📋 Browse Articles

Acute necrotizing encephalopathy (ANE) in children is a critical condition characterized by rapid progression, high mortality rates and potentially cytokine storm imvolvement. Early-stage ANE lacks distinctive clinical features, and its initial symptoms resemble those of febrile seizures (FS) despite differing outcomes. In this study, we utilized FS as a control to identify plasma biomarkers associated with the cytokine storm in ANE through plasma proteomic analysis. We identified 398 differentially expressed proteins in ANE patients, including 345 upregulated and 53 downregulated proteins, which were enriched in biological pathways such as antigen processing and presentation, cell chemotaxis, immune responses, metabolism, and cell matrix adhesion. Using weighted gene co-expression network analysis (WGCNA), we further identified protein modules and hub proteins related to the cytokine storm and ultimately selected eight key proteins (APOE, GAPDH, TPI1, SPP1, ENO1, COL1A1, LUM, and A2M) as immunopathogenic biomarkers. These findings were validated in an independent cohort using targeted quantitative proteomics, with ROC analysis demonstrating their diagnostic potential. This study provides a foundation for early ANE diagnosis and highlights promising targets for therapeutic intervention. Show less

Our understanding of the genetic regulation of lipoprotein(a) [Lp(a)] is hindered by the complex structure of the LPA gene, limited non-European datasets and its elusive cellular receptor(s). This review summarizes recent efforts and advances providing new insights on its genetic architecture, variability across ancestries and regulators beyond the LPA gene. Impressive advances in DNA sequencing and bioinformatics now resolve LPA variants and kringle IV-type 2 copy number at scale. This provides new reference datasets and enables tools that unlock hidden variation also from already available sequencing datasets. In parallel, genetic studies broaden our understanding of the regulation of Lp(a) across ancestries and improve genetic risk scores. Finally, while recent studies implicate new mechanisms for Lp(a) uptake, upcoming genome-wide gene knockout screens allow comprehensive, agnostic scans for regulators and receptors. Puzzlingly, this still converges on the LDL receptor, whose exact role in Lp(a) uptake remains enigmatic. Technological advances establish a foundation for more accurate genetic risk assessment across ancestries. These advances are enhancing our understanding of Lp(a) regulation and build a framework for future integrative genetic studies, which may shed new light on the evolution of the Lp(a) trait, adding important context for its physiological and clinical relevance. Show less

The beneficial effects of omega-3 polyunsaturated fatty acids (PUFA) supplementation during pregnancy have been associated with reduced risk of preterm birth and low birthweight. However, inconsistent findings have been reported regarding their impact on children's neurodevelopmental trajectories. We performed a comprehensive systematic review with meta-analysis of preclinical studies to assess the effects of prenatal omega-3 supplementation on long-term outcomes in offspring and to identify key relevant neurodevelopmental domains to guide the design and prioritization of future clinical follow-up studies. The databases consulted included PubMed/Medline, Scopus and Web of Science. Thirty-five studies were included in the systematic review, and 19 studies were included in the meta-analysis. Relevant information such as characteristics of nutritional interventions, maternal conditions, offspring characteristics and article attributes were extracted. Sample sizes, means, and standard deviation or standard error for the outcome measures were also extracted. The search yielded 3198 articles; 35 met inclusion criteria, with 11 included in a random-effects meta-analysis of memory retention, and 8 in a meta-analysis of brain-derived neurotrophic factor (BDNF) levels. Our findings show that maternal omega-3 PUFA supplementation during pregnancy improves memory retention (SMD=0.671; CI 95 %: 0.163-1.179; p = 0.010) and increases levels of BDNF (SMD=0.838; CI 95 %: 0.369-1.307; p = 0.000) in the offspring. These effects are more pronounced in offspring exposed to prenatal adversities. Maternal omega-3 supplementation shows promise in mitigating oxidative stress and inflammation, although findings remain heterogeneous. Maternal omega-3 supplementation appears as a safe and effective means to improve offspring neurodevelopment, with stronger effects under adverse gestational conditions, highlighting its potential for at-risk populations. Show less

To delineate organ-specific and systemic drivers of metabolic dysfunction-associated steatotic liver disease (MASLD), we applied integrative causal inference across clinical, imaging, and proteomic domains in individuals with and without type 2 diabetes (T2D). Bayesian network analyses and complementary two-sample Mendelian randomization were used to quantify causal pathways linking adipose distribution, glycemia, and insulin dynamics with liver fat in the IMI-DIRECT prospective cohort study. Data included frequently sampled metabolic challenge tests, MRI-derived abdominal and hepatic fat content, serological biomarkers, and Olink plasma proteomics from 331 adults with new-onset T2D and 964 adults without diabetes, with harmonized protocols enabling replication. High basal insulin secretion rate (BasalISR), estimated via C-peptide deconvolution, emerged as the primary potential causal driver of liver fat accumulation in both cohorts. BasalISR, a clearance-independent measure of β-cell insulin output distinct from peripheral insulin levels, was independently linked to hepatic steatosis. Visceral adipose tissue exhibited bidirectional associations with liver fat, suggesting a self-reinforcing metabolic loop. Of 446 analyzed proteins, 34 mapped to these metabolic networks (27 in the non-diabetes network, 18 in the T2D network, and 11 shared). Key proteins directly associated with liver fat included GUSB, ALDH1A1, LPL, IGFBP1/2, CTSD, HMOX1, FGF21, AGRP, and ACE2. Sex-stratified analyses identified GUSB in females and LEP in males as the strongest protein predictors of liver fat. BasalISR may better capture early β-cell-driven disturbances contributing to MASLD. These findings outline a multifactorial, sex- and disease stage-specific proteo-metabolic architecture of hepatic steatosis and identify potential biomarkers or therapeutic targets. Show less

