The Journal of Clinical Investigation最新文献

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Gut-specific histamine 3 receptor signaling orchestrates microglia-dependent resolution of peripheral inflammation. 肠道特异性组胺3受体信号调控小胶质细胞依赖性外周炎症的消退。
The Journal of Clinical Investigation Pub Date : 2025-07-10 DOI: 10.1172/jci184697
Kerstin Dürholz,Leona Ehnes,Mathias Linnerbauer,Eva Schmid,Heike Danzer,Michael Hinzpeter-Schmidt,Lena Lößlein,Lena Amend,Michael Frech,Vugar Azizov,Fabian Schälter,Arne Gessner,Sébastien Lucas,Till-Robin Lesker,R Verena Taudte,Jörg Hofmann,Felix Beyer,Hadar Bootz-Maoz,Yasmin Reich,Hadar Romano,Daniele Mauro,Ruth Beckervordersandforth,Maja Skov Kragsnaes,Torkell Ellingsen,Wei Xiang,Aiden Haghikia,Cezmi A Akdis,Francesco Ciccia,Tobias Bäuerle,Kerstin Sarter,Till Strowig,Nissan Yissachar,Georg Schett,Veit Rothhammer,Mario M Zaiss
{"title":"Gut-specific histamine 3 receptor signaling orchestrates microglia-dependent resolution of peripheral inflammation.","authors":"Kerstin Dürholz,Leona Ehnes,Mathias Linnerbauer,Eva Schmid,Heike Danzer,Michael Hinzpeter-Schmidt,Lena Lößlein,Lena Amend,Michael Frech,Vugar Azizov,Fabian Schälter,Arne Gessner,Sébastien Lucas,Till-Robin Lesker,R Verena Taudte,Jörg Hofmann,Felix Beyer,Hadar Bootz-Maoz,Yasmin Reich,Hadar Romano,Daniele Mauro,Ruth Beckervordersandforth,Maja Skov Kragsnaes,Torkell Ellingsen,Wei Xiang,Aiden Haghikia,Cezmi A Akdis,Francesco Ciccia,Tobias Bäuerle,Kerstin Sarter,Till Strowig,Nissan Yissachar,Georg Schett,Veit Rothhammer,Mario M Zaiss","doi":"10.1172/jci184697","DOIUrl":"https://doi.org/10.1172/jci184697","url":null,"abstract":"Chronic inflammatory diseases, like rheumatoid arthritis (RA) have been described to cause central nervous system (CNS) activation. Less is known about environmental factors that enable the CNS to suppress peripheral inflammation in RA. Here, we identified gut microbiota-derived histamine as such factor. We show that low levels of histamine activate the enteric nervous system, increase inhibitory neurotransmitter concentrations in the spinal cord and restore homeostatic microglia, thereby reducing inflammation in the joints. Selective histamine 3 receptor (H3R) signaling in the intestine is critical for this effect, as systemic and intrathecal application did not show effects. Microglia depletion or pharmacological silencing of local nerve fibers impaired oral H3R agonist-induced pro-resolving effects on arthritis. Moreover, therapeutic supplementation of the short-chain fatty acid (SCFA) propionate identified one way to expand local intestinal histamine concentrations in mice and humans. Thus, we define a gut-CNS-joint axis pathway where microbiota-derived histamine initiates the resolution of arthritis via the CNS.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"694 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combinatorial therapy regimens targeting preclinical models of melanoma resistant to immune checkpoint blockade. 针对抗免疫检查点阻断的黑色素瘤临床前模型的联合治疗方案。
The Journal of Clinical Investigation Pub Date : 2025-07-10 DOI: 10.1172/jci185220
Imran Khan,Aida Rodriguez-Brotons,Anukana Bhattacharjee,Vladimir Bezrookove,Altaf Dar,David De Semir,Mehdi Nosrati,Ryan Ice,Liliana Soroceanu,Stanley P Leong,Kevin B Kim,Yihui Shi,James E Cleaver,James R Miller,Pierre-Yves Desprez,John M Kirkwood,Marcus Bosenberg,Nathan Salomonis,Sean McAllister,Mohammed Kashani-Sabet
