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High serum magnesium level is associated with increased mortality in patients with sepsis: an international, multicenter retrospective study
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-17 DOI: 10.1002/mco2.713
Le Li, Li Li, Qiuyue Zhao, Xiao Liu, Yaohui Liu, Kailin Guo, Dongsu Zhang, Chang Hu, Bo Hu

Magnesium imbalances commonly exist in septic patients. However, the association of serum magnesium levels with mortality in septic patients remains uncertain. Herein, we elucidated the association between serum magnesium and all-cause mortality in septic patients from American and Chinese cohorts by analyzing data from 9099 patients in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and 1727 patients from a university-affiliated hospital’ intensive care unit in China. Patients in both cohorts were categorized into five groups based on serum magnesium quintiles from the MIMIC-IV dataset. Patients with higher serum magnesium levels exhibited an increased risk of 28-day mortality in both cohorts. The restricted cubic spline (RCS) curves revealed a progressively elevated risk of 28-day mortality with increasing serum magnesium in MIMIC-IV cohort, while a J-shaped correlation was observed in institutional cohort. Our findings have validated the association between high serum magnesium and high mortality in sepsis across different races and medical conditions. Serum magnesium levels might be useful in identifying septic patients at higher mortality risk.

脓毒症患者通常会出现镁失衡。然而,脓毒症患者血清镁水平与死亡率的关系仍不确定。在此,我们通过分析美国重症监护医学信息市场-IV(MIMIC-IV)数据库中的 9099 名患者和中国某大学附属医院重症监护室的 1727 名患者的数据,阐明了中美两国脓毒症患者血清镁与全因死亡率之间的关系。根据 MIMIC-IV 数据集中的血清镁五分位数,两个队列中的患者被分为五组。在两个队列中,血清镁水平越高的患者 28 天内死亡的风险越高。受限立方样条曲线(RCS)显示,随着血清镁的增加,MIMIC-IV 组群的 28 天死亡风险逐渐升高,而在机构组群中则观察到了 J 型相关性。我们的研究结果验证了不同种族和医疗条件的败血症患者血清镁高与死亡率高之间的关联。血清镁水平可能有助于识别死亡率较高的脓毒症患者。
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引用次数: 0
Liver cirrhosis: molecular mechanisms and therapeutic interventions
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-17 DOI: 10.1002/mco2.721
Zihe Dong, Yeying Wang, Weilin Jin

Liver cirrhosis is the end-stage of chronic liver disease, characterized by inflammation, necrosis, advanced fibrosis, and regenerative nodule formation. Long-term inflammation can cause continuous damage to liver tissues and hepatocytes, along with increased vascular tone and portal hypertension. Among them, fibrosis is the necessary stage and essential feature of liver cirrhosis, and effective antifibrosis strategies are commonly considered the key to treating liver cirrhosis. Although different therapeutic strategies aimed at reversing or preventing fibrosis have been developed, the effects have not be more satisfactory. In this review, we discussed abnormal changes in the liver microenvironment that contribute to the progression of liver cirrhosis and highlighted the importance of recent therapeutic strategies, including lifestyle improvement, small molecular agents, traditional Chinese medicine, stem cells, extracellular vesicles, and gut remediation, that regulate liver fibrosis and liver cirrhosis. Meanwhile, therapeutic strategies for nanoparticles are discussed, as are their possible underlying broad application and prospects for ameliorating liver cirrhosis. Finally, we also reviewed the major challenges and opportunities of nanomedicine‒biological environment interactions. We hope this review will provide insights into the pathogenesis and molecular mechanisms of liver cirrhosis, thus facilitating new methods, drug discovery, and better treatment of liver cirrhosis.

