Pub Date : 2024-06-01DOI: 10.1016/j.bj.2023.100653
Yu-Chung Hsiao , Thung-Lip Lee , Fang-Ju Lin , Chin-Feng Hsuan , Chih-Fan Yeh , Wei-Tien Chang , Hsien-Li Kao , Jiann-Shing Jeng , Yen-Wen Wu , I-Chang Hsieh , Ching-Chang Fang , Kuo-Yang Wang , Kuan-Cheng Chang , Tsung-Hsien Lin , Wayne Huey-Herng Sheu , Yi-Heng Li , Wei-Hsian Yin , Hung-I Yeh , Jaw-Wen Chen , Chau-Chung Wu
Background
This study aimed to evaluate the performance of a modified U.S. (MUS) model for risk prediction of cardiovascular (CV) events in Asian patients and compare it to European and Japanese models.
Methods
The MUS model, based on the US ACC/AHA 2018 lipid treatment guideline, was employed to stratify patients under primary or secondary prevention. Two multi-center prospective observational registry cohorts, T-SPARCLE and T-PPARCLE, were used to validate the scoring system, and the primary outcome was the time to first occurrence/recurrence of major adverse cardiac events (MACEs). The MUS model's performance was compared to other models from Europe and Japan.
Results
A total of 10,733 patients with the mean age of 64.2 (SD: 11.9) and 36.5% female were followed up for a median of 5.4 years. The MUS model was validated, with an AUC score of 0.73 (95% CI 0.68–0.78). The European and Japanese models had AUC scores ranging from 0.6 to 0.7. The MUS model categorized patients into four distinct CV risk groups, with hazard ratios (HRs) as follows: very high- vs. high-risk group (HR = 1.91, 95% CI 1.53–2.39), high- vs. moderate-risk group (HR = 2.08, 95% CI 1.60–2.69), and moderate- vs. low-risk group (HR = 3.14, 95% CI 1.63–6.03). After adjusting for the MUS model, a history of atherosclerotic vascular disease (ASCVD) was not a significant predictor of adverse cardiovascular outcomes within each risk group.
Conclusion
The MUS model is an effective tool for risk stratification in Asian patients with and without ASCVD, accurately predicting MACEs and performing comparably or better than other established risk models. Our findings suggest that patient management should focus on background risk factors instead of solely on primary or secondary prevention.
背景:本研究旨在评估改良美国(MUS)模型在预测亚洲患者心血管事件风险方面的性能,并将其与欧洲和日本模型进行比较:本研究旨在评估改良的美国(MUS)模型在预测亚洲患者心血管(CV)事件风险方面的性能,并将其与欧洲和日本的模型进行比较:方法:根据美国 ACC/AHA 2018 年血脂治疗指南,采用 MUS 模型对一级或二级预防患者进行分层。两个多中心前瞻性观察登记队列(T-SPARCLE 和 T-PPARCLE)用于验证该评分系统,主要结果是首次发生/再次发生重大心脏不良事件(MACE)的时间。MUS 模型的性能与欧洲和日本的其他模型进行了比较:共对 10,733 名患者进行了中位数为 5.4 年的随访,这些患者的平均年龄为 64.2 岁(SD:11.9),36.5% 为女性。毛里求斯模型得到了验证,AUC 得分为 0.73(95% CI 0.68-0.78)。欧洲和日本模型的 AUC 得分为 0.6 至 0.7。MUS 模型将患者分为四个不同的 CV 风险组,其危险比(HRs)如下:极高风险组与高风险组(HR = 1.91,95% CI 1.53-2.39)、高风险组与中度风险组(HR = 2.08,95% CI 1.60-2.69)、中度风险组与低风险组(HR = 3.14,95% CI 1.63-6.03)。在对MUS模型进行调整后,动脉粥样硬化性血管疾病(ASCVD)病史不是各风险组不良心血管结局的重要预测因素:MUS模型是对伴有或不伴有ASCVD的亚洲患者进行风险分层的有效工具,它能准确预测MACEs,其表现与其他已建立的风险模型相当或更好。我们的研究结果表明,患者管理的重点应放在背景风险因素上,而不是仅仅关注一级或二级预防。
