Experimental & Molecular Medicine

The innate immune system controls bacterial growth and modulates inflammation during wound healing. TCP-25 is a synthetic thrombin-derived host-defense peptide that combines direct antibacterial activity with neutralization of microbial products and modulation of CD14-dependent inflammatory signaling. We investigated whether this dual mechanism translates to human wounds using longitudinal samples from 24 healthy volunteers enrolled in a randomized, double-blind, within-participant, placebo-controlled phase I dose-escalation study of topical TCP-25 gel in matched epidermal suction blister wounds. We assessed inflammatory cytokines, neutrophil-derived proteins, wound exudation, cultivable bacterial burden, spatial bacterial distribution, and microbiome composition. TCP-25 reduced multiple cytokines, myeloperoxidase, and heparin-binding protein, with the strongest effects observed during the peak inflammatory phase. These changes were accompanied by reduced wound exudation and significant reductions in cultivable bacterial burden. Despite this antibacterial effect, microbiome composition and diversity remained largely unchanged, and participant-specific microbial profiles were preserved. TCP-25 therefore coordinated bacterial control, modulation of the physiological inflammatory response, and reduced wound leakage without major disruption of the resident microbiota composition. These findings provide clinical support for translating nature's endogenous host-defense principles into new therapies for complex wounds.

Dermatomyositis is driven by overactivation of type I and II interferons and other proinflammatory cytokines that signal via the JAK-STAT pathway. We conducted a 12-week, open-label study of brepocitinib, an oral TYK2/JAK1 inhibitor, in five adults with severe cutaneous dermatomyositis. Treatment was associated with rapid, clinically meaningful improvement in cutaneous disease activity. Single-cell and spatial transcriptomic profiling of lesional skin showed marked suppression of interferon-responsive pathways and inflammatory cell states by week 4. Together with findings from a Phase 3 randomized trial in DM patients with skin and muscle involvement (VALOR, NCT05437263), these data support TYK2/JAK1 inhibition as a promising therapeutic strategy for DM.

An autocrine pro-adhesive/pro-contractile signaling loop, through the mechanosensitive transcriptional cofactor YAP, promotes fibrosis. The CCN family of matricellular proteins modify adhesive signaling. Of these, CCN3 is antifibrotic. We show that BLR-200, a CCN3-derived peptide, has anti-fibrotic properties in the bleomycin-induced model of scleroderma skin fibrosis. In vitro, BLR-200 delayed, but did not abolish, fibroblast adhesion to collagen and nuclear YAP localization. In vivo, BLR-200 prevented/treated bleomycin-induced skin fibrosis, and reduced bleomycin-induced expression of profibrotic genes including alpha-smooth muscle actin, CCN1 and CCN2. Lineage tracing and scRNA-seq analyses revealed that the myofibroblasts in this model were quantitatively derived from collagen-lineage Pi16+/Col15+ve fibroblasts. BLR-200 prevented myofibroblast differentiation in this model and trajectory of fibroblasts toward a Sfrp2-positive subset, a cell type associated with poor clinical outcome. BLR-200 impairs YAP activation in vitro and appearance of translationally-relevant fibroblast subtypes in vivo and is a novel anti-fibrotic agent for SSc skin fibrosis.

Background: Cutaneous melanoma is the most aggressive malignant skin tumor, and metastasis represents the primary cause of patient mortality. Bisphenol S (BPS) has an unclear influence on melanoma metastasis and its underlying molecular mechanisms. Methods: Potential BPS targets were predicted using the SEA, SwissTargetPrediction, and SuperPred databases. Based on TCGA-SKCM transcriptomic data, differential expression analysis was performed, and Weighted Gene Co-expression Network Analysis (WGCNA) was employed to construct a gene co-expression network. Candidate genes were obtained by integrating BPS-related targets, differentially expressed genes (DEGs), module genes, and univariate Cox regression genes, followed by Gene Ontology (GO)/Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and protein-protein interaction (PPI) network construction. Least Absolute Shrinkage and Selection Operator (LASSO)-Cox regression was applied to screen core prognostic genes and construct a risk prediction model. Further analyses included network construction, molecular docking, and 100 ns molecular dynamics (MD) simulation. Results: Integration of BPS-related targets, DEGs, WGCNA module genes, and Cox regression results yielded 13 candidate genes enriched in kinase activity regulation and melanoma-related pathways. LASSO-Cox regression ultimately identified three core prognostic genes--ABCB1, PIM2, and TSHR--all significantly upregulated in metastatic tissues, with area under the curve (AUC) values of approximately 0.7. High-expression patients exhibited significantly better overall survival than low-expression patients (P < 0.05). A nomogram incorporating the three genes and clinical parameters demonstrated good calibration performance. Within the ceRNA network, MALAT1 and hsa-miR-155-5p were identified as key regulatory molecules, and 37 potential transcription factors were predicted, including CEBPA, JUN, and STAT3. Molecular docking revealed strong binding affinities of BPS toward ABCB1 , PIM2, and TSHR, and MD simulations confirmed the structural stability of all three complexes. Conclusion: ABCB1, PIM2, and TSHR are the core target genes through which BPS influences melanoma metastasis via multidrug resistance, kinase signaling, and receptor-mediated signal transduction. The prognostic model based on these three genes demonstrates good clinical applicability, and the ceRNA and transcription factor regulatory networks provide a systematic molecular basis for understanding the association between BPS exposure and melanoma metastasis.

