Clinical and Translational Medicine

Hearing hypersensitivity (hyperacusis) is a common hearing stress and can cause many psychological diseases, e.g., anxiety, learning disabilities, and attention-deficit/hyperactivity disorder (ADHD). Here, we report an unexpected finding that the upregulation of P2x2 ATP-purinergic receptors in the cochlea links to hyperacusis generation. We found that P2x2 expression in the cochlea but not in auditory centers was upregulated in the hyperacusis generated by Cx26 deficiency. Overexpression of P2x2 in the cochlea also caused hyperacusis. Conversely, downregulation of P2x2 expression or administration of P2x2 antagonists attenuated hyperacusis. We further found that upregulation of P2x2 receptors in the cochlea increased outer hair cell (OHC) electromotility through the post-transcription functional modulation to potentiate active cochlear amplification leading to hearing hypersensitivity. Such enhancements in OHC electromotility and active cochlear amplification were also suppressed by P2x2 receptor antagonists. Overall, these findings demonstrate that P2x2-mediated ATP-purinergic signaling in the cochlea plays a critical role in hyperacusis generation; targeting P2x2 receptors can attenuate hyperacusis stress, which may also offer a therapeutic strategy for other related psychological comorbidities. Significance statementHearing hypersensitivity is a common hearing stress and can cause many other psychological disorders. However, little is known about the underlying genetic and cellular mechanisms. Also, it lacks efficient drugs for their treatments in the clinic. In this study, we found that upregulation of P2x2 ATP-purinergic receptors in the cochlea can potentiate outer hair cell electromotility, which is an active cochlear amplifier in mammals and can increase hearing sensitivity and frequency selectivity, through post-transcription functional modulation to enhance active cochlear amplification leading to hearing hypersensitivity. These enhancements can be inhibited by administrations of P2x2 receptor antagonists both in vitro and in vivo. These findings revealed a new genetic and cellular mechanism underlying hyperacusis generation and opened a new avenue to develop an efficient therapy for this common hearing stress and other associated psychological comorbidities.

Colorectal cancer remains among the most lethal malignancies worldwide, and the proliferative programme that sustains it has proved to be a challenging target, particularly with acceptable selectivity. Herein, we combined stage-resolved transcriptomic analysis with experimental testing in colorectal cancer cells to inquire whether small molecules, in particular melatonin, act on that programme. The comparison of stage II, III and IV colorectal tumours with normal tissue identified 410 genes upregulated at every stage as a core set, dominated by cell-cycle, spindle-assembly and chromosome-segregation functions. Twenty hub genes were extracted from the corresponding protein interaction network, thirteen of which were required for viability across 59 colorectal cancer cell lines in genome-wide CRISPR screening data. Target-set enrichment nominated E2F4, FOXM1, SIN3A and both DNA-binding subunits of NF-Y as upstream regulators. NF-YA and NF-YB were distinctive in one respect: their annotated targets include BUB1 and CCNA2 but exclude NCAPG, yielding a testable prediction. Our experimental results showed melatonin reduces SW480 viability with an IC of 2.63 mM and lowers BUB1 and CCNA2 expression in different manners of concentration-dependency, while NCAPG remains unchanged. Melatonin treatment arrests cells in G1 phase, causes a drastic fall in the cycling S-phase fraction, impairs the migration and proliferation phenotype, and rises apoptosis moderately. We also found {beta}2-microglobulin to be an unsuitable normalization reference gene for CRC research due to changes upon treatment. Selective repression of two NF-Y targets with sparing of a non-target is consistent with reduced NF-Y-dependent transcription, though occupancy and subunit-level evidence are to be established.

