Search Results (37,051)

Background: Type 1 diabetes (T1D) shares clinical characteristics with other forms of diabetes, particularly monogenic diabetes such as maturity-onset diabetes of the young (MODY). Differential diagnosis is complicated by the existence of intermediate phenotypes. We aimed to delineate the phenotypic continuum between T1D and monogenic diabetes. Methods: The multicentric GENEPEDIAB study included patients aged 6 months to 18 years diagnosed with diabetes and treated for either T1D or monogenic diabetes. Analyses comprised glycemic variability, continuous glucose monitoring metrics, application of the DIAMODIA criteria, and genetic investigations. Results: A gradient was observed across T1D, atypical diabetes (Adia), and MODY cohorts for several glycemic parameters. T1D patients exhibited values furthest from treatment targets, whereas MODY patients showed better glycemic control. Stratification of the Adia cohort according to the number of positive DIAMODIA criteria further supported this trend, as demonstrated by glycemic measures and multiple correspondence analysis. Genetic analyses did not identify a uniform causative variant in the Adia cohort; however, several rare variants, including variants of uncertain significance and likely pathogenic variants in diabetes-related genes, were detected. Conclusions: These findings showed, in our specific cohort of pediatric patients, the existence of a phenotypic gradient between T1D and monogenic diabetes, with atypical diabetes occupying an intermediate position, including when stratified by DIAMODIA criteria. Full article

Drought stress severely constrains plant growth and productivity. To mitigate water loss, plants primarily regulate stomatal aperture through the Abscisic acid (ABA) signaling pathway, where the Sucrose Nonfermenting 1-Related Protein Kinase 2 (SnRK2) family kinase Open Stomata 1 (OST1) acts as a central positive regulator. However, the upstream regulators that fine-tune OST1 activity remain incompletely characterized. Aliphatic Suberin Feruloyl Transferase (ASFT), a BAHD acyltransferase essential for suberin aromatic monomer biosynthesis, was previously uncharacterized regarding its function in leaves. Here, we report that ASFT negatively regulates drought tolerance in Arabidopsis thaliana by directly interacting with OST1 and inhibiting its autophosphorylation, thereby restricting stomatal aperture. Consistent with this, the asft mutant exhibited decreased water loss and enhanced survival under drought, whereas ASFT-overexpressing lines showed opposite phenotypes. BiFC, Co-IP and in vitro kinase assays confirmed that ASFT directly interacts with OST1 and suppresses its autophosphorylation, while dehydration-induced OST1 phosphorylation was elevated in the asft mutant. Genetic evidence confirmed that ASFT functions upstream of OST1. This study reveals a moonlighting role for this suberin biosynthetic enzyme in ABA signaling and provides a potential target for breeding drought-resistant crops. Full article

Pear scab, caused by Venturia pyrina, poses a threat to pear cultivation, with particularly severe consequences for Portugal’s high-value Rocha pear industry. Despite its economic impact, few biological control agents are currently available. In this work, the phenotypic and genomic characterization of Pseudomonas capeferrum NFX1 is performed and its role as an effective biocontrol agent against V. pyrina is reported. Detailed genomic analysis revealed that strain NFX1 and other members of the Pseudomonas capeferrum species contain key biosynthetic gene clusters involved in pathogen antagonism, including the cyclic lipopeptide putisolvin. Phenotypic assays showed that strain NFX1 significantly inhibited V. pyrina growth, spore germination, and reduced pear scab lesion severity and fungal colonization in detached leaf assays. Moreover, strain NFX1 reprogrammed the Rocha pear leaf transcriptome to be consistent with a priming state and induced systemic resistance. A novel image-based method quantifying lesion darkening as a proxy for pear scab severity in detached leaves and a qPCR assay targeting the V. pyrina ef1-α gene and optimized for fungal DNA detection in infected pear leaves were also developed, thereby establishing a laboratory workflow specifically tailored to biocontrol evaluation against V. pyrina. Ultimately, the obtained results demonstrated the potential of P. capeferrum NFX1 for sustainable pear scab control. Full article

