Unveiling the hidden role of extracellular vesicles in brain metastases: a comprehensive review.

Background: Extracellular vesicles (EVs) are small, transparent vesicles that can be found in various biological fluids and are derived from the amplification of cell membranes. Recent studies have increasingly demonstrated that EVs play a crucial regulatory role in tumorigenesis and development, including the progression of metastatic tumors in distant organs. Brain metastases (BMs) are highly prevalent in patients with lung cancer, breast cancer, and melanoma, and patients often experience serious complications and are often associated with a poor prognosis. The immune microenvironment of brain metastases was different from that of the primary tumor. Nevertheless, the existing review on the role and therapeutic potential of EVs in immune microenvironment of BMs is relatively limited. Main body: This review provides a comprehensive analysis of the published research literature, summarizing the vital role of EVs in BMs. Studies have demonstrated that EVs participate in the regulation of the BMs immune microenvironment, exemplified by their ability to modify the permeability of the blood-brain barrier, change immune cell infiltration, and activate associated cells for promoting tumor cell survival and proliferation. Furthermore, EVs have the potential to serve as biomarkers for disease surveillance and prediction of BMs. Conclusion: Overall, EVs play a key role in the regulation of the immune microenvironment of brain metastasis and are expected to make advances in immunotherapy and disease diagnosis. Future studies will help reveal the specific mechanisms of EVs in brain metastases and use them as new therapeutic strategies.

Immune checkpoint inhibitor (ICI)-based treatment beyond progression with prior immunotherapy in patients with driver-gene negative advanced non-small cell lung cancer.

BACKGROUND: No definite conclusion has yet to be reached for immunotherapy beyond progression(IBP) of first-line immunotherapy as the second-line treatment for advanced NSCLC patients with negative driver genes. Therefore a retrospective study was conducted to evaluate the efficacy of IBP in this population and investigated whether the cycles best response and progressive mode of first-line immunotherapy could affect the results. PATIENTS AND METHODS: The clinical data of patients with advanced NSCLC whose response was evaluated as progressive disease (PD) after receiving a PD-1/PD-L1 inhibitors as first-line therapy were retrospectively collected and the patients were assigned to the IBP and non-IBP groups. The overall survival (OS), progression-free survival (PFS) were evaluated between the two groups. The survival effects of cycles best response and progressive mode of first-line immunotherapy were also evaluated. RESULTS: Between January 2019 and January 2022, a total of 121 patients was evaluated as PD after first-line immunotherapy in our institution; 53 (43.8%) patients were included in the IBP group and 68 (56.2%) patients were included in the non-IBP group. The OS and PFS were no significantly different between the two groups in whole population. Further analysis revealed the OS was prolonged with the prolongation of first-line medication cycle. The median OS was 15.4m (15.4 vs 10.8 p=0.047) 16.1m (16.1 vs 10.8 p=0.039), 16.3m (16.3 vs 10.9 p=0.029) for patients with ≥4, ≥6, ≥8 cycles in first-line immunotherapy, respectively. The advantages of OS and PFS were also seen in the subgroup of PR (best response) and oligo progression of first-line immunotherapy. CONCLUSIONS: The clinical outcomes of IBP were similar to those of non-IBP in patients with PD after first-line immnuotherapy in advanced NSCLC. But more cycles, PR as best response and oligo progression in first-line was benefit.

Immunotherapy combined with cranial radiotherapy for driver-negative non-small-cell lung cancer brain metastases: a retrospective study.

Background: This study assesses immune checkpoint inhibitors' efficacy for non-small-cell lung cancer (NSCLC) with brain metastases (BM) and explores the role of cranial radiation therapy (CRT) in the immunotherapy era. Methods: The retrospective analysis screened NSCLC patients with BMs from July 2018 to December 2021. Treatment involved chemotherapy combined with immune checkpoint inhibitors as the first-line, with patients divided into CRT and non-CRT groups. Overall survival (OS), progression-free survival and intracranial progression-free survival were calculated and compared. Results: Among 113 patients, 74 who received CRT had significantly better median OS (not reached vs 15.31 months), particularly among those with one to three BMs. Factors correlating with better OS included CRT, PD-L1 expression and diagnosis-specific graded prognostic assessment scores. Conclusion: Integrating CRT with anti-PD-1 therapy notably enhanced long-term survival in NSCLC patients with BMs.

Antiprogrammed death ligand 1 therapy failed to reduce the risk of developing brain metastases in patients with extensive-stage small cell lung cancer: A retrospective analysis.

