1.Shenqi Yiliu Prescription Reverses Cisplatin Resistance in Ovarian Cancer Cells by Regulating PI3K/Akt/mTOR Signaling Pathway-mediated Glycolysis
Lan MA ; Yuping YANG ; Min BAI ; Yongqiang DUAN ; Zhining ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):60-69
ObjectiveTo investigate the mechanism by which Shenqi Yiliu prescription reverses cisplatin resistance in ovarian cancer cells by regulating the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway-mediated glycolysis. MethodsThe human ovarian cancer A2780 cell line was intervened with progressively increasing doses of cisplatin (1 g·L-1) to establish the cisplatin-resistant cell line A2780cisR, and the cell sensitivity to cisplatin was examined by the cell counting kit-8 (CCK-8) assay. High, medium, and low (39.9, 19.95, 9.98 g·kg-1) doses of Shenqi Yiliu prescription-containing sera were used to treat A2780cisR cells for 48 h. Glucose consumption and lactate production were measured by the cuvette assay. Enzyme-linked immunosorbent assay (ELISA) was employed to determine the activities of glucose transporter (GLUT), phosphofructokinase (PFK), and pyruvate kinase (PK). Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was used to detect apoptosis. Western blot was employed to quantify the protein levels of phosphorylated (p)-PI3K, p-Akt, p-mTOR, hexokinase 2 (HK2), pyruvate kinase M2 (PKM2), B-cell lymphoblastoma-2 (Bcl-2), Bcl-2-associated X-protein (Bax), and B-lymphoblastoma-2 gene-related promoter (Bad). Real-time PCR was conducted to determine the mRNA levels of HK2, PKM2, Bax, Bcl-2, and Bad. ResultsThe median inhibitory concentration (IC50) of cisplatin on A2780cisR cells was nearly 3 times that on A2780P cells. Compared with A2780P cells, A2780cisR cells showed increased glucose consumption, lactate production, GLUT, PFK, and PK activities, and mRNA and protein levels of p-PI3K, Akt, p-mTOR, HK2, PKM2, Bax (P<0.05), and decreased apoptosis rate and Bcl-2 expression (P<0.05). Compared with A2780cisR cells, medium- and high-dose Shenqi Yiliu prescription reduced the glucose consumption, lactate production, GLUT, PFK, and PK activities, and mRNA and protein levels of p-PI3K, Akt, p-mTOR, HK2, PKM2, Bax, and Bad (P<0.05), while increasing the apoptosis rate and Bcl-2 expression (P<0.05). ConclusionShenqi Yiliu prescription can inhibit glycolysis mediated by the PI3K/Akt/mTOR pathway to promote apoptosis, thereby reversing cisplatin resistance in ovarian cancer cells.
2.Construction and validation of a prognostic risk assessment model for lung adenocarcinoma based on miR-34 family target genes
Lingyu GU ; Ang GELEMA ; Dan YANG ; Huifeng WANG ; Lixin WANG ; Hui DONG
Acta Universitatis Medicinalis Anhui 2026;61(1):118-126
ObjectiveTo establish a tumor prognostic risk assessment model related to target genes of the miR-34 family. MethodsTarget genes of the miR-34 family were screened, and the scores of miR-34 target genes were assessed in 16 tumor types. Univariate Cox regression analysis was used to identify the tumor type with the strongest correlation between miR-34 target gene scores and overall survival (OS). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to elucidate the functional roles and signaling pathways of miR-34 target genes. A prognostic risk model based on the miR-34 target genes was constructed using univariate Cox and LASSO regression analyses. Quantitative real-time PCR (qPCR) and dual-luciferase reporter assays were conducted to validate whether the target genes bind to miR-34 and measure their RNA expression levels in the relevant tumors. Additionally, the risk score was integrated with other clinical indicators to develop a nomogram prediction model for patient survival. ResultsA total of 65 target genes of the miR-34 family were screened. The cancer type exhibiting stronger correlation between the target gene scores and OS was lung adenocarcinoma (P = 0.003, HR= 5.150). Furthermore, miR-34 target genes were predominantly enriched in oxidative stress pathways and various tumor-related processes. Three genes, LDHA, GALNT7, and SATB2, were identified as core components of the prognostic analysis model for lung adenocarcinoma. Additionally, the constructed nomogram model demonstrated robust predictive performance. ConclusionThe risk model and prognosis model of lung adenocarcinoma constructed based on the key target genes of miR-34 have good predictive performance.
