RESUMO
We comment on an article by Koizumi et al. Elafibranor (EFN) is a dual pero-xisome proliferator-activated receptor α/δ agonist. The experimental results from Koizumi et al demonstrated that EFN significantly increases intestinal barrier function and ameliorates liver fibrosis. These positive outcomes suggest that EFN could be a promising therapeutic option for alcohol-associated liver disease (ALD). However, this study has limitations that necessitate further research to evaluate the efficacy of EFN. Future studies should consider the use of more appropriate animal models and cell types, optimize the administration routes and dosages of the drug, and conduct an in-depth investigation into the underlying mechanisms of action to determine the therapeutic effects of EFN in humans. With sustained and in-depth research, EFN has the potential to emerge as a novel therapeutic agent for the treatment of ALD.
Assuntos
Hepatopatias Alcoólicas , Humanos , Animais , Hepatopatias Alcoólicas/tratamento farmacológico , Chalconas/uso terapêutico , Fígado/efeitos dos fármacos , Fígado/patologia , Fígado/metabolismo , Modelos Animais de Doenças , PropionatosRESUMO
Inflammatory bowel disease (IBD) is a chronic gastrointestinal inflammatory disease. With the emergence of biologics and other therapeutic methods, two biologics or one biologic combined with a novel small-molecule drug has been proposed in recent years to treat IBD. Although treatment strategies for IBD are being optimized, their efficacy and risks still warrant further consideration. This editorial explores the current risks associated with dual-targeted treatment for IBD and the great potential that fecal microbiota transplantation (FMT) may have for use in combination therapy for IBD. We are focused on addressing refractory IBD or biologically resistant IBD based on currently available dual-targeted treatment by incorporating FMT as part of this dual-targeted treatment. In this new therapy regimen, FMT represents a promising combination therapy.
Assuntos
Transplante de Microbiota Fecal , Microbioma Gastrointestinal , Doenças Inflamatórias Intestinais , Transplante de Microbiota Fecal/métodos , Transplante de Microbiota Fecal/efeitos adversos , Humanos , Microbioma Gastrointestinal/efeitos dos fármacos , Doenças Inflamatórias Intestinais/terapia , Doenças Inflamatórias Intestinais/microbiologia , Doenças Inflamatórias Intestinais/imunologia , Resultado do Tratamento , Terapia Combinada/métodos , Fezes/microbiologia , Produtos Biológicos/uso terapêutico , Fármacos Gastrointestinais/uso terapêuticoRESUMO
Background: Contrast-enhanced ultrasound (CEUS) technology has been developed for decades, and its application is becoming increasingly more extensive. In this study, bibliometrics was used to characterize the development status of CEUS over the past 20 years and to identify future research hotspots. Methods: We collected data from the Web of Science and analyzed the literature related to CEUS published from 2002 to 2022. We examined 6,382 publications and analyzed the publication year, country of origin, affiliated institutions, authors, journal, categories, keywords, and research frontiers within the relevant literature. Using bibliometric analysis, we aimed to determine the general research direction and current publication trends. This allowed us to identify the most prolific and outstanding authors, institutions, countries, and keywords in CEUS research. For data collection, analysis, and visualization, we employed VOSviewer (Leiden University, Leiden, the Netherlands), Excel (Microsoft Corp., Redmond, WA, USA), CiteSpace, and biblioshiny. These tools helped us gather, analyze, and visualize the data effectively. Results: The analyzed publications indicated a consistent upward trend in the number of works published between 2002 and 2022. Notably, China and Sun Yat-sen University emerged as the most prolific countries and institutions, respectively. China published 391 articles with 5,817 citations and was the leader in terms of international cooperation. Moreover, pediatrics-related keywords have surged in frequency in recent years. Conclusions: The amount of research on CEUS has increased rapidly and continues to grow, with China being at the forefront of this research field. The application of CEUS in some pediatric diseases is a recent research hotspot and perhaps warrants close attention.
