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Zhu Y, Wu W, Hou D, Zhao Y, Ye J, Shen L, Zhao T, Wu X. Mechanism of Curcumol Targeting the OTUB1/TGFBI Ubiquitination Pathway in the Inhibition of Angiogenesis in Colon Cancer. Int J Mol Sci 2025; 26:4899. [PMID: 40430059 PMCID: PMC12112734 DOI: 10.3390/ijms26104899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2025] [Revised: 05/13/2025] [Accepted: 05/19/2025] [Indexed: 05/29/2025] Open
Abstract
Tumor angiogenesis and metastasis are critical processes in the progression of colon carcinoma. Curcumol, a bioactive sesquiterpenoid derived from curcuma, exhibits anti-angiogenic properties, though its underlying mechanisms remain unclear. In this study, an HT-29 xenograft mouse model demonstrated that curcumol combined with oxaliplatin significantly suppressed tumor growth (Ki67↓) and microvessel density (CD31↓). In vitro assays revealed that curcumol dose dependently inhibited proliferation (MTT), migration (Transwell), and tube formation (CAM assay) in Caco-2/HT-29 and HUVEC cells. Mechanistically, curcumol downregulated OTUB1 expression, promoting TGFB1 degradation via the ubiquitin-proteasome pathway. OTUB1 overexpression activated the TGFB1/VEGF axis, enhancing cell invasiveness and angiogenesis-effects reversed by high-dose curcumol. These findings identify the OTUB1-TGFB1/VEGF axis as a key target of curcumol in inhibiting colon cancer angiogenesis, elucidating its anti-tumor mechanism and offering a novel therapeutic strategy for targeted treatment.
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Affiliation(s)
- Yimiao Zhu
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210046, China; (Y.Z.)
| | - Wenya Wu
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210046, China; (Y.Z.)
| | - Dahai Hou
- School of Integrated Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Yu Zhao
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210046, China; (Y.Z.)
| | - Jinshu Ye
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210046, China; (Y.Z.)
| | - Lizong Shen
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210046, China; (Y.Z.)
- Nanjing Medical University, Nanjing 211166, China
| | - Tong Zhao
- School of Integrated Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xiaoyu Wu
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210046, China; (Y.Z.)
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Qin J, Zhou D, Su M, Huang S, Nong Q, Xian X, Zhang Z. Proteomic hub proteins CDKN2B, TRAPPC2L, WFS1, and ARPP19 drive biochemical recurrence and metastatic progression in prostate cancer: Protein macromolecule action. Int J Biol Macromol 2025; 311:144059. [PMID: 40345286 DOI: 10.1016/j.ijbiomac.2025.144059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2025] [Revised: 05/02/2025] [Accepted: 05/07/2025] [Indexed: 05/11/2025]
Abstract
The biological characteristics and metastasis mechanism of prostate cancer are complex, involving the important role of many proteins in cell transcriptional regulation. This study focused on the role of the proteomic hub proteins CDKN2B, TRAPPC2L, WFS1 and ARPP19 in the biochemical recurrence and metastasis progression of prostate cancer. Cross-platform transcriptome integration and differential expression analysis were used to evaluate transcriptome characteristics in a prostate cancer cohort. Functional enrichment analysis was performed by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway annotation, and weighted gene co-expression network analysis (WGCNA) was used to investigate cancer progression subtypes. It was found that prostate cancer progression showed significant transcriptome heterogeneity, and low-expression genes dominated. We reveal the important role of epithelial-immune interactions and inflammatory signaling in transcriptional remodeling in prostate cancer. The co-expression network topology analysis showed that the immune-metabolic center module plays a central role in cancer progression. CDKN2B was identified as a key transcriptional determinant in prostate cancer typing, while TRAPPC2L and WFS1 acted as core transcriptional regulators, driving metastatic heterogeneity. ARPP19 and LOC650152 also show important transcriptional driving effects in advanced prostate cancer.
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Affiliation(s)
- Junkai Qin
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Dapeng Zhou
- Department of Burn Plastic and Wound Repair Surgery, Affiliated Hospital of Youjiang Medical University for Nationalities and Key Laboratory of Molecular Pathology in Tumors of Baise, Baise 533000, China
| | - Mingchang Su
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Siyuan Huang
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Qian Nong
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Xiaoying Xian
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China.
| | - Zhifu Zhang
- Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China.
