1.Androgen receptor inhibitors in treating prostate cancer.
Ryan N COLE ; Qinghua FANG ; Kanako MATSUOKA ; Zhou WANG
Asian Journal of Andrology 2025;27(2):144-155
Androgens play an important role in prostate cancer development and progression. Androgen action is mediated through the androgen receptor (AR), a ligand-dependent DNA-binding transcription factor. AR is arguably the most important target for prostate cancer treatment. Current USA Food and Drug Administration (FDA)-approved AR inhibitors target the ligand-binding domain (LBD) and have exhibited efficacy in prostate cancer patients, particularly when used in combination with androgen deprivation therapy. Unfortunately, patients treated with the currently approved AR-targeting agents develop resistance and relapse with castration-resistant prostate cancer (CRPC). The major mechanism leading to CRPC involves reactivation of AR signaling mainly through AR gene amplification, mutation, and/or splice variants. To effectively inhibit the reactivated AR signaling, new approaches to target AR are being actively explored. These new approaches include novel small molecule inhibitors targeting various domains of AR and agents that can degrade AR. The present review provides a summary of the existing FDA-approved AR antagonists and the current development of some of the AR targeting agents.
Humans
;
Male
;
Androgen Receptor Antagonists/therapeutic use*
;
Receptors, Androgen/metabolism*
;
Prostatic Neoplasms/drug therapy*
;
Prostatic Neoplasms, Castration-Resistant/drug therapy*
;
Signal Transduction/drug effects*
2.Mechanism of 2,6-DMBQ attenuates airway inflammatory responses in asthmatic mice via the mTOR signaling pathway.
Juan LI ; Shu-Fang LI ; Xiao-Man XIONG ; Qiu-Yan YANG ; Xue-Li XIE ; Yan-Li ZHANG
Chinese Journal of Contemporary Pediatrics 2025;27(4):472-479
OBJECTIVES:
To investigate the therapeutic effects and mechanisms of 2,6-dimethoxy-1,4-benzoquinone (2,6-DMBQ) in a mouse model of asthma.
METHODS:
SPF-grade BALB/c mice were randomly divided into 7 groups (n=8 each group): normal control group, ovalbumin (OVA) group, dimethyl sulfoxide+corn oil group, budesonide (BUD) group, and low, medium, and high dose 2,6-DMBQ groups. An asthma mouse model was established by OVA induction, followed by corresponding drug interventions. Non-invasive lung function tests were performed to measure airway hyperresponsiveness, and enzyme-linked immunosorbent assay was used to determine levels of interleukin (IL)-17, IL-10, and serum immunoglobulin E in bronchoalveolar lavage fluid. A cell counter was employed to detect eosinophil counts in bronchoalveolar lavage fluid, while hematoxylin-eosin staining and periodic acid-Schiff staining were used to assess lung tissue pathological changes. Western blot was conducted to examine the expression of proteins related to the mammalian target of rapamycin pathway (p-AKT/AKT and p-p70S6K/p70S6K), and a fully automated biochemical analyzer was used to evaluate liver and kidney functions.
RESULTS:
Compared with the normal control group, the OVA group showed increased enhanced pause values, inflammation scores from hematoxylin-eosin staining, positive area from periodic acid-Schiff staining, percentage of eosinophils, IL-17/IL-10 ratio, serum immunoglobulin E levels, and relative expression levels of p-AKT/AKT and p-p70S6K/p70S6K (P<0.05). The BUD group and the medium and high dose 2,6-DMBQ groups exhibited decreased values for these indicators compared to the OVA group (P<0.05).
CONCLUSIONS
2,6-DMBQ can inhibit the mTOR pathway to alleviate airway inflammation in asthmatic mice, possibly by mitigating the imbalance between Th17 and regulatory T cells.
