Use of programmed cell death protein ligand 1 assay to predict the outcomes of non-small cell lung cancer patients treated with immune checkpoint inhibitors

The recent discovery of immune checkpoints inhibitors, especially anti-programmed cell death protein 1(PD-1)and anti-programmed cell death protein ligand 1(PD-L1) monoclonal antibodies, has opened new scenarios in the management of non-small cell lung cancer(NSCLC) and this new class of drugs has achieved a rapid development in the treatment of this disease. However, considering the costs of these drugs and the fact that only a subset of patients experience long-term disease control, the identification of predictive biomarkers for the selection of candidates suitable for treatment has become a priority. The research focused mainly on the expression of the PD-L1 receptor on both tumor cells and/or immune infiltrates determined by immunohistochemistry(IHC). However, different checkpoint inhibitors were tested, different IHC assays were used, different targets were considered(tumor cells, immune infiltrates or both) and different expression thresholds were employed in clinical trials. In some trials the assay was used prospectively to select the patients, while in other trials it was evaluated retrospectively. Some confusion emerges, which makes it difficult to easily compare the literature data and to translate them in practice management. This mini-review shows the possibilities and pitfalls of the PD-L1 expression to predict the activity and efficacy of anti PD1/PD-L1 monoclonal antibodies in the treatment of NSCLC.

Unraveling structure and performance of protein a ligands at liquid–solid interfaces: A multi-techniques analysis

Oriented ligand immobilization is one of the most effective strategies used in the design and construction of a high-capacity protein A chromatography. In this work, cysteine was introduced as anchoring sites by substituting a specific residue on Helix Ⅰ, Ⅱ, and at C-terminus of antibody binding domain Z from protein A, respectively, to investigate structural evolution and binding behavior of protein A ligands at liquid-solid interfaces. Among the three affinity dextran-coated Fe_(3)O_(4) magnetic nanoparticles(Fe_(3)O_(4)@Dx MNPs), affinity MNPs with the immobilized ligand via N11C on Helix Ⅰ(Fe_(3)O_(4)@Dx-Z_(1) MNPs) had the highest helical content, and MNPs with the immobilized ligand via G29C on Helix Ⅱ(Fe_(3)O_(4)@Dx-Z_(2) MNPs) had the lowest helical content at the same pHs. It was attributed to less electrostatic attraction of ligand to negatively charged surface on Fe_(3)O_(4)@Dx-Z_(1) MNPs because of less positive charged residues on Helix Ⅰ(K6) than Helix Ⅱ(R27/K35). Among the three affinity MNPs, moreover, the highest affinity to immunoglobulin G(IgG) binding was observed on Fe_(3)O_(4)@Dx-Z_(1) MNPs in isothermal titration calorimetry measurement, further validating greater structural integrity of the ligand on Fe_(3)O_(4)@Dx-Z_(1) MNPs. Finally,the study of IgG binding on MNPs and 96-well plates showed that anchoring sites for ligand immobilization had distinct influences on IgG binding and IgG-mediated antigen binding. This work illustrated that anchoring sites of the ligands had a striking significance for the molecular structure of the ligand at liquid-solid interfaces and raised an important implication for the design and optimization of protein A chromatography and protein A-based immunoassay analysis.

Ligand-binding properties of three odorant-binding proteins of the diamondback moth Plutella xylostella

Strategies for insect population control are currently targeting chemical communication at the molecular level. The diamondback moth Plutella xylostella represents one of the most serious pests in agriculture, however detailed information on the proteins mediating olfaction in this species is still poor. This species is endowed with a repertoire of a large number of olfactory receptors and odorant binding proteins（OBPs）. As a contribution to map the specificities of these chemical sensors in the moth and eventually unrave l the complexity of chemodetection, we have measured the affinities of three selected OBPs to a series of potential odorants. Three proteins are highly divergent in their amino acid sequences and show markedly different expression profiles. In fact, PxylOBP3 is exclusively expressed in the antennae of both sexes, PxylOBP9 is male specific and present only in antennae and reproductive organs, while PxylOBP19, an unusual OBP with nine cysteines, is ubiquitously present in all the organs examined. Such expression pattern suggests that the last two proteins may be involved in non-chemosensory functions. Despite such differences, the three OBPs exhibit similar binding spectra, together with high selectivity. Among the 26 natural compounds tested, only two proved to be good ligands, retinol and coniferyl aldehyde. This second compound is particularly interesting being part of the chemical pathway leading to regeneration of lignin, one of the defense strategies of the plant against insect attack, and might find applications as a repellent for P. xylostella and other pests.

