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Reducing LDL cholesterol prevents atherosclerotic cardiovascular disease (ASCVD) events. The aim of this study was to evaluate the LDL cholesterol-lowering efficacy of a fixed-dose combination (FDC) of obicetrapib, a CETP inhibitor, and ezetimibe. This randomised, double-blind trial across 48 US sites including hospitals, private and group practices, and independent research centres included participants at least 18 years old with pre-existing or high risk for ASVCD or heterozygous familial hypercholesterolaemia with LDL cholesterol concentrations of 1·8 mmol/L (70 mg/dL) or greater despite maximally tolerated lipid-lowering therapy excluding ezetimibe, or having statin intolerance. Participants were randomly assigned (1:1:1:1) to obicetrapib 10 mg plus ezetimibe 10 mg FDC, obicetrapib 10 mg monotherapy, ezetimibe 10 mg monotherapy, or placebo administered daily for 84 days. The co-primary endpoints in the intention-to-treat population were the percent LDL cholesterol changes in the FDC group compared with placebo, ezetimibe monotherapy, and obicetrapib monotherapy, and the placebo-adjusted change in the obicetrapib monotherapy group. The trial was prospectively registered (NCT06005597) and is completed. Between March 4 and July 3, 2024, 407 participants were randomly assigned. The median age was 68·0 years (IQR 62·0-73·0) and 177 (43%) were female. Mean baseline LDL cholesterol was 2·4 mmol/L, 2·5 mmol/L, 2·6 mmol/L, and 2·5 mmol/L in the placebo (n=102), ezetimibe monotherapy (n=101), obicetrapib monotherapy (n=102), and FDC groups (n=102), respectively. At day 84, percent differences in LDL cholesterol reduction with the FDC were -48·6% (95% CI -58·3 to -38·9) versus placebo, -27·9% (-37·5 to -18·4) versus ezetimibe, and -16·8% (-26·4 to -7·1) versus obicetrapib. Obicetrapib monotherapy decreased LDL cholesterol by 31·9% (22·1 to 41·6) versus placebo. Adverse event rates were similar in the FDC (52 [51%] of 102), obicetrapib (55 [54%] of 102), and ezetimibe (54 [53%] of 101) groups and lowest with placebo (38 [37%] of 102). Serious adverse event rates were generally similar across FDC (three [3%] of 102), obicetrapib (six [6%] of 102), ezetimibe (seven [7%] of 101), and placebo (four [4%] of 102) groups. Deaths occurred in one [1%] of 102 participants with FDC, one [1%] of 102 with obicetrapib, one [1%] of 101 with ezetimibe, and none with placebo. Combination therapy of obicetrapib and ezetimibe significantly reduced LDL cholesterol. This oral, single-pill therapy could improve LDL cholesterol management in patients with pre-existing or high risk for ASCVD. NewAmsterdam Pharma. Show less

Whether lipid-modifying drugs directly impact the outcome of sepsis remains uncertain. Therefore, systematic investigations are needed to explore the potential impact of lipid-related therapies on sepsis outcomes and to elucidate the underlying mechanisms involving circulating inflammatory cytokines, which may play critical roles in the pathogenesis of sepsis. This study aimed to utilize drug-target Mendelian randomization to assess the direct causal effects of genetically proxied lipid-modifying therapies on sepsis outcomes. First, a two-sample Mendelian randomization study was conducted to validate the causal associations among high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and sepsis. A subsequent drug-target Mendelian randomization study assessed the direct causal effects of genetically proxied lipid-modifying therapies on the risk of sepsis, sepsis-related critical care admission, and sepsis-related death. The identified lipid-modifying drug targets were subsequently explored for direct causal relationships with 36 circulating inflammatory cytokines. Finally, enrichment analyses of the identified cytokines were conducted to explore the potential relationships of lipid-modifying drugs with the inflammatory response. Genetically proxied cholesteryl ester transfer protein (CETP) inhibitors were significantly associated with sepsis-related critical care admission ( This study supports a causal effect of genetically proxied CETP inhibitors in reducing the risk of sepsis-related critical care admission and death. These findings suggest that the underlying mechanism may involve the modulation of some circulating inflammatory cytokines, influencing the inflammatory response pathway. Show less

Glioma is a highly aggressive malignancy with no effective treatment. This study investigates the role of protein tyrosine phosphatase receptor type N (PTPRN) in glioma progression. The U87 human glioma cell line was used to monitor proliferation, invasion, and migration during PTPRN knockdown. The viability, migration, and invasion were analyzed using the Cell Counting Kit-8 assay, transwell migration, and invasion assays. Additionally, the expression of proteins associated with the cell cycle was examined using western blotting. The knockdown of PTPRN resulted in a reduction in glioma cell proliferation, migration, and invasion, as well as the expression of cell cycle markers like Show less

