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Dysregulation of Farnesoid X Receptor on Neutrophil Homeostasis Exacerbates Intestinal Inflammation via the mTORC1-Glycolysis Signaling Pathway. 通过mtorc1 -糖酵解信号通路,Farnesoid X受体对中性粒细胞稳态的失调加剧肠道炎症。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-08 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70637
Dengfeng Kang, Ai Li, Xiangqi Xie, Han Liu, Liang Chen, Zhongsheng Feng, Xiang Gao, Han Gao, Xiaohan Wu, Huiying Lu, Xiaoyu Li, Jinghan Hua, Long Ju, Haifeng Lian, Xue Li, Zhanju Liu

Neutrophils significantly accumulate within the inflamed intestinal mucosa of patients with inflammatory bowel disease (IBD), where the farnesoid X receptor (FXR) is typically downregulated. However, the mechanisms by which FXR modulates neutrophil-mediated mucosal inflammation in IBD remain elusive. Here, we demonstrated that FXR expression is markedly decreased in neutrophils from patients with active IBD. Fxr -/- mice exhibited exacerbated colitis following DSS insults or Citrobacter rodentium infection, evidenced by heightened neutrophil-driven immune responses including increased neutrophil infiltration and neutrophil extracellular trap (NET) formation. Adoptive transfer of Fxr -/- neutrophils into WT recipients exacerbated DSS-induced intestinal inflammation, indicating that FXR suppresses the pathogenic activity of neutrophils in a neutrophil-intrinsic manner. An ex vivo functional assay revealed that Fxr -/- neutrophils display elevated ROS production, NET formation, and migratory capacity upon inflammatory challenge. Mechanistically, RNA-sequencing and functional assays revealed enhanced mTORC1 signaling and glycolysis in Fxr -/- neutrophils. Consistently, pharmacological activation of FXR with INT-747 significantly restrained the mTORC1-glycolysis-mediated proinflammatory responses in neutrophils from IBD patients. Our findings identify FXR as a critical regulator of neutrophil-mediated mucosal inflammation via the mTORC1-glycolysis pathway, highlighting its therapeutic potential in IBD.

中性粒细胞在炎症性肠病(IBD)患者的炎症肠粘膜内显著积聚,其中法尼脂类X受体(FXR)通常下调。然而,FXR调节IBD中性粒细胞介导的粘膜炎症的机制尚不清楚。在这里,我们证明了活动性IBD患者中性粒细胞中FXR的表达明显降低。Fxr -/-小鼠在DSS损伤或啮齿柠檬酸杆菌感染后表现出加重的结肠炎,中性粒细胞驱动的免疫反应增强,包括中性粒细胞浸润增加和中性粒细胞胞外陷阱(NET)形成。将Fxr -/-中性粒细胞过继转移到WT受体中,会加重dss诱导的肠道炎症,表明Fxr以中性粒细胞固有的方式抑制中性粒细胞的致病活性。一项离体功能分析显示,Fxr -/-中性粒细胞在炎症挑战下显示出ROS生成、NET形成和迁移能力升高。在机制上,rna测序和功能分析显示Fxr -/-中性粒细胞的mTORC1信号传导和糖酵解增强。与此一致的是,用INT-747激活FXR可显著抑制IBD患者中性粒细胞中mtorc1糖酵解介导的促炎反应。我们的研究结果表明,FXR是中性粒细胞介导的粘膜炎症的关键调节剂,通过mtorc1 -糖酵解途径,突出了其在IBD中的治疗潜力。
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引用次数: 0
Oligodendrocyte: Development, Plasticity, Biological Functions, Diseases, and Therapeutic Targets. 少突胶质细胞:发育、可塑性、生物学功能、疾病和治疗靶点。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-08 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70618
Qiong Xiang, Ruo-Lan Shi, You-Xia Huang, Li-Ni Liu, Jia-Sheng Tao, Xian-Hui Li, Xiao-Da Li

