Journal of Personalized Medicine

27 pages, 2080 KiB

Open AccessReview

Patient-Derived Organoid Biobanks for Translational Research and Precision Medicine: Challenges and Future Perspectives

by Floriana Jessica Di Paola, Giulia Calafato, Pier Paolo Piccaluga, Giovanni Tallini and Kerry Jane Rhoden

J. Pers. Med. 2025, 15(8), 394; https://doi.org/10.3390/jpm15080394 - 21 Aug 2025

Abstract

Over the past decade, patient-derived organoids (PDOs) have emerged as powerful in vitro models that closely recapitulate the histological, genetic, and functional features of their parental primary tissues, representing a ground-breaking tool for cancer research and precision medicine. This advancement has led to [...] Read more.

Over the past decade, patient-derived organoids (PDOs) have emerged as powerful in vitro models that closely recapitulate the histological, genetic, and functional features of their parental primary tissues, representing a ground-breaking tool for cancer research and precision medicine. This advancement has led to the development of living PDO biobanks, collections of organoids derived from a wide range of tumor types and patient populations, which serve as essential platforms for drug screening, biomarker discovery, and functional genomics. The classification and global distribution of these biobanks reflect a growing international effort to standardize protocols and broaden accessibility, supporting both basic and translational research. While their relevance to personalized medicine is increasingly recognized, the establishment and maintenance of PDO biobanks remain technically demanding, particularly in terms of optimizing long-term culture conditions, preserving sample viability, and mimicking the tumor microenvironment. In this context, this review provides an overview of the classification and worldwide distribution of tumor and paired healthy tissue-specific PDO biobanks, explores their translational applications, highlights recent advances in culture systems and media formulations, and discusses current challenges and future perspectives for their integration into clinical practice. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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10 pages, 1881 KiB

Open AccessReview

Geometric Aortic Remodeling and Stent-Graft Migration After TEVAR: Insights from Longitudinal 3D Analysis and Literature Review

by Mariangela De Masi, Carine Guivier-Curien, Marine Gaudry, Alexis Jacquier, Philippe Piquet and Valérie Deplano

J. Pers. Med. 2025, 15(8), 393; https://doi.org/10.3390/jpm15080393 - 21 Aug 2025

Abstract

Background: Long-term follow-up after endovascular aortic repair (TEVAR) is crucial to detect adverse aortic remodeling, even with modern stent grafts offering enhanced flexibility and durability. Conventional imaging, based on diameter measurements, may fail to identify complications such as endograft migration. Methods: [...] Read more.

Background: Long-term follow-up after endovascular aortic repair (TEVAR) is crucial to detect adverse aortic remodeling, even with modern stent grafts offering enhanced flexibility and durability. Conventional imaging, based on diameter measurements, may fail to identify complications such as endograft migration. Methods: We conducted a longitudinal 3D geometric analysis of thoracic aortic and stent-graft evolution over 10 years in a patient treated for descending thoracic aortic aneurysm (DTAA) by endovascular treatment. A three-dimensional morphological analysis (length, tortuosity, angulation, and diameter) was carried out using advanced imaging software (EndoSize, MATLAB) to track aortic geometry and stent-graft behavior over time. A focused review of the literature on stent-graft migration, its risk factors, complications, and surveillance strategies was also performed. Results: This case illustrates how progressive geometric remodeling—including aortic elongation and increased tortuosity—can lead to delayed stent-graft migration and late type III endoleaks, with an elevated risk of rupture. The 3D analysis revealed early morphological changes that were undetectable using standard diameter-based follow-up. These observations are consistent with published data showing higher migration rates over time, particularly in tortuous anatomies. The literature review further emphasizes the clinical relevance of geometric surveillance, given the high rates of reintervention, morbidity, and mortality associated with stent-graft migration. Conclusions: This study underlines the importance of personalized and geometry-based surveillance after TEVAR. Advanced morphological assessment tools provide valuable insights for the early detection of complications and tailored patient management. Their integration into routine follow-up could help optimize long-term outcomes and prevent life-threatening events such as rupture. Full article