BACKGROUND: Immunotherapy (IO) has demonstrated promising results in treating extensive-stage small cell lung cancer (ES-SCLC), and the management of ES-SCLC brain metastases (BMs) is now receiving significant clinical attention. The objective of this study was to evaluate the role of IO in the clinical management of BMs. METHODS: Between January 2020 and December 2021, the study included the records of 250 patients who were diagnosed with ES-SCLC. Overall survival (OS), progression-free survival, intracranial progression-free survival, and the cumulative incidence of BMs were calculated using the Kaplan-Meier method and were compared using the log-rank test. In addition, the Cox regression model was used to analyze prognostic factors. RESULTS: In the entire group, 85 patients had baseline BMs (IO plus chemotherapy [IO + ChT], n = 38; ChT alone, n = 47), and 165 patients (IO + ChT, n = 86; ChT alone, n = 79) did not have BMs at the time of initial diagnosis. The median follow-up was 22.4 months. The OS benefit with first-line antiprogrammed death ligand 1 therapy was maintained regardless of whether patients had BMs (with BMs, 17.97 vs. 13.14 months [p = .03]; without BMs, 18.46 vs. 15.05 months [p = .047]). However, in patients without BMs, IO did not delay the median time to developing brain progression (10.84 vs. 10.74 months; p = .84), and it did not significantly reduce the risk of developing intracranial metastases (the 2-year actuarial risk of developing BMs was 57.0% vs. 50.6%, respectively). CONCLUSIONS: Antiprogrammed death ligand 1 therapy improved OS regardless of the presence of BMs. However, IO did not delay the median time to brain progression or reduce the risk of intracranial metastasis in patients without baseline BMs. The findings of this study have important clinical implications for the future management of BMs from ES-SCLC.

Programmed cell death 1 pathway inhibitors improve the overall survival of small cell lung cancer patients with brain metastases.

PURPOSE: The objective of this study was to evaluate the safety and efficacy of immune checkpoint inhibitors in small cell lung cancer patients with brain metastases. METHODS: We retrospectively reviewed the records of small cell lung cancer patients with brain metastases treated with chemotherapy and radiotherapy for brain metastases with or without immune checkpoint inhibitors at our institution from January 2019 to January 2021. Patients were divided into two groups. In Group A, patients received chemotherapy and radiotherapy for brain metastases. In Group B, patients received chemotherapy, radiotherapy for brain metastases and at least four cycles of immunotherapy. Overall survival and intracranial progression-free survival were assessed using Kaplan-Meier estimates and Cox regression models. RESULTS: A total of 282 patients were enrolled in our study. At the end of the study (May 12, 2021), the median overall survival was 13.3 months among 218 patients in Group A and 33.4 months among 64 patients in Group B (hazards ratio [HR] 0.320, 95% confidence interval [CI], 0.189-0.545, P < 0.001). Both univariate and multivariate analyses suggested that two factors were significantly correlated with overall survival: the inclusion of immunotherapy in the regimen and the presence of extracranial metastases. The median intracranial progression-free survival was 6.93 months in Group A and 10.73 months in Group B (HR = 0.540, 95% CI, 0.346-0.841, P = 0.006). The intracranial objective response rate of Group B was greater than that of Group A, but the intracranial disease control rate was similar between the groups. CONCLUSION: Immunotherapy plus chemotherapy and radiotherapy for brain metastases showed promising efficacy for small cell lung cancer patients with brain metastases.

Two novel MKKs (MKK4 and MKK7) from Ctenopharyngodon idella are involved in the intestinal immune response to bacterial muramyl dipeptide challenge.

Mitogen-activated protein kinase kinases (MKKs) are a class of evolutionarily conserved signalling intermediates of the MAPK signalling pathway that can be activated by a diverse range of pathogenic stimuli and are crucial for the regulation of host immune defence. In this study, two fish MKK genes (CiMKK4 and CiMKK7) were first identified and characterized from grass carp (Ctenopharyngodon idella). Similar to other reported MKKs, the present CiMKK4 and CiMKK7 contained a conserved serine/threonine protein kinase (S_TKc) domain and a canonical dual phosphorylation motif. Quantitative real-time PCR results showed that CiMKK4 and CiMKK7 were broadly transcribed in all selected tissues and developmental stages of grass carp. The mRNA expression levels of CiMKK4 and CiMKK7 in the intestine were significantly induced by bacterial muramyl dipeptide (MDP) challenge in a time-dependent manner (P < 0.01). Additionally, the stimulatory effects of bacterial MDP on CiMKK4 and CiMKK7 expression in the intestine were inhibited by the bioactive dipeptide ß-alanyl-l-histidine (carnosine) and alanyl-glutamine (Ala-Gln) (P < 0.05). Moreover, overexpression analysis revealed that CiMKK4 and CiMKK7 were localized throughout the entire cell and could significantly enhance AP-1 reporter gene activation in HEK293T cells. Taken together, these results provide the first experimental demonstration that CiMKK4 and CiMKK7 are involved in the intestinal immune response to MDP challenge in C. idella, which may provide new insight into the bacterial-induced intestinal inflammation of bony fishes.

