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12 pages, 3084 KB  
Case Report
Identification and Functional Characterization of a Novel De Novo SATB1 Frameshift Variant in a Patient with Epilepsy-Dominant Neurodevelopmental Disorders
by Mingchao Xu, Rui Zhang, Shiqi Fan, Miao Sun and Xue Zhang
Genes 2026, 17(5), 565; https://doi.org/10.3390/genes17050565 (registering DOI) - 15 May 2026
Abstract
Background/Objectives: As a global chromatin organizer, SATB1 is increasingly implicated in neurodevelopmental disorders (NDDs). This study aims to delineate the clinical and molecular characteristics of a novel de novo SATB1 variant in a patient presenting with epilepsy-dominant NDDs phenotypes. Methods: Triggered by the [...] Read more.
Background/Objectives: As a global chromatin organizer, SATB1 is increasingly implicated in neurodevelopmental disorders (NDDs). This study aims to delineate the clinical and molecular characteristics of a novel de novo SATB1 variant in a patient presenting with epilepsy-dominant NDDs phenotypes. Methods: Triggered by the onset of seizures, trio-based whole-exome sequencing (Trio-WES) was performed to identify the genetic etiology. Subsequent sleep electroencephalogram (EEG) and magnetic resonance imaging (MRI) were then conducted to further characterize the patient’s clinical phenotypes. Pathogenicity was assessed through structural modeling and functional characterization. Nonsense-mediated mRNA decay (NMD) status, protein expression profiles, and subcellular localization were determined by reverse-transcription quantitative PCR (RT-qPCR), Western blotting, and immunofluorescence staining. The transcriptional regulatory impacts of the variant were quantified using dual-luciferase reporter system targeting known downstream regulatory elements. Clinical responses to antiepileptic intervention was also monitored. Results: We identified a novel de novo heterozygous pathogenic frameshift variant in SATB1 (NM_002971.5: c.1718_1719insCA; p.Val574Argfs*134) in a patient presenting with early-onset epilepsy, mild intellectual developmental disorder (IDD), speech delay, and dental anomalies. Functional assays demonstrated that the variant-derived transcript escaping NMD, yielding a truncated protein that forms irregular punctate aggregates within nuclei. Dual-luciferase assays revealed significantly increased transcriptional activity, indicating a loss of the protein’s innate transcriptional regulatory capacity. Clinically, treatment with sodium valproate (VPA) successfully stabilized seizures of the patient, markedly reducing both frequency and intensity. Conclusions: The study reports a novel SATB1 frameshift variant that exerts pathogenicity significant functional impairment by disrupting protein localization and transcriptional regulation. These findings expand the genetic spectrum of SATB1-related NDDs and underscore the efficacy of targeted antiepileptic management in genetic diseases. Full article
(This article belongs to the Special Issue Diagnosis, Management and Therapy of Rare Diseases)
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52 pages, 1516 KB  
Review
Multinuclear NMR and MRI Beyond Proton Imaging: Principles, Contrast Mechanisms, and Applications in Materials and Biomedicine
by Dorota Bartusik-Aebisher, Klaudia Dynarowicz, Barbara Smolak, Rostyslav Marunych, Wiesław Guz and David Aebisher
Int. J. Mol. Sci. 2026, 27(10), 4384; https://doi.org/10.3390/ijms27104384 - 14 May 2026
Abstract
Magnetic resonance techniques have evolved beyond conventional proton-based imaging, enabling access to a broader range of nuclei that provide complementary structural, functional, and molecular information. This review presents a comprehensive overview of multinuclear NMR and MRI in solid and soft materials as well [...] Read more.
