J Thorac Dis. 2024 Dec 31;16(12):8528-8537. doi: 10.21037/jtd-24-1356. Epub 2024 Dec 28.

ABSTRACT

BACKGROUND: Patients with idiopathic pulmonary fibrosis (IPF) are at risk of lung cancer development. Antifibrotic therapy could slow disease progression of IPF, but there is limited data on its effectiveness on lung cancer. Here, we aimed to investigate lung cancer incidence and the risk of mortality of patients with IPF receiving antifibrotic therapy.

METHODS: Data from the Korean National Health Insurance service database between October 2015 and September 2021 were used. The incidence of lung cancer and all-cause mortality in the IPF cohort was analyzed depending on pirfenidone treatment. Those who were diagnosed with lung cancer prior to IPF diagnosis were excluded.

RESULTS: Among the 5,038 patients with IPF who were eligible for the study, pirfenidone was administered to 880 patients. Median follow-up duration was 4,872.8 and 23,612.1 person-years in the groups receiving and not receiving pirfenidone, respectively. The incidence of lung cancer was significantly higher in the pirfenidone group compared to non-users [2.44 vs. 1.56 per 100 person-years; risk ratio 1.56; 95% confidence interval (CI), 1.27-1.92]. However, the risk of mortality did not differ significantly between patients receiving pirfenidone and those who did not. Further analysis was conducted to assess lung cancer development and pirfenidone therapy. Among patients with lung cancer, those treated with pirfenidone demonstrated significantly improved survival compared to those not receiving pirfenidone therapy (log-rank test, P<0.001). Pirfenidone therapy was associated with a protective effect on mortality in IPF patients with lung cancer [hazard ratio, 0.61; 95% CI, 0.43-0.85].

CONCLUSIONS: Antifibrotic therapy was associated with improved survival in patients with IPF who develop lung cancer, even though the incidence of lung cancer was higher in those receiving antifibrotic treatment compared to those do not.

PMID:39831219 | PMC:PMC11740043 | DOI:10.21037/jtd-24-1356

J Thorac Dis. 2024 Dec 31;16(12):8338-8349. doi: 10.21037/jtd-23-1908. Epub 2024 Dec 20.

ABSTRACT

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) has high mortality and poor prognosis, which brings enormous burdens to families and society. We conducted this meta-analysis to analyze and summarize the risk factors associated with mortality in IPF, hoping to provide reference for clinical prevention and treatment of IPF.

METHODS: We conducted a comprehensive search of PubMed, Cochrane Library, Embase, and Web of Science from inception to August 10, 2023, to include cohort studies on mortality in patients with IPF. Two researchers independently screened the studies and extracted data. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported to identify risk factors for mortality in IPF. In addition, we also carried out sensitivity analysis, Begg's and Egger's tests to evaluate the heterogeneity and publication bias.

RESULTS: Eighteen studies comprising 8,408 patients were included. The meta-analysis suggested that age (HR =1.03; 95% CI: 1.01, 1.04; P<0.001), forced vital capacity (FVC) (HR =0.97; 95% CI: 0.96, 0.99; P=0.005), FVC to predicted value ratio (FVC% pred) (HR =0.98; 95% CI: 0.97, 0.99; P<0.001), diffusing capacity of the lungs for carbon monoxide to predicted value ratio (DLCO% pred) (HR =0.98; 95% CI: 0.97, 0.99; P<0.001), gender-age-physiology (GAP) index (HR =1.70; 95% CI: 1.20, 2.40; P=0.003), and lung cancer (HR =2.75, 95% CI: 1.23, 6.15; P=0.01) were mortality-related risk factors in patients with IPF. Whereas, gender, smoking, body mass index (BMI), diffusing capacity of the lungs for carbon monoxide (DLCO), C-reactive protein (CRP), 6-minute walking distance (6MWD), pulmonary hypertension, gastroesophageal reflux, and cardiovascular disease were not statistically associated with death.

CONCLUSIONS: Age, FVC, FVC% pred, DLCO% pred, GAP index, and lung cancer have been identified as potential risk factors for mortality in patients with IPF. Due to the limited number and quality of included studies, the conclusions need to be verified by further studies.