(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

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10 pages, 1480 KiB

Open AccessArticle

Comparison Between the Human-Sourced Ellipsoid Method and Kidney Volumetry Using Artificial Intelligence in Polycystic Kidney Disease

by Jihyun Yang, Young Rae Lee, Young Youl Hyun, Hyun Jung Kim, Tae Young Shin and Kyu-Beck Lee

J. Pers. Med. 2025, 15(8), 392; https://doi.org/10.3390/jpm15080392 - 20 Aug 2025

Abstract

Background: The Mayo imaging classification (MIC) for polycystic kidney disease (PKD) is a crucial basis for clinical treatment decisions; however, the volumetric assessment for its evaluation remains tedious and inaccurate. While the ellipsoid method for measuring the total kidney volume (TKV) in patients [...] Read more.

Background: The Mayo imaging classification (MIC) for polycystic kidney disease (PKD) is a crucial basis for clinical treatment decisions; however, the volumetric assessment for its evaluation remains tedious and inaccurate. While the ellipsoid method for measuring the total kidney volume (TKV) in patients with PKD provides a practical TKV estimation using computed tomography (CT), its inconsistency and inaccuracy are limitations, highlighting the need for improved, accessible techniques in real-world clinics. Methods: We compared manual ellipsoid and artificial intelligence (AI)-based kidney volumetry methods using a convolutional neural network-based segmentation model (3D Dynamic U-Net) for measuring the TKV by assessing 32 patients with PKD in a single tertiary hospital. Results: The median age and average TKV were 56 years and 1200.24 mL, respectively. Most of the patients were allocated to Mayo Clinic classifications 1B and 1C using the ellipsoid method, similar to the AI volumetry classification. AI volumetry outperformed the ellipsoid method with highly correlated scores (AI vs. nephrology professor ICC: r = 0.991, 95% confidence interval (CI) = 0.9780–0.9948, p < 0.01; AI vs. trained clinician ICC: r = 0.983, 95% CI = 0.9608–0.9907, p < 0.01). The Bland–Altman plot also showed that the mean differences between professor and AI volumetry were statistically insignificant (mean difference 159.5 mL, 95% CI = 11.8368–330.7817, p = 0.07). Conclusions: AI-based kidney volumetry demonstrates strong agreement with expert manual measurements and offers a reliable, labor-efficient alternative for TKV assessment in clinical practice. It is helpful and essential for managing PKD and optimizing therapeutic outcomes. Full article

(This article belongs to the Topic Diagnosis, Management, and Prognostic Assessment of Chronic Disease)

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9 pages, 299 KiB

Open AccessArticle

Five-Year Survival After Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Severe Aortic Valve Stenosis—Do We Choose the Right Treatment for Each Patient? A Propensity Score Matched Analysis

by George Samanidis, Antonios Roussakis, Sotirios Katsaridis, Efthymia Liaretidou, Eirini Kefalidi, Areti Falara, Ilias Georgios Koziakas, Ioannis Nenekidis, Ilias Kosmas, Evangelos Leontiadis, Vassilios Voudris, Ioannis Iakovou and Konstantinos Perreas

J. Pers. Med. 2025, 15(8), 391; https://doi.org/10.3390/jpm15080391 - 20 Aug 2025

Abstract

Background and Objectives: The treatment of choice for aortic valve stenosis in patients with low and intermediate risk is still debated. In this study, we compared the outcomes of low-to-intermediate surgical risk patients who underwent surgical versus transcatheter aortic valve replacement for severe [...] Read more.

