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Current genetic testing for coronary artery disease (CAD) primarily targets monogenic variants in individuals with severe hypercholesterolemia. Whether supplementing monogenic testing with polygenic risk scores for CAD and Lp(a; lipoprotein[a]) levels [PRS A genetic probability for CAD (GenProb In the UK Biobank development cohort, PVs, polygenic risk scores for CAD and PRS GenProb Show less

An accurate understanding of prognosis in Parkinson's disease (PD) is important for patient information provision, personalized treatment, and clinical trial design, but most previous research has been biased towards younger, healthier patients. To describe key clinical outcomes longitudinally and identify baseline prognostic factors (predictors) for these outcomes using population-representative PD cohorts. We meta-analyzed individual patient data from six incidence cohorts in Western Europe (Norway, Sweden, and UK). Each cohort aimed to recruit and follow up all newly diagnosed cases in defined population/incidence periods (between 2000 and 2011). We described postural instability (Hoehn & Yahr Stage 3), functional dependency (needing help with daily activities), dementia, and death with up to 12 years' follow-up and investigated clinical and genetic predictors using frailty Cox models. In 883 population-based incident patients, median age at motor symptom onset was 69.2 years. Median time to postural instability and functional dependency was 7.4 years. Dementia affected 49.6% by 10 years and 54.7% had died by 12 years (median survival 9.4 years). Older age, higher Movement Disorder Society-Unified Parkinson's Disease Rating Scale-Part III (MDS-UPDRS-III) score, and lower Mini-Mental State Examination (MMSE) were significantly associated with all outcomes; cognitive symptoms and GBA polymorphisms with each outcome except mortality; and APOE ε4 with increased mortality and dementia. This first individual patient data meta-analysis of population-based incidence cohorts provides robust prognostic data, with fewer selection biases than previous PD studies, for informing people with PD about prognosis. In incidence cohorts, overall PD prognosis is worse than previously suggested, with key outcomes often occurring early. Further work should develop validated prognostic models for objective stratification of prognostic risk and for personalized medicine. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. Show less

Osteoarthritis (OA) often coexists with metabolic traits (MTs), causing significant disability. Our study aims to uncover the shared genetic mechanisms between OA and MTs, revealing novel OA-MT related genes, proteins and pathways. We first explored the clinical associations between OA and MTs based on UK Biobank data. Using GWAS statistics for 9 OA subtypes and 51 MTs, we identified both global and regional genetic correlations. Multi-trait GWAS helped revealed credible genes and relevant pathways through various methods. Protein-level analyses were also conducted to identify key proteins. We developed polygenic scores (PGS), machine learning models and drug repurposing strategies were explored to translate these findings into clinical applications. We identified 152 trait pairs with significant associations and 709 local regions linked to OA-MT. Key SNVs like rs13135092 (SLC39A8) and rs34811474 (ANAPC4) were associated with multiple OA-MT pairs. Lipid and glucose metabolism emerged as central pathways, with tissue-specific enrichment analyses revealing key gene clusters in hepatocytes, arteries, and brain regions. Protein-level analyses identified 205 protein subgroups. PGS integrating MTs outperformed model based solely on OA, improving AUC by 17.5%. Causal gene-based models showed strong diagnostic accuracy (average AUC = 0.875 in external cohorts). Drug prediction highlighted fenofibrate as a promising treatment among 71 candidates. This study provides new insights into the genetic links between OA and MTs. We identified genes, proteins, and pathways related to comorbidities, revealing shared mechanisms, highlighting the potential of integrating metabolic factors to improve OA prediction, diagnosis, and treatment. Show less

