Advances in clinical chemistry最新文献

{"title":"Hormonal, metabolic and metabolomic biomarkers in long COVID.","authors":"Dimitra Petropoulou, Irene Karampela, Gerasimos Socrates Christodoulatos, Dimitris Kounatidis, Natalia G Vallianou, Maria Dalamaga","doi":"10.1016/bs.acc.2026.01.002","DOIUrl":"10.1016/bs.acc.2026.01.002","url":null,"abstract":"<p><p>Long COVID (LC), a complex syndrome affecting approximately 6-12 % of individuals post infection, is characterized by persistent, fluctuating, or progressive symptoms lasting at least three months. Its pathogenic mechanisms involve viral persistence, chronic inflammation, immune dysregulation, endothelial dysfunction, and endocrine/metabolic abnormalities. Currently, no specific diagnostic tests exist for LC, highlighting the need for reliable biomarkers. This review synthesizes current evidence on hormonal, metabolic, and metabolite biomarkers in LC. While vitamin D deficiency is prevalent in LC, being associated with neurocognitive symptoms, delayed recovery and poor physical performance, particularly in older adults, its lack of specificity reduces diagnostic utility. Insulin resistance markers consistently correlate with fatigue, mood disturbances, and myalgia, suggesting a distinct metabolic LC phenotype. Lower cortisol frequently correlates with fatigue, sensory disturbances, and neurocognitive symptoms. Alterations in cortisol/adrenocorticotropic hormone, growth hormone, prolactin, and gonadotropins suggest a potential hypothalamic-pituitary axis involvement; however, these abnormalities are often transient, dynamic or nonsignificant. While some patients may exhibit low free triiodothyronine associated with fatigue, no significant incidence of thyroid dysfunction and autoimmunity was associated with LC. Despite the absence of a distinct and consistent metabolomic signature, LC is characterized by the activation of the kynurenine pathway, including increased kynurenine and quinolinic acid, being associated with fatigue, neurocognitive and depressive symptoms. Emerging metabolites of mitochondrial dysfunction and lipid metabolism alterations require further validation. Despite promising findings, evidence remains scattered, hindered by small sample sizes and methodological limitations. Future research should prioritize standardization of biomarker assessment, validation in diverse populations, and exploration of targeted therapeutic interventions.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"133 ","pages":"217-283"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary biomarkers in oral diseases: From caries to cancer-advances, challenges, and future directions.","authors":"Samanta Mascarenhas Moraes, Carolina Ruis Ferrari, Marília Afonso Rabelo Buzalaf","doi":"10.1016/bs.acc.2025.11.002","DOIUrl":"10.1016/bs.acc.2025.11.002","url":null,"abstract":"<p><p>Human saliva is a complex biological fluid essential for maintaining oral and systemic homeostasis. In recent years, it has emerged as a valuable, non-invasive, and informative diagnostic medium due to its rich composition of proteins, nucleic acids, metabolites, and microorganisms. Salivary biomarkers have been extensively investigated for their potential in early diagnosis, disease monitoring, and prognosis of various oral conditions, such as dental caries, periodontal disease, and oral cancer. Advances in analytical techniques have significantly enhanced the sensitivity and specificity of salivary biomarker detection, deepened our understanding of pathophysiological mechanisms and accelerated their translation into clinical practice. In this chapter, we detail key salivary biomarkers associated with these major oral conditions, emphasizing their potential clinical applications and addressing the challenges inherent in integrating salivary diagnostics into routine dental care. We also explore the biological foundations of saliva production, highlight current methodologies for salivary biomarker analysis, and discuss their clinical significance in oral diseases. Finally, we examine emerging trends and future perspectives for the incorporation of salivary diagnostics into precision oral healthcare.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"132 ","pages":"57-124"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and risk factors in pancreatogenic diabetes.","authors":"Ravi Kumar Sharma, Alpa Singh, Saurabh Dawra","doi":"10.1016/bs.acc.2025.10.003","DOIUrl":"10.1016/bs.acc.2025.10.003","url":null,"abstract":"<p><p>Pancreatogenic diabetes, i.e. Type 3c Diabetes Mellitus (T3c), is a distinct clinical entity primarily caused by underlying pancreatic disorders. These include acute, chronic, or recurrent pancreatitis, traumatic pancreatitis, pancreatic surgery, cystic fibrosis and pancreatic cancer. Although T3c accounts for approximately 10-15 % of all diabetes, its true burden within the spectrum of pancreatic diseases has been explored in only a limited number of studies. T3c is characterised by both endocrine and exocrine pancreatic insufficiency, and is notable for significant glucose fluctuations resulting from pancreatic tissue loss. It is often misdiagnosed as type 2 diabetes mellitus (T2), making it one of the least investigated and most overlooked forms of diabetes in routine clinical practice. This diagnostic gap frequently leads to ineffective treatment strategies and increased morbidity. Accurate diagnosis hinges on identifying the hallmark features of exocrine pancreatic insufficiency (EPI), which is common in T3c but rarely seen in T2. Two key diagnostic tests include fecal pancreatic elastase and fecal fat quantification. Fat excretion> 7 g/day strongly suggests steatorrhea and significant malabsorption. Given the clinical similarities between T3c and T2, improving diagnostic accuracy is crucial. Early recognition of distinguishing features allows for appropriate medical management and tailored treatment plans that address both endocrine and exocrine dysfunction.