Mitogen-activated protein kinase kinase 6 is involved in the immune response to bacterial di-/tripeptide challenge in grass carp Ctenopharyngodon idella.

Mitogen-activated protein kinase kinase 6 (MKK6) is an essential component of the p38MAPK signaling pathway, which is involved in the modulation of inflammation, cell apoptosis and survival responses in mammals. However, the function of MKK6s in teleosts is still unclear. In this study, a fish MKK6 homolog (CiMKK6) was first identified from the grass carp (Ctenopharyngodon idella), a freshwater fish. CiMKK6 cDNA encodes a putative protein of 357 amino acids that contains conserved structural characteristics of the MKK6 family, including the S_TKc domain, SVAKT motif and DVD site. The deduced CiMKK6 protein exhibits high sequence homology with other reported fish MKK6s and shares the closest relationship with MKK6 from Danio rerio. Quantitative real-time PCR (qRT-PCR) analysis revealed that CiMKK6 mRNA was widely expressed in all tested tissues and stages of embryonic development. Additionally, the transcript levels of CiMKK6 in the intestine were significantly upregulated in response to bacterial muramyl dipeptide (MDP) and L-Ala-γ-D-Glu-meso-diaminopimelic acid (Tri-DAP) stimulation. Moreover, subcellular localization analysis indicated that CiMKK6 was distributed in both the cytoplasm and the nucleus of HEK293T cells. Finally, overexpression of CiMKK6 significantly enhanced the transcriptional activity of the AP-1 reporter gene in HEK293T cells. Overall, these findings may help better clarify the immune function of teleost MKK6s and provide new insight into the immune defense mechanisms of grass carp.

Molecular characterization and dietary regulation of aminopeptidase N (APN) in the grass carp (Ctenopharyngodon idella).

Aminopeptidase N (APN) is a member of the peptidase M1 family and plays an important role in protein digestion. In the present study, an APN gene was cloned from the intestine of Ctenopharyngodon idellus. The full-length cDNA sequence of APN encodes an 892-amino-acid peptide that includes one helix trans-membrane region. Phylogenetic analysis showed that the APN sequence clustered with Danio rerio as its closest neighbor, sharing a sequence similarity of 81.5%. APN mRNA was differentially expressed in different tissues, with a gradient expression from high to low in the tissues of the fore-intestine, hind-intestine, liver, mid-intestine, kidney, muscle, spleen and heart. APN expression in grass carp had a circadian pattern, showing time-dependent higher expression between 06:00 and 18:00 and lower expression between 18:00 and 06:00. In addition, the protein levels and resource in the diet-regulated APN expression suggested that low crude protein (CP) level and fish meal stimulated APN gene expression. Furthermore, the mRNA expression of APN in the intestine was significantly suppressed by high concentrations of glutamine and glutamine dipeptides, respectively. This study may provide valuable knowledge on the regulation of APN expression in teleost, which has potential applications for improving fish dietary formulations.

Characterization and dietary regulation of oligopeptide transporter (PepT1) in different ploidy fishes.

The oligopeptide transporter (PepT1) is located on the brush-border membrane of the intestinal epithelium which has been regarded as a mediator of protein absorption. Here, we cloned and characterized PepT1 genes from diploid (red crucian carp), triploid and tetraploid fish. Then, the PepT1 expression pattern in different tissues and embryogenesis were assayed. Meanwhile, using real-time PCR and western blotting, we showed the expression profiles of diets with different protein levels, protein sources and additives (sodium butyrate) in triploids. The cDNAs of the three different ploidy fishes have a high sequence similarity of PepT1 among vertebrates. PepT1 mRNA expression was also developmentally regulated and showed the strongest expression around the 2-cell and 4-cell stage in all three kinds of fishes. The maternal transcripts were first detected in eggs and dropped from blastula stage to muscle contraction stage. Tissue expression studies showed higher expression of PepT1 genes in the intestines of fishes compared with other tissues. In adults, triploids showed significantly higher expression levels of PepT1 in the intestines of the three kinds of ploidy fishes during breeding season and non-breeding season. In addition, high or low protein level diets both promote PepT1 expression in the intestine. We also confirmed that fish meal showed a significant increase in PepT1 expression than soybean meal in triploid intestines. Furthermore, sodium butyrate additives induce PepT1 expression that may be mediated by CDX2 and CREB. This research provides a new insight into protein absorption and its regulation in triploid fish.

