👤 Qingqing Su

To have maximal benefit, Alzheimer's disease-modifying treatments might need to be started before the onset of clinical symptoms. Mutations of the PSEN1 gene are inherited as fully penetrant, autosomal-dominant traits, which almost always result in the clinical onset of Alzheimer's disease before the age of 65 years. We aimed to evaluate the efficacy, including possible delayed emergence of cognitive impairment, and safety of crenezumab, an anti-amyloid monoclonal antibody, in cognitively unimpaired carriers of the PSEN1 This 5-8-year common-close, double-blind, placebo-controlled, single-centre trial screened kindred members aged 30-60 years from the main health-care site in Medellín, Colombia. Participants who were cognitively unimpaired and carried the PSEN1 619 Colombian API registrants were prescreened, 315 were assessed for eligibility, and 252 were enrolled (crenezumab-carrier, n=85; placebo-carrier, n=84; placebo-non-carrier, n=83; 160 [63%] women and 92 [37%] men) between Dec 20, 2013, and Feb 27, 2017. 237 (94%) completed the trial, with final data collection on March 22, 2022. The annualised rate of change in the API ADAD composite was -1·10 (SE 0·29) in the crenezumab group and -1·43 (0·29) in the placebo group (between-group difference 0·33 [95% CI -0·48 to 1·13]; p=0·43). The annualised rate of change in FCSRT-CI was -0·03 (0·00) in the crenezumab group and -0·04 (0·00) in the placebo group (between-group difference 0·01 [0·00 to 0·02]; p=0·16). All participants had at least one adverse event; serious adverse events occurred in 23 (27%) of 84 in the crenezumab group and 21 (25%) of 84 in the placebo group. No fatalities occurred. Crenezumab therapy administered for 5-8 years did not result in significant benefits on our primary clinical outcomes in cognitively unimpaired participants predisposed to developing ADAD dementia; secondary and exploratory outcomes also showed no significant effect on removal of amyloid plaques or other clinical or biomarker outcomes. Together with the results of other anti-amyloid β trials, robust fibrillar amyloid removal appears necessary for clinical efficacy in people with elevated brain amyloid. This study will further inform the biomarker, cognitive, and clinical trajectory of preclinical ADAD, the risk of clinical progression in amyloid-positive and amyloid-negative mutation carriers, and the size and design of future secondary and primary prevention trials. US National Institute on Aging (NIA), Banner Alzheimer's Institute, Genentech, F Hoffmann-La Roche. Show less

To assess the association between hepatitis C virus (HCV) infection and cognitive impairment among seniors in Taiwan, building on our previous findings from a cross-sectional study. Retrospective cohort study. Taiwan Biobank. 326 participants with positive serum anti-HCV and a control group of 8753 with negative HCV free of cognitive impairment were assessed by the Mini-Mental State Examination at baseline. The association between HCV infection and cognitive impairment was evaluated using Cox proportional hazard models. The analysis was adjusted for age, sex, education, BMI, hypertension, cirrhosis, depression, estimated glomerular filtration rate, APOE genotype, and recruitment periods. Anti-HCV positive patients showed a significantly higher incidence of cognitive impairment compared to anti-HCV negative individuals (14.28 vs. 7.21 per 1000 person-years, P = 0.004). After adjusting for covariates, HCV infection was significantly associated with an increased risk of developing cognitive impairment (adjusted HR [aHR]: 1.80, 95% confidence interval [CI]: 1.12-2.90). Subgroup analyses for individuals diagnosed prior to the public direct-acting antivirals reimbursement in 2017 and with high antibody titres (sample/cutoff ratio ≥ 5), the elevated risk of cognitive impairment remained statistically significant, with aHRs of 1.69 (95% CI: 1.04-2.75) and 1.81 (95% CI: 1.11-2.96) respectively. Additionally, HCV patients carrying the APOE ɛ4 allele had a marginally higher risk (aHR: 2.60, 95% CI: 0.96-7.08, P = 0.06). In Taiwan, our findings strengthen evidence that individuals above the age of 60 with HCV infections are at a greater risk of developing cognitive impairment than their counterparts, who were HCV negative. Show less

Despite therapeutic advances, atherosclerosis remains a major global health challenge. Most current treatments target systemic risk factors rather than the diseased vascular wall. Our previous work identified genistein, a soy isoflavone, as a cannabinoid receptor 1 (CB1) antagonist capable of suppressing CB1-mediated vascular inflammation and atherosclerosis. However, its poor water solubility and low oral bioavailability limit clinical application. We aimed to develop water-soluble, orally bioavailable CB1 antagonists for atherosclerosis and to investigate the role of endothelial CB1 in hemodynamic regulation. RNA-sequencing datasets from the NCBI GEO repository were analyzed to assess CB1 expression in atherosclerotic patients. Apolipoprotein E-deficient (Apoe We found CB1 was upregulated in atherosclerotic lesions from patients and mice, and in endothelial cells exposed to disturbed flow. Mechanistically, this was driven by ZNF610 and Spi1 binding and KLF4 dissociation at the CB1 promoter. Daidzein, a soy isoflavone structurally similar to genistein, was identified as a novel CB1 antagonist. To enhance solubility and bioavailability, we developed genistein 7-O-phosphate (G7P) and daidzein 7-O-phosphate (D7P). Pharmacological treatment with these isoflavone monophosphates or genetic CB1 ablation reversed disturbed flow-induced endothelial dysfunction and endothelial-to-mesenchymal transition (EndMT). Oral administration of G7P and D7P significantly reduced atherosclerotic plaque formation in mice. This is the first study to identify transcriptional regulators that drive endothelial CB1 upregulation in response to disturbed flow. We further demonstrated that isoflavone monophosphates ameliorate disturbed flow-induced endothelial dysfunction and EndMT via CB1 inhibition, offering promising oral therapeutics for atherosclerosis. Show less

