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  • Xiaoxue WANG, Jun HUANG, Danxu YIN, Yuhao DENG, Zusheng ZHENG, Fanghui WU, Tao WANG
    Journal of Army Medical University. 2025, 47(7): 742-748.
    Objective‍

    To explore the behavioral characteristics of using cognitive reappraisal (CR) and expressive suppression (ES) in high trait anxiety individuals under both explicit and implicit conditions.

    Methods‍

    A total of 57 non-psychology undergraduates and postgraduates were recruited in a military medical university from June to July in 2023. All the participants were surveyed with Trait Form of Spielberger’s State-Trait Anxiety Inventory (STAI-T) and Emotion Regulation Questionnaire (ERQ) to investigate their level of anxiety and usage habits of CR and ES strategies. According to the STAI-T results, they were divided to a high trait anxiety (HTA) group (n=28) and a low trait anxiety (LTA) group (n=29). Then the implicit and explicit emotion regulation (ER) tasks were used to analyze and compare 2 strategies on improving negative emotional pleasure and arousal, and the differences in difficulty and success of using CR and ES under the explicit condition.

    Results‍

    ① Both the HTA and LTA individuals showed a higher use of CR and less use of ES [t(27)=3.94, P<0.001; t(28)=11.33, P<0.001], while the HTA individuals used more ES [t(55)=3.02, P<0.01] and less CR than the LTA individuals [t(55)=-2.20, P=0.02]. ②Compared with implicit neutral priming, both implicit CR (Pleasure: 2.56±0.11 vs 2.73±0.12, P<0.01; Arousal: 6.68±0.18 vs 6.51±0.20, P<0.05) and implicit ES priming (Pleasure: 2.56±0.11 vs 2.86±0.11,P<0.001; Arousal: 6.68±0.18 vs 6.30±0.20, P<0.001) improved the negative emotional experiences of both HTA and LTA groups, and ES showed better effect (Pleasure: P<0.001; Arousal: P<0.001). ③ Explicit CR (Pleasure: 2.92±0.12 vs 5.09±0.09, P<0.001; Arousal: 6.43±0.20 vs 4.33±0.21, P<0.001) and explicit ES (Pleasure: 2.92±0.12 vs 4.34±0.09, P<0.001; Arousal: 6.43±0.20 vs 4.22±0.22, P<0.001) ameliorated the negative feelings in the HTA and LTA individuals, and the effect of explicit CR on improving pleasure was superior than that of explicit ES (P<0.001). For the HTA individuals, it is more difficult to implement CR and ES [CR: t(55)=2.16, P=0.02; ES: t(55)=2.92, P<0.01], and ES was less successful in emotion regulation when compared with the LTA individuals [t(55)=-1.88, P=0.03]; the difficulty of using ES was significantly higher than that of CR [4.00±1.81 vs 5.00±1.80, t(27)=-2.78, P<0.01], and the success rate was also lower [7.04±1.00 vs 6.64±1.13, t(27)=2.09, P=0.02]. ④ Comparing the effects of emotion regulation under implicit and explicit conditions, it was presented that explicit CR and ES were better than implicit CR and ES for both HTA and LTA individuals (Pleasure: explicit CR vs implicit CR: 5.09±0.09 vs 2.73±0.12, P<0.001; explicit ES vs implicit ES: 4.34±0.09 vs 2.86±0.11, P<0.001; Arousal: explicit CR vs implicit CR: 4.33±0.21 vs 6.51±0.20, P<0.001; explicit ES vs implicit ES: 4.22±0.22 vs 6.30±0.20, P<0.001).

    Conclusion‍

    In terms of usage habits of ER strategies, HTA individuals tend to use ES more and CR less than LTA individuals. Under the implicit/explicit conditions, HTA individuals can both employ CR and ES to improve negative emotional experience, and the effect of explicit ER is significantly better than implicit condition.

  • Hangke LEI, Dingde HUANG
    Journal of Army Medical University. 2025, 47(6): 489-497.
    Objective‍

    To prepare reactive oxygen species (ROS) scavenging Ce6-Luminol encapsulated liposomes (CLL) and to explore the protective effect of CLL against radiation pneumonitis in mice.

