Common Mechanism Research Articles

Alzheimer's Disease and Cancer: Common Targets.

There is growing epidemiologic evidence of an inverse association between cancer and AD. In addition, both cell survival and death are regulated by the same signaling pathways, and their abnormal regulation may be implicated in the occurrence and development of cancer and AD. Research shows that there may be a common molecular mechanism between cancer and AD. This review will discuss the role of GSK3, DAPK1, PP2A, P53 and CB2R in the pathogenesis of cancer and AD and describe the current research status of drug development based on these targets.

Acute colonic pseudo-obstruction in polytrauma patients.

Acute colonic pseudo-obstruction (ACPO) is characterized by severe colonic distension without mechanical obstruction. It has an uncertain pathogenesis and poses diagnostic challenges. This study aims to explore risk factors and clinical outcomes of ACPO in polytrauma patients, and contributing information to the limited literature on this condition. This retrospective study, conducted at a Level 1 Trauma Centre, analysed data from trauma patients with ACPO admitted between July 2009 and June 2018. A control cohort of major trauma patients was utilized. Data review encompassed patient demographics, abdominal imaging, injury characteristics, analgesic usage, interventions, complications, and mortality. Statistical analyses, including logistic regression and correlation coefficients, were employed to identify risk factors. There were 57 cases of ACPO, with an incidence of 1.7 / 1000 patients, rising to 4.86 in major trauma. Predominantly affecting those over 50 years of age (75%) and males (75%), with motor vehicle accidents (50.8%) and falls from height (36.8%) being the commonest mechanisms. Noteworthy associated injuries included retroperitoneal bleeds (RPB) (37%), spinal fractures (37%), and pelvic fractures (37%). Analysis revealed significant associations between ACPO and Shock Index >0.9, Injury Severity Score > 18, opioid use, RPB, and pelvic fractures. A caecal diameter of ≥12 cm had a significant association with caecal ischemia or perforation. This study underscores the significance of ACPO in polytrauma patients, demonstrating associations with risk factors and clinical outcomes. Clinicians should maintain a high index of suspicion, particularly in older patients with RPB, pelvic fractures, and opioid use. Early supportive therapy, vigilant monitoring, and timely interventions are crucial for a favourable outcome. Further research and prospective trials are warranted to validate these findings and enhance understanding of ACPO in trauma patients. Prognostic and Epidemiological, Level IV.

Continuum Growth Mechanics: Reconciling Two Common Frameworks.

The objective of this study was to investigate whether the two most common growth mechanics modeling frameworks, the constrained-mixture growth model and the kinematic growth model, could be reconciled mathematically. The purpose of this effort was to provide practical guidelines for potential users of these modeling frameworks. Results showed that the kinematic growth model is mathematically consistent with a special form of the constrained-mixture growth model, where only one generation of a growing solid exists at any given time, overturning its entire solid mass at each instant of growth in order to adopt the reference configuration dictated by the growth deformation. The thermodynamics of the kinematic growth model, along with the specialized constrained-mixture growth model, requires a cellular supply of chemical energy to allow deposition of solid mass under a stressed state. A back-of-the-envelope calculation shows that the amount of chemical energy required to sustain biological growth under these models is negligibly small, when compared to the amount of energy normally consumed daily by the human body. In conclusion, this study successfully reconciled the two most popular growth theories for biological growth and explained the special circumstances under which the constrained-mixture growth model reduces to the kinematic growth model.

Night time heart rate predicts next-day pain in fibromyalgia and primary back pain.

Primary chronic pain is pain that persists for over 3 months without associated measurable tissue damage. One of the most consistent findings in primary chronic pain is its association with autonomic hyperactivation. Yet whether the autonomic hyperactivation causes the pain or results from it is still unclear. It is also unclear to what extent autonomic hyperactivation is related to experienced pain intensity in different subtypes or primary chronic pain. Our first aim was to test lagged relationships between the markers of autonomic activation (heart rate) and pain intensity to determine its directionality. The main question here was whether autonomic biomarkers predict pain intensity or whether pain intensity predicts autonomic biomarkers. The second aim was to test whether this relationship is different between people with primary back pain and people with fibromyalgia. Sixty-six patients with chronic pain were observed over an average of 81 days. Sleep heart rate and heart rate variability were measured with a wearable sensor, and pain intensity was assessed from daily subjective reports. The results showed a predictive relationship between sleep heart rate and next-day pain intensity (P < 0.05), but not between daily pain intensity and next night heart rate. There was no interaction with the type of chronic pain. These findings suggest that autonomic hyperactivation, whether stress-driven or arising from other causes, precedes increases in primary chronic pain. Moreover, the present results suggest that autonomic hyperactivation is a common mechanism underlying the pain experience in fibromyalgia and chronic back pain.