Magnetic resonance techniques have evolved beyond conventional proton-based imaging, enabling access to a broader range of nuclei that provide complementary structural, functional, and molecular information. This review presents a comprehensive overview of multinuclear NMR and MRI in solid and soft materials as well as in biomedical applications, with particular emphasis on 1H, 13C, 31P, 23Na, and 19F nuclei. Proton-based methods remain the foundation of magnetic resonance due to their high sensitivity and widespread applicability, offering insights into molecular mobility, hydration, and microstructural heterogeneity. In contrast, heteronuclear approaches enable more specific characterization of chemical structure (13C), phosphorus-containing functional groups and membranes (31P), ionic homeostasis and transport (23Na), and exogenous tracers with negligible biological background (19F). Together, these techniques extend magnetic resonance from primarily anatomical imaging toward functional, metabolic, and molecular-level analysis. The review further discusses key hardware aspects, including magnetic field strength and radiofrequency coil design, highlighting the trade-offs between low- and high-field systems and the growing importance of multinuclear coil architectures. For example, because 1H, 23Na, 31P, and 19F resonate at different Larmor frequencies, multinuclear experiments require dedicated or multi-tuned RF coils that balance sensitivity, field homogeneity, and decoupling between channels. Mechanisms of contrast generation are examined in detail, distinguishing between endogenous sources—such as water, ions, and metabolites—and exogenous contrast agents, including gadolinium-, manganese-, and fluorine-based compounds, as well as targeted and theranostic platforms. A comparative framework of endogenous and exogenous signals is presented, emphasizing their complementary roles in balancing safety, specificity, and sensitivity. Finally, the opportunities and challenges of multinuclear magnetic resonance are critically evaluated, including limitations in sensitivity, signal-to-noise ratio, data interpretation in heterogeneous systems, and technical complexity. Emerging directions such as ultrahigh-field imaging, advanced RF technologies, hyperpolarization, and artificial intelligence-assisted reconstruction are discussed as key drivers for future development. Overall, multinuclear NMR and MRI represent a powerful and expanding toolbox for probing complex material and biological systems, with the potential to significantly enhance diagnostic capabilities and deepen our understanding of structure–function relationships across multiple scales. Full article
(This article belongs to the Special Issue Application of NMR Spectroscopy in Biomolecules: 2nd Edition)
17 pages, 2815 KB  
Article
Beyond Tumor Volume: An Integrated Radiological Model of Tumor Load, Anatomical Spread, and Mass Effect for Survival Prediction in Adult Grade 4 Diffuse Astrocytic Tumors
by Mustafa Emre Sarac, Zeki Boga, Ali Arslan, Ümit Kara, Mehmet Ozer, Ali Harmanoğullarından, Ali Sürmelioğlu, Feryal Karaca, Zişan Nur Sürmelioğlu and Yurdal Gezercan
Medicina 2026, 62(5), 959; https://doi.org/10.3390/medicina62050959 (registering DOI) - 14 May 2026
Abstract
Background and Objectives: Prognostic assessments in grade 4 diffuse astrocytic tumors primarily depend on clinical and molecular characteristics, with radiological attributes frequently assessed in isolation. In this study, we explored whether an integrated radiological approach combining tumor burden, anatomical spread, and mass effect [...] Read more.
Background and Objectives: Prognostic assessments in grade 4 diffuse astrocytic tumors primarily depend on clinical and molecular characteristics, with radiological attributes frequently assessed in isolation. In this study, we explored whether an integrated radiological approach combining tumor burden, anatomical spread, and mass effect could contribute to survival prediction. Materials and Methods: A total of 310 adult patients with histopathologically confirmed grade 4 diffuse astrocytic tumors, diagnosed between January 2022 and January 2025, were included in this retrospective single-center cohort. Preoperative MRI was used to assess contrast-enhancing tumor volume, edema volume, and brain volume, combined with anatomical spread and midline shift as a marker of mass effect. Tumor burden was defined as the ratio of enhancing tumor volume to brain volume (ETV/BV). Overall survival was analyzed using Kaplan–Meier and Cox regression methods. Model performance was evaluated with the C-index, bootstrap internal validation, and 12-month calibration. Results: Tumor burden was higher in IDH-wildtype tumors, which also showed higher midline shift and more frequent deep structure involvement and contralateral extension. In multivariable analysis, IDH status, age, tumor burden, midline shift, and deep structure involvement were independently associated with overall survival. A greater tumor burden was associated with reduced survival. The addition of molecular and imaging-derived variables improved discrimination, increasing the C-index from 0.69 to 0.76. Following bootstrap validation, the corrected value was 0.73. Calibration at 12 months demonstrated acceptable agreement between predicted and observed outcomes. Conclusions: An integrated radiological approach that combines tumor burden, anatomical spread, and mass effect may support prognostic assessment in addition to established clinical and molecular variables. Full article
(This article belongs to the Section Oncology)
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10 pages, 1574 KB  
Case Report
Endoscopic Decompression of Radiculopathy Caused by Vertebral Artery Loop Formation: Case Report and Literature Review
by Tae Hoon Yang, In-Suk Bae, Hee In Kang, Jae Hoon Kim and Cheolsu Jwa
J. Clin. Med. 2026, 15(10), 3643; https://doi.org/10.3390/jcm15103643 - 9 May 2026
Viewed by 123
Abstract
Background: Cervical radiculopathy due to vertebral artery loop formation (VALF) is rare. This case demonstrates endoscopic posterior foraminotomy after failed conservative treatment. Methods: We report a case of VALF treated by means of uniportal full-endoscopic posterior foraminotomy. A focused narrative literature review identified [...] Read more.
