npj Systems Biology and Applications

Modern medicine implicitly assumes that physiological responses to intervention are predictably determined by administered treatments. However, physiological systems containing intrinsic delays between the detection of a stimulus and the biological response may violate this assumption. We investigate the human glucose-insulin system as described by the Ultradian model and mathematically demonstrate that clinically relevant forcing protocols-such as pulsatile insulin delivery and step-wise glucose infusion, both commonly used in intensive care units (ICUs)-can induce sustained temporal chaos that may hamper accurate prediction of the physiological response. If not accounted for, these chaotic dynamics could create difficulties in achieving optimal dosing and timing when administering glucose and insulin in clinical or home care settings. This phenomenon, termed delay-induced uncertainty (DIU), arises from the interaction between physiological delay, intrinsic shear near a limit cycle, and external forcing. Using the Ultradian glucose-insulin model, we compute top Lyapunov exponents to quantify predictability. Across a range of pulsatile and step-wise forcing regimes, including stochastic amplitudes drawn from Markov processes, we observe positive Lyapunov exponents, indicating sustained chaos. Our results suggest that delayed endocrine regulation may fundamentally limit the predictive value of the models used to develop glycemic management strategies, with implications for clinical protocols in the ICU.

Background and Objective: Predicting treatment outcomes in infectious diseases requires accounting for the interplay between drug effects, pathogen dynamics, and host immunity. Integrating pharmacological and immunological approaches into a single simulation environment remains a fundamental challenge in both theory and practice. We aimed to develop and validate a multiscale in silico framework coupling these processes, and to quantify their respective contributions to bacterial clearance. Methods: We present the Drug-Host-Pathogen Interaction (DHPI) framework, combining three independent mechanistic components: a physiologically based pharmacokinetic model of drug disposition, a pharmacokinetic-pharmacodynamic model of drug-induced bacterial killing, and a stochastic agent-based model of the immune response. Continuous concentration profiles are time-averaged onto the agent-based time grid, assigned to bacterial phenotypic states, and converted into per-agent killing probabilities, so that drug-mediated and immune-mediated death events are recorded separately at each step. The framework was applied to simulate symptomatic pulmonary tuberculosis. Phenotype-specific drug-efficacy parameters were inferred using Approximate Bayesian Computation from historical clinical data on eight weeks of 600 mg rifampicin monotherapy, and validated against independent early bactericidal activity data over a disjoint time window. Results: The calibrated framework reproduced the observed decline in bacterial load, and matched reported early bactericidal activity over the first week. In a virtual cohort of symptomatic patients, drug-mediated killing accounted for 81-88% and immune-mediated killing for 12-19% of total bacterial elimination over the 60-day treatment course, while the dormant, granuloma-contained fraction rose from 0.20-0.29 in the first week to 0.85-0.89 at treatment completion. Over a follow-up of up to 50 years, patients reaching clinical cure had accumulated more memory lymphocytes during treatment than those progressing to clinical failure or death; moreover, the final outcome depended on the immune changes occurring during therapy rather than on the initial disease stage. Conclusions: The results show that the DHPI framework can reproduce treatment dynamics observed in patients and enable the analysis of how therapy reshapes host immune responses and subsequent disease trajectories. By explicitly representing drug-host-pathogen interactions, it provides a mechanistic basis for in silico treatment simulations and for the study of long-term immune consequences of antimicrobial therapy.

The dynamics of gene regulatory networks are governed by intrinsic noise, stemming from the random nature of biochemical reactions, and by extrinsic noise, arising from fluctuations in cellular components and environmental conditions. Together, these sources can compromise the reliability of predictive computational models if not properly accounted for, and capturing both effects within a single framework remains a non-trivial task in computational biology. In this work, we propose an uncertainty quantification framework that addresses these two contributions jointly: intrinsic stochasticity is described through a partial integro-differential equation (PIDE) for the protein probability density function, whereas extrinsic noise is represented as parametric uncertainty in the kinetic parameters. The propagation of the uncertainty is carried out via an intrusive polynomial chaos expansion (PCE), in which the PCE coefficients are obtained from a stochastic Galerkin projection of the PIDE, yielding a coupled deterministic system that is solved with standard numerical methods. We illustrate the approach on a positive autoregulatory gene network with one and two uncertain kinetic parameters. The proposed approach accurately reproduces the mean, variance, and full protein probability density function, including the bimodal distributions, at a substantially lower computational cost.

