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20 pages, 833 KB  
Review
Impact of Variant Allele Frequency (VAF) Levels on Clinical Efficacy of Osimertinib in Patients with Metastatic NSCLC
by Abed Agbarya, Kamel Mhameed, Arina Soklakova, Haitam Nasrallah, Mahmoud Abu Amna, Sabri El-Saied, Mohammad Sheikh-Ahmad and Walid Shalata
Med. Sci. 2026, 14(2), 233; https://doi.org/10.3390/medsci14020233 - 1 May 2026
Abstract
Background: Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality despite major advances in diagnostics and therapies. The prognosis remains poor, mostly due to late-stage presentation and molecular heterogeneity. Epidermal growth factor receptor (EGFR) mutations are common drivers of [...] Read more.
Background: Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality despite major advances in diagnostics and therapies. The prognosis remains poor, mostly due to late-stage presentation and molecular heterogeneity. Epidermal growth factor receptor (EGFR) mutations are common drivers of NSCLC. The development of EGFR tyrosine kinase inhibitors (TKIs) has significantly improved outcomes in patients with EGFR mutations. Variant allele frequency (VAF) is a quantitative genomic measure representing the proportion of sequencing reads harboring a given mutation. In NSCLC tissue, the EGFR mutation VAF reflects tumor clonality and intratumoral heterogeneity, and accumulating evidence suggests an association between EGFR VAF and response to EGFR-targeted TKIs. Methods: To address the limited synthesis of data on the relevance of EGFR mutation VAF in NSCLC, we conducted a narrative review of the literature using PubMed/MEDLINE and Embase databases and current clinical guidelines, synthesizing available evidence on EGFR VAF, including its biological, molecular, and therapeutic implications in EGFR-mutated disease. The review was structured in accordance with the SANRA (Scale for the Assessment of Narrative Review Articles) checklist. Results: EGFR VAF and on-treatment VAF dynamics are consistently associated with treatment response, progression-free survival, and overall survival in osimertinib-treated NSCLC. Baseline VAF enables risk stratification, early clearance kinetics predict durable benefit, and longitudinal VAF monitoring facilitates early detection of resistance. Importantly, the prognostic implications of VAF differ fundamentally between tissue-based and plasma-based measurements: high tissue VAF reflects clonal homogeneity and predicts favorable TKI response, whereas high plasma VAF indicates elevated tumor burden and is associated with inferior outcomes. In the second-line setting, the T790M/activating mutation ratio serves as a surrogate for resistance clonality and independently predicts osimertinib efficacy. Conclusions: EGFR VAF represents a promising dynamic molecular biomarker for treatment monitoring and precision decision-making in EGFR-mutated NSCLC. Full article
17 pages, 2546 KB  
Article
A Highly Protective Live-Attenuated Vaccine Generated by Targeted Deletion of the Mycobacterium bovis Virulence Factor VapC40
by Xin Ge, Haoran Wang, Dingpu Liu, Yuhui Dong, Lin Li, Puxiu Shen, Yue Li, Jiaming Zhang, Xiangmei Zhou and Ruichao Yue
Int. J. Mol. Sci. 2026, 27(9), 4067; https://doi.org/10.3390/ijms27094067 - 1 May 2026
Abstract
Type II toxin–antitoxin (TA) systems are significantly expanded in the Mycobacterium tuberculosis complex; however, the functional role of the VapBC40 system in Mycobacterium bovis(M. bovis) pathogenesis remains poorly characterized. This study aimed to investigate the role of VapBC40 in mycobacterial virulence [...] Read more.
