NPC2

NPC2
  • 文章类型: Journal Article
    目的:类固醇急性调节(StAR)相关的脂质转移结构域-3(STARD3)是一种甾醇结合蛋白,可促进胆固醇在细胞器之间的转运。在糖尿病肾病(DKD)条件下,足细胞中胆固醇的积累直接导致白蛋白尿和肾损伤的发病。这项研究的目的是确定STARD3对足细胞内胆固醇的细胞内分布的作用。
    方法:进行体内和体外糖尿病模型。STARD3,尼曼-皮克病C1型(NPC1)的蛋白质水平,通过蛋白质印迹分析分别检测到Niemann-Pick病C2型(NPC2),免疫组织化学,和免疫荧光。Filipin染色用于评估足细胞中胆固醇的亚细胞定位。使用JC-1(CBIC2)和ROS(活性氧)测定评估线粒体损伤。
    结果:STARD3在糖尿病和高血糖状态下的上调增加了胆固醇从晚期内体/溶酶体(LE/LY)到线粒体的转运,导致足细胞线粒体胆固醇积累和细胞损伤。相反,下调STARD3表达减弱线粒体胆固醇积累,和改善线粒体稳态。
    结论:STARD3可能控制足细胞内胆固醇转运,随后导致线粒体代谢的调节。因此,靶向STARD3成为减轻糖尿病诱导的足细胞线粒体胆固醇积累和相关损伤的潜在治疗策略.
    OBJECTIVE: Steroidogenic acute regulatory (StAR)-related lipid transfer domain-3 (STARD3) is a sterol-binding protein that facilitates cholesterol transport between cellular organelles. Cholesterol accumulation in podocytes directly contributes to the pathogenesis of albuminuria and renal injury under the condition of diabetic kidney disease (DKD). The aim of this study is to determine the role of STARD3 on the intracellular distribution of cholesterol within podocytes.
    METHODS: In vivo and in vitro models of diabetes were performed. The protein levels of STARD3, Niemann-Pick disease type C1 (NPC1), and Niemann-Pick disease type C2 (NPC2) were respectively detected by western blot analysis, immunohistochemistry, and immunofluorescence. Filipin staining was used to evaluate the subcellular localization of cholesterol in podocytes. Mitochondrial damage was evaluated using JC-1 (CBIC2) and ROS (reactive oxygen species) assays.
    RESULTS: Upregulation of STARD3 under diabetes and hyperglycemia increases cholesterol transport from the late endosomal/lysosomal (LE/LY) to mitochondria, leading to mitochondrial cholesterol accumulation and cell injury in podocytes. Conversely, downregulating STARD3 expression attenuated mitochondrial cholesterol accumulation, and improved mitochondrial homeostasis.
    CONCLUSIONS: STARD3 may govern intracellular cholesterol transport in podocytes, subsequently leading to regulation of mitochondrial metabolism. Therefore, targeting STARD3 emerges as a potential therapeutic strategy to mitigate diabetes-induced mitochondrial cholesterol accumulation and associated injury in podocytes.
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  • 文章类型: Journal Article
    马尔堡病毒(MARV)是导致人类致命出血热的丝状病毒之一,死亡率高达90%。中和抗体代表预防或治疗病毒疾病的理想候选物。然而,迄今为止,尚未批准抗体用于MARV治疗。在这项研究中,我们鉴定了一种新的人抗体,名为AF-03,它靶向MARV糖蛋白(GP).AF-03对MARVGP具有高结合亲和力,并在体外和体内显示出对假型MARV的中和和保护活性。表位鉴定,包括分子对接和基于实验的突变物种分析,显示AF-03识别GP1内的Niemann-PickC1(NPC1)结合域。有趣的是,我们发现AF-03对假型埃博拉病毒(EBOV,SUDV,和BDBV)带有裂解的GP而不是全长GP。此外,NPC2融合的AF-03通过结合CI-MPR对几种丝状病毒和EBOV突变体表现出中和活性。总之,这项工作表明,AF-03代表了丝状病毒引起的疾病的有希望的治疗货物.
