Lung adenocarcinoma promotion by air pollutants

Sustained NF-κB activation allows mutant alveolar stem cells to co-opt a regeneration program for tumor initiation

Disruptions to regulatory signals governing stem cell fate open the pathway to tumorigenesis. To determine how these programs become destabilized, we fate-map thousands of murine wild-type and KrasG12D-mutant alveolar type II (AT2) stem cells in vivo and find evidence for two independent AT2 subpopulations marked by distinct tumorigenic capacities. By combining clonal analyses with single-cell transcriptomics, we unveil striking parallels between lung regeneration and tumorigenesis that implicate Il1r1 as a common activator of AT2 reprogramming. We show that tumor evolution proceeds through the acquisition of lineage infidelity and reversible transitions between mutant states, which, in turn, modulate wild-type AT2 dynamics. Finally, we discover how sustained nuclear factor κB (NF-κB) activation sets tumorigenesis apart from regeneration, allowing mutant cells to subvert differentiation in favor of tumor growth.

The complex interplay between aging and cancer

Cancer is an age-related disease, but the interplay between cancer and aging is complex and their shared molecular drivers are deeply intertwined. This Review provides an overview of how different biological pathways affect cancer and aging, leveraging evidence mainly derived from animal studies. We discuss how genome maintenance and accumulation of DNA mutations affect tumorigenesis and tissue homeostasis during aging. We describe how age-related telomere dysfunction and cellular senescence intricately modulate tumor development through mechanisms involving genomic instability and inflammation. We examine how an aged immune system and chronic inflammation shape tumor immunosurveillance, fueling DNA damage and cellular senescence. Finally, as animal models are important to untangling the relative contributions of these aging-modulated pathways to cancer progression and to test interventions, we discuss some of the limitations of physiological and accelerated aging models, aiming to improve experimental designs and enhance translation.

Identification of G protein subunit alpha i3 as a promising oncotarget of LUAD

Exploring new oncotargets essential for lung adenocarcinoma (LUAD) cell growth is important. Here the bioinformatical studies revealed that Gαi3 expression is elevated in LUAD tissues and its overexpression correlates with poor survival of the patients. Moreover, overexpression of Gαi3 mRNA and protein was detected in LUAD tissues of patients as well as in primary/immortalized LUAD cells. In both primary and immortalized LUAD cells, genetic silencing (by viral shRNA) or knockout ("KO", through CRISPR/Cas9 method) of Gαi3 potently inhibited LUAD cell proliferation and mobility. The results of caspase-3 activity assay, caspase-9 activity assay, histone DNA ELISA, TUNEL nuclear staining and Annexin V staining showed that inhibition of Gαi3 expression promoted apoptosis. In addition, a significant decrease in mitochondrial membrane potential was found in Gαi3-deficient LUAD cells by JC-1 staining. Overexpression of Gαi3 strengthened the proliferation and migration of LUAD cell. Gene set enrichment analysis revealed that Gαi3 was closely related to PI3k/Akt/mTOR, which we validated experimentally. Akt-S6K phosphorylation was downregulated following Gαi3 silencing or KO, but augmented after Gαi3 overexpression in primary LUAD cells. Restoring Akt-S6K phosphorylation by a S473D constitutively-active mutant Akt1 ameliorated Gαi3 KO-induced LUAD cell proliferation inhibition, migration suppression and apoptosis. In vivo, the growth of subcutaneous LUAD xenografts was largely inhibited after intratumoral injection of Gαi3 shRNA-expressing adeno-associated virus (AAV). Gαi3 downregulation, Akt-mTOR inhibition, proliferation inactivation and apoptosis were detected in the Gαi3 shRNA-treated LUAD xenografts. Together, targeting Gαi3 potently inhibited LUAD cell growth in vitro and in vivo.

Impact of air pollution on the progress-free survival of non-small cell lung cancer patients with anti-PD-1/PD-L1 immunotherapy: A cohort study

Air pollution is a well-established risk factor for lung cancer, but limited evidence exists on its impact on the treatment of lung cancer. The objective of this study was to investigate the impact of key pollutants on the efficacy of PD-1/PD-L1 inhibitor immunotherapy in non-small cell lung cancer (NSCLC) patients, thereby providing clinicians with evidence to potentially enhance the efficacy of PD-1 therapy and inform policy decisions for cancer care. To this end, we conducted a study involving 361 NSCLC patients who received PD-1/PD-L1 inhibitor immunotherapy, examining the correlation between air pollution exposure and progression-free survival (PFS) following immunotherapy treatment. Their moving-average ambient levels up to 1 year of PM2.5 and its constituents (organic matter (OM), black carbon (BC), nitrate (NO3-), sulfate (SO42-), and ammonium (NH4+)), as well as ozone (O3) were estimated using the Tracking Air Pollution in China dataset. Cox proportional hazards models were adopted to estimate the effects of exposure to each pollutant on PFS risk for NSCLC. 179 patients obtained the progression of NSCLC. While PM2.5 exposure prior to the immunotherapy was not associated with NSCLC progression, long-term exposure to BC and OM, the important organic components of PM2.5, were significantly associated with a higher risk of NSCLC progression with corresponding hazard ratios (HRs, 95% confidence intervals) of 2.42 (1.39, 4.23) and 2.41 (1.40, 4.14) for 1-year moving average, respectively. Short-term exposure to O3 was also associated with PFS with a HR of 1.64 (1.08, 2.50) for 3-month averaged exposure. Monotonic increasing dose-response relationships were further observed for the associations of BC, OM and O3 with PFS. Our findings imply the need of implementing effective measures for targeted reduction in specific sources of PM2.5 constituents (especially BC and OM) and O3 at different time windows to improve the prognosis of NSCLC patients especially for their PFS.

Exposomal determinants of non-genetic plasticity in tumor initiation

The classical view of cancer as a genetically driven disease has been challenged by recent findings of oncogenic mutations in phenotypically healthy tissues, refocusing attention on non-genetic mechanisms of tumor initiation. In this context, gene-environment interactions take the stage, with recent studies showing how they unleash and redirect cellular and tissue plasticity towards protumorigenic states in response to the exposome, the ensemble of environmental factors impinging on tissue homeostasis. We conceptualize tumor-initiating plasticity as a phenotype-transforming force acting at three levels: cell-intrinsic, focusing on mutant epithelial cells' responses to environmental variation; reprogramming of non-neoplastic cells of the host, leading to protumor micro- and macroenvironments; and microbiome ecosystem dynamics. This perspective highlights cell, tissue, and organismal plasticity mechanisms underlying tumor initiation that are shaped by the exposome, and how their functional investigation may provide new opportunities to prevent, detect, and intercept cancer-promoting plasticity.

Translating premalignant biology to accelerate non-small-cell lung cancer interception

Over the past decade, substantial progress has been made in the development of targeted and immune-based therapies for patients with advanced non-small-cell lung cancer. To further improve outcomes for patients with lung cancer, identifying and intercepting disease at the earliest and most curable stages are crucial next steps. With the recent implementation of low-dose computed tomography scan screening in populations at high risk, there is an emerging unmet need for new diagnostic, prognostic and therapeutic tools to help treat patients suspected of harbouring premalignant lesions and minimally invasive non-small-cell lung cancer. Continued advances in the identification of the earliest drivers of lung carcinogenesis are poised to address these unmet needs. Employing multimodal approaches to chart the temporal and spatial maps of the molecular events driving lung premalignant lesion progression will refine our understanding of early carcinogenesis. Elucidating the molecular drivers of premalignancy is critical to the development of biomarkers to detect those incubating a premalignant lesion, to stratify risk for progression to invasive cancer and to identify novel therapeutic targets to intercept that process. In this Review, we summarize emerging insights into the earliest cellular and molecular events associated with lung squamous and adenocarcinoma carcinogenesis and highlight the growing opportunity for translating these insights into clinical tools for early detection and disease interception to transform the outcomes for those at risk for lung cancer.

The Erosion of Healthcare and Scientific Integrity: A Growing Concern

Background

Tremendous achievements in healthcare and science over the past 200 years have enhanced life expectancy in parallel with a shift from dogma to humanistic liberal education. Advancements in cancer have included vaccines treating causes of cancer (eg, hepatitis C- induced liver cancer and human papillomavirus-induced cervical cancer) along with improved cancer survival in children. In contrast, developments in cancer, frequently touted as "discoveries" or "breakthroughs" in media headlines, have been demonstrated to be ephemeral rather than game changers. In reality, cancer incidences are increasing, and relapse and mortality rates have not changed substantially. By this, we are experiencing today similar challenges to those before the so-called Humboldt reform. The trend towards managerialism with a focus on quantity in health care and science endangers their integrity.

