Endometriosis affects ~ 10% of reproductive-age women yet its impact extends far beyond pelvic pain: accumulating epidemiologic and mechanistic data implicate endometriosis in systemic immunovascular dysfunction and elevated risk of arterial and venous thrombotic events. Current clinical paradigms treat reproductive disease, endocrine therapy, and thromboembolism as separate domains, overlooking how chronic lesion-level inflammation, iron-driven oxidative stress, and endothelial metabolic reprogramming interact with coagulation and immune effectors to determine embolic risk. Here we synthesize evidence that repetitive hemorrhage and iron overload prime endothelium and immune cells for a pro-coagulant state, that platelet–leukocyte crosstalk and neutrophil extracellular traps stabilize and protect thrombi from lysis, and that abrupt estrogen withdrawal (e.g., GnRH agonist therapy) may serve as a biologically meaningful second hit within a proposed mechanistic model, potentially promoting vascular destabilization in susceptible individuals. We propose the immunothrombotic continuum as a conceptual mechanistic framework, a systems-level framework in which inflammatory, redox, metabolic, and endocrine axes converge to produce emergent thrombotic vulnerability. This model prioritizes biomarker-guided phenotyping, dynamic surveillance during hormonal therapy, and mechanism-targeted prophylaxis, a translational roadmap for precision cardio-reproductive medicine aimed at preventing clinically meaningful embolic outcomes. Not applicable. Immunothrombotic continuum: Conceptualizes thrombotic risk as an emergent property of interacting inflammatory, redox, metabolic, and endocrine networks rather than isolated factors. Endothelial reprogramming as a therapeutic target: Highlights the endothelium as a dynamic integrator of chronic inflammation, iron-driven oxidative stress, and hormonal perturbation, enabling mechanism-guided interventions. Second-hit vulnerability framework: Frames abrupt estrogen withdrawal or endocrine therapy as a biologically significant “second hit” that unmasks pre-existing vascular priming, refining risk prediction. Personalized surveillance thresholds: Advocates adaptive biomarker trajectories, not single static values, to trigger therapy modification or prophylactic intervention. Cross-disease relevance: Positions lessons from endometriosis to inform thrombotic risk in autoimmune, chronic inflammatory, and reproductive-endocrine disorders with systemic vascular impact. Roadmap for precision cardio-reproductive medicine: Integrates mechanistic insights with biomarker-guided phenotyping and dynamic intervention strategies, defining a translational pipeline from molecular understanding to patient-tailored prophylaxis.
Abstract Background Quorum sensing (QS) in bioluminescent bacteria underpins bacterial cell-to-cell communication, but the global evolution of this field has not been comprehensively evaluated scientometrically. This study maps QS research in bioluminescent bacteria to assess its developmental trajectory, intellectual structure, collaboration networks, and emerging frontiers. Main body A comprehensive Scopus search yielded 1,470 original articles published between 1977 and 2025. After data cleaning and standardization, Bibliometrix/Biblioshiny and VOSviewer were used to analyse publication trends, citations, leading authors, institutions, journals, countries, co-authorship, keyword co-occurrence, thematic evolution, strategic thematic mapping, and multidimensional scaling. Publication output grew steadily, accelerating after 2006 and peaking in the early 2020s. The United States and China were the leading contributors, while Princeton University, Ghent University, and Bonnie L. Bassler were particularly influential. Research themes shifted from LuxI/LuxR signaling, bacterial luminescence, and autoinduction toward biofilm regulation, quorum quenching, antimicrobial discovery, aquaculture, microbial ecology, omics technologies, and systems biology. Collaboration became increasingly international and multidisciplinary. Conclusion This study provides the first comprehensive scientometric synthesis of QS research in bioluminescent bacteria, identifying key contributors, evolving knowledge structures, translational gaps, and emerging priorities for future research in microbial communication, biotechnology, environmental microbiology, and anti-virulence research.