肝硬化是慢性肝病的终末阶段,以炎症、坏死、晚期纤维化和再生结节形成为特征。长期的炎症可造成肝组织和肝细胞的持续损伤,并伴有血管张力增高和门静脉高压。其中,纤维化是肝硬化的必经阶段和基本特征,有效的抗纤维化策略通常被认为是治疗肝硬化的关键。虽然旨在逆转或预防肝纤维化的治疗策略层出不穷,但效果并不尽如人意。在这篇综述中,我们讨论了导致肝硬化进展的肝脏微环境异常变化,并强调了近期治疗策略的重要性,包括改善生活方式、小分子制剂、传统中药、干细胞、细胞外囊泡和肠道修复等,这些策略可调节肝纤维化和肝硬化。同时,我们还讨论了纳米粒子的治疗策略,以及其在改善肝硬化方面可能的广泛应用和前景。最后,我们还回顾了纳米医学与生物环境相互作用的主要挑战和机遇。我们希望这篇综述能为肝硬化的发病机理和分子机制提供见解,从而促进肝硬化的新方法、新药发现和更好的治疗。
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引用次数: 0
N1-methylpseudouridine modification level correlates with protein expression, immunogenicity, and stability of mRNA
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-17 DOI: 10.1002/mco2.691
Shaoyi Chen, Zheng Liu, Jingsheng Cai, Haoran Li, Mantang Qiu
<p>Dear Editor,</p><p>Messenger RNA (mRNA) has undergone significant evolution, emerging as a robust platform for diverse therapeutic applications such as vaccines, protein replacement, and adoptive cell therapy across infectious, cancer, and immunological diseases. In vitro transcribed mRNA offers distinct advantages, including cytoplasmic transient expression, devoid of the risk of genomic integration. Nucleotide modifications, such as pseudouridine (Ψ), N1-methylpseudouridine (m1Ψ), and 5-methylcytidine (m5C), play pivotal roles in mRNA immunogenicity, stability, and translational efficiency. Notably, standing out as a state-of-the-art modification, global m1Ψ modification has been performed in the two approved mRNA vaccines against severe acute respiratory syndrome coronavirus 2, mRNA-1273, and BNT162b2. The in vivo stability and translational duration of synthesized mRNA are partially restricted by its immunogenicity. Recognition of foreign RNA by toll-like receptor 3 (TLR3), TLR7, TLR8, and retinoic acid-inducible gene I (RIG-I)-like receptors triggers innate immunity, leading to RNA degradation.<span><sup>1, 2</sup></span> The therapeutic application of mRNA necessitates a delicate balance between immune activation and protein expression. For infectious disease vaccines, chemical modifications can minimize inflammatory responses while ensuring effective mRNA translation. Conversely, cancer vaccines require adequate innate immune stimulation for anti-tumor immunity. Thus far, most studies have investigated alternative m1Ψ modification individually or combined with others. However, it is unknown whether m1Ψ modification ratio in mRNA has an impact on the delicate balance between immunogenicity, stability, and translational efficiency.</p><p>Therefore, we synthesized mRNA encoding enhanced green fluorescent protein (mEGFP) with different m1Ψ modification ratios (5%, 10%, 20%, 50%, 75%, and 100%) through in vitro transcription. HEK-293T cells were transfected with unmodified mEGFP or m1Ψ-modified m1ΨEGFP (m1ΨEGFP-5%, m1ΨEGFP-10%, m1ΨEGFP-20%, m1ΨEGFP-50%, m1ΨEGFP-75%, and m1ΨEGFP-100%). The expression and duration of EGFP were assessed using flow cytometry over a 6-day period. As depicted in Figure 1A (upper part), m1ΨEGFP-5%, m1ΨEGFP-10%, and m1ΨEGFP-20% group exhibited a higher percentage of EGFP-positive cells (EGFP<sup>+</sup>cells %) and mean fluorescence intensity (MFI) compared to mEGFP group. Conversely, m1ΨEGFP-50%, m1ΨEGFP-75%, and m1ΨEGFP-100% group had lower EGFP<sup>+</sup>cells % and MFI. Notably, the EGFP<sup>+</sup>cells % and MFI of cells transfected with m1ΨEGFP-50%, m1ΨEGFP-75%, and m1ΨEGFP-100% were barely undetectable on day 6. EGFP expression detected by Western Blot on days 3, 4, and 5 was consistent with the flow cytometry (Figure 1A, bottom part, and Figure S1A). In summary, our finding indicates that the m1Ψ modification ratio might impact both mRNA translational ability and duration in HEK-293T cells.</p><p>To valida
