1.Inhibitory effects of different concentrations of auranofin on M1 macrophage function and its therapeutic potential in diabetic wound healing
Hongfei PAN ; Zhenbing ZHUANG ; Baiyun XU ; Zhangyang YANG ; Kairui LIN ; Bingqing ZHAN ; Jinghan LAN ; Heng GAO ; Nanbo ZHANG ; Jiayu LIN
Chinese Journal of Tissue Engineering Research 2026;30(6):1390-1397
BACKGROUND:During diabetic wound healing,the sustained activation of M1 macrophages exacerbates the inflammatory response and hinders wound repair.Auranofin,an anti-inflammatory drug,has not been clearly studied for its effects on M1 macrophages and its potential role in diabetic wound healing.OBJECTIVE:To investigate the effects of different concentrations of auranofin on the biological function of M1 macrophages and evaluate its potential application in diabetic wound healing.METHODS:RAW264.7 and THP-1 cells were used as research models.M1 polarization was induced using different concentrations of interferon-γ and lipopolysaccharide.M1 macrophages were treated with 1 and 2 μmol/L auranofin.Cell counting kit-8 assay was used to evaluate the effect of auranofin on cell viability.Quantitative real-time PCR was performed to detect mRNA expression of interleukin-1β,interleukin-6,and tumor necrosis factor-α.ELISA was employed to measure the levels of interleukin-1β,interleukin-6,and tumor necrosis factor-α in the supernatant.Western blot analysis was used to assess the expression of nuclear factor-κB(p65),phosphorylated mitogen-activated protein kinases(MAPK),and total MAPK proteins.Additionally,6-8-week-old male C57BL/6J and db/db diabetic mice were used for wound healing experiments,with the mice divided into C57 control,db/db control and auranofin treatment groups,each containing six animals.Dorsal skin defect modeling and treatment with intraperitoneal injection of auranofin were performed to observe wound healing in mice.RESULTS AND CONCLUSION:(1)Cell experiments showed that co-treatment with interferon-y(10 ng/mL)and lipopolysaccharide(100 ng/mL)significantly induced M1 polarization in RAW264.7 and THP-1 cells,resulting in increased mRNA expression of interleukin-1β,interleukin-6,and tumor necrosis factor-α.Treatment with auranofin(1 and 2 μmol/L)reduced the mRNA expression of these inflammatory factors in the cells and inhibited the secretion of inflammatory factors in the cell supernatant.(2)Auranofin treatment significantly suppressed the activation of nuclear factor-κB(p65)and phosphorylated MAPK signaling pathways.(3)Animal experiments showed that auranofin promoted wound healing in db/db diabetic mice,suggesting that auranofin has strong anti-inflammatory effects and may facilitate the healing of wounds in diabetic mice.
2.Advances and application of neutrophil extracellular traps and activated platelets in lung cancer research
Daiyao YU ; Ping SHI ; Lan YANG ; Zhishu LI ; Yongping LU
Chinese Journal of Tissue Engineering Research 2026;30(1):229-237
BACKGROUND:Neutrophil extracellular traps and activated platelets are involved in the invasion,metastasis,growth,and angiogenesis of lung cancer,and are closely related to the development and prognosis of lung cancer.OBJECTIVE:To review the mechanism of neutrophil extracellular traps and activated platelets in lung cancer and their application in diagnosis,prognosis,and treatment of lung cancer.METHODS:"Platelet activation,lung neoplasms,extracellular traps,treatment"for English search terms and"lung cancer,neutrophil-extracellular traps,platelet activation,P-selectin,treatment"for Chinese search terms were searched in PubMed and CNKI databases.After reading the title and abstract of the literature,according to the inclusion and exclusion criteria,63 articles with high relevance were finally included.RESULTS AND CONCLUSION:(1)Formation of neutrophil extracellular traps and platelet activation were induced by lung tumor.(2)Neutrophil extracellular traps and activated platelets jointly promote the proliferation,growth and metastasis of lung cancer.(3)Neutrophil extracellular traps can be used as a novel biomarker for the diagnosis,prognosis and progression of lung cancer.(4)Targeting neutrophil extracellular traps and activating platelets can be used as potential therapies for lung cancer.
