Severity Of Thedisease Research Articles

Trends and Hospitalization Outcomes of Tetanus Cases: A Multicenter Retrospective Study in Suzhou, 2013-2023.

To investigate the epidemiology, and hospitalization of tetanus in Suzhou, Jiangsu Province, China, focusing on the severity of the disease, treatment, outcomes and hospitalization costs, and to explore the risk factors for severe tetanus. This retrospective, multicenter observational study analyzed tetanus patients admitted to various medical institutions between 2013 and 2023. Patients were classified into two groups as severe or non-severe, using the Ablett classification. Differences between the two groups were compared using the Chi-squared test, Fisher's exact test and Mann-Whitney U-test. Binary logistic regression analysis was used to evaluate potentialrisk factors for severe disease. A total of 63 patients with tetanus were included in this study. The median age of the patients was 57.0 (48.0-74.0) years, with a predominance of males (65.1%). There was an overall increasing trend in the rate of severe illness in tetanus patients from 2013-2023 (P<0.001). The proportion of patients admitted to the hospital was highest (39.7%) in summer (June-August) (P=0.001). The rate of severe tetanus was significantly higher in patients aged ≥65 years than in those aged 0-40 years and 41-64 years (P=0.019). The incubation period was 8.0(5.0-11.0) days for severe tetanus patients and 11.0 (8.0-18.0) days for non-severe patients (P=0.005). Compared to the non-severe group, the severe group shouldered a higher hospitalization cost, with total costs amounting to US $19062.8(4675.4-29,385.4) and US $4291.1(1356.6-19,635.4), respectively. Binary logistic regression analysis revealed that patients aged 65 years and above significantly increased the risk of developing severe disease (OR = 3.345, 95% CI: 1.039-10.770). Tetanus occurs primarily in the summer in Suzhou City, Jiangsu Province, China. The incubation period is shorter in patients with severe tetanus. The elderly are the main affected population, with the risk of developing severe disease escalating with advancing age. Knowledge of tetanus immunoprophylaxis should be strengthened to further reduce morbidity and mortality.

Factors Associated With Presence Of Pneumomediastinum And Pneumothorax In Patients With Covid 19 In Public Hospital In Puebla

Introduction: acute respiratory distress syndrome secondary to covid 19 can lead to the presence of pneumothorax and pneumomediastinum; rare but potentially fatal and is related to mechanical ventilation or the severity of the disease. Recently, cases of pneumomediastinum have been documented despite the use of different protective ventilation measures, without being clear about its origin or prognosis. Material and methods: descriptive, retrospective and single-center study in patients with covid 19 admitted to a second level hospital in the city of puebla during march 1, 2020 to march 1, 2021. Results: during the period from january 2020 to january 2021, 966 patients were admitted to hospital with a diagnosis of covid 19. 29 (3%) patients presented some pleural complication. 23 (84%) had pneumomediastinum and 5 (18%) had pneumothorax. The most prevalent comorbidities were diabetes, arterial hypertension and obesity. 80% of the patients had dyspnea and chest pain as the initial symptom. In laboratory tests, 80% of the patients had high ldh and c-reactive protein associated with leukocytosis. Conclusion: the prevalence of pneumothorax and pneumomediastinum in patients with covid 19 was 3% with a mortality rate of 25%

ХАРАКТЕРИСТИКА ЗУДА И НЕКОТОРЫХ НЕЙРОПЕПТИДОВ ПРИ ПСОРИАЗЕ, АССОЦИИРОВАННОМ С ПСИХИЧЕСКИМИ РАССТРОЙСТВАМИ

Background. Pruritus is one of the most common symptoms accompanying psoriasis. Patients with pruritus report decreased quality of life, depression, anxiety, and body dysmorphic concerns, as well as reduced effectiveness of treatment. Objective. To study the intensity of skin pruritus and the level of neuropeptides in the blood serum in patients with psoriasis associated with mental disorders. Material and methods. The main methods of examination of 110 patients with psoriasis were clinical and anamnestic method as well as clinical laboratory and clinical psychopathological ones. Results. In patients with a combined variant of psoriasis and mental disorders, a significantly higher incidence of skin pruritus (p &lt;0.001), pain (p &lt;0.01), elevated serum levels of substance P (p˂0.001) was established; significantly more often scratching increased pruritus (p&lt;0.05), pruritus led to depression (p&lt;0.01), pruritus was prolonged (p&lt;0.05) with a significant decrease in quality of life (p&lt;0.05), mood swings were characterized as “severe"(p&lt;0.05) and "unbearable" (p&lt;0.001). Conclusion. Pruritus is one of the most common and bothersome symptoms of psoriasis and is often associated with psychosomatic and psychiatric comorbidities, as well as elevated blood serum levels of certain neuropeptides. This fact may indicate the role of the latter in the pathogenesis of this combined pathology. Considering the possibility of therapeutic potential on the neuropeptides production level, the obtained data on their role in the pathogenesis of psoriasis and its comorbid pathology will allow us to develop a personalized approach to therapy, taking into account the severity of the disease and concomitant pathology.

