The Kaohsiung journal of medical sciences最新文献

{"title":"The Choice Between Definitive Radiotherapy and Surgery for Cervical Cancer With Different Histology in Current Clinical Practice.","authors":"Yu-Lun Wu, Chen-Wei Ho, Wen-Shiung Liou, Chun-Hao Yin, Jin-Shuen Chen, Yao-Shen Chen, Yu-Wei Lin, Ju-Chun Chien","doi":"10.1002/kjm2.70272","DOIUrl":"https://doi.org/10.1002/kjm2.70272","url":null,"abstract":"<p><p>For cervical cancer, the choice between definitive radiotherapy (RT) and surgery has long been a topic of debate. Clinical factors, including histology and tumor burden, have been examined in prior studies. Given recent advances in RT and the incorporation of concurrent chemotherapy, our study seeks to assess the optimal treatment modality for cervical cancer in current clinical practice. The cancer registry database of a medical center was screened for cervical cancer patients. Patients receiving curative intent RT or surgery were included. Clinicopathological factors and treatment outcomes were retrospectively collected. The disease-free survival (DFS) and overall survival (OS) were analyzed using Cox regression and Kaplan-Meier analyses. From 2007 to 2021, 369 squamous cell carcinoma (SCC) and 108 adenocarcinoma (AC) cases were enrolled. AC had an increasing proportion over time and was associated with worse survival. Comparing RT to surgery, RT was associated with inferior survival in both early-stage AC (DFS, HR: 8.29, p < 0.001, 95% CI: 3.21-21.42) and SCC group (DFS, HR: 4.01, p < 0.001, 95% CI: 1.99-8.08). The difference was more robust in those with tumors smaller than 4 cm. For advanced-stage disease, the inferiority of RT was observed in the SCC (DFS, HR: 1.85, p = 0.020, 95% CI: 1.10-3.11), but not AC group. There was no statistically significant intergroup difference observed between the AC and SCC groups regarding DFS of RT versus surgery. In our analysis, AC was an independent poor prognostic factor. Despite the addition of concurrent chemotherapy and advanced RT techniques, surgery-based treatment was still associated with superior survival for early-stage cervical cancer.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70272"},"PeriodicalIF":3.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IGF2BP3 Overexpression Accelerates Osteoarthritis Progression by Promoting Glycolysis via m⁶A-Dependent Stabilization of ECM1 mRNA.","authors":"Xing-Shi Yuan, Hao-Jie Zhang, Jia-Xiang Ding, Zheng-Liang Luo, Min Chen, Xiao-Qi Zhang, Xi-Fu Shang, Zhe Ni, Ke-Rong Wu","doi":"10.1002/kjm2.70280","DOIUrl":"https://doi.org/10.1002/kjm2.70280","url":null,"abstract":"<p><p>N⁶-methyladenosine (m⁶A) plays a critical role in osteoarthritis (OA) pathogenesis. This study investigates the role of the m⁶A reader insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3) in OA progression. OA models were established in vivo through destabilization of the medial meniscus (DMM) surgery in mice and in vitro by stimulating primary chondrocytes with interleukin-1β (IL-1β). Cartilage destruction was assessed histopathologically. Chondrocyte viability, proliferation, and apoptosis were measured by CCK-8, EdU, and flow cytometry, respectively. Inflammatory cytokine levels, lactate, glucose, and total m⁶A were quantified using commercial kits. Expression levels of IGF2BP3, extracellular matrix protein 1 (ECM1), ECM turnover markers, and glycolysis-related genes were analyzed by RT-qPCR, Western blot, immunohistochemistry, and immunofluorescence. Potential m⁶A modification sites in ECM1 transcripts were predicted using the SRAMP database, and IGF2BP3-mediated, m⁶A-dependent regulation of ECM1 was validated through RNA immunoprecipitation (RIP), MeRIP-qPCR, and actinomycin D decay assays. Results revealed elevated levels of IGF2BP3, ECM1, m⁶A modification, and glycolytic activity in OA cartilage and IL-1β-treated chondrocytes. IGF2BP3 knockdown reversed IL-1β-induced reductions in chondrocyte viability and proliferation, suppressed apoptosis, decreased inflammatory cytokine secretion, attenuated ECM degradation, and reduced glycolytic flux in vitro, while also mitigating cartilage damage and matrix breakdown in vivo. Mechanistically, IGF2BP3 stabilized ECM1 mRNA in an m⁶A-dependent manner, thereby modulating ECM1 expression. Restoration of ECM1 expression abolished the chondroprotective effects of IGF2BP3 knockdown against injury, inflammation, and enhanced glycolysis. In conclusion, IGF2BP3 enhances ECM1 expression via an m⁶A-dependent pathway, thereby promoting glycolysis and exacerbating OA progression.