Sexually transmitted infections (STIs) caused by HIV, Treponema pallidum (syphilis), and herpes simplex virus type-2 (HSV-2) are interrelated. Due to a mosaic of political, social, and economic situations, migrants are susceptible to acquiring STIs. The objective of this study was to estimate the seroprevalence of HIV, syphilis, and HSV-2 in migrants in transit in Tapachula, Chiapas, Mexico and to analyze their associated factors. A cross-sectional study was conducted between 2021 and 2022 in migrant care centers in the city of Tapachula, Chiapas, Mexico. A behavioral questionnaire was administered and a blood sample was collected. Immunological tests were performed to detect HIV, syphilis, and HSV-2. Associated factors were determined through multivariate binary logistic regression models. A total of 655 migrants participated, of which 51.5% were males. The seroprevalence of HIV, syphilis, and HSV-2 was estimated to be 8.9%, 10.5%, and 33.3%, respectively; for HIV and syphilis, the seroprevalence was higher among males than among females (p < 0.05), especially among men who have sex with men (MSM) and transgender women. A previous history of STIs, genital lesions, age at sexual debut, years of sexual activity, and having sex with members of the same sex were associated factors. In key groups, such as MSM and transgender women, the social and environmental contexts to which they are exposed as migrants, in interaction with clinical and behavioral factors, act as cumulative layers of vulnerability that increase the odds of migrants in transit to acquiring HIV, syphilis or HSV-2.

The recently published case report describing mixed connective tissue disease coexisting with tuberculosis (TB) provides an important contribution to the growing literature on complex autoimmune–infectious disease interactions. This letter expands on the diagnostic challenges highlighted by the authors by defining its added clinical value: Identifying practical diagnostic “red flags”, emphasizing parallel consideration of autoimmunity and infection, and proposing a pragmatic approach to evaluation in TB-endemic settings. Early immunological testing, differentiated pulmonary assessment, and multidisciplinary decision-making are essential when overlapping features obscure timely diagnosis and complicate therapeutic choices.

This review provides a comprehensive analysis on the immunopathogenesis of neurosyphilis and discusses the related clinical perspectives. Neurosyphilis remains one of the most complex and variable forms of syphilitic infection, driven by the interaction between T. pallidum and host innate and adaptive immune cells leading to chronic inflammation and damage to the nervous system. The article highlights three major relevant areas. 1) Cellular and molecular mechanisms. The role of different T-lymphocyte subsets, cytokine cascades, macrophages, and microglia in shaping persistent inflammation, disrupting immune control, and contributing to neurodegenerative processes is examined. In particular, it emphasizes the imbalance between pro- and anti-inflammatory cytokines, as well as the strategies by which the pathogen evades immune surveillance. 2) Clinical manifestations and diagnostic approaches. Current knowledge of the wide clinical spectrum of neurosyphilis is summarized, ranging from asymptomatic forms to severe progressive neurological involvement. Special attention is given to biomarkers, including cerebrospinal fluid indices and immunological tests, as well as instrumental methods such as MRI, serological, and molecular assays, which help refine disease staging and assess activity. 3) Therapeutic opportunities and prospective targets. Existing antibiotic regimens are discussed, along with the challenges of limited efficacy and potential antibiotic resistance. The review further explores the potential of immunotherapy and combined strategies aimed at restoring immune control and reducing central nervous system inflammation. Overall, the review integrates fundamental aspects of immunopathogenesis with practical clinical considerations. By linking cellular and molecular insights with diagnostic and therapeutic perspectives, it provides a relevant resource for both clinicians and researchers primarily engaged in the search for innovative therapeutic strategies against neurosyphilis.

