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20 pages, 400 KB  
Review
Toxicities of CAR-T, Bispecific Antibodies, and Antibody–Drug Conjugates in Multiple Myeloma: A Practical Approach to Risk Mitigation and Management
by Sereen Hej-Ali, Kyle Banwell, Halima Mohamed, Andrea Cervi, Adina Dass, Rasna Gupta, Caroline Hamm, Sindu Kanjeekal, Ian Strange Seguel, Morgan Szalay and Sahar Khan
Cancers 2026, 18(13), 2083; https://doi.org/10.3390/cancers18132083 (registering DOI) - 26 Jun 2026
Abstract
B-cell maturation antigen (BCMA), G protein-coupled receptor class C group 5 member D (GPRC5D)-directed immunotherapies, chimeric antigen receptor T-cell (CAR-T) products, bispecific T-cell engagers (BsAbs), and antibody–drug conjugates (ADCs), have transformed the management of MM. Their adoption is now extending beyond tertiary centers [...] Read more.
B-cell maturation antigen (BCMA), G protein-coupled receptor class C group 5 member D (GPRC5D)-directed immunotherapies, chimeric antigen receptor T-cell (CAR-T) products, bispecific T-cell engagers (BsAbs), and antibody–drug conjugates (ADCs), have transformed the management of MM. Their adoption is now extending beyond tertiary centers following FDA modifications for CAR-T safety and the rapid uptake of off-the-shelf bispecifics suitable for community delivery. Clinicians outside specialist hubs must therefore be conversant with the full toxicity spectrum, including rare but high-consequence events, both for informed consent and for the work-up of post-therapy complications. In this narrative review, we report on the published literature around toxicities of approved and investigational BCMA- and GPRC5D-directed therapies, drawing on pivotal trial data, real-world cohorts, pharmacovigilance studies, and consensus management recommendations, with emphasis on practical recognition and risk mitigation. This review presents toxicities by a temporal pattern including acute (CRS, ICANS, infection, ocular, mucocutaneous), subacute (cranial nerve palsies, parkinsonism, myelitis, peripheral neuropathies IEC-associated enterocolitis and cardiovascular events), and long-term (prolonged cytopenias, second primary malignancies). We discuss validated risk stratification tools, such as the CAR-HEMATOTOX score, EASIX index, and multidisciplinary geriatric assessment, which predicts severe ICANS, infection, and resource utilization, supporting individualized pre-treatment planning. Safe delivery of immune therapies in community settings requires infrastructure for acute critical care, neurology, ophthalmology, infectious disease and long-term surveillance, but is achievable when paired with validated risk stratification and clear referral pathways. Full article
(This article belongs to the Special Issue Myeloma: Pathogenesis and Targeted Therapies)
30 pages, 9740 KB  
Article
Nocturnal Dim Blue Light Is Associated with Splenic Immune Dysregulation and Altered CORT-GR Signalling in High-Fat-Diet-Fed Mice
by Huairuo Shi, Qingyun Guan, Zixu Wang, Jing Cao, Yulan Dong and Yaoxing Chen
Antioxidants 2026, 15(7), 800; https://doi.org/10.3390/antiox15070800 (registering DOI) - 26 Jun 2026
Abstract
Artificial light at night (ALAN) has emerged as a pervasive environmental stressor that disrupts immune homeostasis. This study examined the association between nocturnal dim blue light (dBL) exposure and splenic immune alterations, with particular attention to the corticosterone-glucocorticoid receptor, or CORT-GR, signalling pathway [...] Read more.
Artificial light at night (ALAN) has emerged as a pervasive environmental stressor that disrupts immune homeostasis. This study examined the association between nocturnal dim blue light (dBL) exposure and splenic immune alterations, with particular attention to the corticosterone-glucocorticoid receptor, or CORT-GR, signalling pathway in a high-fat diet-fed mouse model. Male C57BL/6 mice were exposed to dBL (~5 lx) during the dark phase for 12 weeks while maintained on a high-fat diet (HFD). Chronic dBL exposure was associated with splenic atrophy, impaired splenocyte proliferative responses, elevated circulating CORT, and increased splenic GR expression. dBL exposure also coincided with increased NF-κB activation, reduced Nrf2/HO-1 signalling, oxidative stress, and cytokine imbalance in the spleen. Furthermore, in an independent pharmacological cohort, inhibition of CORT synthesis or GR signalling partially attenuated these alterations. Together, these findings suggest that, within an HFD-fed mouse model, dBL exposure is associated with splenic redox-inflammatory imbalance and impaired proliferative responses, a process to which dysregulated CORT-GR signalling appears to contribute. Full article
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22 pages, 1330 KB  
Systematic Review
Vitamin D Supplementation, Total Testosterone, and Androgen Bioavailability Markers in Adult Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Loreto Paez-Allendes, Juan José Valenzuela-Fuenzalida, María P. Moya, Gustavo Oyanedel, Gloria Cifuentes-Suazo, Julio Figueroa-Puig, Mathias Orellana-Donoso, Eduardo Mateluna-Valls, Juan Jose Cabezas-Salgado, Juan Sanchis-Gimeno and Alejandro Bruna-Mejias
Nutrients 2026, 18(13), 2090; https://doi.org/10.3390/nu18132090 (registering DOI) - 26 Jun 2026
Abstract
Background: Vitamin D has traditionally been recognized for its role in calcium homeostasis and skeletal health, but vitamin D receptor expression and vitamin D-metabolizing enzymes have also been identified in extra-skeletal tissues, including components of the male reproductive tract. Observational evidence has suggested [...] Read more.
