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The lifetime prevalence of depression is significantly higher in women. But the lack of ideal antidepressant severely limits therapies for female specific depressive disorders like perinatal depression. Herein, we evaluated whether vitamin C (ascorbic acid), a widely used nutritional supplement and perinatal therapeutic agent, could serve as a potential treatment for female-related depressive disorders using a chronic restraint stress (CRS) mouse model. C57BL/6 adult female mice were submitted to a 14-day CRS paradigm to induce depression-like behaviors. The antidepressant potential of vitamin C (200 mg/kg, i.p., a single dose) were assessed in CRS-exposed female mice that exhibited depression-like phenotype. Furthermore, we explored the underlying mechanisms through RNA sequencing, western blotting, and pharmacological interventions. Vitamin C rapidly ameliorated depression-like phenotypes in CRS-exposed female mice within 24 h. The sucrose preference test indicated that the antidepressant effect of vitamin C lasted for more than 72 h. Transcriptome sequencing analysis revealed that vitamin C reversed CRS-induced transcriptional alterations in 104 genes in the medial prefrontal cortex (mPFC) of female mice, including the dopamine receptor D2 (D2R). Western blotting confirmed that CRS suppressed the D2R-ERK1/2-CREB-BDNF pathway in the mPFC, which was effectively rescued by vitamin C. The antidepressant effect of vitamin C was antagonized by the D2R antagonist sulpiride. Additionally, protein-protein interaction network analysis revealed functional linkages between D2R and other vitamin C-regulated stress-sensitive genes. Our findings suggest that vitamin C may serve as an ideal candidate for the treatment of depression in females, potentially through the restoration of the D2R-BDNF pathway. Show less

Stress-related psychiatric disorders are underpinned by dysfunction in the prefrontal cortex and hippocampus; however, the underlying circuit-specific mechanisms remain ill-defined. Here, we identified the basolateral amygdala (BLA)-to-ventral hippocampus (vHPC) circuit as a critical regulator of stress-coping behaviors. Although chronic social defeat stress reduced the mGluR5 expression in both the vHPC and medial prefrontal cortex (mPFC), our circuit-specific behavioral analysis revealed that the activation of the BLA-vHPC circuit produced a significantly greater improvement in coping behavior compared with the activation of the BLA-mPFC circuit. Subsequently, we mechanistically demonstrated that reduced mGluR5 in the vHPC directly impairs CREB-mediated brain-derived neurotrophic factor (BDNF) transcription, a molecular cascade tightly linked to passive coping. These findings reveal a novel circuit-specific molecular mechanism governing stress recovery, positioning the mGluR5-BDNF pathway as a highly specific and promising therapeutic target for future gene therapy interventions. Show less

The associations between 24-h movement behaviours (24 h MBs) and emotional and behavioural problems (EBPs) in early years are not well understood. This study examined these associations in a nationally representative sample of Chinese preschoolers. As part of the Chinese cohort of the SUNRISE International Study of Movement Behaviors in the Early Years main study, this research recruited 1316 children aged 3-4 years through multistage stratified cluster sampling in urban and rural areas across seven major administrative regions in China. Moderate- to vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA) and sedentary behaviour (SED) were measured using 24-h accelerometry over five consecutive days. Sleep duration was parent-reported. EBPs were evaluated using the parent-rated Strengths and Difficulties Questionnaire (SDQ), which assesses total difficulties, internalising problems, externalising problems and prosocial behaviour. Compositional multiple linear regression was employed to analyse the relationships between 24 h MBs and EBPs. Compositional isotemporal substitution was also utilised to predict changes in EBPs due to reallocating time among 24 h MBs. Isotemporal substitution analyses revealed that replacing as little as 1 min of MVPA, LPA or SED with sleep was associated with significant reductions in total difficulties (β Increasing LPA by reducing MVPA or SED was significantly associated with improvements in internalising and conduct problems, whereas increasing sleep to decrease MVPA or SED-even by small amounts-was consistently associated with improvements in EBPs across all SDQ subscales. However, increasing LPA at the expense of sleep exacerbates total difficulties and externalising problems. Promoting diverse LPA opportunities alongside sufficient sleep, while maintaining a balance between them, is essential for supporting preschoolers' emotional and behavioural development. Show less