Depressive disorders often show recurrent courses that cannot be sufficiently prevented by existing therapeutic protocols. In other affective disorders, recurrence has been linked to three mechanisms -spontaneous recovery, accelerated new/relearning, and reinstatement- which are related to the preservation of disorder-related memory traces even through successful extinction-based interventions. Reconsolidation-interference protocols aim to directly alter such traces by reactivating and destabilizing them before intervention. While this approach has shown benefits in fear, craving, and trauma-related symptoms, its application to depression remains untested. To our knowledge, this study provides the first experimental evidence of its utility in depression-like states. Sixty participants took part in a three-day, three-group, double-blind randomized controlled trial. On day one, helplessness was induced using a modified unsolvable anagram task. On day two, participants were randomized into three groups undergoing different interventions while completing another cognitive demanding task: (1) extinction, where participants experienced success from start to finish; (2) reconsolidation, where participants briefly reexperienced failure before succeeding; or (3) reactivation, where failure repeated. On day three, the helplessness task was presented again to evaluate susceptibility for recurrence across conditions. Behavioral, self-report, and EEG data were collected. Across test days, participants showed reduced motivation and performance, attributing failure to personal ability, confirming successful helplessness induction. However, interventions at day two produced no robust group differences on behavioral, self-report, or EEG measures. Exploratory analyses suggested that brain-derived neurotrophic factor (BDNF) levels may have mediated outcomes. Findings do not confirm reconsolidation-based behavioral interference as effective for depression-like helplessness. Nonetheless, exploratory results highlight BDNF as a potential mediator, warranting further study on its role in postretrieval extinction effects in depression. Show less

Abdominal aortic aneurysm (AAA) refers to a disease where the abdominal aorta progressively dilates to 3.0 cm or more, making it prone to rupture. The etiologic and pathophysiological mechanisms underlying the formation and development of AAA are not yet fully understood. A preliminary investigation was conducted into the effects of Kruppel-like factor 5 (KLF5) regulation of the nuclear factor erythroid-2-related factor 2/heme oxygenase 1 (NRF2/HO-1) signalling pathway on ferroptosis in AAA vascular smooth muscle cells (VSMCs). ApoE KLF5 expression was downregulated in abdominal aorta tissues from AAA mice. KLF5 overexpression ameliorated inflammatory response by reducing phenotypic switching in VSMCs and inhibited ferroptosis and vascular calcification by reducing oxidative stress. Induction of ferroptosis partially reversed the ameliorative effect of KLF5 on vascular calcification in VSMCs. KLF5 exerted antioxidant effects by increasing NRF2 nuclear translocation and upregulating HO-1. Inhibition of the NRF2/HO-1 pathway partially reversed KLF5 regulation of phenotypic switching and vascular calcification in VSMCs. KLF5 may exert a protective effect by inhibiting ferroptosis and calcium deposition in VSMCs in AAA through regulation of the NRF2/HO-1 signalling pathway. Show less

Phthalates are well-known emerging contaminants in the environment and food packaging, posing serious risks to human health as endocrine disruptors with significant neurotoxic potential. Epidemiological and experimental evidence have linked early-life phthalate exposure to neurodevelopmental disorders, including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). However, the precise molecular mechanisms responsible for these associations remain poorly understood. This study aimed to comprehensively investigate the putative toxic targets and molecular pathways underlying phthalate-induced ADHD and ASD through integrated network toxicology and molecular docking approaches. Targets related to phthalates, ADHD, and ASD were extracted from various databases, yielding 21 potential targets associated with ADHD and ASD, which are common to the studied phthalates. Network analysis highlighted BDNF and ESR1 as the top two core targets. Functional enrichment analyses demonstrated that the core targets are involved in multiple pathways. Furthermore, the GEO database was queried to identify differentially expressed genes (DEGs) and gene modules through Weighted Gene Co-expression Network Analysis (WGCNA) using the R package. Moreover, molecular docking demonstrated high binding affinity between phthalates and core targets, with di(2-ethylhexyl) phthalate with BDNF and diisononyl phthalate with ESR1, emphasizing the potential role of phthalate exposure in neurodevelopmental disorders. The stability of these complexes was demonstrated through molecular dynamics simulations, which confirmed their binding interactions remained constant throughout the simulation. Our findings contribute to a deeper understanding of the intricate molecular mechanisms of phthalate-induced neurotoxicity, offering a valuable foundation for the development of future therapeutic strategies to mitigate their adverse effects on neurodevelopment. Show less

Auditory event-related brain potentials such as the mismatch negativity (MMN) and the frequency-following response (FFR) allow exploring speech sound encoding along the auditory pathway. Here, we collected event-related brain potential (ERP) and FFR neural responses to syllables in healthy full-term newborns (N = 17, mean age = 3 days) and adults (N = 21, mean age = 22.7). Participants were passively exposed to alternating blocks of syllables presented at either fast or slow stimulation rates while we recorded electroencephalography (EEG). Specifically, blocks containing the synthetic /oa/ syllable alternated with "oddball" blocks containing three natural syllables differing in place of articulation (one standard /da/ and two deviants /ba/ and /ga/). At the FFR level, we found that 3-day-old newborns (i) exhibit an already functional encoding of vowel pitch, (ii) show an immature encoding of vowel formant structure, replicating previous observations. At the ERP level, the two deviants elicited clear MMN in the two groups, although with different topographies, suggesting an immature sensitivity to place of articulation in newborns. These results confirm the role of experience-dependent developmental factors that may differentially shape FFR and ERPs of speech sound features. Furthermore, this study highlights the feasibility of assessing the hierarchy of neural speech sound encoding in a short experimental session. Show less

