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Melanoma in the Breast: A Diagnostic Challenge. 乳房黑色素瘤:诊断难题。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/WPKX7733
Marita A John, Niloufar Pourfarrokh, Jaya Ruth Asirvatham

Although rare, breast metastases can mimic primary tumors, both clinically, radiologically, and histopathologically. Melanoma is a highly metastasizing tumor, and it is known as a great mimicker of tumors. Metastatic melanoma in the breast can mimic primary breast cancer and pose a diagnostic challenge. In most cases, it is associated with disseminated disease and a poor prognosis, therefore, histologic, immunohistochemical and clinical correlation is crucial in diagnosing these cases. In this case report, we discuss a 63-year-old female who presented with clinical features of probable breast cancer, describe immunohistochemistry workup, and discuss pitfalls in interpretation.

乳腺转移瘤虽然罕见,但在临床、放射学和组织病理学上都可以模仿原发肿瘤。黑色素瘤是一种转移性很强的肿瘤,被称为肿瘤的 "模仿者"。乳房转移性黑色素瘤可与原发性乳腺癌相似,给诊断带来挑战。在大多数病例中,它伴有播散性疾病,预后较差,因此,组织学、免疫组化和临床相关性是诊断这些病例的关键。在本病例报告中,我们讨论了一名 63 岁女性疑似乳腺癌的临床特征,介绍了免疫组化工作,并讨论了解读中的误区。
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引用次数: 0
Advances in Regulating Cellular Behavior Using Micropatterns. 利用微模式调控细胞行为的进展。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/UXOH1740
Yizhou Li, Wenli Jiang, Xintong Zhou, Yicen Long, Yujia Sun, Ye Zeng, Xinghong Yao

Micropatterns, characterized as distinct physical microstructures or chemical adhesion matrices on substance surfaces, have emerged as a powerful tool for manipulating cellular activity. By creating specific extracellular matrix microenvironments, micropatterns can influence various cell behaviors, including orientation, proliferation, migration, and differentiation. This review provides a comprehensive overview of the latest advancements in the use of micropatterns for cell behavior regulation. It discusses the influence of micropattern morphology and coating on cell behavior and the underlying mechanisms. It also highlights future research directions in this field, aiming to inspire new investigations in materials medicine, regenerative medicine, and tissue engineering. The review underscores the potential of micropatterns as a novel approach for controlling cell behavior, which could pave the way for breakthroughs in various biomedical applications.

微图案的特点是在物质表面形成独特的物理微结构或化学粘附基质,已成为操纵细胞活动的有力工具。通过创造特定的细胞外基质微环境,微图案可以影响各种细胞行为,包括定向、增殖、迁移和分化。本综述全面概述了利用微图案调控细胞行为的最新进展。它讨论了微图案形态和涂层对细胞行为的影响及其内在机制。它还强调了这一领域未来的研究方向,旨在启发材料医学、再生医学和组织工程领域的新研究。这篇综述强调了微图案作为一种控制细胞行为的新方法的潜力,它可以为各种生物医学应用的突破铺平道路。
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引用次数: 0
Early Chromatin Remodeling Events in Acutely Stimulated CD8+ T Cells. 急性刺激 CD8+ T 细胞的早期染色质重塑事件
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/AXGU7370
Bryan McDonald, Brent Y Chick, Diana C Hargreaves, Susan M Kaech

T cells undergo extensive chromatin remodeling over several days following stimulation through the T cell receptor. However, the kinetics and gene loci targeted by early remodeling events within the first 24 hours of T cell priming to orchestrate effector differentiation have not been well described. We identified that chromatin accessibility is rapidly and extensively remodeled within 1 hour of stimulation of naïve CD8+ T cells, leading to increased global chromatin accessibility at many effector T cell-associated genes that are enriched for AP-1, early growth response (EGR), and nuclear factor of activated T cells (NFAT) binding sites, but this short duration of stimulation is insufficient for commitment to clonal expansion in vivo. Sustained 24-hour stimulation led to further chromatin remodeling and was sufficient to enable clonal expansion. These data suggest that the duration of antigen receptor signaling is intimately coupled to chromatin remodeling and activation of genes involved in effector cell differentiation and highlight a potential mechanism that helps CD8+ T cells discriminate between foreign- and self-antigens.

