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Pigment Cell & Melanoma Research

Wiley

Preprints posted in the last 30 days, ranked by how well they match Pigment Cell & Melanoma Research's content profile, based on 11 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

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Large distant deletion disrupts CDKN2A enhancer and predisposes to melanoma

Johansson, P. A.; Brooks, K.; Palmer, J. M.; Nathan, V.; Xu, M.; Scales, J. L.; Hennessey, R.; Holland, E. A.; Harland, M.; Hutchison, S.; Chan, P. Y.; Sankar, A.; Papiernik, S.; Dennis, A.; Thakur, R.; Chari, R.; Schmid, H.; Law, M. H.; Curnow, L.; Howlie, M.; Rodgers, C. B.; Mustard, C.; Bishop, T. D.; Newton-Bishop, J.; Mann, G. J.; Cust, A. E.; Adams, D. J.; Brown, K. M.; Hayward, N. K.; Pritchard, A. L.

2026-05-18 genetic and genomic medicine 10.64898/2026.05.07.26352537 medRxiv
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Deleterious CDKN2A germline variants account for ~40% of familial melanoma cases, while rare variants in CDK4, BAP1, and telomere-maintenance genes collectively attribute ~10% of familial risk. We sought to identify new high-penetrance susceptibility variants by sequencing 305 melanoma cases from 89 multi-case families negative for known predisposition gene variants. In one family, cutaneous melanoma co-segregated with a rare variant in DMRTA1 (p.Glu383Gln), located less than 480 kb upstream of CDKN2A on chromosome 9. Whole-genome sequencing then revealed an intergenic 234kb deletion that co-segregated with melanoma in 18 out of 21 cases across four generations. Further investigations revealed a further 10 families carrying this deletion, co-segregating with melanoma. The deleted region was predicted to encompass regulatory sequences and to interact with the CDKN2A promoter region. Tiled CRISPR inhibition of the predicted enhancer region confirmed interactions between the distant upstream deletion with CDKN2A resulting in decreased p16 transcript mRNA expression. Deletion carriers exhibited nearcomplete loss of p16 mRNA expression from the affected chromosome. This distant noncoding deletion is one of the most common founder variants predisposing to melanoma and reveals a new mechanism controlling p16 expression. Routine screening for this deletion in individuals with perceived high risk of melanoma is warranted.

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Telomere maintaining germline and somatic variants in thyroid cancer and melanoma

Liyanarachchi, S.; Brock, P. L.; Li, W.; Nieminen, T. T.; Pozdeyev, N.; Haugen, B. R.; Mcrary, H.; Salhia, B.; Jensen, K.; Naqash, A. R.; Kaur, V.; Farlow, J.; Ringel, M. D.

2026-05-25 genetic and genomic medicine 10.64898/2026.05.22.26353814 medRxiv
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Importance: Non-medullary thyroid cancer (NMTC) and melanoma are associated with inherited long telomeres due to germline pathogenic/likely pathogenic variants (PV/LPV) in POT1, TINF2, and ACD resulting in long-telomere syndrome (LTS) and they commonly have somatic TERT promoter mutations. The genetic relationship between these variants and their clinical associations are defined incompletely and may inform clinical practice. Objective: To test the hypothesis that germline LTS-associated PV/LPV are exclusive from functional somatic TERT variants and assess clinical/genetic associations. Design: Retrospective observational cohort study with/without germline LTS variants, that have somatic sequencing and pathology data. Setting: Participants were enrolled through 18 cancer centers participating in the Oncology Research Information Exchange Network (ORIEN). Participants: 995 adults with NMTC and 993 with melanoma between 2013 and 2025. All adult patients at an ORIEN center were offered enrollment Exposures: All patients with NMTC or melanoma are included. There are no required exposures. Main Outcomes and Measures: The presence/absence of a germline or somatic long-telomere variant; secondary outcomes are associations with tumor stage, telomerase expression, and oncogenes. Results: Germline and somatic variants in POT1/TINF2/ACD, somatic TERT promoter variants, TERT fusions, oncogenes, and telomerase mRNA expression were evaluated in 995 NMTC and 993 melanoma patients. In NMTC, 13 (1.5%) had a germline LTS variant while 0/12 with tumor sequencing had somatic TERT promoter variants/fusions. In melanoma, 7 (0.7%) had a LTS variant; 0/2 with tumor sequencing had a TERT promoter variant/ fusion. Meta-analysis including NMTC and melanoma in the current study, a recent thyroid cancer study, and thyroid TCGA, germline LTS-associated PV/LPV and somatic TERT variants/fusions were mutually exclusive (p=0.036). High telomerase mRNA levels were associated with TERT promoter variants/fusions (p<4e-11) and larger NMTC/distant metastases (p=0.016), but not germline LTS variants. NMTCs with somatic TERT promoter variants/fusions had higher tumor mutation burden (p<0.02) versus tumors from patients with a germline LTS variant. TERT promoter mutant variant allele frequency was lower in smaller and non-metastatic vs larger/metastatic NMTC. Conclusion and Relevance: Germline LTS-associated variants appear to be exclusive from somatic TERT promoter variants/fusions but are not associated with aggressive NMTC, suggesting common roles in tumorigenesis but different biological impacts.

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MAP3K7 novel variants in syndromic 46,XY DSD

Le, T. N. U.; Moradifard, S. M.; Reyes, A. P.; Ngoc Can, T. B.; Gomes, A. T.; Jones, M. C.; Vu Chi, D.; Harley, V.

