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Emerging strategies and novel therapeutic targets in acute myeloid leukemia: current advances and future directions. 急性髓性白血病的新策略和新的治疗靶点:目前的进展和未来的方向。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-10-14 DOI: 10.1186/s40364-025-00839-2
Linyu Cao, Zhe Wang, Yimin Cui, Yuan Li, Qian Xiang

Acute myeloid leukemia (AML) is an aggressive hematologic malignancy characterized by dysregulated differentiation and uncontrolled proliferation of myeloid precursor cells. AML is the second most common type of leukemia after acute lymphoblastic leukemia, yet it has the lower survival rates, with only approximately 30% of adult patients surviving five years post-diagnosis. Standard treatment regimens typically include intensive chemotherapy, advances in allogeneic hematopoietic stem cell transplantation (allo-HSCT) have significantly improved outcomes in the treatment of AML. Advances in molecular profiling technologies have significantly enhanced our understanding of the genetic and epigenetic alterations that drive AML, revealing numerous novel therapeutic targets. Consequently, targeted molecular therapies and epigenetic treatments are becoming increasingly important. Moreover, immunotherapy represents a promising therapeutic strategy that has demonstrated considerable potential in the context of AML. This review summarizes new strategies and emerging therapeutic targets in AML, with a particular focus on recent advancements in immunotherapy. It also explores the feasibility of integrating these therapeutic approaches into current treatment paradigms and their potential impact on future clinical practices.

急性髓系白血病(AML)是一种侵袭性血液系统恶性肿瘤,其特征是髓系前体细胞分化失调和增殖失控。AML是仅次于急性淋巴细胞白血病的第二常见类型的白血病,但它的存活率较低,只有大约30%的成年患者在诊断后存活5年。标准治疗方案通常包括强化化疗,异基因造血干细胞移植(alloo - hsct)的进展显著改善了AML治疗的结果。分子谱技术的进步极大地增强了我们对驱动AML的遗传和表观遗传改变的理解,揭示了许多新的治疗靶点。因此,靶向分子治疗和表观遗传治疗变得越来越重要。此外,免疫疗法代表了一种很有前途的治疗策略,在AML的背景下已经显示出相当大的潜力。本文综述了AML的新策略和新出现的治疗靶点,特别关注免疫治疗的最新进展。它还探讨了将这些治疗方法整合到当前治疗范例中的可行性及其对未来临床实践的潜在影响。
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引用次数: 0
Molecular network of metabolic reprogramming and precision diagnosis and treatment of hepatocellular carcinoma. 代谢重编程分子网络与肝癌精准诊疗。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-10-10 DOI: 10.1186/s40364-025-00844-5
Lingbo An, Zongfang Li

Primary liver cancer, particularly hepatocellular carcinoma (HCC), remains a major cause of cancer-related mortality worldwide, with rising incidence and limited treatment options, especially for patients diagnosed at advanced stages. In recent years, metabolic reprogramming has emerged as a hallmark of cancer that enables HCC cells to survive, proliferate, and resist therapy under hostile conditions. HCC cells undergo profound remodeling of glucose, lipid, and amino acid metabolism to adapt to hypoxia and nutrient deprivation. These processes are orchestrated by key signaling cascades, including the PI3K/AKT/mTOR, Ras-Raf-MEK-ERK-cMYC, and LKB1-AMPK pathways, forming a dynamic and integrated metabolic-signaling network. This review comprehensively integrates recent advances in the understanding of metabolic pathways in HCC, with a particular focus on glycolysis, de novo lipogenesis, and glutamine metabolism. We delineate the regulatory mechanisms underlying these pathways and construct an interaction map linking metabolic circuits to clinical phenotypes such as tumor heterogeneity, metastatic potential, and immune modulation. Furthermore, we systematically evaluate the biomarker potential of metabolic intermediates, rate-limiting enzymes, and key regulators in the context of early detection, molecular classification, prognosis prediction, and therapeutic response in HCC. We also highlight cutting-edge technologies, including metabolic imaging, liquid biopsy-based biomarker detection, and metabolism-targeted therapies. The review explores their potential synergy with immunotherapy, chemotherapy, and radiotherapy, aiming to provide a comprehensive framework for individualized HCC management. Our discussion underscores the translational relevance of metabolic biomarkers and offers insights for future research and clinical innovation.

