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Dual Inhibition of HIF-1α and HIF-2α as a Promising Treatment for VHL-Associated Hemangioblastomas: A Pilot Study Using Patient-Derived Primary Cell Cultures
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The Effect of Fungal Nutraceutical Supplementation on Postoperative Complications, Inflammatory Factors and Fecal Microbiota in Patients Undergoing Colorectal Cancer Surgery with Curative Intent
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Evaluation of the Effects of the Quaternary Ammonium Silane K21 on Zebrafish Viability, Toxicity, Growth, and Development
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Integrative Approaches in the Management of Hypertrophic Cardiomyopathy: A Comprehensive Review of Current Therapeutic Modalities
Journal Description
Biomedicines
Biomedicines
is an international, peer-reviewed, open access journal on biomedicines published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q1 (Pharmacology and Pharmacy) / CiteScore - Q1 (Medicine (miscellaneous))
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 17 days after submission; acceptance to publication is undertaken in 2.9 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for Biomedicines include: IJTM, BioMed, Anesthesia Research and Emergency Care and Medicine.
Impact Factor:
3.9 (2024);
5-Year Impact Factor:
4.2 (2024)
Latest Articles
CX3CR1–TLR4 Axis as a Shared Neuroimmune Target in COVID-19 and Epilepsy: Integrative Transcriptomics and Gabapentin Repositioning
Biomedicines 2025, 13(9), 2133; https://doi.org/10.3390/biomedicines13092133 (registering DOI) - 31 Aug 2025
Abstract
Introduction: Neuroinflammation is a common pathological hallmark of Coronavirus Disease 2019 (COVID-19) and epilepsy; however, their shared immunogenomic mechanisms remain poorly defined. This study explores shared immune-inflammatory transcriptomic signatures and identifies potential repositioning therapeutics. Methods: We integrated single-cell RNA-seq data from peripheral blood
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Introduction: Neuroinflammation is a common pathological hallmark of Coronavirus Disease 2019 (COVID-19) and epilepsy; however, their shared immunogenomic mechanisms remain poorly defined. This study explores shared immune-inflammatory transcriptomic signatures and identifies potential repositioning therapeutics. Methods: We integrated single-cell RNA-seq data from peripheral blood mononuclear cells (PBMCs) of COVID-19 patients and healthy donors (GSE149689), and bulk RNA-seq data from hippocampal tissue of patients with Temporal Lobe Epilepsy with Hippocampal Sclerosis (TLE-HS) and healthy controls (GSE256068). Common Differentially Expressed Genes (DEGs) were identified and subjected to GO/KEGG enrichment, a PPI network, hub gene detection (cytoHubba), and transcriptional regulation analysis (ENCODE-based TF/miRNA networks). Drug repositioning was performed using the LINCS L1000 database. Results: We identified 25 DEGs shared across datasets, including 22 upregulated genes enriched in cytokine–cytokine receptor interaction, NF-κB, and Toll-like receptor pathways. PPI analysis revealed a CX3CR1–TLR4-centered immune module. Gabapentin emerged as a promising repositioning candidate with potential to downregulate CX3CR1, TLR4, and selectin P ligand (SELPLG). Receiver Operating Characteristic (ROC) analysis confirmed the diagnostic value of these targets (AUC > 0.90 in epilepsy). A mechanistic model was proposed to illustrate Gabapentin’s dual action on microglial polarization and cytokine suppression. Conclusions: Our results reveal a shared CX3CR1–TLR4–NF-κB inflammatory axis in COVID-19 and epilepsy, supporting Gabapentin as a potential dual-action immunomodulator. These findings reveal a previously underappreciated immunomodulatory role for Gabapentin, providing mechanistic rationale for its repositioning in neuroinflammatory conditions beyond seizure control.
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(This article belongs to the Section Neurobiology and Clinical Neuroscience)
Open AccessArticle
Identification of Key Biomarkers Related to Lipid Metabolism in Acute Pancreatitis and Their Regulatory Mechanisms Based on Bioinformatics and Machine Learning
by
Liang Zhang, Yujie Jiang, Taojun Jin, Mingxian Zheng, Yixuan Yap, Xuanyang Min, Jiayue Chen, Lin Yuan, Feng He and Bingduo Zhou
Biomedicines 2025, 13(9), 2132; https://doi.org/10.3390/biomedicines13092132 (registering DOI) - 31 Aug 2025
Abstract
Background: Acute pancreatitis (AP) is characterized by the abnormal activation of pancreatic enzymes due to various causes, leading to local pancreatic inflammation. This can trigger systemic inflammatory response syndrome and multi-organ dysfunction. Hyperlipidemia, mainly resulting from lipid metabolism disorders and elevated triglyceride levels,
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Background: Acute pancreatitis (AP) is characterized by the abnormal activation of pancreatic enzymes due to various causes, leading to local pancreatic inflammation. This can trigger systemic inflammatory response syndrome and multi-organ dysfunction. Hyperlipidemia, mainly resulting from lipid metabolism disorders and elevated triglyceride levels, is a major etiological factor in AP. This study aims to investigate the role of lipid metabolism-related genes in the pathogenesis of AP and to propose novel strategies for its prevention and treatment. Methods: We obtained AP-related datasets GSE3644, GSE65146, and GSE121038 from the GEO database. Differentially expressed genes (DEGs) were identified using DEG analysis and gene set enrichment analysis (GSEA). To identify core lipid metabolism genes in AP, we performed least absolute shrinkage and selection operator (LASSO) regression and support vector machine recursive feature elimination (SVM-RFE) analysis. Gene and protein interactions were predicted using GeneMANIA and AlphaFold. Finally, biomarker expression levels were quantified using Real-Time quantitative Polymerase Chain Reaction (RT-qPCR) in an AP mouse model. Results: Seven lipid metabolism-related genes were identified as key biomarkers in AP: Amacr, Cyp39a1, Echs1, Gpd2, Osbpl9, Acsl4, and Mcee. The biological roles of these genes mainly involve fatty acid metabolism, cholesterol metabolism, lipid transport across cellular membranes, and mitochondrial function. Conclusions: Amacr, Cyp39a1, Echs1, Gpd2, Osbpl9, Acsl4, and Mcee are characteristic biomarkers of lipid metabolism abnormalities in AP. These findings are crucial for a deeper understanding of lipid metabolism pathways in AP and for the early implementation of preventive clinical measures, such as the control of blood lipid levels.
