Background:Ferroptosis is a distinct form of regulated cell death characterized by iron-dependent lipid peroxidation, which plays crucial roles in tumor biology and therapeutic response. However, the prognostic significance of ferroptosis-related genes (FRGs) in lung adenocarcinoma (LUAD) remains incompletely understood. This study aimed to construct and validate a ferroptosis-related prognostic model for LUAD by integrating single-cell and bulk transcriptomic data. Methods:Single-cell RNA sequencing (scRNA-seq) data from GSE127465 were integrated with bulk transcriptomic data from The Cancer Genome Atlas lung adenocarcinoma cohort (TCGA-LUAD). FRGs were identified through single-cell gene set scoring with the AUCell algorithm and differential expression analysis. A least absolute shrinkage and selection operator (LASSO)-Cox regression model was constructed and externally validated using the GSE72094 and GSE68465 cohorts. Associations between the model, genomic features, and the tumor immune microenvironment were systematically analyzed. The functional role of SRSF9 was verified through in vitro experiments. Results:A total of 93 candidate genes significantly associated with ferroptosis activity were identified, and an 8-gene prognostic signature (PEBP1, TXN, TIMP1, SRSF9, CFL1, OTUB1, FURIN, and PTPN6) was constructed. The signature demonstrated robust prognostic performance across validation cohorts, with time-dependent area under the curve (AUC) values ranging from 0.65 to 0.74. High-risk patients exhibited elevated tumor mutation burden (TMB) and distinct immune infiltration patterns. Consensus clustering analysis classified patients into two ferroptosis-related molecular subtypes with significantly different prognoses. Functional experiments demonstrated that SRSF9 knockdown inhibited LUAD cell proliferation, migration, and invasion. Moreover, SRSF9 knockdown downregulated glutathione peroxidase 4 (GPX4) and SLC7A11, increased lipid peroxidation and malondialdehyde (MDA) levels, and the resulting cell viability loss was rescued by ferrostatin-1, indicating that SRSF9 knockdown induces ferroptosis in LUAD cells. Conclusions:The ferroptosis-related prognostic signature established in this study may facilitate risk stratification in LUAD patients. SRSF9 may regulate ferroptosis-related pathways through modulation of GPX4 and SLC7A11, and functional experiments further confirmed that SRSF9 knockdown induces ferroptosis in LUAD cells, highlighting SRSF9 as a candidate therapeutic target that warrants further investigation.

BACKGROUND:Sphingosine-1-phosphate (S1P), a metabolite of sphingosine, is associated with the proliferation of pulmonary artery smooth muscle cells (PASMCs). This study aims to address the mechanisms by which S1P induces PASMC proliferation, contributing to pulmonary arterial remodeling. METHODS:Primary cultured rat PASMCs were incubated with S1P. Cyclopamine was used to inhibit Smoothened (SMO) function, while siRNA transfection selectively knocked down the expression of signal transducer and activator of transcription 3 ( STAT3 ), glioma-associated oncogene homolog 1 ( GLI1 ), and forkhead box M1 ( FOXM1 ). Cell proliferation was measured by 5-bromo-2'-deoxyuridine (BrdU) and 5-ethynyl-2'-deoxyuridine (EdU) incorporation assay. Subcellular localization of Gli1 was determined using immunofluorescence staining. In a monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) rat model, PF543 (the inhibitor of S1P synthetase), NSC74859 (the inhibitor of STAT3), and cyclopamine (the inhibitor of sonic hedgehog [Shh] receptor) were administered to evaluate their effects on disease progression. Hemodynamic changes and histological examination were performed to evaluate the development of PAH. The protein levels of sphingosine kinase 1 (SphK1), phosphorylated/total STAT3 (p-/t-STAT3), Shh, Gli1 and FoxM1 were determined using immunoblotting. RESULTS:S1P increased Shh expression by STAT3 activation, which further caused Gli1 upregulation and nuclear translocation in PASMCs. Activation of Gli1 raised FoxM1 expression and then triggered PASMCs proliferation and migration. In MCT-induced PAH rat models, S1P levels were elevated in lung tissues and serum, triggering STAT3 activation and subsequent upregulation of Shh, Gli1, and FoxM1 in lung. Targeting these molecules alleviated pulmonary arterial remodeling and prevented the development of PAH. CONCLUSIONS:S1P/STAT3/Shh/Gli1/FoxM1 pathway plays an important role in PASMCs proliferation and pulmonary arterial remodeling. Targeting this cascade may have potential value for the management of PAH.

