Transcatheter arterial chemoembolization combined with PD-1 inhibitors and Lenvatinib for hepatocellular carcinoma with portal vein tumor thrombus

BACKGROUND Hepatocellular carcinoma(HCC)patients complicated with portal vein tumor thrombus(PVTT)exhibit poor prognoses and treatment responses.AIM To investigate efficacies and safety of the combination of PD-1 inhibitor,transcatheter arterial chemoembolization(TACE)and Lenvatinib in HCC subjects comorbid with PVTT.METHODS From January 2019 to December 2020,HCC patients with PVTT types Ⅰ-Ⅳ were retrospectively enrolled at Beijing Ditan Hospital.They were distributed to either the PTL or TACE/Lenvatinib(TL)group.The median progression-free survival(mPFS)was set as the primary endpoint,while parameters like median overall survival,objective response rate,disease control rate(DCR),and toxicity level served as secondary endpoints.RESULTS Forty-one eligible patients were finally recruited for this study and divided into the PTL(n=18)and TL(n=23)groups.For a median follow-up of 21.8 months,the DCRs were 88.9%and 60.9%in the PTL and TL groups(P=0.046),res-pectively.Moreover,mPFS indicated significant improvement(HR=0.25;P<0.001)in PTL-treated patients(5.4 months)compared to TL-treated(2.7 months)patients.There were no treatment-related deaths or differences in adverse events in either group.CONCLUSION A triplet regimen of PTL was safe and well-tolerated as well as exhibited favorable efficacy over the TL regimen for advanced-stage HCC patients with PVTT types Ⅰ-Ⅳ.

The synergistic regulatory effect of PTP1B and PTK inhibitors on the development of Oedaleus decorus asiaticus Bei-Bienko

Tyrosine phosphorylation is crucial for controlling normal cell growth,survival,intercellular communication,gene transcription,immune responses,and other processes.protein tyrosine phosphatase(PTP)and protein tyrosine kinases(PTK)can achieve this goal by regulating multiple signaling pathways.Oedaleus decorus asiaticus is an important pest that infests the Mongolian Plateau grassland.We aimed to evaluate the survival rate,growth rate,overall performance,and ovarian developmental morphology of the 4th instar nymphs of O.decorus asiaticus while inhibiting the activity of protein tyrosine phosphatase-1B(PTP1B)and PTK.In addition,the expression and protein phosphorylation levels of key genes in the MAPK signaling pathway and antioxidant enzyme activity were assessed.The results showed no significant differences in survival rate,growth rate,or overall performance between PTP1B inhibitor treatment and control.However,after PTK inhibitor treatment,these indexes were significantly lower than those in the control.The ovarian size of female larvae after 15 days of treatment with PTK inhibitors showed significantly slower development,while female larvae treated with PTP1B exhibited faster ovarian growth than the control group.In comparison to controls and nymphs treated with PTK inhibitors,the expression and phosphorylation levels of key genes in the MAPK signaling pathway under PTP1B inhibitor treatments were significantly higher in 4th instar nymphs.However,reactiveoxygen(ROS)species levels and the activities of NADPH oxidase and other antioxidant enzymes were considerably reduced,although they were significantly greater in the PTK inhibitor treatment.The results suggest that PTP1B and PTK feedback inhibition in the mitogen-activated-protein kinases(MAPK)signal transfer can regulate the physiological metabolism of the insect as well as its developmental rate.These findings can facilitate future uses of PTP1B and PTK inhibitors in controlling insect development to help control pest populations.

Efficacy comparison of fruquintinib,regorafenib monotherapy or plus programmed death-1 inhibitors for microsatellite stable metastatic colorectal cancer