Modeling the interplay between disease spread, behaviors, and disease perception with a data-driven approach

Individuals’ perceptions of disease influence their adherence to preventive measures, shaping the dynamics of disease spread. Despite extensive research on the interaction between disease spread, human behaviors, and interventions, few models have incorporated real-world behavioral data on disease perception, limiting their applicability. In this study, we propose an approach to integrate survey data on contact patterns and disease perception into a data-driven compartmental model, by hypothesizing that perceived severity is a determinant of behavioral change. We explore scenarios involving a competition between a COVID-19 wave and a vaccination campaign, where individuals’ behaviors vary based on their perceived severity of the disease. Results indicate that behavioral heterogeneities influenced by perceived severity affect epidemic dynamics, in a way depending on the interplay between two contrasting effects. On the one hand, longer adherence to protective measures by groups with high perceived severity provides greater protection to vulnerable individuals, while premature relaxation of behaviors by low perceived severity groups facilitates virus spread. Differences in behavior across different population groups may impact strongly the epidemiological curves, with a transition from a scenario with two successive epidemic peaks to one with only one (higher) peak and overall more numerous severe outcomes and deaths. The specific modeling choices for how perceived severity modulates behavior parameters do not strongly impact the model’s outcomes. Moreover, the study of several simplified models indicate that the observed phenomenology depends on the combination of data describing age-stratified contact patterns and of the feedback loop between disease perception and behavior, while it is robust with respect to the lack of precise information on the distribution of perceived severity in the population. Sensitivity analyses confirm the robustness of our findings, emphasizing the consistent impact of behavioral heterogeneities across various scenarios. Our study underscores the importance of integrating risk perception into infectious disease transmission models and gives hints on the type of data that further extensive data collection should target to enhance model accuracy and relevance.

Comparison of long term efficacy and cost-effectiveness of omalizumab in 150 mg and 300 mg doses in patients with chronic spontaneous urticaria

BackgroundChronic spontaneous urticaria (CSU) is a clinical condition that affects patients quality of life. Omalizumab is preferred in antihistamines resistant CSU cases. Urticaria activity score-7 (UAS-7) is a scale that shows the severity of the disease. ObjectivesThe authors aimed to compare the long-term (60 months) efficacy and side effects of 150 mg and 300 mg doses of omalizumab in patients with CSU. Methods108 patients followed up at the clinic with the diagnosis of CSU were included. Omalizumab was started in patients who were resistant to conventional CSU treatment. Two groups were formed to receive 150 mg and 300 mg doses of omalizumab. Urticaria activity score (UAS-7), antihistamine usage, time to achieve disease-free stage, relapse after treatment, and side effects of omalizumab treatment were compared in the two groups. ResultsThere were no statistically significant differences between the groups regarding basal characteristics and laboratory findings. Average follow-up time was sixty months. UAS-7 scores were similar in the follow-up. There were no adverse events in both groups. Study limitationsRetroactive design and single-center nature to reach a more significant number of patients. Lack of patients receiving the lowest dose 75 mg and the highest dose 600 mg of omalizumab. Absence of total body mass indexes of all patients. Besides, the use of distinct drugs may contribute to non confident results and is another limitation of this study. ConclusionSince there is no significant difference between 150–300 mg omalizumab doses regarding long-term treatment efficacy and side effects in CSU patients, starting treatment with a 150 mg dose may be suitable. In patients who do not respond to 150 mg, the omalizumab dose can be increased to 300 mg. It will prevent unpredictable dose and time-dependent complications and will be a cost-effective approach even in strong economies.