To investigate the toxic effects of PFNA on aquatic organisms, this study used large yellow croaker (L. crocea) as a model and examined the impacts of 1000 ng/L PFNA exposure for 3, 7, and 14 days on the hepatic and intestinal systems. Histopathological examination, transcriptomic profiling, and 16S rRNA gene sequencing were employed to evaluate tissue damage, gene expression changes, and gut microbial alterations. The results revealed that PFNA exposure induced progressive histopathological changes in the liver, including nuclear enlargement and vacuolization, with increasing severity over time. In the intestine, PFNA caused structural damage to villi, characterized initially by vacuolization and subsequently by erosion, swelling, and dissolution as exposure duration increased. Transcriptomic analysis of liver showed early activation of the peroxisome proliferator-activated receptor (PPAR) signaling pathway, followed by the predominant enrichment of the phosphatidylinositol-3-kinase/protein kinase B (PI3K-Akt) pathway at later stages. These findings suggest a "two-phase" mechanism by which PFNA disrupted lipid and carbohydrate metabolism. Gut microbiota analysis showed that PFNA exposure significantly reduced α-diversity, increased the abundance of Proteobacteria, enriched opportunistic pathogens such as Vibrio spp., and altered functional profiles related to amino acid and carbohydrate metabolism. Correlation analysis identified significant associations between specific gut microbial taxa (e.g., Deferribacterota, Dependentiae) and the expression levels of key hepatic metabolic genes (lpl, foxo3), suggesting a potential mediating role of the gut-liver axis in PFNA-induced hepatotoxicity. From the perspective of aquaculture, this study provided a view of metabolic disruption and host-microbe interaction caused by PFNA. It contributes critical scientific evidence for assessing the ecological risks of per- and polyfluoroalkyl substances (PFAS) in aquatic environments. Show less

The purpose of our study was to assess if spinacetin (SPC), a flavonoid found in spinach, can alleviate the cyclophosphamide (CYP)-induced changes in cystometric and inflammatory parameters indicative of the development of hemorrhagic cystitis. The animal experiments were conducted in female Wistar rats. The cohort of 60 animals was grouped as follows: I-control, II-CYP group, III-SPC group, and IV-CYP + SPC group. The cystometry and biochemical analyses were performed after a fortnight of SPC administration. SPC was found to restore normal cystometric parameters in CYP-induced cystitis and, similarly, it normalized c-Fos expression changes in the central micturition regions. SPC further prevented a massive increase in the bladder wall thickness/permeability due to exposition to CYP administration. CYP instillation resulted in the elevation of biomarkers found in urine (brain-derived neurotrophic factor, BDNF, and nerve growth factor, NGF), and in the bladder detrusor muscle (Rho kinase and vesicular acetylcholine transporter, VAChT), which were successfully restored after administration of SPC. As for the biomarkers in the bladder urothelium, the CYP-induced increases in TNF-α, IL-1β, IL-6, calcitonin gene-related peptide (CGRP), malondialdehyde, 3-nitrotyrosine, insulin-like growth factor-binding protein 3 (IGFBP-3), occludin, organic cation transporter 3 (OCT-3), orosomucoid-1 (ORM1), pituitary adenylate cyclase receptor 1 (PAC1), synaptosomal-associated protein 23 (SNAP23), SNAP25, and synaptic vesicle glycoprotein (SV2A) levels were attenuated by SPC. Finally, CYP administration resulted in a decrease in the heparin-binding EGF-like growth factor (HB-EGF), hemopexin (HPX), T-H protein, and tight junction protein (Z01), and we noted the successful restoration of all these changes in concentrations after application of SPC. In summary, SPC robustly mitigated cyclophosphamide (CYP)-induced cystometric dysfunction and biochemical alterations characteristic of iatrogenic hemorrhagic cystitis. These findings position SPC as a compelling therapeutic candidate and warrant further translational investigation for the management of CYP-induced bladder injury. Show less

Future directions in incretin research: Three major directions currently shape therapeutic innovation in incretin research: multi-receptor agonism, oral drug development, and mechanistic reappraisal of glucose-dependent insulinotropic polypeptide (GIP) physiology. These advances indicate that incretin-based therapies should be understood within an integrated enteroinsular network rather than through isolated hormone actions. DPP-4, dipeptidyl peptidase-4; GCGR, glucagon receptor; GIPR, GIP receptor; GLP-1, glucagon-like peptide-1; GLP-1R, GLP-1 receptor; T2D, type 2 diabetes. Show less

