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First and Second-line Treatments in Metastatic Renal Cell Carcinoma 转移性肾细胞癌的一线和二线疗法
IF 23.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-06 DOI: 10.1016/j.eururo.2024.10.019
Regina Barragan-Carrillo, Eddy Saad, Renee-Maria Saliby, Maxine Sun, Laurence Albiges, Axel Bex, Daniel Heng, Arnaud Mejean, Robert J. Motzer, Elizabeth R. Plimack, Thomas Powles, Brian I. Rini, Tian Zhang, Toni K. Choueiri

Background and objective

The treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved significantly in recent years, leading to improved outcomes. The aim of this review is to provide clinicians with a practical guide for selecting first- and second-line treatments on the basis of current evidence.

Methods

We critically evaluated systemic treatment strategies for mRCC. A comprehensive literature search was conducted in PubMed and Embase, alongside manual searches of guidelines and conference proceedings up to October 2024. A narrative review was performed to reach a consensus, with voting used to resolve differing opinions among authors.

Key findings and limitations

First-line treatment options include immune checkpoint inhibitor (ICI)-based combinations or tyrosine kinase inhibitors (TKIs). Four combination regimens have been approved internationally. Owing to the lack of head-to-head trials and standardized biomarkers, treatment decisions rely on factors such as International Metastatic RCC Database Consortium (IMDC) risk score, functional status, safety profiles, sarcomatoid features, use of immunosuppressive drugs, and need for immediate response. Despite advances, many patients will experience disease progression on ICI-based therapy, necessitating further treatment. The need for standardized second-line approaches remains unmet. TKIs, alone or with everolimus, show promising efficacy, while HIF2a inhibitors offer newer options with a favorable toxicity profile. Rechallenge with ICIs after early progression is not recommended.

Conclusions and clinical implications

For optimal mRCC treatment selection, clinicians must carefully balance efficacy, toxicity, and patient preferences, especially when transitioning between first- and second-line therapies, to provide individualized care.
背景和目的近年来,转移性肾细胞癌(mRCC)的治疗格局发生了显著变化,从而改善了治疗效果。本综述旨在为临床医生提供实用指南,帮助他们在现有证据的基础上选择一线和二线治疗方法。我们在PubMed和Embase上进行了全面的文献检索,并手动检索了截至2024年10月的指南和会议论文集。主要发现和局限性一线治疗方案包括基于免疫检查点抑制剂(ICI)的联合疗法或酪氨酸激酶抑制剂(TKIs)。国际上已批准了四种联合疗法。由于缺乏头对头试验和标准化生物标志物,治疗决定取决于国际转移性 RCC 数据库联盟 (IMDC) 的风险评分、功能状态、安全性概况、肉瘤特征、免疫抑制剂的使用以及是否需要立即治疗等因素。尽管取得了进步,但许多患者在接受基于 ICI 的治疗后仍会出现疾病进展,需要进一步治疗。对标准化二线治疗方法的需求仍未得到满足。TKIs(单独使用或与依维莫司联合使用)显示出良好的疗效,而HIF2a抑制剂则提供了毒性较低的新选择。结论和临床意义为优化 mRCC 治疗选择,临床医生必须仔细权衡疗效、毒性和患者偏好,尤其是在一线和二线疗法之间转换时,以提供个体化治疗。
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引用次数: 0
Enhanced Carbon Sequestration of Sustainable Biochar via Metal Salt Regulation: Insight into Reaction Mechanism and Carbon Footprint 通过金属盐调节增强可持续生物炭的碳封存:洞察反应机制和碳足迹
IF 7.1 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-06 DOI: 10.1021/acssuschemeng.4c0718110.1021/acssuschemeng.4c07181
Shaojie Zhou, Qi Wang, Qian Wang, Xiangdong Zhu, Jiajun Fan, James H. Clark, Bin Chen, Shurong Wang*, Yutao Wang and Shicheng Zhang*, 