3.Exploring Therapeutic Mechanism of Xihuang Wan for Hyperplasia of Mammary Glands Based on Network Pharmacology, Molecular Docking, and Cell Experiments
Junliang WANG ; Peihua LIANG ; Xueli MA ; Juanxia SUN ; Tao HAN ; Yongmei LAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):41-49
ObjectiveTo study the therapeutic mechanism of Xihuang Wan for hyperplasia of mammary glands based on network pharmacology, molecular docking, and cell experiments. MethodsThe active ingredients and targets of Xihuang Wan were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and A Bioinformatics Annotation daTabase for Molecular mechANism of Traditional Chinese Medicine (BATMAN-TCM) and supplemented by searching against PubChem and Swiss Target Prediction. The targets of differential metabolites in tissues and urine were obtained from previous metabolomics studies through PubChem and Swiss Target Prediction. GeneCards, Online Mendelian Inheritance in Man (OMIM), PharmGKB, Therapeutic Target Database (TTD), Drunbank were searched for the targets of hyperplasia of mammary glands. After the common targets were obtained via Veeny2.1.0, the STRING database was used to analyze the protein-protein interactions, and Cytoscape was used for the core target analysis and visualization. Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) were employed for enrichment analysis. Molecular docking was carried out in Autodock, and cell experiments were conducted to verify the prediction results. In the cell experiments, estradiol and progesterone (E2+P) were used to intervene in human mammary epithelial/MCF-10A cells, and thus the MCF-10A cell proliferation model was established. The cells were then treated with Xihuang Wan-medicated serum. The cell counting kit-8 (CCK-8) was used to measure the cell proliferation, and flow cytometry was used to detect apoptosis. The mRNA and protein levels of key factors in MCF-10A cells were determined by real-time PCR and Western blot, respectively. ResultsThe results of network pharmacology showed that 90 active ingredients and 316 common targets were obtained, from which 20 core targets and 38 corresponding active ingredients were screened out. The results of GO and KEGG enrichment analyses showed that Xihuang Wan exerted effect against hyperplasia of mammary glands by regulating a variety of biological processes, which may be related to protein kinase B (Akt)-related molecular functions, estrogen signaling pathway, prolactin signaling pathway and other biological processes. The results of molecular docking showed that estrogen receptor 1 (ESR1), serine/threonine kinase 1 (Akt1), non-receptor tyrosine kinase (SRC), and signal transducer and activator of transcription 3 (STAT3) all had strong binding activity with the nine active ingredients, suggesting that Xihuang Wan exert the effect through the ESR1/SRC/phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway and the Janus kinase (JAK)/STAT3 signaling pathway. The results of cell experiments showed that E2+P intervention in MCF-10A cells promoted the proliferation of MCF-10A cells (P<0.05), while the Xihuang Wan-medicated serum inhibited the proliferation of MCF-10A cells exposed to E2+P (P<0.05). Flow cytometry showed that the Xihuang Wan-medicated serum promoted the apoptosis of MCF-10A cells exposed to E2+P (P<0.01). The results of Real-time PCR showed that the Xihuang Wan-medicated serum down-regulated the mRNA levels of PI3K, Akt, JAK2, and STAT3 in MCF-10A cells treated with E2+P (P<0.01). The results of Western blot showed that the Xihuang Wan-medicated serum inhibited the expression of p-PI3K/PI3K, p-Akt/Akt, p-JAK2/JAK2, and p-STAT3/STAT3 in MCF-10A cells treated with E2+P (P<0.05). ConclusionXihuang Wan may exert the effect against hyperplasia of mammary glands by inhibiting the proliferation and promoting the apoptosis of MCF-10A cells, which may related to the inhibition of the activation of PI3K/Akt and JAK2/STAT3 signaling pathways.
