Unlocking epigenetics for precision treatment of Ewing’s sarcoma

Ewing’s sarcoma(EWS)is a highly aggressive malignant bone tumor primarily affecting adolescents and young adults.Despite the efficacy of chemoradiotherapy in some cases,the cure rate for patients with metastatic and recurrent disease remains low.Therefore,there is an urgent need for innovative therapeutic approaches to address the challenges associated with EWS treatment.Epigenetic regulation,a crucial factor in physiological processes,plays a significant role in controlling cell proliferation,maintaining gene integrity,and regulating transcription.Recent studies highlight the importance of abnormal epigenetic regulation in the initiation and progression of EWS.A comprehensive understanding of the intricate interactions between EWS and aberrant epigenetic regulation is essential for advancing clinical drug development.This review aims to provide a comprehensive overview of both epigenetic targets implicated in EWS,integrating various therapeutic modalities to offer innovative perspectives for the clinical diagnosis and treatment of EWS.

Rifaximin on epigenetics and autophagy in animal model of hepatocellular carcinoma secondary to metabolic-dysfunction associated steatotic liver disease

BACKGROUND Prevalence of hepatocellular carcinoma(HCC)is increasing,especially in patients with metabolic dysfunctionassociated steatotic liver disease(MASLD).AIM To investigate rifaximin(RIF)effects on epigenetic/autophagy markers in animals.METHODS Adult Sprague-Dawley rats were randomly assigned(n=8,each)and treated from 5-16 wk:Control[standard diet,water plus gavage with vehicle(Veh)],HCC[high-fat choline deficient diet(HFCD),diethylnitrosamine(DEN)in drinking water and Veh gavage],and RIF[HFCD,DEN and RIF(50 mg/kg/d)gavage].Gene expression of epigenetic/autophagy markers and circulating miRNAs were obtained.RESULTS All HCC and RIF animals developed metabolic-dysfunction associated steatohepatitis fibrosis,and cirrhosis,but three RIF-group did not develop HCC.Comparing animals who developed HCC with those who did not,miR-122,miR-34a,tubulin alpha-1c(Tuba-1c),metalloproteinases-2(Mmp2),and metalloproteinases-9(Mmp9)were significantly higher in the HCC-group.The opposite occurred with Becn1,coactivator associated arginine methyltransferase-1(Carm1),enhancer of zeste homolog-2(Ezh2),autophagy-related factor LC3A/B(Map1 Lc3b),and p62/sequestosome-1(p62/SQSTM1)-protein.Comparing with controls,Map1 Lc3b,Becn1 and Ezh2 were lower in HCC and RIF-groups(P<0.05).Carm1 was lower in HCC compared to RIF(P<0.05).Hepatic expression of Mmp9 was higher in HCC in relation to the control;the opposite was observed for p62/Sqstm1(P<0.05).Expression of p62/SQSTM1 protein was lower in the RIF-group compared to the control(P=0.024).There was no difference among groups for Tuba-1c,Aldolase-B,alpha-fetoprotein,and Mmp2(P>0.05).miR-122 was higher in HCC,and miR-34a in RIF compared to controls(P<0.05).miR-26b was lower in HCC compared to RIF,and the inverse was observed for miR-224(P<0.05).There was no difference among groups regarding miR-33a,miR-143,miR-155,miR-375 and miR-21(P>0.05).CONCLUSION RIF might have a possible beneficial effect on preventing/delaying liver carcinogenesis through epigenetic modulation in a rat model of MASLD-HCC.

Research Progress of Epigenetics in Liver Cancer

Epigenetic changes are changes in gene expression by regulating gene transcription and translation without changing the nucleotide sequence of the genome. Although the genome itself changes during the occurrence and development of most malignant tumors, recent studies have found that epigenetic changes also play an important role in the occurrence and development of tumors. Epigenetic modification mainly includes DNA methylation, histone modification and miRNA regulation. This review focuses on the role and mechanism of epigenetic modification in the occurrence, metastasis and invasion of hepatocellular carcinoma (HCC), and summarizes the latest methods for the treatment of HCC by restoring dysregulated epigenetic modification. It provides a theoretical basis for revealing the pathogenesis of liver cancer and developing new methods of diagnosis and treatment.

