The American Journal of Pathology

Fuchs endothelial corneal dystrophy (FECD) impacts over 300 million individuals worldwide with corneal transplantation as the primary treatment. There is a dire need to establish non-surgical alternatives which are dependent on mouse models. Transcriptional co-activator with PDZ-binding motif (TAZ, encoded by Wwtr1) is a mechanotransducer implicated in maintaining homeostasis of corneal endothelial cells (CEnC). Wwtr1-/- (TAZ KO) mice serve as an animal model for late-onset FECD. We combined single-cell transcriptomics, transmission electron microscopy, and immunofluorescence staining to elucidate the mechanisms driving pathogenesis in young (2-month-old) and geriatric (11-month-old) mice. A progressive stress response was observed in TAZ KOs defined by endoplasmic reticulum (ER) stress, mitochondrial structural and functional abnormalities, and impaired Na+/K+ ATPase localization. These changes were accompanied by an altered expression of genes involved in extracellular matrix (ECM) organization, oxidative phosphorylation, macroautophagy and response to oxidative stress. Additionally, we noted age-related differences in cellular response with young TAZ KO CEnCs upregulating macroautophagy and downregulating ECM organization while geriatric TAZ KO CEnCs downregulated macroautophagy, and ECM organization. Both TAZ KO groups downregulated response to oxidative stress and cell-substrate adhesion. Together, these findings establish a mechanistic link between disrupted mechanotransduction and organelle stress in CEnC degeneration, further elaborating on potential mechanisms driving FECD pathogenesis. This positions TAZ KO mice as a translational platform for evaluating non-surgical therapeutic strategies targeting FECD. Significance statementFuchs endothelial corneal dystrophy (FECD) is a common, age-related cause of vision loss involving a depletion of corneal endothelial cells (CEnC) that necessitates corneal transplantation. Understanding why corneal endothelial cells progressively fail in this disease is essential for developing non-surgical therapies. Using transcriptomics, electron microscopy and immunofluorescence staining, we demonstrate that loss of the mechanotransducer TAZ disrupts cellular homeostasis by inducing endoplasmic reticulum stress, mitochondrial dysfunction and improper extracellular matrix and functional protein organization in CEnCs. By linking altered mechanotransduction to organelle stress and endothelial cell loss, these findings provide insight into fundamental disease mechanisms and identify pathways that may be targeted to preserve corneal endothelial function in FECD.

Sepsis is defined as a dysregulated response to infection, leading to life-threatening organ dysfunction that particularly affects parenchymal organs. Clinical studies remain inconclusive regarding the impact of biological sex on sepsis, and preclinical studies are predominantly performed in male animals. We examined early (8 h) septic responses in male and female mice using a fecal-induced peritonitis (FIP) model. Blood biochemical parameters, body temperature, and murine sepsis scores provided evidence of a septic response in animals randomized to FIP compared to controls, but showed no physiological differences between male and female mice. Transcriptomic analysis of the liver, kidney, and lung showed consistent inflammatory activation in response to sepsis as compared to controls. Notably, in the kidney and lung, female mice exhibited stronger immune activation and a heightened inflammatory response compared to males. Thus, biological sex differences in the septic response can be detected in early acute sepsis without apparent physiological differences.

Diabetic foot ulcers (DFUs) remain a major clinical challenge as diabetes prevalence rises, emphasizing the need for improved therapeutics and relevant preclinical models. Common rodent wound-healing models poorly recapitulate human skin anatomy and repair. Although porcine skin is comparable to human skin, many studies employ young, healthy pigs that do not reflect typical chronic human wounds. Here, we evaluated wound healing in full-thickness skin wounds in non-diabetic and diabetic Yucatan minipigs. RNA sequencing identified key transcriptional differences in wounds of diabetic versus non-diabetic animals, including pathways linked to increased inflammation and oxidative stress, as well as decreased metabolism and extracellular matrix organization, known hallmarks of DFUs. These findings support this preclinical model as a powerful approach for discovery and therapeutic testing in diabetic wounds and provide a novel data set for further mining of potential gene targets for diabetic wound intervention.