In the past few years, the incidence rate of central nervous system (CNS) diseases is still growing. Meanwhile, the molecular mechanism on the pathogenesis of neurological diseases remains elusive. Oligodendrocyte progenitor cells (OPCs) are distributed in the whole CNS and represent a population of migrating and proliferating adult progenitor oligodendrocytes that can be differentiated into oligodendrocytes (OLs). The main function of OLs is to produce myelin, the membrane wrapping tightly around the axon, which are associated with the myelination and remyelination. During regeneration, the new OLs from OPCs can regenerate lost myelin, which prevents axonal degeneration and restores its plasticity and function. Considering these energy-consuming processes, the high metabolic turnover OLs are susceptible to neurotoxic factors and its excitatory toxicity. Thus, the pathogenesis of OPC and OL are proven in neurological diseases, such as multiple sclerosis, Alzheimer's disease, major psychiatric diseases, and epilepsy. The current study reviewed the development, plasticity as well as application of OPCs and OLs researches on CNS diseases. Additionally, the effective methods and bioengineering technologies as well as biomaterials relevant to regenerative medicine are also discussed, which could provide the novel insight into the therapeutic treatment of those diseases, exploring new pathological clues, identifying the key molecules and targets as well as the potential biomarkers.

近年来,中枢神经系统(CNS)疾病的发病率仍在不断上升。与此同时,神经系统疾病发病的分子机制尚不清楚。少突胶质细胞祖细胞(oligodendrocytes progenitor cells, OPCs)分布于整个中枢神经系统,是一群迁移和增殖的成年祖少突胶质细胞,可分化为少突胶质细胞(oligodendrocytes, OLs)。ol的主要功能是产生髓磷脂,这是一种紧密包裹轴突的膜,与髓鞘形成和再髓鞘形成有关。在再生过程中,来自OPCs的新OLs可以再生失去的髓磷脂,从而防止轴突退化并恢复其可塑性和功能。考虑到这些能量消耗过程,高代谢周转率OLs易受神经毒性因子及其兴奋性毒性的影响。因此,OPC和OL的发病机制在神经系统疾病中得到证实,如多发性硬化症、阿尔茨海默病、重大精神疾病和癫痫。本文综述了OPCs和OLs在中枢神经系统疾病中的研究进展、可塑性及其应用。此外,本文还讨论了再生医学相关的有效方法、生物工程技术和生物材料,为这些疾病的治疗提供新的思路,探索新的病理线索,确定关键分子和靶点以及潜在的生物标志物。
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引用次数: 0
State-of-the-Art Strategies for Circular RNA in Cancers: Opportunity and Challenge. 环状RNA在癌症中的最新策略:机遇与挑战。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-08 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70608
Zehao Ding, Zai Luo, Liao Zhang, Shaopeng Zhang, Renchao Zhang, Zhengjun Qiu, Chen Huang

Circular RNAs (circRNAs) are characterized by their covalently closed structure, remarkable stability, and precise spatiotemporal regulation, evolving from once-overlooked transcriptional byproducts to pivotal molecular regulators. In addition to their well-established function as microRNA sponges, circRNAs serve as protein scaffolds, transcriptional modulators, and even templates for functional peptide synthesis. This review synthesizes recent breakthroughs across the entire circRNA life cycle, encompassing biogenesis, degradation, nucleocytoplasmic transport, and extracellular vesicle-mediated secretion, while systematically analyzing their multifaceted involvement in tumorigenesis, immune evasion, metastatic dissemination, programmed cell death, and tumor-microbiome crosstalk. We highlight their exceptional potential as liquid biopsy biomarkers and critically assess translational applications in circRNA-based vaccines, targeted delivery platforms, and engineered cell therapies like CAR-T. Emerging artificial intelligence approaches that accelerate circRNA discovery, functional characterization, and therapeutic design are also discussed. Addressing current challenges in standardization and delivery methodologies, we propose future directions for incorporating circRNAs and their encoded proteins into precision oncology and next-generation immunotherapies. Together, these advances position circRNAs as a transformative paradigm with the potential to revolutionize cancer diagnostics, targeted therapeutics, and RNA vaccine development.

