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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

Hepatoid lung carcinomas, similar to hepatoid carcinomas of other sites, are defined as extrahepatic tumors exhibiting divergent hepatocellular differentiation. Uniquely, hepatoid carcinomas of lung origin are reported to commonly express only hepatocyte paraffin 1 (HepPar1)-a hepatocellular marker, which recognizes mitochondrial enzyme carbamoyl-phosphate synthetase-1 (CPS1). Recently, HepPar1/CPS1 was found to accumulate in lung adenocarcinomas (LUADs) harboring STK11mutations, presumably as a genotype-associated metabolic adaptation. The impact of these insights on the concept of hepatoid lung carcinoma has not been explored. Here, we performed a detailed clinicopathologic and genomic analysis of carcinomas prospectively regarded as hepatoid with isolated HepPar1 expression (n = 17). We found that although robustly positive for HepPar1, these tumors were entirely negative for an extended panel of other hepatocellular markers (alpha-fetoprotein, Arginase1, Glypican3, and albumin-in situ hybridization). Morphologically, tumors exhibited solid-trabecular architecture with expanded granular-vacuolated-clear cytoplasm, thus evoking hepatoid morphology; however, focal-to-moderate intracytoplasmic mucin was consistently present, and hepatoid resemblance was variable. Pneumocytic markers (TTF1 and Napsin A) were entirely negative (except for cytoplasmic TTF1), commonly leading to diagnostic challenges at metastatic sites. Remarkably, next-generation sequencing revealed invariable STK11 mutations/loss (P < .00001 vs unselected LUAD, n > 2.5K). Patient survival was dismal (median, 5.8 vs 25 months for stage-matched LUAD, P = .0002). Tumors harbored high mitochondrial content by electron microscopy and other methods. For comparison, we reviewed conventional, predominantly acinar LUAD with HepPar1 expression (n = 22) and found that they also lacked any other hepatocellular markers, had invariable STK11 mutations/loss, increased granular cytoplasm, lower TTF1, and poor prognosis. We conclude that isolated HepPar1 expression in LUAD reflects mitochondrial adaptation to STK11 mutations rather than bona fide hepatocellular differentiation, and that HepPar1-expressing solid and granular adenocarcinomas represent an undifferentiated (solid, TTF1 negative) variant in this spectrum of tumors. Recognition of these tumors is warranted due to their exceptionally aggressive behavior, distinct pathogenomic features, and common association with diagnostic challenges. 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

17β-Hydroxysteroid dehydrogenase 3 (17β-HSD3) deficiency is a rare 46XY disorder of sex development (DSD) of androgen biosynthesis. We aimed to describe the complexities in diagnosis, gender assignment, and the timing of irreversible surgical interventions in 17β-HSD3 deficiency. We described three genetically confirmed cases of 46XY DSD due to 17β-HSD3 deficiency. All of them had female-appearing external genitalia, and the third case had well-developed breasts with clitoromegaly. The biochemical evaluation showed hCG-stimulated T/A ratios of 0.4 and 0.35 in Cases 1 and 2, respectively, and an unstimulated T/A ratio of 0.25 in Case 3. Molecular analysis revealed three different 17β-HSD3 deficiency remains a challenging 46 XY DSD due to its clinical heterogeneity and diverse molecular spectrum. This report adds to current molecular knowledge by reporting two novel variants in the Show less

The paraventricular hypothalamus (PVH) controls behavioral and physiologic processes, including appetite, social behavior, autonomic outflow, and pituitary hormone secretion. However, molecular markers for centrally projecting PVH neuron populations remain largely undefined, and a complete census of PVH cell types has not been established. Therefore, we performed extensive single-cell/nucleus RNA sequencing to catalog PVH neuron subtypes and multiplexed error-robust fluorescence in situ hybridization (MERFISH) to map them spatially. Our spatial transcriptomic atlas resolves 26 Sim1 Show less

