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Intrinsic signal optoretinography of dark adaptation abnormality due to rod photoreceptor degeneration. 杆状光感受器变性导致暗适应异常的本征信号视网膜造影。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-01-31 eCollection Date: 2024-01-01 DOI: 10.3389/ebm.2024.10024
Jie Ding, Tae-Hoon Kim, Guangying Ma, Xincheng Yao

This research aims to investigate the potential of using intrinsic optical signal (IOS) optoretinography (ORG) to objectively detect dark adaptation (DA) abnormalities related to rod photoreceptor degeneration. Functional optical coherence tomography (OCT) was employed in both wild-type (WT) and retinal degeneration 10 (rd10) mice to conduct this assessment. Dynamic OCT measurements captured the changes in retinal thickness and reflectance from light-to-dark transition. Comparative analysis revealed significant IOS alterations within the outer retina. Specifically, a reduction in thickness from external limiting membrane (ELM) peak to retinal pigment epithelium (RPE) peak was observed (WT: 1.13 ± 0.69 µm, 30 min DA; rd10: 2.64 ± 0.86 µm, 30 min DA), as well as a decrease in the intensity of the inner segment ellipsoid zone (EZ) in 30 min DA compared to light adaptation (LA). The reduction of relative EZ intensity was notable in rd10 after 5 min DA and in WT after 15 min DA, with a distinguishable difference between rd10 and WT after 10 min DA. Furthermore, our findings indicated a significant decrease in the relative intensity of the hypo-reflective band between EZ and RPE in rd10 retinas during DA, which primarily corresponds to the outer segment (OS) region. In conclusion, the observed DA-IOS abnormalities, including changes in ELM-RPE thickness, EZ, and OS intensity, hold promise as differentiators between WT and rd10 mice before noticeable morphological abnormalities occur. These findings suggest the potential of this non-invasive imaging technique for the early detection of dysfunction in retinal photoreceptors.

本研究旨在探讨使用固有光学信号(IOS)视网膜成像(ORG)客观检测与杆状感光细胞变性有关的暗适应(DA)异常的潜力。在野生型(WT)小鼠和视网膜变性10(rd10)小鼠中采用了功能性光学相干断层扫描(OCT)来进行评估。动态 OCT 测量捕捉了视网膜厚度和反射率从亮到暗的变化。对比分析表明,视网膜外层的 IOS 发生了显著变化。具体来说,观察到从外部极限膜(ELM)峰值到视网膜色素上皮(RPE)峰值的厚度减少(WT:1.13 ± 0.69 µm,30 分钟 DA;rd10:2.64 ± 0.86 µm,30 分钟 DA),以及与光适应(LA)相比,30 分钟 DA 中内节椭圆形区(EZ)强度降低。相对 EZ 强度的降低在 5 分钟 DA 后的 rd10 和 15 分钟 DA 后的 WT 中都很明显,10 分钟 DA 后 rd10 和 WT 之间有明显差异。此外,我们的研究结果表明,在 DA 期间,rd10 视网膜中 EZ 和 RPE 之间低反射带的相对强度显著下降,这主要对应于外节(OS)区域。总之,观察到的 DA-IOS 异常,包括 ELM-RPE 厚度、EZ 和 OS 强度的变化,有望在出现明显的形态异常之前区分 WT 和 rd10 小鼠。这些研究结果表明,这种非侵入性成像技术具有早期检测视网膜感光器功能障碍的潜力。
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引用次数: 0
A phase 1 trial of human telomerase reverse transcriptase (hTERT) vaccination combined with therapeutic strategies to control immune-suppressor mechanisms. 人类端粒酶逆转录酶(hTERT)疫苗接种与控制免疫抑制机制的治疗策略相结合的一期试验。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-01-31 eCollection Date: 2024-01-01 DOI: 10.3389/ebm.2024.10021
Nahid Zareian, Oleg Eremin, Hardev Pandha, Richard Baird, Vineet Kwatra, Gabriel Funingana, Chandan Verma, Desmond Choy, Steven Hargreaves, Pejvak Moghimi, Adrian Shepherd, Dileep N Lobo, Jennifer Eremin, Farzin Farzaneh, Shahram Kordasti, James Spicer

