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Letermovir, a novel anti‐cytomegalovirus (CMV) agent acts by inhibiting the viral terminase complex and is approved for primary prophylaxis in CMV seropositive patients post allogeneic hematopoietic cell transplantation (HCT). The favorable efficacy and safety profile make it an attractive option for use as secondary prophylaxis in patients at high‐risk for CMV reactivation. In this study, we report the efficacy and safety of letermovir secondary prophylaxis after at least one treated episode of CMV reactivation in a cohort of 39 high‐risk patients. Thirty two (82%) patients received anti‐thymocyte globulin (ATG), 27 (69%) received a combination of ATG and post‐transplant cyclophosphamide for graft‐versus‐host disease (GVHD) prophylaxis. Twenty one patients (54%) received CMV seronegative grafts. In addition, 18 (46%) patients had HLA mismatched unrelated or haploidentical donors while 18 (46%) had active GVHD requiring immunosuppression at the time of commencing secondary prophylaxis. Letermovir was initiated at a median of 47 days (range, 41–56) after HCT and was administered for a median duration of 77 days (range, 46–90). A single breakthrough CMV reactivation was noted in this high‐risk cohort. Four additional episodes of CMV reactivation occurred at a median of 28 days (range, 23–59 days) after discontinuation of secondary prophylaxis. The drug was well tolerated and 77% of the cohort completed the planned duration of secondary prophylaxis. None of the patients discontinued treatment due to treatment‐related adverse effects. In conclusion, letermovir is effective and well tolerated and may be considered for secondary prophylaxis in patients at high risk for CMV reactivation. Prospective studies are required to validate these findings. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study explored the denaturation of 11S globulin, a protein known for its diverse functional properties in soy protein applications, at pH 3.0 and pH 10.0, followed by a gradual return to pH 7.0 to facilitate renaturation. It investigated the structural and functional changes during renaturation induced by a change in pH, revealing the stabilization mechanism of 11S globulin. RESULTS: The findings revealed that during pH adjustment to neutral, the denatured soybean 11S globulin – resulting from alkaline (pH 10.0) or acidic (pH 3.0) treatments – experienced a refolding of its extended tertiary structure to varying extents. The particle size and the proportions of α‐helix and β‐sheet in the secondary structure aligned progressively with those of the natural‐state protein. However, for the alkali‐denatured 11S, the β‐sheet content decreased upon adjustment to neutral, whereas an increase was observed for the acid‐denatured 11S. In terms of functional properties, after alkaline denaturation, the foaming capacity (FC) and emulsifying activity index (EAI) of 11S increased by 1.4 and 1.2 times, respectively, in comparison with its native state. The solubility, foamability, and emulsifiability of the alkali‐denatured 11S gradually diminished during renaturation but remained superior to those of the native state. Conversely, these properties showed an initial decline, followed by an increase during renaturation triggered by pH neutralization. CONCLUSIONS: This research contributes to the enhancement of protein functionality, offering a theoretical foundation for the development of functional soy protein products and expanding their potential applications. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

BACKGROUND: Soy 11S globulin has high thermal stability, limiting its application in the production of low‐temperature gel foods. In this study, the low‐frequency magnetic field (LF‐MF, 5 mT) treatment (time, 30, 60, 90, and 120 min) was used to improve the solubility, conformation, physicochemical properties, surface characteristics, and gel properties of soy 11S globulin. RESULTS: Compared with the native soy 11S globulin, the sulfhydryl content, emulsifying capacity, gel strength, water‐holding capacity, and absolute zeta potential values significantly increased (P < 0.05) after LF‐MF treatment. The LF‐MF treatment induced the unfolding of the protein structure and the fracture of disulfide bonds. The variations in solubility, foaming properties, viscosity, surface hydrophobicity, and rheological properties were closely related to the conformational changes of soy 11S globulin, with the optimum LF‐MF modification time being 90 min. CONCLUSION: LF‐MF treatment is an effective method to improve various functional properties of native soy 11S globulin, and this study provides a reference for the development of plant‐based proteins in the food industry. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Background: Periodontitis is characterized by local inflammatory conditions in the periodontium, its severe form has been associated with elevated systemic inflammatory markers. However, the long‐term effects of periodontal inflammation control on systemic inflammatory markers are unclear. Objective: This study aimed to investigate the long‐term effects of periodontal therapy on the levels of peripheral venous blood inflammatory markers in patients with generalized aggressive periodontitis (GAgP), all of whom were now diagnosed as Stage III or IV Grade C periodontitis. Methods: Patients with GAgP were consecutively recruited from April 2013 to August 2014 (T0). Active periodontal treatment (APT) was provided, and follow‐ups were conducted over a 3‐ to 5‐year period (T1). Clinical parameters were assessed and fasting venous blood was collected at T0 and T1. Complete blood cell counts were obtained, and biochemical analyses were performed to evaluate the levels of serum components. The correlations between probing depth (PD) and hematological parameters were analyzed. Results: A total of 49 patients with GAgP completed APT and follow‐ups. Probing depth (PD) reduced from 5.10 ± 1.07 mm at T0 to 3.15 ± 0.65 mm at T1. For every 1‐mm reduction in PD after treatment, the neutrophil count, neutrophil‐lymphocyte ratio, and total protein concentration were reduced by 0.33 × 109/L, 0.26, and 1.18 g/L, respectively. In contrast, the albumin/globulin ratio increased by 0.10. Conclusion: This study indicated that periodontal therapy may have beneficial effects on peripheral venous blood inflammatory markers in patients with GAgP during long‐term observation. [ABSTRACT FROM AUTHOR]

Summary: The gel‐forming ability of the pulse proteins influences the formation of food products with desirable texture, structure, and stability. In this study, Bambara globulin was fractionated into legumin and vicilin for structural and physicochemical analyses, and heat‐induced gel rheological characterisation. Bambara globulin showed major vicilin (7S, Mw: 120 kDa) and minor legumin (11S, Mw: 410 kDa) components by size exclusion chromatography and gel electrophoresis analyses. Legumin had the lowest amount of all the charged amino acids. One basic subunit (22 kDa) was identified in the legumin fraction with predominant helical structures. The sol–gel transition temperatures increased in the order of globulin (40 °C) < legumin (50 °C) < vicilin (80 °C). The G′ and G″ of globulin showed relatively low dependency on heating time beyond the gel point compared to legumin and vicilin subfractions, suggesting a more rapid establishment of its gel network during gelation. Vicilin gel consisted of a microporous structure with a small lath sheet‐like structure compared to others. Bambara vicilin could be a prospective ingredient in the development of new products with defined textural characteristics. [ABSTRACT FROM AUTHOR]

Setting: Previous studies addressed the association between anti‐thyroid antibodies and recurrent miscarriage (RM), however, the role of anti‐thyroid antibodies in RM patients is debatable. Objectives: Therefore, we conducted this meta‐analysis and the aim of this current study was to assess whether anti‐thyroid peroxidase (anti‐TPO) and/or anti‐thyroglobulin (anti‐TG) antibody positivity was associated with RM. Design: A meta‐analysis was conducted. Participants: Recurrent miscarriage patients. Methods: STATA 12.0 software were applied to compute odds ratios (ORs)/relative risks (RRs) and 95% CIs regarding association between anti‐TPO and anti‐TG antibodies and the prevalence of RM. Results: N = 28 studies (8875 participants) explored effect of anti‐thyroid antibodies on RM. Analysis of the 28 studies revealed significant association between anti‐TPO, anti‐TG antibodies and the prevalence of RM with a random effects model (OR/RR = 2.02; 95% CI: 1.63–2.51, p < 0.001; I2 = 44.3%, p value for Q test = 0.004). Analysis of the 20 studies revealed significant association between anti‐TPO antibodies and the prevalence of RM with a random effects model (OR/RR = 1.59; 95% CI: 1.25–2.03, p < 0.001; I2 = 43.1%, p value for Q test = 0.022). Analysis of the 14 studies revealed significant association between anti‐TG antibodies and the prevalence of RM with a random effects model (OR/RR = 2.25; 95% CI: 1.56–3.23, p < 0.001; I2 = 49.2%, p value for Q test = 0.019). Conclusions: Based on the currently available analysis, our findings suggest that women with anti‐TPO and/or anti‐TG antibodies have a higher risk of RM than that in negative antibody women. Further investigation is needed to better clarify the exact role of the anti‐thyroid antibodies in RM and whether treatment is of benefit. Limitations: First, differences from various detection methods and reagents used in different studies may affect the diagnostic interpretation of anti‐thyroid antibodies, which might influence the accuracy of this meta‐analysis. Second, positive anti‐thyroid antibodies seem likely to be part of a more general disorder of maternal immune system, due to restrictions of funding and condition, a complete autoantibody screening investigation is hardly to conduct in all participants, and this could be a possible limitation of all included studies. Third, there is no mention of thyroxine therapy on RM, making the meta‐analysis even more limited. [ABSTRACT FROM AUTHOR]