The research progress of epigenetics and metabolic memory in diabetic kidney disease

Diabetic kidney disease(DKD)is a clinical syndrome that is one of the major causes of end-stage renal disease(ESRD).The pathogenesis of DKD is complex and multifaceted,with most studies indicating its association with genetics,advanced glycosylation end-product deposition,polyol pathway and protein C activation,lipid metabolism abnormalities,microcirculatory dysfunction,oxidative stress,inflammatory factors,and the kallikrein-kinin system.Epigenetics is the science studying gene expression regulation without changes in the DNA sequence.In recent years,increasing evidence has shown that epigenetic mechanisms play a crucial role in the initiation and progression of DKD.For instance,epigenetic modifications such as DNA methylation,histone modifications,and non-coding RNAs can influence the expression of DKD-related genes,thereby regulating the development and progression of DKD.On the other hand,metabolic memory is an important concept in DKD research.Metabolic memory refers to the phenomenon where cells maintain a certain metabolic state even after the disappearance of metabolic stress factors.This state can influence cell function and fate.In DKD,metabolic stress factors such as hyperglycemia can lead to metabolic memory in renal cells,affecting their function and fate,ultimately leading to the development and progression of DKD.Therefore,to further explore the pathogenesis of DKD,research on epigenetics should be strengthened,aiming to provide new ideas and methods for the prevention and treatment of DKD.

种子休眠与萌发调控的研究进展

休眠使植物种子能够为萌发安排时间,直到环境条件变得有利于幼苗的存活与生长。种子的休眠特性具有重要的生态适应性意义和显著的农业价值。植物激素脱落酸(ABA)和赤霉素(GA)是种子休眠与萌发的关键因素,处于休眠状态的成熟种子含有高水平的ABA和低水平的GA;ABA诱导和维持种子休眠,而GA拮抗ABA的作用和促进种子萌发。萌发延迟-1 (DOG1)是种子休眠的主要调控因子,与ABA协同作用延迟萌发。DOG1通过与PP2C ABA过敏感萌发(AHG1/AHG3)结合以增强ABA的信号转导,以及抑制AHG1的作用以增加ABA的敏感性和强加种子休眠。印记基因在受精前后受到表观遗传机制的调控,与种子休眠的建立与释放密切相关。近年来,种子休眠的调控研究取得了显著的进展。本文综述了植物激素ABA和GA对种子休眠与萌发的控制, DOG1调控种子休眠的作用机制,以及种子休眠与萌发的表观遗传调控,并提出了在本领域需要进一步研究的科学问题,以期为深入理解种子休眠与萌发的分子机制、抗穗萌发育种以及促进休眠种子的萌发提供参考。

不同运动方式对人体DNA损伤、DNA甲基化和端粒长度的影响

背景:运动不仅是改善身体健康和心理健康的有效手段,还对代谢性和心脑血管等疾病的发生、发展具有良好的干预效果,其原因与表观遗传因素有关。目的:总结不同运动方式对人体DNA损伤、DNA甲基化和端粒长度的影响,并分析运动调控表观遗传修饰的可能机制,以期为运动改善机体功能提供参考。方法:以“运动,有氧训练,急性运动,无氧训练,抗阻训练,DNA损伤,DNA甲基化,端粒”为中文检索词,以“exercise,sport,aerobic exercise,anaerobic exercise,resistance training,acute exercise,DNA methylation,DNA damage,telomere”为英文检索词。在PubMed、Embase、Web of Science、中国知网数据库中进行检索,并根据纳入与排除标准筛选文献,最终纳入70篇文献。结果与结论:①长期有氧、抗阻和无氧运动均能改善DNA损伤,其原因与运动可以提高机体的抗氧化能力有关。而急性运动则会通过上调活性氧和活性氮氧化物的表达进而加剧DNA损伤程度;②急性运动、长期抗阻运动和无氧运动在降低DNA甲基化方面具有积极作用,其关键机制可能是运动诱导的活性氧使氧化型谷胱甘肽/还原型谷胱甘肽比值和DNA甲基化转移酶、10-11易位酶的表达发生了改变,进而对DNA甲基化产生调控作用;③与其他运动形式相比,长时间有氧运动可能更具有增加端粒长度的潜在价值,其中的生物学机制涉及炎症、氧化应激、DNA甲基化和微小RNA的表达调控;④基于当前文献可知,有氧运动持续2年以上可以增加端粒长度,未来的研究也应进一步明确最佳的运动持续时间。