Lipoprotein(a) [Lp(a)] is a genetically determined, independent risk factor for atherosclerotic cardiovascular disease (ASCVD), unaffected by conventional lipid-lowering therapy. This study assessed the prevalence of elevated Lp(a) in a large, multiethnic cohort in Dubai, United Arab Emirates (UAE), analyzed its distribution across ethnicities, and evaluated its independence from low-density lipoprotein cholesterol (LDL-C). In a single-center multiethnic cohort study, 746 consecutive patients from Mediclinic Parkview Hospital, Dubai, were included. Serum Lp(a) was measured using a standardized immunoturbidometric assay. Positive Lp(a) was defined as ≥75 nmol/L. Levels were stratified by ethnic subgroups and categorized based on ESC/EAS quartiles and risk thresholds (≥105 nmol/L for high risk; >190 nmol/L for very high risk). The correlation between Lp(a) and directly measured LDL-C was assessed using Spearman's rank correlation in both patients receiving optimal lipid-lowering therapy and in those not receiving therapy. The prevalence of positive Lp(a) levels (≥75 nmol/L) was 30.2 %. At higher thresholds, 13.4 % had high-risk levels (≥105 nmol/L) and 9.9 % had very high-risk levels (>190 nmol/L). Ethnic variations were notable: South Asians (32.4 %) and White/Europeans (32.1 %) had the highest prevalence, while East Asians had the lowest (21.6 %) but the highest median level (200.5 nmol/L). Crucially, there was no correlation between Lp(a) and treated LDL-C in patients on optimal lipid-lowering therapy (Spearman's rho = 0.07, p = 0.38). We identified a high prevalence of elevated Lp(a) in a multiethnic cohort in Dubai, with nearly a quarter at high or severe risk. This risk is entirely independent of LDL-C, revealing a significant hidden burden not captured by standard lipid panels. These findings support integrating Lp(a) screening into regional cardiovascular prevention protocols. Show less

Muscle atrophy and weakness are among the most detrimental consequences of disuse, microgravity, hospitalisation and ageing. Oxidative modifications of myofibrillar proteins generated by oxidative stress may contribute to the reduced force- and power-generating capacity of skeletal muscles. As part of the 60-day AGBRESA bed rest (BR) study, we studied (1) how microgravity-induced disuse affected markers of systemic and muscle oxidative stress, (2) how these related to muscle function and (3) to what extent artificial gravity (AG) attenuated these changes. Since the myokine irisin may protect against muscle deterioration in disuse, we additionally assessed serum irisin levels. Sixteen men and eight women (33 ± 9 years) participated in the AGBRESA study. Participants were pseudorandomly assigned to a control group (BR only), or a continuous or intermittent centrifugation group (n = 8 in each group) to assess the efficacy of daily 30-min AG in attenuating the adverse effects of BR-induced disuse. Muscle function, muscle protein carbonyls, serum irisin and key modulators of oxidative stress and cell protection in muscle and blood were assessed before, on Day 6, and at the end of BR. BR caused a reduction in peak torque during maximal voluntary isometric knee extension and knee flexion (p < 0.001) that was greater in women than in men (knee extension, w: -39.7 ± 3.5%, m: -25.1 ± 2.4%; knee flexion, w: -32.9 ± 4.5%, m: -10.2 ± 3.5%, p ≤ 0.002) and faster electrically evoked twitch muscle contractions of plantar flexor and knee extensor muscles (half relaxation time and % peak rate of relaxation, p ≤ 0.003). AG attenuated the BR-induced increase in evoked twitch contraction speed in the knee extensors (group × time interactions: half relaxation time, p = 0.009; % peak rate of relaxation, p = 0.030), and the loss of evoked twitch peak torque of plantar flexors (AG - 25%, Controls -48%, group × time interactions, p = 0.020). Neither BR nor AG affected the circulating levels of systemic oxidative stress and muscle carbonyl concentration and serum irisin levels. However, participants with the highest serum irisin and brain-derived neurotrophic factor levels showed lower levels of 8-iso-PGF2α, a marker of systemic oxidative stress (r = -0.486, p = 0.019; r = -0.512, p = 0.012, respectively) and circulating levels of the C-terminal agrin fragment, a biomarker of neuromuscular junction fragmentation. AG exposure attenuated some of the BR-induced changes in twitch contractile properties. Neither BR nor AG induced significant alterations in systemic oxidative stress, or muscle protein carbonylation, suggesting that the main contribution to the BR-induced loss of muscle strength during the AGBRESA study was not oxidative stress. Show less

