying mechanisms are largely unknown. In this study, we demonstrate that CYP46A1 genes are key determinants of MSC increasing lipid droplet formation. Brain cholesterol is synthesized in situ and cannot cross the blood-brain barrier: to be exported from the central nervous system into the blood circuit, excess cholesterol must be converted to 24S-hydroxycholesterol by the cholesterol 24-hydroxylase encoded by the CYP46A1 gene. To address this issue, we used an adenoassociated virus (AAV) gene transfer strategy to increase CYP46A1 expression in order to investigate the consequences on the human mesenchymal stem cell (hU-MSCs). CYP46A1 expression was assessed with Western blotting and quantitative reverse transcription PCR. We found that CYP46A1 expression was increased during adipogenesis, and treatment with exogenous CYP46A1 increased adipogenesis. Thus, we hypothesize that CYP46A1 overexpression in hU-MSCs would significantly enhance cholesterol turnover in the brain of hypoxic-ischemic encephalopathy (HIE). CYP46A1 can potentially serve as a specific target to modify the therapeutic and biological effects of hU-MSCs on HIE patients.

Modelling the Process of Fused Deposition Modelling and the Effect of Temperature on the Mechanical, Roughness, and Porosity Properties of Resulting Composite Products

Advances in the additive manufacturing (AM) processes have opened up the possibilities of widely using them in various structural sectors. Since 1980s this technology has been in permanent mutations. The ramification of the AM technology makes it difficult to obtain a clear impression of its potentialities. Predicting and controlling the mechanical characteristics of printed products is crucial for their final practical use. This study mainly aims to characterize the impact of printing parameters on the characteristics of printed articles and to evaluate their significance.

OP0011 A RANDOMIZED, DOUBLE-BLIND, ACTIVE-CONTROLLED STUDY OF AVACOPAN IN ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA)-ASSOCIATED VASCULITIS

Background:

Complement fragment C5a is strongly linked to the pathogenesis of Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis (AAV). C5a receptor (C5aR), present on neutrophils, is a G protein-coupled receptor for C5a. Avacopan (previously CCX168) is an orally-administered selective antagonist of C5aR which blocks C5a-induced cell activation. Two previous Phase 2 clinical trials provided evidence of effectiveness of avacopan in AAV and its potential to eliminate extensive use of glucocorticoids (GC) and GC-related toxicities.

Objectives:

This Phase 3 study evaluated the efficacy and safety of avacopan for the treatment of AAV.

Methods:

Eligible subjects were randomized 1:1 to receive either prednisone or avacopan in combination with either a) cyclophosphamide (oral or IV) followed by azathioprine or b) rituximab (four IV infusions). Randomization was stratified by the treatment regimen (rituximab, IV cyclophosphamide, or oral cyclophosphamide), ANCA serotype, and newly-diagnosed or relapsing disease. Treatment period was 52 weeks; primary efficacy endpoints were the proportion of subjects achieving disease remission at Week 26, and sustained disease remission at Week 52. Remission was defined as a Birmingham Vasculitis Activity Score (BVAS) of zero and not taking glucocorticoids for AAV within 4 weeks prior to Week 26. Sustained remission was defined as being in remission at Week 26 and also subsequently in remission as defined above at Week 52. Any relapse of AAV between Weeks 26 and 52 was considered not achieving sustained remission.

Results:

330 subjects were randomized and dosed: 166 in avacopan and 164 in prednisone arms. At Week 26, 72.3% subjects achieved remission in the avacopan arm compared to 70.1% in the prednisone arm (p<0.0001 for non-inferiority). At Week 52, 65.7% subjects achieved sustained remission in the avacopan arm compared to 54.9% in the prednisone arm achieving both non-inferiority and superiority to prednisone arm (p=0.0066 for superiority of avacopan).

The avacopan arm had a significant reduction in glucocorticoid-related toxicity compared to the prednisone arm as measured by the Glucocorticoid Toxicity Index (GTI) of Cumulative Worsening Score (p=0.0002) and Aggregate Improvement Score (p=0.0082).