2026-05-06 genetic and genomic medicine 10.64898/2026.05.05.26352427 medRxiv
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Mutations in MAP3K7 are responsible for two distinct syndromes Cardiospondylocarpofacial (CSCF) and Frontometaphyseal dysplasia 2 (FMD2). Both are characterized by skeletal malformations, facial dysmorphisms, hearing loss, and mild intellectual disability. While cardiac defects are predominant in CSCF, keloid scar is a distinct feature in FMD2. Problem with gonadal development and disorders of sexual development (DSD) have not been previously chracterized. Here we report three syndromic cases of 46,XY DSD with CSCF or FMD2, each carrying a novel heterozygous missense variants in MAP3K7 (NM_145331.3:c.250G>A; p.V84M, NM_145331.3:c.195A>G; p.I65M, and NM_145331.3: c.574A>G; p.S192G). The DSD phenotypes include cryptorchidism, micropenis, small testis, and hypospadias. In silico tools predict all three variants are deleterious. All three MAP3K7 variants occur in the kinase domain at highly conservative positions among mammals. MAP3K7 is highly expressed in human fetal Sertoli cells. MAP3K7 knock-out in HEK293T cells led to downregulation of GATA4 and FOG2 expression by RNA-Seq. Like MAP3K1, MAP3K7 phosphorylated p38 while all three MAP3K7 variants did not alter phosphorylated p38 compared to wildtype in HEK293TMAP3K7-/- cells. Two MAP3K7 missense mutants (p.V84M and p.I65M) ectopically activate ovarian beta catenin/ Wnt signalling in TOPFLASH assays. Our data suggest that MAP3K7 contributes to male sex differentiation by increasing expression of pro-testis genes GATA4 and FOG2 in HEK293TMAP3K7-/- cells and antagonizing pro-ovarian beta-catenin signalling, and that one or more of these activities were likely affected in 3 cases of 46,XY DSD with CSCF/FMD2 during sex development.

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Biallelic CYB5A disruptions in 46,XY Disorder of Sex Development: Identification and Characterization of a Novel Deep Intronic Variant

Moradifard, S.; LE, T. N. U.; Ha, N. T.; Dung, V. C.; Thao, B. P.; Harley, V. R.

2026-05-12 genetic and genomic medicine 10.64898/2026.05.05.26352416 medRxiv
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BackgroundThe diagnostic yield for 46,XY disorders of sex development (DSD) remains limited. Whole-genome sequencing (WGS) improves detection of both coding and non-coding variants that may be missed by routine testing. Cytochrome b5, encoded by CYB5A, is an essential co-factor for CYP17A1-mediated 17,20-lyase activity. We report on WGS on a Vietnamese family with 46,XY DSD with two siblings presenting with female external genitalia. MethodsClinical assessment and hormone profiling were conducted. WGS was conducted on peripheral blood DNA, in two affected siblings followed by variant annotation and ACMG-based classification. A minigene RNA splicing assay in HEK293 cells was used to evaluate the functional impact of the CYB5A intronic variant. ResultsThe patients hormone profile showed low testosterone and estradiol. WGS identified compound-heterozygous CYB5A variants: a paternally inherited missense variant (p.Val34Glu, likely pathogenic) and a maternally inherited deep intronic deletion (c.129+862_129+863del) for which SpliceAI predicted aberrant splicing. Minigene assays confirmed that the intronic deletion creates cryptic splice sites, resulting in pseudoexon inclusion and a premature stop codon, consistent with nonsense-mediated decay. The intronic variant meets ACMG criteria for pathogenicity. ConclusionThis family expands the spectrum of CYB5A-related DSD and demonstrates that compound-heterozygous variants, including deep intronic defects, can lead to a disruption in 17,20-lyase activity. These findings highlight the importance of WGS and functional assays for identifying clinically relevant non-coding variants in DSD.

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Differential causative effects of germline pathogenic variants in MUTYH and PALB2 in a patient with colorectal polyposis and breast cancer

Camacho Valenzuela, J.; Pelletier, D.; Polak, P.; Fu, L.; Hamel, N.; Domecq, C.; Ahmed, A.; Robles-Espinoza, C. D.; Foulkes, W. D.

2026-05-25 genetic and genomic medicine 10.64898/2026.05.15.26352890 medRxiv
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Purpose Patients carrying Germline Pathogenic Variants (GPVs) in multiple cancer susceptibility genes (CSGs) can be described within the context of Multi-locus Inherited Neoplasia Allele Syndrome (MINAS). The role of each GPV is typically interpreted based on clinical phenotypes. Here, we used tumor sequencing, particularly mutational signatures, to investigate the contribution of GPVs in MUTYH and PALB2 to colorectal polyposis and breast cancer in a single patient at a molecular level. Methods We analyzed tumor sequencing data, including mutational signatures and genomic scars, of a breast tumor and a colorectal polyp from a patient with biallelic GPVs in MUTYH and a heterozygous GPV in PALB2. Results The colorectal polyp showed a dominant contribution of MUTYH-associated Base Excision Repair deficiency (BERd) mutational signatures, with no evidence of Homologous Recombination Repair Deficiency (HRD). In contrast, the breast tumor showed both MUTYH-driven BERd and HRD-associated signatures, including SBS3, ID6 and an elevated HRD score, despite the absence of a detectable second hit in PALB2. These findings suggest a differential contribution from the CSGs, with MUTYH contributing to both lesions and PALB2 contributing specifically to the breast tumor. The observed pattern does not align with the additive or synergistic models described in MINAS. Conclusions Our study provides evidence that mutational signatures can elucidate the contribution of multiple CSGs to tumorigenesis within a single patient. These findings extend current interpretations of MINAS beyond additive or synergistic phenotypes, which may help to better understand tumor etiology, with potential clinical implications, including eligibility for targeted therapies.

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Celiac Disease Risk Allele Frequencies in San Luis (Argentina) and Evaluation of a Saliva Direct PCR Genotyping Approach

Perez, C. N.; Pistone, C.; Romero, C.; Carrillo, A.; Manzur, M. J.; Chialva, C.; Quiroz, H.; Juri Ayub, M.

