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Chronobiological disruptions: unravelling the interplay of shift work, circadian rhythms, and vascular health in the context of stroke risk. 时间生物学干扰:从中风风险的角度揭示轮班工作、昼夜节律和血管健康之间的相互作用。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-14 DOI: 10.1007/s10238-024-01514-w
Xiaohong Li, Yanjin He, Dawu Wang, Mohammad Reza Momeni

Shift work, particularly night shifts, disrupts circadian rhythms and increases stroke risk. This manuscript explores the mechanisms connecting shift work with stroke, focusing on circadian rhythms, hypertension, and diabetes. The circadian system, controlled by different mechanisms including central and peripheral clock genes, suprachiasmatic nuclei (SCN), and pineal gland (through melatonin production), regulates body functions and responds to environmental signals. Disruptions in this system affect endothelial cells, leading to blood pressure issues. Type 2 diabetes mellitus (T2DM) is significantly associated with night shifts, with circadian disturbances affecting glucose metabolism, insulin sensitivity, and hormone regulation. The manuscript examines the relationship between melatonin, insulin, and glucose balance, highlighting pathways that link T2DM to stroke risk. Additionally, dyslipidemia, particularly reduced HDL-c levels, results from shift work and contributes to stroke development. High lipid levels cause oxidative stress, inflammation, and endothelial dysfunction, increasing cerebrovascular risks. The manuscript details the effects of dyslipidemia on brain functions, including disruptions in blood flow, blood-brain barrier integrity, and neural cell death. This comprehensive analysis emphasizes the complex interplay of circadian disruption, hypertension, diabetes, and dyslipidemia in increasing stroke risk among shift workers. Understanding these mechanisms is essential for developing targeted interventions to reduce stroke susceptibility and improve cerebrovascular health in this vulnerable population.

轮班工作,尤其是夜班,会扰乱昼夜节律,增加中风风险。本手稿以昼夜节律、高血压和糖尿病为重点,探讨了轮班工作与中风的关联机制。昼夜节律系统由不同的机制控制,包括中枢和外周时钟基因、副上核(SCN)和松果体(通过分泌褪黑激素),调节身体功能并对环境信号做出反应。这一系统的紊乱会影响内皮细胞,导致血压问题。2 型糖尿病(T2DM)与夜班密切相关,昼夜节律紊乱会影响葡萄糖代谢、胰岛素敏感性和激素调节。手稿研究了褪黑激素、胰岛素和葡萄糖平衡之间的关系,强调了 T2DM 与中风风险之间的联系途径。此外,轮班工作导致血脂异常,尤其是高密度脂蛋白-c 水平降低,也是导致中风的原因之一。高血脂会导致氧化应激、炎症和内皮功能障碍,增加脑血管风险。手稿详细阐述了血脂异常对大脑功能的影响,包括血流紊乱、血脑屏障完整性和神经细胞死亡。这一全面分析强调了昼夜节律紊乱、高血压、糖尿病和血脂异常在增加倒班工人中风风险方面复杂的相互作用。了解这些机制对于制定有针对性的干预措施以降低中风易感性和改善这一弱势群体的脑血管健康至关重要。
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引用次数: 0
Clinical characteristics and prognosis analysis of pseudomonas aeruginosa bloodstream infection in adults: a retrospective study. 成人铜绿假单胞菌血流感染的临床特征和预后分析:一项回顾性研究。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-13 DOI: 10.1007/s10238-024-01517-7
Xiaoya Huang, Jiahai Ding, Xin Yang, Bingxin Tian, Runli Yu, Min Lyu, Wen Liu, Qin Ding

