Identification of priority pathogens for aetiological diagnosis in adults with community-acquired pneumonia in China: a multicentre prospective study.

BACKGROUND: Community-acquired pneumonia (CAP) is a major public health challenge worldwide. However, the aetiological and disease severity-related pathogens associated with CAP in adults in China are not well established based on the detection of both viral and bacterial agents. METHODS: A multicentre, prospective study was conducted involving 10 hospitals located in nine geographical regions in China from 2014 to 2019. Sputum or bronchoalveolar lavage fluid (BALF) samples were collected from each recruited CAP patient. Multiplex real-time PCR and bacteria culture methods were used to detect respiratory pathogens. The association between detected pathogens and CAP severity was evaluated. RESULTS: Among the 3,403 recruited eligible patients, 462 (13.58%) had severe CAP, and the in-hospital mortality rate was 1.94% (66/3,403). At least one pathogen was detected in 2,054 (60.36%) patients, with two or more pathogens were co-detected in 725 patients. The ten major pathogens detected were Mycoplasma pneumoniae (11.05%), Haemophilus influenzae (10.67%), Klebsiella pneumoniae (10.43%), influenza A virus (9.49%), human rhinovirus (9.02%), Streptococcus pneumoniae (7.43%), Staphylococcus aureus (4.50%), adenovirus (2.94%), respiratory syncytial viruses (2.35%), and Legionella pneumophila (1.03%), which accounted for 76.06-92.52% of all positive detection results across sampling sites. Klebsiella pneumoniae (p < 0.001) and influenza viruses (p = 0.005) were more frequently detected in older patients, whereas Mycoplasma pneumoniae was more frequently detected in younger patients (p < 0.001). Infections with Klebsiella pneumoniae, Staphylococcus aureus, influenza viruses and respiratory syncytial viruses were risk factors for severe CAP. CONCLUSIONS: The major respiratory pathogens causing CAP in adults in China were different from those in USA and European countries, which were consistent across different geographical regions over study years. Given the detection rate of pathogens and their association with severe CAP, we propose to include the ten major pathogens as priorities for clinical pathogen screening in China.

In Vitro Assessment Reveals the Effects of Environmentally Persistent Free Radicals on the Toxicity of Photoaged Tire Wear Particles.

Tire wear particles (TWP) have been identified as one of the major sources of microplastics (MPs), and few studies have focused on their environmental behaviors and impacts. However, a thorough characteristic and toxicity assessment associated with environmentally persistent free radicals (EPFRs) on the photoaged TWP is missing. In this study, we investigated EPFRs in the process of TWP photoaging and evaluated their toxicity using in vitro bioassays. Our results showed that a total of around 1.0 × 1017 spins/g EPFRs (g-factors ranging 2.00308-2.00318) was formed on TWP with 60 days of light irradiation, which contained more than 29% of reactive EPFRs (r-EPFRs). Using macrophages as model cells for bioassays, TWP-associated EPFRs trigged endpoints, including the decrease of cell viability (27 to 45%) and the increase of oxidative stress response (46-93%) and inflammatory factor secretion. The enhancement of TWP toxicity with photoaging was confirmed to be attributed to the generated EPFRs combined with other TWP's chemical compositions (e.g., various metals and organics). Most importantly, the toxicity of photoaged TWP was closely correlated with the generated r-EPFRs, which induced reactive oxidant species (ROS) generation. This study provides direct evidence of toxicity on the photoaged TWP particles, revealing the potential contributions of EPFRs to the adverse effect on human health and highlighting the need for an improved understanding of the impacts of EPFRs on the risk assessment of TWP released into the environment.

The First Observation of the Formation of Persistent Aminoxyl Radicals and Reactive Nitrogen Species on Photoirradiated Nitrogen-Containing Microplastics.

