Current concepts in ameloblastoma-targeted therapies in B-raf proto-oncogene serine/threonine kinase V600E mutation: Systematic review

BACKGROUND Ameloblastomas are common benign epithelial odontogenic neoplasms that present an aggressive and unpredictable behavior that may modify treatment strategies.Different signaling pathways that participate in the progression of these tumors have been identified.B-raf proto-oncogene serine/threonine kinase(BRAF)is a protein involved in the behavior of ameloblastomas,and it is related to many cell mechanisms.BRAF gene mutations have been identified in ameloblastomas,of which the BRAF V600E(valine substituted by glutamic acid at amino acid 600)mutation has been the most common and can be present concomitantly with other mutations that may be involved in its behavior.Targeted therapies have been used as an alternative in the case of resistance or contraindications to conventional treatments.AIM To document the presence of BRAF V600E and additional mutations,their behavior,and targeted therapies in these tumors.METHODS An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE,Cochrane,EMBASE,and SpringerLink using the terms“ameloblastomas”,“BRAF V600E”,“additional mutations”,and“targeted therapies”.Ameloblastomas were classified according to WHO guidelines.Inclusion criteria were articles in English,published not more than 10 years ago,and studies with laboratory works related to BRAF V600E.Articles were evaluated by two independent reviewers and retrieved for full-text evaluation.The EBLIP Critical Appraisal Checklist was used to evaluate the quality of the eligible studies.Descriptive statistical analysis was performed.RESULTS Two independent reviewers,with a substantial concordance indicated by a kappa coefficient of k=0.76,evaluated a total of 19 articles that were included in this study.The analysis registered 521 conventional ameloblastomas(AM),81 unicystic ameloblastomas(UA),13 ameloblastic carcinomas(AC),three metastatic ameloblastomas(MA),and six peripheral ameloblastomas(PA),of which the histopathological type,anatomic location,laboratory tests,expression of BRAF mutation,and additional mutations were registered.The BRAF V600E mutation was found in 297 AM(57%),63 UA(77.7%),3 AC(23%),1 MA(50%),and 5 PA(83.3%).Follicular type predominated with a total of 116 cases(40%),followed by plexiform type with 63 cases(22.1%).Furthermore,both types presented additional mutations,in which alterations in JAK3 P132T,SMARCB1,PIK3CA,CTNNB1,SMO,and BRAF G606E genes were found.Four case reports were found with targeted therapy to BRAF V600E.CONCLUSION The identification of BRAF V600E and additional mutations as an aid in targeted therapies has been a breakthrough in alternative treatments of ameloblastomas where surgical treatments are contraindicated.

Novel serine/threonine kinase 11 gene mutations in PeutzJeghers syndrome patients and endoscopic management

AIM:To explore mutations in serine/threonine kinase 11(STK11) gene in Peutz-Jeghers syndrome(PJS) with gastrointestinal(GI) hamartomatous polyps.METHODS:Six Japanese PJS patients in 3 families were enrolled in this study.Each of the cases had hamartomatous polyposis in the gastrointestinal tract,including the small intestine,along with mucocutaneous hyperpigmentation.Narrow-band imaging(NBI)-magnification endoscopy was employed to detect microvascular and microsurface irregularities in the GI lesions.NBI magnification findings could be classified into three groups(type A,type B,or type C).Endoscopic polypectomy was performed using double-balloon enteroscopy or colonoscopy.Genomic DNA was extracted from a whole blood sample from each subject.All of the coding exons of STK11 gene,its boundary regions,and the promoter region containing the polymorphic regions were amplified by polymerase chain reaction,and direct sequencing was performed to assess the germline mutations.RESULTS:NBI-magnification endoscopic observation could detect the abnormalities in microvessels and microsurface structures of GI polyps.Overall,we found 5 cases of type A and one case without the examination for the gastric polyps,while there were 4 cases of type B and 2 case of type A for the colorectal polyps.Seventy-nine small-bowel and 115 colorectal polyps over 27 sessions for each were resected endoscopically without significant complications.The only delayed complication included the occurrence of bleeding in a case,and this was successfully managed with hemoclips.Resected polyps contained no malignant components.Based on mutation analysis,all 3 cases in Family I exhibited the +658C>T nonsense mutation in exon 5,which resulted in the production of a truncated protein(Q220X).In Family II,a case had-252C>A and-193C>A in the promoter region.In Family III,a case was found to have the +1062C>G(F342L) mutation in exon 8.CONCLUSION:We found two novel mutations of STK11 in association with PJS.Endoscopic polypectomy of GI polyps in PJS patients appears to be useful to prevent emergency laparotomies and reduce the cancer risk.

