1.Salvianolic Acid F Regulates Bax/Caspase-3/GSDME Signaling Pathway to Inhibit Pyroptosis of HK-2 Cells
Xiancong SHI ; Zhishen XIE ; Liang ZHAO ; Jiajun WANG ; Yafei DUAN ; Pan WANG ; Zhenqiang ZHANG ; Xiaowei ZHANG ; Jiangyan XU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(9):56-64
ObjectiveTo investigate the mechanism of salvianolic acid F (Sal F) in repairing the high glucose-induced injury in human kidney-2 (HK-2) cells via the B-cell lymphoma-2 (Bcl-2)-associated X protein (Bax)/cysteinyl aspartate-specific proteinase 3 (Caspase-3)/gasdermin-E (GSDME) pathway. MethodThe cell counting kit-8 (CCK-8) was used to measure the relative viability of HK-2 cells exposed to high glucose and different concentrations (2.5, 5, 10, 20 μmol·L-1) of Sal F and the relative viability of HK-2 cells treated with Sal F for different time periods. The levels of lactate dehydrogenase (LDH) and interleukin-1β (IL-1β) in the supernatant of the cell culture were measured by the LDH assay kit and enzyme-linked immunosorbent assay (ELISA) kit, respectively. Flow cytometry combined with Annexin V-FITC/propidium iodide (PI) and Hoechst 33342/PI staining was employed to reveal the proportion of PI-positive HK-2 cells exposed to high glucose. Western blotting was employed to determine the protein levels of Bax, Bcl-2, cytochrome C, cysteinyl aspartate-specific proteinase (Caspase)-9, Caspase-3, and GSDME in the HK-2 cells exposed to high glucose and treated with Sal F. The 2,7-dichlorodihydrofluorescein diacetate fluorescence probe (DCFH-DA) and mitochondrial membrane potential assay kit (JC-1) were used to determine the production of reactive oxygen species (ROS) and the mitochondrial membrane potential in the HK-2 cells exposed to high glucose and treated with Sal F. ResultCompared with the blank group, the model group showed decreased cell viability (P<0.01), elevated levels LDH and IL-1β, increased proportion of PI-positive cells (P<0.01), up-regulated protein levels of Bax, cytochrome C, Caspase-9, Caspase-3, and GSDME (P<0.01), down-regulated protein level of Bcl-2 (P<0.01), decreased mitochondrial membrane potential, and excessive ROS accumulation. Compared with the model group, Sal F repaired the high glucose-induced injury in HK-2 cells (P<0.05), lowered the levels of LDH and IL-1β (P<0.05, P<0.01), and decreased the proportion of PI-positive cells (P<0.01). In addition, Sal F down-regulated the protein levels of Bax, cytochrome C, Caspase-9, Caspase-3, and GSDME and up-regulated the protein level of Bcl-2 (P<0.05, P<0.01), increased the mitochondrial membrane potential, and decreased the accumulation of ROS in HK-2 cells. ConclusionSal F can reduce the production of ROS, restore the balance of mitochondrial membrane potential, and inhibit pyroptosis via the Bax/Caspase-3/GSDME signaling pathway to repair the high glucose-induced injury in HK-2 cells.