Background: Vitamin D has traditionally been recognized for its role in calcium homeostasis and skeletal health, but vitamin D receptor expression and vitamin D-metabolizing enzymes have also been identified in extra-skeletal tissues, including components of the male reproductive tract. Observational evidence has suggested associations between vitamin D status and androgen-related markers; however, whether vitamin D supplementation has a measurable effect on androgen bioavailability remains uncertain. Objective: This systematic review and meta-analysis evaluated the effects of vitamin D supplementation on total testosterone (TT) and androgen bioavailability markers in adult men, including sex hormone-binding globulin (SHBG), free androgen index (FAI), calculated free testosterone (calculated FT), and bioactive testosterone (BAT) where methodologically compatible. Methods: The review was registered in PROSPERO (CRD420261365005) and conducted according to PRISMA 2020 and Cochrane methodological guidance. Searches were conducted from database inception to April 2026 in PubMed, Web of Science, Scopus, ClinicalTrials.gov, and the WHO ICTRP. Embase was initially planned but was not searched because institutional access was unavailable; this amendment was made before screening, extraction, risk-of-bias assessment, and synthesis. Records were deduplicated in Zotero, screened in a structured matrix, and converted from report-level records into independent comparison-level datasets where appropriate. Meta-analyses used random-effects REML models with Hartung–Knapp adjustment. Results: The official search set comprised 2854 records, of which 703 duplicates were removed, leaving 2151 records for title and abstract screening. The full-text screening file was reconciled to 162 PRISMA-countable reports/records: 135 reports were assessed, 27 reports could not be assessed because the full text was unavailable or had not been obtained for review, and 27 reports/studies were retained for qualitative synthesis. Eighteen reports were considered candidate sources for quantitative synthesis and were operationalized into 21 comparison-level records. The primary TT model included 11 comparisons and showed no clear effect of vitamin D supplementation on final TT (MD 0.47 nmol/L, 95% CI −0.50 to 1.44; I2 = 24.1%). No clear effects were observed for SHBG (MD 0.27 nmol/L, 95% CI −2.14 to 2.68), FAI (MD −0.37, 95% CI −4.28 to 3.55), calculated FT sensitivity evidence (MD −0.0096 nmol/L, 95% CI −0.0525 to 0.0332), or BAT exploratory evidence (MD −0.47 nmol/L, 95% CI −1.77 to 0.83). GRADE certainty was low for TT, SHBG, and FAI, and very low for calculated FT and BAT. Conclusions: Current randomized evidence does not demonstrate a statistically clear or reproducible effect of vitamin D supplementation on total testosterone or androgen bioavailability markers in adult men. GRADE certainty was low for total testosterone, SHBG, and FAI, and very low for calculated free testosterone and bioactive testosterone. Because directly measured and calculated free testosterone are not analytically equivalent, free testosterone was not pooled as a primary outcome; method-compatible calculated FT was handled as sensitivity evidence and BAT as exploratory evidence. Full article
(This article belongs to the Special Issue Vitamins and Human Health: 3rd Edition)
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22 pages, 3920 KB  
Review
Vitamin D Signaling in Neurodegenerative Disorders: Mechanisms, Therapeutic Potential, and Clinical Implications
by Naveen Soni, Nabendu Debnath, Ella Rekapally, Ayaan Jabbar, Suresh C. Tyagi, Bhawana Bissa and Neetu Tyagi
Nutrients 2026, 18(13), 2082; https://doi.org/10.3390/nu18132082 (registering DOI) - 25 Jun 2026
Abstract
Vitamin D has long been recognized for its role in calcium homeostasis and bone metabolism; however, it is now emerging as an important regulator of central nervous system (CNS) function. Recent evidence suggests that vitamin D signaling contributes to the pathogenesis and progression [...] Read more.