Rationale:Neuropsychiatric lupus (NPSLE) represents a severe disease manifestation where early recognition significantly impacts prognosis. This report highlights the diagnostic challenges and management strategies in NPSLE presenting with coma, aiming to enhance clinical awareness of this life-threatening condition.Patient concerns:A 20-year-old female presented with acute coma of unknown origin. Initial evaluation revealed nonspecific cerebral edema on neuroimaging, while symptomatic treatment yielded minimal improvement. Physical examination showed gangrene of the right toes, indicating significant vascular compromise.Diagnoses:According to the 2019 EULAR management recommendations for systemic lupus erythematosus (SLE), this patient first meets the diagnostic criteria for SLE: positive antiphospholipid antibodies (antinuclear antibody), positive anti-double-stranded DNA antibodies, positive anti-Smith antibodies, decreased complement component 3 and complement component 4 levels, with a total classification criteria score ≥ 10 points, confirming the diagnosis of SLE. Subsequently, the patient developed neuropsychiatric symptoms as defined by the guidelines. After comprehensive exclusion of non-SLE related causes including infections, encephalitis, and metabolic abnormalities, combined with specific laboratory findings (the aforementioned autoantibodies and complement abnormalities) and imaging results, a final diagnosis of NPSLE was established.Interventions:Treatment comprised methylprednisolone pulse therapy (500 mg daily for 3 days) followed by maintenance corticosteroids, combined with intravenous immunoglobulin (25 mg daily for 5 days) and cyclophosphamide (400 mg weekly). Adjunctive measures included mannitol for cerebral edema management and appropriate analgesic therapy.Outcomes:The patient regained consciousness by day 5, followed commands despite residual right-sided weakness (grade 2). Significant motor improvement (grade 4 strength) occurred by day 12, supported by neuroimaging showing reduced cerebral lesions. Discharge occurred on day 18 with substantial neurological recovery, though digital necrosis persisted.Lessons:Unexplained coma in young females warrants consideration of autoimmune etiologies. Comprehensive immunological testing is crucial for accurate diagnosis. The combination of methylprednisolone, immunoglobulin, and cyclophosphamide demonstrated significant efficacy in severe NPSLE. Early recognition and aggressive immunosuppressive therapy are vital for optimizing outcomes.

The recombination activating gene 1 (RAG1) is essential for V(D)J recombination and lymphocyte development. While biallelic null RAG1 mutations cause severe combined immunodeficiency (SCID), hypomorphic variants have increasingly been associated with immune dysregulation and hematologic malignancies. This study aimed to present a pediatric case of Epstein-Barr virus (EBV)-negative Burkitt lymphoma carrying a novel homozygous RAG1 variant and to discuss its potential association with immune function and malignancy risk. A 9-year-old Turkish male from a consanguineous family was evaluated for hereditary cancer predisposition. Clinical, immunologic, and genetic assessments were performed, including whole-exome sequencing (WES), Sanger validation, and mRNA expression analysis. The patient presented with cervical lymphadenopathy and was diagnosed with EBV-negative Burkitt lymphoma; he had no recurrent infections, abnormal vaccine reactions, or SCID-related features. Immunologic testing, including lymphocyte subsets and immunoglobulin levels, was within normal limits. WES identified a homozygous RAG1 variant (NM_000448.2:c.460C>T; p.Leu154Phe), predicted to be deleterious and absent from population databases. Both the patient and his healthy dizygotic twin were homozygous, while parents were heterozygous carriers. RAG1 mRNA expression was reduced in heterozygotes but similar in homozygous and wild-type individuals; enzymatic activity was not assessed. The patient responded to chemotherapy and remains in remission under follow-up. In conclusion, this case expands the phenotypic spectrum of hypomorphic RAG1 variants to include EBV-negative Burkitt lymphoma without overt immunodeficiency, suggesting a possible link between partial RAG1 dysfunction and pediatric lymphoma susceptibility.