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Zhang Z, Lu M, Shen P, Xu T, Tan S, Tang H, Yu Z, Zhou J. TGFBI promotes EMT and perineural invasion of pancreatic cancer via PI3K/AKT pathway. Med Oncol 2025; 42:181. [PMID: 40286004 DOI: 10.1007/s12032-025-02736-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2024] [Accepted: 04/18/2025] [Indexed: 04/29/2025]
Abstract
Pancreatic cancer is a highly lethal malignancy, and perineural invasion (PNI) is a common pathological feature that significantly contributes to poor prognosis. Our research identified TGFBI as a key player in PNI development. The expression of TGFBI in tissue and cancer cells were detected by RT-qPCR, Western blot, Immunohistochemistry, and ELISA. The localization of TGFBI in cells was analyzed by Immunofluorescence staining (IF). The neural invasion ability of cancer cells were assessed by in vitro neural invasion model. Moreover, Western blot was used to investigate epithelial-mesenchymal transition (EMT) markers and PI3K/AKT pathway markers to elucidate the underlying mechanisms. Finally, an in vivo neural invasion model was used to verify the tumorigenic ability of the cancer cells in the sciatic nerve. Our findings highlight that TGFBI is up-regulated in PNI tissue and significantly correlates with poor prognosis in pancreatic cancer patients. Based on in vitro experiments, knockdown of TGFBI reduced neural invasion, as well as EMT, whereas rTGFBI exhibited the reverse effect. Knockdown of TGFBI reduced PI3K/AKT phosphorylation in Capan-2 and CFPAC-1. Moreover, PI3K inhibitor LY294002 was observed to counteract the effects of TGFBI on neural invasion, and EMT in Capan-2 and CFPAC-1. In vivo, knockdown of TGFBI inhibited tumor formation in the sciatic nerve of mice. Finally, we confirmed TGFBI as potential biomarker for PNI and prognosis of pancreatic cancer. Collectively, we concluded that TGFBI activates the PI3K-AKT pathway in pancreatic cancer cells, ultimately promoting EMT and leading to PNI.
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Affiliation(s)
- Zheng Zhang
- Department of Surgery, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Miao Lu
- Department of Hepato-Pancreatico-Biliary Surgery, Zhongda Hospital Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Peiyuan Shen
- Department of Surgery, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Tonglei Xu
- Department of Surgery, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Siyuan Tan
- Department of Surgery, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Haodong Tang
- Department of Surgery, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Zeqian Yu
- Department of Hepato-Pancreatico-Biliary Surgery, Zhongda Hospital Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Jiahua Zhou
- Department of Hepato-Pancreatico-Biliary Surgery, Zhongda Hospital Southeast University, Nanjing, 210009, Jiangsu Province, China.
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Erin N, Tavşan E, Haksever S, Yerlikaya A, Riganti C. Targeting BMP-1 enhances anti-tumoral effects of doxorubicin in metastatic mammary cancer: common and distinct features of TGF-β inhibition. Breast Cancer Res Treat 2025; 210:563-574. [PMID: 39792296 PMCID: PMC11953206 DOI: 10.1007/s10549-024-07592-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2024] [Accepted: 12/17/2024] [Indexed: 01/12/2025]
Abstract
PURPOSE Mammary carcinoma is comprised heterogeneous groups of cells with different metastatic potential. 4T1 mammary carcinoma cells metastasized to heart (4THM), liver (4TLM) and brain (4TBM) and demonstrate cancer-stem cell phenotype. Using these cancer cells we found thatTGF-β is the top upstream regulator of metastatic process. In addition, secretion of bone morphogenetic protein 1 (BMP-1), which is crucial for the proteolytic release of TGF-β, was markedly high in metastatic mammary cancer cells compared to non-metastatic cells. Although TGF-β inhibitors are in clinical trials, systemic inhibition of TGF-β may produce heavy side effects. We here hypothesize that inhibition of BMP-1 proteolytic activity inhibits TGF-β activity and induces anti-tumoral effects. METHOD AND RESULTS Effects of specific BMP-1 inhibitor on liver and brain metastatic murine mammary cancer cells (4TLM and 4TBM), as well as on human mammary cancer MDA-MB-231 and MCF-7 cells, were examined and compared with the results of TGF-β inhibition. Inhibition of BMP-1 activity markedly suppressed proliferation of cancer cells and enhanced anti-tumoral effects of doxorubicin. Inhibition of BMP-1 activity but not of TGF-β activity decreased colony and spheroid formation. Differential effects of BMP-1 and TGF-β inhibitors on TGF-β secretion was also observed. CONCLUSIONS These results demonstrated for the first time that the inhibition of BMP-1 activity has therapeutic potential for treatment of metastatic mammary cancer and enhances the anti-tumoral effects of doxorubicin.
