Multi-omics analysis of kidney, bone and bone marrow explored potential mechanisms of Erzhi Wan against osteoporosis with kidney-Yin deficiency.

Osteoporosis (OP) is a metabolic bone disease that can lead to major health challenges. The theory of Traditional Chinese medicine believes that kidney-Yin deficiency (KYD) is the main cause of postmenopausal osteoporosis. This study was aimed to investigate the effect of EZW on anti-osteoporosis with KYD, and explore potential mechanisms from the perspective of the kidney, bone and bone marrow through analysis of metabolomics and proteomics. The model of OP with KYD was established by rats treated with bilateral ovariectomy (OVX), and then given intragastric administration of thyroid and reserpine to induce. Micro-CT was applied to determine the microstructures of bone. Serum levels associated with bone turnover markers and kidney-Yin deficiency were detected by enzyme-linked immunosorbent (ELISA) assay. The differential metabolites in the kidney, bone and bone marrow were analyzed by metabolomics. The differentially expressed proteins in these three tissues were detected via proteomics. The findings suggested that EZW could alleviate a variety of metabolites and proteins among the kidney, bone and bone marrow, primarily in amino acid metabolism, carbohydrate metabolism, nucleotide metabolism and lipid metabolism, thus leading to improvements of OP with KYD, which provided theoretical basis for clinical treatment of EZW on OP with KYD.

Integrated component identification, network pharmacology, and experimental verification revealed mechanism of Dendrobium officinale Kimura et Migo against lung cancer.

BACKGROUND: Dendrobium officinale Kimura et Migo (DO), a valuable Chinese herbal medicine, has been reported to exhibit potential effects in the prevention and treatment of lung cancer. However, its material basis and mechanism of action have not been comprehensively analyzed. PURPOSE: The objective of this study was to preliminarily elucidate the active components and pharmacological mechanisms of DO in treating lung cancer, according to UPLC-Q/TOF-MS, HPAEC-PAD, network pharmacology, molecular docking, and experimental verification. METHODS: The chemical components of DO were identified via UPLC-Q/TOF-MS, while the monosaccharide composition of Dendrobium officinale polysaccharide (DOP) was determined by HPAEC-PAD. The prospective active constituents of DO as well as their respective targets were predicted in the combined database of Swiss ADME and Swiss Target Prediction. Relevant disease targets for lung cancer were searched in OMIM, TTD, and Genecards databases. Further, the active compounds and potential core targets of DO against lung cancer were found by the C-T-D network and the PPI network, respectively. The core targets were then subjected to enrichment analysis in the Metascape database. The main active compounds were molecularly docked to the core targets and visualized. Finally, the viability of A549 cells and the relative quantity of associated proteins within the major signaling pathway were detected. RESULTS: 249 ingredients were identified from DO, including 39 flavonoids, 39 bibenzyls, 50 organic acids, 8 phenanthrenes, 27 phenylpropanoids, 17 alkaloids, 17 amino acids and their derivatives, 7 monosaccharides, and 45 others. Here, 50 main active compounds with high degree values were attained through the C-T-D network, mainly consisting of bibenzyls and monosaccharides. Based on the PPI network analysis, 10 core targets were further predicted, including HSP90AA1, SRC, ESR1, CREBBP, MAPK3, AKT1, PIK3R1, PIK3CA, HIF1A, and HDAC1. The results of the enrichment analysis and molecular docking indicated a close association between the therapeutic mechanism of DO and the PI3K-Akt signaling pathway. It was confirmed that the bibenzyl extract and erianin could inhibit the multiplication of A549 cells in vitro. Furthermore, erianin was found to down-regulate the relative expressions of p-AKT and p-PI3K proteins within the PI3K-Akt signaling pathway. CONCLUSIONS: This study predicted that DO could treat lung cancer through various components, multiple targets, and diverse pathways. Bibenzyls from DO might exert anti-lung cancer activity by inhibiting cancer cell proliferation and modulating the PI3K-Akt signaling pathway. A fundamental reference for further studies and clinical therapy was given by the above data.

Predicting One-year Recurrence of HCC based on Gadoxetic Acid-enhanced MRI by Machine Learning Models.