原发性肝癌,特别是肝细胞癌(HCC),仍然是世界范围内癌症相关死亡的主要原因,其发病率不断上升,治疗选择有限,特别是对于晚期诊断的患者。近年来,代谢重编程已成为癌症的一个标志,使HCC细胞能够在恶劣条件下存活、增殖和抵抗治疗。HCC细胞经历葡萄糖、脂质和氨基酸代谢的深刻重塑,以适应缺氧和营养剥夺。这些过程由关键的信号级联调控,包括PI3K/AKT/mTOR、Ras-Raf-MEK-ERK-cMYC和LKB1-AMPK通路,形成一个动态的综合代谢信号网络。这篇综述全面整合了HCC代谢途径的最新进展,特别关注糖酵解、新生脂肪生成和谷氨酰胺代谢。我们描述了这些通路的调控机制,并构建了代谢回路与临床表型(如肿瘤异质性、转移潜力和免疫调节)之间的相互作用图。此外,我们系统地评估了代谢中间体、限速酶和关键调节因子在HCC早期检测、分子分类、预后预测和治疗反应方面的生物标志物潜力。我们还强调了尖端技术,包括代谢成像、基于液体活检的生物标志物检测和代谢靶向治疗。本综述探讨了它们与免疫治疗、化疗和放疗的潜在协同作用,旨在为个体化HCC治疗提供一个全面的框架。我们的讨论强调了代谢生物标志物的转化相关性,并为未来的研究和临床创新提供了见解。
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引用次数: 0
Comprehensive assessment of homologous recombination deficiency via simultaneous methylation and mutation analysis in epithelial ovarian cancer: implications for PARP inhibitors efficacy. 通过同时甲基化和突变分析对上皮性卵巢癌的同源重组缺陷进行综合评估:对PARP抑制剂疗效的影响。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-10-10 DOI: 10.1186/s40364-025-00843-6
Lin Dong, Huanwen Wu, Ning Li, Wenbin Li, Yan Song, Yuanyuan Xiong, Huan Yin, Huan Fang, Rongrong Chen, Xin Yi, Jie Huang, Jianming Ying

Background: The advent of poly (ADP-ribose) polymerase inhibitors (PARPi) over the past decade has significantly altered the management of epithelial ovarian cancer (EOC). We proposed that the etiology of homologous recombination deficiency (HRD) might underlie the variable responses to PARPi observed across patient populations.

Methods: As part of the phase 2 study of the Chinese HRD Harmonization Project, we developed a genomic methylation sequencing (GM-seq) pipeline facilitated by the TET enzyme for the simultaneous identification of methylated modifications and genetic variations in EOC tumor samples, and compared with established DNA sequencing-based HRD assays.

Results: Somatic mutation and HRD scores were confounded by low tumor purity in our cohort of 98 locally advanced/advanced EOC patients. In samples with tumor purity ≥ 30% (n = 45), the GM-seq pipeline showed high consistency with DNA sequencing-based HRD assay, identifying genetic variations in homologous recombination repair (HRR) genes and HRD score with 92.6% (25/27) and 97.1% (33/34) consistency respectively, in addition to conducting methylation profiling. Moreover, different underlying mechanisms of HRD were associated with varying degrees of PARPi efficacy, with BRCA1/2 LOH group having the best efficacy (median PFS, undefined), followed by BRCA1 methylation group (median PFS, 23.4 months), and those with unknown etiology of HRD having the worst efficacy (median PFS, 8.8 months, p < 0.001).

