Heterogeneous multi-scale neighbor topologies enhanced drug-disease association prediction.

MOTIVATION: Identifying new uses of approved drugs is an effective way to reduce the time and cost of drug development. Recent computational approaches for predicting drug-disease associations have integrated multi-sourced data on drugs and diseases. However, neighboring topologies of various scales in multiple heterogeneous drug-disease networks have yet to be exploited and fully integrated. RESULTS: We propose a novel method for drug-disease association prediction, called MGPred, used to encode and learn multi-scale neighboring topologies of drug and disease nodes and pairwise attributes from heterogeneous networks. First, we constructed three heterogeneous networks based on multiple kinds of drug similarities. Each network comprises drug and disease nodes and edges created based on node-wise similarities and associations that reflect specific topological structures. We also propose an embedding mechanism to formulate topologies that cover different ranges of neighbors. To encode the embeddings and derive multi-scale neighboring topology representations of drug and disease nodes, we propose a module based on graph convolutional autoencoders with shared parameters for each heterogeneous network. We also propose scale-level attention to obtain an adaptive fusion of informative topological representations at different scales. Finally, a learning module based on a convolutional neural network with various receptive fields is proposed to learn multi-view attribute representations of a pair of drug and disease nodes. Comprehensive experiment results demonstrate that MGPred outperforms other state-of-the-art methods in comparison to drug-related disease prediction, and the recall rates for the top-ranked candidates and case studies on five drugs further demonstrate the ability of MGPred to retrieve potential drug-disease associations.

multi-type neighbors enhanced global topology and pairwise attribute learning for drug-protein interaction prediction.

MOTIVATION: Accurate identification of proteins interacted with drugs helps reduce the time and cost of drug development. Most of previous methods focused on integrating multisource data about drugs and proteins for predicting drug-target interactions (DTIs). There are both similarity connection and interaction connection between two drugs, and these connections reflect their relationships from different perspectives. Similarly, two proteins have various connections from multiple perspectives. However, most of previous methods failed to deeply integrate these connections. In addition, multiple drug-protein heterogeneous networks can be constructed based on multiple kinds of connections. The diverse topological structures of these networks are still not exploited completely. RESULTS: We propose a novel model to extract and integrate multi-type neighbor topology information, diverse similarities and interactions related to drugs and proteins. Firstly, multiple drug-protein heterogeneous networks are constructed according to multiple kinds of connections among drugs and those among proteins. The multi-type neighbor node sequences of a drug node (or a protein node) are formed by random walks on each network and they reflect the hidden neighbor topological structure of the node. Secondly, a module based on graph neural network (GNN) is proposed to learn the multi-type neighbor topologies of each node. We propose attention mechanisms at neighbor node level and at neighbor type level to learn more informative neighbor nodes and neighbor types. A network-level attention is also designed to enhance the context dependency among multiple neighbor topologies of a pair of drug and protein nodes. Finally, the attribute embedding of the drug-protein pair is formulated by a proposed embedding strategy, and the embedding covers the similarities and interactions about the pair. A module based on three-dimensional convolutional neural networks (CNN) is constructed to deeply integrate pairwise attributes. Extensive experiments have been performed and the results indicate GCDTI outperforms several state-of-the-art prediction methods. The recall rate estimation over the top-ranked candidates and case studies on 5 drugs further demonstrate GCDTI's ability in discovering potential drug-protein interactions.

Integration of pairwise neighbor topologies and miRNA family and cluster attributes for miRNA-disease association prediction.