4.Shenqi Yiliu Prescription Reverses Cisplatin Resistance in Ovarian Cancer Cells by Regulating PI3K/Akt/mTOR Signaling Pathway-mediated Glycolysis
Lan MA ; Yuping YANG ; Min BAI ; Yongqiang DUAN ; Zhining ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):60-69
ObjectiveTo investigate the mechanism by which Shenqi Yiliu prescription reverses cisplatin resistance in ovarian cancer cells by regulating the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway-mediated glycolysis. MethodsThe human ovarian cancer A2780 cell line was intervened with progressively increasing doses of cisplatin (1 g·L-1) to establish the cisplatin-resistant cell line A2780cisR, and the cell sensitivity to cisplatin was examined by the cell counting kit-8 (CCK-8) assay. High, medium, and low (39.9, 19.95, 9.98 g·kg-1) doses of Shenqi Yiliu prescription-containing sera were used to treat A2780cisR cells for 48 h. Glucose consumption and lactate production were measured by the cuvette assay. Enzyme-linked immunosorbent assay (ELISA) was employed to determine the activities of glucose transporter (GLUT), phosphofructokinase (PFK), and pyruvate kinase (PK). Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was used to detect apoptosis. Western blot was employed to quantify the protein levels of phosphorylated (p)-PI3K, p-Akt, p-mTOR, hexokinase 2 (HK2), pyruvate kinase M2 (PKM2), B-cell lymphoblastoma-2 (Bcl-2), Bcl-2-associated X-protein (Bax), and B-lymphoblastoma-2 gene-related promoter (Bad). Real-time PCR was conducted to determine the mRNA levels of HK2, PKM2, Bax, Bcl-2, and Bad. ResultsThe median inhibitory concentration (IC50) of cisplatin on A2780cisR cells was nearly 3 times that on A2780P cells. Compared with A2780P cells, A2780cisR cells showed increased glucose consumption, lactate production, GLUT, PFK, and PK activities, and mRNA and protein levels of p-PI3K, Akt, p-mTOR, HK2, PKM2, Bax (P<0.05), and decreased apoptosis rate and Bcl-2 expression (P<0.05). Compared with A2780cisR cells, medium- and high-dose Shenqi Yiliu prescription reduced the glucose consumption, lactate production, GLUT, PFK, and PK activities, and mRNA and protein levels of p-PI3K, Akt, p-mTOR, HK2, PKM2, Bax, and Bad (P<0.05), while increasing the apoptosis rate and Bcl-2 expression (P<0.05). ConclusionShenqi Yiliu prescription can inhibit glycolysis mediated by the PI3K/Akt/mTOR pathway to promote apoptosis, thereby reversing cisplatin resistance in ovarian cancer cells.
5.Construction and Evaluation of Mouse Model of Qi Deficiency and Phlegm Dampness Syndrome
Qichun ZHOU ; Gangxing ZHU ; Yongchun ZOU ; Baoyi LAN ; Zhanyu CUI ; Xi WANG ; Mengfei XU ; Qing TANG ; Sumei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):138-146
ObjectiveQi deficiency and phlegm dampness syndrome is a common type of clinical traditional Chinese medicine(TCM) syndrome. However, there is no standard, scientific, and accurate report on the construction of animal models of Qi deficiency and phlegm dampness syndrome. This study aims to construct a mouse model of Qi deficiency and phlegm dampness syndrome by using a multi-factor composite modeling method and to evaluate the model. MethodsTwenty-one C57BL/6 mice were randomly divided into three groups with seven mice in each group, which were the normal group, model group, and Shenling Baizhusan (SLBZ) group. The control group was fed with ordinary diet and kept in a normal environment. The model group and SLBZ group were fed with a high-fat diet in a high-humidity environment. Swimming with heavy weights until exhaustion and gavage with cold water or lard were used to establish the mouse model of Qi deficiency and phlegm dampness syndrome. In order to test the syndrome by prescription, mice in the SLBZ group were treated with SLBZ for 14 days after model construction. The exhaustive swimming time, body weight, serum lipid levels, tongue changes, "Qi deficiency and phlegm dampness" assessment scale score, and cecal index of mice in each group were measured. The feces of each group of mice were sent for metagenomics and metabolome sequencing, and the changes in intestinal flora and metabolites were analyzed. ResultsAfter the modeling of Qi deficiency and phlegm dampness syndrome, the exhaustive swimming time of mice was obviously shortened (P<0.01). The serum total cholesterol, low density lipoprotein cholesterol, and non-high density lipoprotein cholesterol of mice were significantly increased (all P<0.01). The tongue of mice was significantly different from that of the normal group, and the score of the assessment scale was significantly higher than that of the control group (P<0.01). Cecal index decreased significantly (P<0.01). The serum lipid level, tongue image, assessment scale score, and cecal index were reversed in the SLBZ group. Metagenomic and metabolome sequencing results showed that intestinal flora and fecal metabolites were significantly changed in mice with Qi deficiency and phlegm dampness syndrome. Akkermansia_muciniphila, Faecalibaculum_rodentium, Eubacterium_plexicaudatum, Eubacterium sp 14_2, Candida glabrata, Romboutsia_ilealis, Turicibacter sp TS3, and other bacteria had significant changes, and the expressions of intestinal metabolites such as chenodeoxycholic acid, choline, L-phenylalanine betaine, and 2-phenylbutyric acid were significantly changed. Related metabolic pathways such as linoleic acid metabolism, primary bile acid biosynthesis, lysine degradation, arginine biosynthesis, and alpha-linolenic acid metabolism were affected. ConclusionThe Qi deficiency and phlegm dampness model of mice can be constructed by the multi-factor composite modeling method of high-fat diet feeding, high-humidity environment feeding, exhaustive swimming with heavy weight, and intragastric administration with cold water or lard. The blood lipid level, tongue change, score of "Qi deficiency and phlegm dampness assessment scale", cecal index, and changes in related intestinal flora and metabolites of mice can be used as key indicators for model evaluation.