Background: Cervical radiculopathy due to vertebral artery loop formation (VALF) is rare. This case demonstrates endoscopic posterior foraminotomy after failed conservative treatment. Methods: We report a case of VALF treated by means of uniportal full-endoscopic posterior foraminotomy. A focused narrative literature review identified prior surgical cases of VALF-related cervical radiculopathy. Case description: A 69-year-old woman had a 4-month right C5 radiculopathy (neck pain, arm radiation, Spurling-positive) due to VALF at C4–5, confirmed via MRI and CT angiography. After failed conservative treatment, full-endoscopic posterior foraminotomy was performed; the symptoms resolved at 3 months. Conclusions: Clinicians should be aware that vertebral artery loop formation, although rare, is an important potential cause of cervical radiculopathy. In suspected cases, the vertebral artery should be carefully evaluated with MR or CT angiography to confirm the presence of a loop formation. Full-endoscopic posterior foraminotomy may be technically feasible for carefully selected patients with VALF-related cervical radiculopathy, demonstrating short-term symptom improvement in this case. Full article
(This article belongs to the Section Clinical Neurology)
16 pages, 835 KB  
Article
Significant Correlation of Dynamic Pan-Immune Inflammation Value and Magnetic Resonance Imaging Response in Patients with Locally Advanced Rectal Cancer Treated with Total Neoadjuvant Therapy
by Sukran Celikarslan, Duygu Karahacioglu, Bengi Gurses, Fatih Selcukbiricik, Emre Balik, Derya Salim Uymaz, Ahmet Rencuzogullari, Dursun Bugra, Sahin Lacin, Kerim Kaban, Perran Fulden Yumuk, Nil Molinas Mandel, Ayse Armutlu, Burcu Saka, N. Volkan Adsay, Metin Vural, Merve Duman, Caglayan Selenge Beduk Esen, Nulifer Kilic Durankus, Duygu Sezen, Saliha Ezgi Oymak, Yasemin Atagun and Ugur Selekadd Show full author list remove Hide full author list
Curr. Oncol. 2026, 33(5), 278; https://doi.org/10.3390/curroncol33050278 - 9 May 2026
Viewed by 177
Abstract
Background: Accurate identification of complete or near-complete responders after total neoadjuvant therapy (TNT) is critical for selecting candidates for non-operative management in locally advanced rectal cancer (LARC). While static inflammatory biomarkers have been widely investigated, the predictive value of dynamic changes in [...] Read more.
Background: Accurate identification of complete or near-complete responders after total neoadjuvant therapy (TNT) is critical for selecting candidates for non-operative management in locally advanced rectal cancer (LARC). While static inflammatory biomarkers have been widely investigated, the predictive value of dynamic changes in systemic inflammation during TNT remains unclear. This study evaluated whether changes in the Pan-Immune Inflammation Value (PIV) correlate with magnetic resonance imaging tumor regression grade (mrTRG) and regrowth risk. Methods: Seventy-three patients with LARC treated with TNT between 2018 and 2024 were retrospectively analyzed. Patients were classified as complete/near-complete responders (C-NCRG; mrTRG1–2) or residual disease group (RDG; mrTRG3–5). The PIV was calculated as (platelet × monocyte × neutrophil)/lymphocyte at treatment initiation (first-PIV), three weeks after completion of chemotherapy (last-PIV), and at regrowth (Rg-PIV). Dynamic changes were defined as Δ-PIV (last-PIV minus first-PIV) and ΔRg-PIV (Rg-PIV minus first-PIV). Receiver operating characteristic analysis identified optimal cutoffs, and logistic regression assessed independent associations. Results: The baseline PIV did not differ between groups. Last-PIV and Δ-PIV were significantly lower in the C-NCRG compared with RDG (p = 0.006). A Δ-PIV cutoff of −36.9 discriminated responders (AUC = 0.705; sensitivity 53.7%; specificity 84.4%) and remained independently associated with MRI response in multivariate analysis. In the non-operative management cohort, ΔRg-PIV was significantly lower in patients without regrowth (p = 0.001), with a cutoff of −77.72 (AUC = 0.794; sensitivity 88.9%; specificity 66.7%). Overall survival was superior in the C-NCRG (p = 0.01). Conclusions: A dynamic reduction in the PIV during TNT is significantly associated with favorable MRI response and lower regrowth risk in LARC. PIV dynamics may serve as a noninvasive complementary biomarker to support response assessment and stratification in organ-preservation strategies. Full article
(This article belongs to the Section Gastrointestinal Oncology)
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18 pages, 858 KB  
Review
Subclinical Inflammation in Ischemic Heart Disease and Its Role in the Transition to Heart Failure
by Costin Petru Groza, Ovidiu Oita, Radu Sebastian Gavril, Oana Irina Gavril, Tatiana Dramba, Ionica Grigore, Cristina Strobescu-Ciobanu, Roxana Nemtanu and Irina Mihaela Esanu
Life 2026, 16(5), 789; https://doi.org/10.3390/life16050789 - 8 May 2026
Viewed by 173
Abstract
Ischemic heart disease (IHD) remains the leading cause of chronic heart failure (HF) worldwide, yet the biological processes underlying this transition are not fully elucidated. Growing evidence indicates that chronic, low-grade inflammation acts as a pivotal link between ischemic injury and progressive myocardial [...] Read more.
