Unexpected Role for RNA Editing in Cancer Immune Evasion Uncovered

A new study in Science Immunology has uncovered a previously unrecognized mechanism by which cancer cells may evade immune detection, identifying the RNA helicase DDX6 as a key regulator of RNA editing and innate immune suppression.

The research, led by Larry Ng, PhD, of the Cancer Science Institute of Singapore, found that DDX6 represses a specific form of double-stranded RNA (dsRNA) editing that would otherwise stabilize dsRNA molecules and promote immune activation. When DDX6 was depleted, dsRNA accumulated, triggering innate immune signaling, increasing immune cell infiltration, and reshaping the tumor microenvironment in both patient-derived organoids and mouse models.

The findings provide new insight into how tumors exploit RNA-editing pathways to suppress immune responses and suggest that targeting DDX6 could represent a new strategy for cancer immunotherapy.

“Our cells are equipped with this double-stranded RNA sensing mechanism,” Ng explained. “It is actually a mechanism against viruses.” Cells contain specialized sensors that recognize dsRNA, a molecular pattern commonly associated with viral infection. Activation of these sensors triggers inflammatory responses, including type I interferon signaling, that help eliminate infected cells.

However, dsRNA is not exclusively produced by viruses. Normal cells also generate endogenous RNA transcripts capable of forming double-stranded structures. To prevent inappropriate immune activation, cells rely on RNA-editing enzymes such as adenosine deaminase acting on RNA 1 (ADAR1), which modify dsRNA molecules and reduce their ability to activate immune sensors.

“What RNA editing does is to actually prevent this autoimmunity from happening,” Ng said. “Editing marks our own RNA with this modification, so it will help to prevent the recognition by the sensors.”

This protective mechanism becomes particularly important in cancer. Tumor cells often exhibit extensive chromosomal instability, producing abundant abnormal RNA transcripts and dsRNA structures that could otherwise trigger immune responses.

“Cancers actually have a lot of these double-stranded RNA structures due to chromosomal instability,” Ng said. “But they survive.” According to Ng, tumors accomplish this by co-opting RNA-editing pathways that normally protect healthy cells. “What they do is that they actually hijack this editing function to help them survive,” he said. “If we could target or prevent this editing from happening, we can actually reactivate the covert RNA sensing, and this might help to trigger tumor cell death.”

The study focused on DDX6, an RNA helicase previously linked to cancer development but not fully understood in the context of immune regulation. Ng and colleagues discovered that DDX6 interacts directly with ADAR1 and suppresses a specific category of ADAR1-mediated RNA editing events.

The finding challenges a longstanding assumption in the RNA-editing field.

For years, researchers believed that RNA editing primarily suppresses immune activation by destabilizing dsRNA structures, making them less recognizable to innate immune sensors. Ng’s study reveals that some RNA-editing events have the opposite effect.

“Not all of this editing can actually prevent the recognition of these RNA structures,” Ng said. “It actually helps to stimulate the interferon response.”

These editing events appear to stabilize dsRNA rather than destabilize it, promoting activation of innate immune pathways. DDX6 suppresses these immunostimulatory editing events, thereby preventing immune activation.

“DDX6 actually helps to prevent this potent editing event from happening—this immunostimulatory RNA editing event,” Ng said.

The discovery represents what Ng described as a significant shift in understanding RNA editing biology. “For a very long time, people in the RNA editing field think that editing actually helps to prevent the recognition of double-stranded RNA structures,” he said. “But in this paper we showed that not all of these editing events can actually destabilize. Some of them can help to stabilize.”

The biological consequences of DDX6 suppression were evident in both normal tissues and tumors. Mice lacking DDX6 accumulated dsRNA and developed widespread interferon activation, demonstrating the protein’s importance in preventing excessive innate immune responses in healthy cells.

Within tumors, however, DDX6-mediated suppression appeared to benefit cancer cells by limiting immune activation. “The immune activation actually will result in cell death,” Ng said. “Too much activation is not good for cancer.”

The researchers found that reducing DDX6 levels promoted dsRNA-driven innate immune responses and increased immune cell infiltration within tumors. Nevertheless, Ng emphasized that the study was designed primarily to investigate innate immunity rather than directly demonstrate enhanced antitumor immune activity.

“We see increased immune cell infiltration, and there is evidence of immune cell activation,” he said. “But whether or not this increased immune cell infiltration is causing the tumor to shrink, I do not have the definite evidence yet.”