The dy3K/dy3K Lama2-/- mouse is a model for the severe form of LAMA2-related dystrophy and peripheral neuropathy (LAMA2-RD). In the dystrophic mice, a compensating laminin subunit, Lm4, that lacks polymerization and -dystroglycan-binding activity, replaces the missing Lm2 subunit. It was previously found that an 4-laminin can be modified with two small laminin-binding linker proteins, i.e. LNNd{Delta}G2 and miniagrin to facilitate polymerization and -dystroglycan binding respectively, to enable the key missing functions. Adeno-associated virus serotype 9 (AAV9) was used to deliver minigenes coding for the two proteins in dystrophic mice. AAV9-LNNd{Delta}G2 utilized a universal CBh promoter while AAV9-miniagrin utilized either the CBh promoter or muscle-specific SPc5-12 promoter. The phenotype in the dy3K/dy3K mice was evaluated following i.v. postnatal injection with either AAV9 -LNNd{Delta}G2 alone or in combination with AAV9- LNNd{Delta}G2 + AAV9- miniagrin. Double AAV treatment was found to substantially increase survival and ambulation, as well as increase forelimb grip-strength and improve muscle histology. Of note, the sciatic nerve amyelination characteristic of laminin 2-deficiency was prevented. While single treatment with LNNd{Delta}G2 was inferior to double treatment for muscle strength and survival, it corrected the radial sorting deficit equally, revealing that enablement of laminin polymerization is a sufficient requirement for myelination. HighlightsO_LIThe dy3K/dy3K (Lama2-/-) mouse, a model for severe LAMA2-related dystrophy, expresses laminin-411 that is unable to polymerize or bind to -dystroglycan (DG). C_LIO_LILNNd{Delta}G2 and miniagrin are laminin-411-binding proteins that enable polymerization and DG binding. C_LIO_LIAAV9 delivery of genes coding for LNNd{Delta}G2 and miniagrin ameliorated the dystrophic phenotype in muscle and nerve (survival, growth, mobility, and grip-strength, muscle and nerve histopathology). C_LIO_LISciatic nerve amyelination was prevented by LNNd{Delta}G2 alone. C_LI

0BackgroundA Disintegrin and Metalloprotease 17 (ADAM17) is a key sheddase regulating multiple inflammatory and growth factor-related pathways implicated in diabetic kidney disease (DKD). While cell-specific deletion of ADAM17 has shown renoprotective effects, the impact of global ADAM17 ablation in the context of diabetes remains incompletely understood. MethodsWe investigated the effects of tamoxifen-induced global Adam17 deletion in a murine model of type 1 diabetes induced by streptozotocin. Renal function, structural injury, inflammatory responses, stress-related signalling pathways, and fibrotic remodelling were comprehensively assessed and compared between diabetic Adam17 knockout and control mice. ResultsDespite persistent hyperglycaemia and albuminuria, diabetic Adam17 knockout mice exhibited preservation of glomerular filtration rate and marked attenuation of diabetes-associated renal injury. Global Adam17 deletion reduced mesangial expansion and structural damage, limited macrophage infiltration and chemokine expression, and significantly attenuated fibrotic remodelling. At the molecular level, Adam17 deficiency was associated with selective modulation of stress-related signalling pathways, including reduced activation of the PI3K/Akt axis and partial preservation of mitochondrial stress regulators, without evidence of a generalized suppression of cellular stress responses. ConclusionsOur findings demonstrate that global deletion of ADAM17 confers robust protection against diabetes-induced kidney injury through coordinated attenuation of inflammatory activation, stress-related signalling, and fibrotic progression. These results highlight the context-dependent role of ADAM17 in diabetic kidney disease and support the concept that therapeutic strategies targeting ADAM17-related pathways may require tissue- and disease-specific modulation to achieve renoprotective effects.

Regeneration depends on tightly coordinated transcriptional programs governed by a dynamic epigenetic landscape to regulate cell identity, proliferation, and tissue remodelling following injury. The livers highly regenerative due to the ability to rapidly upregulate genes that drive the cell cycle and other genes important for regeneration. Trimethylation of histone 3 lysine 27 (H3K27me3) is deposited by the polycomb repressive complex 2 (PRC2) and many genes occupied by H3K27me3 in their promoters in uninjured livers become induced following PH. Here we test the hypothesis that depleting H3K27me3 by hepatocyte-specific deletion of Embryonic Ectoderm Development (EedHepKO), a key component of PRC2, changes the regenerative response in the liver. We show that Eed eliminates H3K27me3 in hepatocytes, resulting in reduced liver size, increased hepatocyte death, proliferation and fibrosis associated with upregulation of cell cycle and fibrogenic genes. Though these mice are less likely to survive two-thirds partial hepatectomy than wildtype controls, those that do survive increase liver mass faster than WTs. Importantly the genes that are occupied by H3K27me3 in control uninjured livers are upregulated in EEDHepKO and become further induced following PH. These data show that modulation of PRC2 activity disrupts epigenetic patterning, induces liver injury, and alters regenerative outcomes, suggesting that precise control of PRC2 function could be harnessed to enhance regenerative capacity.