环状rna (circRNAs)具有共价封闭结构、显著的稳定性和精确的时空调控,从曾经被忽视的转录副产物演变为关键的分子调控因子。除了作为microRNA海绵的良好功能外,circrna还可以作为蛋白质支架、转录调节剂,甚至是功能肽合成的模板。这篇综述综合了整个circRNA生命周期的最新突破,包括生物发生、降解、核细胞质运输和细胞外囊泡介导的分泌,同时系统地分析了它们在肿瘤发生、免疫逃避、转移性传播、程序性细胞死亡和肿瘤-微生物组串话中的多方面参与。我们强调了它们作为液体活检生物标志物的特殊潜力,并严格评估了它们在基于circrna的疫苗、靶向递送平台和工程细胞疗法(如CAR-T)中的转化应用。还讨论了加速circRNA发现、功能表征和治疗设计的新兴人工智能方法。针对目前标准化和递送方法方面的挑战,我们提出了将circRNAs及其编码蛋白纳入精准肿瘤学和下一代免疫疗法的未来方向。综上所述,这些进展使环状RNA成为一种变革范例,有可能彻底改变癌症诊断、靶向治疗和RNA疫苗开发。
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引用次数: 0
Accelerate the Highly Efficient Development of mRNA Vaccines Through Advanced Computational Methods. 通过先进的计算方法加速mRNA疫苗的高效开发。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-08 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70612
Ruichu Gu, Duanmiao Si, Dingwei Lei, Xiaoxue Xie, Yongge Li, Han Wen

mRNA medicine is an emerging therapeutic approach that utilizes messenger RNA to synthesize functional proteins directly within target cells. This technology offers notable advantages including rapid development cycles, diverse therapeutic applications, and adaptable platform design for various diseases. However, mRNA therapeutic development faces substantial challenges, particularly in determining optimal mRNA sequences and developing effective delivery systems that ensure stability and achieve precise delivery. Current development processes often involve extensive experimental screening, highlighting the need for more efficient computational approaches. This review first introduces fundamental concepts in the mRNA vaccine field and systematically analyzes the roles and limitations of computational tools in advancing mRNA vaccine development across three key areas: sequence optimization, modification strategies, and delivery system optimization. Finally, we present the current application status of mRNA vaccines and discuss future prospects, highlighting emerging computational opportunities that may shape next-generation mRNA vaccine development. This review spans the entire mRNA vaccine development pipeline, providing a foundational resource for researchers and facilitating technological advancement in this rapidly evolving field.

mRNA医学是一种利用信使RNA直接在靶细胞内合成功能蛋白的新兴治疗方法。该技术具有显著的优势,包括开发周期快,治疗应用广泛,可适应各种疾病的平台设计。然而,mRNA治疗发展面临着巨大的挑战,特别是在确定最佳mRNA序列和开发有效的递送系统以确保稳定性和实现精确递送方面。目前的开发过程往往涉及广泛的实验筛选,强调需要更有效的计算方法。本文首先介绍了mRNA疫苗领域的基本概念,并系统分析了计算工具在推进mRNA疫苗开发中的作用和局限性,涉及三个关键领域:序列优化、修饰策略和递送系统优化。最后,我们介绍了mRNA疫苗的应用现状,并讨论了未来的前景,强调了可能影响下一代mRNA疫苗开发的新兴计算机会。本综述涵盖了整个mRNA疫苗开发管道,为研究人员提供了基础资源,并促进了这一快速发展领域的技术进步。
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引用次数: 0
Metabolic Dysfunction and Coronary Plaque Vulnerability: The Predictive Role of Insulin Resistance Indices in Cardiovascular Outcomes. 代谢功能障碍和冠状动脉斑块易损性:胰岛素抵抗指标在心血管预后中的预测作用。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-05 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70636
Yue Yu, Jiasheng Yin, Weifeng Guo, Han Chen, Changyi Zhou, Chenguang Li, Cheng Yan, Yanli Song, Dijia Wu, Mengsu Zeng, Li Shen, Junbo Ge