Fabry disease in familial Mediterranean fever according to the severity of the disease

ObjectivesMutations in the α-galactosidase A (GLA) gene result in Fabry disease (FD), a rare metabolic condition. FD patients present with heterogeneous clinical manifestations, which may overlap with systemic diseases including familial Mediterranean fever (FMF). The aim of this study was to determine the frequency of FD in patients with mild and severe FMF and to prevent misdiagnosis by increasing clinicians’ awareness. MethodsBased on Tel-Hashomer criteria, the study included a total of 91 FMF patients. Patients were divided into two groups according to the number of recurrent clinical episodes or failure to respond to maximum therapy: those with mild and severe forms of the disease. GLA gene mutations and α-GLA enzyme activity were assessed. Records of MEFV mutations, therapies and demographic characteristics were kept. ResultsFD testing was performed on a cohort of 91 FMF patients, 54.9% had mild FMF, 45.1% had severe FMF, and only one patient in the mild FMF subgroup tested positive for FD. The patient was a 39-year-old woman with a history of recurrent abdominal pain, distal limb pain and fever. She had low GLA enzyme activity and a heterozygous GLA gene mutation. ConclusionsOur findings suggest that FD should be considered in the differential diagnosis of FMF, especially in individuals with unusual symptoms.

In Vitro Anti-inflammatory Effect of Secretome from Umbilical Cord-derived Mesenchymal Stem Cells in COVID-19 Patient Blood: A Study on sIL-6R, sgp130, IL-1RA and Anti/pro Inflammatory Cytokines

COVID-19 exhibits a wide range of clinical manifestations which severity of the disease is linked to uncontrolled escalation of inflammatory mediators. Ongoing research has identified the immunomodulatory effects of the MSC-derived secretome as a potential therapy for COVID-19. However, the precise mechanism by which the secretome exerts its therapeutic effect on COVID-19 remains unclear. This study aims to investigate whether the components of the UC-MSC-derived secretome can alter the inflammatory characteristics of immune cells. To achieve this, an in vitro study will be conducted involving co-incubation of whole blood with secretomes, followed by LPS stimulation. A total of 12 blood samples from severe COVID-19 and healthy subjects were cultured into three groups (RPMI control, 3μl and 9μl secretome group) incubated for 24 hours. Then, the cultures were exposed to LPS for 48 hours. The levels of sIL-6R, sgp130, IL-1RA, IL-6, TNF-α, IFN-γ, and IL-10 were measured. Results showed that LPS increased IL-6, TNF-α, and IL-10 production, while reducing sIL-6R, and sgp130, but no changes seen in IFN-γ in secretome-incubated blood cultures. The post-LPS/pre-LPS ratio analysis was conducted to investigate the anti-inflammatory potential of secretome. It was found that the secretome provides its anti-inflammatory effects through the role of IL-1RA.

Computation and analysis of optimal disturbances of periodic solution of the hepatitis B dynamics model

Abstract Optimal disturbances of the periodic solution of the hepatitis B dynamics model corresponding to the chronic recurrent form of the disease are found. The dependence of the optimal disturbance on the phase of periodic solution is analyzed. Four phases of the solution are considered, they correspond to clinically different periods of development of the immune response and severity of the disease, namely, activation of antiviral immune reactions, attenuation of reactions, peak and minimum viral load. The possibility of using optimal disturbances to exit the domain of attraction of the considered periodic solution using minimal impact is studied. The components of disturbances that may underlie the phenomenon of spontaneous recovery from chronic hepatitis B observed in clinical practice are identified.

Assessment of COVID-19 severity levels and associated factors among patients admitted to the treatment centers in Southern Ethiopia.