Background and Objectives: The treatment of choice for aortic valve stenosis in patients with low and intermediate risk is still debated. In this study, we compared the outcomes of low-to-intermediate surgical risk patients who underwent surgical versus transcatheter aortic valve replacement for severe aortic valve stenosis (AS). Methods: Between 2015 and 2019, 326 consecutive patients with severe AS underwent transcatheter aortic valve implantation (TAVI), while 341 patients underwent surgical aortic valve replacement (SAVR). The two populations were propensity score matched by age, gender and Euroscore II. The survival rate of patients during median 5-year follow-up between SAVR and TAVI patients was evaluated. Results: After propensity score matching, 94 pairs of patients were compared and the mean standard deviation age of patients, sex (female) and Euroscore II were 77.5 (6.6) versus 76.6 (6.5) years, 51.1% versus 51.1% and 3.3 (1.88)% versus 3.0 (1,84)%, respectively. Permanent pacemaker implantation was higher in transcatheter group (21.3% versus 1.1%, p < 0.001). No difference in length of ICU and in-hospital stay was observed, p = 0.08 and p = 0.12, respectively. During follow-up the presence of more than moderate insufficiency of the prosthetic valve postoperatively was significantly less frequent in the surgical versus transcatheter (0% versus 14.3%). Survival rates over 1, 3 and 5 years did not differ in surgical versus transcatheter group (93.6%, 81.9% and 62.8% versus 86.2%, 69.1% and 59.6%, respectively (p = 0.16)). Conclusions: Short- and long-term survival rates were similar in patients who underwent transcatheter versus surgical aortic valve replacement, whereas SAVR showed superior results concerning the postoperative detection of residual regurgitation and need for PPM. It is extremely important to personalize the choice of treatment according to patients’ age, clinical status and life expectancy. Full article

(This article belongs to the Special Issue Clinical Progress in Personalized Management of Cardiac Surgery)

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15 pages, 284 KiB

Open AccessReview

Lost in .*VCF Translation. From Data Fragmentation to Precision Genomics: Technical, Ethical, and Interpretive Challenges in the Post-Sequencing Era

by Massimiliano Chetta, Marina Tarsitano, Nenad Bukvic, Laura Fontana and Monica Rosa Miozzo

J. Pers. Med. 2025, 15(8), 390; https://doi.org/10.3390/jpm15080390 - 20 Aug 2025

Abstract

Background: The genomic era has transformed not only the tools of medicine but the very logic by which we understand health and disease. Whole Exome Sequencing (WES), Clinical Exome Sequencing (CES), and Whole Genome Sequencing (WGS) have catalyzed a shift from Mendelian simplicity [...] Read more.

Background: The genomic era has transformed not only the tools of medicine but the very logic by which we understand health and disease. Whole Exome Sequencing (WES), Clinical Exome Sequencing (CES), and Whole Genome Sequencing (WGS) have catalyzed a shift from Mendelian simplicity to polygenic complexity, from genetic determinism to probabilistic interpretation. This epistemological evolution calls into question long-standing notions of causality, certainty, and identity in clinical genomics. Yet, as the promise of precision medicine grows, so too do the tensions it generates: fragmented data, interpretative opacity, and the ethical puzzles of Variants of Uncertain Significance (VUSs) and unsolicited secondary findings. Results: Despite technological refinement, the diagnostic yield of Next-Generation Sequencing (NGS) remains inconsistent, hindered by the inherent intricacy of gene–environment interactions and constrained by rigid classificatory systems like OMIM and HPO. VUSs (neither definitively benign nor pathogenic) occupy a liminal space that resists closure, burdening both patients and clinicians with uncertainty. Meanwhile, secondary findings, though potentially life-altering, challenge the boundaries of consent, privacy, and responsibility. In both adult and pediatric contexts, genomic knowledge reshapes notions of autonomy, risk, and even personhood. Conclusions: Genomic medicine has to develop into a flexible, morally sensitive paradigm that neither celebrates certainty nor ignores ambiguity. Open infrastructures, dynamic variant reclassification, and a renewed focus on interdisciplinary and humanistic approaches are essential. Only by embracing the uncertainty intrinsic to our biology can precision medicine fulfill its promise, not as a deterministic science, but as a nuanced dialogue between genes, environments, and lived experience. Full article

(This article belongs to the Section Personalized Critical Care)