Significant residual cardiovascular risk persists in patients diagnosed with coronary artery disease despite intensive lipid-lowering therapy. Although insulin resistance (IR) is an established epidemiological risk factor, the biological mechanisms by which it promotes plaque destabilization remain poorly understood. This single-center retrospective study, involving 1271 patients, investigated the relationships between four validated IR indices-triglyceride-glucose (TyG), TyG-body mass index (TyG-BMI), metabolic score for insulin resistance (METS-IR), and atherogenic index of plasma (AIP)-and high-risk coronary plaque characteristics quantified by coronary computed-tomography angiography. Patients with coronary atherosclerosis demonstrated significantly higher IR indices than plaque-free controls, with all indices exhibiting strong correlations with a high-risk plaque burden. During follow-up, 41 patients experienced major adverse cardiovascular events (MACEs), and higher TyG index, AIP, and METS-IR independently predicted MACE after multivariable adjustment, whereas TyG-BMI exhibited a similar but non-significant trend. A composite model integrating high-risk plaque burden, pericoronary fat attenuation index, and the four IR indices achieved superior prognostic accuracy, substantially outperforming individual biomarkers. These findings provide novel mechanistic insights into how metabolic dysfunction promotes coronary plaque vulnerability and identify a promising integrated approach for residual risk stratification in patients with coronary artery disease. In this study, IR indices (TyG, TyG-BMI, AIP, and METS-IR) correlated high-risk coronary plaque features in 1271 patients. During 48-month follow-up, all indices independently predicted MACEs. Combined with coronary imaging markers, the composite model achieved AUC 0.82, revealing metabolic dysfunction drives plaque destabilization in coronary disease.

在诊断为冠状动脉疾病的患者中,尽管进行了强化降脂治疗,但仍存在显著的残余心血管风险。虽然胰岛素抵抗(IR)是一个公认的流行病学危险因素,但其促进斑块不稳定的生物学机制仍然知之甚少。这项涉及1271例患者的单中心回顾性研究,调查了四种有效的IR指标——甘油三酯-葡萄糖(TyG)、TyG-体重指数(TyG- bmi)、胰岛素抵抗代谢评分(METS-IR)和血浆粥样硬化指数(AIP)之间的关系,以及冠状动脉计算机断层血管造影量化的高危冠状动脉斑块特征。冠状动脉粥样硬化患者的IR指数明显高于无斑块的对照组,所有指数均与高危斑块负担密切相关。随访期间,41例患者发生了重大心血管不良事件(MACE),经多变量调整后,较高的TyG指数、AIP和METS-IR独立预测了MACE,而TyG- bmi表现出类似但不显著的趋势。综合高风险斑块负担、冠状动脉周围脂肪衰减指数和四种IR指数的复合模型获得了更高的预后准确性,大大优于个体生物标志物。这些发现为代谢功能障碍如何促进冠状动脉斑块易损性提供了新的机制见解,并为冠状动脉疾病患者的剩余风险分层确定了一种有希望的综合方法。在本研究中,1271例患者的IR指数(TyG、TyG- bmi、AIP和METS-IR)与高危冠状动脉斑块特征相关。在48个月的随访中,所有指标均独立预测mace。结合冠状动脉成像标志物,复合模型的AUC达到0.82,揭示了代谢功能障碍驱动冠心病斑块不稳定。
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引用次数: 0
Nitrate Enhances Gastric Mucosa Defense and Repair Process in Ethanol-Induced Gastric Ulcer Rats via the Notch-Tff2 Pathway. 硝酸通过Notch-Tff2通路增强乙醇性胃溃疡大鼠胃粘膜防御和修复过程。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-05 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70628
Ying Liu, Xin Wen, Yuxuan Lin, Chunmei Zhang, Jinsong Wang, Guangyong Sun, Dong Zhang, Renhong Yan, Mo Chen, Songlin Wang, Shaorong Li

Gastric mucosal integrity is essential for maintaining systemic homeostasis, serving as the primary defense against external insults. Ethanol ingestion is a major clinical cause of gastric mucosal injury, yet effective prevention or treatment remains limited. This study investigates the protective role of nitrate against ethanol-induced gastric ulcers and its underlying mechanisms. In vivo, nitrate significantly ameliorated ethanol-induced gastric bleeding, edema, inflammation, and mucus layer thinning in rats, while strengthening the vascular endothelial barrier. Transcriptomic analyses and trefoil factor 2 (Tff2)-knockdown rats experiment identified Tff2 as the key gene responsible for mediating nitrate's protective effects against ethanol. In vitro, TFF2 was found to be a crucial target for nitrates, which enhance the migratory reparative capacities of human gastric epithelial cells. Further assays revealed that RBPJ regulates the TFF2 promoter, and NICD-RBPJ complex formation is critical for TFF2 transcriptional repression. We demonstrate for the first time that TFF2 is a central effector in nitrate-mediated gastric mucosal defense and repair and implicate the Notch signaling pathway in TFF2 regulation. These findings suggest nitrate exerts a protective effect on the gastric mucosa through multiple ways. TFF2 modulation as a potential preventive strategy for ethanol-induced gastric ulcers.