RESUMO
Immune-related adverse events (irAEs) are complications of the use of immune checkpoint inhibitors (ICIs). ICI-associated gastritis is one of the main irAEs. The gastric microbiota is often related to the occurrence and development of many gastric diseases. Gastric microbiota adjustment may be used to treat gastric disorders in the future. Faecal microbiota transplantation can alter the gut microbiota of patients and has been used for treating ICI-associated colitis. Therefore, we propose gastric microbiota transplantation as a supplementary treatment for patients with ICI-associated gastritis who do not respond well to conventional therapy.
Assuntos
Transplante de Microbiota Fecal , Gastrite , Microbioma Gastrointestinal , Inibidores de Checkpoint Imunológico , Humanos , Transplante de Microbiota Fecal/métodos , Transplante de Microbiota Fecal/efeitos adversos , Mucosa Gástrica/microbiologia , Mucosa Gástrica/imunologia , Mucosa Gástrica/patologia , Mucosa Gástrica/efeitos dos fármacos , Gastrite/microbiologia , Gastrite/imunologia , Gastrite/terapia , Gastrite/induzido quimicamente , Microbioma Gastrointestinal/imunologia , Microbioma Gastrointestinal/efeitos dos fármacos , Inibidores de Checkpoint Imunológico/efeitos adversos , Estômago/microbiologia , Estômago/imunologia , Estômago/cirurgia , Resultado do TratamentoRESUMO
Objective: This meta-analysis examines peak systolic velocities (PSVs) in thyroid arteries as potential biomarkers for thyroid disorders, which includes treated and untreated Graves' disease(GD) and destructive thyrotoxicosis(DT). Methods: A search across databases including PubMed, Google Scholar, Embase, and Web of Science identified studies assessing peak systolic flow velocity in the inferior thyroid artery (ITA-PSV) and superior thyroid artery (STA-PSV) diagnostic efficacy in GD and DT.And the search was restricted to publications in the English language.The analysis compared STA-PSV and ITA-PSV across patient groups, evaluating intra-group variances and synthesizing sensitivity and specificity data. Results: The analysis covered 18 studies with 1276 GD, 564 DT patients, and 544 controls. The difference of STA-PSV between GD group, DT group and normal group and the difference of ITA-PSV were analyzed in subgroups, and there was no statistical significance between subgroups when comparing any two groups. Normal subjects displayed intra-group ITA-PSV and STA-PSV differences with established cut-off values of 20.33 cm/s (95% CI, 17.48-23.18) for ITA-PSV and 25.61 cm/s (95% CI, 20.37-30.85) for STA-PSV. However, no significant intra-group differences were observed in the STA-PSV and ITA-PSV cut-off values among groups with GD or DT. The combined cut-off values for these patient groups and normal subjects were 68.63 cm/s (95% CI, 59.12-78.13), 32.08 cm/s (95% CI, 25.90-38.27), and 23.18 cm/s (95% CI, 20.09-26.28), respectively. The diagnostic odds ratio(DOR) for these values was 35.86 (95% CI, 18.21-70.60), and the area under the summary receiver operating characteristic (SROC) curve was 0.91, with a sensitivity estimate of 0.842 (95% CI, 0.772-0.866). Conclusion: PSVs in thyroid arteries are useful diagnostic tools in distinguishing DT from GD. A PSV above 68.63 cm/s significantly improves GD diagnosis with up to 91% efficacy. No notable differences were found between superior and inferior thyroid arteries in these conditions.
