Elevated cell-free mitochondria DNA level of patients with premature ovarian insufficiency.

BACKGROUND: Premature ovarian insufficiency (POI) patients present with a chronic inflammatory state. Cell-free mitochondria DNA (cf-mtDNA) has been explored as a reliable biomarker for estimating the inflammation-related disorders, however, the cf-mtDNA levels in POI patients have never been measured. Therefore, in the presenting study, we aimed to evaluate the levels of cf-mtDNA in plasma and follicular fluid (FF) of POI patients and to determine a potential role of cf-mtDNA in predicting the disease progress and pregnancy outcomes. METHODS: We collected plasma and FF samples from POI patients, biochemical POI (bPOI) patients and control women. Quantitative real-time PCR was used to measure the ratio of mitochondrial genome to nuclear genome of cf-DNAs extracted from the plasma and FF samples. RESULTS: The plasma cf-mtDNA levels, including COX3, CYB, ND1 and mtDNA79, were significantly higher in overt POI patients than those in bPOI patients or control women. The plasma cf-mtDNA levels were weakly correlated with ovarian reserve, and could not be improved by regular hormone replacement therapy. The levels of cf-mtDNA in FF, rather than those in plasma, exhibited the potential to predict the pregnancy outcomes, although they were comparable among overt POI, bPOI and control groups. CONCLUSIONS: The increased plasma cf-mtDNA levels in overt POI patients indicated its role in the progress of POI and the FF cf-mtDNA content may hold the value in predicting pregnancy outcomes of POI patients.

Identification of MAP1LC3A as a promising mitophagy-related gene in polycystic ovary syndrome.

Increasing evidence suggests that mitophagy is crucially involved in the progression of polycystic ovary syndrome (PCOS). Exploration of PCOS-specific biomarkers related to mitophagy is expected to provide critical insights into disease pathogenesis. In this study, we employed bioinformatic analyses and machine learning algorithms to determine novel biomarkers for PCOS that may be tied with mitophagy. A grand total of 12 differential expressed mitophagy-related genes (DE-MRGs) associated with PCOS were identified. TOMM5 and MAP1LC3A among the 12 DE-MRGs were recognized as potential marker genes by LASSO, RF and SVM-RFE algorithms. The area under the ROC curve (AUROC) of MAP1LC3A were all greater than 0.8 both in the training set and validation sets. The CIBERSORT analysis indicated a potential association between alterations in the immune microenvironment of PCOS individuals and MAP1LC3A expression. In addition, we found that MAP1LC3A was positively related to the testosterone levels of PCOS patients. Overall, MAP1LC3A was identified as optimal PCOS-specific biomarkers related to mitophagy. Our findings created a diagnostic strength and offered a perspective for investigating the mitophagy process in PCOS.

Advanced oxidation protein products attenuate the autophagy-lysosome pathway in ovarian granulosa cells by modulating the ROS-dependent mTOR-TFEB pathway.

Oxidative stress dysfunction has recently been found to be involved in the pathogenesis of premature ovarian insufficiency (POI). Previously, we found that advanced oxidation protein products (AOPPs) in plasma were elevated in women with POI and had an adverse effect on granulosa cell proliferation. However, the mechanism underlying the effects of AOPPs on autophagy-lysosome pathway regulation in granulosa cells remains unclear. In this study, the effect of AOPPs on autophagy and lysosomal biogenesis and the underlying mechanisms were explored by a series of in vitro experiments in KGN and COV434 cell lines. AOPP-treated rat models were employed to determine the negative effect of AOPPs on the autophagy-lysosome systems in vivo. We found that increased AOPP levels activated the mammalian target of rapamycin (mTOR) pathway, and inhibited the autophagic response and lysosomal biogenesis in KGN and COV434 cells. Furthermore, scavenging of reactive oxygen species (ROS) with N-acetylcysteine and blockade of the mTOR pathway with rapamycin or via starvation alleviated the AOPP-induced inhibitory effects on autophagy and lysosomal biogenesis, suggesting that these effects of AOPPs are ROS-mTOR dependent. The protein expression and nuclear translocation of transcription factor EB (TFEB), the key regulator of lysosomal and autophagic function, were also impaired by the AOPP-activated ROS-mTOR pathway. In addition, TFEB overexpression attenuated the AOPP-induced impairment of autophagic flux and lysosomal biogenesis in KGN and COV434 cells. Chronic AOPP stimulation in vivo also impaired autophagy and lysosomal biogenesis in granulosa cells of rat ovaries. The results highlight that AOPPs lead to impairment of autophagic flux and lysosomal biogenesis via ROS-mTOR-TFEB signaling in granulosa cells and participate in the pathogenesis of POI.

