1.The Prospect of Trimethylamine N-oxide Combined With Short-chain Fatty Acids in Atherosclerosis Risk Prediction
Zhi-Chao SHI ; Xu-Ping TIAN ; Si-Yi CHEN ; Shi-Guo LIU
Progress in Biochemistry and Biophysics 2026;53(2):404-417
Atherosclerosis (AS), the primary pathological contributor to cardiovascular diseases (CVDs), has increasingly affected younger populations due to modern dietary habits and sedentary lifestyles. Current diagnostic modalities, including ultrasound, MRI, and CT, primarily identify advanced lesions and inadequately evaluate plaque vulnerability, thereby hindering early detection. Conventional treatments, which involve long-term medications associated with side effects such as hepatic injury and surgical interventions that carry risks of restenosis and hemorrhage, underscore the urgent need for non-invasive, cost-effective early diagnostic methods and targeted therapies. Gut microbiota metabolites are pivotal in AS pathogenesis, with trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs) serving as functionally opposing biomarkers. TMAO is produced when gut bacteria, specifically Firmicutes and Proteobacteria, metabolize dietary choline and carnitine into trimethylamine (TMA), which the liver subsequently converts to TMAO via flavin-containing monooxygenase 3 (FMO3); TMAO is then excreted in urine. Variability in TMAO levels is influenced by marine food consumption and FMO3 modulation, which can be affected by genetics, age, and diet. Mechanistically, TMAO exacerbates AS by disrupting cholesterol metabolism, inducing endothelial dysfunction through the elevation of reactive oxygen species (ROS) and pro-inflammatory cytokines such as IL-6, and reducing nitric oxide levels. Additionally, TMAO activates NF-κB and NLRP3 pathways while enhancing platelet reactivity. Clinically, elevated TMAO levels correlate with early AS and serve as predictors of mortality in patients with stable coronary artery disease (CAD) and acute coronary syndrome (ACS), as well as major adverse cardiovascular events (MACE) in stroke patients. Conversely, SCFAs—namely acetate, propionate, and butyrate—are produced by gut bacteria such as Akkermansia muciniphila and Faecalibacterium prausnitzii through the fermentation of dietary fiber. These metabolites exert anti-AS effects: acetate aids in maintaining metabolic homeostasis; propionate protects endothelial function and reduces plaque area; and butyrate fortifies intestinal barriers while suppressing inflammation. Furthermore, SCFAs cross-regulate bile acid metabolism, thereby influencing TMAO levels, and antagonize the pro-inflammatory and lipid-disrupting effects of TMAO. The use of TMAO and SCFAs as standalone biomarkers is constrained by limitations. TMAO lacks specificity, while SCFA levels fluctuate based on gut microbiota and dietary intake. Traditional AS risk assessment tools, which include clinical indicators, imaging techniques, and single biomarkers such as CRP, LDL-C, and ASCVD scores, overlook gut metabolism and demonstrate inadequate performance in younger populations. This review advocates for an “antagonistic-complementary” combined strategy: utilizing acetate and TMAO for early AS, propionate and TMAO for progressive AS, and butyrate and TMAO for advanced AS, addressing endothelial dysfunction, lipid deposition, and plaque stability/thrombosis risk, respectively. For clinical application, standardization of detection methods is crucial; liquid chromatography-mass spectrometry (LC-MS) is the gold standard, necessitating a unified sample pretreatment protocol, such as extraction with 1% formic acid in methanol. Additionally, dried blood spots (DBS) facilitate non-invasive testing, provided that dietary controls are implemented prior to detection, including a 12-hour fast and avoidance of high-choline and high-fiber foods. Existing challenges encompass the absence of standardized systems, limited large-scale validation, and ambiguous interactions with conditions such as hypertension. The authors’ team has previously established connections between gut metabolites and AS, including the reduction of TMAO as a preventive measure for AS, thereby reinforcing this proposed strategy. Future research should prioritize standardization, the development of machine learning-optimized models, validation of interventions, and the exploration of multi-omics-based “gut microbiota-metabolite-vascular” networks. In conclusion, the combined detection of TMAO and SCFAs offers a novel framework for AS risk assessment, facilitating early diagnosis and targeted interventions while enhancing the integration of gut metabolism into cardiovascular disease management.