Knockdown of Microtubule Associated Serine/threonine Kinase Like Expression Inhibits Gastric Cancer Cell Growth and Induces Apoptosis by Activation of ERK1/2 and Inactivation of NF-κB Signaling

Microtubule-associated serine/threonine kinase(MASTL)functions to regulate chromosome condensation and mitotic progression.Therefore,aberrant MASTL expression is commonly implicated in various human cancers.This study analyzed MASTL expression in gastric cancer vs.adjacent normal tissue for elucidating the association with clinicopathological data from patients.This work was then extended to investigate the effects of MASTL knockdown on tumor cells in vitro.The level of MASTL expression in gastric cancer tissue was assessed from the UALCAN,GEPIA,and Oncomine online databases.Lentivirus carrying MASTL or negative control shRNA was infected into gastric cancer cells.RT-qPCR,Western blotting,cell viability,cell counting,flow cytometric apoptosis and cell cycle,and colony formation assays were performed.MASTL was upregulated in gastric cancer tissue compared to the adjacent normal tissue,and the MASTL expression was associated with advanced tumor stage,Helicobacter pylori infection and histological subtypes.On the other hand,knockdown of MASTL expression significantly reduced tumor cell viability and proliferation,and arrested cell cycle at G2/M stage but promoted tumor cells to undergo apoptosis.At protein level,knockdown of MASTL expression enhanced levels of cleaved PARP1,cleaved caspase-3,Bax and p-ERK1/2 expression,but downregulated expression levels of BCL-2 and p-NF-κB-p65 protein in AGS and MGC-803 cells.MASTL overexpression in gastric cancer tissue may be associated with gastric cancer development and progression,whereas knockdown of MASTL expression reduces tumor cell proliferation and induces apoptosis.Further study will evaluate MASTL as a potential target of gastric cancer therapeutic strategy.

Serine-threonine protein kinase activation may be an effective target for reducing neuronal apoptosis after spinal cord injury

The signaling mechanisms underlying ischemia-induced nerve cell apoptosis are poorly understood. We investigated the effects of apoptosis-related signal transduction pathways following ischemic spinal cord injury, including extracellular signal-regulated kinase（ERK）, serine-threonine protein kinase（Akt） and c-Jun N-terminal kinase（JNK） signaling pathways. We established a rat model of acute spinal cord injury by inserting a catheter balloon in the left subclavian artery for 25 minutes. Rat models exhibited notable hindlimb dysfunction. Apoptotic cells were abundant in the anterior horn and central canal of the spinal cord. The number of apoptotic neurons was highest 48 hours post injury. The expression of phosphorylated Akt（pAkt） and phosphorylated ERK（p-ERK） increased immediately after reperfusion, peaked at 4 hours（p-Akt） or 2 hours（p-ERK）, decreased at 12 hours, and then increased at 24 hours. Phosphorylated JNK expression reduced after reperfusion, increased at 12 hours to near normal levels, and then showed a downward trend at 24 hours. Pearson linear correlation analysis also demonstrated that the number of apoptotic cells negatively correlated with p-Akt expression. These findings suggest that activation of Akt may be a key contributing factor in the delay of neuronal apoptosis after spinal cord ischemia, particularly at the stage of reperfusion, and thus may be a target for neuronal protection and reduction of neuronal apoptosis after spinal cord injury.

Tacolimus Postconditioning Alleviates Apoptotic Cell Death in Rats after Spinal Cord Ischemia-reperfusion Injury via Up-regulating Protein-Serine-Threonine Kinases Phosphorylation

