FOXC1 Aggravates the Ischemia-Reperfusion Induced Injury in Renal Tubular Epithelial Cells by Activating NF-κB/NLRP3 Signaling

Renal ischemia-reperfusion injury (RIRI) is a condition characterized by inflammation and cell damage in the kidneys following a period of ischemia and subsequent reperfusion, which lacks effective treating method in the clinic. Exploring molecular mechanisms holds profound significance in guiding the clinical prevention and treatment of RIRI. Herein, the potential function of Forkhead box C1 (FOXC1), a protein belongs to FOX family, in I/R-induced injury in renal tubular epithelial cells (RTECs) was studied to explore potential targets for RIRI. FOXC1 was upregulated in RIRI rats, expressions of which were elevated as time prolonged. FOXC1-overexpressed or knockdown HK-2 cells were constructed, followed by I/R stimulation. FOXC1 was found markedly upregulated in I/R-stimulated HK-2 cells. Notably repressed cell viability, enhanced apoptosis, increased release of inflammatory cytokines, boosted reactive oxygen species (ROS) and malondialdehyde (MDA) levels, and inactivated superoxide dismutase (SOD) enzyme were observed in I/R-stimulated HK-2 cells, which were sharply reversed by silencing FOXC1 and aggravated by overexpression FOXC1. Furthermore, largely increased levels of NLRP3, caspase-1, GSDMD-N, IL-18, IL-1β, and p-p65/p65 were observed in I/R-stimulated HK-2 cells, which were notably suppressed by silencing FOXC1 and further elevated by overexpression FOXC1. Additionally, FOXC1-overexpressed HK-2 cells were stimulated by I/R with or without 10 μM MCC950, an inhibitor of NLRP3. The enhanced apoptosis, triggered inflammation, and facilitated ROS by FOXC1 overexpression in I/R-stimulated HK-2 cells were remarkably abolished by the coculture of MCC950, accompanied by an inhibition on the NF-κB/NLRP3 signaling. Collectively, FOXC1 aggravated the I/R induced injury in RTECs by activating NF-κB/NLRP3 signaling.

Efficacy and safety of preoperative biliary drainage in patients with Hilar Cholangiocarcinoma: a systematic review and meta-analysis

BACKGROUND

Preoperative biliary drainage (PBD) has been proposed as a strategy to manage the complications associated with biliary obstruction in hilar cholangiocarcinoma patients. However, the efficacy and safety of PBD in remain controversial, even in clinical guidelines. This meta-analysis aimed to provide a comprehensive evaluation of the efficacy and safety of PBD in patients with hilar cholangiocarcinoma.

METHODS

PubMed, Medline, EMBASE, Cochrane Library, and registers were screened to investigate the efficacy and safety of PBD in patients with hilar cholangiocarcinoma. The search timeframe was set before December 2024. Mortality, morbidity, and postoperative infection served as the primary outcomes, while the secondary outcomes included transfusion, operative time, operative bloody loss, intraabdominal abscess, intraabdominal bleeding, leakage (bile leak or anastomotic leakage), hepatic insufficiency, renal insufficiency, second laparotomy, total hospital stay, cholangitis. Studies were evaluated for quality by Newcastle-Ottawa scale. Data were pooled as odds ratio ( OR ) or standard mean difference ( SMD ).

RESULTS

Our meta-analysis of 21 studies (3059 patients) showed that PBD reduced hepatic insufficiency ( OR  = 0.38, 95% CI  = 0.16-0.90, P  = 0.03, I 2  = 69%) but increased risks of long term follow up mortality ( OR  = 1.90, 95% CI  = 1.02-3.56, P  = 0.04, I 2  = 0%), morbidity ( OR  = 1.47, 95% CI  = 1.12-1.92, P  = 0.01, I 2  = 52%), postoperative infection ( OR  = 2.46, 95% CI  = 1.17-5.18, P  = 0.02, I 2  = 69%), transfusion ( OR  = 1.39, 95% CI  = 1.06-1.81, P  = 0.02, I 2  = 49%), leakage ( OR  = 1.67, 95% CI  = 1.08-2.60, P  = 0.02, I 2  = 44%), cholangitis ( OR  = 6.40, 95% CI  = 1.75-23.48, P  = 0.01, I 2  = 51%), and prolonged hospital stay ( SMD  = 0.53, 95% CI  = 0.06-0.99, P  = 0.03, I 2  = 87%). There was no difference in overall mortality, operative time, blood loss, or other complications ( P > 0.05). Subgroup analysis showed that differences in some outcomes lost significance with higher bilirubin levels, fewer PBD cases, studies published after 2010, and strictly select PBD patients ( P < 0.05).

CONCLUSIONS

Routine PBD cannot be recommended but it tends to be a better choice in patients with average initial bilirubin above 218.75 μmol/L, portal vein embolization and malnutrition. Further multicenter randomized studies should address the potential advantages of PBD over NPBD, identify clear patient selection criteria, and determine the optimal bilirubin threshold for PBD.

Efficacy of perioperative dexmedetomidine in postoperative pain and neurocognitive functions in orthopedic surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials

INTRODUCTION

With an estimated 2.1 million hip and knee replacements performed annually in developed countries, orthopedic surgeries can result in complications such as postoperative pain and cognitive dysfunctions. Dexmedetomidine shows potential for reducing pain and opioid use and improving cognitive outcomes, but its efficacy in orthopedic settings needs further evaluation.

METHODS

A comprehensive literature search was performed across electronic databases (e.g., PubMed) up to 1 June 2024 to identify relevant randomized controlled trials (RCTs) investigating the use of dexmedetomidine for orthopedic surgeries. The primary outcomes included visual analog scale (VAS), opioid consumption, incidence of postoperative cognitive dysfunction (POCD), and postoperative delirium (POD). Meta-analysis was conducted using RevMan 5.3 and Stata 16.0, with statistical significance set at P < 0.05. Sensitivity analyses, along with trial sequential analysis (TSA), were used to evaluate the robustness of the findings.

RESULTS

The meta-analysis included 59 RCTs with 7713 participants and demonstrated that dexmedetomidine significantly reduced postoperative VAS score (mean difference [MD] -0.50, P = 0.0003) and opioid consumption (MD -11.91, P < 0.0001) and decreased the incidence of POCD (risk ratio [RR] 0.59, P = 0.006) and POD (RR 0.49, P < 0.0001). Dexmedetomidine also prolonged motor (MD: 1.70, P < 0.0001) and sensory block durations (MD: 1.80, P < 0.0001) and delayed the time to first rescue analgesics (MD: 1.51, P < 0.0001). TSA and sensitivity analysis confirmed the robustness and reliability of the results, whereas meta-regression revealed no significant effect of variables on primary outcomes.

CONCLUSION

Our study demonstrates that intravenous dexmedetomidine significantly improved postoperative pain and neurocognitive functions in orthopedic surgery patients.

Experimental modeling of Alzheimer's disease: Translational lessons from cross-taxon analyses

Alzheimer's disease (AD) is a severely debilitating neurodegenerative disease with a rapidly increasing global prevalence, poorly understood causes, and no efficient treatments. Experimental models are valuable for studying AD pathogenesis, including amyloid beta and tau accumulation, synaptic dysfunction, and neuroinflammation. While no model fully reproduces the disease, we take an evolutionary biology approach to discuss available models across taxa, from mammals (rodents, primates) to zebrafish, Drosophila melanogaster, and Caenorhabditis elegans. Evaluating their strengths and limitations provides insight into disease mechanisms and may refine research strategies for improved diagnostics and therapeutic screening. Traditional models have significantly contributed to AD research, yet their translational limitations highlight the need for physiologically relevant alternatives. Integrating humanized rodent models, zebrafish, organoids, and induced pluripotent stem cell-based systems-along with advances in bioengineering and genetic editing-may offer a more comprehensive framework to bridge the gap between preclinical research and clinical application. HIGHLIGHTS: Experimental models across rodents, primates, zebrafish, fruit flies, and worms provide key insights into Alzheimer's disease (AD). Cross-taxon comparisons assess strengths and weaknesses in AD models. Evolutionary biology approaches refine experimental strategies for AD research. Diverse animal models improve understanding of AD pathogenesis. Cross-species models enhance diagnostics and therapeutic strategy development.

Curcumin dispersed with colloidal nano-particles inhibits enteric viruses replication

Acute gastroenteritis remains one of the most common health problems despite the progress in prevention and vaccination. The options for viral diarrhea therapy are limited and there is the need for effective treatment. Recently a novel form of the nano-dispersed curcumin that is highly bioavailable was described. This form of curcumin was well tolerated by the cells in culture and was rapidly absorbed into the blood plasma after oral administration. We tested the antiviral activity of this curcumin formulation in vitro using several viruses associated with gastrointestinal infections, like astrovirus, norovirus rotavirus, adenovirus, echovirus, and coxackievirus. We did observe strong replication inhibition of all tested viruses. These results suggest that the tested form of curcumin is a promising candidate for a broad-spectrum antiviral drug.

Macrophage biology in the pathogenesis of Helicobacter pylori infection

Infection with H. pylori induces chronic gastric inflammation, progressing to peptic ulcer and stomach adenocarcinoma. Macrophages function as innate immune cells and play a vital role in host immune defense against bacterial infection. However, the distinctive mechanism by which H. pylori evades phagocytosis allows it to colonize the stomach and further aggravate gastric preneoplastic pathology. H. pylori exacerbates gastric inflammation by promoting oxidative stress, resisting macrophage phagocytosis, and inducing M1 macrophage polarization. M2 macrophages facilitate the proliferation, invasion, and migration of gastric cancer cells. Various molecular mechanisms governing macrophage function in the pathogenesis of H. pylori infection have been identified. In this review, we summarize recent findings of macrophage interactions with H. pylori infection, with an emphasis on the regulatory mechanisms that determine the clinical outcome of bacterial infection.

