1
|
Wang G, Wang Y, Ma F. Exploiting bacterial-origin immunostimulants for improved vaccination and immunotherapy: current insights and future directions. Cell Biosci 2024; 14:24. [PMID: 38368397 PMCID: PMC10874560 DOI: 10.1186/s13578-024-01207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/06/2024] [Indexed: 02/19/2024] Open
Abstract
Vaccination is a valid strategy to prevent and control newly emerging and reemerging infectious diseases in humans and animals. However, synthetic and recombinant antigens are poor immunogenic to stimulate efficient and protective host immune response. Immunostimulants are indispensable factors of vaccines, which can promote to trigger fast, robust, and long-lasting immune responses. Importantly, immunotherapy with immunostimulants is increasing proved to be an effective and promising treatment of cancer, which could enhance the function of the immune system against tumor cells. Pattern recognition receptors (PRRs) play vital roles in inflammation and are central to innate and adaptive immune responses. Toll-like receptors (TLRs)-targeting immunostimulants have become one of the hotspots in adjuvant research and cancer therapy. Bacterial-origin immunoreactive molecules are usually the ligands of PRRs, which could be fast recognized by PRRs and activate immune response to eliminate pathogens. Varieties of bacterial immunoreactive molecules and bacterial component-mimicking molecules have been successfully used in vaccines and clinical therapy so far. This work provides a comprehensive review of the development, current state, mechanisms, and applications of bacterial-origin immunostimulants. The exploration of bacterial immunoreactive molecules, along with their corresponding mechanisms, holds immense significance in deepening our understanding of bacterial pathogenicity and in the development of promising immunostimulants.
Collapse
Affiliation(s)
- Guangyu Wang
- College of Food Science and Engineering, Collaborative Innovation Center for Modern Grain Circulation and Safety/Key Laboratory of Grains and Oils Quality Control and Processing, Nanjing University of Finance and Economics, Nanjing, Jiangsu, 210023, China
| | - Yongkang Wang
- College of Food Science and Engineering, Collaborative Innovation Center for Modern Grain Circulation and Safety/Key Laboratory of Grains and Oils Quality Control and Processing, Nanjing University of Finance and Economics, Nanjing, Jiangsu, 210023, China
| | - Fang Ma
- Institute of Veterinary Immunology & Engineering, National Research Center of Engineering and Technology for Veterinary Biologicals, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China.
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, 212013, China.
- GuoTai (Taizhou) Center of Technology Innovation for Veterinary Biologicals, Taizhou, 225300, China.
| |
Collapse
|
2
|
Ahn D, Kwak JH, Lee GJ, Sohn JH. Ultrasound-guided ethanol ablation versus the Sistrunk operation as a primary treatment for thyroglossal duct cysts. Ultrasonography 2024; 43:25-34. [PMID: 38087396 PMCID: PMC10766887 DOI: 10.14366/usg.23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/19/2023] [Accepted: 09/02/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE This study compared ethanol ablation (EA) with the Sistrunk operation (SO) with regard to feasibility, treatment efficacy, and cost-effectiveness. The goal was to evaluate whether EA could replace SO as a primary treatment modality for thyroglossal duct cysts (TGDCs). METHODS This retrospective case-control study included patients with TGDCs who were treated with either EA or SO between 2016 and 2022. The primary outcome variables evaluated were treatment efficacy (as measured by the volume reduction rate [VRR] and treatment success rate), complications, and cost-effectiveness. RESULTS A total of 72 patients were enrolled, with 33 in the EA group and 39 in the SO group. The procedure or operation times for the EA and SO groups were 9 and 82 minutes, respectively (P<0.001). At the final follow-up appointment, the VRR was 94.1% for the EA group and 100.0% for the SO group (P<0.001). Treatment success was achieved for 32 patients (97.0%) in the EA group and for all 39 patients (100.0%) in the SO group (P=0.458). The overall complication rates were 0.0% and 17.9% in the EA and SO groups, respectively (P=0.013). The total costs, including all treatment procedures and follow-up ultrasound examinations, were $485 and $1,081.7 for the EA and SO groups, respectively (P<0.001). CONCLUSION EA demonstrates superiority over SO in terms of feasibility, safety, and costeffectiveness, while maintaining comparable treatment efficacy. Despite the need for multiple treatment sessions in approximately one-quarter of patients, EA can serve as a primary treatment modality for selected patients with TGDCs, supplanting SO.
