Frontiers in Medicine最新文献

{"title":"Early diagnosis of sepsis-associated AKI: based on destruction-replenishment contrast-enhanced ultrasonography.","authors":"Zexing Yu, Xue Shi, Yang Song, Xin Li, Ling Li, Huiyu Ge","doi":"10.3389/fmed.2025.1563153","DOIUrl":"https://doi.org/10.3389/fmed.2025.1563153","url":null,"abstract":"<p><strong>Objective: </strong>Establish a deep learning ultrasound radiomics model based on destruction-replenishment contrast-enhanced ultrasound (DR-CEUS) for the early prediction of acute kidney injury (SA-AKI).</p><p><strong>Method: </strong>This paper proposes a deep learning ultrasound radiomics model (DLUR). Deep learning models were separately established using ResNet18, ResNet50, ResNext18, and ResNext50 networks. Based on the features extracted from the fully connected layers of the optimal model, a deep learning ultrasound radiomics model (DLUR) was established using three classification models (built with 3 classifiers). The predictive performance of the best DLUR model was compared with the visual assessments of two groups of ultrasound physicians with varying levels of experience. The performance of each model and the ultrasound physicians was evaluated by assessing the receiver operating characteristic (ROC) curves. The area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were subsequently calculated.</p><p><strong>Results: </strong>Compared to the ResNet18 model, the DLUR model based on logistic regression (DLUR-LR) demonstrated the best predictive performance, showing a Net Reclassification Improvement (NRI) value of 0.210 (<i>p</i> < 0.05). The Integrated Discrimination Improvement (IDI) value for the corresponding stage was 0.169 (<i>p</i> < 0.05). Additionally, the performance of the DLUR-LR model also surpassed that of senior ultrasound physicians (AUC, 0.921 vs. 0.829, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>By combining deep learning and ultrasound radiomics, a deep learning ultrasound radiomics model with outstanding predictive efficiency and robustness has demonstrated excellent capability in the early prediction of acute kidney injury (SA-AKI).</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1563153"},"PeriodicalIF":3.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchial stenosis requires vigilance against tracheal mucormycosis: a case report.","authors":"Ye Wang, Shiyao Wang, Hongmei Zhao, Chen Wang","doi":"10.3389/fmed.2025.1510292","DOIUrl":"10.3389/fmed.2025.1510292","url":null,"abstract":"<p><p>This report highlights the importance of differentiating the etiology of dyspnea and tracheal stenosis. While acknowledging that tracheal stenosis can significantly cause respiratory distress, we emphasize the need to consider tracheal mucormycosis in the differential diagnosis, particularly in patients with risk factors such as uncontrolled diabetes and trauma. Early recognition and timely antifungal therapy remain crucial in managing this potentially fatal infection. Prioritizing early identification and treatment of mucormycosis before it progresses to the lungs can significantly improve patient outcomes and impact clinical practice.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1510292"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of measuring tools for nursing students' clinical learning environment.","authors":"Yun Xu, Qing Wang, Qi Wei","doi":"10.3389/fmed.2025.1458823","DOIUrl":"10.3389/fmed.2025.1458823","url":null,"abstract":"<p><strong>Objective: </strong>To understand the current situation and progress of clinical learning environment measurement tools for nursing students, this paper reviews the relevant research on clinical learning environment measurement tools for nursing students.</p><p><strong>Methods: </strong>Three databases (Web of Science, PubMed, and CNKI) were searched for relevant articles. Research articles that met specific criteria were included, with identified articles initially screened by title and keyword. Then the abstracts were screened for relevance, and the full text was read for validation before inclusion. Descriptive analysis was performed with relevant findings from data retrieved from various sources.</p><p><strong>Results: </strong>We included 19 articles that met the criteria, and introduced nine measurement scales, which completed the reliability and validity test through empirical research, providing an important reference for the assessment of clinical learning environment for nursing students. The Clinical Learning Environment and Supervision instrument (CLESI) has been translated into many languages and is widely used.