    Methods‍

    ROS scavenging material Ce6-Luminol was chemically synthesized, and then was encapsulated using liposome technology to prepare ROS scavenging CLL liposomes. A laser particle size analyzer was used to characterize particle size, polydispersity index, and zeta potential of prepared CLL liposomes. Flow cytometry was employed to detect the uptake of CLL by A549 cells, HUVEC and Raw 264.7 cells, respectively, and CCK-8 assay was utilized to evaluate the cell viability after CLL uptake. The distribution of CLL in the lung tissue of mouse model of radiation lung injury was investigated using In Vivo Imaging System (IVIS). A total of 75 male C57BL/6J mice (6~8 weeks old, 17~19 g) were randomly divided into a normal control group (Normal) and CLL treatment groups (0, 2, 10, and 50 mg/kg), with 15 animal in each group. After the mice in the CLL treatment groups received 15 Gy X-ray irradiation on their chests, they received CLL injection at the corresponding through tail vein on days 0.25, 3, and 5 post-irradiation. Then on day 7 post-irradiation, the contents of H2O2, inflammatory cytokines TNF-α and IL-1β, and chemokines monocyte chemoattractant protein (MCP-1) and keratinocyte chemoattractant (KC) in lung tissue, and the proportion of neutrophils in bronchoalveolar lavage fluid (BALF) were measured to evaluate the efficacy of CLL in treatment of radiation pneumonitis in mice.

    Results‍

    The ROS scavenging material Ce6-Luminol was successfully synthesized, and CLL liposomes were prepared, with an average particle size of 127.8±0.5 nm, a polydispersity index of 0.164±0.005, and a Zeta potential of -23.6±1.4 mV. The prepared CLL liposomes were taken up by A549 cells, HUVEC and Raw264.7 cells in a time- and dose-dependent manner, without a sharply decrease in cell viability. IVIS revealed that there were significantly more CLL liposomes distributed in the lung tissues of radiation pneumonitis mice than in normal mice (F=351.741, P<0.05). CLL intervention significantly reduced the lung contents of H2O2 (F=15.183, P<0.05), TNF-α (F=5.150, P<0.05), IL-1β (F=10.036, P<0.05), MCP-1 (F=3.777, P<0.05) and KC (F=3.755, P<0.05), and the proportion of neutrophils in BALF (F=17.751, P<0.05) from the radiation pneumonitis mice.

    Conclusion‍

    ROS scavenging CLL liposomes can alleviate radiation pneumonitis in mice, which may be due to the protective role against radiation pneumonitis.

  • Paiyu LIU, Mengjie ZHANG, Jitao ZENG, Bing NI
    Journal of Army Medical University. 2025, 47(6): 498-505.
    Objective‍

    To explore the role and underlying mechanism of the transcriptional coactivator with PDZ-binding motif (TAZ) and a histone variant of acute histone H2A (H2A.Z) in the repair of hypoxia-induced lung injury.

    Methods‍

    A mouse model of hypoxic lung injury was established by being placed in a hypoxia chamber (simulating an altitude of 5 800 m) for 4 d. HE staining was used to observe the severity of lung injury. A hypoxia model of murine alveolar epithelial cells (murine lung epithelial-12, MLE12) was constructed by treating the cells in a hypoxia workstation (1%O2 concentration) for 24 h. Western blotting was employed to detect TAZ expression. The proliferation of alveolar epithelial cells (AECs) was evaluated by CCK-8 assay. Co-immunoprecipitation (Co-IP) assay was utilized to verify the interaction between TAZ and H2A.Z. CUT&Tag sequencing was performed to determine the effect of TAZ on the chromatin deposition of H2A.Z.

