Associations Between Psychological Stress and Hand Pain Among Rural and Urban Adults: Findings From the KoGES Community Cohort Study

Despite known health disparities in chronic pain conditions between rural and urban adults, few studies have examined whether longitudinal associations between psychological stress and hand pain differ. Utilizing community-based cohort data, this study examined whether rural and urban adults differed in the extent to which psychological distress was associated with hand osteoarthritis (OA) symptoms and later functional limitations related to hand pain. Community-dwelling adults (mean age = 51.97, 52.3% women) in a rural (n = 2,971) and urban area (n = 2,782) provided demographic data at baseline and, at a 4-year follow-up, responded to questionnaires about psychological distress and clinical symptoms of hand OA. Levels of functional limitations in hands were assessed at an 8-year follow-up. Ordinal logistic and linear regression were conducted to examine the effects of psychological distress on hand OA symptoms and functional limitations, and whether associations between psychological distress and these pain outcomes were moderated by residential area. The results showed that psychological distress was associated with a higher risk for hand OA symptoms and functional limitations, even after adjusting for demographic and health covariates. There was significant moderation by residential area, such that the association between psychological distress and hand OA was significant only among rural adults and the association with functional limitations was stronger in rural adults than urban adults. Findings suggest greater vulnerability to hand arthritis and hand-related functional limitations among rural adults and the potential for tailored intervention programs to help resolve health disparities among rural communities. PERSPECTIVE: This study compares the association between psychological distress and hand pain outcomes between rural and urban adults using community-based cohort data and suggests that rural adults are more vulnerable to experiencing negative effects of psychological distress on concurrent hand OA symptoms and longitudinal functional limitations in hands.

Preventive Effect of 6-shogaol on D-galactosamine Induced Hepatotoxicity Through NF-?B/MAPK Signaling Pathway in Rats

This analysis aims to see whether 6-shogaol could protect rats against D-galactosamine (D-GalN)-induced Hepatotoxicity. The Wistar rats were divided into four groups (n=6). Group 1 received a standard diet, Group 2 received an oral administration of 6-shogaol (20 mg/kg b.wt), Group 3 received an intraperitoneal injection of D-GalN (400 mg/kg b.wt) on 21st day, and Group 4 received an oral administration of 6-shogaol (20mg/kg b.wt) for 21 days and D-GalN (400 mg/kg b.wt) injection only on 21st day. The hepatic marker enzymes activity, lipid peroxidative markers level increased significantly and antioxidant activity/level significantly reduced in D-GalN-induced rats. 6-shogaol Pretreatment effectively improves the above changes in D-GalN-induced rats. Further, inflammatory marker expression and MAPK signaling molecules were downregulated by 6-shogaol. These findings showed that 6-shogaol exerts hepatoprotective effects via the enhanced antioxidant system and attenuated the inflammation and MAPK signaling pathway in D-GalN-induced rats.

[Determination of misoprostol in workplace air by high performance liquid chromatography]

Objective: To establish a high performance liquid chromatography method for the determination of misoprostol in workplace air. Methods: From February to August 2021, the misoprostol in the workplace air was collected by glass fiber filter membrane, and theeluent was separated by C18 liquid chromatography column, determined by UV detector, and quantified by external standard method. Results: The quantitative lower limit of misoprostol determination method was 0.05 μg/ml, and the lowest quantitative concentration was 1.4 μg/m(3) (calculated by collecting 75 L air sample). The concentration of misoprostol has a good linear relationship between 0.05 to 10.00 μg/ml. The relative coefficient was 0.9998. The regression equation of the standard working curve was y=495759x-45257. The range of average recovery rates were from 95.5% to 102.8%. The intra-assay precision of the method was 1.2%-4.6%, and the inter-assay precision was 2.0%-5.9%. The samples could be stored stably for 7 days at 4 ℃. Conclusion: The high performance liquid chromatography method for the determination of misoprostol has high sensitivity, good specificity and simple procedure of sample pretreatment. It is suitable for the detection of misoprostol in the workplace air.

Preoperative prediction of microvascular invasion and perineural invasion in pancreatic ductal adenocarcinoma with 18F-FDG PET/CT radiomics analysis

AIM

To develop and validate a predictive model based on 2-[¹⁸F]-fluoro-2-deoxy-d-glucose (¹⁸F-FDG) positron-emission tomography (PET)/computed tomography (CT) radiomics features and clinicopathological parameters to preoperatively identify microvascular invasion (MVI) and perineural invasion (PNI), which are important predictors of poor prognosis in patients with pancreatic ductal adenocarcinoma (PDAC).

MATERIALS AND METHODS

Preoperative ¹⁸F-FDG PET/CT images and clinicopathological parameters of 170 patients in PDAC were collected retrospectively. The whole tumour and its peritumoural variants (tumour dilated with 3, 5, and 10 mm pixels) were applied to add tumour periphery information. A feature-selection algorithm was employed to mine mono-modality and fused feature subsets, then conducted binary classification using gradient boosted decision trees.

RESULTS

For MVI prediction, the model performed best on a fused subset of ¹⁸F-FDG PET/CT radiomics features and two clinicopathological parameters, with an area under the receiver operating characteristic curve (AUC) of 83.08%, accuracy of 78.82%, recall of 75.08%, precision of 75.5%, and F1-score of 74.59%. For PNI prediction, the model achieved best prediction results only on the subset of PET/CT radiomics features, with AUC of 94%, accuracy of 89.33%, recall of 90%, precision of 87.81%, and F1 score of 88.35%. In both models, 3 mm dilation on the tumour volume produced the best results.

CONCLUSIONS

The radiomics predictors from preoperative ¹⁸F-FDG PET/CT imaging exhibited instructive predictive efficacy in the identification of MVI and PNI status preoperatively in PDAC. Peritumoural information was shown to assist in MVI and PNI predictions.

Prevalence and influencing factors of anaemia among pregnant women in rural areas of Northwestern China

OBJECTIVES

Anaemia during pregnancy is a significant public health problem that adversely impacts both the mother and foetus. However, the factors influencing maternal anaemia in deprived areas of Northwestern China have not yet been thoroughly investigated. This study aimed to describe the prevalence and potential influencing factors of anaemia among expectant mothers in rural areas of Northwestern China.

STUDY DESIGN

This was a cross-sectional survey.

METHODS

A cross-sectional survey of 586 expectant mothers was conducted to investigate the prevalence of anaemia, prenatal healthcare coverage, dietary diversity and nutrient supplementation intake. The study population was selected from the sample areas using a random sampling method. Data were collected through a questionnaire, and haemoglobin concentrations were measured by a capillary blood test.

RESULTS

The results show that 34.8% of the study population were anaemic, with 13% having moderate-to-severe anaemia. The results of the regression analysis showed that diet was not significantly associated with haemoglobin concentrations or the prevalence of anaemia. However, regular prenatal healthcare attendance was found to be an important influencing factor for both haemoglobin concentration (β = 3.67, P = 0.002) and the prevalence of anaemia (odds ratio = 0.59, P = 0.011).

CONCLUSIONS

Pregnant women receiving regular prenatal care were less likely to be anaemic; thus, it is essential to implement strategies to improve attendance at maternal public health services to reduce the prevalence of maternal anaemia.

First Report of Cobweb Disease in Auricularia cornea var. Li. Caused by Hypomyces mycophilus in China

Auricularia cornea var. Li. is a natural mutation strain of A. cornea which has been preferred by consumers for its white colour, good taste and pharmacological properties (Rebecca et al. 2020). In October 2021, a disease with symptoms similar to that of cobweb disease (Carrasco et al. 2017) was observed in A. cornea var. Li. in four mushroom farms in Fangshan District (115.83°E, 39.55°N), Beijing, China, infecting 20% of the fruiting bodies (Fig. 1A-D). White cottony mycelia formed typically on the casing soil and they gradually spread to the stipes and pileus, covering the whole fruiting body, which eventually died and lost commodity value. Cultures were obtained by aseptically transferring the diseased fruiting bodies onto potato dextrose agar (PDA); they were deposited in the culture collection (ID: JZBQA3) of the Beijing Academy of Agriculture and Forestry Sciences, China. The colonies were floccose with aerial mycelium white. Purplish grey diffusing pigments occasionally formed on the reverse side of the plate at 25 °C (Fig. 2A-B). Conidiophores arising in aerial mycelium, indefinite in length, branches septate, each cell producing denticulate conidiogenous loci, each denticle bearing a single conidium. Conidia mostly oblong to ellipsoidal, smooth, (9.0-)9.9-17.0(-18.0)×(6.0-)6.9-10.2 μm (n = 60), 0~1 septate (Fig. 2C-E). Chlamydospores forming as lateral branches of hyphae were commonly observed, globose, ellipsoid or oblong, 14.8-22×14.7-19.6 μm, l/w = 1.0-1.3 (Fig. 2F-G). The morphological characteristics were consistent with that of Hypomyces mycophilus, whose anamorph was Cladobotryum polypori (Rogerson et al. 1993, Zeng et al. 2017). For further species identification, genomic DNA was extracted using the DNeasy Plant Mini Kit (Qiagen, USA). The internal transcribed spacer (ITS) regions and large subunit ribosomal RNA (LSU) genes were amplified using the primer pairs ITS1/ITS4 (White et al. 1990) and LROR/LR5 (Bhattacharya et al. 2000), respectively. The sequences were deposited in GenBank with accession numbers OP430530 and OP430531. BLAST nucleotide searches showed more than 99% homology with corresponding sequences of Hypomyces mycophilus HMAS 275554 and CBS 175.56. Phylogenetic trees based on ITS and LSU revealed that the strain JZBQA3 was grouped with H. mycophilus with high support value (Fig. 3). A in vivo pathogenicity test was performed using eight mushroom sticks with healthy fruiting bodies in triplicate. Each four sticks were sprayed with conidial suspension (108 spores/mL) of strain JZBQA3 or sterile distilled water, respectively, and maintained in an artificial climate chamber at 25-26°C. Cobweb-like characteristics were observed on the fruiting bodies treated with the JZBQA3 conidial suspension 2-3 days after inoculation, while those treated with sterile distilled water remained symptomless (Fig. 4 A-B). The same pathogen was re-isolated and confirmed from the infected fruiting bodies by integrated analysis of morphological characteristics and gene sequencing data, fulfilling Koch's postulates. Hypomyces mycophilus was first reported on Trametes versicolor in North Carolina (Rogerson et al. 1993), and is the causal agent of cobweb diseases on Auricularia heimuer (Zhang et al. 2023). To our knowledge, this is the first report of cobweb disease caused by H. mycophilus in A. cornea var. Li. This finding is a valuable contribution to the knowledge of cobweb disease development in edible fungi.