The effects of tacrolimus postconditioning on protein-serine-threonine kinases （Akt） phos- phorylation and apoptotic cell death in rats after spinal cord ischemia-reperfusion injury were investi- gated. Ninety male SD rats were randomly divided into sham operation group, ischemia-reperfusion group and tacrolimus postconditioning group. The model of spinal cord ischemia was established by means of catheterization through femoral artery and balloon dilatation. The spinal cord was reperfused 20 min after ischemia via removing saline out of balloon. The corresponding spinal cord segments were excised and determined for Akt activity in spinal cord tissue by using Western blotting at 5, 15, and 60 min after reperfusion respectively. Spinal cord tissue sections were stained immunohistochemically for detection of the phosphorylated Akt expression at 15 min after reperfusion. Flow cytometry was applied to assess apoptosis of neural cells, and dry-wet weights method was employed to measure water content in spinal cord tissue at 24 h after reperfusion. The results showed that the activities of Akt in tarcolimus postconditioning group were significantly higher than those in ischemia-reperfusion group at 5, 15, and 60 min after reperfusion （P〈0.05, P〈0.01）. The Akt activities reached the peak at 15 min after reperfu- sion in ischemia-reperfusion group and tacrolimus postconditioning group. The percentage of apoptotic cells and water content in spinal cord tissue were significantly reduced （P〈0.01） in tacrolimus postcon- ditioning group as compared with those in ischemia-reperfusion group at 24 h after reperfusion. It is concluded that tacrolimus postconditioning can increase Akt activity in spinal cord tissue of rats, inhibit apoptosis of neural cells as well as tissue edema, and thereby alleviate spinal cord ischemia-reperfusion injury.

serine/threonine蛋白激酶功能研究进展

蛋白激酶(protein kinase)具有将ATP的γ-磷酸基转移到蛋白质底物特定的氨基酸残基上的潜在催化能力,从而使蛋白质磷酸化。根据底物上氨基酸的特异性,蛋白激酶可以细分为丝/苏氨酸激酶和酪氨酸激酶。在DNA复制和有丝分裂过程中蛋白激酶起调节作用。同时,蛋白激酶在转录过程也起到重要作用,如在转录因子核转位过程的作用、调节转录因子与DNA结合能力、调节转录因子的激活活性。蛋白激酶的磷酸化作用与肿瘤发生关系密切,其可以促使基因表达的改变等一系列细胞的应答发生,最终导致癌症的发生和发展。

Pathophysiological roles of Pim-3 kinase in pancreatic cancer development and progression

Pim-3 is a member of the provirus integration site for Moloney murine leukemia virus(Pim)family proteins that exhibit serine/threonine kinase activity.Similar to the other Pim kinases(Pim-1 and Pim-2),Pim-3 is involved in many cellular processes,including cell proliferation,survival,and protein synthesis.Although Pim-3is expressed in normal vital organs,it is overexpressed particularly in tumor tissues of endoderm-derived organs,including the liver,pancreas,and colon.Silencing of Pim-3 expression can retard in vitro cell proliferation of hepatocellular,pancreatic,and colon carcinoma cell lines by promoting cell apoptosis.Pim-3 lacks the regulatory domains similarly as Pim-1 and Pim-2 lack,and therefore,Pim-3 can exhibit its kinase activity once it is expressed.Pim-3 expression is regulated at transcriptional and post-transcriptional levels by transcription factors(e.g.,Ets-1)and post-translational modifiers(e.g.,translationally-controlled tumor protein),respectively.Pim-3 could promote growth and angiogenesis of human pancreatic cancer cells in vivo in an orthotopic nude mouse model.Furthermore,a Pim-3 kinase inhibitor inhibited cell proliferation when human pancreatic cancer cells were injected into nude mice,without inducing any major adverse effects.Thus,Pim-3 kinase may serve as a novel molecular target for developing targeting drugs against pancreatic and other types of cancer.

A defect in the PINOID serine/threonine kinase affects leaf shape in cucumber

Examining the plants in any forest or meadow reveals a remarkable diversity of leaf shape,suggesting the importance of this trait for adaptation to various environmental conditions(reviewed in Nicotra et al.2011).Indeed,leaf shape may be constrained by biomechanical factors and affects thermoregulation,susceptibility to herbivory,the available light for photosynthesis,and water balance.