T 细胞在受到 T 细胞受体刺激后的数天内会发生广泛的染色质重塑。然而,关于 T 细胞启动后 24 小时内早期重塑事件的动力学和目标基因位点以协调效应物分化的情况还没有很好的描述。我们发现,在刺激幼稚 CD8+ T 细胞的 1 小时内,染色质可及性被迅速、广泛地重塑,导致许多效应 T 细胞相关基因的全局染色质可及性增加,这些基因富含 AP-1、早期生长应答(EGR)和活化 T 细胞核因子(NFAT)结合位点,但这种短时间的刺激不足以导致体内克隆扩增。持续 24 小时的刺激会导致染色质进一步重塑,并足以实现克隆扩增。这些数据表明,抗原受体信号转导的持续时间与染色质重塑和效应细胞分化相关基因的激活密切相关,并强调了一种帮助 CD8+ T 细胞区分外来抗原和自身抗原的潜在机制。
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引用次数: 0
H19: An Oncogenic Long Non-coding RNA in Colorectal Cancer. H19:结直肠癌中的致癌长非编码 RNA。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/TDBJ7410
Prerana R Chowdhury, Shamala Salvamani, Baskaran Gunasekaran, Hoh B Peng, Vaidehi Ulaganathan

Colorectal cancer (CRC) has been recorded amongst the most common cancers in the world, with high morbidity and mortality rates, and relatively low survival rates. With risk factors such as chronic illness, age, and lifestyle associated with the development of CRC, the incidence of CRC is increasing each year. Thus, the discovery of novel biomarkers to improve the diagnosis and prognosis of CRC has become beneficial. Long non-coding RNAs (lncRNAs) have been emerging as potential players in several tumor types, one among them is the lncRNA H19. The paternally imprinted oncofetal gene is expressed in the embryo, downregulated at birth, and reappears in tumors. H19 aids in CRC cell growth, proliferation, invasion, and metastasis via various mechanisms of action, significantly through the lncRNA-microRNA (miRNA)-messenger RNA (mRNA)-competitive endogenous RNA (ceRNA) network, where H19 behaves as a miRNA sponge. The RNA transcript of H19 obtained from the first exon of the H19 gene, miRNA-675 also promotes CRC carcinogenesis. Overexpression of H19 in malignant tissues compared to adjacent non-malignant tissues marks H19 as an independent prognostic marker in CRC. Besides its prognostic value, H19 serves as a promising target for therapy in CRC treatment.

大肠癌(CRC)是世界上最常见的癌症之一,发病率和死亡率都很高,而存活率却相对较低。由于慢性疾病、年龄和生活方式等风险因素与 CRC 的发病有关,CRC 的发病率正在逐年上升。因此,发现新的生物标志物以改善 CRC 的诊断和预后已变得十分有益。长非编码 RNA(lncRNA)已成为多种肿瘤类型的潜在参与者,lncRNA H19 就是其中之一。这种父系印记的胎盘上基因在胚胎中表达,出生后下调,并在肿瘤中重新出现。H19 通过各种作用机制帮助 CRC 细胞生长、增殖、侵袭和转移,主要是通过 lncRNA-microRNA(miRNA)-信使 RNA(mRNA)-竞争性内源性 RNA(ceRNA)网络,其中 H19 就像一个 miRNA 海绵。从 H19 基因第一个外显子获得的 H19 的 RNA 转录物 miRNA-675 也能促进 CRC 癌变。与邻近的非恶性组织相比,H19 在恶性组织中的过表达标志着 H19 是 CRC 的一个独立预后标志。除了预后价值外,H19 还是治疗 CRC 的一个有希望的靶点。
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引用次数: 0
Evidence for Functional Roles of MicroRNAs in Lineage Specification During Mouse and Human Preimplantation Development. 在小鼠和人类胚胎植入前发育过程中,MicroRNA 在系谱规范中的功能作用证据。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/FOSI4358
Savana Biondic, Sophie Petropoulos

