Abstract
Inhibition of Toll-like receptor 4 (TLR4)-mediated inflammatory pathways exerts a critical effect on neuronal death; therefore, it is a possible new therapeutic approach for traumatic brain injury (TBI). Resatorvid (TAK-242) is a novel small-molecule compound widely used to inhibit TLR4-mediated pathways, but the protective mechanism of TAK-242 in TBI remains unclear. Herein, we analyzed the neuroprotective effects of TAK-242 in rats after TBI. The rat model of brain injury was established using a modified Free-fall device, and the rats were injected with TAK-242 (0.5 mg/kg) through the caudal vein before TBI. The rats were allocated into four groups: a sham group, a TBI group, a TBI + vehicle group, and a TBI + TAK-242 group. The brain tissue was extracted for histology and determination of the expression of autophagy-related proteins and inflammatory mediators. TAK-242 pretreatment significantly reduced the damage to hippocampal neurons. Neuronal autophagy increased after brain injury, whereas TAK-242 significantly reduced autophagy marker protein LC3-II in the hippocampus. In addition, TAK-242 pretreatment significantly downregulated NF-κB p65, TNF-α, and IL-1β in the hippocampus. In conclusion, TAK-242 significantly reduced hippocampal neuronal damage by inhibiting autophagy and neuroinflammatory activity, possibly via the NF-κB signaling pathway.
Graphical abstract

1 Introduction
As a significant contributor to the mortality of young people worldwide, traumatic brain injury (TBI) often places a heavy financial burden on families/society. Based on pathology, TBI is classified as a primary brain injury due to the immediate destruction of brain tissue and a secondary brain injury because of cellular and molecular events after injury [1]. These events promote mitochondrial dysfunction/biochemical cell-death signaling, ultimately leading to neuronal cell damage together with functional deficits [2,3]. Studies in the last decade have proved that innate immunity and inflammatory responses are associated with neurological deficits based on the release of endogenous ligands such as Toll-like receptors (TLRs) [4,5]. Among these TLRs, a pattern recognition receptor for innate immune responders, TLR4, is widespread in the brain and induces an inflammatory response after ischemic stroke or brain injury [6,7]. Myeloid differentiation factor 88 (MyD88) is an endogenous adaptor protein that activates downstream NF-κB by TLR4 agonists as well as families of IL-1 receptors, playing a critical role in coordinating the production of proinflammatory cytokines [8,9].
In stressed cells, autophagy is related to the degradation of proteins and entire organelles [10]. Our preliminary experiments demonstrated that TBI not only activated autophagy but also increased the expression of microtubule-associated protein 1 light chain 3 in neurons, and suppression of neuronal autophagy was neuroprotective in the rat hippocampus [11,12]. Autophagy has been increasingly acknowledged as a crucial factor in an innate immune response, which plays an important role in immunity and inflammation, as well as metabolism and cell survival. In addition, TLR4 acts as an environmental detector of autophagy [13,14]. The selective autophagy of aggresome-like-induced structures has been demonstrated in response to TLR4 stimulation in macrophages [15], and TLR4-dependent autophagy is critical for macrophage-associated inflammatory responses [16]. However, whether TLR4 is associated with neuroinflammation and the autophagic death of neuronal cells after TBI remains unclear.
As a small-molecule TLR4 inhibitor, resatorvid (TAK-242) selectively inhibits TLR4 signaling by binding to Cys747 within the cells [17]. It is safe in humans and is currently under clinical development as a possible therapeutic agent for the treatment of sepsis [18]. TAK-242 also minimizes target organ damage and systemic inflammation in animal models [19]. Importantly, TAK-242 may penetrate the blood–brain barrier to be rapidly distributed and provide neuroprotective effects in a variety of other diseases associated with cerebral hemorrhage and inflammation [20]. Pretreatment with TAK-242 yielded beneficial protection from gram-negative sepsis/peritonitis induced by lipopolysaccharide. TLR4 may be a novel intervention for intracerebral hemorrhage and TBI [21,22]. Therefore, this study was designed to explore the role of TAK-242 in hippocampal neuronal damage using a rat model, showing that TAK-242 might have potential as a novel target for TBI, achieving protection through suppressing autophagy and neuroinflammation.
In this study, we examined the role of TAK-242 in hippocampal neuronal damage using H&E staining in a rat model. Neuronal autophagy and inflammatory cytokines expression were also assessed. Results proved that TAK-242 might have a potential as a novel target for TBI, achieving protection through suppressing autophagy and neuroinflammation.
2 Materials and methods
2.1 Animals and TBI model
The experiments were performed as per the guidelines of the Chinese Council on Animal Protection and ratified by the Animal Ethics Committee of Hebei Medical University. In total, 100 SD rats (male, 280–330 g, Shijiazhuang, China) were kept in a pathogen-free room under a normal 12-h cycle of light and dark and had ad libitum access to food and water before/after surgery. The rat TBI model was established with the application of a modified Free-fall device [23]. Briefly, after anesthesia using isoflurane (4% induction and 2% maintenance), a longitudinal incision along the midline was made to expose the skull before a steel disk (10 mm in diameter and 3 mm in thickness) was fixed to the skull using dental acrylic. Subsequently, rats were positioned on top of a foam mattress, and a 40 g weight was dropped vertically from a height of 1.5 m directly onto the disk to cause a diffuse brain injury. The sham group was subjected to the same surgical procedure but without TBI. To guarantee normal body temperature within the recovery period, the rats were kept on 37°C heat pads for 24 h. The model generally caused moderate brain damage in rats, and there was little difference in the severity of the damage during the model preparation. The extent of brain damage was measured by modified neurological severity scores [24], as shown in Table 1. A total of 100 rats were used in this study, and three died of brain damage after TBI.
Comparison of the score of nerve damage in each group (
Group | Sham | TBI | TBI + vehicle | TBI + TAK-242 |
---|---|---|---|---|
24 h after TBI (score) | 0 | 9 ± 2.8 | 9 ± 3.6 | 8 ± 3.4 |
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Ethical approval: The research related to animal use has complied with all the relevant national regulations and institutional policies for the care and use of animals and has been approved by the Animal Ethics Committee of Hebei Medical University Animal Center (approval ID: 202203146).
