Pub Date : 2024-11-01eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1482186
Yan Li, Xiaoyan Cui, Xiaoyan Yang, Guangqia Liu, Juan Zhang
The issue of antimicrobial resistance (AMR) in pathogenic microorganisms has emerged as a global public health crisis, posing a significant threat to the modern healthcare system. The advent of Artificial Intelligence (AI) and Machine Learning (ML) technologies has brought about revolutionary changes in this field. These advanced computational methods are capable of processing and analyzing large-scale biomedical data, thereby uncovering complex patterns and mechanisms behind the development of resistance. AI technologies are increasingly applied to predict the resistance of pathogens to various antibiotics based on gene content and genomic composition. This article reviews the latest advancements in AI and ML for predicting antimicrobial resistance in pathogenic microorganisms. We begin with an overview of the biological foundations of microbial resistance and its epidemiological research. Subsequently, we highlight the main AI and ML models used in resistance prediction, including but not limited to Support Vector Machines, Random Forests, and Deep Learning networks. Furthermore, we explore the major challenges in the field, such as data availability, model interpretability, and cross-species resistance prediction. Finally, we discuss new perspectives and solutions for research into microbial resistance through algorithm optimization, dataset expansion, and interdisciplinary collaboration. With the continuous advancement of AI technology, we will have the most powerful weapon in the fight against pathogenic microbial resistance in the future.
病原微生物的抗菌药耐药性(AMR)问题已成为全球公共卫生危机,对现代医疗保健系统构成重大威胁。人工智能(AI)和机器学习(ML)技术的出现给这一领域带来了革命性的变化。这些先进的计算方法能够处理和分析大规模生物医学数据,从而揭示抗药性产生背后的复杂模式和机制。人工智能技术越来越多地应用于根据基因含量和基因组组成预测病原体对各种抗生素的耐药性。本文回顾了人工智能和 ML 在预测病原微生物抗药性方面的最新进展。我们首先概述了微生物耐药性的生物学基础及其流行病学研究。随后,我们重点介绍了用于耐药性预测的主要人工智能和 ML 模型,包括但不限于支持向量机、随机森林和深度学习网络。此外,我们还探讨了该领域的主要挑战,如数据可用性、模型可解释性和跨物种抗药性预测。最后,我们讨论了通过算法优化、数据集扩展和跨学科合作研究微生物抗药性的新视角和解决方案。随着人工智能技术的不断进步,未来我们将拥有对抗病原微生物抗药性的最强大武器。
{"title":"Artificial intelligence in predicting pathogenic microorganisms' antimicrobial resistance: challenges, progress, and prospects.","authors":"Yan Li, Xiaoyan Cui, Xiaoyan Yang, Guangqia Liu, Juan Zhang","doi":"10.3389/fcimb.2024.1482186","DOIUrl":"10.3389/fcimb.2024.1482186","url":null,"abstract":"<p><p>The issue of antimicrobial resistance (AMR) in pathogenic microorganisms has emerged as a global public health crisis, posing a significant threat to the modern healthcare system. The advent of Artificial Intelligence (AI) and Machine Learning (ML) technologies has brought about revolutionary changes in this field. These advanced computational methods are capable of processing and analyzing large-scale biomedical data, thereby uncovering complex patterns and mechanisms behind the development of resistance. AI technologies are increasingly applied to predict the resistance of pathogens to various antibiotics based on gene content and genomic composition. This article reviews the latest advancements in AI and ML for predicting antimicrobial resistance in pathogenic microorganisms. We begin with an overview of the biological foundations of microbial resistance and its epidemiological research. Subsequently, we highlight the main AI and ML models used in resistance prediction, including but not limited to Support Vector Machines, Random Forests, and Deep Learning networks. Furthermore, we explore the major challenges in the field, such as data availability, model interpretability, and cross-species resistance prediction. Finally, we discuss new perspectives and solutions for research into microbial resistance through algorithm optimization, dataset expansion, and interdisciplinary collaboration. With the continuous advancement of AI technology, we will have the most powerful weapon in the fight against pathogenic microbial resistance in the future.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1482186"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1463456
Teresa Nascimento, João Inácio, Daniela Guerreiro, Priscila Diaz, Patrícia Patrício, Luís Proença, Cristina Toscano, Helena Barroso
Introduction: Candida auris is an emerging pathogen that represents a worldwide health problem due to its global expansion, multidrug resistance, and difficult laboratory identification. Among the risk factors for colonization/infection by C. auris, a stay in an intensive care unit (ICU) stands out. This prospective multicenter study aimed to monitor the trend of the local epidemiology of Candida spp. and unveil the prevalence of C. auris.
Methods: From 2020 to 2022, axillar/inguinal swabs were collected from adult patients at three points: upon admission (D1) and on the fifth (D5) and eighth (D8) days of their ICU stay. We employed culture-based screening methods combined with molecular techniques to identify Candida spp. down to the species level. Specific screening for Candida auris was conducted using a real-time PCR assay in combination with an improved selective culture medium, mannitol salt agar auris (MSAA). To validate the effectiveness of MSAA, a collection of reference C. auris strains representing the four major geographical clades was used.