2.Mechanism of Yishen Tongluo Prescription in Inhibiting Endoplasmic Reticulum Stress and Improving Apoptosis of Renal Tubular Epithelial Cells Based on PERK/ATF4/CHOP
Xuan SU ; Liang ZHAO ; Mengmeng WANG ; Jing DING ; Zhenqiang ZHANG ; Xiaowei ZHANG ; Jiangyan XU ; Zhishen XIE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(2):26-36
ObjectiveTo investigate the effect of Yishen Tongluo prescription (YSTLP) on apoptosis of renal tubular epithelial cells and explore the mechanism based on endoplasmic reticulum stress pathway of protein kinase R-like endoplasmic reticulum kinase (PERK)/activating transcription factor 4 (ATF4)/transcription factor C/EBP homologous protein (CHOP). MethodThe db/db mice were randomly divided into model group, valsartan group (10 mg·kg-1), and low, middle, high-dose YSTLP groups (1, 2.5, 5 g·kg-1). Samples were collected after eight weeks of drug intervention. In addition, db/m mice in the same litter served as the control group. Human renal tubular epithelial cells (HK-2) were cultured in vitro and divided into the control group, advanced glycated end-product (AGE) group, and AGE + low, middle, and high-dose YSTLP groups (100, 200, 400 mg·L-1). TdT-mediated dUTP nick end labeling (TUNEL) staining was used to detect the apoptosis rate of HK-2 cells. Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay was conducted to detect the viability of HK-2 cells. Calcium fluorescence probe staining and luciferase reporter gene method were adopted to detect the luciferase activity of folded protein response element (UPRE) and endoplasmic reticulum stress. Immunohistochemical (IHC) analysis was carried out to measure the protein expressions of phosphorylated PKR (p-PERK), CHOP, and ATF4. Real-time polymerase chain reaction (Real-time PCR) was used to measure the mRNA expression levels of CHOP and X-box binding protein 1 (XBP1) in mouse kidney and HK-2 cells. Western blot was used to detect the protein expression level of p-PERK, PERK, CHOP, ATF4, B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), and cleaved Caspase-3 in mouse kidney and HK-2 cells. ResultIn the cellular assay, HK-2 cell viability was significantly reduced, and the apoptosis rate was elevated in the AGE group compared with the control group (P<0.01). The mRNA and protein expression levels of apoptosis-related factor Bcl-2 were significantly reduced (P<0.01), and those of Bax were significantly increased (P<0.01). The protein expression level of cleaved Caspase-3 was significantly increased (P<0.01). Compared with the AGE group, YSTLP administration treatment resulted in elevated cell viability and reduced apoptosis rate (P<0.01). The mRNA and protein expression levels of Bcl-2 were significantly elevated in a time- and dose-dependent manner (P<0.01), and those of Bax were significantly reduced in a time- and dose-dependent manner. The protein expression level of cleaved Caspase-3 was significantly reduced in a time- and dose-dependent manner (P<0.01). The intracellular Ca2+ imbalance and UPRE luciferase fluorescence intensity were increased in the AGE group compared with the control group (P<0.01). The mRNA levels of endoplasmic reticulum stress-related factors CHOP and XBP1 were significantly increased (P<0.01), and the protein expression levels of p-PERK, CHOP, and ATF4 were significantly increased (P<0.05). Compared with the AGE group, YSTLP effectively improved intracellular Ca2+ imbalance in HK-2 cells and decreased UPRE luciferase fluorescence intensity in a dose-dependent manner (P<0.01). It reduced the mRNA levels of endoplasmic reticulum stress-related factors CHOP and XBP1 (P<0.01) and the protein expression levels of intracellular p-PERK, CHOP, and ATF4 in a dose- and time-dependent manner (P<0.01). In animal experiments, the protein expression level of Bcl-2 was significantly reduced(P<0.01), and that of cleaved Caspase-3 and Bax was significantly increased in the model group compared with the control group (P<0.05). The protein expression level of Bcl-2 was dose-dependently elevated, and that of cleaved Caspase-3 and Bax was dose-dependently decreased in the YSTLP groups compared with the model group (P<0.01). Compared with the control group, the mRNA expression levels of CHOP and XBP1 were significantly elevated in the model group (P<0.05, P<0.01), and the protein expression levels of p-PERK, CHOP, and ATF4 were significantly increased (P<0.05). Compared with the model group, YSTLP significantly decreased the mRNA expression levels of CHOP and XBP1 (P<0.01) and the protein expression levels of p-PERK, CHOP, and ATF4 (P<0.01). ConclusionYSTLP can effectively inhibit endoplasmic reticulum stress and improve apoptosis of renal tubular epithelial cells, and its mechanism may be related to the regulation of the PERK/AFT4/CHOP pathway.