2.2 Experimental groups and drug administration
A random number table was used to assign the rats to four groups (n = 5): a sham group, a TBI group, a TBI + vehicle group, and a TBI + Resatorvid (TAK-242) group. The rats were sacrificed at 6, 12, 24, 48, or 72 h after TBI. TAK-242 (Millipore) was dissolved in 1% dimethyl sulfoxide (DMSO) and 0.9% saline at a concentration of 0.4 mg/ml before being intravenously (i.v.) injected (0.5 mg/kg, approximately 10 s) into the tail vein 10 min before TBI induction, as described previously [25]. The sham/TBI group was i.v. injected with an equal amount of saline, whereas the vehicle group was injected with equal volumes of DMSO/saline.
2.3 Histological analysis
The rats were anesthetized 24 h after TBI, and the heart was perfused with 4% paraformaldehyde (PFA). The harvested brains were fixed in 4% PFA and then subjected to gradient ethanol dehydration, xylene transparency, and paraffin embedding following the standard histological procedure. The brain was serially sectioned (5 μm thick sections), and the sections (approximately 1.9 mm) in the CA1 area posterior to the bregma were analyzed, with the density of pyramidal cells (cells/mm) counted following H&E staining. Cell counts were performed under an optical microscope for active neurons with well-ordered cells, abundant cytoplasm, and clear nuclei.
2.4 Immunofluorescence analysis
The fixed brain tissue was immersed in sucrose solution (30%) and then embedded in optimal cutting temperature compound before serial sections (15 μm thick) of the hippocampus were cut using a frozen slicer (bregma 1.90–3.00) and Triton X-100 treatment (0.4%, 30 min). Subsequently, the sections were blocked with normal donkey serum (1 h) before incubation overnight at 4°C with the primary rabbit anti-LC3 polyclonal antibody (1:100; Medical & Biological Laboratories Co. (MBL)) and mouse anti-NeuN monoclonal antibody (1:100; Millipore). After phosphate-buffered saline washing, the sections were incubated for 2 h at 37°C with the corresponding Alexa Fluor® 594 (anti-rabbit IgG) or Alexa Fluor® 488 (anti-mouse IgG) conjugated antibodies (1:1,000; Santa Cruz Biotechnology) in the dark. Finally, the sections were counterstained with 4′,6-diamidino-2-phenylindole (DAPI), followed by sealing with an anti-quenching agent and viewed with a laser scanning confocal microscope (Olympus Fluoview™ FV1000).
2.5 Western blotting
After the rapid isolation of the hippocampus, the total protein was extracted and then quantified using the enhanced bicinchoninic acid protein assay kit (Solarbio, Beijing, China). The protein samples (50 μg) were separated by sodium dodecylsulfate-polyacrylamide gel electrophoresis and transferred to polyvinylidene fluoride membranes using transfer apparatus (200 mA, 50 min). The membranes were blocked using skimmed milk powder (5%) (2 h, room temperature), followed by overnight incubation at 4°C with primary rabbit anti-LC3 (1:1,000; MBL), rabbit anti-NF-κB p65, rabbit anti-TNF-α (1:500; Affinity), rabbit anti-IL-1β (1:500; Affinity), and rabbit anti-β-actin (1:1,000; Affinity). Then, the membranes were incubated with the appropriate peroxidase-conjugated secondary antibodies (1:5,000 anti-rabbit IgG; Santa Cruz Biotechnology) for 2 h at room temperature before being developed and fixed with enhanced chemiluminescence in a dark room. The bands were visualized using Image Lab 4.1 (Bio-Rad) and quantified using ImageJ software with β-actin as a loading control.
2.6 Statistical analysis
The data were presented as mean ± standard deviation (SD). SPSS 19.0 software (IBM, Armonk, NY, USA) was used for data analysis. Data comparison among multiple groups was conducted with one-way analysis of variance, and statistical analysis between two groups was performed with the Student-Newman–Keuls post hoc tests. Sample sizes subjected to statistical analysis were at least 5 animals per group (n = 5). Differences were considered significant at p < 0.05.
3 Results
3.1 TAK-242 treatment alleviated hippocampal neuron damage
H&E staining was performed to examine the effect of TAK-242 on hippocampal neuronal damage 24 h after TBI. In contrast to sham controls, morphological alterations were observed in CA1 pyramidal neurons accompanied by neuronal loss in TBI or TBI + vehicle animals (Figure 1, *p < 0.01 vs sham group). TAK-242 treatment not only moderated the morphologic alterations but also decreased the neuronal loss related to TBI (# p < 0.05 vs TBI group).

The effect of TAK-242 on hippocampal neuronal damage by H&E staining. (a) Representative staining in the hippocampal CA1 area after sham, TBI, TBI + vehicle, and TAK-242 groups at 24 h (magnification, 20 μm). Normal hippocampal neurons in sham group (blue arrow), nucleolus shrinkage, neuronal degeneration, and necrosis in TBI or TBI + vehicle group (black arrow). (b) Quantification of viable neurons per millimeter of CA1 in each group. (n = 5, per group; *p < 0.01 vs sham group; # p < 0.05 vs TBI group).
3.2 TAK-242 treatment inhibited autophagy in hippocampal neurons
To assess TAK-242’s effect on autophagic activity in brain damage post-TBI, immunofluorescence staining was doubly carried out to analyze the co-localization of LC3 and NeuN expression. The co-localization of LC3 (red) and NeuN (green) expression in hippocampal neurons is shown in Figure 2a with the DAPI-stained nuclei (blue). LC3 immunoreactivity (red) was observed in NeuN-positive cells (green) 24 h post-TBI, confirming that most TBI-induced autophagy occurred in the neurons. Subsequently, we tested if TAK-242 treatment suppressed LC3 expression from 6 to 72 h post-TBI. Figure 2b reveals that in the hippocampus, LC3-II/I protein levels significantly increased at 12 h in the TBI or TBI + vehicle groups and remained high until 72 h post-injury (*p < 0.01 vs sham group). In addition, TAK-242 pretreatment significantly decreased LC3-II/I expression (# p < 0.05 vs TBI group).