    Results‍

    Hypoxia significantly induced alveolar atrophy and inflammatory infiltration in mouse lung tissues(P<0.01). Hypoxia significantly up-regulated the protein level of TAZ in MLE12 cells (P<0.05). CCK-8 assay showed that knockdown of TAZ significantly reduced the proliferative capacity of AECs (P<0.01). Co-IP assay confirmed the physical interaction between TAZ and H2A.Z. CUT&Tag sequencing revealed that hypoxia promoted the deposition of H2A.Z on chromatin (31 817 peaks under normoxia, 44 078 peaks under hypoxia), which was partially reversed by TAZ knockdown (37 840 peaks).

    Conclusion‍

    Hypoxia significantly up-regulates the expression of TAZ, which combines with H2A.Z and promotes the deposition of H2A.Z on chromatin, thus enhancing the proliferation of AECs in response to hypoxic injury.

  • Wenbin XIN, Qian BAI, Xiangmin NI, Rongjiang HUANG, Xinyu LIANG, Mantian MI, Jian WANG
    Journal of Army Medical University. 2025, 47(6): 506-518.
    Objective‍

    To explore the efficacy of a compound nutrition preparation on wound healing after acute trauma and investigate the underlying mechanism primarily.

    Methods‍

    After skin wound model was successfully constructed on totally 60 male SD rats surgically, they were randomly divided into control group (CON group), whey protein group (WP group) and low- and high-dose nutritional formula groups (LDF and HDF groups), with 15 animals in per group. From the next day after surgery, the rats in each group were given corresponding nutritional interventions for 2 weeks. During the intervention, the wound conditions were observed and recorded, and the wound area was measured. The samples were collected on the 3rd, 7th and 14th days after surgery, respectively. Serum albumin (ALB), prealbumin (PA), total protein (TP), inflammatory factors (TNF-α, IL-1β, IL-6 and IL-10), immunoglobulins (IgA, IgG and IgM) and hydroxyproline (Hyp) were detected by the corresponding reagent kits. The histopathologic changes of wound were observed with HE staining. Masson staining was used to observe the collagen fiber deposition in wound tissue. The angiogenesis of wound tissue was evaluated by immunohistochemical staining.

    Results‍

    Compared with the CON group, the wound healing speed, collagen synthesis and angiogenesis speed were significantly accelerated in the WP group, LDF group and HDF group (P<0.05), and the effects were the most obvious in the HDF group. On the 3rd day after surgery, in the WP, LDF and HDF groups, the serum ALB, PA and TP levels were significantly increased (P<0.05), serum TNF-α and IL-1β levels were obviously decreased (P<0.05), and serum IL-10 level was notably increased (except WP group) when compared with the CON group. The serum IgG and IgM levels were significantly increased in the LDF group and HDF group (P<0.05) and significant increment of IgA was only observed in the HDF group (P<0.05). On the 7th day after modeling, the levels of ALB, PA and TP were significantly increased (P<0.05), the levels of TNF-α, IL-1β and IL-6 were obviously decreased (P<0.05), and the levels of IL-10 were remarkably increased (P<0.05) in the HDF group than the CON group; The LDF group and HDF group had significantly elevated serum IgG and IgM levels (P<0.05), but only the former group had statistically increased serum IgA level (P<0.05). On the 14th day after modeling, the HDF group had significantly increased levels of ALB and TP (P<0.05), decreased levels of IL-1β (P<0.05), and raised levels of IgG and IgM when compared with the CON group (P<0.05).

    Conclusion‍

    Our compound nutrition preparation promotes wound healing in rat model of acute trauma, which might be related to its improving the nutritional status, promoting collagen synthesis, and thus alleviating inflammatory response and enhancing immune function.

  • Wenjun XIA, Yao LU, Huang WU, Aiqing WEN, Wei CHEN
    Journal of Army Medical University. 2025, 47(6): 519-530.
    Objective‍

    To investigate the effects and underlying mechanisms of down-regulating m6A demethylase fat mass and obesity-associated protein (FTO) on proplatelet formation in the MEG-01 megakaryocytic cells.