Cardiovascular disease (CVD) is the leading cause of mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), yet traditional risk predictors remain limited in clinical practice. To develop machine learning (ML) models for classifying prevalent atherosclerotic cardiovascular disease (ASCVD) risk in MASLD patients, and to enhance model interpretability using SHapley Additive exPlanations (SHAP). Methods: This retrospective study included 590 MASLD patients diagnosed at the Affiliated Hospital of Qingdao University between December 2019 and December 2024. Patients were randomly divided into a training set (n=413) and a validation set (n=177), and further stratified based on ASCVD status. Least absolute shrinkage and selection operator (LASSO) regression was used for feature selection. Six ML models were developed and evaluated using sensitivity, specificity, accuracy, area under the receiver operating characteristic curve (AUC), and F1 score. SHAP analysis was performed to interpret feature contributions. ASCVD was present in 434 of 590 patients (73.6%). The Gradient Boosting (GB) model achieved the best performance, with AUCs of 0.918 (95% CI: 0.890-0.944) in the training set and 0.817 (95% CI: 0.739-0.883) in the validation set. SHAP analysis identified the top predictors as the Cholesterol-HDL-Glucose (CHG) index, Castelli Risk Index II (CRI-II), lipoprotein(a) [Lp(a)], serum creatinine (Scr), and uric acid (UA). The GB model demonstrated strong high accuracy in identifying existing ASCVD in MASLD patients and may serve as a useful tool for early risk stratification in clinical settings. Show less

Macroautophagy/autophagy is a stress-responsive lysosomal catabolic pathway that promotes cellular homeostasis and tumor cell survival, but its role in breast cancer progression and metastasis remains unclear. Here, we show that a brain-specific serine/threonine protein kinase, BRSK2, a marker of aggressive metastatic disease in breast cancer patients, is crucial in regulating autophagy. BRSK2 is overexpressed in aggressive cancer and is associated with reduced disease-specific survival. BRSK2 also regulates basal autophagy and activates AKT, STAT3, and NF-κB-mediated cancer cell survival pathways. In addition, BRSK2 overexpression increases the levels of inflammatory cytokines and chemokines in breast cancer cells. Downregulation of BRSK2 using specific siRNAs or the BRSK2 kinase small-molecule inhibitor GW296115 markedly reduced nutrient-deprivation stress-mediated autophagy, cell growth, and metastatic potential, and enhanced breast cancer cell apoptosis. Endogenous BRSK2 is associated with the Vps34-class III PI3K-Beclin-1-ATG14 autophagy signaling complexes that could protect cancer cells from nutrient-deprivation stress. Our findings demonstrate the key role of the BRSK2-mediated protective autophagy and cell growth and survival under nutrient deprivation stress via survival signals, e.g., PI3K/AKT or STAT3-NF-kB, in aggressive breast cancer cells. Show less

The World Health Organization (WHO) has endorsed a range of diagnostic tuberculosis (TB) over the years. A little is documented about the uptake in the WHO African Region (WHO/FR). We assessed the uptake of the endorsed diagnostic technologies for tuberculosis through a literature review. We reviewed literature in French and English from PubMed, Google Scholar, and Embase for TB diagnostics endorsed by WHO between January 2007 and December 2017, extending to December 2021 for recent technologies. We included publications from the 47 countries in the WHO/AFR. Data were analyzed using PRISMA diagrams and STATA 14.0. Out of 3,399 articles, 1,716 articles were screened, and 92 qualified for analysis. The majority of articles were on Xpert MTB/RIF (XPERT) 22 (47%), Line Probe Assay (LPA), 10 (21%), and Mycobacteria Growth Indicator Tube (MGIT) 9 (19%). For rollout, 11 (24%) of countries had publications on Lipoarabinomannan (LAM) and 16 (36%) on XPERT. The median years for uptake were 6 for MGIT, 5 for XPERT, and 2.5 for LPA. For the rollout, the median years for MGIT, LPA, and XPERT were 7, 6, and 5 respectively. Our study shows that the uptake and rollout are slow. Future studies should identify factors affecting rapid uptake and rollout. Show less

