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Drug repurposing: Bortezomib in the treatment of PTEN-deficient iCCA 药物再利用:硼替佐米治疗PTEN缺陷的iCCA
Pub Date : 2024-10-29 DOI: 10.1002/ctd2.70004
Shi-jia Dai, Tian-yi Jiang, Zhen-gang Yuan
<p>Intrahepatic cholangiocarcinoma (iCCA) is an epithelial malignancy arising from intrahepatic biliary tract, characterised by a dismal prognosis with limited therapeutic alternatives.<span><sup>1</sup></span> The standard first-line treatment for patients with unresectable iCCA includes gemcitabine-based chemotherapy and immunotherapy. However, the objective response rate (ORR) of first-line treatment is below 30%, and there is currently insufficient evidence to support the use of second-line chemotherapy.<span><sup>2, 3</sup></span> This underscores an urgent need to identify novel therapeutic targets and effective drugs for iCCA.</p><p>Our previous research has demonstrated that phosphatase and tension homolog (PTEN), a tumour suppressor which counteracts phosphatidylinositol 3-kinase (PI3K)–AKT signalling, is frequently mutated or deleted in iCCA.<span><sup>4</sup></span> We established a spontaneous iCCA model in mice through liver-specific PTEN disruption and Kras activation, highlighting the crucial role of PTEN in iCCA tumourigenesis.<span><sup>5</sup></span> Importantly, we identified PTEN as a pivotal regulator of both the lysosomal and proteasomal systems, which are essential for maintaining cellular proteostasis in CCA cells. PTEN drives lysosome biogenesis and acidification through its protein phosphatase activity, which dephosphorylates transcription factor EB (TFEB) at Ser211, thereby regulating exosome secretion and iCCA metastasis.<span><sup>6</sup></span> Simultaneously, PTEN inhibits proteasomal transcription via its lipid phosphatase activity in a BACH1/MAFF-dependent manner.<span><sup>7</sup></span> Consequently, PTEN deficiency enhances protein synthesis and proteasomal activity, creating a dependency on the proteasome for iCCA cell growth and survival. Therefore, targeting the proteasome machinery by inhibitor bortezomib induces more apoptosis in PTEN-deficient iCCA cells.</p><p>We subsequently conducted a clinical trial (NCT03345303) to assess whether PTEN-deficient iCCA patients could benefit from bortezomib treatment after failure of first-line chemotherapy, investigating PTEN as a potential biomarker for proteasome inhibition. This open-label, single-arm, phase II clinical trial was conducted at the Eastern Hepatobiliary Surgery Hospital, Shanghai. A total of 130 advanced iCCA patients were screened for PTEN expression and 16 were enrolled and treated with single-agent bortezomib. Among the intent-to-treat cohort (<i>n</i> = 16), the ORR was 18.75% (three out of 16), and the disease control rate (DCR) was 43.75% (seven out of 16). Notably, three patients did not undergo efficacy assessment, resulting in more favourable outcomes in the per-protocol (PP) cohort (<i>n</i> = 13), which demonstrated an ORR of 23.08% and a DCR of 53.85%. The median progression-free survival (PFS) was 3.6 months, and median overall survival (OS) was 9.6 months in the PP cohort. To our knowledge, the primary efficacy endpoint of our trail, the
肝内胆管癌(iCCA)是一种发生于肝内胆道的上皮性恶性肿瘤,其特点是预后不佳且治疗手段有限1 。然而,一线治疗的客观反应率(ORR)低于 30%,目前也没有足够的证据支持二线化疗的使用。2, 3 这凸显了为 iCCA 寻找新的治疗靶点和有效药物的迫切需要。我们之前的研究表明,磷酸酶和张力同源物(PTEN)是一种肿瘤抑制因子,可对抗磷酸肌醇 3- 激酶(PI3K)-AKT 信号,在 iCCA 中经常发生突变或缺失。我们通过肝特异性 PTEN 干扰和 Kras 激活建立了小鼠自发性 iCCA 模型,突出了 PTEN 在 iCCA 肿瘤发生过程中的关键作用5。PTEN 通过其蛋白磷酸酶活性驱动溶酶体的生物生成和酸化,使转录因子 EB(TFEB)在 Ser211 处去磷酸化,从而调节外泌体的分泌和 iCCA 的转移。同时,PTEN 通过其脂质磷酸酶活性以 BACH1/MAFF 依赖性方式抑制蛋白酶体转录。7 因此,PTEN 缺乏会增强蛋白质合成和蛋白酶体活性,从而使 iCCA 细胞的生长和存活依赖于蛋白酶体。我们随后开展了一项临床试验(NCT03345303),以评估PTEN缺陷的iCCA患者在一线化疗失败后是否能从硼替佐米治疗中获益,并将PTEN作为蛋白酶体抑制的潜在生物标志物进行研究。这项开放标签、单臂、II期临床试验在上海东方肝胆外科医院进行。共对130名晚期iCCA患者进行了PTEN表达筛查,16名患者入组并接受了硼替佐米单药治疗。在意向治疗队列(n = 16)中,ORR为18.75%(16人中有3人),疾病控制率(DCR)为43.75%(16人中有7人)。值得注意的是,有三名患者没有接受疗效评估,因此按方案治疗队列(13 人)的结果更为理想,ORR 为 23.08%,DCR 为 53.85%。PP队列的中位无进展生存期(PFS)为3.6个月,中位总生存期(OS)为9.6个月。据我们所知,我们研究的主要疗效终点--PP队列的ORR仅低于之前有关FGFR抑制剂的报道,但与其他二线治疗方案相比,如FOLFOX(5%)、瑞戈非尼(11%)和乐伐替尼联合帕博利珠单抗(10%),ORR有了显著改善。此外,硼替佐米相关毒性被认为是可以接受的,没有治疗相关死亡病例,血小板计数下降是最常见的不良反应。这些结果表明,硼替佐米是治疗 PTEN 缺陷 iCCA 的一种很有前景的二线疗法。8 基于从二线单药治疗研究中获得的启示,我们正在推进一项 II 期介入临床试验(ChiCTR2000035916),旨在进一步评估吉西他滨类化疗联合硼替佐米治疗胆管癌(CCA)的疗效(见图 1)。该试验旨在招募200名晚期CCA患者,探讨PTEN和PIK3CA/B的改变是否会影响这种联合疗法的疗效,最终目标是为中国的CCA患者开发出分子定制的治疗方案。初步研究结果表明,PTEN缺乏的患者从联合治疗中获益更大,这也证实了我们在二线单药治疗研究中观察到的结果。在本研究中,我们重点关注硼替佐米。作为第一代蛋白酶体抑制剂,硼替佐米已在临床上应用了近 20 年10 ,对其安全性、耐受性和药代动力学特性进行了广泛的研究,使其更适于 "药物重新定位"。值得注意的是,之前一项评估硼替佐米对非选择性胆道癌(BTC)患者疗效的 II 期试验未能达到主要终点,但取得了令人鼓舞的疾病稳定性和中位 PFS。这表明,生物标志物驱动的患者选择和联合用药策略可能会带来显著疗效。 我们之前的研究发现,PTEN缺陷的iCCA细胞表现出较高的蛋白酶体活性和增殖能力,从而在体外和体内对硼替佐米产生敏感性。从机理上讲,我们发现PTEN-AKT-FOXO1-BACH1/MAFF信号通路调节蛋白酶体基因的转录,并影响硼替佐米的敏感性。因此,我们启动了一项前瞻性临床试验,史无前例地评估了蛋白酶体抑制剂硼替佐米在选定的 PTEN 缺陷 ICC 患者群中的疗效。有效及时的筛查对于指导后续的二线治疗至关重要。在这项研究中,我们采用了多种技术来评估 PTEN 缺陷,包括免疫组化(IHC)、新一代测序(NGS)和 RNA 范围技术。我们的研究结果表明,PTEN 蛋白表达与基因改变密切相关。与我们之前对 50 例 ICC 患者进行 PTEN IHC 和基因测序的研究结果一致,PTEN 缺乏与基因改变显著相关。PTEN 同源缺失或框移突变通常会导致蛋白表达缺失;因此,我们主张将 IHC 作为初步筛查方法。此外,对 "癌症药物敏感性基因组学"(Genomics of Drug Sensitivity in Cancer)和 "癌症治疗反应门户网站"(Cancer Therapeutics Response Portal)数据库的分析表明,PTEN 缺失可提高各种肿瘤对蛋白酶体抑制剂的敏感性,这表明我们的发现可能具有广泛的适用性。在胆囊癌4和胶质母细胞瘤11中也观察到了类似的细胞和动物表型,这表明基于PTEN分子亚型的蛋白酶体抑制剂精准治疗方法可能会扩展到其他肿瘤,使更多PTEN缺失患者受益。总之,我们的研究表明,硼替佐米作为PTEN缺失型iCCA的二线疗法具有可控毒性和良好疗效,在PP队列中毒性可控,中位OS为9.6个月。这些结果支持蛋白酶体抑制剂在实体瘤中的广泛应用,并为PTEN缺陷型恶性肿瘤患者带来了新的希望。
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引用次数: 0
The role of microglia in neurocognitive deficits induced by general anaesthetic agents during neurodevelopment 小胶质细胞在神经发育期全身麻醉剂诱发的神经认知缺陷中的作用
Pub Date : 2024-10-28 DOI: 10.1002/ctd2.70012
Xinyue Liang, Fang Fang, Xiaoqing Wang, Ming Jiang, Jing Cang