Transport of Golgi-localized proteins from the ER is mediated by the coat protein complex II (COPII) and its members, COPII inner coat subunit Sec24 and Secretion-associated Ras-related GTPase 1 (Sar1). Sar1 and Sec24 recognize cytosolic N-termini of glycosyltransferases (GTs) that contain peptide signals required for incorporation into COPII-coated vesicles. Xyloglucan Xylosyltransferases (XXTs) are required for xyloglucan (XyGs) biosynthesis and must be transported to the Golgi for proper function. In this study, we demonstrated that XXTs interact with AtSar1 in the COPII complex but not with AtSec24, which was previously reported to be the main recruiter of cargo proteins into COPII-coated vesicles. The mutation of the arginine to glutamine residues of di-arginine motifs in the N-termini of XXTs caused protein mislocalization and significantly reduced the strength of the interaction with AtSar1. These mutations caused 90% of XXTs to either remain in the ER or localize to small non-Golgi compartments. In turn, such mislocalization significantly suppressed the recovery of XyGs biosynthesis in Arabidopsis thaliana (Arabidopsis) mutants (xxt1xxt2 and xxt3xxt4xxt5), failing to restore their root phenotypes to normal. Our results demonstrate the interaction between cargo and AtSar1, highlighting the critical role of di-arginine motifs in this interaction. These results provide new insights into the mechanism of ER-to-Golgi delivery of plant GTs, which significantly advances our understanding of polysaccharide biosynthesis in the Golgi and the enzymes responsible for it. Full article

Phosphorus (P) limitation is a major selective pressure in plant evolution and a persistent constraint on modern crop production. However, how domestication has reshaped P adaptation strategies remains poorly understood. Here, we compared wild (Solanum pimpinellifolium) and cultivated (Solanum lycopersicum) tomatoes under contrasting P conditions using integrated physiological, ionomic, and transcriptomic analyses. Our findings reveal distinct P strategies between the examined genotypes. Cultivated tomatoes achieved higher biomass under sufficient P supply but were highly sensitive to P deficiency, responding through acquisition-driven phenotypic plasticity characterized by extensive root remodeling and enhanced external P mobilization. In contrast, wild accessions maintained growth and higher P use efficiency under low P by relying on an optimized internal P management strategy, including efficient P uptake, preferential allocation to photosynthetically active tissues, and effective remobilization from older leaves. Consistently, ionomic profiling revealed that wild tomatoes preserved coordinated macro- and micronutrient homeostasis under P stress. Tissue-specific transcriptomic analyses further uncovered pronounced divergence in P-responsive regulation, with cultivated tomatoes showing predominantly root-centered responses, whereas wild accessions exhibited strong activation in old source leaves. This tissue-specific specialization was accompanied by a putative regulatory divergence, with HD-ZIP transcription factors enriched in cultivated tomatoes and G2-like and bHLH factors central in wild accessions. Together, our results indicate that modern cultivars exhibit a stronger reliance on external P acquisition and greater growth sensitivity under sustained P limitation compared to wild accessions, which showed relatively more stable internal P allocation patterns, highlighting wild germplasm as a resource for improving crop P efficiency. Full article

