1.Association between snack consumption and depressive symptoms among first year junior high school students with different left behind experiences in Yunnan Province
LIU Na, WU Huijuan, WANG Liangui, LUO Chengyong, CAO Yanrong, FU Yun, ZHANG Tai,〖JZ〗 KONG Jing, HU Mengdie, XIONG Yuan, XU Honglü ;
Chinese Journal of School Health 2026;47(1):18-22
Objective:
To explore the relationship between snack consumption and depressive symptoms in first year junior high school students with different left behind experiences in Yunnan Province, so as to provide a basis for improving depressive symptoms among first year junior high school students with different left behind experiences.
Methods:
From October to December 2022,a cluster random sampling method was used to select 8 500 first year junior high school students from 11 ethnic minority areas (Fugong County, Longling County, Longyang District, Luchun County, Mojiang County, Nanjian County, Qiaojia County, Shuangjiang County, Tengchong City, Yuanmou County, Zhenyuan County) in Yunnan Province for a questionnaire survey. The Chinese version of Depression Anxiety Stress Scale-21 was applied to assess depressive symptoms in first year junior high school students, and snack consumption was collected by employing food frequency questionnaire. The generalized linear model was used to analyze the association between first year junior high school students snack consumption and depressive symptoms, and the analysis was stratified according to left behind experience.
Results:
The detection rates of depressive symptoms among firstyear junior high school students with and without left behind experience were 36.25% and 26.91%, respectively. After controlling for confounding variables, the generalized linear model analysis showed that sweet snacks ( β=0.16, 95%CI =0.07-0.25), fast food ( β=0.14, 95%CI =0.04-0.23) and carbonated drinks ( β=0.09, 95%CI =0.01-0.17) of first year junior high school students with left behind experience (all P <0.05). Compared with those without such behavior, the risk of depressive symptoms was higher in consumption of fast food ( β=0.13, 95%CI =0.07-0.18) and carbonated drinks ( β=0.10, 95%CI =0.06-0.15)among first year junior high school students without left behind experience (both P <0.05).
Conclusion
Snack consumption among first year junior high school students in Yunnan may increase the risk of developing depressive symptoms, while first year junior high school students with left behind experience may have a greater risk of developing depressive symptoms.
2.Effects of LncRNA MAGI2-AS3 on the migration,invasion,and epithelial mesenchymal transition of gastric cancer cells by regulating the miR-194-5p/CAV1 axis
Guangxin LI ; Huijuan QUAN ; Zhijuan GAO ; Xiaojun WANG ; Liang LI ; Yuqing CAO ; Dongsheng LIU
Journal of Clinical Surgery 2025;33(9):974-980
Objective To investigate the effects of long non coding RNA MAGI2 antisense chain RNA3(LncRNA MAGI2-AS3)on the migration,invasion,and epithelial mesenchymal transition(EMT)of gastric cancer(GCa)cells by regulating the miR-194-5 p/caveolin-1(CAV1)axis.Methods Fifty-two GCa patients who underwent surgical resection in our hospital from August 2022 to December 2023 were selected.Cancer and adjacent tissues were collected,and AGS,MKN45,HGC-27,and GES1 cells were cultured in vitro.The expression of MAGI2-AS3,miR-194-5p,and CAV1 in tissue samples and cell lines was analyzed.AGS cells were randomly separated into AGS group,sh-AGS group sh-MAGI2-AS3 group,miR-NC group,and in miR-194-5p group.The proliferation,apoptosis,migration,and invasion of cells in each group were compared.Immunoblotting was applied to analyze the expression of E-cadherin,CAV1,proliferating cell nuclear antigen(PCNA),N-cadherin,Bax,matrix metalloproteinase 2(MMP2),and vimentin of cells in each group.Dual luciferase assay was applied to analyze the relationship between MAGI2-AS3 and miR-194-5p,and between miR-194-5p and CAV1.Results The expression of MAGI2-AS3 mRNA,CAV1 mRNA,and positive expression rate of CAV1 protein in GCa tissue increased,while the expression of miR-194-5p mRNA decreased(P<0.05).The expression of MAGI2-AS3 mRNA,CAV1 mRNA,and CAV1 protein in HGC-27,MKN45,and AGS cells was higher than that of GES1 cells,the expression of miR-194-5p mRNA was lower than that