Search Results (1,507)

This narrative review summarizes current data on the role of desialylation of low-density lipoproteins (LDL) as a key initiating mechanism of atherogenesis that precedes oxidative modification. The structural and functional significance of sialic acid in apolipoprotein B-100 is considered, and the enzymes of the sialidase (neuraminidase) family responsible for its cleavage are characterized. The pathogenic role of increased sialidase activity in atherosclerosis, type 2 diabetes mellitus, and other diseases is discussed. The advantages of using dietary supplements based on natural sialidase inhibitors for long-term prevention compared with synthetic drugs are shown. Examples of already existing dietary supplements with antiatherosclerotic effects are described. A separate section is devoted to computer methods (molecular docking) for searching for new sialidase inhibitors among flavonoids; according to virtual screening data, gallated catechins were identified as the most promising candidates. The feasibility of further experimental and clinical studies to create effective and safe nutraceuticals that affect the early stages of atherogenesis is substantiated. Full article

This study aimed to elucidate the role of Lactococcus G423 in regulating the AMPK (AMP-activated protein kinase) signaling pathway and gut microbiota, and to investigate the mechanisms underlying its potential to improve lipid metabolism in broilers. In this trial, 960 one-day-old Arbor Acres (AA) broilers were randomly assigned to one of three groups: a control group (CON), a low-dose Lactococcus G423 group (Lac-L), and a high-dose Lactococcus G423 group (Lac-H). Each group consisted of eight replicates, with 40 individuals per replicate. Compared with the CON group, the Lac-L and Lac-H groups showed no significant differences in ADFI (Average Daily Feed Intake), ADG (Average Daily Gain), FCR (Feed Conversion Ratio), breast muscle yield, leg muscle yield, or abdominal fat yield (p > 0.05). Compared with the control group, neither Lac-L nor Lac-H affected serum TG (Triglyceride) or LDL (Low-Density Lipoprotein) levels (p > 0.05). However, both Lac-L and Lac-H significantly decreased serum CHO (Cholesterol) and increased serum HDL (High-Density Lipoprotein) (p < 0.05). Regarding the AMPK signaling pathway, both the Lac-L and Lac-H groups significantly downregulated the hepatic mRNA expression of Acetyl-CoA carboxylase (ACC) (p < 0.05). The Lac-L groups significantly increased the mRNA expression of AMP-activated protein kinase (AMPK) and Sterol Regulatory Element-Binding Protein 1 (SREBP1) (p < 0.05), and the Lac-H groups significantly increased the mRNA expression of Apolipoprotein A1 (APOA1) and Protein kinase B (PKB) (p < 0.05) and significantly reduced the mRNA expression of Fatty acid-binding protein 1 (FABP1) (p < 0.05), compared to the CON group. Gut microbiota analysis indicated that both treatment groups exhibited significantly increased α-diversity indices (p < 0.05) and altered microbial composition at an order level comparable with that of the CON group. Specifically, the abundances of beneficial families such as Lachnospirales and Lactobacillales were elevated, while significant changes were observed in other taxa including Ruminococcaceae and Akkermansiaceae (p < 0.05). These changes corresponded with significant differences in the MDI and GMHI (p < 0.05). In conclusion, Lactococcus G423 may regulate lipid metabolism in broilers through the combined modulation of the AMPK signaling pathway and the gut microbiota. Specifically, Lactococcus G423 appears to regulate broiler lipid metabolism by modulating the gut microbiota–hepatic lipid metabolism axis. Full article

