Vitamin D Treatment Prevents Uremia-Induced Reductions in Aortic microRNA-145 Attenuating Osteogenic Differentiation despite Hyperphosphatemia

In chronic kidney disease, systemic inflammation and high serum phosphate (P) promote the de-differentiation of vascular smooth muscle cells (VSMC) to osteoblast-like cells, increasing the propensity for medial calcification and cardiovascular mortality. Vascular microRNA-145 (miR-145) content is essential to maintain VSMC contractile phenotype. Because vitamin D induces aortic miR-145, uremia and high serum P reduce it and miR-145 directly targets osteogenic osterix in osteoblasts, this study evaluated a potential causal link between vascular miR-145 reductions and osterix-driven osteogenic differentiation and its counter-regulation by vitamin D. Studies in aortic rings from normal rats and in the rat aortic VSMC line A7r5 exposed to calcifying conditions corroborated that miR-145 reductions were associated with decreases in contractile markers and increases in osteogenic differentiation and calcium (Ca) deposition. Furthermore, miR-145 silencing enhanced Ca deposition in A7r5 cells exposed to calcifying conditions, while miR-145 overexpression attenuated it, partly through increasing α-actin levels and reducing osterix-driven osteogenic differentiation. In mice, 14 weeks after the induction of renal mass reduction, both aortic miR-145 and α-actin mRNA decreased by 80% without significant elevations in osterix or Ca deposition. Vitamin D treatment from week 8 to 14 fully prevented the reductions in aortic miR-145 and attenuated by 50% the decreases in α-actin, despite uremia-induced hyperphosphatemia. In conclusion, vitamin D was able to prevent the reductions in aortic miR-145 and α-actin content induced by uremia, reducing the alterations in vascular contractility and osteogenic differentiation despite hyperphosphatemia.     

Cyanidin-3-O-glucoside and Peonidin-3-O-glucoside-Rich Fraction of Black Rice Germ and Bran Suppresses Inflammatory Responses from SARS-CoV-2 Spike Glycoprotein S1-Induction In Vitro in A549 Lung Cells and THP-1 Macrophages via Inhibition of the NLRP3 Inflammasome Pathway

Black rice is a functional food that is high in anthocyanin content, primarily C3G and P3G. It possesses nutraceutical properties that exhibit a range of beneficial effects on human health. Currently, the spike glycoprotein S1 subunit of SARS-CoV-2 (SP) has been reported for its contribution to pathological inflammatory responses in targeting lung tissue and innate immune cells during COVID-19 infection and in the long-COVID phenomenon. Our objectives focused on the health benefits of the C3G and P3G-rich fraction of black rice germ and bran (BR extract) on the inhibition of inflammatory responses induced by SP, as well as the inhibition of NF-kB activation and the NLRP3 inflammasome pathway in an in vitro model. In this study, BR extract was identified for its active anthocyanins, C3G and P3G, using the HPLC technique. A549-lung cells and differentiated THP-1 macrophages were treated with BR extract, C3G, or P3G prior to exposure to 100 ng/mL of SP. Their anti-inflammatory properties were then determined. BR extract at concentrations of 12.5–100 μg/mL exhibited anti-inflammation activity for both A549 and THP-1 cells through the significant suppression of NLRP3, IL-1β, and IL-18 inflammatory gene expressions and IL-6, IL-1β, and IL-18 cytokine secretions in a dose-dependent manner (p < 0.05). It was determined that both cell lines, C3G and P3G (at 1.25–10 μg/mL), were compatibly responsible for the significant inhibition of SP-induced inflammatory responses for both gene and protein levels (p < 0.05). With regard to the anti-inflammation mechanism, BR extract, C3G, and P3G could attenuate SP-induced inflammation via counteraction with NF-kB activation and downregulation of the inflammasome-dependent inflammatory pathway proteins (NLRP3, ASC, and capase-1). Overall, the protective effects of anthocyanins obtained from black rice germ and bran can be employed in potentially preventive strategies that use pigmented rice against the long-term sequelae of COVID-19 infection.     

