Frontiers in Medicine最新文献

{"title":"Interpretable machine learning model to predict 90-day radiographically confirmed pneumonia after chemotherapy initiation in non-Hodgkin lymphoma: development and internal validation of a single-center cohort.","authors":"Zhanna Zhang, Manqi Su, Panruo Jiang, Xiaoxia Wang, Lingling Kong, Xiangmin Tong, Gongqiang Wu","doi":"10.3389/fmed.2025.1674896","DOIUrl":"10.3389/fmed.2025.1674896","url":null,"abstract":"<p><strong>Background: </strong>Radiographically confirmed pneumonia within 90 days of chemotherapy initiation is a frequent and clinically important complication in patients with non-Hodgkin lymphoma, yet interpretable tools for early individualized risk estimation are limited.</p><p><strong>Objective: </strong>To develop and internally validate an interpretable machine-learning model that predicts the 90-day risk of radiographically confirmed pneumonia after chemotherapy initiation in non-Hodgkin lymphoma.</p><p><strong>Methods: </strong>We retrospectively analyzed 205 chemotherapy-treated NHL patients. A two-step feature selection (LASSO followed by random-forest-based recursive feature elimination) identified four predictors: high-grade malignancy, drinking (alcohol use), estimated glomerular filtration rate (eGFR), and smoking. Five algorithms were trained and compared under a stratified 70/30 split (training <i>n</i> = 145; internal hold-out test set <i>n</i> = 60) with leakage-safe preprocessing (within-fold kNN imputation, SMOTE, and scaling). The gradient boosting machine (GBM) performed best and was interpreted using SHAP. A web-based prototype was implemented for research use only.</p><p><strong>Results: </strong>On the internal hold-out test set (<i>n</i> = 60), the GBM achieved an AUC of 0.855 (95% CI 0.746-0.964), an F1 score of 0.679, and a Brier score of 0.155. SHAP identified reduced eGFR, smoking, drinking, and high-grade malignancy as influential contributors; case-level waterfall and force plots enhanced transparency. These estimates reflect internal validation only and were obtained without systematic microbiological confirmation or standardized radiologic rescoring. Accordingly, performance may be optimistic, and real-world use is not advised pending temporal and multicenter external validation (with potential recalibration) and prospective evaluation.</p><p><strong>Conclusion: </strong>The interpretable GBM model demonstrated promising discrimination and calibration on an internal hold-out test set; however, clinical deployment requires temporal and multicenter external validation (as well as prospective assessment with potential recalibration). The accompanying web calculator is a research-only prototype and is not intended for clinical decision-making until such validation is completed.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1674896"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244196","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":"Perioperative management of severe factor VII deficiency: a single-center experience in China.","authors":"Chao Zhu, Jinxia Zhao, Longqiang Xu, Wenfei Lu, Shiguo Liu, Jialiang Guan","doi":"10.3389/fmed.2025.1673206","DOIUrl":"10.3389/fmed.2025.1673206","url":null,"abstract":"<p><strong>Introduction: </strong>Inherited factor VII (FVII) deficiency is a rare autosomal recessive disorder whose clinical phenotypes are highly variable. Many studies have observed the absence of a clear-cut and consistent correlation between bleeding symptoms and FVII levels. Perioperative bleeding is a major concern in patients with FVII deficiency, but validated recommendations about the perioperative management of replacement therapy (RT) with FVII are lacking.</p><p><strong>Methods: </strong>Our study retrospectively summarized and analyzed the perioperative hemostasis management of severe FVII deficiency in 20 patients.</p><p><strong>Results: </strong>We found that replacement therapy is generally effective and that there is no significant correlation between the perioperative hemorrhagic complications after RT and the severity of FVII level before RT. Through multivariate statistical analysis and a retrospective analysis of other coagulation factor deficiencies at our center, we found that postoperative secondary hyperfibrinolysis in patients with FVII deficiency may not be universal.</p><p><strong>Discussion: </strong>Antifibrinolytic treatment may be necessary for patients undergoing surgery at sites with high fibrinolytic activity during the perioperative period. In addition, clinical data such as bleeding phenotype, bleeding history, and surgical sites should be given appropriate attention in perioperative treatment and monitoring.