Biochanin A,as the Lrg1/TGF-β/Smad2 pathway blockade,attenuates blood-brain barrier damage after cerebral ischemiareperfusion by modulating leukocyte migration patterns

Background:Biochanin A is an excellent dietary isoflavone that has the concomitant function of both medicine and foodstuff.The attenuation function of biochanin A on blood-brain barrier(BBB)damage induced by cerebral ischemia-reperfusion remains unclear.Methods:C57BL/6 mice were subjected to 1 h middle cerebral artery occlusion(MCAO)followed by 24 h reperfusion.The infarct volume of the brain was stained by TTC,while leakage of the brain was quantitatively stained by Evans blue,and the neurologic deficit score was measured.Microglial-induced morphologic changes were observed via immunofluorescence staining,and rolling and adhering leukocytes in venules were observed via two-photon imaging,while the inner fluorescein isothiocyanate-albumin of venules were compared with those of surrounding interstitial area through venular albumin leakage.Results:The attenuation effect of biochanin A on tight junction injury was compared in ischemia-reperfusion mice or conventional knockdown of leucine-richα2-glycoprotein 1(Lrg1)mice.Biochanin A could ameliorate BBB injury in mice with cerebral ischemiareperfusion in a dose-dependent manner by strengthening the immunostaining volume of occludin,claudin-5,and zonula occludens-1.The amoeba morphologic changes of microglial combined with the elevated expression of Lrg1 could be relieved under the treatment of biochanin A.Biochanin A played a countervailing role on the rolling leukocytes in the vessel,while the leakage of blood vessels was reduced.Biochanin A diminished its functions to further improved attenuation for tight junction injury on conventional Lrg1-knockout mice,as well as the inhibition effects on TGF-β1,and the phosphorylation of suppressor of mothers against decapentaplegic 2(Smad2)/Smad2 via western blot assay.Conclusion:Biochanin A could alleviate tight junction injury induced by cerebral ischemiareperfusion and blocked the Lrg1/TGF-β/Smad2 pathway to modulate leukocyte migration patterns.

ADRB1 Arg389Gly多态性对比索洛尔疗效影响的Meta分析

目的探索ADRB1 Arg389Gly多态性对比索洛尔疗效的影响,为比索洛尔个体化药物治疗提供参考。方法从PubMed、Embase、Cochrane Library、中国生物医学文献服务系统、中国知网、万方等数据库系统性搜索与比索洛尔和ADRB1 Arg389Gly多态性相关的文献,检索时间为建库至2023年5月。根据研究制定的纳入与排除标准筛选、提取相关文献并进行文献质量评估。使用RevMan 5.4软件对相关结局指标进行Meta分析。结果最终纳入7项研究,共计1339人次。其中4项研究涉及比索洛尔治疗前后收缩压(SBP)和舒张压(DBP)的变化量(ΔSBP和ΔDBP),有4项研究涉及治疗前后左室射血分数(LVEF)的变化量(ΔLVEF)。研究结果显示,比索洛尔对ADRB1 Arg389Gly野生组(AA)和突变组(AG+GG)血压改善的差异均无统计学意义{ΔSBP[SMD=0.17,95%CI(-0.97,1.31),P=0.77]、ΔDBP[SMD=-0.01,95%CI(-0.65,0.62),P=0.97]};比索洛尔对两组ΔLVEF改善的差异亦无统计学意义[SMD=-0.61,95%CI(-2.74,1.53),P=0.58]。结论ADRB1 Arg389Gly多态性对比索洛尔改善心血管患者SBP、DBP和LVEF的作用无显著影响。

PD-1/PD-L1 checkpoint blockade in immune-antitumortherapy：advances and perspectives

