Biomarker For Poor Prognosis Research Articles

Comparative proteomic analysis of patients with acute myeloid leukemia before and after induction therapy.

Acute myeloid leukemia (AML) is a malignant disorder of hematopoietic stem and progenitor cells, characterized by accumulation of immature blasts in the bone marrow and peripheral blood of affected patients. Response to chemotherapy treatment in patients with AML is wide-ranging, and to date there are no adequate molecular biomarkers used to predict clinical outcome. The aim of this study was to identify potential protein biomarkers which could help predict response to induction treatment in AML patients. Peripheral blood samples were obtained from 15 AML patients both before and after treatment. A comparative proteomic analysis was performed using 2D gel electrophoresis followed by Mass Spectrometry. This comparative proteomic study, combined with a protein network analysis, revealed several proteins that could be considered potential biomarkers of poor prognosis in AML: GAPDH which favors increased glucose metabolism; eEF1A1 and Annexin A1 that promote proliferation and migration, cofilin 1 which plays a role in the activation of apoptosis; and GSTP1 which is involved in the processes of detoxification and chemoresistance. This study gives an insight into a panel of protein biomarkers with prognostic potential that should be further investigated.

High expression of WTAP is related to poor prognosis in nasopharyngeal carcinoma.

Wilms' tumor 1-associated protein (WTAP), a component of the m6A methyltransferase complex, recruits the m6A methyltransferases METTL3 and METTL14 to the corresponding mRNA targets to participate in the formation of N6-methyladenosine. However, the molecular mechanism of WTAP in the tumorigenesis and progression of nasopharyngeal carcinoma (NPC) remains unclear. This study aimed to explore the prognostic value and biological function of WTAP in NPC. We assessed WTAP expression and its prognostic significance using microarray datasets from the Gene Expression Omnibus (GSE12452) database and 100 NPC tissues via bioinformatics analysis and immunohistochemistry (IHC), respectively. Moreover, gene ontology (GO) and gene set enrichment analysis (GSEA) were performed. In addition, the correlation of WTAP expression with the expression of immune cell biomarkers was analyzed. The results showed that WTAP expression was significantly overexpressed in NPC tissues in GSE12452. The overexpression of WTAP was validated by the external datasets including NPC tissues (GSE150430) and NPC cell lines (GSE39826). GO analysis suggested enrichment in the nucleoplasm (cellular component) and cell cycle (biological process). The GSEA revealed that differentially expressed genes were enriched in E2F-targets, Myc_targets_v1, G2M checkpoint, Myc_targets_v2, and Interferon-alpha-response. In IHC analysis, WTAP was upregulated in NPC tissues, and high levels of WTAP expression were significantly correlated with the advanced T stage (p=0.047) and advanced N stage (p=0.018). Cox regression demonstrated that WTAP overexpression was an independent biomarker of poor prognosis for overall survival (hazard ratio [HR], 4.747; 95% confidence interval [CI], 1.671-13.482; p=0.003). In IHC analysis, the expression of WTAP was positively correlated with CD206 (biomarker for M2 macrophages) (p=0.018) but negatively correlated with CD8a (biomarker for cytotoxic T cells) (p=0.001). In conclusion, WTAP is a promising prognostic biomarker and may participate in the regulation of immune cell infiltration in NPC.

Fusobacterium Nucleatum-Induced Tumor Mutation Burden Predicts Poor Survival of Gastric Cancer Patients

Co-infection of Helicobacter pylori and Fusobacterium nucleatum is a microbial biomarker for poor prognosis of gastric cancer patients. Fusobacterium nucleatum is associated with microsatellite instability and the accumulation of mutations in colorectal cancer. Here, we investigated the mutation landscape of Fusobacterium nucleatum-positive resected gastric cancer tissues using Illumina TruSight Oncology 500 comprehensive panel. Sequencing data were processed to identify the small nucleotide variants, small insertions and deletions, and unstable microsatellite sites. The bioinformatic algorithm also calculated copy number gains of preselected genes and tumor mutation burden. The recurrent genetic aberrations were identified in this study cohort. For gene amplification events, ERBB2, cell cycle regulators, and specific FGF ligands and receptors were the most frequently amplified genes. Pathogenic activation mutations of ERBB2, ERBB3, and PIK3CA, as well as loss-of-function of TP53, were identified in multiple patients. Furthermore, Fusobacterium nucleatum infection is positively correlated with a higher tumor mutation burden. Survival analysis showed that the combination of Fusobacterium nucleatum infection and high tumor mutation burden formed an extremely effective biomarker to predict poor prognosis. Our results indicated that the ERBB2-PIK3-AKT-mTOR pathway is frequently activated in gastric cancer and that Fusobacterium nucleatum and high mutation burden are strong biomarkers of poor prognosis for gastric cancer patients.