Cisplatin and its analogues are valuable anti-cancer drugs that target the genome, block DNA replication, and induce apoptosis. As a counteractive response, cancer cells activate several mechanisms to maintain uninterrupted DNA replication, and those are yet to be fully elucidated. This study using head and neck squamous carcinoma cells (HNSCC) demonstrated the involvement of DNA polymerase Kappa (Pol{kappa}), a trans-lesion DNA synthesis (TLS) polymerase that primarily functions as a mismatch extender, in cisplatin resistance. Interestingly, the catalytic activity of Pol{kappa} plays a minimal role in adduct bypass; rather, tripartite interactions involving it, rewire and stabilize the stalled replication fork. While the Pol{kappa}-PCNA-Pol{delta} axis facilitates efficient proliferation of cisplatin-resistant cells, the Pol{kappa}-PCNA-USP18 axis stabilizes critical proteins of ATM-ATR, and HR and NHEJ pathways to protect replication fork, repair damage, and restart DNA synthesis under cisplatin-induced stress. In resistant cells, the efficiency of ubiquitin-mediated proteasomal degradation is low, which is further diminished by Pol{kappa}-recruited USP18 deubiquitinase, maintaining a cellular homeostasis. In conclusion, for the first time, we uncovered two critical Pol{kappa} axes crucial for regulating cisplatin toxicity in cells and provided foundation for future drug discovery against advance HNSCC by targeting this non-essential DNA polymerase.

Copy number variations (CNVs) can serve as important clinical biomarkers for tumor classification and stratification. However, the utility of these CNV biomarkers for intraoperative tumor assessment within the timeframe of neurosurgical procedures has remained elusive due to the protracted duration of conventional CNV characterization methods. Here, we introduce CNVisor, a statistical framework for reliable and robust CNV detection from long-read sequencing, even under ultra-low coverage. Applied to neurosurgical tumor specimens, the proposed method enabled genome-wide CNV profiling and identified clinically relevant CNVs using roughly 60,000 reads within 20 minutes of sequencing. Integrating CNVisor with methylation-based classifiers can further reduce turnaround time and increase the accuracy of glioma subtype stratification. Together, these findings establish real-time CNV profiling using ultra-low coverage nanopore sequencing as a feasible strategy for intraoperative, genomics-informed assessment of CNS tumors.

Background: It is well known that genetic variants contribute to cellular sensitivity to chemotherapeutic agents and ionizing radiation (IR). The aim of this study was to identify single nucleotide polymorphisms (SNPs) and genes associated with the spectrum of normal cellular sensitivity of lymphoblastoid cell lines (LCLs) towards ionizing radiation and mitomycin C (MMC). Methods: In a first step, we determined the viability of LCLs established from male participants of the Berlin Aging Study II (BASE-II) aged >=62 years following treatments with increasing doses of IR (n=137 cell lines) or MMC (n=140 cell lines) using the alamarBlue assay. Results from intra-experimental triplicates and three independent experiments for each cell line and treatment were used to calculate the area under the curves (AUCs) representing the specific sensitivity to IR and MMC of each LCL. The data from these experiments were subsequently used as outcomes in genome-wide association studies (GWASs). In addition, we calculated polygenic risk scores (PGS) from UK Biobank GWAS results for four cancer-related phenotypes and assessed the extent to which the variance in the IR and MMC sensitivity is explained by these PGS. Results: The GWAS analyses revealed one variant, rs74728080, located in CDH13 on chromosome 16, to show genome-wide significant (p < 5 x 10-8, beta = 2.81) association with cellular viability after treatment with IR. In the GWAS on MMC sensitivity the most interesting signal was elicited by SNP rs113978558 in an intron of the PLD5 gene on chromosome 1 (p = 9.232 x 10-8; beta = 1.44). Several other SNPs with statistically suggestive (i.e., p < 1 x 10-5) evidence of association with IR or MMC sensitivity were identified. PGSs calculations from GWAS of four cancer-related traits in UKB explained ~5% and ~3% of phenotypic variance in IR- and MMC-induced cell viability, respectively. Conclusion: The genome-wide significant association of rs74728080 with IR sensitivity and the location of this variant in CDH13 is interesting and functionally highly plausible given its known involvement in oxidative-stress response and function as tumor suppressor. Taken together, our novel data suggest that CDH13 may be genuinely involved in regulating cellular IR sensitivity.

