Estrogen Hormone Is an Essential Sex Factor Inhibiting Inflammation and Immune Response in COVID-19

Although vaccines have been evaluated and approved for SARS-CoV-2 infection prevention, there remains a lack of effective treatments to reduce the mortality of COVID-19 patients already infected with SARS-CoV-2. The global data of COVID-19 showed that men have a higher mortality rate than women. We further observed that the proportion of mortality of female increases starting from around the age of 55 significantly. Thus, sex is an essential factor associated with COVID-19 mortality, and sex related genetic factors could be interesting mechanisms and targets for COVID-19 treatment. However, the associated sex factors and signaling pathways remain unclear. Here, we propose to uncover the potential sex associated factors using systematic and integrative network analysis. The unique results indicated that estrogen hormones (ER), e.g., estrone and estriol, 1) interacting with ESR1/2 receptors, 2) can inhibit SARS-CoV-2 caused inflammation and immune response signaling in host cells; and 3) estrogen hormone is associated with the distinct fatality rates between male and female COVID-19 patients. Specifically, a high level of estradiol protecting young female COVID-19 patients, and estrogen loss to an extremely low level in females after about 55 years of age causing the increased fatality rate of women. In conclusion, estrogen hormone, interacting with ESR1/2 receptors, is an essential sex factor that protects COVID-19 patients by inhibiting inflammation and immune response caused by SARS-CoV-2 infection. Medications perturb the down-stream of ESR1/ESR2 to inhibit the inflammation and immune response can be effective or synergistic combined with other existing drugs for COVID-19 treatment.

Single- and Multiple-Dose Trials to Determine the Pharmacokinetics, Safety, Tolerability, and Sex Effect of Oral Ginsenoside Compound K in Healthy Chinese Volunteers

Background and objectives: Ginsenoside compound K (CK) is a candidate drug for rheumatoid arthritis therapy. The objective of this study was to investigate the pharmacokinetic properties, safety and tolerability of CK.

Methods: In randomized, double-blind trials, 76 healthy Chinese subjects received 1 of 7 single oral doses (25, 50, 100, 200, 400, 600, 800 mg) of CK or placebo under fasting condition, and another 36 subjects received repeated oral doses (100, 200, or 400 mg) of CK or placebo for up to 9 days a week after a corresponding single dose, after breakfast. Both sexes were equally represented in the two trials. Pharmacokinetic parameters of CK and its metabolite 20(S)-protopanaxadiol (PPD) were calculated and statistically analyzed according to the plasma concentration data. Tolerability was evaluated by adverse events (AEs) and laboratory examinations.

Results: The range of time to maximum concentration (T_max) was 1.5–6.0 h, with a linear increase in the exposure of CK over the dose range of 100–400 mg. Steady state was reached after the 7th administration, and the accumulation index range was 2.60–2.78. Sex differences were characterized by a higher exposure in females than males with the single administration after breakfast. In addition, no severe AEs were observed.

Conclusion: CK was safe and well-tolerated over the treatment period. The sex- and food-related impacts on CK pharmacokinetics need further investigations to be validated. (Registration number: ChiCTR-TRC-14004824 and ChiCTR-IPR-15006107, http://www.chictr.org.cn/index.aspx).

The Clinical Significance of Ulnar Artery Morphology in Artificial Arterial-Venous Fistula for Hemodialysis

BACKGROUND

The ulnar artery is a terminal branch of the brachial artery. The aim of this study is to provide comprehensive data concerning the morphology of the ulnar artery, with clinical implications for surgeons.

METHODS

The current study includes the dissection of 68 upper limb specimens. It investigates the characteristics of the ulnar artery such as the internal diameter, external diameter, wall thickness, and distance of the ulnar artery origin.

RESULTS

In this study, the ulnar artery arose distal to the superior margin of the head of the radius in 82.65% of cases. The angle degree of the ulnar artery with respect to the brachial artery ranges from to 8° to 30°. The internal and external diameters of the ulnar artery were found to decrease gradually from proximal to distal in both genders. The external and internal diameters of the ulnar artery are greater in males than in females. In all cases, the external and internal diameters and the thickness of the ulnar artery at three levels were found to be greater in the right ulnar artery than the left.

CONCLUSION

The right ulnar artery may be the appropriate choice for artificial arterial-venous fistula for haemodialysis. Due to its wide diameter, the proximal part of the radial artery is a suitable site for the artificial arterial-venous fistula immediately below the origin prior to its profound course. Therefore, it is an easy access for artificial arterial-venous fistula for surgeons. The radiologists must alert the surgeons for surgical modification in the case of high brachial bifurcation.

Contribution of base-pairing interactions between group II intron fragments during trans-splicing in vivo

Group II introns are mobile genetic elements that self-splice from pre-mRNA transcripts. Some fragmented group II introns found in chloroplastic and mitochondrial genomes are able to assemble and splice in trans. The Ll.LtrB group II intron from the Gram-positive bacterium Lactococcus lactis was shown to splice in trans when fragmented at various locations throughout its structure. Here we used Ll.LtrB to assess the contribution of base-pairing interactions between intron fragments during trans-splicing in vivo. By comparing closely located fragmentation sites, we show that Ll.LtrB trans-splices more efficiently when base-pairing interactions can occur between the two intron fragments. Disruptions and stepwise restorations of specific base-pairing interactions between intron fragments resulted respectively in significant reductions and recoveries of the Ll.LtrB trans-splicing efficiency. Finally, although we confirm that LtrA is an important co-factor for trans-splicing, its overexpression cannot compensate for the reduction in trans-splicing efficiency when the potential base-pairing interactions between intron fragments are disrupted. These findings demonstrate the important contribution of base-pairing interactions for the assembly of group II intron fragments during trans-splicing and rationalizes why such interactions were evolutionarily conserved in natural trans-splicing group II introns.