Comparison of ligand migration and binding in heme proteins of the globin family

The binding of small diatomic ligands such as carbon monoxide or dioxygen to heme proteins is among the simplest biological processes known. Still, it has taken many decades to understand the mechanistic aspects of this process in full detail. Here, we compare ligand binding in three heme proteins of the globin family, myoglobin, a dimeric hemoglobin, and neuroglobin. The combination of structural, spectroscopic, and kinetic experiments over many years by many laboratories has revealed common properties of globins and a clear mechanistic picture of ligand binding at the molecular level. In addition to the ligand binding site at the heme iron, a primary ligand docking site exists that ensures efficient ligand binding to and release from the heme iron. Additional, secondary docking sites can greatly facilitate ligand escape after its dissociation from the heme. Although there is only indirect evidence at present, a preformed histidine gate appears to exist that allows ligand entry to and exit from the active site. The importance of these features can be assessed by studies involving modified proteins（via site-directed mutagenesis） and comparison with heme proteins not belonging to the globin family.

Programmed death ligand-1 expression and its prognostic role in esophageal squamous cell carcinoma

AIM To investigate the expression and prognostic role of programmed death ligand-1(PD-L1) in locally advanced esophageal squamous cell carcinoma(ESCC).METHODS A total of 200 patients with ESCC who underwent radical esophagectomy with standard lymphadenectomy as the initial definitive treatment in Seoul National University Hospital from December 2000 to April 2013 were eligible for this analysis. Tissue microarrays were constructed by collecting tissue cores from surgical specimens, and immunostained with antibodies directed against PD-L1, p16, and c-Met. Medical records were reviewed retrospectively to assess clinical outcomes. Patients were divided into two groups by PD-L1 status, and significant differences in clinicopathologic characteristics between the two groups were assessed. RESULTS Tumor tissues from 67 ESCC patients(33.5%) were PDL1-positive. Positive p16 expression was observed in 21 specimens(10.5%). The H-score for c-Met expression was ≥ 50 in 42 specimens(21.0%). Although PDL1-positivity was not significantly correlated with any clinical characteristics including age, sex, smoking/alcoholic history, stage, or differentiation, H-scores for c-Met expression were significantly associated with PDL1-positivity(OR = 2.34, 95%CI: 1.16-4.72, P = 0.017). PD-L1 expression was not significantly associated with a change in overall survival(P = 0.656). In contrast, the locoregional relapse rate tended to increase(P = 0.134), and the distant metastasis rate was significantly increased(HR = 1.72, 95%CI: 1.01-2.79, P = 0.028) in patients with PD-L1-positive ESCC compared to those with PD-L1-negative ESCC.CONCLUSION PD-L1 expression is positively correlated with c-Met expression in ESCC. PD-L1 may play a critical role in distant failure and progression of ESCC.

Pivotal role of long non-coding ribonucleic acid-X-inactive specific transcript in regulating immune checkpoint programmed death ligand 1 through a shared pathway between miR-194-5p and miR-155-5p in hepatocellular carcinoma