Type II toxin–antitoxin (TA) systems are significantly expanded in the Mycobacterium tuberculosis complex; however, the functional role of the VapBC40 system in Mycobacterium bovis(M. bovis) pathogenesis remains poorly characterized. This study aimed to investigate the role of VapBC40 in mycobacterial virulence and evaluate its potential as a target for rational vaccine attenuation. We performed evolutionary analysis and yeast two-hybrid assays to characterize VapBC40 system specificity, conducted in vitro macrophage infection models and in vivo murine studies to assess virulence contribution, and evaluated the immunoprotective efficacy of a VapC40 knockout strain. Evolutionary analysis revealed progressive sequence conservation and stringent homologous pairing specificity within the VapBC40 system. The VapC40 toxin correlates with enhanced intracellular bacterial survival, increased host cell death, and more severe pulmonary pathology with systemic dissemination. Based on these findings, we evaluated the vaccine potential of a vapC40 knockout strain. Immunization with this attenuated strain elicited a Th1 cellular immune response, characterized by enhanced IFN-γ production and increased frequency of CD4+IFN-γ+ T cells. Upon challenge with virulent M. bovis, the knockout strain conferred superior protection compared to the conventional BCG vaccine, significantly reducing lung pathology and restricting extrapulmonary bacterial dissemination. Although the molecular mechanisms underlying VapC40-mediated effects remain to be fully elucidated, our findings suggest an important role of the VapBC40 system in mycobacterial-host interactions and support its potential as a target for next-generation tuberculosis vaccine development. Full article
(This article belongs to the Section Molecular Immunology)
26 pages, 1243 KB  
Review
Neuro-Immune Axis in Trauma-Induced Heterotopic Ossification: Mechanisms and Therapeutic Implications
by Oluomachukwu Jennifer Agu, Clifford Pereira, Ishaan Gupta, Ashley Moran and Tahmineh Mokhtari
Cells 2026, 15(9), 827; https://doi.org/10.3390/cells15090827 - 1 May 2026
Abstract
Trauma-induced heterotopic ossification (tHO) is characterized by aberrant ectopic bone formation in soft tissue following high-energy trauma, affecting >60% of combat-related amputees and >50% of major burn patients. Current prophylactic strategies (including NSAIDs, bisphosphonates, and low-dose radiation) lack mechanistic specificity, carry significant side [...] Read more.
Trauma-induced heterotopic ossification (tHO) is characterized by aberrant ectopic bone formation in soft tissue following high-energy trauma, affecting >60% of combat-related amputees and >50% of major burn patients. Current prophylactic strategies (including NSAIDs, bisphosphonates, and low-dose radiation) lack mechanistic specificity, carry significant side effects, and surgical excision carries a 27% recurrence rate. This review reframes tHO pathogenesis through the neural–immune axis, arguing that ectopic bone formation is a downstream consequence of dysregulated neuroimmune signaling rather than a primary osteogenic event. Following trauma, nociceptor activation drives nociception-induced neural inflammation (NINI), releasing substance P (SP) and calcitonin gene-related peptide (CGRP), which disrupts the blood–nerve barrier, mobilizes neural crest-derived progenitor cells, and, alongside BMP-2/SMAD1/5/8 signaling and M1-polarized macrophage activation, establishes a permissive osteogenic microenvironment. A BMP-2/CGRP positive feedback loop sustains aberrant osteogenesis, converging on osteogenic transcription factors Runx2, SOX5/6/9, and Osterix. Dysregulated noncoding RNAs represent promising pre-radiographic biomarkers. This neural–immune framework motivates mechanism-based therapeutic strategies targeting CGRP (fremanezumab, erenumab), SP/NK1 signaling (aprepitant), and macrophage polarization (metformin, palovarotene, rapamycin), with multi-node combination approaches tailored to the temporal stages of tHO offering the most promise for precision prophylaxis. Full article
(This article belongs to the Special Issue Novel Insights into Neuroinflammation and Related Diseases)
11 pages, 1230 KB  
Review
Retinoblastoma and Its Tumor Microenvironment
by Ashwinaa M. Vaithianathan and George Zanazzi
Curr. Oncol. 2026, 33(5), 264; https://doi.org/10.3390/curroncol33050264 - 1 May 2026
Abstract
Retinoblastoma is the most common intraocular malignancy of childhood and is most often driven by loss of the RB1 tumor suppressor gene. While current treatments achieve high survival rates, they are frequently associated with significant morbidity, highlighting the need for more precise, biology-driven [...] Read more.
Retinoblastoma is the most common intraocular malignancy of childhood and is most often driven by loss of the RB1 tumor suppressor gene. While current treatments achieve high survival rates, they are frequently associated with significant morbidity, highlighting the need for more precise, biology-driven therapeutic methods. Increasing evidence suggests that retinoblastoma progression is not dictated by neoplastic cells alone, but rather by complex interactions within the tumor microenvironment, including stromal and immune components. In this review, we examine the cellular and molecular landscape of retinoblastoma with a particular focus on the immune microenvironment, including the spatial distribution and functional roles of innate and adaptive immune cells, as well as immune checkpoint proteins such as PD-1, PD-L1, and CTLA-4. We discuss how tumor- and treatment-induced immune suppression shapes disease progression and therapeutic response, and how chemotherapy alters immune infiltration and checkpoint expression. Finally, we explore emerging immunotherapeutic and cell-based approaches, emphasizing the potential for combination therapies that integrate immune modulation to improve outcomes and reduce long-term toxicity in retinoblastoma. Full article
(This article belongs to the Special Issue The Impact of Tumor Microenvironment on Therapeutic Resistance)
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20 pages, 2416 KB  
Article
A Longitudinal Murine Model Reveals Biphasic T Cell Remodeling and Progressive Skeletal Deterioration Under Chronic High-Salt Exposure
by Constanza Quiroga, Santiago Boccardo, Camila M. S. Giménez, Daniela J. Porta, Mercedes Lombarte, Lucas R. Brun, Germán Tirao, Eva V. Acosta Rodríguez and María Angélica Rivoira
Cells 2026, 15(9), 825; https://doi.org/10.3390/cells15090825 - 1 May 2026
Abstract
Excessive dietary sodium intake has been associated with immune dysregulation, yet its impact on bone health and immune cell dynamics within the bone–immune axis remains poorly understood. We developed a longitudinal murine model to investigate the effects of a high-salt diet (HSD) on [...] Read more.