17 pages, 308 KiB

Open AccessReview

What Are the Game Changers in Total Knee Arthroplasty? A Narrative Review

by Andrea Baldini, Damiano Ardiri, Lorenzo Benvenuti, Mattia Chirico, Enrico Fiorilli, Alessandro Singlitico and Filippo Leggieri

J. Pers. Med. 2025, 15(8), 389; https://doi.org/10.3390/jpm15080389 - 20 Aug 2025

Abstract

Background: Total knee arthroplasty (TKA) has evolved significantly, yet achieving consistently optimal outcomes remains challenging across diverse patient populations. This comprehensive narrative review identifies evidence-based “game changers” that genuinely transform TKA success while distinguishing them from interventions lacking clinical superiority. The analysis [...] Read more.

Background: Total knee arthroplasty (TKA) has evolved significantly, yet achieving consistently optimal outcomes remains challenging across diverse patient populations. This comprehensive narrative review identifies evidence-based “game changers” that genuinely transform TKA success while distinguishing them from interventions lacking clinical superiority. The analysis organizes findings across three perioperative phases: preoperative optimization, intraoperative techniques, and postoperative management. Preoperative game changers include end-stage bone-on-bone osteoarthritis, preoperative medical optimization of patients performed by dedicated practitioners, cryocompression therapy, and perioperative dexamethasone administration. Intraoperative interventions demonstrating substantial impact encompass reduced surgical time and optimized surgical instrumentation, personalized alignment, medial congruent bearings, cementless implants for high-demanding and high-BMI patients, and perioperative tranexamic acid. Postoperative game changers include early mobilization following surgery, venous thrombo-embolic prophylaxis avoiding high-bleeding-risk pharmaceuticals, and multimodal pain management. The review also identifies those initial promises without established clinical advantages, or “fake game changers”, that consume resources without meaningful benefits. This evidence synthesis demonstrates that TKA optimization requires systematic implementation of validated interventions rather than pursuing technological innovations indiscriminately. The future of TKA lies in evidence-based adoption of proven strategies that translate to genuine patient outcome improvements rather than merely increasing procedural complexity. Full article

(This article belongs to the Special Issue Cutting-Edge Innovations in Hip and Knee Joint Replacement)

10 pages, 520 KiB

Open AccessArticle

From Screening to Therapy: A Personalized Approach to ROP in a National NICU Setting

by Stylianos Christodoulou, Fedonas Herodotou, Annalisa Quattrocchi, Theodoros Potamitis and Vivi Choleva

J. Pers. Med. 2025, 15(8), 388; https://doi.org/10.3390/jpm15080388 - 19 Aug 2025

Abstract

Aim: We aimed to investigate the incidence, treatment patterns, and associated risk factors of type 1 retinopathy of prematurity (ROP) in the only tertiary-level Neonatal Intensive Care Unit (NICU) in Cyprus. Methods: This retrospective study included all infants screened for ROP [...] Read more.

Aim: We aimed to investigate the incidence, treatment patterns, and associated risk factors of type 1 retinopathy of prematurity (ROP) in the only tertiary-level Neonatal Intensive Care Unit (NICU) in Cyprus. Methods: This retrospective study included all infants screened for ROP between January and December 2023. Data were collected from standardized NICU discharge summaries and included gestational age (GA), birth weight (BW), multiple birth, systemic infection, blood transfusion, oxygen therapy, surgical interventions, and ROP outcomes. Infants were categorized into non-ROP, non-type 1 ROP, and type 1 ROP groups. Statistical analysis was performed to identify differences in risk factor distribution. Results: Among 183 infants, 33 (18.0%) developed ROP, with 11 (6.0%) requiring treatment for type 1 ROP. All infants with type 1 ROP were born at ≤28 weeks GA and weighed <1501 g. Type 1 ROP was significantly associated with lower GA, lower BW, systemic infection, surgery, and prolonged oxygen support (p < 0.05). Six infants were treated with laser and three with intravitreal bevacizumab. No recurrence was observed in the anti-VEGF group during 18 months of follow-up. Two infants with aggressive ROP died before treatment. Conclusions: Type 1 ROP in Cyprus occurred exclusively in extremely preterm infants, associated with the cumulative effect of multiple risk factors. Laser remained the primary treatment, while anti-VEGF was used selectively with favorable outcomes. This study emphasizes the importance of tailoring ROP screening and treatment strategies based on individual neonatal risk profiles, supporting a personalized approach to neonatal ophthalmic care. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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14 pages, 942 KiB