2.The Prospect of Trimethylamine N-oxide Combined With Short-chain Fatty Acids in Atherosclerosis Risk Prediction
Zhi-Chao SHI ; Xu-Ping TIAN ; Si-Yi CHEN ; Shi-Guo LIU
Progress in Biochemistry and Biophysics 2026;53(2):404-417
Atherosclerosis (AS), the primary pathological contributor to cardiovascular diseases (CVDs), has increasingly affected younger populations due to modern dietary habits and sedentary lifestyles. Current diagnostic modalities, including ultrasound, MRI, and CT, primarily identify advanced lesions and inadequately evaluate plaque vulnerability, thereby hindering early detection. Conventional treatments, which involve long-term medications associated with side effects such as hepatic injury and surgical interventions that carry risks of restenosis and hemorrhage, underscore the urgent need for non-invasive, cost-effective early diagnostic methods and targeted therapies. Gut microbiota metabolites are pivotal in AS pathogenesis, with trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs) serving as functionally opposing biomarkers. TMAO is produced when gut bacteria, specifically Firmicutes and Proteobacteria, metabolize dietary choline and carnitine into trimethylamine (TMA), which the liver subsequently converts to TMAO via flavin-containing monooxygenase 3 (FMO3); TMAO is then excreted in urine. Variability in TMAO levels is influenced by marine food consumption and FMO3 modulation, which can be affected by genetics, age, and diet. Mechanistically, TMAO exacerbates AS by disrupting cholesterol metabolism, inducing endothelial dysfunction through the elevation of reactive oxygen species (ROS) and pro-inflammatory cytokines such as IL-6, and reducing nitric oxide levels. Additionally, TMAO activates NF-κB and NLRP3 pathways while enhancing platelet reactivity. Clinically, elevated TMAO levels correlate with early AS and serve as predictors of mortality in patients with stable coronary artery disease (CAD) and acute coronary syndrome (ACS), as well as major adverse cardiovascular events (MACE) in stroke patients. Conversely, SCFAs—namely acetate, propionate, and butyrate—are produced by gut bacteria such as Akkermansia muciniphila and Faecalibacterium prausnitzii through the fermentation of dietary fiber. These metabolites exert anti-AS effects: acetate aids in maintaining metabolic homeostasis; propionate protects endothelial function and reduces plaque area; and butyrate fortifies intestinal barriers while suppressing inflammation. Furthermore, SCFAs cross-regulate bile acid metabolism, thereby influencing TMAO levels, and antagonize the pro-inflammatory and lipid-disrupting effects of TMAO. The use of TMAO and SCFAs as standalone biomarkers is constrained by limitations. TMAO lacks specificity, while SCFA levels fluctuate based on gut microbiota and dietary intake. Traditional AS risk assessment tools, which include clinical indicators, imaging techniques, and single biomarkers such as CRP, LDL-C, and ASCVD scores, overlook gut metabolism and demonstrate inadequate performance in younger populations. This review advocates for an “antagonistic-complementary” combined strategy: utilizing acetate and TMAO for early AS, propionate and TMAO for progressive AS, and butyrate and TMAO for advanced AS, addressing endothelial dysfunction, lipid deposition, and plaque stability/thrombosis risk, respectively. For clinical application, standardization of detection methods is crucial; liquid chromatography-mass spectrometry (LC-MS) is the gold standard, necessitating a unified sample pretreatment protocol, such as extraction with 1% formic acid in methanol. Additionally, dried blood spots (DBS) facilitate non-invasive testing, provided that dietary controls are implemented prior to detection, including a 12-hour fast and avoidance of high-choline and high-fiber foods. Existing challenges encompass the absence of standardized systems, limited large-scale validation, and ambiguous interactions with conditions such as hypertension. The authors’ team has previously established connections between gut metabolites and AS, including the reduction of TMAO as a preventive measure for AS, thereby reinforcing this proposed strategy. Future research should prioritize standardization, the development of machine learning-optimized models, validation of interventions, and the exploration of multi-omics-based “gut microbiota-metabolite-vascular” networks. In conclusion, the combined detection of TMAO and SCFAs offers a novel framework for AS risk assessment, facilitating early diagnosis and targeted interventions while enhancing the integration of gut metabolism into cardiovascular disease management.
