Combination of immunotherapy and whole-brain radiotherapy on prognosis of patients with multiple brain metastases: A retrospective cohort study
-
Pengwei Yan
, Changzhai Wang , Duixian Tuoligan , Aji Kabinuer , Sheng Li , Xue Song and Huanfeng Zhu
Abstract
Brain metastases (BMs) usually occur in the advanced stage of cancers with a poor prognosis. This study aimed to compare the clinical efficacy and effects on cognitive function of immunotherapy combined with whole brain radiotherapy (WBRT) and immunotherapy combined with WBRT plus sequential integrated boost (SEB) in the treatment of multiple BMs. A total of 57 patients diagnosed with BMs were included in Kezhou People’s Hospital Affiliated to Nanjing Medical University between 2021 and 2023. Patients were allocated into the WBRT group (n = 27) and the WBRT + SEB group (n = 30) based on whether to receive a boost. The WBRT + SEB group showed a higher complete response rate and objective response rate compared to the WBRT group (26.7 vs 14.8%, 90.0 vs 66.7%) (all P < 0.05). The two groups had a median overall survival (OS) time of 11.2 months (95% confidence interval [CI]: 9.3–13.1) and 9.4 months (95% CI: 6.2–12.6), respectively, with no statistically significant difference (P = 0.176). There was no difference in the levels of mini-mental state examination score at 1, 3, and 6 months, as well as the risk of adverse events, after WBRT between the two groups. In conclusion, SEB may improve the remission rate of lesions but not prolong the OS time. The boost would neither increase serious side effects nor would it aggravate cognitive impairment caused by WBRT.
1 Introduction
Brain metastases (BMs) usually occur in the advanced stage of cancers and bring a significant cause of mortality among patients. The most common sources of BMs are lung, breast, and melanoma [1,2,3,4]. Most patients with BMs have a short life expectancy and a poor prognosis. The traditional treatments for BMs include surgery, radiotherapy, and chemotherapy, but their efficacy is facing bottlenecks in controlling the progression of intracranial lesions and prolonging life.
Immunotherapy recently has shown improved efficacy in comprehensively treating various solid tumors. Immunotherapy drugs, such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and immune checkpoint inhibitors (ICIs), have effectively prolonged the survival time of patients with advanced tumors [5,6,7,8], including patients with newly diagnosed BMs [2,5,9]. Brain radiotherapy, as a supplement to local treatment in the era of immunotherapy, has also been reported to control the progression of intracranial tumors and improve the related symptoms caused by BMs [9,10,11]. However, the current studies have numerous limitations. First, brain radiotherapy combined with immunotherapy may prolong progression-free survival (PFS) for patients with BMs, but with limited impacts on overall survival (OS). Second, most of the included patients had relatively good prognoses with no more than three BMs, and stereotactic radiosurgery (SRS) was utilized instead of whole brain radiotherapy (WBRT) to preserve cognitive function after radiotherapy. Thirdly, more than half of the patients used the CTLA-4 inhibitor.
In the real world, a considerable number of patients are diagnosed with multiple (three or more) BMs. WBRT, rather than SRS, should be the first choice, and the boost dose of radiation should be determined according to the specific location and size of BMs. Considering the influence of adverse drug responses and reimbursement policies, domestic patients are more likely to receive ICIs, rather than CTLA-4 inhibitors. The safety and efficacy of immunotherapy combined with WBRT in patients with multiple BMs, their effects on cognitive function, and the clinical difference of whether + sequential integrated boost (SEB) to BMs have not been reported. Herein, this retrospective study was conducted to explore appropriate modalities for local radiotherapy in multiple BMs in the immunotherapy era.
2 Methods
2.1 Study design and patients
This study retrospectively involved patients with BMs from 2021 to 2023, Department of Oncology (Radiotherapy), Kezhou People’s Hospital Affiliated to Nanjing Medical University. Inclusion criteria were as follows: (1) with definite pathological or histological diagnosis of primary tumor; (2) with diagnosis of multiple BMs (≥3) by brain magnetic resonance imaging (MRI) enhancement or positron emission tomography/computed tomography; (3) without primary intracranial tumor; and (4) the expected survival time ≥1 month. Exclusion criteria were as follows: (1) unable to cooperate with the cognitive function test due to stroke, mental disorders, or cognitive impairment caused by various reasons before treatment; (2) unable to tolerate brain radiotherapy and systemic immunotherapy due to severe underlying diseases; and (3) loss of follow-up.
-
Informed consent: Informed consent has been obtained from all individuals included in this study.
-
Ethical approval: The research related to human use has been complied with all the relevant national regulations and institutional policies and in accordance with the tenets of the Helsinki Declaration and has been approved by the Ethics Committee of the Affiliated Kezhou People’s Hospital of Nanjing Medical University (No. 2023-03-01).
2.2 Immunotherapy
All patients received immunotherapy with ICIs administered at least twice, and the drug was continued after the end of concurrent radiotherapy in conditional patients. The interval between the initiation of immunotherapy and the initial brain radiotherapy was no more than 1 week.
2.3 Radiotherapy
The patients were treated with a 6 MV X-ray from Elekta’s digital linear accelerator using lateral opposing fields for WBRT at a prescribed dose of 30 Gy delivered in 12 fractions over 3 weeks, with 5 fractions per week. According to whether to receive a boost, patients were allocated into the WBRT group (n = 27) to receive a dose of 30 Gy/12 fractions to primary lesions ≥1 cm and the WBRT + SEB group (n = 30) to receive a dose of 30 Gy/12 fractions +12–20 Gy/3–5 fractions to intracranial lesions showed by MRI. Important tissues and organs such as crystals, eyeballs, optic nerves, brain stem, and pituitary gland were in the safe dose range. Symptomatic treatments such as dehydration and intracranial pressure control were given in time during radiotherapy.
2.4 Curative effect and cognitive function
A contrast-enhanced MRI scan at 1 month after radiotherapy was performed to evaluate the changes of BMs according to the response evaluation criteria in solid tumors (RECIST 1.1). The lesions were classified as complete response (CR), partial response, stable disease, or progressive disease. The patients underwent follow-up every 3 months.
The cognitive function of patients was assessed using the mini-mental state examination (MMSE), which had a total score of 30 and was adjusted for education level. The first assessment MMSE scores within 7 days before treatment were used as the baseline level. The MMSE scores were measured at 1, 3, and 6 months after treatment (if the patient was alive and cooperative) and compared with the baseline level. The changes in cognitive function were divided into improvement, stability, or decline.
2.5 Statistical analysis
Statistical analyses were conducted using SPSS 22.0 software. The measurement data from the baseline patients were analyzed using a measurement analysis of variance and compared by two independent sample t-tests, the counting data were expressed in percentage or n (%) and were examined by a chi-square test. The effectiveness of multiple intracranial lesions and cognitive function was expressed as percentages or n (%) and was examined by chi-square test. The Kaplan–Meier survival analysis was used to compare the OS between the two groups.
3 Results
3.1 Characteristics of patients
Totally, 57 patients were enrolled, comprising 30 male and 27 female patients, whose mean age was 59 years. The prevalent diseases were primarily breast cancer, lung cancer, and malignant melanoma. No differences were found between the WBRT and WBRT + SEB groups in terms of age, gender, diagnosis of primary tumor, presence of intracranial lesions, KPS score, and type of immune medication at baseline (Table 1).
Characteristics of study patients
| Variables | WBRT group (n = 27) | WBRT + SEB group (n = 30) | P |
|---|---|---|---|
| Gender, n (%) | 0.520 | ||
| Male | 13 (48.1) | 17 (56.7) | |
| Female | 14 (51.9) | 13 (43.3) | |
| Age, years, Median (min, max) | 60.0 (35–83) | 57.5 (26–81) | 0.468 |
| Primary disease, n (%) | 0.956 | ||
| Non-small cell lung cancer* | 19 (70.4) | 19 (63.3) | |
| Malignant melanoma | 3 (11.1) | 3 (10.0) | |
| Breast cancer** | 3 (11.1) | 4 (13.3) | |
| Esophagus cancer | 1 (3.7) | 2 (6.7) | |
| Gastric cancer | 1 (3.7) | 2 (6.7) | |
| Number of BMs, n (%) | 0.506 | ||
| 3–4 | 12 (44.4) | 16 (53.3) | |
| ≥5 | 15 (55.6) | 14 (46.7) | |
| Distant extracranial metastasis | 0.737 | ||
| Yes | 15 (55.6) | 18 (60.0) | |
| No | 12 (44.4) | 12 (40.0) | |
| KPS score, n (%) | 0.992 | ||
| 70 | 5 (18.5) | 6 (20.0) | |
| 80 | 16 (59.3) | 16 (53.3) | |
| 90 | 6 (22.2) | 7 (23.3) | |
| 100 | 0 | 1 (3.3) | |
| Immune drugs, n (%) | 0.914 | ||
| Pembrolizumab | 2 (7.4) | 1 (3.3) | |
| Camrelizumab | 5 (18.5) | 6 (20.0) | |
| Toripalimab | 6 (22.2) | 9 (30.0) | |
| Tislelizumab | 6 (22.2) | 8 (26.7) | |
| Sintilimab | 7 (25.9) | 5 (16.7) | |
| Durvalumab | 1 (3.7) | 1 (3.3) |
WBRT, whole brain radiotherapy; SEB, sequential integrated boost; BMs, brain metastases; KPS, Karnofsky performance status.
*In the WBRT group, 11 cases were squamous cell carcinoma, 8 cases were adenocarcinoma, and 5 cases had negative driver genes; in the WBRT + SEB group, 10 cases were squamous cell carcinoma, 9 cases were adenocarcinoma, and 5 cases had negative driver genes; driver genes mutations were progress after molecular targeted drug therapy, and/or had symptoms of brain metastasis.
**Triple-negative breast cancer in both groups.
3.2 Efficacy of intracranial lesions
The WBRT + SEB group had a significantly higher complete response rate (CRR) of intracranial lesions compared to the WBRT group (26.7 vs 14.8%, P < 0.05) at 1 month after radiotherapy. Compared with the WBRT group, SEB also improved the objective response rate (ORR) 1 month after radiotherapy (90.0 vs 66.7%, P = 0.032). Table 2 displays the specific efficacy of intracranial lesions, and Figure 1 shows the dose distribution of the groups and the doses to the surrounding important tissues.
Efficacy of intracranial lesions
| Group | CR | PR | SD | PD | P | ORR (%) | P |
|---|---|---|---|---|---|---|---|
| WBRT group (n = 27) | 4 | 14 | 9 | 0 | 0.043 | 66.7 | 0.032 |
| WBRT + SEB group (n = 30) | 8 | 19 | 3 | 0 | 90.0 |
CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; ORR, Objective Response Rate; WBRT, whole brain radiotherapy; SEB, sequential integrated boost.

