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ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs through Bcl-2 pathway

  • Xiaoshan Zhang , ShiBing Deng , Yang Peng , Han Wei and Zhiming Tian EMAIL logo
Published/Copyright: June 15, 2022

Abstract

The dysfunction and apoptosis of vascular endothelial cells are the initiating links in the formation of atherosclerosis. N6-methyladenosine (m6A) is an extremely extensive RNA methylation modification and its abnormality leads to the occurrence of various human diseases. In this study, we explored the effects of demethylase α-ketoglutarate-dependent dioxygenase ALKB homolog 5 (ALKBH5) on TNF-α-induced apoptosis of human umbilical vein endothelial cells (HUVECs). In TNF-α-treated HUVECs, the expression of ALKBH5 was significantly decreased. ALKBH5 overexpression promoted the proliferation and inhibited the apoptosis in TNF-α-treated HUVECs, suggesting that ALKBH5 had a protective effect on cell damage induced by TNF-α. Importantly, ALKBH5 promoted the expression of Bcl-2 in HUVECs. Bcl2 overexpression reduced the expression of Gadd45, Bax, and p21, which are transcriptionally activated by p53. But the expression of p53 has not been significantly affected, indicating that Bcl2 might regulate the apoptosis by inhibiting p53 downstream targets. In addition, ALKBH5 overexpression significantly increased the level of pri-miR-7 and decreased the level of miR-7. In conclusion, ALKBH5 attenuated the TNF-α-induced cell injury via promoting Bcl2 expression. Our research expands the understanding of the progression mechanism of atherosclerosis and provides a potential strategy for the protection of vascular endothelial injury.

1 Introduction

Atherosclerosis (AS) is a systemic or local inflammatory and immunoreactive disease mediated by inflammatory factors and chemokines. The inflammatory damage, dysfunction, and apoptosis of vascular endothelial cells are the initiating links in the formation of AS [1]. Therefore, exploring strategies to protect endothelial cells is of vital importance for the prevention and treatment of AS.

N6-methyladenosine (m6A) is an extremely extensive RNA methylation modification that participates in the transport, shearing, translation, and processing of mRNA [2,3,4]. Its abnormality often leads to changes in the corresponding downstream target proteins, which leads to the occurrence of diseases [2,5]. α-Ketoglutarate-dependent dioxygenase ALKB homolog 5 (ALKBH5) is a primary m6A demethylase, a member of the AlkB family, and also a homolog of obesity-related genes (FTO) [6]. At present, ALKBH5 is found to play a biological and pharmacological role in human cancer or non-cancer diseases [6,7]. ALKBH5 participates in the regulation of the occurrence and metastasis of human tumors by regulating a variety of biological processes, such as proliferation, migration, invasion, and metastasis [7,8]. In addition, ALKBH5 also plays an important role in the reproductive system diseases and bone metabolism [9,10,11]. Studies have shown that m6A methylation is active in vascular endothelial cells. m6A methylation is involved in the pathologies of myocardial ischemia-reperfusion injury and AS, including oxidation, stress, inflammation, and metabolic disorders [12,13]. Currently, the functions of three m6A methylation (METTL3, METTL14, and WTAP) and demethylases FTO in vascular endothelial dysfunction have been reported [14,15,16]. However, the role of ALKBH5 in vascular endothelial injury and AS remains unknown. Here we aimed to explore the specific effect of ALKBH5 on vascular endothelial cells.

In many studies, TNF-α-treated human umbilical vein endothelial cells (HUVECs) were used to simulate arteriosclerosis in vitro. Here we explored the effects of ALKBH5 on TNF-α-induced apoptosis of HUVECs and its specific pathways in an in vitro cell model, trying to provide a potential strategy for the protection of vascular endothelial injury.

2 Methods

2.1 Cell culture and treatment

HUVECs were purchased from KeyGen BioTECH Corp., Ltd (Nanjing, China) and grown in DMEM (11995065, Thermo Fisher Scientific, San Jose, USA) with 5% CO2 at 37℃. The model of endothelial cell injury was constructed with 10 ng/mL TNF-α for 24 h. Overexpression plasmids, pcDNA3.1-ALKBH5 and pcDNA3.1-Bcl2 were purchased from YouBio (Changsha, China). The siRNA-Bcl2 and siRNA-control were synthetized from Sangon Biotech (Shanghai, China). Lipofectamine 2000 (11668500, Thermo Fisher Scientific, San Jose, USA) was used for the transfection. miR-7 mimic (5′-TGGAAGACTAGTGATTTTGTTG-3′) and negative control (NC) mimic (5′-GGUUCGUACGUACACUGUUCA-3′) were synthetized from GeneChem Co., Ltd (Shanghai, China).

2.2 Western blot assay

Total protein was extracted from HUVECs after the treatment or transfection for 24 h using a radio immunoprecipitation assay (RIPA, R0010, Solarbio Science and Technology Ltd, Beijing, China) buffer. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) was performed to separate protein samples. Then, the protein was transferred into a PVDF membrane. After being blocked with non-fat milk for 1 h, the membrane was incubated with the primary antibody for 1 h, and then with the secondary antibody for 1 h at room temperature. The protein was immunoluminescent with ECL kit (CW0048M, CoWin Biotech Co. Ltd, Beijing, China). Antibodies against ALKBH5 (1:1,000, ab195377), Bcl2 (1:1,000, ab32124), p21 (1:2,000, ab109520), Bax (1:2,000, ab32503), and Gadd45 (1:500, ab205252) were purchased from Abcam (Cambridge, UK).