3.Research Advances in Traditional Chinese Medicine Regulation of Pyroptosis for Lung Cancer Prevention and Treatment
Qiongqiong GUO ; Meihao XUE ; Xuchao DONG ; Ping TIAN ; Rong HU ; Longxin XU ; Juan LI ; Jianqing LIANG ; Jintian LI
Medical Journal of Peking Union Medical College Hospital 2026;17(3):716-725
Lung cancer remains one of the leading causes of cancer-related morbidity and mortality worldwide, and its treatment continues to face major challenges such as therapeutic resistance and tumor recurrence. Pyroptosis, a newly characterized form of programmed cell death, induces tumor cell death through gasdermin-mediated membrane pore formation and is accompanied by the release of inflammatory mediators, thereby playing complex roles in lung cancer initiation, progression, and modulation of the tumor microenvironment. Active components and herbal formulas derived from traditional Chinese medicine can modulate pyroptosis-related signaling pathways through multi-target mechanisms, showing potential advantages in inducing lung cancer cell death, inhibiting proliferation and migration, and reversing chemoresistance. This review systematically summarizes relevant studies from domestic and international sources, focusing on the molecular mechanisms of pyroptosis, its roles in lung cancer development and tumor microenvironment remodeling, and the current research progress on traditional Chinese medicine-based interventions targeting pyroptosis, with the aim of providing references for the prevention and treatment of lung cancer using traditional Chinese medicine.
4.Protocol for patient version of the cancer symptom management guideline
Jing CHI ; Lanfang ZHANG ; Tingting YANG ; Shihui XIE ; Chaixiu LI ; Shisi DENG ; Jianyao TANG ; Chuhan ZHONG ; Bingqian GUO ; Qiuyan REN ; Yuman LI ; Zhengya QIN ; Ping ZHAO ; Yanni WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):900-907
Effective symptom management can alleviate the physical and psychological distress experienced by patients with cancer, improve quality of life, and contribute to treatment adherence and improve clinical outcomes. However, most existing guidelines are developed for healthcare professionals, and patients and the public have limited access to standardized and comprehensible guidance on symptom management. To address this gap and to facilitate effective communication and shared decision-making, this study proposes the development of a patient version of the cancer symptom management guideline. The development process will adhere to the methodological framework recommended by the Guidelines International Network and the World Health Organization. The GRADE approach will be employed to assess the certainty of evidence and to formulate recommendations. In addition, the process will be informed by the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) instrument and the Reporting Items for Practice Guidelines in Healthcare-Public or Patient Versions of Guidelines (RIGHT-PVG). This protocol outlines the establishment of the guideline working group, the identification and prioritization of key questions, evidence retrieval and appraisal, and the formulation of recommendations, with the aim of ensuring methodological rigor and transparency in the development of the patient guideline and providing methodological reference for similar guideline initiatives.
5.A new species of Culicoides (Avaritia) (Diptera: Ceratopogonidae) in Heilongjiang Province, China
Ya-yu WANG ; Jiang-fan LI ; Bo-qiao CAI ; Guo-ping LIU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(1):62-65
This study reports a new species of Culicoides(Avaritia)isolated from Xunke County, Heilongjiang Province, China. The new species, Culicoides(Avaritia)dongshanensis Liu et Wang, sp. nov., was identified and illustrated based on female adults. Its diagnostic characteristics are as follows: eyes contiguous over a short distance, with short interfacetal hair, antennal ratio(AR)of 1.20, palpal ratio(PR)of 2.16, wing length of 0.83 mm, mandible with 15 teeth, one pale spot in base cell M1, one pale spot in cell M4, two pale spots in cell A, and two unequal spermathecae. Type specimens were deposited at the Center for Disease Control and Prevention of the Northern Theater Command.
