Interaction between PD-L1 and soluble VEGFR1 in glioblastoma-educated macrophages.

PURPOSE: The combined application of immune checkpoint inhibitors (ICIs) and anti-angiogenesis therapy has shown synergistic effects on glioblastoma (GBM). As important resources of PD-L1 in the tumor microenvironment (TME), tumor-associated macrophages (TAMs) have significant impact of the efficiency of ICIs. However, the effects of anti-angiogenesis agents on immune checkpoints expression are not fully understood. METHOD: GBM-educated macrophages were generated from circulating monocytes of healthy controls and GBM patients under the education of GBM cell line. Surface expression of PD-L1 and VEGFR1 on GBM-educated macrophages was analyzed. VEGFR1 NAb and soluble VEGFR1 (sVEGFR1) were added and their effects on PD-L1 expression on TAMs was investigated. Serum soluble PD-L1 (sPD-L1) and sVEGFR1 levels in GBM patients were measured and their correlation was analyzed. RESULT: The expression intensity of PD-L1 on GBM-educated macrophages was higher and its up-regulation partially depends on VEGFR1 signaling pathway. GBM-educated macrophages secreted less levels of soluble VEGFR1 (sVEGFR1), and exogenous sVEGFR1 down-regulated PD-L1 expression intensity. PD-L1 blockade promoted the secretion of sVEGFR1. Finally, sVEGFR1 and sPD-L1 in serum of GBM patients were overexpressed, and a positive correlation was found. CONCLUSION: These findings reveal the interaction between PD-L1 and VEGFR1 signaling pathway in GBM-educated macrophages. VEGFR1 is involved with PD-L1 overexpression, which can be impeded by autocrine regulation of sVEGFR1. sVEGFR1 secretion by GBM-educated macrophages can be promoted by PD-L1 blockade. Taken together, these findings provide evidences for the combined application of ICIs and anti-angiogenesis therapies in the treatment of GBM.

Fully Endoscopic Microvascular Decompression for Trigeminal Neuralgia Caused by Vertebrobasilar Artery: A Case Series Review: 2-Dimensional Operative Video.

BACKGROUND AND OBJECTIVE: Microvascular decompression (MVD) is the most definitive and preferred surgical treatment for trigeminal neuralgia (TN). Treatment of TN caused by the vertebrobasilar artery (VBA) has been reported to be challenging and less satisfactory in complications and recurrence. Endoscopy has been implemented to provide a comprehensive view of neurovascular conflicts and minimize brain tissue stretch injury while exploring the trigeminal nerve. However, there are few retrospective studies on the treatment of TN caused by VBA by fully endoscopic microvascular decompression (E-MVD). This article aimed to illustrate the safety and efficacy of E-MVD for TN caused by the VBA. METHODS: Clinical data for 26 patients with TN caused by the VBA who underwent E-MVD from 2019 to 2022 were retrospectively analyzed. The characteristics of vertebrobasilar-associated TN were summarized. The safety and efficacy of E-MVD for vertebrobasilar-associated TN were estimated based on the analysis of intraoperative manipulation, postoperative symptom relief, and complications. RESULTS: Intraoperatively, the vertebrobasilar artery was regarded as a direct offending vessel in all 26 patients with TN, the vertebral artery in 18 (69.23%) and the basilar artery in 10 (38.46%). In addition to the vertebrobasilar artery, other vessels involved included the superior cerebellar artery in 12 patients, anterior inferior cerebellar artery in 9, posterior inferior cerebellar artery in 1, and veins in 4. All patients underwent E-MVD, and TN was entirely resolved in 26 (100%) patients immediately postoperatively. During the follow-up period of 12-45 months, no recurrence or serious complications were found. There were no serious postoperative complications, such as cerebellar swelling, intracranial hemorrhage, or death. CONCLUSION: E-MVD for vertebrobasilar-associated TN is effective and safe.

Deep brain stimulation of the subthalamic nucleus increases the risk of sialorrhea in patients with advanced Parkinson's disease.

