Biomedicines

BACKGROUND: Erythrophagocytosis constitutes a major pathogenic mechanism of metabolic dysfunction associated fatty liver disease (MAFLD). Our previous research established a quantitative thin-layer chromatography (TLC) technique for sphingomyelin, revealing reduced levels in the red blood cells (erythrocytes) of patients with metabolic dysfunction associated fatty liver disease (MAFLD). This reduction was accompanied by erythrocyte sphingosine accumulation, a driver of pro-inflammatory erythrophagocytosis, though sphingosine 1-phosphate release remained stable. To better understand erythrocyte sphingosine metabolism, we adapted our quantitative TLC method to analyze sphingosine within the erythrocyte-conditioned media (ECM) of MAFLD patients. Methodology Separation was performed on 10X10cm Silica gel 60 F254 plates using a mobile phase of chloroform, methanol, acetic acid, and water (60:50:1:4 v/v/v/v). The dynamic range, linearity, and range of linearity were assessed by analysing sphingosine levels from 0.1 to 10microg/spot. We validated the system precision and sensitivity by performing triplicate analyses of sphingosine standards (1.25, 2.5, and microg). The limits of detection and quantification were derived from the calibration curve slope and standard deviation (3.3 XSD/slope for LOD; 10 XSD/slope for LOQ). Accuracy was assessed via recovery tests at 100%, 200%, and 300% of a 2.5microg load. We confirmed specificity by evaluating the retention factors against other lipid species. This protocol was applied to Folch-extracted lipids from the ECM (5 X 107 cells/ml) of four MAFLD patients and four healthy controls, spiked with 5microg of sphingosine. Findings The calibration model, based on combined Green and Blue color intensities, followed the linear equation y = -11.171x + 353.25(R2 = 0.94). Interday precision values were 0.21%, 1.65%, and 0.44%, while recovery rates (accuracy) ranged from 94.5% to 98.7%. The measured LOD and LOQ were 0.75microg and 1.21microg, respectively. The sensitivity was calculated at 90ng. Statistical analysis showed no significant variance in sphingosine concentrations in erythrocyte-conditioned media between the MAFLD group and the control group. Summary The described thin layer chromatography is accurate, precise, sensitive, with good limits of detection and quantification, and most importantly is low-cost and time-efficient. Using this method, we show that while erythrocytes of MAFLD patients exhibit sphingosine accumulation, the utilisation of exogenous sphingosine from their erythrocytes is not affected. This suggests that the metabolic shift may be driven by increased sphingosine supply from the plasma.

Objective. Older adults undergoing cardiac surgery may be vulnerable to postoperative cognitive decline. However, no studies have examined postoperative cognitive outcomes in older patients with cardiovascular disease (CVD) according to preoperative mild cognitive impairment (MCI). This study examined 12-month postoperative cognitive outcomes in older CVD patients according to preoperative MCI diagnosis and explored predictors of postoperative cognitive decline. Method. Twenty-two older CVD patients ([≥]65 years) and twenty-five controls were included. Neuropsychological assessment was conducted at baseline in both groups and repeated 12 months after surgery in the CVD group. MCI was diagnosed using current clinical criteria. Postoperative cognitive change was examined across preoperative MCI groups. Results. Fifty percent of patients met criteria for postoperative MCI, showing high diagnostic stability relative to preoperative frequency (45.5%). The preoperative CVD-MCI group showed a decline in working memory, executive functions, visual memory, and naming, whereas CVD-nMCI group declined only in verbal memory. Furthermore, CVD-MCI showed more heterogeneous postoperative cognitive trajectories of change than CVD-nMCI, who showed stability. Estimated IQ, APACHE-II score, and postoperative frailty were important variables in predicting the postoperative pattern. Conclusions. MCI frequency remained high and stable in older CVD patients across the preoperative and one-year postoperative period. However, this apparent diagnostic stability masks subclinical cognitive decline, particularly among patients with preoperative MCI, who showed greater susceptibility to further impairment. Estimated IQ, APACHE-II score, and postoperative frailty may be considered relevant predictors of outcome. These results highlight the value of preoperative neuropsychological assessment for characterizing postoperative cognitive risk in older CVD patients.

