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1.
Plant Physiol Biochem ; 212: 108754, 2024 May 20.
Article in English | MEDLINE | ID: mdl-38824693

ABSTRACT

Ginkgo biloba L. is a relict plant endemic to China that is commonly considered a "living fossil". It contains unique medicinal compounds that play important roles in its response to various stresses and help maintain human health. Ginkgo terpenoids are known to be important active ingredients but have received less attention than flavonoids. Hence, this review focuses on recent progress in research on the pharmacological effects of ginkgo terpenoid and the bioactivities of different terpenoid monomers. Many key structural genes, enzyme-encoding genes, transcription factors, and noncoding RNAs involved in the ginkgo terpenoid pathway were identified. Finally, many external factors (ecological factors, hormones, etc.) that regulate the biosynthesis and metabolism of terpenoids were proposed. All these findings improve the understanding of the biosynthesis, accumulation, and medicinal functions of terpenoids. Finally, this review includes an in-depth discussion regarding the limitations of terpenoid-related studies and potential future research directions.

2.
Article in English | MEDLINE | ID: mdl-38822780

ABSTRACT

The pretreatment of the Cu(In,Ga)Se2 (CIGS) absorption layer using an alkali element can effectively improve the photoelectric conversion efficiency (PCE) of CIGS solar cells. Here, we propose using NaF layer pretreatment below the CIGS absorption layer deposited by a three-stage process. Sodium ions in NaF can effectively suppress the diffusion of Ga elements and form a steep gradient backscatter layer on the back of the CIGS absorption layer, thereby passivating solar cell defects, inhibiting carrier recombination, promoting carrier transmission and collection, improving open circuit voltage (VOC), short circuit current (Jsc), and filling factor (FF), and further improving the PCE.

3.
ACS Nano ; 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38837180

ABSTRACT

While nanostructural engineering holds promise for improving the stability of high-capacity silicon (Si) anodes in lithium-ion batteries (LIBs), challenges like complex synthesis and the high cost of nano-Si impede its commercial application. In this study, we present a local reduction technique to synthesize micron-scale monolithic layered Si (10-20 µm) with a high tap density of 0.9-1.0 g cm-3 from cost-effective montmorillonite, a natural layered silicate mineral. The created mesoporous structure within each layer, combined with the void spaces between interlayers, effectively mitigates both lateral and vertical expansion throughout repeated lithiation/delithiation cycles. Furthermore, the remaining SiO2 network fortifies the layered structure, preventing it from collapsing during cycling. Half-cell tests reveal a capacity retention of 92% with a reversible capacity of 1130 mAh g-1 over 500 cycles. Moreover, the pouch cell integrated with this Si anode (with a mass loading of 3.0 mg cm-2) and a commercial NCM811 cathode delivers a high energy density of 655 Wh kg-1 (based on the total mass of the cathode and anode) and maintains 82% capacity after 200 cycles. This work demonstrates a cost-efficient and scalable strategy to manufacture high-performance micron Si anodes for the ever-growing demand for high-energy LIBs.