外泌体miRNA差异表达可作为诊断慢性心力衰竭合并高尿酸血症患者新型分子标志物及靶基因功能分析

目的分析慢性心力衰竭(CHF)合并高尿酸血症(HUA)患者血清外泌体miRNA的差异表达,探讨其作为CHF合并HUA新型诊断分子标志物的可能性,并对差异miRNA进行靶基因功能分析,分析作用靶点。方法以2020年9月~2023年9月南京中医药大学附属南京中医院心血管病科收治的CHF合并HUA患者为观察组(n=30),选择同期健康志愿者为对照组(n=30)。两组各选取6例样本,采用高通量测序分析血清外泌体中的差异表达miRNA,采用RT-PCR检测对未作高通量测序的观察组和对照组样本(n=24)进行验证,使用R软件进行GO、KEGG富集分析,预测差异表达miRNA的作用靶点,并通过动物实验验证临床筛查的差异miRNA。结果高通量测序分析显示,观察组患者共检测到42个差异表达的miRNA(18个上调,24个下调),其中miR-27a-5p上调(P<0.001),miR-139-3p下调(P<0.001)。RT-PCR检测显示,观察组患者血清外泌体中miR-27a-5p表达量上调(P=0.004)、miR-139-3p表达量下调(P=0.005);ROC曲线下面积(AUC)分析发现,miR-27a-5p、miR-139-3p预测CHF合并HUA发病的AUC分别是0.708(95%CI:0.562-0.855)和0.734(95%CI:0.593-0.876),两者联合预测CHF与HUA发病的AUC为0.899(95%CI:0.812-0.987)。对差异基因进行GO富集分析发现,细胞自噬是富集程度最高的靶点;KEGG功能注释显示,激活AMPK-mTOR信号通路可能是差异表达的miR-27a-5p和miR-139-3p作用靶点之一。进一步动物实验得到了相同的验证。结论血清外泌体中miR-27a-5p上调和miR-139-3p下调可作为精准诊断CHF合并HUA的新型分子标志物,激活AMPK-mTOR信号通路后促进心肌细胞的自噬反应可能是差异表达的miR-27a-5p、miR-139-3p的作用靶点之一。

基于多参数磁共振成像特征的深度学习预测直肠癌患者的BRAF基因突变状态

目的探讨鼠类肉瘤病毒癌基因同源物B基因(B-Raf proto-oncogene serine/threonine kinase,BRAF)突变状态与直肠癌患者生存率的相关性。本研究旨在评估影像组学模型预测结直肠癌患者BRAF基因突变情况的可行性。材料与方法对我院2020年6月至2023年6月确诊为直肠癌的患者病例资料进行回顾性分析,采用外显子测序鉴定BRAF基因突变状态。通过生存分析评估BRAF基因突变与直肠癌预后的关系。从260名接受多参数MRI的直肠癌患者中提取7388个特征模块,包括术前T1加权图像(T1-weighted imaging,T1WI)、T2加权图像(T2-weighted imaging,T2WI)和对比增强T1加权图像(contrast-enhanced T1-weighted imaging,CE-T1WI)。随后,基于卷积神经网络(convolutional neural network,CNN)构建了放射组学模型。通过受试者工作特征曲线(receiver operating characteristic,ROC)曲线、准确率、敏感度和特异度等指标评估模型效能。结果本研究共纳入89例BRAF突变患者和171例BRAF野生型患者。两组在肿瘤恶性分期、年龄、性别等临床特征上差异无统计学意义(P>0.05),但5年生存率差异存在统计学意义,BRAF突变组生存期低于BRAF野生型组(P<0.001)。所构建模型的ROC曲线下面积(area under the curve,AUC)为0.929,与病理结果一致性分析的Kappa统计量为0.87,表明模型具有较高的预测价值。结论基于CNN的放射组学特征模型在区分直肠癌患者BRAF突变状态方面表现优异,为未来无创筛查BRAF突变状态提供了新的研究思路。

LY294002抑制PI3K-Akt信号通路对人甲状腺癌细胞的影响

目的:探讨磷脂酰肌醇3-激酶(PI3K)抑制剂2-(4-吗啉基)-8-苯基-4氢-1-苯并吡喃-4-酮(LY294002)对人甲状腺未分化癌HTH-15细胞中PI3K-丝氨酸苏氨酸激酶(Akt)信号通路、细胞生长、细胞凋亡及细胞侵袭性的影响。方法:HTH-15细胞用不同浓度(0～100μmol/L)LY294002处理,以DMSO处理作为对照组,四甲基偶氮唑盐(MTT)试验检测细胞抑制率;流式细胞仪检测细胞周期百分比;Western blot检测磷酸化Akt(p-Akt)蛋白、基质金属蛋白酶(MMP)-2蛋白表达;Transwell小室检测细胞侵袭性。结果:LY294002能抑制HTH-15细胞的增殖,且呈一定的浓度及时间依赖性,经LY294002处理组后细胞停留在G1期的百分比明显高于DMSO对照组(P<0.05);LY294002能明显抑制p-Akt蛋白和MMP-2蛋白表达,且应用LY294002后,能降低HTH-15细胞的侵袭性。结论:甲状腺未分化癌HTH-15细胞中存在有活性的PI3K-Akt通路,表达高水平的p-Akt蛋白,LY294002可能通过抑制PI3K-Akt信号通路中p-Akt的表达抑制HTH-15细胞增殖,促进细胞凋亡,降低细胞侵袭能力。

