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Alzheimer's disease (AD) is the most prevalent cause of dementia, accounting for 60-80% of all cases and characterized by amyloid beta (Aβ) plaques and tau protein hyperphosphorylation. Among the signaling mechanisms implicated in AD, protein kinase C (PKC) isoforms and neuron-specific embryonic lethal abnormal vision-4 (ELAV4) have gained increasing attention due to their roles in synaptic plasticity, neuroinflammation, and mRNA stability. This review discusses the potential for targeting the PKC-ELAV4 axis to manage dementia. PKC isoforms, including PKC α, δ, and ε, are involved in amyloid-beta (Aβ) processing, tau phosphorylation, and regulation of mitochondrial activities, whereas ELAV4 stabilizes mRNAs that participate in both the degradation of Aβ (e.g., neprilysin) and the synthesis of Aβ (e.g., beta-site amyloid precursor protein cleaving enzyme 1, BACE1). We reviewed 75 papers published over the last 15 years using search terms such as neuroinflammation, synaptic plasticity, mRNA stability in dementia, ELAV, ELAV4, PKC, and PKC isoforms in databases including PubMed, WOS, and Google Scholar. Results were summarized, compared, and research gaps were identified during data collection and interpretation. ELAV4 can influence the processing of amyloid precursor protein (APP), the precursor of the amyloid-beta peptide, a hallmark of AD. Decreased expression of ELAV4 in the hippocampus is associated with dementia. PKC-δ activates c-Jun N-terminal kinase (JNK) expression, releases Beclin-1 from the Bcl2/Beclin-1 complex, and promotes autophagy. Oxidative stress and PKC η regulate the mitogenactivated protein kinase (MAPK) pathway, leading to tau phosphorylation and neuronal death. PKCε activators and ELAV4 inhibitors have positive effects on cognitive function and dementia management by inhibiting neuroinflammation and neuronal apoptosis, while PKC α, β, δ inhibitors may aid in managing different forms of dementia. This review highlights research gaps and proposes future directions for targeting the PKC-ELAV4 axis as a novel strategy in dementia management. Show less

Transitions of cancer cells between distinct cell states, which are typically driven by transcription reprogramming, fuel tumor plasticity, metastasis, and therapeutic resistance. Whether the transitions between cell states can be therapeutically targeted remains unknown. Here, using the epithelial-to-mesenchymal transition (EMT) as a model, we show that the transcription reprogramming during a cell-state transition induces genomic instability through R-loops and transcription-replication conflicts, and the cell-state transition cannot occur without the ATR kinase, a key regulator of the replication stress response. ATR inhibition during EMT not only increases transcription- and replication-dependent genomic instability but also disrupts transcription reprogramming. Unexpectedly, ATR inhibition elevates R-loop-associated DNA damage at the SNAI1 gene, a key driver of the transcription reprogramming during EMT, triggering ATM- and Polycomb-mediated transcription repression of SNAI1. Beyond SNAI1, ATR also suppresses R-loops and antagonizes repressive chromatin at a subset of EMT genes. Importantly, inhibition of ATR in tumors undergoing EMT reduces tumor growth and metastasis, suggesting that ATR inhibition eliminates cancer cells in transition. Thus, during EMT, ATR not only protects genome integrity but also enables transcription reprogramming, revealing that ATR is a safeguard of cell-state transitions and a target to suppress tumor plasticity. Show less

The apolipoprotein E epsilon 4 (APOE ε4) gene is associated with an increased risk of developing sporadic Alzheimer's disease (AD). Several studies have focused on declarative memory, where episodic memory deficits are reported in ε4 carriers, while semantic memory has received much less attention. To clarify whether the impact of APOE ε4 on declarative memory is specific to episodic memory, we administered a novel measure of autobiographical memory, the Semantic Autobiographical Interview. Thirty-eight healthy older adults were recruited, 19 ε4 carriers and 19 noncarriers, matched in age, education, and gender. The groups did not significantly differ in any neuropsychological tests except for recognition memory, where ε4 carriers showed reduced performance. On the original Autobiographical Interview (AI), results revealed a reduced number of target details in carriers. Together, these results suggest a reduction of episodic specificity in ε4 carriers. In contrast, carriers had very similar semantic production to noncarriers, whether it was for off-task semantic details in the AI, or on-task general and personal semantic details produced in the Semantic Autobiographical Interview. These results suggest that older adults retain the gist of their personal experience and that the semanticization of their autobiographical narratives is robust and less sensitive to risk for AD than episodic memory. (PsycInfo Database Record (c) 2026 APA, all rights reserved). Show less

Plasma lipoprotein(a) [Lp(a)] levels greater than 50 mg/dL are an independent risk factor for cardiovascular diseases, including heart failure, atherosclerosis, and aortic valve stenosis. Lp(a) exhibits proatherogenic properties by promoting vascular inflammation, thrombosis, and calcification. Several therapeutic agents specifically designed to reduce Lp(a) formation are currently under evaluation in clinical trials or regulatory review. Muvalaplin is notable as the first orally administered drug developed to lower plasma Lp(a) levels. This review evaluates the efficacy, safety, and tolerability of muvalaplin and compares its profile with other Lp(a)- lowering agents. A systematic literature search was conducted using the PubMed database for articles published between 2020 and 2025, with keywords, including muvalaplin, lipoprotein, and cardiovascular. Only original research, clinical trials, and review articles were included. Muvalaplin is an oral small-molecule inhibitor being studied as the first oral Lp(a)-lowering agent. In Phase I trials, daily administration of muvalaplin for 14 days reduced Lp(a) levels by up to 65%. In Phase II trials, 12 weeks of daily muvalaplin resulted in reductions of up to 86% in Lp(a) levels without significant safety or tolerability concerns. These findings suggest that muvalaplin could be a valuable therapeutic option for managing cardiovascular risk associated with elevated Lp(a). Notably, unlike other Lp(a)-lowering agents, muvalaplin did not cause skinrelated adverse events at injection sites. Although the initial clinical data are promising, Phase III trials are required to establish long-term safety and determine whether reductions in plasma Lp(a) translate into meaningful reductions in cardiovascular events. Show less

