Frontiers in Medicine最新文献

{"title":"Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension.","authors":"Yanqiu Li, Bingbing Zhu, Ke Shi, Yu Lu, Xuanwei Zeng, Yongqi Li, Qun Zhang, Ying Feng, Xianbo Wang","doi":"10.3389/fmed.2025.1515400","DOIUrl":"10.3389/fmed.2025.1515400","url":null,"abstract":"<p><p>Cirrhotic portal hypertension, the most prevalent and clinically significant complication of liver cirrhosis, manifests as elevated portal venous pressure and is associated with severe complications. Although much research on the mechanisms of portal hypertension has focused on liver fibrosis, less attention has been given to the role of intrahepatic and extrahepatic vascular dysfunction, particularly with respect to extrahepatic vasculature. While the role of hepatic fibrosis in cirrhotic portal hypertension is undeniable, the underlying mechanisms involving intrahepatic and extrahepatic vasculature are highly complex. Sinusoidal capillarization and endothelial dysfunction contribute to increased intrahepatic vascular resistance. Hemodynamic changes in the extrahepatic circulation, including splanchnic vasodilation and hyperdynamic circulation, play a significant role in the development of portal hypertension. Additionally, therapeutic strategies targeting these vascular mechanisms are diverse, including improvement of sinusoidal microcirculation, therapies targeting hepatic stellate cells activation, and pharmacological modulation of systemic vascular tone. Therefore, in this review, we will discuss the vascular-related mechanisms and treatment progress of portal hypertension in cirrhosis to provide a new theoretical basis and practical guidance for clinical treatment.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1515400"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432877","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":"Local sympathetic nerve depletion does not alter vitiligo progression in a mouse model.","authors":"Zhichao Hu, Ting Chen, Daoming Chen","doi":"10.3389/fmed.2025.1466996","DOIUrl":"10.3389/fmed.2025.1466996","url":null,"abstract":"<p><p>Vitiligo, an autoimmune skin disorder characterized by melanocyte loss, has long been associated with sympathetic nervous system activity. Clinical observations have suggested links between psychological stress, sympathetic activation, and vitiligo progression. However, direct experimental evidence for the role of sympathetic nerves in vitiligo development has been lacking. Herein, we employed 6-hydroxydopamine (6-OHDA) to induce sympathetic nerve depletion in mice before vitiligo induction. Sympathetic nerve ablation was confirmed through immunofluorescent staining of tyrosine hydroxylase. Vitiligo progression was assessed by quantifying epidermal melanocytes and CD8+ T cells using whole-mount immunofluorescence staining. The loss of melanocytes and infiltration of CD8+ T cells in vitiligo lesions were comparable between sympathectomized and control mice. Overall, our study suggested that previously observed associations between sympathetic nervous system activity and vitiligo may be concomitant effects rather than causative factors, challenging long-held clinical hypotheses.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1466996"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432921","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":"Baseline ¹⁸F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer.","authors":"Lu Zheng, Yanzhu Bian, Yujing Hu, Congna Tian, Xinchao Zhang, Shuheng Li, Xin Yang, Yanan Qin","doi":"10.3389/fmed.2025.1477275","DOIUrl":"10.3389/fmed.2025.1477275","url":null,"abstract":"<p><strong>Objective: </strong>To analyse positron emission tomography/ computed tomography (PET/CT) imaging and clinical data from patients with non-small cell lung cancer (NSCLC), to identify characteristics of survival beneficiaries of immune checkpoint inhibitors (ICIs) treatment and to establish a survival prediction model.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on PET/CT imaging and clinical parameters of 155 NSCLC patients who underwent baseline PET/CT examination at the Department of Nuclear Medicine, Hebei General Hospital. The Kaplan-Meier curve was employed to compare progression-free survival (PFS) and overall survival (OS) between the ICIs and non-ICIs group and to assess the impact of variables on PFS and OS in the ICIs group. Multivariate Cox proportional hazards regression analysis was conducted with parameters significantly associated with survival in univariate analysis.