Decreasing body mass index (BMI) from midlife to late life has been linked to increased Alzheimer's disease (AD) risk and cognitive decline; however, the association with in vivo AD pathology remains unclear. This study aimed to clarify the relationship between midlife-to-late-life BMI changes and in vivo AD pathologies, specifically amyloid-β (Aβ), tau, and AD-signature region cerebral glucose metabolism (AD-CM). This observational cohort study included non-demented older adults recruited from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE) between January 2014 and December 2020. Participants underwent clinical evaluations and positron emission tomography (PET) imaging to measure brain Aβ, tau, and AD-CM. Midlife BMI was retrospectively estimated from self-reported weight at ages 40–50 years, while late-life BMI was measured during the study. Participants were categorized based on BMI changes as decreasing (≤ − 4%), stable (− 4% to < 4%), or increasing (≥ 4%). Associations between BMI patterns and AD pathologies were analyzed using multiple linear regression models. A total of 268 participants (mean age 66.6 ± 7.9 years; 56.3% women; 22.5% APOE ε4 carriers) were analyzed. Higher midlife BMI correlated significantly with lower AD-CM (β = − 0.009; 95% CI, − 0.015 to − 0.003; A decreasing BMI trajectory from midlife to late life is associated with enhanced AD-related neurodegeneration, underscoring the clinical importance of monitoring long-term body weight changes in relation to Alzheimer's disease pathophysiology. The online version contains supplementary material available at 10.1186/s13195-026-01967-z. Show less

The high global prevalence of anxiety disorders, coupled with the limitations of existing treatments, constitutes a severe public health challenge. Chronic stress, as a core environmental trigger, has garnered increasing attention for its mechanism of mediating brain-derived neurotrophic factor (BDNF) imbalance through neuroinflammation. BDNF dysregulation may contribute to anxiety disorders, particularly in subtypes with heightened neuroinflammation. The objective of this review is to comprehensively and methodically explores the potential role of the "M1-like microglia-A1-like astrocyte axis (M1-A1 axis)" in linking chronic stress to BDNF dysregulation in anxiety disorders, and to provide a theoretical basis for intervention strategies targeting this axis. By synthesizing recent relevant clinical and preclinical evidence, this review integrates evidence from molecular to systems levels, focusing on the activation mechanisms of neuroinflammation under chronic stress, the crosstalk between glial cells, and their regulatory network on BDNF. Chronic stress is associated with peripheral and central cascades through hypothalamic-pituitary-adrenal (HPA) axis activation and gut microbiota disruption. Within the central nervous system (CNS), stress induces microglial polarization toward the pro-inflammatory microglial subpopulations (hereinafter referred to as M1-like microglia). The signals released by M1-like microglia, such as Interleukin-1 alpha (IL-1α), Tumor Necrosis Factor-alpha (TNF-α), and Complement Component 1q (C1q) (ITC), drive astrocytes to transform into the neurotoxic astrocyte states (hereinafter referred to as A1-like astrocyte), forming the "M1-A1 axis". This axis contributes to BDNF dysregulation through the following mechanisms: (1) Release of pro-inflammatory cytokines inhibits BDNF transcription and translation; (2) Induction of astrocytic lactate metabolism disruption, which impairs neuronal energy supply and acidifies the microenvironment, further amplifying inflammation and affecting BDNF expression; (3) Compromise of the blood-brain barrier(BBB)enables peripheral immune cells to penetrate into the CNS, and these cells work in synergy with central glial cells to amplify inflammation. The reduction in BDNF and the imbalance in the ratio of its precursor to mature form ultimately lead to impaired synaptic plasticity in brain regions like the hippocampus (HIP) and amygdala, precipitating anxiety-like behaviors. Existing pharmacological interventions are inadequate to reverse this pathological process. The M1-A1 axis may serve as a key node linking chronic stress to BDNF dysregulation and anxiety disorders. Targeting the phenotypic transformation of glial cells, repairing the BBB, or modulating glial cell metabolism (e.g., lactate shuttle) may represent potential strategies requiring further validation. Future research should focus on the spatiotemporal dynamics of this axis and its clinical translation. Show less

Suicidal behavior is a multifactorial and highly heritable phenotype; however, data concerning its genetic determinants in disparate ethnic groups remain limited. Genes implicated in serotonergic neurotransmission and stress response regulation are regarded as primary candidates for elucidating biological vulnerability to suicide. The objective of this study is to investigate the relationship between suicide attempts and candidate gene polymorphisms in an ethnically homogeneous Kazakh population from Astana, Kazakhstan. The study's sample population comprised 126 patients with a documented history of suicide attempts and 120 age- and gender-matched controls without a history of suicidal behavior. A comprehensive genotyping analysis was conducted, encompassing polymorphisms in genes associated with serotonergic signaling, stress response, and neuroplasticity ( Show less