Thermodynamic models quantitatively describe interactions between transcription machinery and bacterial promoters. Contrary to conventional understanding, model analysis by Parisutham et al. (2025) attributes transcriptional inhibition by repressors to overstabilization of the RNA polymerase-promoter complex rather than prevention of its formation. Moreover, it suggests an inverse scaling relationship between basal promoter strength and transcriptional fold change, applicable to both repressor- and activator-mediated regulation. To reevaluate findings from this study, we systematically analyze empirical data and compare its framework with conventional thermodynamic models. In contrast to the inverse scaling relationship, data across multiple sources exhibit a peaked tradeoff between basal promoter strength and fold change, underscoring the importance of broad data coverage in revealing the full pattern required for reliable model inference. Furthermore, we identify the model assumption responsible for the apparent inverse scaling and misinterpretation of regulatory mechanisms. Relaxing this assumption enables the model to capture the peaked tradeoff and yield inferences consistent with established mechanisms of transcriptional repression and activation. We further derive a mathematical solution that connects basal expression to fold change for both repressor- and activator-regulated promoters. Our results underscore the importance of broad data coverage to avoid a blind-men-and-elephant interpretation and establish basal promoter strength as a key design parameter governing transcriptional regulation.

Mechanistic mathematical models have been used extensively to provide a deeper understanding of biological mechanisms, including unveiling the regulation of tumour growth and its response to various treatments. However, given the breadth of biological regulatory mechanisms, these models are frequently large and thus prone to potential issues with parameter identifiability. Statistical metrics like the Akaike and Bayesian information criteria can help identify a parsimonious model by balancing goodness of fit against model complexity. Yet simple models may fail to provide sufficient biological insight if they do not adequately capture known physiological processes or mechanisms. A modeller must therefore balance hypothesis generation and biological learning with model tractability. Here, we illustrate this balance using models of ovarian cancer growth and treatment response to cisplatin and immune checkpoint blockade in homologous recombination (HR)-deficient and HR-proficient immunocompetent mouse models. We develop a hierarchy of mathematical models of increasing complexity to describe tumour growth, treatment response, and immune dynamics. Our results highlight the limits of relying purely on statistical metrics for model selection, particularly when the goal is to obtain biological insight and underscore the importance of balancing model complexity to avoid overfitting and parameter unidentifiability.

Bayesian borrowing of external information can improve trial efficiency, particularly in pediatric and rare disease settings where patient populations are limited, but may introduce bias and inflate the Type~I error rate when the trial differs from external studies. Recent U.S. Food and Drug Administration (FDA) draft Bayesian guidance emphasizes careful evaluation of external information, prior specification, and assessment of operating characteristics. This paper compares three meta-analytic-predictive (MAP)-based methods for Bayesian borrowing: the MAP prior, robust MAP (RMAP) prior, and self-adapting mixture (SAM) prior. An adaptive platform trial design in Rett syndrome is used as a case study. Simulation studies evaluate frequentist operating characteristics under varying prior--data conflict, between-study heterogeneity, treatment effects, and clinically significant differences (CSDs) for the SAM prior. The MAP prior achieved the greatest efficiency when external and current data were compatible but exhibited the largest bias under substantial prior--data conflict. The RMAP priors improved robustness through fixed robust-component weights, whereas the SAM prior adaptively adjusted borrowing and was less sensitive to prior--data conflict while retaining efficiency gains when the data were compatible. Although the CSD influenced the degree of adaptive borrowing, as reflected by effective sample size, it had only a modest impact on frequentist operating characteristics. Sensitivity analyses using a skeptical robust component yielded similar qualitative conclusions, while accentuating the differences between the MAP and RMAP priors. These findings provide guidance for evaluating and selecting MAP-based borrowing strategies before trial implementation, particularly in rare disease settings, consistent with current FDA recommendations.

