Long-term Outcomes after Steroid Pulse Therapy in Patients with Type 1 Autoimmune Pancreatitis.

Objective Steroid pulse therapy is a regimen involving the intravenous administration of supra-pharmacological doses of corticosteroids in the short term. It is used to treat various inflammatory and autoimmune conditions. However, the strengths and limitations of steroid pulse therapy for induction of remission in type 1 autoimmune pancreatitis (AIP) are unknown. Methods Depending on the steroid therapy regimen administered, the 104 patients with type 1 AIP included in this retrospective study were divided into three groups: conventional oral prednisolone (PSL) regimen (PSL group), intravenous methylprednisolone (IVMP) pulse followed by oral PSL regimen (Pulse+PSL group), and IVMP pulse-alone regimen (Pulse-alone group). We then examined the relapse rate and adverse events among the three groups. Results The Kaplan-Meier estimates of the relapse rate at 36 months after steroid therapy were 13.6% in the PSL group, 13.3% in the Pulse+PSL group, and 46.2% in the Pulse-alone group. The log-rank test revealed that the relapse-free survival in the Pulse-alone group was significantly shorter than that in the PSL (p=0.024) and Pulse+PSL groups (p=0.014). The exacerbation of glucose tolerance after steroid therapy was less frequently observed in the Pulse-alone group (0%) than in the PSL group (17%, p=0.050) and Pulse+PSL groups (26%, p=0.011). Conclusion Although treatment with IVMP pulse alone resulted in unsatisfactory relapse prevention outcomes compared with conventional steroid therapy, the IVMP pulse-alone regimen might be an alternative treatment strategy for type 1 AIP from the perspective of avoiding adverse events from steroids.

Serum free light chain assessment in type 1 autoimmune pancreatitis.

BACKGROUND: /Object: Some patients with type 1 autoimmune pancreatitis (AIP), the pancreatic manifestation of IgG4-related disease, have normal serum IgG4. The aim of this study is to investigate the diagnostic value of measuring serum free light chains (FLCs) in type 1 AIP. MATERIALS AND METHODS: Thirty-seven patients with type 1 AIP, and 21 healthy, 17 alcoholic chronic pancreatitis (ACP), 21 idiopathic chronic pancreatitis (ICP) and 20 pancreatic cancer (PC) patients were enrolled. Serum IgG4 and FLC concentrations were measured using sFLC Freelite assays on a nephelometric analyzer. RESULTS: Active AIP patients have significantly higher serum levels of κ (median 30.97 (12.3-227.0) mg/L) and λFLC (median 20.53 (12.36-102.7) mg/L)) than healthy controls (κFLC; median 12.5 (3.1-52.1) mg/L), λFLC: median 12.45 (5.4-39.5) mg/L) (p < 0.05) correlating with raised serum IgG4, and significantly higher summated FLCs (∑) (median 53.09 (25.0-218.0) mg/L) than ICP patients (median 26.77 (15.0-89.2) mg/L) and healthy controls (median 24.43 (8.5-91.6) mg/L) (p < 0.05). AIP patients (median 1.43 (0.84-3.24)) showed significantly higher κ/λ ratios than ACP (median 0.83 (0.42-1.18)), ICP (median 0.87 (0.47-2.16)), PC patients (median 0.90 (0.48-1.27)) and healthy controls (median 0.963 (0.51-1.32)). There was a correlation between increased κ and λ FLCs levels and the number of affected organs involved in IgG4 related disease. CONCLUSION: Patients with type 1 AIP have increased serum k and λ FLC concentrations, Σ FLC, and κ/λ ratios. These novel biomarkers may be useful in the diagnosis of type 1 AIP and in monitoring disease activity.

Extracellular vesicles microRNA analysis in type 1 autoimmune pancreatitis: Increased expression of microRNA-21.