ObjectiveIn recent years, the number of cats kept as companion animals has increased, leading to a growing demand for veterinary care. Although some histone deacetylase (HDAC) inhibitors are promising for the treatment of human cancers and neurological diseases, comprehensive systematic research on HDAC inhibitors in domestic cats remains insufficient. Therefore, this study aimed to investigate the effects of HDAC inhibitors on the transcriptome of feline cells. MethodsTwo types of cells derived from domestic cats, Crandell-Rees Feline Kidney (CRFK; kidney-derived) cells and PG-4 cells (astrocyte-derived), were treated with four HDAC inhibitors (panobinostat, trichostatin A, valproic acid, and vorinostat) for 24 h. Transcriptomic changes after treatment were examined using RNA sequencing. ResultsHDAC inhibitor treatment upregulated the expression of intercellular chemical interactions and signal transduction-related genes, similar to observations in human cells. Although HDAC inhibitors did not suppress the expression of cell cycle-related genes in CRFK cells, as observed in human cells, the inhibitors downregulated the expression of organogenesis-related genes. Consistent with observations in human cells, HDAC inhibitors suppressed the expression of cell cycle- and cancer-related genes in PG-4 cells. Importantly, valproic acid, which is thought to be more effective for neurological diseases than for cancer, suppressed the expression of more cancer-related genes in PG-4 cells than the other three HDAC inhibitors. Conclusion and relevanceOur findings revealed that the responses of cells derived from feline organs to various HDAC inhibitors varied considerably depending on the organ of origin and species. Since few studies, including human studies, have comprehensively compared transcriptomic responses to multiple HDAC inhibitor classes across multiple cell types, the results of this study provide a foundation for future research on the treatment and prevention of cancer and neurological diseases in domestic cats and other mammals.

Most patients with cancer of unknown primary (CUP) still receive platinum-based chemotherapy and have a poor prognosis, with overall survival of less than one year. Recent studies suggest improved outcomes with molecularly guided or site-specific therapies informed by molecular tissue profiling. Here, we analyzed ctDNA from 190 CUP patients using an integrated genomic and epigenomic assay to identify actionable alterations and predict tissue-of-origin (ToO). Integration of actionable biomarkers, ToO prediction and clinical data yielded diagnostic, prognostic or therapeutic information in 90% of unfavorable CUP cases and 88% of patients analyzed at first diagnosis. High ctDNA tumor fraction was associated with poorer prognosis in both favorable and unfavorable CUP. These findings highlight the clinical utility of ctDNA analysis for therapeutic decision-making in CUP and support its incorporation into the diagnostic work-up, particularly when tissue samples are unavailable or insufficient for molecular testing.

Acute myeloid leukemia (AML) is the most common hematologic malignancy in adults and is associated with poor clinical outcomes. Accurate prognostic stratification remains essential for improving patient management and identifying potential therapeutic targets. Here, we analyzed RNA-seq data from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) and The Cancer Genome Atlas (TCGA) cohorts to identify genes associated with overall survival (OS) in patients with AML. Using penalized regression modeling and integrative survival analyses, we identified a prognostic signature composed of seven protein-coding genes (ACOT7, SLC35E4, SELPLG, CCND3, RRAS, ITGAX, and COMTD1) and three processed pseudogenes (FDPSP2, UBE2V1P13, and AL158214.1) consistently associated with OS across independent AML cohorts. Based on these genes, we developed a novel risk score model that stratified AML patients into low- and high-risk groups with significantly different survival outcomes. The model demonstrated reproducible prognostic performance in TARGET and TCGA cohorts. In addition, several genes included in the prognostic signature were significantly dysregulated in AML compared with healthy samples. Functional enrichment analyses further revealed that high-risk AML was associated with suppression of translational and RNA-processing pathways, together with cohort-specific enrichment of metabolic and immune-related programs. Overall, this study presents a novel prognostic risk score integrating protein-coding genes and pseudogenes that robustly predicts OS in AML, providing a framework for improved prognostic stratification and potential biological insights into AML progression.