Cognitive decline is a common aspect of aging, and identifying modifiable lifestyle factors, such as physical activity and sleep, is crucial for promoting healthy brain aging. While both are individually linked to cognition, few studies have simultaneously assessed their independent and combined effects using objective wearable-based data, particularly in older Asian populations. This study aimed to examine the independent and interactive effects of wearable-assessed sleep and physical activity parameters on memory performance in healthy older adults. We also explored whether age and hippocampal volume moderated these associations. This prospective cross-sectional analysis included 88 cognitively healthy community-dwelling adults (≥60 years of age) from the Integrating Systematic Data of Geriatric Medicine to Explore the Solution for Healthy Aging cohort in Taiwan. Participants underwent 12-day wrist-worn actigraphy, brain magnetic resonance imaging, and neuropsychological assessments. Light-intensity physical activity (LPA) and wake after sleep onset (WASO) were selected based on age-adjusted partial correlations with Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery memory scores. Multivariate regressions, age-stratified models (cutoff=72 years), and PROCESS moderation and mediation analyses were conducted, adjusting for age, education, daytime sleepiness, and hippocampal volume. Partial correlation analyses adjusting for age showed that higher LPA (r=0.260; P=.02) and lower WASO (r=-0.251; P=.02) were significantly associated with better memory scores. Age significantly moderated both effects: LPA was beneficial beyond 73.8 years of age, and WASO was detrimental beyond 71.1 years of age. Multivariate regression models confirmed that both WASO (β=-.044; P=.04) and LPA (β=.042; P=.01) were significant predictors of memory. In subgroup analyses (age ≥72 years), both LPA (β=.054; P=.04) and WASO (β=-.111; P=.01) remained significant predictors. Moderated mediation analyses showed that WASO was associated with reduced LPA (β=-.325; P=.03), but the indirect effect on memory via LPA was not significant. Instead, WASO exerted a direct and age-moderated effect on memory performance. Hippocampal volume moderated both associations, supporting the brain reserve hypothesis. Our findings highlight WASO and LPA, as measured by wearable devices, as modifiable behavioral factors linked to memory function in older adults. The impact of these factors intensifies with advancing age and may be influenced by hippocampal reserve. Promoting daily light physical activity and maintaining sleep continuity may serve as accessible, age-tailored strategies for preserving cognitive health in aging populations. ClinicalTrials.gov NCT04207502; https://classic.clinicaltrials.gov/ct2/show/NCT04207502. Show less

To explore the potential categories of fear of falling in elderly stroke patients and analyze the differences in characteristics and influencing factors among patients in different categories. AA total of 386 elderly stroke patients hospitalized in the Department of Neurology of a tertiary grade A general hospital in Jilin Province from March 2024 to June 2024 were selected as research subjects using the convenience sampling method. A general information questionnaire, Modified Falls Efficacy Scale (MFES), Simplified Coping Style Questionnaire (SCSQ), and Social Support Rating Scale (SSRS) were used for the survey. Mplus 8.3 software was applied to conduct latent profile analysis (LPA) on fear of falling in elderly stroke patients to identify potential categories, and multivariate logistic regression was used to further explore the influencing factors of each category. There were 3 potential categories of fear of falling in elderly stroke patients: the high fear of falling group (21.8%), moderate fear of falling group (38.3%), and low fear of falling group (39.9%). Multivariate logistic regression analysis showed that gender, age, type of stroke diagnosis, visual status, hearing status, limb strength, coping style, and social support were the influencing factors for the potential categories of fear of falling in elderly stroke patients. Fear of falling in elderly stroke patients has obvious categorical characteristics. Medical staff should implement targeted interventions based on the characteristics and influencing factors of different potential categories to reduce patients' fear of falling. Show less

Gestational exposure to micro- and/or nanoparticles (M/NPs) may be closely associated with adverse maternal and offspring outcomes involving multiple organ dysfunctions. Organ functional change is achieved through metabolic adaptation in response to changes in the external environment; yet, intricacies of these organ dysfunctions and underlying metabolic changes remain poorly understood, particularly at spatial suborgan level. Using a pregnant mouse model exposed to polystyrene (PS)-M/NPs (sizes: 100 nm, 5 μm, 10 mg/L in drinking water) from gestation day 1 to 18, we construct a comprehensive multisub-organ lipid metabolic landscape. This analysis integrates MALDI-mass spectrometry imaging with histological assessment to monitor changes in maternal suborgans-placenta-fetus unit. Our findings reveal distinct metabolic responses between maternal and fetal organs to gestational PS-M/NPs exposure. We identify potential targeted suborgans and spatial biomarkers associated with PS-M/NPs exposure according to histological damage and metabolic remodeling, including placental junctional and labyrinth zone (e.g., phosphatidylserine, phosphatidylethanolamine [PE]), renal cortex of maternal kidney (e.g., ceramide [Cer], PE, sphingomyelin [SM], phosphatidylglycerol [PG], phosphatidylserine), ventricular muscular layer and interventricular septum of maternal heart (e.g., PE, lysophosphatidylethanolamine [LPE], lysophosphatidic acid [LPA]), fetal brain and spinal cord (e.g., Cer), and fetal liver (e.g., Cer). Furthermore, phosphatidylserine synthesis and glycolipid metabolism pathways are found to be exclusively enriched following PS-NP and PS-MP exposure in the multiorgan network, respectively. We propose an M/NPs scale-exposed suborgan effect framework, which provides a molecular foundation and potential spatial biomarkers for elucidating intersub-organ interactions in response to M/NPs exposure and their role in mediating pregnancy state. Show less