Approximately 10% of breast cancer cases are hereditary and associated with germline BRCA1/2 mutations. To characterize the somatic alteration landscape and HRD-related genomic features, we analyzed next-generation sequencing and clinical data from 1,243 breast cancer patients treated at Tianjin Cancer Hospital Airport Hospital between October 2021 and November 2024. We compared mutation patterns and clinicopathological features between patients with and without germline BRCA (gBRCA) mutations and further assessed somatic alterations and homologous recombination deficiency (HRD) in those carrying pathogenic variants. PIK3CA mutations were significantly more frequent in the Non-Germline and non-gBRCA groups than in the Germline and gBRCA groups (49% vs. 6%; 47% vs. 0%; both P < 0.001), indicating mutual exclusivity with gBRCA mutations. Conversely, PTEN alterations co-occurred in 30% of gBRCA cases, while TP53 mutations were mutually exclusive with MDM2 and FGFR1. HER2 amplification was identified in 10% of gBRCA-mutated tumors, and somatic alterations in non-gBRCA tumors were enriched in endocrine-resistance pathways. HRD scores were markedly higher in gBRCA patients than in non-gBRCA patients (median 59 vs. 24.5, P = 0.015), driven by significant increases in large-scale state transitions (LST) and telomeric allelic imbalance (TAI). The overall gBRCA1/2 mutation frequency was 15.61%, and two previously unreported variants, BRCA1 NM₀₀₇₂₉₄.3:c.4185G>A and BRCA2 NM₀₀₀₀₅₉.3:c.439C>A, were identified in the Chinese population. These findings provide a biological rationale to explore AKT1/HER2-targeted combinations with PARP inhibition in future studies for gBRCA-mutated breast cancer and provide the first evidence of PIK3CA-gBRCA mutual exclusivity in Chinese patients. The elevated HRD scores further underscore the presence of homologous recombination deficiency in the gBRCA group. Show less

The pathological mechanism of Alzheimer's disease (AD) is complex. The binding of Aβ to α7 nicotinic acetylcholine receptor (α7nAChR) contributes to neuronal damage. Sinomenine (SIN) is an alkaloid extracted from the traditional Chinese medicine Qingfengteng (Sinomenium acutum). The anti-inflammatory, antioxidant, and immunomodulatory effects of SIN were confirmed to be closely associated with the α7nAChR. This study aimed to investigate whether α7nAChR serves as a pharmacological target of SIN against AD, and to evaluate the neuroprotective effects of SIN both in vivo and in vitro, focusing on the α7nAChR/Nrf2/Keap1 signaling pathway. In this study, the effects of SIN in both APP/PS1 transgenic mice and SH-SY5Y cells subjected to Aβ1-42-induced injury were assessed. The selective antagonist α-bungarotoxin ‌(α-BTX), the agonist nicotine (Nic) of α7nAChR, and α7nAChR siRNA were employed. The cognitive function, Aβ deposition, synaptic plasticity markers, the tau protein phosphorylation, mitochondrial membrane potential, oxidative stress and the α7nAChR/Nrf2/Keap1 signaling pathway were analyzed in vivo and/or in vitro. SIN significantly enhanced learning and memory abilities in APP/PS1 mice, reduced Aβ plaque deposition and synaptic dysfunction, and inhibited hyperphosphorylation of tau protein and oxidative stress in the brain. In Aβ1-42-induced neuronal injury model, SIN alleviated apoptosis, increased BDNF and ACh levels, inhibited mitochondrial damage, stabilized calcium homeostasis, and suppressed oxidative stress. Meanwhile, SIN disrupted Nrf2-Keap1 binding to promote the Nrf2/HO-1 signaling pathway. Nevertheless, SIN effects above were inhibited by α-BTX. The knockdown of α7nAChR in vitro significantly promoted Nrf2/HO-1 pathway and BDNF expression. SIN exerts neuroprotective effect in APP/PS1 transgenic mice and Aβ1-42-induced neuronal injury by inhibiting oxidative stress via α7nAChR/Nrf2/Keap1 pathway. This study provides evidence for α7nAChR as a new target and the clinical application potential of SIN in AD treatment. Show less

COPD is characterised by chronic airflow limitation and persistent inflammation. Inhaled corticosteroids (ICS) are often used to reduce airway inflammation in patients. However, the response to ICS treatment varies among patients, and blood eosinophils may not fully reflect treatment effectiveness. In this study, we aim to identify gene modules associated with ICS responsiveness and assess the underlying biological pathways. We included 55 patients from the GLUCOLD study with mild-moderate COPD treated with ICS for 6 months with available gene expression data from biopsies. Treatment response was defined as changes in post-bronchodilator forced expiratory volume in 1 s (FEV We identified four gene modules associated to ICS-induced improvement in FEV This study identified gene modules and pathways associated with ICS responsiveness in COPD, providing a potential mechanistic explanation for the variability in ICS treatment responsiveness in COPD. Show less

