{"title":"Extracellular Vesicle-Mediated Communication Between Anterior Cruciate Ligament and Bone Marrow Cells Modulates Hamstring Tenocyte Behavior and Apoptosis.","authors":"Hon-Lok Lo, Shih-Hao Huang, Ting-Hsuan Dai, Shun-Cheng Wu, Cheng-Jung Ho, Cheng-Chang Lu","doi":"10.1002/kjm2.70176","DOIUrl":"10.1002/kjm2.70176","url":null,"abstract":"<p><p>Following anterior cruciate ligament (ACL) reconstruction, enhancing hamstring tenocyte activity and minimizing apoptosis are critical for preventing graft failure and promoting ligamentization. This study investigated the therapeutic potential of extracellular vesicles (EVs) derived from a coculture of ACL remnant cells and bone marrow stromal cells (BMSCs), termed coculture-EV, in comparison with EVs from BMSC monoculture (BMSC-EV). We hypothesized that coculture-EVs could enhance tenocyte activity and reduce apoptosis, with greater effects than BMSC-EVs. ACL remnants, bone marrow, and hamstring tendons were harvested from rabbits 4 weeks post-ACL transection, and the cultured cells were used for coculture and subsequent experiments. EVs were isolated by ultracentrifugation and characterized by nanoparticle size analysis, electron microscopy, and EV-specific markers. Hamstring tenocytes treated with coculture-EVs exhibited significantly improved viability, proliferation (EdU assay), and migration (scratch and transwell assays), along with increased expression of genes related to collagen synthesis, transforming growth factor beta (TGF-β), and vascular endothelial growth factor (VEGF). Importantly, coculture-EV treatment more effectively suppressed both intrinsic and extrinsic apoptotic pathways. Coculture-EV treatment reduced early apoptosis in tenocytes by 54.5%, whereas BMSC-EV produced a 21.1% reduction. These findings suggest that EVs from ACL/BMSC coculture possess superior bioactivity compared with BMSC-derived EVs alone. Coculture-EV enhances tenocyte function and survival, indicating its potential as a cell-free therapeutic strategy to promote hamstring graft maturation and improve outcomes after ACL reconstruction.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70176"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042447","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}
Qing-Song Gu, Yi-Fan Gu, Jian-Qiao Li, Yi-Heng Li, Yu-Hu Chen, Lin-Hui Wang, Zi-Ru Wang, Yi-Cong Wang, Min Yang
{"title":"Valproic Acid Inhibits Ferroptosis and Improves Bone Integration in OVX Rats Through the AMPK/SIRT1 Pathway.","authors":"Qing-Song Gu, Yi-Fan Gu, Jian-Qiao Li, Yi-Heng Li, Yu-Hu Chen, Lin-Hui Wang, Zi-Ru Wang, Yi-Cong Wang, Min Yang","doi":"10.1002/kjm2.70175","DOIUrl":"10.1002/kjm2.70175","url":null,"abstract":"<p><p>The prevalence of postmenopausal osteoporosis (PMOP) has been steadily increasing. Ferroptosis has been recognized as a critical factor influencing the bone-forming ability of bone marrow mesenchymal stem cells (BMSCs). Valproic acid (VPA), an HDAC inhibitor, has been suggested to play a role in regulating osteoporosis development; however, its underlying mechanism remains unclear. This study aims to explore the impact of VPA on ferroptosis, a process that is triggered by Erastin, and to assess its implications for postmenopausal osteoporosis (PMOP). We evaluated the effects of valproate sodium on Erastin-induced ferroptosis in BMSCs through in vitro experiments, including CCK-8 assays, Western blot analysis, mitochondrial function assessments (MDA, GSH, ROS, and MMP), and osteogenic evaluations (ALP and ARS staining). The impact of VPA on bone integration in ovariectomized (OVX) rats was assessed using micro-CT, hematoxylin-eosin (HE) staining, Masson's trichrome staining, and RT-PCR analysis. RNA sequencing was employed to investigate the underlying mechanisms of VPA action. Our findings demonstrate that VPA treatment prevents the Erastin-induced decline in the osteogenic capacity of BMSCs. In addition, VPA treatment suppresses ferroptosis, as indicated by decreased malondialdehyde levels, reduced mitochondrial ROS, and increased glutathione concentrations. Moreover, VPA treatment promotes trabecular bone growth and enhances bone integration. Mechanistic studies reveal that SIRT1-siRNA counteracts the beneficial effects of VPA in Erastin-treated BMSCs. VPA improves bone integration in OVX rats by activating the AMPK/SIRT1 pathway and inhibiting ferroptosis.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70175"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115502","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":"Admission Plasma Lipopolysaccharide-binding protein, Procalcitonin, and Lactate for Early Identification of Nosocomial Infection in Cirrhotic Patients With Upper Gastrointestinal Bleeding: A Retrospective Analysis.","authors":"Li Chen, Shan-Shan Dun, Fang Xiao","doi":"10.1002/kjm2.70180","DOIUrl":"10.1002/kjm2.70180","url":null,"abstract":"<p><p>This study aimed to assess whether admission plasma lipopolysaccharide-binding protein (LBP), procalcitonin (PCT), and lactate could improve detection of nosocomial infection in cirrhotic patients presenting with upper gastrointestinal bleeding (UGIB). A retrospective analysis was conducted in 196 consecutive adults with cirrhotic UGIB admitted between January 2021 and