Atherosclerosis (AS) is a major underlying cause of cardiovascular diseases, with hypercholesterolemia, inflammatory responses, and macrophage polarization being established key contributors. The roles of NLRP3 inflammasome activation and macrophage polarization in AS pathogenesis have garnered significant research interest. This study investigated the therapeutic potential of Schisandrol B (Sol B) against AS using an in vivo model of ApoE Show less

We report the discovery of a chemical series that enhances ApoE secretion from human astrocytes through mechanisms independent of LXR agonism. Target deconvolution of hits from a phenotypic screen in astrocytoma cells employed chemoproteomics, photoaffinity probes, in vitro KINOMEscan analysis, and targeted siRNA knockdown experiments. Photoaffinity labeling coupled with quantitative chemical proteomics identified aryl hydrocarbon receptor (AhR), a transcription factor not previously associated with ApoE secretion, as the primary target. A diverse panel of AhR agonists and antagonists together with genetic knockdown confirmed that ApoE secretion increases when AhR activity is reduced. Using a luciferase reporter assay, we demonstrated that active series analogs exhibit AhR antagonism while inactive compounds do not. Since deletion of AhR has severe peripheral effects, chronic inhibition of AhR is not an attractive therapeutic approach for Alzheimer's disease; nevertheless, these results position AhR as a modulator of ApoE secretion and a biological pathway worth exploring. Show less

Atherosclerosis is a chronic immunometabolic disease driven by lipid accumulation and immune cell infiltration. Macrophages and T cells play key roles throughout plaque development. Galectin-1 (Gal-1), a glycan-binding protein, modulates immune functions in these cells and has been reported to attenuate atherosclerosis, though its mechanisms remain incompletely understood. Here, we investigated the effects of Gal-1 on macrophages and T cells during plaque formation. Effects of Gal-1 on atherosclerosis, macrophages and T cells during lesion formation were studied in Apoe Gal-1 treatment reduced lesion size and increased circulating IL-10 levels, inversely correlating with plaque burden. Unexpectedly, IL-10 neutralization also mitigated atherosclerosis, indicating that its action is at least partially IL-10-independent. In plaques, Gal-1 promoted anti-inflammatory macrophage phenotypes, mirrored by a quiescent metabolic and anti-inflammatory profile in foamy macrophages ex vivo. The use of the Gal-1 Gal-1 protects against atherosclerosis associated with reprogramming macrophages and tuning T cell immunity through glycan-dependent and -independent pathways. Show less

Pro-inflammatory macrophage function is linked to an increase in mitochondrial fission. Melatonin has a positive impact on atherosclerosis and has a significant effect on the control of mitochondrial fission and fusion. Nevertheless, it is still unclear how melatonin contributes to slowing the advancement of atherosclerosis. The ApoE The study found that melatonin treatment decreased the area of atherosclerotic plaque, decreased lipid deposition, suppressed inflammatory cytokine levels, inhibited macrophage pro-inflammatory differentiation, inhibited mitochondrial fragmentation, increased the level of Sirt3, and decreased Drp1 expression in atherosclerosis (AS) mice. However, Sirt3 inhibition abolished the protective affects of melatonin in AS mice. Melatonin therapy upregulated Sirt3 expression in RAW264.7 cells subjected to ox-LDL, blocked Drp1-mediated mitochondrial fission, and reduced inflammatory cytokine levels. On the other hand, melatonin's inhibitory effects on Drp1 expression and mitochondrial fission were lessened by Sirt3 inhibition. Additionally, DRP1 siRNA knockdown inhibited mitochondrial fission and pro-inflammatory differentiation of macrophages induced by ox-LDL. Melatonin inhibits the growth of atherosclerosis and the pro-inflammatory differentiation of macrophages by blocking the Sirt3-Drp1 pathway, which prevents mitochondria from fission. Melatonin's suppression of mitochondrial fission may be a viable strategy for postponing cardiovascular problems in atherosclerosis patients. Show less

Vascular smooth muscle cell (VSMC)-derived foam cell formation is a major contributor to atherosclerosis progression and plaque instability. Meteorin-like protein (METRNL), a secreted organokine with known metabolic and anti-inflammatory effects, has been linked to cardiovascular protection, but its role in atherosclerosis is not well defined. This study investigated the function of METRNL in VSMC-derived foam cell formation and atherosclerosis and explored the underlying signaling mechanisms. ApoE METRNL levels declined during atherosclerosis progression and were restored during regression. METRNL selectively inhibited foam cell formation in VSMCs-but not in macrophages-by downregulating CD36-mediated cholesterol uptake and suppressing endoplasmic reticulum stress through KIT signaling. Deletion of KIT specifically in smooth muscle cells abolished these protective effects. The transcription factor SP1 was found to bind directly to the METRNL promoter and enhance its expression. Clinically, lower serum METRNL levels were independently associated with increased risk and severity of acute coronary syndrome. METRNL protects against VSMC foam cell formation and atherosclerosis by enhancing KIT signaling, thereby reducing ER stress and subsequent cholesterol uptake. These findings position METRNL as a potential therapeutic target and biomarker for atherosclerotic cardiovascular disease. Show less

