Hematological System Research Articles

Abstract CT244: HR001, a novel CD19-targeted CAR-T cell therapy for patients with relapsed/refractory non-Hodgkin's lymphoma: primary results of a phase II study (HRAIN01-NHL01-II)

Abstract Background: HR001 is a CD19-targeted CAR-T cell for patients with relapsed and refractory non-Hodgkin's (R/R NHL). Here, we report the primary results of the phase 2 study (HRAIN01-NHL01-II). Methods: HRAIN01-NHL01-II is an open-label, single-arm, and multicenter (17 centers) study in China. It enrolled R/R NHL patients treated with at least two lines of therapy (must-have anthracycline and CD20-targeted agents) or after autologous hematopoietic stem cell transplantation. All patients received a single infusion of HR001 at the 2.0 × 106 CAR+T cells/kg dose. The disease response was evaluated by the independent review committee with Lugano response criteria [2014]. Results: As of May 16th, 2023, 81 R/R NHL patients with ECOG 0-1 at baseline received the infusion HR001 from the Jinshan manufacturing facility [51.9% male; median age 53.4 years (range 23~74); 3.7% CD19 negative; 91.4% diffuse large B-cell lymphoma; 79.0% III-IV of Ann Arbor classification or Lugano] with a median follow-up of 160 days (range 7 to 454). The median time to best response was 30 days (range 28-358). The 3-month, 6 month and best objective response rate (ORR) was 53.1%(95% CI: 41.7-64.3), 45.7%(95% CI: 34.6-57.1) and 74.1% (95% CI: 63.1-83.2) respectively. The 3-month, 6 month and best complete response rate (CRR) was 32.1%(95% CI: 22.2-43.4), 29.6%(95% CI: 20.0-40.8) and 49.4%(95% CI: 38.1-60.7) respectively. Median duration of response (DOR) and progression-free survival (PFS) were 339 days (95% CI: 149-NE) and 176 days (95% CI: 91-NE) respectively. The overall survival (OS) was not reached. The most common treatment-related adverse events (AEs) happened in the hematologic system. The cytokine release syndrome (CRS) occurred in 95.1% of patients, with ≥3 grade CRS observed in 3.7% of patients. Immune effector cell-associated neurotoxicity syndrome (ICANS) happened in 8.6% of patients, without any ≥ 3 grade ICANS reported. The treatment-related mortality was 1.2%. The median time to CAR T-cell peak expansion was 240 hours (120~672) after infusion, median maximum expansion (Cmax) was 17413.9 copies/μg DNA (124.9~136382.2), and median AUC0-28d was 3201014.0 copies/μg DNA (205082.8~18400016.2). Positive tests for the anti-drug antibody (ADA) were noted in 14.8% of patients, while neutralizing antibody (Nab) tests were positive in 3.7% of patients. Among Nab-positive patients, the complete response was maintained until follow-up. Conclusions: Patients with R/R NHL could benefit from the HR001 treatment with satisfactory objective response, durable remission, and favorable safety profile. Citation Format: Yian Zhang, Yuhua Li, Kai Hu, Wuping Li, Hongwei Xue, Qi Deng, Zheng Ge, Liangquan Geng, Xianmin Song, Kang Yu, Hongmei Jing, Bing Chen, Xin Li, Zhimin Zhai, Jianping Shen, Jiang Cao, Qingming Wang, Peng Liu. HR001, a novel CD19-targeted CAR-T cell therapy for patients with relapsed/refractory non-Hodgkin's lymphoma: primary results of a phase II study (HRAIN01-NHL01-II) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT244.

Anemia and Its Connections to Inflammation in Older Adults: A Review.

Anemia is a common hematological disorder that affects 12% of the community-dwelling population, 40% of hospitalized patients, and 47% of nursing home residents. Our understanding of the impact of inflammation on iron metabolism and erythropoiesis is still lacking. In older adults, anemia can be divided into nutritional deficiency anemia, bleeding anemia, and unexplained anemia. The last type of anemia might be caused by reduced erythropoietin (EPO) activity, progressive EPO resistance of bone marrow erythroid progenitors, and the chronic subclinical pro-inflammatory state. Overall, one-third of older patients with anemia demonstrate a nutritional deficiency, one-third have a chronic subclinical pro-inflammatory state and chronic kidney disease, and one-third suffer from anemia of unknown etiology. Understanding anemia's pathophysiology in people aged 65 and over is crucial because it contributes to frailty, falls, cognitive decline, decreased functional ability, and higher mortality risk. Inflammation produces adverse effects on the cells of the hematological system. These effects include iron deficiency (hypoferremia), reduced EPO production, and the elevated phagocytosis of erythrocytes by hepatic and splenic macrophages. Additionally, inflammation causes enhanced eryptosis due to oxidative stress in the circulation. Identifying mechanisms behind age-related inflammation is essential for a better understanding and preventing anemia in older adults.

