Current Medical Science最新文献

{"title":"Insulin Resistance Markers Predict New-Onset Diabetes in Middle-Aged and Elderly Adults with Cardiovascular-Kidney-Metabolic Syndrome.","authors":"Yan-Ting Liang, Yu-Jian He, Jing-Yuan Liu, Yu-Ting Liu, Nan Hu, Zhen Wang, Hua-Lin Ma, Xin-Zhou Zhang","doi":"10.1007/s11596-026-00249-x","DOIUrl":"https://doi.org/10.1007/s11596-026-00249-x","url":null,"abstract":"<p><strong>Objective: </strong>Insulin resistance (IR) is central to cardiovascular-kidney-metabolic (CKM) syndrome, but the best IR-related marker for identifying CKM patients at high risk of diabetes remains uncertain. This study examined associations between IR-related markers and new-onset diabetes and compared their predictive performance.</p><p><strong>Methods: </strong>We analyzed 6,307 CKM participants from the China Health and Retirement Longitudinal Study (CHARLS) and 6,388 from the National Health and Nutrition Examination Survey (NHANES). Logistic regression and restricted cubic spline analyses were used to assess associations of triglyceride-glucose (TyG), TyG-body mass index (TyG-BMI), TyG-waist-to-height ratio (TyG-WHtR), metabolic score for IR (METS-IR), and estimated glucose disposal rate (eGDR) with diabetes. Subgroup analyses and receiver operating characteristic curves were employed to evaluate robustness and discrimination.</p><p><strong>Results: </strong>Over 7 years, diabetes developed in 736 CHARLS participants (11.67%) and 1,451 NHANES participants (22.71%). Five IR-related markers were significantly associated with the risk of diabetes and demonstrated good predictive performance. Elevated levels of TyG, TyG-BMI, TyG-WHtR, and METS-IR, as well as lower levels of eGDR, were associated with increased diabetes risk (all P < 0.001). Most associations remained robust across subgroup analyses. Among the five markers, eGDR demonstrated the highest predictive performance in the NHANES cohort (AUC: 0.789; 95% CI: 0.776-0.802) and showed favorable predictive ability in the CHARLS cohort.</p><p><strong>Conclusion: </strong>IR-related markers are significantly associated with the risk of diabetes in individuals with CKM syndrome and serve as reliable predictors of new-onset diabetes. Among these indicators, eGDR and TyG-WHtR were relatively reliable predictors, highlighting their potential as valuable tools for early diabetes screening.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227394","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":"Beyond Tumor Treating Fields: Multimodal Antitumor Action and the Clinical Potential of Pulsed Electromagnetic Fields.","authors":"Qian-Wen Zeng, Ming-Jie Liu, Li-Sha Yi, Shuang Wu, Pei-Pei Zhu, Hong-Zhi Hu, Zheng-Qi Shao","doi":"10.1007/s11596-026-00248-y","DOIUrl":"https://doi.org/10.1007/s11596-026-00248-y","url":null,"abstract":"<p><p>Pulsed electromagnetic fields (PEMFs) are a noninvasive, safe, and well-tolerated physical therapy modality with established applications in musculoskeletal disorders. Their potential role in oncology has attracted increasing interest. This review synthesizes current evidence on the antitumor mechanisms and experimental effects of PEMFs across diverse cancer models. Reported biological effects include the induction of apoptosis, regulation of intracellular calcium homeostasis, inhibition of angiogenesis, modulation of immune responses, induction of oxidative stress, regulation of autophagy and cellular metabolism, and enhancement of sensitivity to radiotherapy and chemotherapy. Preclinical studies suggest that PEMFs can selectively suppress proliferation and promote cell death in malignant cells while exerting comparatively limited cytotoxicity in normal cells. Evidence has been reported in models of breast cancer, glioma, hepatocellular carcinoma, melanoma, and other malignancies. Although clinical investigations remain preliminary, studies conducted over the past two decades support a favorable safety profile and suggest potential therapeutic efficacy, particularly in combination with chemotherapy, radiotherapy, or immunotherapy. Artificial intelligence and machine learning may facilitate parameter optimization and the development of individualized treatment regimens. Ultimately, the integration of PEMFs into routine oncology practice will require well-designed, large-scale randomized controlled trials to standardize treatment protocols, define clinical indications, and establish their role in multimodal cancer care.