Background: Chronic obstructive pulmonary disease (COPD) patients admitted to the intensive care unit (ICU) are usually in serious conditions and have a high hospital mortality rate. Our study aimed to explore simple clinical parameters associated with hospital mortality and to establish a novel prediction model. Methods: Patients were retrospectively screened from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and the eICU collaborative research database (eICU-CRD). Logistic regression analysis was used to screen clinical parameters associated with hospital mortality in critically ill patients with COPD, and these parameters were used to construct the prediction model presented in the form of a nomogram. The concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were utilized to evaluate the model. Results: There were 1,174 patients included in the MIMIC-IV database and 3,778 patients available for validation in eICU-CRD. Logistic regression analysis indicated that age (A), leukocyte (L), platelet (P), and red blood cell distribution width-albumin ratio (R) were independent predictors of hospital mortality in critically ill patients with COPD, and the above four predictors were used to construct the ALPR nomogram model. In the ALPR model, the C-index of the establishing set and validation set was 0.759 [95% confidence interval (CI): 0.723-0.794] and 0.717 (95% CI: 0.692-0.742), respectively. ROC and calibration curves also showed good accuracy and discrimination. To a certain extent, the clinical value of the ALPR model was superior to that of the age-adjusted Charlson comorbidity index (CCI) and Sequential Organ Failure Assessment (SOFA) score. Conclusions: The ALPR model can help clinicians predict hospital mortality in critically ill patients with COPD, potentially facilitating personalized treatment.

High fasting plasma glucose (HFPG) has been identified as a risk factor for drug-resistant tuberculosis incidence and mortality. However, the epidemic characteristics of HFPG-attributable multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) remain unclear. We aimed to analyze the global spatial patterns and temporal trends of HFPG-attributable MDR-TB and XDR-TB from 1990 to 2019. Utilizing data from the Global Burden of Disease 2019 project, annual deaths and disability-adjusted life years (DALYs) of HFPG-attributable MDR-TB and XDR-TB were conducted from 1990 to 2019. Joinpoint regression was employed to quantify trends over time. From 1990 to 2019, the deaths and DALYs due to HFPG-attributable MDR-TB and XDR-TB globally showed an overall increasing trend, with a significant increase until 2003 to 2004, followed by a gradual decline or stability thereafter. The low sociodemographic index (SDI) region experienced the most significant increase over the past 30 years. Regionally, Sub-Saharan Africa, Central Asia and Oceania remained the highest burden. Furthermore, there was a sex and age disparity in the burden of HFPG-attributable MDR-TB and XDR-TB, with young males in the 25–34 age group experiencing higher mortality, DALYs burden and a faster increasing trend than females. Interestingly, an increasing trend followed by a stable or decreasing pattern was observed in the ASMR and ASDR of HFPG-attributable MDR-TB and XDR-TB with SDI increasing. The burden of HFPG-attributable MDR-TB and XDR-TB rose worldwide from 1990 to 2019. These findings emphasize the importance of routine bi-directional screening and integrated management for drug-resistant TB and diabetes.

Induction of resistin-like molecule (3 (Relm-(3) and mitofusin 2 (MFN2) mediated aberrant mitochondrial fission have been found to be involved in the pathogenesis of pulmonary arterial hypertension (PAH). However, the molecular mechanisms underlying Relm-(3 regulation of MFN2 therefore mitochondrial fission remain unclear. This study aims to address these issues. Primary cultured PASMCs and monocrotaline (MCT)-induced PAH rats were applied in this study. The results showed that Relm-(3 promoted cells proliferation in PASMCs, this was accompanied with the upregulation of USP18, Twist1 and miR-214, and downregulation of MFN2. We found that Relm-(3 increased USP18 expression which in turn raised Twist1 by suppressing its proteasome degradation. Elevation of Twist1 increased miR-214 expression and then reduced MFN2 expression and mitochondrial fragmentation leading to PASMCs proliferation. In vivo study, we confirmed that Relm-(3 was elevated in MCTinduced PAH rat model, and USP18/Twist1/miR-214/MFN2 axis was altered similar as in vitro. Targeting this cascade by Relm-(3 receptor inhibitor Calhex231, proteasome inhibitor MG-132, Twist1 inhibitor Harmine or miR-214 antagomiR prevented the development of pulmonary vascular remodeling and therefore PAH in MCTtreated rats. In conclusion, we demonstrate that Relm-(3 promotes PASMCs proliferation and vascular remodeling by activating USP18/Twist1/miR-214 dependent MFN2 reduction and mitochondrial fission, suggesting that this signaling pathway might be a promising target for management of PAH.

