Pub Date : 2026-02-01Epub Date: 2025-12-08DOI: 10.1016/j.ebiom.2025.106035
Kristin Kaduk, Marie Kaeber, Anne Kühnel, María Berjano Torrado, Melina Grahlow, Birgit Derntl, Nils B Kroemer
Background: Hunger is commonly linked to negative mood, and mood shifts are believed to arise from sensing the body's internal state. However, it remains unclear whether this link is driven by subconscious effects of circulating glucose levels or by consciously sensed metabolic states. Here, we test whether glucose levels directly influence mood or indirectly via subjective ratings of metabolic state.
Methods: In this observational cohort study, 90 healthy adults (female = 46; male = 44) were continuously monitored throughout the day using interstitial glucose sensors for four weeks while completing ecological momentary assessments up to twice per day (EMA; M = 48 assessments per participant) to rate mood and perceived metabolic states.
Findings: As expected, hungry participants reported lower mood, and metabolic state ratings were associated with glucose levels. Although glucose levels were associated with mood, the metabolic state ratings mediated this association. Individual differences reflecting metabolic health (i.e., BMI and insulin resistance) did not affect the interaction between glucose and metabolic state ratings on mood. Notably, individuals with higher interoceptive accuracy had fewer fluctuations in mood ratings.
Interpretation: We conclude that hunger-related mood shifts depend on conscious sensing of the body's internal state instead of acting subconsciously. Our study highlights the relevance of considering the self-report of bodily signals in understanding mood shifts, offering new fundamental insights into mood regulation mechanisms.
Funding: The study was supported by the German Research Foundation (DFG) grants KR 4555/7-1, KR 4555/9-1, KR 4555/10-1, and DE 2319/22-1.
{"title":"Glucose levels are associated with mood, but the association is mediated by ratings of metabolic state.","authors":"Kristin Kaduk, Marie Kaeber, Anne Kühnel, María Berjano Torrado, Melina Grahlow, Birgit Derntl, Nils B Kroemer","doi":"10.1016/j.ebiom.2025.106035","DOIUrl":"10.1016/j.ebiom.2025.106035","url":null,"abstract":"<p><strong>Background: </strong>Hunger is commonly linked to negative mood, and mood shifts are believed to arise from sensing the body's internal state. However, it remains unclear whether this link is driven by subconscious effects of circulating glucose levels or by consciously sensed metabolic states. Here, we test whether glucose levels directly influence mood or indirectly via subjective ratings of metabolic state.</p><p><strong>Methods: </strong>In this observational cohort study, 90 healthy adults (female = 46; male = 44) were continuously monitored throughout the day using interstitial glucose sensors for four weeks while completing ecological momentary assessments up to twice per day (EMA; M = 48 assessments per participant) to rate mood and perceived metabolic states.</p><p><strong>Findings: </strong>As expected, hungry participants reported lower mood, and metabolic state ratings were associated with glucose levels. Although glucose levels were associated with mood, the metabolic state ratings mediated this association. Individual differences reflecting metabolic health (i.e., BMI and insulin resistance) did not affect the interaction between glucose and metabolic state ratings on mood. Notably, individuals with higher interoceptive accuracy had fewer fluctuations in mood ratings.</p><p><strong>Interpretation: </strong>We conclude that hunger-related mood shifts depend on conscious sensing of the body's internal state instead of acting subconsciously. Our study highlights the relevance of considering the self-report of bodily signals in understanding mood shifts, offering new fundamental insights into mood regulation mechanisms.</p><p><strong>Funding: </strong>The study was supported by the German Research Foundation (DFG) grants KR 4555/7-1, KR 4555/9-1, KR 4555/10-1, and DE 2319/22-1.</p>","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":" ","pages":"106035"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-07DOI: 10.1016/j.ebiom.2025.106119
Christian E Edvardsson, Louise Adermark, Sam Gottlieb, Safana Alfreji, Thaynnam A Emous, Yomna Gouda, Annika Thorsell, Milica Vujičić, Cajsa Aranäs, Anna Benrick, Ingrid Wernstedt Asterholm, Marcelo F Lopez, Howard C Becker, Elisabet Jerlhag
<p><strong>Background: </strong>Alcohol use disorder (AUD) remains a major public health problem, with few effective medications currently available. However, peptides of the gut-brain axis appear to offer promising therapeutic targets for AUD as they influence the mesolimbic reward circuitry.</p><p><strong>Methods: </strong>Here, we examined the effects of tirzepatide, a long-acting dual glucagon-like peptide-1 receptor (GLP-1R) and glucose-dependent insulinotropic polypeptide receptor (GIPR) agonist approved for diabetes and obesity, using behavioural assays (locomotor activity and conditioned place preference), alcohol intake paradigms (intermittent access two-bottle choice, drinking in the dark and the alcohol deprivation effect), and molecular analyses (microdialysis, electrophysiology and proteomics) in rodents.</p><p><strong>Findings: </strong>First, tirzepatide effectively attenuated the rewarding properties of alcohol, measured through locomotor stimulation, conditioned place preference, and accumbal dopamine release (P < 0.001). Subsequently, this GLP-1R/GIPR agonist dose-dependently reduced voluntary alcohol consumption (P < 0.001), prevented binge (P < 0.01) and relapse-like drinking (P < 0.001), and maintained efficacy during repeated administration (P < 0.001). Finally, tirzepatide induced sustained synaptic depression in the lateral septum (P < 0.05) and further altered histone regulatory proteins in this region (P < 0.05), suggesting a potential neural substrate for its effects. Moreover, the GLP-1R/GIPR agonist affected metabolic parameters including body weight (P < 0.001), adipose tissue mass (P < 0.01), hepatic triglycerides (P < 0.01) and circulating pro-inflammatory cytokines (P < 0.05).