Background: Cases requiring 13 or more tissue sections in Mohs micrographic surgery (MMS) demand extended operative time, additional resources, and often specialised closure techniques. Pre-operative identification of such cases would improve surgical scheduling, resource allocation, and patient counselling. We aimed to develop and validate a machine learning prediction tool using pre-operative clinical features to identify cases likely to require13 sections. Objectives: To develop and validate machine learning models for predicting which Mohs procedures will require 13 sections, using pre-operative clinical features, and to identify key predictive factors. Methods: We analysed 408 consecutive Mohs procedures with 16 pre-operative clinical variables. Thirty machine learning algorithms were evaluated, including ensemble methods (Stacking, Voting), gradient boosting (XGBoost, LightGBM, CatBoost), neural networks (3-7 layers), support vector machines, and traditional classifiers. Model performance was assessed using 5-fold stratified cross-validation and independent test set evaluation. Feature importance was determined using SHAP (SHapley Additive exPlanations) analysis. Results: The stacking ensemble achieved the highest cross-validation AUC of 0.891 (95% CI: 0.849-0.934) and test AUC of 0.884. Tumour area (cm2), calculated using the ellipse formula to approximate clinical tumour morphology, emerged as the strongest predictor (SHAP importance: 0.141), followed by tumour size dimensions (0.086 and 0.068), aggressive histopathology (0.046), and recurrence status (0.035). Wide neural network architectures (5-layer) outperformed deeper configurations (7-layer). The model demonstrated 70.7% high-confidence predictions with uncertainty <15%. Conclusions: Machine learning models using pre-operative clinical features can accurately predict which Mohs procedures will require 13 or more sections. The stacking ensemble approach provides robust predictions suitable for clinical decision support. External validation in multi-centre cohorts with diverse patient populations and practice patterns is warranted to assess model generalisability.

Keloids are fibroproliferative skin disorders arising following dermal injury that extend beyond the original wound margins. Their pathogenesis remains poorly understood, and current treatments are associated with high recurrence rates. Identifying transcriptomic biomarkers that distinguish keloids from other skin and scar phenotypes may provide insight into disease mechanisms and facilitate the development of targeted therapeutic approaches. However, previous transcriptomic studies have often been limited by small sample sizes, pairwise comparisons between tissue classes, heterogeneous data-integration strategies, and a reliance on conventional differential gene expression (DGE) analysis. Here, we employed a multi-stage machine learning (ML) workflow for robust keloid biomarker discovery using transcriptomic datasets derived from both bulk RNA sequencing and single-cell RNA sequencing (scRNA-seq). We assembled and harmonized, to the best of our knowledge, the largest curated cross-study keloid transcriptomic cohort currently available, comprising 81 samples from 13 independent studies spanning four clinically relevant tissue classes: normal skin, normotrophic scar, hypertrophic scar, and keloid scar. Through study-aware cross-validation, feature selection, partition-stability analysis, and bootstrap validation across multiple ML classifiers, we identified a panel of eight highly consistent biomarkers capable of distinguishing keloid from non-keloid samples. These biomarkers were associated with dysregulation of extracellular matrix homeostasis, fibrosis-resolution pathways, vascular remodelling, and metabolic reprogramming. Comparison with conventional DGE analysis demonstrated substantial agreement while also highlighting important differences between the two approaches. In particular, FASN was consistently identified by the ML workflow as an upregulated discriminatory biomarker despite exhibiting weak, non-significant differential expression in the DGE analysis. Cell-type-specific analysis further supported this finding, revealing significant FASN upregulation in fibroblast and vascular endothelial populations. These results demonstrate that ML and DGE capture complementary aspects of transcriptomic variation. This study provides a robust strategy for cross-study transcriptomic biomarker discovery and identifies candidate genes and pathways for future mechanistic and therapeutic investigation in keloids. 1 Author SummaryKeloids are abnormal scars that continue to grow beyond the original wound and can be difficult to treat because they frequently recur after therapy. Although many studies have investigated the biology of keloids, the molecular mechanisms that distinguish them from other scar types remain incompletely understood. Identifying biomarkers involved in keloid formation may help inform improved treatment strategies. Previous transcriptomic studies have often been limited by small sample sizes and inconsistent analytical approaches. In this study, we combined gene-expression data from multiple independent studies to create, to the best of our knowledge, the largest cross-study transcriptomic collection available for keloid analysis. We then applied several machine learning approaches to identify genes that consistently distinguished keloids from other skin and scar phenotypes. The identified biomarkers were associated with extracellular matrix remodeling, fibrosis, vascular function, and cellular metabolism. One gene involved in fatty-acid synthesis, FASN, was repeatedly identified by the machine learning analyses despite being overlooked by conventional gene-expression methods. Additional single-cell analyses confirmed elevated FASN expression in specific cell populations within keloid tissue. More broadly, this work provides a strategy for discovering robust biomarkers from heterogeneous biological datasets and identifies molecular targets for future studies of keloid disease.