During the past three decades,studies have shown that tumor cells could"manipulate"host immunity to escape the immune defenses in the tumor microenvironment.One of the most important underlying mechanisms is immune-suppression regulated by programmed cell death-1 or its ligand 1(PD-1/PD-L1),which makes PD-1/PD-L1 blockadea promising target of cancer immune-therapy.Tumors could suppress immuno-response of T cells by activating PD-1/PD-L1 signaling pathway.Therefore,inhibiting the interaction between PD-1 and PD-L1 could reconstitute the enduring antitumor immunity in the tumor microenvironment via enhancing the T-cell response,there after augmenting the endogenous antitumor force of the immune system.Along these lines,inhibitors of PD-1/PD-L1 has been applied in multiple clinical trials against various types of tumors.Recent studies indicated that PD-1/PD-L1 blockade have demonstrated high efficacy and safety against melanoma,lung,kidney and several other solid tumors,as well as hematological malignancies.Nevertheless,the efficacy of this checkpoint blockade approach is not universal.Some investigation suggested that lack of responses to anti-PD-1/PD-L1 therapy of patients without PD-1/PD-L1 over-expression was expected.In this review,we summarize the history and current understanding of multiple intrinsic and extrinsic mechanisms via which PD-1/PD-L1 is regulated and research advances in preclinical/clinical aspects of PD-1/PD-L1,as well as significance and perspectives regarding the PD-1/PD-L1 blockade in immune-antitumor therapy.

Relationship between catecholamine level and gene polymorphism of β1 adrenergic receptor G1165C in children with EV71 infection in hand foot and mouth disease

Objective:To investigate the relationship between the levels of plasma adrenaline and norepinephrine and gene polymorphism of β1 adrenergic receptor G1165 C in children with enterovirus 71(EV71) infection in hand foot and mouth disease(HFMD). Methods:The polymerase chain reaction(PCR) was used to detect the expression of gene polymorphism of β1 adrenergic receptor G1165 C in vitro. The levels of plasma adrenaline and norepinephrine were measured by enzyme-linked immunosorbent assay(ELISA). Results:The plasma norepinephrine level of severe group was significantly higher than the mild group in children with EV71 infection in HFMD(P<0.05); however,the levels of plasma adrenalinein in two groups had no statistical differences(P>0.05); There was no significant difference in the distribution of β1 adrenergic receptor G1165 C genotype and allele between EV71 infection group and healthy control group(P> 0.05). Further analysis of EV71 infection group by dividing it into mild and severe groups showed that there was no significant difference in the distribution of genotype and allele between these two groups as well(P> 0.05). There was no significant difference in the levels of epinephrine and norepinephrine in different genotypes of EV71 infection group(P> 0.05),and in the levels of plasma epinephrine and norepinephrine in the mild and severe groups(P> 0.05). Conclusions:As the disease gets worse,the plasma norepinephrine level has a rising trend in children with EV71 infection in HFMD,which is an important indicator to evaluate the progress of the disease. However,the gene polymorphism of eptor G1165 C have no significant correlation,not only with the susceptibility and severit β1 adrenergic recy of EV71 infection in hand,foot and mouth disease,but also with the levels of catecholamine.

Identification ACTA2 and KDR as key proteins for prognosis of PD-1/PD-L1 blockade therapy in melanoma

Programmed cell death protein 1(PD-1)/programmed cell death ligand 1(PD-L1)blockade is an important therapeutic strategy for melanoma,despite its low clinical response.It is important to identify genes and pathways that may reflect the clinical outcomes of this therapy in patients.We analyzed clinical dataset GSE96619,which contains clinical information from five melanoma patients before and after anti-PD-1 therapy(five pairs of data).We identified 704 DEGs using these five pairs of data,and then the number of DEGs was narrowed down to 286 in patients who responded to treatment.Next,we performed KEGG pathway enrichment and constructed a DEG-associated protein-protein interaction network.Smooth muscle actin 2(ACTA2)and tyrosine kinase growth factor receptor(KDR)were identified as the hub genes,which were significantly downregulated in the tumor tissue of the two patients who re-sponded to treatment.To confirm our analysis,we demonstrated similar expression tendency to the clinical data for the two hub genes in a B16F10 subcutaneous xeno-graft model.This study demonstrates that ACTA2 and KDR are valuable responsive markers for PD-1/PD-L1 blockade therapy.