COVID-19, a highly impactful infectious disease, has been observed to result in psychological distress, organ impairment, and mortality. The severity and consequences of the illness appear to vary based on geographical location and individual characteristics. Understanding the disease and optimizing resource distribution through early classification depend on having data on the severity of COVID-19 patients. There is a dearth of information in this particular region regarding the severity of COVID-19 patients and related factors. Therefore, this study used an ordinal logistic regression model to determine the severity levels of COVID-19 and its associated components. A retrospective follow-up study was conducted on COVID-19 patients admitted between May 30, 2020, and October 15, 2021, at care centers in southern Ethiopia. 845 patients were included in this research. The mean (standard deviation) and median (interquartile range) were used to summarize the data. A multivariable ordinal logistic regression model was used to study the association between independent variables and COVID-19 severity levels. In terms of the severity of the disease, 12.07% of patients had severe COVID-19, 7.81% had critical disease, and 6.39% had moderate disease. 8.28% of the 845 patients died, while 88.88% of them made a full recovery. Older age (> = 40 years) (AOR = 5.75, 95% CI = 3.99, 8.27), comorbidities (AOR = 4.17, 95% CI = 3.03, 5.88), and low oxygen saturation (AOR = 3.44, 95% CI = 2.23, 5.56) were significantly linked to higher odds of experiencing more severe levels of COVID-19 compared to their counterparts. 7.81% of patients were critically ill, while more than one-tenth (12.07%) were considered severely ill. Low oxygen saturation, comorbidities, and advanced age were found to be significantly associated with COVID-19 severity. Therefore, it is crucial to manage comorbidities, provide special treatment, and provide COVID-19 patients with underlying medical issues more attention due to the higher risk of poor outcomes. To speed up their recovery, medical professionals should regularly monitor and provide specialized care to older COVID-19 patients. In order to identify patients who are more likely to experience a severe illness and to better manage their treatment, it is imperative that oxygen saturation levels in COVID-19 patients be promptly identified and monitored.

Serum Biomarkers IL-6 and HIF-1α in Rosacea: Assessing Their Significance in Disease Pathogenesis and Telangiectasia Formation

Introduction: Rosacea, a chronic inflammatory disease primarily affecting the central part of the face, is a complex condition whose mechanisms are still not fully understood. However, research has indicated a positive correlation between two molecules: Hypoxia-inducible factor-1α (HIF-1α) and Interleukin-6 (IL-6). The levels of HIF-1α in rosacea patients have yet to be assessed. Objectives: In this study, the aim was to assess the levels of HIF-1α and IL-6 in patients with rosacea in relation to both the severity of the disease and the primary and secondary clinical manifestations of the condition. Methods: The study included patients diagnosed with rosacea and sex-and age-matched healthy volunteers (N: 40, N: 40). Serum HIF-1α and IL-6 levels were quantified using enzyme-linked immunosorbent assay (ELISA). Results: When compared to the control group, serum levels of HIF-1α and IL-6 were significantly elevated in the patient group. A positive correlation was found between the level of HIF-1α and the severity of the disease (r: 0.374, p: 0.017). Furthermore, a significant association was observed between the presence of telangiectasia, one of the primary symptoms, and HIF-1α (r: 2.401, p: 0.016). Conclusion: The significantly elevated levels of IL-6 and HIF-1α in patients with rosacea compared to the control group support the hypothesis that they play roles in the pathogenesis of the disease. The correlation of HIF-1α with the severity of the disease and its significant elevation in patients with telangiectasia suggest its potential involvement in the pathogenesis of the disease, particularly in the formation of telangiectasia.

The role of epithelial alarmins and Th2 cytokines in the inflammatory response in allergic rhinitis

Allergic rhinitis (AR) occupies a leading position among the causes of morbidity throughout the world, to date, it has been diagnosed in 400 million people. In the formation and progression of AR, a significant role is assigned to cytokines associated with the second type of immune response, in particular, IL-4, IL-5, IL-9, IL-13, IL-25, IL-33, thymic stromal lymphopoietin (TSLP). This literature review provides information on the influence of the listed mediators on the structural cells of the nasal cavity and blood immune cells (T- and B-lymphocytes, eosinophils, macrophages, dendritic cells), and discusses their association with the manifestation of AR symptoms and the severity of the disease. The results of studies aimed at establishing the level of IL-4, IL-5, IL-9, IL-13, IL-25, IL-33 and TSLP in biological fluids (blood serum, nasal lavage) and their expression in nasal epithelial cells in patients with AR compared to healthy people are assessed.

