Journal of Personalized Medicine最新文献

{"title":"Evaluation of a Pre-Transplant Serum FTIR Rejection-Risk Score Across Time Horizons and Rejection Phenotype-Defined Endpoints in Kidney Transplantation.","authors":"Luis Ramalhete, Rúben Araújo, Emanuel Vigia, Miguel Bigotte Vieira, Anibal Ferreira, Cecilia R C Calado","doi":"10.3390/jpm16090485","DOIUrl":"10.3390/jpm16090485","url":null,"abstract":"<p><p><b>Background:</b> Pre-transplant serum Fourier-transform infrared spectroscopy (FTIRS) has identified an internally validated biochemical signal associated with subsequent biopsy-proven kidney allograft rejection. Whether this signal retains discrimination across post-transplant time horizons and rejection-phenotype-defined endpoints remains unclear. <b>Methods:</b> This internally conducted extension study reused the same single-center cohort of 79 kidney transplant recipients (40 with biopsy-proven rejection; 39 with five-year rejection-free follow-up). The primary analysis did not retrain the original model; the fixed nested out-of-fold FTIR-derived score was evaluated at cumulative rejection horizons of 30, 90, 180, 365, 730, 1095, and 1825 days. Discrimination was assessed using AUCs with bootstrap confidence intervals and permutation testing. Cox regression, C-index, Kaplan-Meier analysis, exploratory decision curve analysis, and exploratory endpoint-specific models were also performed. <b>Results:</b> The fixed score retained discrimination across horizons, with AUCs of 0.780, 0.829, 0.845, and 0.860 at 30, 90, 180, and 365 days, respectively, and 0.850 at 1825 days. In Cox analysis, the FTIRS score was associated with rejection risk (HR per SD 1.95, 95% CI 1.40-2.73; <i>p</i> = 0.00009; C-index 0.709). Endpoint-specific models showed variable discrimination but involved small subgroups. <b>Conclusions:</b> The fixed pre-transplant FTIRS score retained discriminatory value across cumulative rejection-time horizons, with numerically highest discrimination within the first year. Endpoint-specific findings were hypothesis-generating and did not establish time- or phenotype-specific spectral signatures. Independent external validation is required.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039300","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":"Artificial Intelligence, eHealth, and Telemedicine in Precision Medicine: From Digital Innovation to Clinical Integration.","authors":"Mirella Veras","doi":"10.3390/jpm16090484","DOIUrl":"10.3390/jpm16090484","url":null,"abstract":"<p><p>Precision medicine has traditionally been associated with using genomic, molecular, and clinical information to tailor prevention, diagnosis, and treatment to individual patients [...].</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039401","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":"Epidemiological Analysis of Otorhinolaryngologic Pathologies Among Seafarers: A Retrospective Study Based on C.I.R.M. Telemedical Assistance Data, 2023-2025.","authors":"Getu Gamo Sagaro, Carmelo Guarneri, Francesco Amenta","doi":"10.3390/jpm16090483","DOIUrl":"10.3390/jpm16090483","url":null,"abstract":"<p><p><b>Background</b>: Seafarers are exposed to a variety of occupational and environmental factors that may influence their individual risk of developing otorhinolaryngologic (Ear, Nose and Throat, ENT) conditions while at sea. Understanding the distribution of ENT-related health problems in this population may inform personalized approaches to prevention, early detection, and remote healthcare management. However, epidemiological information on ENT-related medical consultations among seafarers remains limited. This study aimed to describe the distribution of ENT conditions among seafarers receiving telemedicine assistance from Centro Internazionale Radio Medico (C.I.R.M.), providing insights for individualized healthcare strategies in maritime populations. We also compared demographic and occupational characteristics of ENT and non-ENT medical assistance cases. <b>Methods</b>: A retrospective descriptive study was conducted using C.I.R.M. telemedical assistance records for seafarers who sought medical assistance between 1 January 2023 and 31 December 2025. Cases diagnosed with ENT conditions were identified and analyzed according to age, gender, nationality, occupational rank, worksite, vessel type, and diagnostic category. The frequency and distribution of ENT consultations were described using descriptive statistics. Comparisons between ENT and non-ENT cases were performed using Pearson's chi-square test, with statistical significance set at <i>p</i> < 0.05. <b>Results</b>: A total of 17,897 telemedical-assisted cases were recorded during the study period, of which 751 (4.2%) involved