BackgroundMethyltransferase-like 1 (METTL1) is highly expressed in organs like the pancreas but less so in the brain. The METTL1-WDR4 complex catalyzes N7-methylguanosine (m7G) methylation in tRNA, miRNA, mRNA, and rRNA, which impacts RNA stability and function. These modifications affect mRNA translation and tRNA functionality, influencing protein production and cellular activities. Such modifications can regulate tumor growth, invasion, and metabolism by selectively controlling protein expression. MethodGene expression data from public databases were analyzed to compare METTL1 expression in normal and tumor tissues. Western blot (WB) and immunohistochemistry (IHC) were used to quantify METTL1 levels in glioma samples and assess their prognostic significance. Cell viability, migration, invasion, and proliferation were evaluated using Cell Counting Kit-8 (CCK-8), wound healing, Transwell, cell cycle analysis, and colony formation assays. RNA immunoprecipitation PCR (RIP-PCR) identified m7G methylation sites on EPHA2 mRNA, and RNA stability was assessed with actinomycin D. ResultsBioinformatics analysis revealed that METTL1 is overexpressed in gliomas, correlating with poor prognosis. Knockdown of METTL1 significantly affected cell proliferation, migration, and invasion. RNA sequencing (RNA-seq) and m7G analysis identified EPHA2 as a downstream target, influencing the cell cycle via the AKT pathway. RIP and methylated RNA immunoprecipitation (MeRIP) confirmed two m7G sites on EPHA2 mRNA regulated by METTL1. Small interfering RNA (siRNA)-mediated METTL1 knockdown in EPHA2 mutants affected mRNA stability. Rescue experiments restored cell proliferation and AKT pathway gene expression. ConclusionMETTL1 methylates EPHA2 mRNA, enhancing its stability and expression, which activates the AKT signaling pathway and influences glioma cell proliferation. METTL1 could be a potential therapeutic target in glioma treatment.

Induced pluripotent stem cells (iPSCs) are widely used as patient-specific disease models, yet substantial unexplained variability in molecular and functional readouts limits their reliability. Here, we systematically investigated the sources of variation in iPSC-derived neurons for three rare genetic disorders: Myotonic Dystrophy Type 1, chromodomain-DNA-helicase-binding protein 2-related disorder and N-acetylneuraminic acid synthase deficiency. This was performed by profiling multi-omics layers: genomics, epigenomics, transcriptomics, proteomics, metabolomics and lipidomics. Our study found that clonal variability was comparable to inter-patient differences and that neuronal differentiation state and nutrient-driven metabolic activity emerged as dominant contributors to variability observed across omics layers. Clonal differences could partly be attributed to stochastic differences in DNA methylation established during reprogramming. By modeling and correcting the observed variation, we improved the detection of disease-associated molecular signatures. Our study provides guidelines for improved study design and data analysis to minimize variability, enabling robust biomarker discovery and reliable iPSC-based disease modeling.