PMID:39831203 | PMC:PMC11740034 | DOI:10.21037/jtd-23-1908

NPJ Biosens. 2025;2(1):2. doi: 10.1038/s44328-024-00018-7. Epub 2025 Jan 16.

ABSTRACT

The reactivation of heterotrimeric protein phosphatase 2A (PP2A) through small molecule activators is of interest to therapeutic intervention due to its dysregulation, which is linked to chronic conditions. This study focuses on the PP2A scaffold subunit PR65 and a small molecule activator, ATUX-8385, designed to bind directly to this subunit. Using a label-free single-molecule approach with nanoaperture optical tweezers (NOT), we quantify its binding, obtaining a dissociation constant of 13.6 ± 2.5 μM, consistent with ensemble fluorescence anisotropy results but challenging to achieve with other methods due to low affinity. Single-molecule NOT measurements reveal that binding increases optical scattering, indicating PR65 elongation. This interpretation is supported by all-atom molecular dynamics simulations showing PR65 adopts more extended conformations upon binding. This work highlights NOT's utility in quantifying binding kinetics and structural impact, offering insights valuable for drug discovery.

PMID:39830999 | PMC:PMC11738983 | DOI:10.1038/s44328-024-00018-7

Iran J Pharm Res. 2024 Sep 15;23(1):e149463. doi: 10.5812/ijpr-149463. eCollection 2024 Jan-Dec.

ABSTRACT

BACKGROUND: Dry eye disease (DED) is a multifactorial condition characterized by ocular surface inflammation, tear film instability, and corneal epithelial damage. Current treatments often provide temporary relief without addressing the underlying inflammatory mechanisms.

OBJECTIVES: This study examined the therapeutic potential of crocin and nobiletin, two naturally derived compounds with well-known antioxidant and anti-inflammatory properties, in a mouse model of DED induced by lacrimal gland excision (LGE).

METHODS: Thirty female Balb/c mice were divided into five groups (n = 6 each): Control (sham surgery), untreated DED, nobiletin-treated DED (32.75 µM), crocin-treated DED (34 µM), and 1% betamethasone-treated DED. Treatments were administered three times daily for 28 days. Ocular tissues were evaluated using Hematoxylin and Eosin (H&E) staining and fluorescein staining. Conjunctival inflammatory cytokines, including interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α), were measured by enzyme-linked immunosorbent assay (ELISA).

RESULTS: Histological analysis showed that the crocin and nobiletin treatment groups exhibited reduced epithelial disruption, keratinization, and inflammatory cell infiltration compared to the untreated DED group. The ELISA assay revealed that both compounds efficiently inhibited the production of the pro-inflammatory cytokines IL-6, TNF-α, and IL-1β, which are key mediators of DED pathogenesis. Fluorescein staining further confirmed the protective impact of crocin and nobiletin on corneal epithelial integrity. Moreover, the anti-inflammatory and epithelial-preserving effects of these compounds were comparable to those of the corticosteroid betamethasone.

CONCLUSIONS: Overall, these findings suggest that crocin and nobiletin have therapeutic potential for DED management by modulating inflammatory responses and enhancing ocular surface healing. These naturally derived compounds offer promising avenues for the development of safer and more effective treatments for this challenging condition. However, further investigations, including clinical trials, are essential to elucidate the underlying mechanisms of action and optimize therapeutic approaches.

PMID:39830666 | PMC:PMC11742122 | DOI:10.5812/ijpr-149463

Natl Sci Rev. 2024 Dec 9;12(2):nwae441. doi: 10.1093/nsr/nwae441. eCollection 2025 Feb.

ABSTRACT

The enormous computational requirements and unsustainable resource consumption associated with massive parameters of large language models and large vision models have given rise to challenging issues. Here, we propose an interpretable 'small model' framework characterized by only a single core-neuron, i.e. the one-core-neuron system (OCNS), to significantly reduce the number of parameters while maintaining performance comparable to the existing 'large models' in time-series forecasting. With multiple delay feedback designed in this single neuron, our OCNS is able to convert one input feature vector/state into one-dimensional time-series/sequence, which is theoretically ensured to fully represent the states of the observed dynamical system. Leveraging the spatiotemporal information transformation, the OCNS shows excellent and robust performance in forecasting tasks, in particular for short-term high-dimensional systems. The results collectively demonstrate that the proposed OCNS with a single core neuron offers insights into constructing deep learning frameworks with a small model, presenting substantial potential as a new way for achieving efficient deep learning.