非编码RNA调控真社会性昆虫品级分化和个体分工的研究进展

真社会性昆虫是最具代表性的表型可塑性的研究对象之一,其个体之间分工协作的社会性生活方式增强了整个群体的环境适应性和繁殖力。真社会性昆虫虽然具有相同的遗传背景,个体之间却表现出明显的品级分化和个体分工,这是由环境和遗传共同影响的。表观遗传被认为是应对环境条件下重塑基因表达的主要机制,非编码RNA作为一类广泛参与机体生命活动的不编码蛋白的功能性RNA,在真社会性昆虫的品级分化、个体分工等方面起着重要的调控作用。本文从微小RNA、长链非编码RNA、环状RNA、与PIWI蛋白相作用的RNA等非编码RNA,对蜜蜂、蚂蚁及白蚁等真社会性昆虫的非编码RNA调控机制研究进展进行了综述,以加深对真社会性昆虫内在遗传分子基础的理解和认识,也为害虫防治领域提供新的研发视角。

SEPTIN9与HOXA9基因甲基化在鉴别阑尾和卵巢来源腹膜假黏液瘤中的诊断价值

目的:腹膜假黏液瘤(pseudomyxoma peritonei,PMP)是一种罕见的腹膜恶性肿瘤综合征,其来源鉴别较困难。本研究旨在探讨SEPTIN9与HOXA9基因在阑尾黏液性肿瘤来源的PMP(appendiceal mucinous neoplasms-PMP,AMNs-PMP)与卵巢黏液性肿瘤来源的PMP(ovarian mucinous tumors-PMP,OMTs-PMP)中的甲基化水平及其对PMP鉴别的意义。方法:采用甲基化特异度聚合酶链反应(methylation-specific polymerase chain reaction,MS-PCR)检测SEPTIN9与HOXA9基因在正常阑尾(appendix control,APD control)组(n=10)、正常卵巢(ovary control,OV control)组(n=17)、AMNs-PMP组(n=40)及OMTs-PMP组(n=19)中的甲基化水平,同时对AMNs-PMP组及OMTs-PMP组的组织样本进行细胞角蛋白(cytokeratin,CK)7、CK20免疫组织化学检测。通过t检验分析SEPTIN9及HOXA9基因甲基化在AMNs-PMP组及OMTs-PMP组中表达差异并分析其与免疫组织化学联合检测的作用及价值。结果:AMNs-PMP组中SEPTIN9基因甲基化的阳性率明显高于OMTs-PMP组(92.5%vs 63.2%,P<0.01);OMTs-PMP组中HOXA9基因甲基化的阳性率显著高于AMNs-PMP组(94.7%vs 12.5%,P<0.001)。OMTs-PMP组中HOXA9基因甲基化的ΔCt值显著低于AMNs-PMP组(3.20±0.47 vs 8.63±0.61,P<0.001)。OMTs-PMP组中CK7的阳性率显著高于AMNs-PMP组(94.7%vs17.5%,P<0.001),AMNs-PMP组中CK20的阳性率显著高于OMTs-PMP组(97.5%vs 63.2%,P<0.001)。CK7(-)CK20(+)与SEPTIN9(+)HOXA9(-)基因甲基化在AMNs-PMP中诊断均有较高的敏感度(82.5%vs 87.5%)和特异度(均为94.7%);CK7(+)CK20(-)与SEPTIN9(-)HOXA9(+)基因甲基化在OMTs-PMP诊断中均有较低的敏感度(均为36.8%)、较高的特异度(97.5%vs 92.5%),而CK7(+)HOXA9(+)在与前2种组合特异度相似的情况下,其敏感度为89.5%,显著高于前二者。结论:SEPTIN9(+)HOXA9(-)可用于AMNs-PMP诊断,CK7(+)HOXA9(+)可用于OMTs-PMP诊断。SEPTIN9与HOXA9基因甲基化可成为AMNs-PMP及OMTs-PMP的潜在生物学标志物。