Unveiling the regulatory mechanisms of nodules development and quality formation in Panax notoginseng using multi-omics and MALDI-MSI

IntroductionRenowned for its role in traditional Chinese medicine, Panax notoginseng exhibits healing properties including bidirectional regulatory effects on hematological system diseases. However, the presence of nodular structures near the top of the main root, known as nail heads, may impact the quality of the plant's valuable roots. ObjectivesIn this paper, we aim to systematically analyze nail heads to identify their potential correlation with P. notoginseng quality. Additionally, we will investigate the molecular mechanisms behind nail head development. MethodsMorphological characteristics and anatomical features were analyzed to determine the biological properties of nail heads. Active component analysis and MALDI mass spectrometry imaging (MALDI-MSI) were performed to determine the correlation between nail heads and P. notoginseng quality. Phytohormone quantitation, MALDI-MSI, RNA-seq, and Arabidopsis transformation were conducted to elucidate the mechanisms of nail head formation. Finally, protein-nucleic acid and protein–protein interactions were investigated to construct a transcriptional regulatory network of nodule development and quality formation. ResultsOur analyses have revealed that nail heads originate from an undeveloped lateral root. The content of ginsenosides was found to be positively associated with the amount of nail heads. Ginsenoside Rb1 specifically accumulated in the cortex of nail heads, while IAA, tZR and JAs also showed highest accumulation in the nodule. RNA-seq analysis identified PnIAA14 and PnCYP735A1 as inhibitors of lateral root development. PnMYB31 and PnMYB78 were found to form binary complexes with PnbHLH31 to synergistically regulate the expression of PnIAA14, PnCYP735A1, PnSS, and PnFPS. ConclusionOur study details the major biological properties of nodular structures in P. notoginseng and outlines their impact on the quality of the herb. It was also determined that PnMYB31- and PnMYB78-PnbHLH31 regulate phytohormones and ginsenosides accumulation, further affecting plant development and quality. This research provides insights for quality evaluation and clinical applications of P. notoginseng.

Single and mixed effects of multiple volatile organic compounds exposure on hematological parameters in the U.S. adult population

BackgroundMost research exploring the correlation between volatile organic compounds (VOCs) and hematological parameters have focused on single VOCs. Our study aimed to explore the single and combined effects of VOCs on hematological parameters through three statistical models. MethodsData from 4 cycles of the National Health and Nutrition Examination Survey (NHANES) were used in this study. The correlations between single exposure to 16 VOCs and hematological parameters in the general population were assessed by weighted multiple linear regression. Weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) models were used to explore the relationship between the combined important VOCs selected by the least absolute shrinkage and selection operator (LASSO) and hematological parameters, as well as the effects of smoking status on them. ResultsA total of 4089 adults were included in the study. We found that a variety of VOCs were significantly associated with hematological parameters. Among them, N-acetyl-S-(benzyl)-l-cysteine (BMA) was significantly negatively correlated with white blood cell (WBC), red blood cell (RBC), lymphocyte, and neutrophil counts. N-acetyl-S-(3-hydroxypropyl-1-methyl)-l-cysteine (HPMMA) was significantly positively correlated with WBC, monocyte, lymphocyte, and neutrophil counts. In the WQS analysis, the WQS index of the VOCs mixtures was positively correlated with WBC (β: 0.031; P < 0.001), monocyte (0.023; P = 0.021), and neutrophil (0.040; P = 0.001) counts, while negatively associated with RBC (−0.013; P < 0.001) counts. The BKMR model revealed that combined exposure to VOCs levels ≥70th percentile was significantly associated with lower RBC counts, and BMA was identified as the dominant contributor. Smoking significantly influenced the relationship between VOCs and hematological parameters. ConclusionsOur study indicated the effects of single and overall VOCs exposure on hematological parameters and suggested the hematotoxicity as well as pro-inflammatory effects of VOCs, which had strong public health implications for reducing the potential health hazards of VOCs exposure to the hematologic system.

