U-shaped association between triglyceride and risk of incident diabetes in normoglycemic males with NAFLD: A population-base cohort study.

Background: Serum triglyceride (TG) was an important biomarker for nonalcoholic fatty liver disease (NAFLD), and the association between TG and incident type 2 diabetes mellitus is still under debate with some studies suggesting that elevated TG increase the risk of incident T2DM while others indicative of a negative relationship. These controversial findings may be partially due to the inclusion of the participants with NAFLD. The association between TG and incident type 2 diabetes mellitus in people with NAFLD remained unclear. Therefore, this study aimed to characterize the relationship between the baseline TG levels and incident type 2 diabetes mellitus in a male Japanese cohort with NAFLD. Methods: A total of 1221 males with NAFLD were enrolled from the Nagala (NAFLD in the Gifu Area Longitudinal analysis) study conducted from 2004 to 2015. Cox proportional hazards models were performed to examine the relationship between baseline TG concentration and incident type 2 diabetes mellitus. A two-piecewise linear regression model was explored to evaluate the threshold effect of the baseline TG levels on type 2 diabetes mellitus incidence by using a smoothing function. Results: During a median follow-up of 6.05 years, 39 males with NAFLD at baseline developed type 2 diabetes mellitus. The risk of incident type 2 diabetes mellitus was significantly associated with baseline TG concentration in males with NAFLD after fully adjustment for confounders, with per 10 mg/dl elevation in TG levels increasing the risk of incident diabetes by 8.5% (HR=1.085, CI=1.039-1.132; P<0.001). However, no typical dose-dependent positive association between type 2 diabetes mellitus incidence and the TG levels was observed across the TG tertiles. Interestingly, a U-shaped association between TG concentration and risk of incident type 2 diabetes mellitus was revealed by the two-piecewise linear regression analysis. Baseline TG concentration lower than the threshold values (TG <53mg/dl) were negatively associated with risk of incident type 2 diabetes mellitus. With each 10mg/dl increase in baseline TG levels, the risk of incident type 2 diabetes mellitus decreased by nearly 59% (HR=0.413, 95% CI=0.220-0.778). In contrast, when TG levels were higher than the threshold values (TG>53mg/dl), the risk of incident diabetes increased 9.1% with every 10mg TG elevation (HR=1.091, 95% CI=1.046-1.137). Conclusions: A U-shaped relationship was observed between baseline TG levels and incident type 2 diabetes mellitus in a male normoglycemic Japanese population with NAFLD, although extrapolation of the finding to other populations should be made with caution.

Immune landscape in rejection of renal transplantation revealed by high-throughput single-cell RNA sequencing.

Background: The role of the cellular level in kidney transplant rejection is unclear, and single-cell RNA sequencing (scRNA-seq) can reveal the single-cell landscape behind rejection of human kidney allografts at the single-cell level. Methods: High-quality transcriptomes were generated from scRNA-seq data from five human kidney transplantation biopsy cores. Cluster analysis was performed on the scRNA-seq data by known cell marker genes in order to identify different cell types. In addition, pathways, pseudotime developmental trajectories and transcriptional regulatory networks involved in different cell subpopulations were explored. Next, we systematically analyzed the scoring of gene sets regarding single-cell expression profiles based on biological processes associated with oxidative stress. Results: We obtained 81,139 single cells by scRNA-seq from kidney transplant tissue biopsies of three antibody-mediated rejection (ABMR) patients and two acute kidney injury (AKI) patients with non-rejection causes and identified 11 cell types, including immune cells, renal cells and several stromal cells. Immune cells such as macrophages showed inflammatory activation and antigen presentation and complement signaling, especially in rejection where some subpopulations of cells specifically expressed in rejection showed specific pro-inflammatory responses. In addition, patients with rejection are characterized by an increased number of fibroblasts, and further analysis of subpopulations of fibroblasts revealed their involvement in inflammatory and fibrosis-related pathways leading to increased renal rejection and fibrosis. Notably, the gene set score for response to oxidative stress was higher in patients with rejection. Conclusion: Insight into histological differences in kidney transplant patients with or without rejection was gained by assessing differences in cellular levels at single-cell resolution. In conclusion, we applied scRNA-seq to rejection after renal transplantation to deconstruct its heterogeneity and identify new targets for personalized therapeutic approaches.