Ischemic heart disease (IHD) remains the leading cause of chronic heart failure (HF) worldwide, yet the biological processes underlying this transition are not fully elucidated. Growing evidence indicates that chronic, low-grade inflammation acts as a pivotal link between ischemic injury and progressive myocardial dysfunction. Our review is the most up-to-date and structured synthesis on the pathophysiological pathways, biomarkers, and therapeutic implications of subclinical inflammation in patients with IHD at risk of developing HF. Following acute or repetitive ischemic episodes, persistent immune activation—mediated through interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α)—promotes endothelial dysfunction, microvascular instability, and extracellular matrix remodeling. These mechanisms culminate in ventricular stiffness, diastolic impairment, and adverse structural remodeling, even when left ventricular ejection fraction is preserved. Biomarkers such as Galectin-3, cancer antigen 125 (CA125), and high-sensitivity C-reactive protein (hsCRP) provide valuable insight into the interplay between fibrosis, congestion, and systemic inflammatory load, supporting early detection of subclinical myocardial injury. Advanced imaging modalities, including strain echocardiography and cardiac magnetic resonance imaging (MRI) mapping, enhance the phenotypic characterization of inflammatory cardiomyopathy. Understanding and targeting these inflammatory pathways may open new avenues for precision-based prevention and treatment, ultimately improving outcomes across the IHD–HF continuum. Full article
30 pages, 8659 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
Viewed by 626
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)
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13 pages, 4205 KB  
Article
Development and First-in-Human Translation of Hyperpolarized [1-13C]Alpha-Ketoglutarate MR Spectroscopy in the Brain
by Yaewon Kim, Duy Dang, James Slater, Andrew Riselli, Donghyun Hong, Jeremy W. Gordon, Susan M. Chang, Yan Li, Javier E. Villanueva-Meyer, Adam W. Autry, Evelyn Escobar, Stacy Andosca, Hsin-Yu Chen, Chou T. Tan, Chris Suszczynski, Sri Maddali, Robert A. Bok and Daniel B. Vigneron
Sensors 2026, 26(9), 2753; https://doi.org/10.3390/s26092753 - 29 Apr 2026
Viewed by 402
Abstract
Alpha-ketoglutarate (aKG) is a central intermediate of cerebral energy metabolism and a precursor for glutamate synthesis in the brain. Alterations in aKG metabolism occur in pathological contexts, including isocitrate dehydrogenase (IDH) mutant astrocytomas and oligodendrogliomas, in which mutant IDH converts aKG to the [...] Read more.
Alpha-ketoglutarate (aKG) is a central intermediate of cerebral energy metabolism and a precursor for glutamate synthesis in the brain. Alterations in aKG metabolism occur in pathological contexts, including isocitrate dehydrogenase (IDH) mutant astrocytomas and oligodendrogliomas, in which mutant IDH converts aKG to the oncometabolite 2-hydroxyglutarate. Given its central role in brain metabolism, non-invasive interrogation of aKG-dependent metabolic flux is needed. Hyperpolarized (HP) 13C MR enables real-time visualization of metabolic conversion by transiently enhancing signal intensity by several orders of magnitude. Leveraging this approach, we report the first-in-human feasibility and safety study of HP [1-13C]aKG MR spectroscopy in the healthy brain (n = 3). A standard operating procedure (SOP) was developed for sterile [1-13C]aKG dose production, achieving reproducible polarization levels averaging 30.5 ± 2.2%. Following intravenous administration, time-resolved 13C spectra in healthy volunteers demonstrated the detection of HP aKG resonance and a measurable downstream glutamate signal, consistent across repeat acquisitions, with a delayed temporal profile relative to aKG observed in a representative dataset. Although performed in healthy volunteers, these results establish feasibility for HP [1-13C]aKG metabolic imaging to open a new window into normal and pathological brain cellular metabolism. Full article
(This article belongs to the Special Issue Advances in Biosensing and BioMEMS for Biomedical Engineering)
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17 pages, 5699 KB  
Article
Establishment of an MR-Conditional Porcine Model for Real-Time Assessment of Cerebral Blood Flow During Extracorporeal Circulation
by Michael Hofmann, Martin O. Schmiady, Dominik T. Schulte, Tobias Aigner, Rima Bektas, Manuela Wieser, Martina Lentini, Francesca Del Chicca, Christoph Loeschmann, Michael Hübler, Ruth O’Gorman Tuura, Marianne Schmid Daners and Henning Richter
J. Cardiovasc. Dev. Dis. 2026, 13(5), 182; https://doi.org/10.3390/jcdd13050182 - 27 Apr 2026
Viewed by 344
Abstract
Background and Purpose: Neurological injury remains a major complication of pediatric cardiac surgery and is closely related to alterations in cerebral blood flow during extracorporeal circulation (ECC). However, the real-time assessment of cerebral perfusion under these conditions has been limited by the lack [...] Read more.