LY294002抑制PI3K/Akt信号通路对人胃癌SGC-7901细胞的影响

目的探讨低氧环境下PI3K抑制剂2-（4-吗啉基）-8-苯基-4氢-1-苯并吡喃-4-酮（LY294002）对人胃癌SGC-7901细胞中磷脂酰肌醇3-激酶（PI3K）／丝氨酸苏氨酸激酶（Akt）信号通路、细胞生长、细胞凋亡及低氧诱导因子-1α（HIF-1α）mRNA表达的影响。方法应用LY294002作用于低氧环境中的人胃癌SGC-7901细胞（低氧＋LY294002组），采用CCK-8试剂盒检测SGC-7901细胞生长；流式细胞仪检测细胞凋亡百分比；Western blotting检测P13K和p-Akt蛋白表达；RT—PCR检测HIF-1α mRNA表达。以低氧环境中未加LY294002的细胞作为对照（低氧组）。结果LY294002能抑制低氧环境中SGC-7901细胞增殖，抑制效果在药物作用后第2～6天时最为明显（P〈0．05），低氧＋LY294002组中细胞凋亡百分比明显高于低氧组（P〈0．01）。LY294002能明显抑制PI3K、p-Akt蛋白以及HIF-1α mRNA的表达，与低氧组比较差异均有统计学意义（P〈0．05）。结论LY294002能抑制低氧环境中人胃癌SGC-7901细胞生长，促进细胞凋亡，抑制PI3K／Akt信号通路及其下游HIF-1α mRNA的表达。

磷脂酰肌醇-3-激酶/丝氨酸-苏氨酸激酶抑制剂LY294002对小鼠视网膜新生血管形成的抑制作用

目的探讨磷脂酰肌醇-3-激酶(phosphatidylinositol-3-kinase,PI3K)/丝氨酸-苏氨酸激酶(Serine/threonine kinase,AKT)信号转导通路抑制剂LY294002对小鼠氧诱导视网膜病变(oxygen-induced retinopathy,OIR)的视网膜新生血管(retinal neovascularization,RNV)形成的影响。方法取C57BL/6J小鼠60只,随机分为实验组和对照组,每组各30只,均制备OIR模型。小鼠出氧箱前1 d即鼠龄11 d时实验组玻璃体内注射0.5μL的LY294002,对照组玻璃体内注射等体积的PBS。病理切片计数突破视网膜内界膜的新生血管内皮细胞核数,免疫组织化学和RT-PCR法检测p AKT、VEGF蛋白及m RNA的表达情况。结果实验组小鼠新生血管内皮细胞核数为(12.53±1.71)个,较对照组(25.31±1.42)个明显减少(P<0.05);实验组小鼠p AKT、VEGF的蛋白表达呈弱阳性,阳性细胞的吸光度值(9.12±1.35、13.91±1.49)均较对照组(15.11±2.17、19.72±2.61)明显下降(均为P<0.05);实验组小鼠AKT、VEGF m RNA相对表达量均较对照组明显下降(均为P<0.05)。结论 LY294002通过抑制PI3K/AKT信号转导通路,可有效抑制小鼠OIR的RNV形成,LY294002有望成为防治血管增生性视网膜病变的一种有效方法。