</p><p><strong>Interpretation: </strong>Together, our findings suggest tirzepatide modulates alcohol-related behaviours through reward-related mechanisms while also affecting physiological consequences associated with long-term alcohol use. Given tirzepatide's established clinical use and the consistency of effects observed here, these results support further investigation for treating AUD and associated complications.</p><p><strong>Funding: </strong>The study is supported by grants from the Swedish Research Council (2023-2600, 2020-00559, 2020-01463, 2024-03054), LUA/ALF (723941 & 1005347) from the Sahlgrenska University Hospital, Alcohol Research Council of the Swedish Alcohol Retailing Monopoly (FO2024-0048), National Institutes of Health (NIH) (P50 AA010761 & U01 AA014095), U.S. Department of Veterans Affairs Office of Research and Development (BLR&D I01BX000813 & IK6BX006299), Herbert & Karin Jacobssons Foundation (2024-Forskning-225), Adlerbertska Research Foundation (2024-791), Wilhelm & Martina Lundgren's Research Foundation (2024-SA-4698), Åke Wibergs Foundation (M24-0216), Swedish Diabetes Foundation (DIA 2024-898) and Mary von Sydow Foundation (2024-36 & 2024-185). Thaynnam A Emous held an international internship scholarship from
背景:酒精使用障碍(AUD)仍然是一个主要的公共卫生问题,目前很少有有效的药物可用。然而,肠脑轴的肽似乎为AUD提供了有希望的治疗靶点,因为它们影响中边缘奖励回路。方法:在这里,我们研究了替西肽的作用,替西肽是一种长效双胰高血糖素样肽-1受体(GLP-1R)和葡萄糖依赖性胰岛素性多肽受体(GIPR)激动剂,被批准用于糖尿病和肥胖症,使用行为分析(运动活动和条件位置偏好),酒精摄入范式(间歇性获取两瓶选择,在黑暗中饮酒和酒精剥夺效应)和分子分析(微透析,啮齿类动物的电生理学和蛋白质组学。研究发现:首先,通过运动刺激、条件位置偏好和伏伏多巴胺释放来测量,替西帕肽有效地减弱了酒精的奖励特性(P < 0.001)。随后,这种GLP-1R/GIPR激动剂剂量依赖性地减少了自愿饮酒(P < 0.001),防止酗酒(P < 0.01)和复发样饮酒(P < 0.001),并在重复给药期间保持疗效(P < 0.001)。最后,替西肽诱导外侧隔膜持续突触抑制(P < 0.05),并进一步改变该区域的组蛋白调节蛋白(P < 0.05),提示其作用可能与神经基质有关。此外,GLP-1R/GIPR激动剂影响代谢参数包括体重(P < 0.001)、脂肪组织质量(P < 0.01)、肝脏甘油三酯(P < 0.01)和循环促炎因子(P < 0.05)。综上所述,我们的研究结果表明,替西帕肽通过奖励相关机制调节酒精相关行为,同时也影响与长期饮酒相关的生理后果。鉴于替西帕肽已确立的临床应用和本研究观察到的效果的一致性,这些结果支持进一步研究治疗AUD及相关并发症。资助:该研究得到了瑞典研究委员会(2023-2600,2020-00559,2020-01463,2024-03054),Sahlgrenska大学医院LUA/ALF(723941和1005347),瑞典酒精零售垄断酒精研究委员会(FO2024-0048),美国国立卫生研究院(NIH) (P50 AA010761和U01 AA014095),美国退伍军人事务部研究与发展办公室(BLR&D I01BX000813和IK6BX006299), Herbert & Karin jacobsson基金会(2024-Forskning-225)的资助。Adlerbertska研究基金会(2024-791),Wilhelm & Martina Lundgren研究基金会(2024-SA-4698), Åke Wibergs基金会(M24-0216),瑞典糖尿病基金会(DIA 2024-898)和Mary von Sydow基金会(2024-36和2024-185)。Thaynnam A Emous在哥德堡大学进行研究期间获得了圣保罗研究基金会(FAPESP)的国际实习奖学金,项目编号#2023/1847 -5。
{"title":"Tirzepatide reduces alcohol drinking and relapse-like behaviours in rodents.","authors":"Christian E Edvardsson, Louise Adermark, Sam Gottlieb, Safana Alfreji, Thaynnam A Emous, Yomna Gouda, Annika Thorsell, Milica Vujičić, Cajsa Aranäs, Anna Benrick, Ingrid Wernstedt Asterholm, Marcelo F Lopez, Howard C Becker, Elisabet Jerlhag","doi":"10.1016/j.ebiom.2025.106119","DOIUrl":"10.1016/j.ebiom.2025.106119","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) remains a major public health problem, with few effective medications currently available. However, peptides of the gut-brain axis appear to offer promising therapeutic targets for AUD as they influence the mesolimbic reward circuitry.</p><p><strong>Methods: </strong>Here, we examined the effects of tirzepatide, a long-acting dual glucagon-like peptide-1 receptor (GLP-1R) and glucose-dependent insulinotropic polypeptide receptor (GIPR) agonist approved for diabetes and obesity, using behavioural assays (locomotor activity and conditioned place preference), alcohol intake paradigms (intermittent access two-bottle choice, drinking in the dark and the alcohol deprivation effect), and molecular analyses (microdialysis, electrophysiology and proteomics) in rodents.</p><p><strong>Findings: </strong>First, tirzepatide effectively attenuated the rewarding properties of alcohol, measured through locomotor stimulation, conditioned place preference, and accumbal dopamine release (P < 0.001). Subsequently, this GLP-1R/GIPR agonist dose-dependently reduced voluntary alcohol consumption (P < 0.001), prevented binge (P < 0.01) and relapse-like drinking (P < 0.001), and maintained efficacy during repeated administration (P < 0.001). Finally, tirzepatide induced sustained synaptic depression in the lateral septum (P < 0.05) and further altered histone regulatory proteins in this region (P < 0.05), suggesting a potential neural substrate for its effects. Moreover, the GLP-1R/GIPR agonist affected metabolic parameters including body weight (P < 0.001), adipose tissue mass (P < 0.01), hepatic triglycerides (P < 0.01) and circulating pro-inflammatory cytokines (P < 0.05).</p><p><strong>Interpretation: </strong>Together, our findings suggest tirzepatide modulates alcohol-related behaviours through reward-related mechanisms while also affecting physiological consequences associated with long-term alcohol use. Given tirzepatide's established clinical use and the consistency of effects observed here, these results support further investigation for treating AUD and associated complications.</p><p><strong>Funding: </strong>The study is supported by grants from the Swedish Research Council (2023-2600, 2020-00559, 2020-01463, 2024-03054), LUA/ALF (723941 & 1005347) from the Sahlgrenska University Hospital, Alcohol Research Council of the Swedish Alcohol Retailing Monopoly (FO2024-0048), National Institutes of Health (NIH) (P50 AA010761 & U01 AA014095), U.S. Department of Veterans Affairs Office of Research and Development (BLR&D I01BX000813 & IK6BX006299), Herbert & Karin Jacobssons Foundation (2024-Forskning-225), Adlerbertska Research Foundation (2024-791), Wilhelm & Martina Lundgren's Research Foundation (2024-SA-4698), Åke Wibergs Foundation (M24-0216), Swedish Diabetes Foundation (DIA 2024-898) and Mary von Sydow Foundation (2024-36 & 2024-185). Thaynnam A Emous held an international internship scholarship from ","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106119"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12808897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-24DOI: 10.1016/j.ebiom.2026.106134
