1.The dopamine dilemma: Exogenous L-DOPA or rare dopaminoma?
Amal Hanani Abdul Halim ; Farhi Ain Jamaluddin
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):22-23
Introduction:
Dopaminomas or dopamine-secreting pheochromocytomas
are rare neuroendocrine tumors that frequently lack the
classic paroxysmal symptoms of catecholamine excess
(headache, sweating, palpitation). Diagnosing these tumors
is exceptionally challenging when biochemical markers—
specifically markedly elevated urinary dopamine—are
interpreted in patients receiving exogenous Levodopa
(L-DOPA) therapy, as the intake obscures clinical
significance.
Case:
A 76-year-old male with ischemic heart disease, stage 4
chronic kidney disease, and new-onset hypertension was
admitted for acute cholecystitis. Imaging studies incidentally revealed bilateral adrenal masses and demonstrated
lipid-rich characteristics upon further evaluation with
computed tomography (CT) adrenal washout. Biochemical
evaluation revealed extreme elevations in 24-hour urinary
dopamine (47,534 nmol/24 hours; normal <3,237) and
3-methoxytyramine (18.93 µmol/24 hours; normal <2.60),
whereas downstream urinary noradrenaline (5.0 nmol/24
hours; normal 71.5–505.3), adrenaline (4.0 nmol/24 hours;
normal 9.2–122.3), normetanephrine (0.22 µmol/24 hours;
normal 0.88–2.88), and metanephrine (0.25 µmol/24 hours;
normal 0.33–1.53) levels were all significantly below their
respective reference ranges. The diagnosis was complicated
by the patient’s concurrent use of L-DOPA/Benserazide
for flupentixol-induced parkinsonism. L-DOPA is a direct
precursor to dopamine; its administration can cause
massive, false-positive elevations in urinary dopamine,
mimicking a dopaminoma’s biochemical signature.
However, the unique combination of profoundly high
dopamine alongside suppressed downstream catecholamines and metanephrines suggested a true dopaminesecreting tumor—potentially secondary to dopamine
beta-hydroxylase (DBH) deficiency—rather than drug
interference.
Conclusion
This case illustrates the profound difficulty in diagnosing
dopaminoma when exogenous L-DOPA therapy creates a
near-identical biochemical profile. The diagnostic dilemma
is further amplified by vague symptomatology, multiple
comorbidities, and non-suggestive imaging. However,
the finding of isolated dopamine hypersecretion with
suppressed metanephrines serves as a critical clinical clue.
This pattern points toward an intratumoral biosynthetic
defect rather than drug interference. Clinicians must
maintain a high index of suspicion and perform meticulous
biochemical fractionation to identify these rare, dopamineisolated secreting tumors.
Dopamine
;
Levodopa
2.Clinical features of dyskinesis and related risk factors in female patients with Parkinson disease
Journal of Apoplexy and Nervous Diseases 2025;42(2):109-114
Objective To investigate the clinical features of dyskinesia and related risk factors in female patients with Parkinson disease (PD). Methods A cross-sectional study was conducted among the female patients who met the diagnostic criteria for PD at the outpatient service of PD in Aerospace Center Hospital, and demographic data and clinical data were collected and compared between groups, including levodopa equivalent daily dose (LEDD), Unified Parkinson’s Disease Rating Scale-Ⅲ(UPDRS-Ⅲ), UPDRS-Ⅳ, scores of non-motor symptoms (cognition and depression), presence or absence of dyskinesia, and single levodopa dose (LD) during the onset of dyskinesia. A binary logistic regression analysis was used to investigate the influencing factors for dyskinesia in female patients with PD. Results A total of 146 female PD patients were enrolled, among whom 30 patients had dyskinesia, with an incidence rate of 20.5%. Compared with the non-dyskinesia group in terms of clinical features, the dyskinesia group had a significantly younger age of onset [(54.3±12.5) years vs (62.7±10.0) years, P<0.001], a significantly longer disease duration [(9.9±3.7) years vs (4.5±3.7) years, P<0.001], a significantly higher severity of disease [H-Y stage: (2.65±0.58) vs (2.35±0.83), P=0.03], a significantly longer duration of LD administration [(7.5±3.2) years vs (3.2±2.6) years, P<0.001], a significantly higher LEDD [(703.2±203.9) mg vs (442.1±226.3) mg, P<0.001], and significantly lower body weight [(54.1±8.2) kg vs (60.0±8.7) kg, P=0.001] and BMI [(20.9±3.1) kg/m2 vs (23.4±3.1) kg/m2, P<0.001]. The multivariate logistic regression analysis showed that high BMI (OR=0.770, P=0.005) was a protective factor against dyskinesia in female PD patients, while long disease duration (OR=1.304, P=0.001) and high LEDD (OR=1.003, P=0.012) were risk factors for dyskinesia. Conclusion There is a relatively high incidence rate of dyskinesia in female PD patients, which should be taken seriously in clinical practice, and high BMI is a protective factor, while long disease duration and high LEDD are risk factors for dyskinesia in female PD patients.