Background & AimsClinically relevant postoperative pancreatic fistula (CR-POPF) remains a major cause of morbidity following pancreatic surgery, potentially due to fatty acid release by lipase activity. This study investigated how the biochemical composition of CR-POPF effluents drives cellular injury and transcriptional stress responses. MethodsDrain effluents from 14 patients undergoing pancreatoduodenectomy (7 with CR-POPF and 7 controls) were analyzed using gas chromatography-mass spectrometry. Candidate lipids were tested on human foreskin fibroblasts, mesothelial cells, and pancreatic epithelial cells using viability and cytotoxicity assays. Effluents were applied directly to cultures, and RNA sequencing was performed on cells exposed to the two most cytotoxic CR-POPF samples. ResultsMetabolomic profiling revealed lipolytic traits characterized by long-chain saturated fatty acids, including palmitic and stearic acid, and the palmitic acid monoacylglycerol monopalmitin, in drain effluents. These fatty acids accounted for over 70% of the variance in multivariate metabolomic analyses between CR-POPF and control groups. Dose-response assays confirmed concentration-dependent cytotoxicity (p < 0.0001), with a subtoxic threshold of 0.2 mM. Two effluents (AES1448 and GR1479) consistently reduced cell viability across models (F > 19, p < 0.0001). Transcriptomic profiling showed enrichment of inflammatory, unfolded-protein, and stress-response pathways, along with suppression of proliferation modules. GR1479 induced metabolic adaptation, whereas AES1448 and monopalmitin triggered overt lipotoxic stress. ConclusionsLipolysis-derived lipids may mediate stromal and mesothelial injury in CR-POPF. Integrating metabolomic, functional, and transcriptomic data uncovers a spectrum of cellular responses, spanning from adaptive remodeling to lipolysis-driven proteotoxic stress. These findings support lipid toxicity as a biochemical property of CR-POPF and a potential target for prevention. SynopsisThis study identifies long-chain saturated fatty acids in postoperative pancreatic effluents as key mediators of cytotoxic and inflammatory stress. Integrating metabolomic and transcriptomic analyses link effluent composition directly to cellular injury and impaired healing after pancreatic surgery. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=72 SRC="FIGDIR/small/705517v1_ufig1.gif" ALT="Figure 1"> View larger version (15K): org.highwire.dtl.DTLVardef@2ba175org.highwire.dtl.DTLVardef@752522org.highwire.dtl.DTLVardef@d8f823org.highwire.dtl.DTLVardef@8acb7f_HPS_FORMAT_FIGEXP M_FIG Graphical abstract C_FIG

BackgroundHepatocellular carcinoma (HCC) is a leading cause of cancer-related death in sub-Saharan Africa (SSA). Differentiating primary HCC from metastatic liver tumors remains a significant diagnostic challenge. Understanding the prevalence and clinical predictors of HCC is crucial for improving diagnosis and patient care. This study examined the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and HCC, and clinical predictors of HCC. MethodsWe used immunohistochemical markers on archived liver tumor biopsies and analyzed the data using descriptive and logistic regression analysis. ResultsAmong 58 liver carcinoma cases, 37.9% had HCC, and 62% had metastatic liver carcinoma (MLC). HCC was most common (61.5%) among middle-aged adults (50-59 years). HCC was more frequent in males (47.2%) than in females (22.7%). Over half of the patients (51.7%) tested positive for HBV. HCC was more prevalent in HBV-positive patients than HBV-negative ones (43.3% vs 32.1%). Hepatic fibrosis was identified in 27.6% of cases. HCC was more common in patients with fibrosis (56.2%) than in those without (31%). HCV infection was rare (6.9%) in this study. In multivariable logistic regression analysis, none of the examined predictors reached statistical significance (P>0.05). Patients aged 50-59 years, males, those with HBV infection, and hepatic fibrosis showed higher odds of HCC. Hepatocyte Paraffin-1 (Hep Par-1) demonstrated 97% specificity and a 95% positive predictive value (PPV) for differentiating HCC from MLC. The combined marker pattern of Hep Par-1 positive and AE1/AE3 negative was highly predictive of HCC (100% specificity, 100% PPV, and 93.2% diagnostic accuracy). ConclusionsOur findings indicate that while the assessed risk factors tend to show directional association with HCC, as expected, larger studies are needed to determine their independent effects. The combined Hep Par-1 AE1/AE3 immunophenotype is more accurate than either marker alone. Therefore, this combined test is a valuable diagnostic tool for confirming HCC in resource-limited settings.