Instead, the data support a role for DDX6 in shaping the tumor microenvironment. “It remodels the tumor microenvironment toward the more inflamed state,” Ng said.

Additional studies, including T-cell killing assays and other functional experiments, will be required to determine whether DDX6 inhibition directly enhances immune-mediated tumor destruction.

The broader significance of the work lies in its contribution to understanding how RNA editing influences immunity. “I feel it’s more about the mechanism that I found on how DDX6 behaves or functions as an immune suppressor,” Ng said.

The post Unexpected Role for RNA Editing in Cancer Immune Evasion Uncovered appeared first on Inside Precision Medicine.

Proactive Surveillance Pays Off for Patients with Li-Fraumeni Syndrome

Research presented at the annual conference of the European Society of Human Genetics shows that screening people with the rare, inherited cancer predisposition condition Li-Fraumeni syndrome (LFS) brings both medical benefits and substantial healthcare cost reductions.

The findings “could help inform future discussions about how surveillance protocols for LFS can be further optimized,” said Marion Rolain, a biomedical researcher and engineer in the genetics department at the Centre Hospitalier Universitaire Rouen in France, who presented the research.

“The goal is not necessarily to increase or decrease surveillance, but rather to ensure that screening strategies are as effective, evidence-based and personalized as possible,” she added.

Rolain explained that LFS is caused by pathogenic variants in the TP53 gene, which occur in approximately one in 5,000 to one in 20,000 individuals. It often presents as cancer, particularly rare adrenal or brain tumors, osteosarcoma, soft tissue sarcomas and/or breast cancer, that develops at an unusually young age. LFS is also suspected when a person has multiple primary cancers, including cases of childhood cancer within the same family, with diagnosis confirmed through genetic testing of the TP53 gene.

The high lifetime risk for multiple primary cancers among individuals with LFS means that their care is based on intensive multiorgan surveillance that includes annual whole-body and brain magnetic resonance imaging (MRI), regular clinical examinations of organs at risk, and age- and risk-adapted screening such as abdominal ultrasound, blood pressure measurements, breast MRI in women, and looking for signs of early puberty or virilization caused by potential adrenal tumors in children.

Carla Oliveira, PhD, from the Institute of Research and Innovation in Health at the University of Porto, in Portugal, who coordinated the study as part of the EU PREVENTABLE project, told Inside Precision Medicine that “although surveillance programs for LFS are increasingly implemented, there is still limited real-world evidence on their overall clinical, social, and economic impact.”

Her team wants to better understand and demonstrate the value of proactive prevention, early detection, and specialized care in individuals with hereditary cancer predisposition syndromes, including LFS.

“More broadly, the PREVENTABLE project aims to generate evidence to support a shift from a reactive healthcare model focused on treating advanced cancer to a more proactive approach centered on prevention and earlier diagnosis, when a genetic diagnosis is available,” Oliveira said.

The study included retrospective clinical data from 505 TP53 carriers and 361 non-carrier relatives from seven European countries.

The researchers used standardized French hospital fees to calculate the costs of each individual’s healthcare pathway then compared two groups; those without a prior cancer diagnosis who underwent proactive surveillance with regular screening, and those who received treatment after being diagnosed with cancer.

Among the 155 TP53 carriers (median age 28 years) without a prior cancer diagnosis included in the preventive arm, 18 (11.6%) developed one or more cancers during more than six years of follow-up. The mean cost of prevention was €6047 ($7007) per patient.

In the 273 patients who had already developed cancer prior to genetic testing, (median age 33 years), the mean treatment cost was €53,906 ($62,464) per patient. Within this group, 109 patients had early stage and 164 advanced stage disease.

Rolain noted that as well as a nine-fold lower cost among the patients who received screening before a cancer diagnosis, there were significant improvements in survival among the screened patients.

“From a clinical perspective, our results were not surprising, since intensive screening should enable earlier cancer detection, generally associated with better clinical outcomes. But what is particularly noteworthy is that we have been able to see this reflected in real-world data across several European countries. And we were also struck by the dramatic difference between prevention and treatment costs,” said Rolain.

She added: “While further large-scale prospective studies will be needed to confirm our findings, we believe that they are already sufficient to make the case for investing in early genetic testing in tumor risk syndromes. We have been able to show that catching cancer early or preventing it altogether is not only better for patients, but also for healthcare systems.”