Exploring Gaucher disease: A pediatric case of severe dyslipidemia and unique symptoms

Introduction: Gaucher disease is a rare inherited lysosomal storage disorder caused by mutations in the GBA gene, leading to glucocerebrosidase deficiency. This results in the accumulation of glucocerebroside in macrophages, forming "Gaucher cells" that infiltrate various tissues, primarily affecting the liver, spleen, bone marrow, and nervous system. The disease manifests in three types, with Type 1 being the most common and devoid of neurological symptoms. Diagnosis involves enzyme level testing, genetic screening, and imaging, while treatment primarily consists of enzyme replacement therapy (ERT) and substrate reduction therapy (SRT). Case-Report: A one-year-old girl presented with weakness, irritability, and recurrent fever over six months, previously misdiagnosed with malaria and respiratory infections. Physical examination revealed pallor, hepatosplenomegaly, and cherry-red spots on fundoscopy. Laboratory findings indicated anemia, leukocytosis, and severe dyslipidemia, highlighting atypical features for Gaucher disease. Discussion: This case emphasizes the diagnostic challenges in pediatric Gaucher disease, especially with nonspecific symptoms. The combination of cherry-red spots and dyslipidemia suggests a unique variant or severity of the disease, underlining the necessity for heightened awareness among healthcare providers for prompt diagnosis. Conclusion: Gaucher disease should be considered in pediatric patients with unexplained systemic symptoms. Early detection and ERT initiation can significantly improve clinical outcomes. The case illustrates the variability in clinical presentations, emphasizing the need for comprehensive diagnostic evaluation.

Evaluation of nasal mucociliary clearance in patients with psoriasis.

Psoriasis is an autoimmune pathology characterized by chronic inflammation with known multiorgan involvement. In the literature, there are few studies investigating the effects of psoriasis on upper respiratory tract mucosa. Our aim in our study was to investigate the possible effect of psoriasis disease severity and duration on nasal mucosa. A study group was formed from patients with psoriasis and disease duration, Psoriasis Area Severity Index (PASI) and Nasal Obstruction Symptom Evaluation (NOSE) scores of these patients were recorded. Demographic data were noted in all participants with the participation of control group patients, saccharin test was performed to evaluate the nasal mucosa and nasal mucociliary clearance (NMC) times were measured. Psoriasis patients with pathology that may cause nasal obstruction were excluded from the study. A total of 59 people (30 patients and 29 controls) aged 20-65 years were included in the study. There was no difference in age and gender distribution between the two groups. No statistically significant difference in the NMC time between two groups. In the patients group, a correlation was observed between the NMC time to the NOSE test, but no correlation was observed between the NMC time to the duration of the disease and the PASI score. In our study, no difference was observed in NMC time between the two groups and according to the duration or severity of the disease. In addition, NOSE score of patients was also relatively low. No significant impact of psoriasis on nasal functions was found.

Endocrine disorders in Kearns-Sayre syndrome with different severity of symptoms: two case reports and a literature review.

Kearns-Sayre Syndrome (KSS) is a variant of mitochondrial disorder caused by a Mitochondrial Deoxyribonucleic Acid (mtDNA) deletion. Clinical manifestations of KSS can include different organ and system involvement. Different organ malfunctions, more often cardiac dysfunction, can lead to death. No effective treatment of this condition exists to date. Here, we report two patients with KSS. Female patient with a large-scale deletion of 7,020 base pairs (bp) suffered from hypogonadism, diabetes mellitus with fluctuating glucose levels, and had poor general health. A male patient with a common 4,977 bp deletion did not have diabetes mellitus but had impaired glucose tolerance. He also had a higher level of general health than our female patient. Both patients had reduced Bone Mineral Density (BMD). In female patients, calcium and vitamin D supplementation combined with metabolic therapy and nutritional drink supplements helped increase BMD (up to 32% in L1-L4). Comparing these two patients suggests that the larger the mtDNA deletion is, the more severe the course of the disease is. Not only does the size of the mtDNA deletion probably determine the severity of the disease, but also such factors as mtDNA heteroplasmy level, presence of mtDNA duplications, and pleioplasmy. Moreover, continuous nonconsecutive metabolic therapy and nutritional supplements are helpful in the prevention of deterioration of symptoms and general health.

Hyperexpression of PTAFR and PF4 as Possible Platelet Risk Biomarkers in Patients With COVID-19.

