Chronic Diseases and Translational Medicine最新文献

Over the past few decades, understanding of the pathogenesis of rheumatoid arthritis (RA) has improved substantially. Insights into the cellular and molecular mechanisms involved in RA have enabled the discovery of new therapeutic targets and led to the development of biologics and targeted synthetic disease-modifying antirheumatic drugs. In parallel with the improvement in therapies, the evolution of strategies in the management of RA has also contributed considerably to better outcomes in patients. Major changes include the development of disease activity measures, formulation of the treat-to-target principles as well as increased attention to comorbidities. The presence of comorbidities such as cardiovascular diseases may increase the mortality of RA patients, affect their treatment strategies and result in worse outcomes. Therefore, prevention and management of certain high-risk comorbidities have become increasingly important in the long-term treatment of RA. In this study, we summarized new insights into the pathogenesis and management of rheumatoid arthritis and associated comorbidities, with a special focus on the 2021 update of the American College of Rheumatology (ACR) guideline for RA and key reports presented at the 2021 ACR convergence.

Since the coronavirus disease 2019 (COVID-19) outbreak has become a pandemic, medical staff and researchers have devotedly managed the disease in terms of pathogens, prevention, and treatment. Even so, the virus continues to wreak havoc in people's lives. Recent evidence shows that patients with severe acute respiratory syndrome coronavirus 2 show distinct symptoms ranging from asymptomatic or mild infection to fatal disease. Moreover, this virus not only provokes an acute inflammatory response but could also cause a range of persistent symptoms after the phase of acute infection. The National Institute for Health and Care Excellence defines this phenomenon as long COVID.¹ Currently, there is no definite definition of long COVID. However, the basic argument, that patients who have recovered from acute infection present with persistent symptoms that cannot be explained by another diagnosis beyond 3–4 weeks postinfection, remains the same. Academic publications have estimated that 10%–20% of patients with COVID-19 have some complaints after COVID-19.²

Most patients with COVID-19 present with respiratory dysfunction, fatigue, and psychological disorders during and after acute infection, and their lives are greatly affected. Under this circumstance, pulmonary rehabilitation (PR) has become a powerful weapon to deal with those symptoms in the context of quantities of evidence of its efficiency.³ However, restricting quarantine to minimize viral spread may limit the utility of conventional PR programs. Thus, new techniques and innovative programs or approaches must be discussed and estimated. In this case, we could obtain a more comprehensive and critical perspective on the frontiers of medicine.

The pandemic necessitated a transformation of traditional PR. More physiotherapists have begun to move their attention from face-to-face to remote rehabilitation and evaluate its accessibility and safety. Remote rehabilitation, also named telerehabilitation, involves various techniques and could eliminate the limitations of distance. The techniques range from cell phone messages to videoconferencing and Internet platforms. It may not only provide more access to PR but also help maintain the original outcomes of traditional PR.

Accordingly, it facilitates many new techniques to conduct home-based assessments to guarantee the safety of PR and improve the prescription of PR programs. During the pandemic, artificial intelligence (AI) technology has been used to support diagnosis, treatment and vaccine discovery, epidemiological modeling, patient outcome–related tasks, and infodemiology.^{4, 5} Currently, an increasing number of AI or robotic technologies are used to provide training to students and healthcare professionals, find appropriate remote rehabilitation approaches, and implement a standard PR program.

Initially, the environment and asses

Cellular immunotherapy harnesses the body's own immune system to fight cancer by using engineered T cells, macrophages, or natural killer (NK) cells. Compared to chimeric antigen receptor T (CAR-T) cells that are commonly used to treat hematological malignancies, CAR-NK cells have shown remarkable therapeutic effectiveness while exhibiting enhanced safety, reduced risk of graft-versus-host disease, fewer side effects, and amplified antitumor efficacy. Preclinical trials have unveiled the high potential of adoptive CAR-NK cell therapy to curtail or even eliminate both hematological malignancies and solid tumors in animal models. We brought forth herein the design principle of CAR-NK cells, highlighted the latest progress in the preclinical testing and clinical trials of CAR-NK cells, briefly delved into discussed major roadblocks in CAR-NK therapy, and discussed potential solutions to surmount these challenges. Given the accelerated progress in both basic and translational studies on immune cell engineering, CAR-NK cell therapy promises to become a serious contender and important addition to the next-generation cell-based immunotherapy.