Iain Stewart, Joseph Jacob, Joanna C Porter, Bin Liu, Amanda L Tatler, Nancy Gomez, Matthew R Pugh, Alison E John, Richard J Allen, John F Blaikley, Nazia Chaudhuri, Emma Denneny, Laura Fabbri, Peter M George, Beatriz Guillen-Guio, Bibek Gooptu, Ian P Hall, Ling Pei Ho, Ian Jarrold, Simon Johnson, Mark G Jones, Fasihul Khan, Puja Mehta, Jane Mitchell, Philip L Molyneaux, John E Pearl, Karen Piper Hanley, Manuela Platé, Valerie Quinn, Pilar Rivera-Ortega, Laura C Saunders, David J F Smith, Mark Spears, Lisa G Spencer, Stefan C Stanel, A A Roger Thompson, Simon Walsh, Jim M Wild, Dan G Wootton, Annemarie B Docherty, Fergus Gleeson, William Greenhalf, Ewen M Harrison, Nazir Lone, Jennifer Quint, Anastasia Maslova, Moritz Pohl, Adam Stephens, Simon Young, Amisha Singapuri, Aarti Shikotra, Marco Sereno, Ruth M Saunders, Matthew Richardson, Betty Raman, Krisnah Poinasamy, Hamish J C McAuley, Michael Marks, Olivia C Leavy, Linzy Houchen-Wolloff, Alex Horsley, Victoria C Harris, Neil Greening, Rachael A Evans, Omer Elneima, James D Chalmers, Christopher E Brightling, Rachel C Chambers, Louise V Wain, R Gisli Jenkins
Background: Long term respiratory symptoms are reported following recovery of acute COVID-19 infection and residual lung abnormalities (RLA) on follow-up thoracic computed tomography (CT) after COVID-19 hospitalisation have been observed. It is unknown whether RLA are associated with epithelial lung injury.
Methods: Plasma was sampled from the observational Post HOSPitalisation-COVID cohort at five months post-hospitalisation. Epithelial injury biomarkers Krebs von den Lungen-6 (KL-6), matrix metalloproteinase 7 (MMP-7), surfactant protein-D (SP-D) and surfactant protein-A (SP-A) were assayed. In those without follow-up CT, RLA at-risk was defined by percent predicted DLCO <80% and/or abnormal chest X-ray, otherwise they were considered low-risk. Follow-up CT RLA was defined as combined involvement of ground glass opacity and reticulation ≥10%.
Findings: A total of 957 people were included, 846 people with no CT (at-risk n = 103; 12.2%), 111 people with follow-up CT (RLA ≥10% n = 85; 76.6%). All epithelial injury biomarkers were significantly elevated in people at-risk of RLA compared with low-risk. KL-6 and MMP-7 were significantly higher in people with ≥10% RLA than those with <10%, SP-D and SP-A did not reach significance. SP-D and SP-A were associated with percent involvement of reticulation (3.22%, 95% CI 1.19-5.24; 3.03%, 95% CI 0.76-5.30, respectively).
Interpretation: RLA after acute COVID-19 infection were consistent with elevated epithelial injury biomarkers and pro-fibrotic signalling. Future studies should address the temporal association between fibrotic biomarkers and resolution or progression of radiological involvement.
Funding: MRC-UK Research and Innovation and National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19 (MR/V027859/1; COV0319; MR/W006111/1).
背景:急性COVID-19感染恢复后报告了长期呼吸道症状,并在COVID-19住院后随访胸部计算机断层扫描(CT)上观察到残留肺异常(RLA)。RLA是否与上皮性肺损伤有关尚不清楚。方法:从住院后5个月的观察性covid - 19队列中抽取血浆。检测上皮损伤标志物Krebs von den Lungen-6 (KL-6)、基质金属蛋白酶7 (MMP-7)、表面活性剂蛋白d (SP-D)和表面活性剂蛋白a (SP-A)。在没有随访CT的患者中,RLA有危险的定义为预测DLCO结果的百分比:共纳入957人,846人没有CT(有危险n = 103; 12.2%), 111人有随访CT (RLA≥10% n = 85; 76.6%)。与低风险人群相比,RLA高危人群的所有上皮损伤生物标志物均显著升高。在RLA≥10%的人群中,KL-6和MMP-7显著高于急性COVID-19感染后RLA患者,这与上皮损伤生物标志物和促纤维化信号升高一致。未来的研究应探讨纤维化生物标志物与放射学累及的消退或进展之间的时间相关性。资助:MRC-UK研究与创新和国家卫生研究院(NIHR)应对COVID-19快速反应小组(MR/V027859/1; COV0319; MR/W006111/1)。
{"title":"Residual lung abnormality following COVID-19 hospitalisation is characterised by biomarkers of epithelial injury.","authors":"Iain Stewart, Joseph Jacob, Joanna C Porter, Bin Liu, Amanda L Tatler, Nancy Gomez, Matthew R Pugh, Alison E John, Richard J Allen, John F Blaikley, Nazia Chaudhuri, Emma Denneny, Laura Fabbri, Peter M George, Beatriz Guillen-Guio, Bibek Gooptu, Ian P Hall, Ling Pei Ho, Ian Jarrold, Simon Johnson, Mark G Jones, Fasihul Khan, Puja Mehta, Jane Mitchell, Philip L Molyneaux, John E Pearl, Karen Piper Hanley, Manuela Platé, Valerie Quinn, Pilar Rivera-Ortega, Laura C Saunders, David J F Smith, Mark Spears, Lisa G Spencer, Stefan C Stanel, A A Roger Thompson, Simon Walsh, Jim M Wild, Dan G Wootton, Annemarie B Docherty, Fergus Gleeson, William Greenhalf, Ewen M Harrison, Nazir Lone, Jennifer Quint, Anastasia Maslova, Moritz Pohl, Adam Stephens, Simon Young, Amisha Singapuri, Aarti Shikotra, Marco Sereno, Ruth M Saunders, Matthew Richardson, Betty Raman, Krisnah Poinasamy, Hamish J C McAuley, Michael Marks, Olivia C Leavy, Linzy Houchen-Wolloff, Alex Horsley, Victoria C Harris, Neil Greening, Rachael A Evans, Omer Elneima, James D Chalmers, Christopher E Brightling, Rachel C Chambers, Louise V Wain, R Gisli Jenkins","doi":"10.1016/j.ebiom.2026.106134","DOIUrl":"10.1016/j.ebiom.2026.106134","url":null,"abstract":"<p><strong>Background: </strong>Long term respiratory symptoms are reported following recovery of acute COVID-19 infection and residual lung abnormalities (RLA) on follow-up thoracic computed tomography (CT) after COVID-19 hospitalisation have been observed. It is unknown whether RLA are associated with epithelial lung injury.</p><p><strong>Methods: </strong>Plasma was sampled from the observational Post HOSPitalisation-COVID cohort at five months post-hospitalisation. Epithelial injury biomarkers Krebs von den Lungen-6 (KL-6), matrix metalloproteinase 7 (MMP-7), surfactant protein-D (SP-D) and surfactant protein-A (SP-A) were assayed. In those without follow-up CT, RLA at-risk was defined by percent predicted DL<sub>CO</sub> <80% and/or abnormal chest X-ray, otherwise they were considered low-risk. Follow-up CT RLA was defined as combined involvement of ground glass opacity and reticulation ≥10%.</p><p><strong>Findings: </strong>A total of 957 people were included, 846 people with no CT (at-risk n = 103; 12.2%), 111 people with follow-up CT (RLA ≥10% n = 85; 76.6%). All epithelial injury biomarkers were significantly elevated in people at-risk of RLA compared with low-risk. KL-6 and MMP-7 were significantly higher in people with ≥10% RLA than those with <10%, SP-D and SP-A did not reach significance. SP-D and SP-A were associated with percent involvement of reticulation (3.22%, 95% CI 1.19-5.24; 3.03%, 95% CI 0.76-5.30, respectively).</p><p><strong>Interpretation: </strong>RLA after acute COVID-19 infection were consistent with elevated epithelial injury biomarkers and pro-fibrotic signalling. Future studies should address the temporal association between fibrotic biomarkers and resolution or progression of radiological involvement.</p><p><strong>Funding: </strong>MRC-UK Research and Innovation and National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19 (MR/V027859/1; COV0319; MR/W006111/1).</p>","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106134"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12860639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-31DOI: 10.1016/j.ebiom.2026.106131