OBJECTIVE: Accurate prediction of recurrence risk after resction in patients with Hepatocellular Carcinoma (HCC) may help to individualize therapy strategies. This study aimed to develop machine learning models based on preoperative clinical factors and multiparameter Magnetic Resonance Imaging (MRI) characteristics to predict the 1-year recurrence after HCC resection. METHODS: Eighty-two patients with single HCC who underwent surgery were retrospectively analyzed. All patients underwent preoperative gadoxetic acidenhanced MRI examination. Preoperative clinical factors and MRI characteristics were collected for feature selection. Least Absolute Shrinkage and Selection Operator (LASSO) was applied to select the optimal features for predicting postoperative 1-year recurrence of HCC. Four machine learning algorithms, Multilayer Perception (MLP), random forest, support vector machine, and k-nearest neighbor, were used to construct the predictive models based on the selected features. A Receiver Operating Characteristic (ROC) curve was used to assess the performance of each model. RESULTS: Among the enrolled patients, 32 patients experienced recurrences within one year, while 50 did not. Tumor size, peritumoral hypointensity, decreasing ratio of liver parenchyma T1 value (ΔT1), and α-fetoprotein (AFP) levels were selected by using LASSO to develop the machine learning models. The area under the curve (AUC) of each model exceeded 0.72. Among the models, the MLP model showed the best performance with an AUC, accuracy, sensitivity, and specificity of 0.813, 0.742, 0.570, and 0.853, respectively. CONCLUSION: Machine learning models can accurately predict postoperative 1-year recurrence in patients with HCC, which may help to provide individualized treatment.

Prediction of immunocyte infiltration and prognosis in postoperative hepatitis B virus-related hepatocellular carcinoma patients using magnetic resonance imaging.

Background: The immune microenvironment (IME) is closely associated with prognosis and therapeutic response of hepatitis B virus-related hepatocellular carcinoma (HBV-HCC). Multi-parametric magnetic resonance imaging (MRI) enables non-invasive assessment of IME and predicts prognosis in HBV-HCC. We aimed to construct an MRI prediction model of the immunocyte-infiltration subtypes and explore its prognostic significance. Methods: HBV-HCC patients at the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) with radical surgery (between 1 October and 30 December 2021) were prospectively enrolled. Patients with pathologically proven HCC (between 1 December 2013 and 30 October 2019) were retrospectively enrolled. Pearson correlation analysis was used to examine the relationship between the immunocyte-infiltration counts and MRI parameters. An MRI prediction model of immunocyte-infiltration subtypes was constructed in prospective cohort. Kaplan-Meier survival analysis was used to analyse its prognostic significance in the retrospective cohort. Results: Twenty-four patients were prospectively enrolled to construct the MRI prediction model. Eighty-nine patients were retrospectively enrolled to determine its prognostic significance. MRI parameters (relative enhancement, ratio of the apparent diffusion coefficient value of tumoral region to peritumoral region [rADC], T1 value) correlated significantly with the immunocyte-infiltration counts (leukocytes, T help cells, PD1+Tc cells, B lymphocytes). rADC differed significantly between high and low immunocyte-infiltration groups (1.47 ± 0.36 vs 1.09 ± 0.25, P = 0.009). The area under the curve of the MRI model was 0.787 (95% confidence interval 0.587-0.987). Based on the MRI model, the recurrence-free time was longer in the high immunocyte-infiltration group than in the low immunocyte-infiltration group (P = 0.026). Conclusions: MRI is a non-invasive method for assessing the IME and immunocyte-infiltration subtypes, and predicting prognosis in post-operative HBV-HCC patients.

Hepatic Pecoma versus Hepatocellular Carcinoma In The Noncirrhotic Liver on Gd-EOB-DTPA-Enhanced MRI: A Diagnostic Challenge.

AIM: Hepatic perivascular epithelioid cell tumors (PEComa) often mimic hepatocellular carcinoma (HCC) in patients without cirrhosis. This study aimed to develop a nomogram using imaging characteristics on Gd-EOB-DTPA-enhanced MRI and to distinguish PEComa from HCC in a noncirrhotic liver. METHODS: Forty patients with non-cirrhotic Gd-EOB-DTPA-enhanced magnetic resonance imaging(MRI) were included in our study. A multivariate logistic regression model was used to select significant variables to distinguish PEComa from HCC. A nomogram was developed based on the regression model. The performance of the nomogram was assessed with respect to the ROC curve and calibration curve. Decision curve analysis (DCA) was performed to evaluate the clinical usefulness of the nomogram. RESULTS: Two significant predictors were identified: the appearance of an early draining vein and the T1D value of tumors. The ROC curve showed that the area under the curve (AUC) of the model to predict the risk of PEComa was 0.91 (95% CI: 0.80~1) and showed that the model had high specificity (92.3%) and sensitivity (88.9%). The nomogram incorporating these two predictors showed favorable calibration, which was validated using 1000 resampling procedures, and the corrected C-index of this model was 0.90. Furthermore, DCA analysis showed that the model had clinical practicability. CONCLUSION: In conclusion, the nomogram model showed favorable predictive accuracy for distinguishing PEComa from HCC in non-cirrhotic patients and may aid in clinical decision-making.