Conclusion: Our findings underscore the importance of considering HRD etiology when evaluating PARPi efficacy in EOC patients. The GM-seq pipeline, represents a significant advancement in HRD detection, enabling more accurate predictions of PARPi response.

背景:在过去的十年中,聚(adp -核糖)聚合酶抑制剂(PARPi)的出现显著地改变了上皮性卵巢癌(EOC)的治疗。我们提出同源重组缺陷(HRD)的病因学可能是在不同患者群体中观察到的PARPi的不同反应的基础。方法:作为中国HRD协调项目二期研究的一部分,我们开发了一种由TET酶促进的基因组甲基化测序(gmseq)管道,用于同时鉴定EOC肿瘤样本中的甲基化修饰和遗传变异,并与已建立的基于DNA测序的HRD检测方法进行比较。结果:98例局部晚期/晚期EOC患者的肿瘤纯度低,混淆了体细胞突变和HRD评分。在肿瘤纯度≥30% (n = 45)的样品中,GM-seq管道与基于DNA测序的HRD检测显示出高度一致性,除了进行甲基化分析外,还能识别同源重组修复(HRR)基因的遗传变异和HRD评分,一致性分别为92.6%(25/27)和97.1%(33/34)。此外,HRD的不同潜在机制与PARPi疗效的不同程度相关,BRCA1/2 LOH组疗效最好(中位PFS,未确定),其次是BRCA1甲基化组(中位PFS, 23.4个月),而病因不明的HRD组疗效最差(中位PFS, 8.8个月,p)。GM-seq管道代表了HRD检测的重大进步,能够更准确地预测PARPi的反应。
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引用次数: 0
Analysis of ultrastructural defects in sperm by transmission electron microscopy in asthenozoospermia patients: a study from multiple centers across China. 用透射电镜分析无精子症患者精子超微结构缺陷:一项来自全国多个中心的研究。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-10-08 DOI: 10.1186/s40364-025-00841-8
Mo-Qi Lv, Hai-Xu Wang, Hou-Yang Chen, Jun-Cheng Gao, Hai-Feng Song, Yu-Dong Zhang, Tao Li, Xiao-Hui Ling, Lin-Jie Zhu, Jun-Ren Nong, Yu-Jiao Tong, Liang-Cai Lu, Yun-Jie Wen, Yue-Xiao Wang, Guang-Yu Qin, Jing Li, Guan-Chen Liu, Yan-Qi Yang, Pan Ge, Nan Zhang, Rui-Fang Sun, Ying Sun, Jian Zhang, He-Cheng Li, Yi-Na Jiang, Ming Liu, Dang-Xia Zhou

This study aimed to identify the ultrastructural features of sperm in Chinese asthenozoospermia patients and to evaluate their clinical implications. A total of 139 individuals, including 106 asthenozoospermia patients and 33 fertile controls, were recruited from multiple centers across China. Sperm ultrastructural defects were examined using transmission electron microscopy (TEM), while conventional sperm quality was assessed by light microscopy. Compared with the control group, the asthenozoospermia group showed significant ultrastructural defects, particularly in the sperm tail, including mitochondrial and axonemal defects. Based on tail ultrastructure, participants were further categorized into four groups (normal ultrastructure, simple abnormal axonemes, simple abnormal mitochondria, and both abnormality in axonemes and mitochondria). All three abnormal groups indicated significantly lower value in sperm (motile/kinematic) quality compared to the normal group. However, no statistically significant differences in sperm quality were observed among the three abnormal groups. These nationwide findings indicated that TEM could remedy the limitations of conventional light microscopy, which is difficult to localize organelle-specific defects. This capability may ultimately inform individualized diagnostic and therapeutic strategies.