胃粘膜的完整性是维持系统稳态所必需的,是抵抗外部损伤的主要防御。乙醇摄入是胃粘膜损伤的主要临床原因,但有效的预防或治疗仍然有限。本研究探讨硝酸盐对乙醇性胃溃疡的保护作用及其潜在机制。在体内,硝酸盐可显著改善乙醇诱导的大鼠胃出血、水肿、炎症和黏液层变薄,同时增强血管内皮屏障。转录组学分析和三叶因子2 (Tff2)敲低大鼠实验发现,Tff2是介导硝酸盐对乙醇保护作用的关键基因。在体外,TFF2被发现是硝酸盐的一个重要靶点,硝酸盐可以增强人胃上皮细胞的迁移修复能力。进一步的研究表明,RBPJ调控TFF2启动子,NICD-RBPJ复合物的形成对TFF2转录抑制至关重要。我们首次证明TFF2是硝酸盐介导的胃粘膜防御和修复的中心效应物,并暗示Notch信号通路参与TFF2的调节。这些结果表明,硝酸盐通过多种途径对胃粘膜起保护作用。TFF2调节作为乙醇性胃溃疡的潜在预防策略
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引用次数: 0
Bone Metastasis: Molecular Mechanisms, Clinical Management, and Therapeutic Targets. 骨转移:分子机制、临床管理和治疗靶点。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-05 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70604
Jingyuan Wen, Binghua Li, Shengjia Wang, Yongzhong Yao, Zhao Huang, Decai Yu

Bone metastasis (BoMet) is a common complication in various cancers. Approximately 20-30% of patients with cancer develop BoMet, which is most frequently associated with solid tumors, such as breast, prostate, and lung cancers. BoMet can lead to skeletal-related events such as fractures, bone pain, and hypercalcemia, negatively affecting the patient's quality of life and markedly shortening overall survival. The development of BoMet is a complex, multistep process driven by dynamic interactions between tumor cells and the bone microenvironment. The bone microenvironment provides a supportive niche for disseminated tumor cells, where intricate signaling networks and stromal interactions regulate the initiation, dormancy, reactivation, and progression of BoMet. Although current bone-targeted therapies can reduce the incidence of these complications, the clinical outcomes for patients with BoMet remain poor. Therefore, elucidating the molecular mechanisms governing these interactions is essential for identifying new therapeutic strategies. This review systematically explores the molecular drivers of BoMet progression, dynamic interactions within the metastatic niche, available preclinical models, established treatment modalities, and emerging therapeutic approaches. As fundamental research continues to advance toward clinical translation, the outlook for patients with BoMet is expected to improve significantly.

骨转移(BoMet)是各种癌症的常见并发症。大约20-30%的癌症患者会发生BoMet,它最常与实体肿瘤相关,如乳腺癌、前列腺癌和肺癌。BoMet可导致骨骼相关事件,如骨折、骨痛和高钙血症,对患者的生活质量产生负面影响,并显着缩短总生存期。BoMet的发展是一个复杂的、多步骤的过程,由肿瘤细胞和骨微环境之间的动态相互作用驱动。骨微环境为播散性肿瘤细胞提供了一个支持性的生态位,其中复杂的信号网络和基质相互作用调节BoMet的启动、休眠、再激活和进展。尽管目前的骨靶向治疗可以减少这些并发症的发生率,但BoMet患者的临床结果仍然很差。因此,阐明控制这些相互作用的分子机制对于确定新的治疗策略至关重要。这篇综述系统地探讨了BoMet进展的分子驱动因素、转移性生态位内的动态相互作用、可用的临床前模型、已建立的治疗方式和新兴的治疗方法。随着基础研究继续向临床转化,BoMet患者的前景有望显著改善。
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引用次数: 0
Progress in RNA-Targeted Therapeutics for Human Diseases. rna靶向治疗人类疾病的研究进展
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-05 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70607
Wangzheqi Zhang, Aimin Jiang, Bin-Kui Jia, Yuming Jin, Yinghu Chen, Zhaoyu Li, Yan Liao, Haoling Zhang, Zhiheng Lin, Xiao Fang, Linhui Wang