Extraesophageal reflux: Clinical manifestations and tools for diagnosis and treatment

Extraesophageal reflux is a complex clinical entity, classically presenting with laryngopharyngeal symptoms including chronic cough and vocal changes, but it is also implicated in conditions such as subglottic stenosis and lung injury. Diagnosis is challenging, in large part due to the oftentimes vague presenting symptoms with multiple possible etiologies, as well as limited consistency of currently available diagnostic tests. Furthermore, effective medical treatment is limited, and acid suppression therapy such as proton pump inhibitors has shown low to mixed efficacy in relieving signs and symptoms of reflux outside the esophagus. In this review, we will address laryngopharyngeal reflux and its diagnosis based on symptoms and exam findings, and diagnostic tools such as impedance monitoring and salivary pepsin testing. A summary of the use and limitations of acid-suppressing therapies for extraesophageal reflux and the rationale for targeting pepsin as a nonacid component of reflux will be presented. Finally, the current literature on the potential role of reflux in subglottic stenosis and lessons learned regarding reflux in the lung transplant surgery field in higher risk patient populations will be discussed.

Meta-Analysis of Learning Curve in Endoscopic Spinal Surgery: Impact on Surgical Outcomes

Study DesignSystematic review and meta-analysis.ObjectiveThis meta-analysis aimed to evaluate the learning curve in endoscopic spinal surgery, including the time to mastery and challenges faced by novice surgeons, to improve learning and surgical outcomes.MethodsData extraction included the learning curve period and a comparison of surgeons with more experience or late period of the learning curve (late) and surgeons with less experience and in the early period of the learning curve (early) with respect to demographic, surgical, hospitalization, functional, and complication variables. Statistical analysis was performed using Review Manager 5.4.1 software.ResultsThis meta-analysis included 16 studies (n = 1902). The average number of cases required to reach the learning curve was 32.5 ± 10.5. The uniportal technique required fewer cases (30.1 ± 10.2) than biportal technique (38.7 ± 10.3). There were no significant differences in demographic variables, operation level, or duration of symptoms between the advanced and novice surgeons. Advanced surgeons showed better outcomes in VAS leg pain at less than 6 months (SMD 0.18, 95% CI 0.01-0.34) and >6 months (SMD 0.14, 95% CI 0.02-0.27), as well as VAS back pain at > 6 months (SMD 0.16, 95% CI 0.04-0.29). The incidence of total complications was significantly higher in the novice surgeon group. The specific complications did not differ significantly between the 2 groups.ConclusionsThe average number of cases required to reach the learning curve was 32.5 ± 10.5. Experienced surgeons had shorter surgery and fluoroscopy times, better outcomes in leg and back pain, and a lower incidence of complications than novice surgeons.

A review of the patent literature surrounding TRPV1 modulators

INTRODUCTION

TRPV1, a pivotal therapeutic target for chronic pain and pruritus, has been validated in the pathogenesis of several pathologies from diabetes to cancer. Despite the constellation of chemical structures and strategies, none of these molecules has yet been clinically developed as a new drug application due to safety concerns, particularly in thermoregulation. Thus, clinical development of TRPV1 modulators remains a challenge.

AREAS COVERED

This review covers the patent literature on TRPV1 modulators (2019-2024, PubMed, Google Patents, and Espacenet), from orthosteric ligands to innovative compounds of biotechnological origin such as interfering RNAs or antibodies, and dual modulators that can act on TRPV1 and associated proteins in different tissues.

EXPERT OPINION

Therapeutic strategies that preferentially act on dysfunctional TRPV1 channels appear essential, along with a superior understanding of the underlying mechanisms affecting changes in core body temperature (CBT). Recent findings describing differential receptor interactions of antagonists that do not affect CBT may pave the way to the next generation of orally active TRPV1 inhibitors. Although we have thus far experienced a bitter feeling in TRPV1 drug development, the recent progress in different disciplines, including human-based preclinical models, will set an interdisciplinary approach to design and develop clinically relevant TRPV1 modulators.

Plasma MiR-190 is a potential clinical biomarker for acute respiratory distress syndrome in children and its regulatory role in ARDS cell models by targeting KLF15

BACKGROUND

The present research aimed to investigate the clinical value of plasma miR-190 in children with acute respiratory distress syndrome (ARDS) and the impact of miR-190 on LPS-induced ARDS cell models.

METHODS

The plasma miR-190 levels were measured using real-time quantitative reverse transcription PCR (RT-qPCR). LPS-treated human pulmonary microvascular endothelial cells (HPMECs) were established and then transfected with miR-190 mimic, inhibitor, or miR-negative controls. The levels of inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The effects of miR-190 on HPMEC proliferation and apoptosis were evaluated by CCK-8 assay and flow cytometry. The regulation of KLF15 by miR-190 was detected by luciferase report assay.

RESULTS

The plasma miR-190 expression was increased in ARDS children and it was positively related to the severity and 28 day-survival. Plasma miR-190 could distinguish ARDS children from healthy children. Inhibition of miR-190 increased LPS-induced HPMEC cell proliferation and decreased cell apoptosis and inflammatory cytokines IL-6, IL-1β, and TNF-α. KLF15 was a direct target of miR-190.

CONCLUSION

Increased plasma miR-190 may be a clinical diagnostic and prognostic predictor for ARDS children. Inhibition of miR-190 may improve LPS-induced ARDS by increasing cell proliferation, inhibiting cell apoptosis and inflammatory response by targeting KLF15.

Baicalein inhibits hepatitis B virus through the coiled coil domain containing protein 88A (CCDC88A)-dependent autophagy pathway

BACKGROUND

Chronic infection with the hepatitis B virus (HBV) represents a significant global health concern. Baicalein, a naturally occurring flavone derived from the roots of Scutellaria baicalensis Georgi, has exhibited both anti-inflammatory and antiviral activities. S. baicalensis is extensively utilized in traditional Chinese medicine for the treatment of various liver disorders, including hepatitis. However, the specific anti-HBV effects of baicalein have not been fully elucidated.

PURPOSE

This study aimed to investigate the inhibitory effects of baicalein on HBV and to elucidate its underlying mechanisms.

MATERIALS AND METHODS

The levels of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were measured using enzyme-linked immunosorbent assay (ELISA) kits. Quantification of HBV DNA was performed using quantitative real-time polymerase chain reaction (qRT-PCR). Western blot analysis was conducted to evaluate proteins involved in autophagy, lysosomal acidification, and autophagy-related signaling pathways. Immunofluorescence microscopy was utilized to assess autophagic flux and lysosomal acidification.

RESULTS

Baicalein demonstrated significant inhibition of HBsAg, HBeAg, and HBV-DNA secretion in both in vivo and in vitro environments. Subsequent investigations revealed that baicalein disrupted the intracellular trafficking of the hepatitis B virus by inhibiting the CCDC88A-AKT-mTOR (Coiled coil domain containing protein 88A- protein kinase B-mammalian target of rapamycin) signaling pathway. Additionally, baicalein induced autophagy in HepG2 (Human hepatocellular carcinoma cell line 2) and HepG2.215 cell models. The anti-hepatitis B antigen effect of baicalein was partially attenuated when both early and late stages of autophagy were inhibited. A significant correlation was identified between the phosphorylation of AMPKα and the enhanced autophagy observed in baicalein-treated cells.

CONCLUSIONS

This study elucidates a novel mechanism by which baicalein inhibits the hepatitis B virus (HBV). Specifically, baicalein exerts its antiviral effects by activating autophagy and suppressing the CCDC88A-AKT-mTOR signaling pathway.

Potential of AI and ML in oncology research including diagnosis, treatment and future directions: A comprehensive prospective

Artificial intelligence (AI) and machine learning (ML) have emerged as transformative tools in cancer research, offering the ability to process huge data rapidly and make precise therapeutic decisions. Over the last decade, AI, particularly deep learning (DL) and machine learning (ML), has significantly enhanced cancer prediction, diagnosis, and treatment by leveraging algorithms such as convolutional neural networks (CNNs) and multi-layer perceptrons (MLPs). These technologies provide reliable, efficient solutions for managing aggressive diseases like cancer, which have high recurrence and mortality rates. This review prospective highlights the applications of AI in oncology, a long with FDA-approved technologies like EFAI RTSuite CT HN-Segmentation System, Quantib Prostate, and Paige Prostate, and explore their role in advancing cancer detection, personalized care, and treatment. Furthermore, we also explored broader applications of AI in healthcare, addressing challenges, limitations, regulatory considerations, and ethical implications. By presenting these advancements, we underscore AI's potential to revolutionize cancer care, management and treatment.

Advances in the Study of Metabolic Reprogramming in Gastric Cancer

BACKGROUND

Gastric cancer is one of the most prevalent malignancies of the digestive system and is associated with a poor prognosis, particularly in advanced metastatic stages, where the 5-year survival rate is significantly low.

METHODS

Recent research has demonstrated that metabolic reprogramming-including alterations in glucose, lipid, and amino-acid metabolism-plays a critical role in both the development and progression of this disease. To gain deeper insights into these metabolic shifts, scientists have increasingly employed metabolomics, a non-invasive technique that detects and quantifies small molecules within cancerous tissues, thereby enhancing prognostic assessments.

AIM

Analyzing the metabolic profiles of gastric-cancer tissues can reveal significant changes in key metabolic pathways, which may open new avenues for targeted therapies and ultimately improve patient outcomes.

CONCLUSION

This article reviews recent advancements in the study of metabolic reprogramming in gastric cancer, aiming to identify potential therapeutic targets and offer new hope to patients.