Pseudomonas aeruginosa bloodstream infections (PA BSIs) in adults, especially those complicated by sepsis, are associated with high rates of morbidity and mortality. Early identification of risk factors for both mortality and sepsis-induced coagulopathy (SIC) is critical to optimizing patient management and improving outcomes. We conducted a retrospective analysis of 118 adult patients diagnosed with PA BSIs at the Affiliated Hospital of Xuzhou Medical University from January 2022 to February 2024. Univariate analysis was employed to identify significant clinical factors, followed by multivariate stepwise logistic regression to determine independent predictors of mortality and SIC. Based on these findings, nomogram models were constructed and evaluated using the area under the receiver operating characteristic curve (AUC), Bootstrap resampling, and calibration plots to assess model performance. Empiric sensitive antibiotic therapy (ESAT) (OR = 0.039, P < 0.001), coronary artery disease (CAD) (OR = 10.315, P = 0.010), and invasive mechanical ventilation (OR = 3.926, P = 0.020) emerged as significant predictors of mortality. In contrast, elevated C-reactive protein (CRP) (OR = 1.011, P = 0.003), procalcitonin (PCT) (OR = 1.030, P = 0.005), and lower hemoglobin levels (OR = 0.963, P = 0.004) were independently associated with SIC. The AUC of mortality prediction model is 0.908, while the SIC prediction model yielded an AUC of 0.817. The predictive models developed in this study demonstrate early identification of mortality rates and SIC risk in PA BSI patients, which may have the potential to guide timely therapeutic interventions and improve clinical outcomes in this high-risk population.

成人铜绿假单胞菌血流感染(PA BSI),尤其是并发脓毒症的患者,发病率和死亡率都很高。早期识别死亡率和败血症诱发凝血病(SIC)的风险因素对于优化患者管理和改善预后至关重要。我们对徐州医科大学附属医院 2022 年 1 月至 2024 年 2 月期间确诊为 PA BSI 的 118 例成人患者进行了回顾性分析。我们采用单变量分析来确定重要的临床因素,然后采用多变量逐步逻辑回归来确定死亡率和SIC的独立预测因素。根据这些结果,构建了提名图模型,并使用接收者操作特征曲线下面积(AUC)、Bootstrap重采样和校准图评估模型性能。经验性敏感抗生素治疗(ESAT)(OR = 0.039,P
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引用次数: 0
A systematic review and meta-analysis of the endothelial-immune candidate biomarker endoglin in rheumatic diseases. 风湿性疾病中内皮免疫候选生物标志物内皮素的系统综述和荟萃分析。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-13 DOI: 10.1007/s10238-024-01519-5
Arduino A Mangoni, Angelo Zinellu

Existing challenges in accurately diagnosing various rheumatic diseases (RDs) have stimulated the search for novel biomarkers to aid clinical evaluation and monitoring. We conducted a systematic review and meta-analysis of studies investigating the candidate biomarker endoglin (CD105), a transmembrane glycoprotein expressed in endothelial, myeloid, and lymphoid cells, in RD patients and healthy controls. We searched PubMed, Scopus, and Web of Science from inception to 10 August 2024 to identify relevant studies. We evaluated the risk of bias using the JBI Critical Appraisal Checklist and the certainty of evidence using GRADE (PROSPERO registration number: CRD42023581008). Overall, circulating endoglin concentrations were significantly higher in RD patients compared to controls (13 studies; standard mean difference, SMD = 0.64, 95% CI 0.13 to 1.14, p = 0.014; low certainty of evidence). The effect size of the between-group differences in endoglin concentrations was not significantly associated with age, male-to-female ratio, year of publication, number of participants, or mean RD duration. By contrast, the effect size was statistically significant in studies conducted in the European region (p = 0.033), involving patients with systemic sclerosis (p = 0.032), and measuring serum (p = 0.019). The results of this systematic review and meta-analysis suggest the potential pathophysiological role of endoglin in RDs. This, however, requires further investigation in prospective studies, particularly in patients with systemic sclerosis.