SARS-CoV-2 infection presents different severity levels that suggest the influence of genetic factors on the clinical outcome of the disease. In cases of severe COVID-19, the presence of elevated coagulation markers, increased platelet activation and aggregation and the risk of thrombotic complications are described. Given the participation of these cells in several serious viral infections and their negative role when associated with a prothrombotic response, it is important to understand the mechanistic role of SARS-CoV-2 in platelet physiology. This study evaluated the hyperexpression of platelet-activating factor receptor (PTAFR) and platelet factor 4 (PF4) in unvaccinated and hospitalized patients with COVID-19. The study included 43 COVID-19 patients stratified according to WHO guidelines. Subsequently, the expression of the PTAFR and PF4 genes were evaluated using the real-time quantitative PCR and their possible correlation with the severity of the disease and clinical variables including hospitalization, outcome, sex, age and laboratory parameters (platelet count, INR and D-dimer). The analysis demonstrated a significant (p<0.05) hyperexpression of these genes COVID-19 patients (n=43) compared to healthy controls. Expression of these genes in patients was not statistically significant (p>0.05) different between patients stratified according to clinical variables. The expression of PTAFR and PF4 suggests an important molecular pathway in the pathophysiology of the disease and may be valuable platelet biomarkers to indicate increased risk in patients with COVID-19 who require hospital care, contributing to personalized intervention strategies and improving their clinical management.

003. Diagnosis And Management Flow of Patients with Spontaneous Intestinal Perforation: A Case Report

Background: Spontaneous intestinal perforation is the second most common cause of neonatal bowel perforation. The major dilemma for neonatologists and pediatric surgeons may be caused by NEC and severe SIP may have comparable physical examination findings, as well as radiological examinations showing pneumoperitoneum. Case: This case report describes a five-day-old boy brought by his parents to the ED because of abdominal distension that had occurred for the past two days. Physical examination showed a moderate general condition, CRT &lt;2 seconds, pulse rate 128 beats per minute, respiratory rate 32 breaths per minute, body temperature 38 ?C, SpO2 99% room air, body length 40 cm and body weight 2,800 grams. The patient's abdomen was distended. The patient underwent laparotomy and was diagnosed with post laparotomy exploration + ileum resection + ileoustomy + adhesiolysis in patients Peritonitis dt spontaneous ileum perforation. Differentiation between SIP and NEC is usually based on clinical manifestations and abdominal radiographic findings, although there are many similarities between the two conditions. Conclusion: Primary peritoneal drainage can serve as the primary treatment for critically ill neonates requiring stabilization. Laparotomy allows for assessment of the severity of the disease, removal of necrotic bowel, and hastening recovery and discharge.

Cephalic index and horizontal point of maximum width in children with normal brain development in China

BackgroundTo identify the normal range and distribution in the cephalic index(CI) and horizontal point of maximum width(H-PMW) of Chinese children with normal brain development.MethodsWe retrospectively analyzed Chinese Han children who visited our hospitals between June 2015 and June 2020 because of headache or suspected head injuries. 456 children (257 males, 199 females; aged 0–15 years) were enrolled and divided into 7 groups by age. The values of CI and H-PMW were measured using thin-slice brain computed tomography images.ResultsThe overall mean CI was 86.6 ± 5.2. The mean CI for males was 87.0 ± 5.1, and that for females was 86.0 ± 5.2. The overall mean H-PMW was 53.7 ± 2.4. The mean H-PMW for males was 53.8 ± 2.5, and that for females was 53.5 ± 2.3. The averages CI reached the maximum (89.98) at the age of 4–6 months, then began to decrease, decreased to the minimum (84.31) at the age of 2–3 years, and then gradually increased, and reached 86.17 at the age of 8–15 years. The average H-PMW was the smallest (52.17) at the age of 4–6 months, and reached 54.88 at the age of 8–15 years.ConclusionThe CI and H-PMW values of Chinese normal children reported in this study will provide a valuable reference to diagnose cranial deformities, assess the severity of the disease and the effectiveness of the treatment.

Epigenetic modulation of fungal pathogens: a focus on Magnaporthe oryzae.

Epigenetics has emerged as a potent field of study for understanding the factors influencing the effectiveness of human disease treatments and for identifying alternations induced by pathogens in host plants. However, there has been a paucity of research on the epigenetic control of the proliferation and pathogenicity of fungal plant pathogens. Fungal plant pathogens such as Magnaporthe oryzae, a significant threat to global rice production, provide an important model for exploring how epigenetic mechanisms govern fungal proliferation and virulence. In M. oryzae, epigenetic alterations, such as DNA methylation, histone modification, and non-coding RNAs, regulate gene expression patterns that influence the pathogen's ability to infect its host. These modifications can enhance fungal adaptability, allowing the pathogen to survive in diverse environments and evade host immune responses. Our primary objective is to provide a comprehensive review of the existing epigenetic research on M. oryzae and shed light on how these changes influence the pathogen's lifecycle, its ability to invade host tissues, and the overall severity of the disease. We begin by examining the epigenetic alterations occurring in M. oryzae and their contributions to the virulence and proliferation of the fungus. To advance our understanding of epigenetic mechanisms in M. oryzae and similar plant diseases, we emphasize the need to address unanswered questions and explore future research directions. This information is crucial for developing new antifungal treatments that target epigenetic pathways, which could lead to improved disease management.