Animals
;
Asthma/pathology*
;
Mice, Inbred BALB C
;
Signal Transduction/drug effects*
;
Mice
;
TOR Serine-Threonine Kinases/physiology*
;
Female
;
Benzoquinones/pharmacology*
;
Immunoglobulin E/blood*
;
Interleukin-10/analysis*
;
Interleukin-17/analysis*
;
Bronchoalveolar Lavage Fluid
;
Lung/pathology*
3.FGF19 alleviates inflammatory injury in vascular endothelial cells by activating the Nrf2/HO-1 signaling pathway.
Yan-Jun ZHANG ; Fei-Fei XIAO ; Xiao-Hua LI ; Shen-Hua TANG ; Yi SANG ; Chao-Yue LIU ; Jian-Chang LI
Chinese Journal of Contemporary Pediatrics 2025;27(5):601-608
OBJECTIVES:
To investigate the role and mechanism of fibroblast growth factor (FGF) 19 in inflammation-induced injury of vascular endothelial cells caused by high glucose (HG).
METHODS:
Human umbilical vein endothelial cells (HUVECs) were randomly divided into four groups: control, HG, FGF19, and HG+FGF19 (n=3 each). The effect of different concentrations of glucose and/or FGF19 on HUVEC viability was assessed using the CCK8 assay. Flow cytometry was utilized to examine the impact of FGF19 on HUVEC apoptosis. Levels of interleukin-6 (IL-6), inducible nitric oxide synthase (iNOS), total superoxide dismutase (T-SOD), and malondialdehyde (MDA) were measured by ELISA. Real-time quantitative PCR and Western blotting were used to determine the mRNA and protein expression levels of vascular endothelial growth factor (VEGF), nuclear factor erythroid 2 related factor 2 (Nrf2), and heme oxygenase-1 (HO-1). Cells were further divided into control, siRNA-Nrf2 (siNrf2), HG, HG+FGF19, HG+FGF19+negative control, and HG+FGF19+siNrf2 groups (n=3 each) to observe the effect of FGF19 on oxidative stress injury in HUVECs induced by high glucose after silencing the Nrf2 gene.
RESULTS:
Compared to the control group, the HG group exhibited increased apoptosis rate, increased IL-6, iNOS and MDA levels, and increased VEGF mRNA and protein expression, along with decreased T-SOD activity and decreased mRNA and protein expression of Nrf2 and HO-1 (P<0.05). Compared to the HG group, the HG+FGF19 group showed reduced apoptosis rate, decreased IL-6, iNOS and MDA levels, and decreased VEGF mRNA and protein expression, with increased T-SOD activity and increased Nrf2 and HO-1 mRNA and protein expression (P<0.05). Compared to the HG+FGF19+negative control group, the HG+FGF19+siNrf2 group had decreased T-SOD activity and increased MDA levels (P<0.05).
CONCLUSIONS
FGF19 can alleviate inflammation-induced injury in vascular endothelial cells caused by HG, potentially through the Nrf2/HO-1 signaling pathway.
Humans
;
NF-E2-Related Factor 2/genetics*
;
Signal Transduction
;
Human Umbilical Vein Endothelial Cells/drug effects*
;
Fibroblast Growth Factors/pharmacology*
;
Heme Oxygenase-1/physiology*
;
Apoptosis/drug effects*
;
Glucose
;
Inflammation
;
Interleukin-6/analysis*
;
Vascular Endothelial Growth Factor A/genetics*
;
Nitric Oxide Synthase Type II/analysis*
;
Cells, Cultured
4.Interferon-λ1 improves glucocorticoid resistance caused by respiratory syncytial virus by regulating the p38 mitogen-activated protein kinase signaling pathway.
Li PENG ; Yao LIU ; Fang-Cai LI ; Xiao-Fang DING ; Xiao-Juan LIN ; Tu-Hong YANG ; Li-Li ZHONG
Chinese Journal of Contemporary Pediatrics 2025;27(8):1011-1016
OBJECTIVES:
To investigate the effect of interferon-λ1 (IFN-λ1) on glucocorticoid (GC) resistance in human bronchial epithelial cells (HBECs) stimulated by respiratory syncytial virus (RSV).
