Biomedicines最新文献

{"title":"Last Resort? Rationale for Comprehensive Molecular Analysis in Treatment-Refractory R/M HNSCC: A Case Report of Remarkable Response to Sacituzumab Govitecan Following Molecular and Functional Characterization.","authors":"Henrike Barbara Zech, Philippe Schafhausen, Leonie Ramke, Janna-Lisa Velthaus, Simon Kreutzfeldt, Daniel Hübschmann, Kai Rothkamm, Carsten Bokemeyer, Anna Sophie Hoffmann, Stefan Fröhling, Hanno Glimm, Christian Stephan Betz, Malte Kriegs, Maximilian Christopeit","doi":"10.3390/biomedicines13051266","DOIUrl":"10.3390/biomedicines13051266","url":null,"abstract":"<p><p><b>Background/Objectives</b>: In recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC), the overall prognosis is poor, and systemic treatment options remain limited. While precision therapy approaches have revolutionized treatment strategies in several tumor types, molecularly informed therapies in R/M HNSCC are rare, primarily due to the low number of actionable genetic alterations identified through next-generation sequencing (NGS) panels. There is an urgent need to establish precision therapy approaches in R/M HNSCC using innovative predictive testing. <b>Methods</b>: We report the case of a 43-year-old patient with recurrent oral cancer who was extensively pretreated and comprehensively characterized using both descriptive and functional testing. <b>Results</b>: NGS revealed no targetable alterations. A tumor tissue slice radiosensitivity assay suggested radioresistance, arguing against re-irradiation. Kinome profiling identified upregulated Src-family kinases (SFK), and SFK inhibition reduced kinase activity in vitro. Most notably, mRNA analysis demonstrated high Trop-2 overexpression, confirmed by immunohistochemistry (3+ in 100% of tumor cells). Following six cycles of the Trop-2-directed antibody-drug conjugate Sacituzumab govitecan (SG), the patient had an impressive clinical response. <b>Conclusions</b>: Tumor characterization beyond genetic profiling can identify novel treatment options in therapy-refractory HNSCC. This is the first report of \"real-world\" data on promising antitumor efficacy of SG in a heavily pretreated oral cancer patient with Trop-2 overexpression. Consistent with the findings of the Basket TROPiCS-03 study, SG appears to be a promising novel therapy option for R/M HNSCC after failure of immunotherapy and chemotherapy, particularly in patients with Trop-2 overexpression.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Serum from Patients with Acute Leukemia Inhibits the Growth of Bone Marrow Multipotent Mesenchymal Stromal Cells.","authors":"Nataliya Petinati, Aleksandra Sadovskaya, Irina Shipounova, Alena Dorofeeva, Nina Drize, Anastasia Vasilyeva, Olga Aleshina, Olga Pokrovskaya, Larisa Kuzmina, Sofia Starchenko, Valeria Surimova, Yulia Chabaeva, Sergey Kulikov, Elena Parovichnikova","doi":"10.3390/biomedicines13051265","DOIUrl":"10.3390/biomedicines13051265","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Acute leukemia (AL) alters both hematopoiesis and the bone marrow stromal microenvironment. Attempts to develop a culture of multipotent mesenchymal stromal cells (MSCs) from AL patients' bone marrow are not always successful, as opposed to healthy donors' bone marrow. <b>Methods</b>: To unveil the reason, healthy donors' MSCs were cultured in the presence of sera from healthy donors (control group) or AL patients at the onset of the disease, in short- and long-term remission, and before and after allogeneic hematopoietic stem cell transplantation (allo-HSCT). <b>Results</b>: The cell yield in the presence of patient sera was lower than in the control, regardless of the AL stage. It was assumed that the patients either lacked growth factors to sustain MSCs, or there were inhibitors of MSC growth present. The serum's ability to support MSC growth correlated with platelet count and albumin and calcium concentrations in patients' blood. Platelet-derived growth factors-PDGFA and PDGFB-are known to induce MSC growth. Their concentration in the serum of AL patients and healthy donors was analyzed. A decrease in PDGFA concentration was found in the sera of patients compared to healthy donors. PDGFB concentration was lower at disease onset, increased during remission and decreased again during relapse. PDGFB concentration correlated with platelet count, while PDGFA concentration did not. AL patients' sera reflected systemic disturbances affecting MSC growth. So far, decreases in PDGFs, albumin and calcium concentration, as well as platelet count, are the parameters that might be among the causes of this observation.