Activation cross sections for reactions induced by 14 MeV neutrons on natural titanium

Cross sections for the neutrons around 14 MeV interaction with natural titanium were precisely measured by neutron activation and off-line measurement technique. The fast neutrons were produced by ³H(d,n)⁴He reaction and the neutron energy was obtained by using the cross section ratio method of ⁹⁰Zr(n,2n)⁸⁹Zr to ⁹³Nb(n,2n)^92mNb reactions. Experimental cross sections have been acquired for ^natTi(n,x)⁴⁶Sc, ^natTi(n,x)⁴⁷Sc, ⁵⁰Ti(n,x)⁴⁷Ca and ⁴⁸Ti(n,x)⁴⁸Sc reactions. The measured cross section data are compared with the experimental data available in the previous literature and evaluated nuclear data from the ENDF/B-VIII.0, JEFF-3.3, JENDL-5, BROND-3.1, CENDL-3.2 and FENDL-3.2b libraries. Furthermore, excitation functions for these reactions were calculated by using the theoretical model based on Talys-1.96 code with default and adjusted parameters. Within experimental error, evaluated nuclear data are mostly consistent with experimental data. The excitation function with adjusted parameters can roughly reproduce the experimental data.

Assessment of healthcare quality among village clinicians in rural China: the role of internal work motivation

INTRODUCTION

The quality of primary care is important for health outcomes among residents in China. There is evidence that internal work motivation improves the quality of healthcare provided by clinicians. However, few empirical studies have examined the relationship between internal work motivation and clinical performance among village clinicians in rural China. This study was performed to evaluate healthcare quality among village clinicians, then explore its relationships with internal work motivation among those clinicians.

METHODS

We collected survey data using a standardised patient method and a structured questionnaire. We observed 225 interactions between standardised patients and village clinicians from 21 counties in three provinces. We used logistic regression models to analyse the relationships between work motivation and healthcare quality, then conducted heterogeneity analysis.

RESULTS

Healthcare quality among village clinicians was generally low. There was a significantly positive correlation between internal work motivation and healthcare quality among village clinicians (P<0.1). Additionally, the positive effect of internal work motivation on healthcare quality was strongest among clinicians who received financial incentives and had a lighter workload (fewer patients per month) [P<0.1].

CONCLUSION

Healthcare quality among village clinicians requires urgent improvement. We recommend implementing financial incentives to stimulate internal work motivation among village clinicians, thus improving their clinical performance.

Agreement between Azure Kinect and Marker-Based Motion Analysis during Functional Movements: A Feasibility Study

(1) Background: The present study investigated the agreement between the Azure Kinect and marker-based motion analysis during functional movements. (2) Methods: Twelve healthy adults participated in this study and performed a total of six different tasks including front view squat, side view squat, forward reach, lateral reach, front view lunge, and side view lunge. Movement data were collected using an Azure Kinect and 12 infrared cameras while the participants performed the movements. The comparability between marker-based motion analysis and Azure Kinect was visualized using Bland-Altman plots and scatter plots. (3) Results: During the front view of squat motions, hip and knee joint angles showed moderate and high level of concurrent validity, respectively. The side view of squat motions showed moderate to good in the visible hip joint angles, whereas hidden hip joint angle showed poor concurrent validity. The knee joint angles showed variation between excellent and moderate concurrent validity depending on the visibility. The forward reach motions showed moderate concurrent validity for both shoulder angles, whereas the lateral reach motions showed excellent concurrent validity. During the front view of lunge motions, both the hip and knee joint angles showed moderate concurrent validity. The side view of lunge motions showed variations in concurrent validity, while the right hip joint angle showed good concurrent validity; the left hip joint showed poor concurrent validity. (4) Conclusions: The overall agreement between the Azure Kinect and marker-based motion analysis system was moderate to good when the body segments were visible to the Azure Kinect, yet the accuracy of tracking hidden body parts is still a concern.

Utilisation of village clinics in Southwest China: evidence from Yunnan Province

INTRODUCTION

Primary healthcare in rural China is underutilised, especially in village clinics in Southwest China. The aim of this study was to explore any relationships among the ethnicity of the healthcare provider, the clinical competence of the healthcare provider, and the utilisation of village clinics in Southwest China.

METHODS

This cross-sectional survey study involved 330 village healthcare providers from three prefectures in Yunnan Province in 2017. Multiple logistic regressions were adopted to investigate the utilisation of primary healthcare among different ethnic healthcare providers.

RESULTS

Primary healthcare utilisation was higher in village clinics where healthcare providers were Han Chinese than those where healthcare providers were ethnic minority (151 vs 101, P=0.008). The logistic regression analysis showed that clinical competence was positively associated with the utilisation of primary healthcare (odds ratio [OR]=1.49, 95% confidence interval [CI]=1.12-2.00; P=0.007) and that inadequate clinical competence of ethnic minority health workers may lead to a lag in the utilisation of primary healthcare (OR=0.45, 95% CI=0.23-0.89; P=0.022).

CONCLUSION

Our results confirm differences in the utilisation of primary healthcare in rural Yunnan Province among healthcare providers of different ethnicities. Appropriate enhancements of clinical competence could be conducive to improving the utilisation of primary healthcare, especially among ethnic minority healthcare providers.

[Screening and preliminary validation of biomarkers in sputum-negative pulmonary tuberculosis based on positron emission tomography/computed tomography and transcriptomics]

Objective: To screen and perform preliminary clinical validation of biomarkers of activity based on positron emission tomography/computed tomography (PET-CT) and transcriptomics in sputum-negative pulmonary tuberculosis lesion tissue. Methods: Nine patients with sputum-negative pulmonary tuberculosis treated surgically at the Shanghai Public Health Clinical Center for Thoracic Surgery from January 1, 2017 to December 31, 2019 were retrospectively collected as the discovery group, including four males and five females, aged 20-57 years (mean 36 years). All of the patients underwent PET-CT scanning before surgery, and the resected specimens were postoperatively classified according to preoperative PET-CT. The resected specimens were divided into areas with increased fluorodeoxyglucose (FDG) metabolism (SUVmax>3) and areas with normal FDG metabolism (SUVmax ≤ 3) according to the preoperative PET-CT performance. After sample processing, total RNA was extracted from the tissues of different regions, and then whole gene transcriptome sequencing was performed. Bioinformatics analysis of the two sets of data was performed to discover the expression profiles of the differences in whole gene transcriptome data between the two regions and to screen for candidate biomarkers. Eighty patients with sputum-negative pulmonary tuberculosis admitted to Shanghai Public Health Clinical Center from January 1, 2019 to January 1, 2021 were retrospectively collected as the validation group, including 37 males and 43 females, aged 20-62 years, with an average age of 39 years. The validation group was divided into a group with increased SUV (n=40) and a group without lesions on CT imaging (n=40). Enzyme-linked immunosorbent assay (ELISA) was used to determine the protein levels of candidate biomarkers in the peripheral plasma of patients. The effect of biomarkers was assessed using subject operating characteristic (ROC) curves. Student's t-test was used to determine whether the difference in protein levels between the two groups was statistically significant. Results: Bioinformatics analysis revealed that the expression levels of C1QB, CCL19, CCL5 and HLA-DMB correlated with the metabolic activity of sputum-negative tuberculosis lesion tissue. Further screening and validation by the validation group confirmed that the difference in C1QB protein levels in the peripheral plasma of patients was statistically significant between the group with increased SUV and the group without lesions on CT imaging [(3.55±0.34) mg/L vs. (2.75±0.21) mg/L, t=4.12, P<0.001]. And the ROC curve showed that the area under the curve for C1QB protein levels was 0.731, which had potential clinical value. Conclusion: The C1QB protein level can be used to assess the activity of lesions in patients with sputum-negative tuberculosis and is a potential biomarker.

POS0811 CHARACTERISTICS OF INTESTINAL MICROBIOTA AND ITS RELATIONSHIP WITH LYMPHOCYTE SUBSETS AND CYTOKINES IN PATIENTS WITH VASCULITIS

Background

Vasculitis include a group of autoimmune inflammatory diseases with clinical heterogeneous characterized by inflammation of vascular wall, inflammation of perivascular tissues, and cell-like necrosis[1]. Disorder of gut microbiota, which plays a crucial role in regulating immune cells such as Th1, Th17 and Treg, is associated with other autoimmune diseases[2], and may also be involved in the pathogenesis of vasculitis.

Objectives

To investigate the changes of intestinal microbiota and its correlation with peripheral lymphocyte subsets and inflammatory factors levels in patients with vasculitis.

Methods

Combined with clinical manifestations and laboratory examination, 33 patients with vasculitis who met the 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides[3] and 33 of age- and gender- matched healthy controls (HCs) were selected from the Second Hospital of Shanxi Medical University. The demographic characteristics, general laboratory indicators such as erythrocyte sedimentation rate (ESR), C-reaction protein (CRP), levels of peripheral lymphocyte subpopulations and serum cytokines detected by modified flow cytometry. Fecal microbiota detected by 16S rRNA gene sequencing and compiled and processed using Qiime2 and OTU-profiling tables were collected and analyzed in this study.