Objective: Black groups have increased prevalence and accelerated pathogenicity of systemic lupus erythematosus (SLE) compared to other ethnic/racial groups. The microbiome and systemic microbial translocation are considered contributing factors to SLE disease pathogenesis. However, racial differences in the plasma microbiome and microbial translocation in lupus remain unknown. Methods: In the current study, we investigated plasma levels of microbial translocation (lipopolysaccharide [LPS] and zonulin) and the plasma microbiome using microbial 16S RNA sequencing of Black and White patients with SLE and Black and White healthy controls. Results: Plasma microbial translocation was increased in Black patients versus in White patients and in patients with SLE versus healthy controls regardless of race. Compared to sex, age, and disease status, race had the strongest association with plasma microbiome differences. Black groups (Black controls and Black patients) had lower α‐diversity than White groups (White controls and White patients) and more distinct β‐diversity. Black and White patients demonstrated differences in plasma bacterial presence, including Staphylococcus and Burkholderia. Compared to White patients, Black patients had higher SLE Disease Activity Index (SLEDAI) scores and urinary protein levels as well as a trend for increased anti–double‐stranded DNA (dsDNA) antibody levels consistent with the known increased severity of lupus in Black patients overall. Certain plasma bacteria at the genus level were identified that were associated with the SLEDAI score, urinary protein, and anti‐dsDNA antibody levels. Conclusion: This study reveals racial differences in both quality and quantity of plasma microbial translocation and identified specific plasma microbiome differences associated with SLE disease pathogenesis. Thus, this study may provide new insights into future potential microbiome therapies on SLE pathogenesis. [ABSTRACT FROM AUTHOR]

This study intended to investigate the impact of long‐term tenofovir fumarate (TDF) antiviral regimen on renal function in human immunodeficiency virus (HIV)‐infected patients with low‐risk of kidney injury. The observational study involving 100 HIV‐infected patients without underlying diseases who achieved virological suppression and immunological recovery after sustained antiviral regimen of TDF+ lamivudine+ efavirenz (TLE) for 3.19 years. Renal function, including estimated glomerular filtration rate (eGFR), blood and urine β2 microglobulin, and other parameters, was assessed every 3 months over a period of 2.5 years. The eGFR showed a slight increasement from 116.0 at month 0 to 119.7 at month 30. Blood β2 microglobulin increased from 2.02 mg/L at month 0 to 2.77 mg/L at month 30. Compared to month 0, the difference in blood β2 microglobulin was statistically significant at month 6 and months 12‐30 (P <.05). The incidence of proximal renal tubular dysfunction fluctuated from 2% at month 0 to 2.5% at month 30. The urine β2 microglobulin fluctuated from 0.5 (0.3‐1.1) to 0.8 (0.5‐1.35) mg/L at months 18‐30, which was higher than 0.41 (0.18‐1.1) mg/L at month 0 (P <.05). The abnormal concentration proportion of urine β2 microglobulin fluctuated from 72.7% to 81.3% at months 18‐30, which was higher than the proportion of 57.0% at month 0. The abnormal proportion of blood β2 microglobulin, urine β2 microglobulin, and proximal renal tubular dysfunction were not correlated with eGFR (r1 = 0.119, r2 = −0.008, r3 = −0.165, P >.05). Long‐term TDF antiviral regimen in low‐risk of kidney injury HIV‐infected patients may lead to damage in the proximal renal tubules and glomeruli. Blood and urine β2 microglobulin levels may be helpful in screening for renal dysfunction. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the efficacy and safety of basiliximab (BAS) versus a single dose of anti‐thymocyte globulin (r‐ATG) induction therapy in pediatric kidney transplant recipients (KTRs). Methods: This single‐center retrospective comparative cohort study included all pediatric KTRs from May 2013 to April 2018 and followed up to 12 months. In the first period, all recipients received BAS, while from May 2016, a single 3 mg/kg dose of r‐ATG was instituted. Maintenance therapy consisted of a calcineurin inhibitor plus prednisone plus azathioprine or mycophenolate. Results: A total of 227 patients were included (BAS, n = 113; r‐ATG, n = 114). The main combination of immunosuppressive drugs was tacrolimus, prednisone, and azathioprine in both groups (87% vs. 88%, p =.718). Patients receiving r‐ATG showed superior survival‐free of the composite endpoint (acute rejection, graft loss, or death; 76% vs. 61%, p =.003; HR 2.08, 1.29–3.34, p =.003) and lower incidence of biopsy‐proven acute rejection (10% vs. 21%, p =.015). There was no difference in the overall incidence of CMV infection (33% vs. 37%, p =.457), PTLD (1% vs. 3%, p =.309), 30‐day hospital readmissions (24% vs. 23%, p =.847), and kidney function at 12 months (86 ± 29 vs. 84 ± 30 mL/min/1.73m2, p =.614). Conclusions: These data suggest that induction therapy with a single 3 mg/kg dose of r‐ATG is associated with higher efficacy for preventing acute rejection and similar safety profile compared to BAS. [ABSTRACT FROM AUTHOR]

Background: Current Association for the Advancement of Blood & Biotherapies (AABB) standards require transfusion services to have a policy on Rh immune globulin (RhIG) immunoprophylaxis for when RhD‐negative patients are exposed to RhD‐positive red cells. This is a survey of AABB‐accredited transfusion services in the United States (US) regarding institutional policies and practices on RhIG immunoprophylaxis after RhD‐negative patients receive RhD‐positive (i.e., RhD‐incompatible) packed red blood cell (pRBC) and platelet transfusions. Results: Approximately half of the respondents (50.4%, 116/230) have policies on RhIG administration after RhD‐incompatible pRBC and platelet transfusions, while others had policies for only pRBC (13.5%, 31/230) or only platelet (17.8%, 41/230) transfusions, but not both. In contrast, 18.3% (42/230) report that their institution has no written policies on RhIG immunoprophylaxis after RhD‐incompatible transfusions. Most institutions (70.2%, 99/141) do not have policies addressing safety parameters to mitigate the risk of hemolysis associated with the high dose of RhIG required to prevent RhD alloimmunization after RhD‐incompatible pRBC transfusions. Discussion: With approximately half of US AABB‐accredited institutions report having policies on RhIG immunoprophylaxis after both RhD‐incompatible pRBC and platelet transfusions, some institutions may not be in compliance with AABB standards. Further, most with policies on RhIG immunoprophylaxis after RhD‐incompatible pRBC transfusion do not have written safeguards to mitigate the risk of hemolysis associated with the high dose of RhIG required. Conclusion: This survey underscores the diverse and inadequate institutional policies on RhIG immunoprophylaxis after RhD exposure in Rh‐negative patients via transfusion. This observation identifies an opportunity to improve transfusion safety. [ABSTRACT FROM AUTHOR]

Introduction: In kidney transplant recipients (KTRs), steroid‐free maintenance regimens are used to minimize the negative impact of steroid use. Studies comparing alemtuzumab (ALZ) and anti‐thymocyte globulin (ATG) with rapid steroid withdrawal are limited. The aim of this study was to assess a composite outcome of incidence of de novo donor specific antibodies (dnDSAs), biopsy proven rejection (BPAR), graft failure, or death in KTRs receiving ALZ or ATG with a steroid‐free maintenance regimen. Methods: A single‐center, retrospective cohort study was conducted in adult KTRs who underwent rapid steroid withdrawal. There were two cohorts, KTRs who received induction with ALZ compared to ATG. The primary composite outcome was incidence of dnDSAs, BPAR, graft failure, or death. Secondary outcomes included renal function, cytomegalovirus (CMV) and BK viremia, and leukopenia. Results: Two hundred twenty‐five KTRs were included where 146 received ALZ and 79 received ATG. The Cox proportional hazard of the primary composite outcome in the ALZ compared to ATG group was not significant (unadjusted model HR 1.37, 95% CI.74–2.55). Individual incidences of composite outcome were similar. There was a difference in estimated glomerular filtration rate at 12 months post‐transplant (55.7 vs. 62.3 mL/min/1.73m2, p =.03) and leukopenia at 3 months (3.7 vs. 4.2 × 109/L, p =.03). Other secondary outcomes were similar. Conclusions: There was no difference in composite outcome for dnDSAs, BPAR, graft failure, and death. [ABSTRACT FROM AUTHOR]

Problem: Currently, there is a variety of evidence linking the gut microbiota to changes in sex hormones. In contrast, the causal relationship between SHBG, a carrier of sex hormones, and the gut microbiota is unclear. Method of Study: Bidirectional two‐sample Mendelian randomization (MR) analysis was used to detect the causal effect between SHBG and the gut microbiome. Summary statistics of genome‐wide association studies (GWASs) for the gut microbiome and SHBG were obtained from public datasets. Inverse‐variance weighting (IVW), weighted median, weighted mode, MR‐Egger and simple mode methods were used to operate the MR analysis. F‐statistics and sensitivity analyses performed to evaluate bias and reliability. Results: When we set gut microbiome as exposure and SHBG as outcome, we identified nine causal relationships. In males, Coprobacter (PIVW = 2.01 × 10−6), Ruminococcus2 (PIVW = 3.40 × 10−5), Barnesiella (PIVW = 2.79 × 10−2), Actinobacteria (PIVW = 3.25 × 10−2) and Eubacterium fissicatena groups (PIVW = 3.64 × 10−2) were associated with lower SHBG levels; Alphaproteobacteria (PIVW = 1.61 × 10−2) is associated with higher SHBG levels. In females, Lachnoclostridium (PIVW = 9.75 × 10−3) and Defluviitaleaceae UCG011 (PIVW = 3.67 × 10−2) were associated with higher SHBG levels; Victivallaceae (PIVW = 2.23 × 10−2) was associated with lower SHBG levels. According to the results of reverse MR analysis, three significant causal effect of SHBG was found on gut microbiota. In males, Dorea (PIVW = 4.17 × 10−2) and Clostridiales (PIVW = 4.36 × 10−2) were associated with higher SHBG levels. In females, Lachnoclostridium (PIVW = 7.44 × 10−4) was associated with higherr SHBG levels. No signifcant heterogeneity of instrumental variables or horizontal pleiotropy was found in bidirectional two‐sample MR analysis. Conclusions: This study may provide new insights into the causal relationship between the gut microbiome and sex hormone‐binding protein levels, as well as new treatment and prevention strategies for diseases such as abnormal changes in sex hormones. [ABSTRACT FROM AUTHOR]