The researchers hope that their study findings will contribute to future refinements of existing guidelines and help improve the balance between early cancer detection and the burden associated with intensive long-term screening for patients with LFS and other rare tumor risk syndromes.

Chair of the conference, Alexandre Reymond, PhD, who was not involved in the research, said: “With ever-increasing health system costs, it is time to change from a predominantly curative mantra and put more emphasis on prevention. This study is a beautiful example of the clinical and economic benefits of the implementation of personalized health care.”

The post Proactive Surveillance Pays Off for Patients with Li-Fraumeni Syndrome appeared first on Inside Precision Medicine.

CAR T Success Hinges on Microenvironment Response in GBM

CAR T therapy works best when it activates the tumor microenvironment in a specific way, according to a study published this week in Cell. When natural killer (NK) cells are activated, survival is extended. But if regulatory T cells and immunosuppressive myeloid cells are increased, that may blunt the therapy’s effects.

“We are now working to understand the exact mechanisms underlying response and resistance so we can continue to improve treatment,” Dana Silverbush, PhD, a co-author of the study and an assistant professor of Cancer Biology at University of Pennsylvania and Penn’s Perelman School of Medicine, told Inside Precision Medicine. Other co-authors were Perelman’s Zev Binder, MD, PhD, assistant professor of neurosurgery, and Cécile Alanio, MD, PhD, adjunct professor of neurosurgery.

About a year ago, Phase I clinical trials using this team’s dual-target CAR T-cell therapy improved survival in glioblastoma (GBM) tumor treatment. But the study found that the therapy was triggering tumor reduction and extending survival in some patients, but not all. Relapse remained common.

CAR T-cell therapy is a personalized immunotherapy that uses a patient’s own immune cells to treat their cancer. While successful against blood cancers, it has not yet made significant inroads against solid tumor cancers

In this latest study, a bivalent CAR T-cell therapy was delivered via intracerebroventricular (ICV) injection. This delivers the therapy directly to the cerebrospinal fluid (CSF) surrounding the patient’s brain. As a result, researchers can sample CSF around the infusion at different times and then analyze the levels of immune activation.

“ICV results in greater numbers of CAR T cells reaching the tumor and avoids the need to cross the blood-brain barrier. There are other potential benefits, such as reduced systemic circulation of CAR T cells, which may help reduce the risk of on-target/off-tumor toxicity, that make ICV administration attractive,” Silverbush said. 

GBM is a dire diagnosis. It is the most common brain cancer in adults. There are no drugs approved for recurrent disease. Overall survival for newly diagnosed GBM is around 18 months.

These researchers found that while all patients’ immune systems were activated, there were key differences between those who responded to the treatment and those who did not. Patients who responded had strong activation of NK cells, linked to tumor shrinkage and longer survival. Specifically, those favorable outcomes correlated with expansion of CD56dimCD16pos cytotoxic NK cells.  

Non‑responders showed increased regulatory T cells and immunosuppressive myeloid cells, which appear to blunt the therapy.

These findings point CAR T-cell therapy towards new approaches, for example, researchers can try priming patients’ immune systems with drugs that deplete regulatory cells, or try to armor the CAR T cells with proteins that shut down regulatory T cells.

“Now that we can see on a cellular level how CAR T-cell therapy significantly changes the composition of the patient’s immune system, we can begin to investigate ways to improve the therapy so that more patients might respond to the treatment and that response will last longer,” said Silverbush.

“A lot of what we know about CAR T-cell therapy comes from treating blood cancers, which behave very differently from solid tumors like glioblastoma,” said Alanio. “We can’t do frequent brain surgery on patients receiving CAR T-cell therapy to monitor the tumor’s immune environment, but the ICV gives a unique window into a patient’s cancer that wouldn’t be available if the treatment were delivered another way.”

“When we look ahead to making our dual-target CAR T-cell therapy even more effective, these findings point us in a few promising directions,” added Binde. 

The post CAR T Success Hinges on Microenvironment Response in GBM appeared first on Inside Precision Medicine.

<![CDATA[REFRESH real-world study follows once-nightly sodium oxybate in narcolepsy.]]>

Age-Related Inflammation Linked to R-Loop Nucleic Acids, Opens Therapies

In a new study published in Nature Aging titled, “Nuclear export of R-loop by the DDX1 and XPO1 complex promotes senescence-associated secretory phenotype and inflammaging,” researchers from the University of Texas (UT) MD Anderson Cancer Center have uncovered a previously unknown connection between R-loop nucleic acid structures and age-related inflammation or inflammaging. The results support new intervention options for chronic inflammation and subsequent health conditions.  