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and most often presents with an increase in the number of blasts in the peripheral blood and bone marrow. Although ALL typically presents with circulating blasts, atypical findings such as hypereosinophilia may obscure diagnosis and delay appropriate management. Severe eosinophilia in patients with ALL is a very rare phenomenon and is usually associated with specific genetic abnormalities or myeloid malignancies. The combination of severe eosinophilia, bicytopenia, and cardiac mass is unusual and challenging in diagnosis and treatment. A 4-year-old male patient, with no significant past or family history, presented to the emergency department with persistent fever. On initial examination, hepatosplenomegaly was evident. Blood tests showed WBC = 125,000cell per microliter, Hb = 8.7 g/dL, Plt = 77,000 per microliter, and severe eosinophilia (73.4%) absolute eosinophil count 91,250. A peripheral blood smear showed abundant mature eosinophils without blasts. Chest imaging showed bilateral pulmonary involvement, and ultrasonography showed bilateral pleural effusion. Echocardiography revealed a mass in the right ventricle suggestive of thrombus formation or infiltration, along with some degree of heart failure. Molecular tests for BCR-ABL, PDGFRα, PDGFRβ, FGFR1, and t (5:14) were negative, and bone marrow flow cytometry was also negative. Bone marrow biopsy with immunohistochemistry confirmed the diagnosis of Pre-B acute lymphoblastic leukemia with positive CD20 and TdT. The patient underwent protocol treatment and the MRD at the end of induction was reported to be 0.0011% and the biopsy was negative. The cardiac mass was also resolved during chemotherapy treatment. This case emphasizes the importance of noting unusual eosinophilia with bicytopenia, even in the absence of peripheral blasts, and the need for bone marrow biopsy and immunohistochemical examination for accurate diagnosis. Show less

Conversion of cholesterol into bile acids is a central pathway for cholesterol disposal, which was mainly controlled by cholesterol 7alpha-hydroxylase (Cyp7a1). In present study, we aimed to investigate the effect and the potential underlying mechanism of microRNA-96 (miR-96) on atherosclerosis development. The anti-atherosclerosis effects of a miR-96 inhibitor (miR-96i) were evaluated using ApoE KO mice fed a high-fat diet, which was treated with miR-96i for 8 weeks. The regulatory mechanism was revealed and validated by RNA-seq transcriptomics, quantitative PCR and western blotting analyses in hepatic cells. The authors identified that miR-96i significantly decreased serum cholesterol and bile acid levels and attenuated arterial plaque in mice. We further revealed that miR-96 regulated Cyp7a1 via a FOXO1-involved indirect pathway, in which miR-96 directly modulated FOXO1 in a posttranscriptional manner. A coordinated regulatory effect of miR-96 and miR-185 on FOXO1 was also observed. The full spectrum of mechanisms underlying the antiatherosclerotic activity beside miR-96-FOXO1-CYP7A1 axis remains to be elucidated. This study provides convincing evidence for the pivotal role of miR-96 in FOXO1 modulation and CYP7A1-involved cholesterol-bile acid metabolism, suggesting that miR-96 is a novel therapeutic target for the discovery and development of drugs against ACVD. Show less

Hyperlipidemia is highly prevalent worldwide and can affect cardiac pathophysiology. This study aimed to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the molecular mechanisms of myocardial stress and pathological remodeling in non-obese apolipoprotein E knockout ( Thirty-five 8-week-old male The HFD condition increased serum total cholesterol (TC) and triglyceride (TG) levels, but did not increase body weight, consistent with a lean hyperlipidemia model. Compared with the MICT condition, the HIIT condition demonstrated superior efficacy in reducing HFD-induced TC, TG and BNP levels ( In a non-obese, hypercholesterolemic Show less

Lobar intracerebral haemorrhage (ICH) is associated with cerebral amyloid angiopathy (CAA) pathology. Uncertainty remains about the mechanisms leading from CAA to ICH. We investigated the distribution and characteristics of CAA, and its clinical and neuropathological associations. Participants underwent research autopsy in the Lothian IntraCerebral Haemorrhage, Pathology, Imaging and Neurological Outcome (LINCHPIN) study. Neuropathologists rated tissue for CAA using standardised consensus criteria, as well as non-amyloid small vessel disease, Thal phase, and Braak stage. We compared the presence, distribution, and severity of CAA among different brain regions, and in the lobe or hemisphere affected by lobar ICH to corresponding contralateral regions. We evaluated the diagnostic accuracy of Vonsattel CAA grade on a post-mortem cortical specimen (simulating surgical biopsy) versus the reference standard of moderate-to-severe parenchymal CAA at autopsy. Among 162 participants, parenchymal CAA, meningeal CAA, and CAA-associated vasculopathy were diffusely distributed among all cerebral lobes irrespective of the ICH location, but capillary CAA showed an occipital predominance. In lobar ICH, all CAA measures did not differ between the ICH lobe or hemisphere and the contralateral unaffected region. CAA measures did not increase with age, but they were higher in carriers of APOE ε2 or ε4 alleles and in individuals with higher Thal phase or Braak stage. Using a rule-out category of Vonsattel grade ≥ 1 to diagnose CAA on a simulated cortical biopsy achieved 100% sensitivity (95%CI 93.4-100), and a rule-in category of Vonsattel grade ≥ 2 had 79.5% specificity (95%CI 63.5-90.7) versus the reference standard. The distribution and severity of parenchymal CAA, meningeal CAA, and CAA-associated vasculopathy are diffuse regardless of ICH location, indicating the need to better understand the factors underlying bleeding in CAA-affected vessels. Show less