Methods

Due to the complexity of integrity of healthcare and science, in-depth contemplation of this review contains foundations of actions in healthcare and science, information regarding cancer, as an example, quantity focus of healthcare, technology, publishing, marketing and media, predatory publishers, followed by psychologic and sociologic aspects which influence our perception.

Results

A complex paradoxical transformation has occurred, in which quality and humanism have been replaced by quantity, revenue, and marketing, together with "citation silence", (ignoring original findings), and increased corruption and misconduct. This shift explains why the integrity of healthcare and science is being eroded.

Conclusion

Countries and societies are only as strong as their healthcare and science, both of which are only as strong as their emphasis on quality and integrity. Awareness of this situation may represent a first step toward a renewed focus on accountability.

Interplay of Polygenic Risk Score, Smoking Statuses, and Air Pollution on Lung Adenocarcinoma Risk in a Taiwanese Population

BACKGROUND AND OBJECTIVE

We determined the impact of genetic susceptibility and its interaction with smoking and air pollution on the risk of developing lung adenocarcinoma.

METHODS

This retrospective case-control study utilised data from Taiwan Precision Medicine Initiative (TPMI) project conducted between June 2019 and November 2022. The study population consisted of lung adenocarcinoma patients and 1:4 age-, gender-, and index year-matched non-lung cancer controls. We analysed polygenic risk scores (PRS), smoking status, as well as PM2.5 and PM10 exposures.

RESULTS

A total of 681 lung adenocarcinoma patients and 2724 non-lung cancer participants were included. PRS was significantly higher among lung adenocarcinoma patients than controls (p < 0.001). Overall, a higher PRS was associated with a higher risk of lung adenocarcinoma. A high PM2.5 exposure was associated with a higher risk of lung adenocarcinoma (OR 1.88 [95% CI 1.12-3.14], p = 0.0163) among never-smokers with low genetic risk. Never-smokers with a higher genetic risk were associated with a higher OR for lung adenocarcinoma with the highest OR among Q4 participants with high PM2.5 exposure (4.97 [95% CI 3.10-7.97], p < 0.001). There was no significant impact of PM2.5 exposure among individuals with higher genetic risks. Similar phenomena were observed in the PM10 analyses. There were no significant correlations of PRS with risk of lung adenocarcinoma among smokers.

CONCLUSION

PRS significantly predicted lung adenocarcinoma incident cases in a dose-dependent manner among never-smokers. The PRS effect was not noted in smokers. The results were consistent among participants exposed to different air pollution levels.

Targeting the Tumor Microenvironment in EGFR-Mutant Lung Cancer: Opportunities and Challenges

Tyrosine kinase inhibitors (TKIs) have transformed the treatment of epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer. However, treatment resistance remains a major challenge in clinical practice. The tumor microenvironment (TME) is a complex system composed of tumor cells, immune and non-immune cells, and non-cellular components. Evidence indicates that dynamic changes in TME during TKI treatment are associated with the development of resistance. Research has focused on identifying how each component of the TME interacts with tumors and TKIs to understand therapeutic targets that could address TKI resistance. In this review, we describe how TME components, such as immune cells, fibroblasts, blood vessels, immune checkpoint proteins, and cytokines, interact with EGFR-mutant tumors and how they can promote resistance to TKIs. Furthermore, we discuss potential strategies targeting TME as a novel therapeutic approach.

Copper-enriched automotive brake wear particles perturb human alveolar cellular homeostasis

BACKGROUND

Airborne fine particulate matter with diameter < 2.5 μm (PM2.5), can reach the alveolar regions of the lungs, and is associated with over 4 million premature deaths per year worldwide. However, the source-specific consequences of PM2.5 exposure remain poorly understood. A major, but unregulated source is car brake wear, which exhaust emission reduction measures have not diminished.

METHODS

We used an interdisciplinary approach to investigate the consequences of brake-wear PM2.5 exposure upon lung alveolar cellular homeostasis using diesel exhaust PM as a comparator. This involved RNA-Seq to analyse global transcriptomic changes, metabolic analyses to investigate glycolytic reprogramming, mass spectrometry to determine PM composition, and reporter assays to provide mechanistic insight into differential effects.

RESULTS

We identified brake-wear PM from copper-enriched non-asbestos organic, and ceramic brake pads as inducing the greatest oxidative stress, inflammation, and pseudohypoxic HIF activation (a pathway implicated in diseases associated with air pollution exposure, including cancer, and pulmonary fibrosis), as well as perturbation of metabolism, and metal homeostasis compared with brake wear PM from low- or semi-metallic pads, and also, importantly, diesel exhaust PM. Compositional and metal chelator analyses identified that differential effects were driven by copper.

CONCLUSIONS

We demonstrate here that brake-wear PM may perturb cellular homeostasis more than diesel exhaust PM. Our findings demonstrate the potential differences in effects, not only for non-exhaust vs exhaust PM, but also amongst different sources of non-exhaust PM. This has implications for our understanding of the potential health effects of road vehicle-associated PM. More broadly, our findings illustrate the importance of PM composition on potential health effects, highlighting the need for targeted legislation to protect public health.

S-Adenosylmethionine: A Multifaceted Regulator in Cancer Pathogenesis and Therapy

S-adenosylmethionine (SAMe) is a key methyl donor that plays a critical role in a variety of cellular processes, such as DNA, RNA and protein methylation, essential for maintaining genomic stability, regulating gene expression and maintaining cellular homeostasis. The involvement of SAMe in cancer pathogenesis is multifaceted, as through its multiple cellular functions, it can influence tumor initiation, progression and therapeutic resistance. In addition, the connection of SAMe with polyamine synthesis and oxidative stress management further underscores its importance in cancer biology. Recent studies have highlighted the potential of SAMe as a biomarker for cancer diagnosis and prognosis. Furthermore, the therapeutic implications of SAMe are promising, with evidence suggesting that SAMe supplementation or modulation could improve the efficacy of existing cancer treatments by restoring proper methylation patterns and mitigating oxidative damage and protect against damage induced by chemotherapeutic drugs. Moreover, targeting methionine cycle enzymes to both regulate SAMe availability and SAMe-independent regulatory effects, particularly in methionine-dependent cancers such as colorectal and lung cancer, presents a promising therapeutic approach. Additionally, exploring epitranscriptomic regulations, such as m6A modifications, and their interaction with non-coding RNAs could enhance our understanding of tumor progression and resistance mechanisms. Precision medicine approaches integrating patient subtyping and combination therapies with chemotherapeutics, such as decitabine or doxorubicin, together with SAMe, can enhance chemosensitivity and modulate epigenomics, showing promising results that may improve treatment outcomes. This review comprehensively examines the various roles of SAMe in cancer pathogenesis, its potential as a diagnostic and prognostic marker, and its emerging therapeutic applications. While SAMe modulation holds significant promise, challenges such as bioavailability, patient stratification and context-dependent effects must be addressed before clinical implementation. In addition, better validation of the obtained results into specific cancer animal models would also help to bridge the gap between research and clinical practice.

Toxicity assessment of airborne ultrafine particles: Role of transport emissions

Airborne quasi-ultrafine particle samples were collected from different outdoor sites in Barcelona (NE Spain, 35 samples) and the Valencia subway (about 400 km south of Barcelona, 3 samples). Locations and schedules were designed to cover cold and warm seasons and to represent the impact of different types of transport (cars, trains, ships, and planes). Extracts from PTFE filters (methanol:dichloromethane 1:2) were used to test toxic effects in human cell lines (Induction of reactive oxygen species, inflammatory response) and in zebrafish embryos (expression of xenobiotic response-related genes, cyp1a1, gsa1 and hao1). We observed distinct toxic effects related to different forms of oxidative stress and to inflammatory response, the two types of negative outcomes more closely related to the known epidemiological impacts of air pollution. The highest toxicity values were detected in sites receiving car and/or ship emissions, with maximums during the cold season. Chemical analysis followed by correlation and source apportionment analyses identified PAHs, combustion engines, and biomass burning emissions as the main drivers of the observed toxic effects. Therefore, traffic restrictions, car emission limits, and reduction of combustion processes are necessary to eliminate or at least to limit airborne toxicity in urban environments.