BACKGROUND Regorafenib(R)and fruquintinib(F)are the standard third-line regimens for colorectal cancer(CRC)according to the National Comprehensive Cancer Network guidelines,but both have limited efficacy.Several phase 2 trials have indicated that R or F combined with immune checkpoint inhibitors can reverse immunosuppression and achieve promising efficacy for microsatellite stable or proficient mismatch repair(MSS/pMMR)CRC.Due to the lack of studies comparing the efficacy between F,R,F plus programmed death-1(PD-1)inhibitor,and R plus PD-1 inhibitors(RP),it is still unclear whether the combination therapy is more effective than monotherapy.AIM To provide critical evidence for selecting the appropriate drugs for MSS/pMMR metastatic CRC(mCRC)patients in clinical practice.METHODS A total of 2639 CRC patients were enrolled from January 2018 to September 2022 in our hospital,and 313 MSS/pMMR mCRC patients were finally included.RESULTS A total of 313 eligible patients were divided into F(n=70),R(n=67),F plus PD-1 inhibitor(FP)(n=95)and RP(n=81)groups.The key clinical characteristics were well balanced among the groups.The median progression-free survival(PFS)of the F,R,FP,and RP groups was 3.5 months,3.6 months,4.9 months,and 3.0 months,respectively.The median overall survival(OS)was 14.6 months,15.7 months,16.7 months,and 14.1 months.The FP regimen had an improved disease control rate(DCR)(P=0.044)and 6-month PFS(P=0.014)and exhibited a better trend in PFS(P=0.057)compared with F,and it was also significantly better in PFS than RP(P=0.030).RP did not confer a significant survival benefit;instead,the R group had a trend toward greater benefit with OS(P=0.080)compared with RP.No significant differences were observed between the R and F groups in PFS or OS(P>0.05).CONCLUSION FP is superior to F in achieving 6-month PFS and DCR,while RP is not better than R.FP has an improved PFS and 6-month PFS compared with RP,but F and R had similar clinical efficacy.Therefore,FP may be a highly promising strategy in the treatment of MSS/pMMR mCRC.

BET inhibitors potentiate melanoma ferroptosis and immunotherapy through AKR1C2 inhibition

Dear Editor,Ferroptosis,an iron-dependent form of cell death driven by overwhelming lipid peroxidation,represents a vulnerability in cancers,and therapeutic strategies to further potentiate ferroptosis hold great potential for melanoma treatment.

Research Progress on Targets and Selective Inhibitors of Polo-like Kinase-1(PLK-1)

In this paper,the biological function of PLK-1,the correlation between PLK-1 and tumors,and the latest research progress on PLK-1 inhibitors under study are reviewed,in order to provide references for the research and development of PLK-1 inhibitors.

C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.

隐丹参酮调节HIF-1α/BNIP3信号通路对兔膝骨关节炎模型软骨细胞自噬和凋亡的影响

目的 探究隐丹参酮调节缺氧诱导因子-1α(HIF-1α)/腺病毒E1B19kDa相互作用蛋白3(BNIP3)信号通路对兔膝骨关节炎(KOA)模型软骨细胞自噬和凋亡的影响。方法 取新西兰兔并以改良Videman法构建兔KOA模型,随机分为模型组、空载组、隐丹参酮组、HIF-1α敲低组、隐丹参酮+HIF-1α敲低组,每组9只;另取9只新西兰兔为对照组。分组干预后以Lequesne MG的膝关节级别评估法对兔膝关节临床症状(局部疼痛、步态、关节活动、关节肿胀)进行评分;HE染色检测兔膝关节软骨组织的退变情况并进行改良Mankin's评分;TUNEL染色检测兔膝关节软骨组织细胞凋亡情况;酶联免疫吸附试验(ELISA)检测兔血清炎性因子白细胞介素(IL)-6、IL-18、IL-10水平;蛋白免疫印迹实验检测兔膝关节软骨组织自噬(LC3、Beclin-1)、凋亡(Bax、Cleaved Caspase-3)和HIF-1α/BNIP3信号通路相关蛋白表达。结果 与对照组比较,模型组兔膝关节软骨组织出现明显退变症状,局部疼痛、步态、关节活动及关节肿胀评分、改良Mankin's评分、凋亡率、血清IL-18及IL-6水平、软骨组织LC3Ⅱ/LC3Ⅰ、Beclin-1、Bax、Cleaved Caspase-3、BNIP3蛋白表达水平升高,血清IL-10水平、软骨组织HIF-1α蛋白表达水平降低(P<0.05)。与模型组比较,隐丹参酮组兔膝关节软骨组织退变症状减轻,局部疼痛、步态、关节活动及关节肿胀评分、改良Mankin's评分、凋亡率、血清IL-18及IL-6水平、软骨组织LC3Ⅱ/LC3Ⅰ、Beclin-1、Bax、Cleaved Caspase-3、BNIP3蛋白表达水平降低,血清IL-10水平、软骨组织HIF-1α蛋白表达水平升高(P<0.05);HIF-1α敲低组兔膝关节软骨组织退变症状加重,局部疼痛、步态、关节活动及关节肿胀评分、改良Mankin's评分、凋亡率、血清IL-18及IL-6水平、软骨组织LC3Ⅱ/LC3Ⅰ、Beclin-1、Bax、Cleaved Caspase-3、BNIP3蛋白表达水平升高,血清IL-10水平、软骨组织HIF-1α蛋白表达水平降低(P<0.05);空载组兔各指标无明显变化(P>0.05)。隐丹参酮+HIF-1α敲低组较隐丹参酮组兔膝关节软骨组织退变症状加重,局部疼痛、步态、关节活动及关节肿胀评分、改良Mankin's评分、凋亡率、血清IL-18及IL-6水平、软骨组织LC3Ⅱ/LC3Ⅰ、Beclin-1、Bax、Cleaved Caspase-3、BNIP3蛋白表达水平升高,血清IL-10水平、软骨组织HIF-1α蛋白表达水平降低(P<0.05);较HIF-1α敲低组上述指标变化相反。结论 隐丹参酮可通过上调HIF-1α、下调BNIP3表达,抑制炎症及自噬,减轻KOA兔膝关节软骨组织退变,改善其临床症状。