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Inflammation and Immune Dysregulation in Metabolic-Dysfunction-Associated Steatotic Liver Disease Progression: From Steatosis to Hepatocellular Carcinoma.","authors":"Young-Min Jee, Jeong-Yoon Lee, Tom Ryu","doi":"10.3390/biomedicines13051260","DOIUrl":"10.3390/biomedicines13051260","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Metabolic-dysfunction-associated steatotic liver disease (MASLD) progresses from hepatic steatosis to hepatocellular carcinoma (HCC) as a result of systemic immunometabolic dysfunction. This review summarizes the key roles of the innate and adaptive immune mechanisms driving hepatic injury, fibrogenesis, and carcinogenesis in MASLD. <b>Methods</b>: A comprehensive literature review was performed using PubMed to identify relevant published studies. Eligible articles included original research and clinical studies addressing immunological and metabolic mechanisms in MASLD, as well as emerging therapeutic strategies. <b>Results</b>: We highlight the roles of cytokine networks, the gut-liver axis, and immune cell reprogramming. Emerging therapeutic strategies, including cytokine inhibitors, anti-fibrotic agents, metabolic modulators, and nutraceuticals, offer several indications for attenuating MASLD progression and reducing the prevalence of extrahepatic manifestations. <b>Conclusions</b>: Given the heterogeneity of MASLD, personalized combination-based approaches targeting both inflammation and metabolic stress are essential for effective disease management and the prevention of systemic complications.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Constipation in the Behavior of Circulating Alpha- and Beta-CGRP Levels in Chronic/High-Frequency Migraine Patients After CGRP Monoclonal Antibodies.","authors":"Gabriel Gárate, Marcos Polanco, Jorge Madera, María Muñoz-San Martín, Marta Pascual-Mato, Vicente González-Quintanilla, Julio Pascual","doi":"10.3390/biomedicines13051254","DOIUrl":"10.3390/biomedicines13051254","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Migraines contain neurological and gastrointestinal manifestations. The first specific migraine preventive drugs, CGRP monoclonal antibodies (mAbs), though efficacious and very well-tolerated in general, induce constipation as their main adverse event. Our goal was to analyze the role of the two isoforms of CGRP in the development of constipation in patients treated with mABs. <b>Methods</b>: We prospectively measured by ELISA circulating alpha- and beta-CGRP levels in 133 high-frequency episodic/chronic migraine patients before and three months after mAbs treatment and correlated these levels with a number of clinical variables, including the development of constipation during this treatment. <b>Results</b>: Twelve patients (9.0%) noticed de novo constipation with mAbs. Demographics, efficacy end-points, profile of preventive treatment, and comorbidities, with the exception of anxiety/depression, were superimposable between patients with or without emergent constipation. Basal alpha-CGRP levels (49.5 [29.2-73.8] pg/mL) significantly decreased at month three of treatment (40.5 [20.4-61.0] pg/mL; <i>p</i> < 0.0001), both in patients with and without emergent constipation. Pre-treatment circulating beta-CGRP levels (4.0 [2.1-6.2] pg/mL) remained unchanged after three months of treatment (4.3 [2.5-6.0] pg/mL; <i>p</i> = 0.574) in the whole series but were selectively reduced in patients with emergent constipation (<i>p</i> = 0.034). <b>Conclusions</b>: This is the first work exploring the role of the two isoforms of CGRP in the pathophysiology of constipation with mAbs. Our results suggest that the antagonism on the alpha-CGRP isoform plays a relevant role in the antimigraine action of mABs but not in the development of constipation. By contrast, the specific reduction in beta-CGRP levels in patients with emergent constipation supports the role of beta-CGRP antagonism in the development of this adverse event.