(a) WBRT scheme: A 63-year-old male patient with lung cancer and multiple BMS received lateral opposing fields at a prescription dose of 30 Gy/12 fractions (5 fractions per week). (b) WBRT + SEB scheme: A 66-year-old male patient with lung cancer received integrated boost at a dose of 4 Gy × 3 fractions to the lesions in temporal and occipital lobes after 30 Gy/12 fractions of WBRT, with a total dose of 46 Gy. Dose-volume histogram showed that the prescribed dose in the target area was up to the standard, and the important tissues and organs, including the brain stem, lens, and eyeball, were reasonably protected. WBRT, whole brain radiotherapy; SEB, sequential integrated boost.
3.3 OS
During a median follow-up period of 16 months, the median OS for all 57 patients was 11.0 months. The median OS was estimated to be 9.4 months (95% confidence interval [CI]: 6.2–12.6) for the group receiving WBRT and 11.2 months (95% CI: 9.3–13.1) for the group receiving WBRT + SEB. No significant difference was found in OS between patients receiving WBRT and those receiving WBRT + boost (P = 0.176, hazard ratio [HR]: 0.607, 95% CI: 0.294–1.251) (Figure 2). The median OS time was estimated to be 17 months in patients with CR (95% CI: 8.3–25.7) and 10 months (95% CI: 8.9–11.1) in those without CR, with no statistical difference (P = 0.056).

Survival curves of patients with multiple BMs treated with immunotherapy combined with WBRT and immunotherapy combined with WBRT + SEB BMs, brain metastases; WBRT, whole brain radiotherapy; SEB, sequential integrated boost.
3.4 Assessment of cognitive function
The MMSE was completed by all patients prior to the commencement of brain radiotherapy. At baseline, there was no difference in MMSE scores between the WBRT group and the WBRT + SEB group. The changes in cognitive function in both groups at 1, 3, and 6 months after radiotherapy are shown in Table 3, and the majority of patients achieve stability or improvement after treatment. A few patients showed delayed cognitive decline over time. No significant difference was found between the two groups in the proportion of survivors with cognitive decline at each time point (P > 0.05).
Changes in cognitive function
| Changes in MMSE scores, n (%) | End of radiotherapy | P | 3 months after radiotherapy | P | 6 months after radiotherapy | P | |||
|---|---|---|---|---|---|---|---|---|---|
| WBRT group (n = 27) | WBRT + SEB group (n = 30) | WBRT group (n = 27) | WBRT + SEB group (n = 30) | WBRT group (n = 27) | WBRT + SEB group (n = 30) | ||||
| Improvement | 5 (18.5) | 4 (13.3) | 0.793 | 3 (11.5) | 3 (10.3) | 0.780 | 2 (11.1) | 3 (13.6) | 0.714 |
| Stability | 14 (51.9) | 15 (50.0) | 11 (42.3) | 15 (51.7) | 8 (44.4) | 12 (54.5) | |||
| Decline | 8 (29.6) | 11 (36.7) | 12 (46.2) | 11 (37.9) | 8 (44.4) | 7 (31.8) | |||
MMSE, Mini-mental State Examination; WBRT, whole brain radiotherapy; SEB, sequential integrated boost.
3.5 Adverse events (AEs)
The main AEs were the symptoms caused by BMs and cranial irradiation, mainly including vertigo, headache, nausea, and fatigue, which were all mild to moderate, and were improved by dehydration and controlling intracranial pressure. The patients in the two groups had good tolerance and completed the treatment scheme, with no differences in all adverse reactions and no grade 4 AEs or above (Table 4).
Major adverse reactions
| Adverse reactions, n (%) | WBRT group (n = 27) | WBRT + SEB group (n = 30) | P |
|---|---|---|---|
| Headache | 14 (51.9) | 16 (53.3) | 0.912 |
| Nausea | 11 (40.7) | 13 (43.3) | 0.843 |
| Epileptic seizure | 1 (3.7) | 1 (3.3) | 0.940 |
| Vertigo | 18 (66.7) | 19 (63.3) | 0.792 |
| Paresthesia | 4 (14.8) | 5 (16.6) | 0.849 |
| Fatigue | 15 (55.6) | 16 (53.3) | 0.866 |
| Weight loss | 4 (14.8) | 4 (13.3) | 0.873 |
WBRT, whole brain radiotherapy; SEB, sequential integrated boost.
4 Discussion
BMs, in contrast to extracranial metastases, are generally considered to be relatively less sensitive to immunotherapy [12], mainly because the brain tumor microenvironment contains numerous myeloid cells, while the number and proportion of CD8+ effector T lymphocytes are rather limited [13]. Under physiological conditions, it is difficult for peripheral immune cells to migrate into the brain parenchyma because the blood–brain and blood–cerebrospinal fluid barriers prevent the exchange of various macromolecules [14]. Although some studies suggested that immunotherapy can extend the life expectancy of patients with BMs to a certain extent [5,15], improving the sensitivity and effectiveness of immunotherapy in BM patients remains important [16].
Radiotherapy, an important means of treatment for BMs, can improve the effect of tumor immunotherapy by increasing tumor immunogenicity [17,18]. The synergistic mechanism of brain radiotherapy and immunotherapy includes that the changes in the permeability of the blood–brain barrier during radiotherapy promote peripheral immune cells to migrate into the brain tissue [19], and produce tumor-specific cytotoxic T lymphocytes [20,21,22]. Radiotherapy can affect the secretion of cytokines in the brain and enhance macrophages and dendritic cells in killing BMs, similar to the mechanism of radiotherapy on extracranial metastases. In addition to cytotoxicity, antigen presentation, phagocytosis [13], and triggering immune responses, radiotherapy can induce the abscopal effect, namely, localized radiotherapy can also lead to the regression of distant metastases after immunotherapy [23].
Kiess et al. treated BMs with brain radiotherapy combined with CTLA-4, with ideal intracranial lesion control (1-year regional recurrence-free survival rate: 64–92%), favorable OS outcome (1-year OS rate: 40–65%), and good tolerance [24]. However, not all studies have yielded consistent conclusions. Mathew et al. [25] and Patel et al. [26] found that despite the safety of brain radiotherapy combined with CTLA-4, the clinical benefit was modest, and no survival benefit was observed compared to patients with brain irradiation alone. In contrast, Xiao et al. [27] demonstrated that the combination of immunotherapy prolonged the PFS (HR = 0.48) and OS (HR = 0.64) of lung cancer patients with BMs compared with radiotherapy/chemotherapy alone. Differences in clinical findings may be interpreted by immunotherapy agents. A study found that the average OS of radiotherapy plus ICIs was significantly longer than that of radiotherapy plus CTLA-4 in patients with malignant melanoma and BMs, which was 27.4 and 7.5 months, respectively [28]. The research data of KEYNOTE-006 also acknowledged the higher security of ICIs than CTLA-4; therefore, ICIs were more widely used in metastatic melanoma [29]. In Xiao et al.’s study [27], ICIs combined with brain radiotherapy have also been confirmed to be effective and safe for lung cancer patients with BMs, most of the BMs regressed significantly, and the local and distant intracranial lesions were also controlled. Therefore, ICIs were used for all the immunotherapy in this study.
The remarkable thing is that most patients included in the studies mentioned above had few BMs and SRS. Because of relatively limited BMs and good tolerance to irradiation of a higher biological equivalent dose [30], these patients had a better prognosis than those with multiple BMs or diffuse BMs [9,31]. A previous small-sample retrospective study or a phase I study showed that WBRT + CTLA-4 for multiple BMs was safe but less effective than expected, with most patients experiencing progression of BMs and death, causing early termination of the studies [32,33]. In a study of patients with BMs from non-small cell lung cancer, the median PFS was significantly longer in patients undergoing WBRT combined with ICIs than those undergoing WBRT alone (11 vs 3 months, 95% CI: 6.3–15.6 vs 95% CI: 0.8–5.1), with 71% lower risk of disease progression (HR: 0.29, 95% CI: 0.11 0.80; P = 0.016) and an improved OS trend [10]. Similarly, most of the existing studies compared immunotherapy combined with brain radiotherapy with brain radiotherapy alone [4,34,35,36], while there were few reports comparing different radiotherapy methods under combination therapy. A meta-analysis revealed that the WBRT + ICI group had an ORR and disease control rate of 0 and 57%, respectively, for intracranial lesions, which were inferior to the SRS + ICI group’s 75 and 84%. The ORR and disease control rate of extracerebral tumors were also better in the SRS + ICI group (73 and 50%) than those in the WBRT combined with the ICI group (0 and 43%) [9]. However, it is important to point out that the meta-analysis included a limited number of studies, and patients who received WBRT had a higher tumor burden and worse prognosis, so there was a bias in the baseline.
Since there were few reports on the immunotherapy combined with WBRT for treating multiple BMs, this retrospective study was conducted and included patients who received WBRT with SEB. After reviewing these 57 cases, we found that patients with less than four residual lesions with a diameter greater than 1 cm after WBRT were more likely to be given a SEB. In addition, the different perspectives and choices of their oncologists were also important factors in determining whether a SEB after completing WBRT should be delivered. However, the baseline levels of the two groups were consistent. The median OS time was 11.2 and 9.4 months for the two groups, respectively, significantly better than the expected OS (5.5–10.0 months) of WBRT alone [31,37,38,39]. Although there was no significant improvement in OS in the WBRT + SEB group of this study, SEB could improve the CR and ORR of intracranial lesions, which may contribute to the longer patient survival in cases of multiple BMs. The survival data of the immunotherapy combined with WBRT + SEB group in this study were also consistent with reported data of brain radiotherapy (including SRS) combined with immunotherapy, such as a reduced risk of disease progression and death [4,34] and efficacy of controlling intracranial lesions [35].
In this study, immunotherapy and WBRT were administered concurrently, meaning there was no more than 1 week between the start of immunotherapy and the initial brain radiotherapy. Previous studies have shown that a time interval of more than 3 weeks between brain radiotherapy and immunotherapy can affect sensitivity. Relatively, an interval of no more than 2 weeks or less was not only safe and feasible but also improved BMs control, and 6-month and 1-year survival rates [35,40,41,42,43]. This phenomenon may be explained by changes in blood-brain barrier permeability as a result of brain radiotherapy, thereby enhancing the immune effect of ICI in the brain [44].