2026-05-21 genetic and genomic medicine 10.64898/2026.05.19.26353109 medRxiv
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Celiac disease (CD) is strongly associated with specific HLA DQ heterodimers, formed by HLA DQA1 and HLA DQB1 proteins. In particular DQ2.5 (DQB1*02 associated to DQA1*05) and DQ8 (DQB1*03:02 with DQA1*03) are present in virtually all celiac patients. HLA DQB1*02 is considered the main single genetic susceptibility marker and has been reported in 90 to 95% of CD patients. However, the distribution of these alleles may vary across populations, potentially impacting the performance of genetic screening strategies. In this study, we evaluated the prevalence of HLA DQ2.5 and DQ8 genotypes in celiac patients (n = 41) and an unbiased general population cohort (n = 60) from San Luis, Argentina, using a PCR-based genotyping approach. In addition, we assessed the feasibility of a simplified saliva direct PCR protocol for large scale testing. Overall, 95.1% of CD patients carried DQ2.5 and/or DQ8. Notably, 41.5% of patients were DQ8(+)/DQ2.5(-), and 36.6% lacked the DQB1*02 allele, indicating that DQB1*02 based screening alone would have reduced sensitivity in this population. In the general population, 53.3% of individuals carried CD associated genotypes, with a markedly higher prevalence of DQ8 compared to European cohorts. Genotype distributions deviated from Hardy Weinberg equilibrium in CD patients but not in the general population. We show that DQB1*03:02 is a reliable proxy for DQ8, allowing simplification of genotyping strategies, whereas DQA1*05 typing remains essential to discriminate DQ2.5 from other lower risk DQB1*02 carrying heterodimers. We also describe a saliva direct PCR approach showing a performance comparable to purified DNA based assays. These findings highlight the importance of population specific genetic data for optimizing CD screening strategies and foster the development of simplified, cost effective genotyping approaches for large scale applications.

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Spatial and Bulk Transcriptomic Profiling Defines the Molecular Evolution of Cutaneous Squamous Cell Carcinoma and Reveals Stage-Specific Biomarkers of Clinical Relevance

Naji, F.; Oterino-Sogo, S.; Beltzung, F.; Garciaruano, D.; Mahfouf, W.; Guegan, J.-P.; Bohec, M.; Groppi, A.; Beylot-Barry, M.; Dousset, L.; Nikolski, M.; Rezvani, H.-R.

2026-05-05 cancer biology 10.64898/2026.04.30.721943 medRxiv
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Cutaneous squamous cell carcinoma (cSCC) is a common skin cancer associated with substantial morbidity and mortality in advanced stages. Despite its well-described stepwise progression from actinic keratosis to invasive disease, robust molecular markers for stage discrimination and clinical decision-making remain limited. We sought to define the transcriptional continuum underlying cSCC progression, identify stage-associated biomarkers, and assess the broader relevance of these programs across human malignancies. Bulk RNA sequencing (HTG EdgeSeq) and spatial transcriptomics (GeoMx) were performed on biopsies from eight patients, each presenting multiple disease stages (healthy skin, premalignant lesion, tumor core, and invasive front) within the same lesion field, enabling within-patient analysis of progression. Spatial transcriptomic analyses identified more than 2,000 differentially expressed genes whose expression varied across disease stages. These genes were organized into 18 coordinated expression programs reflecting progressive biological rewiring during tumor evolution. Proliferation, extracellular matrix remodeling, inflammation, and stress-response pathways were progressively upregulated, whereas epithelial differentiation and metabolic processes, including lipid and amino acid metabolism, were downregulated. Macrophages exhibited distinct metabolic reprogramming, with increased purine metabolism, glycolysis, and pyruvate metabolism across progression. To evaluate the broader clinical relevance of these progression-associated programs, we developed a reproducible Snakemake pipeline to systematically screen 32 solid and hematologic malignancies from The Cancer Genome Atlas (TCGA). A combined cSCC-progression signature was significantly associated with poor overall survival (P < 0.05) in 10 additional cancer types. Finally, we identified 12 stage-informative biomarkers, whose spatially restricted expression patterns were validated using Visium HD. This study provides a spatially resolved and stage-aware transcriptomic map of cSCC progression, identifies coordinated gene programs underlying disease evolution, and defines progression-associated signatures with prognostic relevance across multiple cancers, highlighting their potential translational value.

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A single PLAT domain protein couples reproductive arrest and carotenoid pigmentation during diapause in the two-spotted spider mite, Tetranychus urticae Koch

Rismayani, R.; Sai, K.; Ohsako, T.; Murata, K.; Arai, Y.; Takeda, N.; Yamamoto, M.; Umemiya-Shirafuji, R.; Suzuki, T.

2026-05-15 physiology 10.64898/2026.05.13.724795 medRxiv
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Adult females of the two-spotted spider mite, Tetranychus urticae Koch, enter a photoperiodically induced diapause to overwinter. Diapause in T. urticae is accompanied by reproductive arrest and the orange body coloration that arises from the accumulation of astaxanthin esters. How these two traits are coordinated at the molecular level remains poorly understood. Here, we compared the proteomes of adult females reared under diapause-inducing (long-night) and non-diapause-inducing (short-night) photoperiods using liquid chromatography-tandem mass spectrometry, followed by RNA interference (RNAi) of candidate genes. The carotenoid biosynthesis enzymes phytoene desaturase (TuPDS) and lycopene cyclase/phytoene synthase (TuLCPS), both encoded by genes horizontally transferred from fungi, were more abundant in diapausing females than in non-diapausing females. RNAi of the genes encoding TuPDS and TuLCPS markedly reduced orange pigmentation as well as {beta}-carotene and astaxanthin contents, demonstrating that these enzymes are required for diapause-associated pigmentation. Our proteomic analysis further identified a single PLAT (Polycystin-1, Lipoxygenase, Alpha-toxin) domain protein, TuPLAT10, as one of the most strongly upregulated proteins in diapausing females. The PLAT domain is a lipid-binding module, suggesting a role for TuPLAT10 in lipid metabolism. In addition to the suppression of orange pigmentation, RNAi of the TuPLAT10 gene restored reproduction even under diapause-inducing conditions and selectively reduced TuPDS and TuLCPS protein levels, despite the absence of sequence similarity to their genes. We propose that TuPLAT10 acts as a lipid-allocation switch that, in response to photoperiodic information, partitions fatty acids between astaxanthin esterification and yolk lipid supply, thereby coupling reproductive arrest and carotenoid pigmentation during diapause in T. urticae.