Chemical investigation of the soft coral Sclerophytum humesi led to the discovery of (±)-norsclerohumin A (1), a pair of enantiomeric norsesquiterpenoids possessing an unprecedented oxatricyclo[7.2.1.0 Show less

Bazi Bushen (BZBS), a Traditional Chinese Medicine (TCM) formula, is composed of fourteen herbal ingredients, including classic tonics such as Ginseng Radix et Rhizoma and Cistanches Herba. Traditionally used to combat fatigue and promote vitality in aging individuals, BZBS is rooted in TCM principles of kidney essence replenishment and brain function enhancement. Recent pharmacological studies have begun to validate its efficacy in age-related cognitive decline, but its effects and mechanisms in Alzheimer's disease (AD) remain unclear. This study aimed to evaluate the potential therapeutic effects of BZBS in 5 × FAD transgenic mice, a commonly used Alzheimer's disease model, and to shed light on its possible mechanisms of action. Four- and six-month-old 5 × FAD mice were treated with BZBS to examine how it might influence cognitive performance. Behavioral assessments were carried out using Y-Maze and the Morris Water Maze. To investigate the biological changes and uncover the mechanisms involved, we used a range of techniques-Thioflavin S staining, immunofluorescence, Western blotting, and qPCR-to look at Aβ plaque accumulation, Amyloid Precursor Protein C-terminal Fragments (APP-CTF) and β-secretase 1 (BACE1) expression levels, markers of inflammation, and indicators of cellular aging in hippocampus and motor cortex. In the 4-month group, where treatment was started before severe pathology developed, BZBS improved learning and memory performance. It also reduced amyloid deposition in the cortex and hippocampus, and lowered the levels of APP-CTFs and BACE1. In addition, we observed decreased mRNA expression of IL-1α, IL-6, and NF-κB, along with reduced microglial activation in the hippocampus of BZBS-treated mice. Similarly BZBS downregulated key markers of cellular senescence, including p16, p21, and senescence-associated β galactosidase (SA-β-gal) activity. In the 6-month group, which already showed signs of amyloid pathology, BZBS still had beneficial effects-improving cognition, lowering Aβ load, and reducing microglial activity-suggesting that it may be effective even after disease onset. These findings demonstrate that BZBS exerts significant therapeutic effects in 5 × FAD mice, including improved cognitive improvement, reduced Aβ deposition, suppressed microglial activation, and attenuated hippocampal cellular senescence. Notably, BZBS was effective whether administered from the early stage of pathology (at four months of age) or after established amyloidosis (at six months of age), highlighting its dual potential as both a preventive and disease-modifying intervention for Alzheimer's disease (AD). Show less

Huanshaodan (HSD) is a Traditional Chinese Medicine Compound Prescription, traditionally used in the clinical treatment of Alzheimer's disease (AD) in China. Nevertheless, its bioactive constituents and mechanistic basis remain poorly understood. To identify the components derived from HSD that inhibit SIRT2 and investigate the underlying mechanisms in mitigating AD pathogenesis. A luciferase reporter gene assay was employed to screen HSD for components that downregulate SIRT2 expression. The neuroprotective effects and the mechanisms of the screened component, ferulic acid (FA), was evaluated both in SAMP8 mice and HT22-APPswe cell using behavioral tests, H&E, immunohistochemistry, transmission electron microscopy, ELISA, MTT, Western blot, RT-qPCR, immunofluorescence and Co-immunoprecipitation, to assess its effect on SIRT2 expression, SIRT2-APP interaction, as well as the expression of proteins associated with APP proteolytic processing. SIRT2-overexpressing plasmids were transfected to assess FA's neuroprotection via SIRT2 modulation. As a component in HSD, FA inhibited SIRT2 promoter-driven transcription, ameliorated cognitive deficits, protected neuronal and synaptic structures, reduced Aβ deposition in SAMP8 mice and Aβ level in HT22-APPswe cells. FA suppressed SIRT2 expression, inhibited SIRT2-APP interaction, modulated the expression levels of proteins involved in APP proteolytic processing, namely ADAM10, sAPPα, BACE1, sAPPβ, and CTFα in vitro and in vivo. Notably, the regulatory effects of FA on APP proteolytic processing in HT22-APPswe cells were completely abolished upon SIRT2 overexpression. This study demonstrates that FA is an active component in HSD that mitigates AD pathology, potentially by modulating APP proteolytic processing through SIRT2 downregulation. Show less