Higher TYROBP and lower SOX6 as predictive biomarkers for poor prognosis of clear cell renal cell carcinoma: A pilot study

Clear cell renal carcinoma (ccRCC) is the most common subtype of renal cancer, accounting for approximately 75% of all histological types of renal cancer, and is the leading cause of death from renal cancer. However, the molecular mechanism of tyrosine kinase binding protein (TYROBP) and sex-determining region Y Box-6 (SOX6) in the ccRCC was not precise. Bioinformatics analysis was performed to explore the hub role of TYROBP and SOX6 on the ccRCC. A total of 6 patients with clear cell renal cell carcinoma (ccRCC) were recruited. HE staining was performed to observe the pathology result of ccRCC. Immunohistochemistry and Immunofluorescence assay was made to detect the protein expression of TYROBP. Total RNA was extracted using TRIzol to examine the mRNA expression of TYROBP via the Real time quantitative polymerase chain reaction. The strong correlation between the expression of TYROBP and the survival time of ccRCC patients was performed by the BP neural network and support vector machine. Compared with the control group, the expression of SOX6 was downregulated in the samples with ccRCC. However, the expression of TYROBP was higher in the samples with ccRCC than in the control group. Compared with the patients with high SOX6 expression, the patients with low SOX6 expression have a poor survival prognosis (HR=0.39, P < .05). However, the patients with high TYROBP expression have a shorter survival time than the patients with low TYROBP expression (HR=1.66, P < .05). The genes related with TYROBP and SOX6 are mainly enriched in the regulation of cell activation, leukocyte activation, negative regulation of cell activation, myeloid leukocyte activation, positive regulation of response to external stimulus, immune response-regulating signaling pathway. The interaction between TYROBP, SOX6, and kidney neoplasms was drawn, and the inference score of TYROBP and SOX6 on the kidney neoplasms was high. In conclusion, TYROBP is highly expressed in renal clear cell carcinoma, and when this molecule is highly expressed, the survival prognosis of renal carcinoma is poor. TYROBP and SOX6 may be potential targets for diagnosing and treating renal clear cell carcinoma.

High expression of GSKIP is associated with poor prognosis in meningioma

Meningiomas are the most common extra-axial primary central nervous system tumors. There is no effective treatment or targeted therapy for meningioma except excision and radiotherapy. glycogen synthesis kinase 3β interaction protein (GSKIP) is an A-kinase anchor protein that has cytosolic scaffolding function and binds to a protein kinase A and glycogen synthesis kinase 3β to modulate different biological processes and malignant tumorigenesis through the Wnt pathway. The purpose of this study was to investigate the relationship between GSKIP expression and the clinico-pathological parameters in meningioma using immunohistochemical staining. We collected samples from 74 patients, from 2008 to 2012, in the Kaohsiung Medical University Hospital that had data on the staging and prognosis of the meningioma pathological section. Chi-square, Kaplan-Meier method, and cox regression were used to analyze the correlation between clinical parameters and immunohistochemistry staining for GSKIP. Following our immunohistochemical score, we found that higher expression of GSKIP was associated with high World Health Organization grading, recurrence, malignant transformation, and reduced overall survival time and recurrence-free survival time in meningioma. GSKIP may be a biomarker of poor prognosis and a target protein for therapy in meningioma.

Deciphering the Role of p53 and TAp73 in Neuroblastoma: From Pathogenesis to Treatment.

Neuroblastoma (NB) is an embryonic cancer that develops from neural crest stem cells, being one of the most common malignancies in children. The clinical manifestation of this disease is highly variable, ranging from spontaneous regression to increased aggressiveness, which makes it a major therapeutic challenge in pediatric oncology. The p53 family proteins p53 and TAp73 play a key role in protecting cells against genomic instability and malignant transformation. However, in NB, their activities are commonly inhibited by interacting proteins such as murine double minute (MDM)2 and MDMX, mutant p53, ΔNp73, Itch, and Aurora kinase A. The interplay between the p53/TAp73 pathway and N-MYC, a known biomarker of poor prognosis and drug resistance in NB, also proves to be decisive in the pathogenesis of this tumor. More recently, a strong crosstalk between microRNAs (miRNAs) and p53/TAp73 has been established, which has been the focused of great attention because of its potential for developing new therapeutic strategies. Collectively, this review provides an updated overview about the critical role of the p53/TAp73 pathway in the pathogenesis of NB, highlighting encouraging clues for the advance of alternative NB targeted therapies.

The Intricate Interplay between the ZNF217 Oncogene and Epigenetic Processes Shapes Tumor Progression.