It has been previously shown that chronic social defeat stress caused by paired agonistic interactions between male mice is accompanied by the development of depression-like state and immune deficiency. The aim of this study was to investigate changes in the expression of C1qtnf superfamily genes (encoding the complement component related with tumor necrosis factor) in the hypothalamus, thymus and lungs against the background of the Lewis lung adenocarcinoma growth. In the experiments, on the 5th day of social stress, male mice were injected with tumor cells into the tail vein. Chronic social stress continued for the next two weeks. The transcriptomes of the hypothalamus, thymus and lungs of mice were sequenced at the Genoanalytica Collective Center (http://genoanalytica.ru/, Moscow). Changes in the expression of the C1qtnf genes in the tissues of stressed mice were studied compared with the control and mice that were additionally injected with tumor cells. Overall, significant correlations were found between expression of most genes in each tissue of the experimental groups. In the hypothalamus of stressed animals, when tumor cells were introduced, an increase in the expression of the genes C1qtnf1, C1qtnf2, C1qtnf3, C1qtnf6 and C1qtnf7 was observed compared to controls. In the thymus of these animals, tumor cell injection increased expression of the C1qtnf1, C1qtnf5, and C1qtnf6 genes. In the lung of tumor-injected stressed mice, expression of the C1qtnf1, C1qtnf2, C1qtnf7, and C1qtnf9 genes was decreased relative to controls and non-tumor-injected depressed mice, reaching near-zero levels in some mice. Analysis of C1qtnf superfamily gene expression in the all tissues revealed negative correlations between the expression of the C1qtnf1, C1qtnf2, and C1qtnf7 genes in the hypothalamus and lungs indicating synchronization of processes against the background of social stress and Levis lung adenocarcinoma.

Background: Crohn's disease is a chronic relapsing inflammatory bowel disease with an unpredictable clinical course that may lead to recurrent hospitalizations and surgery, making early identification of patients at risk a key challenge in longitudinal monitoring. Objective: To evaluate the prognostic value of blood biomarkers for anticipating hospitalizations in patients with Crohn's disease by moving beyond exclusive reliance on conventional reference intervals toward the analysis of personalized biological drift. The underlying premise is that fluctuations that remain within standard reference ranges (and are therefore invisible to conventional thresholds) may still carry a risk signal when interpreted relative to an individual's optimal baseline. Design: We conducted a retrospective study of 993 patients with Crohn's disease followed at the University Hospital of Liege between 2005 and 2023. Longitudinal laboratory measurements were linked to Crohn's disease-related hospitalizations. Biomarkers were transformed into z-scores relative to optimized and personalized reference populations and classified into drift categories. Time to first hospitalization was analyzed using the Kaplan-Meier method, and recurrent hospitalizations were modeled using Cox models. Results: Hospitalization-free survival differed significantly across drift categories, including for deviations within conventional reference ranges (e.g., albumin, global log-rank p<0.0001). Among 57 biomarkers screened, 32 were significant in the global log-rank analysis, including 5 that were significant for intra-reference drift classes: low lymphocytes (%), low monocytes (%), low albumin, high potassium, and low aspartate aminotransferase. Conclusion: Personalized biomarker drift detects clinically meaningful risk signals that are missed by conventional reference-interval thresholds and may enable earlier risk stratification in Crohn's disease.

Neurodegenerative diseases are a major threat to older adults and represent a growing global health burden as the elderly population continues to expand. The complexity of neurodegenerative diseases and the incomplete understanding of their pathophysiology limit the development of effective therapeutics. To study common neurodegenerative mechanisms and accordingly potential drug targets across Alzheimers, Parkinsons, and Huntingtons diseases, transcriptomic profiles of patients with each disease were analyzed to detect common differentially expressed genes and common enriched pathways. Common differentially expressed genes involved in the shared pathways were identified as key drug targets and validated in silico to study the impact of their dysregulation. Three pathways were enriched and upregulated across the three diseases, along with 274 common differentially expressed genes. Two of the shared pathways were involved in activation of the transcription factor nuclear factor kappa B (NF-{kappa}B), indicating inflammatory signaling. The third pathway involved regulation of BCL2L11 transcription by RUNX3, which contributes to the protective effect of neurodegenerative diseases against cancer. Five key drug targets were identified: NFKBIA, NFKB1, RELA, TRIM4, and SMAD4. They were significantly upregulated across all three diseases and involved in the shared pathways. Drugs that target the expression of these genes and previously approved by Food and Drug Administration were reported for treatment repurposing for the three neurodegenerative diseases. The resultant drug list included the conventional and commonly safe antihyperlipidemics, antihypertensives, antidiabetics, analgesics, diuretics, antiparkinsons, and antipsychotics.