This study aims to construct a prognostic model for hepatocellular carcinoma (HCC) based on palmitoylation-related genes and explore its molecular mechanisms through multi-dimensional analyses. The research integrated single-cell transcriptome data (GSE189903) with bulk transcriptome data (TCGA-LIHC, GEO datasets), focusing on palmitoylation-related genes in HCC epithelial cells. The scAB deconvolution algorithm was used to analyze the association between epithelial cell subsets and patient survival, and hdWGCNA was combined to construct a gene co-expression network. Through differential expression analysis, univariate Cox regression, and LASSO penalized regression, 7 key genes (SERPINE1, FMO3, ALDH2, CPS1, SLCO1B1, ACAT1, ACADS) were identified to build a prognostic risk model. Validation results showed that the model could effectively distinguish the survival prognosis of high-risk and low-risk patients (AUC values for 1/3/5 years in the TCGA cohort were 0.676, 0.656, and 0.642, respectively; those in the GSE14520 validation set were 0.702, 0.658, and 0.654, respectively), and the risk score was an independent prognostic factor. Further analyses revealed that the risk score was associated with tumor staging, immune cell infiltration (e.g., T cells, monocytes), response to immunotherapy, and drug sensitivity. Functional enrichment analysis indicated that the high-risk group was enriched in cell cycle regulation and oncogenic signaling pathways, while the low-risk group was related to metabolic pathways. This study is the first to analyze the regulatory network of palmitoylation in HCC epithelial cells by combining single-cell and bulk transcriptomes, providing new molecular targets and methodological references for HCC prognosis evaluation and precision therapy. Show less

RNA G-quadruplexes (rG4s), formed through guanine self-recognition into stacked tetrads, serve as critical regulators of gene expression, yet their comprehensive mapping and dynamic regulation in physiological contexts remain technically challenging. Here, we develop Ultra-low-input rG4-seq (ULI-rG4-seq), enabling precise rG4 detection enabling precise rG4 detection with ∼140 bp resolution in samples as small as 100 oocytes, and reveal notable enrichment of rG4s near crucial regulatory regions, particularly transcription start sites and end sites. This technological advance, combined with Trim-away or oocyte-specific knockout of DHX36 (also known as G4R1 or RHAU), an rG4-specific helicase, reveals acute and chronic loss of DHX36 leads to opposing effects on rG4 levels. This observation extends beyond the traditional view of helicases as unwinding enzymes and suggests sophisticated cellular mechanisms maintaining RNA structural homeostasis. Through integrated analysis of rG4 landscapes and DHX36-binding profiles, we demonstrate coordination between cytoplasmic rG4 regulation and nuclear gene expression, revealing how RNA structure dynamics orchestrate RNA stability and translation, thereby influencing transcriptional elongation, genome stability, and alternative splicing. Finally, we show that deletion of DHX36 resulted in decreased oocyte quality, premature ovarian failure and complete female infertility due to transcriptional defects and genome instability related to R-loop accumulation. These technological and conceptual advances not only deepen our understanding of RNA-based regulation but also open new therapeutic possibilities for diseases involving RNA structure. Show less

Keratin 17 (K17) is a stress-responsive intermediate filament protein that is upregulated in chronic skin diseases and in several carcinomas. We previously showed that K17 is induced in epidermal keratinocytes following exposure to DNA-damaging agents, promoting keratinocyte survival and chemically induced papilloma formation in mouse skin. Molecularly, K17 is recruited to the nucleus, where it impacts nuclear architecture, gene expression, and the DNA damage response (DDR). Here, we report on efforts to delineate K17-dependent processes during DDR by focusing on its interacting partners. Using mass spectrometry, we identified a network of K17-interacting Rho GTPase signaling proteins, including Rac1 and its activator Dock7. Biochemically, we confirmed that Rac1 and K17 interact directly in vitro and in A431 tumor keratinocytes, both at baseline and after ionizing radiation. We show that Show less

To explore the genetic etiology of 46 Chinese pedigrees affected with Hereditary multiple exostoses (HME) and provide genetic counseling and reproductive intervention. Whole-exome sequencing and Sanger sequencing were carried out on 87 patients from the 46 pedigrees to analyze the variants of EXT1 and EXT2 genes. Pathogenicity of the variants was assessed based on the guidelines from the American College of Medical Genetics and Genomics and Association for Molecular Pathology (ACMG/AMP). Prenatal diagnosis and preimplantation genetic testing (PGT) were provided for couples with identified pathogenic mutations. This study was approved by the Medical Ethics Committee of the hospital (Ethics No.: LL-SC-SG-2014-010). In total 17 and 22 pathogenic variants were respectively identified in the EXT1 and EXT2 genes, among which 5 EXT1 and 12 EXT2 variants were unreported previously. Three patients with no family history were found to harbor de novo variants of the EXT1 gene. Twenty nine couples had opted for PGT or underwent prenatal diagnosis following natural conception, and 17 healthy babies were born. This study has clarified the genetic etiology of 45 HME pedigrees and identified 17 novel variants, which has enriched the mutational spectrum of the EXT1 and EXT2 genes. Reproductive intervention through PGT and prenatal diagnosis have prevented the recurrence of HME in these families. Show less

Membranous nephropathy (MN) is the cause of 3% of pediatric nephrotic syndrome, with increasing incidence in adolescents. It was historically divided into primary and secondary forms but is increasingly described by antigen. The direct clinical value of knowing the MN antigen often depends on the strength of association between antigen and various underlying conditions, prognostic potential, and the presence of commercially available serum antibody testing. In this case, we describe an adolescent with PLA2R-, NELL1-, THSD7A-, and EXT2-negative MN who responded to B-cell depleting therapy. Three years later, he developed proliferative lupus nephritis and ongoing membranous nephritis with newly detected EXT2-positive deposits on kidney biopsy. This discordant MN antigen result demonstrates (1) the potential for apparent change in MN antigen detection over time and (2) that EXT1/2 negativity does not exclude the possibility of later development of lupus nephritis in an adolescent with MN. Show less