Conidiobolus sp. causes conidiobolomycosis, an emerging invasive fungal disease that affects humans and animals, mainly in tropical regions. In sheep, the disease has a major economic impact. We report an outbreak of conidiobolomycosis on a sheep farm in the Brazilian Amazon, as well as give a brief review of the subject. Veterinary care was requested on a rural property on which 3 of 35 sheep had developed prostration, facial edema, and exophthalmos. Two of the sick animals died, and a third was referred to the Veterinary Hospital of the Federal University of Acre (Rio Branco, Acre, Brazil). After imaging tests, the animal was euthanized given the advanced clinical stage of the disease. The main autopsy findings were rhinosinusitis with caseous necrosis, destruction of the nasal turbinates, and pulmonary granulomas. Based on our histologic, immunologic, microbiologic, and molecular tests, the outbreak was confirmed to be caused by Conidiobolus lamprauges, a saprozoonotic agent that has not been reported previously in northern Brazil, to our knowledge.

Immune checkpoint inhibitors (ICIs) have substantially improved the prognosis of many cancer patients but are also associated with various immune-related adverse events (irAEs). Kidney irAEs are relatively rare, with acute tubulointerstitial nephritis being the most common manifestation. However, some patients develop ICIs-associated glomerular diseases, including pauci-immune crescentic glomerulonephritis. In this report, we present the case of a 72-year-old man with lung squamous cell carcinoma treated with nivolumab, a monoclonal antibody targeting programmed cell death 1 (PD-1). The patient developed rapidly progressive glomerulonephritis a few weeks after initiating nivolumab therapy. Immunological tests yielded negative results, and a kidney biopsy revealed pauci-immune crescentic glomerulonephritis. Immunohistological examination confirmed programmed death ligand-1 (PD-L1) expression in the glomeruli. Despite intensive therapy, including corticosteroid pulse treatment, the patient's kidney function did not recover, necessitating maintenance hemodialysis. This is the first report demonstrating PD-L1 staining in injured glomeruli caused by anti-PD-1 therapy. Immunohistochemistry for PD-L1 may aid in diagnosing glomerulonephritis related to anti-PD-1 therapy.

The auxiliary diagnostic performance of creation tuberculin skin test for mycobacterium tuberculosis compared with QuantiFERON-TB Gold Plus: A diagnostic accuracy study.

Platelet transfusion refractoriness (PTR) presents a significant clinical challenge, often requiring specialized diagnostic and donor-matching strategies. Existing immunoassays detect anti-platelet antibodies but do not assess their functional impact. This study aimed to evaluate the feasibility of using ultrasound-induced chemiluminescence (UICL) as a functional assay to detect interactions between platelet concentrates (PCs) and selected antibodies (anti-HLA and ABO antibodies). Native and antibody-exposed PCs were analyzed using luminol-based chemiluminescence following high-frequency ultrasound stimulation. The signal intensity, reflecting reactive oxygen species production, was measured and standardized using an activation index. Microscopic, cytometric, and hematologic assessments were performed to validate platelet activation. Native PCs present low spontaneous chemiluminescence, which increase approximately tenfold upon ultrasound stimulation. The presence of anti-platelet antibodies additionally enhances the chemiluminescence signal following ultrasound activation. Using a quantitative activation index allows for comparison of platelet-antibody interactions and differentiation of compatible versus incompatible PCs. The lower the activation index, the better the antigenic match between the donor platelets and the patient's immune system. The method correlates with conventional HLA matching techniques (e.g., flow cytometry) and may support the selection of compatible PCs for alloimmunized patients. Morphological and volumetric changes confirm platelet activation post-sonication. UICL is a rapid, sensitive, and functionally informative method for assessing platelet-antibody interactions. It holds promise as a complementary or alternative approach to traditional immunologic testing in the management of immune-mediated PTR and may enhance transfusion decision-making, especially in settings where immunogenetic data are limited or time-sensitive.