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135355","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":"Beyond Fluid Responsiveness: Why Venous Congestion Matters in Sepsis.","authors":"Matteo Guarino, Michela Cascio, Francesco Luppi, Michele Domenico Spampinato, Roberto De Giorgio","doi":"10.1007/s11596-026-00246-0","DOIUrl":"https://doi.org/10.1007/s11596-026-00246-0","url":null,"abstract":"<p><p>Sepsis resuscitation has traditionally been guided by a flow-centered approach aimed at restoring arterial perfusion, often leading to standardized fluid administration strategies. However, recent evidence and international guidelines increasingly support individualized fluid therapy based not only on fluid responsiveness but also on fluid tolerance. Despite this paradigm shift, the venous side of the circulation remains largely under-recognized in bedside hemodynamic assessment. Organ perfusion depends not only on arterial inflow but also on effective venous drainage, and elevated venous pressure may impair tissue perfusion and contribute to organ dysfunction even in the presence of apparently adequate systemic hemodynamics. In septic patients, capillary leakage, myocardial dysfunction, vasoplegia, and altered venous compliance may create heterogeneous hemodynamic profiles in which fluid responsiveness and venous congestion can coexist. Consequently, fluid administration may transiently improve cardiac output while simultaneously worsening tissue edema and venous congestion. Emerging ultrasound-based tools, such as the Venous Excess Ultrasound (VExUS) score, aim to integrate venous assessment into resuscitation strategies, although their role in sepsis remains incompletely defined. Recognizing fluid tolerance as a complementary component of hemodynamic evaluation may help avoid one of the most common pitfalls of sepsis resuscitation: improving flow at the expense of congestion.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079957","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":"Xinmailong Injection Attenuates Doxorubicin-Induced Chronic Heart Failure by Regulating the SIRT1/Caspase-3 Axis and Metabolic Reprogramming: An Integrative Network Pharmacology and Metabolomics Study.","authors":"Chang-Ling Lv, Yan-Ni Xue, De-Xiao Wang, Lu Jin, Di Tan, Ding-Yu Wu, Fang Peng","doi":"10.1007/s11596-026-00238-0","DOIUrl":"https://doi.org/10.1007/s11596-026-00238-0","url":null,"abstract":"<p><strong>Objective: </strong>Chronic heart failure (CHF) is characterized by progressive cardiac dysfunction, myocardial remodeling, apoptosis, and metabolic disturbance. Xinmailong injection (XML) has demonstrated therapeutic potential for CHF; however, its underlying mechanisms remain incompletely understood.</p><p><strong>Methods: </strong>A total of 40 SPF rats were used to establish a doxorubicin-induced CHF model, with another 8 rats serving as the normal control group. The model rats were randomized into 5 groups (n = 8 per group): model, digoxin (0.025 mg/kg), XML low- (60 mg/kg), XML medium- (120 mg/kg), XML high- (240 mg/kg) groups with a 2-week intervention. Cardiac function, serum biomarkers, histopathology and cardiomyocyte apoptosis were detected. Untargeted metabolomics, network pharmacology, molecular docking and in vivo validation were integrated to explore the mechanisms of XML.</p><p><strong>Results: </strong>XML dose-dependently elevated left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular systolic pressure (LVSP) and maximum rate of left ventricular pressure change (± dp/dtmax), while reducing left ventricular end-diastolic pressure (LVEDP) (P < 0.01). It downregulated serum cardiac stress and myocardial injury markers (BNP, ANP, CK-MB, cTn-I, MYO, and LDH) and enhanced the activity of the antioxidant marker GSH-PX (P < 0.05 or P < 0.01); it alleviated myocardial necrosis, inflammatory infiltration and collagen deposition. Metabolomics indicated that XML reversed CHF-associated metabolic disorders mainly involving glycerophospholipids, linoleic acid, taurine and hypotaurine, pyrimidine metabolism, and the tricarboxylic acid (TCA) cycle. Network pharmacology screened 59 overlapping targets of XML and CHF, with sirtuin 1 (SIRT1) and caspase-3 as core hubs; molecular docking verified favorable binding affinities between XML's main active ingredients and the two targets (binding energy ≤  -4.65 kcal/mol). Consistent with above data, XML upregulated SIRT1 and B-cell lymphoma-2 (Bcl-2), downregulated BCL2-associated X protein (BAX) and cleaved caspase-3, restored the Bcl-2/BAX ratio and suppressed apoptosis of cardiomyocytes (P < 0.01).</p><p><strong>Conclusion: </strong>XML ameliorates doxorubicin-induced CHF via improving cardiac function, mitigating myocardial injury/fibrosis, restoring metabolic homeostasis and inhibiting cardiomyocyte apoptosis, which is closely related to regulating the SIRT1/caspase-3 axis and multiple metabolic pathways.