Startseite Collagen changes in rabbit conjunctiva after conjunctival crosslinking
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Collagen changes in rabbit conjunctiva after conjunctival crosslinking

  • Li-Juan Mo , Han-Min Wang , Huan-Ming Zhou , Li Huang , Yan-Xiang Gui und Qing-Song Li EMAIL logo
Veröffentlicht/Copyright: 23. Mai 2023

Abstract

This study aims to determine the ultrastructural changes in collagen fibrils in rabbit conjunctiva after conjunctival crosslinking using riboflavin and ultraviolet A (UVA) light at an irradiation intensity of 45 mW/cm2. Conjunctival crosslinking may increase conjunctival stiffness. The supertemporal quadrants of the right eyes of 24 adult rabbits were treated with a topical riboflavin solution (0.25%) before irradiation with UVA light at 45 mW/cm2 for 4 min. After 3 weeks, the collagen fibrils in fibril bundles were examined by electron microscopy. Immunohistochemical staining was used to detect the expression levels of collagen I and collagen III in the rabbits’ conjunctiva. The diameter of the collagen fibrils in the fibril bundles varied slightly, ranging from 30 to 60 nm in the conjunctival stroma of the control group. In the treatment group, the diameter of collagen fibrils ranged from 60 to 90 nm. The thickest collagen fibrils were observed in the treatment group (up to 90 nm in diameter). In contrast, those in the conjunctival stroma of the control group were considerably smaller (up to 60 nm in diameter). However, thicknesses of collagen fibrils displayed a unimodal distribution. Both collagen I and collagen III increased after treatment with riboflavin and UVA light irradiation at 45 mW/cm2. The data indicate that in rabbits, conjunctival crosslinking with riboflavin and UVA light at 45 mW/cm2 for 4 min is safe and does not induce ultrastructural alterations of the conjunctival cells. The conjunctival crosslinking with riboflavin and UVA light at 45 mW/cm2 can increase the diameter of collagen fibrils, but the average densities of collagen I and collagen III have no statistical significance.

1 Introduction

Conjunctivochalasis (CCh) is a common eye disease related to age characterized by loosely redundant conjunctiva folds between the eyeball and the lower eyelid, causing a foreign body sensation, tears, and other symptoms [1]. The condition is associated with the biomechanical properties of the conjunctiva [1,2]. During CCh development, the conjunctiva undergoes an active remodeling process, which causes a progressive thinning and weakening of the tissue. A reduction in the size and number of the collagen fibers of the conjunctiva is known to be the main pathogenic factor in progressive CCh, during which the conjunctiva becomes weaker and more extensible [2].

Despite extensive research, there is still no effective method to prevent the progression of CCh. Recently, riboflavin and ultraviolet A (UVA)-induced collagen crosslinking (CXL) was successfully used to prevent the progression of keratoconus and keratectasia after photorefractive keratectomy and laser in situ keratomileusis (LASIK) [3,4]. In 2016, Choy et al. [5] conducted a prospective study on five patients and concluded that a single session of crosslinking was effective in limiting leakage from the filtering bleb. In recent years, more scholars have also confirmed that CXL could strengthen collagen fibers of the conjunctiva that form the outer lining of the cystic bleb and thus would be effective in treating bleb leak [6,7]. Therefore, for typically collagenous tissues like the cornea, it can be logically hypothesized that conjunctival CXL may strengthen the conjunctiva to prevent CCh progression.

Based on this hypothesis, we conducted an electron microscopy and immunohistochemical (IHC) staining investigation aiming to provide a comprehensive ultrastructural description and a morphometric analysis of the conjunctival structure to explore the CXL technology used in CCh.

2 Materials and methods

All methods are reported in accordance with ARRIVE guidelines.

2.1 Animals and anesthesia

Twenty-four adult New Zealand white rabbits (aged 3–4 months) were used in this experiment. The animals were maintained with free access to water and food in an air-conditioned room on a 12-h light–dark cycle. The animals were anesthetized with intramuscular ketamine (50 mg/kg) plus xylazine (10 mg/kg). To prevent a decrease in body temperature, the animals were positioned on a heated workstation. Conjunctival crosslinking was performed in the right eyes of the animals; the left eyes remained untreated and served as the control group.

  1. Ethical approval: The research related to animal use has been complied with all the relevant national regulations and institutional policies for the care and use of animals and has been approved by the Ethics Committee of Putuo District Center Hospital, Shanghai (Putuo Hospital, Shanghai University of Traditional Chinese Medicine) (No: PTEC-R-2020-23(Y)-1).

2.2 Conjunctival crosslinking

The animals were given general anesthesia, and the supertemporal quadrants of the right eyes were exposed. ParaCel (a formula containing 0.25% riboflavin, hydroxy propyl methylcellulose, ethylene diamine tetra acetic acid, trimethyl methylamine, and acetic acid n-butyl ester) was applied to completely cover the supertemporal conjunctiva. This process was repeated every 90 s for 4 min. The conjunctival surface was flushed thoroughly with VibeX Xtra (a formula containing 0.25% riboflavin and hypotonic saline). Sufficient VibeX Xtra was applied to completely cover the supertemporal conjunctival surface, and this process was repeated every 90 s for 6 min. The conjunctiva was rinsed completely with a balanced salt solution (BSS). An ultraviolet-irradiation apparatus was used to facilitate a rapid transepithelial CXL treatment. The treatment plan was to use an irradiation intensity of 45 mW/cm2, an irradiation spot diameter of 9 mm, a pulse irradiation mode with an interval of 1:1 s, and a total irradiation time of 320 s to obtain a total irradiation energy of 7.2 J. The conjunctiva was rinsed completely with BSS. After the irradiation procedure, levofloxacin eye drops (0.05%) were administered [8,9].

2.3 Electron microscopy

The treatment method proposed by Karl et al. [10] was used to observe the collagen after rabbit conjunctiva.