Advancements in multi-omics for nutraceutical enhancement and traits improvement in buckwheat

Buckwheat (Fagopyrum spp.) is a typical pseudocereal, valued for its extensive nutraceutical potential as well as its centuries-old cultivation. Tartary buckwheat and common buckwheat have been used globally and become well-known nutritious foods due to their high quantities of: proteins, flavonoids, and minerals. Moreover, its increasing demand makes it critical to improve nutraceutical, traits and yield. In this review, bioactive compounds accumulated in buckwheat were comprehensively evaluated according to their chemical structure, properties, and physiological function. Biosynthetic pathways of flavonoids, phenolic acids, and fagopyrin were methodically summarized, with the regulation of flavonoid biosynthesis. Although there are classic synthesis pathways presented in the previous research, the metabolic flow of how these certain compounds are being synthesized in buckwheat still remains uncovered. The functional genes involved in the biosynthesis of flavonols, stress response, and plant development were identified based on multi-omics research. Furthermore, it delves into the applications of multi-omics in improving buckwheat's agronomic traits, including: yield, nutritional content, stress resilience, and bioactive compounds biosynthesis. While pangenomics combined with other omics to mine elite genes, the regulatory network and mechanism of specific agronomic traits and biosynthetic of bioactive components, and developing a more efficient genetic transformation system for genetic engineering require further investigation for the execution of breeding designs aimed at enhancing desirable traits in buckwheat. This critical review will provide a comprehensive understanding of multi-omics for nutraceutical enhancement and traits improvement in buckwheat.

Scoping review of anticancer drug utilization in lung cancer patients at the end of life

PURPOSE

This scoping review aims to deepen the understanding of end-of-life anticancer drug use in lung cancer patients, a disease marked by high mortality and symptom burden. Insight into unique end-of-life treatment patterns is crucial for improving the appropriateness of cancer care for these patients.

METHODS

Comprehensive searches were carried out in Medline and Embase to find articles on the utilization of anticancer drugs in the end of life of lung cancer patients.

RESULTS

We identified 68 publications, highlighting the methodological characteristics of studies including the timing of the research, disease condition, treatment regimen, type of treatment, and features of the treatment. We outlined the frequency of anticancer drug use throughout different end-of-life periods.

CONCLUSION

This review provides a comprehensive overview of primary studies exploring end-of-life treatments in lung cancer patients. Methodological inconsistencies pose many challenges, revealing a notable proportion of patients experiencing potential overtreatment, warranting more standardized research methods for robust evaluations.

Engineering of Erythrocytes as Drug Carriers for Therapeutic Applications

Erythrocytes, also known as red blood cells (RBCs), have garnered considerable attention as potential carriers for drug delivery, owing to their inherent properties such as biocompatibility, biodegradability, and prolonged circulation half-life. This paper presents a comprehensive overview of the role of erythrocytes in drug delivery, elucidating recent advancements in delivering a diverse array of therapeutic agents, including small molecules, nucleic acids, antibodies, protein enzymes, and nanoparticles. Two primary strategies for encapsulating drugs within erythrocytes are systematically discussed: internal loading and surface loading. Each strategy offers distinct advantages in terms of drug stability and release kinetics. Notably, the utilization of erythrocyte membrane camouflaged nanocarriers holds promise for enhancing the biocompatibility of conventional nanoparticles and facilitating targeted drug delivery. Furthermore, the broad spectrum of biomedical applications of erythrocyte-based drug delivery systems are examined, ranging from cancer treatment to diabetes management, thrombosis prevention, and immunotherapy. This review provides a comprehensive evaluation of current technologies in erythrocyte-loaded drug delivery, highlighting the strengths, weaknesses, and future directions for advancing therapeutic interventions in various disease contexts.

The Value of Whole-Volume Radiomics Machine Learning Model Based on Multiparametric MRI in Predicting Triple-Negative Breast Cancer

OBJECTIVE

This study aimed to investigate the value of radiomics analysis in the precise diagnosis of triple-negative breast cancer (TNBC) based on breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and apparent diffusion coefficient (ADC) maps.

METHODS

This retrospective study included 326 patients with pathologically proven breast cancer (TNBC: 129, non-TNBC: 197). The lesions were segmented using the ITK-SNAP software, and whole-volume radiomics features were extracted using a radiomics platform. Radiomics features were obtained from DCE-MRI and ADC maps. The least absolute shrinkage and selection operator regression method was employed for feature selection. Three prediction models were constructed using a support vector machine classifier: Model A (based on the selected features of the ADC maps), Model B (based on the selected features of DCE-MRI), and Model C (based on the selected features of both combined). Receiver operating characteristic curves were used to evaluate the diagnostic performance of the conventional MR image model and the 3 radiomics models in predicting TNBC.

RESULTS

In the training dataset, the AUCs for the conventional MR image model and the 3 radiomics models were 0.749, 0.801, 0.847, and 0.896. The AUCs for the conventional MR image model and 3 radiomics models in the validation dataset were 0.693, 0.742, 0.793, and 0.876, respectively.

CONCLUSIONS

Radiomics based on the combination of whole volume DCE-MRI and ADC maps is a promising tool for distinguishing between TNBC and non-TNBC.

The role of cytokines in shaping the future of Cancer immunotherapy

As essential immune system regulators, cytokines are essential for modulating both innate and adaptive immunological responses. They have become important tools in cancer immunotherapy, improving the immune system's capacity to identify and destroy tumor cells. This article examines the background, workings, and therapeutic uses of cytokines, such as interleukins, interferons, and granulocyte-macropHage colony-stimulating factors, in the management of cancer. It examines the many ways that cytokines affect immune cell activation, signaling pathways, tumor development, metastasis, and prognosis by modifying the tumor microenvironment. Despite the limited effectiveness of cytokine-based monotherapy, recent developments have concentrated on new fusion molecules such as immunocytokines, cytokine delivery improvements, and combination techniques to maximize treatment efficacy while reducing adverse effects. Current FDA-approved cytokine therapeutics and clinical trial results are also included in this study, which offers insights into how cytokines might be used with other therapies including checkpoint inhibitors, chemotherapy, and radiation therapy to address cancer treatment obstacles. This study addresses the intricacies of cytokine interactions in the tumor microenvironment, highlighting the possibility for innovative treatment methods and suggesting fresh techniques for enhancing cytokine-based immunotherapies. PEGylation, viral vector-mediated cytokine gene transfer, antibody-cytokine fusion proteins (immunocytokines), and other innovative cytokine delivery techniques are among the novelties of this work, which focuses on the most recent developments in cytokine-based immunotherapy. Additionally, the study offers a thorough examination of the little-reviewed topic of cytokine usage in conjunction with other treatment techniques. It also discusses the most recent clinical studies and FDA-approved therapies, providing a modern perspective on the developing field of cancer immunotherapy and suggesting creative ways to improve treatment effectiveness while lowering toxicity. BACKGROUND: Cytokines are crucial in cancer immunotherapy for regulating immune responses and modifying the tumor microenvironment (TME). However, challenges with efficacy and safety have driven research into advanced delivery methods and combination therapies to enhance their therapeutic potential.

Investigation of the Association of Acute Pancreatitis Outcomes with Social Vulnerability Indicators

BACKGROUND AND AIM

Geospatial analyses integrate location-based sociodemographic data, offering a promising approach to investigate the impact of social determinants on acute pancreatitis outcomes. This study aimed to examine the association of Social Vulnerability Index (SVI) and its constituent 16 attributes in 4 domains (socioeconomic status, household composition and disability, minority status and language, and housing type and transportation), with outcomes in patients with acute pancreatitis.

METHODS

This study included acute pancreatitis patients hospitalized between 1/1/2008 and 12/31/2021 and recorded their demographics and clinical outcomes. Physical addresses were geocoded to determine SVI, a composite variable which was ranked and divided into quartiles (I-IV: IV representing the highest vulnerability).

RESULT

In 824 eligible patients [age of 53.0 ± 10 years and 48.2% females], with 993 acute pancreatitis-related hospitalizations, we noted a significant association in patients residing in communities with higher SVI, a higher prevalence of no/federal/state insurance (P < .001) and underserved ethnic/racial background (P < .001). We observed a significant association of alcohol withdrawal in patients with residence in areas with higher SVI despite adjustment for age, body mass index, and comorbidities (odds ratios: 1.62 [95% CI: 1.19-2.22]; P = .003). However, we observed no association of SVI with severity of acute pancreatitis, inpatient opioid use, length of stay, 30-day admission rate, and mortality.

CONCLUSIONS

We noted significantly higher alcohol withdrawal in patients residing in areas with higher SVI ranks, despite no differences in severity of acute pancreatitis, inpatient opioid use, length of stay, 30-day admission rate, and mortality.

Traditional Chinese exercises for the treatment of neuropsychiatric symptoms in Parkinson's disease: A systematic review and meta-analysis

OBJECTIVE

To systematically evaluate the efficacy of traditional Chinese exercises (TCEs) for neuropsychiatric symptoms (NPSs) in patients with Parkinson's disease.

METHODS

A comprehensive literature search was performed across eight databases, including PubMed, Cochrane Library, Embase, Web of Science (WoS), SinoMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Periodical Database (VIP), and Wanfang Database, covering studies published from their inception up to April 23, 2024. The search focused on identifying randomized controlled trials (RCTs) assessing the effectiveness of TCEs for NPSs in PD patients. The authors independently performed literature screening and data extraction. Meta-analysis was executed employing Review Manager V.5.3 software, and Stata 17.0 was used to detect publication bias and perform sensitivity analysis. GRADEpro GDT was used to grade the certainty of each outcome evidence.

