1.Inhibitory Effect and Mechanisms of Yupingfeng San on HMGB1-induced Angiogenesis in Liver Cancer via Modulating RAGE/MEK/ERK Signaling Pathway
Qian XU ; Wenyue HOU ; Shaomei GAO ; Yichao YAN ; Ting ZOU ; Lurong ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):1-11
ObjectiveTo investigate the inhibitory effects and mechanisms of Yupingfeng San (YPFS) on high-mobility group box protein 1 (HMGB1)-induced angiogenesis in liver cancer. MethodsAn orthotopic liver cancer model was established in 30 C57BL/6 mice. The mice were randomly divided into a model group, YPFS low-, medium-, and high-dose groups (20, 30, 40 g·kg-1, respectively), a positive control group (sorafenib, 10 mg·kg-1), and a normal control group. After 14 days of medication, tumor and adjacent tissues were harvested. Tumor inhibition rates were calculated based on tumor weight. Microvascular density was determined via immunohistochemistry. HMGB1 and vascular endothelial growth factor (VEGF) expression levels were determined using immunofluorescence. An HMGB1-induced human umbilical vein endothelial cell (HUVEC) proliferation model was established, and cell proliferation was evaluated by a methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay. HUVECs were randomly divided into a blank group, a model group (HMGB1 800 μg·L-1), along with YPFS low-, medium-, and high-dose groups (HMGB1 800 μg·L-1 + YPFS 10, 30, 50 g·L-1, respectively). HUVEC migration ability was evaluated via a scratch assay and a Trans well chamber assay. Tube formation ability was detected by a tube formation assay. Microvascular sprouting ability was evaluated by an aortic ring assay. Furthermore, RAGE/MEK1/2/ERK1/2 pathway-related protein expression in HUVECs was measured using Western blot (WB). ResultsCompared with the model group, all three doses of YPFS significantly reduced tumor weight in mice with orthotopic liver cancer (P<0.01), with inhibition rates of 31.49% ± 8.27%, 49.60% ± 3.77%, and 56.81% ± 9.70%, respectively. Also, YPFS significantly decreased microvascular density in tumor and adjacent tissues (P<0.05), as well as VEGF and HMGB1 expression levels (P<0.01). Compared with the blank group, HMGB1 promoted HUVEC proliferation, migration, tube formation, and microvascular sprouting in aortic rings (P<0.05). After YPFS administration, the HMGB1-induced proliferation rate, migration rate, number of tube formations, and microvascular sprouting in aortic rings were significantly reduced compared with the model group (P<0.01). Additionally, YPFS downregulated receptor for advanced glycation end products (RAGE), mitogen-activated protein kinase kinase 1/2 (MEK1/2), phosphorylated MEK1/2 (p-MEK1/2), extracellular signal-regulated kinase 1/2 (ERK1/2), and phosphorylated ERK1/2 (p-ERK1/2) protein expression in HMGB1-induced HUVECs (P<0.01). ConclusionYPFS exerts anti-angiogenic effects against HMGB1 induction by suppressing the RAGE/MEK/ERK signaling pathway, thereby inhibiting liver cancer tumor growth.