Background and Aims

Microglia are the innate immune cells of central nervous system which play critical roles in brain homeostasis. Recently, the effects of general anesthetic agents (GAAs) on microglia and their potential neurotoxicity in neurodevelopment have attracted the attention of anesthesiologists and neuroscientists.

Methods

Here, we review the physiology of microglia in neurodevelopment, the potential mechanisms of GAAs on microglia and the consequent changes in microglial function.

Outcomes

Microglia-mediated neuroinflammation is a key mechanism of neurocognitive deficits during neurodevelopment. In addition, microglia could be primed by active inflammatory processes and have innate immune memory, both of which make them a potential candidate responsible of long-term neural deficits.

Conclusion

This review aims in summarizing the in vivo and in vitro studies associating microglia with general anesthesia and describing how GAAs induce neurocognitive deficits via microglia to further explore the effects of GAAs on neurodevelopment.

背景和目的 小胶质细胞是中枢神经系统的先天性免疫细胞,在脑平衡中发挥着关键作用。最近,全身麻醉剂(GAAs)对小胶质细胞的影响及其在神经发育过程中的潜在神经毒性引起了麻醉学家和神经科学家的关注。 方法 在此,我们回顾了神经发育过程中的小胶质细胞生理学、GAAs 对小胶质细胞的潜在作用机制以及由此导致的小胶质细胞功能变化。 结果 小胶质细胞介导的神经炎症是神经发育过程中神经认知缺陷的关键机制。此外,小胶质细胞可能被活跃的炎症过程激活,并具有先天性免疫记忆,这两者都使其成为造成长期神经缺陷的潜在候选因素。 结论 本综述旨在总结小胶质细胞与全身麻醉相关的体内和体外研究,描述 GAAs 如何通过小胶质细胞诱导神经认知缺陷,从而进一步探讨 GAAs 对神经发育的影响。
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引用次数: 0
Organoid-driven diagrammatic devolution: Elevating precision in pancreatic cystic lesions diagnosis 器官驱动的图解演化:提高胰腺囊性病变诊断的精确度
Pub Date : 2024-10-25 DOI: 10.1002/ctd2.70008
Fei Jiang, Dongyan Cao, Gengming Niu, Hui Jiang, Zhendong Jin, Yingbin Liu, Dongxi Xiang
<p>Dear Editor,</p><p>Pancreatic cystic lesions pose a diagnostic challenge. The accuracy of distinguishing low-grade from high-grade dysplasia is suboptimal, with the progression risk varying based on the types of cysts (simple retention cysts, pseudocysts and cystic neoplasms).<span><sup>1</sup></span> Traditional imaging-based radiological approaches (computed tomography [CT] and magnetic resonance imaging [MRI]), endoscopic ultrasound (EUS)-guided fine needle aspiration, including analysis of cystic fluid components such as amylase, glucose, carcinoembryonic antigen (CEA) levels, liquid-based cytology and more recently molecular markers can enhance the diagnosis of pancreatic cystic lesions.<span><sup>2</sup></span> Even though, there is a pressing need for a stable and accurate model that allows in-depth analysis of cell components of cystic lesions and reflects their behaviour. Organoids as 3D multicellular structures resemble features of their original tissue individually for self-organization and self-renewal.<span><sup>3, 4</sup></span> Organoid-based longitudinal testing aids in monitoring translational diagnosis, disease progression, treatment response and adapting therapies. To enhance precision in diagnosing pancreatic cystic lesions, we collected cystic fluids for organoid culture, evaluating their growth phenotypes and molecular markers. The cell context of successfully constructed organoids was further validated by single-cell RNA sequencing (scRNA-Seq) (Figure 1A).</p><p>A comprehensive explanation of the methods is in the Supporting Information. A 34-year-old female (patient #<i>X</i>) complained of epigastric pain persisting for 5 years with recurrent pancreatitis. The CT data showed a pancreatic cystic lesion measuring 5 cm in diameter within the pancreatic body, raising suspicion of a pancreatic pseudocyst (Figure 1B). Subsequent enhanced MRI and contrast EUS suggested the lesion as a mucinous cystic neoplasm with enhanced mural nodules (Figure 1C). An EUS-guided fine needle aspiration was conducted and approximately 40 mL of cystic fluid was aspirated. The cystic fluid revealed amylase at a level of 165 328 U/L (>250 U/mL suggests the possibility of pancreatic pseudocyst), CEA level of 261.98 ng/mL (>192 ng/mL indicates the possibility of pancreatic mucinous cystic neoplasm) and glucose level of 9 mg/dL (<50 mg/dL suggests the possibility of pancreatic mucinous cystic neoplasm). Meanwhile, a small volume of cyst fluid (∼3 mL) from the puncture was performed for organoid culture (Figure 1D). Notably, organoids derived from this case exhibited robust growth. Haematoxylin and eosin staining highlighted abnormal structures in cell nuclei (Figure 1E). Immunohistochemical staining for CEA, TP53 and MIK67, as well as immunostaining for MUC5AC, all yielded positive results (Figure 1F,G). These staining data may confirm the diagnosis of this patient with high-grade intraepithelial neoplasia.</p><p>The patient eventually unde