With increasing life expectancy, the prevalence of cardiovascular disease (CVD) accompanied by comorbidities is rising, presenting a growing challenge for healthcare systems. Understanding shared genetic factors underlying CVD and its comorbid conditions may facilitate the development of more effective strategies for prevention and treatment. In this study, we investigated genetic correlations between CVD and common comorbidities using genome-wide association study (GWAS) summary statistics from the FinnGen R12 release, comprising data from 500,000 Finnish individuals. Following standard quality control procedures, we examined 19 disease endpoints using linkage disequilibrium score regression (LDSC) to estimate heritability and pairwise genetic correlations. Disease traits with significant heritability (z-score ≥ 4) and Bonferroni-corrected significant correlations (adjusted Out of the 19 diseases, four CVDs (transient ischemic attack, atrial fibrillation, myocardial infarction and heart failure) and seven comorbidities (type 2 diabetes, asthma, obesity, depression, chronic obstructive pulmonary disease, gingivitis and hypertension) showed statistically significant genetic correlations. A multivariate GWAS of the LGF identified 141 novel associated loci across 29 independent SNPs. These loci overlapped with 16 protein-coding genes, including These findings underscore a shared genetic architecture between CVD and its comorbidities. We provide genetic evidence supporting the re-evaluation of these gene targets in the context of integrated, holistic and multi-disease treatment strategies. The online version contains supplementary material available at 10.1186/s12920-025-02279-1. Show less

Osteoporotic bone defects pose significant clinical challenges. While icariin (ICA) exhibits pro-osteogenic effects in vitro, its capacity to repair osteoporosis (OP)-related bone defects remains unverified. This study investigates ICA' s therapeutic role in bone regeneration and elucidates its molecular mechanisms via the Hippo pathway in bone marrow mesenchymal stem cells (BMSCs) and OP rats. Rat BMSCs were isolated and characterized by flow cytometry (CD29+/CD34-/CD45-). BMSCs were induced under osteogenic conditions with ICA at 25 and 50 mg/L. Osteogenic differentiation and mineralization were assessed by ALP and Alizarin Red staining and by measuring mRNA and protein levels of ALP, Runx2, and OCN. The Hippo/TAZ pathway was evaluated by Western blot and qPCR for MST1, p-MST1, TAZ, and p-TAZ. A rescue experiment employed the Hippo pathway agonist lysophosphatidic acid (LPA). An ovariectomized (OVX) rat model of osteoporosis was established to validate ICA's effects in vivo, examined by micro-CT, histology, and tibial expression analyses of osteogenic markers and Hippo/TAZ signaling components. ICA promoted osteogenic differentiation and mineralization of BMSCs. Mechanistically, ICA did not alter MST1 or TAZ transcripts but markedly reduced MST1 and TAZ phosphorylation, thereby stabilizing total TAZ and enhancing downstream osteogenesis. Co-treatment with LPA abrogated ICA-induced osteogenesis, confirming Hippo/TAZ pathway dependence. In OVX rats, ICA mitigated bone loss, improved trabecular microarchitecture (BMD, BV/TV, Tb.N), and upregulated tibial expression of ALP, Runx2, and OCN. Consistently, ICA reduced p-MST1 and p-TAZ levels and increased total TAZ in bone tissues. ICA promotes bone formation both in vitro and in vivo by inhibiting Hippo kinase activity and stabilizing TAZ, thereby enhancing osteogenic differentiation. Our findings identify the Hippo/TAZ axis as a potential therapeutic target for OP and support further translational exploration of ICA as an anti-osteoporotic agent. Show less

The rising global incidence of obesity underscores the urgent demand for effective therapeutic interventions. Natural products have emerged as promising alternatives; however, identifying candidates that effectively target the complex mechanisms underlying obesity remains a critical challenge. In this study, the specialized metabolites of Dendrobium albosanguineum were investigated for their anti-obesity potential. Methanolic extraction was performed on the entire plant, followed by systematic fractionation and compound elucidation using mass spectrometry and nuclear magnetic resonance spectroscopy. A set of in vitro colorimetric assays was employed to assess pancreatic lipase inhibition, cytotoxicity, intracellular lipid storage, triglyceride content, and glycerol release in murine (3T3-L1) and/or human (PCS-210-010) adipocyte models. In addition, flow cytometry, western blotting analysis, and RT-qPCR were used to evaluate the effects of a chosen metabolite on cell cycle progression and the expression of adipogenesis-related genes and proteins. Eight metabolites were isolated, including bibenzyls (moscatilin, chrysotoxine), lignans (syringaresinol, foliachinenoside C), a sterol (daucosterol), a phenylpropanoid (n-octacosyl-trans-p-coumarate), and flavonoids (rhoifolin, kaempferol-3-O-(2″,6″-dirhamnosyl)glucoside). Among them, foliachinenoside C exhibited the most potent activity, with 94.77 ± 0.85% inhibition of pancreatic lipase (IC Show less

Present paper elicits the synthesis of a series of 2,2-dimethyl-2H-[1,3]dioxino[4,5-b]pyrrol-4(7H)-one derivatives as novel selective BACE1 inhibitors for the treatment of Alzheimer's disease (AD). A four-component, solvent-free condensation process, catalyzed by 10 mol% NiCl₂·6H₂O strategy was explored to achieve their synthesis. The structures of the synthesized compounds were ascertained using different spectroscopic techniques, including FT-IR, Show less