Quantitative assessment of inflammation and evaluation of spatial heterogeneity for non-alcoholic fatty liver disease in mice based on iron-adjustive T1.

Background: A sensitive and non-invasive method is necessary to diagnose non-alcoholic fatty liver disease (NAFLD). We explored the iron-adjustive T1 (aT1) ability to quantify the degree of liver inflammation and evaluate the spatial heterogeneity. Methods: Male C57BL/6J mice were randomly categorized as the NAFLD model (n=40), NAFLD-related liver cirrhosis model (n=20), and normal mice (n=10). T1 and T2* maps were acquired using a 3.0T scanner of magnetic resonance imaging (MRI) and aT1 maps through post-processing corrected iron's effect on T1 using T2*. Pathological changes in the left and right liver lobes were assessed using the Non-alcoholic Steatohepatitis-Clinical Research Network scoring system, though hepatic ballooning lesion were rare in models. Spearman's and partial correlation analyses were used to evaluate correlations, and the receiver operating characteristic curve was used to analyze the diagnostic performance. Results: aT1 was highly correlated with NAFLD activity score (NAS) (r=0.747, P<0.001) but not with the fibrosis stage when adjusted by NAS (r=-0.135, P=0.147). The area under the curve (AUC) of the aT1 value distinguishing groups with 0< NAS <4 and NAS ≥4 was 0.802. On analyzing the histogram features of aT1, the entropy, interquartile range, range, and variance were significantly different between the groups with 0< NAS <4 and NAS ≥4 (P<0.05). The entropy was the risk factor of NAS ≥4. Conclusions: aT1 could help evaluate the inflammatory activity in NAFLD mice unaffected by mild fibrosis, and the higher the degree of inflammation, the higher the heterogeneity of the aT1 map.

Preoperative assessment of peripheral vascular invasion of pancreatic ductal adenocarcinoma based on high-resolution MRI.

OBJECTIVES: Preoperative imaging of vascular invasion is important for surgical resection of pancreatic ductal adenocarcinoma (PDAC). However, whether MRI and CT share the same evaluation criteria remains unclear. This study aimed to compare the diagnostic accuracy of high-resolution MRI (HR-MRI), conventional MRI (non-HR-MRI) and CT for PDAC vascular invasion. METHODS: Pathologically proven PDAC with preoperative HR-MRI (79 cases, 58 with CT) and non-HR-MRI (77 cases, 59 with CT) were retrospectively collected. Vascular invasion was confirmed surgically or pathologically. The degree of tumour-vascular contact, vessel narrowing and contour irregularity were reviewed respectively. Diagnostic criteria 1 (C1) was the presence of all three characteristics, and criteria 2 (C2) was the presence of any one of them. The diagnostic efficacies of different examination methods and criteria were evaluated and compared. RESULTS: HR-MRI showed satisfactory performance in assessing vascular invasion (AUC: 0.87-0.92), especially better sensitivity (0.79-0.86 vs. 0.40-0.79) than that with non-HR-MRI and CT. HR-MRI was superior to non-HR-MRI. C2 was superior to C1 on CT evaluation (0.85 vs. 0.79, P = 0.03). C1 was superior to C2 in the venous assessment using HR-MRI (0.90 vs. 0.87, P = 0.04) and in the arterial assessment using non-HR-MRI (0.69 vs. 0.68, P = 0.04). The combination of C1-assessed HR-MRI and C2-assessed CT was significantly better than that of CT alone (0.96 vs. 0.86, P = 0.04). CONCLUSIONS: HR-MRI more accurately assessed PDAC vascular invasion than conventional MRI and may contribute to operative decision-making. C1 was more applicable to MRI scans, and C2 to CT scans. The combination of C1-assessed HR-MRI and C2-assessed CT outperformed CT alone and showed the best efficacy in preoperative examination of PDAC.