Summary: To compare the clinical efficacy of porcine anti‐lymphocyte globulin (p‐ALG) and rabbit anti‐thymocyte globulin (r‐ATG) in the treatment of haematological malignancies using haploidentical haematopoietic stem cell transplantation (haplo‐HSCT), this study was conducted. The incidences of neutrophil and platelet engraftment, respectively, were 100%, 93.6% and 94.4%; 100%, 93.6% and 90.3% in p‐ALG 75 mg/kg (n = 57), p‐ALG 90 mg/kg (n = 49), and r‐ATG 7.5 mg/kg (n = 72). The median time to neutrophil engraftment and platelet engraftment were 11, 12 and 12 days (p = 0.032); 13, 14 and 13 days (p = 0.013), respectively. The incidence of grades II–IV acute graft‐versus‐host disease and cumulative incidence of chronic graft‐versus‐host disease were 16.7% versus 12.5% versus 13.3% (p = 0.817) and 14.7% versus 12.1% versus 19.5% in p‐ALG 75 mg/kg, p‐ALG 90 mg/kg and r‐ATG groups. Notably, the cytomegalovirus infection rate in the p‐ALG 75 mg/kg group was significantly lower than the other two groups. The cumulative incidence of 2‐year relapse and 2‐year overall survival rates were similar (p = 0.901, p = 0.497). The lower dose of p‐ALG (75 mg/kg) had a similar efficacy and safety profile compared with r‐ATG (7.5 mg/kg) in the setting of haplo‐HSCT. Therefore, p‐ALG (75 mg/kg) may be an appropriate alternative to r‐ATG in the conditioning regimen of haplo‐HSCT. [ABSTRACT FROM AUTHOR]

Background: Data on the factors affecting blood ionized calcium concentration (ciCa2+) and diagnostic performance of serum total calcium concentration (ctCa) measurements to detect abnormal blood iCa2+ status are lacking in sick adult cattle. Objective: Assess the association of ciCa2+ with venous blood pH, plasma concentrations of chloride (cCl), sodium (cNa), and potassium (cK), and ctCa, and total protein, albumin, and globulin concentrations in sick adult cattle. Animals: Two‐hundred and sixty‐five adult cattle (≥1‐year‐old) with different diseases. Methods: Prospective study. Whole blood pH, ciCa2+, cNa, cK, and cCl were measured using a blood gas and electrolyte analyzer, whereas ctCa, and total protein, and albumin concentrations were determined using an autoanalyzer. The relationship between ciCa2+ and venous blood pH, plasma cCl, cNa, cK, and ctCa, and total protein, albumin, and globulin concentrations was investigated. Sensitivity and specificity were calculated for ctCa for diagnosis of abnormal ciCa2+. Results: Sensitivity of ctCa measurements to detect abnormal ciCa2+ was 66.0% whereas specificity of ctCa measurements was 72.3%. Serum total calcium concentration measurements accounted for 42% of adjusted blood ionized calcium (iCa2+7.40) concentration variance. Plasma cCl, and cK had explanatory power of ciCa2+7.40, accounting for an additional 21% and 9% of the variance, respectively. Conclusions and Clinical Importance: Serum tCa measurements failed to accurately predict blood iCa2+ status in ill adult cattle. Serum tCa concentrations and plasma cCl were the strongest predictors of ciCa2+ in sick adult cattle. [ABSTRACT FROM AUTHOR]

Nonspecific hypergammaglobulinemia (HGG) occurs in symptomatic human visceral leishmaniasis (VL) caused by L. L. infantum. This study assessed this finding in experimental infection in hamsters and natural infection in dogs. The serum concentration of proteins, albumin and globulins was determined through the biuret and bromocresol green reaction, where the HGG was better expressed through the albumin/globulin (A/G) ratio. HGG was associated with a higher concentration of specific anti‐glycan antibodies (BSA‐G)/promastigote soluble extract (PSE) and the presence of circulating immune complexes (IC) by dissociative enzyme‐linked immunoassay (ELISA). The study found monovalent IC in 37.9% (PSE) and 50% (BSA‐G) of sera from infected hamsters, with increased frequency as the disease progressed. HGG was found in >60% of the samples in dogs with VL, associated with higher levels of specific immunoglobulin (Ig)A and IgM, but not IgG, determined using the PSE and BSA‐G ELISA. HGG was associated with the presence of monovalent IC in 58.9% (PSE) and 63.4% (BSA‐G) positive dog samples. HGG may result not only from the nonspecific activation of B cells, with greater production of specific and nonspecific antibodies, but also due to lower IgG excretion due to the presence of soluble monovalent IC. HGG correlates to the progression of VL and may be a marker for manifested disease. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare two immunosuppressive strategies, based on the use of either rabbit antithymocyte globulin (ATG) or posttransplant cyclophosphamide (PTCY), as a prophylaxis of graft‐versus‐host disease (GVHD) for patients with acute lymphoblastic leukemia (ALL) in first complete remission who underwent hematopoietic cells transplantation from matched unrelated donors. Methods: Overall, 117 and 779 adult patients who received PTCY and ATG, respectively, between the years 2015 and 2020 were included in this retrospective study. The median patient age was 40 and 43 years in the PTCY and ATG groups, respectively, and 37% and 35% of patients, respectively, had Philadelphia chromosome‐positive ALL. Results: In univariate analysis, the cumulative incidence of acute and chronic GVHD did not differ significantly between the study groups. The cumulative incidence of relapse at 2 years was reduced in the PTCY group (18% vs. 25%; p =.046) without a significant impact on nonrelapse mortality (11% vs. 16% in the ATG group; p =.29). The rates of leukemia‐free survival (LFS) and overall survival were 71% versus 59%, respectively (p =.01), and 82% versus 74%, respectively (p =.08). In multivariate analysis, the receipt of ATG compared with PTCY was associated with a reduced risk of extensive chronic GVHD (hazard ratio, 0.54; 95% confidence interval, 0.3–0.98; p =.04) and an increased risk of low LFS (hazard ratio, 1.57; 95% confidence interval, 1.01–2.45; p =.045). Conclusions: The receipt of ATG compared with PTCY, despite the reduced risk of extensive chronic GVHD, is associated with inferior LFS in adults with ALL who undergo hematopoietic cell transplantation from 10/10 human leukocyte antigen‐matched unrelated donors. These findings warrant verification in prospective trials. In this registry‐based study, the authors demonstrate that, for adult patients with acute lymphoblastic leukemia who undergo hematopoietic cell transplantation from 10/10 human leukocyte antigen‐matched unrelated donors, immunosuppression based on posttransplant use of cyclophosphamide is associated with improved leukemia‐free survival compared with protocols that include antithymocyte globulin. These findings suggest preferential use of posttransplant cyclophosphamide in this setting. [ABSTRACT FROM AUTHOR]

Objectives: Immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporin A is the standard treatment for aplastic anemia (AA). However, the efficacy of repeated IST with rabbit ATG (rATG) as salvage therapy remains unclear in patients with relapsed or refractory AA. Methods: We retrospectively evaluated the efficacy and safety of IST2 with rATG (IST2-rATG) in 19 consecutive patients with relapsed or refractory AA who received first-line IST with rATG in two centers between 2009 and 2020. Results: The overall 6-month response rate of the patients was 58%. The response rates were similar between patients with relapsed and refractory AA. The presence of glycophosphatidylinositol-deficient blood cells was associated with a better response to IST2-rATG. Despite retreatment with the same rATG, serum disease and severe allergic reactions were not observed. Conclusion: IST2-rATG is effective and safe for the treatment of adult patients with relapsed and refractory AA after receiving first-line IST with rATG. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the causal relationship between sex hormone‐binding globulin (SHBG) and major depression using two‐sample Mendelian randomization (MR) studies. Methods: Based on the genome‐wide association study (GWAS) summary data of SHBG and major depression in the European population, which included 214,989 female SHBG samples, 185,221 male SHBG samples, and 500,199 major depression samples, we used genetic factors as instrumental variables to conduct two‐sample MR analyses. We used methods including inverse variance weighted (IVW), weighted median, weighted mode, and MR Egger to evaluate the bidirectional causal relationship between SHBG and major depression. Results: The results showed that there was a causal relationship between female SHBG and major depression, which was positively correlated. The ORs were 1.056 (95% CI: 1.005–1.109, p = 0.031) for the weighted median and 1.067 (95% CI: 1.012–1.126, p = 0.021) for the weighted mode. There was no significant effect of male SHBG on major depression (p > 0.05), and there was no significant effect of major depression on female SHBG (p > 0.05). Major depression was negatively correlated with male SHBG, indicating that major depression could lead to a decrease in male SHBG. The OR was 0.954 (95% CI: 0.916–0.993, p = 0.023) for IVW. Conclusion: Female SHBG was positively correlated with the risk of major depression, however, major depression was found to be negatively correlated with serum SHBG levels in men, indicating that SHBG plays distinct roles in patients with major depression of different genders. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This report describes a rare case of developing Guillain–Barre syndrome (GBS) following receiving rabbit antithymocyte globulin (ATG) after kidney transplantation to prevent acute allograft rejection in a 34‐year‐old man. The patient presented severe pain in the right temporomandibular joint, fever, chills, myalgia, polyarthralgia, and bone pain. Twelve hours later, he developed quadriplegia, paresthesia, and a limited range of active motions in all extremities. No antecedent viral or bacterial infection was identified. The EMG/NCV evaluation displayed acute inflammatory sensory‐motor polyneuropathy. After the administration of GBS treatment, the neurologic symptoms started to improve. Over a few days, the reflexes came back completely, and the patient was able to walk. To our knowledge, this is the second case report of ATG‐related GBS after kidney transplantation. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine whether maternal serum haptoglobin values could have an effect on predicting diagnosis and neonatal outcomes in preeclampsia and HELLP syndrome. Materials and Methods: Hundred sixteen pregnant women who met the inclusion criteria were included in the study. To evaluate whether serum haptoglobin level in maternal blood could be used in early diagnosis of preeclampsia and HELLP syndrome, 49 pregnant women diagnosed with preeclampsia and 13 pregnant women diagnosed with HELLP syndrome were included in the study group, and 54 healthy pregnant women in the control group. The groups were compared regarding maternal serum haptoglobin level, platelet count, ALT, AST, LDH, and uric acid levels. Moreover, the age, obstetric histories, and newborn outcomes of all pregnant women were recorded and compared between groups. Results: The mean haptoglobin values were 0.29 ± 0.23 g/L in the HELLP syndrome group, 1.01 ± 0.52 g/L in the preeclampsia group, and 1.16 ± 0.37 g/L in the control group. The mean haptoglobin result was lower in the HELLP syndrome group compared to the preeclampsia and control groups (p < 0.001). While the differences between HELLP syndrome and the control and preeclampsia groups were statistically significant, no significant difference was determined between the preeclampsia and control groups. There was a significant positive correlation between haptoglobin value with the week of delivery, umbilical cord pH value, and the first and fifth‐minute Apgar scores (p < 0.05). Conclusion: It was concluded that haptoglobin values could be used together with other biochemical parameters to diagnose HELLP syndrome and predict newborn outcomes. [ABSTRACT FROM AUTHOR]