The presence of inhibitory immune cells and difficulty in generating activated effector T cells remain obstacles to development of effective cancer vaccines. We designed a vaccine regimen combining human telomerase reverse transcriptase (hTERT) peptides with concomitant therapies targeting regulatory T cells (Tregs) and cyclooxygenase-2 (COX2)-mediated immunosuppression. This Phase 1 trial combined an hTERT-derived 7-peptide library, selected to ensure presentation by both HLA class-I and class-II in 90% of patients, with oral low-dose cyclophosphamide (to modulate Tregs) and the COX2 inhibitor celecoxib. Adjuvants were Montanide and topical TLR-7 agonist, to optimise antigen presentation. The primary objective was determination of the safety and tolerability of this combination therapy, with anti-cancer activity, immune response and detection of antigen-specific T cells as additional endpoints. Twenty-nine patients with advanced solid tumours were treated. All were multiply-pretreated, and the majority had either colorectal or prostate cancer. The most common adverse events were injection-site reactions, fatigue and nausea. Median progression-free survival was 9 weeks, with no complete or partial responses, but 24% remained progression-free for ≥6 months. Immunophenotyping showed post-vaccination expansion of CD4+ and CD8+ T cells with effector phenotypes. The in vitro re-challenge of T cells with hTERT peptides, TCR sequencing, and TCR similarity index analysis demonstrated the expansion following vaccination of oligoclonal T cells with specificity for hTERT. However, a population of exhausted PD-1+ cytotoxic T cells was also expanded in vaccinated patients. This vaccine combination regimen was safe and associated with antigen-specific immunological responses. Clinical activity could be improved in future by combination with anti-PD1 checkpoint inhibition to address the emergence of an exhausted T cell population.

抑制性免疫细胞的存在以及难以产生活化的效应 T 细胞仍然是开发有效癌症疫苗的障碍。我们设计了一种疫苗方案,将人类端粒酶逆转录酶(hTERT)多肽与针对调节性 T 细胞(Tregs)和环氧化酶-2(COX2)介导的免疫抑制的同步疗法相结合。这项1期试验将源自hTERT的7肽库与口服低剂量环磷酰胺(调节Tregs)和COX2抑制剂塞来昔布结合在一起,前者是为了确保90%的患者HLA I类和II类都能呈现。辅助药物为蒙他尼和局部TLR-7激动剂,以优化抗原递呈。首要目标是确定这种联合疗法的安全性和耐受性,抗癌活性、免疫反应和抗原特异性 T 细胞的检测是附加终点。29名晚期实体瘤患者接受了治疗。所有患者均接受过多重预处理,大多数患者患有结直肠癌或前列腺癌。最常见的不良反应是注射部位反应、疲劳和恶心。无进展生存期中位数为9周,没有完全或部分反应,但24%的患者无进展生存期≥6个月。免疫分型显示,接种后具有效应表型的CD4+和CD8+T细胞扩增。用hTERT肽对T细胞进行体外再挑战、TCR测序和TCR相似性指数分析表明,接种疫苗后具有hTERT特异性的寡克隆T细胞扩增。不过,接种疫苗的患者体内也扩增了PD-1+细胞毒性T细胞。这种疫苗组合方案是安全的,并能产生抗原特异性免疫反应。未来可通过与抗PD1检查点抑制剂联合使用来改善临床活性,以解决T细胞群衰竭的问题。
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引用次数: 0
Editorial: Experimental biology and medicine: new frontiers. 社论:实验生物学与医学:新领域。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-01-30 eCollection Date: 2024-01-01 DOI: 10.3389/ebm.2024.10069
Steven R Goodman
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引用次数: 0
Assessments of tumor mutational burden estimation by targeted panel sequencing: A comprehensive simulation analysis 通过靶向面板测序评估肿瘤突变负荷:综合模拟分析
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-08 DOI: 10.1177/15353702231211882
Dan Li, Dong Wang, Donald J. Johann, H. Hong, Joshua Xu
Tumor mutational burden (TMB), when at a high level, is an emerging indicative factor of sensitivity to immune checkpoint inhibitors. Previous studies have shown that the more affordable and accurate targeted panels can be used to measure TMB as a substitute for whole exome sequencing (WES). However, additional processes, such as hotspot mutations exclusion and TMB adjustment, are usually required to deal with the effect of the limited panel sizes. A comprehensive investigation of the effective factors is needed for accurate TMB estimation by targeted panels. In this study, we quantitatively evaluated the variances of TMB values calculated by WES and targeted panels using 10,000 simulated targeted panels with panel sizes ranging from 0.2 to 3.1 million bases. With The Cancer Genome Atlas (TCGA) cancer samples and mutation profiles, we fixed regressions on WES-TMBs and panel-TMBs to assess the performance of a given targeted panel. Panel size was found as one of the major effective factors of TMB estimation. Meanwhile, by investigating the well-performing small panels that reported TMB values similar to those of WES, we demonstrated the evidence of the cancer type–specific impacts of genes on TMB estimation and identified high-impact gene sets for different cancer types based on the TCGA data. This study revealed the quantitative correlations between TMB variance and panel size, and the potential impacts of individual genes on TMB estimation. Our results suggested that for cancer patients diagnosed using targeted panels, it would be highly beneficial to have the capability to directly measure TMB from the targeted sequencing data. This would greatly assist in making decisions regarding the use of immunotherapies.
肿瘤突变负荷(Tumor mutational burden, TMB),当处于高水平时,是对免疫检查点抑制剂敏感性的一个新兴指示性因素。先前的研究表明,更实惠和准确的靶向面板可用于测量TMB,作为全外显子组测序(WES)的替代品。然而,通常需要额外的过程,如热点突变排除和TMB调整,以处理有限的面板尺寸的影响。为了准确估算目标面板的TMB,需要对有效因素进行全面的研究。在这项研究中,我们使用10,000个模拟目标面板,面板尺寸从20到310万个碱基不等,定量评估了WES和目标面板计算的TMB值的差异。利用癌症基因组图谱(TCGA)癌症样本和突变谱,我们对WES-TMBs和panel- tmbs进行了固定回归,以评估给定目标面板的性能。研究发现,面板大小是TMB估算的主要影响因素之一。同时,通过调查报告TMB值与WES相似的表现良好的小型小组,我们展示了基因对TMB估计的癌症类型特异性影响的证据,并根据TCGA数据确定了不同癌症类型的高影响基因集。本研究揭示了TMB方差与面板大小之间的定量相关性,以及个体基因对TMB估计的潜在影响。我们的结果表明,对于使用靶向小组诊断的癌症患者,能够从靶向测序数据中直接测量TMB将是非常有益的。这将极大地有助于作出有关使用免疫疗法的决定。
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引用次数: 0
Data science in drug discovery safety: Challenges and opportunities 药物发现安全中的数据科学:挑战与机遇
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-07 DOI: 10.1177/15353702231215890
Nicholas J Coltman, Ruth A Roberts, James E Sidaway
Early de-risking of drug targets and chemistry is essential to provide drug projects with the best chance of success. Target safety assessments (TSAs) use target biology, gene and protein expression data, genetic information from humans and animals, and competitor compound intelligence to understand the potential safety risks associated with modulating a drug target. However, there is a vast amount of information, updated daily that must be considered for each TSA. We have developed a data science–based approach that allows acquisition of relevant evidence for an optimal TSA. This is built on expert-led conventional and artificial intelligence–based mining of literature and other bioinformatics databases. Potential safety risks are identified according to an evidence framework, adjusted to the degree of target novelty. Expert knowledge is necessary to interpret the evidence and to take account of the nuances of drug safety, the modality, and the intended patient population for each TSA within each project. Overall, TSAs take full advantage of the most recent developments in data science and can be used within drug projects to identify and mitigate risks, helping with informed decision-making and resource management. These approaches should be used in the earliest stages of a drug project to guide decisions such as target selection, discovery chemistry options, in vitro assay choice, and end points for investigative in vivo studies.
早期降低药物靶点和化学的风险对于为药物项目提供最佳的成功机会至关重要。靶标安全性评估(tsa)使用靶标生物学、基因和蛋白质表达数据、人类和动物的遗传信息以及竞争对手的复合智能来了解与调节药物靶标相关的潜在安全风险。然而,每个运输安全管理局都必须考虑每天更新的大量信息。我们开发了一种基于数据科学的方法,可以获得最佳TSA的相关证据。这是建立在专家主导的传统和人工智能为基础的文献和其他生物信息学数据库的挖掘。根据证据框架识别潜在安全风险,并根据目标的新颖性进行调整。专家知识是解释证据和考虑药物安全性、方式和每个项目中每个TSA的预期患者群体的细微差别所必需的。总的来说,tsa充分利用了数据科学的最新发展,可以在药物项目中使用,以识别和降低风险,帮助做出明智的决策和资源管理。这些方法应用于药物项目的早期阶段,以指导诸如靶点选择、发现化学选择、体外测定选择和体内研究性研究的终点等决策。
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引用次数: 0
Explainable hierarchical clustering for patient subtyping and risk prediction. 用于患者亚型划分和风险预测的可解释分层聚类。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2023-12-15 DOI: 10.1177/15353702231214253
Enrico Werner, Jeffrey N Clark, Alexander Hepburn, Ranjeet S Bhamber, Michael Ambler, Christopher P Bourdeaux, Christopher J McWilliams, Raul Santos-Rodriguez

We present a pipeline in which machine learning techniques are used to automatically identify and evaluate subtypes of hospital patients admitted between 2017 and 2021 in a large UK teaching hospital. Patient clusters are determined using routinely collected hospital data, such as those used in the UK's National Early Warning Score 2 (NEWS2). An iterative, hierarchical clustering process was used to identify the minimum set of relevant features for cluster separation. With the use of state-of-the-art explainability techniques, the identified subtypes are interpreted and assigned clinical meaning, illustrating their robustness. In parallel, clinicians assessed intracluster similarities and intercluster differences of the identified patient subtypes within the context of their clinical knowledge. For each cluster, outcome prediction models were trained and their forecasting ability was illustrated against the NEWS2 of the unclustered patient cohort. These preliminary results suggest that subtype models can outperform the established NEWS2 method, providing improved prediction of patient deterioration. By considering both the computational outputs and clinician-based explanations in patient subtyping, we aim to highlight the mutual benefit of combining machine learning techniques with clinical expertise.

我们介绍了一个管道,在该管道中,机器学习技术被用于自动识别和评估英国一家大型教学医院在 2017 年至 2021 年期间收治的住院病人的亚型。患者聚类是利用日常收集的医院数据确定的,如英国国家预警评分 2 (NEWS2) 中使用的数据。迭代分层聚类过程用于确定聚类分离的最小相关特征集。利用最先进的可解释性技术,对确定的亚型进行解释并赋予其临床意义,以说明其稳健性。与此同时,临床医生根据自己的临床知识,评估了已确定患者亚型的群组内相似性和群组间差异。针对每个聚类,对结果预测模型进行了训练,并对照未聚类患者队列的 NEWS2 对其预测能力进行了说明。这些初步结果表明,亚型模型可以超越既定的 NEWS2 方法,改进对患者病情恶化的预测。通过同时考虑计算输出和临床医生对患者亚型的解释,我们旨在强调机器学习技术与临床专业知识相结合的互利性。
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引用次数: 0
Mesenchymal stem cells with p38 mitogen-activated protein kinase interference ameliorate mouse ischemic stroke. 干扰 p38 丝裂原活化蛋白激酶的间充质干细胞可改善小鼠缺血性中风。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2023-12-30 DOI: 10.1177/15353702231220663
Yingying Bai, Lishan Wang, Rong Xu, Ying Cui

Mesenchymal stem cells (MSCs) have been widely used in the treatment of ischemic stroke. However, factors such as high glucose, oxidative stress, and aging can lead to the reduced function of donor MSCs. The p38 mitogen-activated protein kinase (MAPK) signaling pathway is associated with various functions, such as cell proliferation, apoptosis, senescence, differentiation, and paracrine secretion. This study examined the hypothesis that the downregulation of p38 MAPK expression in MSCs improves the prognosis of mice with ischemic stroke. Lentiviral vector-mediated short hairpin RNA (shRNA) was constructed to downregulate the expression level of p38 MAPK in mouse bone marrow-derived MSCs. The growth cycle, apoptosis, and senescence of MSCs after infection were examined. A mouse model of ischemic stroke was constructed. After MSC transplantation, the recovery of neurological function in the mice was evaluated. Lentivirus-mediated shRNA significantly downregulated the mRNA and protein expression levels of p38 MAPK. The senescence of MSCs in the p38 MAPK downregulation group was significantly reduced, but the growth cycle and apoptosis did not significantly change. Compared with the control group, the infarct volume was reduced, and the neurological function and the axonal remodeling were improved in mice with ischemic stroke after transplantation of MSCs with downregulated p38 MAPK. Immunohistochemistry confirmed that in the p38 MAPK downregulation group, apoptotic cells were reduced, and the number of neuronal precursors and the formation of white matter myelin were increased. In conclusion, downregulation of p38 MAPK expression in MSCs improves the therapeutic effect in mice with ischemic stroke, an effect that may be related to a reduction in MSC senescence. This method is expected to improve the efficacy of MSCs in patients, especially in patients with underlying diseases such as diabetes, thus providing a basis for clinical individualized treatment for cerebral infarction.

间充质干细胞(MSCs)已被广泛用于缺血性中风的治疗。然而,高血糖、氧化应激和衰老等因素会导致供体间充质干细胞功能降低。p38 丝裂原活化蛋白激酶(MAPK)信号通路与细胞增殖、凋亡、衰老、分化和旁分泌等多种功能有关。本研究探讨了下调间充质干细胞中 p38 MAPK 表达可改善缺血性中风小鼠预后的假设。研究人员构建了慢病毒载体介导的短发夹RNA(shRNA)来下调小鼠骨髓间充质干细胞中p38 MAPK的表达水平。研究考察了感染后间叶干细胞的生长周期、凋亡和衰老。建立了缺血性脑卒中小鼠模型。移植间充质干细胞后,对小鼠神经功能的恢复情况进行了评估。慢病毒介导的 shRNA 能显著下调 p38 MAPK 的 mRNA 和蛋白表达水平。p38 MAPK下调组间充质干细胞的衰老明显减少,但生长周期和细胞凋亡没有明显变化。与对照组相比,下调 p38 MAPK 的间充质干细胞移植后,缺血性脑卒中小鼠的梗死体积缩小,神经功能和轴突重塑得到改善。免疫组化证实,p38 MAPK 下调组凋亡细胞减少,神经元前体数量和白质髓鞘形成增加。总之,下调间充质干细胞中 p38 MAPK 的表达可提高对缺血性中风小鼠的治疗效果,这种效果可能与间充质干细胞衰老的减少有关。这种方法有望提高间充质干细胞对患者的疗效,尤其是对有糖尿病等基础疾病的患者,从而为脑梗死的临床个体化治疗提供依据。
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引用次数: 0
Transcriptomic profiling of cerebrospinal fluid identifies ALS pathway enrichment and RNA biomarkers in MND individuals. 脑脊液转录组学分析鉴定ALS通路富集和RNA生物标志物在MND个体。
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2023-11-24 DOI: 10.1177/15353702231209427
Alexander Fröhlich, Abigail L Pfaff, Vivien J Bubb, John P Quinn, Sulev Koks

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder and the most common form of motor neurone disease (MND) which is characterized by the damage and death of motor neurons in the brain and spinal cord of affected individuals. Due to the heterogeneity of the disease, a better understanding of the interaction between genetics and biochemistry with the identification of biomarkers is crucial for therapy development. In this study, we used cerebrospinal fluid (CSF) RNA-sequencing data from the New York Genome Center (NYGC) ALS Consortium and analyzed differential gene expression between 47 MND individuals and 29 healthy controls. Pathway analysis showed that the affected genes are enriched in many pathways associated with ALS, including nucleocytoplasmic transport, autophagy, and apoptosis. Moreover, we assessed differential expression on both gene- and transcript-based levels and demonstrate that the expression of previously identified potential biomarkers, including CAPG, CCL3, and MAP2, was significantly higher in MND individuals. Ultimately, this study highlights the transcriptomic composition of CSF which enables insights into changes in the brain in ALS and therefore increases the confidence in the use of CSF for biomarker development.

肌萎缩性侧索硬化症(ALS)是一种致命的神经退行性疾病,是运动神经元疾病(MND)最常见的形式,其特征是受影响个体的大脑和脊髓运动神经元的损伤和死亡。由于疾病的异质性,更好地了解遗传学和生物化学之间的相互作用以及生物标志物的鉴定对治疗发展至关重要。在这项研究中,我们使用来自纽约基因组中心(NYGC) ALS联盟的脑脊液(CSF) rna测序数据,分析了47名MND患者与29名健康对照者之间的差异基因表达。通路分析显示,受影响的基因在与ALS相关的许多通路中富集,包括核胞质转运、自噬和凋亡。此外,我们评估了基因和转录水平上的差异表达,并证明先前确定的潜在生物标志物(包括CAPG, CCL3和MAP2)的表达在MND个体中显着更高。最后,本研究强调了脑脊液的转录组组成,使人们能够深入了解ALS患者大脑的变化,从而增加了使用脑脊液开发生物标志物的信心。
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引用次数: 0
Curcumin induces ferroptosis and apoptosis in osteosarcoma cells by regulating Nrf2/GPX4 signaling pathway. 姜黄素通过调节 Nrf2/GPX4 信号通路诱导骨肉瘤细胞的铁蛋白沉着和凋亡
IF 3.2 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-03 DOI: 10.1177/15353702231220670
Chuanjian Yuan, Rong Fan, Kai Zhu, Yutong Wang, Wenpeng Xie, Yanchen Liang

Curcumin, an antitumor agent, has been shown to inhibit cell growth and metastasis in osteosarcoma. However, there is no evidence of curcumin and its regulation of cell ferroptosis and nuclear factor E2-related factor 2 (Nrf2)/glutathione peroxidase 4 (GPX4) signaling pathways in osteosarcoma. This study aimed to investigate the effects of curcumin on osteosarcoma both in vitro and in vivo. To explore the effects and mechanisms of curcumin on osteosarcoma, cells (MNNG/HOS and MG-63) and xenograft mice models were established. Cell viability, cell apoptosis rate, cycle distribution, cell migration, cell invasion, reactive oxygen species, malonaldehyde and glutathione abilities, and protein levels were detected by cell counting kit-8, flow cytometry, wound healing, transwell assay, respectively. Nrf2 and GPX4 expressions were detected using an immunofluorescence assay. Nrf2/GPX4-related protein levels were detected using western blotting. The results showed that curcumin effectively decreased cell viability and increased apoptosis rate. Meanwhile, curcumin inhibited tumor volume in the xenograft model, and Nrf2/GPX4-related protein levels were also altered. Interestingly, the effects of curcumin were reversed by liproxstatin-1 (an effective inhibitor of ferroptosis) and bardoxolone-methyl (an effective activator of Nrf2). Our results indicate that curcumin has therapeutic effects on osteosarcoma cells and a xenograft model by regulating the expression of the Nrf2/GPX4 signaling pathway.

姜黄素是一种抗肿瘤药物,已被证明可抑制骨肉瘤的细胞生长和转移。然而,目前还没有证据表明姜黄素及其对骨肉瘤细胞铁变态反应和核因子E2相关因子2(Nrf2)/谷胱甘肽过氧化物酶4(GPX4)信号通路的调节作用。本研究旨在探讨姜黄素在体外和体内对骨肉瘤的影响。为了探索姜黄素对骨肉瘤的影响和机制,研究人员建立了细胞(MNNG/HOS 和 MG-63)和异种移植小鼠模型。通过细胞计数试剂盒-8、流式细胞仪、伤口愈合和透孔试验分别检测了细胞活力、细胞凋亡率、周期分布、细胞迁移、细胞侵袭、活性氧、丙二醛和谷胱甘肽能力以及蛋白质水平。免疫荧光试验检测了 Nrf2 和 GPX4 的表达。用 Western 印迹法检测 Nrf2/GPX4 相关蛋白水平。结果表明,姜黄素能有效降低细胞活力,提高细胞凋亡率。同时,姜黄素抑制了异种移植模型的肿瘤体积,Nrf2/GPX4相关蛋白水平也发生了改变。有趣的是,姜黄素的作用被脂氧司他丁-1(一种有效的铁变态反应抑制剂)和巴多酮-甲基(一种有效的 Nrf2 激活剂)逆转。我们的研究结果表明,姜黄素通过调节 Nrf2/GPX4 信号通路的表达,对骨肉瘤细胞和异种移植模型具有治疗作用。
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引用次数: 0
Decision rules for personalized statin treatment prescriptions over multi-objectives. 多目标个性化他汀类药物治疗处方的决策规则。
IF 2.8 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-12-01 Epub Date: 2024-01-27 DOI: 10.1177/15353702231220660
Pui Ying Yew, Yue Liang, Terrence J Adam, Julian Wolfson, Peter J Tonellato, Chih-Lin Chi

In our previous study, we demonstrated the feasibility of producing a proactive statin prescription strategy - a personalized statin treatment plan (PSTP) - using neural networks with big data. However, its non-transparency limited result interpretations and clinical usability. To improve the transparency of our previous approach with minimal compromise to the maximal statin treatment benefit-to-risk ratio, this study proposed a five-step pipeline approach called the decision rules for statin treatment (DRST). Steps 1-3 of our proposed pipeline improved our previous PSTP model in optimizing individual benefit-to-risk ratio; Step 4 used a decision tree model (DRST) to provide straightforward rules in the initial statin treatment plan; Step 5 aimed to evaluate the efficacy of these decision rules by conducting a clinical trial simulation. We included 107,739 de-identified patient data from Optum Labs Database Warehouse in this study. The final decision rules were compact and efficient, resulting from a decision tree with only a maximum depth of 3 and 11 nodes. The DRST identified three factors that are easily obtainable at the point of care: age, low-density lipoprotein cholesterol (LDL-C) level, and age-adjusted Charlson score. Moreover, it also identified six subpopulations that can benefit most from these decision rules. In our clinical trial simulations, DRST was found to improve statin benefit in LDL-C reduction by 4.15 percentage points (pp) and reduce risks of statin-associated symptoms (SAS) and statin discontinuation by 11.71 and 3.96 pp, respectively, when compared to the standard of care. Moreover, these DRST results were only less than 0.6 pp suboptimal to PSTP, demonstrating that building DRST that provide transparency with minimal compromise to the maximal benefit-to-risk ratio of statin treatments is feasible.

在我们之前的研究中,我们证明了利用神经网络和大数据制定主动他汀处方策略--个性化他汀治疗计划(PSTP)--的可行性。然而,这种方法的不透明性限制了结果的解释和临床可用性。为了提高以往方法的透明度,同时尽量不影响他汀治疗的最大收益风险比,本研究提出了一种五步流水线方法,即他汀治疗决策规则(DRST)。我们提出的流程中的第 1-3 步改进了之前的 PSTP 模型,优化了个体获益风险比;第 4 步使用决策树模型(DRST)为初始他汀治疗计划提供了简单明了的规则;第 5 步旨在通过进行临床试验模拟来评估这些决策规则的有效性。在这项研究中,我们纳入了 Optum 实验室数据库仓库中 107,739 个去标识化的患者数据。最终的决策规则紧凑高效,决策树的最大深度仅为 3,节点数为 11。DRST 确定了三个在护理点很容易获得的因素:年龄、低密度脂蛋白胆固醇(LDL-C)水平和年龄调整后的 Charlson 评分。此外,它还确定了最能从这些决策规则中获益的六个亚人群。在我们的临床试验模拟中发现,与标准治疗相比,DRST 可将他汀类药物在降低 LDL-C 方面的获益提高 4.15 个百分点(pp),并将他汀类药物相关症状(SAS)和他汀类药物停用的风险分别降低 11.71 个百分点和 3.96 个百分点。此外,这些 DRST 结果仅比 PSTP 差不到 0.6 个百分点,这表明建立 DRST 是可行的,它能在最大限度地降低他汀类药物治疗的最大收益风险比的同时提供透明度。
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