2.4 Immunohistochemistry

After removal, the eyes were soaked for 24 h in 4% paraformaldehyde phosphate-buffered saline (PBS). Each eye was dissected along the corneal limbus under a microscope, and the anterior segment was removed after dehydration using the sucrose gradient method. An optical cutting temperature compound (Tissue Tek, Sakura, Japan) was used to freeze the microtome-processed serial section to the treatment conjunctiva (thickness: 10 µm). After drying for 24 h at room temperature, the samples were preserved in a refrigerator at 4°C.

2.5 IHC staining procedure

The sample sections were removed from the freezer and placed for 30 min at room temperature. Then, they were immersed in acetone at 4°C for about 10 min and washed with PBS for 5 min three times. The samples were incubated for 10 min in 3% hydrogen peroxide to eliminate enzymatic activity, and they were washed twice with PBS for 5 min each time. Then, a 5% goat serum (PBS dilution) was used to seal the samples, and they were incubated for 10 min at room temperature. The serum was removed without washing, and the samples were dropped into the primary antibody (1:125) dilution, where they remained overnight at 4°C. The next day, the samples were washed in PBS for 5 min three times before being dropped into the secondary antibody, which was marked with biotin (1:125 1% bovine serum albumin in PBS dilution); then, they were incubated for 20 min at 37°C. The samples were washed with PBS for 5 min three times over; then, they were dropped into streptavidin marked with horseradish peroxidase (PBS dilution) and incubated for 20 min at 37°C. They were washed with PBS for 5 min three times and placed into a color-developing agent (3,3 N-diaminobenzidine tetrahydrochloride) or 3-amino-9-ethyl carbazole. The samples were fully washed using running water and dyed again. Finally, the film was sealed, and images were taken.

2.6 Histology

After the rabbits were euthanized, the treated area was positioned with 10-0 nonabsorbable sutures. Subsequently, enucleation of the eye was performed on each animal, and the eyes were immersed in neutral buffered formalin for 2 days. Subsequently, 2 × 4-mm strips were cut for histological analysis, including from the conjunctiva and sclera. All the sections were subsequently embedded in paraffin. To compare the histological changes, 4-µm-thick paraffin sections of the conjunctiva and sclera were prepared for staining with hematoxylin and eosin (HE). A terminal deoxynucleotidyl transferase-mediated biotin nick-end labeling (TUNEL) assay was performed using a TUNEL assay kit (Promega, USA) according to the manufacturer’s instructions.

The expression of collagen I and collagen III is a reliable marker of fibroblast proliferation. To evaluate this, mouse monoclonal anti-collage antibody (1:100 dilution in PBS) (Merck) was used along with biotinylated goat anti-mouse IgG (code B-6398; Sigma-Aldrich) as the secondary antibody according to the manufacturer’s instructions. All sections were examined using an Axioplan 2 imaging system (Zeiss). Five fields were randomly selected from each section at a magnification of 400× for histological evaluation [11].

2.7 Data analysis

As per the previous description by Young [12], longitudinal (filamentous), frontal (circular), and oblique (ellipsoidal) profiles of collagen fibril bundles were found, depending on the orientation within the images.

Because the research objectives are the same, the same analytical method as that of Karl et al. [10] was adopted to measure the diameter of collagen fibers. The method is explained as follows:

To obtain the orientation of the independent diameters of the fibrils, the shortest diameter of each fibril profile was measured. Assuming that the distribution of the collagen fibrils in one bundle was equal in each part of the bundle, fibril distribution patterns were generated from the diameters of 100 neighboring fibrils in one fibril bundle measured using Image-Pro Plus 6.0 analysis software. We used the counting function of the software, which indicates the measured distances automatically with consecutive numbering. Measured distances were automatically transferred into corresponding Excel datasheets and processed as described below. Fibril diameters were plotted against the fibril incidence, and normal distribution fits were made using the IBM SPSS Statistics 19 platform. The data are presented as mean ± standard deviation. For the fibrils’ data, bar charts were generated. Significance was determined with a T-test and was accepted at P < 0.05. The density and the collagen content of the fibrils were evaluated in images acquired by STEM, and the number of collagen fibrils per μm2 was determined using Analysis and Prism software. The collagen fraction (the relative area filled with dark collagen fibrils within the bright interfibrillar matrix) was evaluated with custom-made software that recognized brightness thresholds.

3 Results

3.1 Ultrastructure of the rabbit conjunctiva

Collagen fibril bundles were present in the conjunctival stroma. The fibril bundles were long and appeared to be interwoven (Figure 1). After conjunctival crosslinking with riboflavin and irradiation with UVA light at 45 mW/cm2 for 6 min, the ultrastructure of the conjunctival stroma and the morphology of the cells in these layers showed no difference between the treated and control tissues (not shown). The fibroblasts exhibited distinct signs of cellular activation and degeneration, including cell process thickening, dilation of the endoplasmic reticulum, and cytoplasmic vacuoles (not shown). In addition, erythrocytes in the extracellular matrix indicated the presence of hemorrhage (not shown).

Figure 1 
                  The electron microscopy image of the conjunctiva displays fibroblasts (fb), which are embedded in the interfibrillar matrix (gs: ground substance) and collagen fibril bundles (cf). Fibroblasts display an elliptical nucleus (n) and thin cytoplasmic processes (p), which run parallel to the surface of the eye. Fibroblasts in the conjunctiva contain substantial amounts of rough endoplasmic reticulum (*).
Figure 1

The electron microscopy image of the conjunctiva displays fibroblasts (fb), which are embedded in the interfibrillar matrix (gs: ground substance) and collagen fibril bundles (cf). Fibroblasts display an elliptical nucleus (n) and thin cytoplasmic processes (p), which run parallel to the surface of the eye. Fibroblasts in the conjunctiva contain substantial amounts of rough endoplasmic reticulum (*).