Objective: A better knowledge of the hormonal etiology of prostate cancer is essential for its prevention and treatment. The goal of this study was to provide causal estimates of the connection between sex hormone‐binding globulin and prostate cancer and investigate the possible mediating function of other modifiable risk indicators. Methods: We used two‐step, two‐sample multivariable Mendelian randomization using single‐nucleotide polymorphisms as instrumental variables for exposure and mediators. Single‐nucleotide polymorphisms associated with sex hormone‐binding globulin and bioavailable testosterone were screened via a genome‐wide association study enrolling European‐descent adult male individuals. Summary‐level data for prostate cancer (79,148 cases and 61,106 controls) were extracted from the PRACTICAL consortium. The total effect of sex hormone‐binding globulin on prostate cancer risk was decomposed into direct and indirect effects through the mediator, bioavailable testosterone. An inverse‐variance‐weighted method was the primary Mendelian randomization analysis method. Sensitivity analyses were performed via Mendelian randomization–Egger regression, heterogeneity test, pleiotropy test, and leave‐one‐out test. The directionality that exposure causes the outcome was verified using Mendelian randomization–Steiger test. Results: In the univariable Mendelian randomization analysis, genetically predicted higher sex hormone‐binding globulin levels had a causal association with lower prostate cancer risk (odds ratio = 0.944, 95% confidence interval = 0.897–0.993, p = 0.027) and an inverse association with bioavailable testosterone level (odds ratio = 0.945, 95% confidence interval = 0.926–0.965, p = 1.62E‐07) without controlling for other factors. Moreover, an increase of one standard deviation (59.5 pmol/L) in genetically predicted bioavailable testosterone level was significantly associated with a 22.0% increase in the overall prostate cancer risk (odds ratio = 1.220, 95% confidence interval = 1.064–1.398, p = 0.004) after adjusting for sex hormone‐binding globulin level. The effect size ratio of bioavailable testosterone‐mediated sex hormone‐binding globulin to prostate cancer was further analyzed to clarify the importance of the mediating effect. Notably, the mediator bioavailable testosterone explained 19.28% (95% confidence interval = 10.76%, 73.78%) of the total effect of sex hormone‐binding globulin level on prostate cancer risk. Conclusion: The results support the potentially protective causal effect of genetically predicted higher sex hormone‐binding globulin levels against prostate cancer with mediation by the modifiable risk factor, bioavailable testosterone. More research is needed to determine how this possible sex hormone‐binding globulin–bioavailable testosterone–prostate cancer link works. Targeting sex hormone‐binding globulin and bioavailable testosterone traits may be a valuable strategy for preventing prostate cancer. [ABSTRACT FROM AUTHOR]

Background: Electrophoresis can be used to aid in the diagnosis of different diseases in avian species. Capillary zone electrophoresis (CZE) is an automated method that is proposed to be superior to the dye methods used in agarose gel electrophoresis (AGE). However, reference intervals (RIs) for CZE in avian species and comparison studies between electrophoretic methods are lacking. Objectives: The goals of the current study were to compare AGE and CZE methods and determine reference intervals for CZE using plasma from bald eagles (Haliaeetus leucocephalus). Methods: Heparinized plasma samples from 44 bald eagles (mean age 18.7 years) under managed care were examined by AGE and CZE. Method comparison analyses were completed, as well as the generation of preliminary RIs using the CZE method and ASVCP guidelines. Results: Passing‐Bablok regression and Bland–Altman plots demonstrate that these methods are not equivalent. All fractions were significantly correlated between the methods except for alpha 1 globulin. Inter‐assay and intra‐assay CVs for CZE were lower or comparable to AGE and ranged from 2.4% to 15.4%, and 0.8% to 8.3%, respectively. CZE resolved more fractions than AGE with two fractions observed in the beta and gamma region vs one for AGE in each region. Conclusions: CZE provided improved resolution and reproducibility for the quantitation of protein fractions in the bald eagle. Although most fraction results correlated with AGE, these methods were judged as not equivalent, necessitating method‐specific Rls. Reference intervals generated from a limited number of mostly aged individuals under managed care should be considered preliminary; additional studies will aid in the production of more robust intervals. [ABSTRACT FROM AUTHOR]

Summary: The angiotensin I converting enzyme (ACE, antihypertensive effect) and dipeptidyl peptidase IV (DPP IV, antidiabetic effect) inhibitory potential of peptides derived from the quinoa globulin hydrolysis with thermolysin were evaluated by in silico and in vitro analysis. The in silico hydrolysis of the globulin fractions resulted in peptides (~400 sequences) of different sizes and sequence conformations, of which 25 presented a high bioactivity probability score (>0.8). When the 25 sequences were evaluated for their stability against in silico simulated gastrointestinal digestion, four sequences resulted, PR, SPH, IPPG and SG all of them with a high bioactivity profile against ACE and DPP IV inhibition, where SPH and IPPG turned out to be new sequences not reported before. The molecular docking study found a high affinity between IPPG‐ACE and IPPG‐DPP IV and SPH‐DPP IV, with several interaction points with the active sites of the enzymes evaluated. The IC50 values for ACE and DPP IV found by the in vitro hydrolysis with thermolysin in a protein concentrate and in quinoa globulin support the findings of the in silico approach. Therefore, we conclude that the globulin fraction of quinoa hydrolyzed with thermolysin represents a potential source of antihypertensive and antidiabetic peptides. [ABSTRACT FROM AUTHOR]

Background: Tacrolimus (TAC)‐mediated renal disease occurs in up to 70% of pediatric liver transplant (LT) recipients. The safety and efficacy of renal‐sparing immunosuppression using anti‐thymocyte globulin (ATG) induction and delayed TAC administration has not been studied in children. We evaluated the safety and efficacy of ATG induction on preserving renal function in children within the first year (Y1) post‐LT in a single‐center retrospective cohort study. Methods: Children under age 18 years of who received isolated LT from 2008 to 2020 with a GFR < 70 received renal‐sparing (RS) protocol consisting of ATG with methylprednisolone (MP), delayed TAC administration, lower initial TAC trough goals, and mycophenolate mofetil (MMF). The RS group was matched 1:2 by age and LT indication with standard immunosuppression (SI) group. Changes in renal function as well as adverse events within Y1 post‐LT were compared. Results: Forty‐four pediatric patients were included in the analysis, of which 13 received RS. As expected, the RS group had significantly lower mean TAC trough levels at 30 days (10.3 vs. 13.2, p =.001) post‐LT. Renal function was significantly preserved at 6 (−0.26 vs. 0.21, p =.004) and 12 months (−0.33 vs. 0.11, p =.003) post‐LT in the RS versus SI group as measured by mean change in serum creatinine, with similar trends observed in eGFR and cystatin C. ACR, sepsis, viremia, graft loss and mortality occurred at similar rates in both RS and SI groups. Conclusion: Induction immunosuppression with ATG and delayed TAC administration in children with renal impairment is safe and effectively preserves renal function during Y1 post‐LT. [ABSTRACT FROM AUTHOR]