BACKGROUND Anti-programmed death therapy has thrust immunotherapy into the spotlight.However,such therapy has a modest response in hepatocellular carcinoma(HCC).Epigenetic immunomodulation is a suggestive combinatorial therapy with immune checkpoint blockade.Non-coding ribonucleic acid(ncRNA)driven regulation is a major mechanism of epigenetic modulation.Given the wide range of ncRNAs that co-opt in programmed cell-death protein 1(PD-1)/programmed death ligand 1(PD-L1)regulation,and based on the literature,we hypothesized that miR-155-5p,miR-194-5p and long non-coding RNAs(lncRNAs)X-inactive specific transcript(XIST)and MALAT-1 are involved in a regulatory upstream pathway for PD-1/PD-L1.Recently,nutraceutical therapeutics in cancers have received increasing attention.Thus,it is interesting to study the impact of oleuropein on the respective study key players.AIM To explore potential upstream regulatory ncRNAs for the immune checkpoint PD-1/PD-L1.METHODS Bioinformatics tools including microrna.org and lnCeDB software were adopted to detect targeting of miR-155-5p,miR-194-5p and lncRNAs XIST and MALAT-1 to PD-L1 mRNA,respectively.In addition,Diana tool was used to predict targeting of both aforementioned miRNAs to lncRNAs XIST and MALAT-1.HCC and normal tissue samples were collected for scanning of PD-L1,XIST and MALAT-1 expression.To study the interaction among miR-155-5p,miR-194-5p,lncRNAs XIST and MALAT-1,as well as PD-L1 mRNA,a series of transfections of the Huh-7 cell line was carried out.RESULTS Bioinformatics software predicted that miR-155-5p and miR-194-5p can target PDL1,MALAT-1 and XIST.MALAT-1 and XIST were predicted to target PD-L1 mRNA.PD-L1 and XIST were significantly upregulated in 23 HCC biopsies compared to healthy controls;however,MALAT-1 was barely detected.MiR-194 induced expression elevated the expression of PD-L1,XIST and MALAT-1.However,overexpression of miR-155-5p induced the upregulation of PD-L1 and XIST,while it had a negative impact on MALAT-1 expression.Knockdown of XIST did have an impact on PD-L1 expression;however,following knockdown of the negative regulator of X-inactive specific transcript(TSIX),PD-L1 expression was elevated,and abolished MALAT-1 activity.Upon co-transfection of miR-194-5p with siMALAT-1,PD-L1 expression was elevated.Co-transfection of miR-194-5p with siXIST did not have an impact on PD-L1 expression.Upon co-transfection of miR-194 with siTSIX,PD-L1 expression was upregulated.Interestingly,the same PD-L1 expression pattern was observed following miR-155-5p cotransfections.Oleuropein treatment of Huh-7 cells reduced the expression profile of PD-L1,XIST,and miR-155-5p,upregulated the expression of miR-194-5p and had no significant impact on the MALAT-1 expression profile.CONCLUSION This study reported a novel finding revealing that opposing acting miRNAs in HCC,have the same impact on PD-1/PD-L1 immune checkpoint by sharing a common signaling pathway.

Mechanisms of C-reactive protein, interleukin-6 and soluble CD40L blood concentration changes after coronary stent implantation

Background: The pathway linking inflammation and thrombosis has been extensively studied. Experimental data support that arterial thrombosis also induces a detectable inflammatory response, which in turn, activates prothrombotic pathways closing a vicious circle that interconnects inflammation and thrombosis. Aim: We designed this study to investigate the causes of inflammatory markers increase after coronary angioplasty. Methods: We analyzed the interrelationship of thrombotic and inflammatory markers and the effect of blocking thrombus formation on the inflammatory response in 50 patients undergoing high thrombotic risk coronary angioplasty. The relationship of platelet number to soluble CD40 Ligand, Interleukin-6 and C-reactive protein blood levels was studied. Half of the study population was treated with standard antithrombotic drugs and the other half with the standard therapy plus platelet GP IIb-IIIa receptor inhibitor Eptifibatide. Results: There was a clear correlation between basal platelet count and sCD40L basal levels, post-angioplasty sCD40L increase and post-angioplasty IL-6 levels and post-angioplasty IL-6 levels with post-angioplasty CRP levels. Postangioplasty CRP, IL-6 and sCD40L blood levels were influenced by GP IIb-IIIa treatment in patients with angiographic thrombus. Conclusion: Platelet aggregation induces a proinflammatory response which is blocked by a GP IIb-IIIa inhibitor agent, particularly in patients with patent angiographic thrombus.

“New-Look” Opioids: Biased Ligands

Between the illicit use of opioids and attendant overdoses, and accidental overdoses with prescribed drugs, overuse of opioids has become a serious problem. At the same time, finding that fine balance between minimizing the risk of opioid misuse and abuse while at the same time providing access to treatment for patients who need pain control presents an ongoing challenge. Efforts to discover and develop better agents have led to what we term “new-look” opioids. We summarize here one such approach—known as biased ligands. By targeting a subset of GPCR signal transduction, this approach attempts to increase the separation between therapeutic and adverse effects.

血清HMGB1、CCL20、HSP27水平与慢性牙周炎患者牙周病变程度的相关性分析

目的探讨血清高迁移率族蛋白1(HMGB1)、CC趋化因子配体20(CCL20)、热休克蛋白27(HSP27)水平与慢性牙周炎(CP)患者牙周病变程度的相关性。方法选取2021年9月至2023年8月在新乡医学院第一附属医院诊治的60例CP患者纳入观察组,根据1∶1原则,另选取同期牙周健康者60例纳入对照组。比较两组及不同牙周病变程度CP患者血清HMGB1、CCL20、HSP27水平,分析各指标水平与CP牙周病变程度的相关性及联合诊断价值,并分析不同血清水平患者发生CP的危险度。结果观察组血清HMGB1、CCL20、HSP27水平高于对照组(P<0.05);不同牙周病变程度CP患者血清HMGB1、CCL20、HSP27水平比较:轻度<中度<重度,且各指标水平与牙周病变程度均呈正相关(P<0.05);入院时HMGB1、CCL20、HSP27水平联合诊断CP的曲线下面积(AUC)为0.905,最佳诊断敏感度为91.67%,特异度为88.33%,约登指数0.800,且各指标高水平患者发生CP的危险度是低水平的1.105倍、1.034倍、1.105倍(P<0.05)。结论HMGB1、CCL20、HSP27在CP患者血清中呈异常高表达,各指标水平与牙周病变程度均呈正相关,且联合检测对CP具有较高诊断价值,可作为临床诊断CP、评估牙周病变程度的有效指标。