4.
J Neuroinflammation ; 21(1): 147, 2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38835057

ABSTRACT

BACKGROUND: The gut microbiota plays a critical role in regulating brain function through the microbiome-gut-brain axis (MGBA). Dysbiosis of the gut microbiota is associated with neurological impairment in Traumatic brain injury (TBI) patients. Our previous study found that TBI results in a decrease in the abundance of Prevotella copri (P. copri). P. copri has been shown to have antioxidant effects in various diseases. Meanwhile, guanosine (GUO) is a metabolite of intestinal microbiota that can alleviate oxidative stress after TBI by activating the PI3K/Akt pathway. In this study, we investigated the effect of P. copri transplantation on TBI and its relationship with GUO-PI3K/Akt pathway. METHODS: In this study, a controlled cortical impact (CCI) model was used to induce TBI in adult male C57BL/6J mice. Subsequently, P. copri was transplanted by intragastric gavage for 7 consecutive days. To investigate the effect of the GUO-PI3K/Akt pathway in P. copri transplantation therapy, guanosine (GUO) was administered 2 h after TBI for 7 consecutive days, and PI3K inhibitor (LY294002) was administered 30 min before TBI. Various techniques were used to assess the effects of these interventions, including quantitative PCR, neurological behavior tests, metabolite analysis, ELISA, Western blot analysis, immunofluorescence, Evans blue assays, transmission electron microscopy, FITC-dextran permeability assay, gastrointestinal transit assessment, and 16 S rDNA sequencing. RESULTS: P. copri abundance was significantly reduced after TBI. P. copri transplantation alleviated motor and cognitive deficits tested by the NSS, Morris's water maze and open field test. P. copri transplantation attenuated oxidative stress and blood-brain barrier damage and reduced neuronal apoptosis after TBI. In addition, P. copri transplantation resulted in the reshaping of the intestinal flora, improved gastrointestinal motility and intestinal permeability. Metabolomics and ELISA analysis revealed a significant increase in GUO levels in feces, serum and injured brain after P. copri transplantation. Furthermore, the expression of p-PI3K and p-Akt was found to be increased after P. copri transplantation and GUO treatment. Notably, PI3K inhibitor LY294002 treatment attenuated the observed improvements. CONCLUSIONS: We demonstrate for the first time that P. copri transplantation can improve GI functions and alter gut microbiota dysbiosis after TBI. Additionally, P. copri transplantation can ameliorate neurological deficits, possibly via the GUO-PI3K/Akt signaling pathway after TBI.


Subject(s)
Brain Injuries, Traumatic , Disease Models, Animal , Mice, Inbred C57BL , Animals , Mice , Male , Neurological Rehabilitation/methods , Prevotella , Gastrointestinal Microbiome/physiology , Phosphatidylinositol 3-Kinases/metabolism
5.
Clin Transl Oncol ; 2024 May 02.
Article in English | MEDLINE | ID: mdl-38698279

ABSTRACT

BACKGROUND: The Niemann-Pick disease type C1 (NPC1) protein plays a pivotal role in lipid transport, particularly free cholesterol, within lysosomal/late endosomal membranes. Previous studies have highlighted NPC1 as a promising target for cholesterol trafficking and cancer therapy. Nevertheless, the expression of NPC1 in gastric cancer (GC) and its clinical implications remain unexplored. This study aims to investigate NPC1 expression in GC and its correlation with patient prognosis. METHODS: NPC1 expression levels in GC and normal tissues were assessed using the GEPIA database, and survival analysis was conducted via Kaplan‒Meier Plotter. Evaluation of potential biological effects of NPC1 in GC by protein-protein interaction network and GO, KEGG bioenrichment analysis. Immunohistochemistry was performed on surgical samples collected from 306 GC patients. Correlations between NPC1 expression, clinical characteristics, and patient prognosis were analyzed. RESULTS: NPC1 mRNA expression was elevated in GC tissues compared to normal tissues (P < 0.05) and significantly associated with poorer prognosis. In our cohort of 306 patients, NPC1 exhibited significant upregulation in GC versus adjacent normal tissues (P = 0.031). High NPC1 expression correlated with adverse clinical characteristics, including lymph node metastasis, distant metastasis, and advanced TNM stage (all P < 0.05). Patients with high NPC1 expression experienced notably shorter overall survival (P < 0.001), particularly in stages III and IV (P = 0.003). Multivariate Cox regression analysis identified high NPC1 expression as an independent prognostic factor for GC patients (HR 1.57, 95% CI 1.14-2.18, P = 0.006). Lastly, an optimized nomogram incorporating NPC1, tumor size, and TNM stage was constructed. CONCLUSIONS: NPC1 expression is upregulated in GC and serves as a pivotal prognostic factor for adverse outcomes in GC patients.

