1.Effect of dimethylglyoxal glycine on osteogenic,adipogenesis differentiation,and mitophagy of human bone marrow mesenchymal stem cells
Qiheng CHEN ; Tujun WENG ; Jiang PENG
Chinese Journal of Tissue Engineering Research 2026;30(1):50-57
BACKGROUND:Bone marrow mesenchymal stem cells play a crucial role in treatment of diseases,such as femoral head necrosis,and the therapeutic efficacy is closely related to the quality of the cells.The empowerment of cells has become a research focus.OBJECTIVE:To investigate the effects of hypoxia mimetic dimethylglyoxal glycine pretreatment on mitophagy and differentiation capacity of human bone marrow mesenchymal stem cells.METHODS:Bone marrow mesenchymal stem cells were extracted from the bone marrow of patients' iliac crest and cultured in vitro to the third passage.The cells were treated with dimethylglyoxal glycine at 0,10,50,and 100 μmol/Lfor 24 hours,followed by the replacement with an osteogenic induction differentiation medium,which constituted the pretreatment group.The continuous treatment group was cultured directly in osteogenic induction medium containing 0,10,50,and 100 μmol/L dimethylglyoxal glycine after cell adhesion.After 7 days of induction,alkaline phosphatase staining was performed to select the most favorable conditions for osteogenic differentiation for subsequent experiments,with normally cultured bone marrow mesenchymal stem cells serving as the control group.Alkaline phosphatase staining,alkaline phosphatase activity,oil red O staining,and related RT-qPCR were used to evaluate the osteogenic and adipogenic differentiation differences of bone marrow mesenchymal stem cells between the two groups.MitoSox staining was used to detect mitochondrial reactive oxygen species levels.Mito-tracker and Lyso-tracker staining were used to detect the co-localization of mitochondria and lysosomes.The fluorescent probe JC-1 was used to measure mitochondrial membrane potential.RESULTS AND CONCLUSION:Alkaline phosphatase staining indicated that the most beneficial treatment for bone marrow mesenchymal stem cell osteogenesis was pretreatment with 10 μmol/L dimethylglyoxal glycine for 24 hours.Compared with the control group,the experimental group showed enhanced alkaline phosphatase staining expression,increased alkaline phosphatase activity and osteogenic gene expression,reduced lipid droplet formation and adipogenic gene expression as indicated by oil red O staining,decreased mitochondrial reactive oxygen species production,increased co-localization of mitochondria and lysosomes,and elevated mitochondrial membrane potential.The results suggest that 10 μmol/L dimethylglyoxal glycine pretreatment can promote osteogenic differentiation of bone marrow mesenchymal stem cells,inhibit adipogenic differentiation,and enhance mitophagy.
2.Isometric exercise reduces resting blood pressure:a meta-analysis of moderating factors and dose effects
Yang JIANG ; Hao PENG ; Yanping SONG ; Na YAO ; Yueyu SONG ; Xingxiao YIN ; Yanqi LI ; Qigang CHEN
Chinese Journal of Tissue Engineering Research 2026;30(4):975-986
OBJECTIVE:Elevated blood pressure increases the risk of cardiovascular diseases.Isometric exercise training has been shown to significantly reduce resting blood pressure,but the factors influencing its effectiveness remain unclear,and specific application guidelines are yet to be established.This study aims to evaluate the impact of isometric exercise training on resting blood pressure through meta-analysis,explore its moderating factors,and provide evidence-based recommendations based on its dose-response relationship.METHODS:Following the PRISMA guidelines,a systematic search was conducted in PubMed,Embase,Cochrane Library,Scopus,and Web of Science databases using keywords"Isometric exercise training,""Systolic blood pressure,"and"Diastolic blood pressure,"covering literature up to September 2024.Randomized controlled trials involving isometric exercise training and resting blood pressure were included.Three independent researchers performed literature screening and data extraction,assessing bias risk and quality grades using the Risk of Bias 2.0 tool and GRADE framework.Main effect pooling,publication bias assessment,subgroup,and regression analysis were conducted using R software(version 4.3.4).RESULTS:A total of 28 articles(comprising 32 randomized controlled trials)involving 977 participants were included.