BackgroundSedentary behavior is common in older adulthood and is associated with poor health outcomes. Less is known about how sedentary behavior relates to cognition in older adulthood and how it relates to increased risk for cognitive decline associated with Alzheimer's disease (AD).ObjectiveWe sought to examine these associations in a large, population-based cohort of community-dwelling older adults residing in a Rust Belt region of the United States.MethodsA subset of the population-based Monongahela-Youghiogheny Healthy Aging Team (MYHAT) participants (n = 193) completed 7 days of wrist-accelerometry following comprehensive neuropsychological assessment. Cross-sectional linear regression models related sedentary time to domains of cognition. Models were adjusted by age, sex, education, and Show less

LDL-C and non-HDL-C do not fully capture coronary heart disease (CHD) risk attributed to all apoB-containing lipoproteins. Use of apolipoprotein B (apoB) as a marker of total atherogenic particle number improves risk prediction, but risk may still be underestimated when triglyceride-rich lipoproteins (TRL/remnants) and lipoprotein(a) [Lp(a)] are elevated. The aim was to formulate a new metric-risk-weighted apoB (RW-apoB)-designed to capture risk from LDL, TRL/remnants, and Lp(a) in a single number. Based on previously published estimates of the relative atherogenicity of LDL, TRL/remnant, and Lp(a) particles, RW-apoB was developed (using UK Biobank data) as an atherogenicity-weighted apoB-sum calculated as: RW-apoB = 11.65×TG(mmol/L) + 0.215×lipoprotein(a)(nmol/L) + 0.736×apoB(mg/dL). Assigning RW-apoB to individuals substantially reclassified their risk status. Compared with ranking by measured apoB, 52% of individuals were up- or down-ranked by ≥10 percentiles. About one-third of those in the top RW-apoB quintile-with elevated TRL and Lp(a) and a CHD event rate of 5.4%-were misclassified as lower risk by apoB. Conversely, individuals in the top measured apoB quintile but with low TRL and Lp(a) had a lower event rate (3.9%) and were correctly down-ranked. RW-apoB improved risk prediction, significantly increasing Harrell's C-index relative to apoB (P < .0001). In statin-treated subjects, RW-apoB was potentially a better index of residual risk. RW-apoB consistently outperformed apoB as a risk predictor in Cox models across the UK Biobank and three other large population cohorts. RW-apoB represents not only particle number but also accounts for the higher atherogenicity of TRL and Lp(a). It offers clinically meaningful improvements in CHD risk stratification. Show less

Alzheimer's Disease (AD), the primary etiology of dementia, remains a considerable challenge owing to the limited availability of pharmacological interventions that effectively modify the course of the disease. This review evaluates CRISPR/Cas9 gene editing as a therapeutic strategy for AD, focusing on its capacity to target genetic drivers (e.g., APP, APOE, PSEN1/2, CD2AP) and modify disease pathology. CRISPR offers unprecedented precision in disrupting AD-associated pathogenic alleles, addressing the limitations of conventional Aβ/tau-targeted therapies that have failed in clinical trials. CRISPR corrects mutations in iPSC/organoid models, normalizing Aβ42/40 ratios and reducing tau hyperphosphorylation. Preclinical studies demonstrate reversal of amyloid accumulation and synaptic degeneration. Key challenges include off-target effects, blood-brain barrier (BBB) delivery limitations, and ethical concerns around permanent genome modifications. This study emphasizes that CRISPR/Cas9 holds transformative potential for AD therapy by targeting root genetic causes. Future success hinges on enhancing delivery systems (e.g., BBB-penetrant vectors) and integrating next-generation editors (base/prime editing) for clinical translation. Show less

Depression induce by chronic neuroinflammation disrupts daily life and work, underscoring the importance of its treatment. It this study, depressive- and anxiety-like behaviors were induced in mice by injecting bacillus Calmette-Guérin (BCG), resulting from chronic neuroinflammation. Daily stimulation with specific acupuncture points (Baihui and Yintang, GV20 and GV29) with electroacupuncture (EA) for 14 days significantly alleviated depressive- and anxiety-like behaviors. Additionally, it also markedly reduced the levels of pro-inflammatory cytokines, including interleukin (IL)-6, IL-1β, and tumor necrosis factor-α, as well as inflammatory markers such as cyclooxygenase-2, in both the plasma and hippocampus. EA Stimulation significantly increased brain-derived neurotrophic factor (BDNF) mRNA expression in the hippocampus. Our results demonstrated that EA stimulation improved depression- and anxiety-like behaviors induced by chronic inflammation, an effect associated with the decreased expression of BDNF via regulation of NF-κB pathway. Show less

Growing evidence suggests that women with endometriosis may be particularly vulnerable to disordered eating behaviors (DEBs) and clinically defined eating disorders (EDs). This narrative review aims at integrating and critically analyzing the current evidence regarding the relationship between endometriosis and EDs, as well as highlighting the psychosocial and neurobiological vulnerabilities of women with endometriosis to DEBs. A large-scale genetic study showed a nearly threefold increase in the odds of EDs in women with endometriosis, and a significant genetic correlation. Although the prevalence of formal ED diagnoses appears low in small clinical samples, DEBs such as emotional eating, binge tendencies, and maladaptive dietary restriction, are common and strongly associated with pain intensity, and borderline BMI. Psychological factors, including body image disturbance, heightened self-criticism, emotional dysregulation, and the need for control further contribute to the vulnerability to EDs. At the biological level, the dysregulation of leptin, endocannabinoids, dopamine, brain-derived neurotrophic factor, and inflammatory cytokines, molecules involved in both appetite regulation and some aspects of the pathophysiology of endometriosis, suggests overlapping neuroimmune pathways that may link endometriosis to DEBs and EDs. Clinical management must, therefore, integrate screening for DEBs, supervised and personalized dietary counseling, balanced exercise prescription, and psychological interventions targeting pain coping, emotion regulation, and body image. A multidimensional, biopsychosocial framework is essential to prevent the onset or exacerbation of EDs in women with endometriosis. Show less