Early diagnosis of breast cancer (BC) remains challenging. The limited sensitivity and specificity of existing serum tumor markers for reliable clinical application highlight the need to develop a more accurate and efficient screening workflow. This study analyzed serum samples from 255 breast cancer patients and 300 healthy controls using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, identifying 58 differentially expressed peptides (37 upregulated, 21 downregulated). Combined with machine learning, peptide identification, and external validation, a complete standardized workflow was established. Nine machine learning (ML) algorithms were employed and compared, including SVM, LightGBM, XGBoost, etc. The models were interpreted using SHAP and LIME to identify key features. Peptides of interest were sequenced via mass spectrometry. Their expression and potential prognostic value were further validated in breast cancer transcriptomic datasets. Nine machine learning algorithms showed favorable discriminatory ability in the study cohort. The LightGBM model achieved an AUC of 0.97 internally and maintained an AUC of 0.88, an accuracy of 0.8543, and a precision of 0.9799 externally. However, after correcting for the markedly elevated prevalence (80.3%) in the external cohort, the positive predictive value (PPV) decreased substantially under real-world screening scenarios, warranting prospective validation in true screening populations. Model interpretation and subsequent sequencing identified six core biomarker peptides: Apolipoprotein A-IV (APOA4), Serum Deprivation Response Protein (SDPR), Alpha-1-Antitrypsin (SERPINA1), Ezrin (EZR), Serglycin (SRGN), and Fibrinogen Alpha Chain (FGA). Transcriptomic corroboration suggested that these molecules were significantly dysregulated in breast cancer tissues and showed univariate prognostic associations with patient survival. These findings demonstrated the potential of a proteomics-driven integrated machine learning pipeline as a proof-of-concept auxiliary risk-stratification tool for enhancing early breast cancer diagnosis, warranting further prospective validation in real-world screening cohorts before clinical translation. Full article

Background: Myelodysplastic neoplasms (MDSs) are clonal hematopoietic stem cell disorders associated with ineffective hematopoiesis, chronic inflammation, and increased cardiovascular morbidity. Although metabolic dysregulation has been implicated in MDS pathogenesis, systemic metabolic alterations remain incompletely characterized. Methods: Plasma samples from treatment-naïve patients with MDS or chronic myelomonocytic leukemia (CMML) and age-matched healthy controls were analyzed using quantitative nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry (LC-MS). Metabolomic profiles were compared using unsupervised and supervised multivariate analyses, validated in an independent external MDS cohort, and integrated with re-analysis of publicly available RNA-sequencing datasets from purified CD14⁺ CMML monocytes. Results: Patients with MDS and CMML exhibited broad reductions in circulating lipoprotein-associated metabolites, including HDL-, LDL-, IDL-, and apolipoprotein-associated fractions, indicating disturbed systemic lipoprotein homeostasis. Within the discovery cohort, CMML samples showed higher concentrations of the ketone bodies 3-hydroxybutyrate and acetoacetate, as well as succinate. LC-MS analysis demonstrated selective increases in C18:1 acylcarnitine, oleic and isopalmitic acids, whereas free carnitine abundance remained unchanged. Elevated 3-hydroxybutyrate levels were not associated with mutational burden, hematologic parameters, disease risk, or immunophenotypic features. Re-analysis of public CMML monocyte transcriptomes demonstrated increased expression of genes involved in lipid uptake and intracellular lipid trafficking, including FABP5, APOE, LPL, and SLC27A2, without coordinated activation of fatty acid oxidation pathways. External cohort analysis confirmed the overall MDS-associated plasma metabolomic profile. Conclusions: MDSs and CMML are associated with reproducible alterations in systemic lipid metabolism characterized by reduced circulating lipoprotein-associated metabolites, while CMML showed more pronounced ketone body- and acylcarnitine-associated metabolic phenotype accompanied by changes in lipid-handling transcriptional programs. These findings support altered systemic lipid metabolism and carnitine-dependent fatty acid handling as characteristic features of myeloid neoplasms and provide a rationale for future functional studies investigating lipid metabolism in disease pathogenesis. Full article