Excessive dietary sodium intake has been associated with immune dysregulation, yet its impact on bone health and immune cell dynamics within the bone–immune axis remains poorly understood. We developed a longitudinal murine model to investigate the effects of a high-salt diet (HSD) on bone properties and immunity. Male and female C57BL/6J and Foxp3-GFP mice underwent unilateral nephrectomy and were fed either a normal salt diet (0.2% NaCl) or HSD (4% NaCl) for 20, 60, or 150 days. HSD mice exhibited a transient increase in systolic blood pressure and sustained calciuria without changes in serum calcium or PTH. Progressive impairment of femoral strength and tibial trabecular microarchitecture were observed, along with reduced cortical calcium and phosphorus content. Immune analysis revealed early splenic and bone marrow activation of effector T cells, with increased Th17 and Tc17 populations and a disrupted Th17/Treg balance at 20 days. These changes normalized by 60 days and shifted to suppressed T cell activation at 150 days, suggesting a biphasic immune response. Th17/Treg ratio was associated with bone deterioration. Notably, both sexes showed comparable physiological and immune trends. This integrative model provides a platform to dissect mechanisms linking chronic salt overload, immune dysregulation, and bone fragility. Full article
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14 pages, 9703 KB  
Article
Interface-Enhanced Mg/PLA Composite with Superior Mechanical, Biodegradable and Biocompatible Properties for Orthopedic Implants
by Wencheng Teng, Zhuoyi Wang, Ziyue Xu, Jie Xin, Chao Sun, Yi Shao, Cheng Wang, Chenglin Chu, Feng Xue and Jing Bai
J. Funct. Biomater. 2026, 17(5), 210; https://doi.org/10.3390/jfb17050210 - 1 May 2026
Abstract
Magnesium (Mg) reinforced polylactic acid (PLA) composites have attracted increasing interest for orthopedic implants to solve the insufficient strength of PLA and to utilize the bioactive advantages of Mg ions in promoting bone formation. However, the weak interfacial adhesion between the Mg and [...] Read more.
Magnesium (Mg) reinforced polylactic acid (PLA) composites have attracted increasing interest for orthopedic implants to solve the insufficient strength of PLA and to utilize the bioactive advantages of Mg ions in promoting bone formation. However, the weak interfacial adhesion between the Mg and PLA limits the applications of the composite. In this study, a dual interfacial enhancement approach was designed to combine surface fluorination with perforation. During hot pressing, molten PLA infiltrates the pores to form a ‘rivet-like’ mechanical interlocking. This structure significantly alters the load transfer and degradation behaviors of the composite. Compared to pure PLA, the dual treatment significantly elevated the bending strength by 49%, alongside an increase in the bending strain from 15% to 25%. Moreover, in vitro degradation tests revealed that this strategy suppresses H2-induced delamination, and stabilizes both pH and Mg2+ release. Consequently, the bending strength remained at 86% after six weeks of in vitro degradation. In addition, the composite exhibits excellent biocompatibility, with MC3T3-E1 cell viability exceeding 90% in 100% extract. These results demonstrate that the reinforced Mg/PLA composite exhibits excellent mechanical properties, degradation stability, and biocompatibility, showing high potential for load-bearing orthopedic fixation applications. Full article
(This article belongs to the Special Issue Metals and Alloys for Biomedical Applications (2nd Edition))
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29 pages, 1997 KB  
Article
Kun-Ling Wan Formula Ameliorates Postmenopausal Osteoporosis and Adipose Accumulation by Suppressing mTOR Signaling in Mesenchymal Stem Cells
by Xiaoqing Lu, Tingting Xie, He Lan, Yaqi Fan, Jie Yang, Qianzan Liao, Yuxin Jin, Yaoxuan Zhu, Jingxin Zhang, Dexin Li, Chunshui Pan, Quan Li, Kai Sun, Xinmei Huo, Ting Yuwen, Jing-Yan Han and Yin Li
Pharmaceuticals 2026, 19(5), 719; https://doi.org/10.3390/ph19050719 - 30 Apr 2026
Abstract
Background: Postmenopausal osteoporosis is a common metabolic bone disorder characterized by decreased bone mass and microstructural deterioration, often accompanied by increased bone marrow adiposity and systemic fat accumulation. Kun-Ling Wan Formula (KLW) is a compound Chinese medicine clinically used for gynecological disorders, [...] Read more.