BACKGROUND: The molecular basis of type 1 autoimmune pancreatitis (AIP) remains unclear. Recent attention on the role of extracellular vesicles microRNA (EV miRNA) in immune homeostasis has prompted us to perform an extensive miRNA screening of serum-derived EV in AIP. METHODS: EV miRNA expression was analyzed using microarrays in AIP, chronic pancreatitis (CP), and healthy adult (HC) samples (n = 10 from each group). Differences in signals, > 3 or <1/3 times, represented significant differences in expression. Another cohort of AIP (n = 14), CP (n = 10), and HC (n = 10) samples of EV miRNA was analyzed using reverse-transcription polymerase chain reaction (RT-PCR). miRNA expression in pancreatic tissues was evaluated using in situ hybridization (ISH) in three additional subjects from each group. RESULTS: Signals of eight miRNAs (miR-659-3p, -27a-3p, -99a-5p, -21-5p, -205-5p, -100-5p, -29c-3p, and -125b-1-3p) were significantly higher, while those of two miRNAs (miR-4252 and -5004-5p) were significantly lower in AIP than in HC. EV miR-21-5p was significantly up-regulated in AIP than in HC (P = 0.035) and CP (P = 0.048). The number of miR-21-5p positive inflammatory cells was significantly elevated in AIP than in CP (P = 0.014). CONCLUSIONS: Circulating EVs exhibited altered miRNA expression patterns with elevated miR-21-5p in AIP when compared with those in HC and CP. miR-21-5p was highly expressed in pancreatic inflammatory cells in AIP. Our data suggests that miR-21-5p may be involved in the regulation of effector pathways in the pathophysiology of AIP, thus differentiating AIP from CP.

Clinical implications of elevated serum interleukin-6 in IgG4-related disease.

INTRODUCTION: Some patients with IgG4-related disease (IgG4-RD) exhibit elevated serum interleukin (IL)-6 with excessive inflammatory reactions or with repeating relapse. To date few reports pertaining to clinical implications of elevated serum IL-6 in IgG4-RD patients have been published. The aims of the current retrospective study were to investigate the clinical implications of elevated serum IL-6 in IgG4-RD patients, and to examine whether IL-6 can predict the activity and/or relapse of the disease. MATERIALS AND METHODS: We examined the clinical picture at the onset of 43 patients who were diagnosed with IgG4-RD in our hospital and were able to measure serum IL-6 before steroid treatment. RESULTS: The median level of serum IL-6 was 2.2 pg/mL. There was a significant correlation between IL-6 and C-reactive protein (CRP) level (r = 0.397, p = 0.008), hemoglobin level (r = -0.390, p = 0.010) and albumin level (r = -0.556, p < 0.001). When 43 patients were divided into two groups by using a cut-off IL-6 of 4 pg/mL, the high IL-6 group showed higher age, lower albumin, higher CRP and higher aspartate aminotransferase (AST) (age p = 0.014, albumin p = 0.006, CRP p <0.001, AST p = 0.009). Hepatic swelling and splenomegaly were significantly more prevalent in the high IL-6 group than it was in the low IL-6 group (liver p < 0.001, spleen p = 0.020). Biliary tract involvement tended to admit more in the high IL-6 group (p = 0.060). CONCLUSION: Serum IL-6 level at the onset of IgG4-RD may be significantly correlated with clinical inflammatory parameters and it may also be associated with involvement of the bile duct, liver, and spleen.

Proton transport properties of proton-conducting phosphate glasses at their glass transition temperatures.

The proton transport properties of 32 kinds of proton-conducting phosphate glasses with broad ranges of glass transition temperature, proton conductivity, and the proton carrier concentration were studied. Almost constant proton mobility of around 2 × 10-8 cm2 V-1 s-1 at the glass transition temperature, corresponding to a diffusion coefficient of approximately 4 × 10-10 cm2 s-1, was found for the glasses. The reason why the diffusion coefficient of protons is almost constant in various proton-conducting phosphate glasses was discussed based on the role of the protons as a cross-linker within the phosphate framework via hydrogen bonding. We evaluated the highest proton conductivity of the phosphate glasses and melts based on the almost constant mobility at their glass transition temperatures and obtained a highest expected proton conductivity of 7.5 × 10-3 S cm-1 at 300 °C. The potential of proton-conducting phosphate glasses as electrolytes in intermediate temperature fuel cells was also discussed.

Colloidal Zn(Te,Se)/ZnS Core/Shell Quantum Dots Exhibiting Narrow-Band and Green Photoluminescence.

Colloidal CdSe quantum dot (QD) phosphors have attracted considerable attention as green and red phosphors for blue backlight downconversion in next-generation liquid-crystal displays because of their excellent emission features including tunable emission wavelength and narrow emission bands. Alternatives to CdSe, which do not contain toxic cadmium, are strongly desired to ensure safety and reduce the environmental load of consumer products. Herein, we synthesized colloidal Zn(Te,Se)/ZnS core/shell QDs and demonstrated narrow-band green photoluminescence (PL) emission. A full width at half-maximum of 30 nm was achieved for PL emission at 535 nm from Zn(Te0.77Se0.23)/ZnS core/shell QDs with a core QD diameter of 4.3 nm. This emission characteristic was as good as that of CdSe QDs.

