Annals of medicine最新文献

{"title":"Integrative profiling of oral fungal communities across <i>Mycobacterium Tuberculosis</i> burden groups in Xpert-positive patients.","authors":"Yilin Wang, Rui Li, Zihan Tang, Zichun Ma, Xiaowei Dong, Wei Shu, Junwei Cui, Mingchong Wei, Zubi Liu, Dan Shen, Liang Li, Yu Pang","doi":"10.1080/07853890.2026.2698284","DOIUrl":"10.1080/07853890.2026.2698284","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB), caused by <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>), remains a major global health burden. A growing body of evidence suggests that mucosal microbial communities may reflect or modulate host responses during infection. However, the oral microbiome in TB patients with different bacterial loads remains poorly characterized. This study aimed to investigate alterations in oral fungal communities among Xpert-positive patients, stratified by <i>Mtb</i> burden based on Xpert MTB/RIF testing.</p><p><strong>Methods: </strong>In this prospective multicenter cohort study (May-August 2024), 278 Xpert-positive TB patients were enrolled across five hospitals in China. Participants were stratified into high, medium, low, and very low <i>Mtb</i> burden groups according to Xpert MTB/RIF cycle threshold values. Paired sputum and tongue swab samples were collected. Oral fungal profiles were characterized <i>via</i> ITS sequencing, followed by taxonomic assignment, diversity analysis, and multivariable association testing (MaAsLin 2) to identify robust biomarkers.</p><p><strong>Results: </strong>Oral fungal community structure varied significantly across <i>Mtb</i> burden strata. Beta-diversity analysis revealed distinct clustering between the very low burden group and higher burden groups (high, medium, low). High-burden patients were enriched with environmental taxa such as <i>Blumeria</i> and <i>Toxicocladosporium</i>, whereas low-burden groups exhibited higher abundances of <i>Candida</i>, <i>Aspergillus</i>, and <i>Penicillium</i>. Notably, MaAsLin 2 analysis confirmed that <i>Penicillium</i> and <i>Podosphaera</i> were independently associated with lower <i>Mtb</i> burden after adjusting for confounders. Neutral model analysis indicated that stochastic processes predominantly drive the assembly of these oral fungal communities. Functional prediction suggested enhanced aerobic respiration and metabolic enzyme activity in high-burden groups.</p><p><strong>Conclusions: </strong>This study analyzed the oral fungal microbiome stratified by <i>Mtb</i> burden strata in Xpert-positive patients, revealing distinct shifts in fungal composition and functional potential. Fungal dysbiosis and altered microbial metabolic capacity may offer insight into host-microbe interactions in pulmonary TB (PTB). These findings underscore the potential value of fungal microbiome profiling for assessing <i>Mtb</i> burden, beyond its application in TB diagnosis alone.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2698284"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of antithrombotic therapy on outcomes of incidental unruptured intracranial aneurysms in patients with ischemic stroke.","authors":"Chao Chen, Yiya Xu, Yingchao He, Ting Chen, Xingyong Chen","doi":"10.1080/07853890.2026.2705593","DOIUrl":"10.1080/07853890.2026.2705593","url":null,"abstract":"<p><strong>Background: </strong>The coexistence of acute ischemic stroke (AIS) and unruptured intracranial aneurysms (UIAs) is relatively common, but the safety of antithrombotic therapy in this population remains uncertain. This study evaluated whether different secondary prevention regimens influence UIA progression or rupture risk.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients with AIS and concomitant saccular UIAs between January 2016 and December 2021. Patients were categorized according to long-term antithrombotic exposure: single antiplatelet therapy (SAPT), anticoagulation, or no regular therapy. Dual antiplatelet therapy (DAPT) was analyzed separately. The primary outcome was aneurysm rupture; secondary outcomes included symptomatic events and radiographic progression (≥1 mm growth).</p><p><strong>Results: </strong>Among 197 patients (mean age 68.4 ± 10.2 years; 53.8% female), 140 received SAPT, 36 received anticoagulation, and 21 received no regular therapy. During a mean follow-up of 28.6 ± 18.4 months, aneurysm rupture occurred in two patients (1.0%). No ruptures occurred in the anticoagulation group. Firth's penalized logistic regression showed no significant association between antithrombotic regimen and aneurysm rupture (anticoagulation vs SAPT: OR 0.41, 95% CI 0.01-5.21; no therapy vs SAPT: OR 3.21, 95% CI 0.21-45.6; both <i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>In patients with small incidental saccular UIAs and AIS, standard secondary prevention regimens were not associated with an increased risk of aneurysm rupture. However, the limited number of rupture events and potential residual confounding warrant cautious interpretation. Secondary stroke prevention should remain the priority, with individualized assessment of aneurysm-related risks.