{"title":"Combinatorial therapy regimens targeting preclinical models of melanoma resistant to immune checkpoint blockade.","authors":"Imran Khan,Aida Rodriguez-Brotons,Anukana Bhattacharjee,Vladimir Bezrookove,Altaf Dar,David De Semir,Mehdi Nosrati,Ryan Ice,Liliana Soroceanu,Stanley P Leong,Kevin B Kim,Yihui Shi,James E Cleaver,James R Miller,Pierre-Yves Desprez,John M Kirkwood,Marcus Bosenberg,Nathan Salomonis,Sean McAllister,Mohammed Kashani-Sabet","doi":"10.1172/jci185220","DOIUrl":"https://doi.org/10.1172/jci185220","url":null,"abstract":"Few effective therapeutic options exist following progression on immune checkpoint blockade (ICB) for melanoma. Here we utilize a platform incorporating transcriptomic profiling, high-throughput drug screening (HTDS) and murine models to demonstrate the pre-clinical efficacy of several combinatorial regimens against ICB-resistant melanoma. Transcriptomic analysis of ICB-resistant melanomas demonstrated activation of several targetable pathways. HTDS targeting these pathways identified several effective combinations in ICB-resistant patient-derived xenograft models. The combination of cobimetinib and regorafenib (termed Cobi+Reg) emerged as a particularly promising regimen, with efficacy against distinct molecular melanoma subtypes and following progression on ICB in immunocompetent models. Transcriptomic and spatial analysis of Cobi+Reg-treated tumors demonstrated upregulation of antigen presentation machinery, with concomitantly increased activated T cell infiltration. Combining Cobi+Reg with ICB was superior to either modality in vivo. This analytical platform exploits the biology of ICB-resistant melanoma to identify therapeutic vulnerabilities, resulting in the identification of drug combinations that form the basis for rational clinical trial design in the setting of advanced melanoma resistant to ICB.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Somatic mutations in TBX3 promote hepatic clonal expansion by accelerating VLDL secretion. TBX3的体细胞突变通过加速VLDL分泌促进肝脏克隆扩增。
The Journal of Clinical Investigation Pub Date : 2025-07-10 DOI: 10.1172/jci191855
Gregory Mannino,Gabriella Quinn,Min Zhu,Zixi Wang,Xun Wang,Boyuan Li,Meng-Hsiung Hsieh,Thomas Mathews,Lauren Zacharias,Wen Gu,Purva Gopal,Natalia Brzozowska,Peter Campbell,Matt Hoare,Glen Liszczak,Hao Zhu
{"title":"Somatic mutations in TBX3 promote hepatic clonal expansion by accelerating VLDL secretion.","authors":"Gregory Mannino,Gabriella Quinn,Min Zhu,Zixi Wang,Xun Wang,Boyuan Li,Meng-Hsiung Hsieh,Thomas Mathews,Lauren Zacharias,Wen Gu,Purva Gopal,Natalia Brzozowska,Peter Campbell,Matt Hoare,Glen Liszczak,Hao Zhu","doi":"10.1172/jci191855","DOIUrl":"https://doi.org/10.1172/jci191855","url":null,"abstract":"Somatic mutations that increase clone fitness or resist disease are positively selected, but the impact of these mutations on organismal health remains unclear. We previously showed that Tbx3 deletion increases hepatocyte fitness within fatty livers. Here, we detected TBX3 somatic mutations in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). In mice, Tbx3 deletion protected against, whereas Tbx3 overexpression exacerbated MASLD. Tbx3 deletion reduced lipid overload by accelerating VLDL secretion. Choline deficient diets, which block VLDL secretion, abrogated this protective effect. TBX3 transcriptionally suppressed the conventional secretory pathway and cholesterol biosynthesis. Hdlbp is a direct target of TBX3 that is responsible for the altered VLDL secretion. In contrast to wild-type TBX3, the TBX3 I155S and A280S mutations found in patients failed to suppress VLDL secretion. In conclusion, TBX3 mutant clones expand during MASLD through increased lipid disposal, demonstrating that clonal fitness can benefit the liver at the cost of hyperlipidemia.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treg activation during allograft tolerance induction requires mitochondrial-induced TGFβ1 in type 1 conventional dendritic cells. 同种异体移植物耐受诱导过程中的Treg激活需要线粒体诱导的1型常规树突状细胞中的TGFβ1。