Although several ancillary tests are available in limited laboratories, diagnosis of microphthalmia (MiT)/TFE family translocation renal cell carcinoma (tRCC) could be challenging due to diverse and overlapping tumor morphology and the lack of reliable biomarkers. GPNMB has been recently identified as a diagnostic marker for various renal neoplasms with FLCN/TSC/mTOR-TFE alterations. However, the sensitivity and specificity of GPNMB immunostain are suboptimal and the result interpretation in ambiguous cases could be difficult. To search additional biomarkers that could improve the screening sensitivity and predict genetic aberrations in FLCN/TSC/mTOR-TFE pathway in renal tumors, we performed bioinformatic analysis of publicly available cancer databases and found GPR143, a transmembrane protein regulated by MiT transcription factors, was highly expressed in a subset of renal cell carcinomas (RCCs). In two the Cancer Genome Atlas (TCGA) kidney cancer cohorts, RCCs with high levels of GPR143 expression were enriched for renal neoplasms with FLCN/TSC/mTOR-TFE alterations. Similar to GPNMB labeling, GPR143 immunostain was positive in the majority of tRCC cases and renal tumors with FLCN/TSC/mTOR alterations, suggesting that GPR143 could function as another surrogate marker for FLCN/TSC/mTOR-TFE alterations in certain renal tumors. Interestingly, despite the concordant GPR143 and GPNMB immunoreactivity in most renal neoplasms with FLCN/TSC/mTOR-TFE alterations, diffuse GPR143 immunostain was observed in some cases with negative or focal GPNMB labeling. Taken together, our results indicate GPR143 could serve as a useful adjunct marker to improve the sensitivity for screening renal tumors with FLCN/TSC/mTOR-TFE alterations.

IntroductionIn hemorrhagic shock, plasma resuscitation preserves vascular integrity and protects against trauma-induced coagulopathy and organ injury. Despite demonstrated clinical benefit, the endothelial mechanisms underlying plasma resuscitation remain incompletely defined. This study investigated endothelial-specific responses to plasma resuscitation to identify targetable pathways that promote vascular repair after traumatic injury. MethodsA murine model of severe polytrauma-hemorrhagic shock (PT/HS) with demonstrable vascular endotheliopathy by 24 hours was used to compare pulmonary vascular endothelial cell (EC) responses to resuscitation with lactated Ringers (LR) relative to fresh frozen plasma (FFP). Whole blood was collected for inflammatory biomarker analysis, and pulmonary vascular leak was quantified by dextran extravasation. Pulmonary EC glycocalyx (eGC) structure was assessed by transmission electron microscopy and immunofluorescence. Spatial transcriptomic profiling of pulmonary ECs was performed using a GeoMx Digital Spatial Profiler. Key transcriptomic findings related to mitochondrial biogenesis were validated by immunostaining and by treating primary human lung EC with FFP or LR. ResultsAt 24 hours after injury, FFP reduced systemic inflammatory cytokines, pulmonary innate immune cell infiltration, and PT/HS-induced vascular leak compared to LR. Plasma levels of syndecan-1, syndecan-4, and hyaluronan were decreased, consistent with enhanced pulmonary eGC expression. Although few differences in eGC-related genes were detected, pathway analysis revealed enrichment of cellular bioenergetics and metabolic recovery pathways in ECs after FFP, whereas LR was associated with oxidative stress and inflammatory signaling. FFP enhanced mitochondrial content in pulmonary EC after PT/HS and in treated human EC compared to LR-treated controls. ConclusionsFFP resuscitation after PT/HS reduces systemic inflammation and preserves pulmonary vascular barrier function, potentially through promotion of mitochondrial signaling, metabolic recovery, and endothelial stress regulation.

ATF6 is a regulator of the Unfolded Protein Response that maintains cellular homeostasis during ER stress. In patients, ATF6 mutations cause photoreceptor dystrophy and sensorineural hearing loss. Atf6-/- mice develop progressive hearing loss with stereocilia disorganization and mild retinal dysfunction, suggesting that ATF6 loss may impair the structural integrity of sensory cells. To test this possibility, we analyzed the retinal ultrastructure of Atf6-/- mouse photoreceptors using transmission electron microscopy and identified a novel defect in which the ciliary rootlet is unbundled, disorganized, and possibly detached from the basal body. These findings demonstrate that ATF6 is essential for maintaining the structural organization of the photoreceptor ciliary apparatus, linking ER proteostasis to cytoskeletal integrity and providing a potential mechanistic basis for the progressive degeneration of photoreceptor outer segments and stereocilia observed in ATF6-deficient patients.