The doses of WBRT + SEB and fraction designing in this study were selected based on several previous studies [45,46,47,48,49,50]. A study involving 52 patients with BMs from lung cancer compared WBRT + SEB (WBRT: 30 Gy/10 fractions and BMs: 4 Gy × 3 fractions) with simultaneous WBRT + SEB (WBRT: 30 Gy/10 fractions and BMs: 40 Gy × 10 fractions). The study revealed that the survival rates at 1, 2, and 3 years were 60.0% compared to 47.8%, 41.1% compared to 19.1, and 27.4% compared to 0%, respectively, with the median survival time of 15 and 10 months, respectively; patients with less than 2 BMs had longer survival with SEB, and the MMSE score at 3 months after radiotherapy in the SEB group was higher than that in the SEB group [45]. The mechanisms driving improved SEB response rates were attributed to the higher equivalent biological dose effect and also resulted in better local control. Although WBRT + SEB significantly improved the response rate of BMs to radiation, not all the increasing radiotherapy dose in the above studies had translated SEB into a significant improvement in OS [48,49], which was consistent with the current study. It is important to note that the majority of patients in the aforementioned studies did not receive or were not reported to receive ICIs, and the numbers of BMs were not identical. SEB of 42–50 Gy may be safe for the right lesions (distance from the brain stem, crystal, optic nerve >2 cm). The total dose of WBRT was difficult to increase, which resulted in a higher risk of local recurrence. However, WBRT + SEB can effectively increase the dose of irradiation to target lesions, and the dose decay at the lesion edge would not increase the dose excessively to important tissue structures beyond 2 cm, thus safely and effectively making up for the deficiency of WBRT. The CRR of WBRT + SEB was significantly better than that of WBRT alone, which may further prolong the life expectancy of patients.
Brain radiotherapy, especially WBRT, on patients’ cognitive function is still a matter of debate. Reygagne et al. [51] believed that WBRT could effectively improve the prognosis of patients’ central nervous system. However, more papers reported that WBRT can cause damage to cognitive function, and the probability of a decline in cognitive function in patients with BMs in 3 and 12 months after WBRT was 31–57% and 48–89%, respectively. Therefore, SRS was more recommended for patients with less than 4 BMs [52]. In our study, the changes in cognitive function 1–6 months after brain radiotherapy were consistent [52]. Due to the large number of BMs in all patients, the radiotherapy methods adopted in this study were based on WBRT. In addition to some patients whose intracranial lesions were alleviated or effectively controlled, thus, cognitive function was improved; more than half of the patients had decreased or stable cognitive function during the 6-month follow-up after radiotherapy. Our study also showed that ICIs combined with WBRT + a limited boost dose did not aggravate cognitive impairment in patients with multiple BMs nor did it increase the risk of serious side effects.
There were some limitations in our study. First, this study had an insufficient sample size. Second, the PD-L1 expression levels were not detected in the retrospective study. Third, due to the large number and different distribution of BMs in the enrolled patients, the hippocampal structure was not specifically spared during radiation field design. Evaluation of the impact of radiotherapy and immunotherapy on treatment for BMs further needs to be separated into different tumor types to be meaningful. Validation through larger prospective studies with extended follow-up would be warranted.
5 Conclusion
In the present study, a combination of immunotherapy and WBRT was safe and feasible for patients with multiple BMs. On the basis of this combined therapy, SEB could improve the total resection rate of lesions but could not prolong the OS time. The boost may neither increase serious side effects nor aggravate cognitive impairment caused by WBRT.
Acknowledgments
The authors thank Dr Xinliang Liu for proofreading this manuscript.
-
Funding information: Authors state no funding involved.
-
Author contributions: (1) Pengwei Yan, Changzhai Wang, and Huanfeng Zhu, conceived and designed the study; (2) Pengwei Yan, Changzhai Wang, Duixian Tuoligan, Aji Kabinuer, Sheng Li, and Xue Song collected the data; (3) Pengwei Yan, Changzhai Wang, Duixian Tuoligan, Aji Kabinuer, Sheng Li, and Xue Song analyzed and interpreted the data; (4) Pengwei Yan and Changzhai Wang wrote the manuscript; (5) Huanfeng Zhu provided critical revisions that are important for the intellectual content; and (6) Pengwei Yan, Changzhai Wang, Duixian Tuoligan, Aji Kabinuer, Sheng Li, Xue Song, and Huanfeng Zhu approved the final version of the manuscript.
-
Conflict of interest: Authors state no conflict of interests.
-
Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
[1] Hartgerink D, van der Heijden B, De Ruysscher D, Postma A, Ackermans L, Hoeben A, et al. Stereotactic radiosurgery in the management of patients with brain metastases of non-small cell lung cancer: indications, decision tools and future directions. Front Oncol. 2018;8:154.10.3389/fonc.2018.00154Search in Google Scholar PubMed PubMed Central
[2] Kamath SD, Kumthekar PU. Immune checkpoint inhibitors for the treatment of central nervous system (CNS) metastatic disease. Front Oncol. 2018;8:414.10.3389/fonc.2018.00414Search in Google Scholar PubMed PubMed Central
[3] Kumar Shah B, Pak I, Budhathoki N, Buker K. Targeted therapy for leptomeningeal metastases in non-small cell lung cancer - Changing treatment paradigms. Chin J Cancer Res. 2017;29(6):535–42.10.21147/j.issn.1000-9604.2017.06.08Search in Google Scholar PubMed PubMed Central
[4] Gadgeel SM, Lukas RV, Goldschmidt J, Conkling P, Park K, Cortinovis D, et al. Atezolizumab in patients with advanced non-small cell lung cancer and history of asymptomatic, treated brain metastases: Exploratory analyses of the phase III OAK study. Lung Cancer (Amsterdam, Netherlands). 2019;128:105–12.10.1016/j.lungcan.2018.12.017Search in Google Scholar PubMed
[5] Iorgulescu JB, Harary M, Zogg CK, Ligon KL, Reardon DA, Hodi FS, et al. Improved risk-adjusted survival for melanoma brain metastases in the era of checkpoint blockade immunotherapies: results from a national cohort. Cancer Immunol Res. 2018;6(9):1039–45.10.1158/2326-6066.CIR-18-0067Search in Google Scholar PubMed PubMed Central
[6] Garassino MC, Gadgeel S, Speranza G, Felip E, Esteban E, Dómine M, et al. Pembrolizumab plus pemetrexed and platinum in nonsquamous non-small-cell lung cancer: 5-year outcomes from the phase 3 KEYNOTE-189 study. J Clin Oncol. 2023;41(11):1992–8.10.1200/JCO.22.01989Search in Google Scholar PubMed PubMed Central
[7] Doki Y, Ajani JA, Kato K, Xu J, Wyrwicz L, Motoyama S, et al. Nivolumab combination therapy in advanced esophageal squamous-cell carcinoma. N Engl J Med. 2022;386(5):449–62.10.1056/NEJMoa2111380Search in Google Scholar PubMed
[8] Brahmer JR, Lee JS, Ciuleanu TE, Bernabe Caro R, Nishio M, Urban L, et al. Five-year survival outcomes with nivolumab plus ipilimumab versus chemotherapy as first-line treatment for metastatic non-small-cell lung cancer in CheckMate 227. J Clin Oncol. 2023;41(6):1200–12.10.1200/JCO.22.01503Search in Google Scholar PubMed PubMed Central
[9] Chu X, Niu L, Xiao G, Peng H, Deng F, Liu Z, et al. The long-term and short-term efficacy of immunotherapy in non-small cell lung cancer patients with brain metastases: a systematic review and meta-analysis. Front Immunol. 2022;13:875488.10.3389/fimmu.2022.875488Search in Google Scholar PubMed PubMed Central
[10] Khan M, Zhao Z, Li X, Liao G. Anti-PD1 therapy plus whole-brain radiation therapy may prolong PFS in selected non-small cell lung cancer patients with brain metastases: a retrospective study. Int J Gen Med. 2021;14:8903–18.10.2147/IJGM.S333890Search in Google Scholar PubMed PubMed Central
[11] Lehrer EJ, McGee HM, Peterson JL, Vallow L, Ruiz-Garcia H, Zaorsky NG, et al. Stereotactic radiosurgery and immune checkpoint inhibitors in the management of brain metastases. Int J Mol Sci. 2018;19(10):3054.10.3390/ijms19103054Search in Google Scholar PubMed PubMed Central
[12] Jackson CM, Kochel CM, Nirschl CJ, Durham NM, Ruzevick J, Alme A, et al. Systemic tolerance mediated by melanoma brain tumors is reversible by radiotherapy and vaccination. Clin Cancer Res. 2016;22(5):1161–72.10.1158/1078-0432.CCR-15-1516Search in Google Scholar PubMed PubMed Central
[13] Sevenich L. Turning “cold” into “hot” tumors-opportunities and challenges for radio-immunotherapy against primary and metastatic brain cancers. Front Oncol. 2019;9:163.10.3389/fonc.2019.00163Search in Google Scholar PubMed PubMed Central
[14] Forrester JV, McMenamin PG, Dando SJ. CNS infection and immune privilege. Nat Rev Neurosci. 2018;19(11):655–71.10.1038/s41583-018-0070-8Search in Google Scholar PubMed
[15] Di Giacomo AM, Ascierto PA, Queirolo P, Pilla L, Ridolfi R, Santinami M, et al. Three-year follow-up of advanced melanoma patients who received ipilimumab plus fotemustine in the Italian Network for Tumor Biotherapy (NIBIT)-M1 phase II study. Ann Oncol. 2015;26(4):798–803.10.1093/annonc/mdu577Search in Google Scholar PubMed
[16] Protopapa M, Kouloulias V, Nikoloudi S, Papadimitriou C, Gogalis G, Zygogianni A. From whole-brain radiotherapy to immunotherapy: a multidisciplinary approach for patients with brain metastases from NSCLC. J Oncol. 2019;2019:3267409.10.1155/2019/3267409Search in Google Scholar PubMed PubMed Central
[17] Sahebjam S, Sharabi A, Lim M, Kesarwani P, Chinnaiyan P. Immunotherapy and radiation in glioblastoma. J Neuro-Oncol. 2017;134(3):531–9.10.1007/s11060-017-2413-0Search in Google Scholar PubMed