The Journal of Clinical Investigation Pub Date : 2025-07-10 DOI: 10.1172/jci178960
Samantha L Schroth,Lei Zhang,Rebecca Tl Jones,Kristofor Glinton,Nikita L Mani,Hiroyasu Inui,Jesse T Davidson,Samuel E Weinberg,Navdeep Chandel,Maria-Luisa Alegre,Edward B Thorp
{"title":"Treg activation during allograft tolerance induction requires mitochondrial-induced TGFβ1 in type 1 conventional dendritic cells.","authors":"Samantha L Schroth,Lei Zhang,Rebecca Tl Jones,Kristofor Glinton,Nikita L Mani,Hiroyasu Inui,Jesse T Davidson,Samuel E Weinberg,Navdeep Chandel,Maria-Luisa Alegre,Edward B Thorp","doi":"10.1172/jci178960","DOIUrl":"https://doi.org/10.1172/jci178960","url":null,"abstract":"The role of type 1 conventional dendritic cells (cDC1) in tolerance induction to solid organ allografts is unknown and important for strategies that seek to prolong allograft viability. Using a murine model deficient in cDC1s, we report cDC1s are required for donor antigen and costimulation blockade (DST + CoB) tolerance induction and survival of cardiac allografts. cDC1 deficiency led to decreases in CD4+CD25+FoxP3+ T cells within both allograft and spleen tissue of transplant recipients and this was found to be antigen specific. Donor antigen stimulation induced TGF-β1 expression both in vivo cDC1 and in vitro Flt3L derived cDC1. Genetic deletion of Tgfβ1 in cDC1s prevented induction of antigen specific CD4+CD25+FoxP3+ T cells and was associated with cardiac allograft rejection. In parallel, single-cell RNA sequencing and metabolic analysis revealed upregulation of cDC1 mitochondrial metabolic signatures after in vivo exposure to DST + CoB. Genetic inactivation of cDC1 mitochondrial metabolism reduced expression of cDC1 TGF-β1, decreased antigen specific T regulatory cell populations, and impaired allograft tolerance. Taken together, our findings newly implicate cDC1s in strategies to preserve solid organ allografts and also implicate mitochondrial metabolism of cDC1s as a molecular mechanism to enhance the generation of antigen-specific CD4+CD25+FoxP3+ T cells through TGF-β1.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
NOTCH1 reverses immune suppression in small cell lung cancer through reactivation of STING. NOTCH1通过STING的再激活逆转小细胞肺癌的免疫抑制。
The Journal of Clinical Investigation Pub Date : 2025-07-08 DOI: 10.1172/jci185423
Yoo Sun Kim,Barzin Y Nabet,Briana N Cortez,Nai-Yun Sun,Robin Sebastian,Christophe E Redon,Anagh Ray,Liang Liu,Afeez A Ishola,Sarah Loew,Anjali Dhall,Sivasish Sindiri,Velimir Gayevskiy,Min-Jung Lee,Shraddha Rastogi,Nahoko Sato,Noemi Kedei,Thorkell Andresson,Sudipto Das,Suresh Kumar,Alan E Bers,Hongliang Zhang,Alberto Chiappori,Priyanka Gopal,Mohamed E Abazeed,Haobin Chen,Mirit I Aladjem,Yves Pommier,Moises J Velez,David S Shames,Nitin Roper
{"title":"NOTCH1 reverses immune suppression in small cell lung cancer through reactivation of STING.","authors":"Yoo Sun Kim,Barzin Y Nabet,Briana N Cortez,Nai-Yun Sun,Robin Sebastian,Christophe E Redon,Anagh Ray,Liang Liu,Afeez A Ishola,Sarah Loew,Anjali Dhall,Sivasish Sindiri,Velimir Gayevskiy,Min-Jung Lee,Shraddha Rastogi,Nahoko Sato,Noemi Kedei,Thorkell Andresson,Sudipto Das,Suresh Kumar,Alan E Bers,Hongliang Zhang,Alberto Chiappori,Priyanka Gopal,Mohamed E Abazeed,Haobin Chen,Mirit I Aladjem,Yves Pommier,Moises J Velez,David S Shames,Nitin Roper","doi":"10.1172/jci185423","DOIUrl":"https://doi.org/10.1172/jci185423","url":null,"abstract":"Downregulation of antigen presentation and lack of immune infiltration are defining features of small cell lung cancer (SCLC) limiting response to immune checkpoint blockade (ICB). While a high MHC Class I, immune-inflamed