Results

Compared with HCs, the richness and diversity of intestinal flora in patients with vasculitis tended to decrease with a statistically significant difference in β diversity (P = 0.025, Figure 1 A and B). More specifically, vasculitis patients had a lower frequency of Firmicutes while higher Proteobacteria and Bacteroidota at the phylum level (P < 0.001, Figure 1C). In vasculitis patients, the relative abundances of 23 bacteria differed from HCs at the genus level was all decreased, including Gemella, Anaeroglobus, Campylobacter, Fournierella, et al (P < 0.001, Figure 1D and E). More importantly, the relative abundance of Muribaculaceae were positively correlated with the absolute count of Th2 and the proportions of Th1 and CD4+T cells and negatively correlated with CRP and ESR, while relative abundance of [Eubacterium]_ventriosum were positively associated with the absolute number of Treg cells and negatively correlated with the percentages of Th2 and CD8+T cells (Figure 1F).

Figure 1.

Differences in α diversity (A), β diversity (B), phylum (C), genus (D), and microbial composition (E) between vasculitis patients and HC and correlation analysis between differential microflora and clinical data in patients with vasculitis (F).

Conclusion

Disturbance of intestinal flora, mainly manifested by decreased diversity and richness, may be involved in the occurrence and development of vasculitis by inducing disroders in lymphocyte subsets and cytokines. Consequently, further studies on the immune mechanisms and influencing factors of intestinal flora may provide new ideas for the diagnosis and treatment of the disease for vasculitis patients.

References

[1]Aierken X, Zhu Q, Wu T, et al. Increased Urinary CD163 Levels in Systemic Vasculitis with Renal Involvement[J]. Biomed Res Int, 2021, 2021: 6637235. DOI: 10.1155/2021/6637235.

[2]Zhang X, Zhang D, Jia H, et al. The oral and gut microbiomes are perturbed in rheumatoid arthritis and partly normalized after treatment[J]. Nat Med, 2015, 21(8): 895-905. DOI: 10.1038/nm.3914.

[3]Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides[J]. Arthritis Rheum, 2013, 65(1): 1-11. DOI: 10.1002/art.37715.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No.82001740).

Disclosure of Interests

None declared

AB0202 GUT MICROBIOTA DYSBIOSIS WERE CLOSELY CORRELATED WITH LYMPHOCYTE SUBSETS AND CYTOKINES IN PATIENTS WITH INFLAMMATORY ARTHRITIS

Background

Inflammatory arthritis includes a group of chronic conditions, particularly rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA)[1].Growing evidences link gut microbiota dysbiosis with the development of inflammatory arthritis[2].

Objectives

The aim of this study was to discover the characters of microbiota in inflammatory arthritis patients and compare the relationship between the microbiota and peripheral lymphocyte subsets and cytokines.

Methods

Fecal samples were collected from 73 arthritis patients (13 PsA, 30 AS, 30 RA patients) and 140 sex- and age-matched healthy controls (HCs). The gut microbiota was studied by sequencing the V3-V4 variable regions of bacterial 16S rRNA genes by the Illumina Miseq PE300 system. Peripheral lymphocyte subsets in these participants were assessed by flow cytometry. Measures of disease activity such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were recorded. Alpha and Beta diversity was assessed using results from QIIME2 and gut microbiome profiles were compared using linear discriminant analysis (LDA) effect size (LEfSe). R (version 4.0.1) was used for comparative statistics, using pearson correlation analysis to assess the correlation between the relative abundance of genus in the sample and clinical parameters.

Results

Compared with HCs, the richness of gut microbiota (ACE and Chao 1) was significantly lower (p < 0.05) in arthritis patients, and bacterial diversity including Shannon and Simpson indices (p < 0.001) was also significant in arthritis decreased (Figure 1A). β-diversity analysis based on Bray-curtis distance revealed significant differences in microbial communities between arthritis and HCs (Figure 1B, r=0.098, p=0.001, ANOSIM). In addition, compared with HCs at the genus level, 9 bacterial groups were significantly different in PsA (p < 0.05), 19 bacterial groups in AS (p < 0.05), and 17 bacterial groups in RA(p < 0.05) (Figure 1C). There was a significant positive correlation between CD4+T and Prevotella(p<0.01), T and Prevotella(p<0.05), Blautia(p<0.05) as well as Megamonas(p<0.05), Th17 and Prevotella(p<0.01), CD8+T and Megamonas(p<0.01), Th1 and Megamonas(p<0.05), Prevotella(p<0.01),Coprococcus(p<0.05), B and Erysipelotricbaceae_UCG-003(p<0.01), and Erysipelotricbaceae_UCG-003(p<0.01), Anaerostipes(p<0.01), CRP and Fusobacterium(p<0.05) as well as Roseburia(p<0.05). There were negative correlations between T and Erysipelotricbaceae_UCG-003 (p<0.05),CD8+T and Fusobacterium(p<0.01), CD4+T and Fusobacterium(p<0.05), NK and Fusicatenibacter(p<0.05).

Conclusion

The gut microbiota of patients with inflammatory arthritis differs from HC and also varies among individual arthritis, which was closely related to lymphocyte subsets.

References

[1]Wu X. Innate Lymphocytes in Inflammatory Arthritis[J]. Front Immunol, 2020, 11: 565275.DOI: 10.3389/fimmu.2020.565275

[2]Breban M. Gut microbiota and inflammatory joint diseases[J]. Joint Bone Spine, 2016, 83(6): 645-649.DOI: 10.1016/j.jbspin.2016.04.005

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

POS0745 GUT DYSBIOSIS ASSOCIATED WITH PERIPHERAL LYMPHOCYTES AND CYTOKINES IN PATIENTS WITH SJÖGREN’S SYNDROME

Background

Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by disorders of lymphocyte subpopulations with various cytokines and auto-antibodies1. Growing evidences suggest that gut microbiome dysbiosis may contribute to the development of pSS2.

Objectives

To investigate the alterations to the gut microbiome and the correlation with peripheral lymphocytes and serum cytokines as well as inflammatory factors in pSS patients.

Methods

A total of 101 pSS patients and 101 age- and sex- matched healthy controls (HCs) were enrolled in this study from The Second Hospital of Shanxi Medical University (Taiyuan, Shanxi, China). Patients fulfilled the 2019 ACR/EULAR classification criteria. We conducted 16S rRNA gene sequencing using fecal microbiota samples and analyzed the peripheral lymphocyte subsets by flow cytometry. Serum cytokines, erythrocyte sedimentation rate (ESR), C-reaction protein (CRP), unstimulated and stimulated whole saliva (UWS and SWS) secretion rate was also collected, respectively. Sequence data were compiled and processed using Qiime2 and OTU-profiling tables were constructed. Correlations between different taxa and gut microbiome, as well as clinical variables, were calculated by Spearman’s rank test.

Results

Patients with pSS exhibited a significant reduction in the richness and diversity of gut microbiota compared with those of HCs (Figure 1A-B, p < 0.05). Detailly, at the phylum level, pSS patients had a lower frequency of Firmicutes while higher Proteobacteria (Figure 1C, p < 0.05). Compared with HCs, 11 species of flora were discovered to be distinctly different at the genus level (p < 0.05). Patients presented fewer Faecalibacterium and Roseburia but more Lactobacillus (Figure 1D, p < 0.05). Lactobacillus negatively correlated with T cells (r=-0.407), CD8+T (r=-0.417) and Th2 (r=-0.323). There was a significant positive correlation between Faecalibacterium and IL-2(r=0.312), IFN-γ(r=0.338), TNF-α levels(r=0.322) (Figure 1E, p < 0.05). As for clinical disease measures, IL-6 increases were in line with ESR and CRP, while IL-2 levels inversely related to CRP. Additional UWS secretion rate and SWS secretion rate had negative correlation with ESR (Figure 1F, p < 0.05).

Conclusion

The structural disorder of gut microbiota was distinct in pSS which were associated with peripheral lymphocyte subsets and cytokines. Disorders of gut microbiota and immune systems may contribute to the occurrence and development of pSS.

References

[1]Mariette X, Criswell LA. Primary Sjogren’s Syndrome. N Engl J Med 2018;378(10):931-39. doi: 10.1056/NEJMcp1702514

[2]Trujillo-Vargas CM, Schaefer L, Alam J, et al. The gut-eye-lacrimal gland-microbiome axis in Sjogren Syndrome. Ocul Surf 2020;18(2):335-44. doi: 10.1016/j.jtos.2019.10.006

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

POS0330 DIFFERENCES IN GUT MICROBIOTA ASSOCIATED WITH LYMPHOCYTE SUBSETS, CYTOKINES AND DISEASE ACTIVITY IN ANKYLOSING SPONDYLITIS

Background

Ankylosing spondylitis (AS), a common chronic inflammatory disease, is a prototype of spondyloarthritis affecting sacroiliac joints and spine with or without peripheral arthritis and other systemic symptoms[1]. Environmental factors, especially microorganisms have been suggested to implicate with AS pathogenesis[2].

Objectives

Utilizing 16S rRNA genes sequencing on the feces of untreated AS patients and healthy controls (HCs), our study aimed to provide an in-depth understanding of AS gut microbiota and identifying a feasible diagnostic strategy for AS.

Methods

Fecal samples were collected from 62 AS patients and 62 age-and-gender- matched HCs. Microbial genome was extracted from approximately 250mg fresh fecal samples from all participants using QIAamp PowerFecal DNA Kit (Qiagen). The V3-V4 variable regions of bacterial 16S rRNA genes were sequenced with the Illumina Miseq PE300 system. QIIME2 based pipeline was used to process the raw sequence data. Alpha and beta diversities were assessed using result from QIIME2, and comparisons of gut microbiome profile were performed using linear discriminant analysis (LDA) effect size (LEfSe) to examine differences between AS and HCs. R (version 4. 0.1) was used for comparative statistics, and pearson’s correlation was used to assess the correlations between the relative abundances of bacterial genera and clinical parameters; correlations with p<0.05 were considered significant.