Ischemic stroke is one of the leading global causes of disability and death. Despite advances in modern medical technology that improve acute treatment and rehabilitation measures, post-stroke anxiety and depression (PSD) do not receive sufficient attention. To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice. This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024. Based on assessments using the Hamilton Rating Scale for Anxiety (HAMA) and Hamilton Rating Scale for Depression (HAMD) at 2 weeks (± 3 days) post-stroke, patients were classified into the PSD group (HAMA ≥ 7 and/or HAMD ≥ 7) and the non-PSD group (HAMA < 7 and HAMD < 7). Observation indicators included psychological assessment, demographic and clinical characteristics, stroke-related clinical indicators, neuroimaging assessments, and laboratory biomarkers. Multivariate logistic regression analysis was used to identify independent risk factors for PSD, and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers. Of the 112 patients, 46 (41.1%) were diagnosed with PSD. Multivariate analysis identified five independent risk factors: Female gender [Odds ratio (OR) = 2.32, 95% confidence interval (CI): 1.56-3.45], history of mental disorders prior to stroke (OR = 3.17, 95%CI: 1.89-5.32), infarct location in the frontal lobe or limbic system (OR = 2.86, 95%CI: 1.73-4.71), stroke severity with National Institutes of Health Stroke Scale ≥ 8 at admission (OR = 2.54, 95%CI: 1.62-3.99), and low social support (Social Support Rating Scale < 35, OR = 2.18, 95%CI: 1.42-3.36). Subgroup analysis showed that depression patients more commonly had left hemisphere lesions (68.4% PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry, neuroinflammatory responses, and dysfunction of the hypothalamic-pituitary-adrenal axis. Show less

This study develops and tests an AI-empowerment Configural Model to explain how artificial intelligence (AI) empowers language learning engagement. Grounded in ecological systems theory (EST) and ecological affordance theory (EAT), the model theorizes AI as an interactive agent within the learning ecosystem. A mixed-methods study of 475 Chinese university language learners demonstrates that AI'S effect on engagement is significantly mediated by the perceived quality of its ecological coupling with teachers, peers, and the environment. Latent profile analysis (LPA) further identifies three distinct learner configurations: low coupling-low engagement, moderate coupling-moderate engagement and high coupling-high engagement, which systematically differ in their coupling of AI. The model ultimately shifts the paradigm from tool implementation to strategic ecological governance, providing a practical basis for designing learning environments that leverage synergistic human-AI coupling to foster deeper, sustained engagement. Show less

To identify latent family resilience profiles among families of patients with first-episode stroke in the intensive care unit (ICU) and examine factors associated with resilience heterogeneity, with the aim of informing targeted family-support interventions. A cross-sectional study was conducted among 335 ICU patients with first-episode stroke and their primary caregivers. Family resilience was assessed using the Chinese version of the Family Resilience Assessment Scale (FRAS-C). Latent profile analysis (LPA) was used to identify subgroups of family resilience, while LASSO regression and multiple binary logistic regression were applied to determine influencing factors. Two distinct resilience profiles were identified: Developing Families, characterized by lower levels of communication, resource utilization, and positive outlook; and Optimized Families, characterized by higher resilience across all dimensions. ICU admission count (OR = 2.299, 95% CI: 1.066-4.960), frequency of care and support from relatives or friends (OR = 1.851, 95% CI: 1.068-3.206), and number of additional organ system dysfunctions (OR = 0.233, 95% CI: 0.122-0.445) were significantly associated with family resilience profiles (all Family resilience among ICU first-episode stroke patients shows notable heterogeneity, with two typical resilience patterns. Early identification of high-risk families-particularly those with limited social support or higher disease complexity-can guide clinicians in delivering targeted communication support, psychological counseling, and resource linkage interventions. Tailored resilience-enhancing strategies may contribute to better patient recovery and improved family adaptation during critical care. Show less

The risk of developing psychiatric disorders, particularly stress-related disorders such as major depressive disorder (MDD) and post-traumatic stress disorder (PTSD), is increased threefold in patients with epilepsy. While this increased risk may arise as a consequence of living with epilepsy, shared neurobiological mechanisms, particularly dysregulation of GABAergic signaling, may also contribute. To investigate this link, we investigated the function of GABAergic neurons co-expressing the neuropeptide cortistatin (CST), which has anticonvulsant effects and is implicated in both MDD and PTSD. Targeting CST+ neurons in the prelimbic cortex (PrL), a rodent brain region that is functionally and anatomically similar to the human dorsal anterior cingulate cortex (dACC), we found that ablating CST+ neurons disrupts context-dependent fear renewal, causes spontaneous convulsive seizures, dramatically increases susceptibility to chemically-induced seizures, and increases anxiety-like phenotypes following stressors. We further show that repeated chemogenetic inhibition of CST+ neurons increases the rate of seizure kindling in female mice, and that disruption of brain derived neurotrophic factor signaling in CST+ neurons phenocopies the effects of acute inhibition. These data support the hypothesis that epilepsy and stress-related psychiatric disorders potentially share common neurobiological mechanisms, and that loss of CST+ neuron function may be a critical feature underlying fear dysregulation and cortical hyperexcitability. Show less