Triple-negative breast cancer (TNBC) is an aggressive subtype with limited treatment options. Emerging evidence shows that mechanotransduction, driven by matrix stiffness and mechanical signaling, promotes TNBC invasion and metastasis. As breast cancer progresses, expansion of fibroblasts and tumor-reactive stroma increases extracellular matrix deposition, generating matrix tension and enhancing mechanotransduction, which promotes cell proliferation, invasion, and metastatic potential through altered gene expression patterns. To investigate the molecular mechanisms underlying these changes, human TNBC cells were subjected to constant or oscillatory strain, followed by comprehensive transcriptomic analysis. Results revealed pronounced differential expression of genes involved in cell migration, adhesion, and transforming growth factor-β (TGFβ) signaling, with RT-PCR validation confirming SKI Like Proto Oncogene (SKIL) as the most strongly upregulated gene. Analysis of The Cancer Genome Atlas (TCGA) datasets indicated that SKIL is highly expressed in multiple breast cancer subtypes. Cross-sectional comparison of oscillatory strain-induced genes with TCGA data revealed coordinated upregulation of TGFβ, SKIL, and other genes associated with invasive phenotypes, immune suppression, and drug resistance, highlighting the vital role of TGFβ signaling. Transcription factor enrichment analysis further identified regulators linked to oncogenic pathways, including TGFβ effectors and Hippo signaling, supporting a mechanotransduction-driven transcriptional program in breast cancer. Full article

The transition from Sanger to next-generation sequencing (NGS) for HIV-1 drug resistance testing offers enhanced sensitivity but also introduces bioinformatic variability. This study evaluated four strategies: the commercial Exatype platform, the academic Stanford HIVdb-NGS, the open-source Quasitools (HyDRA) suite, and a custom de novo assembly workflow, iLunaR. Using 85 clinical HIV-1 pol MiSeq sequencing datasets, concordance was assessed at a 2% mutation detection threshold. A majority consensus standard defined true presence if a mutation was detected by at least three pipelines and supported by Sanger sequencing. While the datasets were successfully processed by all pipelines, discordances emerged in detecting low-abundance mutations and a specific case of structural mutation. iLunaR achieved perfect agreement (Cohen’s kappa = 1.000; 95% CI: 1.000–1.000). Quasitools demonstrated the lowest agreement (Cohen’s kappa = 0.901; 95% CI: 0.807–0.995) due to consistent reporting of mutations at lower abundance levels and aligner-induced reference bias misclassifying a deletion as a point mutation. Exatype (Cohen’s kappa = 0.951; 95% CI: 0.884–1.000) and Stanford (Cohen’s kappa = 0.926; 95% CI: 0.846–1.000) exhibited specific failures, including an omitted integrase mutation and codon translation errors, respectively. These findings confirm that bioinformatic algorithm choice remains a critical clinical variable despite NGS advancements in HIV-1 drug resistance testing. Full article

The natriuretic peptides A and B, encoded by NPPA and NPPB, respectively, have complementary and redundant functions in cardiovascular homeostasis. To establish their coordinated roles, we analyzed the cardiac phenotype of a mouse line in which the Nppa–Nppb cluster was deleted from the genome. At 8 weeks of age, Nppa–Npbb^−/−-/- mice (HOM) had significantly larger hearts and cardiomyocytic hypertrophy compared to wild-type and heterozygous mice. Electrocardiogram comparisons showed QRS prolongation in HOM mice. Hypertrophy was confirmed by echocardiography, which further indicated preservation of left ventricular systolic function. Bulk-transcriptomic analysis revealed moderate changes in gene expression of the left ventricle. Genes involved in fatty acid metabolism, ion handling and conductivity, including genes marking the ventricular conduction system, were down-regulated. Spatial transcriptomic analysis revealed the greatest changes in gene expression in the subendocardial wall, where the ventricular conduction system is located. Tbx5, the encoding dosage-sensitive T-box transcription factor Tbx5 that is essential for the expression of ventricular conduction system genes and for Nppa and Nppb, was down-regulated in the ventricles of HOM mice, indicating that a positive feedback loop normally maintains Tbx5 expression. We conclude that homozygous Nppa–Nppb deficiency in mice causes cardiac hypertrophy, including a likely perturbation of the ventricular conduction system. Full article