Clinical Interpretability of Deep Learning for Predicting Microvascular Invasion in Hepatocellular Carcinoma by Using Attention Mechanism.

Preoperative prediction of microvascular invasion (MVI) is essential for management decision in hepatocellular carcinoma (HCC). Deep learning-based prediction models of MVI are numerous but lack clinical interpretation due to their "black-box" nature. Consequently, we aimed to use an attention-guided feature fusion network, including intra- and inter-attention modules, to solve this problem. This retrospective study recruited 210 HCC patients who underwent gadoxetate-enhanced MRI examination before surgery. The MRIs on pre-contrast, arterial, portal, and hepatobiliary phases (hepatobiliary phase: HBP) were used to develop single-phase and multi-phase models. Attention weights provided by attention modules were used to obtain visual explanations of predictive decisions. The four-phase fusion model achieved the highest area under the curve (AUC) of 0.92 (95% CI: 0.84-1.00), and the other models proposed AUCs of 0.75-0.91. Attention heatmaps of collaborative-attention layers revealed that tumor margins in all phases and peritumoral areas in the arterial phase and HBP were salient regions for MVI prediction. Heatmaps of weights in fully connected layers showed that the HBP contributed the most to MVI prediction. Our study firstly implemented self-attention and collaborative-attention to reveal the relationship between deep features and MVI, improving the clinical interpretation of prediction models. The clinical interpretability offers radiologists and clinicians more confidence to apply deep learning models in clinical practice, helping HCC patients formulate personalized therapies.

Sanghuangporus vaninii ethanol extract alleviates hyperuricemic renal injury by regulating the uric acid transporters and inhibiting HK-2 apoptosis.

AIM OF THE STUDY: To investigate the acute toxicity of Sanghuangporus ethanol extract (SHEE) on ICR mice and the underlying mechanism of anti-hyperuricemic renal injury. MATERIALS AND METHODS: ICR mice were given a single gavage of 1250, 2500, and 5000 mg/kg SHEE, and the general behavior, mortality, body weight, dietary, and water intake were evaluated within 14 days to determine the acute toxicity level. The hyperuricemic kidney injury model in ICR mice was induced with potassium oxonate (PO) and adenine, and the mice were subsequently treated with SHEE (125, 250, 500 mg/kg). HE and hexamine silver staining (PASM) were used to observe the pathology of the kidney. Biochemical markers were tested by uric acid (UA), creatinine (Cr), blood urea nitrogen (BUN), xanthine oxidase (XOD), alanine transferase (ALT), and aspartate transaminase (AST) kits. An MTT assay was used to measure the effects of SHEE on the proliferation of HK-2 damaged by UA. Western blotting and RT-PCR were used to determine the expression of Bcl-2 family-related proteins and major UA transporters, including URAT1, GLUT9, OAT1, OAT3, and ABCG2, respectively. RESULTS: Firstly, the acute toxicity study data showed that the median lethal dose (LD50) of SHEE was above 5000 mg/kg, and its oral administration was nontoxic at 2500 mg/kg and below. In addition, SHEE alleviated HUA and its renal injury in ICR mice. SHEE reduced the contents of UA, Cr, BUN and XOD in blood and the contents of ALT and AST in the liver. Furthermore, SHEE inhibited the expression of URAT1 and GLUT9 and promoted the expression of OAT1, OAT3, and ABCG2. More importantly, SHEE could downregulate the apoptosis level and caspase-3 activity. CONCLUSIONS: Overall, an oral dose of SHEE below 2500 mg/kg is safe. SHEE inhibits HUA-induced kidney injury by regulating the UA transporters URAT1, GLUT9, OAT1, OAT3 and ABCG2 and inhibiting HK-2 apoptosis.

Evaluation of Hypoxia in Hepatocellular Carcinoma Using Quantitative MRI: Significances, Challenges, and Advances.