This study examined the relationship between motor competence (MC) and Physical Activity (PA) in school-aged children, and assessed the mediating role of physical fitness, based on the Model of the Relationship between Children’s Motor Development and Obesity Risk. From March to April 2022, 1,026 children (53.6% boys, mean age 8.93 years) from four public primary schools in Shijiazhuang City, China, were recruited via stratified cluster sampling. MC was assessed using the Test of Gross Motor Development, 3rd edition (TGMD-3), PA was measured via a three-axis accelerometer, and physical fitness was evaluated according to the Chinese National Student Physical Health Standards (2014 revision). Data were analyzed using SPSS 26.0, with mediation tested via the bias-corrected bootstrap method (10,000 resamples). Ball skills ( Ball skills are critical for promoting MVPA in school-aged children, with physical fitness acting as a significant mediator. Systematic ball skill training is recommended as a core strategy to enhance physical activity via improved fitness. 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

Physical inactivity is a health concern for children and adolescents with neurodevelopmental disorders (NDDs) as it directly increases their risk of developing various health problems. Evidence on differences in accelerometer-assessed physical activity between children and adolescents with and without NDDs is inconclusive. And age- and body mass index (BMI)-related effects on physical activity remain unclear. The systematic literature searches were performed in 6 databases up to March 2025. Methodological quality was evaluated by the Newcastle-Ottawa Scales. Data were pooled using a random-effects model. Hedges' g was used to express the effect size index with 95 % confidence interval (CI). Meta-regression on age and BMI was also performed to investigate the potential moderating effects. Out of the 2167 studies initially identified, 28 were included in the analysis, which comprised total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA) included in the meta-analysis, respectively. These studies involved 1060 children and adolescents with NDDs and 1820 without, aged 6.6-16.9 years. A small-to-moderate effect size exists for the difference in TPA (g=-0.299) and MVPA (g=-0.479) between children and adolescents with and without NDD, particularly indicating a difference in 12.7 min of MVPA daily. The difference in LPA was not significant (g=0.450, p = 0.125). The decline in MVPA with age was more pronounced in those with NDDs, and the difference in MVPA was smaller for those with lower BMI. The variation in MVPA differences by age and BMI highlights the need to develop better physical activity habits and reduce these disparities for children and adolescents with NDDs. Show less

Huntington's disease (HD) is a progressive neurodegenerative disorder characterized by motor, cognitive, and metabolic dysfunction, largely driven by mitochondrial impairment and defective energy metabolism. Altered signaling through hypoxia-inducible factor-1α (HIF-1α) and PI3K/AKT cascades contributes to neuronal vulnerability. Canagliflozin (Cana), a sodium-glucose cotransporter-2 inhibitor, has shown cognitive benefits in experimental studies. Here, we evaluated whether Cana mitigates 3-nitropropionic acid (3NP, 10 mg/kg, i.p., 14 days)-induced HD-like neurotoxicity in rats. Animals received Cana (5 or 10 mg/kg, p.o.) daily for 14 days, followed by behavioral assessments (open-field, Morris water maze, novel object recognition), histopathology, immunohistochemistry, and biochemical assays. Cana treatment significantly improved locomotor and memory performance, reduced striatal histopathological alterations, and attenuated GFAP immunoreactivity. Mechanistically, Cana upregulated HIF-1α and downstream GLUT1/GLUT3/HKII, restored PI3K/AKT/CREB/BDNF signaling, and enhanced SIRT1/PGC-1α/Nrf2 antioxidant responses, while suppressing inflammatory mediators and caspase-3 activation. These findings highlight Cana as a promising disease-modifying strategy for HD by targeting both energy metabolism and pro-survival pathways. 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