6.
Cell Stem Cell ; 2024 May 10.
Article in English | MEDLINE | ID: mdl-38759653

ABSTRACT

ß0/ß0 thalassemia is the most severe type of transfusion-dependent ß-thalassemia (TDT) and is still a challenge facing lentiviral gene therapy. Here, we report the interim analysis of a single-center, single-arm pilot trial (NCT05015920) evaluating the safety and efficacy of a ß-globin expression-optimized and insulator-engineered lentivirus-modified cell product (BD211) in ß0/ß0 TDT. Two female children were enrolled, infused with BD211, and followed up for an average of 25.5 months. Engraftment of genetically modified hematopoietic stem and progenitor cells was successful and sustained in both patients. No unexpected safety issues occurred during conditioning or after infusion. Both patients achieved transfusion independence for over 22 months. The treatment extended the lifespan of red blood cells by over 42 days. Single-cell DNA/RNA-sequencing analysis of the dynamic changes of gene-modified cells, transgene expression, and oncogene activation showed no notable adverse effects. Optimized lentiviral gene therapy may safely and effectively treat all ß-thalassemia.

7.
Research (Wash D C) ; 7: 0366, 2024.
Article in English | MEDLINE | ID: mdl-38783913

ABSTRACT

Muscle strength (MS) is related to our neural and muscle systems, essential for clinical diagnosis and rehabilitation evaluation. Although emerging wearable technology seems promising for MS assessment, problems still exist, including inaccuracy, spatiotemporal differences, and analyzing methods. In this study, we propose a wearable device consisting of myoelectric and strain sensors, synchronously acquiring surface electromyography and mechanical signals at the same spot during muscle activities, and then employ a deep learning model based on temporal convolutional network (TCN) + Transformer (Tcnformer), achieving accurate grading and prediction of MS. Moreover, by combining with deep clustering, named Tcnformer deep cluster (TDC), we further obtain a 25-level classification for MS assessment, refining the conventional 5 levels. Quantification and validation showcase a patient's postoperative recovery from level 3.2 to level 3.6 in the first few days after surgery. We anticipate that this system will importantly advance precise MS assessment, potentially improving relevant clinical diagnosis and rehabilitation outcomes.

8.
Cancer Cell ; 2024 May 23.
Article in English | MEDLINE | ID: mdl-38788718

ABSTRACT

Neuroendocrine carcinomas (NECs) are extremely lethal malignancies that can arise at almost any anatomic site. Characterization of NECs is hindered by their rarity and significant inter- and intra-tissue heterogeneity. Herein, through an integrative analysis of over 1,000 NECs originating from 31 various tissues, we reveal their tissue-independent convergence and further unveil molecular divergence driven by distinct transcriptional regulators. Pan-tissue NECs are therefore categorized into five intrinsic subtypes defined by ASCL1, NEUROD1, HNF4A, POU2F3, and YAP1. A comprehensive portrait of these subtypes is depicted, highlighting subtype-specific transcriptional programs, genomic alterations, evolution trajectories, therapeutic vulnerabilities, and clinicopathological presentations. Notably, the newly discovered HNF4A-dominated subtype-H exhibits a gastrointestinal-like signature, wild-type RB1, unique neuroendocrine differentiation, poor chemotherapeutic response, and prevalent large-cell morphology. The proposal of uniform classification paradigm illuminates transcriptional basis of NEC heterogeneity and bridges the gap across different lineages and cytomorphological variants, in which context-dependent prevalence of subtypes underlies their phenotypic disparities.