A study to untangle the puzzle of urinary incontinence and frailty co-occurrence among older adults: The roles of depression and activity engagement.

To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways. A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China. Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism. A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant. The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement. The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence. What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers' understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence. The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines. No patient or public contribution.

Abstract 4752: Enhancer of zeste homolog 2 inhibitors overcome glucocorticoid resistance in acute lymphoblastic leukemia by augmenting pro-apoptotic signaling

Abstract Introduction Relapsed acute lymphoblastic leukemia (ALL) portends a poor prognosis. Glucocorticoids (GCs) are a central component of a multi-agent regimen to treat ALL. GCs mediate ligand-dependent global transcriptional changes activating feedback loop that increases GC receptor (GR) expression and pro-apoptotic signaling. GC resistance is a common mechanism in relapsed/refractory ALL. Altered function of Enhancer of Zeste Homolog 2 (EZH2), a histone methyl transferase (HMT), including increased expression and activating mutations have been reported in ALL. Previously, EZH2 inhibitors have been shown to increase GC efficacy in non-ALL B-cell lymphoid malignancies including non-Hodgkin lymphoma. Furthermore, EZH2 inhibitors reversed GC resistance and increased efficacy of GCs in an ALL subtype with an activating point mutation in an HMT called nuclear set domain 2. Overcoming GC resistance by novel therapeutic strategies may help improve outcomes in relapsed/refractory ALL. Hypothesis EZH2 inhibitors may enhance GC efficacy by augmenting downstream effects of GCs. Methods We performed in-vitro studies of EZH2 inhibitors, EPZ-6438 and CPI-1205, at graded doses in GC resistance human-derived B-cell (SUPB15) and T-cell (SUPT1, KOPTK1, PEER) ALL cell lines followed by graded doses of dexamethasone (dex). Cell viability was performed using CellTiter-Glo assay. Induction of apoptosis was measured with Annexin V flow cytometry. Pro-apoptotic BIM mRNA and protein levels were measured using real-time PCR and immunoblot. Global H3K27me3 protein levels were assessed using immunoblot. Results GC resistant B-cell ALL and T-cell ALL treated with EZH2 inhibitors for 3-7 days followed by the addition of dex for 48-72 hours led to decreased cell viability and increased apoptosis of the ALL cells compared to cells treated with vehicle (DMSO) and dex alone. EZH2 inhibitors on their own did not cause apoptosis. SynergyFinder revealed Bliss synergy scores between 23- 31 in B-cell ALL and T-cell ALL cell lines with greater than 10 considered a synergistic drug interaction. Immunoblotting of cells treated with EZH2 inhibitors alone showed an increase in pro-apoptotic protein, BIM. BIM level was further enhanced when dex was added in combination with EZH2 inhibitors compared to vehicle and dex alone suggesting that EZH2 inhibitors were augmenting BIM expression. Further assessment of the mechanism of how EZH2 inhibitors lead to improved GC efficacy will be performed by integrating transcriptomic and epigenomic profiling in the presence and absence of EZH2 inhibitors. Furthermore, in-vivo testing of EZH2 inhibitors in patient derived xenografts will be performed. Conclusion EZH2 inhibitors can overcome GC resistance in ALL posing as a potential novel therapeutic agent to treat relapsed/refractory ALL. Citation Format: Mansi Dalal, Joanna Yi, Jianping Li, Amin Shobh, Daphne DupereRicher, Richard Bennett, Jonathan Licht. Enhancer of zeste homolog 2 inhibitors overcome glucocorticoid resistance in acute lymphoblastic leukemia by augmenting pro-apoptotic signaling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4752.