PMID:39830389 | PMC:PMC11737406 | DOI:10.1093/nsr/nwae441

ISME Commun. 2024 Dec 18;5(1):ycae164. doi: 10.1093/ismeco/ycae164. eCollection 2025 Jan.

ABSTRACT

Harmful Algal Blooms (HABs) of the toxigenic dinoflagellate Karenia brevis (KB) are pivotal in structuring the ecosystem of the Gulf of Mexico (GoM), decimating coastal ecology, local economies, and human health. Bacterial communities associated with toxigenic phytoplankton species play an important role in influencing toxin production in the laboratory, supplying essential factors to phytoplankton and even killing blooming species. However, our knowledge of the prevalence of these mechanisms during HAB events is limited, especially for KB blooms. Here, we introduced native microbial communities from the GoM, collected during two phases of a Karenia bloom, into KB laboratory cultures. Using bacterial isolation, physiological experiments, and shotgun metagenomic sequencing, we identified both putative enhancers and mitigators of KB blooms. Metagenome-assembled genomes from the Roseobacter clade showed strong correlations with KB populations during HABs, akin to symbionts. A bacterial isolate from this group of metagenome-assembled genomes, Mameliella alba, alleviated vitamin limitations of KB by providing it with vitamins B1, B7 and B12. Conversely, bacterial isolates belonging to Bacteroidetes and Gammaproteobacteria, Croceibacter atlanticus, and Pseudoalteromonas spongiae, respectively, exhibited strong algicidal properties against KB. We identified a serine protease homolog in P. spongiae that putatively drives the algicidal activity in this isolate. While the algicidal mechanism in C. atlanticus is unknown, we demonstrated the efficiency of C. atlanticus to mitigate KB growth in blooms from the GoM. Our results highlight the importance of specific bacteria in influencing the dynamics of HABs and suggest strategies for future HAB management.

PMID:39830096 | PMC:PMC11740886 | DOI:10.1093/ismeco/ycae164

ACS Omega. 2024 Dec 20;10(1):1419-1428. doi: 10.1021/acsomega.4c09036. eCollection 2025 Jan 14.

ABSTRACT

The human gut microbiota (HGM) is a complex ecosystem subtly dependent on the interplay between hundreds of bacterial species and numerous metabolites. Dietary phenols, whether ingested (e.g., plant-derived guaiacol, mequinol, or resveratrol) or products of bacterial fermentation (e.g., p-cresol), have been attributed with influencing bacterial growth and host health. They are cleared by phase II metabolism, one form utilizing β-d-glucuronidation, but encounter bacterially derived glucuronidases capable of hydrolyzing them to release their phenolic and glucuronic acid moieties with potential effects on host cells or the surrounding bacterial population. Tools to enable the detailed study of their activity are currently lacking. Syntheses of β-d-glucuronides from methyl 1,2,3,4 tetra-acetyl β-d-glucopyranosyluronate by direct glycosylation with 2-, 3-, or 4-methoxy- and 4-fluorophenol acceptors employing trimethylsilyl triflate catalysis are reported. Yields (methoxy series) were modest. An improved route from methyl 1,2,3,4-tetra-acetyl β-d-glucopyranosyluronate via selective anomeric deprotection (N-methyl piperazine) and conversion to an α-trichloroacetimidate glycosyl donor was employed. Coupling with 2- and 3-methoxyphenol acceptors and deprotection provided 2- and 3-methoxyphenyl β-d-glucuronides in 2-fold improved overall yield. These naturally occurring methoxyphenyl glucuronides augment available model substrates of dietary glucuronides, which include 3- and 4'-linked resveratrol. The use of model glucuronides as substrates was illustrated in studies of β-d-glucuronidase activity employing cell lysates of 9 species of HGM (Bacteroidetes), revealing distinct outcomes. Contrasting effects on bacterial growth were also observed between the free phenolic components, their respective glucuronides, and glucuronic acid. The glucuronide of 4-fluorophenol provided sensitive and background-free detection of β-glucuronidase activity using 19F NMR.