{"title":"A risk stratification model modified from the U.S. guideline could be applied in an Asian population with or without ASCVD: Validation study","authors":"Yu-Chung Hsiao , Thung-Lip Lee , Fang-Ju Lin , Chin-Feng Hsuan , Chih-Fan Yeh , Wei-Tien Chang , Hsien-Li Kao , Jiann-Shing Jeng , Yen-Wen Wu , I-Chang Hsieh , Ching-Chang Fang , Kuo-Yang Wang , Kuan-Cheng Chang , Tsung-Hsien Lin , Wayne Huey-Herng Sheu , Yi-Heng Li , Wei-Hsian Yin , Hung-I Yeh , Jaw-Wen Chen , Chau-Chung Wu","doi":"10.1016/j.bj.2023.100653","DOIUrl":"10.1016/j.bj.2023.100653","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to evaluate the performance of a modified U.S. (MUS) model for risk prediction of cardiovascular (CV) events in Asian patients and compare it to European and Japanese models.</p></div><div><h3>Methods</h3><p>The MUS model, based on the US ACC/AHA 2018 lipid treatment guideline, was employed to stratify patients under primary or secondary prevention. Two multi-center prospective observational registry cohorts, T-SPARCLE and T-PPARCLE, were used to validate the scoring system, and the primary outcome was the time to first occurrence/recurrence of major adverse cardiac events (MACEs). The MUS model's performance was compared to other models from Europe and Japan.</p></div><div><h3>Results</h3><p>A total of 10,733 patients with the mean age of 64.2 (SD: 11.9) and 36.5% female were followed up for a median of 5.4 years. The MUS model was validated, with an AUC score of 0.73 (95% CI 0.68–0.78). The European and Japanese models had AUC scores ranging from 0.6 to 0.7. The MUS model categorized patients into four distinct CV risk groups, with hazard ratios (HRs) as follows: very high- vs. high-risk group (HR = 1.91, 95% CI 1.53–2.39), high- vs. moderate-risk group (HR = 2.08, 95% CI 1.60–2.69), and moderate- vs. low-risk group (HR = 3.14, 95% CI 1.63–6.03). After adjusting for the MUS model, a history of atherosclerotic vascular disease (ASCVD) was not a significant predictor of adverse cardiovascular outcomes within each risk group.</p></div><div><h3>Conclusion</h3><p>The MUS model is an effective tool for risk stratification in Asian patients with and without ASCVD, accurately predicting MACEs and performing comparably or better than other established risk models. Our findings suggest that patient management should focus on background risk factors instead of solely on primary or secondary prevention.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417023000902/pdfft?md5=6e47c31c0ef3fb72396469975665e92e&pid=1-s2.0-S2319417023000902-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.bj.2024.100755
Aila Akosua Kattner
This issue of the Biomedical Journal features a special section exploring mycobiota. Three articles examine the role of fungi in common metabolic disorders in, Clostridium difficile infection, and in immunocompromised patients. Additionally, the potential and challenges of the metaverse in healthcare are reviewed, alongside a holistic approach to improve patient outcomes in pancreatic cancer. In this issue also possible mechanism contributing to long COVID are discussed, as well as biomarkers that effectively predict sepsis outcomes, and key targets in osteosarcoma progression. Moreover, factors leading to peri-intubation cardiac arrest are analyzed, healthcare strategies from various regions are employed to predict cardiovascular events in Asian populations, two approaches to cavernous sinus dural arteriovenous fistula are compared, and a combination therapy against soft tissue sarcoma is presented.