RESULTS

Eighteen studies involving 937 participants were included. The meta-analysis showed significant improvements in depression-related scales (standardized mean difference (SMD) = -1.30, 95 % confidence interval (CI): -2.10 to -0.49, p = 0.002), anxiety-related scales (SMD = -1.11, 95 %CI: -2.14 to -0.08, p = 0.03), sleep disorder-related scales (SMD = -0.71, 95 %CI: -0.99 to -0.43, p < 0.00001), and cognition-related scales (SMD = 0.91, 95 %CI: 0.44-1.38, p = 0.0001). Quality of life also improved (SMD = -1.35, 95 % CI: -2.38 to -0.31, p = 0.01; SMD = 0.99, 95 % CI: 0.54-1.43, p < 0.0001). Subgroup analyses grounded in the duration of the intervention suggested that interventions lasting up to 12 weeks showed more significant anti-depression and anti-anxiety effects while those lasting beyond 12 weeks demonstrated greater improvements in sleep quality and cognitive function. Additionally, subgroup analyses based on the type of intervention revealed that both using TCEs alone and the combination of TCEs with conventional medications showed greater effects on anti-depression and cognitive function, while the latter yield more significant anti-anxiety effects. However, no statistical significance was found for fatigue-related scales. The clinical trials included in this review also lacked a thorough description of the randomization process, and only a small proportion reported adequate allocation concealment procedures, raising concerns about potential selection bias. Moreover, owing to the inherent characteristics of TCEs, blinding both participants and practitioners is challenging, which may result in performance bias. Additionally, the absence of blinding could allow assessors' subjective influences to affect the outcomes, leading to detection bias. The overall quality of the evidence, as assessed according to the GRADE criteria, was rated as very low or low for most of outcomes.

CONCLUSIONS

The findings indicated that the use of TCEs may have potential to alleviate the severity of NPSs including depression, anxiety, sleep disorders, and enhance cognition function and overall quality of life in PD patients. Nevertheless, given the limited number of studies and their methodologic issues such as the absence of blinding, along with the small sample sizes, significant heterogeneity across these primary studies, careful interpretation of the results is warranted. More high-quality research with larger sample sizes, including double-blind studies or those employing an active control group involving exercises such as walking, ought to be carried out to validate the above findings and strengthen the evidence base.

REGISTRATION

PROSPERO: CRD42024540164.

Pain Lateralization in Cluster Headache and Associated Clinical Factors

BACKGROUND AND PURPOSE

The pain lateralization in cluster headache (CH) may be related to the asymmetry in the functions of the brain hemispheres. The right-sided dominance of pain in CH has been found inconsistently across studies, and so we aimed to characterize this and identify the factors influencing pain lateralization during current and previous bouts.

METHODS

This study enrolled 227 patients from the Korean Cluster Headache Registry between October 2018 and December 2020. We evaluated the side of pain during current and previous bouts, demographic features, and clinical characteristics, including handedness. Multivariable logistic regression analyses were performed to identify factors associated with the side of pain.

RESULTS

The 227 patients with CH included 131 (57.7%) with right-sided pain and 86 (37.9%) with left-sided pain during the current bout (p<0.001). The 189 patients with previous bouts of CH included 86.8% who consistently reported the same side of pain throughout multiple bouts (side-locked pain), with a higher prevalence of pain on the right than the left side (55.0% vs. 31.7%, p<0.001). Multivariable analyses revealed that higher age at diagnosis (odds ratio [OR]=1.045, p=0.031) and shorter CH attacks (OR=0.992, p=0.017) were associated with left-side-locked pain. However, handedness was not associated with the lateralization of left-side-locked pain.

CONCLUSIONS

This study has confirmed the predominance of right-sided pain throughout multiple CH bouts. We found that higher age at diagnosis and shorter CH attacks were associated with left-side-locked pain, suggesting that certain clinical factors are associated with the pain laterality. However, the underlying mechanisms linking these factors to lateralized pain remain unclear and therefore require further investigation.

The canonical Wnt/β-catenin signaling pathway upregulates carbonic anhydrase 2 via transcription factor 7-like 2 to promote cardiomyopathy in type 2 diabetic mice

Excessive activation of the canonical Wnt/β-catenin pathway contributes to the development of diabetic cardiomyopathy (DCM). Transcription factor 7-like 2 (TCF7L2) is the main β-catenin partner of the TCF family in adult human hearts. Carbonic anhydrase 2 (CA2) is implicated in various hypertrophic cardiomyopathy. In this study, we aimed to investigate the role of the Wnt/β-catenin/TCF7L2 signaling and CA2 in the development of DCM. Streptozotocin (STZ)/high-fat diet (HFD)-induced diabetic mice and high glucose-stimulated neonatal rat cardiomyocytes (NRCMs) were used as in-vivo and in-vitro models of Type 2 diabetes (T2DM), respectively. Histopathological changes in the mouse myocardium were assessed with hematoxylin-eosin (HE) or Masson's trichrome staining. Cardiac function was evaluated with echocardiography. TCF7L2, β-catenin, and CA2 expression was determined with RT-qPCR, western blotting, and immunohistochemistry. Immunoprecipitation (IP) was used to evaluate the formation of the β-catenin/TCF7L2 bipartite. The regulatory relationship between the β-catenin/TCF7L2 bipartite and CA2 was investigated with chromatin immunoprecipitation (ChIP) and a luciferase reporter assay. Compared with the control mice, the T2DM mice exhibited increased myocardial β-catenin and TCF7L2 expression that was concentrated in the nucleus. Treatment of diabetic mice with the β-catenin/TCF7L2 bipartite inhibitor iCRT14 prevented myocardial remodeling and improved cardiac dysfunction. iCRT14 also prevented high glucose-induced hypertrophy in NRCMs, while the β-catenin stabilizer SKL2001 worsened hypertrophy. IP experiments confirmed the formation of the β-catenin/TCF7L2 bipartite in the control and T2DM mouse cardiomyocytes. Moreover, based on the results of RNA-sequencing analysis, CA2 was upregulated in T2DM cardiomyocytes in vitro and in vivo. TCF7L2 overexpression upregulated CA2, while iCRT14 treatment or TCF7L2 knockdown downregulated CA2. CA2 knockdown ameliorated NRCM hypertrophy induced by high glucose and SKL2001. The ChIP experiments revealed an increased interaction between β-catenin/TCF7L2 and the transcription initiation region of CA2 in the heart tissue of T2DM mice. The luciferase reporter assay confirmed that CA2 is directly regulated by the β-catenin/TCF7L2 bipartite. The results indicate that the canonical Wnt/β-catenin pathway upregulates CA2 via TCF7L2 to promote DCM. This research sheds new light on the pathogenesis of DCM and presents new potential therapeutic targets for this disease.

Emerging importance of HER3 in tumorigenesis and cancer therapy

HER3 is a member of the HER/ErbB family of receptor tyrosine kinases, together with EGFR (HER1), HER2 and HER4. Despite having only weak intrinsic kinase activity, HER3 can contribute to oncogenic signalling via ligand-induced heterodimerization with other HER family members. Evidence indicates that HER3 is altered or aberrantly expressed across a variety of tumour types and can be associated with poor clinical outcomes. Whereas anticancer agents targeting EGFR and HER2 have been approved for decades, no drug targeting HER3 had been approved until very recently. Initial targeting of HER3 with monoclonal antibodies as single agents or in combination with other therapeutics produced disappointing clinical results. Subsequently, efforts have been made to target HER3 with novel agents such as antibody-drug conjugates and bispecific antibodies, with promising efficacy observed in several trials encompassing various tumour types. In December 2024, the HER3 × HER2 bispecific antibody zenocutuzumab was granted FDA Accelerated Approval for the treatment of non-small-cell lung cancers or pancreatic cancers harbouring fusions involving NRG1, the gene encoding the high-affinity HER3 ligand neuregulin 1. In this Review, we provide an essential guide to HER3 signalling and oncogenesis, HER3 expression in cancer and its prognostic implications, oncogenic HER3 somatic mutations as well as rare NRG1 fusions that might depend on HER3 signalling, and the roles of HER3 in resistance to cancer therapies. We also highlight efforts to target HER3 with diverse therapeutic strategies and the potential interplay between HER3 and the antitumour immune response.

PCSK9 Promotes the Malignancy of Triple-negative Breast Cancer Cells by Reducing Cholesterol Levels at the Plasma Membrane to Activate EGFR and HER3

Triple-negative breast cancer (TNBC) is a highly heterogeneous and clinically aggressive disease with the highest mortality rate among all subtypes of breast cancer. To discover new driver genes for metastatic TNBC, this work compares the transcription profiles of MDA-MB-231-GFP cells and 231-GFP-derived lung metastatic cells (4-11). Results reveal that proprotein convertase subtilisin/kexin type 9 (PCSK9) is highly upregulated in 4-11 cells. Knockdown of PCSK9 greatly decreases the tumorigenic and metastatic potential of 4-11 cells, whereas overexpression of PCSK9 significantly enhances tumor maliganancy. Mechanistically, the binding of PCSK9 to the low-density lipoprotein receptor (LDLR) results in decreased LDLR at the plasma membrane, which further decreases cholesterol and lipid raft in the plasma membrane and activates human epidermal growth factor receptor 1 and 3 (EGFR and HER3). Subsequently, phosphorylated EGFR and HER3 activate the Src/ERK/c-Jun to increase the levels of cyclin D3 and vimentin and thereby enhance cell growth and metastasis. Metadata analyses also reveal that TNBC patients with high PCSK9 expression exhibited worse clinical outcomes. Taken together, these findings not only reveal a novel mechanism by which PCSK9 promotes the malignant potential of TNBC but also indicate that PCSK9 is a potential therapeutic target for treating TNBC patients.

Fatigue Behavior of the Auxetic Porous Bone Screw Under the Multiaxial Cyclic Loads in Tibiotalocalcaneal Arthrodesis

PURPOSE

The auxetic porous bone screw (AS) has favorable anti-pullout and osseointegration performance, demonstrating application potential in orthopedic surgeries. The uniaxial fatigue behavior of AS has been well understood. Considering that AS will withstand complex physiological loads in practical application, this study aims to investigate the fatigue behavior of AS under the multiaxial loads in tibiotalocalcaneal arthrodesis.

METHODS

AS and nonauxetic bone screw (NS) with the same porosity were designed based on re-entrant and hexagonal units, respectively. Finite element models of tibiotalocalcaneal arthrodesis implanted with AS and NS were established. Based on the curves of ground reaction forces borne by foot during normal gait cycle, the multiaxial loading spectrums were created and applied to the models. The multiaxial fatigue simulations were conducted to calculate the fatigue life and principal stress distributions of bone screws.