The apolipoprotein E (APOE) gene represents the strongest genetic determinant of sporadic Alzheimer's disease (AD), yet its interaction with sex-specific endocrine factors remains poorly understood. Lifetime estrogen exposure, estimated through reproductive lifespan, may modulate neurodegenerative risk, but findings are inconsistent. Previous studies have examined reproductive factors and APOE interactions in relation to cognitive outcomes, but dose-dependent effects across all APOE alleles (ε2, ε3, ε4) in clinically diagnosed AD patients remain underexplored. This study investigates the joint effects of reproductive lifespan, age at natural menopause (ANM), and APOE genotype on AD risk in females. A total of 396 female participants (103 with AD, 293 cognitively healthy controls) were retrospectively analyzed. Demographic, clinical, and reproductive data were extracted from medical records. APOE genotyping was performed by sequencing rs429358 and rs7412 polymorphisms. Logistic regression models tested associations between ANM, reproductive lifespan, and AD diagnosis, adjusting for education, body mass index (BMI), smoking, diabetes, hypertension, and number of children. Moderation analyses assessed the interaction between reproductive variables and APOE ε2, ε3, and ε4 alleles, and were followed by simple slope analyses to clarify the direction of significant effects. AD females exhibited later ANM (50.3 ± 4.4 vs. 48.3 ± 6.2 years; This work provides novel evidence that extended ovarian function is associated with increased AD vulnerability in females, particularly among APOE ε4 carriers. These findings highlight a dose-dependent, genotype-specific interaction between reproductive aging and neurodegeneration, suggesting APOE as a molecular bridge linking estrogenic exposure and AD risk. Show less

Traumatic spinal cord injury (SCI) induces neuronal apoptosis and neuroinflammation, which exacerbate secondary damage and hinder functional recovery. Efficient clearance of apoptotic cells and modulation of the inflammatory microenvironment of spinal cord are essential for promoting tissue repair. This study aimed to investigate whether Midkine (MDK), a heparin-binding growth factor, facilitates functional recovery after SCI and explores the underlying mechanisms. A rat model of moderate SCI was established using Allen's impact method. Lentiviral vectors were used to overexpress MDK in the spinal cord. Behavioral assessments, including BBB score and gait analysis, were performed to evaluate motor function recovery. Motor evoked potentials (MEPs) serve as a neurophysiological tool for evaluating the functional integrity of the corticospinal tract. In vivo and in vitro experiments were conducted to assess microglial efferocytosis and elucidate the underlying molecular mechanisms. Transcriptomic bioinformatic analysis suggests that SCI is characterized by pronounced accumulation of apoptotic cells and robust neuroinflammatory responses, whereas single-cell analysis implicates MDK as a key contributor to neurorepair after SCI. MDK expression is dynamically regulated following SCI, with an early upregulation followed by a gradual decline over time, its location predominantly observed around microglial cells. Functionally, MDK overexpression significantly enhances motor recovery after SCI, accompanied by reduced neuroinflammation, decreased neuronal apoptosis, and improved neuroprotection. Mechanistically, MDK promotes microglial efferocytosis both in vivo and in vitro, activates the AKT/mTOR signaling pathway, upregulates BDNF and LRP-1 expression, and facilitates microglial polarization toward an anti-inflammatory M2 phenotype. Notably, inhibition of LRP-1 with receptor-associated protein (RAP) abolished the efferocytic and neuroprotective effects of recombinant MDK, highlighting LRP-1 as a key mediator of MDK's actions in microglia. Our study unveils the MDK/LRP-1/efferocytosis axis as a previously unrecognized therapeutic target for SCI. By orchestrating apoptotic cell clearance, dampening neuroinflammation, and fostering neuroprotection, this axis critically shapes the post-injury microenvironment to facilitate recovery. These findings suggest that MDK-centered therapy may represent a strategy for spinal cord repair, with LRP-1 modulation offering precise control over microglial responses. Show less

Although traditional rehabilitation training can partially improve motor function in patients with post-stroke motor disorders, its impact on neural plasticity remains limited. Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive method targeting the auricular branch of the vagus nerve, represents a promising neuromodulatory approach. This prospective study aimed to assess the therapeutic effects of taVNS on functional recovery in this population. A total of 147 patients with post-stroke motor disorders were consecutively enrolled between February 2023 and November 2024. After excluding 8 dropouts, 139 patients were randomly assigned via a random number table to either an electrical stimulation group (taVNS group) or a rehabilitation group (conventional training). The taVNS group initially included 73 patients, with 3 dropouts yielding a final sample of 70. The rehabilitation group initially included 74 patients, with 5 dropouts resulting in 69 participants. All participants underwent comprehensive assessments at baseline and following a 4-week intervention period. Outcome measures encompassed neuroelectrophysiological parameters (motor evoked potential latency and amplitude), clinical functional evaluations (Action Research Arm Test, Fugl-Meyer Assessment for Upper Extremity, Modified Barthel Index), serum biomarker levels (brain-derived neurotrophic factor, S100 calcium-binding protein β), and systematic documentation of adverse events. Based on post-treatment Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scores, patients were further categorized into improvement and non-improvement subgroups for additional comparative analysis. Pearson correlation analysis was utilized to examine potential relationships between functional scores, neurophysiological data, and biomarker concentrations. Baseline characteristics were comparable between groups ( taVNS is an effective and safe adjunctive therapy for post-stroke motor recovery. It enhances neuroelectrophysiological function, improves motor and daily living abilities, and favorably modulates biomarkers of neural injury and repair. The consistent correlations among functional, neurophysiological, and biochemical outcomes highlight an integrated recovery pathway, supporting the integration of taVNS into standard neurorehabilitation protocols. Show less