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001415","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":"Huaiqihuang Alleviates Imiquimod-Induced Psoriasis-Like Skin Lesions and Depressive-Like Behaviors in Mice.","authors":"Song Zhang, Zi-Lu Zeng, Xin-Er Lin, Jie Ran, Qin-Yi Wang, Jia-Bin Yang, Yan Wu, Neng-Xing Lin","doi":"10.1007/s11596-026-00226-4","DOIUrl":"https://doi.org/10.1007/s11596-026-00226-4","url":null,"abstract":"<p><strong>Objective: </strong>Depression is a significant comorbidity of psoriasis, prompting an exploration of the potential use of traditional Chinese medicine for the concurrent treatment of both conditions. This study aimed to investigate the effects of Huaiqihuang (HQH) on psoriasis and its comorbid depressive-like behavior in a murine model.</p><p><strong>Methods: </strong>We utilized an imiquimod (IMQ)-induced psoriasis-like model to mimic psoriasis and concurrent depression. The mice received oral HQH extract, and subsequent assessments were performed to monitor changes in skin lesions, inflammatory cells, and depressive behaviors. A network pharmacology approach was used to identify target genes for protein‒protein interaction analysis, and potential signaling pathways were suggested. Based on the above prediction results, we investigated the effects of HQH on Th17 cell levels in the brains, skin-draining lymph nodes, and spleens of model mice to elucidate the underlying mechanisms.</p><p><strong>Results: </strong>Our results revealed a significant reduction in the mouse skin PASI score and pathological score following HQH treatment. Furthermore, HQH had inhibitory effects on CD3⁺ T-cell infiltration and epidermal proliferation, as supported by Ki67 staining in skin lesions. Additionally, HQH ameliorated weight loss in mice following IMQ-induced modeling and improved depressive-like behavior, as assessed by open field and swimming experiments. The network pharmacology approach predicted the importance of the TNF and IL-17 signaling pathways in the intervention of psoriasis comorbid with depression by HQH. Subsequent experimental validation demonstrated that HQH reduced the proportion of Th17 cells in the spleen, draining lymph nodes, and brain tissues of the mice.</p><p><strong>Conclusions: </strong>HQH reduced psoriasis skin lesions, relieved depressive-like behaviors and decreased the abundance of Th17 cells in the spleen, lymph nodes, and brain, suggesting the promise of traditional Chinese medicine for managing psoriasis and its comorbidities by targeting Th17 cells.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988537","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 Switching from Entecavir to Tenofovir Alafenamide for Chronic Hepatitis B Patients with Low-Level Viremia.","authors":"Dong Yan, Si-Heng Zhu, Ying-Ying Yuan, Yan-di Huang, Jie-Zuan Yang","doi":"10.1007/s11596-026-00243-3","DOIUrl":"https://doi.org/10.1007/s11596-026-00243-3","url":null,"abstract":"<p><strong>Objective: </strong>Clinical data on the efficacy and safety of tenofovir alafenamide fumarate (TAF) in chronic hepatitis B (CHB) patients with suboptimal response to entecavir (ETV) are limited. This study was designed to investigate the efficacy and safety of switching to TAF in CHB patients with low-level viremia (LLV).</p><p><strong>Methods: </strong>CHB patients with LLV who received ETV treatment for more than 52 weeks were divided into TAF group (n = 104) and ETV group (n = 395). Propensity score matching (PSM) was performed to adjust for baseline differences in age between the two groups. The outcomes included complete virological response (CVR) at weeks 12 and 24, normalization rates of aminotransferase (ALT) and aspartate aminotransferase (AST), and renal function and blood lipid levels.</p><p><strong>Results: </strong>Compared with the ETV group, the TAF group had significantly higher rates of CVR at week 12 and week 24 in both the raw cohort and the PSM cohort (all P < 0.05). In the PSM cohort, the superiority of TAF over ETV in achieving CVR remained statistically significant at both time points (all P < 0.05). ALT and AST normalization rates were also significantly greater in the TAF group than in the ETV group at week 24 (all P < 0.05). No significant differences in creatinine (Cr) levels or estimated glomerular filtration rate (eGFR) were observed between week 24 and baseline in the raw cohort. No significant changes in blood lipid levels were detected in the TAF group at week 24 (all P > 0.05).</p><p><strong>Conclusion: </strong>Switching to TAF may be beneficial for patients with LLV after prolonged ETV therapy, as it is associated with a significantly higher rate of CVR. No lipid metabolism-related disorders were observed following the switch to TAF.