准确诊断各种风湿性疾病(RDs)所面临的挑战促使人们寻找新型生物标记物来帮助临床评估和监测。我们对研究 RD 患者和健康对照组的候选生物标志物内皮素(CD105)的研究进行了系统回顾和荟萃分析,内皮素是一种在内皮细胞、髓细胞和淋巴细胞中表达的跨膜糖蛋白。我们检索了从开始到 2024 年 8 月 10 日的 PubMed、Scopus 和 Web of Science,以确定相关研究。我们使用 JBI 关键评估清单评估了偏倚风险,并使用 GRADE 评估了证据的确定性(PROSPERO 注册号:CRD42023581008)。总体而言,与对照组相比,RD 患者的循环内皮素浓度明显较高(13 项研究;标准平均差,SMD = 0.64,95% CI 0.13 至 1.14,p = 0.014;证据确定性较低)。内皮素浓度组间差异的效应大小与年龄、男女比例、发表年份、参与者人数或平均 RD 持续时间无显著相关性。相比之下,在欧洲地区进行的研究(p = 0.033)、涉及系统性硬化症患者的研究(p = 0.032)和测量血清的研究(p = 0.019)的效应大小具有统计学意义。本系统综述和荟萃分析的结果表明,内胚叶蛋白在 RDs 中具有潜在的病理生理作用。不过,这还需要在前瞻性研究中进行进一步调查,尤其是在系统性硬化症患者中。
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引用次数: 0
Analysis of METTL14 expression in pancreatic cancer and adjacent tissues and its prognostic value for patient outcomes. 分析胰腺癌和邻近组织中 METTL14 的表达及其对患者预后的价值。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-11 DOI: 10.1007/s10238-024-01506-w
Siyu Meng, Cong Wang

This study aims to analyze the differential expression of METTL14 in pancreatic cancer (PC) tissues and adjacent normal tissues, and its correlation with clinical outcomes. According to the inclusion and exclusion criteria, a total of 80 patients diagnosed in our hospital from January 2021 to January 2023 were chosen as research subjects. RTQ-PCR has detected the mRNA level expression of METTL14 in cancer and para-cancerous tissues. Immunohistochemistry was used to detect the protein expression of METTL14 in cancer and para-cancerous tissues. To compare the relationship between METTL14 expression and clinicopathological parameters in different PC patients. Kaplan-Meier survival analysis of the relationship between METTL14 expression in PC tissues and patient survival prognosis. The Multifactor COX model evaluates factors affecting the prognosis of PC. The expression level of METTL14 mRNA in PC tissues was 5.51 ± 0.35 (kDa), and the positive rate of METTL14 protein expression in PC tissues of all patients was 73.75 (59/80). Tumor location (P = 0.012), tumor differentiation degree (P = 0.028), tumor AJCC stage (P = 0.000), and lymph node metastasis (P = 0.000) were significantly related to the positive rate of METTL14 protein expression in PC tissue. Follow-up results showed that among 80 patients, 63 died. The three-year survival rate of the METTL14 positive group was 13.56% (8/59), and the three-year survival rate of the negative group was 42.86% (9/21). The difference in the three-year survival rate between METTL14 positive and negative expression groups was statistically significant (P = 0.031). Multivariate COX regression analysis results showed that METTL14 was positive (OR 2.797, 95% CI 1.233-5.877), tumor AJCC stage II-III (OR 1.628, 95% CI 1.435-3.859) and lymph node metastasis (OR 1.733, 95% CI 1.122-2.372) were substantive risk factors for poor prognosis in patients with PC. METTL14 expression increases in PC tissue, which is related to tumor AJCC stage, tumor differentiation, and lymph node metastasis, and can be evaluated in the survival prognosis of patients with PC.