of GES1 cells(P<0.05).Compared with the AGS and sh-AGS groups,the cell absorbance,number of clones,invasion and migration,expression of CAV1,PCNA,N-cadherin,MMP2,and vimentin in sh-MAGI2-AS3 group decreased,the apoptosis rate,expression of E-cadherin,and Bax increased(P<0.05).Compared with the miR-NC group and sh-MAGI2-AS3 group,the cell absorbance,number of clones,invasion and migration,expression of CAV1,PCNA,N-cadherin,MMP2,and vimentin in in-miR-194-5p group increased,the apoptosis rate,expression of E-cadherin,and Bax reduced(P<0.05).ENCORI database found that there were multiple binding sites between MAGI2-AS3 and miR-194-5p,and between miR-194-5p and CAV1.Compared with the WT-MAGI2-AS3+miR-NC group,the luciferase activity in the WT-MAGI2-AS3+miR-194-5p group decreased(P<0.05),while compared with the WT-CAV1+miR-NC group,the luciferase activity in the WT-CAV1+miR-194-5p group decreased(P<0.05).Conclusion LncRNA MAGI2-AS3 silencing can target miR-194-5p to downregulate CAV1,thereby inhibiting GCa cell migration,invasion,and EMT.
3.The effect of lncRNA SNHG16/miR-455-3p regulation of NF-κB signaling pathway on radiotherapy sensitivity of cervical cancer cells
Qinxue CAO ; Lu REN ; Huijuan JIANG ; Changping QU ; Shanshan MAO
Chinese Journal of Radiation Oncology 2025;34(6):600-606
Objective:To analyze the effect of long noncoding RNA (lncRNA) small nucleolar RNA host gene 16 (SNHG16) on the radiosensitivity of cervical cancer cells and explore its regulatory role in the miR-455-3p/ nuclear factor-κB (NF-κB) signaling pathway.Methods:The expression levels of lncRNA SNHG16 and miR-455-3p in human normal cervical epithelial cells H8, human cervical cancer cells SiHa, and radioresistant cervical cancer cells SiHa-R were detected by real-time reverse transcription polymerase chain reaction. SiHa-R cells were transfected separately, and then given a single dose of 4 Gy X-ray irradiation and continued to be cultured for subsequent experiments. The cells in each group were named siRNA-NC, siRNA-SNHG16 (interfering lncRNA SNHG16), NC mimic, miR-455-3p mimic (overexpressing miR-455-3p), siRNA-SNHG16+inhibitor NC, and siRNA-SNHG16+miR-455-3p inhibitor groups, respectively. The survival fraction of SiHa-R cells was detected by clone formation assay. The apoptosis rate of SiHa-R cells was analyzed by flow cytometry. The expression levels of apoptotic proteins [cysteine-containing aspartate-specific protease (Caspase)-3, Caspase-9, Bax] and NF-κB signaling pathway related proteins [NF-κB p65, phosphorylated (p)-NF-κB p65, p-IκB (inhibitory protein of NF-κB)] were measured by Western blot. The targeting relationship between lncRNA SNHG16 and miR-455-3p was determined by dual luciferase reporter gene assay. Comparison among different groups was conducted by one-way ANOVA, and paired comparison was carried out by LSD t-test. Comparison between two groups was performed by t-test. Results:Compared with H8 cells, the expression levels of lncRNA SNHG16 were increased in SiHa and SiHa-R cells, and SiHa-R cells had a higher level than SiHa cells. The expression levels of miR-455-3p were decreased in SiHa and SiHa-R cells, and SiHa-R cells had a lower level than SiHa cells (all P<0.001). Compared with the siRNA-NC group, the survival fraction of SiHa-R cells in the siRNA-SNHG16 group was decreased, the radiosensitization ratio (SER) was 1.571 (>1), the apoptosis rate and levels of Caspase-3, Caspase-9, and Bax proteins were increased, while the levels of p-NF-κB p65 and p-IκB proteins were decreased (all P<0.001). lncRNA SNHG16 could target miR-455-3p. Compared with the NC mimic group, miR-455-3p level in the miR-455-3p mimic group was increased, cell survival fraction was decreased, the SER was 1.826 (>1), the apoptosis rate and the levels of Caspase-3, Caspase-9, Bax proteins were increased, and the levels of p-NF-κB p65 and p-IκB proteins were decreased (all P<0.001). Inhibition of miR-455-3p expression could weaken the effect of interfering with lncRNA SNHG16 expression on SiHa-R cell apoptosis, radiotherapy sensitivity, and NF-κB signaling pathway (all P<0.001). Conclusions:Interference with lncRNA SNHG16 expression could induce the apoptosis of cervical cancer cells and enhance their radiation sensitivity by regulating the miR-455-3p/NF-κB signaling pathway.