特发性免疫性血小板减少症患儿血清MST4和HSP70水平及临床意义

目的探讨特发性免疫性血小板减少症(ITP)患儿血清丝氨酸/苏氨酸蛋白激酶4(MST4)、热休克蛋白70(HSP70)水平及临床意义。方法回顾性选取2019年4月至2023年4月来西北妇女儿童医院就诊的98例ITP患儿作为ITP组,另以同期体检的50例健康儿童为对照组。采用酶联免疫吸附试验检测血清MST4、HSP70水平,比较不同ITP程度患儿血清MST4、HSP70水平差异。采用Pearson相关分析各指标的相关性,Logistic回归模型筛选ITP预后的影响因素,受试者工作特征曲线分析血清MST4、HSP70对ITP预后的评估价值。结果ITP组血清MST4、HSP70、CD8^(+)高于对照组,血小板计数(PLT)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。轻度组、中度组和重度组血清MST4、HSP70水平依次升高,差异均有统计学意义(P<0.05)。相关性分析显示,血清MST4、HSP70与CD8^(+)呈正相关(P<0.05),与PLT、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈负相关(P<0.05)。预后不良组ITP患儿病程、血清MST4、HSP70高于预后良好组,差异有统计学意义(P<0.05)。Logistic回归分析显示,病程(OR=1.579,P<0.001)、血清MST4(OR=1.451,P<0.001)、血清HSP70(OR=1.442,P<0.001)均为影响ITP患儿预后的独立危险因素。血清MST4、HSP70联合对ITP患儿不良预后的评估的曲线下面积大于血清MST4、HSP70单项指标,差异有统计学意义(Z=4.568、4.672,均P<0.001)。结论ITP患儿血清MST4、HSP70水平升高,均与患儿病情程度及细胞免疫功能状态有关,二者联合对ITP患儿预后具有较高的评估价值。

鞘内注射LY294002缓解大鼠骨癌痛

目的：观察鞘内注射（ intrathecal injection,i. t.）磷脂酰肌醇3-激酶（ PI3K）抑制剂LY294002对骨癌痛大鼠疼痛行为学、脊髓背角磷酸化Akt （ p-Akt ）表达的影响。方法♀SD大鼠40只,体质量180～200 g,随机分为5组（n=8）：假手术组（Ⅰ组）、假手术＋LY294002组（Ⅱ组）、骨癌痛组（Ⅲ组）、骨癌痛＋二甲基亚砜（ DMSO ）组（ IV 组）、骨癌痛＋LY294002（V 组）,于大鼠左侧胫骨干骺端骨髓腔内注射Walker256乳腺癌细胞构建胫骨癌痛模型。术后d 7～9鞘内连续注射浓度为2．5 g·L＾-1的LY29400210μL 或10μL 的5%DMSO。观测术前及术后d 7给药后每小时机械痛阈（至8 h）。术后d 9处死大鼠,取各组大鼠的L4～6脊髓组织进行免疫组化染色,检测脊髓背角PI3K 活化标志p-Akt 的表达。结果骨癌痛组大鼠（Ⅲ、Ⅳ、Ⅴ组）机械痛阈（MWT）明显低于假手术组（Ⅰ组）（P 〈0．01）,V 组在给药后2～4h 痛阈明显升高（P 〈0．05）,3 h 达到峰值（P 〈0．01）。与Ⅰ组比较,Ⅲ、Ⅳ组脊髓背角p-Akt 阳性细胞数明显增加,p-Akt 表达增多（ P 〈0．01）。与Ⅲ、Ⅳ组比较,Ⅴ组鞘内注射 LY294002后能明显降低脊髓背角p-Akt 的表达（P 〈0．05）。结论 PI3K/ Akt 通路可能参与大鼠骨癌痛的发生。

STK40在脑胶质瘤中的表达及其临床意义的生信分析

目的探讨丝氨酸/酸酸蛋白激酶40(STK40)在脑胶质瘤中的表达及其临床意义。方法计算机检索GEPIA数据库,运用生物信息学方法分析STK40在胶质瘤组织及正常脑组织中的表达差异;同时,检索CGGA数据库中693例脑胶质瘤的基因信息及临床资料,运用Kaplan-Meier生存曲线分析STK40表达水平与脑胶质瘤生存预后的关系;采用多因素Cox比例回归风险模型分析脑胶质瘤生存预后的影响因素。结果GEPIA数据库分析显示,胶质母细胞瘤组织STK40表达水平较正常脑组织明显增高(P<0.05)。STK40表达水平与胶质瘤病理级别呈正相关,随胶质瘤病理级别增高,STK40表达水平明显增高(P<0.0001)。多因素Cox风险比例回归模型分析结果显示,STK40高表达是脑胶质瘤生存预后不良的独立危险因素(P<0.05)。Kaplan-Meier生存曲线分析显示,STK40高表达组中位总生存期较低表达组明显缩短(P<0.0001);而且STK40高表达明显降低胶质瘤放/化疗的效果(P<0.0001)。Pearson相关性分析显示,ERK下游产物SRF与STK40呈明显正相关(r=0.45;P<0.0001),JNK下游产物ATF2与STK40表达水平呈明显负相关(r=-0.167;P<0.0001)。结论胶质瘤STK40呈高表达,与病人生存预后不良有关,其作用机制可能与ERK/MAPK及JNK/MAPK信号通路有关。