3.Mechanism Exploration of TG Regulating PI3K/Akt to Improve Insulin Resistance in Liver of T2DM Rats Based on Transcriptomics
Qin LI ; Yonglin LIANG ; Xiaowei SHI ; Xuan LIU ; Xiangdong ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(2):99-109
ObjectiveTo investigate the effect of Tangzhi pills on the improvement of insulin resistance (IR) in the liver with type 2 diabetes (T2DM) by regulating phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway based on differential genes and its possible molecular mechanism. MethodT2DM rat models were prepared by high fat (HFD) diet combined with streptozotocin (STZ) intraperitoneal injection. The experiment was divided into blank group, model group, metformin hydrochloride group (0.18 g·kg-1), Tangzhi pills high (1.08 g·kg-1), medium (0.54 g·kg-1) and low (0.27 g·kg-1) dose groups. Rat serum, liver, and pancreatic tissue were collected, and the pathological tissue of the liver and pancreas was observed using hematoxylin-eosin (HE) staining. The fasting blood glucose level (FBG) was detected, and oral glucose tolerance (OGTT) tests were conducted. Enzyme-linked immunosorbent assay (ELISA) was used to detect fasting serum insulin (FINS) and glycated hemoglobin (GHb) levels in rats. IR homeostasis model index (HOMA-IR), β cellular homeostasis index (HOMA-β), and insulin sensitivity index (ISI) were calculated. Biochemical methods were used to determine the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) in rat serum. Transcriptomics obtained differentially expressed mRNA from liver tissue and enriched differentially expressed pathways. Real-time reverse transcriptase polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of cyclic adenylate responsive element binding protein 3-like protein 2 antibody (CREB3l2), B-lymphocyte tumor 2 (Bcl-2), Toll-like receptor 2 (TLR2), cyclin-dependent kinase inhibitor 1A (CDNK1A), and DNA damage induced transcription factor 4-like protein (DDIT4) in liver tissue. Western blot was used to detect the protein expression of phosphorylated phosphatidylinositol 3-kinase (p-PI3K), phosphorylated protein kinase B (p-Akt), glucose transporter 4 (GLUT4), insulin receptor (INSR), and insulin receptor substrate 2 (IRS2). ResultThe pharmacodynamic experiment results showed that compared with model group, Tangzhi pills groups repaired liver and pancreatic tissue to varying degrees, reduced blood sugar (P<0.01), and promoted a decrease in serum FINS, GHb, and HOMA-IR (P<0.05, P<0.01). In addition, HOMA-β and ISI increased (P<0.05, P<0.01). The levels of TC, TG, and LDL-C decreased (P<0.05, P<0.01), while the levels of HDL-C increased (P<0.05, P<0.01). The transcriptomics experimental results confirmed that the PI3K/Akt signaling pathway was significantly expressed in both the blank group and model group, as well as in the high-dose Tangzhi pills group and model group. CDNK1A, DDIT4, CREB3l2, Bcl-2, and TLR2 were significantly differentially expressed mRNA during TG intervention in T2DM. Compared with the model group, the protein expression of p-PI3K, p-Akt, GLUT4, INSR, and IRS2 increased in all Tangzhi pills groups (P<0.01). The mRNA expression of CREB3l2, Bcl-2, and TLR2 increased (P<0.01), while that of CDNK1A and DDIT4 decreased (P<0.01). ConclusionTangzhi pills may regulate the PI3K/Akt signaling pathway based on the differential mRNA expression of CREB3l2, Bcl-2, TLR2, CDNK1A, and DDIT4, thereby improving IR in the liver with T2DM.