6.Variations of Chemical Components in Gardeniae Fructus Before and After Being Charred Analyzed by UPLC-Q-Orbitrap MS/MS
Lan LI ; Jie HONG ; Yanan SONG ; Yilan LI ; Yun WANG ; Cun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):175-182
ObjectiveTo investigate the changes in chemical components of Gardeniae Fructus(GF) before and after being charred, providing data support for research on the material basis of GF Carbonisata(GFC). MethodsUltra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Orbitrap MS/MS) was used to conduct a comprehensive analysis of the chemical components in GF and GFC under positive and negative ion modes with Compound Discoverer 3.3 software and online database. Then, principal component analysis and partial least squares-discriminant analysis in SIMCA14.1 software were used to analyze the MS data of each sample. Based on the principle of variable importance in the projection(VIP) value>1, differential secondary and primary metabolites before and after carbonization were screened. In addition, MetaboAnalyst website was used for pathway enrichment of Kyoto Encyclopedia of Genes and Genomes(KEGG), so as to provide a reference for clarifying the processing mechanism. ResultsA total of 185 components were identified, including 96 secondary metabolites and 89 primary metabolites. These components were classified into nine categories, primarily including iridoid glycosides, flavonoids, and terpenoids, their fragmentation pathways were also analyzed. Simultaneously, multivariate statistical analysis was performed on the secondary and primary metabolites, identifying 70 and 59 differential metabolites, respectively. The secondary metabolites were enriched in two metabolic pathways, including C5-branched dibasic acid metabolism and flavonoid and flavonol biosynthesis, while the primary differential metabolites were enriched in seven pathways such as linoleic acid metabolism and tyrosine metabolism. ConclusionThe chemical components of GF change significantly after carbonization, with a significant decrease in the contents of iridoid glycosides and terpenoids such as hydroxyisogeniposide, crocin Ⅱ, crocetin, and jasminoside B. while the contents of 4-hydroxycoumarin, geniposidic acid, gentiopicroside, and gardenoside methyl ester increase significantly. This change is presumed to be associated with the enhanced cooling and hemostatic effects of the processed products. The identified key components provide a basis for elucidating the material basis underlying the efficacy changes before and after carbonization.