PMID:39829562 | PMC:PMC11740244 | DOI:10.1021/acsomega.4c09036

Psychopharmacology (Berl). 2025 Jan 20. doi: 10.1007/s00213-025-06743-9. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: In vivo receptor interactions vary as a function of behavioral endpoint, with key differences between reflexive and non-reflexive measures that assess the motivational aspects of pain and pain relief. There have been no assessments of D1 dopamine agonist / mu opioid receptor (MOR) agonist interactions in non-reflexive behavioral measures of pain. We examined the hypothesis that D1/MOR mixtures show enhanced effectiveness in blocking pain depressed behaviors while showing decreased side effects such as sedation and drug reward.

METHODS: SKF82958 and methadone were used as selective/high efficacy D1 and mu agonists, respectively. An FR10 operant schedule was utilized in the presence and absence of a lactic acid inflammatory pain-like manipulation, to measure antinociceptive and operant-rate-suppressing effects, respectively. Rewarding properties of the drug combinations were determined using a conditioned place preference procedure.

RESULTS: Methadone alone, but not SKF82958 alone, produced dose-dependent restoration of pain-depressed responding. Both SKF82958 and methadone produced dose-dependent response rate suppression. Three fixed proportion mixtures, based on the relative potencies of the drugs in the rate suppression assay, produced dose-dependent antinociception and sedation. Isobolographic analysis indicated that the 0.17:1 mixture produced supra-additive antinociception and additive sedation. The 0.055:1 mixture produced additive antinociception with sub-additive sedation, and the 0.018:1 mixture had the highest therapeutic index (TI) relative to other mixtures and drugs alone. The antinociceptive doses and component doses for the 0.018:1 mixture did not produce conditioned place preference.

CONCLUSIONS: These results suggest that D1-selective dopamine agonists may have utility as candidate opioid-sparing analgesics.

PMID:39832015 | DOI:10.1007/s00213-025-06743-9

Pharmacotherapy. 2025 Jan 20. doi: 10.1002/phar.4648. Online ahead of print.

ABSTRACT

INTRODUCTION: Heart failure (HF) affects more than 6 million adults in the United States, contributing to substantial morbidity, mortality, and health care costs. Despite advances in medical care, many medications can exacerbate HF, yet their prevalence of use remains unknown. This study examined the national use of prescription medications that could exacerbate HF in adults with self-reported HF.

METHODS: We analyzed data from US adults with self-reported HF in the National Health and Nutrition Examination Survey (NHANES) from 2011 to March 2020. Medications known to exacerbate HF, identified from HF guidelines, were documented through pill bottle reviews. Weighted estimates were used to calculate prevalence overall and by sex, race and ethnicity, and level of evidence for avoidance. Multivariable logistic regression models calculated adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for the use of these high-risk medications by sex and race and ethnicity.

RESULTS: A total of 687 participants, representing 5.2 million U.S. adults with HF after applying sampling weights, were included (mean age, 66.1 [95% CI 64.9, 67.4] years; 50.4% female [95% CI 45.9%, 55.0%]). Overall, 14.5% (95% CI 10.4%, 19.5%; n = 92) of adults with HF were prescribed at least one medication known to exacerbate HF, with the most common being diltiazem, meloxicam, and ibuprofen. Use of these medications was not significantly different by sex nor by race and ethnicity. Of these medications, 21.7% (95% CI 10.7%, 38.8%) had level A evidence warning against use, and 78.3% (95% CI 61.2%, 89.3%) had B level evidence.

CONCLUSION: Over one-seventh of U.S. adults with HF were likely to have been prescribed medications that could exacerbate the condition, underscoring the need to optimize care. Reducing high-risk medication use may mitigate HF exacerbations and improve outcomes in this vulnerable population.

PMID:39831652 | DOI:10.1002/phar.4648

Br J Hosp Med (Lond). 2024 Dec 30;85(12):1-12. doi: 10.12968/hmed.2024.0380. Epub 2024 Jul 16.