</p><p><strong>Conclusion: </strong>This review includes multiple clinical learning environment measurement tools for nursing students, which have important value in evaluating the clinical environment of nursing students and can provide reference for scholars to carry out relevant research and practice. It also introduces the research prospects in this field, aiming to inspire future research.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1458823"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The varied Q creatinine in multi ethnics population and impact of adopting three different estimated glomerular filtration rates based on creatinine in adult populations: a call for performance validation.","authors":"Ferdy Royland Marpaung, Santi Wulan Purnami, Shofi Andari, Ali Rohman, Reny I'tishom, Hari Basuki Notobroto, Jusak Nugraha, Risky Vitria Prasetyo, Djoko Santoso, Etienne Cavalier, Aryati Aryati","doi":"10.3389/fmed.2025.1467503","DOIUrl":"10.3389/fmed.2025.1467503","url":null,"abstract":"<p><strong>Background: </strong>The determination of kidney function is commonly done by estimating the glomerular filtration rate (eGFR) using serum creatinine levels. Various eGFR formulas, including the recently developed European Kidney Function Consortium (EKFC) and the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI), have been adopted and are commonly utilized in clinical settings. Nevertheless, the extent of acceptance among these formulations in the multi ethnics populace is still undetermined. Thus, this study aimed to evaluate the performance of these formulations across different glomerular filtration rate categories in the adult population.</p><p><strong>Methods: </strong>The research involved a total of 9,557 individuals (median age of 40 years and 85% being male) who underwent routine medical examinations. Enzymatic or modified Jaffe techniques were employed to measure serum creatinine levels. The CKD-EPI2009 eGFR was employed as corresponding GFR in the comparisons. The Bland-Altman method was used to determine the average discrepancies and 95% confidence intervals of eGFR between each formula. Ultimately, in order to compare the equations, Lin's correlation coefficients were calculated for various eGFR categories.</p><p><strong>Results: </strong>The median creatinine level in the different island population showed variability. The CKD-EPI 2009 as well as different equations showed categorical agreement within the range of 91.42 to 92.77%. The correlations between CKD-EPI2009 and CKD-EPI 2021 and EKFC were 0.998 and 0.79, respectively (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>A substantial variation in creatinine and eGFR assessment were observed among different eGFR analysis for the adult population. Prospective study in various clinical contexts using measured GFR is essential to validate eGFR.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1467503"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of intravitreal injection of aflibercept biosimilar for treating diabetic macular edema.","authors":"Gaixia Zhai, Chao Sun, Xia Zhang, Yuanzhen Su","doi":"10.3389/fmed.2025.1528104","DOIUrl":"10.3389/fmed.2025.1528104","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy and safety of intravitreal injection of aflibercept biosimilar in the treatment of diabetic macular edema (DME).</p><p><strong>Methods: </strong>Clinical data were collected from 33 patients (40 eyes) newly diagnosed with DME in the ophthalmology department of our hospital between February and April 2024, all of whom were treated with the aflibercept biosimilar. Patients were managed according to the 3+ Pro re nata (PRN) regimen and completed a minimum follow-up period of 6 months. The best-corrected visual acuity (BCVA) testing, optical coherence tomography, optical coherence tomography angiography, and multifocal electroretinography were performed before and after treatment. BCVA and central retinal thickness (CRT) were compared at baseline and 1-, 3-, and 6-months post-treatment. Additionally, the changes in the foveal avascular zone area, vascular density (VD) of superficial and deep retinal capillaries in the macular region, and the first positive peak amplitude density in ring 1 were analyzed 6 months post-treatment.