This review aimed to perform a scoping review of promising MRI methods in assessing tumor hypoxia in hepatocellular carcinoma (HCC). The hypoxic microenvironment and upregulated hypoxic metabolism in HCC are determining factors of poor prognosis, increased metastatic potential, and resistance to chemotherapy and radiotherapy. Assessing hypoxia in HCC is essential for personalized therapy and predicting prognoses. Oxygen electrodes, protein markers, optical imaging, and positron emission tomography can evaluate tumor hypoxia. These methods lack clinical applicability because of invasiveness, tissue depth, and radiation exposure. MRI methods, including blood oxygenation level-dependent, dynamic contrast-enhanced MRI, diffusion-weighted imaging, MRI spectroscopy, chemical exchange saturation transfer MRI, and multinuclear MRI, are promising noninvasive methods that evaluate the hypoxic microenvironment by observing biochemical processes in vivo, which may inform on therapeutic options. This review summarizes the recent challenges and advances in MRI techniques for assessing hypoxia in HCC and highlights the potential of MRI methods for examining the hypoxic microenvironment via specific metabolic substrates and pathways. Although the utilization of MRI methods for evaluating hypoxia in patients with HCC is increasing, rigorous validation is needed in order to translate these MRI methods into clinical use. Due to the limited sensitivity and specificity of current quantitative MRI methods, their acquisition and analysis protocols require further improvement. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 4.

Efficacy of Disitamab Vedotin in a heavily pre-treated HER2 positive lung adenocarcinoma patient: case report and literature review.

Cancer therapies targeting human epidermal growth factor receptor 2 (HER2) have been attracting increasing attention worldwide, especially in lung adenocarcinoma. Disitamab vedotin is an antibody-drug conjugate designed for targeting HER2 that has been approved for urothelial carcinoma and gastric cancer. However, there is still a lack of clinical evidence for applying Disitamab vedotin in lung adenocarcinoma. Herein, we reported a case of a 52-year-old man with advanced lung adenocarcinoma carrying HER2 amplification as well as HER2 immunohistochemistry (IHC) 2 + who underwent treatment with Disitamab vedotin after disease progression. The patient was treated with chemotherapy, anti-angiogenesis therapy, and immunotherapy as first-line therapy, achieving a remarkable progression-free survival of 16 months. After the disease continued to continuous progress, the patient was administrated with Disitamab vedotin, which resulted in improvement of both the lung lesions and the brain lesions. Our findings provide a valuable reference for the utilization of Disitamab Vedotin in HER2 IHC2+ lung adenocarcinoma.

IL-6 drives T cell death to participate in lymphopenia in COVID-19.

Lymphopenia is a common observation in patients with COVID-19. To explore the cause of T cell lymphopenia in the disease, laboratory results of 64 hospitalized COVID-19 patients were retrospectively analyzed and six patients were randomly selected to trace their changes of T lymphocytes and plasma concentration of IL-6 for the course of disease. Results confirmed that the T-cell lymphopenia, especially CD4+ T cell reduction in COVID-19 patients, was a reliable indicator of severity and hospitalization in infected patients. And CD4+ T cell count below 200 cells/µL predicts critical illness in COVID-19 patients. In vitro assay supported that exposure to key contributors (IL-1ß, IL-6, TNF-α and IFN-γ) of COVID-19 cytokine storm caused substantial death of activated T cells. Among these contributors, IL-6 level was found to probably reversely correlate with T cell counts in patients. And IL-6 alone was potent to induce T cell reduction by gasderminE-mediated pyroptosis, inferring IL-6 took a part in affecting the function and status of T cells in COVID-19 patients. Intervention of IL-6 mediated T cell pryprotosis may effectively delay disease progression, maintain normal immune status at an early stage of infection.

The preparation and evaluation mechanism of mesoporous spherical silica/porous carbon-filled polypropylene composites obtained from coal gasification fine slag.