Characterization of oligopeptide transporter (PepT1) in grass carp (Ctenopharyngodon idella).

The oligopeptide transporter (PepT1) is located on the brush-border membrane of the intestinal epithelium, and plays an important role in dipeptide and tripeptide absorptions from protein digestion. In this study, we cloned the PepT1 cDNA from grass carp and characterized its expression profile in response to dietary protein and feed additives (sodium butyrate) treatments. The PepT1 gene encodes a protein of 714 amino acids with high sequence similarity with other vertebrate homologues. Expression analysis revealed highest levels of PepT1 mRNA expression in the foregut of grass carp. In addition, PepT1 mRNA expression exhibited diurnal variation in all three bowel segments of intestine with lower levels of expression in daytime than nighttime. During embryonic development, PepT1 showed a dynamic pattern of expression reaching maximal levels of expression in the gastrula stage and minimal levels in the organ stage. The PepT1 expression showed constant levels from 14 to 34 day post-hatch. To determine whether fish diet of different protein contents may have any effect on PepT1 expression, we extended our research to dietary regulation of PepT1 expression. We found that dietary protein levels had a significant effect on PepT1 gene expression. In addition, PepT1 mRNA levels were higher after feeding with fish meal than with soybean meal. Moreover, in vitro and in vivo sodium butyrate treatments increased PepT1 expression in the intestine of grass carp. The results demonstrate for the first time that PepT1 mRNA expression is regulated in a temporal and spatial pattern during development, and dietary protein and feed additives had a significant effects on PepT1 gene expression in grass carp.

Isolation and evaluation of 18 microsatellite markers in Siniperca chuatsi (Basilewsky).

Eighteen novel microsatellite markers were isolated in the Chinese perch Siniperca chuatsi (Basilewsky) using the FIASCO method, from (AC/TG)(n) , (AG/TC)(n) , (AT/TA)(n) , (GATA/CTAT)(n) and (GATT/CTAA)(n) repeat genomic libraries. The number of alleles per locus ranged from two to eight in a sample of 30 individuals from a wild population. Observed heterozygosity was between 0.100 and 0.737. Seven loci showed significant deviation from Hardy-Weinberg equilibrium, null alleles were suggested at nine loci but no linkage disequilibrium between loci was detected. These loci could be useful in the population genetic study of S. chuatsi.

[Microsatellite marker analysis of genetic variation between the allotetraploid crucian-carp and their original parents].

Twelve individuals from the allotetraploid crucian-carp,common carp, and red crucian carp were analyzed by using 32 pairs microsatellite primers of the poly (CA) type which were isolated from common carp (Cyprinus carpio L.) by Crooijmans et al. Electrophoretogram patterns showed that 15 pairs of microsatellite primers reproducibly produced the well-identifiable bands. The number of alleles per marker varied from 1 to 8, and the size of alleles ranged from 100 bp to 420 bp. The genetic similarity index between the allotetraploid crucian-carp and their original maternal red crucian carp was 0.5625, and the genetic similarity index between the allotetraploid crucian-carp and their original paternal common carp was 0.5125. The similarity index between red crucian carp and common carp was 0.4204. Both microsatellite and RAPD showed the similar results of the genetic similarity index. However, greater genetic distances were found among microsatellite markers than those among RAPD. These results demonstrate that the microsatellite-based analysis of the genetic variation is useful in measuring intrabiotype differences.

[Toxicity of surfactant, acid rain and Cd2+ combined pollution to the nucleus of Vicia faba root tip cells].

The toxicity of Cd2+ and its combination with surfactant or simulated acid rain to Vicia faba root tip cell was studied by using micro-nucleus technique. The results showed that the formation of micro-nucleus in Vicia faba root tip cell was strongly induced by Cd2+ in its concentration of 0-10.0 mg.L-1. The micro-nucleus rate was 13.85@1000 at 6.0 mg.L-1Cd2+, 4.53@1000 at 0 mg.L-1Cd2+, and the pollution index (PI) was 3.06. The micro-nucleus ratio and PI decreased when the accompanied surfactant LAS was also presented or the pH values decreased to 4.5 or 3.5. In the meantime, many deformed nuclei and grains were observed in the root tip cells. The growth of the Vicia faba roots was restrained, and the root cells were not easy to be scattered. Therefore, the toxicity of Cd2+ was increased by its combination with surfactant or acid rain. The Cd2+ toxicity to Vicia faba cells at pH3.5 was stronger than that at pH4.5. When the mutation effect of contaminant with high concentration or with strong toxicity to plant cell was tested, the contaminant should be diluted for at least three times, and hence, the highest micro-nucleus ratio and pollution index (PI) could be found.