Pulmonary hypertension (PH) is a complex condition in which early diagnosis remains challenging, particularly in patients with exertional symptoms and normal or borderline resting haemodynamics. Although right heart catheterisation is the diagnostic gold standard, transthoracic echocardiography is the recommended first-line non-invasive test. However, resting echocardiography provides only a static assessment and may underestimate disease severity in early or latent pulmonary vascular disease due to preserved pulmonary vascular compliance and adaptive right ventricular responses. Because pulmonary haemodynamics are intrinsically flow-dependent, pathological abnormalities may only emerge during increased cardiac output. Stress echocardiography, performed using exercise or pharmacological stress, enables dynamic evaluation of pulmonary pressure responses, cardiac output augmentation, right ventricular contractile reserve, and ventricular interaction. Increasing evidence indicates that stress echocardiography can unmask abnormal pulmonary pressure–flow relationships, impaired pulmonary vascular reserve, and reduced right ventricular–pulmonary arterial coupling that are not apparent at rest, thereby improving functional and haemodynamic characterisation in selected patients. This Diagnostic Review outlines the physiological basis for stress echocardiographic assessment of pulmonary circulation, proposes practical recommendations for patient selection and testing protocols, and provides a framework for interpretation centered on pressure–flow relationships rather than absolute pulmonary pressure thresholds. Particular attention is given to clinical scenarios with high diagnostic yield, including unexplained exertional dyspnoea, systemic sclerosis, suspected heart failure with preserved ejection fraction, at-risk relatives of patients with pulmonary arterial hypertension, selected athletes, and paediatric populations. Stress echocardiography should not be considered a standalone diagnostic test for PH but, when performed in experienced centers and integrated within structured diagnostic pathways, it represents a valuable non-invasive adjunct to guide referral for invasive haemodynamic confirmation. Full article

Background: Vertigo and dizziness in children represent diagnostically challenging conditions with heterogeneous etiologies. At initial presentation, a substantial proportion of pediatric patients remain without a definitive etiological diagnosis. Evidence on the impact of longitudinal follow-up on etiological classification in pediatric vertigo is limited. Methods: This observational cohort study uses prospectively collected clinical data. Children aged 1–17 years who presented to a tertiary ENT clinic with vertigo and/or dizziness between 2015 and 2020 were systematically enrolled and followed. The present study represents a retrospective revision of a previously published cohort of 257 children. In 2025, extended follow-up data were reviewed to reassess etiological classification using the same diagnostic categories as in the original analysis. Descriptive statistics were applied to compare etiological distributions at initial evaluation and after follow-up revision. Results: After data revision, the proportion of children with unclassified etiology decreased from 44% to 10%. Central etiologies accounted for 35% of cases, peripheral vestibular disorders for 18%, hemodynamic causes for 16%, psychogenic etiologies for 10%, and other specific causes for 7%. Follow-up duration ranged from 0 to 132 months (mean 17.6 months; median 4.5 months). Diagnostic investigations were frequently performed; however, the etiological yield of certain tests, particularly cranial computed tomography, was low. Conclusions: Extended follow-up significantly improves etiological classification in children with vertigo and dizziness, demonstrating that diagnostic uncertainty at initial presentation often reflects evolving clinical phenotypes rather than the absence of an underlying disorder. A longitudinal, clinically guided, and multidisciplinary approach is essential to enhance diagnostic accuracy and optimize the use of diagnostic investigations in pediatric vertigo. Full article