Genomics-guided precision oncology has improved survival in cancer entities with actionable mutations but cannot capture oncogenic signaling that manifests at the protein level. Here, we report a prospective, real-world pan-cancer study profiling proteomes and phosphoproteomes of 1,998 tumor samples from adults and children with rare or advanced cancers enrolled in the German precision oncology programs DKFZ/NCT/DKTK MASTER, CATCH and INFORM and their molecular tumor boards (MTBs). We developed tumor proteome activity status (TOPAS) scores for 46 clinically relevant kinases, an immune activity score capturing antigen presentation and T-cell activation and identified therapeutically targetable cell-surface proteins for 94% of patients. These readouts enhance MTB recommendations by exposing actionable non-genomic kinase activity, refining interpretation of oncogenic genome alterations, and highlighting cell-surface treatment options. Three proof-of-concept analyses indicate clinical utility including kinase activity-stratified pazopanib response in sarcoma, immune activity score-tracked checkpoint-inhibitor outcomes pan-cancer, and a phosphoproteomic biomarker distinguishing EGFR-inhibitor response in chordoma.

Spinal cord injury (SCI) disrupts supraspinal autonomic pathways that regulate cardiovascular function, producing marked blood pressure instability and contributing to secondary injury in peripheral organs. The kidney is particularly vulnerable to these disturbances because renal blood flow (RBF) depends on tightly regulated interactions between neural, myogenic, and vascular control mechanisms. However, how SCI level and chronicity alter dynamic renal autoregulation remains poorly defined. Here, we investigated the effects of high- and low-thoracic SCI on renal hemodynamic control using in vivo blood pressure and RBF recordings in female mice. Hemodynamics were assessed at baseline and during acute sympathetic stimulation induced by norepinephrine (NE; 10 g/kg, i.v.) at 24 h and 4 wk following spinal cord transection at thoracic level 3 (T3) or thoracic level 10 (T10). Time-domain analyses quantified systolic blood pressure recovery, while frequency-domain analyses were used to resolve myogenic and sympathetic contributions to RBF regulation. High-thoracic SCI caused marked disruption of renal vascular responses to acute hypertension, producing paradoxical increases in RBF during NE-induced pressure elevations and sustained reductions in baseline and evoked RBF activity within frequency ranges associated with myogenic and sympathetic vasomotion. These impairments were most pronounced during the chronic phase of injury, consistent with loss of dynamic autoregulatory control and vascular remodeling. In contrast, low-thoracic SCI preserved baseline renal vasomotor activity and demonstrated recovery of dynamic autoregulatory responses over time. These findings identify SCI level and chronicity as critical determinants of renal microvascular regulation and demonstrate that high-thoracic SCI produces persistent autonomic-vascular uncoupling. This disruption of dynamic renal autoregulation represents a previously underappreciated mechanism of secondary organ vulnerability following neurotrauma.