Parkinson Disease
;
Dyskinesias
;
Levodopa
3.Impact of tyrosine phosphorylation site mutation in FUNDC1 protein on mitophagy in H9c2 cardiomyocytes.
Zhaoyang ZHANG ; Yanli YU ; Jieyun WU ; Wei TIAN ; Jingman XU
Chinese Journal of Cellular and Molecular Immunology 2025;41(7):629-636
Objective To investigate the effect of FUNDC1 tyrosine phosphorylation site mutations on mitophagy in H9c2 myocardial cells by constructing tyrosine site mutant plasmids (Y11 and Y18) of the FUN14 domain-containing protein 1 (FUNDC1). Methods The mutant plasmids constructed by whole-gene synthesis were transfected into rat myocardial H9c2 cells and divided into five groups: empty plasmid group, FUNDC1 overexpression group, Y11 mutant group, Y18 mutant group, and Y11 combined with Y18 mutant group. The viability of H9c2 cells was assessed using the CCK-8 assay. Additionally, tetramethylrhodamine ethyl ester (TMRE) staining was utilized to detect mitochondrial membrane potential. The protein expression levels of FUNDC1, translocase of the outer mitochondrial membrane 20 (TOM20), and cytochrome c oxidase IV (COX IV) were detected by Western blot analysis. Confocal microscopy was used to evaluate transfection efficiency as well as the co-localization of mitochondria and lysosomes. Results The FUNDC1 overexpression, Y11, Y18, and Y11 combined with Y18 mutant plasmids were successfully constructed. After plasmid transfection, widespread GFP fluorescence expression was observed under confocal microscopy. Compared with the empty plasmid group, FUNDC1 protein expression levels were significantly increased in the FUNDC1 overexpression group, Y11 mutation group, Y18 mutation group, and Y11 combined with Y18 mutation group, while cell viability and mitochondrial membrane potential showed no significant changes. Compared to the empty plasmid group, cells transfected with Y18 and Y11 combined with Y18 mutant plasmids showed increased TOM20 and COX IV expression levels and decreased mitochondrial-lysosomal co-localization. Conclusion Transfection with FUNDC1 Y18 or Y11 combined with Y18 mutant plasmids inhibited mitophagy in H9c2 myocardial cells.
Animals
;
Rats
;
Mitophagy/genetics*
;
Myocytes, Cardiac/cytology*
;
Mitochondrial Proteins/metabolism*
;
Mutation
;
Phosphorylation
;
Tyrosine/genetics*
;
Cell Line
;
Membrane Proteins/metabolism*
;
Membrane Potential, Mitochondrial
4.Clinical and genetic features of 5 neonates with centronuclear myopathy caused by MTM1 gene variation.