9.
Focus (Am Psychiatr Publ) ; 22(1): 109-119, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38694155

ABSTRACT

Polycystic ovary syndrome (PCOS) is one of the most prevalent gynecological endocrine conditions affecting reproductive women. It can feature a variety of symptoms, such as obesity, insulin resistance, skin conditions, and infertility. Women with PCOS are susceptible to illnesses including mood disorders, diabetes, hypertension, and dyslipidemia. Among them, depression is the most common in PCOS and has a detrimental effect on quality of life. Depression may occasionally develop due to the pathological traits of PCOS, but its exact pathogenesis in PCOS have eluded researchers to date. Therefore, there is an urgent need to explore the pathogenesis and treatments of depression in PCOS. The present review discusses the epidemiology of depression in PCOS, potential pathogenic mechanisms underlying PCOS and depression, as well as some potential factors causing depression in PCOS, including obesity, insulin resistance, hyperandrogenism, inflammation, and infertility. Meanwhile, some common treatment strategies for depression in PCOS, such as lifestyle intervention, acupuncture, oral contraceptive pills, psychological intervention, and insulin-sensitizer, are also reviewed. To fully understand the pathogenesis and treatment of depression in PCOS, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies. Appeared originally in Front Psychiatry 2022; 13:1001484.

10.
Cureus ; 16(4): e57635, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38707004

ABSTRACT

Maxillofacial soft tissue swelling is a common clinical symptom with various etiologies. While odontogenic space infection is the most common cause, it is crucial not to overlook maxillofacial swellings caused by specific pathogenic infections and other local factors. This paper reports the case of an adult patient with right-sided swelling of his face, persistent oral mucosal ulcers, and recurrent hyperthermia for 30 days. He had received various antibiotics for the initial diagnosis of "right buccal space infection," but the antibiotics did not have any effect on his symptoms. None of the blood tests, histological examinations, bone marrow biopsies, and immune-related tests produced diagnostic findings. A diagnosis of Epstein-Barr virus (EBV) infection was finally confirmed by biopsy tissue genomics sequencing and quantitative analysis of EBV nucleic acid. In this report, we describe the diagnosis and treatment process for this patient and suggest that facial swelling could be an important clinical symptom of EBV infection.

11.
Front Plant Sci ; 15: 1394285, 2024.
Article in English | MEDLINE | ID: mdl-38736451

ABSTRACT

Introduction: Drip irrigation under mulch film promotes a non-uniform salinity distribution in salt fields. The effect of different N application methods on the growth and yield of cotton under drip irrigation under mulch film conditions in eastern coastal saline-alkaline soils in China remain remained unclear. Methods: A randomized complete block design was used in the experiment. Three N application methods were assigned: N applied under mulch film (low-salinity area; UM), N applied between mulch films (high-salinity area; BM), and half N applied under mulch film and half between mulch films (HUHB). Results: Plant height, photosynthesis, Chl content, boll load, biomass, boll weight and boll density under UM were all significantly higher than those under the other two treatments. The N absorption of UM was higher than in the other two treatments, which might be attributed to the expression of GHNRT1.5 and GHNRT2.1. The net NO3- influx in the roots in UM increased significantly compared with that in BM. The yield and FNRE of UM were 3.9% and 9.1%, respectively, and were 26.52% and 90.36% higher than under HUHB and BM treatments. Discussion: UM not only improved cotton yield but also alleviated the pollution of N residue on drip irrigation under mulch film conditions in salt areas.

12.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 38(5): 626-632, 2024 May 15.
Article in Chinese | MEDLINE | ID: mdl-38752252

ABSTRACT

Objective: To summarize the dynamic and synchronized changes between the hair cycle and dermal adipose tissue as well as the impact of dermal adipose tissue on hair growth, and to provide a new research idea for the clinical treatment of hair loss. Methods: An extensive review of relevant literature both domestic and international was conducted, analyzing and summarizing the impact of dermal adipose precursor cells, mature dermal adipocytes, and the processes of adipogenesis in dermal adipose tissue on the transition of hair cycle phases. Results: Dermal adipose tissue is anatomically adjacent to hair follicles and closely related to the changes in the hair cycle. The proliferation and differentiation of dermal adipose precursor cells promote the transition of hair cycle from telogen to anagen, while mature adipocytes can accelerate the transition from anagen to catagen of the hair cycle by expressing signaling molecules, with adipogenesis in dermal adipose tissue and hair cycle transition signaling coexistence. Conclusion: Dermal adipose tissue affects the transition of the hair cycle and regulates hair growth by secreting various signaling molecules. However, the quantity and depth of existing literature are far from sufficient to fully elucidate its prominent role in regulating the hair cycle, and the specific regulatory mechanisms needs to be further studied.