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The phenotypic nonspecificity of cell-to-cell signalling in Drosophila melanogaster.

Percival-Smith, A.; Brabrook, C.

2026-05-21 genetics 10.64898/2026.05.19.726339 medRxiv
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An expectation of a hypothesis that proposes cell-to-cell signalling pathways are redundant due to the redundancy of pathway terminal transcription factors (TFs) was tested by screening 35 signalling ligands (SLs) for rescue of a decapentaplegic (dpp) hypomorphic wing growth phenotype. The screen identified three examples of partial rescue: Hedgehog (HH), Semphorin 1a (SEMA1A) and Wnt ortholog 2 (WNT2). HH overexpression with dppGAL4 may increase the expression of DPP activity from the hypomorphic dpp alleles. However, SEMA1A and WNT2 did not phenocopy ectopic expression of HH or DPP and neither SEMA1A nor WNT2 were required for wing growth suggesting substitution of DPP for partial restoration of wing growth. The WNT2 rescue was dependent on the Frizzled 4 (FZ4) WNT receptor excluding the possibility that WNT2 weakly binds the DPP receptor. Although examples of phenotypic nonspecificity of SL function were identified, this is an expectation, and not direct proof, of the hypothesis of TF redundancy. Screen Report SummaryAn expectation of a hypothesis proposing that cell-to-cell signalling pathways are redundant due to the redundancy of the pathway terminal transcription factors was tested by screening for replacement of one signalling ligand (DPP; SLa) with another SLb for wing growth. Three non-DPP SLs were identified in the screen of 35SLs: HH, SEMA1A and WNT2. Genetic analysis of Sema1a and Wnt2 suggests functional complementation of dpp for wing growth suggesting that SEMA1A and WNT2 partially replace DPP for wing growth. Therefore, an expectation of the hypothesis is met.

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A portable molecular laboratory for rapid genotyping in the field: application to sickle cell disease

Grunder, F.; Haemmerli, A.-F.; Bokembya, C. I. N.; Hennart, S.; Helmers, M.; Porret, N. A.; Graz, B.; Choudja Ouabo, C.; Abriel, H.

2026-05-12 genetic and genomic medicine 10.64898/2026.05.05.26352080 medRxiv
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BackgroundSickle cell disease (SCD) is the most common recessive genetic disorder, caused by pathogenic variants of the HBB gene. SCD is associated with a range of clinical manifestations, including vaso-occlusive crises, infections, and severe anaemia, which contribute to increased morbidity and mortality. The frequency of pathogenic alleles is high in Sub-Saharan African countries, with heterozygous carriers reaching up to 25% of the population. Several methods can be employed for molecular diagnostics, with HBB gene sequencing being the most precise. However, access to DNA analyses and sequencing in Low- and Middle-Income Countries (LMICs), where SCD prevalence is high, is limited. Understanding genetic profiles is crucial at both individual and population levels, as it can guide public health strategies and facilitate accurate genetic counselling. AimThis feasibility study aimed to demonstrate that a portable medical genetic laboratory (in suitcases) can be used to genotype individuals for the HBB A, S, and C alleles and their combinations within a few hours outside of a laboratory setting. Methods and resultsWe established a portable medical genetics laboratory capable of DNA extraction and isothermal DNA amplification using a commercially available kit for the A, S, and C alleles of the HBB gene. During one single study day, this portable lab was set up in a room where the Swiss Association of Patients with SCD was holding its annual meeting. We analysed the samples of 27 participants who were aware of their A, S, or C status. We collected buccal swabs and dried blood samples for genotyping. Genotype results for all participants were obtained within five hours after sample collection. In four cases, we observed discrepancies between the buccal swab and blood genotypes; three were resolved upon repeat testing, and one reflected donor chimerism following hematopoietic stem-cell transplantation. ConclusionsThis study demonstrates the feasibility and efficiency of using a portable medical genetics laboratory for rapid genotyping of HBB SCD alleles in community settings.This approach can improve access to molecular diagnostics in resource-limited environments. Such tools have the potential to significantly enhance local capabilities for genetic screening, counselling, and public health planning in regions heavily affected by SCD.

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Desmoglein-3 modulates p38MAPK and ERK signaling responses through the mechano-sensitive channel Piezo1

Leal-Fischer, K.; Franz, H.; Buczak, K.; Zimmermann, A.; Spindler, V.

2026-05-13 cell biology 10.64898/2026.05.11.723746 medRxiv
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BackgroundSkin is constantly exposed to mechanical forces such as pressure and friction, which need to be sensed and buffered to ensure tissue homeostasis and barrier function. Desmosomes are essential for epidermal integrity, but their role in converting mechanical cues into cellular signaling responses are not well understood. MethodsHere, we combine proteomics and shear-stress assays with live-cell reporters to investigate how desmosomes modulate stress-kinase pathways in keratinocytes. ResultsWe show that the desmosomal adhesion molecule DSG3 is essential not only for cell-cell adhesion but also for modulating p38MAPK and ERK signaling. Loss of DSG3 disrupts mechanotransduction-related protein networks, including the expression of the mechanosensitive channel Piezo1. Under static conditions, DSG3 dampens ERK activity via Piezo1-dependent mechanisms, whereas DSG3 suppresses p38MAPK activity through an independent mechanism. In contrast, DSG3 is required to trigger an activation of both ERK and p38MAPK in response to shear stress in a Piezo1-dependent manner. Experiments with domain-specific DSG3 mutants demonstrate that cell cohesion and signaling responses are partially uncoupled, while maintaining DSG3 tail integrity was crucial for p38MAPK and ERK responses. ConclusionThese findings demonstrate that DSG3 independently coordinates adhesion and mechanotransduction in a domain-specific manner, providing novel insights into how DSG3 contributes to epithelial integrity under dynamic mechanical environments.