Pancreatic β cells require tightly controlled cholesterol distribution to maintain glucose sensing, insulin-granule trafficking, and regulated exocytosis. ATP-binding cassette transporter A1 (ABCA1) exports cellular cholesterol and phospholipids to lipid-poor apolipoprotein A-I and is a central component of β-cell cholesterol homeostasis. β-cell-specific Abca1 deletion causes cholesterol accumulation and impaired glucose-stimulated insulin secretion, whereas human studies of rare ABCA1 loss-of-function mutations have reported heterogeneous secretory phenotypes. Endocrine, metabolic, inflammatory, lipoprotein, and post-transcriptional signals regulate pancreatic ABCA1. Exendin-4 activates CaMKK/CaMKIV/PREB-dependent transcription, insulin-like growth factor-1 acts through PI3K/Akt/FoxO1 signaling, and pemafibrate increases ABCA1 through PPAR-α-dependent regulation in experimental models. Conversely, angiotensin II, tumor necrosis factor-α, oxidized low-density lipoprotein, and N-methyl-D-aspartate suppress ABCA1 through distinct or partially convergent pathways, while miR-33a directly suppresses ABCA1 in human and mouse islets. β-cell function depends on the balance among LDLR-dependent cholesterol uptake, PCSK9-mediated receptor regulation, intracellular sterol trafficking and esterification, ABCG1-dependent handling, and ABCA1-dependent export rather than on total cellular cholesterol alone. Although several regulator-specific mechanisms remain preclinical and await independent replication, this review integrates these pathways and discusses their nutritional and translational relevance in type 2 diabetes. Full article

Gut microbial metabolism links intestinal ecology with systemic physiology and neural pathology, but its effects vary across disease stage, tissue compartment, and host background. This review uses Alzheimer’s disease (AD) as the principal model and compares selected features with Parkinson’s disease (PD) and amyotrophic lateral sclerosis (ALS). Across the AD continuum, fermentation-related changes appear in prodromal cohorts, whereas broader alterations in amino acid products, host–microbial co-metabolites, bile acids, and lipids accompany mild cognitive impairment and dementia. These group-level patterns do not constitute a fixed patient trajectory. Microbial production, intestinal absorption, hepatic conversion, renal clearance, barrier integrity, and tissue-specific receptors jointly determine biological exposure. Experimental studies connect short-chain fatty acids and indole derivatives with epithelial and neuroimmune homeostasis, while imidazole propionate, trimethylamine N-oxide, selected kynurenine products, and remodeled bile acid pools engage vascular, inflammatory, amyloid, or tau-related pathways. Cerebral pathology can also remodel the intestinal ecosystem, creating reciprocal feedback. Apolipoprotein E4 modifies lipid handling, vascular permeability, and immune responses, helping to explain why comparable metabolic profiles may carry different consequences among individuals. Translation therefore requires more than a change in community composition. Trials must verify microbial function, metabolite target engagement, AD biomarker response, and clinical benefit in appropriately stratified participants. Shared pathways in PD and ALS provide comparison points, but disease-specific cells, proteinopathies, and treatment exposures constrain direct transfer of AD-derived targets. Full article

Circulating tumor cell (CTC) clustering is a key driver of metastatic progression in non-small cell lung cancer (NSCLC), but the underlying molecular mechanisms remain largely unknown. Here, we performed single-cell proteomic sequencing on CTC clusters and individual CTCs isolated from lung cancer patients, identifying 912 proteins in total, of which 246 were significantly upregulated in clusters versus single CTCs. Enrichment analyses revealed a prominent involvement of lipid and cholesterol metabolism pathways. Apolipoprotein E (APOE) emerged as a central hub, exhibiting marked upregulation in CTC clusters. Functional experiments showed that cholesterol supplementation promoted cluster formation in NSCLC cell lines and accelerated metastatic dissemination in vivo, whereas APOE depletion impaired clustering capacity. Mechanistically, we identified USF2 as a potential transcriptional regulator of APOE through direct binding to the promoter, as supported by Chromatin Immunoprecipitation (ChIP) and reporter assays. Clinical validation in a cohort of 75 lung cancer patients demonstrated that elevated APOE expression was strongly associated with advanced pathological grade, distant metastasis, and poor survival. Taken together, these findings establish a novel USF2–APOE–cholesterol axis that governs CTC clustering and metastatic progression, positioning APOE as both a prognostic biomarker and a potential therapeutic target for NSCLC metastasis. Full article