Induction of resistin-like molecule β (Relm-β) and mitofusin 2 (MFN2) mediated aberrant mitochondrial fission have been found to be involved in the pathogenesis of pulmonary arterial hypertension (PAH). However, the molecular mechanisms underlying Relm-β regulation of MFN2 therefore mitochondrial fission remain unclear. This study aims to address these issues. Primary cultured PASMCs and monocrotaline (MCT)-induced PAH rats were applied in this study. The results showed that Relm-β promoted cells proliferation in PASMCs, this was accompanied with the upregulation of USP18, Twist1 and miR-214, and downregulation of MFN2. We found that Relm-β increased USP18 expression which in turn raised Twist1 by suppressing its proteasome degradation. Elevation of Twist1 increased miR-214 expression and then reduced MFN2 expression and mitochondrial fragmentation leading to PASMCs proliferation. In vivo study, we confirmed that Relm-β was elevated in MCT-induced PAH rat model, and USP18/Twist1/miR-214/MFN2 axis was altered similar as in vitro. Targeting this cascade by Relm-β receptor inhibitor Calhex231, proteasome inhibitor MG-132, Twist1 inhibitor Harmine or miR-214 antagomiR prevented the development of pulmonary vascular remodeling and therefore PAH in MCT-treated rats. In conclusion, we demonstrate that Relm-β promotes PASMCs proliferation and vascular remodeling by activating USP18/Twist1/miR-214 dependent MFN2 reduction and mitochondrial fission, suggesting that this signaling pathway might be a promising target for management of PAH.

Stromal derived factor 1 (SDF1) has been shown to be involved in the pathogenesis of pulmonary artery hypertension (PAH). However, the detailed molecular mechanisms remain unclear. To address this, we utilized primary cultured rat pulmonary artery smooth muscle cells (PASMCs) and monocrotaline (MCT)-induced PAH rat models to investigate the mechanisms of SDF1 driving PASMCs proliferation and pulmonary arterial remodeling. SDF1 increased runt-related transcription factor 2 (Runx2) acetylation by Calmodulin (CaM)-dependent protein kinase II (CaMKII)-dependent HDAC4 cytoplasmic translocation, elevation of Runx2 acetylation conferred its resistance to proteasome-mediated degradation. The accumulation of Runx2 further upregulated osteopontin (OPN) expression, finally leading to PASMCs proliferation. Blocking SDF1, suppression of CaMKII, inhibition the nuclear export of HDAC4 or silencing Runx2 attenuated pulmonary arterial remodeling and prevented PAH development in MCT-induced PAH rat models. Our study provides novel sights for SDF1 induction of PASMCs proliferation and suggests that targeting SDF1/CaMKII/HDAC4/Runx2 axis has potential value in the management of PAH.