Identifying disease-related microRNAs (miRNAs) assists the understanding of disease pathogenesis. Existing research methods integrate multiple kinds of data related to miRNAs and diseases to infer candidate disease-related miRNAs. The attributes of miRNA nodes including their family and cluster belonging information, however, have not been deeply integrated. Besides, the learning of neighbor topology representation of a pair of miRNA and disease is a challenging issue. We present a disease-related miRNA prediction method by encoding and integrating multiple representations of miRNA and disease nodes learnt from the generative and adversarial perspective. We firstly construct a bilayer heterogeneous network of miRNA and disease nodes, and it contains multiple types of connections among these nodes, which reflect neighbor topology of miRNA-disease pairs, and the attributes of miRNA nodes, especially miRNA-related families and clusters. To learn enhanced pairwise neighbor topology, we propose a generative and adversarial model with a convolutional autoencoder-based generator to encode the low-dimensional topological representation of the miRNA-disease pair and multi-layer convolutional neural network-based discriminator to discriminate between the true and false neighbor topology embeddings. Besides, we design a novel feature category-level attention mechanism to learn the various importance of different features for final adaptive fusion and prediction. Comparison results with five miRNA-disease association methods demonstrated the superior performance of our model and technical contributions in terms of area under the receiver operating characteristic curve and area under the precision-recall curve. The results of recall rates confirmed that our model can find more actual miRNA-disease associations among top-ranked candidates. Case studies on three cancers further proved the ability to detect potential candidate miRNAs.

GVDTI: graph convolutional and variational autoencoders with attribute-level attention for drug-protein interaction prediction.

MOTIVATION: Identifying proteins that interact with drugs plays an important role in the initial period of developing drugs, which helps to reduce the development cost and time. Recent methods for predicting drug-protein interactions mainly focus on exploiting various data about drugs and proteins. These methods failed to completely learn and integrate the attribute information of a pair of drug and protein nodes and their attribute distribution. RESULTS: We present a new prediction method, GVDTI, to encode multiple pairwise representations, including attention-enhanced topological representation, attribute representation and attribute distribution. First, a framework based on graph convolutional autoencoder is constructed to learn attention-enhanced topological embedding that integrates the topology structure of a drug-protein network for each drug and protein nodes. The topological embeddings of each drug and each protein are then combined and fused by multi-layer convolution neural networks to obtain the pairwise topological representation, which reveals the hidden topological relationships between drug and protein nodes. The proposed attribute-wise attention mechanism learns and adjusts the importance of individual attribute in each topological embedding of drug and protein nodes. Secondly, a tri-layer heterogeneous network composed of drug, protein and disease nodes is created to associate the similarities, interactions and associations across the heterogeneous nodes. The attribute distribution of the drug-protein node pair is encoded by a variational autoencoder. The pairwise attribute representation is learned via a multi-layer convolutional neural network to deeply integrate the attributes of drug and protein nodes. Finally, the three pairwise representations are fused by convolutional and fully connected neural networks for drug-protein interaction prediction. The experimental results show that GVDTI outperformed other seven state-of-the-art methods in comparison. The improved recall rates indicate that GVDTI retrieved more actual drug-protein interactions in the top ranked candidates than conventional methods. Case studies on five drugs further confirm GVDTI's ability in discovering the potential candidate drug-related proteins. CONTACT: zhang@hlju.edu.cn Supplementary information: Supplementary data are available at Briefings in Bioinformatics online.

Integrating specific and common topologies of heterogeneous graphs and pairwise attributes for drug-related side effect prediction.

MOTIVATION: Computerized methods for drug-related side effect identification can help reduce costs and speed up drug development. Multisource data about drug and side effects are widely used to predict potential drug-related side effects. Heterogeneous graphs are commonly used to associate multisourced data of drugs and side effects which can reflect similarities of the drugs from different perspectives. Effective integration and formulation of diverse similarities, however, are challenging. In addition, the specific topology of each heterogeneous graph and the common topology of multiple graphs are neglected. RESULTS: We propose a drug-side effect association prediction model, GCRS, to encode and integrate specific topologies, common topologies and pairwise attributes of drugs and side effects. First, multiple drug-side effect heterogeneous graphs are constructed using various kinds of similarities and associations related to drugs and side effects. As each heterogeneous graph has its specific topology, we establish separate module based on graph convolutional autoencoder (GCA) to learn the particular topology representation of each drug node and each side effect node, respectively. Since multiple graphs reflect the complex relationships among the drug and side effect nodes and contain common topologies, we construct a module based on GCA with sharing parameters to learn the common topology representations of each node. Afterwards, we design an attention mechanism to obtain more informative topology representations at the representation level. Finally, multi-layer convolutional neural networks with attribute-level attention are constructed to deeply integrate the similarity and association attributes of a pair of drug-side effect nodes. Comprehensive experiments show that GCRS's prediction performance is superior to other comparing state-of-the-art methods for predicting drug-side effect associations. The recall rates in top-ranked candidates and case studies on five drugs further demonstrate GCRS's ability in discovering potential drug-related side effects. CONTACT: zhang@hlju.edu.cn.

