1.Transposable elements in health and disease: Molecular basis and clinical implications.
Chinese Medical Journal 2025;138(18):2220-2233
Transposable elements (TEs), once considered genomic "junk", are now recognized as critical regulators of genome function and human disease. These mobile genetic elements-including retrotransposons (long interspersed nuclear elements [LINE-1], Alu, short interspersed nuclear element-variable numbers of tandem repeats-Alu [SVA], and human endogenous retrovirus [HERV]) and DNA transposons-are tightly regulated by multilayered mechanisms that operate from transcription through to genomic integration. Although typically silenced in somatic cells, TEs are transiently activated during key developmental stages-such as zygotic genome activation and cell fate determination-where they influence chromatin architecture, transcriptional networks, RNA processing, and innate immune responses. Dysregulation of TEs, however, can lead to genomic instability, chronic inflammation, and various pathologies, including cancer, neurodegeneration, and aging. Paradoxically, their reactivation also presents new opportunities for clinical applications, particularly as diagnostic biomarkers and therapeutic targets. Understanding the dual role of TEs-and balancing their contributions to normal development and disease-is essential for advancing novel therapies and precision medicine.
Humans
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DNA Transposable Elements/physiology*
;
Animals
;
Long Interspersed Nucleotide Elements/genetics*
;
Neoplasms/genetics*
;
Genomic Instability/genetics*
;
Endogenous Retroviruses/genetics*
2.Expert consensus on clinical application of immunotherapy intelligent prediction for colorectal cancer based on artificial intelligence platform(2025 version).
Chinese Journal of Surgery 2025;63(10):866-872
Microsatellite instability (MSI) serves as a molecular marker for DNA mismatch repair deficiency (dMMR), present in approximately 15% of colorectal cancer patients. The MSI status provides predictive information guiding treatment decisions; for instance, patients with microsatellite instability-high colorectal cancer demonstrate better responses to immune checkpoint inhibitor therapy. Currently, MSI testing requires methods such as immunohistochemistry or next-generation sequencing. Although multiple clinical guidelines recommend routine MSI testing, its widespread adoption within China remains limited due to various constraints. Deep learning algorithms offer a novel AI-driven pattern recognition classification strategy, presenting a feasible approach to overcome limitations in MSI testing and enhance immunotherapy efficacy evaluation. Consequently, the Colorectal Surgery Group of the Surgery Branch of the Chinese Medical Association, in collaboration with Beihang University and drawing on current research utilizing artificial intelligence systems to assess colorectal cancer immunotherapy efficacy, has formulated the "Expert consensus on clinical application of immunotherapy intelligent prediction for colorectal cancer based on artificial intelligence platform(2025 version)". This consensus aims to facilitate the prediction of MSI status and other relevant indicators in colorectal cancer patients, while also supporting clinical decision-making regarding the selection and application of immunotherapy regimens.
Humans
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Colorectal Neoplasms/immunology*
;
Artificial Intelligence
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Immunotherapy
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Microsatellite Instability
;
Consensus
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Deep Learning
;
Algorithms
3.The expression characteristics of TXN in pan cancer and its impact on tumor immunity and prognosis.