Abstract 4434: Cancer cell-derived adrenomedullin downregulates Zeb1 in adipocytes to induce adipolysis and promote breast cancer progression

Abstract Background: Once breast carcinoma in situ breaks through the basement membrane, it preferentially invades the lipid-rich microenvironment around the mammary gland, which indicates a poor prognosis. However, the detailed mechanisms of this interaction remain elusive. Here, we describe bidirectional communication between breast cancer cells and cancer-associated adipocytes (CAAs). Different from the common hormone-driven mechanism of lipolysis of adipocytes, we found that CAAs perform a unique lipolysis program, and Zeb1 plays an important role in this lipolysis process. Methods: Fabp4-cre;Zeb1-/- as adipose tissue-specific Zeb1 gene knockout homozygous mice and Fabp4-cre;Zeb1 tg as adipose tissue-specific Zeb1 gene overexpression mice were constructed to study mammary gland development and perform orthotopic tumor transplantation experiments. Tetracycline-induced Zeb1-overexpressing stable cells were constructed from mouse preadipocytes 3T3-L1 to study phenotypes of lipolysis. Single-cell sequencing, targeted lipidomics, and RNA sequencing analysis were used to investigate the interaction between cancer cells and adipocytes. Western blotting and immunohistochemical staining assays were used to detect the expression Zeb1 at the cellular level, in mouse models and in patient tissue samples. Results: Our results indicated that breast cancer cell-derived adrenomedullin (ADM) significantly down-regulates Zeb1 expression in adipocytes, which drives downstream gene expression of Pnpla2/HSL/SCD1 and induces adipocyte lipolysis into CAA, a process that results in the release of excess palmitoleic acid. Consequently, we proved that palmitoleic acid could replace arachidonic acid (ARA) in the phospholipid sn-2 position of breast cell membrane, which enhances the fluidity and invasiveness of cancer cells. In addition, overexpression of Zeb1 in adipocytes reduces the ability of cancer cells to induce adipolysis and inhibits the malignant progression of cancer cells. Conclusion: These results indicate that Zeb1 plays a pivotal role as core transcriptional factor in CAA lipolysis. The interaction between breast cancer cells and adipocytes leads to the reprogramming of metabolism within their tumor microenvironment, which may become a new target for breast cancer treatment. Citation Format: Lixia Cao, Xiao Chen, Yi Shi, Shuang Yang. Cancer cell-derived adrenomedullin downregulates Zeb1 in adipocytes to induce adipolysis and promote breast cancer progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4434.

Abstract 964: Updated results of a prospective observational multicenter study on resistance mechanisms to osimertinib using circulating tumor DNA analyses in EGFR-mutated non-small cell lung cancer patients (ELUCIDATOR study)

Abstract Background: Although osimertinib (Osi) is the key standard therapy for patients (pts) with advanced non-small cell lung cancer (NSCLC) harboring sensitizing epidermal growth factor receptor (EGFR) mutations, most of cases experience the progressive disease (PD) after initial response to the treatment. Therefore, understanding the Osi resistance mechanisms and identifying the poor responders are essential to develop better treatment strategies. Thus, we conducted a prospective observational multicenter study and analyzed serially collected circulating tumor DNA (ctDNA). Here we report the results from updated analyses focusing on the association between genetic information from ctDNA and clinical outcome. Methods: Patient eligibility criteria were as follows: a definitive diagnosis of non-squamous NSCLC confirmed through biopsy or cytology, EGFR exon 19 deletion (19del) or L858R mutation, Osi planned as first-line treatment, and pts who could provide blood specimens. Paired plasma DNA samples were collected before starting Osi as baseline (BL) and at PD and analyzed to investigate Osi resistance by next-generation sequencing (NGS). Correlations between genetic information obtained from ctDNA and clinical outcome such as progression free survival (PFS) and overall survival (OS) were evaluated. The median follow-up time was 33.1 months. Results: One hundred eighty-eight pts were enrolled between May 2019 and January 2021, and 125 (66%) were female, 96 (51%) were EGFR 19del mutation, and 109 (58%) were never smoker. Among those, 178 pts were included in the analyses, and 111 experienced PD. In consistent with previous reports, median PFS (mPFS) and median OS (mOS) were 19.1 months and 36.0 months, respectively. The efficacy of Osi differed between 19del and L858R in both PFS and OS, with 19del being longer outcome [mPFS, 23.3 months vs. 17.2 months, HR: 1.56 (95%CI: 1.08-2.26), mOS, 40.3 months vs. 30.4 months, HR: 1.54 (95%CI: 0.98-2.45)]. Univariate analysis revealed that the presence of TP53 mutations and MET amplification (amp) at BL was a predictive factor of shorter PFS and OS. Multivariate analysis also revealed that the TP53 mutations at BL was a predictive factor of shorter PFS and OS. Plasma samples from 85 pts were available for ctDNA analysis. New adaptive mutations or amp at PD were detected in genes such as PIK3CA in 3 cases, MET amp in 4, TP53 in 4, BRIMP3 in 2, APC in 1, and BRAF in 2. Secondary EGFR C797S resistance mutation was detected in 1 case. Conclusions: TP53 mutation at BL could be predictive of poor response to Osi. MET amp and PIK3CA mutations were detected as the most common resistance mechanisms, and secondary EGFR resistance mutations were observed less frequently than previous reports. Citation Format: Mitsuo Osuga, Akihiro Tamiya, Daijiro Harada, Yasuyuki Mizumori, Shun-ichi Isa, Yoshihiko Taniguchi, Keiichi Nakamura, Tsutomu Shinohara, Hidetoshi Yanai, Katsumi Nakatomi, Masahide Oki, Masahide Mori, Tomohito Kuwako, Koji Yamazaki, Atsuhisa Tamura, Masahiko Ando, Yasuhiro Koh. Updated results of a prospective observational multicenter study on resistance mechanisms to osimertinib using circulating tumor DNA analyses in EGFR-mutated non-small cell lung cancer patients (ELUCIDATOR study) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 964.