Nitrogen-containing microplastics (N-MPs) are widely present in the atmosphere, but their potential health risks have been overlooked. In this study, the formation of persistent aminoxyl radicals (PAORs) and reactive nitrogen species (RNSs) on the N-MPs under light irradiation was investigated. After photoaging, an anisotropic triplet with the g-factor of ∼2.0044, corresponding to PAORs, was detected on the nonaromatic polyamide (PA) rather than amino resin (AmR) by electron paramagnetic resonance and confirmed by density functional theory calculations. The generated amine oxide portions on the photoaged PA were identified using X-ray photoelectron spectroscopy and Raman spectroscopy, which were considered to be the main structural basis/precursors of a PAOR. Surprisingly, RNSs were also observed on the irradiated PA. The generated ·NO due to the aphotolysis of nitrone groups simultaneously reacted with peroxide radicals and O2·- to yield ·NO2 and peroxynitrite, respectively, which were responsible for peroxyacyl nitrates (PAN) and CO3·- formation. Besides, a significantly higher oxidative potential and reductive potential were observed for the aged PA than AmR, which is assigned to the abundant RNSs, organic hydroperoxides and PANs, and a strong ability to transfer electrons from PAOR, respectively. This work provides important information for the potential risks of airborne N-MPs and may serve as a guide for future toxicological assessments.

CLEC12B suppresses lung cancer progression by inducing SHP-1 expression and inactivating the PI3K/AKT signaling pathway.

Lung cancer is the leading cause of cancer mortality worldwide. CLEC12B, a C-type lectin-like receptor, is low-expressed in lung cancer tissues. However, the function of CLEC12B in lung cancer and its underlying mechanism remain unclear. Here, an obvious down-regulation of CLEC12B was observed in lung cancer cells compared with the normal lung epithelial cells. CLEC12B over-expression suppressed cell viability and cell cycle entry in lung cancer, along with the reduction of PCNA and cyclin D1 expressions, while silencing CLEC12B possessed the opposite effects. Over-expression of CLEC12B promoted lung cancer cell apoptosis, accompanied by decreased Bcl-2 and increased Bax, cleaved caspase-3 and cleaved caspase-9. Moreover, CLEC12B decreased phosphorylation of PI3K-p85 and AKT proteins. By contrast, CLEC12B knockdown activated the PI3K/AKT pathway. In vivo, CLEC12B inhibited tumor growth in lung cancer, which can be reversed by CLEC12B inhibition. Co-IP and immunofluorescence assays confirmed the interaction between CLEC12B and SHP-1, and CLEC12B over-expression increased SHP-1 level. Furthermore, knocking down SHP-1 abrogated the above biological phenotypes caused by CLEC12B elevation. Taken together, our findings demonstrate that CLEC12B serves as a tumor-suppressing gene in lung cancer through positively regulating SHP-1 expression, which may be mediated by the PI3K/AKT signaling pathway.

Exploring the immune characteristions of CRKP pneumonia at single-cell level.

The immune dysregulation associated with carbapenem-resistant Klebsiella pneumoniae (CRKP) severity was investigated through single-cell RNA sequencing (scRNA-seq) of 5 peripheral blood samples from 3 patients with moderate and severe CRKP pneumonia. Additionally, scRNA-seq datasets from two individuals with COVID-19 were included for comparative analysis. The dynamic characterization and functional properties of each immune cell type were examined by delineating the transcriptional profiles of immune cells throughout the transition from moderate to severe conditions. Overall, most immune cells in CRKP patients exhibited a robust interferon-α response and inflammatory reaction compared to healthy controls, mirroring observations in COVID-19 patients. Furthermore, cell signatures associated with NK cells, macrophages, and monocytes were identified in CRKP progression including PTPRCAP for NK cells, C1QB for macrophages, and S100A12 for both macrophages and monocytes. In summary, this study offers a comprehensive scRNA-seq resource for illustrating the dynamic immune response patterns during CRKP progression, thereby shedding light on the associations between CRKP and COVID-19.

Antiviral role of Toll-like receptors and cytokines against the new 2009 H1N1 virus infection.