Brain-derived growth factor, BDNF, has critical roles in a wide variety of neuronal aspects, including cell survival, differentiation, and synaptic function after their maturation. TrkB, a high-affinity receptor for BDNF, is a major contributor in these neuronal aspects, and its functions are exerted via stimulating intracellular signaling pathways including the mitogen-activated protein kinase (MAPK) pathways. As a family of MAPKs, the functions of ERK1/2, p38MAPK, and JNKs have been extensively studied using in vivo and in vitro neuronal systems. ERK 1/2, a major serine-threonine kinase and belonging to the MAPK family, also works as a downstream molecule after activation of the BDNF/TrkB system. Interestingly, growing evidence has demonstrated that ERK1/2 signaling exerts a positive or negative influence on neurons in both healthy and pathological conditions in the central nervous system (CNS). Indeed, activation of ERK 1/2 stimulated by the BDNF/TrkB system is involved in the regulation of synaptic plasticity. On the other hand, overactivation of ERK1/2 signaling under pathological conditions is closely related to neurodegeneration. Furthermore, cell stress activates p38MAPKs and JNK signaling, contributing to the progression of neurodegeneration. In this review, we show how MAPK pathway signaling affects neuronal fate, including cell survival or cell death, in the CNS. Moreover, we discuss the involvement of overactivation of MAPK signaling in the neurodegeneration observed in Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD). Show less

To evaluate the effect of inclisiran therapy on the blood lipid profile 90 days post-injection and to describe the baseline structural and ultrasound characteristics of carotid and femoral plaques in high- and very high-risk patients who failed to achieve low-density lipoprotein cholesterol goals despite ongoing lipid-lowering treatment. This prospective observational single-center study included 22 patients (mean age 50.9±8.6 years, 50% men) with dyslipidemia and atherosclerotic plaques in peripheral arteries narrowing the lumen by 25-49%. Familial hypercholesterolemia was diagnosed in 59% of patients, and statin intolerance in 36%. Duplex scanning of the carotid and femoral arteries was performed. The gray-scale median (GSM) method is currently used for the quantitative assessment of carotid artery (CA) plaque echogenicity. Inclisiran was administered on day 1, day 90, and then every six months. Blood lipid profiles, including low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides, and lipoprotein (a) [Lp(a)], were assessed. At baseline, median concentrations were 3.7 [2.5; 5.4] mmol/l for LDL-C, 5.4 [4.4; 6.8] mmol/l for TC, and 22.0 [5.0; 108.0] mg/dl for Lp(a). Carotid artery evaluation showed a median of 4.0 [2.0; 4.0] plaques, total stenosis of 110% [63.8; 118.8], and a GSM of 38.6 [28.6; 52.4], with a predominance of heterogeneous plaques (59%). Femoral artery assessment revealed a median of 2.0 [2.0; 3.0] plaques, 75% [42.5; 111.3] total stenosis, and a minimum echogenicity of 41.5 [33.4; 57.4] gray-scale units, with 65% heterogeneous plaques. Ninety days post-initiation of inclisiran, LDL-C was reduced by 65% (to 1.3 [1.2; 2.9] mmol/L, p<0.01), TC by 30% (p<0.01), triglycerides by 35%, and Lp(a) by 33%. Inclisiran demonstrated high efficacy in reducing LDL-C levels in patients at high and very high risk of cardiovascular disease who failed to reach targets with standard therapy. The identified plaque characteristics indicate a high risk of atherothrombosis in this cohort. The dynamics of these structural plaque changes will be assessed after completing the one-year follow-up. Show less

In the phase 3 CLEAR study, lenvatinib plus pembrolizumab showed improved efficacy versus sunitinib for patients with clear cell renal cell carcinoma (ccRCC). Previous preclinical studies demonstrated that lenvatinib attenuated tumor-associated macrophage (TAM) infiltration into tumor tissues by inhibiting fibroblast growth factor receptor (FGFR). However, the role of the FGFR pathway in ccRCC remains underexplored. This study aims to evaluate FGFR1-4 expression in ccRCC and investigate its relationship with the tumor microenvironment, particularly TAM. We primarily analyzed FGFR1-4 expression and CD163 positive cell count as estimation of TAM infiltration in 57 ccRCC specimens from patients undergoing nephrectomy using immunohistochemistry. Transcriptomic analysis was performed to assess immune-related gene signature and gene expressions. FGFR1 expression was elevated in over 80% of ccRCC samples and was significantly associated with increased CD163-positive TAM infiltration. FGFR1 expression was also negatively correlated with the IMmotion150 Teff gene signature and the expression of interferon-γ signaling targeted genes such as IFNG, GZMB, and CD274, suggesting an immunosuppressive phenotype. In contrast, FGFR2 and FGFR4 expression were less prevalent, and FGFR3 expression was not detected. This study provides the first comprehensive evaluation of FGFR1-4 expression in ccRCC and suggests that FGFR1 expression may contribute to the immunosuppressive tumor microenvironment by recruiting TAM. These findings indicate that FGFR1 could serve as a potential biomarker for therapeutic strategies and highlight the need for further research to explore FGFR-targeted therapies in ccRCC. Show less

To identify associations of polymorphic variants of the genes of Two hundred thirty-five patients with AfD and 62 patients with AR and comorbid AlD aged 18 to 65 years were examined. The severity of AfD was assessed using the Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorder Version (SIGH-SAD) and the Clinical Global Impression (CGI), and the level of anxiety was assessed using the Hamilton Anxiety Rating Scale (HARS) at baseline and on Day 28 of psychopharmacotherapy. Polymorphic variants rs6265, rs7124442, rs11030104, and rs7103411 of the In AfD patients, rs3924999* The polymorphic variants rs3924999 of the Show less

Uveal melanoma (UM), a rare yet aggressive ocular malignancy in adults, highlights the critical need for targeted therapies to improve clinical outcomes. Elevated FGFR1 expression in UM correlates with aggressive disease progression and poor survival outcomes, underscoring its therapeutic value. This study reports the development of [ Show less