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Clinical Predictors of Outcome in Nonsegmental Vitiligo: A Prospective Cohort Study

Kumari, L.; K, S.; Nagpal, S.; Gupta, V.; Pandey, S.; Sahni, K.; Ramam, M.; Gupta, S.

2026-05-05 dermatology 10.64898/2026.04.29.26352012 medRxiv
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BackgroundNon-segmental vitiligo(NSV) shows marked heterogeneity in activity, progression, and treatment response. Reliable clinical markers that predict prognosis and patient-reported outcomes are lacking. ObjectivesTo identify clinicodemographic and clinical predictors of disease extent, progression, repigmentation, treatment dependency, noticeability, and psychosocial impact in NSV. MethodsIn this prospective cohort study, 275 patients with NSV were followed for 12 months. Sixteen baseline variables, including demographic features, autoimmune history, and clinical markers (koebnerization, confetti and trichrome patterns, leukotrichia, mucosal, acral, and periorificial involvement), were recorded. Outcomes included body surface area(BSA), progression, repigmentation, treatment dependency, Vitiligo Noticeability Scale(VNS), and quality-of-life indices(VIS-22, DLQI, C-DLQI, F-VIS). Multivariable analyses and cluster analysis were performed at 6 and 12 months. ResultsMarkers of disease activity leukotrichia, trichrome and confetti lesions, koebnerization, and mucosal, acral, and periorificial involvement were strongly associated with greater BSA, poor repigmentation, higher noticeability, and treatment dependency. Leukotrichia was consistent predictor of poor repigmentation and high VNS. Family history of autoimmunity predicted progression and treatment dependency. Early-onset vitiligo showed lower disease extent but greater family-related psychosocial burden. Cluster analysis identified severe, intermediate, and mild phenotypes with distinct therapeutic responses. ConclusionsSimple clinical markers can stratify NSV patients into prognostic subgroups, enabling individualized treatment and counseling. Plain Language SummaryVitiligo behave variably in different people, some people may have slow-spreading course, while others develop widespread or persistent patches. In this study, we followed 275 people with non-segmental vitiligo for one year to find signs on the skin that could predict how the disease would behave and how it would affect daily life. We found that features such as white hair within patches (leukotrichia), speckled (confetti) or three-colored lesions (trichrome), new patches appearing after injury (koebnerization), and involvement of the lips, mouth, hands, feet were linked to more severe disease, poorer response to treatment, and greater cosmetic concern. A family history of autoimmune disease increased the risk of worsening vitiligo. Patients who developed vitiligo early in life had less skin involvement but greater emotional and family-related impact. These easily recognized signs can help doctors and patients plan treatment and set realistic expectations. Significance of the studyNon-segmental vitiligo (NSV) has a heterogeneous and unpredictable clinical course with variable progression and response to therapy. However, robust prospective data linking these markers with long-term outcomes and patient-reported measures remain limited. In our prospective cohort of 275 patients, clinical markers such as leukotrichia, trichrome and confetti lesions, koebnerization, and acral/mucosal/periorificial involvement, were strongly associated with greater disease extent, poorer repigmentation, higher treatment dependency, and increased noticeability. Leukotrichia consistently predicted poor repigmentation. Thereby, prognostic stratification can also improve patient counselling regarding expected repigmentation, treatment duration, and psychosocial burden.

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Reparative and regenerative immature neutrophil-like population derived from HL-60 cells

Kaur, S.; Shukla, A.; Gupta, A.; Bashyal, B.; Suresh, V.; Saikia, U. N.; Gupta, P. C.; Luthra-Guptasarma, M.

2026-05-13 cell biology 10.64898/2026.05.11.724223 medRxiv
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Unlike the conventional mature neutrophils, immature neutrophils have been investigated for their regenerative properties; however, their limited availability necessitates alternative generation strategies. Here, we used a combination of dimethylsulfoxide (DMSO) and 1,25-dihydroxyvitamin D3 (D3) to differentiate myeloid leukemia (HL-60) cells into immature neutrophil-like cells. Differentiated cells exhibited reduced cell size, loss of uniformity, decreased nuclear-to-cytoplasmic ratio, band-shaped nuclei, increased proportion of CD11b+CD14+ cells (indicative of immature neutrophils), decreased proportion of CD11b+CD16+ cells (indicative of mature neutrophils), higher levels of arginase 1, TGF{beta}1 (markers of immature neutrophils), and no expression of CD16, MRC1 (markers of mature neutrophils and M2 macrophages, respectively). Proteomic analysis revealed enrichment of proteins associated with immature neutrophils and wound healing. Functionally, these cells supported limbal stem cell growth and wound closure in vitro, indicating relevance for corneal regeneration. Administration of these cells to ex-vivo and in-vivo alkali-injured corneas, resulted in significant effect on promotion of wound healing, with epithelial regeneration and decreased fibrotic markers, proving that such cells hold promise for clinical translation as a therapeutic tool for tissue repair.

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A Foundational Exome Resource for Jordan: Dual Ancestry Admixture and Population-Specific Variants to Improve Clinical Variant Interpretation

Froukh, T.

