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Background/aim: The loss or mutation of serine-threonine kinase 11/liver kinase B1 (STK11/LKB1) is known to negatively impact prognosis and immunotherapy outcomes in non-small cell lung cancer (NSCLC), and germline mutations in this gene cause gastrointestinal adenocarcinomas in patients with Peutz-Jeghers syndrome (PJS). Although STK11/LKB1 mutations are rare in colorectal cancer, the down-regulation of STK11/LKB1 has been implicated in its tumorigenesis. However, the relationship between STK11/LKB1 expression and the immunosuppressive tumor microenvironment in colorectal cancer remains unclear.

Materials and methods: In this study, we collected tissues from patients with colorectal adenocarcinoma (COAD) and constructed tissue microarrays (TMAs). STK11/LKB1 expression was assessed by immunohistochemistry and quantified by calculating H-scores. We also examined subsets of intratumoral tumor-infiltrating lymphocytes (TILs), including CD45+, CD8+, PD-1+, and CD45RO+ TILs, in these TMAs.

Results: STK11/LKB1 expression was significantly correlated with nodal metastasis. Kaplan-Meier survival analysis demonstrated that low STK11 expression was associated with significantly poorer overall survival (OS), particularly in COAD patients with KRAS mutations. However, STK11/LKB1 expression was not correlated with the presence of intratumoral CD45+, CD8+, PD-1+, or CD45RO+ TILs. Finally, multivariate Cox proportional regression analysis identified STK11/LKB1 expression as an independent prognostic factor in COAD patients.

Conclusion: While STK11/LKB1 expression is associated with tumor progression and survival outcomes, there is no evidence that STK11/LKB1 expression influences the infiltration of lymphocytes into the tumor microenvironment.

Background/aim: Chronic kidney disease (CKD) contributes significantly to morbidity, mortality, and healthcare costs. CKD is not only an independent risk factor for cardiovascular disease (CVD) but also a severe complication for patients with CVD, impacting substantially their prognosis and quality of life.

Case report: A 79-year-old male with a complex medical history, including asthma, hypertension, myocardial infarction, ischaemic heart disease, and recent atrial fibrillation, presented with new-onset exertional breathlessness and peripheral oedema following cardiac arrest and pacemaker insertion. Investigations, including medication reviews conducted shortly after in an outpatient setting, revealed severe renal impairment with creatinine levels at 250 μmol/l (reference range for adult males: 59-104), representing an initial acute kidney injury (AKI) that did not resolve and resulted in the diagnosis of stage 4 CKD (eGFR 25 ml/min/1.73 m²). The patient was treated with furosemide, dapagliflozin, and adjusted doses of ramipril and edoxaban. Following treatment, the patient's symptoms ameliorated and renal function slightly improved (eGFR 27 ml/min/1.73 m²).

Conclusion: This case highlights the importance of individualised treatment for patients with CKD alongside complex cardiovascular multi-morbidity. The administration of dapagliflozin and furosemide, together with careful adjustments to ramipril, were instrumental in stabilising the patient's renal function and alleviating symptoms. This case demonstrates how a multifaceted approach, continuous monitoring, and patient education are essential for achieving optimal outcomes in patients with CKD and cardiovascular comorbidities.

Background/aim: A high percentage of cancer patients use complementary therapies (CM) during their disease journey. Several barriers for CM prescription still exist among oncologists. This study explored oncologists' attitudes toward prescribing CM with oral supplements or confirming prescriptions made by others.

Materials and methods: The study employed a mixed semi-quantitative and qualitative research strategy via a web-based platform interview as a preliminary step for a program of observational studies on the oncologist's prescriptions of oral supplements in cancer management, in Italy.

Results: Out of 95 invited oncologists, 40 participated in the study, mainly working in a general hospital or a cancer center. The deep knowledge of guidelines on integrative medicine was generally poor. The symptoms driving oncologists to initiate discussions on CM with patients were fatigue, anorexia/poor appetite, weight loss, insomnia, distress, neuropathy, or pain. The presence of reliable data in the medical literature on prescribing CM was a significant factor in choosing a supplement.

Conclusion: This study reveals that oncologists' limited knowledge and lack of standardized guidelines hinder the prescription of CM, despite recognizing its potential benefits. CM discussions are primarily patient-driven, with prescriptions influenced by reliable scientific data and symptom management. Expanding integrative medicine services and research on CM efficacy could enhance oncologists' confidence, improve patient care, and address unmet needs in oncology.