本研究旨在探讨中国弱精子症患者精子的超微结构特征,并探讨其临床意义。共有139人,包括106名弱精子症患者和33名生育对照组,从中国多个中心招募。透射电镜观察精子超微结构缺陷,光镜观察常规精子质量。与对照组相比,弱精子症组表现出明显的超微结构缺陷,尤其是在精子尾部,包括线粒体和轴突缺陷。根据尾超微结构进一步将参与者分为4组(超微结构正常组、单纯轴突异常组、单纯线粒体异常组、轴突和线粒体均异常组)。与正常组相比,所有三个异常组的精子(运动/运动)质量值均显著降低。然而,三个异常组的精子质量没有统计学上的显著差异。这些全国性的发现表明,TEM可以弥补传统光学显微镜难以定位细胞器特异性缺陷的局限性。这种能力可能最终为个性化的诊断和治疗策略提供信息。
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引用次数: 0
Single-cell sequencing technology in renal cancer: insights into tumor biology and clinical application. 单细胞测序技术在肾癌:洞察肿瘤生物学和临床应用。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-10-01 DOI: 10.1186/s40364-025-00811-0
Hanzhong Zhang, Ying Liu, Wenqiang Liu, Anqi Lin, Yu Fang, Le Qu, Xu Zhang, Peng Luo, Linhui Wang, Aimin Jiang

Renal cancer, particularly clear cell renal cell carcinoma (ccRCC), is characterized by significant intratumoral heterogeneity, which poses challenges for diagnosis and treatment. Single-cell sequencing (SCS) provides unprecedented insights into the cellular landscape of renal cancer, allowing for detailed characterization of tumor heterogeneity at the single-cell level. This review highlights how SCS has been instrumental in elucidating the origins of different renal cancer subtypes, understanding mechanisms of tumor initiation and progression, and dissecting the complex tumor microenvironment (TME). It discusses the identification of novel biomarkers and therapeutic targets, as well as the potential of SCS to inform personalized treatment strategies. The review also explores the integration of SCS with spatial omics technologies, which enhances the understanding of cellular interactions within their spatial context. Moreover, it addresses the challenges and future directions in applying SCS to clinical practice, emphasizing its significance in advancing renal cancer biology and improving clinical interventions.

肾癌,特别是透明细胞肾细胞癌(ccRCC),具有显著的肿瘤内异质性,这给诊断和治疗带来了挑战。单细胞测序(SCS)为肾癌的细胞景观提供了前所未有的见解,允许在单细胞水平上详细表征肿瘤异质性。这篇综述强调了SCS如何在阐明不同肾癌亚型的起源、了解肿瘤发生和进展的机制以及解剖复杂肿瘤微环境(TME)方面发挥重要作用。它讨论了新的生物标志物和治疗靶点的鉴定,以及SCS为个性化治疗策略提供信息的潜力。该综述还探讨了SCS与空间组学技术的整合,这增强了对空间环境中细胞相互作用的理解。此外,文章还阐述了SCS在临床应用中的挑战和未来发展方向,强调了其在推进肾癌生物学和改善临床干预方面的重要意义。
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引用次数: 0
Blood proteomics for quantitative biomarkers of cellular therapies. 血液蛋白质组学用于细胞治疗的定量生物标志物。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-09-29 DOI: 10.1186/s40364-025-00837-4
Philip R Gafken, Sophie Paczesny

Cellular therapies for several blood cancers particularly of lymphoid origin have made remarkable leaps forward. In parallel, blood proteomics, specifically quantitative proteomics, has been a powerful tool for identifying and quantifying protein biomarkers associated with cellular therapies, providing insights into treatment efficacy and toxicity. Both mass spectrometry (MS)-based proteomics and large-scale affinity-based platforms such as Olink and SomaScan have been increasingly implemented in research and clinical laboratories to identify and quantify candidate biomarkers in the blood. Biomarkers are used for risk stratification, early diagnosis, prognosis, and for treatment response prediction and monitoring in context of treatment efficacy and toxicity. These biomarkers might facilitate timely and selective therapeutic intervention and understand pathogenesis mechanisms of responses and adverse events. They are anticipated to undergo faster transition from bench to bedside soon. This review article summarizes recent technical progresses in clinical proteomics. The review also provides current information on validated biomarkers in the field of cellular therapies.