The cornerstone of treating lower extremity deep venous thrombosis (LEDVT) lies in anticoagulation therapy to prevent thrombus progression and recurrence. However, patient adherence to medication is a critical factor influencing treatment efficacy. Traditional research often simplifies adherence into binary categories of "adherent" and "non-adherent," which fails to comprehensively reflect the complex behavioral patterns. Based on latent profile analysis (LPA), medication adherence in LEDVT patients can be categorized into distinct classes, enabling more precise identification of their characteristics. Therefore, exploring these latent classes and their influencing factors holds significant importance for optimizing intervention strategies and improving prognosis. A cross-sectional survey was used to study LEDVT. From March 14, 2024 to September 20, 2024, a random sampling method was used to recruit 469 patients with LEDVT from four grade-A tertiary hospitals in Urumqi, China. Participants completed questionnaires on general demographic information, the Medication Adherence Scale, the Perceived Health Competence Scale, the Herth Hope Index, the Patient Activation Measure, the Beliefs about Medicines Questionnaire-Specific. LPA was conducted to analyze the medication adherence characteristics of patients with LEDVT. Univariate analysis and multivariate logistic regression were used to identify the influencing factors of their latent profiles. Data analysis was performed using Mplus 8.3 and SPSS 25.0 software. LPA was employed to investigate medication adherence in LEDVT patients, revealing three distinct latent classes: the poorest adherence group (44.99%), the moderate adherence group (19.83%), and the good adherence group (35.18%). The logistic regression results demonstrated that, perceived health competence, hope, activation, beliefs about medication necessity, and concerns about medication were influential factors affecting the potential profile of medication adherence (all p < 0.05). LEDVT patients exhibit significant individual differences in medication adherence. Personalized intervention strategies can be designed based on different adherence classes to enhance medication adherence. Additionally, targeted interventions addressing perceived health competence, hope, positive affect, and medication beliefs can effectively improve adherence. Show less

Skeletal muscle atrophy is a common complication of heart failure, with myocardial infarction (MI) being the primary cause. Yet, the mechanisms linking post-MI cardiac insufficiency to muscle atrophy have remained unclear. The molecular basis for the beneficial effects of exercise on exercise intolerance in MI patients also remains absent. Serum IL-27 levels were measured in 48 MI patients and correlated with cardiac injury markers. Along with this, a rat model of post-MI cardiac insufficiency was used to assess skeletal muscle mass, cross-sectional area (CSA) of muscle fibers, and the expression of atrophy-related (MAFbx, MuRF-1) and differentiation-related markers (MyoD, Myogenin). The impact of exercise on muscle atrophy, cardiac inflammation, and IL-27 expression was then evaluated, with a focus on macrophage polarization. Serum IL-27 level was significantly elevated in MI patients and that it was positively correlated with myocardial injury and cardiac insufficiency. In post-MI rats, skeletal muscle mass and CSA of muscle fibers were reduced. Meanwhile, the expression level of myogenic markers was downregulated, while that atrophy markers was upregulated. IL-27 treatment promoted catabolism in L6 myotubes, and of note, HIF-1α overexpression in macrophages enhanced IL-27 secretion, and increased MAFbx and MuRF-1 expression. IL-27 level was also elevated in the heart, serum, and gastrocnemius muscle of MI rats. Exercise counteracted these effects by promoting M2-like macrophage polarization and suppressing HIF-1α, thereby reducing IL-27 expression. Furthermore, exercise ameliorated IL-27-induced muscle atrophy via the WSX-1/gp130/pSTAT3 signaling axis. IL-27 contributes to muscle atrophy in post-MI cardiac insufficiency. Exercise attenuates IL-27-driven muscle wasting by modulating inflammation and promoting M2-like macrophage polarization. These findings provide insights into the mechanisms of MI-induced muscle atrophy and highlight the therapeutic potential of exercise in cardiac rehabilitation. [Image: see text] The online version contains supplementary material available at 10.1186/s12967-025-07527-7. Show less

With a global annual cumulative incidence of depression at 4.5% in community-dwelling older adults, understanding non-pharmacological interventions is essential. This narrative review explores the neuroprotective mechanisms of physical activity (PA) on brain function and mental health in individuals aged 60 and older. We conducted a search across multiple databases (MEDLINE, PsycINFO, EMBASE) using keywords related to aging, cognition, and physical activity. Our analysis of relevant studies shows that PA benefits the brain through several pathways. Early findings focused on improved cerebral blood flow and glucose utilization. More recent evidence highlights that PA increases neurotrophic factors like BDNF and IGF-1, enhances mood-regulating neurotransmitters, and promotes structural adaptations in key brain regions. These findings suggest that PA is a cost-effective, multi-domain intervention. This review provides healthcare professionals with actionable evidence to incorporate PA into clinical practice for older adults. Show less