2.3 Quantitative real-time PCR (qRT-PCR)

Total mRNA was extracted from HUVECs using miRNA Purification Kit and Ultrapure RNA Kit (CW0627 and CW0581, CoWin Biotech Co. Ltd, Beijing, China). Reverse transcription was performed using cDNA Synthesis Kits (CW2141 and CW2569, CoWin Biotech Co. Ltd, Beijing, China). Then, the expression of miRNA was detected using qPCR Assay Kits (CW2142 and CW0957, CoWin Biotech Co. Ltd, Beijing, China). Relative expression levels were calculated using 2−ΔΔCT method. Primers for Bcl-2 (sense, 5′-AGACTCTGCTCAGTTTGGCC-3′; antisense, 5′-TCACTTGTGGCCCAGATAGG-3′), miR-7 (5′-TGGAAGACTAGTGATTTTGTT-3′) and pre-miR-7 (5′-CGCTTCGTGTTGTATGGAAGAC-3′) were used in this research.

2.4 CCK8 assay

Cell viability was detected using CCK8 assay. After the transfection or treatment, cells were seeded into a 96-well plate at a density of 5000 cells/well. Cell viability was measured every 24 h. 10 µL of CCK8 reagent (CA1210, Solarbio Science and Technology Ltd, Beijing, China) was added to the cells and maintained for 1.5 h at 37°C. The cell absorbance was measured at 450 nm using a spectrophotometer.

2.5 Flow cytometry

The apoptosis was detected using Flow cytometry analysis. After the transfection or treatment for 24 h, cells were incubated with Annexin V/FITC (Thermo Fisher Scientific, San Jose, USA) at room temperature for 5 min and incubated with PI at room temperature for 15 min. FlowJo software was used to analyze the flow results.

2.6 Statistical analysis

Data in this research was presented as mean value ± standard deviation (SD). Statistical analysis was performed using GraphPad Prism 7 software. Differences between two groups were analyzed using the student’s t test, and differences between three and four groups were analyzed using the one-way ANOVA. All data were generated in three replicates. P < 0.05 was considered statistically significant.

  1. Ethics approval and consent to participate: This research study was approved by the Institutional Review Board of First School of Clinical Medicine College.

3 Results

m6A methylation is involved in the transport, shearing, translation, and processing of mRNA. Its abnormality leads to changes in the corresponding downstream target proteins and the occurrence of human diseases. Here we detected the expression of methyltransferases and demethylases in TNF-α-treated HUVECs. Downregulated ALKBH5 was observed in TNF-α-induced inflammatory HUVECs. In the present research, we proved that ALKBH5 inhibited TNF-α-induced apoptosis through Bcl-2 pathway in HUVECs.

3.1 ALKBH5 was downregulated in TNF-α-treated HUVECs

HUVECs were treated with 10 ng/mL TNF-α for 24 h to generate the vascular endothelial cell injury model (Figure 1a). As shown in Figure 1b, cell viability of HUVECs treated with TNF-α for 24 h declined significantly compared with that of the PBS-treated HUVECs. Based on this model, we investigated the specific effect of ALKBH5 on vascular endothelial cell injury.

Figure 1 
                  The model of vascular endothelial cell injury was constructed using TNF-α. (a) HUVECs were treated with 10 ng/mL TNF-α for 24 h, and cell viability was detected using CCK8 assay. PBS buffer was used as the control. The expression of ALKBH5 in TNF-α and control groups after the treatment for 24 h was analyzed using western blot. (b) Cell viability was detected using CCK8 assay. **P < 0.01; ***P < 0.001.
Figure 1

The model of vascular endothelial cell injury was constructed using TNF-α. (a) HUVECs were treated with 10 ng/mL TNF-α for 24 h, and cell viability was detected using CCK8 assay. PBS buffer was used as the control. The expression of ALKBH5 in TNF-α and control groups after the treatment for 24 h was analyzed using western blot. (b) Cell viability was detected using CCK8 assay. **P < 0.01; ***P < 0.001.

To determine the effect of cell injury on ALKBH5 expression, the protein was extracted from HUVECs after the treatment of 10 ng/mL TNF-α for 24 h. As shown in Figure 1b, ALKBH5 was downregulated significantly after TNF-α treatment. Therefore, we further explored whether abnormal expression of ALKBH5 might affect HUVECs injury induced by TNF-α.

3.2 ALKBH5 attenuated the cell injury induced by TNF-α in HUVECs

To investigate the specific effect of ALKBH5 on vascular endothelial cell injury, the overexpression plasmid of ALKBH5 was transfected into TNF-α-treated HUVECs with the empty plasmid as a negative control and TNF-α-treated HUVECs as the blank control. Western blot was performed to detect the level of ALKBH5. As shown in Figure 2a and b, compared with the empty plasmid, ALKBH5 overexpression plasmid significantly promoted the expression of ALKBH5. Then, we detected cell viability in these three groups. As shown in Figure 2c, cell viability indicated by OD450 increased significantly in HUVECs transfected with ALKBH5 plasmid. Results of flow cytometry for the apoptosis showed the opposite trend (Figure 2d). Compared to the negative control, the percentage of apoptotic cells in high ALKBH5 cells decreased significantly (Figure 2e). These data indicated that ALKBH5 might have a protective effect on TNF-induced cell injury in HUVECs.