3.2 Thickness of collagen fibrils

To determine whether conjunctival crosslinking induces alterations in the thickness of conjunctival collagen fibrils, we measured the diameter of single collagen fibrils in the conjunctival stroma. Note that 100 neighboring fibrils were measured to calculate their diameter, whereas the density of the fibrils described the number of corresponding fibrils per μm2 area. The collagen fraction indicated the relative area filled with collagen fibrils within the interfibrillar matrix.

The diameter of the collagen fibrils in the fibril bundles varied slightly and ranged from 30 to 60 nm in the control group of the conjunctival stroma (Figure 2a). In the treatment group, the diameter of the collagen fibrils ranged from 60 to 90 nm (Figure 2a). The thickest collagen fibrils were observed in the treatment group, with fibril diameters measuring up to 90 nm, whereas the thickest collagen fibrils in the control group were considerably smaller (up to 60 nm in diameter). Both collagen fibril groups displayed a unimodal distribution in thicknesses.

Figure 2 
                  (a) Examples of collagen fibril profiles in electron microscopy images of the conjunctiva of the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2. (b) Number of collagen fibrils per μm2 in the fibril bundles of the conjunctiva of the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2. (c) Collagen fraction (the relative area filled with collagen fibrils within the interfibrillar matrix of the conjunctiva) of the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2. (d) The diameter of single collagen fibrils in the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2 (*P < 0.05).
Figure 2

(a) Examples of collagen fibril profiles in electron microscopy images of the conjunctiva of the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2. (b) Number of collagen fibrils per μm2 in the fibril bundles of the conjunctiva of the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2. (c) Collagen fraction (the relative area filled with collagen fibrils within the interfibrillar matrix of the conjunctiva) of the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2. (d) The diameter of single collagen fibrils in the control eyes and the eyes treated with UV light at an intensity of 45 mW/cm2 (*P < 0.05).

The densities of the collagen fibrils were 117.33 ± 5.2 fibrils per μm2 and 79.57 ± 5.3 fibrils per μm2 in the control and treatment groups, respectively (Figure 2b). The collagen fractions were 0.33 ± 0.01 and 0.39 ± 0.02, respectively (Figure 2c). As shown, treatment with riboflavin and UVA light at 45 mW/cm2 significantly increased (P < 0.01 and P < 0.001, respectively) the diameter of the collagen fibrils in the conjunctival stroma compared with the control group (Figure 2d) and strongly decreased the density of the collagen fibrils in the fibril bundles (Figure 2b). In addition, the collagen fraction (the relative area filled with collagen fibrils within the interfibrillar matrix of the conjunctival stroma) was not significantly increased (P > 0.05) after treatment with riboflavin and UVA light at 45 mW/cm2.

3.3 Changes in collagen fibrils in the rabbit conjunctiva

To detect the change in collagen fibrils in the rabbit conjunctiva, HE and Masson tissue staining techniques were used. In Figures 3 and 4, we can see that more collagen fibrils were found in the treatment group compared with those in the control group, and the collagen fibers in the treatment group were arranged more tightly with thicker fibers.

Figure 3 
                  HE staining of conjunctival collagen fibers in control group and treatment group (400×, (a) control group; (b) treatment group).
Figure 3

HE staining of conjunctival collagen fibers in control group and treatment group (400×, (a) control group; (b) treatment group).

Figure 4 
                  Masson staining of conjunctival collagen fibers in the control group and treatment group (400×, (a) control group; (b) treatment group).
Figure 4

Masson staining of conjunctival collagen fibers in the control group and treatment group (400×, (a) control group; (b) treatment group).

3.4 Changes in collagen I and collagen III in the rabbit conjunctiva

In our study, the frozen sections were evaluated using IHC staining. Collagen I and collagen III were observed in both the control and treatment groups. The positive staining of collagen I and collagen III was located outside the cell and presented a brown color. A semi-quantitative analysis of IHC staining results was conducted using Image-Pro Plus 6.0 software.

The average optical densities of collagen I were 0.18 ± 0.02 and 0.19 ± 0.04 in the control and treatment groups, respectively (Figure 5). The average densities of collagen III were 0.17 ± 0.01 and 0.18 ± 0.01 in the control and treatment groups, respectively (Figure 6). In our study, average optical densities of both collagen I and collagen III were not significantly increased (P > 0.05) after treatment with riboflavin and UVA light at 45 mW/cm2 (Figure 7).

Figure 5 
                  IHC staining of frozen sections. Collagen I was found in the rabbit conjunctiva. When compared with the control group, more collagen fibers were found in the in the treatment group: (a) control group; (b) treatment group.
Figure 5

IHC staining of frozen sections. Collagen I was found in the rabbit conjunctiva. When compared with the control group, more collagen fibers were found in the in the treatment group: (a) control group; (b) treatment group.

Figure 6 
                  IHC staining of frozen sections. Collagen III was found in the rabbit conjunctiva. When compared with the control group, more collagen fibers were found in the in the treatment group: (a) control group; (b) treatment group.
Figure 6

IHC staining of frozen sections. Collagen III was found in the rabbit conjunctiva. When compared with the control group, more collagen fibers were found in the in the treatment group: (a) control group; (b) treatment group.

Figure 7 
                  When comparing the control group, the average optical density of collagen I and collagen III were not significantly increased after treatment with riboflavin and UVA light at 45 mW/cm2 (P > 0.05).
Figure 7

When comparing the control group, the average optical density of collagen I and collagen III were not significantly increased after treatment with riboflavin and UVA light at 45 mW/cm2 (P > 0.05).

4 Discussion

CXL was used to increase the tension and stability of the collagen fibers, which causes intra- and inter-molecular covalent bonding. The principle is to use a UVA wavelength of 370 nm to irradiate the tissue infiltrated by the photosensitizer riboflavin. The riboflavin molecule is excited to a triplet state, resulting in an active oxygen species dominated by singlet oxygen [13,14]. Reactive oxygen species can react with various molecules and induce chemical crosslinking reactions between the amino groups of collagen fibers, thereby increasing the mechanical strength of collagen fibers and their ability to resist protease digestion.