The oncogenic transcription factor ZNF217 orchestrates several molecular signaling networks to reprogram integrated circuits governing hallmark capabilities within cancer cells. High levels of ZNF217 expression provide advantages to a specific subset of cancer cells to reprogram tumor progression, drug resistance and cancer cell plasticity. ZNF217 expression level, thus, provides a powerful biomarker of poor prognosis and a predictive biomarker for anticancer therapies. Cancer epigenetic mechanisms are well known to support the acquisition of hallmark characteristics during oncogenesis. However, the complex interactions between ZNF217 and epigenetic processes have been poorly appreciated. Deregulated DNA methylation status at ZNF217 locus or an intricate cross-talk between ZNF217 and noncoding RNA networks could explain aberrant ZNF217 expression levels in a cancer cell context. On the other hand, the ZNF217 protein controls gene expression signatures and molecular signaling for tumor progression by tuning DNA methylation status at key promoters by interfering with noncoding RNAs or by refining the epitranscriptome. Altogether, this review focuses on the recent advances in the understanding of ZNF217 collaboration with epigenetics processes to orchestrate oncogenesis. We also discuss the exciting burgeoning translational medicine and candidate therapeutic strategies emerging from those recent findings connecting ZNF217 to epigenetic deregulation in cancer.

Enhanced MCM5 Level Predicts Bad Prognosis in Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is a fatal heterogeneous hematologic malignancy. There is an urgent need to identify potential biomarkers to better classify sufferers with bad outcomes that might need more advanced treatment. The objective of this study was to investigate prognostic indicators that predict the outcome of sufferers with AML. The datasets of AML sufferers including mRNA sequencing data and clinical information were acquired from GEO datasets (GSE38865) and TCGA datasets. Kaplan–Meier curves and Cox regression analysis to screen genes correlated to survival. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses biological process analysis were utilized in verifying the function of various genes. Sufferers with elevated MCM5 level exhibited a worse prognosis, according to the survival analysis. It was indicated through multivariate and univariate analysis that MCM5 level was an independent adverse prognostic element for over survival in AML sufferers based on GEO and TCGA datasets. Meanwhile, MCM5 level in AML samples was higher than in normal samples. Additionally, it was indicated through PPI network and functional enrichment analyses that through accelerating cell cycle and DNA replication, MCM5 promoted AML progression. In conclusions, MCM5 level was an independent poor prognostic element in AML sufferers based on GEO and TCGA datasets. This is the first time that MCM5 is reported to be a biomarker of poor prognosis in AML.

CD10 expression in urinary bladder urothelial carcinoma is associated with high-tumor grade and stage.

Primary urinary bladder carcinoma is a common cancer worldwide. There is limited published data about CD10 immunoexpression pattern in urothelial bladder carcinoma (UBC). This study aims to examine CD10 immunoexpression in UBC and evaluate its relationship with clinicopathological parameters. The retrospective study examined 130 samples of UBC tissue and 30 samples of non-neoplastic urothelial bladder tissue, which were obtained from the Anatomic Pathology Department, King Abdulaziz University, Jeddah, Saudi Arabia. The project started in June 2019 and completed in February 2021. Tissue microarrays (TMA) were prepared from paraffin blocks and tissue sections prepared from the recipient blocks were used for immunohistochemistry studies utilizing CD10 antibody. The immunostaining results were recorded and analyzed. Positive staining of CD10 was observed in 64 (49%) cases of UBC and was not detected in any non-neoplastic urothelium samples. CD10-positive staining was identified in 36.7% and 66.7% of low and high-grade tumors, respectively. There was an association between positive CD10 immunostaining and high tumor grade (p=0.006) and muscularis propria invasion (p=0.007). There was no association between CD10 immunoexpression and age, gender, nodal and distant metastasis, lymphovascular invasion, and tumor recurrence. CD10 immunoexpression was not associated with the probabilities of overall survival (log rank 1.663, p=0.197) or disease-free survival (log rank 1.637, p=0.201). In UBC, CD10 immunoexpression is associated with higher tumor grade and muscle invasion, but it is not associated with patient survival or other clinicopathological parameters. CD10 immunoexpression cannot be used as a biomarker for poor prognosis in UBC.

Clinicopathological and prognostic value of Ki-67 expression in oral malignant melanoma: A systematic review and meta-analysis.

Background. Ki-67 is one of the new biological markers with clinical value in the pathology and prognosis of oral melanoma. It is a nuclear protein involved in regulating cell proliferation. Some studies have suggested an association between Ki-67 and poor survival in patients with oral melanoma. This systematic review was undertaken to clarify this issue. Methods. Databases of PubMed, Scopus, and Web of Science were searched using relevant English keywords from 1988 to April 2022. STATA software version 16 and random models were used for meta-analysis. Results. Eleven articles were included in this systematic review, six of which were selected for meta-analysis. The mean expression of the Ki-67 index in patients with oral melanoma was estimated at 43.81% (28.66‒58.95 with 95% CI, I2=94.2, P<0.001). In addition, the results showed a significant relationship between Ki-67 expression and the prognosis of oral melanoma lesions. Increased expression of this marker weakens the prognosis and decreases the survival rate. Conclusion. High expression of Ki-67 may serve as a predictive biomarker for poor prognosis in patients with malignant oral melanoma. Therefore, classifying this malignancy by Ki-67 expression may be considered for therapy regimen selection and integrated management.