    Methods‍

    ①MEG-01 cells were treated with 1 nmol/L phorbol myristate acetate (PMA) (treatment group) or DMSO (control group) for 72 h. FTO expression was measured by Western blotting and RT-qPCR. ② MEG-01 cells were infected with targeted FTO shRNA (knockdown group, sh-FTO) or negative control shRNA (negative control group, sh-NC) viruses. FTO knockdown group and negative control group MEG-1 cells were treated with 1 nmol/L PMA for 72 h, and the protein and mRNA expression levels of FTO were detected by Western blotting and RT-qPCR. Cell cycle, viability and apoptosis were assessed by propidium iodide (PI) DNA staining, CCK-8 assay and Annexin V-FITC/PI double staining and TUNEL staining. The expression of cleaved Caspase-3 protein was determine by Western blotting. Megakaryocyte maturation was assessed by CD41/CD61 staining. Proplatelet formation was observed under bright field and detected by CD61 immunofluorescence assay. The expression of apoptosis-related molecules (Caspase3, BAD, BAK1, BCL2 and MCL1) was detected by RT-qPCR, and the protein change of BCL2 was further verified by Western blotting. The dataset was screened out from the gene expression omnibus (GEO) database, and then analyzed with University of California, Santa Cruz (UCSC) genome browser to compare the methylation sequencing peaks on BCL2 mRNA, and m6A methylated RNA immunoprecipitation (m6A-RIP) was used to assess the m6A methylation levels of BCL2 target gene mRNAs in MEG-01 megakaryocytes. Then, the changes in the m6A methylation enrichment level of BCL2 mRNA were observed between the sh-NC group and the sh-FTO group. mRNA stability and ribosome profiling assays were performed to assess translational efficiency of target genes.

    Results‍

    ①PMA treatment upregulated the expression of FTO at protein (P<0.05) and mRNA (P<0.01) levels. ② FTO shRNA resulted in reduced FTO expression at both mRNA and protein levels (P<0.01). Compared to the negative control group, the FTO knockdown group showed more cells arrested at the G1/S phase [(60.80±1.29)% vs (72.13±1.18)%, P<0.01], significantly reduced cell viability [(1.17±0.03)% vs (0.69±0.05)%, P<0.01], increased Annexin V-FITC/PI positive cells [(12.87±0.83)% vs (17.45±1.58)%, P<0.01], more TUNEL positive cells [(1.03±0.27)% vs (17.49±9.91)%, P<0.01], enhanced protein level of cleaved Caspase-3 (P<0.01), decreased proportion of CD41/CD61 positive cells [(51.63±1.13)% vs (34.08±0.53)%, P<0.01], and less proplatelet formation in MEG-01 megakaryocytes [(26.49±6.73)% vs (13.31±5.97)%, P<0.01]. ③Compared to sh-NC group, the FTO knockdown group had significantly decreased protein and mRNA expression of anti-apoptotic molecule BCL2 (P<0.01). UCSC GEO sequencing data revealed there were m6A methylation modification sites on BCL2 mRNA, which was verified through m6A-RIP experiment in MEG-01 megakaryocytes. Compared with GAPDH mRNA, BCL2 mRNA exhibited a significantly enriched m6A signal (P<0.01). Compared to sh-NC group, a significant increase in m6A methylation modification was observed on BCL2 mRNA. BCL2 mRNA stability was significantly decreased, and its translation efficiency significantly was decreased(P<0.01).

    Conclusion‍

    m6A demethylase FTO rgulates BCL2 mRNA stability and translation efficiency,thereby promoting proplatelet formation in MEG-01 megakaryocytes.

  • Xuemei CHEN, Jun ZHANG, Xin LI, Ran YAO, Deng LIU, Jiang FENG, Lin TAN, Yanli GUO
    Journal of Army Medical University. 2025, 47(6): 531-538.
    Objective‍

    To evaluate the effect of dapagliflozin on myocardial function in early spontaneously hypertensive rats (SHR) with layer-specific global longitudinal strain (GLS).