{"title":"And those who were seen dancing: Human interactions with fungi and vice versa","authors":"Aila Akosua Kattner","doi":"10.1016/j.bj.2024.100755","DOIUrl":"10.1016/j.bj.2024.100755","url":null,"abstract":"<div><p>This issue of the Biomedical Journal features a special section exploring mycobiota. Three articles examine the role of fungi in common metabolic disorders in, <em>Clostridium difficile</em> infection, and in immunocompromised patients. Additionally, the potential and challenges of the metaverse in healthcare are reviewed, alongside a holistic approach to improve patient outcomes in pancreatic cancer. In this issue also possible mechanism contributing to long COVID are discussed, as well as biomarkers that effectively predict sepsis outcomes, and key targets in osteosarcoma progression. Moreover, factors leading to peri-intubation cardiac arrest are analyzed, healthcare strategies from various regions are employed to predict cardiovascular events in Asian populations, two approaches to cavernous sinus dural arteriovenous fistula are compared, and a combination therapy against soft tissue sarcoma is presented.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417024000581/pdfft?md5=ecf4adc910ccd70d8ca8af07fd7ce50b&pid=1-s2.0-S2319417024000581-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.bj.2023.100632
Background
Biomarker dynamics in different time-courses might be the primary reason why a static measurement of a single biomarker cannot accurately predict sepsis outcomes. Therefore, we conducted this prospective hospital-based cohort study to simultaneously evaluate the performance of several conventional and novel biomarkers of sepsis in predicting sepsis-associated mortality on different days of illness among patients with suspected sepsis.
Methods
We evaluated the performance of 15 novel biomarkers including angiopoietin-2, pentraxin 3, sTREM-1, ICAM-1, VCAM-1, sCD14 and 163, E-selectin, P-selectin, TNF-alpha, interferon-gamma, CD64, IL-6, 8, and 10, along with few conventional markers for predicting sepsis-associated mortality. Patients were grouped into quartiles according to the number of days since symptom onset. Receiver operating characteristic curve (ROC) analysis was used to evaluate the biomarker performance.
Results
From 2014 to 2017, 1483 patients were enrolled, of which 78% fulfilled the systemic inflammatory response syndrome criteria, 62% fulfilled the sepsis-3 criteria, 32% had septic shock, and 3.3% developed sepsis-associated mortality. IL-6, pentraxin 3, sCD163, and the blood gas profile demonstrated better performance in the early days of illness, both before and after adjusting for potential confounders (adjusted area under ROC curve [AUROC]:0.81–0.88). Notably, the Sequential Organ Failure Assessment (SOFA) score was relatively consistent throughout the course of illness (adjusted AUROC:0.70–0.91).
Conclusion
IL-6, pentraxin 3, sCD163, and the blood gas profile showed excellent predictive accuracy in the early days of illness. The SOFA score was consistently predictive of sepsis-associated mortality throughout the course of illness, with an acceptable performance.
{"title":"Using time-course as an essential factor to accurately predict sepsis-associated mortality among patients with suspected sepsis","authors":"","doi":"10.1016/j.bj.2023.100632","DOIUrl":"10.1016/j.bj.2023.100632","url":null,"abstract":"<div><h3>Background</h3><p>Biomarker dynamics in different time-courses might be the primary reason why a static measurement of a single biomarker cannot accurately predict sepsis outcomes. Therefore, we conducted this prospective hospital-based cohort study to simultaneously evaluate the performance of several conventional and novel biomarkers of sepsis in predicting sepsis-associated mortality on different days of illness among patients with suspected sepsis.</p></div><div><h3>Methods</h3><p>We evaluated the performance of 15 novel biomarkers including angiopoietin-2, pentraxin 3, sTREM-1, ICAM-1, VCAM-1, sCD14 and 163, E-selectin, P-selectin, TNF-alpha, interferon-gamma, CD64, IL-6, 8, and 10, along with few conventional markers for predicting sepsis-associated mortality. Patients were grouped into quartiles according to the number of days since symptom onset. Receiver operating characteristic curve (ROC) analysis was used to evaluate the biomarker performance.</p></div><div><h3>Results</h3><p>From 2014 to 2017, 1483 patients were enrolled, of which 78% fulfilled the systemic inflammatory response syndrome criteria, 62% fulfilled the sepsis-3 criteria, 32% had septic shock, and 3.3% developed sepsis-associated mortality. IL-6, pentraxin 3, sCD163, and the blood gas profile demonstrated better performance in the early days of illness, both before and after adjusting for potential confounders (adjusted area under ROC curve [AUROC]:0.81–0.88). Notably, the Sequential Organ Failure Assessment (SOFA) score was relatively consistent throughout the course of illness (adjusted AUROC:0.70–0.91).</p></div><div><h3>Conclusion</h3><p>IL-6, pentraxin 3, sCD163, and the blood gas profile showed excellent predictive accuracy in the early days of illness. The SOFA score was consistently predictive of sepsis-associated mortality throughout the course of illness, with an acceptable performance.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417023000690/pdfft?md5=8c7ed27e8824475c4fc37be363f94c91&pid=1-s2.0-S2319417023000690-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Given the heterogeneity and high mortality associated with metastatic soft tissue sarcoma, this study aims to evaluate the therapeutic efficacy of combining 177Lu-FAPI-46 with Pazopanib against this malignancy.