People are generally susceptible to the 2009 new mutate of H1N1 influenza due to lack of appropriate immunity. Influenza H1N1 2009 infection triggers a massive inflammatory response that contributes to fever, lung impairment or other tissue damage, eventually leading to death. Infection with pathogenic influenza virus H1N1 induces severe pulmonary immune pathology. To date, more than 10,000 cases worldwide have died of the disease. It still has strong infectious ability although the mortality of influenza isn't currently high. Therefore, to explore the pathogenesis of H1N1 influenza can help with the disease prevention, diagnosis and provide a theoretical basis and the new ideas of treatment. Laboratory confirmed cases of pandemic influenza H1N1 2009 were enrolled to collect general information on pre-clinical, clinical and laboratory data for analysis. Blood samples were obtained from patients with H1N1, healthy volunteers and patients with bacterial pneumonia. Serum were separated and collected. RT-PCR and ELISA methods were applied to detect the different expression of TLRs and cytokines. The young, pregnant and postpartum women and infant are highly susceptible to influenza H1N1 2009 infection; degree of susceptibility is not associated with BMI. Biochemical changes can be seen in the patients with influenza H1N1 2009 infection: ALT, AST, CK, LDH increased in varying degrees. TLR2, TLR3, TLR9 expression increased in the patients with influenza H1N1 2009 infection; no obvious changes of TLR4, TLR7, TLR8 can be detected. In pregnant and postpartum women group, only TLR9 expression increased. The expression of IL-2, IL-6, IFN-γ, TNF-α in the patients with influenza H1N1 2009 infection was significantly increased; while IL-10 expression decreased and IL-4 expression did not change. H1N1 influenza-infected pregnant and postpartum women group, only IL-2 and TNF-α expression expression increased, other cytokines decreased or didn't change. TLR2, TLR3, TLR9 are the major members of TLR family in the recognition of the novel H1N1 virus to start the innate immune response and adaptive immune responses. TLR9 may be the key receptor among pattern recognized receptors to recognize and bind to H1N1 virus. Cellular immune responses induced by Th1 may participate in modulating the influenza H1N1 2009.

Inorganic anions influenced the photoaging kinetics and mechanism of polystyrene microplastic under the simulated sunlight: Role of reactive radical species.

The photo-transformation of microplastic (MP) in natural water may involve interactions with various ingredients, but the photoaging kinetics and underlying mechanism are not well understood. This work systematically explored the photoaging process of polystyrene microplastic (PS-MP) in the presence of commonly-found inorganic anions, including NO3-, HCO3-, Br- and Cl-. The addition of these ions led to more obvious changes in the morphology, functional groups and molecular weight of photoaging PS-MP. The evolution of carbonyl index value for the photoaged samples conformed to pseudo-first-order kinetic model, and the photoaging rate constant (k) in the presence of inorganic anions at their environmentally relevant concentrations of 0.6 mM, 1.2 mM, 0.1 M and 0.1 mM was calculated to be kHCO3- = 0.0074 d-1, kNO3- = 0.01001 d-1, kCl- = 0.00783 d-1, and kBr- = 0.00888 d-1, which was higher than that in ultrapure water (k=0.00705 d-1). Electron paramagnetic resonance technique and quenching experiments demonstrated that photo-transformation of PS-MP was mainly mediated by indirect photolysis, i.e., the formation of reactive radical species. The photosensitivity of NO3- promoted more •OH production, thereby accelerated the indirect photoaging of PS-MP. Meanwhile, the presence of halide ions promoted the generation of reactive halogen species, which were also involved in the indirect photoaging of PS-MP. Interestingly, as •OH scavenger, HCO3- had no inhibitory effect on PS-MP photoaging, attributing to the oxidation of CO3•-. This study provides valuable insights into the understanding of photo-transformation of MPs in natural aquatic environments.

Generation of environmental persistent free radicals (EPFRs) enhances ecotoxicological effects of the disposable face mask waste with the COVID-19 pandemic.

A large amount of disposable plastic face masks (DPFs) is produced and used during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which results in an inevitable consequence of the dramatic increase of DPFs waste. However, the impact of DPFs exposure to the environment on their toxicity is rarely considered. In this study, a range of 76-276 items/L microplastics (MPs) was detected in the DPFs leachates, and fibrous (> 80.3%) and polypropylene (PP, > 89.2%) MPs were dominant. Co, Cu, Ni, Sr, Ti and Zn, were commonly detected in all leachates of the tested DPFs. Organics, such as acetophenone, 2,4-Di-tert-butylphenol, benzothiazole, bisphenol-A and phthalide, were found in the DPFs leachate, which were including organic solvents and plasticizer. Besides, we first found an emerging environmental risk substance, namely environmentally persistent free radicals (EPFRs), was generated in the DPFs leachates. The characteristic g-factors of the EPFRs was in a range of 2.003-2.004, identified as mixture of carbon- and oxygen-centered radicals. By means of in vitro toxicity assay, the DPFs leachate were confirmed to cause cytotoxicity and oxidative stress. Significantly, it is found that the formed EPFRs could contribute more toxic effects. Furthermore, when compared to N95 respirators, the tested surgical masks tend to release more MPs, leach more metals and organics, and generate more EPFRs. Surgical masks were thus showed higher risk than N95 respirators after exposure to water. This work highlights the importance of understanding the chemical complexity and possible toxicity of DPFs for their risk assessment.