6.Differences in arousal threshold among obstructive sleep apnea patients of different genetic backgrounds and influencing factors
Rui ZHAO ; Ping YAO ; Zhiqiang ZHANG ; Zhiguo GUO ; Minqi XIE ; Hui DANG ; Yanrong JIA ; Jing CHENG ; Dongsheng LYU
Sichuan Mental Health 2026;39(3):240-245
BackgroundObstructive sleep apnea (OSA) represents a prevalent sleep disordered breathing condition characterized by complex pathophysiology. The arousal threshold (ArTH), a core non-anatomical contributor to OSA pathogenesis, is intimately tied to the disease severity and clinical phenotypes. To date, research regarding factors associated with ArTH has yielded inconsistent findings, and ArTH profiles and disparities across populations with different genetic backgrounds are not fully elucidated. ObjectiveTo explore the differences of ArTH in OSA patients with different genetic backgrounds and analyze the key factors affecting ArTH, thereby providing evidence for understanding OSA pathophysiology and formulating targeted treatment regimens. MethodsA total of 285 patients who met the diagnostic criteria for OSA, as defined by the Multidisciplinary Diagnosis and Treatment Guidelines for Adult Obstructive Sleep Apnea, were retrospectively enrolled in this study. All participants underwent overnight polysomnography (PSG) at the Sleep Medicine Center of Inner Mongolia Mental Health Center from December 2022 to May 2024. Based on the study design, the cohort was stratified into two distinct genetic background subgroups (group A and group B). Demographic and clinical characteristics, the Epworth Sleepiness Scale (ESS) score, and overnight PSG data were collected. The apnea hypopnea index (AHI), the lowest pulse oxygen saturation (LSpO2), and fraction of hypopneas (FHypopneas) were utilized as surrogate indicators to estimate ArTH in OSA patients. The influencing factors of low ArTH were tested by binary Logistic regression analysis. ResultsAmong the 285 OSA patients, there were 227 cases (79.65%) in group A and 58 cases (20.35%) in group B. Comparisons between the two genetic background subgroups revealed no statistically significant differences in the proportion of low ArTH, ESS score, PSG parameters, and the three markers for low ArTH (AHI<30 events/h, LSpO2>82.5%, FHypopneas>58.3%) (P>0.05). Binary Logistic regression analysis identified sex (OR=2.421, 95% CI: 1.070–5.478), BMI (OR=0.847, 95% CI: 0.770–0.932), N1 sleep duration (OR=0.974, 95% CI: 0.963–0.985), and hypertension (OR=0.348, 95% CI: 0.143–0.848) as independent factors associated with low ArTH in the total cohort. Stratified analysis by genetic backgrounds revealed that sex(OR=3.799, 95% CI: 1.389–10.392), BMI(OR=0.819, 95% CI:0.723–0.929), and N1 sleep duration(OR=0.973, 95% CI: 0.961–0.986) were independent factors of low ArTH in group A. In contrast, only N1 sleep duration (OR=0.951, 95% CI: 0.911–0.993) remained a significant factor in group B. ConclusionArthur may have conservative characteristics in patients with OSA with different genetic backgrounds, but the pathophysiological mechanism of OSA may have population heterogeneity. [Funded by Inner Mongolia Autonomous Region Natural Science Fundation Project (number, 2024QN08050); Intra-institutional Scientific Research Project of Inner Mongolia Mental Health Center (number, 2022QNWN0010)]
7.Convergent modulation of default mode network effective connectivity by modified Suanzaoren Decoction and estazolam in patients with chronic insomnia disorder
Ke WANG ; Yiding HAN ; Haohao YAN ; Xingyan GUO ; Wuhong LIN ; Ping YAO ; Min LIU ; Min CHEN ; Longbiao CUI ; Wenbin GUO ; Dongsheng LYU
Sichuan Mental Health 2026;39(4):356-366
BackgroundBoth modified Suanzaoren Decoction and estazolam serve as effective treatments for chronic insomnia disorder (CID). Default mode network (DMN) dysfunction is recognized as the primary pathophysiological mechanism underlying CID. However, it remains unclear whether the two treatments exert their therapeutic effects via convergent modulation of DMN functional connectivity. ObjectiveTo investigate the convergent remodeling characteristics of bidirectional effective connectivity (EC) of core DMN nodes with both the intra-network and the remaining whole-brain regions in CID patients with Yin-deficiency and fire-hyperactivity syndrome following the treatment with modified Suanzaoren Decoction or