Proper formation of the blastocyst, including the specification of the first embryonic cellular lineages, is required to ensure healthy embryo development and can significantly impact the success of assisted reproductive technologies (ARTs). However, the regulatory role of microRNAs in early development, particularly in the context of preimplantation lineage specification, remains largely unknown. Taking a cross-species approach, this review aims to summarize the expression dynamics and functional significance of microRNAs in the differentiation and maintenance of lineage identity in both the mouse and the human. Findings are consolidated from studies conducted using in vitro embryonic stem cell models representing the epiblast, trophectoderm, and primitive endoderm lineages (modeled by naïve embryonic stem cells, trophoblast stem cells, and extraembryonic endoderm stem cells, respectively) to provide insight on what may be occurring in the embryo. Additionally, studies directly conducted in both mouse and human embryos are discussed, emphasizing similarities to the stem cell models and the gaps in our understanding, which will hopefully lead to further investigation of these areas. By unraveling the intricate mechanisms by which microRNAs regulate the specification and maintenance of cellular lineages in the blastocyst, we can leverage this knowledge to further optimize stem cell-based models such as the blastoids, enhance embryo competence, and develop methods of non-invasive embryo selection, which can potentially increase the success rates of assisted reproductive technologies and improve the experiences of those receiving fertility treatments.

囊胚的正确形成,包括第一个胚胎细胞系的规范化,是确保胚胎健康发育的必要条件,而且会对辅助生殖技术(ART)的成功产生重大影响。然而,microRNA 在早期发育中的调控作用,尤其是在植入前细胞系规范方面的作用,在很大程度上仍不为人所知。本综述采用跨物种方法,旨在总结 microRNA 在小鼠和人类血统特征的分化和维持过程中的表达动态和功能意义。本综述综合了使用代表上胚层、滋养层和原始内胚层的体外胚胎干细胞模型(分别以幼稚胚胎干细胞、滋养层干细胞和胚外内胚层干细胞为模型)进行的研究结果,以深入了解胚胎中可能发生的情况。此外,还讨论了直接在小鼠和人类胚胎中进行的研究,强调了与干细胞模型的相似之处以及我们在认识上的差距,希望这些研究能促进对这些领域的进一步研究。通过揭示microRNA调控囊胚中细胞系的规范和维持的复杂机制,我们可以利用这些知识进一步优化囊胚等基于干细胞的模型,提高胚胎能力,开发无创胚胎选择方法,从而有可能提高辅助生殖技术的成功率,改善接受生育治疗者的体验。
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引用次数: 0
Protective Effects of Chia Seeds and Omega-3 Fatty Acid against Cyclophosphamide-Induced Oligospermia in Male Wistar Rats: Potential Risks of Adverse Drug Interaction with Chia Seeds. Chia Seeds 和 Omega-3 脂肪酸对环磷酰胺诱导的雄性 Wistar 大鼠少精症的保护作用:奇异籽与药物不良相互作用的潜在风险。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/PAEJ4854
Prince B Vaghela, Archana M Navale, Chirangi B Patel, Nishant H Patidar, Prachi D Nahar, Farmi Patel, Zainab Pathan, Barsha Kumari

