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Długotrwała korzyść kliniczna z zastosowania pembrolizumabu u chorego na niedrobnokomórkowego raka płuca z niską ekspresją PD-L1 (< 1%)
No full textPomimo postępu w leczeniu niedrobnokomórkowego raka płuca (NDRP), rokowanie chorych z późno wykrytąchorobą nowotworową w stopniu IV zaawansowania pozostaje niekorzystne. Immunoterapia znajduje zastosowaniew leczeniu nowotworów od ponad dekady — z upływem czasu coraz lepiej rozumiane są możliwości wykorzystaniajej potencjału oraz sposoby jego zwiększania poprzez skojarzenie z konwencjonalną chemioterapiąi radioterapią. W niniejszej pracy przedstawiono przypadek chorego z niską ekspresją PD-1, u którego uzyskanodługotrwałą korzyść kliniczną z leczenia pembrolizumabem. Pokrótce omówiono również potencjalne mechanizmyzwiększenia skuteczności immunoterapii w wyniku skojarzenia jej z chemioterapią i radioterapią
Clinical and immunological features of bullous pemphigoid: A single-centre retrospective study
No full textBackground: Bullous pemphigoid (BP) is an autoimmune blistering disorder predominantly affecting the elderly. This study aimed to characterize the clinical and immunological profiles of BP patients diagnosed in a single dermatology unit over a 10-year period.
Material and methods: A retrospective analysis was conducted on 19 patients with confirmed BP, based on clinical criteria, direct immunofluorescence (DIF), and detection of circulating autoantibodies via indirect immunofluorescence (IIF). ELISA or biochip assays were not available. Clinical data, histopathological findings, and serological correlations were analyzed.
Results: The predominant DIF pattern was co-deposition of IgG, IgA, and complement component 3 (C3) (68.4%). Two patients exhibited IgA and C3 deposition without IgG, raising the possibility of linear IgA bullous dermatosis (LABD), though clinical features did not warrant reclassification. A statistically significant association was observed between BP180 autoantibody positivity and both type 2 diabetes and amlodipine use.
Conclusions: This study highlights an atypically high prevalence of IgA deposits in BP tissue and supports the potential link between calcium channel blockers — especially amlodipine — and BP180 autoantibody development. Limitations include the small cohort size, retrospective design, and lack of ELISA testing. Further multicenter studies are needed to validate these findings and explore immunological variants of BP
Electroacupuncture ameliorates depressive-like behaviors by activating Sirt1 to enhance oligodendrocyte differentiation and myelination in the prefrontal cortex of rats
No full textIntroduction. This study investigated the therapeutic mechanisms of electroacupuncture (EA) in chronic unpredictable stress (CUS)-induced depression rat model. Since SIRT1 plays in oligodendrocyte differentiation and neuroprotection, we hypothesize that it may mediate the effect of electroacupuncture (EA) on myelin regeneration in depression.
Material and methods. Sixty adult male Sprague-Dawley rats were divided into control, CUS, EA + CUS and CUS + EA + SIRT1-specific inhibitor — EX527 (EX) groups. We established a CUS-induced depression rat model by subjecting rats to 4-week CUS paradigm. Four weeks post-modeling, EA treatment and intraperitoneal administration of EX527 were applied. Behavioral tests including open field test, forced swim test and sucrose preference test were performed to assess the depressive-like state. Immunohistochemistry and stereological analysis for quantification of oligodendroglial cell populations was performed. Immunohistochemical staining and transmission electron microscope were performed for evaluation of myelination. Western blot and qRT-PCR analyses were performed to detect the mRNA and protein expression of SIRT1 in the prefrontal cortex (PFC) of rats in each group.
Results. Four weeks of EA intervention significantly alleviated depressive-like behaviors in CUS rats, as evidenced by increased sucrose preference (P < 0.05), enhanced exploratory activity (P < 0.01), and reduced immobility time (P < 0.05) compared to the CUS group. Histopathological and ultrastructural analyses demonstrated that EA restored myelin integrity in the PFC, with myelin basic protein immunoreactivity significantly higher in the EA+CUS group than in untreated CUS rats (P < 0.05). Electroacupuncture promoted oligodendrocyte differentiation, reversing the chronic stress-induced reduction in CC1+/Olig2+/BrdU+ progenitor cells (31.5 ± 3.1% vs. 3.23 ± 1.4% in CUS + EA + EX group, P < 0.01). Mechanistically, EA upregulated SIRT1 mRNA and protein expression in the PFC (P < 0.05 vs. CUS), while pharmacological inhibition of Sirt1 with EX-527 abolished these effects, reducing Sirt1 mRNA and SIRT1 protein expression (P < 0.01, P < 0.01, respectively) and Olig2 expression (P < 0.05). EX-527 treatment also blocked EA-induced behavioral improvements and myelin regeneration, confirming the critical role of the Sirt1.