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1673206"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244255","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 of hematologic malignancies following herpes zoster after COVID-19: a global cohort study.","authors":"Chien-Lin Lu, Joshua Wang, Ching-Liang Ho, Yan-Jun Wu, Kuo-Cheng Lu, Chung-Chi Yang","doi":"10.3389/fmed.2025.1651614","DOIUrl":"10.3389/fmed.2025.1651614","url":null,"abstract":"<p><strong>Introduction: </strong>Herpes zoster (HZ) has been reported as a potential post-viral complication in individuals recovering from COVID-19, possibly due to virus-induced immune dysregulation. We aimed to investigate whether post-COVID HZ is associated with an elevated risk of hematologic or infectious complications.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX global research network, which aggregates de-identified electronic health records from more than 140 healthcare institutions. Adults diagnosed with COVID-19 between January 2020 and January 2022 were stratified by the presence or absence of HZ within one year of infection and matched 1:1 by age, sex, and comorbidities. Outcomes including leukopenia, urinary tract infection, multiple myeloma, and acute leukemia were evaluated over a three-year follow-up using time-to-event and multivariable Cox regression analyses.</p><p><strong>Results: </strong>Individuals with post-COVID HZ had significantly higher risks of developing hematologic and infectious complications. Subgroup analyses identified older age, impaired kidney function, elevated inflammatory markers, and metabolic abnormalities as factors associated with greater risk.</p><p><strong>Discussion: </strong>These findings suggest that HZ following COVID-19 may serve as a clinical indicator of immune vulnerability and heightened susceptibility to hematologic and infectious disorders. Long-term monitoring may be warranted in high-risk populations.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1651614"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244276","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 rare case of pseudoaneurysm caused by <i>Listeria monocytogenes</i>.","authors":"Dee Xi, Chunhua Luo, Qianyuan Li, Shaohua Xu, Xingrong She, Yan Gao","doi":"10.3389/fmed.2025.1615160","DOIUrl":"10.3389/fmed.2025.1615160","url":null,"abstract":"<p><p>Mycotic aneurysm is rare in clinical practice, but it is dangerous because it may expand rapidly, rupture, and threaten the patient's life if left untreated. The common pathogens include <i>Staphylococcus</i>, <i>Salmonella</i>, and <i>Streptococcus</i> species. Infection caused by <i>Listeria monocytogenes</i> is very rare, with no more than 40 cases reported worldwide to date. To our knowledge, this is the first case of a pseudoaneurysm in the brachial artery caused by <i>L. monocytogenes</i>. Most previously reported cases involved a single aneurysm; however, the case we report is very different. The patient had a medical history of hypertension and cerebral infarction and suffered from aneurysms and pseudoaneurysms at different sites on more than one occasion. The patient was admitted to our hospital due to a pseudoaneurysm in the brachial artery of the left upper limb. Blood culture suggested the infection was caused by <i>L. monocytogenes</i>. The inflammation was almost controlled after 1 month of antibiotic therapy, after which surgery was performed to remove the pseudoaneurysm and reconstruct the left brachial artery using an autologous great saphenous vein graft. Postoperatively, the patient continued to receive antibiotics and was discharged 1 week later in good condition.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1615160"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243462","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":"Barriers and determinants of over-the-counter antibiotic sales de-escalation: perspectives of community pharmacists in Aseer, Saudi Arabia.","authors":"Sultan M Alshahrani, Sirajudeen Shaik Alavudeen","doi":"10.3389/fmed.2025.1677246","DOIUrl":"10.3389/fmed.2025.1677246","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) represents a significant global health threat, which is worsened by the inappropriate distribution of antibiotics without a prescription. Cultural conventions and the easy accessibility of pharmacies in Saudi Arabia further aggravate this situation. Community pharmacists play a crucial role in antimicrobial stewardship, yet they continue to face substantial challenges.