Background: Serum albumin to globulin ratio (A/G) has been widely used as a representative biomarker for assessing inflammation and nutrition status. However, in patients with acute ischemic stroke (AIS), the predictive value of serum A/G has rarely been reported. We aimed to evaluate whether serum A/G is associated with prognosis in stroke. Methods: We analyzed data from the Third China National Stroke Registry. The patients were categorized into quartile groups according to the serum A/G at admission. Clinical outcomes included poor functional outcomes (modified Rankin Scale [mRS] score of 3–6 or 2–6) and all‐cause mortality at 3 months and1 year. Multivariable logistic regressions and Cox proportional hazards regressions were used to evaluate the association of serum A/G with the risk of poor functional outcomes and all‐cause mortality. Results: A total of 11, 298 patients were included in this study. After adjustment for confounding factors, patients in the highest serum A/G quartile had a lower proportion of mRS score 2–6 (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.76–1.00) and mRS score 3–6 (OR, 0.87; 95% CI, 0.73–1.03) at 3 months follow‐up. At 1 year follow‐up, there was a significant association between higher serum A/G and mRS score 3–6 (OR, 0.68; 95% CI, 0.57–0.81). We also found that the highest serum A/G was related to decreased risk of all‐cause mortality (hazard ratio [HR], 0.58; 95% CI, 0.36–0.94) at 3 months follow‐up. Similar results were found at 1‐year follow‐up. Conclusions: Lower serum A/G levels were associated with poor functional outcomes and all‐cause mortality at 3 months and 1‐year follow‐up in patients with acute ischemic stroke. [ABSTRACT FROM AUTHOR]

This study was performed to detect the expression of ceruloplasmin in the peripheral blood of patients with drug‐resistant epilepsy and explore the mechanisms of iron metabolism disorder in drug‐resistant epilepsy. Peripheral blood was collected from 32 patients with drug‐resistant epilepsy, labeled the drug‐resistant group; 30 patients who were drug responsive, labeled the drug‐responsive group; and 34 healthy people, named the normal group.The expression levels of ceruloplasmin mRNA and ceruloplasmin protein in the peripheral blood of the 3 groups were detected using real‐time fluorescence‐based quantitative polymerase chain reaction and Western blot. The differences in the expression of ceruloplasmin mRNA of different seizure frequencies and types, electroencephalogram abnormal discharges, and different medication methods were analyzed and compared. The relative expression of ceruloplasmin mRNA and ceruloplasmin protein in the drug‐resistant epilepsy group was significantly higher than that in the drug‐responsive group (P =.002 and.010, respectively) and higher in the drug‐responsive group compared with the normal group (P =.014 and.005, respectively). The relative expression of ceruloplasmin mRNA in patients with epilepsy using different medication methods was statistically significant (P =.001). Patients who received a combination of 2 or 3 drugs exhibited a higher expression than those treated with single‐drug treatment, whereas those who received a combination of 3 drugs had a higher expression than those with 2 drugs (P =.013,.001, and.011, respectively). There was no significant difference in the relative expression of Cp mRNA in patients with epilepsy with different seizure frequencies and types and abnormal electroencephalogram discharges (all P >.05). The increased expression of ceruloplasmin in the peripheral blood of patients with drug‐resistant epilepsy was closely related to the different medication methods, but no obvious correlation with epileptic seizure frequencies or types and abnormal electroencephalogram discharges was identified. The increased expression of ceruloplasmin enhanced iron oxidative damage and may be the potential mechanism of drug‐resistant epilepsy and may be one of the drug resistance indicators for combination drugs when treating drug‐resistant epilepsy. [ABSTRACT FROM AUTHOR]

Objective: To analyze the proteomic profile of salivary pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA) samples and correlate them with the malignant transformation of the PA. Materials and methods: Thirty samples (10 PA, 16 CXPA, and 4 residual PA) were microdissected and submitted to liquid chromatography‐tandem mass spectrometry (LC‐MS/MS). The proteomic data and protein identification were analyzed through LC‐MS/MS spectra using the MaxQuant software. Results: The proteomic analysis identified and quantified a total of 240 proteins in which 135 were found in PA, residual PA, and CXPA. The shared proteins were divided into six subgroups, and the proteins that showed statistically significant differences (p > 0.05) and fold‐change > or <2.5 in one subgroup to another subgroup were included. Seven proteins (Apolipoprotein A‐I—APOA1, haptoglobin—HP, protein of the synaptonemal complex 1—SYCP1, anion transport protein of band 3—SLC4A1, subunit μ1 of AP‐1 complex—AP1M1, beta subunit of hemoglobin—HBB, and dermcidin—DCD) were classified as potential protein signatures, being HP, AP1M1, and HBB with higher abundance for PA to residual PA, APOA1 with higher abundance for PA to CXPA, SLC4A1 with lower abundance in the PA to CXPA, SYCP1with lower abundance for residual PA to CXPA, and DCD with higher abundance in the CXPA with epithelial differentiation to myoepithelial differentiation. Conclusions: In this work, we demonstrated the comparative proteomic profiling of PA, residual PA, and CXPA, and seven were proposed as protein signatures, some of which may be associated with the malignant phenotype acquisition. [ABSTRACT FROM AUTHOR]

Background: High‐pressure homogenization (HPH) is commonly used as a non‐thermal processing technique for soybean and soy protein products, and the preparation of soy protein gel products often requires the synergistic effect of HPH and heat treatment. The dissociative association behavior of 11 S is the key to the protein gel formation state. In this study, therefore, 11 S thermal gels were prepared by high‐pressure homogenization and co‐induction (90 °C, 30 min) (adding Ca2+ to promote gel formation before heat treatment), and the effects of different high‐pressure homogenization pressures (0–100 MPa) and co‐treatment on the dissociative association behavior of 11 S protein, gel properties, and microstructure of 11 S gels were investigated. Results: The results showed that HPH at higher pressures led to the breaking of disulfide bonds of aggregates and disrupted non‐covalent interactions in protein aggregates, leading to collisions between protein aggregates and the reduction of large protein aggregates. High‐pressure homogenization treatment at 60 MPa improved the gel properties of 11 S more. The HPH combined with heating changed the binary and tertiary structure of 11 S soy globulin and enhanced the hydrophobic interaction between 11 S molecules, thus improving the gel properties of 11 S. The change in intermolecular forces reflected the positive effect of HPH treatment on the formation of denser and more homogeneous protein gels. Conclusion: In conclusion, high‐pressure homogenization combined with heating can improve the properties of 11 S gels by changing the structure of 11 S protein, providing data and theoretical support for soy protein processing and its further applications. © 2022 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Summary: In a prospective, explorative study, the donor‐source difference of haploidentical family (HF), matched sibling (MS), and unrelated donors (UD) was evaluated for the outcome of haematopoietic cell transplantations (HCT) in 101 patients with acute myeloid leukaemia (AML) in complete remission (CR). To eliminate compounding effects, a uniform conditioning regimen containing antithymocyte globulin (ATG) was used. After transplantation, there was a significantly higher cumulative incidence of acute graft‐versus‐host disease (GVHD) in HF‐HCT patients (49%, 7%, and 16% for HF‐, MS‐ and UD‐HCT respectively; p < 0.001). A quarter of acute GVHD cases observed in HF‐HCT patients occurred within three days of engraftment and were characterized by diffuse skin rash, fever, weight gain, and hypoalbuminaemia. This peri‐engraftment acute GVHD was not observed in MS‐HCT or UD‐HCT patients. Additionally, a significantly higher proportion of HF‐HCT patients achieved complete donor chimaerism in the peripheral mononuclear cells at one month (88%, 46%, and 69% for HF‐, MS‐ and UD‐HCT respectively; p = 0.001). There was no significant difference in engraftment, chronic GVHD, leukaemia recurrence, non‐relapse mortality, and patient survival. In patients with AML in CR who received HCT using ATG‐containing conditioning, stronger donor–patient alloreactivity was observed in HF‐HCT, in terms of increased acute GVHD and higher likelihood of complete donor chimaerism. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to analyze the relationship between serum globulin levels and immune restoration and HIV reservoir size during long‐term antiretroviral therapy (ART). Methods: We enrolled 13 patients living with HIV who had been receiving ART for 5 years. We measured levels of serum globulin, cell‐associated (CA) HIV DNA and RNA, and p24 antibody at 0, 1, 3, and 5 years of ART. CD38 and human leukocyte antigen – DR isotype (HLA‐DR) were used as activation markers for T‐cell activation. Serum concentrations of the inflammatory cytokines interferon gamma‐inducible protein (IP)‐10 and soluble CD163 (sCD163) were detected by enzyme‐linked immunosorbent assay. We analyzed the relationship between serum globulin levels, HIV reservoir size, immune restoration, T‐cell immune activation, and inflammatory levels during long‐term ART. Results: Our data showed that serum globulin levels in people living with HIV were higher than in healthy controls and significantly decreased during the first year of ART. Serum globulin levels during long‐term ART were positively correlated with CA HIV DNA, CA HIV RNA, p24 antibody levels, and CD8+ T‐cell counts and negatively correlated with CD4+ T‐cell counts and CD4/CD8 ratios. Moreover, serum globulin levels were positively correlated with CD4+ and CD8+ T‐cell activation and the concentrations of inflammatory biomarkers IP‐10 and sCD163 during long‐term ART. Conclusions: Our findings suggest that serum globulin levels may be associated with HIV reservoir size and immune restoration during long‐term ART. [ABSTRACT FROM AUTHOR]