In subjects with renal disease at baseline, the avacopan arm showed a mean increase in estimated glomerular filtration rate (eGFR) of 7.3 mL/min/1.73 m2 from baseline to week 52 as compared to 4.0 mL/min/1.73 m2 increase in the prednisone arm (p=0.0259).

Overall subject incidence of serious adverse events (SAEs) was generally consistent with previous AAV trials at 45.1% and 42.2% for prednisone and avacopan groups, respectively. Serious infections were 15.2% and 13.3%, serious hepatic adverse events 3.7% vs 5.4%, and SAEs of white blood cell count decreases were 4.9% vs 2.4% for prednisone and avacopan, respectively. No meningococcal infections were reported.

Conclusion:

Avacopan treatment resulted in remission in AAV patients receiving rituximab or cyclophosphamide/azathioprine at a rate that was non-inferior to the active comparator prednisone at week 26 and superior to prednisone in sustained remission at Week 52. A significant reduction in glucocorticoid-related toxicity was observed in the avacopan vs. prednisone arms. Significant increase in eGFR in subjects with renal disease was also observed in avacopan vs. prednisone. The safety profile of avacopan appears acceptable for development in AAV. Avacopan treatment for AAV is efficacious and exhibits benefits not seen with chronic prednisone therapy.

References:

None.

Disclosure of Interests:

Peter A Merkel Grant/research support from: AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Kypha, TerumoBCT, Consultant of: Abbvie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Pfizer, Sparrow, Talaris, David Jayne Grant/research support from: ChemoCentryx, GSK, Roche/Genentech, Sanofi-Genzyme, Consultant of: Astra-Zeneca, ChemoCentryx, GSK, InflaRx, Takeda, Insmed, Chugai, Boehringer-Ingelheim, Huibin Yue Shareholder of: ChemoCentryx, Employee of: ChemoCentryx, Thomas Schall Shareholder of: ChemoCentryx, Employee of: ChemoCentryx, Catherine Kelleher Shareholder of: Amgen, ChemoCentryx, Inc., Grant/research support from: Not active, Consultant of: Independent Consultant in the past, Employee of: ChemoCentryx, Inc., Pirow Bekker Shareholder of: Stock options ChemoCentryx, Consultant of: ChemoCentryx, Employee of: ChemoCentryx

Influence of residential greenness on adverse pregnancy outcomes: A systematic review and dose-response meta-analysis

BACKGROUND

With the development of urbanization, there is a decreasing tendency for people contact with natural greenness. Whether maternal exposure to greenness has an impact on pregnancy complications and pregnancy outcomes remains to be confirmed.

OBJECTIVES

To estimate the association and dose-response relationship between residential greenness and pregnancy outcomes.

DATA SOURCES

PubMed, Embase, Ovid, Scopus and Web of Science from inception to 1st December 2019 were searched.

SYNTHESIS METHODS

The summary regression coefficient (β) and odds ratio (OR) with corresponding 95% confidence interval (95%CI) were calculated. The linear dose-response relationship between greenness and adverse pregnancy outcomes was also investigated.

RESULTS

Overall, 36 studies with a total of 11,983,089 participants were included. Birth weight was significantly higher in highest level of greenness exposure group compared to lowest level group (e.g. β:20.22, 95%CI:13.50-26.93 at 100 m buffer). The odds of low birth weight (LBW) decreased in the highest level of group compared to lowest level group (e.g. OR:0.86, 95%CI:0.75-0.99 at 100 m buffer). The odds of small for gestational age (SGA) also decreased in the highest group (OR:0.93, 95%CI:0.88-1.00 at 100 m buffer). In addition, maternal exposure to greenness was associated with increased head circumference and decreased mental disorders. The dose-response models showed a 2% decrease risk of LBW per 0.1 normalized difference vegetation index (NDVI) increase within 300 m buffer (OR:0.98, 95%CI:0.97-0.99, P < 0.001) and a 1% decrease risk of SGA per 0.1 NDVI increase within 300 m buffer (OR:0.99, 95%CI:0.98-1.00, P = 0.037). No significant associations were found on preterm birth, gestational age, gestational diabetes mellitus, gestational hypertension or preeclampsia.