This method is currently used to treat keratoconus. The pathogenesis of CCh is similar to that of keratoconus [15]. The type, number, and spatial structure of collagen are changed, and its mechanical tension is reduced. In this study, we determined the ultrastructural changes in cells and collagen fibrils in the rabbit conjunctiva after conjunctival treatment with riboflavin and irradiation with UV light.

We found that conjunctival crosslinking with riboflavin and irradiation with a UV light intensity of 45 mW/cm2 for 6 min influenced the amount and diameter of the collagen fibrils in the bundles of the conjunctival stroma. The fibroblasts showed distinct signs of cellular activation, and the presence of erythrocytes in the conjunctival extracellular matrix indicated the existence of hemorrhage (not shown). It cannot be excluded that the changes observed under the conditions used in this study were not caused by light irradiation but by the surgical procedure itself. The results suggest that conjunctival crosslinking with riboflavin and UV light at 45 mW/cm2 for 6 min is safe and does not induce various inflammatory or degenerative processes in the conjunctiva and adjacent tissues.

It has been suggested that the biomechanical properties of the conjunctiva result from the diameter, distribution, and orientation of collagen fibrils [16,17]. We found that the diameter of collagen fibrils in the conjunctival stroma varied slightly from 30 to 60 nm in the control group and from 60 to 90 nm in the treatment group. This range is similar to the data described in a previous study [12]. However, we found that the diameter of the collagen fibrils exhibited a unimodal distribution.

In this study, we detected the changes in collagen fibrils in rabbit conjunctiva by HE and Masson tissue staining. In Figures 3 and 4, we can see that more collagen fibrils were found in the treatment group compared with those in the control group. The collagen fibers in the treatment group were arranged more tightly, and the fibers were thicker.

In our experiment, we also applied frozen-section IHC staining to detect collagen I and III expressions in the rabbit conjunctiva by changing the conjunctival morphology. We observed that the positive staining of collagen I and collagen III was located outside the cell and presented a brown color. Average densities of both collagen I and collagen III were not increased after treatment with riboflavin and UVA light at 45 mW/cm2. CCh is associated with a thinning of the conjunctival collagen fibrils, which may be a reason for the decrease in conjunctival stiffness and thinning [18,19,20]. We found that treatment with riboflavin and UVA light at an intensity of 45 mW/cm2 caused a significant increase in the diameter of the collagen fibrils in the fibril bundles. In the conjunctiva, activated fibroblasts and macrophages may produce collagen-degrading exoenzymes.

The results of this study may indicate that crosslinking with riboflavin and UV light results in a remodeling of the conjunctival extracellular matrix, which includes the degradation of thick collagen fibers and/or the de novo synthesis of collagen fibers [21,22]. However, there was temporal damage to the conjunctival cells after conjunctival crosslinking using riboflavin and UVA light. Delayed resettlement of conjunctival cells in the treated tissue leads to prolonged regeneration processes and long-lasting biomechanical stiffening effects [12]. Conjunctival remodeling may also contribute to scarring and stiffening. Extensive conjunctival light irradiation should be avoided due to the risk of tissue damage in the choroid and retina. Advanced technologies using high light intensities and minimized irradiation spots (similar to spot welding) can use the benefits of such remodeling side effects to stiffen the conjunctiva and prevent tissue damage to the retina.

5 Conclusion

To increase the safety of the conjunctival crosslinking method, developing different therapeutic approaches to prevent the harmful effects of high-intensity light treatment without inhibiting crosslinking efficiency may be helpful. In addition, the topical administration of anti-inflammatory agents may help prevent chronic inflammation.


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Acknowledgments

We would like to acknowledge the hard and dedicated work of all the staff who implemented the intervention and evaluation components of the study.

  1. Funding information: This work was supported by Shanghai Municipal Health Commission (No. 202040148).

  2. Author contributions: Conception and design of the research: L.J.M., O.S.L. Acquisition of data: L.J.M., H.M.W., L.H., Y.X.G. Analysis and interpretation of the data: L.J.M., H.M.W., H.M.Z. Statistical analysis: H.M.Z. Obtaining financing: Q.S.L. Writing of the manuscript: L.J.M. Critical revision of the manuscript for intellectual content: Q.S.L. All authors read and approved the final draft.

  3. Conflict of interest: Authors state no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2022-11-07
Revised: 2023-02-15
Accepted: 2023-03-27
Published Online: 2023-05-23

