Journal of investigative medicine : the official publication of the American Federation for Clinical Research最新文献

{"title":"The predictive value of C-reactive protein combined with platelets for the progression and prognosis of sepsis: A retrospective cohort study.","authors":"Tengfei Chen, Maoyu Ding, Yumei Yang, Qinxiang Yang, Wei Guo, Xiaolong Xu, Qingquan Liu","doi":"10.1177/10815589251375026","DOIUrl":"10.1177/10815589251375026","url":null,"abstract":"<p><p>This retrospective cohort study aimed to explore the predictive value of the C-reactive protein (CRP)/platelet count (PLT) ratio for sepsis progression and prognosis. A total of 237 sepsis patients admitted to the ICU between January 2019 and November 2024 were divided into survivor (<i>n</i> = 157) and non-survivor (<i>n</i> = 80) groups based on 28-day outcomes. Intergroup comparison, receiver operating characteristic (ROC) curve analysis, survival analysis, LASSO regression analysis, and Cox regression analysis were employed to evaluate the impact of clinical data, dynamic CRP/PLT ratios (on days 1 and 7), and change degree ((CRP/PLT day 7 - CRP/PLT day 1)/CRP/PLT day 1) on the progression and prognosis of sepsis. The non-survivor group showed significantly higher CRP/PLT ratios on day 1 (0.80 vs 0.39, <i>p</i> < 0.001), day 7 (1.40 vs 0.29, <i>p</i> < 0.001), and change degree (0.44 vs -0.31, <i>p</i> < 0.001) compared to the survivor group. Time-dependent ROC analysis revealed the CRP/PLT ratio on day 7 had the highest prognostic accuracy for short-term mortality (AUC = 0.819). After LASSO selection and multivariable adjustment, CRP/PLT ratio on day 7 > 0.51 (HR = 2.21, 95% CI: 1.17, 4.15) and change degree > -0.04 (HR = 1.89, 95% CI: 1.06, 3.38) remained significant prognostic factors for mortality. These findings suggest the CRP/PLT ratio, particularly on day 7, and the change degree can serve as effective indicators for the early assessment of mortality risk in sepsis patients, aiding clinical prognosis and treatment adjustment.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251375026"},"PeriodicalIF":2.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPRESS: Peripheral eosinophilia and preserved ratio impaired spirometry (PRISm).","authors":"Yuhan Wang, Hailing Liu, Jingyi Zhang, Mengcan Wang, Ke Hu","doi":"10.1177/10815589251375118","DOIUrl":"https://doi.org/10.1177/10815589251375118","url":null,"abstract":"<p><p>Preserved ratio impaired spirometry (PRISm) may be in the pre-stage of chronic obstructive pulmonary disease. However, little is known about peripheral eosinophils in PRISm. This study ultimately enrolled 7,301 community-dwelling participants aged 20 to 79 years without airflow obstruction. Participants were categorized based on spirometry into two groups: normal spirometry and PRISm. Peripheral eosinophilia is defined by peripheral eosinophil counts ≥300 cells/µL. Multivariable logistic regression model was employed to examine the association between peripheral eosinophil counts and PRISm, as appropriate. Among the community adults finally recruited, 9.43% of participants exhibited PRISm, while 90.57% exhibited normal spirometry. Compared with the normal spirometry population, PRISm participants had a higher prevalence of peripheral eosinophilia in individuals aged 40 to 79 years (27.41% vs. 21.37%, P=0.01), non-Hispanic Whites (29.22% vs. 21.32%, P=0.01), those with a body mass index of 18.5-<25 kg/m2 (25.01% vs. 16.75%, P=0.03), never smokers (23.47% vs. 18.65%, P=0.03), individuals without a history of asthma (26.81% vs. 20.67%, P<0.001), and those with FeNO levels <50 parts per billion (P<0.05). Multivariable regression analysis showed a significant association between participants with eosinophil counts ≥300 cells/µL and PRISm compared to those with counts <150 cells/µL, with an adjusted odds ratio of 1.39 (95% CI: 1.12, 1.72). Peripheral eosinophilia was associated with PRISm in individuals without airflow obstruction. It is necessary to focus on the characteristics of peripheral eosinophils in this population.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251375118"},"PeriodicalIF":2.