本研究旨在分析METTL14在胰腺癌(PC)组织和邻近正常组织中的差异表达及其与临床预后的相关性。根据纳入和排除标准,选择 2021 年 1 月至 2023 年 1 月在我院确诊的 80 例患者作为研究对象。RTQ-PCR 检测癌症和癌旁组织中 METTL14 的 mRNA 水平表达。免疫组化法检测癌症和癌旁组织中 METTL14 的蛋白表达。比较不同 PC 患者中 METTL14 表达与临床病理参数之间的关系。对PC组织中METTL14表达与患者生存预后的关系进行Kaplan-Meier生存分析。多因素 COX 模型评估了影响 PC 预后的因素。PC 组织中 METTL14 mRNA 的表达水平为 5.51 ± 0.35(kDa),所有患者 PC 组织中 METTL14 蛋白表达的阳性率为 73.75(59/80)。肿瘤位置(P = 0.012)、肿瘤分化程度(P = 0.028)、肿瘤 AJCC 分期(P = 0.000)和淋巴结转移(P = 0.000)与 PC 组织中 METTL14 蛋白表达阳性率显著相关。随访结果显示,80 名患者中有 63 人死亡。METTL14阳性组的三年生存率为13.56%(8/59),阴性组的三年生存率为42.86%(9/21)。METTL14阳性表达组和阴性表达组的三年生存率差异有统计学意义(P = 0.031)。多变量 COX 回归分析结果显示,METTL14 阳性(OR 2.797,95% CI 1.233-5.877)、肿瘤 AJCC II-III 期(OR 1.628,95% CI 1.435-3.859)和淋巴结转移(OR 1.733,95% CI 1.122-2.372)是 PC 患者预后不良的主要危险因素。METTL14在PC组织中的表达增加,与肿瘤AJCC分期、肿瘤分化和淋巴结转移有关,可用于评估PC患者的生存预后。
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引用次数: 0
Tumor-immune hybrid cells evade the immune response and potentiate colorectal cancer metastasis through CTLA4. 肿瘤免疫杂交细胞通过 CTLA4 逃避免疫反应并促进结直肠癌转移。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-05 DOI: 10.1007/s10238-024-01515-9
Pariyada Tanjak, Amphun Chaiboonchoe, Thanawat Suwatthanarak, Kullanist Thanormjit, Onchira Acharayothin, Jantappapa Chanthercrob, Thammawat Parakonthun, Asada Methasate, Jared M Fischer, Melissa H Wong, Vitoon Chinswangwatanakul

Understanding the metastatic cascade is critical for the treatment and prevention of cancer-related death. Within a tumor, immune cells have the capacity to fuse with tumor cells to generate tumor-immune hybrid cells (THCs). THCs are hypothesized to be a subset of cancer cells with the capacity to enter circulation as circulating hybrid cells (CHC) and seed metastases. To understand the mechanism of THC metastasis, we investigated CHCs in peripheral blood from patients with stage IV colorectal cancer (CRC), as well as THCs in tissues of primary colorectal cancers and their liver metastasis sites using immunofluorescence, spatial proteomic, spatial transcriptomic, molecular classification, and molecular pathway analyses. Our findings indicated a high prevalence of CHCs and THCs in patients with stage IV CRC. THCs expressed CTLA4 in primary CRC lesions and correlated with upregulation of CD68, CD4, and HLA-DR in metastatic liver lesions, which is found in the consensus molecular subtype (CMS) 1 of primary CRC tissue. Pathway analysis of these genes suggested that THCs are associated with neutrophils due to upregulation of neutrophil extracellular trap signaling (NET) and neutrophil degranulation pathways. These data provide molecular pathways for the formation of THCs suggesting fusion with neutrophils, which may facilitate extravasation and metastatic seeding.

了解转移级联对于治疗和预防癌症相关死亡至关重要。在肿瘤内部,免疫细胞有能力与肿瘤细胞融合,生成肿瘤免疫混合细胞(THC)。据推测,THC 是癌细胞的一个亚群,有能力以循环杂交细胞(CHC)的形式进入血液循环,并播下转移的种子。为了了解 THC 转移的机制,我们采用免疫荧光、空间蛋白质组、空间转录组、分子分类和分子通路分析等方法研究了 IV 期结直肠癌(CRC)患者外周血中的 CHC,以及原发性结直肠癌及其肝转移部位组织中的 THC。我们的研究结果表明,在 IV 期 CRC 患者中,CHC 和 THC 的发病率很高。THCs在原发性CRC病变中表达CTLA4,并与转移性肝脏病变中CD68、CD4和HLA-DR的上调相关,这在原发性CRC组织的共识分子亚型(CMS)1中也有发现。这些基因的通路分析表明,THCs 与中性粒细胞有关,因为中性粒细胞胞外陷阱信号(NET)和中性粒细胞脱颗粒通路上调。这些数据为THCs的形成提供了分子途径,表明THCs与中性粒细胞融合,可能会促进外渗和转移播种。
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引用次数: 0
Development and validation of a model for predicting who can benefit from multiple TACE in HCC patients. 开发并验证一个模型,用于预测哪些 HCC 患者可从多次 TACE 中获益。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-02 DOI: 10.1007/s10238-024-01516-8
Huizhi Zhang, Xingxing Wang, Hongxiang Wang, Junchi Li, Kai Lei, Run Hu, Zuojin Liu