The effect of TAK-242 on neuronal autophagy. (a) Co-localization of LC3 and NeuN at 24 h post-TBI was determined by immunofluorescent staining (magnification, 50 μm), and cell nuclei were counterstained by DAPI. The orange coloring in the merged image suggests co-localization. (b) Western blot shows the levels of LC3 and β-actin in hippocampus at 6, 12, 24, 48, and 72 h in TBI or sham surgery. Densitometry analysis of LC3-II/I band was corresponding to β-actin. LC3-II/I was significantly elevated from 12 to 72 h in TBI or TBI + vehicle group (*p < 0.01 vs sham group). TAK-242 treatment significantly decreased the level of LC3-II/I protein expression (# p < 0.05 vs TBI group). Data were expressed as mean ± SD (n = 5 per group).
3.3 TAK-242 treatment decreases NF-κB expression in the hippocampus
To further explore the role of TAK-242 in neuroinflammation post-TBI, the expression of NF-κB p65, a signaling molecule downstream of TLR4, was assessed at 6, 12, 24, 48, and 72 h post-TBI. As demonstrated in Figure 3, compared to the sham group, there was significant upregulation of NF-κB p65 expression in the TBI/TBI + vehicle group (*p < 0.01 vs sham group). TAK-242 treatment attenuated NF-κB p65 expression in rats’ hippocampus from 12 to 72 h in contrast to the TBI group with statistical significance, among which the protein level peaked at 24 h (# p < 0.05 vs TBI group).

(a) Western blot analysis demonstrates levels of NF-κB p65 in the hippocampus of rats from 6 to 72 h in sham, TBI, TBI + vehicle, or TAK-242 group (n = 5 per group). (b) Densitometry of the NF-κB p65 band correlates to the β-actin band. Results demonstrated TBI-induced NF-κB p65 activation (*p < 0.01 vs sham group); and TAK-242 treatment significantly reduced the level of NF-κB p65 protein expression at 12, 24, 48, and 72 h post-TBI (# p < 0.05 vs TBI group). The bars represent mean ± SD (n = 5 per group).
3.4 TAK-242 treatment decreased the levels of TNF-α/IL-1β in the hippocampus
Elevated levels of proinflammatory cytokines have been demonstrated to be positively correlated with the severity of TBI after brain damage [26]. Therefore, we evaluated TNF-α/IL-1β levels, showing that they significantly increased in the TBI/TBI + vehicle group in contrast to the sham group at 6, 12, 24, 48, and 72 h with the greatest increase at 24 h post-TBI (Figure 4, *p < 0.01 vs sham group). The upregulation of TNF-α and IL-1β levels was significantly downregulated by TAK-242 pretreatment (# p < 0.05 vs TBI group). Taken together, these results suggest that TAK-242 might have the potential to reduce TNF-α and IL-1β levels in the hippocampus of a TBI model.

(a) Western blot analysis demonstrated levels of TNF-α and IL-1β in the hippocampus of rats from 6 to 72 h in sham, TBI, TBI + vehicle, or TAK-242 group (n = 5 per group). (b) Densitometry of the TNF-α and IL-1β band correlates to the β-actin band. Results demonstrated a significant increase in TNF-α and IL-1β expressions in TBI or TBI + vehicle group (*p < 0.01 vs sham group); and TAK-242 treatment significantly downregulated the levels of TNF-α and IL-1β at 12, 24, and 48 h post-TBI (# p < 0.05 vs TBI group). The bars represent mean ± SD (n = 5 per group).
4 Discussion
Based on mechanisms related to primary and secondary brain injuries, TBI is considered a highly complicated disorder. Extensive preclinical animal studies have been conducted to develop treatments for TBI. However, to date, no pharmacological treatment has been translated into common clinical practice; therefore, novel strategies for TBI are imperative. Preclinical data have demonstrated that TLR4 exerts a critical impact on neuronal death and thus may be a potential effective intervention for TBI [21,27]. Meanwhile, TAK-242, a small-molecule compound that selectively inhibits TLR4 signaling, is neuroprotective in cerebral ischemia or intracerebral hemorrhage [22,28]. Herein, we investigated the neuroprotective effect of TAK-242 in rats with TBI, showing that TAK-242 could reduce hippocampal neuron damage by inhibiting autophagy and neuroinflammatory activity, and the mechanism may be related to the NF-κB signaling pathway.
Male SD rats were used in this study because the hormonal changes caused by the physiological cycle of female animals are relatively large, which may affect the experimental results. It has also been reported that estrogen has a protective effect against brain damage [29,30], so estrogen interference in female rats may affect the model or the results of the drug administration. A sex bias in TLR activation has already been shown, with women exhibiting increased cellular- and humoral-mediated immune responses and a higher risk of autoimmune disease compared to men [31]. Sex-related differences in immune activity have been well documented and are known to extend to the brain [32]. Doyle et al. reported that TLR4 inhibition enhanced the analgesic effects of morphine in female rats but not in male rats [33]. Male and female TLR4−/− mice also show region-specific changes in brain-derived neurotrophic factor (BDNF) expression, as TLR4−/− females show reduced hippocampal BDNF expression compared to wild type (WT) females, whereas no differences were seen between the male TLR4−/− and WT mice [34]. However, there is still a lack of scientific and experimental knowledge about sex differences in TLR function and traumatic craniocerebral injury, so future studies will use female mice or TLR4−/− mice to further investigate the neuroprotective effect of TAK-242 after brain injury.