In preclinical models, the administration of KPT-330 (selinexor) prevented export of R-loops and led to significant improvement in inflammation, liver damage, fat gain, muscle loss and overall lifespan.   

“Chronic, widespread inflammation is a driving factor in many age-related diseases, including cancer, and our research has discovered one reason why this happens,” said Rugang Zhang, PhD, professor and chair of Experimental Therapeutics at UT MD Anderson and corresponding author on the study. “Understanding the cause is the first step toward developing treatments. We saw encouraging results using a drug that has already been tested in humans, paving the way for potential clinical use to alleviate age-related conditions.”

Cells begin releasing signals that contribute to chronic inflammation once they enter senescence and stop dividing. Researchers have now pinpointed R-loops as a key component to modulating these inflammatory signals.

An R-loop is a temporary cellular structure created during transcription, when a double strand of RNA and DNA becomes tangled with a third displaced single strand of DNA. While R-loops are traditionally confined to the cell nucleus, the study found that cells in senescence increasingly export R-loops into the cytoplasm. These R-loops attach to fragments of DNA debris to trigger chronic inflammation.

This study identified the two proteins involved in exporting R-loops, DDX1 and XPO1. DDX1 attaches to the R-loop inside the nucleus to facilitate export. XPO1 allows the R-loops to be transported into the cytoplasm by forming a complex with DDX1.

Researchers administered KPT-330, a FDA-approved drug for treating multiple myeloma that blocks nuclear export. The R-loops remain trapped inside the nucleus and could not trigger an inflammatory response.

The study showed that shutting down nuclear export by blocking XPO1 in preclinical mouse models suppressed inflammaging, reduced liver fibrosis, lowered systemic inflammatory markers, and reversed age-related body composition changes.

In a separate experiment, the same inflammatory alarm enabled the immune system to find and eliminate precancerous cells. The authors state that future studies could explore blocking DDX1 specifically, instead of shutting down all nuclear export, to mitigate side effects.

The post Age-Related Inflammation Linked to R-Loop Nucleic Acids, Opens Therapies appeared first on GEN – Genetic Engineering and Biotechnology News.

The Download: a reality check for geoengineering and the science of interoception

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

Hacking the atmosphere: geoengineering gets a reality check

Solar geoengineering, the controversial idea that we could deliberately intervene in the climate system to counteract global warming, is moving beyond computer simulations and into the practical engineering challenges required to make it real.

Researchers are now working on aircraft, materials, and other systems for solar geoengineering. But as they delve into these details, they’re finding that even early deployment would require significant new infrastructure, time, and investment.

Find out what happens when solar geoengineering encounters the realities of trying to cool the planet.

—James Temple

MIT Technology Review Narrated: inside interoception, the hidden sense of how you feel inside

Scientists have a word for how we sense ourselves from the inside: interoception. Today, thanks to a 2021 Nobel Prize and new tools that can map internal signaling across the body, research into interoception is taking off.

As researchers decode how signals move between body and brain, a clearer picture is starting to take shape—with implications for how we treat conditions from obesity to anxiety.

—Katherine W. Isaacs

This is our latest story to be turned into an MIT Technology Review Narrated podcast, which we publish each week on Spotify and Apple Podcasts. Just navigate to MIT Technology Review Narrated on either platform, and follow us to get all our new content as it’s released.

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 SpaceX is now valued higher than Amazon 
Its market value hit $2.659 trillion yesterday. (Axios)
+ A post-IPO stock surge also briefly pushed it above Microsoft’s. (Quartz)
+ It’s now the world’s fifth most valuable company. (Guardian)
+ SpaceX is acquiring AI coding startup Cursor for $60 billion. (CNBC)

2 G7 leaders want access to top US AI models
They’re pushing to escape restrictions on the likes of Fable 5. (Reuters $)
+ The Mythos shutdown has sparked a global scramble for sovereign AI. (Fortune)
+ The world is looking to ditch US AI models. (MIT Technology Review)

3 Trump’s AI export strategy has run into Trump’s export controls
His administration risks undermining its own AI plans. (Axios)
+ It now effectively has a licensing regime for frontier AI. (Fortune)
+ Here’s how a top Chinese AI model overcame US sanctions. (MIT Technology Review) 