Mask-Guided Target Node Feature Learning and Dynamic Detailed Feature Enhancement for lncRNA-Disease Association Prediction.

Identifying new relevant long noncoding RNAs (lncRNAs) for various human diseases can facilitate the exploration of the causes and progression of these diseases. Recently, several graph inference methods have been proposed to predict disease-related lncRNAs by exploiting the topological structure and node attributes within graphs. However, these methods did not prioritize the target lncRNA and disease nodes over auxiliary nodes like miRNA nodes, potentially limiting their ability to fully utilize the features of the target nodes. We propose a new method, mask-guided target node feature learning and dynamic detailed feature enhancement for lncRNA-disease association prediction (MDLD), to enhance node feature learning for improved lncRNA-disease association prediction. First, we designed a heterogeneous graph masked transformer autoencoder to guide feature learning, focusing more on the features of target lncRNA (disease) nodes. The target nodes were increasingly masked as training progressed, which helps develop a more robust prediction model. Second, we developed a graph convolutional network with dynamic residuals (GCNDR) to learn and integrate the heterogeneous topology and features of all lncRNA, disease, and miRNA nodes. GCNDR employs an interlayer residual strategy and a residual evolution strategy to mitigate oversmoothing caused by multilayer graph convolution. The interlayer residual strategy estimates the importance of node features learned in the previous GCN encoding layer for nodes in the current encoding layer. Additionally, since there are dependencies in the importance of features of individual lncRNA (disease, miRNA) nodes across multiple encoding layers, a gated recurrent unit-based strategy is proposed to encode these dependencies. Finally, we designed a perspective-level attention mechanism to obtain more informative features of lncRNA and disease node pairs from the perspectives of mask-enhanced and dynamic-enhanced node features. Cross-validation experimental results demonstrated that MDLD outperformed 10 other state-of-the-art prediction methods. Ablation experiments and case studies on candidate lncRNAs for three diseases further proved the technical contributions of MDLD and its capability to discover disease-related lncRNAs.

Learning Association Characteristics by Dynamic Hypergraph and Gated Convolution Enhanced Pairwise Attributes for Prediction of Disease-Related lncRNAs.

As the long non-coding RNAs (lncRNAs) play important roles during the incurrence and development of various human diseases, identifying disease-related lncRNAs can contribute to clarifying the pathogenesis of diseases. Most of the recent lncRNA-disease association prediction methods utilized the multi-source data about the lncRNAs and diseases. A single lncRNA may participate in multiple disease processes, and multiple lncRNAs usually are involved in the same disease process synergistically. However, the previous methods did not completely exploit the biological characteristics to construct the informative prediction models. We construct a prediction model based on adaptive hypergraph and gated convolution for lncRNA-disease association prediction (AGLDA), to embed and encode the biological characteristics about lncRNA-disease associations, the topological features from the entire heterogeneous graph perspective, and the gated enhanced pairwise features. First, the strategy for constructing hyperedges is designed to reflect the biological characteristic that multiple lncRNAs are involved in multiple disease processes. Furthermore, each hyperedge has its own biological perspective, and multiple hyperedges are beneficial for revealing the diverse relationships among multiple lncRNAs and diseases. Second, we encode the biological features of each lncRNA (disease) node using a strategy based on dynamic hypergraph convolutional networks. The strategy may adaptively learn the features of the hyperedges and formulate the dynamically evolved hypergraph topological structure. Third, a group convolutional network is established to integrate the entire heterogeneous topological structure and multiple types of node attributes within an lncRNA-disease-miRNA graph. Finally, a gated convolutional strategy is proposed to enhance the informative features of the lncRNA-disease node pairs. The comparison experiments indicate that AGLDA outperforms seven advanced prediction methods. The ablation studies confirm the effectiveness of major innovations, and the case studies validate AGLDA's ability in application for discovering potential disease-related lncRNA candidates.