ABSTRACT

Aims/Background Tinnitus is a very common condition, and is a side effect of many medications. The panorama of drug-induced tinnitus has widened in recent decades, and post-marketing data are needed to gain a better insight into adverse drug reactions related to tinnitus. However, there are currently few studies on drug-induced tinnitus. We aimed to explore the details of real-world drug-related tinnitus. Methods We collected data on adverse drug reactions related to tinnitus from the Food and Drug Administration Adverse Event Reporting System (FAERS) database for the fourth quarter of 2012 to the fourth quarter of 2023. The top 25 tinnitus-associated drugs and indications were analyzed, and reporting odds ratios (RORs) were used to assess the association between drugs and adverse events (AEs). Results A total of 29,460 patients were enrolled in our study, with a greater proportion of women (59.1%) than men (31.7%). Among all tinnitus-related drugs, duloxetine (n = 1510, ROR [95% confidence interval (CI)] = 11.99 [11.38-12.63]), ciprofloxacin (n = 938, ROR [95% CI] = 9.96 [9.33-10.63]), and adalimumab (n = 759, ROR [95% CI] = 0.68 [0.64-0.73]) displayed the strongest associations. Among all tinnitus-related indications, depression (n = 1172), rheumatoid arthritis (n = 947), and multiple sclerosis (n = 914) were the most relevant indications. Vertigo (n = 2443, ROR [95% CI] = 7.51 [7.21-7.82]), deafness (n = 1740, ROR [95% CI] = 13.50 [12.86-14.18]), and hypoacusis (n = 1550, ROR [95% CI] = 6.11 [5.81-6.43]) were the most common concomitant ototoxic AEs in patients reporting tinnitus. Conclusion Our study mined and analyzed the AEs signals of drug-induced tinnitus and provided a reference for the safe clinical application of the drugs.

PMID:39831503 | DOI:10.12968/hmed.2024.0380

Brain Behav. 2025 Jan;15(1):e70200. doi: 10.1002/brb3.70200.

ABSTRACT

INTRODUCTION: The cognitive side-effects of medication are common, but often overlooked in practice, and not routinely considered in interventional trials or post-market surveillance. The cognitive footprint of a medication seeks to quantify the impact of its cognitive effects based on magnitude, duration, and interaction with other factors, evaluated across the exposed population.

METHODS: Bayesian multivariable regression analysis of retrospective population-based cross-sectional cohorts.

RESULTS: We replicate positive and negative cognitive effects of commonly used medications in UK Biobank, and extend observed associations to two additional cohorts, the EPIC Norfolk, and the Caerphilly Prospective Cohort. We quantify the resultant cumulative impact at the population level given known patterns of prescribing and compare it with exemplar common diseases.

CONCLUSION: The cognitive side-effects of commonly used drugs may have significant impact at the population level. Consideration should be given to a routine structured assessment of cognition in interventional trials and post-market surveillance.

PMID:39829148 | DOI:10.1002/brb3.70200

Cell Rep. 2025 Jan 18;44(2):115220. doi: 10.1016/j.celrep.2024.115220. Online ahead of print.

ABSTRACT

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease characterized by excess accumulation of the extracellular matrix (ECM). The role of macrophage-fibroblast crosstalk in lung fibrogenesis is incompletely understood. Here we found that fibroblast growth factor-inducible molecule 14 (Fn14), the receptor for tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is highly induced in myofibroblasts in the lungs of IPF patients and the bleomycin-induced lung fibrosis model. TWEAK-Fn14 signaling inhibits fibroblast activation and ECM synthesis and induces chemokine expression to recruit monocytes/macrophages into the lung. Fn14 deficiency increases ECM production and impairs macrophage infiltration and differentiation, leading to exacerbated lung fibrosis and impaired alveolar regeneration in a bleomycin model. Interestingly, Fn14 deficiency diminishes an injury-induced SiglecF- CD11b- MHCIIlo intermediate macrophage (IntermM) subpopulation, which promotes alveolar type II (AT2) cell proliferation in organoid cultures. These results collectively demonstrate a protective role of TWEAK-Fn14 signaling in lung fibrosis, highlighting the complexities and multilayered regulation of macrophage-fibroblast crosstalk.