亲爱的编辑,胰腺囊性病变给诊断带来了挑战。区分低级别和高级别发育不良的准确性并不理想,其进展风险因囊肿类型(单纯潴留囊肿、假性囊肿和囊性瘤)而异。1 传统的基于影像学的放射学方法(计算机断层扫描 [CT] 和磁共振成像 [MRI])、内窥镜超声 (EUS) 引导下的细针穿刺术(包括分析囊液成分,如淀粉酶、葡萄糖、癌胚抗原 (CEA) 水平)、液基细胞学以及最近的分子标记物均可提高胰腺囊性病变的诊断率。尽管如此,目前仍迫切需要一种稳定而准确的模型,以深入分析囊性病变的细胞成分并反映其行为。3、4 基于类器官的纵向测试有助于监测转化诊断、疾病进展、治疗反应和调整疗法。为了提高胰腺囊性病变诊断的准确性,我们收集囊性液体进行类器官培养,评估其生长表型和分子标记物。单细胞RNA测序(scRNA-Seq)进一步验证了成功构建的类器官的细胞背景(图1A)。一名 34 岁的女性(患者 X 号)主诉上腹痛持续 5 年,并伴有反复发作的胰腺炎。CT 数据显示,胰腺体内有一个直径为 5 厘米的胰腺囊性病变,这引起了对胰腺假性囊肿的怀疑(图 1B)。随后的增强 MRI 和对比 EUS 显示病变为粘液性囊性肿瘤,伴有增强壁结节(图 1C)。在 EUS 引导下进行了细针穿刺,抽出了约 40 毫升的囊液。囊液显示淀粉酶水平为 165 328 U/L(250 U/mL,提示胰腺假性囊肿的可能性),CEA 水平为 261.98 ng/mL(192 ng/mL,提示胰腺粘液性囊性肿瘤的可能性),葡萄糖水平为 9 mg/dL(50 mg/dL,提示胰腺粘液性囊性肿瘤的可能性)。同时,从穿刺处抽取少量囊液(∼3 mL)进行类器官培养(图 1D)。值得注意的是,从该病例中提取的类器官生长旺盛。血色素和伊红染色显示细胞核结构异常(图 1E)。CEA、TP53和MIK67的免疫组化染色以及MUC5AC的免疫染色均呈阳性结果(图1F,G)。由于急性胰腺炎反复发作,患者最终接受了手术切除,术后病理报告为胰腺粘液性囊腺瘤伴低度上皮内瘤变。这一差异引起了作者和我们医疗团队的担忧,促使我们质疑术后病理取样不完整是否会影响研究结果。我们请经验丰富的病理学家对更多蜡块进行了重新切片、染色和复查,最终在某些区域发现了高级别病变的证据(如图 1H 箭头所示),同时发现 MUC5AC 和 MKI67 染色阳性(图 1H)。这些发现证实了最初的类器官培养结果,确认了高级别上皮内瘤变的存在。此外,为了在分子水平上验证 X 号患者诊断的准确性,对约 3 mL 的囊液进行了 scRNA 序列分析。经过质控过滤后,保留了 10 565 个单细胞用于后续分析(图 2A)5。它们是成纤维细胞(COL1A1、COL3A1 和 DCN)、CD4T(CD3D、CD3E 和 CD4)、CD8T(CD3D、CD3E 和 CD8A)、B 细胞(CD79A 和 MS4A1)、血浆细胞(IGHA2 和 IGLC2)、巨噬细胞(C1QC、C1QB 和 C1QA)、单核细胞(FCN1 和 S100A8)、DC_CD1C(CD1C 和 CD1E)、DC_LAMP3(LAMP3 和 FSCN1)、增殖细胞(MKI67 和 TOP2A)以及重要的上皮细胞(EPCAM、KRT8 和 MUC5AC)组(图 2B)。上皮细胞的拷贝数变异(CNV)水平各不相同(图 2C)。基因组富集分析表明,CNV_low 组富集于细胞质翻译和多肽生物合成过程(图 2D)。scRNA-Seq 数据显示的 RNA 表达模式与蛋白质水平一致(图 2E)。这些发现与类器官数据一致,支持高级别上皮内瘤变而非低级别上皮内瘤变的诊断。
{"title":"Organoid-driven diagrammatic devolution: Elevating precision in pancreatic cystic lesions diagnosis","authors":"Fei Jiang,&nbsp;Dongyan Cao,&nbsp;Gengming Niu,&nbsp;Hui Jiang,&nbsp;Zhendong Jin,&nbsp;Yingbin Liu,&nbsp;Dongxi Xiang","doi":"10.1002/ctd2.70008","DOIUrl":"https://doi.org/10.1002/ctd2.70008","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;Pancreatic cystic lesions pose a diagnostic challenge. The accuracy of distinguishing low-grade from high-grade dysplasia is suboptimal, with the progression risk varying based on the types of cysts (simple retention cysts, pseudocysts and cystic neoplasms).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Traditional imaging-based radiological approaches (computed tomography [CT] and magnetic resonance imaging [MRI]), endoscopic ultrasound (EUS)-guided fine needle aspiration, including analysis of cystic fluid components such as amylase, glucose, carcinoembryonic antigen (CEA) levels, liquid-based cytology and more recently molecular markers can enhance the diagnosis of pancreatic cystic lesions.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Even though, there is a pressing need for a stable and accurate model that allows in-depth analysis of cell components of cystic lesions and reflects their behaviour. Organoids as 3D multicellular structures resemble features of their original tissue individually for self-organization and self-renewal.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; Organoid-based longitudinal testing aids in monitoring translational diagnosis, disease progression, treatment response and adapting therapies. To enhance precision in diagnosing pancreatic cystic lesions, we collected cystic fluids for organoid culture, evaluating their growth phenotypes and molecular markers. The cell context of successfully constructed organoids was further validated by single-cell RNA sequencing (scRNA-Seq) (Figure 1A).&lt;/p&gt;&lt;p&gt;A comprehensive explanation of the methods is in the Supporting Information. A 34-year-old female (patient #&lt;i&gt;X&lt;/i&gt;) complained of epigastric pain persisting for 5 years with recurrent pancreatitis. The CT data showed a pancreatic cystic lesion measuring 5 cm in diameter within the pancreatic body, raising suspicion of a pancreatic pseudocyst (Figure 1B). Subsequent enhanced MRI and contrast EUS suggested the lesion as a mucinous cystic neoplasm with enhanced mural nodules (Figure 1C). An EUS-guided fine needle aspiration was conducted and approximately 40 mL of cystic fluid was aspirated. The cystic fluid revealed amylase at a level of 165 328 U/L (&gt;250 U/mL suggests the possibility of pancreatic pseudocyst), CEA level of 261.98 ng/mL (&gt;192 ng/mL indicates the possibility of pancreatic mucinous cystic neoplasm) and glucose level of 9 mg/dL (&lt;50 mg/dL suggests the possibility of pancreatic mucinous cystic neoplasm). Meanwhile, a small volume of cyst fluid (∼3 mL) from the puncture was performed for organoid culture (Figure 1D). Notably, organoids derived from this case exhibited robust growth. Haematoxylin and eosin staining highlighted abnormal structures in cell nuclei (Figure 1E). Immunohistochemical staining for CEA, TP53 and MIK67, as well as immunostaining for MUC5AC, all yielded positive results (Figure 1F,G). These staining data may confirm the diagnosis of this patient with high-grade intraepithelial neoplasia.&lt;/p&gt;&lt;p&gt;The patient eventually unde","PeriodicalId":72605,"journal":{"name":"Clinical and translational discovery","volume":"4 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ctd2.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142540906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of microRNA on the growth and targeted therapy response on lung cancer 微小核糖核酸对肺癌生长和靶向治疗反应的影响
Pub Date : 2024-10-25 DOI: 10.1002/ctd2.70011
Mengchen Zhu, Yi Jiang, Lingshuang Liu

