CCL16

CCL16
  • 文章类型: Journal Article
    涉及趋化因子及其在肿瘤微环境中的肿瘤和免疫成分上的同源受体的复杂信号级联已经引起了大量的研究兴趣。我们的研究描述了趋化因子(C-C基序)配体16(CCL16)对肝细胞癌(HCC)的临床病理特征和肿瘤发生的贡献。对237对HCC标本的分析揭示了CCL16表达与血管浸润之间的显着关联。早期临床病理特征,并降低HCC患者的无复发生存率。临床HCC标本的免疫组织化学(IHC)测定表明肿瘤组织与正常肝组织中CCL16升高。我们的体内实验表明CCL16过表达促进了肿瘤增殖,而体外试验表明,CCL16介导的单核细胞和M2巨噬细胞的趋化募集是通过CCR1和CCR5协调进行的.与之前的声明相反,CCL16在生理上是不相关的,并且对其受体(CCR1,CCR2,CCR5,CCR8)具有最小的亲和力,我们的发现揭示了通过受体特异性拮抗剂抑制CCL16/CCR1和CCL16/CCR5相互作用明显阻碍了CCL16定向的趋化性,迁移,附着力,和白细胞募集。此外,CCL16在肝癌中的过度表达显着增加了与肿瘤进展有关的几种细胞因子的水平。即IL-6、IL-10和VEGFA。对CCL16过表达的异种移植物的IHC分析引起VEGFA和IL-6的水平大大提高,而对HCC标本的评估证实CCL16表达与IL-6和VEGFA水平之间呈正相关。总的来说,我们的研究强调了CCL16在肝癌发生中的致癌作用,并为针对CCL16/CCR1/CCR5轴的新型治疗干预提供了基础.
    Intricate signaling cascades involving chemokines and their cognate receptors on neoplastic and immune constituents within tumor microenvironment have garnered substantial research interest. Our investigation delineates the contribution of Chemokine (C-C motif) ligand 16 (CCL16) to the clinico-pathological features and tumorigenesis of hepatocellular carcinoma (HCC). Analysis of 237 pairs of HCC specimens unraveled a significant association between CCL16 expression and vascular invasion, early-stage clinicopathological features, and diminished recurrence-free survival among HCC patients. Immunohistochemical (IHC) assays of the clinical HCC specimens indicated elevated CCL16 in tumorous versus normal hepatic tissues. Our in vivo experiments demonstrated CCL16 overexpression fostered tumor proliferation, whereas in vitro assays elucidated that CCL16-mediated chemotactic recruitment of monocytes and M2 macrophages was orchestrated via CCR1 and CCR5. In contrast to previous claims that CCL16 is physiologically irrelevant and has minimal affinity for its receptors (CCR1, CCR2, CCR5, CCR8), our findings unravel that inhibition of CCL16/CCR1 and CCL16/CCR5 interactions through receptor-specific antagonists markedly impeded CCL16-directed chemotaxis, migration, adhesion, and leukocyte recruitment. Moreover, CCL16-overexpression in HCCs significantly augmented levels of several cytokines implicated in tumor progression, namely IL-6, IL-10 and VEGFA. IHC analysis of CCL16-overexpressing xenografts elicited greatly enhanced levels of VEGFA and IL-6, while assessments of HCC specimens confirmed a positive correlation between CCL16 expression and IL-6 and VEGFA levels. Collectively, our study highlights oncogenic role of CCL16 in hepatocarcinogenesis and provides a foundational basis for novel therapeutic interventions targeting the CCL16/CCR1/CCR5 axis.
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  • 文章类型: Journal Article
    背景:促炎分子的增加是SARS-CoV-2感染患者出现严重症状的主要原因。这项研究评估了SARS-CoV-2的S基因突变和hsa-miR-223-5p的表达。白细胞介素2受体α(IL-2Rα),和CCL16趋化因子在住院SARS-CoV-2感染患者中的应用。
    方法:这是一项横断面研究。
    方法:本研究包括75例SARS-CoV-2感染严重症状的患者和75例年龄性别匹配的健康对照。实时聚合酶链反应技术用于评估hsa-miR-223-5p的表达水平,IL-2Rα,和CCL16趋化因子。Sanger技术用于从23,274到23,641位对SARS-CoV-2的S基因进行测序。
    结果:在SARS-CoV-2感染患者中,hsa-miR-223-5p的相对表达显着增加,而IL-2Rα的相对表达显着降低。在SARS-CoV-2的S基因的23,403位发现了两个突变(p。Asp23403Gly)和23525(第SARS-CoV-2的S基因的His23525Tyr)。
    结论:hsa-miR-223-5p升高可能是IL-2Rα下调的主要原因,它是T调节淋巴细胞的主要开发者。SARS-CoV-2感染患者的S基因的突变可能会影响对该分子的免疫反应,并改变病毒与人细胞相互作用的亲和力。
    BACKGROUND: Increased proinflammatory molecules are a main reason for severe symptoms in patients infected with SARS-CoV-2. This study evaluated mutations in the S gene of SARS-CoV-2 and the expression of hsa-miR-223-5p, interleukin 2 receptor α (IL-2Rα), and CCL16 chemokine in hospitalized SARS-CoV-2 infected patients.