Approximately 40% of patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-), advanced breast cancer (ABC) have PIK3CA alterations, which contributes to endocrine therapy resistance. Alpelisib, an α-selective phosphatidylinositol 3-kinase inhibitor and degrader, given in combination with fulvestrant, is approved for the treatment of PIK3CA-mutated, HR+, HER2- ABC, based on the SOLAR-1 trial. Aside from PIK3CA, other gene alterations are associated with poor prognosis and limited response to treatment in this patient population. In this retrospective analysis, we performed tissue-based next-generation sequencing of 398 patients (237 PIK3CA-altered, 161 PIK3CA-wild type) from SOLAR-1. Progression-free survival (PFS) correlative analysis was performed in the PIK3CA-altered cohort. PIK3CA-altered and PIK3CA-wild type tumors had distinct genomic profiles. In the PIK3CA-altered cohort, patients who received alpelisib plus fulvestrant had a median PFS (mPFS) of 11.01 months versus 5.55 months for those receiving placebo plus fulvestrant (P=0.0004). Patients in the lowest tumor mutational burden quartile as well as those with FGFR1 or FGFR2 alterations derived greater PFS benefit from alpelisib plus fulvestrant versus placebo plus fulvestrant (18.5 versus 3.22 months; HR 0.38; 95% CI 0.21-0.68. FGFR1 12.71 versus 3.75 months; HR 0.38; 95% CI 0.17-0.81; P=0.32. FGFR2: 9.63 versus 2.78 months; HR 0.31; 95% CI 0.1-0.94; P=0.29); patients with MYC or RAD21 alterations derived limited PFS benefit. Cox and multi-task machine learning models identified lower Eastern Cooperative Oncology Group performance status, prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) treatment, and PTEN or TP53 alterations among the most deleterious factors for PFS in the PIK3CA-altered cohort. Alpelisib plus fulvestrant provides clinical benefit for patients with PIK3CA-altered, HR+, HER2- ABC across a range of concomitant alterations, including those previously implicated in endocrine therapy or CDK4/6i resistance. Machine learning models identified factors including gene mutations that influenced PFS. Show less

Endometriosis is a heterogeneous chronic inflammatory disorder associated with substantial diagnostic delay and limited therapeutic options, highlighting the need of robust non-invasive biomarkers and actionable molecular targets to complement existing low-sensitivity tests. To identify conserved pathogenic mechanisms with translational potential, here, we uniformly reprocessed three independent the Gene Expression Omnibus (GEO) microarray cohorts (GSE7305, GSE25628, and GSE11691) and applied a strict, directionally consistent intersection strategy to identify conserved transcriptional signals. We identified 262 consensus differentially expressed genes enriched for immunity/inflammation, cell adhesion and migration, and angiogenesis, consistent with key biological hallmarks of lesion establishment and persistence. Protein-protein interaction topology prioritized 11 highly connected hub genes ( Show less

Parkinson's disease (PD) involves heterogeneous neurodegenerative processes across brain cell types. The cell-type-specific effects of genetic risk remain unclear. We aimed to identify cell-type-specific causal genes for PD and to link genetic risk to molecular mechanisms and therapeutic opportunities. We performed the first cell-stratified Mendelian randomization integrating single-cell expression quantitative trait loci data from eight brain cell types with large PD genome-wide association studies datasets, followed by validation, neuropathological correlation, and postmortem expression analyses. Thirteen significant causal associations for four genes (ARL17A, ARL17B, KANSL1, LRRC37A) were identified across seven cell types, with consistent replication. ARL17A increased risk, whereas ARL17B, KANSL1, and LRRC37A were protective. Gene expression correlated with disease severity and showed cell-type-specific dysregulation. Drug-gene interaction screen highlighted US Food and Drug Administration-approved agents including raloxifene and dorzolamide as potential therapeutic modulators. This study contributed to cell-type-specific genetic mechanisms in PD, linking risk variants to molecular alterations and nominating therapeutic targets. © 2026 International Parkinson and Movement Disorder Society. Show less

Older adults increasingly rely on digital health resources, yet evidence regarding the relationship between eHealth literacy (eHL) and 24-hour movement behaviors (24-HMB), including physical activity (PA), sedentary behavior (SB), and sleep, remains underexplored. This study examined the associations between eHL and 24-HMB in Chinese older adults and examined self-efficacy as a potential mediator and moderator. Using a convenience sampling approach, 564 community-dwelling older adults (aged 60-74 years) were recruited from four urban Chinese cities via an online survey. A total of 553 valid cases were retained for analyses. eHL was assessed using the eHealth Literacy Scale-Web 3.0, and self-efficacy was assessed using a validated Self-Efficacy Scale. PA and SB were assessed objectively using ActiGraph GT3X+ accelerometers over three consecutive days (two weekdays and one weekend day). Sleep duration was derived from accelerometer-based estimates anchored by daily sleep logs. Multiple linear regression analyses were conducted to examine associations, and mediation and moderation were tested using PROCESS macro (Model 4 and Model 1, respectively), adjusting for age, sex, and education. After adjustment for covariates ( In this cross-sectional, urban, device-using sample of older adults, higher eHL was associated with a more favorable 24-HMB profile, particularly higher LPA and lower SB, while associations with sleep duration were weaker. Self-efficacy showed modest indirect associations consistent with partial mediation for PA and SB and also acted as a moderator of several associations. Given the observational design and modest effect sizes, findings should be interpreted cautiously and require confirmation in longitudinal or experimental studies with more representative sampling and improved sleep assessment. Show less