Coal gasification fine slag is a by-product of the entrained-flow gasifier, which has caused some environmental pollution. Through acid dissolution and calcination at different temperatures, mesoporous spherical silica/porous carbon composite filler was prepared using coal gasification fine slag. The particle size and specific surface area of the composite filler decreased with the decrease of unburned carbon content. The analysis of X-ray photoelectron spectroscopy (XPS) indicated the decrease of oxygen-containing functional groups and the increase of C-C groups with the decrease of the content of carbon. The effects of mesoporous spherical silica/porous carbon with different carbon content on the comprehensive properties of filled polypropylene (PP) were studied. The tensile strength and interface interaction increased at first and then decreased with the decrease of carbon content, due to the synergistic effect of mesoporous spherical silica and rough amorphous carbon. The scanning electron microscope showed that the composite filler with the carbon content of 14.47 wt.% at the calcination temperature of 450 °C had the best compatibility with the matrix. Thermodynamic analysis of the PP composites indicated that thermal insulation properties and thermal stability improved with the incorporation of the composite filler. Differential scanning calorimetry (DSC) testing indicated the highest crystallinity of the matrix corresponding to the best comprehensive performances of the composites. XRD patterns revealed that the cooperation of fillers brought characteristic peaks and did not change the primary crystal structure of PP. Simultaneously, heavy calcium powders (CC) were used as comparative fillers, and the overall properties of the PP composites filled with the composite filler were better compared to those of the CC-filled PP composite. The results illustrated that mesoporous spherical silica/porous carbon particles can completely replace CC used in the PP composites, which can be used in auto bumpers, plastic pipes, display cases, and car air deflectors. The CGFS can be processed into a plastic filler for substituting heavy calcium powder particles, which can solve the environmental pollution caused by the accumulation of solid waste.

Reducing plant-derived ethylene concentrations increases the resistance of temperate grassland to drought.

Model predictions indicate that extreme drought events will occur more frequently by the end of this century, with major implications for terrestrial ecosystem functions such as plant productivity and soil respiration. Previous studies have shown that drought-induced ethylene produced by plants is a key factor affecting plant growth and development, but the impact of drought-induced ethylene on ecosystem functions in natural settings has not yet been tested. Here, we reduced the amount of plant-derived ethylene concentrations by adding the ethylene inhibitor aminoethoxyvinylglycine (AVG), and investigated in situ plant productivity, soil respiration and ethylene concentrations for two years in a semi-arid temperate grassland in Inner Mongolia, China. Drought significantly reduced plant productivity and soil respiration, but the application of AVG reduced ethylene concentrations and significantly increased aboveground plant productivity and soil respiration, effectively enhancing resistance to drought. The reason for this could be that AVG application increased the activity of 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase and abundance of the acdS gene (the key gene for ACC deaminase), facilitating reduced ACC concentrations in the plant tissue and reduced in planta ethylene synthesis. In addition, there was a significant correlation between soil ACC deaminase activity and plant productivity. Given the global distribution of arid and semi-arid areas, and the expected increases in the frequency and intensity of drought stress, this is a significant concern. These results provide novel evidence of the impact of drought-induced plant ethylene production on ecosystem functions in semi-arid temperate grassland ecosystems.

CD20+CD22+ADAM28+ B Cells in Tertiary Lymphoid Structures Promote Immunotherapy Response.

Background: As the indication for immunotherapy is rapidly expanding, it is crucial to accurately identify patients who are likely to respond. Infiltration of B cells into many tumor types correlates with a good response to immune checkpoint inhibitor (ICI) therapy. However, B cells' roles in the anti-tumor response are far from clear. Methods: Based on single-cell transcriptomic data for ICI-treated patients, we identified a B-cell cluster [BIR (ICI-Responsive B) cells] and described the phenotype, cell-cell communication, biological processes, gene signature, and prognosis value of BIR cells through bioinformatic analysis, tissue immunofluorescence, and animal experiments. Surgery samples from 12 non-small cell lung carcinoma (NSCLC) patients with adjuvant checkpoint blockade were evaluated as external validation. Results: BIR cells were identified as a subset of CD20+CD22+ADAM28+ B cells with a memory phenotype. Bioinformatic analysis revealed that BIR cells had enhanced cell viability and epigenetic regulation, and that ALOX5AP, MIF, and PTPRC/CD45 expressed by myeloid cells may be critical coordinators of diverse biological processes of BIR cells. Immunofluorescence confirmed the presence of BIR cells in tertiary lymphoid structures (TLSs) in skin SCC, RCC, CRC, and breast cancer. BIR-associated gene signatures correlate with positive outcomes in patients with melanoma, glioblastoma, NSCLC, HNSCC, or RCC treated with ICI therapy, and BIR-cell density predicted NSCLC patients' response to checkpoint immunotherapy. In line with this, melanoma-bearing mice depleted of BIR cells were resistant to ICIs. Conclusions: CD20+CD22+ADAM28+ BIR cells were present in cancer-associated TLS and promoted the response to ICI therapy.

68Ga-WRWWWW Is a Potential Positron Emission Tomography Probe for Imaging Inflammatory Diseases by Targeting Formyl Peptide Receptor 2.