To address the molecular mechanisms underlying macrophage migration inhibitory factor (MIF) induced pulmonary artery smooth muscle cells (PASMCs) proliferation, migration and vascular remodeling in pulmonary hypertension (PH), primary cultured rat PASMCs and monocrotaline (MCT)-induced rats with PH were applied in the present study. The results showed that MIF increased signal transducer and activator of transcription 3 (STAT3) phosphorylation, and then stimulated activating transcription factor 6 (ATF6) activation, subsequently triggered autophagy activation, which further led to programmed cell death factor 4 (PDCD4) lysosomal degradation, and eventually promoted PASMCs proliferation/migration. In lung tissues of MCT rats, MIF protein expression was elevated, phosphorylation of STAT3 and activation of ATF6 were increased, activation of autophagy was evident, and reduction of PDCD4 was observed. Intervention with MIF inhibitor 4-Iodo-6-phenylpyrimidine (4-IPP), ATF6 blocker melatonin or autophagy inhibitor chloroquine, confirmed the in vitro interaction among MIF, STAT3, ATF6, autophagy and PDCD4 in MCT induced rats with PH. Targeting MIF/STAT3/ATF6/autophagy/PDCD4 axis effectively prevented the development of PH by suppressing PASMCs proliferation and vascular remodeling. In conclusions, we demonstrate that MIF activates the STAT3/ATF6/autophagy cascade and then degrades PDCD4 leading to PASMCs proliferation/migration and pulmonary vascular remodeling, suggesting that intervention this axis might have potential value in management of PH.

Background: It has been demonstrated that elevated telomerase reverse transcriptase (TERT) expression or activity is implicated in pulmonary hypertension (PH). In addition, activation of peroxisome-proliferator-activated receptor gamma (PPAR-gamma) has been found to prevent PH progression. However, the molecular mechanism responsible for the protective effect of PPAR-gamma activation on TERT expression in the pathogenesis of PH remains unknown. This study was performed to address these issues. Methods: Intraperitoneal injection of monocrotaline (MCT) was used to establish PH. BIBR1532 was applied to inhibit the activity of telomerase. The right ventricular systolic pressure (RVSP) and histological analysis were used to detect the development of PH. The protein levels of p-Akt, t-Akt, c-Myc and TERT were determined by western blotting. Pharmacological inhibition of TERT by BIBR1532 effectively suppressed RVSP, RVHI and the WT% in MCT-induced PH rats. Results: Pharmacological inhibition of Akt/c-Myc pathway by LY294002 diminished TERT upregulation, RVSP, RVHI and WT% in MCT-PH rats. Activation of PPAR-gamma by pioglitazone inhibited p-Akt and c-Myc expressions and further downregulated TERT, thus to reduced RVSP, RVHI and WT% in MCT-treated PH rats. Conclusions: In conclusion, TERT upregulation contributes to PH development in MCT-treated rats. Activation of PPAR-gamma prevents pulmonary arterial remodeling through Akt/c-Myc/TERT axis suppression.

Objective This study aimed to analyze the correlation between quantitative computed tomography (CT) parameters and airflow obstruction in patients with COPD. Methods PubMed, Embase, Cochrane and Web of Knowledge were searched by two investigators from inception to July 2022, using a combination of pertinent items to discover articles that investigated the relationship between CT measurements and lung function parameters in patients with COPD. Five reviewers independently extracted data, and evaluated it for quality and bias. The correlation coefficient was calculated, and heterogeneity was explored. The following CT measurements were extracted: percentage of lung attenuation area <−950 Hounsfield Units (HU), mean lung density, percentage of airway wall area, air trapping index, and airway wall thickness. Two airflow obstruction parameters were extracted: forced expiratory volume in the first second as a percentage of prediction (FEV 1 %pred) and FEV 1 divided by forced expiratory volume lung capacity. Results A total of 141 studies (25,214 participants) were identified, which 64 (6,341 participants) were suitable for our meta-analysis. Results from our analysis demonstrated that there was a significant correlation between quantitative CT parameters and lung function. The absolute pooled correlation coefficients ranged from 0.26 (95% CI, 0.18 to 0.33) to 0.70 (95% CI, 0.65 to 0.75) for inspiratory CT and 0.56 (95% CI, 0.51 to 0.60) to 0.74 (95% CI, 0.68 to 0.80) for expiratory CT. Conclusions Results from this analysis demonstrated that quantitative CT parameters are significantly correlated with lung function in patients with COPD. With recent advances in chest CT, we can evaluate morphological features in the lungs that cannot be obtained by other clinical indices, such as pulmonary function tests. Therefore, CT can provide a quantitative method to advance the development and testing of new interventions and therapies for patients with COPD.