Results

AS for alpha-diversity, ACE and Chao1 indices were lower in AS compared with those HCs(Figure 1A, p<0.05), though no significant differences observed in Shannon and Simpson index. Bray curtis distance-based beta-diversity analysis revealed significant differences in the microbial community between AS and HCs (Figure 1B, p=0.003, ANOSIM). Fecal microbial communities in AS differed significantly from those in HCs, driven by higher abundances of Escherichia-Shigella, Turicibacter, Enterococcus, et al. and a lower abundance of Agathobacter, Roseburia, Eubacterium_eligens_group, et al (Figure 1C, p<0.05). There was a significant positive correlation between ESR and Klebsiella, Butyricicoccus, Roseburia, CRP and Faecalibacterium, Muribaculaceae, ASDAS-CRP score and Faecalibacterium, Ruminococcus, total lymphocyte cells and Agathobacter, Ruminococcus, T cell and Agathobacter, CD4+T cell and Agathobacter, B cell and Agathobacter, Streptococcus, Th1 and Prevotella, CAG−352, Th2 and Agathobacter, Th17 and Prevotella, Agathobacter, IL-2 and Agathobacter, IL-4 and Agathobacter, IL-6 and Lachnospiraceae_UCG−004, Muribaculaceae, IL-17 and Eubacterium_hallii_group, IFN-gama and Phascolarctobacterium.There were negative correlations between total lymphocytes and Escherichia−Shigella, CD4+T cell and Enterobacteriaceae, Th2 cell and Escherichia−Shigella, IL-10 and CAG−352, Ruminococcus (Figure 2, p<0.05).

Figure 1.

Feature of gut microbiota in AS patients and HCs. (A) Alpha-diversity assessed by richness (Chao1, ACE) and diversity (Shannon, Simpson), Median estimates compared across cohorts. (B) PCoA plot based on the Bray curtis distance of gut microbiota samples from AS patients vs. HC group(p=0.003, ANOSIM). (C) Panel demonstrated the average relative abundance of different genus in AS and HCs. (D) Distribution of gut microbiota at genus level.

Figure 2.

Correlations between the relative abundance of significantly different bacteria and clinical variables. *p<0.05, **p < 0.01, ***p <0 .001, ****p < 0.0001.

Conclusion

Human gut microbiome in patients with AS differed from that of the HCs. Characters of bacteria communities were associated with disease activity.

References

[1]Simone D, Al Mossawi M H, Bowness P. Progress in our understanding of the pathogenesis of ankylosing spondylitis [J]. Rheumatology (Oxford), 2018, 57(suppl_6): vi4-vi9.

[2]Zhou C, Zhao H, Xiao X Y, et al. Metagenomic profiling of the pro-inflammatory gut microbiota in ankylosing spondylitis [J]. J Autoimmun, 2020, 107(102360.

Acknowledgements

This project was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

AB0492 INTESTINAL MICROBIOLOGICAL DISORDER CLOSELY ASSOCIATED WITH PERIPHERAL LYMPHOCYTE SUBSETS AND CYTOKINES IN SYSTEMIC LUPUS ERYTHEMATOSUS

Background

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by widespread inflammation and tissue damage in multiple organs[1]. Microbiome is one of environmental factors that has been suggested to contribute to the occurrence and development of SLE[2].

Objectives

This study aims to the understanding of the pathogenesis of SLE from the perspective of intestinal microorganisms and investigate the associations between flora and peripheral lymphocyte subpopulations and cytokines in SLE patients.

Methods

Fecal samples were collected from 96 patients with SLE, and 96 sex-and age-matched healthy controls (HCs). The gut microbiota were investigated via 16s rRNA sequencing and the peripheral T lymphocyte subsets of these participants were assessed by flow cytometry. Indicators of disease activity such as erythrocyte sedimentation rate (ESR), C-reaction protein (CRP), complement C3 and C4 were recorded. Differential abundance analysis was carried out using the edgeR algorithm. The Wilcoxon rank-sum test was used to compare alpha diversity indices, bacterial abundances, and the F/B ratio between groups. R (version 4.0.1) was used for comparative statistics, and pearson’s correlation analysis was used to assess the correlations between the relative abundances of bacterial genera and serum levels of ESR, CRP, C3 and C4 in the samples; correlations with p < 0.05 were considered significant.

Results

The alpha estimators of richness (ACE and Chao 1) were significantly reduced in SLE feces samples compared with those of HCs (p < 0.0001). Bacterial diversity estimators, including the Shannon (p < 0.001) and Simpson’s (p < 0.01) indices, were also significantly lower in SLE (Figure 1A-D). The microbial community structures of the SLE and HCs could be separated by unweighted UnFrac-based principal coordinates analysis (PCoA) (R = 0.186, and p = 0.001; Figure 1E). Significant differences in gut microbiota composition between SLE and HCs were found using the edgeR algorithm. Compared with HCs, 24 species of flora were discovered to be distinctly different(p < 0.05). Moreover, there was a significant positive correlation between Tregs and Corynebacterium(p < 0.05), CD8+T and Corynebacterium (p < 0.05), CD4+T and Corynebacterium (p < 0.05), T and Corynebacterium (p < 0.05), Th1 and Escherichia−Shigella (p < 0.01), Th2 and Dielma (P<0.001) as well as Eubacterium eligens group (p < 0.05), NK and Faecalibacterium (p < 0.01). as well as Corynebacterium (p < 0.001), IL-6 and Coprococcus (p < 0.05), IL-10 and Eubacterium eligens group (p < 0.001) as well as Veillonella (p < 0.05). and Lachnospira (p < 0.01). As for clinical disease measures, there were positive correlations between CRP and Eubacterium ventriosum (p < 0.05). and Coprococcus (p < 0.05), C4 and the abundance of Corynebacterium (p < 0.05) (Figure 1F).

Conclusion

Patients with gut dysbiosis that mainly characterized by reduced the diversity and impaired abundance of the intestinal flora. Abnormality of T cell subsets and cytokines, especially the level of CD4+T, CD8+T, NK, Treg, Th, IL-6 and IL-10 cells contributes to the occurrence and progression of SLE, which may be related to the disturbance of gut microbiota. The discovery of the associated intestinal microbiota of SLE may provide a new idea for treatment.

References

[1]Fava A, Petri M. Systemic lupus erythematosus: diagnosis and clinical management. J Autoimmun. (2019) 96:1–13. 10.1016/j.jaut.2018.11.001

[2]He Z, Shao T, Li H, Xie Z, Wen C: Alterations of the gut microbiome in Chinese patients with systemic lupus erythematosus. Gut pathogens 2016, 8:64.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

POS0556 ALTERATION OF THE GUT MICROBIOTA IN CHINESE POPULATION WITH RHEUMATOID ARTHRITIS

Background

Rheumatoid arthritis (RA) is an aggressive immune-mediated joint disease characterized by synovial proliferation and inflammation, cartilage destruction, and joint destruction. Growing evidences suggests a chronic inflammatory response induced by gut microbiome critically contribute to the development of rheumatoid arthritis.

Objectives

The aim of this study was to evaluate and quantify differences in the composition of gut microbiota in RA patients and investigate the associations between flora and clinical variables in RA patients.

Methods

Fecal samples from 145 RA patients and 145 age- and gender- matched healthy controls (HCs) were collected for bacterial 16S rRNA genes sequencing. The alpha-diversity, beta-diversity and the microbial composition (at the phylum and genus level) analysis of the gut microbiome were used to define the difference of gut microbiota profiles between RA patients and HCs. The peripheral lymphocytes of these patients were assessed by flow cytometry, and inflammatory biomarkers (ESR, CRP), auto-antibodies(ACPA, MCV) and cytokines measured by ELISA were recorded. Correlations between different taxa and clinical variables, were calculated by Spearman’s rank test.

Results

Consistent with trends observed for diversity, patients with RA had a lower richness compared with those of HCs (p < 0.01, Figure 1a), suggesting gut microbiome was markedly less diverse in composition in RA. Bray curtis distance-based beta diversity analysis revealed significant differences in the microbial community between RA and HCs (ANOSIM, R2=0.061, p=0.001, Figure 1b). Ten selected taxonomic biomarkers at different phylogenetic levels showed great discriminant ability, with Log10 LDA score > 4.0 (Figure 1e-g). Detailly, at the phylum level, RA patients had a lower frequency of Firmicutes while higher Proteobacteria. RA patients presented fewer Faecalibacterium but more Escherichia_Shigella at the genus level (Figure 1c-d). PICRUSt analysis found that in the KEGG pathways, the microbial gene functions related to Propanoate metabolism were higher in the fecal microbiome of RA patients (Figure 1h). Escherichia_Shigella positively correlated with ACPA antibodies (r=0.176, p < 0.05) and IL-4 (r=0.204, p < 0.05, Figure 1i), wheras Faecalibacterium as a probiotic showed no significant correlation with our clinical measures.

Figure 1.

Conclusion

Specific gut microbiota played an important role in the pathogenesis of RA, which may aid in the diagnosis or determination of the susceptibility of individuals to RA via detection of the gut microbiome.

References

[1]de Oliveira GLV, Leite AZ, Higuchi BS, et al. Intestinal dysbiosis and probiotic applications in autoimmune diseases. Immunology 2017;152(1):1-12. doi: 10.1111/imm.12765

[2]Chen J, Wright K, Davis JM, et al. An expansion of rare lineage intestinal microbes characterizes rheumatoid arthritis. Genome Med 2016;8(1):43. doi: 10.1186/s13073-016-0299-7

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared.