    METHODS: This is a cross-sectional study.
    METHODS: This study included 75 SARS-CoV-2-infected patients with severe symptoms and 75 age-sex-matched healthy controls. Real-time polymerase chain reaction techniques were used to evaluate the expression levels of hsa-miR-223-5p, IL-2Rα, and CCL16 chemokine. The Sanger technique was used to sequence the S gene of SARS-CoV-2 from positions 23,274 to 23,641.
    RESULTS: The relative expression of hsa-miR-223-5p was significantly increased whereas that of IL-2Rα was significantly decreased in the SARS-CoV-2 infected patients. Two mutations were found in the S gene of SARS-CoV-2 at positions 23,403 (p.Asp23403Gly) and 23,525 (p.His23525Tyr) of the S gene of SARS-CoV-2.
    CONCLUSIONS: Increased hsa-miR-223-5p may be a main cause for the downregulation of IL-2Rα, which is a main developer of T-regulatory lymphocytes. The mutations in the S gene of SARS-CoV-2-infected patients may affect immune responses to the molecule and alter the avidity of virus-human cell interactions.
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  • 文章类型: Journal Article
    肿瘤微环境的异质性显著影响肝细胞癌(HCC)患者的预后,通过配体-受体复合物的细胞通讯起着核心作用。
    我们使用CellChat对10个HCC组织进行了单细胞转录组学分析,以鉴定参与恶性HCC细胞通讯的配体-受体基因。利用来自TCGA肝癌(TCGA-LIHC)和肝癌的RNA-Seq数据-RIKEN,JP(LIRI-JP)同伙,我们采用Cox回归分析筛选预后相关基因.通过无监督聚类和差异基因表达分析构建预后风险模型。随后,建立了涉及肿瘤细胞和巨噬细胞的共培养系统。一系列的实验,包括Transwell分析,免疫荧光染色,免疫沉淀,流式细胞术,和免疫组织化学,进行以阐明HCC细胞通过CCL16-CCR1轴募集巨噬细胞的机制。
    单细胞分析揭示了恶性HCC细胞与巨噬细胞之间的显着相互作用,鉴定76个相关的配体受体基因。根据八种预后相关的配体受体基因的表达模式,将患者分为三种亚型。预后最差的亚型表现为T细胞相关免疫细胞浸润减少,免疫检查点基因的下调,和增加M2样肿瘤相关巨噬细胞评分。体外实验证实了CCL16-CCR1轴在肿瘤相关巨噬细胞的募集和M2极化中的关键作用。临床样本显示CCL16蛋白表达水平与晚期之间存在显著关联,淋巴结转移,和远处转移。免疫组织化学和免疫荧光染色进一步证实了CCL16与CCR1、CD68、CD206之间的相关性,以及CD68+CCR1+巨噬细胞浸润。
    我们的研究确定了分子亚型,预后模型,和基于配体-受体相互作用的恶性肝癌细胞通讯的免疫微环境特征。此外,我们揭示了HCC细胞通过CCL16-CCR1轴募集M2样肿瘤相关巨噬细胞的促瘤作用.
    The heterogeneity of the tumor microenvironment significantly influences the prognosis of hepatocellular carcinoma (HCC) patients, with cell communication through ligand-receptor complexes playing a central role.