4.Effect of exogenous short-chain fatty acids preconditioning on expression of zonula occludens-1 in lung tissues of rats undergoing extracorporeal circulation
Qi CHU ; Xiaoyan ZHANG ; Huijuan CAO ; Yingjie SUN ; Yugang DIAO ; Tiezheng ZHANG
Chinese Journal of Anesthesiology 2025;45(10):1335-1337
Objective:To evaluate the effect of exogenous short-chain fatty acids (SCFAs) preconditioning on the expression of zonula occludens-1 (ZO-1) in lung tissues of rats undergoing extracorporeal circulation (ECC).Methods:Thirty-six clean-grade healthy adult male Sprague-Dawley rats, weighing 320-420 g, were divided into sham operation group (S group), ECC group (E group) and SCFAs group, with 12 rats in each group. Seven days before the ECC, short-chain fatty acids dissolved in 2 ml of normal saline was given by gavage daily in SCFAs group, while the equal volume of normal saline was given by gavage in S group and E group. On the 8th day, E group and SCFAs group underwent arteriovenous catheterization and ECC for 1 h, while S group only underwent catheterization without ECC. Lung tissues were collected to observe the pathological results and detect the expression of ZO-1 (by Western blot), and the wet/dry lung weight ratio was calculated.Results:Compared with S group, the wet/dry lung weight ratio was significantly increased ( P<0.05), the expression of ZO-1 protein in lung tissue was down-regulated ( P<0.05), and the pathological damage of lung tissues was aggravated in E group and SCFAs group. Compared with E group, the wet/dry lung weight ratio was significantly decreased, the expression of ZO-1 protein in lung tissues was up-regulated ( P<0.05), and the pathological damage of lung tissues was significantly alleviated in SCFAs group. Conclusions:The mechanism by which SCFAs preconditioning attenuates lung injury may be related to up-regulation of ZO-1 expression in lung tissues of rats undergoing ECC.
5.Effects of LncRNA MAGI2-AS3 on the migration,invasion,and epithelial mesenchymal transition of gastric cancer cells by regulating the miR-194-5p/CAV1 axis
Guangxin LI ; Huijuan QUAN ; Zhijuan GAO ; Xiaojun WANG ; Liang LI ; Yuqing CAO ; Dongsheng LIU
Journal of Clinical Surgery 2025;33(9):974-980
Objective To investigate the effects of long non coding RNA MAGI2 antisense chain RNA3(LncRNA MAGI2-AS3)on the migration,invasion,and epithelial mesenchymal transition(EMT)of gastric cancer(GCa)cells by regulating the miR-194-5 p/caveolin-1(CAV1)axis.Methods Fifty-two GCa patients who underwent surgical resection in our hospital from August 2022 to December 2023 were selected.Cancer and adjacent tissues were collected,and AGS,MKN45,HGC-27,and GES1 cells were cultured in vitro.The expression of MAGI2-AS3,miR-194-5p,and CAV1 in tissue samples and cell lines was analyzed.AGS cells were randomly separated into AGS group,sh-AGS group sh-MAGI2-AS3 group,miR-NC group,and in miR-194-5p group.The proliferation,apoptosis,migration,and invasion of cells in each group were compared.Immunoblotting was applied to analyze the expression of E-cadherin,CAV1,proliferating cell nuclear antigen(PCNA),N-cadherin,Bax,matrix metalloproteinase 2(MMP2),and vimentin of cells in each group.Dual luciferase assay was applied to analyze the relationship between MAGI2-AS3 and miR-194-5p,and between miR-194-5p and