RNA-targeted therapy is reshaping molecular medicine by shifting the traditional "protein-centric" view toward an "RNA-regulatory network" paradigm. Beyond carrying genetic information, RNA plays essential roles in posttranscriptional regulation, signaling pathways, and epigenetic modulation. Advances in high-throughput sequencing, structural biology, and delivery technologies have accelerated the development of diverse RNA therapeutics, including antisense oligonucleotides (ASOs), small interfering RNA (siRNA), microRNA (miRNA) modulators, messenger RNA (mRNA) therapeutics, aptamers, short hairpin RNA, and CRISPR/Cas-guided single-guide RNAs. However, a concise comparison of these major RNA modalities and the translational barriers that limit their broader clinical application is still lacking. This review outlines the mechanisms and representative applications of these RNA-based strategies in gene silencing, editing, protein replacement, immune activation, and targeted drug delivery. Special emphasis is placed on ASOs and siRNAs for neurological, metabolic, and infectious diseases, as well as mRNA therapeutics that are transforming vaccine development. Common challenges-such as in vivo stability, delivery efficiency, and immune activation-are also discussed. Finally, we highlight how chemical modification, nanotechnology, and artificial intelligence-assisted design are enhancing the specificity, stability, and safety of RNA therapeutics, providing a framework for advancing next-generation precision RNA medicine.

rna靶向治疗通过将传统的“以蛋白质为中心”的观点转变为“rna调控网络”范式,正在重塑分子医学。除了携带遗传信息外,RNA在转录后调控、信号通路和表观遗传调节中起着重要作用。高通量测序、结构生物学和递送技术的进步加速了各种RNA疗法的发展,包括反义寡核苷酸(ASOs)、小干扰RNA (siRNA)、微RNA (miRNA)调节剂、信使RNA (mRNA)疗法、适体、短发夹RNA和CRISPR/ cas引导的单导RNA。然而,这些主要的RNA模式和限制其广泛临床应用的翻译障碍的简明比较仍然缺乏。本文综述了这些基于rna的策略在基因沉默、编辑、蛋白质替代、免疫激活和靶向药物递送等方面的机制和代表性应用。特别强调用于神经、代谢和传染病的ASOs和sirna,以及正在改变疫苗开发的mRNA疗法。共同的挑战,如体内稳定性,给药效率和免疫激活,也进行了讨论。最后,我们强调了化学修饰、纳米技术和人工智能辅助设计如何增强RNA疗法的特异性、稳定性和安全性,为推进下一代精确RNA医学提供了一个框架。
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引用次数: 0
Ventilator-Induced Lung Injury: Mechanotransduction and Potential Therapeutic Targets. 呼吸机诱导的肺损伤:机械转导和潜在的治疗靶点。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-03 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70598
He Ren, Ziqi Shang, Alastair G Stewart, Ying-Xin Qi, Kai Huang

Mechanical ventilation (MV) serves as a critical intervention to maintain adequate gas exchange. Unfortunately, MV often leads to the development of ventilator-induced lung injury (VILI). VILI pathogenesis involves alveolar-capillary barrier disruption, dysregulated inflammation, and mechanotransduction-driven cellular dysfunction, but the interplay of these mechanisms remains incompletely understood. Here, we review the types of mechanical stress in VILI, key signaling pathways implicated in MV-induced lung injury, with particular emphasis on the impact of altered mechanical forces in VILI. Furthermore, we discuss the cell-specific mechanisms in VILI. We also delineate the intricate molecular mechanisms that orchestrate intercellular communication in VILI. In addition, we discuss the limitations of current clinical strategies, and the identification of novel drug targets with transformative potential for treatment of VILI. Moreover, we summarize the current and emerging therapeutic strategies and discuss the existing knowledge gaps and future directions for VILI prevention. By integrating mechanical mechanistic insights with translational perspectives, this review identifies novel biomarkers and potential therapeutics to mitigate VILI. Our synthesis not only advances the understanding of VILI pathophysiology but also provides a framework for precision medicine approaches in critical care, ultimately optimizing MV outcomes.

