Association of PD-L1 expression and clinical outcomes in ROS1 - rearranged advanced non-small cell lung cancer treated with crizotinib.

Background: Programmed cell death ligand 1 (PD-L1) is more readily expressed in ROS proto-oncogene 1 (ROS1) rearranged non-small cell lung cancer (NSCLC) compared to NSCLC cases lacking driver gene mutations. Prior research has established a link between PD-L1 expression and reduced effectiveness of EGFR or ALK inhibitors in EGFR or ALK-positive NSCLC. Nonetheless, the relationship between initial PD-L1 levels and the clinical impact of first-line crizotinib therapy in ROS1-rearranged NSCLC is still uncertain. Methods: From January 2016 to December 2021, a total of 246 patients with ROS1 positive tumors were collected. Out of these, 82 patients with advanced ROS1-rearranged NSCLC, who were treated with crizotinib as their initial therapy, were selected for the study. The study aimed primarily to evaluate the objective response rate (ORR) and progression-free survival (PFS), and secondarily to assess disease control rate (DCR) and overall survival (OS). Results: Of the 82 advanced ROS1-rearranged NSCLC patients, 38 exhibited PD-L1 positivity, subdivided into 11 with high and 27 with low expression levels, while the remaining 44 showed no PD-L1 expression. The ORR for all included patients was 80.5%. No statistically significant variance in ORR was observed among ROS1-rearranged NSCLC patients across differing PD-L1 expression statuses. However, there was a statistically significant difference in DCR between PD-L1 negative group (100%) and high expression group (90.9%) (p=0.04). The median PFS spanned 26.4 months for the PD-L1 negative group, 16.6 for the low expression group, and 13.7 for the high expression group (p=0.001). Additionally, a notable statistical disparity was also observed in median PFS between the PD-L1 negative and positive groups (p=0.02). For the entire study population, the median OS was 53.0 months (95% CI 43.8 - 62.2). In the PD-L1-negative group, the median OS reached 57.2 months, compared to 53.0 months in the PD-L1-positive group, a difference lacking statistical significance (p=0.43). Conclusions: Our results suggest that for ROS1-positive NSCLC patients receiving crizotinib as first-line therapy, PD-L1 expression may serve as a negative prognostic marker for PFS rather than OS.

CPPLS-MLP: a method for constructing cell-cell communication networks and identifying related highly variable genes based on single-cell sequencing and spatial transcriptomics data.

In the growth and development of multicellular organisms, the immune processes of the immune system and the maintenance of the organism's internal environment, cell communication plays a crucial role. It exerts a significant influence on regulating internal cellular states such as gene expression and cell functionality. Currently, the mainstream methods for studying intercellular communication are focused on exploring the ligand-receptor-transcription factor and ligand-receptor-subunit scales. However, there is relatively limited research on the association between intercellular communication and highly variable genes (HVGs). As some HVGs are closely related to cell communication, accurately identifying these HVGs can enhance the accuracy of constructing cell communication networks. The rapid development of single-cell sequencing (scRNA-seq) and spatial transcriptomics technologies provides a data foundation for exploring the relationship between intercellular communication and HVGs. Therefore, we propose CPPLS-MLP, which can identify HVGs closely related to intercellular communication and further analyze the impact of Multiple Input Multiple Output cellular communication on the differential expression of these HVGs. By comparing with the commonly used method CCPLS for constructing intercellular communication networks, we validated the superior performance of our method in identifying cell-type-specific HVGs and effectively analyzing the influence of neighboring cell types on HVG expression regulation. Source codes for the CPPLS_MLP R, python packages and the related scripts are available at 'CPPLS_MLP Github [https://github.com/wuzhenao/CPPLS-MLP]'.

GTADC: A Graph-Based Method for Inferring Cell Spatial Distribution in Cancer Tissues.