© 2023 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  27. Primary retroperitoneal angiosarcoma: A case report
  28. Metabolomic analysis-identified 2-hydroxybutyric acid might be a key metabolite of severe preeclampsia
  29. Malignant pleural effusion diagnosis and therapy
  30. Effect of spaceflight on the phenotype and proteome of Escherichia coli
  31. Comparison of immunotherapy combined with stereotactic radiotherapy and targeted therapy for patients with brain metastases: A systemic review and meta-analysis
  32. Activation of hypermethylated P2RY1 mitigates gastric cancer by promoting apoptosis and inhibiting proliferation
  33. Association between the VEGFR-2 -604T/C polymorphism (rs2071559) and type 2 diabetic retinopathy
  34. The role of IL-31 and IL-34 in the diagnosis and treatment of chronic periodontitis
  35. Triple-negative mouse breast cancer initiating cells show high expression of beta1 integrin and increased malignant features
  36. mNGS facilitates the accurate diagnosis and antibiotic treatment of suspicious critical CNS infection in real practice: A retrospective study
  37. The apatinib and pemetrexed combination has antitumor and antiangiogenic effects against NSCLC
  38. Radiotherapy for primary thyroid adenoid cystic carcinoma
  39. Design and functional preliminary investigation of recombinant antigen EgG1Y162–EgG1Y162 against Echinococcus granulosus
  40. Effects of losartan in patients with NAFLD: A meta-analysis of randomized controlled trial
  41. Bibliometric analysis of METTL3: Current perspectives, highlights, and trending topics
  42. Performance comparison of three scaling algorithms in NMR-based metabolomics analysis
  43. PI3K/AKT/mTOR pathway and its related molecules participate in PROK1 silence-induced anti-tumor effects on pancreatic cancer
  44. The altered expression of cytoskeletal and synaptic remodeling proteins during epilepsy
  45. Effects of pegylated recombinant human granulocyte colony-stimulating factor on lymphocytes and white blood cells of patients with malignant tumor
  46. Prostatitis as initial manifestation of Chlamydia psittaci pneumonia diagnosed by metagenome next-generation sequencing: A case report
  47. NUDT21 relieves sevoflurane-induced neurological damage in rats by down-regulating LIMK2
  48. Association of interleukin-10 rs1800896, rs1800872, and interleukin-6 rs1800795 polymorphisms with squamous cell carcinoma risk: A meta-analysis
  49. Exosomal HBV-DNA for diagnosis and treatment monitoring of chronic hepatitis B
  50. Shear stress leads to the dysfunction of endothelial cells through the Cav-1-mediated KLF2/eNOS/ERK signaling pathway under physiological conditions
  51. Interaction between the PI3K/AKT pathway and mitochondrial autophagy in macrophages and the leukocyte count in rats with LPS-induced pulmonary infection
  52. Meta-analysis of the rs231775 locus polymorphism in the CTLA-4 gene and the susceptibility to Graves’ disease in children
  53. Cloning, subcellular localization and expression of phosphate transporter gene HvPT6 of hulless barley
  54. Coptisine mitigates diabetic nephropathy via repressing the NRLP3 inflammasome
  55. Significant elevated CXCL14 and decreased IL-39 levels in patients with tuberculosis
  56. Whole-exome sequencing applications in prenatal diagnosis of fetal bowel dilatation
  57. Gemella morbillorum infective endocarditis: A case report and literature review
  58. An unusual ectopic thymoma clonal evolution analysis: A case report
  59. Severe cumulative skin toxicity during toripalimab combined with vemurafenib following toripalimab alone
  60. Detection of V. vulnificus septic shock with ARDS using mNGS
  61. Novel rare genetic variants of familial and sporadic pulmonary atresia identified by whole-exome sequencing
  62. The influence and mechanistic action of sperm DNA fragmentation index on the outcomes of assisted reproduction technology
  63. Novel compound heterozygous mutations in TELO2 in an infant with You-Hoover-Fong syndrome: A case report and literature review
  64. ctDNA as a prognostic biomarker in resectable CLM: Systematic review and meta-analysis
  65. Diagnosis of primary amoebic meningoencephalitis by metagenomic next-generation sequencing: A case report
  66. Phylogenetic analysis of promoter regions of human Dolichol kinase (DOLK) and orthologous genes using bioinformatics tools
  67. Collagen changes in rabbit conjunctiva after conjunctival crosslinking
  68. Effects of NM23 transfection of human gastric carcinoma cells in mice
  69. Oral nifedipine and phytosterol, intravenous nicardipine, and oral nifedipine only: Three-arm, retrospective, cohort study for management of severe preeclampsia
  70. Case report of hepatic retiform hemangioendothelioma: A rare tumor treated with ultrasound-guided microwave ablation
  71. Curcumin induces apoptosis in human hepatocellular carcinoma cells by decreasing the expression of STAT3/VEGF/HIF-1α signaling
  72. Rare presentation of double-clonal Waldenström macroglobulinemia with pulmonary embolism: A case report
  73. Giant duplication of the transverse colon in an adult: A case report and literature review
  74. Ectopic thyroid tissue in the breast: A case report
  75. SDR16C5 promotes proliferation and migration and inhibits apoptosis in pancreatic cancer
  76. Vaginal metastasis from breast cancer: A case report
  77. Screening of the best time window for MSC transplantation to treat acute myocardial infarction with SDF-1α antibody-loaded targeted ultrasonic microbubbles: An in vivo study in miniswine
  78. Inhibition of TAZ impairs the migration ability of melanoma cells
  79. Molecular complexity analysis of the diagnosis of Gitelman syndrome in China
  80. Effects of maternal calcium and protein intake on the development and bone metabolism of offspring mice
  81. Identification of winter wheat pests and diseases based on improved convolutional neural network
  82. Ultra-multiplex PCR technique to guide treatment of Aspergillus-infected aortic valve prostheses
  83. Virtual high-throughput screening: Potential inhibitors targeting aminopeptidase N (CD13) and PIKfyve for SARS-CoV-2
  84. Immune checkpoint inhibitors in cancer patients with COVID-19
  85. Utility of methylene blue mixed with autologous blood in preoperative localization of pulmonary nodules and masses
  86. Integrated analysis of the microbiome and transcriptome in stomach adenocarcinoma
  87. Berberine suppressed sarcopenia insulin resistance through SIRT1-mediated mitophagy
  88. DUSP2 inhibits the progression of lupus nephritis in mice by regulating the STAT3 pathway