Subject(s)
Adipocytes , Adipogenesis , Adipose Tissue , Cell Differentiation , Hair Follicle , Hair , Humans , Adipose Tissue/metabolism , Adipose Tissue/cytology , Hair Follicle/metabolism , Adipocytes/cytology , Adipocytes/metabolism , Hair/growth & development , Hair/metabolism , Signal Transduction , Dermis/metabolism , Dermis/cytology , Animals , Cell Proliferation , Alopecia/metabolism
13.
Invest Ophthalmol Vis Sci ; 65(5): 22, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38743414

ABSTRACT

Purpose: To describe the clinical, electrophysiological and genetic spectrum of inherited retinal diseases associated with variants in the PRPH2 gene. Methods: A total of 241 patients from 168 families across 15 sites in 9 countries with pathogenic or likely pathogenic variants in PRPH2 were included. Records were reviewed for age at symptom onset, visual acuity, full-field ERG, fundus colour photography, fundus autofluorescence (FAF), and SD-OCT. Images were graded into six phenotypes. Statistical analyses were performed to determine genotype-phenotype correlations. Results: The median age at symptom onset was 40 years (range, 4-78 years). FAF phenotypes included normal (5%), butterfly pattern dystrophy, or vitelliform macular dystrophy (11%), central areolar choroidal dystrophy (28%), pseudo-Stargardt pattern dystrophy (41%), and retinitis pigmentosa (25%). Symptom onset was earlier in retinitis pigmentosa as compared with pseudo-Stargardt pattern dystrophy (34 vs 44 years; P = 0.004). The median visual acuity was 0.18 logMAR (interquartile range, 0-0.54 logMAR) and 0.18 logMAR (interquartile range 0-0.42 logMAR) in the right and left eyes, respectively. ERG showed a significantly reduced amplitude across all components (P < 0.001) and a peak time delay in the light-adapted 30-Hz flicker and single-flash b-wave (P < 0.001). Twenty-two variants were novel. The central areolar choroidal dystrophy phenotype was associated with 13 missense variants. The remaining variants showed marked phenotypic variability. Conclusions: We described six distinct FAF phenotypes associated with variants in the PRPH2 gene. One FAF phenotype may have multiple ERG phenotypes, demonstrating a discordance between structure and function. Given the vast spectrum of PRPH2 disease our findings are useful for future clinical trials.


Subject(s)
Electroretinography , Peripherins , Phenotype , Retinal Dystrophies , Visual Acuity , Humans , Peripherins/genetics , Middle Aged , Adult , Male , Female , Adolescent , Retinal Dystrophies/genetics , Retinal Dystrophies/physiopathology , Retinal Dystrophies/diagnosis , Aged , Visual Acuity/physiology , Child , Young Adult , Child, Preschool , Tomography, Optical Coherence , Mutation , Fluorescein Angiography , Genetic Association Studies , Retrospective Studies , DNA Mutational Analysis , DNA/genetics , Pedigree
14.
Microsyst Nanoeng ; 10: 68, 2024.
Article in English | MEDLINE | ID: mdl-38799404

ABSTRACT

Triboelectric nanogenerators (TENGs) have emerged as a promising approach for generating electricity and providing electrical stimuli in medical electronic devices. Despite their potential benefits, the clinical implementation of TENGs faces challenges such as skin compliance and a lack of comprehensive assessment regarding their biosafety and efficacy. Therefore, further research is imperative to overcome these limitations and unlock the full potential of TENGs in various biomedical applications. In this study, we present a flexible silk fibroin-based triboelectric nanogenerator (SFB-TENG) that features an on-skin substrate and is characterized by excellent skin compliance and air/water permeability. The range of electrical output generated by the SFB-TENG was shown to facilitate the migration and proliferation of Hy926, NIH-3T3 and RSC96 cells. However, apoptosis of fibroblast NIH-3T3 cells was observed when the output voltage increased to more than 20 V at a frequency of 2 Hz. In addition, the moderate electrical stimulation provided by the SFB-TENG promoted the cell proliferation cycle in Hy926 cells. This research highlights the efficacy of a TENG system featuring a flexible and skin-friendly design, as well as its safe operating conditions for use in biomedical applications. These findings position TENGs as highly promising candidates for practical applications in the field of tissue regeneration.