This study was to develop and validate a model for predicting who can benefit from multiple transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients.228 and 98 patients were included in the development and validation sets, respectively. The primary clinical endpoint was benefiting from consecutive multiple TACE treatments. Logistic regression analysis was used to screen the independent risk factors for the clinical endpoint. The independent risk factors were then used to construct the predictive model. The area under receiver operating characteristic (ROC) curves, calibration curves, and clinical decision curves were used to evaluate the predictive ability of the model.Multivariate Logistic regression analysis showed that complete envelope, hepatic lopes, tumor number, and alpha-fetoprotein (AFP) were independent risk factors for benefiting from multiple TACE in HCC patients. The area under the curve (AUC) of the model constructed by using independent risk factors in the development and validation sets was 0.843 (95% confidence interval [CI]: 0.784-0.902) and 0.828 (95%CI: 0.739-0.916), respectively. The calibration curves and clinical decision curves showed that the model had good predictive ability.The model established in this study has a good predictive effect on HCC patients who can benefit from multiple TACE.

这项研究旨在开发和验证一个模型,用于预测肝细胞癌(HCC)患者中哪些人可以从多次经导管动脉化疗栓塞术(TACE)中获益。主要临床终点是从连续多次TACE治疗中获益。逻辑回归分析用于筛选临床终点的独立风险因素。然后利用独立风险因素构建预测模型。多变量逻辑回归分析表明,完全包膜、肝洛佩斯、肿瘤数目和甲胎蛋白(AFP)是HCC患者从多次TACE中获益的独立危险因素。在开发集和验证集中使用独立风险因素构建的模型的曲线下面积(AUC)分别为0.843(95%置信区间[CI]:0.784-0.902)和0.828(95%CI:0.739-0.916)。校准曲线和临床决策曲线显示,该模型具有良好的预测能力。
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引用次数: 0
GUCA2A dysregulation as a promising biomarker for accurate diagnosis and prognosis of colorectal cancer. GUCA2A 失调是准确诊断和预后结直肠癌的一种有前途的生物标记物。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-01 DOI: 10.1007/s10238-024-01512-y
Pooya Jalali, Shahram Aliyari, Marziyeh Etesami, Mahsa Saeedi Niasar, Sahar Taher, Kaveh Kavousi, Ehsan Nazemalhosseini Mojarad, Zahra Salehi

Colorectal cancer is a leading cause of global mortality and presents a significant barrier to improving life expectancy. The primary objective of this study was to discern a unique differentially expressed gene (DEG) that exhibits a strong association with colorectal cancer. By achieving this goal, the research aims to contribute valuable insights to the field of translational medicine. We performed analysis of colorectal cancer microarray and the TCGA colon adenoma carcinoma (COAD) datasets to identify DEGs associated with COAD and common DEGs were selected. Furthermore, a pan-cancer analysis encompassing 33 different cancer types was performed to identify differential genes significantly expressed only in COAD. Then, comprehensively in-silico analysis including gene set enrichment analysis, constructing Protein-Protein interaction, co-expression, and competing endogenous RNA (ceRNA) networks, investigating the correlation between tumor-immune signatures in distinct tumor microenvironment and also the potential interactions between the identified gene and various drugs was executed. Further, the candidate gene was experimentally validated in tumoral colorectal tissues and colorectal adenomatous polyps by qRael-Time PCR. GUCA2A emerged as a significant DEG specific to colorectal cancer (|log2FC|> 1 and adjusted q-value < 0.05). Importantly, GUCA2A exhibited excellent diagnostic performance for COAD, with a 99.6% and 78% area under the curve (AUC) based on TCGA-COAD and colon cancer patients. In addition, GUCA2A expression in adenomatous polyps equal to or larger than 5 mm was significantly lower compared to smaller than 5 mm. Moreover, low expression of GUCA2A significantly impacted overall patient survival. Significant correlations were observed between tumor-immune signatures and GUCA2A expression. The ceRNA constructed included GUCA2A, 8 shared miRNAs, and 61 circRNAs. This study identifies GUCA2A as a promising prognostic and diagnostic biomarker for colorectal cancer. Further investigations are warranted to explore the potential of GUCA2A as a therapeutic biomarker.

