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BackgroundAntimicrobial peptide expression is associated with disease activity in inflammatory bowel disease (IBD) patients. IBD patients have abnormal expression of elafin, a human elastase-specific protease inhibitor and antimicrobial peptide. We determined elafin expression in blood, intestine, and mesenteric fat of IBD and non-IBD patients.MethodsSerum samples from normal and IBD patients were collected from two UCLA cohorts. Surgical resection samples of human colonic and mesenteric fat tissues from IBD and non-IBD (colon cancer) patients were collected from Cedars-Sinai Medical Center.ResultsHigh serum elafin levels were associated with a significantly elevated risk of intestinal stricture in Crohn's disease (CD) patients. Microsoft Azure Machine learning algorithm using serum elafin levels and clinical data identified stricturing CD patients with high accuracy. Serum elafin levels had weak positive correlations with clinical disease activity (Partial Mayo Score and Harvey Bradshaw Index), but not endoscopic disease activity (Mayo Endoscopic Subscore and Simple Endoscopic Index for CD) in IBD patients. Ulcerative colitis (UC) patients had high serum elafin levels. Colonic elafin mRNA and protein expression were not associated with clinical disease activity and histological injury in IBD patients, but stricturing CD patients had lower colonic elafin expression than non-stricturing CD patients. Mesenteric fat in stricturing CD patients had significantly increased elafin mRNA and protein expression, which may contribute to high circulating elafin levels. Human mesenteric fat adipocytes secrete elafin protein.ConclusionsHigh circulating elafin levels are associated with the presence of stricture in CD patients. Serum elafin levels may help identify intestinal strictures in CD patients.

The deep integration of higher education with digital technology represents an inevitable trend, and evaluating the interplay between higher education resources (HER) and digital infrastructure construction (DIC) holds significant value for advancing the development of digital higher education and mitigating regional disparities in China. This study establishes two comprehensive evaluation frameworks for HER and DIC. Panel data from 31 provinces, spanning the period from 2011 to 2020, are utilized for analysis. The coupling coordination degree (CCD) model is employed in this work to evaluate the synergy between HER and DIC in China. Furthermore, we analyze the regional differences, spatial distribution, and trend evolution of this synergy. The study results revealed that there is an initial decrease followed by an increase in the synergy between HER and DIC, and the overall CCD is at a moderate coordination, with the mean CCD of the eastern region being significantly higher than that of the other three regions, and the inter-regional difference is the main source of regional disparity in this synergy. The current state of synergistic development reveals a slight inclination towards multi-polarization, although the disparity in regional development was decreasing. Additionally, there is an observed convergence in the coordinated development of HER and DIC, with spatial factors playing a significant role. These findings offer empirical support for efforts to enhance the integration of HER and DIC, reduce regional disparities in higher education, and foster sustainable development in China's higher education sector. [ABSTRACT FROM AUTHOR]