PMID:39827460 | DOI:10.1016/j.celrep.2024.115220

J Biol Chem. 2025 Jan 17:108206. doi: 10.1016/j.jbc.2025.108206. Online ahead of print.

ABSTRACT

It has been well established that adenosine plays a key role in the control of inflammation through G protein coupled receptors and recently shown that it can regulate thermogenesis. Here we investigated the specific requirements of the adenosine A2A receptor (A2AR) in mature adipocytes for thermogenic functionality and metabolic homeostasis. We generated fat tissue specific adenosine A2A receptor knock-out mice to assess the influence of signaling through this receptor on brown and beige fat functionality, obesity, insulin sensitivity, inflammation and liver function. Fat specific A2AR knock-out and wild type littermate mice were compared for potential differences in cold tolerance and energy metabolism. In addition, we measured glucose metabolism, AT inflammation and liver phenotypes in mice of the two genotypes after exposure to a diet rich in fat. Our results provide novel evidence indicating that loss of the adenosine A2A receptor specifically in adipocytes is associated with cold intolerance and decreased oxygen consumption. Furthermore, mice with fat specific ablation of the A2AR exposed to a diet rich in fat showed increased propensity to obesity, decreased insulin sensitivity, elevated adipose tissue inflammation and hepato-steatosis and -steatitis. Overall, our data provide novel evidence that A2AR in mature adipocytes safeguards metabolic homeostasis, suggesting the possibility of targeting this receptor selectively in fat for the treatment of metabolic disease.

PMID:39828097 | DOI:10.1016/j.jbc.2025.108206

N Biotechnol. 2025 Jan 17:S1871-6784(25)00006-8. doi: 10.1016/j.nbt.2025.01.005. Online ahead of print.

ABSTRACT

In order to improve predictability of outcome and reduce costly rounds of trial-and-error, machine learning models have been of increasing importance in the field of synthetic biology. Besides applications in predicting genome annotation, process parameters and transcription initiation frequency, such models have also been of help for pathway optimization. The latter is a common strategy in metabolic engineering and improves the production of a desirable compound by optimizing enzyme expression levels of the production pathway. However, engineering steps might not lead to sufficient improvement, and bottlenecks may remain hidden among the hundreds of metabolic reactions occurring in a living cell, especially if the production pathway is highly interconnected with other parts of the cell's metabolism. Here, we use the synthesis of chitooligosaccharides (COS) to show that the production from such complex pathways can be improved by using machine learning models and feature importance analysis to find new compounds with an impact on COS production. We screened Escherichia coli libraries of engineered transcription regulators with an expected broad range of metabolic diversity and trained several machine learning models to predict COS production titers. Subsequent feature analysis led to the finding of iron, whose addition we could show improved COS production in vivo up to 2-fold. Additionally, the analysis revealed important clues for future engineering steps.

PMID:39827984 | DOI:10.1016/j.nbt.2025.01.005

Comput Biol Med. 2025 Jan 18;186:109624. doi: 10.1016/j.compbiomed.2024.109624. Online ahead of print.

ABSTRACT

Studying and analysing the various phases and key proteins of cell cycles is essential for the understanding of cell development and differentiation. To this end, mechanistic models play an important role towards a system level understanding of the interactions between cell cycle components. Many quantitative models of cell cycles have been previously constructed using either stochastic or deterministic approaches. However, cell cycle models are inherently hybrid requiring the full and accurate interplay of the continuous system dynamics and their corresponding discrete events. Moreover, not all required experimental data are usually available when designing in-silico experiments for these scenarios. In this paper, we employ hybrid Petri nets to implement a hybrid model of the Caulobacter crescentus cell cycle. The model handles all required logics of cell cycles in a very elegant way. We then extend this model to support fuzzy kinetics for those parts where sufficient experimental data are not available and thus precise kinetic parameters cannot be estimated. With some of the kinetic parameters being set as fuzzy numbers, the model produces uncertain bands of outputs reflecting different possibilities of an output comprising most likely the correct one.