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPRESS: The Long-Term Outcomes of Combining Pyloroplasty with Gastric Electrical Stimulation in Drug-Refractory Gastroparesis: A prospective single-arm trial.","authors":"Irene Sarosiek, Mohammad Bashashati, Zorisadday Gonzalez, Tamis Bright, Karina Espinosa, Jameson Forster, Katherine Aguirre, Jerzy Sarosiek, Jesus Diaz, Osvaldo Padilla, Brian Davis, Richard McCallum","doi":"10.1177/10815589251366904","DOIUrl":"https://doi.org/10.1177/10815589251366904","url":null,"abstract":"<p><p>Surgical treatments for drug-refractory gastroparesis (GP) include gastric electrical stimulation (GES) and pyloric interventions. No longitudinal studies have evaluated the clinical outcomes and safety of combined GES and pyloroplasty (PP). We aimed to investigate the long-term clinical effectiveness of concurrent utilization of GES and PP in gastroparesis. Forty-nine gastroparetics (35 female; 38 diabetics [DM]) were enrolled and followed up. Baseline and follow-up total symptom scores (TSS) and individual symptom components were assessed, and a 4-hour scintigraphy gastric emptying test (GET) was performed. Hospitalization days, medication use, HbA1c level, and serious adverse events (SAE) were recorded. The median follow-up was 47 months (range 5-90). Mean TSS was significantly reduced from 18.6 to 6.2 points (p ≤ 0.001). GET mean retention of isotope-labeled meal was reduced from 74% to 47% at 2h and from 47% to 19% at 4h (p <0.01). Mean HbA1c improved from 9.0 to 7.9. Annual hospitalization days were reduced from a mean of 25 to 2 (p < 0.05). The overall satisfaction rate was subjectively graded as 87% by the patients. There were no immediate complications; SAEs attributed to GES occurred in 9% of patients. Based on this study, combining GES with pyloroplasty shows long-term: 1) improvement in GP symptoms and a high patient satisfaction rate; 2) acceleration and in some patients' normalization of gastric emptying; 3) a decrease in hospitalizations; and 4) an acceptable safety and SAE profile.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251366904"},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise-induced stress pathways: Crosstalk between AMPK, HSPs, and inflammation.","authors":"Lijuan Xiang, Zhanguo Su","doi":"10.1177/10815589251366914","DOIUrl":"10.1177/10815589251366914","url":null,"abstract":"<p><p>Exercise is a potent physiological stressor that disrupts cellular homeostasis and triggers a complex network of adaptive reactions. Heat shock proteins (HSPs), AMP-activated protein kinase (AMPK), and signaling pathways associated with inflammation are key modulators of this stress response. To restore energy balance and promote mitochondrial biogenesis, AMP/ATP ratio changes during exercise activate AMPK, a metabolic master switch. HSPs act as molecular chaperones, protecting protein integrity and promoting cellular resistance to mechanical, oxidative, and heat stress. Cytokine release, a hallmark of the acute inflammatory response to exercise, promotes tissue repair and adaptation; however, it can also have maladaptive effects when dysregulated. Emerging evidence suggests a complex and dynamic crosstalk between these pathways, wherein HSPs can inhibit inflammatory signaling and stabilize key proteins involved in energy metabolism. At the same time, AMPK modulates inflammatory cascades and influences the expression of HSPs. This review synthesizes the most recent findings from cellular and molecular studies.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251366914"},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends and disparities in cardiovascular mortality among individuals with inflammatory bowel disease: A U.S. nationwide analysis.","authors":"Abdalhakim Shubietah, Mohammad Bdair, Anwar Zahran, Mohammed AbuBaha, Maisam Tobeh, Abubakar Nazir, Mohamed S Elgendy, Ameer Awashra, Mohammed Tareq Mutar, Jehad Zeidalkilani, Hosam I Taha, Fathi Milhem, Ahmed Emara, Suleiman Khreshi, Abdallah Hussein","doi":"10.1177/10815589251366911","DOIUrl":"10.1177/10815589251366911","url":null,"abstract":"<p><p>While the link between inflammatory bowel disease (IBD) and cardiovascular disease (CVD) is established, long-term trends in cardiovascular mortality among IBD patients remain unclear. This nationwide study analyzed U.S. mortality data from 1999-2020 using the CDC's Wide-ranging Online Data for Epidemiologic Research. We identified deaths with CVD as the underlying cause and IBD as a contributing factor, calculating age-adjusted mortality rates (AAMRs) by demographic and geographic factors. Among 11,891 CVD deaths linked to IBD, AAMRs declined significantly from 1999 to 2015 (-2.74% annually; <i>p</i> = 0.0064), then plateaued. Post-2015 increases were noted among Black individuals (+23.03%, 2017-2020; <i>p</i> = 0.0416) and men (+27.19%, 2018-2020; <i>p</i> = 0.0100). Mortality was highest among White and non-Hispanic populations, with regional variation. Forecasting models project rising mortality through 2040, especially among men and White individuals. These trends highlight persistent disparities and the need for targeted cardiovascular risk reduction in IBD populations.