Background: Postmenopausal osteoporosis is a common metabolic bone disorder characterized by decreased bone mass and microstructural deterioration, often accompanied by increased bone marrow adiposity and systemic fat accumulation. Kun-Ling Wan Formula (KLW) is a compound Chinese medicine clinically used for gynecological disorders, though its effects on postmenopausal osteoporosis and associated fat accumulation remain unclear. Distinct from previous herbal formulation studies that primarily focused on bone outcomes, our study uniquely integrates bone protection, marrow adiposity reduction, systemic metabolic improvement, and multi-omics mechanistic dissection in a high-fat diet-fed ovariectomized mouse model. Methods: KLW chemical composition was analyzed by UPLC-Q-TOF/MS. Ovariectomized (OVX) C57BL/6J mice fed high-fat or normal diet were treated with KLW at clinically equivalent or double doses, with estrogen and active compounds as controls. Bone microstructure was assessed by micro-CT, bone marrow fat by MRI-PDFF, and metabolism by OGTT, ITT, and metabolic cages. Network pharmacology, proteomics, molecular docking, and dynamics simulations identified core targets. C3H10T1/2 cells were used to assess osteogenic/adipogenic differentiation and mTOR pathway activation. Results: Twelve compounds were identified in KLW. In OVX mice, KLW significantly improved bone mineral density and trabecular microstructure, reduced adiposity and bone marrow fat, and enhanced glucose tolerance and insulin sensitivity. In vitro, KLW promoted osteogenesis and suppressed adipogenesis in C3H10T1/2 cells. Integrative analyses identified mTOR as a central target, with chrysophanol, pyrogallol, and apigenin showing high-affinity binding. KLW inhibited mTOR/S6K phosphorylation during differentiation, an effect reversible by leucine. Conclusions: KLW ameliorates osteoporosis and reduces fat accumulation in OVX mice by shifting mesenchymal stem cell differentiation toward osteogenesis via mTOR pathway modulation. Full article
(This article belongs to the Section Natural Products)
26 pages, 1671 KB  
Review
Th9 and IL9 in Chronic Superior Airway Inflammation: A Narrative Review
by Mihai Dumitru, Ovidiu Berghi, Gabriela Musat, Crenguta Serboiu, Alina Oancea, Alina Gabriela Berghi, Adina Zamfir-Chiru-Anton and Daniela Vrinceanu
Biomedicines 2026, 14(5), 1026; https://doi.org/10.3390/biomedicines14051026 - 30 Apr 2026
Abstract
Inflammation at the superior airway level has multiple manifestations, and allergic rhinitis and chronic rhinosinusitis with or without polyps are two of the most frequent and troublesome of them, with innate and adaptive immunity being implicated. Dendritic cells, epithelial cells, neutrophils, macrophages, mucosal [...] Read more.
Inflammation at the superior airway level has multiple manifestations, and allergic rhinitis and chronic rhinosinusitis with or without polyps are two of the most frequent and troublesome of them, with innate and adaptive immunity being implicated. Dendritic cells, epithelial cells, neutrophils, macrophages, mucosal mast cells, eosinophils, basophils, innate lymphoid cells (ILCs), and NK cells are the players in innate immunity, while regulatory T (Treg), TH1, TH2, TH17, T follicular helper, and B cells are components of the adaptative immune system. Th9 cells, a subset of T helper cells discovered in 2008 that produce interleukin-9 (IL-9), play a vital role in the adaptive immune response and have advantageous and harmful effects in different diseases due to the induction pattern. We queried international databases for current, up-to-date information regarding the interplay between interleukin 9 (IL-9) and helper T cells (especially Th9 cells), and by other immune cells. Interleukin-9 has multiple immunological functions, acting on various target cells through its specific receptor (IL-9R), such as the following: the regulation of allergic (Th2-type) immune responses; effects on epithelial and mucosal cells, mast cells, and eosinophils; chronic inflammation; and autoimmunity. Thus, there is a further need to translate laboratory findings into clinical practice regarding IL-9. Full article
29 pages, 4570 KB  
Article
Combined Effects of Mediterranean Diet Adherence and Physical Activity on Metabolic Homeostasis and Beta-Cell Function in Male Adolescents
by Karin Herrera-Carrasco, Maria Puche-Juarez, Juan Manuel Toledano, Francisco Manuel Ocaña-Peinado, Julio J. Ochoa, Javier Diaz-Castro and Jorge Moreno-Fernandez
Nutrients 2026, 18(9), 1453; https://doi.org/10.3390/nu18091453 - 30 Apr 2026
Abstract
Background/Objectives: Adolescence is a critical developmental period during which dietary quality and physical activity (PA) may influence insulin sensitivity and pancreatic β-cell function. This observational cohort study investigated how adherence to the Mediterranean diet (MedDiet) and participation in structured physical activity (PA) relate [...] Read more.