Figure 2 
                  ALKBH5 attenuated the cell injury induced by TNF-α in HUVECs. (a) The overexpression plasmid of ALKBH5 was transfected into TNF-α-treated HUVECs with the empty plasmid as a negative control. Western blot was performed to detect the ALKBH5 protein level. (b) Relative protein level was analyzed using Image J software. (c) Cell viability was detected using CCK8 assay. (d) Flow cytometry analysis was preformed to detect the apoptosis of HUVECs. (e) The percentage of apoptotic cell number was analyzed using flowJo software. **P < 0.01; ***P < 0.001.
Figure 2

ALKBH5 attenuated the cell injury induced by TNF-α in HUVECs. (a) The overexpression plasmid of ALKBH5 was transfected into TNF-α-treated HUVECs with the empty plasmid as a negative control. Western blot was performed to detect the ALKBH5 protein level. (b) Relative protein level was analyzed using Image J software. (c) Cell viability was detected using CCK8 assay. (d) Flow cytometry analysis was preformed to detect the apoptosis of HUVECs. (e) The percentage of apoptotic cell number was analyzed using flowJo software. **P < 0.01; ***P < 0.001.

3.3 Bcl2 blocked TNF-α-induced apoptosis by inhibiting the activity of genes downstream of p53

Previous studies have shown that ALKBH5 inhibits Bcl2 degradation by reducing m6A modification, thereby regulating cell apoptosis in ovarian cancer, hepatocellular carcinoma, and cerebral ischemia-reperfusion injury [17,18,19]. To explore the mechanisms by which ALKBH5 inhibited the injury induced by TNF-α, we detected the effect of ALKBH5 on Bcl2 expression. As shown in Figure 3a and b, Bcl2 expression increased significantly after the overexpression of ALKBH5 in TNF-α-treated HUVECs. Importantly, the mRNA level of Bcl2 also increased markedly in ALKBH5 overexpressed cells, suggesting that ALKBH5 may block the degradation of Bcl2 mRNA through demethylation in HUVECs (Figure 3c).

Figure 3 
                  Bcl2 blocked the apoptosis induced by TNF-α through inhibiting transcriptional activity of p53. (a) The expression of Bcl2 was determined by western bolt in TNF-α treated HUVECs. (b) The relative protein level was analyzed using Image J software. (c) The mRNA level of Bcl2 was detected using qPCR. (d) The overexpression plasmid of Bcl2 was transfected into TNF-α-treated HUVECs with the empty plasmid as a negative control. Cell viability was detected using CCK8 assay. (e) The expression levels of apoptosis relative protein were detected using western blot. The protein levels of Bcl2 (f), p53 (g), Gadd45 (h), Bax (i), p21 (j) were analyzed using Image J software. **P < 0.01; ***P < 0.001.
Figure 3

Bcl2 blocked the apoptosis induced by TNF-α through inhibiting transcriptional activity of p53. (a) The expression of Bcl2 was determined by western bolt in TNF-α treated HUVECs. (b) The relative protein level was analyzed using Image J software. (c) The mRNA level of Bcl2 was detected using qPCR. (d) The overexpression plasmid of Bcl2 was transfected into TNF-α-treated HUVECs with the empty plasmid as a negative control. Cell viability was detected using CCK8 assay. (e) The expression levels of apoptosis relative protein were detected using western blot. The protein levels of Bcl2 (f), p53 (g), Gadd45 (h), Bax (i), p21 (j) were analyzed using Image J software. **P < 0.01; ***P < 0.001.

To investigate the pathway by which Bcl2 inhibits the apoptosis, Bcl2 overexpression plasmid was transfected into HUVECs. As shown in Figure 3c, cell viability was enhanced after the overexpression of Bcl2. Then, the expression levels of apoptosis relative protein were determined using western blot (Figure 3d). As predicted, Bcl2 expression was upregulated after the transfection of Bcl2 overexpression plasmid (Figure 3e). Interestingly, there was no significant change in the expression of p53 after Bcl2 overexpression (Figure 3f). However, the expression levels of p53 transcription targets decreased significantly after Bcl2 overexpression, including Gadd45, Bax, and p21 (Figure 3g–i). These results indicated that Bcl2 attenuated TNF-α-induced cell injury through inhibiting the expression of p53 downstream targets.

3.4 ALKBH5 inhibits TNF-α-induced apoptosis of HUVEs via regulating Bcl2 expression

To verify the hypothesis proposed above, the overexpression plasmid of ALKBH5 and Bcl2-siRNA were co-transfected into TNF-α-treated HUVECs. As shown in Figure 4a, the optical density (OD) value increased significantly after ALKBH5 overexpression, while it decreased to the control level after knocking down Bcl2, suggesting that Bcl2 knockdown hindered the promotion effect of ALKBH5 on cell viability. Knockdown of Bcl2 could counteract the significant decrease in apoptotic cell ratio caused by ALKBH5, and maintain it at the control level (Figure 4b and c). From the results of western blot, Gadd45, Bax, and p21 were significantly inhibited by ALKBH5, but the effect disappeared when Bcl2 was knocked down (Figure 4d–h). These results indicated that ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs via regulating Bcl2 signaling pathway.