ENT conditions. The most common ENT consultations were ear symptoms and inflammation (No. = 286, 38.0%) and tonsillopharyngitis (No. = 180, 24.0%). Among ENT cases, the largest proportion occurred among seafarers aged 30-39 years (39.3%), deck crew members (30.4%), personnel working in the deck department (48.7%), and non-European seafarers (50%). Significant differences were observed between ENT and non-ENT cases according to age group (χ² = 16.58, <i>p</i> = 0.001), occupational rank (χ² = 11.14, <i>p</i> = 0.025), and nationality (χ² = 82.76, <i>p</i> < 0.001). <b>Conclusions</b>: ENT conditions accounted for a small but noteworthy proportion of telemedical assistance cases among seafarers, with significant variations according to age, rank, and nationality. These findings highlight population subgroups with different healthcare needs and may contribute to more personalized preventive and telemedical strategies for seafarers.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038883","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 Gut-Skin Axis in Atopic Dermatitis and Inflammatory Bowel Disease: Mechanisms, Microbiota, and Therapeutic Implications.","authors":"Ezzuddin Abuhussein, Edith V Bowers, Yukihiro Yamaguchi, Keita Nishiyama, Olivia G Cassidy, Koichi Tsuboi, Lei Huang","doi":"10.3390/jpm16090482","DOIUrl":"10.3390/jpm16090482","url":null,"abstract":"<p><p>The gut-skin axis is a bidirectional communication network linking the gastrointestinal tract, skin, microbiota, and immune system. As major barrier organs, the gut and skin harbor complex microbial communities that contribute to tissue homeostasis, immune regulation, and protection from environmental insults. Increasing evidence indicates that dysbiosis of the gut and skin microbiota is associated with inflammatory diseases through interconnected microbial, metabolic, and immune pathways. Clinical observations further reveal strong associations between gastrointestinal disorders, including inflammatory bowel disease (IBD) and celiac disease, and cutaneous manifestations. Atopic dermatitis (AD) is characterized by epithelial barrier dysfunction, immune dysregulation, microbial imbalance, and environmental influences. Patients with AD frequently exhibit reduced gut microbial diversity, depletion of beneficial short-chain fatty acid (SCFA)-producing bacteria, and enrichment of potentially pathogenic microorganisms. Cutaneous dysbiosis, particularly expansion of <i>Staphylococcus aureus</i>, can further impair the skin barrier and sustain inflammation. Microbial metabolites, including SCFAs, tryptophan-derived aryl hydrocarbon receptor ligands, and bile acid metabolites, may mediate gut-skin communication by regulating epithelial integrity, immune tolerance, and inflammatory signaling. IBD is also increasingly recognized as a systemic disorder involving alterations in skin microbiota and cutaneous immunity. Intestinal inflammation may disrupt immune tolerance to skin commensals and promote cutaneous inflammation through cytokine signaling and immune-cell trafficking, while emerging evidence suggests reciprocal skin-to-gut effects. Epidemiologic, genetic, and clinical studies indicate an association between AD and IBD, potentially reflecting shared genetic susceptibility, barrier dysfunction, dysbiosis, and immune pathways. This review summarizes current evidence linking the gut-skin axis to AD and IBD.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039343","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":"Exploratory Biomarker-Defined Phenotypic Heterogeneity Beyond a Single Physiological Reserve Construct.","authors":"Muneera O AlTaweel, Aftab Ahmed Jalbani, Fahad Memon, Ayman Aly Mahmoud, Paras Memon, Islam Elnasharty, Amin Elshehawey, Ali Al Qarni","doi":"10.3390/jpm16090481","DOIUrl":"10.3390/jpm16090481","url":null,"abstract":"<p><p><b>Background</b>: Patient heterogeneity in routine biomarkers is often collapsed into a single physiological reserve score, but whether that one-dimensional representation holds across acute and chronic settings-or whether it obscures biomarker-defined subgroups relevant to individualized care-is unclear. <b>Methods</b>: We harmonized routine biomarkers (BMI, blood pressure, eGFR, LDL, total cholesterol, and HbA1c) across two cohorts from the same health system: an acute cardiorenal syndrome cohort and a chronic outpatient cohort treated with dapagliflozin and/or semaglutide, excluding 15 patients common to both. We tested whether these biomarkers supported a one-factor structure via exploratory factor analysis, then a categorical alternative via Gaussian mixture modeling, assessed six-month class persistence in the chronic cohort, and applied the derived classes