The heterogeneity of tumors poses a challenge for understanding cell interactions and constructing complex ecosystems within cancer tissues. Current research strategies integrate spatial transcriptomics (ST) and single-cell sequencing (scRNA-seq) data to thoroughly analyze this intricate system. However, traditional deep learning methods using scRNA-seq data tend to filter differentially expressed genes through statistical methods. In the context of cancer tissues, where cancer cells exhibit significant differences in gene expression compared to normal cells, this heterogeneity renders traditional analysis methods incapable of accurately capturing differences between cell types. Therefore, we propose a graph-based deep learning method, GTADC, which utilizes Silhouette scores to precisely capture genes with significant expression differences within each cell type, enhancing the accuracy of gene selection. Compared to traditional methods, GTADC not only considers the expression similarity of genes within their respective clusters but also comprehensively leverages information from the overall clustering structure. The introduction of graph structure effectively captures spatial relationships and topological structures between the two types of data, enabling GTADC to more accurately and comprehensively resolve the spatial composition of different cell types within tissues. This refinement allows GTADC to intricately reconstruct the cellular spatial composition, offering a precise solution for inferring cell spatial composition. This method allows for early detection of potential cancer cell regions within tissues, assessing their quantity and spatial information in cell populations. We aim to achieve a preliminary estimation of cancer occurrence and development, contributing to a deeper understanding of early-stage cancer and providing potential support for early cancer diagnosis.

eCRUIS captures RNA-protein interaction in vitro and in vivo.

As an information bridge between DNA and protein, RNA regulates cellular processes and gene expression in various ways. From its synthesis to degradation, RNA is associated with a range of RNA-binding proteins. Therefore, it is necessary to develop innovative methods to study the interaction between RNA and proteins. Previously, we developed an RNA-centric method, called CRISPR-based RNA-United Interacting System (CRUIS), to capture RNA-protein interaction in cells. On this basis, here we develop an enhanced CRUIS (eCRUIS) by combining the power of dCas13d and the engineered promiscuous ligase TurboID. The current version allows us to rapidly label RNA-binding proteins on the target RNA within 30 minutes, potentially for in vivo use. By introducing bait-assay with exogenous RNA, we confirm that eCRUIS can effectively label RNA-binding proteins on bait RNA in a short time. eCRUIS provides a broader range of in vitro and in vivo applications for studying RNA-protein interactions.

A new species of Svistella Gorochov, 1987 from Xizang, China (Orthoptera, Trigonidiidae, Trigonidiinae).

The genus Svistella Gorochov, 1987 includes 10 species from Asia, with nine documented in China. In this study, a new species, Svistellayayun He, sp. nov., is described from Xizang, China. Morphologically, it resembles S.rufonotata (Chopard, 1932) but can be distinguished by a smaller inner tympanum, dark-brown setae on the 5th segment of the maxillary palp, and a rounded apex on the ectoparamere. To validate our morphological inferences and support the description of S.yayunsp. nov. as a new species, we performed a PCA based on bioacoustics parameters and molecular analysis. All Svistella species documented in China are distinguished by integrating their songs and DNA barcoding.

Description of a new species of the genus Woznessenskia from Xizang, China (Orthoptera: Gryllacrididae).

The gryllacridid genus Woznessenskia Gorochov, 2002 comprises 13 extant species from Asia, with 8 species reported from China and 5 species reported from Vietnam. A new species from Xizang, China, Woznessenskia lianhua sp. nov., is reported in this paper.

Interplay Between Intracellular Transport Dynamics and Liquid‒Liquid Phase Separation.

Liquid‒liquid phase separation (LLPS) is a ubiquitous process in which proteins, RNA, and biomolecules assemble into membrane-less compartments, playing important roles in many biological functions and diseases. The current knowledge on the biophysical and biochemical principles of LLPS is largely from in vitro studies; however, the physiological environment in living cells is complex and not at equilibrium. The characteristics of intracellular dynamics and their roles in physiological LLPS remain to be resolved. Here, by using single-particle tracking of quantum dots and dynamic monitoring of the formation of stress granules (SGs) in single cells, the spatiotemporal dynamics of intracellular transport in cells undergoing LLPS are quantified. It is shown that intracellular diffusion and active transport are both reduced. Furthermore, the formation of SG droplets contributes to increased spatial heterogeneity within the cell. More importantly, the study demonstrated that the LLPS of SGs can be regulated by intracellular dynamics in two stages: the reduced intracellular diffusion promotes SG assembly and the microtubule-associated transport facilitates SG coalescences. The work on intracellular dynamics not only improves the understanding of the mechanism of physiology phase separations occurring in nonequilibrium environments but also reveals an interplay between intracellular dynamics and LLPS.

Quarter-Wave Plate Metasurfaces for Generating Multi-Channel Vortex Beams.