Background/aim: Studies have demonstrated that patients with HIV are at a higher risk of Pneumocystis jirovecii pneumonia (PJP). Epidemiological knowledge of the risk of PJP among patients with HIV infection is lacking. This study aimed to assess the risk of PJP among patients with HIV.

Patients and methods: This cross-sectional study was conducted using the National Health Insurance Research Database of Taiwan. The participants were 18,929 patients with new-onset HIV infection from 2002 to 2015. Each patient was matched with four HIV-negative patients for age, sex, insured salary, urbanization status, Charlson Comorbidity Index score, and year of enrollment. The logistic regression with adjustment for relevant variables was performed to analyze the risk of PJP among patients with HIV at the 3-year follow-up. Sensitivity analysis was performed to compare the risk of PJP among different cohorts (patients with chronic kidney disease) and at different follow-up periods (6-month, 1-year, and 2-year follow-up).

Results: Patients with HIV had a higher risk of PJP [adjusted odds ratio (aOR)=199.36; 95% confidence interval (CI)=119.47-332.66] than HIV-negative individuals at the 3-year follow-up. Male patients had a higher risk of PJP (aOR=1.62; 95%CI=1.18-2.24) than female patients. Patients with chronic obstructive pulmonary disease (COPD) had a higher risk of PJP (aOR=1.74; 95%CI=1.27-2.39) at the 3-year follow-up.

Conclusion: Patients with HIV had a higher risk of PJP. Male patients had a higher risk of PJP than female patients. The risk of PJP was higher among patients with COPD.

Background/aim: Pentraxin 3 (PTX3), initially discovered as a key player in the defense against infectious pathogens, is crucial for inflammation and tissue regeneration. This study aimed to explore the impact of PTX3 gene variants on the development and progression of diabetic neuropathy (DN).

Materials and methods: The potential impact of PTX3 gene variants on the susceptibility to DN was examined by genotyping four single-nucleotide polymorphisms (SNPs) of the PTX3 gene (rs1840680, rs2305619, rs3816527, and rs2120243) in a study involving 730 DN cases and 861 diabetic controls with normal neurologic function.

Results: We demonstrated that diabetic subjects homozygous for the minor allele at rs1840680 [AA; adjusted odds ratio (AOR)=1.486; 95% confidence interval (CI)=1.050-2.103; p=0.02] or rs2120243 (AA; AOR=1.483; 95%CI=1.051-2.091; p=0.025) were more likely to develop neurologic complications compared to those homozygous for the corresponding major allele. Further stratification revealed that this correlation with DN risk was observed specifically in males but not in females. In addition, another SNP of the PTX3 gene, rs2305619, was found to be associated with the risk for DN in males (AA vs. GG, AOR=1.686; 95%CI=1.086-2.617, p=0.020), indicating a sex-specific impact of PTX3 gene polymorphisms on damage to the nerves in diabetic patients. Furthermore, DN patients homozygous for the minor allele of rs1840680 (AA), particularly males, had higher levels of LDL-cholesterol than those homozygous for the reference allele (GG) (p=0.034).

Conclusion: PTX3 gene polymorphisms are associated with dyslipidemia and nerve damage in diabetic patients in a sex-specific manner.

Background/aim: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multi-organ inflammation and damage across multiple organs, typically managed with steroids and immunomodulators. However, prolonged use of these treatments is often associated with significant side effects, underscoring the need for adjunctive therapies that improve disease outcomes while minimizing adverse effects. Molecular hydrogen (H₂) has demonstrated potential as an antioxidant and anti-inflammatory agent. This report discusses a case of SLE with cardiac complications, evaluating the therapeutic impact of molecular hydrogen therapy on fatigue, immune modulation, and cardiac function.

Case report: A 51-year-old female with SLE and acute decompensated heart failure initially received steroids and immunomodulators for disease management. Subsequently, molecular hydrogen therapy was introduced as an adjuvant treatment. Over several months, her cardiac function showed notable improvement, evidenced by reductions in anti-dsDNA and anti-Ro52 antibody levels, and Pro-BNP levels, as well as favorable shifts in T and B cell subsets. Additionally, the patient experienced a significant reduction in fatigue. She successfully tapered off steroids while maintaining disease stability with ongoing molecular hydrogen therapy.

Conclusion: This case highlights the potential of molecular hydrogen therapy as an adjuvant treatment in SLE, with observed benefits in immune modulation and fatigue reduction. Further studies are warranted to elucidate its therapeutic role and applicability in autoimmune diseases.