RESULTS

Under the multiaxial loads in tibiotalocalcaneal arthrodesis, fatigue fracture was prone to occur in the AS and NS implanted in medial calcaneus. The minimum fatigue life and maximum principal stress of AS and NS were all located near the screw caps connected with the fixation plate. The tensile stress concentration of AS was significantly higher. The estimated fatigue life of AS and NS was approximately 46400 and 1820000 cycles, respectively.

CONCLUSION

The fatigue life of AS was significantly lower than that of NS, which could not meet the fatigue resistance requirement during the recovery period of tibiotalocalcaneal arthrodesis. Local optimization should be conducted near the screw cap of AS to improve its multiaxial fatigue resistance.

Prevalence and risk factors of hospital acquired venous thromboembolism

ObjectivesTo investigate the prevalence, clinical characteristics and risk factors of hospital acquired venous thromboembolism (HA-VTE) in a Chinese Hospital.MethodsRetrospective analysis of patients diagnosed as HA-VTE in a single institution from January 2016 to December 2022 was performed. Patients with VTE prior to admission or within 48 h after admission were excluded. Demographic data of patients was retrieved from the electronic medical database, and parameters affecting the occurrence of HA-VTE were analyzed.Results4,022 patients from 321,997 episodes of medical admissions were diagnosed as VTE. Among these, 952 (23.7%) fulfilled the criteria of HA-VTE, corresponding to an incidence of 0.296%. 76% of patients presented with HA-deep vein thrombosis (DVT) alone, 13% presented with isolated HA-pulmonary embolism (PE), and 11% presented with concomitant HA- DVT and PE. Risk factor analyses showed statistically higher incidence in patients with elder age (67.5 ± 15.5 vs 48.3 ± 17.2 years, p < .001), male gender (0.346% vs 0.262%, p < .001), malignancy (0.513% vs 0.252%, p < .001), trauma (0.659% vs 0.28%, p < .001), emergency admission (0.664% vs 0.186%, p < .001), ICU stay (2.981% vs 0.226%, p < .001), and patients undergoing major surgery (0.702% vs 0.176%, p < .001). Patients with HA-VTE had longer hospital stay (22.5 ± 26.6 vs 7.21 ± 9.23 days, p < .001) and higher mortality rate (8.51% vs 1.01%, p < .001). The crude incidence rate of HA-VTE increased annually from 0.75 per 1,000 patients in 2016 to 5.89 per 1,000 patients in 2022. The subspecialties with the highest incidence rate of HA-VTE were cardiovascular surgery (1.40%), neurosurgery (1.10%), and respiratory medicine (0.72%).ConclusionThis is one of the few large scale studies to show that HA-VTE, accounting for nearly one quarter of all VTE events, occurs in 0.296% of adult hospitalizations. Patients with elder age, malignancy, ICU stay, and undergoing major surgery require more intensive HA-VTE surveillance and prevention.

Irreversible electroporation combined with PD-L1/IL-6 dual blockade promotes anti-tumor immunity via cDC2/CD4+T cell axis in MHC-I deficient pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) is a "cold" solid tumor with frequent Major Histocompatibility Complex I (MHC-I) deficiency, thereby making it resistant to type-1-conventional dendritic cell (cDC1)-CD8+T cell mediated anti-tumor immunity. Current studies have demonstrated the emerging compensatory role of MHC-II-mediated antigen presentation and CD4+T cell activation in anti-tumor immunity against MHC-I-deficient tumors. However, the underlying mechanism of the compensatory immune response by CD4+T cells in cancer ablation therapy remains to be elucidate. In clinical samples and murine models, we observed that irreversible electroporation (IRE) ablation therapy promoted immune infiltration and the conversion of CD4+T cells into anti-tumor IFN-γ+Th1 cells and Th17 cells in MHC-I low-expressed PDAC using scRNA-seq and flow-cytometry analyses. Furthermore, we found that PD-L1 blockade predominantly enhanced the activation of CD11b+CD103-type-2 conventional dendritic cells (cDC2s) and their antigen presentation to CD4+T cells after ablation, stimulating the anti-tumor immune response through the tumor antigen-specific IFN-γ+Th1-NK cell axis. Elevated plasma levels of IL-6 in pancreatic cancer patients receiving ablation therapy are significant indicators for impaired prognosis. IL-6 and PD-L1 dual blockade could significantly augment the ratio of IFN-γ+Th1 in CD4+T cells to boost the anti-tumor immunity of NK cells, leading to prolonged survival of mouse bearing pancreatic cancer. Collectively, we have elucidated that PD-L1 blockade activates the cDC2-CD4+T cell axis after IRE therapy, thereby playing a pivotal compensatory anti-tumor role in MHC-I low-expressed pancreatic cancer. Moreover, a combination strategy involving dual-target blockade of PD-L1/IL-6 along with ablation therapy could emerge as a novel therapeutic approach for MHC-I deficient tumors.

Oleic acid promotes lipid accumulation in bovine adipocytes: the role of peroxisome proliferator-activated receptor alpha (PPARα) signaling

Excessive lipid mobilization due to negative energy balance in periparturient dairy cows increases their risk for diseases and decreases their productivity, highlighting the importance of enhancing energy availability during the immediate postpartum to limit negative energy balance. Oleic acid (OA) supplementation increases the energy density of the diet and holds promise in addressing metabolic challenges. In periparturient cows, OA limits lipolysis and improves adipose tissue (AT) insulin sensitivity. However, the mechanisms behind these effects are still unknown. Our objective was to characterize the effects of OA, alone and in combination with palmitic acid (PA), on lipogenic function and identify a mechanism of action in bovine adipocytes. We hypothesized that OA enhances lipid accumulation in bovine adipocytes via peroxisome proliferator-activated receptor alpha (PPARα)-dependent activation of lipogenic pathways. Pre-adipocytes were isolated from AT of Holstein dairy cows and induced to differentiate into adipocytes. Mature adipocytes were cultured with standard differentiation media (CON) supplemented with PA or OA (100, 200, and 300 µM), and mixtures of PA-OA (60-40, 50-50, and 40-60 ratios at 300 µM) for 4 or 7 d. To evaluate the effect of PPARα signaling, adipocytes were treated with or without a PPARα-specific antagonist (GW6471; 10 µM) for 7 d after induction. Compared with CON, fatty acid treatments had no effect on preadipocyte differentiation (P = 0.65). The treatments 300PA, 200OA, 300OA, 60-40, 50-50, and 40-60 increased lipid accumulation compared with CON (P < 0.0001). At d 4, 300PA and 300OA increased PPARα protein expression compared with CON (P = 0.04). PPARα inhibition decreased triglyceride levels in OA and 60-40 (P < 0.05) but not in PA (P = 0.26). Our results show a direct effect of OA supplementation on bovine adipocyte metabolism, resulting in lipid accumulation, mainly through PPARα signaling, which in turn activates lipogenic networks. Hence, providing mechanistic evidence for the use of OA, along with PA, in dairy cow diets during the periparturient period to enhance lipid accumulation and limit lipolysis. Improving energy balance will ultimately minimize health disorders and improve the production of early postpartum cows.

The relationship between oral burns and oral squamous cell carcinoma: a systematic review

Background

Micro-RNAs (miRNAs) have been found to play crucial roles in various biological processes and have been implicated in the development and progression of many diseases, including cancer. In recent years, several studies have suggested that miRNA may have a potential role in the relationship between oral burns and various. This systematic review aims to summarize the current evidence on the roles of miRNA in the relationship between oral burns and oral squamous cell carcinoma (OSCC).

Materials and methods

The present systematic review was performed using PubMed, Google Scholar, Science Direct, ProQuest, Ovid, and Embase from April 2024 to May 2024 following the "Preferred Reporting Items for Systematic Reviews" guidelines. The keywords, including "oral burn OR burning tongue OR burning mouth" AND "Oral squamous cell carcinoma" AND "miRNA."

Results

The study reviewed 9 publications, examining miRNA interactions common to oral burns and cancers. Among them, 5 studies focused on various burn types, while 4 addressed oral malignancies. Synthesizing these findings identified 5 shared miRNAs between burns and oral cancers. Regarding burn types, thermal burns were most mentioned, followed by carbon dioxide laser and chemical burns. For cancer, oral squamous cell carcinoma was predominant, with one study on tongue squamous cell carcinoma. Noteworthy miRNAs include hsa-miR-205, hsa-miR-18a, hsa-mir-23b, hsa-mir-203, and hsa-mir-150, each exhibiting distinct roles and expression patterns in burns and carcinogenesis.

Conclusion

Overall, the findings of this systematic review highlight the potential importance of miRNA in the relationship between oral burns and OSCC.

Alzheimer's disease as an auto-innate immune pathology with potential cell trans-differentiation and enhanced trained immunity in 3xTg-AD mouse model

BackgroundAlzheimer's disease (AD) is a neurodegenerative disorder characterized by memory impairment. Neuroinflammatory processes, mediated by glial and immune cells, contribute to neuronal damage. Emerging evidence implicates innate immune mechanisms, including trained immunity and cell trans-differentiation, in AD pathogenesis, though their roles remain unclear.ObjectiveTo investigate transcriptomic changes in the 3xTg-AD mouse model, focusing on trained immunity and cell trans-differentiation in disease mechanisms.MethodsRNA-sequencing was performed on brain tissue (cortex plus hippocampus) from 11-month-old female 3xTg-AD and wild-type mice (n = 3/group). Differentially expressed genes (fold change > 1.5, p < 0.05) were identified and followed by bioinformatics and knowledge-based transcriptomic profiling. Public AD datasets were also analyzed.Results3xTg-AD mice exhibited 316 upregulated and 412 downregulated genes. Downregulated genes included those for blood-brain barrier protein, while upregulated genes related to cerebrospinal fluid. Increased expression of proinflammatory markers, as well as genes related to cell differentiation, proliferation, activation, and adhesion. Upregulation of genes associated with cell migration and trans-differentiation suggests a potential role for inflammation and cellular plasticity. Additionally, genes involved in inflammasome pathways, immunometabolism, and trained immunity were upregulated. Mechanistically, these genes were modulated by knockdown of trained immunity promoter SET-7, overexpression of trained immunity inhibitor IL-37, and knockout of inflammasome genes IL-1 receptor, caspase-1, and pattern recognition receptor CD36.ConclusionsThe finding underscore the potential role of trained immunity and cell trans-differentiation in AD, revealing a mechanistic framework in which danger-associated molecular patterns drive innate immune responses, inflammasome activation, and cell plasticity contribute to AD, offering therapeutic targets for neuroinflammation and cellular reprograming.