January 2025, in whom index biomarkers were defined as the first blood samples obtained within 24 h of hospital arrival and before any diagnosis of nosocomial infection. Nosocomial infection within 28 days of admission occurred in 58 of 196 patients. Compared with noninfected patients, those with nosocomial infection had higher WBC, CRP, PCT, LBP, lactate, international normalized ratio (INR), and total bilirubin (TB), lower albumin and sodium, a higher neutrophil-to-lymphocyte ratio (NLR), and a lower lymphocyte-to-monocyte ratio (LMR). Individual discrimination was excellent for LBP (area under the curve [AUC] 0.967), CRP (0.918), WBC (0.914), lactate (0.910), and PCT (0.901). In multivariable analysis, LBP, CRP, and albumin remained independently associated with nosocomial infection. A WBC + CRP model achieved an AUC of 0.975, whereas LBP + CRP + albumin and LBP + PCT + lactate panels yielded AUCs of 0.997 and 0.999, respectively; both LBP-based panels significantly outperformed WBC + CRP. An admission LBP + CRP + albumin model provides a pragmatic, high-performing tool for early risk stratification, while an LBP + PCT + lactate panel offers near-perfect discrimination as an expanded option; these LBP-based tri-marker models may help refine early risk stratification and targeted management in cirrhotic patients with UGIB.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70180"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032224","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":"PRMT5 Mediates Sepsis-Associated Lung Injury by Modulating JAK1 Arginine Methylation: A Mechanism Study.","authors":"Bo Wang, Zhen Ge, Fei-Xiang Chen","doi":"10.1002/kjm2.70174","DOIUrl":"10.1002/kjm2.70174","url":null,"abstract":"<p><p>Lung injury is a common complication in critical sepsis. PRMT5 is implicated in endothelial inflammation and lung diseases, but its role in sepsis-associated lung injury remains unclear. This study collected clinical sepsis samples and detected the mRNA expression of PRMT5. Subsequently, a murine sepsis model (CLP) was constructed to assess disease severity (survival, sepsis score, temperature, weight). Then, lung histopathology was evaluated with HE staining. ELISA evaluated the expression of inflammatory cytokines in mice blood, and immunohistochemistry detected PRMT5 expression. In vitro, a sepsis cell model was generated by LPS stimulation of human pulmonary microvascular endothelial cells (HPMECs). qRT-PCR confirmed transfection efficiency. CCK-8 assay, ELISA, MDA/T-AOC kits, and flow cytometry tested cell viability, inflammatory cytokines, oxidative stress markers, and apoptosis, respectively. Bioinformatic analysis predicted PRMT5-interacting proteins, validated by Co-IP and immunofluorescence. JAK1 arginine methylation, JAK1 protein stability, and activation of the JAK1/STAT3 pathway were assessed by Western blot. The results showed that PRMT5 was upregulated in sepsis patients. PRMT5 knockdown attenuated septic symptoms in CLP mice, manifested by increased survival, reduced sepsis scores, restored physiological parameters, and alleviated lung injury. PRMT5 silencing reversed LPS-induced decreased viability of HPMECs, inflammatory cytokine release, and oxidative product accumulation. Mechanistically, PRMT5 stabilizes JAK1 protein through arginine methylation, activates the JAK1/STAT3 signaling pathway, and thereby promotes inflammatory responses and oxidative damage. In summary, PRMT5 regulates sepsis-induced lung injury through a methylation-dependent JAK1/STAT3 pathway, serving as a potential target for clinical intervention.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70174"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020572","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":"Autophagy Plays a Suppressive Role in Bladder Tumor Formation in an Orthotopic Mouse Model and Bladder Cancer Patient Specimens.","authors":"Wan-Ting Kuo, Chin-Chen Pan, Yi-Wen Liu, Nan-Haw Chow, Hong-Lin Cheng, Shan-Ying Wu, Sheng-Hui Lan, Chih-Peng Chang, Hsiao-Sheng Liu","doi":"10.1002/kjm2.70179","DOIUrl":"10.1002/kjm2.70179","url":null,"abstract":"<p><p>Autophagy plays either a suppressing or promoting role during tumor development. Clarifying the role of autophagy in bladder tumorigenesis both in vitro and in vivo is crucial for developing novel therapeutic strategies through manipulating autophagy activity. Herein, we noninvasively monitored how autophagy affects bladder tumor formation using a murine model of orthotopic bladder tumor formation by \"in vivo imaging system (IVIS) and transabdominal micro-ultrasound imaging (MUI)\" and validated the notion in cell lines and bladder cancer patients. Mimic clinical administration, all the drugs were delivered into the urinary bladder of the mice via intravesical instillation. Plasma biochemistry parameters, hemograms, blood pressure, and blood concentration of amiodarone and desethylamiodarone were analyzed in treated mice. Low autophagy activity was detected in the bladder tumors and associated with poor overall survival of bladder cancer patients. Amiodarone-induced autophagy activity suppressed bladder tumor formation, whereas silencing Atg5 expression reversed the suppression. Notably, amiodarone showed equivalent anti-tumor efficacy but with fewer side effects on the treated mice compared to the clinical anti-cancer drug Mitomycin C (MMC). Furthermore, amiodarone delivered by intravesical route showed a negligible influence on the physiologic conditions of the treated mice. Our orthotopic mouse model revealed that increasing autophagy activity alleviated bladder tumor development. Similarly, low autophagy is associated with a poor overall survival rate. Furthermore, repurposing amiodarone-induced autophagy accompanied by trivial side effects shows potential for the treatment of bladder cancer patients.