Methods
Patient-derived xenograft (PDX)-bearing mice were randomly divided into three groups: the control group, the 177Lu-FAPI-46 monotherapy group, and the 177Lu-FAPI-46 combined with Pazopanib therapy group. Therapeutic efficacy was regularly monitored.
Results
The microPET imaging showed a 0.84-fold decrease in the T/M ratio of 68Ga-FAPI-46 on day 7/8 post combination therapy, while the control group exhibited a 1.23-fold increase. Combination therapy significantly inhibited tumor proliferation, as evidenced by reduced Ki-67 and increased caspase 3 expressions. Notably, there was no significant body weight loss observed in any group.
Conclusion
This study successfully demonstrated the reduction in FAP expression and suppression of tumor volume in sarcoma PDX following the combination therapy of 177Lu-FAPI-46 with Pazopanib.
{"title":"The synergy of 177Lu-FAPI-46 with tyrosine kinase inhibitor in a sarcoma patient-derived xenograft mouse model","authors":"Jing-Ren Tseng , Cheng-Lung Hsu , Hsin-Hua Hsieh , Kung-Chu Ho , Yi-Hsiu Chung , Chun-Yi Wu","doi":"10.1016/j.bj.2024.100744","DOIUrl":"10.1016/j.bj.2024.100744","url":null,"abstract":"<div><h3>Background</h3><p>Given the heterogeneity and high mortality associated with metastatic soft tissue sarcoma, this study aims to evaluate the therapeutic efficacy of combining <sup>177</sup>Lu-FAPI-46 with Pazopanib against this malignancy.</p></div><div><h3>Methods</h3><p>Patient-derived xenograft (PDX)-bearing mice were randomly divided into three groups: the control group, the <sup>177</sup>Lu-FAPI-46 monotherapy group, and the <sup>177</sup>Lu-FAPI-46 combined with Pazopanib therapy group. Therapeutic efficacy was regularly monitored.</p></div><div><h3>Results</h3><p>The microPET imaging showed a 0.84-fold decrease in the T/M ratio of 68Ga-FAPI-46 on day 7/8 post combination therapy, while the control group exhibited a 1.23-fold increase. Combination therapy significantly inhibited tumor proliferation, as evidenced by reduced Ki-67 and increased caspase 3 expressions. Notably, there was no significant body weight loss observed in any group.</p></div><div><h3>Conclusion</h3><p>This study successfully demonstrated the reduction in FAP expression and suppression of tumor volume in sarcoma PDX following the combination therapy of <sup>177</sup>Lu-FAPI-46 with Pazopanib.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417024000477/pdfft?md5=d699bc1c7097a9fd7425c027312f9a35&pid=1-s2.0-S2319417024000477-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.bj.2023.100679
Yong Li , Dinesh Visva Gunasekeran , Narrendar RaviChandran , Ting Fang Tan , Jasmine Chiat Ling Ong , Arun James Thirunavukarasu , Bryce W. Polascik , Ranya Habash , Khizer Khaderi , Daniel S.W. Ting
The Metaverse has gained wide attention for being the application interface for the next generation of Internet. The potential of the Metaverse is growing, as Web 3·0 development and adoption continues to advance medicine and healthcare. We define the next generation of interoperable healthcare ecosystem in the Metaverse. We examine the existing literature regarding the Metaverse, explain the technology framework to deliver an immersive experience, along with a technical comparison of legacy and novel Metaverse platforms that are publicly released and in active use. The potential applications of different features of the Metaverse, including avatar-based meetings, immersive simulations, and social interactions are examined with different roles from patients to healthcare providers and healthcare organizations. Present challenges in the development of the Metaverse healthcare ecosystem are discussed, along with potential solutions including capabilities requiring technological innovation, use cases requiring regulatory supervision, and sound governance. This proposed concept and framework of the Metaverse could potentially redefine the traditional healthcare system and enhance digital transformation in healthcare. Similar to AI technology at the beginning of this decade, real-world development and implementation of these capabilities are relatively nascent. Further pragmatic research is needed for the development of an interoperable healthcare ecosystem in the Metaverse.