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"131 ","pages":"177-193"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic low-grade inflammation in vegetarians and vegans: Biomarker evidence and methodological considerations.","authors":"Ines Peremin, Goran Gajski, Marko Gerić, Ivone Jakaša","doi":"10.1016/bs.acc.2026.03.003","DOIUrl":"10.1016/bs.acc.2026.03.003","url":null,"abstract":"<p><p>The association between vegetarian and vegan dietary patterns and chronic low-grade inflammation represents a growing area within nutritional epidemiology, with potential implications for lifestyle-based prevention and management of non-communicable diseases. Although recent meta-analyses of cross-sectional studies conducted over the past 25 years suggest a trend toward lower levels of inflammatory biomarkers among vegetarians compared to non-vegetarians, the strength of this evidence remains limited. This chapter offers a state-of-the-art overview of this topic, providing a brief summary of key inflammatory biomarkers, assay technologies, and analytical considerations. It advocates for the use of high-sensitivity, high-throughput multiplex platforms to assess C-reactive protein as a clinically relevant marker, complemented by broader cytokine panels, to more precisely capture subtle differences across distinct dietary groups. Special emphasis is placed on the critical evaluation of findings from cross-sectional studies and related meta-analyses, with particular attention to their inherent methodological limitations.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"134 ","pages":"109-152"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial myopathy biomarkers.","authors":"Marco Refrigeri, Alessandra Tola, Rosangela Mogavero, Maria Michela Pietracupa, Giulia Gionta, Roberto Scatena","doi":"10.1016/bs.acc.2026.01.007","DOIUrl":"10.1016/bs.acc.2026.01.007","url":null,"abstract":"<p><p>Mitochondrial myopathies comprise a heterogeneous group of disorders arising from structural or functional mitochondrial impairments that disrupt oxidative phosphorylation and cellular ATP production. The resulting energy deficit manifests not only in muscle but frequently leads to multi-systemic disease involving the brain, heart, kidneys, and endocrine system, creating a complex and often confounding clinical presentation. A critical, often overlooked aspect of their pathophysiology is that mitochondrial dysfunction extends far beyond bioenergetics. These organelles are vital hubs for biosynthetic pathways, calcium homeostasis, thermogenesis, apoptosis, and redox-sensitive signaling pathways that govern gene expression. The disruption of these integrated functions, whose molecular consequences are still being elucidated, is central to the disease's progression and heterogeneity. This clinical and molecular complexity contributes to significant diagnostic delay, with many remaining undiagnosed. Therefore, the development and strategic implementation of reliable biomarkers are essential. This review critically evaluates current and emerging biomarkers, proposing a diagnostic framework designed to improve diagnostic accuracy, limit unnecessary procedures, and ensure timely access to therapeutic interventions and genetic counseling.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"133 ","pages":"161-216"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomics of the skeletal muscle dystrophin complex.","authors":"Paul Dowling, Dieter Swandulla, Kay Ohlendieck","doi":"10.1016/bs.acc.2026.08.001","DOIUrl":"https://doi.org/10.1016/bs.acc.2026.08.001","url":null,"abstract":"<p><p>Proteomics is a widely applied analysis pipeline in biomedical research and clinical chemistry. In skeletal muscle biology, proteomics has been extensively used to identify and characterize individual proteoforms in normal and diseased contractile tissue. This article outlines mass spectrometric approaches to study the proteome of myofibers and associated cell types. We highlight sample preparation and protein digestion for bottom-up proteomics, as well as mass analyzers and bioinformatic data handling. As an illustrative example, the identification and characterization of the sarcolemmal dystrophin-glycoprotein complex, which is primarily involved in the progressive muscle wasting disorder Duchenne muscular dystrophy, are explored.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"135 ","pages":"75-115"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autophagy in lipid metabolism.","authors":"Mouliganesh Sekar, Kavitha Thirumurugan","doi":"10.1016/bs.acc.2025.10.007","DOIUrl":"10.1016/bs.acc.2025.10.007","url":null,"abstract":"<p><p>Autophagy is a complex and highly regulated cellular process essential for maintaining homeostasis in adipose tissue by modulating adipocyte differentiation, lipogenesis, and lipolysis. Although lipids are primarily known as energy-storage compounds, they also play a role in triglyceride transport, intracellular communication via steroid hormones, organ protection, and thermoregulation. Lipid metabolism relies on the dynamic balance between synthesis, storage and degradation of key lipid classes such as: triglycerides, sterols and phospholipids. Among the pathways controlling lipid metabolism, autophagy plays a critical role by facilitating lipid degradation via enzymatic lipolysis and lipophagy. The latter emerges as a central mechanism in selectively degrading lipid droplets (LD), thus preventing lipid overload and lipotoxicity. Dysregulation of autophagy contributes to the onset and progression of various metabolic disorders, including obesity, non-alcoholic fatty liver disease, and lysosomal storage diseases. This review provides a comprehensive overview of the molecular mechanisms underpinning autophagy, its role in lipid metabolism, and its pathological relevance in lipid-associated disorders, offering insights into potential therapeutic strategies targeting autophagic pathways for restoring lipid balance.