(1)Meta-analysis results indicated that isometric exercise training significantly reduced resting systolic blood pressure(MD=-8.01,95%CI=-9.22 to-6.80,P<0.01,I2=18.20%,low evidence grade)and diastolic blood pressure(MD=-3.46,95%CI=-4.64 to-2.28,P<0.01,I2=0%,moderate evidence grade)compared to no exercise.(2)Subgroup analysis results revealed significant influences of gender,health status,exercise modality,frequency,intensity,duration,sets per session,rest duration,and baseline blood pressure on the main effects for both systolic(P<0.01)and diastolic blood pressure(P<0.05).(3)Regression analysis results did not show any significant influencing factors,but body mass index(β=-4.11,P=0.091)showed a significant negative trend on the main effect for systolic blood pressure.(4)No significant publication bias was observed in the meta-analysis results(P>0.05).CONCLUSION:(1)Isometric exercise training significantly lowers systolic(low evidence grade)and diastolic(moderate evidence grade)blood pressure with clinically meaningful thresholds.(2)Participant characteristics(gender,health status,baseline blood pressure,and body mass index)and isometric exercise training protocols(modality,frequency,intensity,duration,cycle,sets per session,and rest duration)influence its antihypertensive effects.(3)The article recommends the optimal blood pressure management prescription:three sessions per week,with four sets per session,each set lasting 2 minutes with a 2-minute rest,at an intensity of 95%HRpeak using isometric wall squat exercises;the intervention period can be adjusted around a 6-week node.Future high-quality research is urgently needed to further validate and support these conclusions.
3.Effect of dimethylglyoxal glycine on osteogenic,adipogenesis differentiation,and mitophagy of human bone marrow mesenchymal stem cells
Qiheng CHEN ; Tujun WENG ; Jiang PENG
Chinese Journal of Tissue Engineering Research 2026;30(1):50-57
BACKGROUND:Bone marrow mesenchymal stem cells play a crucial role in treatment of diseases,such as femoral head necrosis,and the therapeutic efficacy is closely related to the quality of the cells.The empowerment of cells has become a research focus.OBJECTIVE:To investigate the effects of hypoxia mimetic dimethylglyoxal glycine pretreatment on mitophagy and differentiation capacity of human bone marrow mesenchymal stem cells.METHODS:Bone marrow mesenchymal stem cells were extracted from the bone marrow of patients' iliac crest and cultured in vitro to the third passage.The cells were treated with dimethylglyoxal glycine at 0,10,50,and 100 μmol/Lfor 24 hours,followed by the replacement with an osteogenic induction differentiation medium,which constituted the pretreatment group.The continuous treatment group was cultured directly in osteogenic induction medium containing 0,10,50,and 100 μmol/L dimethylglyoxal glycine after cell adhesion.After 7 days of induction,alkaline phosphatase staining was performed to select the most favorable conditions for osteogenic differentiation for subsequent experiments,with normally cultured bone marrow mesenchymal stem cells serving as the control group.Alkaline phosphatase staining,alkaline phosphatase activity,oil red O staining,and related RT-qPCR were used to evaluate the osteogenic and adipogenic differentiation differences of bone marrow mesenchymal stem cells between the two groups.MitoSox staining was used to detect mitochondrial reactive oxygen species levels.Mito-tracker and Lyso-tracker staining were used to detect the co-localization of mitochondria and lysosomes.The fluorescent probe JC-1 was used to measure mitochondrial membrane potential.RESULTS AND CONCLUSION:Alkaline phosphatase staining indicated that the most beneficial treatment for bone marrow mesenchymal stem cell osteogenesis was pretreatment with 10 μmol/L dimethylglyoxal glycine for 24 hours.Compared with the control group,the experimental group showed enhanced alkaline phosphatase staining expression,increased alkaline phosphatase activity and osteogenic gene expression,reduced lipid droplet formation and adipogenic gene expression as indicated by oil red O staining,decreased mitochondrial reactive oxygen species production,increased co-localization of mitochondria and lysosomes,and elevated mitochondrial membrane potential.The results suggest that 10 μmol/L dimethylglyoxal glycine pretreatment can promote osteogenic differentiation of bone marrow mesenchymal stem cells,inhibit adipogenic differentiation,and enhance mitophagy.