Full article
(This article belongs to the Section Cancer Biology and Oncology)
Open AccessArticle
Chemerin Is the Adipokine Linked with Endothelin-Dependent Vasoconstriction in Human Obesity
by
Francesca Schinzari, Rossella Montenero, Carmine Cardillo and Manfredi Tesauro
Biomedicines 2025, 13(9), 2131; https://doi.org/10.3390/biomedicines13092131 (registering DOI) - 31 Aug 2025
Abstract
Background/Objectives: The remodeling of adipose tissue occurring in obesity is associated with dysregulated production of various adipokines with vasoactive properties. Among the local mediators physiologically involved in vascular homeostasis, the endothelin (ET-1) system is upregulated in obesity, leading to vasoconstriction and vascular damage.
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Background/Objectives: The remodeling of adipose tissue occurring in obesity is associated with dysregulated production of various adipokines with vasoactive properties. Among the local mediators physiologically involved in vascular homeostasis, the endothelin (ET-1) system is upregulated in obesity, leading to vasoconstriction and vascular damage. We hypothesized that in human obesity, a link might exist between changed circulating levels of vasoactive adipokines and ET-1-dependent vasoconstriction; Methods: We compared plasma concentrations of selected adipokines (Luminex assay) and the vasoactive response to blockade of endothelin type A receptors (ETA) by BQ-123 (strain-gauge plethysmography) in lean and obese individuals; Results: Plasma levels of adipokines with deleterious vascular actions, such as chemerin, visfatin, adipsin, and leptin, were higher in obese than in lean subjects (all p < 0.05). In contrast, circulating adiponectin, an adipokine with vasoprotective properties, showed no difference between groups (p > 0.05). The blood flow response to BQ-123 was greater in obese subjects than in lean subjects (p < 0.001), indicating an obesity-associated enhancement in ET-1-mediated vasoconstriction. In the entire population, circulating chemerin showed a direct correlation with the vasodilator response to BQ-123 (r = 0.30; p = 0.01). In contrast, no significant correlation was observed between concentrations of other adipokines and the response to BQ-123 (all p > 0.05). Conclusions: In human obesity, a direct link exists between increased circulating chemerin and augmented ET-1-mediated vasoconstriction. This observation contributes to explaining the detrimental vascular actions of chemerin and supports the view that targeting this adipokine might help prevent obesity-related vasculopathy.
Full article
(This article belongs to the Section Endocrinology and Metabolism Research)
Open AccessArticle
Comparative Preclinical Analysis of Anti-B7-H3 CAR-T Cells Targeting Neuroblastoma
by
Dzmitry V. Lutskovich, Alexander N. Meleshko, Valeria M. Stepanova, Dmitri O. Dormeshkin and Yury P. Rubtsov
Biomedicines 2025, 13(9), 2130; https://doi.org/10.3390/biomedicines13092130 (registering DOI) - 31 Aug 2025
Abstract
Background: Neuroblastoma is a childhood tumor that is usually fatal after relapse in high-risk patients. Most clinical trials of CAR-T therapy for neuroblastoma are based on targeting the disialoganglioside GD2. B7-H3, a protein from the immunoglobulin superfamily, is a specific marker for
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Background: Neuroblastoma is a childhood tumor that is usually fatal after relapse in high-risk patients. Most clinical trials of CAR-T therapy for neuroblastoma are based on targeting the disialoganglioside GD2. B7-H3, a protein from the immunoglobulin superfamily, is a specific marker for neuroblastoma and a number of other solid tumors. We conducted a preclinical study of three variants of anti-B7-H3 CAR-T cells in order to justify the selection of the best candidate for subsequent clinical trials. Methods: The expression level of B7-H3 was measured in a number of cell lines and neuroblastoma tissue samples via flow cytometry. The functional activity of CAR-T cells was compared using an NFAT-inducible reporter assay, a cytotoxicity test, cytokine production, and a repeated stimulation assay. Results: The obtained CAR-T cells carrying all resulting CAR variants specifically recognized and killed B7-H3-positive tumor cells in vitro. Nevertheless, TE9-28z and 8H9-28BBz demonstrated superior activation and cytokine production compared to the second-generation 8H9-BBz construct. TE9-28z and 8H9-28BBz exhibited functional differences in expansion, exhaustion markers, and cytokine secretion in co-cultures with target cells in vitro. In particular, TE9-28z induced higher IFNγ production, while 8H9-28BBz showed increased TNFα release. Despite comparable cytotoxicity, TE9-28z and 8H9-28BBz CAR-T cells exhibited varying persistence depending on the tumor type, and showed signs of functional exhaustion upon prolonged exposure to the target antigen. Conclusion: TE9-28z and 8H9-28BBz were selected for further preclinical development as promising candidates for the effective targeting of B7-H3-expressing malignancies.
Full article
(This article belongs to the Section Gene and Cell Therapy)
Open AccessArticle
Impacts of PACAP 1-38 and BGP-15 on the Healing of Fasciocutaneous Groin Flaps Affected by Ischemia–Reperfusion in Rats
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Anna Orsolya Flasko, Laszlo Adam Fazekas, Gergo Kincses, Adam Varga, Adam Attila Matrai, Ildiko Czirjak, Noemi Dodity, Ildiko Katalin Bacskay, Agota Peto, Dora Reglodi, Csaba Filler, Tamas Juhasz and Norbert Nemeth
Biomedicines 2025, 13(9), 2129; https://doi.org/10.3390/biomedicines13092129 (registering DOI) - 31 Aug 2025
Abstract
Background/Objectives: To prevent flap failure, adequate tissue perfusion and effective regenerative processes, undisturbed wound healing are essential, among others. To improve wound healing, various locally and systematically administered pharmacons can be used. This study investigated the effect of PACAP 1-38 (pituitary adenylate
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Background/Objectives: To prevent flap failure, adequate tissue perfusion and effective regenerative processes, undisturbed wound healing are essential, among others. To improve wound healing, various locally and systematically administered pharmacons can be used. This study investigated the effect of PACAP 1-38 (pituitary adenylate cyclase activating polypeptide) and BGP-15 (a nicotinic amidoxime derivative) on the healing of epigastric fasciocutaneous flaps exposed to ischemia–reperfusion (I/R). Methods: Wistar rats were randomly divided into control (no substance), PACAP 1-38, and BGP-15 groups. Groin flaps were prepared bilaterally. The left flap was exposed to 120 min of ischemia prior to suturing it back. We applied wound gels containing substances. Laboratory tests (hematology, erythrocyte deformability, and aggregation) were performed before surgery on the 1st, 3rd, and 7th postoperative days. Lastly, flap skin samples were taken for histological and tensile strength measurements. Results: Impaired erythrocyte deformability and enhanced aggregation were found because of flap I/R. The pharmacons were able to reduce the systemic micro-rheological impairment to varying degrees. The tensile strength increased in the areas of better perfusion. Conclusions: The anti-inflammatory effects of PACAP 1-38 and BPG-15, as well as the impact of PACAP 1-38 on collagen and elastic fiber composition, have been demonstrated.