Sarah L Laverty, Imogen Felton, Michelle Casey, Benjamin Hopwood, Nicholas Simmonds, Darius Armstrong-James, Anand Shah, Peter Kelleher
Background: The impact of CFTR modulator therapy on host immunity and outcomes in people with Cystic Fibrosis (CF)-related Aspergillus lung disease is poorly defined. We aimed to characterise fungal-relevant clinical outcomes post-CFTR modulators and assess effects on the Aspergillus-dependent Type I/III interferome.
Methods: Biomarkers of Aspergillus-related lung disease (Aspergillus-specific IgE/IgG), anti-fungal and corticosteroid therapy were analysed in a retrospective cohort of people with CF pre and post Elexacaftor/Tezacaftor/Ivacaftor (ETI) modulator therapy. Homozygous F508del (CF) and CFTR TALEN-corrected bronchial epithelial cells (BECs) were challenged with Aspergillus conidia and hyphae in the presence or absence of ETI CFTR modulator therapy with bulk RNA transcriptomics and RT-PCR used to analyse Type I/III interferon genes. Effects of exogenous type I and III interferons on CF-neutrophil antifungal effector function was further characterised.
Findings: CFTR modulator (ETI) therapy was associated with a significant reduction in Aspergillus biomarkers alongside use of corticosteroid and anti-fungal therapy. In vitro Aspergillus stimulation enriched the Type I/III interferome in CFTR-corrected BECs compared to CF BECs, with ETI therapy partially restoring type I/III interferon gene expression in CF BECs. Administration of exogenous IFNλ1 increased anti-fungal killing in CF neutrophils without increased reactive-oxygen species or neutrophil extracellular trap production.
Interpretation: CFTR modulators have led to improved clinical outcomes in CF related Aspergillus-related lung disease potentially due to partial restoration of the host antifungal epithelial type I/III interferon response. Exogenous IFNλ1 further improved antifungal killing capacity of CF-neutrophils presenting a plausible future therapeutic strategy.
Funding: This study was funded by the Cystic Fibrosis Trust (SRC015).
{"title":"CFTR modulators partially restore the epithelial interferome in Aspergillus infection to improve clinical outcome.","authors":"Sarah L Laverty, Imogen Felton, Michelle Casey, Benjamin Hopwood, Nicholas Simmonds, Darius Armstrong-James, Anand Shah, Peter Kelleher","doi":"10.1016/j.ebiom.2026.106131","DOIUrl":"10.1016/j.ebiom.2026.106131","url":null,"abstract":"<p><strong>Background: </strong>The impact of CFTR modulator therapy on host immunity and outcomes in people with Cystic Fibrosis (CF)-related Aspergillus lung disease is poorly defined. We aimed to characterise fungal-relevant clinical outcomes post-CFTR modulators and assess effects on the Aspergillus-dependent Type I/III interferome.</p><p><strong>Methods: </strong>Biomarkers of Aspergillus-related lung disease (Aspergillus-specific IgE/IgG), anti-fungal and corticosteroid therapy were analysed in a retrospective cohort of people with CF pre and post Elexacaftor/Tezacaftor/Ivacaftor (ETI) modulator therapy. Homozygous F508del (CF) and CFTR TALEN-corrected bronchial epithelial cells (BECs) were challenged with Aspergillus conidia and hyphae in the presence or absence of ETI CFTR modulator therapy with bulk RNA transcriptomics and RT-PCR used to analyse Type I/III interferon genes. Effects of exogenous type I and III interferons on CF-neutrophil antifungal effector function was further characterised.</p><p><strong>Findings: </strong>CFTR modulator (ETI) therapy was associated with a significant reduction in Aspergillus biomarkers alongside use of corticosteroid and anti-fungal therapy. In vitro Aspergillus stimulation enriched the Type I/III interferome in CFTR-corrected BECs compared to CF BECs, with ETI therapy partially restoring type I/III interferon gene expression in CF BECs. Administration of exogenous IFNλ1 increased anti-fungal killing in CF neutrophils without increased reactive-oxygen species or neutrophil extracellular trap production.</p><p><strong>Interpretation: </strong>CFTR modulators have led to improved clinical outcomes in CF related Aspergillus-related lung disease potentially due to partial restoration of the host antifungal epithelial type I/III interferon response. Exogenous IFNλ1 further improved antifungal killing capacity of CF-neutrophils presenting a plausible future therapeutic strategy.</p><p><strong>Funding: </strong>This study was funded by the Cystic Fibrosis Trust (SRC015).</p>","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106131"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-31DOI: 10.1016/j.ebiom.2026.106149
Florian Deisenhammer, Harald Hegen
{"title":"Letter in response to \"Kappa free light chain index as a substitute to oligoclonal bands in diagnosing multiple sclerosis\".","authors":"Florian Deisenhammer, Harald Hegen","doi":"10.1016/j.ebiom.2026.106149","DOIUrl":"10.1016/j.ebiom.2026.106149","url":null,"abstract":"","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106149"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12882639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-02-02DOI: 10.1016/j.ebiom.2026.106135