Carboxymethylcellulose (CMC), a common food emulsifier, induces microbiota dysbiosis and systemic inflammation; however, its impact on transplant immunity remains unclear. Allogenic heart rejection was observed in CMC-fed recipient mice, with increased abundance of lysophosphatidic acid (LPA)-producing bacteria and increased serum LPA concentration. CMC-induced transplant rejection was caused by the gut microbiota, as confirmed by fecal microbiota transplantation and gut microbiota depletion. Furthermore, LPA-treated macrophages demonstrated a proinflammatory ability to accelerate allograft rejection in cytotoxic T lymphocyte-associated protein 4 immunoglobulin-induced allograft survival by upregulating glycolysis. Conversely, the administration of a glycolysis inhibitor resulted in allograft survival and abrogated the detrimental effect of LPA. Mass spectrometry and single-cell RNA sequencing confirmed that transplant patients with rejection showed significantly elevated serum LPA levels and LPA receptor 6 (LPAR6) expression in graft-infiltrate macrophages. Mechanistically, LPA preferentially promoted LPAR6 expression, which interacted with Rho-associated protein kinase 2 to activate the mammalian target of rapamycin/hypoxia-inducible factor 1-alpha pathway, thereby enhancing glycolysis and inducing proinflammatory macrophage polarization. Treatment with Ki16425, an LPAR antagonist, prolonged allograft survival in CMC-fed recipients. Our findings reveal a major detrimental effect of CMC on macrophage physiology and suggest that controlling LPAR6 expression or glycolysis in macrophages may improve allograft survival in transplant recipients. Show less

This is a cross-sectional study designed to identify the latent profiles of psychological resilience in elderly patients with fracture and examine the relationship between resilience categories and fear of falling (FOF), thereby informing individualized rehabilitation strategies. A convenience sample was drawn from elderly patients admitted to the Department of Traumatology and Orthopedics at a tertiary general hospital in Beijing between September 2024 and July 2025 due to fall-related fractures. A total of 213 older adults aged 60 and above with fall-related fractures were included. Psychological resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC), and FOF was measured with the Falls Efficacy Scale-International (FES-I). Latent Profile Analysis (LPA) was used to identify resilience profiles. Logistic and linear regression analyses, adjusting for age, sex, comorbidities, pain level, functional status, and time since fracture/surgery, were performed to explore the relationship between resilience subtypes (entered as a continuous CD-RISC score), demographic and clinical factors, and FOF levels. The age of elderly patients with fall-related fractures was 60–98 (75.28 ± 8.73) years old, and the median age was 74 years old. Three latent resilience profiles were identified: low (33.5%), moderate (22.7%), and high (43.8%) resilience groups. Patients in the high-resilience group exhibited significantly lower FOF scores than those in the other two groups ( Psychological resilience is independently associated with fear of falling among elderly fracture patients, with a clear gradient across resilience profiles. Enhancing resilience, particularly in low-resilience individuals, may be a potential target for intervention, though causal inference is limited by the cross-sectional design and single-center, convenience sampling strategy. Integrating resilience assessment into clinical evaluation could support more holistic rehabilitation planning. ChiCTR2400089221, September 4, 2024. Show less

Lipoprotein (a) [Lp(a)] is viewed as a cholesterol-rich, LDL-like particle, yet potential heterogeneity in its lipid composition is not well understood. We developed and validated a novel immune-isolation assay to directly quantify triglycerides (TGs) associated with Lp(a) [Lp(a)-TGs]. Lp(a) was selectively isolated from plasma using magnetic beads conjugated with monoclonal antibody LPA4 targeting apolipoprotein(a), followed by enzymatic quantification of TGs. Assay specificity was ensured using washing buffers to prevent nonspecific lipoprotein interactions. Spike-in experiments with purified VLDL/intermediate density lipoprotein lacking Lp(a) demonstrated no measurable interference. Lp(a)-cholesterol [Lp(a)-C] was measured using an established immune-isolation method. The ratio of Lp(a)-TG to Lp(a)-C was calculated to distinguish TG-enriched Lp(a) particles from the typical cholesterol-rich, LDL-like phenotype. Lp(a)-TG, Lp(a)-C, Lp(a) molar concentration, and estimated compositional ratios were quantified in 36 normotriglyceridemic individuals and 114 individuals with moderate hypertriglyceridemia (150-500 mg/dl). In normotriglyceridemic individuals, mean (SD) TGs were 98.4 (31.9) mg/dl, Lp(a)-TG 1.42 (2.83) mg/dl, Lp(a)-C 4.03 (4.01) mg/dl, and the Lp(a)-TG/Lp(a)-C ratio was 0.59 (1.27). Lp(a)-TG and Lp(a)-C accounted for mean (SD) 1.22% (0.10) of total plasma TGs and 2.62% (2.01) of total plasma cholesterol. In individuals with hypertriglyceridemia, mean (SD) TGs were 284 (85) mg/dl, Lp(a)-TG 53.7 (25.3) mg/dl, Lp(a)-C 14.4 (6.9) mg/dl, and the Lp(a)-TG/Lp(a)-C ratio was 3.99 (1.20). Lp(a)-TG and Lp(a)-C accounted for mean (SD) 19.9% (6.53) of total plasma TGs and 9.68% (4.41) of total plasma cholesterol. This immune-isolation assay is the first validated, high-throughput method for direct quantification of Lp(a)-TG. This study demonstrates that Lp(a) lipid composition is variable and enriched in triglycerides and cholesterol in hypertriglyceridemic states. It provides a platform for future mechanistic, epidemiologic, and pharmacologic studies of Lp(a)-triglyceride interactions. This immune-isolation assay is the first validated, high-throughput method for direct quantitation of Lp(a)-TG. Show less