Figure 4 
                  ALKBH5 inhibits TNF-α-induced apoptosis of HUVEs through regulating the expression of Bcl2. (a) The overexpression plasmids of ALKBH5 and Bcl2-siRNA were transfected into TNF-α treated HUVECs. Cell viability was detected using CCK8 assay. (b) Flow cytometry analysis was preformed to detect the apoptosis of HUVECs. (c) The percentage of apoptotic cell number was analyzed using flowJo software. (d) The expression levels of apoptosis relative protein were detected using western blot. The protein levels of Bcl2 (e), Gadd45 (f), Bax (g), and p21 (h) were analyzed using Image J software. The levels of miR-7 (i) and pri-miR-7 (j) were detected using qPCR. (k) negative or miR-7 mimic was transfected into HUVECs, and Bcl2 expression was detected using western blot. *P < 0.05 vs TNF-α + ALKBH5 group; **P < 0.01 vs TNF-α + ALKBH5 group; ***P < 0.001 vs TNF-α + ALKBH5 group; ##
                     P < 0.01 vs TNF-α + ALKBH5 + Bcl2 group; ###
                     P < 0.001 vs TNF-α + ALKBH5 + Bcl2 group.
Figure 4

ALKBH5 inhibits TNF-α-induced apoptosis of HUVEs through regulating the expression of Bcl2. (a) The overexpression plasmids of ALKBH5 and Bcl2-siRNA were transfected into TNF-α treated HUVECs. Cell viability was detected using CCK8 assay. (b) Flow cytometry analysis was preformed to detect the apoptosis of HUVECs. (c) The percentage of apoptotic cell number was analyzed using flowJo software. (d) The expression levels of apoptosis relative protein were detected using western blot. The protein levels of Bcl2 (e), Gadd45 (f), Bax (g), and p21 (h) were analyzed using Image J software. The levels of miR-7 (i) and pri-miR-7 (j) were detected using qPCR. (k) negative or miR-7 mimic was transfected into HUVECs, and Bcl2 expression was detected using western blot. *P < 0.05 vs TNF-α + ALKBH5 group; **P < 0.01 vs TNF-α + ALKBH5 group; ***P < 0.001 vs TNF-α + ALKBH5 group; ## P < 0.01 vs TNF-α + ALKBH5 + Bcl2 group; ### P < 0.001 vs TNF-α + ALKBH5 + Bcl2 group.

3.5 ALKBH5 inhibits the maturation of miR-7 in HUVECs

Previous study has shown that ALKBH5 promoted the expression of Bcl2 through regulating miR-7 in ovarian cancer [18]. Therefore, we detected the levels of miR-7 and pri-miR-7 in ALKBH5 overexpressed HUVECs by qPCR. As shown in Figure 4i and j, after ALKBH5 overexpression, miR-7 level increased significantly, while the level of pri-miR-7 decreased significantly compared with the control cells. Then, miR-7 mimic was transfected into HUVECs with the negative mimic as the control. As shown in Figure 4k, Bcl2 expression was significantly inhibited by miR-7 mimic. Combined with previous reports, we hypothesized that ALKBH5 might regulate the maturation of miR-7 through m6A modification, thereby regulating the expression of Bcl-2.

4 Discussion

In the present research, we investigated the specific role of demethylase ALKBH5 on TNF-α-induced vascular endothelial injury. ALKBH5 was identified as an RNA demethylase in 2013 [20,21]. It belongs to the α-ketoglutarate-dependent dioxygenase family and catalyzes the demethylation of m6A in a Fe(ii) and α-ketoglutarate-dependent manner. The modification and regulation of mRNA by M6A involves a variety of cellular processes, including mRNA splicing, export, localization, translation, and stability [22]. When methyltransferase is absent or demethylase is abnormal, it can affect cell development, differentiation, and metabolism. Therefore, the abnormality of m6A modification mechanism is related to a variety of human diseases [22]. Studies have shown that m6A methylation is relatively active in cardiomyocytes. In primary rat cardiomyocytes, 3,922 signal peaks of m6A methylation modification were detected [23]. In normal mouse myocardium, 24% of the transcripts can be detected with m6A methylation modification signals [24]. M6A methylation has been found to be closely related to common heart diseases such as cardiac hypertrophy, heart failure, and arrhythmia [24,25,26]. Importantly, m6A methylation is also associated with myocardial ischemic damage and hereditary heart disease [12,17,27].

According to our results, the expression level of demethylase ALKBH5 was significantly decreased in TNF-α-treated HUVECs. Importantly, ALKBH5 overexpression promoted proliferation and inhibited the apoptosis in TNF-α-treated HUVECs, suggesting that ALKBH5 could protect cells from TNF-α-induced cell injury. At present, there are few reports on the role and mechanism of m6A methylation related genes in AS. The expression of METTL14 and m6A level is significantly upregulated in atherosclerotic vascular endothelial cells (ASVEC). METTL14 promotes cell viability through promoting the processing of mature miR-19a [14]. In an analysis between m6A-associated single nucleotide polymorphisms (SNP) and blood pressure, approximately 10% of the blood pressure-associated m6A SNPs are correlated with stroke or coronary artery disease [28]. In another analysis, coronary artery disease (CAD)-associated m6A-SNPs are identified [29].

We further found that ALKBH5 could promote the expression of Bcl-2 in HUVECs. At the same time, high expression of Bcl2 reduced the expression of GADD45, Bax, and p21, which are transcriptionally activated by p53, but the expression of p53 has not been significantly affected. Based on the above results, we hypothesized that Bcl2 can regulate apoptosis by inhibiting the transcriptional activation of p53. However, there is no more evidence that the transcriptional activity of p53 is directly inhibited by ALKBH5, which still needs further experimental research. Several studies have shown that ALKBH5 inhibits Bcl2 degradation by reducing m6A modification, thereby regulating cell apoptosis in ovarian cancer, hepatocellular carcinoma and cerebral ischemia-reperfusion injury [17,18,19]. However, the specific pathway of this effect remains to be explored.