Maintaining a prescribed composition in engineered microbial consortia is difficult because small fitness differences can drive competitive exclusion. We study a two-strain consortium in continuous culture and develop a feedback architecture that regulates composition by selectively slowing the fast strain as a function of the population ratio. At the population level, we derive an idealized ratio-feedback law with a tunable positive coexistence equilibrium. We then propose a biomolecular realization using orthogonal quorum sensing, an sRNA-based ratiometric controller, and a ppGpp-mediated growth actuator. Exploiting the separation between slow population growth and faster intracellular controller dynamics, we use singular perturbation theory to show that, for sufficiently fast controller dynamics, the full implementation model inherits the coexistence equilibrium and its local stability properties from the reduced model. Numerical simulations validate the reduction and show how weaker timescale separation or loss of the assumed molecular regime degrades performance.

Bladder carcinoma in situ (CIS) is a multifocal, non-muscle-invasive disease with a high risk of progression to muscle-invasive cancer. Current management strategies are often guided by genomic profiling of single tumor samples, which incompletely capture tumor heterogeneity and may contribute to treatment failure. In particular, the multifocal nature of CIS raises uncertainty regarding the uniformity of genomic, immunologic, and microenvironmental features across anatomically distinct sites within the same patient. To address this, we performed spatial transcriptomic profiling of CIS-containing tissue from four anatomically distinct sites within a single individual. Unsupervised clustering with marker-based annotation, integrated with metabolic inference, identified epithelial tumor populations alongside stromal, immune, and smooth muscle compartments. While key cellular states were conserved, their spatial organization and relative abundance varied by site. Metabolic analysis further revealed region-specific microenvironments shaped by local cellular architecture. These findings indicate that both cellular composition and metabolic activity are spatially structured. Collectively, these results demonstrate that CIS exhibits significant intra-patient heterogeneity not captured by single-site profiling. These findings require validation in larger cohorts but support multi-region sampling could help improve risk stratification, biomarker development, and prediction of response to intravesical therapies, with potential implications for more personalized treatment strategies.

Microbial communities are dynamic, adaptive ecosystems whose collective behavior emerges from metabolic interactions such as cross-feeding, competition, and cooperation, rather than taxonomic diversity or individual metabolic potential alone. This distinction is clinically significant in the postmenopausal urinary tract, where recurrent urinary tract infections (rUTIs) are associated with complex, persistent infection dynamics including multiple contributing bacterial species. The ability of resident microbial communities to prevent pathogen establishment, known as colonization resistance, is increasingly attributed to the metabolic interactions within the urobiome itself rather than any single resident species. However, current approaches, such as taxonomic profiling and classical differential abundance analysis, can only partially describe the presence or maintenance of such interactions. Consequently, the community-level metabolic architecture determining pathogen resistance remains incompletely understood. To address this gap, we developed PhenoRewire, a network-based framework that quantifies how metabolite co-variation is rewired between biological states using untargeted metabolomics data. We applied this framework to an induced pluripotent stem cell (iPSC) urothelial organoid-derived barrier co-cultured with synthetic urobiome communities as a model of urobiome-pathogen dynamics relevant to rUTIs in two approaches. In an infection model, clinically isolated uropathogens Escherichia coli and Enterococcus faecalis, were co-cultured with a three-member urobiome community consisting of Lactobacillus gasseri, Lactobacillus crispatus, and Gardnerella vaginalis. Here we show how E. coli drove the metabolic reorganization, while E. faecalis amplified it disproportionately. PhenoRewire disentangled the 6-fold metabolic network amplification mediated by E. faecalis as a metabolic facilitator, revealing an emergent urobiome-pathogen co-variation architecture (1,781 vs 227 edges) not recapitulated by either community alone. Moreover, in a six-member urobiome single-strain dropout experiment, we revealed that removal of the sole Actinomycete Winkia anitrata caused significant network collapse (Louvain modularity falls from 0.707 to 0.038), identifying it as the single non-redundant keystone of the community. More broadly, these results demonstrate how untargeted metabolomics co-variation network analysis can be applied to defined synthetic urobiomes in combination with a urothelial host model to elucidate community dynamics. This framework provides a template that can be extended beyond the urobiome to investigate any complex microbial community where ecological behavior remains an open question.