Tian XIE ; Jia-Jing GE ; Zi-Ming ZHANG ; Ding-Wen WU ; Yan-Ping XU ; Li-Ping SHI ; Xiao-Lu MA ; Zheng CHEN
Chinese Journal of Contemporary Pediatrics 2025;27(9):1071-1075
OBJECTIVES:
To study clinical manifestations and gene mutation features of neonates with centronuclear myopathy.
METHODS:
A retrospective analysis was conducted on the medical data of 5 neonates with centronuclear myopathy diagnosed in the Neonatal Intensive Care Unit of Children's Hospital, Zhejiang University School of Medicine from January 2020 to August 2024. The data included gender, gestational age, birth weight, Apgar score, clinical manifestations, creatine kinase level, electromyography, genetic testing results and the outcomes of the infants.
RESULTS:
All 5 male neonates had a history of postpartum asphyxia and resuscitation. They all presented with hypotonia, myasthenia, and respiratory failure; two neonates also had swallowing dysfunction. Of the five neonates, three had normal creatine kinase levels, while two had slightly elevated levels. Electromyography was performed for three neonates, among whom two had myogenic damage. MTM1 gene mutations were identified by genetic testing in all five neonates, including two nonsense mutations and three missense mutations, among which one variant had not been previously reported. Four mutations were inherited from the mother, and the other one was a de novo mutation. The five neonates showed no clinical improvement following treatment, failed weaning from mechanical ventilation, and ultimately died after withdrawal of life-sustaining therapy.
CONCLUSIONS
Centronuclear myopathy caused by MTM1 gene mutation often has a severe phenotype and a poor prognosis, and it should be considered for neonates with hypotonia and myasthenia after birth. Genetic testing should be performed as soon as possible.
Humans
;
Myopathies, Structural, Congenital/genetics*
;
Male
;
Infant, Newborn
;
Retrospective Studies
;
Mutation
;
Female
;
Protein Tyrosine Phosphatases, Non-Receptor/genetics*
5.Mechanism of DYRK1A in Cytarabine Resistance in Acute Myeloid Leukemia.
Journal of Experimental Hematology 2025;33(3):648-652
OBJECTIVE:
To investigate the role of DYRK1A in the cytarabine (Ara-C) resistance mechanism of acute myeloid leukemia (AML) cells.
METHODS:
Overexpression and silencing of DYRK1A gene in THP-1 cells were used to observe whether the sensitivity of THP-1 cells to Ara-C was altered. RT-PCR was used to detect the changes in mRNA expression of related genes during Ara-C transport or metabolism. Western blot and RT-PCR were used to detect SAMHD1 expression after regulating DYRK1A expression in Ara-C treated cells. Co-IP technology was used to detect the interaction between Cyclin L2, DYRK1A, and SAMHD1.
RESULTS:
Overexpression of DYRK1A decreased Ara-C sensitivity in THP-1 cells while silencing DYRK1A increased it. Overexpression and silencing of DYRK1A did not affect Ara-C transport or metabolic gene expression. Overexpression of DYRK1A could increase the expression of SAMHD1 protein in cells, while silencing DYRK1A reduced SAMHD1 expression. Cyclin L2 interacted with DYRK1A and SAMHD1 in THP-1 cells.
CONCLUSION
DYRK1A is involved in Ara-C resistance in AML cells, and its mechanism may be related to increased expression of SAMHD1 by interacting with Cyclin L2.
Humans
;
Cytarabine/pharmacology*
;
Protein-Tyrosine Kinases/metabolism*
;
Leukemia, Myeloid, Acute
;
Dyrk Kinases
;
Drug Resistance, Neoplasm
;
Protein Serine-Threonine Kinases/metabolism*
;
SAM Domain and HD Domain-Containing Protein 1
;
Cell Line, Tumor
6.A Case Report of Coexistence of EGFR and ROS-1 Gene Mutations in Non-small Cell Lung Cancer.