PMID:39827734 | DOI:10.1016/j.compbiomed.2024.109624

Sci Rep. 2025 Jan 19;15(1):2452. doi: 10.1038/s41598-025-86422-z.

ABSTRACT

Misoprostol was originally used to treat gastric ulcers, and has been widely used in abortion, cervical maturation, induced labour and postpartum hemorrhage. But there are still many undetected adverse events (AEs). The purpose of this study was to provide a comprehensive overview of the safety of misoprostol. Adverse events related to misoprostol were collected from the FDA Adverse Event Reporting System (FAERS) database from the first quarter of 2004 to the second quarter of 2024. This study used proportional disequilibrium methods such as reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM) to detect AEs. After analyzing 17,427,762 adverse event reports, a total of 2032 adverse events reports related to misoprostol were identified, involving 23 system organ classes and 30 preferred terms. The most common AEs were foetal exposure during delivery(n = 201), uterine tachysystole(n = 95), uterine rupture (n = 95), and heart rate decreased (n = 93). Although most AEs complied with the drug instruction, new AEs signals such as congenital aqueductal stenosis and congenital brain damage were also identified. Clinicians should make appropriate evaluation when using misoprostol, closely monitor the indicators of patients, and have appropriate countermeasures for possible adverse events.

PMID:39828758 | DOI:10.1038/s41598-025-86422-z

Zhonghua Yi Xue Za Zhi. 2025 Jan 21;105(3):233-239. doi: 10.3760/cma.j.cn112137-20240725-01713.

ABSTRACT

Objective: To evaluate the efficacy of domestic and imported sugammadex for reversal of rocuronium-induced deep neuromuscular block (NMB) in adult patients. Methods: The clinical data of adult patients who scheduled for elective surgery with general anesthesia that required muscle relaxants in Peking University First Hospital from June 2023 to June 2024 were prospectively included. The patients were devided into domestic group and imported group according to random number table method. Anesthetized patients received rocuronium for intubation and muscle relaxation, and anesthesia was maintained with propofol, sevoflurane, and remifentanil. The effect of neuromuscular block was monitored. During deep muscle relaxation (with a single stimulation muscle twitch count of 1-2 after tetanic stimulation), domestic and imported sugammadex 4 mg/kg was given, respectively. The primary outcome was the recovery time from sugammadex injection to return of the train-of-four ratio (TOFr) to 0.9, with a non-inferiority margin of 1 minute (the range of non-inferiority boundary value is ±1 minute). The secondary outcome included the ratios of TOFr to 0.9 at different times and adverse effects. Results: A total of 70 patients were included, including 35 patients in the domestic group (13 males and 22 females), aged (46.9±12.7) years, and 35 patients in the imported group (13 males and 22 females), aged (45.7±11.5) years. There was no statistically significant difference in demographic characteristics, surgical time, anesthesia time, total rocuronium dose, and extubation time between two groups. All patients recovered to a TOFr of 0.9 within 5 minutes. Reversal time was 1.8 (1.3, 2.6) minutes in the domestic sugammadex group and 2.0 (1.7, 2.9) minutes in the imported sugammadex group respectively. The difference in reversal times between two groups was -0.40 minutes (95%CI:-0.75 to -0.02, P=0.039), which was within the range of non-inferiority threshold. Within 5 minutes of administration of antagonists, the incidence of bradycardia was 14% (5/35 and 5/35) in both domestic and imported groups. The incidence of skin allergy in patients transported to the post-anesthesia recovery room (PACU) was 3% (3/35) and 0 in both groups, respectively, with no statistical significance (all P>0.05). There were no serious drug-related adverse events in both groups. Conclusion: The effect of domestic sugammadex is not inferior to imported sugammadex in reversal of deep rocuronium-induced neuromuscular block in adult patients, and the incidence of postoperative adverse events is not increased.

PMID:39828581 | DOI:10.3760/cma.j.cn112137-20240725-01713

Dig Liver Dis. 2025 Jan 18:S1590-8658(25)00038-6. doi: 10.1016/j.dld.2025.01.037. Online ahead of print.