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(This article belongs to the Section Cell Biology and Pathology)
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Open AccessArticle
Clinical Manifestations and Cytokine Profiles of the Th1, Th2, and Th17 Response Associated with SARS-CoV-2 Omicron Subvariants
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Matheus Amorim Barreto, Amanda Mendes Silva Cruz, Delana Melo Volle, Wanderley Dias das Chagas Júnior, Iran Barros Costa, Juliana Abreu Lima Nunes, Aline Collares Pinheiro de Sousa, Izabel Keller Moreira Lima, Patrícia Yuri Nogami, Iami Raiol Borges, Luany Rafaele da Conceição Cruz, Paula Fabiane da Rocha Nobre, Edvaldo Tavares da Penha Junior, Jones Anderson Monteiro Siqueira, Victória Figueiredo Brito do Carmo, Darleise de Souza Oliveira, Hugo Reis Resque, Marcos Rogério Menezes da Costa, Rita Catarina Medeiros Sousa, Mirleide Cordeiro dos Santos, Maria Izabel de Jesus, Luana Soares Bargelata, Luciana Damascena da Silva and Igor Brasil-Costaadd
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Biomedicines 2025, 13(9), 2128; https://doi.org/10.3390/biomedicines13092128 (registering DOI) - 31 Aug 2025
Abstract
Background: The SARS-CoV-2 Omicron variant became the dominant driver during the COVID-19 pandemic due to its high transmissibility and immune escape potential. Although clinical outcomes are generally mild to moderate, the inflammatory mechanisms triggered by Omicron subvariants remain poorly defined. The goal of
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Background: The SARS-CoV-2 Omicron variant became the dominant driver during the COVID-19 pandemic due to its high transmissibility and immune escape potential. Although clinical outcomes are generally mild to moderate, the inflammatory mechanisms triggered by Omicron subvariants remain poorly defined. The goal of this study was to consider both viral evolution and the host immune response by assessing plasma cytokine levels in patients infected with SARS-CoV-2 Omicron subvariants. Methods: A total of 115 individuals were recruited, including 40 with laboratory-confirmed SARS-CoV-2 infection by RT-qPCR. Demographic, clinical, and comorbidity data were collected. Plasma levels of IL-6, TNF, IFN-γ, IL-4, IL-2, IL-10, and IL-17A were quantified using Cytometric Bead Array. Subvariant data were obtained from GISAID records and grouped into early (BA.1-lineage) and late (BA.4/BA.5-lineage) Omicron clusters. Statistical analysis included non-parametric and parametric tests, correlation matrices, and multivariate comparisons. Results: Pharyngitis, nasal discharge, cough, and headache were the most common symptoms among infected individuals. Despite no significant variation in symptom distribution across subvariants, infected patients showed higher levels of IFN-γ, TNF, IL-10, IL-4, and IL-2 compared to non-SARS-CoV-2 infected controls (p < 0.05). IL-4 and IL-10 levels were significantly higher in early Omicron infections. No associations were observed between cytokine levels and comorbidities. A significant correlation was found between reporting fewer symptoms and having received three vaccine doses. Conclusions: Infection with Omicron subvariants elicits a strong yet balanced cytokine response. Despite genetic divergence between lineages, immune and clinical patterns remain conserved, with vaccination appearing to mitigate the symptom burden.
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(This article belongs to the Section Immunology and Immunotherapy)
Open AccessArticle
Atherogenic Index of Plasma Predicts Futile Reperfusion and Early Deterioration After Successful Recanalization: A Multicenter Study of EVT-Treated LAA Stroke
by
Jong-Hee Sohn, Yong-Ho In, Chulho Kim, Joo Hye Sung, Minwoo Lee, Yerim Kim, Jae Jun Lee and Sang-Hwa Lee
Biomedicines 2025, 13(9), 2127; https://doi.org/10.3390/biomedicines13092127 (registering DOI) - 31 Aug 2025
Abstract
Background: Futile reperfusion (FR), which is defined as successful revascularization without a favorable functional outcome, is a major limitation of endovascular treatment (EVT) for acute ischemic stroke. Although clinical and imaging predictors of FR have been studied, the role of systemic metabolic markers,
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Background: Futile reperfusion (FR), which is defined as successful revascularization without a favorable functional outcome, is a major limitation of endovascular treatment (EVT) for acute ischemic stroke. Although clinical and imaging predictors of FR have been studied, the role of systemic metabolic markers, such as the atherogenic index of plasma (AIP), remains unclear. No prior studies have examined the use of AIP in patients with large artery atherosclerosis (LAA)-related stroke. Methods: We analyzed data from four university-affiliated, prospectively maintained registries in the Republic of Korea (2015–2024). We included patients with anterior-circulation LVO who underwent EVT and achieved successful reperfusion. AIP was calculated as log(triglyceride/HDL-C) in mmol/L. The primary outcome was FR, defined as modified Rankin Scale (mRS) 3–6 at 3 months. The secondary outcome was early neurological deterioration (END). Multivariable logistic regression and ROC analysis were used. Results: Among the 406 LAA patients, 227 (55.9%) experienced FR, while 82 (20.2%) had END. Higher AIP quartiles were significantly associated with an increased risk of both FR and END (p for trend < 0.01). The highest AIP quartile (Q4 ≥ 0.26) had adjusted odds ratios of 4.34 (95% CI: 2.18–8.65) for FR and 9.62 (95% CI: 3.66–25.26) for END. The AUCs were 0.775 for FR and 0.726 for END. Conclusions: In a multicenter cohort of EVT-treated LAA stroke with successful reperfusion, elevated AIP independently predicted FR and END. AIP is a simple, widely available biomarker that may support pre-procedural risk stratification and inform post-reperfusion management after EVT.