Sporadic late-onset Alzheimer's disease (AD) is characterized by a long pre-clinical phase where amyloid-beta (Aβ) and tau begin to accumulate in the brain. The primary objective was to determine the age at which AD starts by finding the average population age when both positron emission tomography (PET) Aβ (Aβ-PET) and plasma Aβ42/40 become abnormal. Two high performance immunoprecipitation-mass spectrometry (IP-MS) assays (WashU/C2N and Shimadzu) were tested on samples from 1,450 participants who were diagnosed as cognitively unimpaired (CU), mild cognitive impairment (MCI), or AD-dementia across 4 international cohorts. Natural history modeling and trajectory analyses of the combined Aβ-PET and plasma Aβ42/40 data were analyzed. Data from both assays demonstrated Aβ42/40 undergoes a rapid change at approximately 15 Centiloid (CL), at an average population disease age at 66 years. On average, plasma Aβ42/40 becomes abnormal approximately 2 years before Aβ-PET, whereby it falls sharply to a stable level at the onset of preclinical AD. Average disease age where Aβ42/40 becomes abnormal, and the corresponding Centiloid level are lower for APOE allele carriers compared with non-carriers. Plasma Aβ42/40 ratio presents a step-like function of peripheral change shortly before the detection of plaques by Aβ-PET. Results are consistent with plasma Aβ42/40 falling to a steady-state level in participants with Aβ-PET levels greater than approximately 14CL for both assays. The age at which this occurs is dependent on APOE ε4 carriership, consistent with the approximate 7-year age difference in Centiloid abnormality between carriers and non-carriers. ANN NEUROL 2026;99:1327-1342. Show less

Melanocortin 4 receptor (MC4R) is a G-protein-coupled receptor expressed in the hypothalamus, playing a key role in regulating feeding behavior and energy homeostasis. MC4R is integral to the POMC-MC4R and leptin-MC4R pathways, which control food intake and body weight. Mutations in the POMC gene lead to severe early-onset obesity and increased food consumption. Recently, glucagon-like peptide-1 (GLP-1) analogs, including semaglutide, tirzepatide, and retatrutide, have been explored as potential anti-obesity therapies. This study aimed to assess and compare the efficacy of these GLP-1 analogs in MC4R knockout (KO) mice, which are deficient in the POMC-MC4R pathway. GLP-1 analogs were administered for 21 days to MC4R KO mice and compared their efficacy. The percentage of body weight reduction was 19.7 ± 4.1% for semaglutide, 31.6 ± 7.6% for tirzepatide, and 24.1 ± 5.8% for retatrutide. Body composition analysis, including fat and lean mass, was performed using the Echo-MRI system, revealing significant suppression of both fat and lean mass by all three GLP-1 analogs. Furthermore, GLP-1 analogs improved plasma insulin levels, HOMA-IR, cholesterol levels, and markers of liver damage (AST and ALT), as well as reduced liver hypertrophy. While GLP-1 analogs suppressed genes related to fatty acid synthesis, they had no significant effect on inflammation-related gene expressions. Additionally, GLP-1 analogs reduced energy expenditure, with only tirzepatide showing a significant decrease in the respiratory quotient (RQ) in MC4R KO mice. Our findings demonstrate that all three GLP-1 analogs, semaglutide, tirzepatide, and retatrutide, exhibit significant anti-obesity effects in MC4R KO mice. These results suggest that GLP-1 analogs may provide an effective treatment option for patients with MC4R-POMC pathway deficiencies. Moreover, the efficacy of these drugs in MC4R KO mice aligns with clinical studies, indicating that MC4R KO mice serve as a reliable animal model for obesity research. Show less