Vitamin D has long been recognized for its role in calcium homeostasis and bone metabolism; however, it is now emerging as an important regulator of central nervous system (CNS) function. Recent evidence suggests that vitamin D signaling contributes to the pathogenesis and progression of several neurodegenerative disorders. Vitamin D exerts neuroprotective effects through multiple mechanisms, including regulation of calcium homeostasis, modulation of immune responses, reduction in oxidative stress, stimulation of neurotrophic factors, and maintenance of blood–brain barrier (BBB) integrity. Vitamin D receptors and metabolizing enzymes are widely distributed across several brain regions, highlighting their direct involvement in neuronal function. This review summarizes the biosynthesis, metabolism, and signaling pathways of vitamin D. It explores its role in neurodegenerative diseases such as Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), stroke, and traumatic brain injury (TBI). Evidence from experimental and clinical studies indicates that vitamin D deficiency is associated with an increased risk and severity of these conditions, while supplementation may provide therapeutic benefits. Full article
(This article belongs to the Special Issue Impacts of Nutrition on Cognitive Function and Nervous System Health)
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20 pages, 4461 KB  
Article
Immunogenetic and Transcriptomic Evidence Implicating the NKG2D-MICA/MICB Axis in CALR-Mutated Myeloproliferative Neoplasms
by Velizar Shivarov, Gergana Tsvetkova, Ilina Micheva, Evgueniy Hadjiev, Jasmina Petkova, Galia Madjarova and Milena Ivanova
Cancers 2026, 18(13), 2052; https://doi.org/10.3390/cancers18132052 (registering DOI) - 24 Jun 2026
Abstract
Background/Objectives: Immune surveillance is increasingly recognized as a modifier of myeloproliferative neoplasm (MPN) initiation and evolution, yet the contribution of the NKG2D receptor and its ligands MICA/MICB to CALR-mutated disease remains unclear. Methods: We performed high-resolution next-generation sequencing genotyping of MICA and MICB [...] Read more.
Background/Objectives: Immune surveillance is increasingly recognized as a modifier of myeloproliferative neoplasm (MPN) initiation and evolution, yet the contribution of the NKG2D receptor and its ligands MICA/MICB to CALR-mutated disease remains unclear. Methods: We performed high-resolution next-generation sequencing genotyping of MICA and MICB in 43 patients with CALR-mutated MPN (WHO 2022 criteria) and compared the allele and haplotype distributions with those of 156 healthy Bulgarian controls and 85 patients with JAK2 V617F-positive MPN. Associations were tested using age- and sex-adjusted additive generalized linear models; bi-locus haplotypes were evaluated using haplotype score methods. In a genotyped subgroup (35 CALR-mutated MPN patients and 105 controls), functional KLRK1 (NKG2D) polymorphisms were analyzed for haplotype-level associations. We also performed 700 ns molecular dynamics simulations of selected MICA variants in complex with NKG2D and reanalyzed publicly available single-cell RNA-sequencing data (GSE117826) and RNA-sequencing data from CRISPR/Cas9-edited CALR-mutant iPSC-derived megakaryocytes to evaluate MICA/MICB expression. Results: MICA*004:001 was significantly associated with CALR-mutated MPN versus controls (p = 0.004; Bonferroni-adjusted p = 0.047), while MICB*008:001 showed only nominal association. Exploratory haplotype analyses identified a MICA*009:01-MICB*004:001 haplotype associated with CALR-mutated status (p = 0.008) and a KLRK1 G-A-G-T haplotype (rs1049174-rs2617160-rs2246809-rs2617170) associated with increased CALR-mutated MPN risk (OR = 3.61; p = 0.029). Transcriptomic reanalysis indicated a higher fraction of CALR-mutant stem and progenitor cells expressing detectable MICA/MICB transcripts, and heterozygous CALR-mutant megakaryocytes exhibited higher MICA expression than the wild type. Conclusions: Together, these data support an exploratory immunogenetic and transcriptomic link between the NKG2D-MICA/MICB axis and CALR-mutated MPN, but direct protein-level and functional studies are required before mechanistic or therapeutic conclusions can be drawn. Full article
10 pages, 469 KB  
Article
Is Virulence Gene papGII a Predictor of Urosepsis in Uropathogenic E. coli?
by Nihitta Hanna, Suji Thangamani, Rosemol Varghese, Jiji Smila Arockiasamy, Balaji Veeraraghavan and Rani Diana Sahni
Infect. Dis. Rep. 2026, 18(4), 63; https://doi.org/10.3390/idr18040063 (registering DOI) - 24 Jun 2026
Viewed by 46
Abstract
Background: Urosepsis is a life-threatening condition accounting for approximately 20–30% of all sepsis cases and typically arises from ascending infection by uropathogenic Escherichia coli (UPEC). Disease progression is mediated by virulence factors, including adhesins, iron acquisition systems, and toxins. Among these, P fimbriae, [...] Read more.