Background/Objectives: Adolescence is a critical developmental period during which dietary quality and physical activity (PA) may influence insulin sensitivity and pancreatic β-cell function. This observational cohort study investigated how adherence to the Mediterranean diet (MedDiet) and participation in structured physical activity (PA) relate to metabolic changes over six months in Spanish male adolescents. Methods: A total of 78 participants (median age 11 years; IQR 10–12) were followed in a school-based study (2020–2021) and categorized by MedDiet adherence using the KIDMED index into medium (M) and high (H) groups. Metabolic health was assessed at baseline (T1) and after six months (T2) using lipid profiles, glucose, insulin, and several indirect indices of insulin resistance and β-cell function, including HOMA-IR, QUICKI, and SPINA indices. Statistical analyses included correlations and adjusted linear models, with false discovery rate correction applied. Results: At baseline, higher MedDiet adherence was associated with lower fasting insulin and improved insulin resistance markers (p ≤ 0.002). Over six months, adolescents with high adherence showed more favorable changes in insulin sensitivity (fasting insulin, HOMA-IR, QUICKI) and β-cell function (SPINA indices), with results remaining significant after correction (all pFDR < 0.05). LDL cholesterol levels also improved more markedly in participants combining high MedDiet adherence with structured PA (pFDR < 0.001). In contrast, triglycerides and TG-related indices increased across all groups, without differences between them (pFDR < 0.001). Conclusions: High MedDiet adherence combined with structured PA was associated with more favorable trajectories in insulin sensitivity, attenuated β-cell secretory demand, and a more favorable LDL-c profile. These findings support integrated lifestyle approaches for early cardiometabolic prevention in male adolescence. Full article
(This article belongs to the Section Clinical Nutrition)
32 pages, 3068 KB  
Review
ELISPOT as a Functional for Biomarker Study in Cancer Immunotherapy: Applications and Future Directions
by Laura R. Fernández Castro, Matias Regiart, Francisco Gabriel Ortega-Sánchez, Rodrigo Rodríguez, Gonzalo Tortella and Martín A. Fernández-Baldo
Int. J. Mol. Sci. 2026, 27(9), 4056; https://doi.org/10.3390/ijms27094056 - 30 Apr 2026
Abstract
The Enzyme-Linked ImmunoSpot (ELISPOT) assay is a highly sensitive and widely used technique for assessing antigen-specific cellular immune responses in cancer research. By enabling the quantification of cytokine secretion at the single-cell level, particularly interferon gamma (IFN-γ), ELISPOT provides a functional readout of [...] Read more.
The Enzyme-Linked ImmunoSpot (ELISPOT) assay is a highly sensitive and widely used technique for assessing antigen-specific cellular immune responses in cancer research. By enabling the quantification of cytokine secretion at the single-cell level, particularly interferon gamma (IFN-γ), ELISPOT provides a functional readout of T cell activity with applications in both preclinical and clinical settings. This systematic review presents a structured qualitative synthesis of 78 studies investigating the use of ELISPOT in cancer immunotherapy, including cancer vaccines, oncolytic viruses, cellular therapies, immune checkpoint inhibitors, and biomarker development. Studies were selected following PRISMA guidelines from PubMed, Scopus, and Embase, focusing on both clinical and preclinical research with translational relevance. The evidence indicates that ELISPOT is widely used to validate tumor-associated antigens and neoantigens, monitor antigen-specific T cell responses during cancer immunotherapy, including immune checkpoint blockade, cancer vaccines, and adoptive cell therapies, and characterize antigen-specific T cell function. However, only a limited subset of studies establishes direct associations between ELISPOT responses and clinically meaningful outcomes. In addition, substantial variability in assay protocols and reporting criteria limits cross-study comparability and reproducibility. Overall, ELISPOT remains a valuable tool for immune monitoring in cancer research. Still, its implementation as a clinically validated biomarker requires further standardization, prospective validation, and integration with complementary analytical approaches. Full article
(This article belongs to the Special Issue Biomarkers in Oncology)
20 pages, 1031 KB  
Article
Genistein and Resveratrol: Inhibitors of Kv1.3 Channels in Cancer Cells
by Andrzej Teisseyre, Anna Uryga, Kamila Środa-Pomianek and Anna Palko-Labuz
Membranes 2026, 16(5), 159; https://doi.org/10.3390/membranes16050159 - 30 Apr 2026
Abstract
Background: Genistein and resveratrol are bioactive compounds isolated from plants, recognized for their diverse biological activities including anti-cancer properties. Both compounds are also known as modulators of various types of ion channels, including voltage-gated potassium channels, Kv1.3. These channels are widely expressed in [...] Read more.