Chronic stress is associated with inflammatory activation and oxidative stress responses leading to endothelial dysfunction, which promotes the development of atherosclerosis (AS). SGLT2 inhibitors, such as Dapagliflozin (DAPA), exhibit a protective effect against cardiovascular diseases. However, the effects and mechanisms of DAPA on chronic stress-induced AS are largely unknown. The aim of this study was to determine whether DAPA confers a protective effect against chronic stress-induced AS and to elucidate its further molecular mechanisms. The combined high-fat diet-fed and chronic unpredictable mild stress in ApoE-/- mice and lipopolysaccharides- and corticosterone-induced human umbilical vein endothelial cells (HUVECs) were employed to evaluate the antiatherosclerotic effect of DAPA under chronic stress in vivo and in vitro. Histological staining, western blot analysis, siRNA transfection, reactive oxygen species (ROS) staining, and apoptosis assessment were used to investigate the potential mechanisms of DAPA against AS under chronic stress. The results indicate that DAPA significantly improved plaque size and increased plaque stability in the aorta under chronic stress and reduced inflammation and oxidative stress and inhibited apoptosis in the aorta and HUVECs. Chronic stress upregulated regulated in development and DNA damage response 1 (REDD1) expression, which exacerbated cellular inflammation, oxidative stress, and apoptosis levels, leading to endothelial dysfunction. In contrast, DAPA downregulated REDD1 expression and activated the AKT/FoxO1 pathway. In addition, p53 was a transcriptional regulator of REDD1 under chronic stress. More importantly, p53 agonists prevented DAPA from downregulating REDD1 and inhibited AKT/FoxO1 activation, thereby exacerbating chronic stress-induced endothelial dysfunction. These results suggest that DAPA effectively attenuates chronic stress-induced endothelial dysfunction and AS by downregulating REDD1 to activate the AKT/FoxO1 pathway. 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

Branched-chain α-amino acids (BCAAs) support protein synthesis and their oxidation is restrained by branched-chain α-keto acid dehydrogenase kinase (BCKDK). We previously observed that in the brains of Bckdk knockout (KO) mice, BCAAs fall while glutamate is preserved and other amino acids rise. We asked why this profile emerges and how it affects skeletal muscle versus brain during nutrient stress. Motor behavior, protein synthesis and nutrient signaling were compared in the skeletal muscle and brains of wildtype (WT) and Bckdk KO male mice. In addition, nitrogen delivery into brain from BCAAs was assessed using stable isotope tracing and mass spectrometry imaging. Bckdk KO showed normal grip strength but poor beam traversal and reduced wheel running during protein restriction. In skeletal muscle, leucine or protein-feeding stimulated and fasting suppressed mechanistic target of rapamycin complex 1 (mTORC1) signaling in both genotypes. Fasting reduced muscle protein synthesis in both strains without activating the integrated-stress response (ISR). In contrast, Bckdk KO brains exhibited ISR activation during fasting, and up-regulation of Atf4 and its target genes, including Slc7a5 mRNA. Tracer studies revealed lower serum [ Show less

Prenatal stress, including maternal immune activation (MIA), affects cognitive performance in the offspring. Since insulin could improve cognitive function in several aspects, we hypothesized that intranasal insulin would attenuate MIA-induced learning and memory deficits. In the present study, the pregnant Wistar rats received lipopolysaccharide (LPS, 250 µg/kg) intraperitoneally on gestational day 15. Intranasal insulin (2 IU, 7 days) was administered to male pups from PND 34-47. During late adolescence, the Morris Water Maze and in vivo electrophysiological recording were performed in male rats to assess spatial learning and memory and long-term potentiation (LTP), respectively. Also, the hippocampal expression of BDNF and PSD-95 was evaluated using real-time PCR. Our results demonstrated that MIA impaired spatial learning and memory in the male pups. Hippocampal synaptic plasticity was also impaired in the adolescent male rats. However, intranasal administration of insulin could overcome MIA-induced impairments and improve learning, memory, and synaptic plasticity in the male pups. Although BDNF and PSD-95 levels were not altered in the hippocampus of MIA pups, intranasal insulin increased PSD-95 expression. Taken together, these findings suggest that intranasal insulin promotes cognitive performance in MIA-exposed pups during adolescence; however, the underlying molecular mechanisms remain to be elucidated. 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

Sex differences are evident in anxiety and depression, and women more frequently present with comorbid anxiety and depression alongside gastrointestinal disturbances. This pattern suggests contributions from sex-specific biological mechanisms and gut-brain communication. Negr1, a molecule regulating neuronal growth and connectivity, has been linked to depression-relevant behaviors in animal models. However, its mechanisms and potential sex-specific effects remain unclear. Behavioral tests were used to assess phenotypes related to depression, anxiety, and learning in male and female wild-type (WT) and Negr1 Negr1 This study demonstrates that, in Negr1 Show less

