The evolution of robotic surgery: surgical and anaesthetic aspects.

Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems. We examine the challenges, obstacles and limitations of robotic surgery and its future potential including integrated real-time anatomical and immune-histological imaging and data assimilation with improved visualisation, haptic feedback and robot-surgeon interactivity. We consider current evidence, cost-effectiveness and the learning curve in relation to the surgical and anaesthetic journey, and what is required to continue to realise improvements in surgical operative care. The innovative impact of this technology holds the potential to achieve transformative clinical improvements. However, despite over 30 yr of incremental advances it remains formative in its innovative disruption.

Molecular Mechanism of Fasting-Mimicking Diet in Inhibiting Colorectal Cancer Progression: Implications for Immune Therapy and Metabolic Regulation.

Recently, fasting-mimicking diet and caloric restriction have been shown to improve antitumor immunity. In this issue of Cancer Research, Zhong and colleagues provide insights into the molecular mechanism of fasting-mimicking diet-mediated metabolic reprogramming in colorectal cancer progression. The authors performed comprehensive mechanistic experiments in mouse models to show that fasting-mimicking diet prevents colorectal cancer progression by lowering intratumoral IgA+ B cells by accelerating fatty acid oxidation to inhibit B-cell IgA class switching. In addition, they found that fatty acid oxidation-dependent acetylation prevents IgA class switching and that IgA+ B cells interfere with the anticancer effects of fasting-mimicking diet in colorectal cancer. Overall, their study establishes that fasting-mimicking diet has the potential to activate anticancer immunity and to induce tumor regression in colorectal cancer. See related article by Zhong et al., p. 3529.

An overview of proteomic and metabolomic technologies and their application to pregnancy research.

'Omic' technologies represent a strategy towards high-throughput, simultaneous analysis of thousands of biological molecules. Their development has been accelerated in the post-genomic era since these molecules represent the interaction of genes and environment or the 'functional genome'. Omic domains are of particular interest in the search for predictive disease biomarkers and have additional relevance in understanding pathophysiology and the development of molecularly targeted therapeutics. This review examines the fields of proteomics and metabolomics in the context of obstetrics and gynaecology, including a discussion of methodology, challenges, potential applications and current research.

Plasma from women with preeclampsia inhibits trophoblast invasion.

To assess whether plasma from women with preeclampsia altered trophoblast invasion, SGHPL-4 extravillous trophoblasts were treated with pooled plasma from women with preeclampsia (PE-P; 10%) or with plasma from healthy pregnant controls (C-P). PE-P significantly inhibited SGHPL-4 invasion through Matrigel-coated transwells (P < .01), reduced mitochondrial dehydrogenase activity (P < .01), and increased apoptosis (P < .05); however, invading cells were no more susceptible to PE-P-induced apoptosis than their static counterparts. C-P did not alter rates of invasion, proliferation, or apoptosis. The bioactivity of PE-P was retained after removal of the 6 most abundant plasma proteins using an immunodepletion column (P < .05). Fractionation of PE-P demonstrated that the reduction in invasion was predominantly mediated by factors >100 kd in size. The authors conclude that plasma from women with preeclampsia contains multiple factors that inhibit invasion. These factors do not specifically target invading cells, but instead may reduce the number of cells available to invade.