机械通气(MV)是维持足够气体交换的关键干预措施。不幸的是,MV经常导致呼吸机诱导的肺损伤(VILI)的发展。VILI的发病机制包括肺泡-毛细血管屏障破坏、炎症失调和机械转导驱动的细胞功能障碍,但这些机制的相互作用仍不完全清楚。在这里,我们回顾了VILI中机械应力的类型,以及与mv诱导的肺损伤相关的关键信号通路,特别强调了VILI中机械力改变的影响。此外,我们还讨论了VILI的细胞特异性机制。我们还描述了在VILI中协调细胞间通讯的复杂分子机制。此外,我们还讨论了当前临床策略的局限性,以及具有治疗VILI变革潜力的新型药物靶点的确定。此外,我们总结了当前和新兴的治疗策略,并讨论了现有的知识差距和未来的方向VILI预防。通过将机械机制的见解与翻译的观点相结合,本综述确定了新的生物标志物和潜在的治疗方法来减轻VILI。我们的合成不仅促进了对VILI病理生理学的理解,而且为危重症护理中的精准医学方法提供了框架,最终优化了MV结果。
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引用次数: 0
Cleavage and Polyadenylation Specificity Factor Subunit 5 Regulates Pulmonary Artery Smooth Muscle Expansion and Hypoxic Response. 裂解和聚腺苷化特异性因子亚单位5调控肺动脉平滑肌扩张和缺氧反应。
IF 10.7 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-03 eCollection Date: 2026-02-01 DOI: 10.1002/mco2.70610
Scott D Collum, Lisha Zhu, Tingting W Mills, Rene Girard, Jamie Tran, Tinne C J Mertens, Cory Wilson, Nancy Wareing, Erik E Suarez, Howard J Huang, Rahat Hussain, Bindu Akkanti, Wenjin J Zheng, Hari K Yalamanchili, Bela Patel, Eric J Wagner, Sandeep Agarwal, Harry Karmouty-Quintana

Pulmonary hypertension (PH) is a fatal condition that affects individuals with systemic sclerosis (SSc), a multiorgan fibrotic disease with limited treatment options. A central feature of PH is vascular remodeling, defined by the narrowing of the arteriole lumen due to cell proliferation and extracellular matrix deposition. Herein, we identify a central mechanism that can regulate multiple transcripts important for vascular remodeling. The highlight of our study is the demonstration that reduced pulmonary artery smooth muscle (PASMC) Nudt21, which codes for the RNA binding protein Cleavage and Polyadenylation Specificity Factor Subunit 5 (CPSF5) The, known to regulate alternative polyadenylation, results in heightened right ventricle systolic pressures in mice exposed to hypoxia-sugen. We also report that increased PASMC proliferation is present in mice with reduced PASMC Nudt21 under normoxic conditions, recapitulating features of hypoxia-sugen exposure. Our studies reveal that reduced CPSF5 leads to 3' untranslated region shortening of PTGER3 and CBFB, the latter contributing to increased levels of proliferative transcription factor RUNX1. We also identify miR-3163 as novel negative regulator of NUDT21 expression in PH. These observations are validated in remodeled vessels from patients with SSc associated with PH and in and point to common mechanisms of RNA processing deficits that contribute to vascular remodeling in PH.

肺动脉高压(PH)是一种影响系统性硬化症(SSc)患者的致命疾病,这是一种治疗选择有限的多器官纤维化疾病。PH的一个中心特征是血管重构,由细胞增殖和细胞外基质沉积引起的小动脉管腔狭窄所定义。在这里,我们确定了一个中心机制,可以调节多种转录对血管重塑的重要。我们研究的重点是证明肺动脉平滑肌(PASMC) Nudt21减少,其编码RNA结合蛋白切割和聚腺苷化特异性因子亚基5 (CPSF5),已知可调节选择性聚腺苷化,导致暴露于缺氧的小鼠右心室收缩压升高。我们还报道,在常氧条件下,PASMC Nudt21降低的小鼠中,PASMC增殖增加,再现了缺氧糖暴露的特征。我们的研究表明,CPSF5的减少导致PTGER3和CBFB的3'非翻译区缩短,后者有助于增加增殖转录因子RUNX1的水平。我们还发现miR-3163是PH中NUDT21表达的新型负调节因子。这些观察结果在与PH相关的SSc患者的重构血管中得到了验证,并指出了导致PH中血管重构的RNA加工缺陷的共同机制。
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