EXPRESSION OF Fas LIGAND IN HUMAN COLON CANCER CELL LINES

Objective: To investigate the expression of Fas ligand in human colon carcinoma cell lines. Methods: A total of six human colon cancer cell lines were examined for the expression of Fas ligand mRNA and cell surface protein by using RT-PCR and flow cytometry respectively. Results: The results showed that Fas ligand mRNA was expressed in all of the six cancer cell lines and Fas ligand cell surface protein was expressed in part of them. Conclusion: These data suggest that Fas ligand was expressed, at least in part, in human colon cancer cell lines and might facilitate to escape from immune surveillance of the host.

血清LBP、CXCL-10对小儿急性上呼吸道细菌感染的鉴别诊断价值及其影响因素

目的探讨血清脂多糖结合蛋白(LBP)、血清CXC趋化因子配体-10(CXCL-10)对小儿急性上呼吸道细菌感染的鉴别诊断价值及其影响因素。方法将2021年7月至2022年6月该院收治的90例急性上呼吸道感染患儿纳入研究作为研究组。另选取同期于本院进行体检40例健康儿童作为健康组。根据痰液细菌培养结果将研究组患儿分为细菌感染组(51例)和非细菌感染组(39例)。采用酶联免疫吸附法检测血清LBP、CXCL-10水平。采用受试者工作特征(ROC)曲线评估血清LBP、CXCL-10对小儿急性上呼吸道细菌感染的鉴别诊断价值。采用多因素Logistic回归分析小儿急性上呼吸道细菌感染的影响因素。结果研究组血清LBP、CXCL-10水平高于健康组(P<0.05)。细菌感染组血清LBP、CXCL-10水平高于非细菌感染组(P<0.05)。血清LBP、CXCL-10单独及联合用于诊断小儿急性上呼吸道细菌感染的曲线下面积(AUC)分别为0.779(95%CI:0.724~0.822)、0.843(95%CI:0.796~0.898)、0.906(95%CI:0.852~0.959)。细菌感染组家庭成员吸烟、铁元素缺乏、钙元素缺乏者所占比例、年均抗菌药使用次数、血清LBP、CXCL-10水平均高于非细菌感染患者(P<0.05)。Logistic多因素回归分析显示,年均抗菌药使用次数≥2次(OR=2.305,95%CI:1.483~3.582)、LBP≥104.26 ng/mL(OR=2.573,95%CI:1.446~4.578)、CXCL-10≥112.98 pg/mL(OR=1.208,95%CI:0.110~1.314)是小儿急性上呼吸道细菌感染的影响因素(P<0.05)。结论血清LBP、CXCL-10水平升高与儿童急性上呼吸道细菌感染密切相关,可作为鉴别诊断急性上呼吸道细菌感染的指标且二者联合诊断的效能更高。