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular Vesicles as Emerging Therapeutic Strategies in Spinal Cord Injury: Ready to Go.","authors":"Jiali Jiang, Ziyi Wang, Qinghua Bao, Shenyuan Chen, Wenrong Xu, Jiajia Jiang","doi":"10.3390/biomedicines13051262","DOIUrl":"10.3390/biomedicines13051262","url":null,"abstract":"<p><p>Spinal cord injury (SCI) is a prevalent central nervous system disorder that causes significant disability and mortality. Unfortunately, due to the complex pathophysiological mechanisms involved, there remains a critical paucity of effective therapeutic interventions capable of achieving neural tissue regeneration and functional recovery enhancement in SCI patients. The advancements in extracellular vesicles (EVs) as a cell-free therapy for SCI have displayed notable benefits. These include their small size, low immunogenicity, capacity to target specific areas, and ability to cross the blood‒brain barrier (BBB). EVs offer the potential to not only repair tissue damage and stimulate regeneration but also effectively deliver and release them at the site of SCI when combined with diverse biomaterials. This review explores the biological role and importance of EVs in treating SCI, highlighting the combined use of modified EVs with different biomaterials and their potential for future applications. It presents new and hopeful treatment approaches for individuals afflicted with SCI.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Presence and Significance of Bacteria and Fungi in Bile Aspirated During ERC-A Retrospective Analysis.","authors":"Sylvia Weigand, Arne Kandulski, Ina Zuber-Jerger, Marcus Scherer, Jens Werner, Jan Bornschein, Kilian Weigand","doi":"10.3390/biomedicines13051255","DOIUrl":"10.3390/biomedicines13051255","url":null,"abstract":"<p><p><b>Background:</b> Infections of the biliary tract are found frequently in pathologically or surgically altered bile ducts. Mostly these infections result from the ascent of bacteria or fungi from the small bowel, although hematogeneous infections of the biliary system may also occur. The biliary sphincter and the continuous flow of bile are thought to prevent or limit ascending infections. Obstructive alterations in the biliary system are the most frequent indication of endoscopic retrograde cholangiography (ERC). The aim of this study was to analyze the spectrum and frequency of microbes within the bile, and discover the influence of earlier sphincterotomy. <b>Methods:</b> In our department, we routinely aspirate bile for microbiologic culture during ERC. For this study, all ERC performed in 2014-2018 were retrospectively analyzed, including all microbiological reports. Indications for the endoscopic examination were also recorded. In addition, the findings were correlated with whether or not a sphincterotomy had been previously performed, and whether or not there had been antibiotic treatment prior to the examination. <b>Results:</b> A total of 2253 successful standard ERC procedures were performed between 2014 and 2016. In 486 cases, bile was aspirated and sent for microbiologic culture. In total, 1220 bile samples were analyzed, and bacteria or fungi were found in 1029 (86.0%). <i>Enterococci</i> and <i>Enterobacter</i> were found most commonly, but <i>E. coli</i>, <i>streptococci</i>, <i>klebsiella</i>, and <i>staphylococci</i> were also found. In 11.2% of positive cultures, multiresistant pathogens were identified. In up to 29% <i>Candida</i> spp., most commonly, <i>Candida albicans</i> (68%) were also found, either alone or in conjunction with bacteria. Neither prior sphincterotomy nor the use of peri-interventional antibiotics had a major influence on the frequency with which positive bile cultures were detected. <b>Conclusions:</b> Aspiration of bile during ERC is of high clinical relevance, because microbiological analysis reveals the frequent presence of bacteria and fungi, knowledge of which may be useful for deciding on anti-infective treatment.