    Marburg virus (MARV) is one of the filovirus species that cause deadly hemorrhagic fever in humans, with mortality rates up to 90%. Neutralizing antibodies represent ideal candidates to prevent or treat virus disease. However, no antibody has been approved for MARV treatment to date. In this study, we identified a novel human antibody named AF-03 that targeted MARV glycoprotein (GP). AF-03 possessed a high binding affinity to MARV GP and showed neutralizing and protective activities against the pseudotyped MARV in vitro and in vivo. Epitope identification, including molecular docking and experiment-based analysis of mutated species, revealed that AF-03 recognized the Niemann-Pick C1 (NPC1) binding domain within GP1. Interestingly, we found the neutralizing activity of AF-03 to pseudotyped Ebola viruses (EBOV, SUDV, and BDBV) harboring cleaved GP instead of full-length GP. Furthermore, NPC2-fused AF-03 exhibited neutralizing activity to several filovirus species and EBOV mutants via binding to CI-MPR. In conclusion, this work demonstrates that AF-03 represents a promising therapeutic cargo for filovirus-caused disease.
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  • 文章类型: Journal Article
    尼曼-皮克病(NPD)是一种罕见的常染色体隐性遗传疾病,属于溶酶体贮积症。已经描述了三种类型的NPD:NPDA型,B,和C.NPDA型和B型是由编码鞘磷脂磷酸二酯酶1的基因SMPD1中的突变引起的,因此缺乏酸性鞘磷脂酶活性。因此,这些疾病被分类为酸性鞘磷脂酶缺乏(ASMD)。C型NPD是一种神经系统疾病,由于NPC1或NPC2基因突变,导致胆固醇运输和酯化缺陷。尽管所有三种类型的NPD都可以表现为肺部受累,肺部疾病在NPDB型中更常见,通常患有间质性肺病,反复肺部感染,和呼吸衰竭。在这个意义上,支气管镜检查与支气管肺泡灌洗或活检与高分辨率计算机断层扫描是基本的诊断工具。尽管已经做出了一些努力来寻找NPD的有效疗法,到目前为止,只有有限的治疗选择是可用的。用Olipudaseα进行的酶替代疗法是第一个也是唯一一个被批准用于ASMD患者的疾病修饰疗法。文献中还描述了ASMD的肺移植和造血干细胞移植。NPDC型中唯一批准的疾病改善疗法是米格卢司他,基材还原处理。这篇综述的目的是描述NPD的遗传基础和肺部受累的最新技术,注重临床表现,该病的放射学和组织病理学特征,和可用的治疗选择,凝视未来的治疗策略。
    Niemann-Pick Disease (NPD) is a rare autosomal recessive disease belonging to lysosomal storage disorders. Three types of NPD have been described: NPD type A, B, and C. NPD type A and B are caused by mutations in the gene SMPD1 coding for sphingomyelin phosphodiesterase 1, with a consequent lack of acid sphingomyelinase activity. These diseases have been thus classified as acid sphingomyelinase deficiencies (ASMDs). NPD type C is a neurologic disorder due to mutations in the genes NPC1 or NPC2, causing a defect of cholesterol trafficking and esterification. Although all three types of NPD can manifest with pulmonary involvement, lung disease occurs more frequently in NPD type B, typically with interstitial lung disease, recurrent pulmonary infections, and respiratory failure. In this sense, bronchoscopy with broncho-alveolar lavage or biopsy together with high-resolution computed tomography are fundamental diagnostic tools. Although several efforts have been made to find an effective therapy for NPD, to date, only limited therapeutic options are available. Enzyme replacement therapy with Olipudase α is the first and only approved disease-modifying therapy for patients with ASMD. A lung transplant and hematopoietic stem cell transplantation are also described for ASMD in the literature. The only approved disease-modifying therapy in NPD type C is miglustat, a substrate-reduction treatment. The aim of this review was to delineate a state of the art on the genetic basis and lung involvement in NPD, focusing on clinical manifestations, radiologic and histopathologic characteristics of the disease, and available therapeutic options, with a gaze on future therapeutic strategies.
