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sRecent evidence suggests that CD147 serves as a novel receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Blocking CD147 via anti-CD147 antibody could suppress the in vitro SARS-CoV-2 replication. Meplazumab is a humanized anti-CD147 IgG2 monoclonal antibody, which may effectively prevent SARS-CoV-2 infection in coronavirus disease 2019 (COVID-19) patients. Here, we conducted a randomized, double-blinded, placebo-controlled phase 1 trial to evaluate the safety, tolerability, and pharmacokinetics of meplazumab in healthy subjects, and an open-labeled, concurrent controlled add-on exploratory phase 2 study to determine the efficacy in COVID-19 patients. In phase 1 study, 59 subjects were enrolled and assigned to eight cohorts, and no serious treatment-emergent adverse event (TEAE) or TEAE grade ≥3 was observed. The serum and peripheral blood Cmax and area under the curve showed non-linear pharmacokinetic characteristics. No obvious relation between the incidence or titer of positive anti-drug antibody and dosage was observed in each cohort. The biodistribution study indicated that meplazumab reached lung tissue and maintained >14 days stable with the lung tissue/cardiac blood–pool ratio ranging from 0.41 to 0.32. In the exploratory phase 2 study, 17 COVID-19 patients were enrolled, and 11 hospitalized patients were involved as concurrent control. The meplazumab treatment significantly improved the discharged (P = 0.005) and case severity (P = 0.021), and reduced the time to virus negative (P = 0.045) in comparison to the control group. These results show a sound safety and tolerance of meplazumab in healthy volunteers and suggest that meplazumab could accelerate the recovery of patients from COVID-19 pneumonia with a favorable safety profile.

To explore the expression and significance of respiratory chain enzyme of cells in urine sediment in mitochondrial encephalopathy myopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome.Through enzyme histochemistry, the authors analyzed the changes of respiratory chain enzyme in urine sediment in 20 MELAS patients due to mitochondrial A3243G mutation (MELAS group) and 20 health peoples (control group). And the impact on the expression of protein encoded by nuclear DNA (A21347) and mitochondrial DNA (A6404) was detected by immunochemistry. Image pro Plus 6.0 software was used for analysis of absorbance (A) of staining images as staining intensity. The data were expressed as M (Q1, Q3) and analyzed through statistical software.The staining intensity of complexes Iin the MELAS group was lower than that in the control group (0.06(0.01, 0.12) vs 0.12(0.01, 0.62), P = 0.010). The intergroup staining intensity of complex II showed no marked difference. Increased density of blue particle and cytoplasmic gathering was found in 13 cased (65%) of the MELAS group under light microscope. The staining intensity of complexes IV was expressed at a low level in the MELAS group (0.14(0.03, 0.32) vs 0.23(0.06, 0.43), P = 0.038). The expression of protein encoded by nuclear DNA (A21347) was lower than that in the control group (0.05(0.02, 0.45) vs 0.17(0.03, 0.70), P = 0.000). The expression of protein encoded by mitochondrial DNA (A6404) was also lower than that in the control group (0.03(0.01, 0.07) vs 0.15 (0.09, 0.23), P = 0.000).Abnormal change of respiratory chain enzyme in urine sediment in MELAS due to mitochondrial A3243G mutation and a low expression of proteins encoded by two kinds of DNA in complexes IV can help to confirm the genetic diagnosis of mitochondrial encephalomyopathies so that different subtypes may be classified and its pathogenesis elucidated.

To summarize the clinical audiologic features of patients with mitochondrial DNA (mtDNA) A3243G mutation and explore the lesion location of hearing loss so as to examine its correlation with the related syndrome.A total of 44 patients with mtDNA A3243G mutation from 2009-2011 were studied. Audiological evaluations consisted of measurements of pure-tone and speech audiometry, tympanometry, distortion-product otoacoustic emissions and auditory brainstem response. We investigated a possible correlation between the degree of hearing loss and gender, age and mutation rate.(1) Pure tone test was performed in 41 patients and showed normal hearing or symmetrical sensorineural hearing loss. Pure tone audiogram (PTA) showed high-frequency loss and descending curve in a majority of patients. There were 75 ears with hearing loss in 82 ears (91.46%), 22 ears with abnormal speech audiometry in 26 ears, 77 ears with abnormal distortion product otoacoustic emissions (DPOAE)testing in 86 ears, including 5 ears with normal PTA, 31 ears with abnormal electrocochleography in 75 ears, 25 ears with abnormal auditory brainstem response (ABR) in 82 ears. The abnormal ABR showed elevated threshold in 10 ears, delayed interpeak latencies of wave I-V in 2 ears and disappearance of wave V before wave I in 1 ear. In addition, there were 2 ears with speech audiometry abnormal but with normal ABR. (2) The correlation between the severity of hearing and gender did not reach statistical significance, nor the severity of hearing and mutation ratio. Age could influence the hearing of A3243G-induced MELAS.The predominant lesions of mtDNA A3243G is at cochlea and retrocochlear sites. Significant variations in clinical manifestation of hearing are the prominent features in patient with A3243G mutation. There was no correlation between the degree of hearing loss and mutation load. However, hearing impairment is the most common symptom of A3243G mutation.