Background Lichen Planus (LP) is a chronic inflammatory disorder that can affect the skin, hair, nails, and mucous membranes. Oral lichen planus (OLP), the most common LP subtype, is a disease of the oral mucosa, often diagnosed through clinical examination and histopathological confirmation. Extracellular vesicles (EVs) transfer proteins, lipids, and nucleic acids among cells and have become increasingly studied for their potential as minimally invasive diagnostic biomarkers and therapeutic agents in inflammatory and autoimmune diseases. Methods PUBMED and Embase were searched from inception through June 27th, 2026. Human studies investigating EV-associated miRNA or protein biomarkers in LP and its subtypes were included, with risk of bias assessed using a modified Newcastle-Ottawa Scale. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) and BRMA models when sufficient data were available. Results Ten articles met the inclusion criteria, encompassing biomarker discovery, functional, and mechanistic studies of EVs in OLP. These included studies (n = 10) comprised 298 individuals with LP (weighted mean age 50.7 years; 61.5% female) and 194 controls (weighted mean age 47.8 years; 58.5% female). OLP-specific cohorts (n = 9 studies) included 261 individuals with OLP (weighted mean age 50.7 years; 61.4% female). Although no individual EV-associated miRNAs or proteins overlapped across studies, EV-associated miRNAs demonstrated substantial heterogeneity, while EV-associated protein findings centered on pathways related to antigen presentation, inflammatory signaling, and immune activation. Several candidate biomarkers, including miR-4484, miR-34a-5p, GJA1, PDIA3, and Cx43, showed potential diagnostic or prognostic relevance. ROC analyses demonstrated good diagnostic utility for miR-4484 (AUC = 0.81), and the combination of GJA1 and Cx43 showed the strongest discriminatory ability (AUC = 0.892). The diagnostic accuracy meta-analysis showed good discrimination (pooled AUC = 0.89). Functional and mechanistic studies suggested that EVs may actively contribute to OLP pathogenesis through promoting epithelial injury and activating inflammatory signalling pathways. Conclusions EV-associated miRNAs and proteins are potential biomarker candidates for LP and may provide insight into the inflammatory and immune mechanisms underlying disease pathophysiology. Functional and mechanistic evidence further suggests that EVs may play an active role in disease progression. However, current evidence has limitations such as small sample sizes and methodological heterogeneity. Larger, standardized, and longitudinal studies are needed to v

Despite the significant technical advancement in spatial transcriptomics, its clinical usage is largely untapped. Here, we develop an integrated system, ENDO-Genome, for minimally invasive in-body transcript sampling to facilitate live spatial transcriptomic analysis of human internal organs. This is achieved by integrating a nanoarrayed biochip with existing endoscope to perform pressure-sensor-calibrated "Touch & Go" RNA extraction directly from human internal organs, including the highly vascularized liver or kidney, without the need for tissue biopsy, voiding any bleeding risks. By a demonstration using gastrointestinal endoscopy, multiplexed landscape of 55 mRNA transcripts was obtained from multiple locations of human intestinal tract via a 5-minute operation in routine examinations. Benefiting from a sequencing-free approach, each assay costs less than 10 US dollars. For the clinical study involving 15 Crohn' s disease (CD) patients, no complication case was reported out of 47 ENDO-Genome operations, showcasing the gentle deposition and excellent safety of the technique. The live spatial transcriptomics provides direct in vivo pictures of the heterogenous spatial transcriptional programs underlying CD pathological response at different intestinal locations, revealing distinct ileal phenotypes. This is manifested by unique microscale scattering of inflammation gene clusters, along with the discovery of a tissue-specific cooperative mechanisms between inflammation and RNA methylation regulations at single- or multi-cell scales.

Background: HIV infection has long been associated with increased incidence of severe cutaneous adverse reactions (SCAR). It remains unknown whether this increased incidence is a direct biological result of HIV infection, differences in drug exposure, or other demographic factors. Objective: To evaluate the association between HIV and SCAR and determine whether this relationship persists after adjusting for demographic factors and structured drug exposure. Methods: We analyzed reports from the FDA Adverse Event Reporting System (FAERS) from 2013-2023. SCAR outcomes included Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed drug eruption (GBFDE). HIV status was determined using antiretroviral exposure, indication text, and machine-learning imputation. Logistic regression models were constructed sequentially: unadjusted, demographic-adjusted, and fully adjusted with drug principal components to account for polypharmacy. Drug-level disproportionality and HIV-drug interaction analyses were also performed. Results: In unadjusted models, HIV was strongly associated with SCAR (OR ~2.0-2.7). Adjustment for demographics attenuated this association, and further adjustment for drug exposure reduced the effect to near null for overall SCAR and DRESS. A modest residual association persisted for SJS/TEN (OR ~1.3). Disproportionality analyses demonstrated enrichment of specific high-risk drugs in PLWH. Interaction modeling revealed drug-specific amplification of SCAR risk in HIV, notably for carbamazepine and clarithromycin, whereas other drugs showed minimal interaction. Conclusion: The association between HIV and SCAR is largely explained by differences in drug exposure and demographic factors. Residual risk is drug-specific rather than uniform, supporting a model in which HIV modifies susceptibility to select drug triggers rather than acting as a global risk factor. Further prospective and retrospective studies are required to quantify associations.