Background: Urosepsis is a life-threatening condition accounting for approximately 20–30% of all sepsis cases and typically arises from ascending infection by uropathogenic Escherichia coli (UPEC). Disease progression is mediated by virulence factors, including adhesins, iron acquisition systems, and toxins. Among these, P fimbriae, particularly papGII adhesin subunit, have been implicated in the transition from uncomplicated urinary tract infection (UTI) to severe urosepsis. This study aimed to evaluate whether papGII carriage, alone or in combination with other UPEC virulence determinants and clinical risk factors, can predict urosepsis. Methods: A total of 60 paired Escherichia coli isolates from concurrent blood and urine samples of adults with clinical sepsis were collected between January and June 2024. Control isolates were obtained from patients with cystitis (n = 28) and pyelonephritis (n = 32). Polymerase chain reaction (PCR) assays were used to detect fifteen virulence-associated genes, including the pap operon (with papG allelic variants), the type 1 fimbriae (fimH), S fimbriae (sfaS), curli fimbriae (csgA), afa/Dr adhesin operon genes, cytotoxic necrotizing factor 1 (cnf1), and the aerobactin biosynthesis (iucD) and receptor (iutA) genes. Associations between gene carriage and clinical groups were analyzed using chi-square tests. Results: The incidence of urosepsis increased with age, peaking in the 60–69-year age group. Renal disease and catheterization were identified as significant risk factors (p < 0.05). More than 95% of UPEC isolates carried the csgA gene associated with biofilm formation and the iucD gene. The α- hemolysin toxin (hlyA) was significantly associated with urosepsis [X2(1, N = 120) = 6.62, p = 0.03]. No significant differences were observed in the carriage of papA, papC, or fimH. Although papGII was present in 65% of urosepsis-associated UPEC isolates, it did not demonstrate a statistically significant independent association with urosepsis [p = 0.1]. Conclusion: This study demonstrates that while papGII may contribute to the pathogenic potential of UPEC and facilitate systemic infection, it is not a reliable independent predictor of urosepsis. Full article
(This article belongs to the Section Bacterial Diseases)
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23 pages, 2344 KB  
Review
Role of NLRP3 Inflammasome Inhibitors in Endothelial Dysfunction and Vascular Repair
by Thangasrinivasan Samyuktha, Sridharan Yukta, Kumar Ganesan and Kunka Mohanram Ramkumar
Antioxidants 2026, 15(7), 784; https://doi.org/10.3390/antiox15070784 (registering DOI) - 24 Jun 2026
Viewed by 52
Abstract
Endothelial dysfunction (ED) is an early event in cardiovascular and metabolic diseases, including atherosclerosis, diabetes, and hypertension. Emerging evidence highlights the interplay between chronic inflammation and oxidative stress, collectively termed OxInflammation, as a major driver of vascular injury and impaired tissue repair. Among [...] Read more.
Endothelial dysfunction (ED) is an early event in cardiovascular and metabolic diseases, including atherosclerosis, diabetes, and hypertension. Emerging evidence highlights the interplay between chronic inflammation and oxidative stress, collectively termed OxInflammation, as a major driver of vascular injury and impaired tissue repair. Among the key mediators of this response is the Nod like receptor family pyrin domain containing 3 (NLRP3) inflammasome, a multiprotein complex that promotes the release of inflammatory cytokines, including Interleukin 1β (IL-1β) and Interleukin-18 (IL-18), and induces gasdermin D-mediated pyroptotic cell death. Activation of NLRP3 disrupts endothelial function, reduces nitric oxide availability, and accelerates vascular inflammation and injury. This review discusses current evidence on pharmacological strategies targeting NLRP3 inflammasome signaling using both natural and synthetic inhibitors. Studies have shown that inhibiting NLRP3 can reduce inflammation and oxidative stress, preserve endothelial integrity, improve vascular function, and support tissue repair. Several NLRP3-targeting compounds have advanced into early-phase clinical trials, showing encouraging safety profiles and efficacy in individuals with cardiovascular risk factors. By integrating the emerging concept of OxInflammation with endothelial dysfunction, this review critically evaluates the therapeutic and translational potential of NLRP3 inflammasome inhibition in cardiovascular and metabolic disorders. Collectively, the available evidence supports NLRP3 as a promising therapeutic target for restoring endothelial homeostasis and promoting vascular repair. However, further clinical studies are needed to establish long-term efficacy, optimal dosing strategies, and appropriate patient selection criteria. Full article
(This article belongs to the Special Issue The OxInflammation Process and Tissue Repair)
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14 pages, 560 KB  
Article
Low-Frequency PPM1D Gene Mutations Affect Treatment Response to BCMA-Targeted CAR T-Cell Therapy in Multiple Myeloma
by Katharina van der Weg, Martina Bertschinger, Ulrike Bacher, Michele Hoffmann, Henning Nilius, Katja Seipel and Thomas Pabst
Cancers 2026, 18(13), 2032; https://doi.org/10.3390/cancers18132032 (registering DOI) - 23 Jun 2026
Viewed by 94
Abstract
Background: BCMA-targeted Chimeric Antigen Receptor (CAR) T-cell therapy has revolutionized the treatment of Relapsed/Refractory Multiple Myeloma (RRMM). However, the disease is not curable and progression after CAR T-cell treatment remains a challenge. Clonal hematopoiesis, specifically mutations in the DNA damage response gene [...] Read more.