Assuntos
Doença de Graves , Glândula Tireoide , Tireotoxicose , Humanos , Doença de Graves/fisiopatologia , Doença de Graves/diagnóstico , Glândula Tireoide/irrigação sanguínea , Glândula Tireoide/fisiopatologia , Glândula Tireoide/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo/fisiologia , Tireotoxicose/diagnóstico , Tireotoxicose/fisiopatologia , Artérias/fisiopatologia , Artérias/diagnóstico por imagem , Diagnóstico Diferencial , SístoleRESUMO
Objective: To explore the application of multiparametric MRI-based radiomic nomogram for assessing HER-2 2+ status of breast cancer (BC). Methods: Patients with pathology-proven HER-2 2+ invasive BC, who underwent preoperative MRI were divided into training (72 patients, 21 HER-2-positive and 51 HER-2-negative) and validation (32 patients, 9 HER-2-positive and 23 HER-2-negative) sets by randomization. All were classified as HER-2 2+ FISH-positive (HER-2-positive) or -negative (HER-2-negative) according to IHC and FISH. The 3D VOI was drawn on MR images by two radiologists. ADC, T2WI, and DCE images were analyzed separately to extract features (n = 1906). L1 regularization, F-test, and other methods were used to reduce dimensionality. Binary radiomics prediction models using features from single or combined imaging sequences were constructed using logistic regression (LR) classifier then and validated on a validation dataset. To build a radiomics nomogram, multivariate LR analysis was conducted to identify independent indicators. An evaluation of the model's predictive efficacy was made using AUC. Results: On the basis of combined ADC, T2WI, and DCE images, ten radiomic features were extracted following feature dimensionality reduction. There was superior diagnostic efficiency of radiomic signature using all three sequences compared to either one or two sequences (AUC for training group: 0.883; AUC for validation group: 0.816). Based on multivariate LR analysis, radiomic signature and peritumoral edema were independent predictors for identifying HER-2 2 +. In both training and validation datasets, nomograms combining peritumoral edema and radiomics signature demonstrated an effective discrimination (AUCs were respectively 0.966 and 0. 884). Conclusion: The nomogram that incorporated peritumoral edema and multiparametric MRI-based radiomic signature can be used to effectively predict the HER-2 2+ status of BC.
RESUMO
The gut microbiota is recognized as an endocrine organ with the capacity to influence distant organs and associated biological pathways. Recent advancements underscore the critical role of gut microbial homeostasis in female health; with dysbiosis potentially leading to diseases among women such as polycystic ovarian syndrome, endometriosis, breast cancer, cervical cancer, and ovarian cancer etc. Despite this, there has been limited discussion on the underlying mechanisms. This editorial explores the three potential mechanisms through which gut microbiota dysbiosis may impact the development of diseases among women, namely, the immune system, the gut microbiota-estrogen axis, and the metabolite pathway. We focused on approaches for treating diseases in women by addressing gut microbiota imbalances through probiotics, prebiotics supplementation, and fecal microbiota transplantation (FMT). Future studies should focus on determining the molecular mechanisms underlying associations between dysbiosis of gut microbiota and female diseases to realize precision medicine, with FMT emerging as a promising intervention.
Assuntos
Neoplasias da Mama , Endometriose , Microbioma Gastrointestinal , Feminino , Humanos , Disbiose , EstrogêniosRESUMO
HLA-DPA1*02:117 differs from HLA-DPA1*02:02:02:01 by one nucleotide in exon 2.
Assuntos
Cadeias alfa de HLA-DP , Nucleotídeos , Humanos , Alelos , Cadeias alfa de HLA-DP/genética , China , Análise de Sequência de DNARESUMO
Background: The reporting and data system (RADS) has been researched across the world since it was first developed. This study used bibliometrics to analyze the research trends and current status of this field over the past almost 23 years and explored possible future research hotspots. Methods: We searched the Web of Science (WOS) literature on RADSs from January 1, 2000, to November 1, 2022, and evaluated the findings visually with VOSviewer (1.6.18), CiteSpace (6.1.3), and the "bibliometrix" package in R version 4.2.1. Results: We included 6,239 publications from 88 countries and regions. The number of published has shown an overall growth trend, especially since 2016. The United States was the country with the highest number of publications and citations. The top 10 most productive institutions in RADS research were mainly from South Korea and the United States. Kim EK was the most published author, and Turkbey B had the most cited publication. European Radiology had the most publications on the subject, while Radiology was the most influential journal. Magnetic resonance imaging, carcinoma, ultrasound, RADS, mammography, breast neoplasms, and diagnosis were the most common keywords. Artificial intelligence (AI) appears to be an emerging hotspot in the research of RADS. Conclusions: This study provides an overview of the development status of research into RADSs over the past 23 years. Research into RADSs has included various systems of the body, with the most studied being the breast, prostate, liver, and thyroid. In terms of auxiliary diagnosis, there is an increasing amount of research into the application of AI in RADSs, which along with the interpretability of AI, will be a hotspot of research in the following years.
