Objective To investigate the potential role and underlying mechanisms of Pleckstrin homology-like Domain,Family A,Member 1(PHLDA1)in ischemic cardiomyopathy(ICM).Methods In this study,male Balb/C mice were administered control AAV9-U6 and AAV9-U6-shPHLDA1 vectors via tail vein injec-tion.Two weeks later,mice were randomly divided into four groups:two groups underwent coronary artery ligation to induce an acute myocardial infarction(MI)model,while the other two groups underwent sham sur-gery.Protein expression levels were assessed using Western blotting,immunofluorescence,and real-time fluo-rescence quantitative PCR(qPCR).Myocardial morphology and cardiac fibrosis progression were evaluated through immunohistochemistry and Masson staining.Results The results of immunoblotting and immunoflu-orescence experiments showed that PHLDA1 expression was elevated in the myocardial tissue of the construc-ted MI mouse model.Inhibiting the expression of PHLDA1 in the MI mouse model could significantly improve its survival rate.Immunohistochemical and Masson staining results showed that the cardiac outcome of MI mice was negatively correlated with PHLDA1 expression(P<0.05).In the MI model,inhibiting the expres-sion of PHLDA1 could promote the phosphorylation of phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)in myocardial tissue.Overexpression of PHLDA1 significantly inhibited the phosphorylation of PI3K/Akt in myocardial tissue.Conclusion PHLDA1 plays an important role in improving the cardiac outcomes of ICM,and inhibiting PHLDA1 expression can alleviate ischemic cardiomyopathy by promoting PI3K/Akt phos-phorylation.

OBJECTIVE: To analyze the clinical phenotype and genetic basis of four children with CHARGE syndrome. METHODS: A retrospective analysis was conducted on four children diagnosed with CHARGE syndrome at Xiamen Children's Hospital from May 2019 to May 2025. Peripheral venous blood samples were collected from the children and their parents and subjected to trio-whole exome sequencing. Candidate variants were verified by Sanger sequencing. Online tools were used for the conservation analysis and protein structure prediction. This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2024-126). RESULTS: The four children have included two neonates, one infant and one child, with their age at the initial diagnosis ranging from 16 days after birth to 11 years old. Their initial manifestations were not typical of CHARGE syndrome. All children were found to harbor missense variants of the CHD7 gene, including c.3059T>C (p.L1020S), c.3302G>A (p.C1101Y), c.5879C>T (p.S1960F) and c.8093C>T (p.S2698L). Sanger sequencing confirmed that two were de novo variants, and two were inherited from their parents. In child 1, the leucine at position 1020 was highly conserved, and the p.L1020S variant did not alter the spatial structure and hydrogen bond connections of the CHD7 protein, though the shape of the binding cavity and the number and distribution of binding probe clusters have changed. In child 4, an unreported variant in the epilepsy gene SCN9A (c.2152T>C, p.Y718H) was detected, along with bilateral lower limb deformities. Literature review suggested that missense variants of the CHD7 gene were most common (32.1%) among the Chinese population, whilst nonsense variants had the highest lethality rate (41.2%) in neonates. CONCLUSION Variants of the CHD7 gene probably underlay the pathogenesis in the four children. Changes in the binding sites and binding cavity morphology play an important role in CHARGE syndrome. The types of genetic variants in CHARGE patients may vary between different regions and races.
Humans ; CHARGE Syndrome/genetics* ; Male ; Female ; Child ; Infant ; Infant, Newborn ; DNA Helicases/genetics* ; DNA-Binding Proteins/chemistry* ; Mutation, Missense ; Retrospective Studies ; Child, Preschool ; Exome Sequencing ; Phenotype