Wilms tumor, i.e., nephroblastoma, is rare in adults and lacks standardized treatment, complicating clinical decision-making. Within the functional precision medicine study (DEDUCER), we profiled two spatially distinct tumor regions (T1 and T2) of an adult Wilms tumor patient using integrated histopathology, whole-exome sequencing, FFPE transcriptomics, and ex vivo drug screening of short-term cultured patient-derived cancer cells (PDCs) with 528 compounds. Genomic profiling revealed a truncal ASXL1 frameshift and shared F7, UBA1, COL21A1, and ATM variants alongside region-specific alterations: a TP53 mutation and broad copy-number (CN) gains in T1, versus ARID1A and KMT2D stop-gains in copy-neutral T2. Transcriptomics of tumor areas identified convergent activation of the G2/M checkpoint, E2F targets, and mitotic spindle programs across regions, consistent with high proliferation and partially comparable biomarker signatures to those observed in an open-source pediatric Wilms tumor dataset (n = 130). Functional assays uncovered distinct and shared drug vulnerabilities: although ATM alterations were present in both tumors, T1 PDCs showed selective sensitivity to topoisomerase I and BCL-2 inhibition in the context of an additional T1-specific TP53 alteration, while broader single-agent sensitivity and stronger drug synergies were observed in T2. Pathway-centric data integration indicated that differential gene expression and copy-number gains, rather than single mutations alone, better predicted ex vivo drug responses, revealing actionable shared dependencies despite pronounced spatial heterogeneity and establishing a translational framework for individualized management in this rare disease. HIGHLIGHTS- In the adult Wilms tumor, multi-region genomics revealed a truncal ASXL1 frameshift together with F7, UBA1, COL21A1 and ATM mutations across two tumor regions (T1 and T2), as well as region-specific alterations: TP53 mutation and widespread copy-number gains in T1, versus ARID1A and KMT2D stop-gains in copy-neutral T2, illustrating spatial heterogeneity. - Transcriptomics showed convergent activation of E2F targets, G2/M checkpoint, and mitotic spindle programs in both regions, consistent with high proliferation and aligning with Wilms tumor signatures (TARGET dataset); these pathways were associated with higher ex vivo drug sensitivity scores. - Functional drug sensitivity testing of patient -derived cancer cells ex vivo uncovered distinct and shared vulnerabilities: Although both tumors shared an ATM mutation, T1-specific TP53 alteration and death-pathway/stress-response alterations may underlie selective sensitivity to topoisomerase I inhibitors and BCL-2 inhibition. - Clinically relevant combinations, including vincristine plus dactinomycin and doxorubicin plus dactinomycin, showed ex vivo synergy. These findings are consistent with the patients more than five-year relapse-free outcome following vincristine, doxorubicin, and dactinomycin treatment combined with surgery, supporting the translational relevance of the ex vivo drug testing approach. - Pathway-centric integration (copy-number gains and differential expression) predicted drug response better than single-gene biomarkers. Overall, pathway-level dependencies provide robust, actionable targets despite genomic and phenotypic heterogeneity in adult Wilms tumor.

Inadequate autophagy promotes smoking-induced cellular senescence involved in chronic obstructive pulmonary disease (COPD) pathogenesis. Transcription factor EB (TFEB) is a master regulator of the autophagy-lysosome axis. For the first time, we investigated the therapeutic potential of pemafibrate, a putative TFEB inducer. COPD lung epithelial cells showed reduced TFEB expression. Pemafibrate enhanced autophagy/mitophagy flux and restored lysosomal acidification observed during cigarette smoke (CS) extract exposure in human bronchial epithelial cells, resulting in reduced cellular senescence. TFEB knockdown demonstrated involvement of pemafibrate-induced TFEB in these effects. Pemafibrate induced TFEB expression, mitigated alveolar enlargement and airflow obstruction, and attenuated the CS-induced increase in static lung compliance in a long-term CS-exposed mouse model. It reduced the CS exposure-induced cellular senescence, possibly through autophagy/mitophagy, as suggested by bulk RNA sequencing of mouse lungs. A retrospective cohort study showed that patients given pemafibrate displayed attenuated FEV1.0 decline compared with those given bezafibrate or fenofibrate. In conclusion, pemafibrate is a promising therapeutic agent for COPD, potentially exerting its effects through the regulation of the TFEB-autophagy/mitophagy-lysosome axis.

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.