Lupus nephritis (LN) is a severe autoimmune disease often complicated by steroid resistance (SR), leading to treatment failure and poor prognosis like atherosclerosis (AS). Our study found that Panax notoginseng saponins (PNS) improve lipid metabolism and prevent AS in steroid-resistant LN by up-regulating PPARγ, though mechanisms are unclear. Recent research highlights the roles of macrophages, with M1 Mø promoting inflammation and M2 Mø providing protection, as PPARγ influences Mø's polarization, linking it to inflammation and M2 polarization, necessitating further investigation. Therefore, we conduct this study to investigate the regulatory effect of PNS on the "Mø M2 polarization-PPARγ" positive regulation, endeavoring to elucidate its therapeutic potential of delaying AS and reversing SR in LN. PPARγ expression in polarized Mø was measured via PCR and WB, while M1/M2 biomarkers and cytokines, influenced by PPARγ modulation, were assessed using flow cytometry and ELISA. In mouse Mø treated with PNS, IL-4, or both, PPARγ and cytokines were measured. ICR and MRL/lpr mice were used to establish an in vivo SR model to confirm PNS's role in M2 polarization of Mø and AS protection by analyzing blood lipid levels, iNOS, Lp(a), and apoptosis rates through WB, immunohistochemistry, HE-staining, and TUNEL. PNS's efficacy in renal protection and SR reversal was evaluated through Scr, BUN, urine protein, renal pathology, and P-gp; MDR1 expression was assessed via biochemical detection, HE-staining, flow cytometry, and WB. This study confirmed that PNS upregulates PPARγ and promotes M2 polarization, improving abdominal aorta pathology and delaying AS. It also enhances renal function and reverses SR by reducing P-gp and MDR1. This study shows that PNS promotes Mø polarization to M2 and enhances PPARγ expression, effectively preventing AS, improving renal function, and reversing SR in LN, offering insights for LN treatment and expanding PNS's therapeutic benefits for future research. Show less

Problematic social media use (PSMU) has emerged as a societal and behavioral concern, especially among young adults. However, individual differences in symptom manifestation remain understudied. The present study adopted a person-centered approach to identify distinct profiles of PSMU and to examine the predictive roles of fear of missing out (FoMO), problematic smartphone use (PSU), age, and sex among a sample of 625 Italian university students aged 18 to 40 years ( Show less

Alzheimer's disease (AD) is an age-related neurodegenerative disorder that is characterized by neurocognitive dysfunction, deposition of amyloid-β (Aβ) plaques, and formation of hyperphosphorylated tau protein. Oxidative stress and neuroinflammation are the main pathological events in AD development. AD is a gender-dependent brain disorder that is predominant in females. Cessation of production of female hormones, such as 17β-estradiol (either due to menopausal or surgical menopause causes), exhibited pro-AD and neurotoxic activities that deteriorate cognitive functions and promote AD development. We investigated the key regulatory role of gender-dependent factors that control the process of AD neuropathogenesis, on the activities of Nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3) inflammasome, Nuclear factor erythroid 2-related factor 2 (Nrf2), and Apolipoprotein E (APOE). This review aimed to examine the impact of gender-based differences on incidence rates of AD dementia and to reveal the mechanisms regulating the gender differences in AD. In addition, we highlighted the anti-AD activities of sex hormones and the current application of hormonal replacement therapy and estrogen receptor beta-based therapeutic interventions. Furthermore, we presented the impact of gender differences on metabolism in the brain, insulin resistance, and astrocytic activity. Show less

Conflicting data have explored the association between lipoprotein(a) [Lp(a)] and atherosclerotic cardiovascular disease (ASCVD) among individuals with different glucose metabolism statuses. We aimed to prospectively evaluate this association and to assess whether it is modified by C-reactive protein (CRP). This population-based cohort study was derived from the UK Biobank database. Lp(a) and CRP were measured between 2006 and 2010. Cox proportional hazards models and restricted cubic spline curves were employed to assess the relationship between Lp(a) levels and time to ASCVD events. A total of 307 269 participants without prevalent ASCVD were included, comprising 253 746 individuals with normal glucose regulation (NGR), 38 020 with prediabetes, and 15 503 with diabetes. The mean age was 57 years (Q1-Q3: 50-63), and 55.3% were female. Over a median follow-up of 13.2 years, 29 521 ASCVD events occurred. Higher Lp(a) levels were associated with an increased risk of ASCVD across all glucose metabolism statuses. In fully adjusted models, the hazard ratio (95% confidence interval) for ASCVD comparing participants in the top 10% of Lp(a) with those in the bottom 33% was 1.28 (1.22-1.34) among those with NGR, 1.23 (1.12-1.35) among those with prediabetes, and 1.16 (1.02-1.31) among those with diabetes. No significant interactions were observed after stratification by CRP (<2/≥2 mg/L) across glucose metabolism groups (P for interaction >0.05). Elevated Lp(a) levels were associated with a higher risk of ASCVD across different glucose metabolism statuses, particularly among individuals with NGR and prediabetes, independent of baseline CRP levels. Show less

Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis (CAVS), with plasma levels largely unaffected by lifestyle modification or conventional lipid-lowering therapy. Although international guidelines increasingly recognize Lp(a) as a risk-enhancing factor, in many Asian populations thresholds for high Lp(a) and treatment strategies remain undefined. This Korean position paper, developed by the Lp(a) Task Force of the Korean Society of Lipid and Atherosclerosis, presents an evidence-based summary of the pathophysiology, clinical relevance, and therapeutic landscape surrounding Lp(a), with a focus on Korean-specific data. It reviews the genetic architecture of Lp(a), ethnic variability in concentrations, and its mechanistic roles in inflammation, thrombosis, and calcification. Based on large Korean cohorts, a 3-tiered classification is proposed of normal (<30 mg/dL), borderline high (30-49 mg/dL), and high (≥50 mg/dL), harmonizing global thresholds with local data. The document also highlights the limitations of current Lp(a) assays in Korea, and calls for standardized, isoform-insensitive testing. Novel therapeutics, including antisense oligonucleotides, small interfering RNAs, and small molecular inhibitors, have shown promising Lp(a)-lowering effects, with multiple phase 3 trials currently ongoing, or in planning. Given the unmet clinical need, the paper recommends incorporating Lp(a) into cardiovascular risk assessment, and calls for Korean-specific longitudinal studies, national screening strategies, and participation in clinical trials. These efforts will help clarify Lp(a)-associated risk in Korean patients and guide the adoption of future targeted therapies. Show less

Melanocortin 4 receptor (MC4R) deficiency is the most common monogenic cause of obesity, yet remains underdiagnosed. Patients with monogenic obesity often undergo a frustrating diagnostic and therapeutic odyssey of years of ineffective lifestyle interventions before a causal diagnosis is made. We report a four-generation family where genetic testing in a child identified a likely pathogenic MC4R variant also carried by three ancestors. The studied family included a 7-year-old index patient, her mother, grandmother, and great-grandmother with a history of early-onset obesity. Panel sequencing of monogenic obesity genes was performed in the index patient whereas in the relatives targeted analysis of the familial MC4R variant was performed by Sanger sequencing. The index patient developed severe obesity by age 2 years, with hyperphagia, tall stature, and dyslipidemia. Despite lifestyle interventions, her body mass index (BMI) continued to increase. At the age of 7 years, genetic panel testing identified a rare monoallelic variant in the MC4R gene c.913C > T; p.Arg305Trp, previously shown to impair receptor function. Treatment with liraglutide (3.0 mg/day) was initiated at age 8 years, resulting in marked reduction in BMI during the first year of treatment. Subsequent genetic testing of family members identified the same variant in her mother, grandmother, and great-grandmother, all of whom had a history of early-onset obesity and related comorbidities, consistent with segregation of the variant within the family. This case underscores the importance of early genetic testing in severe childhood obesity to avoid ineffective treatments and enable targeted therapies (e.g., GLP-1 analogues). Diagnosing (likely) pathogenic MC4R variants can also identify at-risk relatives, providing psychological and clinical benefits across generations. Show less

To investigate the dose-response relationship between e-health literacy and light physical activity (LPA) in older adults is to provide evidence for targeted interventions that enhance e-health literacy and promote LPA, thereby advancing healthy aging. This study used a convenience sampling method to select two residential neighborhoods. Subsequently, a random cluster sampling approach was employed, resulting in a total final sample of 105 community-dwelling older adults (aged 60 and above) from these neighborhoods. A three-axis accelerometer (ActiGraph wGT3X-BT) recorded the older adults' LPA, and the Electronic Health Literacy Scale assessed their e-health literacy. Multiple linear regression was used to explore the dose-response relationship between LPA and e-health literacy and sub-dimension scores. Multiple linear regression revealed that both the overall e-health literacy score and its components were positively associated with daily LPA (Tables 2 and 3). However, the empirical impact varied substantially across components. For each 1-point increase, LPA increased by 2.8 min for the overall score, 11 min for judgment ability, and 19.4 min for decision-making ability, whereas the effect of application ability was statistically significant but minimal. Notably, the effect sizes of all e-health literacy components were substantially smaller than that of educational attainment (β = 0.638-0.947), which was the strongest predictor in all models. This study provides empirical evidence that higher e-health literacy and its specific sub-dimensions are positively associated with light physical activity (LPA) among community-dwelling older adults, with educational attainment emerging as a key independent predictor. These findings suggest that public health interventions aimed at promoting LPA could be enhanced by incorporating strategies to improve e-health literacy, particularly targeting older adults with lower educational backgrounds. The development of tailored, theory-informed programs based on these insights holds promise for fostering healthy aging at the community level. Show less

Environmental enrichment (EE) has been used as a non-pharmacological intervention to facilitate neurotransmission and improve neurobehaviour. In this study, we examined whether EE improves learning and memory in mice subjected to social isolation (SI)-induced stress through serotonin (5-HT)-mediated histone modifications. Field-caught mice EE mice showed reduced SI-induced anxiety-like behaviour and improved learning and memory compared to STSC and LTSC mice. Furthermore, EE conferred resilience to SI-induced changes in the serotonergic system [e.g., levels of 5-HT; serotonin transporter (SERT); 5-HT3A receptor, and monoamine oxidase A] and facilitated the interaction with transforming growth factor-β1 (TGFB1). The SERT + TGFB1 complex further activated transglutaminase-2 and tryptophan-aspartic acid repeat-containing protein-5, enhances histone-3 lysine-4 trimethylation (H3K4me3), serotonylation of histone-3 glutamine-5 (H3Q5Ser), dual modification (i.e. H3K4me3Q5Ser), and reduced the activity of lysine-specific demethylase 1. Elevated levels of H3K4me3Q5Ser regulated methylation of the brain-derived neurotrophic factor ( Taken together, EE conferred resilience to SI-induced stress and enhanced SERT and TGFB1 interaction, which in turn facilitated the activation of the serotonergic system and histone serotonylation-mediated active transcription of BDNF. Consequently, EE mice exhibited reduced anxiety-like behaviours and improved learning and memory. The online version contains supplementary material available at 10.1186/s13072-025-00653-y. Show less