Biomagnetic monitoring of urban atmospheric pollution: A review of magnetic signatures from different types of plants

Biomagnetic monitoring has rapidly emerged as a valuable tool in urban atmospheric pollution (UAP) assessment due to its high spatial resolution, complementing traditional monitoring systems. This review systematically elucidates the principles of plant dust retention and the factors influencing it, while also reviewing the advancements in global research on UAP monitoring through the magnetic properties of various plant species. We provide a comprehensive analysis of the current applications of biomagnetic monitoring in UAP and identify critical challenges, including species-specific monitoring discrepancies, complex pollution sources, and non-standardized sample preparation methods. Additionally, we propose future research directions to address these challenges and enhance the efficacy of biomagnetic monitoring in UAP.

Influence of air quality on lung cancer in people who have never smoked

OBJECTIVE

Lung cancer is the leading cause of cancer-related death. The percentage of people who have never smoked with lung cancer has risen recently, but alternative risk factors require further study. Our goal was to determine the influence of air quality on incidence of lung cancer in people who have smoked or never smoked.

METHODS

The cancer registry from a large urban medical center was queried to include every new diagnosis of lung cancer from 2013 to 2021. Air quality and pollution data for the county were obtained from the US Environmental Protection Agency from 1980 to 2018. Patient demographics, location of residence, smoking history, and tumor stage were recorded. Bivariate comparison analyses were conducted in R (R Foundation for Statistical Computing).

RESULTS

A total of 2223 new cases of lung cancer were identified. Mean age was 69.2 years. There was a nonsmoking rate of 8.1%. A total of 37% of patients identified as a racial minority. People who have never smoked were more likely to be diagnosed at an advanced stage. When analyzing geographic distribution, incidence of lung cancer among people who have never smoked was more closely associated with highly polluted areas. People who have never smoked with lung cancer had significantly higher exposure levels of multiple pollutants.

CONCLUSIONS

Newly diagnosed lung cancer appears to be more related to poor air quality among people who have never smoked than people who have smoked. Future studies are needed to examine the associations of specific pollutants with lung cancer incidence.

IARC Workshop on the Key Characteristics of Carcinogens: Assessment of End Points for Evaluating Mechanistic Evidence of Carcinogenic Hazards

BACKGROUND

The 10 key characteristics (KCs) of carcinogens form the basis of a framework to identify, organize, and evaluate mechanistic evidence relevant to carcinogenic hazard identification. The 10 KCs are related to mechanisms by which carcinogens cause cancer. The International Agency for Research on Cancer (IARC) Monographs programme has successfully applied the KCs framework for the mechanistic evaluation of different types of exposures, including chemicals, metals, and complex exposures, such as environmental, occupational, or dietary exposures. The use of this framework has significantly enhanced the identification and organization of relevant mechanistic data, minimized bias in evaluations, and enriched the knowledge base regarding the mechanisms of known and suspected carcinogens.

OBJECTIVES

We sought to report the main outcomes of an IARC Scientific Workshop convened by the IARC to establish appropriate, transparent, and uniform application of the KCs in future IARC Monographs evaluations.

METHODS

A group of experts from different disciplines reviewed the IARC Monographs experience with the KCs of carcinogens, discussing three main themes: a) the interpretation of end points forming the evidence base for the KCs, b) the incorporation of data from novel assays on the KCs, and c) the integration of the mechanistic evidence as part of cancer hazard identification. The workshop participants assessed the relevance and the informativeness of multiple KCs-associated end points for the evaluation of mechanistic evidence in studies of exposed humans and experimental systems.

DISCUSSION

Consensus was reached on how to enhance the use of in silico, molecular, and cellular high-output and high-throughput data. In addition, approaches to integrate evidence across the KCs and opportunities to improve methodologies of mechanistic evaluation of cancer hazards were explored. The findings described herein and in a forthcoming IARC technical report will support future working groups of experts in reporting and interpreting results under the KCs framework within the IARC Monographs or in other contexts. https://doi.org/10.1289/EHP15389.

Microplastic exposure induces HSP90α secretion and aggravates asthmatic airway remodeling via PI3K-Akt-mTOR pathway

Microplastics pollution has raised a considerable awareness due to their extensive distribution in the environment. It has potential side effects on human health. Microplastics can enter the human respiratory system, then deposit in the lung, destroying the structure of the bronchus and alveoli, and causing pulmonary inflammation, mucus production, and airway hyperresponsiveness, leading to the aggravation of asthma. Nevertheless, the underlying mechanism remains elusive. There are several cytokines involved in the inflammatory response of asthma. Heat shock protein 90α(HSP90α) is one of cytokines involving in inflammation which is a member of the HSPs family. The aim of this study is to explore the mechanism by which microplastics influence the secretion of HSP90α and the progression of asthma. Initially, we found that microplastics were destroyed airway epithelial barrier, resulting in inherent dysfunction in the secretion of HSP90α. Then, microplastics were proved to activate PI3K-Akt-mTOR pathway by prompting airway epithelial cells secrete HSP90α and proliferation of airway smooth muscle cells(ASMCs), leading to airway narrowing and hypersensitivity. 1G6-D7 is a monoclonal antibody to HSP90, which can reverse the pulmonary inflammation infiltration, mucus production, and airway hyperresponsiveness(AHR). Overall, these finding suggested that microplastics elicited inflammation via the PI3K-Akt-mTOR signaling pathway and stimulated the proliferation of ASMCs. Hence, the present study unveils a novel mechanism responsible for microplastic-induced inflammation and airway hyperreactivity, establishing a basis for further research and risk evaluations of microplastics.

Distributions and trends in the global burden of young-onset tracheal, bronchus, and lung cancer by region, age, and sex from 1990 to 2021: An age-period-cohort analysis

BACKGROUND

The young onset Tracheal, Bronchus, and Lung Cancer (TBLC) exhibits distinct gene mutations and clinical characteristics. With worsening air pollution, the incidence of young onset TBLC is increasing, resulting in significant economic burdens. The specific epidemiology of the disease burden remains elusive.

METHODS

The updated Global Burden of Disease (GBD) 2021 study was employed. This study reports on the disease burden trends of young TBLC (≤54 years) and its risk factors. Data is presented as counts and age-standardized rates (ASRs) per 100,000 people across different age groups, years, sexes, sociodemographic levels (SDI), and geographic locations (global, regional, and national). An age-period-cohort (APC) model was used to analyze longitudinal curves on age, period, and cohort effects for young TBLC. Decomposition analysis broke down temporal changes into three factors: population aging, population growth, and epidemiological change, to quantify the changes and identify their causes. An inequality index was applied to examine the inequality of disease burden of young TBLC by sex across different SDI levels between 1990 and 2021.

RESULTS

From 1990-2021, the global number of individuals under 55 diagnosed with TBLC increased from 320,715 to 489,080, representing a 52 % rise. However, the age-standardized rates of prevalence (Average annual percentage changes (AAPC) -0.05 %), incidence (AAPC -0.59 %), mortality (AAPC -0.88 %), and disability-adjusted life-years (DALYs) (AAPC -0.92 %) all showed a notable decline tendency. In 2021, there were 258,360 new diagnoses and 207,000 deaths from young TBLC, with ASRs of incidence and mortality at 6.43 and 5.49 per 100,000, respectively. Regionally, East Asia bore the highest burden, with about 117,730 new young TBLC cases and an ASR of 12.01 per 100,000 people. Decomposition analysis indicated that population growth was the primary driver for the increased prevalence of young TBLC. While tobacco-related DALYs for young TBLC decreased globally, tobacco remains the leading risk factor. In contrast, air pollution-related DALYs have significantly increased in middle and lower SDI regions. Over the past two decades, the burden of young TBLC among females has grown substantially, with increased inequality observed in 2021. Tobacco was the largest contributor to the PAF of young female DALYs in high SDI regions, whereas air pollution was the leading contributor in other SDI regions.

CONCLUSION

While the total number of young TBLC cases has been on the rise trend, primarily due to population changes, the ASRs of young TBLC burdens have decreased over the past two decades. In 2021, East Asia recorded the highest ASRs for young TBLC in terms of prevalence, incidence, and mortality. Tobacco remains the primary risk factor for young TBLC, and the DALYs burden from tobacco use has significantly decreased. However, the incidence of TBLC among non-smoking young females has grown rapidly over the past two decades, mainly due to air pollution, leading to increased inequality.