The Bacterial Chaperone High-Temperature Protein G (HtpG) Decreases in Abundance with Induction Therapy in Children with Acute Lymphoblastic Leukemia

Introduction: Heat shock proteins (HSPs) are ancient and highly conserved genes that participate in protein quality control in eukaryotes and bacteria. These proteins are produced in large quantities when cells are exposed to stress that causes denaturation of essential proteins. HSPs help maintain cellular homeostasis, and act as molecular chaperones, assisting with protein folding and stability, multi-protein assembly, intracellular protein trafficking and degrading damaged proteins. The Hsp90 family of proteins includes 4 genes, with 1 (HtpG) being a bacterial form. Members of the Hsp90 family interact with a diverse set of client proteins, some involved in cell signalling and proliferation. Many of these client proteins are involved in growth, survival and adaptation of cancer cells. Eukaryotic Hsp90 plays an important role in tumorigenesis and there has been much research into the use of Hsp90 inhibitors to inhibit growth of cancer cells, but little has been done to examine what role the other paralogues have in stabilizing cancer cells. In addition, no work to date has looked at whether bacterial HtpG paralogues might interact with cancer cells. While it is anticipated that bacterial stress and the behaviour of HtpG would correlate to the host response to stress, this has not been examined. The first step is to examine bacterial HtpG gene levels before and during induction to determine if there are changes in HtpG gene abundance. Methods: Forty-eight stool samples were collected from 29 pediatric patients with Acute Lymphoblastic Leukemia (ALL) being treated at the IWK health centre, Nova Scotia, Canada after informed consent. DNA was extracted and whole shotgun metagenome sequencing (Illumina, Nextera XT) was performed. Low quality and contaminated sequences (human and PhiX174) were removed using the kneaddata pipeline (Trimmomatic and Bowtie2). Paired cleaned sequences were concatenated and HUMAnN3 was used to assign gene families to reads using the Uniref90 database. Genes assigned to HtpG or "Hsp90-like" gene families were included and summed from each sample and corrected for sequencing depth. Samples were grouped by phase of treatment (13 pre-treatment samples from 13 patients and 35 induction samples from 23 patients) for analysis. Comparisons between pre-treatment (PT) and induction (IN) samples were performed using Wilcoxon-Mann-Whitney U. Fisher's exact test was used to compare age group and sex between PT and IN samples. The study was approved by the IWK ethics board. Results: Neither sex nor age category differed between PT and IN (p=1). HtpG gene counts among the 48 stool samples from 29 patients ranged from 0 to 329 (mean 119). The mean counts of HtpG genes were significantly decreased in samples during induction therapy compared to pre-treatment (p=0.002). Shannon diversity, a measure of microbial diversity, did not differ between PT and IN samples (p=0.2793), nor did counts of bacteria (Chao-1 p=0.47). Discussion: Studies have found that Hsp90 is generally over expressed in cancer patients with elevated levels, suggesting poorer overall survival. They have been proposed as a potential biomarker of poor prognosis. We had anticipated increased stress and protein damage to occur in the gut environment as a result of chemotherapy, rather than as a result of the underlying cancer. The anticipated increase in HtpG during induction did not occur but rather declined with cancer remission. One possibility is that the decline in HtpG genes was a result of a loss of bacterial diversity due to treatment. However, we did not see significant differences in diversity between PT and IN. The increase in HtpG genes during PT and reduction during induction therapy seems to follow a similar pattern to Hsp90 expression in host cells, suggesting that bacterial HtpG might also serve as a marker of disease remission. It also highlights that a better understanding of bacterial HtpG, a protein known to be present in outer membrane vesicles, which are crucial for host communication and have been implicated in contributing to carcinogenic potential is warranted. Conclusion: This study suggests that the bacterial chaperone HtpG is possibly related to degree of inflammation caused by leukemic cells rather than leukemia treatment. A larger study is needed to verify the potential of HtpG as a marker of cancer remission or treatment toxicity or cancer immune response.