Lung cancer represents a significant public health concern worldwide. Lung cancer typically receives a diagnosis at a late stage, leading to a generally unfavourable prognosis. Additionally, traditional treatments frequently fail in cases of metastatic lung cancer. However, targeted therapy has advanced considerably in the management of lung cancer, and overcoming drug resistance has emerged as a significant hurdle in achieving optimal treatment outcomes. As a result, there has been a new trend toward precision therapy for lung cancer based on changes at the molecular and genetic levels. On the other hand, for lung cancer, early diagnosis plays a crucial role in treatment and prognosis. Based on existing knowledge, we strongly believe that it is imperative to promptly identify innovative biomarkers. The emergence of microRNAs (miRNAs) provides new ideas. The expression profiles of miRNAs have been investigated using noninvasive blood samples to explore the regulatory mechanisms played by miRNAs during the progression and targeted therapy resistance of lung cancer. Due to the complexity of miRNA profiles, they may play the role of tumour suppressors or oncogenes. However, specific regulatory mechanisms are still a huge topic to be explored. In this Review, we summarize the latest research that has shed light on the potential regulatory mechanisms of miRNAs in driving lung cancer progression, their value for clinical application as biomarkers and their role in targeted therapy resistance.

肺癌是全球关注的重大公共卫生问题。肺癌通常在晚期才被确诊,因此预后普遍不佳。此外,对于转移性肺癌,传统治疗方法经常会失败。然而,靶向治疗在肺癌的治疗中取得了长足的进步,克服耐药性已成为实现最佳治疗效果的重要障碍。因此,基于分子和基因水平变化的肺癌精准治疗已成为一种新趋势。另一方面,对于肺癌来说,早期诊断在治疗和预后中起着至关重要的作用。基于现有的知识,我们坚信,当务之急是及时确定创新的生物标志物。微小核糖核酸(miRNA)的出现提供了新的思路。研究人员利用无创血液样本对 miRNAs 的表达谱进行了研究,以探索 miRNAs 在肺癌进展和靶向治疗耐药过程中的调控机制。由于 miRNA 图谱的复杂性,它们可能扮演肿瘤抑制因子或致癌基因的角色。然而,具体的调控机制仍是一个有待探索的巨大课题。在这篇综述中,我们总结了最新的研究,这些研究揭示了 miRNA 在推动肺癌进展中的潜在调控机制、其作为生物标志物的临床应用价值以及在靶向治疗耐药性中的作用。
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引用次数: 0
Otubain 2 promotes muramyl dipeptide-mediated anti-colitogenic effects due to de-ubiquitination of receptor interaction protein 2 由于受体相互作用蛋白 2 的去泛素化作用,奥图巴因 2 促进了氨甲酰二肽介导的抗胆碱酯酶作用
Pub Date : 2024-10-23 DOI: 10.1002/ctd2.70014
Jochen Mattner
<p>Immune responses in the gut need to be tightly controlled in order to maintain mucosal immune tolerance and proper interactions with intestinal microbiota. Disruptions of these immune-microbiota circuits presumably underlie different immune-mediated disorders including inflammatory bowel disease (IBD). Distinct genetic traits that alter the expression and/or function of molecules and consequently the immune signalling networks they are embedded in can disrupt immune-microbiota interactions and microbe recognition and thus, promote mucosal inflammation. However, the molecular mechanisms and cellular circuits underlying the pathogenesis of IBD are only incompletely understood. Du and colleagues investigated the influence of posttranslational modifications on the complex signalling network in the gut in an experimental colitis model and in patients with ulcerative colitis.<span><sup>1</sup></span></p><p>The nucleotide-binding oligomerization domain-containing protein 2 (NOD2) is an intracellular pattern recognition receptor which contributes to intestinal homeostasis through the regulation of epithelial cell functions and innate and adaptive immune responses. Hematopoietic cells of both myeloid and lymphoid origin as well as intestinal epithelial cells and Paneth cells express NOD2.<span><sup>2</sup></span> NOD2 senses intracellular muramyl dipeptide (MDP), a peptidoglycan component conserved in Gram-positive and Gram-negative bacteria. Following engagement by MDP, NOD2 undergoes oligomerization and subsequently attracts and activates receptor interaction protein 2 (RIPK2) through homotypic interactions, followed by transforming growth factor-beta-activated kinase 1 recruitment and activation which engages nuclear factor kappa-beta (NFκB) and mitogen-activated protein kinase pathways for pro-inflammatory cytokine production.<span><sup>3</sup></span></p><p>Allelic variations of the gene encoding NOD2 have been associated with IBD. The three most common risk variants of the more than 2400 NOD2 variant genes reported to date are typically present in a heterozygous state and account for more than 80% of the NOD2 variations.<span><sup>4</sup></span> These allelic risk variants are predicted to encode loss-of-function mutations that impair NFκB activation in response to MDP and to promote the onset and progression of IBD by altering the interaction with and the composition of intestinal microbiota.<span><sup>5, 6</sup></span> Along with this assumption, MDP administration protects from experimental colitis and this protective effect of MDP is lost when NOD2 signalling is defective,<span><sup>7, 8</sup></span> Thus, proper NOD2 signalling is pivotal for the maintenance of intestinal immune tolerance and the restriction of inflammatory insults.</p><p>Next to genetic NOD2 mutations, the versatile and complex signalling network NOD2 is embedded in as well as various posttranslational modifications regulate NOD2 function and thus, influence the outcome of d