Gastrointestinal features of pediatric iga vasculitis and their association with renal complications: an observational study

Immunoglobulin A (IgA) vasculitis is the most common systemic vasculitis in childhood, primarily affecting the skin, gastrointestinal system (GIS), joints, and kidneys. This study aimed to evaluate the clinical and laboratory characteristics of mild and severe GIS involvement in pediatric patients with IgA vasculitis and to investigate its association with renal involvement. A retrospective review was conducted on 794 pediatric patients diagnosed with IgA vasculitis between 1997 and 2024. Demographic data, clinical findings, and laboratory parameters were collected from patient records. GIS involvement was classified as mild (abdominal pain, vomiting, or occult blood in stool) or severe (melena, hematochezia, or intussusception). Renal involvement was defined based on hematuria, proteinuria, hypertension, or renal insufficiency. Among 794 patients, 430 (54.2%) were male, with a mean age at diagnosis of 7.8 ± 3.3 years. GIS involvement was observed in 422 (53.1%) patients, of whom 333 (78.9%) had mild GIS involvement and 89 (21.1%) had severe GIS involvement. Renal involvement was detected in 171 (21.5%) patients, and was more frequent in those with GIS involvement (26.3% vs. 16.1%, p = 0.001). GIS (55.6% (n = 306) vs. 47.1% (n = 115)) and renal (24.5% (n = 134) vs. 15.2% (n = 37)) involvement were more common in patients aged > 5 years than in patients ≤ 5 years (p = 0.027, p = 0.004, respectively). GIS involvement was significantly associated with leukocytosis (p < 0.001) and elevated C-reactive protein (CRP) (p = 0.018), but these parameters did not correlate with renal involvement. Patients with positive fecal occult blood tests had a significantly higher risk of renal involvement (p < 0.001). However, there was no significant difference in renal involvement between patients with mild and severe GIS involvement (p = 0.082).

CONCLUSION

GIS involvement, older age (> 5 years), and the presence of occult blood in stool were associated with a higher likelihood of renal involvement in pediatric IgA vasculitis. However, the severity of GIS involvement did not correlate with renal involvement, suggesting that renal pathology may be influenced by independent mechanisms rather than the severity of GIS symptoms.

WHAT IS KNOWN

• Older age, persistent palpable purpura, abdominal pain, GIS involvement, recurrent disease episodes are risk factors for renal involvement in IgA vasculitis.

WHAT IS NEW

• GIS involvement, fecal occult blood positivity, and age over five years were significantly associated with renal involvement in pediatric IgA vasculitis. However, the severity of GIS involvement did not predict the presence or severity of renal involvement.

Association of diabetic retinopathy with kidney disease progression according to baseline kidney function and albuminuria status in individuals with type 2 diabetes

BACKGROUND

Whether diabetic retinopathy (DR) can predict kidney disease progression in individuals with diabetes remains unclear. Furthermore, there are only a limited number of studies investigating the association between DR and kidney outcomes classified according to baseline kidney function and albuminuria status. Here, we examined the association of DR with kidney disease progression in individuals with type 2 diabetes.

METHODS

This retrospective cohort study included 6759 Japanese adults with type 2 diabetes (36.3% women). Kidney insufficiency and albuminuria were defined as eGFR < 60 mL/min/1.73 m2 and urinary albumin-to-creatinine ratio ≥ 30 mg/g, respectively. The exposure and outcome were baseline DR and the composite of eGFR halving or the initiation of kidney replacement therapy, respectively. The hazard ratios for the outcome were estimated using the multivariable Cox proportional hazards model.

RESULTS

During the median follow-up period of 8.4 years, 922 reached the outcome. Among the individuals without kidney insufficiency, those with DR at baseline had a significantly higher incidence of the outcome than those without DR regardless of baseline albuminuria status (p < 0.05), whereas the presence of DR was not the risk factor among individuals with kidney insufficiency. There was an interaction between baseline DR and kidney insufficiency with respect to the outcome incidence (p = 0.043). When baseline eGFRs were classified into eGFR categories based on the Kidney Disease: Improving Global Outcomes guideline, the above findings were more clearly shown.

CONCLUSIONS

DR may be able to predict kidney disease progression only among individuals with type 2 diabetes exhibiting preserved kidney function.

MicroRNA-122 regulates inflammatory and autophagic proteins by downregulating pyruvate kinase M2 in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is one of the serious global health concerns, leading to non-alcoholic steatohepatitis (NASH), and to hepatocellular carcinoma (HCC). Despite its prevalence, the molecular mechanisms regulating NAFLD progression remain elusive. The present study aims to determine role of microRNA-122-mediated regulation of pyruvate kinase M2 (PKM2) on regulating inflammatory and autophagic proteins during the pathogenesis of NAFLD. Huh7 cells were incubated with free fatty acids (FFAs) or transfected with single guide RNA to PKM2 containing CRISPR-Cas9 system or miR-122 for up to 72 h. C57BL/6 mice were fed with sham-operated control, choline sufficient L-amino acid defined (CSAA) or choline-deficient L-amino acid defined (CDAA) diet for 6, 18, 32 and 54 weeks. The RNA or protein was isolated from the Huh7 cells and the liver tissue of the mice. RT-PCR was performed for miR-122 expression and Western blots were performed for PKM2, iNOS, COX2, Beclin-1, Atg7 and LC3-II. FFAs induced the expression of PKM2, iNOS and COX2, while decreased the expression of miR-122, Beclin-1, Atg7 and LC3-II. Overexpression of miR-122 resulted in decreased PKM2, iNOS and COX2 and increased Beclin-1, Atg7 and LC3-II. Silencing of PKM2 led to decreased iNOS and COX2 and increased Beclin-1, Atg7 and LC3-II. In CDAA fed-mice, there was a significant increase in PKM2, iNOS and COX2 and decreased miR-122, Beclin-1, Atg7 and LC3-II. The data showed that FFAs downregulated miR-122 expression, which resulted in the upregulation of PKM2, which in turn upregulated inflammatory proteins and downregulated autophagic proteins during the pathogenesis of NAFLD.

The effect of overnight culture after thawing of D3 cleavage-stage embryos on clinical pregnancy outcomes: focus on embryo development to day 4

Objective

This study aims to investigate the impact of day-3 (D3) cleavage-stage embryo thawing with immediate transfer versus thawing and overnight culture before transfer on clinical outcomes. It also examines the relationship between cleavage-stage embryo developmental speed after overnight culture and clinical pregnancy outcomes, as well as factors influencing clinical pregnancy in frozen embryo transfer (FET).

Methods

A retrospective analysis was conducted on 1,040 patients who underwent D3 cleavage-stage frozen embryo transfer at Yulin City Maternal and Child Health Hospital between July 2022 and December 2023. Patients were divided into two groups based on embryo culture time after thawing: control (same-day transfer, 2-3 hours) and experimental (overnight culture, 18-20 hours). Clinical pregnancy rates, embryo implantation rates, early miscarriage rates, and multiple pregnancy rates were compared between groups. The experimental group was further subdivided based on the number of cleavage blastomeres increased after culture: A1 (≥4 blastomeres), A2 (1-3 blastomeres), and A3 (no increase). A binary logistic regression analysis identified independent factors affecting clinical pregnancy outcomes in FET.

Results

No significant differences were found between the control and experimental groups in clinical pregnancy rate (37.2% vs. 40.2%), embryo implantation rate (24.9% vs. 26.4%), early miscarriage rate (13.1% vs. 18.8%), or multiple pregnancy rate (9.2% vs. 10.2%) (P > 0.05). In the experimental group, clinical pregnancy rates for A1, A2, and A3 subgroups were 44.2%, 29.8%, and 25.5%, respectively. Early miscarriage rates were 18.6%, 10.7%, and 38.5%, showing statistically significant differences (P < 0.05). Female age, endometrial thickness, embryo morphology, and the number of cleavage blastomeres were identified as independent factors influencing clinical pregnancy rate.

Conclusion

This study indicates that D3 embryos with an increase in the number of blastomeres to more than four or entering the compaction stage after overnight culture have better pregnancy outcomes. Female age and endometrial thickness are important factors influencing clinical pregnancy rates. Optimizing culture conditions and ensuring optimal endometrial thickness may help improve the success rate of frozen-thawed embryo transfer.