Background: BCMA-targeted Chimeric Antigen Receptor (CAR) T-cell therapy has revolutionized the treatment of Relapsed/Refractory Multiple Myeloma (RRMM). However, the disease is not curable and progression after CAR T-cell treatment remains a challenge. Clonal hematopoiesis, specifically mutations in the DNA damage response gene PPM1D, has been linked to therapy resistance and inferior survival in lymphoma patients undergoing cellular therapy. The impact of PPM1D mutations on MM patient outcome after CAR T-cell therapy remains undefined. Methods: We conducted a retrospective single-center study of 83 patients with RRMM patients treated with idecabtagene vicleucel or ciltacabtagene autoleucel between 2022 and 2025. Next-generation sequencing was performed on peripheral blood mononuclear cells collected prior to CAR T-cell infusion to identify PPM1D exon 6 mutations (variant allele frequency > 0.01). We analyzed associations between mutational status, clinical characteristics, toxicity, and survival. Results: PPM1D mutations were detected in 14.5% (12/83) of patients. PPM1D-mutated patients had fewer prior autologous stem cell transplantation compared to wild-type patients (50% vs. 82%, p = 0.02) and presented more advanced disease burden and adverse prognostic features (R-ISS stage III 58% vs. 20%, p = 0.05). Notably, PPM1D status did not impact initial efficacy; complete remission rates were comparable between groups (67% vs. 69%). However, PPM1D mutations were significantly associated with inferior progression-free survival (PFS) (median PFS: 6 months vs. 16 months, p = 0.04). Regarding toxicity, the mutated subgroup exhibited significantly higher rates of grade ≥2 cytokine release syndrome and a trend toward increased neurotoxicity (25% vs. 7%). Conclusions: PPM1D clonal hematopoiesis is frequent in RRMM and despite deep initial responses, patients harboring PPM1D mutations face a significantly higher risk of early relapse. PPM1D mutations may serve as a biomarker for poor durability of response and should be further evaluated in larger, prospective trials. Full article
(This article belongs to the Special Issue CAR T-Cell Therapy and Multiple Myeloma)
15 pages, 805 KB  
Article
Site-Specific Responses to SERM Treatment in Postmenopausal Osteoporosis: No Clear Age Attenuation in a Real-World Study
by Takashi Nagai, Eriko Hoshi, Koji Ishikawa, Koki Tsuchiya, Soji Tani, Yusuke Dodo, Keizo Sakamoto, Nobuyuki Kawate and Yoshifumi Kudo
Medicina 2026, 62(7), 1220; https://doi.org/10.3390/medicina62071220 (registering DOI) - 23 Jun 2026
Viewed by 123
Abstract
Background: Selective estrogen receptor modulators (SERMs) are widely used for postmenopausal osteoporosis, yet whether treatment response attenuates with aging in routine practice remains unclear. We examined age- and site-specific responses to SERM therapy. Methods: We retrospectively analyzed postmenopausal women with primary [...] Read more.
Background: Selective estrogen receptor modulators (SERMs) are widely used for postmenopausal osteoporosis, yet whether treatment response attenuates with aging in routine practice remains unclear. We examined age- and site-specific responses to SERM therapy. Methods: We retrospectively analyzed postmenopausal women with primary osteoporosis treated with a SERM for 1 year (2017–2021). Participants were stratified by age (50–64, 65–74, and ≥75 years). We evaluated changes in bone mineral density (BMD) at the lumbar spine (L2–4) and femoral neck and changes in urinary NTX and serum BAP. Multivariable linear regression modeled BMD change ratios (1-year/baseline) adjusting for baseline site-specific BMD, estimated glomerular filtration rate (eGFR), and active vitamin D co-therapy (none, alfacalcidol, or eldecalcitol). The primary endpoint was the 1-year change in lumbar spine BMD; secondary endpoints included femoral neck BMD and bone turnover markers. Results: Lumbar spine BMD increased significantly across all age groups, whereas femoral neck BMD increased significantly only in women aged 50–64 years. However, BMD change ratios did not differ among age groups at either site. In adjusted models, age was not independently associated with BMD change at the lumbar spine or femoral neck. Lower baseline BMD predicted larger relative gains at both sites, and eldecalcitol co-therapy was independently associated with femoral neck BMD response. Conclusions: In real-world practice, BMD changes observed during SERM treatment were site-specific rather than clearly age-dependent. Lumbar spine BMD improved across age groups, whereas femoral neck changes were smaller and less consistent. Full article
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19 pages, 2376 KB  
Article
Transcriptomic Analysis Reveals Molecular Mechanisms of Fleeing, Adhesion, and Thanatosis Patterns in Sea Cucumber Apostichopus japonicus
by Guo Wu, Hengye Wu, Xiajing Wang, Qiang Gao and Chong Zhao
Biology 2026, 15(12), 975; https://doi.org/10.3390/biology15120975 (registering DOI) - 22 Jun 2026
Viewed by 170
Abstract
Sea cucumbers (Apostichopus japonicus) show fleeing, adhesion, and thanatosis patterns upon exposure to various stressors. However, the molecular mechanisms underlying these contrasting stress response patterns remain largely unknown. In the present study, we performed a transcriptomic analysis of coelomocytes on stressed [...] Read more.