血清TNF-α、HIF-1α水平与纤维化性间质性肺病相关性分析

目的 探究血清TNF-α、HIF-1α水平及纤维化性间质性肺病患者肺纤维化评分与肺功能的相关性,为进一步探索巨噬细胞极化相关细胞因子在纤维化性间质性肺病中的作用提供新的思绪。方法 本文前瞻性收集2022年4月至2022年12月安徽医科大学第一附属医院住院治疗的纤维化性间质性肺病患者临床资料30例作为研究组,同期健康体检的研究志愿者15例作为对照组。比较两组的一般资料,血清中TNF-α、HIF-1α的水平,对两组血清中有差异的细胞因子水平及肺纤维化评分与肺功能进行相关性分析。结果 1.两组之间年龄、性别比较,差异均不具有统计学意义(P>0.05);2.研究组血清TNF-α水平高于对照者,差异均具有统计学意义(P<0.05),血清HIF-1α水平低于对照组,差异具有统计学意义(P<0.05);3.研究组患者的肺纤维化评分与肺功能中的D_(L)CO(%)呈显著负相关(P<0.05)。结论 纤维化性间质性肺疾病患者血清TNF-α水平高于健康者,而HIF-1α水平低于对照组,研究组肺纤维化评分与D_(L)CO(%)呈现负相关性,此结果为进一步探究巨噬细胞极化相关因子与纤维化性间质性肺病的关系提供了参考信息。

温经通络汤含药血清对小鼠软骨细胞损伤及IκB-ζ/HIF-1α/LDHA轴的影响研究

目的研究温经通络汤含药血清对白细胞介素-1β(IL-1β)诱导的小鼠原代软骨细胞损伤的影响及机制。方法采用IL-1β诱导小鼠原代软骨细胞损伤模型,检测细胞中炎症因子IL-1β、IL-6、TNF-α,软骨降解相关蛋白酶基质金属蛋白酶(MMP)3、MMP9、MMP13、ADAM金属肽酶含血小板反应蛋白1基元4(ADAMTS4)以及糖酵解相关酶乳酸脱氢酶A(LDHA)、M2型丙酮酸激酶(PKM2)、还原型辅酶Ⅱ氧化酶2(NOX2)、还原型辅酶Ⅱ氧化酶4(NOX4)的mRNA表达;测定细胞内MMP3、MMP13、P65、IκB-ζ、缺氧诱导因子1α(HIF-1α)以及LDHA蛋白表达水平;进一步检测细胞上清液中一氧化氮(NO)、丙二醛(MDA)和乳酸的浓度,测定细胞内辅酶Ⅰ(NAD)的还原态(NADH)和氧化态(NAD+)的比率,以及细胞内活性氧(ROS)水平。结果温经通络汤含药血清可显著抑制IL-1β软骨细胞内IL-1β、IL-6、TNF-α的mRNA表达(P<0.01),降低细胞上清液中NO浓度(P<0.05,P<0.01),下调IκB-ζ(P<0.05)和P65蛋白表达(P<0.05,P<0.01)。温经通络汤含药血清可显著下调MMP3、MMP9、MMP13以及ADAMTS4 mRNA表达(P<0.01),抑制MMP13(P<0.05,P<0.01)和MMP3(P<0.05)的蛋白表达。氧化应激方面,它可显著抑制软骨细胞内ROS的产生,提高NADH/NAD+比率,降低上清液中MDA浓度,下调HIF-1α蛋白表达(P<0.01)。温经通络汤含药血清可显著降低乳酸浓度,下调LDHA、PKM2、NOX2、NOX4的表达,降低细胞内糖酵解水平(P<0.05,P<0.01)。结论温经通络汤含药血清可通过抑制炎症、软骨降解、氧化应激和糖酵解,缓解IL-1β诱导的小鼠原代软骨细胞损伤,其机制可能与调控IκB-ζ/HIF-1α/LDHA轴有关。