Lipoprotein(a) (Lp(a)) is a proatherogenic particle that is considered an important cardiovascular risk modifier due to its association with atherosclerotic cardiovascular disease (ASCVD) as well as calcific aortic valve stenosis (CAVS). Data on the clinical burden associated with elevated lipoprotein(a) levels in patients at high and very high cardiovascular risk remain limited. We evaluated the prevalence of ASCVD and LDL-C target achievement in subjects with high and very high elevated Lp(a) levels referred to a lipid unit. In this retrospective study, 1755 subjects were evaluated; 265 with Lp(a) ≥240nmol/L were included. The population was divided into two groups: high Lp(a) (240-429nmol/L, n=216) and very high Lp(a) (≥430nmol/L, n=49). ASCVD prevalence was 58% in the very high group and 48% in the high group (p=0.23). Age and statin intensity were higher in the very high Lp(a) group. LDL-C target achievement was low in both groups: 20.0% and 25.4% of very high-risk patients reached <55mg/dL as well as 18.2% and 17.2% of high-risk patients reached <70mg/dL in very high and high Lp(a) groups, respectively. Subjects with elevated Lp(a) levels showed a high prevalence of ASCVD and low LDL-C target attainment despite high-intensity statin therapy. These findings support the need for Lp(a) screening and additional lipid-lowering strategies in high-risk patients. Show less

Identifying reliable circulating biomarkers is crucial for improving the diagnosis and risk stratification of patients with ischemic stroke. In this study, we evaluated several whole-blood circulating miRNAs (miR-106b-5p, miR-16-5p, miR-15b-5p, let-7e-5p, and miR-125a-3p/-5p) to determine their diagnostic and disease severity in acute ischemic stroke (AIS). Sixty AIS patients and thirty age- and sex-matched controls were included. Whole-blood miRNAs were quantified at admission and on day 7. Statistical analyses included ROC curves, multivariate logistic regression, and SHAP-based machine learning. Bioinformatic analyses assessed predicted miRNA targets, pathway enrichment, and interaction networks. MiR-125a-3p was significantly reduced in AIS at both time points, while miR-125a-5p was elevated at admission and decreased by day 7. Both miRNAs showed moderate diagnostic value (AUC 0.675 and 0.712, respectively). Higher admission levels of miR-16-5p were strongly associated with greater neurological deficit (NIHSS) and unfavorable outcome (mRS ≥ 3). Multivariate analyses confirmed high miR-16-5p and elevated CRP as independent predictors of poor outcome. Bioinformatic analyses revealed that miR-16-5p targets were enriched in pathways relevant to ischemic injury, including hypoxia response, platelet activation, coagulation, TGF-β and BDNF signaling. A target-interaction network highlighted IL6, FN1, TGFB1, ICAM1, and TLR4 as central nodes linking miR-16-5p to ischemia-inflammatory mechanisms in AIS. Circulating miRNAs display distinct expression patterns in the acute phase of AIS. miR-16-5p emerges as a promising biomarker associated with stroke severity and unfavorable outcome, while miR-125a-3p and miR-125a-5p show potential diagnostic utility. These findings strengthen mechanistic links between platelet-derived miRNAs and ischemic stroke biology. Larger, longitudinal studies integrating functional validation are warranted to confirm their clinical value. Show less

The timing of physical activity may influence metabolic health through interactions with circadian rhythms, yet its role in type 2 diabetes mellitus (T2DM) development is unclear. We investigated associations between time-of-day-specific physical activity and incident T2DM, and whether theoretically reallocating activity from morning to later in the day was associated with changes in T2DM risk. We included 4615 participants from The Maastricht Study cohort without diabetes (age 59.2 ± 8.6 years; 56.3% women). Device-based physical activity was measured over 7 days using activPAL monitors and classified into light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA), for morning (06:00-11:59 AM), afternoon (12:00-17:59 PM), evening (18:00-23:59 PM) and night (00:00-05:59 AM). Incident T2DM was assessed during a median 8.2-year follow-up. Cox proportional hazard and isotemporal substitution models were used, adjusted for sociodemographic and lifestyle factors, including diet, employment and sleep duration. During follow-up, 168 participants (3.6%) developed T2DM. Each additional 10 min/day of afternoon LPA or MVPA was associated with lower T2DM risk (LPA: hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.70-0.97; MVPA: HR 0.85, 95% CI 0.72-1.00). Evening MVPA was also inversely associated with T2DM risk (0.65; 0.45-0.93), whereas night-time MVPA was associated with an increased risk (3.64; 1.30-10.17). No significant associations were found of morning LPA and MVPA or evening and night LPA with T2DM incidence. Substitution analyses indicated that reallocating 10 min of morning LPA to afternoon LPA (HR 0.71; 0.54-0.95) or morning MVPA to evening MVPA (HR: 0.64; 0.43-0.96) was associated with a lower T2DM risk, while no other significant associations were observed. Later-day physical activity, particularly in the afternoon, was associated with a lower incidence of T2DM, independent of intensity. This highlights the potential relevance of activity timing in relation to T2DM incidence. Show less