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  • 文章类型: Journal Article
    癌症的高发病率和高死亡率危害着人类的健康和生命,它已经成为一个全球性的公共卫生问题。NPC的一些成员已经在一些癌症中进行了研究,但大多数癌症缺乏全面的预后分析。在这项研究中,我们使用癌症基因组图谱(TCGA)数据基因组学和转录组技术来检查33个癌症样本中NPCs的差异表达和预后,以及研究NPCs突变及其对患者预后的影响,并评估癌症中NPCs的甲基化水平。随后研究了相关机制和药物耐药性,以研究前瞻性的肿瘤治疗方法。NPCs与免疫浸润的关系,免疫细胞,免疫调节物质,和免疫途径也进行了研究。最后,使用单因素和多因素COX回归分析建立LUAD和KICH预后预测模型.此外,还鉴定了NPCs的mRNA和蛋白质水平。
    Cancer\'s high incidence and death rate jeopardize human health and life, and it has become a global public health issue. Some members of NPCs have been studied in a few cancers, but comprehensive and prognostic analysis is lacking in most cancers. In this study, we used the Cancer Genome Atlas (TCGA) data genomics and transcriptome technology to examine the differential expression and prognosis of NPCs in 33 cancer samples, as well as to investigate NPCs mutations and their effect on patient prognosis and to evaluate the methylation level of NPCs in cancer. The linked mechanisms and medication resistance were subsequently investigated in order to investigate prospective tumor therapy approaches. The relationships between NPCs and immune infiltration, immune cells, immunological regulatory substances, and immune pathways were also investigated. Finally, the LUAD and KICH prognostic prediction models were built using univariate and multivariate COX regression analysis. Additionally, the mRNA and protein levels of NPCs were also identified.
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  • 文章类型: Journal Article
    胆固醇是所有细胞发挥作用所必需的。细胞内胆固醇转运蛋白Npc1和Npc2控制固醇的运输,它们的功能障碍导致Neimann-PickC型疾病,一种影响神经系统和肠道的罕见疾病。与编码单个Npc1和Npc2转运蛋白的人类不同,苍蝇包括两个Npc1(Npc1a-1b)和八个Npc2(Npc2a-2h)成员,大多数Npc2家族基因仍未被研究。这里,我们关注Npc2c在成人中的肠道功能。我们发现Npc2c对肠干细胞(ISC)有丝分裂是必需的,维护ISC谱系,病原体感染后的生存,以及肿瘤的生长。Npc2c沉默的中肠的有丝分裂受损伴随着Cyclin基因的表达降低,和编码ISC调节因子的基因,比如Delta,unpaired1和Sock36E。ISC特异性Npc2c沉默诱导Attacin-A表达,一种让人联想到革兰氏阴性细菌过多的表型。Npc2c耗尽的中肠的宏基因组分析表明肠道生态失调,由此降低的共生复杂性伴随着增加的γ-变形杆菌。ISC特异性Npc2c沉默也导致胆固醇聚集增加。有趣的是,非甾体蜕皮激素受体激动剂的给药,RH5849,挽救Npc2c沉默的中肠的有丝分裂,并增加蜕皮激素反应基因Broad的表达,强调Npc2c和固醇在蜕皮激素信号传导中的作用。对其他Npc2家族成员的评估表明Npc2c在ISC控制和对蜕皮激素信号传导的反应中的潜在冗余作用。我们的结果强调了Npc2c在ISC有丝分裂中的一个先前尚未确定的重要作用,以及在果蝇中肠蜕皮激素信号传导和微生物组组成中的重要作用。
    Cholesterol is necessary for all cells to function. The intracellular cholesterol transporters Npc1 and Npc2 control sterol trafficking and their malfunction leads to Neimann-Pick Type C disease, a rare disorder affecting the nervous system and the intestine. Unlike humans that encode single Npc1 and Npc2 transporters, flies encompass two Npc1 (Npc1a-1b) and eight Npc2 (Npc2a-2h) members, and most of the Npc2 family genes remain unexplored. Here, we focus on the intestinal function of Npc2c in the adult. We find that Npc2c is necessary for intestinal stem cell (ISC) mitosis, maintenance of the ISC lineage, survival upon pathogenic infection, as well as tumor growth. Impaired mitosis of Npc2c-silenced midguts is accompanied by reduced expression of Cyclin genes, and genes encoding ISC regulators, such as Delta, unpaired1 and Socs36E. ISC-specific Npc2c silencing induces Attacin-A expression, a phenotype reminiscent of Gram-negative bacteria overabundance. Metagenomic analysis of Npc2c-depleted midguts indicates intestinal dysbiosis, whereby decreased commensal complexity is accompanied by increased gamma-proteobacteria. ISC-specific Npc2c silencing also results in increased cholesterol aggregation. Interestingly, administration of the non-steroidal ecdysone receptor agonist, RH5849, rescues mitosis of Npc2c-silenced midguts and increases expression of the ecdysone response gene Broad, underscoring the role of Npc2c and sterols in ecdysone signaling. Assessment of additional Npc2 family members indicates potential redundant roles with Npc2c in ISC control and response to ecdysone signaling. Our results highlight a previously unidentified essential role of Npc2c in ISC mitosis, as well as an important role in ecdysone signaling and microbiome composition in the Drosophila midgut.