4.Isometric exercise reduces resting blood pressure:a meta-analysis of moderating factors and dose effects
Yang JIANG ; Hao PENG ; Yanping SONG ; Na YAO ; Yueyu SONG ; Xingxiao YIN ; Yanqi LI ; Qigang CHEN
Chinese Journal of Tissue Engineering Research 2026;30(4):975-986
OBJECTIVE:Elevated blood pressure increases the risk of cardiovascular diseases.Isometric exercise training has been shown to significantly reduce resting blood pressure,but the factors influencing its effectiveness remain unclear,and specific application guidelines are yet to be established.This study aims to evaluate the impact of isometric exercise training on resting blood pressure through meta-analysis,explore its moderating factors,and provide evidence-based recommendations based on its dose-response relationship.METHODS:Following the PRISMA guidelines,a systematic search was conducted in PubMed,Embase,Cochrane Library,Scopus,and Web of Science databases using keywords"Isometric exercise training,""Systolic blood pressure,"and"Diastolic blood pressure,"covering literature up to September 2024.Randomized controlled trials involving isometric exercise training and resting blood pressure were included.Three independent researchers performed literature screening and data extraction,assessing bias risk and quality grades using the Risk of Bias 2.0 tool and GRADE framework.Main effect pooling,publication bias assessment,subgroup,and regression analysis were conducted using R software(version 4.3.4).RESULTS:A total of 28 articles(comprising 32 randomized controlled trials)involving 977 participants were included.(1)Meta-analysis results indicated that isometric exercise training significantly reduced resting systolic blood pressure(MD=-8.01,95%CI=-9.22 to-6.80,P<0.01,I2=18.20%,low evidence grade)and diastolic blood pressure(MD=-3.46,95%CI=-4.64 to-2.28,P<0.01,I2=0%,moderate evidence grade)compared to no exercise.(2)Subgroup analysis results revealed significant influences of gender,health status,exercise modality,frequency,intensity,duration,sets per session,rest duration,and baseline blood pressure on the main effects for both systolic(P<0.01)and diastolic blood pressure(P<0.05).(3)Regression analysis results did not show any significant influencing factors,but body mass index(β=-4.11,P=0.091)showed a significant negative trend on the main effect for systolic blood pressure.(4)No significant publication bias was observed in the meta-analysis results(P>0.05).CONCLUSION:(1)Isometric exercise training significantly lowers systolic(low evidence grade)and diastolic(moderate evidence grade)blood pressure with clinically meaningful thresholds.(2)Participant characteristics(gender,health status,baseline blood pressure,and body mass index)and isometric exercise training protocols(modality,frequency,intensity,duration,cycle,sets per session,and rest duration)influence its antihypertensive effects.(3)The article recommends the optimal blood pressure management prescription:three sessions per week,with four sets per session,each set lasting 2 minutes with a 2-minute rest,at an intensity of 95%HRpeak using isometric wall squat exercises;the intervention period can be adjusted around a 6-week node.Future high-quality research is urgently needed to further validate and support these conclusions.
5.Serpina3c Mitigates Adipose Tissue Inflammation by Inhibiting the HIF1α-Mediated Endoplasmic Reticulum Overoxidation in Adipocytes
Yu JIANG ; Jia-Qi GUO ; Ya WU ; Peng ZHENG ; Shao-Fan WANG ; Meng-Chen YANG ; Gen-Shan MA ; Yu-Yu YAO
Diabetes & Metabolism Journal 2026;50(1):62-76
Background:
Visceral white adipose tissue (vWAT) inflammation is a critical pathology of obesity-caused heart damage and is closely associated with adipocyte endoplasmic reticulum (ER) dysfunction. Serine (or cysteine) peptidase inhibitor, clade A, member 3C (Serpina3c) has been identified as an adipokine with anti-vWAT inflammatory effects. However, it remains unclear whether Serpina3c deficiency promotion of vWAT inflammation involves adipocyte ER dysfunction and whether it further contributes to heart damage in obesity.