The lymphatic system maintains tissue fluid balance, and FOXC2 mutations cause lymphoedema-distichiasis syndrome, which is characterized by lymphatic valve defects. Although oscillatory shear stress regulates FOXC2 expression, other extracellular regulators remain unclear. In this study, we identified LPA4 and LPA6, two Gα12/Gα13-coupled receptors for the bioactive lipid lysophosphatidic acid (LPA), as key regulators of FOXC2 expression and lymphatic valve development. Lymphatic endothelial cell-specific (LEC-specific) Lpa4 Lpa6-deficient mice exhibited impaired lymphatic valve formation and maintenance, which resembled phenotypes of LEC-specific Foxc2-deficient mice, including abnormal lymphatic vessel patterning. Mechanistically, lymphatic endothelial Lpa4/Lpa6 ablation reduced FOXC2 expression in vitro and in vivo. NF-κB was found to be essential for LPA-induced FOXC2 expression through the LPA4/LPA6-Gα12/Gα13-Rho kinase signaling axis. Accordingly, pharmacological inhibition of NF-κB and Rho kinase impaired lymphatic valve maintenance in mice. These results suggested that lymphatic endothelial LPA4 and LPA6 synergistically regulate FOXC2 expression through NF-κB activation and play an important role in lymphatic valve formation and maintenance. Our findings provide a molecular basis for lymphatic vessel development with a therapeutic potential for targeting lymphatic system-associated diseases. Show less

Postoperative symptoms in lung cancer patients are complex and dynamic, yet recovery is highly heterogeneous. Traditional analyses often fail to capture individual recovery trajectories, limiting the ability to provide personalized care. This study aimed to identify distinct postoperative symptom trajectories and their clinical predictors using a person-centered approach. We conducted a prospective longitudinal study with 394 patients undergoing uniportal video-assisted thoracoscopic surgery (uniportal VATS) for early-stage non-small cell lung cancer. Patient-reported symptoms were collected at 1, 7, 14, and 30 days postoperatively. Latent Profile Analysis (LPA) was used to identify distinct symptom profiles, and Latent Transition Analysis (LTA) modeled the transitions between these profiles over time. Multinomial logistic regression was used to identify predictors of these transitions. LPA identified two distinct recovery profiles: a "Rapid Recovery" group (C1) and a "High-Symptom, Slow Recovery" group (C2). The first postoperative week was a critical window, with 73.0% of patients in the High-Symptom, Slow Recovery group transitioning to the Rapid Recovery group. This transition rate slowed significantly in subsequent weeks. A higher ASA classification, use of a thicker chest tube, and extensive lymph node dissection predicted a slower recovery. Conversely, better pulmonary function (FEV1%, MVV%) facilitated a faster transition, while postoperative complications were associated with a negative trajectory shift. Postoperative recovery in lung cancer patients follows predictable, heterogeneous trajectories. This person-centered approach enables the early identification of high-risk patients based on preoperative and surgical factors. Understanding these distinct pathways allows for a shift from a one-size-fits-all model to staged, personalized interventions designed to optimize symptom management and enhance patient recovery. Show less

Hypertriglyceridemia (HTG) increases cardiovascular and pancreatitis risk. Antisense oligonucleotide (ASO) therapies like volanesorsen and olezarsen target ApoC-III mRNA to reduce ApoC-III, enhancing lipoprotein lipase activity and lowering triglycerides (TGs). This meta-analysis evaluates the efficacy and safety of these ASOs in severe HTG. A systematic review (PROSPERO: CRD42024577110) was conducted following PRISMA, sourcing studies from PubMed, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov until July 2024. Randomized controlled trials (RCTs) involving severe HTG (≥200 mg/dL) treated with volanesorsen or olezarsen vs. placebo were included. Data were synthesized using a random effects model in RevMan 5.4, and bias was assessed with the Cochrane tool. Of 31 identified articles, 9 RCTs (341 patients treated with ASOs, 209 controls) were included. ASOs significantly reduced TG levels [mean difference (MD): -53.72; 95% confidence interval (CI): -77.04 to -30.40; p<0.00001]. Reductions were also seen in very low-density lipoprotein cholesterol (MD: -55.76; p<0.00001), ApoC-III (MD: -74.78; p<0.00001), and APOB48 (MD: -69.45; p<0.00001). Olezarsen uniquely reduced APOB (MD: -15.60; p<0.00001). Non-high-density lipoprotein cholesterol (HDL-C) decreased (MD: -23.25; p<0.00001), while HDL-C increased (MD: +42.14; p<0.00001). Volanesorsen was linked to higher low-density lipoprotein-cholesterol (MD: +62.74; p=0.004). For safety, local injection reactions, thrombocytopenia, and nausea were more common with volanesorsen. Acute pancreatitis occurred only in the placebo group (relative risk: 0.15; p=0.0004), indicating ASO protection. This meta-analysis confirms that ASOs effectively lower TGs and improve lipid profiles in severe HTG. Show less