Background & AimsIntrahepatic biliary epithelial cell (BEC) heterogeneity remains challenging to define. Here, we sought to identify BEC subpopulations and biomarkers in mouse liver. MethodsWe performed scRNA-seq on Sox9EGFP+ liver epithelium from mice subjected to bile duct ligation (BDL) and sham controls. A machine learning algorithm, NSForest, identified minimal, multi-gene signatures for BEC subpopulations. These "metagenes" were validated using hybridization chain reaction (HCR) FISH in tissue sections from wild-type mice and on primary BECs expanded in vitro. Metagenes were used to match BDL subpopulations to their corresponding sham subpopulations for differential gene expression (DGE) analysis. ResultsWe identified 4 BEC subpopulations in sham controls, each associated with 1-2 gene metagenes. Spatial localization of metagene-defined BEC subpopulations by HCR FISH revealed heterogeneous cellular composition of intrahepatic bile ducts. BECs belonging to a given subpopulation were most likely to have neighbors of the same identity, forming homogenous cellular compartments within ducts. BDL downregulated subpopulation-specific genes and upregulated a damage-associated gene set. BDL samples also included a proliferative subpopulation not found in sham controls, which contained populations enriched for three of the four metagenes. All BEC subpopulations were also found in monolayers in vitro, where they clustered spatially with BECs of the same subtype. ConclusionsNovel metagene biomarkers of BEC subpopulations facilitated spatial localization of BECs in situ, identified subpopulation specific injury responses, and confirmed that BEC heterogeneity is preserved in vitro. The presence of locally homogenous BEC "neighborhoods" in vitro suggests some degree of BEC organization may be epithelial-autonomous.

We describe a standardized and reproducible procedure to generate human organotypic lung cultures from surgical lung resection for the study of respiratory infections. The protocol details tissue harvesting, biopsy punching, mechanical slicing, culture at the air-liquid interface. This technique enables robust ex vivo infections of human lung tissue with respiratory viruses, including Influenza A and Nipah. The described system can be used to study host-pathogen interactions, analyze innate immune responses, and evaluate antiviral candidates in physiologically relevant human lung tissue. For complete details on the use and execution of this protocol, please refer to Cezard et al1.

BackgroundWhile pancreatic cysts have been described in syndromic ciliopathies, the pancreas is not commonly recognized as a target organ. However, several ciliary gene knockout mouse models develop a pancreatic phenotype combining acinar atrophy and adipocyte accumulation, hereby called adipopancreatosis, suggesting a link between ciliary dysfunction and pancreatic disease. ObjectiveWe investigated whether mutations in ciliopathy-associated genes are linked to pancreatic dysfunction in humans. DesignWe analyzed a cohort of 341 patients with pediatric-onset pancreatic anomalies and characterized the pancreatic phenotype of new mouse models with conditional Nphp3 inactivation or bearing Nphp3 mutations recapitulating human mutations. In patients, pancreatic fat content was quantified using Dixon-MRI. ResultsMutations in the cilium-related HNF1B and NPHP3 were identified in patients presenting with both renal and pancreatic dysfunction. Nphp3 mutant mice developed acinar atrophy, adipopancreatosis, and moderate inflammation. Adipocytes in the pancreas exhibited a white adipocyte-like profile and likely originated from mesothelial-derived fibroblasts. Reduced numbers and altered length of ductal cilia were monitored. Interestingly, secretory canaliculi, typically unnoticed structures found within and between acinar cells and connected to the acinar lumen, exhibited a microcystic morphology. Consistent with the mouse phenotype, Dixon-MRI revealed significantly increased pancreatic fat content in patients with HNF1B and NPHP3 mutations. ConclusionWe describe a previously unrecognized pancreatic manifestation of ciliopathies, which we name ciliogenic pancreatopathy. Patients with known ciliopathy-causing mutations should be evaluated for this pancreatic condition, particularly those with kidney disease, as concomitant exocrine pancreatic insufficiency may further compromise renal function or the outcome of kidney graft. What is already known on this topicO_LICiliopathies, resulting from defects in primary cilia, are genetic disorders primarily affecting the kidney and liver. C_LIO_LIPancreatic cysts have been sporadically reported in syndromic ciliopathies. C_LIO_LIThe pancreas is not currently recognized as a major target organ of ciliary dysfunction. C_LIO_LIA clear link between ciliary gene mutations and pancreatic anomalies is still unknown. C_LIO_LIAnimal studies have suggested a possible association between ciliary dysfunction and pancreatic anomalies. C_LI What this study addsO_LIIdentifies HNF1B and NPHP3 mutations as genetic causes of a pancreatic phenotype characterized by acinar atrophy and adipose replacement (adipopancreatosis). C_LIO_LIDemonstrates the presence of defective ductal cilia and moderate inflammation in the pancreas of Nphp3 mutant mice. C_LIO_LIReveals that secretory canaliculi in the exocrine pancreas of Nphp3 mutant mice acquire a microcystic morphology. C_LIO_LIShows that patients with HNF1B or NPHP3 mutations have significantly increased pancreatic fat content by Dixon-MRI. C_LIO_LIDefines a new disease entity, ciliogenic pancreatopathy, as a pancreatic manifestation of ciliopathies. C_LI How this study might affect research, practice or policyO_LIEstablishes the pancreas as a novel and clinically relevant target of ciliopathies. C_LIO_LIExpands the phenotypic spectrum of HNF1B- and NPHP3-related diseases to include exocrine pancreatic dysfunction. C_LIO_LISuggests that patients with ciliopathy-causing mutations should be evaluated for exocrine pancreatic insufficiency. C_LIO_LIHighlights the need to consider pancreatic function monitoring in kidney disease and transplant settings. C_LIO_LIOpens new research avenues into the role of primary cilia in pancreatic homeostasis and disease. C_LI