Role of chemokines in aging and age-related diseases

Chemokines (chemotactic cytokines) play essential roles in developmental process, immune cell trafficking, inflammation, immunity, angiogenesis, cellular homeostasis, aging, neurodegeneration, and tumorigenesis. Chemokines also modulate response to immunotherapy, and consequently influence the therapeutic outcome. The mechanisms underlying these processes are accomplished by interaction of chemokines with their cognate cell surface G protein-coupled receptors (GPCRs) and subsequent cellular signaling pathways. Chemokines play crucial role in influencing aging process and age-related diseases across various tissues and organs, primarily through inflammatory responses (inflammaging), recruitment of macrophages, and orchestrated trafficking of other immune cells. Chemokines are categorized in four distinct groups based on the position and number of the N-terminal cysteine residues; namely, the CC, CXC, CX3C, and (X)C. They mediate inflammatory responses, and thereby considerably impact aging process across multiple organ-systems. Therefore, understanding the underlying mechanisms mediated by chemokines may be of crucial importance in delaying and/or modulating the aging process and preventing age-related diseases. In this review, we highlight recent progress accomplished towards understanding the role of chemokines and their cellular signaling pathways involved in aging and age-relaed diseases of various organs. Moreover, we explore potential therapeutic strategies involving anti-chemokines and chemokine receptor antagonists aimed at reducing aging and mitigating age-related diseases. One of the modern methods in this direction involves use of chemokine receptor antagonists and anti-chemokines, which suppress the pro-inflammatory response, thereby helping in resolution of inflammation. Considering the wide-spectrum of functional involvements of chemokines in aging and associated diseases, several clinical trials are being conducted to develop therapeutic approaches using anti-chemokine and chemokine receptor antagonists to improve life span and promote healthy aging.

Arginine Metabolism Reprogramming in Perfluorooctanoic Acid (PFOA)-Induced Liver Injury

Perfluorooctanoic acid (PFOA) is a persistent pollutant that has gained worldwide attention, owing to its widespread presence in the environment. Previous studies have reported that PFOA upregulates lipid metabolism and is associated with liver injury in humans. However, when the fatty acid degradation pathway is activated, lipid accumulation still occurs, suggesting the presence of unknown pathways and mechanisms that remain to be elucidated. In this study, adult C57BL/6N mice were exposed to PFOA at 0.1, 1, and 10 mg/kg/day. Using integrated metabolomics and transcriptomics, it was uncovered that arginine metabolism was differentially downregulated in all three groups. In vitro studies confirmed the downregulation of arginine metabolism in MIHA cell lines treated with PFOA. Supplementation of arginine could effectively rescue liver injury and downregulate the chemokine levels caused by PFOA. This finding highlights the contribution of arginine metabolism in maintaining liver health following PFOA exposure and suggests potential mechanisms of metabolic and immune modulation.

Cancer evolution: from Darwin to the Extended Evolutionary Synthesis

The fundamental evolutionary nature of cancer has been recognized for decades. Increasingly powerful genetic and single cell sequencing technologies, as well as preclinical models, continue to unravel the evolution of premalignant cells, and progression to metastatic stages and to drug-resistant end-stage disease. Here, we summarize recent advances and distil evolutionary principles and their relevance for the clinic. We reveal how cancer cell and microenvironmental plasticity are intertwined with Darwinian evolution and demonstrate the need for a conceptual framework that integrates these processes. This warrants the adoption of the recently developed Extended Evolutionary Synthesis (EES).

Transcriptome-Wide Analysis of N6-Methyladenosine-Modified Long Noncoding RNAs in Particulate Matter-Induced Lung Injury

BACKGROUND

N6-methyladenosine (m6A) modification plays a crucial role in the regulation of diverse cellular processes influenced by environmental factors. Nevertheless, the involvement of m6A-modified long noncoding RNAs (lncRNAs) in the pathogenesis of lung injury induced by particulate matter (PM) remains largely unexplored.

METHODS

Here, we establish a mouse model of PM-induced lung injury. We utilized m6A-modified RNA immunoprecipitation sequencing (MeRIP-seq) to identify differentially expressed m6A peaks on long non-coding RNAs (lncRNAs). Concurrently, we performed lncRNA sequencing (lncRNA-seq) to determine the differentially expressed lncRNAs. The candidate m6A-modified lncRNAs in the lung tissues of mice were identified through the intersection of the data obtained from these two sequencing approaches.

RESULTS

A total of 664 hypermethylated m6A peaks on 644 lncRNAs and 367 hypomethylated m6A peaks on 358 lncRNAs are confirmed. We use bioinformatic tools to analyze the potential functions and pathways of these m6A-modified lncRNAs, revealing their involvement in regulating inflammation, immune response, and metabolism-related pathways. Three key m6A-modified lncRNAs (lncRNA NR_003508, lncRNA uc008scb.1, and lncRNA ENSMUST00000159072) are identified through a joint analysis of the MeRIP-seq and lncRNA-seq data, and their validation is carried out using MeRIP-PCR and qRT-PCR. Analysis of the coding-non-coding gene co-expression network reveals that m6A-modified lncRNAs NR_003508 and uc008scb.1 participate in regulating pathways associated with inflammation and immune response.

CONCLUSIONS

This study first provides a comprehensive transcriptome-wide analysis of m6A methylation profiling in lncRNAs associated with PM-induced lung injury and identifies three pivotal candidate m6A-modified lncRNAs. These findings shed light on a novel regulatory mechanism underlying PM-induced lung injury.

CircDNA2-Educated YTHDF2 Phase Separation Promotes PM2.5-Induced Malignant Transformation Through the Blunting of GADD45A Expression

Substantial epidemiological evidence suggests a significant correlation between particulate matter 2.5 (PM2.5) and lung cancer. However, the mechanism underlying this association needs to be further elucidated. Circular RNAs (circRNAs) have emerged as an important topic in the field of epigenetics and are involved in various cancers. This study aimed to explore the molecular basis of PM2.5-induced lung cancer from an epigenetic perspective and identify potential biomarkers. Initially, the construction of a chronic PM2.5 exposure model confirmed that PM2.5 exposure promoted the malignant transformation of human bronchial epithelial (HBE) cells. Mechanistically, abnormally upregulated circDNA2 inhibited the tumor suppressor gene growth arrest and DNA damage 45 alpha (GADD45A) mRNA in an N6-methyladenosine (m6A)-dependent manner, mediated by YTH N6-Methyladenosine RNA Binding Protein F2 (YTHDF2) after PM2.5 exposure. Further analyses revealed that circDNA2 can specifically bind to the YTHDF2 LC domain to promote YTHDF2 protein liquid-liquid phase separation (LLPS), providing sufficient evidence linking LLPS and particulate pollutant-induced tumorigenesis. In conclusion, this study provides new insights into the role of circDNA2 in PM2.5-induced lung cancer and confirms its clinical value as a potential prognostic biomarker for lung cancer.

Deciphering key nano-bio interface descriptors to predict nanoparticle-induced lung fibrosis

BACKGROUND

The advancement of nanotechnology underscores the imperative need for establishing in silico predictive models to assess safety, particularly in the context of chronic respiratory afflictions such as lung fibrosis, a pathogenic transformation that is irreversible. While the compilation of predictive descriptors is pivotal for in silico model development, key features specifically tailored for predicting lung fibrosis remain elusive. This study aimed to uncover the essential predictive descriptors governing nanoparticle-induced pulmonary fibrosis.

METHODS

We conducted a comprehensive analysis of the trajectory of metal oxide nanoparticles (MeONPs) within pulmonary systems. Two biological media (simulated lung fluid and phagolysosomal simulated fluid) and two cell lines (macrophages and epithelial cells) were meticulously chosen to scrutinize MeONP behaviors. Their interactions with MeONPs, also referred to as nano-bio interactions, can lead to alterations in the properties of the MeONPs as well as specific cellular responses. Physicochemical properties of MeONPs were assessed in biological media. The impact of MeONPs on cell membranes, lysosomes, mitochondria, and cytoplasmic components was evaluated using fluorescent probes, colorimetric enzyme substrates, and ELISA. The fibrogenic potential of MeONPs in mouse lungs was assessed by examining collagen deposition and growth factor release. Random forest classification was employed for analyzing in chemico, in vitro and in vivo data to identify predictive descriptors.