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2705593"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted muscle reinnervation surgery modulates apoptosis and synaptic plasticity to improve motor function following tibial nerve injury in rats.","authors":"Wei Lu, Jian Ping Li, Si Yuan Li, Lu Hong Long, Lin Yang","doi":"10.1080/07853890.2026.2704964","DOIUrl":"10.1080/07853890.2026.2704964","url":null,"abstract":"<p><strong>Background: </strong>Targeted muscle reinnervation (TMR) is represents an advanced neural-machine interface that enhances prosthetic control and facilitates motor recovery in amputees. Although TMR is known to connect residual nerve fibers and supply neurotrophic factors, its impact on spinal cord motor neurons remains understudied. This study investigated the effects and possible mechanisms of TMR on spinal motor neurons in a rat model of tibial nerve transection (TNT).</p><p><strong>Materials and methods: </strong>There were 30 Sprague Dawley rats grouped into control, TNT, and TMR groups. TMR was grafted proximal tibial nerve into the gastrocnemius muscle. Outcome measures included the sciatic functional index, the muscle wet weight ratio, muscle fibrosis <i>via</i> Masson's trichrome staining, and immunohistochemical analysis of caspase-3 and Bcl-2 expression in spinal anterior horn. RT-PCR analysis of synaptic markers' mRNA expression.</p><p><strong>Results: </strong>The TNT group showed a marked SFI reduction, whereas the TMR group exhibited a significantly higher SFI (<i>p</i> < .01). Similarly, The operated muscle weight retention was preserved in the TMR relative to the TNT group (<i>p</i> < .01), indicating improved limb function and reduced atrophy. Masson trichrome staining demonstrated lower collagen deposition in the TMR group (<i>p</i> < .05). PCR analysis showed that TMR significantly downregulated spinal GAP43 mRNA (<i>p</i> < .05) while upregulating synapsin (SYN) and PSD-95 transcripts (both <i>p</i> < .05) versus TNT. Immunohistochemically, TMR decreased Bcl-2 (<i>p</i> < .05) and increased Caspase-3 (<i>p</i> < .01) expression relative to TNT.</p><p><strong>Conclusions: </strong>These findings suggest that TMR promotes the spinal motor neuron recovery and synaptic remodelling, likely contributing to improve muscle morphology and overall post-injury functional outcomes.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2704964"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertonic glucose vs insulin-dextrose to prevent hypoglycaemia following treatment for hyperkalaemia (HIGH-K): protocol for a double-blind randomized controlled trial.","authors":"Samuel Ford, Adam La Caze, Ian Coombes, Angela Hills, Jaimi Greenslade, Julian Williams","doi":"10.1080/07853890.2026.2701477","DOIUrl":"10.1080/07853890.2026.2701477","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalaemia is a life-threatening electrolyte abnormality commonly managed with intravenous insulin-dextrose therapy (IDT). Although effective, IDT frequently causes hypoglycaemia, particularly in patients without diabetes. Glucose-only therapy, which leverages endogenous insulin production, may offer comparable potassium-lowering effects with reduced hypoglycaemia risk. However, evidence remains limited.</p><p><strong>Methods: </strong>The HIGH-K Trial is a single-centre, double-blind, randomised controlled trial in adult, non-diabetic patients presenting to an Australian Emergency Department with hyperkalaemia (>5.5 mmol/L [99 mg/dL]). Ninety-five participants are randomised 1:1 to receive either glucose-only therapy (100 mL 50% dextrose bolus followed by 250 mL 10% dextrose infusion over 2 h) or standard IDT (10 units IV insulin with 25 g dextrose followed by 250 mL saline infusion). The primary safety outcome is the incidence of hypoglycaemia (<3.9 mmol/L [70 mg/dL]) within six hours. The primary non-inferiority outcome is the mean change in serum potassium from baseline to two hours, using a non-inferiority margin of -0.5 mmol/L (-9 mg/dL). Secondary outcomes include severity of hypoglycaemia, rescue insulin requirements, and serum insulin/C-peptide levels.</p><p><strong>Discussion: </strong>This is the first double-blind, randomised controlled trial to directly compare the safety and biochemical non-inferiority of glucose-only therapy versus standard insulin-dextrose therapy in the emergency department. By utilising a continuous glucose infusion following a bolus, the protocol aims to sustain endogenous insulin release and optimise intracellular potassium shift while preventing hypoglycaemia. If non-inferiority is demonstrated, this approach could provide a safer alternative in high-acuity or resource-limited clinical settings.