3.Automatic quantitative analysis of myopia-related ocular fundus morphological parameters based on artificial intelligence
Ting LI ; Panpan XIAO ; Yonghua GU ; Fangxia ZHANG ; Xizhen GUO ; Xiaolin CHEN ; Hui YANG ; Shuang ZHANG
International Eye Science 2026;26(5):888-895
AIM:To automatically identify and quantitatively assess myopia-related fundus structural changes by combining non-mydriatic color fundus photography with an artificial intelligence(AI)-powered quantitative fundus analysis system and to further analyze the correlations between these fundus parameters and spherical equivalent(SE), axial length(AL), and age, providing the objective basis for monitoring myopia progression and supporting the formulation of personalized myopia prevention and control strategies. METHODS:A cross-sectional study was conducted enrolling myopic patients aged 18-50 y who underwent myopia screening from March 2023 to December 2023. Patients were stratified into three groups based on SE: the -3.00 D
4.Mechanism of Polygonum cuspidatum in alleviating silicosis based on network pharmacology, molecular docking, and experimental validation
Anning YANG ; Wenyan YANG ; Rui BAO ; Shengpeng WEN ; Huning ZHANG ; Sirong CHANG ; Wenyue ZHANG ; Xiaoyu LUO ; Yue SUN
China Occupational Medicine 2026;53(1):8-16
Objective To explore the potential mechanism of Polygonum cuspidatum in alleviating silicosis using network pharmacology, molecular docking, and experimental validation. Methods i) The targets of active components of Polygonum cuspidatum and silicosis-related targets were retrieved from multiple databases. The overlapping targets were imported into Venny2.1.0 and STRING platforms. "Polygonum cuspidatum-active components-potential therapeutic targets for silicosis" network was constructed and core targets of Polygonum cuspidatum that can alleviate silicosis were identified using the Cytoscape3.10.2 software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using the DAVID database, and molecular docking was conducted with AutoDock software. ii) Human embryonic lung fibroblast MRC-5 cells were divided into three groups. Cells in the control group were cultured in high-glucose Dulbecco's modified Eagle's medium containing 10.00% (V/V)fetal bovine serum. Cells in the silica group were treated with silica suspension at a final concentration of 150 μg·cm² (equivalent to 75 mg/L) for 48 hours. Cells in the silica + β-sitosterol group were first treated with silica suspension for 24 hours, then were cultured in medium containing β-sitosterol at a mass concentration of 50 μg/L for another 24 hours. Immunofluorescence assay and Western blotting were used to detect the effects of β-sitosterol, a core component of Polygonum cuspidatum, on the expression of phosphorylated protein kinase B (p-AKT), B-cell lymphoma-2 (BCL-2), and α-smooth muscle actin (α-SMA) in cells. Results i) A total of ten main active components of Polygonum cuspidatum, 840 targets of the active components, and 231 potential therapeutic targets for silicosis were screened through retrieval. A total of 10 core therapeutic targets were further screened, including tumor protein p53, serine/threonine protein kinase B1 (AKT1), heat shock protein 90-α, interleukin (IL)-6 , tumor necrosis factor, Src tyrosine kinase, estrogen receptor 1, epidermal growth factor receptor, BCL-2, and IL-1β. KEGG enrichment analysis yielded 178 related target pathways, among which, the phosphatidylinositol 3-kinase-protein kinase B (PI3K/AKT) signaling pathway was most relevant to silicosis. Molecular docking results showed that the top five compounds of Polygonum cuspidatum with high degree centrality, including quercetin, luteolin, physovenine, rhein, and β-sitosterol, had strong binding affinities with core targets. Among them, β-sitosterol, a key component of Polygonum cuspidatum, ranked high in binding affinity to all core targets. Molecular docking visualization indicated that β-sitosterol ranked high in binding affinitiy with the core target proteins AKT1 and BCL-2. ii) Both immunofluorescence and Western blotting results showed that, the relative expression of p-AKT, BCL-2, and α-SMA proteins increased in MRC-5 cells of the silica group compared with the control group (all P<0.05), except for p-AKT detected by Western blotting. Compared with the silica group, the relative expression levels of p-AKT, BCL-2, and α-SMA proteins in the silica+β-sitosterol group decreased (all P<0.05). Conclusion β-sitosterol, the core component of Polygonum cuspidatum, may alleviate silicosis fibrosis via the PI3K/AKT signaling pathway.