RESUMO
Objectives: The purpose of this research is to summarize the structure of radiomics-based knowledge and to explore potential trends and priorities by using bibliometric analysis. Methods: Select radiomics-related publications from 2012 to October 2022 from the Science Core Collection Web site. Use VOSviewer (version 1.6.18), CiteSpace (version 6.1.3), Tableau (version 2022), Microsoft Excel and Rstudio's free online platforms (http://bibliometric.com) for co-writing, co-citing, and co-occurrence analysis of countries, institutions, authors, references, and keywords in the field. The visual analysis is also carried out on it. Results: The study included 6428 articles. Since 2012, there has been an increase in research papers based on radiomics. Judging by publications, China has made the largest contribution in this area. We identify the most productive institutions and authors as Fudan University and Tianjie. The top three magazines with the most publications areãFRONTIERS IN ONCOLOGYã, ãEUROPEAN RADIOLOGYã, and ãCANCERSã. According to the results of reference and keyword analysis, "deep learning, nomogram, ultrasound, f-18-fdg, machine learning, covid-19, radiogenomics" has been determined as the main research direction in the future. Conclusion: Radiomics is in a phase of vigorous development with broad prospects. Cross-border cooperation between countries and institutions should be strengthened in the future. It can be predicted that the development of deep learning-based models and multimodal fusion models will be the focus of future research. Advances in knowledge: This study explores the current state of research and hot spots in the field of radiomics from multiple perspectives, comprehensively, and objectively reflecting the evolving trends in imaging-related research and providing a reference for future research.
Assuntos
COVID-19 , Radiômica , Humanos , Bibliometria , COVID-19/epidemiologia , China , Fluordesoxiglucose F18RESUMO
Inflammatory bowel disease (IBD) is a nonspecific inflammatory disease of the intestine that includes Crohn's disease and ulcerative colitis. Because IBD is difficult to heal and easily relapses, it could worsen patient quality of life and increase economic burdens. Curcumin (CUR) is a bioactive component derived from the rhizome of turmeric (Curcuma longa). Many basic and clinical studies have shown that CUR can efficiently treat IBD by decreasing the activity of proinflammatory cytokines by communicating with transcription factors and signaling molecules. However, due to the limitations of being almost insoluble in aqueous solutions and having low oral bioavailability, it is important to select appropriate pharmaceutical preparations.