Juan ZHAO ; Jiaofeng YU ; Ye FU ; Yan ZHAO ; Mingli ZHAO
Chinese Journal of Lung Cancer 2025;28(6):482-486
Lung cancer represents one of the most prevalent malignant tumors globally, and its treatment has entered the era of targeted therapy. The epidermal growth factor receptor (EGFR) mutation is a common type of genetic mutation in non-small cell lung cancer (NSCLC), while c-ros oncogene 1 receptor tyrosine kinase (ROS-1) fusion mutation is a rare mutation site. Currently, there are few case reports on the coexistence of EGFR and ROS-1 gene mutations. This study reports a case of NSCLC with coexisting EGFR and ROS-1 gene mutations, aiming to provide relevant treatment strategies for clinical practice.
.
Humans
;
Carcinoma, Non-Small-Cell Lung/enzymology*
;
Lung Neoplasms/enzymology*
;
ErbB Receptors/genetics*
;
Mutation
;
Protein-Tyrosine Kinases/genetics*
;
Proto-Oncogene Proteins/genetics*
;
Male
;
Middle Aged
;
Female
7.Effect of Bushen Huoxue Granule on Clearance of Pathological α-Synuclein in MPP+-Induced PC12 Cells.
Zhen-Xian LUAN ; Xiang-Lin TANG ; Fei-Ran HAO ; Min LI ; Shao-Dan LI ; Ming-Hui YANG
Chinese journal of integrative medicine 2025;31(9):830-836
OBJECTIVE:
To investigate the effects of Bushen Huoxue Granule on the ubiquitin-proteasome system (UPS) in an in vitro model of Parkinson's disease.
METHODS:
After treated with 1-methyl-4-phenylpyridinium (MPP+, 1 mmol/L) for 24 h, the cells were incubated with drug-free serum, Madopar-containing serum or Bushen Huoxue Granule-containing serum (BCS, 5%, 10%, and 20%) for another 24 h. The levels of α-synuclein (α-syn), tyrosine hydroxylase (TH) and UPS-related proteins were detected by Western blot. The expression levels of α-syn in PC12 cells were also analyzed by Western blot after treated with proteasome inhibitor MG132 and WT-α-syn plasmid transfection, respectively, as well as the alterations induced by subsequent BCS intervention. Immunocytochemistry was performed to determine the changes in α-syn phosphorylation at serine 129 (pSer129-α-syn) expression. The 20S proteasome levels were measured by enzyme-linked immunosorbnent assay.
RESULTS:
BCS (volume fraction ⩽20%) intervention could alleviate the MMP+-induced cell viability decrease (P<0.05). In the MPP+ treated cells, α-syn was up-regulated, while TH and proteins of UPS such as ubiquitin (Ub), Ub binding with Ub-activating enzyme (UBE1), Parkin and Ub C-terminal hydrolase-1 (UCHL-1) were down-regulated (P<0.05). BCS intervention could attenuate the above changes (P<0.05). The activity of BCS on blocking α-syn accumulation was weakened by MG132 (P<0.05). While α-syn level was significantly increased in cells transfected with plasmid, and reduced by BCS intervention (P<0.05). pSer129-α-syn was increased in MPP+-induced PC12 cells, whereas decreased by later BCS intervention (P<0.05). The 20S proteasome activity of MPP+-induced PC12 cells was decreased, but increased after BCS intervention (P<0.05).
CONCLUSION
BCS intervention protected UPS function, increased 20S proteasome activity, promoted pathological α-syn clearance, restored cell viability, and reversed the damage caused by MPP+ in the in vitro model of Parkinson's disease.
PC12 Cells
;
alpha-Synuclein/metabolism*
;
Rats
;
Animals
;
1-Methyl-4-phenylpyridinium/toxicity*
;
Proteasome Endopeptidase Complex/metabolism*
;
Drugs, Chinese Herbal/pharmacology*
;
Ubiquitin/metabolism*
;
Cell Survival/drug effects*
;
Phosphorylation/drug effects*
;
Tyrosine 3-Monooxygenase/metabolism*
8.Inhibitory Effects of Nardostachys Jatamansi DC. Volatile Oil on Psychological Factors SP/CORT-Induced Hyperpigmentation.