ABSTRACT

BACKGROUND: Immune-related sclerosing cholangitis (irSC) induced by immune checkpoint inhibitors (ICIs) is relatively rare, and its clinical and pathological features are not well known.

AIMS: We aimed to compare the clinical course and pathological findings of irSC with those of non-irSC liver injury.

METHODS: Clinical data were retrospectively collected from 2416 patients with advanced malignancies treated with ICIs between September 2014 and October 2023. The data of patients with severe ICI-induced liver injury who underwent liver biopsy were analyzed and compared between patients with irSC and non-irSC.

RESULTS: Ninety-three (3.8 %) patients had severe ICI-induced liver injury, and 38 underwent liver biopsy. Of these, five were diagnosed with irSC. The irSC group had a significantly longer time to onset of ICI-induced liver injury and a lower rate of improvement of liver injury than did the non-irSC group (irSC, 3/5; non-irSC, 32/33). Liver biopsies revealed more moderate-to-severe pathological cholangitis in the irSC group than in the non-irSC group (irSC, n = 5/5; non-irSC, n = 16/33). Other pathological findings were similar between the two groups.

CONCLUSION: Appropriate management of irSC requires an understanding of its characteristics of late onset and steroid resistance, and liver biopsy, in addition to imaging, may be useful for diagnosing irSC.

PMID:39828442 | DOI:10.1016/j.dld.2025.01.037

Hum Vaccin Immunother. 2025 Dec;21(1):2449714. doi: 10.1080/21645515.2025.2449714. Epub 2025 Jan 19.

ABSTRACT

To analyze the coverage rate of adult herpes zoster (HZ) vaccine and the incidence of Adverse event following immunization (AEFI) in Jiangsu province, China. The vaccination information of HZ vaccine in people aged 50 years and above in Jiangsu province in 2023 and the AEFI information of HZ vaccine from 2020 to 2023 were collected through the Jiangsu Province vaccination management information system and China AEFI information management system, and the vaccination rate and AEFI incidence of HZ vaccine were analyzed. The overall vaccination rate among individuals aged 50 years and above was merely 0.19%. About 20% of vaccinated individuals (12,821 people) received only the first dose, failing to complete the recommended two-dose regimen. A total of 43 and 217 cases of AEFIs following vaccination were reported after administration of the HZ vaccine during the periods of 2020-2021 and 2022-2023, respectively, resulting in reporting rates (RRs) of 240.7 and 201.2 per 100,000 doses, correspondingly. The majority of AEFIs following vaccination with HZ vaccines were common reactions, while rare reactions and coincidental events accounted for only 1.5% and 0.4% of cases, respectively. Over 55% of AEFIs occurred within 30 minutes post-vaccination , with fever, allergic eruptions, and drowsiness being the most reported systemic symptoms, and redness and induration being the main symptoms at the injection site. Despite the proven safety profile of the HZ vaccine, its coverage remains significantly low among individuals aged 50 years and above in Jiangsu Province, China as of 2023. The majority of AEFIs were mild and commonly observed. To enhance the comprehensiveness of post-marketing safety data, it is imperative to conduct further active surveillance studies.

PMID:39827897 | DOI:10.1080/21645515.2025.2449714

Eur J Radiol. 2025 Feb;183:111926. doi: 10.1016/j.ejrad.2025.111926. Epub 2025 Jan 13.

ABSTRACT

Pathologies of the vulva encompass a wide range of mesenchymal and epithelial benign and malignant lesions. Suspicion is raised by non-specific symptoms or clinical findings detected during routine gynecological examinations, and histopathology is essential for the diagnosis. The role of imaging has often been limited, but it can be essential in guiding treatment and, in some cases, in helping differential diagnosis. In particular, magnetic resonance imaging (MRI) can play a central role in identifying the extent of disease and planning surgical treatment. To this aim, rigorous image acquisition, correct disease evaluation in the context of vulvar anatomy and understanding of the possible differential diagnosis are essential. The aim of this article is to review the role of MRI in the evaluation of rare vulvar pathologies, focusing on different sites of origin, imaging characteristics, and local extent.

PMID:39826155 | DOI:10.1016/j.ejrad.2025.111926