亲爱的编辑,信使核糖核酸(mRNA)经历了重大的演变,已成为疫苗、蛋白质替代品和收养性细胞疗法等多种治疗应用的强大平台,可用于各种传染病、癌症和免疫学疾病。体外转录 mRNA 具有独特的优势,包括细胞质瞬时表达,没有基因组整合的风险。核苷酸修饰,如假尿苷(Ψ)、N1-甲基假尿苷(m1Ψ)和 5-甲基胞苷(m5C),在 mRNA 的免疫原性、稳定性和翻译效率方面起着关键作用。值得注意的是,作为最先进的修饰技术,m1Ψ全局修饰已在两种获批的 mRNA 疫苗中得到应用,这两种疫苗分别是针对严重急性呼吸道综合征冠状病毒 2 的 mRNA-1273,以及针对 BNT162b2 的 mRNA-1273。合成的 mRNA 在体内的稳定性和翻译持续时间部分受到其免疫原性的限制。外来 RNA 被类收费受体 3(TLR3)、TLR7、TLR8 和类视黄酸诱导基因 I(RIG-I)受体识别后会触发先天性免疫,导致 RNA 降解。对于传染病疫苗来说,化学修饰可以最大限度地减少炎症反应,同时确保 mRNA 的有效翻译。相反,癌症疫苗则需要充分的先天免疫刺激以获得抗肿瘤免疫力。迄今为止,大多数研究都是单独或结合其他方法研究替代性 m1Ψ 修饰。因此,我们通过体外转录合成了不同m1Ψ修饰比例(5%、10%、20%、50%、75%和100%)的编码增强型绿色荧光蛋白(mEGFP)的mRNA。用未修饰的 mEGFP 或 m1Ψ 修饰的 m1ΨEGFP (m1ΨEGFP-5%、m1ΨEGFP-10%、m1ΨEGFP-20%、m1ΨEGFP-50%、m1ΨEGFP-75% 和 m1ΨEGFP-100%)转染 HEK-293T 细胞。使用流式细胞术评估了 6 天内 EGFP 的表达和持续时间。如图 1A(上半部分)所示,与 mEGFP 组相比,m1ΨEGFP-5%、m1ΨEGFP-10% 和 m1ΨEGFP-20% 组表现出更高的 EGFP 阳性细胞百分比(EGFP+细胞百分比)和平均荧光强度(MFI)。相反,m1ΨEGFP-50%、m1ΨEGFP-75% 和 m1ΨEGFP-100% 组的 EGFP+ 细胞百分比和 MFI 较低。值得注意的是,转染 m1ΨEGFP-50%、m1ΨEGFP-75% 和 m1ΨEGFP-100% 的细胞在第 6 天几乎检测不到 EGFP+ 细胞% 和 MFI。第 3、4 和 5 天 Western 印迹检测到的 EGFP 表达与流式细胞术结果一致(图 1A 底部和图 S1A)。总之,我们的发现表明,m1Ψ修饰比例可能会影响mRNA在HEK-293T细胞中的翻译能力和持续时间。为了在其他细胞类型中验证结果,我们用未修饰和m1Ψ修饰的mRNA转染了RAW264.7和Jurkat细胞(图1B,左侧部分)。在 RAW264.7 细胞中,m1ΨEGFP-10% 组的 EGFP+ 细胞百分比和 MFI 最高,而 m1ΨEGFP-100% 组最低。同样,在 Jurkat 细胞中,m1ΨEGFP-5% 组的 EGFP+ 细胞百分比和 MFI 最高,而 m1ΨEGFP-50% 组最低。与 HEK-293T 细胞一致,低 m1Ψ 比修饰的 mRNA 比未修饰的 mRNA 蛋白表达更好,持续时间更长,而高 m1Ψ 比修饰的 mRNA 蛋白表达更差。在 A549 细胞中,5% 的 m1Ψ 修饰显示出最高的 EGFP+ 细胞百分比和 MFI,而其他比率显示出与未修饰相似。在 H1299 细胞中,与 mEGFP 相比,50%、75% 和 100% 的 m1Ψ 修饰会降低 EGFP+ 细胞百分比和 MFI。在 LLC 细胞中,m1ΨEGFP-5% 和 m1ΨEGFP-10% 的 EGFP 表达高于 mEGFP,而 m1ΨEGFP-50%、m1ΨEGFP-75% 和 m1ΨEGFP-100% 的 EGFP 表达较低,其中 m1ΨEGFP-100% 的表达最低。为了尽量减少内吞、胞内逃逸、转运和降解等细胞因素的影响,我们采用了无细胞翻译系统来直接分析蛋白质翻译。有趣的是,75%和100%的修饰都有增强蛋白质翻译的趋势,但只有100%的修饰有显著差异(图1C,左侧部分)。值得注意的是,在细胞中蛋白表达增强的 m1ΨEGFP-5%、m1ΨEGFP-10%、m1ΨEGFP-20% 和 m1ΨEGFP-50% 在无细胞系统中并没有更高的蛋白产量。尽管之前的研究表明全局 m1Ψ 修饰会提高蛋白质的表达,3 但碱基修饰会改变 mRNA 的二级结构,翻译的改变取决于修饰的位置。
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引用次数: 0
Copper homeostasis and cuproptosis in health and disease
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-17 DOI: 10.1002/mco2.724
Yunuo Yang, Jiaxuan Wu, Lisheng Wang, Guang Ji, Yanqi Dang

Copper is a vital trace element in human physiology, essential for the synthesis of numerous crucial metabolic enzymes and facilitation of various biological processes. Regulation of copper levels within a narrow range is imperative for maintaining metabolic homeostasis. Numerous studies have demonstrated the significant roles of copper homeostasis and cuproptosis in health and disease pathogenesis. However, a comprehensive and up-to-date systematic review in this domain remains absent. This review aims to consolidate recent advancements in understanding the roles of cuproptosis and copper homeostasis in health and disease, focusing on the underlying mechanisms and potential therapeutic interventions. Dysregulation of copper homeostasis, manifesting as either copper excess or deficiency, is implicated in the etiology of various diseases. Cuproptosis, a recently identified form of cell death, is characterized by intracellular copper overload. This phenomenon mediates a diverse array of evolutionary processes in organisms, spanning from health to disease, and is implicated in genetic disorders, liver diseases, neurodegenerative disorders, and various cancers. This review provides a comprehensive summary of the pathogenic mechanisms underlying cuproptosis and copper homeostasis, along with associated targeted therapeutic agents. Furthermore, it explores future research directions with the potential to yield significant advancements in disease treatment, health management, and disease prevention.