  89. Lung abscess by Fusobacterium nucleatum and Streptococcus spp. co-infection by mNGS: A case series
  90. Genetic alterations of KRAS and TP53 in intrahepatic cholangiocarcinoma associated with poor prognosis
  91. Granulomatous polyangiitis involving the fourth ventricle: Report of a rare case and a literature review
  92. Studying infant mortality: A demographic analysis based on data mining models
  93. Metaplastic breast carcinoma with osseous differentiation: A report of a rare case and literature review
  94. Protein Z modulates the metastasis of lung adenocarcinoma cells
  95. Inhibition of pyroptosis and apoptosis by capsaicin protects against LPS-induced acute kidney injury through TRPV1/UCP2 axis in vitro
  96. TAK-242, a toll-like receptor 4 antagonist, against brain injury by alleviates autophagy and inflammation in rats
  97. Primary mediastinum Ewing’s sarcoma with pleural effusion: A case report and literature review
  98. Association of ADRB2 gene polymorphisms and intestinal microbiota in Chinese Han adolescents
  99. Tanshinone IIA alleviates chondrocyte apoptosis and extracellular matrix degeneration by inhibiting ferroptosis
  100. Study on the cytokines related to SARS-Cov-2 in testicular cells and the interaction network between cells based on scRNA-seq data
  101. Effect of periostin on bone metabolic and autophagy factors during tooth eruption in mice
  102. HP1 induces ferroptosis of renal tubular epithelial cells through NRF2 pathway in diabetic nephropathy
  103. Intravaginal estrogen management in postmenopausal patients with vaginal squamous intraepithelial lesions along with CO2 laser ablation: A retrospective study
  104. Hepatocellular carcinoma cell differentiation trajectory predicts immunotherapy, potential therapeutic drugs, and prognosis of patients
  105. Effects of physical exercise on biomarkers of oxidative stress in healthy subjects: A meta-analysis of randomized controlled trials
  106. Identification of lysosome-related genes in connection with prognosis and immune cell infiltration for drug candidates in head and neck cancer
  107. Development of an instrument-free and low-cost ELISA dot-blot test to detect antibodies against SARS-CoV-2
  108. Research progress on gas signal molecular therapy for Parkinson’s disease
  109. Adiponectin inhibits TGF-β1-induced skin fibroblast proliferation and phenotype transformation via the p38 MAPK signaling pathway
  110. The G protein-coupled receptor-related gene signatures for predicting prognosis and immunotherapy response in bladder urothelial carcinoma
  111. α-Fetoprotein contributes to the malignant biological properties of AFP-producing gastric cancer
  112. CXCL12/CXCR4/CXCR7 axis in placenta tissues of patients with placenta previa
  113. Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis
  114. Significance of sTREM-1 and sST2 combined diagnosis for sepsis detection and prognosis prediction
  115. Diagnostic value of serum neuroactive substances in the acute exacerbation of chronic obstructive pulmonary disease complicated with depression
  116. Research progress of AMP-activated protein kinase and cardiac aging
  117. TRIM29 knockdown prevented the colon cancer progression through decreasing the ubiquitination levels of KRT5
  118. Cross-talk between gut microbiota and liver steatosis: Complications and therapeutic target
  119. Metastasis from small cell lung cancer to ovary: A case report
  120. The early diagnosis and pathogenic mechanisms of sepsis-related acute kidney injury
  121. The effect of NK cell therapy on sepsis secondary to lung cancer: A case report
  122. Erianin alleviates collagen-induced arthritis in mice by inhibiting Th17 cell differentiation
  123. Loss of ACOX1 in clear cell renal cell carcinoma and its correlation with clinical features
  124. Signalling pathways in the osteogenic differentiation of periodontal ligament stem cells
  125. Crosstalk between lactic acid and immune regulation and its value in the diagnosis and treatment of liver failure
  126. Clinicopathological features and differential diagnosis of gastric pleomorphic giant cell carcinoma
  127. Traumatic brain injury and rTMS-ERPs: Case report and literature review
  128. Extracellular fibrin promotes non-small cell lung cancer progression through integrin β1/PTEN/AKT signaling
  129. Knockdown of DLK4 inhibits non-small cell lung cancer tumor growth by downregulating CKS2
  130. The co-expression pattern of VEGFR-2 with indicators related to proliferation, apoptosis, and differentiation of anagen hair follicles
  131. Inflammation-related signaling pathways in tendinopathy
  132. CD4+ T cell count in HIV/TB co-infection and co-occurrence with HL: Case report and literature review
  133. Clinical analysis of severe Chlamydia psittaci pneumonia: Case series study
  134. Bioinformatics analysis to identify potential biomarkers for the pulmonary artery hypertension associated with the basement membrane
  135. Influence of MTHFR polymorphism, alone or in combination with smoking and alcohol consumption, on cancer susceptibility
  136. Catharanthus roseus (L.) G. Don counteracts the ampicillin resistance in multiple antibiotic-resistant Staphylococcus aureus by downregulation of PBP2a synthesis
  137. Combination of a bronchogenic cyst in the thoracic spinal canal with chronic myelocytic leukemia
  138. Bacterial lipoprotein plays an important role in the macrophage autophagy and apoptosis induced by Salmonella typhimurium and Staphylococcus aureus
  139. TCL1A+ B cells predict prognosis in triple-negative breast cancer through integrative analysis of single-cell and bulk transcriptomic data
  140. Ezrin promotes esophageal squamous cell carcinoma progression via the Hippo signaling pathway
  141. Ferroptosis: A potential target of macrophages in plaque vulnerability
  142. Predicting pediatric Crohn's disease based on six mRNA-constructed risk signature using comprehensive bioinformatic approaches
  143. Applications of genetic code expansion and photosensitive UAAs in studying membrane proteins
  144. HK2 contributes to the proliferation, migration, and invasion of diffuse large B-cell lymphoma cells by enhancing the ERK1/2 signaling pathway
  145. IL-17 in osteoarthritis: A narrative review
  146. Circadian cycle and neuroinflammation
  147. Probiotic management and inflammatory factors as a novel treatment in cirrhosis: A systematic review and meta-analysis
  148. Hemorrhagic meningioma with pulmonary metastasis: Case report and literature review
  149. SPOP regulates the expression profiles and alternative splicing events in human hepatocytes
  150. Knockdown of SETD5 inhibited glycolysis and tumor growth in gastric cancer cells by down-regulating Akt signaling pathway