5.Exploring Effect of Method of Warming Yang and Relieving Depression on Susceptibility to Mental Disorders in a Two-hit Mice via BDNF/TrkB Signaling Pathway
Zihan GONG ; Jingwen YANG ; Ying WANG ; Wenqing LIANG ; Guangxin YUE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):154-163
ObjectiveTo investigate the mechanism underlying the effects of three formulas of the method of warming Yang and relieving depression on anxiety- and depression-like behaviors in the mice subjected to a two-hit paradigm of maternal separation (MS) combined with restraint stress (RS). MethodsNeonatal mice were randomly assigned into the following groups: Blank control, MS alone, model (MS+RS), warming Yang (WY,5.85 g·kg-1), relieving depression (RD,12.03 g·kg-1), warming Yang and relieving depression (WYRD,16.71 g·kg-1), and fluoxetine groups (2.6 mg·kg-1). MS was conducted on postnatal day 5 (PD5). Weaning and preventive drug administration were carried out on PD21, and restraint stress was applied on PD90. Anxiety- and depression-like behaviors were assessed using the open field test (OFT), the elevated zero maze test and tail suspension test (TST). High-performance liquid chromatography with electrochemical detection (HPLC-ECD) was employed to measure the levels of neurotransmitters, including 5-hydroxytryptamine (5-HT) and dopamine (DA), in the hippocampus. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression levels of 5-HT1A receptor (5-HT1AR), serotonin transporter (SERT), monoamine oxidase A (MAOA), glucocorticoid receptor (GR), adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), brain-derived neurotrophic factor (BDNF), and tyrosine kinase receptor B (TrkB). Immunohistochemistry (IHC) was applied to assess the protein expression levels of 5-HT1AR, 5-HT2A receptor (5-HT2AR), 5-HT2C receptor (5-HT2CR), GR, and CRH receptor 1 (CRHR1). The protein expression levels of BDNF and TrkB in the hippocampus were measured using the fully automated protein expression analysis system (Simple Wes). ResultsIn the behavioral tests, compared with the blank control group, the model group exhibited significant increases in locomotor distance and central area crossings (P<0.05, P<0.01)in OFT, as well as a significant increase in immobility time in the TST (P<0.05). Compared with the model group, the RD, WYRD, and fluoxetine groups all showed significantly reduced central area crossings (P<0.05, P<0.01). Regarding neurotransmitter levels, compared with the blank control group, the model group had significantly decreased hippocampal epinephrine (E) and dopamine (DA) content (P<0.05, P<0.01). Compared with the MS group, the model group showed significant decreases in hippocampal norepinephrine (NE), E, and 5-HT content (P<0.05, P<0.01). Compared with the model group, the WY group decreased hippocampal NE, DA, and 5-HT content (P<0.01), while the RD, WYRD, and fluoxetine groups exhibited significantly increased hippocampal E content (P<0.01). At the molecular level, compared with the blank control and MS groups, the model group showed significant increases in mRNA levels of 5-HT1AR, SERT, MAOA, ACTH, and CRH (P<0.01), and significant decreases in mRNA levels of tryptophan hydroxylase (TPH), GR, BDNF, and TrkB (P<0.01). Protein expression of 5-HT1AR, 5-HT2AR, and 5-HT2CR was also significantly elevated (P<0.05, P<0.01) in the model group. Compared with the model group, the RD group showed significant decreases in SERT, MAOA, and CRH mRNA (P<0.05, P<0.01), significant increases in TPH, BDNF, and TrkB mRNA (P<0.01), significantly reduced protein expression of 5-HT1AR, 5-HT2AR, and 5-HT2CR (P<0.05), and significantly increased GR protein expression. The WY group showed a significant increase in ACTH mRNA expression (P<0.01). The fluoxetine group exhibited significant decreases in MAOA and CRH mRNA (P<0.05, P<0.01), significant increases in TPH, BDNF, and TrkB mRNA (P<0.01), significantly reduced 5-HT2AR protein expression (P<0.01), and significantly increased GR protein expression(P<0.05). ConclusionThe method of warming Yang and relieving depression can ameliorate anxiety- and depression-like behaviors in two-hit mice. Its mechanism may be associated with the BDNF/TrkB signaling pathway, as well as the HPA axis and serotonergic system.
