OBJECTIVE: To investigate the effects of the combined Yiqi Huoxue Jiedu formula (YHJF) on intestinal microbiota in elderly patients with pulmonary-derived sepsis and identify potential microbial targets. METHODS: A prospective randomized double-blind controlled trial was conducted. Elderly patients with pulmonary infection-induced sepsis admitted to the emergency department of Guangdong Provincial Hospital of Traditional Chinese Medicine (TCM), intensive care unit (ICU) of Fangcun Hospital, and ICU of Daxuecheng Hospital, from November 2020 to October 2021 were enrolled and randomized into two groups. Both groups received conventional Western medicine treatment. The observation group additionally received YHJF (composed of 15 g of Panax ginseng, 9 g of Panax notoginseng, and 3 g of Rheum palmatum, dissolved in 50 mL warm water) orally or via nasogastric tube twice daily for 7 days; while the control group received a placebo. Clinical data and fresh fecal samples were collected before treatment and on days 5-7 of treatment. Intestinal microbiota diversity and structure were analyzed via 16S rDNA sequencing and bioinformatics [α diversity, β diversity, and linear discriminant analysis effect size (LEfSe)]. RESULTS: Fifty-five patients were included (29 in the control group, 26 in the observation group). There were no significantly differences in gender, age, comorbidities, and baseline sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation II (APACHE II), acute gastrointestinal injury (AGI) classification score, and gastrointestinal failure (GIF) score between the two groups. Compared to the control group, the observation group showed significantly lower serum procalcitonin, APACHE II score, and greater reduction in GIF score by day 7. Thirty fecal samples were collected pre-treatment (baseline group), 29 post-treatment from the control group, and 26 from the observation group. Gut microbiota α diversity analysis revealed that Simpson index in the observation group and control group were significantly decreased compared to the baseline group [0.75 (0.53, 0.91), 0.81 (0.32, 0.91) vs. 0.88 (0.87, 0.89), both P < 0.05], but there was no significantly difference between the observation group and the control group. There were no significantly differences in Chao1, Ace, and Shannon indices among three groups. β diversity analysis indicated that distinct microbiota structures among three groups (R² = 0.096, P = 0.026). Species difference analysis showed that, at the phylum level, Firmicutes (53.69%), Actinobacteria (16.23%), Proteobacteria (15.39%), and Bacteroidetes (9.57%) dominated, with no significant intergroup differences. At the genus level, 38 taxa showed significant differences. Compared to the control group, the observation group exhibited increased Erysipelatoclostridium (P = 0.014) and Faecalibacterium (P = 0.013), and decreased Bacteroides (P = 0.009), Bilophila (P = 0.005), Eggerthella (P = 0.002), and Collinsella (P = 0.043). LEfSe analysis highlighted Lactobacillus salivarius, Erysipelatoclostridium, Collinsella, Cloacibacillus, and Bacteroides as key discriminators. CONCLUSION YHJF combined with conventional therapy alters intestinal microbiota structure in patients with elderly pulmonary-derived sepsis, with Bacteroides, Erysipelatoclostridium, and Collinsella identified as potential microbial targets.
Humans ; Gastrointestinal Microbiome/drug effects* ; Drugs, Chinese Herbal/therapeutic use* ; Double-Blind Method ; Sepsis/drug therapy* ; Aged ; Prospective Studies ; RNA, Ribosomal, 16S/genetics* ; Male ; Female ; Panax notoginseng ; Rheum