Annan SUN ; Luna SUN ; Hao WU ; Pu LI
Chinese Journal of Cellular and Molecular Immunology 2025;41(8):706-716
Objective TXN is a thioredoxin (TXN) that participates in many redox reactions and plays a crucial role in various signaling pathways. However, the role of TXN in many cancers is still unclear. The objective of this study is to investigate and visualize the diagnostic, prognostic, and immunological implications of TXN expression across various cancer types. Methods The clinical data were downloaded from the cancer genome mapping project(TCGA) database to analyze the expression level of TXN in pan cancer, and the expression level was preliminarily verified by human protein mapping (HPA)(https://www.proteinatlas.org/)database. The ESTIMATE algorithm and CIBERSORT algorithm were applied to calculate the correlation between TXN expression and immune cell infiltration. The correlation between TXN and microsatellite instability (MSI) and tumor mutation burden (TMB) was analyzed using Spearman method. Gene Set Enrichment Analysis (GSEA) is used for gene biology functional analysis and sensitivity analysis of genes to pan cancer therapeutic drugs. Results TXN is highly expressed in most malignant tumors. The high expression of TXN is associated with overall survival (OS), disease-specific survival (DSS), disease-free interval (DFI), and progression free interval (PFI) in various cancers. Moreover, TXN expression is associated with TMB, MSI, tumor microenvironment, chemotherapy sensitivity and so on. Conclusion TXN may become a potential prognostic biomarker in pan cancer, providing strong theoretical basis for future tumor diagnosis and prognosis judgment. The retinoic acid-inducible gene-I (RIG-I)-like receptor signaling pathway, Toll-like receptor (TLR) signaling pathway, and nucleotide binding oligomerization domain (NOD)-like receptor signaling pathway may be crucial pathways through which TXN influences tumor immunity.
Humans
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Prognosis
;
Neoplasms/diagnosis*
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Thioredoxins/metabolism*
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Microsatellite Instability
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Gene Expression Regulation, Neoplastic
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Biomarkers, Tumor/genetics*
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Mutation
;
Tumor Microenvironment
4.Expert consensus on neoadjuvant therapy with short-course radiotherapy followed by chemotherapy combined with immunotherapy for patients with mismatch repair-proficient/microsatellite stable locally advanced rectal cancer (2025 edition).
Chinese Journal of Gastrointestinal Surgery 2025;28(10):1096-1104
Rectal cancer is one of the most common malignant tumors in China, with more than half of patients diagnosed at the locally advanced stage. Currently, the standard treatment for locally advanced rectal cancer (LARC) primarily involves neoadjuvant chemoradiotherapy followed by radical surgery. The advent of immune checkpoint inhibitors has revolutionized the neoadjuvant treatment landscape for mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) rectal cancer. However, most rectal cancer patients exhibit mismatch repair-proficient/microsatellite stable (pMMR/MSS) status and show poor responsiveness to immunotherapy. In recent years, multiple studies have demonstrated that neoadjuvant short-course radiotherapy followed by chemotherapy and immunotherapy can improve the pathological complete response rate in pMMR/MSS LARC patients. Nevertheless, controversies persist regarding patient selection, efficacy evaluation, adverse event management, postoperative adjuvant therapy, and follow-up strategies. Considering the Colorectal Surgery Group of the Surgery Branch of the Chinese Medical Association, in collaboration with the Colorectal and Anal Surgery Committee of the Chinese Research Hospital Association, the Chinese Colorectal Cancer Clinical Research Collaborative Group, and related experts, has developed this consensus document by referencing domestic and international research advancements. The aim is to provide standardized guidance for the clinical application of this treatment approach.
Humans
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Rectal Neoplasms/genetics*
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Neoadjuvant Therapy
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Immunotherapy
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DNA Mismatch Repair
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Microsatellite Instability
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Consensus
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Combined Modality Therapy
5.Single-cell and spatial transcriptomic analysis reveals that an immune cell-related signature could predict clinical outcomes for microsatellite-stable colorectal cancer patients receiving immunotherapy.