Background and Purpose: Neurological injury remains a major complication of pediatric cardiac surgery and is closely related to alterations in cerebral blood flow during extracorporeal circulation (ECC). However, the real-time assessment of cerebral perfusion under these conditions has been limited by the lack of magnetic resonance (MR)-compatible perfusion systems. The aim of this pilot feasibility study was to establish a porcine model enabling simultaneous cardiopulmonary bypass (CPB) and real-time MR-based assessment of cerebral blood flow during simulated pediatric cardiac surgery. Methods: We conducted a pilot study on 11 Duroc pigs (14.6 ± 1.4 kg BW), designed in iterative cycles. The experimental setup included an MR-conditional heart-lung machine and a surgical protocol closely mimicking pediatric cardiac surgery. After the initiation of CPB and hemodynamic stabilization, animals were cooled to target temperatures (20 °C or 28 °C) depending on the perfusion strategy. Structural and functional MRI, including phase-contrast imaging, arterial spin labeling, diffusion-weighted imaging, and MR spectroscopy, were performed during cooling and rewarming. Procedural feasibility, technical challenges, and optimization strategies were systematically documented. Results: The study successfully established a reproducible porcine model enabling MR imaging during extracorporeal circulation. Key technical challenges, including vascular access, cannulation of the ascending aorta, and blood volume management, were identified and addressed through the iterative refinement of the surgical and perfusion protocols. The use of the Seldinger technique significantly improved cannulation safety and reduced blood loss. Stable CPB conditions and target hypothermic temperatures were achieved in successfully cannulated animals. MRI acquisition during CPB was feasible, providing simultaneous structural and functional assessment of cerebral perfusion. Representative imaging data demonstrate the capability of the model to capture cerebral hemodynamics in real time. Conclusions: This pilot study establishes a novel MR-compatible porcine model for the real-time assessment of cerebral blood flow during extracorporeal circulation. The platform provides a robust foundation for future quantitative investigations of cerebral perfusion, mechanisms of brain injury, and neuroprotective strategies in pediatric cardiac surgery. Full article
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16 pages, 386 KB  
Article
Differential Roles of IL-18 and IL-8 Gene Variations in Multiple Sclerosis: Associations with Susceptibility and MRI Disease Activity
by Sezgin Kehaya, Arzu Ay, Nevra Alkanli and Ayse Nur Cesme
J. Clin. Med. 2026, 15(9), 3281; https://doi.org/10.3390/jcm15093281 - 25 Apr 2026
Viewed by 311
Abstract
Background/Objectives: Cytokine-mediated immune dysregulation contributes to the heterogeneity of multiple sclerosis (MS). Interleukin-18 (IL-18) and interleukin-8 (IL-8) are involved in distinct inflammatory pathways; however, their genetic contributions to disease susceptibility and radiological activity remain incompletely defined. Methods: In this study, 98 [...] Read more.
Background/Objectives: Cytokine-mediated immune dysregulation contributes to the heterogeneity of multiple sclerosis (MS). Interleukin-18 (IL-18) and interleukin-8 (IL-8) are involved in distinct inflammatory pathways; however, their genetic contributions to disease susceptibility and radiological activity remain incompletely defined. Methods: In this study, 98 relapsing–remitting MS (RRMS) patients and 98 healthy controls were genotyped for IL-18 and IL-8 variations using PCR-based methods. Clinical data and MRI findings were analyzed in the MS cohort. Associations with disease susceptibility, clinical severity (EDSS), and MRI activity were evaluated using regression analyses. Results: IL-18 (−137 G/C) and IL-8 variations were significantly associated with MS susceptibility. The G allele of IL-18 (−137), the T allele of IL-8 (−251), and the C allele of IL-8 (+781) were more frequent in MS patients. No significant associations were observed between cytokine variations and clinical severity measures. However, IL-18 (−137) variation was significantly associated with higher baseline MRI lesion burden, with C allele carriers showing increased lesion counts. In addition, IL-8 (−251 AA genotype) was independently associated with increased annual lesion development. These findings were confirmed in multivariable regression analyses. Conclusions: IL-18 and IL-8 gene variations contribute to MS through distinct but complementary mechanisms. IL-18 appears to be primarily involved in disease susceptibility and baseline inflammatory burden, whereas IL-8 is more closely associated with ongoing radiological activity. These results highlight the importance of integrating genetic and imaging biomarkers to better understand disease heterogeneity in MS. Full article
(This article belongs to the Section Clinical Neurology)
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13 pages, 1318 KB  
Article
Low-Density Lipoprotein Cholesterol Is Independently Associated with White Matter Injury Beyond Coronary Artery Calcium: Insights into Brain Aging
by Özgür Çakır, Burak Açar, Mustafa Kemal Dönmez, Almotasem Shatat, Sena Destan Bünül, Rıdvan Erten, Ahmet Yalnız and Ercüment Çiftçi
J. Clin. Med. 2026, 15(9), 3277; https://doi.org/10.3390/jcm15093277 - 25 Apr 2026
Viewed by 280
Abstract
Background/Objectives: The interplay between cardiovascular risk factors and brain aging remains incompletely understood. We aimed to investigate the comparative associations of coronary artery calcium (CAC) and low-density lipoprotein cholesterol (LDL-C) with MRI-derived volumetric measures of the brain. Methods: In this retrospective, [...] Read more.