Gating-Enhanced Hierarchical Structure Learning in Hyperbolic Space and Multi-scale Neighbor Topology Learning in Euclidean Space for Prediction of Microbe-Drug Associations.

Identifying drug-related microbes may help us explore how the microbes affect the functions of drugs by promoting or inhibiting their effects. Most previous methods for the prediction of microbe-drug associations focused on integrating the attributes and topologies of microbe and drug nodes in Euclidean space. The heterogeneous network composed of microbes and drugs has a hierarchical structure, and the hyperbolic space is helpful for reflecting the structure. However, the previous methods did not fully exploit the structure. We propose a multi-space feature learning enhanced microbe-drug association prediction method, MFLP, to fuse the hierarchical structure of microbe and drug nodes in hyperbolic space and the multiscale neighbor topologies in Euclidean space. First, we project the nodes of the microbe-drug heterogeneous network on the sphere in hyperbolic space and then construct a topology which implies hierarchical structure and forms a hierarchical attribute embedding. The node information from multiple types of neighbor nodes with the new topological structure in the tangent plane space of a sphere is aggregated by the designed gating-enhanced hyperbolic graph neural network. Second, the gate at the node feature level is constructed to adaptively fuse the hierarchical features of microbe and drug nodes from two adjacent graph neural encoding layers. Third, multiple neighbor topological embeddings for each microbe and drug node are formed by neighborhood random walks on the microbe-drug heterogeneous network, and they cover neighborhood topologies with multiple scales, respectively. Finally, as each scale of topological embedding contains its specific neighborhood topology, we establish an independent graph convolutional neural network for the topology and form the topological representations of microbe and drug nodes in Euclidean space. The comparison experiments based on cross validation showed that MFLP outperformed several advanced prediction methods, and the ablation experiments verified the effectiveness of MFLP's major innovations. The case studies on three drugs further demonstrated MFLP's ability in being applied to discover potential candidate microbes for the given drugs.

Breath Measurement Method for Synchronized Reproduction of Biological Tones in an Augmented Reality Auscultation Training System.

An educational augmented reality auscultation system (EARS) is proposed to enhance the reality of auscultation training using a simulated patient. The conventional EARS cannot accurately reproduce breath sounds according to the breathing of a simulated patient because the system instructs the breathing rhythm. In this study, we propose breath measurement methods that can be integrated into the chest piece of a stethoscope. We investigate methods using the thoracic variations and frequency characteristics of breath sounds. An accelerometer, a magnetic sensor, a gyro sensor, a pressure sensor, and a microphone were selected as the sensors. For measurement with the magnetic sensor, we proposed a method by detecting the breathing waveform in terms of changes in the magnetic field accompanying the surface deformation of the stethoscope based on thoracic variations using a magnet. During breath sound measurement, the frequency spectra of the breath sounds acquired by the built-in microphone were calculated. The breathing waveforms were obtained from the difference in characteristics between the breath sounds during exhalation and inhalation. The result showed the average value of the correlation coefficient with the reference value reached 0.45, indicating the effectiveness of this method as a breath measurement method. And the evaluations suggest more accurate breathing waveforms can be obtained by selecting the measurement method according to breathing method and measurement point.

Integrating multi-scale neighbouring topologies and cross-modal similarities for drug-protein interaction prediction.