Assuntos
Colite Ulcerativa , Doença de Crohn , Curcumina , Doenças Inflamatórias Intestinais , Humanos , Curcumina/uso terapêutico , Qualidade de Vida , Doenças Inflamatórias Intestinais/tratamento farmacológico , Colite Ulcerativa/tratamento farmacológico , Doença de Crohn/tratamento farmacológicoRESUMO
Background: Differences in lung function for Chronic Obstructive Pulmonary Disease (COPD) cause bias in the findings when identifying frequent exacerbator phenotype-related causes. The aim of this study was to determine whether computed tomographic (CT) biomarkers and circulating inflammatory biomarkers were associated with the COPD frequent exacerbator phenotype after eliminating the differences in lung function between a frequent exacerbator (FE) group and a non-frequent exacerbator (NFE) group. Methods: A total of 212 patients with stable COPD were divided into a FE group (n=106) and a NFE group (n=106) according to their exacerbation history. These patients were assessed by spirometry, quantitative CT measurements and blood sample measurements during their stable phase. Univariate and multivariate logistic regression were used to assess the association between airway thickening or serum cytokines and the COPD frequent exacerbator phenotype. Receiver operating characteristic (ROC) curves were calculated for Pi10, WA%, IL-1ß and IL-4 to identify frequent exacerbators. Results: Compared with NFE group, FE group had a greater inner perimeter wall thickness of a 10 mm diameter bronchiole (Pi10), a greater airway wall area percentage (WA%) and higher concentrations of IL-1ß and IL-4 (p<0.001). After adjusting for sex, age, BMI, FEV1%pred and smoking pack-years, Pi10, WA%, IL-ß and IL-4 were independently associated with a frequent exacerbator phenotype (p<0.001). Additionally, there was an increase in the odds ratio of the frequent exacerbator phenotype with increasing Pi10, WA%, IL-4, and IL-1ß (p for trend <0.001). The ROC curve demonstrated that IL-1ß had a significantly larger calculated area under the curve (p < 0.05) than Pi10, WA% and IL-4. Conclusion: Pi10, WA%, IL-4, and IL-1ß were independently associated with the frequent exacerbator phenotype among patients with stable COPD, suggesting that chronic airway and systemic inflammation contribute to the frequent exacerbator phenotype. Trial Registration: This trial was registered in Chinese Clinical Trial Registry (https://www.chictr.org.cn). Its registration number is ChiCTR2000038700, and date of registration is September 29, 2020.
Assuntos
Doença Pulmonar Obstrutiva Crônica , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Interleucina-4 , Bronquíolos , Citocinas , Biomarcadores , Progressão da Doença , FenótipoRESUMO
Risk stratification for normal karyotype acute myeloid leukemia (NK-AML) remains unsatisfactory, which is reflected by the high incidence of leukemia relapse. This study aimed to evaluate the role of gene mutations and clinical characterization in predicting the relapse of patients with NK-AML. A prognostic system for NK-AML was constructed. A panel of gene mutations was explored using next-generation sequencing. A nomogram algorithm was used to build a genomic mutation signature (GMS) nomogram (GMSN) model that combines GMS, measurable residual disease, and clinical factors to predict relapse in 347 patients with NK-AML from four centers. Patients in the GMS-high group had a higher 5-year incidence of relapse than those in the GMS-low group (p < 0.001). The 5-year incidence of relapse was also higher in patients in the GMSN-high group than in those in the GMSN-intermediate and -low groups (p < 0.001). The 5-year disease-free survival and overall survival rates were lower in patients in the GMSN-high group than in those in the GMSN-intermediate and -low groups (p < 0.001) as confirmed by training and validation cohorts. This study illustrates the potential of GMSN as a predictor of NK-AML relapse.
Assuntos
Leucemia Mieloide Aguda , Nucleofosmina , Humanos , Mutação , Prognóstico , Doença Crônica , Leucemia Mieloide Aguda/genética , Recidiva , CariótipoRESUMO
Nickel (Ni), as one of the essential micronutrients, exists widely in nature, but high concentration of Ni in soil can pose certain biological toxicity. Nano zero-valent iron (nZVI) and rhamnolipid modified nZVI (RL@nZVI) can effectively stabilize Ni in soil. In this study, the stabilization effect of nZVI and RL@nZVI on the Ni-polluted soil under simulated acid rain and the microbial community response during the soil remediation under different Ni levels (200, 600, and 1800 mg/kg) were investigated. The results show that the addition of nZVI and RL@nZVI increased the pH of leachate to neutral and decreased the amount of Ni in leachate (23.33%-47.06% by nZVI and 50.01%-70.47% by RL@nZVI), indicating that nZVI and RL@nZVI could reduce the potential radial migration risk of Ni in soil under simulated acid rain. The addition of RL@nZVI was beneficial to recover the soil bacterial community diversity, which was inhibited by Ni pollution, and rhamnolipid coating could reduce the toxicity of nZVI. The dominant bacteria in RL@nZVI-treated soil with low, medium, and high Ni pollution were Firmicutes, Proteobacteria and Actinobacteria, respectively. Soil potential, total organic carbon, and pH were the main driving factors affecting the bacterial community structure, while Ni stress only caused changes in the relative abundance of some tolerant bacteria.