Objectives: The aim of this study was to investigate whether chia (Salvia hispanica) seeds, which are rich in omega-3 fatty acids, amino acids, and vitamins with antioxidant properties, can mitigate the negative effects on male reproductive function caused by cyclophosphamide, a frequently used chemotherapeutic agent. Methods: Male wistar rats are divided into seven groups (n=6). All groups except the normal control (NC) received cyclophosphamide (30mg/kg, i.p.) for the first 5 days. The standard group received clomiphene citrate (0.25 mg/kg, p.o.). Treatment groups T1%, T5%, T10%, and ω-3 received 1%, 5%, and 10% chia seeds in the diet, and 880 mg/kg omega-3 fatty acid (p.o) respectively for 15 days. The effect on the reproductive system was evaluated by analysis of epididymal sperm characteristics, biochemical parameters, and serum testosterone level. Results: Clomiphene citrate improved oligospermia via hormone mediated effect. Chia seeds and omega-3 fatty acid treatment also showed improvement in reproductive parameters including oxidative stress and histological features of the testes. Omega-3 fatty acid treatment was more effective for the prevention of cyclophosphamide toxicity on testes as compared to chia seeds. Nasal bleeding was noted in several animals subjected to chia seed treatment. This occurrence might be attributed to chia seeds' impact on coagulation and/or platelet function, potentially heightened due to chemotherapy associated bone marrow suppression. Conclusions: In our study, chia seeds as well as omega-3 fatty acid treatment were found to be protective against cyclophosphamide-induced reproductive toxicity in rats. However, the adverse effect of hemorrhage associated with drug interaction of chia seeds with cytotoxic chemotherapeutic drugs needs careful attention and further investigation.

研究目的本研究旨在探讨富含欧米伽-3 脂肪酸、氨基酸和具有抗氧化特性的维生素的奇异籽(西班牙鼠尾草)能否减轻常用化疗药物环磷酰胺对男性生殖功能的负面影响。研究方法雄性wistar大鼠分为7组(n=6)。除正常对照组(NC)外,其他各组在头 5 天均接受环磷酰胺(30 毫克/千克,静脉注射)治疗。标准组接受枸橼酸氯米芬(0.25 毫克/千克,口服)。治疗组T1%、T5%、T10%和ω-3分别在饮食中添加1%、5%和10%的奇亚籽,以及880毫克/千克的ω-3脂肪酸(p.o.),持续15天。通过分析附睾精子特征、生化指标和血清睾酮水平,评估了对生殖系统的影响。结果枸橼酸氯米芬通过激素介导作用改善了少精症。奇异籽和欧米伽-3脂肪酸治疗也改善了生殖参数,包括氧化应激和睾丸组织学特征。与奇异籽相比,欧米伽-3 脂肪酸治疗对预防环磷酰胺对睾丸的毒性更有效。接受奇异籽治疗的几只动物出现了鼻出血。这可能是由于奇异籽对凝血和/或血小板功能的影响,而化疗相关的骨髓抑制可能会增强这种影响。结论:在我们的研究中发现,奇异籽和ω-3脂肪酸处理对环磷酰胺诱导的大鼠生殖毒性具有保护作用。然而,奇异籽与细胞毒性化疗药物相互作用引起的出血不良反应还需要仔细关注和进一步研究。
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引用次数: 0
CRNDE: A Pivotal Oncogenic Long Non-Coding RNA in Cancers. CRNDE:癌症中至关重要的致癌长非编码 RNA。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/VHYE2306
Yi Zhen Hor, Shamala Salvamani, Baskaran Gunasekaran, Koh Rhun Yian

Colorectal Neoplasia Differentially Expressed (CRNDE), a long non-coding RNA that was initially identified as aberrantly expressed in colorectal cancer (CRC) has also been observed to exhibit elevated expression in various other human malignancies. Recent research has accumulated substantial evidence implicating CRNDE as an oncogenic player, exerting influence over critical cellular processes linked to cancer progression. Particularly, its regulatory interactions with microRNAs and proteins have been shown to modulate pathways that contribute to carcinogenesis and tumorigenesis. This review will comprehensively outline the roles of CRNDE in colorectal, liver, glioma, lung, cervical, gastric and prostate cancer, elucidating the mechanisms involved in modulating proliferation, apoptosis, migration, invasion, angiogenesis, and radio/chemoresistance. Furthermore, the review highlights CRNDE's potential as a multifaceted biomarker, owing to its presence in diverse biological samples and stable properties, thereby underscoring its diagnostic, therapeutic, and prognostic applications. This review aims to provide comprehensive insights of CRNDE-mediated oncogenesis and identify CRNDE as a promising target for future clinical interventions.