Our previous research has shown that TAK-242 may have a neuroprotective effect by inhibiting neuronal autophagy and the TLR4-mediated inflammatory pathway in a TBI rat model [11]. However, this study has some shortcomings and is a complement and extension of the previous study. First, we did not clearly describe the morphological changes in rat brain tissue after injury. In this study, TAK-242 was protective against trauma-induced hippocampus neuron damage in the rat TBI model. In contrast to the TBI group, TAK-242 pretreatment not only moderated the morphologic alterations but also decreased the neuronal loss related to TBI. Therefore, TAK-242 was protective against trauma-induced hippocampus neuron damage in the rat TBI model consistent with previous studies suggesting the neuroprotective potential of TAK-242 post-brain injury [11,21,27]. In addition, recent research confirms that DMSO is suitable for use in studies investigating neuroprotective treatment strategies as it does not influence post-traumatic brain damage [35]. However, Bulama et al. showed that DMSO improves the functional recovery of cognitive function in rats after TBI by increasing the level of antioxidant enzymes that quench and inhibit the formation of reactive oxygen species [36]. Therefore, to eliminate the influence of DMSO on the experimental results, we added the vehicle group. The results were consistent with the former with no statistical difference between the TBI and TBI + vehicle groups, indicating that DMSO did not affect our results after brain injury in rats.
Previous studies have also reported that TAK-242 alleviates brain edema and neurological deficits following TBI [11], and therefore, we did not conduct repeated verification in this study. Studies on the effects of TAK-242 on hypoxic-ischemic encephalopathy (HIE) showed that TAK-242 alleviates neurological deficits and improves neurobehavioral function in a neonatal HIE rat model [37]. In addition, TAK-242 was similarly confirmed to improve the neurobehavior of intraventricular hemorrhage rats and attenuate their learning and spatial memory deficits, suggesting early TAK-242 intervention is beneficial for blocking the progression of neurocognitive deficits induced by hydrocephalus [22].
It has been demonstrated that neuronal autophagy is induced at 6 h or earlier, peaking at 24 h and lasting until 72 h in the hippocampus following TBI [38–40]. Compared with our previous study, we added two additional time points, namely, 6 and 72 h, but did not observe autophagy occurring at 6 h after injury, and the expression of LC3-II/I protein in the hippocampus was significantly upregulated 12 h following TBI or in the TBI + vehicle group and persisted for 72 h following injury. This may be related to the severity of brain damage in rats, which is also a question for subsequent studies. Accumulating evidence suggests that autophagy is related to secondary brain injury after TBI, so if the pathway is inhibited, it may reduce the degree of brain injury and improve the deficits in functional outcomes [11,41,42]. However, Lipinski et al. [43] have shown that augmented and/or restored autophagy flux directly reduces neuronal cell death and neuroinflammation and promotes re-myelination necessary for long-term recovery, which is also a potential treatment strategy after TBI and spinal cord injury. In the present study, our results show that the enhancement of neuronal autophagy is consistent with the severity of neuronal injury after brain injury in rats. Neurons are terminally differentiated cells that last throughout the life cycle of the organism, so autophagy is particularly important in neurons [44,45]. As our results clarified alterations, most autophagy induced following TBI occurred in neurons. In addition, TAK-242 can remarkably reduce the occurrence of neuronal injury and autophagy. Therefore, it could be inferred that the neuroprotective impact of TAK-242 on brain injury may decrease neuronal autophagy.
The neuroprotective mechanism of TAK-242-associated alleviation of neuronal autophagy in the hippocampus is unclear. Herein, we hypothesized that the suppressed neuronal autophagy responds to anti-inflammatory properties via the down-regulation of NF-κB expression. Studies have shown that protein expression of TLR4 is upregulated after TBI and reaches a maximum at 24 hours. Compared with wild-type mice, TLR4−/− mice showed attenuated functional impairment, brain edema and cytokine release post-TBI [46]. TLR4 can activate IκB phosphorylation/degradation to translocate NF-κB from the cytoplasm to the nucleus, further inducing the expression of inflammatory mediators [47]. NF-κB, an essential nuclear transcription factor, participates in immune/inflammatory responses. It could be activated when cells receive pathological stimuli, leading to nuclear translocation and consequently inducing the expression of TNF-α or IL-1β observed in secondary brain injury post-TBI [48]. The present study showed that there was a significant upregulation of NF-κB p65, TNF-α, and IL-1β expression from 6 to 72 h in the TBI group or TBI + vehicle group compared to the sham group. Also, TAK-242 pre-treatment significantly reduced the expression of NF-κB p65 and its downstream inflammatory factors in the rat hippocampus from 12 to 72 h. Dong et al. showed that TAK-242 pretreatment ameliorates epileptic symptoms in mice via inhibition of the TLR4/NF-κB inflammatory pathway [49]. Recent studies have shown that TAK-242 inhibits the activation of extracellular signal-regulated kinases and NF-κB pathways and further reduces Fra-1 expression during ischemia–reperfusion injury in rats [50]. So, it could be inferred that neuronal autophagy could be inhibited by TAK-242 pretreatment in the rat hippocampus, and the autophagic pathway could be affected by TAK-242 based on the downregulation of the TLR4/NF-κB signaling cascade.
In conclusion, TAK-242 pretreatment of a rat TBI model remarkably alleviated hippocampal neuron damage and thus is a potential treatment to inhibit neuronal autophagy and neuroinflammation via the TLR4/NF-κB signaling cascade, providing an insight into the underlying mechanism of TAK-242 in TBI.
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Funding information: This project has been financially supported by the Natural Science Foundation of Hebei Province (Grant no. H2021206449), the Medical Science Research Project of Hebei Province (Grant no. 20220112).
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Author contributions: Z.J.Y. conceived and designed the experiments; Y.F. collected the data and wrote the article; Y.R.J. and Q.W. analyzed the results and explained; and G.Z.S. has made important revisions to this article. All authors (Y.F., Y.R.J., J.C.L., G.Z.S., and Z.J.Y.) reviewed the results and approved the final version of the manuscript.
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Conflict of interest: Authors state no conflict of interest.