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(This article belongs to the Section Neurobiology and Clinical Neuroscience)
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Open AccessCommunication
Tyrosine Hydroxylase-Expressing Neurons in the Vagal Ganglia: Characterization and Implications
by
Artin Khaky, Nicole Lee Yang, Valerie van Weperen, Shail Avasthi, Neil Jani and Marmar Vaseghi
Biomedicines 2025, 13(9), 2126; https://doi.org/10.3390/biomedicines13092126 (registering DOI) - 31 Aug 2025
Abstract
Background/Objectives: A combination of sympathoexcitation and parasympathetic withdrawal contributes to the occurrence of ventricular arrhythmias, sudden cardiac death, and progression of heart failure after myocardial injury. As a result, vagal nerve stimulation has been under investigation as a potential option to increase cardiac
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Background/Objectives: A combination of sympathoexcitation and parasympathetic withdrawal contributes to the occurrence of ventricular arrhythmias, sudden cardiac death, and progression of heart failure after myocardial injury. As a result, vagal nerve stimulation has been under investigation as a potential option to increase cardiac vagal tone, but the results of clinical trials have been mixed. Prior studies have suggested that the vagal ganglia and nerves may contain sympathetic neurons that express tyrosine hydroxylase (TH), which, if stimulated, could potentially mitigate the effects of vagal nerve stimulation. The goal of the current study was to better characterize these neurons. Methods: Immunohistochemical staining was performed to evaluate for the presence of TH-expressing neurons in the inferior vagal (nodose) ganglia from six pigs. Additional staining was performed for dopamine beta-hydroxylase (DBH), which is required for the production of norepinephrine (NE), to determine if these neurons are indeed sympathetic and capable of releasing NE. Analysis of stellate ganglia was also performed, given that these ganglia are known to provide sympathetic innervation to the heart and release NE in the myocardium. Results: While nearly all TH-expressing neurons in the stellate ganglia expressed DBH, confirming that they can produce or release NE, none of the TH-expressing neurons in the vagal ganglia expressed DBH, demonstrating that these are dopaminergic but not noradrenergic neurons. Conclusions: TH-expressing neurons in the vagal ganglia previously reported to be potentially “sympathetic” do not express DBH and are, therefore, not capable of synthesizing NE.
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(This article belongs to the Special Issue Cardiac Arrhythmias and Arrhythmogenic Disorders: Technological Frontiers, Drug Development and Future Directions)
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Open AccessReview
Work-Related Stress and Glucose Regulation in Air Traffic Control Officers: Implications for Medical Certification
by
Paola Verde, Laura Piccardi, Sandro Gentile, Graham A. Roberts, Andrea Mambro, Sofia Pepe and Felice Strollo
Biomedicines 2025, 13(9), 2125; https://doi.org/10.3390/biomedicines13092125 (registering DOI) - 30 Aug 2025
Abstract
Background/Objectives: Following the recent publication of reassuring outcomes from the ARA MED 330 protocol regarding long-term insulin use in pilots, combined with continuous advancements in diabetes technology, European aeromedical examiners are increasingly optimistic about establishing more flexible medical requirements for insulin-treated aviation professionals.
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Background/Objectives: Following the recent publication of reassuring outcomes from the ARA MED 330 protocol regarding long-term insulin use in pilots, combined with continuous advancements in diabetes technology, European aeromedical examiners are increasingly optimistic about establishing more flexible medical requirements for insulin-treated aviation professionals. These professionals have historically been considered unfit for duty due to hypoglycemic risks. According to current research, hypoglycemia, the primary incapacitation risk for flight crew, is considered virtually non-existent among air traffic controllers (ATCOs). Additionally, stress-induced hyperglycemia also represents a low-frequency risk in these professionals, who are experienced in managing highly stressful operational environments. This study presents a narrative review examining stress and its metabolic effects in healthy individuals, ATCOs, and people with diabetes (PwD). Methods: This narrative review was conducted based on a comprehensive PubMed search performed by two independent reviewers (GAR and AM) spanning January 2023 to January 2025. The search strategy focused on English-language, peer-reviewed studies involving human participants and addressed stress, glucose regulation, and occupational factors in ATCOs and people with diabetes. Additional relevant articles were identified through reference screening. A total of 33 studies met the inclusion criteria. Studies focusing solely on oxidative or molecular mechanisms were excluded from the analysis. Results: Stressful events consistently triggered the expected hyperglycemic reaction in both healthy individuals and PwD. However, the literature indicates ATCOs demonstrate remarkable stress resilience and adaptation to the demanding conditions of their work environment, suggesting a unique occupational profile regarding metabolic stress responses. Conclusions: These findings contribute valuable insights to ongoing discussions regarding aeromedical fitness standards. The evidence suggests that ATCOs may not face the same metabolic risks as flight crews, indicating that current medical certification processes for insulin-treated aviation professionals warrant reconsideration in light of this emerging evidence. This research supports the potential for more individualized, occupation-specific aeromedical standards that better reflect the actual risk profiles of different aviation roles.