We conducted a systematic review and meta-analysis of associations between apolipoprotein E (APOE) alleles and frontotemporal lobar degeneration (FTLD)-spectrum disorders. MEDLINE, Embase, CENTRAL, and Google Scholar were searched. APOE2 and APOE4 carrier status were compared between FTLD-spectrum disorders and healthy controls (HCs) or individuals with Alzheimer’s disease (AD). Forty studies were included. APOE4 carriage was more frequent in frontotemporal dementia (FTD) compared with HC (OR = 1.72; 95% CI = 1.45–2.04) and less common than in AD (OR = 0.35; 95% CI = 0.29–0.42). In contrast, APOE2 carriage was less prevalent in FTD relative to HC (OR = 0.83; 95% CI = 0.70–0.98) but more frequent compared with AD (OR = 1.80; 95% CI = 1.29–2.52). APOE4 effects were most pronounced in behavioral variant FTD. In clinically confirmed progressive supranuclear palsy (PSP), APOE4 carriage was not associated with PSP. Analysis restricted to pathologically confirmed PSP cases, however, showed lower APOE4 carriage in PSP than in healthy controls (OR = 0.78, 95% CI = 0.65–0.94), although this association failed to reach the multiplicity-adjusted significance threshold. APOE2 carriage was not associated with PSP in either clinically established or pathologically confirmed samples. Evidence was insufficient to establish or exclude associations for other FTLD-spectrum disorders because of the limited available data. In conclusion, APOE alleles show distinct associations across the FTLD spectrum. Full article

Background/Objectives: Evaluating noninvasive, accessible ocular and blood-based biomarkers could aid in early risk stratification and disease detection during the preclinical phase of Alzheimer’s disease. This study investigates associations between plasma biomarkers of neurodegeneration and retinal structural and microvasculature parameters in cognitively normal adults with familial or genetic risk factors for Alzheimer’s disease. Methods: Forty-one participants underwent plasma sampling for glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), amyloid-beta42 (β42), amyloid-β42/40 ratio, and phosphorylated-tau217 (p-tau217), and also underwent optical coherence tomography (OCT) and OCT angiography (OCTA) imaging. Apolipoprotein E genotyping and family history of Alzheimer’s disease were recorded. Generalized estimating equations adjusting for age, sex, race, treated hypertension, Alzheimer’s disease family history, and APOE ε4 carrier status assessed associations between plasma biomarker concentrations and OCT and OCTA measurements. Results: Higher plasma GFAP and NfL concentrations were significantly associated with reduced superficial capillary plexus perfusion density and vessel density on macular OCTA. In additional analyses restricted to participants with plasma biomarker and retinal imaging assessments obtained within 9 months, associations with GFAP remained significant, whereas NfL associations no longer remained significant after correction for multiple comparisons. Conclusions: Retinal OCTA and OCT metrics may reflect general neurovascular aging in cognitively normal individuals with familial or genetic risk factors for Alzheimer’s disease. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes (T2DM) have been associated with dyslipidemia. This study aimed to investigate the association between lipid values and markers of hepatic steatosis and fibrosis in patients with T2DM. Methods: This is a post hoc analysis of the AleCardio randomized controlled trial in patients with T2DM and recent acute coronary syndrome. Risk of liver steatosis was estimated with the Hepatic Steatosis Index (HSI), risk of liver fibrosis with the NAFLD Fibrosis Score (NFS). Results: Of 7226 participants, 526 were untreated with lipid-lowering medication and formed the analysis cohort. Mean age was 61 ± 10 years, and body mass index (BMI) was 28.5 ± 5.8 kg/m². A total of 75% of individuals had an HSI score > 36, associated with high risk of liver steatosis, elevated NFS scores > 0.67, associated with high risk of liver fibrosis, were present in 15%. Patients with elevated HSI scores had higher BMI, HOMA IR, triglycerides, remnant cholesterol, and lower high-density lipoprotein compared to those with lower scores. Patients with elevated NFS scores had greater BMI and HOMA IR, and had lower triglycerides, remnant cholesterol, and apolipoprotein B in linear regression analyses. Conclusion: Patients with T2DM, cardiovascular disease, and blood-based indices suggesting liver steatosis or fibrosis differed significantly with respect to the lipid profile. An elevated HSI score, suggesting steatosis, was associated with dyslipidemia, an elevated NFS score, suggesting fibrosis, was not. A possible explanation for the latter findings is reduced very-low-density lipoprotein (VLDL-C) synthesis or secretion accompanying advanced hepatocellular dysfunction. Full article