Sustainable biochar can sequester carbon and therefore, mitigate climate change. However, only a small fraction of biomass carbon is retained during biochar synthesis, greatly restricting its carbon-sequestration capacity. A significant boost of the carbon-sequestration potential of biochar has so far been a challenge. This study reveals that when biochar is modified by FeCl3, its carbon-sequestration capacity is boosted to 247.73% of that of pristine biochar derived at 500 °C. Meanwhile, pristine biochar retains only 43.18% of its biomass carbon, while FeCl3-modified biochar retains 75.20% of its carbon by forming complexes between the iron salts and the carboxyl- and hydroxyl-rich organic compounds derived from biomass pyrolysis. As react proceeds, the complexes are further converted into ferrites and organic carbon. The resulting minerals provide physical barriers against carbon decomposition, further enhancing the long-term stability of biochar. Life cycle assessment results further show that ferric salt can markedly enhance the greenhouse gas─reduction potential of biomass-to-biochar-to-soil systems. The more cycles from biomass to upgraded biochar, the more potent the carbon-negative effect is. Undoubtedly, such discoveries hold significant implications for accelerating carbon neutrality.

可持续生物炭可以固碳,从而减缓气候变化。然而,在生物炭合成过程中,只有一小部分生物质碳被保留下来,这大大限制了生物炭的固碳能力。迄今为止,如何大幅提高生物炭的碳封存潜力一直是个难题。本研究发现,当生物炭经 FeCl3 改性后,其碳螯合能力提高到 500 °C 原始生物炭的 247.73%。同时,原始生物炭仅保留了 43.18% 的生物质碳,而 FeCl3 改性生物炭通过铁盐与生物质热解产生的富含羧基和羟基的有机化合物形成络合物,保留了 75.20% 的碳。随着反应的进行,络合物进一步转化为铁氧体和有机碳。由此产生的矿物质提供了防止碳分解的物理屏障,进一步增强了生物炭的长期稳定性。生命周期评估结果进一步表明,铁盐可显著提高生物质-生物炭-土壤系统的温室气体减排潜力。从生物质到升级生物炭的循环次数越多,碳负效应就越强。毫无疑问,这些发现对加快实现碳中和具有重要意义。
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引用次数: 0
Hacking Death in Dublin. 都柏林的死亡黑客
IF 25.7 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-06 DOI: 10.1053/j.gastro.2024.09.019
Seamus O'Mahony
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引用次数: 0
Maintenance and functional regulation of immune memory to COVID-19 vaccines in tissues 组织中 COVID-19 疫苗免疫记忆的维持和功能调节
IF 32.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-06 DOI: 10.1016/j.immuni.2024.10.003
Julia Davis-Porada, Alex B. George, Nora Lam, Daniel P. Caron, Joshua I. Gray, Jenny Huang, Jennifer Hwu, Steven B. Wells, Rei Matsumoto, Masaru Kubota, YoonSeung Lee, Rory Morrison-Colvin, Isaac J. Jensen, Basak B. Ural, Namir Shaabani, Daniela Weiskopf, Alba Grifoni, Alessandro Sette, Peter A. Szabo, John R. Teijaro, Donna L. Farber
Memory T and B cells in tissues are essential for protective immunity. Here, we performed a comprehensive analysis of the tissue distribution, phenotype, durability, and transcriptional profile of COVID-19 mRNA vaccine-induced immune memory across blood, lymphoid organs, and lungs obtained from 63 vaccinated organ donors aged 23–86, some of whom experienced SARS-CoV-2 infection. Spike (S)-reactive memory T cells were detected in lymphoid organs and lungs and variably expressed tissue-resident markers based on infection history, and S-reactive B cells comprised class-switched memory cells resident in lymphoid organs. Compared with blood, S-reactive tissue memory T cells persisted for longer times post-vaccination and were more prevalent with age. S-reactive T cells displayed site-specific subset compositions and functions: regulatory cell profiles were enriched in tissues, while effector and cytolytic profiles were more abundant in circulation. Our findings reveal functional compartmentalization of vaccine-induced T cell memory where surveilling effectors and in situ regulatory responses confer protection with minimal tissue damage.
组织中的记忆性 T 细胞和 B 细胞对保护性免疫至关重要。在这里,我们对 COVID-19 mRNA 疫苗诱导的免疫记忆在血液、淋巴器官和肺部的组织分布、表型、持久性和转录谱进行了全面分析,研究对象是 63 名年龄在 23-86 岁之间的器官捐献者,其中一些人曾感染过 SARS-CoV-2。在淋巴器官和肺部检测到尖峰(S)反应记忆T细胞,并根据感染史不同表达不同的组织驻留标记,S反应B细胞包括驻留在淋巴器官的类调换记忆细胞。与血液相比,S反应性组织记忆T细胞在接种疫苗后持续存在的时间更长,而且随着年龄的增长更为普遍。S 反应性 T 细胞显示出特定部位的亚群组成和功能:调节细胞特征在组织中更为丰富,而效应细胞和细胞溶解特征在循环中更为丰富。我们的研究结果揭示了疫苗诱导的 T 细胞记忆的功能分区,在这些分区中,监测效应细胞和原位调节反应可提供保护,同时将组织损伤降到最低。
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引用次数: 0
Valorization of Polycaprolactone to γ-Caprolactone over Lewis Acidic Ionic Liquids 在路易斯酸性离子液体上将聚己内酯有效化为 γ-己内酯
IF 7.1 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-06 DOI: 10.1021/acssuschemeng.4c0697110.1021/acssuschemeng.4c06971
Hui Zhang, Yuepeng Wang, Yanfei Zhao*, Yusi Wang, Wei Zeng, Rongxiang Li, Minhao Tang, Daolan Liu and Zhimin Liu*, 