Fibroproliferative diseases such as systemic sclerosis are complex conditions characterized by chronic skin inflammation and progressive fibrosis, with fibroblast activation as a central feature. While Transforming Growth Factor Beta (TGF-{beta}) signaling is a well-established driver of fibrosis in SSc, inflammatory pathways such as Nuclear Factor Kappa B (NF-{kappa}B) also contribute substantially to disease morbidity. We previously identified CD109 as a TGF-{beta} co-receptor and negative regulator of fibrotic signaling; however, its role in inflammatory signaling remains unknown. Here, we investigate the function of CD109 in regulating inflammatory signaling in skin fibroblasts. We show that, CD109 co-localizes and associates with Toll-like receptors (TLR2, TLR4) and tumor necrosis factor receptors (TNFRI, TNFRII), and that loss of CD109 enhances TNF--induced NF-{kappa}B activation and reprograms cytokine production in human dermal fibroblasts. Furthermore, both global and fibroblast-specific CD109 knockout mice exhibit increased immune cell infiltration and skin inflammation. In parallel, single-cell transcriptomic analyses across a pan-disease fibroblast atlas show that CD109 expression is preferentially maintained in structural and homeostatic fibroblast subtypes, whereas immune-interacting fibroblast subsets consistently display decreased CD109 levels. Pathway-level analyses of fibroblast pseudobulk samples reveal altered activity of canonical inflammatory pathways in SSc compared to healthy skin. Together, these findings identify CD109 as a fibroblast-intrinsic negative regulator of inflammatory signaling and suggest a broader role for CD109 in modulating inflammatory responses in systemic sclerosis. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=102 SRC="FIGDIR/small/736423v1_ufig1.gif" ALT="Figure 1"> View larger version (53K): org.highwire.dtl.DTLVardef@be9e08org.highwire.dtl.DTLVardef@794173org.highwire.dtl.DTLVardef@b81eb5org.highwire.dtl.DTLVardef@1e811f5_HPS_FORMAT_FIGEXP M_FIG Graphical Abstract: CD109 Restrains Fibroblast-Driven Inflammation by Modulating NF-{kappa}B Signaling. Generated using FigureLabs.ai and edited using Adobe Photoshop. C_FIG

Chronic wounds, such as diabetic foot ulcers, fail to progress through the normal healing process and impose a significant burden on healthcare systems. While previous single-cell studies have characterized specific wound conditions, a unified understanding of the shared and distinct cellular landscapes across diverse wound microenvironments has been lacking. Therefore, we integrated over 500,541 cells from patients and mice across multiple wound conditions, including acute wound, diabetic foot ulcer, and venous ulcer as well as their healing outcome. Fibroblast-focused analysis identified a bifurcation in differentiation trajectories and identified STAT3 as a potential regulator of a reparative program in chronic wound. Furthermore, we discovered immune dysfunctions in non-healed chronic wounds, contrasting the quiescent memory-like T cells and TIMP1+ macrophages in healed chronic wounds with the exhausted T cells and foamy SPP1+ macrophage enriched in non-healed chronic wounds. Finally, we translated these results into a clinically applicable three-gene signature (CHI3L1, TIMP1, and SPP1) that accurately predicts chronic wound healing. To support wound biology community, we developed WoundSCAtlas, an interactive web resource for exploring diverse wound pathologies. In conclusion, this work provides a comprehensive and cross-species landscape of chronic wound healing, identifying conversed wound outcome-associated molecular programs, predictive biomarker, and interactive data resource.