Shijin YUAN ; Yan XIA ; Guangwei DAI ; Shun RAO ; Rongrong HU ; Yuzhen GAO ; Qing QIU ; Chenghao WU ; Sai QIAO ; Yinghua XU ; Xinyou XIE ; Haizhou LOU ; Xian WANG ; Jun ZHANG
Journal of Zhejiang University. Science. B 2025;26(4):371-392
Recent data suggest that vascular endothelial growth factor receptor inhibitor (VEGFRi) can enhance the anti-tumor activity of the anti-programmed cell death-1 (anti-PD-1) antibody in colorectal cancer (CRC) with microsatellite stability (MSS). However, the comparison between this combination and standard third-line VEGFRi treatment is not performed, and reliable biomarkers are still lacking. We retrospectively enrolled MSS CRC patients receiving anti-PD-1 antibody plus VEGFRi (combination group, n=54) or VEGFRi alone (VEGFRi group, n=32), and their efficacy and safety were evaluated. We additionally examined the immune characteristics of the MSS CRC tumor microenvironment (TME) through single-cell and spatial transcriptomic data, and an MSS CRC immune cell-related signature (MCICRS) that can be used to predict the clinical outcomes of MSS CRC patients receiving immunotherapy was developed and validated in our in-house cohort. Compared with VEGFRi alone, the combination of anti-PD-1 antibody and VEGFRi exhibited a prolonged survival benefit (median progression-free survival: 4.4 vs. 2.0 months, P=0.0024; median overall survival: 10.2 vs. 5.2 months, P=0.0038) and a similar adverse event incidence. Through single-cell and spatial transcriptomic analysis, we determined ten MSS CRC-enriched immune cell types and their spatial distribution, including naive CD4+ T, regulatory CD4+ T, CD4+ Th17, exhausted CD8+ T, cytotoxic CD8+ T, proliferated CD8+ T, natural killer (NK) cells, plasma, and classical and intermediate monocytes. Based on a systemic meta-analysis and ten machine learning algorithms, we obtained MCICRS, an independent risk factor for the prognosis of MSS CRC patients. Further analyses demonstrated that the low-MCICRS group presented a higher immune cell infiltration and immune-related pathway activation, and hence a significant relation with the superior efficacy of pan-cancer immunotherapy. More importantly, the predictive value of MCICRS in MSS CRC patients receiving immunotherapy was also validated with an in-house cohort. Anti-PD-1 antibody combined with VEGFRi presented an improved clinical benefit in MSS CRC with manageable toxicity. MCICRS could serve as a robust and promising tool to predict clinical outcomes for individual MSS CRC patients receiving immunotherapy.
Humans
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Colorectal Neoplasms/drug therapy*
;
Male
;
Female
;
Immunotherapy
;
Middle Aged
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Aged
;
Tumor Microenvironment/immunology*
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Retrospective Studies
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Microsatellite Instability
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Transcriptome
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Single-Cell Analysis
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Programmed Cell Death 1 Receptor/immunology*
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Gene Expression Profiling
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Immune Checkpoint Inhibitors/therapeutic use*
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Adult
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Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors*
6.A pan-cancer analysis of PYCR1 and its predictive value for chemotherapy and immunotherapy responses in bladder cancer.
Yutong LI ; Xingyu SONG ; Ruixu SUN ; Xuan DONG ; Hongwei LIU
Journal of Southern Medical University 2025;45(4):880-892
OBJECTIVES:
To explore the potential of pyrroline-5-carboxylate reductase 1 (PYCR1) as a pan-cancer biomarker and investigate its expression, function, and clinical significance in bladder cancer (BLCA).
METHODS:
Bioinformatics analysis was conducted to evaluate the associations of PYCR1 with prognosis, immune microenvironment remodeling, tumor mutation burden (TMB), and microsatellite instability (MSI) in cancer patients. Using the TCGA-BLCA dataset, univariate and multivariate regression analyses were performed to assess the potential of PYCR1 as an independent prognostic risk factor for BLCA, and a clinical decision model was constructed. The IMvigor210 cohort was utilized to evaluate the potential of PYCR1 for independently predicting the efficacy of immunotherapy. The pRRophetic was employed to screen candidate chemotherapeutic agents for treating BLCA with high PYCR1 expression. The CMap-XSum algorithm and molecular docking techniques were used to explore and validate small molecule inhibitors of PYCR1.
RESULTS:
A high expression of PYCR1 was significantly associated with poor prognosis, immune cell infiltration, TMB and MSI in various tumors (r>0.3). PYCR1 was overexpressed in BLCA, and high PYCR1 expression was closely related to poor prognosis in BLCA patients (HR: 1.14, 95% CI: 1.02-1.68, P=0.006). The IC50 of the anti-cancer drugs cetuximab, 5-fluorouracil, and doxorubicin increased significantly in BLCA cell lines with high PYCR1 expressions (P<0.0001).