MOTIVATION: Identifying the proteins that interact with drugs can reduce the cost and time of drug development. Existing computerized methods focus on integrating drug-related and protein-related data from multiple sources to predict candidate drug-target interactions (DTIs). However, multi-scale neighboring node sequences and various kinds of drug and protein similarities are neither fully explored nor considered in decision making. RESULTS: We propose a drug-target interaction prediction method, DTIP, to encode and integrate multi-scale neighbouring topologies, multiple kinds of similarities, associations, interactions related to drugs and proteins. We firstly construct a three-layer heterogeneous network to represent interactions and associations across drug, protein, and disease nodes. Then a learning framework based on fully-connected autoencoder is proposed to learn the nodes' low-dimensional feature representations within the heterogeneous network. Secondly, multi-scale neighbouring sequences of drug and protein nodes are formulated by random walks. A module based on bidirectional gated recurrent unit is designed to learn the neighbouring sequential information and integrate the low-dimensional features of nodes. Finally, we propose attention mechanisms at feature level, neighbouring topological level and similarity level to learn more informative features, topologies and similarities. The prediction results are obtained by integrating neighbouring topologies, similarities and feature attributes using a multiple layer CNN. Comprehensive experimental results over public dataset demonstrated the effectiveness of our innovative features and modules. Comparison with other state-of-the-art methods and case studies of five drugs further validated DTIP's ability in discovering the potential candidate drug-related proteins.

Graph Reasoning Method Based on Affinity Identification and Representation Decoupling for Predicting lncRNA-Disease Associations.

An increasing number of studies have shown that dysregulation of lncRNAs is related to the occurrence of various diseases. Most of the previous methods, however, are designed based on homogeneity assumption that the representation of a target lncRNA (or disease) node should be updated by aggregating the attributes of its neighbor nodes. However, the assumption ignores the affinity nodes that are far from the target node. We present a novel prediction method, GAIRD, to fully leverage the heterogeneous information in the network and the decoupled node features. The first major innovation is a random walk strategy based on width-first searching and depth-first searching. Different from previous methods that only focus on homogeneous information, our new strategy learns both the homogeneous information within local neighborhoods and the heterogeneous information within higher-order neighborhoods. The second innovation is a representation decoupling module to extract the purer attributes and the purer topologies. Third, a module based on group convolution and deep separable convolution is developed to promote the pairwise intrachannel and interchannel feature learning. The experimental results show that GAIRD outperforms comparing state-of-the-art methods, and the ablation studies prove the contributions of major innovations. We also performed case studies on 3 diseases to further demonstrate the effectiveness of the GAIRD model in applications.

Learning Multi-Types of Neighbor Node Attributes and Semantics by Heterogeneous Graph Transformer and Multi-View Attention for Drug-Related Side-Effect Prediction.

Since side-effects of drugs are one of the primary reasons for their failure in clinical trials, predicting their side-effects can help reduce drug development costs. We proposed a method based on heterogeneous graph transformer and capsule networks for side-effect-drug-association prediction (TCSD). The method encodes and integrates attributes from multiple types of neighbor nodes, connection semantics, and multi-view pairwise information. In each drug-side-effect heterogeneous graph, a target node has two types of neighbor nodes, the drug nodes and the side-effect ones. We proposed a new heterogeneous graph transformer-based context representation learning module. The module is able to encode specific topology and the contextual relations among multiple kinds of nodes. There are similarity and association connections between the target node and its various types of neighbor nodes, and these connections imply semantic diversity. Therefore, we designed a new strategy to measure the importance of a neighboring node to the target node and incorporate different semantics of the connections between the target node and its multi-type neighbors. Furthermore, we designed attentions at the neighbor node type level and at the graph level, respectively, to obtain enhanced informative neighbor node features and multi-graph features. Finally, a pairwise multi-view feature learning module based on capsule networks was built to learn the pairwise attributes from the heterogeneous graphs. Our prediction model was evaluated using a public dataset, and the cross-validation results showed it achieved superior performance to several state-of-the-art methods. Ablation experiments undertaken demonstrated the effectiveness of heterogeneous graph transformer-based context encoding, the position enhanced pairwise attribute learning, and the neighborhood node category-level attention. Case studies on five drugs further showed TCSD's ability in retrieving potential drug-related side-effect candidates, and TCSD inferred the candidate side-effects for 708 drugs.