Puerarin is a flavonoid bioactive component extracted from the Chinese herb radix puerariae, which has been reported to have anti-inflammatory and neuroprotective effects and is a potential drug for the treatment of neuroinflammatory diseases. There is increasing evidence that the gut-liver-brain axis is closely related to neurological disorders. However, studies on the use of puerarin for the treatment of depression based on gut-liver-brain axis-mediated inflammatory injury have not been reported. In the present study, a 4-week chronic restraint stress (CRS) mouse depression model was established. Place the mice in 50 mL centrifuge tubes for restraint. The tubes should be perforated with 15-20 small holes to ensure adequate ventilation. The restraint period is from 9:00 a.m. to 1:00 p.m. daily, during which food and water are withheld. Based on the results of previous studies, the better antidepressant dose of puerarin, 100 mg/kg, was chosen, and fluoxetine was used as a positive control to investigate the intervention effect and potential mechanism of puerarin on depression. All of the aforementioned drugs were administered via oral gavage. Sucrose preference test (SPT), tail suspension test (TST), open field test (OFT), novelty suspended feeding test (NSFT) and forced swimming test (FST) were used to observe the behavioral changes in mice to assess the antidepressant effects. The microbial composition of the intestinal tract was analyzed using 16S rRNA gene sequencing. Histopathological changes in colon and liver were also observed by HE staining method. The levels of lipopolysaccharide (LPS) in colon, serum, liver and prefrontal cortex (PFC) and the levels of 5-hydroxytryptamine (5-HT) in prefrontal cortex were detected by enzyme-linked immunosorbent assay (ELISA). The method was developed for the detection of 5-HT in the prefrontal cortex. The serum levels of glutamate transaminase (AST) and alkaline phosphatase (ALP) were measured by microplate assay. Finally, the expression of brain-derived neurotrophic factor (BDNF), TLR4, MYD88, p-IκB-α, and p-p65 proteins were determined by immunoblotting assay (Western Blot, WB) in mice with PFC. Puerarin was effective in alleviating CRS-induced depression-like behaviors measured in SPT, TST, FST and NSFT in mice. Compared with the CRS model group, puerarin increased the rate of sugar-water preference in the SPT and shortened the cumulative immobility time in the TST and FST as well as the ingestion latency in the NSFT in depressed mice. In addition, puerarin administration ameliorated CRS-induced gut microbiota dysbiosis in mice, elevating the abundance of Lactobacillaceae, Lactobacillus spp. Decreased the relative abundance of Ruminococcaceae, Ruminococcus, Desulfovibrionaceae, and Prevotella spp. Puerarin also reduced LPS, AST and ALP levels, improved damaged colon and liver tissues, inhibited neuroinflammatory damage mediated by the TLR4/MYD88/NF-κB signaling pathway, and up-regulated the levels of 5-HT and BDNF in the prefrontal cortex of the mice, thereby reversing CRS-induced depressive-like behaviors in depressed mice. Puerarin can improve CRS-induced depression in mice by regulating the gut-liver-brain axis and its related molecules. For example, it can regulate CRS-induced intestinal flora disorders and intestinal permeability, thereby reducing systemic LPS levels and the relative levels of AST and ALP, inhibiting the activation of the TLR4/MYD88/NF-κB signaling pathway by LPS, thereby reducing neuroinflammatory damage, and ultimately improving the depressive symptoms of CRS mice. Show less

Lead is a toxic heavy metal that poses significant health risks, which include neurodevelopmental disorders such as autism spectrum disorder (ASD). This review examines the effects of lead neurotoxicity on synaptic pathways which are relatively unexplored and their potential role in the development of ASD. Lead exposure occurs through various environmental sources, including contaminated water, soil, paint, and industrial appliances. Once absorbed, lead accumulates in soft tissues and bones, causes prolonged neurological damage, especially in children. ASD is characterised by impaired communication, repetitive behaviours, and cognitive challenges, with increasing evidence linking environmental factors like heavy metal exposure to its onset. Synaptic signalling disruption is a key aspect of ASD and lead interferes with the synaptic pathways by inhibiting calcium influx, leading to cognitive impairments and memory issues. This review is an overview of the previously reported findings that explains the role of lead in reducing N-methyl-D-aspartate receptors (NMDAR) function, disrupting the brain-derived neurotrophic factor (BDNF) pathway, and impairing Wnt, GABAergic and dopaminergic signalling pathways. These alterations result in cognitive decline, impaired synaptic plasticity and increased ASD symptoms. Understanding these mechanisms is crucial for developing strategies to mitigate the adverse effects of lead exposure on neurodevelopment. Show less

Our early study showed the vasoactive effects of soybean lecithin-derived lysophosphatidic acid (LPA). The finding indicates that the oral administration of LPA-rich supplements is beneficial to human health. Our studies have showed five beneficial effects of LPA in the upper digestive systems. First, we detected LPA at high levels in various herbs used in Chinese traditional medicine for the treatment of gastric ulcers, as well as other foods, including various vegetables. Second, we found human mixed saliva to be an LPA-rich biological fluid, suggesting its protective effect on human oral mucosa. Third, LPA levels in gingival crevicular fluid from patients with periodontitis was lower than that in healthy subjects, reinforcing the protective quality of LPA. Fourth, daily topical injections of LPA in rat buccal gingiva reduced the degree of alveolar bone absorption induced by oral bacteria in rats with experimental periodontitis. Fifth, repeated intragastric administration of LPA-rich herb reduced the degrees of gastric ulcer induced by stress (rats) or medication (mouse). Previous findings on the beneficial effects of LPA acting on the lumen side of the lower digestive tracts in mammals are well documented, although results on the harmful effects of LPA on mouse and rats with genetically easy to progress colon cancer are noted. Our studies also showed a novel pathway of LPA generation by lysophospholipase D activity of glycerophosphodiesterase 7 on the lumen side of digestive tracts. These findings suggest that additional research into creative food supplements focusing on LPA as a food factor could be beneficial. Show less