瑞马唑仑调节HIF-1α/BNIP3信号通路对OGD/R诱导神经细胞自噬和凋亡的影响

目的探讨瑞马唑仑对OGD/R诱导的神经细胞自噬和凋亡的影响及作用机制。方法体外培养小鼠海马神经元细胞(HT22)并进行神经细胞氧糖剥夺/再复氧(OGD/R),筛选实验用瑞马唑仑浓度;将HT22细胞分为对照组、OGD/R组、瑞马唑仑组、2-ME2组、瑞马唑仑+2-ME2组;CCK8法检测5组HT22细胞活力;流式细胞术检测5组HT22细胞凋亡率;透射电子显微镜观察5组HT22细胞自噬小体的形成;Western blot检测5组HT22细胞HIF-1α、BNIP3、LC3-Ⅱ/LC3-Ⅰ的表达。结果确定实验用瑞马唑仑浓度为50μg/mL;与对照组比较,OGD/R组HT22细胞OD450值、HIF-1α、BNIP3、LC3-Ⅱ/LC3-Ⅰ蛋白水平下调,凋亡率上调(P<0.05);与OGD/R组比较,瑞马唑仑组HT22细胞自噬小体增加,OD450值、HIF-1α、BNIP3、LC3-Ⅱ/LC3-Ⅰ蛋白水平上调,凋亡率下调(P<0.05);2-ME2组HT22细胞OD450值、HIF-1α、BNIP3、LC3-Ⅱ/LC3-Ⅰ蛋白水平下调,凋亡率上调(P<0.05)。与瑞马唑仑组比较,瑞马唑仑+2-ME2组HT22细胞自噬小体数量减少,OD450值、HIF-1α、BNIP3、LC3-Ⅱ/LC3-Ⅰ蛋白水平下调,凋亡率上调(P<0.05);与2-ME2组比较,瑞马唑仑+2-ME2组HT22细胞OD450值、HIF-1α、BNIP3、LC3-Ⅱ/LC3-Ⅰ蛋白水平上调,凋亡率下调(P<0.05)。结论瑞马唑仑可通过激活HIF-1α/BNIP3信号通路促进OGD/R诱导的神经细胞自噬,抑制细胞凋亡,从而减轻OGD/R诱导的神经细胞损伤。

荜茇酰胺调控STAT3/HIF-1α通路诱导乳腺癌和乳腺细胞凋亡的机制

目的:探究荜茇酰胺对乳腺癌细胞MDA-MB-231、MCF-7和正常乳腺细胞MCF-10A增殖、凋亡和细胞周期的影响及其潜在的分子机制。方法:采用不同浓度荜茇酰胺干预MDA-MB-231、MCF-7、MCF-10A细胞,MTT法检测细胞增殖能力;细胞克隆形成法检测细胞克隆形成能力;流式细胞术检测细胞凋亡和细胞周期;Western Blot检测细胞中cleaved Caspase-3、Bcl-2、Bax、Cyclin D1、p53、p-JAK2、p-STAT3、HIF-1α、Survivin蛋白表达。结果:荜茇酰胺可呈浓度依赖性抑制MDA-MB-231、MCF-7细胞增殖并诱导其凋亡,而对MCF-10A细胞无明显抑制作用;荜茇酰胺可下调MDA-MB-231细胞p53、Bcl-2、Cyclin D1、p-STAT3、Survivin、HIF-1α及MCF-7细胞p53、p-STAT3、Survivin、HIF-1α蛋白表达,上调MDA-MB-231细胞cleaved Caspase-3、Bax蛋白表达。结论:荜茇酰胺能抑制乳腺癌细胞MDA-MB-231、MCF-7增殖并诱导其凋亡,其机制可能与负向调控STAT3/HIF-1α通路有关。