结直肠癌是导致全球死亡的主要原因之一,也是提高预期寿命的一大障碍。这项研究的主要目的是找出与结直肠癌密切相关的独特差异表达基因(DEG)。通过实现这一目标,研究旨在为转化医学领域贡献有价值的见解。我们对结直肠癌微阵列和 TCGA 结肠腺瘤癌(COAD)数据集进行了分析,以确定与 COAD 相关的 DEGs,并筛选出常见的 DEGs。此外,还对 33 种不同癌症类型进行了泛癌症分析,以确定仅在 COAD 中显著表达的差异基因。然后,进行了包括基因组富集分析、构建蛋白-蛋白相互作用、共表达和竞争性内源性 RNA(ceRNA)网络在内的全面海内分析,研究了不同肿瘤微环境中肿瘤-免疫特征之间的相关性,以及所识别基因与各种药物之间的潜在相互作用。此外,还通过 qRael-Time PCR 在肿瘤结直肠组织和结直肠腺瘤息肉中对候选基因进行了实验验证。GUCA2A 成为结直肠癌特异性的重要 DEG(|log2FC|> 1,调整后的 q-value
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引用次数: 0
Early minimal residual disease eradication in light chain amyloidosis generates deeper and faster cardiac response. 早期根除轻链淀粉样变性的极小残留病变可产生更深更快的心脏反应。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-01 DOI: 10.1007/s10238-024-01511-z
Tianhong Xu, Jing Li, Yang Yang, Wenjing Wang, Chi Zhou, Pu Wang, Chenqi Yu, Peng Liu

Minimal residual disease (MRD) is of growing interest in light chain (AL) amyloidosis and is associated with higher rates of cardiac response. A new graded cardiac response criteria has been proposed for better assessment of cardiac improvement. We evaluated MRD status in 63 patients with cardiac AL amyloidosis using next generation flow cytometry (sensitivity ≥ 1*10-5) within four cycles after treatment initiation and cardiac response kinetics. All patients were treated with first-line proteasome inhibitor (100%) and predominantly bortezomib (87.3%). The overall early MRD negative rates were 33.3%. Patients who achieved early MRD negativity were less likely to harbor t(11;14) (21.1% vs 57.5%, P = 0.009). The MRD negative rates amongst patients in hematologic complete response were 66.7% (14/21), and in very good partial response 29.2% (7/24). Early MRD negativity was associated with a higher likelihood of achieving ≥ cardiac partial response (≥ CarPR) (66.7% vs 38.1%, P = 0.032) and ≥ cardiac very good partial response (≥ CarVGPR) (38.1% vs 11.9%, P = 0.023) throughout first-line therapy. The cumulative incidence curve of achieving ≥ CarPR (P = 0.034) and ≥ CarVGPR (P = 0.026) showed significant difference between early MRD negative and positive group. After a median follow-up time of 27.2 months, the median progression free survival was longer in early MRD negative group (not reached vs 31.3 months, P = 0.033). Early MRD eradication in cardiac AL amyloidosis generated deeper and faster cardiac organ response.