Treatments for advanced melanoma have markedly improved, but a significant proportion of patients still receive little to no survival benefit with standard-of-care therapies due to resistance and relapse1-5. The discovery and development of novel targets and therapies are needed to continue to improve patient outcomes in advanced melanoma. The identification of ligand-dependent BMP signaling that inhibits differentiation and promotes survival of melanoma cells suggests it is a potential therapeutic target that could complement current therapies6. Expression of the BMP ligand GDF6 (a.k.a BMP13) is responsible for this activity, and its expression is correlated with poor outcomes for melanoma patients. Here, we describe a novel monoclonal antibody targeting GDF6 that causes melanoma cell differentiation and death and blunts tumor growth in vivo. Together, these results indicate BMP-directed therapy has significant potential as a novel therapy for patients with advanced melanoma.

Background Erythema nodosum leprosum (ENL) is a severe immune-mediated complication of multibacillary leprosy requiring prolonged immunosuppression. Steroid-sparing agents are essential to reduce relapse and treatment-related morbidity. Methods This longitudinal analytical observational study compared outcomes in patients with ENL treated with prednisolone plus thalidomide (Group A; n=30) and prednisolone plus tofacitinib (Group B; n=31). Patients were followed for 6 months. Primary outcomes included relapse rate and ENLIST ENL Severity Score (EESS). Secondary outcomes were neutrophil-lymphocyte ratio (NLR), Dermatology Life Quality Index (DLQI), steroid dependency, and adverse events. Inter-group comparisons and longitudinal analyses were performed using non-parametric tests. Correlations between NLR, EESS, and DLQI were assessed using Spearmans rank correlation. Results Relapse occurred in 36.7% of patients in Group A and 71.0% in Group B (p=0.007). The mean number of relapses was significantly lower in Group A (0.70{+/-}1.06 vs 1.84{+/-}1.51, p=0.002). At 3 and 6 months, Group A demonstrated significantly lower NLR values (p=0.017 and p<0.001, respectively). DLQI and EESS scores improved in both groups; however, sustained improvement was more consistent in Group A. Steroid-free status at 6 months was achieved in 93.3% of Group A compared with 58.1% of Group B (p<0.001). NLR showed a positive correlation with EESS ({rho}=0.269, p=0.018) and DLQI ({rho}=0.604, p<0.001) at 6 months. On multivariable logistic regression analysis adjusting for baseline confounders, patients receiving tofacitinib had significantly higher odds of relapse compared with those receiving thalidomide (adjusted OR 9.87, 95% CI 1.73-27.12; p = 0.006).Adverse events were predominantly mild to moderate, with differing safety profiles between groups. Conclusion Thalidomide demonstrated superior relapse prevention and steroid-sparing efficacy compared with tofacitinib in ENL. NLR correlated with disease severity and quality of life, supporting its role as a useful biomarker for monitoring disease activity during follow-up.

The aim of this study was to explore the scalp bacterial flora structure and functional characteristics in androgenetic alopecia (AGA) patients, analyze its association with disease phenotypes and unhealthy lifestyles, and provide a basis for clarifying AGAs microecological pathogenic mechanism and targeted interventions. A total of 7 AGA patients and 6 healthy controls (HC) were enrolled, with scalp microbial samples collected. High-throughput sequencing of the 16S rRNA V3-V4 region was used to analyze flora alpha/beta diversity, species composition and differential species. LEfSe and KEGG functional prediction screened marker bacteria and differential pathways, and clinical/lifestyle data were collected for inter-group comparisons. No significant difference in Chao index was observed between groups (P>0.05), but Shannon/Simpson indices/Pielou evenness (P<0.01) and intra-group Bray-Curtis distance (P<0.001) were significantly higher in the AGA group, indicating reduced community stability. Staphylococcus dominated healthy scalps; the AGA group had fewer symbiotic bacteria but enriched Acinetobacter, Pseudomonas, andCutibacterium. LEfSe identified Firmicutes/Staphylococcus as HC markers and Proteobacteria/Gammaproteobacteria/Acinetobacter/Pseudomonas as AGA dysbiotic flora. KEGG showed upregulated metabolic, immune and cell motility pathways in AGA (P<0.05), with only infectious diseases pathway enriched in HC. AGA patients had more frequent hair washing and higher rates of staying up late, high-fat diet and insufficient fruits/vegetables (all P<0.05). In conclusion, AGA patients have typical scalp microecological dysbiosis closely related to unhealthy lifestyles, which may accelerate alopecia by inducing follicular inflammation. Scalp flora can be potential biomarkers and targets for AGA assessment and intervention.