Muscle biopsy has long been regarded as the cornerstone for diagnosing pediatric muscular disorders; however, it is invasive and may be limited by sampling error and inconclusive histopathological findings. This study aimed to evaluate whether whole-exome sequencing (WES) can effectively replace muscle biopsy as a first-line diagnostic approach in children with suspected neuromuscular disorders. Between January 2018 and December 2025, we prospectively enrolled 47 pediatric patients presenting with clinical features suggestive of muscular disorders at a tertiary medical center in Taiwan. The cohort included patients with suspected muscular dystrophies (n = 21), congenital myopathies (n = 23), and multiplex ligation-dependent probe amplification (MLPA)-negative Duchenne muscular dystrophy (DMD; n = 3). All patients underwent WES as the initial diagnostic test without prior muscle biopsy. Trio-based analysis using parental samples was performed in 29.8% of cases. Variant interpretation followed the American College of Medical Genetics and Genomics (ACMG) guidelines. WES identified a definitive molecular diagnosis in 72.3% of patients (34/47). Diagnostic yields varied by subgroup: 100% (3/3) in MLPA-negative DMD, 71.4% (15/21) in muscular dystrophies, and 69.6% (16/23) in congenital myopathies. Pathogenic or likely pathogenic variants were detected in 31 distinct genes, including COL6A1 and COL6A3, which are associated with Ullrich congenital muscular dystrophy. Notably, 58.8% of diagnosed patients (20/34) received molecular diagnoses that differed from their initial clinical impression, encompassing conditions such as ZSWIM6-associated neurodevelopmental disorders, GJB2-related hearing loss, OCRL-associated Lowe syndrome, and various metabolic or syndromic disorders. In all three MLPA-negative DMD cases, WES identified point mutations amenable to mutation-specific therapies. No patient required a muscle biopsy for diagnostic confirmation during the study period. First-tier WES demonstrates high diagnostic utility in pediatric muscular disorders while avoiding invasive muscle biopsy. The high rate of diagnostic reclassification underscores the substantial phenotypic overlap between primary neuromuscular diseases and other neurological or systemic conditions. These findings support the early implementation of genetic testing to enable accurate diagnosis and timely initiation of targeted therapies. Full article

Cardiovascular diseases (CVDs) remain the leading cause of global mortality, with aortic pathologies such as atherosclerosis and thoracic aortic aneurysm posing significant risks due to their asymptomatic nature and potential fatal complications. This study investigates molecular mechanisms underlying CVDs by examining key cellular components of the aortic wall—vascular smooth muscle cells (VSMCs), fibroblasts, and macrophages—and their responses to low-density lipoproteins (LDLs). Using in vitro models, we analyzed phenotypic characteristics, LDL internalization capacity, and secretion/expression of pro-inflammatory mediators (IL-6, IL-8, IL-1β, CCL2) in primary VSMCs (from tunica intima and media), fibroblasts (977hTERT), and THP-1 macrophages. Fluorescence staining with BDP 630/650 revealed that all cell types internalize LDLs, with macrophages showing the highest lipid accumulation. ELISA and RT-qPCR demonstrated cell-specific patterns of cytokine secretion and gene expression, both in control conditions and after LDL exposure. The results indicate that VSMCs and fibroblasts, normally involved in vascular tone maintenance and extracellular matrix (ECM) synthesis, acquire pro-inflammatory features under pathological conditions, including increased secretion of IL-6, IL-8, and CCL2. Macrophages exhibited enhanced expression of the scavenger receptor CD36 and pro-inflammatory cytokines (especially IL-1β) after LDL treatment. Full article

Chronic obstructive pulmonary disease (COPD) is a major contributor to global respiratory morbidity and exhibits substantial sex- and gender-related differences in incidence, phenotype, pathophysiology, and outcomes across the life course. Historically regarded as a predominantly male disease due to higher smoking rates, COPD is now increasingly recognized among women, reflecting changing exposure patterns and enhanced diagnostic attention. Moreover, evidence indicates that women may be more biologically susceptible to the harmful effects of tobacco smoke and often develop COPD at younger ages. Clinical manifestations also differ, with women more frequently reporting dyspnea, anxiety, and depression, whereas men may exhibit more cough and sputum production. Imaging studies suggest that airway-predominant disease is more common in women, while men are more likely to demonstrate emphysema-predominant patterns. Furthermore, women face an increased risk of exacerbation, yet they are more likely to experience underdiagnosis or misdiagnosis. Treatment responses and comorbidity patterns also show sex- and gender-related variations. Despite these differences, most clinical guidelines and therapeutic strategies do not differentiate by sex and gender, highlighting a gap in personalized COPD management. Overall, growing evidence underscores the importance of incorporating sex and gender as biological and sociocultural variables in COPD research, diagnosis, and treatment. Recognizing sex/gender-specific risk profiles, symptom patterns, and disease phenotypes may improve early detection and enable more targeted, effective interventions. This narrative synthesis, derived from a meticulous search in PubMed and the critical selection of 74 articles from the 448 identified originally, integrates evidence from guideline statements, registry studies, mechanistic and preclinical research, imaging and physiology investigations, systematic reviews, and randomized controlled trials that report sex- and gender-disaggregated data. Full article