Peeling pressure-sensitive adhesive elastica from elastica with pinned and roller ends

Quasi-static peeling of a horizontal elastica (the tape) from another horizontal elastica (the beam) supported by a pinned end and a roller end is analyzed. Bending resistance is assumed to dominate the behavior, and large deflections and rotations are allowed. The tape is shorter than the beam and is pulled upward at a constant angle with the horizontal. A transversality (debonding) condition is derived for peeling, based on the common fracture mechanics approach. Displacement control is considered. The associated force exhibits its peak value at the onset of peeling. The vertical deflection of the pulled end of the tape also is of interest, especially when the tape detaches from the beam. Equilibrium curves are determined, and the effects of the following parameters on the peak force and the detachment deflection are investigated: the relative thicknesses and moduli of elasticity of the tape and the beam; the relative lengths of the tape and the beam; the angle of pulling; and the nondimensional work of adhesion. The system may be used as a model of peeling bandages, medical patches, biosensors, and other wearable devices from skin. Other possible thin flexible substrates include fabric, paper, leather, rubber, and plastics.

Long term trends in the incidence of distal radius fractures in Sindhudurg, west coast of Maharashtra Retrospective analysis of 1776 distal radius fractures (1989 to 1999), hospital based study

The over all incidences related to age, gender with secular trends and seasonal variation in the catchment area of Sindhudurg, are reported in this study. This study included all the patients of distal radius fractures treated by the author at Government. hospital Kudal, Sindhudurg between 1989 to 1999. A retrospective analysis was done extracting the data from Government hospital OPD registers, indoor case papers, cross-checked with operation theatre, radiology files. Overall 1776 distal radius fractures conferred of which 692(39.0%) were women. The annual incidence was 1.41 for 1989 and 2.58 for 1999 per 10,000 inhabitants. There was an exponential increase in incidence of adolescents of 11 to 20 years [26(22.1%) in 1989 and 56(25.4%) in 1999] and between 51 to 70 years age group [37(31.4%) in 1989 and 82(37.2%) in 1999] in both genders. After 71 years there was gradual decline in incidence in both men and women. Low velocity injuries due to indoor and outdoor falling was the most common mechanism of injury in 1340(75.5%). Associated ulnar styloid fracture was seen in 912(51.3%). Surgical intervention was done in 522(57.2%) with ulnar styloid fracture and in 186(21.5%) with intact ulnar styloid.The annualincidence of distal radius fracture is consistently increasing over a decade time, much more so in adolescents. Men and women between 51 to 70 years had a higher risk of fracture than other groups. Low energy injuries were most predominant.