</p><p><strong>Objective: </strong>The objective of this study was to examine the barriers and determinants that influence community pharmacists' capability to reduce over-the-counter (OTC) antibiotic sales in the Aseer region of Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted with 269 community pharmacists, utilizing a validated, self-administered questionnaire. Data were analyzed using descriptive statistics, Chi-square tests, Kruskal-Wallis tests, and ordinal logistic regression to assess associations between demographic characteristics and pharmacists' views of obstacles and stewardship practices.</p><p><strong>Results: </strong>The type of pharmacy was significantly associated with perceived barriers (<i>p</i> = 0.027), with chain pharmacists reporting more challenges than independent pharmacists. Logistic regression also showed that working in a chain pharmacy (OR = 2.01) and holding a PharmD degree (OR = 1.56) were predictors of higher perceived barriers. These findings suggest that both organizational factors and educational background shape how pharmacists perceive obstacles to reducing inappropriate antibiotic dispensing. Other demographic variables lacked statistical significance.</p><p><strong>Conclusion: </strong>The study highlights that systemic and educational factors strongly influence pharmacists' roles in antimicrobial stewardship. This indicates that targeted interventions such as continuous professional education, digital prescription monitoring, and stronger regulatory enforcement are necessary to support pharmacists and reduce the dispensing of inappropriate antibiotics. These measures also align with Saudi Arabia's Vision 2030 healthcare priorities. To our knowledge, this is the first study to investigate these barriers within the Aseer region, offering novel evidence on how organizational and educational contexts shape stewardship practices. The findings provide insights that extend beyond Saudi Arabia, informing global antimicrobial resistance containment strategies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1677246"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243990","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":"Cardiovascular disease in idiopathic pulmonary fibrosis: a systematic review and meta-analysis of observational studies.","authors":"Yang Li, Weili Tan, Yangyini Zhang, Fang Cao, Zhisong Wu, Yang Jiao, Jie Niu","doi":"10.3389/fmed.2025.1653435","DOIUrl":"10.3389/fmed.2025.1653435","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular (CV) comorbidities can affect drug tolerability and health outcomes in patients with idiopathic pulmonary fibrosis (IPF). This systematic review and meta-analysis aimed to quantify the magnitudes of association between IPF and both overall and specific categories of CV disease.</p><p><strong>Methods: </strong>The PRISMA guidelines and PICO model were followed. We searched PubMed, Embase, Web of Science, Cochrane Library, and Chinese Biomedical Literature Service System (Sinomed) from inception to April 2025 for studies investigating CV disease in IPF patients. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled odds ratio (OR) for case-control/cross-sectional datasets and relative risk (RR) for cohort datasets were calculated using Review Manager 5.4. The <i>I</i> ² test was used to evaluate the heterogeneity and the sources of heterogeneity were explored through sensitivity analyses, meta-regression, and subgroup analyses. The funnel plot and Egger's test were used to evaluate publication bias.</p><p><strong>Results: </strong>A total of 28 studies comprising 29 case-control/cross-sectional datasets and four cohort datasets were included, which indicated a positive association between IPF and CV disease (OR 2.44, 95% CI 1.84-3.24, <i>P</i> < 0.001; RR 1.44, 95% CI 1.07-1.92, <i>P</i> = 0.02). Meta-regression and maximized subgroup analyses confirmed the influence of control characteristics (<i>P</i> < 0.001), data source (<i>P</i> = 0.027), Newcastle-Ottawa Scale (NOS) score (<i>P</i> = 0.022), certainty of CV disease diagnosis (<i>P</i> = 0.027), body mass index (BMI), smoking status, and diabetes prevalence on both heterogeneity and risk estimates in the case-control/cross-sectional datasets. The OR varied across the CV disease category, with 1.14- to 2.51-fold increased risks for ischemic heart disease, thromboembolic disease, pulmonary hypertension, and other forms of heart disease.</p><p><strong>Conclusion: </strong>Idiopathic pulmonary fibrosis is significantly associated with CV disease, emphasizing the urgent need for systematic screening and risk reduction strategies in IPF patients.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251013917, identifier CRD420251013917.