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70179"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032185","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":"Identification of Clinical Factors Associated With the Immunogenicity of Homologous ChAdOx1-nCoV-19 Vaccine in Hemodialysis Patients.","authors":"Chia-Wei Chang, Ping-Hsun Wu, Li-Yun Chang, Yu-Ying Huang, Teng-Hui Huang, Su-Chu Lee, Yi-Wen Chiu, Shang-Jyh Hwang, Tsun-Yung Kuo, Mei-Chuan Kuo","doi":"10.1002/kjm2.70173","DOIUrl":"10.1002/kjm2.70173","url":null,"abstract":"<p><p>Hemodialysis (HD) patients are at higher risk of severe COVID-19 and may exhibit suboptimal vaccine responses. This study evaluates the factors influencing vaccine-induced immunity in HD patients following the second dose of the Vaxzevria. A total of 276 HD patients and 126 controls were included. Antibody responses were assessed using binding antibody units (BAU). Operational antibody thresholds used in prior literature were applied to classify antibody levels as evaluated as 50% and 60% vaccine efficacy (VE) levels after the first dose and second dose separately. Linear regression model and stratification by baseline characteristics were performed to identify clinical factors associated with vaccine responses. HD patients had significantly lower median antibody levels compared to healthy subjects. Antibody levels decreased with age, with the oldest tertile having the lowest response. Higher BMI and favorable body composition, such as increased fat tissue index, were positively correlated with stronger immune responses. Patients with elderly, diabetes mellitus, heart failure, and low BMI were associated with reduced antibody responses and lower rates of achieving 50% and 60% VE thresholds. Vaccine-induced immunity in HD patients is influenced by age, BMI, body composition, and comorbidities. Tailored vaccination strategies, including booster doses, are essential to enhance protection in this vulnerable population.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70173"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000280","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":"Systemic Immune-Inflammation Index and Gait Speed in Older Adults: Evidence From NHANES 1999-2002.","authors":"Ying-Lun Chen, Zhen-Xuan Ma","doi":"10.1002/kjm2.70270","DOIUrl":"10.1002/kjm2.70270","url":null,"abstract":"","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70270"},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611659","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}
Meng Jia, Yang Luo, Zhao-Yang Tan, Xiao-Ling Zhou, Xi-You Zhang, Jing-Ying Sun, Ye Du
{"title":"Determinants of Early Renal Function Recovery After TIPS in Patients With Portal Hypertension.","authors":"Meng Jia, Yang Luo, Zhao-Yang Tan, Xiao-Ling Zhou, Xi-You Zhang, Jing-Ying Sun, Ye Du","doi":"10.1002/kjm2.70268","DOIUrl":"10.1002/kjm2.70268","url":null,"abstract":"<p><p>Renal dysfunction frequently occurs in patients with portal hypertension and is linked to unfavorable clinical outcomes. Transjugular intrahepatic portosystemic shunt (TIPS) has the potential to enhance renal perfusion through portal decompression; however, factors predicting early improvement in renal function remain insufficiently defined. This retrospective, single-center study analyzed 188 consecutive patients with portal hypertension who underwent TIPS. Patients receiving renal replacement therapy or with baseline eGFR < 15 mL/min/1.73 m<sup>2</sup> were excluded. The primary endpoint was early renal function improvement, defined as a > 10% reduction in serum creatinine within 7 days. Early renal function improvement was observed in 27.7% of the cohort. Lower baseline eGFR was independently associated with higher probability of improvement (adjusted OR: 0.980, 95% CI: 0.966-0.993; p = 0.004). Neither pre- nor post-TIPS portal venous pressure nor the magnitude of pressure reduction was significantly associated with renal response. Restricted cubic spline analysis indicated a linear inverse relationship between baseline eGFR and improvement probability. The multivariable model demonstrated modest discriminative ability (AUC 0.666). Baseline renal function was associated with early post-TIPS early renal function improvement, whereas intra-procedural portal pressure parameters were not predictive. These findings suggest that early renal function improvement following TIPS may predominantly reflect reversible functional impairment rather than established structural kidney injury.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70268"},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611631","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}