Comparative Analysis of the Benefits of Glutathione-Rich Yeast Hydrolysate and Astaxanthin on Growth Performance, Antioxidant Capacity and Lipid Metabolism in Pacific White Shrimp (Litopenaeus vannamei)

Antioxidants, both glutathione (GSH) and astaxanthin (AX), possess beneficial applications in animal growth and antioxidant properties. In this study, three experimental diets with isoproteic and isolipidic were formulated, the control diet (CON), the control diet added with 0.03% Carophyll Pink (contains 10% AX), the control diet added with 0.67% glutathione-rich yeast hydrolysate (GYH, contains 5% GSH). The effects of AX and GYH on the growth performance, antioxidant capacity and lipid metabolism of Litopenaeus vannamei (0.36 ± 0.01 g) were compared. After an 8-week feeding experiment, shrimp growth and intestinal morphology showed significantly better performance in the GYH group. Both dietary AX and GYH regulated the expression levels of genes related to lipid metabolism, increased antioxidant enzyme activities and total antioxidant capacity of shrimp and reduced haemolymph malondialdehyde and hepatopancreas reactive oxygen species production. Compared with the CON and GYH groups, dietary AX significantly increased the redness (a*) and yellowness (b*) values of cooked shrimp. Based on the evaluation of the above results, AX and GYH were comparable in terms of antioxidant performance, and AX was superior in improving the red body colour of shrimp, but GYH has more significant advantages in promoting shrimp growth and intestinal development. Therefore, supplementation with GYH or AX in diet presents specific benefits to the growth, body colour and antioxidant of L. vannamei.

Optimal Timing of Vaccination: A Narrative Review of Integrating Strategies for COVID-19, Influenza, and Respiratory Syncytial Virus

Lower respiratory tract infections caused by SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) cause a significant disease burden globally, despite the availability of effective vaccines. Certain populations, such as older adults (≥ 60 years) and individuals of all ages with particular comorbidities, are at increased risk for severe outcomes, including hospitalization and death. National administration schedules for available vaccines against respiratory viruses are not unified, and not all current guidelines are clear and directive, concerning the optimal timing of vaccination. Herein, we formulate an evidence-based position regarding the optimal timing of COVID-19, influenza, and RSV vaccination for older adults and individuals with chronic comorbidities, based on a synthesis of the literature and current guidelines. Vaccination impact and timing were found to be influenced by vaccinee risk factors, including age and comorbidities, and waning vaccine effectiveness and seasonal pathogen burden. Because COVID-19, influenza, and RSV display unique seasonal patterns within and between regions, local epidemiological surveillance of each virus is crucial for determining optimal vaccination timing and guidelines. To maximize the benefits of these respiratory virus vaccines, the timing of peak vaccine effectiveness and period of greatest risk for severe outcomes should be aligned. Thus, COVID-19, influenza, and other recommended vaccines given ahead of the start of the respiratory virus season (or other regionally appropriate time) and co-administered at a single, routine visit represent the optimal approach to protecting at-risk populations. More data will be required to establish the clinical benefit of additional RSV vaccine doses and whether these may be integrated within a seasonal schedule. Coordinated policy decisions that align with strain selection for new and annually reformulated vaccines would enable the timely raising of public health awareness, ultimately leading to enhanced vaccine uptake. Implementation strategies will require engagement of healthcare providers and strong, evidence-based public health recommendations for integrated vaccine schedules.

Inhibitory and Curative Effects and Mode of Action of Hydroxychloroquine on Botrytis cinerea of Tomato

Gray mold is an important disease of crops and is widespread, harmful, difficult to control, and prone to developing fungicide resistance. Screening new fungicides is an important step in controlling this disease. Hydroxychloroquine is an anti-inflammatory and antimalarial agent that has shown marked inhibitory activity against many fungi in medicine. This study evaluated the inhibitory activity of hydroxychloroquine against several phytopathogenic fungi, finding a half-maximal effective concentration of 113.82 μg/ml against the hyphal growth of Botrytis cinerea, with significant in vivo curative effects of 92.37 or 78.37% for gray mold on detached tomato leaves or fruits at 10.0 or 200.0 mg/ml, respectively. Ultrastructural studies indicated that hydroxychloroquine induced collapse of hyphae, with a wrinkled surface, unclear organelle boundaries, and organelle disintegration. Transcriptomic assays revealed that hydroxychloroquine could affect the expression of metabolism-related genes. Molecular docking and molecular dynamics analyses indicated that hydroxychloroquine bound to glucose-methanol-choline oxidoreductase, with a low free energy value of -11.4 kcal/mol. Cell membrane permeability assays and hyphal staining confirmed that hydroxychloroquine damaged the cell membrane, causing leakage of hyphal contents and disturbing cell function. Biochemical assays indicated that hydroxychloroquine reduced the concentration of soluble proteins and reducing sugars in the hyphae. Overall, hydroxychloroquine disturbed amino acid metabolism, therefore inhibiting the production of biomacromolecules, damaging the cell membrane, and restraining the growth of hyphae, hence inhibiting gray mold on tomato. This study explored the use of medicine in the development of agricultural fungicides and their application in managing crop diseases, providing valuable background information.

Risk factors associated with Helicobacter pylori infection in the urban population of China: A nationwide, multi-center, cross-sectional study

OBJECTIVES

To assess the risk factors associated with Helicobacter pylori infection in the urban Chinese population.

METHODS

The study was conducted from March to November 2023, including 12,902 urban participants aged 18-60 years across 52 cities distributed over 26 provinces in China. Risk factors included socioeconomic status, lifestyles, and public understanding. Univariate and multivariate logistic regression analysis was used to calculate corrected odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

According to multivariate logistic regression, risk factors associated with significantly higher H. pylori infection rates included residency in developing (OR 1.27, 95% CI 1.13-1.43) and undeveloped cities (OR 1.15, 95% CI 1.02-1.29), obesity (OR 1.37, 95% CI 1.05-1.78), alcohol consumption (OR 1.16, 95% CI 1.05-1.29), tea consumption (OR 1.11, 95% CI 1.01-1.21), and soft drink consumption (OR 1.24, 95% CI 1.09-1.40). Conversely, individuals with moderate awareness (OR 0.79, 95% CI 0.71-0.88) and high awareness (OR 0.57, 95% CI 0.48-0.69) of H. pylori had lower infection rates.

CONCLUSION

Our findings highlight the importance of promoting a healthy lifestyle and improving the understanding of H. pylori in reducing the infection rate of the bacterial pathogen in the urban Chinese population.

Radiomics and Artificial Intelligence Landscape for [18F]FDG PET/CT in Multiple Myeloma

[18F]FDG PET/CT is a powerful imaging modality of high performance in multiple myeloma (MM) and is considered the appropriate method for assessing treatment response in this disease. On the other hand, due to the heterogeneous and sometimes complex patterns of bone marrow infiltration in MM, the interpretation of PET/CT can be particularly challenging, hampering interobserver reproducibility and limiting the diagnostic and prognostic ability of the modality. Although many approaches have been developed to address the issue of standardization, none can yet be considered a standard method for interpretation or objective quantification of PET/CT. Therefore, advanced diagnostic quantification approaches are needed to support and potentially guide the management of MM. In recent years, radiomics has emerged as an innovative method for high-throughput mining of image-derived features for clinical decision making, which may be particularly helpful in oncology. In addition, machine learning and deep learning, both subfields of artificial intelligence (AI) closely related to the radiomics process, have been increasingly applied to automated image analysis, offering new possibilities for a standardized evaluation of imaging modalities such as CT, PET/CT and MRI in oncology. In line with this, the initial but steadily growing literature on the application of radiomics and AI-based methods in the field of [18F]FDG PET/CT in MM has already yielded encouraging results, offering a potentially reliable tool towards optimization and standardization of interpretation in this disease. The main results of these studies are presented in this review.

Molecular mechanisms of andrographolide-induced kidney injury and senescence via SIRT3 inhibition

Andrographolide, a diterpene compound derived from the medicinal plant Andrographis paniculata, possesses anti-inflammatory, antioxidant, antitumor, and antiviral properties. Injectable formulations containing andrographolide, such as Potassium Sodium Dehydroandrographolide Succinate for Injection (PSDS), are widely used in clinical practice to treat various diseases, including upper respiratory tract infections. However, clinical reports have highlighted that andrographolide-based herbal injections may induce acute kidney injury and other renal adverse effects, thereby restricting its clinical application. Despite these concerns, the molecular mechanisms underlying andrographolide-induced nephrotoxicity remain poorly understood. In this study, we demonstrated that andrographolide induces inflammation and fibrosis in renal tubular epithelial cells and mouse kidneys. Notably, we identified for the first time that andrographolide promotes cellular senescence in renal tubular epithelial cells and mouse kidneys while downregulating the expression and enzymatic activity of SIRT3. Mechanistic investigations revealed that andrographolide mediates kidney injury and senescence through inhibition of the SIRT3/p53 signaling pathway. Furthermore, andrographolide was found to disrupt the interaction between SIRT3 and p53, resulting in increased acetylation of p53 and upregulation of its downstream target genes involved in inflammation, fibrosis, and senescence. These findings elucidate the molecular mechanisms of andrographolide-induced nephrotoxicity and provide a scientific basis for developing strategies to reduce its toxic effects.

Aperiodic and periodic components of resting-state EEG in primary insomnia

BACKGROUND

Insomnia is one of the most prevalent health concerns within the general population, with a multitude of existing electroencephalographic (EEG) spectral studies supporting heightened levels of high-frequency EEG activity as an index of cortical arousal. Nevertheless, traditional spectral analysis has been limited by its inability to distinguish between aperiodic and periodic elements. In contrast, a novel method, Spectral Parameterization (SpecParam), can separate these components and reveal the neural mechanisms of cortical arousal.

METHODS

The aperiodic and periodic activities of 42 insomnia disorder (ID) patients and 45 age- and sex-matched healthy controls (HC) were evaluated during eyes-closed resting state. The associations between behavioral scales and aperiodic/periodic parameters were further examined to elucidate the underlying psychophysiological significance.

RESULTS

We found that the aperiodic exponent was diminished in the ID group compared to the HC group. Additionally, the ID group exhibited an elevated central frequency and a more constrained bandwidth for periodic activity within the alpha band. Within-group correlation analyses revealed that a reduced exponent was associated with worse sleep quality and more frequent failures in inhibitory control within the ID group.