结直肠癌差异表达(CRNDE)是一种长非编码 RNA,最初被发现在结直肠癌(CRC)中异常表达,也被观察到在其他各种人类恶性肿瘤中表达升高。最近的研究积累了大量证据,表明 CRNDE 是一种致癌物质,对与癌症进展相关的关键细胞过程产生影响。特别是,它与 microRNA 和蛋白质之间的调控相互作用已被证明可调节导致癌变和肿瘤发生的途径。本综述将全面概述 CRNDE 在结直肠癌、肝癌、胶质瘤、肺癌、宫颈癌、胃癌和前列腺癌中的作用,阐明其参与调节增殖、凋亡、迁移、侵袭、血管生成和放射/化疗耐药性的机制。此外,该综述还强调了 CRNDE 作为一种多方面生物标记物的潜力,因为它存在于不同的生物样本中,且性质稳定,从而突出了其在诊断、治疗和预后方面的应用。本综述旨在提供有关 CRNDE 介导的肿瘤发生的全面见解,并将 CRNDE 确定为未来临床干预的一个有前途的靶点。
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引用次数: 0
OMA1 and YME1L as a Diagnostic Panel in Hepatocellular Carcinoma. 将 OMA1 和 YME1L 作为肝细胞癌的诊断面板
IF 3.9 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.59249/BWBY8971
Shimaa A Abass, Nabil Mohie Abdel-Hamid, Ahmed M Elshazly, Walied Abdo, Sherin Zakaria

Identifying new hepatocellular carcinoma (HCC)-driven signaling molecules and discovering their molecular mechanisms are crucial for efficient and better outcomes. Recently, OMA1 and YME1L, the inner mitochondrial proteases, were displayed to be associated with tumor progression in various cancers; however, their role in HCC has not yet been studied. Therefore, we evaluated the possible role of OMA1/YME1L in HCC staging and discussed their potential role in cellular apoptosis and proliferation. Our study was performed using four groups of male albino rats: a normal control and three diethyl nitrosamine-treated groups for 8, 16, and 24 weeks. The OMA1 and YME1L, matrix-metalloproteinase-9 (MMP-9), and cyclin D1 content were measured in liver tissues, while alpha-fetoprotein (AFP) level was assessed in serum. Additionally, Ki-67 expression was evaluated by immunohistochemistry. The relative hepatic expression of Bax, and tissue inhibitor matrix metalloproteinase (TIMP-3) was measured. Herein, we confirmed for the first time that OMA1 is down-regulated while YME1L is up-regulated in HCC in the three studied stages with subsequent inhibition of apoptosis and cell cycle progression. Furthermore, these proteases have a possible role in metastasis. These newly recognized results suggested OMA1 and YME1L as possible diagnostic tools and therapeutic targets for HCC management.

确定新的肝细胞癌(HCC)信号传导分子并发现其分子机制对于有效和更好地治疗至关重要。最近,线粒体内部蛋白酶 OMA1 和 YME1L 被证实与多种癌症的肿瘤进展有关,但它们在 HCC 中的作用尚未得到研究。因此,我们评估了 OMA1/YME1L 在 HCC 分期中的可能作用,并讨论了它们在细胞凋亡和增殖中的潜在作用。我们的研究使用了四组雄性白化大鼠:一组正常对照组和三组二乙基亚硝胺处理组,处理时间分别为 8 周、16 周和 24 周。我们测量了肝组织中的 OMA1 和 YME1L、基质金属蛋白酶-9(MMP-9)和细胞周期蛋白 D1 的含量,同时评估了血清中甲胎蛋白(AFP)的水平。此外,还通过免疫组化评估了 Ki-67 的表达。还测量了 Bax 和组织抑制基质金属蛋白酶(TIMP-3)在肝脏中的相对表达。在此,我们首次证实,在所研究的三个阶段中,OMA1 在 HCC 中被下调,而 YME1L 则被上调,从而抑制了细胞凋亡和细胞周期的进展。此外,这些蛋白酶还可能在转移中发挥作用。这些新发现表明,OMA1 和 YME1L 可作为诊断工具和治疗 HCC 的靶点。
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引用次数: 0
"Big Data" Analyses Underlie Clinical Discoveries at the Aortic Institute. 主动脉研究所的“大数据”分析掩盖了临床发现。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-09-29 eCollection Date: 2023-09-01 DOI: 10.59249/LNDZ2964
Mohammad A Zafar, Bulat A Ziganshin, Yupeng Li, Nicolai P Ostberg, John A Rizzo, Maryann Tranquilli, Sandip K Mukherjee, John A Elefteriades