Inflammation plays a significant role in many physiological and pathological processes. Molecular imaging could provide functional as well as anatomical information for visualizing various inflammatory diseases. Advancements in imaging tracers for inflammation would improve the accuracy of diagnosis and monitoring, thus facilitating patient care. The positron emission tomography (PET) imaging tracer, 68Ga-labeled antagonist peptide Trp-Arg-Trp-Trp-Trp-Trp (WRWWWW, WRW4), targets formyl peptide receptor 2 (FPR2), which is in turn widely distributed in a variety of tissues and is associated with many inflammatory diseases. In the current study, we aimed to investigate the potential of 68Ga-WRW4 for detecting and monitoring inflammatory lesions in mice. We established an inflammation mouse model by the intramuscular injection of turpentine oil into the left thigh. WRW4 was labeled with 68Ga with an overall radiochemical yield >90% and radiochemical purity >99%. 68Ga-WRW4 uptake in inflamed muscle peaked on day 2 (1.14 ± 0.01 percentage of the injected dose per gram of tissue (%ID/g)) and the uptake ratio of inflammatory/normal muscle also reached a maximum (12.36 ± 2.35). Strong PET signals were detected in the left thigh at 60 min after the injection of 68Ga-WRW4 in experimental mice, but weak or no signals were detected in mice in the blocking and control groups. 68Ga-WRW4 uptake was in agreement with the dynamics of immune cell infiltration during the inflammatory reaction. These results suggest that 68Ga-WRW4 is a promising PET tracer suitable for the noninvasive detection of FPR2 expression and for monitoring inflammatory activity in inflammation-bearing mice.

Local Release of TGF-ß Inhibitor Modulates Tumor-Associated Neutrophils and Enhances Pancreatic Cancer Response to Combined Irreversible Electroporation and Immunotherapy.

Pancreatic cancer is a deadly disease with little response to standard therapies. Irreversible electroporation (IRE) has emerged as a novel ablative technique for the clinical treatment of pancreatic cancer. Combinations of IRE and immunotherapies, including anti-programmed death 1 (αPD1) immune checkpoint blockade, have shown promising efficacy in both preclinical and clinical studies. However, tumor recurrence remains an obstacle that needs to be overcome. It herein is shown that IRE induces a substantial infiltration of neutrophils into pancreatic tumors. These neutrophils are then polarized into a protumor phenotype by immunosuppressive cues, in particular transforming growth factor ß (TGF-ß). Using glutathione-responsive degradable mesoporous silica nanoparticles loaded with SB525334, an inhibitor of TGF-ß1 receptor, it is demonstrated that local inhibition of TGF-ß within the tumor microenvironment promotes neutrophil polarization into an antitumor phenotype, enhances pancreatic cancer response to combined IRE and αPD1 therapy, and induces long-term antitumor memory. The therapeutic efficacy is also attributed to tumor infiltration by CD8+ cytotoxic T cells, depletion of regulatory T cells, and maturation of antigen-presenting dendritic cells. Thus, modulating neutrophil polarization with nanomedicine is a promising strategy for treating pancreatic cancer.

Mesenchymal Stem Cell-Derived Extracellular Vesicles Inhibit Osteoporosis via MicroRNA-27a-Induced Inhibition of DKK2-Mediated Wnt/ß-Catenin Pathway.

Osteoporosis (OP) is a systemic skeletal disease that promotes bone fragility and the risk of fractures. Recent studies have shown the relevance of microRNAs (miRNAs) in the development of OP. This study aimed to evaluate the possible mechanisms of action underlying miR-27a loaded by mesenchymal stem cell (MSC)-derived extracellular vesicles (MSC-EVs) in OP. Serum samples from OP patients and normal controls were collected for miRNA microarray analysis. The expression of filtered miRNA was upregulated in osteoblasts (OB) and osteoclasts (OCs) for biological activity assessment. After developing OP mice using ovariectomy (OVX) and confirming OP, the miR-27a expression level was upregulated in mice by MSC-EV application. Dual-luciferase assays were conducted to validate the relationship between miR-27a and DKK2 expression. The poor expression of miR-27a was observed in patients with OP. miR-27a increased the expression of OB markers, the number of ALP-positive cells, and the number of calcium nodules in OCs. In OVX mice, miR-27a increased bone density, improved bone structure damage recovery, decreased the levels of bone resorption markers, and decreased OC number. miR-27a transmitted by MSC-EVs interacted with DKK2. MSC-EVs exerted the same protective effects as miR-27a on OP, whereas miR-27a inhibitor abolished the attenuating effects of MSC-EVs. In contrast, DKK2 depletion reversed the stimulatory effects of the miR-27a inhibitor on OP. The Wnt/ß-catenin pathway was activated upon MSC-EV application and DKK2 silencing and was impaired upon the downregulation of the expression of miR-27a. MSC-EVs are effective in preventing mouse OP. This mechanism is mediated by the miR-27a/DKK2/Wnt/ß-catenin signaling pathway.