RESULTS

The nano-bio interactions induced diverse changes in the 4 characteristics of MeONPs and had variable effects on the 14 cellular functions, which were quantitatively evaluated in chemico and in vitro. Among these 18 quantitative features, seven features were found to play key roles in predicting the pro-fibrogenic potential of MeONPs. Notably, IL-1β was identified as the most important feature, contributing 27.8% to the model's prediction. Mitochondrial activity (specifically NADH levels) in macrophages followed closely with a contribution of 17.6%. The remaining five key features include TGF-β1 release and NADH levels in epithelial cells, dissolution in lysosomal simulated fluids, zeta potential, and the hydrodynamic size of MeONPs.

CONCLUSIONS

The pro-fibrogenic potential of MeONPs can be predicted by combination of key features at nano-bio interfaces, simulating their behavior and interactions within the lung environment. Among the 18 quantitative features, a combination of seven in chemico and in vitro descriptors could be leveraged to predict lung fibrosis in animals. Our findings offer crucial insights for developing in silico predictive models for nano-induced pulmonary fibrosis.

Absence of a Causal Link between Elemental Carbon Exposure and Short-Term Respiratory Toxicity in Human-Derived Organoids and Cellular Models

Black carbon or elemental carbon (EC) in the atmosphere plays an ambiguous role in acute respiratory toxic effects. Here, we evaluate the contribution of EC to the short-term toxicity (including cytotoxicity and oxidative stress potency) of fine particulate matter (PM2.5) on the human respiratory tract using in vitro airway organoids and cell lines. The toxic potency of EC per unit mass, including char and soot, is more than 2 orders of magnitude lower than that of polycyclic aromatic hydrocarbons (PAHs), which are coemitted from incomplete combustion. EC contributes approximately 1 order of magnitude less to PM2.5 toxicity than PAHs, despite its positive associations with PM2.5-induced toxic potency (p < 0.0001). Furthermore, PAHs contribute 71.9 ± 12.2% and 61.9 ± 32.8% of the overall toxic potency of PM2.5 emitted from typical incomplete burning of solid and liquid fuels, respectively, while the PM2.5 toxicity significantly correlates with PAHs content (r = 0.94, p = 0.002). Hence, EC is not a cause of inducing acute toxicity, likely attributed to coemitted PAHs. These findings provide causal evidence for understanding the respiratory health risks associated with exposure to PM2.5 and further benefit to establishing efficient air pollution control policies.

Effects of acute PM2.5 purification on cognitive function and underlying mechanisms: Evidence from integrating alternative splicing into multi-omics

The relationship between fine particulate matter (PM2.5) and cognition has been extensively investigated. However, the causal impact of acute PM2.5 purification on cognition improvement and the underlying biological mechanisms remain relatively opaque. Our double-blinded randomized controlled trial assessed the impact of acute PM2.5 purification on executive function, underpinned by multi-omics approaches including alternative splicing (AS) analysis. A total of 93 participants experienced a two-hour exposure to either reduced and normal PM2.5 levels. We measured the cognition of healthy young adults, collected peripheral blood before and after intervention, and performed multi-omics analysis including transcriptomics, metabolomics, and proteomics. Results indicated that reducing PM2.5 by 1 μg/m3 was associated with a 0.10 % (95 % CI: [0.18 %, 0.01 %]; p = 0.031) improvement in executive function. Notably, we identified 96 AS events without concurrent transcriptional amount alterations. Multi-layered omics analyses revealed disrupted pathways in hypoxia, mitochondrial function and energy metabolism, and immune responses, validated by ELISA and biochemical assay. These findings demonstrated short-term improvements of cognition following PM2.5 purification and provide mechanistic understandings of PM2.5-induced cognition alterations. This study underscores the significance of incorporating AS in the molecular framework of multi-omics research by exploring variable exon splicing, which could enrich multi-omics analysis methodologies and expose to broader audience.

Cytokines in cancer

Cytokines are proteins used by immune cells to communicate with each other and with cells in their environment. The pleiotropic effects of cytokine networks are determined by which cells express cytokines and which cells express cytokine receptors, with downstream outcomes that can differ based on cell type and environmental cues. Certain cytokines, such as interferon (IFN)-γ, have been clearly linked to anti-tumor immunity, while others, such as the innate inflammatory cytokines, promote oncogenesis. Here we provide an overview of the functional roles of cytokines in the tumor microenvironment. Although we have a sophisticated understanding of cytokine networks, therapeutically targeting cytokine pathways in cancer has been challenging. We discuss current progress in cytokine blockade, cytokine-based therapies, and engineered cytokine therapeutics as emerging cancer treatments of interest.

Associations of short-term exposure to air pollution with risk of pulmonary space-occupying lesions morbidity based on a time-series study

BACKGROUND

Pulmonary space-occupying lesions are typical chronic pulmonary diseases that contribute significantly to healthcare resource use and impose a large disease burden in China. A time-series ecological trend study was conducted to investigate the associations between environmental factors and hospitalizations for pulmonary space-occupying lesions in North of China from 2014 to 2022.

METHODS

The DLNM was used to quantify the association of environmental factors with lung cancer admissions. The heating-, age-, gender-, malignancy-specific effects were further estimated to identify the susceptible groups.

RESULTS

During the study period, fluctuations in air pollutants and climate conditions closely mirrored changes in hospitalizations for pulmonary space-occupying lesions. Totally, the distributed lag surface showed clear positive associations between pulmonary tumor hospitalization and PM2.5 (RRlag30: 1.000912; 95%CI: 1.000076, 1.00175), PM10 (RRlag30: 1.002246; 95%CI: 1.000474, 1.004021), SO2 (RRlag30: 1.002714; 95%CI: 1.001071, 1.004414), CO (RRlag30: 1.002231; 95%CI: 1.000592, 1.003873). Additionally, the associations between air pollutants and hospitalizations for pulmonary space-occupying lesions were significantly stronger during the heating season. Population aged 65 or older, females and those diagnosed with malignancies were more vulnerable for the risk of pulmonary space-occupying lesions diseases due to air pollution exposure.

CONCLUSIONS

The present study illustrated risk and burden for pulmonary space-occupying lesions hospitalization associated with air pollution, especially among population aged ≥ 65, or female.

Global, regional and national burden of tracheal, bronchus, and lung cancer attributable to ambient particulate matter pollution from 1990 to 2021: an analysis of the global burden of disease study

BACKGROUND

The ambient particulate matter pollution may play a critical role in the initiation and development of tracheal, bronchus, and lung (TBL) cancer. Up to now, far too little attention has been paid to TBL cancer attributable to ambient particulate matter pollution. This study aims to assess the disease burden of TBL cancer attributable to ambient particulate matter pollution in global, regional and national from 1990 to 2021 to update the epidemiology data of this disease.

METHODS

Leveraging data from the Global Burden of Disease (GBD) 2021 study, we analyzed the worldwide burden of TBL cancer resulting from ambient particulate matter pollution using indices including disability-adjusted life years (DALYs), age-standardised rate of DALYs (ASDR). This burden was further segmented based on variables including geographical location, and socio-demographic index (SDI), age and sex.

RESULTS

The ASDR per 100,000 population of TBL cancer attributable to ambient particulate matter pollution increased by 0.2%[95% UI 0.1 to 0.3] to 79.6[95% UI 49.0 to 111.2] from 1990 to 2021 Globally. Middle-aged and elderly individuals accounted for the majority of the disease burden, with the highest value at the 65-69 years. Most of the disease burden was concentrated in countries with High-middle SDI. There was a positive correlation between ASDR of TBL cancer due to particulate matter pollution and the SDI(ρ = 0.66, p < 0.001). East Asia and Central Europe exhibited higher observed values than the fitted curves, while such as Austraiasia South Asia and Western Sub-Saharan Africa had a lower observed values than the fitted curves. Decomposition analysis showed that population aging and growth were the two major drivers of the increase in DALYs.

CONCLUSIONS

The disease burden of TBL cancer attributable to ambient particulate matter pollution has increased, especially in regions and countries with High-middle SDI.