Christiane Helgestad Gjerde, Katrin Kleinmanns, Anika Langer, Gorka Ruiz de Garibay Ponce, Ezekiel Rozmus, Gina Nyhus Stangeland, Calum Leitch, Rammah Elnour, Harsh Nitin Dongre, Constantin Berger, Okan Gultekin, Christopher Forcados, Maria Stensland, Tuula Anneli Nyman, Kaisa Lehti, Ben Davidson, Sébastien Wälchli, Pascal Gelebart, Daniela Elena Costea, Spiros Kotopoulis, Line Bjørge, Emmet McCormack
Background: High-grade serous ovarian carcinoma (HGSOC) presents a significant therapeutic challenge. Late-stage disease is frequently associated with peritoneal carcinomatosis. The peritoneal metastases exhibit a unique tumour microenvironment (TME) distinct from the primary tumours and other metastatic sites. Understanding the critical influence of the extracellular matrix (ECM) in shaping the tumour phenotype is essential for the development of effective new therapies.
Methods: This study introduces a three-dimensional (3D) model of HGSOC peritoneal metastases using a porcine decellularised peritoneal-derived ECM scaffold, referred to as peritoneal matrix (PerMa).
Findings: We show that the decellularisation maintains the structural integrity and composition of ECM molecules. Comparative analysis reveals structural, compositional, and mechanical similarities between porcine and human peritoneal matrices, underscoring the porcine model's translational relevance for modelling human peritoneum physiology. The PerMa supports the 3D growth of HGSOC cell lines. The model enables the assessment of sensitivity to traditional chemotherapy and novel cell-based immunotherapy through confocal imaging and quantification of cell volume.
Interpretation: Our model offers a valuable platform for investigating peritoneal carcinomatosis in HGSOC, with the potential to contribute significantly to developing novel therapeutic approaches.
Funding: Financial support was provided by the University of Bergen, Helse Vest RHF (F-12183-D10616, 779, 911182, 912035, and 912146), Helse Bergen HF (240222), the Norwegian Cancer Society (6833652 and 182735), the Research Council of Norway grants (250317, 326300, 223250, 262652, and 295910), the Novo Nordisk Foundation (NNF21OC0070381), the Kolbjørn Brambani Legat for Kreftforskning, the National Institute of Health (R01CA199646) and the Swedish Cancer Society (21 1888 Pj).
背景:高级别浆液性卵巢癌(HGSOC)提出了一个重大的治疗挑战。晚期疾病常与腹膜癌有关。腹膜转移表现出独特的肿瘤微环境(TME)不同于原发肿瘤和其他转移部位。了解细胞外基质(ECM)在形成肿瘤表型中的关键影响对于开发有效的新疗法至关重要。方法:本研究采用猪脱细胞腹膜来源ECM支架(称为腹膜基质(PerMa))建立了HGSOC腹膜转移的三维(3D)模型。研究结果:我们发现脱细胞维持了ECM分子的结构完整性和组成。对比分析揭示了猪和人腹膜基质在结构、组成和力学上的相似性,强调了猪模型在模拟人类腹膜生理学方面的翻译相关性。PerMa支持HGSOC细胞系的3D生长。该模型能够通过共聚焦成像和细胞体积量化来评估对传统化疗和新型细胞免疫疗法的敏感性。解释:我们的模型为研究HGSOC腹膜癌提供了一个有价值的平台,有可能为开发新的治疗方法做出重大贡献。资助:财政支持由卑尔根大学、Helse Vest RHF (F-12183-D10616、779、911182、912035和912146)、Helse Bergen HF(240222)、挪威癌症协会(6833652和182735)、挪威研究委员会资助(250317、326300、223250、262652和295910)、诺和诺德基金会(NNF21OC0070381)、Kolbjørn Brambani Legat for Kreftforskning、国家卫生研究所(R01CA199646)和瑞典癌症协会(21 1888 Pj)提供。
{"title":"A 3D ovarian cancer metastasis model using a decellularised peritoneal matrix to study therapy response.","authors":"Christiane Helgestad Gjerde, Katrin Kleinmanns, Anika Langer, Gorka Ruiz de Garibay Ponce, Ezekiel Rozmus, Gina Nyhus Stangeland, Calum Leitch, Rammah Elnour, Harsh Nitin Dongre, Constantin Berger, Okan Gultekin, Christopher Forcados, Maria Stensland, Tuula Anneli Nyman, Kaisa Lehti, Ben Davidson, Sébastien Wälchli, Pascal Gelebart, Daniela Elena Costea, Spiros Kotopoulis, Line Bjørge, Emmet McCormack","doi":"10.1016/j.ebiom.2026.106135","DOIUrl":"10.1016/j.ebiom.2026.106135","url":null,"abstract":"<p><strong>Background: </strong>High-grade serous ovarian carcinoma (HGSOC) presents a significant therapeutic challenge. Late-stage disease is frequently associated with peritoneal carcinomatosis. The peritoneal metastases exhibit a unique tumour microenvironment (TME) distinct from the primary tumours and other metastatic sites. Understanding the critical influence of the extracellular matrix (ECM) in shaping the tumour phenotype is essential for the development of effective new therapies.</p><p><strong>Methods: </strong>This study introduces a three-dimensional (3D) model of HGSOC peritoneal metastases using a porcine decellularised peritoneal-derived ECM scaffold, referred to as peritoneal matrix (PerMa).</p><p><strong>Findings: </strong>We show that the decellularisation maintains the structural integrity and composition of ECM molecules. Comparative analysis reveals structural, compositional, and mechanical similarities between porcine and human peritoneal matrices, underscoring the porcine model's translational relevance for modelling human peritoneum physiology. The PerMa supports the 3D growth of HGSOC cell lines. The model enables the assessment of sensitivity to traditional chemotherapy and novel cell-based immunotherapy through confocal imaging and quantification of cell volume.</p><p><strong>Interpretation: </strong>Our model offers a valuable platform for investigating peritoneal carcinomatosis in HGSOC, with the potential to contribute significantly to developing novel therapeutic approaches.</p><p><strong>Funding: </strong>Financial support was provided by the University of Bergen, Helse Vest RHF (F-12183-D10616, 779, 911182, 912035, and 912146), Helse Bergen HF (240222), the Norwegian Cancer Society (6833652 and 182735), the Research Council of Norway grants (250317, 326300, 223250, 262652, and 295910), the Novo Nordisk Foundation (NNF21OC0070381), the Kolbjørn Brambani Legat for Kreftforskning, the National Institute of Health (R01CA199646) and the Swedish Cancer Society (21 1888 Pj).</p>","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106135"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-02-02DOI: 10.1016/j.ebiom.2026.106145
Lilly Bar, Rebecca J Darrah, Sriram Vaidyanathan
Background: The presence of cystic fibrosis (CF) in diverse groups is known but its incidence is not established in non-European populations. We predict that the number of births with CF in populations with non-European and European ancestry are comparable, and that sampling the general population may inform improved diagnostic and therapeutic strategies.