Preoperative Prediction of Cytokeratin 19 Expression for Hepatocellular Carcinoma with Deep Learning Radiomics Based on Gadoxetic Acid-Enhanced Magnetic Resonance Imaging.

PURPOSE: Cytokeratin 19 (CK19) expression is a proven independent prognostic predictor of hepatocellular carcinoma (HCC). This study aimed to develop and validate the performance of a deep learning radiomics (DLR) model for CK19 identification in HCC based on preoperative gadoxetic acid-enhanced magnetic resonance imaging (MRI). PATIENTS AND METHODS: A total of 141 surgically confirmed HCCs with preoperative gadoxetic acid-enhanced MRI from two institutions were included. Prediction models were established based on hepatobiliary phase (HBP) images using a training set (n=102) and validated using time-independent (n=19) and external (n=20) test sets. A receiver operating characteristic curve was used to evaluate the performance for CK19 prediction. Recurrence-free survival (RFS) was also analyzed by incorporating the CK19 expression and other factors. RESULTS: For predicting CK19 expression, the area under the curve (AUC) of the DLR model was 0.820 (95% confidence interval [CI]: 0.732-0.907, P<0.001) with sensitivity, specificity, accuracy of 0.800, 0.766, and 0.775, respectively, and reached 0.781 in the external test set. Combined with alpha fetoprotein, the AUC increased to 0.833 (95% CI: 0.753-0.912, P<0.001) and the sensitivity was 0.960. Intratumoral hemorrhage and peritumoral hypointensity on HBP were independent risk factors for HCC recurrence by multivariate analysis. Based on predicted CK19 expression and the independent risk factors, a nomogram was developed to predict RFS and achieved C-index of 0.707. CONCLUSION: This study successfully established and verified an optimal DLR model for preoperative prediction of CK19-positive HCCs based on gadoxetic acid-enhanced MRI. The prediction of CK19 expression in HCC using a non-invasive method can help inform preoperative planning.

A Case of a Huge Inferior Vena Cava Leiomyosarcoma: Precise Preoperative Evaluation with Gadobutrol-Enhanced MRI.

BACKGROUND: Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumour with poor prognosis. Surgical resection is the first line of treatment to achieve the best possible outcome. However, precise preoperative evaluation is essential to guide therapeutic decisions. Here, the preoperative evaluation potential of gadobutrol-enhanced magnetic resonance imaging (MRI) was assessed in the management of a 42-year-old patient with a large IVC mass. METHODS: The patient first underwent enhanced computed tomography (CT), but the relationship between the left renal vein and the mass in the dilated IVC was ambiguous, and it remained unclear whether the right hepatic vein was invaded by the lesion. To make a precise assessment of the tumour, the patient subsequently underwent high-resolution MRI angiography examination combined with high-concentration contrast medium gadobutrol. RESULTS: MRI demonstrated the integrity of the right hepatic vein and the left renal vein. Following a multidisciplinary consultation, a complicated surgery including complete resection of the mass, artificial vessel replacement of IVC, total hepatectomy, and bilateral nephrectomy with liver and kidney auto-transplantation was performed successfully. The surgical plan formulated after reviewing the MRI preoperatively was adhered to the course of the surgery. Postoperative CT re-examination showed that the blood flow of the artificial blood vessel and the right hepatic vein was unobstructed. Histopathological examination confirmed the tumour to be a leiomyosarcoma. CONCLUSION: Preoperative imaging diagnosis and assessment have important implications for the surgical planning of IVC leiomyosarcoma. High-resolution MRI angiography examination with high concentration contrast medium gadobutrol may be of particular benefit in IVC tumours.