Open AccessArticle

A Precision Surgery Framework for Lung Resection: Robotic, Video-Assisted, and Open Segmentectomy

by Chiara Catelli, Miriana D’Alessandro, Federico Mathieu, Roberto Corzani, Marco Ghisalberti, Andrea Lloret Madrid, Susanna Guerrini, Piero Paladini and Luca Luzzi

J. Pers. Med. 2025, 15(8), 387; https://doi.org/10.3390/jpm15080387 - 19 Aug 2025

Abstract

Objectives: To evaluate outcomes of patients undergoing lung segmentectomy using open thoracotomy, Video-Assisted Thoracoscopic Surgery (VATS), or Robotic-Assisted Thoracoscopic Surgery (RATS) approaches. Methods: A total of 157 patients (mean age: 68.7 years; 58% male) who underwent lung segmentectomy from 2015 to 2024 at [...] Read more.

Objectives: To evaluate outcomes of patients undergoing lung segmentectomy using open thoracotomy, Video-Assisted Thoracoscopic Surgery (VATS), or Robotic-Assisted Thoracoscopic Surgery (RATS) approaches. Methods: A total of 157 patients (mean age: 68.7 years; 58% male) who underwent lung segmentectomy from 2015 to 2024 at the Thoracic Surgery of Siena were retrospectively enrolled and divided into groups based on the surgical approach: thoracotomy (n = 60), VATS (n = 58), and RATS (n = 39). No significant differences were observed between groups in terms of age, gender, or tumor stage. Peri-operative outcomes, and, in patients with non-small cell lung cancer (NSCLC, n = 104), long-term outcomes, were analyzed. Group comparisons were conducted using Kruskal–Wallis, Dunn’s test, Chi-squared, or Fisher’s exact test and Kaplan–Meier analysis with log-rank test. Results: Conversion rate was 13% and 0% for VATS and RATS, respectively (p = 0.005). Pleural effusion on first post-operative day was lower in RATS than VATS (p = 0.0006) and open (p < 0.0001). The maximum Visual Analogue Scale (VAS) value recorded was lower in RATS than open (p = 0.016) and VATS (p = 0.013). Surgery time was longer for RATS than open (p = 0.001) and VATS (p = 0.013). No differences were found in hospital stay and post-operative complications. In patients with NSCLC, the median follow-up was 25 months. The 90-day mortality rate was 9.5% in thoracotomy, 0% in VATS and RATS (p = 0.05). The 1- and 2-year overall survival was higher in VATS and RATS groups than thoracotomy (p = 0.001 and p = 0.040, respectively). The number of harvested lymph nodes was larger in the open group (p = 0.010), while a higher number of stations were harvested in RATS and open than VATS (p = 0.001). No differences were found in local recurrence (p= 0.08). Conclusions: RATS segmentectomy ensures a lower conversion rate, less post-operative pain, reduced daily pleural effusion, and a greater number of harvested lymph node stations compared to VATS, providing comparable peri-operative outcomes. RATS and VATS segmentectomy offer an advantage over the open approach in short- and long-term survival. Full article

(This article belongs to the Special Issue Precision Medicine in Thoracic Oncology: Targeted Therapies and Personalized Treatment Strategies)