Mast cells (MCs) are myeloid cells of the innate immune system. As a first line of defence they fulfill effector functions and immune modulatory properties. Upon activation they release pro-inflammatory mediators such as cytokines and proteases. It has been suggested that MCs may contribute to the development of liver fibrosis. However, investigating hepatic MC biology in mice is challenging due to low MC numbers and a lack of suitable detection techniques relying on MC proteins and their modifications. Here, we evaluated whether the expression strength of MC markers correlates with the degree of liver fibrosis in mice and aimed to determine the frequency and localization of hepatic MCs. We applied both a toxic (DEN/CCl4 treatment) and a genetic (Mdr2-/- mice) liver fibrosis model in C57BL/6 mice and found a significant correlation between fibrosis grade and the expression of several established mast cell markers. This correlation was further supported in patients with fibrosis and hepatocellular carcinoma (HCC) using publicly available transcriptomics datasets. We used FACS to purify and isolate MCs from fibrotic mouse livers and verified MC signatures by qPCR analysis of MC-specific gene expression. Hepatic MCs were predominantly negative for Mast-Cell-Protease 5 (Mcpt5) and occurred at a low frequency (approximately 1-2% of leukocytes). Using Molecular CartographyTM of fibrotic liver sections, we determined the spatial localization, expression signature, abundance (approximately 2 cells/mm2) and cellular environment of murine hepatic MCs. In summary, we demonstrated the existence of MCs in murine fibrotic livers and defined an MC expression signature that correlates with the strength of liver fibrosis. These findings will help to study MC biology in murine models of liver disease more effectively in the future.

BackgroundOptimal pre-analytical management of breast tissue specimens, particularly formalin fixation, is essential for accurate immunohistochemical (IHC) biomarker assessment in invasive breast cancer. Although international guidelines suggest using 4% neutral buffered formalin with controlled fixation time, many laboratories in low-resource settings deviate from these standards. This study aimed to determine whether fixative preparation (4% neutral buffered formaldehyde vs. 4% non-buffered formaldehyde) and cold ischemia time impact the preservation and evaluation of tissue biomarkers in invasive breast cancer. MethodsWe conducted an experimental study using fresh mastectomy tissue from a 34-year-old patient with invasive ductal carcinoma (pT4, hormone receptor-positive, HER2-negative, Ki67=40%) who had not received neoadjuvant chemotherapy. Fifty microsamples (5-15 mm in length, 1 mm in width) were obtained and divided into four cohorts: (1) 19 samples fixed in 4% neutral buffered formaldehyde for 0.5 to 144 hours; (2) 19 samples fixed in 4% non-buffered formaldehyde for 0.5 to 144 hours; (3) 6 samples with delayed fixation (0.5 to 8 hours) then fixed in neutral buffered formaldehyde for 10 hours; (4) 6 samples with delayed fixation (0.5 to 8 hours) then fixed in non-buffered formaldehyde for 10 hours. Hormone receptors (estrogen receptor-ER, progesterone receptor-PR) and Ki67 expression were evaluated by IHC using the Allred scoring system and current international recommendations. ResultsFixative preparation had a statistically significant, yet minimal, biological impact on biomarker evaluation. The mean percentage of ER-positive cells was 96.89{+/-}0.74% with neutral buffered formaldehyde compared to 94.32{+/-}1.51% with non-buffered formaldehyde (p=0.011). Similar trends were seen for PR (94.89{+/-}0.95% vs. 92.63{+/-}1.67%, p=0.027) and staining intensity. However, Allred scores remained constant. Cold ischemia time was strongly correlated with decreased biomarker expression regardless of fixative preparation. Hormone receptor expression and Ki67 remained stable with minimal Allred score changes for up to 2 hours of cold ischemia, but significantly decreased after 2 hours, with scores decreasing in proportion to the duration of ischemia (p<0.05). ConclusionsNon-buffered formaldehyde preserves tissue biomarkers almost as effectively as neutral buffered formaldehyde for IHC analysis. Following guidelines, a cold ischemia time of up to 1 hour is still a wise standard to guarantee accurate biomarker assessment. These results are significant for pathology laboratories in resource-limited settings where neutral buffered formalin may not be easily accessible.