作者优雅地描述了在炎症性疾病背景下,NOD2 参与后 RIPK2 翻译后稳定的新机制。最重要的是,他们的研究表明,即使患者本身不携带 NOD2 基因突变,也会出现 NOD2 信号缺陷。此外,某些基因变异(包括影响 NOD2 信号传导的 Otub2 变异)可能会导致 IBD 易感性。该研究主要关注化学诱导结肠炎模型中的造血细胞(而非非造血细胞),以及骨髓衍生巨噬细胞中的 NOD2 信号传导。目前仍不清楚从 DSS 处理的小鼠肠道组织中纯化的巨噬细胞中是否保留了 OTUB2 介导的 NOD2 信号。此外,还需要进一步研究,以解释 MDP 如何在体外增强巨噬细胞释放炎性细胞因子的情况下,仍能减少 DSS 结肠炎模型中的炎性免疫反应。因此,OTUB-2 介导的保护粘膜免于炎症的确切机制值得进一步研究。其中一个方面可能是某些病原菌在巨噬细胞激活后会优先被清除,从而抑制肠道的二次炎症过程。要详细解决这个问题,感染驱动的结肠炎模型可能会有所帮助。进一步的研究还需要评估 OTUB2 在其他细胞群中的作用,以及微生物群的功能和结构组成在 MDP 信号传入单个细胞群后会受到怎样的影响。
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引用次数: 0
EccDNA, STING activation, and their potential roles in DLBCL prognosis and therapy EccDNA、STING 激活及其在 DLBCL 预后和治疗中的潜在作用
Pub Date : 2024-10-23 DOI: 10.1002/ctd2.70013
Xi-Bo Hu, Wei-Ying Wang, Xiao-Jian Sun, Qun-Ling Zhang
<p>Diffuse large B-cell lymphoma (DLBCL), the most common lymphoma in adults, poses a significant clinical challenge due to its marked heterogeneity and high incidence of patients suffering relapse or becoming refractory after the first-line immunochemotherapy. DLBCL cells may originate from different stages of lymphoid differentiation, and thus their gene expression profiling can delineate two distinct molecular subtypes of DLBCL: germinal center B-cell-like (GCB) and activated B-cell-like (ABC) subtypes, with a minority of cases remaining unclassifiable. Alternatively, immunohistochemistry-based algorithms can also dichotomize DLBCL into GCB and non-GCB subtypes. In addition to these classifications related to cell-of-origin, recent in-depth genomic analyses have also revealed recurrent genomic aberrations, prompting the proposal of new classification systems for DLBCL.<span><sup>1, 2</sup></span> However, as yet the correlation between prognosis and molecular subtypes remains elusive.<span><sup>3</sup></span> As an effort to further explore the heterogeneity of DLBCL, in an article recently published in <i>Clinical and Translational Medicine</i>, Wu et al. reported the first profiling of extrachromosomal circular DNA (eccDNA) in DLBCL cells and identified the oncogenic role and prognostic significance of the eccDNAs in DLBCL. Meanwhile, their multi-omic and mechanistic studies uncovered an activation of the stimulator of interferon genes (STING) signalling pathway by eccDNAs in DLBCL cells, thus suggesting a potential therapeutic approach combining chemotherapy with STING inhibition (Figure 1).<span><sup>4</sup></span></p><p>EccDNAs are circular double-strand DNA molecules that are originally derived from, but physically independent of, chromosomal DNA. They are heterogeneous in size ranging from a few hundred to millions of base pairs and appear to be derived from either repetitive sequences or unique genomic sequences, and many eccDNAs can be self-replicated. While the biogenesis and functions of eccDNAs remain to be fully understood, an increase in eccDNA has been observed in several types of human cancers. Importantly, because the eccDNAs provide a significant source of oncogene amplification and can be segregated unequally to daughter cells, they are believed to contribute enormously to tumour evolution and intratumor heterogeneity,<span><sup>5</sup></span> and the presence of eccDNAs in patient tumour samples has been found to be associated with poor outcomes across many types of cancers.<span><sup>6</sup></span> Furthermore, studies have shown that eccDNAs can function as potent innate immunostimulants, which require the STING signalling pathways to serve as intracellular DNA sensors.<span><sup>7</sup></span></p><p>By integrating circular DNA sequencing (circle-seq), atomic force microscopy, whole exome sequencing (WES) and single-cell RNA sequencing (scRNA-seq) techniques, Wu et al. performed a comprehensive eccDNA profiling of 18 DLBC
9 本文提出的支持这一点的证据包括:Western印迹结果显示H组和L组细胞系中cGAS蛋白水平无明显差异;cGAS抑制(cGAS抑制剂或敲除cGAS)对细胞增殖的效果相对较差;患者来源的DLBCL细胞中cGAS免疫荧光染色水平不一,与p-STING水平无关。然而,要牢固确立这一点,还需要更多的实验,而且这种cGAS独立性是细胞类型特异性的,还是代表了eccDNA刺激STING活化的普遍机制,还有待澄清。结果表明,STING 抑制剂(而非 STING 激动剂或 cGAS 抑制剂)能有效抑制 H 组 DLBCL 细胞的增殖和异种移植小鼠模型的肿瘤进展。基于DNA损伤性化疗可促进DLBCL中eccDNA的生成和STING的激活这一逻辑,Wu等人进一步发明了将化疗药物与STING抑制剂相结合的联合治疗方法。本研究为评估eccDNA和下游STING激活在DLBCL预后和治疗中的潜在作用开辟了新的视角;然而,仍有几个有趣的问题有待解决。首先,尽管本研究开发了转录组特征来反映DLBCL细胞中eccDNA的丰度,但eccDNA本身,尤其是考虑到其相对稳定性和不仅在细胞中而且在血浆和尿液中的易检测性,10 也可被视为DLBCL预后的潜在生物标志物。其次,如果eccDNA刺激STING活化真的与cGAS无关,那么阐明eccDNA感应的确切机制就非常重要。第三,尽管在这项研究中,STING抑制剂在治疗DLBCL方面显示出了相当的疗效,但鉴于STING信号通路在不同细胞/组织,尤其是在免疫系统中的多种功能,在将其应用于临床之前,还需要更多的研究来评估和管理其效益和风险。最后,除了 DLBCL,研究本文提出的机制和治疗方法是否适用于其他类型的癌症也很有意义。