subset benefits from ICB, underlying mechanisms of immune response in SCLC have yet to be elucidated. Here we show that in the landmark IMpower133 clinical trial high, but not low, NOTCH1 expression is significantly associated with longer survival with the addition of ICB to chemotherapy among ~80% of SCLC patients with neuroendocrine-enriched tumors (ASCL1-enriched, HR 0.39, P = 0.0012; NEUROD1-enriched, HR 0.44, P = 0.024). Overexpression or pharmacologic activation of NOTCH1 in ASCL1 and NEUROD1 SCLC cell lines dramatically upregulates MHC Class I through epigenetic reactivation of STING. In syngeneic mouse models, Notch1 activation reprograms SCLC tumors from immune-excluded to immune-inflamed, facilitating durable, complete responses with ICB combined with a STING agonist. STING1 expression is significantly enriched in high compared to low NOTCH1 expressing tumors in IMpower133 thereby validating our proposed mechanism. Our data reveal a previously undiscovered role for NOTCH1 as a critical driver of SCLC immunogenicity and a potential predictive biomarker for ICB in SCLC. NOTCH1 activation may be a therapeutic strategy to unleash anti-tumor immune responses in SCLC and other neuroendocrine cancers in which NOTCH1 is typically suppressed.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ICOS regulates IL-10 production in group 2 innate lymphoid cells via cholesterol and cortisol biosynthesis. ICOS通过胆固醇和皮质醇的生物合成调节2组先天淋巴样细胞IL-10的产生。
The Journal of Clinical Investigation Pub Date : 2025-07-08 DOI: 10.1172/jci193134
Yoshihiro Sakano,Kei Sakano,Benjamin P Hurrell,Mohammad H Kazemi,Xin Li,Stephen Shen,Omid Akbari
{"title":"ICOS regulates IL-10 production in group 2 innate lymphoid cells via cholesterol and cortisol biosynthesis.","authors":"Yoshihiro Sakano,Kei Sakano,Benjamin P Hurrell,Mohammad H Kazemi,Xin Li,Stephen Shen,Omid Akbari","doi":"10.1172/jci193134","DOIUrl":"https://doi.org/10.1172/jci193134","url":null,"abstract":"Group 2 innate lymphoid cells (ILC2s) play a crucial role in inducing type 2 inflammation in the lungs in response to allergens. Our study investigated the regulatory mechanism of IL-10 production by ILC2s and its impact on airway hyperreactivity (AHR), focusing on the role of ICOS. We found that inhibiting ICOS in pulmonary ILC2s significantly enhances IL-10 production. The absence of ICOS reprograms ILC2 steroid metabolism, leading to increased cholesterol and cortisol biosynthesis, and subsequent Glucocorticoid receptor (GR) activation. This reprogramming regulates MAF and NFIL3 activation, promoting IL-10 production. Notably, in vivo GR inhibition or ILC2-specific GR deficiency exacerbated AHR development in multiple mouse models. We extended these findings to human ILC2s, demonstrating concordant results between murine models and human cells. Our results indicate that ICOS negatively regulates IL-10 production in ILC2s by controlling cholesterol and cortisol biosynthesis. This mechanism provides new insights into the complex interplay between ILC2s, ICOS, and glucocorticoid signaling in the context of allergic airway inflammation.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Caloric Restriction Promotes Resolution of Atherosclerosis in Obese Mice, while Weight Regain Accelerates its Progression. 热量限制促进肥胖小鼠动脉粥样硬化的解决,而体重增加加速其进展。
The Journal of Clinical Investigation Pub Date : 2025-07-08 DOI: 10.1172/jci172198
Bianca Scolaro,Franziska Krautter,Emily J Brown,Aleepta Guha Ray,Rotem Kalev-Altman,Marie Petitjean,Sofie Delbare,Casey Donahoe,Stephanie Pena,Michela L Garabedian,Cyrus A Nikain,Maria Laskou,Ozlem Tufanli,Carmen Hannemann,Myriam Aouadi,Ada Weinstock,Edward A Fisher