In the present research, we also explored the mechanism by which ALKBH5 promotes the expression of Bcl2. Previous studies have shown that ALKBH5 can regulate the expression of Bcl2 through miR-7, but the specific mechanism is still unclear [18]. In this study, we detected the levels of miR-7 and pri-miR-7 after ALKBH5 overexpression, and the results showed that ALKBH5 overexpression significantly increased the level of pri-miR-7 and decreased the level of miR-7. M6A-modified pri-miRNA can be recognized and processed by RNA-binding proteins, resulting in a decrease in mature miRNA expression and an increase in unprocessed pri-miRNA [30,31]. Therefore, we hypothesized that ALKBH5 may inhibit miR-7 maturation through m6A modification, thereby promoting Bcl2 levels. But this hypothesis needs further experimental confirmation.

5 Conclusion

ALKBH5 was downregulated in TNF-α-treated HUVECs and attenuated the TNF-α-induced cell injury through promoting the expression of Bcl2. This research expands our understanding of the progression mechanism of AS and provides potential treatment strategies for AS.

Acknowledgments

Not applicable.

  1. Funding information: Not applicable.

  2. Conflict of interest: The authors declare that they have no competing interests exist.

  3. Data availability statement: The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2021-06-28
Revised: 2022-03-28
Accepted: 2022-04-15
Published Online: 2022-06-15