Antioxidant supplements have emerged as promising strategies to mitigate the impact of Alzheimer's disease (AD) and associated dementia. We explored the neuroprotective potential of Carvone nanoemulsion (CANO) using a rat model of AD-associated dementia. Our experimental groups comprised non-AD control rats (CON), untreated AD rats (AD), and AD rats treated with CANO at two different dosages: 40 mg/kg (CANO40) and 80 mg/kg (CANO80). We assessed various behavioral parameters, malondialdehyde (MDA) and brain-derived neurotrophic factor (BDNF) levels,ferric-reducing ability of plasma (FRAP). AD induction caused a significant reduction in step-through latency (P < 0.001), center time (P < 0.001), the number of visits (P < 0.001), and total distance traveled (P < 0.001), time spent in open arms (P < 0.001), and both FRAP (P < 0.001) and BDNF levels (P < 0.001) in comparison to the CON group, while elevating escape latency, time in target zone and platform location latency, and MDA levels (P < 0.001). Treatment with CANO, particularly at the CANO80 dosage, significantly improved these parameters compared to the AD group, resulting in decreased time in the target zone (P < 0.001), escape latency (P < 0.001), and platform location latency (P < 0.001) and higher FRAP (P < 0.05) and BDNF levels (P < 0.05), along with decreased MDA levels (P < 0.05). CANO, especially at the 80 mg/kg dosage, shows promise in alleviating symptoms associated with AD-associated dementia. However, further research is warranted to validate and expand upon these findings. Show less

Parkinson's disease (PD) is a heterogeneous clinical syndrome representing the final stage of a complex and long-lasting neurodegenerative process that involves not only dysfunction of the dopaminergic system but also impairments in other neurotransmitter systems. The diversity of the clinical presentation of PD, together with the existence of Parkinsonian syndromes and atypical Parkinsonism-such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and dementia with Lewy bodies (DLB)-has important implications for rehabilitation outcomes and underscores the need for individualized, stage-dependent therapeutic approaches. Juggling is a complex motor activity that integrates cognitive, visuomotor, and balance processes, requiring a high level of concentration, precision, and motor adaptation. In recent years, there has been growing interest in this form of activity as a potential tool for supporting neuroplasticity, cognitive functions, and neurological rehabilitation. The aim of this review was to summarize current scientific evidence on the effects of juggling training on cognitive functions, visuomotor coordination, and balance, as well as to discuss the potential benefits of combining it with controlled hypoxia in patients with Parkinson's disease (PD). This narrative review additionally considers how disease heterogeneity and stage of progression may influence the effectiveness of such multimodal interventions. This paper reviews the literature concerning the neurophysiological basis of learning to juggle and the mechanisms of brain plasticity, including increases in gray matter volume, improvements in white matter integrity, and reorganization of neuronal networks in motor and associative regions. Attention is drawn to the synergistic potential of combining juggling training with exposure to moderate, controlled hypoxia, which may induce an adaptive response involving the transcription factor HIF-1α, enhance the expression of brain-derived neurotrophic factor (BDNF), and promote angiogenesis and mitochondrial biogenesis. Although juggling and hypoxia are not directly related to training stimuli, both interventions activate overlapping and complementary neuroplastic pathways, providing a conceptual rationale for their parallel consideration and potential integration within future rehabilitation protocols. Juggling delivers task-specific motor-cognitive learning, whereas hypoxia may amplify molecular plasticity signaling, potentially enhancing responsiveness to motor interventions, particularly in patients at early stages of PD when compensatory mechanisms and neuroplastic capacity are relatively preserved. Findings from existing studies suggest that juggling under controlled hypoxic conditions may represent an innovative, safe, and multimodal form of training that supports both cognitive and motor components. Such effects may be particularly relevant in patients at early stages of PD, when compensatory mechanisms and neuroplastic potential are relatively preserved. Such an intervention may contribute to improvements in balance, attention, executive functions, and cognitive flexibility, which is particularly relevant in the context of rehabilitation for patients with neurodegenerative diseases. Importantly, to date, no randomized clinical trials have directly examined juggling performed under controlled hypoxic conditions in PD. Therefore, the present concept should be regarded as translational and exploratory, integrating evidence from juggling-induced neuroplasticity and hypoxia-related physiological adaptations. In this context, the proposed approach represents a proof-of-concept framework for future multimodal interventions rather than an established therapeutic strategy. Available evidence suggests that combining complex sensorimotor skill training with physiological modulation of the internal environment may constitute a novel direction in PD rehabilitation, extending beyond conventional exercise-based models. Despite promising reports, further well-designed clinical studies are needed to determine the optimal training parameters (frequency, intensity, duration, and degree of hypoxia), to evaluate the long-term sustainability of therapeutic effects, and to account for the heterogeneity of PD and related Parkinsonian disorders. Show less