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70280"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Syndrome and Dementia Risk in Older Adults: A Narrative Review.","authors":"Hyojin Park, Mallika Chuansangeam, Yuan-Han Yang","doi":"10.1002/kjm2.70276","DOIUrl":"https://doi.org/10.1002/kjm2.70276","url":null,"abstract":"<p><p>Dementia is a major global health issue in aging societies. Metabolic syndrome (MetS), a cluster of metabolic abnormalities, has been proposed as a modifiable risk factor for dementia, although existing evidence remains inconsistent. This review examined recent studies on the association between MetS and dementia risk in older adults. We searched PubMed for original studies published between January 1, 2014, and July 15, 2024, using the keywords \"metabolic syndrome\" and \"dementia.\" Fourteen studies met the inclusion criteria: five retrospective cohort studies, two prospective cohort studies, four cross-sectional studies, two bioinformatics studies, and one meta-analysis. Overall, MetS was associated with adverse cognitive outcomes, with relatively more consistent evidence for vascular dementia and progression from mild cognitive impairment to dementia than for Alzheimer disease. Hypertension, abdominal obesity, and low high-density lipoprotein cholesterol were associated with adverse cognitive outcomes in some studies, although component-specific findings varied across studies. Temporal patterns of MetS also appeared to be relevant, with some studies reporting higher dementia risk in individuals with worsening or persistent metabolic burden, although findings after MetS resolution were not consistent. Several studies also reported deficits in executive, attention, and visuospatial function. Bioinformatics studies suggested possible genetic links, including overlap with apolipoprotein E-related pathways, although evidence remains limited. MetS may represent a clinically relevant risk marker for adverse cognitive outcomes in older adults, although its association varies according to MetS definition, study population, and cognitive outcome. Further large-scale studies are needed to clarify the underlying mechanisms and subtype-specific associations.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70276"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NETosis in the Kidney, Liver, and Lung of Mice With Cecal Ligation and Puncture-Induced Sepsis and the Ameliorating Effects of Adipose-Derived Stem Cell Exosomes.","authors":"Shao-Chun Wu, Tsu-Hsiang Lu, Yi-Chan Wu, Chia-Wei Lin, Chia-Wen Tsai, Ching-Hua Hsieh","doi":"10.1002/kjm2.70273","DOIUrl":"https://doi.org/10.1002/kjm2.70273","url":null,"abstract":"<p><p>Sepsis-induced organ failure involves dysregulated neutrophil responses, including neutrophil extracellular trap (NET) formation, via NETosis. Exosomes generated from adipose-derived stem cells (ADSCs) have shown potential in sepsis treatment. This study characterized organ-specific NETosis in the kidney, liver, and lungs using a murine cecal ligation and puncture (CLP) model and assessed the modulatory effects of ADSC exosomes. Male C57BL/6 mice were grouped as follows: control, CLP, and CLP with ADSC exosome therapy (n = 6 per group). Plasma cell-free DNA (cfDNA) and tissue citrullinated histone H3 (CitH3) levels were measured at 16 h postoperatively. Confocal immunofluorescence was performed by co-staining for CitH3 and Ly6G. Organ-derived Ly6G-enriched neutrophils were subjected to quantitative reverse transcription polymerase chain reaction for seven NETosis-related genes: CYBB, Padi4, H2ac20, H2bc21, Nlrc4, Nlrp3, and Ripk3. CLP significantly elevated plasma cfDNA and lung CitH3 levels, whereas ADSC exosome treatment reduced both. Kidney and liver CitH3 levels remained unchanged across the