Association between essential hypertension and polymorphisms of beta 1 adrenergic receptor gene G1165C (Gly389Arg) in Chinese Mongolian population

BACKGROUND： The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is helpful to develop researches on the genetics of various diseases including hypertension in Mongolian population. OBJECTIVE： To analyze the association between the polymorphism of beta1 adrenergic receptor （β1-AR） gene G1165C （Arg389Gly）, an important candidate gene for various diseases of cardiovascular system, and essential hypertension in Mongolian population. DESIGN ： A cross-sectional study SETTINGS： Department of Neurology, the First Affiliated Hospital of Inner Mongolia Medical College; Wulate Houqi Red Cross Society. PARTICIPANTS： The survey was carried out from February 2003 to March 2005. Totally 239 Mongolian residents, whose blood relations of 3 generations were all Mongolians, were selected from Wulate Houqi, Inner Mongolia, and they were all informed with the survey and detected items. Based on the diagnostic standard of hypertension set by WHO in 1999, the subjects were divided into two groups according to the level blood pressure： ① Normal blood pressure group （n=117）： systolic blood pressure （SBP） 〈 140 mm Hg （1 mm Hg =0.133 kPa）, diastolic blood pressure （DBP） 〈 90 mm Hg, and those having histories of cerebrovascular disease, heart disease, diseases of liver, kidney and tiroides, and diabetes mellitus were excluded. ② Essential hypertension group （n=122）： including 51 patients with simple high SBP. All the enrolled subjects had no blood relationship with each other, and had no history of miscegenation. METHODS ： The body height, body mass, waist circumference and blood lipids were measured routinely, and their habits of smoking and drinking were also investigated. Penpheral venous blood （5 mL） was drawn, the genome DNA was extracted, and the polymorphisms of the β1-AR Gl165C （Gly389Arg） genotype were detected with the Sequenom system. Polymerase chain reaction （PCR） experiment and SNP detection were performed in Huada Gene Laboratory of Bejing, then the univariate analysis of variance was applied in the sample comparison among groups, and the chi-square test was used to compare the genotypes and allele frequencies. The odd ratio （OR） and 95% confidence interval （CO were calculated. MAIN OUTCOME MEASURES： The distributions of β1-AR Gl165C （Gly389Arg） genotypes and alleles were observed. RESULTS： A11 the 239 subjects were involved in the analysis of results, and no one missed, ①Comparison of β1-AR G1165C （Gly389Arg） genotypes and allele distnbutions： In Mongolian population, the frequencies of CC and GG＋GC genotypes at β1-AR G1165C （Gly389Arg） site in the essential hypertension group （72%, 28%） were not significantly different from those in the normal blood pressure group （67%, 33%） （xz=0.841, P=-0.359; OR 0.773, 95%Cl： 0.445-1.342）; The frequencies of C and G alleles also had no significant differences between the essential hypertension group （85%, 15%） and the normal blood pressure group （82%, 18%） （x^2=1.136, P=-0.287; OR： 0.769, 95%Cl： 0.747-1.248）. ②The frequencies of CC and GG＋GC genotypes at β1-AR G1165C （Gly389Arg） site had no significant differences between the patients with simple high SBP （71%, 29%） and the normal blood pressure group （x^2=0.250, P=-0.617; OR： 0.833, 95%C/： 0.408-1.703）; The frequencies of C and G alleles were not significantly different between the patients with simple high SBP （86%, 14%） and the normal blood pressure group （x^2=0.670, P=-0.413; OR 0.766, 95%Cl： 0.404-1.453）. CONCLUSION： In Mongolian population, the distributions of the genotypes and alleles of β1-AR Gl165C （Gly389Arg） have no obvious differences between the subjects with normal blood pressure and the patients with essential hypertension （including simple SBP increase）, which suggests that G1165C （Glu389Asp） site of β1-AR gene may be not a genetic mark of essential hypertension and simple high SBP in Mongolian population.

Combination of tumor-associated regulatory T cell deletion and PD-1/PD-L1 blockade: A promising immunotherapy for hepatocellular carcinoma?

During the past decades,the treatment of hepatocellular carcinoma(HCC)has been limited to surgical resection and liver transplantation,but the prognosis is still poor.Recently,tumor immunotherapy,particularly immune checkpoints programmed cell death-1/programmed cell death ligand-1(PD-1/PD-L1)blockade,brings a breakthrough for HCC[1,2].However,anti-PD-1/PD-L1 immunotherapy is not satisfactory and the response rates were between 20%and 30%[3].How to improve the efficacy of PD-1/PD-L1blockade is the main issue.