Background: Longitudinal patterns of immune globulins (IG) use have not been described in large populations. Understanding IG usage is important given potential supply limitations impacting individuals for whom IG is the sole life‐saving/health‐preserving therapy. The study describes US IG utilization patterns from 2009 to 2019. Study Design and Methods: Using IBM MarketScan commercial and Medicare claims data, we examined four metrics overall and by condition‐specific categories during 2009–2019: (1) IG administrations per 100,000 person‐years, (2) IG recipients per 100,000 enrollees, (3) average annual administrations per recipient, and (4) average annual dose per recipient. Results: In the commercial and Medicare populations respectively: IG administrations per 100,000 person‐years increased by 120% (213–470) and 144% (692–1693); IG recipients per 100,000 enrollees grew by 71% (24–42) and 102% (89–179); average annual administrations per recipient rose by 28% (8–10) and 19% (8–9); and average annual dose (grams) per recipient increased by 29% (384–497) and 34% (317–426). IG administrations associated with immunodeficiency (per 100,000 person‐years) increased by 154% (from 127 to 321) and 176% (from 365 to 1007). Autoimmune and neurologic conditions were associated with higher annual average administrations and dose than other conditions. Discussion: IG use increased, coinciding with a growth in the IG recipient population in the United States. Several conditions contributed to the trend, with the largest increase observed among immunodeficient individuals. Future investigations should assess changes in the demand for IVIG by disease state or indication and consider treatment effectiveness. [ABSTRACT FROM AUTHOR]

BACKGROUND: Soybean 11S globulin has good functional properties, which are widely used in the field of food. However, natural soybean 11S globulin (N-11S) has low flexibility and is easy to aggregate, impacting its foaming process. Studies have shown that soybean 11S globulin in molten globule state (MG-11S) has better molecular flexibility than N-11S, and trehalose has been shown to improve the properties of proteins. Therefore, this study investigated the interaction mechanism between trehalose and MG-11S, and its impact on rheological and foaming properties of MG-11S. RESULTS: The molecular docking and intrinsic fluorescence results showed that hydrogen bonding was the main interaction force at lower than 0.5 mol L-1 trehalose added. Meanwhile, rheology and foaming showed that the MG-11S-trehalose complexes had better viscoelasticity, foaming ability (66.67-86.67%) and foaming stability (75.00-89.29%) than N-11S (16.67% foaming ability and 40.00% foaming stability); however, when the trehalose was higher than 0.5 mol L-1, molecular crowding occurred and H-bonds were weakened, resulting in reduction of foaming capacities. Microstructure determination showed that trehalose attached to the surface of foam membrane; meanwhile, the foaming structure of the complex with 0.5 mol L-1 trehalose had a thicker liquid film with decreased drainage rate, less agglomeration and disproportionation of foam, illustrating the best foaming ability and foaming stability. CONCLUSION: The results suggested that trehalose at different concentrations can interact with MG-11S through different mechanisms, and improve the foaming capacity of MS-11S. This provided a reference for the application of MS-11S in foaming food. [ABSTRACT FROM AUTHOR]

Unicompartmental knee arthroplasty (UKA) has been proven as an ideal alternative surgical procedure to treat symptomatic isolated knee osteoarthritis, and recently this technique has gained its popularity. However, postoperative complications would inevitably compromise the effectiveness and patients' satisfaction. The objective of this study is to demonstrate the incidence and risk factors of delayed wound healing (DWH) after UKA. This retrospective cohort study was conducted from February 2021 to May 2022 and a total of 211 patients were enrolled. Demographic characteristics, operation‐related variables, and laboratory indexes were extracted. Receiver operating characteristic analysis was performed to detect the optimum cut‐off value for continuous variables. Univariate and multivariate logistic regression analysis was performed to demonstrate the risk factors of DWH. There were 155 female and 56 male patients with an average age of 64. 6 ± 6.9 years included in this study. After 6.6 ± 4.9 months' follow‐up, 12 cases of DWH were observed which indicated an incidence of DWH of 5.7%, mean wound healing duration for 12 patients was 43.1 ± 19.3 days. In the univariate analysis, age > 62.5 years, postoperative hospital stay < 5.5 days, surgical incision < 10.5 cm, barbed suture, body mass index (BMI) > 32.0 kg/m2, operation duration > 102.5 minutes, intraoperative blood loss > 102.5 mL, preoperative white blood cell count > 5.95*109/L, preoperative seroglobulin (GLB) > 29.6 g/L, postoperative total protein < 63.4 g/L, postoperative serum albumin < 36.4 g/L, and postoperative GLB > 26.8 g/L were significantly different between patients with and without DWH (P <.05). In final multivariate logistic analysis, results showed that intraoperative blood loss > 102.5 mL (odds ratio [OR], 3.09; P =.001), postoperative hospital stay < 5.5 days (OR, 1.74; P =.014), surgical incision < 10.5 cm (OR, 1.67; P =.000), and BMI > 32.0 kg/m2 (OR, 4.47; P =.022) were independent risk factors for DWH. DWH prolongs hospital stay in UKA patients and increases healthcare expenditure; also affected the implementation schedule of postoperative functional exercise plans. Surgeons should identify patients at risk, meanwhile, make timely and correct clinical interventions to decrease the incidence of this complication. [ABSTRACT FROM AUTHOR]

Aims: We studied whether androgen excess and low sex hormone‐binding globulin (SHBG) measured in early pregnancy are independently associated with fasting and post‐prandial hyperglycaemia, gestational diabetes (GDM), and its severity. Materials and Methods: This nationwide case–control study included 1045 women with GDM and 963 non‐diabetic pregnant controls. We measured testosterone (T) and SHBG from biobanked serum samples (mean 10.7 gestational weeks) and calculated the free androgen index (FAI). We first studied their associations with GDM and secondly with the type of hyperglycaemia (fasting, 1 and 2 h glucose concentrations during the oral glucose tolerance test), early‐onset GDM (<20 gestational weeks) and the need for anti‐diabetic medication. Results: After adjustments for gestational weeks at sampling, pre‐pregnancy BMI, and age, women with GDM had 3.7% (95% CI 0.1%–7.3%) lower SHBG levels, 3.1% (95% CI 0.1%–6.2%) higher T levels, and 4.6% (95% CI 1.9%–7.3%) higher FAI levels than controls. SHBG was inversely associated with fasting glucose, whereas higher FAI and T were associated with higher post‐prandial glucose concentrations. Women with early‐onset GDM had 6.7% (95% CI 0.7%–12.7%) lower SHBG levels and women who needed insulin for fasting hyperglycaemia 8.7% (95% CI 1.8%–14.8%) lower SHBG levels than other women with GDM. Conclusions: Lower SHBG levels were associated especially with early‐onset GDM, higher fasting glucose and insulin treatment, whereas androgen excess was associated with higher post‐prandial glucose values. Thus, a low SHBG level may reflect the degree of existing insulin resistance, while androgen excess might impair post‐prandial insulin secretion. [ABSTRACT FROM AUTHOR]

Chickpea is a crop that is known as a source of high‐quality proteins. CL‐AI, which belongs to the 11S globulin and cupin superfamily, was initially identified in chickpea seeds. CL‐AI has recently been shown to inhibit various types of α‐amylases. To determine its molecular mechanism, the crystal structure of CL‐AI was solved at a final resolution of 2.2 Å. Structural analysis indicated that each asymmetric unit contains three molecules with threefold symmetry and a head‐to‐tail association, and each molecule is divided into an α‐chain and a β‐chain. CL‐AI has high structural similarity to other 11S globulins and canonical metal‐dependent enzyme‐related cupin proteins, whereas its stimilarity to α‐amylase inhibitor from Phaseolus vulgaris is quite low. The structure presented here will provide insight into the function of CL‐AI. [ABSTRACT FROM AUTHOR]

The high colloidal stability of antibody (immunoglobulin) solutions is important for pharmaceutical applications. Inert cosolutes, excipients, are generally used in therapeutic protein formulations to minimize physical instabilities, such as liquid–liquid phase separation (LLPS), aggregation and precipitation, which are often encountered during manufacturing and storage. Despite their widespread use, a detailed understanding of how excipients modulate the specific protein‐protein interactions responsible for these instabilities is still lacking. In this work, we demonstrate the high sensitivity to pressure of globulin condensates as a suitable means to suppress LLPS and subsequent aggregation of concentrated antibody solutions. The addition of excipients has only a minor effect. The high pressure sensitivity observed is due to the fact that these flexible Y‐shaped molecules create a considerable amount of void volume in the condensed phase, leading to an overall decrease in the volume of the system upon dissociation of the droplet phase by pressure already at a few tens of to hundred bar. Moreover, we show that immunoglobulin molecules themselves are highly resistant to unfolding under pressure, and can even sustain pressures up to about 6 kbar without conformational changes. This implies that immunoglobulins are resistant to the pressure treatment of foods, such as milk, in high‐pressure food‐processing technologies, thereby preserving their immunological activity. [ABSTRACT FROM AUTHOR]

Summary: Defatted lentil seed flour proteins were separated into their constituent albumin (ALB), globulin (GLB) and glutelin (GLT) fractions followed by determination of their structural and functional properties. The GLB fraction demonstrated superior solubility (84%–100%) at acidic and alkaline pH values when compared to the lower values for ALB and GLT. Amino acid composition analysis showed lower contents of hydrophobic and sulphur‐containing residues for GLB. However, GLB had the highest in vitro protein digestibility, which may be due to lower contents of rigid secondary structure fractions like the β‐sheet and β‐turns. In contrast, water and oil holding capacities as well as gelling ability were better for GLT and ALB than GLB. The GLT fraction formed very poor emulsions at pH 3 and 5 but emulsification was significantly (p < 0.05) improved (smaller oil droplets) at pH 7 and 9. Foaming capacity was strongest for GLB, especially at pH 5, 7 and 9 where increase in protein concentration had a negative effect on foam formation. Overall, the protein type and pH of the environment had stronger effects on emulsion and foaming properties than the protein concentration. [ABSTRACT FROM AUTHOR]