2026-05-27 genetic and genomic medicine 10.64898/2026.05.23.26353895 medRxiv
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Currently, the genetic architecture of Middle Eastern populations is underrepresented in global genomic databases. This gap increases the rate of Variants of Uncertain Significance (VUSs) and clinical misinterpretations of genomic data especially in Middle Eastern populations. Whole exome sequencing was conducted on 90 healthy individuals from Jordan and the data were analysed using Principal Component Analysis (PCA) and multi-computational filtering. PCA revealed a double ancestry (EUR-AFR) admixture rather than a triple admixture (EUR-AFR-AMR). More than 3,500 populations-specific variants (PSVs) were identified, of which 72% were singletons. Additionally, 19 variants were significantly enriched compared to the maximum allele frequencies in public global databases (Fisher's exact test with Benjamini-Hochberg false discovery rate correction, p-value < 0.05). Consequently, the results suggest the reclassification of variants of Uncertain Significance (VUS) which reside in the ECE2 gene to likely benign and the variants of Conflicting Classification of Pathogenicity in the genes IL1RN and THPO to benign based on the significant allele frequency (AF=0.0389, p-value < 0.05). Furthermore, a pathogenic ClinVar variant was identified in a healthy individual, warranting careful interpretation. The findings underscore the importance of identifying PSVs in order to minimize or even prevent clinical misdiagnosis and highlight the unique genetic signature in Jordan. The study serves as a foundational resource for precision medicine in the region.

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Quantification of Mouse Total Body Surface Area: Implications for Preclinical Burn Research

Barlow, A.; Morales, M.; Barre, M.; Kingren, M.; Porter, C.

2026-05-05 physiology 10.64898/2026.04.30.722020 medRxiv
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Clinically, burn severity is reported as the size (and depth) of burn wounds relative to total body surface area (TBSA). This nomenclature is also often used in rodent models of burns. Accordingly, accurate determination and reporting of rodent TBSA is required to ensure the rigor and reproducibility of preclinical burn research. Rodent TBSA is typically estimated indirectly as a function of body mass. Further, empirical quantification of rodent TBSA through pelt dissection does not consider differences in rodent and human anatomy, making comparison of relative burn size in rodents and humans a challenge. Here, we compared commonly used approaches to directly determine or indirectly estimate rodent TBSA to demonstrate the impact different approaches can have on the calculation of relative burn size. A total of n=48 C57BL/6J background mice (55% male) ranging from 4 to 45 weeks of age and 17 to 40 grams were used. Mice were weighed prior to euthanasia. After euthanasia, mouse length was measured from the nose to anus. Mice were then placed into clear polypropylene sheet protectors (21.6 x 27.9 cm) to trace the areas of both the dorsal and ventral surfaces as well as all four limbs (dorsal-ventral (DV) tracing). Next, the pelt was carefully excised from the body through cutting a lateral line from the mouth to the genitalia, then again proximally to distally on all four limbs. The pelt was gently placed on a sheet protector and traced when both relaxed and stretched. The ears and tail were removed and traced separately. Photographs were taken of all tracings next to a ruler for scale and analyzed in ImageJ. Stretched pelt measurements of TBSA were 34% (79.4{+/-}7.6 vs. 57.5{+/-}7.5 cm2, P<0.001) and 30% (70.6{+/-}10.9 vs. 52.7{+/-}8.1 cm2, P<0.001) greater than relaxed pelt TBSA measurements in male and female mice respectively. TBSA estimated by DV tracing was 9% greater in males (62.5{+/-}10.9 vs. 57.5{+/-}7.5 cm2) and 15% in females (60.6{+/-}12.3 vs. 52.7{+/-}8.1 cm2) compared to TBSA measurements made on relaxed pelts. Accordingly, empirically derived Meeh constants (k) from DV tracing were greater than those derived from relaxed pelt measurements for both males (7.14{+/-}0.59 vs. 6.58{+/-}0.72) and females (7.72{+/-}0.58 vs. 6.78{+/-}0.80). In contrast k values derived from stretched pelt measures of TBSA were significantly greater than those determined in relaxed pelts for males (8.91{+/-}0.87 vs. 6.58{+/-}0.72, P<0.001) and females (8.85{+/-}1.25 vs. 6.78{+/-}0.80, P>0.001). The combined ears and tail represent approximately 7% and 8% of the TBSA measured by the relaxed pelt approach, respectively. Exclusion of the tail and ears from the calculated TBSA results in derived k values that are [~]16-17% lower. The approach used to determine TBSA in mice significantly influences measured areas and thus derived k values. We suggest that stretching the pelt prior to tracing inflates TBSA values, where measurements made from relaxed pelts or by DV tracing likely provide more accurate estimates of actual TBSA. Further, exclusion of the tail and ears (the latter of which is not typically considered in estimates of TBSA in humans) may be a useful approach relating relative burn sizes of mice to those of humans.

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Integrated Spatial Multi-omic Profiling Identifies HSV-associated Inflammatory Macrophage Niches Linked to Oncolytic Virotherapy Response in Melanoma

Wagner, E.; Legg, S.; Applebee, C. J.; Padget, J.; Larijani, B.; Kirane, A. R.