细胞疗法对几种血癌特别是淋巴细胞起源的已经取得了显著的飞跃。与此同时,血液蛋白质组学,特别是定量蛋白质组学,已经成为鉴定和量化与细胞治疗相关的蛋白质生物标志物的有力工具,为治疗疗效和毒性提供了见解。基于质谱(MS)的蛋白质组学和大型亲和平台(如Olink和SomaScan)已越来越多地应用于研究和临床实验室,以识别和量化血液中的候选生物标志物。生物标志物用于风险分层、早期诊断、预后,以及在治疗疗效和毒性的背景下预测和监测治疗反应。这些生物标志物可能有助于及时和选择性的治疗干预,并了解反应和不良事件的发病机制。预计他们很快就会经历从实验室到临床的更快过渡。本文综述了近年来临床蛋白质组学的研究进展。该综述还提供了细胞治疗领域中有效生物标志物的最新信息。
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引用次数: 0
Machine learning-based radiomics model: prognostic prediction and mechanism exploration in patients with endometrial cancer. 基于机器学习的放射组学模型:子宫内膜癌患者预后预测及机制探讨。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-09-29 DOI: 10.1186/s40364-025-00836-5
Yu Zhang, Xiaoqing Bao, Yaru Wang, Linrui Li, Long Liu, Qibing Wu

Objectives: To investigate the predictive value of machine-learning-based Radiomics models for postoperative overall survival (OS) of endometrial cancer (EC) patients and their biological mechanisms.

Methods: Data from 469 patients with endometrial cancer in three Centers (271 in Center 1, 154 in Center 2, and 44 in Center 3) were retrospectively and 90 patients in Center 1 were prospectively analyzed. Three-dimensional Radiomics parameters of the primary lesion and its surrounding 5 mm region in T2WI were collected from all patients. Ten machine learning methods were used to calculate the optimal Radiomics score (Radscore), whose incremental value to the available clinical indexes, pathomics, transcriptomics, and proteomics were revealed. Eventually, TCGA and CPTAC were used for the exploration of biological mechanisms of Radiomics model, with experimental validation.

Results: Radiomics features of tumor and peritumor showed some complementarity in the prognostic prediction of EC patients. The best predictive efficacy was demonstrated by the combined Radiomics model based on XGboost, with AUCs of 0.862, 0.885, 0.870 (validation set) and 0.823, 0.869, 0.849 (test set 1) and 0.850, 0.731, 0.800 (test set 2). Radiomics models demonstrated high incremental value to existing clinical indicators and can effectively improve prognostic prediction. In addition, Radiomics models have been shown to have synergistic prognostic predictive potential with pathomics, transcriptomics, and proteomics. Finally, mechanical explorations suggest that Radiomics models may be associated with tumor angiogenesis-related pathways, of which FLT1 was highlighted.

Conclusions: Machine learning-based Radiomics model contributes to predicting postoperative OS in EC patients and suggests a correlation with tumor angiogenesis.