[18] Margolin K. Ipilimumab in a Phase II trial of melanoma patients with brain metastases. Oncoimmunology. 2012;1(7):1197–9.10.4161/onci.20687Search in Google Scholar PubMed PubMed Central
[19] Corso CD, Ali AN, Diaz R. Radiation-induced tumor neoantigens: imaging and therapeutic implications. Am J Cancer Res. 2011;1(3):390–412.Search in Google Scholar
[20] Takeshima T, Chamoto K, Wakita D, Ohkuri T, Togashi Y, Shirato H, et al. Local radiation therapy inhibits tumor growth through the generation of tumor-specific CTL: its potentiation by combination with Th1 cell therapy. Cancer Res. 2010;70(7):2697–706.10.1158/0008-5472.CAN-09-2982Search in Google Scholar PubMed
[21] Ahn GO, Tseng D, Liao CH, Dorie MJ, Czechowicz A, Brown JM. Inhibition of Mac-1 (CD11b/CD18) enhances tumor response to radiation by reducing myeloid cell recruitment. Proc Natl Acad Sci U S Am. 2010;107(18):8363–8.10.1073/pnas.0911378107Search in Google Scholar PubMed PubMed Central
[22] Russell JS, Brown JM. The irradiated tumor microenvironment: role of tumor-associated macrophages in vascular recovery. Front Physiol. 2013;4:157.10.3389/fphys.2013.00157Search in Google Scholar PubMed PubMed Central
[23] Postow MA, Callahan MK, Barker CA, Yamada Y, Yuan J, Kitano S, et al. Immunologic correlates of the abscopal effect in a patient with melanoma. N Engl J Med. 2012;366(10):925–31.10.1056/NEJMoa1112824Search in Google Scholar PubMed PubMed Central
[24] Kiess AP, Wolchok JD, Barker CA, Postow MA, Tabar V, Huse JT, et al. Stereotactic radiosurgery for melanoma brain metastases in patients receiving ipilimumab: safety profile and efficacy of combined treatment. Int J Radiat Oncol Biol Phys. 2015;92(2):368–75.10.1016/j.ijrobp.2015.01.004Search in Google Scholar PubMed PubMed Central
[25] Mathew M, Tam M, Ott PA, Pavlick AC, Rush SC, Donahue BR, et al. Ipilimumab in melanoma with limited brain metastases treated with stereotactic radiosurgery. Melanoma Res. 2013;23(3):191–5.10.1097/CMR.0b013e32835f3d90Search in Google Scholar PubMed
[26] Patel KR, Shoukat S, Oliver DE, Chowdhary M, Rizzo M, Lawson DH, et al. Ipilimumab and stereotactic radiosurgery versus stereotactic radiosurgery alone for newly diagnosed melanoma brain metastases. Am J Clin Oncol. 2017;40(5):444–50.10.1097/COC.0000000000000199Search in Google Scholar PubMed
[27] Xiao G, Liu Z, Gao X, Wang H, Peng H, Li J, et al. Immune checkpoint inhibitors for brain metastases in non-small-cell lung cancer: from rationale to clinical application. Immunotherapy. 2021;13(12):1031–51.10.2217/imt-2020-0262Search in Google Scholar PubMed
[28] Choong ES, Lo S, Drummond M, Fogarty GB, Menzies AM, Guminski A, et al. Survival of patients with melanoma brain metastasis treated with stereotactic radiosurgery and active systemic drug therapies. Eur J Cancer (Oxford, England: 1990). 2017;75:169–78.10.1016/j.ejca.2017.01.007Search in Google Scholar PubMed
[29] Schachter J, Ribas A, Long GV, Arance A, Grob JJ, Mortier L, et al. Pembrolizumab versus ipilimumab for advanced melanoma: final overall survival results of a multicentre, randomised, open-label phase 3 study (KEYNOTE-006). Lancet (London, England). 2017;390(10105):1853–62.10.1016/S0140-6736(17)31601-XSearch in Google Scholar PubMed
[30] Zindler JD, Bruynzeel AME, Eekers DBP, Hurkmans CW, Swinnen A, Lambin P. Whole brain radiotherapy versus stereotactic radiosurgery for 4-10 brain metastases: a phase III randomised multicentre trial. BMC Cancer. 2017;17(1):500.10.1186/s12885-017-3494-zSearch in Google Scholar PubMed PubMed Central
[31] Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK, et al. Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. Jama. 2016;316(4):401–9.10.1001/jama.2016.9839Search in Google Scholar PubMed PubMed Central
[32] Gerber NK, Young RJ, Barker CA, Wolchok JD, Chan TA, Yamada Y, et al. Ipilimumab and whole brain radiation therapy for melanoma brain metastases. J Neuro-Oncology. 2015;121(1):159–65.10.1007/s11060-014-1617-9Search in Google Scholar PubMed PubMed Central
[33] Williams NL, Wuthrick EJ, Kim H, Palmer JD, Garg S, Eldredge-Hindy H, et al. Phase 1 study of ipilimumab combined with whole brain radiation therapy or radiosurgery for melanoma patients with brain metastases. Int J Radiat Oncol Biol Phys. 2017;99(1):22–30.10.29046/JHNJ.013.1.003Search in Google Scholar
[34] Shaverdian N, Lisberg AE, Bornazyan K, Veruttipong D, Goldman JW, Formenti SC, et al. Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial. Lancet Oncol. 2017;18(7):895–903.10.1016/S1470-2045(17)30380-7Search in Google Scholar PubMed PubMed Central
[35] Shepard MJ, Xu Z, Donahue J, Eluvathingal Muttikkal TJ, Cordeiro D, Hansen L, et al. Stereotactic radiosurgery with and without checkpoint inhibition for patients with metastatic non-small cell lung cancer to the brain: a matched cohort study. J Neurosurg. 2019;133(3):685–92.10.3171/2019.4.JNS19822Search in Google Scholar PubMed
[36] Singh C, Qian JM, Yu JB, Chiang VL. Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases. J Neurosurg. 2019;132(2):512–7.10.3171/2018.10.JNS181371Search in Google Scholar PubMed
[37] Yang Z, Zhang Y, Li R, Yisikandaer A, Ren B, Sun J, et al. Whole-brain radiotherapy with and without concurrent erlotinib in NSCLC with brain metastases: a multicenter, open-label, randomized, controlled phase III trial. Neuro-Oncology. 2021;23(6):967–78.10.1093/neuonc/noaa281Search in Google Scholar PubMed PubMed Central
[38] Rusthoven CG, Yamamoto M, Bernhardt D, Smith DE, Gao D, Serizawa T, et al. Evaluation of first-line radiosurgery vs whole-brain radiotherapy for small cell lung cancer brain metastases: the FIRE-SCLC cohort study. JAMA Oncol. 2020;6(7):1028–37.10.1001/jamaoncol.2020.1271Search in Google Scholar PubMed PubMed Central
[39] Tsao MN, Xu W, Wong RK, Lloyd N, Laperriere N, Sahgal A, et al. Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev. 2018;1(1):Cd003869.10.1002/14651858.CD003869.pub4Search in Google Scholar PubMed PubMed Central
[40] Kotecha R, Kim JM, Miller JA, Juloori A, Chao ST, Murphy ES, et al. The impact of sequencing PD-1/PD-L1 inhibitors and stereotactic radiosurgery for patients with brain metastasis. Neuro-Oncology. 2019;21(8):1060–8.10.1093/neuonc/noz046Search in Google Scholar PubMed PubMed Central
[41] Gerber DE, Urbanic JJ, Langer C, Hu C, Chang IF, Lu B, et al. Treatment design and rationale for a randomized trial of cisplatin and etoposide plus thoracic radiotherapy followed by nivolumab or placebo for locally advanced non-small-cell lung cancer (RTOG 3505). Clin Lung Cancer. 2017;18(3):333–9.10.1016/j.cllc.2016.10.009Search in Google Scholar PubMed PubMed Central
[42] Koenig JL, Shi S, Sborov K, Gensheimer MF, Li G, Nagpal S, et al. Adverse radiation effect and disease control in patients undergoing stereotactic radiosurgery and immune checkpoint inhibitor therapy for brain metastases. World Neurosurg. 2019;126:e1399–411.10.1016/j.wneu.2019.03.110Search in Google Scholar PubMed
[43] Ahmed KA, Kim S, Arrington J, Naghavi AO, Dilling TJ, Creelan BC, et al. Outcomes targeting the PD-1/PD-L1 axis in conjunction with stereotactic radiation for patients with non-small cell lung cancer brain metastases. J Neuro-Oncol. 2017;133(2):331–8.10.1007/s11060-017-2437-5Search in Google Scholar PubMed
[44] Sprowls SA, Arsiwala TA, Bumgarner JR, Shah N, Lateef SS, Kielkowski BN, et al. Improving CNS delivery to brain metastases by blood-tumor barrier disruption. Trends cancer. 2019;5(8):495–505.10.1016/j.trecan.2019.06.003Search in Google Scholar PubMed PubMed Central
[45] Qing D, Zhao B, Zhou YC, Zhu HL, Ma DY. Whole-brain radiotherapy plus sequential or simultaneous integrated boost for the treatment of a limited number of brain metastases in non-small cell lung cancer: A single-institution study. Cancer Med. 2020;9(1):238–46.10.1002/cam4.2696Search in Google Scholar PubMed PubMed Central
[46] Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet (London, England). 2004;363(9422):1665–72.10.1016/S0140-6736(04)16250-8Search in Google Scholar PubMed
[47] Dobi Á, Fodor E, Maráz A, Együd Z, Cserháti A, Tiszlavicz L, et al. Boost irradiation integrated to whole brain radiotherapy in the management of brain metastases. Pathol Oncol Res: POR. 2020;26(1):149–57.10.1007/s12253-018-0383-ySearch in Google Scholar PubMed
[48] Lu F, Hou Y, Xia Y, Li L, Wang L, Cao K, et al. Survival and intracranial control outcomes of whole-brain radiotherapy (WBRT) alone versus WBRT plus a radiotherapy boost in non-small-cell lung cancer with brain metastases: a single-institution retrospective analysis. Cancer Manag Res. 2019;11:4255–72.10.2147/CMAR.S203461Search in Google Scholar PubMed PubMed Central
[49] Rades D, Kueter JD, Hornung D, Veninga T, Hanssens P, Schild SE, et al. Comparison of stereotactic radiosurgery (SRS) alone and whole brain radiotherapy (WBRT) plus a stereotactic boost (WBRT + SRS) for one to three brain metastases. Strahlenther Onkol. 2008;184(12):655–62.10.1007/s00066-008-1946-8Search in Google Scholar PubMed
[50] Sun H, Xu L, Wang Y, Zhao J, Xu K, Qi J, et al. Additional radiation boost to whole brain radiation therapy may improve the survival of patients with brain metastases in small cell lung cancer. Radiat Oncol (London, England). 2018;13(1):250.10.1186/s13014-018-1198-4Search in Google Scholar PubMed PubMed Central
[51] Reygagne E, Du Boisgueheneuc F, Berger A. Brain metastases: Focal treatment (surgery and radiation therapy) and cognitive consequences. Bull Cancer. 2017;104(4):344–55.10.1016/j.bulcan.2016.12.003Search in Google Scholar PubMed
[52] De Felice F, Musio D, Cassese R, Tombolini V. Radiotherapeutic treatment approaches for brain metastases. Anticancer Res. 2014;34(12):6913–8.Search in Google Scholar
© 2025 the author(s), published by De Gruyter
This work is licensed under the Creative Commons Attribution 4.0 International License.