Objective:To evalaute the role of hippocampal ubiquinol cytochrome C reductase core protein 1 (UQCRC1) in cognitive dysfunction after global cerebral ischemia (GCI) in mice.Methods:Forty SPF healthy male C57BL/6J mice, aged 12 weeks, weighing 22-26 g, were selected, and 20 of them were divided into 2 groups ( n=10 each) using a random number table method: sham operation group and GCI1 group. The other 20 mice were divided into 2 groups ( n=10 each) by the random number table method: GCI2 group and GCI+ UQCRC1 overexpression group (GCI+ UQCRC1 group). In Sham group, the skin was directly sutured after exposing both common carotid arteries. Global cerebral ischemia was induced by occlusion of bilateral common carotid arteries for 20 min in GCI1, GCI2 and GCI+ UQCRC1 group, and lentivirus VSVG-Lentivirus-hSyn-EGFP-P2A-UQCRC1-WPRE-pA 500 nl was injected into the bilateral hippocampus at 2 weeks before developing the model in GCI+ UQCRC1 group. The novel object recognition task was carried out on the 2nd day following completion of model development, and the percentage of time spent exploring the novel object was calculated. The fear conditioning test was carried out on days 3-4 after completion of model development, and the freezing time was recorded. Morris water maze test was performed on days 5-10 after completion of model development, and the escape latency and time spent in the target quadrant were recorded. After the Morris water maze test, the expression of UQCRC1 in the hippocampal CA1 region was detected by immunofluorescence and Western blot. Results:Compared with Sham group, the percentage of time spent exploring the novel object was significantly decreased, the percentage of freezing time in training and test stages was decreased, the escape latency on days 6-9 was prolonged, the percentage of time spent in the target quadrant was decreased, and the expression of UQCRC1 in the hippocampal CA1 was down-regulated in GCI1 group ( P<0.05). Compared with GCI2 group, the percentage of time spent exploring the novel object was significantly increased, the percentage of freezing time in training and test stages was increased, the escape latency on days 6-9 was shortened, the percentage of time spent in the target quadrant was increased, and the expression of UQCRC1 in the hippocampal CA1 region was up-regulated in GCI+ UQCRC1 group ( P<0.05). Conclusions:Hippocampal UQCRC1 is involved in the process of cognitive dysfunction following GCI in mice.

Objective:To evalaute the role of hippocampal ubiquinol cytochrome C reductase core protein 1 (UQCRC1) in cognitive dysfunction after global cerebral ischemia (GCI) in mice.Methods:Forty SPF healthy male C57BL/6J mice, aged 12 weeks, weighing 22-26 g, were selected, and 20 of them were divided into 2 groups ( n=10 each) using a random number table method: sham operation group and GCI1 group. The other 20 mice were divided into 2 groups ( n=10 each) by the random number table method: GCI2 group and GCI+ UQCRC1 overexpression group (GCI+ UQCRC1 group). In Sham group, the skin was directly sutured after exposing both common carotid arteries. Global cerebral ischemia was induced by occlusion of bilateral common carotid arteries for 20 min in GCI1, GCI2 and GCI+ UQCRC1 group, and lentivirus VSVG-Lentivirus-hSyn-EGFP-P2A-UQCRC1-WPRE-pA 500 nl was injected into the bilateral hippocampus at 2 weeks before developing the model in GCI+ UQCRC1 group. The novel object recognition task was carried out on the 2nd day following completion of model development, and the percentage of time spent exploring the novel object was calculated. The fear conditioning test was carried out on days 3-4 after completion of model development, and the freezing time was recorded. Morris water maze test was performed on days 5-10 after completion of model development, and the escape latency and time spent in the target quadrant were recorded. After the Morris water maze test, the expression of UQCRC1 in the hippocampal CA1 region was detected by immunofluorescence and Western blot. Results:Compared with Sham group, the percentage of time spent exploring the novel object was significantly decreased, the percentage of freezing time in training and test stages was decreased, the escape latency on days 6-9 was prolonged, the percentage of time spent in the target quadrant was decreased, and the expression of UQCRC1 in the hippocampal CA1 was down-regulated in GCI1 group ( P<0.05). Compared with GCI2 group, the percentage of time spent exploring the novel object was significantly increased, the percentage of freezing time in training and test stages was increased, the escape latency on days 6-9 was shortened, the percentage of time spent in the target quadrant was increased, and the expression of UQCRC1 in the hippocampal CA1 region was up-regulated in GCI+ UQCRC1 group ( P<0.05). Conclusions:Hippocampal UQCRC1 is involved in the process of cognitive dysfunction following GCI in mice.

Genomic instability remains an enabling feature of cancer and promotes malignant transformation. Alterations of DNA damage response (DDR) pathways allow genomic instability, generate neoantigens, upregulate the expression of programmed death ligand 1 (PD-L1) and interact with signaling such as cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling. Here, we review the basic knowledge of DDR pathways, mechanisms of genomic instability induced by DDR alterations, impacts of DDR alterations on immune system, and the potential applications of DDR alterations as biomarkers and therapeutic targets in cancer immunotherapy.