Results: We enrolled 675 patients, and 355 Candida isolates were retrieved from the 988 swab samples collected. From those, 185/355 (52.1%) were identified as C. albicans and 170/355 (47.9%) as non-albicans Candida (NAC). MSAA medium showed a specificity of 94.8%, albeit C. auris was not detected in this cohort. The dynamics of Candida spp. colonization by ICU were significant at the three collection points. Upon admission, C. albicans was associated with the Beatriz Ângelo Hospital ICU (p=0.003) and C. tropicalis with the general Hospital Professor Doutor Fernando Fonseca (FFH) ICU (p=0.006). C. parapsilosis and C. lusitaniae were associated with FFH ICUs, with the general ICU at D5 (p=0.047) and surgical ICU at D8 (p=0.012). The dynamics of NAC colonization by ICU were significantly different at D1 (p=0.011), D5 (p=0.047), and D8 (p=0.012).
Conclusion: We developed and implemented a screening protocol for C. auris while uncovering the colonization patterns of Candida in the ICU. Our findings contribute to the optimization of overall patient management, ensuring that ICU protocols are resilient and adaptive to emerging fungal threats.
{"title":"Enhancing ICU <i>Candida</i> spp. surveillance: a cost-effective approach focused on <i>Candida auris</i> detection.","authors":"Teresa Nascimento, João Inácio, Daniela Guerreiro, Priscila Diaz, Patrícia Patrício, Luís Proença, Cristina Toscano, Helena Barroso","doi":"10.3389/fcimb.2024.1463456","DOIUrl":"10.3389/fcimb.2024.1463456","url":null,"abstract":"<p><strong>Introduction: </strong><i>Candida auris</i> is an emerging pathogen that represents a worldwide health problem due to its global expansion, multidrug resistance, and difficult laboratory identification. Among the risk factors for colonization/infection by <i>C. auris</i>, a stay in an intensive care unit (ICU) stands out. This prospective multicenter study aimed to monitor the trend of the local epidemiology of <i>Candida</i> spp. and unveil the prevalence of <i>C. auris</i>.</p><p><strong>Methods: </strong>From 2020 to 2022, axillar/inguinal swabs were collected from adult patients at three points: upon admission (D1) and on the fifth (D5) and eighth (D8) days of their ICU stay. We employed culture-based screening methods combined with molecular techniques to identify <i>Candida</i> spp. down to the species level. Specific screening for <i>Candida auris</i> was conducted using a real-time PCR assay in combination with an improved selective culture medium, mannitol salt agar auris (MSAA). To validate the effectiveness of MSAA, a collection of reference <i>C. auris</i> strains representing the four major geographical clades was used.</p><p><strong>Results: </strong>We enrolled 675 patients, and 355 <i>Candida</i> isolates were retrieved from the 988 swab samples collected. From those, 185/355 (52.1%) were identified as <i>C. albicans</i> and 170/355 (47.9%) as non-<i>albicans Candida</i> (NAC). MSAA medium showed a specificity of 94.8%, albeit <i>C. auris</i> was not detected in this cohort. The dynamics of <i>Candida</i> spp. colonization by ICU were significant at the three collection points. Upon admission, <i>C. albicans</i> was associated with the Beatriz Ângelo Hospital ICU (<i>p</i>=0.003) and <i>C. tropicalis</i> with the general Hospital Professor Doutor Fernando Fonseca (FFH) ICU (<i>p</i>=0.006). <i>C. parapsilosis</i> and <i>C. lusitaniae</i> were associated with FFH ICUs, with the general ICU at D5 (<i>p</i>=0.047) and surgical ICU at D8 (<i>p</i>=0.012). The dynamics of NAC colonization by ICU were significantly different at D1 (<i>p</i>=0.011), D5 (<i>p</i>=0.047), and D8 (<i>p</i>=0.012).</p><p><strong>Conclusion: </strong>We developed and implemented a screening protocol for <i>C. auris</i> while uncovering the colonization patterns of <i>Candida</i> in the ICU. Our findings contribute to the optimization of overall patient management, ensuring that ICU protocols are resilient and adaptive to emerging fungal threats.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1463456"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1494651
Qianqian Zhang, Zhiyi Wang, Shijiao Shen, Junzhe Wang, Jun Cao, Yongqiang Deng, He Meng, Lin Ma
Enzymes play a significant role in mediating inflammatory and immune responses in periodontitis. Effective diagnosis, timely treatment, and continuous management of periodontal enzymes are essential to prevent undesirable consequences; however, this remains a significant challenge. Nanoparticles (NPs) have attracted significant attention in biomedicine because of their advantageous nanosized effects. NPs are conjugated with specific enzyme substrates at responsive sites that are triggered by periodontitis enzyme biomarkers, leading to functional or characteristic changes. In contrast, NPs with enzyme-mimetic activities exhibit catalytic activity, effectively destroying pathogenic biofilms and modulating the immune response in periodontitis. The unique properties of enzyme-targeting NPs have enabled the development of biosensors and fluorescent probes capable of identifying enzyme biomarkers associated with periodontitis. Enzyme-responsive and enzyme-mimetic NPs both exert therapeutic applications in the treatment of periodontitis. In this review, we provide a comprehensive overview of the enzymes associated with periodontitis, the mechanisms of enzyme-responsive and enzyme-mimetic NPs, recent advancements in the use of NPs for detecting these enzymes, and the therapeutic applications of NPs in targeting or mimicking enzyme functions. We also discuss the challenges and prospects of using NPs in the diagnosis and treatment of periodontitis.