The APOA1 rs670 (−75 G>A) polymorphism has been implicated in lipid metabolism and susceptibility to metabolic syndrome (MetS). However, individual studies have reported inconsistent associations with circulating apolipoprotein A1 (Apo A1) and lipid parameters, and no meta-analysis has comprehensively evaluated these associations stratified by metabolic disorder status. We therefore quantified the associations between APOA1 rs670 and serum Apo A1 and lipid parameters, and determined whether these associations are modified by metabolic disorder status. PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched from inception to March 2026. Eligible studies reported APOA1 rs670 genotype data with quantitative lipid measurements. Forty studies involving 22,175 participants met the inclusion criteria. Pooled effect sizes were estimated as standardized mean differences (SMDs) with 95% confidence intervals (CIs) using random-effects models. This review was registered in PROSPERO (CRD420261333145). A allele carriers had significantly higher serum Apo A1 (SMD, 0.20; p < 0.001) and HDL-C levels (SMD, 0.14; p < 0.001) than GG homozygotes. Subgroup analyses stratified by metabolic disorder status revealed that the associations with Apo A1 (SMD, 0.53 vs. 0.11) and HDL-C (SMD, 0.23 vs. 0.08) were substantially stronger among individuals with metabolic disorders than among metabolically healthy individuals. No significant associations were observed for LDL-C or triglyceride levels. The APOA1 rs670 polymorphism is associated with higher circulating Apo A1 and HDL-C levels, with stronger associations in individuals with metabolic disorders. These findings suggest that metabolic status modifies the phenotypic effects of rs670 on the Apo A1–HDL pathway. Full article

Background: Obesity is a heterogeneous condition with variable cardiometabolic risk (CMR). The concept of metabolically healthy obesity (MHO) challenges the traditional paradigm that excess adiposity is invariably associated with metabolic dysfunction. However, its clinical validity remains controversial. Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar, primarily covering studies published between 2020 and 2025, with landmark earlier studies included when relevant. Results: Traditional definitions of MHO rely predominantly on metabolic parameters and fail to capture residual cardiovascular risk (CVR). Individuals with obesity frequently exhibit discordance between low-density lipoprotein cholesterol (LDL-C) and atherogenic particle burden, reflected by elevated apolipoprotein B and remnant lipoproteins. Visceral adiposity and reduced skeletal muscle mass further contribute to metabolic dysfunction. Cardiorespiratory fitness emerges as a major determinant of cardiometabolic resilience, independently associated with reduced mortality. Conclusions: Current evidence suggests that although some individuals may maintain metabolic health over extended periods, MHO frequently represents a dynamic phenotype that may progress toward metabolic dysfunction over time. An integrated approach incorporating lipid burden, body composition, and functional capacity enables more accurate CVR stratification and supports phenotype-based personalized strategies. Full article