METHODS:
HBECs were divided into five groups: control, dexamethasone, IFN-λ1, RSV, and RSV+IFN-λ1. CCK-8 assay was used to measure the effect of different concentrations of IFN-λ1 on the viability of HBECs, and the sensitivity of HBECs to dexamethasone was measured in each group. Quantitative real-time PCR was used to measure the mRNA expression levels of p38 mitogen-activated protein kinase (p38 MAPK), glucocorticoid receptor (GR), and MAPK phosphatase-1 (MKP-1). Western blot was used to measure the protein expression level of GR in cell nucleus and cytoplasm, and the nuclear/cytoplasmic ratio of GR was calculated.
RESULTS:
At 24 and 72 hours, the proliferation activity of HBECs increased with the increase in IFN-λ1 concentration in a dose- and time-dependent manner (P˂0.05). Compared with the RSV group, the RSV+IFN-λ1 group had significant reductions in the half-maximal inhibitory concentration of dexamethasone and the mRNA expression level of p38 MAPK (P<0.05), as well as significant increases in the mRNA expression levels of GR and MKP-1, the level of GR in cell nucleus and cytoplasm, and the nuclear/cytoplasmic GR ratio (P<0.05).
CONCLUSIONS
IFN-λ1 can inhibit the p38 MAPK pathway by upregulating MKP-1, promote the nuclear translocation of GR, and thus ameliorate GC resistance in HBECs.
Humans
;
p38 Mitogen-Activated Protein Kinases/genetics*
;
Glucocorticoids/pharmacology*
;
Receptors, Glucocorticoid/analysis*
;
Dual Specificity Phosphatase 1/physiology*
;
Dexamethasone/pharmacology*
;
Drug Resistance/drug effects*
;
Respiratory Syncytial Viruses
;
Interferons/pharmacology*
;
MAP Kinase Signaling System/drug effects*
;
Epithelial Cells/drug effects*
;
Signal Transduction/drug effects*
;
Cells, Cultured
5.Shenge powder inhibits myocardial fibrosis in rats with post-myocardial infarction heart failure through LOXL2/TGF-β1/IL-11 signaling pathway.
Hang XIE ; Boyong QIU ; Haitao LI ; Ruoyu SHI
Journal of Zhejiang University. Medical sciences 2025;54(3):350-359
OBJECTIVES:
To investigate the effect of Shenge powder (SGP) on myocardial fibrosis in rats with heart failure after myocardial infarction and its relation with lysyl oxidase like protein 2 (LOXL2)/transforming growth factor-β1 (TGF-β1)/IL-11 signaling pathway.
METHODS:
Seventy-two SPF male SD rats were divided into blank control group, model control group, SGP small dose group, SGP large dose group, positive control group, SGP large dose+LOXL2 activator group, with 12 rats in each group. Except for the blank control group, post-myocardial infarction heart failure was induced by coronary constriction. Corresponding treatments were given immediately after successful modeling, once a day for 4 weeks. Left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF) in rats were detected by color Doppler ultrasound imaging. Levels of IL-1β and IL-6 in serum were analyzed by ELISA method. Myocardial collagen volume fraction (CVF) was evaluated by Masson staining. Expressions of collagen Ⅰ and α-smooth muscle actin (α-SMA) in myocardial tissue were detected by immunohistochemical staining. The mRNA expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) in myocardial tissue were detected by qRT-PCR. Expression of LOXL2, TGF-β1, and IL-11 proteins in myocardial tissue were detected by Western blotting.
RESULTS:
Compared with the blank control group, the LVFS and LVEF of the model control group decreased, the levels of serum IL-6 and IL-1β elevated, and the CVF value, the expressions of collagen Ⅰ and α-SMA in myocardial tissue, MMP-9 and TIMP-1 mRNA, and LOXL2, TGF-β1, IL-11 proteins increased (all P<0.05). Compared with the model control group, the LVFS and LVEF of SGP small dose group, SGP large dose group and positive control group increased, the levels of serum IL-6 and IL-1β decreased, and the CVF value, the expressions of collagen Ⅰ and α-SMA in myocardial tissue, MMP-9 and TIMP-1 mRNA, and LOXL2, TGF-β1, IL-11 proteins decreased (all P<0.05); while LOXL2 activator reversed the improvement effect of high-dose SGP on myocardial fibrosis in heart failure rats after myocardial infarction.