CONCLUSIONS

A smaller exponent within the ID group may reflect impaired inhibitory neuronal activity, potentially leading to cortical hyperarousal. The association of a smaller exponent with deteriorated sleep quality and impaired inhibitory control supports this hypothesis. Furthermore, the increased center frequency of the alpha band across extensive brain regions, along with a narrower alpha bandwidth in the left frontal and right parieto-occipital regions, may represent abnormal manifestations associated with excessive arousal. In summary, these results support the role of aperiodic activity as an index of impaired excitation/inhibition balance in neural activity within in ID group.

Development and validation of a relatively accurate gastric cancer high-risk group screening scoring system in urban residents

PURPOSE

Our study aimed to develop a relatively accurate gastric cancer (GC) screening score system for urban residents and to validate the screening efficacy.

METHODS

The present study included a derivation cohort (n = 3406) and a validation cohort (n = 868) of urban residents. Applying the full-stack engineering intelligent system platform of Hualian Health Big Data of Shandong University, the clinical physical examination data of subjects were collected. Univariate and multivariate analyses were used to identify risk factors for GC, and subsequently, an optimal prediction rule was established to create three distinct scoring systems.

RESULTS

In the GC-risk scoring system I, age, plateletocrit (PCT), carcinoembryonic antigen (CEA), glucose, albumin, creatinine were independent risk factors of GC, with scores ranging from 0 to 28 and optimal cut-off was 15.5. The second scoring system consisted of age, PCT, RDW-CV, CEA, glucose, albumin, and creatinine, with scores ranging from 0 to 31. The optimal cut-off point was determined to be 15.5. The scoring system III comprise of age, sex, PCT, RDW CV, CEA, glucose, with scores ranging from 0 to 21 and optimal cut-off was 10.5. All three scoring systems demonstrated excellent discrimination for GC, achieving an AUC of 0.884, 0.89, and 0.876, respectively. In external validation, the AUC values were 0.654, 0.658, and 0.714. Notably, the GC-risk scoring system III exhibited the highest screening efficiency.

CONCLUSIONS

Urban residents benefited from the effective and verified GC-risk scoring systems, which demonstrated excellent performance in identifying individuals with an elevated risk of GC.

Catechin promotes endoplasmic reticulum stress-mediated gastric cancer cell apoptosis via NOX4-induced reactive oxygen species

Catechin, a polyphenolic compound in various foods and beverages, shows strong anti-cancer effects against gastric cancer (GC) cells. This study explored the effect of catechin on GC cell apoptosis and endoplasmic reticulum (ER) stress. GC cells were treated with different catechin concentrations to assess effects on cell viability, LDH release, invasion, migration, apoptosis, intracellular calcium (Ca2⁺), ER stress markers, and reactive oxygen species (ROS). siRNA knockdown targeted GRP78, PERK, CHOP, and NOX4 to examine their roles in catechin-induced ER stress and apoptosis. Catechin treatment significantly reduced GC cell viability, increased LDH release, and induced apoptosis dose-dependently. Catechins elevated intracellular Ca2⁺ and ER stress markers. Co-treatment with thapsigargin (TG) intensified these effects, implicating ER stress in apoptosis. Knocking down GRP78, PERK, and CHOP mitigated catechin-induced apoptosis and restored viability. Additionally, catechins raised ROS levels, while co-treatment with Diphenyleneiodonium (DPI) or N-acetylcysteine (NAC) lowered ROS, cell damage, and ER stress markers. NOX4 knockdown countered catechin-induced viability loss and upregulated CHOP and cleaved caspase-3. Catechin induces apoptosis in GC cells through ER stress and ROS generation. Key mediators include GRP78, PERK, CHOP, and NOX4, suggesting potential therapeutic targets for enhancing catechin efficacy in GC treatment.

Identifying potential action points for reducing kinesiophobia among atrial fibrillation patients: a network and DAG analysis

PURPOSE

Kinesiophobia is prevalent among patients with atrial fibrillation (AF), leading to a notable decrease in exercise tolerance and quality of life (QoL). AF-related kinesiophobia encompasses a complex cascade reaction, influenced by psycho-physiological and behavioral factors. To investigate the complex interconnections associated with kinesiophobia among AF patients and identify potential intervention points for its management.

METHODS

From June 2021 to November 2022, we collected data through paper surveys, using convenience sampling to invite patients with AF. 541 AF patients were included in this study. Data were collected using Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Atrial Fibrillation Effect on Quality-of-Life (AFEQT), the Brief Illness Perception Questionnaire (BIPQ), and Medical Coping Modes Questionnaire (MCMQ), respectively. Network analysis and directed acyclic graphs (DAG) were used to visualize the intricate relationships of the factors.

RESULTS

The network structure identifies "Avoidance of Exercise" as a central node, which, alongside "Illness Perception" and "Resignation," acting as bridges that link and activate other factors of AF-related kinesiophobia. The DAG suggests that AF symptoms, located upstream, may act as a trigger, initiating a cascade effect impacting illness perception and coping styles.

CONCLUSIONS

"AF symptoms," along with psychological factors such as "illness perception," and "coping styles," may serve as potential action points to reduce AF-related kinesiophobia and ultimately improve the overall QoL for AF patients.

The diverse functions of syntaxin 13 in endosome-mediated membrane fusion

SNARE is a crucial membrane fusion factor. It forms SNARE complex that play significant roles in regulating various biological functions. The SNARE protein family, including syntaxin13 (STX13), is highly conserved across various species, from yeast to humans. This review summarizes the molecular mechanisms by which STX13-associated SNARE complexes contribute to diverse endosome-mediated membrane fusions. Furthermore, multiple cofactors are essential for regulating the SNARE complexes-mediated membrane fusion. These include but are not limited to Rab GTPases and their effectors. The interaction of these factors with SNARE proteins constitutes a critical component driving vesicle fusion processes.

Serum soluble Tim‑3 is elevated in patients with cervical cancer and is higher in advanced clinical stages

T-cell immunoglobulin and mucin domain-containing protein-3 (Tim-3) is an immune checkpoint molecule that is expressed generally on the cell membrane of immune and cancer cells and is implicated as a negative regulator of anti-tumour immune responses; this occurs through the interaction of Tim-3 with galectin-9. Although the function of membrane Tim-3 is well known, the role of soluble Tim-3 (sTim-3) has been poorly explored. The aim of the present study was to compare the serum levels of sTim-3 in the cervical cancer group of patients vs. the control group, to determine the association between the serum levels of sTim-3 with the clinicopathological characteristics of patients with cervical cancer and with serum galectin-9 levels. The concentrations of serum sTim-3 and galectin-9 were determined using ELISA. A receiver operating characteristic (ROC) curve was performed to determine the diagnostic value of sTim-3. The Mann-Whitney and Kruskall-Wallis tests were used to compare the serum sTim-3 concentrations between the control and cervical cancer groups and among the clinical subgroups. The association between the concentrations of sTim-3 and galectin-9 was determined using Spearman's rank correlation coefficient. sTim-3 expression was higher in patients with cervical cancer compared with control patients. The ROC curve revealed that sTim-3 has diagnostic potential, with a specificity of 95% and a sensitivity of 85.19%. sTim-3 was higher in patients with International Federation of Gynaecology and Obstetrics (FIGO) stage IV compared with those with FIGO stages I, II and III. A moderate positive correlation (ρ=0.41) was identified between sTim-3 and galectin-9. This was the first report of changes in the serum concentrations of sTim-3 in patients with cervical cancer and their diagnostic value. The association between sTim-3 with cervical cancer progression, and the positive correlation between the serum concentrations of sTim-3 and galectin-9 suggested that both proteins might be involved in the immune dysregulation in cervical cancer, but this requires further exploration.

Validation of an osteoporosis self-assessment tool for Vietnamese postmenopausal women and men over 50 years

INTRODUCTION

The aim of this study was to validate the effectiveness of the osteoporosis self-assessment tool for Asians (OSTA) in the screening and diagnosis of osteoporosis in men aged over 50 years and postmenopausal women in the northern Vietnam population.

MATERIALS AND METHODS

This study included 8077 participants (7044 postmenopausal women and 1033 men aged over 50) who attended health examinations at the National Institute of Nutrition, Vietnam, from 2010-2019. Osteoporosis is defined by a T-score ≤ -2.5 at the femoral neck, total hip, or L1-L4. OSTA scores were assessed for identifying osteoporosis via receiver operating characteristic (ROC) curves. The optimal cut-off points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined.

RESULTS

The study showed that the prevalence of osteoporosis was 13.4% in men and 25.5% in women. In women, a higher BMI and OSTA scores decreased the OR of osteoporosis (all p-values < 0.001). In men, a higher BMI decreased the OR of osteoporosis (p-value < 0.001). The results showed that the OSTA value was -1 which had a sensitivity of over 70% in both men and women. The OSTA value was -4 which had a sensitivity of over 90% and specificity of over 80% in both men and women. The optimal OSTA value was -3 which had a sensitivity of over 90% and a specificity of over 80% in both men and women.

CONCLUSIONS

The OSTA might be a simple tool for the screening and diagnosis of osteoporosis in Vietnamese postmenopausal women and men aged over 50 years.

IL-33 protects from recurrent C. difficile infection by restoration of humoral immunity

Clostridioides difficile infection (CDI) recurs in 1 of 5 patients. Monoclonal antibodies targeting the virulence factor TcdB reduce disease recurrence, suggesting that an inadequate anti-TcdB response to CDI leads to recurrence. In patients with CDI, we discovered that IL-33 measured at diagnosis predicts future recurrence, leading us to test the role of IL-33 signaling in the induction of humoral immunity during CDI. Using a mouse recurrence model, IL-33 was demonstrated to be integral for anti-TcdB antibody production. IL-33 acted via ST2+ ILC2 cells, facilitating germinal center T follicular helper (GC-Tfh) cell generation of antibodies. IL-33 protection from reinfection was antibody-dependent, as μMT KO mice and mice treated with anti-CD20 mAb were not protected. These findings demonstrate the critical role of IL-33 in generating humoral immunity to prevent recurrent CDI.