Methods:
Wild type and Serpina3c knockout (Serpina3c–/–) mice were fed a high-fat diet (HFD) for 12 weeks. An adeno-associated virus (AAV) was injected locally into epididymal white adipose tissue (eWAT) of Serpina3c–/– mice to induce eWAT-adipocyte- specific overexpression of Serpina3c (AAV-Serpina3c) or knockdown of hypoxia-inducible factor 1α (AAV-shHIF1α). In vitro experiments were performed in 3T3-L1 adipocytes.
Results:
Serpina3c–/– mice exhibited more severe eWAT, serum and heart inflammation after HFD feeding. Consistently, these adverse phenotypes were mitigated in AAV-Serpina3c and AAV-shHIF1α mice. Mechanistically, ER oxidoreductase 1α (Ero1α) and protein disulfide isomerase (PDI) family members PDIA3 and PDIA4 were found to be target genes of HIF1α. In the obese mice, Serpina3c deficiency caused adipocyte more hypertrophy, and activated HIF1α-Ero1α/PDI mediated ER overoxidation and ER stress in eWAT. Subsequently, this led to increased adipocyte apoptosis and chemokine production and decreased adiponectin expression, which promoted macrophage infiltration and M1 polarization in eWAT, thus exacerbating eWAT inflammation and ultimately facilitating serum and distal heart inflammation.
Conclusion
These findings indicate that Serpina3c is a significant regulator of adipocyte ER redox homeostasis, thus highlighting Serpina3c as a potential therapeutic target for obesity-related eWAT inflammation and heart damage.
6.Consistent Detection of Aquaporin-4 Antibodies:A Comparative Analysis Between Fixed and Live Cell-Based Assays
Jing WANG ; Linge WANG ; Xiaolin YANG ; Zhizhong LI ; Jinyu JIANG ; Qiao XU ; Siyuan HUANG ; Qing FU ; Yang YANG ; Rongrong ZHANG ; Lin YANG ; Ai CHEN ; Xiaopeng ZENG ; Ke XU ; Peng ZHENG ; Xinyue QIN ; Jinzhou FENG
Journal of Clinical Neurology 2026;22(2):212-220
Background:
and Purpose Live cell-based assays (LCBA) are increasingly used for serological antibody detection due to their ability to preserve antigen conformation, offering moderately higher sensitivity than fixed cell-based assays. However, the clinical necessity of prioritizing LCBA for the detection of aquaporin-4 immunoglobulin G (AQP4-IgG) in neuromyelitis optica spectrum disorder (NMOSD) remains unclear, especially when compared to its established role in diagnosing myelin oligodendrocyte glycoprotein antibody-associated disease.
Methods:
We compared the performance of live cell-based assays using immunofluorescence (LCBA-IF) and fixed cell-based assays using immunofluorescence (FCBA-IF) in detecting AQP4-IgG in 90 cases of NMOSD meeting 2015 International Panel for Neuromyelitis Optica Diagnosis criteria, alongside 40 controls. Additionally, we further investigated the relationship between AQP4-IgG titers as measured by LCBA-IF and FCBA-IF and clinical parameters in NMOSD patients.
Results:
Results showed 96.9% agreement between LCBA-IF and FCBA-IF (Cohen’s κ=0.935), with a strong Spearman correlation (0.977, p<0.001). Both methods demonstrated 100% specificity, with LCBA-IF showing slightly higher sensitivity compared to FCBA-IF. Within LCBAIF-tested groups, statistically significant differences in annualized relapse rates were observed across all pairwise comparisons (low-titer vs. moderate-titer, low-titer vs. high-titer, and moderate-titer vs. high-titer; all p<0.050). However, this association reached statistical significance in some FCBA-IF-tested groups.