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  • 文章类型: Journal Article
    背景:Niemann-PickC2型疾病(NP-C2)是一种由溶酶体胆固醇转运蛋白NPC2缺陷引起的致命性神经内脏疾病。因此,胆固醇和其他脂质在溶酶体内积累,导致临床表现的异质性。鼠模型对于增加对NP-C2复杂病理的理解至关重要。这项研究,因此,目的描述NPC2缺陷小鼠模型中的神经内脏病理学,以评估其与人NP-C2的相关性。
    方法:本研究使用携带LST105突变的Npc2-/-小鼠(Npc2Gt(LST105)BygNya)。在六只和12周龄的Npc2-/-小鼠中进行了身体和器官重量以及组织病理学评估,特别强调神经病理学。浦肯野细胞(PC)标记calbindin,星形细胞标记GFAP,和小胶质细胞标志物IBA1被纳入评估PC变性和神经炎症,分别。此外,肝脏的病理学,肺,使用苏木精和伊红染色评估脾脏。
    结果:6周龄症状前的Npc2-/-小鼠表现出脾肿大和明显的神经病理变化,尤其是小脑,其中最初的PC损失和神经炎症是明显的。Npc2-/-小鼠在8周龄时出现神经症状,严重进展,直到12周时疾病的末期。在疾病的末期,Npc2-/-小鼠的特征是生长迟缓,震颤,小脑共济失调,脾肿大,泡沫细胞在肺部积聚,肝脏,和脾脏,脑萎缩,明显的PC变性,和严重的神经炎症.
    结论:Npc2Gt(LST105)BygNya小鼠模型与NP-C2患者的病理相似,是增加对复杂疾病表现的理解的有价值的模型,并且与测试新治疗策略的有效性相关。
    Niemann-Pick type C2 disease (NP-C2) is a fatal neurovisceral disorder caused by defects in the lysosomal cholesterol transporter protein NPC2. Consequently, cholesterol and other lipids accumulate within the lysosomes, causing a heterogeneous spectrum of clinical manifestations. Murine models are essential for increasing the understanding of the complex pathology of NP-C2. This study, therefore, aims to describe the neurovisceral pathology in the NPC2-deficient mouse model to evaluate its correlation to human NP-C2.
    Npc2-/- mice holding the LST105 mutation were used in the present study (Npc2Gt(LST105)BygNya). Body and organ weight and histopathological evaluations were carried out in six and 12-week-old Npc2-/- mice, with a special emphasis on neuropathology. The Purkinje cell (PC) marker calbindin, the astrocytic marker GFAP, and the microglia marker IBA1 were included to assess PC degeneration and neuroinflammation, respectively. In addition, the pathology of the liver, lungs, and spleen was assessed using hematoxylin and eosin staining.
    Six weeks old pre-symptomatic Npc2-/- mice showed splenomegaly and obvious neuropathological changes, especially in the cerebellum, where initial PC loss and neuroinflammation were evident. The Npc2-/- mice developed neurological symptoms at eight weeks of age, severely progressing until the end-stage of the disease at 12 weeks. At the end-stage of the disease, Npc2-/- mice were characterized by growth retardation, tremor, cerebellar ataxia, splenomegaly, foam cell accumulation in the lungs, liver, and spleen, brain atrophy, pronounced PC degeneration, and severe neuroinflammation.
    The Npc2Gt(LST105)BygNya mouse model resembles the pathology seen in NP-C2 patients and denotes a valuable model for increasing the understanding of the complex disease manifestation and is relevant for testing the efficacies of new treatment strategies.