铜是人体生理中的一种重要微量元素,是合成多种重要代谢酶和促进各种生物过程所必需的。要维持新陈代谢的平衡,就必须将铜的含量控制在一个很小的范围内。大量研究表明,铜平衡和铜中毒在健康和疾病发病机制中发挥着重要作用。然而,在这一领域仍然缺乏全面、最新的系统综述。本综述旨在整合近期在理解铜氧化酶和铜稳态在健康和疾病中的作用方面取得的进展,重点关注其潜在机制和潜在的治疗干预措施。铜平衡失调表现为铜过剩或缺乏,与多种疾病的病因有关。铜中毒是最近发现的一种细胞死亡形式,其特点是细胞内铜超载。这种现象介导了生物体从健康到疾病的各种进化过程,并与遗传性疾病、肝脏疾病、神经退行性疾病和各种癌症有关。本综述全面总结了铜氧化酶和铜平衡的致病机制,以及相关的靶向治疗药物。此外,它还探讨了未来的研究方向,有望在疾病治疗、健康管理和疾病预防方面取得重大进展。
{"title":"Copper homeostasis and cuproptosis in health and disease","authors":"Yunuo Yang,&nbsp;Jiaxuan Wu,&nbsp;Lisheng Wang,&nbsp;Guang Ji,&nbsp;Yanqi Dang","doi":"10.1002/mco2.724","DOIUrl":"https://doi.org/10.1002/mco2.724","url":null,"abstract":"<p>Copper is a vital trace element in human physiology, essential for the synthesis of numerous crucial metabolic enzymes and facilitation of various biological processes. Regulation of copper levels within a narrow range is imperative for maintaining metabolic homeostasis. Numerous studies have demonstrated the significant roles of copper homeostasis and cuproptosis in health and disease pathogenesis. However, a comprehensive and up-to-date systematic review in this domain remains absent. This review aims to consolidate recent advancements in understanding the roles of cuproptosis and copper homeostasis in health and disease, focusing on the underlying mechanisms and potential therapeutic interventions. Dysregulation of copper homeostasis, manifesting as either copper excess or deficiency, is implicated in the etiology of various diseases. Cuproptosis, a recently identified form of cell death, is characterized by intracellular copper overload. This phenomenon mediates a diverse array of evolutionary processes in organisms, spanning from health to disease, and is implicated in genetic disorders, liver diseases, neurodegenerative disorders, and various cancers. This review provides a comprehensive summary of the pathogenic mechanisms underlying cuproptosis and copper homeostasis, along with associated targeted therapeutic agents. Furthermore, it explores future research directions with the potential to yield significant advancements in disease treatment, health management, and disease prevention.</p>","PeriodicalId":94133,"journal":{"name":"MedComm","volume":null,"pages":null},"PeriodicalIF":10.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mco2.724","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244542","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
Patient-reported outcome and survival in premenopausal hormone receptor-positive breast cancer patients at moderate to high risk: comparing toremifene with aromatase inhibitor in a real-world study 中高风险绝经前激素受体阳性乳腺癌患者的患者报告结果和生存率:在一项真实世界研究中比较托瑞米芬和芳香化酶抑制剂
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-15 DOI: 10.1002/mco2.698
Yaping Yang, Fengxia Gan, Ting Luo, Qun Lin, Wenqian Yang, Lili Chen, Wei Zhang, Qiang Liu, Chang Gong

Toremifene, a selective estrogen receptor modulator, is commonly used in China for premenopausal breast cancer patients. This real-world study aimed to compare patient-reported outcome (PRO) and survival between toremifene and aromatase inhibitor (AI) plus ovarian function suppression (OFS) in patients with moderate-/high-risk premenopausal hormone receptor (HR)-positive breast cancer. The primary endpoint was PROs, assessed using SF-36 and EQ-5D-5L questionnaires between January and March 2023. A total of 392 patients were included, with 171 receiving toremifene and 221 receiving AI. The toremifene group showed significantly higher scores in the role physical (p = 0.034) and mental health (= 0.009) dimensions of SF-36 and lower anxiety/depression (AD) scores (= 0.038) in EQ-5D-5L compared to AI group. The estimated 5- and 8-year disease-free survival (DFS) rates were similar in toremifene and AI groups: 96.5% versus 91.9%, and 87.4% versus 87.8% (= 0.39), respectively. Adverse event rates were similar in two groups, except for a greater risk of endometrial thickening (< 0.001) and a lower occurrence of morning stiffness (< 0.001) in the toremifene compared to the AI group. Premenopausal HR-positive breast cancer patients receiving toremifene plus OFS had better role physical and mental health outcomes and lower AD dimensions than those receiving AI plus OFS. Both treatments had comparable DFS and favorable tolerability profiles.