Methods: We curated pathogenic CFTR variants from the Genome Aggregation Database (gnomAD, versions 2.1 and 4.0) for different groups and estimated the incidence per 100,000 births using Hardy-Weinberg equilibrium. To estimate annual births with CF, we used United Nations population statistics. Additionally, we estimated the percentages of alleles missed by common screening panels and those not approved for treatment using highly effective modulator therapies (HEMT).
Findings: CF affects 44-52, 11-14, 7, 6, 4, and 0.2-1 births per 100,000 in European, African/African American, Admixed American, South Asian, East Asian, and Middle Eastern groups, respectively. Due to higher birth rates, the estimated annual births with CF in India (1426-1582) and Brazil (330-390) are comparable to those in the US (∼1000) and UK (∼300). The expanded Wisconsin screening panel misses the fewest variants in all groups (1-30% pathogenic alleles), while other screening panels miss 25->70% of pathogenic alleles from non-European groups. Of the pathogenic alleles in non-European groups, 25-40% were not approved for treatment using HEMT.
Interpretation: Absolute number of CF births in South America, Asia, and Africa may be comparable to those in the US and Europe. Improved diagnostics, therapeutics, and access to HEMT will benefit thousands of people with CF globally.
{"title":"Analysis of the Genome Aggregation Database (gnomAD) reveals a global burden of cystic fibrosis and the need for improved diagnosis and care.","authors":"Lilly Bar, Rebecca J Darrah, Sriram Vaidyanathan","doi":"10.1016/j.ebiom.2026.106145","DOIUrl":"10.1016/j.ebiom.2026.106145","url":null,"abstract":"<p><strong>Background: </strong>The presence of cystic fibrosis (CF) in diverse groups is known but its incidence is not established in non-European populations. We predict that the number of births with CF in populations with non-European and European ancestry are comparable, and that sampling the general population may inform improved diagnostic and therapeutic strategies.</p><p><strong>Methods: </strong>We curated pathogenic CFTR variants from the Genome Aggregation Database (gnomAD, versions 2.1 and 4.0) for different groups and estimated the incidence per 100,000 births using Hardy-Weinberg equilibrium. To estimate annual births with CF, we used United Nations population statistics. Additionally, we estimated the percentages of alleles missed by common screening panels and those not approved for treatment using highly effective modulator therapies (HEMT).</p><p><strong>Findings: </strong>CF affects 44-52, 11-14, 7, 6, 4, and 0.2-1 births per 100,000 in European, African/African American, Admixed American, South Asian, East Asian, and Middle Eastern groups, respectively. Due to higher birth rates, the estimated annual births with CF in India (1426-1582) and Brazil (330-390) are comparable to those in the US (∼1000) and UK (∼300). The expanded Wisconsin screening panel misses the fewest variants in all groups (1-30% pathogenic alleles), while other screening panels miss 25->70% of pathogenic alleles from non-European groups. Of the pathogenic alleles in non-European groups, 25-40% were not approved for treatment using HEMT.</p><p><strong>Interpretation: </strong>Absolute number of CF births in South America, Asia, and Africa may be comparable to those in the US and Europe. Improved diagnostics, therapeutics, and access to HEMT will benefit thousands of people with CF globally.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106145"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-20DOI: 10.1016/j.ebiom.2026.106124
Xiaohui Bian, Zachary K Snow, Caroline J Zinn, Anastasia L Bratulin, Khaled M Elhusseiny, Tamar Tchkonia, James L Kirkland, Yi Zhu, Sundeep Khosla, Seo Rin Kim, Lilach O Lerman, LaTonya J Hickson
Background: Maladaptive inflammation and cellular senescence contribute to diabetic kidney disease (DKD) pathogenesis and represent important therapeutic targets. Senolytic agents selectively remove senescent cells and reduce inflammation-associated tissue damage. In our pilot clinical trial in patients with DKD, the senolytic combination dasatinib plus quercetin (D + Q) reduced systemic inflammation, senescent cell abundance, and macrophage infiltration in fat. However, D + Q senotherapeutic effects on diabetic kidney injury, senescence, inflammation, and geroprotective factors have not been established.
Methods: Diabetes mellitus was induced with intraperitoneal streptozotocin in male C57BL/6J mice, followed by a 5-day oral gavage regimen of either D + Q (5 and 50 mg/kg, respectively) or vehicle. Kidney function and markers of injury, fibrosis, inflammation, cellular senescence, and geroprotective factors were measured. In vitro studies examined reparative effects of D + Q in high glucose-treated human renal tubular epithelial cells (HK2), endothelial cells (HUVECs), and U937-derived macrophages.
Findings: D + Q improved kidney function and reduced markers of kidney injury (glomerular and tubular), fibrosis, senescence (p16Ink4a), macrophage- and senescence-associated inflammation (versus diabetic controls) without altering glucose levels. Additionally, geroprotective factors (α-Klotho, Sirtuin-1) increased. D + Q treatment in vitro reduced high glucose-induced senescence and inflammation (NF-κB) in HK2, HUVECs, and macrophages.