Evaluation and Use of Organs from Donors Poisoned by Organophosphorus Pesticide.

BACKGROUND The aim of this study was to explore the evaluation and use of donor organs from donors with brain death caused by acute severe organophosphorus pesticides and provide a basis for the use of such donor organs. MATERIAL AND METHODS Seven cases of brain dead donors caused by acute organophosphorus pesticide poisoning from January 2014 to December 2018 in the hospital were collected, and a retrospective analysis was made of the donors' age, race, physiological and pathological changes, donor organ function changes and the organ use, liver or kidney function recovery, and complications of the recipients. The 18 recipients were followed up until June 31, 2022. RESULTS We found that 71.42% of organ donors were male, and 71.42% of organ donors were under 50 years old. The main cause of death was respiratory failure caused by organophosphorus pesticide poisoning. The liver and kidney functions of 7 donors were damaged, and 3 livers could not be used due to severe functional damage, but the liver or kidney function of 18 recipients gradually recovered after transplantation. Delayed recovery of graft function occurred after transplantation accounted for 21.43%, and the grafts had good short-term to medium-term performance. CONCLUSIONS Although the function of organs from donor with brain death due to acute severe organophosphorus pesticide poisoning is seriously damaged, most of the organs can still be used for transplantation. Individualized functional maintenance according to the situation of donors is conducive to improving the quality of organs.

Evaluation and application of donors with primary central nervous system tumors.

BACKGROUND: This study aimed to explore the safety of donors with primary central nervous system tumors for kidney and liver transplantations. METHODOLOGY: Clinical data of 29 donors with primary CNS tumors in January 2007 to December 2017, as well as the follow-up data of 16 liver transplant recipients and 46 kidney transplant recipients, were analyzed. According to the risk factors, the high-risk group was classified as Group 1, the low-risk factors were classified as Group 2, and the unknown risk group was classified as Group 3. The incidence of donor-transmitted CNS tumors was calculated and compared. RESULTS: The duration from the diagnosis of 29 donors to donation was 5.67 ± 6.36 months. None of the liver and kidney transplant recipients who were followed up had tumor metastasis. Although the mean survival time of Group 1 was lower than that of Group 2 and Group 3, the Kaplan-Meier curve showed no significant difference in survival time. CONCLUSION: No obvious difference was observed between high-risk and low-risk and unknown risk CNS tumors in terms of the survival rate of transplants and tumor metastasis rate. High-risk CNS tumor donors can be used with the informed consent of recipients after a full evaluation.

Cloning and characterization of a shrimp ML superfamily protein.

ML superfamily proteins, including MD-1, MD-2, Niemann-Pick type C2 (Npc2) protein, GM2 activator protein, phosphatidylinositol/phosphatidylglycerol transfer protein (PG/PI-TP) and mite allergen Der p 2, bind to specific lipids and play important roles in lipid-recognition and metabolism. Among these ML (MD-2-related lipid-recognition) proteins, MD-2 is essential for lipopolysaccharide (LPS) signaling and the following secretion of proinflammatory factors. In this report, we identified the cDNA and gene of an ML protein from an important white shrimp Litopenaeus vannamei and named it LvML. The gene consists of four exons and three introns. The putative LvML contains 6 cysteines which may form 3 disulfide bonds that are conserved in ML proteins. Reverse transcription PCR analysis showed that in the examined tissues LvML mRNA is only expressed in the hepatopancreas, while not in hemocytes, eyestalk, gill, heart, stomach, intestine, nerve core, muscle or pyloric caecum. Its expression is positively regulated after injection of LPS. Then enzyme-linked immunosorbent assay showed that the recombinant LvML possessed activity of binding to LPS, and that the binding was inhibited by pre-incubation with LPS. We suggested that the LvML may play roles in the shrimp innate immunity.

