医学最新文献

{"title":"Reallocation time of accelerometer-measured movement behaviours, genetic susceptibility, and incident chronic obstructive pulmonary disease.","authors":"Darui Gao, Wenya Zhang, Yanyu Zhang, Mengmeng Ji, Xiaobo Han, Jie Liang, Yang Pan, Fanfan Zheng, Lixin Xie, Wuxiang Xie","doi":"10.1080/25310429.2026.2649099","DOIUrl":"10.1080/25310429.2026.2649099","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about the associations between reallocating time from one movement behaviour to another within 24 h with the risk of chronic obstructive pulmonary disease (COPD), particularly in the context of genetics.</p><p><strong>Methods: </strong>This study included 87 656 participants from the UK Biobank with valid wrist-worn accelerometer data and without prevalent COPD for the primary analysis. The isotemporal substitution model was used to evaluate the potential impact on COPD incidence of replacing one behaviour with an equivalent duration of another.</p><p><strong>Results: </strong>Our study showed that replacing 1 h/day of sleep, sedentary behaviours (SB), or light-intensity physical activity (LIPA) with an equal amount of time spent in moderate-to-vigorous physical activity (MVPA) was associated with 40%, 43%, and 39% lower risk of incident COPD, respectively. Stratified by genetic risk, within each subgroup, the inverse relationship between replacing sleep, SB, and LIPA with MVPA and COPD remained significant. In the joint association analysis of genetic susceptibility and MVPA duration with COPD, participants with intermediate and low genetic predisposition plus low MVPA duration were significantly associated with a 1.72- (95% CI: 1.32-2.24) and 1.39- (95% CI: 1.04-1.87) fold higher risk of incident COPD, respectively, compared to those with a high genetic predisposition and high MVPA duration.</p><p><strong>Conclusion: </strong>Irrespective of genetic susceptibility, substituting MVPA for other movement behaviours was associated with a lower risk of incident COPD. More MVPA involvement seemed to be able to mitigate the genetic risk of COPD.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2649099"},"PeriodicalIF":5.3,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The economic burden of preeclampsia: a systematic review.","authors":"Adili Adilan, Haoran Zhan, Yanan Hu, Lana McClements, Emily J Callander","doi":"10.1080/10641955.2026.2694980","DOIUrl":"10.1080/10641955.2026.2694980","url":null,"abstract":"<p><strong>Objective: </strong>Preeclampsia is a serious pregnancy complication associated with substantial maternal and infant morbidity worldwide. The adverse outcomes related to preeclampsia increase healthcare costs, highlighting the importance of quantifying its economic burden to inform healthcare policy and resource allocation. This systematic review aimed to synthesize evidence on the economic burden of preeclampsia and identify key cost drivers.</p><p><strong>Methods: </strong>MEDLINE, PubMed, Web of Science, and the Cochrane Library were searched for English-language studies published between 2014 and 2024. Studies reporting healthcare resource utilization or costs associated with preeclampsia were included. The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025650091).</p><p><strong>Results: </strong>Of 3,107 records identified, 12 studies were included; most were conducted in high-income countries. All cost estimates were converted to 2024 US dollars for comparability. Direct medical costs ranged from US$109.84 to US$87,339.71, with a mean cost of US$33,585.48 per patient. National healthcare system costs were estimated at €6.5-€9.1 million in Ireland and US$2.18 billion in the United States.</p><p><strong>Conclusion: </strong>Preterm birth was identified as a major driver of economic burden, with earlier gestational age significantly increasing maternal and infant costs. Indirect costs and regional disparities remain underexplored, highlighting important gaps for future research.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"45 1","pages":"2694980"},"PeriodicalIF":3.