类风湿关节炎患者血清SAA、CCL20、MMP-3表达水平及临床意义

目的探讨类风湿关节炎(RA)患者血清淀粉样蛋白A(SAA)、趋化因子配体20(CCL20)及基质金属蛋白酶3(MMP-3)水平变化及临床意义。方法回顾性选取2020年9月至2023年1月大同市第五人民医院收治的RA患者108例作为研究对象,依据28个关节的疾病活动度评分(DAS28)评分,将患者分为缓解期组(n=35,DSA28评分<2.6)与活动期组(n=73,DSA28评分≥2.6),并将活动期患者进一步分为轻度活动期(n=20,DSA28评分2.6~3.2)、中度活动期(n=29,DSA28评分>3.2~5.1)与重度活动期(n=24,DSA28为>5.1);另选取同期健康体检者80名作为对照组。所有受试者均检测血清SAA、CCL20、MMP-3水平。比较不同组别血清SAA、CCL20、MMP-3水平;使用Pearson相关分析血清SAA、CCL20、MMP-3水平与红细胞沉降率(ESR)、C反应蛋白(CRP)的相关性;使用受试者工作特征(ROC)曲线评价各指标对RA疾病活动度的诊断价值。结果RA组血清SAA、CCL20、MMP-3水平分别为(42.25±13.46)mg/L、(45.69±12.78)pg/mL、(85.41±25.14)ng/mL,均显著高于对照组[(7.14±2.12)mg/L、(18.12±5.47)pg/mL、(27.36±8.21)ng/mL],差异均有统计学意义(P<0.05)。RA活动期组患者血清SAA、CCL20、MMP-3水平分别为(51.78±10.71)mg/L、(53.14±10.45)pg/mL、(106.10±20.39)ng/mL,显著高于缓解期组[(22.37±7.14)mg/L、(30.15±8.24)pg/mL、(42.25±13.64)ng/mL],差异均有统计学意义(P<0.05)。重度活动度组血清SAA、CCL20、MMP-3水平均高于中度活动度组和轻度活动度组,差异均有统计学意义(P<0.05),随着疾病活动度提高,血清SAA、CCL20、MMP-3水平逐渐增高。Pearson相关分析显示,活动期RA患者血清SAA、CCL20、MMP-3水平与CRP、ESR均呈正相关(P<0.05)。ROC曲线分析得出,血清SAA、CCL20、MMP-3区分RA轻度活动度与中度活动度的曲线下面积(AUC)分别为0.852、0.756、0.725,区分中度活动度与重度活动度的AUC分别为0.852、0.756、0.725,均显示出一定的诊断能力。结论RA患者血清SAA、CCL20、MMP-3水平均呈高表达,这3项指标可作为评估疾病活动度的生物标志物,可为临床预测病情进展提供参考。

血清Ephrin-A1、CTRP9对糖尿病性视网膜病变的诊断价值及与机体氧化应激的相关性分析

目的分析血清肝配蛋白A1(Ephrin-A1)、C1q肿瘤坏死因子相关蛋白9(CTRP9)对糖尿病性视网膜病变的诊断价值及与机体氧化应激的相关性。方法回顾性选择自2021年1月至2023年1月新疆维吾尔自治区人民医院接诊的80例糖尿病性视网膜病变患者作为观察组,另选同期的80例单纯2型糖尿病患者作为对照组。检测两组患者血清Ephrin-A1、CTRP9及氧化应激指标[超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛],分析不同分期的糖尿病性视网膜病变患者血清Ephrin-A1、CTRP9水平的差异性,使用受试者工作特征(ROC)曲线分析血清Ephrin-A1、CTRP9对糖尿病性视网膜病变的诊断效能,Pearson相关性分析糖尿病性视网膜病变患者血清Ephrin-A1、CTRP9水平与机体氧化应激指标的相关性。结果观察组血清Ephrin-A1水平为(7.81±2.34)ng/mL,高于对照组[(2.25±0.76)ng/mL],CTRP9水平为(98.17±10.13)pg/mL,低于对照组[(156.42±15.89)pg/mL],差异均有统计学意义(P<0.05)。观察组血清SOD、GSH水平分别为(50.14±5.63)U/L、(142.34±13.98)mg/L,均低于对照组[(73.52±8.52)U/L、(189.71±23.56)mg/L],丙二醛水平为(6.89±3.07)μmol/L,高于对照组[(3.56±1.02)μmol/L],差异均有统计学意义(P<0.05)。增生型糖尿病性视网膜病变患者血清Ephrin-A1为(15.42±4.80)ng/mL,高于非增生型糖尿病性视网膜病变患者[(6.09±2.11)ng/mL],CTRP9水平为(75.25±6.73)pg/mL,低于非增生型糖尿病性视网膜病变患者[(119.46±13.08)pg/mL],差异均有统计学意义(P<0.05)。经ROC曲线分析,血清Ephrin-A1联合CTRP9诊断糖尿病性视网膜病变的敏感度为92.68%、特异度为53.69%、AUC为0.931。经Pearson相关性分析,糖尿病性视网膜病变患者血清Ephrin-A1与SOD、GSH呈负相关,与丙二醛呈正相关(P<0.05);CTRP9水平与SOD、GSH呈正相关,与丙二醛呈负相关(P<0.05)。结论血清Ephrin-A1联合CTRP9可提高对糖尿病性视网膜病变的诊断效能,其中机体氧化应激与Ephrin-A1呈正性关联,与CTRP9呈负性关联,值得进一步研究应用。