Alzheimer's disease (AD) is characterized by an insidious onset and complex pathophysiology, necessitating the development of effective strategies for early detection and intervention. This exploratory study aimed to identify differentially expressed genes (DEGs) and disrupted molecular pathways in AD by analyzing blood samples from participants recruited in Valle del Cauca, Colombia, a region with high genetic admixture and persistent underrepresentation in genomic research. A total of 41 individuals (AD, n = 14; cognitively healthy controls (CHC), n = 27) were included. Groups did not differ significantly in age, education, sex distribution, or vascular comorbidities. Peripheral blood RNA was sequenced using 150-bp paired-end reads, and transcriptomic profiling revealed 399 DEGs, with 378 upregulated and 21 downregulated in the AD group. Key genes such as APOE, MMP2, PPARG, and TUBB3 were enriched in the Metabolism of Proteins pathway. At the same time, TUBB3, CACNA2D1, and GABBR2 were implicated in transmission across chemical synapses, suggesting synaptic signaling and protein metabolism dysregulation. Multiple factor analysis (MFA), integrating gene expression with neurocognitive and functional outcomes, revealed distinct molecular signatures associated with cognitive decline and functional impairment. These findings highlight the role of systemic metabolic dysfunction and synaptic dysregulation in AD pathogenesis. By focusing on an ancestrally diverse cohort, this study underscores the critical need to expand the molecular characterization of AD beyond European-ancestry populations, informing the development of inclusive biomarkers and precision strategies for early diagnosis and intervention. Show less

Lewy body dementia (LBD), encompassing dementia with Lewy bodies and Parkinson's disease dementia, is neuropathologically defined by neuronal accumulation of α-synuclein encoded by the SNCA gene. Genetic risk factors strongly influence LBD susceptibility, including SNCA multiplication, particularly triplication, and the apolipoprotein E ε4 allele (APOE4), the strongest common genetic risk factor for LBD. While SNCA is predominantly expressed in neurons and APOE primarily in glial cells, how these genetic factors converge to impact neuronal vulnerability and regional pathology in the human brain remains poorly understood. Here, we applied spatial transcriptomics to postmortem temporal cortex tissue from LBD cases with SNCA triplication or different APOE genotypes, alongside age- and sex-matched controls, to map gene expression within intact cortical architecture. We identified layer 5 of the gray matter as a particularly vulnerable region, characterized by elevated SNCA expression, pronounced synaptic and metabolic dysregulation, and exacerbation of these alterations in APOE4 carriers. Reelin signaling emerged as a core Lewy body-associated pathway disrupted across cortical layers, validated in independent postmortem cohorts and human-induced pluripotent stem cell (iPSC)-derived cortical organoids. In contrast, white matter exhibited distinct molecular alterations, including disrupted myelination pathways, with APOE4 carriers showing increased myelin debris and glial responses compared with non-carriers. Cell-type deconvolution informed by single-nucleus RNA sequencing further revealed APOE4-associated impairments in neuronal vulnerability and intercellular communication. Together, these findings define spatially and cell-type-specific mechanisms through which SNCA dosage and APOE4 genotype impact LBD pathology, providing insight into regionally distinct disease processes and potential targets for genetically stratified therapeutic interventions. Show less

Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease. Although Lp(a) levels are generally stable, the extent of intraindividual variation and the need for repeat Lp(a) testing remain unclear. To evaluate the intraindividual variation in Lp(a) levels assess the clinical impact of repeat testing on cardiovascular risk classification. This retrospective study analyzed 250 patients from a tertiary care lipid clinic with ≥2 Lp(a) measurements over a mean of 17.1 ± 15.5 months. Baseline levels were positively skewed (median of 56.0 nmol/L; interquartile range 21.0-154.3 nmol/L). Intraindividual coefficients of variation (CV) were 19.0% (mean-based) and 33.6% (log-transformed), exceeding the European Federation of Clinical Chemistry and Laboratory Medicine database CV (10.2%; 4.3%-26.7%). Cardiovascular risk reclassification occurred for 12.4% using the National Lipid Association thresholds (75 and 125 nmol/L) and 6.8% using the European Society of Cardiology threshold (105 nmol/L). Variability was not associated with time between measurements, medications, or biochemical parameters on multivariable analysis. Hence, repeat Lp(a) testing is generally unnecessary but could be considered in those near risk thresholds or those being evaluated for Lp(a)-lowering therapies. Show less