15.
Chem Commun (Camb) ; 60(44): 5747-5750, 2024 May 28.
Article in English | MEDLINE | ID: mdl-38747111

ABSTRACT

CoO/Fe3O4 nanosheets exhibit a superior rechargeable zinc-air battery (ZAB) performance of 276 mW cm-2 and stability over 600 h. The all-solid-state ZAB also affords a high power density of 107 mW cm-2.

16.
Article in English | MEDLINE | ID: mdl-38810990

ABSTRACT

A bottom-contact organic field-effect transistor (OFET) is easily adaptable to the standard lithography process because the contact electrodes are deposited before the organic semiconductor (OSC). However, the low surface energy of bare electrodes limits utilizing solution-processed single-crystal OSCs. Additionally, the bare electrode usually leads to a significant charge injection barrier, owing to its relatively low work function (WF). Here, we simultaneously improved the surface energy and WF of gold electrodes by conducting oxygen plasma treatment to achieve high-performance OFET based on solution-processed organic single crystals. We cultivated a thin layer of gold oxide on Au electrodes to increase the WF by ∼0.7 eV. The surface energy of Au electrodes was enhanced to the same as AlOx dielectric surface, enabling the seamless growth of large-area C8-BTBT (2,7-dioctyl[1]benzothieno[3,2-b][1]benzothiophene) organic single-crystal thin films via solution shearing. This technique facilitates the production of high-performance OFETs with the highest carrier mobility of 6.7 cm2 V-1 s-1 and sharp switching characterized by a subthreshold swing of 63.6 mV dec-1. The bottom-contact OFETs exhibited a lower contact resistance of 1.19 kΩ cm than its F4-TCNQ-doped top-contact control device. This method offers a straightforward and effective strategy for producing high-quality single-crystal OFETs, which are potentially suitable for commercial applications.

17.
Phytochemistry ; : 114165, 2024 May 28.
Article in English | MEDLINE | ID: mdl-38815884

ABSTRACT

Ten C-geranylated flavonoids, along with three known analogues, were isolated from the leaves of Artocarpus communis. The chemical structures of these compounds were unambiguously determined via comprehensive spectroscopic analysis, single-crystal X-ray diffraction experiments, and quantum chemical electronic circular dichroism calculations. Structurally, artocarones A-I (1-9) represent a group of unusual, highly modified C-geranylated flavonoids, in which the geranyl chain is cyclised with the ortho-hydroxy group of flavonoids to form various heterocyclic scaffolds. Notably, artocarones E and G-I (5 and 7-9) feature a 6H-benzo[c]chromene core that is hitherto undescribed in C-geranylated flavonoids. Artocarone J (10) is the first example of C-9-C-16 connected C-geranylated aurone. Meanwhile, the plausible biosynthetic pathways for these rare C-geranylated flavonoids were also proposed. Notably, compounds 1, 2, 4, 8, 11, and 12 exhibited promising in vitro inhibitory activities against respiratory syncytial virus and herpes simplex virus type 1.

18.
Front Optoelectron ; 17(1): 15, 2024 May 31.
Article in English | MEDLINE | ID: mdl-38819471

ABSTRACT

Chiral inorganic semiconductors with high dissymmetric factor are highly desirable, but it is generally difficult to induce chiral structure in inorganic semiconductors because of their structure rigidity and symmetry. In this study, we introduced chiral ZnO film as hard template to transfer chirality to CsPbBr3 film and PbS quantum dots (QDs) for circularly polarized light (CPL) emission and detection, respectively. The prepared CsPbBr3/ZnO thin film exhibited CPL emission at 520 nm and the PbS QDs/ZnO film realized CPL detection at 780 nm, featuring high dissymmetric factor up to around 0.4. The electron transition based mechanism is responsible for chirality transfer.