CAV1.Results The expression of MAGI2-AS3 mRNA,CAV1 mRNA,and positive expression rate of CAV1 protein in GCa tissue increased,while the expression of miR-194-5p mRNA decreased(P<0.05).The expression of MAGI2-AS3 mRNA,CAV1 mRNA,and CAV1 protein in HGC-27,MKN45,and AGS cells was higher than that of GES1 cells,the expression of miR-194-5p mRNA was lower than that of GES1 cells(P<0.05).Compared with the AGS and sh-AGS groups,the cell absorbance,number of clones,invasion and migration,expression of CAV1,PCNA,N-cadherin,MMP2,and vimentin in sh-MAGI2-AS3 group decreased,the apoptosis rate,expression of E-cadherin,and Bax increased(P<0.05).Compared with the miR-NC group and sh-MAGI2-AS3 group,the cell absorbance,number of clones,invasion and migration,expression of CAV1,PCNA,N-cadherin,MMP2,and vimentin in in-miR-194-5p group increased,the apoptosis rate,expression of E-cadherin,and Bax reduced(P<0.05).ENCORI database found that there were multiple binding sites between MAGI2-AS3 and miR-194-5p,and between miR-194-5p and CAV1.Compared with the WT-MAGI2-AS3+miR-NC group,the luciferase activity in the WT-MAGI2-AS3+miR-194-5p group decreased(P<0.05),while compared with the WT-CAV1+miR-NC group,the luciferase activity in the WT-CAV1+miR-194-5p group decreased(P<0.05).Conclusion LncRNA MAGI2-AS3 silencing can target miR-194-5p to downregulate CAV1,thereby inhibiting GCa cell migration,invasion,and EMT.
6.Effect of exogenous short-chain fatty acids preconditioning on expression of zonula occludens-1 in lung tissues of rats undergoing extracorporeal circulation
Qi CHU ; Xiaoyan ZHANG ; Huijuan CAO ; Yingjie SUN ; Yugang DIAO ; Tiezheng ZHANG
Chinese Journal of Anesthesiology 2025;45(10):1335-1337
Objective:To evaluate the effect of exogenous short-chain fatty acids (SCFAs) preconditioning on the expression of zonula occludens-1 (ZO-1) in lung tissues of rats undergoing extracorporeal circulation (ECC).Methods:Thirty-six clean-grade healthy adult male Sprague-Dawley rats, weighing 320-420 g, were divided into sham operation group (S group), ECC group (E group) and SCFAs group, with 12 rats in each group. Seven days before the ECC, short-chain fatty acids dissolved in 2 ml of normal saline was given by gavage daily in SCFAs group, while the equal volume of normal saline was given by gavage in S group and E group. On the 8th day, E group and SCFAs group underwent arteriovenous catheterization and ECC for 1 h, while S group only underwent catheterization without ECC. Lung tissues were collected to observe the pathological results and detect the expression of ZO-1 (by Western blot), and the wet/dry lung weight ratio was calculated.Results:Compared with S group, the wet/dry lung weight ratio was significantly increased ( P<0.05), the expression of ZO-1 protein in lung tissue was down-regulated ( P<0.05), and the pathological damage of lung tissues was aggravated in E group and SCFAs group. Compared with E group, the wet/dry lung weight ratio was significantly decreased, the expression of ZO-1 protein in lung tissues was up-regulated ( P<0.05), and the pathological damage of lung tissues was significantly alleviated in SCFAs group. Conclusions:The mechanism by which SCFAs preconditioning attenuates lung injury may be related to up-regulation of ZO-1 expression in lung tissues of rats undergoing ECC.