在轻链(AL)淀粉样变性中,最小残留病(MRD)越来越受到关注,它与较高的心脏反应率有关。为了更好地评估心脏疾病的改善情况,人们提出了一种新的心脏反应分级标准。我们采用新一代流式细胞术(灵敏度≥ 1*10-5)评估了63例心脏AL淀粉样变性患者在治疗开始后四个周期内的MRD状态和心脏反应动力学。所有患者都接受了一线蛋白酶体抑制剂治疗(100%),主要是硼替佐米(87.3%)。总体早期MRD阴性率为33.3%。早期MRD阴性的患者携带t(11;14)的可能性较低(21.1% vs 57.5%,P = 0.009)。血液学完全反应患者的MRD阴性率为66.7%(14/21),部分反应非常好的患者为29.2%(7/24)。在整个一线治疗过程中,早期MRD阴性与更有可能实现≥心脏部分反应(≥ CarPR)(66.7% vs 38.1%,P = 0.032)和≥心脏非常好部分反应(≥ CarVGPR)(38.1% vs 11.9%,P = 0.023)相关。早期MRD阴性组和阳性组达到≥CarPR(P = 0.034)和≥CarVGPR(P = 0.026)的累积发生率曲线显示出显著差异。中位随访时间为 27.2 个月后,早期 MRD 阴性组的中位无进展生存期更长(未达到 vs 31.3 个月,P = 0.033)。在心脏AL淀粉样变性病中早期根除MRD可产生更深更快的心脏器官反应。
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引用次数: 0
Genetics, diet, microbiota, and metabolome: partners in crime for colon carcinogenesis. 遗传、饮食、微生物群和代谢组:结肠癌发生的犯罪同伙。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-29 DOI: 10.1007/s10238-024-01505-x
Marta La Vecchia, Gloria Sala, Marika Sculco, Anna Aspesi, Irma Dianzani

Colorectal cancer (CRC) ranks among the most prevalent malignant tumors worldwide, with a multifactorial etiology encompassing genetic, environmental, and life-style factors, as well as the intestinal microbiota and its metabolome. These risk factors often work together in specific groups of patients, influencing how CRC develops and progresses. Importantly, alterations in the gut microbiota act as a critical nexus in this interplay, significantly affecting susceptibility to CRC. This review highlights recent insights into unmodifiable and modifiable risk factors for CRC and how they might interact with the gut microbiota and its metabolome. Understanding the mechanisms of these interactions will help us develop targeted, precision-medicine strategies that can adjust the composition of the gut microbiota to meet individual health needs, preventing or treating CRC more effectively.