Genetic factors play an important role in metabolic disease susceptibility. Apolipoproteins E (APOE) and A1 (APOA1) are key regulators of lipid metabolism and have been individually associated with dyslipidemia and type 2 diabetes mellitus (T2DM). This study aimed to examine the individual and combined associations of APOE (rs429358, rs7412) and APOA1 (rs5069) gene polymorphisms with obesity and T2DM. A case-control study was conducted including 350 participants categorized into four groups: controls (n = 100), euglycemic obese individuals (n = 100), obese individuals with T2DM (n = 100), and non-obese individuals with T2DM (n = 50). Biochemical parameters, including lipid profiles and glycemic indices, were assessed. Genotyping was performed using TaqMan Metabolic disturbances and dyslipidemia were observed across all patient groups, with the most pronounced abnormalities in obese individuals with T2DM. The APOE ε4 allele and ε4/ε4 genotype were significantly associated with obese T2DM compared with controls and euglycemic obese subjects. The APOA1 rs5069 A allele and AA genotype were associated with both obesity and T2DM. Spearman correlation analysis revealed a positive co-occurrence of APOE and APOA1 genotypes in euglycemic obese (ρ = 0.264, p = 0.008) and obese T2DM (ρ = 0.347, p < 0.001) groups, but not in non-obese T2DM individuals. However, in multivariate logistic regression models adjusted for age, sex, and BMI, the APOE × APOA1 interaction term did not reach statistical significance (p = 0.138). APOE ε4 and APOA1 rs5069 A alleles were independently associated with obesity-related T2DM. Although these variants demonstrated correlated distribution patterns in obese individuals, the formal gene-gene interaction on T2DM risk was not statistically significant after multivariable adjustment. These findings suggest that obesity may represent a metabolic context in which combined genetic associations are more evident, warranting further investigation in larger and well-powered cohorts. Show less

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

Statins are a class of cholesterol-lowering agents widely used in clinical practice to reduce plasma levels of low-density lipoprotein cholesterol in hyperlipidemic patients. Beyond their lipidlowering roles, statins exhibit several additional effects. In the current review, we searched PubMed, ScienceDirect, and Google Scholar databases using the keywords "Statins," "HMG-CoA reductase inhibitors," "Anti-inflammatory," "Antioxidant," and "Anticancer" to provide an overview of the effects of statins. Articles published on these topics between 1990 and 2025 were included. The retrieved records were imported into EndNote, and duplicates were removed. Multiple potential therapeutic benefits of statins have been described, including suppression of apoptosis, antioxidant, anti-inflammatory and anticancer effects, immunomodulation and neuroprotection. NADPH oxidases (NOX) play a crucial role in the development of various diseases through excessive production of reactive oxygen species (ROS) and the creation of oxidative stress conditions. Stimulation of BDNF/Nrf2, inhibition of NOX pathways, and reduction of intracellular ROS via enhanced antioxidant activity represent possible mechanisms through which statins exert their effects. Interestingly, ROS and inflammatory cytokines activate nuclear factor kappa B (NF-κB), a critical factor in the development of malignant tumors, which induces the expression of genes involved in cell proliferation and carcinogenesis. Furthermore, statins inhibit NF-κB activity, a key transcriptional regulator in inflammatory responses. Clinical evidence suggests that statins may reduce the risk of various cancers and disease recurrence due to their anti-inflammatory and antioxidant properties. These findings form the basis for new therapeutic avenues in cancer treatment, potentially offering a more promising strategy than statin monotherapy. Show less