2026-05-21 cancer biology 10.64898/2026.05.20.726697 medRxiv
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BackgroundPrimary and secondary resistance to immune checkpoint blockade (ICB) remains a critical challenge in advanced melanoma. Oncolytic Viruses (OV) selectively lyse tumor cells while generating systemic anti-tumor immune responses with minimal side effects. Yet their clinical use is limited to refractory melanoma patients and are only given in combination with second-line ICB regimens. ICB can both help and hinder OV efficacy depending on the source of checkpoint interactions across the tumor-immune microenvironment (TiME). However, functional checkpoint interactions are typically inferred from gene or protein expression and rarely contextualized within myeloid- and antigen presenting cell-associated immune niches during OV therapy, despite these populations dominating melanoma TiMEs and serving as key regulators of anti-viral immunity. MethodsAn integrated multi-omics framework combining Nanostring GeoMx digital spatial profiling (DSP), COMET sequential immunofluorescence (seqIF) and functional oncology mapping (FuncOmap) was applied to melanoma patient tissues collected pre- and post-neoadjuvant Talimogene Laherparepvec (T-VEC) to characterize immune remodeling and directly quantify checkpoint interaction dynamics associated with pathologic responses to OV therapy. ResultsT-VEC induced broad lymphocyte- and myeloid-associated immune transcriptional activation across melanoma TiMEs; however, pathologic responses could not be defined by bulk transcriptomics or cellular deconvolution alone. COMET seqIF analysis identified that HSV-associated M1/APC-like tumor-associated macrophages (TAMs) were enriched in complete pathologic response (CR) tissues and were a major source of PD-1/PD-L1 interaction niches. While partial (PR) and non-pathologic response (NR) tissues retained melanoma-centered PD-1/PD-L1 interaction niches and were enriched for B cell and M2-like TAM populations. FuncOmap analysis indicated that post-T-VEC PD-1/PD-L1 interaction states were consistently elevated in tumor bed, but not in lymph node tissues, across all pathologic response groups. Suggesting that immune checkpoint interactions may benefit T-VEC therapeutic responses depending on their spatial and immune context relative to OV infection. ConclusionsThese findings highlight the importance of integrated transcriptomic and functional proteomic analyses for resolving the spatial distribution and functional status of immune niches during OV therapy. Resolving PD-1/PD-L1 interaction states to specific M1/APC-like TAM and B cell niches may define mechanisms of responses and resistance to OV therapy.

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Germline polygenic score for prostate cancer aggressiveness

Xu, G. J.; Karunamuni, R.; Dornisch, A. M.; Brunette, C. A.; Danowski, M. E.; Desai, H.; Dochtermann, D.; Garraway, I. P.; Hauger, R. L.; Kibel, A. S.; Lynch, J. A.; Pyarajan, S.; Rose, B. S.; Teerlink, C. C.; Andreassen, O. A.; Dale, A. M.; Donovan, J. L.; Hamdy, F.; Kachuri, L.; Lane, A.; Martin, R. M.; Mills, I. G.; Neal, D. E.; Turner, E. L.; Witte, J. S.; Schleutker, J.; Pashayan, N.; Batra, J.; Australian Prostate Cancer BioResource (APCB), ; Nordestgaard, B. G.; Hamilton, R. J.; Wolk, A.; Albanes, D.; Atkins, J.; Blot, W. J.; Mucci, L. A.; Nielsen, S. F.; Cussenot, O.; Berndt, S. I.; K

2026-05-10 genetic and genomic medicine 10.64898/2026.05.07.26352488 medRxiv
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BackgroundRisk stratification for prostate cancer (PCa) progression or aggressiveness is often based on clinicopathologic features, some of which may be influenced by genetic factors. We developed a novel, germline polygenic risk score (PRSagg) to predict likelihood of developing aggressive PCa. MethodsPRSagg was developed using data from 38,688 patients with PCa (case-only analysis) from the Million Veteran Program (MVP) through a genome-wide search for variants associated with PCa grade group at diagnosis. We tested associations of PRSagg with grade group using the entire MVP dataset using the .632 bootstrap method. In an MVP cohort with localized PCa that was initially monitored without treatment, we tested PRSagg for association with unfavorable outcomes (subsequent development of grade group 4-5, metastasis, and/or biochemical recurrence after definitive treatment). We performed external validation in data from patients in the PRACTICAL Consortium (n=45,214) and from participants in the ProtecT randomized trial who underwent active monitoring (n=316). Odds ratios (ORs) were calculated per standard deviation (SD) increase with 95% confidence intervals, while adjusting for age, genetic ancestry, a previously developed polygenic score for risk of PCa (PHS601), and a polygenic score for benign elevated prostate-specific antigen (PRSPSA). For the outcome of metastasis, we additionally adjusted for PSA at diagnosis. ResultsIn the MVP training dataset, PRSagg (172 variants) was associated with higher grade group at diagnosis (OR = 1.53 [1.51-1.56]) and with increased risk of unfavorable outcomes during monitoring (OR = 1.13 [1.09-1.18]). These findings were confirmed in the external datasets. PRSagg was associated with greater odds of higher grade group at diagnosis (OR = 1.09 [1.06-1.11]). Among ProtecT participants undergoing active monitoring, PRSagg was associated with higher risk of metastasis (OR = 2.15 [1.02-3.88]). Among MVP participants with high polygenic risk of developing any PCa, the risk of aggressive disease was highest in men with high PRSagg and low genetic risk of PSA elevation. ConclusionsAmong men who develop PCa, a weighted sum of common germline variants (PRSagg) is independently associated with PCa aggressiveness. These findings may inform future study of germline influence on tumor evolution and risk-stratified intensity of active surveillance.

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AAV-NRF2 protects retinal and choroidal vasculature in a GDF15-dependent manner in an oxidative damage model of AMD

Wang, S.; Zhao, S.; Daniels, A.; Naaman, E.; Gardner, A.; Wang, T.; Sun, Y.; Fu, Z.; Smith, L. E. H.; Cepko, C. L.