7.The effect of lncRNA SNHG16/miR-455-3p regulation of NF-κB signaling pathway on radiotherapy sensitivity of cervical cancer cells
Qinxue CAO ; Lu REN ; Huijuan JIANG ; Changping QU ; Shanshan MAO
Chinese Journal of Radiation Oncology 2025;34(6):600-606
Objective:To analyze the effect of long noncoding RNA (lncRNA) small nucleolar RNA host gene 16 (SNHG16) on the radiosensitivity of cervical cancer cells and explore its regulatory role in the miR-455-3p/ nuclear factor-κB (NF-κB) signaling pathway.Methods:The expression levels of lncRNA SNHG16 and miR-455-3p in human normal cervical epithelial cells H8, human cervical cancer cells SiHa, and radioresistant cervical cancer cells SiHa-R were detected by real-time reverse transcription polymerase chain reaction. SiHa-R cells were transfected separately, and then given a single dose of 4 Gy X-ray irradiation and continued to be cultured for subsequent experiments. The cells in each group were named siRNA-NC, siRNA-SNHG16 (interfering lncRNA SNHG16), NC mimic, miR-455-3p mimic (overexpressing miR-455-3p), siRNA-SNHG16+inhibitor NC, and siRNA-SNHG16+miR-455-3p inhibitor groups, respectively. The survival fraction of SiHa-R cells was detected by clone formation assay. The apoptosis rate of SiHa-R cells was analyzed by flow cytometry. The expression levels of apoptotic proteins [cysteine-containing aspartate-specific protease (Caspase)-3, Caspase-9, Bax] and NF-κB signaling pathway related proteins [NF-κB p65, phosphorylated (p)-NF-κB p65, p-IκB (inhibitory protein of NF-κB)] were measured by Western blot. The targeting relationship between lncRNA SNHG16 and miR-455-3p was determined by dual luciferase reporter gene assay. Comparison among different groups was conducted by one-way ANOVA, and paired comparison was carried out by LSD t-test. Comparison between two groups was performed by t-test. Results:Compared with H8 cells, the expression levels of lncRNA SNHG16 were increased in SiHa and SiHa-R cells, and SiHa-R cells had a higher level than SiHa cells. The expression levels of miR-455-3p were decreased in SiHa and SiHa-R cells, and SiHa-R cells had a lower level than SiHa cells (all P<0.001). Compared with the siRNA-NC group, the survival fraction of SiHa-R cells in the siRNA-SNHG16 group was decreased, the radiosensitization ratio (SER) was 1.571 (>1), the apoptosis rate and levels of Caspase-3, Caspase-9, and Bax proteins were increased, while the levels of p-NF-κB p65 and p-IκB proteins were decreased (all P<0.001). lncRNA SNHG16 could target miR-455-3p. Compared with the NC mimic group, miR-455-3p level in the miR-455-3p mimic group was increased, cell survival fraction was decreased, the SER was 1.826 (>1), the apoptosis rate and the levels of Caspase-3, Caspase-9, Bax proteins were increased, and the levels of p-NF-κB p65 and p-IκB proteins were decreased (all P<0.001). Inhibition of miR-455-3p expression could weaken the effect of interfering with lncRNA SNHG16 expression on SiHa-R cell apoptosis, radiotherapy sensitivity, and NF-κB signaling pathway (all P<0.001). Conclusions:Interference with lncRNA SNHG16 expression could induce the apoptosis of cervical cancer cells and enhance their radiation sensitivity by regulating the miR-455-3p/NF-κB signaling pathway.
8.Application of Matching-adjusted Indirect Comparison Methods in Efficacy Evaluation of Traditional Chinese Medicine
Guodong LI ; Xinyu HU ; Huijuan CAO
Journal of Traditional Chinese Medicine 2024;65(23):2413-2418
Randomized controlled trials (RCTs) have been widely used in clinical efficacy evaluation of traditional Chinese medicine (TCM), but also having limitations such as high cost,time consuming, and difficulty in patient recruitment and enrollment. The introduction of matching adjusted indirect comparison (MAIC) can alleviate the problem caused by the limitation of traditional RCT methodology to some extent. This paper introduced the basic principles of MAIC, and analyzed the similarities and differences, advantages and disadvantages of the two design methods, that is the anchored and the non-anchored. By analyzing two case studies in the evaluation of TCM efficacy, which are acupuncture for paroxysmal migraine and moxibustion for diarrhea-type irritable bowel syndrome, respectively, this paper introduced the methodological characteristics of MAIC in the efficacy evaluation of TCM, explored the strengths and feasibility of MAIC in the evaluation of efficacy evidence in TCM, the evaluation of efficacy of non-pharmacological TCM therapy and the development of new Chinese medicine, and discussed the limitations of existing research, matching factors and sample size. Additionally, the paper offered prospects by combining the simulation treatment comparison method and emulated target trials, with the goal of providing recommendations and references for the clinical efficacy evaluation of TCM.
