Integrative transcriptomic and experimental analyses prioritize TPT1 as a PANoptosis-associated candidate molecular marker in sarcopenia.

Background: Sarcopenia lacks sensitive molecular markers for early detection, and its relationship with integrated inflammatory cell-death programs remains unclear. PANoptosis integrates apoptotic, pyroptotic, and necroptotic signaling and therefore provides a plausible framework for investigating inflammatory-stress remodeling in aging skeletal muscle. Methods: We integrated four bulk-transcriptomic datasets from the Gene Expression Omnibus into a training cohort (66 controls; 37 sarcopenia) and used GSE111016 as an external validation cohort (20 controls; 20 sarcopenia). We intersected differentially expressed genes with a curated PANoptosis-associated gene set and then performed enrichment analysis; least absolute shrinkage and selection operator (LASSO), random forest and extreme gradient boosting (XGBoost) feature selection; nomogram and receiver operating characteristic (ROC) analyses; CIBERSORT immune-cell deconvolution; and single-nucleus RNA sequencing (snRNA-seq) reanalysis. We assessed tumor protein, translationally controlled 1 (TPT1) expression in D-galactose-treated mouse and C2C12 models. Results: Among 608 differentially expressed genes, 47 overlapped with the curated PANoptosis-associated gene set. These genes were enriched in apoptotic signaling; cytokine, nuclear factor kappa B (NF-κB), tumor necrosis factor (TNF), and nucleotide-binding oligomerization domain (NOD)-like receptor pathways; regulated necrosis; extracellular-matrix remodeling; and impaired oxidative phosphorylation. Three machine-learning algorithms converged on neurotrophic receptor tyrosine kinase 1 (NTRK1), TPT1, and TNF receptor-associated protein 1 (TRAP1). TPT1 showed the strongest single-gene discrimination, with areas under the ROC curve of 0.819 (95% confidence interval [CI], 0.737-0.900) in the training cohort and 0.753 (95% CI, 0.598-0.907) in the external cohort. Immune-cell deconvolution linked the candidate genes to estimated mast-cell, plasma-cell, cluster of differentiation 8-positive (CD8 Conclusion: This study prioritizes TPT1 as a candidate molecular marker associated with the bulk-transcriptomic sarcopenia phenotype. The aging-muscle and D-galactose analyses provide biological context but do not establish sarcopenia specificity or causality. Prospective clinical validation and functional perturbation studies are required.