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The redox architecture of gestational diabetes mellitus: from cellular stress engine to epigenetic and mitochondrial rewiring

Free Radic Biol Med. 2026 Sep 9;256:441-460. doi: 10.1016/j.freeradbiomed.2026.09.006. Online ahead of print.

ABSTRACT

Gestational diabetes mellitus (GDM) is a common pregnancy complication with a rising global prevalence, posing serious short-term and long-term health threats to both mothers and offspring. This review repositions GDM as a systemic disorder in which oxidative stress acts as a proposed mechanistic hub, linking upstream risk factors to downstream pathophysiology. We first examine how "upstream" factors-including genetic susceptibility, pre-conception status, and environmental exposures-converge to promote a state of pathological redox imbalance. We then examine key mechanistic pathways through which oxidative stress is thought to contribute to systemic insulin resistance and pancreatic Ξ²-cell failure, highlighting novel pathways involving intercellular communication via tunneling nanotubes and exosomes. Furthermore, we explore the downstream cascade, where oxidative stress may program maternal accelerated biological aging and multi-organ offspring disease trajectories through nuclear epigenetic programming and mitochondrial dysfunction programming, leaving what has been termed a persistent "metabolic memory". Consequently, this review evaluates emerging strategies that target oxidative stress for early prediction and precision intervention. Early prediction models based on direct redox biomarkers and multi-omics signatures hold potential to shift diagnosis from late-gestation oral glucose tolerance test (OGTT) to first-trimester risk stratification. Current supporting evidence draws from human epidemiological associations, ex vivo placental analyses, and experimental models. However, direct causal and interventional validation in pregnant women remains limited. Integrating targeted redox risk stratification and precision interventions into a life-course clinical framework may help interrupt the intergenerational transmission of metabolic disease initiated by GDM.

PMID:42716407 | DOI:10.1016/j.freeradbiomed.2026.09.006

A visual analysis of the research dynamics of biomarkers for lung cancer screening

Clin Epigenetics. 2026 May 26;18(1):90. doi: 10.1186/s13148-026-02084-2.

ABSTRACT

BACKGROUND: Non-invasive biomarkers offer potential to improve risk stratification and early diagnosis of lung cancer, complementing low-dose computed tomography (LDCT) screening. This study employed bibliometric analysis to identify global research trends, collaborative networks, and future directions in lung cancer biomarker research. Publications on lung cancer biomarkers for screening were retrieved from the Web of Science Core Collection (WoSCC). Data processing and visualisation were performed using Citespace, VOSviewer, KH Coder, Latent Dirichlet Allocation (LDA) topic modelling, and the online bibliometric analysis platform. Burst detection analysis was performed to predict emerging research trends.

RESULTS: Analysis of 3636 publications revealed exponential growth in research output since 2014. International collaboration demonstrated a dual-core structure centred on China and the United States, with Chinese institutions showing high publication volumes and American institutions demonstrating greater citation influence. Journal citation mapping revealed three evolutionary phases: basic mechanisms-clinical translation-intelligent integration. LDA topic modelling identified 22 topics grouped into five core research directions: imaging and pathological diagnostic techniques; molecular and omics marker research; liquid biopsy and new detection technologies; clinical and translational medicine research; and tumour biology and treatment mechanisms. Burst detection analysis predicted future four priority areas: epigenetic studies centred on DNA methylation for risk prediction; treatment resistance and invasion mechanisms; liquid biopsy technology development; and targeted therapy clinical trials.

CONCLUSIONS: Lung cancer biomarker research has evolved towards multimodal, intelligent screening approaches. Future research priorities include DNA methylation-based markers, circulating microRNA signatures, and artificial intelligence-assisted diagnostic platforms to improve early detection accuracy and complement LDCT screening.

PMID:42185923 | DOI:10.1186/s13148-026-02084-2

A review of organoid-immune co-culture platforms to model the immune microenvironment of hepatocellular carcinoma and guide immunotherapy

J Transl Med. 2026 May 20. doi: 10.1186/s12967-026-08278-9. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is characterized by a highly immunosuppressive and heterogeneous tumor microenvironment that limits the effectiveness of current immunotherapies. Conventional two-dimensional cultures and animal models fail to fully capture patient-specific tumor-immune interactions, creating an urgent need for more physiologically relevant platforms.

MAIN BODY: This review summarizes recent advances in co-culture systems integrating patient-derived HCC organoids with defined immune cell populations to reconstruct essential features of the tumor microenvironment. We describe strategies for organoid establishment and validation, outline immune cell integration approaches, and compare static three-dimensional cultures, microfluidic organ-on-chip systems, and bioengineered multicellular platforms. We further highlight key tumor-immune interaction mechanisms that have been functionally interrogated in these systems, including immune checkpoint-mediated T-cell dysfunction, adenosine-driven metabolic suppression, and chemokine-regulated immune recruitment. Importantly, we critically evaluate current limitations, including immune cell exhaustion artifacts, lack of stromal and vascular complexity, and variability across protocols, which may affect the reproducibility and translational interpretation of these models. While emerging studies suggest potential for predicting immunotherapy responses, robust clinical validation in HCC remains limited.

CONCLUSIONS: Organoid-immune co-culture platforms represent an emerging translational framework that bridges mechanistic tumor immunology with functional precision oncology. With improved standardization and integration of multicellular bioengineering and multi-omics technologies, these systems have strong potential to guide personalized immunotherapy strategies, although further clinical validation is required.

PMID:42163357 | DOI:10.1186/s12967-026-08278-9

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