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Data availability statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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- Erratum
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- Retraction
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Articles in the same Issue
- Biomedical Sciences
- Systemic investigation of inetetamab in combination with small molecules to treat HER2-overexpressing breast and gastric cancers
- Immunosuppressive treatment for idiopathic membranous nephropathy: An updated network meta-analysis
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- Novel CPLANE1 c.8948dupT (p.P2984Tfs*7) variant in a child patient with Joubert syndrome
- Antiphospholipid antibodies and the risk of thrombosis in myeloproliferative neoplasms
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- Identification of iron metabolism-related genes as diagnostic signatures in sepsis by blood transcriptomic analysis
- Long noncoding RNA ACART knockdown decreases 3T3-L1 preadipocyte proliferation and differentiation
- Surgery, adjuvant immunotherapy plus chemotherapy and radiotherapy for primary malignant melanoma of the parotid gland (PGMM): A case report
- Dosimetry comparison with helical tomotherapy, volumetric modulated arc therapy, and intensity-modulated radiotherapy for grade II gliomas: A single‑institution case series
- Soy isoflavone reduces LPS-induced acute lung injury via increasing aquaporin 1 and aquaporin 5 in rats
- Refractory hypokalemia with sexual dysplasia and infertility caused by 17α-hydroxylase deficiency and triple X syndrome: A case report
- Meta-analysis of cancer risk among end stage renal disease undergoing maintenance dialysis
- 6-Phosphogluconate dehydrogenase inhibition arrests growth and induces apoptosis in gastric cancer via AMPK activation and oxidative stress
- Experimental study on the optimization of ANM33 release in foam cells
- Primary retroperitoneal angiosarcoma: A case report
- Metabolomic analysis-identified 2-hydroxybutyric acid might be a key metabolite of severe preeclampsia
- Malignant pleural effusion diagnosis and therapy
- Effect of spaceflight on the phenotype and proteome of Escherichia coli
- Comparison of immunotherapy combined with stereotactic radiotherapy and targeted therapy for patients with brain metastases: A systemic review and meta-analysis
- Activation of hypermethylated P2RY1 mitigates gastric cancer by promoting apoptosis and inhibiting proliferation
- Association between the VEGFR-2 -604T/C polymorphism (rs2071559) and type 2 diabetic retinopathy
- The role of IL-31 and IL-34 in the diagnosis and treatment of chronic periodontitis
- Triple-negative mouse breast cancer initiating cells show high expression of beta1 integrin and increased malignant features
- mNGS facilitates the accurate diagnosis and antibiotic treatment of suspicious critical CNS infection in real practice: A retrospective study
- The apatinib and pemetrexed combination has antitumor and antiangiogenic effects against NSCLC
- Radiotherapy for primary thyroid adenoid cystic carcinoma
- Design and functional preliminary investigation of recombinant antigen EgG1Y162–EgG1Y162 against Echinococcus granulosus
- Effects of losartan in patients with NAFLD: A meta-analysis of randomized controlled trial
- Bibliometric analysis of METTL3: Current perspectives, highlights, and trending topics
- Performance comparison of three scaling algorithms in NMR-based metabolomics analysis
- PI3K/AKT/mTOR pathway and its related molecules participate in PROK1 silence-induced anti-tumor effects on pancreatic cancer
- The altered expression of cytoskeletal and synaptic remodeling proteins during epilepsy
- Effects of pegylated recombinant human granulocyte colony-stimulating factor on lymphocytes and white blood cells of patients with malignant tumor
- Prostatitis as initial manifestation of Chlamydia psittaci pneumonia diagnosed by metagenome next-generation sequencing: A case report
- NUDT21 relieves sevoflurane-induced neurological damage in rats by down-regulating LIMK2
- Association of interleukin-10 rs1800896, rs1800872, and interleukin-6 rs1800795 polymorphisms with squamous cell carcinoma risk: A meta-analysis
- Exosomal HBV-DNA for diagnosis and treatment monitoring of chronic hepatitis B
- Shear stress leads to the dysfunction of endothelial cells through the Cav-1-mediated KLF2/eNOS/ERK signaling pathway under physiological conditions
- Interaction between the PI3K/AKT pathway and mitochondrial autophagy in macrophages and the leukocyte count in rats with LPS-induced pulmonary infection
- Meta-analysis of the rs231775 locus polymorphism in the CTLA-4 gene and the susceptibility to Graves’ disease in children
- Cloning, subcellular localization and expression of phosphate transporter gene HvPT6 of hulless barley
- Coptisine mitigates diabetic nephropathy via repressing the NRLP3 inflammasome
- Significant elevated CXCL14 and decreased IL-39 levels in patients with tuberculosis
- Whole-exome sequencing applications in prenatal diagnosis of fetal bowel dilatation
- Gemella morbillorum infective endocarditis: A case report and literature review
- An unusual ectopic thymoma clonal evolution analysis: A case report
- Severe cumulative skin toxicity during toripalimab combined with vemurafenib following toripalimab alone
- Detection of V. vulnificus septic shock with ARDS using mNGS
- Novel rare genetic variants of familial and sporadic pulmonary atresia identified by whole-exome sequencing
- The influence and mechanistic action of sperm DNA fragmentation index on the outcomes of assisted reproduction technology
- Novel compound heterozygous mutations in TELO2 in an infant with You-Hoover-Fong syndrome: A case report and literature review
- ctDNA as a prognostic biomarker in resectable CLM: Systematic review and meta-analysis
- Diagnosis of primary amoebic meningoencephalitis by metagenomic next-generation sequencing: A case report
- Phylogenetic analysis of promoter regions of human Dolichol kinase (DOLK) and orthologous genes using bioinformatics tools
- Collagen changes in rabbit conjunctiva after conjunctival crosslinking
- Effects of NM23 transfection of human gastric carcinoma cells in mice
- Oral nifedipine and phytosterol, intravenous nicardipine, and oral nifedipine only: Three-arm, retrospective, cohort study for management of severe preeclampsia
- Case report of hepatic retiform hemangioendothelioma: A rare tumor treated with ultrasound-guided microwave ablation
- Curcumin induces apoptosis in human hepatocellular carcinoma cells by decreasing the expression of STAT3/VEGF/HIF-1α signaling