CONCLUSIONS

This review confirms an inverse association between residential greenness and adverse pregnancy outcomes. Findings of our study provide evidences for pregnant women to increase greenness exposure.

[Effects on the respiration and nervous system of rat exposed to the thermobaric bomb simulated gas]

Objective: To investigate the effects of simulated-thermobaric explosive gas on the respiration and nervous system in rats. Methods: 70 of SPF SD rats were randomly divided into four thermobaric explosive gas groups, two restoration observation groups and control group from April to August in 2018. The exposure time of in four thermobaric explosive gas groups were 3.75, 7.5, 15.0 and 30 min, respectively. The restoration observation groups were designed to observe for 30 and 120 min after exposure thermobaric explosive gas 30 min. The bloods were collected and analyzed at the end of exposure and recovery observation. The endogenous carbon monoxide (CO) , nitric oxide (NO) , glutamic acid (GLU) , acetylcholinesterase (AchE) and dopamine (DA) were detected in brain tissues, respectively. Results: The blood gas index (pH, PCO(2), PO(2), COHb, O(2)Hb, MeHbt) and blood electrolytes (Na(+), K(+), Ca(2+) and Cl(-)) in exposure groups have significant differences with these in control (P<0.05) . The pH value decreased with the exposure time longer. However, it basically returned to normal level when terminating exposure for 120 min. The concentration of PCO(2), MeHb and CoHb increased first and then decreased with the exposure time extension. Conversely, The PO(2) and O(2)Hb decreased first and then increased with the exposure time longer. The concentration of endogenous CO, GLU, and AchE decreased and NO increased in exposure group 4 and the restoration observation group 1 compared with those in control (P<0.01) . In addition, there were pathological changes in lung and brain tissue of exposure group, such as inflammatory cell infiltration and edema. Conclusion: The blood gas index, electrolytes, neurotransmitter, histopathology of lung and brain were changed to various degrees by thermobaric bomb gas exposure. These findings would provide some beneficial support for evaluating the damage effect of thermobaric bomb gas on organisms.

Endoscopic submucosal multi-tunnel dissection for large early esophageal cancer lesions

OBJECTIVE

To evaluate the safety and efficacy of endoscopic submucosal multi-tunnel dissection (ESMTD) for early esophageal cancer lesions larger than 3 cm in diameter or cumulatively greater than 1/2 lumen size.

METHOD

Early esophageal cancer lesions in 15 patients were detected by endoscopy and endoscopic ultrasonography in our endoscopy center from December 2012 to June 2015. All lesions were successfully resected by ESMTD and diagnosed by pathology, and therapeutic efficiency and safety were followed after surgery.

RESULTS

All 15 of the early esophageal cancer lesions were resected by ESMTD. The pathological results showed 9 moderately differentiated and 6 highly differentiated squamous cell carcinomas. En bloc resection was achieved in 13 lesions, with negative lateral and basal margins on pathology, whereas the other 2 required additional surgery. The average diameter of the resected lesions was 4.2±0.9 cm. The mean procedure time was 94.7±52.9 min. Esophageal stenosis was observed in 7 patients for whom esophageal water balloon dilatation was performed. No residual or recurrent lesion was found during the 6-36-month follow-up period.

CONCLUSION

ESMTD is a safe and efficient technique for treating large early esophageal cancer lesions. Grasping the key techniques of this procedure can reduce operating difficulty and shorten the operating time.