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of doravirine/islatravir for HIV-1: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.","authors":"Hamzah M Alghzawi, Syed Zohad Shah, Zain Ul Abideen, Muhammad Farhan Ashraf","doi":"10.1080/25787489.2026.2698230","DOIUrl":"10.1080/25787489.2026.2698230","url":null,"abstract":"<p><strong>Background: </strong>The combination of doravirine and islatravir (DOR/ISL) is a novel two-drug regimen for HIV-1. Early development faced challenges due to dose-dependent immunological signals. We aimed to synthesize the evidence on the efficacy and safety of DOR/ISL across all treatment-experience categories, specifically evaluating the impact of islatravir dosage (0.25 mg vs 0.75 mg) on clinical and immunological outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) following PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, and Google Scholar from inception through April 2026. Primary outcomes were virological suppression (<50 copies/mL) and mean change in CD4+ T-cell count at week 48. Data were pooled using random-effects models. Islatravir dose was evaluated as a pre-specified moderator. Quality was assessed using Cochrane RoB 2.0 and certainty of evidence was graded using the GRADE approach.</p><p><strong>Results: </strong>Seven RCTs (<i>n</i> = 3,600 participants) were included. At Week 48, DOR/ISL showed non-inferior suppression rates (RR 1.01 [95% CI 0.99-1.02]; <i>p</i> = 0.516; moderate-certainty evidence) and a statistically significant reduction in virological failure risk (RR 0.55 [0.33-0.92]; <i>p</i> = 0.022) compared to active control. Overall CD4+ gain was lower with DOR/ISL (MD -34.55 cells/μL; low-certainty evidence); however, a profound moderator effect of dose was observed (<i>p</i> < 0.0001). The 0.75 mg dose was associated with significant CD4+ and lymphocyte declines, whereas the approved 0.25 mg dose was immunologically neutral. DOR/ISL was weight-neutral compared to bictegravir/emtricitabine/tenofovir alafenamide (MD -0.25 kg [-0.66 to 0.16]; low-certainty evidence).</p><p><strong>Conclusion: </strong>DOR/ISL 100/0.25 mg once daily achieved virological suppression comparable to standard-of-care ART regimens and was associated with lower rates of virological failure compared with active comparators. The immunological safety concerns observed in early trials were successfully resolved by dose optimization. These findings support the use of DOR/ISL (IDVYNSO) as a potential treatment option for both treatment-naïve and virologically suppressed adults while emphasizing long-term safety surveillance.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2698230"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-ecological factors associated with becoming street-connected among working and homeless children and youth in Namibia.","authors":"Ndilimeke Johanna Christa Nashandi, Dennis N Makau, Minhae Cho, Erick O Buko, Elizabeth Lightfoot","doi":"10.1080/17441692.2026.2700820","DOIUrl":"https://doi.org/10.1080/17441692.2026.2700820","url":null,"abstract":"<p><p>Although Southern Afrikan governments implement child protection programs, children and youth who work and/or live on the streets remain a persistent challenge. Guided by Ubuntu and Adaptive Calibration frameworks, this cross-sectional survey examined socioecological factors at individual, family and street levels to inform child protection interventions that is linked to the UN sustainable development goal 1 (SDG). Bivariate analyses of 217 purposively sampled street-connected participants aged 6 to 21 in urban Namibia showed that early adolescence (mean age 13.5) remains a high-risk period for transitioning to street life. Multivariable logistic regression showed that higher odds of homelessness were associated with out-of-school, living with siblings or extended family before street involvement, leaving home due to neglect; sexual, physical, or psychological abuse; or parental alcohol abuse, earning less than N$100 and utilising shelter services. These associations reflect participants adaptive calibration of psychosocial stressors and economic realities of the urban landscape but, is in tension with the Ubuntu principle of belonging and interdependence. Findings suggest that family poverty is a key driver to enter the street economy while maltreatment and school dropout sever ties to the home, highlighting the need for longitudinal studies, strategies to prevent street-involvement and ultimately achieve SDG-1.</p>","PeriodicalId":12735,"journal":{"name":"Global Public Health","volume":"21 1","pages":"2700820"},"PeriodicalIF":2.