Spanish Translation and Linguistic Validation of the Glucose Monitoring Experiences Questionnaire (GME-Q) in Continuous Glucose Monitoring Users

Background and Aims:The use of continuous glucose monitoring (CGM) has become standard practice in people with type 1 diabetes. The evaluation of user satisfaction is crucial. The Glucose Monitoring Experiences questionnaire (GME-Q) includes 23 items with a 5-point Likert scale to produce a total satisfaction score and three subscale scores. The study aimed to translate the GME-Q from English into Spanish and to validate its use in Spanish-speaking CGM users with type 1 diabetes.Methods:The linguistic translation and validation process of the GME-Q was established. T1D CGM users were asked to complete the produced Spanish version of the GME-Q and interviewed about difficulties or misunderstandings. Total satisfaction, effectiveness, convenience and intrusiveness subscales and internal consistency reliability were computed.Results:Forward and backward translations and cognitive debriefing produced a final version of the GME-Q in Spanish. Ninety-eight subjects with type 1 diabetes were selected (age: 40 ± 12 years, 63% females, Hb1c: 7.2 ± 0.9% (55 ± 10 mmol/l), pump users: 78%, CGM use: 3.7 ± 2.6 years). The completion rate was 99% and the Cronbach’s alpha coefficient was 0.8. The total satisfaction score was 3.9 ± 0.4 (effectiveness: 4.1 ± 0.6, convenience: 3.8 ± 0.6, intrusiveness: 2.2 ± 0.7).Conclusion:The GME-Q was translated into Spanish and validated for Spanish-speaking CGM users with type 1 diabetes.     

Prolyl Isomerase Pin1 Expression in the Spinal Motor Neurons of Patients With Sporadic Amyotrophic Lateral Sclerosis

Background and PurposeAmyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease. Selective deficiency of edited adenosine deaminase acting on RNA 2 (ADAR2), a key molecule in the acquisition of Ca²⁺ resistance in motor neurons, has been reported in sporadic ALS (sALS) spinal motor neurons. Since ADAR2 activity is positively regulated by prolyl isomerase Protein never in mitosis gene A interacting-1 (Pin1), a known phosphorylation-dependent peptidyl-prolyl cis/trans isomerase, we investigated Pin1 expression in spinal motor neurons in sALS.MethodsSpecimens of the spinal cord were obtained from the lumbar region in eight sALS patients and age-matched five controls after postmortem examinations. The specimens were double stained with anti-Pin1 and anti-TAR DNA-binding protein of 43 kDa (TDP-43) antibodies, and examined under a fluorescence microscope.ResultsThis study analyzed 254 and 422 spinal motor neurons from 8 sALS patients and 5 control subjects, respectively. The frequency of motor neurons with high cytoplasmic Pin1 expression from the spinal cord did not differ significantly between sALS specimens without cytoplasmic TDP-43 inclusions and control specimens. However, in sALS specimens, neurons for which the Pin1 immunoluminescence intensity in the cytoplasm was at least twice that in the background were more common in specimens with cytoplasmic TDP-43 inclusions (p<0.05 in χ² test).ConclusionsIn sALS, neurons with higher expression levels of Pin1 levels had more TDP-43 inclusions. Despite the feedback mechanism between Pin1 and ADAR2 being unclear, since Pin1 positively regulates ADAR2, our results suggest that higher Pin1 expression levels in motor neurons with TDP-43 pathology from sALS patients represent a compensatory mechanism.     