临床资料联合CT影像组学特征评估胃癌程序性死亡配体1状态

目的观察临床资料联合CT影像组学特征评估胃癌程序性死亡配体1(PD-L1)状态的价值。方法回顾性按7∶3比例将277例胃癌患者随机分为训练集(n=195)与验证集(n=82):训练集含PD-L1阳性亚组88例、阴性亚组107例,验证集各含37及45例。比较不同集别亚组间临床及常规CT特征,分析胃癌PD-L1状态的独立影响因素,基于CT筛选影像组学特征,建立临床模型、影像组学模型及临床-影像组学联合模型,观察各模型评估胃癌PD-L1状态的效能。结果训练集亚组间Borrmann分型、cN分期、cM分期、临床分期、肿瘤最大径及厚径差异均有统计学意义(P均<0.05);Borrmann分型、临床分期及肿瘤厚径均为PD-L1阳性的独立影响因素(P均<0.05)。临床模型、影像组学模型及临床-影像组学联合模型评估训练集胃癌PD-L1状态的曲线下面积(AUC)分别为0.748、0.832及0.841,在验证集分别为0.657、0.801及0.789;临床模型的AUC均低于其他模型(P均<0.05)。结论临床资料联合CT影像组学特征有助于评估胃癌PD-L1状态。

丹参酮ⅡA调节骨关节炎小鼠骨代谢的作用机制

目的探讨丹参酮ⅡA(TanⅡA)通过介导Yes激酶相关蛋白(Yes-associated protein,YAP)、核因子-κB受体活化因子配基(receptor activator of nuclear factor-κB ligand,RANKL)/核因子κB受体活化因子(eceptor activator of nuclear factor-κB,RANK)/骨保护蛋白(osteoprotegerin,OPG)调节骨关节炎小鼠骨代谢的作用机制。方法建立骨关节炎小鼠模型,将60只小鼠随机分成假手术组、模型组、TanⅡA低剂量组和TanⅡA高剂量组,每组15只,造模成功后灌胃给药,连续4周。HE和番红O固绿染色观察软骨组织病理损伤并进行Mankin评分。酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测血清骨碱性磷酸酶(bone alkaline phosphatase,BALP)、骨钙素(osteocalcin,OC)、Ⅰ型胶原交联羧基末端肽(C-telopeptide of typeⅠcollagen,CTX)、白细胞介素(interleukin,IL)-1β、IL-6、IL-8和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)。蛋白质印迹法(Western blotting)检测基质金属蛋白酶(matrix metalloproteinases,MMPs)、YAP、RANK、RANKL和OPG蛋白。结果TanⅡA可改善小鼠软骨组织病理变化并降低Mankin评分。与假手术组比较,模型组BALP、OC水平下降,CTX、TNF-α、IL-6、IL-1β、IL-8、MMP1、MMP3和MMP13水平升高(P<0.05)。与模型组比较,TanⅡA低剂量组、TanⅡA高剂量组BALP、OC水平升高,CTX、TNF-α、IL-6、IL-1β、IL-8、MMP1、MMP3和MMP13水平降低(P<0.05)。与假手术组比较,模型组小鼠软骨组织中YAP、OPG和RANK蛋白水平下降,RANKL蛋白水平升高(P<0.05);与模型组比较,TanⅡA 2组小鼠软骨组织中YAP、OPG和RANK蛋白水平上升,RANKL蛋白水平下降(P<0.05)。结论TanⅡA可能通过介导YAP、RANK/RANKL/OPG信号通路调控骨关节炎。