9.Chinese Translation of the Stanford Expectations of Treatment Scale and Its Application Evaluation on Traditional Chinese Medicine for Diarrhea-Predominant Irritable Bowel Syndrome with Liver-Constraint and Spleen-Deficiency Syndrome
Shibing LIANG ; Yingying ZHANG ; Zhijie WANG ; Zeyu YU ; Mei HAN ; Huijuan CAO ; Guoyan YANG ; Shihuan CAO ; Hongjie CHENG ; Qiaoyan ZHANG ; Youzhu SU ; Yufei LI ; Jianping LIU
Journal of Traditional Chinese Medicine 2024;65(19):1994-2001
ObjectiveTo adapt the Stanford Expectations of Treatment Scale(SETS) into Chinese(C-SETS) and test the feasibility, validity and reliability of its application in patients with diarrhea-predominant irritable bowel syndrome(IBS-D) with liver-constraint and spleen-deficiency syndrome treated with traditional Chinese medicine(TCM). MethodsWe obtained authorisation from the developer of the SETS, and followed the principle of "two-way translation" to translate the SETS by literal translation and back translation to form the C-SETS. Ninety-six IBS-D patients with liver-constraint and spleen-deficiency syndrome were enrolled as respondents and filled out C-SETS before receiving treatment; the feasibility was assessed by the recall rate, completion rate and the duration of filling out the scale; the reliability was assessed by Cronbach's α; the structural validity was assessed by exploratory and confirmatory factor analysis, and the content validity was assessed by correlation analysis. ResultsThe C-SETS consists of 10 items, with the 1st, 3rd, and 5th rating items constituting the Positive Expectations subscale, and the 2nd, 4th, and 6th rating items constituting the Negative Expectations subscale, each of which is rated on a 7-point Likert Scale. The recall of C-SETS was 100%(96/96), the completion rate was 89.58%(86/96); Cronbach's α for the Positive and Negative Treatment Expectations subscales were 0.845 and 0.854, respectively; exploratory factor analysis showed that the coefficient of commonality for all six entries was larger than 0.4, and that the six entries could be used by both factors to explain 77.092% of the total variance; validation factor analysis showed that the goodness-of-fit index, comparative fit index, root mean square of approximation error, canonical fit coefficient, and chi-square degrees of freedom ratio took the values of 0.943, 1.003, 0, 0.943, and 0.626, respectively; and the results of Spearman's analysis suggested that the C-SETS had good content validity. ConclusionThe C-SETS has well feasibility, reliability, and validity, which initially proves that it can be used as a tool to assess the treatment expectation of patients with IBS-D with liver-constraint and spleen-deficiency syndrome before receiving TCM treatment.