POS1153 CHARACTERISTICS OF GUT MICROBIOME AND THEIR ASSOCIATIONS WITH PERIPHERAL LYMPHOCYTE SUBPOPULATIONS AND CYTOKINES IN RHEUMATOID ARTHRITIS PATIENTS COMPLICATED WITH OSTEOPOROSIS

Background

Osteoporosis(OP) is one of the major comorbidities of rheumatoid arthritis(RA) which is associated with immune disorders[1]. The gut microbiota has been highlighted to be an important environmental factor to influence immune system in maintaining bone health and regulating bone remodeling[2]. However, the alterations of intestinal flora and its relationship with immune system in RA patients with OP are unclear.

Objectives

To investigate the characteristics of gut microbiome as well as the associations between flora and peripheral lymphocyte subpopulations and cytokines in rheumatoid arthritis patients complicated with osteoporosis.

Methods

Total 28 RA patients were divided into 14 RA-non-OP and 14 gender- and age-matched RA-OP groups according to their bone mineral density (BMD) and the history of fragility fracture. Gut microbiota of participants were investigated by 16s rRNA and peripheral lymphocyte subsets and cytokines were assessed via flow cytometry. Indicators like erythrocyte sedimentation rate (ESR), C-reaction protein (CRP), anti-cyclic citrullinated peptide antibody (ACPA) and anti-mutated citrullinated vimentin (MCV) antibody were recorded meanwhile. Alpha diversity (ACE, Chao1, Simpson, Shannon) and beta diversity indices were analyzed using QIIME2. Biomarker species were recognized based on STEMP. Spearman analysis was adopted for correlation of two variables. All P-values reported herein were two-tailed and P-value<0.05 was taken as statistically significant.

Results

The alpha-diversity have no significant difference between RA-non-OP and RA-OP groups (P >0.05, Figure 1A). The community structure of microflora differed between two groups (P <0.05, Figure 1B). As for the composition of intestinal flora at genus level, Faecalibacterium, Proteus, Catenibacterium, Enterobacter and Erysipelatoclostridium in RA-OP group as well as Lachnospiraceae_ND3007_group, Parasutterella, Megasphaera, Tyzzerella, UCG-005, Clostridium_sensu_stricto_1, UCG-002, Lachnospiraceae_NK4A136_group, Christensenellaceae_R-7_group, Prevotella, Parabacteroides in RA-non-OP group were significantly increased (Figure 1C). There were positive correlations between Lachnospiraceae_NK4A136_group and the level of T, Th1 and Th17 cells, but negative relevance with ESR, CRP and IL-10 (P <0.05). The relative abundance of Faecalibacterium was negatively correlated with IL-2, IL-4, TNF-α and positively with MCV (P <0.05). Clostridium_sensu_stricto_1 and Lachnospiraceae_ND3007_group were negatively correlated with ACPA and MCV respectively as well as IL-2 (P <0.05, Figure 1D-E).

Conclusion

Abnormality of immune system may contribute directly or indirectly to OP in RA, which may be related to the disturbance of gut microbiota.

References

[1]Horta-Baas G, Romero-Figueroa MDS, Montiel-Jarquín AJ, et al. Intestinal Dysbiosis and Rheumatoid Arthritis: A Link between Gut Microbiota and the Pathogenesis of Rheumatoid Arthritis. J Immunol Res. 2017;2017:4835189.

[2]Raterman HG, Bultink IE, Lems WF. Osteoporosis in patients with rheumatoid arthritis: an update in epidemiology, pathogenesis, and fracture prevention. Expert Opin Pharmacother. 2020 Oct;21(14):1725-1737.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

AB0844 Characterizing Gut Microbial Enterotypes in undifferentiated spondyloarthritis

Background

The presence of dysbiosis in the gut microbiome is responsible for the initiation of autoinflammatory and autoimmune diseases. However, such dysbiosis is difficult to characterize in sweeping generalization owing to the high dimensional complexity of the gut microbiota.

Objectives

This study designed to characterize the gut microbial enterotype in patients with undifferentiated spondyloarthritis (USpA) from lower dimensionality and describe the dysbiosis.

Methods

The Fecal samples of 105 patients were diagnosed with USpA and gender- and age- matched 105 healthy controls (HC) were included in the intestinal microbiota composition analyses via Illumina sequencing of bacterial 16S rRNA genes. Microbiota-derived clustering was performed using Dirichlet multinomial mixtures (DMM) modeling. To identify discriminative features in abundance between enterotypes, the Linear Discriminant Analysis Effect Size (LEfSe) algorithm was used with the online interface Galaxy (Log10 LDA score > 4.0). The phyloseq R package to compute alpha diversity (ACE, Chao1, Shannon and Simpson indices), beta diversity (Bray-Curtis dissimilarity) and the microbial composition (at the genus level) to describe the richness and diversity of the microbiota between two enterotypes.

Results

As showed in Figure 1A and C, by evaluating the Laplace approximation to the negative log mode, 2 distinctly enterotypes were identified in the USpA and HC microbiota dataset. LEfSe Analysis indicated the distinctive abundant microbial clades between the 2 enterotypes (LDA score >4) in both the USpA and HC group respectively. At the genus level, Faecalibacterium and Prevotella was the driving genus of enterotype 1 and Bacteroides contributed to enterotype 2 (Figure 1B, D). The alpha-diversity and beta diversity between the distinctive enterotypes was highly significantly different (P < 0.01, Figure 1E, F). Distinct bacterial profiles were also observed in enterotype 1 and 2 (Figure 1G). Interestingly, no significant differences were found between USpA patients and HC for the corresponding same intestinal type. This may be because USpA was at a comparatively early stage of spondyloarthritis (SpA).

Conclusion

Two significantly distinct bacterial microbiota structures existed in the USpA patients which was consistent with the general healthy population.

References

[1]Belkaid Y, Hand TW: Role of the microbiota in immunity and inflammation. Cell 2014, 157(1):121-141.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

The longitudinal connection between depressive symptoms and inflammation: Mediation by sleep quality

Although there is a strong association between depressive symptoms and markers of inflammation, it remains unclear whether depressive symptoms at one point in life may predict inflammation later in life. Moreover, despite extant literature linking sleep with both depressive symptoms and inflammation, there is little research investigating poor sleep as a mechanism linking depressive symptoms with later inflammation. The links between depression and physical health can also vary by gender. In longitudinal analyses with data from the Midlife in the United States (MIDUS) study, we examined whether depressive symptoms were associated with inflammatory markers 11 years later and whether these associations were mediated by sleep disturbances or moderated by gender. Participants reported depressive symptoms and demographic information at baseline. At 11-year follow-up, the same participants (n = 968) reported depressive symptoms, sleep quality and duration using validated scale items, and provided a blood sample from which inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) were quantified. Actigraphy assessment of sleep was obtained in a subsample (n = 276). After adjusting for concurrent depressive symptoms and other relevant covariates, baseline depressive symptoms were associated with CRP 11 years later in the full sample, and with IL-6 among women. Subjective sleep quality mediated the association between depressive symptoms and CRP. Results suggest that depressive symptoms may be longitudinally associated with inflammation; however, directionality issues cannot be determined from the present work, particularly as inflammation markers (which might have been associated with baseline depressive symptoms) were not available at baseline. Findings further suggest that longitudinal associations between depressive symptoms and inflammation may potentially be explained by sleep and may reflect gender specific patterns.

OP0087 INTEGRATED SYSTEMS ANALYSIS OF THE GUT MICROBIOTA PHENOTYPES IN THE RHEUMATOID ARTHRITIS

Background

Patients with rheumatoid arthritis (RA) displays extreme dysbiosis in microbiota. However, such dysbiosis is difficult to characterize owing to the high dimensional complexity of the gut microbiota1,2.

Objectives

The aim of this study was to discover the enterotype characters of intestinal flora in RA.

Methods

Fecal samples from 145 RA patients were collected for bacterial 16S rRNA genes sequencing. Mathematical modeling using Dirichlet multinomial mixtures (DMM) was applied to describe the variability in the microbiome data and cluster samples into enterotypes. The alpha-diversity, beta-diversity and the microbial composition analysis of the gut microbiome were used to define the difference of gut microbiota profiles between different enterotypes. The nonredundant taxonomic biomarkers for each enterotype were selected by using LEfSe. Inflammatory biomarkers (ESR, CRP), auto-antibodies(ACPA, MCV), peripheral lymphocytes subsets and cytokines were analyzed in our cohort using the Kruskal-Wallis test.

Results

Laplace approximation of DMM indicated two significantly distinct bacterial microbiota structures (RAE1 and RA E2) existed in the dataset (Figure 1a). Principal co-ordinates analyses confirmed that these two microbiota states explained a reasonable proportion of observed variance in microbiota composition(ANOSIM R2 = 0.267, p = 0.001; Figure 1b), with distinct bacterial genus distribution of in each enterotype (Figure 1c). RA E1 were primarily dominated by Prevotella while RA E2 by Bacteroides. Interestingly, Chao1, ACE, Shannon and Simpson revealed a higher alpha diversity in Prevotella-enriched enterotype (p< 0.001, Figure 1d). Fourteen selected taxonomic biomarkers at different phylogenetic levels showed great discriminant ability, with Log10 LDA score > 4.0 (Figure 1e-g). Further, inflammatory biomarkers (ESR, CRP) and auto-antibodies(ACPA, MCV) as well as the number of T, B and CD4+T, Th1, Th2, Th17, and Treg were consistent in RA E1 and RA E2 (p > 0.05, Figure 2h). But CD8+T were significantly higher in RA E2 than in RA E2 (p < 0.05).

Conclusion

Despite RA gut microbiota being of different dysbiosis, two patterns of dysbiosis, designated as RA-enterotypes, were predominant among the RA patient cohort. RA E2 exhibited a loss of Prevotella but a growth of Bacteroides, while RA E1 presented the opposite results.