{"title":"The next generation of healthcare ecosystem in the metaverse","authors":"Yong Li , Dinesh Visva Gunasekeran , Narrendar RaviChandran , Ting Fang Tan , Jasmine Chiat Ling Ong , Arun James Thirunavukarasu , Bryce W. Polascik , Ranya Habash , Khizer Khaderi , Daniel S.W. Ting","doi":"10.1016/j.bj.2023.100679","DOIUrl":"10.1016/j.bj.2023.100679","url":null,"abstract":"<div><p>The Metaverse has gained wide attention for being the application interface for the next generation of Internet. The potential of the Metaverse is growing, as Web 3·0 development and adoption continues to advance medicine and healthcare. We define the next generation of interoperable healthcare ecosystem in the Metaverse. We examine the existing literature regarding the Metaverse, explain the technology framework to deliver an immersive experience, along with a technical comparison of legacy and novel Metaverse platforms that are publicly released and in active use. The potential applications of different features of the Metaverse, including avatar-based meetings, immersive simulations, and social interactions are examined with different roles from patients to healthcare providers and healthcare organizations. Present challenges in the development of the Metaverse healthcare ecosystem are discussed, along with potential solutions including capabilities requiring technological innovation, use cases requiring regulatory supervision, and sound governance. This proposed concept and framework of the Metaverse could potentially redefine the traditional healthcare system and enhance digital transformation in healthcare. Similar to AI technology at the beginning of this decade, real-world development and implementation of these capabilities are relatively nascent. Further pragmatic research is needed for the development of an interoperable healthcare ecosystem in the Metaverse.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417023001166/pdfft?md5=63258882a2d39f807c8d3144e43e3bf2&pid=1-s2.0-S2319417023001166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138481833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.bj.2024.100719
Dorra Elhaj Mahmoud , Anaïs Hérivaux , Florent Morio , Benoit Briard , Cécile Vigneau , Guillaume Desoubeaux , Jean-Philippe Bouchara , Jean-Pierre Gangneux , Gilles Nevez , Solène Le Gal , Nicolas Papon
Transplant patients, including solid-organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, are exposed to various types of complications, particularly rejection. To prevent these outcomes, transplant recipients commonly receive long-term immunosuppressive regimens that in turn make them more susceptible to a wide array of infectious diseases, notably those caused by opportunistic pathogens. Among these, invasive fungal infections (IFIs) remain a major cause of mortality and morbidity in both SOT and HSCT recipients. Despite the continuing improvement in early diagnostics and treatments of IFIs, the management of these infections in transplant patients is still complicated. Here, we provide an overview concerning the most recent trends in the epidemiology of IFIs in SOT and HSCT recipients by describing the prominent yeast and mold species involved, the timing of post-transplant IFIs and the risk factors associated with their occurrence in these particularly weak populations. We also give special emphasis into basic research advances in the field that recently suggested a role of the global and long-term prophylactic regimen in orchestrating various biological disturbances in the organism and conditioning the emergence of the most adapted fungal strains to the particular physiological profiles of transplant patients.
