{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:48:27Z","timestamp":1782388107445,"version":"3.54.5"},"reference-count":62,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"national natural science foundation of china","doi-asserted-by":"publisher","award":["82460250"],"award-info":[{"award-number":["82460250"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013064","name":"key research and development program of jiangxi province","doi-asserted-by":"publisher","award":["20202BBG73030"],"award-info":[{"award-number":["20202BBG73030"]}],"id":[{"id":"10.13039\/501100013064","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020205","name":"health commission of jiangxi province","doi-asserted-by":"publisher","award":["202310246"],"award-info":[{"award-number":["202310246"]}],"id":[{"id":"10.13039\/501100020205","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004479","name":"natural science foundation of jiangxi province","doi-asserted-by":"publisher","award":["20202BABL206078"],"award-info":[{"award-number":["20202BABL206078"]}],"id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Current understanding of molecular mechanisms driving moyamoya disease (MMD) remains limited. This study aimed to elucidate the role of TGF-\u03b2 signaling in MMD vascular remodeling via endothelial-to-mesenchymal transition (EndMT). Spatial transcriptomics (10x Visium) was performed on 11 MMD specimens, while hematoxylin-eosin (HE) staining, immunohistochemistry (lHC), and immunofluorescence were conducted on a total of 51 MD and 11 control vascular specimens. Pseudotemporal trajectory analysis and cell\u2013cell communication modeling were employed to map EndMT dynamics. MMD vessels exhibited intimal hyperplasia (STA:\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    1\/\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    \u2009=\u20090.38\u2009\u00b1\u20090.12 vs 0.25\u2009\u00b1\u20090.12,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01) and medial atrophy. Spatial transcriptomics identified dual-positive SMC-Endo clusters (13.6%) within hyperplastic intima, co-expressing endothelial (PECAM1, CDH5) and mesenchymal markers (ACTA2, S100A4). The TGF-\u03b2 pathway was significantly enriched in EndMT-active cells (FDR\u2009=\u20092.1\u2009\u00d7\u200910\n                    <jats:sup>-5<\/jats:sup>\n                    ), with elevated TGFBR1 and Snail expression in MMD intima (TGFBR1: 0.020\u2009\u00b1\u20090.008 vs 0.005\u2009\u00b1\u20090.004,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001; Snail: 0.10\u2009\u00b1\u20090.03 vs 0.06\u2009\u00b1\u20090.02,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Cell\u2013cell networks revealed TGF-\u03b2-driven pro-fibrotic interactions. Immunofluorescence confirmed increased PECAM1+ \u03b1-SMA+ dual-positive cells in MMD vessels. These findings establish TGF-\u03b2\/Snail-driven EndMT as a key mechanism in MMD vascular remodeling. Targeting TGF-\u03b2 signaling or transitional cell states may halt or potentially reverse intimal hyperplasia, offering novel therapeutic strategies. Further validation in preclinical models is warranted.\n                  <\/jats:p>","DOI":"10.1177\/0271678x251388370","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:39:13Z","timestamp":1764225553000},"page":"852-866","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Spatial transcriptomics reveals TGF-\u03b2-driven endothelial\u2013mesenchymal transition in vascular remodeling of moyamoya disease"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2597-8928","authenticated-orcid":false,"given":"Jinlin","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"},{"name":"Pingxiang People\u2019s Hospital, Pingxiang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwen","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianda","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingpeng","family":"Qiu","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuye","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canyang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People\u2019s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daya","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6227-1012","authenticated-orcid":false,"given":"Erming","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jiangxi Medical College, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, 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