Approximately 24 000 people die of colorectal cancer (CRC) in Germany each year. New developments in prevention, diagnosis, and treatment are improving long-term outcomes. These measures have been incorporated in the updated guideline and are presented here along with the findings of other new randomized controlled trials (RCTs). A systematic search (2022-2023) was conducted for guidelines, reviews/meta-analyses, and primary studies (search term "colorectal cancer"; databases: international guideline registries, PubMed, Cochrane). 123 reviews were identified, evaluated, and used in the creation of the guideline. Early detection is performed with colonoscopy every 10 years, sigmoidoscopy every 5 years, or an immunological stool test for occult blood every 1-2 years; it can lower cancer-related mortality by up to 30%. Hereditary forms (Lynch syndrome, polyposis) require more intensive monitoring. All diagnosed cases must be presented to a tumor board. In the case of low-risk pT1 carcinoma, extended resection is not indicated after complete endoscopic removal. As for surgery, robotic and laparoscopic procedures are equivalent (3-year recurrence rate 1.6% and 4.0% respectively, in a recent RCT; adjusted hazard ratio, 0.39; 95% confidence interval: [0.19; 0.80]). Treatment of patients with mismatch repair deficiency (dMMR) or microsatellite instability (MSI) with checkpoint inhibitors yields response above 90%. Further systemic therapies are based on the molecular tumor profile (dMMR/MSI, RAS, and BRAF). Organ-preserving strategies after a complete response require intensive follow-up care. The efficacy of early detection is undisputed. Less evidence is available concerning the optimal level of intensity of follow-up care. The clinical and molecular stratification of tumors enables differential treatment. Organ-preserving strategies after a complete response to therapy are an important area of current research.

Hog cholera (HC) or classical swine fever is one of the highly contagious and devastating viral diseases of domestic pigs and wild boar. It causes great economic loss to the pig industries. The disease is endemic in North Eastern Region of India. Accurate diagnosis of the disease is very essential to adopt appropriate preventive measures. In addition to the clinical and postmortem changes, laboratory diagnostic tests are essential to confirm the HCV infection in pigs. The present study was undertaken to evaluate the efficacy of different immunological tests (FAT, S-ELISA and AGPT) for diagnosis of hog cholera in field samples. a total of nine outbreaks were attended. Free grazing Doom variety pigs (83) were found mostly affected and comparatively lesser number of cases were recorded in crossbred pig (27) and Hampshire pigs (10). Pigs at the age group of 1-4 months (44.16%) were found highly susceptible which was followed by 0-2 months (27.50%), &gt; 8 months (15%) and 4-6 months (13.3%) of age group. Clinically affected pigs showed mostly high fever, anorexia, constipation, diarrhoea, conjunctivitis, hyperaemia of skin, incoordination of movements, abortion, stillbirth and fetal mummification. Altogether, 314 samples were processed for detection of HCV antigen. In direct FAT, 163 (51.91%) samples showed positive results, of which tonsillar tissue showed the highest percentage (67.12%) of positivity, while in mesenteric lymph nodes, leucocytes, spleen and kidney, the percentage positivity was less. In sandwich ELISA, 147 (46.81%) samples were found positive for HCV antigen, and tonsil showed higher percentage (56.16%) of positivity than other organs. Highest virus concentration (≥1:32) was detected in tonsil and lowest (34.52%) in spleen tissues. In AGPT, 19.74 percent samples were found positive for HCV antigen. Again, tonsilar tissue (35.60%) exhibited highest number of positive cases and lowest was recorded in mesenteric lymph nodes (12.16%). Statistically, the results of FAT and ELISA were comparable to each other for HCV antigen detection and were significantly (P &lt; 0.05) different from that of AGPT. Tonsil was found to be the most suitable sample for HCV detection.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease affecting multiple organ systems. It predominantly occurs in women of reproductive age, with a global prevalence ranging from approximately 20 to 150 cases per 100,000 individuals. The diagnosis of SLE can be supported by antinuclear antibody (ANA) testing, which includes an initial screening with immunofluorescence ANA (ANA-IF), followed by an ANA profile to identify specific autoantibodies. A 20-year-old female presented with complaints of easy fatigue, fever, joint pain, and hair loss. Laboratory investigations revealed anemia. Immunological testing demonstrated a positive ANA-IF result with a titer of 1:1000 and a delicate speckled pattern, meeting the EULAR/ACR criteria that consider a positive ANA-IF titer ≥1:80. Based on these clinical and laboratory findings, the patient was diagnosed with SLE and commenced on corticosteroid therapy. Subsequent follow-up showed clinical improvement. This case highlights the importance of careful interpretation of ANA-IF titers and patterns for the early detection of SLE. Additionally, specific autoantibody profiling remains essential to support a more precise diagnosis.