西藏地区结直肠癌免疫治疗和靶向治疗相关分子标志物的检测及意义

目的研究西藏地区结直肠癌中SWI/SNF相关、基质相关、肌动蛋白依赖性染色质调节因子A亚科成员4(SMARCA4)/Brahma相关基因1、V-raf鼠类肉瘤病毒癌基因同源物B(BRAF)、P53、程序性死亡受体1(PD-1)及程序性死亡配体1(PD-L1)免疫组织化学表达和BRAF、神经营养因子酪氨酸受体激酶(NTRK)基因改变情况,为西藏地区结直肠癌患者的靶向治疗及免疫治疗提供依据。方法收集2015年1月至2021年7月西藏自治区人民医院经手术切除病理确诊为结直肠癌病例64例,全部病例均进行SMARCA4、BRAF、P53、PD-1、PD-L1免疫组织化学染色和NTRK1、NTRK2、NTRK3融合基因荧光原位杂交检测及BRAF V600E基因突变PCR检测。结果64例结直肠癌病例男女比例1.21∶1,平均年龄(56.59±13.27)岁;46例(71.88%)位于结肠,18例(28.12%)位于直肠;60例(93.75%)为腺癌,4例(6.25%)为其他类型;11例(17.19%)为T1或T2期,53例(82.81%)为T3或T4期;24例(37.50%)出现淋巴结转移。免疫组织化学方面,64例中1例(1.56%)SMARCA4部分肿瘤细胞表达减弱或缺失,4例(6.25%)BRAF肿瘤细胞阳性表达,35例(54.69%)P53为突变型表达;45例(70.31%)PD-1肿瘤相关免疫细胞阳性比例分数<10%,19例(29.69%)≥10%;52例(81.25%)PD-L1联合阳性分数<10,12例(18.75%)≥10。64例NTRK1、NTRK2、NTRK3融合基因检测均为阴性;4例(6.25%)检测到BRAF V600E基因突变;1例SMARCA4表达缺失病例未检测到SMARCA4基因改变。PD-L1的表达与错配修复缺陷/高度微卫星不稳定和PD-1的高表达呈显著正相关(χ^(2)=10.223,P=0.001;χ^(2)=11.979,P=0.001)。结论西藏地区结直肠癌中较少出现SMARCA4表达减弱或缺失及NTRK融合基因改变,少数病例有BRAF V600E基因突变,Pan-TRK和BRAF免疫组织化学可作为NTRK融合基因及BRAF基因突变的初筛方法。错配修复缺陷/高度微卫星不稳定的病例中更容易出现PD-L1蛋白高表达,这部分患者有望获益于免疫治疗。P53突变与PD-L1表达无相关性,PD-1的高表达和PD-L1的高表达呈正相关。

基于MRI影像组学构建PD-1/PD-L1抑制剂治疗dMMR/MSI-H直肠癌疗效的预测模型

目的:探讨MRI影像组学模型在程序性细胞死亡蛋白-1(PD-1)/程序性细胞死亡-配体1(PD-L1)抑制剂联合全程新辅助治疗(TNT)局部进展期直肠癌(LARC)的疗效预测价值。方法:收集河南中医药大学第一附属医院PD-1/PD-L1抑制剂联合TNT治疗的80例错配修复基因缺陷(dMMR)/微卫星高度不稳定(MSI-H)基因型中低位LARC患者的临床和影像资料。将入组患者按7∶3比例分为训练集和测试集,提取影像组学特征,从中筛选并构建影像组学模型。描绘影像组学模型的Rad-score与病理金标准之间的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),并评价模型的诊断效能。采用决策曲线分析(DCA)计算风险阈值的范围,并评估临床获益情况。收集湖南省人民医院25例dMMR/MSI-H基因型LARC患者的影像资料作为外部验证集。结果:训练集、测试集及外部验证集三者之间的临床特征无统计学差异(P>0.05)。经过降维处理、t检验及一致性检验以及LASSO交叉验证后,筛选出一阶偏度特征和体积2个特征构建影像组学模型。训练集、测试集和外部验证集的影像组学预测模型ROC曲线的AUC、灵敏度、特异度、阳性预测值和阴性预测值分别为0.920、97.1%、85.7%、91.9%、94.7%;0.885、80.0%、88.9%、92.3%、72.7%;0.875、87.5%、88.9%、93.3%、80.0%。DCA曲线显示,当风险阈值范围为0%~82%时,采用影像组学模型预测LARC患者为病理完全缓解(pCR)的获益大于将所有患者都视为pCR或者无病理完全缓解(npCR)。结论:基于MRI影像组学构建的dMMR/MSI-H型局部进展期直肠癌PD-1/PD-L1抑制剂联合全程新辅助放化疗疗效预测模型,有较大潜力为不同基因分型的直肠癌患者制定个体化治疗策略提供量化依据。

基于PD-L1蛋白表达水平的胃癌免疫治疗专家共识(2023年版)

以程序性死亡蛋白-1(programmed death protein-1,PD-1)抑制剂为代表的免疫检查点抑制剂在胃癌中显示良好疗效,逐步改变晚期胃癌的治疗格局。对于程序性死亡蛋白配体-1(programmed death-ligand 1,PD-L1)高表达的患者,PD-L1单抗的治疗效果更为优异,且与PD-L1蛋白表达水平呈正相关。而对于PD-L1阴性或低表达这类免疫治疗非优势人群,以PD-1单抗为基础的用药方案疗效有限,尝试双特异性抗体、ADC等不同药物的联合也是一种趋势。为了精准指导临床实践,中国抗癌协会胃癌专业委员会组织国内胃癌领域专家进行多轮讨论,系统汇总国内外最新指南和循证证据,并结合我国临床实际,从病理检测、晚期治疗以及围术期治疗3个方面制订了本专家共识,旨在提高胃癌诊治的科学性和规范性,尤其是指导基层医生对免疫治疗的选择和应用。