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer accounting for most cancer-related deaths worldwide. Despite substantial recent advances in targeted therapies and immunotherapy, the prognosis for advanced-stage disease remains comparably poor, which is why the identification of novel molecular biomarkers as well as therapeutic targets influencing tumor development, progression, and metastasis remain important. This study focusses on SERPINB13, a serine-protease inhibitor expressed in selected tissues that is dysregulated in several tumor entities. However, its role in NSCLC still remains largely unclear. We analyzed SERPINB13 transcription in a cohort of non-small cell lung cancer (NSCLC) cases including both lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) by transcriptome profiling. Epigenetic modifications were assessed via Methylation BeadChips. Additionally, SERPINB13 protein expression was assessed by immunohistochemistry (IHC) in an independent cohort of NSCLC comprising 126 LUSC patients. Correlation analyses were performed to associate SERPINB13 expression with key clinico-pathological parameters, including overall survival and extent of tumor-infiltrating immune cells. To functionally investigate the regulatory influence of peripheral blood mononuclear cells (PBMCs) on SERPINB13 expression in LUSC tumor cells in vitro, we utilized the SERPINB13-expressing LUSC cell line LUDLU-1. Here, gene transcription was analyzed by quantitative real-time PCR (RT-qPCR), confirmed by Western blot on the protein level. Transcriptome analysis revealed a significant upregulation of SERPINB13 in lung squamous cell carcinoma (LUSC) compared to lung adenocarcinoma (LUAD), highlighting a subtype-specific expression pattern. This differential expression was further associated with a distinct epigenetic DNA methylation signature at the SERPINB13 loci in LUSC, suggesting transcriptional regulation via hypomethylation. IHC analysis demonstrated that high SERPINB13 protein expression is significantly associated with prolonged overall survival in LUSC. Notably, SERPINB13 expression was enriched in immune-inflamed ("hot") tumors, characterized by elevated infiltrating lymphocytes and immune activation. Mechanistically, co-culture experiments with PBMCs induced SERPINB13 expression in a LUSC cell line in a dose- and time-dependent manner in the absence of direct cell contact. This suggests that soluble factors secreted by immune cells might play a key role in regulating SERPINB13 expression in the tumor microenvironment. Taken together, SERPINB13 is a novel prognostic indicator in LUSC that is modulated by Immune cells. Further studies are necessary to decipher the crosstalk of Immune cells on the Serpin B13 expressing tumor cells in depth, with regard to a possible interventional strategy. immunomodulatory potential strategies and personalized therapeutic approaches in NSCLC.

ObjectiveTo characterize gut microbiota dysbiosis in hypertension and investigate its multilevel interactions with the host immune system. MethodsIntegrated multi-cohort microbiome data were used to evaluate microbial diversity, differential abundance, and co-occurrence network features between individuals with hypertension and healthy controls. The scBPS framework was applied to analyze microbiome-cell associations, enabling the resolution of relationships between key microbial taxa and functional states of immune cells at single-cell resolution. ResultsSeveral potentially protective genera reduced in hypertension and occupied central topological positions in the co-occurrence networks. Single-cell analyses further demonstrated that multiple key genera were closely associated with the functional states of monocytes and T cells (p<0.05). Specifically, Bacteroides and Bifidobacterium were associated with the proliferation and repair of classical monocytes; Butyricimonas showed a negative association with antigen processing and presentation pathways in monocytes; and Oscillospira promoted the transition of dnT cells toward an immunoregulatory state, suggesting its potential role in immune homeostasis. ConclusionsIntegrated multi-omics analyses reveal that hypertension-associated gut microbes may contribute to disease development through immune regulation, providing insights into microbiome-immune interaction mechanisms and potential targets for precision interventions.

Background and Objective: Due to the heterogeneity of bladder cancer, minimally invasive molecular profiling may improve tumor characterization at the time of diagnosis. We evaluated whether integrated genomic and fragmentomic profiling of plasma and urinary circulating tumor DNA (ctDNA) detects BC-derived signals for diagnosis and disease stratification across all tumor stages. Methods: In this real-world cohort, 202 plasma and urine samples were obtained from 33 patients with non-muscle-invasive BC (NMIBC), mostly Ta tumors, and 15 patients with muscle-invasive BC (MIBC), as well as from 58 cancer-free controls. Low-coverage whole-genome sequencing was performed to assess ctDNA fragmentation, chromosomal instability and copy number variations. Matched tumor tissue was analyzed to evaluate concordance between liquid biopsy and tissue-derived molecular alterations. Key Findings and Limitations: Complementary genomic and fragmentomic profiling of cfDNA achieved detection rates of 75.8% in NMIBC patients and 91.7% in MIBC patients with paired plasma and urine. Distinct differences were observed between MIBC, NMIBC and cancer-free controls, consistent with increasing ctDNA signals during disease progression. Tumor tissue analysis confirmed BC-associated molecular alterations. Limitations include the single-center design and limited sample size. Conclusions and Clinical Implications: Multimodal profiling of plasma and urinary cfDNA enabled the detection of tumor-derived molecular signals for all bladder cancer stages, including early-stage disease. By integrating genomic and fragmentomic features, this minimally invasive approach provides molecular tumor characterization at the time of diagnosis and may support future risk-adapted diagnostic, therapeutic and surveillance strategies.