Traumatic spinal cord injury: A four-year study in Puerto Rico

Objective Assess the occurrence of traumatic spinal cord injury (TSCI) in Puerto Rico, a geographically delimited territory. Design Retrospective review of data from all encounters with ICD-10-CM codes S12-14, S22-24, S32-34, G82.2 and G82.5 for years 2019-2022. Setting Puerto Rico Trauma Hospital. Outcome measures Patient (sex, age) and injury characteristics (neurological level, mechanism of injury, severity score, length of stay, mortality, and disposition). Results Annual incidence rates did not change over time with an increasing trend among older adults (P = 0.08). Median age was 44 yrs and 85% were men. The most frequent neurological level was thoracic (P = 0.03). Falls were the most common mechanism and was associated with age (P < 0.0001). In-hospital mortality was 24.8%, higher (P = 0.05) in 2020-2021. Median length of stay was 26 days, higher (P = 0.014) in 2020-2021. An increase (P < 0.001) over time in discharges to inpatient rehabilitation was observed. The SARS-CoV-2 lockdown resulted in fewer and older patients; more cervical injuries and falls; longer length of stay, and higher in-hospital mortality. Conclusion The risk of TSCI in Puerto Rico was 74% lower than in the United States. The incidence of TSCI in older adults in Puerto Rico appears to be on the rise due to falls. Preventive strategies should include fall prevention education and social interventions to decrease motor vehicle accidents and firearm violence. Disasters such as the COVID-19 pandemic, can change demographic trends in TSCI. Trauma centers should consider implementing a physiatry consult service to improve patient disposition.

The interplay of contextual and immediate uncertainty: evidence for a common processing mechanism in prediction and cognitive control

The interplay of contextual and immediate uncertainty: evidence for a common processing mechanism in prediction and cognitive control

Comorbid functional pathology in gastroenterology. Possibilities and prospects for drug treatment: A review

Functional disorders of the gastrointestinal tract (FD GT) and their intersection are relevant due to their high prevalence in the population, decrease and, in some cases, loss of performance, low quality of life and treatment difficulties. Despite the large number of consensuses and clinical recommendations at the national and international level, the effectiveness of therapy for FD GT and their overlap does not exceed 30-50%. There is a high degree of comorbidity of these diseases, called “overlap syndromes,” due to common pathogenetic mechanisms. This predetermines the need to use drugs with a multi-target therapeutic effect in the treatment of such pathology. Such drugs include trimebutine (Trimedate®), probiotics and psychotropic drugs. Data obtained in recent years on the presence of anti-inflammatory, antimicrobial, regenerative effects in relation to nervous and epithelial tissue and anti-carcinogenic effects in trimebutine make it unique for the treatment of gastrointestinal diseases and their intersection. Currently, there is a search for new promising drugs for the treatment of both individual FD GT and their overlap, as well as improving the regimens of existing treatment methods. The review article is devoted to existing opportunities and new horizons for the treatment of FD GT and their overlap.

A second hotspot for pathogenic exon-skipping variants in CDC45.

Biallelic pathogenic variants in CDC45 are associated with Meier-Gorlin syndrome with craniosynostosis (MGORS type 7), which also includes short stature and absent/hypoplastic patellae. Identified variants act through a hypomorphic loss of function mechanism, to reduce CDC45 activity and impact DNA replication initiation. In addition to missense and premature termination variants, several pathogenic synonymous variants have been identified, most of which cause increased exon skipping of exon 4, which encodes an essential part of the RecJ-orthologue's DHH domain. Here we have identified a second cohort of families segregating CDC45 variants, where patients have craniosynostosis and a reduction in height, alongside common facial dysmorphisms, including thin eyebrows, consistent with MGORS7. Skipping of exon 15 is a consequence of two different variants, including a shared synonymous variant that is enriched in individuals of East Asian ancestry, while other variants in trans are predicted to alter key intramolecular interactions in α/β domain II, or cause retention of an intron within the 3'UTR. Our cohort and functional data confirm exon skipping is a relatively common pathogenic mechanism in CDC45, and highlights the need for alternative splicing events, such as exon skipping, to be especially considered for variants initially predicted to be less likely to cause the phenotype, particularly synonymous variants.

Recent Progress in Implantable Drug Delivery Systems.