    We conducted single-cell transcriptomic analysis on ten HCC tissues to identify ligand-receptor genes involved in malignant HCC cell communication using CellChat. Leveraging RNA-Seq data from the TCGA Liver Cancer (TCGA-LIHC) and Liver Cancer - RIKEN, JP (LIRI-JP) cohorts, we employed Cox regression analysis to screen for prognosis-related genes. Prognostic risk models were constructed through unsupervised clustering and differential gene expression analysis. Subsequently, a co-culture system involving tumor cells and macrophages was established. A series of experiments, including Transwell assays, immunofluorescence staining, immunoprecipitation, flow cytometry, and immunohistochemistry, were conducted to elucidate the mechanism through which HCC cells recruit macrophages via the CCL16-CCR1 axis.
    Single-cell analysis unveiled significant interactions between malignant HCC cells and macrophages, identifying 76 related ligand-receptor genes. Patients were classified into three subtypes based on the expression patterns of eight prognosis-related ligand-receptor genes. The subtype with the worst prognosis exhibited reduced infiltration of T cell-related immune cells, downregulation of immune checkpoint genes, and increased M2-like tumor-associated macrophage scores. In vitro experiments confirmed the pivotal role of the CCL16-CCR1 axis in the recruitment and M2 polarization of tumor-associated macrophages. Clinical samples demonstrated a significant association between CCL16 protein expression levels and advanced stage, lymph node metastasis, and distant metastasis. Immunohistochemistry and immunofluorescence staining further confirmed the correlation between CCL16 and CCR1, CD68, and CD206, as well as CD68+CCR1+ macrophage infiltration.
    Our study identified molecular subtypes, a prognostic model, and immune microenvironment features based on ligand-receptor interactions in malignant HCC cell communication. Moreover, we revealed the pro-tumorigenic role of HCC cells in recruiting M2-like tumor-associated macrophages through the CCL16-CCR1 axis.
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  • 文章类型: Journal Article
    考虑到长链非编码RNA(lncRNA)在非小细胞肺癌(NSCLC)中的关键作用,我们试图分析细胞外囊泡(EV)来源的LINC00482在NSCLC脑转移发生中的作用。在从NSCLC患者的血清样品分离的EV(血清-EV)中定量LINC00482表达。在与血清-EV共培养的小胶质细胞系HMC3和NSCLC的异种移植小鼠模型中进行异位表达和耗竭测定,以探索EV携带的LINC00482的作用。LINC00482在血清-EV中富集并在体外诱导小胶质细胞HMC3的M2极化。LINC00482竞争性结合miR-142-3p并上调miR-142-3p靶基因TGF-β1在HMC3细胞中的表达,从而促进小胶质细胞M2极化。EV衍生的LINC00482诱导的M2小胶质细胞促进NSCLC细胞的恶性特性。体内数据表明,EV通过LINC00482调节miR-142-3p/TGF-β1轴,诱导小胶质细胞M2极化并影响转移前的生态位,从而增强NSCLC的脑转移。总的来说,抑制肿瘤来源的LINC00482或含有LINC00482的EV的表达,可作为减少NSCLC脑转移的有效靶点。
    Considering the crucial role of long non-coding RNAs (lncRNAs) in non-small cell lung cancer (NSCLC), we tried to analyze the role of extracellular vesicle (EV)-derived LINC00482 in the occurrence of brain metastasis in NSCLC. LINC00482 expression was quantified in EVs isolated from serum samples of NSCLC patients (serum-EVs). Ectopic expression and depletion assays were conducted in the microglial cell line HMC3 co-cultured with serum-EVs and in xenograft mouse models of NSCLC to explore the roles of EV-carried LINC00482. LINC00482 was enriched in serum-EVs and induced M2 polarization of microglial cells HMC3 in vitro. LINC00482 competitively bound to miR-142-3p and upregulated the expression of miR-142-3p target gene TGF-β1 in HMC3 cells, thus promoting microglial M2 polarization. EV-derived LINC00482-induced M2 microglia promoted the malignant properties of NSCLC cells. In vivo data demonstrated that EVs transmitted LINC00482 to regulate the miR-142-3p/TGF-β1 axis, induce microglial M2 polarization and affect the pre-metastatic niche, thus enhancing brain metastasis of NSCLC. Overall, suppression of the expression of tumor-derived LINC00482 or LINC00482-containing EVs, may serve as an effective target for contributing to the reduction of brain metastasis of NSCLC.