  151. PTX3 promotes IVIG resistance-induced endothelial injury in Kawasaki disease by regulating the NF-κB pathway
  152. Pancreatic ectopic thyroid tissue: A case report and analysis of literature
  153. The prognostic impact of body mass index on female breast cancer patients in underdeveloped regions of northern China differs by menopause status and tumor molecular subtype
  154. Report on a case of liver-originating malignant melanoma of unknown primary
  155. Case report: Herbal treatment of neutropenic enterocolitis after chemotherapy for breast cancer
  156. The fibroblast growth factor–Klotho axis at molecular level
  157. Characterization of amiodarone action on currents in hERG-T618 gain-of-function mutations
  158. A case report of diagnosis and dynamic monitoring of Listeria monocytogenes meningitis with NGS
  159. Effect of autologous platelet-rich plasma on new bone formation and viability of a Marburg bone graft
  160. Small breast epithelial mucin as a useful prognostic marker for breast cancer patients
  161. Continuous non-adherent culture promotes transdifferentiation of human adipose-derived stem cells into retinal lineage
  162. Nrf3 alleviates oxidative stress and promotes the survival of colon cancer cells by activating AKT/BCL-2 signal pathway
  163. Favorable response to surufatinib in a patient with necrolytic migratory erythema: A case report
  164. Case report of atypical undernutrition of hypoproteinemia type
  165. Down-regulation of COL1A1 inhibits tumor-associated fibroblast activation and mediates matrix remodeling in the tumor microenvironment of breast cancer
  166. Sarcoma protein kinase inhibition alleviates liver fibrosis by promoting hepatic stellate cells ferroptosis
  167. Research progress of serum eosinophil in chronic obstructive pulmonary disease and asthma
  168. Clinicopathological characteristics of co-existing or mixed colorectal cancer and neuroendocrine tumor: Report of five cases
  169. Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis
  170. Precisional detection of lymph node metastasis using tFCM in colorectal cancer
  171. Advances in diagnosis and treatment of perimenopausal syndrome
  172. A study of forensic genetics: ITO index distribution and kinship judgment between two individuals
  173. Acute lupus pneumonitis resembling miliary tuberculosis: A case-based review
  174. Plasma levels of CD36 and glutathione as biomarkers for ruptured intracranial aneurysm
  175. Fractalkine modulates pulmonary angiogenesis and tube formation by modulating CX3CR1 and growth factors in PVECs
  176. Novel risk prediction models for deep vein thrombosis after thoracotomy and thoracoscopic lung cancer resections, involving coagulation and immune function
  177. Exploring the diagnostic markers of essential tremor: A study based on machine learning algorithms
  178. Evaluation of effects of small-incision approach treatment on proximal tibia fracture by deep learning algorithm-based magnetic resonance imaging
  179. An online diagnosis method for cancer lesions based on intelligent imaging analysis
  180. Medical imaging in rheumatoid arthritis: A review on deep learning approach
  181. Predictive analytics in smart healthcare for child mortality prediction using a machine learning approach
  182. Utility of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in predicting acute-on-chronic liver failure survival
  183. A biomedical decision support system for meta-analysis of bilateral upper-limb training in stroke patients with hemiplegia
  184. TNF-α and IL-8 levels are positively correlated with hypobaric hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats
  185. Stochastic gradient descent optimisation for convolutional neural network for medical image segmentation
  186. Comparison of the prognostic value of four different critical illness scores in patients with sepsis-induced coagulopathy
  187. Application and teaching of computer molecular simulation embedded technology and artificial intelligence in drug research and development
  188. Hepatobiliary surgery based on intelligent image segmentation technology
  189. Value of brain injury-related indicators based on neural network in the diagnosis of neonatal hypoxic-ischemic encephalopathy
  190. Analysis of early diagnosis methods for asymmetric dementia in brain MR images based on genetic medical technology
  191. Early diagnosis for the onset of peri-implantitis based on artificial neural network
  192. Clinical significance of the detection of serum IgG4 and IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy
  193. Forecast of pain degree of lumbar disc herniation based on back propagation neural network
  194. SPA-UNet: A liver tumor segmentation network based on fused multi-scale features
  195. Systematic evaluation of clinical efficacy of CYP1B1 gene polymorphism in EGFR mutant non-small cell lung cancer observed by medical image
  196. Rehabilitation effect of intelligent rehabilitation training system on hemiplegic limb spasms after stroke
  197. A novel approach for minimising anti-aliasing effects in EEG data acquisition
  198. ErbB4 promotes M2 activation of macrophages in idiopathic pulmonary fibrosis
  199. Clinical role of CYP1B1 gene polymorphism in prediction of postoperative chemotherapy efficacy in NSCLC based on individualized health model
  200. Lung nodule segmentation via semi-residual multi-resolution neural networks
  201. Evaluation of brain nerve function in ICU patients with Delirium by deep learning algorithm-based resting state MRI
  202. A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis
  203. Markov model combined with MR diffusion tensor imaging for predicting the onset of Alzheimer’s disease
  204. Effectiveness of the treatment of depression associated with cancer and neuroimaging changes in depression-related brain regions in patients treated with the mediator-deuterium acupuncture method
  205. Molecular mechanism of colorectal cancer and screening of molecular markers based on bioinformatics analysis
  206. Monitoring and evaluation of anesthesia depth status data based on neuroscience
  207. Exploring the conformational dynamics and thermodynamics of EGFR S768I and G719X + S768I mutations in non-small cell lung cancer: An in silico approaches
  208. Optimised feature selection-driven convolutional neural network using gray level co-occurrence matrix for detection of cervical cancer
  209. Incidence of different pressure patterns of spinal cerebellar ataxia and analysis of imaging and genetic diagnosis