Metasurfaces of quarter-wave plate (QWP) meta-atoms have exhibited high flexibility and versatile functionalities in the manipulation of light fields. However, the generation of multi-channel vortex beams with the QWP meta-atom metasurfaces presents a significant challenge. In this study, we propose dielectric metasurfaces composed of QWP meta-atoms to manipulate multi-channel vortex beams. QWP meta-atoms, systematically arranged in concentric circular rings, are designed to introduce the modulations via the propagation phase and geometric phase, leading to the generation of co- and cross-polarized vortex beams in distinct channels. Theoretical investigations and simulations are employed to analyze the modulation process, confirming the capability of QWP meta-atom metasurfaces for generating the multi-channel vortex beams. This study presents prospective advancements for the compact, integrated, and multifunctional nanophotonic platforms, which have potential applications in classical physics and quantum domains.

Excitation characteristics of circumferential SH guided waves in steel pipes generated by EMATs with few-cycle PPM.

Circumferential Shear Horizontal (CSH) guided waves provide an effective method for detecting defects like axial cracks and corrosion in pipes. Periodic Permanent Magnet Electromagnetic Acoustic Transducers (PPM EMATs) are typically used to generate CSH guided waves. However, there is an offset problem to which little attention has been paid. The offset problem refers to the offset of the center (position of maximum energy) of the operating region caused by the variation in the peak frequency of the spatial spectra of PPM with 2 or fewer cycles. Furthermore, the excitability of guided waves is one of the factors that needs to be considered when selecting the excitation parameters of EMATs, but there are still some studies that have not sufficiently addressed this issue. In this paper, the offset problem and the excitability of CSH guided waves were investigated. Firstly, by obtaining the operating regions corresponding to PPM with different cycles, the cause and influences of the offset problem were studied. The results show that the offset in the peak frequency of the spatial spectrum of PPM is the fundamental reason causing the offset problem, and it not only leads to incorrect prediction of the excitation efficiency of guided waves but also affects the selection of the excitation parameters of EMATs. Secondly, finite element simulations and experiments were performed to assess the influence of the excitability on the excitation efficiency of the CSH0 and CSH1 modes in pipes. By analyzing the simulation and experimental results of 2-cycle PPM, as well as the simulation results for PPM with 1 to 5 cycles, the impact of the excitability on the CSH1 mode was confirmed from two perspectives. The final conclusion indicates that an accurate prediction of the amplitudes of CSH guided waves with different modes is only possible through a comprehensively consideration of the operating region of EMAT and the excitability of guided waves.

Efficacy of chemo-immunotherapy in metastatic BRAF-mutated lung cancer: a single-center retrospective data.

Background: The effectiveness of combining immune checkpoint inhibitors (ICIs) with chemotherapy in treating non-small cell lung cancers (NSCLCs) with BRAF mutations has not been sufficiently explored. Methods: We compiled data from 306 NSCLC patients with identified BRAF mutations. We looked at efficacy by assessing the objective response rate (ORR) and disease control rate (DCR), as well as survival through measuring progression-free survival (PFS) and overall survival (OS). Results: Out of the patient pool, 44 were treated with a regimen of immune-chemotherapy. Patients undergoing ICI in combination with chemotherapy had a median PFS of 4 months, and the median OS was recorded at 29 months. There was a notable increase in OS in patients receiving first-line treatment versus subsequent lines (29 vs 9.75 months, p=0.01); however, this was not the case with PFS (9 vs 4 months, p=0.46). The ORR for patients on ICIs was 36.3%. PFS and OS rates did not significantly differ between patients with the BRAF-V600E mutation and those with non-V600E mutations (p=0.75 and p=0.97, respectively). Additionally, we found a significant variation in PD-L1 expression between those who responded to treatment and those who didn't (p=0.04). Conclusion: Our findings indicate that chemo-immunotherapy as an initial treatment may lead to improved OS in patients with BRAF-mutated NSCLC when compared to its use in subsequent lines of therapy. Further studies are needed to validate these results and to delve deeper into how specific types of BRAF mutations and PD-L1 expression levels might predict a patient's response to treatments in NSCLC.

Efficacy of immune checkpoint inhibitors in advanced large cell neuroendocrine carcinoma of the lung: A single­institution experience.