运动促进肝脏健康:表观遗传视域下非酒精性脂肪肝病的转归

非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)是与遗传或不良生活方式有关的代谢性疾病。表观遗传修饰的改变与NAFLD的发生发展密切相关。表观遗传修饰可被饮食和运动等环境因素影响。因此,本综述基于环境-基因范畴探讨表观遗传修饰在NAFLD发病机制中的作用,以及运动通过表观遗传修饰途径改善NAFLD的潜在机制。综述发现,运动可通过调控肝脏、骨骼肌等多器官/组织中的DNA甲基化修饰水平,直接或间接缓解肝脏脂肪变性;运动也可通过组蛋白修饰,调控肝脏糖脂代谢相关基因的表达,改善饮食诱导的肝脏糖脂代谢异常;运动还可通过调节微小RNA、长链非编码RNA等非编码RNA的表达,调控脂质合成分解、自噬和胰岛素信号传导等机制,进而改善NAFLD相关肝脏脂质沉积。重要的是,运动通过表观遗传修饰发挥的代谢益处具有明显的代际遗传效应,这为运动防治NAFLD提供了新的研究视角。

软骨肉瘤的表观遗传学研究进展

软骨肉瘤是第二常见的原发性恶性骨肿瘤,其治疗效果差,易复发和转移,对放化疗均不敏感,治疗方式在过去30~40年间停滞不前,还是以手术切除为主。对于软骨肉瘤的发生发展机制研究仍未完全明确,亦无特效药物。因此,探寻软骨肉瘤新的发生发展机制,从而寻找新的治疗方法和药物靶点,对临床治疗具有重大意义。有研究发现表观遗传学在软骨肉瘤发生发展中有重要作用。表观遗传学是指DNA序列未发生变化,但生物体的表型发生了可遗传性的改变,其机制主要包括DNA甲基化、非编码RNA调控、组蛋白修饰、染色质重塑等。该文就目前表观遗传学在软骨肉瘤中的研究进展做一综述,为进一步深入软骨肉瘤的研究,寻找新的治疗靶点提供方向。

Genetic and epigenetic targets of natural dietary compounds as anti-Alzheimer's agents

Alzheimer’s disease is a progressive neurodegenerative disorder and the most common cause of dementia that principally affects older adults.Pathogenic factors,such as oxidative stress,an increase in acetylcholinesterase activity,mitochondrial dysfunction,genotoxicity,and neuroinflammation are present in this syndrome,which leads to neurodegeneration.Neurodegenerative pathologies such as Alzheimer’s disease are considered late-onset diseases caused by the complex combination of genetic,epigenetic,and environmental factors.There are two main types of Alzheimer’s disease,known as familial Alzheimer’s disease(onset<65 years)and late-onset or sporadic Alzheimer’s disease(onset≥65 years).Patients with familial Alzheimer’s disease inherit the disease due to rare mutations on the amyloid precursor protein(APP),presenilin 1 and 2(PSEN1 and PSEN2)genes in an autosomaldominantly fashion with closely 100%penetrance.In contrast,a different picture seems to emerge for sporadic Alzheimer’s disease,which exhibits numerous non-Mendelian anomalies suggesting an epigenetic component in its etiology.Importantly,the fundamental pathophysiological mechanisms driving Alzheimer’s disease are interfaced with epigenetic dysregulation.However,the dynamic nature of epigenetics seems to open up new avenues and hope in regenerative neurogenesis to improve brain repair in Alzheimer’s disease or following injury or stroke in humans.In recent years,there has been an increase in interest in using natural products for the treatment of neurodegenerative illnesses such as Alzheimer’s disease.Through epigenetic mechanisms,such as DNA methylation,non-coding RNAs,histone modification,and chromatin conformation regulation,natural compounds appear to exert neuroprotective effects.While we do not purport to cover every in this work,we do attempt to illustrate how various phytochemical compounds regulate the epigenetic effects of a few Alzheimer’s disease-related genes.