Hirschsprung disease (HSCR) is a congenital neurodevelopmental disorder characterized by segmental aganglionosis due to impaired developmental processes of enteric neural crest cells (NCCs). Despite being the leading genetic cause of functional intestinal obstruction in early childhood, HSCR represents a paradigmatic challenge in precision medicine: its multifactorial etiology, complex gene-environment interactions and limited resolution of single-modality analyses have long hindered mechanistic understanding and therapeutic translation. Here, we applied an integrative multi-omics approach combining genetic, phenotypic, epigenomic and transcriptomic analyses of matched ganglionic and aganglionic formalin-fixed paraffin-embedded (FFPE) patient tissues, complemented by patient-specific in vitro models. Beyond established genetic contributors, our integrative approach reveals novel regulatory pathways predominantly affecting enteric NCC differentiation, with convergent evidence pointing to epigenetic dysregulation as a primary disease mechanism. Notably, we identified over 1,300 differentially methylated positions between ganglionic and aganglionic FFPE samples, with HAND2 emerging as a key candidate due to multiple hypermethylated sites and consistently reduced expression levels in aganglionic tissues and in vitro models, suggesting a potential role in HSCR pathophysiology. We propose that our multi-omics approach offers a powerful and comprehensive framework for dissecting disease mechanisms. Beyond advancing biological understanding, this strategy holds promise for paving the way for molecularly informed patient stratification and supporting the development of personalized treatment and postoperative management strategies.

Microtubule-destabilizing agents (MDAs) and microtubule-stabilizing agents (MSAs) are commonly used chemotherapeutic agents due to its activity to induce cell death by compromising the dynamics of spindles during mitosis. Ewing sarcoma, the second most common pediatric bone cancer, is known to selectively respond to MDAs as a first-line treatment, but not to MSAs. Ewing sarcoma cells carry an aberrant EWSR1-FLI1 fusion gene and only one wildtype EWSR1 allele. To investigate the origin of this MDA sensitivity, we used an (AID-EWSR1/wt: EWSR1-FLI1-mCherry/wt) cell line that enables conditional induction of EWSR1-FLI1 expression (Tet-On system) and EWSR1 knockdown derived from one EWSR1 allele (auxin-degron system). A combination of EWSR1-FLI1 expression and EWSR1 knockdown induces apoptosis upon nocodazole treatment, a type of MDA. Our study revealed that the mitotic spindles of Ewing sarcoma cells (A673, RD-ES and SK-ES1) contain elevated levels of tubulin damage, visualized with GTP-tubulin, compared to mesenchymal stem cells (MSC). Consistently, the combination of EWSR1-FLI1 expression and EWSR1 knockdown in (AID-EWSR1/wt: EWSR1-FLI1-mCherry/wt) cell line also leads to an increased incidence of damage in mitotic spindles. Together, we propose that the sensitivity of Ewing sarcoma cells is derived from the increased levels of damage to mitotic spindles caused by EWSR1-FLI1 expression and EWSR1 knockdown.

1.Cancer-induced bone pain (CIBP) occurs in a majority of patients when primary or metastatic cancer develops within the bone. This pain has a significant impact on quality of life, yet there are limited effective treatment options available. Nerve sprouting is a complex mechanism that has been implicated in CIBP. Netrin-1 is a neuronal guidance molecule that is produced by numerous cell types, including cancer cells. In this study we aimed to determine whether netrin-1 inhibition (with NP137 - a humanized IGg1 monoclonal antibody) could ameliorate nerve sprouting, and nociception by extension, in three models of CIBP - osteosarcoma, metastatic breast cancer, and metastatic prostate cancer. Sustained administration of NP137 failed to produce an anti-nociceptive effect in these models, but a delayed onset was observed in the osteosarcoma model. NP137 did not produce a disease-modifying effect, as micro-computed tomography did not reveal reduced bone destruction in the NP137-treated groups. Additionally, there was no nerve fibre density reduction in any of the groups at the late-stage of the disease, suggesting that nerve sprouting occurs in early- to mid-stage CIBP development. Investigation of NP137 exposure indicated that serum levels of NP137 were comparable between the sham and cancer groups. Our study indicates that netrin-1 may play a role in early-stage CIBP development, but inhibition of this mechanism does not produce robust anti-nociception.