{"title":"Caloric Restriction Promotes Resolution of Atherosclerosis in Obese Mice, while Weight Regain Accelerates its Progression.","authors":"Bianca Scolaro,Franziska Krautter,Emily J Brown,Aleepta Guha Ray,Rotem Kalev-Altman,Marie Petitjean,Sofie Delbare,Casey Donahoe,Stephanie Pena,Michela L Garabedian,Cyrus A Nikain,Maria Laskou,Ozlem Tufanli,Carmen Hannemann,Myriam Aouadi,Ada Weinstock,Edward A Fisher","doi":"10.1172/jci172198","DOIUrl":"https://doi.org/10.1172/jci172198","url":null,"abstract":"While weight loss is highly recommended for those with obesity, >60% will regain their lost weight. This weight cycling is associated with elevated risk of cardiovascular disease, relative to never having lost weight. How weight loss/regain directly influence atherosclerotic inflammation is unknown. Thus, we studied short-term caloric restriction (stCR) in obese hypercholesterolemic mice, without confounding effects from changes in diet composition. Weight loss was found to promote atherosclerosis resolution independent of plasma cholesterol. From single-cell RNA-sequencing and subsequent mechanistic studies, this can be partly attributed to a unique subset of macrophages accumulating with stCR in epididymal white adipose tissue (eWAT) and atherosclerotic plaques. These macrophages, distinguished by high expression of Fcgr4, help to clear necrotic cores in atherosclerotic plaques. Conversely, weight regain (WR) following stCR accelerated atherosclerosis progression with disappearance of Fcgr4+ macrophages from eWAT and plaques. Furthermore, WR caused reprogramming of immune progenitors, sustaining hyper-inflammatory responsiveness. In summary, we have developed a model to investigate the inflammatory effects of weight cycling on atherosclerosis and the interplay between adipose tissue, bone marrow, and plaques. The findings suggest potential approaches to promote atherosclerosis resolution in obesity and weight cycling through induction of Fcgr4+ macrophages and inhibition of immune progenitor reprogramming.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Type 1 Classical Dendritic Cells Govern Long-term Cardiac Allograft Acceptance. 1型经典树突状细胞控制心脏同种异体移植的长期接受。
The Journal of Clinical Investigation Pub Date : 2025-07-08 DOI: 10.1172/jci192811
Macee C Owen,Vinay R Penna,Hao Dun,Wenjun Li,Benjamin J Kopecky,Kenneth M Murphy,Daniel Kreisel,Kory J Lavine
{"title":"Type 1 Classical Dendritic Cells Govern Long-term Cardiac Allograft Acceptance.","authors":"Macee C Owen,Vinay R Penna,Hao Dun,Wenjun Li,Benjamin J Kopecky,Kenneth M Murphy,Daniel Kreisel,Kory J Lavine","doi":"10.1172/jci192811","DOIUrl":"https://doi.org/10.1172/jci192811","url":null,"abstract":"","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Therapeutic horizons in metabolic dysfunction-associated steatohepatitis. 代谢功能障碍相关脂肪性肝炎的治疗前景。
The Journal of Clinical Investigation Pub Date : 2025-07-01 DOI: 10.1172/jci186425
Philip N Newsome,Rohit Loomba
{"title":"Therapeutic horizons in metabolic dysfunction-associated steatohepatitis.","authors":"Philip N Newsome,Rohit Loomba","doi":"10.1172/jci186425","DOIUrl":"https://doi.org/10.1172/jci186425","url":null,"abstract":"Metabolic dysfunction-associated steatohepatitis (MASH), the progressive inflammatory form of MASLD, is now a leading cause of chronic liver disease worldwide. Driven by obesity and type 2 diabetes, MASH significantly increases the risk of cirrhosis, hepatocellular carcinoma, and liver failure. While public health interventions remain essential, therapeutic strategies targeting metabolic dysfunction, inflammation, and fibrosis are urgently needed. This Review focuses on pharmacological treatments in advanced development, including incretin-based