Biological factors driving colorectal cancer metastasis

Approximately 20%of colorectal cancer(CRC)patients present with metastasis at diagnosis.Among Stage I-III CRC patients who undergo surgical resection,18%typically suffer from distal metastasis within the first three years following initial treatment.The median survival duration after the diagnosis of metastatic CRC(mCRC)is only 9 mo.mCRC is traditionally considered to be an advanced stage malignancy or is thought to be caused by incomplete resection of tumor tissue,allowing cancer cells to spread from primary to distant organs;however,increa-sing evidence suggests that the mCRC process can begin early in tumor development.CRC patients present with high heterogeneity and diverse cancer phenotypes that are classified on the basis of molecular and morphological alterations.Different genomic and nongenomic events can induce subclone diversity,which leads to cancer and metastasis.Throughout the course of mCRC,metastatic cascades are associated with invasive cancer cell migration through the circulatory system,extravasation,distal seeding,dormancy,and reactivation,with each step requiring specific molecular functions.However,cancer cells presenting neoantigens can be recognized and eliminated by the immune system.In this review,we explain the biological factors that drive CRC metastasis,namely,genomic instability,epigenetic instability,the metastatic cascade,the cancer-immunity cycle,and external lifestyle factors.Despite remarkable progress in CRC research,the role of molecular classification in therapeutic intervention remains unclear.This review shows the driving factors of mCRC which may help in identifying potential candidate biomarkers that can improve the diagnosis and early detection of mCRC cases.

热应激对牛卵子及其胚胎表观遗传修饰与发育能力的影响

旨在探究热应激对牛卵子及其胚胎表观遗传修饰与发育能力的影响。本研究将卵子置于体外热应激条件下培养(41℃12 h+38.5℃12 h),进行体外成熟(in vitro maturtion, IVM)和体外受精(in vitro fertilization, IVF),检测对照组(38.5℃24 h)和热应激组牛卵子和胚胎的发育能力及表观遗传修饰组蛋白H1、组蛋白H2、组蛋白H4和DNA甲基化的修饰水平。本研究还检测了卵子活性氧(reactive oxygen species, ROS)水平、线粒体膜电位(mitochondrial membrane potential,ΔΨm)水平及与表观遗传修饰和发育能力相关基因的表达水平。结果表明,热应激处理组卵子成熟率((59.21±4.29)%)、卵裂率((57.78±4.58)%)和囊胚率((22.31±1.67)%)均显著低于对照组((85.10±6.75)%、(78.64±2.46)%、(42.64±1.38)%,P<0.05);热应激组牛卵子及各阶段胚胎表观遗传修饰组蛋白H1、组蛋白H2、组蛋白H4、DNA甲基化水平显著低于对照组(P<0.05);热应激组牛卵子ΔΨm水平显著低于对照组(P<0.05);热应激组牛卵子ROS水平显著高于对照组(P<0.05);热应激组牛卵子表观遗传修饰相关基因DNMT1、DNMT3A、DNMT3B、Histone H2A、SMYD3、IGF-2R的mRNA表达水平显著低于对照组(P<0.05);热应激组牛卵子发育能力相关基因C-MOS、GDF-9和POU5F1的mRNA表达水平显著低于对照组(P<0.05)。本研究表明,热应激显著降低了牛卵子和胚胎表观遗传修饰组蛋白H1、组蛋白H2、组蛋白H4、DNA甲基化水平,显著降低了牛卵子ΔΨm水平及与表观遗传修饰和发育能力相关基因的mRNA表达水平,显著提高了ROS水平,降低了卵子质量。

N6-甲基腺嘌呤甲基化:中医药防治疾病的新兴靶点

N6-甲基腺嘌呤(N6-methyladenosine,m6A)修饰是真核细胞信使RNA(messenger RNA,mRNA)最常见的一种表观遗传修饰方式,近年来发现其在疾病的发生发展中扮演重要角色。通过国内外权威数据库检索分析,阐述了m6A修饰的概念、作用机制及其研究背景,介绍了参与调控m6A的三大类甲基化酶在m6A修饰过程中扮演的角色及其在疾病发生发展中的作用,并对近年来中药及其有效成分通过干预m6A修饰防治疾病的相关研究成果进行了系统地梳理和归纳发现,中药及其有效成分是宝贵的天然m6A调节剂,其在防治癌症、心血管疾病、生殖系统疾病及骨相关等疾病中具有较好的干预作用,但其干预m6A修饰防治疾病的研究正处于探索阶段,进一步探析其具体网络调控机制无疑是未来中医药研究的热门方向。为今后进一步探索中医药通过m6A修饰治疗疾病的潜在价值,挖掘开发可调控表观遗传的中药提供理论参考及依据。

基因的表达调控与Epigenetics

本文概述了ep igenetics的发展过程及其成京。Ep igenetics指的是基因表达改变的遗传物质变化,包括基因组和染色质(含组蛋白)的化学修饰,如DNA甲基化、乙酰化等等。其中甲基化所引起ep igenetics异常具有重要生理与病理生理学意义。影响基因表达调控与ep igenetics异常的研究对若干疾病(如癌症)的发生机制及探索治疗药物已获得可喜成果。