移植患者,包括实体器官移植(SOT)和造血干细胞移植(HSCT)受者,会面临各种类型的并发症,尤其是排斥反应。为了预防这些后果,移植受者通常要接受长期的免疫抑制治疗,这反过来又使他们更容易感染各种传染病,尤其是由机会性病原体引起的传染病。其中,侵袭性真菌感染(IFI)仍然是导致SOT和造血干细胞移植受者死亡和发病的主要原因。尽管侵袭性真菌感染的早期诊断和治疗方法不断改进,但移植患者的感染管理仍然十分复杂。在此,我们概述了 SOT 和造血干细胞移植受者 IFI 流行病学的最新趋势,介绍了其中主要涉及的酵母和霉菌种类、移植后 IFI 的发生时间以及在这些特别脆弱的人群中发生 IFI 的相关风险因素。我们还特别强调了该领域的基础研究进展,这些研究最近提出,全面和长期的预防性治疗方案在协调机体内的各种生物紊乱和调节最适应移植患者特殊生理特征的真菌菌株的出现方面发挥了作用。
{"title":"The epidemiology of invasive fungal infections in transplant recipients","authors":"Dorra Elhaj Mahmoud , Anaïs Hérivaux , Florent Morio , Benoit Briard , Cécile Vigneau , Guillaume Desoubeaux , Jean-Philippe Bouchara , Jean-Pierre Gangneux , Gilles Nevez , Solène Le Gal , Nicolas Papon","doi":"10.1016/j.bj.2024.100719","DOIUrl":"10.1016/j.bj.2024.100719","url":null,"abstract":"<div><p>Transplant patients, including solid-organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, are exposed to various types of complications, particularly rejection. To prevent these outcomes, transplant recipients commonly receive long-term immunosuppressive regimens that in turn make them more susceptible to a wide array of infectious diseases, notably those caused by opportunistic pathogens. Among these, invasive fungal infections (IFIs) remain a major cause of mortality and morbidity in both SOT and HSCT recipients. Despite the continuing improvement in early diagnostics and treatments of IFIs, the management of these infections in transplant patients is still complicated. Here, we provide an overview concerning the most recent trends in the epidemiology of IFIs in SOT and HSCT recipients by describing the prominent yeast and mold species involved, the timing of post-transplant IFIs and the risk factors associated with their occurrence in these particularly weak populations. We also give special emphasis into basic research advances in the field that recently suggested a role of the global and long-term prophylactic regimen in orchestrating various biological disturbances in the organism and conditioning the emergence of the most adapted fungal strains to the particular physiological profiles of transplant patients.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417024000222/pdfft?md5=c62b435bdbb421652262813ad375b8f3&pid=1-s2.0-S2319417024000222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.bj.2023.100686
Lamei Wang , Yangchun Cao , Eddie Lou , Xuanyin Zhao , Xinhua Chen
Clostridioides difficile, the etiological agent of C. difficile infection (CDI), elicits a spectrum of diarrheal symptoms with varying severity and the potential to result in severe complications such as colonic perforation, pseudomembranous colitis, and toxic megacolon. The perturbation of gut microbiome, often triggered by antibiotic usage, represents the primary factor augmenting the risk of CDI. This underscores the significance of interactions between C. difficile and the microbiome in determining pathogen adaptability. In recent years, researchers have increasingly recognized the pivotal role played by intestinal microbiota in host health and its therapeutic potential as a target for medical interventions. While extensive evidence has been established regarding the involvement of gut bacteria in CDI, our understanding of symbiotic interactions between hosts and fungi within intestinal microbiota remains limited. Herein, we aim to comprehensively elucidate both composition and key characteristics of gut fungal communities that significantly contribute to CDI, thereby enhancing our comprehension from pharmacological and biomarker perspectives while exploring their prospective therapeutic applications for CDI.