目的:探讨基于机器学习的放射组学模型对子宫内膜癌(EC)患者术后总生存期(OS)的预测价值及其生物学机制。方法:回顾性分析三个中心469例子宫内膜癌患者的资料(1中心271例,2中心154例,3中心44例),1中心90例患者的资料进行前瞻性分析。收集所有患者的T2WI原发病灶及其周围5mm区域的三维放射组学参数。采用10种机器学习方法计算最佳放射组学评分(Radscore),揭示其对现有临床指标、病理、转录组学和蛋白质组学的增量值。最终利用TCGA和CPTAC对放射组学模型的生物学机制进行探索,并进行实验验证。结果:肿瘤与肿瘤周围放射组学特征在预测EC患者预后方面具有一定的互补性。基于XGboost的联合放射组学模型预测效果最佳,auc分别为0.862、0.885、0.870(验证集),0.823、0.869、0.849(测试集1)和0.850、0.731、0.800(测试集2)。放射组学模型对现有临床指标具有较高的增量价值,可有效改善预后预测。此外,放射组学模型已被证明与病理学、转录组学和蛋白质组学具有协同预测预后的潜力。最后,机械探索表明放射组学模型可能与肿瘤血管生成相关通路有关,其中FLT1被强调。结论:基于机器学习的放射组学模型有助于预测EC患者术后OS,并提示与肿瘤血管生成相关。
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引用次数: 0
1-year risks of cancers associated with COVID-19 vaccination: a large population-based cohort study in South Korea. 与COVID-19疫苗接种相关的1年癌症风险:韩国一项基于人群的大型队列研究
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-09-26 DOI: 10.1186/s40364-025-00831-w
Hong Jin Kim, Min-Ho Kim, Myeong Geun Choi, Eun Mi Chun

The oncogenic potential of SARS-CoV-2 has been hypothetically proposed, but real-world data on COVID-19 infection and vaccination are insufficient. Therefore, this large-scale population-based retrospective study in Seoul, South Korea, aimed to estimate the cumulative incidences and subsequent risks of overall cancers 1 year after COVID-19 vaccination. Data from 8,407,849 individuals between 2021 and 2023 were obtained from the Korean National Health Insurance database. The participants were categorized into two groups based on their COVID-19 vaccination status. The risks for overall cancer were assessed using multivariable Cox proportional hazards models, and data were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). The HRs of thyroid (HR, 1.351; 95% CI, 1.206-1.514), gastric (HR, 1.335; 95% CI, 1.130-1.576), colorectal (HR, 1.283; 95% CI, 1.122-1.468), lung (HR, 1.533; 95% CI, 1.254-1.874), breast (HR, 1.197; 95% CI, 1.069-1.340), and prostate (HR, 1.687; 95% CI, 1.348-2.111) cancers significantly increased at 1 year post-vaccination. In terms of vaccine type, cDNA vaccines were associated with the increased risks of thyroid, gastric, colorectal, lung, and prostate cancers; mRNA vaccines were linked to the increased risks of thyroid, colorectal, lung, and breast cancers; and heterologous vaccination was related to the increased risks of thyroid and breast cancers. Given the observed associations between COVID-19 vaccination and cancer incidence by age, sex, and vaccine type, further research is needed to determine whether specific vaccination strategies may be optimal for populations in need of COVID-19 vaccination.

SARS-CoV-2的致癌潜力已被假设提出,但关于COVID-19感染和疫苗接种的真实数据不足。因此,这项在韩国首尔进行的大规模人群回顾性研究旨在估计COVID-19疫苗接种后1年的累积发病率和总体癌症的后续风险。从韩国国民健康保险数据库获得了2021年至2023年期间8,407,849人的数据。参与者根据他们的COVID-19疫苗接种状况被分为两组。使用多变量Cox比例风险模型评估总体癌症风险,数据以风险比(hr)和95%置信区间(ci)表示。甲状腺癌(HR, 1.351, 95% CI, 1.206-1.514)、胃癌(HR, 1.335, 95% CI, 1.130-1.576)、结直肠癌(HR, 1.283, 95% CI, 1.122-1.468)、肺癌(HR, 1.533, 95% CI, 1.254-1.874)、乳腺癌(HR, 1.197, 95% CI, 1.069-1.340)和前列腺癌(HR, 1.687, 95% CI, 1.348-2.111)的HR在接种疫苗后1年显著增加。在疫苗类型方面,cDNA疫苗与甲状腺癌、胃癌、结直肠癌、肺癌和前列腺癌的风险增加相关;mRNA疫苗与甲状腺癌、结直肠癌、肺癌和乳腺癌的风险增加有关;异源疫苗接种与甲状腺癌和乳腺癌的风险增加有关。鉴于已观察到按年龄、性别和疫苗类型划分的COVID-19疫苗接种与癌症发病率之间存在关联,需要进一步研究以确定特定的疫苗接种策略是否适合需要接种COVID-19疫苗的人群。
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引用次数: 0
Bridging the barrier: insights into blood biomarkers and therapeutic strategies targeting choroid plexus and BBB dysfunction in alzheimer's disease. 弥合障碍:针对阿尔茨海默病脉络膜丛和血脑屏障功能障碍的血液生物标志物和治疗策略的见解。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-09-26 DOI: 10.1186/s40364-025-00829-4
Niti Sharma, Danyeong Kim, Himadri Sharma, Moon Il Kim, Hyon Lee, Minju Kim, Nayoung Ryoo, Min Ju Kang, Jung-Min Pyun, Young Ho Park, Jisun Ryu, Hyun Jung Oh, Hyun-Sik Yang, Hang-Rai Kim, Geon Ha Kim, Sangwon Han, YoungSoon Yang, Young Chul Youn, Charlotte Teunissen, Henrik Zetterberg, Philip Scheltens, Seong Soo A An, Young-Bum Kim, SangYun Kim