19.
Sci Adv ; 10(19): eadn6642, 2024 May 10.
Article in English | MEDLINE | ID: mdl-38718123

ABSTRACT

Existing grippers for unmanned aerial vehicle (UAV) manipulation have persistent challenges, highlighting a need for grippers that are soft, self-adaptive, self-contained, easy to control, and lightweight. Inspired by tendril plants, we propose a class of soft grippers that are voltage driven and based on winding deformation for self-adaptive grasping. We design two types of U-shaped soft eccentric circular tube actuators (UCTAs) and propose using the liquid-gas phase-transition mechanism to actuate UCTAs. Two types of UCTAs are separately cross-arranged to construct two types of soft grippers, forming self-contained systems that can be directly driven by voltage. One gripper inspired by tendril climbers can be used for delicate grasping, and the other gripper inspired by hook climbers can be used for strong grasping. These grippers are ideal for deployment in UAVs because of their self-adaptability, ease of control, and light weight, paving the way for UAVs to achieve powerful manipulation with low positioning accuracy, no complex grasping planning, self-adaptability, and multiple environments.

20.
J Transl Med ; 22(1): 438, 2024 May 08.
Article in English | MEDLINE | ID: mdl-38720336

ABSTRACT

BACKGROUND: Advanced unresectable gastric cancer (GC) patients were previously treated with chemotherapy alone as the first-line therapy. However, with the Food and Drug Administration's (FDA) 2022 approval of programmed cell death protein 1 (PD-1) inhibitor combined with chemotherapy as the first-li ne treatment for advanced unresectable GC, patients have significantly benefited. However, the significant costs and potential adverse effects necessitate precise patient selection. In recent years, the advent of deep learning (DL) has revolutionized the medical field, particularly in predicting tumor treatment responses. Our study utilizes DL to analyze pathological images, aiming to predict first-line PD-1 combined chemotherapy response for advanced-stage GC. METHODS: In this multicenter retrospective analysis, Hematoxylin and Eosin (H&E)-stained slides were collected from advanced GC patients across four medical centers. Treatment response was evaluated according to iRECIST 1.1 criteria after a comprehensive first-line PD-1 immunotherapy combined with chemotherapy. Three DL models were employed in an ensemble approach to create the immune checkpoint inhibitors Response Score (ICIsRS) as a novel histopathological biomarker derived from Whole Slide Images (WSIs). RESULTS: Analyzing 148,181 patches from 313 WSIs of 264 advanced GC patients, the ensemble model exhibited superior predictive accuracy, leading to the creation of ICIsNet. The model demonstrated robust performance across four testing datasets, achieving AUC values of 0.92, 0.95, 0.96, and 1 respectively. The boxplot, constructed from the ICIsRS, reveals statistically significant disparities between the well response and poor response (all p-values < = 0.001). CONCLUSION: ICIsRS, a DL-derived biomarker from WSIs, effectively predicts advanced GC patients' responses to PD-1 combined chemotherapy, offering a novel approach for personalized treatment planning and allowing for more individualized and potentially effective treatment strategies based on a patient's unique response situations.


Subject(s)
Deep Learning , Immune Checkpoint Inhibitors , Programmed Cell Death 1 Receptor , Stomach Neoplasms , Humans , Stomach Neoplasms/drug therapy , Stomach Neoplasms/pathology , Male , Female , Treatment Outcome , Middle Aged , Immune Checkpoint Inhibitors/therapeutic use , Programmed Cell Death 1 Receptor/antagonists & inhibitors , Aged , Retrospective Studies , ROC Curve , Adult
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