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16 pages, 277 KiB

Open AccessArticle

Genetic Modulation of Silodosin Exposure and Efficacy: The Role of CYP3A4, CYP3A5, and UGT2B7 Polymorphisms in Benign Prostatic Hyperplasia Management

by Shokhrukh P. Abdullaev, Maksim N. Shatokhin, Pavel O. Bochkov, Svetlana N. Tuchkova, Oleg B. Loran, Sherzod P. Abdullaev, Karin B. Mirzaev and Dmitry A. Sychev

J. Pers. Med. 2025, 15(8), 386; https://doi.org/10.3390/jpm15080386 - 18 Aug 2025

Abstract

Objectives: Silodosin, a selective α1A-adrenoceptor antagonist, is used to treat lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Genetic polymorphisms in drug-metabolizing enzymes and transporters may contribute to interindividual variability in its efficacy and safety. This study aimed to [...] Read more.

Objectives: Silodosin, a selective α1A-adrenoceptor antagonist, is used to treat lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Genetic polymorphisms in drug-metabolizing enzymes and transporters may contribute to interindividual variability in its efficacy and safety. This study aimed to investigate the influence of CYP3A4, CYP3A5, UGT2B7, and ABCB1 polymorphisms on silodosin pharmacokinetics, efficacy, and safety in Russian patients with BPH. Methods: A prospective observational study included 103 Russian male patients with moderate-to-severe LUTS (IPSS > 8) due to BPH, treated with silodosin (8 mg daily) for 8 weeks. Genotyping for CYP3A4*1B, CYP3A4*22, CYP3A5*3, UGT2B7 (rs73823859, rs7439366, and rs7668282), and ABCB1 (rs4148738, rs1045642, rs2032582, and rs1128503) was performed using real-time PCR. The silodosin minimum steady-state plasma concentration (Css min) was measured via HPLC-MS. Efficacy was evaluated by the International Prostate Symptom Score (IPSS), quality of life scale, maximum urinary flow rate (Qmax), residual urine volume (RUV), and prostate volume at the baseline and week 8. Adverse drug reactions (ADRs) were recorded. Results: CYP3A4*22 CT carriers (n = 6) exhibited higher Css min (17.59 ± 2.98 vs. 9.0 ± 10.47 ng/mL, p = 0.049) but less absolute IPSS improvement (p < 0.05), likely due to higher baseline symptom severity. However, the change in IPSS (ΔIPSS_1–4) from the baseline to week 8 did not differ significantly (−5.78 ± 5.29 vs. −6.0 ± 4.54, p = 0.939). CYP3A5*3 GG homozygotes (n = 96) showed greater ΔIPSS_1–4 improvement (−6.25 ± 4.60 vs. 0.0 ± 9.53, p = 0.042) and a lower IPSS at day 28 (7.64 ± 4.50 vs. 20.0 ± 6.55, p < 0.001). UGT2B7 rs7439366 TT carriers (n = 34) had an improved Qmax (ΔQmax_1–4 5.4 vs. 3.3 and 2.0 mL/s for CC and CT, p = 0.041). ABCB1 1236C>T TT homozygotes (n = 25) showed a trend toward reduced RUV (p = 0.053). No polymorphisms were associated with adverse drug reactions (15 events in 42 patients, 35.7%). Conclusions: Genetic polymorphisms CYP3A4*22, CYP3A5*3, and UGT2B7 rs7439366 may modulate silodosin pharmacokinetics and efficacy parameters in BPH patients but not safety. Larger-scale studies are warranted to validate these initial findings. Full article

(This article belongs to the Special Issue New Approaches in Pharmacogenomics)

58 pages, 758 KiB

Open AccessReview

The Exchange Breathing Method for Seizure Intervention: A Historical and Scientific Review of Epilepsy and Its Evolving Therapeutic Paradigms

by Frederick Robert Carrick, Pamela Daniels, Stephen Pelletier, Sofia Prysmakova, Ahmed Hankir, Mahera Abdulrahman and Nouf Al-Rumaihi

J. Pers. Med. 2025, 15(8), 385; https://doi.org/10.3390/jpm15080385 - 18 Aug 2025

Abstract

Epilepsy is a complex and ancient neurological disorder affecting approximately 50 million individuals globally. Despite significant advancements in pharmacological treatments, surgical procedures, and neurostimulation techniques, a substantial subset of patients remains pharmacoresistant or experiences intolerable side effects, highlighting the need for novel, safe, [...] Read more.