Three-dimensional (3D) mural cell morphology is heterogeneous and coupled to vessel geometry, however, measurements from two-dimensional (2D) maximum intensity projections (MIP) obscure overlapping processes and cell-vessel contacts. Accordingly, we developed Mural-VISTA, a semi-automated Python workflow for mural cell-vessel interaction and single-cell topo-morphology analysis of reconstructed surface meshes. This workflow integrates mesh pretreatment, interactive centerline extraction, hierarchical segmentation of cell soma, main axis and secondary processes (branches), and extraction of 36 multiscale (cell process segment level, process level, and whole cell level) topo-morphological and vessel-referenced metrics. Mural-VISTA identified morphological changes in pericytes and vascular smooth muscle cells (vSMCs) with altered RhoA activity. Constitutive active RhoA (RhoA CA) over-expression reduced branch complexity and increased process alignment in both cell types, while increased whole-cell and branch solidity only in vSMCs. Dominant negative RhoA (RhoA DN) over-expression increased branch abundance and reduced branch solidity in pericytes but not vSMCs, suggesting cell-type specific effect of reduced RhoA activity. In conclusion, Mural-VISTA enables quantitative 3D profiling of mural cell architecture and its spatial relationship with the vessel.

Background: Low-dose computed tomography (LDCT) screening reduces lung cancer mortality but is limited by low uptake and associated with high rates of false-positives and indeterminate-nodules. Breath volatile organic compound (VOC) analysis is a non-invasive candidate biomarker approach that could complement LDCT, but prior work has relied on laboratory-based high-resolution mass spectrometry (HRMS), limiting point-of-care deployment. Methods: In this pilot study, breath samples were collected from 40 patients with treatment-naive, pathologically confirmed non-small cell lung cancer (NSCLC) and 25 lung-cancer-screening-eligible healthy controls. Paired samples were analyzed via a compact point-of-care GC-MS platform (CLARION) and a laboratory HRMS reference. Diagnostic classification models were built independently for each platform using elastic net logistic regression with leave-one-out cross-validation, and performance was evaluated by area under the receiver operating characteristic curve (AUC). Results: CLARION identified 103 VOCs across breath specimens, compared to over 900 identified by HRMS. Despite this difference in panel size, CLARION achieved diagnostic performance nearly identical to HRMS for distinguishing NSCLC cases from controls (AUC 0.864 vs. 0.863). Compared to controls, performance statistics were similar for early-stage NSCLC (AUC 0.854 vs. 0.841) and adenocarcinoma (AUC 0.770 vs. 0.787). VOCs of interest include p-cymene, phenol, propylbenzene, tetradecane, {beta}-ocimene, 2,3-dihydro-indole, and 1-methylthio-(Z)-1-propene. Conclusion: A compact, point-of-care breath GC-MS platform achieved diagnostic performance for NSCLC detection comparable to a laboratory HRMS reference despite a substantially smaller detected VOC panel. These findings support continued development of point-of-care breath VOC testing as a non-invasive, field-deployable complement to LDCT-based lung cancer screening.

Focal adhesions maintain force-bearing attachment between cells and the extracellular matrix but can also undergo dynamic remodeling. Their assembly and actomyosin tension are coupled through mechanochemical feedback. The processes underlying this feedback are not instantaneous and therefore involve a time delay. However, how this delayed feedback gives rise to stable adhesion maintenance or dynamic remodeling remains unclear. Here, paired time-lapse measurements of vinculin fluorescence and traction stress revealed distinct local adhesion-force dynamics, including low-fluctuation and recurrent fluctuation patterns. To examine how these patterns could arise, we formulated a minimal mechanochemical model coupling focal adhesion assembly and actomyosin force through delayed reciprocal feedback. The model exhibited stable and oscillatory modes depending on feedback strength, the balance of opposing feedback effects, and the effective feedback delay. Bistability and hysteretic switching also occurred in a subset of parameter space, and the oscillation period followed a power-law relation with the delay. These results suggest that stable adhesion maintenance and dynamic remodeling can emerge from a common mechanochemical feedback architecture.

Genomic instability is a major driver of tumor evolution, promoting diversification and adaptation while simultaneously increasing the accumulation of deleterious alterations. How tumor populations balance these opposing effects remains poorly understood. Here, we introduce a computational framework that explicitly represents diploid genomes, functional gene classes, point mutations, and chromosome-segregation errors in spatially constrained and well-mixed tumor populations. We identify a viability boundary separating sustained tumor expansion from instability-induced population collapse. Within the viable regime, mutation and selection generate a stable distribution of genomic-instability classes that is accurately captured by an analytical replicator--mutator description. Near the viability boundary, tumor dynamics exhibit prolonged extinction transients and strong sensitivity to stochastic fluctuations, with important differences between solid and liquid architectures. Chromosomal alterations further modify growth by creating transient benefits through increased gene dosage and genetic redundancy, while ultimately increasing genomic fragility. Finally, simulated interventions show that eliminating low-instability subpopulations or increasing the global mutational burden can displace tumors beyond their viability boundary and trigger irreversible collapse. These results identify genome instability as both an evolutionary advantage and an intrinsic vulnerability, providing a quantitative framework for developing therapies that exploit the limits of tumor evolution.