美国不良事件报告系统中丝氨酸/苏氨酸蛋白激酶/丝裂原活化蛋白激酶联合抑制剂不良反应信号数据挖掘与分析

目的:本研究旨在比较维莫非尼联合考比替尼、达拉非尼联合曲美替尼和康奈非尼联合贝美替尼3种丝氨酸/苏氨酸蛋白激酶(serine/threonine-protein kinase B-raf,BRAF)/丝裂原活化蛋白激酶(mitogen-activated protein kinases,MEK)联合抑制剂间药品不良反应(adverse drug reaction,ADR)的差异,以期指导临床安全用药。方法:收集2011年第1季度—2023年第2季度美国FDA不良事件报告系统中的ADR报告,使用报告比值比法和贝叶斯可信区间递进神经网络法进行数据分析,同时采用Chi-square统计方法对组间数据进行分析。结果:研究共纳入17982份ADR报告,其中达拉非尼联合曲美替尼报告数最多,为12746份,且报告死亡结局的比例(26.62%)也高于其他方案组。3种治疗方案主要累及系统器官分别为皮肤及皮下组织类疾病、全身性疾病及给药部位各种反应和胃肠系统疾病。在维莫非尼联合考比替尼和康奈非尼联合贝美替尼方案中,浆液性视网膜病关联性最强,维莫非尼联合考比替尼方案发生器质性脑综合征ADR致死概率为100.00%。结论:临床上应关注维莫非尼联合考比替尼方案发生器质性脑综合征ADR致死风险,不同BRAF/MEK联合抑制剂与特定系统器官的ADR关联强度存在差异,临床医生可根据患者的具体需求合理选择药物,并对ADR进行有效监测。

基于PI3K/Akt/mTOR 通路探究七氟醚麻醉对大鼠神经细胞凋亡的影响

目的探讨七氟醚麻醉对大鼠认知功能及神经细胞凋亡的影响。方法取96只大鼠,随机分为对照组(吸入2 L·min^(−1)氧气)、七氟醚低浓度组(吸入体积分数为1%的七氟醚+2 L·min^(−1)氧气)、七氟醚中浓度组(吸入体积分数为2%的七氟醚+2 L·min^(−1)氧气)、七氟醚高浓度组(吸入体积分数为4%的七氟醚+2 L·min^(−1)氧气),持续吸入6 h。用Morris水迷宫实验观察各组大鼠认知能力,用HE染色观察海马组织学形态,用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)测定海马组织中枢神经特异性蛋白(soluble protein 100β,S-100β)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、白细胞介素-1β(interleukin-1β,IL-1β)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平,流式细胞术测定神经细胞凋亡情况,蛋白印迹法(Western blotting)测定海马组织B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)、Bcl-2相关X蛋白(Bcl2-associated X protein,Bax)、磷酸化磷脂酰肌醇3-激酶(phosphorylated phosphatidylinositol 3-kinase,p-PI3K)、磷酸化丝氨酸/苏氨酸激酶(phosphorylated serine/threonine kinase,p-Akt)和磷酸化哺乳动物雷帕霉素靶蛋白(phosphorylated mammalian target of rapamycin,p-mTOR)的水平。结果HE染色结果表明,对照组海马组织神经细胞结构正常,排列紧密,七氟醚各浓度组大鼠海马组织神经细胞减少,排列紊乱,分布不均匀。与对照组比较,七氟醚各浓度组大鼠逃避潜伏期时间,S100-β、NSE、IL-1β、TNF-α水平,Bax蛋白水平和神经细胞凋亡率均升高,穿越平台次数,平台停留时间,Bcl-2、p-PI3K、p-Akt和p-mTOR蛋白水平均降低(P<0.05);七氟醚各浓度组诸项指数水平变化规律相同,并呈剂量依赖性(P<0.05)。结论七氟醚麻醉可诱导大鼠神经细胞凋亡,使大鼠认知能力衰退,其可能与调控PI3K/Akt/mTOR信号通路有关。