References

[1]Arumugam M, Raes J, Pelletier E, et al. Enterotypes of the human gut microbiome. Nature 2011;473(7346):174-80. doi: 10.1038/nature09944

[2]Costea PI, Hildebrand F, Arumugam M, et al. Enterotypes in the landscape of gut microbial community composition. Nat Microbiol 2018;3(1):8-16. doi: 10.1038/s41564-017-0072-8

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared.

Association of Smartphone Use With Body Image Distortion and Weight Loss Behaviors in Korean Adolescents

IMPORTANCE

Despite high use of smartphones among adolescents, little is known about the association of smartphone use with body image and related behaviors.

OBJECTIVE

To examine the associations of duration of smartphone use and types of content most frequently accessed via smartphone with body image distortion and weight loss behaviors in adolescents.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used data from the population-based Korea Youth Risk Behavior Web-Based Survey 2017. Participants comprised a nationally representative sample of 53 133 Korean adolescents aged 12 to 18 years. Data were collected from June 1 to July 18, 2017. The analysis was performed from February 7, 2020, to March 30, 2022.

EXPOSURES

Self-reported duration of smartphone use (min/d) and types of content (educational or informational searches; chatting, messaging, or email; social networking services or forums; games; videos, movies, or music; webtoons or web novels; and shopping or other activities) most frequently accessed during smartphone use.

MAIN OUTCOMES AND MEASURES

Body image distortion (overperception of body weight), weight loss attempt, use of inappropriate weight loss strategies (skipping meals, eating only 1 food at a time, vomiting, or using laxatives), and healthy weight loss behaviors (muscle-strengthening and aerobic physical activity). Multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and 95% CIs, accounting for survey sampling and adjusting for potential confounders.

RESULTS

Among 53 133 participants, the mean (SD) age was 15.0 (1.8) years; 50.7% of participants were female, and 49.3% were male. After adjusting for types of content accessed, prolonged smartphone use (≥301 min/d) was positively associated with body image distortion (boys: OR, 1.17; 95% CI, 1.07-1.28; girls: OR, 1.20; 95% CI, 1.10-1.30) and inappropriate weight loss strategies (boys: OR, 1.54; 95% CI, 1.25-1.90; girls: OR, 2.45; 95% CI, 2.14-2.79) in both sexes compared with minimal smartphone use (1-120 min/d). After adjusting for duration of smartphone use, the use of smartphones mainly for videos, movies, or music (OR, 1.15; 95% CI, 1.02-1.29), webtoons or web novels (OR, 1.28; 95% CI, 1.10-1.48), and games (OR, 1.17; 95% CI, 1.03-1.32) was positively associated with body image distortion in boys compared with the use of smartphones mainly for educational or informational content. Among boys, the use of smartphones mainly for chatting, messaging, or email was positively associated with muscle-strengthening activity (OR, 1.31; 95% CI, 1.18-1.44) and aerobic physical activity (OR, 1.41; 95% CI, 1.29-1.55), as was the use of smartphones mainly for social networking services or forums (muscle-strengthening activity: OR, 1.27; 95% CI, 1.13-1.42; aerobic physical activity: OR, 1.28; 95% CI, 1.15-1.43). Among girls, the use of smartphones mainly for chatting, messaging, or email was positively associated with weight loss attempts (OR, 1.34; 95% CI, 1.19-1.51) and the use of inappropriate weight loss strategies (OR, 1.57; 95% CI, 1.25-1.99), as was the use of smartphones mainly for social networking services or forums (weight loss attempts: OR, 1.20; 95% CI, 1.07-1.36; use of inappropriate weight loss strategies: OR, 1.37; 95% CI, 1.08-1.73).

CONCLUSIONS AND RELEVANCE

In this cross-sectional study, both the duration of smartphone use and the types of content most frequently accessed via smartphone were associated with body image distortion and weight loss behaviors in adolescents. These findings suggest a need for the identification of strategies to help adolescents develop healthy smartphone use behaviors.

Updating species diversity of Colletotrichum, with a phylogenomic overview

The genus Colletotrichum includes important plant pathogens, endophytes, saprobes and human pathogens. Even though the polyphasic approach has facilitated Colletotrichum species identification, knowledge of the overall species diversity and host distribution is largely incomplete. To address this, we examined 952 Colletotrichum strains isolated from plants representing 322 species from 248 genera, or air and soil samples, from 87 locations in China, as well as 56 strains from Saudi Arabia, Thailand, Turkey, and the UK. Based on morphological characteristics and multi-locus phylogenetic analyses, the strains were assigned to 107 species, including 30 new species described in this paper and 18 new records for China. The currently most comprehensive backbone tree of Colletotrichum, comprising 16 species complexes (including a newly introduced C. bambusicola species complex) and 15 singleton species, is provided. Based on these analyses, 280 species with available molecular data are accepted in this genus, of which 139 have been reported in China, accounting for 49.6 % of the species. Colletotrichum siamense, C. karsti, C. fructicola, C. truncatum, C. fioriniae, and C. gloeosporioides were the most commonly detected species in China, as well as the species with the broadest host range. By contrast, 76 species were currently found to be associated with a single plant species or genus in China. To date, 33 Colletotrichum species have been exclusively reported as endophytes. Furthermore, we generated and assembled whole-genome sequences of the 30 new and a further 18 known species. The most comprehensive genome tree comprising 94 Colletotrichum species based on 1 893 single-copy orthologous genes was hence generated, with all nodes, except four, supported by 100 % bootstrap values. Collectively, this study represents the most comprehensive investigation of Colletotrichum diversity and host occurrence to date, and greatly enhances our understanding of the diversity and phylogenetic relationships in this genus.

[Influence of guided bone regeneration on marginal bone loss of implants in the mandible posterior region: a 10-year retrospective cohort study]

Objective: To investigate the effect of guided bone regeneration (GBR) on marginal bone loss (MBL) in the region of the mandibular posterior tooth by using a retrospective cohort study, in order to provide reference for clinical practice. Methods: The research subjects were patients who received dental implants from October 2008 to June 2011 in the region of the mandibular posterior tooth at the Department of Oral Implantology, School of Stomatology, The Fourth Military Medical University. According to whether GBR was performed or not and the time of implant insertion, the patients were divided into the controls group (patients without bone grafting), simultaneous GBR implantation group, and delayed GBR implantation group. On this basis, the MBL was measured according to radiographs by comparing the marginal bone level from that of immediate postoperation 10 years ago. General data was collected and compared among groups, including modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), and gingival papilla height. Results: The controls group (patients without bone grafting), implantation group, and delayed GBR implantation group followed 58, 76, 26 implants in 26, 32, 13 patients aging at (46.5±9.9), (45.5±10.7), (58.3±6.4) respectively. The duration of the follow-up was (11.2±0.7), (11.1±0.8), (11.1±0.9) years respectively. The 10-year implant survival rate was 100% (58/58), 100% (76/76), 100% (26/26). The MBL was (0.91±0.28), (0.84±0.27), (1.01±0.27) mm respectively. The MBL difference of patients with simultaneous GBR implantation and delayed GBR implantation showed statistical significance (P<0.05), but these two groups showed no statistical significance compared with the controls group (P>0.05). The mPI, mSBI, PD, and gingival papilla height of the three groups all had no significance on statistics (P>0.05). Conclusions: It can be concluded that there is no difference in long-term marginal bone resorption between simultaneous and delayed implantation with or without GBR (using autologous blood mixed with granular bone meal) in the posterior mandibular area.

Reduced miR-363-3p expression in non-small cell lung cancer is associated with gemcitabine resistance via targeting of CUL4A

The article "Reduced miR-363-3p expression in non-small cell lung cancer is associated with gemcitabine resistance via targeting of CUL4A", W.-G. Bian, X.-N. Zhou, S. Song, H.-T. Chen, Y. Shen, P. Chen, published in Eur Rev Med Pharmacol Sci 2019; 23 (2): 649-659-DOI: 10.26355/eurrev_201901_16879-PMID: 30720173, has been retracted by the authors due to several inaccuracies in the research design. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/16879.

Development of patulin certified reference material using mass balance and quantitative NMR

The certified reference materials (CRMs) are necessary for accurate quantification and insurance of comparability and traceability of results. Patulin is a typical mycotoxin in a variety of food commodities. Here, patulin CRM GBW(E)100673 was characterised and its purity was assessed by two independent orthogonal approaches including mass balance (MB) and quantitative nuclear magnetic resonance spectroscopy (qNMR) methods. From MB equation, the calculated purity was 996.9 mg/g with subtraction of water, volatile solvent, inorganic and structurally related impurities. In the other qNMR method, the calculated purity was 996.7 mg/g. This CRM was homogeneous and stable for at least 9 months under -20 °C in dark. Finally, a purity of 997 mg/g with an expanded uncertainty of 3 mg/g (k=2) was finally assigned to patulin CRM in this study. High-purity patulin CRM was fully characterised and assessed for the first time. The new CRM can be applicable to routine monitoring and risk assessment for assurance of accuracy results in food safety.

POS0109 IDENTIFICATION OF PRIMARY SJOGREN’S SYNDROME SUBTYPES BY MACHINE LEARNING

Background:

Sjogren’s syndrome(pSS) is a chronic, progressive, and systematic autoimmune disease characterized by lymphocytic infiltration of exocrine glands 1 2. Sicca symptoms and abnormal fatigue are the main clinical presentation, but those symptoms are non-specific to patients, which lead to delayed diagnosis 1 3. The heterogeneous of clinical manifestation raise challenges regarding diagnosis and therapy in pSS, thus it’s necessary for us to sub-classify pSS.

Objectives:

To explore new biomarkers for diagnosis and subtypes of pSS based on Machine Learning Primary.