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  • 文章类型: Journal Article
    背景:已发现环状RNA(circularRNA)在许多疾病的进展中起重要作用,包括小儿肺炎.然而,circ_0044411在小儿肺炎进展中的作用尚不清楚。
    方法:将MRC-5细胞与脂多糖(LPS)孵育12h,建立婴儿肺炎的体外细胞模型。逆转录-定量聚合酶链反应(RT-qPCR)用于检测circ_0044411、miR-141-3p(micoRNA-141-3p)和CCL16(CC基序趋化因子配体16)的水平。通过3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四唑溴化物(MTT)测定和5-乙炔基-2'-脱氧尿苷(EdU)测定来评估细胞活力和增殖。炎症因子IL-1β水平,采用酶联免疫吸附测定试剂盒测定IL-6和TNF-α。流式细胞术和caspase-3活性检测试剂盒检测细胞凋亡和caspase-3活性。通过双荧光素酶报告基因测定证实了靶相互作用,RNA免疫沉淀测定和RNA下拉测定。
    结果:Circ_0044411在小儿肺炎患者血清和LPS诱导的MRC-5细胞中被高度抑制。Circ_0044411能促进细胞活力和增殖,抑制LPS诱导的MRC-5细胞的炎症反应和凋亡。Circ_0044411可以作为miR-141-3p的海绵,miR-141-3p可以逆转circ_0044411对LPS诱导的MRC-5细胞损伤的作用。此外,miR-141-3p可以靶向CCL16,miR-141-3p可以通过靶向CCL16保护MRC-5细胞免受LPS诱导的细胞损伤。此外,circ_0044411海绵作用miR-141-3p正向调节CCL16表达。
    结论:Circ_0044411敲低可促进细胞活力和增殖,通过调节miR-141-3p/CCL16轴抑制炎症反应和细胞凋亡,表明circ_0044411可能是IP的潜在治疗靶标。
    BACKGROUND: Circular RNA (circRNA) has been found to play an important role in the progression of many diseases, including infantile pneumonia. However, the role of circ_0044411 in infantile pneumonia progression is still unclear.
    METHODS: MRC-5 cells were incubated with lipopolysaccharide (LPS) for 12 h to establish the in vitro cellular model for infantile pneumonia. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to detect the levels of circ_0044411, miR-141-3p (micoRNA-141-3p) and CCL16 (CC motif chemokine ligand 16). Cell viability and proliferation was assessed by 3-(4, 5-dimethylthiazol-2-y1)-2, 5-diphenyl tetrazolium bromide (MTT) assay and 5-ethynyl-2\'-deoxyuridine (EdU) assay. The levels of inflammatory factors IL-1β, IL-6 and TNF-α were determined by enzyme-linked immunosorbent assay kits. Cell apoptosis and caspase-3 activity were detected by flow cytometry analysis and caspase-3 activity assay kit. The target interaction was confirmed by dual-luciferase reporter assay, RNA immunoprecipitation assay and RNA pull-down assay.
    RESULTS: Circ_0044411 was highly repressed in the serum of infantile pneumonia patients and LPS-induced MRC-5 cells. Circ_0044411 could promote the cell viability and proliferation, inhibit inflammatory response and apoptosis in LPS-induced MRC-5 cells. Circ_0044411 could serve as a sponge of miR-141-3p, and miR-141-3p could reverse the function of circ_0044411 on LPS-induced MRC-5 cell injury. In addition, miR-141-3p could target CCL16, and miR-141-3p could protect MRC-5 cells from LPS-induced cell injury by targeting CCL16. Furthermore, circ_0044411 sponged miR-141-3p to positively regulate CCL16 expression.
    CONCLUSIONS: Circ_0044411 knockdown promoted cell viability and proliferation, inhibited inflammatory response and apoptosis by regulating miR-141-3p/CCL16 axis, indicating that circ_0044411 might be a potential therapeutic target for IP.
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  • 文章类型: Journal Article
    人C-C基序配体16(CCL16)是一种趋化因子,其特征在于具有未知意义的大的可切割C-末端延伸。有关其组织分布和表达调节的数据相互矛盾,呈现CCL16的生物学功能神秘。这里,我们报道了一种表征这种趋化因子的综合方法,包括对其表达特征的重新评估以及对其结构和动力学的生物物理研究。我们的数据表明,CCL16主要由肝细胞合成,对炎症介质没有明显的反应,并以全长蛋白质的形式在血液中循环。虽然CCL16的晶体结构证实了经典趋化因子结构域的存在,分子动力学模拟支持以下观点:C端延伸会损害糖胺聚糖结合位点的可及性,因此可能充当生物活性的内在调节剂。
    Human C-C motif ligand 16 (CCL16) is a chemokine that is distinguished by a large cleavable C-terminal extension of unknown significance. Conflicting data have been reported concerning its tissue distribution and modulation of expression, rendering the biological function of CCL16 enigmatic. Here, we report an integrated approach to the characterisation of this chemokine, including a re-assessment of its expression characteristics as well as a biophysical investigation with respect to its structure and dynamics. Our data indicate that CCL16 is chiefly synthesised by hepatocytes, without an appreciable response to mediators of inflammation, and circulates in the blood as a full-length protein. While the crystal structure of CCL16 confirms the presence of a canonical chemokine domain, molecular dynamics simulations support the view that the C-terminal extension impairs the accessibility of the glycosaminoglycan binding sites and may thus serve as an intrinsic modulator of biological activity.