    Methods‍

    A total of 45 male SHR aged 6 weeks were randomly divided into control group (normal saline), dapagliflozin group [1 mg/(kg·day)], and losartan group [10 mg/(kg·day)]. Fifteen male Wistar-Kyoto (WKY) rats at same age with normal blood pressure were subjected and served as blank control group. During 8 weeks of intervention, systolic blood pressure (SBP) was measured, and conventional echocardiography and two-dimensional speckle tracking echocardiography (2DSTE) were performed and the results were collected to acquire the longitudinal strain of each layer of left ventricular (LV) myocardium. The parameters were compared among the groups. The pathological changes of myocardium were observed in each group of rats.

    Results‍

    Compared with the WKY group, LV ejection fraction (LVEF) and LV fraction shortening (LVFS) at week 8 were decreased in the control group (P<0.05), but no such decreases were observed in the dapagliflozin group and the losartan group. The GLS of endo-myocardium (GLSendo) at the 6th week was decreased, and GLSendo, GLSmid and GLSepi at the 8th week were all decreased in the control group than the WKY group (all P<0.05). But there were no statistical differences in the above 3 indicators in the dapagliflozin and losartan groups when compared with the WKY group (all P>0.05). The pathological results showed that myocardial interstitial fibrosis was observed in the control group at the 6th week.

    Conclusion‍

    Dapagliflozin can effectively improve myocardial function in early SHR.

  • Chenyu WANG, Zhizhou WU, li LIU, Yunhua XIAO, Xuequan HUANG
    Journal of Army Medical University. 2025, 47(6): 539-550.
    Objective‍

    To investigate the impact of serine/threonine-protein kinase 1(AKT1)-mediated autophagy in hepatocellular carcinoma (HCC) cells on their sensitivity to 125I seed irradiation.

    Methods‍

    ① iProX database and STRING12.0 website were utilized to analyze the proteomic data of HCC before and after 125I seed irradiation to explore the differentially expressed proteins and associated functional connections. Meanwhile, The Cancer Genomics Atlas (TCGA) database was employed to analyze the relationship between AKT1 expression level and the survival of HCC patients. ② Human HCC cell lines HUH7 and Hep3B were exposed to continuous irradiation from 125I radioactive seeds with an initial apparent activity of 0.8 mCi per seed for approximately 120 h, accumulating a total dose of 8 Gy, while the control cells were cultured under normal condition for 120 h. ③ Autophagy inhibitor, chloroquine (CQ) and inducer, rapamycin (RAPA) were used to treat the HCC cells respectively to establish the CQ group and the RAPA group. The lentiviral transfection technique was employed to construct the HCC cells with overexpressed AKT1, namely the AKT1 group. The HCC cells treated in the same way were continuously irradiated with 125I seeds for 120 h to construct the CQ+125I group, the RAPA+125I group, and the AKT1+125I group. ④The changes in microtubule-associated protein light chain 3 (LC3), p62, AKT1 and p-AKT1 were detected by Western blotting. Cell immunofluorescence assay was employed to observe the expression of autophagy related proteins, such as LC3. The colony forming ability and apoptotic rate were detected with plate cloning assay and flow cytometry.

    Results

    ① Continuous irradiation with 125I seeds resulted in decreased expression of p62 and increased ratio of LC3Ⅱ/LC3Ⅰ (P<0.05) when compared with the negative control (NC) group. Immunofluorescence assay revealed more green fluorescence spots of LC3. When compared with the 125I group, the CQ + 125I group had significantly increased expression of p62 (P<0.01), decreased ratio of LC3Ⅱ/LC3Ⅰ(P<0.01), lower apoptotic rate (P<0.01), and more colony formations (P<0.01). In contrast, the results in the RAPA + 125I group were opposite to those of the CQ + 125I group. ② Analysis on the iProX database showed that the expression of AKT1 was decreased in the irradiated group, and analysis on the TCGA database indicated that high expression of AKT1 predicted a poor prognosis for HCC patients (P<0.01). ③After irradiation with 125I seeds, the expression of AKT1 at both the RNA and protein levels was decreased in the 125I group (P<0.01). After overexpression of AKT1, the level of autophagy was decreased (P<0.05). Irradiation of HCC cells with overexpressed AKT1 using 125I seeds could partially restore the level of autophagy. In the AKT1 + 125I group, the expression of AKT1, pAKT1 and p62 were all decreased, and the ratio of LC3Ⅱ/LC3Ⅰ was increased than the AKT1 group (P<0.05). ④ The apoptotic rate of the AKT1 + 125I group was lower than that of the 125I group (P<0.05) and higher than that in the AKT1 group (P<0.05). In HUH7 cells, the clonogenic ability of the AKT1 + 125I group was higher than that of the 125I group (P<0.05). In Hep3B cells, the clonogenic ability of the AKT1 + 125I group was higher than that of the 125I group, and the clonogenic ability of the AKT1 group was higher than that of the NC group (P<0.05).