- Rare presentation of double-clonal Waldenström macroglobulinemia with pulmonary embolism: A case report
- Giant duplication of the transverse colon in an adult: A case report and literature review
- Ectopic thyroid tissue in the breast: A case report
- SDR16C5 promotes proliferation and migration and inhibits apoptosis in pancreatic cancer
- Vaginal metastasis from breast cancer: A case report
- 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
- Inhibition of TAZ impairs the migration ability of melanoma cells
- Molecular complexity analysis of the diagnosis of Gitelman syndrome in China
- Effects of maternal calcium and protein intake on the development and bone metabolism of offspring mice
- Identification of winter wheat pests and diseases based on improved convolutional neural network
- Ultra-multiplex PCR technique to guide treatment of Aspergillus-infected aortic valve prostheses
- Virtual high-throughput screening: Potential inhibitors targeting aminopeptidase N (CD13) and PIKfyve for SARS-CoV-2
- Immune checkpoint inhibitors in cancer patients with COVID-19
- Utility of methylene blue mixed with autologous blood in preoperative localization of pulmonary nodules and masses
- Integrated analysis of the microbiome and transcriptome in stomach adenocarcinoma
- Berberine suppressed sarcopenia insulin resistance through SIRT1-mediated mitophagy
- DUSP2 inhibits the progression of lupus nephritis in mice by regulating the STAT3 pathway
- Lung abscess by Fusobacterium nucleatum and Streptococcus spp. co-infection by mNGS: A case series
- Genetic alterations of KRAS and TP53 in intrahepatic cholangiocarcinoma associated with poor prognosis
- Granulomatous polyangiitis involving the fourth ventricle: Report of a rare case and a literature review
- Studying infant mortality: A demographic analysis based on data mining models
- Metaplastic breast carcinoma with osseous differentiation: A report of a rare case and literature review
- Protein Z modulates the metastasis of lung adenocarcinoma cells
- Inhibition of pyroptosis and apoptosis by capsaicin protects against LPS-induced acute kidney injury through TRPV1/UCP2 axis in vitro
- TAK-242, a toll-like receptor 4 antagonist, against brain injury by alleviates autophagy and inflammation in rats
- Primary mediastinum Ewing’s sarcoma with pleural effusion: A case report and literature review
- Association of ADRB2 gene polymorphisms and intestinal microbiota in Chinese Han adolescents
- Tanshinone IIA alleviates chondrocyte apoptosis and extracellular matrix degeneration by inhibiting ferroptosis
- Study on the cytokines related to SARS-Cov-2 in testicular cells and the interaction network between cells based on scRNA-seq data
- Effect of periostin on bone metabolic and autophagy factors during tooth eruption in mice
- HP1 induces ferroptosis of renal tubular epithelial cells through NRF2 pathway in diabetic nephropathy
- Intravaginal estrogen management in postmenopausal patients with vaginal squamous intraepithelial lesions along with CO2 laser ablation: A retrospective study
- Hepatocellular carcinoma cell differentiation trajectory predicts immunotherapy, potential therapeutic drugs, and prognosis of patients
- Effects of physical exercise on biomarkers of oxidative stress in healthy subjects: A meta-analysis of randomized controlled trials
- Identification of lysosome-related genes in connection with prognosis and immune cell infiltration for drug candidates in head and neck cancer
- Development of an instrument-free and low-cost ELISA dot-blot test to detect antibodies against SARS-CoV-2
- Research progress on gas signal molecular therapy for Parkinson’s disease
- Adiponectin inhibits TGF-β1-induced skin fibroblast proliferation and phenotype transformation via the p38 MAPK signaling pathway
- The G protein-coupled receptor-related gene signatures for predicting prognosis and immunotherapy response in bladder urothelial carcinoma
- α-Fetoprotein contributes to the malignant biological properties of AFP-producing gastric cancer
- CXCL12/CXCR4/CXCR7 axis in placenta tissues of patients with placenta previa
- Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis
- Significance of sTREM-1 and sST2 combined diagnosis for sepsis detection and prognosis prediction
- Diagnostic value of serum neuroactive substances in the acute exacerbation of chronic obstructive pulmonary disease complicated with depression
- Research progress of AMP-activated protein kinase and cardiac aging
- TRIM29 knockdown prevented the colon cancer progression through decreasing the ubiquitination levels of KRT5
- Cross-talk between gut microbiota and liver steatosis: Complications and therapeutic target
- Metastasis from small cell lung cancer to ovary: A case report
- The early diagnosis and pathogenic mechanisms of sepsis-related acute kidney injury
- The effect of NK cell therapy on sepsis secondary to lung cancer: A case report
- Erianin alleviates collagen-induced arthritis in mice by inhibiting Th17 cell differentiation
- Loss of ACOX1 in clear cell renal cell carcinoma and its correlation with clinical features
- Signalling pathways in the osteogenic differentiation of periodontal ligament stem cells
- Crosstalk between lactic acid and immune regulation and its value in the diagnosis and treatment of liver failure
- Clinicopathological features and differential diagnosis of gastric pleomorphic giant cell carcinoma
- Traumatic brain injury and rTMS-ERPs: Case report and literature review
- Extracellular fibrin promotes non-small cell lung cancer progression through integrin β1/PTEN/AKT signaling
- Knockdown of DLK4 inhibits non-small cell lung cancer tumor growth by downregulating CKS2
- The co-expression pattern of VEGFR-2 with indicators related to proliferation, apoptosis, and differentiation of anagen hair follicles
- Inflammation-related signaling pathways in tendinopathy
- CD4+ T cell count in HIV/TB co-infection and co-occurrence with HL: Case report and literature review
- Clinical analysis of severe Chlamydia psittaci pneumonia: Case series study
- Bioinformatics analysis to identify potential biomarkers for the pulmonary artery hypertension associated with the basement membrane
- Influence of MTHFR polymorphism, alone or in combination with smoking and alcohol consumption, on cancer susceptibility
- Catharanthus roseus (L.) G. Don counteracts the ampicillin resistance in multiple antibiotic-resistant Staphylococcus aureus by downregulation of PBP2a synthesis
- Combination of a bronchogenic cyst in the thoracic spinal canal with chronic myelocytic leukemia
- Bacterial lipoprotein plays an important role in the macrophage autophagy and apoptosis induced by Salmonella typhimurium and Staphylococcus aureus