Upcycling spent polyesters into useful chemicals is of great significance for achieving a circular carbon economy. Herein, we report the valorization of polycaprolactone (PCL) to γ-caprolactone over binary ionic liquid systems derived from 1-butyl-3-methylimidazolium bromide ([BMIm]Br) and CuBr2 under mild conditions (e.g., 160 °C). It was found that the in situ formed Lewis acidic [CuBr4]2– anion could activate the ester group of PCL via coordination with carbonyl O, while [Br] anion could attack the C atom of alkyl C–O to achieve the decomposition of PCL, forming the key ionic intermediate, 6-bromohexanoate. This intermediate subsequently undergoes β-elimination reaction and isomerization–lactonization transformation facilitated by the synergistic effect of cation and anion of the ionic liquids, thus producing γ-caprolactone in high yield and selectivity. This simple, green, and efficient protocol to valorize PCL into γ-caprolactone holds great promise for application in industry.

将废旧聚酯升级再造为有用的化学品对于实现循环碳经济具有重要意义。在此,我们报告了在温和的条件下(如 160 °C),在由 1-丁基-3-甲基溴化咪唑鎓([BMIm]Br)和 CuBr2 衍生的二元离子液体体系中将聚己内酯(PCL)转化为 γ-己内酯的过程。研究发现,原位形成的路易斯酸性[CuBr4]2-阴离子可通过与羰基 O 配位激活 PCL 的酯基,而[Br]-阴离子则可攻击烷基 C-O 的 C 原子,实现 PCL 的分解,形成关键的离子中间体 6-溴己酸酯。在离子液体阳离子和阴离子的协同作用下,该中间体随后会发生β-消除反应和异构化-内酯化转变,从而高产率、高选择性地生成γ-己内酯。这种简单、绿色、高效的将 PCL 转化为 γ-己内酯的方法有望在工业中得到广泛应用。
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引用次数: 0
The new horizon of Clostridioides difficile infection treatment 艰难梭菌感染治疗的新视野
IF 29.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-05 DOI: 10.1053/j.gastro.2024.10.032
Ed.J. Kuijper, Kevin W. Garey
No Abstract
无摘要
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引用次数: 0
Correction to Lancet Public Health 2024; 9: e834–35 柳叶刀公共卫生》2024; 9: e834-35 更正
IF 5 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-04 DOI: 10.1016/s2468-2667(24)00265-2
Tan M. Mandatory salt targets: a key policy tool for global salt reduction efforts. Lancet Public Health 2024; 9: e834–35—In this Linked Comment, the fifth sentence of the third paragraph should have said US$8·0 billion. This correction has been made as of Nov 4, 2024.
Tan M. Mandatory salt targets: a key policy tool for global salt reduction efforts.Lancet Public Health 2024; 9: e834-35-In this Linked Comment, the fifth sentence of the third paragraph should have said US$8-0 billion.该更正已于 2024 年 11 月 4 日作出。
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引用次数: 0
The 2024 China report of the Lancet Countdown on health and climate change: launching a new low-carbon, healthy journey 柳叶刀健康与气候变化倒计时2024中国报告:开启低碳健康新征程
IF 5 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-04 DOI: 10.1016/s2468-2667(24)00241-x
Wenjia Cai, Chi Zhang, Shihui Zhang, Yuqi Bai, Max Callaghan, Nan Chang, Bin Chen, Huiqi Chen, Liangliang Cheng, Hancheng Dai, Weicheng Fan, Dabo Guan, Yixin Hu, Yifan Hu, Junyi Hua, Cunrui Huang, Hong Huang, Jianbin Huang, Xiaomeng Huang, John S Ji, Peng Gong
2023 was a landmark year for climate change globally, across Asia, and within China. Global average temperatures were 1·45°C higher than the pre-industrial average, making it the warmest year on record since 1850. In Asia, 2023 was the second-hottest year documented. China recorded its highest-ever average temperature at 10·71°C (0·82°C above the 1981–2010 average), had its second-lowest rainfall since 2012, and endured notable flood and drought events.
2023 年是全球、亚洲和中国气候变化具有里程碑意义的一年。全球平均气温比工业化前平均气温高出1-45°C,成为自1850年以来有记录以来最热的一年。在亚洲,2023 年是有记录以来第二热的年份。中国的平均气温为 10-71°C (比 1981-2010 年的平均气温高出 0-82°C ),创下了自 2012 年以来的第二低降雨量,并经历了显著的洪水和干旱事件。
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引用次数: 0
Insights into the Role of Deep Eutectic Solvents in Sorbitol Dehydration: A Combined Experimental and Molecular Dynamics Study 深入了解深共晶溶剂在山梨醇脱水过程中的作用:实验与分子动力学联合研究
IF 7.1 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-03 DOI: 10.1021/acssuschemeng.4c0746110.1021/acssuschemeng.4c07461
Xindi Feng, Dian Jin, Youcai Zhu, Jiale Peng, Yue Mu, Li Sun*, Zuoxiang Zeng and Zhen Liu*, 