</p><p><strong>Results: </strong>BCVA improved significantly from 0.53 ± 0.12 logMAR at baseline to 0.31 ± 0.12, 0.26 ± 0.10, and 0.26 ± 0.08 logMAR at 1-, 3-, and 6-months post-treatment, respectively, (<i>p</i> < 0.05). CRT decreased significantly from 422.4 ± 63.04 μm at baseline to 294.7 ± 47.89, 272.1 ± 47.43, and 281.0 ± 40.72 μm at 1-, 3-, and 6-months post-treatment, respectively, (<i>p</i> < 0.05). The foveal avascular zone area significantly reduced from 0.40 ± 0.08 mm² at baseline to 0.35 ± 0.07 mm² at 6 months post-treatment. Superficial VD increased significantly from 38.90 ± 7.88% at baseline to 41.21 ± 7.98% at 6 months post-treatment, while deep VD significantly increased from 35.67 ± 7.50% at baseline to 38.72 ± 6.90% (<i>p</i> < 0.05). The first positive peak amplitude improved significantly from 55.30 ± 9.45 to 72.90 ± 7.44 nv/deg² at 6 months post-treatment (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Intravitreal injections of aflibercept biosimilar can significantly reduce DME, improve BCVA, enhance macular perfusion, and restore macular function.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1528104"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study on early diagnosis for fracture non-union prediction using deep learning and bone morphometric parameters.","authors":"Hui Yu, Qiyue Mu, Zhi Wang, Yu Guo, Jing Zhao, Guangpu Wang, Qingsong Wang, Xianghong Meng, Xiaoman Dong, Shuo Wang, Jinglai Sun","doi":"10.3389/fmed.2025.1547588","DOIUrl":"10.3389/fmed.2025.1547588","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of non-union fractures is vital for treatment planning, yet studies using bone morphometric parameters for this purpose are scarce. This study aims to create a fracture micro-CT image dataset, design a deep learning algorithm for fracture segmentation, and develop an early diagnosis model for fracture non-union.</p><p><strong>Methods: </strong>Using fracture animal models, micro-CT images from 12 rats at various healing stages (days 1, 7, 14, 21, 28, and 35) were analyzed. Fracture lesion frames were annotated to create a high-resolution dataset. We proposed the Vision Mamba Triplet Attention and Edge Feature Decoupling Module UNet (VM-TE-UNet) for fracture area segmentation. And we extracted bone morphometric parameters to establish an early diagnostic evaluation system for the non-union of fractures.</p><p><strong>Results: </strong>A dataset comprising 2,448 micro-CT images of the rat fracture lesions with fracture Region of Interest (ROI), bone callus and healing characteristics was established and used to train and test the proposed VM-TE-UNet which achieved a Dice Similarity Coefficient of 0.809, an improvement over the baseline's 0.765, and reduced the 95th Hausdorff Distance to 13.1. Through ablation studies, comparative experiments, and result analysis, the algorithm's effectiveness and superiority were validated. Significant differences (<i>p</i> < 0.05) were observed between the fracture and fracture non-union groups during the inflammatory and repair phases. Key indices, such as the average CT values of hematoma and cartilage tissues, BS/TS and BS/TV of mineralized cartilage, BS/TV of osteogenic tissue, and BV/TV of osteogenic tissue, align with clinical methods for diagnosing fracture non-union by assessing callus presence and local soft tissue swelling. On day 14, the early diagnosis model achieved an AUC of 0.995, demonstrating its ability to diagnose fracture non-union during the soft-callus phase.</p><p><strong>Conclusion: </strong>This study proposed the VM-TE-UNet for fracture areas segmentation, extracted micro-CT indices, and established an early diagnostic model for fracture non-union. We believe that the prediction model can effectively screen out samples of poor fracture rehabilitation caused by blood supply limitations in rats 14 days after fracture, rather than the widely accepted 35 or 40 days. This provides important reference for the clinical prediction of fracture non-union and early intervention treatment.