</p><p><strong>Conclusion: </strong>Results will be disseminated in peer-reviewed journals and at national and international conferences. Findings may inform future research and clinical practice guidelines regarding glucose-only therapy for hyperkalaemia.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2701477"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and factors influencing the occurrence of postoperative thrombosis in patients with lower limb fractures across different age groups: a retrospective study.","authors":"Mengwen Xue, Hui Liu, Rui An, Ruiping Bai, Li Zhang, Xin Shen","doi":"10.1080/07853890.2025.2585602","DOIUrl":"10.1080/07853890.2025.2585602","url":null,"abstract":"<p><strong>Background: </strong>Postoperative venous thrombosis (PVT) is a common complication following lower limb fracture surgery, yet age-specific risk factors remain unclear. This study aimed to identify distinct predictors and develop tailored prediction models for young/middle-aged and elderly patients.</p><p><strong>Patients and methods: </strong>This multicentre retrospective cohort study analysed factors influencing of PVT in 483 patients undergoing lower limb fracture surgery at two tertiary hospitals between 1 January 2020 and 31 December 2022. Participants were divided into young/middle-aged (18-59 years, <i>n</i> = 269) and elderly (≥60 years, <i>n</i> = 214) groups for stratified analysis. Comprehensive perioperative variables were analysed. PVT was diagnosed via ultrasound within seven days postoperatively. Age-specific predictors were identified using multivariable logistic regression, and nomogram models were subsequently developed. Model performance was evaluated through the area under the curve (AUC).</p><p><strong>Results: </strong>The overall PVT incidence was 15.24% and 23.36% (<i>p</i> < 0.05) in young/middle-aged and elderly patients, respectively. Predictive of postoperative thrombosis among the young/middle aged population were intraoperative colloid infusion rate (OR = 0.784, 95% CI: 0.667-0.921), preoperative prothrombin time activity (OR = 0.947, 95% CI: 0.913-0.982) and postoperative anticoagulant use (OR = 7.117, 95% CI: 2.062-24.560) and among the elderly group were total intraoperative crystalloids (OR = 1.001, 95% CI: 1.000-1.001) and colloid infusion rate (OR = 1.101, 95% CI: 1.104-1.208), postoperative total protein (OR = 0.937, 95% CI: 0.886-0.990) and serum sodium (OR = 0.918, 95% CI: 0.848-0.994). The AUC and total score points for young/middle-aged group model was 0.760 and 204 points, and 0.750 and 116 points among the elderly.</p><p><strong>Conclusions: </strong>Fracture patients of different age groups require distinct risk management and perioperative treatments. This study developed age-specific PVT prediction models, highlighting the different risk profiles between young/middle-aged and elderly patients. For young/middle-aged patients, preoperative coagulation status should be optimized, postoperative anticoagulant overuse limited and fluid volume recovery enhanced. For elderly patients, intraoperative fluid input should be strictly restricted, and postoperative protein and electrolyte levels monitored.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2585602"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homocysteine, cysteine and methionine are associated with 90-day prognosis in intracerebral hemorrhage patients.","authors":"Ming Fang, Tianliang Xia, Yan Yin","doi":"10.1080/07853890.2026.2719236","DOIUrl":"10.1080/07853890.2026.2719236","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective study explored the associations of plasma homocysteine (Hcy), cysteine (Cys) and methionine (Met) levels with 90-day prognosis in intracerebral hemorrhage (ICH) patients and evaluated their predictive value for ICH prognosis.</p><p><strong>Methods: </strong>A total of 212 ICH patients and 215 age- and sex-matched healthy controls were enrolled. ICH patients were categorized into favorable and unfavorable prognostic groups based on their 90-day prognosis. Plasma Hcy, Cys and Met levels were compared between groups. Multivariate logistic regression and ROC curve analyses were used to assess their prognostic correlations and predictive efficacy. Restricted Cubic Spline (RCS) analysis explored the nonlinear relationship between Met and prognosis. The predictive model was internally validated and compared with classic ICH prognostic scoring systems.</p><p><strong>Results: </strong>ICH patients had significantly higher Hcy, Cys and Met levels than healthy controls. Unfavorable prognosis patients presented higher Hcy and Cys levels but lower Met levels. High Hcy (OR = 1.235, 95%CI 1.137-1.342) and Cys (OR = 1.017, 95%CI 1.008-1.025) were independent risk factors for poor prognosis. Met exerted a dual nonlinear effect and played a protective role at levels <32.88 μmol/L (OR = 0.924, 95%CI 0.860-0.992). The combined three biomarkers yielded the optimal predictive performance (AUC = 0.819), superior to all single and pairwise biomarker combinations.