Dehydration of sorbitol catalyzed by inorganic acids has been regarded as an efficient way to produce isosorbide, which shows application in the manufacture of various high value-added compounds. However, these catalysts can cause equipment corrosion and are not recyclable. As a cheap and environmentally friendly catalyst with special tunability and stability, a deep eutectic solvent (DES) composed of p-toluenesulfonic acid (p-TSA) and choline chloride (ChCl) has emerged to meet the demand for “green production” of isosorbide. The conditions for the dehydration of sorbitol catalyzed by DESs were systematically investigated. The differences in catalytic efficiency stemming from the structural diversity of DESs were explored by FT-IR characterization and molecular dynamics simulation. The results showed that isosorbide exhibited notable selectivity (88%) within the DESs (p-TSA:ChCl = 1.2), and achieved a high extraction rate (83%) under the synergistic effect of ethyl acetate and acetone (4:1). MD simulations indicated that hydrogen bonding was the dominant factor influencing the catalytic activity. The theoretical understanding of the p-TSA/ChCl structure may provide a reference for the tunability of novel DESs to meet the requirements of catalysis, absorption, and extraction.

无机酸催化山梨醇脱水一直被视为生产异山梨醇的有效方法,可用于生产各种高附加值化合物。然而,这些催化剂会对设备造成腐蚀,而且无法回收利用。由对甲苯磺酸(p-TSA)和氯化胆碱(ChCl)组成的深共晶溶剂(DES)作为一种廉价且环保的催化剂,具有特殊的可调性和稳定性,能够满足异山梨醇 "绿色生产 "的需求。我们系统地研究了 DES 催化山梨醇脱水的条件。通过傅立叶变换红外表征和分子动力学模拟,探讨了 DESs 结构多样性导致的催化效率差异。结果表明,异山梨醇在 DESs(p-TSA:ChCl = 1.2)中表现出显著的选择性(88%),并在乙酸乙酯和丙酮(4:1)的协同作用下实现了较高的萃取率(83%)。MD 模拟表明,氢键是影响催化活性的主要因素。对 p-TSA/ChCl 结构的理论理解可为新型 DES 的可调性提供参考,以满足催化、吸收和萃取的要求。
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引用次数: 0
Isolation and escape mapping of broadly neutralizing antibodies against emerging delta-coronaviruses 针对新出现的δ-冠状病毒的广谱中和抗体的分离和逃逸图谱绘制
IF 32.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-11-01 DOI: 10.1016/j.immuni.2024.10.001
Megi Rexhepaj, Daniel Asarnow, Lisa Perruzza, Young-Jun Park, Barbara Guarino, Mathew Mccallum, Katja Culap, Christian Saliba, Giada Leoni, Alessio Balmelli, Courtney N. Yoshiyama, Miles S. Dickinson, Joel Quispe, Jack T. Brown, M. Alejandra Tortorici, Kaitlin R. Sprouse, Ashley L. Taylor, Davide Corti, Tyler N. Starr, Fabio Benigni, David Veesler
Porcine delta-coronavirus (PDCoV) spillovers were recently detected in febrile children, underscoring the recurrent zoonoses of divergent CoVs. To date, no vaccines or specific therapeutics are approved for use in humans against PDCoV. To prepare for possible future PDCoV epidemics, we isolated PDCoV spike (S)-directed monoclonal antibodies (mAbs) from humanized mice and found that two, designated PD33 and PD41, broadly neutralized a panel of PDCoV variants. Cryoelectron microscopy (cryo-EM) structures of PD33 and PD41 