Atherosclerosis is a major cause of cardiovascular diseases, and endothelial cells (ECs) senescence plays a key role in its initiation and progression. This study investigates the function and epigenetic regulatory mechanisms of long non-coding RNA (lncRNA) OIP5 antisense RNA 1 (OIP5-AS1) in oxidized low-density lipoprotein (Ox-LDL)-induced senescence and atherosclerosis in human aortic endothelial cells (HAECs). The experiments show that Ox-LDL stimulation upregulates the expression of OIP5-AS1 and RASA1 while inhibiting miR-30b-5p. Silencing OIP5-AS1 significantly suppresses the expression of senescence-associated secretory phenotype (SASP) factors, alleviates HAECs senescence, and enhances proliferation, migration, and angiogenesis. Methylation-specific primers (MSP) and bisulfite-specific primers (BSP) analyses reveal that Ox-LDL stimulation activates OIP5-AS1 expression by reducing the DNA methylation level in its promoter region and altering histone modifications (increased H3K27ac and decreased H3K9me3). Luciferase assays show that OIP5-AS1 acts as a competing endogenous RNA (ceRNA) by binding to miR-30b-5p and upregulating RASA1. Animal experiments further confirm that the knockdown of OIP5-AS1 alleviates atherosclerosis in ApoE Show less

Only a limited number of studies have reported on TOF with absent pulmonary valve (APV). Similarly, while cases of TOF with absent pulmonary artery (PA) have been documented, case reports describing TOF with both APV and absent PA are extremely rare. The present study investiged the case of a 1-year-old girl born at term with no initial clinical or physical signs of cyanosis. A subtle additional heart murmur detected during routine examination prompted referral to a cardiologist. Subsequent echocardiography and computed tomography (CT) angiography confirmed TOF with APV and absence of the left pulmonary artery (LPA). The patient later underwent corrective surgery, including pulmonary valve reconstruction and pulmonary artery plication. Although TOF is a common cyanotic congenital heart disease, certain variants of TOF, such as TOF with APV and absent LPA, may present without the typical cyanotic or respiratory symptoms. Therefore, even the slightest additional heart murmur should be thoroughly investigated. While clinical examination, arterial oxygenation, and echocardiography are essential, definitive diagnosis and precise anatomical characterization ultimately require CT angiography. Show less

Individuals with chronic conditions have persistent, co-occurring symptoms affecting quality of life. Understanding symptom severity susceptibilities is critical for early risk identification, but gaps remain among racial and ethnic minority men with chronic conditions. As such, this study identifies symptom severity profiles in non-Hispanic Black and Hispanic men based on five common symptoms (fatigue, pain, shortness of breath, sleep disturbance, depression) and its associated demographic, clinical, and modifiable sociobehavioral risk factors. Online survey data from 1,982 men aged 40 and older with chronic conditions was analyzed using latent profile analysis (LPA) to identify symptom severity profiles. LPA revealed three symptom severity profiles: lowest (63.4%); moderate (13.9%); and highest (22.7%). Multinomial and binary logistic regressions were used to analyze demographic, clinical, social, and behavioral factors associated with symptom severity profiles. Compared to men in the lowest symptom severity profile, men in the highest symptom severity profile were younger (OR = 0.98, p < 0.001), had lower incomes (OR = 0.95, p = 0.028), had more comorbidities (OR = 1.92, P = 0.001), had more medications (OR = 1.09, P = 0.012), reported current tobacco (OR = 1.55, P < 0.001) or cannabis (OR = 1.45, P = 0.011) use, experienced more social disconnectedness (OR = 1.34, P < 0.001), and had poorer self-management efficacy (OR = 0.93, P < 0.001). Compared to men in the moderate profile, men in the highest profile had lower education (OR = 0.53, P = 0.002), more comorbidities (OR = 1.77, P = 0.018), higher medication use (OR = 1.11 P = 0.009), and increased cannabis use (OR = 1.56, P = 0.017). Findings highlight diverse symptom experiences and key factors that can be targeted in prevention and treatment strategies to reduce symptom severity within these subpopulations. Show less