Depression and anxiety were not only common but also with serious consequence in inflammatory bowel diseases (IBD) patients. The current study endeavors to define distinct depression and anxiety profiles of IBD patients and identify central symptoms within different profiles to facilitate targeted interventions. The research employed K-means Clustering to delineate the depression and anxiety profiles, followed by a repetition of the analysis using Latent Profile Analysis (LPA). Furthermore, network analysis was utilized to identify central symptoms within the various profiles. K‑means Clustering identified Cluster 1 (38.89%), Cluster 2 (45.33%) and Cluster 3 (15.78%), while LPA yielded the low-risk group (39.56%), the mild-risk group (44.22%) and the high-risk group (16.22%). A majority of patients in the three clusters were predominantly in a single LPA-derived patient class (96.1-99.0%). Network analysis revealed that connections within each symptom in PHQ-9 and GAD-7 were stronger than those between symptoms. Furthermore, PHQ 6 ("guilt"), PHQ2 ("sad mood")and GAD 7 ("feeling afraid") were identified as the central symptoms in Cluster 1. PHQ2 ("sad mood"), GAD 3("excessive worry") and GAD 1 ("nervousness") emerged as the central symptoms in Cluster 2. Additionally, GAD3 ("excessive worry"), GAD 4 ("trouble relaxing") and GAD 6("irritability") were identified as the central symptoms in Cluster 3. We defined three distinct depression and anxiety profiles among IBD patients and pinpointed central symptoms within each profile. These findings underscore the importance of directing research towards those central symptoms within each profile in order to develop targeted intervention strategies. Show less

This study aimed to identify the heterogeneity of attitudes toward ageing among older adults in the “early transition period” (the initial 2–4 weeks after nursing homes transition from home to nursing homes). and the mediation effect of self-efficacy between attitudes toward ageing and quality of life (QoL). A total of 300 older adults were enrolled from October 2023 to May 2024. Participants completed the General Information Questionnaire, the Attitudes to Ageing Questionnaire (AAQ), the World Health Organization Quality of Life-Brief (WHOQOL-BREF), and the General Self-Efficacy Scale (GSES). Latent profile analysis (LPA), R3STEP methods, BCH methods, and mediation analysis were conducted to analyze the data. LPA categorized the attitudes toward ageing into three profiles: most negative (18.333%), moderately negative (64.000%), and positive (17.667%). Attitudes toward ageing profiles were associated with the following factors: age, pension, number of children, number of chronic diseases, ADL, willingness to reside in nursing homes, and social isolation. Self-efficacy partially mediates between attitudes toward ageing and the three dimensions of QoL (physical health, psychological health, and environmental health). Older adults during the “early transition period” had negative attitudes toward ageing. It may be related to the Chinese traditional interpersonal communication mode, family culture, and various maladaptive problems. Older adults who have two or more children, chronic diseases, no pension, moderate to severe dependency, involuntary admission to nursing homes, and social isolation are associated with more negative attitudes toward ageing. Mediation analysis reminds that self-efficacy can be used as intervention targets to improve the QoL. The online version contains supplementary material available at 10.1186/s12877-026-07007-7. Show less

Extensive research has documented a high comorbidity prevalence between depression and Internet gaming disorder (IGD). However, the distinct comorbidity patterns in adolescents have not been thoroughly investigated. Additionally, the longitudinal dynamics of these comorbidity patterns over time and the specific factors that may drive these transitions remain poorly understood. A total of 3,296 adolescents (1,501 boys; age baseline: 15.17 [1.44] years) were included in the current study. Latent profile analysis (LPA) was used to identify optimal comorbidity patterns of depression and IGD, while random intercept latent transition analysis (RI-LTA) was conducted to assess transitions in the comorbidity patterns over one and a half years and to identify factors influencing these transitions. Three patterns of comorbidity between depression and IGD symptoms were identified: no symptoms, low depression-high IGD symptoms, and high depression-low IGD symptoms. Results indicate that 72 % of individuals exhibited a stable symptom pattern trajectory. From Time 1 to Time 2, the probabilities of remaining in the three patterns were 78.3 %, 31.5 %, and 51.5 %, respectively. Findings also showed that sex, grade levels, boarding status, father's occupation as well as educational attainment, intra-week and weekend screen time, parent-child relationship, and perceived social support influenced the probabilities of transitions between comorbidity patterns in adolescents over time. Adopting targeted interventions for different comorbidity patterns and transitions, while considering specific influencing factors, provides insights into adolescent mental health dynamics and inform more effective prevention and support strategies. Show less