INTRODUCTION: Sialorrhea is a common neurological manifestation of Parkinson's disease (PD). No specifically designed prospective study has tested the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) on sialorrhea in patients with advanced PD. We focused on the effect of STN-DBS on the incidence of sialorrhea in patients with PD. METHODS: This multicenter, prospective, non-randomized concurrent clinical trial analyzed the incidence of sialorrhea during long-term follow-up in 170 patients with advanced PD (84 patients with STN-DBS and 86 patients with medication therapy). RESULTS: After STN-DBS, 58.1% of patients presented with sialorrhea (Drooling Rating Scale (DRS) > 5) compared with 39.3% of patients with medication therapy (P < 0.001). STN-DBS stimulation demonstrated a significant increase in DRS and Drooling Severity and Frequency Scale (DSFS) compared with the patients with medication therapy (P < 0.001). At follow-up, the onabotulinumtoxin-A (BTX-A) injection ratio was significantly higher in the STN-DBS group (29.8% vs. 11.9%, P = 0.0057) compared with the patients with medication therapy. CONCLUSIONS: STN-DBS increased the risk of sialorrhea in patients with advanced PD. TRIAL REGISTRATION: clinicaltrials. gov (NCT06090929).

Acute Visual Impairment in a Patient with Parkinson's Disease after Successful Bilateral Subthalamic Nucleus Deep Brain Stimulation with Low-Dose Levodopa: A Case Report.

BACKGROUND: Subthalamic nucleus deep brain stimulation (STN-DBS) is widely used for the treatment of primary motor symptoms in patients with Parkinson's disease (PD). Further, recent evidence suggests that STN-DBS may relieve a few ophthalmic symptoms in PD, such as eye-blink rate and the flexibility of eye saccades. However, its exact effect on visual function remains unknown. Herein, we report the case of a patient with PD who underwent STN-DBS and experienced visual symptoms following levodopa reduction. CASE PRESENTATION: A 63-year-old male patient with PD developed severe visual impairment after six months of high-frequency STN-DBS. His symptoms resolved after adjusting the levodopa dose prescribed to the patient. CONCLUSIONS: This case report suggests that DBS is beneficial in patients with PD in terms of eye-blink rate. However, the rapid reduction of medication after STN-DBS may lead to retinal atrophy and the shrinkage of vessel density in the ocular fundus. Thus, neurosurgeons should pay close attention to patients with visual symptoms when adjusting levodopa dosages.

CsBP2O6(OH)2: a second-order NLO material with a unique borophosphate anionic partial structure and strong SHG effect.

A noncentrosymmetric (NCS) alkali-metal borophosphate CsBP2O6(OH)2 (CBPO) containing a unique borophosphate anionic partial structure has been obtained through a mixed-solvent thermal method. Its structure could be regarded as a 1-D chain that is built by Cs+ cations and a unique anionic chain [BP2O6(OH)2]∞n- composed of BO4 and PO3(OH) groups. CBPO possesses a wide UV-vis transparent range and shows a strong SHG response. Moreover, we have well explored and established the origin of the SHG effect by dipole moment and PDOS calculations. This work will help inspire and stimulate scientists to discover more such excellent NLO materials.

Synthesis and evaluation of a novel cationic konjac glucomannan-based flocculant.

A novel cationic flocculant of konjac glucomannan-graft-poly-(2-methacryloyloxyethyl)trimethyl ammonium chloride (KGM-g-PDMC), was successfully synthesized by using acidic ammonium cerium (IV) nitrate (CAN) as initiator in homogeneous aqueous solution. The graft copolymer was characterized using Fourier-transform infrared (FT-IR) spectroscopy, (1)H nuclear magnetic resonance ((1)H NMR), thermogravimetric analysis (TGA) and elemental analysis. The influences of degree of substitution (DS) of KGM, concentration of NaCl and pH value on turbidity removal rate of the cationic flocculant were investigated. The results demonstrated that the flocculant exhibited excellent flocculating ability in the presence of salt and a wide range of pH (1