- TCL1A+ B cells predict prognosis in triple-negative breast cancer through integrative analysis of single-cell and bulk transcriptomic data
- Ezrin promotes esophageal squamous cell carcinoma progression via the Hippo signaling pathway
- Ferroptosis: A potential target of macrophages in plaque vulnerability
- Predicting pediatric Crohn's disease based on six mRNA-constructed risk signature using comprehensive bioinformatic approaches
- Applications of genetic code expansion and photosensitive UAAs in studying membrane proteins
- HK2 contributes to the proliferation, migration, and invasion of diffuse large B-cell lymphoma cells by enhancing the ERK1/2 signaling pathway
- IL-17 in osteoarthritis: A narrative review
- Circadian cycle and neuroinflammation
- Probiotic management and inflammatory factors as a novel treatment in cirrhosis: A systematic review and meta-analysis
- Hemorrhagic meningioma with pulmonary metastasis: Case report and literature review
- SPOP regulates the expression profiles and alternative splicing events in human hepatocytes
- Knockdown of SETD5 inhibited glycolysis and tumor growth in gastric cancer cells by down-regulating Akt signaling pathway
- PTX3 promotes IVIG resistance-induced endothelial injury in Kawasaki disease by regulating the NF-κB pathway
- Pancreatic ectopic thyroid tissue: A case report and analysis of literature
- 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
- Report on a case of liver-originating malignant melanoma of unknown primary
- Case report: Herbal treatment of neutropenic enterocolitis after chemotherapy for breast cancer
- The fibroblast growth factor–Klotho axis at molecular level
- Characterization of amiodarone action on currents in hERG-T618 gain-of-function mutations
- A case report of diagnosis and dynamic monitoring of Listeria monocytogenes meningitis with NGS
- Effect of autologous platelet-rich plasma on new bone formation and viability of a Marburg bone graft
- Small breast epithelial mucin as a useful prognostic marker for breast cancer patients
- Continuous non-adherent culture promotes transdifferentiation of human adipose-derived stem cells into retinal lineage
- Nrf3 alleviates oxidative stress and promotes the survival of colon cancer cells by activating AKT/BCL-2 signal pathway
- Favorable response to surufatinib in a patient with necrolytic migratory erythema: A case report
- Case report of atypical undernutrition of hypoproteinemia type
- Down-regulation of COL1A1 inhibits tumor-associated fibroblast activation and mediates matrix remodeling in the tumor microenvironment of breast cancer
- Sarcoma protein kinase inhibition alleviates liver fibrosis by promoting hepatic stellate cells ferroptosis
- Research progress of serum eosinophil in chronic obstructive pulmonary disease and asthma
- Clinicopathological characteristics of co-existing or mixed colorectal cancer and neuroendocrine tumor: Report of five cases
- Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis
- Precisional detection of lymph node metastasis using tFCM in colorectal cancer
- Advances in diagnosis and treatment of perimenopausal syndrome
- A study of forensic genetics: ITO index distribution and kinship judgment between two individuals
- Acute lupus pneumonitis resembling miliary tuberculosis: A case-based review
- Plasma levels of CD36 and glutathione as biomarkers for ruptured intracranial aneurysm
- Fractalkine modulates pulmonary angiogenesis and tube formation by modulating CX3CR1 and growth factors in PVECs
- Novel risk prediction models for deep vein thrombosis after thoracotomy and thoracoscopic lung cancer resections, involving coagulation and immune function
- Exploring the diagnostic markers of essential tremor: A study based on machine learning algorithms
- Evaluation of effects of small-incision approach treatment on proximal tibia fracture by deep learning algorithm-based magnetic resonance imaging
- An online diagnosis method for cancer lesions based on intelligent imaging analysis
- Medical imaging in rheumatoid arthritis: A review on deep learning approach
- Predictive analytics in smart healthcare for child mortality prediction using a machine learning approach
- Utility of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in predicting acute-on-chronic liver failure survival
- A biomedical decision support system for meta-analysis of bilateral upper-limb training in stroke patients with hemiplegia
- TNF-α and IL-8 levels are positively correlated with hypobaric hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats
- Stochastic gradient descent optimisation for convolutional neural network for medical image segmentation
- Comparison of the prognostic value of four different critical illness scores in patients with sepsis-induced coagulopathy
- Application and teaching of computer molecular simulation embedded technology and artificial intelligence in drug research and development
- Hepatobiliary surgery based on intelligent image segmentation technology
- Value of brain injury-related indicators based on neural network in the diagnosis of neonatal hypoxic-ischemic encephalopathy
- Analysis of early diagnosis methods for asymmetric dementia in brain MR images based on genetic medical technology
- Early diagnosis for the onset of peri-implantitis based on artificial neural network
- Clinical significance of the detection of serum IgG4 and IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy
- Forecast of pain degree of lumbar disc herniation based on back propagation neural network
- SPA-UNet: A liver tumor segmentation network based on fused multi-scale features
- Systematic evaluation of clinical efficacy of CYP1B1 gene polymorphism in EGFR mutant non-small cell lung cancer observed by medical image
- Rehabilitation effect of intelligent rehabilitation training system on hemiplegic limb spasms after stroke
- A novel approach for minimising anti-aliasing effects in EEG data acquisition
- ErbB4 promotes M2 activation of macrophages in idiopathic pulmonary fibrosis
- Clinical role of CYP1B1 gene polymorphism in prediction of postoperative chemotherapy efficacy in NSCLC based on individualized health model
- Lung nodule segmentation via semi-residual multi-resolution neural networks
- Evaluation of brain nerve function in ICU patients with Delirium by deep learning algorithm-based resting state MRI
- A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis
- Markov model combined with MR diffusion tensor imaging for predicting the onset of Alzheimer’s disease
- 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