</p><p><strong>Results: </strong>Significant differences were observed in PFS (<i>χ²</i>  = 11.910, <i>p</i> = 0.0006) and OS (<i>χ²</i>  = 8.343, <i>p</i> = 0.0039). Independent predictors of PFS in the ICIs group included smoking history[hazard ratio (HR) = 2.522, 95% confidence interval (CI): 1.044 ~ 6.091, <i>p</i> = 0.0398], SUVmax of the primary lesion(HR = 0.2376, 95%CI: 0.1018 ~ 0.5548, <i>p</i> = 0.0009), MTVp (HR = 0.0755, 95%CI: 0.0284 ~ 0.2003, <i>p</i> < 0.001), and TLGp (HR = 0.1820, 95%CI: 0.0754 ~ 0.4395, <i>p</i> = 0.0002). These were also independent predictors of OS in the ICIs group[HR(95%CI) were 2.729 (1.125 ~ 6.619), 0.2636 (0.1143 ~ 0.6079), 0.0715 (0.0268 ~ 0.1907), 0.2102 (0.0885 ~ 0.4992), both <i>p</i> < 0.05)]. Age was an additional independent predictor of OS (HR = 0.4140, 95%CI: 0.1748 ~ 0.9801, <i>p</i> = 0.0449).</p><p><strong>Conclusion: </strong>Smoking history, primary lesion SUVmax, MTVp, and TLGp were independent predictors of PFS, whilst age, smoking history, SUVmax, MTVp, and TLGp were independent predictors of OS in the ICIs group. Patients without a history of smoking and with SUVmax ≤19.2, MTVp ≤20.745cm³, TLGp ≤158.62 g, and age ≤ 60 years benefited more from ICI treatment.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1477275"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432881","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 diagnosis of DIC: a current overview.","authors":"Hongyu Yang, Xiaochun Ma, Xu Li","doi":"10.3389/fmed.2025.1502628","DOIUrl":"10.3389/fmed.2025.1502628","url":null,"abstract":"<p><p>The name of disseminated intravascular coagulation (DIC) and its diagnostic criteria remain controversial. DIC is a clinical syndrome caused by a variety of etiologies, which determines its high heterogeneity. It is inappropriate to adopt the same diagnostic criteria. DIC has its common characteristics. First, in most DIC, thrombosis and bleeding coexist. Second, DIC is a dynamic process. Third, endothelial cell injury and systemic coagulation activation are the core of DIC. Fourth, DIC is an initiating factor of multiple organ dysfunction syndrome (MODS). There are still controversies about the diagnostic criteria of DIC. First, it relies on clinical manifestations and laboratory tests, which cannot reflect pathophysiology. Second, the clinical manifestations were not sensitive or specific. Third, there is a lack of sensitive biomarkers. Fourth, the parameters in the current diagnostic criteria cannot fully reflect the actual coagulation function. Fifth, it is obviously inappropriate to use the same scoring system for diagnosis of clinical syndromes with different etiologies and pathophysiology. Therefore, it is urgent to re-establish the diagnostic criteria for DIC. In recent years, the understanding of DIC has been continuously improved, including the in-depth understanding of the pathogenesis, the classification of coagulation phenotypes, and the development of the \"two-step\" diagnosis of DIC, etc. All of these contribute to the establishment of new diagnostic criteria for DIC. In conclusion, it is necessary to develop personalized diagnostic criteria based on etiology, reflecting pathophysiological mechanisms, establishing clear cut-off values for parameters, being clinical applicable, being globally unified, and most importantly, being able to identify therapeutic targets.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1502628"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431945","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":"Comparison of macular retinal thickness measurements using spectral-domain and swept-source optical coherence tomography in healthy eyes.","authors":"Huan Wan, Zhaode Wu, Ziling Liu, Bo Qin","doi":"10.3389/fmed.2025.1529719","DOIUrl":"10.3389/fmed.2025.1529719","url":null,"abstract":"<p><strong>Aim: </strong>This study compares retinal thickness measurements in healthy eyes using one SD-OCT and two SS-OCT devices to assess differences and consistency for clinical application.</p><p><strong>Methods: </strong>Forty-eight eyes with a mean age of 28.15 ± 8.85 years were enrolled. Retinal thickness was measured using Heidelberg Spectralis SD-OCT, Svision VG200 SS-OCT, and TowardPi En Face SS-OCT. Normally distributed data were presented as mean ± SD; non-normal data as median (P25-P75). Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to assess agreement, with a 7 μm error threshold.