Plasma metabolomic characterization of premature ovarian insufficiency.

BACKGROUND: Premature ovarian insufficiency (POI) patients are predisposed to metabolic disturbances, including in lipid metabolism and glucose metabolism, and metabolic disorders appear to be a prerequisite of the typical long-term complications of POI, such as cardiovascular diseases or osteoporosis. However, the metabolic changes underlying the development of POI and its subsequent complications are incompletely understood, and there are few studies characterizing the disturbed metabolome in POI patients. The aim of this study was to characterize the plasma metabolome in POI by using ultrahigh-performance liquid chromatography-mass spectrometry (UHPLC-MS/MS) metabolomics and to evaluate whether these disturbances identified in the plasma metabolome relate to ovarian reserve and have diagnostic value in POI. METHODS: This observational study recruited 30 POI patients and 30 age- and body mass index (BMI)-matched controls in the Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, from January 2018 to October 2020. Fasting venous blood was collected at 9:00 am on days 2-4 of the menstrual cycle and centrifuged for analysis. An untargeted quantitative metabolomic analysis was performed using UHPLC-MS/MS. RESULTS: Our study identified 48 upregulated and 21 downregulated positive metabolites, and 13 upregulated and 48 downregulated negative metabolites in the plasma of POI patients. The differentially regulated metabolites were involved in pathways such as caffeine metabolism and ubiquinone and other terpenoid-quinone biosynthesis. Six metabolites with an AUC value > 0.8, including arachidonoyl amide, 3-hydroxy-3-methylbutanoic acid, dihexyl nonanedioate, 18-HETE, cystine, and PG (16:0/18:1), were correlated with ovarian reserve and thus have the potential to be diagnostic biomarkers of POI. CONCLUSION: This UHPLC-MS/MS untargeted metabolomics study revealed differentially expressed metabolites in the plasma of patients with POI. The differential metabolites may not only be involved in the aetiology of POI but also contribute to its major complications. These findings offer a panoramic view of the plasma metabolite changes caused by POI, which may provide useful diagnostic and therapeutic clues for POI disease.

His-Purkinje conduction system pacing combined with atrioventricular node ablation improves quality of life in older patients with persistent atrial fibrillation refractory to multiple ablation procedures.

BACKGROUND: Recurrence of atrial fibrillation (AF) is common in patients with persistent AF even after multiple ablation procedures. His-Purkinje conduction system pacing (HPCSP) combined with atrioventricular node ablation (AVNA) is effective in managing patients with AF and heart failure. This study aimed to determine whether HPCSP combined with AVNA can improve quality of life and alleviate symptoms in older patients with symptomatic persistent AF refractory to multiple ablation procedures, as well as evaluate the feasibility and safety of this therapy. METHODS: Older patients (≥ 65 years) with symptomatic persistent AF refractory to at least two ablation procedures were treated with combined HPCSP and AVNA. The success rates and complications were recorded. Pacing parameters, European Heart Rhythm Association (EHRA) scores, and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) scores obtained perioperatively were compared with those recorded at the 6-month follow-up examination. RESULTS: Thirty-one patients were enrolled; of those, only thirty patients were eventually treated with AVNA because one patient developed a complete atrioventricular block following the withdrawal of the His bundle pacing lead. The success rates were 100% for HPCSP (22 cases with His bundle pacing, and 9 cases with left bundle branch pacing) and 93.3% (28/30) for AVNA, respectively. By the 6-month follow-up examination, EHRA scores improved significantly (3.00 ± 0.73 vs. 2.44 ± 0.63, P = 0.014) and AFEQT scores increased markedly (49.6 ± 20.6 vs. 70.9 ± 14.0, P = 0.001). No severe complications developed. CONCLUSIONS: When used in older patients with symptomatic persistent AF refractory to multiple ablation procedures, HPCSP combined with AVNA significantly alleviated symptoms and improved quality of life during short-term follow-up. This therapy was proved to be safe and effective in this patient population.