托瑞米芬是一种选择性雌激素受体调节剂,在中国常用于治疗绝经前乳腺癌患者。这项真实世界研究旨在比较托瑞米芬与芳香化酶抑制剂(AI)加卵巢功能抑制(OFS)治疗中度/高风险绝经前激素受体(HR)阳性乳腺癌患者的患者报告结果(PRO)和生存率。主要终点是PROs,在2023年1月至3月期间使用SF-36和EQ-5D-5L问卷进行评估。该研究共纳入了392名患者,其中171人接受了托瑞米芬治疗,221人接受了人工受孕治疗。与人工流产组相比,托瑞米芬组在SF-36的生理作用(p = 0.034)和心理健康(p = 0.009)维度上的得分明显更高,而在EQ-5D-5L中的焦虑/抑郁(AD)得分(p = 0.038)则更低。估计的 5 年和 8 年无病生存率(DFS)在托瑞米芬组和人工受精组相似:分别为 96.5% 对 91.9% 和 87.4% 对 87.8% (p = 0.39)。两组的不良事件发生率相似,但托瑞米芬组比人工授精组发生子宫内膜增厚的风险更高(p <0.001),发生晨僵的风险更低(p <0.001)。接受托瑞米芬+OFS治疗的绝经前HR阳性乳腺癌患者与接受AI+OFS治疗的患者相比,具有更好的身心健康效果和更低的AD维度。两种治疗方法的 DFS 和耐受性情况相当。
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引用次数: 0
A novel small molecule ZYZ384 targeting SMYD3 for hepatocellular carcinoma via reducing H3K4 trimethylation of the Rac1 promoter 新型小分子 ZYZ384 通过减少 Rac1 启动子的 H3K4 三甲基化,靶向 SMYD3 治疗肝细胞癌
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-15 DOI: 10.1002/mco2.711
Qian Ding, Jianghong Cai, Li Jin, Wei Hu, Wu Song, Peter Rose, Zhiyuan Tang, Yangyang Zhan, Leilei Bao, Wei Lei, Yi Zhun Zhu

SMYD3 (SET and MYND domain-containing 3) is a histone lysine methyltransferase highly expressed in different types of cancer(s) and is a promising epigenetic target for developing novel antitumor therapeutics. No selective inhibitors for this protein have been developed for cancer treatment. Therefore, the current study describes developing and characterizing a novel small molecule ZYZ384 screened and synthesized based on SMYD3 structure. Virtual screening was initially used to identify a lead compound and followed up by modification to get the novel molecules. Several technologies were used to facilitate compound screening about these novel molecules' binding affinities and inhibition activities with SMYD3 protein; the antitumor activity has been assessed in vitro using various cancer cell lines. In addition, a tumor-bearing nude mice model was established, and the activity of the selected molecule was determined in vivo. Both RNA-seq and chip-seq were performed to explore the antitumor mechanism. This work identified a novel small molecule ZYZ384 targeting SMYD3 with antitumor activity and impaired hepatocellular carcinoma tumor growth by reducing H3K4 trimethylation of the Rac1 promoter triggering the tumor cell cycle arrest through the AKT pathway.

SMYD3(含 SET 和 MYND 结构域的 3)是一种组蛋白赖氨酸甲基转移酶,在不同类型的癌症中高度表达,是开发新型抗肿瘤疗法的一个有前景的表观遗传学靶点。目前尚未开发出治疗癌症的该蛋白选择性抑制剂。因此,本研究介绍了根据 SMYD3 结构筛选和合成的新型小分子 ZYZ384 的开发和表征情况。虚拟筛选最初用于确定先导化合物,随后通过修饰得到新型分子。研究人员利用多种技术对这些新型分子与 SMYD3 蛋白的结合亲和力和抑制活性进行了化合物筛选;并利用多种癌症细胞系对其抗肿瘤活性进行了体外评估。此外,还建立了肿瘤裸鼠模型,并在体内测定了所选分子的活性。为探索抗肿瘤机制,还进行了 RNA-seq 和芯片-seq 研究。这项研究发现了一种靶向SMYD3的新型小分子ZYZ384,它具有抗肿瘤活性,通过减少Rac1启动子的H3K4三甲基化,通过AKT通路引发肿瘤细胞周期停滞,从而抑制肝细胞癌肿瘤的生长。
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引用次数: 0
Unlocking fresh perspectives: molecular breakthroughs in pediatric acute myeloid leukemia classification and prognosis 打开新视角:小儿急性髓性白血病分类和预后的分子突破
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-15 DOI: 10.1002/mco2.750
Yu Tao, Li Wei, Hua You
<p>Recently, a novel transcriptome and genome profiling study published in the <i>Journal of Nature Genetics</i>, expanded the prognosis-related molecular classification coverage of pediatric acute myeloid leukemia (pAML) from 68.5% (as defined by the WHO 5th edition) to 91.4%.<span><sup>1</sup></span> This framework was strongly associated with clinical outcomes, potentially shaping future classifications and treatment of pediatric AML.</p><p>Differences in molecular profiles between pediatric and adult AML restrict the use of risk stratification tools designed for adults when applied to pediatric patients. For instance, while the TP53 mutation, present in about 8% of adult AML cases and linked to poor outcomes, is emphasized in the European LeukemiaNet (ELN) 2022 guidelines,<span><sup>2</sup></span> it is infrequently observed in pediatric AML. Furthermore, numerous driver alterations that are specific to pediatric cases are not adequately represented in the existing classification schemas, and risk stratification for pediatric AML is still evolving. This prompted Umeda and colleagues to comprehensively explore the increasingly intricate genomic landscape within the framework of the latest hematological malignancy classification systems and to create a categorization system uniquely designed for pediatric AML.