Retrospective cohort study of patients undergoing single-level L5-S1 anterior or transforaminal lumbar interbody fusion between 2012 and 2024 at a single academic institution, with preoperative and one-year postoperative radiographic assessment of sagittal alignment parameters. To quantify changes in lumbar pelvic angle (LPA), pelvic tilt (PT), global lumbar lordosis (L1-S1), regional lumbar lordosis (L4-S1), and segmental lumbar lordosis (L5-S1) among single-level L5-S1 ALIF and TLIF patients. Restoration of sagittal alignment is a primary goal of lumbar fusion. While ALIF is regarded as superior to TLIF in restoring segmental lordosis, its effect on global and regional alignment remains uncertain, and few studies directly compare their impact on spinopelvic parameters. The electronic medical record was queried for patients who underwent single-level L5-S1 ALIF or TLIF with preoperative and one-year postoperative imaging. Sagittal parameters were measured using Surgimap software. Group comparisons were assessed with unpaired t-tests or Wilcoxon signed-rank tests. Radiographic measurements were available for 174 patients (ALIF n=73, TLIF n=101). ALIF patients had significantly greater improvement in L4-S1 (+4.2° vs. -1.1°, P=0.002) and L5-S1 lordosis (+4.6° vs. -4.8°, P<0.001). No significant differences were observed in postoperative changes for L1-S1 lordosis (+2.2° vs. -1.4°, P=0.250), LPA (-1.9° vs. -1.4°, P=0.743), or PT (-0.9° vs. +0.4°, P=0.093). Permutation testing confirmed that the observed difference in LPA improvement between cohorts (-0.51°) was not statistically significant (P=0.673), and post hoc analysis confirmed adequate power to detect a difference of 3.37°. Sensitivity analyses using ANCOVA, adjusting for baseline radiographic values and covariates, were concordant. ALIF provided superior regional and segmental lordosis but did not improve global alignment compared with TLIF. This study is the first to quantify the effect of ALIF versus TLIF on LPA, highlighting the limited impact of single-level fusion on global spinopelvic alignment. Show less

Abdominal aortic aneurysm (AAA) is a cardiovascular condition characterized by the abnormal dilation of the abdominal aorta. A circular RNA (circRNA) microarray was utilized to identify differentially expressed circRNAs in angiotensin II (Ang II)-stimulated AAA mice. Male apolipoprotein E-deficient (apoE-/-) mice were randomly assigned to 2 groups and subjected to 28 days of infusion with either Ang II or saline. At the end of the experiment, the mice were euthanized via exsanguination under anesthesia. The periadventitial tissues were carefully removed from the aortic wall to measure the maximal external diameter of the suprarenal aorta, and then stored for further analysis. Samples from both the control and AAA groups were used for circRNA expression profiling. The R package Bioconductor was employed to perform Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Arraystar's proprietary miRNA target prediction software, integrating miRanda and TargetScan, was used to predict the circRNA/miRNA interactions. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was employed to confirm the reliability of the microarray results. A total of 13,103 circRNAs were detected. Compared to the control group, 90 circRNAs were upregulated and 234 were downregulated in the Ang II-induced AAA group. Gene Ontology analysis indicated that the target genes associated with the differentially expressed circRNAs were involved in a variety of biological processes. The KEGG pathway analysis revealed that the differentially expressed circRNAs influenced several critical pathways, including the MAPK signaling pathway, insulin signaling pathway, Ras signaling pathway, and autophagy. The results of RT-qPCR showed that the expression levels of circRNA₃₀₃₉₅, circRNA₃₀₃₉₈ and circRNA₀₁₂₅₉₄ were significantly increased in AAA, while circRNA₀₀₆₀₉₇ and circRNA₀₀₉₉₃₂ were notably decreased. The top 5 miRNAs related to each validated circRNA were identified through bioinformatic analysis. Among these differentially expressed circRNAs, miR-136-5p was predicted to be the target gene of circRNA₃₀₃₉₈ with high probability. The differential expression of various circRNAs identified in AAA suggests that the circRNA-miRNA-mRNA axis may serve as a potential molecular regulatory mechanism for AAA. Show less

Hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) are characterized by left ventricular hypertrophy and diastolic dysfunction. Despite overlapping remodeling features, their distinct mechanisms and therapeutic responses remain unclear. This study integrated genetic, imaging, and proteomic data to identify key mediators underlying β1-adrenergic receptor blockers (β1-blockers)-related therapeutic heterogeneity between HHD and HCM. Genetic instruments for β1-blockers were derived from two genome-wide association studies and integrated with cardiac magnetic resonance radiomic traits and plasma proteomic data from the UK Biobank, along with disease outcomes from FinnGen. A refined two-stage network Mendelian randomization framework with pleiotropy-robust estimators identified mediators of treatment response. To further elucidate their biological and clinical significance, additional analyses were performed, including drug-target profiling, molecular docking, adverse events (AEs) assessment, and drug prediction. We identified three types of imaging features and ten mediator proteins that contributed to therapeutic responses in HHD and HCM. These mediators were categorized as either mediating (aligned with therapeutic outcomes) or suppressing (opposing therapeutic outcomes). Left ventricular regional radial strain acted as a suppressing factor in HHD but a mediating factor in HCM, whereas end-diastolic and end-systolic volumes consistently showed suppressing effects in both. Regional myocardial wall thickness also exerted a suppressing role in HCM. Among protein mediators, APOE, CGREF1, ITGA5, LSP1, NOS3, and NPPB were linked to HHD, whereas DUSP13, ITGA11, NID1, and SERPINA4 were related to HCM. Specifically, APOE, ITGA5, NOS3, NPPB, DUSP13, and ITGA11 acted as mediating factors, while CGREF1, LSP1, NID1, and SERPINA4 served as suppressing ones. These findings remained robust after pleiotropy adjustment and other genetic analyses. Molecular docking revealed interactions between ADRB1, the β1-blockers target, and downstream proteins, while drug prediction identified eight potential compounds linked to these mediators. Additionally, AE analyses indicated that some targets, such as DUSP13, could both mitigate and aggravate common AEs while contributing to cardiac therapy. This integrative multi-omics analysis revealed distinct imaging and proteomic mechanisms of genetically proxied β1-blockers in HHD and HCM, providing genetic evidence for differential therapeutic responses and highlighting molecular targets for precision cardiovascular therapy. Show less