CONCLUSIONS
Shenge powder may inhibit myocardial fibrosis in heart failure rats after myocardial infarction by inhibiting the LOXL2/TGF-β1/IL-11 pathway.
Animals
;
Male
;
Rats, Sprague-Dawley
;
Myocardial Infarction/complications*
;
Transforming Growth Factor beta1/metabolism*
;
Signal Transduction/drug effects*
;
Drugs, Chinese Herbal/therapeutic use*
;
Rats
;
Heart Failure/pathology*
;
Myocardium/metabolism*
;
Fibrosis
;
Amino Acid Oxidoreductases/metabolism*
;
Interleukin-11/metabolism*
;
Tissue Inhibitor of Metalloproteinase-1/metabolism*
;
Matrix Metalloproteinase 9/metabolism*
6.Advances in pharmacological research for retinopathy of prematurity.
Yanxi XIE ; Suilian ZHENG ; Hui YANG
Journal of Zhejiang University. Medical sciences 2025;54(3):411-421
Retinopathy of prematurity (ROP) is a proliferative retinal vascular disease that threatens the vision of premature infants. Various novel drugs have demonstrated therapeutic potential for ROP by targeting signaling pathways associated with vascular endothelial growth factor (VEGF) [such as PI3K/AKT, hypoxia-inducible factor (HIF)-1α/VEGF], oxidative stress, tumor necrosis factor (TNF)-α, and Notch pathways. Propranolol, insulin-like growth factor-1, and celecoxib attenuate pathological neovascularization via the PI3K/Akt signaling pathway. Tripterine and melatonin inhibit retinal neovascularization by modulating the HIF-1α/VEGF signaling axis. Adiponectin mitigates the damage caused by oxidative stress and preserves endothelial function by enhancing endothelial nitric oxide synthase activity. Omega-3 polyunsaturated fatty acids suppress TNF-α-mediated inflammatory responses, modulate retinal development and angiogenesis, and reduce retinal neovascular lesions. DAPT, a γ-secretase inhibitor, blocks Notch signaling to suppress abnormal vascular proliferation. These agents exhibit synergistic multi-pathway anti-angiogenic effects in preclinical models and early-phase clinical trials, offering critical insights for advancing drug development and clinical translation in ROP management.
Retinopathy of Prematurity/metabolism*
;
Humans
;
Signal Transduction/drug effects*
;
Infant, Newborn
;
Vascular Endothelial Growth Factor A/metabolism*
;
Hypoxia-Inducible Factor 1, alpha Subunit/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
Oxidative Stress/drug effects*
;
Fatty Acids, Omega-3/therapeutic use*
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Receptors, Notch/metabolism*
;
Angiogenesis Inhibitors/therapeutic use*
;
Insulin-Like Growth Factor I/therapeutic use*
7.Ginsenoside-Rg5 Synergizes with Imatinib to Enhances the Anti-Chronic Myeloid Leukemia K562 Cell Activity through PI3K/AKT/mTOR Pathway.
Di JIN ; Chang-Qing GUI ; Qian-Qian YE ; Guo-Fang DENG ; Chang-Ling ZHU ; Li XU
Journal of Experimental Hematology 2025;33(1):1-8
OBJECTIVE:
To investigate the synergistic effect and its mechanism of ginsenoside-Rg5 in combination with imatinib in inhibiting proliferation of chronic myeloid leukemia K562 cells.
METHODS:
K562 cells were treated with ginsenoside-Rg5 and imatinib. Cell survival was detected by CCK-8 assay, and IC50 were calculated separately for each drug. Based on the value of IC50 of ginsenoside-Rg5 and imatinib, an appropriate concentration gradient was selected for the combination. The synergistic effect of the two drug was analyzed using the online software synergy finder. The effects of single or combination therapy on apoptosis rate and the cell cycle distribution of K562 cells were analyzed by flow cytometry. Western blot was used to detect the expression of PI3K/AKT/mTOR signaling pathway related proteins and apoptosis related proteins in K562 cells after single or combination therapy.