</p><p>In their study, RNA sequencing (RNA-seq) data of 887 pAML patients were assessed, complemented by DNA sequencing data, allowing for a comprehensive examination of genetic features, including internal or partial tandem duplications (ITD/PTD), copy-number variations, single nucleotide mutations, fusions, and insertions and deletions (indels). It was revealed that while WHO 5th identified 68.5% of pAML cases with specified genetic alterations, the new pAML classification system, which incorporates 12 additional molecular categories, captures 91.4% of cases. The discovery of these new major entities such as UBTF tandem duplications, GLIS family rearrangements, and BCL11B structural variants and outlier expression will lead to greater attention and analysis of these patients’ biological and clinical features.</p><p>Further clinicopathological association analysis revealed that pAML morphological features are defined by the identified driver alterations and developmental stages. Given that numerous category-defining alterations are either cytogenetically obscure or involve somatic mutations, this underscores the necessity for sequencing techniques to achieve precise molecular diagnosis of pAML. As for gene expression, molecular categories with favorable prognosis (such as CBFB::MYH11, CEBPA, RUNX1::RUNX1T1) typically exhibited high granulocyte–monocyte progenitor scores. Conversely, KMT2Ar, associated with poor prognosis, had low stemness-related scores and variable differentiation-related scores. The differences in the aforementioned prognosis or drug–response-related patterns reflect that molecular categories are associated with unique
最近,发表在《自然遗传学杂志》(Journal of Nature Genetics)上的一项新型转录组和基因组剖析研究将小儿急性髓性白血病(pAML)与预后相关的分子分类覆盖率从68.5%(根据世界卫生组织第五版的定义)扩大到91.4%。例如,欧洲白血病网络(ELN)2022 年指南2 强调了 TP53 突变,这种突变在成人急性髓细胞白血病病例中约占 8%,并与不良预后有关,但在儿科急性髓细胞白血病中却很少见。此外,儿科病例特有的许多驱动基因改变在现有的分类模式中没有得到充分体现,儿科急性髓细胞白血病的风险分层仍在不断发展。这促使 Umeda 及其同事在最新的血液恶性肿瘤分类系统框架内全面探索日益复杂的基因组状况,并创建了一套专为小儿急性髓细胞白血病设计的分类系统。在他们的研究中,对887名小儿急性髓细胞性白血病患者的RNA测序(RNA-seq)数据进行了评估,并辅以DNA测序数据,从而对遗传特征进行了全面检查,包括内部或部分串联重复(ITD/PTD)、拷贝数变异、单核苷酸突变、融合以及插入和缺失(indels)。研究显示,世卫组织第 5 次发现 68.5%的 pAML 病例存在特定的基因改变,而新的 pAML 分类系统则纳入了 12 个额外的分子类别,涵盖了 91.4% 的病例。UBTF串联重复、GLIS家族重排、BCL11B结构变异和离群表达等这些新的主要实体的发现,将使人们更加关注和分析这些患者的生物学和临床特征。鉴于许多定义类别的改变要么在细胞遗传学上不明显,要么涉及体细胞突变,这凸显了测序技术对实现 pAML 精确分子诊断的必要性。在基因表达方面,预后良好的分子类别(如 CBFB::MYH11、CEBPA、RUNX1::RUNX1T1)通常表现出较高的粒细胞-单核细胞祖细胞评分。相反,与预后不良相关的KMT2Ar,其干细胞相关评分较低,分化相关评分不一。上述预后或药物反应相关模式的差异反映出分子类别与独特的病理生理学特征相关。考虑到类别间的相似性,形成了广泛的集群,包括 AMKL/AEL、CBF 白血病、未成熟 AML、CEBPA 以及以 HOXA 和 HOXB 基因表达为特征的两个集群。具体来说,HOXA和HOXB组在干细胞相关基因、单核细胞相关基因或信号相关基因的表达以及突变模式方面表现出明显的差异。具有HOXB特征的分子类别与FLT3-ITD和WT1突变密切相关,而具有HOXA特征的类别则与KRAS突变有关。这一发现为同一群组的共同生物学机制和潜在个性化疗法提供了理论依据。在887例pAML患者中,有76例仍未分类。21例有已知的驱动基因改变,9例未检测到致病基因改变,其余至少有一种致病基因改变,涉及骨髓增生异常相关基因、ETV6、RUNX1和TP53等基因,同时伴有复杂的核型,但未定义特定亚型。目前,我们已经对这 23 种分子类型的突变和表达特征有了全面的了解。然而,这些分子类别,尤其是新定义的分子类别,是否与临床结果相关?来自 AAML1031 试验的数据证实了这些类别、诊断年龄、FLT3-ITD 受累和最小残留病(MRD)阳性之间的关联。例如,PICALM::MLLT10、UTBTF 和 KAT6Ar 被确定为高风险组,而 CBFB-GDXY 插入被归类为低风险组。
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引用次数: 0
Androgen-type 2 innate lymphoid cells-dendritic cell axis modulates sex-associated differences in skin immune responses 雄激素 2 型先天淋巴细胞-树突状细胞轴调节皮肤免疫反应中与性别相关的差异
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-15 DOI: 10.1002/mco2.732
Shi-Jun He, Jian-Ping Zuo, Ze-Min Lin
<p>A recent study by Chi and colleagues in <i>Science</i> identified skin type 2 innate lymphoid cells (ILC2s) as crucial for maintaining skin dendritic cell (DC) network homeostasis through cytokine production.<span><sup>1</sup></span> Their findings reveal that the interplay between sex hormones and the microbiota shapes tissue immune set points and DC network strength, with hormones influencing local immunity and the microbiota modulating its intensity.</p><p>Differences in the immune systems of females and males contribute to observed sexual dimorphisms in susceptibility to a range of diseases, including cancers, autoimmune diseases, allergies, and infectious diseases, including coronavirus disease 2019, particularly in barrier tissues which are primary sites for infections and are regulated by a complex microbial community. Laffont et al. first identified the role of androgen signaling in regulating ILC2 responses, showing that females have more ILC2s than males.<span><sup>2</sup></span> This disparity arises not from estrogen enhancement in females but from androgen inhibition of ILC2 maintenance and local expansion in males.<span><sup>2</sup></span> Building on this observation, Chi et al. examined the impact of androgen-mediated regulation of ILC2s on the skin DC network and its subsequent effects on adaptive immune responses.