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota Dysbiosis in Japanese Female Patients with Nontuberculous Mycobacteria-Associated Lung Disease: An Observational Study.","authors":"Kanako Kono, Yutaka Kozu, Shun Yokota, Kouta Hatayama, Kenji Mizumura, Shuichiro Maruoka, Hiroaki Masuyama, Yasuhiro Gon","doi":"10.3390/biomedicines13051264","DOIUrl":"10.3390/biomedicines13051264","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Nontuberculous mycobacterial pulmonary disease (NTM-PD) is treated using a combination of multiple antimicrobial agents and prolonged therapy; however, recurrence and reinfection rates remain high. Susceptibility to NTM-PD is not fully understood. We aimed to investigate the association between NTM-PD and gut microbiota and determine the impact of antimicrobial therapy on the composition of the gut microbiota. <b>Methods:</b> We analyzed the gut microbiota of 20 Japanese females with NTM-PD (mean age: 67.9 years; range: 50-80 years) at different treatment stages-before, during, and at recurrence-alongside 20 healthy individuals, using 16S rRNA gene amplicon sequencing. <b>Results:</b> Subgroup A (pre-treatment) showed a small difference in β-diversity when compared with the healthy control (HC) group, while no significant differences in α-diversity were observed. Subgroup B (during treatment) exhibited a larger difference in β-diversity compared with the HC group, along with a decrease in α-diversity. The α-diversity of the gut microbiota in Subgroup C (at recurrence) was lower than that in Subgroup A but higher than that in Subgroup B. In Subgroups A and C, the bacterial taxa <i>Sutterella</i>, <i>Adlercreutzia</i>, <i>Odoribacter</i>, and <i>Prevotella</i> had decreased relative abundance, while <i>Erysipelatoclostridium</i>, <i>Massilimicrobiota</i>, <i>Flavonifractor</i>, <i>Eggerthella</i>, and <i>Fusobacterium</i> had increased relative abundance compared to those in the HC group. <b>Conclusions:</b> The loss of normal resident gut bacteria may hinder reacquisition. Treatment may be associated with the persistence of a dysbiotic gut microbiota, fostering susceptibility to NTM-PD. Gut microbiota dysbiosis may heighten susceptibility to NTM-PD, complicate treatment outcomes, and increase the risk of microbiological recurrence following therapy.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Heterogeneity of Intratumoral Microbiota: A New Frontier in Cancer Immunotherapy Resistance.","authors":"Qiwen Tan, Xiongjing Cao, Falong Zou, Hanwenchen Wang, Lijuan Xiong, Shenghe Deng","doi":"10.3390/biomedicines13051261","DOIUrl":"10.3390/biomedicines13051261","url":null,"abstract":"<p><p>The intratumoral microbiota, as an important component of the tumor microenvironment, is increasingly recognized as a key factor in regulating responses to cancer immunotherapy. Recent studies have revealed that the intratumoral microbiota is not uniformly distributed but instead exhibits significant spatial heterogeneity, with its distribution patterns influenced by factors such as tumor anatomy, local immune status, and therapeutic interventions. This spatial heterogeneity not only alters the interactions between microbes and the host immune system but may also reshape the immunogenic and immunosuppressive landscapes of tumors. The enrichment or depletion of microbiota in different tumor regions can influence immune cell infiltration patterns, metabolic pathway activities, and immune checkpoint molecule expression, thereby driving the development of resistance to immunotherapy. Moreover, certain bacterial metabolites form concentration gradients between the tumor core and margins, thereby regulating immune cell function. Therefore, understanding and manipulating the spatial distribution of intratumoral microbiota, particularly in resistant patients, holds promise for developing new strategies to overcome immunotherapy resistance. In the future, precise modulation strategies targeting microbial spatial heterogeneity, such as engineered bacterial vectors, probiotic combinations, and phage therapy, may open new avenues for immunotherapy.