ObjectiveThis study aimed to analyse the burden and temporal trends of tuberculosis (TB) incidence and mortality globally, as well as the association between mortality-to-incidence ratio (MIR) and Socio-Demographic Index (SDI).DesignA retrospective analysis of TB data from 1990 to 2019 was conducted using the Global Burden of Disease Study database.ResultsBetween 1990 and 2019, there was a declining trend in the global incidence and mortality of TB. High SDI regions experienced a higher declining rate than in low SDI regions during the same period. Nearly half of the new patients occurred in South Asia. In addition, there is a sex–age imbalance in the overall burden of TB, with young males having higher incidence and mortality than females. In terms of the three subtypes of TB, drug-sensitive (DS)-TB accounted for more than 90% of the incidents and deaths and experienced a decline over the past 30 years. However, drug-resistant TB (multidrug-resistant (MDR)-TB and extensively drug-resistant (XDR)-TB) showed an overall increasing trend in age-standardised incidence rates and age-standardised mortality rates, with an inflection point after the year 2000. At the regional level, South Asia and Eastern Europe remained a high burden of drug-resistant TB incidence and mortality. Interestingly, a negative correlation was found between the MIR and SDI for TB, including DS-TB, MDR-TB and XDR-TB. Notably, central sub-Saharan Africa had the highest MIR, which indicated a higher-than-expected burden given its level of sociodemographic development.ConclusionThis study provides comprehensive insights into the global burden and temporal trends of TB incidence and mortality, as well as the relationship between MIR and SDI. These findings contribute to our understanding of TB epidemiology and can inform public health strategies for prevention and management.

BACKGROUND:Macrophage migration inhibitory factor (MIF) and GTPase dynamin-related protein 1 (Drp1)-dependent aberrant mitochondrial fission are closely linked to the pathogenesis of asthma. However, it is unclear whether Drp1-mediated mitochondrial fission and its downstream targets mediate MIF-induced proliferation of airway smooth muscle cells (ASMCs) in vitro and airway remodeling in chronic asthma models. The present study aims to clarify these issues.METHODS:In this study, primary cultured ASMCs and ovalbumin (OVA)-induced asthmatic rats were applied. Cell proliferation was detected by CCK-8 and EdU assays. Western blotting was used to detect extracellular signal-regulated kinase (ERK) 1/2, Drp1, autophagy-related markers and E-cadherin protein phosphorylation and expression. Inflammatory cytokines production, airway reactivity test, histological staining and immunohistochemical staining were conducted to evaluate the development of asthma. Transmission electron microscopy was used to observe the mitochondrial ultrastructure.RESULTS:In primary cultured ASMCs, MIF increased the phosphorylation level of Drp1 at the Ser616 site through activation of the ERK1/2 signaling pathway, which further activated autophagy and reduced E-cadherin expression, ultimately leading to ASMCs proliferation. In OVA-induced asthmatic rats, MIF inhibitor 4-iodo-6-phenylpyrimidine (4-IPP) treatment, suppression of mitochondrial fission by Mdivi-1 or inhibiting autophagy with chloroquine phosphate (CQ) all attenuated the development of airway remodeling.CONCLUSIONS:The present study provides novel insights that MIF promotes airway remodeling in asthma by activating autophagy and degradation of E-cadherin via ERK/Drp1 signaling pathway, suggesting that targeting MIF/ERK/Drp1 might have potential therapeutic value for the prevention and treatment of asthma.

Abstract BackgroundTuberculosis especially drug resistance tuberculosis is the most pervasive infectious diseases worldwide. Studies examining the scope, variation and influence factor of the worldwide burden of tuberculosis and drug resistance status are lacking.MethodsIn this cross-sectional study, epidemiologic data were gathered using the Global Health Data Exchange query tool, covering persons of all ages with tuberculosis in 204 countries and 21 regions from January 1, 1990, to December 31, 2019; data analysis was completed on December 1, 2022. All participants met the Global Burden of Disease Study inclusion criteria. We analyzed the incidence, mortality and variation trends and influence factor of drug-susceptible and drug-resistant tuberculosis at global, regional and national levels using data from 1990 to 2019.ResultsOutcomes included incidence, deaths, and disability-adjusted life-years (DALYs) by drug-resistance type. Measures were stratified by region, country and socio-demographic index (SDI). The estimated annual percentage changes (EAPCs) and age-standardized rates (ASR) were calculated to evaluate the temporal trends. We also provide the association of age-standardized incidence rates of tuberculosis and the incidence proportion of drug-resistant tuberculosis (DR-TB) with SDI.ConclusionWe found the incidence, deaths and DALYs for tuberculosis appeared to decrease annually, but the increasing incidence and deaths of drug-resistant tuberculosis in all SDI quintiles raises notable points, especially in low- and middle-income countries. This study suggests an increasing global burden of tuberculosis. And the geographic disparities may provide support for tuberculosis health care planning and resource allocation.

