Chimeric antigen receptor (CAR) T-cell therapy is highly effective in the treatment of B-cell acute lymphoblastic leukemia (ALL) or B-cell lymphoma, providing alternative therapeutic options for patients who failed to respond to conventional treatment or relapse. Moreover, it can bridge other therapeutic strategies and greatly improve patient prognosis, with broad applicable prospects. Even so, 30–60% patients relapse after treatment, probably due to persistence of CAR T-cells and escape or downregulation of CD19 antigen, which is a great challenge for disease control. Therefore, understanding the mechanisms that underlie post-CAR relapse and establishing corresponding prevention and treatment strategies is important. Herein, we discuss post-CAR relapse from the aspects of CD19-positive and CD19-negative and provide some reasonable prevention and treatment strategies.

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Carbonic anhydrase related protein 8 (Car8) is known to be abundantly expressed in Purkinje cells (PCs), and its genetic mutation causes a motor coordination defect. To determine the underlying mechanism, we analyzed the mouse cerebellum carrying a Car8 mutation. Electrophysiological analysis showed that spontaneous excitatory transmission was largely diminished while paired pulse ratio at parallel fiber-PC synapses was comparable to wild-type, suggesting functional synapses have normal release probability but the number of functional synapses may be lower in mutants. Light microscopic study revealed an abnormal extension of climbing fibers to the distal PC dendrites. At the ultrastructural level, we found numerous PC spines not forming synapses primarily in distal dendrites and occasionally multiple spines contacting a single varicosity. These abnormalities of parallel fiber-PC synapses may underlie the functional defect in excitatory transmission. Thus, Car8 plays a critical role in synaptogenesis and/or maintenance of proper synaptic morphology and function in the cerebellum.

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Background In December 2019, pneumonia cases of unknown origin were reported in Wuhan City, Hubei Province, China. Identified as the coronavirus disease (COVID-19), the number of cases grew rapidly by human-to-human transmission in Wuhan. Social media, especially Sina Weibo (a major Chinese microblogging social media site), has become an important platform for the public to obtain information and seek help. Objective This study aims to analyze the characteristics of suspected or laboratory-confirmed COVID-19 patients who asked for help on Sina Weibo. Methods We conducted data mining on Sina Weibo and extracted the data of 485 patients who presented with clinical symptoms and imaging descriptions of suspected or laboratory-confirmed cases of COVID-19. In total, 9878 posts seeking help on Sina Weibo from February 3 to 20, 2020 were analyzed. We used a descriptive research methodology to describe the distribution and other epidemiological characteristics of patients with suspected or laboratory-confirmed SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. The distance between patients’ home and the nearest designated hospital was calculated using the geographic information system ArcGIS. Results All patients included in this study who sought help on Sina Weibo lived in Wuhan, with a median age of 63.0 years (IQR 55.0-71.0). Fever (408/485, 84.12%) was the most common symptom. Ground-glass opacity (237/314, 75.48%) was the most common pattern on chest computed tomography; 39.67% (167/421) of families had suspected and/or laboratory-confirmed family members; 36.58% (154/421) of families had 1 or 2 suspected and/or laboratory-confirmed members; and 70.52% (232/329) of patients needed to rely on their relatives for help. The median time from illness onset to real-time reverse transcription-polymerase chain reaction (RT-PCR) testing was 8 days (IQR 5.0-10.0), and the median time from illness onset to online help was 10 days (IQR 6.0-12.0). Of 481 patients, 32.22% (n=155) lived more than 3 kilometers away from the nearest designated hospital. Conclusions Our findings show that patients seeking help on Sina Weibo lived in Wuhan and most were elderly. Most patients had fever symptoms, and ground-glass opacities were noted in chest computed tomography. The onset of the disease was characterized by family clustering and most families lived far from the designated hospital. Therefore, we recommend the following: (1) the most stringent centralized medical observation measures should be taken to avoid transmission in family clusters; and (2) social media can help these patients get early attention during Wuhan’s lockdown. These findings can help the government and the health department identify high-risk patients and accelerate emergency responses following public demands for help.

BackgroundAutism is a pervasive neurodevelopmental disorder,thought to be caused by a combination of genetic heritability and environmental risk factors. Some autistic-like traits have been reported in mothers of autistic children. We hypothesized that dysregulation of oxytocin (OXT), Arg-vasopressin (AVP) and sex hormones, found in autistic children, may also exist in their mothers.MethodsWe determined plasma levels of OXT (40 in autism vs. 26 in control group), AVP (40 vs. 17) and sex hormones (61 vs. 47) in mothers of autistic and normal children by enzyme immunoassay and radioimmunoassay, respectively and investigated their relationships with the children’s autistic behavior scores (Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC)).ResultsSignificantly lower plasma concentrations of OXT (p<0.001) and AVP (p<0.001), as well as a higher level of plasma testosterone (p<0.05), were found in mothers of autistic children vs. those of control. The children’s autistic behavior scores were negatively associated with maternal plasma levels of OXT and AVP.ConclusionsThese results suggest that dysregulation of OXT, AVP and/or testosterone systems exist in mothers of autistic children, which may impact children’s susceptibility to autism.

Chimeric antigen receptor (CAR) T-cell therapy has yielded impressive outcomes and transformed treatment algorithms for hematological malignancies. To date, five CAR T-cell products have been approved by the US Food and Drug Administration (FDA). Nevertheless, some significant toxicities pose great challenges to the development of CAR T-cell therapy, most notably cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Understanding the mechanisms underlying these toxicities and establishing prevention and treatment strategies are important. In this review, we summarize the mechanisms underlying CRS and ICANS and provide potential treatment and prevention strategies.

Intracellular trafficking is critical for delivering molecules and organelles to their proper destinations to carry out normal cellular functions. Disruption of intracellular trafficking has been implicated in the pathogenesis of various neurodegenerative disorders. In addition, a number of genes involved in vesicle/organelle trafficking are also essential for pigmentation, and loss of those genes is often associated with mouse coat-color dilution and human hypopigmentary disorders. Hence, we postulated that screening for mouse mutants with both neurological defects and coat-color dilution will help identify additional factors associated with intracellular trafficking in neuronal cells. In this study, we characterized a mouse mutant with a unique N-ethyl-N-nitrosourea (ENU)–induced mutation, named nur17. nur17 mutant mice exhibit both coat-color dilution and ataxia due to Purkinje cell degeneration in the cerebellum. By positional cloning, we identified that the nur17 mouse carries a T-to-C missense mutation in archain 1 (Arcn1) gene which encodes the δ subunit of the coat protein I (COPI) complex required for intracellular trafficking. Consistent with this function, we found that intracellular trafficking is disrupted in nur17 melanocytes. Moreover, the nur17 mutation leads to common characteristics of neurodegenerative disorders such as abnormal protein accumulation, ER stress, and neurofibrillary tangles. Our study documents for the first time the physiological consequences of the impairment of the ARCN1 function in the whole animal and demonstrates a direct association between ARCN1 and neurodegeneration.