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(This article belongs to the Section Endocrinology and Metabolism Research)
Open AccessArticle
Phenotyping Bronchiectasis Frequent Exacerbator: A Single Centre Retrospective Cluster Analysis
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Francesco Rocco Bertuccio, Nicola Baio, Simone Montini, Valentina Ferroni, Vittorio Chino, Lucrezia Pisanu, Marianna Russo, Ilaria Giana, Elisabetta Gallo, Lorenzo Arlando, Klodjana Mucaj, Mitela Tafa, Maria Arminio, Emanuela De Stefano, Alessandro Cascina, Amelia Grosso, Erica Gini, Federica Albicini, Virginia Valeria Ferretti, Eleonora Fresi, Angelo Guido Corsico, Giulia Maria Stella and Valentina Conioadd
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Biomedicines 2025, 13(9), 2124; https://doi.org/10.3390/biomedicines13092124 (registering DOI) - 30 Aug 2025
Abstract
Background: Bronchiectasis is a chronic respiratory condition characterized by permanent bronchial dilation, recurrent infections, and progressive lung damage. A subset of patients, known as frequent exacerbators, experience multiple exacerbations annually, leading to accelerated lung function decline, hospitalizations, and reduced quality of life. The
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Background: Bronchiectasis is a chronic respiratory condition characterized by permanent bronchial dilation, recurrent infections, and progressive lung damage. A subset of patients, known as frequent exacerbators, experience multiple exacerbations annually, leading to accelerated lung function decline, hospitalizations, and reduced quality of life. The aim of this study is to identify distinct phenotypes and treatable traits in bronchiectasis frequent exacerbators, since it could be crucial for optimizing patient management. Research question: Could clinically distinct phenotypes and treatable traits be identified among frequent exacerbators with bronchiectasis to guide personalized management strategies? Methods: We analysed a cohort of 56 bronchiectasis frequent exacerbator patients using 21 clinically relevant variables, including pulmonary function tests, radiological patterns, and microbiological data. Hierarchical clustering and k-means algorithms were applied to identify subgroups. Key outcomes included cluster-specific characteristics, treatable traits, and their implications for management. Results: Four distinct clusters were identified: 1. Mild, idiopathic bronchiectasis (Cluster 1): Predominantly mild disease (FACED), idiopathic etiology (93.3%), and cylindrical bronchiectasis with moderate obstruction (60%). 2. Rheumatological and NTM-associated bronchiectasis (Cluster 2): Patients with systemic inflammatory diseases (50%) and NTMever (50%) but minimal infections by Pseudomonas aeruginosa. 3. Mild, post-infective bronchiectasis (Cluster 3): Exclusively mild disease, mixed idiopathic and post-infective etiologies, and preserved lung function. 4. Severe, chronic infection phenotype (Cluster 4): Severe disease with high colonization rates of Pseudomonas aeruginosa (71.4%), advanced structural damage (57.1% varicose, 50% cystic bronchiectasis), and frequent exacerbations. Interpretation: This analysis highlights the heterogeneity of bronchiectasis and its frequent exacerbator phenotype. The treatable traits framework underscores the importance of aggressive infection control and management of airway inflammation in severe cases, while milder clusters may benefit from preventive strategies. These findings support the integration of precision medicine in bronchiectasis care, focusing on phenotype-specific interventions to improve outcomes.
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(This article belongs to the Special Issue Advanced Research in Chronic Respiratory Diseases (CRDs))
Open AccessReview
Nephroprotective Mechanisms of SGLT2i: Beyond the Glucose-Lowering Effect
by
Alessio Mazzieri and Livia Maria Rita Marcon
Biomedicines 2025, 13(9), 2123; https://doi.org/10.3390/biomedicines13092123 (registering DOI) - 30 Aug 2025
Abstract
Chronic kidney disease (CKD) is a fast-growing cause of death worldwide. Systemic hypertension and diabetes mellitus are the major causes of kidney damage leading to a reduction in glomerular filtration rate and to urinary protein loss. Sodium–glucose cotransporter 2 inhibitors (SGLT2is) are drugs
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Chronic kidney disease (CKD) is a fast-growing cause of death worldwide. Systemic hypertension and diabetes mellitus are the major causes of kidney damage leading to a reduction in glomerular filtration rate and to urinary protein loss. Sodium–glucose cotransporter 2 inhibitors (SGLT2is) are drugs able to address both of these deleterious effects, preventing kidney damage from progressing. Initially born as hypoglycemic agents, SGLT2is subsequently proved to have not only positive metabolic but also pleiotropic effects on the kidney and the cardiovascular system. Indeed, they improve the metabolic profile, reducing uric acid, blood sugar levels, and body weight. Moreover, they exert an anti-inflammatory and antifibrotic effect, reducing endothelial dysfunction and reactive oxygen species (ROS) production. Finally, they reduce renal hyperfiltration and control blood pressure, inducing osmotic diuresis and restoring tubulo-glomerular feedback. All these metabolic, anti-inflammatory, and hemodynamic effects contribute to significantly reducing the risk of cardiorenal events, as widely demonstrated in randomized clinical trials. The pleiotropic actions of SGLT2is together with their good tolerability make them a pillar treatment of CKD regardless of the presence of diabetes mellitus. Further studies will be needed in order to expand the indications to populations previously excluded from clinical trials such as transplant recipients or glomerulonephritis patients. This narrative review aims to summarize current knowledge regarding the nephroprotective mechanisms of SGLT2is which, after initial use as a hypoglycemic agent, have assumed a pivotal role in the actual and future management of patients with CKD.
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(This article belongs to the Special Issue New Advances in Chronic Kidney Disease: Biology, Diagnosis and Therapy (2nd Edition))
Open AccessArticle
Establishing Human and Canine Xenograft Murine Osteosarcoma Models for Application of Focused Ultrasound Ablation
by
Alayna N. Hay, Alex Simon, Lauren N. Ruger, Jessica Gannon, Sheryl Coutermarsh-Ott, Elliana R. Vickers, William Eward, Nathan J. Neufeld, Eli Vlaisavljevich and Joanne Tuohy
Biomedicines 2025, 13(9), 2122; https://doi.org/10.3390/biomedicines13092122 (registering DOI) - 30 Aug 2025
Abstract
Background: Osteosarcoma (OS) is the most commonly occurring type of bone cancer in both humans and canines. The survival outcomes for OS patients have not improved significantly in decades. A novel and innovative treatment option that is currently under investigation for OS in
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Background: Osteosarcoma (OS) is the most commonly occurring type of bone cancer in both humans and canines. The survival outcomes for OS patients have not improved significantly in decades. A novel and innovative treatment option that is currently under investigation for OS in the veterinary field is the focused ultrasound ablation modality, histotripsy. Histotripsy is a non-thermal, non-invasive, non-ionizing ablation modality that destroys tissue through generation of acoustic cavitation. Objective: In the current study, we sought to investigate the utility of an orthotropic OS xenograft murine model for characterization of chronic ablative and clinical outcomes post-histotripsy ablation. Method: Given the high comparative relevance of canine to human OS, histotripsy was delivered to orthotopic OS tumors in both human and canine xenograft murine models. Results: Histotripsy improved limb function in tumor-bearing mice compared to untreated tumor bearing mice. The results of this study demonstrated the utility of the orthotopic OS xenograft murine model for histotripsy-based preclinical studies. Conclusions: The current study is the first published investigation for the use of an orthotopic xenograft murine model for the development of histotripsy ablation for OS. The developmental process of the model, technical limitations, and future directions are discussed.