组蛋白乳酸化修饰在结直肠癌发展中作用的研究进展

结直肠癌(colorectal cancer,CRC)是一种常见的肠道恶性肿瘤,据统计,每年约有180万例新发病例和90万人死亡[1-2]。CRC的发病率和死亡率在全部恶性肿瘤中分别位于第二位和第四位,是全世界第三大高发癌症。尽管CRC在早期局部阶段可以治愈,但仍有25%的患者转化为转移性CRC,其5年生存率仅约为14%[3]。

扶正祛邪方抑制表观遗传调控蛋白EZH2对卵巢癌细胞的影响及其机制

目的研究扶正祛邪方对卵巢癌细胞增殖、凋亡、迁移和侵袭的影响及其可能的机制。方法扶正祛邪方作用于人卵巢癌SKOV3细胞后,通过MTT、细胞克隆、细胞划痕和Transwell实验,检测对SKOV3细胞增殖、凋亡、侵袭和迁移的影响;通过Western blotting和实时PCR检测负性表观遗传调控蛋白EZH2及其相关蛋白E-cadherin,以及细胞凋亡相关蛋白Bax、Bcl-2的表达水平。结果扶正祛邪方可呈浓度及时间依赖性提高SKOV3细胞的生长抑制率,可明显抑制SKOV3细胞的增殖、侵袭和迁移能力;Western blotting及实时PCR结果表明,扶正祛邪方与GSK126联合能抑制EZH2及Bcl-2转录,促进Bax、E-cadherin转录,下调EZH2、Bcl-2蛋白表达,促进Bax、E-cadherin蛋白表达。结论扶正祛邪方能抑制人卵巢癌SKOV3细胞增殖和侵袭,诱导其发生凋亡,可能是通过抑制EZH2参与调控E-cadherin表达及卵巢癌细胞的增殖、侵袭和迁移,并通过Bcl-2及Bax调控卵巢癌细胞的凋亡。

Research Progress on the Association between Schizophrenia and Toxoplasma gondii Infection

Toxoplasma gondii(T.gondii or Tg),is an obligatory intracellular parasite with humans as its intermediate hosts.In recent years,significant correlations between T.gondii infection and schizophrenia have been reported,including the possible mediating mechanisms.Currently,mechanisms and hypotheses focus on central neurotransmitters,immunity,neuroinflammation,and epigenetics;however,the exact underlying mechanisms remain unclear.In this article,we review the studies related to T.gondii infection and schizophrenia,particularly the latest research progress.Research on dopamine(DA)and other neurotransmitters,the blood-brain barrier,inflammatory factors,disease heterogeneity,and other confounders is also discussed.In addition,we also summarized the results of some new epidemiological investigations.

Rethinking neurodegenerative diseases:neurometabolic concept linking lipid oxidation to diseases in the central nervous system

Currently,there is a lack of effective medicines capable of halting or reve rsing the progression of neurodegenerative disorde rs,including amyotrophic lateral sclerosis,Parkinson s disease,multiple sclerosis,or Alzheimer s disease.Given the unmet medical need,it is necessary to reevaluate the existing para digms of how to to rget these diseases.When considering neurodegenerative diseases from a systemic neurometabolic perspective,it becomes possible to explain the shared pathological features.This innovative approach presented in this paper draws upon exte nsive research conducted by the authors and researchers worldwide.In this review,we highlight the importance of metabolic mitochondrial dysfunction in the context of neurodegenerative diseases.We provide an overview of the risk factors associated with developing neurodegenerative disorders,including genetic,epigenetic,and environmental fa ctors.Additionally,we examine pathological mechanisms implicated in these diseases such as oxidative stress,accumulation of misfolded proteins,inflammation,demyelination,death of neurons,insulin resistance,dysbiosis,and neurotransmitter disturbances.Finally,we outline a proposal for the restoration of mitochondrial metabolism,a crucial aspect that may hold the key to facilitating curative therapeutic interventions for neurodegenerative disorders in forthcoming advancements.

Prediction of treatment response to antipsychotic drugs for precision medicine approach to schizophrenia:randomized trials and multiomics analysis

Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).