Inflammation drives early recurrent cardiovascular risk in type 2 diabetes mellitus (T2DM) patients following acute myocardial infarction (AMI), particularly within 30-90 days post-discharge. Sodium-glucose co-transporter 2 (SGLT2) inhibitors such as empagliflozin (EMPA) provide cardiometabolic benefits, but their anti-inflammatory effects and optimal timing after AMI remain unclear. Given the prognostic role of systemic markers like the neutrophil-to-lymphocyte ratio, we investigated whether early initiation of EMPA modulates NOD-like receptor protein-3 (NLRP3) inflammasome activity and inflammatory responses in monocyte-derived macrophages (MDMs) from T2DM-AMI patients.
Sixty-six participants were randomised to receive EMPA either at discharge (Arm-A) or following a 90-day delay (Arm B). Clinical data and biological samples were collected over 180 days. CD14+ MDMs and plasma were obtained at days 0, 30, and 90 (EMPA vs. no EMPA), and days 90, 120, and 180 (early vs. delayed). Inflammatory and metabolic markers were assessed using RT-qPCR, luminescence-based caspase-1 and ATP assays, and targeted immunoassays.
Early EMPA administration was associated with reduced NLRP3 priming (IL1β mRNA) and activation (caspase-1 activity), potentially linked to decreased release of ATP, a danger associated molecular pattern (DAMP). In the absence of EMPA, pro-inflammatory cytokines (TNFα, IL6, MCP1) and M1 macrophage markers (e.g., CD80) either increased or remained unchanged over time. Early EMPA treatment appeared to stabilise or reduce their expression. Markers of cell senescence (p21, IL8, BCL2) were also modulated. Plasma levels of senescence-associated markers (MMP9, OPN, Serpin E1) remained largely unchanged, highlighting the importance of evaluating macrophage-specific responses.
Early empagliflozin administration in T2DM-AMI patients was associated with modulation of NLRP3-related inflammatory and senescence pathways in patient-derived macrophages, benefits observed when cells were stimulated ex-vivo with an inflammatory stimulus. These findings provide mechanistic insight into the timing-dependent anti-inflammatory effects of EMPA and underscore its potential for immediate post-AMI use to reduce inflammation and lower residual cardiovascular risk, supporting further clinical investigation.
© 2026. The Author(s).

The results of a Phase 1 trial of autologous mitochondrial transplantation for the treatment of acute ischemic stroke during mechanical thrombectomy are presented. Standardized methods were used to isolate viable autologous mitochondria in the acute clinical setting, allowing for timely transplantation within the ischemic window. No significant adverse events were observed with the endovascular approach during reperfusion therapy. Safety outcomes in study participants were comparable to those of matched controls who did not undergo transplantation. This study represents the first use of mitochondrial transplantation in the human brain, highlighting specific logistical challenges related to the acute clinical setting, such as limited tissue samples and constrained time for isolation and transplantation. We also review the opportunities and challenges associated with further clinical translation of mitochondrial transplantation in the context of acute cerebral ischemia and beyond.

Obesity promotes a range of associated conditions, including hearing impairment; however, mechanisms are lacking. Self-evidently, an insult on any cellular constituent of the auditory organ can disrupt hearing. Here, using the mouse auditory cell line, HEI-OC1, we provide insights into adipose-associated ototoxicity. Adipose extracts from mice with obesity, diet- or genetically induced, suppress HEI-OC1's survival and ATP generation. Proteomic profiling shows an upregulation of the inflammatory response pathway and proteins such as Podoplanin and Low-density lipoprotein receptor. Likewise, the Programmed cell death 4 (PDCD4) protein was induced. These results correspond to a downregulation of glycolysis and oxidative phosphorylation but an upregulation of the G2/M checkpoint. Additionally, pathways such as IL6-JAK-STAT3, IL2-STAT5, interferon gamma response, cholesterol response, bile acid metabolism, RAS, Apoptosis, and TGF-β were upregulated. Furthermore, the adipose extracts cause cellular morphological changes consistent with cells under stress. Functional assays point to alterations in levels of proteins related to calcium and ER homeostasis/stress. The ER-resident protein SARAF, an inhibitor of calcium overfilling, is among the proteins markedly downregulated. GRP78 protein levels increased, suggesting ER/calcium stress. Finally, Thapsigargin impairs HEI-OC1 survival, reminiscent of the effect of the adipose tissue extracts. Our analyses warrant further exploration of inflammation and ER/calcium stress in connection to obesity-associated ototoxicity.
© 2025. The Author(s).

Although anticancer therapies inducing necrosis, necroptosis and pyroptosis trigger cell swelling, plasma membrane rupture (PMR) and release of damage-associated molecular patterns (DAMPs), potentially facilitating antitumor immunity, little was known of proteins and mechanisms controlling the life-death decision of whether swollen and stressed cancer cells enter PMR and undergo lytic cell death.
We conducted a genome-wide CRISPR screen with selection against a lytic cell death inducer, complemented by studies using breast cancer cells in 2D culture, patient-derived organoids and orthotopic mouse xenografts. The effect of FGD3 on immunogenicity was explored by immunoblotting, immunofluorescence staining and NK-cell mediated cytotoxicity assays. The correlation between the level of FGD3 expression and patient prognosis and response to chemotherapy was assessed by analysis of patient databases.
We identified FGD3 as a key mediator, coupling cell swelling to PMR and lytic cell death induced by emerging and current breast cancer therapies, including ErSO, aprepitant, doxorubicin and epirubicin. FGD3 coupled cell swelling to PMR across the spectrum of immunogenic lytic cell death pathways, including necrosis, necroptosis and pyroptosis. Mechanistically, FGD3 facilitated PMR by controlling actin reorganization via the Cdc42-ARP2/3 axis. Notably, elevated FGD3 increased release of DAMPs, strongly enhanced exposure of immunogenic cell surface calreticulin and increased sensitivity of cancer cells to NK cell-mediated lysis. Supporting clinical relevance, high FGD3 expression strongly correlated with improved relapse-free survival in breast cancer patients after chemotherapy and this correlation was stronger than was seen for NINJ1 and other proteins associated with lytic cell death.
FGD3 is a key mediator of chemotherapy-induced plasma membrane rupture and lytic cell death. It is also a useful biomarker for identifying breast cancer patients most likely to benefit from lytic cell death-inducing immunogenic anticancer therapies.
© 2025. The Author(s).

ABSTRACT Actin-mediated mitochondrial fission is essential for cellular homeostasis, yet the mechanisms by which actin is recruited to mitochondria and how it couples the outer and inner mitochondrial membranes (IMM) remain poorly understood. Using a phosphoproteomic screen in a rat model of α-synucleinopathy, we identified BASP1 as a calcineurin-dependent substrate that is constitutively dephosphorylated under pathological Ca 2+ elevations and phosphorylated under neuroprotective calcineurin inhibition. Immunoprecipitation and mass spectrometry of phosphomutant BASP1 expressed in neurons revealed that dephosphorylation promotes interactions with actin and IMM proteins. Dephosphorylated BASP1 recruits actin to mitochondria, while subsequent phosphorylation enables actin-mediated mitochondrial fission and neurite elongation. Constitutive dephosphorylation, as it occurs in α-synucleinopathy, impairs mitochondrial fission, inhibits neurite growth and promotes α-synuclein aggregation. Our findings position BASP1 as a Ca 2+ -CaN-regulated hub that coordinates actin remodeling and couples mitochondrial membranes to drive fission, revealing a mechanistic axis linking mitochondrial dysfunction to neuronal morphogenesis and α-synuclein pathobiology.