Metabolic Biomarkers Affecting Cell Proliferation and Prognosis in Polycythemia Vera

Background Polycythemia vera (PV) is a malignant clonal hematological disease of hematopoietic stem cells characterized by proliferation of peripheral blood cells, and JAK2 mutation is one of the main causes of PV peripheral blood cell proliferation. Abnormal cell metabolism is a new feature of malignant proliferation of tumor cells, but the role of metabolism in the pathogenesis and prognosis of PV remains unclear. Methods Metabolic profiling of peripheral blood sera from 32 patients with PV and 20 HCs was performed using liquid chromatography-mass spectrometry (LC-MS). Partial least-squares with latent structure discriminant analysis (PLS-DA) was used for data analysis. Results To assess whether there were significant changes in the metabolic profiles of PV patients and healthy controls, we performed a multifactorial analysis of the metabolic profiles of the two groups. Figure 1 shows the score plots of the PLS-DA in positive and negative modes. Both data from positive and negative modes suggested that the serum metabolites of PV patients were significantly changed. Subsequently, we identified endogenous metabolites between PV patients and HCs. These potential biomarkers were eventually identified as fatty acids, acylcarnitine, sphingolipids, amino acids, etc. To clarify the abnormal metabolic pathways in PV, we performed enrichment analysis of the metabolic pathways of the biomarkers. The results showed there were 9 important metabolic pathways associated with PV, namely: D-glutamine and D-glutamate metabolism, sphingolipid metabolism, pyruvate metabolism, alanine, aspartate and glutamate metabolism, arginine and proline metabolism, tryptophan metabolism, lysine degradation, arginine biosynthesis and glycolysis/gluconeogenesis (Figure 2). Therefore, fatty acid metabolism, glucose metabolism, sphingolipid metabolism and amino acid metabolism were significantly altered in PV. To explore the effect of JAK2-associated metabolic abnormalities on cell proliferation in PV patients, we screened for endogenous metabolites associated with JAK2, and found 7 metabolites that differed significantly between the JAK2 mutated and unmutated groups. The levels of Cer(d18:2/22:6-2OH(7S, 17S)), SM(d18:0/PGF1α), CerP(d18:1/16:0), glutamic acid, lactic acid, melibiose and xylose were significantly higher in the JAK2-mutated group than in the JAK2-unmutated group. Among them, Cer(d18:2/22:6-2OH(7S, 17S)) (r=0.817; P<0.001) and SM(d18:0/PGF1α) (r=0.463; P=0.021) levels were positively correlated with JAK2 mutational burden. Then we evaluated the relationship between JAK2 mutation and blood cell count in PV patients. PLT and HCT levels were significantly higher in JAK2 mutated PV patients than in JAK2 unmutated PV patients (P=0.006; P=0.044) and found a significant positive correlation between JAK2 mutational burden and WBC and PLT levels (r=0.62, P=0.001; r=0.55, P=0.007). Finally, we found that Cer(d18:2/22:6-2OH(7S, 17S)) levels were positively correlated with WBC (r=0.650, P<0.001), and SM(d18:0/PGF1α) levels were positively correlated with WBC and PLT (r=0.444, P=0.011 and r=0.623; P<0.001, respectively). Therefore, we speculate that Cer(d18:2/22:6-2OH(7S, 17S)) and SM(d18:0/PGF1α) are closely associated with JAK2 mutations and may contribute to the proliferation of peripheral blood cells in PV patients. According to the prognostic point system, PV patients can be divided into low-risk group (n=11) and intermediate/high-risk group (n=21). Compared to the low-risk group, the levels of 8 endogenous metabolites in the intermediate/high-risk group were significantly elevated. We next used binary logistic regression to analyze the combined biomarkers and then determine the ROC curve. A set of potential biomarkers containing four endogenous metabolites with an AUC > 0.77 was found to provide an AUC of 0.952, with a sensitivity of 90.905% and specificity of 90.909% at the optimal cutoff point. Therefore, elevated levels of Cer(d18:2/22:6-2OH(7S, 17S)), SM(d18:0/PGF1α), CerP(d18:1/16:0) and octadec-13-enoylcarnitine could be used as potential metabolic biomarkers of poor prognosis in patients with PV. Conclusion Metabonomics provides an important tool for the study of the pathogenesis of PV and the relationship between JAK2 gene mutation. Furthermore, the potential biomarkers of this study may provide a reference for the prognosis of PV. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

SKA1/2/3 is a biomarker of poor prognosis in human hepatocellular carcinoma.