Sea cucumbers (Apostichopus japonicus) show fleeing, adhesion, and thanatosis patterns upon exposure to various stressors. However, the molecular mechanisms underlying these contrasting stress response patterns remain largely unknown. In the present study, we performed a transcriptomic analysis of coelomocytes on stressed sea cucumbers to elucidate the potential molecular mechanisms. The RNA-seq results revealed that several matrix metalloproteinase (MMP) family genes, along with HTR4, HRH2, and ADRA1D (which are involved in neuroactive ligand–receptor interactions), were significantly upregulated in the fleeing pattern. These genes may facilitate rapid movement. In the adhesion pattern, PHKA and PGK were significantly downregulated, and the differentially expressed genes (DEGs) were significantly enriched in the longevity regulating pathway, accompanied by downregulation of KRAS and HSPA1. These genes and the pathway may be involved in the reallocation of energy resources during the adhesion pattern. In the thanatosis pattern, DEGs were significantly enriched in the MAPK signaling pathway (including upregulation of ANGPT1 and FGFR1) and in the Rap1 and Ras signaling pathways (with downregulation of key genes: RAPGEF4, RRAS2, and RaLA). These genes potentially contribute to sustaining the thanatosis pattern. These transcriptomic profiles provide novel insights into the distinct molecular signatures underlying each stress response pattern in A. japonicus. Full article
(This article belongs to the Special Issue Metabolic and Stress Responses in Aquatic Animals (2nd Edition))
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18 pages, 667 KB  
Review
1α,25(OH)2 Vitamin D3 Signaling in Adipose Tissue: Bridging Classical and Non-Classical Pathways in Metabolic Regulation Complexity
by Alice Lima Rosa Mendes, Paola Miranda Sulis, Murilo Ferenz, Bruna Antunes Zaniboni, Marcela Aragón, Guilherme Brasil Pintarelli, Daniela Ota Hisayasu Suzuki, Carine Royer and Fátima Regina Mena Barreto Silva
Nutrients 2026, 18(12), 2026; https://doi.org/10.3390/nu18122026 (registering DOI) - 22 Jun 2026
Viewed by 218
Abstract
Background: Adipose tissue is increasingly recognized as a highly dynamic endocrine and immunometabolic organ with marked functional heterogeneity. It serves as a reservoir for the active form of vitamin D3, 1α,25-dihydroxyvitamin D3 or calcitriol (1α,25-D3), since it expresses [...] Read more.
Background: Adipose tissue is increasingly recognized as a highly dynamic endocrine and immunometabolic organ with marked functional heterogeneity. It serves as a reservoir for the active form of vitamin D3, 1α,25-dihydroxyvitamin D3 or calcitriol (1α,25-D3), since it expresses enzymes responsible for its activation and inactivation and contains the vitamin D receptor (VDR). Through both classical and non-classical mechanisms, calcitriol modulates adipocyte proliferation and differentiation, protein expression and energy metabolism. This review aims to explore the signal transduction mechanisms of calcitriol in adipocytes, detailing the classical pathways mediated by the nuclear VDR (VDRn), as well as non-classical pathways involving membrane-associated VDR (VDRm), microRNAs, AMP-activated protein kinase (AMPK), and sirtuin 1 (SIRT1). Methods: A literature search was conducted using PubMed, ScienceDirect, and MDPI-indexed journals, prioritizing studies published within the last 10 years to ensure the inclusion of up-to-date evidence. Results: This review summarizes current knowledge on both classical and non-classical signaling pathways that are activated by calcitriol and highlights key molecular targets with potential relevance for drug development and therapeutic intervention. Through VDRn, calcitriol regulates the expression of proteins involved in inflammation and energy metabolism. Additionally, it modulates cellular processes such as energy production and secretion via the AMPK/SIRT1 axis and microRNA-mediated pathways, contributing to mitochondrial function and metabolic homeostasis. Conclusions: Calcitriol plays a central role in adipocyte biology by integrating multiple signaling pathways that regulate metabolic and inflammatory responses. These mechanisms highlight its potential as a therapeutic target and biomarker in metabolic diseases. Moreover, microRNAs emerge as critical posttranscriptional regulators in these processes, reinforcing their relevance as both biomarkers and targets for future interventions. Full article
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14 pages, 3688 KB  
Article
Parathyroid Hormone Modifies the Effect of Vitamin D Supplementation on Risk of Relapse or Death in Patients with Digestive Tract Cancer: A Post Hoc Subgroup Analysis of the AMATERASU Randomized Clinical Trial
by Akitaka Sasaki, Taisuke Akutsu, Hironori Ohdaira, Yutaka Suzuki, Ken Eto and Mitsuyoshi Urashima
Cancers 2026, 18(12), 2015; https://doi.org/10.3390/cancers18122015 (registering DOI) - 22 Jun 2026
Viewed by 124
Abstract
Background/Objectives: Parathyroid hormone (PTH), which rises compensatory with vitamin D insufficiency and has been shown to down-regulate vitamin D receptor expression, represents a biologically plausible effect modifier. We investigated whether pretreatment serum PTH modifies the effect of postoperative vitamin D supplementation on [...] Read more.