estazolam, so as to provide neuroimaging evidence for the convergent neural mechanisms underlying the therapeutic effects of both therapies in treating CID. MethodsEighty-two patients diagnosed with CID according to the International Classification of Sleep Disorder, third edition (ICSD-3) were consecutively recruited from the outpatient clinic of the Inner Mongolia Autonomous Region Mental Health Center from October 2020 to September 2023. Based on treatment preference, patients were assigned to receive a 6-week intervention in either the modified Suanzaoren Decoction group (n=52) or the estazolam group (n=30). Ultimately, 66 patients completed follow-up assessments (modified Suanzaoren Decoction group, n=41; estazolam group, n=25). All CID patients underwent resting-state functional magnetic resonance imaging scanning before and after treatment. Core DMN nodes including medial prefrontal cortex (mPFC), bilateral inferior parietal lobule (IPL), and precuneus (PCUN) were selected as seed regions. Granger causality analysis (GCA) was employed to assess bidirectional EC between the seed regions and both the other intra-DMN nodes and the remaining whole-brain regions. Hepatic and renal function indices were detected pre- and post-treatment to evaluate the safety profiles of both treatments. ResultsAt baseline, significant between-group differences were identified in EC from the left IPL to the left middle fronto-orbital gyrus/gyrus rectus (t=5.24, Z=4.84, voxel-level P<0.001, cluster-level P<0.05, GRF-corrected), with the modified Suanzaoren Decoction group exhibiting stronger EC than the estazolam group. No significant between-group differences were observed in EC between other core DMN nodes and remaining whole-brain regions (P>0.05). Within-group pre- to post-treatment comparisons demonstrated consistent connectivity alterations in both groups. Specifically, EC from the left IPL to the supplementary motor area (SMA) decreased after treatment (modified Suanzaoren Decoction group: t=-6.28, Z=5.208; estazolam group: t=-5.58, Z=4.425). Conversely, EC from the SMA to the left IPL increased (modified Suanzaoren Decoction group: t=5.89, Z=4.968; estazolam group: t=6.15, Z=4.720). Furthermore, both groups demonstrated reduced EC from the PCUN to the left IPL (modified Suanzaoren Decoction group: t=-5.85, Z=4.94; estazolam group: t=-5.75, Z=4.515), and elevated EC from the left IPL to the PCUN (modified Suanzaoren Decoction group: t=5.29, Z=4.579; estazolam group: t=4.55, Z=3.826) (voxel-level P<0.001, cluster-level P<0.05, GRF-corrected). No significant pre- to post-treatment differences were observed in hepatic or renal function indices in either group (P>0.05). ConclusionIn CID patients with Yin-deficiency and fire-hyperactivity syndrome, both modified Suanzaoren Decoction and estazolam induce convergent bidirectional remodeling of EC between the left IPL and the SMA and the PCUN. [Funded by Natural Science Fund Project of Inner Mongolia Autonomous Region (number, 2019MS08099); ClinicalTrials.gov number, NCT06452953]
8.A Novel Risk Prediction Model for Chronic Atrophic Gastritis Based on Traditional Chinese Medicine Spleen Deficiency and Blood Stasis Syndromes and Gastric Stem Cell Dynamics
Qingqing ZHANG ; Di WU ; Fengyun GUO ; Shengnan YANG ; Ruiying ZHANG ; Lijing BAO ; Ping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):191-200
ObjectiveTo construct a risk prediction model for chronic atrophic gastritis (CAG) that combines disease and syndrome by integrating spleen deficiency and blood stasis syndrome scores, gastric stem cell marker analysis, and network pharmacology and to elucidate the mechanism link between spleen deficiency, blood stasis, and gastric stem cell dysregulation. MethodsA total of 60 patients were stratified into high-risk CAG, low-risk CAG, and non-atrophic groups based on the operative link for gastritis assessment (OLGA)/operative link for gastric intestinal metaplasia assessment (OLGIM) stages. General data and syndrome scores of the patients were collected. Immunohistochemistry was employed to measure the protein levels of leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5), trefoil factor 2 (TFF2), and β-catenin in gastric mucosa across groups. Transcriptomic data (GSE130823) from the Gene Expression Omnibus (GEO) database were analyzed to validate the expression of these molecular