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引用次数: 0
Integrating single-cell RNA sequencing data to decipher heterogeneity and function of macrophages in various organs and diseases 整合单细胞 RNA 测序数据,解读巨噬细胞在不同器官和疾病中的异质性和功能
Pub Date : 2024-10-23 DOI: 10.1002/ctd2.70005
Xinjie Xu, Zichen Wu, Zhiwei Zeng, Jiaying Cao, Liang Chen
<p>Macrophages are essential components of the innate immune system, playing crucial roles in host defence, immune surveillance and tissue repair processes. Developmentally, macrophages can be divided into embryonic origin and postnatal origin.<span><sup>1</sup></span> Embryonic-origin macrophages are derived from the yolk sac and foetal liver during embryogenesis. They migrate to tissues early in development and maintain their populations with self-renewal mechanisms throughout the lifecycle. These macrophages are commonly found in tissues such as the brain (microglia), liver (Kupffer cells) and lungs (alveolar macrophages). In contrast, postnatal-origin macrophages are derived from hematopoietic stem cells in the bone marrow. During instances of injury, inflammation or tumorigenesis, monocytes are mobilized from the bone marrow to the blood and differentiate into macrophages upon reaching distinct tissues. Functionally, macrophages have traditionally been classified into M1 and M2 types based on in vitro activation modes. M1 macrophages exhibit pro-inflammatory properties, while M2 macrophages are involved in anti-inflammatory responses and tissue repair. M2 macrophages are further classified into subtypes M2a, M2b, M2c and M2d based on distinct activation signals.<span><sup>2</sup></span> However, recent perspectives suggest that macrophage functions exist on a spectrum rather than binary states, with significant heterogeneity across organs and diseases, challenging the simplistic polarization classification in explaining diverse pathophysiological processes.</p><p>The advent of single-cell RNA sequencing (scRNA-seq) technology has revolutionized the study of macrophages, providing unprecedented resolution to unravel their origin, heterogeneity and functional diversity in various physiological and pathological contexts. The integrated multi-organ scRNA-seq studies of macrophages aim to address the following key scientific questions: 1. Deciphering macrophage heterogeneity: Several studies integrated macrophages from normal tissues and tumour tissues of different organs for fine annotation, revealing significant heterogeneity of macrophages, rather than polarized classification.<span><sup>3, 4</sup></span> 2. Functional regulation of macrophage: In-depth analysis of macrophage function is crucial, such as inflammatory response and metabolism, thus informing therapeutic strategies aimed at modulating macrophage activity. For instance, TREM2+ macrophages have been identified in the brain, fat, liver, blood vessels and other physiological and pathological conditions, and have diverse functions such as phagocytosis, metabolism and pro-inflammatory effects.<span><sup>5</sup></span> SPP1+ macrophages have been identified in different diseases such as tumours and atrial fibrillation, and have diverse functions such as promoting fibrosis and regulating immunity.<span><sup>6</sup></span> 3. Inference of macrophage lineage origin and differentiation traj
巨噬细胞是先天性免疫系统的重要组成部分,在宿主防御、免疫监视和组织修复过程中发挥着至关重要的作用。从发育角度看,巨噬细胞可分为胚胎源巨噬细胞和产后源巨噬细胞。1 胚胎源巨噬细胞来自胚胎发育过程中的卵黄囊和胎肝。它们在发育早期迁移到组织中,并在整个生命周期中通过自我更新机制维持其数量。这些巨噬细胞通常存在于大脑(小胶质细胞)、肝脏(Kupffer 细胞)和肺部(肺泡巨噬细胞)等组织中。而出生后来源的巨噬细胞则来自骨髓中的造血干细胞。在受伤、发炎或肿瘤发生时,单核细胞会从骨髓转移到血液中,并在到达不同组织后分化成巨噬细胞。在功能上,传统上根据体外激活模式将巨噬细胞分为 M1 和 M2 两种类型。M1 型巨噬细胞具有促炎特性,而 M2 型巨噬细胞则参与抗炎反应和组织修复。根据不同的激活信号,M2 巨噬细胞又分为 M2a、M2b、M2c 和 M2d 亚型。单细胞 RNA 测序(scRNA-seq)技术的出现彻底改变了对巨噬细胞的研究,为揭示巨噬细胞在各种生理和病理环境中的起源、异质性和功能多样性提供了前所未有的分辨率。对巨噬细胞的多器官scRNA-seq综合研究旨在解决以下关键科学问题:1.解密巨噬细胞的异质性:多项研究整合了不同器官正常组织和肿瘤组织的巨噬细胞进行精细标注,发现巨噬细胞具有显著的异质性,而非极化分类。巨噬细胞的功能调控:深入分析巨噬细胞的功能至关重要,如炎症反应和新陈代谢,从而为旨在调节巨噬细胞活性的治疗策略提供信息。例如,在大脑、脂肪、肝脏、血管等生理和病理状态中发现了 TREM2+ 巨噬细胞,它们具有吞噬、新陈代谢和促炎作用等多种功能:伪时间和 RNA 速度分析等算法可用于推断巨噬细胞的血统起源和分化轨迹。多器官单细胞 RNA 测序表明,常驻的 Timd4+Lyve1+Folr2+ 巨噬细胞起源于卵黄囊和胎儿单核细胞前体7 4. 细胞通讯和细胞网络:探索巨噬细胞在实质细胞、间质细胞和微环境中的相互作用是研究的前沿,也是该领域的难点。配体-受体分析等算法被用来推断相互作用。8 (见图 1)然而,这些基于全息数据的发现和推断需要谨慎的解释和彻底的验证,从表达验证到功能验证。smFISH 和免疫染色等技术可验证亚群的存在;系谱追踪动物模型可验证巨噬细胞的系谱起源和亚型转换;功能研究可证明特定分子和细胞-细胞相互作用的调控作用。例如,空间全息技术可精确定位巨噬细胞的空间龛位,并在空间背景下确认其微环境和相互作用。集成单细胞技术,如 scATAC-seq 和 CITE-seq 可以研究系统生物学的不同层面,包括表观遗传学、转录和蛋白质在生理和病理过程中的作用。9 目前,已经构建了正常和疾病状态下各种器官的单细胞图谱,并从人类细胞图谱和基因型-组织表达中获得了不同器官和疾病的大量数据。在癌症研究中,泛癌症研究整合了各种数据,对巨噬细胞进行了精细注释。Daccache 等人
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引用次数: 0
“Single-cell multimodal chromatin profiles revealing epigenetic regulations of cells in hepatocellular carcinoma” "单细胞多模式染色质图谱揭示肝癌细胞的表观遗传调控"
Pub Date : 2024-10-18 DOI: 10.1002/ctd2.70002
Vikas Kumar, Samuel Beck