Articles in the same Issue
- Biomedical Sciences
- Mechanism of triptolide regulating proliferation and apoptosis of hepatoma cells by inhibiting JAK/STAT pathway
- Maslinic acid improves mitochondrial function and inhibits oxidative stress and autophagy in human gastric smooth muscle cells
- Comparative analysis of inflammatory biomarkers for the diagnosis of neonatal sepsis: IL-6, IL-8, SAA, CRP, and PCT
- Post-pandemic insights on COVID-19 and premature ovarian insufficiency
- Proteome differences of dental stem cells between permanent and deciduous teeth by data-independent acquisition proteomics
- Optimizing a modified cetyltrimethylammonium bromide protocol for fungal DNA extraction: Insights from multilocus gene amplification
- Preliminary analysis of the role of small hepatitis B surface proteins mutations in the pathogenesis of occult hepatitis B infection via the endoplasmic reticulum stress-induced UPR-ERAD pathway
- Efficacy of alginate-coated gold nanoparticles against antibiotics-resistant Staphylococcus and Streptococcus pathogens of acne origins
- Battling COVID-19 leveraging nanobiotechnology: Gold and silver nanoparticle–B-escin conjugates as SARS-CoV-2 inhibitors
- Neurodegenerative diseases and neuroinflammation-induced apoptosis
- Impact of fracture fixation surgery on cognitive function and the gut microbiota in mice with a history of stroke
- COLEC10: A potential tumor suppressor and prognostic biomarker in hepatocellular carcinoma through modulation of EMT and PI3K-AKT pathways
- High-temperature requirement serine protease A2 inhibitor UCF-101 ameliorates damaged neurons in traumatic brain-injured rats by the AMPK/NF-κB pathway
- SIK1 inhibits IL-1β-stimulated cartilage apoptosis and inflammation in vitro through the CRTC2/CREB1 signaling
- Rutin–chitooligosaccharide complex: Comprehensive evaluation of its anti-inflammatory and analgesic properties in vitro and in vivo
- Knockdown of Aurora kinase B alleviates high glucose-triggered trophoblast cells damage and inflammation during gestational diabetes
- Calcium-sensing receptors promoted Homer1 expression and osteogenic differentiation in bone marrow mesenchymal stem cells
- ABI3BP can inhibit the proliferation, invasion, and epithelial–mesenchymal transition of non-small-cell lung cancer cells
- Changes in blood glucose and metabolism in hyperuricemia mice
- Rapid detection of the GJB2 c.235delC mutation based on CRISPR-Cas13a combined with lateral flow dipstick
- IL-11 promotes Ang II-induced autophagy inhibition and mitochondrial dysfunction in atrial fibroblasts
- Short-chain fatty acid attenuates intestinal inflammation by regulation of gut microbial composition in antibiotic-associated diarrhea
- Application of metagenomic next-generation sequencing in the diagnosis of pathogens in patients with diabetes complicated by community-acquired pneumonia
- NAT10 promotes radiotherapy resistance in non-small cell lung cancer by regulating KPNB1-mediated PD-L1 nuclear translocation
- Phytol-mixed micelles alleviate dexamethasone-induced osteoporosis in zebrafish: Activation of the MMP3–OPN–MAPK pathway-mediating bone remodeling
- Association between TGF-β1 and β-catenin expression in the vaginal wall of patients with pelvic organ prolapse
- Primary pleomorphic liposarcoma involving bilateral ovaries: Case report and literature review
- Effects of de novo donor-specific Class I and II antibodies on graft outcomes after liver transplantation: A pilot cohort study
- Sleep architecture in Alzheimer’s disease continuum: The deep sleep question
- Ephedra fragilis plant extract: A groundbreaking corrosion inhibitor for mild steel in acidic environments – electrochemical, EDX, DFT, and Monte Carlo studies
- Langerhans cell histiocytosis in an adult patient with upper jaw and pulmonary involvement: A case report
- Inhibition of mast cell activation by Jaranol-targeted Pirin ameliorates allergic responses in mouse allergic rhinitis
- Aeromonas veronii-induced septic arthritis of the hip in a child with acute lymphoblastic leukemia
- Clusterin activates the heat shock response via the PI3K/Akt pathway to protect cardiomyocytes from high-temperature-induced apoptosis
- Research progress on fecal microbiota transplantation in tumor prevention and treatment
- Low-pressure exposure influences the development of HAPE
- Stigmasterol alleviates endplate chondrocyte degeneration through inducing mitophagy by enhancing PINK1 mRNA acetylation via the ESR1/NAT10 axis
- AKAP12, mediated by transcription factor 21, inhibits cell proliferation, metastasis, and glycolysis in lung squamous cell carcinoma
- Association between PAX9 or MSX1 gene polymorphism and tooth agenesis risk: A meta-analysis
- A case of bloodstream infection caused by Neisseria gonorrhoeae
- Case of nasopharyngeal tuberculosis complicated with cervical lymph node and pulmonary tuberculosis
- p-Cymene inhibits pro-fibrotic and inflammatory mediators to prevent hepatic dysfunction
- GFPT2 promotes paclitaxel resistance in epithelial ovarian cancer cells via activating NF-κB signaling pathway
- Transfer RNA-derived fragment tRF-36 modulates varicose vein progression via human vascular smooth muscle cell Notch signaling
- RTA-408 attenuates the hepatic ischemia reperfusion injury in mice possibly by activating the Nrf2/HO-1 signaling pathway
- Decreased serum TIMP4 levels in patients with rheumatoid arthritis
- Sirt1 protects lupus nephritis by inhibiting the NLRP3 signaling pathway in human glomerular mesangial cells
- Sodium butyrate aids brain injury repair in neonatal rats
- Interaction of MTHFR polymorphism with PAX1 methylation in cervical cancer
- Convallatoxin inhibits proliferation and angiogenesis of glioma cells via regulating JAK/STAT3 pathway
- The effect of the PKR inhibitor, 2-aminopurine, on the replication of influenza A virus, and segment 8 mRNA splicing
- Effects of Ire1 gene on virulence and pathogenicity of Candida albicans
- Small cell lung cancer with small intestinal metastasis: Case report and literature review
- GRB14: A prognostic biomarker driving tumor progression in gastric cancer through the PI3K/AKT signaling pathway by interacting with COBLL1
- 15-Lipoxygenase-2 deficiency induces foam cell formation that can be restored by salidroside through the inhibition of arachidonic acid effects
- FTO alleviated the diabetic nephropathy progression by regulating the N6-methyladenosine levels of DACT1
- Clinical relevance of inflammatory markers in the evaluation of severity of ulcerative colitis: A retrospective study
- Zinc valproic acid complex promotes osteoblast differentiation and exhibits anti-osteoporotic potential
- Primary pulmonary synovial sarcoma in the bronchial cavity: A case report
- Metagenomic next-generation sequencing of alveolar lavage fluid improves the detection of pulmonary infection
- Uterine tumor resembling ovarian sex cord tumor with extensive rhabdoid differentiation: A case report
- Genomic analysis of a novel ST11(PR34365) Clostridioides difficile strain isolated from the human fecal of a CDI patient in Guizhou, China
- Effects of tiered cardiac rehabilitation on CRP, TNF-α, and physical endurance in older adults with coronary heart disease
- Changes in T-lymphocyte subpopulations in patients with colorectal cancer before and after acupoint catgut embedding acupuncture observation
- Modulating the tumor microenvironment: The role of traditional Chinese medicine in improving lung cancer treatment
- Alterations of metabolites related to microbiota–gut–brain axis in plasma of colon cancer, esophageal cancer, stomach cancer, and lung cancer patients
- Research on individualized drug sensitivity detection technology based on bio-3D printing technology for precision treatment of gastrointestinal stromal tumors
- CEBPB promotes ulcerative colitis-associated colorectal cancer by stimulating tumor growth and activating the NF-κB/STAT3 signaling pathway
- Oncolytic bacteria: A revolutionary approach to cancer therapy
- A de novo meningioma with rapid growth: A possible malignancy imposter?