6.Changes in serum CT-1 and ANGPTL3 levels in patients with coronary heart disease and heart failure undergoing PCI and their clinical significance
Yanhua YANG ; Jianmin TANG ; Yinchuan ZHU ; Fengyun WANG ; Dongsheng SU
Chinese Journal of Arteriosclerosis 2025;33(3):244-250
Aim To detect the changes of serum cardiotrophin-1(CT-1)and angiopoietin-like protein 3(ANGPTL3)levels in patients with coronary heart disease(CHD)complicated with heart failure(HF)after percutaneous coronary intervention(PCI),and analyze their relationship with prognosis.Methods 199 patients with CHD compli-cated with HF who underwent PCI in the Second Affiliated Hospital of Zhengzhou University from March 2022 to March 2023 were selected.The serum CT-1 and ANGPTL3 levels of patients with different New York Heart Association(NYHA)cardiac function grades were compared before surgery.The prognosis was followed up after PCI,and the pa-tients who had major adverse cardiovascular event(MACE)were included in the poor prognosis group,and the rest were included in the good prognosis group.The general data and serum CT-1 and ANGPTL3 levels were compared between the poor prognosis group and the good prognosis group.Logistic regression model was used to analyze the influencing factors of poor prognosis after surgery in patients with CHD and HF.The predictive value of serum CT-1 and ANGPTL3 alone and in combination were analyzed.Results Compared with the patients with cardiac function grade Ⅰ,the serum CT-1 and ANGPTL3 levels of the patients with cardiac function grade Ⅱ,Ⅲ and Ⅳ were increased(P<0.05).Compared with the patients with cardiac function grade Ⅱ,the serum CT-1 and ANGPTL3 levels of the patients with cardiac function grade Ⅲ and Ⅳ were increased(P<0.05).Compared with the patients with cardiac function grade Ⅲ,the serum CT-1 and ANGPTL3 levels of the patients with acrdiac function grade Ⅳ were increased(P<0.05).Spearman correlation a-nalysis showed that the serum CT-1 and ANGPTL3 levels were positively correlated with NYHA cardiac function grade(r=0.518,95%CI:0.408~0.613,P<0.001,r=0.737,95%CI:0.666~0.794,P<0.001).The poor prognosis rate of patients was 17.93%.Compared with the good prognosis group,the serum CT-1 and ANGPTL3 levels of the poor progno-sis group were increased(P<0.05).Logistic regression model analysis showed that smoking,diabetes,lesion vessel number ≥3,irregular medication outside the hospital,serum CT-1 and ANGPTL3 levels were the influencing factors of poor prognosis in patients with CHD complicated with HF(P<0.05).ROC curve analysis showed that the sensitivity and area under the curve(AUC)of combined serum CT-1 and ANGPTL3 levels for predicting poor prognosis of patients with CHD complicated with HF were higher than those of either marker alone,while the specificity was basically similar to that of sin-gle-marker prediction.Conclusion Serum CT-1 and ANGPTL3 levels are abnormally elevated in patients with CHD complicated with HF after PCI,and are closely related to the cardiac function and prognosis.