Enlicitide (MK-0616) is an oral proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor for the treatment of hypercholesterolemia. We conducted the first systematic review and meta-analysis evaluating the efficacy and safety of enlicitide across randomized controlled trials enrolling adults with hypercholesterolemia or heterozygous familial hypercholesterolemia (HeFH). The primary outcome was the baseline-to-endpoint percentage change in low-density lipoprotein cholesterol (LDL-C); secondary outcomes included apolipoprotein B (ApoB), non-high-density lipoprotein cholesterol (non-HDL-C), lipoprotein(a) [Lp(a)], and safety. Four randomized controlled trials involving 3894 participants were included. Enlicitide achieved a substantial reduction in LDL-C (mean difference [MD]: −55.78 percentage points; 95% confidence interval [CI]: −61.15 to −50.42; p < 0.0001; I² = 99.58%), with sustained efficacy demonstrated in the newly available 52-week Phase 3 CORALreef data. Significant reductions were also observed in ApoB (MD: −47.95 pp; 95% CI: −51.22 to −44.67), non-HDL-C (MD: −49.42 pp; 95% CI: −54.23 to −44.60), and Lp(a) (MD: −22.70 pp; 95% CI: −28.62 to −16.78). The pooled incidence of any adverse event was not statistically significant (event rate: 0.21; p = 0.087), and treatment discontinuation due to adverse events was uncommon (event rate: 0.007). Enlicitide demonstrated substantial lipid-lowering efficacy with an acceptable safety profile. The ongoing CORALreef Outcomes trial will determine whether these lipid improvements translate into reductions in major adverse cardiovascular events. Full article

Mounting evidence implicates dysregulation of the neuroimmune system in Alzheimer’s disease (AD). Neuroimmune cells, namely microglia and astrocytes, have the potential to contribute to AD through mechanisms such as promoting neuroinflammation and propagating amyloid-β (Aβ) and tau aggregates. Human induced pluripotent stem cell (hiPSC)-derived models offer advantages for studying the AD neuroimmune system, such as recapitulating genetic variants associated with the disease and allowing for precise manipulation of human cells in vitro. Here, we provide an overview of modern techniques for generating 2-dimensional (2D) monocultures and co-cultures, 3-dimensional (3D) organoids and assembloids, and chimeras containing hiPSC-derived microglia and astrocytes. Then, we highlight recent studies that have utilized hiPSC-derived neuroimmune models to investigate AD risk variants in genes encoding apolipoprotein E (APOE) and triggering receptor on myeloid cells 2 (TREM2), mutations known to cause familial AD in genes encoding presenilin 1 (PSEN1) and 2 (PSEN2) and amyloid precursor protein (APP), and trisomy 21 leading to Down syndrome-associated AD (DS-AD). We then briefly summarize recent studies that have utilized hiPSC-derived neuroimmune models lacking disease-associated variants to study the clearance of Aβ and tau aggregates. Finally, we discuss notable limitations of these models and reflect on future directions for this area of research, including the use of cultures with increasing cellular diversity and structural complexity, advancements in live-imaging techniques for detecting AD pathology in vitro, and drug screening. Full article

Despite major advances in reperfusion strategies and guideline-directed medical therapy, patients surviving myocardial infarction (MI) remain at substantial risk of recurrent cardiovascular events. Among the multiple determinants of post-MI cardiovascular risk, persistent atherothrombotic vulnerability remains a major therapeutic challenge despite guideline-directed secondary prevention. This review provides an integrated overview of residual atherothrombotic risk after MI, focusing on the complementary roles of lipid, inflammatory, and thrombotic pathways. Current evidence supports the use of biomarkers such as apolipoprotein B, lipoprotein(a), remnant cholesterol, triglyceride-rich lipoproteins, and high-sensitivity C-reactive protein to improve risk stratification beyond LDL-C. Landmark clinical trials have demonstrated that intensive lipid-lowering therapy, selected anti-inflammatory agents, and individualized antithrombotic strategies can further reduce recurrent cardiovascular events in appropriately selected patients. However, these pathogenic pathways rarely occur in isolation and frequently overlap, generating heterogeneous residual risk phenotypes. We propose a pragmatic multi-layered model in which lipid, inflammatory, and thrombotic mechanisms are viewed as interconnected biological processes rather than independent entities. This framework supports a personalized approach to secondary prevention based on comprehensive risk assessment, targeted therapeutic intensification, and longitudinal reassessment. Integrating these complementary domains may provide a framework for more individualized secondary prevention after MI, although its clinical utility requires prospective validation. Full article