Protective Effect of Royal Jelly on Some Hematologic Parameters Against Sodium Arsenite Toxicity: A Study in Rats

This study examined the effect of royal jelly on some hematological values against sodium arsenite (NaAsO2)-induced toxicity in rats. Royal jelly is a known functional bee product; therefore, its potential to protect against these effects is of great importance. In this study, the effects of royal jelly on hematologic changes were investigated. In the study, 35 healthy Wistar albino male rats weighing 250–300 g and 12–13 weeks old were used. Rats were divided into different groups by gavage daily for 14 days. WBC, LYM, MID, GRA, RBC, HGB, MCHC, MCH, MCV, HCT, PLT, MPV, and PDW values were measured in blood samples. When the measured values were analyzed, the MID, RBC, MCHC, MCH, MCV, and PDV values did not show statistical significance in all experimental groups (P&gt;0.005). However, significant decreases in %LYM, %MID, HCT, and PLT values and increases in WBC, GRA, and %GRA counts were observed in all groups (P &lt; 0.005). This review shows that royal jelly has a potential effect on the hematological and immune systems against toxicity caused by harmful heavy metals such as arsenic. In particular, further research is required to identify the most effective dosage of royal jelly. The results highlight the protective potential of royal jelly against toxicity, which requires further investigation.

Pancytopenia Caused by Nitrous Oxide Toxicity: Two Cases Report

Recreational nitrous oxide (N2O) is increasingly common among young people, leading to attendant health disadvantages. Related complications primarily involve the hematological and neurological systems. We report two relatively uncommon cases of pancytopenia due to substantial N2O inhalation. One possible cause is that N2O toxicity results in vitamin B12 inactivation and an insufficient intake of nutrients. The patient’s symptoms partially improved after cessation of N2O inhalation and supplementation with vitamin B12. In conclusion, if the patients presented with unexplained bone marrow failure, a history of prolonged N2O exposure should be considered, which would greatly help in early diagnosis, therapy, and the reduction of unnecessary costs.

Abstract 5331: Spatial resolution of immune cell lineages in the tumor microenvironment of plasma cell dyscrasias

Abstract Plasma cell dyscrasias (PCDs) are diseases of the hematologic system, with Multiple Myeloma as the most common disease. Less common PCDs include primary and secondary extramedullary plasmacytomas (EMP), which occur in soft tissues. EMPs are typically solitary and infrequent, often localized in the upper aerodigestive and gastrointestinal tracts, lung, and lymph nodes among other organs, and can convert to Multiple Myeloma. Secondary extramedullary plasmacytomas are often noted in advanced disease following multiple rounds of therapy and are commonly associated with poor prognosis. Studies aimed at gaining a better understanding of soft tissue EMPs, whether solitary plasmacytomas with undiagnosed multiple myeloma or in the context of recurrent or metastatic EMP disease, are limited. In this study, we employ a comprehensive approach using multiple modalities, including dissociated CITE-seq, spatial transcriptomics, and multiplexed spatial immuno-fluorescence imaging to interrogate the tumor and immune landscape in EMP disease. Importantly, the use of the same biomarker antibodies across these modalities provides a cross-data-framework for a deep contextual understanding of the immune and tumor cell organization and cell-to-cell signaling in EMP. Ultimately, this study provides new insights into patient-to-patient and tumor location variability, tumor and immune cell microenvironment heterogeneity, and possible future therapeutic strategies for EMP. Citation Format: Medbh A. Dillon, Lisa Arvidson, Cole G. Phalen, Julian R. Ishibashi, John B. Johanneson, Zachary J. Thomson, Peiyao A. Zhao, Jocelin Malone, Mackenzie S. Kopp, Matthew Norton, Gabriella Spang, Susan A. Ludmann, Adam K. Savage, Claire E. Gustafson, Marla Glass, Emma L. Kuan, Tao Peng, Lucas T. Graybuck, Xiao-jun Li, Troy R. Torgerson, Peter J. Skene, Ananda W. Goldrath, Samuel Jensen, Stephanie Anover-Sombke, Melinda L. Angus-Hill. Spatial resolution of immune cell lineages in the tumor microenvironment of plasma cell dyscrasias [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5331.

Hematological Complications of Human Immunodeficiency Virus (HIV) Infection: An Update From an HIV-Endemic Setting.