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911007","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":"Haikun Shenxi Capsule Ameliorates Renal Fibrosis by Modulating Gut Microbiota and Metabolism.","authors":"Hui Wang, Ai-Ling Yin, Zi-Lin Si, Chen-Wen Wang, Pei-Peng Chen, Hao-Wei Yu, Zhi-Heng Gong, Wan-Ting Peng, Xiao-Fei An, Xu-Dong Cai, Xiao-Meng Lin, Xin Peng, Wei Zhou, Ye Zhang","doi":"10.1007/s11596-026-00242-4","DOIUrl":"https://doi.org/10.1007/s11596-026-00242-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the specific biological mechanisms by which Haikun Shenxi capsule (HKSX) alleviates renal fibrosis (RF), with a particular focus on the interplay between gut microbiota regulation and host metabolic modulation. Methods The therapeutic effects of HKSX were evaluated using a unilateral ureteral obstruction (UUO) mouse model.</p><p><strong>Methods: </strong>The therapeutic effects of HKSX were evaluated using a unilateral ureteral obstruction (UUO) mouse model. Untargeted metabolomic analyses were performed on serum and fecal samples to identify metabolic changes. Gut microbiota composition was assessed via 16S rRNA sequencing. Renal injury and fibrosis were evaluated by histopathological examination and by measuring the expression of fibrotic markers, including α-smooth muscle actin (α-SMA) and type I collagen (collagen I).</p><p><strong>Results: </strong>HKSX modulates metabolic homeostasis by regulating the concentrations of pyruvic acid and ornithine in mouse serum and feces. These alterations affect key pathways, including the pentose phosphate pathway, tricarboxylic acid (TCA) cycle, and amino acid metabolism, contributing to the restoration of metabolic equilibrium. Concurrently, 16S rRNA sequencing revealed that HKSX improved the gut microbiota composition by increasing microbial diversity and increasing the abundance of beneficial bacteria, particularly Akkermansia. Moreover, HKSX alleviated UUO-induced renal damage and suppressed the expression of α-SMA and collagen I.</p><p><strong>Conclusion: </strong>These findings provide strong evidence that HKSX exerts its renoprotective effects through bidirectional regulation of gut microbiota and host metabolism. The integration of traditional Chinese medicine (TCM) with modern systems biology offers fresh perspectives for developing improved natural therapies for RF and related metabolic disorders.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891129","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 Jiannao Tongluo Granules in the Treatment of Convalescent Cerebral Infarction: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Clinical Trial.","authors":"Ruo-Xuan Xiao, Si-Cheng Li, Qing-Qing Wu, Jia-Ling Sun, Yu-Tong Zhang, Ping-Wei Zhang, Geng-Yong Zou, Yu-Fei Chong, Can Duan, Zheng-Liang Li, Wen-Guang Xia","doi":"10.1007/s11596-026-00240-6","DOIUrl":"https://doi.org/10.1007/s11596-026-00240-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the efficacy and safety of Jiannao Tongluo (JNTL) granules in patients with convalescent cerebral infarction and to explore the underlying mechanisms.</p><p><strong>Methods: </strong>A randomized, double-blind, placebo-controlled, parallel-group clinical trial was conducted from November 2024 to November 2025. A total of 110 eligible patients were randomly assigned at a 1:1 ratio to receive either JNTL granules or placebo control for 12 weeks on the basis of standard secondary prevention and comprehensive rehabilitation. The primary outcome was the variation in the Montreal Cognitive Assessment (MoCA) score. The secondary outcomes included the Vascular Dementia Assessment Scale-Cognitive Subscale (VaDAS-cog), Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA), modified Barthel index (MBI), and TCM symptom score (SYM), which were measured at baseline and at weeks 4, 12, and 24. Serum inflammatory factors (hs-CRP, IL-6, IL-1β, TNF-α, and SAA) and neurotrophic factors (BDNF and VEGF) were measured at baseline and week 12. The activation of the cerebral cortex was evaluated by functional near-infrared spectroscopy (fNIRS) at baseline and week 12. Safety was monitored throughout the trial.