Fifteen-year mortality and prognostic factors in patients with dilated cardiomyopathy: persistent standardized application of drug therapy and strengthened management may bring about encouraging change in an aging society.

BACKGROUND: There is scarce data on the long-term mortality and associated prognostic factors in patients with dilated cardiomyopathy (DCM). The study aimed to investigate the all-cause mortality up to 15 years (mean 7.9 ± 5.7 years) in such patients, and the independent prognostic factors influencing their long-term mortality. METHODS: One hundred and sixty-six consecutive patients with DCM were prospectively enrolled from 2002 to 2003. The mean age of patients was 59.5 ± 10.4 years, and approximately 57% were male. They were followed up by telephone or outpatient visit at least every three months until 2019 or all-cause death occurred. Predictors of mortality were identified using multivariate logistic regression analysis. RESULTS: During the 15 years of follow-up, five patients were lost to follow-up, and the complete data records of 161 patients were included in the analysis. Patients were treated with angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin-receptor blocker (ARB), ß-blockers, mineralocorticoid receptor antagonist (MRA), diuretics and digitalis from 2002 to 2004, and maintained at the maximum tolerated doses between 2004 and 2019. Our safety targets to maintain heart rate and blood pressure at 60-80 beats/min and 90-120/60-80 mmHg, respectively. All-cause mortality in the first five years was 55.9%. The independent risk factors for the 5-year mortality were age ≥ 70 years old (OR = 5.45, P = 0.006), systolic blood pressure (SBP) > 120 mmHg (OR = 3.63, P = 0.004), 6-minute walk distance (6MWD) < 450 m (OR = 3.84, P = 0.001). 15-year all-cause mortality was 65.8%. The independent risk factors for 15-year mortality were age ≥ 70 years old (OR = 16.07, P = 0.009), LVEF ≤ 35% (OR = 5.69, P = 0.003), and SBP > 120 mmHg (OR = 9.56, P < 0.001). CONCLUSIONS: This study was the first to demonstrate the 15-year survival rate of 34% in DCM patients. The DCM patients' first five-year all-cause mortality decreased significantly after continuous standardized treatment and intensive management. The mortality then plateaued in the following 10 years. Age ≥ 70 years, LVEF ≤ 35%, and SBP > 120 mmHg were independent predictors of 15-year all-cause mortality.

SNP and haplotype analysis reveals new HFE variants associated with iron overload trait.

Hereditary hemochromatosis is a common-recessive-autosomal disease characterized by progressive iron overload, and its prevalence correlates with c.845G>A (p. C282Y) mutation of the HFE gene. Two other variants c.187C>G and c.193A>T are associated with a mild iron overload phenotype. The correlation studies have revealed incompletely penetrance of the HFE mutations, as well as the lack of mutation on some chromosomes from patients. We screened for SNPs before examining allele and haplotype association with elevated iron parameters. We confirmed that the c.845G>A mutation is in complete linkage disequilibrium with a unique haplotype, whereas two haplotypes proved to account for 79.8 and 20.2% of the c.187G chromosomes whose only difference was the g.4694C>G variation. A greater prevalence of the g.4694G allele among patients' chromosomes, compared to controls, was observed. In addition, among non-mutant chromosomes the analyses revealed a risk haplotype and a protective haplotype, and the g.4694G and the c.1007-47A alleles were associated with a higher risk of elevated iron parameters. We determined that the g.4694C allele was located within a putative hypoxia-response element, protein binding was evidenced and was reduced with the g.4694C>G change. In addition, IVS4 was not spliced as well in the c.1007-47A allele compared to the c.1007-47G allele.