</p><p><strong>Results: </strong>Significant differences were found between the three devices (<i>p</i> < 0.001). SD-OCT measurements were consistently lower than SS-OCT (<i>p</i> < 0.001), while the two SS-OCT devices showed no significant differences except in the nasal region (<i>p</i> = 0.006). ICC values between SD-OCT and SS-OCT devices were low (0.125-0.532), while SS-OCT devices showed better agreement (ICC: 0.369-0.922). Bland-Altman analysis found only 8.33% of SD-OCT and SS-OCT measurements within the 7 μm error range, compared to 81.25-83.33% for SS-OCT devices.</p><p><strong>Conclusion: </strong>The measurements of macular retinal thickness using SD-OCT and SS-OCT devices showed poor consistency and cannot be used interchangeably. However, measurements obtained from different SS-OCT devices demonstrated good consistency. To enhance the accuracy of results, it is recommended to maintain consistency in the devices used for follow-up examinations in the same patient.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1529719"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432883","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":"Investigating key elements of digital resilience among nursing undergraduates: a qualitative study.","authors":"Fanfan Li, Qiuping Ma, Chunxiao Yang, Mingyang Zhong","doi":"10.3389/fmed.2024.1452580","DOIUrl":"10.3389/fmed.2024.1452580","url":null,"abstract":"<p><strong>Objective: </strong>To explore key elements of digital resilience in nursing undergraduates, providing a foundation for comprehensive assessment and training during medical colleges' digital transformation.</p><p><strong>Methods: </strong>Conducted semi-structured interviews with 20 nursing undergraduates experienced in online learning or digital resource use from March-May 2024, utilizing descriptive qualitative research and directed content analysis.</p><p><strong>Results: </strong>Identified five themes with nineteen sub-themes: understanding digital threats (information overload, decreased learning engagement, impaired social interaction, digital technology failures, digital security risks), knowing coping strategies (seeking teacher support, seeking peer support, seeking social support), learning knowledge and skills (nursing expertise, autonomous learning ability, digital technology application skills, digital learning skills, digital communication skills), overcoming digital threats stress (psychological resilience, learning perseverance), and adapt to digital environment (self-regulation and motivational efficacy, online learning self-efficacy, digital skills self-efficacy, social interaction self-efficacy).</p><p><strong>Conclusion: </strong>Nursing undergraduates' digital resilience is multifaceted. Medical colleges should strengthen these aspects to empower students to confidently navigate digital risks and adapt to educational and healthcare digital transformation.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1452580"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432790","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":"Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis.","authors":"Shan Wang, Lin Zhang, Jin Li, Jiajun Feng, Jie Gao, Rui Huang","doi":"10.3389/fmed.2025.1417222","DOIUrl":"10.3389/fmed.2025.1417222","url":null,"abstract":"<p><strong>Introduction: </strong>Liver disease remains a significant global health concern. In China, the number of patients with liver cirrhosis is estimated to reach 7 million. In addition to the high risk of death, cirrhosis leads to several severe complications. Patients with cirrhosis have significantly longer hospital stays and higher total hospital costs than those without cirrhosis. We aimed to investigate the predictors of readmission among patients with cirrhosis in China.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study to evaluate adult patients with cirrhosis. Data on various sociodemographic, clinical, and hospitalization characteristics were collected. We defined the primary endpoint as the first liver-related readmission occurring within 30-90 days of initial hospitalization. Adult patients with cirrhosis admitted to our hospital between January 2009 and December 2022 were included. Differences between groups were analyzed using Student's t-test and chi-square test. Logistic and multiple linear regression analyses were performed to identify predictors associated with readmission and the length of the first hospitalization.