Alzheimer's disease (AD) is the most common cause of dementia and accounts for approximately 60-80% of total dementia patients. Currently, accurate diagnosis for AD relies on cerebrospinal fluid (CSF) sampling or a positron emission tomography (PET) scan, methods that cannot be done in primary care centers where most people go with cognitive complaints. This Limitation calls for the urgent need to develop blood-related diagnostic tests that could facilitate early detection and enable timely treatment. Recent CSF proteomic research categorized AD into five molecular subtypes with discrete Genetic risk profiles. Subtypes 1-3, namely neuronal hyperplasticity, innate immune activation, and RNA dysregulation, were characterized by more classical AD-related changes, like accumulation of amyloid/tau and synaptic and immune dysfunction, respectively. On the contrary, non-traditional AD mechanisms in subtypes 4-5 were choroid plexus (CP) dysfunction and blood-brain barrier (BBB) dysfunction, emphasizing clearance deficits in association with brain barrier dysfunction. The unchanged tau levels later may be explained by an alternate disease mechanism (clearance dysfunction). These subtypes included BBB and CP dysfunction. Biomarker identification based on the mechanism of disease progression would increase the precision of diagnoses, allowing for tailored interventions and aiding in the creation of novel therapies for subtypes that might not react favorably to conventional amyloid/tau-targeting strategies. Finding biomarkers specific to each subtype would aid in patient classification, resulting in more individualized therapy as opposed to a "one-size-fits-all" strategy. The present review emphasized the importance of identifying blood-based biomarkers (BBMs) related to brain barrier dysfunction from CSF studies and personalized treatment strategies to streamline the diagnostic workup, and may be utilized in standard clinical practice for the early detection of AD.