Background/Objectives: Parathyroid hormone (PTH), which rises compensatory with vitamin D insufficiency and has been shown to down-regulate vitamin D receptor expression, represents a biologically plausible effect modifier. We investigated whether pretreatment serum PTH modifies the effect of postoperative vitamin D supplementation on relapse-free survival, and whether adding tumor p53 status further refines subgroup identification in an exploratory analysis. Methods: This post hoc analysis utilized data from the AMATERASU trial (UMIN000001977), a single-center, randomized, double-blind, placebo-controlled trial evaluating vitamin D3 (2000 IU/day) versus placebo in patients with curatively resected stage I–III digestive tract cancers (maximum follow-up, 7.5 years). Patients were dichotomized at the cohort median PTH (41 pg/mL). The primary outcome was relapse-free survival (RFS), analyzed using multivariable Cox proportional hazards models. Results: Of 417 randomized patients, 410 had baseline PTH data. In the lower PTH subgroup (≤41 pg/mL), vitamin D significantly improved RFS compared with placebo (fully adjusted hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.24–0.81; p = 0.008). Conversely, no benefit was observed in the higher PTH subgroup (>41 pg/mL; fully adjusted HR, 1.25; 95% CI, 0.64–2.44; p for interaction = 0.016). Exploratory stratification of 365 patients with p53 data showed that the supplementation benefit appeared greatest in patients with both low PTH (≤41 pg/mL) and p53-positive tumors (fully adjusted HR, 0.38; 95% CI, 0.18–0.78; p = 0.009). Conclusions: Pretreatment serum PTH is a candidate effect modifier of postoperative vitamin D supplementation in digestive tract cancers. Full article
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15 pages, 899 KB  
Article
Enzalutamide Versus Abiraterone After Docetaxel in Metastatic Castration-Resistant Prostate Cancer: Real-World Outcomes and Exploratory Prognostic Stratification
by Mert Tohumcuoğlu, Tolga Köşeci, Alpay Düşgün, Abdullah Evren Yetişir, Cem Mirili, Burak Mete and Mahmut Büyükşimşek
J. Clin. Med. 2026, 15(12), 4816; https://doi.org/10.3390/jcm15124816 (registering DOI) - 21 Jun 2026
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Abstract
Background/Objectives: Enzalutamide and abiraterone acetate are commonly used androgen receptor pathway inhibitors in metastatic castration-resistant prostate cancer (mCRPC), including after docetaxel. However, real-world outcomes remain heterogeneous, and simple prognostic markers may help describe this variability. This study aimed to describe survival outcomes with [...] Read more.
Background/Objectives: Enzalutamide and abiraterone acetate are commonly used androgen receptor pathway inhibitors in metastatic castration-resistant prostate cancer (mCRPC), including after docetaxel. However, real-world outcomes remain heterogeneous, and simple prognostic markers may help describe this variability. This study aimed to describe survival outcomes with enzalutamide and abiraterone acetate after docetaxel and to explore the prognostic value of a routine clinical-inflammatory risk classification. Methods: This retrospective single-center study included 136 patients with mCRPC treated with enzalutamide or abiraterone acetate after docetaxel. A composite risk classification was defined using four routinely available variables: pan-immune-inflammation value (PIV) > 457.99, time to castration resistance < 12 months, baseline hemoglobin ≤ 12 g/dL, and Gleason score ≥ 8. One point was assigned for each adverse factor, and patients were classified as low, moderate, or high risk. Overall survival (OS) was assessed using Kaplan–Meier estimates and Cox regression. The prognostic score and Cox regression-based nomogram were evaluated as exploratory tools. Results: Of the 136 patients, 8 (5.9%) were classified as low risk, 67 (49.3%) as moderate risk, and 61 (44.9%) as high risk. Median OS was not reached in the low-risk group, compared with 33.84 months in the moderate-risk group and 9.66 months in the high-risk group. In multivariable analysis, high-risk status was independently associated with worse OS (HR = 9.87; 95% CI: 2.38–40.92; p = 0.002). No statistically significant OS difference was observed between enzalutamide and abiraterone acetate in this non-randomized cohort (HR = 1.36; 95% CI: 0.90–2.06; p = 0.142). Conclusions: In this real-world post-docetaxel mCRPC cohort, no statistically significant OS difference was observed between enzalutamide and abiraterone acetate; however, the study was not designed to establish comparative effectiveness or therapeutic equivalence. The exploratory risk classification based on routine clinical and inflammatory variables was associated with distinct survival outcomes. External validation is required before clinical application. Full article
(This article belongs to the Section Oncology)
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18 pages, 5557 KB  
Article
Super-Resolution 3D Imaging Reveals Disarray of Dyadic Calcium Ion Channels in Failing Hearts Expressing Low Thyroid Hormone Function
by Atieh Ashkezari, Megha Schmalzle, Amanda Charest, Sanketh Kumar, Riddhi Modi, Nicholas Nasta, Andrea Bertolini, Alessandro Saba, Paolo Cifani, Youhua Zhang, A. Martin Gerdes, Randy F. Stout and Kaie Ojamaa
Int. J. Mol. Sci. 2026, 27(12), 5601; https://doi.org/10.3390/ijms27125601 (registering DOI) - 21 Jun 2026
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Abstract
Ventricular remodeling occurring in heart failure (HF) involves structural disarray of the sarcolemma T-tubule (TT)–sarcoplasmic reticulum (SR) dyad junctions, thereby disrupting the close apposition of L-type Ca2+ channels (CaV1.2) with ryanodine receptors (RyR2) that trigger SR Ca2+ release and [...] Read more.