Hepatocellular carcinoma (HCC) remains a major health concern, with angiogenesis playing a key role in its progression. Medicinal plants offer valuable anticancer potential. Eremurus spectabilis (ES), traditionally used in folk medicine, has not been fully explored for its anticancer properties. This study investigates its cytotoxicity on Hep3B cells and its anti-angiogenic activity. E. spectabilis fractions (hexane, chloroform, ethyl acetate, and aqueous ethanol) were obtained from the ethanolic extract. The total phenolic content (TPC) was measured, and the active fractions were analyzed using gas chromatography-mass spectrometry (GC-MS). The xCELLigence Real-Time Cell Analyzer was used to evaluate cytotoxicity against Hep3B cells. Anti-angiogenic activity was assessed using the CAM assay, and docking studies were conducted to predict the mechanism of anti-angiogenesis. ESEA (154.80 ± 0.10 mg/g) had the highest phenolic content, followed by ESC (84.81 ± 6.81 mg/g). Palmitic acid (26%), khusimyl acid (15.9%), glycerol (12.1%), and D-(+)-talofuranose pentakis(trimethylsilyl) ether (9.7%) were the major compounds in ESC, while D-glucopyranose (19.4%), β-D-(+)-talopyranose (15.7%), and D-(-)-tagatofuranose pentakis(trimethylsilyl) ether (13.6%) were among the major compounds in ESEA. All fractions revealed significant cytotoxicity on Hep3B cells, with ESEA (24-h IC E. spectabilis shows a promising dual action for cancer therapy. However, further research is necessary to predict the exact mechanism of action. Show less

Oxymatrine is an alkaloid with the property of immunomodulation. Recent studies have demonstrated that oxymatrine inhibits experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS), by promoting the production of interferon-β (IFN-β). However, the mechanism through which oxymatrine regulates the production of IFN-β remains unclear. The aim of this study was to investigate the pharmacological effects and related molecular mechanisms of oxymatrine in the treatment of EAE through in vivo and in vitro experiments. Oxymatrine alleviated neurological dysfunction, demyelination, and inflammation in EAE mice. It reduced microglia/macrophage infiltration and polarization, lowered pro-inflammatory cytokine levels (iNOS, TNF-α), and enhanced the expression of IL-10 and IL-27. Additionally, oxymatrine upregulated the STING/TBK1/IRF3 signaling pathway in EAE mice, promoting IFN-β production by microglia. Similarly, in LPS-induced BV2 cells, oxymatrine suppressed inflammatory factors and activated the STING/TBK1/IRF3 pathway to enhance IFN-β production. Notably, treatment with the STING inhibitor, C176, reversed these effects in both EAE mice and LPS-induced BV2 cells, confirming the pathway's critical role in the mechanism of oxymatrine therapy. Oxymatrine promotes IFN-β production in microglia by upregulating the STING/TBK1/IRF3 signaling pathway, thereby alleviating the neurological dysfunction of EAE and reducing pathological and inflammatory events. This study identifies a novel anti-EAE mechanism of oxymatrine: promoting IFN-β production in microglia by activating the STING/TBK1/IRF3 pathway. However, it lacks clinical sample verification. If validated later, oxymatrine may provide a more economical, convenient endogenous IFN-β induction regimen for MS patients. Show less

Metabolic dysfunction-associated steatotic liver disease (MASLD) can progress to steatohepatitis (MASH), which is closely associated with obesity and insulin resistance. Resmetirom, and semaglutide, have been shown to have therapeutic effects in clinical studies. We compared these mechanisms in western diet (WD)-fed melanocortin 4 receptor knockout (MC4R-KO) mice, a human MASH pathology model. Male MC4R-KO mice were fed WD for 6 weeks starting from 22 weeks of age for disease induction and were administered drugs for 7 weeks with WD feeding, for a total duration of 13 weeks. Both resmetirom and semaglutide treatments for 7 weeks substantially improved these parameters. Although resmetirome and semaglutide improved liver hydroxyproline deposition and total fat mass, semaglutide markedly suppressed total lean mass. Moreover, resmetirom enhanced oxygen consumption, whereas semaglutide reduced energy expenditure. Histopathological evaluation showed that resmetirom significantly and semaglutide tended to improve liver steatosis score. On the fibrosis score, semaglutide significantly reduced it. Resmetirom and semaglutide have different mechanisms of action against MASH. Similar to clinical evidence, semaglutide treatment, might cause muscle mass reduction due to food intake suppression. This is the first study to simultaneously compare the effects of resmetirom and semaglutide on MASH phenotypes and reveal the differences on their mechanisms of action in WD-fed MC4R-KO mice. Show less