The number of studies on nanoformulated tocotrienols is increasing and have been extensively researched for clinical applications. However, no comprehensive bibliometric analysis has been conducted in this field. Hence, this study aims to evaluate the bibliometric landscape of nanotocotrienol studies over the past 10 years. Web of Science and Scopus databases were utilised for the search from 1999 to February 2025. Research tools used in the analysis include ScientoPy for trend analysis, VOSviewer for visualizing research networks and Biblioshiny for mapping thematic evolution. The analysis focused on key bibliometric indicators of publication output, citation impact, and keyword co-occurrence patterns. Findings revealed a consistent upward trend in publications with major contributions from China (72), the United States (60), and India (37). The predominant journals were International Journal of Pharmaceutics (18) and Biomaterials (12). Citation analysis identified influential studies on bioavailability, drug delivery and cancer therapy. Keyword analysis categorised five major thematic clusters, including nanomedicine, cancer therapy, antioxidant systems and lipid-based drug delivery. Overall, the findings highlight the interdisciplinary growth of research on nanoformulated tocotrienols and emphasize the need for stronger collaboration and continued advancement in formulation strategies.
Osteoporosis (OP) remains a therapeutic challenge, partly due to the limitations of the traditional “bone resorption–bone formation imbalance” paradigm. Although the Wnt signaling pathway is known to regulate bone metabolism, a systematic framework explaining how traditional Chinese medicine (TCM) corrects osteoblast dysfunction by positioning Wnt as a central “metabolic–transcriptional hub” is lacking. This review proposes that osteoblast metabolic senescence is a key pathological driver of OP, unfolding as a multi-stage cascade of “energy reprogramming → turbid stasis accumulation → collateral fixation.” We hypothesize that this cascade parallels the TCM pathogenesis of “Kidney deficiency with essence depletion, turbid stasis obstructing collaterals.” The Wnt/β-catenin pathway may serve as a crucial molecular executor of the “Kidney governing bones” function, acting as a master switch for osteogenic differentiation and a hub integrating energy metabolism with bone formation. TCM leverages its multi-component, multi-target advantages to regulate this network: kidney-warming herbs (flavonoids) stabilize β-catenin and enhance mitochondrial function; spleen-kidney tonifying herbs (glycosides, polysaccharides) couple energy regulation with autophagy; and heat-clearing, dampness-resolving herbs (alkaloids) modulate inflammation via the gut-bone axis. Acupuncture and therapeutic exercises further improve the metabolic milieu. Future directions should focus on developing novel drugs targeting metabolic pathways, establishing precise patient subtyping based on “pattern–metabolite profiles,” and building a robust evidence chain for clinical translation.
Abstract Background Duloxetine hydrochloride (DL) is a widely prescribed serotonin–norepinephrine reuptake inhibitor requiring stringent quality control due to the potential presence of 1-naphthol (NP), a genotoxic process-related impurity. DL and NP exhibit nearly identical native fluorescence spectra, posing a significant challenge for their simultaneous quantification by conventional fluorometric methods. Objective This study aimed to develop and validate a rapid, sensitive, and sustainable synchronous fluorescence spectroscopy (SFS) method with improved environmental profile for the simultaneous determination of DL and NP in pharmaceutical and biological matrices, without chromatographic separation or chemical derivatization. Method A dual-wavelength SFS approach was optimized using a fixed wavelength difference (Δλ = 125 nm), enabling selective detection at 356–362 nm for DL and 359–366 nm for NP in an 80% methanol–Britton–Robinson buffer system (pH 3.0). The method was fully validated by ICH Q2(R1) guidelines and rigorously evaluated for sustainability using four complementary greenness metrics: AGREE, ComplexMoGAPI, Analytical Eco-Scale, and Blue Applicability Grade Index (BAGI). Results Linear calibration curves (r² ≥ 0.9996) were obtained over 20–500 ng/mL for both analytes. The limits of detection were 6.19 ng/mL (DL) and 6.54 ng/mL (NP), with intra- and inter-day precision (%RSD < 1.5%) and mean recoveries of 100.26% (DL) and 99.89% (NP). The method showed excellent specificity in Cymbalta® capsules and spiked human plasma. Comprehensive greenness assessment confirmed high sustainability: AGREE score = 0.79, ComplexMoGAPI = 72.5/100, Analytical Eco-Scale = 81, and BAGI = 72.5/100, collectively classifying the method as “excellent green analysis” with strong practical applicability. Conclusion The proposed SFS method represents a chromatography-free, derivatization-free, and validated platform with enhanced sustainability features that successfully balance analytical performance, environmental responsibility, and laboratory feasibility. It offers a sustainable, cost-effective, and regulatory-compliant solution for routine quality control and bioanalytical monitoring of DL and its genotoxic impurity NP.