{"title":"Integrating enzyme-nanoparticles bring new prospects for the diagnosis and treatment of immune dysregulation in periodontitis.","authors":"Qianqian Zhang, Zhiyi Wang, Shijiao Shen, Junzhe Wang, Jun Cao, Yongqiang Deng, He Meng, Lin Ma","doi":"10.3389/fcimb.2024.1494651","DOIUrl":"10.3389/fcimb.2024.1494651","url":null,"abstract":"<p><p>Enzymes play a significant role in mediating inflammatory and immune responses in periodontitis. Effective diagnosis, timely treatment, and continuous management of periodontal enzymes are essential to prevent undesirable consequences; however, this remains a significant challenge. Nanoparticles (NPs) have attracted significant attention in biomedicine because of their advantageous nanosized effects. NPs are conjugated with specific enzyme substrates at responsive sites that are triggered by periodontitis enzyme biomarkers, leading to functional or characteristic changes. In contrast, NPs with enzyme-mimetic activities exhibit catalytic activity, effectively destroying pathogenic biofilms and modulating the immune response in periodontitis. The unique properties of enzyme-targeting NPs have enabled the development of biosensors and fluorescent probes capable of identifying enzyme biomarkers associated with periodontitis. Enzyme-responsive and enzyme-mimetic NPs both exert therapeutic applications in the treatment of periodontitis. In this review, we provide a comprehensive overview of the enzymes associated with periodontitis, the mechanisms of enzyme-responsive and enzyme-mimetic NPs, recent advancements in the use of NPs for detecting these enzymes, and the therapeutic applications of NPs in targeting or mimicking enzyme functions. We also discuss the challenges and prospects of using NPs in the diagnosis and treatment of periodontitis.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1494651"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aerobic respiration is the key driver of Vibrio cholerae proliferation and infection. Our previous transcriptome results suggested that degS knockout downregulates a few genes involved in NADH and ATP synthesis in the aerobic respiratory pathway. In this study, non-targeted metabolomics results showed that the differential metabolites affected by degS knockout were associated with aerobic respiration. Further results suggested that the key products of aerobic respiration, NADH and ATP, were reduced upon degS deletion and were not dependent on the classical σE pathway. The two-component system response factor aerobic respiration control A (ArcA) is involved in regulating NADH and ATP levels. qRT-PCR demonstrated that DegS negatively regulates the transcription of the arcA gene, which negatively regulates the expression of isocitrate dehydrogenase (ICDH), a key rate-limiting enzyme of the tricarboxylic acid cycle. NADH and ATP levels were partially restored with the knockout of the arcA gene in the ΔdegS strain, while levels were partially restored with overexpression of ICDH in the ΔdegS strain. In a growth experiment, compared to the ΔdegS strain, the growth rates of ΔdegSΔarcA and ΔdegS-overexpressed icdh strains (ΔdegS+icdh) were partially restored during the logarithmic growth period. Colonization of the intestines of suckling mice showed a significant reduction in the colonizing ability of the ΔdegS strain, similar colonizing ability of the ΔdegS::degS strain and the wild-type strain, and a partial recovery of the colonizing ability of the ΔdegS+icdh strain. Overall, these findings suggest that the DegS protease regulates the expression of ICDH through ArcA, thereby affecting the NADH and ATP levels of V. cholerae and its growth and intestinal colonization ability.
{"title":"DegS regulates the aerobic metabolism of <i>Vibrio cholerae</i> via the ArcA-isocitrate dehydrogenase pathway for growth and intestinal colonization.","authors":"Jiajun Zhao, Xiaoyu Huang, Qingqun Li, Fangyu Ren, Huaqin Hu, Jianbo Yuan, Kaiying Wang, Yuanqin Hu, Jian Huang, Xun Min","doi":"10.3389/fcimb.2024.1482919","DOIUrl":"10.3389/fcimb.2024.1482919","url":null,"abstract":"<p><p>Aerobic respiration is the key driver of <i>Vibrio cholerae</i> proliferation and infection. Our previous transcriptome results suggested that <i>degS</i> knockout downregulates a few genes involved in NADH and ATP synthesis in the aerobic respiratory pathway. In this study, non-targeted metabolomics results showed that the differential metabolites affected by <i>degS</i> knockout were associated with aerobic respiration. Further results suggested that the key products of aerobic respiration, NADH and ATP, were reduced upon <i>degS</i> deletion and were not dependent on the classical σ<sup>E</sup> pathway. The two-component system response factor aerobic respiration control A (ArcA) is involved in regulating NADH and ATP levels. qRT-PCR demonstrated that DegS negatively regulates the transcription of the <i>arcA</i> gene, which negatively regulates the expression of isocitrate dehydrogenase (ICDH), a key rate-limiting enzyme of the tricarboxylic acid cycle. NADH and ATP levels were partially restored with the knockout of the <i>arcA</i> gene in the <i>ΔdegS</i> strain, while levels were partially restored with overexpression of ICDH in the <i>ΔdegS</i> strain. In a growth experiment, compared to the <i>ΔdegS</i> strain, the growth rates of <i>ΔdegSΔarcA</i> and <i>ΔdegS</i>-overexpressed <i>icdh</i> strains (<i>ΔdegS+icdh</i>) were partially restored during the logarithmic growth period. Colonization of the intestines of suckling mice showed a significant reduction in the colonizing ability of the <i>ΔdegS</i> strain, similar colonizing ability of the <i>ΔdegS::degS</i> strain and the wild-type strain, and a partial recovery of the colonizing ability of the <i>ΔdegS</i>+<i>icdh</i> strain. Overall, these findings suggest that the DegS protease regulates the expression of ICDH through ArcA, thereby affecting the NADH and ATP levels of <i>V. cholerae</i> and its growth and intestinal colonization ability.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1482919"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-31eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1495311
Donglin Yu, Shiqin Xie, Mingmin Guo, Yi Wu, Qianghong Tian, Zhiyan Wang, Sainan Zhou, Ying Cai
Objectives: Recent studies have increasingly demonstrated that a multiplatform water environment combined with lard gavage is an effective method for establishing a mouse model of diarrhea. However, the interactions between intestinal microorganisms and diarrhea, as well as the relationships among energy metabolism, fluid balance, and gastrointestinal function in this model, remain poorly understood.