Investigating futile recanalization indicators is very important. Here, we explored plasma endothelial microvesicles (EMVs) as biomarkers for recombinant tissue plasminogen activator (rtPA)-treated acute ischemic stroke. This study prospectively enrolled 195 acute IS patients who underwent rtPA and measured plasma EMVs levels via fluorescence nanoparticle tracking analysis at baseline, 24 h and 90 days. Early futile recanalization was assessed by transcranial Doppler and the National Institutes of Health Stroke Scale. The ROC curves and corresponding areas under the curve (AUC) of the EMVs were analysed. The plasma EMVs levels at baseline and 24 h were positively related to both early and late futile recanalization. In both the late recanalization and futile recanalization groups, the plasma levels of EMVs significantly increased at 24 h but decreased at 90 days. For early futile recanalization, the baseline and 24-h EMVs AUCs were 0.7 and 0.67, respectively. For late futile recanalization, the AUCs for baseline and 24-h EMVs levels were 0.52 and 0.66, respectively. Collectively, the results imply that the plasma level of EMVs could serve as a surrogate indicator of futile recanalization (both early and late) following rtPA administration in acute IS.

Neurodegenerative diseases are complex disorders characterised by progressive neuronal loss and widespread transcriptomic dysregulation; however, the coordinated interactions among coding and non-coding RNAs that contribute to disease progression remain incompletely understood. In this study, RNA-seq datasets from disease-relevant neuronal populations and brain regions representing Alzheimer's disease (AD), Parkinson's disease (PD) and amyotrophic lateral sclerosis (ALS) were analysed using an integrative network-based framework. Differential expression analysis coupled with weighted gene co-expression network analysis identified modules significantly correlated with disease and prioritised highly connected hub genes. Integration of these hub genes with curated RNA interaction database enabled the construction of candidate lncRNA-miRNA-mRNA regulatory networks. Functional enrichment analysis revealed Gene Ontology biological processes associated with synaptic signalling, mitochondrial function, RNA metabolism and neuroinflammatory responses across neurodegenerative conditions. The inferred regulatory networks suggested both disease-specific and shared post-transcriptional regulatory modules involving key hub genes and non-coding RNAs. Additionally, putative sequence variants were identified within untranslated regions of selected hub genes, suggesting potential alterations in miRNA-mediated regulations. Therefore, this study provides a systems-level view of transcriptomic dysregulation across major neurodegenerative diseases and identifies candidate regulatory interactions and molecular targets for future functional investigation

Background: Pancreatic ductal adenocarcinoma (PDAC) is characterized by extensive molecular complexity, profound stromal remodeling, and limited responsiveness to systemic therapies. Although gemcitabine-based regimens remain widely utilized, the molecular pathways that influence treatment-associated biological variation are incompletely understood. The TGF{beta} and JAK/STAT signaling networks are recognized regulators of tumor progression, immune modulation, and therapeutic resistance; however, their genomic architecture in clinically stratified PDAC populations remains poorly defined. Methods: We employed a conversational artificial intelligence-driven analytical framework to investigate TGF{beta} and JAK/STAT pathway alterations in a cohort of 184 PDAC patients. Clinical and molecular data were integrated to generate age- and treatment-stratified cohorts, enabling pathway-level and gene-level analyses according to gemcitabine exposure. Findings generated through AI-assisted interrogation were subsequently evaluated using conventional statistical approaches. Results: TGF{beta} pathway alterations were identified in approximately one-quarter to one-third of tumors across clinical subgroups and demonstrated relatively stable frequencies regardless of age at diagnosis or gemcitabine treatment status. Gene-level analyses revealed that pathway disruption was predominantly driven by recurrent alterations in SMAD4, with additional low-frequency events involving TGFBR1 and TGFBR2. Notably, TGFBR2 mutations were significantly more frequent among late-onset PDAC patients receiving gemcitabine compared with untreated late-onset patients (8.8% vs. 1.4%; p = 0.04), suggesting a potential treatment-associated enrichment. In contrast, JAK/STAT pathway alterations were rare throughout the cohort, with only isolated mutations observed in pathway components including JAK1, JAK2, JAK3, STAT1, STAT3, and related regulatory genes. No significant differences in JAK/STAT alteration frequencies were identified according to age or treatment exposure. Conclusions: TGF{beta} and JAK/STAT pathways exhibit distinct genomic architectures in PDAC. TGF{beta} pathway disruption represents a recurrent feature of disease biology, largely driven by SMAD4 alterations, while TGFBR2 enrichment in gemcitabine-treated late-onset tumors suggests a potential context-specific association worthy of further investigation. Conversely, genomic alterations within the JAK/STAT pathway are uncommon, indicating that pathway activity may be regulated predominantly through non-genomic mechanisms. These findings demonstrate the utility of conversational artificial intelligence agents for rapid, scalable, and clinically contextualized pathway interrogation and support future studies integrating multi-omic data to refine precision medicine strategies in PDAC.