While there was no difference in the incidence of severe Stage 3-4 skin aGVHD between patients with haGVHD versus others (46% vs. 30%, I p i = 0.2), severe Stage 3-4 liver and gastrointestinal aGVHD were more frequent in patients with haGVHD (38% vs. 18%, I p i = 0.015; and 15% vs. 4%, I p i = 0.0002 respectively). (C) Cumulative incidence of severe National Institutes of Health (NIH) Stage 2-3 chronic GVHD gl Overall, we found a low incidence of haGVHD in our cohort, only 10.4% of patients with Grade II-IV aGVHD leading to a day 14 cumulative incidence of 2.7%. OS was comparable between patients with Grade II-IV haGVHD (53.9%, 95% CI 24.8%-76.0%) and patients with Grade II-IV aGVHD after day 14 (45.7%, 95% CI 35.4%-55.4%, I p i = 0.23) (Figure 1A). [Extracted from the article]

Background: Streptococcus pneumoniae is the major cause of life‐threatening infections. Toll‐like receptors (TLRs) and NOD‐like receptors (NLRs) could recognise S. pneumoniae and regulate the production of pro‐inflammatory cytokines. UGRP1, highly expressed in lung, is predominantly secreted in airways. However, the function of UGRP1 in pneumonia is mainly unknown. Methods and results: We showed that upon TLR2/TLR4/NOD2 agonists stimulation or S. pneumoniae infection, treatment with UGRP1 could promote phosphorylation of p65 and enhance IL‐6, IL‐1β and TNFα production in macrophages. We further elucidated that after binding with cell‐surface receptor PDPN, UGRP1 could activate RhoA to enhance interaction of IKKγ and IKKβ, which slightly activated NF‐κB to improve expression of TLR2, MyD88, NOD2 and NLRP3. Deletion of UGRP1 or blocking UGRP1 interaction with PDPN protected mice against S. pneumoniae‐induced severe pneumococcal pneumonia, and activating RhoA with agonist in UGRP1‐deficient mice restored the reduced IL‐6 production. Conclusion: We demonstrated that UGRP1–PDPN–RhoA signaling could activate NF‐κB to promote expression of TLR2, MyD88, NOD2 and NLRP3, which enhanced inflammatory cytokines secretion during S. pneumoniae infection. Antibodies, which could interrupt interaction of UGRP1 and PDPN, are potential therapeutics against S. pneumoniae. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) remains a global public health threat. Hence, more effective and specific antivirals are urgently needed. Here, COVID-19 hyperimmune globulin (COVID-HIG), a passive immunotherapy, is prepared from the plasma of healthy donors vaccinated with BBIBP-CorV (Sinopharm COVID-19 vaccine). COVID-HIG shows high-affinity binding to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein, the receptor-binding domain (RBD), the N-terminal domain of the S protein, and the nucleocapsid protein; and blocks RBD binding to human angiotensin-converting enzyme 2 (hACE2). Pseudotyped and authentic virus-based assays show that COVID-HIG displays broad-spectrum neutralization effects on a wide variety of SARS-CoV-2 variants, including D614G, Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Kappa (B.1.617.1), Delta (B.1.617.2), and Omicron (B.1.1.529) in vitro. However, a significant reduction in the neutralization titer is detected against Beta, Delta, and Omicron variants. Additionally, assessments of the prophylactic and treatment efficacy of COVID-HIG in an Adv5-hACE2-transduced IFNAR-/- mouse model of SARS-CoV-2 infection show significantly reduced weight loss, lung viral loads, and lung pathological injury. Moreover, COVID-HIG exhibits neutralization potency similar to that of anti-SARS-CoV-2 hyperimmune globulin from pooled convalescent plasma. Overall, the results demonstrate the potential of COVID-HIG against SARS-CoV-2 infection and provide reference for subsequent clinical trials. [ABSTRACT FROM AUTHOR]

This study examines the effects of combined high pressure (0.1, 200, and 400 MPa) and temperature (25 and 50°C) on the solubility, aggregation, conformation, foaming, emulsifying capacity, and rheological properties of soy 11S globulin. The foaming stability, particle size, free sulfhydryl groups content, emulsifying activity, emulsifying stability, and shear stress of soy 11S globulin were decreased significantly (p ≤.05) compared with that of 0.1 MPa‐treated sample, but the solubility, surface hydrophobicity, foaming capacity, and apparent viscosity were increased significantly (p ≤.05), except the sample treated at 400 MPa and 50 ± 2°C. The solubility, surface hydrophobicity and free sulfhydryl groups content of soy 11S globulin decreased significantly (p ≤.05) with increasing pressure and temperature, which caused the decrease of the foaming capacity, emulsifying activity, emulsifying stability, shear stress, and apparent viscosity. Overall, the use of high‐pressure and thermal treatments combined could change the foaming, emulsifying, and rheological properties of soy 11S globulin through the increase/decrease of protein solubility, aggregation, surface hydrophobicity, and free sulfhydryl groups content. Practical applications: This study provides a method of high‐pressure and thermal treatments combined, which can change the solubility, foaming, and rheological properties soy 11S globulin, and its use should be expanded in food processing. [ABSTRACT FROM AUTHOR]

The human exposure to diverse endocrine‐disrupting chemicals (EDCs) has increased dramatically over several decades with very adverse health effects. Plasticizers and flame retardants constitute important classes of EDCs interfering in endocrine physiology including the thyroid function. Thyroxine (T4) is an important hormone regulating metabolism and playing key roles in developmental processes. In this study, six phthalate and nonphthalate plasticizers and one flame retardant (BDE‐153) were subjected to structural binding against thyroxine‐binding globulin (TBG). The aim was to understand their potential role in thyroid dysfunction using structural binding approach. The structural study was performed using Schrodinger's induced fit docking, followed by binding energy estimations of ligands and the molecular interaction analysis between the ligands and the amino acid residues in the TBG ligand‐binding pocket. The results indicated that all the compounds packed tightly into the TBG ligand‐binding pocket with similar binding pattern to that of TBG native ligand, T4. A high majority of TBG interacting amino acid residues for ligands showed commonality with native ligand, T4. The estimated binding energy values were highest for BDE‐153 followed by nonphthalate plasticizer, DINCH, with values comparable with native ligand, T4. The estimated binding energy values of other plasticizers DEHP, DEHT, DEHA, ATBC, and TOTM were less than DINCH. In conclusion, the tight docking conformations, amino acid interactions, and binding energy values of the most of the indicated ligands were comparable with TBG native ligand, T4, suggesting their potential for thyroid dysfunction. The results revealed highest potential thyroid disruptive action for BDE‐153 and DINCH. Plasticizers and flame retardants constitute important classes of EDCs interfering in endocrine physiology including the thyroid function. In this study, six phthalate and nonphthalate plasticizers and one flame retardant (BDE‐153) were subjected to structural binding against thyroxine‐binding globulin (TBG) using Schrodinger's induced fit docking, followed by binding energy estimations. The structural binding parameters such as amino acid interactions and binding energy values of most of the indicated ligands were comparable with TBG native ligand, T4, suggesting their potential for thyroid dysfunction. [ABSTRACT FROM AUTHOR]

The effects of high‐pressure‐modified soy 11S globulin (0.1, 200, and 400 MPa) on the gel properties, water‐holding capacity, and water mobility of pork batter were investigated. The high‐pressure‐modified soy 11S globulin significantly increased (P < 0.05) the emulsion stability, cooking yield, hardness, springiness, chewiness, resilience, cohesiveness, the a* and b* values, and the G′ and G′′ values of pork batter at 80 °C, compared with those of 0.1 MPa‐modified globulin. In contrast, the centrifugal loss and initial relaxation time of T2b, T21, and T22 significantly decreased (P < 0.05). Meanwhile, the microstructure was denser, and the voids were smaller and more uniform compared with those of 0.1 MPa‐modified globulin. In addition, the sample with 11S globulin modified at 400 MPa had the best water‐holding capacity, gel structure, and gel properties among the samples. Overall, the use of high‐pressure‐modified soy 11S globulin improved the gel properties and water‐holding capacity of pork batter, especially under 400 MPa. [ABSTRACT FROM AUTHOR]

Antithymocyte globulin (ATG) is a commonly used induction agent in kidney transplant recipients. However, the optimal dosing has not been well defined. Our protocol aims for a 5–6 mg/kg cumulative dose. It is unclear if a dose lower than 5 mg/kg is associated with more rejection. We performed a retrospective cohort study of patients who received a kidney transplant at our center between January 1, 2013 and December 31, 2016. Primary outcome was biopsy proven acute rejection (clinical and subclinical) in the first 6 months after kidney transplant. CMV viremia in high risk (D+/R−) recipients and BK viremia was compared as a secondary endpoint. Of the 543 patients, the Low Dose (LD) group (n = 56) received <5 mg/kg ATG and Regular Dose (RD) group (n = 487) received ≧5 mg/kg. Patients in RD were more sensitized (higher PRA and CPRA). LD received a dose of 4 ± 1.1 mg/kg ATG whereas RD received 5.6 ±.3 mg/kg ATG (P <.001). TCMR (Banff 1A or greater) was present in 34% of patients in LD versus 22% in RD (P =.04) (OR 2.1; 95%CI 1.12–3.81; P =.019). There was no difference in the incidence of CMV or BK viremia. ATG doses lower than 5 mg/kg may be associated with a heightened risk of rejection despite a low degree of sensitization. [ABSTRACT FROM AUTHOR]