Plants adapt to abiotic stresses by modulating morphological, physiological, and biochemical processes, which constitute the fundamental mechanisms of stress tolerance. Rice is highly susceptible to drought stress at all developmental stages, leading to substantial reductions in growth and yield, signifying the urgent need to develop drought-tolerant rice genotypes. In this study, recombinant inbred lines (RILs) in rice with enhanced drought tolerance were developed through a cross between the high-yielding rice variety BRRI-28 and the commercial variety BINA-7, followed by successive selfing and phenotypic selection. The resulting lines were evaluated using integrated morphological, physiological, biochemical, and anatomical analyses under well-watered (WW) and drought conditions (DC). BRRIdhan-56, a known drought-tolerant variety, was included as a check genotype. Among the tested lines, RIL-3 exhibited superior agronomic performance under DC, including a significantly higher tiller number, plant height, and seed dry weight, and improved root attributes compared with its parental lines and, for several traits, exceeding those of BRRIdhan-56. Leaf rolling was absent in RIL-3 and the check variety until the 23rd day of drought stress, whereas other genotypes exhibited varying degrees of stress symptoms. Panicle exertion under DC was observed exclusively in RIL-3 and the check. Although all genotypes showed reductions in biomass, relative water content, and chlorophyll levels under DC, RIL-3 consistently maintained higher values than its parental lines and comparable or superior levels to the check variety. Notably, RIL-3 exhibited a distinctive physiological response characterized by sustained chlorophyll retention and low proline accumulation under severe drought, in contrast to the high proline levels observed in sensitive lines. A root anatomical analysis further revealed well-developed aerenchyma formation in RIL-3 following drought treatment, supporting its drought tolerance. Together, these results demonstrate that RIL-3 combines an enhanced drought tolerance with a stable agronomic and yield-related performance and a unique physiological trait profile under drought stress, highlighting its potential value as a promising genotype for drought-tolerance breeding programs. Full article

Melanoma is an aggressive cancer characterized by a rapid metastatic process. Thus, understanding the mechanisms underlying its progression is urgently needed to improve patient outcomes. In this regard, there is consistent evidence of a tumor-sustaining crosstalk between melanoma and subcutaneous adipose tissue; however, the role of extracellular vesicles (EVs) in this communication still needs to be clarified. We demonstrated that the EVs derived from adipocytes did not alter melanoma cell proliferation but significantly promoted tumor cell migration and invasion by determining an enrichment in mesenchymal markers, such as N-cadherin and vimentin. In particular, these changes were accompanied by the transition towards a stem-like phenotype, characterized by enhanced spherogenic ability and ABCG2 upregulation; interestingly, this led to a reduced in vitro response to the BRAF inhibitor vemurafenib. Mechanistically, an increase in PGC-1α expression was found, resulting in higher mitochondrial mass and activity, ATP synthesis, and ROS overproduction; of note, treatment of melanoma cells with SR-18292 and XCT790, two inactivators of mitochondrial biogenesis, and N-acetylcysteine, a ROS scavenger, successfully counteracted the above EV-related effects, suggesting that mitochondrial function could be targeted to suppress the vesicular interactions between adipose tissue and melanoma. Taken together, these results highlight the crucial role played by EVs in melanoma stroma, pointing out the ability of adipocyte-derived vesicles to sustain cancer aggressiveness via PGC-1α–dependent mitochondrial reprogramming. Full article