Conclusions. The findings indicate that EA ameliorates depression-like behavior by enhancing oligodendrocyte maturation and myelin repair via activating SIRT1 signaling. These findings provide novel mechanistic insights into non-pharmacological interventions for depression
A protocol of ‘A post-market national POLish registry of biological prostheses with RESilia tissue (POLRES)’
No full textHoarseness caused by aneurysmal central pulmonary artery secondary to a giant patent ductus arteriosus associated with Eisenmenger’s syndrome
No full textCirculating microRNA-1 as a diagnostic biomarker for acute myocardial infarction: a meta-analysis
No full textBackground: The aim of this study was to evaluate the diagnostic performance of microRNA-1 in the diagnosis of acute myocardial infarction (AMI).
Methods: PubMed, Embase, Cochrane, Web of science and CNKI databases were searched by computer to collect English literature evaluating the diagnostic value of microRNA-1 in AMI patients. The retrieval period is from the establishment of the database to September 2023. Two researchers independently screened the literature according to inclusion and exclusion criteria, extracted data, and evaluated the risk of bias in the included studies using QUADAS-2 tools. Stata15.0 software was used for meta-analysis. The combined sensitivity, specificity, positive likelihood ratio, negative likelihoodratio, diagnostic odds ratio, and area under the summary receiver operator characteristic (SROC) curve were calculated.
Results: This study included 11 pieces of literature, which included 894 patients with AMI and 600 controls. The main results of meta-analysis were as follows: The pooled sensitivity and specificity of microRNA-1 for the diagnosis of AMI were 78% (95% CI: 0.69–0.85) and 85% (95% CI: 0.76–0.91), respectively, the positive likelihood ratio was 5.1 (95%CI: 3.0–8.6), the negative likelihood ratio was 0.26 (95% CI: 0.17–0.38), the diagnostic odds ratio was 20 (95% CI: 9–47), and the area under the SROC curve (AUC) was 88% (95% CI: 0.85–0.91).
Conclusions: Plasma microRNA-1 has high sensitivity and specificity for early AMI, and has certain diagnostic value, which can help distinguish AMI from patients with other systemic diseases, and can be combined with other biomarkers to diagnose AMI
Diagnosis of Graves’ orbitopathy: imaging methods, challenges, and new perspectives
No full textPrecise assessment of Graves` orbitopathy (GO) predicts therapeutic strategies. Various imaging techniques and different measurement methods are used, but there is a lack of standardization. Traditionally, the Clinical Activity Score (CAS) has been used for assessing GO, especially for evaluating disease activity to predict response to glucocorticoid (GC) therapy, but technological developments have led to a shift towards more objective imaging methods that offer accuracy. Imaging methods for Graves' orbitopathy assessment include ultrasonography (USG), computed tomography (CT), magnetic resonance imaging (MRI), and single photon emission computed tomography(SPECT). These can be divided into those that assess disease activity (MRI, SPECT) and those that assess disease severity (USG, CT, MRI, SPECT). USG is the accessible first-aid tool that provides non-invasive imaging of orbital structures, with a short time of examination making it highly suitable for initial evaluation and monitoring of GO. It does have limitations, particularly in visualizing the apex of the orbit. Initially, orbital CT was thought to provide more accurate morphological information, particularly in extraocular muscles, and superior visualization of bone structures compared to MRI, making it the imaging modality of choice prior to planned orbital decompression; however, it has difficulty in accurately assessing the inflammatory activity stages of GO. Although CT offers a better view of deeper-lying tissue, it is limited by radiation exposure. MRI is best suited for follow-up examinations because it offers superior soft tissue visualization and precise tissue differentiation. However, it is not specific for orbital changes, the examination is very expensive, and it is rarely available. Recent literature proposes that nuclear medicine imaging techniques may be the best discipline for assessing GO. SPECT fused with low-dose CT scans is now used to increase the diagnostic value of the investigation. It provides functional information on top of the anatomical images. The use of cost-effective radioisotope — technetium-99m (99mTc)-DTPA — gives great diagnostic results with short examination time, low radiation exposure, and satisfactory spatial resolution.
Nowadays, 36 years after CAS development and with technological improvement, researchers aim to integrate artificial intelligence tools with SPECT/CT imaging to diagnose and stage GO activity more effectively