A Preliminary Study of Pre-Season Taekwondo Preparation Strategy: Personal Isolation Training Effect for Elite Athletes.

BACKGROUND: The global coronavirus disease pandemic (COVID-19) has had a considerable impact on athletic competition and team sports training. Athletes have been forced to train alone at home. However, the isolation training model effects are still unknown. PURPOSE: This study compared the effects of personal isolation training (PIT) and detraining (DT) on specific sport performances (flexibility, power, reaction time, acceleration, and aerobic capacity) and body composition in elite taekwondo athletes. METHODS: Eleven elite taekwondo athletes were recruited as voluntary subjects. Athletes were randomly paired by weight into the personal isolation training group (PIT group: N = 5, age: 21.2 ± 0.4 years, BMI: 22.2 ± 0.8 kg/m2) or detraining group (DT group: N = 6, age: 19.8 ± 0.3 years, BMI: 23.1 ± 1.0 kg/m2). All subjects performed the same training content prior to the pre-test (T1). When the pre-test was completed, all subjects underwent 12 weeks of PIT or DT. Athletes were then administrated the post-test (T2). The athlete's sport performances and body composition were measured to compare the differences between the two groups (PIT and DT) and two phases (T1 and T2). RESULTS: There were no significant differences in kicking reaction time and flexibility in both groups (p > 0.05). The PIT showed significant improvements in 10 m (10M) sprint performance (p < 0.05), and displayed a progress trend in Abalakov jump performance. In addition, the PIT resulted in a better change response in 10M sprint performance (PIT: -4.2%, DT: +2.1%), aerobic endurance performance (PIT: -10.2%, DT: -18.4%), right arm muscle mass (PIT: +2.9%, DT: -3.8%), and trunk muscle mass (PIT: +2.2%, DT: -1.9%) than DT (p < 0.05). The fat mass percentage showed a negative change from T1 to T2 in both groups (p < 0.05). CONCLUSIONS: PIT showed a trend toward better body composition (arm and trunk muscle) and sport performances (10M sprint and aerobic capacity) compared to DT. This finding may provide information on the effectiveness of a personal isolation training model for optimal preparation for taekwondo athletes and coaches. It may also serve as a useful and safe guideline for training recommendations during the coronavirus disease (COVID-19).

Let-7e modulates the proliferation and the autophagy of human granulosa cells by suppressing p21 signaling pathway in polycystic ovary syndrome without hyperandrogenism.

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in reproductive-aged women, and its pathogenesis is still under debate. Recent studies suggest crucial roles for microRNAs (miRNAs) in PCOS development. The let-7 family miRNAs constitute the most abundant miRNAs in human granulosa cells (GCs), and plays an important role in follicular development. However, research on the let-7e implications of the non-hyperandrogenic (non-HA) phenotype remains unclear. This study aimed at determining the role of let-7e in the progression of PCOS. We performed quantitative real-time PCR to examine the levels of let-7e in fifty-two non-HA PCOS patients and fifty-two controls. A receiver operating characteristic (ROC) curve were used to reveal the diagnostic value of let-7e in non-HA PCOS. Using an immortalized human granulosa cell line, KGN, we investigated the influence of let-7e on cell proliferation and autophagy. Our data substantiated the expression of let-7e was significantly increased in non-HA PCOS group, and associated with an increased antral follicle count. The ROC curve indicated a major separation between non-HA PCOS group and the control group. Let-7e knockdown suppressed cell proliferation and enhanced cell autophagy by activating p21 pathway. Conversely, let-7e overexpression promoted cell proliferation and inhibited cell autophagy by suppressing p21 pathway. Our results indicate that increased let-7e levels in non-HA PCOS GCs may contribute to excessive follicular activation and growth, thereby involving in the pathogenesis of PCOS. Let-7e may thus be a potential therapeutic target in non-HA PCOS.