Endothelial senescence contributes to the development and progression of atherosclerosis. Poliumoside (Pol), a natural compound with diverse bioactivities, has been shown to attenuate oxidative stress and inflammation, major triggers of senescence. As the role of Pol in Human Umbilical Vein Endothelial Cells (HUVECs) senescence remains elusive, this study aimed to determine whether Pol protects against atherosclerosis by modulating senescence in HUVECs and to elucidate the underlying mechanisms. In the present study, compared with ApoE Show less

Parents of children with congenital heart disease (CHD) face chronic stress impairing family functioning and well-being. As a key protective factor, family resilience aids their adaptation. However, existing research predominantly measures general family resilience, neglecting heterogeneous resilience patterns and subgroup profiles. Our study uses person-centered Latent Profile Analysis (LPA) to identify latent family resilience classes in Chinese culture to provide tailored support. This study adopted a cross-sectional survey design. From October 2024 to July 2025, convenience sampling was used to recruit 426 eligible parents of children with CHD from two tertiary hospitals in Yunnan Province, China. Data were collected using the General Information Questionnaire, Family Hardiness Index (FHI), Simplified Coping Style Questionnaire (SCSQ), and Social Support Rating Scale (SSRS). LPA was applied to classify the family resilience levels of these parents. Subsequently, univariate and multivariate ordinal logistic regression analyses were conducted to explore the factors associated with different latent classes of family resilience. A total of 400 valid questionnaires were collected, with an effective response rate of 93.9%. The mean total score for family resilience in parents of children with CHD was 58.13 ± 5.79, suggesting a moderate overall level of family resilience in this group. The family resilience of parents of children with CHD was classified into three latent profiles: “High family resilience responsibility-anchored type” ( Parents of children with CHD demonstrate heterogeneity in family resilience. Healthcare professionals should pay attention to the family resilience differences among parents of children with CHD and implement targeted intervention measures based on the characteristics of different subgroups, thereby enhancing parents’ family resilience and further promoting family well-being. The online version contains supplementary material available at 10.1186/s12889-025-26143-0. Show less

The melanocortin-4 receptor (MC4R), a key regulator of energy balance and feeding behavior, plays a critical role in sheep growth. Herein, we identified a naturally occurring conserved functional SNP (g.59480661G > A, E100K, P.Glu100Lys) in the sheep MC4R gene. Using the Kompetitive Allele Specific PCR method, we detected this mutation in 2,151 sheep from six different breeds. Association analysis revealed that this mutation affects the growth traits of Luxi Blackhead sheep, and the individuals with AA (K100) genotype exhibited superior growth performance compared to the GG (E100) genotype. Additionally, whole-genome sequencing data from 49 sheep breeds, totaling 968 individuals, showed a higher mutation frequency of this variant in some large-sized sheep breeds. Functional studies demonstrated that the E100K mutation does not affect protein localization or transport but reduces surface and total protein expression. The mutated receptor exhibited decreased basal activity and reduced binding efficiency with agonists (α-MSH and β-MSH), resulting in a partial loss of function. Transcriptomic analysis indicated that this mutation affects downstream pathways, including osteoclast differentiation and the MAPK signaling pathway, which may influence growth regulation associated with the E100K mutation. Collectively, these findings underscore the substantial role of the partial loss-of-function MC4R E100K mutation in regulating growth traits in sheep. Show less

Apolipoprotein C3 (apoC3) circulates primarily on triglyceride-rich lipoproteins and promotes atherosclerosis by fostering lipidemia and inflammation. Thus, apoC3 represents an important cardiovascular risk factor and is associated with cardiovascular events and mortality. Due to their dual nature as hemostatic and immunomodulatory effector cells, platelets play an important role in the development and progression of atherosclerosis and are responsible for thrombotic/thromboembolic events upon plaque rupture. We aimed to elucidate the impact of apoC3 on prothrombotic platelet functions. Platelets were isolated from healthy volunteers and the effect of apoC3 on their activation and aggregation was assessed by flow cytometry, ELISA, and light transmission and multiple electrode aggregometry. Platelet spreading and cytoskeletal remodeling were examined by immunofluorescence microscopy. In vivo relevance was confirmed in a murine model of FeCl ApoC3 strongly reduced platelet aggregation independently of the presence of plasma or other blood cells and impaired both α We identified apoC3 as lipoprotein-derived inhibitor of prothrombotic platelet functions, mediating antiaggregatory effects, likely via modulating AKT and VASP signaling and interfering with actin cytoskeleton remodeling to impair lamellipodia formation. Thus, apoC3 may counterbalance its proatherogenic properties on lipid metabolism and inflammation by dampening thrombotic risk in hyperlipidemia. Show less