Background/Objectives: The interplay between cardiovascular risk factors and brain aging remains incompletely understood. We aimed to investigate the comparative associations of coronary artery calcium (CAC) and low-density lipoprotein cholesterol (LDL-C) with MRI-derived volumetric measures of the brain. Methods: In this retrospective, single-center, cross-sectional study, 84 participants who underwent coronary computed tomography for CAC scoring and brain magnetic resonance imaging within 90 days were included; LDL-C levels were available in 69 participants for LDL-based analyses. Brain volumetric measures were obtained using the automated lesionBrain pipeline within the volBrain platform, which performs fully automated tissue segmentation and lesion quantification based on multi-atlas and patch-based approaches. Associations were evaluated using Spearman’s correlation with false discovery rate correction and hierarchical multivariable regression, supported by bootstrap validation and post hoc power analysis. The cohort had a mean age of 58.0 ± 13.0 years (range 19–78) and was derived from routine clinical imaging. Results: LDL-C was positively associated with abnormal white matter volume (ρ = 0.334, p = 0.005), although this did not remain statistically significant after FDR correction (pFDR = 0.090). In fully adjusted models, LDL-C remained the only independent predictor (β = 0.006, 95% CI: 0.002–0.010, p = 0.007; standardized β = 0.225; partial R2 = 11.7%), corresponding to a 6.2% increase in abnormal white matter volume per 10 mg/dL increase (derived from log-transformed models). CAC showed only a marginal association (p = 0.059). Post hoc power analysis demonstrated adequate power for LDL-C but insufficient power for CAC. Neither marker was associated with gray matter volume. Conclusions: In this cross-sectional cohort, higher LDL-C was independently associated with greater abnormal white matter volume after adjustment for cardiovascular risk factors, statin use, and CAC. No CAC–brain association was detected in this cohort, but limited statistical power means that small CAC effects cannot be excluded. These findings should be interpreted as associative rather than causal or mechanistic. Full article
(This article belongs to the Section Nuclear Medicine & Radiology)
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15 pages, 693 KB  
Article
Picropodophyllotoxin Mitigates Severe Inflammation Through HMGB1 Inhibition
by Gyuri Han, Ga Eun Kim and Jong-Sup Bae
Biomolecules 2026, 16(5), 638; https://doi.org/10.3390/biom16050638 - 24 Apr 2026
Viewed by 393
Abstract
Background/Objectives: Plant-derived phytochemicals are being increasingly explored for their ability to treat various illnesses, especially those affecting the vasculature. High mobility group box 1 (HMGB1) acts as a crucial mediator during the late phase of sepsis, promoting the secretion of pro-inflammatory cytokines and [...] Read more.