HBV相关慢加急性肝衰竭患者sPD-1/sPD-L1与T细胞的相关性分析

目的:探讨乙型肝炎病毒(hepatitis B virus,HBV)相关慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)患者病程中可溶性程序性死亡蛋白1(soluble Programmed cell death protein1,sPD-1)、可溶性程序性死亡蛋白配体-1(soluble Programmed cell death ligand1,sPD-L1)、T淋巴细胞、白细胞介素-10(interleukin-10,IL-10)和转化生长因子-β(transforming growth factor-β,TGF-β)的表达水平及各指标间的相关性。方法:收集71例确诊为HBV-ACLF患者的资料及外周血标本,根据研究对象28 d的随访结果,分为存活组40例和死亡组31例。采用流式细胞术检测研究对象外周血CD4+T及CD8+T细胞的比例。采用流式液相多重蛋白定量(cytometric bead array,CBA)技术检测sPD-1和sPD-L1的表达。采用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)检测TGF-β和IL-10的表达。Pearson法分析HBVACLF患者血清中sPD-1/sPD-L1与患者MELD评分、T细胞及细胞因子水平的相关性。结果:死亡组外周血及血清中CD4+T细胞百分比、sPD-1、sPD-L1、IL-10和TGF-β高于存活组,而CD8+T细胞百分比低于存活组(P均<0.05)。经相关性分析显示,sPD-1水平与IL-10、TGF-β和CD4+T细胞百分比呈正相关,与CD8+T细胞百分比呈负相关。sPD-L1水平与终末期肝病模型(model for end-stage liver disease,MELD)评分、IL-10、TGF-β和CD4+T呈正相关,与CD8+T细胞比例呈负相关(P均<0.05)。结论:sPD-1/sPDL1可能参与了HBV-ACLF发生、发展过程中的免疫应答,通过综合考虑患者sPD-1和sPD-L1水平可以为HBV-ACLF患者开展及时有效的治疗提供一定的参考。

绿盲蝽气味结合蛋白AlucOBP31配体筛选及EAG测定

绿盲蝽Apolyguslucorum是重要的农业害虫,了解其化学感受机制对该虫的绿色防控具有重要指导意义。气味结合蛋白(Odorant-binding proteins,OBPs)在昆虫化学感受过程中发挥关键作用。为深入探究绿盲蝽OBP家族成员AlucOBP31的生物学功能,本研究采用荧光竞争结合试验和触角电位技术(Electroantennogram,EAG),系统分析了AlucOBP31对候选配体化合物的结合特性及其电生理活性。荧光竞争结合试验结果表明,重组Aluc OBP31蛋白能够与16种配体化合物发生不同程度的结合,其中与植物挥发物β-紫罗兰酮的结合能力最强,而与十二醛和顺-丁酸-3-己烯酯的结合能力相对较弱。值得注意的,AlucOBP31能与绿盲蝽性信息素组分4-氧代-反-2-己烯醛结合,提示其可能参与绿盲蝽的性信息素识别过程。此外,AlucOBP31还对槲皮素、芦丁水合物、棉酚和单宁酸等4种非挥发性苦味物质具有强结合能力,暗示其可能在绿盲蝽的味觉识别中发挥一定作用。EAG试验进一步验证了AlucOBP31配体的电生理活性。绿盲蝽雌、雄成虫的触角对12种AlucOBP31挥发性配体均产生了明显的EAG反应,其中对顺-丁酸-3-己烯酯和4-氧代-反-2-己烯醛的EAG响应值显著高于其它配体,并且雄性触角对这些配体的EAG反应普遍强于雌性,提示AlucOBP31介导的化学感受过程可能存在性别差异。综上所述,本研究系统分析了绿盲蝽AlucOBP31的结合特性及相应配体的电生理活性,发现该蛋白能够结合寄主植物挥发物、绿盲蝽性信息素组分以及多种非挥发性苦味物质,表明AlucOBP31可能在绿盲蝽的嗅觉和味觉识别过程中发挥多重生物学功能。这一发现为进一步探究AlucOBP31与其配体在绿盲蝽寄主选择、交配等重要生命活动中的生物学意义提供了研究基础,加深了我们对绿盲蝽化学感受机制的认知,也为绿盲蝽的绿色防控提供了新的分子靶标。