姜黄素通过调控HIF-1α/miR-760/LTBP2机制轴抑制口腔黏膜下纤维化的效果研究

目的:探究姜黄素通过调控缺氧诱导因子-1α/微小RNA-760/潜在转化生长因子结合蛋白2(HIF-1α/miR-760/LTBP2)机制轴抑制口腔黏膜下纤维化的效果。方法:40只SD大鼠中随机取10只作为正常组,正常饲养不作处理;另30只大鼠采用槟榔碱诱导建立口腔黏膜下纤维化模型。将30只模型大鼠随机分为模型组、姜黄素组和阳性对照组,每组10只。姜黄素组和阳性对照组大鼠分别予以相应药物,正常组和模型组大鼠给予等体积生理盐水灌胃,1次/d,连续给药8周。比较各组大鼠张口度、颊黏膜组织变化、纤维化标志物及HIF-1α/miR-760/LTBP2信号轴表达情况。结果:与正常组比较,模型组大鼠张口度明显减小(P<0.05),颊黏膜评分、颊黏膜组织TGF-β1、ColⅢ、IFN-γ水平、miR-760 mRNA、HIF-1αmRNA、LTBP2 mRNA及HIF-1α、LTBP2蛋白表达均明显升高(P<0.05);与模型组比较,姜黄素组和阳性对照组张口度均明显增大(P<0.05),颊黏膜评分、TGF-β1、ColⅢ、IFN-γ水平、miR-760 mRNA、HIF-1αmRNA、LTBP2 mRNA及蛋白表达均明显降低(P<0.05),且姜黄素组张口度大于阳性对照组(P<0.05),颊黏膜评分、TGF-β1、ColⅢ、IFN-γ、miR-760 mRNA、LTBP2 mRNA及HIF-1α、LTBP2蛋白表达均低于阳性对照组(P<0.05)。结论:姜黄素可能降低HIF-1α、miR-760、LTBP2表达,抑制口腔黏膜下纤维化。

HIF-1α信号通路对脂多糖诱导鸡巨噬细胞炎症的调节作用研究

【目的】探究鸡巨噬细胞(HD11)在脂多糖(LPS)诱导条件下,缺氧诱导因子-1α(HIF-1α)信号通路和线粒体功能对细胞炎症反应的影响。【方法】试验以HD11细胞为研究对象,分别用不同浓度LPS作用于细胞,培养24 h后检测细胞活力,筛选LPS最佳作用浓度;同时在最佳LPS作用浓度下,筛选LPS最佳作用时间。将HD11细胞分为对照组和模型组,模型组加入最佳作用浓度LPS培养,对照组加等量的完全培养液,按照LPS最佳作用时间培养后,提取细胞总RNA进行转录组测序,并对差异表达基因进行GO功能注释和KEGG通路富集分析。利用实时荧光定量PCR和Western blotting分别检测HIF-1α信号通路相关因子mRNA和蛋白表达量;通过流式细胞术检测线粒体膜电位和活性氧(ROS)水平变化。【结果】LPS诱导的HD11细胞炎症模型中最适条件为1μg/mL LPS培养12 h,以此条件成功建立了细胞炎症模型。与对照组相比,模型组共检测到2063个差异表达基因,其中1319个上调,744个下调。GO功能注释结果显示,差异表达基因显著富集到免疫系统应答、对外部刺激的反应和细胞因子受体结合等过程。KEGG通路富集分析结果显示,差异表达基因显著富集在50条信号通路,主要涉及免疫细胞介导的炎症反应和Toll样受体、核转录因子-κB(NF-κB)、HIF-1α等信号通路。其中有13个显著上调表达的基因集中在HIF-1α相关信号通路,包括Toll样受体4(TLR4)、NF-κB、HIF-1α、血管内皮生长因子(VEGF)基因等。实时荧光定量PCR和Western blotting结果显示,NF-κB p65、HIF-1α、VEGF等mRNA和蛋白表达水平均显著上调(P<0.05)。流式细胞术检测结果显示,与对照组相比,模型组线粒体膜电位极显著下降(P<0.01),ROS水平显著升高(P<0.05)。【结论】成功建立LPS诱导鸡巨噬细胞炎症模型,HIF-1α与NF-κB信号通路相互串扰共同参与LPS诱导的细胞炎症过程。同时,细胞线粒体功能下降,导致ROS生成增多,进而促进HIF-1α的表达,共同加重了炎性反应和代谢紊乱。