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(This article belongs to the Section Cancer Biology and Oncology)
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Open AccessReview
Roots of Progress: Uncovering Cerebellar Ataxias Using iPSC Models
by
Michela Giacich, Valentina Naef, Filippo Maria Santorelli and Devid Damiani
Biomedicines 2025, 13(9), 2121; https://doi.org/10.3390/biomedicines13092121 (registering DOI) - 30 Aug 2025
Abstract
The inaccessibility of human cerebellar tissue and the complexity of its development have historically hindered the study of cerebellar ataxias, a genetically diverse group of neurodegenerative disorders. Induced pluripotent stem cell (iPSC) technology offers a powerful solution, enabling the generation of patient-specific cerebellar
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The inaccessibility of human cerebellar tissue and the complexity of its development have historically hindered the study of cerebellar ataxias, a genetically diverse group of neurodegenerative disorders. Induced pluripotent stem cell (iPSC) technology offers a powerful solution, enabling the generation of patient-specific cerebellar models that retain individual genetic backgrounds. This review examines recent progress in iPSC-derived cerebellar models and their application in relation to major hereditary ataxias, including Friedreich’s ataxia, ataxia–telangiectasia, and spinocerebellar ataxias (SCAs). These models have provided valuable insights into disease mechanisms and supported the development of therapeutic strategies, such as gene therapy and high-throughput drug screening. However, challenges remain, particularly in achieving the full maturation of cerebellar cell types and incorporating microglial interactions. Moreover, emerging evidence suggests that neurodevelopmental alterations may act as early contributors to degeneration. Despite the current limitations, the advancement of patient-derived iPSC cerebellar models holds great promise for uncovering novel disease pathways and for driving precision medicine approaches in cerebellar ataxia research.
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(This article belongs to the Special Issue Pluripotent Stem Cells: Current Understanding and Future Directions—2nd Edition)
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Open AccessReview
Pulmonary Emphysema: Current Understanding of Disease Pathogenesis and Therapeutic Approaches
by
Abderrazzak Bentaher, Olivier Glehen and Ghania Degobert
Biomedicines 2025, 13(9), 2120; https://doi.org/10.3390/biomedicines13092120 (registering DOI) - 30 Aug 2025
Abstract
Pulmonary emphysema, the main component of chronic obstructive pulmonary disease, is a chronic lung inflammatory disease characterized by the loss of lung elasticity and impaired gas exchange due in large part to the destruction of alveolar walls. Cigarette smoking represents the most frequent
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Pulmonary emphysema, the main component of chronic obstructive pulmonary disease, is a chronic lung inflammatory disease characterized by the loss of lung elasticity and impaired gas exchange due in large part to the destruction of alveolar walls. Cigarette smoking represents the most frequent etiologic factor, but other factors involving environmental pollution and respiratory infections contribute to disease pathogenesis and worsening. In this review, we provide a review about emphysema covering risk factors; underlying mechanisms of disease pathogenesis; experimental models that mimic, as closely as possible, human disease features; and available therapeutics. Lastly, exploratory therapeutic approaches aimed at improving patient health through evidence-based and personalized medicine are presented as well.
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(This article belongs to the Section Molecular and Translational Medicine)
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Assessment of Diffuse Myocardial Fibrosis and Myocardial Oedema in Sepsis Survivors Using Cardiovascular Magnetic Resonance: Correlation with Left Ventricular Systolic Function
by
Ella Jacobs, Samuel Malomo, Thomas Oswald, Anthony Yip, Thomas Alway, Stanislav Hadjivassilev, Steven Coombs, Susan Ellery, Joon Lee, Claire Phillips, Barbara Philips, David Hildick-Smith, Victoria Parish and Alexander Liu
Biomedicines 2025, 13(9), 2119; https://doi.org/10.3390/biomedicines13092119 (registering DOI) - 30 Aug 2025
Abstract
Background/Objectives: Survivors of sepsis can develop left ventricular (LV) systolic function with focal myocardial fibrosis. The relationship between diffuse myocardial fibrosis or oedema and LV systolic function remains unknown in this patient cohort. This study sought to address this knowledge gap using
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Background/Objectives: Survivors of sepsis can develop left ventricular (LV) systolic function with focal myocardial fibrosis. The relationship between diffuse myocardial fibrosis or oedema and LV systolic function remains unknown in this patient cohort. This study sought to address this knowledge gap using cardiovascular magnetic resonance (CMR) parametric mapping methods. Methods: Sepsis survivors who underwent CMR at a UK cardiac centre were included. CMR images analysed include cines, native T1-mapping, native T2-mapping, and post-contrast T1-mapping. Synthetic extracellular volume (ECV) fraction was also estimated. Native myocardial T1 values, native myocardial T2 values, and ECV values were compared against LV ejection fraction (LVEF). Results: Of the 37 sepsis survivors (age 53 ± 16 years old; 57% males), the mean left ventricular ejection fraction (LVEF) was 55% (IQR 43–62), and 43% of the patients had LV systolic dysfunction (LVEF < 50%). Mean native myocardial T1 values were 1055 ± 65 ms (septal) and 1051 ± 60 ms (global). Mean synthetic ECV values were 0.30 ± 0.04. Mean native myocardial T2 values were 52 ± 7 ms (septal) and 53 ± 6 ms (global). Septal and global native myocardial T1 values were not significantly correlated with LVEF (rho = 0.080, p = 0.637; rho = 0.036, p = 0.831, respectively). Synthetic ECV was not significantly correlated to LVEF (rho = −0.082; p = 0.723). Septal and global native myocardial T2 values were weakly correlated with LVEF (rho = 0.261, p = 0.281; rho = 0.216, p = 0.375, respectively). On ROC analysis, the performance of native myocardial T1 values, ECV, and native myocardial T2 values for predicting LV dysfunction was modest (AUC: 0.53 ± 0.10, 0.54 ± 11, and 0.68 ± 0.14; all p > 0.05, respectively). Conclusions: CMR markers of diffuse myocardial fibrosis (native T1-mapping and ECV) and myocardial oedema (native T2-mapping) have weak relationships with left ventricular systolic function in this study cohort of sepsis survivors. Further work is needed to better assess the role of diffuse myocardial fibrosis and oedema in the pathophysiology of post-sepsis cardiomyopathy.