<span><sup>1</sup></span></p><p>Acting as nuclear regulators, sex hormone receptors play a pivotal role in fine-tuning immune responses at the transcriptional level, which in turn influences disease outcomes. In the domain of cancer immunology, these receptors oversee specific pathways in both the innate and adaptive immune systems, providing potential avenues for therapeutic interventions in reproductive cancers. Specifically, androgen receptor (AR) signaling has been linked to the suppression of CD8<sup>+</sup> T cell function within the tumor microenvironment.<span><sup>3</sup></span> Meanwhile, testosterone, the primary male hormone governing sex differentiation and the development of male sex characteristics, interacts with cytosolic or membrane-bound ARs to modulate gene transcription either directly or indirectly. ARs are expressed across a variety of cells, including many in developmental stages and some mature immune cells. Further studies across infectious diseases, autoimmunity, and cancer highlight testosterone's direct influence on immune cell development and function, typically leading to immunosuppressive effects.<span><sup>3</sup></span> Additionally, gender disparities in the immune system render males more susceptible to microbial infections and less effective in viral clearance, albeit affording greater protection against autoimmune diseases.<span><sup>1</sup></span> Barrier tissues serve as primary sites for infections and injury and are perpetually inhabited by a diverse microbial community that modulates host defense mechanisms. Despite this, the immune differences specific to each sex in these
Chi 及其同事最近在《科学》(Science)杂志上发表的一项研究发现,皮肤 2 型先天性淋巴细胞(ILC2s)对通过细胞因子的产生维持皮肤树突状细胞(DC)网络的平衡至关重要。他们的研究结果表明,性激素和微生物群之间的相互作用塑造了组织免疫设定点和DC网络的强度,激素影响局部免疫,微生物群调节免疫强度。女性和男性免疫系统的差异导致了对一系列疾病易感性的性双态性,这些疾病包括癌症、自身免疫性疾病、过敏和传染病,包括2019年冠状病毒疾病,尤其是在屏障组织中,因为屏障组织是感染的主要场所,并受到复杂微生物群落的调控。拉丰等人首次发现了雄激素信号在调节 ILC2 反应中的作用,表明女性的 ILC2 数量多于男性2 。基于这一观察结果,Chi 等人研究了雄激素介导的 ILC2 对皮肤 DC 网络的调控及其对适应性免疫反应的影响。在癌症免疫学领域,这些受体监督着先天性免疫系统和适应性免疫系统的特定途径,为生殖系统癌症的治疗干预提供了潜在的途径。雄激素受体(AR)信号传导与肿瘤微环境中 CD8+ T 细胞功能的抑制有关。3 同时,睾酮是控制性别分化和男性性征发育的主要雄性激素,它与细胞膜或膜结合的 ARs 相互作用,直接或间接地调节基因转录。ARs 在多种细胞中表达,包括许多处于发育阶段的细胞和一些成熟的免疫细胞。3 此外,免疫系统中的性别差异使男性更容易受到微生物感染,清除病毒的能力也更弱,但却能更好地抵御自身免疫性疾病的侵袭。尽管如此,这些组织中男女特有的免疫差异以及微生物群对它们的调节作用还没有得到很好的描述。Chi 等人的研究表明,性别差异会影响对微生物群的免疫反应,特别是影响 T 辅助细胞 17(Th17)和 T 细胞对感染的反应1 。这表现在雌性小鼠肺部和皮肤中的主要经典 T 细胞亚群(包括 Th1 细胞、Th17 细胞和产生白细胞介素-17 的 CD8+ T 细胞)数量都比雄性多。有趣的是,虽然研究发现无菌小鼠皮肤中的T细胞存在性别特异性差异,但肺中却没有这种差异,这表明性别对皮肤免疫力的影响与微生物无关。此外,Chi 等人的研究涉及用表皮葡萄球菌对成年无菌小鼠进行常规化处理,该研究加剧了性别差异,尤其是在 17 型细胞和 Treg 细胞反应方面。研究结果表明,微生物群可能在形成雌性小鼠对 17 型和 Treg 细胞免疫的性别特异性偏向方面发挥作用。在青春期前期,性激素水平较低,雌性和雄性淋巴细胞的差异很小。然而,随着性成熟的开始和雄性性激素的激增,这些差异变得更加明显。切除性腺的实验表明,雄性激素主要调节观察到的表型。值得注意的是,阉割雄性小鼠可使 T 细胞的组成和表型恢复到与雌性小鼠相似的水平,这凸显了雄性激素在决定淋巴细胞偏向中的关键作用。
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引用次数: 0
The interaction of innate immune and adaptive immune system 先天性免疫系统和适应性免疫系统的相互作用
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-15 DOI: 10.1002/mco2.714
Ruyuan Wang, Caini Lan, Kamel Benlagha, Niels Olsen Saraiva Camara, Heather Miller, Masato Kubo, Steffen Heegaard, Pamela Lee, Lu Yang, Huamei Forsman, Xingrui Li, Zhimin Zhai, Chaohong Liu

The innate immune system serves as the body's first line of defense, utilizing pattern recognition receptors like Toll-like receptors to detect pathogens and initiate rapid response mechanisms. Following this initial response, adaptive immunity provides highly specific and sustained killing of pathogens via B cells, T cells, and antibodies. Traditionally, it has been assumed that innate immunity activates adaptive immunity; however, recent studies have revealed more complex interactions. This review provides a detailed dissection of the composition and function of the innate and adaptive immune systems, emphasizing their synergistic roles in physiological and pathological contexts, providing new insights into the link between these two forms of immunity. Precise regulation of both immune systems at the same time is more beneficial in the fight against immune-related diseases, for example, the cGAS–STING pathway has been found to play an important role in infections and cancers. In addition, this paper summarizes the challenges and future directions in the field of immunity, including the latest single-cell sequencing technologies, CAR-T cell therapy, and immune checkpoint inhibitors. By summarizing these developments, this review aims to enhance our understanding of the complexity interactions between innate and adaptive immunity and provides new perspectives in understanding the immune system.