Long non-coding RNA H19 and the underlying epigenetic function in response to DNA damage of lung cancer cells.

The purpose of the current study is to clarify the epigenetic function of long non-coding RNA (lncRNA) H19 in lung cancer as well as the relevant regulatory mechanism. We first determined H19 upregulation in A549 cells. DNA damage model was established in A549 cells by exposure to X-ray and then ionizing radiation (IR). The degree of DNA damage in the IR cell model was assessed by Comet assay. Gain- and loss-of-function assays were employed to clarify the roles of H19 and miR-675 in DNA damage of A549 cells. The results demonstrated that H19 knockdown inhibited the response of lung cancer cells to IR-induced DNA damage but promoted the damage repair. H19 could interact with miR-675, whereby aggravating IR-induced DNA damage. Furthermore, p62 was identified to be a downstream gene positively regulated by miR-675 while APEX1 was a target gene negatively regulated by miR-625-5p. Meanwhile, silencing of H19 could inhibit APEX1 expression by upregulating miR-625-5p, thereby accelerating DNA damage repair in A549 cells. In conclusion, H19 could function as a modulator of DNA damage response in lung cancer cells.

MiR-148b suppressed non-small cell lung cancer progression via inhibiting ALCAM through the NF-κB signaling pathway.

BACKGROUND: Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. MiRNAs are recognized as important molecules in cancer biology. The aim of the study was to identify a novel biomarker miR-148b and its mechanism in the modulation of NSCLC progression. METHODS: The expressional level of miR-148b was analyzed by RT-PCR. The effect of miR-4317 on proliferation was evaluated through 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2Htetrazolium bromide (MTT) assay. The effect of miR-148b on the metastasis of NSCLC was detected through transwell assays. The verification of the target of miR-148b was assessed by TargetScan and dual-luciferase reporter assay. The related proteins in this study were analyzed by western blot. RESULTS: Our findings confirmed that miR-148b was decreased in NSCLC and NSCLC patients with lower expression exhibited poorer overall survival (OS). Increasing miR-148b significantly repressed proliferation, invasion and migration. More importantly, activated leukocyte cell adhesion molecule (ALCAM) was determined as the direct target of miR-148b, and reintroduction of ALCAM attenuated miR-148b effect on the progress of NSCLC. In addition, NF-κB signaling pathway was modulated by miR-148b/ALCAM axis. CONCLUSIONS: Our results indicated that miR-148b is able to suppress NSCLC growth and metastasis via targeting ALCAM through the NF-κB pathway. These findings provided new evidence that miR-148b serves as a potential biomarker and novel target for NSCLC treatment.

Enhanced cytotoxicity of photoaged phenol-formaldehyde resins microplastics: Combined effects of environmentally persistent free radicals, reactive oxygen species, and conjugated carbonyls.

Phenol-formaldehyde resin microplastic (PF-MP) is one of the major inhalable microplastics in environments released from the manufacture, processing and usage of PF materials. The associated toxicities of PF-MP might be affected by photoaging. In this study, the dynamic evolutions of the oxidative potential (OP) and redox-active species, including environmentally persistent free radicals (EPFRs), reactive oxygen species (ROS), peroxides and conjugated carbonyls, as well as the associated cytotoxicity of PF-MP were systematically investigated as a result of the simulated sunlight irradiation. As the photoaging time extended, the OP of PF-MP increased. The contents of the produced conjugated carbonyls, ROS and PF-bound EPFRs due to light irradiation increased as well, and displayed significant correlations with the OP (Spearman r > 0.6, p < 0.05). The photoaged PF-MP distinctly increased the cellular ROS and reduced the cell viability of human lung epithelial adenocarcinoma cells (A549). The cytotoxicity of PF-MP showed a similar trend with the OP level in PF-MP, suggesting that the produced active species induced the in vitro toxicities. The results not only highlight the adverse health effects of photoaged PF-MP, but also provide new perspectives for the environmental risks of airborne MPs.