Background: Genistein and resveratrol are bioactive compounds isolated from plants, recognized for their diverse biological activities including anti-cancer properties. Both compounds are also known as modulators of various types of ion channels, including voltage-gated potassium channels, Kv1.3. These channels are widely expressed in normal and cancer tissues. Their activity is crucial in regulating cell proliferation and apoptosis in cells that express Kv1.3 channels. The potential clinical application of channel inhibitors may extend to treating cancers characterized by an overexpression of these channels. Methods: This study investigates the inhibitory effects of genistein and resveratrol on Kv1.3 channels expressed in the cancer cell line Jurkat T by applying a whole-cell patch clamp. Results: Applying both compounds at concentrations ranging from 3 μM to 90 μM leads to a dose-dependent inhibition of channel activity, reducing it to approximately 50% of the control level. This inhibitory effect was reversible and associated with a significant reduction in the activation rate. When combined with simvastatin, the inhibitory effect exhibited synergy; however, it was additive when co-applied with mevastatin. Conclusions: The channel inhibition may putatively be linked to the anti-cancer activities of these compounds on Kv1.3 channel-expressing cancer cells, especially when co-applied with the statins. Full article
24 pages, 2981 KB  
Article
Cudratricusxanthone A Exhibits Antitumor Activities Against NSCLC Harboring EGFR L792H and G796R Triple Mutations via Regulating EGFR-ERK/AKT/STAT3 Signaling
by Yinghao Wang, Jiamin Xian, Zhuoyi Wang, Jingmeng Wang, Ruohan Zhang, Jun Sheng, Jing Wang and Peiyuan Sun
Molecules 2026, 31(9), 1504; https://doi.org/10.3390/molecules31091504 - 30 Apr 2026
Abstract
Background: Acquired resistance to the third-generation EGFR tyrosine kinase inhibitor osimertinib, often mediated by EGFR triple mutations, poses a major clinical challenge in non-small cell lung cancer (NSCLC) treatment. Among these, some rare mutations, such as L858R/T790M/L792H and L858R/T790M/G796R, create steric hindrance that [...] Read more.
Background: Acquired resistance to the third-generation EGFR tyrosine kinase inhibitor osimertinib, often mediated by EGFR triple mutations, poses a major clinical challenge in non-small cell lung cancer (NSCLC) treatment. Among these, some rare mutations, such as L858R/T790M/L792H and L858R/T790M/G796R, create steric hindrance that directly interferes with osimertinib binding, yet effective targeted therapeutic strategies for these specific mutations remain lacking. Cudratricusxanthone A (CTXA), a natural xanthone derivative isolated from Cudrania tricuspidata Bur., has demonstrated various pharmacological activities, but its effects against EGFR triple-mutant NSCLC have not been systematically investigated. Methods: Stable Ba/F3 and NIH/3T3 cell lines expressing EGFR L858R/T790M/L792H or L858R/T790M/G796R triple mutations were generated via electroporation. The antiproliferative effects of CTXA were evaluated by MTT/MTS assays, colony formation, and wound healing assays. Cell cycle distribution and apoptosis were analyzed by flow cytometry. Protein expression of EGFR signaling pathway components (p-EGFR, p-ERK, p-AKT, p-STAT3) and cell cycle regulators (Cyclin D1, CDK4) were examined by Western blotting. Molecular docking and 200 ns molecular dynamics simulations were performed to investigate the stability and binding modes of CTXA to the mutant EGFR kinase domains. Results: The successfully established triple-mutant cell lines exhibited high EGFR expression, IL-3-independent growth, and significant resistance to osimertinib. CTXA inhibited the proliferation of all triple-mutant cell lines in a time- and concentration-dependent manner, with 48 h IC50 values ranging from 0.362 to 2.488 μM. Mechanistically, CTXA suppressed EGFR autophosphorylation and downregulated downstream p-ERK, p-AKT, and p-STAT3. CTXA induced G1 phase cell cycle arrest by downregulating Cyclin D1 and CDK4, significantly promoted apoptosis, and inhibited cell migration. Molecular docking revealed that while