Depression, a global mental disorder, is linked to gut-brain axis (GBA) dysfunction. This review explores how traditional Chinese medicine (TCM)-including single herbs (eg, Astragalus membranaceus, Lycium barbarum), herbal formulas (eg, Xiaoyaosan, Xiaochaihu Decoction), and acupuncture-alleviates depression via the GBA, focusing on neuroscience-relevant mechanisms (inflammation, neurotrophy). A systematic literature search was conducted on PubMed, China National Knowledge Infrastructure (CNKI), and Embase from database inception to July 2025. Keywords included ["Traditional Chinese Medicine" or "TCM" or "herb" or "herbal extracts" or "Chinese herbal formulas"], ["depression" or "Depressive like behavior"], ["immune regulation"], ["inflammatory reaction"], ["neuroregeneration" or "nerve" or "neurotransmitter"]. Including peer-reviewed studies on human/animal models, articles that do not meet the requirements are excluded. A total of 307 eligible studies were included. TCM regulates gut microbiota composition-eg, increasing Lactobacillus and Bifidobacterium while reducing pathogenic taxa. Mechanistically, TCM inhibits pro-inflammatory pathways: herbs (eg, Astragalus membranaceus) and formulas (eg, Xiaoyaosan) downregulate IL-6, TNF-α, and IL-1β via suppressing NLRP3 inflammasome and TLR4/NF-κB signaling. They also enhance anti-inflammatory IL-10, elevate neurotransmitters (5-HT, DA), and upregulate BDNF. Acupuncture mirrors these effects, reducing plasma IL-6/TNF-α and restoring microbial balance to improve depressive behaviors. TCM alleviates depression by integrating gut microbiota modulation, inflammatory suppression, and neuroprotection through the GBA. This review highlights TCM's potential as a safe, alternative therapy for depression and identifies directions for standardized, large-scale clinical validation. Show less

While a growing body of literature suggests a role for infections in Alzheimer's disease (AD), microbial contributions to AD remains a contentious topic, in part due to challenges in reconciling the positive evidence with studies reporting null findings. Here, we examine the evidence that argues against a role for infections in AD, while offering mechanistic hypotheses that may account for both the negative and positive findings, including dysregulated host immunity and gene-environment interactions of AD-associated genes. Show less

While physical inactivity represents a global health concern, the relationship between structured sports participation and overall physical activity patterns remains unclear. This study examined whether football practice enhances adherence to physical activity guidelines and influences lifestyle activity patterns beyond structured practice sessions. Twenty-seven participants [football players (EG) Show less

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized primarily by deterioration in memory, cognition, and learning ability. Its etiology is complex and influenced by multiple factors, including genetics and environment. With advancing research into mitochondrial function and mechanisms, impaired mitophagy has been proposed as a significant mechanism contributing to AD. The ApoE ε4 allele, a high-risk genetic factor for AD, may play a key role in disease pathogenesis by inducing mitophagy dysfunction and apoptosis. From the perspective of APOE gene polymorphisms, this study investigates abnormal changes in mitochondrial function and autophagy in humanized APOE4 mice primary astrocytes under oxidative stress, as well as the regulatory effect of curcumin (Cur) on mitophagy and oxidative stress-induced apoptosis, thereby exploring its potential to ameliorate AD through targeting mitophagy. Mitochondrial function analysis revealed that APOE4 expression reduced the antioxidant capacity and respiratory function of primary astrocytes, leading to mitochondrial membrane damage, intracellular reactive oxygen species (ROS) accumulation, and decreased ATP production. Curcumin effectively protected mitochondrial integrity, reduced the number of damaged mitochondria, improved overall mitochondrial function, and helped maintain mitochondrial homeostasis involving in PINK1/Parkin pathway. Regarding autophagy and apoptosis, curcumin was shown to restore autophagic flux, mitigate autophagy disruption caused by oxidative stress, and reverse early-stage apoptosis. Show less