Large cell neuroendocrine carcinoma (LCNEC) is a rare and highly invasive lung cancer subtype with an overall poor prognosis. Due to its low incidence rate and unusual pathological features, the clinical management of LCNEC remains controversial. The present study aimed to assess the effect of immune checkpoint inhibitors (ICIs) on treatment response and survival outcomes in patients with advanced LCNEC. The clinical data from 148 patients with LCNEC treated with ICIs at The First Affiliated Hospital of Zhengzhou University (Zhengzhou, China) between January 2019 and September 2021 were retrospectively analyzed. Kaplan-Meier and multivariable Cox regression analyses were used to evaluate associations between clinicopathological variables and patient outcomes. Patients treated with ICIs demonstrated extended median overall survival (mOS) times [23.5 months; 95% confidence interval (CI), 18.524-28.476] compared with patients who did not receive ICIs (11.2 months; 95% CI, 4.530-18.930) (P<0.001). Univariate analysis revealed that histological subtype (P=0.043), lymph node metastases (P=0.032) and number of metastatic organs (P=0.009) were associated with a poor prognosis. The heterogeneity of pathological components was associated with prognosis, and the mOS time was shorter for mixed LCNEC than that for pure LCNEC (P=0.043). The median progression-free survival (mPFS) (9.78 vs. 9.37 months; P=0.82) and mOS (20.70 vs. 25.79 months; P=0.181) times showed no significant association with regard to different regimens of immuno-based combination therapy (chemotherapy combined with ICIs vs. anti-angiogenic agents combined with ICIs). Poor Eastern Cooperative Oncology Group performance status score (P=0.04), multiple organ metastases (P=0.02) and high cancer antigen 125 levels (P=0.01) were independent risk factors of a poor prognosis. The present findings offer valuable insights into potential prognostic markers and highlight the favorable impact of ICIs on OS in advanced LCNEC. Prospective clinical studies are required to validate the therapeutic value of ICIs in LCNEC.

Gut microbiota composition may be an indicator of erectile dysfunction.

Erectile Dysfunction (ED) is considered a physical and mental illness. A variety of potential associations between gut microbiota and health or disease have been found. By comparing the gut microbiota of healthy controls and ED patients, our study investigated the relationship between ED and gut microbiota. The results revealed that the ED group exhibited a significantly higher relative abundance of Bacteroides, Fusobacterium, Lachnoclostridium, Escherichia-Shigella and Megamonas, while showing a significantly lower relative abundance of Bifidobacterium compared to the control group. The dysbiosis of gut microbiota played a role in the onset and progression of ED by influencing the gut barrier, cardiovascular system and mental health, which provided a novel perspective on understanding the pathophysiology of ED. What is more, we had identified several key gut microbiota. By combining 16S rRNA sequencing with machine learning techniques, we were able to uncover the significant value and impact of gut microbiota in the early detection of ED.

Photoelectron velocity map imaging spectroscopy of group 14 elements and iron tetracarbonyl anionic clusters MFe(CO)4- (M = Si, Ge, Sn).

The heteronuclear group 14 M-iron tetracarbonyl clusters MFe(CO)4- (M = Si, Ge, Sn) anions have been generated in the gas phase by laser ablation of M-Fe alloys and detected by mass and photoelectron spectroscopy. With the support of quantum chemical calculations, the geometric and electronic structures of MFe(CO)4- (M = Si, Ge, Sn) are elucidated, which shows that all the MFe(CO)4- clusters have the M-Fe bonded, iron-centered, and carbonyl-terminal M-Fe(CO)4 structure with the C2v symmetry and a 2B2 ground state. The M-Fe bond can be considered a double bond, which includes one σ electron sharing bond and one π dative bond. The C-O bonds in those anionic clusters are calculated to be elongated to different extents, and in particular, the C-O bonds in SiFe(CO)4- are elongated more. The Si-Fe alloy thus turns out to be a better collocation to activate the C-O bonds in the gas phase among group 14. The present findings have important implications for the rational development of high-performance catalysts with isolated metal atoms/clusters dispersed on supports.

GTAD: a graph-based approach for cell spatial composition inference from integrated scRNA-seq and ST-seq data.

With the emergence of spatial transcriptome sequencing (ST-seq), research now heavily relies on the joint analysis of ST-seq and single-cell RNA sequencing (scRNA-seq) data to precisely identify cell spatial composition in tissues. However, common methods for combining these datasets often merge data from multiple cells to generate pseudo-ST data, overlooking topological relationships and failing to represent spatial arrangements accurately. We introduce GTAD, a method utilizing the Graph Attention Network for deconvolution of integrated scRNA-seq and ST-seq data. GTAD effectively captures cell spatial relationships and topological structures within tissues using a graph-based approach, enhancing cell-type identification and our understanding of complex tissue cellular landscapes. By integrating scRNA-seq and ST data into a unified graph structure, GTAD outperforms traditional 'pseudo-ST' methods, providing robust and information-rich results. GTAD performs exceptionally well with synthesized spatial data and accurately identifies cell spatial composition in tissues like the mouse cerebral cortex, cerebellum, developing human heart and pancreatic ductal carcinoma. GTAD holds the potential to enhance our understanding of tissue microenvironments and cellular diversity in complex bio-logical systems. The source code is available at https://github.com/zzhjs/GTAD.