Conclusions
Overall, there is a strong concordance between LCBA-IF and FCBA-IF in detecting AQP4-IgG, where LCBA-IF shows slightly higher sensitivity. Furthermore, there is a potential link between elevated AQP4-IgG titers and an increased risk of relapse, and this correlation may appear more pronounced when using LCBA-IF.
7.Changing trend of benign hepatobiliary and pancreatic diseases among people aged 15—39 years in China in 1990—2021
Wenkai JIANG ; Huiqi SUN ; Junhao FENG ; Ru HE ; Wenrui PENG ; Ming TIAN
Journal of Clinical Hepatology 2026;42(1):160-166
ObjectiveTo investigate the changing trends of the incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs) of benign hepatobiliary and pancreatic diseases among people aged 15 — 39 years in China in 1990 — 2021. MethodsThe data of 2021 Global Burden of Disease Study were downloaded to obtain the epidemiological data of liver fibrosis/chronic liver disease, benign gallbladder/biliary tract diseases, and pancreatitis among people aged 15 — 39 years in China, and estimated annual percentage change (EAPC) was calculated to assess the changing trends of incidence, prevalence, mortality, and DALY rates. The Bayesian age-period-cohort model was used to predict the incidence and mortality rates from 2022 to 2030. ResultsIn 2021, there were 10 448 778 new cases of benign hepatobiliary and pancreatic diseases among the individuals aged 15 — 39 years in China, which was increased by 3.8% compared with the data in 1990, while the numbers of prevalent cases, deaths, and DALYs were reduced by 20.4%, 59.6%, and 50.2%, respectively. In 2021, the age-standardized incidence rates of liver fibrosis/chronic liver disease, benign gallbladder/biliary tract diseases, and pancreatitis were 1 104.40/100 000, 1 045.05/100 000, and 16.64/100 000, respectively; the age-standardized prevalence rates were 20 592.37/100 000, 2 364.85/100 000, and 9.43/100 000, respectively; the age-standardized mortality rates were 1.61/100 000, 0.04/100 000, and 0.18/100 000, respectively. From 1990 to 2021, there was a tendency of increase in the age-standardized incidence rate of liver fibrosis/chronic liver disease (EAPC=0.43, 95% confidence interval [CI]: 0.23 — 0.63), and there was also a tendency of increase in the age-standardized incidence and prevalence rates of benign gallbladder/biliary tract diseases (incidence rate: EAPC=1.07, 95%CI: 0.91 — 1.24; prevalence rate: EAPC=0.75, 95%CI: 0.59 — 0.89), while there was a tendency of reduction in the age-standardized mortality rate of all three disease categories. Predictions for 2022 — 2030 indicated a potential reduction in the incidence rate of benign gallbladder/biliary tract diseases and an increase in the incidence rate of pancreatitis. ConclusionThere has been an overall upward trend in the incidence rate of liver fibrosis/chronic liver disease and gallbladder/biliary tract diseases over the past three decades, and it is needed to pay attention to the disease burden of benign hepatobiliary diseases among the people aged 15 — 39 years in China.