therapies (GLP-1, dual, and triple agonists), metabolic modulators (PPAR, FGF21, and THR-β agonists), and novel agents such as fatty acid synthase inhibitors. Current regulatory approval is based on histological end points, with increasing interest in noninvasive biomarkers and personalized treatment approaches. Recent trials with agents such as semaglutide, tirzepatide, survodutide, lanifibranor, pegozafermin, and resmetirom demonstrate substantial promise in resolving MASH and improving fibrosis, but unresolved issues remain regarding treatment duration, response heterogeneity, and long-term adherence. Genetic variants (e.g., PNPLA3 polymorphisms) and emerging molecular biomarkers may enhance stratification, while artificial intelligence is beginning to shape trial design and drug development. As the field moves toward combination therapies and precision medicine, the definition of therapeutic success will likely evolve to reflect both histological improvement and patient-reported outcomes. This Review provides a timely synthesis of the landscape, challenges, and future directions in MASH therapeutics.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"184 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Iron supplementation alleviates pathologies in a mouse model of facioscapulohumeral muscular dystrophy. 铁的补充减轻了面部肩胛肱肌营养不良小鼠模型的病理。
The Journal of Clinical Investigation Pub Date : 2025-07-01 DOI: 10.1172/jci181881
Kodai Nakamura,Huascar-Pedro Ortuste-Quiroga,Naoki Horii,Shin Fujimaki,Toshiro Moroishi,Keiichi I Nakayama,Shinjiro Hino,Yoshihiko Saito,Ichizo Nishino,Yusuke Ono
{"title":"Iron supplementation alleviates pathologies in a mouse model of facioscapulohumeral muscular dystrophy.","authors":"Kodai Nakamura,Huascar-Pedro Ortuste-Quiroga,Naoki Horii,Shin Fujimaki,Toshiro Moroishi,Keiichi I Nakayama,Shinjiro Hino,Yoshihiko Saito,Ichizo Nishino,Yusuke Ono","doi":"10.1172/jci181881","DOIUrl":"https://doi.org/10.1172/jci181881","url":null,"abstract":"Facioscapulohumeral muscular dystrophy (FSHD) is a genetic muscle disease caused by ectopic expression of the toxic protein DUX4, resulting in muscle weakness. However, the mechanism by which DUX4 exerts its toxicity remains unclear. In this study, we observed abnormal iron accumulation in muscles of patients with FSHD and in muscle-specific DUX4-expressing (DUX4-Tg) mice. Treatment with iron chelators, an iron-deficient diet, and genetic modifications inhibiting intracellular uptake of iron did not improve but rather exacerbated FSHD pathology in DUX4-Tg mice. Unexpectedly, however, iron supplementation, either from a high-iron diet or intravenous iron administration, resulted in remarkable improvement in grip strength and running performance in DUX4-Tg mice. Iron supplementation suppressed abnormal iron accumulation and the ferroptosis-related pathway involving increased lipid peroxidation in DUX4-Tg muscle. Muscle-specific DUX4 expression led to retinal vasculopathy, a part of FSHD pathology, which was prevented by iron administration. Furthermore, high-throughput compound screening of the ferroptosis pathway identified drug candidates including Ferrostatin-1 (Fer-1), a potent inhibitor of lipid peroxidation. Treatment with Fer-1 dramatically improved physical function in DUX4-Tg mice. Our findings demonstrate that DUX4-provoked toxicity is involved in the activation of the ferroptosis-related pathway and that supplementary iron could be a promising and readily available therapeutic option for FSHD.","PeriodicalId":520097,"journal":{"name":"The Journal of Clinical Investigation","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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