Hepatocellular carcinoma (HCC), with its increasing prevalence globally, is emerging as a major health challenge. Hepatocellular carcinoma cells exhibit both significant homogeneity and heterogeneity, governed by complex epigenomic regulations. Recently, numerous single-cell unimodal techniques have been used to study HCC at various levelswhich have already revealed a complex interplay at genomic, transcriptomic, spatial and epigenomic levels. However, the use of single-cell multimodal techniques combining different unimodal layers in HCC remains quite limited, necessitating further studies focusing on these methods to uncover novel markers, and mechanisms at epigenetic levels. In this commentary, we highlight how integrating multimodal approaches with epigenetic modifications can provide new insights into HCC and foster future therapeutic advancements.

肝细胞癌(HCC)在全球的发病率越来越高,正在成为一项重大的健康挑战。在复杂的表观基因组调控下,肝癌细胞表现出明显的同质性和异质性。最近,许多单细胞单模态技术被用于从不同层面研究 HCC,这些技术已经揭示了基因组、转录组、空间和表观基因组层面的复杂相互作用。然而,结合不同单模态层的单细胞多模态技术在 HCC 中的应用仍然相当有限,因此有必要进一步研究这些方法,以发现新的标记和表观遗传学水平的机制。在这篇评论中,我们将重点介绍将多模态方法与表观遗传修饰相结合如何为 HCC 提供新的见解并促进未来的治疗进展。
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引用次数: 0
Liquid biopsy—A biomarker-based revolutionising technique in cancer therapy 液体活检--基于生物标记的癌症治疗革命性技术
Pub Date : 2024-10-10 DOI: 10.1002/ctd2.70006
Subham Sarkar, Samraggi Chakraborty, Soubhagya Ghosh, Ekanansha Roy Chowdhury, Jenifer Rajak, Arup Kumar Mitra, Ajoy Kumer, Bikram Dhara