Cervical Cancer is the second most common gynecological malignancy affecting a large group of women worldwide. The molecular mechanism of cervical cancer progression is still not very clear. As a result, diagnosis of cervical cancer occurs at a very advanced stage when the disease has spread to its malignant stage, causing death in the majority of women. EMT is a major culprit associated with the malignant transformation of tumor cells during cancer progression and metastasis. Hence, identification of new biomarkers to detect cervical cancer at an early stage is essential to minimize incidence and mortality. The present study aims to identify Common Differentially Expressed Genes (DEGs) and early biomarkers associated with EMT in cervical cancer. The Datasets were downloaded from the Gene Expression Omnibus (GEO) database, with Accession numbers GSE26511, GSE67522, and GSE9750. Then, the Gene Ontology (GO), KEGG pathway enrichment analysis, and protein-protein interactions (PPI) were done. Further hub genes were identified by molecular interaction networks using Cytoscape from the constructed network of DEGs. Afterwards, survival analysis was performed to assess the prognostic significance of eight hub genes associated with EMT in cervical cancer. A total of 11,339 overlapping DEGs were identified from all three datasets, among all the total 61 DEGS, and 8 hub genes were linked to the EMT pathway. Our study suggests that these eight hub genes, CDH1, CDH2, MMP2, CD44, FN1, FGF2, SNAI1, and SNAI2, may be critically associated with EMT progression. Among the eight identified EMT hub genes, CDH2 (N-cadherin) demonstrated a significant association with overall survival, while FN1 (fibronectin) was notably linked to disease-free survival, underscoring their prognostic value in cervical cancer. Based on these findings, our study suggests that CDH1, CDH2, MMP2, CD44, FN1, FGF2, SNAI1, and SNAI2 hold potential diagnostic and prognostic significance in the progression of cervical cancer. Show less

Mitochondrial unfolded protein response (UPR The data were sourced from the cancer genome atlas (TCGA) and GSE31210 dataset and MRGs were retrieved to identify those with prognostic relevance, which were applied to recognize the molecular clusters in LUAD. The cluster-specific differentially expressed genes (DEGs) were identified for the functional enrichment analysis. The independent differentially expressed MRGs were sorted out to develop a risk model. Besides, the tumor immune microenvironment was analyzed using the ESTIMATE, TIMER, MCP-counter, and ssGSEA algorithms. The data were processed with Mutect2 to evaluate the genetic mutation landscape, while the IMvigor210 cohort and pRRophetic package were utilized to predict immunotherapeutic responses and drug sensitivity. Finally, in vitro validation was performed via quantitative real-time PCR (qRT-PCR), cell counting kit-8 (CCK-8), wound healing, and Transwell assays. Most MRGs were higher expressed in LUAD, and CREB binding protein (CREBBP), lysine demethylase 6B (KDM6B) and leucine rich pentatricopeptide repeat containing (LRPPRC) were the top 3 genes with mutation frequency. 8 MRGs were applied to identify 2 molecular clusters, with the worst prognosis seen in cluster C1. The clusters-specific DEGs were mainly enriched in cell proliferation-related pathways and the established risk model based on 4 hub genes (ANLN, FAM83A, CPS1 and KRT6A) showed satisfying efficacy in predicting the prognosis and was negatively correlated with most immune cells. Besides, the tumor mutation burden tended to be stronger in high risk group with high gene mutation frequency. In IMvigor210 cohort, higher RiskScore was seen in patients with progressive disease and stable disease and related to a worse survival. 3 drug candidates, including Roscovitine, Rapamycin and PHA.665752 were positively correlated with RiskScore. Besides, all 4 MRGs were highly expressed in LUAD cells and the silencing of ANLN repressed the LUAD cell proliferation, migration and invasion. The established 4-MRGs signature not only serves as a robust prognostic indicator but also highlights the significant involvement of mitochondrial unfolded protein response in shaping tumor microenvironment and influencing immunotherapy outcomes in LUAD. The 4 MRGs may contribute to the understanding on UPR Show less

17β-Hydroxysteroid dehydrogenase 3 deficiency (17β-HSDD) and 5α-reductase type 2 deficiency (5α-RD) are rare 46,XY differences of sex development (DSD). This study aims to enlarge the limited knowledge on long-term gonadal function and gonadal pathology in these conditions. Retrospective multicentre cohort study. Data on phenotype, laboratory results, and hormone treatment were collected from patients aged ≥16 years at time of data collection with genetically confirmed 17β-HSDD and 5α-RD from 10 centres via the I-DSD Registry. If gonadectomy or gonadal biopsy had been performed, pathology reports and/or gonadal tissue or images were collected. All 16 patients with 17β-HSDD were raised female; 1 (6%) changed to male gender at age 14. Three females were treated with gonadotrophin-releasing hormone agonists (GnRHa) to prevent virilisation. Thirteen underwent gonadectomy at median age 8 (range 0-17). None had germ cell (pre)malignancies. Of 14 patients with 5α-RD, 10 (71%) were raised female. Five changed gender at age 7-23, of whom 4 to male gender. One was treated with GnRHa. Six underwent gonadectomy at median age 10 (range 0-31). None had germ cell (pre)malignancies. With gonads in situ, puberty spontaneously progressed. Three were treated with dihydrotestosterone. A significant percentage of individuals with 17β-HSDD and 5α-RD changed gender, and some were treated with GnRHa to prevent virilisation before making a definitive decision about gonadectomy. When left in situ, spontaneous puberty occurs and germ cell (pre)malignancies seem uncommon at least until early adulthood. Together, these data support delaying a decision about gonadectomy until late adolescence in these conditions. Show less