IRE1α缺陷通过上调内质网钙稳态蛋白降低软骨细胞的自噬功能

目的探究肌醇依赖性激酶1α（IRE1α）通过调控内质网钙稳态蛋白（CHERP）影响软骨细胞自噬功能的相关机制。方法衣霉素（TM）处理人软骨细胞C28/I2，Western blot检测不同时间点的内质网应激和自噬相关蛋白指标。4μ8c、雷帕霉素（Rapa）处理C28/I2（分为：NC组、4μ8c组、Rapa组、4μ8c+Rapa组），Western blot检测自噬相关蛋白指标。分别从软骨组织特异性ERN1基因敲除小鼠（ERN1 CKO）和对照小鼠（Control）软骨组织分离原代软骨细胞，qPCR检测ERN1及自噬相关蛋白ATG5、ATG7的mRNA水平，Western blot检测IRE1α/p-IRE1α、CHERP表达水平，流式细胞术检测胞内钙离子含量。巴佛洛霉素A1（Bafilomycin A1）处理原代软骨细胞（分为Control组、Control+Bafilomycin A1组、ERN1 CKO组、ERN1 CKO+Bafilomycin A1组），Western blot检测LC3Ⅱ、LC3Ⅰ的表达。自噬双荧光病毒在Rapa处理下检测自噬流（分为Control+Rapa组、ERN1 CKO+ Rapa组）。C28/I2中过表达CHERP与IRE1α，免疫荧光检测自噬水平。结果TM处理C28/I2细胞后，内质网应激相关标志蛋白表达上调，LC3Ⅱ/LC3Ⅰ比值上调（P＜0.05），p62表达下调（P＜0.05）。相较对照组，Rapa上调LC3Ⅱ/LC3Ⅰ比值（P＜0.001），4μ8c+ Rapa组相较Rapa组的LC3Ⅱ/LC3Ⅰ比值降低（P＜0.05）。相较于对照组，原代软骨细胞中敲除ERN1/IRE1α后，ERN1（P＜0.01）、ATG5（P＜0.001）、ATG7（P＜0.001）mRNA水平显著下调。IRE1α/p-IRE1α蛋白表达缺失或显著下调（P＜0.01），CHERP蛋白表达上调（P＜0.05），胞内钙离子含量显著上升（P＜0.001）。巴佛洛霉素A1处理原代软骨细胞后，Control+Bafilomycin A1组较Control组的LC3Ⅱ/LC3Ⅰ比值上调（P＜0.01），ERN1 CKO+Bafilomycin A1组较ERN1 CKO组的LC3Ⅱ/LC3Ⅰ比值上调（P＜0.05）、较Control+Bafilomycin A1组的LC3Ⅱ/LC3Ⅰ比值下降（P＜0.05）。自噬双荧光病毒处理后，ERN1 CKO+Rapa组较Control+Rapa组未淬灭LC3-GFP荧光增强（P＜0.05）。C28/I2细胞中过表达CHERP降低LC3荧光强度，过表达IRE1α增强LC3荧光表达并能部分挽救CHERP导致的荧光降低情况。结论IRE1α缺陷通过上调内质网钙稳态蛋白，升高胞内钙离子含量，进一步导致软骨细胞的自噬功能受损。     

小檗碱通过激活Nrf2-HO-1/GPX4通路抑制小鼠海马神经元HT22细胞的铁死亡

目的探讨小檗碱对于Erastin诱导小鼠海马神经元HT22细胞的铁死亡的保护作用及其可能机制。方法以HT22小鼠海马神经元细胞为研究对象，分为对照组、Erastin模型组、Erastin+30 μmol/L BBR组、Erastin+60 μmol/L BBR组。采用CCK-8法、特异性Fe²⁺荧光探针、荧光染料（DAPI）检测和荧光探针（H2DCFH-DA）检测各实验组细胞的增殖情况、活性铁水平、细胞凋亡和活性氧（ROS）变化。RT-qPCR和Western blot分别检测各实验组细胞的Nrf2、HO-1、GPX4 mRNA和蛋白表达情况。以60 μmol BBR的最适浓度来进一步探究其作用机制，分为对照组、Erastin模型组、Erastin+60 μmol/L BBR组、Erastin+60 μmol/L BBR+2 μmol Nrf2抑制剂ML385组。通过使用荧光探针和Western blot检测Nrf2抑制剂（ML385）作用后的活性铁的水平、活性氧含量以及Nrf2、HO-1、GPX4蛋白的表达来验证小檗碱调节的Nrf2-HO-1/GPX4通路对Erastin处理的HT22细胞的保护作用。结果0.5 μmol/L Erastin作用于HT22细胞8 h，细胞存活率与对照组相比显著被抑制（P < 0.05）；同时细胞凋亡、ROS以及活性铁含量增加（P < 0.05）。与Erastin组比较，Erastin+30 μmol/L BBR组和Erastin+60 μmol/L BBR组的细胞存活率明显升高（P < 0.05），同时显著降低细胞凋亡、ROS以及活性铁含量（P < 0.05）。小檗碱增加HT22细胞中Nrf2、HO-1、GPX4基因及蛋白的表达量（P < 0.05）。加入Nrf2抑制剂ML385后，Nrf2-HO-1/GPX4通路被抑制，并且ROS以及活性铁含量升高（P < 0.05）。结论Erastin诱导HT22细胞发生铁死亡，小檗碱抑制Erastin诱导的铁死亡，可能机制是激活了Nrf2-HO-1/GPX4通路。     

Pembrolizumab-related Immune Thrombocytopenia in a Patient with Lung Adenocarcinoma Treated by Radiotherapy: Potential Immune-related Adverse Event Elicited by Radiation Therapy

The effect of radiotherapy during immunotherapy on immune-related adverse events (irAEs) is not fully understood. We herein report a 74-year-old woman diagnosed with lung adenocarcinoma with programmed death ligand 1 expression ≥50% and treated with pembrolizumab. She developed fatal immune thrombocytopenia associated with pembrolizumab immediately following radiotherapy. A flow cytometry analysis of peripheral blood detected an increased expression of programmed death-1 (PD-1) and Ki-67 in CD4^＋ and CD8^＋ T cells after radiotherapy, compared with pre-irradiation measurements. This case suggests that radiotherapy may evoke irAEs during treatment with anti-PD-1 antibodies, which physicians should consider when using radiotherapy in patients treated with these drugs.     