Atherosclerotic lesions are the fundamental pathologies of cardiovascular diseases. The exact role of the nuclear factor erythroid 2-related factor 2 (NRF2) in macrophages in atherosclerosis remains uncertain. This study aimed to investigate the role of NRF2 in myeloid cells in the development of atherosclerosis. Single-cell RNA sequencing databases were used to explore the expression levels of NRF2 in human and murine atherosclerosis. Plaque areas, necrotic core size, instability index, and efferocytosis in aortic lesions were investigated in myeloid cell-specific Nrf2-knockout mice on an ApoE-deficient background (Nrf2(M)-KO; ApoE NRF2 expression was upregulated in the macrophages of human and murine atherosclerotic arteries compared with their corresponding controls. Nrf2(M)-KO; ApoE Myeloid-specific deletion of Nrf2 promotes inflammation and inhibits macrophage efferocytosis, thereby leading to the aggravation of atherosclerosis. NRF2 activation in macrophages could be a valuable strategy for preventing and treating atherosclerosis. Show less

Hypertension is a multifactorial condition of unknown cause that affects more than 1.28 billion adults worldwide and impacts the sexes differently. The hypothalamic paraventricular nucleus (PVN) plays a central role in blood pressure (BP) regulation by modulating sympathetic tone and releasing neuropeptides that affect the cardiovascular function. In this study, we investigated the transcriptomic profile of the PVN in hypertensive strains and across sexes, aiming to identify novel sex-specific molecular pathways involved in the regulation of BP. To accomplish this goal, we sequenced RNA from the PVNs of normotensive Wistar rats and Spontaneously Hypertensive Rats (SHR), both male and female. We also performed a cardiovascular assessment based on blood pressure (BP) measurements and their variability. Cardiovascular assessment revealed higher SBP in SHRs than in Wistar rats; while males exhibited greater autonomic regulation associated with vasomotor and neurohumoral mechanisms, while females maintained comparable SBP levels primarily through an increase in heart rate, reflecting distinct autonomic adaptations. Hypertension also impacted gene expression, with influences from both the hypertensive state and sex. Compared with female SHRs, male SHRs presented a marked increase in differentially expressed genes (DEGs). Key upregulated genes in males, including Brain-Derived Neurotrophic Factor (Bdnf) and Hypocretin (Hcrt), have already been linked to elevated BP, and Angiotensin II Receptor Type 1 (Agtr1a) is possibly associated with increased SBP-VLF variability, which serves as an indirect measure of enhanced sympathetic tone. In contrast, the female transcriptomic signature was characterized by the upregulation of anti-inflammatory pathways, with upregulation of NLR Family CARD Domain Containing 3 (Nlrc3) and Paired Ig-like Receptor B (Pirb), and downregulation of Absent in Melanoma 2 (Aim2), and S100 Calcium Binding Protein B (S100b). Notably, genes associated with neuroinflammation, such as the downregulation of Annexin A1 (Anxa1) and the upregulation of Solute Carrier Family 11 Member 1 (Slc11a1), were consistently altered in both sexes. These results provide new insights into the cardiovascular and molecular basis of sex differences in hypertension, suggesting distinct neurohumoral autonomic profile in males, whereas in females a greater anti-inflammatory component. These findings offer a valuable framework for developing future sex-specific therapeutic strategies. Show less

Traumatic brain injury (TBI) is a well-recognized risk factor for late-life cognitive decline. However, few studies have examined individual differences in sex and genetics, which may modify risk. We examined sex differences in gene-TBI interactions for dementia risk genes apolipoprotein E (APOE) and selected brain-derived neurotrophic factor (BDNF) single-nucleotide polymorphisms (SNPs) in predicting late-life cognitive decline. We studied 4293 individuals without dementia at baseline (mean age: 74.93, SD: 6.87 years, 57% female). Approximately 25% reported a history of TBI. Linear mixed effects models examined associations between sex, TBI characteristics, APOE genotype, BDNF SNPs and their interactions, with cognitive decline. Compared to males, females experienced fewer TBIs across the lifespan, the majority occurring in late-life. Number of TBI interacted with sex and APOE genotype such that female APOE ε4 allele carriers with multiple TBIs exhibited worse outcomes on global cognition (P < .001; eg, ε4+/TBI2+ estimated marginal means [EMMs] from baseline to year 10 = -17.22 points compared with ε4-/TBI2+ = -7.21), whereas males did not exhibit differential decline by APOE ε4 alleles and TBI number. BDNF Val66Met genotype showed trend-level moderation of TBI history and cognitive decline, with slower decline experienced by heterozygous individuals with multiple TBIs compared with homozygous major allele carriers. There were few significant associations between timing and severity of TBI with cognitive outcomes. These results underscore the importance of considering individual differences of sex and APOE and BDNF-related gene variants on the long-term cognitive effects of TBI. Show less

Lymphoplasmacytic lymphoma (LPL) is a rare, indolent B-cell malignancy, with the IgG subtype being particularly uncommon. We present a case of IgG-type LPL complicated by kidney dysfunction due to light chain deposition disease (LCDD), representing the first documented instance of LCDD-related kidney impairment in this lymphoma subtype. A 65-year-old man presented with lower extremity edema and was found to have significant kidney dysfunction. Laboratory tests revealed elevated serum creatinine, heavy proteinuria, and a markedly skewed free light chain κ/λ ratio. Immunofixation electrophoresis identified an IgG-κ monoclonal protein and Bence Jones protein (κ light chain). Bone marrow biopsy confirmed LPL with a MYD88 L265P mutation, while kidney biopsy demonstrated mesangial proliferation, interstitial fibrosis, and granular κ light chain deposits consistent with LCDD. Given the rarity of IgG-type LPL with kidney involvement, this case underscores the importance of a thorough diagnostic workup in patients presenting with both hematologic malignancy and kidney dysfunction. Early recognition and appropriate management are critical for improving patient outcomes. As non-IgM LPL cases have historically been associated with poorer prognoses compared to Waldenström macroglobulinemia, the identification of underlying kidney complications such as LCDD is essential. Further accumulation of similar cases is needed to establish optimal treatment strategies. Show less