Background: Liquid biopsy-based monitoring of circulating tumor DNA (ctDNA) holds promises for real-time assessment of tumor burden and treatment response in precision oncology. However, mutation-based approaches alone show limited sensitivity, particularly in low-shedding tumors. We evaluated whether integrating epigenomic biomarkers (specifically LINE-1 retrotransposon (L1PA) hypomethylation and copy number variation (CNV)) with standard mutation-based ctDNA analysis could improve cancer detection and longitudinal monitoring in patients enrolled in the SHIVA02 precision oncology trial. Methods: We performed a retrospective analysis of 32 patients with advanced or metastatic solid tumors who received molecularly matched targeted therapies within the SHIVA02 trial (NCT03084757). Plasma samples were collected at baseline and longitudinally every two months and at progression. Multimodal ctDNA profiling was performed using the DRAGON targeted NGS panel covering SNVs, indels and focal CNVs in 571 genes and the DIAMOND assay profiling L1PA methylation and genome-wide CNV. A three-step classification algorithm integrating maximum variant allele frequency (MaxVAF), L1PA methylation-based cancer probability (MethPCancer), and genome-wide CNV scores was developed to maximize ctDNA detectability. Results: At baseline, mutation-based profiling detected ctDNA in 62.5% of patients. L1PA hypomethylation alone identified ctDNA in 78.1% of patients, including cases with undetectable mutations. The three-step integrative model increased overall detectability to 93.8%. Concordance analyses between tumor tissue and plasma revealed that 80.6% of mutations and 60% of CNVs identified in tumor biopsies were detectable in matched ctDNA. The three modalities showed limited pairwise correlation at baseline, supporting their complementarity. Longitudinal analysis demonstrated that changes in MaxVAF, MethPCancer, and L1PA CNV scores over time were informative on treatment response across tumor types, with ctDNA detected in 94.5% of samples collected at disease progression. In selected patients, ctDNA alterations preceded radiological progression by four months. Conclusions: Multimodal ctDNA profiling integrating mutation analysis, CNV profiling, and LINE-1 hypomethylation substantially improves ctDNA detection at baseline and during treatment in a pan-cancer precision oncology setting. These complementary genomic and epigenomic biomarkers provide a more comprehensive and dynamic assessment of tumor burden than single-modality approaches, supporting prospective validation in larger cohorts for integration into precision oncology workflows.

HighlightsO_LIIdentified hundreds of potential chromatin-associated circRNAs in HEK293 cells, H9, and HeLa cells C_LIO_LIThe first report suggesting global interaction of circular RNAs with chromatin C_LIO_LIChromatin-associated circular RNAs interact with various RBPs involved in RNA splicing or processing C_LI Circular RNAs (circRNAs) have emerged as novel regulators of gene expression by interacting with various proteins and RNAs in a spatiotemporal manner. CircRNAs localized in the cytoplasm regulate mRNA translation or stability by binding to microRNAs and RNA-binding proteins (RBPs), while circRNAs in the nucleus regulate transcription and pre-mRNA splicing by associating with transcription factors and splicing factors. In this study, we sought to explore the interaction between circRNAs and chromatin. Analyzing published RNA-seq data from chromatin fractions identified hundreds of chromatin-associated circRNAs (cacRNAs) in various human cells. We validated the enrichment of a subset of circRNAs in the chromatin fraction and established the direct interaction of circDYNC1H1 and circKIF2C with chromatin in HEK293T cells. Furthermore, cacRNAs were found to interact with RBPs. Together, our research demonstrates the global association of hundreds of circRNAs with chromatin and expands our understanding of novel functional aspects of the circRNAs. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=186 SRC="FIGDIR/small/739476v1_ufig1.gif" ALT="Figure 1"> View larger version (69K): org.highwire.dtl.DTLVardef@1fc8831org.highwire.dtl.DTLVardef@516cdcorg.highwire.dtl.DTLVardef@1c20395org.highwire.dtl.DTLVardef@79313a_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOGraphical abstractC_FLOATNO C_FIG