Individuals differ in their sensitivity to external stimuli. The Highly Sensitive Child (HSC) scale can be used to measure sensitivity in children and adolescents. However, the German version has yet to be validated. We examined the psychometric properties of the German self- and the parent report version of the HSC. Measurement invariance (MI) across age groups was tested for the parent report version and latent profile analysis (LPA) was used to identify sensitivity groups. Pooled data from German-speaking countries ( The online version contains supplementary material available at 10.1007/s12144-026-09244-w. Show less

Pituitary macroadenomas often cause visual pathway impairment due to optic chiasm compression. The association between systemic neurotrophic factors and visual recovery remains insufficiently explored. This prospective observational cohort study included 53 patients (106 eyes); 36 patients (72 eyes) completed a 12-month follow-up. Patients were assigned to a treatment group (surgical and/or pharmacological; Show less

The 24-h movement behavior framework includes all physical activity (PA), sedentary behavior (SB), and sleep as interdependent components of a full day. While evidence highlights the benefits of higher PA, lower SB, and adequate sleep for health, the combined effects of these behaviors on mental and physical health remain unclear. This systematic review will explore the associations between 24-h movement behavior compositions and mental and physical health outcomes, providing insights for developing balanced movement behavior guidelines. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guideline. PubMed, PsycINFO, Embase, Web of Science, and Sport Discus will be searched for studies published between 2015 and 2025. Eligible studies must report 24-h movement behavior metrics-the composition of time allocated to sleep, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Included studies must also examine at least one mental (e.g., depression, anxiety) or physical (e.g., BMI, systolic blood pressure, all-cause mortality) health outcome. For each study, we will extract the time allocated to each behavior and effect estimates with 95% CIs (e.g., percent change in BMI, odds ratios for depression, hazard ratios for mortality) to quantify the magnitude and direction of associations. Screening, data extraction, and quality assessment will be conducted independently by two reviewers. The quality of evidence for each outcome will be assessed using the GRADE approach. Due to expected heterogeneity in study designs, a meta-analysis will not be performed. Instead, a structured narrative synthesis will be presented, stratified by age group and health condition, to summarize findings and identify key research gaps. The proposed systematic review will be the first to comprehensively review how combinations of PA, SB, and sleep are associated with mental and physical health using compositional data analysis. By emphasizing the interdependent nature of 24-h movement behaviors, the findings will provide a clearer understanding of how time spent among these behaviors influences health outcomes. The review aims to support evidence-based recommendations for optimizing daily movement behavior patterns to improve health across diverse populations. PROSPERO (CRD42023445730). Show less

This first-in-human Phase I study evaluated the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of KN069, a novel dual Glucagon-like peptide-1 receptor agonist (GLP-1RA)/Glucose-dependent insulinotropic polypeptide receptor (GIPR) antagonist in Chinese men with overweight/obesity. This randomised, double-blind trial included a single ascending dose (SAD; 12-120 mg, N = 36, 3:1 active-to-placebo) and a multiple ascending dose (MAD; N = 12, dose escalation 15-60 mg) phase. Safety was assessed via adverse events (AEs) and compliance. PK was analysed using a sandwich enzyme-linked immunosorbent assay (ELISA) for Intact and Total KN069. PD included measurements of body weight, waist circumference, body mass index (BMI) and metabolic parameters. Immunogenicity was assessed by detecting anti-drug antibodies (ADA). KN069 was well tolerated, with predominantly mild-to-moderate gastrointestinal adverse events. PK showed dose-proportional exposure (12-90 mg) with a long half-life for Total KN069 (899.74-1099.01 h). In the SAD part, preliminary dose-dependent weight reductions were observed, with maximum early changes at Day 7 (90 mg: -4.71% vs. placebo: -0.41%) and sustained for up to 133 days. In the MAD part, Group B (60 mg) achieved a -2.57% mean weight reduction from baseline at Day 25, alongside a significant decrease in waist circumference (p = 0.0446). Metabolic improvements included lower fasting glucose, triglycerides, uric acid and elevated insulin/C-peptide. KN069 exhibits favourable safety, long-acting PK and preliminary dose-dependent weight reduction alongside expected pharmacologic metabolic effects, supporting further clinical development. gov Identifier: NCT06547775. Show less