LRRK2基因R1067Q和GBA基因R202Q双变异致早发型帕金森病一例

患者男性,42岁。主因左手抖动18个月,左下肢抖动伴运动迟缓6个月,于2023年7月8日入院。患者18个月前(2022年1月)无明显诱因出现左上肢不自主抖动,静止时出现、持物及动作时消失,无动作迟缓、反应变慢等其他伴随症状。于2022年11月至外院就诊,头部MRI检查无明显异常,结合临床症状,考虑帕金森病(PD),服用普拉克索0.375 mg/d并逐渐增量至0.375 mg/次、2次/d长期治疗,症状无明显改善。6个月前(2023年1月)出现左下肢不自主抖动,并逐渐出现动作迟缓,左侧肢体活动不灵活,体位变化或行走时偶有头晕,不伴视物旋转及恶心呕吐等,持续数分钟后头晕可自行好转,无嗅觉丧失、情绪低落,睡眠质量尚可,无多梦、呓语、乱喊乱叫、手舞足蹈等症状。

右美托咪定下调PI3K/AKT信号通路改善脂多糖诱导的结肠炎结肠上皮细胞损伤

为研究右美托咪定对脂多糖(LPS)诱导的人结肠上皮NCM-460细胞的炎症、增殖和凋亡的影响及磷脂酰肌醇-3-激酶/丝氨酸-苏氨酸激酶(PI3K/AKT)信号通路的调控作用,本研究体外培养人结肠上皮NCM-460细胞,将其分为对照组、LPS组(1μg/mL LPS)和不同质量浓度右美托咪定组(1μg/mL LPS+1.25、2.50、5.00和10.00μg/mL右美托咪定),干预24 h,筛选出合适的右美托咪定作用质量浓度用于后续试验。随后,将人结肠上皮NCM-460细胞分为对照组、LPS组、右美托咪定组(1μg/mL LPS+5.00μg/mL右美托咪定)、LY294002组(1μg/mL LPS+10μmol/L PI3K/AKT通路抑制剂LY294002)、抑制剂组(1μg/mL LPS+5.00μg/mL右美托咪定+10μmol/L LY294002)和激活剂组(1μg/mL LPS+5.00μg/mL右美托咪定+10μmol/L PI3K/AKT通路激动剂SC79),干预24 h。用细胞计数试剂盒-8(CCK-8)检测细胞活力;通过酶联免疫吸附试验(ELISA)检测肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)的表达水平;用5-乙炔基-2'脱氧尿嘧啶核苷(EdU)测定细胞增殖率;用Hoechst 33258染色法测定细胞凋亡率;用蛋白免疫印迹(WB)法测定细胞周期蛋白D1(Cyclin D1)、剪切的半胱氨酸蛋白酶-3(cleaved Caspase 3)和PI3K/AKT信号通路关键蛋白的表达水平。根据细胞活力和炎症因子TNF-α的表达水平选择5.00μg/mL右美托咪定用于后续试验。结果显示,与对照组相比,LPS组细胞增殖率和Cyclin D1的表达水平显著降低(P<0.05),细胞凋亡率、TNF-α、IL-8、cleaved Caspase 3的表达水平、p-PI3K/PI3K及p-AKT/AKT的比值显著升高(P<0.05);右美托咪定组和LY294002组中的右美托咪定和LY294002扭转了LPS对人结肠上皮NCM-460细胞的上述作用(P<0.05);与右美托咪定组相比,抑制剂组中的LY294002增强了右美托咪定对LPS诱导的人结肠上皮NCM-460细胞的作用(P<0.05),激活剂组中的SC79则削弱了右美托咪定对LPS诱导的人结肠上皮NCM-460细胞的作用(P<0.05)。研究表明,右美托咪定能促进LPS诱导的人结肠上皮NCM-460细胞增殖,抑制其炎症和凋亡,其作用机制可能与阻滞PI3K/PI3K信号通路信号转导有关。本研究为结肠炎的治疗提供了新的方向。