BACKGROUND The efficacy and safety of transarterial chemoembolization(TACE)combined with lenvatinib plus programmed cell death protein-1(PD-1)for unresectable hepato-cellular carcinoma(HCC)have rarely been evaluated a...BACKGROUND The efficacy and safety of transarterial chemoembolization(TACE)combined with lenvatinib plus programmed cell death protein-1(PD-1)for unresectable hepato-cellular carcinoma(HCC)have rarely been evaluated and it is unknown which factors are related to efficacy.AIM To evaluate the efficacy and independent predictive factors of TACE combined with lenvatinib plus PD-1 inhibitors for unresectable HCC.METHODS This study retrospectively enrolled patients with unresectable HCC who received TACE/lenvatinib/PD-1 treatment between March 2019 and April 2022.Overall survival(OS)and progression-free survival(PFS)were determined.The objective response rate(ORR)and disease control rate(DCR)were evaluated in accordance with the modified Response Evaluation Criteria in Solid Tumors.Additionally,the prognostic factors affecting the clinical outcome were assessed.RESULTS One hundred and two patients were enrolled with a median follow-up duration of 12.63 months.The median OS was 26.43 months(95%CI:17.00-35.87),and the median PFS was 10.07 months(95%CI:8.50-11.65).The ORR and DCR were 61.76%and 81.37%,respectively.The patients with Barcelona Clinic Liver Cancer Classification(BCLC)B stage,early neutrophil-to-lymphocyte ratio(NLR)response(decrease),or early alpha-fetoprotein(AFP)response(decrease>20%)had superior OS and PFS than their counterparts.CONCLUSION This study showed that TACE/lenvatinib/PD-1 treatment was well tolerated with encouraging efficacy in patients with unresectable HCC.The patients with BCLC B-stage disease with early NLR response(decrease)and early AFP response(decrease>20%)may achieve better clinical outcomes with this triple therapy.展开更多
Studies have shown that C1q/tumor necrosis factor-related protein-6 (CTRP6) can alleviate renal ischemia/reperfusion injury in mice. However, its role in the brain remains poorly understood. To investigate the role of...Studies have shown that C1q/tumor necrosis factor-related protein-6 (CTRP6) can alleviate renal ischemia/reperfusion injury in mice. However, its role in the brain remains poorly understood. To investigate the role of CTRP6 in cerebral ischemia/reperfusion injury associated with diabetes mellitus, a diabetes mellitus mouse model of cerebral ischemia/reperfusion injury was established by occlusion of the middle cerebral artery. To overexpress CTRP6 in the brain, an adeno-associated virus carrying CTRP6 was injected into the lateral ventricle. The result was that oxygen injury and inflammation in brain tissue were clearly attenuated, and the number of neurons was greatly reduced. In vitro experiments showed that CTRP6 knockout exacerbated oxidative damage, inflammatory reaction, and apoptosis in cerebral cortical neurons in high glucose hypoxia-simulated diabetic cerebral ischemia/reperfusion injury. CTRP6 overexpression enhanced the sirtuin-1 signaling pathway in diabetic brains after ischemia/reperfusion injury. To investigate the mechanism underlying these effects, we examined mice with depletion of brain tissue-specific sirtuin-1. CTRP6-like protection was achieved by activating the sirtuin-1 signaling pathway. Taken together, these results indicate that CTRP6 likely attenuates cerebral ischemia/reperfusion injury through activation of the sirtuin-1 signaling pathway.展开更多
BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,i...BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.展开更多
目的探讨苏葶平喘汤对激素抵抗型难治性哮喘小鼠癌蛋白Fos(c-Fos)及血清核转录因子激活蛋白-1(activator protein 1,AP-1)表达的影响,试分析苏葶平喘汤对难治性哮喘的干预机制。方法将50只雌性SPF级BALB/c小鼠随机分为5组,分别为空白组...目的探讨苏葶平喘汤对激素抵抗型难治性哮喘小鼠癌蛋白Fos(c-Fos)及血清核转录因子激活蛋白-1(activator protein 1,AP-1)表达的影响,试分析苏葶平喘汤对难治性哮喘的干预机制。方法将50只雌性SPF级BALB/c小鼠随机分为5组,分别为空白组(A)、模型组(B)、苏葶平喘汤组(C)、地塞米松组(D)和苏葶平喘汤+地塞米松组(E),每组10只。除空白组外,剩余4组均将小鼠建立为激素抵抗型哮喘模型。药物干预结束后进行取材,利用酶联免疫吸附测定(ELISA)法、实时荧光定量聚合酶链式反应(Real-time PCR)分别检测小鼠血清AP-1、肺组织c-Fos的表达水平。结果1.ELISA检测结果显示:模型组小鼠较空白组小鼠血清中AP-1的值明显增高(P<0.05),苏葶平喘汤组、地塞米松组及苏葶平喘汤+地塞米松组较空白组的小鼠血清AP-1值均降低(P<0.05),其中以苏葶平喘汤+地塞米松组的降低最为显著(P<0.05)。2.PCR检测结果显示:模型组与其余各组相比小鼠肺组织的c-FosmRNA表达明显升高(P<0.05),苏葶平喘汤组、地塞米松组和苏葶平喘汤+地塞米松组c-FosmRNA表达下降(P<0.05),地塞米松组、苏葶平喘汤组和苏葶平喘汤+地塞米松组小鼠的肺组织c-FosmRNA表达水平则无明显差异。结论苏葶平喘汤治疗激素抵抗型哮喘可通过影响AP-1及c-Fos的表达水平来实现抑制哮喘炎症反应控制激素抵抗型哮喘症状的作用。展开更多
目的研究麻杏解毒合剂对冠状病毒肺炎模型小鼠炎性因子表达的影响,基于p38MAPK/AP-1通路研究其疗效机制。方法60只昆明种(KM)小鼠随机分成空白对照组、模型组、p38MAPK抑制剂组及麻杏解毒合剂高、中、低剂量组,每组10只。采用模拟寒湿...目的研究麻杏解毒合剂对冠状病毒肺炎模型小鼠炎性因子表达的影响,基于p38MAPK/AP-1通路研究其疗效机制。方法60只昆明种(KM)小鼠随机分成空白对照组、模型组、p38MAPK抑制剂组及麻杏解毒合剂高、中、低剂量组,每组10只。采用模拟寒湿环境、表达h ACE2的重组腺相关病毒转导、SARS-CoV-2spike假病毒气管内给药建立小鼠冠状病毒肺炎模型。检测各组小鼠血清炎性因子、肺组织病理改变、肺组织p38MAPK、c-jun、c-fos的mRNA水平和蛋白表达情况。结果与空白对照组比较,模型组小鼠血清炎性因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的表达均显著升高(P<0.01),肺组织炎性改变明显,c-fos m RNA水平和p-p38、c-fos、c-jun蛋白表达均显著增加(P<0.05)。与模型组比较,麻杏解毒合剂高、中剂量组小鼠血清炎性因子显著降低(P<0.01或P<0.05),小鼠肺组织炎性损伤明显减轻,同时肺组织中c-fos的mRNA水平和p-p38、c-fos的蛋白表达均显著下调(P<0.05)。结论麻杏解毒合剂能降低病毒性肺炎模型小鼠血清炎性因子水平,减轻肺组织炎性损伤,其疗效机制与抑制p38MAPK蛋白的磷酸化,下调AP-1通路mRNA及蛋白表达有关。展开更多
In this editorial,we comment on the article(World J Gastrointest Oncol 2024;16:1236-1247),which is a retrospective study of transarterial chemoembolization(TACE)combined with multi-targeted tyrosine kinase inhibitor(T...In this editorial,we comment on the article(World J Gastrointest Oncol 2024;16:1236-1247),which is a retrospective study of transarterial chemoembolization(TACE)combined with multi-targeted tyrosine kinase inhibitor(TKI)and programmed cell death protein-1(PD-1)inhibitor for the treatment of unresectable hepatocellular carcinoma(HCC).Herein,we focus specifically on the mechanisms of this triple therapy,administration sequence and selection of each medication,and implications for future clinical trials.Based on the interaction mechanisms between medications,the triple therapy of TACE+TKI+PD-1 is proposed to complement the deficiency of each monotherapy,and achieve synergistic antitumor effects.Although this triple therapy has been evaluated by several retrospective trials,it is still controversial whether the triple therapy achieves better clinical benefits,due to the flawed study design and heterogeneity in medications.In addition,the administration sequence,which may greatly affect the clinical benefit,needs to be fully considered at clinical decision-making for obtaining better prognosis.We hope that this editorial could contribute to the design and optimization of future trials.展开更多