阿帕替尼联合PD-1单抗后线治疗晚期结直肠癌患者的疗效和安全性

目的探讨阿帕替尼联合PD-1单抗在标准方案治疗失败的晚期结直肠癌(colorectal cancer,CRC)中的疗效安全性及预后影响因素分析。方法研究设计为回顾性分析,纳入43例临床上后线接受阿帕替尼联合PD-1单抗联合治疗的晚期CRC患者。阿帕替尼用药剂量为250 mg或500 mg,PD-1单抗为已经在中国获批的PD-1单抗。通过医院电子病历系统整理患者接受治疗后的疗效及安全性数据,并对患者进行定期的随访获取长期生存的数据。此外,进行无进展生存期(PFS)和基线亚组资料的关联分析探讨影响预后的风险因素。结果最佳的疗效评估结果表明部分缓解患者11例,疾病稳定患者20例,疾病进展患者12例。因此,阿帕替尼联合PD-1单抗后线治疗晚期CRC患者的客观缓解率(ORR)为25.6%[95%置信区间(CI):13.5%~41.2%],疾病控制率(DCR)为72.1%(95%CI:56.3%~84.7%)。通过后续的访视获取的预后数据表明43例晚期CRC患者的中位PFS为5.8个月(95%CI:3.81~7.79),中位OS为10.3个月(95%CI:5.75~14.85)。最常见的不良反应分别有乏力、高血压、腹泻和手足综合征等。PFS的影响因素分析提示ECOG评分和左右半结直肠癌可能是预测患者PFS的独立影响因素。结论阿帕替尼联合PD-1单抗后线治疗晚期CRC患者具有潜在的疗效和可控的安全性。ECOG评分和肿瘤部位可能是影响患者PFS的潜在风险因素。研究结论尚需要大样本临床研究进一步验证。

既往免疫经治的晚期非小细胞肺癌患者接受安罗替尼联合PD-1单抗的疗效及安全性

目的 旨在探讨既往免疫经治的晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者接受安罗替尼联合PD-1单抗治疗方案的疗效和安全性。方法 纳入临床实践中接受安罗替尼联合PD-1单抗治疗的既往免疫经治的52例晚期NSCLC患者。安罗替尼为临床常规用法用量,PD-1单抗为目前已经在中国上市的PD-1单抗,包括信迪利单抗,卡瑞利珠单抗和帕博利珠单抗。回顾性地收集患者治疗过程中的疗效及安全性数据,并对患者进行定期的随访获取长期生存的数据。结果 最佳的疗效结果提示接受安罗替尼联合PD-1单抗治疗的既往免疫经治的晚期NSCLC患者中取得部分缓解患者12例,疾病稳定患者32例,疾病进展患者8例。因此,该方案的客观缓解率为23.1%(95%CI:12.5%~36.8%),疾病控制率为84.6%(95%CI:71.9%~93.1%)。中位无进展生存期为6.3个月(95%CI:2.64~9.96),中位的总生存期为16.6个月(95%CI:8.08~25.12)。既往免疫相关方案不耐受的患者(10例)接受该方案治疗时具有相对较好的预后(中位OS:23.4个月vs. 11.5个月,P=0.034)。安全性分析结果提示在接受安罗替尼联合PD-1单抗的总体不良反应安全可控。结论 在既往免疫经治的晚期NSCLC患者中安罗替尼联合PD-1单抗的治疗方案具有潜在的疗效和较好的安全性。既往免疫相关方案不耐受的患者可能从该方案中获益。研究结论尚需要大样本研究进一步验证。

安罗替尼联合PD-1抑制剂治疗广泛期小细胞肺癌的疗效及安全性

目的 本研究旨在探索安罗替尼联合PD-1单抗治疗广泛期小细胞肺癌患者的疗效和安全性。方法 本研究回顾性分析了36例既往至少接受过一种系统化疗方案治疗的广泛期SCLC患者,所有患者均接受了安罗替尼联合PD-1单抗的治疗。结果 36例SCLC患者均可进行疗效和安全性分析,最佳疗效结果显示客观缓解率为27.8%(95%CI:14.2%~45.2%),疾病控制率为80.6%(95%CI:64.0%~91.8%)。无进展生存期(PFS)和中位点生存期(OS)分别为4.6个月(95%CI:3.1~6.1)和9.3个月(95%CI:3.3~15.3),总体不良反应安全可控。Cox回归分析提示ECOG体质状况评分是PFS的独立影响因素。结论 真实世界中安罗替尼联合PD-1单抗治疗广泛期SCLC患者具有初步的疗效和可控的安全性。