CONCLUSIONS
High PYCR1 expression is an independent risk factor for poor prognosis in BLCA patients and can serve as a significant indicator for clinical decision-making as well as a marker for predicting sensitivity to chemotherapeutic agents and the efficacy of immunotherapy.
Humans
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Urinary Bladder Neoplasms/genetics*
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Immunotherapy
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Prognosis
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Pyrroline Carboxylate Reductases/metabolism*
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Biomarkers, Tumor/genetics*
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delta-1-Pyrroline-5-Carboxylate Reductase
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Microsatellite Instability
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Tumor Microenvironment
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Mutation
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Computational Biology
;
Molecular Docking Simulation
7.Pan-cancer analysis of MZB1 expression and its association with immune infiltration and clinical prognosis.
Yu ZHANG ; Haitao LI ; Yuqing PAN ; Jiexian CAO ; Li ZHAI ; Xi ZHANG
Journal of Southern Medical University 2025;45(9):2006-2018
OBJECTIVES:
To investigate the expression levels of marginal zone B and B1-cell-specific protein (MZB1) in pan-cancer and its association with patient prognosis and tumor microenvironment (TME).
METHODS:
MZB1 expression data, clinicopathological parameters, and survival data from 33 cancer types were extracted from the UCSC database for analyzing the correlations of MZB1 with clinical stage, patient prognosis, immunomodulatory genes, immune checkpoint genes, tumor stemness, immune cell infiltration, tumor mutational burden (TMB), and microsatellite instability (MSI). MZB1 gene mutations in pan-cancer were assessed using cBioPortal online database, and the value of MZB1 for cancer diagnosis was evaluated using ROC curve analysis. MZB1 expression levels in myeloid leukemia and renal carcinoma cells were detected using RT-qPCR and Western blotting, and the effect of MZB1 knockdown on cell proliferation was examined using EdU assay.
RESULTS:
MZB1 was significantly overexpressed in 20 cancer types, including kidney renal clear cell carcinoma (KIRC), breast invasive carcinoma, and acute myeloid leukemia. Its expression was associated with TNM stage, clinical stage, overall survival, and progression-free survival in multiple cancers. In most tumors, MZB1 expression was correlated significantly with immunomodulatory genes, immune checkpoint genes, tumor stemness, immune cell infiltration, TMB, and microsatellite instability. Gene amplification was the predominant mutation type of MZB1 in pan-cancer, and MZB1 showed high diagnostic value for skin cutaneous melanoma, KIRC, and head and neck squamous cell carcinoma. MZB1 was highly expressed in different myeloid leukemia cell lines and renal carcinoma cell lines, and MZB1 knockdown significantly suppressed the proliferation of HL60 and 769-P cells.
CONCLUSIONS
MZB1 is highly expressed in a variety of tumors, and its aberrant expression affects the occurrence and prognosis of many tumors, suggesting its potential as a novel tumor biomarker and immunomodulatory target.
Humans
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Prognosis
;
Tumor Microenvironment
;
Neoplasms/pathology*
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Cell Line, Tumor
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Mutation
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Kidney Neoplasms
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Microsatellite Instability
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Cell Proliferation
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Carcinoma, Renal Cell
8.Optimized derivation and culture system of human naïve pluripotent stem cells with enhanced DNA methylation status and genomic stability.
