The Effect of Online Hemodiafiltration on Infections: Results from the CONvective TRAnsport STudy

Background

Hemodialysis (HD) patients have a high risk of infections. The uremic milieu has a negative impact on several immune responses. Online hemodiafiltration (HDF) may reduce the risk of infections by ameliorating the uremic milieu through enhanced clearance of middle molecules. Since there are few data on infectious outcomes in HDF, we compared the effects of HDF with low-flux HD on the incidence and type of infections.

Patients and Methods

We used data of the 714 HD patients (age 64 ±14, 62% men, 25% Diabetes Mellitus, 7% catheters) participating in the CONvective TRAnsport STudy (CONTRAST), a randomized controlled trial evaluating the effect of HDF as compared to low-flux HD. The events were adjudicated by an independent event committee. The risk of infectious events was compared with Cox regression for repeated events and Cox proportional hazard models. The distributions of types of infection were compared between the groups.

Results

Thirty one percent of the patients suffered from one or more infections leading to hospitalization during the study (median follow-up 1.96 years). The risk for infections during the entire follow-up did not differ significantly between treatment arms (HDF 198 and HD 169 infections in 800 and 798 person-years respectively, hazard ratio HDF vs. HD 1.09 (0.88–1.34), P = 0.42. No difference was found in the occurrence of the first infectious event (either fatal, non-fatal or type specific). Of all infections, respiratory infections (25% in HDF, 28% in HD) were most common, followed by skin/musculoskeletal infections (21% in HDF, 13% in HD).

Conclusions

HDF as compared to HD did not result in a reduced risk of infections, larger studies are needed to confirm our findings.

Trial Registration

ClinicalTrials.gov NCT00205556     

Association of 25-Hydroxyvitamin D status and genetic variation in the vitamin D metabolic pathway with FEV1 in the Framingham Heart Study

Background

Vitamin D is associated with lung function in cross-sectional studies, and vitamin D inadequacy is hypothesized to play a role in the pathogenesis of chronic obstructive pulmonary disease. Further data are needed to clarify the relation between vitamin D status, genetic variation in vitamin D metabolic genes, and cross-sectional and longitudinal changes in lung function in healthy adults.

Methods

We estimated the association between serum 25-hydroxyvitamin D [25(OH)D] and cross-sectional forced expiratory volume in the first second (FEV₁) in Framingham Heart Study (FHS) Offspring and Third Generation participants and the association between serum 25(OH)D and longitudinal change in FEV₁ in Third Generation participants using linear mixed-effects models. Using a gene-based approach, we investigated the association between 241 SNPs in 6 select vitamin D metabolic genes in relation to longitudinal change in FEV₁ in Offspring participants and pursued replication of these findings in a meta-analyzed set of 4 independent cohorts.

Results

We found a positive cross-sectional association between 25(OH)D and FEV₁ in FHS Offspring and Third Generation participants (P = 0.004). There was little or no association between 25(OH)D and longitudinal change in FEV₁ in Third Generation participants (P = 0.97). In Offspring participants, the CYP2R1 gene, hypothesized to influence usual serum 25(OH)D status, was associated with longitudinal change in FEV₁ (gene-based P < 0.05). The most significantly associated SNP from CYP2R1 had a consistent direction of association with FEV₁ in the meta-analyzed set of replication cohorts, but the association did not reach statistical significance thresholds (P = 0.09).

Conclusions

Serum 25(OH)D status was associated with cross-sectional FEV₁, but not longitudinal change in FEV₁. The inconsistent associations may be driven by differences in the groups studied. CYP2R1 demonstrated a gene-based association with longitudinal change in FEV₁ and is a promising candidate gene for further studies.

Electronic supplementary material

The online version of this article (doi:10.1186/s12931-015-0238-y) contains supplementary material, which is available to authorized users.     

Do male golden egg bugs carry eggs they have fertilized? A microsatellite analysis

In the golden egg bug, Phyllomorpha laciniata (Heteroptera,Coreidae), both males and females carry eggs on their back.Although females cannot carry their own eggs, males may carryeggs that they have fertilized. If males carry eggs they havefertilized, their behavior may be interpreted as paternal care.In this article, we provide genetic data for paternity assignmentof eggs carried by 40 males collected from the field. The malesand the eggs were typed by using four highly polymorphic microsatelliteDNA markers. Out of the 247 eggs typed, 87% were excluded fromthe father-offspring relationship based on single-locus (leastconservative exclusion) mismatches. Under the more conservative(exclusion by at least two single locus mismatches) method,78% of the eggs were nonpaternal. Relatedness estimates furthersupported our paternity analyses. The average relatedness ofthe eggs to the carrying males was low (b_em = -0.052 ±0.024 SE). Within the population, males were unrelated to eachother (b_mm = -0.004 ± 0.0002 SE), as were the eggs carriedby individual males (b_eggs = -0.004 ± 0.0001 SE). Thisfirst genetic study on the breeding system of the golden eggbugs did not find any support for the claim that egg carryingfunctioned as paternal care, nor did it support kin selectionas explanation for conspecific egg carrying.     