Long-term phototransformation of microplastics under simulated sunlight irradiation in aquatic environments: Roles of reactive oxygen species.

Microplastics may experience photoaging and breakdown into nanoplastics in aquatic environment as a result of long-term light irradiation. However, the underlying mechanisms responsible for the photodegradation of microplastics are largely overlooked. In this study, the photodegradation of microplastics, utilizing polystyrene microplastic (PS-MP) as a model, was investigated under irradiation with simulated solar light for as long as 150 d. A large amount of reactive oxygen species (ROS), including O2•-, 1O2, H2O2 and •OH, were detected in the PS-MP suspension due to light irradiation, which displayed significant relationships with the generated environmentally persistent free radicals (EPFRs). Distinct photoaging of PS-MP was observed with increased surface roughness and decreased particle size. However, these photoaging effects were significantly inhibited by ROS quenchers, suggesting that the generation ROS played a vital role in the PS-MP phototransformation. In addition, ROS induced formation of more oxidative functional groups on the PS-MP, thus enhancing the negative surface potential and the stability of PS-MP in water. This study elucidated the mechanism of formation of ROS by simulated solar light irradiated MPs and their subsequent roles in the phototransformation of MP, thus expanding current knowledge on the fate of MPs in aquatic environments.

K9(C4H4FN2O2)2Nd(PW11O39)2·25H2O induces apoptosis in human lung cancer A549 cells.

Lung cancer is the leading cause of cancer-associated mortality worldwide. The present study investigated the effects of K9(C4H4FN2O2)2Nd(PW11O39)2·25H2O (FNdPW), a chemically synthesized polyoxometalate that contains rare earth elements, on lung cancer growth, and explored the mechanism underlying its actions. The effects of FNdPW on the cell viability and apoptosis of human lung cancer A549 cells were measured using MTT assay, acridine orange/ethidium bromide staining and electron microscopy. The expression of apoptosis-related proteins, including B-cell lymphoma (Bcl)-2-associated death promoter (Bad), phosphorylated (p)-Bad, X-linked inhibitor of apoptosis (XIAP), apoptosis-inducing factor (AIF), Bcl-2-associated X protein (Bax) and Bcl-2, was determined by western blotting. Caspase-3 activity was measured using a caspase-3 activity kit. After 72 h of incubation, FNdPW reduced cell viability and induced apoptosis in A549 cells in a concentration- and time-dependent manner. FNdPW upregulated the pro-apoptotic Bad and Bax proteins, and downregulated the anti-apoptotic p-Bad, Bcl-2 and XIAP proteins. Furthermore, FNdPW also enhanced caspase-3 activity and increased the protein level of AIF in A549 cells, which was independent of the caspase-3 pathway. These events were associated with the regulation exerted by FNdPW on multiple targets involved in A549 cell proliferation. Therefore, FNdPW may be a novel drug for the treatment of lung cancer.

Identifying candidate agents for lung adenocarcinoma by walking the human interactome.

Despite recent advances in therapeutic strategies for lung cancer, mortality is still increasing. Therefore, there is an urgent need to identify effective novel drugs. In the present study, we implement drug repositioning for lung adenocarcinoma (LUAD) by a bioinformatics method followed by experimental validation. We first identified differentially expressed genes between LUAD tissues and nontumor tissues from RNA sequencing data obtained from The Cancer Genome Atlas database. Then, candidate small molecular drugs were ranked according to the effect of their targets on differentially expressed genes of LUAD by a random walk with restart algorithm in protein-protein interaction networks. Our method identified some potentially novel agents for LUAD besides those that had been previously reported (eg, hesperidin). Finally, we experimentally verified that atracurium, one of the potential agents, could induce A549 cells death in non-small-cell lung cancer-derived A549 cells by an MTT assay, acridine orange and ethidium bromide staining, and electron microscopy. Furthermore, Western blot assays demonstrated that atracurium upregulated the proapoptotic Bad and Bax proteins, downregulated the antiapoptotic p-Bad and Bcl-2 proteins, and enhanced caspase-3 activity. It could also reduce the expression of p53 and p21Cip1/Waf1 in A549 cells. In brief, the candidate agents identified by our approach may provide greater insights into improving the therapeutic status of LUAD.