RESULTS:
Ginsenoside-Rg5 and imatinib were able to inhibit the proliferative activity of K562 cells in a dosedependent manner(r =-0.991, r =-0.942). The synergy score ZIP >10 was measured by Synergy Finder online software, indicating that ginsenoside-Rg5 and imatinib act synergistically on K562 cells. The apoptotic rates of K562 cells after single treatments with ginsenoside-Rg5 and imatinib were 11.96% and 8.13%, respectively, while the rate increased to 21.35% with the combination of two drugs, the apoptosis rate in the combination group was higher than that in the single-drug group ( P <0.05). The proportion of K562 cells in the G0/G1 phase was significantly increased with the combined treatment of two drugs( P <0.05). The protein expression levels of p-PI3K, p-AKT, p-mTOR in K562 cells treated with the combination were significantly decreased, with noticeable downregulation of BCL-2 and upregulation of BAX, leading to a decreased Bcl-2/BAX ratio, while no significant changes were observed in the non-phosphorylated forms of PI3K, AKT, and mTOR proteins.
CONCLUSION
The combination of ginsenoside-Rg5 and imatinib can inhibit the proliferation of CML cells and induce apoptosis, and the mechanism may act through PI3K/AKT/mTOR signaling pathways.
Humans
;
Ginsenosides/pharmacology*
;
Imatinib Mesylate
;
K562 Cells
;
TOR Serine-Threonine Kinases/metabolism*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Signal Transduction/drug effects*
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism*
;
Drug Synergism
;
Apoptosis/drug effects*
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Cell Proliferation/drug effects*
8.Inhibitory Effect of Simvastatin Combined with Doxorubicin on Biological Functions of Diffuse Large B-Cell Lymphoma Cells and Its Mechanism.
Yao WANG ; Min-An ZHANG ; Huan ZHOU ; Qing-Feng XUE ; Wen-Yu SHI ; Ya-Ping ZHANG
Journal of Experimental Hematology 2025;33(1):82-92
OBJECTIVE:
To explore the effect of simvastatin monotherapy or in combination with doxorubicin on diffuse large B-cell lymphoma (DLBCL) cells and its possible molecular mechanisms.
METHODS:
The differences in the expression levels of genes and proteins related to the mevalonate (MVA) pathway between DLBCL tissues and reactive lymph node hyperplasia tissues were compared via database analysis, as well as their effects on the prognosis. CCK-8 assay was used to detect the effect of simvastatin and doxorubicin on the viability of different subtypes of DLBCL cells, EdU was used to detect cell proliferation, flow cytometry was used to detect apoptosis, and Western blot was used to detect related protein and signaling pathway proteins.
RESULTS:
The expression levels of MVA pathway-related genes were increased in tumor tissues of DLBCL patients through the TCGA database, and the median overall survival time of DLBCL patients in HMGCR high expression group was shorter (all P < 0.05). Meanwhile, according to The Human Protein Atlas database, HMGCR protein was significantly high expressed in DLBCL tumor tissue compared with normal tissue. The viability of DLBCL cell lines treated with simvastatin or doxorubicin monotherapy was decreased in time- and concentration-dependent manner, and could be further inhibited by simvastatin combined with doxorubicin especially in GCB subtype cell lines. Both simvastatin and doxorubicin could inhibit the proliferation of DLBCL cell lines, and their combination further suppressed dramatically. Both the two drugs promoted apoptosis in DLBCL cell lines, and the apoptosis was further increased after their combination. Compared with monotherapy, the expression of HMGCR protein and apoptosis-related protein Bcl-2 was further decreased but cleaved-caspase3 and Bax increased after combination therapy. Meanwhile, the expression level of phosphorylated proteins in PI3K-Akt pro-survival signaling pathway were decreased especially in GCB subtype cell lines.