Ventricular remodeling occurring in heart failure (HF) involves structural disarray of the sarcolemma T-tubule (TT)–sarcoplasmic reticulum (SR) dyad junctions, thereby disrupting the close apposition of L-type Ca2+ channels (CaV1.2) with ryanodine receptors (RyR2) that trigger SR Ca2+ release and myofilament contraction. In a rat ischemic heart failure model expressing low thyroid hormone (TH) function, we used 3D stochastic optical reconstruction microscopy (STORM) to image RyR2 clusters with CaV1.2 channels, and the associated protein junctophilin-2 (Jph2). We tested whether treatment with T3, the biologically active form of TH, throughout progression of the disease would preserve T-tubule structure and dyadic ion channel organization. Confocal microscopy of isolated cardiomyocytes (CMs) stained with ANEPPS membrane dye showed significantly decreased TT density in diseased CMs while T3 treatment attenuated TT disorganization. 3D STORM images of dyadic ion channels labeled with fluorescent-tagged antibodies to RyR-Dylight550, Jph-CF647 and CaV1.2/IgG-Dylight488 were captured. A density-based algorithm defined RyR2 clusters, and a 400 nm spherical 3D volume of interest around each RyR2 cluster’s centroid determined the number of CaV1.2 and Jph2 localizations associated with each RyR2 cluster. Analysis revealed significant reduction in RyR2 cluster size and number with reduced co-localized Jph2 in failing CMs. T3 treatment increased RyR2 cluster numbers and cluster volumes albeit non-significantly, with increased co-clustering of Jph2. The number of CaV1.2 co-localized with RyR2 clusters trended lower in the failing CMs. These results support maintaining TH homeostasis in optimizing the nanoscale organization of Ca2+ ion channels in triggering Ca2+ release and myofibrillar contraction in patients with heart disease. Full article
(This article belongs to the Special Issue The Role of Ion Channels in Health and Disease)
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11 pages, 4603 KB  
Article
IL-13Rα2 Regulates C2C12 Myoblast Proliferation via the Akt–Cyclin D1–CDK4 Pathway
by Mitsutoshi Kurosaka and Kazuhisa Kohda
Int. J. Mol. Sci. 2026, 27(12), 5600; https://doi.org/10.3390/ijms27125600 (registering DOI) - 21 Jun 2026
Viewed by 160
Abstract
Interleukin-13 receptor α2 (IL-13Rα2) has traditionally been considered a decoy receptor; however, its cellular functions beyond the immune system remain unclear. We aimed to investigate the role of IL-13Rα2 in C2C12 myoblast proliferation and differentiation. IL-13Rα2 expression was knocked down in C2C12 cells [...] Read more.
Interleukin-13 receptor α2 (IL-13Rα2) has traditionally been considered a decoy receptor; however, its cellular functions beyond the immune system remain unclear. We aimed to investigate the role of IL-13Rα2 in C2C12 myoblast proliferation and differentiation. IL-13Rα2 expression was knocked down in C2C12 cells using siRNA. Myogenic differentiation was evaluated by myosin heavy chain (MyHC) immunostaining and by quantifying the expression of myogenic regulatory and fusion-related genes. Myoblast proliferation was assessed using BrdU incorporation and cell number analyses, and signaling events induced by IL-13Rα2 knockdown were analyzed via immunoblotting and immunocytochemical analysis. IL-13Rα2 knockdown did not alter myogenic differentiation or the expression of fusion-associated genes. In contrast, IL-13Rα2 knockdown significantly increased BrdU incorporation and cell number, accompanied by increased Akt phosphorylation and decreased ERK phosphorylation. Cyclin D1 and cyclin-dependent kinase 4 (CDK4) levels were also increased. Akt inhibition abolished the enhanced proliferation and normalized Cyclin D1/CDK4 levels, whereas ERK activation did not further modify the knockdown-associated phenotype. These findings demonstrate that IL-13Rα2 negatively regulates myoblast proliferation by modulating the Akt–Cyclin D1–CDK4 signaling pathway, while being dispensable for myogenic differentiation. Full article
(This article belongs to the Section Molecular Biology)
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