Yan BI ; Jindian HU ; Tao WU ; Zhaohui OUYANG ; Tan LIN ; Jiaxing SUN ; Xinbao ZHANG ; Xiaoyu XU ; Hong WANG ; Ke WEI ; Shaorong GAO ; Yixuan WANG
Protein & Cell 2025;16(10):858-872
Human naïve pluripotent stem cells (PSCs) hold great promise for embryonic development studies. Existing induction and culture strategies for these cells, heavily dependent on MEK inhibitors, lead to widespread DNA hypomethylation, aberrant imprinting loss, and genomic instability during extended culture. Here, employing high-content analysis alongside a bifluorescence reporter system indicative of human naïve pluripotency, we screened over 1,600 chemicals and identified seven promising candidates. From these, we developed four optimized media-LAY, LADY, LUDY, and LKPY-that effectively induce and sustain PSCs in the naïve state. Notably, cells reset or cultured in these media, especially in the LAY system, demonstrate improved genome-wide DNA methylation status closely resembling that of pre-implantation counterparts, with partially restored imprinting and significantly enhanced genomic stability. Overall, our study contributes advancements to naïve pluripotency induction and long-term maintenance, providing insights for further applications of naïve PSCs.
Humans
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DNA Methylation/drug effects*
;
Genomic Instability
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Pluripotent Stem Cells/metabolism*
;
Cell Culture Techniques/methods*
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Cells, Cultured
9.Immune aging and infectious diseases.
Ruochan CHEN ; Ju ZOU ; Jiawang CHEN ; Ling WANG ; Rui KANG ; Daolin TANG
Chinese Medical Journal 2024;137(24):3010-3049
The rise in global life expectancy has led to an increase in the older population, presenting significant challenges in managing infectious diseases. Aging affects the innate and adaptive immune systems, resulting in chronic low-grade inflammation (inflammaging) and immune function decline (immunosenescence). These changes would impair defense mechanisms, increase susceptibility to infections and reduce vaccine efficacy in older adults. Cellular senescence exacerbates these issues by releasing pro-inflammatory factors, further perpetuating chronic inflammation. Moreover, comorbidities, such as cardiovascular disease and diabetes, which are common in older adults, amplify immune dysfunction, while immunosuppressive medications further complicate responses to infections. This review explores the molecular and cellular mechanisms driving inflammaging and immunosenescence, focusing on genomic instability, telomere attrition, and mitochondrial dysfunction. Additionally, we discussed how aging-associated immune alterations influence responses to bacterial, viral, and parasitic infections and evaluated emerging antiaging strategies, aimed at mitigating these effects to improve health outcomes in the aging population.
Humans
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Aging/physiology*
;
Communicable Diseases/immunology*
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Immunosenescence/physiology*
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Inflammation/immunology*
;
Genomic Instability
10.Neoadjuvant immunotherapy for colorectal cancer.
Chinese Journal of Gastrointestinal Surgery 2023;26(1):58-67
Immunotherapy has been one of the hot topics in the field of colorectal cancer research in recent years. Patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) are the main beneficiaries of immunotherapy. The response rate of patients with dMMR/MSI-H colorectal cancer receiving neoadjuvant immunotherapy is nearly 100%, of which the pathological complete response rate approximately accounts for 60%-67%. The prospect of neoadjuvant immunotherapy in dMMR or MSI-H colorectal cancer patients, especially in the rectal cancer patients, lies in achieving sustainable clinical complete response so as to achieve organ preservation and avoid adverse effects on reproductive, sexual, bowel and bladder function after surgery and radiotherapy. Studies have shown that part of the colorectal cancer patients of microsatellite stability (MSS) or mismatch repair proficient (pMMR) can respond to neoadjuvant immunotherapy in combination with other treatment methods such as radiotherapy and chemotherapy. In pMMR or MSS colorectal cancer, optimizing neoadjuvant immunotherapy regimens and finding effective efficacy prediction biomarkers are important research directions. In neoadjuvant immunotherapy, overcoming primary and secondary resistance and identifying the pseudoprogression and hyperprogression of neoadjuvant immunotherapy are clinical challenges that require attention. This paper comprehensively reviews the research progress, controversies,challenges and future research directions of neoadjuvant immunotherapy (mainly immune checkpoint inhibitors) in colorectal cancer.
Humans
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Neoadjuvant Therapy/methods*
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Colorectal Neoplasms/drug therapy*
;
Colonic Neoplasms/pathology*
;
Immunotherapy/methods*
;
DNA Mismatch Repair
;
Microsatellite Instability

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