Photo-induced crosslinked and anti-PD-L1 peptide incorporated liposomes to promote PD-L1 multivalent binding for effective immune checkpoint blockade therapy

Immune checkpoint blockade(ICB)therapy targeting PD-L1 via monoclonal antibody(m Ab)has shown extensive clinical benefits in the diverse types of advanced malignancies.However,most patients are completely refractory to ICB therapy owing to the PD-L1 recycling mechanism.Herein,we propose photo-induced crosslinked and anti-PD-L1 peptide incorporated liposomes(immune checkpoint blockade liposomes;ICB-LPs)to promote PD-L1 multivalent binding for inducing lysosomal degradation of PD-L1 in tumor cells.The ICB-LPs are prepared by formulation of DC_(8,9)PC with photo-polymerized diacetylenic moiety,1,2-dipalmitoylphosphatidylcholine(DPPC)and anti-PD-L1peptide(D-form NYSKPTDRQYHF)-conjugated DSPE-PEG_(2k)(anti-PD-L1-DSPE-PEG_(2k))in a molar ratio of 45:45:10,followed by cross-linking of liposomal bilayer upon UV irradiation.The 10 mol% antiPD-L1-DSPE-PEG_(2k)incorporated ICB-LPs have a nano-sized lipid bilayer structure with an average diameter of 137.7±1.04 nm,showing a high stability in serum condition.Importantly,the ICB-LPs efficiently promote the multivalent binding with PD-L1 on the tumor cell membrane,which are endocytosed with aim to deliver PD-L1 to the lysosomes,wherein the durable PD-L1 degradation is observed for72 h,in contrast to anti PD-L1 m Abs showing the rapid PD-L1 recycling within 9 h.The in vitro coculture experiments with CD8^(+)T cells show that ICB-LPs effectively enhance the T cell-mediated antitumor immune responses against tumor cells by blocking the PD-L1/PD-1 axis.When ICB-LPs are intravenously injected into colon tumor-bearing mice,they efficiently accumulate within the targeted tumor tissues via both passive and active tumor targeting,inducing a potent T cell-mediated antitumor immune response by effective and durable PD-L1 degradation.Collectively,this study demonstrates the superior antitumor efficacy of crosslinked and anti-PD-L1 peptide incorporated liposome formulation that promotes PD-L1 multivalent binding for trafficking of PD-L1 toward the lysosomes instead of the recycling endosomes.

Inhalable metal–organic framework-mediated cuproptosis combined with PD-L1 checkpoint blockade for lung metastasis synergistic immunotherapy

Cuproptosis shows enormous application prospects in lung metastasis treatment.However,the glycolysis,Cu^(+)efflux mechanisms,and insufficient lung drug accumulation severely restrict cuproptosis efficacy.Herein,an inhalable poly(2-(N-oxide-N,N-diethylamino)ethyl methacrylate)(OPDEA)-coated copper-based metal–organic framework encapsulating pyruvate dehydrogenase kinase 1 siRNA(siPDK)is constructed for mediating cuproptosis and subsequently promoting lung metastasis immunotherapy,namely OMP.After inhalation,OMP shows highly efficient lung accumulation and long-term retention,ascribing to the OPDEA-mediated pulmonary mucosa penetration.Within tumor cells,OMP is degraded to release Cu2+under acidic condition,which will be reduced to toxic Cu^(+)to induce cuproptosis under glutathione(GSH)regulation.Meanwhile,siPDK released from OMP inhibits intracellular glycolysis and adenosine-5ʹ-triphosphate(ATP)production,then blocking the Cu^(+)efflux protein ATP7B,thereby rendering tumor cells more sensitive to OMP-mediated cuproptosis.Moreover,OMP-mediated cuproptosis triggers immunogenic cell death(ICD)to promote dendritic cells(DCs)maturation and CD8^(+)T cells infiltration.Notably,OMP-induced cuproptosis up-regulates membrane-associated programmed cell death-ligand 1(PD-L1)expression and induces soluble PD-L1 secretion,and thus synergizes with anti-PD-L1 antibodies(aPD-L1)to reprogram immunosuppressive tumor microenvironment,finally yielding improved immunotherapy efficacy.Overall,OMP may serve as an efficient inhalable nanoplatform and afford preferable efficacy against lung metastasis through inducing cuproptosis and combining with aPD-L1.