7.Role of mitochondrial biogenesis in rat model of coal workers' pneumoconiosis based on PGC-1α-NRF1-TFAM signaling pathway
Mei ZHANG ; Xiaoqiang HAN ; Lulu LIU ; Yan WANG ; Xin MA ; Yu XIONG ; Huifang YANG ; Na ZHANG
Journal of Environmental and Occupational Medicine 2025;42(12):1429-1437
Background Mitochondrial biogenesis is pivotal in coal workers' pneumoconiosis fibrosis, yet the role of the peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α)-nuclear respiratory factor 1 (NRF1)-mitochondrial transcription factor A (TFAM) pathway inmitochondrial biogenesis remains elusive, warranting further investigation. Objective To elucidate the role of the PGC-1α-NRF1-TFAM pathway in mitochondrial biogenesis in a rat coal workers' pneumoconiosis model through in vivo and in vitro experiments. Methods (1)n vivo: twelve SPF male SD rats (200-220 g) were randomized into a control group and a coal dust group (n=6 per group). After acclimatization, the coal dust group received 1 mL 50 mg·mL−1 coal dust suspension via intratracheal instillation; the controls received saline. Lung tissues were harvested after two months for histopathology [HE, Masson, and transmission electron microscopy (TEM) ], protein and mRNA analysis, and mitochondrial DNA (mtDNA) quantification by quantitative real-time polymerase chain reaction (qPCR). (2) In vitro: rat lung type II epithelial cells (RLE-6TN) cells were exposed to coal dust (50, 100, 200, and 400 mg·L−1, 24 h). CCK-8 assay determined optimal doses. Ultrastructural changes were analyzed by TEM. Cells were transfected with OE-PGC-1α (PGC-1α overexpression) or shRNA-PGC-1α plasmids (PGC-1α knockdown), and the transfection efficiency was determined by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR). The expression levels of alpah-smooth muscle actin (α-SMA), citrate synthase (CS), PGC-1α, NRF1, TFAM, and fibronectin (Fn) proteins and their corresponding mRNA were detected using Western blot and RT-qPCR, respectively. The relative content of mtDNA was determined by qPCR. Results In vivo: the control group lung samples exhibited soft, pink parenchyma, while the coal dust-exposed lungs showed blackened surfaces with soft texture. The histopathological evaluation revealed intact alveolar walls in the controls versus structural destruction, micro-nodules, and fibrotic areas in the coal dust group. After Masson staining, coal dust deposits were found surrounded by blue collagen fibers in the exposed lungs, but absent in the controls. The coal dust group displayed significant upregulation of fibrotic marker α-SMA and downregulation of mitochondrial biogenesis markers (CS, PGC-1α, NRF1, TFAM) and mtDNA compared to the controls (P<0.05). In vitro: coal dust exposure reduced cell density and induced morphological alterations. TEM revealed evenly distributed normal mitochondria in controls versus mitochondrial swelling, disrupted cristae, and reduced numbers in exposed cells. The mitochondrial biogenesis markers were elevated in the coal dust + OE-PGC-1α group compared to the coal dust + OE-NC group (P<0.05); in contrast, they were decreased in the coal dust + shRNA-PGC-1α group compared to the coal dust + shRNA-NC group (P<0.05). Compared to the control group, the expression levels of the fibrosis marker α-SMA mRNA and protein were increased in the coal dust group (P<0.05). Overexpression of PGC-1α reduced α-SMA expression, while downregulation of PGC-1α increased its expression (P<0.05). Conclusion Coal dust exposure induces mitochondrial dysfunction and pulmonary fibrosis in vivo and in vitro via the PGC-1α-NRF1-TFAM pathway dysregulation. Targeting this pathway may mitigate coal dust-induced fibrosis by restoring mitochondrial biogenesis.