In recent years, tremendous effort is devoted to developing platforms, such as implantable drug delivery systems (IDDSs), with temporally and spatially controlled drug release capabilities and improved adherence. IDDSs have multiple advantages: i) the timing and location of drug delivery can be controlled by patients using specific stimuli (light, sound, electricity, magnetism, etc.). Some intelligent "closed-loop" IDDS can even realize self-management without human participation. ii) IDDSs enable continuous and stable delivery of drugs over a long period (months to years) and iii) to administer drugs directly to the lesion, thereby helping reduce dosage and side effects. iv) IDDSs enable personalized drug delivery according to patient needs. The high demand for such systems has prompted scientists to make efforts to develop intelligent IDDS. In this review, several common stimulus-responsive mechanisms including endogenous (e.g., pH, reactive oxygen species, proteins, etc.) and exogenous stimuli (e.g., light, sound, electricity, magnetism, etc.), are given in detail. Besides, several types of IDDS reported in recent years are reviewed, including various stimulus-responsive systems based on the above mechanisms, radio frequency-controlled IDDS, "closed-loop" IDDS, self-powered IDDS, etc. Finally, the advantages and disadvantages of various IDDS, bottleneck problems, and possible solutions are analyzed to provide directions for subsequent research.

A case of an unfavorable outcome of a new coronavirus infection COVID-19 in an obese teenager

The new coronavirus infection COVID-19, as a rule, in children and teenagers has a lighter course compared to adults. However, in a number of comorbid patients, this disease can be severe and even end fatally. This concomitant pathology includes obesity, which became even more common in the population, including in childhood, during the COVID-19 pandemic and has a number of common pathogenetic mechanisms of inflammation with this infection. The article considers such a clinical case in a 17-year-old teenager with an unfavorable outcome, the purpose of demonstrating which was to determine the risks of a severe course of a new coronavirus infection.

EGFR-T790M mutation associated with acquired resistance to first-generation EGFR tyrosine kinase inhibitors in Vietnamese Non-Small-Cell Lung Cancer patients

Background: non-small cell lung cancer (NSCLC) patients who had epidermal growth factor receptor (EGFR) mutations sensitive to EGFR tyrosine kinase inhibitors (TKIs) had a high response rate to target therapies. Epidermal growth factor receptor (EGFR) T790M mutation is the most common mechanism of acquired resistance to first-generation EGFR TKIs. Objective: The aim of this study was to analyze the incidence of EGFR T790 mutation, the progression-free survival (PFS) in the patients who progress on the first‑ generation EGFR‑TKIs. This study also investigates the correlation between T790M mutation and clinical, subclinical features, progression-free survival of NSCLC Vietnamese patients.&#x0D; Patients and methods: We analyzed 66 NSCLC patients who had acquired resistance to first-generation EGFR-TKIs. The clinical data, PFS and the mechanism of acquired resistance were obtained. The Kaplan-Meier method and the log-rank test were used to analyze the PFS and compare between subgroups of patient characteristics. The correlations between the patient’s characteristics and EGFR-T790M mutation status were analyzed by Chi-square and Fisher’s exact tests.&#x0D; Results: At the progressive period, EGFR T790M mutation was detected in 54.5% of patients. The median PFS were 14.48 ± 3.9 months (range: 8- 26 months). Patients who were older than 60 years old or had comorbidities had significantly shorter PFS than the subgroups without (P≤0.05). The age, gender, smoking status, comorbidities, pathological features were not significantly correlated with the development of EGFR-T790M (P &gt; 0.05). The average PFS was not significantly different between the EGFR-T790M group and the non-EGFR-T790M group (P=0.642).&#x0D; Conclusion: In our cohort study, more than half of all patients had T790M mutation after being treated with first-generation EGFR TKIs. Age and comorbidities were associated with PFS but the EGFR-T790M mutation was not correlated with PFS.

Therapeutic role of miR-26a on cardiaorenal injury in mice model of angiotensin-II induced chronic kidney disease through inhibition of LIMS1/ILK pathway.