Glioma-associated oncogene homolog 1 (GLI1), a zinc-finger transcription factor, is upregulated in tumors and promotes cancer cell proliferation and migration. However, whether GLI1 involves in pulmonary artery smooth muscle cells (PASMCs) proliferation and migration and the detailed molecular mechanisms underlying GLI1 in pulmonary arterial hypertension (PAH) are not yet clear. Primary cultured rat PASMCs and monocrotaline (MCT)-induced PAH rats model were applied to address these issues in the present study. We found that the expression of GLI1 was significantly increased in endothelin-1 (ET-1) treated PASMCs, accompanied with the activation of microRNA (miR)-27b-3p/F-box and WD repeat domain containing 7 (FBXW7)/kruppel-like factor 5 (KLF5)/GLI1 pathway through endothelin-1 receptor type A (ETAR). Elevated miR-27b-3p suppressed FBXW7 expression, which led to KLF5 accumulation by decreasing its ubiquitinated degradation, KLF5 further induced GLI1 upregulation leading to PASMCs proliferation and migration. In addition, in MCT-induced PAH rats, targeting ETAR/miR-27b-3p/FBXW7/KLF5/GLI1 pathway effectively prevented the pulmonary vascular remodeling and the development of PAH in rats. Our study indicates that interfering ETAR/miR-27b-3p/FBXW7/KLF5/ GLI1 signaling axis might have a potential value in the prevention and treatment of PAH.

It has been shown that activation of autophagy promotes the development of pulmonary arterial hypertension (PAH). Meanwhile, forkhead box M1 (FOXM1) has been found to induce autophagy in several types of cancer. However, it is still unclear whether FOXM1 mediates autophagy activation in PAH, and detailed mechanisms responsible for these processes are indefinite. PAH was induced by a single intraperitoneal injection of monocrotaline (MCT) to rats. The right ventricle systolic pressure (RVSP), right ventricular hypertrophy index (RVHI), percentage of medial wall thickness (%MT), α-smooth muscle actin (α-SMA) staining, and Ki67 staining were performed to evaluate the development of PAH. The protein levels of FOXM1, phospho-focal adhesion kinase (p-FAK), FAK, and LC3B were determined by immunoblotting or immunohistochemistry. FOXM1 protein level and FAK activity were significantly increased in MCT-induced PAH rats, this was accompanied with the activation of autophagy. Pharmacological inhibition of FOXM1 or FAK suppressed MCT-induced autophagy activation, decreased RVSP, RVHI and %MT in MCT-induced PAH rats, and inhibited the proliferation of pulmonary arterial smooth muscle cells and pulmonary vessel muscularization in MCT-induced PAH rats. FOXM1 promotes the development of PAH by inducing FAK phosphorylation and subsequent activation of autophagy in MCT-treated rats.