    Conclusion‍

    125I seed irradiation induce lethal autophagy in HCC cells by reducing the expression of AKT1, providing a new theoretical basis for the implantation of 125I radioactive seeds in the treatment of HCC.

  • Lei YANG, Na WU, Lanqing YANG, Yanxiu CHEN, Xinghua CHEN, Zhiquan YUAN, Chengying LI, Long WU, Yuhong ZENG, Yu WANG, Li ZHONG, Jingyuan YANG, Yafei LI
    Journal of Army Medical University. 2025, 47(6): 551-560.
    Objectives

    ‍To explore the association of peripheral blood PIWI-interacting RNA, piR-hsa-2700592, with all-cause mortality and stroke outcomes in patients with atrial fibrillation (AF), and to determine whether piR-hsa-2700592 has the potential to be an AF biomarker.

    Methods‍

    A total of 127 patients with non-valvular AF were enrolled, and the relative expression level of plasma piR-hsa-2700592 was detected. Cox proportional hazard regression was used to analyze the correlation between the expression of piR-hsa-2700592 and all-cause death as well as stroke outcome in the patients. Then the molecule expression level was combined with CHA2DS2-VASc score and ABC stroke (or death ) score to establish 2 new prediction models, the improvement of the predictive performance was compared and analyzed. Receiver operating characteristic (ROC) curve analysis (area under the curve, AUC), net reclassification index (NRI), and comprehensive discriminant improvement index (IDI) were used to evaluate the predictive performance, and decision curve analysis (DCA) was employed to assess the clinical benefit.

    Results‍

    Multivariate Cox regression analysis showed that the patients with higher expression level of piR-hsa-2700592 in peripheral blood had a higher risk of stroke (HR: 2.203, 95%CI: 1.120~4.332; P=0.022). In the stroke outcome, combination of plasma piR-hsa-2700592 expression level with CHA2DS2-VASc score and ABC stroke score obtained an AUC of 0.70 (95%CI: 0.55~0.85, P<0.001) and 0.84 (95%CI: 0.73~0.96, P=0.02), respectively. But, no significant association was observed between high plasma piR-hsa-2700592 level and all-cause mortality in the AF patients (HR: 1.997; 95%CI: 0.884~4.509; P=0.096). Combination of plasma piR-hsa-2700592 level improved the discriminative capability than the single CHA2DS2-VASc score and ABC stroke score models, with an NRI and IDI value of 44.20% (95%CI: 3.40~59.90, P<0.001) and 8.20% (95%CI: 0.60~15.40, P<0.001), respectively for the new CHA2DS2-VASc score model, and an NRI and IDI value of 44.20% (95%CI: 9.80~58.90, P<0.001) and 10.40% (95%CI: 0.70~21.40, P<0.001), respectively for the new ABC stroke score model. The DCA curve showed that both new prediction models obtained better net clinical benefits.

    Conclusion‍

    High peripheral blood expression of piR-hsa-2700592 is an independent risk factor for stroke in the AF patients, and the indicator has a good predictive value for prognosis of the patients. piR-hsa-2700592 might be used as a potential biomarker in the diagnosis and prevention of cardiovascular diseases.

  • Yan HAN, Yujie LI, Bin YI
    Journal of Army Medical University. 2025, 47(6): 561-570.
    Objective‍

    To investigate the influencing factors for post-hepatectomy liver failure (PHLF) in hepatocellular carcinoma (HCC) patients with HBV infection at low viral load, and then construct a risk prediction model.