2.RNA binding protein LIN28B promotes chemosensitivity of colon cancer by regulating the synthesis and activity of glutathione
Ning NING ; Yeqing SONG ; Yichao YAN ; Lin CHEN ; Yankai ZHANG
Chinese Journal of General Surgery 2025;40(8):643-649
Objective:To explore the influence of LIN28B on chemosensitivity of colon cancer by regulating GSH.Methods:Functional enrichment analysis of LIN28B target genes was performed using database. The primary tumor tissues of colon cancer patients who received neoadjuvant chemotherapy at Department of Gastroenterology, Peking University International Hospital from Nov 2017 to May 2020 were collected, and their LIN28B levels were detected by immunohistochemistry. According to the tumor regression grade, they were divided into chemotherapy sensitive group and chemotherapy resistant group, and the difference of LIN28B expression between the two groups was compared. LIN28B overexpression and knockdown colon cancer cell lines were constructed, and the effect of LIN28B on the chemosensitivity of colon cancer cells was detected by MTT assay. Double luciferase reporting experiment and Western blot were used to detect the direct binding and regulation of LIN28B to mRNA of four GSH related enzymes. At the same time, the regulation of LIN28B on total GSH and reduced GSH was tested. Finally, by detecting the level of reactive oxygen species (ROS) γ-H2AX and Comet assay to analyze the potential impact of LIN28B on genomic instability.Results:GSH-related enzymes were highly enriched in LIN28B target genes. The expression of LIN28B was heterogeneous in colon cancer patients. Compared with the low expression group, the average survival time of patients with high expression of LIN28B was significantly increased [(50.2±2.9 )months vs. (31.1±4.0 )months, P=0.001], and the proportion of tumor regression grade 0-1 was significantly different (48.0% vs. 16.0%, P=0.032). The expression level of LIN28B in chemotherapy sensitive group was significantly higher than that in drug resistant group ( P<0.01). LIN28B overexpression significantly increased the chemosensitivity of HCT116 cells to 5-fluorouracil (5-Fu) and oxaliplatin (L-OPH). The synthesis and activity of GSH were further inhibited (all P<0.01). At the same time, the ROS level of LIN28B overexpression cells was significantly increased after treatment with L-OPH. The level of γ-H2AX was significantly increased, and the content of comet tail DNA was also significantly increased ( P<0.01). Conclusion:LIN28B may increase the chemosensitivity of colon cancer cells by directly inhibiting the expression of GSH related enzymes, resulting in the decrease of GSH synthesis and activity, the increase of ROS level and genomic instability.
3.A prospective randomized clinical study of folic acid in the intervention of radiation esophagitis induced by concurrent chemoradiotherapy in lung cancer
Hao ZHANG ; Yiying ZHU ; Weiwei OUYANG ; Shengfa SU ; Zhu MA ; Qingsong LI ; Yichao GENG ; Wengang YANG ; Xiaxia CHEN ; Bing LU
Chinese Journal of Radiation Oncology 2025;34(1):65-72
Objective:To investigate the efficacy of oral folic acid intervention in lung cancer patients with radiation esophagitis (RE) caused by concurrent chemoradiotherapy.Methods:In this randomized, controlled, single-center clinical trial, a total of 82 patients with stage N 2-N 3 lung cancer including small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to October 2023 were prospectively included. All enrolled patients were randomly divided into the experimental group (folic acid group) and control group according to 1 vs. 1 of simple random method, and patients in both groups were required to receive radiation therapy for lung lesions and mediastinal metastatic lymph nodes [≥2 cycles of chemotherapy were completed during the same period of radiotherapy (≥40 Gy / 20 F) or targeted drugs were given simultaneously]. The severity of RE was evaluated using the modified common terminology criteria for adverse events criteria of the National Cancer Institute in both groups weekly at the onset of radiation esophagitis symptoms and thereafter until 1 week after the end of radiotherapy. Conventional treatment of RE was delivered according to the grading criteria of the Radiation Therapy Oncology Group. Patients in the folic acid group were given with folic acid tablets 30 mg/d orally at the beginning of radiotherapy until the end of radiotherapy, while those in the control group did not receive any drug intervention. The onset time, severity and duration of RE, and changes in the severity of esophageal toxicity after conventional treatment were recorded and analyzed. Serum folate value, serum vitamin B 12 value and homocysteine value were measured before and after radiotherapy. For continuous quantitative variables, independent sample t-test or independent sample rank-sum test was used for comparison among different groups. For categorical data, Chi-square test or Fisher's exact probability method was used for comparison among different groups. Results:During the observation period, no grade 4 or above RE was reported between two groups. The incidence of grade 0, 1, 2 and 3 RE in the folic acid and control groups was 10% (4/40) and 5% (2/41), 70% (28/40) and 42% (17/41), 15% (6/40) and 51% (21/41), 5% (2/40) and 2% (1/41), respectively. The differences were not statistically significant between two groups ( P=0.456). However, the incidence of grade 0-1 RE in the folic acid group was significantly higher than that in the control group ( Z=2.72, P=0.006). The median time of RE in the folic acid group and control group was 12 d (range 7-52 d) and 15 d (range 11-56 d) after the start of radiotherapy, respectively, with no statistically significant difference ( χ2=-0.75, P=0.456). However, median duration of the individual's most severe RE was 12 d (range 4-36 d) and 21 d (range 7-38 d) in the folic acid group and control groups, respectively, and the differences were statistically significant ( χ2=2.10, P=0.039). In the folic acid group, the grades of swallowing with pain and dysphagia were significantly declined after folic acid intervention, especially at 2 weeks after the occurrence of RE ( P=0.001, P=0.002). The remission rate of RE after 1 week in the folic acid group was higher than that in the control group, and the difference was statistically significant ( χ2=7.36, P=0.012). Conclusion:Oral intake of folic acid during concurrent chemoradiotherapy for lung cancer cannot reduce the incidence of RE, but it may reduce its severity, shorten the duration of the most severe RE in individuals, and have a certain protective effect.