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SII serves as an independent diagnostic indicator for GDM and is regulated by placental 5-HT/NF-κB signaling.","authors":"Weizhao Lin, Yujuan Tang, Jiahua Chen, Furong Liu, Shixin Chen, Qing Zhang, Xian Li, Pingping Song, Xuefeng Ma","doi":"10.1080/10641955.2026.2627865","DOIUrl":"10.1080/10641955.2026.2627865","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) poses a significant threat to perinatal health. Diagnosis based solely on glycemic parameters shows limited accuracy. The Systemic Immune-Inflammation Index (SII), a quantitative marker of inflammation, may improve diagnostic precision. This study analyzed clinical data stratified by GDM and obesity status to evaluate the diagnostic utility of SII and its underlying mechanisms involving placental NF-κB and 5-hydroxytryptamine (5-HT) signaling. We observed elevated SII levels in GDM patients, which correlated positively with glucose levels and inflammatory indicators (white blood cell count, fasting blood glucose, postprandial blood glucose). Logistic regression and receiver operating characteristic analyses confirmed the diagnostic value of SII, which was further enhanced when combined with clinical covariates. Placental expression of tryptophan hydroxylase 1 (TPH1) and NF-κB was significantly increased in GDM and closely linked to SII levels. Dysregulation of placental 5-HT signaling, characterized by increased TPH1 and monoamine oxidase A (MAO-A) expression alongside reduced serotonin transporter (SERT), was associated with maternal overweight. Moreover, SII, BMI, TPH1, and NF-κB all correlated with insulin resistance (IR). These results support SII as a non-invasive diagnostic indicator for GDM and highlight the role of placental 5-HT/NF-κB signaling in its pathogenesis, providing insights for early diagnosis and targeted therapy.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"45 1","pages":"2627865"},"PeriodicalIF":3.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of systemic inflammatory response index with severity of preeclampsia.","authors":"Lina Gao, Yan Dong, Xiaohui Liu, De Chen, Huixin Cheng, Jian Liu","doi":"10.1080/10641955.2026.2632210","DOIUrl":"10.1080/10641955.2026.2632210","url":null,"abstract":"<p><strong>Objective: </strong>The systemic inflammatory response index (SIRI), a novel and integrated hematological index calculated as (neutrophil count × monocyte count)/lymphocyte count, has been recognized as a reliable marker of systemic inflammation. This article undertakes an analysis of clinical data from preeclampsia (PE) patients, aiming to comprehensively assess the relationship between SIRI, PE, and the severity of PE.</p><p><strong>Methods: </strong>A total of 783 pregnant women in their third trimester were divided into severe preeclampsia (SP) (<i>n</i> = 275), non-SP (<i>n</i> = 273), and control (<i>n</i> = 235) groups. Pearson correlation analysis was performed to investigate the relationship between SIRI and blood pressure. Receiver operating characteristic (ROC) curves were employed to evaluate the predictive ability of SIRI. Multivariate logistic regression analysis was used to assess the association between SIRI and the severity of PE.</p><p><strong>Results: </strong>There was a significant relationship between SIRI and systolic blood pressure (<i>r</i> = 0.488, <i>p</i> < 0.001) as well as diastolic blood pressure (<i>r</i> = 0.462, <i>p</i> < 0.001). ROC curve revealed that pregnant women with SIRI ≥ 1.84 × 10⁹/L were more likely to experience non-SP (AUC: 0.662; 95% CI: 0.615-0.710; <i>p</i> < 0.001), and those with SIRI ≥ 2.45 × 10⁹/L were prone to SP (AUC: 0.879; 95% CI: 0.850-0.910; <i>p</i> < 0.001). Multivariate logistic regression analysis demonstrated that SIRI served as an independent risk factor for both non-SP and SP (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>There is a strong correlation between SIRI and the severity of PE, and SIRI shows potential in predicting the severity of PE.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"45 1","pages":"2632210"},"PeriodicalIF":3.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging characteristics and clinical outcomes of posterior reversible encephalopathy syndrome in preeclamptic and eclamptic patients.","authors":"Ahmet Beyazıt, İbrahim Barışcan Soydan, Kenan Serdar Dolapçıoğlu, Hanifi Bayaroğulları, Oya Soylu Karapınar, Arif Güngören","doi":"10.1080/10641955.2026.2636602","DOIUrl":"10.1080/10641955.2026.2636602","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome (PRES) is a neurological complication linked to preeclampsia and eclampsia. This study compared the clinical and radiological features of PRES in patients with these conditions. This retrospective single-center cohort study from 2010 to 2024 included patients diagnosed with preeclampsia and eclampsia who underwent MRI due to neurological symptoms. Two radiologists, blinded to the clinical data, re-evaluated the MRIs twice. PRES cases were assessed based on the sites and patterns of involvement. Maternal and perinatal outcomes, along with laboratory characteristics, were reviewed through medical records. The study included 157 patients with preeclampsia and eclampsia who underwent MRI for neurological symptoms. PRES was diagnosed in 55 patients (35.0%), with a higher incidence of eclampsia (64.71%) compared to preeclampsia (20.75%). Patients with PRES were younger, had lower gravidity and parity, and were at an earlier gestational age than those with normal MRI findings. The parietal and occipital regions were the most affected in both preeclampsia and eclampsia patients with PRES. Parietal lobe and bilateral involvement were more common in the eclampsia group. Atypical involvement, including brainstem and cerebellar lesions, was observed in both groups. These findings suggest that eclampsia may represent a neurological manifestation of PRES.