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(This article belongs to the Special Issue Pathogenesis, Diagnosis, and Treatment of Cardiomyopathy)
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Artificial Intelligence-Driven Neuromodulation in Neurodegenerative Disease: Precision in Chaos, Learning in Loss
by
Andrea Calderone, Desirèe Latella, Elvira La Fauci, Roberta Puleo, Arturo Sergi, Mariachiara De Francesco, Maria Mauro, Angela Foti, Leda Salemi and Rocco Salvatore Calabrò
Biomedicines 2025, 13(9), 2118; https://doi.org/10.3390/biomedicines13092118 (registering DOI) - 30 Aug 2025
Abstract
Neurodegenerative disorders such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and multiple sclerosis (MS) are marked by progressive network dysfunction that challenges conventional, protocol-based neurorehabilitation. In parallel, neuromodulation, encompassing deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), vagus
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Neurodegenerative disorders such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and multiple sclerosis (MS) are marked by progressive network dysfunction that challenges conventional, protocol-based neurorehabilitation. In parallel, neuromodulation, encompassing deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS), and artificial intelligence (AI), has matured rapidly, offering complementary levers to tailor therapy in real time. This narrative review synthesizes current evidence at the intersection of AI and neuromodulation in neurorehabilitation, focusing on how data-driven models can personalize stimulation and improve functional outcomes. We conducted a targeted literature synthesis of peer-reviewed studies identified via PubMed, Embase, Scopus, and reference chaining, prioritizing recent clinical and translational reports on adaptive/closed-loop systems, predictive modeling, and biomarker-guided protocols. Across indications, convergent findings show that AI can optimize device programming, enable state-dependent stimulation, and support clinician decision-making through multimodal biomarkers derived from neural, kinematic, and behavioral signals. Key barriers include data quality and interoperability, model interpretability and safety, and ethical and regulatory oversight. Here we argue that AI-enhanced neuromodulation reframes neurorehabilitation from static dosing to adaptive, patient-specific care. Advancing this paradigm will require rigorous external validation, standardized reporting of control policies and artifacts, clinician-in-the-loop governance, and privacy-preserving analytics.
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(This article belongs to the Special Issue Application of Artificial Intelligence in Biomedicines)
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The Role of Body Mass Index in Outcomes of Radial Shock Wave Therapy for Adhesive Capsulitis
by
Diana-Lidia Tache-Codreanu, Iuliana David, Mihai-Andrei Butum-Cristea, Ana-Maria Tache-Codreanu, Claudia-Camelia Burcea, Elena Rusu, Andrei Tache-Codreanu, Rodica Olteanu, Teodor Dan Poteca and Corina Sporea
Biomedicines 2025, 13(9), 2117; https://doi.org/10.3390/biomedicines13092117 - 29 Aug 2025
Abstract
Background: Radial shock wave therapy (RSWT) has increasingly been integrated into treatment protocols for adhesive capsulitis. While associations with diabetes and other systemic disorders are well documented, the role of obesity remains underexplored, particularly in relation to RSWT outcomes. Methods: Forty patients with
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Background: Radial shock wave therapy (RSWT) has increasingly been integrated into treatment protocols for adhesive capsulitis. While associations with diabetes and other systemic disorders are well documented, the role of obesity remains underexplored, particularly in relation to RSWT outcomes. Methods: Forty patients with adhesive capsulitis completed a 10-day treatment protocol combining RSWT with conventional physiotherapy. Pain (VAS), disability (SPADI), and range of motion (ROM) were assessed at baseline and immediately after treatment. At one-month follow-up, VAS and SPADI were reassessed alongside the Patient Global Impression of Change (PGIC). Correlations between body mass index (BMI) and clinical outcomes were analyzed, and potential confounding effects of comorbidities and affected-side dominance were examined. Clinical relevance was assessed using minimal clinically important differences (MCID) and effect sizes (Cohen’s d). Results: All clinical outcomes improved significantly post-treatment and at follow-up, with most changes exceeding MCID thresholds and showing large effect sizes. Higher BMI was significantly correlated with greater improvements in SPADI, VAS, shoulder extension, and internal rotation. Most comorbidities were negatively associated with outcomes, except neurologic conditions, which supported mobility improvement. Conclusions: RSWT appears effective in alleviating symptoms of adhesive capsulitis. The observed association between higher BMI and greater mobility improvement suggests potential benefits in overweight and obese patients. These findings warrant further investigation.
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(This article belongs to the Section Molecular and Translational Medicine)
Open AccessArticle
Design, Synthesis, and Computational Insights into PKMYT1 Inhibitors for the Treatment of Breast Cancer
by
Jinyu Yu, Haoyu Zhang, Chuanxu Su, Shizhe Yuan, Nian Liu, Yin Sun, Yixiang Sun, Zixuan Gao, Dongmei Zhao and Maosheng Cheng
Biomedicines 2025, 13(9), 2116; https://doi.org/10.3390/biomedicines13092116 - 29 Aug 2025
Abstract
Background: Membrane-associated tyrosine-threonine protein kinase 1 (PKMYT1), which is identified as a synthetic lethal partner of CCNE1, emerged as a promising therapeutic target in oncology. Methods: A series of novel PKMYT1 inhibitors were designed by employing a pharmacophore fusion strategy.