Medical professionals, particularly in regions with a high burden of human immunodeficiency virus (HIV), should be alert to the hematological complications of HIV, which may include cytopenias, malignancy, and coagulation disturbances. Patients may present with these conditions as the first manifestation of HIV infection. Hematological abnormalities are often multifactorial with opportunistic infections, drugs, malignancy, and HIV infection itself contributing to the clinical presentation, and the diagnosis should consider all these factors. Life-threatening hematological complications requiring urgent diagnosis and management include thrombotic thrombocytopenic purpura, superior mediastinal syndrome, spinal cord compression, and tumor lysis syndrome due to aggressive lymphoma. Antiretroviral therapy is the therapeutic backbone, including for patients with advanced HIV, in addition to specific therapy for the complication. This article reviews the impact of HIV on the hematological system and provides a clinical and diagnostic approach, including the role of a bone marrow biopsy, focusing on perspectives from sub-Saharan Africa.

Medical cannabis use in oncology and associated outcomes: A scoping review.

Natural and synthetic cannabinoids are being used worldwide to treat various symptoms in cancer patients. This study aims to map the therapeutic benefits and adverse effects associated with the use of cannabis-based drugs in these outcomes. Following Joanna Briggs Institute guidelines a scoping review was conducted. The study protocol was available in the Open Science Framework public repository. An extensive search strategy involving databases like Cochrane Library, Embase, CINAHL, Medline/PubMed, Lilacs, Google Scholar, and Open Gray for gray literature analysis was executed by a skilled librarian. The inclusion criteria were primary studies (observational and randomized) that evaluated the efficacy and safety of cannabinoids in cancer patients. The review encompassed studies of diverse designs, publication years, and types, as long as they addressed cannabinoids' impact in oncology. Twenty-nine (82.86%) out of total of 35 were randomized and 6 (14.14%) were non-randomized. About 57.1% of studies utilized registered products as interventions, with THC being the most natural cannabinoid cited in variable doses and administration routes. Moreover, 62.85% of studies specified the cancer types (breast, lung, sarcomas, hematological and reproductive system), while only one study detailed cancer staging. The evaluated outcomes encompassed nausea and vomiting (77.14%), appetite (11.43%), pain (8.57%), and tumor regression (2.86%) across different proportions of studies. Cannabinoids show promise in managing pain, emesis, and anorexia/cachexia linked to cancer progression. New randomized clinical trials with a larger number of participants and observational studies on long-term safety are crucial to affirm their medicinal utility for cancer patients unresponsive to conventional drugs.

Fisetin nanoparticles based on cells cycle and apoptosis intervention for the treatment of lymphoma and leukemia

Lymphoma and leukemia are both hematological system tumors with complex etiology, and mainly treated with chemotherapeutic drugs. However, therapeutic drugs can interrupt curative effect due to different side effects. Therefore, it is worthwhile to develop a novel therapeutic for providing insights for clinical tumor treatment. In this study, we developed a fisetin nanoparticles (Fisetin NPs) through a self-assembled method, and investigated the activity and potential mechanism of Fisetin NPs against lymphoma and leukemia. The spherical and uniformly distributed Fisetin NPs effectively inhibited both tumor cells proliferation, arrested EL4 cells G0/G1 phase and K562 cells G2/M phase, and induced apoptosis in vitro. In vivo, Fisetin NPs exhibited excellent tumor growth inhibition, effective inhibition of cell proliferation and angiogenesis, significant induction of apoptosis and ideal safety. Mechanically, fisetin upregulated genes (Fas, Pidd, Puma, Apaf1, and p21) in the p53 signaling pathway and bound to N-acetyltransferase 10 (NAT10), ribosomal protein L34 (RPL34) and GTP binding protein 4 (GTPBP4). Collectively, Fisetin NPs have promising therapeutic effects on lymphoma and leukemia, which are of great significant for clinical implications.

Safety of Atypical Antipsychotics in a Child and Adolescent Inpatient Setting: A Naturalistic Study.

This study's objective was to investigate the adverse effects of atypical antipsychotics (AAPs) on the metabolic, hematological, and endocrinological systems in the inpatient environment for children and adolescents with diverse psychiatric disorders. A retrospective assessment of 208 children's and adolescents' medical records was conducted. All patients were on AAP monotherapy. At baseline and after treatment, measurements of body weight, height, body mass index (BMI), BMI z-score, fasting blood glucose (FBG), total cholesterol, low-density lipoprotein cholesterol, triglycerides, high-density lipoprotein cholesterol, complete blood count, liver functions, thyroid functions, and prolactin levels were made. Scores from the Children's Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were preserved. The overall patient population had a mean age of 14.50 ± 2.32 years, 139 girls, and 69 boys. Of the patients, 63 (30.29%) were on risperidone (RIS), 69(33.17%) were on aripiprazole (ARI), 32 (15.39%) were on quetiapine (QUE), 42 (20.19%) were on olanzapine (OLA), and 2 (0.96%) were on clozapine (CLO). In the OLA group, the BMI and BMI z-score increased more than in the RIS, QUE, and ARI groups (P = .030, P = .014, and P = .001, respectively) (P = .001). The mean difference in CGAS and HoNOSCA between the start of antipsychotic medication and hospital discharge was statistically different for all four groups (P = .001 for all). The mean FBG levels in the OLA group increased statistically significantly (P = .013, P = .021) in contrast to the RIS group. In addition, a statistically significant difference in triglycerides across the groups was found (P = .003). According to the findings of our study, children and adolescents appear to be at a significant risk for psychotropic-induced PRL increase, weight gain, metabolic, and hematological consequences. To prevent serious health problems, a meticulous risk-benefit assessment for AAPs treatment should be done between clinicians and patients and their families.