阿尔茨海默病(AD)是痴呆症的最常见原因,约占痴呆症患者总数的60-80%。目前,阿尔茨海默病的准确诊断依赖于脑脊液(CSF)取样或正电子发射断层扫描(PET)扫描,这些方法在大多数患有认知疾病的人去的初级保健中心无法完成。这一限制要求迫切需要开发与血液有关的诊断测试,以促进早期发现和及时治疗。最近的脑脊液蛋白质组学研究将AD分为具有离散遗传风险谱的五种分子亚型。亚型1-3,即神经元超可塑性、先天免疫激活和RNA失调,其特征分别为更经典的ad相关变化,如淀粉样蛋白/tau蛋白积累和突触和免疫功能障碍。相反,在亚型4-5中,AD的非传统机制是脉络膜丛(CP)功能障碍和血脑屏障(BBB)功能障碍,强调与脑屏障功能障碍相关的清除缺陷。之后的tau水平不变可能由另一种疾病机制(清除功能障碍)来解释。这些亚型包括血脑屏障和CP功能障碍。基于疾病进展机制的生物标志物识别将提高诊断的准确性,允许量身定制的干预措施,并有助于为可能对传统淀粉样蛋白/tau靶向策略反应不良的亚型创造新的治疗方法。找到针对每种亚型的生物标志物将有助于对患者进行分类,从而产生更个性化的治疗,而不是“一刀切”的策略。本综述强调了从脑脊液研究中识别与脑屏障功能障碍相关的血液生物标志物(BBMs)和个性化治疗策略的重要性,以简化诊断工作,并可能在标准临床实践中用于早期发现AD。
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引用次数: 0
NPC1 as a novel therapeutic target for induction of pyroptosis in cancers. NPC1作为癌症诱导焦亡的新治疗靶点。
IF 11.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-09-26 DOI: 10.1186/s40364-025-00823-w
Chuanchao Zhang, Qiang Wang, Pan Su, Jianfei Qian, Qi Guo, Wei Wu, Rui Duan, Yufei Zhang, Youli Zu, Ling Zhong, Liuling Xiao, Qing Yi

Background: Cholesterol metabolism reprogramming is a hallmark of cancer cells that exhibit cholesterol addiction by absorbing low-density lipoprotein (LDL) to generate cholesterol for growth. Yet the underlying mechanisms remain unclear.

Methods: We began by identifying Niemann-Pick C1 (NPC1) as a key cholesterol uptake gene linked to cancer progression through clinical data analysis. Using three tumor models, we showed that NPC1 promotes tumor growth by suppressing pyroptosis. Finally, we demonstrated that the NPC1 inhibitor U18666A effectively inhibits tumor growth, supporting its therapeutic potential.

Results: Here we report that NPC1, a key player in cholesterol transport, protects cancer cells from pyroptosis across multiple cancer types. NPC1 expression was highly elevated in human cancers and negatively correlated with patient survival. NPC1 deficiency led to reduced cancer growth and enhanced sensitivity to pyroptosis under pyroptotic stress. NPC1 protects cancer cells from pyroptosis by maintaining cholesterol homeostasis and facilitating LDL-mediated cholesterol uptake, leading to enhanced geranylgeranyl pyrophosphate synthesis for cancer cell survival. Moreover, NPC1 inhibitor U18666A induced cancer cell pyroptosis and was highly therapeutic, either alone or combined with chemotherapeutics, against human hematologic and solid cancers in xenograft mouse models.

Conclusion: This study reveals that NPC1 may be a potential therapeutic target for the treatment of human cancers.

背景:胆固醇代谢重编程是癌细胞通过吸收低密度脂蛋白(LDL)产生用于生长的胆固醇而表现出胆固醇成瘾的一个标志。然而,其潜在机制仍不清楚。方法:我们首先通过临床数据分析确定Niemann-Pick C1 (NPC1)是与癌症进展相关的关键胆固醇摄取基因。通过三种肿瘤模型,我们发现NPC1通过抑制焦亡来促进肿瘤生长。最后,我们证明了NPC1抑制剂U18666A有效抑制肿瘤生长,支持其治疗潜力。结果:在这里,我们报道了NPC1,胆固醇转运的关键参与者,保护多种癌症类型的癌细胞免于焦亡。NPC1在人类癌症中的表达高度升高,并与患者生存率呈负相关。NPC1缺乏导致肿瘤生长减少,并在焦亡应激下增强对焦亡的敏感性。NPC1通过维持胆固醇稳态和促进ldl介导的胆固醇摄取来保护癌细胞免于焦亡,从而增强香叶香叶基焦磷酸合成,促进癌细胞存活。此外,在异种移植小鼠模型中,NPC1抑制剂U18666A诱导癌细胞焦亡,并且单独或联合化疗药物对人类血液学和实体癌具有很高的治疗作用。结论:本研究揭示了NPC1可能是治疗人类癌症的潜在靶点。
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Biomarker Research
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