groups. Confocal imaging confirmed active NETosis predominantly in the lung, with minimal signals in the kidneys and liver. In kidney and liver neutrophils, only Nlrp3 and Ripk3 were significantly upregulated by CLP. In the lungs, all seven genes were significantly elevated; ADSC exosomes significantly reduced Padi4, H2ac20, Nlrp3, and Ripk3. CLP-induced NETosis was more pronounced in the lungs at the protein and transcriptional levels, where ADSC exosomes broadly suppressed NETotic pathways. NETosis reduction by ADSC exosomes was not observed in renal and hepatic neutrophils, indicating their possible protective role in sepsis within the pulmonary system.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70273"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Ultrasound-Guided Intercostal Nerve Block With Liposomal Bupivacaine for Treating Postherpetic Neuralgia in Adult Patients.","authors":"Jin Li, Xiang-Yu Fang","doi":"10.1002/kjm2.70277","DOIUrl":"https://doi.org/10.1002/kjm2.70277","url":null,"abstract":"<p><p>The study aimed to investigate the efficacy of ultrasound-guided intercostal nerve block (ICNB) with liposomal bupivacaine (LB) comparing ropivacaine-dexamethasone (RD) for treating postherpetic neuralgia (PHN) in adult patients. A total of 108 patients were randomized 1:1 to receive ICNB with LB or ICNB with RD. The Visual Analogue Scale scores in the ICNB-LB were significantly lower than those in the ICNB-RD at 1 and 2 weeks posttreatment (p < 0.001). According to the EuroQol Health-Related Quality of Life 5-Dimension, 3-Level questionnaire (EQ-5D-3L), lower proportions of patients reporting problems at 2 weeks posttreatment were observed in the ICNB-LB regarding the domains of pain/discomfort (p = 0.031), usual activities (p = 0.027), and symptom of anxiety/depression (p = 0.038), versus the ICNB-RD. The ICNB-LB had less consumption of pregabalin than the ICNB-RD at 1 week (p = 0.006) and 2 weeks (p = 0.013) posttreatment. The rate of pregabalin discontinuation was higher and the proportion of patients who required rescue analgesics was lower in ICNB-LB versus ICNB-RD up to Week 2 posttreatment. These results demonstrate LB provides an analgesic superiority through 2 weeks without causing new safety concerns comparing with RD in ultrasound-guided ICNB for treating adult patients with PHN.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70277"},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WTAP-Mediated m6A Modification of TXNDC5 mRNA Promotes Cervical Carcinogenesis.","authors":"Ling Chen, Nuo-Xin Hu, Zhao-Ying Chen, Ke-An Zhu, Wei Huang","doi":"10.1002/kjm2.70259","DOIUrl":"https://doi.org/10.1002/kjm2.70259","url":null,"abstract":"<p><p>WT1-associated protein (WTAP), a core component of the methyltransferase complex, is involved in various tumor pathological processes, but its specific mechanism in cervical cancer (CC) remains unclear. This study, based on single-cell transcriptomic data (including 3 CC and 2 normal tissues), constructed a CC microenvironment cell atlas through unsupervised clustering and identified a novel malignant subpopulation, TXNDC5⁺ epithelial cells (TXNDC5⁺EPCs). This epithelial subpopulation was specifically enriched in cancerous tissues compared to normal tissues. Furthermore, within the TXNDC5⁺EPC subpopulation, WTAP and TXNDC5 were co-expressed. In vitro experiments demonstrated that knocking down WTAP reduced the m6A modification level, mRNA stability, and expression of TXNDC5. RIP experiments confirmed their direct binding. In CCK-8, colony formation, Transwell assays, flow cytometry, and Western Blot analysis, WTAP knockdown inhibited cell proliferation/migration and accelerated apoptosis, while TXNDC5 overexpression reversed these effects. This study is the first to elucidate that the TXNDC5⁺EPC subpopulation is a dominant malignant driver in CC, regulated by WTAP-mediated m6A post-transcriptional modification. Targeting the WTAP-TXNDC5 axis holds promise as a novel therapeutic strategy for CC, directing a new pathway for clinical intervention.