Advancing environmental epidemiologic methods to confront the cancer burden

Even though many environmental carcinogens have been identified, studying their effects on specific cancers has been challenging in nonoccupational settings, where exposures may be chronic but at lower levels. Although exposure measurement methods have improved considerably, along with key opportunities to integrate multi-omic platforms, there remain challenges that need to be considered, particularly around the design of studies. Cancer studies typically exclude individuals with prior cancers and start recruitment in midlife. This translates into a failure to capture individuals who may have been most susceptible because of both germline susceptibility and higher early-life exposures that lead to premature mortality from cancer and/or other environmentally caused diseases like lung diseases. Using the example of breast cancer, we demonstrate how integration of susceptibility, both for cancer risk and for exposure windows, may provide a more complete picture regarding the harm of many different environmental exposures. Choice of study design is critical to examining the effects of environmental exposures, and it will not be enough to just rely on the availability of existing cohorts and samples within these cohorts. In contrast, new, diverse, early-onset case-control studies may provide many benefits to understanding the impact of environmental exposures on cancer risk and mortality. This article is part of a Special Collection on Environmental Epidemiology.

Pulmonary neuroendocrine neoplasms: the molecular landscape, therapeutic challenges, and diagnosis and management strategies

Lung neuroendocrine neoplasms are a group of diverse, heterogeneous tumours that range from well-differentiated, low-grade neuroendocrine tumours-such as typical and atypical carcinoids-to high-grade, poorly differentiated aggressive malignancies, such as large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC). While the incidence of SCLC has decreased, the worldwide incidence of other pulmonary neuroendocrine neoplasms has been increasing over the past decades. In addition to the standard histopathological classification of lung neuroendocrine neoplasms, the introduction of molecular and sequencing techniques has led to new advances in understanding the biology of these diseases and might influence future classifications and staging that can subsequently improve management guidelines in the adjuvant or metastatic settings. Due to the rarity of neuroendocrine neoplasms, there is a paucity of prospective studies that focus on the lungs, especially in rare, well-differentiated carcinoids and LCNECs. In contrast with the success of targeted therapies in non-small-cell lung cancer (NSCLC), high-grade neuroendocrine carcinomas of the lung often only have a few specific targetable gene alterations. Optimal therapy for LCNECs is not well defined and treatment recommendations are based on extrapolating guidelines for the management of patients with SCLC and NSCLC. This Review explores the epidemiology, diagnosis, and staging of lung neuroendocrine neoplasms to date. In addition, we focus on the evolving molecular landscape and biomarkers, ranging from tumour phenotypes to functional imaging studies and novel molecular biomarkers. We outline the various clinical outcomes, challenges, the treatment landscape, ongoing clinical trials, and future directions.

The role of PM2.5 exposure in lung cancer: mechanisms, genetic factors, and clinical implications

Lung cancer is one of the most critical global health threats, as the second most common cancer and leading cause of cancer deaths globally. While smoking is the primary risk factor, an increasing number of cases occur in nonsmokers, with lung cancer in nonsmokers (LCNS) now recognized as the fifth leading cause of cancer mortality worldwide. Recent evidence identifies air pollution, particularly fine particulate matter (PM2.5), as a significant risk factor in LCNS. PM2.5 can increase oxidative stress and inflammation, induce genetic alterations and activation of oncogenes (including the epidermal growth factor receptor, EGFR), and contribute to lung cancer progression. This review summarizes the current understanding of how exposure to PM2.5 induces lung carcinogenesis and accelerates lung cancer development. It underscores the importance of prevention and early detection while calling for targeted therapies to combat the detrimental effects of air pollution. An integrated approach that combines research, public health policy, and clinical practice is essential to reduce the lung cancer burden and improve outcomes for those affected by PM2.5 exposurrre.

State of Lung Cancer in Egypt: Moving Towards Improved Guidelines for Prevention, Screening, Treatment, and Clinical Care Programs

Lung cancer remains a leading cause of cancer-related mortality globally and presents significant challenges in Egypt. In 2023, the first annual meeting of the Thoracic Oncology Multidisciplinary Faculty, organized by the Egyptian Cancer Research Network and the Egyptian Society of Respiratory Neoplasms, was held in Cairo, Egypt. The meeting aimed to address gaps in lung cancer management across Egypt and the broader Middle East and North Africa region. The discussions focused on the challenges posed by NSCLC and SCLC and emphasized the need for enhanced prevention, early detection, and treatment strategies. Key areas of concern include limited access to advanced diagnostics, such as comprehensive genomic profiling, and the underutilization of targeted therapies and immunotherapies, mainly owing to financial barriers. The meeting highlighted the importance of strengthening lung cancer screening programs, improving smoking cessation efforts, and addressing environmental risk factors like air pollution. Furthermore, the event underscored the need for greater research and collaboration, particularly in areas like precision oncology. The conference concluded with strategic recommendations to improve lung cancer prevention, screening, and treatment, aligning Egypt's lung cancer care with global advancements and ensuring equitable access to cutting-edge therapies.

Impact of Exposure to Environmental Particulate Matter on the Onset of Giant Cell Arteritis

OBJECTIVE

The aim of this study was to investigate the association between exposure to particulate matter with an aerodynamic diameter ≤10 μm (PM10) and the development of giant cell arteritis (GCA) and its ischemic complications.

METHODS

This was case-crossover study on consecutive patients who received a diagnosis of GCA in three hospitals in northern Italy between 2013 and 2021. The PM10 hourly and daily average concentrations, collected in the Italian monitoring network and archived by Istituto Superiore per la Protezione e la Ricerca Ambientale, were determined using European reference. We used a Bayesian hierarchical model to determine patients' daily exposures to them. We employed conditional logistic regression to estimate the effect of exposure on GCA symptoms onset or ischemic complications.

RESULTS

We included 232 patients. A positive association was observed between exposure to PM10 and GCA risk, with an incremental odd of 27.1% (95% confidence interval 5.8-52.6) for every 10-μg/m3 increase in PM10 concentration within a 60-day period. We did not find any significant association for shorter periods or with ischemic complications. Subgroup analysis found a significantly higher incremental risk at a 60-day lag for patients ≥70 years old. Comparing patients who were chronically exposed to high PM10 levels (26.9 ± 13.8 μg/m3) to those who were not (11.9 ± 7.9 μg/m3) revealed that only in the former group was there an association between GCA onset and increased PM10 levels in the preceding 60 days.

CONCLUSION

Exposure to environmental PM10 in the preceding 60 days seems to be associated with an increased risk of developing GCA, especially in older individuals with prolonged exposure to high levels of air pollution.

Accelerating progress to reduce the cancer burden through prevention and control in the United States

Improvements in cancer prevention and control are poised to be main contributors in reducing the burden of cancer in the United States. We quantify top opportunities to accelerate progress using projected life-years gained and deaths averted as measures. We project that over the next 25 years, realistic gains from tobacco control can contribute 0.4-17 million additional life-years gained per intervention and 8.4 million additional life-years gained from improving uptake of screening programs over the lifetime of 25 annual cohorts. Additional opportunities include addressing modifiable risk factors (excess weight, alcohol consumption), improving methods to prevent or treat oncogenic infections, and reducing cancer health disparities. Investment is needed in the pipeline of new preventive agents and technologies for early detection to continue progress. There is also a need for additional research to improve the access to and uptake of existing and emerging interventions for cancer prevention and control and to address health disparities. These gains are undeniably within our power to realize for the US population.

Global, Regional, and National Burden of Tracheal, Bronchus, and Lung Cancer in 2022: Evidence from the GLOBOCAN Study

BACKGROUND

Tracheal Bronchus and Lung cancers (TBL) represent one of the leading causes of cancer deaths worldwide. This study aimed to examine the disease and economic burden of TBL cancers in 185 countries worldwide in 2022.

METHODS

The estimates of TBL cancer incidence and mortality (counts and age-standardized rates) were obtained from the GLOBOCAN 2022 data produced by the International Agency for Research on Cancer. Mortality-to-incidence ratios (MIR) were utilized as a proxy of 5-year survival rates. Multivariate regression was utilized to examine the association between TBL cancer burden and tobacco use prevalence.

RESULTS

Globally, there were 2.48 million incident cases and 1.82 million deaths due to TBL cancers in 2022. Males accounted for 63.4% of incident cases (1.57 million) and 67.85% of TBL deaths (1.23 million) in 2022. For both sexes combined, the age-standardized rate was 23.1 per 100,000, and the age-standardized mortality rate was 16.8/100,000. The Mortality-to-incidence ratio (MIR) at the global level stood at 0.71. Eastern Asia had the largest burden of TBL cancers among the 21 UN-defined regions, with around 51% of incident cases (1.24 million) and 46.9% of global deaths (851,876), followed by Northern America (incidence: 257,284; deaths: 150,675) and Eastern Europe (incidence: 158,141; deaths: 126,840). At the country level, human development index (HDI) and adult tobacco use prevalence could explain 67% and 64% variation in ASIR and ASMR, respectively. HDI was statistically significantly related to MIR, explaining a 48% variation in MIR.