[A clinical study of Proteus syndrome caused by a mosaic somatic mutation in AKT1 gene]

Objective: Proteus syndrome is a rare disease. The aim of the present study was to analyze the clinical characteristics and gene mutations of Proteus syndrome with a case report and relevant literature review. Methods: Clinical data of the patient with Proteus syndrome were collected in detail and biochemical measurements and radiological examinations were conducted. Tissues from phalanges with lesions were obtained to extract DNA, and Sanger sequencing of AKT1 gene was carried on. The pathogenic mutation was further tested in peripheral blood samples of the patient, his parents and 250 healthy volunteers. Orthopaedic surgery was performed on the affected limbs of the patient. Results: The patient was presented with progressive overgrowth of the right extremity, scoliosis, cerebral connective tissue nevus and lower extremity venous. A heterozygous mutation of AKT1 gene (c. 49G>A) was identified in DNA extracted from the affected bone tissue of the patient, but not be found in genomic DNA of peripheral blood samples from the patient, his parents and 250 healthy volunteers. Movement function of the affected limb improved significantly after the operations. Conclusions: The prominent features of Proteus syndrome are overgrowth of one extremity and cerebral connective tissue nevus. A mosaic somatic mutation of AKT1 gene is one of the pathogenic mutations for Proteus syndrome, and orthopedic surgery may be a good way to improve symptoms of the disease.

Birth population survey in Huai'an in 2015: perinatal-neonatal mortality and preterm birth rate in emerging regions in China

Objective: This survey followed the birth population-based study conducted in 2010 in Huai'an, Jiangsu Province, with the aim to estimate perinatal-neonatal mortality and preterm birth rate in emerging regions with similar maternal-fetal and neonatal care conditions in China.Materials and methods: Data of total births in 2015 were prospectively collected by regional perinatal network collaboration in Huai'an, a subprovincial region with a population of 5,644,500 and gross domestic production of 9082 USD per capita.Results: The 59,424 birth registries (including 59,023 live births and 167 stillbirths) corresponded to a birth rate of 10.5‰ and a Male-to-female ratio of 113.7:100. All births there were from 85, 16, and 6 level I, II, and III hospitals, with a delivery rate of 30.4, 40.2, and 29.4%, respectively. Of all births, 14.1% had pregnancy-associated comorbidities and complications, 54.4% (32,226/59,190) had cesarean delivery, and multiple pregnancies and birth defects occurred in 2.1% (1,250) and 5.5‰ (324), respectively. The mean birth weight was 3448 ± 507 g with 13.9% being macrosomia, and 2.86% (1695/59,190) low birth weight. Preterm birth rate was 4.06% (2404/59,190) with a mortality rate of 8.5%. There were 94.5% recorded as healthy newborns and 5.5% (3263) requiring hospitalization after birth. The perinatal and neonatal mortality rate was 5.2‰ (167 stillbirths, 139 early neonatal deaths) and 4.0‰, respectively. Compared with the 2010 survey, these data demonstrated generally improved status of perinatal-neonatal healthcare.Conclusions: The low rates of perinatal-neonatal mortality, preterm birth and preterm mortality suggest that the concept and study protocol of perinatal-neonatal healthcare in Huai'an may serve as the benchmark for estimating regional vital statistics and perinatal and neonatal outcomes.

TLR-Induced SMPD3 Defects Enhance Inflammatory Response of B Cell and Macrophage in the Pathogenesis of SLE

B lymphocyte and macrophages may contribute to SLE pathogenesis through cytokine production after TLR stimulation. Emerging evidences suggested that defects of sphingolipid metabolism were responsible for SLE pathogenesis. However, it is not clear whether these defects exist in B cells and macrophages under SLE condition and whether TLR signalling pathway was related to the dysfunction of sphingolipid metabolism in SLE. Here, we demonstrated that the enzymes involved in the sphingolipid metabolism expressed abnormally in B cells from SLE patients and lupus-prone mice. Moreover, we found that TLR signalling induced the abnormal expression of sphingomyelin phosphodiesterase 3 (SMPD3), sphingosine-1-phosphate phosphatase 2 (SGPP2), ceramide kinase (CERK) and UDP glycosyltransferase 8 (UGT8), which were involved in sphingolipid metabolism. TLR signalling also induced the transportation of SMPD3 from Golgi apparatus. Furthermore, the dysfunction of SMPD3 enhanced TLR-induced inflammatory response of B cells and macrophages in turn. Thus, these findings provide an innovative direction and a new target for research and treatment of SLE.