4.SETD1B gene related epilepsy and language delay: A case report and literature review
Xiaoli ZHANG ; Mingyue JIN ; Mengyue WANG ; Na MA ; Jinshuang GAO ; Jialin LI ; Yichao MA
Chinese Journal of Medical Genetics 2025;42(6):713-718
Objective:To explore the clinical features and genetic etiology of a child with a SETD1B gene variant causing seizures and language delay. Methods:A child with a SETD1B gene variant admitted to the Department of Pediatric Neurology at the Third Affiliated Hospital of Zhengzhou University in September 2022 was selected as the study subject. Clinical data of the child were collected, and peripheral blood samples from the child and her parents were obtained. Whole exome sequencing (WES) was performed for genetic testing, and Sanger sequencing was used for familial validation of the candidate variant. Using " SETD1B" and " epilepsy" as the Chinese and English keywords, relevant cases were retrieved from databases including CNKI, Wanfang Data, OMIM and PubMed, with the search period spanning from database inception to June 2024. Results:① The child was a 6-year-old female presenting with myoclonic seizures accompanied by global developmental delay. ② WES and Sanger sequencing revealed that the child has carried a de novo SETD1B gene variant, namely, c. 5582G>A (p.Cys1961Tyr). According to the American College of Medical Genetics and Genomics (ACMG) guidelines for sequence variant interpretation, this variant was classified as likely pathogenic (PS2+ PM2_Supporting+ PP2+ PP3). ③ The child was not controlled with effective doses of valproate, levetiracetam, or clonazepam but was successfully managed with low-dose lamotrigine. Follow-up electroencephalography showed normal results, and developmental progress gradually improved. ④ A total of 37 epilepsy cases with SETD1B gene variants were reported across six studies. The predominant seizure types included absence seizures and myoclonic absence seizures, accompanied by delayed language development. The response to pharmacological treatment was generally poor, with no statistically significant difference in incidence between males and females. Conclusion:SETD1B gene variant may induced neurological disorders with drug-resistant epilepsy and severe clinical manifestations. Lamotrigine is effective in controlling the epileptic seizures.
5.Clinical and genetic analysis of RARS2-related pontocerebellar hypoplasia
Xiaoli ZHANG ; Mengyue WANG ; Jialin LI ; Yichao MA ; Junling WANG ; Xiaoli LI ; Rui HAN ; Dan XU ; Shuang JIN ; Tianming JIA ; Shujin LI ; Xianjie HUANG ; Yueqin LI
Chinese Journal of Medical Genetics 2025;42(9):1096-1105
Objective:To analyze the clinical characteristics and genotypic changes of six children with RARS2 gene variants. Methods:The clinical data of 6 children with RARS2 gene variants diagnosed at the Third Affiliated Hospital of Zhengzhou University from January 2017 to August 2024 were collected. Genetic variants were detected using trio-whole exome sequencing. Genomic DNA was extracted from samples and subjected to high-throughput sequencing. Variants were detected and analyzed using relevant databases and software. Pathogenic variants were validated by Sanger sequencing. The protein structure encoded by a previously unreported variant was predicted using a SWISS-MODEL online server. This study was approved by the Medical Ethics Committee of the Third Affiliated Hospital of Zhengzhou University (Ethics No.: 2024-373-01). Results:Among the six children, four were males and two were females, with the most recent follow-up age ranging from 1-year-and-1-month to 7 years old. The age of onset was under 1 year in all cases. All six children exhibited seizures, including infantile spasms in three, spasms and tonic spasms in one, and focal seizures in two. One child became seizure-free for 4 ~ 5 years following Valproic acid combined with topiramate and adrenocorticotropic hormone (ACTH) pulse therapy, but subsequently experienced a relapse. Another child has remained seizure-free for nearly one year with oral sodium valproate, levetiracetam, and a " cocktail" therapy. Seizures were not controlled in the remaining four children. Pontocerebellar hypoplasia was observed on neuroimaging in two children. All six patients exhibited severe psychomotor retardation. A total of 10 RARS2 gene variants were identified, three of which were previously unreported. Conclusion:The predominant clinical features of Pontocerebellar hypoplasia associated with RARS2 gene variants include infantile onset, severe psychomotor retardation or regression, drug-resistant epilepsy, and feeding difficulties. The characteristic neuroimaging finding is pontocerebellar hypoplasia. However, its appearance may vary widely with time. The majority of affected children have a poor prognosis.