Background/aim: Class 1 human leukocyte antigen (HLA) ensures that cytotoxic T lymphocytes (CTLs) attack tumor cells. As part of tumor de-differentiation, the expression of HLA on the tumor cell surface may decrease, which can facilitate tumor growth. Therefore, reduced expression of HLA is generally negatively associated with overall survival (OS). The reverse is true for programmed cell death protein (PD-1) and programmed death ligand 1 (PD-L1). The presence of PD-1 and PD-L1 on the surface of cancer cells inhibits immune defense mechanisms against cancer cells. Therefore, one would expect that increased PD-1/PDL-1 expression would result in decreased 5-year survival. The aim of this study was to correlate the expression levels of HLA-A and HLA-B/C with the expression levels of PD-1 and PDL-1 to evaluate the reliability of their prediction of 5-year OS.

Materials and methods: This study retrospectively examined patients upon the start of a new therapy line for metastatic breast cancer (MBC). The pilot cohort fulfilling very demanding inclusion criteria consisted of 34 patients. The diagnostics were primarily carried out using RT-qPCR.

Results: The expression of HLA-A, HLA-B/C, PD-1, and PD-L1 is not significantly associated with OS.

Conclusion: This pilot study found no significant association between HLA-A, HLA-B/C, PD-1, or PD-L1 expression and OS in MBC, indicating limited prognostic value for these biomarkers in this cohort.

Skin and subcutaneous diseases represent a significant public health burden, profoundly impacting quality of life, social interactions, mental health, and daily activities-raising concerns worldwide. In modern cryogenics, cryosurgery is among the therapeutic approaches employed by healthcare professionals to address this broad and complex range of diseases. Over the past four decades, cryosurgery has evolved into a valuable treatment option, used alone or as an adjunct therapy, and is adaptable to the needs of various special populations. This approach offers distinct advantages over established treatments due to its safety, efficiency, feasibility, and cost-effectiveness. However, a comprehensive, up-to-date review of cryosurgery's applications is lacking, which limits research dissemination and recognition among dermatologists. This review aims to provide an overview of cryosurgery principles and its current clinical practice in dermatology, covering a broad range of benign, premalignant, and malignant cutaneous conditions, and highlighting its potential as an essential approach in global healthcare.

Fibroma of tendon sheath (FTS) is a benign fibroblastic/myofibroblastic neoplasm that primarily occurs in the fingers and hands of young and middle-aged adults. The lesion typically presents as a small, firm, slow-growing, painless nodule. Ultrasonography usually shows a focal nodular mass with homogeneous hypoechogenicity. Magnetic resonance imaging reveals a well-defined nodular mass with decreased signal on all pulse sequences. No or minimal peripheral enhancement is often seen after intravenous contrast. Histologically, the lesion is well circumscribed and consists of bland spindle cells in a dense collagenous stroma with slit-like thin-walled vessels at the periphery. A cellular variant of FTS has also been described and shows at least a focal morphological overlap with nodular fasciitis. Immunohistochemistry does not play a significant role in the diagnosis of FTS. Cytogenetic studies have demonstrated the presence of 11q rearrangements. A significant subset of cellular variants of FTS are characterized by ubiquitin specific peptidase 6 (USP6) rearrangements, with a variety of fusion partners. Complete surgical excision is the treatment of choice. This review provides an updated overview of the clinical, radiological, histological, cytogenetic and molecular genetic features of FTS and discusses the differential diagnosis of this uncommon entity.

Background/aim: Periodontal diseases and edentulism remain a prevalent and disabling oral health condition worldwide, with significant regional disparities. This study systematically evaluated the burden of periodontal disease and edentulism at global, regional, and national levels from 1990 to 2021, using the Global Burden of Disease (GBD) 2021 framework.

Patients and methods: We analyzed trends in incidence, prevalence, and years lived with disability (YLD), exploring their associations with the socio-demographic index (SDI) and other risk factors.

Results: The findings reveal considerable variations across SDI regions, with low and low-middle SDI regions experiencing the highest burden. In 2021, the global prevalence of periodontal diseases reached approximately 1.07 billion cases, and the age-standardized incidence and prevalence rates varied significantly by SDI levels. The burden of periodontal disease showed an increasing trend among middle-aged and elderly populations. While sex differences were present in both edentulism and periodontal diseases, they were relatively minor. ARIMA model projections indicate that the burden of edentulism will fluctuate by 2050, while the burden of periodontal diseases will remain stable.

Conclusion: This study underscores the need for targeted public health interventions, particularly in resource-limited regions, to improve access to oral healthcare and integrate preventive strategies into broader health initiatives.