8.Analysis on the current status of management and treatment of patients with severe mental disorders and their regional characteristics in Ningxia Hui Autonomous Region
Hong JIANG ; Wei HUANG ; Chao XU ; Yuan LIU ; Yongling ZHOU ; Lei TIAN ; Xia YANG ; Xuehui ZHANG ; Caixia LYU ; Xuebing XU
Sichuan Mental Health 2025;38(6):528-533
BackgroundSevere mental disorders are characterized by high recurrence rate, high disability rate, high rates of harmful incidents, and low treatment-seeking rate, with affected patients demonstrating increased frequencies of dangerous behaviors. Ningxia Hui Autonomous Region has implemented community management for patients with severe mental disorders across the region since 2004, while the current status and regional characteristics of the managed patients remain unclear. ObjectiveTo analyze the current status of management and treatment of patients with severe mental disorders in Ningxia Hui Autonomous Region, and to explore their regional distribution characteristics, so as to provide references for optimizing regional prevention and control strategies. MethodsPatients with severe mental disorders diagnosed and registered in the Severe Mental Disorder Management Information Platform of Ningxia Hui Autonomous Region from August 1, 2011 to December 31, 2021 were selected. Patients' basic information, management indicators, and treatment metrics were extracted from the platform, followed by descriptive statistical analysis of the corresponding data. ResultsAs of December 31, 2021, the permanent resident population of Ningxia Hui Autonomous Region was 6 946 540, with 29 787 registered patients with severe mental disorders. The majority of the patients were female (50.25%), aged 18-59 years (79.01%), with educational level of junior high school or below (84.63%), married (52.87%), farmers (56.01%), and diagnosed with schizophrenia (55.91%), while ethnic minority patients accounted for a relatively high proportion (31.35%). In 2021, the reported prevalence rate of severe mental disorders in Ningxia Hui Autonomous Region was 0.43%, with standardized management and regular medication adherence rates at 90.39% and 66.34%, respectively. The standardized management rate in 8 counties/districts (36.36%) was lower than the average level of Ningxia Hui Autonomous Region, while 10 counties/districts (45.45%) showed below-average medication adherence rates, of which 6 counties/districts(60.00%) were located in the south-central region. ConclusionPatients with severe mental disorders in Ningxia Hui Autonomous Region are predominantly young and middle-aged adults with low level of education, and those in the central-southern region demonstrate lower medication adherence. [Funded by Key Research and Development Program Project of Ningxia Hui Autonomous Region (number, 2023BEG02029)]
9.Prenatal diagnosis and genetic counseling of 20 fetuses with 15q11.2 BP1-BP2 microdeletion syndrome.
Meijuan LI ; Xinyou YU ; Lanhua YANG ; Xiaoyan WANG ; Bo WEI
Chinese Journal of Medical Genetics 2025;42(1):64-68
OBJECTIVE:
To explore the clinical phenotype, pregnancy outcome and follow-up of fetuses with 15q11.2BP1-BP2 microdeletions in order to provide a basis for prenatal and reproductive consultation.
METHODS:
From March 2019 to December 2023, 20 fetuses who were diagnosed with 15q11.2BP1-BP2 microdeletion syndrome at the Prenatal Diagnosis Center of General Hospital of Ningxia Medical University were selected as the study subjects. Results of genetic testing and ultrasound examination, outcome of pregnancy, and postnatal follow-up were retrospectively analyzed. This study has been approved by the Ethics Committee of General Hospital of Ningxia Medical University ([2020]0520B).