4.Study on the mechanism of astragaloside Ⅰ inhibiting podocyte pyroptosis in diabetic kidney disease
Yafei DUAN ; Xiancong SHI ; Liang ZHAO ; Mingzhen LYU ; Xinqi REN ; Yulei GU ; Jiangyan XU ; Zhenqiang ZHANG ; Jinxin MIAO ; Zhishen XIE ; Xiaowei ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2024;47(10):1408-1415
Objective To investigate the mechanism of astragaloside Ⅰ,the active constituent of milkvetch root,in inhibiting podocyte injury and improving diabetic kidney disease.Methods According to the body weight,60 male db/db mice were randomly divided into the model group,astragaloside Ⅰ low-dose group(10 mg/kg),astragaloside Ⅰ medium-dose group(20 mg/kg),astragaloside Ⅰ high-dose group(40 mg/kg),and valsartan group(10mg/kg),with 12 mice per group.Twelve db/db littermate control db/m mice were used as the control group.The drug was administered by gavage for 8 weeks.Transmission electron microscope was used to observe the ultrastructure of the kidney;immunohistochemistry and Western blotting were used to detect the expression of nephrotic protein(nephrin),a marker of renal podocytes;enzyme-linked immunosorbent assay was used to detect the contents of interleukin-1β(IL-1β)and interleukin-18(IL-18)in the serum of mice;Western blotting was used to detect the protein expressions of NOD-like receptor thermoprotein domain-related protein 3(NLRP3),cysteinyl aspartate specific proteinase 1(Caspase-1),and Gasdermin D(GSDMD)in kidney tissue.Results Compared with the control group,the glomeruli of the model group showed obvious podocyte loss and foot process fusion;the protein expression of nephrin was decreased(P<0.05);the contents of IL-1 β and IL-18 in serum were increased(P<0.05);the protein expressions of NLRP3,Cleaved-Caspase-1,and GSDMD-N were increased(P<0.05).Compared with the model group,the renal pathological damage in the astragaloside Ⅰ administration groups were alleviated;the protein expression of nephrin was increased(P<0.05);the contents of IL-1β and IL-18 in serum were decreased(P<0.05);the protein expressions of NLRP3,Cleaved-Caspase-1,and GSDMD-N were decreased(P<0.05).Conclusion Astragaloside Ⅰ may play a role in intervening diabetic kidney disease by inhibiting pyroptosis and improving podocyte injury.
5.A national questionnaire survey on endoscopic treatment for gastroesophageal varices in portal hypertension in China
Xing WANG ; Bing HU ; Yiling LI ; Zhijie FENG ; Yanjing GAO ; Zhining FAN ; Feng JI ; Bingrong LIU ; Jinhai WANG ; Wenhui ZHANG ; Tong DANG ; Hong XU ; Derun KONG ; Lili YUAN ; Liangbi XU ; Shengjuan HU ; Liangzhi WEN ; Ping YAO ; Yunxiao LIANG ; Xiaodong ZHOU ; Huiling XIANG ; Xiaowei LIU ; Xiaoquan HUANG ; Yinglei MIAO ; Xiaoliang ZHU ; De'an TIAN ; Feihu BAI ; Jitao SONG ; Ligang CHEN ; Yingcai MA ; Yifei HUANG ; Bin WU ; Xiaolong QI
Chinese Journal of Digestive Endoscopy 2024;41(1):43-51
Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.
6.A real-world study of first-line albumin-bound paclitaxel in the treatment of advanced pancreatic cancer in China
Juan DU ; Xin QIU ; Jiayao NI ; Qiaoli WANG ; Fan TONG ; Huizi SHA ; Yahui ZHU ; Liang QI ; Wei CAI ; Chao GAO ; Xiaowei WEI ; Minbin CHEN ; Zhuyin QIAN ; Maohuai CAI ; Min TAO ; Cailian WANG ; Guocan ZHENG ; Hua JIANG ; Anwei DAI ; Jun WU ; Minghong ZHAO ; Xiaoqin LI ; Bin LU ; Chunbin WANG ; Baorui LIU
Chinese Journal of Oncology 2024;46(11):1038-1048
Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P<0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.