7.Analysis of HPV Infection Characteristics and Influencing Factors for Lesion Grade in Patients with Cervical Squamous Intraepithelial Lesion and Cervical Cancer
Jingjing HAN ; Lijie ZHANG ; Ruyu CAI ; Haili LI ; He WANG ; Le DANG ; Hongda CHEN ; Ming'e LI ; Lan ZHU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):156-165
To summarize the distribution characteristics of human papillomavirus(HPV) infection types in patients with cervical squamous intraepithelial lesion(SIL) and cervical cancer(CC), and to explore the impact of HPV vaccination, HPV infection types, and general clinical data on different grades of cervical lesions. Clinical data of women attending the gynecological colposcopy clinic of Shenzhen People's Hospital from January 2020 to December 2023 were retrospectively collected. Patients with HPV genotyping records and histopathologically diagnosed SIL or CC were included and divided into three groups based on pathological results: low-grade squamous intraepithelial lesion(LSIL) group, high-grade squamous intraepithelial lesion(HSIL) group, and CC group. The distribution of high-risk HPV subtypes was analyzed among the three groups, and multivariate Logistic regression was used to identify influencing factors for high-grade cervical lesions. A total of 4162 patients were included, comprising 4057 cervical SIL patients(3317 LSIL and 740 HSIL) and 105 CC patients. The overall mean age was(39.9±11.2) years. The HPV infection rate was 95.1%(3959/4162), and 25.0%(1040/4162) of patients had received HPV vaccination. Among high-risk HPV infections, HPV 52, HPV 16, HPV 58, and HPV 18 were the most common subtypes. HPV 52 had the highest infection rate in the LSIL group(27.6%), while HPV 16 was the most prevalent in the HSIL group(45.3%) and CC group(64.9%). Multivariate Logistic regression analysis showed that HPV vaccination( HPV infection is common in patients with SIL and CC, but the distribution of high-risk HPV subtypes varies among different grades of cervical lesions. It is recommended to strengthen cervical cancer screening and monitoring of key high-risk HPV infections in older and multiparous women in Shenzhen, and to continue promoting HPV vaccination.
8.Quality Evaluation of Naomaili Granules Based on Multi-component Content Determination and Fingerprint and Screening of Its Anti-neuroinflammatory Substance Basis
Ya WANG ; Yanan KANG ; Bo LIU ; Zimo WANG ; Xuan ZHANG ; Wei LAN ; Wen ZHANG ; Lu YANG ; Yi SUN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):170-178
ObjectiveTo establish an ultra-performance liquid fingerprint and multi-components determination method for Naomaili granules. To evaluate the quality of different batches by chemometrics, and the anti-neuroinflammatory effects of water extract and main components of Naomaili granules were tested in vitro. MethodsThe similarity and common peaks of 27 batches of Naomaili granules were evaluated by using Ultra performance liquid chromatography (UPLC) fingerprint detection. Ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) technology was used to determine the content of the index components in Naomaili granules and to evaluate the quality of different batches of Naomaili granules by chemometrics. LPS-induced BV-2 cell inflammation model was used to investigate the anti-neuroinflammatory effects of the water extract and main components of Naomaili granules. ResultsThe similarity of fingerprints of 27 batches of samples was > 0.90. A total of 32 common peaks were calibrated, and 23 of them were identified and assigned. In 27 batches of Naomaili granules, the mass fractions of 14 components that were stachydrine hydrochloride, leonurine hydrochloride, calycosin-7-O-glucoside, calycosin,tanshinoneⅠ, cryptotanshinone, tanshinoneⅡA, ginsenoside Rb1, notoginsenoside R1, ginsenoside Rg1, paeoniflorin, albiflorin, lactiflorin, and salvianolic acid B were found to be 2.902-3.498, 0.233-0.343, 0.111-0.301, 0.07-0.152, 0.136-0.228, 0.195-0.390, 0.324-0.482, 1.056-1.435, 0.271-0.397, 1.318-1.649, 3.038-4.059, 2.263-3.455, 0.152-0.232, 2.931-3.991 mg∙g-1, respectively. Multivariate statistical analysis showed that paeoniflorin, ginsenoside Rg1, ginsenoside Rb1 and staphylline hydrochloride were quality difference markers to control the stability of the preparation. The results of bioactive experiment showed that the water extract of Naomaili granules and the eight main components with high content in the prescription had a dose-dependent inhibitory effect on the release of NO in the cell supernatant. Among them, salvianolic acid B and ginsenoside Rb1 had strong anti-inflammatory activity, with IC50 values of (36.11±0.15) mg∙L-1 and (27.24±0.54) mg∙L-1, respectively. ConclusionThe quality evaluation method of Naomaili granules established in this study was accurate and reproducible. Four quality difference markers were screened out, and eight key pharmacodynamic substances of Naomaili granules against neuroinflammation were screened out by in vitro cell experiments.
