Discovery medicine最新文献

Sepsis is a life-threatening organ dysfunction caused by the maladjustment of the body's response to infection. Abnormal immune response plays an important role in the progression of sepsis, and immunomodulatory therapy is a promising therapeutic strategy for sepsis. Great efforts have been made recently to elucidate the mechanism by which immune dysfunction contributes to sepsis, and identify potential biomarkers and targets for the diagnosis and therapy of sepsis induced by emerging pathogens, especially for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19. In this review, we summarize recent progress on the understanding of immune dysregulation involved in sepsis, and highlight potential biomarkers and targets to evaluate immune status of the patients with sepsis for individualized and precise immunotherapy.

miR-21 is involved in the mechanisms of inflammatory bowel disease (IBD). It negatively regulates PTEN, which is an upstream regulatory gene of the PI3K/Akt/mTOR signaling pathway. But the relationship between miR-21 and immune tolerance and intestinal epithelial injury, and the mechanism by which miR-21 participates in Crohn's disease (CD) have not been studied. We aimed to address these two questions. The results of the present study showed that the levels of miR-21 and PTEN respectively decreased and increased significantly in the intestinal mucosa from active CD compared with control ones. Transfection with miR-21-5p mimics significantly downregulated the expression of PTEN and upregulated PI3K-Akt-mTOR signaling and the downstream pathway in PBMCs, while transfection with a miR-21-5p inhibitor antagomiR-21had the opposite effect. Moreover, the ratio of Treg/Th1 cells differentiated from peripheral blood mononuclear cells (PBMCs) decreased after being transfected with mimics, and increased with the inhibitor. AntagomiR-21 significantly relieved the lesions in colons of mice with TNBS-induced colitis, accompanied by the upregulation of PTEN and downregulation of mTOR. Inhibition of miR-21 also effectively suppressed the process of epithelial-mesenchymal transition (EMT) in vivo. In conclusion, the level of miR-21 decreased in CD, resulting in an upregulated PI3K-Akt-mTOR signaling pathway, compromised immune tolerance, and elevated inflammation.

Fractional flow reserve (FFR) is a gold standard for the assessment of hemodynamic change during coronary stenosis, but it has several limitations such as high cost, the requirement of invasive pressure wire, and adverse drug reactions, which limit the wide application of FFR in clinical practice. In contrast, quantitative flow ratio (QFR) is a recently developed method for rapid calculation of FFR through 3-dimensional quantitative coronary angiography without the use of vasodilators and pressure wire. In this review we provide an updated summary of the principle of QFR, the correlation between QFR and FFR, and current applications of QFR in clinical cardiology. In conclusion, QFR provides a platform for functional evaluation of coronary stenoses based on angiographic data without invasive procedures; further development and optimization of QFR techniques will expand the application of QFR in clinical cardiology, ranging from diagnosis to coronary intervention to cardiac surgery, and benefit more patients.

Immune checkpoint inhibitors (ICIs) are novel immunotherapy drugs that have significantly improved the outcomes of a variety of cancers including lung cancer. However, ICIs could induce immune-related adverse effects (irAEs) characterized by clinical manifestations that resemble autoimmune disorders. The main type of IrAEs in the kidneys is acute kidney injury (AKI). In this review, we describe the types of ICIs targeting lung cancer, especially those approved by the U.S. Food and Drug Administration for clinical trials in lung cancer patients. Next, we summarize current understandings of the mechanisms involved in ICIs-induced AKI. Finally, we highlight further directions to address ICIs-associated AKI for the benefits of lung cancer patients in the clinic.

The increase of dietary fat energy supply ratio has led to a gradual increase in obesity, and the risk of hypertension in patients with obesity is much higher than that in the normal population. Weight loss has become a popular method to control obesity and hypertension. Metabolic bariatric surgery (MBS), which is also called weight loss surgery, can have significant effects on the weight and body metabolism of the patients. Recent studies have shown that the blood pressure of obese patients with hypertension is significantly improved after MBS. Therefore, in this review we will briefly describe the relationship between obesity and hypertension, summarize the effects of MBS on hypertension, and then focus on the mechanisms by which MBS achieves satisfactory efficacy to treat hypertension.

Myeloid-derived suppressor cells (MDSCs) constitute an important component in regulating immune responses in cancer. Long non-coding RNAs (lncRNAs) are untranslated functional RNA molecules. There is growing evidence that lncRNAs are involved in modulating transcriptional factors to become complex regulatory networks that regulate the immune function and activity of MDSCs in the immunosuppressive tumor microenvironment. This review focuses on the emerging role of lncRNAs in MDSCs activity. We summarize how lncRNAs modulate the differentiation, expansion, and immunosuppressive functions of MDSCs and the underlying mechanisms. It is hoped that lncRNAs targeting may prevent the growth and development of MDSCs in the immunosuppressive tumor microenvironment.

Glycogen synthase kinase 3 beta (GSK3β) has emerged as a therapeutic target for breast cancer. As inhibitors of GSK-3β, 1,2,4-thiadiazole-3,5-dione (TDZD) family members have been reported as potential candidates for cancer treatment. In this study, the anticancer effects of ethiadin (ETD-174), one of the chemical synthesis compounds of TDZD, were investigated in MCF-7 human breast cancer cells. MCF-7 cells incubated with different doses of ETD-174 for different time periods. CCK-8 assays were carried out to test the effect of ETD-174 on the proliferation of MCF-7 cells. The occurrence of apoptosis was detected by Hoechst 33258 staining and flow cytometry. ETD-174 on cell migration and colony formation were examined by wound healing experiments and soft agar assays. Relative protein expressions were conducted with immunoblot assay. ETD-174 demonstrated a higher degree of cytotoxicity in MCF-7 cells. Topical morphological changes of apoptotic body formation after ETD-174 treatment were observed. Meanwhile, apoptosis was elicited by ETD-174. Also, ETD-174 could inhibit the migration and clonality of MCF-7 cells. After the treatment with ETD-174, the level of phosphorylation of GSK3β^Ser9 in MCF-7 cells increased significantly, and the enzymatic activity of GSK3β decreased. ETD-174 is likely to have an effective suppressor role in breast cancer, suggesting that pharmacological inhibition of GSK3β as a novel treatment modality for breast cancer should warrant further investigation.