To investigate the spectrum of mitochondrial DNA (deoxyribonucleic acid) 3271TC, 8356TC, 9176TC/G and 13513GA mutations in Chinese patients with mitochondrial encephalomyopathies.Peripheral blood samples were collected from 500 mitochondrial encephalomyopathies patients clinically diagnosed as mitochondrial encephalomyopathy lactic acidosisstroke-like episodes (MELAS), myoclonus epilepsyragged-red fibers (MERRF) or Leigh's syndrome from October 2005 to October 2009. The methods of PCR- polymerase chain reaction-restriction fragment length polymorphism (RFLP) and PCR-sequencing were performed to identify the mutations.No patients with the 3271TC, 8356TC, 9176TC/G or 13513GA mutations were identified.The mutations of 3271TC, 8356TC, 9176TC/G and 13513GA are rare causes of mitochondrial encephalomyopathies in Chinese patients.

A3243G mutation in mitochondrial DNA is the most common pathogenic point mutation causing a variety of phenotypes. The clinical phenotype and the relationship between the clinical phenotype and the ratio of A3243G mutation were studied in the members from nuclear families carrying A3243G mutation.A total of 42 families carrying A3243G mutation were recruited and their clinical symptoms, laboratory results and the ratio of A3243G analyzed.(1) In probands, myopathy, seizure, hirsutism, headache, cognitive impairment, weight loss and short stature were the most common clinical features. They tended to occur simultaneously. Lactic acid, pyruvate and MRI were abnormal in most probands; (2) most carriers had a normal phenotype. Myopathy, weight loss and short stature were their most common clinical features; (3) the ratio of A3243G mutation in urine was higher than that in blood in probands (t = -15.06, P0.001). And the ratio of A3243G mutation in urine was higher than that in blood in their mothers (z = -6.241, P0.001); (4) the ratio of A3243G mutation in probands was 2-fold higher than that in their mothers in both blood and urine.The phenotype of patients carrying A3243G mutation is varied. The clinical symptoms and laboratory results of probands are worse than those of mothers. It is probably due to a higher mutation ratio of m.3243AG in their tissues.

To identify a better non-invasive method to detect the carrier of mitochondrial A3243G mutation, a cause of mitochondrial encephalopathy-lactic acidosis-stroke like episode (MELAS) syndrome.DNA was extracted from the peripheral blood, urine, hair follicle, and saliva of 25 MELAS syndrome patients carrying A3243G mutation and their mothers and other maternal relatives, 33 persons in number, and the muscle tissues from 5 patients obtained by biopsy. A3243G mutation was detected by PCR-RFLP method, and the A3243G mutation ratio was identified by measuring the density of each band and calculation with the software AlphaEase 5.0.A3243G mutations were detected in all tissues of the 25 MELAS patients. The A3243G mutation ratio in urine was 62% +/- 9%, significantly higher than that in the blood [(36% +/- 10%), t = -11.13, P0.01]. A3243G mutations were detected in at least one tissue of the 28 maternal relatives. The A3243G mutation rates in their urine samples was 33.0% (5.0% - 70.4%), significantly higher than that in their blood samples [8.0% (0 - 33.3%), z = -4.197, P0.01]. There was no significant difference in A3243G mutation ratio among the samples of hair follicle, saliva, and blood.The A3243G mutation ratio in urine is significantly higher than those in blood samples of the patients and their maternal relatives. A noninvasive method, A3243G mutation ratio analysis of urine is superior to that in blood.

To conduct a molecular epidemiological survey on the mitochondrial DNA C1494T mutation in non-syndromic hearing loss patients in Chinese population.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to screen the mitochondrial DNA 12S rRNA C1494T mutation in 20 patients with aminoglycoside antibiotic induced hearing loss, 136 sporadic non-syndromic hearing loss patients and 50 probands of pedigrees with non-syndromic hearing loss.The C1494T mutation did not appear in all cases except for the positive control.Incidence of mitochondrial DNA C1494T mutation is much lower than that of mitochondrial DNA A1555G mutation in non-syndromic hearing loss of Chinese population. Mitochondrial DNA C1494T mutation may be a rare variation in non-syndromic hearing loss and is not the main cause of aminoglycoside antibiotic induced-deafness.