先天性免疫系统是人体的第一道防线,它利用模式识别受体(如 Toll 样受体)来检测病原体并启动快速反应机制。在最初的反应之后,适应性免疫系统通过 B 细胞、T 细胞和抗体对病原体进行高度特异性和持续性的杀灭。传统上,人们认为先天性免疫激活了适应性免疫;然而,最近的研究揭示了更为复杂的相互作用。本综述详细剖析了先天性免疫系统和适应性免疫系统的组成和功能,强调了它们在生理和病理环境中的协同作用,为人们了解这两种免疫形式之间的联系提供了新的视角。同时对两种免疫系统进行精确调控更有利于对抗免疫相关疾病,例如,研究发现 cGAS-STING 通路在感染和癌症中发挥着重要作用。此外,本文还总结了免疫领域的挑战和未来发展方向,包括最新的单细胞测序技术、CAR-T 细胞疗法和免疫检查点抑制剂。通过总结这些发展,本综述旨在加深我们对先天性免疫和适应性免疫之间复杂互动的理解,并为理解免疫系统提供新的视角。
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引用次数: 0
Anoikis in cell fate, physiopathology, and therapeutic interventions 细胞命运、生理病理和治疗干预中的无氧状态
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-15 DOI: 10.1002/mco2.718
Jie Mei, Xue-Yao Jiang, Hui-Xiang Tian, Ding-Chao Rong, Jia-Nan Song, Luozixian Wang, Yuan-Shen Chen, Raymond C. B. Wong, Cheng-Xian Guo, Lian-Sheng Wang, Lei-Yun Wang, Peng-Yuan Wang, Ji-Ye Yin

The extracellular matrix (ECM) governs a wide spectrum of cellular fate processes, with a particular emphasis on anoikis, an integrin-dependent form of cell death. Currently, anoikis is defined as an intrinsic apoptosis. In contrast to traditional apoptosis and necroptosis, integrin correlates ECM signaling with intracellular signaling cascades, describing the full process of anoikis. However, anoikis is frequently overlooked in physiological and pathological processes as well as traditional in vitro research models. In this review, we summarized the role of anoikis in physiological and pathological processes, spanning embryonic development, organ development, tissue repair, inflammatory responses, cardiovascular diseases, tumor metastasis, and so on. Similarly, in the realm of stem cell research focused on the functional evolution of cells, anoikis offers a potential solution to various challenges, including in vitro cell culture models, stem cell therapy, cell transplantation, and engineering applications, which are largely based on the regulation of cell fate by anoikis. More importantly, the regulatory mechanisms of anoikis based on molecular processes and ECM signaling will provide new strategies for therapeutic interventions (drug therapy and cell-based therapy) in disease. In summary, this review provides a systematic elaboration of anoikis, thus shedding light on its future research.

细胞外基质(ECM)控制着一系列细胞的命运过程,其中特别强调的是整合素依赖性细胞死亡形式--anoikis。目前,anoikis 被定义为一种内在凋亡。与传统的细胞凋亡和坏死不同,整合素将 ECM 信号与细胞内信号级联联系起来,描述了 anoikis 的整个过程。然而,在生理和病理过程以及传统的体外研究模型中,anoikis 经常被忽视。在这篇综述中,我们总结了anoikis在生理和病理过程中的作用,包括胚胎发育、器官发育、组织修复、炎症反应、心血管疾病、肿瘤转移等。同样,在以细胞功能进化为重点的干细胞研究领域,anoikis为体外细胞培养模型、干细胞治疗、细胞移植和工程应用等各种挑战提供了潜在的解决方案,而这些挑战主要基于anoikis对细胞命运的调控。更重要的是,基于分子过程和 ECM 信号转导的 anoikis 调节机制将为疾病的治疗干预(药物治疗和基于细胞的治疗)提供新的策略。总之,这篇综述系统地阐述了 "嗜酸性细胞",从而为其未来的研究提供了启示。
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引用次数: 0
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