Man YANG ; Kang CHENG ; Jie GU ; Hua-Li WU ; Yi-Ming LI
Chinese journal of integrative medicine 2025;31(12):1097-1104
OBJECTIVE:
To explore the inhibitory effects of Nardostachys Jatamansi DC. volatile oil (NJVO) on psychological factors substance P (SP)/cortisol (CORT)-induced hyperpigmentation.
METHODS:
The model of psychologically-induced hyperpigmentation of B16F10 cells was created using SP (10 nmol/L) + CORT (10 µmol/L) for 72 h. The levels of melanin content, tyrosinase (TYR) activity using NaOH lysis and L-dihydroxyphenylalanine (L-DOPA) oxidation methods were assessed, respectively. The effect of NJVO on SP/CORT-induced normal human skin tissue pigmentation was detected by Masson staining. Protein expressions of tyrosinase-related protein 1 (TRP-1), tyrosinase-relative protein 2 (DCT), and microphthalmia-associated transcription factor were determined using Western blot. The melanosome number, maturation, and melanosomal structure changes were detected through transmission electron microscopy and immunofluorescence experiments. In vivo, zebrafish pigment content was evaluated in SP/CORT-induced zebrafish hyperpigmentation model.
RESULTS:
NJVO significantly reduced the melanin content (P<0.01) and inhibited tyrosinase activity (P<0.01), the pigmentation of the normal skin tissue in the NJVO group was significantly lower than that in the SP/CORT group (P<0.05). And NJVO considerably downregulated expressions of melanogenesis-related proteins (TYR, TRP-1, DCT) in cells (P<0.01). In addition, the number of melanosomes was decreased and the dentrites formation of B16F10 cells was inhibited after NJVO treatment (P<0.01). In vivo, NJVO significantly reduced the pigment content in the zebrafish body (P<0.01).
CONCLUSION
NJVO effectively reversed SP/CORT-induced hyperpigmentation by suppressing the activity and expression of TYR and TRPs and inhibiting melanosome maturation in mouse B16F10 melanoma cells.
Animals
;
Hyperpigmentation/psychology*
;
Zebrafish
;
Oils, Volatile/therapeutic use*
;
Melanins/metabolism*
;
Humans
;
Monophenol Monooxygenase/metabolism*
;
Mice
;
Nardostachys/chemistry*
;
Substance P
;
Hydrocortisone
;
Skin Pigmentation/drug effects*
;
Cell Line, Tumor
;
Melanosomes/ultrastructure*
;
Microphthalmia-Associated Transcription Factor/metabolism*
;
Melanoma, Experimental
;
Oxidoreductases/metabolism*
;
Intramolecular Oxidoreductases/metabolism*
9.Targeting WEE1: a rising therapeutic strategy for hematologic malignancies.
Hao-Bo LI ; Thekra KHUSHAFA ; Chao-Ying YANG ; Li-Ming ZHU ; Xing SUN ; Ling NIE ; Jing LIU
Acta Physiologica Sinica 2025;77(5):839-854
Hematologic malignancies, including leukemia, lymphoma, and multiple myeloma, are hazardous diseases characterized by the uncontrolled proliferation of cancer cells. Dysregulated cell cycle resulting from genetic and epigenetic abnormalities constitutes one of the central events. Importantly, cyclin-dependent kinases (CDKs), complexed with their functional partner cyclins, play dominating roles in cell cycle control. Yet, efforts in translating CDK inhibitors into clinical benefits have demonstrated disappointing outcomes. Recently, mounting evidence highlights the emerging significance of WEE1 G2 checkpoint kinase (WEE1) to modulate CDK activity, and correspondingly, a variety of therapeutic inhibitors have been developed to achieve clinical benefits. Thus, WEE1 may become a promising target to modulate the abnormal cell cycle. However, its function in hematologic diseases remains poorly elucidated. In this review, focusing on hematologic malignancies, we describe the biological structure of WEE1, emphasize the latest reported function of WEE1 in the carcinogenesis, progression, as well as prognosis, and finally summarize the therapeutic strategies by targeting WEE1.