This issue of the Yale Journal of Biology and Medicine (YJBM) focuses on Big Data and precision analytics in medical research. At the Aortic Institute at Yale New Haven Hospital, the vast majority of our investigations have emanated from our large, prospective clinical database of patients with thoracic aortic aneurysm (TAA), supplemented by ultra-large genetic sequencing files. Among the fundamental clinical and scientific discoveries enabled by application of advanced statistical and artificial intelligence techniques on these clinical and genetic databases are the following: From analysis of Traditional "Big Data" (Large data sets). 1. Ascending aortic aneurysms should be resected at 5 cm to prevent dissection and rupture. 2. Indexing aortic size to height improves aortic risk prognostication. 3. Aortic root dilatation is more malignant than mid-ascending aortic dilatation. 4. Ascending aortic aneurysm patients with bicuspid aortic valves do not carry the poorer prognosis previously postulated. 5. The descending and thoracoabdominal aorta are capable of rupture without dissection. 6. Female patients with TAA do more poorly than male patients. 7. Ascending aortic length is even better than aortic diameter at predicting dissection. 8. A "silver lining" of TAA disease is the profound, lifelong protection from atherosclerosis. From Modern "Big Data" Machine Learning/Artificial Intelligence analysis: 1. Machine learning models for TAA: outperforming traditional anatomic criteria. 2. Genetic testing for TAA and dissection and discovery of novel causative genes. 3. Phenotypic genetic characterization by Artificial Intelligence. 4. Panel of RNAs "detects" TAA. Such findings, based on (a) long-standing application of advanced conventional statistical analysis to large clinical data sets, and (b) recent application of advanced machine learning/artificial intelligence to large genetic data sets at the Yale Aortic Institute have advanced the diagnosis and medical and surgical treatment of TAA.

本期《耶鲁生物学与医学杂志》(YJBM)聚焦于医学研究中的大数据和精确分析。在耶鲁-纽黑文医院主动脉研究所,我们的绝大多数研究都来自我们的胸主动脉瘤(TAA)患者的大型前瞻性临床数据库,并辅以超大型基因测序文件。通过在这些临床和遗传数据库中应用先进的统计和人工智能技术,实现了以下基本临床和科学发现:来自传统“大数据”(大数据集)的分析。1.升主动脉瘤应在5cm处切除,以防止夹层和破裂。2.将主动脉大小与高度进行指数化可提高主动脉风险预测。3.主动脉根部扩张比升主动脉中段扩张更恶性。4.患有二叶主动脉瓣的升主动脉瘤患者的预后并不比先前假设的差。5.降主动脉和胸腹主动脉能够在不剥离的情况下破裂。6.女性TAA患者的表现比男性患者差。7.在预测主动脉夹层时,上行主动脉长度甚至优于主动脉直径。8.TAA疾病的“一线希望”是对动脉粥样硬化的终身保护。来自现代“大数据”机器学习/人工智能分析:1。TAA的机器学习模型:优于传统解剖标准。2.TAA基因检测及新致病基因的分离与发现。3.利用人工智能进行表型遗传表征。4.RNA小组“检测”TAA。这些发现基于(a)先进的传统统计分析在大型临床数据集中的长期应用,以及(b)耶鲁主动脉研究所最近在大型遗传数据集中应用先进的机器学习/人工智能,促进了TAA的诊断、医疗和外科治疗。
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引用次数: 0
Homozygous Mutations in Thyroid Peroxidase (TPO) in Hypothyroidism with Intellectual Disability, Developmental Delay, and Hearing and Ocular Anomalies in Two Families: Severe Manifestation of Untreated TPO-deficiency Poses a Diagnostic Dilemma. 甲状腺过氧化物酶(TPO)的纯合突变在两个家族的智力残疾、发育迟缓、听力和视力异常的甲状腺功能减退症中:未经治疗的TPO缺乏症的严重表现带来诊断难题。
IF 2.5 3区 工程技术 Q2 BIOLOGY Pub Date : 2023-09-29 eCollection Date: 2023-09-01 DOI: 10.59249/SSRG6507
Syeda Farwa Naqvi, Esra Yıldız-Bölükbaşı, Muhammad Afzal, Gökhan Nalbant, Sara Mumtaz, Aslıhan Tolun, Sajid Malik