结直肠癌(CRC)是全球发病率最高的恶性肿瘤之一,其病因是多因素的,包括遗传、环境和生活方式因素,以及肠道微生物群及其代谢组。在特定的患者群体中,这些风险因素往往共同作用,影响着 CRC 的发生和发展。重要的是,肠道微生物群的改变是这种相互作用的关键环节,对 CRC 的易感性有重大影响。本综述重点介绍了最近对 CRC 不可改变和可改变风险因素的认识,以及这些因素如何与肠道微生物群及其代谢组相互作用。了解这些相互作用的机制将有助于我们开发有针对性的精准医疗策略,调整肠道微生物群的组成以满足个人健康需求,从而更有效地预防或治疗 CRC。
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引用次数: 0
Identifying the prognostic significance of mitophagy-associated genes in multiple myeloma: a novel risk model construction. 识别多发性骨髓瘤中丝裂噬相关基因的预后意义:一种新型风险模型的构建。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-29 DOI: 10.1007/s10238-024-01499-6
Rui Min, Zeyu Hu, Yulan Zhou
<p><p>Multiple myeloma (MM) is a highly heterogeneous hematological malignancy that is currently incurable. Individualized therapeutic approaches based on accurate risk assessment are essential for improving the prognosis of MM patients. Nevertheless, current prognostic models for MM exhibit certain limitations and prognosis heterogeneity still an unresolved issue. Recent studies have highlighted the pivotal involvement of mitochondrial autophagy in the development and drug sensitivity of MM. This study seeks to conduct an integrative analysis of the prognostic significance and immune microenvironment of mitophagy-related signature in MM, with the aim of constructing a novel predictive risk model. GSE4581 and GSE47552 datasets were acquired from the Gene Expression Omnibus database. MM-differentially expressed genes (DEGs) were identified by limma between MM samples and normal samples in GSE47552. Mitophagy key module genes were obtained by weighted gene co-expression network analysis in the Cancer Genome Atlas (TCGA)-MM dataset. Mitophagy DEGs were identified by the overlap genes between MM-DEGs and mitophagy key module genes. Prognostic genes were selected through univariate Cox regression and least absolute shrinkage and selection operator (LASSO) analysis, and a risk model was subsequently constructed based on these prognostic genes. Subsequently, the MM samples were stratified into high- and low-risk groups based on their median risk scores. The validity of the risk model was further evaluated using the GSE4581 dataset. Moreover, a nomogram was developed using the independent prognostic factors identified from the risk score and various clinical indicators. Additionally, analyses were conducted on immune infiltration, immune scores, immune checkpoint, and chemotherapy drug sensitivity. The 17 mitophagy DEGs were obtained by intersection of 803 MM-DEGs and 1084 mitophagy key module genes. Five prognostic genes (CDC6, PRIM1, SNRPB, TOP2A, and ZNF486) were selected via LASSO and univariate cox regression analyses. The predictive performance of the risk model, which was constructed based on the five prognostic genes, demonstrated favorable results in both TCGA-MM and GSE4581 datasets as indicated by the receiver operating characteristic (ROC) curves. In addition, calibration curve, ROC curve, and decision curve analysis curve corroborated that the nomogram exhibited superior predictive accuracy for MM. Furthermore, immune analysis results indicated a significant difference in stromal scores of two risk groups categorized on median risk scores. And four immune checkpoints (CD274, CTLA4, LAG3, and PDCD1LG2) showed significant differences in different risk groups. The analysis of chemotherapy drug sensitivity revealed that etoposide and doxorubicin, which target TOP2A, exhibited superior treatment outcomes in the high-risk group. A novel prognostic model for MM was developed and validated, demonstrating significant potential in predicting patient o
多发性骨髓瘤(MM)是一种高度异质性的血液恶性肿瘤,目前无法治愈。基于准确风险评估的个体化治疗方法对于改善多发性骨髓瘤患者的预后至关重要。然而,目前的 MM 预后模型存在一定的局限性,预后异质性仍是一个悬而未决的问题。最近的研究强调了线粒体自噬在 MM 的发展和药物敏感性中的关键作用。本研究试图对 MM 中线粒体自噬相关特征的预后意义和免疫微环境进行综合分析,以构建一个新的预测风险模型。GSE4581 和 GSE47552 数据集来自基因表达总库数据库。在 GSE47552 数据集中,通过 limma 在 MM 样本和正常样本之间鉴定 MM 差异表达基因(DEGs)。在癌症基因组图谱(TCGA)-MM 数据集中,通过加权基因共表达网络分析获得了丝裂噬关键模块基因。有丝分裂 DEGs 是通过 MM-DEGs 与有丝分裂关键模块基因之间的重叠基因确定的。通过单变量考克斯回归和最小绝对缩小和选择算子(LASSO)分析筛选出预后基因,然后根据这些预后基因构建风险模型。随后,根据中位风险评分将 MM 样本分为高风险组和低风险组。利用 GSE4581 数据集进一步评估了风险模型的有效性。此外,还利用从风险评分和各种临床指标中识别出的独立预后因素绘制了一个提名图。此外,还对免疫浸润、免疫评分、免疫检查点和化疗药物敏感性进行了分析。通过803个MM-DEG和1084个有丝分裂关键模块基因的交叉得到了17个有丝分裂DEG。通过LASSO和单变量cox回归分析,筛选出5个预后基因(CDC6、PRIM1、SNRPB、TOP2A和ZNF486)。根据五个预后基因构建的风险模型的预测性能在 TCGA-MM 和 GSE4581 数据集中均显示出良好的结果,如接收者操作特征曲线(ROC)所示。此外,校准曲线、ROC 曲线和决策曲线分析曲线都证实了提名图对 MM 具有更高的预测准确性。此外,免疫分析结果表明,根据中位风险评分划分的两个风险组的基质评分存在显著差异。而四个免疫检查点(CD274、CTLA4、LAG3 和 PDCD1LG2)在不同风险组中有显著差异。对化疗药物敏感性的分析表明,靶向TOP2A的依托泊苷和多柔比星在高风险组中显示出更优越的治疗效果。该研究开发并验证了一种新的 MM 预后模型,该模型在预测患者预后方面显示出巨大潜力,并为个性化免疫疗法咨询提供了宝贵指导。
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Clinical and Experimental Medicine
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