All living organisms rely on the movement of ions across cell membranes as the fundamental physical basis of their internal energy and signaling, and plants are no exception. Plants perceive, integrate, and respond to environmental stimuli through electrical signals, classified as action, variation, and system potentials, that are coupled with calcium waves, reactive oxygen species, and hydraulic and hormonal changes to coordinate whole-organism responses despite the absence of a nervous system. Yet most studies characterize these signals using a single feature, such as amplitude or spike duration, in a single tissue, an approach that cannot establish how such signals correspond to the underlying ionic activity, mobility, and structural complexity of the signaling environment, or how this correspondence varies across organs. Here, we correlate plant bioelectrical signals with potential ionic energy flow using a multi-domain framework, combining discrete spike events, continuous waveform properties, spectral composition, and signal complexity applied to leaf, stem, and root recordings from tomato (Solanum lycopersicum) exposed to different stimulus. Electrical activity with increased stimulus strength, likely reflecting increased ionic flow, with the root showing the largest response. This suggests plant electrical signaling works as a distributed, ion-based information system, useful for stress monitoring and bio-inspired sensor design.

Background: Spatial organization is increasingly recognized as a key determinant of tumor-immune interactions in head and neck squamous cell carcinoma (HNSCC). The GSE300147 Xenium spatial transcriptomic resource generated by McCord and colleagues established a framework for mapping spatially coordinated T-cell states in HNSCC. However, how tumor-enriched epithelial immune states relate to metabolic, redox, and stress-adaptive transcript programs remains incompletely defined. Methods: A secondary, data-driven reanalysis of GSE300147 was performed, focusing on 17 confirmed HNSCC Xenium sections after exclusion of a non-HNSCC ameloblastoma specimen. A total of 1,148,244 cells were analyzed, including 558,867 EpCAM+ tumor-enriched epithelial cells. Tumor-enriched epithelial cells were classified into Hot, Intermediate, and Cold states using a Composite Hotness framework integrating T-cell inflammatory signature score, checkpoint-associated signaling, CD274 expression, IFN/antigen-presentation signature score (IFN/AP), and tumor-immune proximity. Six metabolic ecosystem states, neighborhood profiling, spatial permutation testing, and an integrated Immune-Metabolic-Redox Ecosystem Score (IMRES) were then applied. Results: Immune activation was spatially heterogeneous across HNSCC sections. Immune-hot tumor-enriched epithelial regions showed not only inflammatory, checkpoint-associated, and antigen-presentation signature scores, but also coordinated metabolic, oxidative-redox, and stress-response transcript programs. IMRES, derived from available immune, metabolic, redox, and stress-response transcript components represented in the Xenium panel, increased progressively from Cold to Intermediate to Hot tumor-enriched epithelial states and was associated with NFE2L2, GDF15, HLA-DRA, CD274, KEAP1, and MDM2. Integrating IMRES with Composite Hotness identified a distinct Hot+IMREShigh ecosystem comprising 106,874 tumor-enriched epithelial cells. This state showed the strongest immune-active and stress-adaptive features and was positioned closer to immune populations than expected by random assignment. An alternative rank-based robustness analysis reproduced the IMRES-associated ecosystem axis and correlated with the original module-based score (Spearman r = 0.597). Conclusions: This secondary reanalysis extends the original spatial T-cell framework by defining a complementary tumor-centered immune-metabolic-redox ecosystem in HNSCC. IMRES provides a transcript-derived framework for identifying Hot+IMREShigh neighborhoods where immune activation, checkpoint signaling, metabolic remodeling, and stress adaptation converge, providing a hypothesis-generating framework for studying immune resistance and therapeutic vulnerability.