Background: High body mass index (BMI) plays a key role in the progression of asthma and asthma related to high BMI resulted in a high burden of disease globally.Objective: To explore the geographic and temporal trends in the global burden of asthma associated with high BMI from 1990 to 2019.Methods: This is a retrospective analysis with data based on the Global Burden of Disease Study 2019 database. Deaths, disability-adjusted life-years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) were estimated according to sex, age, and sociodemographic index levels. The estimated annual percentage change was used to evaluate the variation trends of ASMR and ASDR from 1990 to 2019.Results: In 2019, the number of global asthma deaths and DALYs related to high BMI increased by 69.69% and 63.91%, respectively, compared with 1990, among which more deaths and DALYs occurred in women. The corre-sponding ASMR and ASDR exhibited a slightly decreasing tendency globally. South Asia accounted for the highest number of deaths and DALYs, with India ranking first worldwide in 2019. The number of deaths and DALYs were mainly seen in individuals 60 to 79 years old and 55 to 69 years old, respectively, from 1990 to 2019. The heavi-est burden existed in the low-middle sociodemographic index region.Conclusion: The global asthma burden associated with obesity increased in absolute value but the standardized burden decreased slightly. Large variations existed in the high BMI-related asthma burdens among sexes, ages, and regions.(c) 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Cancer is the most important leading cause of death in the world and vascular events are the second-leading cause of death in cancer patients after cancer itself. Understanding related risk factors associated with vascular events may help clinicians develop appropriate treatment strategies. However, few large-scale population-based studies have investigated the risk factors for vascular events among cancer patients. The study involved a retrospective evaluation of medical records from the SEER database. Ten most common cancers in the past 20 years were extracted from the database. Cox proportional hazards model was used to analyze risk factors affecting vascular events that caused death among cancer patients. This study revealed that cancer patients had a serious risk of vascular events caused death, the 1-year, 3-year, 5-year and the overall rates of mortality from vascular events were 6.0%, 10.8%, 17.9% and 25.8%, respectively. The results showed that male, black race, elderly, AJCC stage II, stage III and stage IV, with no multiple primary cancers and no surgical treatment were associated with a significantly increased risk of vascular events caused death. We hope this research can alert clinicians and help them select high-risk cancer patients who may die from vascular events. And for those patients, we recommend that clinicians regularly monitor the patient's coagulation function and perform individualized thromboprophylaxis promptly to reduce the risk of death from vascular events. El cáncer es la causa más importante de muerte a nivel mundial, y los episodios vasculares son la segunda causa más importante de muerte en los pacientes de cáncer, tras la enfermedad en sí misma. Comprender los factores de riesgo relacionados con los episodios vasculares puede ayudar a los facultativos a desarrollar estrategias terapéuticas adecuadas. Sin embargo, son pocos los estudios a gran escala basados en población que investigan los factores de riesgo de los episodios vasculares entre los pacientes de cáncer. El estudio incluyó la evaluación retrospectiva de las historias médicas de la base de datos SEER, de donde se extrajeron los 10 tipos de cáncer más comunes en los últimos 20 años. Se utilizó el modelo de regresión de Cox para analizar los factores de riesgo que afectan a los episodios vasculares que causaron la muerte entre los pacientes de cáncer. Este estudio reveló que los pacientes de cáncer tenían un riesgo grave de muerte causada por episodios vasculares. Las tasas de mortalidad causada por episodios vasculares a 1, 3, 5 años y global, fueron del 6, 10,8, 17,9 y 25,8%, respectivamente. Los resultados reflejaron que los varones, de raza negra, mayores, con AJCC estadios II, III y IV, sin cánceres primarios múltiples y sin tratamiento quirúrgico estaban relacionados con el incremento del riesgo significativo de muertes causadas por episodios vasculares. Esperamos que esta investigación pueda alertar a los clínicos, y ayudarles a seleccionar a los pacientes de cáncer con alto riesgo de muerte causada por episodios vasculares. Y recomendamos también que los facultativos supervisen regularmente la función de coagulación de dichos pacientes, realizando tromboprofilaxis individualizada para reducir el riesgo de muertes causadas por episodios vasculares.

Background Metagenomic next-generation sequencing (mNGS) is a powerful method for pathogen detection. In this study, we assessed the value of mNGS for bronchoalveolar lavage (BAL) samples in the diagnosis of pulmonary infections. Methods From February 2018 to April 2019, BAL samples were collected from 235 patients with suspected pulmonary infections. mNGS and microbial culture were performed to evaluate the effectiveness of mNGS in pulmonary infection diagnosis. Results We employed mNGS to evaluate the alpha diversity, results suggesting that patients with confirmed pathogens had a lower microbial diversity index compared to that of patients with uncertain pathogens. For the patients admitted to the respiratory intensive care unit (RICU) or on a ventilator, they experienced a lower diversity index than that of the patients in the general ward or not on a ventilator. In addition, mNGS of BAL had a diagnostic sensitivity of 88.89% and a specificity of 14.86% in pulmonary infection, with 21.16% positive predictive value (PPV) and 83.87% negative predictive value (NPV). When rare pathogens were excluded, the sensitivity of mNGS decreased to 73.33%, and the specificity increased to 41.71%. For patients in the simple pulmonary infection group and the immunocompromised group, the main infection types were bacterial infection (58.33%) and mixed-infection (43.18%). Furthermore, mNGS had an advantage over culture in describing polymicrobial ecosystem, demonstrating the microbial distribution and the dominant strains of the respiratory tract in patients with different underlying diseases. Conclusions The study indicated that mNGS of BAL samples could provide more accurate diagnostic information in pulmonary infections and demonstrate the changes of respiratory microbiome in different underlying diseases. This method might play an important role in the clinical use of antimicrobial agents in the future.