8.Clinical characteristics and prognosis of immunotherapy for recurrent/metastatic nasopharyngeal carcinoma: a single-center retrospective analysis
WANG Haoqiang ; LIU Baiyang ; YANG Ning ; LIU Peng ; CHENG Donghai ; PENG Lijun ; WANG Xianci ; HUANG Xueqin ; DONG Enlai ; JIANG Yiming ; ZHOU Juan ; XIE Bo
Chinese Journal of Cancer Biotherapy 2026;33(1):84-90
[摘 要] 目的:探讨复发/转移性鼻咽癌(NPC)接受含PD-1单抗免疫治疗的临床特征和预后影响因素。方法:回顾性分析2019年3月至2024年7月期间南部战区总医院确诊的95例NPC患者的临床资料和外周血生化及免疫学指标。预后分析采用Kaplan-Meier曲线,组间比较使用Log-rank检验,采用Cox比例风险模型进行单因素和多因素分析。结果:95例患者中男性81例,女性14例,中位年龄49.72岁(16~74岁),Ⅳ期91例(95.79%),所有患者均采用免疫治疗,联合或不联合化疗方案治疗,中位无进展生存期(mPFS)为10.5个月,客观缓解率(ORR)70.53%,疾病控制率(DCR)89.47%,接受含铂治疗方案患者PFS相对更长,且差异有统计学意义。紫杉醇 + 顺铂 + 氟尿嘧啶(TPF)对比吉西他滨 + 顺铂(GP)和紫杉醇 + 顺铂(TP)显示出更长的PFS,但差异无统计学意义。不同PD-1单抗治疗组间的PFS未显示出有统计学意义的差异。单因素及多因素Cox回归分析结果显示,肿瘤复发状态、初始血浆EBV感染状态、治疗周期数、基线外周血SII是复发/转移性NPC患者接受PD-1抑制剂治疗疗效预测的独立相关因素(均P < 0.05),并且非复发患者、初始血浆EBV DNA阳性、接受 ≥ 4治疗周期、基线外周血SII < 772.81的患者接受PD-1抑制剂治疗预后相对更好。结论:在接受PD-1抑制剂治疗的复发/转移性NPC患者中,非复发患者、初始血浆EBV DNA阳性、≥ 4治疗周期且外周血SII < 772.81者PFS相对更长,可早期识别免疫治疗效果不佳患者并精准干预。
9.Mechanism of MEK/Ras/Raf/ERK Signaling Pathway Modulated by Mimenghua Prescription on Inflammatory Response in Dry Eye Animal Model
Shi TAN ; Pei LIU ; Yuan ZHONG ; Sainan TIAN ; Pengfei JIANG ; Genyan QIN ; Qinghua PENG ; Jun PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):211-221
ObjectiveThis paper aims to investigate the effects and mechanism of Mimenghua prescription in modulating the mitogen-activated protein kinase kinase (MEK)/rat sarcoma viral oncogene homolog (Ras)/rapidly accelerated fibrosarcoma kinase (Raf)/extracellular signal-regulated kinase (ERK) signaling pathway to inhibit inflammatory responses in a dry eye animal model. MethodsA total of 60 C57BL/6J mice (eight weeks old, half male and half female) were used in the experiment. Ten mice were randomly selected as the blank control group, while the remaining 50 were exposed to a controlled dry system and received instillation of 0.2% benzalkonium chloride (BAC) into the eyes for four weeks to establish a dry eye mouse model. After successful modeling, the mice were randomly divided into five groups: Model group, sodium hyaluronate group, and Mimenghua prescription groups with low dose (4.83 g·kg-1), medium dose (9.67 g·kg-1), and high dose (19.34 g·kg-1). The mice in the model group received an equal volume of normal saline via gavage for four weeks. The mice in the sodium hyaluronate group received instillation of sodium hyaluronate eye drops twice daily for 14 consecutive days. The tear secretion volume, tear film break-up time (TBUT), and corneal fluorescein staining were evaluated once every two weeks. After four weeks of administration, mice were euthanized, and their lacrimal gland tissues and corneas were harvested. Hematoxylin-eosin (HE) staining was used to assess histopathological morphology. Western blot was performed to detect the protein expression levels of MEK, Ras, Raf, and ERK. Enzyme-linked immunosorbent assay (ELISA) was used to measure the contents and expressions of MEK, Ras, Raf, ERK, and interleukin (IL)-1β in lacrimal gland and corneal tissues of the mice in each group. Quantitative real-time polymerase chain reaction (Real-time PCR) was employed to determine mRNA expression levels of MEK, Ras, Raf, and ERK. ResultsThe Mimenghua prescription groups and the sodium hyaluronate group exhibited significantly increased tear secretion volume (P<0.05) and prolonged TBUT (P<0.05) after treatment. Ocular surface damage of mice was visibly recovered. Western blot results indicated that protein expression levels of MEK, Ras, Raf, and ERK in the lacrimal gland and corneal tissues were significantly downregulated in the sodium hyaluronate group and Mimenghua prescription group with high dose (P<0.05). ELISA results showed that IL-1β levels were highest in the model group but significantly reduced in the sodium hyaluronate group and Mimenghua prescription groups (P<0.05). Both ELISA and Real-time PCR results demonstrated that the expression levels of MEK, Ras, Raf, and ERK in the lacrimal glands and corneal tissues were significantly elevated in the model group (P<0.05), but markedly downregulated in the sodium hyaluronate group and Mimenghua prescription groups (P<0.05), suggesting that Mimenghua prescription can decrease the expressions of MEK, Ras, Raf, and ERK in the lacrimal glands and corneal tissues. ConclusionMimenghua prescription can reduce inflammatory responses, increase tear secretion, prolong TBUT, and promote corneal recovery by inhibiting the MEK, Ras, Raf, and ERK signaling pathways in lacrimal gland and corneal tissues.