Acute kidney injury (AKI) is a sudden episode of kidney failure linked to a wide range of health conditions. High mortality in AKI highlights the need to identify new therapeutic approaches. Homeostasis in multicellular organisms is exquisitely regulated by phagocytosis of apoptotic cells, also known as efferocytosis. Apoptotic cells are frequently observed at sites of inflammation, including in AKI. Engulfment and cell motility protein-1 (ELMO1) is a regulator of the actin cytoskeleton that promotes apoptotic cell removal by phagocytes during efferocytosis. Mutations in the human ELMO1 gene are linked with diabetic nephropathy and, in animal models of this disease, high ELMO1 levels promote renal dysfunction. However, the role of ELMO1 in AKI was not known. Here, we describe the links between ELMO1 and kidney pathology and test global and tissue-specific ELMO1-deficient mice in models of AKI. While global loss of Elmo1 expression did not impact the immediate loss of renal function after ischemia-reperfusion elicited AKI, ELMO1 deficiency resulted in increased tissue injury in AKI caused by cisplatin injection. Cisplatin induced robust renal cell apoptosis that was significantly elevated in mice with the global loss of ELMO1, but not in mice with the macrophage-specific Elmo1 deletion. Using primary cell culture and immunofluorescence approaches, we highlight the role of ELMO1 in efferocytosis by several renal cell types, suggesting possible additive effects during nephrotoxic injury.

AO_SCPLOWBSTRACTC_SCPLOWO_ST_ABSBackgroundC_ST_ABSTransthyretin amyloidosis (ATTR) is a progressive, degenerative disease affecting the heart and other organ systems, as well as the peripheral, autonomic, and central nervous systems. Although pharmacological and genetic evidence establishes aggregation as a driver of ATTR pathology, the mechanism by which aggregation compromises post-mitotic tissue function is poorly understood. We utilized bottom-up proteomics on wild-type (WT) human cardiac (WT/WT genotype) and V122I human cardiac (V122I/WT genotype) tissue, combined with tissue clearing technology to create an optically transparent tissue architecture to visualize three-dimensional relationships, to better understand TTR cardiomyopathy (CM). MethodsFlash-frozen 0.5 mm cardiac tissue slices from human subjects with end-stage WT-TTR CM, end-stage V122I CM, and slices from an age-matched human control were used for these experiments. Fibril extraction from diseased tissue followed published protocols. Strong denaturant-mediated proteome tissue extraction on samples from each subject facilitated bottom-up proteomics by using liquid chromatography (LC)-mass spectrometry (MS)/MS. Tissue clearing was performed on 0.5 mm cardiac slices utilizing a lauryl sulfate-based lipid removal strategy. Slices were stained using indirect immunofluorescence with antibodies to protein targets identified by proteomics. We used an antibody to non-native TTR and AmyTracker 480 (an oligothiophene dye that binds to amyloid fibrils) to image TTR deposits. ATTR fibrils were characterized structurally using cryogenic electron microscopy (cryo-EM) followed by helical reconstruction. ResultsProteomic cardiac analysis afforded high spectral counts for transthyretin (TTR) and proteins typically associated with amyloid fibrils, e.g. serum amyloid P (APCS). Fibril and cardiac homogenate proteomics revealed high levels of angiogenic and hemostatic proteins, including those composing the complement and coagulation cascades. 3D imaging revealed loss of normal microvascular architecture in CM samples with regions of hyper- and hypovascularization. Microvascular obstruction by capillary thrombosis was also observed in CM. ATTR fibrils adopted the common spearhead fold and were decorated with collagen VI (COLVI), an extracellular matrix component. ConclusionsWe hypothesize that ATTR CM is a microangiopathy driven by capillary bed thrombo-inflammation and dysregulated angiogenic revascularization. Phenotypic convergence of WT ATTR CM and V122I ATTR CM was observed via proteomics, 3D imaging, and ex vivo fibril characterization by cryo-EM. We provide evidence of capillary thrombosis in ex vivo ATTR CM tissue. Vasodilation and increased capillary permeability expose components of the vascular basement membrane (VBM) to misfolded TTR. These components are known to promote TTR aggregation and stabilize amyloid fibrils in the extracellular space. Congestion of the VBM prevents appropriate revascularization, reducing cardiac exertional capacity over time, leading to heart failure. Our ATTR CM heart tissue proteomics data shows significant overlap with the proteomic profiles of human AD brain tissues, revealing key amyloid, coagulation, complement, and angiogenesis proteins being changed in amyloidoses.