to the acute cohort for descriptive independent cohort application. <b>Results</b>: A one-factor representation was not supported (KMO = 0.485; covariance concentrated in two definitionally related variable pairs). Gaussian mixture modeling favored a two-class solution, distinguished mainly by LDL, total cholesterol, HbA1c, and diastolic blood pressure. Class assignment showed moderate six-month agreement (κ = 0.46) in a subgroup enriched for closer monitoring. In the acute cohort, class structure was not clearly associated with age, BNP, ejection fraction, length of stay, CKD stage, HF phenotype, NYHA class, or comorbidities; associations with outcomes were descriptive, not causal. <b>Conclusions</b>: Rather than reducing to a single reserve score, these biomarkers were better described by an exploratory two-class, biomarker-defined phenotype structure that captured observable patient heterogeneity, showed moderate short-term persistence, and was not clearly related to acute illness severity. These findings are specific to the biomarkers and cohorts studied and should not be generalized without independent replication.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039311","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":"Immunotherapy for Newly Diagnosed Glioblastoma: Current Evidence and Future Perspectives.","authors":"Rudolfh Batista Arend, Bruno Zilli Peroni, Natan Lucca Lima, Miguel Cruz Garcia, Amanda Hedel Koerich, André Felipe do Nascimento, Rafael Torres Fonseca Dos Santos, Kelvin Tapia, Daniel Kerpel, Gustavo Simiano Jung, Alex Roman, Guilherme Gago, Martin Batista Coutinho da Silva, Antonio Delacy Martini Vial, Edoardo Agosti","doi":"10.3390/jpm16090479","DOIUrl":"10.3390/jpm16090479","url":null,"abstract":"<p><p><b>Background</b>: Glioblastoma (GBM) represents the most aggressive and lethal primary malignancy of the central nervous system in adults. Although clinical trials evaluating immunotherapy strategies have increased substantially in recent years, the available evidence remains highly fragmented. This scoping review aimed to synthesize the available evidence from clinical trials investigating immunotherapy for newly diagnosed GBM. <b>Methods</b>: PubMed, Scopus, Embase, and Web of Science were searched from inception to July 2026 for clinical trials of first-line immunotherapy in adults with newly diagnosed GBM; recurrent, mixed-setting, preclinical, and abstract-only reports were excluded. Outcomes were overall survival (OS) and progression-free survival (PFS), adverse events, and treatment-related deaths. <b>Results</b>: Six therapeutic classes were represented: immune checkpoint inhibitors (13 reports), peptide and neoantigen vaccines (12), dendritic cell vaccines (10), adoptive cell therapies (5), oncolytic viral and gene therapies (3), and autologous formalin-fixed tumor vaccines (2). The evidence base was predominantly early-phase: 36 of 45 studies enrolled fewer than 100 patients, only 14 included a randomized comparison, and 5 were phase III. Median OS ranged from 11.5 to 38.4 months and median PFS from 1.3 to 60.1 months, the highest estimates arising from small, highly selected single-arm cohorts. No randomized trial improved OS. Important adverse events were rare and almost exclusively confined to checkpoint inhibitor trials. <b>Conclusions</b>: Immunotherapy in newly diagnosed GBM is feasible and tolerable but has not improved survival, with outcomes still determined more by MGMT promoter status and extent of resection than by treatment assignment. Biomarker-enriched selection, lymphocyte-sparing design and rational combinations are required in future trials.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039252","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":"Within a Heartbeat: A Machine Learning Approach Using VCG for Heart Failure Assessment in Sinus Rhythm.","authors":"Ioannis Marios Karagiannis, Athanasios Samaras, Dimitrios Filos, George Giannakoulas, Ioanna Chouvarda","doi":"10.3390/jpm16090480","DOIUrl":"10.3390/jpm16090480","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Heart failure (HF) is associated with structural changes such as ventricular dilation, hypertrophy and fibrosis that alter conduction pathways and leave characteristic traces in the electrical activity of each heartbeat. Individuals diagnosed with HF exhibit a range of clinical manifestations and require diverse therapeutic interventions. Nevertheless, an accurate and timely diagnosis must precede any therapeutic approach. Patients with HF and a high ejection fraction (EF) frequently remain undiagnosed, as preliminary medical assessments cannot effectively distinguish them from asymptomatic individuals. <b>Methods:</b> In this work, vectorcardiography (VCG) data (277 samples) were used from the PTB and MUSIC databases, with a primary endpoint of identifying individuals with a high likelihood of HFpEF (EF ≥ 50%) compared to healthy subjects to help mitigate overlooked cases and lay the groundwork for patient-centered care. The second endpoint was to screen whether an individual was healthy or had an HF subtype (HFrEF or HFpEF), making it relevant as a potential triage support in clinical practice. To achieve these objectives, heart-rate variability (HRV) features and continuous wavelet transform (CWT) features for each QRS complex and ST-T segment were extracted to train traditional machine learning (ML) models: support vector machine (SVM), random forest (RF), and eXtreme gradient boosting (XGBoost). <b>Results:</b> Across 100 random train/test splits, the first endpoint achieved Recall = 0.88 and AUROC = 0.98. For the second endpoint, aggregated across three internal test sets, the classification of healthy individuals, HFrEF and HFpEF resulted in Recall = 0.88, AUROC = 0.99, Recall = 0.76, AUROC = 0.87, Recall = 0.60 and AUROC = 0.79, respectively. <b>Conclusions:</b> These findings suggest that ECG/VCG-based machine learning approaches may contribute to HF subtype stratification and have the potential to broaden access to precision diagnosis and personalized medicine. As healthy and HF patients come from different databases and the study lacks external validation, findings should be interpreted with care.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039415","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":"Glucagon-like Peptide-1 Receptor Agonists Are Not Associated with Increased Risk of Acute Pancreatitis or Pancreatic Complications, Including Pancreatic Cancer, in Type 2 Diabetes: A Global Propensity-Matched Cohort Study.","authors":"Yan Sun, Benjamin Liu, Hanyou Loh, Samantha Mathialagan, Cindy Hsin-Ti Lin, Yasir Tarabichi, Donovan Veccia, Richard Wong, William Tse, Gengqing Song","doi":"10.3390/jpm16090478","DOIUrl":"10.3390/jpm16090478","url":null,"abstract":"<p><p><b>Introduction:</b> Association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and pancreatitis and its long-term complications remains controversial. Using a global electronic health record database, we evaluated pancreatic outcomes following GLP-1 RA initiation in adults with type 2 diabetes mellitus (T2DM). <b>Methods:</b> Adults aged ≥18 years who were alive at the index date; T2DM patients initiating GLP-1 RAs between 2013 and 2025 were identified in the TriNetX network and compared with patients initiating sodium-glucose cotransporter-2 inhibitors (SGLT2i). Sensitivity analyses included comparisons with other second-line diabetes therapies, excluding dipeptidyl peptidase-4 inhibitors, and analyses were restricted to U.S.-based health care organizations. Patients with pre-existing pancreatic conditions were excluded. Cohorts were propensity score-matched for treatment indications, pancreatitis risk factors, and demographics. Kaplan-Meier and Cox proportional hazard models evaluated acute pancreatitis (overall and biliary), chronic pancreatitis, pancreatic pseudocyst, and pancreatic cancer. <b>Results:</b> After matching, 291,152 patients were included in each cohort. GLP-1 RA initiation was not associated with an increased hazard of overall acute pancreatitis compared with SGLT2i initiation (HR 1.095; 95% CI 0.996-1.204), with concordant Kaplan-Meier analyses. A modest, etiology-specific increase in biliary acute pancreatitis was observed in the primary comparison (HR 1.276; 95% CI 1.010-1.612) but was not consistent across sensitivity analyses. No differences were observed in the risks of pancreatic pseudocyst (HR 0.729; 95% CI 0.525-1.014) or pancreatic cancer (HR 1.069; 95% CI 0.940-1.215). Results were similarly consistent in sensitivity analyses. <b>Conclusion:</b> GLP-1 RAs are not associated with an increased risk of acute pancreatitis, pancreatitis-related complications, or pancreatic cancer in T2DM adults; a modest biliary pancreatitis signal was observed, but was not consistent across sensitivity analyses.