  210. Pathogenic bacteria and treatment resistance in older cardiovascular disease patients with lung infection and risk prediction model
  211. Adoption value of support vector machine algorithm-based computed tomography imaging in the diagnosis of secondary pulmonary fungal infections in patients with malignant hematological disorders
  212. From slides to insights: Harnessing deep learning for prognostic survival prediction in human colorectal cancer histology
  213. Ecology and Environmental Science
  214. Monitoring of hourly carbon dioxide concentration under different land use types in arid ecosystem
  215. Comparing the differences of prokaryotic microbial community between pit walls and bottom from Chinese liquor revealed by 16S rRNA gene sequencing
  216. Effects of cadmium stress on fruits germination and growth of two herbage species
  217. Bamboo charcoal affects soil properties and bacterial community in tea plantations
  218. Optimization of biogas potential using kinetic models, response surface methodology, and instrumental evidence for biodegradation of tannery fleshings during anaerobic digestion
  219. Understory vegetation diversity patterns of Platycladus orientalis and Pinus elliottii communities in Central and Southern China
  220. Studies on macrofungi diversity and discovery of new species of Abortiporus from Baotianman World Biosphere Reserve
  221. Food Science
  222. Effect of berrycactus fruit (Myrtillocactus geometrizans) on glutamate, glutamine, and GABA levels in the frontal cortex of rats fed with a high-fat diet
  223. Guesstimate of thymoquinone diversity in Nigella sativa L. genotypes and elite varieties collected from Indian states using HPTLC technique
  224. Analysis of bacterial community structure of Fuzhuan tea with different processing techniques
  225. Untargeted metabolomics reveals sour jujube kernel benefiting the nutritional value and flavor of Morchella esculenta
  226. Mycobiota in Slovak wine grapes: A case study from the small Carpathians wine region
  227. Elemental analysis of Fadogia ancylantha leaves used as a nutraceutical in Mashonaland West Province, Zimbabwe
  228. Microbiological transglutaminase: Biotechnological application in the food industry
  229. Influence of solvent-free extraction of fish oil from catfish (Clarias magur) heads using a Taguchi orthogonal array design: A qualitative and quantitative approach
  230. Chromatographic analysis of the chemical composition and anticancer activities of Curcuma longa extract cultivated in Palestine
  231. The potential for the use of leghemoglobin and plant ferritin as sources of iron
  232. Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM
  233. Bioengineering and Biotechnology
  234. Biocompatibility and osteointegration capability of β-TCP manufactured by stereolithography 3D printing: In vitro study
  235. Clinical characteristics and the prognosis of diabetic foot in Tibet: A single center, retrospective study
  236. Agriculture
  237. Biofertilizer and NPSB fertilizer application effects on nodulation and productivity of common bean (Phaseolus vulgaris L.) at Sodo Zuria, Southern Ethiopia
  238. On correlation between canopy vegetation and growth indexes of maize varieties with different nitrogen efficiencies
  239. Exopolysaccharides from Pseudomonas tolaasii inhibit the growth of Pleurotus ostreatus mycelia
  240. A transcriptomic evaluation of the mechanism of programmed cell death of the replaceable bud in Chinese chestnut
  241. Melatonin enhances salt tolerance in sorghum by modulating photosynthetic performance, osmoregulation, antioxidant defense, and ion homeostasis
  242. Effects of plant density on alfalfa (Medicago sativa L.) seed yield in western Heilongjiang areas
  243. Identification of rice leaf diseases and deficiency disorders using a novel DeepBatch technique
  244. Artificial intelligence and internet of things oriented sustainable precision farming: Towards modern agriculture
  245. Animal Sciences
  246. Effect of ketogenic diet on exercise tolerance and transcriptome of gastrocnemius in mice
  247. Combined analysis of mRNA–miRNA from testis tissue in Tibetan sheep with different FecB genotypes
  248. Isolation, identification, and drug resistance of a partially isolated bacterium from the gill of Siniperca chuatsi
  249. Tracking behavioral changes of confined sows from the first mating to the third parity
  250. The sequencing of the key genes and end products in the TLR4 signaling pathway from the kidney of Rana dybowskii exposed to Aeromonas hydrophila
  251. Development of a new candidate vaccine against piglet diarrhea caused by Escherichia coli
  252. Plant Sciences
  253. Crown and diameter structure of pure Pinus massoniana Lamb. forest in Hunan province, China
  254. Genetic evaluation and germplasm identification analysis on ITS2, trnL-F, and psbA-trnH of alfalfa varieties germplasm resources
  255. Tissue culture and rapid propagation technology for Gentiana rhodantha
  256. Effects of cadmium on the synthesis of active ingredients in Salvia miltiorrhiza
  257. Cloning and expression analysis of VrNAC13 gene in mung bean
  258. Chlorate-induced molecular floral transition revealed by transcriptomes
  259. Effects of warming and drought on growth and development of soybean in Hailun region
  260. Effects of different light conditions on transient expression and biomass in Nicotiana benthamiana leaves
  261. Comparative analysis of the rhizosphere microbiome and medicinally active ingredients of Atractylodes lancea from different geographical origins
  262. Distinguish Dianthus species or varieties based on chloroplast genomes
  263. Comparative transcriptomes reveal molecular mechanisms of apple blossoms of different tolerance genotypes to chilling injury
  264. Study on fresh processing key technology and quality influence of Cut Ophiopogonis Radix based on multi-index evaluation
  265. An advanced approach for fig leaf disease detection and classification: Leveraging image processing and enhanced support vector machine methodology
  266. Erratum
  267. Erratum to “Protein Z modulates the metastasis of lung adenocarcinoma cells”
  268. Erratum to “BRCA1 subcellular localization regulated by PI3K signaling pathway in triple-negative breast cancer MDA-MB-231 cells and hormone-sensitive T47D cells”
  269. Retraction
  270. Retraction to “Protocatechuic acid attenuates cerebral aneurysm formation and progression by inhibiting TNF-alpha/Nrf-2/NF-kB-mediated inflammatory mechanisms in experimental rats”
Heruntergeladen am 5.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/biol-2022-0604/html
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