- Diagnosis of secondary tuberculosis infection in an asymptomatic elderly with cancer using next-generation sequencing: Case report
- Hesperidin and its zinc(ii) complex enhance osteoblast differentiation and bone formation: In vitro and in vivo evaluations
- Research progress on the regulation of autophagy in cardiovascular diseases by chemokines
- Anti-arthritic, immunomodulatory, and inflammatory regulation by the benzimidazole derivative BMZ-AD: Insights from an FCA-induced rat model
- Immunoassay for pyruvate kinase M1/2 as an Alzheimer’s biomarker in CSF
- The role of HDAC11 in age-related hearing loss: Mechanisms and therapeutic implications
- Evaluation and application analysis of animal models of PIPNP based on data mining
- Therapeutic approaches for liver fibrosis/cirrhosis by targeting pyroptosis
- Fabrication of zinc oxide nanoparticles using Ruellia tuberosa leaf extract induces apoptosis through P53 and STAT3 signalling pathways in prostate cancer cells
- Haplo-hematopoietic stem cell transplantation and immunoradiotherapy for severe aplastic anemia complicated with nasopharyngeal carcinoma: A case report
- Modulation of the KEAP1-NRF2 pathway by Erianin: A novel approach to reduce psoriasiform inflammation and inflammatory signaling
- The expression of epidermal growth factor receptor 2 and its relationship with tumor-infiltrating lymphocytes and clinical pathological features in breast cancer patients
- Innovations in MALDI-TOF Mass Spectrometry: Bridging modern diagnostics and historical insights
- BAP1 complexes with YY1 and RBBP7 and its downstream targets in ccRCC cells
- Hypereosinophilic syndrome with elevated IgG4 and T-cell clonality: A report of two cases
- Electroacupuncture alleviates sciatic nerve injury in sciatica rats by regulating BDNF and NGF levels, myelin sheath degradation, and autophagy
- Polydatin prevents cholesterol gallstone formation by regulating cholesterol metabolism via PPAR-γ signaling
- RNF144A and RNF144B: Important molecules for health
- Analysis of the detection rate and related factors of thyroid nodules in the healthy population
- Artesunate inhibits hepatocellular carcinoma cell migration and invasion through OGA-mediated O-GlcNAcylation of ZEB1
- Endovascular management of post-pancreatectomy hemorrhage caused by a hepatic artery pseudoaneurysm: Case report and review of the literature
- Efficacy and safety of anti-PD-1/PD-L1 antibodies in patients with relapsed refractory diffuse large B-cell lymphoma: A meta-analysis
- SATB2 promotes humeral fracture healing in rats by activating the PI3K/AKT pathway
- Overexpression of the ferroptosis-related gene, NFS1, corresponds to gastric cancer growth and tumor immune infiltration
- Understanding risk factors and prognosis in diabetic foot ulcers
- Atractylenolide I alleviates the experimental allergic response in mice by suppressing TLR4/NF-kB/NLRP3 signalling
- FBXO31 inhibits the stemness characteristics of CD147 (+) melanoma stem cells
- Immune molecule diagnostics in colorectal cancer: CCL2 and CXCL11
- Inhibiting CXCR6 promotes senescence of activated hepatic stellate cells with limited proinflammatory SASP to attenuate hepatic fibrosis
- Cadmium toxicity, health risk and its remediation using low-cost biochar adsorbents
- Pulmonary cryptococcosis with headache as the first presentation: A case report
- Solitary pulmonary metastasis with cystic airspaces in colon cancer: A rare case report
- RUNX1 promotes denervation-induced muscle atrophy by activating the JUNB/NF-κB pathway and driving M1 macrophage polarization
- Morphometric analysis and immunobiological investigation of Indigofera oblongifolia on the infected lung with Plasmodium chabaudi
- The NuA4/TIP60 histone-modifying complex and Hr78 modulate the Lobe2 mutant eye phenotype
- Experimental study on salmon demineralized bone matrix loaded with recombinant human bone morphogenetic protein-2: In vitro and in vivo study
- A case of IgA nephropathy treated with a combination of telitacicept and half-dose glucocorticoids
- Analgesic and toxicological evaluation of cannabidiol-rich Moroccan Cannabis sativa L. (Khardala variety) extract: Evidence from an in vivo and in silico study
- Wound healing and signaling pathways
- Combination of immunotherapy and whole-brain radiotherapy on prognosis of patients with multiple brain metastases: A retrospective cohort study
- To explore the relationship between endometrial hyperemia and polycystic ovary syndrome
- Research progress on the impact of curcumin on immune responses in breast cancer
- Biogenic Cu/Ni nanotherapeutics from Descurainia sophia (L.) Webb ex Prantl seeds for the treatment of lung cancer
- Dapagliflozin attenuates atrial fibrosis via the HMGB1/RAGE pathway in atrial fibrillation rats
- Glycitein alleviates inflammation and apoptosis in keratinocytes via ROS-associated PI3K–Akt signalling pathway
- ADH5 inhibits proliferation but promotes EMT in non-small cell lung cancer cell through activating Smad2/Smad3
- Apoptotic efficacies of AgNPs formulated by Syzygium aromaticum leaf extract on 32D-FLT3-ITD human leukemia cell line with PI3K/AKT/mTOR signaling pathway
- Novel cuproptosis-related genes C1QBP and PFKP identified as prognostic and therapeutic targets in lung adenocarcinoma
- Bee venom promotes exosome secretion and alters miRNA cargo in T cells
- Treatment of pure red cell aplasia in a chronic kidney disease patient with roxadustat: A case report
- Comparative bioinformatics analysis of the Wnt pathway in breast cancer: Selection of novel biomarker panels associated with ER status
- Kynurenine facilitates renal cell carcinoma progression by suppressing M2 macrophage pyroptosis through inhibition of CASP1 cleavage
- RFX5 promotes the growth, motility, and inhibits apoptosis of gastric adenocarcinoma cells through the SIRT1/AMPK axis
- ALKBH5 exacerbates early cardiac damage after radiotherapy for breast cancer via m6A demethylation of TLR4
- Phytochemicals of Roman chamomile: Antioxidant, anti-aging, and whitening activities of distillation residues
- Circadian gene Cry1 inhibits the tumorigenicity of hepatocellular carcinoma by the BAX/BCL2-mediated apoptosis pathway
- The TNFR-RIPK1/RIPK3 signalling pathway mediates the effect of lanthanum on necroptosis of nerve cells
- Longitudinal monitoring of autoantibody dynamics in patients with early-stage non-small-cell lung cancer undergoing surgery
- The potential role of rutin, a flavonoid, in the management of cancer through modulation of cell signaling pathways
- Construction of pectinase gene engineering microbe and its application in tobacco sheets
- Construction of a microbial abundance prognostic scoring model based on intratumoral microbial data for predicting the prognosis of lung squamous cell carcinoma
- Sepsis complicated by haemophagocytic lymphohistiocytosis triggered by methicillin-resistant Staphylococcus aureus and human herpesvirus 8 in an immunocompromised elderly patient: A case report
- Sarcopenia in liver transplantation: A comprehensive bibliometric study of current research trends and future directions
- Advances in cancer immunotherapy and future directions in personalized medicine
- Can coronavirus disease 2019 affect male fertility or cause spontaneous abortion? A two-sample Mendelian randomization analysis
- Heat stroke associated with novel leukaemia inhibitory factor receptor gene variant in a Chinese infant
- PSME2 exacerbates ulcerative colitis by disrupting intestinal barrier function and promoting autophagy-dependent inflammation
- Hyperosmolar hyperglycemic state with severe hypernatremia coexisting with central diabetes insipidus: A case report and literature review
- Efficacy and mechanism of escin in improving the tissue microenvironment of blood vessel walls via anti-inflammatory and anticoagulant effects: Implications for clinical practice
- Merkel cell carcinoma: Clinicopathological analysis of three patients and literature review
- Genetic variants in VWF exon 26 and their implications for type 1 Von Willebrand disease in a Saudi Arabian population
- Lipoxin A4 improves myocardial ischemia/reperfusion injury through the Notch1-Nrf2 signaling pathway
- High levels of EPHB2 expression predict a poor prognosis and promote tumor progression in endometrial cancer
- Knockdown of SHP-2 delays renal tubular epithelial cell injury in diabetic nephropathy by inhibiting NLRP3 inflammasome-mediated pyroptosis
- Exploring the toxicity mechanisms and detoxification methods of Rhizoma Paridis
- Concomitant gastric carcinoma and primary hepatic angiosarcoma in a patient: A case report
- Ecology and Environmental Science
- Optimization and comparative study of Bacillus consortia for cellulolytic potential and cellulase enzyme activity
- The complete mitochondrial genome analysis of Haemaphysalis hystricis Supino, 1897 (Ixodida: Ixodidae) and its phylogenetic implications
- Epidemiological characteristics and risk factors analysis of multidrug-resistant tuberculosis among tuberculosis population in Huzhou City, Eastern China
- Indices of human impacts on landscapes: How do they reflect the proportions of natural habitats?
- Genetic analysis of the Siberian flying squirrel population in the northern Changbai Mountains, Northeast China: Insights into population status and conservation
- Diversity and environmental drivers of Suillus communities in Pinus sylvestris var. mongolica forests of Inner Mongolia
- Global assessment of the fate of nitrogen deposition in forest ecosystems: Insights from 15N tracer studies
- Fungal and bacterial pathogenic co-infections mainly lead to the assembly of microbial community in tobacco stems
- Influencing of coal industry related airborne particulate matter on ocular surface tear film injury and inflammatory factor expression in Sprague-Dawley rats
- Temperature-dependent development, predation, and life table of Sphaerophoria macrogaster (Thomson) (Diptera: Syrphidae) feeding on Myzus persicae (Sulzer) (Homoptera: Aphididae)
- Eleonora’s falcon trophic interactions with insects within its breeding range: A systematic review
- Agriculture
- Integrated analysis of transcriptome, sRNAome, and degradome involved in the drought-response of maize Zhengdan958
- Variation in flower frost tolerance among seven apple cultivars and transcriptome response patterns in two contrastingly frost-tolerant selected cultivars
- Heritability of durable resistance to stripe rust in bread wheat (Triticum aestivum L.)
- Molecular mechanism of follicular development in laying hens based on the regulation of water metabolism
- Animal Science
- Effect of sex ratio on the life history traits of an important invasive species, Spodoptera frugiperda
- Plant Sciences
- Hairpin in a haystack: In silico identification and characterization of plant-conserved microRNA in Rafflesiaceae
- Widely targeted metabolomics of different tissues in Rubus corchorifolius
- The complete chloroplast genome of Gerbera piloselloides (L.) Cass., 1820 (Carduoideae, Asteraceae) and its phylogenetic analysis
- Field trial to correlate mineral solubilization activity of Pseudomonas aeruginosa and biochemical content of groundnut plants