Circadian rhythms have been reported in a variety of physiological processes that may influence cardiovascular disease, while little is known about the effects of circadian rhythm-related genes (CRRGs) on acute myocardial infarction (AMI). The genome-wide association study (GWAS) data of AMI (ukb-a-533) and expression quantitative trait loci (eQTL) data of CRRGs were downloaded from the integrative epidemiology unit Open GWAS database. The relationship between the CRRGs and AMI was assessed by the two-sample Mendelian randomization (TSMR) analysis. The hub genes that could directly affect AMI were identified based on the inverse variance weighted (IVW) algorithms. Subsequently, the TSMR results were evaluated via sensitivity analyses and MR-Steiger filtering. Then, the expression in immune cells and tissues was predicted from the Human Protein Atlas and Genotype-Tissue Expression databases. Finally, the molecular regulatory networks were generated based on the hub genes. In TSMR results, NR1H3 (IVW: odds ratio (OR) = 1.0009, 95% confidence interval (CI) = 1.0005-1.0013), SREBF1 (IVW: OR = 1.0015, 95% CI = 1.0007-1.0022), SIRT1 (IVW: OR = 1.0007, 95% CI = 1.0001-1.0013), and HIF1A (IVW: OR = 1.0022, 95% CI = 1.0004-1.0039) were risk factors for AMI patients, while NCOA1 (IVW: OR = 0.9984, 95% CI = 0.9969-0.9998) was a protective factor for AMI patients (P < .05). Importantly, the 5 hub genes could affect AMI occurrence in one direction. The expression levels of HIF1A, NCOA1, and SREBF1 were highest in neutrophils than the other immune cells. Also, HIF1A and SREBF1 had higher expression in the heart (left ventricle and atrial appendage) and artery (aorta, tibial, and coronary). Moreover, the transcription factor, NFKB1, might regulate the hub genes except for NCOA1. Generally, 4 risk genes (NR1H3, SREBF1, SIRT1, and HIF1A) and 1 protective gene (NCOA1) associated with circadian rhythm for AMI patients were identified, providing new insights into the diagnosis and treatment of AMI. Show less

Stressful life events (SLE) are associated with an increased likelihood of developing depression. However, the underlying mechanisms and the long-lasting consequences of SLE exposure during adolescence, a critical period for physical, sexual, and behavioural maturation, are largely unknown. Recent studies suggest that they might be mediated by aberrant epigenetic mechanisms, such as alterations in DNA methylation, histone modifications and the expression of microRNAs. This systematic review aims at investigating the epigenetic markers affected by SLE during adolescence and their (causal) contribution to the onset of depression later in life. In line with the PRISMA 2020 guidelines and following a pre-registered protocol (CRD42023441784), PubMed, Web of Science and Embase were screened and 30 studies, including both rodents (n = 19) and humans (n = 11), met the pre-defined inclusion criteria. The preclinical findings converge on SLE-related changes in DNA methylation of Bdnf gene and alterations in microRNAs implicated in the regulation of Bdnf- and glucocorticoid-related pathways. The clinical studies focused primarily on DNA methylation and microRNAs alterations. Whilst a consensus on specific SLE-related epigenetic modifications did not emerge, novel pathways, including extracellular vesicle (EV) miRNAs, should be further investigated to be employed as biomarkers for preventive screening. Overall, our systematic review provides early suggestive evidence on the role of epigenetic mechanisms in mediating the effects of SLE in adolescence and the consequent onset of depression-relevant symptoms in later life. However, the paucity and the heterogeneity of the findings highlight the need for additional studies to address this fundamental research question and provide solid evidence for causality. Show less

Small dense low-density lipoprotein (sdLDL) is a highly atherogenic LDL subclass associated with cardiovascular disease (CVD). While type 1 diabetes confers increased cardiovascular risk despite adequate glycemic control, the role of sdLDL and its regulators remains unclear. In this cross-sectional observational study, plasma from 69 individuals with long-standing type 1 diabetes and 24 healthy controls was analyzed. sdLDL-cholesterol (sdLDL-C) concentration, sdLDL-C/LDL-cholesterol ratio, LDL size and subclasses were assessed using homogeneous assays, NMR spectroscopy, and gradient gel electrophoresis. Apolipoprotein C3 (ApoC3), hepatic lipase (HL), endothelial lipase (EL), and cholesteryl ester transfer protein (CETP) activity were measured by immunoturbidimetric, ELISA and functional assays. Despite adequate glycemic control (mean HbA1c 7.6% [60 mmol/mol]) and near-normal lipid levels, individuals with type 1 diabetes had significantly higher sdLDL-C (0.56 ± 0.28 mmol/L vs 0.43 ± 0.26 mmol/L), increased sdLDL-C/LDL-cholesterol ratio (0.20 ± 0.08 vs 0.12 ± 0.06) and smaller LDL particle size (26.32 ± 1.08 nm vs 26.81 ± 0.68 nm) compared with controls. ApoC3 and HL mass/activity were significantly increased (8.67 ± 3.22 mg/dL vs 6.53 ± 2.42; 46.60 ± 16.12 ng/mL vs 15.45 ± 7.40 ng/mL and 1.03 ± 0.24 U/mL vs 0.89 ± 0.23 U/mL; respectively), CETP activity significantly reduced (808.8 ± 197.0 pmol/mL/h vs 929.7 ± 149.6 pmol/mL/h), and endothelial lipase levels unchanged. sdLDL-C positively correlated with ApoC3 (r = 0.7517) and inversely with CETP activity (r = -0.2682). Long-standing type 1 diabetes with adequate glycemic control is associated with an atherogenic sdLDL profile despite near-normal conventional lipid levels. This first multi-method characterization study of sdLDL in type 1 diabetes highlights the contribution of ApoC3, CETP and HL to sdLDL-C enrichment and suggests that direct assessment of sdLDL may improve cardiovascular risk stratification. Show less