Humans
;
Protein-Tyrosine Kinases/physiology*
;
Hematologic Neoplasms/drug therapy*
;
Cell Cycle Proteins/antagonists & inhibitors*
;
Nuclear Proteins/antagonists & inhibitors*
;
Cyclin-Dependent Kinases
;
Molecular Targeted Therapy
;
Animals
10.Mechanism of Jianpi Bushen Yiqi Decoction in promoting AChR clustering and improving neuromuscular junction function in EAMG mice based on Agrin/LRP4/MuSK signaling pathway.
Jia-Hui WANG ; Ru-Ge LIU ; Han-Bin LIU ; Jia-Hao WEI ; Jie ZHANG ; Xue-Ying LIU ; Feng GAO ; Jun-Hong YANG
China Journal of Chinese Materia Medica 2025;50(15):4325-4332
This study investigated the mechanism by which Jianpi Bushen Yiqi Decoction promotes acetylcholine receptor(AChR) clustering in myasthenia gravis through the Agrin/low-density lipoprotein receptor-related protein 4(LRP4)/muscle-specific receptor tyrosine kinases(MuSK) signaling pathway. A total of 114 female C57BL/6J mice were divided into the normal group, modeling group, and solvent control group. The normal group and the solvent control group were immunized with phosphate-buffered saline(PBS), while the modeling group was established as an experimental autoimmune myasthenia gravis(EAMG) model using the murine-derived AChR-α subunit R97-116 peptide fragment. After successful modeling, the mice were randomly assigned to the model group, the low-, medium-, and high-dose Jianpi Bushen Yiqi Decoction groups, and the prednisone group. After four weeks of continuous treatment, muscle strength was assessed using Lennon scores and grip strength tests. Immunofluorescence staining was conducted on differentiated C2C12 myotubes incubated with a drug-containing serum to observe the number of AChR clusters. The integrity of AChR on myofilaments in mouse gastrocnemius muscles was further assessed by immunofluorescence staining. Hematoxylin-Eosin(HE)staining was applied to examine pathological changes in the gastrocnemius muscles of EAMG mice treated with Jianpi Bushen Yiqi Decoction. Western blot was utilized to detect the expression of key proteins in the Agrin/LRP4/MuSK signaling pathway in both C2C12 myotubes and mouse gastrocnemius muscles. The results demonstrated that compared to the model group, the prednisone group exhibited a significant decrease in the body weights of mice, whereas no significant differences in the body weights of mice were observed among the low-, medium-, and high-dose Jianpi Bushen Yiqi Decoction groups. All treatment groups showed significantly improved grip strength and Lennon scores. Additionally, the formula promoted AChR clustering on myotubes and enhanced AChR integrity in gastrocnemius myofilaments and reduced inflammatory infiltration between muscle tissue and fibrous hyperplasia. Furthermore, Jianpi Bushen Yiqi Decoction upregulated the protein expression of AChRα1, Agrin, and p-MuSK in C2C12 myotubes and increased the protein expression of AChRα1, Agrin, MuSK, p-MuSK, LRP4, and docking protein 7(Dok-7)in gastrocnemius tissue. In conclusion, Jianpi Bushen Yiqi Decoction may promote AChR clustering by targeting key proteins in the Agrin/LRP4/MuSK signaling pathway, thereby improving neuromuscular junction function and enhancing muscle strength.
Animals
;
Agrin/genetics*
;
Mice
;
Drugs, Chinese Herbal/administration & dosage*
;
Signal Transduction/drug effects*
;
Receptors, Cholinergic/genetics*
;
Female
;
Mice, Inbred C57BL
;
Receptor Protein-Tyrosine Kinases/genetics*
;
Neuromuscular Junction/metabolism*
;
Myasthenia Gravis, Autoimmune, Experimental/physiopathology*
;
Humans
;
LDL-Receptor Related Proteins


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