</p><p><strong>Results: </strong>In total, 1,285 patients were diagnosed with cirrhosis. Among these patients, 767 (59.7%) were males, and the mean age was 58.9 ± 12.3 years. Seventy-two (5.6%) and 154 (12.0%) patients were readmitted within 30 and 90 days, respectively. Compared with those who were not readmitted, patients readmitted at 30-day and 90-day had a higher proportion of males, ascites, spontaneous bacterial peritonitis, electrolyte abnormalities, higher Child-Pugh-Turcotte scores, longer initial hospital stays, and higher initial hospitalization costs. Logistic regression analysis indicated that hepatic encephalopathy, spontaneous bacterial peritonitis, diabetes, and ascites were predictors of 30- and 90-day readmission. Hypertension and spontaneous bacterial peritonitis were significant predictors of the length of the first hospitalization.</p><p><strong>Conclusion: </strong>Patients with cirrhosis presenting with hepatic encephalopathy, ascites, and spontaneous bacterial peritonitis may have a higher risk of rehospitalization.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1417222"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432915","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":"Risk factors for multidrug resistance in pulmonary tuberculosis patients with diabetes mellitus.","authors":"Lianpeng Wu, Na Chen, Dandan Xia, Xiangao Jiang","doi":"10.3389/fmed.2025.1516207","DOIUrl":"10.3389/fmed.2025.1516207","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the risk factors for multidrug resistance (MDR) in patients with pulmonary tuberculosis (PTB) and diabetes mellitus (DM), including those with and without prior TB treatment.</p><p><strong>Methods: </strong>A retrospective study was conducted from 1 January 2021, to 31 December 2023, at Wenzhou Central Hospital. Patients diagnosed with PTB and DM were included, with multidrug-resistant tuberculosis (MDR-TB) defined as resistance to at least rifampicin and isoniazid. Data on demographics, clinical symptoms, laboratory tests, and treatment history were collected. Multivariate logistic regression analysis was used to identify independent risk factors for MDR, and receiver operating characteristic (ROC) curves were constructed to evaluate the predictive value of these factors.</p><p><strong>Results: </strong>A total of 318 patients were analyzed, with 253 in the non-MDR group and 65 in the MDR group. Significant independent predictors of MDR included a history of TB treatment, smoking, and elevated hemoglobin A1c (HbA1c) levels. ROC curve analysis showed that the combination of TB treatment history, smoking history, and HbA1c levels had an area under the curve (AUC) of 0.809, with 64.62% sensitivity and 82.61% specificity. In patients without prior TB treatment, smoking history and HbA1c were identified as independent risk factors, with an AUC of 0.771 for their combination. For patients with prior TB treatment, place of residence and pulmonary cavity were independent predictors, with an AUC of 0.802 for their combination.</p><p><strong>Conclusion: </strong>This study highlights the importance of smoking history, HbA1c levels, place of residence, and pulmonary cavity as risk factors for MDR in PTB and DM patients. Early identification of these risk factors can aid in the timely diagnosis and treatment of MDR-TB, potentially reducing its burden. Further research is needed to develop targeted interventions based on these findings.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1516207"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432924","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":"Development and validation of a prediction model for acute kidney injury following cardiac valve surgery.","authors":"Xiaotong Jia, Jun Ma, Zeyou Qi, Dongni Zhang, Junwei Gao","doi":"10.3389/fmed.2025.1528147","DOIUrl":"10.3389/fmed.2025.1528147","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) often accompanies cardiac valve surgery, and worsens patient outcome. The aim of our study is to identify preoperative and intraoperative independent risk factors for AKI in patients undergoing cardiac valve surgery. Using these factors, we developed a risk prediction model for AKI after cardiac valve surgery and conducted external validation.</p><p><strong>Methods: </strong>Our retrospective study recruited 497 adult patients undergoing cardiac valve surgery as a derivation cohort between February and August 2023. Patient demographics, including medical history and perioperative clinical information, were acquired, and patients were classified into one of two cohorts, AKI and non-AKI, according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Using binary logistic stepwise regression analysis, we identified independent AKI risk factors after cardiac valve surgery. Lastly, we constructed a nomogram and conducted external validation in a validation cohort comprising 200 patients. The performance of the nomogram was evaluated based on the area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analysis (DCA).