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative Approaches in the Management of Hypertrophic Cardiomyopathy: A Comprehensive Review of Current Therapeutic Modalities.","authors":"Marco Maria Dicorato, Gaetano Citarelli, Francesco Mangini, Rossella Alemanni, Miriam Albanese, Sebastiano Cicco, Cosimo Angelo Greco, Cinzia Forleo, Paolo Basile, Maria Cristina Carella, Marco Matteo Ciccone, Andrea Igoren Guaricci, Ilaria Dentamaro","doi":"10.3390/biomedicines13051256","DOIUrl":"10.3390/biomedicines13051256","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is often associated with left ventricular outflow tract (LVOT) obstruction, which affects a substantial proportion of patients. This obstruction results from a range of anatomical abnormalities involving both the valvular and subvalvular structures. Pharmacological therapies play a pivotal role in the management of LVOT obstruction, with a range of drug classes exhibiting distinct mechanisms of action. Beta-blockers, including atenolol and nadolol, are considered the first-line treatment due to their ability to reduce heart rate and myocardial contractility and enhance diastolic filling. Non-dihydropyridine calcium channel blockers, such as verapamil and diltiazem, are utilized as second-line agents when beta-blockers are ineffective or contraindicated. Disopyramid, a Class 1A antiarrhythmic agent, is employed for patients who do not respond to initial therapeutic interventions and can reduce LVOT gradients. Recent advancements in cardiac myosin modulators, such as Mavacamten and Aficamten, offer targeted therapies by modulating myosin-actin interactions to reduce LVOT gradients and improve symptoms, with promising results from clinical trials. Although gene therapy is still in its nascent stages, it has the potential to address the genetic basis of HCM by employing techniques such as genome editing, gene replacement, and the modulation of signaling pathways. For patients exhibiting severe symptoms or demonstrating unresponsiveness to medical treatment, invasive therapies, such as septal reduction therapy and alcohol septal ablation, are considered. Ultimately, the treatment and prevention of atrial fibrillation and sudden cardiac death are two key points of HCM management in both obstructive and non-obstructive forms. This review aims to provide an overview of current pharmacological and invasive strategies, as well as emerging therapies, in the management of HCM.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Clinical Impact of Obstructive Sleep Apnea in Patients with Severe Aortic Stenosis Undergoing Valve Replacement.","authors":"Hilary Miranda-Mendoza, Luis M Amezcua-Guerra, Gustavo Rojas-Velasco, Daniel Manzur-Sandoval, Jennifer Escobar-Alvarado, Luis Chávez-Sánchez, Wendy G Vázquez-González, Laura L Rodríguez Chávez, Humberto Martínez Hernández, Malinalli Brianza-Padilla","doi":"10.3390/biomedicines13051252","DOIUrl":"10.3390/biomedicines13051252","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Aortic stenosis (AS) is the most prevalent valvular disease among older adults. Although obstructive sleep apnea (OSA) has been linked to adverse cardiovascular outcomes, its specific impact on patients with severe AS remains unclear. This study aimed to determine the prevalence of OSA and its influence on postoperative recovery following aortic valve replacement. <b>Methods</b>: A prospective case-control study was conducted at the Instituto Nacional de Cardiología Ignacio Chávez. Patients aged 40-80 years with echocardiographically confirmed severe AS were categorized into groups with and without OSA, based on respiratory polygraphy (Apnea-Hypopnea Index [AHI] threshold of >15 events per hour). Clinical, biochemical, echocardiographic, body composition, and hemodynamic parameters were assessed. Daytime sleepiness and sleep quality were evaluated using validated questionnaires. Inflammatory biomarkers were also analyzed. This study was approved by the institutional ethics committee. <b>Results</b>: Of the 30 patients included, 66.6% were diagnosed with OSA. Compared to non-OSA patients, those with OSA had a higher left ventricular mass index (160 vs. 108; <i>p</i> = 0.001), greater postoperative increases in central venous pressure [8 (8-10) vs. 8 (6-8); <i>p</i> = 0.037], and lower mixed venous oxygen saturation within the first 24 h (69.2 vs. 76; <i>p</i> = 0.027). OSA patients also had longer hospital stays (11 vs. 8 days; <i>p</i> = 0.014). Trends toward a heightened subclinical inflammatory state were noted in the OSA group. <b>Conclusions</b>: OSA is frequent and underdiagnosed in patients with severe AS and is associated with more complicated postoperative recovery. Systematic OSA screening is recommended for candidates undergoing aortic valve surgery.</p>","PeriodicalId":8937,"journal":{"name":"Biomedicines","volume":"13 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}