Methods: Building on previous research, this study aimed to optimiz and replicate a multiplatform water environment combined with a lard gavage model. Male Kunming mice, free of specific pathogens, were randomly divided into four groups: a normal control group (ZC), a standing group (ZL), a standing combined with lard group (ZLZ), and a standing combined with internal and external wet conditions group (ZLZS). The mice in the ZL, ZLZ, and ZLZS groups were subjected to 4 hours of daily standing in a custom-designed multiplatform water environment. Starting on day 8, mice in the ZLZ and ZLZS groups were gavaged with lard (0.4 mL per session, twice daily) for 7 consecutive days, while those in the ZLZS group were additionally exposed to a wet litter environment (50 g/100 mL). The ZC and ZL groups received equal volumes of sterile water via gavage. The microbiota in the small intestine, as well as serum levels of cAMP, cGMP, VIP, Gas, and D-xylose, were analyzed.
Results: Compared with the ZLZ group, the ZLZS group showed significantly lower serum levels of cAMP/cGMP (p<0.01) and Gas (p<0.01). D-xylose levels were lower in the ZL, ZLZ, and ZLZS groups compared to the ZC group, while VIP levels were significantly higher in the ZL and ZLZS groups (p<0.01). Moverover, Corynebacterium, Empedobacter, and Pseudochrobactrum were identified as characteristic bacterial genera in the ZLZS group. The mechanism by which the small intestinal microbiota induces diarrhea was linked to the biosynthesis of secondary bile acids.
Conclusion: A multiplatform water environment combined with lard gavage can effectively induce diarrhea, and the addition of an external wet environment exacerbates this condition by affecting small intestinal contents microbiota and other functions.
{"title":"External damp environment aggravates diarrhea in spleen deficiency and dampness syndrome in mice: involvement of small intestinal contents microbiota, energy metabolism, gastrointestinal and fluid functions.","authors":"Donglin Yu, Shiqin Xie, Mingmin Guo, Yi Wu, Qianghong Tian, Zhiyan Wang, Sainan Zhou, Ying Cai","doi":"10.3389/fcimb.2024.1495311","DOIUrl":"10.3389/fcimb.2024.1495311","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies have increasingly demonstrated that a multiplatform water environment combined with lard gavage is an effective method for establishing a mouse model of diarrhea. However, the interactions between intestinal microorganisms and diarrhea, as well as the relationships among energy metabolism, fluid balance, and gastrointestinal function in this model, remain poorly understood.</p><p><strong>Methods: </strong>Building on previous research, this study aimed to optimiz and replicate a multiplatform water environment combined with a lard gavage model. Male Kunming mice, free of specific pathogens, were randomly divided into four groups: a normal control group (ZC), a standing group (ZL), a standing combined with lard group (ZLZ), and a standing combined with internal and external wet conditions group (ZLZS). The mice in the ZL, ZLZ, and ZLZS groups were subjected to 4 hours of daily standing in a custom-designed multiplatform water environment. Starting on day 8, mice in the ZLZ and ZLZS groups were gavaged with lard (0.4 mL per session, twice daily) for 7 consecutive days, while those in the ZLZS group were additionally exposed to a wet litter environment (50 g/100 mL). The ZC and ZL groups received equal volumes of sterile water via gavage. The microbiota in the small intestine, as well as serum levels of cAMP, cGMP, VIP, Gas, and D-xylose, were analyzed.</p><p><strong>Results: </strong>Compared with the ZLZ group, the ZLZS group showed significantly lower serum levels of cAMP/cGMP (<i>p</i><0.01) and Gas (<i>p</i><0.01). D-xylose levels were lower in the ZL, ZLZ, and ZLZS groups compared to the ZC group, while VIP levels were significantly higher in the ZL and ZLZS groups (<i>p</i><0.01). Moverover, <i>Corynebacterium</i>, <i>Empedobacter</i>, and <i>Pseudochrobactrum</i> were identified as characteristic bacterial genera in the ZLZS group. The mechanism by which the small intestinal microbiota induces diarrhea was linked to the biosynthesis of secondary bile acids.</p><p><strong>Conclusion: </strong>A multiplatform water environment combined with lard gavage can effectively induce diarrhea, and the addition of an external wet environment exacerbates this condition by affecting small intestinal contents microbiota and other functions.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1495311"},"PeriodicalIF":4.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-31eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1471027
Yuanting Tang, Xia Wang, Jialing Huang, Yongmei Jiang, Fan Yu
Introduction: Intraamniotic infection is crucial in preterm prelabor rupture of membranes(PPROM), a clinical condition resulting from the invasion of vaginal opportunistic microbes into the amniotic cavity. Although previous studies have suggested potential associations between infection and PPROM, the role of vaginalopportunistic bacteria in PPROM has received limited attention.