© 2022 Xiaoshan Zhang et al., published by De Gruyter

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

Articles in the same Issue

  1. Research Articles
  2. AMBRA1 attenuates the proliferation of uveal melanoma cells
  3. A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma
  4. Differences in complications between hepatitis B-related cirrhosis and alcohol-related cirrhosis
  5. Effect of gestational diabetes mellitus on lipid profile: A systematic review and meta-analysis
  6. Long noncoding RNA NR2F1-AS1 stimulates the tumorigenic behavior of non-small cell lung cancer cells by sponging miR-363-3p to increase SOX4
  7. Promising novel biomarkers and candidate small-molecule drugs for lung adenocarcinoma: Evidence from bioinformatics analysis of high-throughput data
  8. Plasmapheresis: Is it a potential alternative treatment for chronic urticaria?
  9. The biomarkers of key miRNAs and gene targets associated with extranodal NK/T-cell lymphoma
  10. Gene signature to predict prognostic survival of hepatocellular carcinoma
  11. Effects of miRNA-199a-5p on cell proliferation and apoptosis of uterine leiomyoma by targeting MED12
  12. Does diabetes affect paraneoplastic thrombocytosis in colorectal cancer?
  13. Is there any effect on imprinted genes H19, PEG3, and SNRPN during AOA?
  14. Leptin and PCSK9 concentrations are associated with vascular endothelial cytokines in patients with stable coronary heart disease
  15. Pericentric inversion of chromosome 6 and male fertility problems
  16. Staple line reinforcement with nebulized cyanoacrylate glue in laparoscopic sleeve gastrectomy: A propensity score-matched study
  17. Retrospective analysis of crescent score in clinical prognosis of IgA nephropathy
  18. Expression of DNM3 is associated with good outcome in colorectal cancer
  19. Activation of SphK2 contributes to adipocyte-induced EOC cell proliferation
  20. CRRT influences PICCO measurements in febrile critically ill patients
  21. SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis
  22. lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells
  23. circ_AKT3 knockdown suppresses cisplatin resistance in gastric cancer
  24. Prognostic value of nicotinamide N-methyltransferase in human cancers: Evidence from a meta-analysis and database validation
  25. GPC2 deficiency inhibits cell growth and metastasis in colon adenocarcinoma
  26. A pan-cancer analysis of the oncogenic role of Holliday junction recognition protein in human tumors
  27. Radiation increases COL1A1, COL3A1, and COL1A2 expression in breast cancer
  28. Association between preventable risk factors and metabolic syndrome
  29. miR-29c-5p knockdown reduces inflammation and blood–brain barrier disruption by upregulating LRP6
  30. Cardiac contractility modulation ameliorates myocardial metabolic remodeling in a rabbit model of chronic heart failure through activation of AMPK and PPAR-α pathway
  31. Quercitrin protects human bronchial epithelial cells from oxidative damage
  32. Smurf2 suppresses the metastasis of hepatocellular carcinoma via ubiquitin degradation of Smad2
  33. circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury
  34. Sonoclot’s usefulness in prediction of cardiopulmonary arrest prognosis: A proof of concept study
  35. Four drug metabolism-related subgroups of pancreatic adenocarcinoma in prognosis, immune infiltration, and gene mutation
  36. Decreased expression of miR-195 mediated by hypermethylation promotes osteosarcoma
  37. LMO3 promotes proliferation and metastasis of papillary thyroid carcinoma cells by regulating LIMK1-mediated cofilin and the β-catenin pathway
  38. Cx43 upregulation in HUVECs under stretch via TGF-β1 and cytoskeletal network
  39. Evaluation of menstrual irregularities after COVID-19 vaccination: Results of the MECOVAC survey
  40. Histopathologic findings on removed stomach after sleeve gastrectomy. Do they influence the outcome?
  41. Analysis of the expression and prognostic value of MT1-MMP, β1-integrin and YAP1 in glioma
  42. Optimal diagnosis of the skin cancer using a hybrid deep neural network and grasshopper optimization algorithm
  43. miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells
  44. Clinical value of SIRT1 as a prognostic biomarker in esophageal squamous cell carcinoma, a systematic meta-analysis
  45. circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8
  46. miR-22-5p regulates the self-renewal of spermatogonial stem cells by targeting EZH2
  47. hsa-miR-340-5p inhibits epithelial–mesenchymal transition in endometriosis by targeting MAP3K2 and inactivating MAPK/ERK signaling
  48. circ_0085296 inhibits the biological functions of trophoblast cells to promote the progression of preeclampsia via the miR-942-5p/THBS2 network
  49. TCD hemodynamics findings in the subacute phase of anterior circulation stroke patients treated with mechanical thrombectomy
  50. Development of a risk-stratification scoring system for predicting risk of breast cancer based on non-alcoholic fatty liver disease, non-alcoholic fatty pancreas disease, and uric acid
  51. Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway
  52. circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis
  53. Human amniotic fluid as a source of stem cells
  54. lncRNA NONRATT013819.2 promotes transforming growth factor-β1-induced myofibroblastic transition of hepatic stellate cells by miR24-3p/lox
  55. NORAD modulates miR-30c-5p-LDHA to protect lung endothelial cells damage
  56. Idiopathic pulmonary fibrosis telemedicine management during COVID-19 outbreak
  57. Risk factors for adverse drug reactions associated with clopidogrel therapy
  58. Serum zinc associated with immunity and inflammatory markers in Covid-19
  59. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies
  60. LncRNA expression in idiopathic achalasia: New insight and preliminary exploration into pathogenesis
  61. Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway
  62. Moscatilin suppresses the inflammation from macrophages and T cells
  63. Zoledronate promotes ECM degradation and apoptosis via Wnt/β-catenin
  64. Epithelial-mesenchymal transition-related genes in coronary artery disease
  65. The effect evaluation of traditional vaginal surgery and transvaginal mesh surgery for severe pelvic organ prolapse: 5 years follow-up
  66. Repeated partial splenic artery embolization for hypersplenism improves platelet count
  67. Low expression of miR-27b in serum exosomes of non-small cell lung cancer facilitates its progression by affecting EGFR
  68. Exosomal hsa_circ_0000519 modulates the NSCLC cell growth and metastasis via miR-1258/RHOV axis
  69. miR-455-5p enhances 5-fluorouracil sensitivity in colorectal cancer cells by targeting PIK3R1 and DEPDC1
  70. The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture
  71. Isocitrate dehydrogenase 1 mutation in cholangiocarcinoma impairs tumor progression by sensitizing cells to ferroptosis
  72. Artemisinin protects against cerebral ischemia and reperfusion injury via inhibiting the NF-κB pathway
  73. A 16-gene signature associated with homologous recombination deficiency for prognosis prediction in patients with triple-negative breast cancer
  74. Lidocaine ameliorates chronic constriction injury-induced neuropathic pain through regulating M1/M2 microglia polarization