Spindle and kinetochore-associated complex subunits 1-3 (SKA1-3) stabilize the kinetochore-attached spindle microtubules in metaphase. Due to the dysregulation in multiple cancers, SKA1-3 is considered a predictor for the prognosis of the patients. However, the potential clinical applications of SKA1-3, particularly in hepatocellular carcinoma (HCC) prognosis and progression, have completely unknown yet. For the analysis of SKA1-3 expression and applications in clinics in HCC patients, several databases, such as STRING, UALCAN, GEO, and TCGA, were searched. In addition, the underlying mechanisms of SKA for the regulation of HCC occurrence, development, and progression were also explored. Compared to the normal controls, HCC patients showed dramatically elevated SKA1-3 expression at the mRNA level, and the values of the area under the curve (AUC) were 0.982, 0.887, and 0.973, respectively. Increased SKA1-3 expression levels were associated with the clinical stage, age, body mass index, tumor grade, tissue subtype, and Tp53 mutation status in HCC patients. The analyses of Kyoto Encyclopedia of Genes and Genome (KEGG) and Gene ontology (GO) demonstrated that SKA1-3 are enriched mainly in the Fanconi anemia, homologous recombination, spliceosome, DNA replication, and cell cycle signaling pathways. The hub genes, such as CDK1, CCNB1, CCNA2, TOP2A, BUB1, AURKB, CCNB2, BUB1B, NCAPG, and KIF11, were identified in protein-protein interactions (PPIs). The expression levels of hub genes were increased in HCC patients and predictive of a poor prognosis. Finally, the expression levels of SKA1-3 were determined using the GEO database. SKA1-3 are potential prognostic biomarkers of and targets for HCC. In addition, SKA1-3 may affect HCC prognosis via the Fanconi anemia pathway, homologous recombination, spliceosome, DNA replication, and cell cycle signaling pathway.

Lysophosphatidylcholines modulate immunoregulatory checkpoints in peripheral monocytes and are associated with mortality in people with acute liver failure

Acute liver failure (ALF) is a life-threatening disease characterised by high-grade inflammation and immunoparesis, which is associated with a high incidence of death from sepsis. Herein, we aimed to describe the metabolic dysregulation in ALF and determine whether systemic immune responses are modulated via the lysophosphatidylcholine (LPC)-autotaxin (ATX)-lysophosphatidylcholinic acid (LPA) pathway. Ninety-six individuals with ALF, 104 with cirrhosis, 31 with sepsis and 71 healthy controls (HCs) were recruited. Pathways of interest were identified by multivariate statistical analysis of proton nuclear magnetic resonance spectroscopy and untargeted ultraperformance liquid chromatography-mass spectrometry-based lipidomics. A targeted metabolomics panel was used for validation. Peripheral blood mononuclear cells were cultured with LPA 16:0, 18:0, 18:1, and their immune checkpoint surface expression was assessed by flow cytometry. Transcript-level expression of the LPA receptor (LPAR) in monocytes was investigated and the effect of LPAR antagonism was also examined invitro. LPC 16:0 was highly discriminant between ALF and HC. There was an increase in ATX and LPA in individuals with ALF compared to HCs and those with sepsis. LPCs 16:0, 18:0 and 18:1 were reduced in individuals with ALF and were associated with a poor prognosis. Treatment of monocytes with LPA 16:0 increased their PD-L1 expression and reduced CD155, CD163, MerTK levels, without affecting immune checkpoints on T and NK/CD56+T cells. LPAR1 and 3 antagonism in culture reversed the effect of LPA on monocyte expression of MerTK and CD163. MerTK and CD163, but not LPAR genes, were differentially expressed and upregulated in monocytes from individuals with ALF compared to controls. Reduced LPC levels are biomarkers of poor prognosis in individuals with ALF. The LPC-ATX-LPA axis appears to modulate innate immune response in ALF via LPAR1 and LPAR3. Further investigations are required to identify novel therapeutic agents targeting these receptors. We identified a metabolic signature of acute liver failure (ALF) and investigated the immunometabolic role of the lysophosphatidylcholine-autotaxin-lysophosphatidylcholinic acid pathway, with the aim of finding a mechanistic explanation for monocyte behaviour and identifying possible therapeutic targets (to modulate the systemic immune response in ALF). At present, no selective immune-based therapies exist. We were able to modulate the phenotype of monocytes invitro and aim to extend these findings to murine models of ALF as a next step. Future therapies may be based on metabolic modulation; thus, the role of specific lipids in this pathway require elucidation and the relative merits of autotaxin inhibition, lysophosphatidylcholinic acid receptor blockade or lipid-based therapies need to be determined. Our findings begin to bridge this knowledge gap and the methods used herein could be useful in identifying therapeutic targets as part of an experimental medicine approach.

SLC11A1 associated with tumor microenvironment is a potential biomarker of prognosis and immunotherapy efficacy for colorectal cancer.