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  • 文章类型: Journal Article
    多项研究使用Olink亲和蛋白质组学平台研究了血液循环蛋白在COVID-19疾病中的作用。然而,研究纳入标准和样本收集条件因研究而异,导致有时不一致的联想。为了确定疾病的最强大的蛋白质标记和在所有条件下相关的潜在途径,识别最广泛复制的蛋白质是至关重要的。在这里,我们将两项新招募的COVID-19研究(N=68和N=98)的Olink蛋白质组学图谱与三项先前发表的COVID-19研究(N=383,N=83,N=57)的Olink蛋白质组学图谱相结合。对于这些研究,比较了三个Olink面板(炎症和心血管II和III)与253种独特的蛋白质。病例/对照分析显示13种蛋白质(CCL16,CCL7,CXCL10,CCL8,LGALS9,CXCL11,IL1RN,CCL2,CD274,IL6,IL18,MERTK,IFNγ,和IL18R1)在所有五项研究中都在COVID-19患者中差异表达。除了CCL16,在对照组中更高,所有蛋白质在COVID-19患者中均过表达。通路分析揭示了所有研究与细胞因子-细胞因子相互作用相关的通路的一致趋势,IL18信令,流体剪切应力和类风湿性关节炎。我们的结果重申了与COVID-19细胞因子风暴综合征相关的先前发现。COVID-19特异性蛋白质表达谱的交叉研究稳健性支持亲和蛋白质组学作为一种工具和用于识别潜在治疗靶标的用途。
    Multiple studies have investigated the role of blood circulating proteins in COVID-19 disease using the Olink affinity proteomics platform. However, study inclusion criteria and sample collection conditions varied between studies, leading to sometimes incongruent associations. To identify the most robust protein markers of the disease and the underlying pathways that are relevant under all conditions, it is essential to identify proteins that replicate most widely. Here we combined the Olink proteomics profiles of two newly recruited COVID-19 studies (N=68 and N=98) with those of three previously published COVID-19 studies (N=383, N=83, N=57). For these studies, three Olink panels (Inflammation and Cardiovascular II & III) with 253 unique proteins were compared. Case/control analysis revealed thirteen proteins (CCL16, CCL7, CXCL10, CCL8, LGALS9, CXCL11, IL1RN, CCL2, CD274, IL6, IL18, MERTK, IFNγ, and IL18R1) that were differentially expressed in COVID-19 patients in all five studies. Except CCL16, which was higher in controls, all proteins were overexpressed in COVID-19 patients. Pathway analysis revealed concordant trends across all studies with pathways related to cytokine-cytokine interaction, IL18 signaling, fluid shear stress and rheumatoid arthritis. Our results reaffirm previous findings related to a COVID-19 cytokine storm syndrome. Cross-study robustness of COVID-19 specific protein expression profiles support the utility of affinity proteomics as a tool and for the identification of potential therapeutic targets.
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  • 文章类型: Journal Article
    UNASSIGNED: Emerging evidence shows that long noncoding RNA (lncRNA) has been a novel insight in various diseases, including pneumonia. Even though lncRNA X-inactive-specific transcript (XIST) is well studied, its role in pneumonia remains to be largely unrevealed.
    UNASSIGNED: Expression of XIST, miRNA-30b-5p (miR-30b-5p), and CC chemokine ligand 16 (CCL16) was detected using reverse transcriptase quantitative polymerase chain reaction and western blotting; their interaction was confirmed by dual-luciferase reporter assay. Apoptosis, inflammation, and toll-like receptor 4 (TLR4)/NF-κB signaling pathway were measured using methyl thiazolyl tetrazolium assay, flow cytometry, western blotting, and enzyme-linked immunosorbent assay.