Human Immunodeficiency Virus (HIV) remains a global epidemic and is frequently associated with neurocognitive impairment, known as HIV-Associated Neurocognitive Disorder (HAND). Brain-Derived Neurotrophic Factor (BDNF), which regulates neuroplasticity, learning, and memory, may play a key role in this process. This study aimed to investigate the correlation between BDNF, CD4 levels, and cognitive function in patients with HIV. We conducted a cross-sectional study at Adam Malik General Hospital, Medan, Indonesia, from July 2024 to January 2025. Fifty-eight HIV-positive patients aged 18-60 years with CD4 ≥200 cells/mm³ and on antiretroviral therapy for at least 4 months were included. Blood samples were analyzed for serum BDNF (ELISA) and CD4 counts. Cognitive function was assessed using the Stroop Test, and correlations were examined with Spearman's test Result: Participants had a mean age of 38.77 ± 9.28 years; 79.3% were male. The mean BDNF level was 1.08 ± 0.59 ng/mL, the mean CD4 count was 512.60 ± 331.08 cells/mm³, and the mean Stroop Test score was 68.75 ± 24.60 seconds. A significant negative correlation was observed between BDNF and Stroop performance (r = -0.288, p = 0.028), indicating that higher BDNF was associated with better cognitive function. No significant correlation was found between CD4 and cognitive function (p = 0.336) Discussion: These findings suggest that reduced BDNF may contribute to cognitive impairment in HIV, whereas CD4 levels may not directly reflect neurocognitive status, particularly in patients with CD4 ≥200. BDNF levels are significantly correlated with cognitive function in HIV-positive patients, underscoring its potential role as a biomarker for HAND. Show less

Postoperative complications are common issues that may arise from anesthetic drugs or surgical procedures. This study aimed to investigate the protective and therapeutic effects of ginsenosides on anesthesia-associated side effects and postoperative complications. This study was conducted following the PRISMA 2020 guidelines. A comprehensive search was conducted across PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library to identify relevant studies published prior to October 13, 2024. Predefined inclusion and exclusion criteria were applied, and duplicates were removed. Ginsenosides inhibit oxidative stress and enhance cognitive function by activating pathways such as phosphoinositide 3-kinase (PI3K)/Protein kinase B (PKB) (AKT)/glycogen synthase kinase-3 beta (GSK-3β), promoting neuroplasticity, alleviating oxidative stress, and modulating neuroinflammatory markers, as well as microglia and astrocytes. They help to maintain mitochondrial integrity, thereby reducing apoptosis and neurotoxicity caused by anesthetic agents. Ginsenosides also alleviate postoperative pain by modulating N-methyl-D-aspartate (NMDA) and suppressing inflammatory cytokines. They also improved neuropsychological problems by increasing Nerve Growth Factor (NGF) and Brain-Derived Neurotrophic Factor (BDNF). The anti-fatigue properties of ginsenosides are attributed to enhanced antioxidant activity, improved skeletal muscle metabolic function, and increased Adenosine Triphosphate (ATP) production. These results are consistent with prior studies demonstrating the neuroprotective effects of ginsenosides. Despite promising outcomes, the prevalence of animal studies and the absence of clinical data underscore the necessity for clinical validation and safety profiling in future research. Preclinical evidence shows ginsenosides, particularly Rg1, Rb1, and Rg3, demonstrate promising protective and therapeutic effects against anesthesia-associated adverse effects and postoperative complications. Show less

Dietary intake is a primary route of exposure to polychlorinated biphenyls (PCBs). The absorption and adverse effects of pollutants are markedly influenced by sex. However, insights into sex-specific differences in PCB oral bioavailability remain limited. In this study, PCB oral bioavailability was assessed in adult female and male Balb/c mice. At different exposure doses, the oral bioavailability of PCBs in female mice (14.2-22.8%) was significantly higher than that in male mice (12.3-18.8%). Correspondingly, males excreted a greater proportion of PCBs via feces, with fecal excretion percentages of 9.50-10.4% in males compared to 6.98-8.13% in females. Mechanistic analyses revealed that the higher PCB oral bioavailability in females was associated with greater dietary lipid assimilation efficiency and elevated postprandial serum apoB-48 levels, which are key indicators of chylomicron-mediated transport of lipophilic pollutants. Gut microbiota analysis revealed a more pronounced increase in Show less