- Correlation analysis between semen routine parameters and sperm DNA fragmentation index in patients with semen non-liquefaction: A retrospective study
- Plasticity of the anatomical traits of Rhododendron L. (Ericaceae) leaves and its implications in adaptation to the plateau environment
- Effects of Piriformospora indica and arbuscular mycorrhizal fungus on growth and physiology of Moringa oleifera under low-temperature stress
- Effects of different sources of potassium fertiliser on yield, fruit quality and nutrient absorption in “Harward” kiwifruit (Actinidia deliciosa)
- Comparative efficiency and residue levels of spraying programs against powdery mildew in grape varieties
- The DREB7 transcription factor enhances salt tolerance in soybean plants under salt stress
- Using plant electrical signals of water hyacinth (Eichhornia crassipes) for water pollution monitoring
- Food Science
- Phytochemical analysis of Stachys iva: Discovering the optimal extract conditions and its bioactive compounds
- Review on role of honey in disease prevention and treatment through modulation of biological activities
- Computational analysis of polymorphic residues in maltose and maltotriose transporters of a wild Saccharomyces cerevisiae strain
- Optimization of phenolic compound extraction from Tunisian squash by-products: A sustainable approach for antioxidant and antibacterial applications
- Liupao tea aqueous extract alleviates dextran sulfate sodium-induced ulcerative colitis in rats by modulating the gut microbiota
- Toxicological qualities and detoxification trends of fruit by-products for valorization: A review
- Polyphenolic spectrum of cornelian cherry fruits and their health-promoting effect
- Optimizing the encapsulation of the refined extract of squash peels for functional food applications: A sustainable approach to reduce food waste
- Advancements in curcuminoid formulations: An update on bioavailability enhancement strategies curcuminoid bioavailability and formulations
- Impact of saline sprouting on antioxidant properties and bioactive compounds in chia seeds
- The dilemma of food genetics and improvement
- Bioengineering and Biotechnology
- Impact of hyaluronic acid-modified hafnium metalorganic frameworks containing rhynchophylline on Alzheimer’s disease
- Emerging patterns in nanoparticle-based therapeutic approaches for rheumatoid arthritis: A comprehensive bibliometric and visual analysis spanning two decades
- Application of CRISPR/Cas gene editing for infectious disease control in poultry
- Preparation of hafnium nitride-coated titanium implants by magnetron sputtering technology and evaluation of their antibacterial properties and biocompatibility
- Preparation and characterization of lemongrass oil nanoemulsion: Antimicrobial, antibiofilm, antioxidant, and anticancer activities
- Corrigendum
- Corrigendum to “Utilization of convolutional neural networks to analyze microscopic images for high-throughput screening of mesenchymal stem cells”
- Corrigendum to “Effects of Ire1 gene on virulence and pathogenicity of Candida albicans”
- Retraction
- Retraction of “Down-regulation of miR-539 indicates poor prognosis in patients with pancreatic cancer”
Articles in the same Issue
- Biomedical Sciences
- Mechanism of triptolide regulating proliferation and apoptosis of hepatoma cells by inhibiting JAK/STAT pathway
- Maslinic acid improves mitochondrial function and inhibits oxidative stress and autophagy in human gastric smooth muscle cells
- Comparative analysis of inflammatory biomarkers for the diagnosis of neonatal sepsis: IL-6, IL-8, SAA, CRP, and PCT
- Post-pandemic insights on COVID-19 and premature ovarian insufficiency
- Proteome differences of dental stem cells between permanent and deciduous teeth by data-independent acquisition proteomics
- Optimizing a modified cetyltrimethylammonium bromide protocol for fungal DNA extraction: Insights from multilocus gene amplification
- Preliminary analysis of the role of small hepatitis B surface proteins mutations in the pathogenesis of occult hepatitis B infection via the endoplasmic reticulum stress-induced UPR-ERAD pathway
- Efficacy of alginate-coated gold nanoparticles against antibiotics-resistant Staphylococcus and Streptococcus pathogens of acne origins
- Battling COVID-19 leveraging nanobiotechnology: Gold and silver nanoparticle–B-escin conjugates as SARS-CoV-2 inhibitors
- Neurodegenerative diseases and neuroinflammation-induced apoptosis
- Impact of fracture fixation surgery on cognitive function and the gut microbiota in mice with a history of stroke
- COLEC10: A potential tumor suppressor and prognostic biomarker in hepatocellular carcinoma through modulation of EMT and PI3K-AKT pathways
- High-temperature requirement serine protease A2 inhibitor UCF-101 ameliorates damaged neurons in traumatic brain-injured rats by the AMPK/NF-κB pathway
- SIK1 inhibits IL-1β-stimulated cartilage apoptosis and inflammation in vitro through the CRTC2/CREB1 signaling
- Rutin–chitooligosaccharide complex: Comprehensive evaluation of its anti-inflammatory and analgesic properties in vitro and in vivo
- Knockdown of Aurora kinase B alleviates high glucose-triggered trophoblast cells damage and inflammation during gestational diabetes
- Calcium-sensing receptors promoted Homer1 expression and osteogenic differentiation in bone marrow mesenchymal stem cells
- ABI3BP can inhibit the proliferation, invasion, and epithelial–mesenchymal transition of non-small-cell lung cancer cells
- Changes in blood glucose and metabolism in hyperuricemia mice
- Rapid detection of the GJB2 c.235delC mutation based on CRISPR-Cas13a combined with lateral flow dipstick
- IL-11 promotes Ang II-induced autophagy inhibition and mitochondrial dysfunction in atrial fibroblasts
- Short-chain fatty acid attenuates intestinal inflammation by regulation of gut microbial composition in antibiotic-associated diarrhea
- Application of metagenomic next-generation sequencing in the diagnosis of pathogens in patients with diabetes complicated by community-acquired pneumonia
- NAT10 promotes radiotherapy resistance in non-small cell lung cancer by regulating KPNB1-mediated PD-L1 nuclear translocation
- Phytol-mixed micelles alleviate dexamethasone-induced osteoporosis in zebrafish: Activation of the MMP3–OPN–MAPK pathway-mediating bone remodeling
- Association between TGF-β1 and β-catenin expression in the vaginal wall of patients with pelvic organ prolapse
- Primary pleomorphic liposarcoma involving bilateral ovaries: Case report and literature review
- Effects of de novo donor-specific Class I and II antibodies on graft outcomes after liver transplantation: A pilot cohort study
- Sleep architecture in Alzheimer’s disease continuum: The deep sleep question
- Ephedra fragilis plant extract: A groundbreaking corrosion inhibitor for mild steel in acidic environments – electrochemical, EDX, DFT, and Monte Carlo studies
- Langerhans cell histiocytosis in an adult patient with upper jaw and pulmonary involvement: A case report
- Inhibition of mast cell activation by Jaranol-targeted Pirin ameliorates allergic responses in mouse allergic rhinitis
- Aeromonas veronii-induced septic arthritis of the hip in a child with acute lymphoblastic leukemia
- Clusterin activates the heat shock response via the PI3K/Akt pathway to protect cardiomyocytes from high-temperature-induced apoptosis
- Research progress on fecal microbiota transplantation in tumor prevention and treatment
- Low-pressure exposure influences the development of HAPE
- Stigmasterol alleviates endplate chondrocyte degeneration through inducing mitophagy by enhancing PINK1 mRNA acetylation via the ESR1/NAT10 axis
- AKAP12, mediated by transcription factor 21, inhibits cell proliferation, metastasis, and glycolysis in lung squamous cell carcinoma
- Association between PAX9 or MSX1 gene polymorphism and tooth agenesis risk: A meta-analysis
- A case of bloodstream infection caused by Neisseria gonorrhoeae
- Case of nasopharyngeal tuberculosis complicated with cervical lymph node and pulmonary tuberculosis
- p-Cymene inhibits pro-fibrotic and inflammatory mediators to prevent hepatic dysfunction
- GFPT2 promotes paclitaxel resistance in epithelial ovarian cancer cells via activating NF-κB signaling pathway
- Transfer RNA-derived fragment tRF-36 modulates varicose vein progression via human vascular smooth muscle cell Notch signaling
- RTA-408 attenuates the hepatic ischemia reperfusion injury in mice possibly by activating the Nrf2/HO-1 signaling pathway
- Decreased serum TIMP4 levels in patients with rheumatoid arthritis
- Sirt1 protects lupus nephritis by inhibiting the NLRP3 signaling pathway in human glomerular mesangial cells
- Sodium butyrate aids brain injury repair in neonatal rats
- Interaction of MTHFR polymorphism with PAX1 methylation in cervical cancer
- Convallatoxin inhibits proliferation and angiogenesis of glioma cells via regulating JAK/STAT3 pathway
- The effect of the PKR inhibitor, 2-aminopurine, on the replication of influenza A virus, and segment 8 mRNA splicing
- Effects of Ire1 gene on virulence and pathogenicity of Candida albicans
- Small cell lung cancer with small intestinal metastasis: Case report and literature review
- GRB14: A prognostic biomarker driving tumor progression in gastric cancer through the PI3K/AKT signaling pathway by interacting with COBLL1
- 15-Lipoxygenase-2 deficiency induces foam cell formation that can be restored by salidroside through the inhibition of arachidonic acid effects
- FTO alleviated the diabetic nephropathy progression by regulating the N6-methyladenosine levels of DACT1
- Clinical relevance of inflammatory markers in the evaluation of severity of ulcerative colitis: A retrospective study
- Zinc valproic acid complex promotes osteoblast differentiation and exhibits anti-osteoporotic potential
- Primary pulmonary synovial sarcoma in the bronchial cavity: A case report
- Metagenomic next-generation sequencing of alveolar lavage fluid improves the detection of pulmonary infection
- Uterine tumor resembling ovarian sex cord tumor with extensive rhabdoid differentiation: A case report
- Genomic analysis of a novel ST11(PR34365) Clostridioides difficile strain isolated from the human fecal of a CDI patient in Guizhou, China
- Effects of tiered cardiac rehabilitation on CRP, TNF-α, and physical endurance in older adults with coronary heart disease
- Changes in T-lymphocyte subpopulations in patients with colorectal cancer before and after acupoint catgut embedding acupuncture observation
- Modulating the tumor microenvironment: The role of traditional Chinese medicine in improving lung cancer treatment
- Alterations of metabolites related to microbiota–gut–brain axis in plasma of colon cancer, esophageal cancer, stomach cancer, and lung cancer patients
- Research on individualized drug sensitivity detection technology based on bio-3D printing technology for precision treatment of gastrointestinal stromal tumors
- CEBPB promotes ulcerative colitis-associated colorectal cancer by stimulating tumor growth and activating the NF-κB/STAT3 signaling pathway
- Oncolytic bacteria: A revolutionary approach to cancer therapy
- A de novo meningioma with rapid growth: A possible malignancy imposter?