Interpretation: A "hit-and-run" senolytic treatment with D + Q improved kidney function and mitigated murine DKD by modulating the inflammatory landscape, reducing senescent cell abundance, and restoring geroprotective factors. Taken together, the beneficial effects in kidneys of mice and prior systemic effects in humans, support the rationale for further clinical investigations applying D + Q to enhance healthspan in individuals with DKD.
Funding: This research was supported by National Institutes of Health (NIH): [DK123492, DK109134, and AG076537 (LJH); DK120292 and HL158691 (LOL); AG087387 (YZ); R37AG013925 (TT and JLK)]; NIDDK Diabetes Complications Consortium [DK115255, DK076169 (LJH)]; Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (LJH); TT and JLK are supported by a grant from the Hevolution Foundation (HF-GRO-23-1199148-3), Cedars-Sinai Medical Center, the Connor Fund, and Robert J. and Theresa W. Ryan.
{"title":"Senolytics, dasatanib plus quercetin, reduce kidney inflammation, senescent cell abundance, and injury while restoring geroprotective factors in murine diabetic kidney disease.","authors":"Xiaohui Bian, Zachary K Snow, Caroline J Zinn, Anastasia L Bratulin, Khaled M Elhusseiny, Tamar Tchkonia, James L Kirkland, Yi Zhu, Sundeep Khosla, Seo Rin Kim, Lilach O Lerman, LaTonya J Hickson","doi":"10.1016/j.ebiom.2026.106124","DOIUrl":"10.1016/j.ebiom.2026.106124","url":null,"abstract":"<p><strong>Background: </strong>Maladaptive inflammation and cellular senescence contribute to diabetic kidney disease (DKD) pathogenesis and represent important therapeutic targets. Senolytic agents selectively remove senescent cells and reduce inflammation-associated tissue damage. In our pilot clinical trial in patients with DKD, the senolytic combination dasatinib plus quercetin (D + Q) reduced systemic inflammation, senescent cell abundance, and macrophage infiltration in fat. However, D + Q senotherapeutic effects on diabetic kidney injury, senescence, inflammation, and geroprotective factors have not been established.</p><p><strong>Methods: </strong>Diabetes mellitus was induced with intraperitoneal streptozotocin in male C57BL/6J mice, followed by a 5-day oral gavage regimen of either D + Q (5 and 50 mg/kg, respectively) or vehicle. Kidney function and markers of injury, fibrosis, inflammation, cellular senescence, and geroprotective factors were measured. In vitro studies examined reparative effects of D + Q in high glucose-treated human renal tubular epithelial cells (HK2), endothelial cells (HUVECs), and U937-derived macrophages.</p><p><strong>Findings: </strong>D + Q improved kidney function and reduced markers of kidney injury (glomerular and tubular), fibrosis, senescence (p16<sup>Ink4a</sup>), macrophage- and senescence-associated inflammation (versus diabetic controls) without altering glucose levels. Additionally, geroprotective factors (α-Klotho, Sirtuin-1) increased. D + Q treatment in vitro reduced high glucose-induced senescence and inflammation (NF-κB) in HK2, HUVECs, and macrophages.</p><p><strong>Interpretation: </strong>A \"hit-and-run\" senolytic treatment with D + Q improved kidney function and mitigated murine DKD by modulating the inflammatory landscape, reducing senescent cell abundance, and restoring geroprotective factors. Taken together, the beneficial effects in kidneys of mice and prior systemic effects in humans, support the rationale for further clinical investigations applying D + Q to enhance healthspan in individuals with DKD.</p><p><strong>Funding: </strong>This research was supported by National Institutes of Health (NIH): [DK123492, DK109134, and AG076537 (LJH); DK120292 and HL158691 (LOL); AG087387 (YZ); R37AG013925 (TT and JLK)]; NIDDK Diabetes Complications Consortium [DK115255, DK076169 (LJH)]; Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (LJH); TT and JLK are supported by a grant from the Hevolution Foundation (HF-GRO-23-1199148-3), Cedars-Sinai Medical Center, the Connor Fund, and Robert J. and Theresa W. Ryan.</p>","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106124"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-30DOI: 10.1016/j.ebiom.2026.106133
Cha Lin, Hao Wu, Wenbiao Xian, Yifan Zheng, Wenxuan Du, Xinyi Chen, Jinxia Li, Weineng Chen, Lishan Lin, Fengjuan Su, Zhong Pei, Ganqiang Liu
<p><strong>Background: </strong>The glymphatic system plays a critical role in brain waste clearance and health. Diffusion tensor imaging along the perivascular space (DTI-ALPS) is an emerging approach to assess glymphatic function, but manual analysis is limited by its subjectivity and laboriousness in clinical practice. To address these challenges, we developed a deep learning-enhanced DTI-ALPS (dALPS) method that automates and enhances measurement of DTI-ALPS in large-scale cohorts, enabling us to uncover its genetic and environmental determinants.</p><p><strong>Methods: </strong>We proposed an automated workflow combining convolutional neural network (CNN) and You Only Look Once (YOLO) for region-of-interest detection in DTI images. Using this method, we calculated dALPS index for over 65,000 participants from UK Biobank and multiple cohorts, and performed a genome-wide association study (GWAS). Additionally, we conducted transcriptome-wide association study (TWAS) and proteome-wide association study (PWAS) to explore the genetic and molecular underpinnings of glymphatic function. Associations between dALPS and demographic, lifestyle, and clinical traits were comprehensively evaluated. Mediation analysis was conducted to explore the potential mediating role of pharmacological treatments, including antidepressants and sleep medications, in the relationship between disease status and dALPS outcomes.