Papillary thyroid carcinoma (PTC) is the most common form of thyroid cancer, with the majority of cases driven by genetic alterations that activate the MAPK signaling pathway. The BRAF V600E mutation is the most frequent alteration, while BRAF fusions are relatively rare but increasingly recognized as oncogenic drivers. These fusions typically involve the loss of BRAF's autoinhibitory N-terminal domain, leading to constitutive MAPK pathway activation. Here, we report a novel SORBS2::BRAF fusion in a case of PTC, further expanding the spectrum of BRAF alterations in thyroid cancer. A 32-year-old male was incidentally found to have a left thyroid nodule during a routine physical examination. Follow-up examinations revealed changes in the nodule's characteristics, prompting fine-needle aspiration biopsy, which identified atypical follicular epithelial cells suggestive of papillary thyroid carcinoma. Histopathological examination confirmed the diagnosis, and next-generation sequencing (NGS) revealed a novel in-frame fusion between SORBS2 exon 18 and BRAF exon 9. The resulting fusion protein retains the BRAF kinase domain while replacing its autoinhibitory domains with those of SORBS2. RT-PCR and Sanger sequencing confirmed the presence of the SORBS2::BRAF fusion. Quantitative PCR profiling of MAPK transcriptional output genes (DUSP6, CCND1, ETV4, c-Myc, and c-FOS) revealed marked upregulation in the tumor versus adjacent normal tissue, providing functional evidence for pathway activation. The SORBS2::BRAF fusion has not been previously reported in PTC or any other tumor type. Given the deletion of BRAF's inhibitory domain, this fusion likely acts as a tumor driver through constitutive activation of the MAPK pathway. This case underscores the importance of molecular diagnostics in identifying rare genetic alterations and highlights the need for further research into targeted therapies for BRAF fusion-driven cancers. The discovery of this novel fusion expands our understanding of the molecular landscape of PTC and provides a foundation for future therapeutic development. Show less

Lipoprotein apheresis (LA) is the only approved treatment for patients with elevated lipoprotein(a) [Lp(a)]. The Lp(a)FRONTIERS APHERESIS trial investigated whether pelacarsen reduces the need for LA in patients from Germany with elevated Lp(a) and established cardiovascular disease (CVD). Adult patients with Lp(a) levels >60 mg/dl who had undergone ≥35 LA sessions in the prior year were randomized to receive pelacarsen 80 mg or placebo every 4 weeks for 52 weeks. Weekly LA sessions were performed if the Lp(a) measurement from the prior visit was >60 mg/dL. The primary endpoint was the rate of performed LA sessions normalized to the weekly LA schedule (the number of actual LA sessions divided by the number of planned LA sessions during the 52-week period). Secondary endpoints were time to LA avoidance (for ≥24 consecutive weeks) and total LA avoidance from week 12 to week 52. Fifty-one patients were randomized (mean age 61.7 years, mean Lp(a) at baseline 85.4 mg/dL, and mean 44.0 LA sessions in the past 12 months), with 25 of 26 (96.2%) in the pelacarsen arm and 23 of 25 (92.0%) in the placebo arm completing the study. Baseline characteristics were generally balanced between treatment arms. Pelacarsen reduced the mean rates of LA (0.16 vs 0.93 in placebo, odds ratio 0.006, 95% confidence interval [CI] 0.003, 0.013; P < .0001) and substantially increased the hazard of achieving LA avoidance (hazard ratio: 88.3; P = .0014; median time to achieve LA avoidance: 6.1 weeks) and total LA avoidance (odds ratio: 163.2; P = .0005). The placebo-adjusted Lp(a) change from baseline at week 52 was -72% (95% CI: -79%, -61%; P < .0001). Treatment emergent adverse events were similar between arms, except for mostly mild injection site erythema (pelacarsen 38.5%; placebo 0%). Pelacarsen is a highly effective and well-tolerated Lp(a)-targeted therapy that substantially reduces the need for LA in patients with elevated Lp(a) and established CVD. NCT05305664. Show less