ATP11C promotes the differentiation of pre-B cells into immature B cells but does not affect their IL-7-dependent proliferation.

The P4-type ATPases are believed to function as flippases that contribute to the organization of the asymmetric aminophospholipid distribution on the plasma membranes of eukaryotes by their ability to internalize specific phospholipids from the outer leaflet to the inner leaflet. Despite the existence of 14 members of the P4-type ATPases in humans and 15 in mice, their roles in the immune system have not been fully understood. So far, ATP11C was shown to be important for B cells, and mice deficient for ATP11C had a developmental arrest at the pro-B to pre-B cell transition stage of B cell development. Using an ATP11C-deficient pre-B cell line generated through CRISPR/Cas9 engineering, we here tested the role of ATP11C in pre-B cells in vitro and showed that ablation of ATP11C in pre-B cells causes a defect in the flippase activity. We further demonstrated that loss of ATP11C does not impede the proliferation of pre-B cells in response to IL-7. However, pre-B cells lacking ATP11C failed to differentiate into immature B cells upon removal of IL-7. These results suggest that disruption of lipid asymmetry by loss of ATP11C in pre-B cells may control the switch from proliferation to differentiation in pre-B cells.

Effectiveness of a Group Game Intervention in Reducing Preoperative Anxiety Levels of Children and Parents: A Randomized Controlled Trial.

Surgical experiences are often stressful for children and their parents. This study aimed to determine the effect of a group game intervention on the preoperative anxiety levels of 94 parent-child dyads who were awaiting elective minor surgery at a pediatric surgery clinic. The experimental group intervention included routine preoperative preparation and a group (ie, child, parent, and researcher) game. After the parent dressed the child for surgery, a research team member assessed the child's and parent's anxiety levels using the Facial Affective Scale and Visual Facial Anxiety Scale, respectively. Before the child was transferred to the OR, the research team member reassessed both anxiety levels. When compared to the control group, the results showed that children and parents involved in facilitated group play experienced significantly decreased anxiety levels (P < .001).