CD28 costimulation contributes to pathogenic T cell responses in inflammatory bowel disease (IBD), but current B7-directed blockade also limits CTLA-4 signaling. Using a sensitive NanoBiT split-luciferase screening platform, we identified and optimized CA-23, a small molecule antagonist that directly binds human and mouse CD28 without measurable binding to CD80, CD86, or CTLA-4. CA-23 inhibited CD28-B7 engagement and CD28-dependent T cell activation without agonist activity in human whole blood and peripheral blood mononuclear cells. CA-23 achieved exposure in the colon and mesenteric lymph nodes and reduced disease severity, histologic injury, and pathogenic Th1 and Th17 responses in a T cell transfer model of colitis. In PBMCs from donors with ulcerative colitis or Crohns disease, CA-23 suppressed inflammatory cytokine production and T cell activation to a degree matching or exceeding Abatacept. In human intestinal epithelial-PBMC co-cultures, CA-23 preserved Treg suppressive activity and epithelial barrier integrity, whereas Abatacept reduced Treg function. CA-23 did not alter CD80 or CD86 expression on autologous antigen-presenting cells and showed no substantial off-target activity in the tested selectivity panel. These findings support direct CD28 antagonism as a mechanistically differentiated alternative to B7-directed co-stimulation blockade for suppressing pathogenic T cell responses in preclinical models of IBD. One Sentence SummaryA CD28-selective small molecule blocks pathogenic T cell activation and preserves Treg function unlike Abatacept in IBD models.

Emerin (EMD), an inner nuclear membrane protein essential for nuclear architecture integrity, gene expression, cellular signaling, and chromatin stability, interacts with the LINC complex and participates in cytoskeleton-nucleoskeleton communication by binding to nuclear actin filaments. EMD is implicated in migration, invasion, and metastasis in some tumors, but its role in glioblastoma (GBM) remains unclear. This study evaluated the effects of EMD knockdown and overexpression in GBM cell lines following genotoxic treatment with cisplatin. In both wild-type p53 (U87-MG) and mutant p53 (U138-MG) GBM cells, EMD expression is high, and cisplatin treatment did not affect these protein levels. EMD knockdown in U87-MG cells significantly increased cisplatin IC50, viability, and proliferation. Conversely, stable overexpression of EMD in U87-MG cells led to reduced cisplatin IC50, viability, proliferation, and migration. EMD knockdown or overexpression did not affect any U138-MG phenotypes, with or without cisplatin treatment. Modulation of EMD levels causes morphological changes in stress fiber cytoskeleton, whereas overexpression of EMD in U87-MG cells promotes an increase and a decrease in nuclear and cytoplasmic actin levels, respectively. These biological responses of U87-MG cells overexpressing EMD were coincidentally associated with alterations in the levels of pH2AX(Ser139), p-p53(Ser15), p53, and p21Kip1 proteins after cisplatin exposure. In sum, modulation of EMD levels affects the viability, migration, and proliferation of wild-type p53 GBM cells treated with cisplatin, suggesting unknown roles in the DNA damage response and repair. This work highlights EMD as a potential regulator of GBM chemoresistance and a target for therapeutic intervention.