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"130 ","pages":"99-132"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug induced renal injury (DIRI) biomarkers.","authors":"Emina Karahmet Sher, Marijana Marković Boras, Almir Fajkić, Faris Begović","doi":"10.1016/bs.acc.2026.01.006","DOIUrl":"10.1016/bs.acc.2026.01.006","url":null,"abstract":"<p><p>Drug-induced renal injury (DIRI) remains a substantial issue in clinical practice, contributing to high morbidity, mortality, socioeconomic and healthcare cost. Traditional markers, such as serum creatinine or blood urea nitrogen, have low specificity and sensitivity for early identification, underscoring the need for new reliable biomarkers. This chapter investigates biomarker improvements for DIRI, focusing on clinical uses, limitations, and future possibilities. The chapter examines biomarkers such as neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, cystatin C, β₂-microglobulin and clusterin for diagnosing nephrotoxicity. In addition, we highlight the role of proteomics and metabolomics in facilitating the identification and development of novel biomarker candidates via high-throughput ultra-sensitive technology in investigating DIRI mechanisms. The chapter discusses validation frameworks, regulatory criteria for biomarker adoption in clinical settings, and how they are integrated into treatment monitoring and personalized medicine. Case examples demonstrate the real-world applicability in early diagnosis, risk classification, and therapy optimization. Standardization, cost, and translational gaps are discussed, as well as the potential for artificial intelligence and machine learning to improve biomarker processing and interpretation. Finally, this chapter emphasizes the transformative potential of DIRI biomarkers in providing a pathway to more accurate and timely identification of renal injury, improved patient outcomes, and reduced healthcare costs. Future research and global collaboration are required to fully realize the potential of these advances in clinical and regulatory settings.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"133 ","pages":"1-44"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidative stress and glycosylation in viral infection and inflammatory response.","authors":"Sanchita Chakraborty, Anand Kasirajan, Agiesh Kumar Balakrishna Pillai","doi":"10.1016/bs.acc.2026.08.005","DOIUrl":"https://doi.org/10.1016/bs.acc.2026.08.005","url":null,"abstract":"<p><p>Reactive oxygen species (ROS) act as key intracellular signaling molecules, especially during infection and inflammation. Increased ROS disrupts cellular processes and worsens infectious disorders. While redox-related patterns are observed in several viral diseases, few studies examine redox and glycan metabolism. Glycans are sugar chains on cell and viral surfaces that influence viral entry and immune recognition. Studying glycan pathways under oxidative stress may enable new therapies. This review discusses an overview on the interactions between the host key regulators like of the ROS-driven oxidative stress like Nrf2 and NLRP3, and the antiviral host guanylate binding protein 5 (GBP5) during the viral infections and their impact on glycosylation.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"135 ","pages":"1-38"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in nanopore sensing: Signal processing prospects for the future.","authors":"Naren Das, Arnav Jhalani","doi":"10.1016/bs.acc.2025.10.011","DOIUrl":"10.1016/bs.acc.2025.10.011","url":null,"abstract":"<p><p>Nanopore sensing has developed as a revolutionary analytical tool in clinical chemistry, which facilitates fast, label-free analysis of biomolecules from nucleic acids through proteins and small metabolites. Its potential for converting molecular interaction into measurable ionic current fingerprints makes real-time, high-resolution analysis of clinically relevant targets possible in complex biological matrices. In this chapter, we discuss the changing scene of signal processing methods that augment the diagnostic potential of nanopore platforms. The focus areas are reduction of noise, extraction of features, and integration of machine learning for precise biomarker identification under physiologically noisy environments. The chapter also mentions advances in real-time processing essential for point-of-care diagnostics, such as the adoption of edge AI and application-specific integrated circuits (ASICs). Finally, we present the future application of quantum computing and multimodal sensing in pushing nanopore-based clinical diagnostics forward.</p>","PeriodicalId":101297,"journal":{"name":"Advances in clinical chemistry","volume":"130 ","pages":"205-234"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}