  75. MicroRNA 322-5p reduced neuronal inflammation via the TLR4/TRAF6/NF-κB axis in a rat epilepsy model
  76. miR-1273h-5p suppresses CXCL12 expression and inhibits gastric cancer cell invasion and metastasis
  77. Clinical characteristics of pneumonia patients of long course of illness infected with SARS-CoV-2
  78. circRNF20 aggravates the malignancy of retinoblastoma depending on the regulation of miR-132-3p/PAX6 axis
  79. Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis
  80. Rack1 regulates pro-inflammatory cytokines by NF-κB in diabetic nephropathy
  81. Comprehensive analysis of molecular mechanism and a novel prognostic signature based on small nuclear RNA biomarkers in gastric cancer patients
  82. Smog and risk of maternal and fetal birth outcomes: A retrospective study in Baoding, China
  83. Let-7i-3p inhibits the cell cycle, proliferation, invasion, and migration of colorectal cancer cells via downregulating CCND1
  84. β2-Adrenergic receptor expression in subchondral bone of patients with varus knee osteoarthritis
  85. Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia
  86. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria
  87. Potential biomarkers for inflammatory response in acute lung injury
  88. A low serum uric acid concentration predicts a poor prognosis in adult patients with candidemia
  89. Antitumor activity of recombinant oncolytic vaccinia virus with human IL2
  90. ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs through Bcl-2 pathway
  91. Risk prediction of cardiovascular disease using machine learning classifiers
  92. Value of ultrasonography parameters in diagnosing polycystic ovary syndrome
  93. Bioinformatics analysis reveals three key genes and four survival genes associated with youth-onset NSCLC
  94. Identification of autophagy-related biomarkers in patients with pulmonary arterial hypertension based on bioinformatics analysis
  95. Protective effects of glaucocalyxin A on the airway of asthmatic mice
  96. Overexpression of miR-100-5p inhibits papillary thyroid cancer progression via targeting FZD8
  97. Bioinformatics-based analysis of SUMOylation-related genes in hepatocellular carcinoma reveals a role of upregulated SAE1 in promoting cell proliferation
  98. Effectiveness and clinical benefits of new anti-diabetic drugs: A real life experience
  99. Identification of osteoporosis based on gene biomarkers using support vector machine
  100. Tanshinone IIA reverses oxaliplatin resistance in colorectal cancer through microRNA-30b-5p/AVEN axis
  101. miR-212-5p inhibits nasopharyngeal carcinoma progression by targeting METTL3
  102. Association of ST-T changes with all-cause mortality among patients with peripheral T-cell lymphomas
  103. LINC00665/miRNAs axis-mediated collagen type XI alpha 1 correlates with immune infiltration and malignant phenotypes in lung adenocarcinoma
  104. The perinatal factors that influence the excretion of fecal calprotectin in premature-born children
  105. Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study
  106. Does the use of 3D-printed cones give a chance to postpone the use of megaprostheses in patients with large bone defects in the knee joint?
  107. lncRNA HAGLR modulates myocardial ischemia–reperfusion injury in mice through regulating miR-133a-3p/MAPK1 axis
  108. Protective effect of ghrelin on intestinal I/R injury in rats
  109. In vivo knee kinematics of an innovative prosthesis design
  110. Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis
  111. lncRNA WT1-AS attenuates hypoxia/ischemia-induced neuronal injury during cerebral ischemic stroke via miR-186-5p/XIAP axis
  112. Correlation of cardiac troponin T and APACHE III score with all-cause in-hospital mortality in critically ill patients with acute pulmonary embolism
  113. LncRNA LINC01857 reduces metastasis and angiogenesis in breast cancer cells via regulating miR-2052/CENPQ axis
  114. Endothelial cell-specific molecule 1 (ESM1) promoted by transcription factor SPI1 acts as an oncogene to modulate the malignant phenotype of endometrial cancer
  115. SELENBP1 inhibits progression of colorectal cancer by suppressing epithelial–mesenchymal transition
  116. Visfatin is negatively associated with coronary artery lesions in subjects with impaired fasting glucose
  117. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis
  118. Neonatal stroke surveillance study protocol in the United Kingdom and Republic of Ireland
  119. Oncogenic role of TWF2 in human tumors: A pan-cancer analysis
  120. Mean corpuscular hemoglobin predicts the length of hospital stay independent of severity classification in patients with acute pancreatitis
  121. Association of gallstone and polymorphisms of UGT1A1*27 and UGT1A1*28 in patients with hepatitis B virus-related liver failure
  122. TGF-β1 upregulates Sar1a expression and induces procollagen-I secretion in hypertrophic scarring fibroblasts
  123. Antisense lncRNA PCNA-AS1 promotes esophageal squamous cell carcinoma progression through the miR-2467-3p/PCNA axis
  124. NK-cell dysfunction of acute myeloid leukemia in relation to the renin–angiotensin system and neurotransmitter genes
  125. The effect of dilution with glucose and prolonged injection time on dexamethasone-induced perineal irritation – A randomized controlled trial
  126. miR-146-5p restrains calcification of vascular smooth muscle cells by suppressing TRAF6
  127. Role of lncRNA MIAT/miR-361-3p/CCAR2 in prostate cancer cells
  128. lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2
  129. Noninvasive diagnosis of AIH/PBC overlap syndrome based on prediction models
  130. lncRNA FAM230B is highly expressed in colorectal cancer and suppresses the maturation of miR-1182 to increase cell proliferation
  131. circ-LIMK1 regulates cisplatin resistance in lung adenocarcinoma by targeting miR-512-5p/HMGA1 axis
  132. LncRNA SNHG3 promoted cell proliferation, migration, and metastasis of esophageal squamous cell carcinoma via regulating miR-151a-3p/PFN2 axis
  133. Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic
  134. lncRNA-AC130710/miR-129-5p/mGluR1 axis promote migration and invasion by activating PKCα-MAPK signal pathway in melanoma
  135. SNRPB promotes cell cycle progression in thyroid carcinoma via inhibiting p53
  136. Xylooligosaccharides and aerobic training regulate metabolism and behavior in rats with streptozotocin-induced type 1 diabetes
  137. Serpin family A member 1 is an oncogene in glioma and its translation is enhanced by NAD(P)H quinone dehydrogenase 1 through RNA-binding activity
  138. Silencing of CPSF7 inhibits the proliferation, migration, and invasion of lung adenocarcinoma cells by blocking the AKT/mTOR signaling pathway
  139. Ultrasound-guided lumbar plexus block versus transversus abdominis plane block for analgesia in children with hip dislocation: A double-blind, randomized trial
  140. Relationship of plasma MBP and 8-oxo-dG with brain damage in preterm
  141. Identification of a novel necroptosis-associated miRNA signature for predicting the prognosis in head and neck squamous cell carcinoma
  142. Delayed femoral vein ligation reduces operative time and blood loss during hip disarticulation in patients with extremity tumors
  143. The expression of ASAP3 and NOTCH3 and the clinicopathological characteristics of adult glioma patients