Colorectal cancer (CRC) is one of the most lethal cancers of the digestive system. The tumor microenvironment (TME) plays a central role in the initiation and development of CRC. However, little is known about the modulation mechanism of the TME in CRC. In our study, we attempted to identify a biomarker related to the TME modulation that could serve as a potential prognostic biomarker for CRC. We identified differentially expressed genes between the ImmuneScore high/low and StromalScore high/low groups. Using univariate COX regression analysis and hub gene analysis (cytoHubba), SLC11A1 was identified as the only candidate gene for subsequent analysis. CIBERSORT, EPIC, MCPcounter, and immunogenic cell death were performed to evaluate the effect of SLC11A1 on the TME. We also collected samples and performed Real-time quantitative PCR to verify the expression levels of SLC11A1 in CRC and adjacent normal tissues. The IMvigor210 cohort, TIDE score, and immunophenoscore (IPS) were used to analyze the association between SLC11A1 and immunotherapy efficacy. SLC11A1 was highly expressed in CRC tissues compared with its expression in normal colorectal tissues and was associated with poor prognosis and advanced clinicopathological stages. Gene set enrichment analysis showed that TGF-β pathways, JAK-STAT pathways, and angiogenesis were significantly enriched in the high-SLC11A1 group. Single-cell analysis validated the correlation between SLC11A1 and the TME. Using CIBERSORT, EPIC, and MCPcounter algorithms, we found that there was more macrophage and fibroblast infiltration in the SLC11A1 high-expression group. Meanwhile, high-SLC11A1 patients had lower IPS scores, higher TIDE scores, and fewer immunotherapy benefits than those of low-SLC11A1 patients. In conclusion, SLC11A1 plays a crucial role in the TME and could serve as a potential biomarker for poor prognosis and immunotherapy efficacy in CRC.

Growth Differentiation Factor-15 as a Predictor of Functional Capacity, Frailty, and Ventricular Dysfunction in Patients With Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

In aortic stenosis (AS), left ventricular (LV) remodeling often occurs before symptom onset, and early intervention may be beneficial. Risk stratification remains challenging and identification of biomarkers may be useful. We evaluated the association between growth differentiation factor-15 (GDF-15) and soluble suppression of tumorigenicity 2 (sST2) and known markers of poor prognosis in AS. Baseline plasma GDF-15 and sST2 levels were measured in 70 patients with moderate-severe AS (aortic valve area <1.5 cm2) and preserved LV ejection fraction (>45%). Patients were categorized into "low GDF-15" versus "high GDF-15" and "low sST2" versus "high sST2" groups. Groups were compared for differences in cardiovascular risk factors, 6-minute walk test, 5 m gait speed, cognitive function (Montreal Cognitive Assessment), and echocardiographic parameters. Overall, 44% of patients were deemed asymptomatic by New York Heart Association class, 61% had severe AS (aortic valve area <1 cm2) and all patients had preserved LV ejection fraction. GDF-15 levels were not predictive of AS severity. However, high GDF-15 (>1,050 pg/ml) was associated with LV dysfunction as shown by lower indexed stroke volume (p <0.01), worse LV global longitudinal strain (p=0.04), greater mean E/e' (p=0.02) and indexed left atrial volume (p <0.01). It was also associated with decreased functional capacity with shorter 6-minute walk test (p=0.01) and slower 5 m gait speed (p=0.02). Associations between sST2 levels and markers of poor prognosis were less compelling. In this study of patients with moderate to severe AS, elevated GDF-15 levels are associated with impaired functional capacity, poorer performance on fragility testing, and LV dysfunction. In conclusion, GDF-15 may integrate these markers of adverse outcomes into a single biomarker of poor prognosis.

Serum amyloid A (SAA) and Interleukin-6 (IL-6) as the potential biomarkers for gastric cancer.

To explore serum amyloid A (SAA) and interleukin-6 (IL-6) as potential diagnostic biomarkers for gastric cancer (GCa) and the application value of the combined diagnosis of SAA, IL6, and Cancer embryonic antigen. Serum samples were collected before the initial surgery from 159 patients comprising samples from 122 patients with GCa and 37 patients with benign gastric disease. All patients were hospitalized at Beijing Aerospace General Hospital in China between 2018 and 2020. The IL-6 and SAA levels were assessed using standard laboratory protocols. The levels of SAA and IL-6 were significantly higher in patients with GCa than in controls. Compared with the healthy group, the concentration of SAA and IL-6 in FIGO III-IV group were significantly higher and the difference were statistically significant. In addition, significant differences were observed between the FIGO III-IV group and FIGO I-II groups. The Receiver operating characteristic (ROC) curve for the combined detection of SAA, IL-6, and Cancer embryonic antigen showed an area under the curve (AUC) of 0.948, sensitivity of 91.0%, and specificity of 89.2%. Spearman's correlation analysis indicated obvious correlations among the levels of serum SAA, IL-6, advanced FIGO stage, lymphatic invasion, and distant metastasis. AA and IL-6 may serve as useful biomarkers for poor prognosis of GCa. Clinical diagnosis combined with SAA and IL-6 may help assess therapeutic outcomes.