Methods: This study aimed to confirm the vaginal bacterial etiology of PPROM. We investigated vaginal microbiotas using automatic analysis of vaginal discharge, microbiological tests, and 16s rRNA genehigh-throughput sequencing.
Results: The research findings revealed that the proportion of parabasal epitheliocytes, leukocytes, toxic leukocytes, and bacteria with diameters smaller than 1.5 um was significantly higher in the PPROM group than that in the normal full-term labor (TL) group. The top three vaginal opportunistic bacterial isolates in all participants were 9.47% Escherichia coli, 5.99% Streptococcus agalactiae, and 3.57% Enterococcus faecalis. The bacterial resistance differed, but all the isolates were sensitive to nitrofurantoin. Compared with the vaginal microbiota dysbiosis (VMD) TL (C) group, the VMD PPROM (P) group demonstrated more operational taxonomic units, a high richness of bacterial taxa, and a different beta-diversity index. Indicator species analysis revealed that Lactobacillus jensenii, Lactobacillus crispatus, and Veillonellaceae bacterium DNF00626 were strongly associated with the C group. Unlike the C group, the indicator bacteria in the P group were Enterococcus faecalis, Escherichia coli, and Streptococcus agalactiae.
Discussion: These findings provide solidevidence that an abnormal vaginal microbiome is a very crucial risk factorclosely related to PPROM. There were no unique bacteria in the vaginalmicrobiota of the PPROM group; however, the relative abundance of bacteria inthe abnormal vaginal flora of PPROM pregnancies differed. Antibiotics should bereasonably selected based on drug sensitivity testing. The findings presented in this paper enhance our understanding of Streptococcus agalactiae, Enterococcus faecalis, and Escherichia coli vaginal bacterial etiology of PPROM in Western China.
导言:羊膜腔内感染在早产胎膜早破(PPROM)中至关重要,PPROM 是阴道机会性微生物侵入羊膜腔导致的一种临床症状。尽管之前的研究表明感染与早产儿胎膜早破之间存在潜在联系,但阴道机会性细菌在早产儿胎膜早破中的作用受到的关注有限:本研究旨在证实 PPROM 的阴道细菌病因。我们采用阴道分泌物自动分析、微生物检测和 16s rRNA 基因高通量测序等方法对阴道微生物进行了调查:结果:研究结果显示,PPROM 组阴道旁上皮细胞、白细胞、毒性白细胞和直径小于 1.5 um 的细菌的比例明显高于正常足月分娩(TL)组。在所有参与者中,阴道机会性细菌分离率排名前三位的分别是 9.47% 的大肠杆菌、5.99% 的无乳链球菌和 3.57% 的粪肠球菌。细菌的耐药性各不相同,但所有分离菌都对硝基呋喃妥因敏感。与阴道微生物群失调(VMD)TL(C)组相比,VMD PPROM(P)组显示出更多的可操作分类单元、更丰富的细菌类群和不同的β-多样性指数。指示物种分析表明,简森乳酸杆菌、脆性乳酸杆菌和 Veillonellaceae 细菌 DNF00626 与 C 组密切相关。与 C 组不同,P 组的指示菌是粪肠球菌、大肠杆菌和无乳链球菌:讨论:这些研究结果提供了确凿的证据,证明阴道微生物群异常是与早产儿窒息症密切相关的重要风险因素。PPROM 组孕妇的阴道微生物群中没有独特的细菌;但是,PPROM 组孕妇异常阴道菌群中细菌的相对丰度有所不同。应根据药敏试验合理选择抗生素。本文的研究结果加深了我们对中国西部地区PPROM阴道细菌病因的了解。
{"title":"The microbiome biomarkers of pregnant women's vaginal area predict preterm prelabor rupture in Western China.","authors":"Yuanting Tang, Xia Wang, Jialing Huang, Yongmei Jiang, Fan Yu","doi":"10.3389/fcimb.2024.1471027","DOIUrl":"10.3389/fcimb.2024.1471027","url":null,"abstract":"<p><strong>Introduction: </strong>Intraamniotic infection is crucial in preterm prelabor rupture of membranes(PPROM), a clinical condition resulting from the invasion of vaginal opportunistic microbes into the amniotic cavity. Although previous studies have suggested potential associations between infection and PPROM, the role of vaginalopportunistic bacteria in PPROM has received limited attention.</p><p><strong>Methods: </strong>This study aimed to confirm the vaginal bacterial etiology of PPROM. We investigated vaginal microbiotas using automatic analysis of vaginal discharge, microbiological tests, and 16s rRNA genehigh-throughput sequencing.</p><p><strong>Results: </strong>The research findings revealed that the proportion of parabasal epitheliocytes, leukocytes, toxic leukocytes, and bacteria with diameters smaller than 1.5 um was significantly higher in the PPROM group than that in the normal full-term labor (TL) group. The top three vaginal opportunistic bacterial isolates in all participants were 9.47% Escherichia coli, 5.99% Streptococcus agalactiae, and 3.57% Enterococcus faecalis. The bacterial resistance differed, but all the isolates were sensitive to nitrofurantoin. Compared with the vaginal microbiota dysbiosis (VMD) TL (C) group, the VMD PPROM (P) group demonstrated more operational taxonomic units, a high richness of bacterial taxa, and a different beta-diversity index. Indicator species analysis revealed that Lactobacillus jensenii, Lactobacillus crispatus, and Veillonellaceae bacterium DNF00626 were strongly associated with the C group. Unlike the C group, the indicator bacteria in the P group were Enterococcus faecalis, Escherichia coli, and Streptococcus agalactiae.</p><p><strong>Discussion: </strong>These findings provide solidevidence that an abnormal vaginal microbiome is a very crucial risk factorclosely related to PPROM. There were no unique bacteria in the vaginalmicrobiota of the PPROM group; however, the relative abundance of bacteria inthe abnormal vaginal flora of PPROM pregnancies differed. Antibiotics should bereasonably selected based on drug sensitivity testing. The findings presented in this paper enhance our understanding of Streptococcus agalactiae, Enterococcus faecalis, and Escherichia coli vaginal bacterial etiology of PPROM in Western China.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1471027"},"PeriodicalIF":4.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-31eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1454931