BackgroundCardiovascular diseases and cancer are the leading causes of death in the United States and worldwide. Although various therapies against cancer improve patient survival, cardiotoxicity remains a life-threatening adverse outcome, with emerging evidence of downstream effects, including neural dysfunction. While autonomic regulation of the cardiovascular system is well-studied, regulation of the nervous system by the heart is not fully clear. We hypothesized that cardiac cells secrete non-canonical paracrine metabolic factors that support neuronal growth and function, and chemotherapy disrupts this signaling. MethodsWe employed co- culture models of the well-established H9C2 cardiac and PC12 neuronal cell lines and human induced pluripotent stem cells (hiPSCs), and assessed them with molecular, omic, biochemical, morphological, physiological, and pharmacological assays. ResultsHealthy H9C2 cells robustly induced PC12 neurite outgrowth (neurite length and number of neurite-bearing cells) both directly (with cellular contact) and indirectly (only conditioned media), whereas doxorubicin-exposed H9C2 cells failed to produce this effect. Recently approved anti-cancer agents (2020 or later) also reduced or attenuated cardiac cell-induced outgrowth. Untargeted metabolomic analysis of conditioned media revealed multiple novel potential neurite-promoting factors, and pharmacologically inhibiting them significantly reduced PC12 neurite outgrowth. The analysis also identified distinct metabolites that were differentially regulated following doxorubicin exposure. These findings were further supported in a hiPSC-based model, in which conditioned media from doxorubicin-injured hiPSC cardiomyocytes reduced {beta}III-tubulin intensity and norepinephrine secretion in hiPSC-derived sympathetic neurons. ConclusionTogether, these findings unravel a new line of research on cardio-neuronal communication and reveal novel metabolic targets that may inform future strategies to mitigate neurotoxicity induced by chemotherapy-associated cardiac injury.

Research on targeted genetic therapies for myocardial diseases, such as cardiomyopathies, currently focuses on (r)AAVs as the delivery method. Despite substantial efforts and advances in animal trials, predicting biodistribution and transduction efficacy in human tissue remains challenging due to interspecies differences in tissue tropism and the difficulty of accurately assessing alternative delivery routes and vector differences. The application in humans has also proven challenging, in part due to severe adverse events associated with systemic administration of (r)AAVs. This necessitates implementing alternative trial designs and stringent evaluation methods that minimize harm or risk to patients. Applying a predesigned vector carrying a gene-editing tool to a normothermic machine-perfused living beating heart in an ex vivo setting could overcome conventional obstacles and limitations. This can serve as a basis for safe and effective gene-therapy testing and assist in evaluating effects at the molecular level. Boxed-Breathing-Heart is a translational trial assessing the feasibility of ex vivo gene editing and gene translation in normothermic machine-perfused human hearts. Human hearts explanted from cardiomyopathy patients undergoing heart transplantation are donated for research and immediately placed in an Organ Care System, where they are surgically connected. The viability of the heart is maintained through normothermic perfusion of system solutions and donor blood. A predesigned AAV containing a CRISPR-Cas system is infused into the circulation and dispersed throughout the tissue via coronary perfusion. The changes at the cellular and molecular levels are assessed continuously via frequent sequential myocardial biopsies. Furthermore, after the pre-planned 72-hour perfusion, the heart is sectioned and analyzed using spatial and single-cell omics. The aim is to provide a proof-of-concept for genetic therapeutic options delivered to the human heart via AAV in an ex vivo perfusion setup. In summary, Boxed-Breathing-Heart provides an ex vivo translational platform for evaluating targeted cardiac gene therapies, enabling molecular analysis directly in human hearts and accelerating clinical translation without posing risks to patients.