Advanced Oxidation Protein Products Induce G1/G0-Phase Arrest in Ovarian Granulosa Cells via the ROS-JNK/p38 MAPK-p21 Pathway in Premature Ovarian Insufficiency.

The mechanism underlying the role of oxidative stress and advanced oxidation protein products (AOPPs) in the aetiology of premature ovarian insufficiency (POI) is poorly understood. Here, we investigated the plasma AOPP level in POI patients and the effects of AOPPs on granulosa cells both in vitro and in vivo. KGN cells were treated with different AOPP doses, and cell cycle distribution, intracellular reactive oxygen species (ROS), and protein expression levels were measured. Sprague-Dawley (SD) rats were treated daily with PBS, rat serum albumin, AOPP, or AOPP+ N-acetylcysteine (NAC) for 12 weeks to explore the effect of AOPPs on ovarian function. Plasma AOPP concentrations were significantly higher in both POI and biochemical POI patients than in controls and negatively correlated with anti-Müllerian hormone and the antral follicle count. KGN cells treated with AOPP exhibited G1/G0-phase arrest. AOPP induced G1/G0-phase arrest in KGN cells by activating the ROS-c-Jun N-terminal kinase (JNK)/p38 mitogen-activated protein kinase (MAPK)-p21 pathway. Pretreatment with NAC, SP600125, SB203580, and si-p21 blocked AOPP-induced G1/G0-phase arrest. In SD rats, AOPP treatment increased the proportion of atretic follicles, and NAC attenuated the adverse effects of AOPPs in the ovary. In conclusion, we provide mechanistic evidence that AOPPs may induce cell cycle arrest in granulosa cells via the ROS-JNK/p38 MAPK-p21 pathway and thus may be a novel biomarker of POI.

Iron metabolism in macrophages from HFE hemochromatosis patients.

HFE-linked hereditary hemochromatosis is a common form of iron-overload disease in European populations. We studied the role of HFE in macrophage iron metabolism. Patients under venesection treatment had higher EPO levels and drastically reduced levels of transferrin receptor (TfRC and TfR2) mRNA, and also decreased levels of HAMP mRNA in macrophages cultured in autologous serum. Macrophages from C282Y/C282Y patients cultured either in autologous serum or in FBS with or without iron supplementation, had elevated CYBRD1 (cytochrome b reductase 1), SLC40A1 (ferroportin) and FTL (ferritin L) mRNA levels. Those incubated with holo-Tf also showed lower levels of TfRC and TfR2 mRNA. Iron flux from C282Y/C282Y macrophages incubated with a low concentration of non-transferrin-bound iron (NTBI) was similar to that from wild-type macrophages, but incubation with holo-Tf or high NTBI did not trigger a continuous increase in the cytosolic calcein-chelatable iron pool in C282Y/C282Y macrophages conversely to wild-type cells. All culture conditions revealed a high level of intracellular ferritin in C282Y/C282Y macrophages compared to wild-type cells. These results suggest that the non-functional C282Y form of HFE may alter the balance between cytosolic calcein-chelatable iron and sequestered iron, thereby disrupting the iron uptake and release equilibrium in cells involved in iron storage.

Hydroxyapatite/chemically reduced graphene oxide composite: Environment-friendly synthesis and high-performance electrochemical sensing for hydrazine.

It is unexpectedly found that, the in-situ growth of hydroxyapatite (HAP) on graphene oxide (GO) under a moderate temperature (85°C) can effectively trigger the reduction of GO, which needs neither extra reducing agents nor high-temperature thermal treatment. The transmission electron microscope (TEM) experiment demonstrates that the rod-like HAP particles are well attached on the surface of reduced GO (rGO) to form the composite. Electrochemical sensing assays show that the synthesized HAP-rGO nanocomposite presents excellent electrocatalytic capacity for the oxidation of a toxic chemical of hydrazine. When the HAP-rGO modified electrode was utilized as an electrochemical sensor for hydrazine detection, outstanding performances in the indexes of low fabrication cost, short response time (~2s), wide linear range, low detection limit (0.43µM), and good selectivity were achieved. The developed sensor also shows satisfactory results for the detection of hydrazine in real industrial wastewater sample were achieved.