</p><p><strong>Results: </strong>In the derivation cohort, 172 developed AKI (34.6%). Relative to non-AKI patients, the AKI patients exhibited elevated postoperative complication incidences and worse outcome. Based on multivariate analysis, advanced age (OR: 1.855; <i>p</i> = 0.011), preoperative hypertension (OR: 1.91; <i>p</i> = 0.017), coronary heart disease (OR: 6.773; <i>p</i> < 0.001), preoperative albumin (OR: 0.924; <i>p</i> = 0.015), D-Dimer (OR: 1.001; <i>p</i> = 0.038), plasma creatinine (OR: 1.025; <i>p</i> = 0.001), cardiopulmonary bypass (CPB) duration (OR: 1.011; <i>p</i> = 0.001), repeat CPB (OR: 6.195; <i>p</i> = 0.010), intraoperative red blood cell transfusion (OR: 2.560; <i>p</i> < 0.001), urine volume (OR: 0.406 <i>p</i> < 0.001) and vasoactive-inotropic score (OR: 1.135; <i>p</i> = 0.009) were independent risk factors for AKI. The AUC of the nomogram in the derivation and validation cohorts were 0.814 (95%CI: 0.775-0.854) and 0.798 (95%CI: 0.726-0.871), respectively. Furthermore, the calibration curve revealed that the predicted outcome was in agreement with the actual observations. Finally, the DCA curves showed that the nomogram had a good clinical applicability value.</p><p><strong>Conclusion: </strong>Several perioperative factors modulate AKI development following cardiac valve surgery, resulting in poor patient prognosis. The proposed AKI predictive model is both sensitive and precise, and can assist in high-risk patient screening in the clinics.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1528147"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432889","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":"Increased serum soluble PD-l1 levels in patients with advanced stages of chronic kidney disease.","authors":"Ayaka Hayashi, Hiroto Ishihara, Mayuko Kawabe, Kazuhiko Kato, Akio Nakashima, Izumi Yamamoto, Teppei Sakano, Hiroe Kobashi, Makoto Morita, Takashi Yokoo, Mitsuyoshi Urashima","doi":"10.3389/fmed.2025.1530804","DOIUrl":"10.3389/fmed.2025.1530804","url":null,"abstract":"<p><strong>Background: </strong>Programed death-ligand 1 (PD-L1) is overexpressed on renal tubular and vascular epithelial cells in inflammatory kidney diseases as well as on aged kidney podocytes, contributing to chronic kidney disease (CKD) progression. The association of serum soluble programed death-ligand 1 (sPD-L1) levels and chronic kidney disease (CKD) progression is unknown.</p><p><strong>Methods: </strong>To compare serum sPD-L1 levels among healthy individuals and patients with various CKD stages, including those undergoing dialysis, a secondary analysis was performed using clinical data and residual serum samples from four distinct cohorts, each prospectively collected for different research purposes: The Vaccine Cohort (2021-2022), the Cancer Cohort (2010-2018), the Dialysis Initiation Cohort (2023-2024), and the Dialysis Maintenance Cohort (2011-2015) included patients on stable maintenance dialysis.</p><p><strong>Results: </strong>The study analyzed serum sPD-L1 levels in 2,829 participants (mean age, 54.2 years; male, 54.2%) across the four cohorts. In the Vaccine and Cancer cohorts, sPD-L1 levels increased significantly with age (<i>P</i> < 0.001) and male sex (<i>P</i> < 0.001). In the Vaccine Cohort, elevated median sPD-L1 levels (pg/mL) were significantly associated with CKD stage progression (<i>P</i> < 0.001), showing exponentially higher levels with CKD progression. A similar association was observed and validated in the Cancer Cohort (<i>P</i> < 0.001). In the Dialysis Initiation Cohort (<i>n</i> = 15), sPD-L1 levels significantly increased three months after dialysis initiation compared to pre-dialysis levels (<i>P</i> = 0.03). In the Dialysis Maintenance Cohort, sPD-L1 levels increased with longer dialysis duration (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Serum sPD-L1 levels might increase with CKD stage progression, dialysis initiation and longer dialysis duration. Further clinical investigation is required to confirm these results.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1530804"},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432918","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}