Tumors commonly exhibit a leaky vasculature and innate and/or adaptive immune cell infiltration. A recent study showed that a non-leaky and normalized mouse breast cancer vasculature after conditional deletion of the Shb gene in endothelial cells (EC) displayed a suppressive immune cell profile. To extend those findings further, regulation of immunomodulatory gene expression of normalized breast cancer EC was related to healthy human breast and human breast cancer EC gene expression. A considerable correlation was observed in the gene expression profiles of immunoregulatory genes between normal breast arterial EC and normalized (Shb-deficient) EC, and these changes did not primarily seem to involve gene products forming conduits for tumor leukocyte transendothelial migration but other aspects of immune suppression as for example cytokine expression. In addition to breast cancer, healthy lung and colonic EC exhibited an immune suppressive phenotype compared to their lung cancer and colorectal cancer counterparts. It is concluded that normalized EC may confer a non-leaky and immune suppressed phenotype, an insight that may be exploited to enhance the efficacy of immunotherapy.

Background Bone-avid tracer myocardial scintigraphy for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) has traditionally employed imaging at one or 3-hour intervals. Technetium-99m hydroxydiphosphonate (99mTc-HDP) has unique characteristics that may enable earlier imaging. We investigated the diagnostic concordance of immediate versus 1-hour acquisitions. Methods Consecutive patients with suspected ATTR-CM underwent planar imaging and SPECT/CT immediately and at 1-hour following the administration of 99mTc-HDP. Perugini grades and heart to contralateral lung (H/CL) ratios were assessed. Target-to-background ratios (TBRs) were calculated on the SPECT/CT acquisitions using the left ventricular (LV) septum and three background regions: aorta, LV blood-pool, and vertebrae. We assessed diagnostic concordance using Cohen's Kappa ({kappa}), temporal stability using paired t-tests, and correlation between timepoints using Pearson's coefficient (r). The 1-hour SPECT/CT interpretation served as the protocol reference standard. Results Forty-eight patients (83% male; median age, 80 [73-85] years) were evaluated. One-hour SPECT/CT identified 19 positive and 29 negative cases. Immediate SPECT/CT demonstrated 100% diagnostic concordance with the 1-hour reference standard ({kappa} = 1.000; 95% CI: 1.00 to 1.00; p < 0.001). The LV septum/LV Blood-Pool TBR showed the highest correlation (r = 0.956; 95% CI: 0.922 to 0.975; p < 0.001). The LV Septum/Aorta TBR demonstrated high correlation (r = 0.918; 95% CI: 0.857 to 0.953; p < 0.001) and remained stable in the ATTR-negative cohort (-0.02; 95% CI: -0.08 to 0.04; p = 0.54). Significant decrease in the LV Septum/Vertebrae TBR in the ATTR-negative (-0.55; 95% CI: -0.64 to -0.47; p < 0.001) and ATTR-positive cohorts (-1.14; 95% CI: -1.39 to -0.89; p < 0.001) was observed. Conclusions Immediate 99mTc-HDP SPECT/CT is diagnostically concordant with standard 1-hour protocols. By leveraging SPECT/CT and the favorable kinetics of 99mTc-HDP, immediate-phase imaging can accurately reproduce 1-hour acquisitions in cases of suspected ATTR-CM. This expedited approach may improve nuclear laboratory throughput and patient satisfaction.