9.Analysis of Quality Changes of Small Packaged Alismatis Rhizoma Decoction Pieces Under Different Packaging and Storage Conditions
Gaoting YANG ; Rui XIAN ; Zimin WANG ; Zongyi ZHAO ; Zhiqiong LAN ; Xiaoli PAN ; Min LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):179-188
ObjectiveTo screen suitable packaging and storage conditions for small packaged Alismatis Rhizoma decoction pieces, laying the foundation for developing standardized storage, maintenance techniques and determining shelf life. MethodsUsing the accelerated stability test method, the small packaged decoction pieces of Alismatis Rhizoma were placed in polyethylene plastic bags, aluminum foil polyethylene composite bags, and cowhide coated paper bags under temperature of (40±2) ℃ and relative humidity of (75±5)% conditions, the quality testing was conducted at the end of the 0th, 1st, 2nd, 3rd, and 6th month, respectively. Using long-term stability test method, an orthogonal experiment was designed to investigate storage conditions, packaging materials, and packaging methods. At the end of the 0th, 1st, 3rd, 6th, 9th, 12th, 18th, and 24th month, the quality of small packaged Alismatis Rhizoma decoction pieces was tested under different packaging and storage conditions(including 2 packaging methods:vacuum packaging and sealed packaging, 3 storage conditions:room temperature, cool, and modified atmosphere, 3 packaging materials:cowhide coated paper bag, aluminum foil polyethylene composite bag, and polyethylene plastic bag). Then, the G1-entropy weight method combined with orthogonal experiment was used to analyze the quality changes of the decoction pieces under different packaging and storage conditions to identify optimal packaging and storage conditions. The quality testing indicators for Alismatis Rhizoma decoction pieces were expanded beyond those specified in the 2020 edition of the Pharmacopoeia of the People's Republic of China. In addition to the existing indicators(characteristics, moisture content, extractives, and the total content of 23-acetyl alisol B and 23-acetyl alisol C), new indicators including color value, water activity, total triterpenoid content, and alisol B content have been added. ResultsThe accelerated stability test results indicated that the quality of small packaged Alismatis Rhizoma decoction pieces was more stable when packaged in aluminum foil-polyethylene composite materials compared to cowhide-coated paper bags and polyethylene plastic bags. Analysis of the long-term stability test results using the G1-entropy weight method combined with orthogonal experiment revealed that storage conditions had the greatest impact on both raw and salt-processed products, followed by packaging materials, while the packaging method had the least influence. For both types of small packaged Alismatis Rhizoma decoction pieces, modified atmosphere storage demonstrated superior efficacy compared to cool storage or room temperature storage. Storage in aluminum foil-polyethylene composite bags was superior to polyethylene plastic bags or cowhide-coated paper bags. However, the stability of sealed raw products was better than vacuum-packed ones, whereas vacuum-packed salt-processed products exhibited greater stability than their sealed counterparts. ConclusionBased on the results of the quality changes of small packaged Alismatis Rhizoma decoction pieces under different storage conditions, it is recommended that the suitable storage packaging conditions for small packaged raw products are sealed packaging with aluminum foil polyethylene composite bags and controlled atmosphere storage, and the suitable storage and packaging conditions for small packaged salt-processed products are vacuum packaging with aluminum foil polyethylene composite bags and controlled atmosphere storage.
10.Advances in the mechanisms of endothelial-to-mesenchymal transition in corneal endothelial cell
International Eye Science 2026;26(1):35-38
Corneal endothelial cells(CECs), which form the innermost cellular layer of the cornea, play a pivotal role in sustaining corneal transparency and preserving visual acuity. However, CECs are vulnerable to damage induced by a spectrum of pathological conditions or traumatic injuries. Once the density of CECs declines below a critical threshold, corneal endothelial dysfunction is precipitated, ultimately leading to corneal edema and progressive visual impairment. Penetrating keratoplasty and corneal endothelial transplantation remain the first-line therapeutic strategies for managing advanced corneal endothelial dysfunction. Nevertheless, the global shortage of donor corneas severely limits the accessibility and scalability of these surgical interventions. Consequently, regenerative medicine approaches targeting corneal endothelial repair and regeneration have emerged as a major focus of international research in ophthalmology. A key challenge in the in vitro expansion of CECs is their propensity to undergo endothelial-to-mesenchymal transition(EndMT). EndMT is a process of cellular phenotypic transformation, through which endothelial cells lose their intrinsic functions and acquire the characteristic features of mesenchymal cells. The EndMT significantly impedes the clinical translation of in vitro-cultured CECs for regenerative applications. In this review, the risk factors and related signaling pathways involved in EndMT were summarized, aiming to provide references for the basic research and clinical treatment of relevant diseases.

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