OBJECTIVES:High-mobility group box-1 (HMGB1) and aberrant mitochondrial fission mediated by excessive activation of GTPase dynamin-related protein 1 (Drp1) have been found to be elevated in patients with pulmonary arterial hypertension (PAH) and critically implicated in PAH pathogenesis. However, it remains unknown whether Drp1-mediated mitochondrial fission and which downstream targets of mitochondrial fission mediate HMGB1-induced pulmonary arterial smooth muscle cells (PASMCs) proliferation and migration leading to vascular remodelling in PAH. This study aims to address these issues. METHODS:Primary cultured PASMCs were obtained from male Sprague-Dawley (SD) rats. We detected RNA levels by qRT-PCR, protein levels by Western blotting, cell proliferation by Cell Counting Kit-8 (CCK-8) and EdU incorporation assays, migration by wound healing and transwell assays. SD rats were injected with monocrotaline (MCT) to establish PAH. Hemodynamic parameters were measured by closed-chest right heart catheterization. RESULTS:HMGB1 increased Drp1 phosphorylation and Drp1-dependent mitochondrial fragmentation through extracellular signal-regulated kinases 1/2 (ERK1/2) signalling activation, and subsequently triggered autophagy activation, which further led to bone morphogenetic protein receptor 2 (BMPR2) lysosomal degradation and inhibitor of DNA binding 1 (Id1) downregulation, and eventually promoted PASMCs proliferation/migration. Inhibition of ERK1/2 cascade, knockdown of Drp1 or suppression of autophagy restored HMGB1-induced reductions of BMPR2 and Id1, and diminished HMGB1-induced PASMCs proliferation/migration. In addition, pharmacological inhibition of HMGB1 by glycyrrhizin, suppression of mitochondrial fission by Mdivi-1 or blockage of autophagy by chloroquine prevented PAH development in MCT-induced rats PAH model. CONCLUSIONS:HMGB1 promotes PASMCs proliferation/migration and pulmonary vascular remodelling by activating ERK1/2/Drp1/Autophagy/BMPR2/Id1 axis, suggesting that this cascade might be a potential novel target for management of PAH.

Galectin-3(Gal-3) is an effective regulator in the pathological process of pulmonary arterial hypertension (PAH). However, the detailed mechanisms underlying Gal-3 contribution to PAH are not yet entirely clear. The aim of the present study was to explore these issues. Proliferation of rat pulmonary arterial smooth muscle cells (PASMCs) was determined using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Small interfering RNA (siRNA) was applied to silence the expression of yes-associated protein (YAP) and Forkhead box M1 (FOXM1). The protein expression and phosphorylation were measured by immunoblotting. The subcellular location of YAP was determined using immunoblotting and immunofluorescence. Gal-3-stimulated PASMCs proliferation in a time- and dose-dependent manner, this was accompanied with, YAP upregulation, dephosphorylation, and nucleus translocation. Gal-3 further increased FOXM1 and cyclinD1 expression via YAP activation. Interfering YAP/FOXM1 axis suppressed Gal-3-induced PASMCs proliferation. Activation of AMPK also inhibited Gal-3-triggered cells proliferation by targeting YAP/FOXM1/cyclinD1 pathway. Gal-3 induced PASMCs proliferation by regulating YAP/FOXM1/cyclinD1 signaling cascade, and activation of AMPK targeted on this axis and suppressed Gal-3-stimulated PASMCs proliferation. Our study provides novel therapeutic targets for prevention and treatment of PAH.