Acute kidney injury (AKI) secondary to kidney ischemia-reperfusion (IRI) is driven by profound metabolic perturbations that shape oxidative stress, inflammation, and cell death responses. Despite growing evidence of lipid dysregulation in AKI, its biological and mechanistic relevance remains unclear. To address this gap, we performed comprehensive untargeted kidney lipidomics using LC-QTOF-MS to delineate dynamic lipid changes during the acute phase of murine kidney IRI. Integration of lipidomic signatures with kidney gene-expression profiling and curated datamining revealed early activation of lipid pathways associated with injury responses. IRI induced marked lipidomic reprogramming, characterized by a marked accumulation of glycerolipids, including triacylglycerols (TGs) species detected exclusively after injury, together with increased levels of sphingolipids (ceramides, sphingomyelins, and hexosylceramides). Cardiolipins and most glycerophospholipids declined sharply following IRI, whereas specific phosphatidylcholines (PCs) exhibited opposite regulation, consistent with dynamic membrane remodeling. Datamining linked TG accumulation and altered transcriptional regulation of PC metabolism to repair-prone type 1 injured proximal tubular cells, highlighting its role in early tubular injury. Correlation analyses revealed strong associations between glycerolipids/sphingolipids and markers of renal dysfunction and inflammation, identifying TG 54:9 as a candidate for injury biomarker. Conversely, PE 40:6, PI 38:6, together with several lysophosphatidylcholines and ether-linked phospholipids, correlated positively with nephroprotective and antioxidant markers. Together, these patterns delineate two major lipid modules: a damage-associated module and a nephroprotection-associated module. These findings establish lipid remodeling as a central yet underexplored determinant of AKI pathogenesis and underscore lipidomics as a powerful discovery tool for identifying novel biomarkers and mechanistic targets in kidney disease.

BackgroundHistologic descriptors such as lymphovascular invasion (LVI), visceral pleural invasion (VPI), spread through air spaces (STAS), and grading system have each been associated with adverse outcomes in lung adenocarcinoma (LUAD). However, with the exception of VPI, these features are not formally incorporated into the TNM staging system. We evaluated the prognostic value and incremental contribution of these histologic descriptors within the framework of the 9th edition TNM staging system. MethodsIn total, 1,745 individuals diagnosed with stage I-III invasive non-mucinous lung adenocarcinoma (NM-LUAD) were included in this study, comprising 1139 French-Canadian patients who underwent surgical resection at IUCPQ-Universite Laval (discovery cohort) and 606 patients from the National Cancer Center Hospital in Tokyo, Japan (validation cohort). The objective of this study was to assess the prognostic contribution of histologic descriptors, including STAS, and LVI, as complements to conventional 9th edition TNM staging. ResultsGrade 3 tumors, LVI, and STAS were identified in 880 (50.4%), 809 (46.4%), and 775 (44.4%) of 1745 cases, respectively. Histologic grade and LVI demonstrated the strongest associations, particularly in early-stage disease, while STAS exhibited a stage-dependent effect, being more impactful in stages II-III. VPI showed less consistent prognostic value. Incorporating these histologic descriptors into TNM staging improved prognostic model performance, with the largest gains driven by histologic grade and LVI, while STAS provided additional, complementary prognostic refinement. ConclusionThese findings demonstrate that key histologic descriptors--including grading system, LVI, and STAS--represent robust and reproducible prognostic parameters. Importantly, these descriptors provide complementary, stage-dependent information that may enhance risk stratification and inform refinement of future TNM staging frameworks, including the forthcoming 10th edition.