in complex with the S receptor-binding domain (RBD) and ectodomain trimer revealed the epitopes recognized by these mAbs, rationalizing their broad inhibitory activity. We show that both mAbs competitively interfere with host aminopeptidase N binding to neutralize PDCoV and used deep-mutational scanning epitope mapping to associate RBD antigenic sites with mAb-mediated neutralization potency. Our results indicate a PD33-PD41 mAb cocktail may heighten the barrier to escape. PD33 and PD41 are candidates for clinical advancement against future PDCoV outbreaks.
最近在发热儿童中发现了猪三角冠状病毒(PDCoV)的外溢,这突显了不同的 CoVs 在人畜间的反复传播。迄今为止,还没有针对 PDCoV 的疫苗或特定疗法获准用于人类。为了应对未来可能出现的 PDCoV 流行病,我们从人源化小鼠体内分离出了 PDCoV 穗状病毒(S)定向单克隆抗体 (mAbs),并发现 PD33 和 PD41 这两种单克隆抗体能广泛中和一系列 PDCoV 变种。PD33 和 PD41 与 S 受体结合域(RBD)和外显子三聚体的冷冻电子显微镜(cryo-EM)结构揭示了这些 mAbs 识别的表位,从而使其广泛的抑制活性更加合理。我们发现这两种 mAb 都能竞争性地干扰宿主氨肽酶 N 的结合,从而中和 PDCoV,并利用深度突变扫描表位图谱将 RBD 抗原位点与 mAb 介导的中和效力联系起来。我们的研究结果表明,PD33-PD41 mAb 鸡尾酒可增强逃逸障碍。PD33 和 PD41 是应对未来 PDCoV 爆发的候选临床药物。
{"title":"Isolation and escape mapping of broadly neutralizing antibodies against emerging delta-coronaviruses","authors":"Megi Rexhepaj, Daniel Asarnow, Lisa Perruzza, Young-Jun Park, Barbara Guarino, Mathew Mccallum, Katja Culap, Christian Saliba, Giada Leoni, Alessio Balmelli, Courtney N. Yoshiyama, Miles S. Dickinson, Joel Quispe, Jack T. Brown, M. Alejandra Tortorici, Kaitlin R. Sprouse, Ashley L. Taylor, Davide Corti, Tyler N. Starr, Fabio Benigni, David Veesler","doi":"10.1016/j.immuni.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.immuni.2024.10.001","url":null,"abstract":"Porcine delta-coronavirus (PDCoV) spillovers were recently detected in febrile children, underscoring the recurrent zoonoses of divergent CoVs. To date, no vaccines or specific therapeutics are approved for use in humans against PDCoV. To prepare for possible future PDCoV epidemics, we isolated PDCoV spike (S)-directed monoclonal antibodies (mAbs) from humanized mice and found that two, designated PD33 and PD41, broadly neutralized a panel of PDCoV variants. Cryoelectron microscopy (cryo-EM) structures of PD33 and PD41 in complex with the S receptor-binding domain (RBD) and ectodomain trimer revealed the epitopes recognized by these mAbs, rationalizing their broad inhibitory activity. We show that both mAbs competitively interfere with host aminopeptidase N binding to neutralize PDCoV and used deep-mutational scanning epitope mapping to associate RBD antigenic sites with mAb-mediated neutralization potency. Our results indicate a PD33-PD41 mAb cocktail may heighten the barrier to escape. PD33 and PD41 are candidates for clinical advancement against future PDCoV outbreaks.","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"79 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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