Introduction Proteasome-associated autoinflammatory syndromes (PRAAS) are monogenic systemic autoinflammatory diseases (SAIDs) caused by proteasome mutations. PSMB9 deficiency is classified as an autoinflammatory disease in the IUIS2024. They show a strong type I interferon response, which can be modulated by JAK inhibitors. Case A 9-year-old girl, born to non-consanguineous parents, with no relevant family history. Healthy until age 8, when she developed fever, bicytopenia, hyperferritinemia (20,000 ng/mL), and bone marrow hemophagocytosis; diagnosed with partial hemophagocytic lymphohistiocytosis (HLH), which improved with corticosteroids. After tapering steroids, she had recurrent episodes of systemic hyperinflammation with fever, arthralgias, and shock, requiring ICU admission. Labs showed leukocytosis with neutrophilia, thrombocytosis, anemia, hyperfibrinogenemia, hyperferritinemia, elevated erythrocyte sedimentation rate and C-reactive protein, and high IL-6 (1,336 pg/mL). Immunological tests (CD3, CD4, CD8, CD19, and immunoglobulins) were normal. Symptoms were partially controlled with corticosteroids. She was refractory to cyclosporine after 6 months. No infection, autoimmunity, malignancy, or rheumatologic disease was found. To investigate the disease mechanism, we analyzed the interferon (IFN) pathway in patient cells using droplet digital PCR. Our results showed overexpression of type I (MX1, ISG15, IFIT1, RSAD2) and type II (GBP1, IRF1, IRF8, ICAM1) IFN-inducible genes. IFN-α signature: 19.8 (cutoff: 8.4); IFN-γ signature: 14.6 (cutoff: 3.6). IFN-γ mRNA also elevated. Due to dysregulated type I/II IFN signaling, ruxolitinib (2.5 mg twice a day) was started, leading to clinical/lab improvement after 3 months. Subsequently, gene panel (371 genes) found novel variant of uncertain significance (VUS) heterozygous PSMB9 variant (c.88G&amp;gt;A, p.G30R). Discussion IFN pathway testing guided JAK inhibitor use in suspected monogenic SAID unresponsive to steroids with clinical improvement. Later genetic testing identified a VUS in the PSMB9 gene, which was reclassified to probably pathogenic through functional studies. Together, functional and genetic approaches led to the patient’s definitive diagnosis.

In 2022, tuberculosis (TB) caused 1.3 million deaths worldwide, making it the second leading infectious cause of death. Diagnosing TB remains challenging because current immunological tests cannot distinguish between TB disease and TB infection (TBI). Research suggests that ratios such as monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte, along with absolute counts of various blood cells, could help develop a low-cost and easy-to-use diagnostic tool to distinguish TB disease from TBI among IFN-γ release assay (IGRA)-positive subjects without relying on microbiological tests. We enrolled 112 TB-infected subjects and used blood cell count parameters and ratios to develop a TB score that can indicate TB status. We then validated the score in another cohort of IGRA-positive hospitalized patients. We developed a TB score based on 11 blood parameters to identify TB disease among IGRA-positive subjects, with 93% specificity and 71% sensitivity. This score can support physicians in making therapeutic decisions for IGRA-positive subjects, offering a practical approach to differentiate TB disease from TBI.