Gonadotropin dysregulation seems to play a potential role in the carcinogenesis of testicular germ cell tumor (TGCT). The aim of this study was to explore the expression of specific genes related to sex hormone regulation, synthesis, and metabolism in TGCT and to define specific hormonal clusters. Two publicly available databases were used for this analysis (TCGA and GSE99420). By means of hard-threshold regularized KMEANS clustering, we assigned TGCT samples into four clusters defined in respect to different expression of the sex hormone-related genes. We analysed clinical data, protein and gene expression, signaling regarding hormonal clusters. Based on whole-transcriptome gene expression, prediction of anti-cancer drug response was made by RIDGE models. Cluster #1 (12-16%) consisted primarily of non-seminomatous germ cell tumor (NSGCT), characterized by high expression of PRL, GNRH1, HSD17B2 and SRD5A1. Cluster #2 (42-50%) included predominantly seminomas with high expression of SRD5A3, being highly infiltrated by T and B cells. Cluster #3 (8.3-18%) comprised of NSGCT with high expression of CGA, CYP19A1, HSD17B12, HSD17B1, SHBG. Cluster #4 (23-30%), which consisted primarily of NSGCT with a small fraction of seminomas, was outlined by increased expression of STAR, POMC, CYP11A1, CYP17A1, HSD3B2 and HSD17B3. Elevated fibroblast levels and increased extracellular matrix- and growth factor signaling-related gene signature scores were described in cluster #1 and #3. In the combined model of progression-free survival, S2/S3 tumor marker status, hormonal cluster #1 or #3 and teratoma histology, were independently associated with 25-30% increase of progression risk. Based on the increased receptor tyrosine kinase and growth factor signaling, cluster #1, #3 and #4 were predicted to be sensitive to tyrosine kinase inhibitors, FGFR inhibitors or EGFR/ERBB inhibitors. Cluster #2 and #4 were responsive to compounds interfering with DNA synthesis, cytoskeleton, cell cycle and epigenetics. Response to apoptosis modulators was predicted only for cluster #2. Hormonal cluster #1 or #3 is an independent prognostic factor regarding poor progression-free survival. Hormonal cluster assignment also affects the predicted drug response with cluster-dependent susceptibility to specific novel therapeutic compounds. Show less

Various studies have highlighted significant differences in developmental kinetics and sensitivity to developmental conditions between male and female bovine embryos. These differences are thought to be caused in part by the sexually dimorphic expression of genes located on the sex or autosomal chromosomes. However, little is known about the dimorphic gene expression patterns of bovine embryos at the initiation of elongation, which is one of the critical stages of development. Furthermore, to the best of our knowledge, there is little or no data available on the sexually dimorphic gene expression patterns in bovine embryos in relation to maternal environmental conditions during the initiation of elongation. Therefore, the main objective of this study was to investigate the sexually dimorphic gene expression responses of embryos to the maternal environment at the initiation of elongation in embryos developed in lactating dairy cows and nonlactating nulliparous heifers. Gene expression analysis showed that 159 genes including those involved in steroid biosynthesis and gastrulation were differentially expressed exclusively between male and female embryos developed in cows. Among these, 61 genes including CYP39 A1, CYP2R1 and CYP27B1 were upregulated and 98 genes including HSD17B1, HSD17B10 and aromatase (CYP19 A1) were downregulated in male embryos. Chromosomal analysis showed that 31.2% of the differentially expressed genes (DEGs) including glucose-6-phosphate dehydrogenase (G6PD) were located on the X chromosome, and 96% of those were upregulated in female embryos. Similarly, 254 genes including those involved in female sex differentiation, placenta development, transmembrane transport, and cell adhesion were differentially expressed exclusively between the male and female embryos developed in heifers. Of these, 108 genes including HSD17B11, HSD17B12, and HSD3B1 were upregulated, and 146 genes including SLC16 A9, SLC10 A1, SLC10 A3, SLC16 A5, SLC22 A23, SLC25 A43, SLC35 A2, SLC35 C1, and SLC4 were downregulated in male compared to female embryos. In addition, 17.3% of the DEGs were located on the X chromosome and 75% of the DEGs located on the X chromosome were upregulated in female embryos. On the other hand, 38 genes including SLC30 A10, SLC10 A4, ATP6 AP1, and KDM5 C showed sexually dimorphic expression patterns in day 13 bovine embryos irrespective of the maternal environment. These genes accounted for only 19% and 13% of the genes that showed sexually dimorphic expression in embryos developed in cows and heifers, respectively and the expression difference of these genes in male and female embryos was then likely influenced by the sex of the embryo. This study revealed that embryos developed in lactating cows showed sexually dimorphic expression of genes involved in various functions including steroid biosynthesis and gastrulation. In contrast, embryos developed in heifers displayed sexually dimorphic expression of genes related to placental development, female sex differentiation, and transmembrane transport. This suggests that the reproductive tract environments of cows and heifers differently affect the sex specific expression of genes in bovine embryos. A higher proportion of genes that showed sexually dimorphic expression in cow embryos were located on the X chromosome, and the majority of these genes were upregulated in female embryos. Overall, this study provides insight into genes that exhibit sexually dimorphic expression patterns in day 13 bovine embryos due to the maternal reproductive tract microenvironment or solely due to the sex of the embryo. Show less