E2F2 Reprograms Macrophage Function By Modulating Material and Energy Metabolism in the Progression of Metabolic Dysfunction-Associated Steatohepatitis.

Macrophages are essential for the development of steatosis, hepatic inflammation, and fibrosis in metabolic dysfunction-associated steatohepatitis(MASH). However, the roles of macrophage E2F2 in the progression of MASH have not been elucidated. This study reveals that the expression of macrophage E2F2 is dramatically downregulated in MASH livers from mice and humans, and that this expression is adversely correlated with the severity of the disease. Myeloid-specific E2F2 depletion aggravates intrahepatic inflammation, hepatic stellate cell activation, and hepatocyte lipid accumulation during MASH progression. Mechanistically, E2F2 can inhibit the SLC7A5 transcription directly. E2F2 deficiency upregulates the expression of SLC7A5 to mediate amino acids flux, resulting in enhanced glycolysis, impaired mitochondrial function, and increased macrophages proinflammatory response in a Leu-mTORC1-dependent manner. Moreover, bioinformatics analysis and CUT &Tag assay identify the direct binding of Nrf2 to E2F2 promoter to promote its transcription and nuclear translocation. Genetic or pharmacological activation of Nrf2 effectively activates E2F2 to attenuate the MASH progression. Finally, patients treated with CDK4/6 inhibitors demonstrate reduced E2F2 activity but increased SLC7A5 activity in PBMCs. These findings indicated macrophage E2F2 suppresses MASH progression by reprogramming amino acid metabolism via SLC7A5- Leu-mTORC1 signaling pathway. Activating E2F2 holds promise as a therapeutic strategy for MASH.

E-selectin and asymmetric dimethylarginine plasma levels in adult cyanotic congenital heart disease patients: relation to biochemical parameters, vascular function, and clinical status.

Abstract Background and Aim Patients with cyanosis secondary to congenital heart disease (CHD) are characterized by erythrocytosis and increased blood viscosity, which contributes to endothelial dysfunction, increased arterial stiffness, and impaired vascular function, which may affect the final clinical presentation. Asymmetric dimethylarginine (ADMA) and e-selectin (e-sel) are valuable biomarkers for prognosis of endocardial dysfunction and vascular damage. Their concentration levels in blood serum have the potential to be a rapid and easily accessible tool that reflects the severity of the disease. We aimed to assess e-sel and ADMA levels, their relationship with clinical status, as well as endothelial and vascular function. Methods A cross-sectional study including 36 adult CHD cyanotic patients [(17 males)(42.3 +/- 16.3 years)] with arterial blood oxygen saturation less than 92% and 20 healthy controls [(10 males)( 38.2 +/- 8.5 years)] was performed. All patients underwent clinical examination, blood testing, and cardiopulmonary tests. Endothelial function was assessed using intima-media thickness and flow-mediated dilatation (FMD). Vascular function using applanation tonometry methods was completed while considering aortic systolic pressure, aortic pulse pressure (AoPP), augmentation pressure (AP), augmentation index (AI), pulse pressure amplification (PPampl), and pulse wave velocity (PWV). Results Concentrations of e-sel and ADMA were significantly higher in patients with CHD than in controls (56.3 ± 13.6 ng/mL vs. 15.5 +/- 8.6 ng/mL, p&amp;lt;0.001) and (1.48 ± 0.48 ng/mL vs. 0.46 ± 0.1 ng/mL, p&amp;lt;0.001) respectively. E-sel levels correlated with gender, blood oxygen saturation, red blood cell, hemoglobin concentration, hematocrit, augmentation pressure, forced expiratory one second volume, forced vital capacity, and oxygen uptake. ADMA levels were found to correlate with age only. Conclusions E-sel level, unlike ADMA concentration, reflects the degree of severity of erythrocytosis and hypoxia and, thus, the physical status of patients with cyanotic CHD. E-selectin predicts increased augmentation pressure.Figure 1.A) ROC analysis for e-selectin