[Surveillance for HIV infection in MSM selected through respondent driven sampling in Beijing, 2005-2012]

Objective: To understand the HIV prevalence among men who have sex with men (MSM) and discuss the feasibility of respondent driven sampling (RDS) as a tool to conduct long term HIV surveillance in MSM in Beijing. Methods: From 2005 to 2012 RDS was used to recruit MSM for face-to-face interview with structured questionnaire to collect their demographic characteristics and HIV risk-related behavior. Blood samples were collected from them for HIV test. Results: A total of 427, 540, 607, 614, 616, 602, 579 and 600 MSM were surveyed, respectively, from 2005 to 2012. The HIV infection prevalence increased from 4.2%(95%CI: 1.9-7.0) in 2005 to 10.1% (95%CI: 7.2-13.2) in 2012 (P=0.02). Meanwhile, HIV prevalence substantially increased among MSM aged >25 years, in floating population and with lower education level (≤high school), from 6.4%(95%CI: 2.2-9.5), 3.3%(95%CI: 1.8-5.4) and 5.5% (95%CI: 2.2-8.9) in 2005 to 7.6% (95%CI: 5.4-10.3, P=0.04), 10.7% (95% CI: 7.8-14.6, P=0.04) and 10.4% (95% CI:7.2-14.3, P=0.04) in 2012, respectively. Moreover, the HIV infection prevalence in MSM aged ≤25 years old and with higher education level (>high school) increased from 1.7%(95%CI: 0.4-3.1) in 2009 and 1.1%(95%CI: 0.2-1.7) in 2007 to 13.7%(95%CI: 7.2-20.4) and 9.1%(95%CI: 4.7-13.8) in 2012, respectively, the differences were not significant. Furthermore, the HIV infection prevalence in MSM who had 2-9 male sex partners in the last six months increased from 4.0% (95% CI: 1.0-8.0) in 2005 to 12.6% (95% CI: 8.7-16.7) in 2012 (P=0.02). Conclusions: Studies have shown that RDS is an effective and feasible sampling method for long term HIV surveillance in MSM. The HIV infection prevalence in MSM in Beijing increased from 2005 to 2012, especially among those with older age, in floating population and with lower educational level. More attention should be paid to MSM with younger age and with higher educational level.

Novel mutations in the SEC24D gene in Chinese families with autosomal recessive osteogenesis imperfecta

We sought to characterize the phenotypes and identify the SEC24D gene mutations associated with Chinese families of osteogenesis imperfecta (OI). Using whole-exome sequencing, we discovered two novel compound SEC24D mutations of OI patients. Our study extended both the phenotypic and the genotype of the OI patients with SEC24D mutations.

INTRODUCTION

To date, only three compound heterozygous mutations in the SEC24D gene have been found to cause recessively inherited forms of OI. We sought to characterize the phenotypes and to identify the SEC24D gene mutations associated with Chinese families with OI.

METHODS

Using whole-exome sequencing in two probands, we identified two novel compound heterozygous mutations in SEC24D. In family 1, the proband was a 23-year-old male; he had recurrent fractures and dentinogenesis imperfecta. His anterior fontanel was not closed, and he showed facial dysmorphism. A computed tomography three-dimensional imaging of the cranium showed skull deformities associated with a broad ossification defect in the frontoapical area, a widened sagittal suture, and Wormian bones. In family 2, the proband was a 7-year-old boy, who also had recurrent fractures and dentinogenesis imperfecta. His anterior fontanel was not closed, and he did not have obvious facial dysmorphism.