</p><p><strong>Conclusion: </strong>Elevated Hcy, Cys and Met levels are observed in ICH patients. High Hcy and Cys predict unfavorable prognosis. Met exhibited concentration-dependent correlational trends, lower odds of adverse outcomes were observed for Met <32.88 μmol/L. Combined detection of the three biomarkers yielded the highest predictive accuracy in internal single-center validation, pending external prospective verification before clinical translation.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2719236"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of three different serum-free light chain assays in the diagnosis of multiple myeloma.","authors":"Facai Cui, Jinlin Wang, Xiao Chen, Yaxuan Niu, Min Hu, Fengzhen Liu, Hanxiao Li","doi":"10.1080/07853890.2026.2615487","DOIUrl":"10.1080/07853890.2026.2615487","url":null,"abstract":"<p><strong>Background: </strong>The lack of analysis methods and standardization are the core problems of serum free light chain (sFLC) detection in Multiple myeloma (MM). This study validated a new KHB sFLC assay through comparative analysis with conventional assays.</p><p><strong>Materials and methods: </strong>Serum samples from 97 hospitalized MM patients were continuously collected. KHB, Freelite and N Latex assays were used to detect sFLC. The Bland-Altman and Passing-Bablok regressions were used for methodological comparison and bias evaluation. Spearman's test and Cohen's kappa coefficients were used to evaluate the correlation and clinical concordance.</p><p><strong>Results: </strong>The sFLC results for KHB, Freelite, and N Latex showed a significant correlation. Passing-Bablok regression analysis revealed strong concordance between the KHB and N Latex for κFLC, and between KHB and Freelite assays for λFLC and FLC-ratio (κ/λ). When using N Latex and Freelite assays for sFLC determination, selecting iFLC/niFLC ≥ 20 or iFLC/niFLC ≥ 100 could lead to different clinical treatment decisions for approximately 9%∼12% of patients. When using KHB and Freelite assays for sFLC determination, selecting iFLC/niFLC ≥ 20 or iFLC/niFLC ≥ 100 could lead to different clinical treatment decisions for approximately 5%∼7% of patients.</p><p><strong>Conclusion: </strong>KHB, as a sFLC detection method based on polyclonal antibodies and immunoturbidimetric principles, has a good correlation between its detection results and freelite and N Latex. The absolute difference in sFLC results among the three assays increased with increasing sFLC concentration, and selecting the same cutoff value for iFLC/niFLC may lead to inconsistent clinical treatment decisions in some patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2615487"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global trends in hearing loss among the working-age population: a 30-year epidemiological analysis.","authors":"Bing-Yu Liang, Ping-Ting Zhou, Zi-Hui Xie, Ke Han, Fen-Fen Li, Zi-Yue Fu, Yan-Xun Han, Shan-Wen Chen, Ye-Hai Liu, Yu-Jie Liu, Qin Wang, Yu-Chen Liu, Bu-Sheng Tong","doi":"10.1080/07853890.2026.2616970","DOIUrl":"10.1080/07853890.2026.2616970","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss (HL) is the leading cause of disability worldwide, with a particularly severe impact on low- and middle-income countries and causing a huge economic burden. While child HL prevention exists, working-age adults (WAP) struggle to avoid occupational and environmental risks.</p><p><strong>Method: </strong>Using Global Burden of Disease 2021 data, this study analyzed global HL prevalence trends in the WAP (1992-2021). Analyses included age-standardized prevalence rates (ASPR), estimated annual percentage change, and age-period-cohort (APC) modeling, stratified by gender, age, cause, severity, and Social Demographic Index (SDI).</p><p><strong>Result: </strong>Global WAP HL prevalence significantly increased to 524 million in 2021 (a 56.9% increase since 1992), primarily due to population growth and aging. Age period cohort (APC) analysis revealed different patterns: as age increases, risk increases and cyclical effects generally increased (except in low SDI regions). The upward trend of birth cohorts in high to middle SDI countries was worrying. In addition, this study also observed that there was a gender difference in the prevalence trend of HL in WAP (male incidence rate was higher, but female growth was faster), and the patient population was gradually younger. Improved trends from 2017-2021 globally and regionally suggest a potential, albeit unexpected, positive influence of the COVID-19 pandemic on HL prevalence.</p><p><strong>Conclusion: </strong>The global HL burden in the WAP is large and uneven, necessitating targeted interventions focusing on modifiable risks and SDI disparities. Further research is essential to understand the trends observed during the COVID-19 pandemic and to improve prevention strategies.