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"45 1","pages":"2636602"},"PeriodicalIF":3.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polyclonal B-cell lymphocytosis: a rare, benign condition that mimics a chronic lymphoproliferative disorder.","authors":"Emily Parkes, Pedro Martin-Cabrera, Hannah Creasey, David Bloxham, George Follows","doi":"10.1080/16078454.2026.2704266","DOIUrl":"10.1080/16078454.2026.2704266","url":null,"abstract":"<p><strong>Objectives: </strong>We report a case of Persistent polyclonal B-cell lymphocytosis (PPBL), a rare and benign lymphoproliferative disorder, to highlight the importance of recognising its characteristic features in order to avoid unnecessary investigations and inappropriate treatment. We also underscore the potential reversibility of disease features with smoking cessation.</p><p><strong>Results: </strong>The patient presented with a prolonged history of low-level abdominal discomfort and unintentional weight loss on a background of a significant smoking history. Physical examination revealed splenomegaly. The laboratory results revealed a persistent lymphocytosis, prompting a referral to a haematology specialist with a working diagnosis of a malignant lymphoproliferative disorder. Subsequent investigations revealed markedly elevated polyclonal IgM with no monoclonal paraprotein via serum electrophoresis. A peripheral blood smear demonstrated characteristic binucleate lymphocytes, and flow cytometry confirmed polyclonal B-cell expansion with a normal immunophenotype. Molecular and cytogenetic analysis excluded B-cell neoplasia and supported a final diagnosis of PPBL.</p><p><strong>Discussion: </strong>PPBL can closely mimic malignant chronic lymphoproliferative disorders. Recognition of its characteristic laboratory and morphological features, namely polyclonal lymphocytosis, atypical binucleated lymphocytes, and elevated serum immunoglobulin M (IgM) without a monoclonal paraprotein, is essential to avoid unnecessary invasive investigations and inappropriate treatment. PPBL pathogenesis remains elusive but is likely to involve a genetic predisposition and chronic antigen stimulation. Cigarette smoking appears to be the dominant environmental trigger, with cessation often leading to stabilisation or resolution of lymphocytosis. The role of the Epstein‒Barr virus has been proposed given the binucleated lymphocytes and polyclonal B-cell expansion, but evidence remains inconclusive.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognising PPBL to avoid unnecessary invasive investigations and inappropriate treatment and underscores the potential reversibility of disease features with smoking cessation.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2704266"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactate/AARS1-mediated H3K18la in the modulation of ACSL4 transcription to trigger ferroptosis in myocardial ischemia reperfusion.","authors":"Dianhua Zhou, Jianfeng Ye, Zhubin Lun, Wenwei Feng, Xiaohan Ye","doi":"10.1080/10641963.2026.2704866","DOIUrl":"10.1080/10641963.2026.2704866","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Hypertension serves as a pivotal risk factor for myocardial ischemia reperfusion injury (MIRI). Reciprocally, MIRI exacerbates hypertension by inducing oxidative stress, inflammatory responses, cardiomyocyte death, fibrosis-associated myocardial remodeling, and RAAS system disruption, forming a vicious feedback cycle. This study aimed to investigate the regulatory role and underlying molecular mechanism of the lactate-related signaling axis in cardiomyocyte ferroptosis during MIRI, and to identify novel potential therapeutic targets for interrupting this detrimental feedback loop.