{"title":"The role of gut fungi in Clostridioides difficile infection","authors":"Lamei Wang , Yangchun Cao , Eddie Lou , Xuanyin Zhao , Xinhua Chen","doi":"10.1016/j.bj.2023.100686","DOIUrl":"10.1016/j.bj.2023.100686","url":null,"abstract":"<div><p><em>Clostridioides difficile,</em> the etiological agent of <em>C. difficile</em> infection (CDI), elicits a spectrum of diarrheal symptoms with varying severity and the potential to result in severe complications such as colonic perforation, pseudomembranous colitis, and toxic megacolon. The perturbation of gut microbiome, often triggered by antibiotic usage, represents the primary factor augmenting the risk of CDI. This underscores the significance of interactions between <em>C. difficile</em> and the microbiome in determining pathogen adaptability. In recent years, researchers have increasingly recognized the pivotal role played by intestinal microbiota in host health and its therapeutic potential as a target for medical interventions. While extensive evidence has been established regarding the involvement of gut bacteria in CDI, our understanding of symbiotic interactions between hosts and fungi within intestinal microbiota remains limited. Herein, we aim to comprehensively elucidate both composition and key characteristics of gut fungal communities that significantly contribute to CDI, thereby enhancing our comprehension from pharmacological and biomarker perspectives while exploring their prospective therapeutic applications for CDI.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417023001233/pdfft?md5=ab1964fe39db322a5608165ba1e185d8&pid=1-s2.0-S2319417023001233-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138573591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.bj.2024.100751
Parvati Iyer , David M. Ojcius
The microbiota and its effect on health has been extensively studied over the past decade. In many studies, the term microbiota has become synonymous with the bacterial component of the microbiota. Other microbes in the microbiota, such as viruses and fungi, have been neglected until recently. This special issue provides some background on the mycobiota and explores the role of gut fungi in human diseases such as cancer, metabolic diseases, and infection by Clostridiodes difficile, and describes the incidence of fungal infections in transplant patients. The mycobiota, once overlooked, now garners increasing attention.
{"title":"Unveiling the mycobiota: The fungal frontier of human health","authors":"Parvati Iyer , David M. Ojcius","doi":"10.1016/j.bj.2024.100751","DOIUrl":"10.1016/j.bj.2024.100751","url":null,"abstract":"<div><p>The microbiota and its effect on health has been extensively studied over the past decade. In many studies, the term microbiota has become synonymous with the bacterial component of the microbiota. Other microbes in the microbiota, such as viruses and fungi, have been neglected until recently. This special issue provides some background on the mycobiota and explores the role of gut fungi in human diseases such as cancer, metabolic diseases, and infection by <em>Clostridiodes difficile</em>, and describes the incidence of fungal infections in transplant patients. The mycobiota, once overlooked, now garners increasing attention.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417024000544/pdfft?md5=b8b72f63c1e8a6b6abff43d343872727&pid=1-s2.0-S2319417024000544-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.bj.2023.100696
Pancreatic cancer is a highly aggressive malignancy with a poor prognosis. Over the past decade, significant therapeutic advancements have improved the survival rates of patients with pancreatic cancer. One of the primary factors contributing to these positive outcomes is the evolution of chemotherapy, from monotherapy to doublet or triplet regimens, and the integration of multimodal approaches. Additionally, targeted agents tailored to patients with specific genetic alterations and the development of cell therapies show promise in benefiting certain subpopulations. This article focuses on examining pivotal studies that explore the role of chemotherapy in neoadjuvant, adjuvant, maintenance, and salvage settings; highlights interesting findings related to cell therapy; and provides an overview of ongoing trials concerning metastatic settings. This review primarily aimed to offer recommendations based on therapeutic evidence, recent advancements in new treatment combinations, and the most innovative approaches. A unique aspect of this review is the inclusion of published papers on clinical trials and real-world data in Taiwan, thus adding a valuable perspective to the overall analysis.