Integration of Neighbor Topologies Based on Meta-Paths and Node Attributes for Predicting Drug-Related Diseases.

Identifying new disease indications for existing drugs can help facilitate drug development and reduce development cost. The previous drug-disease association prediction methods focused on data about drugs and diseases from multiple sources. However, they did not deeply integrate the neighbor topological information of drug and disease nodes from various meta-path perspectives. We propose a prediction method called NAPred to encode and integrate meta-path-level neighbor topologies, multiple kinds of drug attributes, and drug-related and disease-related similarities and associations. The multiple kinds of similarities between drugs reflect the degrees of similarity between two drugs from different perspectives. Therefore, we constructed three drug-disease heterogeneous networks according to these drug similarities, respectively. A learning framework based on fully connected neural networks and a convolutional neural network with an attention mechanism is proposed to learn information of the neighbor nodes of a pair of drug and disease nodes. The multiple neighbor sets composed of different kinds of nodes were formed respectively based on meta-paths with different semantics and different scales. We established the attention mechanisms at the neighbor-scale level and at the neighbor topology level to learn enhanced neighbor feature representations and enhanced neighbor topological representations. A convolutional-autoencoder-based module is proposed to encode the attributes of the drug-disease pair in three heterogeneous networks. Extensive experimental results indicated that NAPred outperformed several state-of-the-art methods for drug-disease association prediction, and the improved recall rates demonstrated that NAPred was able to retrieve more actual drug-disease associations from the top-ranked candidates. Case studies on five drugs further demonstrated the ability of NAPred to identify potential drug-related disease candidates.

Real-Time Expanded Field-of-View for Minimally Invasive Surgery Using Multi-Camera Visual Simultaneous Localization and Mapping.

Minimally invasive surgery is widely used because of its tremendous benefits to the patient. However, there are some challenges that surgeons face in this type of surgery, the most important of which is the narrow field of view. Therefore, we propose an approach to expand the field of view for minimally invasive surgery to enhance surgeons' experience. It combines multiple views in real-time to produce a dynamic expanded view. The proposed approach extends the monocular Oriented features from an accelerated segment test and Rotated Binary robust independent elementary features-Simultaneous Localization And Mapping (ORB-SLAM) to work with a multi-camera setup. The ORB-SLAM's three parallel threads, namely tracking, mapping and loop closing, are performed for each camera and new threads are added to calculate the relative cameras' pose and to construct the expanded view. A new algorithm for estimating the optimal inter-camera correspondence matrix from a set of corresponding 3D map points is presented. This optimal transformation is then used to produce the final view. The proposed approach was evaluated using both human models and in vivo data. The evaluation results of the proposed correspondence matrix estimation algorithm prove its ability to reduce the error and to produce an accurate transformation. The results also show that when other approaches fail, the proposed approach can produce an expanded view. In this work, a real-time dynamic field-of-view expansion approach that can work in all situations regardless of images' overlap is proposed. It outperforms the previous approaches and can also work at 21 fps.

Estimation of Respiratory Rate from Thermography Using Respiratory Likelihood Index.

Respiration is a key vital sign used to monitor human health status. Monitoring respiratory rate (RR) under non-contact is particularly important for providing appropriate pre-hospital care in emergencies. We propose an RR estimation system using thermal imaging cameras, which are increasingly being used in the medical field, such as recently during the COVID-19 pandemic. By measuring temperature changes during exhalation and inhalation, we aim to track the respiration of the subject in a supine or seated position in real-time without any physical contact. The proposed method automatically selects the respiration-related regions from the detected facial regions and estimates the respiration rate. Most existing methods rely on signals from nostrils and require close-up or high-resolution images, while our method only requires the facial region to be captured. Facial region is detected using YOLO v3, an object detection model based on deep learning. The detected facial region is divided into subregions. By calculating the respiratory likelihood of each segmented region using the newly proposed index, called the Respiratory Quality Index, the respiratory region is automatically selected and the RR is estimated. An evaluation of the proposed RR estimation method was conducted on seven subjects in their early twenties, with four 15 s measurements being taken. The results showed a mean absolute error of 0.66 bpm. The proposed method can be useful as an RR estimation method.