CONCLUSION
HMGCR, the protein associated with cholesterol synthesis pathway, is highly expressed in DLBCL tumor tissues and indicates poor prognosis. Simvastatin, a lipid-lowering drug, combined with doxorubicin can further affect the survival of DLBCL tumor cells at the cellular level.
Humans
;
Lymphoma, Large B-Cell, Diffuse/metabolism*
;
Doxorubicin/pharmacology*
;
Simvastatin/pharmacology*
;
Apoptosis/drug effects*
;
Cell Proliferation/drug effects*
;
Signal Transduction
;
Cell Line, Tumor
;
Hydroxymethylglutaryl CoA Reductases/metabolism*
9.Effect of Huayu Tongluo moxibustion on learning-memory ability in rats with vascular dementia based on hippocampal Mst1/NF-κB p65 pathway.
Ping WANG ; Jun YANG ; Yu KONG ; Yating ZHANG ; Yinqiu FAN ; Haiping SHI ; Lanying LIU
Chinese Acupuncture & Moxibustion 2025;45(1):53-60
OBJECTIVE:
To observe the effects of Huayu Tongluo (transforming stasis and unblocking collaterals) moxibustion on learning-memory ability and hippocampal mammalian sterile 20-like kinase 1 (Mst1)/nuclear factor κB (NF-κB) p65 pathway related to inflammatory response in rats with vascular dementia (VD).
METHODS:
A total of 60 male Wistar rats of SPF grade were randomly divided into a sham operation group (12 rats) and a modeling group (48 rats). VD model was established by the method of modified bilateral common carotid artery permanent ligation in the modeling group. Thirty-six rats with successful modeling were randomly divided into a model group, a moxibustion group and a western medication group, with 12 rats in each group. Huayu Tongluo moxibustion was applied at "Dazhui" (GV14), "Baihui" (GV20) and "Shenting" (GV24) in the moxibustion group, 20 min each time, once a day, 7 day-intervention was as one course, and 1 day-interval was taken between two courses, for a total of 3 courses. In the western medication group, piracetam was given 0.72 mg/kg by intragastric administration, twice a day, the course of intervention was same as that of the moxibustion group. The learning-memory ability was detected by Morris water maze test; the morphology of hippocampal CA1 region was observed by HE staining; the mRNA expression of Mst1, M1 microglia markers CD86, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) was detected by real-time PCR; the levels of IL-6 and TNF-α in hippocampus were detected by ELISA; and the protein expression of Mst1 and NF-κB p65 in hippocampus was detected by Western blot in rats of each group.
RESULTS:
Compared with the sham operation group, the escape latency was prolonged in the model group (P<0.05); compared with the model group, the escape latency was shortened in the moxibustion group and the western medication group (P<0.05). The cells in the CA1 region of hippocampus were disordered, cell collapse and irregular nuclei could be observed in the model group; compared with the model group, the cell arrangement in the CA1 region of hippocampus was more regular, and the damage was improved in the moxibustion group and the western medication group. Compared with the sham operation group, the mRNA expression of Mst1, CD86, IL-6 and TNF-α, as well as the protein expression of Mst1, NF-κB p65 in hippocampus were increased in the model group (P<0.05). Compared with the model group, the mRNA expression of Mst1, CD86, IL-6 and TNF-α, as well as the protein expression of Mst1, NF-κB p65 in hippocampus were decreased in the moxibustion group and the western medication group (P<0.05). Compared with the sham operation group, the levels of IL-6 and TNF-α in hippocampus were increased in the model group (P<0.05). Compared with the model group, the levels of IL-6 and TNF-α in hippocampus were decreased in the moxibustion group and the western medication group (P<0.05).
CONCLUSION
Huayu Tongluo moxibustion can improve the learning-memory ability of VD rats, the mechanism may be related to regulating the activation of microglia through Mst1/NF-κB p65 pathway, reducing the release of pro-inflammatory factors i.e. IL-6 and TNF-α, so as to alleviating the damage of inflammatory factors in the hippocampus of VD rats.