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2616970"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum PLA2R-IgG4/PLA2R-IgG ratio dynamics reveal pathogenic autoantibody subclass switch during progression of PLA2R-associated membranous nephropathy.","authors":"Yongzhong Zhong, Yunyun Liu, Dan Zhou, Jing Tian, Dacheng Chen, Dandan Liang, Shaoshan Liang, Tianyu Zhen, Xiaodong Zhu, Biao Huang, Caihong Zeng","doi":"10.1080/07853890.2025.2610874","DOIUrl":"10.1080/07853890.2025.2610874","url":null,"abstract":"<p><strong>Background: </strong>Pathogenic autoantibody subclass switch has been found in lots of autoimmune disease. However, the information on anti-phospholipase A2 receptor antibody subclass switch in membranous nephropathy (MN) is limited and controversial. Here, we aim to uncover the subclass change during the PLA2R-associated MN progression.</p><p><strong>Methods: </strong>Biopsy-proven PLA2R-associated MN cases with sufficient tissue for light microscopy, immunofluorescence, and electron microscopy (October 2022 - March 2023) were included. Serum levels of PLA2R-IgG4 and PLA2R-IgG were measured by TRFIA. The correlation of the ratio with EM stage and other clinical parameters was analyzed.</p><p><strong>Results: </strong>Among 116 enrolled patients, glomerular IgG1 (<i>r</i> = 0.15, <i>p</i> = .01; <i>r</i> = 0.18, <i>p</i> = .002) and IgG3 (<i>r</i> = 0.17, <i>p</i> = .005; <i>r</i> = 0.27, <i>p</i> < .001) intensities were positively correlated with C3 and C1q intensities, respectively. The PLA2R-IgG4/PLA2R-IgG ratio was significantly positively correlated with serum albumin (<i>r</i> = 0.26, <i>p</i> = .005) but inversely correlated with both the intensity of glomerular IgG1 (<i>r</i> = -0.20, <i>p</i> = .03) and IgG3 deposits (<i>r</i> = -0.24, <i>p</i> = .009), as well as with C1q staining intensity (<i>r</i> = -0.27, <i>p</i> = .004). The median PLA2R-IgG4/PLA2R-IgG ratio significantly increased with pathological stage (Stage I: 18.92%; Stage II: 39.74%; Stage III: 59.38%; Stage IV: 68.99%) and was strongly positively correlated with EM stage (<i>r</i> = 0.52, <i>p</i> < .001). Advanced EM stages were observed more frequently with higher PLA2R-IgG4/PLA2R-IgG ratio.</p><p><strong>Conclusions: </strong>During the disease progression, EM stages were correlated with altered autoantibody IgG subclass profiles: early stages featured IgG1 or IgG3 autoantibodies, while late EM stages shifted to IgG4 predominance.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2610874"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin like growth factor - insulin like growth factor binding protein family in osteoporosis: mechanistic and clinical insights.","authors":"Xiuwen Wang, Jie Zhang, Zhidan Luo","doi":"10.1080/07853890.2026.2665524","DOIUrl":"10.1080/07853890.2026.2665524","url":null,"abstract":"<p><strong>Introduction: </strong>The imbalance between osteoblasts and osteoclasts is central to osteoporosis.Insulin like growth factor (IGF) has protective effects on bone. As an IGF-binding protein, the role of IGFBP in bone has also begun to come into the public's view. IGFBP not only serves as an IGF reservoir but also acts independently, interacting with other ligands to regulate cell proliferation and differentiation. Due to the complexity of the molecular network of IGF-IGFBP, the specific mechanism by which IGF-IGFBP affects bone is still unknown. This review introduces the IGF-IGFBP network and its roles in osteogenesis and osteoclast differentiation, and explores its potential as a novel therapeutic target for osteoporosis.</p><p><strong>Method: </strong>Relevant studies were identified in PubMed and Web of Science using the keywords 'IGFBP', 'Bone', and 'Osteoporosis', followed by a comprehensive review of the literature.</p><p><strong>Results: </strong>IGF-IGFBP regulates bone metabolism by modulating the differentiation of bone marrow mesenchymal stem cells (BMSCs) into osteogenic and adipogenic lineages, as well as the differentiation process of osteoclasts. Current studies mainly focuson osteogenic differentiation, while research on adipogenic and osteoclastogenic differentiationis limited. Some IGFBP molecules show inhibitory effects in osteogenesis, but their detailed molecular mechanisms are not fully elucidated.</p><p><strong>Conclusion: </strong>The IGF-IGFBP family influences bone metabolism through multiple biological pathways. However, the precise molecular mechanisms by which this system regulates bone metabolism remain incompletely understood. Future studies are needed to systematically elucidate its functional networks and pathophysiological significance in bone metabolism.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2665524"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}