6.Effect of miR-137 on atherosclerotic vulnerable plaques in mice through targeting sex determining region Y box protein 4
Siliang HAN ; Yichao ZHANG ; Junmin XIE ; Zhe WANG ; Shaoqing SHEN ; Fanchang KONG
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(5):642-649
Objective To investigate the effect and underlying mechanism of miR-137 on athero-sclerosis(AS)plaques in apolipoprotein E(ApoE)gene knockout(ApoE)mice.Methods Sixty ApoE-/-mice were fed with high-fat diet for 12 weeks to establish an AS model.Then they were assigned into AS group,negative control group,miR-137 group,Ad negative control group,and combination group,with 12 mice in each group;Another 12 wild-type C57BL/6 mice fed with chow diet were subjected as the Control group.Fully automated biochemical analyzer was applied to detect serum lipid levels,including total cholesterol(TC),triglycerides(TG),low-density lipo-protein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C).ELISA was con-ducted to detect the levels of serum inflammatory factors,including TNF-α,IL-4,IL-6,and IL-10.HE staining was used to observe the morphological changes of mouse aortic tissue.Oil red O stai-ning was employed to observe the overall formation of aortic plaques.Immunofluorescence stai-ning was utilized to detect the expression of inducible nitric oxide synthase(iNOS)and arginase-1(Arg-1)in the aortic tissue.Real-time qPCR was applied to detect the mRNA expression of miR-137 and sex determining region Y box protein 4(SOX4)in the aorta.Results The miR-137 group has significantly lower serum levels of TG,TC,LDL-C,TNF-α and IL-6,and higher levels of HDL-C,IL-10 and IL-4 when compared with the AS group and negative control group(P<0.05).The combination treatment resulted in increased serum levels of TG,TC,LDL-C,TNF-αand IL-6,while decreased levels of HDL-C,IL-10 and IL-4 in comparison with the Ad negative control group(P<0.05).Larger aortic plaque area,more severe overall aortic plaque injury and stronger iNOS fluorescence intensity were observed in the AS group than the control group(P<0.05).Treatment of miR-137 reversed above histological changes,resulting in smaller aortic plaque area,attenuated overall aortic plaque injury,decreased iNOS fluorescence intensity,and elevated Arg-1 fluorescence intensity when compared with the AS group and negative control group(P<0.05).Compared with the Ad negative control group,the aortic plaque area,overall aortic plaque injury and iNOS fluorescence intensity were increased,while the Arg-1 fluorescence intensity was significantly decreased in the combined group(P<0.05).Double luciferase assay showed that the luciferase activity of SOX4-containing wild-type cells was significantly decreased after transfection of miR-137 mimics when compared with transfection of mimics negative control(0.37±0.05 vs 1.00±0.08,P<0.05).Conclusion Overexpression of miR-137 inhibits the activa-tion of rat sarcoma/mitogen-activated protein kinase pathway probably by down-regulating SOX4 expression,and then suppress M1 macrophage polarization and promote M2 macrophage polariza-tion,reduces inflammatory response and the formation of AS plaques.