CONCLUSIONS

With 1.9 million deaths in 2022, TBL cancer is a significant global cause of mortality. Despite the knowledge and awareness of smoking and lung cancer, adult smoking rates remain high in many countries, including the United States and China. Renewed and sustained global efforts are needed to reduce smoking prevalence and PM2.5 levels, particularly in China and low- and middle-income countries.

Interleukin-1α release during necrotic-like cell death generates myeloid-driven immunosuppression that restricts anti-tumor immunity

Necroptosis can promote antigen-specific immune responses, suggesting induced necroptosis as a therapeutic approach for cancer. Here we sought to determine the mechanism of immune activation but found the necroptosis mediators RIPK3 and MLKL dispensable for tumor growth in genetic and implantable models of breast or lung cancer. Surprisingly, inducing necroptosis within established breast tumors generates a myeloid suppressive microenvironment that inhibits T cell function, promotes tumor growth, and reduces survival. This was dependent upon the release of the nuclear alarmin interleukin-1α (IL-1α) by dying cells. Critically, IL-1α release occurs during chemotherapy and targeting this molecule reduces the immunosuppressive capacity of tumor myeloid cells and promotes CD8+ T cell recruitment and effector function. Neutralizing IL-1α enhances the efficacy of single agent paclitaxel or combination therapy with PD-1 blockade in preclinical models. Low IL1A levels correlates with positive patient outcome in several solid malignancies, particularly in patients treated with chemotherapy.

Calls to action on lung cancer management and research

Lung cancer, the leading cause of cancer-related deaths globally, remains a pressing health issue despite significant medical advances. The New York Lung Cancer Foundation brought together experts from academia, the pharmaceutical and biotech industries as well as organizational leaders and patient advocates, to thoroughly examine the current state of lung cancer diagnosis, treatment, and research. The goal was to identify areas where our understanding is incomplete and to develop collaborative public health and scientific strategies to generate better patient outcomes, as highlighted in our "Calls to Action." The consortium prioritized 8 different calls to action. These include (1) develop strategies to cure more patients with early-stage lung cancer, (2) investigate carcinogenesis leading to lung cancers in patients without a history of smoking, (3) harness precision medicine for disease interception and prevention, (4) implement solutions to deliver prevention measures and effective therapies to individuals in under-resourced countries, (5) facilitate collaborations with industry to collect and share data and samples, (6) create and maintain open access to big data repositories, (7) develop new immunotherapeutic agents for lung cancer treatment and prevention, and (8) invest in research in both the academic and community settings. These calls to action provide guidance to representatives from academia, the pharmaceutical and biotech industries, organizational and regulatory leaders, and patient advocates to guide ongoing and planned initiatives.

Imperfect wound healing sets the stage for chronic diseases

Although the age of the genome gave us much insight about how our organs fail with disease, it also suggested that diseases do not arise from mutations alone; rather, they develop as we age. In this Review, we examine how wound healing might act to ignite disease. Wound healing works well when we are younger, repairing damage from accidents, environmental assaults, and battles with pathogens. Yet, with age and accumulation of mutations and tissue damage, the repair process can devolve, leading to inflammation, fibrosis, and neoplastic signaling. We discuss healthy wound responses and how our bodies might misappropriate these pathways in disease. Although we focus predominantly on epithelial-based (lung and skin) diseases, similar pathways might operate in cardiac, muscle, and neuronal diseases.

Pulmonary surfactant biogenesis blockage mediated polyhexamethylene guanidine disinfectant induced pulmonary fibrosis

The widespread use of disinfectants and inhalation exposure to aerosolized forms is closely associated with adverse health effects on the respiratory system and pulmonary fibrosis, but the mechanism remains unclear. Here, we investigated the time-course pulmonary fibrosis effects of polyhexamethylene guanidine (PHMG) disinfectant inhalation exposure and elucidated its underlying mechanism. Specifically, scRNA-seq analysis revealed an initial increase in epithelial cell numbers after 4 weeks of PHMG exposure during induced pulmonary fibrosis, followed by a subsequent decrease after 8 weeks of exposure. Mechanistically, PHMG disrupted autophagic flux leading to intracellular accumulation and blocked pulmonary surfactant biogenesis in alveolar type II epithelial (AT2) cells both in vitro and in vivo. Furthermore, intervention studies using metformin confirmed that autophagy dysfunction mediated the blockage of pulmonary surfactant biogenesis in AT2 cells, playing a pivotal role in PHMG-induced pulmonary fibrosis. Our elucidation of these toxicological mechanisms provides valuable insights into the pathogenesis of pulmonary fibrosis triggered by environmental PHMG exposure, thereby offering a promising therapeutic target for mitigating and treating PHMG-associated pulmonary fibrosis.

Unequal toxic effects of size-segregated single particles emitted from typical industrial plants, vehicles, and road dust

The health risks of particulate matters (PMs) associated with their chemical components and sizes have attracted increasing attention. However, the toxic effect of critical toxic components in size-segregated PMs from specific emission source remains unclear. We present the toxicity of size-segregated elements in PMs via integrating toxic analysis and online single-particle measurements of real-world industrial plants, vehicles, and road dust. The number fractions of elemental carbon (EC)- and Fe-containing particles were 5-11 and 3-12 folds greater than those of other metal-containing particles, respectively. A unimodal distribution with the peak at 0.4 µm was observed for the toxic metals emitted from industrial plants and road dust, while the distribution was relatively flat for vehicles. When integrating the abundance with toxicity of metals, especially Mn, Cu, V, and Fe, the peak for PM toxicity occurred at 0.4 µm for road dust, 0.4-0.7 µm for industrial plants, and 0.8 µm for vehicle-emitted PM. The inhalation risk in the alveolar region increased for these source-emitted PMs due to the efficient deposition of toxic PMs within 0.4-0.8 µm. These results reveal the complex coupling of health risks and size distributions of PMs, and further highlight that the health-oriented control of air pollution should consider PM1.

Genetic immune escape in cancer: timing and implications for treatment

Genetic immune escape (GIE) alterations pose a significant challenge in cancer by enabling tumors to evade immune detection. These alterations, which can vary significantly across cancer types, may often arise early in clonal evolution and contribute to malignant transformation. As tumors evolve, GIE alterations are positively selected, allowing immune-resistant clones to proliferate. In addition to genetic changes, the tumor microenvironment (TME) and non-genetic factors such as inflammation, smoking, and environmental exposures play crucial roles in promoting immune evasion. Understanding the timing and mechanisms of GIE, alongside microenvironmental influences, is crucial for improving early detection and developing more effective therapeutic interventions. This review highlights the implications of GIE in cancer development and immunotherapy resistance, and emphasizes the need for integrative approaches.

Non-Genotoxic and Environmentally Relevant Lower Molecular Weight Polycyclic Aromatic Hydrocarbons Significantly Increase Tumorigenicity of Benzo[a]pyrene in a Lung Two-Stage Mouse Model

The World Health Organization has classified air pollution as a carcinogen, and polycyclic aromatic hydrocarbons (PAHs) are major components of air particulates of carcinogenic concern. Thus far, most studies focused on genotoxic high molecular weight PAHs; however, recent studies indicate potential carcinogenicity of the non-genotoxic lower molecular weight PAHs (LMW PAHs) that are found in indoor and outdoor air pollution as well as secondhand cigarette smoke. We hypothesize that LMW PAHs contribute to the promotion stage of cancer when combined with benzo[a]pyrene (B[a]P), a legacy PAH. We specifically determined the effects of an LMW PAH mixture containing 1-methylanthracene (1MeA), fluoranthene (Flthn), and phenanthrene (Phe) combined with B[a]P on lung tumor promotion. To test this hypothesis, we used a two-stage, initiation/promotion BALB/ByJ female lung tumor mouse model. The mice were initiated with 3-methylcholanthrene followed by exposures to B[a]P, the LMW PAH mixture, and the combination of the LMW PAH mixture plus B[a]P, all at 10 mg/kg. The LMW PAHs combined with B[a]P significantly increased the promotion and incidence of lung tumors over that of B[a]P alone. The LMW PAHs in the absence of B[a]P did not significantly promote tumors, indicating strong co-promotional activities. We further assessed the effects of these PAHs on other hallmarks of cancer, namely, bronchoalveolar lavage fluid inflammatory infiltrates, pro-inflammatory transcripts, KC protein content, and mRNA expression of the gap junction (Gja1) and epiregulin (Ereg) genes. The LMW PAHs increased the biomarkers of inflammation, decreased Gja1 expression, and increased Ereg expression, all consistent with tumor promotion. This study indicates that non-genotoxic LMW PAHs can contribute to the cancer process and warrants further studies to assess the carcinogenic risks of other LMW PAHs.