A fraction of patients treated with radiotherapy are known to be more sensitive to ionizing radiations. Skin fibroblasts from such radiosensitive individuals exhibit a higher cellular toxicity after irradiation and a delay in DNA repair. Deciphering the molecular mechanisms underlying these cellular defects is thus of major importance. We previously observed that the transcription factor NFATc2 is expressed at a reduced level in fibroblasts from radiosensitive patients. The present work aimed to elucidate the role of NFATc2 in the regulation of DNA repair, particularly the repair of radiation-induced double-strand breaks. We demonstrate an interaction of NFATc2 with the NHEJ repair protein Ku80 and observe that the NFATc2 RHD domain is necessary and sufficient for this interaction. Moreover, we show that NFATc2-Ku80 complexes are not colocalized to DNA double-strand breaks sites suggesting an involvement upstream of the DNA repair pathway. The silencing of NFATc2 impairs the NHEJ repair activities by delaying Ku70-Ku80 interaction in the early steps of this pathway. Finally, stable over-expression of NFATc2 in patients fibroblasts partially rescues their defective DNA repair phenotype, especially in the most radiosensitive cells. Altogether, our data reveal that NFATc2 is a regulator of DNA repair in skin fibroblasts and therefore a potential modulator of cellular radiosensitivity.

Background and Aims: Brugada syndrome (BrS) is an inherited arrhythmia associated with ventricular fibrillation and sudden cardiac death. While pathogenic SCN5A variants account for approximately 20-25% of cases, most patients have no identifiable causal rare variant. Genome-wide association studies have identified common susceptibility variants near transcription factor genes involved in cardiac development, suggesting that developmental abnormalities may contribute to BrS pathogenesis beyond sodium channel dysfunction. We therefore investigated whether genetically distinct forms of BrS exhibit altered developmental transcriptomic trajectories during human cardiogenesis. Methods: Daily bulk 3' RNA sequencing was performed throughout a 30-day directed cardiac differentiation of hiPSC lines derived from two healthy controls and four BrS patients representing distinct genetic backgrounds: SCN5A haploinsufficiency (BrS-SCN5A and BrS-SCN5A-2), a pathogenic RRAD variant (BrS-RRAD), and a patient without rare pathogenic variants but carrying a high burden of common BrS susceptibility alleles (ACV). Results: Transcriptomic trajectories markedly differed according to the underlying genetic architecture. While the BrS-SCN5A line remained largely similar to controls throughout differentiation, BrS-RRAD and BrS-ACV lines diverged as early as day 5, corresponding to the onset of cardiac specification. Differential expression analysis identified only 113 dysregulated genes in the BrS-SCN5A line compared with 525 and 383 genes in the BrS-RRAD and BrS-ACV lines, respectively. The BrS-RRAD and BrS-ACV models shared a common developmental signature characterized by early downregulation of key regulators of cardiac conduction system development, including NKX2-5, IRX3 and IRX5, together with upregulation of genes involved in extracellular matrix organization. Interestingly, similarly to the BrS-SCN5A line, the BrS-SCN5A-2 line presented a transcriptomic remodeling that diverge from the BrS-RRAD and BrS-ACV lines. Consistent with these findings, predicted IRX5 regulatory normal interactions were completely lost in both non-SCN5A models, whereas transcriptomic remodeling remained minimal in both the BrS-SCN5A hiPSC line and an independent Scn5a haploinsufficient mouse model. Conclusion: BrS associated with SCN5A haploinsufficiency and non-SCN5A genetic backgrounds follows distinct developmental transcriptomic trajectories. Our findings support a model in which non-SCN5A BrS is associated with early dysregulation of developmental transcriptional networks controlling cardiac conduction and extracellular matrix organization, whereas SCN5A-mediated BrS primarily results from sodium channel deficiency with limited developmental remodeling. These results identify developmental heterogeneity as a potential determinant of BrS pathophysiology and clinical variability.