Metabolic dysfunction-associated steatotic liver disease (MASLD), the leading cause of chronic liver pathologies worldwide, represents a growing clinical burden. Its diagnosis remains reliant on liver biopsy that limits early detection and the ability to capture molecular changes across disease progression. A systematic understanding of stage-dependent gene expression changes is essential to identify biomarkers and effectively characterize disease mechanisms. Therefore recent studies provided databases for searching genes as well as prediction of multi-gene signatures for disease progression. However, there is still a need for interactive and comprehensive meta-analysis of datasets of MASLD patients with available histological metadata. Herein, we performed a meta-analysis of RNA-seq datasets using NAFLD Activity Score (NAS; n = 897) and fibrosis stage (n = 856) upon conducting pairwise comparisons across histological stages and identified differentially expressed genes associated with disease progression. Most importantly, we provide our findings via a dedicated web server, the MASLD-META NETWORK (https://masld.scilicium.com), enabling users to interactively explore meta-analysis results across diverse network modalities. In addition, we characterized gene expression dynamics across increasing disease stages to identify consistent progression-associated pathways using Louvain clustering. Network-based parameters such as centrality in combination with meta-analysis scores further highlighted central genes and pathways implicated in disease mechanisms. Accordingly, MASLD-META NETWORK enabled an integrative reassessment of recently published gene signatures, identifying COL1A1, COL3A1, THBS2, FBLN5, and PDGFA as the most central genes, and SULF2, MMP14, IL32, GPNMB, and COL3A1 as candidate markers of earlier transcriptional alterations. Network analysis of MASLD associated biological modules further identified LAMA2 and LAMA3 as previously unrecognized central candidate targets.

Identifying causal connections between existing drugs and mechanistic profiles of diseases is a foundational step for effective drug repurposing. Although knowledge graphs (KGs) are highly suited for consolidating biomedical databases and tracking these connections, a single biomedical KG is constrained by its ingestion pipeline and knowledge sources. While different biomedical KGs could be complementary if combined, efforts to combine them into a unified and more comprehensive KG are hindered by lack of interoperability and poor provenance. To address those issues, we present EC-KG, a Biolink Model-compatible KG for computational drug repurposing. EC-KG is an interoperable, provenance-first KG which integrates RTX-KG2, ROBOKOP, and PrimeKG at the network-level, encapsulating over 7 million nodes and 81 million edges from 95 primary data sources. EC-KG has improved coverage of core biomedical entities such as drugs, targets, and diseases relevant to drug repurposing vs source graphs, and captures complex biomedical mechanisms within its topology. We demonstrate that the network unification in EC-KG leads to emergence of novel, mechanistically relevant pathways which are disconnected in the underlying constituent networks and show its applications in method development, benchmarking and predictive drug repurposing applications. EC-KG has already been successfully used in drug repurposing research to surface Botulinum Toxin A as a candidate to treat Major Depressive Disorder, as well as to validate repurposing of Lenalidomide and Dexamethasone for a subgroup of patients with Rosai-Dorfman Disease.

Spatial omics technologies resolve molecular expression and spatial architecture at single-cell resolution, but profiling whole slides remains costly. In practice, only a few regions of interest (ROIs) are profiled, leaving the rest of the tissue unmeasured. S2-omics was the first framework to unify ROI selection with out-of-ROI prediction, but it operates on superpixels rather than individual cells and predicts discrete cell types rather than continuous molecular profiles. Superpixel-based representations do not explicitly preserve cell boundaries, while categorical cell-type labels cannot quantify molecular expression within cells. Here we present RECON, a two-stage framework that performs ROI inference and whole-slide molecular reconstruction at single-cell resolution, predicting both continuous molecular profiles and discrete cell-type labels. In the first stage, RECON extracts morphological and microenvironmental features from individual cells to identify a representative ROI for spatially resolved single-cell molecular profiling. In the second stage, RECON trains deep learning models on molecular measurements acquired within the selected ROI and reconstructs transcriptomic or proteomic profiles for all remaining cells on the slide. Benchmarked against pathologist annotations, RECONs ROI selection outperforms the superpixel-based S2-omics approaches (IoU: 0.75 versus 0.64). For transcriptomics, refining the modeling unit from superpixels to single cells improves per-gene Pearson correlation by 22%. For proteomics, RECON surpasses the current state-of-the-art method, ROSIE, across all 16 markers, with a median per-cell Pearson correlation of 0.91 versus 0.84. Moreover, RECON delineates tumour boundaries and regions with distinct immune-cell densities, and highlights candidate tertiary lymphoid structures. Together, these results demonstrate that RECON enables informative ROI selection and whole-slide molecular reconstruction at single-cell resolution for both spatial transcriptomics and spatial proteomics.