    Methods‍

    A total of 403 HCC patients who underwent initial hepatectomy in the First Affiliated Hospital of Army Medical University between January 1, 2015 and March 1, 2023 were recruited, and randomly assigned into a training set and a verification set in a ratio of 7:3. Lasso regression and multivariate logistic regression analyses were applied to screen the risk factors for occurrence of PHLF, and based on these identified factors, a nomogram prediction model was constructed. Receiver operating characteristic (ROC) curve analysis (area under the curve, AUC), calibration curve analysis, decision curve analysis, and clinical impact curve analysis were preformed to assess the predictive efficacy of the model.

    Results‍

    History of anti-viral therapy, history of drinking, logHBsAg, and international normalized ratio (INR) were independent influencing factors for the occurrence of PHLF in HCC patients with HBV infection at low viral load. The model established based on these indicators demonstrated excellent discriminative capabilities in both the training and validation sets, with an AUC value of 0.744 and 0.737, respectively. Calibration curve analysis indicated our model of high accuracy (training: P=0.995; validation: P=0.701), and decision curve analysis and clinical impact curve analysis displayed that our model provided greater clinical benefit.

    Conclusion‍

    Our model can effectively evaluate the risk of PHLF in HCC patients with HBV infection at low viral load, and shows good predictive performance, which has certain guiding significance for timely identification of high-risk populations.

  • Tongkun YANG, Hongmei PENG, Yizhuo YANG, Yuan GAO, Sha MU, Mingli DONG, Jialin LIU
    Journal of Army Medical University. 2025, 47(6): 571-580.
    Objective‍

    To investigate the gene expression profile of cervical exfoliated cells from woman treated by artificial cycle, and their potential association with endometrial receptivity in order to screen specific biomarkers closely related to the receptivity.

    Methods‍

    A total of 19 female patients were enrolled from those preparing for frozen embryo transfer (FET) at the Reproductive Center of First Medical Center of Chinese PLA General Hospital from February 2024 to October 2024. Under the artificial cycle frozen embryo transfer protocol, the endometrial tissues were collected on the 4th day after progesterone administration (P+4) to verify their endometrial receptivity status. Additionally, cervical exfoliated cells were collected on the 4th day (P+4) and the 6th day (P+6) after progesterone administration. RNA sequencing (RNA-Seq) was used to detect gene expression profiles. Differentially expressed genes (DEGs) were identified using the criteria of |log2fold change| >1 and a false discovery rate (FDR) <0.05, followed by bioinformatics analysis. The protein-protein interaction (PPI) network of DEGs was constructed using R software (4.4.1) and analyzed with gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) analyses. The candidate genes were identified based on the PPI network using Cytoscape software. Quantitative reverse transcription PCR (RT-qPCR) was employed to validate the target candidate genes both in vitro and in vivo.

    Results‍

    The rsERT confirmed that all 19 women were in state of endometrial receptivity at P+6. RNA-Seq identified 3 458 DEGs in cervical exfoliated cells between P+4 and P+6. The up-regulated DEGs were mainly enriched in the pathways associated with immune response and cell differentiation, and the down-regulated ones were mainly enriched in the pathways associated with lipid metabolism and cell proliferation. Using maximal clique Centrality (MCC) algorithm in the PPI network, the top 20 genes were selected. Among them, 6 genes, such as IFIT2, OASL, MX1,RSAD2,IFIT1 and IFIT3, tied for the first place, and the 6 genes all belong to interferon-stimulated genes (ISGs). qRT-PCR indicated that the above 6 genes showed significantly higher expression levels in the cervical exfoliated cells at the P+4 stage than the cells at the P+6 stage (P<0.05).

    Conclusion‍

    There are changes in the expression levels of the genes related to immunity and cytoskeleton remodeling in cervical exfoliated cells during the endometrial receptivity phase. The decrease in the expression of ISGs may serve as a potential biomarker for endometrial receptivity.