10.Homozygous Variant of FANCM of the Fanconi Anemia Pathway Causes Premature Ovarian Insufficiency:Investigation of the Pathogenic Mechanism
Xingxing WEN ; Menghan CHAI ; Qiannan ZHANG ; Huijuan ZOU ; Zhiguo ZHANG ; Yunxia CAO ; Beili CHEN
Journal of Sichuan University (Medical Sciences) 2024;55(3):559-565
Objective Infertility affects approximately one-sixth of the people of childbearing age worldwide,causing not only economic burdens of treatment for families with fertility problems but also psychological stress for patients and presenting challenges to societal and economic development.Premature ovarian insufficiency(POI)refers to the loss of ovarian function in women before the age of 40 due to the depletion of follicles or decreased quality of remaining follicles,constituting a significant cause of female infertility.In recent years,with the help of the rapid development in genetic sequencing technology,it has been demonstrated that genetic factors play a crucial role in the onset of POI.Among the population suffering from POI,genetic studies have revealed that genes involved in processes such as meiosis,DNA damage repair,and mitosis account for approximately 37.4% of all pathogenic and potentially pathogenic genes identified.FA complementation group M(FANCM)is a group of genes involved in the damage repair of DNA interstrand crosslinks(ICLs),including FANCA-FANCW.Abnormalities in the FANCM genes are associated with female infertility and FANCM gene knockout mice also exhibit phenotypes similar to those of POI.During the genetic screening of POI patients,this study identified a suspicious variant in FANCM.This study aims to explore the pathogenic mechanisms of the FANCM genes of the FA pathway and their variants in the development of POI.We hope to help shed light on potential diagnostic and therapeutic strategies for the affected individuals.Methods One POI patient was included in the study.The inclusion criteria for POI patients were as follows:women under 40 years old exhibiting two or more instances of basal serum follicle-stimulating hormone levels>25 IU/L(with a minimum interval of 4 weeks inbetween tests),alongside clinical symptoms of menstrual disorders,normal chromosomal karyotype analysis results,and exclusion of other known diseases that can lead to ovarian dysfunction.We conducted whole-exome sequencing for the POI patient and identified pathogenic genes by classifying variants according to the standards and guidelines established by the American College of Medical Genetics and Genomics(ACMG).Subsequently,the identified variants were validated through Sanger sequencing and subjected to bioinformatics analysis.Plasmids containing wild-type and mutant FANCM genes were constructed and introduced into 293T cells.The 293T cells transfected with wild-type and mutant human FANCM plasmids and pEGFP-C1 empty vector plasmids were designated as the EGFP FANCM-WT group,the EGFP FANCM-MUT group,and the EGFP group,respectively.To validate the production of truncated proteins,cell proteins were extracted 48 hours post-transfection from the three groups and confirmed using GFP antibody.In order to investigate the impact on DNA damage repair,immunofluorescence experiments were conducted 48 hours post-transfection in the EGFP FANCM-WT group and the EGFP FANCM-MUT group to examine whether the variant affected FANCM's ability to localize on chromatin.Mitomycin C was used to induce ICLs damage in vitro in both the EGFP FANCM-WT group and the EGFP FANCM-MUT group,which was followed by verification of its effect on ICLs damage repair using γ-H2AX antibody.Results In a POI patient from a consanguineous family,we identified a homozygous variant in the FANCM gene,c.1152-1155del:p.Leu386Valfs*10.The patient presented with primary infertility,experiencing irregular menstruation since menarche at the age of 16.Hormonal evaluation revealed an FSH level of 26.79 IU/L and an anti-Müllerian hormone(AMH)level of 0.07 ng/mL.Vaginal ultrasound indicated unsatisfactory visualization of the ovaries on both sides and uterine dysplasia.The patient's parents were a consanguineous couple,with the mother having regular menstrual cycles.The patient had two sisters,one of whom passed away due to osteosarcoma,while the other exhibited irregular menstruation,had been diagnosed with ovarian insufficiency,and remained childless.Bioinformatics analysis revealed a deletion of four nucleotides(c.1152-1155del)in the exon 6 of the patient's FANCM gene.This variant resulted in a frameshift at codon 386,introducing a premature stop codon at codon 396,which ultimately led to the production of a truncated protein consisting of 395 amino acids.In vitro experiments demonstrated that this variant led to the production of a truncated FANCM protein of approximately 43 kDa and caused a defect in its nuclear localization,with the protein being present only in the cytoplasm.Following treatment with mitomycin C,there was a significant increase in γ-H2AX levels in 293T cells transfected with the mutant plasmid(P<0.01),indicating a statistically significant impairment of DNA damage repair capability caused by this variant.Conclusions The homozygous variant in the FANCM gene,c.1152-1155del:p.Leu386Valfs*10,results in the production of a truncated FANCM protein.This truncation leads to the loss of its interaction site with the MHF1-MHF2 complex,preventing its entry into the nucleus and the subsequent recognition of DNA damage.Consequently,the localization of the FA core complex on chromatin is disrupted,impeding the normal activation of the FA pathway and reducing the cell's ability to repair damaged ICLs.By disrupting the rapid proliferation and meiotic division processes of primordial germ cells,the reserve of oocytes is depleted,thereby triggering premature ovarian insufficiency in females.


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