RESULTS:
None of the 20 fetuses was found to have chromosomal abnormality, whilst all were found to harbor a 15q11.2 BP1-BP2 microdeletion by low-depth whole genome sequencing (CNV-seq). The range of deletions was determined as 0.26 ~ 0.87 Mb, and all were rated as pathogenic CNVs. Three fetuses had abnormal ultrasound findings, including 1 with widened renal pelvis, 1 with agenesis of corpus callosum, and 1 with nuchal fold thickening. Parental verification in 10 couples verified that two fetal deletions were de novo, whilst the remaining eight were inherited from a phenotypically normal parent. Following genetic counseling, three couples had opted to terminate the pregnancy, whilst the remaining 17 had continued with the pregnancy until delivery. The 17 liveborns were followed up for 2 months to 5 years, with no obvious abnormality in growth and development noted.
CONCLUSION
CNV-seq plays an important role in the prenatal diagnosis of 15q11.2 BP1-BP2 microdeletions. Such deletions may not always lead to disease phenotypes. Individualized consultation and long-term follow-up, in combination with intrauterine ultrasound and parental verification are necessary.
Humans
;
Female
;
Pregnancy
;
Chromosomes, Human, Pair 15/genetics*
;
Genetic Counseling
;
Prenatal Diagnosis
;
Chromosome Deletion
;
Adult
;
Fetus/abnormalities*
;
Retrospective Studies
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Pregnancy Outcome
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Ultrasonography, Prenatal
;
Genetic Testing
;
DiGeorge Syndrome/diagnosis*
;
Male
10.A case report of glycogen storage disease type III combined with Guillain-Barré syndrome and literature review.
Miaomiao YANG ; Xinyou YU ; Yinxia ZHAO
Chinese Journal of Medical Genetics 2025;42(8):981-990
OBJECTIVE:
To investigate the clinical manifestations and genetic characteristics of a child with glycogen storage disease type III (GSD-III) complicated with Guillain-Barré syndrome (GBS) caused by AGL gene variants, and to analyze the pathogenesis, potential correlation, treatment and prognosis of the two diseases.
METHODS:
A child with GSD-III who visited the General Hospital of Ningxia Medical University due to "limb weakness for more than ten days" in July 2024 was selected as the study subject. Clinical data of the child were collected. Peripheral blood samples of the child and his parents were collected for whole exome sequencing and Sanger sequencing. Candidate variants were verified, and pathogenicity analysis was conducted for the variant sites. This study was approved by the Medical Ethics Committee of General Hospital of Ningxia Medical University (Ethics No.: KYLL-2025-1984).
RESULTS:
The child has presented with inability to stand or walk independently, difficulty in grasping, accompanied by numbness and pain at the distal end, choking when drinking water, occasional non-projectile vomiting, and enlargement of liver and spleen. Laboratory tests showed abnormal liver function and a significant increase in creatine kinase. Color Doppler ultrasound of the heart showed an enlarged left atrium and mild regurgitation of mitral and tricuspid valves. Genetic testing confirmed that he has harbored compound heterozygous variants of the AGL gene, namely c.1611G>A (p.E537E) and c.579del (p.W194Gfs*7), which were inherited from his father and mother, respectively. According to the guidelines from the American Collage for Medical Genetics and Genomics (ACMG), the two variants were respectively predicted as variant of unknown significance (PM2_Supporting+PM3+PP3_Supporting) and likely pathogenic (PVS1+PM2_Supporting). Electrophysiological examination confirmed that the child had severe damage to the motor and sensory nerves accompanied by axonal injury, which was consistent with the axonal variant type of GBS -acute motor and sensory axonal neuropathy. After a clear diagnosis, the child was treated with intravenous human immunoglobulin. His condition deteriorated progressively, presenting with breathing difficulties, liver failure, and gastrointestinal bleeding, and eventually deceased due to multiple organ failures.
CONCLUSION
The etiology of GSD-III and GBS involves multiple aspects such as genetics, metabolism and immunity. In clinical practice, it should be noted that similar clinical manifestations may occur in both conditions. Close attention should be paid to the patients' blood glucose, blood gas, coagulation function and liver function, etc. Clinical intervention should be carried out as early as possible to improve the prognosis.
Humans
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Male
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Guillain-Barre Syndrome/complications*
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Glycogen Storage Disease Type III/complications*
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Mutation
;
Child

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