Background/Objectives: Plant-derived phytochemicals are being increasingly explored for their ability to treat various illnesses, especially those affecting the vasculature. High mobility group box 1 (HMGB1) acts as a crucial mediator during the late phase of sepsis, promoting the secretion of pro-inflammatory cytokines and thereby fueling inflammation and systemic complications. Higher plasma HMGB1 levels not only hinder accurate diagnosis and prognosis but also worsen disease outcomes in inflammatory states. Picropodophyllotoxin (PPT), a key bioactive ingredient isolated from the root of Podophyllum hexandrum, has shown a range of beneficial effects, including anti-cancer and anti-proliferative actions, across several tumor types. Nevertheless, its possible involvement in HMGB1-driven severe vascular inflammation remains unexplored. The current work aimed to investigate whether PPT could influence lipopolysaccharide (LPS)-induced HMGB1 activity and its related inflammatory signaling in human umbilical vein endothelial cells (HUVECs). Methods: A combination of in vitro and in vivo approaches was used to assess the anti-inflammatory action of PPT. These included measurements of endothelial barrier function, cell survival, leukocyte attachment and migration, levels of cell adhesion molecules, and the release of pro-inflammatory factors. Both cultured human endothelial cells and mouse disease models were used to thoroughly evaluate how PPT affects HMGB1-triggered inflammatory reactions. Results: The findings showed that PPT markedly reduced HMGB1 movement from inside HUVECs to the outside, thereby limiting its release into the environment. Moreover, PPT effectively decreased neutrophil sticking and migration, lowered the appearance of HMGB1 receptors, and prevented the activation of nuclear factor-κB (NF-κB), a master switch in inflammatory signaling. At the same time, PPT treatment strongly lowered tumor necrosis factor-α (TNF-α) production, adding to its anti-inflammatory profile. Conclusions: Taken together, these results indicate that PPT potently inhibits HMGB1-driven inflammatory processes by acting at several levels of the inflammatory cascade, such as HMGB1 movement, receptor binding, NF-κB activation, and subsequent cytokine release. Therefore, PPT stands out as a hopeful therapeutic option for HMGB1-related inflammatory diseases and deserves further exploration in preclinical and clinical studies. Full article
(This article belongs to the Section Cellular Biochemistry)
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12 pages, 2105 KB  
Article
PSA Density and PIRADS 5 Lesions as Key Determinants of Upstaging After Radical Prostatectomy
by Patryk Patrzałek, Mikołaj Kisiała, Marcel Dawidowicz, Jakub Wieland, Karol Zagórski, Jakub Karwacki, Adam Gurwin, Jan Łaszkiewicz, Wojciech Tomczak, Wojciech Urbański, Dawid Janczak, Wojciech Krajewski, Tomasz Szydełko and Bartosz Małkiewicz
Cancers 2026, 18(8), 1319; https://doi.org/10.3390/cancers18081319 - 21 Apr 2026
Viewed by 423
Abstract
Introduction: Clinical staging based on digital rectal examination is imprecise, leading to pathological upstaging in patients with prostate cancer (PCa). Accurate preoperative assessment remains a challenge despite the use of multiparametric magnetic resonance imaging (mpMRI) and fusion-guided biopsy. This study aims to [...] Read more.
Introduction: Clinical staging based on digital rectal examination is imprecise, leading to pathological upstaging in patients with prostate cancer (PCa). Accurate preoperative assessment remains a challenge despite the use of multiparametric magnetic resonance imaging (mpMRI) and fusion-guided biopsy. This study aims to identify key predictors of upstaging in preoperative patients. Materials and Methods: A retrospective analysis of 924 patients who underwent radical prostatectomy between July 2012 and January 2025 was performed. Variables included prostate-specific antigen, prostate volume, biopsy type, MRI, body mass index and age. Upstaging was defined as ≥pT3 in patients staged clinically as cT1–2. Optimal cut-offs for continuous variables were defined statistically. Multivariable logistic regression was applied to identify independent predictors of upstaging and minor staging upgrading (MSU)—defined as any upward shift in the pathological T stage relative to the clinical T stage. Model performance was evaluated using the area under the Receiver Operating Characteristic (ROC) curve (AUC). Results: Upstaging occurred in 31.9% and MSU in 50.6% of patients. The mean age was 65 years. Cut-off values for PSA density (PSAD) were 0.29 for upstaging and 0.28 for MSU. In the full-cohort model (AUC = 0.628), PSAD (odds ratio (OR) = 2.55), age (OR = 1.04), and hypertension (HT) (OR = 1.47) were associated with upstaging. In PIRADS-based models, PIRADS 5 and PSAD predicted both upstaging (OR = 1.62 and 6.10, respectively; AUC = 0.664) and MSU (OR = 1.75 and 4.67, respectively; AUC = 0.659). MSU was also associated with HT and a lack of fusion biopsy (AUC = 0.622). Conclusions: PSAD and PIRADS 5 lesions are strong determinants of pathological upstaging and MSU in PCa. These factors should be considered in preoperative risk stratification to improve staging accuracy. Despite advances in imaging and biopsy techniques, upstaging remains a common phenomenon, underlining the need for further refinement of diagnostic protocols. Full article
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14 pages, 347 KB  
Article
Impact of Maternal Valaciclovir Therapy on Early Neurodevelopment in Congenital CMV Infection: A Retrospective Pilot Study
by Francesca Arcieri, Adele Vasta, Gregorio Volpe, Fabio Natale, Barbara Caravale, Daniele Di Mascio, Valentina D’Ambrosio, Michela De Cicco, Gianluca Terrin, Lucia Oliva, Costanza Prestianni, Giuseppina Liuzzi, Lucia Manganaro and Antonella Giancotti
Children 2026, 13(4), 566; https://doi.org/10.3390/children13040566 - 18 Apr 2026
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Abstract
Background/Objectives: Maternal valaciclovir therapy is increasingly used to reduce fetal viral replication in cases of primary cytomegalovirus (CMV) infection during pregnancy. However, data on its impact on early neurodevelopmental outcomes remain limited. This study aimed to evaluate the association between prenatal valaciclovir exposure [...] Read more.