Interdependency between mechanical parameters and afferent nerve discharge in hypertrophic intestine of rats.

Partial intestinal obstruction causes smooth muscle hypertrophy, enteric neuronal plasticity, motility disorders, and biomechanical remodeling. In this study we characterized the stimulus-response function of afferent fibers innervating the partially obstructed jejunum. A key question is whether changes in afferent firing arise from remodeled mechanical tissue properties or from adaptive afferent processes. Partial obstruction was created by placing a polyethylene ring for 2 wk in jejunum of seven rats. Sham obstruction was made in six rats and seven rats served as normal controls. Firing from mesenteric afferent nerve bundles was recorded during mechanical ramp, relaxation, and creep tests. Stress-strain, spike rate increase ratio (SRIR), and firing rate in single units were assessed for evaluation of interdependency of the mechanical stimulations, histomorphometry data, and afferent nerve discharge. Partial intestinal obstruction resulted in hypertrophy and jejunal stiffening proximal to the obstruction site. Low SRIR at low strains during fast distension and at high stresses during slow distension was found in the obstructed rats. Single unit analysis showed increased proportion of mechanosensitive units but absent high-threshold (HT) units during slow stimulation, decreased number of HT units during fast stimulation, and shift from HT sensitivity towards low threshold sensitivity in the obstructed jejunum. Biomechanical remodeling and altered afferent response to mechanical stimulations were found in the obstructed jejunum. Afferents from obstructed jejunum preserved their function in encoding ongoing mechanical stimulation but showed changes in their responsiveness. The findings support that mechanical factors rather than adaption are important for afferent remodeling.

The association between objective tongue color and endoscopic findings: results from the Kyushu and Okinawa population study (KOPS).

BACKGROUND: The relation between tongue color and gastroesophageal disease is unclear. This study was done to investigate the associations between tongue color (TC), endoscopic findings, Helicobacter.pylori infection status, and serological atrophic gastritis (SAG). METHODS: The participants were 896 residents of Ishigaki Island, Okinawa, aged 28-86 years. The tongue was photographed, esophagogastroduodenoscopy was done, and serum antibody to H.pylori was measured. SAG was defined as a serum Pepsinogen (PG)Ilevel ≤70 ng/ml and a PGI/IIratio ≤3.0. TC was measured by the device-independent international commission on Illumination 1976 L*a*b* color space standards at four points: (1) edge, (2) posterior, (3) middle, and (4) apex. We also calculated the ratio of the tongue edge to the three other measured points to examine the association between the coating of the tongue and the endoscopic and laboratory findings. RESULTS: Participants were excluded who had two or more endoscopic findings (n = 315) or who had SAG without seropositivity to H.pylori (n = 33). The remaining 548 participants were divided into three groups: SAG and seropositive to H.pylori (n = 67), seropositive to H.pylori alone (n = 56), and without SAG and seronegative for H.pylori (n = 425). We divided 425 residents into a single endoscopic finding positive group (n = 207) and a negative group, which served as a control (n = 218). The most frequent single endoscopic finding was esophageal hernia (n = 110), followed by erosive esophagitis (n = 35) and erosive gastritis (EG) (n = 45). EH was significantly associated with TC (2b*/1b*) (P < 0.05). EG was significantly associated with TC (3a*, 3b*) (P < 0.05). Seropositivity to H.pylori was significantly associated with TC (3 L*, 3 L*/1 L*) (P < 0.05, <0.01), and seropositivity to both H.pylori and SAG was significantly associated with TC (3 L*/1 L*) (P < 0.05). Multivariate analysis extracted TC (3a*, 3b*) as an independent factor associated with a differential diagnosis of EG (Odds ratio (OR) 2.66 P = 0.008, OR 2.17 P = 0.045). CONCLUSIONS: The tongue body color of the middle area reflects acute change of gastric mucosa, such as erosive gastritis. Tongue diagnosis would be a useful, non-invasive screening tool for EG.