Blocking beta 2-adrenergic receptor inhibits dendrite ramification in a mouse model of Alzheimer's disease

Dendrite ramification affects synaptic strength and plays a crucial role in memory. Previous studies revealed a correlation between beta 2-adrenergic receptor dysfunction and Alzheimer＇s disease （AD）, although the mechanism involved is still poorly understood. The current study investigated the potential effect of the selective β2-adrenergic receptor antagonist, ICI 118551 （ICI）, on Aβ deposits and AD-related cognitive impairment. Morris water maze test results demonstrated that the performance of AD-transgenic （TG） mice treated with ICI （AD-TG/ICI） was significantly poorer compared with NaCl-treated AD-TG mice （AD-TG/NaCl）, suggesting that β2-adrenergic receptor blockage by ICI might reduce the learning and memory abilities of mice. Golgi staining and immunohistochemical staining revealed that blockage of the β2-adrenergic receptor by ICI treatment decreased the number of dendritic branches, and ICI treatment in AD-TG mice decreased the expression of hippocampal synaptophysin and synapsin 1. Western blot assay results showed that the blockage of β2-adrener- gic receptor increased amyloid-β accumulation by downregulating hippocampal a-secretase activity and increasing the phosphorylation of amyloid precursor protein. These findings suggest that blocking the β2-adrenergic receptor inhibits dendrite ramification of hippocampal neurons in a mouse model of AD.

安罗替尼联合PD-1单抗三线及以上治疗晚期非小细胞肺癌的疗效和安全性

目的:探讨安罗替尼联合PD-1单抗作为三线及以上方案治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效和安全性。方法:采用回顾性研究,收集2020年01月01日至2021年12月31日在我院肿瘤内科接受安罗替尼联合PD-1作为三线及以上方案治疗的晚期NSCLC患者。主要观察指标为无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS),次要观察指标为客观缓解率(objective response rate,ORR)和疾病控制率(disease control rate,DCR),同时以不良事件的发生率评估该方案的安全性。结果:在接受安罗替尼联合PD-1单抗作为三线及以上方案治疗的62例晚期NSCLC患者中,8例患者实现了部分缓解(partial response,PR),中位PFS为6.4个月(95%CI:5.4~7.4个月),中位OS为15.4个月(95%CI:13.4~17.4个月)。在治疗过程中,最常见的不良反应为乏力、食欲减退、高血压和手足综合征,最严重的不良事件为甲状腺功能亢进。结论:安罗替尼联合PD-1在晚期NSCLC的三线及以上治疗中具有良好的疗效,且表现出较好的耐受性。