Background & AimsThe human esophagus undergoes a tightly regulated developmental program, transitioning from a simple columnar epithelium in early development to a mature stratified squamous tissue essential for adult barrier function. Here, we constructed a developmental cell atlas spanning early development to adulthood and leveraged it to generate physiologically relevant in vitro models. MethodsWe utilized single-cell RNA sequencing and spatial multiplex proteomics of human esophageal tissue from early development through adulthood. We established a feeder-supported 2D culture system and a Matrigel-free, suspension-based 3D esophagoid model in a 96-well format. To interrogate WNT2B function, we analyzed patient tissue harboring WNT2B loss-of-function mutations and performed WNT inhibition in esophagoids. ResultsSequencing profiling identified stage-specific epithelial populations: multiciliated and GPC3 basal cells were unique to early development; KRT14 basal and CRNN luminal cells were adult-specific; and COL17A1, LY6D, and KRT4 populations were shared across stages. Spatially organized WNT2B, KIT, and VWC2 mesenchymal subtypes were identified. The 2D system preserved both epithelial and mesenchymal compartments with transcriptional fidelity. Esophagoids exhibited basal-to-luminal stratification, mesenchymal compartmentalization, and required stromal interactions for formation. WNT2B repressed self-renewal of TP63 basal progenitors and inhibited proliferation, confirmed by pharmacologic inhibition of WNT in the in vitro esophagoids. ConclusionsWe present a stage-resolved atlas of human esophageal development and a scalable esophagoid platform recapitulating esophageal architecture. WNT2B regulates progenitor dynamics by restraining basal cell self-renewal. Esophagoids provide a physiologically relevant system for modeling esophageal development and disease. Visual Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=139 SRC="FIGDIR/small/733451v1_ufig1.gif" ALT="Figure 1"> View larger version (45K): org.highwire.dtl.DTLVardef@1af5743org.highwire.dtl.DTLVardef@8a061dorg.highwire.dtl.DTLVardef@1975c3forg.highwire.dtl.DTLVardef@292ce9_HPS_FORMAT_FIGEXP M_FIG C_FIG Key Findings and ImplicationsO_LIDevelopmental Atlas: The study presents a comprehensive transcriptional and structural atlas of the human esophageal epithelium, identifying conserved and stage-specific epithelial populations from early development to adulthood. Notably, stage-specific gene expression of multiciliated and GPC3 basal cells were unique to early development, while KRT14 basal and CRNN luminal cells were adult specific, with COL17A1+ (basal), LY6D+ (epibasal), and KRT4+ (middle), shared at all stages. C_LIO_LIMesenchymal Diversity: Spatial and transcriptional profiling revealed distinct mesenchymal subtypes, including WNT2B, KIT, and VWC2 populations, which are spatially organized and contribute to epithelial-mesenchymal signaling. These findings reinforce the role of stromal-epithelial interactions in esophageal development. C_LIO_LI2D Esophagus Cell Culture System: A feeder-supported 2D cell culture system was developed that retains both epithelial and mesenchymal populations, preserving transcriptional fidelity and enabling long-term expansion for mechanistic studies. C_LIO_LI3D Esophagoid Model: A suspension-based 3D organoid system was optimized using a 96-well format, enabling high-throughput generation of esophagoids with robust epithelial stratification and mesenchymal compartmentalization. These organoids recapitulate key features of the human esophagus, including basal-to-luminal organization, and require stromal interactions for formation. C_LIO_LIFunctional Role of WNT2B in esophagus development: Both in vivo and in vitro analyses demonstrated that WNT2B regulates epithelial progenitor dynamics and tissue architecture by repressing self-renewal of basally localized TP63+ cells and inhibiting proliferation. Loss-of-function models and WNT pathway modulation confirmed its role in epithelial-mesenchymal crosstalk and organoid integrity. C_LI

Despite the revolutionary impact of genome engineering tools in medicine, the safe and effective intracellular delivery of CRISPR remains a major obstacle for clinical applications. Here, we implement precision molecular medicine and delivery strategies based on CRISPR/dCas9 systems adapted for epigenetic repression (dCas9-KRAB) to silence oncogenic drivers with high genomic selectivity. As proof-of-principle, we target the EWSR1-FLI1 translocation, which encodes a chimeric and hard-to-drug oncogenic transcription factor driving approximately 85% of the cases of Ewing Sarcoma (EWS)-an aggressive malignancy affecting children and adolescents. We describe the development of a non-viral and programmable polymeric system for the delivery of dCas9-KRAB as ribonucleoprotein (RNP) payloads for selective EWSR1-FLI1 repression. We demonstrate highly efficient intracellular delivery of RNPs loaded in polyamide-amine (PAMAM) polymers functionalized by guanidino groups, resulting in robust silencing of EWSR1-FLI1 both in established cell line xenografts and in patient-derived xenografts (PDXs) of EWS. Moreover, silencing of EWSR1-FLI1 is accompanied by potent anti-tumor effects. To our knowledge, we describe the first non-viral platform for in vivo delivery of dCas9-KRAB/RNPs, which can be adapted for the repression of any oncogene. We further outline dCas9/RNP formulations for future therapeutic applications to treat poor-prognosis cancers driven by hard-to-drug oncogenes.