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1547588"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The gamma-glutamyl transpeptidase to platelet ratio: a good noninvasive biomarker for predicting for the occurrence and prognosis of patients with hepatitis E virus-related acute liver failure.","authors":"Shuai Zhu, Jun Yuan, Feng Ju, Mengmeng Gu, Ze Xiang, Yan Zhang","doi":"10.3389/fmed.2025.1573114","DOIUrl":"10.3389/fmed.2025.1573114","url":null,"abstract":"<p><strong>Background: </strong>The relationship between GPR and hepatitis E has not been reported. This study evaluates the GPR levels in AHE patients and HEV-ALF patients and explores the role of GPR levels in the prognosis of HEV-ALF patients, offering new strategies and methods for the diagnosis and prognosis of HEV-ALF patients.</p><p><strong>Methods: </strong>Serum samples were collected from 206 AHE patients and 217 HEV-ALF patients admitted to the First Affiliated Hospital of Zhejiang University School of Medicine, Suzhou Yongding Hospital, and Nanjing Medical University Affiliated Suzhou Hospital between January 1, 2017, and November 30, 2024.</p><p><strong>Results: </strong>The GPR level in the HEV-ALF group was significantly higher than in the AHE group (<i>p</i> < 0.001). OPLS-DA analysis revealed that INR, TBIL, PLT, GPR, TCH, ALT, AFP, TP, ALB, and AST were the major influential factors for the occurrence of HEV-ALF. GPR showed good diagnostic performance with an AUC of 0.701. DCA further supported the utility of GPR across a range of threshold probabilities. Regarding the prediction of 30-day mortality, GPR levels were significantly higher in the non-survival group compared to the survival group (<i>p</i> < 0.001). OPLS-DA analysis highlighted GPR as the most influential factor for predicting 30-day mortality. GPR demonstrated an AUC of 0.703. DCA results also indicated GPR's strong decision-making ability for predicting 30-day mortality in HEV-ALF patients.</p><p><strong>Conclusion: </strong>GPR is highly expressed in HEV-ALF patients and is closely related to their prognosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1573114"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic obstructive pulmonary disease across three decades: trends, inequalities, and projections from the Global Burden of Disease Study 2021.","authors":"Yan Wang, Ruiyang Han, Xiao Ding, Wenjia Feng, Runguo Gao, Anning Ma","doi":"10.3389/fmed.2025.1564878","DOIUrl":"10.3389/fmed.2025.1564878","url":null,"abstract":"<p><strong>Objective: </strong>To assess the global burden of chronic obstructive pulmonary disease (COPD) and cross-country inequalities from 1990 to 2021 and project changes until 2045.</p><p><strong>Methods: </strong>Data on prevalence, mortality, and disability-adjusted life-years (DALYs) for COPD were extracted from the Global Burden of Disease Study 2021 (https://vizhub.healthdata.org/gbd-results/). Trends were analyzed globally, regionally, and nationally, considering population growth, aging, and epidemiological changes. Inequalities were quantified using the World Health Organization's health equity framework. Future projections were estimated to 2045.</p><p><strong>Results: </strong>From 1990 to 2021, global age-standardized rates of COPD prevalence, mortality, and DALYs declined annually by -0.04, -1.75%, and -1.71%, respectively. However, absolute cases, deaths, and DALYs increased by 112.23, 49.06, and 40.23%, driven by population growth and aging. Men consistently showed higher age-standardized rates. East Asia reported the highest absolute cases and deaths, while South Asia had the largest DALYs. High-income North America and Oceania had the highest age-standardized rates, while Australasia and Eastern Europe saw the steepest declines in prevalence and mortality, respectively. Disparities in COPD burden across sociodemographic index levels widened over time. By 2045, absolute numbers of COPD cases, deaths, and DALYs are projected to rise despite declining age-standardized rates.</p><p><strong>Conclusion: </strong>While global age-standardized rates of COPD prevalence, mortality, and DALYs have declined, the absolute burden has increased due to demographic shifts. Persistent disparities in COPD burden, particularly in low- and middle-sociodemographic index regions, underscore the need for targeted prevention and management strategies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1564878"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the efficacy of low-molecular-weight heparin in managing umbilical artery thrombosis during pregnancy: does it offer therapeutic benefits?","authors":"Peng Zhao, Yicheng Lu, Sitong Liu, Lidan Zhang, Chong Chen, Xiaofu Yang","doi":"10.3389/fmed.2025.1540685","DOIUrl":"10.3389/fmed.2025.1540685","url":null,"abstract":"<p><strong>Introduction: </strong>Umbilical artery thrombosis (UAT) is a rare but serious pregnancy complication, potentially causing fetal growth restriction, distress, and stillbirth. Diagnosis relies on Doppler ultrasound and pathological assessment. Close monitoring and potential low-molecular-weight heparin (LMWH) therapy aim to prolong gestation and improve outcomes, but debate persists on its efficacy compared to expectant management.