Background and Aims

Cancer has grabbed the attention of scientists and medical professionals all over the world much more than any other disease. In the past few decades, the medical field has improved quite a lot but progress in the path to find a solution for cancer is very less. As the popularity of invasive technologies is diminishing in cancer treatment, scientists have come up withminimally invasive or non-invasive alternatives, among which liquid biopsy, by far is the most suitable.

Methods

Liquid biopsy is used to analyse nucleic acids, subcellular components and circulating tumour cells in various biological fluids for diagnosis of cancer. It can also be used to know the efficacy of cancer drugs in a patient by analysing multiple samples.

Outcomes

Liquid biopsy is becoming standard of care as it allows biopsy of those samples in which solid tumour biopsies are not possible. The diversity of sampling procedures, such as collection of urine for urothelial carcinoma or bladder or prostate cancer and phlebotomy for other types of cancer, make liquid biopsy one of the best methods for diagnosis of cancer.

Conclusion

This review aims in discussing the several techniques used for the detection of cancer biomarkers and some clinical manifestations due to the changes in the biomarkers which are analysed by liquid biopsy.

背景与目标 癌症比其他任何疾病都更能吸引全世界科学家和医学专家的关注。在过去的几十年里,医学领域有了很大的进步,但在寻找癌症解决方案的道路上却进展甚微。随着侵入性技术在癌症治疗中的普及,科学家们提出了微创或非侵入性的替代方法,其中液体活检是迄今为止最合适的方法。 方法 液体活检用于分析各种生物液体中的核酸、亚细胞成分和循环肿瘤细胞,以诊断癌症。它还可通过分析多个样本了解抗癌药物对患者的疗效。 成果 液体活检正在成为标准的治疗方法,因为它可以对无法进行实体瘤活检的样本进行活检。液体活检的取样程序多种多样,如收集尿液用于尿路上皮癌或膀胱癌或前列腺癌,以及抽血用于其他类型的癌症,因此液体活检是诊断癌症的最佳方法之一。 结论 本综述旨在讨论用于检测癌症生物标志物的几种技术,以及通过液体活检分析的生物标志物变化引起的一些临床表现。
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引用次数: 0
Developing messenger RNA biomarkers: A workflow to characterise and identify transcript target sequences unaffected by alternative splicing for reproducible gene transcript quantification by reverse transcriptase quantitative polymerase chain reaction 开发信使 RNA 生物标记物:表征和识别不受替代剪接影响的转录本目标序列的工作流程,以便通过反转录酶定量聚合酶链反应对基因转录本进行可重复的定量分析
Pub Date : 2024-10-07 DOI: 10.1002/ctd2.70009
Bhaja Krushna Padhi, Guillaume Pelletier

Most eukaryotic genes generate multiple messenger RNA (mRNA) transcript variants by alternative splicing. The incomplete annotation of gene transcripts in genomic databases can result in improper primer design, adversely affecting the reliability of gene expression measurements by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR). Hence, we present a workflow combining bioinformatics analyses, to select two to three evolutionarily conserved constitutive exons in rats, mice and humans as target sequences for PCR primer design, with experimental RT-PCR amplification and amplicon sequencing to confirm the expression and identity of gene transcript targets. The application of this workflow to the characterization of neurodevelopmental biomarker genes identified an unannotated exon in the rat Map2 gene, illustrating the importance of target sequence validation for the development of translational mRNA biomarkers for toxicological and biomedical studies.

大多数真核生物基因通过替代剪接产生多种信使 RNA(mRNA)转录本变体。基因组数据库中基因转录本的注释不完整会导致引物设计不当,从而影响反转录酶定量聚合酶链反应(RT-qPCR)测量基因表达的可靠性。因此,我们提出了一种工作流程,将生物信息学分析与实验性 RT-PCR 扩增和扩增子测序相结合,选择大鼠、小鼠和人类中两到三个进化上保守的组成外显子作为 PCR 引物设计的目标序列,以确认基因转录物目标的表达和身份。将这一工作流程应用于神经发育生物标记基因的表征,发现了大鼠 Map2 基因中一个未注释的外显子,说明了靶序列验证对于开发用于毒理学和生物医学研究的翻译 mRNA 生物标记的重要性。
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引用次数: 0
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Clinical and translational discovery
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