Assuntos
Chuva Ácida , Níquel/toxicidade , Ferro , SoloRESUMO
Clostridioides difficile infection (CDI) is a global health problem. The association of appendectomy on the severity and prognosis of CDI has been reported in many literatures, but there are still contradictions. In a retrospective study entitled "Patients with Closterium diffuse infection and prior appendectomy may be prone to word outcomes" published in World J Gastrointest Surg 2021, the author found that prior appendectomy affects the severity of CDI. Appendectomy may be a risk factor for increasing the severity of CDI. Therefore, it is necessary to seek alternative treatment for patients with prior appendectomy when they are more likely to have severe or fulminant CDI.
RESUMO
A winter precipitation-type prediction is a challenging problem due to the complexity in the physical mechanisms and computability in numerical modeling. In this study, we introduce a new method of precipitation-type prediction based on the machine learning approach LightGBM. The precipitation-type records of the in situ observations collected from 32 national weather stations in northern China during 1997-2018 are used as the labels. The features are selected from the conventional meteorological data of the corresponding hourly reanalysis data ERA5. The evaluation results of the model performance reflect that randomly sampled validation data will lead to an illusion of a better model performance. Extreme climate background conditions will reduce the prediction accuracy of the predictive model. A feature importance analysis illustrates that the features of the surrounding area with a -12 h offset time have a higher impact on the ground precipitation types. The exploration of the predictability of our model reveals the feasibility of using the analysis data to predict future precipitation types. We use the ECMWF precipitation-type (ECPT) forecast products as the benchmark to compare with our machine learning precipitation-type (MLPT) predictions. The overall accuracy (ACC) and Heidke skill score (HSS) of the MLPT are 0.83 and 0.69, respectively, which are considerably higher than the 0.78 and 0.59 of the ECPT. For stations at elevations below 800 m, the overall performance of the MLPT is even better.
RESUMO
OBJECTIVE: Cervical fractures with ankylosing spondylitis (CAS) are a specific type of spinal fracture with poor stability, low healing rate, and high disability rate. Its treatment is mainly surgical, predominantly through the anterior approach, posterior approach, and the anterior-posterior approach. Although many clinical studies have been conducted on various surgical approaches, controversy still exists concerning the choice of these surgical approaches by surgeons. The authors present here a systematic evaluation and meta-analysis exploring the utility of the anterior-posterior approach versus the anterior approach and the posterior approach. METHODS: After a comprehensive literature search of PubMed, Cochrane, Web of Science, and Embase databases, 12 clinical studies were included in the final qualitative analysis and 8 in the final quantitative analysis. Of these studies, 11 conducted a comparison between the anterior-posterior approach and the anterior approach and posterior approaches, while one examined only the anterior-posterior approach. Where appropriate, statistical advantage ratios and 95% confidence intervals were calculated. RESULTS: The present meta-analysis of postoperative neurological improvement showed no statistical difference in the overall neurological improvement rate between the anterior-posterior approach and anterior approach (OR 1.70, 95% CI 0.61 to 4.75; p = 0.31). However, the mean change in postoperative neurological function was lower in patients who received the anterior approach than in those who received the anterior-posterior approach (MD 0.17, 95% CI -0.02 to 0.36; p = 0.08). There was an identical trend between the anterior-posterior approach and posterior approach, with no statistically significant difference in the overall rate of neurological improvement (OR 1.37, 95% CI 0.70 to 2.56; p = 0.38). Nevertheless, the mean change in neurological function was smaller in patients receiving the anterior-posterior approach compared with the posterior approach, but there was no statistically significant difference between the two (MD 0.17, 95% CI -0.02 to 0.36; p = 0.08). CONCLUSIONS: The results of this review and meta-analysis suggest that the benefits of the anterior-posterior approach are different from those of the anterior and posterior approaches in the treatment of ankylosing spondylitis-related cervical fractures. In a word, there is no significant difference between the cervical surgical approach and the neurological functional improvement. Therefore, surgeons should pay more attention to the type of cervical fracture, the displacement degree of cervical fracture, the spinal cord injury, the balance of cervical spine and other aspects to comprehensively consider the selection of appropriate surgical methods.