</p><p><strong>Methods: </strong>A retrospective study, conducted between January 2013 and December 2023, enrolled singleton pregnant women diagnosed with UAT during pregnancy. The experiment group included pregnant women who underwent LMWH with anti-coagulation therapy during pregnancy, while the expectant group comprised pregnancies that received standard prenatal care without any specific intervention for UAT.</p><p><strong>Results: </strong>The expectant group showed a significant increase in birth weight (expectant vs. experiment: 2434.40 ± 770.20 g vs. 1874.46 ± 717.83 g, <i>P</i> < 0.05) and a significant decrease in the incidence of births before 34 weeks (expectant vs. experiment: 42.24% vs. 82.75%, <i>P</i> < 0.05). Gestational age at birth was notably higher in the expectant group as compared to the experiment group (35.32 ± 3.89 vs. 33.59 ± 4.17), although the difference did not reach statistical significance (<i>p</i> = 0.110). The multi-factor ANOVA revealed statistically significant effects of anti-coagulation therapy (<i>F</i> = 4.479, <i>p</i> = 0.039) and gestational age at birth (<i>F</i> = 179.110, <i>p</i> = 0.000) on birth weight. This study found that the relationship between these variables can be formulated as: birth weight = -3314.782-256.106 × anti-coagulation therapy (coded as 1 if yes and 0 if no) +161.858 × gestational age at birth.</p><p><strong>Conclusion: </strong>Our study suggests that expectant therapy may offer substantial benefits compared to experimental therapy involving the administration of LMWH.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1540685"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T helper cell 17/regulatory T cell balance regulates ulcerative colitis and the therapeutic role of natural plant components: a review.","authors":"Da Zhao, Anqi Ge, Cong Yan, Xingci Liu, Kailin Yang, Yexing Yan, Moujia Hao, Junpeng Chen, Pawan Daga, Charles C Dai, Changping Li, Hui Cao","doi":"10.3389/fmed.2024.1502849","DOIUrl":"10.3389/fmed.2024.1502849","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a chronic relapsing inflammatory disease characterized by progressive mucosal damage. The incidence rate of UC is rising rapidly, which makes the burden of medical resources aggravated. In UC, due to various pathogenic factors such as mucosal immune system disorders, gene mutations and environmental factors disrupting the mucosal barrier function, the midgut pathogenic bacteria and exogenous antigens translocate into the lamina propria, thereby aggravating the inflammatory response and further damages the mucosal barrier. During the progression of UC, Th17 populations that cause inflammation generally increase, while Tregs that suppress Th17 activity decrease. Among them, Th17 mediates immune response, Treg mediates immunosuppression, and the coordinated balance of the two plays a key role in the inflammation and immune process of UC. Natural plant components can regulate biological processes such as immune inflammation from multiple levels of proinflammatory cytokines and signaling pathways. These characteristics have unique advantages and broad prospects in the treatment of UC. In immunomodulation, there is substantial clinical and experimental evidence for the modulatory role of natural plant products in restoring balance between Th17/Treg disturbances in UC. This review summarizes the previous studies on the regulation of Th17/Treg balance in UC by natural plant active ingredients, extracts, and traditional Chinese medicine prescriptions, and provides new evidence for the development and design of lead compounds and natural new drugs for the regulation of Th17/Treg balance in the future, and then provides ideas and evidence for future clinical intervention in the treatment of UC immune disorders and clinical trials.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1502849"},"PeriodicalIF":3.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}