文摘BACKGROUND The efficacy and safety of transarterial chemoembolization(TACE)combined with lenvatinib plus programmed cell death protein-1(PD-1)for unresectable hepato-cellular carcinoma(HCC)have rarely been evaluated and it is unknown which factors are related to efficacy.AIM To evaluate the efficacy and independent predictive factors of TACE combined with lenvatinib plus PD-1 inhibitors for unresectable HCC.METHODS This study retrospectively enrolled patients with unresectable HCC who received TACE/lenvatinib/PD-1 treatment between March 2019 and April 2022.Overall survival(OS)and progression-free survival(PFS)were determined.The objective response rate(ORR)and disease control rate(DCR)were evaluated in accordance with the modified Response Evaluation Criteria in Solid Tumors.Additionally,the prognostic factors affecting the clinical outcome were assessed.RESULTS One hundred and two patients were enrolled with a median follow-up duration of 12.63 months.The median OS was 26.43 months(95%CI:17.00-35.87),and the median PFS was 10.07 months(95%CI:8.50-11.65).The ORR and DCR were 61.76%and 81.37%,respectively.The patients with Barcelona Clinic Liver Cancer Classification(BCLC)B stage,early neutrophil-to-lymphocyte ratio(NLR)response(decrease),or early alpha-fetoprotein(AFP)response(decrease>20%)had superior OS and PFS than their counterparts.CONCLUSION This study showed that TACE/lenvatinib/PD-1 treatment was well tolerated with encouraging efficacy in patients with unresectable HCC.The patients with BCLC B-stage disease with early NLR response(decrease)and early AFP response(decrease>20%)may achieve better clinical outcomes with this triple therapy.
基金supported by the National Natural Science Foundation of China,Nos.82102295(to WG),82071339(to LG),82001119(to JH),and 81901994(to BZ).
文摘Studies have shown that C1q/tumor necrosis factor-related protein-6 (CTRP6) can alleviate renal ischemia/reperfusion injury in mice. However, its role in the brain remains poorly understood. To investigate the role of CTRP6 in cerebral ischemia/reperfusion injury associated with diabetes mellitus, a diabetes mellitus mouse model of cerebral ischemia/reperfusion injury was established by occlusion of the middle cerebral artery. To overexpress CTRP6 in the brain, an adeno-associated virus carrying CTRP6 was injected into the lateral ventricle. The result was that oxygen injury and inflammation in brain tissue were clearly attenuated, and the number of neurons was greatly reduced. In vitro experiments showed that CTRP6 knockout exacerbated oxidative damage, inflammatory reaction, and apoptosis in cerebral cortical neurons in high glucose hypoxia-simulated diabetic cerebral ischemia/reperfusion injury. CTRP6 overexpression enhanced the sirtuin-1 signaling pathway in diabetic brains after ischemia/reperfusion injury. To investigate the mechanism underlying these effects, we examined mice with depletion of brain tissue-specific sirtuin-1. CTRP6-like protection was achieved by activating the sirtuin-1 signaling pathway. Taken together, these results indicate that CTRP6 likely attenuates cerebral ischemia/reperfusion injury through activation of the sirtuin-1 signaling pathway.
文摘BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.