- Diagnosis of secondary tuberculosis infection in an asymptomatic elderly with cancer using next-generation sequencing: Case report
- Hesperidin and its zinc(ii) complex enhance osteoblast differentiation and bone formation: In vitro and in vivo evaluations
- Research progress on the regulation of autophagy in cardiovascular diseases by chemokines
- Anti-arthritic, immunomodulatory, and inflammatory regulation by the benzimidazole derivative BMZ-AD: Insights from an FCA-induced rat model
- Immunoassay for pyruvate kinase M1/2 as an Alzheimer’s biomarker in CSF
- The role of HDAC11 in age-related hearing loss: Mechanisms and therapeutic implications
- Evaluation and application analysis of animal models of PIPNP based on data mining
- Therapeutic approaches for liver fibrosis/cirrhosis by targeting pyroptosis
- Fabrication of zinc oxide nanoparticles using Ruellia tuberosa leaf extract induces apoptosis through P53 and STAT3 signalling pathways in prostate cancer cells
- Haplo-hematopoietic stem cell transplantation and immunoradiotherapy for severe aplastic anemia complicated with nasopharyngeal carcinoma: A case report
- Modulation of the KEAP1-NRF2 pathway by Erianin: A novel approach to reduce psoriasiform inflammation and inflammatory signaling
- The expression of epidermal growth factor receptor 2 and its relationship with tumor-infiltrating lymphocytes and clinical pathological features in breast cancer patients
- Innovations in MALDI-TOF Mass Spectrometry: Bridging modern diagnostics and historical insights
- BAP1 complexes with YY1 and RBBP7 and its downstream targets in ccRCC cells
- Hypereosinophilic syndrome with elevated IgG4 and T-cell clonality: A report of two cases
- Electroacupuncture alleviates sciatic nerve injury in sciatica rats by regulating BDNF and NGF levels, myelin sheath degradation, and autophagy
- Polydatin prevents cholesterol gallstone formation by regulating cholesterol metabolism via PPAR-γ signaling
- RNF144A and RNF144B: Important molecules for health
- Analysis of the detection rate and related factors of thyroid nodules in the healthy population
- Artesunate inhibits hepatocellular carcinoma cell migration and invasion through OGA-mediated O-GlcNAcylation of ZEB1
- Endovascular management of post-pancreatectomy hemorrhage caused by a hepatic artery pseudoaneurysm: Case report and review of the literature
- Efficacy and safety of anti-PD-1/PD-L1 antibodies in patients with relapsed refractory diffuse large B-cell lymphoma: A meta-analysis
- SATB2 promotes humeral fracture healing in rats by activating the PI3K/AKT pathway
- Overexpression of the ferroptosis-related gene, NFS1, corresponds to gastric cancer growth and tumor immune infiltration
- Understanding risk factors and prognosis in diabetic foot ulcers
- Atractylenolide I alleviates the experimental allergic response in mice by suppressing TLR4/NF-kB/NLRP3 signalling
- FBXO31 inhibits the stemness characteristics of CD147 (+) melanoma stem cells
- Immune molecule diagnostics in colorectal cancer: CCL2 and CXCL11
- Inhibiting CXCR6 promotes senescence of activated hepatic stellate cells with limited proinflammatory SASP to attenuate hepatic fibrosis
- Cadmium toxicity, health risk and its remediation using low-cost biochar adsorbents
- Pulmonary cryptococcosis with headache as the first presentation: A case report
- Solitary pulmonary metastasis with cystic airspaces in colon cancer: A rare case report
- RUNX1 promotes denervation-induced muscle atrophy by activating the JUNB/NF-κB pathway and driving M1 macrophage polarization
- Morphometric analysis and immunobiological investigation of Indigofera oblongifolia on the infected lung with Plasmodium chabaudi
- The NuA4/TIP60 histone-modifying complex and Hr78 modulate the Lobe2 mutant eye phenotype
- Experimental study on salmon demineralized bone matrix loaded with recombinant human bone morphogenetic protein-2: In vitro and in vivo study
- A case of IgA nephropathy treated with a combination of telitacicept and half-dose glucocorticoids
- Analgesic and toxicological evaluation of cannabidiol-rich Moroccan Cannabis sativa L. (Khardala variety) extract: Evidence from an in vivo and in silico study
- Wound healing and signaling pathways
- Combination of immunotherapy and whole-brain radiotherapy on prognosis of patients with multiple brain metastases: A retrospective cohort study
- To explore the relationship between endometrial hyperemia and polycystic ovary syndrome
- Research progress on the impact of curcumin on immune responses in breast cancer
- Biogenic Cu/Ni nanotherapeutics from Descurainia sophia (L.) Webb ex Prantl seeds for the treatment of lung cancer
- Dapagliflozin attenuates atrial fibrosis via the HMGB1/RAGE pathway in atrial fibrillation rats
- Glycitein alleviates inflammation and apoptosis in keratinocytes via ROS-associated PI3K–Akt signalling pathway
- ADH5 inhibits proliferation but promotes EMT in non-small cell lung cancer cell through activating Smad2/Smad3
- Apoptotic efficacies of AgNPs formulated by Syzygium aromaticum leaf extract on 32D-FLT3-ITD human leukemia cell line with PI3K/AKT/mTOR signaling pathway
- Novel cuproptosis-related genes C1QBP and PFKP identified as prognostic and therapeutic targets in lung adenocarcinoma
- Bee venom promotes exosome secretion and alters miRNA cargo in T cells
- Treatment of pure red cell aplasia in a chronic kidney disease patient with roxadustat: A case report
- Comparative bioinformatics analysis of the Wnt pathway in breast cancer: Selection of novel biomarker panels associated with ER status
- Kynurenine facilitates renal cell carcinoma progression by suppressing M2 macrophage pyroptosis through inhibition of CASP1 cleavage
- RFX5 promotes the growth, motility, and inhibits apoptosis of gastric adenocarcinoma cells through the SIRT1/AMPK axis
- ALKBH5 exacerbates early cardiac damage after radiotherapy for breast cancer via m6A demethylation of TLR4
- Phytochemicals of Roman chamomile: Antioxidant, anti-aging, and whitening activities of distillation residues
- Circadian gene Cry1 inhibits the tumorigenicity of hepatocellular carcinoma by the BAX/BCL2-mediated apoptosis pathway
- The TNFR-RIPK1/RIPK3 signalling pathway mediates the effect of lanthanum on necroptosis of nerve cells
- Longitudinal monitoring of autoantibody dynamics in patients with early-stage non-small-cell lung cancer undergoing surgery
- The potential role of rutin, a flavonoid, in the management of cancer through modulation of cell signaling pathways
- Construction of pectinase gene engineering microbe and its application in tobacco sheets
- Construction of a microbial abundance prognostic scoring model based on intratumoral microbial data for predicting the prognosis of lung squamous cell carcinoma
- Sepsis complicated by haemophagocytic lymphohistiocytosis triggered by methicillin-resistant Staphylococcus aureus and human herpesvirus 8 in an immunocompromised elderly patient: A case report
- Sarcopenia in liver transplantation: A comprehensive bibliometric study of current research trends and future directions
- Advances in cancer immunotherapy and future directions in personalized medicine
- Can coronavirus disease 2019 affect male fertility or cause spontaneous abortion? A two-sample Mendelian randomization analysis
- Heat stroke associated with novel leukaemia inhibitory factor receptor gene variant in a Chinese infant
- PSME2 exacerbates ulcerative colitis by disrupting intestinal barrier function and promoting autophagy-dependent inflammation
- Hyperosmolar hyperglycemic state with severe hypernatremia coexisting with central diabetes insipidus: A case report and literature review
- Efficacy and mechanism of escin in improving the tissue microenvironment of blood vessel walls via anti-inflammatory and anticoagulant effects: Implications for clinical practice
- Merkel cell carcinoma: Clinicopathological analysis of three patients and literature review
- Genetic variants in VWF exon 26 and their implications for type 1 Von Willebrand disease in a Saudi Arabian population
- Lipoxin A4 improves myocardial ischemia/reperfusion injury through the Notch1-Nrf2 signaling pathway
- High levels of EPHB2 expression predict a poor prognosis and promote tumor progression in endometrial cancer
- Knockdown of SHP-2 delays renal tubular epithelial cell injury in diabetic nephropathy by inhibiting NLRP3 inflammasome-mediated pyroptosis
- Exploring the toxicity mechanisms and detoxification methods of Rhizoma Paridis
- Concomitant gastric carcinoma and primary hepatic angiosarcoma in a patient: A case report
- Ecology and Environmental Science
- Optimization and comparative study of Bacillus consortia for cellulolytic potential and cellulase enzyme activity
- The complete mitochondrial genome analysis of Haemaphysalis hystricis Supino, 1897 (Ixodida: Ixodidae) and its phylogenetic implications
- Epidemiological characteristics and risk factors analysis of multidrug-resistant tuberculosis among tuberculosis population in Huzhou City, Eastern China
- Indices of human impacts on landscapes: How do they reflect the proportions of natural habitats?
- Genetic analysis of the Siberian flying squirrel population in the northern Changbai Mountains, Northeast China: Insights into population status and conservation
- Diversity and environmental drivers of Suillus communities in Pinus sylvestris var. mongolica forests of Inner Mongolia
- Global assessment of the fate of nitrogen deposition in forest ecosystems: Insights from 15N tracer studies
- Fungal and bacterial pathogenic co-infections mainly lead to the assembly of microbial community in tobacco stems
- Influencing of coal industry related airborne particulate matter on ocular surface tear film injury and inflammatory factor expression in Sprague-Dawley rats
- Temperature-dependent development, predation, and life table of Sphaerophoria macrogaster (Thomson) (Diptera: Syrphidae) feeding on Myzus persicae (Sulzer) (Homoptera: Aphididae)
- Eleonora’s falcon trophic interactions with insects within its breeding range: A systematic review
- Agriculture
- Integrated analysis of transcriptome, sRNAome, and degradome involved in the drought-response of maize Zhengdan958
- Variation in flower frost tolerance among seven apple cultivars and transcriptome response patterns in two contrastingly frost-tolerant selected cultivars
- Heritability of durable resistance to stripe rust in bread wheat (Triticum aestivum L.)
- Molecular mechanism of follicular development in laying hens based on the regulation of water metabolism
- Animal Science
- Effect of sex ratio on the life history traits of an important invasive species, Spodoptera frugiperda
- Plant Sciences
- Hairpin in a haystack: In silico identification and characterization of plant-conserved microRNA in Rafflesiaceae
- Widely targeted metabolomics of different tissues in Rubus corchorifolius
- The complete chloroplast genome of Gerbera piloselloides (L.) Cass., 1820 (Carduoideae, Asteraceae) and its phylogenetic analysis
- Field trial to correlate mineral solubilization activity of Pseudomonas aeruginosa and biochemical content of groundnut plants
- Correlation analysis between semen routine parameters and sperm DNA fragmentation index in patients with semen non-liquefaction: A retrospective study
- Plasticity of the anatomical traits of Rhododendron L. (Ericaceae) leaves and its implications in adaptation to the plateau environment
- Effects of Piriformospora indica and arbuscular mycorrhizal fungus on growth and physiology of Moringa oleifera under low-temperature stress
- Effects of different sources of potassium fertiliser on yield, fruit quality and nutrient absorption in “Harward” kiwifruit (Actinidia deliciosa)
- Comparative efficiency and residue levels of spraying programs against powdery mildew in grape varieties
- The DREB7 transcription factor enhances salt tolerance in soybean plants under salt stress
- Using plant electrical signals of water hyacinth (Eichhornia crassipes) for water pollution monitoring
- Food Science
- Phytochemical analysis of Stachys iva: Discovering the optimal extract conditions and its bioactive compounds
- Review on role of honey in disease prevention and treatment through modulation of biological activities
- Computational analysis of polymorphic residues in maltose and maltotriose transporters of a wild Saccharomyces cerevisiae strain
- Optimization of phenolic compound extraction from Tunisian squash by-products: A sustainable approach for antioxidant and antibacterial applications
- Liupao tea aqueous extract alleviates dextran sulfate sodium-induced ulcerative colitis in rats by modulating the gut microbiota
- Toxicological qualities and detoxification trends of fruit by-products for valorization: A review
- Polyphenolic spectrum of cornelian cherry fruits and their health-promoting effect
- Optimizing the encapsulation of the refined extract of squash peels for functional food applications: A sustainable approach to reduce food waste
- Advancements in curcuminoid formulations: An update on bioavailability enhancement strategies curcuminoid bioavailability and formulations
- Impact of saline sprouting on antioxidant properties and bioactive compounds in chia seeds
- The dilemma of food genetics and improvement
- Bioengineering and Biotechnology
- Impact of hyaluronic acid-modified hafnium metalorganic frameworks containing rhynchophylline on Alzheimer’s disease
- Emerging patterns in nanoparticle-based therapeutic approaches for rheumatoid arthritis: A comprehensive bibliometric and visual analysis spanning two decades
- Application of CRISPR/Cas gene editing for infectious disease control in poultry
- Preparation of hafnium nitride-coated titanium implants by magnetron sputtering technology and evaluation of their antibacterial properties and biocompatibility
- Preparation and characterization of lemongrass oil nanoemulsion: Antimicrobial, antibiofilm, antioxidant, and anticancer activities
- Corrigendum
- Corrigendum to “Utilization of convolutional neural networks to analyze microscopic images for high-throughput screening of mesenchymal stem cells”
- Corrigendum to “Effects of Ire1 gene on virulence and pathogenicity of Candida albicans”
- Retraction
- Retraction of “Down-regulation of miR-539 indicates poor prognosis in patients with pancreatic cancer”