7.Relationship of lncRNA UCA1 and miR-665 with coronary restenosis in patients with ACS after interventional therapy
Yichao ZHANG ; Siliang HAN ; Shaoqing SHEN ; Junmin XIE
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(2):140-144
Objective To investigate the correlation between the peripheral blood levels of long non-coding RNA urothelial carcinoma associated 1(lncRNA UCA1)and miR-665 with the occur-rence of coronary restenosis in patients with ACS after interventional treatment.Methods A total of 315 ACS patients admitted to the Affiliated Hospital of Hebei University from July 2022 to Ju-ly 2023 were recruited and then divided into occurrence group(62 cases)and non-occurrence group(253 cases)according to the occurrence of coronary restenosis.The expression of lncRNA UCA1 and miR-665 in peripheral blood samples was detected by real-time fluorescence quantita-tive PCR.Pearson analysis was applied to analyze the correlation between peripheral blood ln-cRNA UCA1 and miR-665 in ACS patients.Logistic regression analysis was used to identify the influencing factors for coronary restenosis in ACS patients.ROC curve was plotted to analyze the predictive value of peripheral blood lncRNA UCA1 and miR-665 for the restenosis,and their AUC values were calculated.Results The peripheral blood expression of lncRNA UCA1 was signifi-cantly higher,and that of miR-665 was obviously lower in the occurrence group than the non-occurrence group(1.28±0.22 vs 1.01±0.21,P=0.001;0.76±0.24 vs 1.01±0.22,P=0.001).Pearson analysis showed there was a negative correlation between miR-665 and lncRNA UCA1 expression levels in the ACS patients(r=-0.585,P<0.05).Multivariate logistic regression anal-ysis indicated that LncRNA UCA1 was a risk factor(OR=2.124,95%CI:1.324-3.406,P=0.002),and miR-665 was a protective factor(OR=0.765,95%CI:0.653-0.897,P=0.001)for the occurrence of coronary restenosis in ACS patients after interventional treatment.ROC curve analysis revealed that the combination of peripheral blood lncRNA UCA1 and miR-665 had the highest AUC value in predicting the occurrence of coronary restenosis,which was better than the value of single molecule(Z=2.256,P=0.024;Z=2.904,P=0.004).Conclusion Combination of peripheral blood levels of lncRNA UCA1 and miR-665 has good performance for predicting coro-nary restenosis in ACS patients after interventional therapy.
8.Preclinical study of platelet-rich plasma combined with adipose stem cell transplantation in accelerating wound healing:a systematic evaluation and meta-analysis
Li LIN ; Linxi JIAO ; Fangning YU ; Yichao MA ; Bo ZHANG ; Xuying XU
Chinese Journal of Tissue Engineering Research 2025;29(13):2753-2763
OBJECTIVE:Researches show that a combination of platelet-rich plasma and adipose-derived stem cells can accelerate the healing of skin lesions.However,systematic evidence for the combination of the two is still lacking.The purpose of this study was to assess the efficacy of a combination of two interventions in a clinical rodent skin wound model.METHODS:We searched PubMed,Embase,Cochrane,and CNKI and selected the studies of platelet-rich plasma,adipose-derived stem cell transplantation,or their combination on skin wounds in experimental animals published until July 2023.Wound healing and wound transformation growth factor β,CD31,type Ⅰ collagen,and vascular endothelial growth factor were used as indicators.RevMan 5.3 and Stata 15.0 were used to analyze the data.RESULTS:A total of 12 studies were included,of which 8 studies used rats as experimental subjects and 4 studies used mice as experimental subjects.The experimental group was treated with platelet-rich plasma combined with adipose-stem cell transplantation,and the control group was treated with platelet-rich plasma alone.The results of meta-analysis showed that the wound healing rate of the experimental group at 3,7,and 10 days after treatment was greater than that of the control group[SMD=2.65,95%CI(1.29,4.01),Z=3.81,P=0.0001;SMD=3.38,95%CI(2.47,4.30),Z=7.24,P<0.00001;SMD=2.62,95%CI(1.50,3.73),Z=4.61,P<0.00001].The wound healing time of the experimental group was shorter than that of the control group[SMD=-2.12,95%CI(-3.5,-0.74),P=0.003].The expression of transforming growth factor β,positive rate of CD31,expression of type Ⅰ collagen,and vascular endothelial growth factor in wound of experimental group were higher than those of control group[SMD=5.65,95%CI(1.22,10.08),Z=2.50,P=0.01;SMD=2.49,95%CI(1.96,3.02),Z=9.28,P<0.00001;SMD=3.44,95%CI(0.72,6.17),Z=2.48,P=0.01;SMD=2.38,95%CI(0.97,3.79),Z=3.30,P=0.0010].CONCLUSION:Our results show that platelet-rich plasma+adipose-derived stem cells combined treatment can improve the wound healing rate,shorten the wound healing time,and at the same time increase the expression of transforming growth factor β,CD31,type Ⅰ collagen,and vascular endothelial growth factor to accelerate healing.Due to the limitations of the model,more animal testing and clinical trials are needed.
