Neutrophil Percentage to Albumin Ratio was Associated with Clinical Outcomes in Coronary Care Unit Patients.

Background: Neutrophil percentage to albumin ratio (NPAR) has been shown to be correlated with the prognosis of various diseases. This study aimed to explore the effect of NPAR on the prognosis of patients in coronary care units (CCU). Method: All data in this study were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III, version1.4) database. All patients were divided into four groups according to their NPAR quartiles. The primary outcome was in-hospital mortality. Secondary outcomes were 30-day mortality, 365-day mortality, length of CCU stay, length of hospital stay, acute kidney injury (AKI), and continuous renal replacement therapy (CRRT). A multivariate binary logistic regression analysis was performed to confirm the independent effects of NPAR. Cox regression analysis was performed to analyze the association between NPAR and 365-day mortality. The curve in line with overall trend was drawn by local weighted regression (Lowess). Subgroup analysis was used to determine the effect of NPAR on in-hospital mortality in different subgroups. Receiver operating characteristic (ROC) curves were used to evaluate the ability of NPAR to predict in-hospital mortality. Kaplan-Meier curves were constructed to compare the cumulative survival rates among different groups. Result: A total of 2364 patients in CCU were enrolled in this study. The in-hospital mortality rate increased significantly as the NPAR quartiles increased (p < 0.001). In multivariate logistic regression analysis, NPAR was independently associated with in-hospital mortality (quartile 4 versus quartile 1: odds ratio [OR], 95% confidence interval [CI]: 1.83, 1.20-2.79, p = 0.005, p for trend < 0.001). In Cox regression analysis, NPAR was independently associated with 365-day mortality (quartile 4 versus quartile 1: OR, 95% CI: 1.62, 1.16-2.28, p = 0.005, p for trend < 0.001). The Lowess curves showed a positive relationship between NPAR and in-hospital mortality. The moderate ability of NPAR to predict in-hospital mortality was demonstrated through ROC curves. The area under the curves (AUC) of NPAR was 0.653 (p < 0.001), which is better than that of the platelet to lymphocyte ratio (PLR) (p < 0.001) and neutrophil count (p < 0.001) but lower than the Sequential Organ Failure Assessment (p = 0.046) and Simplified Acute Physiology Score II (p < 0.001). Subgroup analysis did not reveal any obvious interactions in most subgroups. However, Kaplan-Meier curves showed that as NPAR quartiles increased, the 30-day (log-rank, p < 0.001) and 365-day (log-rank, p < 0.001) cumulative survival rates decreased significantly. NPAR was also independently associated with AKI (quartile 4 versus quartile 1: OR, 95% CI: 1.57, 1.19-2.07, p = 0.002, p for trend = 0.001). The CCU and hospital stay length was significantly prolonged in the higher NPAR quartiles. Conclusions: NPAR is an independent risk factor for in-hospital mortality in patients in CCU and has a moderate ability to predict in-hospital mortality.

The reversal of PXR or PPARα activation-induced hepatomegaly.

The activation of pregnane X receptor (PXR) or peroxisome proliferator-activated receptor α (PPARα) can induce liver enlargement. Recently, we reported that PXR or PPARα activation-induced hepatomegaly depends on yes-associated protein (YAP) signaling and is characterized by hepatocyte hypertrophy around the central vein area and hepatocyte proliferation around the portal vein area. However, it remains unclear whether PXR or PPARα activation-induced hepatomegaly can be reversed after the withdrawal of their agonists. In this study, we investigated the regression of enlarged liver to normal size following the withdrawal of PCN or WY-14643 (typical agonists of mouse PXR or PPARα) in C57BL/6 mice. The immunohistochemistry analysis of CTNNB1 and KI67 showed a reversal of hepatocyte size and a decrease in hepatocyte proliferation after the withdrawal of agonists. In details, the expression of PXR or PPARα downstream proteins (CYP3A11, CYP2B10, ACOX1, and CYP4A) and the expression of proliferation-related proteins (CCNA1, CCND1, and PCNA) returned to the normal levels. Furthermore, YAP and its downstream proteins (CTGF, CYR61, and ANKRD1) also restored to the normal states, which was consistent with the change in liver size. These findings demonstrate the reversibility of PXR or PPARα activation-induced hepatomegaly and provide new data for the safety of PXR and PPARα as drug targets.

Innexin hemichannel activation by Microplitis bicoloratus ecSOD monopolymer reduces ROS.

The extracellular superoxide dismutases (ecSODs) secreted by Microplitis bicoloratus reduce the reactive oxygen species (ROS) stimulated by the Microplitis bicoloratus bracovirus. Here, we demonstrate that the bacterial transferase hexapeptide (hexapep) motif and bacterial-immunoglobulin-like (BIg-like) domain of ecSODs bind to the cell membrane and transiently open hemichannels, facilitating ROS reductions. RNAi-mediated ecSOD silencing in vivo elevated ROS in host hemocytes, impairing parasitoid larva development. In vitro, the ecSOD-monopolymer needed to be membrane bound to open hemichannels. Furthermore, the hexapep motif in the beta-sandwich of ecSOD49 and ecSOD58, and BIg-like domain in the signal peptides of ecSOD67 were required for cell membrane binding. Hexapep motif and BIg-like domain deletions induced ecSODs loss of adhesion and ROS reduction failure. The hexapep motif and BIg-like domain mediated ecSOD binding via upregulating innexins and stabilizing the opened hemichannels. Our findings reveal a mechanism through which ecSOD reduces ROS, which may aid in developing anti-redox therapy.

Simulating immunosuppressive mechanism of Microplitis bicoloratus bracovirus coordinately fights Spodoptera frugiperda.

Parasitoid wasps control pests via a precise attack leading to the death of the pest. However, parasitoid larvae exhibit self-protection strategies against bracovirus-induced reactive oxygen species impairment. This has a detrimental effect on pest control. Here, we report a strategy for simulating Microplitis bicoloratus bracovirus using Mix-T dsRNA targeting 14 genes associated with transcription, translation, cell-cell communication, and humoral signaling pathways in the host, and from wasp extracellular superoxide dismutases. We implemented either one-time feeding to the younger instar larvae or spraying once on the corn leaves, to effectively control the invading pest Spodoptera frugiperda. This highlights the conserved principle of "biological pest control," as elucidated by the triple interaction of parasitoid-bracovirus-host in a cooperation strategy of bracovirus against its pest host.