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039342","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":"Early Ocular-Surface Changes During Dupilumab Treatment According to Hyaluronic Acid Use: A Prospective Cohort Study.","authors":"Giuseppe Demichele, Giulia Ciccarese, Aurora De Marco, Giovanni Petruzzella, Chiara Barlusconi, Cristiana Mileti, Giovanni Alessio, Maria Gabriella La Tegola, Rosa Anna Favale, Francesca Ambrogio, Alexandre Raphael Meduri, William Andrew Rosato, Rossana Spadavecchia, Paolo Romita, Domenico Bonamonte, Caterina Foti","doi":"10.3390/jpm16090476","DOIUrl":"10.3390/jpm16090476","url":null,"abstract":"<p><p><b>Background</b>: Ocular-surface abnormalities are common in patients with moderate-to-severe atopic dermatitis and may predispose to dupilumab-associated ocular surface disease (DAOSD). We investigated early ocular-surface changes during dupilumab treatment and whether baseline-guided hyaluronic acid (HA) eye-drop use was associated with more favorable ocular outcomes. <b>Methods</b>: In this prospective single-center cohort study, patients with moderate-to-severe atopic dermatitis underwent ophthalmologic assessment before dupilumab initiation and after 4 months. HA 0.15% eye drops were prescribed to patients with at least one basal or reflex Schirmer value ≤15 mm and ocular symptoms. Ocular outcomes included tear break-up time (TBUT), basal and reflex Schirmer tests, meibography, and the Ocular Surface Disease Index (OSDI). Follow-up values were compared between HA users and non-users using baseline-adjusted models with false-discovery-rate correction. <b>Results</b>: Thirty-nine patients were included; 18 received HA eye drops and 21 did not. Twenty-seven patients (69.2%) had at least one baseline Schirmer value ≤15 mm. At 4 months, reflex Schirmer values were higher in HA users than in non-users after baseline adjustment (adjusted mean difference, 5.60 mm; 95% CI, 1.64-9.57; <i>p</i> = 0.007; <i>q</i> = 0.035). In the low-Schirmer subgroup, HA use was associated with higher reflex Schirmer (8.50 mm; 95% CI, 4.84-12.17; <i>q</i> < 0.001) and basal Schirmer values (5.07 mm; 95% CI, 1.41-8.73; <i>q</i> = 0.022). Among untreated patients with low baseline Schirmer values, reflex tear production decreased in eight of nine patients, despite OSDI scores remaining within the conventional normal range. <b>Conclusions</b>: HA supplementation at dupilumab initiation was associated with more favorable changes in tear production, particularly among patients with reduced baseline Schirmer measurements. Objective deterioration in tear production despite persistently low OSDI scores highlights the limitations of symptom-based assessment alone. These findings support baseline ophthalmologic evaluation and combined objective and symptom monitoring during dupilumab treatment. Larger controlled studies are needed to determine whether early, targeted HA eye-drop use can prevent clinically relevant dupilumab-associated ocular surface disease.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039471","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":"Nasal Cytology in Precision Rhinology: From Local Cellular Phenotyping to Personalized Management of Nasal Inflammatory Diseases.","authors":"Matteo Gelardi","doi":"10.3390/jpm16090477","DOIUrl":"10.3390/jpm16090477","url":null,"abstract":"<p><p>Nasal cytology provides a direct and minimally invasive assessment of the cellular environment of the nasal mucosa and may represent a valuable tool within the emerging framework of precision rhinology. Beyond its traditional diagnostic role, cytological examination can identify distinct local inflammatory patterns characterized by neutrophils, eosinophils, mast cells, and mixed cellular profiles, thereby revealing biological heterogeneity that may not be fully captured by clinical phenotype or systemic biomarkers alone. This review discusses the potential role of nasal cytology as a local cellular phenotyping approach in inflammatory diseases of the upper airways. Particular emphasis is placed on the interpretation of major cytological patterns, their relationship with underlying inflammatory mechanisms, and their possible integration with clinical, laboratory, and endoscopic information. The repeatability of nasal sampling also allows for longitudinal evaluation of cellular changes over time, supporting the concept of cytology as a dynamic local biomarker for monitoring disease evolution and treatment response. Nasal cytology has also recently undergone Delphi-based standardization, providing consensus recommendations that support methodological consistency, reproducibility, and broader clinical implementation. Representative original micrographs from a long-standing educational nasal cytology archive are included to illustrate the principal cellular phenotypes discussed. Although further standardization, validation, and integration with molecular biomarkers are needed, nasal cytology may contribute to a more individualized assessment of nasal inflammatory diseases by providing direct information from the target tissue. Its incorporation into multimodal diagnostic pathways could help bridge traditional rhinological evaluation and personalized management.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039372","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}