Prostate androgen-regulated mucin-like protein (PARM1) is known to promote cell survival via protecting the cell surface, thus being involved in cancer development. The Gene Expression Profiling Interactive Analysis (GEPIA), MEXPRESS database, LinkedOmics database, GeneMANIA database, and the Tumor Immune Estimation Resource (TIMER) database were accessed to explore the epigenetic regulation, prognostic value, biological functions and mechanisms of PARM1 in diffuse large B-cell lymphoma (DLBCL). Hypomethylation and resultant overexpression of PARM1 was found in DLBCL. The high-level expression of PARM1 was related to the poor outcome of DLBCL patients. PARM1 participated in DNA repair, cell cycle, and cellular response to stress. PARM1 was also associated with autophagy, apoptosis, Ras pathway, and MAPK cascade. Significant kinase targets of PARM1 included ATM, CDK1, and CDK2. Significant transcription factor targets of PARM1 involved ELK1, MYC and so on. Significant miRNA targets of PARM1 included miR21, miR202, miR323, and miR345. Further analysis suggested that the PARM1 regulated autophagy through the PI3K-Akt signaling. PARM1 was found to be correlated with immune cell infiltration, which indicated the important roles of PARM1 in microenvironment of DLBCL. Our study lays a foundation for further research on the impact of PARM1 in DLBCL tumorigenesis and precision therapy.

Objective: The aim of this study is to determine the role of serum exosomal miRNAs as potential non-invasive biomarkers for distinguishing no-or-mild fibrosis from significant fibrosis in patients with chronic hepatitis B (CHB).

Methods: Next-generation sequencing was used to identify fibrosis-related serum exosomal miRNAs in 9 CHB patients. The candidate exosomal miRNAs were further validated by qRT-PCR in 282 CHB patients. Receiver operating characteristic curves were generated to assess the diagnostic performance of exosomal miRNAs and other non-invasive models.

Results: Seventy-two miRNAs were differentially expressed in serum exosomes between patients with no-or-mild fibrosis and significant fibrosis. The expression of serum exosomal miR-92a-3p and miR-146a-5p progressively increased with the aggravation of liver fibrosis in the validation cohort. Multivariate analysis identified miR-92a-3p (P<0.001), miR-146a-5p (P<0.001), and liver stiffness measurement (LSM) (P=0.012) as independent predictors for significant fibrosis. The area under the receiver operating characteristic curve (AUROC) of exosomal miR-92a-3p (AUROC=0.88) was significantly higher than that of APRI (aspartate aminotransferase-to-platelet ratio index) (AUROC=0.72, P<0.001), FIB-4 (AUROC=0.71, P<0.001), and LSM (AUROC=0.80, P=0.022) for identifying significant fibrosis. Similarly, the AUROC of exosomal miR-146a-5p (AUROC=0.82) was also significantly better than that of APRI (AUROC=0.72, P=0.009), FIB-4 (AUROC=0.71, P=0.002), and comparable to LSM (AUROC=0.80, P=0.551) for discriminating significant fibrosis.

Conclusion: Serum exosomal miR-92a-3p and miR-146a-5p are superior to APRI, FIB-4, and LSM for diagnosing significant fibrosis in CHB patients and offer a promising non-invasive alternative to liver biopsy.

Background: Few studies reported the risk factors of fatal outcome of hospitalized patients with coronavirus disease 2019 (COVID-19). We aimed to identify the independent risk factors associated with fatal outcome of hospitalized COVID-19 patients.

Methods: The clinical data of 109 consecutive COVID-19 patients including 40 (36.7%) common cases and 69 (63.3%) severe cases were included and analyzed.

Results: Multivariate regression analysis indicated that platelets (PLT, OR, 0.988; 95% CI, 0.978-0.998; P=0.017) and C-reactive protein (CRP) (OR, 1.047; 95% CI, 1.026-1.068; P<0.001) levels were the independent risk factors of fatal outcome in COVID-19 patients. The optimal cut-off value of PLT counts for predicting fatal outcome was 161x109/L with the area under receiver operating characteristic curve (AUROC) of 0.824 (95% CI, 0.739-0.890). The optimal cut-off value of CRP for the prediction of fatal outcome was 46.2 mg/L with the AUROC of 0.954 (95% CI, 0.896-0.985). The CRP levels had higher predictive values for fatal outcome than PLT (P=0.016). The cumulative survival rate was significantly higher in patients with PLT>161x109/L compared with patients with PLT≤161x109/L (89.4% vs. 12.5%, log-rank test X2=72.17; P<0.001). Survival rate of COVID-19 patients was prominently higher in CRP≤46.2 mg/L patients compared with patients with CRP>46.2 mg/L (95.9% vs. 22.9%, log-rank test X2=77.85; P<0.001).

Conclusions: PLT counts and CRP levels could predict fatal outcome of hospitalized COVID-19 patients with relatively high accuracy.