4 Huawei’s big comeback has exposed the limits of US chip controls
It’s overcome restrictions on advanced chipmaking gear. (Financial Times $)
+ The AI boom has ignited Asia’s chip companies. (NYT $)

5 AI fears are pushing Silicon Valley toward gene-editing startups
They want smarter babies to counter superintelligent AI. (Mother Jones)
+ The pursuit of perfect babies is an ethical mess. (MIT Technology Review)

6 A brain implant has enabled a speechless ALS patient to work full-time
The system translates his brain activity into speech. (The Register)
+ He’s become the first “power user” of a BCI. (MIT Technology Review)

7 A leak has revealed details of Peter Thiel’s secret society
Its program ranges from cult-building to prepping for World War III. (Wired $)

8 ChatGPT’s market share has slipped below 50% for the first time
Thanks to the rise of Gemini and Claude. (TechCrunch)

9 A quantum state that lasts forever may finally be within our grasp
Experiments suggest that quantum “eternity” is possible. (New Scientist $)

10 Commodore has made a digital detox phone that isn’t dumb
The Callback combines gadget nostalgia with modern needs. (The Verge)

Quote of the day

“The Entity List is like whack-a-mole and you’ve got to ‌keep whacking ⁠the moles.” 

—Philip Luck, who studies global supply chains at the Center for Strategic and International Studies, tells Reuters that a lack of new blacklistings is likely leading American innovations to adversaries who could use them against the US.

One More Thing

A model generated by AlphaFold shows how amino acids fold to form a protein.

COURTESY OF DEEPMIND


This is the reason Demis Hassabis started DeepMind

Watching DeepMind’s AI master the ancient board game Go, Demis Hassabis realized that his company was ready to take on one of the most important and complicated puzzles in biology: predicting the structure of proteins. 

The result was AlphaFold2, an AI that could predict the shape of proteins down to the nearest atom. “It’s the most complex thing we’ve ever done,” Hassabis told MIT Technology Review.

Taking on scientific problems is the culmination of what Hassabis set out to achieve, and it’s what he wants to be known for.  “This is the reason I started DeepMind,” he says. “In fact, it’s why I’ve worked my whole career in AI.”

Discover how he plans to transform science with AI. 

—Will Douglas Heaven

We can still have nice things

A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ This mesmerising footage of wind rolling through grass looks like CGI.
+ The glorious early days of internet discovery have been revived by the return of StumbleUpon.
+ A German subway entrance has been delightfully designed as an old tram car crashing into the pavement.
+ The Last Museum lets you search across 5.8 million museum artworks spanning from 3000 BC to the present day.

From network hub to therapeutic target: the role of mediodorsal thalamic nucleus in epilepsy

Mediodorsal thalamic nucleus (MD) is a pivotal hub for cortical functions, characterized by significant heterogeneity in its anatomical connectivity, cytoarchitecture, and function, constituting a complex nucleus composed of multiple functionally specialized subregions. We elaborates on the heterogeneous anatomical connectivity of MD and its crucial role in supporting higher cognitive functions such as working memory, cognitive control, and emotional integration. It then focuses on the multifaceted role of MD within epileptic pathological networks. Substantial evidence indicates that MD in patients with epilepsy exhibits structural atrophy and abnormalities in functional connectivity, with its activity being recruited early during seizures and likely involved in seizure propagation and generalization. However, the therapeutic efficacy of neuromodulation targeting MD, such as deep brain stimulation (DBS), remains contentious, highlighting the current insufficient understanding of its distinct functional subregions and specific pathway mechanisms. Finally, the review discusses the challenges and future directions in translating MD into an effective therapeutic target. It emphasizes that future research must endeavor to elucidate its causal mechanisms within epileptic networks at the subregional level, account for the heterogeneity of seizure onset frequencies, and develop precise intervention strategies targeting specific epileptogenic pathways, thereby advancing novel therapies focused on thalamocortical circuits toward clinical application.