Biological and therapeutic implications of the cancer-related germline mutation landscape in lung cancer

Although smoking is the primary cause of lung cancer, only about 15% of lifelong smokers develop the disease. Moreover, a substantial proportion of lung cancer cases occur in never-smokers, highlighting the potential role of inherited genetic factors in the cause of lung cancer. Lung cancer is significantly more common among those with a positive family history, especially for early-onset disease. Therefore, the presence of pathogenic germline variants might act synergistically with environmental factors. The incorporation of next-generation sequencing in routine clinical practice has led to the identification of cancer-predisposing mutations in an increasing proportion of patients with lung cancer. This Review summarises the landscape of germline susceptibility in lung cancer and highlights the importance of germline testing in patients diagnosed with the disease, which has the potential to identify individuals at risk, with implications for tailored therapeutic approaches and successful prevention through genetic counselling and screening.

Association Between Incense Burning and the Risk of Lung Cancer in Asian Population: Meta-Analysis of Nine Case-Control Studies

BACKGROUND

Various studies have explored the potential association between incense burning and the risk of lung cancer. However, the findings from these studies have been inconsistent.

OBJECTIVES

This study aimed to provide a more comprehensive understanding of the relationship between incense burning and lung cancer risk in the Asian population through a meta-analysis.

METHODS

This meta-analysis, which includes nine case-control studies conducted in Asia and identified through Google Scholar, PubMed, and ScienceDirect up to January 7, 2024, was performed to evaluate the relevant literature. Using a fixed-effects model, the pooled odds ratio (OR) was calculated to determine the overall association between incense burning and lung cancer.

RESULTS

The results of the meta-analysis revealed a significant association between incense burning and the development of lung cancer (pooled OR = 1.33, 95% confidence interval [CI]: 1.20-1.48). Furthermore, a subgroup analysis was conducted based on smoking status. It was found that ever-smokers had a significantly higher risk of developing lung cancer when exposed to incense burning (pooled OR = 1.34, 95% CI: 1.09-1.65). Both hospital-based case-control studies (pooled OR = 1.28, 95% CI: 1.10-1.48) and population-based case-control studies (pooled OR = 1.39, 95% CI: 1.21-1.60) yielded significant associations between incense burning and lung cancer. Limitations of this study include the lack of detailed histologic information in most of the selected studies, highlighting the need for future research to include cohort studies that can more accurately assess the association between incense smoke inhalation and specific lung cancer subtypes.

CONCLUSION

In conclusion, the findings of this meta-analysis, based on nine case-control studies, suggest that the risk of developing lung cancer among Asians may increase with exposure to incense burning.

Comprehensive utilization of in silico approach and in vitro experiment to unveil the molecular mechanisms of mono (2-ethylhexyl) phthalate-induced lung adenocarcinoma

Mono (2-ethylhexyl) phthalate (MEHP), the main bioactive metabolite of commonly used plasticizer Di (2-ethylhexyl) phthalate, has received increasing attention due to its carcinogenic toxicity. This study aims to systematically explore the molecular mechanisms underlying MEHP-induced lung adenocarcinoma (LUAD). Firstly, network toxicology was employed to construct the interaction network of MEHP-targeted LUAD-related proteins and identify core proteins. Subsequently, functional analyses were used to determine the key pathways of these proteins enriched. Next, expression and survival analyses of multiple public datasets were conducted to emphasize the importance of core genes, and an optimized prognostic model was constructed based on independent prognostic genes to explore the relationship of gene risk with immune infiltration and immunotherapy. Ultimately, molecular docking and dynamics simulation were used to predict the binding modes and affinities of MEHP with core proteins, and surface plasmon resonance experiments were utilized to further validate their direct interactions. The findings demonstrated that MEHP targets 167 LUAD-related proteins, including 28 core target proteins. These proteins form the critical networks that regulate cancer and immune-associated pathways to induce the occurrence and development of LUAD, and further coordinate patient prognosis and treatment by altering the immune microenvironment. Most importantly, their direct interactions (especially PTGS2) lay the structural foundation of MEHP regulating core proteins, greatly supporting its LUAD toxicity. In conclusion, this study introduces a novel approach for evaluating the safety of plasticizers and elucidates the molecular mechanisms behind MEHP-induced LUAD, thus offering new and effective targets and strategies for cancer prevention and treatment.

Emerging strategies to investigate the biology of early cancer

Early detection and intervention of cancer or precancerous lesions hold great promise to improve patient survival. However, the processes of cancer initiation and the normal-precancer-cancer progression within a non-cancerous tissue context remain poorly understood. This is, in part, due to the scarcity of early-stage clinical samples or suitable models to study early cancer. In this Review, we introduce clinical samples and model systems, such as autochthonous mice and organoid-derived or stem cell-derived models that allow longitudinal analysis of early cancer development. We also present the emerging techniques and computational tools that enhance our understanding of cancer initiation and early progression, including direct imaging, lineage tracing, single-cell and spatial multi-omics, and artificial intelligence models. Together, these models and techniques facilitate a more comprehensive understanding of the poorly characterized early malignant transformation cascade, holding great potential to unveil key drivers and early biomarkers for cancer development. Finally, we discuss how these new insights can potentially be translated into mechanism-based strategies for early cancer detection and prevention.

Lung cancer research and treatment: global perspectives and strategic calls to action

BACKGROUND

Lung cancer remains a critical public health issue, presenting multifaceted challenges in prevention, diagnosis, and treatment. This article aims to review the current landscape of lung cancer research and management, delineate the persistent challenges, and outline pragmatic solutions.

MATERIALS AND METHODS

Global experts from academia, regulatory agencies such as the Food and Drug Administration (FDA) and the European Medicines Agency (EMA), the National Cancer Institute (NCI), professional societies, the pharmaceutical and biotech industries, and patient advocacy groups were gathered by the New York Lung Cancer Foundation to review the state of the art in lung cancer and to formulate calls to action.

RESULTS

Improving lung cancer management and research involves promoting tobacco cessation, identifying individuals at risk who could benefit from early detection programs, and addressing treatment-related toxicities. Efforts should focus on conducting well-designed trials to determine the optimal treatment sequence. Research into innovative biomarkers and therapies is crucial for more personalized treatment. Ensuring access to appropriate care for all patients, whether enrolled in clinical trials or not, must remain a priority.

CONCLUSIONS

Lung cancer is a major health burden worldwide, and its treatment has become increasingly complex over the past two decades. Improvement in lung cancer management and research requires unified messaging and global collaboration, expanded education, and greater access to screening, biomarker testing, treatment, as well as increased representativeness, participation, and diversity in clinical trials.

The Role of Environmental Exposures on Survival After Non-Small Cell Lung Cancer Resection

Background

Socioeconomic status and pollution exposure have been described as risk factors for poor survival in patients with non-small cell lung cancer (NSCLC). However, the relationship between these factors is complex and inadequately studied. This study aimed to evaluate the relationship between environmental and social factors and their impact on survival after NSCLC resection.

Methods

A prospective database for all patients with NSCLC who underwent primary resection from 2006 to 2021 was analyzed. Ambient fine particulate matter (air pollution smaller than 2.5 μm [PM2.5]), greenness, and deprivation index (a measure of neighborhood-level material deprivation composed of 6 factors) were linked to individual patients by geocoding their residential address.

Results

A total of 661 patients who underwent pulmonary resection for NSCLC were evaluated. Black patients had increased levels of community deprivation compared with White patients; however, there was no difference in PM2.5 exposure or overall survival between races. Increased PM2.5 exposure was an independent predictor of worse survival on univariable and multivariable analysis (hazard ratio, 1.06; P = .003).

Conclusions

Increased PM2.5 exposure is associated with worse overall survival in resected NSCLC and was a more significant factor than race and material deprivation in this population. Interventions to reduce environmental air pollution could improve lung cancer survival.