Jing Guo, Xianyue Yan, Liping Han
Endometriosis (EMT) has a significant impact on women's physical and mental health. In this study, high-throughput sequencing technology was employed to detect differences in gut microbiota between EMT patients and healthy individuals (CTL). Additionally, Spearman correlation analysis was utilized to analyze the correlation between different bacterial genera and EMT biomarkers (CA125 and CA199). The results demonstrated that at the phylum level, the relative abundances of Proteobacteria and Desulfobacterota_G_459546 in the EMT group were significantly higher than those in the CTL group, while the relative abundances of Bacteroidota and Firmicutes_A in the EMT group were significantly lower than those in the CTL group. At the genus level, the relative abundances of Burkholderiales and Sphingomonadales in the EMT group were significantly higher than those in the CTL group, while the relative abundances of Bacteroidales and Roseburia in the EMT group were significantly lower than those in the CTL group. The correlation analysis results show that CA125 and CA199 are significantly positively correlated with Burkholderiales and Sphingomonadales, and significantly negatively correlated with Bacteroidales, Oscillospirales, and Roseburia. The PICRUSt2 results show that the relative abundance in the cell motility and xenobiotics biodegradation and metabolism pathways in the EMT group was higher than that in the CTL group, while the relative abundance in the translation, replication and repair, folding, sorting and degradation, metabolism of terpenoids and polyketides and metabolism of cofactors and vitamins pathways in the EMT group was lower than that in the CTL group. In brief, there is a close correlation between the imbalance of gut microbiota and the onset of EMT. The intestinal microbiota has great significance broad prospects for the prevention, diagnosis and treatment of EMT.
{"title":"The potential role of gut microbiota in the occurrence and development of endometriosis.","authors":"Jing Guo, Xianyue Yan, Liping Han","doi":"10.3389/fcimb.2024.1454931","DOIUrl":"10.3389/fcimb.2024.1454931","url":null,"abstract":"<p><p>Endometriosis (EMT) has a significant impact on women's physical and mental health. In this study, high-throughput sequencing technology was employed to detect differences in gut microbiota between EMT patients and healthy individuals (CTL). Additionally, Spearman correlation analysis was utilized to analyze the correlation between different bacterial genera and EMT biomarkers (CA125 and CA199). The results demonstrated that at the phylum level, the relative abundances of Proteobacteria and Desulfobacterota_G_459546 in the EMT group were significantly higher than those in the CTL group, while the relative abundances of Bacteroidota and Firmicutes_A in the EMT group were significantly lower than those in the CTL group. At the genus level, the relative abundances of <i>Burkholderiales</i> and <i>Sphingomonadales</i> in the EMT group were significantly higher than those in the CTL group, while the relative abundances of <i>Bacteroidales</i> and <i>Roseburia</i> in the EMT group were significantly lower than those in the CTL group. The correlation analysis results show that CA125 and CA199 are significantly positively correlated with <i>Burkholderiales</i> and <i>Sphingomonadales</i>, and significantly negatively correlated with <i>Bacteroidales</i>, <i>Oscillospirales</i>, and <i>Roseburia</i>. The PICRUSt2 results show that the relative abundance in the cell motility and xenobiotics biodegradation and metabolism pathways in the EMT group was higher than that in the CTL group, while the relative abundance in the translation, replication and repair, folding, sorting and degradation, metabolism of terpenoids and polyketides and metabolism of cofactors and vitamins pathways in the EMT group was lower than that in the CTL group. In brief, there is a close correlation between the imbalance of gut microbiota and the onset of EMT. The intestinal microbiota has great significance broad prospects for the prevention, diagnosis and treatment of EMT.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1454931"},"PeriodicalIF":4.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The homeostasis of the microbiome in lower respiratory tract is crucial in sustaining normal physiological functions of the lung. Different pulmonary diseases display varying degrees of microbiome imbalance; however, the specific variability and clinical significance of their microbiomes remain largely unexplored.