Biocompatibility assessment of bovine serum albumin conjugated manganese dioxide nanoparticle and their therapeutic role against microwave radiation induced haematological toxicity in male Wistar rats

Microwave (MW) radiations are widely used in communications, radar and medical treatment and thus human exposure to MW radiations have increased tremendously, raising health concerns as MW has been implicated in induction of oxidative stress condition in our body. Few metallic nanoparticles (NPs) have been shown to mimic the activity of antioxidant enzymes and hence can be applied for the modulation of adverse effects caused by MW. Present study aimed to assess the biocompatibility of Bovine serum albumin (BSA) conjugated manganese dioxide nanoparticles (MNP*) and to counteract the impact of MW on the haematological system of male Wistar rats. Experiments were conducted in two sets. Set I involved biodistribution and antioxidant activity evaluation of MNP* at different doses. Results showed a dose-dependent increase in antioxidant potential and significant biodistribution in the liver, spleen, kidney, and testis, with no organ damage, indicating its biocompatibility. Experiment set II constituted the study of separate and combined effects of MW and MNP* on haematological parameters, oxidative status, and genotoxic study in the blood of rats. MW exposure significantly altered red blood cell count, hemoglobin, packed cell volume percentage, monocyte percentage, aspartate aminotransferase, Alanine aminotransferase and uric acid. MW also induced significant DNA damage in the blood. A significant increase in lipid peroxidation and a decrease in antioxidant enzyme superoxide dismutase was also observed in MW exposed group. However, these alterations were reduced significantly when MNP* was administered. Thus, MNP* showed biocompatibility and modulatory effects against MW-induced alterations in the haematological system of rats.

Risks for animal and human health related to the presence of polychlorinated naphthalenes (PCNs) in feed and food.

EFSA was asked for a scientific opinion on the risks for animal and human health related to the presence of polychlorinated naphthalenes (PCNs) in feed and food. The assessment focused on hexaCNs due to very limited data on other PCN congeners. For hexaCNs in feed, 217 analytical results were used to estimate dietary exposures for food-producing and non-food-producing animals; however, a risk characterisation could not be performed because none of the toxicological studies allowed identification of reference points. The oral repeated dose toxicity studies performed in rats with a hexaCN mixture containing all 10 hexaCNs indicated that the critical target was the haematological system. A BMDL20 of 0.05 mg/kg body weight (bw) per day was identified for a considerable decrease in the platelet count. For hexaCNs in food, 2317 analytical results were used to estimate dietary exposures across dietary surveys and age groups. The highest exposure ranged from 0.91 to 29.8 pg/kg bw per day in general population and from 220 to 559 pg/kg bw per day for breast-fed infants with the highest consumption of breast milk. Applying a margin of exposure (MOE) approach, the estimated MOEs for the high dietary exposures ranged from 1,700,000 to 55,000,000 for the general population and from 90,000 to 230,000 for breast-fed infants with the highest consumption of breast milk. These MOEs are far above the minimum MOE of 2000 that does not raise a health concern. Taking account of the uncertainties affecting the assessment, the Panel concluded with at least 99% certainty that dietary exposure to hexaCNs does not raise a health concern for any of the population groups considered. Due to major limitations in the available data, no assessment was possible for genotoxic effects or for health risks of PCNs other than hexaCNs.

Feline infectious peritonitis: A comprehensive evaluation of clinical manifestations, laboratory diagnosis, and therapeutic approaches.