Introduction. Respiratory diseases are widespread on livestock farms, especially in high-yielding animals, and they are particularly severe in young animals. Non-specific bronchopneumonia in calves is caused by a combination of factors including opportunistic respiratory microbiota, which can become pathogenic under unfavorable conditions, overcrowding, nutritional imbalances, stress, drafts, noise, other environmental stressors as well as compromised immunity in newborn animals. Objective. Immunological control of aerosol phytotherapy of acute catarrhal bronchopneumonia for its effectiveness in calves. Materials and methods. One – three month-old calves with acute catarrhal bronchopneumonia ( n = 60) were used for the study. The calves were divided into three test groups, 20 calves per group. Blood samples were collected from the diseased animals before the start of treatment, as well as on day 7 and 12 after treatment and used for immunological tests. Results. Aerosol administration of Hypericum perforatum extract, herbal product, in the complex treatment of calves with acute catarrhal bronchopneumonia demonstrated high efficacy compared to two other treatment regimens. In the test group receiving phytotherapy overall clinical improvement was observed as early as on (4.90 ± 0.64) day, which was 47.0% faster than in the group where animals were treated according to the treatment regime routinely used on the farm. Furthermore, the calves in this group demonstrated a faster recovery of appetite, consumed feed more readily, their coats became smooth and shiny, and their cellular and humoral immunity levels, as well as their pro-inflammatory cytokine levels reached the reference levels of clinically healthy animals by day 12 and day 7, respectively. Conclusion. While all three regimens for acute catarrhal bronchopneumonia were effective, the aerosolized Hypericum perforatum extract produced the best results. Calves receiving this treatment showed the most significant improvements in cellular and humoral immunity, along with the reduction in pro-inflammatory cytokine levels.

BACKGROUND. In patients over 60 years of age, senile asthenia (SA), the main geriatric syndrome, may be the background for tuberculosis. The development of SA is accompanied by a decrease in physical and functional activity, adaptive and restorative reserves of the body, which makes the elderly vulnerable to infectious diseases, including tuberculosis. OBJECTIVE. To study the features of detection and diagnosis of respiratory tuberculosis in patients with senile asthenia over the age of 60 in 2018–2024. MATERIALS AND METHODS. A retrospective prospective cohort study wasconducted, which included 301 patients over 60 years of age with newly diagnosed respiratory tuberculosis in 2018–2024 in the Yaroslavl and Kostroma regions. The diagnosis of tuberculosis in all patients was carried out using clinical, laboratory, and instrumental examination methods generally accepted in phthisiology. All patients were screened for SA using the «Age is not a hindrance» questionnaire; asthenia was recorded with a score of 5 or more (Senile asthenia. Clinical guidelines, 2018, 2024). The patients were divided into two groups: 51 patients with SA in the first group, 250 patients without SA in the second group. RESULTS. The time frame for detecting tuberculosis from the moment of contacting the general medical network to the diagnosis was more than one month in 59.1 % of patients over 60 years of age. In most cases (44.8 %), tuberculosis was detected by internists in the general treatment network (GTN) when patients complained of intoxication and bronchopulmonary disorders that had been bothering them for more than 3 weeks. In the group of patients with SA, disseminated (52.3 %) and infiltrative (31.3 %) forms prevailed, and tuberculosis of the bronchi (8.3 %) and tuberculosis of the bronchi (8.3 %) also occurred. Classical radiological signs of pulmonary tuberculosis in patients over 60 years of age werefound in 90.8 % of cases. Patients with SA were more likely to have a negative Mantoux test result with 2 TE than among patients without SA (39.2 % and 64.0 %; p &lt;0.01). The ELISPOT test (T-SPOT.TV) was positive in 100% of cases. CONCLUSIONS. In patients over 60 years of age with SA, there is a late diagnosis of tuberculosis. Tuberculosis is detected mainly by complaints of the development of widespread, disseminated processes against the background of reduced immune reactivity. It is advisable to include computed tomography of the chest organs, sputum analysis for Mycobacterium tuberculosis by molecular genetic methods, microscopy and culture, as well as immunological tests for tuberculosis using the ELISPOT method in the algorithms for diagnosing tuberculosis in patients over 60 years of age.