markers at the gene level. A Firth penalized maximum likelihood logistic regression model was employed to integrate clinical, molecular, and TCM syndrome data to develop a CAG risk prediction model. Finally, network pharmacology analysis was conducted on spleen-invigorating herbs (Astragali Radix, Atractylodis Macrocephalae Rhizoma, and Dioscorea Rhizoma) and blood-activating herbs (Hedyotis diffusa, Salviae Miltiorrhizae Radix et Rhizoma, and Curcumae Rhizoma) to identify overlapping targets between these herbs and differentially expressed genes between low-grade intraepithelial neoplasia (LGIN) and gastritis, thereby clarifying the role of spleen deficiency and blood stasis in CAG progression from a pharmacological perspective. ResultsHigh-risk CAG patients exhibited higher blood stasis scores (4.60±1.50,2.62±1.32, P<0.01), progressive nuclear accumulation of β-catenin (A 0.28-0.53, P<0.01), and an increased LGR5+/TFF2+ ratio (A 1.02-1.92, P<0.01). Blood stasis scores were correlated with LGR5/TFF2 imbalance (P=0.03) and activation of the Wnt/β-catenin signaling pathway (CTNNB1 increase, log2=0.78). The integrated prediction model (blood stasis score≥5 + β-catenin>0.38 + LGR5/TFF2>1.5) outperformed a pure biomarker approach [Area Under the Curve (AUC) 0.92,0.89, ΔAUC=0.03, P=0.02]. Moreover, network pharmacology revealed 66 overlapping targets between spleen-invigorating/blood-activating herbs and LGIN, which were functionally enriched in mucosal repair and anti-oxidative stress, and negatively correlated with the Wnt/β-catenin signaling pathway (P<0.01). ConclusionThis study developed an integrated risk prediction model for CAG by combining TCM spleen deficiency and blood stasis syndromes with gastric stem cell molecular markers. Furthermore, it proposed for the first time the "blood stasis-Wnt/β-catenin-stem cell axis" hypothesis, preliminarily elucidating that spleen deficiency and blood stasis may exacerbate gastric stem cell dysregulation and promote malignant transformation of CAG through hypoxia-induced Wnt activation. This provides a theoretical foundation and a translational tool for risk stratification and multi-target TCM intervention in CAG.
9.A Novel Risk Prediction Model for Chronic Atrophic Gastritis Based on Traditional Chinese Medicine Spleen Deficiency and Blood Stasis Syndromes and Gastric Stem Cell Dynamics
Qingqing ZHANG ; Di WU ; Fengyun GUO ; Shengnan YANG ; Ruiying ZHANG ; Lijing BAO ; Ping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):191-200
ObjectiveTo construct a risk prediction model for chronic atrophic gastritis (CAG) that combines disease and syndrome by integrating spleen deficiency and blood stasis syndrome scores, gastric stem cell marker analysis, and network pharmacology and to elucidate the mechanism link between spleen deficiency, blood stasis, and gastric stem cell dysregulation. MethodsA total of 60 patients were stratified into high-risk CAG, low-risk CAG, and non-atrophic groups based on the operative link for gastritis assessment (OLGA)/operative link for gastric intestinal metaplasia assessment (OLGIM) stages. General data and syndrome scores of the patients were collected. Immunohistochemistry was employed to measure the protein levels of leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5), trefoil factor 2 (TFF2), and β-catenin in gastric mucosa across groups. Transcriptomic data (GSE130823) from the Gene Expression Omnibus (GEO) database were analyzed to validate the expression of these molecular markers at the gene level. A Firth penalized maximum likelihood logistic regression model was employed to integrate clinical, molecular, and TCM syndrome data to develop a CAG risk prediction model. Finally, network pharmacology analysis was conducted on spleen-invigorating herbs (Astragali Radix, Atractylodis Macrocephalae Rhizoma, and Dioscorea Rhizoma) and blood-activating herbs (Hedyotis diffusa, Salviae Miltiorrhizae Radix et Rhizoma, and Curcumae Rhizoma) to identify overlapping targets between these herbs and differentially expressed genes between low-grade intraepithelial neoplasia (LGIN) and gastritis, thereby clarifying the role of spleen deficiency and blood stasis in CAG progression from a pharmacological perspective. ResultsHigh-risk CAG patients exhibited higher blood stasis scores (4.60±1.50,2.62±1.32, P<0.01), progressive nuclear accumulation of