Methods: In this study, we delineated the pathogen spectrum and commensal microorganisms in the lower respiratory tract of various pulmonary diseases using metagenomic sequencing. We analyzed the disparities and commonalities of the microbial features and examined their correlation with disease characteristics.
Results: We observed distinct pathogen profiles and a diversity in lower airway microbiome in patients diagnosed with cancer, interstitial lung disease, bronchiectasis, common pneumonia, Nontuberculous mycobacteria (NTM) pneumonia, and severe pneumonia.
Discussion: This study illustrates the utility of Metagenomic Next-generation Sequencing (mNGS) in identifying pathogens and analyzing the lower respiratory microbiome, which is important for understanding the microbiological aspect of pulmonary diseases and essential for their early and precise diagnosis.
{"title":"Pathogen spectrum and microbiome in lower respiratory tract of patients with different pulmonary diseases based on metagenomic next-generation sequencing.","authors":"Rujun Hong, Sheng Lin, Siting Zhang, Yaxing Yi, Lanfeng Li, Haitao Yang, Zhenshan Du, Xuefang Cao, Wenjie Wu, Ruotong Ren, Xiujuan Yao, Baosong Xie","doi":"10.3389/fcimb.2024.1320831","DOIUrl":"10.3389/fcimb.2024.1320831","url":null,"abstract":"<p><strong>Introduction: </strong>The homeostasis of the microbiome in lower respiratory tract is crucial in sustaining normal physiological functions of the lung. Different pulmonary diseases display varying degrees of microbiome imbalance; however, the specific variability and clinical significance of their microbiomes remain largely unexplored.</p><p><strong>Methods: </strong>In this study, we delineated the pathogen spectrum and commensal microorganisms in the lower respiratory tract of various pulmonary diseases using metagenomic sequencing. We analyzed the disparities and commonalities of the microbial features and examined their correlation with disease characteristics.</p><p><strong>Results: </strong>We observed distinct pathogen profiles and a diversity in lower airway microbiome in patients diagnosed with cancer, interstitial lung disease, bronchiectasis, common pneumonia, Nontuberculous mycobacteria (NTM) pneumonia, and severe pneumonia.</p><p><strong>Discussion: </strong>This study illustrates the utility of Metagenomic Next-generation Sequencing (mNGS) in identifying pathogens and analyzing the lower respiratory microbiome, which is important for understanding the microbiological aspect of pulmonary diseases and essential for their early and precise diagnosis.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1320831"},"PeriodicalIF":4.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-31eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1467915
Pavlo Petakh, Oleksandr Kamyshnyi
Leptospirosis is an emerging illness presenting a broad range of clinical manifestations, ranging from asymptomatic or mild cases to severe and fatal outcomes. Early detection is crucial for effective treatment; however, similar clinical presentations in various febrile illnesses or co-infections, along with challenges in laboratory diagnostics, can lead to misdiagnosis and severe consequences. Identifying clinical predictors for severe forms of the disease is essential in mitigating complications and reducing mortality. Consequently, we conducted a retrospective case-control study to identify clinical markers indicative of severe disease in leptospirosis patients from the Transcarpathian region. The study focused on patients admitted with clinically suspected leptospirosis, involving a total of 51 diagnosed cases, with 13 resulting in severe outcomes and death. Categorical variables were analyzed using χ2, revealing a mean patient age of 50 years, predominantly male (n = 36, 70.5%). Oliguria emerged as a significant independent factor associated with mortality (odds ratio [OR], 13.5; 95% confidence interval [CI], 2.56-71.12; p = 0.001). Additionally, our analysis uncovered a noteworthy increase in leptospirosis notification rates in Transcarpathian compared to Ukraine, with 150 cases out of the total 433 in Ukraine. The highest notification rates were observed in Mukachevo District and Perechyn District. These findings highlight the importance of early recognition of key clinical markers, such as oliguria, which are critical for predicting severe outcomes in leptospirosis patients. The higher notification rates in Transcarpathian regions also underscore the need for enhanced surveillance, targeted public health interventions, and timely treatment to reduce mortality in endemic areas.
{"title":"Oliguria as a diagnostic marker of severe leptospirosis: a study from the Transcarpathian region of Ukraine.","authors":"Pavlo Petakh, Oleksandr Kamyshnyi","doi":"10.3389/fcimb.2024.1467915","DOIUrl":"10.3389/fcimb.2024.1467915","url":null,"abstract":"<p><p>Leptospirosis is an emerging illness presenting a broad range of clinical manifestations, ranging from asymptomatic or mild cases to severe and fatal outcomes. Early detection is crucial for effective treatment; however, similar clinical presentations in various febrile illnesses or co-infections, along with challenges in laboratory diagnostics, can lead to misdiagnosis and severe consequences. Identifying clinical predictors for severe forms of the disease is essential in mitigating complications and reducing mortality. Consequently, we conducted a retrospective case-control study to identify clinical markers indicative of severe disease in leptospirosis patients from the Transcarpathian region. The study focused on patients admitted with clinically suspected leptospirosis, involving a total of 51 diagnosed cases, with 13 resulting in severe outcomes and death. Categorical variables were analyzed using χ<sup>2</sup>, revealing a mean patient age of 50 years, predominantly male (n = 36, 70.5%). Oliguria emerged as a significant independent factor associated with mortality (odds ratio [OR], 13.5; 95% confidence interval [CI], 2.56-71.12; p = 0.001). Additionally, our analysis uncovered a noteworthy increase in leptospirosis notification rates in Transcarpathian compared to Ukraine, with 150 cases out of the total 433 in Ukraine. The highest notification rates were observed in Mukachevo District and Perechyn District. These findings highlight the importance of early recognition of key clinical markers, such as oliguria, which are critical for predicting severe outcomes in leptospirosis patients. The higher notification rates in Transcarpathian regions also underscore the need for enhanced surveillance, targeted public health interventions, and timely treatment to reduce mortality in endemic areas.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1467915"},"PeriodicalIF":4.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-31eCollection Date: 2024-01-01DOI: 10.3389/fcimb.2024.1419884
Shenghui Li, Shao Fan, Yufang Ma, Chuan Xia, Qiulong Yan
Background: The symbiotic gut microbiota is pivotal for human health, with its composition linked to various diseases and metabolic disorders. Despite its significance, there remains a gap in systematically evaluating how host phenotypes, such as gender, age, and body mass index (BMI), influence gut microbiota.