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1653435"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244115","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":"Content accuracy and reliability of pulmonary nodule information on social media platforms: a cross-platform study of YouTube, Bilibili, and TikTok.","authors":"Yunanji Zhou, Xiang Zeng, Ting Yuan, Qian Wang, Siqi Wu, Lei Du, Lihua Wang, Jun He","doi":"10.3389/fmed.2025.1613526","DOIUrl":"10.3389/fmed.2025.1613526","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary nodules (PNs) are often overlooked, potentially leading to health risks. Social media platforms are increasingly used for health information dissemination. This study evaluates the quality and engagement of PN-related videos on YouTube, Bilibili, and TikTok.</p><p><strong>Methods: </strong>On March 1, 2025, we searched each platform using \"pulmonary nodule\" or its Chinese equivalent. After screening, 271 videos were analyzed. Video characteristics were documented, and quality was assessed using PEMAT, VIQI, GQS, and mDISCERN tools. Inter-rater reliability was high (<i>κ</i> = 0.81).</p><p><strong>Results: </strong>The final sample included 98 (YouTube), 74 (Bilibili), and 99 (TikTok) videos. TikTok videos were the shortest (median 114 s) yet had the highest engagement. Nonprofit organizations dominated YouTube uploads; physicians were most common on Bilibili and TikTok. Treatment was the most covered topic. YouTube scored highest in comprehensibility and actionability (PEMAT-T/A), while Bilibili and TikTok scored higher in production quality (VIQI, GQS). Video quality did not differ significantly between professional and non-professional uploaders. Most quality metrics showed weak correlation with audience engagement.</p><p><strong>Conclusion: </strong>Long-form platforms (YouTube and Bilibili) offer higher-quality PN information but lower engagement, whereas short-form platforms (TikTok) show high interaction but lower informational depth. Social media can play a supportive role in public PN education. We provide recommendations for creators, platforms, and viewers to improve the quality and reliability of medical content.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1613526"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244126","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":"<i>TP53</i> expression in PCAT in coronary artery disease combined with type 2 diabetes mellitus and its correlation with CCTA radiomic features: novel imaging biomarkers.","authors":"Haicheng Qi, Yahui Hu, Yan Li, Xiumei Li, Yan Xing","doi":"10.3389/fmed.2025.1626390","DOIUrl":"10.3389/fmed.2025.1626390","url":null,"abstract":"<p><strong>Aims: </strong>To explore the changes in differentially expressed genes in pericoronary adipose tissue (PCAT) and serum from patients with coronary artery disease (CAD) complicated with type 2 diabetes mellitus (T2DM) and to analyse its correlation with PCAT radiomic features based on coronary CT angiography (CCTA).</p><p><strong>Methods: </strong>Intersecting genes that were differentially expressed in both CAD and T2DM patients were obtained from the GEO database and analyzed to obtain candidate genes. PCAT and serum samples were collected from CAD patients who underwent coronary artery bypass grafting (CABG) from May 2023 to January 2024. RT-qPCR was used to determine the expression of candidate differentially expressed genes in PCAT, to search for genes related to patients with CAD combined with T2DM, and to verify the protein expression levels by immunohistochemistry (IHC). Enzyme-linked immunosorbent assays (ELISAs) were also used to determine the expression of candidate differentially expressed genes in the serum. Finally, the PCAT radiomic features of the right coronary artery in patients with CAD combined with T2DM were extracted and correlated with the candidate genes.</p><p><strong>Results: </strong><i>HLA-DRB1</i>, <i>TP53</i>, and <i>CCR9</i> were screened from the GEO database. RT-qPCR results revealed that <i>TP53</i> expression was significantly increased in the T2DM group compared with the control group (3.082 ± 0.580 vs. 1.663 ± 0.698, <i>p</i> < 0.001). IHC results revealed that the area of positive expression around the nucleus was increased in the fat cells of the T2DM group compared with those of the control group, with increased perinuclear areas with positive expression (0.521 ± 0.082 vs. 0.327 ± 0.074, <i>p</i> < 0.001), and 14 PCAT radiomic features in CAD combined with T2DM patients correlated with <i>TP53</i> (r_s > 0.5, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong><i>TP53</i> expression was significantly elevated in the PCAT of patients with CAD combined with T2DM, suggesting that this molecule plays a role in the development of this disease. Four first-order features and 10 texture features in the PCAT radiomic features were associated with abnormal <i>TP53</i> expression. The association of radiomic features with <i>TP53</i> suggests that CCTA-based radiomic features can be used to predict abnormalities in differential gene expression, thus providing a new way to noninvasively predict CAD combined with T2DM.