Vagus Nerve Stimulation differentially modulates P3b in responders and non-responders: toward a biomarker of therapeutic efficacy

IntroductionAlthough vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy, its mechanisms of action remain unresolved, resulting in variable clinical efficacy. Given the strong anatomical and functional coupling between vagal afferents and the locus coeruleus–noradrenergic system, this study investigated whether VNS directly impacts an electrophysiological marker of this system, the P3b event-related potential, and how such modulation relates to therapeutic outcomes.MethodsFifteen adults who had undergone long-term VNS implantation performed an auditory oddball task with the device disabled (OFF) and enabled (ON), with ON separated into electrical pulse-train (ON HIGH) and inter-burst break (ON LOW) phases to investigate the direct impact of electrical stimulation on the P3b.ResultsLinear mixed-effects modelling revealed a significant interaction between VNS condition and clinical response: responders showed reduced P3b amplitude (p = 0.023) and prolonged latency during ON (p = 0.007), whereas non-responders exhibited increased amplitude (p = 0.009) and trending shortened latency (p = 0.078). These VNS-induced changes correlated monotonically with a continuous clinical response score (r_amplitude = −0.62, r_latency = 0.48). In addition, a simple classification approach based on a composite amplitude-to-latency index was included to illustrate the potential of P3b modulation as a biomarker for distinguishing responders from non-responders, showing an overall accuracy of 86.7%. No pulse-locked modulation was observed between ON HIGH and ON LOW.DiscussionThese findings demonstrate that VNS elicits group-specific acute effects on cognitive–electrophysiological markers and support P3b modulation as a promising biomarker for predicting therapeutic efficacy.

The relationship between healthy sleep patterns and the risk of scoliosis: a large prospective cohort study

BackgroundCurrently, prospective evidence on how sleep habits specifically affect scoliosis is nearly nonexistent. We therefore sought to clarify the association between comprehensive sleep behavior patterns and the incidence of this disease.MethodsThis study conducted a prospective cohort study based on the UK Biobank (UKB), including 408,870 participants who did not have scoliosis at baseline. We have constructed a comprehensive sleep scoring system that integrates the following five key indicators: sleep chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. To evaluate the association between healthy sleep patterns and the risk of scoliosis, we conducted a statistical analysis using the Cox proportional hazards regression model.ResultsOver a mean follow-up of 15.82 years, 2,976 incident cases of scoliosis were recorded (0.73%). The 408,870 participants who were free of scoliosis at baseline had a mean age of 56.48 years. Distribution of the healthy sleep score was as follows: 9,939 participants (2.43%) had 0–1 of the five healthy sleep behaviors, 46,175 (11.29%) had 2 behaviors, 115,094 (28.15%) had 3 behaviors, 150,287 (36.76%) had 4 behaviors, and 87,375 (21.37%) had all five. In multivariable models, each 1-point increase in the healthy sleep score was associated with a 10% lower risk of scoliosis [hazard ratio (HR) = 0.90; 95% confidence interval (CI) = 0.87, 0.93]. Compared with the 0–1 score group, the multivariable-adjusted HR (95% CI) for participants with a score of 5 was 0.64 (0.52, 0.80). In subgroup analyses, the inverse association between sleep score and scoliosis risk persisted among participants without diabetes but was absent among those with diabetes (pinteraction < 0.05).ConclusionCohort analysis results confirm that adherence to a healthy sleep-behavior pattern significantly reduces the risk of scoliosis.

Impact of C-reactive protein–triglyceride–glucose and systemic immune-inflammation indices on obstructive sleep apnea in older adults with depression

ObjectiveBoth the C-reactive protein (CRP)–triglyceride–glucose index (CTI) and the systemic immune-inflammation index (SII) are easily accessible, cost-effective, and rapid indices derived from biochemical examinations. The study aimed to identify the roles of the CTI and SII in older adults with comorbid obstructive sleep apnea (OSA) and depression.MethodsThe study included 52 older patients with depression coexisting with OSA and 108 patients with depression but without OSA. The CTI was calculated using the following equation: 0.412 × Ln (CRP) (mg/dL) + Ln [triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The SII was calculated using the formula: platelet × neutrophil/lymphocyte.ResultsA greater proportion of men and a higher mean body mass index were found in older adults with comorbid OSA and depression compared to those with depression only (p < 0.05). Older adults with comorbid OSA and depression also showed higher levels of fasting glucose, triglycerides, CRP, the triglyceride–glucose (TyG) index, and the CTI than those with depression alone. We also found that older adults with comorbid OSA and depression had higher neutrophil counts, a higher neutrophil-to-lymphocyte ratio (NLR), and a higher platelet-to-lymphocyte ratio (PLR), and an increased SII compared to those with depression alone. Logistic regression analysis demonstrated that male sex and higher CTI and SII values were correlated with the presence of OSA in patients with depression.ConclusionThe study demonstrated that higher CTI and SII values may be associated with comorbid OSA and depression in older adults.