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70259"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DARS2 Promotes Tumorigenesis and Metastasis by Activating PI3K/Akt/GSK-3β/β-Catenin Signaling Pathway in Breast Cancer.","authors":"Na Wang, Ming Huang","doi":"10.1002/kjm2.70267","DOIUrl":"10.1002/kjm2.70267","url":null,"abstract":"<p><p>Aspartyl-tRNA synthetase 2 (DARS2), the mitochondrial enzyme responsible for aminoacylation of aspartyl-tRNA, is traditionally known for its effect on protein synthesis. Recently, DARS2 is reported to be implicated in tumorigenesis. However, its specific effect on breast cancer (BC) is poorly understood. The present work employed bioinformatics tools for analyzing DARS2 expression among BC patients and its association with clinicopathological characteristics and patient prognosis. We evaluated DARS2 expression within BC cells and tissues and assessed how DARS2 knockdown or PI3K pathway activation affected cell growth, migration, invasion, apoptosis, as well as cell cycle progression. Mechanistically, we analyzed how DARS2 regulated the PI3K/Akt/GSK-3β/β-catenin pathway. Additionally, a xenograft tumor model was constructed to validate our in vitro findings. According to our observations, DARS2 expression significantly increased in BC cells and tissues. Knockdown of DARS2 markedly suppressed cell growth, invasion, migration, and epithelial-mesenchymal transition (EMT), but enhanced their apoptosis. Mechanistic studies revealed that DARS2 knockdown suppressed the PI3K/Akt/GSK-3β/β-catenin pathway, whereas PI3K pathway activation with 740Y-P reversed the impacts of DARS2 knockdown. In vivo experimental results further verified that DARS2 suppression significantly suppressed tumor growth and metastasis through downregulating the PI3K/Akt/GSK-3β/β-catenin pathway. Collectively, these results indicate that DARS2 promotes the growth, migration, invasion, and EMT of BC cells by regulating the PI3K/Akt/GSK-3β/β-catenin signaling pathway.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70267"},"PeriodicalIF":3.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Proton Pump Inhibitor Use on Outcomes Following Carotid Artery Stenting for Asymptomatic Carotid Stenosis: A Population-Based Cohort Study.","authors":"Chia-En Wong, Pang-Shuo Perng, Pei-Wen Chen, Yu Chang, Chih-Hao Tien, Jung-Shun Lee, Liang-Chao Wang, Chih-Yuan Huang","doi":"10.1002/kjm2.70178","DOIUrl":"10.1002/kjm2.70178","url":null,"abstract":"<p><p>Carotid artery stenting (CAS) is an effective treatment for carotid stenosis. Proton-pump inhibitors (PPIs) are commonly prescribed in the general population. However, the impact of PPI use on outcomes following CAS remains unknown. This study investigated the impact of PPI use on CAS using a retrospective, matched-cohort analysis from the TriNetX research network. Propensity score matching (PSM) was employed to create two balanced cohorts consisting of regular PPI users and nonusers who underwent CAS for asymptomatic carotid stenosis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the TriNetX platform to compare cerebrovascular and cardiovascular outcomes. A total of 20,153 patients were included. After PSM, 4691 patients were included in both the PPI and non-PPI cohorts. The mean age at the time of CAS was 70.4 years in both groups. Compared with non-PPI users, patients in the PPI cohort had a higher incidence of 30-day periprocedural stroke (OR: 1.35; 95% CI: 1.08-1.69; p = 0.009). Analyses of 2-year outcomes demonstrated that regular PPI users had a higher incidence of ischemic stroke (OR: 1.16; 95% CI: 1.01-1.32; p = 0.034), transient ischemic attack (TIA) (OR: 1.30; 95% CI: 1.14-1.49; p < 0.001), and myocardial infarction (OR: 1.19; 95% CI: 1.03-1.38; p = 0.018) compared with non-PPI users. In patients undergoing CAS for asymptomatic carotid stenosis, PPI use was associated with an increased risk of periprocedural stroke, as well as a higher incidence of ischemic stroke, TIA, and myocardial infarction over a 2-year follow-up period.