7.Reflections on quarantine and supervision policies of imported experimental animals in Japan
Ning DING ; Jiaqi LIANG ; Hongkun FU ; Ying WANG ; Chunxia WANG ; Jiao REN ; Haiqiong YU ; Zhixiong LIN ; Lidan MA ; Daozhong ZHU ; Zhiqiang GAO ; Xiaowei WU ; Yufeng TAO
Chinese Journal of Comparative Medicine 2024;34(6):93-99
Japan is one of the main trading partners for the import and export of experimental animals in China,and its quarantine and supervision policies for the import and export of experimental animals are very detailed and strict.This article takes experimental dogs,cats,and monkeys as examples to provide an in-depth analysis of the quarantine and supervision policies for the main experimental animals exported to Japan.At the same time,it reflects on the current laws and regulations,import and export management method,standards,biosafety,breeding and management status,as well as the import and export business status of experimental animals in China.Suggestions are provided in improving the laws and regulations,import and export management method,ensuring national biosafety,improving the management level of experimental animal breeding,and promoting the import and export trade of experimental animals,in order to provide reference for comprehensively improving the production,use,and breeding management level of experimental animals in China and strengthening the trade between China and Japan.
8.Talaketides A-G,linear polyketides with prostate cancer cytotoxic activity from the mangrove sediment-derived fungus Talaromyces sp.SCSIO 41027
Chunmei CHEN ; Xueni WANG ; Wenxuan FANG ; Jiaqi LIANG ; Jian CAI ; Dehua YANG ; Xiaowei LUO ; Chenghai GAO ; Xiangxi YI ; Yonghong LIU ; Xuefeng ZHOU
Chinese Journal of Natural Medicines (English Ed.) 2024;22(11):1047-1056
Seven novel linear polyketides,talaketides A-G(1-7),were isolated from the rice media cultures of the mangrove sed-iment-derived fungus Talaromyces sp.SCSIO 41027.Among these,talaketides A-E(1-5)represented unprecedented unsaturated lin-ear polyketides with an epoxy ring structure.The structures,including absolute configurations of these compounds,were elucidated through detailed analyses of nuclear magnetic resonance(NMR)and high-resolution mass spectrometry(HR-MS)data,as well as elec-tronic custom distributors(ECD)calculations.In the cytotoxicity screening against prostate cancer cell lines,talaketide E(5)demon-strated a dose-dependent inhibitory effect on prostate cancer PC-3 cell lines,with an IC50 value of 14.44 μmol·L-1.Moreover,com-pound 5 significantly inhibited the cloning formation of PC-3 cell lines and arrested the cell cycle in S-phase,ultimately inducing ap-optosis.These findings indicate that compound 5 may serve as a promising lead compound for the development of a potential treat-ment for prostate cancer.
9.A real-world study of first-line albumin-bound paclitaxel in the treatment of advanced pancreatic cancer in China
Juan DU ; Xin QIU ; Jiayao NI ; Qiaoli WANG ; Fan TONG ; Huizi SHA ; Yahui ZHU ; Liang QI ; Wei CAI ; Chao GAO ; Xiaowei WEI ; Minbin CHEN ; Zhuyin QIAN ; Maohuai CAI ; Min TAO ; Cailian WANG ; Guocan ZHENG ; Hua JIANG ; Anwei DAI ; Jun WU ; Minghong ZHAO ; Xiaoqin LI ; Bin LU ; Chunbin WANG ; Baorui LIU
Chinese Journal of Oncology 2024;46(11):1038-1048
Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P<0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.
10.Progress of Basic Research on the Intervention of TCM Targeted Ferroptosis in Diabetic Nephropathy
Qin LI ; Xiankang MA ; Xiangdong ZHU ; Xiaowei SHI ; Xuan LIU ; Yonglin LIANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(6):181-186
Diabetic nephropathy(DN)is one of the most serious microangiopathies in diabetes mellitus and the leading cause of death in patients with end-stage renal disease.Ferroptosis,as a mode of programmed cell death,is mainly manifested by excessive accumulation of intracellular lipid peroxides and iron.Ferroptosis is involved in a series of pathological processes such as damage to DN renal podocytes,mesangial cells,and renal tubular epithelial cells.Chinese materia medica has the characteristics of significant therapeutic effects and minimal adverse reactions in the treatment of diseases,and has been widely used in the prevention and treatment of DN.This article summarized the key factors regulating ferroptosis in DN,as well as the active components and TCM formulas targeting the inhibition of ferroptosis in the prevention and treatment of DN,providing reference for the development of DN targeted drugs.

Result Analysis
Print
Save
E-mail