Background/Objectives: Maternal valaciclovir therapy is increasingly used to reduce fetal viral replication in cases of primary cytomegalovirus (CMV) infection during pregnancy. However, data on its impact on early neurodevelopmental outcomes remain limited. This study aimed to evaluate the association between prenatal valaciclovir exposure and early neurodevelopment in infants with confirmed congenital CMV infection (cCMV). Methods: In this retrospective monocentric cohort study, 30 infants with PCR-confirmed cCMV infection were assessed at 4–8 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants were stratified according to prenatal exposure to maternal valaciclovir. Univariate analyses and multivariable linear regression models were performed to evaluate the association between prenatal antiviral exposure and cognitive outcome, adjusting for brain MRI findings and selected clinical variables. Results: Fifteen infants (50%) were exposed to prenatal valaciclovir. Exposed infants demonstrated higher cognitive composite scores compared with unexposed infants (median 105 [IQR 100–110] vs. 90 [85–110]; p = 0.030). In multivariable analysis, prenatal valaciclovir exposure remained significantly associated with higher cognitive scores (β = 11.89, 95% CI 2.86–20.92; p = 0.012), while neonatal MRI abnormalities were not independently associated with outcome. No significant differences were observed in language or motor domains. The final model explained 30% of the variance in cognitive scores (R2 = 0.30). Conclusions: Prenatal valaciclovir exposure was associated with higher cognitive composite scores after adjustment for selected covariates. Although causality cannot be inferred, these findings suggest a potential association with early neurodevelopmental outcomes and support the inclusion of functional neurodevelopmental endpoints in future prospective studies. These results should be considered exploratory and hypothesis-generating Full article
(This article belongs to the Special Issue Advances in Neurodevelopmental Outcomes for Preterm Infants)
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23 pages, 4234 KB  
Article
Humanized Murine Glioblastoma Models for Evaluation of Coxsackievirus Oncolytic Therapy
by Yana D. Gumennaya, Marat P. Valikhov, Elizaveta R. Naberezhnaya, Pavel O. Vorobyev, Veronika V. Vadekhina, Olga N. Alekseeva, Anastasiia O. Sosnovtseva, Dmitry V. Kochetkov, Alesya V. Soboleva, Leen Ibrahim, Stepan A. Ionov, Gaukhar M. Yusubalieva, Alexander V. Ivanov, Peter M. Chumakov and Anastasia V. Poteryakhina
Cancers 2026, 18(8), 1280; https://doi.org/10.3390/cancers18081280 - 17 Apr 2026
Viewed by 520
Abstract
Background/Objectives: Glioblastoma remains the most lethal primary brain tumor in adults, and progress in oncolytic virotherapy is limited by the lack of immunocompetent models permissive to human-tropic viruses. Methods: Here, murine CT-2A and GL261 glioma and B16 melanoma cell lines were [...] Read more.
Background/Objectives: Glioblastoma remains the most lethal primary brain tumor in adults, and progress in oncolytic virotherapy is limited by the lack of immunocompetent models permissive to human-tropic viruses. Methods: Here, murine CT-2A and GL261 glioma and B16 melanoma cell lines were engineered to express human Coxsackievirus and Adenovirus Receptor (CXADR) fused to tagBFP, generating “humanized” tumors that preserve parental growth characteristics while acquiring high susceptibility to group B Coxsackieviruses (CVBs) and adenovirus serotype 5. Results: CXADR expression in CT-2A, GL261, and B16 cells markedly enhanced binding, internalization, and replication of CVBs in vitro, with the strongest effect observed for LEV14 (attenuated CVB5), which reached up to 105-fold higher viral titers in humanized cells compared with parental cells. Unchanged sensitivity to vesicular stomatitis virus indicated receptor-specific effects. Humanized CT-2A-CXADR-BFP and GL261-CXADR-BFP cells initiated aggressive subcutaneous and intracranial tumors in syngeneic C57BL/6 mice without signs of immune rejection, and histology and MRI confirmed invasive high-grade glioma phenotypes. In intracranial CT-2A-CXADR-BFP tumors, repeated intratumoral LEV14 administration induced extensive tumor necrosis and prolonged survival despite the rapid development of neutralizing antibodies. Systemic intravenous LEV14 dosing produced strong oncolytic activity against subcutaneous CT-2A-CXADR-BFP tumors, as demonstrated by pronounced tumor growth inhibition, long-lasting regression in a subset of animals with gliomas, and improved overall survival. Conclusions: Collectively, these data establish CXADR-humanized models as versatile, immunocompetent platforms for evaluation of CXADR-dependent oncolytic enteroviruses. Full article
(This article belongs to the Special Issue Tumor Model for the Development of Anti-Cancer Drugs)
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