10.Analysis of Clinical Prognostic Characteristics in Patients with Primary Sjögren's Syndrome-Related Renal Fanconi Syndrome
Xiaoxiao SHI ; Yuan DONG ; Jiahe JIANG ; Peng XIA ; Shuo ZHANG ; Yubing WEN ; Dong XU ; Fengchun ZHANG ; Limeng CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(2):358-369
Renal Fanconi syndrome (FS) is a rare renal manifestation of primary Sjögren's syndrome (pSS). This study aims to analyze the clinical and prognostic characteristics of patients with pSS-associated renal FS (pSS-FS) and provide insights for clinical management. Patients diagnosed with pSS-FS via renal biopsy at Peking Union Medical College Hospital from 1993 to 2024 were enrolled. Data collected included age, sex, clinical symptoms (xerostomia, xerophthalmia, skin purpura, arthralgia, polyuria, and systemic symptoms), laboratory findings [serum immunoglobulin G (IgG) and IgM, complement (C3, C4), antinuclear antibody, anti-Sjögren's syndrome-associated antigen A antibody (SSA), anti-SSB antibody, 24-hour urinary protein quantification, tubular proteinuria, serum creatinine, serum electrolytes], treatment, and follow-up information. Systematic assessments included the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) score, pulmonary involvement (including non-infectious interstitial pneumonia, pulmonary fibrosis, pulmonary hypertension, etc.), hematological involvement (anemia, leukopenia, thrombocytopenia), etc. Efficacy evaluations encompassed improvements in immunological parameters, renal function, and tubular function. Group comparisons were performed using chi-square/Fisher's exact tests, A total of 38 patients with pSS-FS were included, with 37(97.4%) being female. The median age at pSS diagnosis was 43(37, 57) years. Xerostomia (76.3%) and xerophthalmia (71.1%) were the predominant clinical symptoms. The most common renal tubular dysfunctions were generalized aminoaciduria (96.9%), tubular proteinuria (96.0%), and hypokalemia (94.7%). The median eGFR was 52.57(32.04, 76.10)mL/(min·1.73 m2), with 60.5% (23/38) of patients having an eGFR below 60 mL/(min·1.73 m2).After six months of immunosuppressive therapy, including moderate-to-high-dose glucocorticoids, significant improvements were observed in immunological parameters (improvement rate: 69.2%), renal tubular function (89.5%), and renal function (44.4%). Following immunosuppressive treatment, the median eGFR increased from 54.95(33.06, 76.10)mL/(min·1.73 m2) to 65.56(56.24, 83.58)mL/(min·1.73 m2).Compared to patients with normal or mildly impaired baseline eGFR [≥ 60 mL/(min·1.73 m2)], those with significantly decreased baseline eGFR [< 60 mL/(min·1.73 m2)] were older (46 years This study reports the clinical characteristics of the largest single-center cohort of pSS-FS patients internationally, characterized by varying degrees of proximal renal tubular dysfunction and renal impairment. Timely initiation of immunosuppressive therapy, including glucocorticoids, is crucial, particularly for patients with significantly reduced eGFR, who may experience more substantial renal function improvement.

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