Chronic kidney disease (CKD) is associated with common pathophysiological processes, such as inflammation and fibrosis, in both the heart and the kidney. However, the underlying molecular mechanisms that drive these processes are not yet fully understood. Therefore, this study focused on the molecular mechanism of heart and kidney injury in CKD. We generated a microRNA (miR)-26a knockout (KO) mouse model to investigate the role of miR-26a in angiotensin (Ang)-II-induced cardiac and renal injury. We performed Ang-II modeling in wild type (WT) mice and miR-26a KO mice, with six mice in each group. In addition, Ang-II-treated AC16 cells and HK2 cells were used as in vitro models of cardiac and renal injury in the context of CKD. Histological staining, immunohistochemistry, quantitative real-time polymerase chain reaction (PCR), and Western blotting were applied to study the regulation of miR-26a on Ang-II-induced cardiac and renal injury. Immunofluorescence reporter assays were used to detect downstream genes of miR-26a, and immunoprecipitation was employed to identify the interacting protein of LIM and senescent cell antigen-like domain 1 (LIMS1). We also used an adeno-associated virus (AAV) to supplement LIMS1 and explored the specific regulatory mechanism of miR-26a on Ang-II-induced cardiac and renal injury. Dunnett's multiple comparison and t-test were used to analyze the data. Compared with the control mice, miR-26a expression was significantly downregulated in both the kidney and the heart after Ang-II infusion. Our study identified LIMS1 as a novel target gene of miR-26a in both heart and kidney tissues. Downregulation of miR-26a activated the LIMS1/integrin-linked kinase (ILK) signaling pathway in the heart and kidney, which represents a common molecular mechanism underlying inflammation and fibrosis in heart and kidney tissues during CKD. Furthermore, knockout of miR-26a worsened inflammation and fibrosis in the heart and kidney by inhibiting the LIMS1/ILK signaling pathway; on the contrary, supplementation with exogenous miR-26a reversed all these changes. Our findings suggest that miR-26a could be a promising therapeutic target for the treatment of cardiorenal injury in CKD. This is attributed to its ability to regulate the LIMS1/ILK signaling pathway, which represents a common molecular mechanism in both heart and kidney tissues.

Theoretical Insight into the Palladium-Catalyzed Prenylation and Geranylation of Oxindoles with Isoprene.

This work presents a comprehensive mechanistic study of the ligand-controlled palladium-catalyzed prenylation (with C5 added) and geranylation (with C10 added) reactions of oxindole with isoprene. The calculated results indicate that the prenylation with the bis-phosphine ligand and geranylation with the monophosphine ligand fundamentally share a common mechanism. This mechanism involves the formation of two crucial species: a η3-allyl-Pd(II) cation and an oxindole carbon anion. Furthermore, the reactions necessitate the assistance of a second oxindole molecule, which serves as a Brønsted acid, providing a proton to generate the oxindole nitrogen anion. The oxindole nitrogen anion then acts as a Brønsted base, abstracting a C-H proton from another oxindole molecule to form an oxindole carbon anion. These mechanistic details differ significantly from those proposed in the experimental work. The present calculations do not support the presence of the Pd-H species and the η3, η3-diallyl-Pd(II) intermediate, which were previously suggested in experiments. The theoretical results rationalize the experimental finding that the bis-phosphine ligand favors the prenylation of oxindole, while the monophosphine ligand enables the geranylation of oxindole.

Integrative research of Mediterranean climate regions: a global call to action

SummaryMediterranean climate regions (hereafter ‘Med-regions’) cover small areas globally but harbour a wide diversity of ecosystems that are under serious threat due to current global climate change. Despite intensive research and conservation efforts in freshwater, marine and terrestrial ecosystems to prevent the consequences of habitat fragmentation, overfishing and changes in fire regimes and heatwaves, there is still no global consensus on how to conserve and manage Med-region ecosystems. We define integrative research as an interdisciplinary approach with common concepts and metrics enabling a better understanding of the general mechanisms underlying ecosystems. Building upon existing literature that promotes integrative research in Med-region ecosystems, we advocate for a more integrative approach that takes into consideration cross-ecosystem generalities and common resilience mechanisms. We propose examples of potential studies for implementing such integrative research, including: (1) integrative research across ecosystems; (2) integrative research across Med-regions; and (3) integrative research across political boundaries. We then offer recommendations for promoting integrative studies, including leveraging biodiversity data, establishing working groups in research syntheses and testing theoretical frameworks. Promoting integrative research in Med-regions would enable and facilitate the roadmap towards a better understanding of Med-region ecosystems’ responses to natural and anthropogenic disturbances and the identification of ecological baselines. We seek to foster future research synergies to identify tipping points across ecosystems and aid in determining desired future conditions in Med-regions globally.