文摘目的探讨苏葶平喘汤对激素抵抗型难治性哮喘小鼠癌蛋白Fos(c-Fos)及血清核转录因子激活蛋白-1(activator protein 1,AP-1)表达的影响,试分析苏葶平喘汤对难治性哮喘的干预机制。方法将50只雌性SPF级BALB/c小鼠随机分为5组,分别为空白组(A)、模型组(B)、苏葶平喘汤组(C)、地塞米松组(D)和苏葶平喘汤+地塞米松组(E),每组10只。除空白组外,剩余4组均将小鼠建立为激素抵抗型哮喘模型。药物干预结束后进行取材,利用酶联免疫吸附测定(ELISA)法、实时荧光定量聚合酶链式反应(Real-time PCR)分别检测小鼠血清AP-1、肺组织c-Fos的表达水平。结果1.ELISA检测结果显示:模型组小鼠较空白组小鼠血清中AP-1的值明显增高(P<0.05),苏葶平喘汤组、地塞米松组及苏葶平喘汤+地塞米松组较空白组的小鼠血清AP-1值均降低(P<0.05),其中以苏葶平喘汤+地塞米松组的降低最为显著(P<0.05)。2.PCR检测结果显示:模型组与其余各组相比小鼠肺组织的c-FosmRNA表达明显升高(P<0.05),苏葶平喘汤组、地塞米松组和苏葶平喘汤+地塞米松组c-FosmRNA表达下降(P<0.05),地塞米松组、苏葶平喘汤组和苏葶平喘汤+地塞米松组小鼠的肺组织c-FosmRNA表达水平则无明显差异。结论苏葶平喘汤治疗激素抵抗型哮喘可通过影响AP-1及c-Fos的表达水平来实现抑制哮喘炎症反应控制激素抵抗型哮喘症状的作用。
文摘目的研究麻杏解毒合剂对冠状病毒肺炎模型小鼠炎性因子表达的影响,基于p38MAPK/AP-1通路研究其疗效机制。方法60只昆明种(KM)小鼠随机分成空白对照组、模型组、p38MAPK抑制剂组及麻杏解毒合剂高、中、低剂量组,每组10只。采用模拟寒湿环境、表达h ACE2的重组腺相关病毒转导、SARS-CoV-2spike假病毒气管内给药建立小鼠冠状病毒肺炎模型。检测各组小鼠血清炎性因子、肺组织病理改变、肺组织p38MAPK、c-jun、c-fos的mRNA水平和蛋白表达情况。结果与空白对照组比较,模型组小鼠血清炎性因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的表达均显著升高(P<0.01),肺组织炎性改变明显,c-fos m RNA水平和p-p38、c-fos、c-jun蛋白表达均显著增加(P<0.05)。与模型组比较,麻杏解毒合剂高、中剂量组小鼠血清炎性因子显著降低(P<0.01或P<0.05),小鼠肺组织炎性损伤明显减轻,同时肺组织中c-fos的mRNA水平和p-p38、c-fos的蛋白表达均显著下调(P<0.05)。结论麻杏解毒合剂能降低病毒性肺炎模型小鼠血清炎性因子水平,减轻肺组织炎性损伤,其疗效机制与抑制p38MAPK蛋白的磷酸化,下调AP-1通路mRNA及蛋白表达有关。
基金The National Natural Science Foundation of China,No.82104525The Natural Science Foundation of the Jiangsu Higher Education Institutions of China,No.21KJB360009.
文摘In this editorial,we comment on the article(World J Gastrointest Oncol 2024;16:1236-1247),which is a retrospective study of transarterial chemoembolization(TACE)combined with multi-targeted tyrosine kinase inhibitor(TKI)and programmed cell death protein-1(PD-1)inhibitor for the treatment of unresectable hepatocellular carcinoma(HCC).Herein,we focus specifically on the mechanisms of this triple therapy,administration sequence and selection of each medication,and implications for future clinical trials.Based on the interaction mechanisms between medications,the triple therapy of TACE+TKI+PD-1 is proposed to complement the deficiency of each monotherapy,and achieve synergistic antitumor effects.Although this triple therapy has been evaluated by several retrospective trials,it is still controversial whether the triple therapy achieves better clinical benefits,due to the flawed study design and heterogeneity in medications.In addition,the administration sequence,which may greatly affect the clinical benefit,needs to be fully considered at clinical decision-making for obtaining better prognosis.We hope that this editorial could contribute to the design and optimization of future trials.