BackgroundSystemic inflammation triggered by microbial insults can disrupt endothelial homeostasis, impair blood-brain and blood-retinal barriers, leading to neurovascular remodeling in the central nervous system (CNS). Subnuclear condensates, paraspeckles, play a substantial role in stress-induced gene regulation, yet their contribution to the inflammatory relay from microbial insults to neurovascular remodeling remains unelucidated. ResultsOur comparative transcriptomic analysis followed by experimental validation identified a cross-species NEAT1_2/CYR61/FGF2 signature in the CNS positively associated with neurovascular remodeling across human disease cohorts and multiple mouse models. Notably, systemic inflammation triggered by microbial insults, including sepsis or gut dysbiosis, enhanced NEAT1_2 expression in the brain and retina with neurovascular remodeling. Microbial insults induced hyper-assembly of paraspeckles and the expression of CYR61 and FGF2 in vascular endothelial cells. Paraspeckle assembly and its required NEAT1_2 Domain C, rather than NEAT1_2 expression levels, play a pivotal role in endothelial homeostasis control and neurovascular remodeling by sequestering the RNA-binding protein RBM14 from the CYR61 promoter, thereby relieving its repression of CYR61 transcription. Moreover, secreted CYR61 enhanced FGF2-mediated endothelial remodeling signals in a paracrine manner. Disrupting paraspeckle assembly by targeting Domain C intercepts neurovascular remodeling, restoring endothelial homeostasis in vivo. ConclusionsOur results demonstrate an essential and conserved role for paraspeckles in the inflammatory relay from microbial insults to neurovascular remodeling by sequestering RBM14 to enhance CYR61-FGF2 signaling. Furthermore, our study underscores paraspeckle assembly as a promising therapeutic target for neurovascular remodeling and related diseases.

Urinary tract infections (UTIs) are among the most common bacterial infections, yet the genetic factors influencing susceptibility remain poorly understood. We performed a genome-wide association study of recurrent UTI involving 1,860,836 individuals (213,869 cases and 1,646,967 controls). We identified 36 independent non-HLA genome-wide significant loci encoding kidney epithelial and immune response genes and demonstrated that some loci have sex-specific effects. Integrative functional annotation, expression and protein quantitative trait locus colocalization, and single-cell multi-omic analyses revealed that UTI risk alleles preferentially modulated gene expression in kidney, ureter, and bladder epithelia. Multi-omic prioritization converged on a number of pathogenic pathways: epithelial barrier and mucosal glycocalyx defense (PSCA, UMOD, CLPTM1L, FUT2), innate immune regulation (FES, PTPRC, NEK7, HOTAIR, NFATC1, BTN3A2), infection resolution and regulated cell death (STK3, CASP7, TAX1BP1, ZFP36L2), epithelial identity maintenance (GLIS2, CLDN10, ZFHX3, SPDEF, MPP7), urinary tract development (FGFR2, BMP7, HGF, MET, HOXA9, TSHZ2, WNT7B/LINC00899), and nutritional immunity through iron sequestration (SLC11A2, FAM210B, RPS10). Approximately one-third of loci colocalized with gene expression in kidney tubules, suggesting direct modulation of epithelial host-defense programs. Among all loci, PSCA, which encodes a GPI-anchored epithelial surface protein expressed in the kidney papilla and urinary tract epithelia, emerged as the strongest candidate causal gene. We demonstrated that PSCA was secreted into urine, bound uropathogenic E. coli, and inhibited bacterial growth in vitro, implicating it as a constitutive epithelial defense factor. We also demonstrated that while PSCA was protective against urinary infections and duodenal ulcers, it was associated with increased risk of bladder, prostate, and gastric cancers, suggesting antagonistic pleiotropy between mucosal defenses and oncogenesis. Together, our findings define the polygenic architecture of UTI susceptibility, highlighting epithelial surface defense, innate immune regulation, developmental patterning, and nutritional immunity as central components of host defense, providing a new framework for host-directed, non-antibiotic interventions.