Abstract Background: Cytolytic activity (CYT), a widely used transcriptomic surrogate of anti-tumor immune cytotoxicity derived from GZMA (granzyme A) and PRF1 (Perforin 1) expression, is associated with clinical outcomes across cancers. MicroRNAs (miRNAs) are key post-transcriptional regulators of tumor immunity, yet their pan-cancer roles in modulating cytolytic activity remain incompletely understood. Objective: This study aimed to identify conserved miRNA regulators of tumor cytolytic activity and their downstream gene-mediated networks across diverse cancer types, while evaluating their clinical and therapeutic relevance. Methods: Matched miRNA and mRNA expression profiles from 9,288 primary tumors across 31 TCGA cancer types were analyzed. A multi-stage framework was applied: per-cancer Spearman correlations (|{rho}| >= 0.30, FDR < 0.05) identified recurrent CYT-associated miRNAs (at least 3 cancer types); these were integrated with TargetScan-predicted targets and subjected to pan-cancer and cross-cancer triple filtering (miRNA-gene and gene-CYT associations). All associations underwent tumor purity adjustment using Consensus Purity Estimate (CPE), with LUMP (Leukocytes Unmethylation for Purity) as sensitivity analysis. Candidates were further prioritized by random forest modeling with bootstrap stability, cancer-type-adjusted Cox regression, mediation analysis, immune cell deconvolution, k-means molecular subtyping, pathway enrichment, and DGIdb-based drug-target prioritization. Results: The analysis converged on 38 high-confidence miRNA-gene-CYT regulatory triplets involving 9 conserved miRNAs and 31 target genes after stringent purity adjustment and multi-layer validation. All nine miRNAs exhibited complete bootstrap stability. Mediation analysis confirmed significant gene-level mediation in 37 of 38 triplets (FDR < 0.01), with mediated proportions up to 94%. The final miRNA signature defined two distinct pan-cancer immune subtypes (immune-hot vs. immune-cold) with significantly different cytolytic activity and overall survival (OS) (HR = 0.754, FDR = 1.12 x 10^-4). The network was enriched for T-cell activation and lymphocyte differentiation pathways and highlighted multiple druggable targets, including CTLA4 and CD274 (PD-L1), nominating 124 candidate compounds. Conclusions: In conclusion, this tumor purity-adjusted pan-cancer study defines a compact, reproducible, and clinically relevant miRNA network that regulates cytolytic activity across diverse malignancies. By linking miRNA biology to immune subtyping and actionable therapeutic targets, the present work provides a valuable foundation for advancing precision immuno-oncology.

SynNotch-CAR circuits improve T cell specificity by coupling antigen recognition to inducible CAR expression. However, basal CAR expression without receptor activation, termed here as leakiness, can reduce the separation between killing of intended target cells and sparing of antigen-positive off-target cells, limiting target-cell discrimination. Here, we systematically quantified basal CAR expression for several synNotch-CAR designs and developed a coupled ordinary differential equation model to show that discrimination depends on basal output, CAR potency, and effector-to-target ratio. We introduced C-terminal tags such as fluorescent proteins, degron domains, endocytosis signals, and endoplasmic reticulum retention motifs as a strategy to reduce CAR leakiness. We found that fluorescent proteins and degron-containing tags reduced basal CAR surface expression while preserving antigen-induced CAR expression, improving discrimination of antigen-density sensing and combinatorial circuits in vitro. In xenograft models, fluorescent protein-tagged CARs improved discrimination by reducing activity against off-target cells while retaining activity against high-antigen tumors. Degron-containing constructs reduced basal CAR expression in vitro but showed suboptimal performance in vivo, revealing a trade-off between basal CAR suppression and induced CAR persistence. Together, these findings demonstrate that basal output expression is a key parameter for inducible genetic circuit designs and establish layered transcriptional and post-translational regulation as a strategy to improve the fidelity of inducible T cell circuits.