2026-05-15 cell biology 10.64898/2026.05.13.724735 medRxiv
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Oxidative stress is proposed to be a driver of age-related diseases. Age-related macular degeneration is one such disease, where the retinal pigment epithelium (RPE) is affected early in the disease. Vasculature damage also occurs, sometimes preceding RPE damage. To model some aspects of dry AMD, we used the NaIO3 mouse model of oxidative damage. Disruption of the deep retinal vascular plexus, disorganization and death of capillaries within the choriocapillaris, and marked electroretinographic decline were observed. AAV overexpressing the transcription factor, NRF2, which induces anti-oxidation enzymes and represses inflammation, was tested for protection of damage. The BEST1 promoter limited expression to the RPE. The RPE, photoreceptors, and vascular architecture in both retinal and choroidal compartments were protected. Conditioned medium from RPE-choroid explants, infected by AAV8/BEST1-NRF2, was sufficient to transfer partial protection in vivo, indicating that NRF2 induces a protective secreted factor(s). Analysis of RNA-seq data identified growth differentiation factor 15 (GDF15) as a candidate downstream mediator. Injection of recombinant GDF15 reproduced key protective phenotypes in vivo, whereas Gdf15-deficiency attenuated NRF2-mediated rescue. Pharmacologic inhibition of TGF-{beta} receptor signaling diminished NRF2 associated protection, supporting involvement of this signaling pathway. In a laser-induced choroidal neovascularization model, intravitreal GDF15 injection reduced fluorescein leakage and lesion size. These findings support a model in which NRF2 activation in the RPE induces expression of GDF15, which is capable of protecting the RPE, photoreceptors, and the retinal and choroidal vasculature. NRF2 and GDF15 have therapeutic potential for ocular diseases, as well as for other diseases with vascular pathology.

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Cell line-dependent effects of spheroid formation method on drug response in melanoma models

Zilyte, A.; Petrikaite, V.

2026-05-14 cancer biology 10.64898/2026.05.12.724514 medRxiv
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In this study, we evaluated the impact of different in vitro 3D culture modelling methods on the activity of doxorubicin (DOX) and 5-fluorouracil (5-FU) in human melanoma spheroids. Human melanoma A375 and IGR39 spheroids were generated using the hanging drop and non-adhesive surface methods. Spheroid growth dynamics were assessed by measuring changes in spheroid diameter. To compare the effects of anticancer drugs in spheroids of different sizes, spheroids of approximately 200 and 400 {micro}m were formed. Drug activity was evaluated based on spheroid growth and cell viability using the MTT assay. A375 spheroids formed using the non-adhesive surface method were more sensitive to DOX than spheroids formed using the hanging drop method. In smaller A375 spheroids, 10 {micro}M 5-FU reduced cell viability more effectively in spheroids formed using the hanging drop method. In contrast, IGR39 spheroids formed by the hanging drop method were more resistant than those formed on a non-adhesive surface. However, in IGR39 spheroids, the effects of DOX and 5-FU on growth and viability did not significantly differ between formation methods. In conclusion, A375 spheroid growth was not significantly influenced by the formation method, whereas IGR39 spheroid growth depended on the method used. A375 spheroids formed on non-adhesive surfaces were more sensitive to DOX, whereas 5-FU activity depended on drug concentration and spheroid size. In IGR39 spheroids, the effects of DOX and 5-FU on growth and viability were largely independent of the spheroid formation method. Based on these results, it can be concluded that the researchers should carefully select the spheroid formation method for their studies, as this may influence the results of the tested compounds effect on their size and viability.

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Large-scale association study identifies lung cancer susceptibility copy number variants and their potential functional role in genetic instability

Xiao, F.; Qin, F.; Luo, X.; Slewitzke, S. E.; Fernandes, G. F.; Johansson, M.; Xiao, X.; Zaridze, D.; Bojesen, S. E.; Shete, S.; Albanes, D.; Aldrich, M. C.; Tardon, A.; Fernandez-Tardon, G.; Le Marchand, L.; Rennert, G.; Bickeböeller, H.; Wichmann, H.-E.; Risch, A.; Muley, T.; Rosenberger, A.; Field, J. K.; Davies, M.; Woll, P.; Kiemeney, L. A.; Haugen, A.; Zienolddiny, S.; Lam, S.; Johansson, M.; Grankvist, K.; Schabath, M. B.; Andrew, A.; Lazarus, P.; Arnold, S. M.; Zhu, D.; Brenner, H.; Neuhouser, M. L.; Hung, R. J.; Christiani, D. C.; McKay, J.; Cai, G.; Xia, J.; Amos, C. I.

2026-05-15 genetic and genomic medicine 10.64898/2026.05.11.26352741 medRxiv
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Background: Genome-wide association studies (GWAS) have identified numerous lung cancer susceptibility loci based on single nucleotide polymorphisms (SNPs), yet a substantial proportion of heritability remains unexplained. We therefore evaluated germline copy number variants (CNVs) as an underexplored source of genetic susceptibility and potential contributors to genomic instability in lung cancer. Methods: We conducted a genome-wide analysis of germline CNVs using 19,342 cases and 15,917 controls from the Transdisciplinary Research in Cancer of the Lung (TRICL) consortium, with replication in two independent cohorts. High-confidence CNVs were identified by integrating two CNV callers including PennCNV and modSaRa2. Association analyses were performed using both gene-based and CNV region-based approaches. Polygenic risk scores (PRS) were constructed from top loci, and functional validation was conducted using siRNA-mediated knockdown in lung fibroblast cells. Results: We identified CNVs in four genomic regions (1p36.22, 2q31.2, 6p21.32, and 19q13.32) significantly associated with lung cancer risk. Two loci (1p36.22 and 2q31.2) were consistently supported across both analytical strategies. A CNV-based PRS constructed from key genes (CLCN6, NFE2L2, OPA3, and PSMB8) was significantly associated with lung cancer risk and replicated across independent datasets. Functional assays demonstrated that knockdown of NFE2L2 and OPA3 increased endogenous DNA damage, supporting a role in genomic stability. Conclusions: Germline CNVs contribute to lung cancer susceptibility and may influence carcinogenesis through mechanisms related to genomic instability. Impact: These findings expand the genetic architecture of lung cancer and highlight CNVs as potential biomarkers for improving risk stratification and informing precision prevention strategies.