{"title":"Systemic treatments in pancreatic cancer: Taiwan pancreas society recommendation","authors":"","doi":"10.1016/j.bj.2023.100696","DOIUrl":"10.1016/j.bj.2023.100696","url":null,"abstract":"<div><p>Pancreatic cancer is a highly aggressive malignancy with a poor prognosis. Over the past decade, significant therapeutic advancements have improved the survival rates of patients with pancreatic cancer. One of the primary factors contributing to these positive outcomes is the evolution of chemotherapy, from monotherapy to doublet or triplet regimens, and the integration of multimodal approaches. Additionally, targeted agents tailored to patients with specific genetic alterations and the development of cell therapies show promise in benefiting certain subpopulations. This article focuses on examining pivotal studies that explore the role of chemotherapy in neoadjuvant, adjuvant, maintenance, and salvage settings; highlights interesting findings related to cell therapy; and provides an overview of ongoing trials concerning metastatic settings. This review primarily aimed to offer recommendations based on therapeutic evidence, recent advancements in new treatment combinations, and the most innovative approaches. A unique aspect of this review is the inclusion of published papers on clinical trials and real-world data in Taiwan, thus adding a valuable perspective to the overall analysis.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417023001336/pdfft?md5=98f0e24d127c5118a2db9f2e906ba557&pid=1-s2.0-S2319417023001336-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139062201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-25DOI: 10.1016/j.bj.2024.100749
After transplantation of allogeneic tissues and organs, recognition by recipient T cells of donor MHC molecules initiates the pro-inflammatory adaptive immune response leading to allograft rejection. T cell allorecognition has long been known to be mediated via two distinct pathways: the direct pathway in which T cells recognize intact allogeneic MHC molecules displayed on donor cells and the indirect pathway whereby T cells recognize donor MHC peptides processed and presented by recipient antigen-presenting cells (APCs). It is believed that direct allorecognition is the driving force behind early acute allograft rejection while indirect allorecognition is involved in chronic allograft rejection, a progressive condition characterized by graft vasculopathy and tissue fibrosis. Recently, we and others have reported that after transplantation of allogeneic skin and organs, donor MHC molecules are transferred from donor cells to the host's APCs via trogocytosis or extracellular vesicles. Recipient APCs having captured donor MHC molecules can either present them to T cells in their intact form on their surface (semi-direct pathway) or the form of peptides bound to self-MHC molecules (indirect pathway). The present article provides an overview of recent studies evaluating the role of intercellular exchange of MHC molecules in T cell alloimmunity and its contribution to allograft rejection and tolerance.
异体组织和器官移植后,受体 T 细胞对供体 MHC 分子的识别会引发促炎性适应性免疫反应,导致异体移植排斥反应。长期以来,人们一直知道 T 细胞异体识别是通过两种不同的途径介导的:一种是直接途径,即 T 细胞识别供体细胞上显示的完整异体 MHC 分子;另一种是间接途径,即 T 细胞识别由受体抗原递呈细胞(APCs)处理和递呈的供体 MHC 肽。据认为,直接异体识别是早期急性异体移植排斥反应的驱动力,而间接异体识别则参与慢性异体移植排斥反应,这是一种以移植物血管病变和组织纤维化为特征的渐进性疾病。最近,我们和其他人报告说,异体皮肤和器官移植后,供体 MHC 分子会通过逆行细胞吞噬或细胞外囊泡从供体细胞转移到宿主的 APC。俘获了供体 MHC 分子的受体 APC 可将这些分子以完整形式(半直接途径)或与自身 MHC 分子结合的肽形式(间接途径)呈现给 T 细胞。本文概述了最近对细胞间交换 MHC 分子在 T 细胞异体免疫中的作用及其对异体移植物排斥和耐受的贡献进行评估的研究。
{"title":"Intercellular transfer of MHC molecules in T cell alloimmunity and allotransplantation","authors":"","doi":"10.1016/j.bj.2024.100749","DOIUrl":"10.1016/j.bj.2024.100749","url":null,"abstract":"<div><p>After transplantation of allogeneic tissues and organs, recognition by recipient T cells of donor MHC molecules initiates the pro-inflammatory adaptive immune response leading to allograft rejection. T cell allorecognition has long been known to be mediated via two distinct pathways: the <em>direct pathway</em> in which T cells recognize intact allogeneic MHC molecules displayed on donor cells and the <em>indirect pathway</em> whereby T cells recognize donor MHC peptides processed and presented by recipient antigen-presenting cells (APCs). It is believed that direct allorecognition is the driving force behind early acute allograft rejection while indirect allorecognition is involved in chronic allograft rejection, a progressive condition characterized by graft vasculopathy and tissue fibrosis. Recently, we and others have reported that after transplantation of allogeneic skin and organs, donor MHC molecules are transferred from donor cells to the host's APCs via trogocytosis or extracellular vesicles. Recipient APCs having captured donor MHC molecules can either present them to T cells in their intact form on their surface (<em>semi-direct pathway</em>) or the form of peptides bound to self-MHC molecules (indirect pathway). The present article provides an overview of recent studies evaluating the role of intercellular exchange of MHC molecules in T cell alloimmunity and its contribution to allograft rejection and tolerance.</p></div>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2319417024000520/pdfft?md5=5e97b85c45ffc848a6e45cd3bc7c9074&pid=1-s2.0-S2319417024000520-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}