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Background: Membrane-associated tyrosine-threonine protein kinase 1 (PKMYT1), which is identified as a synthetic lethal partner of CCNE1, emerged as a promising therapeutic target in oncology. Methods: A series of novel PKMYT1 inhibitors were designed by employing a pharmacophore fusion strategy. The underlying mechanisms were investigated by means of pharmacological experiments and molecular simulations. Results: Compound MY-14 demonstrated optimal kinase inhibition (IC50 = 0.002 μM) and significant anti-proliferative efficacy against CCNE1-amplified cells (IC50-HCC1569 = 1.06 μM and IC50-OVCAR3 = 0.80 μM). Furthermore, MY-14 induced concentration-dependent apoptosis, inhibited colony formation, and effectively arrested cell-cycle progression at the S-phase through synthetic lethality. Molecular dynamics simulations, Hirshfeld surface analysis, dynamic cross-correlation matrix (DCCM), and MM/GBSA calculations elucidated the molecular mechanism underlying MY-14’s interaction with PKMYT1. Conclusions: MY-14 emerged as a promising compound for the development of a novel PKMYT1 inhibitor.
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(This article belongs to the Special Issue New Horizons in Enzyme Inhibitor Discovery: Targets, Design and Evaluation)
Open AccessArticle
17βH-Neriifolin Improves Cardiac Remodeling Through Modulation of Calcium Handling Proteins in the Heart Failure Rat Model
by
Rajasegar Anamalley, Yusof Kamisah, Nurhanan Murni Yunos and Satirah Zainalabidin
Biomedicines 2025, 13(9), 2115; https://doi.org/10.3390/biomedicines13092115 - 29 Aug 2025
Abstract
Background: Cardiac glycosides such as digoxin have been commonly used for patients with heart failure; however, their toxicity remains a main concern. 17βH-neriifolin (SNA209), a cardiac glycoside compound, has been recently isolated from Ceberra odollum Gaertn and was shown to improve the heart’s
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Background: Cardiac glycosides such as digoxin have been commonly used for patients with heart failure; however, their toxicity remains a main concern. 17βH-neriifolin (SNA209), a cardiac glycoside compound, has been recently isolated from Ceberra odollum Gaertn and was shown to improve the heart’s pumping ability in failing hearts ex vivo. Thus, this study aimed to investigate the potential use of SNA209 as a treatment for isoprenaline (ISO)-induced heart failure in rats. Methods: Forty male Wistar rats were randomly divided into five groups. Heart failure was induced by isoprenaline (ISO, 10 mg/kg/s.c) for 14 days daily, followed by SNA209 treatment (5 mg/kg; p.o) for another 14 days daily. Control rats were given saline as a vehicle for ISO and DMSO as a vehicle for SNA209. Results: Systolic and diastolic blood pressure (SBP and DBP) in all ISO-treated groups were significantly increased compared to the control group (p < 0.05), and SNA209 treatment managed to reduce the SBP and DBP. Additionally, SNA209 treatment significantly increased the heart rate and normalized the ECG parameters in ISO-treated rats. Pro-B-type natriuretic peptide and troponin T level, a cardiac injury markers, was remarkably reduced by SNA209 in the ISO-treated group. Cardiac hypertrophy was evident in increased cardiomyocyte size in ISO groups; however, SNA reduced the cardiomyocyte size. The left ventricular developed pressure (LVDP) in ISO treated with SNA209 was significantly raised, indicating a chronotropic effect. Cardiac Na+/K+-ATPase expression of the α1 subunit, sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2a (SERCA2a), and sodium–calcium exchanger subunit were significantly increased in the SNA treatment groups. Conclusions: The SNA 209 treatment improved cardiac function and structure, likely via modulating intracellular calcium management, so underscoring its potential as an adjuvant therapy for heart failure.
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(This article belongs to the Special Issue Advances in Cardiovascular Diseases: Pathophysiological Insights, Therapeutic Strategies and Future Directions)
Open AccessArticle
Identification of Pyroptosis-Related Genes and Immune Landscape in Myocardial Ischemia–Reperfusion Injury
by
Yanfang Zhu, Haoyan Zhu, Jia Zhou, Jiahe Wu, Xiaorong Hu, Chenze Li, Huanhuan Cai and Zhibing Lu
Biomedicines 2025, 13(9), 2114; https://doi.org/10.3390/biomedicines13092114 - 29 Aug 2025
Abstract
Background: Cardiomyocyte death is a key factor in myocardial ischemia–reperfusion injury (MI/RI), and the expression patterns and molecular mechanisms of pyroptosis-related genes (PRGs) in ischemia–reperfusion injury are poorly understood. Methods: The mouse MI/RI injury-related datasets GSE61592 and GSE160516 were obtained from the
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Background: Cardiomyocyte death is a key factor in myocardial ischemia–reperfusion injury (MI/RI), and the expression patterns and molecular mechanisms of pyroptosis-related genes (PRGs) in ischemia–reperfusion injury are poorly understood. Methods: The mouse MI/RI injury-related datasets GSE61592 and GSE160516 were obtained from the Gene Expression Omnibus database, and differential expression analysis was performed on each to identify differentially expressed genes (DEGs). The DEGs were intersected with the PRGs obtained from GeneCards to identify differentially expressed PRGs in MI/RI. Enrichment analysis identified key pathways, while PPI network analysis revealed hub genes. The expression patterns and immune cell infiltration of hub genes were also investigated. The molecular docking prediction of key genes was performed using MOE software in conjunction with the ZINC small molecular compounds database. Key gene expression was validated in an external dataset (GSE4105), a mouse MI/RI model, and an HL-1 cell hypoxia/reoxygenation model via RT-qPCR. Results: A total of 29 differentially expressed PRGs were identified, which are primarily associated with pathways such as “immune system process”, “response to stress”, “identical protein binding”, and “extracellular region”. Seven key genes (Fkbp10, Apoe, Col1a2, Ppic, Tlr2, Fstl1, Serpinh1) were screened, all strongly correlated with immune infiltration. Seven FDA-approved small molecule compounds exhibiting the highest docking potential with each key gene were selected based on a comprehensive evaluation of S-scores and hydrogen bond binding energies. Apoe, Tlr2, and Serpinh1 were successfully validated across external datasets, the mouse MI/RI model, and the cardiomyocyte H/R model. Conclusions: Apoe, Tlr2, and Serpinh1 may be key genes involved in MI/RI-related pyroptosis. Targeting these genes may provide new insights into the treatment of MI/RI.
Full article
(This article belongs to the Special Issue Pathogenesis, Diagnosis, and Treatment of Cardiomyopathy)

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