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  • 文章类型: Journal Article
    胆固醇是细胞膜的结构组分。对快速生长的肿瘤细胞如何维持膜胆固醇稳态知之甚少。这里,我们发现胶质母细胞瘤(GBM),最致命的脑肿瘤,维持膜胆固醇的正常水平,但在其脂滴(LD)中大量存在胆固醇酯(CE)。机械上,SREBP-1(固醇调节元件结合蛋白1),胆固醇消耗后被激活的主要转录因子,上调关键的自噬基因,包括ATG9B,ATG4A,LC3B,以及溶酶体胆固醇转运蛋白NPC2。这种上调促进LD吸脂性,导致CEs的水解和胆固醇从溶酶体中的释放,从而维持质膜胆固醇稳态。当这条路被阻断时,GBM细胞对胆固醇缺乏变得相当敏感,在体外生长不良。我们的研究揭示了SREBP-1-自噬-LD-CE水解途径,该途径在维持膜胆固醇稳态中起着重要作用,同时为GBM提供了潜在的治疗途径。
    Cholesterol is a structural component of cell membranes. How rapidly growing tumor cells maintain membrane cholesterol homeostasis is poorly understood. Here, we found that glioblastoma (GBM), the most lethal brain tumor, maintains normal levels of membrane cholesterol but with an abundant presence of cholesteryl esters (CEs) in its lipid droplets (LDs). Mechanistically, SREBP-1 (sterol regulatory element-binding protein 1), a master transcription factor that is activated upon cholesterol depletion, upregulates critical autophagic genes, including ATG9B, ATG4A, and LC3B, as well as lysosome cholesterol transporter NPC2. This upregulation promotes LD lipophagy, resulting in the hydrolysis of CEs and the liberation of cholesterol from the lysosomes, thus maintaining plasma membrane cholesterol homeostasis. When this pathway is blocked, GBM cells become quite sensitive to cholesterol deficiency with poor growth in vitro. Our study unravels an SREBP-1-autophagy-LD-CE hydrolysis pathway that plays an important role in maintaining membrane cholesterol homeostasis while providing a potential therapeutic avenue for GBM.
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  • 文章类型: Journal Article
    目标:在发育性和癫痫性脑病(DEEs)中,确定精确的遗传因素指导临床医生为患者应用最合适的治疗方法。由于高度的基因座异质性,WES分析是DEE基因诊断的一种有前途的方法。因此,本研究的目的是评估WES在DEE患者诊断和治疗中的实用性.
    方法:对29例DEE患者的外显子组数据进行筛选,检测1896个癫痫相关基因的破坏性和错义突变,以检测致病变异并检查基因型-表型相关性。我们用可用的DNA样品进行Sanger测序,以跟踪家族中变体与疾病表型的共分离。此外,p.Asn1053Ser的结构效应,KCNMA1、NPC2和SCN2A蛋白上的p.Pro120Ser和p.Glu1868Gly突变,分别,通过分子动力学(MD)和分子对接模拟进行了评估。
    结果:在29名患者中,有9名(31%)患有SCN2A的病理(P)或可能的病理(LP)突变,KCNQ2、ATP1A2、KCNMA1和MECP2基因,3例患者在SCN1A和SCN2A基因中存在VUS变异(10%)。Sanger测序结果表明,三名患者具有从头突变,而其中八名患者携带父系和/或母系遗传的致病变异。MD和分子对接模拟支持突变对KCNMA1,NPC2和SCN2A蛋白结构的破坏性影响。
    结论:在此我们证明了WES对具有高基因座异质性的DEE的有效性。遗传病因的确定指导临床医生为患者调整适当的治疗方法。
    OBJECTIVE: In Developmental and Epileptic Encephalopathies (DEEs), identifying the precise genetic factors guides the clinicians to apply the most appropriate treatment for the patient. Due to high locus heterogeneity, WES analysis is a promising approach for the genetic diagnosis of DEE. Therefore, the aim of the present study is to evaluate the utility of WES in the diagnosis and treatment of DEE patients.
    METHODS: The exome data of 29 DEE patients were filtrated for destructive and missense mutations in 1896 epilepsy-related genes to detect the causative variants and examine the genotype-phenotype correlations. We performed Sanger sequencing with the available DNA samples to follow the co-segregation of the variants with the disease phenotype in the families. Also, the structural effects of p.Asn1053Ser, p.Pro120Ser and p.Glu1868Gly mutations on KCNMA1, NPC2, and SCN2A proteins, respectively, were evaluated by molecular dynamics (MD) and molecular docking simulations.