Spectroscopic Signature of the Carbon-Carbon Coupling Reaction between Carbon Monoxide and Nickel Carbide.

Spectroscopic characterization of ketenylidene complexes is of essential importance for understanding the structure-reactivity relationships of the catalytic sites. Here, we report a size-specific photoelectron velocity map imaging spectroscopic study of the reactions of carbon monoxide with nickel carbide. Quantum chemical calculations have been conducted to search for the energetically favorable isomers and to recognize the experimental spectra. The target products with the chemical formula of NiC(CO)n- (n = 3-5) are characterized to have an intriguing ketenylidene CCO unit. The evolution from NiC(CO)3- to NiC(CO)4- involves the breaking and formation of the Ni-C bond and the coordination conversion between the terminal and bridging carbonyls. Experimental and theoretical analyses reveal an efficient C-C bond formation process within the reactions of carbon monoxide and laser-vaporized nickel carbide. This work highlights the pivotal roles played by metal carbides in the C-C bond formation and also proposes new ideas for the design and chemical control of a broad class of complexes with unique physical and chemical properties.

100Gb/s coherent optical secure communication over 1000†km based on analog-digital hybrid chaos.

In recent years, the transmission capacity of chaotic secure communications has been greatly expanded by combining coherent detection and multi-dimensional multiplexing. However, demonstrations over 1000 km fiber are yet to be further explored. In this paper, we propose a coherent optical secure transmission system based on analog-digital hybrid chaos. By introducing an analog-digital converter (ADC) and a bit extraction into the feedback loop of entropy source, the broadband analog chaos is converted into a binary digital signal. This binary digital signal is then mapped to a 65536-level pulse amplitude modulation (PAM) signal and injected into the semiconductor laser (SL) to regenerate the analog chaos, forming a closed loop. The binary digital signal from the chaos source and the encrypted signal are transmitted via wavelength division multiplexing (WDM). By using conventional digital signal processing (DSP) algorithms and neural networks for post-compensation, long-haul high-quality chaotic synchronization and high-performance secure communication are achieved. In addition, the probability density distribution of the analog chaotic signal is effectively improved by adopting the additional higher-order mapping operation in the digital part of the chaos source. The proof-of-concept experimental results show that our proposed scheme can support the secure transmission of 100 Gb/s quadrature phase shift keying (QPSK) signals over 1000 km of standard single-mode fiber (SSMF). The decrypted bit error rate (BER) reaches 9.88 × 10-4, which is well below the 7% forward error correction (FEC) threshold (BER = 3.8 × 10-3). This research provides a potential solution for high-capacity long-haul chaotic optical communications and fills the gap in secure communications based on analog-digital hybrid chaos.

Clinical analysis, diagnosis, and treatment strategies for otogenic brain abscesses.

Objective: To explore the clinical features, diagnosis, and treatment strategies for otogenic brain abscesses (OBA). Methods: Clinical data from 10 patients with OBA were analyzed retrospectively. Clinical characteristics, diagnosis, and treatment experiences were summarized. Results: Two were first diagnosed in the Department of Otorhinolaryngology, 5 in Neurosurgery, and 3 in other departments. There were 6 cases of temporal lobe abscess and 4 cases of cerebellar abscesses. Five cases were accompanied by 1 or more intracranial complications. Headache is a common presentation in all cases. The main pathogenic bacteria were anaerobic bacteria. All patients had no previous ear or brain surgery history, and no history of traumatic brain injury, 7 received surgical treatment in the neurosurgery and/or otolaryngology department. Two patients died, the other 8 fully recovered and so were discharged. Conclusions: Diagnosis and treatment of OBA must involve multiple departments. Multidisciplinary consultation (MDT) is crucial to the success of the first OBA diagnosis. The diagnosis and treatment team develops personalized treatment plans by integrating MDT treatment opinions and combining the actual condition of patients, thereby making the diagnosis and treatment of OBA accurate and timely.