Methodology/principal findings: We conducted an analysis of the gut microbiota of 185 Chinese adults based on whole-metagenome shotgun sequencing of fecal samples. Our investigation focused on assessing the effects of gender, age, and BMI on gut microbiota across three levels: diversity, gene/phylogenetic composition, and functional composition. Our findings suggest that these phenotypes have a minor impact on shaping the gut microbiome compared to enterotypes, they do not correlate significantly within- or between-sample diversity. We identified a substantial number of phenotype-associated genes and metagenomic linkage groups (MLGs), indicating variations in gut microflora composition. Specifically, we observed a decline in beneficial Firmicutes microbes, such as Eubacterium, Roseburia, Faecalibacterium and Ruminococcus spp., in both older individuals and those with higher BMI, while potentially harmful microbes like Erysipelotrichaceae, Subdoligranulum and Streptococcus spp. increased with age. Additionally, Blautia and Dorea spp. were found to increase with BMI, aligning with prior research. Surprisingly, individuals who were older or overweight exhibited a lack of Bacteroidetes, a dominant phylum in the human gut microbiota that includes opportunistic pathogens, while certain species of the well-known probiotics Bifidobacterium were enriched in these groups, suggesting a complex interplay of these bacteria warranting further investigation. Regarding gender, several gender-associated MLGs from Bacteroides, Parabacteroides, Clostridium and Akkermansia were enriched in females. Functional analysis revealed a multitude of phenotype-associated KEGG orthologs (KOs).
Conclusions/significance: Our study underscores the influence of gender, age, and BMI on gut metagenomes, affecting both phylogenetic and functional composition. However, further investigation is needed to elucidate the precise roles of these bacteria, including both pathogens and probiotics.
{"title":"Influence of gender, age, and body mass index on the gut microbiota of individuals from South China.","authors":"Shenghui Li, Shao Fan, Yufang Ma, Chuan Xia, Qiulong Yan","doi":"10.3389/fcimb.2024.1419884","DOIUrl":"10.3389/fcimb.2024.1419884","url":null,"abstract":"<p><strong>Background: </strong>The symbiotic gut microbiota is pivotal for human health, with its composition linked to various diseases and metabolic disorders. Despite its significance, there remains a gap in systematically evaluating how host phenotypes, such as gender, age, and body mass index (BMI), influence gut microbiota.</p><p><strong>Methodology/principal findings: </strong>We conducted an analysis of the gut microbiota of 185 Chinese adults based on whole-metagenome shotgun sequencing of fecal samples. Our investigation focused on assessing the effects of gender, age, and BMI on gut microbiota across three levels: diversity, gene/phylogenetic composition, and functional composition. Our findings suggest that these phenotypes have a minor impact on shaping the gut microbiome compared to enterotypes, they do not correlate significantly within- or between-sample diversity. We identified a substantial number of phenotype-associated genes and metagenomic linkage groups (MLGs), indicating variations in gut microflora composition. Specifically, we observed a decline in beneficial Firmicutes microbes, such as <i>Eubacterium</i>, <i>Roseburia</i>, <i>Faecalibacterium</i> and <i>Ruminococcus</i> spp., in both older individuals and those with higher BMI, while potentially harmful microbes like <i>Erysipelotrichaceae</i>, <i>Subdoligranulum</i> and <i>Streptococcus</i> spp. increased with age. Additionally, <i>Blautia</i> and <i>Dorea</i> spp. were found to increase with BMI, aligning with prior research. Surprisingly, individuals who were older or overweight exhibited a lack of Bacteroidetes, a dominant phylum in the human gut microbiota that includes opportunistic pathogens, while certain species of the well-known probiotics <i>Bifidobacterium</i> were enriched in these groups, suggesting a complex interplay of these bacteria warranting further investigation. Regarding gender, several gender-associated MLGs from <i>Bacteroides</i>, <i>Parabacteroides</i>, <i>Clostridium</i> and <i>Akkermansia</i> were enriched in females. Functional analysis revealed a multitude of phenotype-associated KEGG orthologs (KOs).</p><p><strong>Conclusions/significance: </strong>Our study underscores the influence of gender, age, and BMI on gut metagenomes, affecting both phylogenetic and functional composition. However, further investigation is needed to elucidate the precise roles of these bacteria, including both pathogens and probiotics.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1419884"},"PeriodicalIF":4.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}