Serum CCL23 emerges as a biomarker for poor prognosis in patients with intracerebral hemorrhage

BackgroundCCL23 is involved in the inflammatory response and associated with the progression of brain injury. Herein, we assessed the relationship between serum CCL23 levels and inflammation, hematoma severity, and unfavorable outcome after intracerebral hemorrhage (ICH). MethodsIn this prospective observational study of 94 ICH patients and 47 controls, serum CCL23 levels were measured. Hemorrhage severity was reflected by the National Institutes of Health Stroke Scale (NIHSS) score and hematoma volume. An unfavorable outcome was defined as a modified Rankin Scale > 2 at 6 months after ICH. Its association with clinical outcome was confirmed using the binary logistic regression analysis. Predictive efficiency was verified under receiver operating characteristic (ROC) curve. ResultsSignificantly increased serum CCL23 levels were observed in ICH patients, as compared to controls. Serum CCL23 levels were highly related to NIHSS score, hematoma volume, ICH score, Glasgow coma scale score, serum C-reactive protein levels, blood leucocyte count, and neutrophil count. CCL23 ≥ 62.95 pg/ml served as an independent predictor of 6-month unfavorable outcome and death, and its validity was confirmed by ROC analysis. ConclusionCCL23 may be implicated in the inflammatory response and serve as a potential marker for predicting the prognosis of patients with ICH.

Tumor expression of CXCL12 and survival of patients with colorectal cancer: A meta-analysis.

C-X-C motif chemokine ligand 12 (CXCL12) has been suggested as a possible biomarker of poor prognosis in patients with various malignancies. However, the association between tumor expression of CXCL12 and survival of patients with colorectal cancer (CRC) remains to be comprehensively analyzed. A meta-analysis to systematically evaluate this association was performed in the present study. Relevant cohort studies were retrieved by searching the PubMed, Embase and Web of Science databases from inception to March 22, 2022. A conservative random-effect model incorporating the possible influence of between-study heterogeneity was used to pool the results. A total of 14 cohort studies that included 2,060 patients with CRC contributed to the meta-analysis, and 1,055 (51.2%) of them had higher tumor expression levels of CXCL12. Pooled results showed that a higher tumor expression level of CXCL12 was associated with poor overall survival [hazard ratio (HR), 1.74; 95% confidence interval (CI), 1.29-2.34; P<0.001; I2, 33%] and progression-free survival (HR, 2.00; 95% CI, 1.47-2.73; P<0.001; I2, 33%). Subgroup analyses showed that the association between higher cancer expression levels of CXCL12 and poor survival in patients with CRC was not significantly affected by the country of the study, the location of the tumor, the cancer stage or the methods used for measuring tumor CXCL12 levels (all P>0.05). In conclusion, the study found that a higher tumor expression level of CXCL12 was associated with the poor survival of patients with CRC. Studies are warranted to determine if CXCL12-targeted intervention could improve the prognosis of patients with CRC.

Impact of response patterns for patients with advanced acral melanoma treated with anti-programmed death-1 monotherapy.

Acral melanoma (AM) is less responsive to immunotherapy than nonacral cutaneous melanoma. Variable responses are seen during immunotherapy, including pseudoprogression, hyperprogressive disease (HPD) and heterogeneous responses. There are currently no studies on the response patterns of patients with AM treated with immunotherapy and the impact on the outcome. To evaluate the response patterns and prognosis of patients with AM treated with anti-programmed death (PD)-1 antibodies. Patients with advanced AM treated prospectively in five clinical trials of anti-PD-1 monotherapy at Peking University Cancer Hospital were included. Responses of individual metastases and heterogeneous responses were evaluated during immunotherapy. Cox proportional hazards regression analysis was conducted to identify the possible predictive factors and generate a nomogram to predict the risk of 1-year and 2-year mortality. The overall response rate was 18·0%, the disease control rate was 36·1%, median progression-free survival was 3·5 months [95% confidence interval (CI) 1·7-5·3] and median overall survival was 17·5 months (95% CI 15·1-19·9) for anti-PD-1 monotherapy. Overall, 9·8% of patients met the criteria of HPD, and displayed a dramatically worse outcome than patients without HPD. In total, 369 metastatic lesions were assessed, with the highest response rate in lymph nodes (20·4%) and the lowest in the liver (5·6%). Homogeneous response, heterogeneous response and heterogeneous or homogeneous progression had different prognoses from the best to the worst. A predictive model was constructed and achieved good accuracy with a C-index of 0·73 (95% CI 0·63-0·84) in the training set and 0·74 (95% CI 0·61-0·86) in the validation set. HPD during immunotherapy serves as an essential biomarker of poor prognosis in advanced AM. Metastases in different sites respond distinctively to immunotherapy. Clinically heterogeneous responses to immunotherapy affect the outcome of patients. A predictive model was built to distinguish the prognosis of acral melanoma under immunotherapy.