Identification and functional study of a shrimp Relish homologue.

Rel/NF-kappaB transcription factors play central roles in induction and regulation of innate immune responses. Here we describe the identification and functional analysis of a Relish homologue, LvRelish and its shorter isoform sLvRelish, from the Pacific white shrimp, Litopenaeus vannamei. The LvRelish gene has 22 exons in approximately 15 kb genomic sequence. The full-length cDNA of LvRelish is 4071 bp with an open reading frame that encodes 1207 amino acids. LvRelish contains a conserved Rel homology domain (RHD), a nucleus localization signal, an IkappaB-like domain (six ankyrin repeats), and a death domain, suggesting that it belongs to the class I NF-kappaB. sLvRelish cDNA is 1051 bp encoding 317 amino acids. It shares the RHD region with LvRelish. RT-PCR analysis showed that LvRelish and sLvRelish mRNAs were expressed at different levels in tissues. Western blot analysis showed that recombinant intact LvRelish could be cleaved into two fragments in S2 cells, and immunofluorescence assay showed that the plasmid-expressed LvRelish protein was seen both in the cytoplasm and the nucleus. Electrophoretic mobility shift assay showed that recombinant RHD of LvRelish in S2 cells bound specifically with Drosophila melanogaster kappaB motifs in vitro. Both the LvRelish and its RHD domain transactivated the reporter gene controlled by the 5' flanking region of penaeidin 4, an antibacterial peptide of shrimp, suggesting that LvRelish can regulate the transcription of penaeidin 4 gene. Identification of LvRelish will help us better understand shrimp immunity and may help obtain more effective methods to prevent shrimp diseases.

A novel prophenoloxidase 2 exists in shrimp hemocytes.

The prophenoloxidase (proPO)-activating system in crustaceans and other arthropods is regarded as a constituent of the immune system and plays an important role in defense against pathogens. Hitherto in crustaceans, only one proPO gene per species has been identified. Here we report the identification of a novel proPO-2 (LvproPO-2) from the hemocytes of Litopenaeus vannamei, which shows 72% identity to proPO-1 (LvproPO-1) cloned previously. Northern blotting analysis and quantitative real-time PCR reveal that LvproPO-2 is mainly expressed in the hemocytes, and its expression is down-regulated in shrimp challenged with white spot syndrome virus (WSSV). Western blotting analysis shows that most LvproPO-2/LvPO-2 (L. vannamei phenoloxidase-2) exists in the hemocytes, but not in plasma of L. vannamei. LvproPO-2/LvPO-2 could be detected on the hemocyte surface and the nucleus of hemocytes by indirect immunofluorescence assay (IFA). These findings provide insight into the molecular biological basis for further studying on the defense mechanism of shrimp innate immunity, especially on the proPO-activating system and melanization cascade of shrimp.

A Toll receptor in shrimp.

Outbreaks of infectious diseases have resulted in high mortality and huge economic losses in penaeid shrimp culture. Interest in understanding shrimp immunity has increased because of its importance in disease control. Here we report cDNA cloning of a Toll receptor from the white shrimp Litopenaeus vannamei. L. vannamei Toll (lToll) is 926 residues, with a putative signal peptide of 19 residues. The protein contains distinct structural/functional motifs of the Toll like receptor (TLR) family, including an extracellular domain containing 16 leucine-rich repeats (LRRs) flanked by cysteine-rich motifs and a cytoplasmic Toll/interleukin-1 receptor (TIR) domain. The lToll TIR domain showed high similarity to Apis mellifer Toll and Drosophila melanogaster Toll, with 59.9% and 54.3% identity, respectively. Reverse-transcription polymerase chain reaction (RT-PCR) analysis showed that lToll was expressed in hemocyte, gill, heart, brain, stomach, intestine, pyloric caecum, muscle, nerve and spermary, with a lower expression level in eyestalk and hepatopancreas. Identification of lToll will help to elucidate the Toll pathway in shrimp innate immunity.