Adaptive tracking control for nonlinear systems with uncertain control gains and its application to a TCP/AQM network.

This paper is concerned with the adaptive tracking control problem for nonlinear systems with virtual control coefficients including known and unknown items. The known items are employed for controller design directly, such that more information is utilized to achieve better performance. To deal with the unknown items, a novel real control law is firstly constructed by introducing an auxiliary system. The proposed controller is designed and applied to an uncertain TCP/AQM network system, which guarantees the practical boundedness of all the signals in the closed-loop system. Finally, the effectiveness and practicability of the developed control strategy are validated by simulation results.

Validation of a Computerized Cognitive Training Tool to Assess Cognitive Impairment and Enable Differentiation Between Mild Cognitive Impairment and Dementia.

BACKGROUND: Age-related cognitive decline is a chronic, progressive process that requires active clinical management as cognitive status changes. Computerized cognitive training (CCT) provides cognitive exercises targeting specific cognitive domains delivered by computer or tablet. Meanwhile, CCT can be used to regularly monitor the cognitive status of patients, but it is not clear whether CCT can reliably assess cognitive ability or be used to diagnose different stages of cognitive impairment. OBJECTIVE: To investigate whether CCT can accurately monitor the cognitive status of patients with cognitive impairment as well as distinguish patients with dementia from patients with mild cognitive impairment (MCI). METHOD: We included 116 patients (42 dementia and 74 MCI) in final analysis. Cognitive ability was assessed by averaging the patient performance on the CCT to determine the Cognitive Index. The validity of the Cognitive Index was evaluated by its correlation with neuropsychological tests, and internal consistency was measured to assess the reliability. Additionally, we determined the diagnostic ability of the Cognitive Index to detect dementia using receiver operating characteristic (ROC) analysis. RESULTS: The Cognitive Index was highly correlated with the Montreal Cognitive Assessment (r = 0.812) and the Mini-Mental State Examination (r = 0.694), indicating good convergent validity, and the Cronbach's alpha coefficient was 0.936, indicating excellent internal consistency. The area under the ROC curve, sensitivity, and specificity of the Cognitive Index to diagnose dementia were 0.943, 83.3%, and 91.9%, respectively. CONCLUSIONS: CCT can be used to assess cognitive status and detect dementia in patients with cognitive impairment.

Effect on cell survival and cytoophidium assembly of the adRP-10-related IMPDH1 missense mutation Asp226Asn.

Introduction: Inosine monophosphate dehydrogenase 1 (IMPDH1) is a critical enzyme in the retina, essential for the correct functioning of photoreceptor cells. Mutations in IMPDH1 have been linked to autosomal dominant retinitis pigmentosa subtype 10 (adRP-10), a genetic eye disorder. Some of these mutations such as the Asp226Asn (D226N) lead to the assembly of large filamentous structures termed cytoophidia. D226N also gives IMPDH1 resistance to feedback inhibition by GDP/GTP. This study aims to emulate the adRP-10 condition with a long-term expression of IMPDH1-D226N in vitro and explore cytoophidium assembly and cell survival. We also assessed whether the introduction of an additional mutation (Y12C) to disrupt the cytoophidium has an attenuating effect on the toxicity caused by the D226N mutation. Results: Expression of IMPDH1-D226N in HEp-2 cells resulted in cytoophidium assembly in ∼70% of the cells, but the presence of the Y12C mutation disrupted the filaments. Long-term cell survival was significantly affected by the presence of the D226N mutation, with a decrease of ∼40% in the cells expressing IMPDH1-D226N when compared to IMPDH1-WT; however, survival was significantly recovered in IMPDH1-Y12C/D226N, with only a ∼10% decrease when compared to IMPDH1-WT. On the other hand, the IMPDH1 expression level in the D226N-positive cells was <30% of that of the IMPDH1-WT-positive cells and only slightly higher in the Y12C/D226N, suggesting that although cell survival in Y12C/D226N was recovered, higher expression levels of the mutated IMPDH1 were not tolerated by the cells in the long term. Conclusion: The IMPDH1-D226N effect on photoreceptor cell survival may be the result of a sum of problems: nucleotide unbalance plus a toxic long-life cytoophidium, supported by the observation that by introducing Y12C in IMPDH1 the cytoophidium was disrupted and cell survival significantly recovered, but not the sensibility to GDP/GTP regulation since higher expression levels of IMPDH1-D226N were not tolerated.