    RESULTS: Out of 29, nine patients (31%) harbor pathological (P) or likely pathological (LP) mutations in SCN2A, KCNQ2, ATP1A2, KCNMA1, and MECP2 genes, and three patients have VUS variants (10%) in SCN1A and SCN2A genes. Sanger sequencing results indicated that three of the patients have de novo mutations while eight of them carry paternally and/or maternally inherited causative variants. MD and molecular docking simulations supported the destructive effects of the mutations on KCNMA1, NPC2, and SCN2A protein structures.
    CONCLUSIONS: Herein we demonstrated the effectiveness of WES for DEE with high locus heterogeneity. Identification of the genetic etiology guided the clinicians to adjust the proper treatment for the patients.
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  • 文章类型: Journal Article
    目的:大部分过敏原与小分子配体结合,这些化合物中的许多被归类为脂质。然而,在大多数情况下,我们不知道配体在变应性致敏或变应性效应期所起的作用。
    结果:致力于鉴定过敏原配体。这导致鉴定了一些可以发挥活性免疫调节作用或影响过敏原分子和过敏特性的脂质化合物。四个过敏原家族(脂质运载蛋白,NPC2,nsLTP,和PR-10)在其配体结合特性方面是最好的。来自这四个家族的变应原能够结合许多化学上不同的分子。这些分子可以直接与人免疫系统相互作用和/或影响变应原的构象和稳定性。虽然有更多关于过敏原及其小分子配体的数据,我们才刚刚开始了解它们在过敏中的作用。
    A significant fraction of allergens bind small molecular ligands, and many of these compounds are classified as lipids. However, in most cases, we do not know the role that is played by the ligands in the allergic sensitization or allergic effector phases.
    More effort is dedicated toward identification of allergens\' ligands. This resulted in identification of some lipidic compounds that can play active immunomodulatory roles or impact allergens\' molecular and allergic properties. Four allergen families (lipocalins, NPC2, nsLTP, and PR-10) are among the best characterized in terms of their ligand-binding properties. Allergens from these four families are able to bind many chemically diverse molecules. These molecules can directly interact with human immune system and/or affect conformation and stability of allergens. While there is more data on the allergens and their small molecular ligands, we are just starting to understand their role in allergy.
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  • 文章类型: Journal Article
    背景:众所周知,NPC2是胆固醇运输的参与者。然而,NPC2在癌症发展和治疗中的生物学作用尚不清楚。
    方法:这里,我们通过整合来自TCGA和GTEx的RNA-seq数据,探索NPC2在多种癌症类型的预后和免疫治疗中的潜在作用,来自CPTAC的蛋白质数据,和多个网络分析数据库。
    结果:肿瘤和正常组织之间的表达描述表明,NPC2在大多数最常见的癌症类型中过度表达,包括胶质母细胞瘤和胰腺癌,两种癌症大多难以诊断和治疗。
    结论:胶质母细胞瘤的癌干性与NPC2水平呈负相关。NPC2的表达与免疫细胞浸润和几个免疫检查点的表达呈正相关。GBM中IDH1突变与NPC2水平呈负相关,胰腺癌中TP53突变与NPC2表达呈正相关。NPC2还与用于诊断胰腺癌的血清生物标志物的水平相关。
    BACKGROUND: NPC2 is well known as a player for cholesterol transport. However, the biological role of NPC2 in cancer development and therapy is far from clear.
    METHODS: Here, we explore the potential role of NPC2 in prognosis and immunotherapy across multiple cancer types by integrating RNA-seq data from TCGA and GTEx, protein data from CPTAC, and multiple web analysis databases.
    RESULTS: Expression depiction between tumour and normal tissues indicated that NPC2 is overexpressed in the majority of the most common cancer types, including glioblastoma and pancreatic cancer, two cancers mostly difficult to diagnose and treat.
    CONCLUSIONS: Cancer stemness in glioblastoma is negatively associated with NPC2 level. NPC2 expression is positively correlated with immune cell infiltration and the expression of several immune checkpoints. IDH1 mutation in GBM is negatively correlated with NPC2 level, while a positive correlation has been found between TP53 mutation and NPC2 expression in pancreatic cancer. NPC2 is also correlated with levels of serum biomarkers used for diagnosis of pancreatic cancer.
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