Plasma exchange treats severe intrahepatic cholestasis caused by dacomitinib: A case report

Rationale:Dacomitinib-induced liver injury is often manifested by mild elevations of transaminases and bilirubin, and severe intrahepatic cholestasis caused by dacomitinib for simultaneous taking orally cytochrome P450 2D6 (CYP2D6) competitive substrates has been rarely reported.Patient concerns:The patient was a 69-year-old woman with non–small cell lung cancer (NSCLC) who was prescribed oral dacomitinib for a month; she was given oral loratadine due to “allergic rhinitis” and metoprolol extended action tablets due to “tachycardia” separately for a few days during the course of dacomitinib treatment. The patient developed liver damage, increased fatigue, yellow urine, and pruritus, with significantly elevated serum levels of bilirubin and glutamyltranspetidase.Diagnosis:Intrahepatic cholestasis, drug-induced liver injury, and NSCLC.Interventions:After admission, the patient was prescribed adenosylmethionine, acetylcysteine, ursodeoxycholic acid capsule, methylprednisolone and fenofibrate for a month, with progressive elevation of liver biochemical parameters. Through drug enzyme gene assays in the liver tissue after percutaneous liver biopsy, we found both CYP2D6*10/*10 and ATP-binding cassette subfamily B member 1 GG variants (rs1045642) positive. After the poor response to the conventional medication, the patient underwent plasma exchange.Outcomes:The patient was discharged after her liver parameters improved; the parameters remained normal at several follow-up visits, and she renewed the NSCLC regimens without dacomitinib after being evaluated by oncologists.Lessons:Dacomitinib can induce severe intrahepatic cholestasis. It is considered that patients with intermediate metabolic CYP2D6 are susceptible to drug-induced liver injury caused by dacomitinib; plasma exchange may be an effective treatment.     

五味沙棘散对卵清蛋白诱导的过敏性支气管哮喘大鼠的保护作用及机制

目的 探究五味沙棘散对卵清蛋白（ovalbumin,OVA）诱导的过敏性哮喘大鼠的保护作用及机制。方法 SD大鼠随机分为对照组、模型组、地塞米松（0.5 mg/kg）组和五味沙棘散（0.5、2.0 g/kg）组,建立OVA诱导的大鼠早期支气管哮喘模型,苏木素-伊红（HE）和Masson染色观察支气管病理情况及纤维化程度;免疫组化检测支气管间隙连接蛋白43（connexin 43,Cx43）的表达和分布;ELISA检测血清中免疫球蛋白E（immunoglobulin E,IgE）和白细胞介素-13（interleukin-13,IL-13）水平;亚甲基蓝法和WSP-1荧光探针法测定血清中硫化氢（hydrogen sulfide,H₂S）水平。建立CdCl₂诱导的支气管上皮BEAS-2B细胞损伤模型,MTT法检测细胞活性;Hoechest 33342染色法观察细胞核形态变化;MitoSOX染色检测细胞线粒体活性氧（mitochondrial reactive oxygen species,mtROS）水平;Western blotting检测半胱氨酸天冬氨酸蛋白酶-3（cystein-asparate protease-3,Caspase-3）、核因子红细胞系2相关因子（nuclear factor erythroid 2-related factor,Nrf2）和Kelch样ECH关联蛋白1（Kelch like ECH associated protein 1,Keap1）蛋白表达。结果 五味沙棘散能够减少支气管黏膜上皮细胞脱落和黏液分泌（P＜0.001）,降低胶原纤维的沉积和Cx43的表达及分布（P＜0.05、0.01、0.001）,降低血清中IgE、IL-13水平（P＜0.05）,升高血清中H₂S水平（P＜0.05、0.01）。五味沙棘散含药血清呈剂量相关性地抑制CdCl₂诱导的BEAS-2B细胞凋亡及mtROS水平（P＜0.01、0.001）,上调Caspase-3和Nrf2蛋白表达（P＜0.05、0.01）,下调Keap1蛋白表达（P＜0.01）。结论 五味沙棘散对OVA诱导的哮喘大鼠和CdCl₂诱导的支气管上皮细胞凋亡均具有保护作用,其机制可能与调控Nrf2/Keap1信号通路有关。