程序性死亡蛋白-1抑制剂单药治疗老年晚期非小细胞肺癌患者的疗效及安全性研究

背景以程序性死亡蛋白-1(PD-1)抑制剂为代表的免疫治疗近年来逐步成为晚期非小细胞肺癌(NSCLC)的标准治疗方案,改变了该病的治疗格局。大部分PD-1抑制剂相关研究排除了70或75岁以上的老年晚期NSCLC患者,使得老年患者使用PD-1抑制剂治疗的疗效及安全性数据相对较少。目的本研究旨在探讨PD-1抑制剂在老年晚期NSCLC患者中的疗效及安全性。方法选取2018年10月至2021年11月在甘肃中医药大学第四附属医院胸外科和肿瘤科接受PD-1抑制剂单药治疗的65岁及以上的晚期NSCLC患者,最终纳入符合标准的患者63例。本研究中PD-1抑制剂均为已经在中国获批上市的PD-1抑制剂单抗,包括卡瑞利珠单抗、信迪利单抗和帕博利珠单抗。通过医院电子病历系统整理患者接受治疗后的疗效及安全性数据,并对患者进行定期随访获取长期生存数据,随访至2022-03-15,收集患者PD-1抑制剂的疗效资料、老年晚期NSCLC患者的预后情况和接受PD-1抑制剂治疗的毒副作用情况,采用Cox比例风险模型探讨老年晚期NSCLC患者预后的影响因素。结果63例老年晚期NSCLC患者的中位年龄为71(65,89)岁。接受PD-1抑制剂治疗期间的最佳疗效评估结果显示无患者完全缓解,14例患者获得部分缓解,21例患者疾病稳定,28例患者疾病进展。PD-1抑制剂单药治疗晚期NSCLC患者的客观缓解率(ORR)为22.2%(14/63),疾病控制率(DCR)为66.7%(14/21)。预后数据提示63例老年晚期NSCLC患者的中位无进展生存期(PFS)为3.3(2.0,4.6)个月。中位OS为10.2(6.1,14.3)个月。接受PD-1单药治疗期间,63例老年晚期NSCLC中46例患者出现了治疗相关的毒副作用(73.0%),其中3级以上的毒副作用发生率为14.3%(9/63)。常见的毒副作用类型有乏力、腹泻、皮疹和肝功能异常,发生率分别为23.8%(15/63)、19.1%(12/63)、15.9%(10/63)和14.3%(9/63)。Cox比例风险回归分析结果显示,东部肿瘤协作组(ECOG)体质状态评分和转移病灶数目是老年晚期NSCLC患者接受PD-1抑制剂后PFS的独立影响因素(HR=0.56、0.48)。结论PD-1抑制剂单药在老年晚期NSCLC患者中具有初步的疗效和可耐受的安全性。ECOG体质状态评分和转移病灶数目可能是影响该类患者PFS的潜在风险因素。

Immune blockade inhibitors and the radiation abscopal effect in gastrointestinal cancers

The field of tumor immunology has produced in the recent years a revolution in cancer therapeutics putting an end in the long lasting frustration of investigators in the area stemming from largely unsuccessful strides to develop cancer vaccines. This progress has come from the introduction of immune checkpoint inhibitors, monoclonal antibodies blocking ligand/receptor pairs with inhibitory effects for immune cells. Through this blockade immune checkpoint blockers are able to ac-tivate the immune system and create an anti-tumoral effect. A significant sub-set of patients with various types of cancers such as melanoma, lung carcinomas and urothelial cancers benefit from treatment with these drugs and survivals have improved in some ca-ses. However other cancers are primarily resistant to immune blockers and secondary resistance is also the norm. Radiation therapy is often used in the palliative treatment of patients with advanced cancers and, in addition to the local effect in the irradiated field, it may in rare cases produce a systemic antitumor effect, termed "abscopal". This effect has been suggested to be produced by immune mechanisms. Thus an opportunity presents for a synergistic effect of immune stimulation between radiation and immune blockade inhibitors. The therapeutic opportunities presented with the combination of radiation and these drugs for gastrointestinal cancers will be discussed in this editorial overview.

Renin-angiotensin system blockade: Effect on renal mRNA expression in 5/6 nephrectomized rats

The aim of this study was to determinate the gene expression levels of angiotensinogen, angiotensin converting enzyme, renin, (pro)renin receptor, and the final rennin-angiotensin system (RAS) products Angiotensin (Ang) II and Ang 1-7 inthe remnant kidney of 5/6 nephrectomized rats and its response to RAS pharmacological blockade. Male Wistar rats were divided into five groups: sham operated (SO), 5/6 nephrectomized (NFX), NFX + captopril (50 mg/ kg/day), NFX + losartan (10 mg/kg/day), and NFX + aliskiren (10 mg/kg/day). Animals were followed up for 60 days and protein urine excretion was measured. Systolic blood pressure, renal tissue RAS mRNA expression levels, plasma Ang II, and plasma Ang 1-7 were evaluated at day 60 after nephrectomy. Blood pressure and urine protein were increased after 5/6 nephrectomy. Ang II levels were increased 9.4 fold, whereas Ang 1-7 decreased 72.9% in NFX animals compared with SO rats. 5/6 nephrectomy increased renal angiotensinogen and (pro)renin receptor mRNA expression but down-regulated renin mRNA expression. RAS blockade restored the systolic blood pressure to normal values and slowed down urinary protein excretion, and also prevented changes in Ang II and Ang 1-7. RAS blockade reduced (pro)renin receptor, ACE, and AGT mRNA expression in the remnant kidney. However, renin mRNA expression increased compared with NFX rats. In conclusion these results suggest that inhibition of Ang II synthesis by RAS blockade is associated with renal regulation of RAS mRNA expression and this may be through a mechanism related with the Ang II/Ang 1-7 balance.