Cholesteryl ester transfer protein (CETP) is a crucial therapeutic target for combating cardiovascular disease (CVD) due to its strong influence in modulating high-density lipoprotein (HDL) levels. CETP is responsible for the bidirectional transfer of cholesteryl esters (CEs) and triglycerides (TGs) between different lipoprotein fractions. Although CETP encounters both these neutral lipid substrates when it penetrates deep into lipoprotein cores and can acquire either lipid, prior studies have examined its conformational space only in the presence of CEs or TGs individually. Here, we investigate the uncharacterised dynamics of CETP in heterogeneous lipid environments (CE-TG and TG-CE) using molecular dynamics simulations. Compared to the stable, homogeneous CE-bound state, the introduction of TG, particularly in mixed CE/TG configurations, induces significant structural instability and protein expansion. Mixed-lipid occupancy leads to elevated flexibility in critical lipoprotein-binding loops and the distortion of vital secondary structural elements. Furthermore, large-scale collective motion analyses reveal that heterogeneous binding forces CETP into aberrant, asymmetric, and hyper-twisted conformations. This disrupts the symmetric bending-twisting balance essential for efficient lipid exchange. Free energy landscapes confirm that the TGs within the mixed-lipid systems exhibit varied conformational states and adopt orientations that deviate from their reported parallel N-N orientation for lipid transfer through CETP. These findings suggest that the simultaneous presence of CE and TG imposes considerable conformational strain, fundamentally impairing CETP's lipid transport mechanism and offering novel mechanistic insights for future CETP-targeted therapeutics. Show less

Lumbrokinase belongs to a group of fibrinolytic enzymes, particularly tissue plasminogen activator (tPA), which can facilitate the proteolytic maturation of brain-derived neurotrophic factor (BDNF). Drugs administered via oral or intravenous routes are often metabolized in the liver or kidneys, and these delivery methods for brain-targeted therapies must overcome the natural barriers of the central nervous system (CNS). Intranasal drug delivery via the nose-to-brain route has emerged as a promising approach to bypass these barriers, enhance drug penetration into the brain, and minimize exposure to peripheral organs. In this study, we demonstrate that intranasally administered lumbrokinase successfully reached the brain. Behaviorally, lumbrokinase significantly improved chronic social defeat stress (CSDS)-induced social avoidance and cognitive impairments. At the molecular level, CSDS increased hippocampal precursor BDNF (proBDNF) expression and reduced mature BDNF (mBDNF) compared with control mice. Importantly, lumbrokinase treatment promoted the expression of tPA and plasmin, thereby restoring the proBDNF/mBDNF balance in the hippocampus and reversing stress-induced maladaptive behaviors. Additionally, lumbrokinase increased TrkB, PSD95, and enhanced phosphorylation of PI3K, AKT, and mTOR in the hippocampus, indicating improved synaptic signaling and plasticity. In conclusion, this study demonstrates that intranasal delivery enables lumbrokinase to reach the brain effectively, providing robust therapeutic benefits against CSDS-induced behavioral and cognitive deficits. Enhancing plasmin-mediated BDNF maturation through non-invasive intranasal enzyme delivery may represent a promising approach for treating stress-related mood disorders. Show less

While a link between cardiovascular risk factors and increased Alzheimer's disease (AD) risk has been reported, it remains unclear whether AD pathology has a direct effect on cardiac function and myocardial innervation. AD and amyloidosis are known to impair neuronal function and affect brain neurotrophic factors (NGF and BDNF) expression. Amyloid aggregates and neuro-signaling impairments may also expose AD patients to peripheral nervous system deficits, promoting cardiac disorders. Here, we provide novel understanding of cardiac physiological impairment, amyloid pathology, neurotrophic factors loss, and impoverishment of cardiac neuronal fibers in Tg2576-AD mice hearts, human cardiomyocytes in culture, and human AD post-mortem left ventricular (LV) heart tissue. We reveal that Tg2576 animals exhibit increased myocardial fibrosis, amyloid β (Aβ) deposition, and brain/heart-axis neurotrophic deficiencies, resulting in myocardial denervation and cardiac dysfunction. Aβ oligomers challenge reduces BDNF expression in both human immortalized and iPSC-derived cardiomyocytes, by disrupting TrkB/CREB signaling. Analysis of human LV AD post-mortem tissue confirms cell and animal results. Our findings reveal potential pathways by which Aβ pathology may disrupt cardiac neurotrophic signaling and physiology, identifying a possible link between AD and heart degeneration. Show less