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;&lt;i&gt;In vivo&lt;/i&gt; mouse MIRI models, &lt;i&gt;in vitro&lt;/i&gt; cardiomyocyte oxygen‒glucose deprivation/reoxygenation (OGD/R) models, and spontaneously hypertensive rat (SHR) models were successfully established. Oxaloacetate and β-alanine were administered to inhibit lactate production and protein lactylation, respectively. Hematoxylin‒eosin (HE) and Masson staining were performed to evaluate myocardial histopathological damage and fibrosis. Immunohistochemistry (IHC) and Western blotting were used to detect the protein expression levels of lysine lactylation (Kla), H3K18la, alanyl-tRNA synthetase 1 (AARS1), and acyl-CoA synthetase long-chain family member 4 (ACSL4). An enzyme-linked immunosorbent assay (ELISA) was adopted to quantify the lactate content and ferroptosis-related marker levels. Transmission electron microscopy (TEM), immunofluorescence staining, and chromatin immunoprecipitation (ChIP) assays were separately utilized to observe the mitochondrial ultrastructure, assess cellular lipid peroxidation, and verify gene promoter enrichment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Lactate, Kla, and H3K18la levels were markedly elevated in the MIRI and OGD/R models, accompanied by severe myocardial injury, fibrosis, and excessive cardiomyocyte ferroptosis. Inhibition of lactate production effectively reduced lactylation levels and mitigated ferroptosis as well as myocardial structural damage. Mechanistically, H3K18la was enriched in the promoter region of ACSL4 to facilitate its transcriptional activation, and knockdown of ACSL4 markedly reversed OGD/R-triggered cardiomyocyte ferroptosis. AARS1 overexpression strengthened lactylation and ACSL4 expression to promote ferroptosis, while its mutant did not. Notably, hypertension aggravated MIRI, promotes further increases in the level of histone lactylation mediated by AARS1, and exacerbates ferroptosis. Pharmacological intervention with β-alanine blocked the lactate/AARS1/H3K18la/ACSL4 axis and attenuated MIRI-induced myocardial damage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Abnormal lactate accumulation facilitates H3K18la modification via AARS1-dependent regulation, which transcriptionally activates ACSL4 and modulates cardiomyocyte ferroptosis, ultimately contributing to the pathological progression of MIRI. Targeting the lactate/AARS1/H3K18la/ACSL4 regulatory axis is a promis","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":"48 1","pages":"2704866"},"PeriodicalIF":6.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highly suppressive functional CCR7 ^<b>low</b> Treg subset cells may correlate with poor prognosis of B-ALL.","authors":"Sui Songnan, Jiamian Zheng, Jing Lai, Yupei Zhang, Xu Jiang, Ling Xu, Liye Zhong, Jie Chen, Jie Wu, Xun Zhu, Yangqiu Li, Guocai Wu, Zhanghui Chen","doi":"10.1080/16078454.2026.2702683","DOIUrl":"10.1080/16078454.2026.2702683","url":null,"abstract":"<p><strong>Background: </strong>Regulatory T cells (Tregs) may influence prognosis in leukemia. This study aimed to explore the effects and mechanisms of Treg subclusters on the prognosis in B-cell acute lymphoblastic leukemia (B-ALL) using single-cell RNA sequencing (scRNA-Seq).</p><p><strong>Methods: </strong>scRNA-seq was performed on sorted T cells from adults with newly diagnosed (Dix) B-ALL and healthy donors (HD) to establish the training cohort. Treg phenotypes, functions, and prognostic relevance were evaluated. A scRNA-seq dataset from the GEO database, including Dix and relapsed B-ALL, served as the validation cohort. Key findings were confirmed by flow cytometry. Transcription factor and cell-cell interaction analyses were conducted to clarify the mechanisms linking Treg subsets to prognosis.</p><p><strong>Results: </strong>Tregs were divided into CCR7^high and CCR7^low subclusters. The proportion of CCR7^low Tregs was higher in B-ALL than in HD and in Rel than in Dix. Patients with higher CCR7^low Treg signature scores had a poorer prognosis. Compared with CCR7^high Tregs, CCR7^low Tregs exhibited enhanced activation, proliferation, and immunosuppression. Trajectory analysis suggested differentiation from CCR7^high to CCR7^low Tregs. IKZF2 and JUNB showed consistently increased activity and expression in CCR7^low Tregs across cohorts. CCR7^low Tregs showed increased interactions with terminal effector and exhausted CD8⁺ T cells through the LGALS9-P4HB/HAVCR2/CD44 pathway.</p><p><strong>Conclusion: </strong>An increased proportion of CCR7^low Tregs correlated with poor prognosis in B-ALL, potentially due to enhanced activation, proliferation, and immunosuppression. IKZF2 and JUNB upregulation may promote CCR7^low Treg differentiation and function. Moreover, CCR7^low Tregs may impair CD8⁺ T cell immunity through the LGALS9-P4HB/HAVCR2/CD44 signaling.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2702683"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}