osimertinib binding was blocked by steric hindrance from His-792 or Arg-796, CTXA adapted to the mutated ATP-binding pockets through multiple hydrogen bonds and extensive hydrophobic interactions. Molecular dynamics simulations confirmed the stable binding of CTXA to both mutant EGFR proteins over the 200 ns simulations. Conclusions: This study demonstrates for the first time that the natural compound CTXA possesses antitumor efficacy against EGFR L858R/T790M/L792H and L858R/T790M/G796R mutants by regulating EGFR-ERK/AKT/STAT3 signaling. Our findings position CTXA as a promising lead compound for tackling this challenging form of acquired resistance and highlight the value of natural products in multi-target antitumor drug discovery. Full article
33 pages, 1983 KB  
Review
Danger or Salvation? The Role of DAMPs in Cancer Therapy
by Anna A. Vedunova, Evgenii L. Guryev, Sergey V. Gudkov, Tatiana A. Mishchenko and Maria V. Vedunova
Cancers 2026, 18(9), 1442; https://doi.org/10.3390/cancers18091442 - 30 Apr 2026
Abstract
Background: Modern oncology views immune system dysfunction as a key factor in carcinogenesis. The induction of immunogenic cell death (ICD), a form of regulated cell death capable of activating adaptive immunity, represents a promising therapeutic strategy. Damage-associated molecular patterns (DAMPs) play a central [...] Read more.
Background: Modern oncology views immune system dysfunction as a key factor in carcinogenesis. The induction of immunogenic cell death (ICD), a form of regulated cell death capable of activating adaptive immunity, represents a promising therapeutic strategy. Damage-associated molecular patterns (DAMPs) play a central role in this process. This review aims to summarize current knowledge of DAMPs, their release mechanisms during ICD, their classification, and their prognostic and therapeutic significance in antitumor immunity. Methods: We systematically reviewed and synthesized literature published in Pubmed and Google Scholar on ICD and DAMPs, focusing on distinct forms of DAMPs which were categorized based on recognition mechanisms (five classes) and cellular origin (extracellular, mitochondrial, nuclear, and cytosolic). Key molecules, their receptors, downstream signaling pathways, and clinical associations were analyzed. Results: The spatiotemporally coordinated release of the pattern of DAMPs promotes dendritic cell maturation, antigen presentation, activation of cytotoxic T lymphocytes, and elimination of tumor cells. DAMPs can exhibit a dual role: they are able to induce sterile inflammation essential for antitumor immunity, but may also contribute to metastasis and chronic inflammation. Among all DAMPs, high-mobility group box 1 (HMGB1, a nuclear DAMP) and calreticulin (CRT, a cytosolic protein) demonstrate the greatest prognostic value. Other DAMPs (e.g., extracellular matrix components, uric acid) act as signal amplifiers during various forms of cell death. Conclusions: Understanding the spatiotemporal dynamics of DAMP release is critical for activating immune responses against malignant cells. Monitoring DAMPs may improve patient stratification, predict therapeutic responses, and enable personalized immunotherapeutic strategies. Further investigation of ICD mechanisms and DAMP release represents a fundamental basis for developing novel anticancer therapies. Full article
(This article belongs to the Special Issue Cancer Cell Death and Immune Response)
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16 pages, 3168 KB  
Article
BmATG5, BmATG6 and BmATG8 Are Involved in Autophagy and Apoptosis During Metamorphosis Induced by Cadmium in Bombyx mori
by Cuijie Cui, Meihereayi Mutailifu, Maierhaba Sailaijiang, Xutong Wang, Yuning Zhang, Danni Chen and Kun Xie
Int. J. Mol. Sci. 2026, 27(9), 4036; https://doi.org/10.3390/ijms27094036 - 30 Apr 2026
Abstract
Cadmium (Cd) is a pervasive environmental contaminant with potent cytotoxic effects in a wide range of organisms. Although autophagy and apoptosis are recognized as major cellular responses to heavy metal stress, the molecular basis of Cd-induced cell death in insects remains insufficiently understood. [...] Read more.