Introduction: Acute viral rhinitis is one of the most prevalent upper respiratory conditions, primarily caused by rhinovirus, with other viruses such as coronavirus, adenovirus, RSV, and influenza contributing to smaller proportions. Although diagnosis is typically clinical, laboratory testing plays an increasingly important role in distinguishing between viral and bacterial etiologies, preventing unnecessary antibiotic use, and enhancing clinical decision-making. Methods: A literature search was conducted using PubMed and Google Scholar for articles published from 2020 to 2025. Keywords included “Acute Viral Rhinitis,” “Common Cold,” “Laboratory Diagnosis,” “Multiplex PCR,” and “Point-of-Care Test.” From 89 initially identified studies, screening based on inclusion and exclusion criteria resulted in nine eligible publications. These were synthesized using a narrative review approach and evaluated using the SANRA instrument. Results: Molecular diagnostic methods such as RT-PCR and multiplex PCR demonstrated the highest diagnostic accuracy (&gt;95%) for detecting respiratory viral pathogens. Classic immunological tests, including skin prick testing and ImmunoCAP, remain relevant for assessing allergic rhinitis but are less useful for differentiating between viral and bacterial infections. Basic biomarkers such as CRP and procalcitonin provided moderate sensitivity and supported early clinical screening. Emerging point-of-care tests, particularly assays measuring MxA and CRP, have shown promising accuracy in distinguishing between viral and bacterial infections, making them valuable for primary care settings. Conclusion: No single laboratory method is ideal for diagnosing acute viral rhinitis. A combined approach integrating classical, molecular, and point-of-care diagnostics enhances diagnostic precision and promotes rational antibiotic stewardship. Future practice should prioritize wider access to molecular testing, the adoption of validated point-of-care tools, and the continued development of novel biomarkers to enhance rapid and accurate diagnosis in diverse clinical settings.

BackgroundIn the small non-malignant specimens acquired through respiratory endoscopy, the conventional pathological examination approaches such as acid-fast staining have certain restrictions in the sensitivity of tuberculosis diagnosis.ObjectiveTo investigate the sensitizing effect and clinical value of polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) based on fluorescent probe nucleic acid detection technology in improving the diagnostic positive rate of non-malignant small specimens obtained by respiratory endoscopy.MethodsA retrospective analysis was conducted on 729 patients with suspected TB who underwent respiratory endoscopy. All patients provided small non-malignant specimens for TB-PCR, acid-fast staining, and mycobacterial culture. A clinical composite diagnosis served as the gold standard. Diagnostic performance was assessed by accuracy, sensitivity, specificity, and area under the ROC curve (AUC). A subgroup of 113 patients underwent additional testing (T-SPOT. TB, TB-Ab, BALF-G-Xpert, BALF-TB) for extended comparison.ResultsThe AUC, accuracy, sensitivity, specificity, PPV and NPV of TB-PCR in the diagnosis of TB were 0.88 (95% CI: 0.86–0.90), 0.88 (95% CI: 0.85–0.90), 0.99 (95% CI: 0.98–1.00), 0.78 (0.74–0.82), 0.79 (95% CI: 0.75–0.83), 0.99 (95% CI: 0.97–1.00), respectively. Among 729 patients (391 TB+, 338 TB-), TB-PCR showed significantly higher overall diagnostic efficacy (AUC: 0.88) than acid-fast staining (AUC: 0.77, P<0.05) and was comparable to culture (AUC: 0.87). TB-PCR also demonstrated superior accuracy (0.89 vs 0.61–0.85, P<0.05) compared to immunologic and BALF-based tests in the subgroup analysis, achieving nearly perfect sensitivity (0.99–1.00) and high NPV (0.99–1.00).ConclusionThe application of TB-PCR for the detection of lung samples obtained through respiratory endoscopy holds significant clinical application value in the diagnosis of TB. Clinicians should fully recognize the merits and potential of TB-PCR technology, proactively apply it in clinical practice, and choose appropriate detection methods based on the specific conditions of patients.