Adipose tissue metabolism plays a crucial role in sheep meat quality and the optimization of adipose tissue utilization. To reveal the molecular mechanisms of adipose tissue metabolism during growth in naturally grazing sheep, we investigated the mRNA and miRNA profiles in subcutaneous adipose tissue (SAT) from naturally grazing Sunit sheep at 6, 18, and 30 months of age (Mth-6, Mth-18, and Mth-30). We identified 927 differentially expressed (DE) genes and 134 DE miRNAs in the SAT of sheep at different growth stages. Specifically, the expressions of Show less

BACKGROUND Defects in androgen synthesis, such as 17-beta-hydroxysteroid dehydrogenase type 3 (17-ß-HSD3) deficiency, can lead to ambiguous genitalia in people with karyotype 46,XY due to impaired testosterone and dihydrotestosterone production. This condition may be initially diagnosed as androgen insensitivity syndrome (AIS), an X-linked disorder characterized by female external genitalia, absence of Mullerian structures, inguinal testes, and primary amenorrhea in adolescence. This report describes the case of a 13-year-old phenotypic female with 46,XY karyotype and a history of virilization due to 17-ß-HSD3 deficiency, previously diagnosed with AIS. CASE REPORT We report the case of a 13-year-old phenotypic female who was initially diagnosed with AIS during early childhood at a rural hospital. Several years later, she presented to a pediatric endocrinology clinic with progressive signs of virilization, including hirsutism, deepening of the voice, and severe facial acne. Laboratory evaluation, including a human chorionic gonadotropin (hCG) stimulation test, revealed a markedly low testosterone-to-androstenedione (T/AND) ratio of 0.1, strongly suggestive of 17ß-HSD3 deficiency. Whole-exome sequencing identified a homozygous missense variant of uncertain significance in exon 4 of the HSD17B3 gene. As the patient had been raised as a female, the parents chose to maintain her female gender assignment. Subsequently, the patient underwent bilateral orchiectomy along with clitoroplasty and labioplasty at another medical center. CONCLUSIONS Genetic and hormonal testing play a crucial role in differentiating among various types of disorders of sex development, thereby reducing the risk of diagnostic uncertainty. Early referral to a pediatric endocrinologist is essential to ensure accurate diagnosis and appropriate management of affected individuals. Show less

Sepsis-associated acute lung injury (SA-ALI), a critical complication of sepsis, is characterized by immune dysregulation-induced pulmonary dysfunction. Shenmai Injection (SMI) is a standardized herbal preparation consisting of Panax ginseng C.A.Mey (Hongshen) and Ophiopogon japonicus (Thunb.) Ker Gawl (Maidong), traditionally used for qi-replenishing, collapse-stabilizing, and lung-moistening therapy. Although clinically utilized in the management of SA-ALI, the specific mechanisms by which it acts against SA-ALI necessitate further investigation. The present study endeavors to comprehensively determine the therapeutic efficacy of SMI against SA-ALI through an integrated approach combining network pharmacology, metabolomics, metagenomic sequencing, and experimental validation. In this study, murine SA-ALI was established using lipopolysaccharide (LPS) and Poly(I:C). Results indicated that SMI administration significantly attenuated pulmonary inflammation, restored blood-gas barrier integrity, reduced serum pro-inflammatory cytokines and suppressed NF-κB pathway activation in SA-ALI mice. Network pharmacology elucidated the multi-targeted mechanism of SMI in modulating steroid hormone biosynthesis. Integrated metabolomics and target analysis revealed that ophiopogonin A/B and luteolin in SMI alleviates metabolic dysregulation by targeting key enzymes, including AKR1C3, HSD17B1/2, and SULT1E1. Metagenomic profiling demonstrated SMI-mediated gut microbiota remodeling, marked by suppression of pathogenic Chlamydiaceae (particularly Chlamydia abortus) and enrichment of commensal Lactobacillaceae. Correlation analysis showed that intestinal androstenedione and androsterone levels during SMI treatment recovery were negatively correlated with Chlamydia abortus abundance. In conclusion, SMI enhances the recovery from sepsis-associated SA-ALI by dual modulation of gut microbial ecology and host metabolic homeostasis, thereby establishing its potential as a multi-mechanistic therapeutic candidate for sepsis-related organ injury. Show less