The mobility of proton carriers in phosphate glasses depends on polymerization of the phosphate framework.

Proton conducting phosphate glasses were prepared by electrochemical substitution of sodium ions with protons applied to glasses with the compositions xNaO1/2-1WO3-8NbO5/2-5LaO3/2-(86 - x)PO5/2 (x = 28, 32, 35, 38, and 40). The mobilities of proton carriers in the glasses were studied in terms of the polymerization degree of the phosphate framework. The proton mobility at 200 °C increased as the depolymerization of the phosphate framework developed up to x = 38, and decreased at x = 40. On the basis of Raman and infrared spectra measurements of the O-H stretching vibration region, the decreasing mobility at x > 38 was attributed to the increasing concentration of protons trapped by non-bridging oxygen in P2O74- ions, owing to strong O-H bonding. We found that the highly polymerized phosphate framework decreased the mobility of proton carriers, not because of suppression of the proton dissociation from oxygen atoms but rather the suppression of the proton migration. The compositions at which the phosphate framework was sufficiently depolymerized and did not contain P2O74- ions as a main component, achieved high mobility of proton carriers in phosphate glasses.

Formation of Amorphous H3Zr2Si2PO12 by Electrochemical Substitution of Sodium Ions in Na3Zr2Si2PO12 with Protons.

The sodium ions in Na3Zr2Si2PO12 (NASICON) were substituted with protons using an electrochemical alkali-proton substitution (APS) technique at 400 °C under a 5% H2/95% N2 atmosphere. The sodium ions in NASICON were successfully substituted with protons to a depth of <400 µm from the anode. Completely protonated NASICON, i.e., H3Zr2Si2PO12, was obtained to a depth <40 µm from the anode, although complete protonation of NASICON cannot be achieved by ion exchange in aqueous acid. H3Zr2Si2PO12 was amorphous, whereas the partially protonated NASICON was crystalline, and its unit cell volume decreased with an increase in the extent of substitution. Amorphous H3Zr2Si2PO12 was prepared by pressure-induced amorphization of the NASICON framework, in which an internal pressure of ∼3.5 GPa was induced by the substitution of large sodium ions with small protons during APS at 400 °C.

Fabrication of Thermoresponsive Nanoactinia Tentacles by a Single Particle Nanofabrication Technique.

Nanowires that are retractable by external stimulus are the key to fabrication of nanomachines that mimick actinia tentacles in nature. A single particle nanofabrication technique (SPNT) was applied over a large area to the fabrication of retractable nanowires (nanoactinia tentacles) composed of poly(N-isopropylacrylamide) (PNIPAM) and poly(vinylpyrrolidone) (PVP), which are thermoresponsive and hydrophilic polymers. The nanowires were transformed with increasing temperature from rod-like- to globule-forms with gyration radii of ∼1.5 and ∼0.7 µm, respectively. The transformation of the nanowires was reversible and reproducible under repeated cycles of heating and cooling. The reversible transformation was driven by hydration and dehydration of PNIPAM, the thermoresponsive segments, resulting in coil-to-globule transformation of the segments. The nanoactinia tentacle systems trapped the nanoparticles as a model of living cells under thermal stimulation, and the trapping was controlled by temperature. We present herein a unique nanomachine system which can be applicable to nanoparticle filtering/sensing systems and expandable to large-area functionalization and demonstrate polymer-based nanoactuators via scaling of molecular level coil-to-globule transformation into micron-sizes.

Fabrication of enzyme-degradable and size-controlled protein nanowires using single particle nano-fabrication technique.

Protein nanowires exhibiting specific biological activities hold promise for interacting with living cells and controlling and predicting biological responses such as apoptosis, endocytosis and cell adhesion. Here we report the result of the interaction of a single high-energy charged particle with protein molecules, giving size-controlled protein nanowires with an ultra-high aspect ratio of over 1,000. Degradation of the human serum albumin nanowires was examined using trypsin. The biotinylated human serum albumin nanowires bound avidin, demonstrating the high affinity of the nanowires. Human serum albumin-avidin hybrid nanowires were also fabricated from a solid state mixture and exhibited good mechanical strength in phosphate-buffered saline. The biotinylated human serum albumin nanowires can be transformed into nanowires exhibiting a biological function such as avidin-biotinyl interactions and peroxidase activity. The present technique is a versatile platform for functionalizing the surface of any protein molecule with an extremely large surface area.