    UNASSIGNED: Lipopolysaccharide (LPS) stimulation decreased cell viability and B cell lymphoma (Bcl)-2 expression, and increased cell apoptosis rate and expression of Bcl-2-associated X protein (Bax), cleaved-caspase-3, interleukin (IL)-6, IL-1β, and tumor necrosis factor α (TNF-α) in WI-38 cells. Expression of XIST and CCL16 was upregulated in the serum of patients with pneumonia and LPS-induced WI-38 cells, respectively; silencing XIST and CCL16 could suppress LPS-induced apoptosis and inflammation in WI-38 cells, and this protection was abolished by miR-30b-5p downregulation. Moreover, XIST and CCL16 could physically bind to miR-30b-5p, and XIST regulated CCL16 expression via sponging miR-30b-5p. TLR4 and phosphorylated P65 (p-P65) and p-IκB-α were highly induced by LPS treatment, and this upregulation was diminished by blocking XIST, accompanied with CCL16 downregulation and miR-30b-5p upregulation.
    UNASSIGNED: Silencing XIST could alleviate LPS-induced inflammatory injury in human lung fibroblast WI-38 cells through modulating miR-30b-5p/CCL16 axis and inhibiting TLR4/NF-κB signaling pathway.
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  • 文章类型: Journal Article
    Rationale: Considerable evidence suggests that breast cancer metastasis and recurrence occur due to emergence of cancer stem cells (CSCs). In our previous study, we designed a high-throughput siRNA screening platform that identifies inflammation genes involved in the regulation of cancer cell stemness. We reported that CCL16 protein decreases OCT4 expression and reduces the ALDH+ subpopulation. However, the mechanism by which CCL16 maintains stem cell-like properties remains unclear. Methods: Tissue microarrays were used to evaluate CCL16 expression. Cancer stemness assays were performed in CCL16 knockdown and overexpressing cells in vitro and in a xenograft model in vivo. Human phosphokinase array, immunofluorescence and chromatin immunoprecipitation assays were performed to explore the underlying mechanism. Results: We report that CCL16 was overexpressed in breast tumors and significantly correlated with clinical progression. We found that silencing CCL16 in MDA-MB-231 and BT549 cells diminished CSC properties including ALDH+ subpopulation, side population, chemo-resistance, and sphere formation. Furthermore, mice bearing CCL16-silenced MDA-MB-231 xenografts had lower tumorigenic frequency and developed smaller tumors. Exploration of the underlying mechanism found that CCL16 selects CCR2 to activate p-AKT/GSK3β signaling and facilitate β-catenin nuclear translocation. Further, CCL16 binds to the OCT4 promoter and promotes OCT4 expression. In addition, shRNAs targeting CCR2 and XAV939 targeting β-catenin abolished CCL16-mediated cancer stemness. Upstream, IL10 mediates STAT3 activation, which binds to the CCL16 promoter and enhances its expression. The STAT3-targeted inhibitor Stattic suppressed CCL16 expression in vitro and restrained tumor progression in vivo. Conclusions: We identified a potential CSC regulator and suggest a novel mechanism for how CCL16 governs cancer cell stemness. We propose that CCL16 could be an effective target for breast cancer therapy.
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  • 文章类型: Journal Article
    OBJECTIVE: The aim of this study was to investigate the effect of the medical and the surgical treatment on the olfactory functions, clinical scoring systems and inflammation markers in patients with nasal polyposis. In addition, the secondary aim was to investigate the correlation between those investigated parameters.
    METHODS: A total of 30 patients, who completed the standardized medical and surgical treatment and also came to 3 months of follow-ups regularly after the surgery, were included in the study. The Sniffin\' Sticks olfactory tests, radiological and the endoscopic stagings, liver-expressed chemokine (CCL16) and endothelin (ET) levels and sino-nasal outcome test-22 (SNOT-22) were performed at the initial and at the end of the study.
    RESULTS: The current study had four major findings: (1) significant improvement in odor functions after treatment was determined; however, the majority of the patients had been already hyposmic. (2) In addition, significant improvement was found in ET and CCL16 levels, SNOT-22 results, and radiologic and endoscopic stagings at the end of the study. (3) However, there was no correlation between the olfactory functions and the investigated parameters. (4) There was a positive correlation between polyp recurrence and ET levels.
    CONCLUSIONS: The standardized medical and surgical treatment provided a significant improvement in the olfactory functions. However, only one patient (3.3%) had become normosmic at the end of the study.
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