- Molecular mechanism of colorectal cancer and screening of molecular markers based on bioinformatics analysis
- Monitoring and evaluation of anesthesia depth status data based on neuroscience
- Exploring the conformational dynamics and thermodynamics of EGFR S768I and G719X + S768I mutations in non-small cell lung cancer: An in silico approaches
- Optimised feature selection-driven convolutional neural network using gray level co-occurrence matrix for detection of cervical cancer
- Incidence of different pressure patterns of spinal cerebellar ataxia and analysis of imaging and genetic diagnosis
- Pathogenic bacteria and treatment resistance in older cardiovascular disease patients with lung infection and risk prediction model
- 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
- From slides to insights: Harnessing deep learning for prognostic survival prediction in human colorectal cancer histology
- Ecology and Environmental Science
- Monitoring of hourly carbon dioxide concentration under different land use types in arid ecosystem
- Comparing the differences of prokaryotic microbial community between pit walls and bottom from Chinese liquor revealed by 16S rRNA gene sequencing
- Effects of cadmium stress on fruits germination and growth of two herbage species
- Bamboo charcoal affects soil properties and bacterial community in tea plantations
- Optimization of biogas potential using kinetic models, response surface methodology, and instrumental evidence for biodegradation of tannery fleshings during anaerobic digestion
- Understory vegetation diversity patterns of Platycladus orientalis and Pinus elliottii communities in Central and Southern China
- Studies on macrofungi diversity and discovery of new species of Abortiporus from Baotianman World Biosphere Reserve
- Food Science
- Effect of berrycactus fruit (Myrtillocactus geometrizans) on glutamate, glutamine, and GABA levels in the frontal cortex of rats fed with a high-fat diet
- Guesstimate of thymoquinone diversity in Nigella sativa L. genotypes and elite varieties collected from Indian states using HPTLC technique
- Analysis of bacterial community structure of Fuzhuan tea with different processing techniques
- Untargeted metabolomics reveals sour jujube kernel benefiting the nutritional value and flavor of Morchella esculenta
- Mycobiota in Slovak wine grapes: A case study from the small Carpathians wine region
- Elemental analysis of Fadogia ancylantha leaves used as a nutraceutical in Mashonaland West Province, Zimbabwe
- Microbiological transglutaminase: Biotechnological application in the food industry
- Influence of solvent-free extraction of fish oil from catfish (Clarias magur) heads using a Taguchi orthogonal array design: A qualitative and quantitative approach
- Chromatographic analysis of the chemical composition and anticancer activities of Curcuma longa extract cultivated in Palestine
- The potential for the use of leghemoglobin and plant ferritin as sources of iron
- Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM
- Bioengineering and Biotechnology
- Biocompatibility and osteointegration capability of β-TCP manufactured by stereolithography 3D printing: In vitro study
- Clinical characteristics and the prognosis of diabetic foot in Tibet: A single center, retrospective study
- Agriculture
- Biofertilizer and NPSB fertilizer application effects on nodulation and productivity of common bean (Phaseolus vulgaris L.) at Sodo Zuria, Southern Ethiopia
- On correlation between canopy vegetation and growth indexes of maize varieties with different nitrogen efficiencies
- Exopolysaccharides from Pseudomonas tolaasii inhibit the growth of Pleurotus ostreatus mycelia
- A transcriptomic evaluation of the mechanism of programmed cell death of the replaceable bud in Chinese chestnut
- Melatonin enhances salt tolerance in sorghum by modulating photosynthetic performance, osmoregulation, antioxidant defense, and ion homeostasis
- Effects of plant density on alfalfa (Medicago sativa L.) seed yield in western Heilongjiang areas
- Identification of rice leaf diseases and deficiency disorders using a novel DeepBatch technique
- Artificial intelligence and internet of things oriented sustainable precision farming: Towards modern agriculture
- Animal Sciences
- Effect of ketogenic diet on exercise tolerance and transcriptome of gastrocnemius in mice
- Combined analysis of mRNA–miRNA from testis tissue in Tibetan sheep with different FecB genotypes
- Isolation, identification, and drug resistance of a partially isolated bacterium from the gill of Siniperca chuatsi
- Tracking behavioral changes of confined sows from the first mating to the third parity
- The sequencing of the key genes and end products in the TLR4 signaling pathway from the kidney of Rana dybowskii exposed to Aeromonas hydrophila
- Development of a new candidate vaccine against piglet diarrhea caused by Escherichia coli
- Plant Sciences
- Crown and diameter structure of pure Pinus massoniana Lamb. forest in Hunan province, China
- Genetic evaluation and germplasm identification analysis on ITS2, trnL-F, and psbA-trnH of alfalfa varieties germplasm resources
- Tissue culture and rapid propagation technology for Gentiana rhodantha
- Effects of cadmium on the synthesis of active ingredients in Salvia miltiorrhiza
- Cloning and expression analysis of VrNAC13 gene in mung bean
- Chlorate-induced molecular floral transition revealed by transcriptomes
- Effects of warming and drought on growth and development of soybean in Hailun region
- Effects of different light conditions on transient expression and biomass in Nicotiana benthamiana leaves
- Comparative analysis of the rhizosphere microbiome and medicinally active ingredients of Atractylodes lancea from different geographical origins
- Distinguish Dianthus species or varieties based on chloroplast genomes
- Comparative transcriptomes reveal molecular mechanisms of apple blossoms of different tolerance genotypes to chilling injury
- Study on fresh processing key technology and quality influence of Cut Ophiopogonis Radix based on multi-index evaluation
- An advanced approach for fig leaf disease detection and classification: Leveraging image processing and enhanced support vector machine methodology
- Erratum
- Erratum to “Protein Z modulates the metastasis of lung adenocarcinoma cells”
- Erratum to “BRCA1 subcellular localization regulated by PI3K signaling pathway in triple-negative breast cancer MDA-MB-231 cells and hormone-sensitive T47D cells”
- Retraction
- Retraction to “Protocatechuic acid attenuates cerebral aneurysm formation and progression by inhibiting TNF-alpha/Nrf-2/NF-kB-mediated inflammatory mechanisms in experimental rats”