Assuntos
Lesões do Pescoço , Traumatismos da Medula Espinal , Fraturas da Coluna Vertebral , Espondilite Anquilosante , Humanos , Fraturas da Coluna Vertebral/cirurgia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/cirurgia , Vértebras Cervicais/cirurgia , Vértebras Cervicais/lesões , Pescoço , Resultado do TratamentoRESUMO
Nonalcoholic fatty liver disease (NAFLD) is the most rapidly growing contributor to liver mortality and morbidity. Hepatocellular injury in nonalcoholic steatohepatitis (NASH) is caused by an increase in metabolic substrates (glucose, fructose, and fatty acids), leading fatty acids to participate in pathways that cause cellular injury and a poor response to injury. The pathogenesis of this disease is largely associated with obesity, type 2 diabetes, and increasing age. To date, there are no Food and Drug Administration-approved treatments for NAFLD/NASH or its associated fibrosis. Since one of the pathogenic drivers of NASH is insulin re-sistance, therapies approved for the treatment of type 2 diabetes are being evaluated in patients with NASH. Currently, the glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide is a safe, well-studied therapeutic for NAFLD/ NASH patients. Existing research demonstrates that semaglutide can increase the resolution of NASH but not improve fibrosis. However, improving the fibrosis of NAFLD is the only way to improve the long-term prognosis of NAFLD. Given the complex pathophysiology of NASH, combining therapies with complementary mechanisms may be beneficial. Researchers have conducted trials of semaglutide in combination with antifibrotic drugs. However, the results have not fully met expectations, and it cannot be ruled out that the reason is the short trial time. We should continue to pay increasing attention to GLP-1RAs.
Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatia Gordurosa não Alcoólica , Humanos , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Peptídeo 1 Semelhante ao Glucagon , Diabetes Mellitus Tipo 2/tratamento farmacológico , Ácidos Graxos , FibroseRESUMO
OBJECTIVES: This study retrospectively investigated in which cycle measurable residual disease (MRD) is associated with prognosis in patients in first complete remission (CR1) of intermediate-risk acute myeloid leukemia (AML). METHODS: The study enrolled 235 younger patients with intermediate-risk AML. MRD was evaluated by multiparameter flow cytometry after the 1st, 2nd, and 3rd chemotherapy cycles (MRD1-3, respectively). RESULTS: No significant association was detected after the 1st and 2nd cycles. However, the 5-year incidence of relapse was higher in the MRD3-positive group (n = 99) than in the negative group (n = 136) (48.7% vs. 13.7%, P = 0.005), while 5-year disease-free survival (DFS) and overall survival (OS) were lower in the MRD3-positive group than in the negative group (43.2% vs. 81.0% and 45.4% vs. 84.1%; P = 0.003 and 0.005, respectively). Allogeneic hematopoietic stem cell transplantation led to a lower 5-year relapse, and higher DFS and OS rates than chemotherapy in the MRD3-positive group (22.3% vs. 71.5%, 65.9% vs. 23.0%, and 67.1% vs. 23.9%; P < 0.001, 0.002, and 0.022, respectively), but did not affect the MRD-negative group. CONCLUSIONS: MRD3 could serve as an indicator for post-remission treatment choice and help improve outcomes for intermediate-risk AML in CR1.