Graphene Oxide Directed One-Step Synthesis of Flowerlike Graphene@HKUST-1 for Enzyme-Free Detection of Hydrogen Peroxide in Biological Samples.

A novel metal-organic framework (MOF)-based electroactive nanocomposite containing graphene fragments and HKUST-1 was synthesized via a facile one-step solvothermal method using graphene oxide (GO), benzene-1,3,5-tricarboxylic acid (BTC), and copper nitrate (Cu(NO3)2) as the raw materials. The morphology and structure characterization revealed that the GO could induce the transformation of HKUST-1 from octahedral structure to the hierarchical flower shape as an effective structure-directing agent. Also, it is interesting to find out that the GO was torn into small fragments to participate in the formation of HKUST-1 and then transformed into the reduction form during the solvothermal reaction process, which dramatically increased the surface area, electronic conductivity, and redox-activity of the material. Electrochemical assays showed that the synergy of graphene and HKUST-1 in the nanocomposite leaded to high electrocatalysis, fast response, and excellent selectivity toward the reduction of hydrogen peroxide (H2O2). Based on these remarkable advantages, satisfactory results were obtained when the nanocomposite was used as a sensing material for electrochemical determination of H2O2 in the complex biological samples such as human serum and living Raw 264.7 cell fluids.

ß-Cyclodextrin functionalized graphene as a highly conductive and multi-site platform for DNA immobilization and ultrasensitive sensing detection.

A versatile nanocomposite containing ß-cyclodextrin and graphene (CD-GR) was prepared through a simple chemical reduction method. The characterization experiments show that the nanocomposite remains the flake-like morphology of GR, but its solubility and stability in aqueous solution are greatly improved. Then the nanocomposite was modified at glassy carbon electrode (GCE) surface, and was used as a functional matrix for the covalent immobilization of probe DNA using 2,4,6-trichloro-1,3,5-triazine (TCT) as the crosslinker. Due to the synergetic effect of large surface area of GR and rich hydroxyl of CD, the probe density for the developed biosensor was determined to as high as 3.82×10(13) molecules cm(-2). Meanwhile, the biosensor shows high hybridization efficiency and hybridization kinetic. When the biosensor was applied for the impedance-based hybridization test, a wide linear range from 1.0×10(-16) to 1.0×10(-12) M and an ultralow detection limit of 3.4×10(-17) M were achieved. The biosensor also displays excellent stability, selectivity, and reproducibility.

Highly dispersible and stable copper terephthalate metal-organic framework-graphene oxide nanocomposite for an electrochemical sensing application.

A highly dispersible and stable nanocomposite of Cu(tpa)-GO (Cu(tpa) = copper terephthalate metal-organic framework, GO = graphene oxide) was prepared through a simple ultrasonication method. The morphology and structure of the obtained composite were characterized via scanning electron microscopy (SEM), transmission electron microscopy (TEM), UV-vis, Fourier-transform infrared (FT-IR), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). On the basis of the characterization results, the binding mechanism of the Cu(tpa) and GO was speculated to be the cooperative interaction of π-π stacking, hydrogen bonding, and Cu-O coordination. The electrochemical sensing property of Cu(tpa)-GO composite was investigated through casting the composite on a glassy carbon electrode (GCE), followed by an electro-reduction treatment to transfer the GO in the composite to the highly conductive reduced form (electrochemically reduced graphene, EGR). The results demonstrated that the electrochemical signals and peak profiles of the two drugs of acetaminophen (ACOP) and dopamine (DA) were significantly improved by the modified material, owing to the synergistic effect from high conductivity of EGR and unique electron mediating action of Cu(tpa). Under the optimum conditions, the oxidation peak currents of ACOP and DA were linearly correlated to their concentrations in the ranges of 1-100 and 1-50 µM, respectively. The detection limits for ACOP and DA were estimated to be as low as 0.36 and 0.21 µM, respectively.