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251366911"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPRESS: Liquid Biopsy in Breast Cancer Management: From Circulating Biomarkers to Clinical Breakthroughs.","authors":"Anmar Ghanim Taki, Abdulkareem Shareef, Lalji Baldaniya, Rami Oweis, S Renuka Jyothi, Udaybir Singh, Samir Sahoo, Ashish Singh Chauhan, Alisher Khazratov, Hayder Naji Sameer, Ahmed Yaseen, Zainab H Athab, Mohaned Adil","doi":"10.1177/10815589251366905","DOIUrl":"https://doi.org/10.1177/10815589251366905","url":null,"abstract":"<p><p>Breast cancer continues to be a major global health concern, particularly for women, despite improvements in early detection and treatment strategies. Traditional tissue biopsies have long been the foundation of diagnosis and treatment planning; however, they come with limitations-such as being invasive, providing only a single snapshot of a dynamic disease, and often missing the evolving molecular landscape, especially in metastatic cases. In recent years, liquid biopsy has emerged as a powerful, non-invasive tool offering real-time insights into tumor biology. By analyzing materials shed by tumors into the bloodstream-like circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes, and cell-free RNA (cfRNA)-liquid biopsy can reveal changes in tumor burden, treatment response, and the appearance of drug resistance. These advantages make it especially valuable in personalizing care for breast cancer patients across various subtypes, including hormone receptor-positive, HER2-positive, and triple-negative breast cancer. This review highlights the components and technological platforms that underpin liquid biopsy, explores its current clinical applications, and discusses future directions, including integration with artificial intelligence and multi-omics analysis. As research advances and clinical evidence grows, liquid biopsy holds the promise of reshaping breast cancer care, making it more precise, timely, and individualized.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251366905"},"PeriodicalIF":2.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispecific T-cell engagers for relapsed/refractory multiple myeloma after solid organ transplantation: A case series.","authors":"Raul Gregg-Garcia, Rafat Abonour, Attaya Suvannasankha","doi":"10.1177/10815589251364807","DOIUrl":"10.1177/10815589251364807","url":null,"abstract":"<p><p>The emergence of bispecific antibodies for multiple myeloma presents a critical unanswered question for solid organ transplant recipients: Can these T-cell dependent therapies overcome concurrent immunosuppression without triggering graft rejection? While teclistamab and similar agents demonstrate remarkable efficacy in immunocompetent patients, their mechanism demands functional T-cells-precisely what calcineurin inhibitors and antimetabolites suppress in transplant recipients. This creates a perilous therapeutic trilemma: (1) Maintaining standard immunosuppression risks blunting bispecific efficacy, (2) reducing immunosuppression may precipitate graft rejection, while (3) both strategies compound already elevated infection risks from dual immunosuppressive effects. Our experience treating two renal transplant recipients with teclistamab reveals these tensions in practice-one patient achieved sustained response without rejection, while another faced infectious complications preceding disease progression. These cases highlight three urgent research priorities: prospective studies to define (a) minimum effective immunosuppression levels during bispecific therapy, (b) biomarkers predicting graft rejection risk, and (c) optimal infection prophylaxis strategies. Until such data exists, clinicians navigate this high-stakes balancing act without evidence, forced to weigh theoretical risks of allograft loss against known mortality from progressive myeloma.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251364807"},"PeriodicalIF":2.