</p><p><strong>Results: </strong>A total of 97 patients (48 in the JNTL granule group and 49 in the control group) completed the trial, for a dropout rate of 11.8%. Baseline characteristics were well balanced between the groups (all P > 0.05). At 12 and 24 weeks, the JNTL granule group showed more substantial increases in the MoCA, MMSE, FMA, and MBI scores and lower VaDAS-cog and SYM scores than the control group (all P < 0.05). At week 12, compared with the control treatment, JNTL granules treatment significantly reduced serum levels of hs-CRP, IL-6, IL-1β, TNF-α, and SAA, and increased serum BDNF and VEGF levels (all P < 0.05). fNIRS revealed that the JNTL granules significantly enhanced task-evoked HbO activation in the temporal cortex (TC), Broca's area, and premotor and supplementary motor cortex (PreM/SMC) (all P < 0.05). There were no reports of serious adverse events.</p><p><strong>Conclusion: </strong>JNTL granules effectively improve cognitive function, motor function, and activities of daily living (ADL) in patients with convalescent cerebral infarction of wind-phlegm obstructing collateral syndrome, with durable efficacy and favorable safety. The mechanisms may involve the suppression of excessive inflammatory responses, the promotion of neuroprotection and angiogenesis, and the enhancement of activation in key cognitive-motor-related cortical regions.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873189","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":"Targeting GLUTs in Cancer: Mechanisms, Combination Strategies, and Translational Challenges.","authors":"Mei-Na Shi, Dong-Fan Yang, Tong Chu, Da-Yuan Zheng, Wen-Zhe Ma","doi":"10.1007/s11596-026-00245-1","DOIUrl":"https://doi.org/10.1007/s11596-026-00245-1","url":null,"abstract":"<p><p>Cancer cells exhibit metabolic reprogramming, most notably the Warburg effect, which underscores their heightened dependency on glucose uptake facilitated by glucose transporters (GLUTs). While targeting GLUTs holds promise for disrupting tumor metabolism, monotherapeutic inhibition often leads to compensatory resistance mechanisms, metabolic plasticity, and dose-limiting toxicity. This review comprehensively examines the rationale and mechanisms underlying combined strategies that integrate GLUT inhibitors with conventional chemotherapy, targeted therapy, immunotherapy, and radiotherapy. Such combinations exploit synthetic lethality, reverse immunosuppression, enhance DNA damage, and overcome adaptive resistance. We also discuss emerging approaches such as isoform-specific inhibitors, nanocarrier-based delivery, and artificial intelligence-guided combination design to improve selectivity and efficacy. Finally, we highlight key translational challenges and discuss how cross-disease insights into GLUT biology may inform the safety, selectivity, and therapeutic design of cancer-directed GLUT-targeted combination strategies.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873183","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":"NCOA1 Attenuates High Glucose-Induced Mesangial Matrix Expansion Through ITGA5 Inhibition.","authors":"Shu-Xin Song, Li-Li Gai, Chun-Tao Lei","doi":"10.1007/s11596-026-00244-2","DOIUrl":"https://doi.org/10.1007/s11596-026-00244-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether nuclear receptor coactivator 1 (NCOA1) participates in the pathogenesis of diabetic kidney disease (DKD) by modulating extracellular matrix (ECM) production in mesangial cells (MCs), and to explore the underlying molecular mechanism.</p><p><strong>Methods: </strong>The rat glomerular MCs and streptozotocin-induced DKD mouse models were employed. NCOA1 expression was evaluated under both normal and high-glucose conditions. The functional role of NCOA1 was assessed via plasmid-mediated overexpression in high-glucose treated MCs. Integrin alpha 5 (ITGA5) expression was examined in vivo and in vitro, and its regulatory relationship with NCOA1 was investigated. Furthermore, siRNA-mediated knockdown of ITGA5 was performed to determine its necessity in high-glucose driven ECM overproduction.</p><p><strong>Results: </strong>NCOA1 was abundantly expressed in resting MCs but markedly downregulated upon high-glucose stimulation. Plasmid-driven overexpression of NCOA1 significantly attenuated high-glucose induced ECM protein synthesis. Notably, ITGA5 expression was substantially elevated in the glomerular mesangium of DKD mice and in high-glucose exposed MCs, and this upregulation was negatively governed by NCOA1. Functionally, ITGA5 silencing effectively abrogated the excessive matrix production provoked by high glucose, phenocopying the protective effect of NCOA1 overexpression.</p><p><strong>Conclusion: </strong>NCOA1 protects against high-glucose induced mesangial expansion in DKD, at least partially, through negative regulation of ITGA5. These findings identify the NCOA1/ITGA5 axis as a potential therapeutic target for counteracting glomerular fibrosis in DKD.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863899","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}