For decades gene amplifications were described as an attribute of tumor cells and as a physiological mechanism to increase gene copy numbers for the higher protein demand during development of amphibians and flies. An increasing number of publications describe gene amplifications in normal mammalian cells during differentiation. Many amplified genes detected in tumor cells overlap with amplified genes detected during stem cell differentiation. Since stem cells have a valuable potency in regenerative therapies and since cartilage regeneration is a highly demanded therapeutic strategy, we investigated gene amplification dynamics during chondrogenic differentiation of human mesenchymal stem cells (hMSCs). Using quantitative PCR, we analyzed copy number changes for genes previously implicated in differentiation as well as genes amplified in chondrosarcoma including CDK4, MDM2, AGAP2, CPT1B, SHANK3, TRIB1, and MYC. Amplifications were transient and stage-specific: CDK4, CPT1B, and SHANK3 exhibited the highest copy number increases at day 2, followed by a gradual decline by day 7, while AGAP2 and MDM2 increased later in differentiation. Laser microdissection of toluidine blue-stained areas revealed heterogeneity in amplification patterns: CDK4 amplification was prominent in areas lacking or showing moderate proteoglycan deposition; CPT1B amplification occurred in regions with absent, moderate, or intense proteoglycan deposition; and SHANK3 amplification was restricted to areas with intense proteoglycan deposition. Notably, regions with the strongest proteoglycan staining exhibited no gene amplification, suggesting that gene amplification is an early, transient event that diminishes as differentiation progresses. These findings highlight gene amplification as a mechanism during chondrogenesis, potentially critical for early differentiation stages and genome stability in mature cells.

In 2022, Austria legalised physician-assisted suicide (PAS). Among 1,847,919 older adults, there were 92 PAS and 977 unassisted suicides (UAS) in 2022-2023. Compared to the general population, older adults who died by either PAS or UAS, were older and more likely to live alone. Compared with UAS, older adults who died by PAS were more likely to be female, higher-educated, live in urban areas, and diagnosed with cancer, or diseases of the nervous system, and less likely diagnosed with mental/ behavioural disorders. PAS and UAS among older adults in Austria showed different sociodemographic and comorbidity characteristics.

Background: Endoscopic submucosal dissection (ESD) of superficial esophageal squamous cell carcinoma (SESCC), with or without the esophageal gland duct involvement (DI or NDI), has been reported in small case series, but ESD-related safety, efficacy, and outcomes remain unknown. We conducted a retrospective study of those issues in consecutive 748 patients treated at our center in China. Material and Methods: Over the study period from January 2014 to January 2019, we identified 748 eligible SESCC patients who were divided into the DI (22.6%, 169/748) and NDI (77.4%, 579/748) groups, based on histopathologic reports. Following the European and Japanese guidelines on endoscopic resection of SESCC, we investigated and statistically compared characteristics of clinicopathology and ESD-related safety, efficacy, and prognosis between DI and NDI groups. Results: The mean age of patients was 64.9 years for the cohort and significantly older in the DI (66.1) than in the NDI (64.5) group (P<0.05). There was no significant difference in smoking/alcohol abuse and comorbidity. Endoscopically, the DI group showed significantly larger tumor size and deeper invasion than the NDI group. There was no ESD-related death in the cohort. Although the en bloc resection rate was 100%, the complete and curative resection rates were significantly lower in the DI (88.2% and 61.2%, respectively) than in the NDI (96.4%, and 86.9%, respectively) group (P<0.01). ESD-related infection (0.7%) and bleeding (2.3%) rates were very low and no significant difference was found between the two groups. Only one perforation (0.1%) occurred in the NDI group. Post-ESD stenosis was 11.9% for the cohort and significantly more common in the DI (20.7%) than in the NDI (9.3%) group (P<0.01). The overall survival rate was 95.7% for the cohort and significantly lower in the NDI (94.6%) than in the DI (100.0%) group (P<0.05). However, there was no significant difference in disease-specific death, recurrence-free survival, distant metastasis, and the requirement for subsequent chemoradiation therapy and surgery between the two groups. Conclusion: In our cohort, there was no ESD-associated death; ESD-related infection and bleeding were minimal; and perforation was rare. Post-ESD stenosis was 11.9% in prevalence and successfully managed by endoscopic dilation. The overall survival rate was 95.7%. Compared to the NDI group, the DI group showed older age, larger tumor size, deeper invasion, lower complete and curative resection rates, higher prevalence of post-ESD stenosis; there was no significant difference in disease-specific death. Taken together, ESD was safe with excellent efficacy and prognosis for endoscopic resection of SESCC with or without esophageal gland duct involvement. Keywords: superficial esophageal squamous cell carcinoma, endoscopic submucosal dissection, ductal involvement, survival, postoperative stenosis.