Summary: Objective: Testosterone and sex hormone‐binding globulin (SHBG) concentrations are reported to decline during male ageing, but whether these changes reflect physiological ageing or age‐related comorbidities remains uncertain. We examined longitudinal changes in serum testosterone and SHBG concentrations in middle‐aged to older men, concordance between baseline and follow‐up values and relationships with concomitant changes in lifestyle and medical factors. Design: Population‐based longitudinal cohort study. Participants: Community‐dwelling men aged 40–69 years. Measurements: Immunoassay serum total testosterone (n = 7812) and SHBG (n = 6491) at baseline (2006–2010) and follow‐up (2012–2013). Free testosterone (cFT) was calculated. Bland–Altman analyses and concordance correlation of repeated measurements were conducted. Associations of changes in hormone concentrations with lifestyle and medical factors were explored using Spearman's rank correlation. Results: Over 4.3 years follow‐up, there was a negligible mean change (±SE) in serum total testosterone concentration (+0.06 ± 0.03 nmol/L), whereas mean SHBG concentration increased (+3.69 ± 0.12 nmol/L) and cFT decreased (−10.7 ± 0.7 pmol/L). Concordance estimates were 0.67 (95% confidence interval [CI]: 0.66–0.69) for total testosterone, 0.83 (CI = 0.82–0.84) for SHBG and 0.56 (CI = 0.54–0.58) for cFT. Changes in serum total testosterone correlated with changes in SHBG (Spearman's rank ρ = 0.33, CI = 0.30–0.35), and inversely with changes in body mass index (BMI) (ρ = −0.18, CI = −0.20 to −0.16) and waist circumference (ρ = −0.13, CI = −0.15 to −0.11) and in SHBG with changes in BMI (ρ = −0.34, CI = −0.36 to −0.32) and waist circumference (ρ = −0.21, CI = −0.24 to −0.19). Conclusion: In relatively healthy middle‐aged to older men, mean serum total testosterone concentration is stable with ageing, while mean SHBG concentration increases. Both total testosterone and SHBG concentrations were highly concordant over time. [ABSTRACT FROM AUTHOR]

In donor selection for allogeneic stem cell transplant, several factors are considered for potential impact on transplant outcome. Previous publications suggested single HLA‐mismatched unrelated donors (MMUD) may be equivalent to 10/10 matched unrelated donors (MUDs). We retrospectively examined factors affecting outcome in a single‐center study using ATG followed by post‐transplant cyclophosphamide, termed ATG‐PTCy, GvHD prophylaxis. Fifty‐two patients who received grafts from MMUD and 188 patients transplanted from MUD between January 2015 and December 2019, at Princess Margaret Cancer Centre, Canada, were enrolled. All patients received reduced‐intensity conditioning. Overall survival for 9/10 recipients at 2 years was significantly worse, 37.2% versus 68.5% for 10/10 MUDs, p <.001, as were NRM at 1 year 39.5% versus 11.7%, p <.001, and GRFS at 2 years 29.8% versus 58.8%, p <.001, respectively, potentially due to higher incidence of infections including CMV. By multivariable analysis, factors correlating with survival negatively were DRI, and MMUD, whereas for NRM MMUD and increasing age were unfavorable. For GRFS significant unfavorable factors included donor age ≤32 years, female donor to male recipient, DRI high‐very high and MMUD. These data suggest that MMUD, primarily HLA‐A and HLA‐B MMUD, confer significantly inferior outcome despite use of ATG‐PTCy. Further development of novel conditioning regimens and GvHD prophylaxis is needed to mitigate these risks. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) and chlorinated derivatives (Chlorinated bisphenol A, Cl‐BPA) are recognized as chemicals that destroy the endocrine system and widely exist in the environment. Because theirs structure is similar to thyroxin, it can compete after binding with Cl‐BPA were studied by fluorescence spectroscopy, Förster resonance energy transfer, Fourier transform infrared spectroscopy, molecular docking and quantum chemistry. The results of fluorescence experiments show that Cl‐BPA can quench the fluorescence of TBG by static quenching and non‐radiative energy transfer. The number of binding sites (n) of Cl‐BPA‐TBG complex is about 1, and the binding constant (Ka) is greater than 1.00×106 L⋅mol−1. Combined with thermodynamic parameter analysis and molecular docking analysis, Cl‐BPA can bind to TBG through hydrogen bonding and hydrophobicity. Quantum chemical analysis further confirmed that the oxygen atoms in Cl‐BPA compounds are easy to form hydrogen bonding forces with NH and OH in TBG. Further molecular dynamics simulation analysis showed that the protein structure changed after Cl‐BPA combined with TBG. In this study, we have a deep understanding of the interaction mechanism between Cl‐BPA and thyroid protein through various spectral experiments and computer simulation methods. [ABSTRACT FROM AUTHOR]

Summary: This research optimized the extraction and purification of globulin from wheat germ and assessed the molecular weight distribution and structure properties of the globulin obtained. The results showed that the relative extraction efficiency and purity of wheat germ globulin (WGG) reached 18.0% and 89.1% under the enzymolysis conditions of 0.32‰ α‐amylase, pH 6.5, and 55 °C. The maximal precipitation rate of WGG (91.3%) was obtained with pH 4.3 (acid precipitation). Additionally, the molecular weight of WGG was mainly distributed below 70 kDa. FT‐IR confirmed that random coils (30.95%), β‐sheet (27.02%), α‐helix (26.55%), and β‐turn (15.48%) were the secondary structures of WGG. Furthermore, LTQ mass spectrometry showed that WGG was rich in variety and high in complexity, which retrieved 1274 proteins belonging to 392 proteomes by inverse peptide analysis. The findings endow a great potential of preparing WGG with superior functionality for food applications. [ABSTRACT FROM AUTHOR]

Introduction: Renal insufficiency is one of the common complications in multiple myeloma (MM) and an independent factor indicating a poor prognosis. Cystatin C (Cys C) is considered to be expected to replace creatinine to calculate glomerular filtration rate due to its own characteristics. Gene expression analysis suggested that cystatin C is up‐regulated nearly 50‐fold in patients with multiple myeloma. Methods: To further clarify the role of cystatin C in multiple myeloma, we retrospectively evaluated pretreatment cystatin C levels in 195 newly diagnosed patients through statistical analysis. Results: The elevation of serum cystatin C was positively related to the elevation of serum creatinine (P <.001), LDH (P =.006), β2‐microglobulin (P <.001), bone marrow plasma cell proportion (P =.005) and the reduction of hemoglobin levels (P <.001). Patients with serum cystatin C levels >1.6 mg/L had a significantly shorter progression‐free survival (PFS) or overall survival (OS) than patients with serum cystatin C levels <1.6 mg/L (median PFS: median unreached vs 16.7 months, P <.001; median OS: 68 months vs 42 months, P =.014). Although serum cystatin C is not an independent prognostic factor of OS and PFS in patients with multiple myeloma, serum cystatin C can be considered as a sensitive indicator to differentiate well OS and PFS in the group of ISS II patients. Conclusion: Serum cystatin C is associated with tumor burden of multiple myeloma and cystatin C can further differentiate the prognosis of ISS II patients. More prospective studies are required to explore the role of serum cystatin C in multiple myeloma. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to synthesise available data and evaluate the clinical evidence regarding the effect of early enteral nutrition versus total parenteral nutrition on nutritional status and blood glucose in patients with gastric cancer complicated with diabetes mellitus after gastrectomy. Methods: This systematic review and meta‐analysis was designed, conducted and reported following the PRISMA guideline. We performed searches in PubMed, Embase, Medline, Web of Science, Cochrane Library, Chinese Biomedicine Literature Database, Chinese Scientific Journal Database, Chinese National Knowledge Infrastructure and Wanfang Database. The study designs were randomised controlled trials, quasi‐randomised controlled trials, and controlled clinical trials. The trials compared early enteral nutrition (experimental group) with total parenteral nutrition (control group) in patients with gastric cancer complicated with diabetes mellitus after gastrectomy. The risk of bias was assessed using the Cochrane risk of bias tool. Results: A total of 19 trials (1255 patients) were included. Meta‐analysis showed a significantly shorter length of hospital stay (days; mean difference −5.07, 95% confidence interval [CI] [−6.28, −3.86], p < 0.00001) and a lower post‐operative complications rate (%; odds ratio 0.29, 95% CI [0.16, 0.50], p < 0.0001) in the early enteral nutrition group than in the total parenteral nutrition group. Compared with the total parenteral nutrition group, the early enteral nutrition group had lower blood glucose fluctuation values (mmol/L; mean difference −2.03, 95% CI [−2.44, −1.61], p < 0.00001), lower levels of glycosylated haemoglobin (%; mean difference −0.62, 95% CI [−1.22, −0.03], p = 0.04), higher levels of prealbumin (g/L; p = 0.002), transferrin (g/L; p = 0.002), total protein (g/L; p = 0.001) and haemoglobin (g/L; p = 0.005). Conclusions: Early enteral nutrition may maintain stable blood glucose levels and improve nutritional status, leading to better therapeutic effectiveness in gastric cancer complicated with diabetes mellitus patients. [ABSTRACT FROM AUTHOR]