Methods:

All microarray raw datas (CEL files) were screened and downloaded from Gene Expression Omnibus (GEO). Meta-analysis to identify the consistent DEGs by MetaOmics. Weighted gene co-expression network analysis (WGCNA) was used to the modules related to SS for further analysis. Subclasses were computed using a consensus Non-negative Matrix Factorization (NMF) clustering method. Immune cell infiltration was used to evaluate the expression of immune cells and obtain various immune cell proportions from samples. P value < 0.05 were considered statistically significant. All the analyses were conducted under R environment (version 4.03).

Results:

A total of 3715 consistent DEGs were identified from the four datasets, including 1748 up-regulated and 1967 down-regulated genes. Tour meaningful modules, including yellow, turquoise, grey60 and bule, were identified (Figure 1A,1B). And 183 overlapping gene were screened from the DEGs and the Hub genes in the four modles for further analysis. We final divided pSS patients into three subtypes, of which yellow and turquoise in Sub1, grey60 in Sub2 and blue in Sub3. Sub1 and Sub3 were related to cell metabolism, while Sub2 had connection with virus infection (Figure 1C,1D). Infiltrated immune cells were also different among these three types (Figure 1E,1F).

Conclusion:

Patients with pSS could be classified into 3 subtypes, this classification might help for assessing prognosis and guiding precise treatment.

References:

[1]Ramos-Casals M, Brito-Zerón P, Sisó-Almirall A, et al. Primary Sjogren syndrome. BMJ (Clinical research ed) 2012;344:e3821. doi: 10.1136/bmj.e3821 [published Online First: 2012/06/16].

[2]Brito-Zeron P, Baldini C, Bootsma H, et al. Sjogren syndrome. Nat Rev Dis Primers 2016;2:16047. doi: 10.1038/nrdp.2016.47 [published Online First: 2016/07/08].

[3]Segal B, Bowman SJ, Fox PC, et al. Primary Sjogren’s Syndrome: health experiences and predictors of health quality among patients in the United States. Health Qual Life Outcomes 2009;7:46. doi: 10.1186/1477-7525-7-46 [published Online First: 2009/05/29].

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

POS0847 IDENTIFICATION OF MOLECULAR PHENOTYPES IN SYSTEMIC SCLEROSIS BY INTEGRATIVE SYSTEMS ANALYSIS

Background:

Systemic sclerosis (scleroderma, SSc) is a systemic autoimmune disease characterized by inflammation, fibrosis and vasculopathy and associated with high mortality and high morbidity1. Stratification based on whole-genome gene expression data could provide a new basis for clinical diagnosis from a micro perspective2.

Objectives:

The objective of this study is to stratify patients with SSc, combine with clinical skin scores and clinical features, and provide a preliminary assessment and novel insights for assessing disease severity, and treatment design.

Methods:

The original data mRNA expression profiles of GSE95065 (including 18 SSc patients and 4 healthy controls) and GSE130955 (including 58 SSc patients and 33 healthy controls) were downloaded from the public Gene Expression Omnibus (GEO) database. After batch correction, background adjustment, and other pre-processing, a large gene matrix was obtained to identify the differently expressed genes (DEGs) of SSc compared with healthy controls. Then the gene expression matrix decomposition was used to identify SSc subtypes by NMF algorithm. The cluster-based signature genes were applied to pathway enrichment analysis by Metascape3. Immune infiltrating cells and clinical skin scores were evaluated in all SSc subtypes.

Results:

Total 325 DEGs were imputed to NMF unsupervised machine learning algorithm. Patients were divided into 2 subtypes (Figure 1A), one of which (sub1) was mostly enriched in the defense response to bacterium and cellular response to lipopolysaccharide pathway and another subtype (sub2) was enriched in the PPAR signaling and alcohol metabolic process pathway (Figure 1B-C). According to immune infiltration, sub1 had higher level of immune cells such as B cells, CD4+T cells, DC cells, Th2 cells and Tregs compared with sub2 (P < 0.01). Sub2 had more skin-related cells, including Epithelial cells, Fibroblasts and Sebocytes (P < 0.05). Interestingly, combined with clinical information, sub1 showed a severe clinical skin score over those of Sub2 patients (P < 0.05)(Figure 1D-E).

Conclusion:

Our findings indicated that SSc patients could be stratified into 2 subtypes which had different molecular profiles of disease progression and clinical disease activities. This result could serve as a template for future studies to design stratified approaches for SSc patients.

References:

[1]Xu X, Ramanujam M, Visvanathan S, et al. Transcriptional insights into pathogenesis of cutaneous systemic sclerosis using pathway driven meta-analysis assisted by machine learning methods. PLoS One 2020;15(11):e0242863. doi: 10.1371/journal.pone.0242863 [published Online First: 2020/12/01].

[2]Xu C, Meng LB, Duan YC, et al. Screening and identification of biomarkers for systemic sclerosis via microarray technology. Int J Mol Med 2019;44(5):1753-70. doi: 10.3892/ijmm.2019.4332 [published Online First: 2019/09/24].

[3]Zhou Y, Zhou B, Pache L, et al. Metascape provides a biologist-oriented resource for the analysis of systems-level datasets. Nat Commun 2019;10(1):1523. doi: 10.1038/s41467-019-09234-6 [published Online First: 2019/04/05].

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

OP0184 PHENOTYPING OF MOLECULAR SIGNATURES IN THE SYNOVIAL TISSUE OF RHEUMATOID ARTHRITIS BY INTEGRATIVE SYSTEMS ANALYSIS

Background:

Rheumatoid arthritis (RA) is an aggressive immune-mediated joint disease characterized by synovial proliferation and inflammation, cartilage destruction, and joint destruction1. Despite efforts to characterize the disease subsets and to predict the differential prognosis in RA patients, disease heterogeneity is not adequately translated into the current clinical subclassification2.

Objectives:

To develop and validate an integrative system approach for stratifying patients with RA according to disease status and whole-genome gene expression data.

Methods:

An RNA sequencing dataset of synovial tissues from 124 RA patients (including 57 patients with early RA, 95 with established RA) and 15 healthy controls (HC) was imported from the Gene Expression Omnibus (GEO) database (GSE89408) by software package R (version 4.0.3). After filtrating of differentially expressed genes (DEGs) between RA and HC, non-negative matrix factorization, functional enrichment, and immune cell infiltration were applied to illustrate the landscapes of these patients for classification. Clinical features (age, gender, and auto-antibodies) were also compared to discover the signatures of these classifications.

Results:

A matrix of 576 DEGs from RA samples was classified into 5 subtypes (early/C1–C3, established/C4-C5) with distinct molecular and cellular signatures and two sub-groups (S1 and S2) (Figure 1A-1D). New-onset patients (early C2) and established C4 patients were named as S1, they shared similar gene signatures mainly characterized by prominent immune cells and proinflammatory signatures, and enriched in the chemokine-mediated signaling pathway, lymphocyte activation, response to bacterium and Primary immunodeficiency. S2(C1, C3 and C5) were more occupied by synovial fibroblasts of destructive phenotype. They were mainly enriched in the response to external factors and PPAR signaling pathway (Figure 1E-1H). Interestingly, combined with clinical information, S1 and S2 had no significance in age and gender (P > 0.05). But patients in S1 had a stronger association with the presence of anti-citrullinated protein antibodies (ACPA) (P < 0.05) (Figure 1I-1J).

Conclusion:

We successfully deconvoluted RA synovial tissues into pathobiological discrete subsets using an unsupervised machine learning method and described their distinct molecular and cellular characteristics. These results provide important insights into divergent and shared mechanistic features of RA and serve as a template for future studies to guide drug tar-get discovery by synovial molecular signatures and de-sign stratified approaches for patients with RA.

References:

[1]Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet 2016;388(10055):2023-38. doi: 10.1016/S0140-6736(16)30173-8 [published Online First: 2016/10/30]

[2]Jung SM, Park KS, Kim KJ. Deep phenotyping of synovial molecular signatures by integrative systems analysis in rheumatoid arthritis. Rheumatology (Oxford) 2020 doi: 10.1093/rheumatology/keaa751 [published Online First: 2020/11/25]

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

POS0458 IDENTIFICATION OF HUB GENES AND MOLECULAR PATHWAYS IN PATIENTS WITH RHEUMATOID ARTHRITIS BY BIOINFORMATICS ANALYSIS

Background:

Rheumatoid arthritis (RA) is a chronic, inflammatory synovitis based systemic disease of unknown etiology1. The genes and pathways in the inflamed synovium of RA patients are poorly understood.

Objectives:

This study aims to identify differentially expressed genes (DEGs) associated with the progression of synovitis in RA using bioinformatics analysis and explore its pathogenesis2.

Methods:

RA expression profile microarray data GSE89408 were acquired from the public gene chip database (GEO), including 152 synovial tissue samples from RA and 28 healthy synovial tissue samples. The DEGs of RA synovial tissues were screened by adopting the R software. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed. Protein-protein interaction (PPI) networks were assembled with Cytoscape software.

Results:

A total of 654 DEGs (268 up-regulated genes and 386 down-regulated genes) were obtained by the differential analysis. The GO enrichment results showed that the up-regulated genes were significantly enriched in the biological processes of myeloid leukocyte activation, cellular response to interferon-gamma and immune response-regulating signaling pathway, and the down-regulated genes were significantly enriched in the biological processes of extracellular matrix, retinoid metabolic process and regulation of lipid metabolic process. The KEGG annotation showed the up-regulated genes mainly participated in the staphylococcus aureus infection, chemokine signaling pathway, lysosome signaling pathway and the down-regulated genes mainly participated in the PPAR signaling pathway, AMPK signaling pathway, ECM-receptor interaction and so on. The 9 hub genes (PTPRC, TLR2, tyrobp, CTSS, CCL2, CCR5, B2M, fcgr1a and PPBP) were obtained based on the String database model by using the Cytoscape software and cytoHubba plugin3.