BMP9下调HIF-1α抑制乳腺癌MDA-MB-231细胞的有氧糖酵解和迁移侵袭

目的研究骨形成蛋白BMP9对三阴性乳腺癌MDA-MB-231细胞有氧糖酵解和迁移侵袭的调控作用。方法实验组使用人BMP9重组腺病毒(AdBMP9)感染MDA-MB-231细胞,对照组用空载的GFP腺病毒感染细胞。采用乳酸、葡萄糖和ATP检测试剂盒检测细胞的葡萄糖摄取量、乳酸和ATP生成量;通过GEPIA2数据库,分析BMP9在泛癌中与糖酵解关键酶基因的相关性;qRT-PCR检测过表达BMP9后,MDA-MB-231中糖酵解关键酶GLUT1、HK2、PKM2、LDHA的mRNA表达水平;STRING数据库分析BMP9抑制MDA-MB-231有氧糖酵解潜在靶点;Western blot检测细胞HIF-1α和下游蛋白表达水平;划痕实验和Transwell实验评估不同处理后,细胞的迁移与侵袭能力的改变。结果与对照组相比,BMP9下调乳腺癌MDA-MB-231细胞的葡萄糖摄取、乳酸生成及ATP水平(P<0.01),抑制HIF-1α及其下游蛋白表达;Rescue实验中,过表达HIF-1α能逆转BMP9对MDA-MB-231细胞有氧糖酵解和迁移侵袭的抑制作用。结论BMP9下调HIF-1α抑制乳腺癌细胞MDA-MB-231有氧糖酵解和迁移侵袭能力。

由HIF-1α探讨中医药对骨质疏松症的作用机制

HIF-1α是一种重要的转录因子,HIF-1α信号通路参与多种疾病的发生、发展过程,如肿瘤、心血管疾病、骨质疏松症(osteoporosis,OP)等。HIF-1α还参与骨血管生成及影响骨细胞铁死亡来防治骨质疏松症。中医药对于OP的治疗有着独特的优势,中药的活性成分及复方均能对HIF-1α信号通路产生影响,但其机制尚需多方面研究。故本文从HIF-1α信号通路入手,研究中医药防治OP的作用机制及疗效的进展情况。

紫草素调节HIF-1α/NLRP3信号通路对蛛网膜下腔出血大鼠神经功能损伤的影响

目的探究紫草素调节缺氧诱导因子-1α(HIF-1α)/NOD样受体热蛋白结构域相关蛋白3(NLRP3)信号通路对蛛网膜下腔出血(SAH)大鼠神经功能损伤的影响。方法大鼠随机分为假手术组、模型组、YC-1(HIF-1α抑制剂,5 mg/kg)组、紫草素低剂量组(4 mg/kg)、紫草素高剂量组(25 mg/kg)、紫草素高剂量(25 mg/kg)+AG1(HIF-1α激活剂,10 mg/kg)组,每组15只。采用颈内动脉刺破法制备SAH模型。采用Zea-Longa评分法评估6组大鼠神经功能;ELISA法检测血清肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)和IL-1β水平;HE染色观察大鼠海马组织形态学变化,TUNEL染色法检测海马神经元凋亡率;伊文思蓝染色检测血脑屏障通透性;商品化试剂盒检测大鼠脑组织超氧化物歧化酶(SOD)、过氧化氢酶(MDA)、丙二醛(CAT)水平,Western blot检测大鼠脑组织Bax、Bcl-2、HIF-1α、NLRP3蛋白表达。结果假手术组大鼠海马神经元形态结构正常;与假手术组相比,模型组大鼠海马神经元有大量水肿、结构模糊,有细胞核溶解,变型固缩,部分细胞核消失,大鼠神经功能评分、血清TNF-α、IL-6和IL-1β水平、海马神经元凋亡率、伊文思蓝渗出量、脑组织MDA水平、Bax、HIF-1α、NLRP3水平显著增加,脑组织SOD、CAT水平、Bcl-2蛋白水平显著降低(P<0.05);与模型组比较,紫草素低剂量组、紫草素高剂量组和YC-1组鼠海马神经元病理损伤显著改善,大鼠神经功能评分、血清TNF-α、IL-6和IL-1β水平、海马神经元凋亡率、伊文思蓝渗出量、脑组织MDA水平、Bax、HIF-1α、NLRP3水平显著降低,SOD、CAT水平、Bcl-2蛋白水平显著升高(P<0.05);与紫草素高剂量组比较,紫草素高剂量+AG1组大鼠海马神经元病理损伤显著加重,大鼠神经功能评分、血清TNF-α、IL-6和IL-1β水平、海马神经元凋亡率、伊文思蓝渗出量、脑组织MDA水平、Bax、HIF-1α、NLRP3水平显著增加,SOD、CAT水平、Bcl-2蛋白水平显著降低(P<0.05)。结论紫草素抑制HIF-1α/NLRP3信号通路以降低氧化应激和炎性反应,进而改善SAH大鼠神经功能损伤。