β-catenin (A 0.28-0.53, P<0.01), and an increased LGR5+/TFF2+ ratio (A 1.02-1.92, P<0.01). Blood stasis scores were correlated with LGR5/TFF2 imbalance (P=0.03) and activation of the Wnt/β-catenin signaling pathway (CTNNB1 increase, log2=0.78). The integrated prediction model (blood stasis score≥5 + β-catenin>0.38 + LGR5/TFF2>1.5) outperformed a pure biomarker approach [Area Under the Curve (AUC) 0.92,0.89, ΔAUC=0.03, P=0.02]. Moreover, network pharmacology revealed 66 overlapping targets between spleen-invigorating/blood-activating herbs and LGIN, which were functionally enriched in mucosal repair and anti-oxidative stress, and negatively correlated with the Wnt/β-catenin signaling pathway (P<0.01). ConclusionThis study developed an integrated risk prediction model for CAG by combining TCM spleen deficiency and blood stasis syndromes with gastric stem cell molecular markers. Furthermore, it proposed for the first time the "blood stasis-Wnt/β-catenin-stem cell axis" hypothesis, preliminarily elucidating that spleen deficiency and blood stasis may exacerbate gastric stem cell dysregulation and promote malignant transformation of CAG through hypoxia-induced Wnt activation. This provides a theoretical foundation and a translational tool for risk stratification and multi-target TCM intervention in CAG.
10.Heterogeneity of Adipose Tissue From a Single-cell Transcriptomics Perspective
Yong-Lang WANG ; Si-Si CHEN ; Qi-Long LI ; Yu GONG ; Xin-Yue DUAN ; Ye-Hui DUAN ; Qiu-Ping GUO ; Feng-Na LI
Progress in Biochemistry and Biophysics 2025;52(4):820-835
Adipose tissue is a critical energy reservoir in animals and humans, with multifaceted roles in endocrine regulation, immune response, and providing mechanical protection. Based on anatomical location and functional characteristics, adipose tissue can be categorized into distinct types, including white adipose tissue (WAT), brown adipose tissue (BAT), beige adipose tissue, and pink adipose tissue. Traditionally, adipose tissue research has centered on its morphological and functional properties as a whole. However, with the advent of single-cell transcriptomics, a new level of complexity in adipose tissue has been unveiled, showing that even under identical conditions, cells of the same type may exhibit significant variation in morphology, structure, function, and gene expression——phenomena collectively referred to as cellular heterogeneity. Single-cell transcriptomics, including techniques like single-cell RNA sequencing (scRNA-seq) and single-nucleus RNA sequencing (snRNA-seq), enables in-depth analysis of the diversity and heterogeneity of adipocytes at the single-cell level. This high-resolution approach has not only deepened our understanding of adipocyte functionality but also facilitated the discovery of previously unidentified cell types and gene expression patterns that may play key roles in adipose tissue function. This review delves into the latest advances in the application of single-cell transcriptomics in elucidating the heterogeneity and diversity within adipose tissue, highlighting how these findings have redefined the understanding of cell subpopulations within different adipose depots. Moreover, the review explores how single-cell transcriptomic technologies have enabled the study of cellular communication pathways and differentiation trajectories among adipose cell subgroups. By mapping these interactions and differentiation processes, researchers gain insights into how distinct cellular subpopulations coordinate within adipose tissues, which is crucial for maintaining tissue homeostasis and function. Understanding these mechanisms is essential, as dysregulation in adipose cell interactions and differentiation underlies a range of metabolic disorders, including obesity and diabetes mellitus type 2. Furthermore, single-cell transcriptomics holds promising implications for identifying therapeutic targets; by pinpointing specific cell types and gene pathways involved in adipose tissue dysfunction, these technologies pave the way for developing targeted interventions aimed at modulating specific adipose subpopulations. In summary, this review provides a comprehensive analysis of the role of single-cell transcriptomic technologies in uncovering the heterogeneity and functional diversity of adipose tissues.


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