Isg15 controls p53 stability and functions

Degradation of p53 is a cornerstone in the control of its functions as a tumor suppressor. This process is attributed to ubiquitin-dependent modification of p53. In addition to polyubiquitination, we found that p53 is targeted for degradation through ISGylation. Isg15, a ubiquitin-like protein, covalently modifies p53 at 2 sites in the N and C terminus, and ISGylated p53 can be degraded by the 20S proteasome. ISGylation primarily targets a misfolded, dominant-negative p53, and Isg15 deletion in normal cells results in suppression of p53 activity and functions. We propose that Isg15-dependent degradation of p53 represents an alternative mechanism of controlling p53 protein levels, and, thus, it is an attractive pathway for drug discovery.     

Enterovirus71 (EV71) Utilise Host microRNAs to Mediate Host Immune System Enhancing Survival during Infection

Hand, Foot and Mouth Disease (HFMD) is a self-limiting viral disease that mainly affects infants and children. In contrast with other HFMD causing enteroviruses, Enterovirus71 (EV71) has commonly been associated with severe clinical manifestation leading to death. Currently, due to a lack in understanding of EV71 pathogenesis, there is no antiviral therapeutics for the treatment of HFMD patients. Therefore the need to better understand the mechanism of EV71 pathogenesis is warranted. We have previously reported a human colorectal adenocarcinoma cell line (HT29) based model to study the pathogenesis of EV71. Using this system, we showed that knockdown of DGCR8, an essential cofactor for microRNAs biogenesis resulted in a reduction of EV71 replication. We also demonstrated that there are miRNAs changes during EV71 pathogenesis and EV71 utilise host miRNAs to attenuate antiviral pathways during infection. Together, data from this study provide critical information on the role of miRNAs during EV71 infection.     

High-performance liquid chromatographic assay for catecholamines and metanephrines using fluorimetric detection with pre-column 9-fluorenylmethyloxycarbonyl chloride derivatization

A convenient HPLC-fluorescent assay of norepinephrine (NE), epinephrine (E), dopamine (DA) and their 3-O-methylated metabolites, normetanephrine (NM) and metanephrine (MN) was developed. These analytes were coupled to 9-fluorenylmethyloxycarbonyl chloride (FMOC-Cl) before assays. Results showed that using a linear gradient elution, peaks of FMOC-NE, FMOC-E, FMOC-DA, FMOC-NM, FMOC-MN and FMOC-DHBA (3,4-dihydroxybenzylamine, internal standard) were simultaneously resolved within 40 min. Optimization of the chromatographic and derivatization conditions, and validation of the assay were further discussed in the paper. The structures of these derivatives were confirmed by atmospheric pressure chemical ionization mass spectrometry (APCI-MS). The molecular ions [M+H]⁺ of FMOC-NE, FMOC-E, FMOC-DA, FMOC-NM and FMOC-MN were m/z 836, 850, 820, 628 and 642, respectively. Based on these findings, the FMOC-derivatives of metanephrines and catecholamines were confirmed to be bi-substituted and tri-substituted respectively at the amino and catechol functional groups. Finally, the assay was successfully applied to the measurement of urinary E, DA, NM and MN after direct derivatization and simple cleaning.     

Harmonizing Energy and Power Density toward 2.7 V Asymmetric Aqueous Supercapacitor

Tremendous research efforts are devoted to developing wide potential window aqueous supercapacitors to resolve their low energy density concern. While the operational potential window is dictated by the intrinsic electrochemical stability of water (1.23 V), such a bottleneck may be surpassed by leveraging the additional overpotential of the oxygen evolution reaction and the hydrogen evolution reaction (HER). Herein, by employing an electroreduction technique, Na⁺ is adsorbed onto the carbon negative electrode which effectively acts as a physical barrier to hinder intermediate HER product formation, thereby reducing HER activity. To complement the wide potential carbon electrode, Na_0.25MnO₂ is employed as the positive electrode to take advantage of the extra energy (i.e., increased overpotential) required for Na⁺ insertion process into the structure. The asymmetric supercapacitor exhibits high energy density of 61.1 W h kg^?1 at a power density of 982 W kg^?1, and even at an ultrahigh power density of 42.9 kW kg^?1, a respectable energy density of 16.3 W h kg^?1 is attained. In addition, 93.7% capacitance retention is recorded after cycling for 10 000 cycles which further demonstrates its suitability as supercapacitor. The present success in fabricating a 2.7 V asymmetric supercapacitor will open a promising research route toward achieving high energy density and high power density.