Conclusion:

The findings identified the molecular mechanisms and the key hub genes of pathogenesis and progression of RA.

References:

[1]Xiong Y, Mi BB, Liu MF, et al. Bioinformatics Analysis and Identification of Genes and Molecular Pathways Involved in Synovial Inflammation in Rheumatoid Arthritis. Med Sci Monit 2019;25:2246-56. doi: 10.12659/MSM.915451 [published Online First: 2019/03/28]

[2]Mun S, Lee J, Park A, et al. Proteomics Approach for the Discovery of Rheumatoid Arthritis Biomarkers Using Mass Spectrometry. Int J Mol Sci 2019;20(18) doi: 10.3390/ijms20184368 [published Online First: 2019/09/08]

[3]Zhu N, Hou J, Wu Y, et al. Identification of key genes in rheumatoid arthritis and osteoarthritis based on bioinformatics analysis. Medicine (Baltimore) 2018;97(22):e10997. doi: 10.1097/MD.0000000000010997 [published Online First: 2018/06/01]

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

AB0005 IDENTIFICATION OF KEY GENES AND PATHWAYS FOR PSORIASIS BASED ON GEO DATABASES BY BIOINFORMATICS ANALYSIS

Background:

Psoriasis is an immune-mediated, genetic disease manifesting in the skin or joints or both, and also has a strong genetic predisposition and autoimmune pathogenic traits1. The hallmark of psoriasis is sustained inflammation that leads to uncontrolled keratinocyte proliferation and dysfunctional differentiation. And it’s also a chronic relapsing disease, which often necessitates a long-term therapy2.

Objectives:

To investigate the molecular mechanisms of psoriasis and find the potential gene targets for diagnosis and treating psoriasis.

Methods:

Total 334 gene expression data of patients with psoriasis research (GSE13355 GSE14905 and GSE30999) were obtained from the Gene Expression Omnibus database. After data preprocessing and screening of differentially expressed genes (DEGs) by R software. Online toll Metascape3 was used to analyze Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of DEGs. Interactions of proteins encoded by DEGs were discovered by Protein-protein interaction network (PPI) using STRING online software. Cytoscape software was utilized to visualize PPI and the degree of each DEGs was obtained by analyzing the topological structure of the PPI network.

Results:

A total of 611 DEGs were found to be differentially expressed in psoriasis. GO analysis revealed that up-regulated DEGs were mostly associated with defense and response to external stimulus while down-regulated DEGs were mostly associated with metabolism and synthesis of lipids. KEGG enrichment analysis suggested they were mainly enriched in IL-17 signaling, Toll-like receptor signaling and PPAR signaling pathways, Cytokine-cytokine receptor interaction and lipid metabolism. In addition, top 9 key genes (CXCL10, OASL, IFIT1, IFIT3, RSAD2, MX1, OAS1, IFI44 and OAS2) were identified through Cytoscape.

Conclusion:

DEGs of psoriasis may play an essential role in disease development and may be potential pathogeneses of psoriasis.

References:

[1]Boehncke WH, Schon MP. Psoriasis. Lancet 2015;386(9997):983-94. doi: 10.1016/S0140-6736(14)61909-7 [published Online First: 2015/05/31].

[2]Zhang YJ, Sun YZ, Gao XH, et al. Integrated bioinformatic analysis of differentially expressed genes and signaling pathways in plaque psoriasis. Mol Med Rep 2019;20(1):225-35. doi: 10.3892/mmr.2019.10241 [published Online First: 2019/05/23].

[3]Zhou Y, Zhou B, Pache L, et al. Metascape provides a biologist-oriented resource for the analysis of systems-level datasets. Nat Commun 2019;10(1):1523. doi: 10.1038/s41467-019-09234-6 [published Online First: 2019/04/05].

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

POS0199 TIME-SERIES ANALYSIS IN MODERATE TO SEVERE PLAQUE PSORIASIS UNDER DIFFERENT BIOLOGICS TREATMENTS

Background:

Moderate to Severe Plaque Psoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients’ quality of life. As one of the most significant therapeutic advancements in the field of dermatology, Biologics such as TNF inhibitors, IL-12/23 inhibitor, IL-17 inhibitors, and IL-23 inhibitors, have higher efficacy compared with oral medications or phototherapy1. However, the previous studies did not focus on the simultaneous comparison of molecular changes in different classes of biologics. The identification of time-series genes (TSGs) could help to uncover the mechanisms underlying transcriptional regulation2.

Objectives:

In this study, we aimed to compare the differences in expression patterns and functions of time-series genes in Moderate to Severe Plaque Psoriasis under different biologics treatments.

Methods:

The transcription profile of GSE117239 and GSE51440 were obtained from the Gene Expression Omnibus database (GEO). The GSE117239 included 19 samples treated with Etanercept (TNF inhibitors) and 16 samples treated with Ustekinumab (IL-12/23 inhibitor). The GSE51440 included 4 samples treated with Guselkumab (IL-23 inhibitors). Skin biopsy samples (LS: lesion, NL: non-lesion) were collected at baseline, weeks 1 and 12, respectively. After background adjustment and other pre-procession, differentially expressed genes (DEGs) were extracted from LS skin biopsy and untreated NL skin biopsy at different times after three different biologics treatments, respectively. The Short Time-series Expression Miner (STEM) software was used to cluster and compare average DEGs with coherent changes. Afterward, the different expression patterns of TSGs under the three treatment groups were compared. GO analysis and KEGG pathway enrichment analysis of TSGs were performed by Metascape.

Results:

Different DEGs varied in LS skin compared with those of NL skin biopsy: 976 genes in Ustekinumab group, 996 genes in Etanercept group, and 601 genes in Guselkumab group detailly (P < 0.05 and [log FC] > 1). Gene landscapes suggested the signatures of LS gradually changed during the treatment process, and gradually converge to NL signatures (Fig.1a, 2a,3a). Time-series genes in the three treatment groups had different expression patterns and functions. In the Ustekinumab group, a total of 448 TSGs in profile 3 showed a stable-stable-decreasing expression trend and significantly associated with mitotic nuclear division and defense response to other organism, whereas in profile 4 represented a stable-stable-increasing expression trend and significantly associated with positive regulation of cellular response to organic 9 compound (Fig.1). With the treatment of Etanercept, 22 TSGs had a stable-increasing-increasing expression tendency and closely associated with fatty acid metabolism and steroid metabolic process (Fig.2). After Guselkumab treatment, 13 TSGs also represented a stable-increasing-increasing expression tendency that mainly characterized by defense response to other organism and epidermis development (Fig.3). Interestingly, both Ustekinumab and Guselkumab treatment dramatically influenced defense response to other organism-related genes, while Etanercept mainly affected genes involved in fatty acid metabolism and steroid metabolic process.

Conclusion:

Biologics effectively reconstituted the gene signatures of psoriasis in different aspects. TSG features could be one of indicator for precise intervention for psoriasis.

References:

[1]Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. Jama 2020;323(19):1945-60. doi: 10.1001/jama.2020.4006 [published Online First: 2020/05/20]

[2]Ernst J, Bar-Joseph Z. STEM: a tool for the analysis of short time series gene expression data. BMC Bioinformatics 2006;7:191. doi: 10.1186/1471-2105-7-191 [published Online First: 2006/04/07]

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

POS0363 IDENTIFICATION OF MOLECULAR PHENOTYPES AND IMMUNE CELL INFILTRATION IN PSORIATIC ARTHRITIS PATIENTS’ SKIN TISSUES BY INTEGRATED BIOINFORMATICS ANALYSIS

Background:

Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease associated with cutaneous psoriasis1. Heterogeneity of clinical manifestation often makes differential diagnosis difficult 2. Thus, the underlying molecular pathogenesis of PsA need to be further studied to diagnose early and ensure optimal management of arthritis and key comorbidities.

Objectives:

This research was conducted to identify molecular phenotypes and immune infiltration in the skin tissues of psoriatic arthritis patients according to bioinformatics analysis.

Methods:

The mRNA expression profiles of GSE13355 (116 samples), GSE14905 (56 samples) and GSE30999 (162 samples) were obtained from the publicly GEO databases. Non-negative matrix factorization (NMF), functional enrichment and cibersort algorithm were applied to illustrate the conditions of PsA patients’ skin tissues for classification after screening the differentially expressed genes (DEGs) between lesion biopsy and non-lesion biopsy.

Results:

Two subsets (Sub1 and Sub2) were identified and validated by NMF typing of 612 detected DEGs (Figure 1a). A total of 54 signature genes (18 in Sub1 and 36 in Sub2) were obtained (Figure 1b). GO and KEGG enrichment analysis showed the signature genes in Sub1 were mainly involved in proliferation and differentiation of immune cells, whereas genes in Sub2 were related to humoral immune response mediated by antimicrobial peptide (Figure 1c.1d). Further, immune cell infiltration results revealed Sub2 had higher levels of resting NK cells (P<0.001), macrophages M1(P<0.001), resting mast cells (P<0.001) and regulatory T cells (P<0.001) but lower concentrations of activated CD4+ memory T cells (P<0.001), activated NK cells (P<0.05), activated dendritric cells(P<0.001), eosinophils (P<0.05) and neutrophil (P<0.001) (Figure 1e).

Conclusion:

The pathogenesis of psoriatic arthritis is related to both cellular immunity and humoral immunity. It is indispensable to adjust the treatment strategies according to patient’s immune status.

References:

[1]Ritchlin CT, Colbert RA, Gladman DD. Psoriatic Arthritis. The New England journal of medicine 2017;376(10):957-70. doi: 10.1056/NEJMra1505557 [published Online First: 2017/03/09].

[2]Veale DJ, Fearon U. The pathogenesis of psoriatic arthritis. Lancet (London, England) 2018;391(10136):2273-84. doi: 10.1016/s0140-6736(18)30830-4 [published Online First: 2018/06/13].

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared