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Artificial intelligence-based evaluation of prognosis in cirrhosis. 基于人工智能的肝硬化预后评估。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-14 DOI: 10.1186/s12967-024-05726-2
Yinping Zhai, Darong Hai, Li Zeng, Chenyan Lin, Xinru Tan, Zefei Mo, Qijia Tao, Wenhui Li, Xiaowei Xu, Qi Zhao, Jianwei Shuai, Jingye Pan

Cirrhosis represents a significant global health challenge, characterized by high morbidity and mortality rates that severely impact human health. Timely and precise prognostic assessments of liver cirrhosis are crucial for improving patient outcomes and reducing mortality rates as they enable physicians to identify high-risk patients and implement early interventions. This paper features a thorough literature review on the prognostic assessment of liver cirrhosis, aiming to summarize and delineate the present status and constraints associated with the application of traditional prognostic tools in clinical settings. Among these tools, the Child-Pugh and Model for End-Stage Liver Disease (MELD) scoring systems are predominantly utilized. However, their accuracy varies significantly. These systems are generally suitable for broad assessments but lack condition-specific applicability and fail to capture the risks associated with dynamic changes in patient conditions. Future research in this field is poised for deep exploration into the integration of artificial intelligence (AI) with routine clinical and multi-omics data in patients with cirrhosis. The goal is to transition from static, unimodal assessment models to dynamic, multimodal frameworks. Such advancements will not only improve the precision of prognostic tools but also facilitate personalized medicine approaches, potentially revolutionizing clinical outcomes.

肝硬化是一项重大的全球性健康挑战,其发病率和死亡率都很高,严重影响人类健康。及时、准确的肝硬化预后评估对改善患者预后和降低死亡率至关重要,因为它能让医生识别高危患者并实施早期干预。本文对肝硬化预后评估进行了全面的文献综述,旨在总结和描述传统预后评估工具在临床应用中的现状和制约因素。在这些工具中,主要使用 Child-Pugh 和终末期肝病模型 (MELD) 评分系统。然而,它们的准确性差异很大。这些系统通常适用于广泛的评估,但缺乏针对具体病情的适用性,也无法捕捉与患者病情动态变化相关的风险。该领域的未来研究将深入探索人工智能(AI)与肝硬化患者常规临床和多组学数据的整合。目标是从静态、单模态评估模型过渡到动态、多模态框架。这种进步不仅能提高预后工具的精确度,还能促进个性化医疗方法的发展,从而有可能彻底改变临床结果。
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引用次数: 0
CTPAD: an interactive web application for comprehensive transcriptomic profiling in allergic diseases. CTPAD:用于过敏性疾病综合转录组分析的交互式网络应用程序。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-14 DOI: 10.1186/s12967-024-05459-2
Suizi Zhou, Wanqiao Huang, Yitong Liu, Peng Luo, Anqi Lin, Hong Yang, Qianhui Qiu

Background: Allergic diseases are systemic chronic inflammatory diseases associated with multiorgan damage and complex pathogenesis. Several studies have revealed the association of gene expression abnormalities with the development of allergic diseases, but the biomedical field still lacks a public platform for comprehensive analysis and visualization of transcriptomic data of allergic diseases.

Objective: The aim of the study is to provide a comprehensive web tool for multiple analysis in allergic diseases.

Methods: We retrieved and downloaded human and mouse gene expression profile data associated with allergic diseases from the Gene Expression Omnibus (GEO) database and standardized the data uniformly. We used gene sets obtained from the MSigDB database for pathway enrichment analysis and multiple immune infiltration algorithms for the estimation of immune cell proportion. The basic construction of the web pages was based on the Shiny framework. Additionally, more convenient features were added to the server to improve the efficiency of the web pages, such as jQuery plugins and a comment box to collect user feedback.

Results: We developed CTPAD, an interactive R Shiny application that integrates public databases and multiple algorithms to explore allergic disease-related datasets and implement rich transcriptomic visualization capabilities, including gene expression analysis, pathway enrichment analysis, immune infiltration analysis, correlation analysis, and single-cell RNA sequencing analysis. All functional modules offer customization options and can be downloaded in PDF format with high-resolution images.

Conclusions: CTPAD largely facilitates the work of researchers without bioinformatics background to enable them to better explore the transcriptomic features associated with allergic diseases. CTPAD is available at https://smuonco.shinyapps.io/CTPAD/ .

背景:过敏性疾病是一种全身性慢性炎症性疾病,伴有多器官损伤,发病机制复杂。多项研究揭示了基因表达异常与过敏性疾病发病的关联,但生物医学领域仍缺乏一个对过敏性疾病转录组数据进行综合分析和可视化的公共平台:本研究旨在为过敏性疾病的多重分析提供一个全面的网络工具:方法:我们从基因表达总库(GEO)数据库中检索并下载了与过敏性疾病相关的人类和小鼠基因表达谱数据,并对数据进行了统一的标准化处理。我们使用从 MSigDB 数据库获得的基因集进行通路富集分析,并使用多重免疫浸润算法估算免疫细胞比例。网页的基本构建基于 Shiny 框架。此外,我们还在服务器上添加了更多方便的功能,以提高网页的效率,如 jQuery 插件和收集用户反馈的评论框:我们开发的 CTPAD 是一个交互式 R Shiny 应用程序,它整合了公共数据库和多种算法,用于探索过敏性疾病相关数据集,并实现了丰富的转录组可视化功能,包括基因表达分析、通路富集分析、免疫浸润分析、相关性分析和单细胞 RNA 测序分析。所有功能模块都提供定制选项,并可下载 PDF 格式的高分辨率图像:结论:CTPAD 在很大程度上方便了没有生物信息学背景的研究人员,使他们能够更好地探索与过敏性疾病相关的转录组特征。CTPAD 可在 https://smuonco.shinyapps.io/CTPAD/ 上获取。
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引用次数: 0
m6A-modified circXPO1 accelerates colorectal cancer progression via interaction with FMRP to promote WWC2 mRNA decay. m6A修饰的circXPO1通过与FMRP相互作用促进WWC2 mRNA衰变,从而加速结直肠癌的进展。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-14 DOI: 10.1186/s12967-024-05716-4
Xiaowen Zhu, Pengxia Zhang

Background: Recent evidence has demonstrated the vital roles of circular RNAs (circRNAs) in the progression of colorectal cancer (CRC); however, their functions and mechanisms in CRC need to be further explored. This study aimed to uncover the biological function of circXPO1 in CRC progression.

Methods: CircXPO1 was identified by Sanger sequencing, RNase R, and actinomycin D treatment assays. Colony formation, scratch, transwell assays, and mouse xenograft models were adopted to evaluate CRC cell growth and metastasis in vitro and in vivo. Subcellular expression of circXPO1 was detected by FISH and nuclear-cytoplasmic separation assays. Molecular mechanisms were investigated by MeRIP, RIP, and RNA pull-down assays. Target molecular expression was detected by RT-qPCR, Western blotting and immunohistochemical staining.

Results: circXPO1 was up-regulated in CRC tissues and cells, which indicated a poor prognosis of CRC patients. circXPO1 deficiency delayed the growth, EMT, and metastasis of CRC cells. Mechanistical experiments indicated that down-regulation of ALKBH5 enhanced IGF2BP2-mediated m6A modification of circXPO1 to increase circXPO1 expression. Furthermore, circXPO1 interacted with FMRP to reduce the mRNA stability of WWC2, which consequently resulted in Hippo-YAP pathway activation. Rescue experiments suggested that WWC2 overexpression abrogated circXPO1-mediated malignant capacities of CRC cells. The in vivo growth and liver metastasis of CRC cells were restrained by circXPO1 depletion or WWC2 overexpression.

Conclusions: m6A-modified circXPO1 by ALKBH5/IGF2BP2 axis destabilized WWC2 via interaction with FMRP to activate Hippo-YAP pathway, thereby facilitating CRC growth and metastasis. Targeting circXPO1 might be a potential therapeutic strategy for CRC.

背景:最近的证据表明,环状RNA(circRNA)在结直肠癌(CRC)的进展中起着至关重要的作用;然而,它们在CRC中的功能和机制还需要进一步探索。本研究旨在揭示circXPO1在CRC进展中的生物学功能:方法:通过桑格测序、RNase R 和放线菌素 D 处理试验鉴定了 CircXPO1。采用集落形成、划痕、跨孔试验和小鼠异种移植模型来评估 CRC 细胞在体外和体内的生长和转移情况。通过 FISH 和核-胞质分离实验检测了 circXPO1 的亚细胞表达。通过 MeRIP、RIP 和 RNA pull-down 试验研究了分子机制。结果:circXPO1 在 CRC 组织和细胞中上调,表明 CRC 患者预后不良。机理实验表明,ALKBH5的下调增强了IGF2BP2介导的circXPO1的m6A修饰,从而增加了circXPO1的表达。此外,circXPO1与FMRP相互作用,降低了WWC2的mRNA稳定性,从而导致Hippo-YAP通路的激活。拯救实验表明,WWC2的过量表达会削弱circXPO1介导的CRC细胞恶性能力。结论:通过ALKBH5/IGF2BP2轴,m6A修饰的circXPO1通过与FMRP相互作用破坏WWC2的稳定性,激活Hippo-YAP通路,从而促进CRC的生长和转移。靶向circXPO1可能是治疗CRC的一种潜在策略。
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引用次数: 0
Identification of the metabolic protein ATP5MF as a potential therapeutic target of TNBC. 将代谢蛋白 ATP5MF 鉴定为 TNBC 的潜在治疗靶点。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-14 DOI: 10.1186/s12967-024-05692-9
Kaiyan Chen, Yingchun Wu, Linfeng Xu, Changyong Wang, Jinqiu Xue

Background: Triple-negative breast cancer (TNBC), a distinct subtype of breast cancer, is characterized by its high invasiveness, high metastatic potential, proneness to relapse, and poor prognosis. Effective treatment regimens for non-BRCA1/2 mutation TNBC are still lacking. As a result, there is a pressing clinical necessity to develop novel treatment approaches for non-BRCA1/2 mutation TNBC.

Methods: For this research, the scRNA data was obtained from the GEO database, while the transcriptome data was obtained from the TCGA and METABRIC databases. Quality control procedures were conducted on single-cell sequencing data. and then annotation and the Copycat algorithm were applied for anlysis. Employing the high dimensional weighted gene coexpression network analysis (hdWGCNA) method, we analyzed the tumor epithelial cells from non-BRCA1/2 mutation TNBC to identify the functional module genes. PPI analysis and survival analysis were further emplyed to identify the key gene. siRNA-NC and siRNA-ATP5MF were transfected into two MDA-MB-231 and BT-549 TNBC cell lines. Cell growth was determined by CCK8 assay, colony formation and migration assay. Electron microscopy was used to examine the structure of mitochondria in cells. JC-1 staining was used to measure the potential of the mitochondrial membrane. A tumor xenograft animal model was established by injecting TNBC cells into nude mice. The animal model was usded to evaluated in vivo tumor response aftering ATP5MF silencing.

Results: Using hdWGCNA, we have identified 136 genes in module 3. After PPI and survival analysis, we have identified ATP5MF as a potential therapeutic gene. High ATP5MF expression was associated with poor prognosis of non-BRCA1/2 mutation TNBC. The high expression of ATP5MF in TNBC tissues was evaluated using the TCGA database and IHC staining of clinical TNBC specimens. Silencing ATP5MF in two TNBC cell lines reduced the growth and colony formation of TNBC cells in vitro, and hindered the growth of TNBC xenografts in vivo. Additionally, ATP5MF knockdown impaired mitochondrial functions in TNBC cells.

Conclusion: In summary, the metabolic protein ATP5MF plays a crucial role in the non-BRCA1/2 mutation TNBC cells, making it a potential novel diagnostic and therapeutic oncotarget for non-BRCA1/2 mutation TNBC.

背景:三阴性乳腺癌(TNBC)是乳腺癌的一个独特亚型,具有高侵袭性、高转移潜能、易复发和预后差等特点。目前仍缺乏针对非 BRCA1/2 突变 TNBC 的有效治疗方案。因此,临床上迫切需要开发针对非 BRCA1/2 突变 TNBC 的新型治疗方法:本研究的 scRNA 数据来自 GEO 数据库,转录组数据来自 TCGA 和 METABRIC 数据库。对单细胞测序数据进行质量控制,然后应用注释和 Copycat 算法进行分析。利用高维加权基因共表达网络分析(hdWGCNA)方法,我们对非 BRCA1/2 突变 TNBC 的肿瘤上皮细胞进行了分析,以确定功能模块基因。将 siRNA-NC 和 siRNA-ATP5MF 转染到 MDA-MB-231 和 BT-549 两种 TNBC 细胞系中。细胞生长通过 CCK8 试验、集落形成和迁移试验进行测定。电子显微镜用于检查细胞中线粒体的结构。JC-1 染色法用于测量线粒体膜的电位。通过向裸鼠注射 TNBC 细胞,建立了肿瘤异种移植动物模型。该动物模型用于评估 ATP5MF 沉默后体内肿瘤的反应:结果:利用 hdWGCNA,我们在模块 3 中发现了 136 个基因。结果:利用 hdWGCNA,我们在模块 3 中发现了 136 个基因,经过 PPI 和生存分析,我们发现 ATP5MF 是一个潜在的治疗基因。ATP5MF的高表达与非BRCA1/2突变TNBC的不良预后有关。利用TCGA数据库和临床TNBC标本的IHC染色评估了ATP5MF在TNBC组织中的高表达情况。在两种TNBC细胞系中沉默ATP5MF可减少TNBC细胞在体外的生长和集落形成,并阻碍TNBC异种移植物在体内的生长。此外,ATP5MF敲除还会损害TNBC细胞的线粒体功能:总之,代谢蛋白ATP5MF在非BRCA1/2突变TNBC细胞中起着至关重要的作用,使其成为非BRCA1/2突变TNBC潜在的新型诊断和治疗肿瘤靶点。
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引用次数: 0
BNIP3+ fibroblasts associated with hypoxia and inflammation predict prognosis and immunotherapy response in pancreatic ductal adenocarcinoma. 与缺氧和炎症相关的 BNIP3+ 成纤维细胞可预测胰腺导管腺癌的预后和免疫疗法反应。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-14 DOI: 10.1186/s12967-024-05674-x
Bo Gao, Guohua Hu, Boshi Sun, Wenqiang Li, Hao Yang

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most malignant tumors that lacks effective treatment options. Cancer-associated fibroblasts (CAFs), an important component of the tumor microenvironment, associated with tumor progression, prognosis, and treatment response. This work aimed to explore the novel CAFs-associated target to improve treatment strategies in PDAC.

Methods: The PDAC single-cell sequencing data (CRA001160, n = 35) were downloaded and integrated based on GSA databases to classify fibroblasts into fine subtypes. Functional enrichment analysis and coexpression regulatory network analysis were used to identify the functional phenotypes and biological properties of the different fibroblast subtypes. Fibroblast differentiation trajectories were constructed using pseudochronological analysis to identify initial and terminally differentiated subtypes of fibroblasts. The changes in the proportions of different fibroblast subtypes before and after PDAC immunotherapy were compared in responsive and nonresponding patients, and the relationships between fibroblast subtypes and PDAC immunotherapy responsiveness were determined based on GSA and GEO database. Using molecular biology methods to confirm the effects of BNIP3 on hypoxia and inflammation in CAFs. CAFs were co cultured with pancreatic cancer cells to detect their effects on migration and invasion of pancreatic cancer.

Results: Single-cell data analysis divided fibroblasts into six subtypes. The differentiation trajectory suggested that BNIP3+ Fibro subtype exhibited terminal differentiation, and the expression of genes related to hypoxia and the inflammatory response increased gradually with differentiation time. The specific overexpressed genes in the BNIP3+ Fibro subtype were significantly associated with overall and disease progression-free survival in the patients with PDAC. Interestingly, the greater the proportion of the BNIP3+ Fibro subtype was, the worse the response of PDAC patients to immunotherapy, and the CRTL treatment regimen effectively reduced the proportion of the BNIP3+ Fibro subtype. After knocking out BNIP3, the hypoxia markers and inflammatory factors of CAFs were inhibited. Co-culture of CAFs with pancreatic cancer cells can increase the migration and invasion of pancreatic cancer, but this could be reversed by knocking out BNIP3.

Conclusions: This study revealed the BNIP3+ Fibro subtype associated with hypoxia and inflammatory responses, which was closely related to the poor prognosis of patients with PDAC, and identified signature genes that predict the immunotherapy response in PDAC.

背景:胰腺导管腺癌(PDAC)是最恶性的肿瘤之一,缺乏有效的治疗方案。癌症相关成纤维细胞(CAFs)是肿瘤微环境的重要组成部分,与肿瘤进展、预后和治疗反应相关。本研究旨在探索新型CAFs相关靶点,以改善PDAC的治疗策略:方法:下载PDAC单细胞测序数据(CRA001160,n = 35),并基于GSA数据库进行整合,将成纤维细胞分为精细亚型。功能富集分析和共表达调控网络分析用于确定不同成纤维细胞亚型的功能表型和生物学特性。利用伪时序分析构建了成纤维细胞分化轨迹,以确定成纤维细胞的初始亚型和终末分化亚型。比较了有反应和无反应患者在PDAC免疫治疗前后不同成纤维细胞亚型比例的变化,并基于GSA和GEO数据库确定了成纤维细胞亚型与PDAC免疫治疗反应性之间的关系。利用分子生物学方法证实BNIP3对CAFs缺氧和炎症的影响。将CAFs与胰腺癌细胞共培养,检测其对胰腺癌迁移和侵袭的影响:结果:单细胞数据分析将成纤维细胞分为六种亚型。分化轨迹表明,BNIP3+成纤维亚型表现为终末分化,随着分化时间的延长,与缺氧和炎症反应相关的基因表达量逐渐增加。BNIP3+ Fibro亚型中的特定过表达基因与PDAC患者的总生存期和无疾病进展生存期显著相关。有趣的是,BNIP3+ Fibro亚型的比例越高,PDAC患者对免疫疗法的反应越差,而CRTL治疗方案能有效降低BNIP3+ Fibro亚型的比例。敲除BNIP3后,CAFs的缺氧标志物和炎症因子受到抑制。CAFs与胰腺癌细胞共培养可增加胰腺癌的迁移和侵袭,但敲除BNIP3后可逆转这一趋势:这项研究揭示了与缺氧和炎症反应相关的BNIP3+纤维亚型,它与PDAC患者的不良预后密切相关,并确定了预测PDAC免疫治疗反应的特征基因。
{"title":"BNIP3+ fibroblasts associated with hypoxia and inflammation predict prognosis and immunotherapy response in pancreatic ductal adenocarcinoma.","authors":"Bo Gao, Guohua Hu, Boshi Sun, Wenqiang Li, Hao Yang","doi":"10.1186/s12967-024-05674-x","DOIUrl":"https://doi.org/10.1186/s12967-024-05674-x","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma (PDAC) is one of the most malignant tumors that lacks effective treatment options. Cancer-associated fibroblasts (CAFs), an important component of the tumor microenvironment, associated with tumor progression, prognosis, and treatment response. This work aimed to explore the novel CAFs-associated target to improve treatment strategies in PDAC.</p><p><strong>Methods: </strong>The PDAC single-cell sequencing data (CRA001160, n = 35) were downloaded and integrated based on GSA databases to classify fibroblasts into fine subtypes. Functional enrichment analysis and coexpression regulatory network analysis were used to identify the functional phenotypes and biological properties of the different fibroblast subtypes. Fibroblast differentiation trajectories were constructed using pseudochronological analysis to identify initial and terminally differentiated subtypes of fibroblasts. The changes in the proportions of different fibroblast subtypes before and after PDAC immunotherapy were compared in responsive and nonresponding patients, and the relationships between fibroblast subtypes and PDAC immunotherapy responsiveness were determined based on GSA and GEO database. Using molecular biology methods to confirm the effects of BNIP3 on hypoxia and inflammation in CAFs. CAFs were co cultured with pancreatic cancer cells to detect their effects on migration and invasion of pancreatic cancer.</p><p><strong>Results: </strong>Single-cell data analysis divided fibroblasts into six subtypes. The differentiation trajectory suggested that BNIP3+ Fibro subtype exhibited terminal differentiation, and the expression of genes related to hypoxia and the inflammatory response increased gradually with differentiation time. The specific overexpressed genes in the BNIP3+ Fibro subtype were significantly associated with overall and disease progression-free survival in the patients with PDAC. Interestingly, the greater the proportion of the BNIP3+ Fibro subtype was, the worse the response of PDAC patients to immunotherapy, and the CRTL treatment regimen effectively reduced the proportion of the BNIP3+ Fibro subtype. After knocking out BNIP3, the hypoxia markers and inflammatory factors of CAFs were inhibited. Co-culture of CAFs with pancreatic cancer cells can increase the migration and invasion of pancreatic cancer, but this could be reversed by knocking out BNIP3.</p><p><strong>Conclusions: </strong>This study revealed the BNIP3+ Fibro subtype associated with hypoxia and inflammatory responses, which was closely related to the poor prognosis of patients with PDAC, and identified signature genes that predict the immunotherapy response in PDAC.</p>","PeriodicalId":17458,"journal":{"name":"Journal of Translational Medicine","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comprehensive biomarker and modeling approach to support dose finding for BI 836880, a VEGF/Ang-2 inhibitor. 支持血管内皮生长因子/Ang-2 抑制剂 BI 836880 剂量确定的综合生物标志物和建模方法。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-14 DOI: 10.1186/s12967-024-05612-x
Sascha Keller, Ulrich Kunz, Ulrike Schmid, Jack Beusmans, Martin Büchert, Min He, Girish Jayadeva, Christophe Le Tourneau, Doreen Luedtke, Heiko G Niessen, Zohra Oum'hamed, Sina Pleiner, Xiaoning Wang, Ralph Graeser

Background: BI 836880 is a humanized bispecific nanobody® that binds to and blocks vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2). A comprehensive biomarker and modeling approach is presented here that supported dose finding for BI 836880.

Methods: Two Phase I dose-escalation studies (1336.1 [NCT02674152], 1336.6 [NCT02689505]) assessed BI 836880 in adults with confirmed locally advanced or metastatic solid tumors, refractory to standard therapy or for which standard therapy was not reliably effective. Two dosing schedules were investigated, 3 weeks (q3w) or once weekly (qw), starting at a dose of 40 mg. In a comprehensive biomarker approach, soluble pharmacodynamic markers (free and total plasma VEGF-A and Ang-2), as well as circulating angiogenic factors (soluble VEGF3, soluble Tie2 and placenta growth factor, amongst others) were analyzed to assess target engagement in peripheral blood for q3w doses. A Population based pharmacokinetics/pharmacodynamics (PopPK/PD) model was built using the limited Phase I dataset to support dose finding by simulations. In order to demonstrate drug activity in the tumor, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was applied.

Results: DCE-MRI scans supported target engagement in the tumor. Free VEGF-A was depleted at all doses, whereas free Ang-2 decreased dose-dependently, reaching depletion in most patients from 360 mg q3w onwards. While total VEGF-A levels increased in a dose-dependent manner, reaching saturation at 360 mg q3w, total Ang-2 levels increased, but did not plateau. Angiogenic biomarkers showed changes from doses ≥ 360 mg q3w. PopPK/PD modeling showed that doses ≥ 360 mg q3w led to > 90% inhibition of free Ang-2 at steady-state in most patients. By increasing the dose to ≥ 500 mg q3w, > 90% of patients are expected to achieve this level.

Conclusions: The comprehensive analyses of multiple target engagement markers support BI 836880 720 mg q3w as a biologically relevant monotherapy dose schedule.

Trial registration: NCT02674152 and NCT02689505.

背景:BI 836880是一种人源化双特异性纳米抗体®,能结合并阻断血管内皮生长因子(VEGF)和血管生成素-2(Ang-2)。本文介绍了支持 BI 836880 剂量发现的综合生物标志物和建模方法:两项 I 期剂量递增研究(1336.1 [NCT02674152]、1336.6 [NCT02689505])评估了 BI 836880 对标准疗法难治或标准疗法疗效不佳的确诊局部晚期或转移性实体瘤成人患者的治疗效果。研究采用了两种给药方案:3 周一次(q3w)或每周一次(qw),起始剂量为 40 毫克。在综合生物标记方法中,分析了可溶性药效学标记物(游离和总血浆 VEGF-A 和 Ang-2)以及循环血管生成因子(可溶性 VEGF3、可溶性 Tie2 和胎盘生长因子等),以评估 q3w 剂量的外周血中的目标参与度。利用有限的 I 期数据集建立了一个基于群体的药代动力学/药效学(PopPK/PD)模型,为通过模拟寻找剂量提供支持。为了证明药物在肿瘤中的活性,应用了动态对比增强磁共振成像(DCE-MRI):结果:DCE-MRI 扫描支持肿瘤中的靶点参与。在所有剂量下,游离的 VEGF-A 均被耗尽,而游离的 Ang-2 则随剂量减少,从 360 毫克 q3w 开始,大多数患者的游离 Ang-2 均被耗尽。总 VEGF-A 水平的增加与剂量有关,360 毫克 q3w 时达到饱和,而总 Ang-2 水平有所增加,但没有达到稳定。从剂量≥ 360 毫克 q3w 开始,血管生成生物标志物出现变化。PopPK/PD 模型显示,在大多数患者中,剂量≥ 360 毫克 q3w 可使稳态时的游离 Ang-2 抑制率大于 90%。通过将剂量增加到≥ 500 mg q3w,>90%的患者有望达到这一水平:多靶点参与标记物的综合分析支持将 BI 836880 720 毫克 q3w 作为生物相关的单药治疗剂量表:试验注册:NCT02674152和NCT02689505。
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引用次数: 0
Radiotherapy enhances the anti-tumor effect of CAR-NK cells for hepatocellular carcinoma. 放疗增强了 CAR-NK 细胞治疗肝细胞癌的抗肿瘤效果。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-13 DOI: 10.1186/s12967-024-05724-4
Xiaotong Lin, Zishen Liu, Xin Dong, Kunyuan Wang, Yao Sun, Han Zhang, Fei Wang, Ying Chen, Jing Ling, Yuetong Guo, Hongjin Xiang, Qiankun Xie, Yuqin Zhang, Zhaoze Guo, Ryohichi Sugimura, Guozhu Xie

Background: Chimeric antigen receptor (CAR)-NK cell therapy has shown remarkable clinical efficacy and safety in the treatment of hematological malignancies. However, this efficacy was limited in solid tumors owing to hostile tumor microenvironment (TME). Radiotherapy is commonly used for solid tumors and proved to improve the TME. Therefore, the combination with radiotherapy would be a potential strategy to improve therapeutic efficacy of CAR-NK cells for solid tumors.

Methods: Glypican-3 (GPC3) was used as a target antigen of CAR-NK cell for hepatocellular carcinoma (HCC). To promote migration towards HCC, CXCR2-armed CAR-NK92 cells targeting GPC3 were first developed, and their cytotoxic and migration activities towards HCC cells were evaluated. Next, the effects of irradiation on the anti-tumor activity of CAR-NK92 cells were assessed in vitro and in HCC-bearing NCG mice. Lastly, to demonstrate the potential mechanism mediating the sensitized effect of irradiation on CAR-NK cells, the differential gene expression profiles induced by irradiation were analyzed and the expression of some important ligands for the NK-cell activating receptors were further determined by qRT-PCR and flow cytometry.

Results: In this study, we developed CXCR2-armed GPC3-targeting CAR-NK92 cells that exhibited specific and potent killing activity against HCC cells and the enhanced migration towards HCC cells. Pretreating HCC cells with irradiation enhanced in vitro anti-HCC effect and migration activity of CXCR2-armed CAR-NK92 cells. We further found that only high-dose (8 Gy) but not low-dose (2 Gy) irradiation in one fraction could significantly enhanced in vivo anti-HCC activity of CXCR2-armed CAR-NK92 cells. Irradiation with 8 Gy significantly up-regulated the expression of NK cell-activating ligands on HCC cells.

Conclusions: Our results indicate the evidence that irradiation could efficiently enhance the anti-tumor effect of CAR-NK cells in solid tumor model. The combination with radiotherapy would be an attractive strategy to improve therapeutic efficacy of CAR-NK cells for solid tumors.

背景:嵌合抗原受体(CAR)-NK 细胞疗法在治疗血液恶性肿瘤方面显示出显著的临床疗效和安全性。然而,由于肿瘤微环境(TME)恶劣,这种疗法在实体瘤中的疗效有限。放疗常用于实体瘤,并被证明能改善肿瘤微环境。因此,与放疗相结合将是提高 CAR-NK 细胞治疗实体瘤疗效的潜在策略:方法:Glypican-3(GPC3)被用作 CAR-NK 细胞治疗肝细胞癌(HCC)的靶抗原。为了促进对 HCC 的迁移,首先开发了靶向 GPC3 的 CXCR2-armed CAR-NK92 细胞,并评估了它们对 HCC 细胞的细胞毒性和迁移活性。接着,研究人员在体外和携带HCC的NCG小鼠体内评估了辐照对CAR-NK92细胞抗肿瘤活性的影响。最后,为了证明辐照对 CAR-NK 细胞增敏作用的潜在机制,我们分析了辐照诱导的不同基因表达谱,并通过 qRT-PCR 和流式细胞术进一步确定了 NK 细胞激活受体的一些重要配体的表达:本研究中,我们开发了CXCR2-armed GPC3靶向CAR-NK92细胞,它对HCC细胞具有特异性和强大的杀伤活性,并能增强对HCC细胞的迁移。对HCC细胞进行辐照预处理可增强CXCR2-armed CAR-NK92细胞的体外抗HCC效果和迁移活性。我们进一步发现,只有高剂量(8 Gy)而非低剂量(2 Gy)辐照才能显著增强CXCR2-armed CAR-NK92细胞的体内抗HCC活性。8Gy辐照能明显上调HCC细胞上NK细胞激活配体的表达:我们的研究结果表明,在实体瘤模型中,辐照可有效增强 CAR-NK 细胞的抗肿瘤作用。与放疗相结合将是提高 CAR-NK 细胞治疗实体瘤疗效的一种有吸引力的策略。
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引用次数: 0
Immunometabolic changes and potential biomarkers in CFS peripheral immune cells revealed by single-cell RNA sequencing. 通过单细胞 RNA 测序揭示 CFS 外周免疫细胞的免疫代谢变化和潜在生物标志物。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-11 DOI: 10.1186/s12967-024-05710-w
Yujing Sun, Zhenhua Zhang, Qincheng Qiao, Ying Zou, Lina Wang, Tixiao Wang, Bo Lou, Guosheng Li, Miao Xu, Yanxiang Wang, Zhenhong Zhang, Xinguo Hou, Li Chen, Ruxing Zhao

The pathogenesis of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remains unclear, though increasing evidence suggests inflammatory processes play key roles. In this study, single-cell RNA sequencing (scRNA-seq) of peripheral blood mononuclear cells (PBMCs) was used to decipher the immunometabolic profile in 4 ME/CFS patients and 4 heathy controls. We analyzed changes in the composition of major PBMC subpopulations and observed an increased frequency of total T cells and a significant reduction in NKs, monocytes, cDCs and pDCs. Further investigation revealed even more complex changes in the proportions of cell subpopulations within each subpopulation. Gene expression patterns revealed upregulated transcription factors related to immune regulation, as well as genes associated with viral infections and neurodegenerative diseases.CD4+ and CD8+ T cells in ME/CFS patients show different differentiation states and altered trajectories, indicating a possible suppression of differentiation. Memory B cells in ME/CFS patients are found early in the pseudotime, indicating a unique subtype specific to ME/CFS, with increased differentiation to plasma cells suggesting B cell overactivity. NK cells in ME/CFS patients exhibit reduced cytotoxicity and impaired responses, with reduced expression of perforin and CD107a upon stimulation. Pseudotime analysis showed abnormal development of adaptive immune cells and an enhanced cell-cell communication network converging on monocytes in particular. Our analysis also identified the estrogen-related receptor alpha (ESRRA)-APP-CD74 signaling pathway as a potential biomarker for ME/CFS in peripheral blood. In addition, data from the GSE214284 database confirmed higher ESRRA expression in the monocyte cell types of male ME/CFS patients. These results suggest a link between immune and neurological symptoms. The results support a disease model of immune dysfunction ranging from autoimmunity to immunodeficiency and point to amyloidotic neurodegenerative signaling pathways in the pathogenesis of ME/CFS. While the study provides important insights, limitations include the modest sample size and the evaluation of peripheral blood only. These findings highlight potential targets for diagnostic biomarkers and therapeutic interventions. Further research is needed to validate these biomarkers and explore their clinical applications in managing ME/CFS.

肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)的发病机制仍不清楚,但越来越多的证据表明炎症过程在其中起着关键作用。本研究利用外周血单核细胞(PBMCs)的单细胞 RNA 测序(scRNA-seq)来解读 4 名 ME/CFS 患者和 4 名健康对照者的免疫代谢谱。我们分析了主要 PBMC 亚群组成的变化,观察到总 T 细胞频率增加,NK、单核细胞、cDC 和 pDC 明显减少。进一步研究发现,每个亚群中细胞亚群的比例发生了更为复杂的变化。基因表达模式显示,与免疫调节相关的转录因子以及与病毒感染和神经退行性疾病相关的基因上调。ME/CFS 患者的 CD4+ 和 CD8+ T 细胞显示出不同的分化状态和改变的轨迹,表明分化可能受到抑制。ME/CFS患者的记忆B细胞出现在假性时间的早期,表明这是ME/CFS特有的亚型,向浆细胞分化的增加表明B细胞过度活跃。ME/CFS患者的NK细胞细胞毒性降低,反应能力减弱,刺激后穿孔素和CD107a的表达减少。伪时间分析显示,适应性免疫细胞发育异常,细胞-细胞通讯网络增强,特别是向单核细胞聚集。我们的分析还发现,雌激素相关受体α(ESRRA)-APP-CD74信号通路是外周血中ME/CFS的潜在生物标志物。此外,来自 GSE214284 数据库的数据证实,男性 ME/CFS 患者的单核细胞类型中 ESRRA 表达较高。这些结果表明免疫和神经症状之间存在联系。研究结果支持从自身免疫到免疫缺陷的免疫功能障碍疾病模型,并指出淀粉样变性神经退行性信号通路是 ME/CFS 的发病机制。虽然这项研究提供了重要的见解,但也存在局限性,包括样本量不大以及只对外周血进行了评估。这些发现突出了诊断生物标志物和治疗干预的潜在目标。还需要进一步的研究来验证这些生物标志物,并探索它们在管理 ME/CFS 方面的临床应用。
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引用次数: 0
Treatment of chronic nonbacterial prostatitis by modifying gut microbiota: a step forward, a long way to go. 通过调整肠道微生物群治疗慢性非细菌性前列腺炎:迈出了一步,但任重道远。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-11 DOI: 10.1186/s12967-024-05742-2
Zhiguo Zhu, Junwen Zhang, Zesong Jiang, Fuding Lu
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引用次数: 0
New insights from a systematic review and meta-analysis on the treatment of difficult-to-treat rheumatoid arthritis. 关于难以治疗的类风湿关节炎治疗的系统综述和荟萃分析的新见解。
IF 6.1 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-11 DOI: 10.1186/s12967-024-05721-7
Xianyao He, Anqi Wu, Xianlun Pang
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引用次数: 0
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Journal of Translational Medicine
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