RESULTS

We identified one novel compound heterozygous missense substitution in the proband in family 1, including c.2723G>A (p. Cys908Tyr) and c.2842T>C (p. Ser948Pro). In the proband in family 2, we identified another novel compound heterozygous missense substitution, including c.938G>A (p. Arg313His) and c.875C>T (p. Pro292Leu).

CONCLUSIONS

We discovered two novel compound SEC24D mutations of autosomal recessive OI patients. Our study extended both the phenotypic and the genotypic spectrum of the autosomal recessive OI patients with SEC24D mutations.

The identification of up-regulated ebv-miR-BHRF1-2-5p targeting MALT1 and ebv-miR-BHRF1-3 in the circulation of patients with multiple sclerosis

Epstein-Barr virus (EBV) is a well-documented aetiological factor for multiple sclerosis (MS). EBV encodes at least 44 microRNAs (miRNAs) that are readily detectable in the circulation of human. Previous studies have demonstrated that EBV-encoded miRNAs regulate host immune response and may serve as biomarkers for EBV-associated diseases. However, the roles of EBV miRNAs in MS are still unknown. To fill the gap, we conducted a comprehensive profiling of 44 mature EBV miRNAs in 30 relapsing-remitting MS (RRMS) patients at relapse and 30 matched healthy controls. Expression levels of ebv-miR-BHRF1-2-5p and ebv-miR-BHRF1-3 were elevated significantly in the circulation and correlated positively with the expanded disability status scale (EDSS) scores of MS patients. Receiver operating characteristic (ROC) analyses confirmed that the expression of these two miRNAs distinguished MS patients clearly from healthy controls. Luciferase assays revealed that ebv-miR-BHRF1-2-5p may directly target MALT1 (mucosa-associated lymphoid tissue lymphoma transport protein 1), a key regulator of immune homeostasis. In conclusion, we described the expression of EBV miRNAs in MS and preliminarily validated the potential target genes of significantly altered EBV miRNAs. The findings may pave the way for prospective study about the pathogenesis of MS.

Associations of polymorphisms in the SOST gene and bone mineral density in postmenopausal Chinese Women

The bone mineral density (BMD) of a total of 1,379 healthy postmenopausal Chinese women was measured. Ten tagging SNPs of the sclerostin (SOST) gene were genotyped. Our results suggest that the polymorphisms of the rs2023794 and rs74252774 in the SOST gene were associated with BMD of the lumbar spine in postmenopausal Chinese women.

INTRODUCTION

The purpose of the study was to determine the associations between polymorphisms of SOST gene and BMD in postmenopausal Chinese women.

METHODS

A total of 1,379 independent healthy postmenopausal Chinese women including 703 in our previous study were recruited. The BMD of the lumbar spine 1-4 (L1-4) and left proximal femur including total hip and femoral neck were measured by dual-energy X-ray absorptiometry. Ten tagging SNPs (rs1234612, rs1513670, rs1634330, rs1708635, rs2023794, rs7220711, rs74252774, rs851057, rs851058, and rs865429) of the SOST gene were genotyped.

RESULTS

The rs2023794 and rs74252774 and the haplotype ACCATTCT of SOST gene were associated with age and body mass index (BMI) adjusted L1-4 BMD (P values were 0.010, 0.007, and 0.007, respectively) even after performing the Bonferroni multiple-significance-test correction. There was a clear trend in these regions that the CC genotype of the rs2023794 and the TT genotype of the rs74252774 have higher BMD values than other genotypes. The contributions of the rs2023794 and rs74252774 to the phenotypic variation of L1-4 BMD were 0.6 and 0.7 %, respectively. We failed to find any association between the 10 SNPs and 6 haplotypes of the SOST gene and BMD at the hip site in this study.

CONCLUSIONS

Our results suggest that the polymorphisms of the rs2023794 and rs74252774 in the SOST gene were associated with BMD of the lumbar spine in a large sample of postmenopausal Chinese women.