Collapse
Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Hye Kwak
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Gil Joon Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin Ho Sohn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| |
Collapse
|
3
|
Ahn D. Ultrasound-Guided Ethanol Ablation for Thyroglossal Duct Cyst: A Review of Technical Issues and Potential as a New Standard Treatment. J Clin Med 2023; 12:5445. [PMID: 37685512 PMCID: PMC10487699 DOI: 10.3390/jcm12175445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
The thyroglossal duct cyst (TGDC) is the most common congenital neck mass, accounting for 70-75% of all congenital neck masses. Although the Sistrunk operation has been used as a standard of treatment, it is accompanied by a considerable surgical burden, including the need for general anesthesia, a visible surgical scar on the neck surface, and postoperative complications. Ultrasound-guided ethanol ablation (US-EA) is a minimally invasive and office-based technique that is widely used as a non-surgical treatment for several benign cystic lesions, particularly benign thyroid cysts. Recently, US-EA has also been gaining popularity as a good alternative for TGDC treatment, which is associated with high feasibility, a high safety profile, and favorable treatment outcomes. To our best knowledge, seven studies on the use of EA as a primary treatment option for TGDC have been published since 2011. Although these studies have reported promising results, there is a lack of consensus on several issues regarding the application of EA for TGDC, particularly its detailed techniques and role as a primary treatment. This article aims to provide a comprehensive review of EA for TGDC, addressing technical issues and its possible role as a new standard of treatment for TGDC.
Collapse
Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea
| |
Collapse
|
4
|
Ahn D, Kwak JH, Lee GJ, Sohn JH. Ultrasound-Guided Ethanol Ablation as a Primary Treatment for Thyroglossal Duct Cyst: Feasibility, Characteristics, and Outcomes. Otolaryngol Head Neck Surg 2023; 168:1381-1388. [PMID: 36939631 DOI: 10.1002/ohn.231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/11/2022] [Accepted: 11/28/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To evaluate the feasibility, characteristics, and outcomes of ultrasound-guided ethanol ablation (US-EA) as a primary treatment for thyroglossal duct cysts (TGDCs). STUDY DESIGN Prospective case series. SETTING Single center study. METHODS The inclusion criteria were as follows: (i) patients with TGDC aged ≥18 years, (ii) benign TGDC in imaging and cytological examinations, and (iii) patients' need for nonsurgical scarless treatment. US-EA was used as the primary treatment strategy. The primary outcome variables were the volume reduction rate (VRR) and cosmetic score at the last follow-up. RESULTS We enrolled 28 patients with TGDC. The median TGDC volume at baseline was 6.7 mL. The median procedure time of the US-EA was 6.5 minutes. The median volumes of the cyst aspirate and injected ethanol were 4.0 and 2.0 mL, respectively. Overall, 18, 8, and 2 patients underwent 1, 2, and 3 treatment sessions, respectively. There were no complications. The median VRR was 96.2%, and the treatment success rate was 96.4%. The World Health Organization cosmetic score decreased from 4 (baseline) to 1 (after treatment) in all patients. The subjective grade for cosmetic satisfaction was satisfactory or highly satisfactory in all patients. The VRR, treatment success rate, and the number of treatment sessions did not differ as functions of the characteristics of the TGDC, including the initial volume, septation, debris, or viscosity of the cyst fluid. CONCLUSION US-EA was feasible, safe, and effective in patients with TGDC. Therefore, US-EA can be used as a primary treatment for TGDC, evading general anesthesia and surgical scar.
Collapse
Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Hye Kwak
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Gil Joon Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin Ho Sohn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| |
Collapse
|
5
|
Stillman MD, Waring NA, Kuo JH. Ethanol Ablation of a Thyroglossal Duct Cyst and Review of the Literature. JCEM CASE REPORTS 2023; 1:luad070. [PMID: 37908570 PMCID: PMC10580405 DOI: 10.1210/jcemcr/luad070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Indexed: 11/02/2023]
Abstract
Ultrasound-guided ethanol ablation (EA) is a less invasive alternative to surgical resection for the management of thyroglossal duct cysts (TGDCs). However, to date, EA is rarely used in the United States to treat TGDCs. We present a case of TGDC successfully treated with EA in the United States. A 66-year-old man presented with a mobile anterior neck mass. Neck ultrasonography revealed a complex cystic mass in the midline directly anterior to the trachea, measuring 52 × 41 × 50 mm. Fine needle aspiration revealed no malignant cells, and pathology was consistent with TGDC. The patient had no contraindications to surgical resection. The patient's pretreatment symptom score was 7 and cosmetic score was 3. One month after EA, volume reduction ratio was 40%, symptom score was 1, and cosmetic score was 3. Four months after EA, the TGDC was resolved without need for an additional procedure. The volume reduction ratio was 96.8%, and symptom score and cosmetic score were both 1. In summary, EA is a viable alternative to surgical resection, even in patients who are surgical candidates. EA is attractive due to its simplicity, cost effectiveness, and tolerable side effect profile. Further studies are needed to evaluate long-term safety and efficacy, particularly in United States patients.