Cadmium (Cd) is a pervasive environmental contaminant with potent cytotoxic effects in a wide range of organisms. Although autophagy and apoptosis are recognized as major cellular responses to heavy metal stress, the molecular basis of Cd-induced cell death in insects remains insufficiently understood. In this study, we used fifth-instar day-4 (5L4D) larvae of Bombyx mori and the silkworm-derived Bm-12 cell line to investigate the involvement of three core autophagy-related proteins, Bombyx mori Autophagy-related protein 5(BmATG5), Bombyx mori Autophagy-related protein 6(BmATG6), and Autophagy-related protein 8(BmATG8), in Cd-induced autophagy and apoptosis. Exposure to CdCl2 markedly induced autophagic and apoptotic responses in both larval midgut tissue and Bm-12 cells, as demonstrated by monodansylcadaverine(MDC) staining, Lyso-Tracker Red staining, DAPI and Hoechst 33258 staining, and DNA fragmentation assays. qPCR and Western blot analyses showed significant upregulation of BmATG5, BmATG6, and BmATG8 following Cd exposure. Notably, the cleaved forms tBmATG5-N (24 kDa) and tBmATG6-C (35 and 37 kDa), as well as the lipidated form BmATG8-PE (12 kDa), accumulated substantially under Cd stress. In parallel, intracellular Ca2+ levels and calpain activity were significantly increased, suggesting activation of a calcium-dependent regulatory pathway. Pharmacological inhibition experiments further indicated that autophagy and apoptosis are functionally interconnected during the Cd response. Collectively, these findings demonstrate that BmATG5, BmATG6, and BmATG8, together with their processed forms, play central roles in coordinating autophagy–apoptosis crosstalk during Cd-induced cytotoxicity in Bombyx mori. This study provides new mechanistic insight into heavy metal toxicity in insects and expands our understanding of stress-induced programmed cell death during silkworm metamorphosis. Full article
(This article belongs to the Section Molecular Biology)
14 pages, 448 KB  
Article
Variation in the Circulating Levels of Retinoic Acid and Type 2 Diabetes: Relationships with Glycemic Control Indices, Disease Treatment and Complications
by Aseel A. Alsaidan, Basil M. Alomair, Abdulrahman H. Almaeen, Jumanah M. Q. Aldirbas, Bdour R. S. Alanazi, Raghad H. S. Algaed, Alanoud F. B. Alruwaili, Nouf M. S. Alruwaili, Duna F. A. Aljbab, Lama A. A. Alenzi, Razan S. S. Albalawi, Alaa A. Mohamed and Tarek H. EL-Metwally
Diagnostics 2026, 16(9), 1359; https://doi.org/10.3390/diagnostics16091359 - 30 Apr 2026
Abstract
Background/Objectives: Type 2 diabetes mellitus (T2-DM) is a continuing national and global health challenge. Retinoic acid (RA), the major transcription-regulating ligand, plays a critical role in energy metabolism, and pancreatic β-cell homeostasis. However, human data linking circulating RA levels to T2-DM and its [...] Read more.
Background/Objectives: Type 2 diabetes mellitus (T2-DM) is a continuing national and global health challenge. Retinoic acid (RA), the major transcription-regulating ligand, plays a critical role in energy metabolism, and pancreatic β-cell homeostasis. However, human data linking circulating RA levels to T2-DM and its clinical outcomes are sparse and inconsistent. In this ethically approved cross-sectional study of consented hospital-diagnosed adult T2-DM patients (n = 292) and matched healthy controls (n = 64), variation in plasma RA levels and its relationship with disease and patient characteristics were investigated. Methods: RA concentrations assayed via specific ELISA were related to glycemic control indices [fasting blood glucose (FBG) and HbA1c], the triglyceride–glucose ratio for insulin resistance (TyG-IR), treatment modalities, and complications derived from patients’ medical records. Results: RA concentrations were substantially lower in patients with T2-DM (mean ± SD 2.63 ± 1.54 ng/mL) than in controls (5.21 ± 4.3 ng/mL; p < 0.001). Within the diabetic cohort, RA was inversely correlated with indices of glycemic dysregulation and insulin resistance. Plasma RA exhibited strong discriminatory performance for distinguishing diabetic patients from healthy adults. Its AUC is 0.870 (p < 0.0001 and 95% CI = 0.832–0.902) with a sensitivity of 79.7% and a specificity of 81.3%, at an optimal cutoff of ≤3.061 ng/mL. Conclusions: Circulating RA is associated with metabolic perturbations that define T2-DM, and therefore is promising as a clinically useful biomarker. It may reflect pathophysiological processes linking nutrient signaling, energy handling and β-cell function in T2-DM that merit further evaluation. Full article
(This article belongs to the Special Issue Advances in Modern Diabetes Diagnosis and Treatment Technology)
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