Breeding objectives for turfgrass species include continued improvement of aesthetics and persistence while minimizing inputs such as water, fertilizers, and fungicides. In order to achieve the objectives, breeders must evaluate large amounts of germplasm for multiple traits in multiple environments to develop resilient grasses suitable for sport, lawn, and landscape uses. Fungal endophytes of the genus Epichloë develop a mutualistic relationship with many turfgrass species, including ryegrass (Lolium spp.) and fescues (Festuca spp.), imparting a high tolerance to biotic and abiotic stresses. The development of improved turfgrasses with endophyte is of great value to reduce maintenance costs and conserve resources. It has been reported that red thread disease (caused by the pathogen Laetisaria fuciformis) and dollar spot disease (caused by Sclerotinia homoeocarpa) can be suppressed in fine fescues that are infected with endophytes. Grasses colonised by Epichloë endophytes have shown high tolerance to foliar feeding insects such as billbugs (Sphenophorus spp.). Several studies have also demonstrated that endophytes confer protection to perennial ryegrass and tall fescue from water stress by increasing the availability of primary metabolites, e.g. concentrations of glucose and fructose. Breeders can use established immunological tests to determine if Epichloë endophytes are present in plant seed, but there is no guarantee that the endophyte is viable. To determine viability, the same immunological tests (commonly known as growouts) can be performed on grass seedlings to determine viable endophyte infection frequencies across grass populations. To deliver grass cultivars with high (&gt;70%) endophyte infection frequencies, these cultivars must be developed with endophyte infection frequencies near 100%. Many grass breeders in the United States maintain high endophyte frequencies in the live plant material to ensure the mutualistic relationship between the plant genotype and endophyte genotype is maintained throughout the breeding cycle. However, viable endophyte infection frequencies can decrease over time depending on the environment and cultural practices deployed. Maintaining breeder seed of a cultivar with a high endophyte infection frequency requires cold storage with low humidity in addition to an established endophyte assessment protocol. However, delivering this quality endophyte-seed product for commercial production requires a quality assurance program that is not currently available on an industry wide scale in the United States.

Cutaneous lupus erythematosus (CLE) encompasses a spectrum of skin manifestations that may occur as an isolated dermatological condition or in association with systemic lupus erythematosus (SLE). This review provides an updated synthesis of current knowledge on CLE, including its classification, pathogenesis, clinical presentation and diagnostic strategy. It will discuss recent advances in pathogenesis, particularly the central role of type I interferons and interferon-producing cells. Diagnostic evaluation involves clinical assessment, histopathology and immunological testing, with specific focus on CLE mimickers. In recent years, validated tools such as the Cutaneous Lupus Area and Severity Index (CLASI) have facilitated standardized assessment in clinical trials. Management of CLE requires a multifaceted approach incorporating general measures, topical therapies, antimalarials, systemic immunosuppressants and emerging biologics. Treatment should be tailored based on CLE subtype, severity, scarring risk and the presence or absence of systemic involvement. Antimalarials, particularly hydroxychloroquine, remain the cornerstone of systemic therapy. Second-line or third-line agents such as methotrexate, retinoids, dapsone, thalidomide and lenalidomide are recommended in refractory cases. Biological therapies, including belimumab and anifrolumab, are approved in the setting of SLE. Promising results from recent trials of targeted therapies including inhibitors of plasmacytoid dendritic cells, TLR7/8 and TYK2 are paving the way for novel treatment strategies in CLE.