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Affiliation(s)
- Nuray Erin
- Department of Medical Pharmacology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
| | - Esra Tavşan
- Department of Medical Pharmacology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Seren Haksever
- Department of Medical Pharmacology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Azmi Yerlikaya
- Department of Medical Biology, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Chiara Riganti
- Department of Oncology, University of Torino, Via Nizza 44, 10126, Turin, Italy
- Molecular Biotechnology Center "Guido Tarone", Via Nizza 44, 10126, Turin, Italy
- Interdepartmental Center "G.Scansetti" for the Study of Asbestos and Other Toxic Particulates, University of Torino, 10126, Turin, Italy
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Xiao L, Shen Z, Pan Z, Qiu Y, Huang D, Liu Y, Liu C, Zhang X. High-dimensional deconstruction of HNSC reveals clinically distinct cellular states and ecosystems that are associated with prognosis and therapy response. J Transl Med 2025; 23:254. [PMID: 40025504 PMCID: PMC11872339 DOI: 10.1186/s12967-025-06299-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Accepted: 02/23/2025] [Indexed: 03/04/2025] Open
Abstract
BACKGROUND Characterizing the variety of cell types in the tumor microenvironment (TME) and their organization into cellular communities is vital for elucidating the biological diversity of cancer and informing therapeutic strategies. METHODS Here, we employed a machine learning-based algorithm framework, EcoTyper, to analyze single-cell transcriptomes from 139 patients with head and neck squamous cell carcinoma (HNSC)and gene expression profiles from 983 additional HNSC patients, aiming to delineate the fundamental cell states and ecosystems integral to HNSC. RESULTS A diverse landscape of 66 cell states and 9 ecosystems within the HNSC microenvironment was identified, revealing classical cell types while also expanding upon previous immune classifications. Survival analysis revealed that specific cell states and ecotypes (ecosystems) are associated with patient prognosis, underscoring their potential as indicators of clinical outcomes. Moreover, distinct cell states and ecotypes exhibited varying responses to immunotherapy and chemotherapy, with several showing promise as predictive biomarkers for treatment efficacy. CONCLUSION Our large-scale integrative transcriptome analysis provides high-resolution insights into the cellular states and ecosystems of HNSC, facilitating the discovery of novel biomarkers and supporting the development of precision therapies.
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Affiliation(s)
- Lei Xiao
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China
| | - Zhe Shen
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China
| | - Zhaoyu Pan
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China
| | - Yuanzheng Qiu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China
| | - Donghai Huang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China
| | - Yong Liu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China
| | - Chao Liu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China.
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China.
| | - Xin Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, 410008, Hunan, China.
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, 410008, Hunan, China.
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Han J, Shin YH, Kim E, Park HM, Kim JY. Proteomic Characterization of NEDD4 Unveils Its Potential Novel Downstream Effectors in Gastric Cancer. J Proteome Res 2025; 24:891-902. [PMID: 39874481 DOI: 10.1021/acs.jproteome.4c01109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2025]
Abstract
The E3 ubiquitin ligase neural precursor cell-expressed developmentally down-regulated 4 (NEDD4) is involved in various cancer signaling pathways, including PTEN/AKT. However, its role in promoting gastric cancer (GC) progression is unclear. This study was conducted to elucidate the role of NEDD4 in GC progression. We found that the inhibition of NEDD4 expression significantly reduced the migratory and proliferative abilities of GC cells, with minimal impact on the PTEN expression or p-AKT activation, suggesting that NEDD4 may exert its GC-promoting effects through alternative pathways. To gain novel insights into the role of NEDD4 in GC, we performed a comprehensive proteomic analysis to search for proteins with altered expression levels following NEDD4 gene knockdown, identifying a total of 3916 proteins. Pathway analysis of differentially expressed proteins (DEPs) indicated the potential involvement of NEDD4 in cancer-related metabolic pathways. Furthermore, the protein-protein interaction network of the DEPs revealed enriched core modules, highlighting key cellular processes and signaling pathways regulated by NEDD4 in GC. Additionally, we identified proteins whose expression was altered by NEDD4 inhibition, some of which were associated with poor prognosis in GC. These findings suggest that these proteins may act as downstream effectors that contribute to NEDD4-mediated GC progression.