基于HIF-1α/PD-L1通路探讨补血生髓方对肿瘤相关性贫血小鼠的改善作用

目的:探讨补血生髓方对肿瘤相关性贫血(cancer related anemia, CRA)小鼠的改善作用及可能的作用机制。方法:C57BL/6雌性小鼠腹腔注射苯肼(50mg/kg),并且皮下接种肺癌LLC细胞建立CRA模型,随机分成模型组、EPO组(1365IU/kg)、补血生髓方组(60.67g/kg),每组10只,另取10只正常小鼠作为空白组,给药2周。ELISA检测促红细胞生成素、血清干扰素-γ(interferon-γ,IFN-γ)水平,流式细胞术检测外周血Tregs细胞比例,Real time-PCR及免疫荧光检测缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)、程序性死亡-配体1(programmed cell death ligand 1,PD-L1)mRNA及蛋白的表达。结果:与模型组相比,补血生髓方组小鼠的肿瘤体积、肿瘤质量均显著降低(P<0.01)。与空白组相比,模型组血红蛋白、促红细胞生成素、IFN-γ水平显著下调(P<0.01),外周血Tregs细胞比例显著升高(P<0.05)。与模型组相比,补血生髓方组血红蛋白、促红细胞生成素、IFN-γ水平显著上调(P<0.01),外周血Tregs细胞比例显著下降(P<0.01),HIF-1α、PD-L1mRNA和蛋白表达显著降低(P<0.01)。结论:补血生髓方能够改善CRA小鼠的贫血状态,通过下调HIF-1α/PD-L1通路调节CRA小鼠的免疫功能,从而抑制肿瘤的生长。

电针通过HIF-1α和SOX-9维持兔膝骨关节炎软骨稳态及抗炎机制研究

目的观察电针对兔膝骨关节炎(knee osteoarthritis,KOA)模型软骨缺氧诱导因子1α(hypoxia inducible factor-1α,HIF-1α)、性别决定区Y框蛋白9(SRY-box transcription factor 9,SOX-9)、基质金属蛋白酶1(matrix metalloproteinase-1,MMP-1)、基质金属蛋白酶13(matrix metalloproteinase-13,MMP-13)、Ⅱ型胶原蛋白和炎症因子表达的影响,探讨电针干预改善KOA软骨稳态以及抗炎的可能作用机制。方法采用随机数字表法将实验兔分为对照组、模型组和电针组,每组10只。对模型组和电针组实验兔的右膝关节采用木瓜蛋白酶制造兔KOA模型。制模完成后,电针组给予电针犊鼻及内膝眼穴干预,每次30 min,每天1次,共14 d。模型组每天在固定器上固定15 min。对照组右膝关节注射等量0.9%氯化钠溶液。使用苏木精-伊红染色(hematoxylin-eosin staining,HE染色)检测软骨组织的病理情况,原位末端转移酶标记技术(terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay,TUNEL)检测软骨细胞的凋亡情况,免疫组化检测软骨中Ⅱ型胶原蛋白的表达情况,酶联免疫吸附实验(enzyme linked immunosorbent assay,ELISA)检测软骨中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白细胞介素-1β(interleukin-1β,IL-1β)的水平,蛋白质免疫印迹(Western Blot,WB)检测HIF-1α、SOX-9、MMP-1和MMP-13的蛋白表达水平,实时荧光定量PCR(real-time quantitative PCR,qRT-PCR)检测HIF-1α、SOX-9、MMP-1和MMP-13的mRNA水平。结果HE染色结果显示,与对照组相比,模型组软骨细胞数量明显减少,细胞核皱缩,基质染色呈浅色,潮线不完整,而电针组较模型组显著改善;改良Mankin's评分结果显示,模型组较对照组显著升高,电针组较模型组显著降低;TUNEL结果显示,电针组软骨细胞凋亡率显著低于模型组;免疫组化结果显示,与模型组相比,电针组的Ⅱ型胶原蛋白表达明显升高;ELISA结果显示与模型组相比,电针组的TNF-α、IL-1β表达明显降低;WB和qRT-PCR结果显示,与对照组相比,模型组的HIF-1α和SOX-9蛋白表达水平和mRNA水平显著降低(P<0.05),与模型组相比,电针组显著升高(P<0.05)。结论电针可能通过上调HIF-1α和SOX-9的表达,减少MMP-1、MMP-13、TNF-α、IL-1β的表达,增加Ⅱ型胶原蛋白的形成,从而发挥缓解软骨损伤、减少炎症反应的作用。