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70178"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Liposomal vs. Conventional Bupivacaine Erector Spinae Plane Block Plus Gabapentin for Postherpetic Neuralgia.","authors":"Xia-Jing Xu, Li-Juan Liu, Fa-Ming Xu, Xiang-Yu Fang","doi":"10.1002/kjm2.70169","DOIUrl":"10.1002/kjm2.70169","url":null,"abstract":"<p><p>This study aimed to compare efficacy and safety of ultrasound-guided erector spinae plane block (ESPB) using liposomal (LB) versus conventional bupivacaine (CB), each plus standardized gabapentin, in patients with postherpetic neuralgia (PHN). A total of 116 PHN patients were randomized to ESPB-LB or ESPB-CB; both groups received standardized gabapentin. The primary outcome was resting pain assessed by Numeric Rating Scale (NRS). Secondary outcomes were 72-h event-free time (time to first rescue medication or resting NRS ≥ 4), cumulative rescue opioid exposure in morphine milligram equivalents (MME), sleep by the Pittsburgh Sleep Quality Index (PSQI), health-related quality of life by the Patient-Reported Outcomes Measurement Information System (PROMIS), Patient Global Impression of Change (PGIC), and adverse events (AEs). ESPB-LB achieved lower resting NRS at day 1, day 3 and day 7 (all p < 0.05), with no between-group differences at day 30 or day 60. Event-free time favored LB (median 54.10 h vs. 18.95 h; log-rank p = 0.002). LB reduced cumulative MME at 48 h and 72 h, with convergence by days 7-60. PGIC favored LB at days 7 and 30, converging by day 60. Sleep and health-related quality of life improved similarly with no between-group differences; AEs were comparable, and no serious events occurred through day 60. In PHN, ESPB-LB plus gabapentin provided an early advantage characterized by superior early analgesia, higher early responder rates, longer opioid-free analgesia within 72 h, and short-term opioid sparing versus ESPB-CB, while longer-term outcomes and safety profiles were similar between groups.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70169"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Effects of Puerarin and Adipose-Derived Stem Cells on Alveolar Bone Preservation and Inflammation Control in Periodontitis Through p38MAPK Modulation.","authors":"Ting Yang, Xu Zhang, Liang-Fu Zhang","doi":"10.1002/kjm2.70182","DOIUrl":"10.1002/kjm2.70182","url":null,"abstract":"<p><p>This study evaluated the effects of puerarin and adipose-derived stem cells (ADSCs), alone or combined, on p38MAPK activity, alveolar bone preservation, and inflammatory responses in a rat periodontitis (PD) model and in vitro. ADSCs were exposed to various puerarin concentrations to assess cell proliferation, osteogenic differentiation, and p38MAPK-related protein expression. Additional experiments employed anisomycin (a p38 MAPK activator) and Porphyromonas gingivalis LPS (Pg-LPS) to determine whether puerarin attenuates p38MAPK overactivation and reduces pro-inflammatory cytokine production. In vivo, ligature- and Porphyromonas gingivalis-induced periodontitis rats were randomized to Normal, PD, PD + ADSCs, PD + puerarin, or PD + puerarin + ADSCs groups, and alveolar bone microarchitecture (micro-CT) and periodontal p38MAPK activation and osteogenic/inflammatory proteins (Western blot, ELISA) were assessed. At 10^-6 M, puerarin significantly increased ADSC proliferation and osteogenic differentiation, whereas anisomycin activation diminished these benefits, which were restored by co-treatment with puerarin. Puerarin also reduced Pg-LPS induced secretion of pro-inflammatory cytokines by suppressing p38MAPK. In vivo, the periodontitis group showed substantial alveolar bone loss and marked inflammatory cell infiltration. Both ADSCs and puerarin partially alleviated these changes but did not fully reverse them. Notably, their combination provided the greatest benefit, nearly normalizing alveolar bone parameters, strongly inhibiting p38MAPK, and further reducing inflammatory cytokine levels in periodontal tissues. Collectively, puerarin and ADSCs exert complementary anti-inflammatory and pro-osteogenic effects associated with attenuation of p38MAPK signaling. Co-administration produced superior therapeutic outcomes, supporting this dual approach as a potential strategy for periodontitis-associated bone loss.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70182"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}