Animals
;
Male
;
Rats
;
Moxibustion
;
Hippocampus/metabolism*
;
Rats, Wistar
;
Dementia, Vascular/genetics*
;
Memory/drug effects*
;
Humans
;
Transcription Factor RelA/genetics*
;
Learning
;
Protein Serine-Threonine Kinases/genetics*
;
Acupuncture Points
;
Interleukin-6/genetics*
;
Signal Transduction/drug effects*
;
Drugs, Chinese Herbal
10.Inhibition of interferon regulatory factor 4 orchestrates T cell dysfunction, extending mouse cardiac allograft survival.
Wenjia YUAN ; Hedong ZHANG ; Longkai PENG ; Chao CHEN ; Chen FENG ; Zhouqi TANG ; Pengcheng CUI ; Yaguang LI ; Tengfang LI ; Xia QIU ; Yan CUI ; Yinqi ZENG ; Jiadi LUO ; Xubiao XIE ; Yong GUO ; Xin JIANG ; Helong DAI
Chinese Medical Journal 2025;138(10):1202-1212
BACKGROUND:
T cell dysfunction, which includes exhaustion, anergy, and senescence, is a distinct T cell differentiation state that occurs after antigen exposure. Although T cell dysfunction has been a cornerstone of cancer immunotherapy, its potential in transplant research, while not yet as extensively explored, is attracting growing interest. Interferon regulatory factor 4 (IRF4) has been shown to play a pivotal role in inducing T cell dysfunction.
METHODS:
A novel ultra-low-dose combination of Trametinib and Rapamycin, targeting IRF4 inhibition, was employed to investigate T cell proliferation, apoptosis, cytokine secretion, expression of T-cell dysfunction-associated molecules, effects of mitogen-activated protein kinase (MAPK) and mammalian target of rapamycin (mTOR) signaling pathways, and allograft survival in both in vitro and BALB/c to C57BL/6 mouse cardiac transplantation models.
RESULTS:
In vitro , blockade of IRF4 in T cells effectively inhibited T cell proliferation, increased apoptosis, and significantly upregulated the expression of programmed cell death protein 1 (PD-1), Helios, CD160, and cytotoxic T lymphocyte-associated antigen (CTLA-4), markers of T cell dysfunction. Furthermore, it suppressed the secretion of pro-inflammatory cytokines interferon (IFN)-γ and interleukin (IL)-17. Combining ultra-low-dose Trametinib (0.1 mg·kg -1 ·day -1 ) and Rapamycin (0.1 mg·kg -1 ·day -1 ) demonstrably extended graft survival, with 4 out of 5 mice exceeding 100 days post-transplantation. Moreover, analysis of grafts at day 7 confirmed sustained IFN regulatory factor 4 (IRF4) inhibition, enhanced PD-1 expression, and suppressed IFN-γ secretion, reinforcing the in vivo efficacy of this IRF4-targeting approach. The combination of Trametinib and Rapamycin synergistically inhibited the MAPK and mTOR signaling network, leading to a more pronounced suppression of IRF4 expression.
CONCLUSIONS
Targeting IRF4, a key regulator of T cell dysfunction, presents a promising avenue for inducing transplant immune tolerance. In this study, we demonstrate that a novel ultra-low-dose combination of Trametinib and Rapamycin synergistically suppresses the MAPK and mTOR signaling network, leading to profound IRF4 inhibition, promoting allograft acceptance, and offering a potential new therapeutic strategy for improved transplant outcomes. However, further research is necessary to elucidate the underlying pharmacological mechanisms and facilitate translation to clinical practice.
Animals
;
Mice
;
Mice, Inbred BALB C
;
Mice, Inbred C57BL
;
Interferon Regulatory Factors/metabolism*
;
Heart Transplantation/methods*
;
T-Lymphocytes/immunology*
;
Sirolimus/therapeutic use*
;
Pyridones/therapeutic use*
;
Graft Survival/drug effects*
;
Pyrimidinones/therapeutic use*
;
Cell Proliferation/drug effects*
;
Apoptosis/drug effects*
;
Male
;
Signal Transduction/drug effects*

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