Collapse
Affiliation(s)
- Mason D Stillman
- Section of Endocrine Surgery, Columbia University, New York, NY 10032, USA
| | - Nicholas A Waring
- Section of Endocrine Surgery, Columbia University, New York, NY 10032, USA
| | - Jennifer H Kuo
- Section of Endocrine Surgery, Columbia University, New York, NY 10032, USA
| |
Collapse
|
6
|
Park SI, Baek JH, Chung SR, Choi YJ, Lee JH, Kim TY, Lee YM, Baek SM. Ethanol ablation for the treatment of thyroglossal duct cysts: follow-up results for longer than 2 years. Eur Radiol 2022; 32:3525-3531. [PMID: 34993573 DOI: 10.1007/s00330-021-08402-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the long-term efficacy and safety of ethanol ablation (EA) for the treatment of thyroglossal duct cysts (TGDCs). METHODS This retrospective study included 81 consecutive patients diagnosed with and treated for symptomatic TGDCs at two institutions between Jan 2008 and Oct 2018. Preprocedural evaluation included US assessment with calculation of the TGDC volume. EA was performed under US guidance using 99% ethanol. Post-treatment follow-up was scheduled within 3 months, 6 months, and then annually. Immediate success was defined as a volume reduction ratio (VRR; ratio of the volume difference after EA to the initial TGDC volume) > 50% within 3 months. Long-term success was defined as VRR > 50% or resolution or improvement of cosmetic problems and symptoms without recurrence at last follow-up. RESULTS Seventy-seven patients underwent EA, and outcomes were assessed in 68 patients with available follow-up data. The immediate success rate of the first EA was 81% (55/68), with a mean VRR within 3 months of 73% ± 31%. One patient (1.5%, 1/68) developed wound inflammation after the first EA. Forty-two patients were followed up for longer than 2 years. For the median follow-up of 69 months (range, 24-131 months), the long-term success rate was 83% (35/42), with a mean VRR at last follow-up of 81% ± 35%. No patients developed malignancy from the ablated TGDCs. CONCLUSIONS EA for treatment of TGDCs achieved acceptable rates of immediate and long-term efficacy with a low complication rate, and can be considered as a first-line treatment for the management of TGDCs. KEY POINTS • The immediate success rate of EA for the treatment of TGDCs was 81% (55/68), with a mean VRR within 3 months of 73% ± 31%. • For the median follow-up of 69 months (range, 24-131 months), the long-term success rate was 83% (35/42), with a mean VRR at last follow-up of 81% ± 35%. • No patients developed malignancy from the ablated TGDCs but one patient (1.5%, 1/68) developed wound inflammation after the first EA.
Collapse
Affiliation(s)
- Sang Ik Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea.
| | - Sae Rom Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea
| | - Yu-Mi Lee
- Division of Endocrine Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea
| | - Seon Mi Baek
- Department of Radiology, Haeundae Sharing and Happiness Hospital, Busan, Korea
| |
Collapse
|
7
|
Manson KC, Graham JL, Rozanski EA. Diagnosis and management of a laryngeal cyst in a domestic shorthair cat. JFMS Open Rep 2022; 8:20551169221104545. [PMID: 35795822 PMCID: PMC9251989 DOI: 10.1177/20551169221104545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Case summary A 7-year-old male neutered domestic shorthair cat was presented with a 3-month history of dyspnea when exercising and increased respiratory noise when purring. Initial radiographs identified a suspected laryngeal mass. Point-of-care ultrasound found a fluid-filled structure on the larynx, which was drained percutaneously. The cat initially recovered well but, due to recurrence of clinical signs, a CT scan was performed, which confirmed the presence of a laryngeal cyst that was subsequently surgically resected. Histopathological analysis was consistent with a suspected thyroglossal cyst. Relevance and novel information This is only the second report of a laryngeal cyst in the cat. While malignant laryngeal disease may be more prevalent in the cat, benign differentials should be considered as treatment could be curative, as was observed in this case.
Collapse
Affiliation(s)
- Katrina C Manson
- Cummings Veterinary Medical Center at Tufts University, Henry & Lois Foster Hospital for Small Animals, North Grafton, MA, USA
| | - Julia L Graham
- Cummings Veterinary Medical Center at Tufts University, Henry & Lois Foster Hospital for Small Animals, North Grafton, MA, USA
| | - Elizabeth A Rozanski
- Cummings Veterinary Medical Center at Tufts University, Henry & Lois Foster Hospital for Small Animals, North Grafton, MA, USA
| |
Collapse
|