This study aimed to investigate the clinical and laboratory characteristics of naturally occurring feline infectious peritonitis (FIP) and estimate the median survival time of FIP cats treated with prednisolone to guide further therapeutic planning. In this retrospective study, data from a total of 116 cats with effusion were fully recorded. Forty-five FIP-diagnosed cats were enrolled for analysis. The study findings indicate that FIP was a disease affecting cats aged 1-2 years and was highly prevalent among male cats. Clinical manifestations of FIP affected the digestive (60%), hematological (53.3%), respiratory (33.3%), neurological (6.7%), and ocular (4.4%) systems. Blood profiles revealed mild anemia, lymphopenia, thrombocytopenia, hypoalbuminemia, hyperglobulinemia, and an albumin to globulin ratio of 0.4. Fluid analysis and cytology of FIP cats demonstrated a transparent yellow fluid with a protein content of 6 gm/dl and a total nucleated cell count of approximately 5,000-10,000 cells. During the observation period, FIP cats treated with prednisolone exhibited a median survival time of 31 days. Confirming FIP cases can be challenging; therefore, a tentative diagnosis of FIP must be made with care. This study provided practical diagnostic tools to diagnose FIP based on clinical signs and multiple abnormalities, which allowed for more efficient and rapid detection.

Genetic background of hematological parameters in Holstein cattle based on genome-wide association and RNA sequencing analyses

Hematological parameters refer to the assessment of changes in the number and distribution of blood cells, including leukocytes (LES), erythrocytes (ERS), and platelets (PLS), which are essential for the early diagnosis of hematological system disorders and other systemic diseases in livestock. In this context, the primary objectives of this study were to investigate the genomic background of 19 hematological parameters in Holstein cattle, focusing on LES, ERS, and PLS blood components. Genetic and phenotypic (co)variances of hematological parameters were calculated based on the Average Information Restricted Maximum Likelihood (AIREML) method and 1,610 genotyped individuals and 5,499 hematological parameter records from 4,543 cows. Furthermore, we assessed the genetic relationship between these hematological parameters and other economically important traits in dairy cattle breeding programs. We also carried out genome-wide association studies and candidate gene analyses. Blood samples from 21 primiparous cows were used to identify candidate genes further through RNA sequencing (RNA-seq) analyses. Hematological parameters generally exhibited low-to-moderate heritabilities ranging from 0.01 to 0.29, with genetic correlations between them ranging from -0.88 ± 0.09 (between mononuclear cell ratio and lymphocyte cell ratio) to 0.99 ± 0.01 (between white blood cell count and granulocyte cell count). Furthermore, low to moderate approximate genetic correlations between hematological parameters with one longevity, 4 fertility, and 5 health traits were observed. One-hundred-and-99 significant single nucleotide polymorphisms (SNP) located primarily on the Bos taurus autosomes (BTA) BTA4, BTA6, and BTA8 were associated with 16 hematological parameters. Based on the RNA-seq analyses, 6,687 genes were significantly downregulated and 4,119 genes were upregulated when comparing 2 groups of cows with high and low phenotypic values. By integrating genome-wide association studies (GWAS), RNA-seq, and previously published results, the main candidate genes associated with hematological parameters in Holstein cattle were ACRBP, ADAMTS3, CANT1, CCM2L, CNN3, CPLANE1, GPAT3, GRIP2, PLAGL2, RTL6, SOX4, WDFY3, and ZNF614. Hematological parameters are heritable and moderately to highly genetically correlated among themselves. The large number of candidate genes identified based on GWAS and RNA-seq indicate the polygenic nature and complex genetic determinism of hematological parameters in Holstein cattle.

Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China

BackgroundBrucellosis is a severe zoonotic disease that is often overlooked, particularly in impoverished countries. Timely identification of focal complications in brucellosis is crucial for improving treatment outcomes. However, there is currently a lack of established indicators or biomarkers for diagnosing these complications. Therefore, this study aimed to investigate potential warning signs of focal complications in human brucellosis, with the goal of providing practical parameters for clinicians to aid in the diagnosis and management of patients.MethodsA multi-center cross-sectional study was conducted in China from December 2019 to August 2021. The study aimed to investigate the clinical characteristics and complications of patients with brucellosis using a questionnaire survey and medical record system. The presence of warning signs for complications was assessed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used for variable screening and model evaluation.ResultsA total of 880 participants diagnosed with human brucellosis were enrolled. The median age of the patients was 50 years [interquartile range (IQR): 41.5–58.0], and 54.8% had complications. The most common organ system affected by complications was the osteoarticular system (43.1%), with peripheral arthritis (30.0%), spondylitis (16.6%), paravertebral abscess (5.0%), and sacroiliitis (2.7%) being the most prevalent. Complications in other organ systems included the genitourinary system (4.7%), respiratory system (4.7%), and hematologic system (4.6%). Several factors were found to be associated with focal brucellosis. These factors included a long delay in diagnosis [odds ratio (OR) = 3.963, 95% confidence interval (CI) 1.906–8.238 for > 90 days], the presence of underlying disease (OR = 1.675, 95% CI 1.176–2.384), arthralgia (OR = 3.197, 95% CI 1.986–5.148), eye bulging pain (OR = 3.482, 95% CI 1.349–8.988), C-reactive protein (CRP) > 10 mg/L (OR = 1.910, 95% CI 1.310–2.784) and erythrocyte sedimentation rate (ESR) elevation (OR = 1.663, 95% CI 1.145–2.415). The optimal cutoff value in ROC analysis was > 5.4 mg/L for CRP (sensitivity 73.4% and specificity 51.9%) and > 25 mm/h for ESR (sensitivity 47.9% and specificity 71.1%).ConclusionsMore than 50% of patients with brucellosis experienced complications. Factors such as diagnostic delay, underlying disease, arthralgia, eye pain, and elevated levels of CRP and ESR were identified as significant markers for the development of complications. Therefore, patients presenting with these conditions should be closely monitored for potential complications, regardless of their culture results and standard tube agglutination test titers.

The top 50 most-cited articles about COVID-19 and the complications of COVID-19: A bibliometric analysis

Background This bibliometric analysis examines the top 50 most-cited articles on COVID-19 complications, offering insights into the multifaceted impact of the virus. Since its emergence in Wuhan in December 2019, COVID-19 has evolved into a global health crisis, with over 770 million confirmed cases and 6.9 million deaths as of September 2023. Initially recognized as a respiratory illness causing pneumonia and ARDS, its diverse complications extend to cardiovascular, gastrointestinal, renal, hematological, neurological, endocrinological, ophthalmological, hepatobiliary, and dermatological systems. Methods Identifying the top 50 articles from a pool of 5940 in Scopus, the analysis spans November 2019 to July 2021, employing terms related to COVID-19 and complications. Rigorous review criteria excluded non-relevant studies, basic science research, and animal models. The authors independently reviewed articles, considering factors like title, citations, publication year, journal, impact factor, authors, study details, and patient demographics. Results The focus is primarily on 2020 publications (96%), with all articles being open access. Leading journals include The Lancet, NEJM, and JAMA, with prominent contributions from Internal Medicine (46.9%) and Pulmonary Medicine (14.5%). China played a major role (34.9%), followed by France and Belgium. Clinical features were the primary study topic (68%), often utilizing retrospective designs (24%). Among 22,477 patients analyzed, 54.8% were male, with the most common age group being 26-65 years (63.2%). Complications of COVID-19 affected 13.9% of patients, with a recovery rate of 57.8%. Conclusion Analyzing these top-cited articles offers clinicians and researchers a comprehensive, timely understanding of influential COVID-19 literature. This approach uncovers attributes contributing to high citations and provides authors with valuable insights for crafting impactful research. As a strategic tool, this analysis facilitates staying updated and making meaningful contributions to the dynamic field of COVID-19 research.

Efficient leukocytes detection and classification in microscopic blood images using convolutional neural network coupled with a dual attention network

Leukocytes, also called White Blood Cells (WBCs) or leucocytes, are the cells that play a pivotal role in human health and are vital indicators of diseases such as malaria, leukemia, AIDS, and other viral infections. WBCs detection and classification in blood smears offers insights to pathologists, aiding diagnosis across medical conditions. Traditional techniques, including manual counting, detection, classification, and visual inspection of microscopic images by medical professionals, pose challenges due to their labor-intensive nature. However, traditional methods are time consuming and sometimes susceptible to errors. Here, we propose a high-performance convolutional neural network (CNN) coupled with a dual-attention network that efficiently detects and classifies WBCs in microscopic thick smear images. The main aim of this study was to enhance clinical hematology systems and expedite medical diagnostic processes. In the proposed technique, we utilized a deep convolutional generative adversarial network (DCGAN) to overcome the limitations imposed by limited training data and employed a dual attention mechanism to improve accuracy, efficiency, and generalization. The proposed technique achieved overall accuracy rates of 99.83%, 99.35%, and 99.60% for the peripheral blood cell (PBC), leukocyte images for segmentation and classification (LISC), and Raabin-WBC benchmark datasets, respectively. Our proposed approach outperforms state-of-the-art methods in terms of accuracy, highlighting the effectiveness of the strategies employed and their potential to enhance diagnostic capabilities and advance real-world healthcare practices and diagnostic systems.