Digital technology is frequently regarded as a tool to alleviate loneliness and enhance mental health among older adults, yet its effectiveness remains contested. This study explores whether digital exclusion moderates the association between loneliness and depressive, and examines symptom structure and depressive subtypes. Drawing on data form the 2018 and 2020 waves of the CHARLS (N = 13,719), we employed fixed-effect and mixed-effect models to assess the effect of loneliness on depressive and the moderating role of digital exclusion. Latent profile analysis (LPA) was used to identify symptoms subtypes, while symptom network analysis assessed centrality and network stability. Loneliness significantly predicted depressive symptoms across multiple models, demonstrating robust effects. Digital exclusion was positively associated with depressive symptoms but did not exhibit a statistically significant moderating effect on the loneliness-depression relationship (p > 0.05, Δβ ≈ 0.011). LPA identified six psychologically meaningful subtypes of depression. Symptom network analysis revealed that emotional and motivational symptoms occupied central positions within the network structure, whereas loneliness, despite its strong connections, exhibited relatively low centrality. The overall network structure remained stable over two years, with the digital access group exhibiting stronger network connectivity. This study emphasizes that digital access alone is not a universal remedy for alleviating loneliness. The psychological benefits of digital technology depend on the alignment between individual motivations, usage patterns, and broader social contexts. Future research should focus on digital usage quality and contextual adaptability of interventions, promoting a shift from customization in digital mental health intervention strategies. Show less

This study aims to identify distinct subgroups of digital resilience among nursing students and examine the factors associated with these subgroups. Digital resilience, the ability to adapt to technological changes and overcome challenges in higher education, is crucial for protecting students' psychological health and improving academic performance. In the context of Artificial Intelligence (AI) and digital transformation in nursing education, this resilience is essential for students to navigate virtual learning and integrate advanced technologies into their practice. A cross-sectional study. This study was conducted in eight universities in China guided by ecological systems theory and nursing students were recruited through convenience sampling. Latent profile analysis (LPA) identified subgroups and logistic regression examined related factors. A total of 331 (81.73 %) participants were included in the final analysis. The average age of participants was 20.41SD0.67 years, with 283 female (85.55 %). Latent profile analysis revealed two subgroups: the "High Digital Resilience Group" (n = 278, 83.99 %) and the "Low Digital Resilience Group" (n = 53, 16.01 %). Participants who were male (OR = 3.47, p = 0.02), had low household income (OR = 0.23, p = 0.01, low professional identity (OR = 0.86, p < 0.001) and low friend support (OR = 0.82, p < 0.001) were more likely to belong to the low digital resilience group. Educators should focus on enhancing students' professional identity and providing social support, especially for those with low digital resilience. The findings provide practical guidance for integrating AI into nursing education to enhance digital resilience. Show less

Physical activity (PA) is an important non-pharmacological intervention that can slow the progression of Chronic Obstructive Pulmonary Disease (COPD). Unfortunately, PA levels in older adults with COPD remain low, and there is substantial heterogeneity within this population. Therefore, identifying potential subgroups is essential for developing targeted interventions. The purpose of this study is to identify latent profiles of PA, and explore the associated factors to inform personalized interventions for this population. This multicenter cross-sectional study was conducted from November 2024 to March 2025 at a tertiary hospital and four community health service centers in the Changning District of Shanghai. The revised International Physical Activity Questionnaire-Long (IPAQ-L) was utilized to assess PA and sedentary behavior. Latent profile analysis (LPA) was employed to classify the subgroups, followed by multinomial logistic regression to explore influencing factors. A total of 423 older adults with COPD (male N = 383; aged 60-89) were included in this study. LPA identified three distinct PA profiles, named the "moderate activity-moderate sedentary-low barrier (C1) group", the "low activity-high sedentary-high barrier (C2) group", and the "high activity-low sedentary-moderate barrier (C3) group". The factors were significantly associated with PA, including Body Mass Index (BMI), disease duration, number of hospitalizations, GOLD stage, COPD Assessment Test (CAT) score, exercise self-efficacy, and exercise social support (p < 0.05). LPA identified three subgroups of PA in older adults with COPD. The results of this research will facilitate targeted interventions for each of the identified subgroups with distinct characteristics, thereby enhancing the management of COPD and reducing healthcare burdens. Show less

Recent studies highlight the role of uric acid in tumor development, but its impact on prostate cancer (PCa) remains underexplored. This study aimed to investigate how uric acid influences PCa prognosis by analyzing transcriptomic data on PCa and uric acid-related genes (UARGs) from public databases. Differential expression analysis, protein-protein interaction (PPI) network, univariate Cox regression, and machine learning were used to identify prognostic genes. A risk model was then constructed based on these genes. Six prognostic genes (AHSG, AOX1, APOC1, LPL, NKX2-2, NKX6-1) were identified through the analysis of 1 433 differentially expressed genes (DEGs) and 3 806 UARGs. The risk model showed strong predictive ability, with the high-risk group (HRG) exhibiting poorer prognosis. Additionally, 10 immune cell types were significantly different between risk groups, with the HRG showing higher tumor mutation burden. A total of 8 drugs were found to correlate with risk scores. Enrichment analysis revealed that AHSG, AOX1, and APOC1 were linked to oxidative stress and Parkinson's disease, while NKX2-2 and NKX6-1 were associated with RNA degradation. These findings suggest that oxidative stress may be a key mechanism in PCa progression. This study offers a novel perspective on PCa treatment by identifying 6 prognostic genes and providing a prognostic risk model. Show less