</p><p><strong>Findings: </strong>Our automated dALPS index showed excellent reliability and reproducibility compared to conventional manual techniques (intraclass correlation coefficient = 0·95). We observed that the dALPS index was associated with a wide range of body composition measures and brain structures across different age groups and sex. GWAS identified five significant genetic loci associated with dALPS, two of which were replicated in an independent dataset. Subsequent TWAS and PWAS analyses highlighted potential causal genes and proteins linked to brain fluid dynamics. We found that higher healthy lifestyle index (HLI) was positively correlated with improved dALPS, and confirmed the associations between reduced dALPS and various central nervous system (CNS) disorders, including depression, anxiety and neurodegenerative diseases. Notably, mediation analysis indicated that antidepressants were a risk factor for lower brain glymphatic function (P = 0·004) by partly mediating the risk factor of depression.</p><p><strong>Interpretation: </strong>The dALPS analysis provides a reliable, precise, and automated biomarker for assessing brain glymphatic function. Our findings illuminate the genetic and environmental determinants of glymphatic activity, underscoring the potential of dALPS in clinical assessment, disease prediction and targeted therapeutic strategies.</p><p><strong>Funding: </strong>G.L.'s work is supported by National Natural Science Foundation of China (No. 32470708, No. 32270701), Shenzhen Fundamental Research Program (JCYJ2024081
背景:淋巴系统在脑废物清除和健康中起着至关重要的作用。沿血管周围间隙弥散张量成像(DTI-ALPS)是一种评估淋巴功能的新方法,但人工分析在临床实践中因其主观性和费力性而受到限制。为了应对这些挑战,我们开发了一种深度学习增强的DTI-ALPS (dALPS)方法,该方法可以在大规模队列中自动化和增强DTI-ALPS的测量,使我们能够发现其遗传和环境决定因素。方法:我们提出了一种结合卷积神经网络(CNN)和You Only Look Once (YOLO)的DTI图像兴趣区域检测自动化工作流程。利用该方法,我们计算了来自UK Biobank和多个队列的65,000多名参与者的dALPS指数,并进行了全基因组关联研究(GWAS)。此外,我们还进行了转录组全关联研究(TWAS)和蛋白质组全关联研究(PWAS),以探索淋巴功能的遗传和分子基础。综合评估dALPS与人口统计学、生活方式和临床特征之间的关系。进行中介分析,探讨药物治疗,包括抗抑郁药和睡眠药物,在疾病状态和dALPS结果之间的关系中的潜在中介作用。结果:与传统手工技术相比,我们的自动dALPS指数具有良好的可靠性和重复性(类内相关系数= 0.95)。我们观察到,dALPS指数与不同年龄组和性别的身体成分测量和大脑结构有关。GWAS鉴定出5个与dALPS相关的重要遗传位点,其中2个在一个独立的数据集中被复制。随后的TWAS和PWAS分析强调了与脑流体动力学相关的潜在致病基因和蛋白质。我们发现较高的健康生活方式指数(HLI)与dALPS改善呈正相关,并证实dALPS降低与多种中枢神经系统(CNS)疾病(包括抑郁、焦虑和神经退行性疾病)之间存在关联。值得注意的是,中介分析表明,抗抑郁药物通过部分中介抑郁的危险因素,是脑淋巴功能低下的危险因素(P = 0.004)。解释:dALPS分析为评估脑淋巴功能提供了可靠、精确和自动化的生物标志物。我们的研究结果阐明了淋巴活性的遗传和环境决定因素,强调了dALPS在临床评估、疾病预测和靶向治疗策略方面的潜力。资金:基准线国家自然科学基金项目(No. 32470708, No. 32270701),深圳市基础研究计划项目(JCYJ20240813151132042),广东省青年人才招聘项目(2019QN01Y139),深圳市炎症性疾病系统医学重点实验室(ZDSYS20220606100803007),广东省科技规划项目(2023B1212060018)资助。Z.P.国家自然科学基金(No. 82271266)和深圳市医学研究基金(No. C2501030)资助。
{"title":"Deep learning enhanced ALPS reveals genetic and environmental factors of brain glymphatic function.","authors":"Cha Lin, Hao Wu, Wenbiao Xian, Yifan Zheng, Wenxuan Du, Xinyi Chen, Jinxia Li, Weineng Chen, Lishan Lin, Fengjuan Su, Zhong Pei, Ganqiang Liu","doi":"10.1016/j.ebiom.2026.106133","DOIUrl":"10.1016/j.ebiom.2026.106133","url":null,"abstract":"<p><strong>Background: </strong>The glymphatic system plays a critical role in brain waste clearance and health. Diffusion tensor imaging along the perivascular space (DTI-ALPS) is an emerging approach to assess glymphatic function, but manual analysis is limited by its subjectivity and laboriousness in clinical practice. To address these challenges, we developed a deep learning-enhanced DTI-ALPS (dALPS) method that automates and enhances measurement of DTI-ALPS in large-scale cohorts, enabling us to uncover its genetic and environmental determinants.</p><p><strong>Methods: </strong>We proposed an automated workflow combining convolutional neural network (CNN) and You Only Look Once (YOLO) for region-of-interest detection in DTI images. Using this method, we calculated dALPS index for over 65,000 participants from UK Biobank and multiple cohorts, and performed a genome-wide association study (GWAS). Additionally, we conducted transcriptome-wide association study (TWAS) and proteome-wide association study (PWAS) to explore the genetic and molecular underpinnings of glymphatic function. Associations between dALPS and demographic, lifestyle, and clinical traits were comprehensively evaluated. Mediation analysis was conducted to explore the potential mediating role of pharmacological treatments, including antidepressants and sleep medications, in the relationship between disease status and dALPS outcomes.</p><p><strong>Findings: </strong>Our automated dALPS index showed excellent reliability and reproducibility compared to conventional manual techniques (intraclass correlation coefficient = 0·95). We observed that the dALPS index was associated with a wide range of body composition measures and brain structures across different age groups and sex. GWAS identified five significant genetic loci associated with dALPS, two of which were replicated in an independent dataset. Subsequent TWAS and PWAS analyses highlighted potential causal genes and proteins linked to brain fluid dynamics. We found that higher healthy lifestyle index (HLI) was positively correlated with improved dALPS, and confirmed the associations between reduced dALPS and various central nervous system (CNS) disorders, including depression, anxiety and neurodegenerative diseases. Notably, mediation analysis indicated that antidepressants were a risk factor for lower brain glymphatic function (P = 0·004) by partly mediating the risk factor of depression.</p><p><strong>Interpretation: </strong>The dALPS analysis provides a reliable, precise, and automated biomarker for assessing brain glymphatic function. Our findings illuminate the genetic and environmental determinants of glymphatic activity, underscoring the potential of dALPS in clinical assessment, disease prediction and targeted therapeutic strategies.</p><p><strong>Funding: </strong>G.L.'s work is supported by National Natural Science Foundation of China (No. 32470708, No. 32270701), Shenzhen Fundamental Research Program (JCYJ2024081","PeriodicalId":11494,"journal":{"name":"EBioMedicine","volume":"124 ","pages":"106133"},"PeriodicalIF":10.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}