Semiconducting cross-linked polymer nanowires prepared by high-energy single-particle track reactions.

High-energy charged particle irradiation of cross-linking polymers gives nanowires formed by cross-linking reactions along the ion track trajectories. Here, the direct formation of nanowires consisting of a conjugated polymer by single-particle nanofabrication technique (SPNT) is investigated. Poly(9,9'-di-n-octylfluorene) (PFO), regioregular poly(3-hexylthiophene) (rrP3HT), and poly[2-methoxy-5-(2'-ethylhexyloxy)-1,4-phenylenevinylene] (MEH-PPV) underwent an efficient cross-linking reaction upon irradiation, resulting in the formation of 1-dimensional nanostructures with high and desired aspect ratio reaching up to ∼200. The size of nanowires was perfectly interpreted by well-sophisticated theoretical aspects based on the statistical theory of polymer backbone configurations, suggesting that simple cross-linking reactions of the polymers determine the size and structure of nanowires. PFO based nanostructures exhibited sharp and intense emission with high fluorescence quantum yield indicating the absence of any significant inter/intra polymer chromophore interactions in the nanowires assemblies.

Temperature-responsive one-dimensional nanogels formed by the cross-linker-aided single particle nanofabrication technique.

A single particle nanofabrication technique was successfully applied to the fabrication of homogeneous poly(N-isopropylacrylamide) (PNIPAAm) 1D nanogels over a large area, using N,N'-methylene-bis-acrylamide (MBAAm) as a cross-linker. The PNIPAAm 1D nanogels with high aspect ratio over 130 were formed uniformly on the substrate, and the mechanical strength and the length of the 1D nanogels can be easily controlled by adjusting the MBAAm content. The 1D nanogels were transformed from the non-aggregated to aggregated forms over a lower critical solution temperature (LCST) of approximately 32 °C in water. Precise trace of the temperature induced change in the size of the 1D nanogel was well interpreted by the coil-to-globule transition of PNIPAAm, which was clearly visualized in the present study. This is the first report of uniform shape change for a 1D nanogel by external stimulus over a large area.

Fullerene nanowires as a versatile platform for organic electronics.

The development of organic semiconducting nanowires that act as charge carrier transport pathways in flexible and lightweight nanoelectronics is a major scientific challenge. We report on the fabrication of fullerene nanowires that is universally applicable to its derivatives (pristine C(60), methanofullerenes of C(61) and C(71), and indene C(60) bis-adduct), realized by the single particle nanofabrication technique (SPNT). Nanowires with radii of 8-11 nm were formed via a chain polymerization reaction induced by a high-energy ion beam. Fabrication of a poly(3-hexylthiophene) (P3HT): [6,6]-phenyl C(61) butyric acid methyl ester (PC(61)BM) bulk heterojunction organic photovoltaic cell including PC(61)BM nanowires with precisely-controlled length and density demonstrates how application of this methodology can improve the power conversion efficiency of these inverted cells. The proposed technique provides a versatile platform for the fabrication of continuous and uniform n-type fullerene nanowires towards a wide range of organic electronics applications.

Customized morphologies of self-condensed multisegment polymer nanowires.

The direct formation of multisegment nanowires consisting of polymer domains by ion beam irradiation is investigated. Cross-linking reactions in the ion tracks result in localized gelation, giving isolated nanowires on substrates. It is demonstrated that the morphology of the final nanostructure is customized by appropriate selection of the ion fluence, combination of polymers, and the solvent employed for development. Octopus-like nanostructures consisting of a tangled hydrophilic polymer core and splayed hydrophobic polymer segments are successfully produced as an example of the process. The present technique provides universal feasibility for the formation of nanostructures based on "any" polymer materials in which radiation induces cross-linking reactions.

Self-condensed nanoparticles of oligofluorenes with water-soluble side chains.

Self-condensation of the amphiphilic fluorene trimer occurs in the solvent mixture, giving pure "green" fluorescent nanoparticles with controlled radii of 20-100 nm. The origin of the green fluorescence is attributed to the excimer emission via excitation of aggregated dimer structures in the nanoparticles rather than the keto-defects. The present study also suggests the possibility of spectral tuning of emissions from oligofluorene aggregates.