  144. Longitudinal analysis of factors related to Helicobacter pylori infection in Chinese adults
  145. HOXA10 enhances cell proliferation and suppresses apoptosis in esophageal cancer via activating p38/ERK signaling pathway
  146. Meta-analysis of early-life antibiotic use and allergic rhinitis
  147. Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas
  148. HPV16 E6E7 up-regulates KIF2A expression by activating JNK/c-Jun signal, is beneficial to migration and invasion of cervical cancer cells
  149. Amino acid profiles in the tissue and serum of patients with liver cancer
  150. Pain in critically ill COVID-19 patients: An Italian retrospective study
  151. Immunohistochemical distribution of Bcl-2 and p53 apoptotic markers in acetamiprid-induced nephrotoxicity
  152. Estradiol pretreatment in GnRH antagonist protocol for IVF/ICSI treatment
  153. Long non-coding RNAs LINC00689 inhibits the apoptosis of human nucleus pulposus cells via miR-3127-5p/ATG7 axis-mediated autophagy
  154. The relationship between oxygen therapy, drug therapy, and COVID-19 mortality
  155. Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data
  156. SETD1A promotes the proliferation and glycolysis of nasopharyngeal carcinoma cells by activating the PI3K/Akt pathway
  157. The role of Shunaoxin pills in the treatment of chronic cerebral hypoperfusion and its main pharmacodynamic components
  158. TET3 governs malignant behaviors and unfavorable prognosis of esophageal squamous cell carcinoma by activating the PI3K/AKT/GSK3β/β-catenin pathway
  159. Associations between morphokinetic parameters of temporary-arrest embryos and the clinical prognosis in FET cycles
  160. Long noncoding RNA WT1-AS regulates trophoblast proliferation, migration, and invasion via the microRNA-186-5p/CADM2 axis
  161. The incidence of bronchiectasis in chronic obstructive pulmonary disease
  162. Integrated bioinformatics analysis shows integrin alpha 3 is a prognostic biomarker for pancreatic cancer
  163. Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway
  164. Comparison of hospitalized patients with severe pneumonia caused by COVID-19 and influenza A (H7N9 and H1N1): A retrospective study from a designated hospital
  165. lncRNA ZFAS1 promotes intervertebral disc degeneration by upregulating AAK1
  166. Pathological characteristics of liver injury induced by N,N-dimethylformamide: From humans to animal models
  167. lncRNA ELFN1-AS1 enhances the progression of colon cancer by targeting miR-4270 to upregulate AURKB
  168. DARS-AS1 modulates cell proliferation and migration of gastric cancer cells by regulating miR-330-3p/NAT10 axis
  169. Dezocine inhibits cell proliferation, migration, and invasion by targeting CRABP2 in ovarian cancer
  170. MGST1 alleviates the oxidative stress of trophoblast cells induced by hypoxia/reoxygenation and promotes cell proliferation, migration, and invasion by activating the PI3K/AKT/mTOR pathway
  171. Bifidobacterium lactis Probio-M8 ameliorated the symptoms of type 2 diabetes mellitus mice by changing ileum FXR-CYP7A1
  172. circRNA DENND1B inhibits tumorigenicity of clear cell renal cell carcinoma via miR-122-5p/TIMP2 axis
  173. EphA3 targeted by miR-3666 contributes to melanoma malignancy via activating ERK1/2 and p38 MAPK pathways
  174. Pacemakers and methylprednisolone pulse therapy in immune-related myocarditis concomitant with complete heart block
  175. miRNA-130a-3p targets sphingosine-1-phosphate receptor 1 to activate the microglial and astrocytes and to promote neural injury under the high glucose condition
  176. Review Articles
  177. Current management of cancer pain in Italy: Expert opinion paper
  178. Hearing loss and brain disorders: A review of multiple pathologies
  179. The rationale for using low-molecular weight heparin in the therapy of symptomatic COVID-19 patients
  180. Amyotrophic lateral sclerosis and delayed onset muscle soreness in light of the impaired blink and stretch reflexes – watch out for Piezo2
  181. Interleukin-35 in autoimmune dermatoses: Current concepts
  182. Recent discoveries in microbiota dysbiosis, cholangiocytic factors, and models for studying the pathogenesis of primary sclerosing cholangitis
  183. Advantages of ketamine in pediatric anesthesia
  184. Congenital adrenal hyperplasia. Role of dentist in early diagnosis
  185. Migraine management: Non-pharmacological points for patients and health care professionals
  186. Atherogenic index of plasma and coronary artery disease: A systematic review
  187. Physiological and modulatory role of thioredoxins in the cellular function
  188. Case Reports
  189. Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series
  190. A case of successful pembrolizumab monotherapy in a patient with advanced lung adenocarcinoma: Use of multiple biomarkers in combination for clinical practice
  191. Unusual neurological manifestations of bilateral medial medullary infarction: A case report
  192. Atypical symptoms of malignant hyperthermia: A rare causative mutation in the RYR1 gene
  193. A case report of dermatomyositis with the missed diagnosis of non-small cell lung cancer and concurrence of pulmonary tuberculosis
  194. A rare case of endometrial polyp complicated with uterine inversion: A case report and clinical management
  195. Spontaneous rupturing of splenic artery aneurysm: Another reason for fatal syncope and shock (Case report and literature review)
  196. Fungal infection mimicking COVID-19 infection – A case report
  197. Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
  198. Paraganglioma-induced inverted takotsubo-like cardiomyopathy leading to cardiogenic shock successfully treated with extracorporeal membrane oxygenation
  199. Lineage switch from lymphoma to myeloid neoplasms: First case series from a single institution
  200. Trismus during tracheal extubation as a complication of general anaesthesia – A case report
  201. Simultaneous treatment of a pubovesical fistula and lymph node metastasis secondary to multimodal treatment for prostate cancer: Case report and review of the literature
  202. Two case reports of skin vasculitis following the COVID-19 immunization
  203. Ureteroiliac fistula after oncological surgery: Case report and review of the literature
  204. Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
  205. Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
  206. Commentary
  207. Commentary on “Clinicopathological features of programmed cell death-ligand 1 expression in patients with oral squamous cell carcinoma”
  208. Rapid Communication
  209. COVID-19 fear, post-traumatic stress, growth, and the role of resilience
  210. Erratum
  211. Erratum to “Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway”
  212. Erratum to “Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study”
  213. Erratum to “lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2”
  214. Retraction
  215. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  216. Retraction to “miR-519d downregulates LEP expression to inhibit preeclampsia development”
  217. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part II
  218. Usefulness of close surveillance for rectal cancer patients after neoadjuvant chemoradiotherapy
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