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent writing versus ChatGPT-generated manuscript followed by extensive human editing: The products become similar?","authors":"Shigeki Matsubara","doi":"10.1177/10815589251363634","DOIUrl":"10.1177/10815589251363634","url":null,"abstract":"","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251363634"},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in mucin expression in the lungs of infant piglets following cardiopulmonary bypass with deep hypothermic circulatory arrest.","authors":"Ludmila Khailova, Justin Robison, Richard J Ing, Suzanne M Lujan-Osorio, Jesse A Davidson","doi":"10.1177/10815589251363491","DOIUrl":"10.1177/10815589251363491","url":null,"abstract":"<p><p>Atelectasis and mucus plugging are common complications following pediatric cardiac surgery with cardiopulmonary bypass (CPB). Mucins increase in airway lavage after pediatric CPB; however, tissue expression and regional variation remain to be evaluated in a translational model. The objective of this study was to analyze mucins in the lungs of infant pigs undergoing CPB with deep hypothermic circulatory arrest (DHCA). Piglets underwent CPB with DHCA followed by survival for 4 h (n = 5). Anesthesia controls (n = 7) were mechanically ventilated for 7 h without CPB. Gene expression of Muc4, Muc5AC, and Muc5B in the right apex (RA) and right lower lobe (RLL) was analyzed using RT-PCR, and localization and production were evaluated by immunohistochemistry. CPB/DHCA animals had significantly increased Muc4 (26.7 ± 30.6 vs 1.2 ± 1.2; p = 0.017), Muc5AC (7.8 ± 8.6 vs 1.1 ± 1.0; p = 0.0025), and Muc5B (8.1 ± 8.9 vs 1.5 ± 1.4; p = 0.017) mRNA levels and higher number of Muc5B positive cells in submucosal glands and bronchiole surface of the RLL compared to controls, with similar trends in the RA. Muc5AC localized mainly to bronchiole goblet cells, and its production qualitatively increased in the lungs of CPB/DHCA animals. Tissue mucin expression and production increase in the lungs of piglets exposed to CPB/DHCA, particularly in the lower lobes. Thus, the risk of mucus plugging in the acute period may be somewhat higher in the lower lobes, which are already affected by atelectasis and inflammation. Our model may serve as a valuable platform for future studies evaluating the mechanism and therapy of mucin production and airway obstruction following pediatric cardiac surgery. <i>New and noteworthy</i>: We provide insight to mucin expression and its regional variations in the lungs of piglets undergoing CPB with DHCA. Increased tissue mucins in the lower lobes suggest a potential mechanism for atelectasis and mucus plugging in the postoperative period. They also represent a novel therapeutic target, as Muc5AC therapeutic small interfering RNAs are currently being tested in phase 1/2a clinical trial.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251363491"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of autoimmune gastritis in patients with celiac disease.","authors":"Ramazan Erdem Er, Volkan Yilmaz, Yigit Baykara, Fatih Acehan, Cagdas Kalkan, Irfan Soykan","doi":"10.1177/10815589251361891","DOIUrl":"10.1177/10815589251361891","url":null,"abstract":"<p><p>Celiac disease (CD) is an immune-mediated disease triggered by gluten in genetically susceptible individuals. Autoimmune gastritis (AIG) is an autoimmune disease of the stomach characterized by autoantibodies directed against some structures containing H⁺/K⁺-ATPase and intrinsic factor. Both diseases may lead to micronutrient malabsorption and anemia. The goals of this study were to investigate the prevalence of AIG in patients with CD and determine the possible factors that might predict presence of AIG in patients with CD. Patients diagnosed with CD were investigated and data were collected regarding patient demographics, presence of concomitant autoimmune diseases, serological markers, and micronutrient levels. Diagnosis of CD has been established according to the Marsh classification. AIG was diagnosed according to histopathologic findings. One hundred eighty-three patients with CD were enrolled. Out of 183 patients, there were 19 patients with AIG (10.4%). In multivariable regression analysis, Marsh type 2 CD (odds ratio (OR): 15.838; 95% confidence interval (CI): 4.774-52.545) and the absence of anti-endomysium IgA (OR: 0.257; 95% CI: 0.084-0.786) were identified as predictors of AIG in patients with CD. Ten point four percent of patients with CD also had AIG. Factors that might predict the presence of a concomitant AIG were the presence of Marsh type 2 CD and absence of anti-endomysium IgA in patients with CD. Therefore, we suggest that patients negative for anti-endomysium IgA antibody and who have Marsh type 2 CD should be screened for the presence of AIG.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251361891"},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}