{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T16:35:03Z","timestamp":1790440503906,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019018","name":"Chinese Academy of Medical Sciences Initiative for Innovative Medicine","doi-asserted-by":"publisher","award":["NO.2023\u2010I2M\u2010C&T\u2010B\u2010126"],"award-info":[{"award-number":["NO.2023\u2010I2M\u2010C&T\u2010B\u2010126"]}],"id":[{"id":"10.13039\/501100019018","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cellular Molecular Medi"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The global incidence of biliary tract cancer (BTC) is on the rise, presenting a substantial healthcare challenge. The integration of immune checkpoint inhibitors (ICIs) with molecularly targeted therapies is emerging as a strategy to enhance immune responses. However, the efficacy and underlying mechanisms of these treatments in BTC are still largely unexplored. In this study, tissue samples from 19 BTC patients treated with camrelizumab and apatinib were analysed using the NanoString 289\u2010panel to identify key molecular biomarkers. Comparative analyses and subsequent experimental validations, including cell\u2010based assays and histopathological examinations, identified adrenomedullin (ADM) as a critical molecular marker associated with treatment efficacy and poor prognosis. ADM has been shown to promote BTC cell proliferation, migration and angiogenesis, primarily by interacting with vascular endothelial growth factor (VEGF) and increasing AKT phosphorylation. Furthermore, ADM disrupts endothelial cell barrier function via the calcitonin receptor\u2010like receptor (CRLR) and vascular endothelial (VE)\u2010cadherin signalling pathway. Preclinical inhibition of ADM or CRLR resulted in suppressed tumour growth. Additionally, elevated ADM expression was correlated with increased tumour\u2010infiltrating immune cells and higher immune checkpoint expression. These findings suggest that ADM plays a pivotal role in resistance to immunotherapy and anti\u2010angiogenic treatment in BTC, and thus, targeting ADM may offer a promising therapeutic approach to enhance treatment efficacy.<\/jats:p>","DOI":"10.1111\/jcmm.70460","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T03:36:17Z","timestamp":1741836977000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Adrenomedullin Inhibits the Efficacy of Combined Immunotherapy and Targeted Therapy in Biliary Tract Cancer by Disrupting Endothelial Cell Functions"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5332-5290","authenticated-orcid":false,"given":"Zhengfeng","family":"Xuan","sequence":"first","affiliation":[{"name":"Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University &amp; Research Unit of Liver Transplantation and Transplant Immunology Chinese Academy of Medical Sciences  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoran","family":"Hu","sequence":"additional","affiliation":[{"name":"Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University &amp; Research Unit of Liver Transplantation and Transplant Immunology Chinese Academy of Medical Sciences  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of General Surgery Changzhou Jintan District People's Hospital  Changzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Ling","sequence":"additional","affiliation":[{"name":"Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University &amp; Research Unit of Liver Transplantation and Transplant Immunology Chinese Academy of Medical Sciences  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University &amp; Research Unit of Liver Transplantation and Transplant Immunology Chinese Academy of Medical Sciences  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhu","family":"Li","sequence":"additional","affiliation":[{"name":"Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University &amp; Research Unit of Liver Transplantation and Transplant Immunology Chinese Academy of Medical Sciences  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junda","family":"Li","sequence":"additional","affiliation":[{"name":"Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University &amp; Research Unit of Liver Transplantation and Transplant Immunology Chinese Academy of Medical Sciences  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Jiangsu Simcere Diagnostics Co. 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