Intellectual disability (ID) involves compromised intellectual, learning and cognitive skills, and behavioral capabilities with reduced psychomotor skills. One of the preventable causes of ID is congenital hypothyroidism (CH), which may be due to biallelic mutations in thyroid peroxidase (TPO). In low- and middle-income countries with no newborn screening programs, CH poses a great risk of ID and long-term morbidity. We report two large Pakistani families with a total of 16 patients afflicted with CH. Detailed clinical and behavioral assessments, SNP-based homozygosity mapping, linkage analysis, and exome sequencing were performed. Initially, affected individuals were referred as suffering ID (in 11 of 16 patients) and developmental delay (in 14). Secondary/associated features were verbal apraxia (in 13), goiter (in 12), short stature (in 11), limb hypotonia (in 14), no pubertal onset (five of 10 of age ≥14 years), high myopia (in eight), muscle cramps (in six), and in some, variable microcephaly and enuresis/encopresis, fits, chronic fatigue, and other behavioral symptoms, which are not characteristics of CH. Molecular genetic analyses led to the discovery of homozygous variants in TPO: novel missense variant c.719A>G (p.Asp240Gly) in family 1 and rare c.2315A>G (p.Tyr772Cys) in family 2. In low-resource countries where neonatal screening programs do not include a CH test, the burden of neurodevelopmental disorders is likely to be increased due to untreated CH. Secondly, in the background of the high prevalence of recessive disorders due to high parental consanguinity, the severe manifestation of TPO-deficiency mimics a wide range of neurological and other presentations posing a diagnostic dilemma.

智力残疾包括智力、学习和认知技能受损,以及心理运动技能下降的行为能力。ID的可预防原因之一是先天性甲状腺功能减退症(CH),这可能是由于甲状腺过氧化物酶(TPO)的双等位基因突变。在没有新生儿筛查项目的中低收入国家,CH存在很大的ID和长期发病风险。我们报告了两个巴基斯坦大家庭,共有16名CH患者。进行了详细的临床和行为评估、基于SNP的纯合子定位、连锁分析和外显子组测序。最初,受影响的个体被称为患有ID(16名患者中有11名)和发育迟缓(14名)。次要/相关特征为言语失用症(13例)、甲状腺肿(12例)、身材矮小(11例)、肢体张力减退(14例)、未青春期发作(10例中有5例年龄≥14岁)、高度近视(8例)、肌肉痉挛(6例),在某些情况下,可变小头症和遗尿/尿崩、痉挛、慢性疲劳和其他行为症状,这些都不是CH的特征。分子遗传学分析导致在TPO中发现纯合变体:家族1中的新错义变体c.719A>G(p.Asp240Gly)和家族2中的罕见变体c.2315A>G(p.Tyr772Cys)。在低资源国家,新生儿筛查项目不包括CH检测,由于未经治疗的CH,神经发育障碍的负担可能会增加。其次,在父母高血亲导致隐性疾病高患病率的背景下,TPO缺乏症的严重表现模拟了造成诊断困境的广泛的神经和其他表现。
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Yale Journal of Biology and Medicine
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