(063) The Role of Leptin as a Testicular Immune Microenvironment Modulator and Leydig Stem Cell Function

Abstract Introduction The testicular microenvironment, consisting of cells including Sertoli and peritubular cells, releases paracrine factors that may regulate testicular function. In previous research, Leptin was identified as a critical paracrine factor in the testicular microenvironment. Leptin is secreted by Sertoli and peritubular cells and binds to its receptor in Leydig cells. This interaction triggers the expression of the desert hedgehog signaling pathway, which is essential for Leydig stem cell differentiation into adult Leydig cells, which are capable of producing testosterone. However, our earlier study had a limitation: the human cell model used was derived from testes biopsies, lacking an intact immune microenvironment. This study investigates the effect of Leptin on a complete testicular immune microenvironment in a murine model. Objective To investigate the impact of Leptin on a complete testicular immune microenvironment. Methods We used 6-week-old C57BL6 mice, exposed to two different concentrations of Leptin, 10 and 100 mg/ml, for seven days. After the treatment period, the animals were humanely euthanized, and their blood and testes were collected. Blood samples underwent a complete blood count differential profile analysis using a Hemavet Mascot Multispecies Hematology System Counter 1500R. Testes samples were subjected to comprehensive immunophenotyping, allowing us to assess the impact of Leptin treatment on various immune cell types within the testes Results Leptin at a low dose (10 mg/ml) showed increased, but not significant, levels of serum testosterone (13.20 + 0.37 ng/dl), while LH and FSH levels significantly (p&amp;lt;0.05) increased. In contrast, animals receiving 100 mg/ml Leptin showed no significant changes in hormone levels. CBC profiling indicated that lymphocytes and platelets were significantly influenced, specifically with low doses of Leptin. Comprehensive immunophenotyping revealed a significant increase in CD4+ (helper T cells) and CD8+ (cytotoxic T lymphocytes) cell numbers in animals treated with low doses of Leptin, a pattern not observed with high doses. Conclusions This study uncovers previously unexplored aspects of how paracrine factors, released by Sertoli and peritubular myoid cells, can modulate the immune microenvironment within the testis, potentially impacting testosterone production. Future research will investigate the relationship between changes in immune cell types, increased T cell numbers, and their influence on Leydig stem cell differentiation into adult Leydig cells Disclosure No.

(251) Exogenous Leptin Treatment Augments Testicular T-cell Secretion and Function Differentially in Context to BMI in Murine Models

Abstract Introduction In previous research, we explored the effects of exogenous Leptin treatment on modulating the immune landscape within the testicular microenvironment (TME). We found that within the TME, it is the CD8+ T cells which were enriched upon Leptin treatment. However, our earlier study did not took into account the impact of variations in BMI which could potentially confound the effects of Leptin on T cells and on TME as a whole. Objective To investigate the impact of Leptin on a complete testicular immune microenvironment. Methods We used 6-week-old C57BL6 mice (n=30), grouped into three, with first group subjected to regular diet, second to Lean fat and third to high fat inducing diet. Once the mice reached the desired weights, they were exposed to two different concentrations of Leptin, 10 and 100 mg/ml, for seven days. After the treatment period, the animals were humanely euthanized, and their blood and testes were collected. Blood samples underwent a CBC differential profile analysis using a Hemavet Mascot Multispecies Hematology System Counter 1500R. Testes samples were subjected to comprehensive immunophenotyping, allowing us to assess the impact of Leptin treatment on various immune cell types within the testes. Results In mice with regular BMI, Leptin at a low dose (10 mg/ml) showed increased, but not significant, levels of serum testosterone (13.20 + 0.37 ng/dl), while LH and FSH levels significantly (p&amp;lt;0.05) increased. In contrast, animals receiving 100 mg/ml Leptin showed no significant changes in hormone levels. CBC profiling indicated that lymphocytes and platelets were significantly influenced, specifically upon low doses of Leptin. Comprehensive immunophenotyping revealed a significant increase in CD4+ (helper T cells) and CD8+ (cytotoxic T lymphocytes) cell numbers in animals treated with low doses of Leptin, a pattern not observed with high doses. These results were in contrast to the mice which represented lean and obese conditions. Conclusions This study uncovers previously unexplored aspects of how exogenous Leptin treatments can modulate the immune microenvironment within the testis, potentially impacting testosterone production. Future research will investigate the relationship between changes in immune cell types, increased T cell numbers, and their influence on Leydig stem cell differentiation into adult Leydig cells. Disclosure No.