Bone marrow aplasia is a common feature in acute myeloid leukemia (AML) patients during their remission induction treatment, and is associated with potential complications such as bleeding, infection and anemia. Frequent platelet and red cell transfusions are administered to prevent and treat these complications. However, platelet counts are poorly associated with bleeding events in this population. Therefore, plasma protein levels could add valuable insights to improve our understanding of the patient's health state. In this study, we aimed to delineate the plasma proteome, including inflammatory pathways, hemostatic and immune components, of AML patients during treatment with intensive transfusion support. We employed unbiased mass spectrometry (MS)-based proteomics on longitudinal plasma samples from 10 AML patients during intensive-transfusion treatment phase with healthy individuals as baseline control. A total of 450 proteins were quantified in plasma samples from AML patients and healthy controls. Alteration in proteins levels were mainly observed for proteins involved in inflammation (e.g. SAA1 and CRP), and complement (e.g. C9 and MASP2) when comparing AML versus healthy individuals. Correlation analysis revealed additional affected protein dynamics, including proteins associated with coagulation cascade, endopeptidase inhibitors activity and lipoprotein remodeling. The plasma proteome from AML patients during intensive treatment shows a disbalance in inflammation, endopeptidase inhibitors activity, lipoprotein remodeling, coagulation and complement. These effects and potential associations with bleeding risk will be further studied in a bigger cohort.
Atheroma is a serious atherosclerotic lesion related to plaque rupture, thrombosis, and ischemic disease. To clarify the pathogenesis of human atheroma, particularly the formation of the liponecrotic tissue in the necrotic core, the distribution of connective tissue fibers, such as collagen and elastic fibers, and related substances was investigated in this study. Atherosclerotic lesions in human coronary arteries were classified into three categories: pathologic intimal thickening (PIT), atheroma with lipid core (ALC), and atheroma with necrotic core (ANC). PIT and ALC consisted of the lipid pool and the lipid core, respectively. The necrotic core of ANC was composed of a lipid core-like region and liponecrotic tissue containing amorphous materials and lacking cells and connective tissue fibers. The distribution of collagen type I, elastin, C-terminal crosslinked telopeptide of collagen type I (CTX-I), and cathepsin K (CatK) was investigated through immunohistochemistry. CTX-I is a fragmented peptide consisting of the C-terminal region of collagen type I that is generated by CatK. The distribution of denatured and unfolded collagen chains was also investigated through collagen hybridizing peptide staining. Collagen type I, denatured and unfolded collagen chains, and elastin were positively stained in the PIT, ALC, and lipid core-like region of ANC. However, they were negatively stained in the liponecrotic tissue of ANC. CTX-I and CatK were positively stained in all four regions, and their grade of staining appeared to show a positive relationship. Both CTX-I and CatK demonstrated higher staining grades in the liponecrotic tissue. These findings suggested that pre-existing collagen type I was severely degraded by CatK, resulting in the production of CTX-I in the liponecrotic tissue, and that pre-existing elastin was also degraded in this region. CatK was mainly found in macrophage foam cells, many of which were localized within and around the liponecrotic tissue. This study suggests that the liponecrotic tissue in the necrotic core of human atheroma is formed by severe degradation of pre-existing connective tissue fibers and consequent collapse of tissue structure. This degradation is likely caused by proteolytic enzymes, such as CatK, secreted by macrophage foam cells.
Antiretroviral therapy (ART) has significantly improved the prognosis for people living with human immunodeficiency virus (PLWH). However, alterations in the gut microbiota of PLWH affect their metabolic environment and may contribute to chronic inflammation and premature aging, despite effective ART. Given that inflammation in the body have been shown to be risk factors for age-related diseases, elucidating changes in the gut microbiota and metabolic levels over time in individuals would be for understanding the dynamics in the body that lead to disease development. The study assessed changes in blood markers, gut microbiota, and metabolic environment of PLWH on ART for four years, with participants divided into two groups based on median CD4 cell count (580/µL). The high-CD4 group was more obese than the low-CD4 group, but there was no significant difference in comorbidities, such as diabetes, hypertension, and dyslipidemia. An investigation of the alterations in gut microbiota over a 4-year period revealed a reduction in specific groups of bacteria that produce short-chain fatty acids (SCFAs) and an increase in the occurrence of Enterobacteriaceae. In addition, a decline in bacterial thiamine synthesis was predicted, and a decreased abundance of the Ruminococcus gauvreauii group, which relies on supplementation with thiamine from symbiotic bacteria, was observed. The abundance of Collinsella and Catenibacterium at baseline was positively correlated with the predicted number of thiamine-synthesizing pathway. The presence of Catenibacterium at follow-up was inversely correlated with the rate of increase in plasma levels of lipopolysaccharide-binding protein, an indicator of a leaky gut. In terms of assessing the diversity of gut microbiota, a trend towards an increase in opportunistic bacteria with different genetic distances was observed in the high-CD4 group at follow-up. These observations suggested that, despite effective ART, the thiamine-deficient environment in the gut continues to reduce thiamine-requiring bacteria, such as certain SCFA-producing bacteria. As a result, secondary effects, such as proliferation of opportunistic bacteria and chronic inflammation associated with increased intestinal permeability, proceed in PLWH. Thus, certain essential nutrient deficiencies for gut metabolic environment may disrupt the symbiotic relationship between gut bacteria and increase the risk of developing inflammatory diseases.
Breast cancer (BC) is the primary cause of cancer-related deaths among women. BH3 only proteins expression profile in BC has been linked to chemotherapy and treatment outcomes. Clinical biomarkers provide insights into disease progression. Therefore, we systematically investigated the prognostic significance of proapoptotic Bcl-2 Homology Domain 3 (BH3) only proteins in Disease-Free Survival (DFS) and Overall Survival (OS) among BC patients. We explored four databases, screening titles, abstracts, and full articles based on predefined criteria. The quality of cohort studies and randomized clinical trials were assessed. Data of BH3-only gene and proteins’ expression were extracted and meta-analysis using random effects model was performed. Of the 3541 studies identified, nine studies met inclusion criteria. The meta-analysis revealed that the BH3-only protein-positive group had a higher chance of 5-year DFS risk ratio (RR = 1.17, 95
Delirium, characterized by a sudden onset of neuropsychiatric symptoms, is a highly prevalent syndrome whose diagnosis is defined solely through clinical evaluation. Due to the often challenging reliability of assessments, especially in non-cooperative patients, there is a growing emphasis on exploring new reliable biomarkers, such as Neuron-Specific Enolase (NSE). NSE, an enzyme primarily found in neuronal and neuroendocrine tissues, has been clinically used to assess the prognosis of patients who have experienced traumatic or hypoxic brain injuries. Thus, the primary purpose of the present review is to examine the literature to determine whether NSE is applicable for diagnosis and/or prognosis of patients with delirium. Literature was searched using Pubmed, Lilacs and Scielo databases, and all published reports identified as potentially relevant were independently assessed by each reviewer. All relevant original studies were included and independent extraction of articles was performed by three authors using predefined data fields. Twenty one studies (2,311 patients) satisfied the entry criteria, among which only eight suggest a possible association between NSE and delirium, particularly in intensive care settings, and only one correlate NSE with delirium prognosis. Also, significant heterogeneity was observed among studies, varying across study design, setting, and methodologies. Furthermore, the majority of the selected studies presented severe methodological limitations, particularly small samples. In conclusion, this systematic review underscores the need for further research with larger, standardized studies to establish the reliability and validity of NSE as a diagnostic and prognostic tool for delirium. The current evidence does not sufficiently support its routine clinical application in assessing patients with delirium.