Backfat thickness, a key selection trait in pig-breeding programmes, has traditionally been measured as a homogeneous layer. However, backfat is anatomically structured into three distinct layers, and each layer likely contributes differently to carcass quality. In addition, previous studies have shown that the deposition of the third layer of backfat is phenotypically correlated with intramuscular fat (IMF). Therefore, targeted selection for specific backfat layers, particularly the third layer, represents a potential strategy to increase IMF content while maintaining a high lean meat percentage. However, the genetic architecture of these distinct porcine backfat layers remains poorly understood. The aim of this study was to estimate the genetic parameters and identify key candidate genes underlying the three backfat layers. We collected B-mode ultrasound images from 561 Landrace pigs to measure individual layer thickness, followed by DNA extraction, genotyping, genetic parameter estimation, and a genome-wide association study (GWAS). Our measurements showed that the first layer of backfat (FBF) is the thickest, followed by the second (SBF) and the third (TBF) layers. Genetic parameter estimation yielded heritability estimates of 0.37, 0.42, 0.38, 0.34, 0.32, 0.24, and 0.21 for total backfat (BF), FBF, FBF/BF, SBF, SBF/BF, TBF, and TBF/BF, respectively. Through integrated analysis of GWAS, Bayesian fine-mapping, and gene annotation, we identified 15 non-redundant candidate genes associated with different backfat layers. These included two genes (SOAT1 and ACBD6) shared by BF and SBF, LPL for BF and FBF, and CAND1 for TBF and TBF/BF. Additionally, SERPINA12 and SERPINA6 were associated with BF; PRKAG1 and PRDM16 with FBF; EPRS1 and SLC39A10 with FBF/BF; PTGES and CRAT with SBF; and ACLY, CAVIN1, and PDZRN3 with SBF/BF. Our results indicate that each layer is governed by a distinct set of genes, which advances our understanding of the genetic basis of backfat layers in pigs. Show less

Intracerebroventricular (ICV) streptozotocin (STZ) deveops Alzheimer's disease (AD)-like conditions in rodents, which are characterized by insulin resistance, tau pathology, and neurodegeneration. Hentriacontane, a natural compound found in various sources, including beeswax, possesses anti-inflammatory and antioxidant properties. In the present investigation, we performed in silico molecular docking, molecular dynamics, MMGBSA, PCA, and FEL analysis of hentriacontane and rivastigmine with acetylcholinesterase (AchE). Further, we assessed the in vivo neuroprotective effects of hentriacontane in an ICV-STZ-induced AD-like condition in rats. STZ (3 mg/kg/ICV) was injected into male Sprague-Dawley rats. Cognitive functions were evaluated by Barnes-Maze (BM), novel object recognition test (NORT), and passive avoidance test (PAT). Hentriacontane (3 and 5 mg/kg) and rivastigmine (1 mg/kg) were given intraperitoneally for 14 days. Brain-derived neurotrophic factor (BDNF), AchE, oxidative stress parameters including GSH, MDA, SOD, and CAT, and proinflammatory cytokines including IL-6, TNF-α, IL-1β, and NF-ҡB were measured via ELISA. Further, we have also estimated the BACE1 and NO levels. Histopathological evaluation was conducted using hematoxylin and eosin staining. In silico molecular docking, dynamics, and post-dynamics data revealed promising binding affinities of hentriacontane for AchE. Further, hentriacontane attenuated ICV-STZ-induced cognitive deficit in BM, NORT, and PAT. Additionally, altered oxidative stress, proinflammatory, and cell signalling parameters were restored. Histopathology revealed that the hentriacontane-treated group showed significant restoration of the small pyramidal cells in the CA1 and CA2 regions of the brain. Hentriacontane demonstrated neuroprotective effects by modulation of AchE, leading to improved cognitive functions as evidenced by in silico and in vivo investigations. Show less

Alzheimer's disease (AD) is characterized by amyloid-β (Aβ) accumulation and brain atrophy; however, the assocation between plasma Aβ biomarkers and regional neurodegeneration remains unclear. We investigated whether plasma Aβ42, Aβ40, and the Aβ42/40 ratio are associated with temporal lobe atrophy measured using tensor-based morphometry (TBM) in cognitively healthy controls (HC) and participants with mild cognitive impairment (MCI). We analyzed longitudinal MRI and plasma biomarkers data from 29 participants from ADNI (HC = 14, MCI = 15) with imaging and blood samples available at baseline, 24 months, and 48 months. TBM Jacobian maps were summarized within temporal lobe regions of interest (ROIs). Associations between plasma Aβ measures and TBM-derived atrophy were examined with linear mixed-effects models, adjusting for age, sex, and APOE ε4 status, with false-discovery-rate correction. Participants with MCI showed greater temporal lobe atrophy compared with HC people, with significantly lower TBM values at follow-up. Plasma Aβ42, Aβ40, and Aβ42/40 levels showed no consistent or robust differences between diagnostic groups. After covariate adjustment and FDR correction, no plasma Aβ-TBM associations were significant at baseline or 24 months. At 48 months, positive associations were identified between Aβ42 and temporal lobe atrophy (measure 2) in HC participants (β = 0.70, p = 0.046) and between Aβ40 and measure 2 in participants with MCI (β = 0.60, p = 0.036). In contrast, a negative association was observed between the Aβ42/40 and temporal lobe atrophy (measure 2) in MCI group (β = -0.53, p = 0.049). TBM captured greater temporal lobe atrophy in participants with MCI compared with HC. Plasma amyloids showed only limited and inconsistent associations with temporal lobe atrophy over time. These findings suggest that plasma Aβ measures alone may not reliably reflect longitudinal regional neurodegeneration in early AD. Show less