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1626390"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244283","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 use of CytoSorb hemoadsorption in critically ill patients: a narrative review.","authors":"Kaixin Lei, Ao Chen, Xinqi An, Jun Guo, Baihai Su, Yupei Li","doi":"10.3389/fmed.2025.1628241","DOIUrl":"10.3389/fmed.2025.1628241","url":null,"abstract":"<p><p>Inflammation, a complex biological response against injury or infection, is an important pathological basis for various critical diseases. A \"normal\" immune response exemplifies a balanced dialogue between immunological cells and a medley of pro- and anti-inflammatory mediators. However, under pathological conditions, this equilibrium is disrupted by the overwhelming release of cytokines, also known as a cytokine storm, which significantly contributes to multiple organ dysfunction and death. Accumulating clinical evidence highlights the efficacy of CytoSorb® hemoadsorption in eliminating damage-associated molecular patterns, pathogen-associated molecular patterns and excessive cytokines from the blood, which underscores the broad use of CytoSorb® in managing various critical conditions. In this narrative review, we conduct a state-of-the-art review of CytoSorb® hemoadsorption in daily critical care practice. By searching 'CytoSorb®', 'cytokine absorption', 'hemoadsorption' and 'hemoperfusion' in PubMed, Embase and Web of Science, we discussed the rationale and research progress for cytokine adsorption with CytoSorb® from January 2019 to May 2025. Then, we summarize the latest clinical evidence regarding the use of CytoSorb® in sepsis, cardiac surgery, extracorporeal membrane oxygenation, hepatic diseases, rhabdomyolysis and burn injuries. Finally, we elaborated on the impact of CytoSorb® on the clearance rates of antibiotics and anticoagulants to address its safety concerns and highlighted ongoing debates on the timing, dose and patient selection criteria of CytoSorb® hemoadsorption, which requires future research to optimize actual benefits.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1628241"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244323","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":"Anti-<i>Porphyromonas gingivalis</i> lipopolysaccharide antibody in rheumatoid arthritis patients with emphysema.","authors":"Shomi Oka, Takashi Higuchi, Kota Shimada, Misuzu Fujimori, Atsushi Hashimoto, Akiko Komiya, Koichiro Saisho, Norie Yoshikawa, Michita Suzuki, Toshihiro Matsui, Naoshi Fukui, Kiyoshi Migita, Shigeto Tohma, Hiroshi Furukawa","doi":"10.3389/fmed.2025.1654271","DOIUrl":"10.3389/fmed.2025.1654271","url":null,"abstract":"<p><strong>Objective: </strong>Lung diseases that are chronic (emphysema [EMP], airway disease, interstitial lung disease) can complicate rheumatoid arthritis (RA) as extra-articular manifestations. Anti-<i>Porphyromonas gingivalis</i> (<i>P. gingivalis</i>) antibody (Ab) has been analyzed for the diagnosis of periodontal disease and RA patients showed increased anti-<i>P. gingivalis</i> Ab levels. However, amounts of anti-<i>P. gingivalis</i> Ab in RA complicated with chronic lung disease (CLD) are unknown. We measured anti-<i>P. gingivalis</i> Ab in cases of RA with CLD.</p><p><strong>Methods: </strong>Anti-<i>P. gingivalis</i> lipopolysaccharide (LPS) Ab were measured in RA patient sera by enzyme immunoassay.</p><p><strong>Results: </strong>Anti-<i>P. gingivalis</i> LPS Ab levels in RA with EMP were significantly lower than in RA cases without CLD (<i>P</i> = 0.0190, mean ± standard deviation [SD], 32.7 ± 64.2 [×10³U/mL] vs. 403.5 ± 2552.7 [×10³U/mL]). Multiple logistic regression analyses revealed the independence of this association. Anti-<i>P. gingivalis</i> LPS Ab amounts were increased in RA without CLD (<i>P</i> = 0.0412) compared with healthy controls (77.6 ± 183.7 [×10³U/mL]).</p><p><strong>Conclusion: </strong>Anti-<i>P. gingivalis</i> LPS Ab levels in RA with EMP were lower compared with RA without CLD. Citrullinated peptides were mainly generated in the lungs of RA with EMP and the oral cavity of RA without CLD, suggesting the heterogeneity of RA.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1654271"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243987","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}