Hepatic arterial infusion chemotherapy with anti-angiogenesis agents and immune checkpoint inhibitors for unresectable hepatocellular carcinoma and meta-analysis

BACKGROUND Hepatic arterial infusion chemotherapy(HAIC)has been proven to be an ideal choice for treating unresectable hepatocellular carcinoma(uHCC).HAIC-based treatment showed great potential for treating uHCC.However,large-scale studies on HAIC-based treatments and meta-analyses of first-line treatments for uHCC are lacking.AIM To investigate better first-line treatment options for uHCC and to assess the safety and efficacy of HAIC combined with angiogenesis inhibitors,programmed cell death of protein 1(PD-1)and its ligand(PD-L1)blockers(triple therapy)under real-world conditions.METHODS Several electronic databases were searched to identify eligible randomized controlled trials for this meta-analysis.Study-level pooled analyses of hazard ratios(HRs)and odds ratios(ORs)were performed.This was a retrospective single-center study involving 442 patients with uHCC who received triple therapy or angiogenesis inhibitors plus PD-1/PD-L1 blockades(AIPB)at Sun Yat-sen University Cancer Center from January 2018 to April 2023.Propensity score matching(PSM)was performed to balance the bias between the groups.The Kaplan-Meier method and cox regression were used to analyse the survival data,and the log-rank test was used to compare the suvival time between the groups.RESULTS A total of 13 randomized controlled trials were included.HAIC alone and in combination with sorafenib were found to be effective treatments(P values for ORs:HAIC,0.95;for HRs:HAIC+sorafenib,0.04).After PSM,176 HCC patients were included in the analysis.The triple therapy group(n=88)had a longer median overall survival than the AIPB group(n=88)(31.6 months vs 14.6 months,P<0.001)and a greater incidence of adverse events(94.3%vs 75.4%,P<0.001).CONCLUSION This meta-analysis suggests that HAIC-based treatments are likely to be the best choice for uHCC.Our findings confirm that triple therapy is more effective for uHCC patients than AIPB.

紫癜肾煎剂对过敏性紫癜性肾炎大鼠PI3K/AKT及HIF-1α/VEGFA信号通路的影响

目的 观察紫癜肾煎剂对过敏性紫癜性肾炎(Henoch Schonlein purpura nephritis, HSPN)模型大鼠的治疗作用,并基于PI3K/AKT和HIF-1α/VEGFA信号通路探讨其作用机制。方法 随机选7只SD大鼠分为正常对照组,其余大鼠应用“BSA+LPS+CCL4”联合干姜建立HSPN大鼠模型,12周后随机抽取正常对照组和造模组的大鼠各1只,取肾组织固定包埋,采用免疫荧光检测造模组大鼠肾组织中IgA沉积并伴有蛋白尿,正常组无上述表现,提示造模成功。将造模成功的HSPN大鼠模型随机分模型组、紫癜肾煎剂低、高剂量(6.10、24.40 g/kg)组和西药(3.93 mg/kg)组,每组6只。给药结束后,采用溴甲酚紫法测定尿蛋白浓度,计算24 h尿蛋白定量;各组大鼠肾组织病理和免疫荧光检测;采用Western blotting法检测SD大鼠肾组织PI3K、AKT、HIF-1α、VEGFA蛋白表达情况。结果 紫癜肾煎剂可以显著降低24 h尿蛋白(P<0.05),减少肾小球系膜区免疫复合物沉积;与模型组比较,中药方组和西药组大鼠肾组织PI3K、AKT、HIF-1α、VEGFA蛋白表达明显降低,差异均有统计学意义(P<0.05)。结论 紫癜肾煎剂能减少HSPN大鼠24 h蛋白尿,改善肾功能及肾组织病理损伤,延缓HSPN病情进展,其机制可能与调控PI3K/AKT和HIF-1α/VEGFA信号通路有关。