Expression of hippocampal adrenergic receptor mRNA in a rat model of depression

Adrenergic receptor dysfunction is suggested as a potential cause of hippocampal vulnerability to stress-related pathology. We examined mRNA expression of adrenergic receptor （AR） subtypes α1-AR, α1-AR, and β1-AR in hippocampal subregions （CA1, CA3, dentate gyrus） using in situ hybridization in a depression model induced by chronic unpredictable mild stress and social isolation, α1-AR mRNA expression was significantly increased in the CA3 and dentate gyrus, β1-AR mRNA was significantly increased in the CA1, and α1-AR mRNA remained unchanged in all regions of depression rats compared with controls. Thus, different AR subtypes exhibit a differing pattern of mRNA expression in various hippocampal subregions following depression.

不同浓度β_(1)肾上腺素能受体自身抗体对大鼠心电指标和心肌病理的早期影响

目的探讨不同浓度β_(1)肾上腺素能受体自身抗体(β_(1)-adrenergic receptor autoantibodies,β_(1)AAbs)对大鼠心电指标及心肌细胞病理的早期影响。方法24只雄性SD大鼠随机分为对照组,免疫组(低浓度组、中浓度组、高浓度组),免疫组经尾静脉注射β_(1)AAbs建立被动免疫β_(1)AAbs升高模型,通过酶联免疫吸附试验测定大鼠心肌组织中环磷酸腺苷(cAMP)含量,验证造模是否成功。各组大鼠均佩戴穿戴式心电传感器在自然状态下连续监测5 d,分析心率,昼夜节律;使用LEAD-7000心电生理仪记录大鼠基线、免疫第一天、第三天、第五天的6导心电图,免疫5 d后行大鼠心肌细胞HE染色。结果(1)各组大鼠夜间心率均高于白天,各免疫组5 d内平均心率较对照组增快(P<0.05);(2)免疫低浓度组在免疫第四天达到心率高峰;中浓度组在免疫5 d内心率持续增快;高浓度组在免疫第二天达到心率高峰,第三天开始下降(P<0.05);(3)各免疫组P波时限延长,免疫中、高浓度组P波振幅增高,免疫低浓度组QTc间期延长,免疫低、中浓度组QRS波振幅增高(P<0.05);(4)免疫低、中浓度组心肌细胞完整性降低,免疫高浓度组心肌细胞明显碎裂,细胞核空泡状。结论β_(1)AAbs增高早期可增加大鼠心率,延长P波时限;低浓度β_(1)AAbs延长QTc间期;低、中浓度β_(1)AAbs可使心肌细胞完整性降低,高浓度使心肌细胞碎裂。

TIGIT和PD-1/PD-L1双重阻断途径在肿瘤免疫治疗中的研究进展

程序性死亡蛋白-1和程序性死亡蛋白配体-1(programmed death-1/programmed death-ligand 1,PD-1/PD-L1)作为一种抑制T细胞活化的调节性免疫检查点分子,在肿瘤的免疫治疗发挥着重要的作用。近年来,越来越多的靶向治疗药物得到研发,但是单一免疫检查点阻断剂并不能很好的抑制肿瘤的发生,肿瘤逃逸现象时有发生,而靶向药物的联合治疗可作为抑制肿瘤发生发展的重要手段之一。属于1型脊髓灰质炎病毒受体的抑制性受体T细胞免疫球蛋白和免疫受体酪氨酸抑制基序(immunoreceptor tyrosine-based inhibition motif,ITIM)结构域(T cell immunoglobulin and ITIM domain,TIGIT)是近年靶向药物治疗研究的热点,其与PD-1/PD-L1的联合治疗可减少肿瘤逃逸,更有效地抑制肿瘤的发生。因此,本文就TIGIT和PD-1/PD-L1双重阻断途径在肿瘤免疫治疗中的研究进展进行归纳总结,旨在肿瘤免疫治疗提供一定的理论依据。