9.Efficacy of artificial tiger bone powder in the treatment of knee osteoarthritis with Wnt/β-catenin pathway
Yichao WU ; Shengting ZHANG ; Ao GUO ; Cong SUI
China Modern Doctor 2025;63(16):62-68,98
Objective To explore the efficacy of artificial tiger bone powder in the treatment of knee osteoarthritis(KOA)through Wnt/β-catenin pathway.Methods Forty SD rats were divided into control group,KOA group,low-dose group and high-dose group.The KOA group,low-dose group and high-dose group were all modeled by anterior cruciate ligament transection.After modeling,high-dose and low-dose groups were treated with artificial tiger bone powder at a dose of 10g/kg and 5g/kg orally respectively.Cartilage tissue specimens of rats in each group were collected for hematoxylin-eosin staining and immunohistochemical staining,and Mankin score was conducted.The cartilage tissues of the knee joints of normal SD rats were taken for primary chondrocyte culture.After passage,they were divided into blank group(without any stimulation),interleukin-1β(IL-1β)group(incubated with 10ng/ml IL-1β for 1 day),and IL-1β+artificial tiger bone powder group(incubated with 10ng/ml IL-1β and 10μg/ml artificial tiger bone powder for 1 day).Detect the activities of related substances such as typeⅡ collagen(Col Ⅱ),matrix metalloproteinase-13(MMP-13),and β-catenin in each group.Results Compared with KOA group,after artificial tiger bone powder treatment,the degree of redness and swelling of the knee joints in rats was reduced,the range of joint motion was significantly improved,and the levels of inflammatory factors were decreased.Compared with the IL-1β group,the expression levels of Col Ⅱ protein and mRNA in IL-1β+artificial tiger bone powder group were significantly increased(P<0.05),while the expression levels of MMP-13,β-catenin protein and mRNA decreased significantly(P<0.05).After adding the Wnt agonist LiCL,the mRNA expression levels of Wnt1,β-catenin and MMP-13 increased,while the addition of the Wnt inhibitor WIF1 could reduce the mRNA expression levels of Wnt1,β-catenin and MMP-13.Conclusion Artificial tiger bone powder can inhibit the progression of KOA by regulating Wnt/β-catenin pathway.
10.SETD1B gene related epilepsy and language delay: A case report and literature review.
Xiaoli ZHANG ; Mingyue JIN ; Mengyue WANG ; Na MA ; Jinshuang GAO ; Jialin LI ; Yichao MA
Chinese Journal of Medical Genetics 2025;42(6):713-718
OBJECTIVE:
To explore the clinical features and genetic etiology of a child with a SETD1B gene variant causing seizures and language delay.
METHODS:
A child with a SETD1B gene variant admitted to the Department of Pediatric Neurology at the Third Affiliated Hospital of Zhengzhou University in September 2022 was selected as the study subject. Clinical data of the child were collected, and peripheral blood samples from the child and her parents were obtained. Whole exome sequencing (WES) was performed for genetic testing, and Sanger sequencing was used for familial validation of the candidate variant. Using "SETD1B" and "epilepsy" as the Chinese and English keywords, relevant cases were retrieved from databases including CNKI, Wanfang Data, OMIM and PubMed, with the search period spanning from database inception to June 2024.
RESULTS:
The child was a 6-year-old female presenting with myoclonic seizures accompanied by global developmental delay. WES and Sanger sequencing revealed that the child has carried a de novo SETD1B gene variant, namely c.5582G>A (p.Cys1961Tyr). According to the American College of Medical Genetics and Genomics (ACMG) guidelines for sequence variant interpretation, this variant was classified as likely pathogenic (PS2+PM2_Supporting+PP2+PP3). The child was not controlled with effective doses of valproate, levetiracetam, or clonazepam but was successfully managed with low-dose lamotrigine. Follow-up electroencephalography showed normal results, and developmental progress gradually improved. A total of 37 epilepsy cases with SETD1B gene variants were reported across six studies. The predominant seizure types included absence seizures and myoclonic absence seizures, accompanied by delayed language development. The response to pharmacological treatment was generally poor, with no significant difference in incidence between males and females.
CONCLUSION
SETD1B gene variants may cause neurological disorders with drug-resistant epilepsy and severe clinical manifestations. Lamotrigine is effective in controlling the epileptic seizures.
Humans
;
Female
;
Child
;
Epilepsy/genetics*
;
Language Development Disorders/genetics*
;
Histone-Lysine N-Methyltransferase/genetics*
;
Exome Sequencing
;
Male

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