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Affiliation(s)
- Jisoo Han
- Graduate School of Analytical Science and Technology (GRAST), Chungnam National University, Daejeon 34134, Republic of Korea
| | - Yoon-Hee Shin
- Advanced Analysis and Data Center, Korea Institute of Science and Technology (KIST), Seoul 02456, Republic of Korea
| | - Eunjung Kim
- Natural Product Systems Biology Research Center, Korea Institute of Science and Technology (KIST), Gangneung 25451, Republic of Korea
| | - Hyun-Mee Park
- Advanced Analysis and Data Center, Korea Institute of Science and Technology (KIST), Seoul 02456, Republic of Korea
| | - Jae-Young Kim
- Graduate School of Analytical Science and Technology (GRAST), Chungnam National University, Daejeon 34134, Republic of Korea
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Zhang X, Li G, Tan F, Yu T, Xu C, Li K, Zhang F, Zhang M, Wang J. MARCHF8-mediated ubiquitination via TGFBI regulates NF-κB dependent inflammatory responses and ECM degradation in intervertebral disc degeneration. PLoS One 2025; 20:e0314021. [PMID: 39752341 PMCID: PMC11698339 DOI: 10.1371/journal.pone.0314021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 11/05/2024] [Indexed: 01/06/2025] Open
Abstract
AIM To explore the role of the hub gene Transforming Growth Factor Beta Induced (TGFBI) in Intervertebral disc degeneration (IDD) pathogenesis and its regulatory relationship with Membrane Associated Ring-CH-Type Finger 8 (MARCHF8). BACKGROUND IDD is a prevalent musculoskeletal disorder leading to spinal pathology. Despite its ubiquity and impact, effective therapeutic strategies remain to be explored. OBJECTIVE Identify key modules associated with IDD and understand the impact of TGFBI on nucleus pulposus (NP) cell behavior, extracellular matrix (ECM)-related proteins, and the Nuclear Factor kappa-light-chain-enhancer of Activated B cells (NF-κB) signaling pathway. METHODS The GSE146904 dataset underwent Weighted Gene Co-Expression Network Analysis (WGCNA) for key module identification and Differentially Expressed Genes (DEGs) screening. Intersection analysis, network analysis, and co-expression identified TGFBI as a hub gene. In vitro experiments delved into the interplay between TGFBI and MARCHF8 and their effects on NP cells. RESULTS WGCNA linked the MEturquoise module with IDD samples, revealing 145 shared genes among DEGs. In vitro findings indicated that MARCHF8 determines TGFBI expression. TGFBI boosts apoptosis and ECM breakdown in Lipopolysaccharide-stimulated (LPS-stimulated) NP cells. Altering TGFBI levels modulated these effects and the NF-κB signaling pathway, influencing inflammatory cytokine concentrations. Moreover, MARCHF8 ubiquitination controlled TGFBI expression. CONCLUSION TGFBI, modulated by MARCHF8, significantly influences IDD progression by affecting NP cell apoptosis, ECM degradation, and inflammation through the NF-κB signaling pathway.
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Affiliation(s)
- Xingpeng Zhang
- Department of Orthopedics, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Guang Li
- Department of Traumatic Surgery, Emergency Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fang Tan
- Department of Orthopedics, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Tao Yu
- Department of Orthopedics, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Chengping Xu
- Department of Orthopedics, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Kai Li
- Department of Orthopedics, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Feng Zhang
- Department of Orthopedics, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Meiyan Zhang
- Shanghai Circle Harmony Xinyong Clinic, Shanghai, China
| | - Jian Wang
- Department of Orthopedics, Shanghai Pudong New Area People’s Hospital, Shanghai, China
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