Epilepsy is a complex and ancient neurological disorder affecting approximately 50 million individuals globally. Despite significant advancements in pharmacological treatments, surgical procedures, and neurostimulation techniques, a substantial subset of patients remains pharmacoresistant or experiences intolerable side effects, highlighting the need for novel, safe, and effective interventions. In this review, we examine a promising non-invasive technique known as the Exchange Breathing Method (EBM), developed through the observations of Gemma Herbertson, a British mother who discovered that exhaling gently into her son’s nostrils could consistently interrupt ongoing seizures. The EBM has since gained anecdotal support from a growing international community reporting similar positive outcomes. This paper situates the EBM within the broader historical and clinical context of epilepsy treatment, tracing its evolution from ancient practices to modern therapeutic strategies. We explore the neurophysiological mechanisms that may underlie the EBM, particularly its interaction with autonomic and respiratory pathways implicated in seizure modulation. By integrating emerging grassroots data with current scientific knowledge, this review proposes a rationale for further empirical investigation into the EBM and its potential role in the personalized, emergency management of epilepsy. Full article

(This article belongs to the Special Issue New Advances in the Prevention and Treatment of Neurological Diseases)

15 pages, 563 KiB

Open AccessReview

The Role of Oxidative Stress in the Relationship Between Periodontitis and Alzheimer’s Disease: A Review of the Literature

by Konstantinos Antonios Papadakis, Aikaterini-El Doufexi, Mary S. Kalamaki, Evangelos Bourazanas and Evgenia Lymperaki

J. Pers. Med. 2025, 15(8), 384; https://doi.org/10.3390/jpm15080384 - 18 Aug 2025

Abstract

Periodontitis, a chronic inflammatory disease affecting the supporting tissues of the teeth, has been linked to the onset of neurological diseases, including Alzheimer’s disease (AD). A primary mechanism connecting these two issues is oxidative stress caused by an imbalance between antioxidant defenses and [...] Read more.

Periodontitis, a chronic inflammatory disease affecting the supporting tissues of the teeth, has been linked to the onset of neurological diseases, including Alzheimer’s disease (AD). A primary mechanism connecting these two issues is oxidative stress caused by an imbalance between antioxidant defenses and reactive oxygen species (ROS) synthesis. This review compiles results from both animal and human studies that explore how oxidative stress resulting from periodontitis leads to neuroinflammation, mitochondrial dysfunction, and cognitive decline in AD. Studies in animals indicate that periodontal infections worsen brain oxidative damage, as evidenced by elevated lipid peroxidation markers, such as malondialdehyde (MDA), and indicators of oxidative DNA damage, including 8-hydroxy-2′-deoxyguanosine (8-OHdG). Additionally, significant reductions in crucial antioxidant enzymes, including superoxide dismutase (SOD) and glutathione peroxidase, along with neuroinflammation and cognitive deficits, are observed in mouse models of induced periodontitis. Supporting evidence from human studies reveals lower total antioxidant capacity (TAC) in individuals with both Alzheimer’s disease (AD) and periodontitis, as well as increased systemic oxidative stress markers, such as advanced oxidation protein products (AOPRs). These findings suggest a mechanistic relationship through oxidative stress pathways between periodontal inflammation and neurodegeneration. Given the extensive impact of periodontitis, enhancing periodontal health could be a viable strategy to reduce oxidative damage and lower the risk of cognitive decline. Further research is needed to clarify causality and to investigate antioxidant treatments aimed at preventing or slowing the progression of AD in patients with periodontal disease. Full article

(This article belongs to the Special Issue Advancing Personalized Medicine: Targeting Oxidative Stress in Neurodegenerative Diseases)

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14 pages, 1192 KiB

Open AccessSystematic Review

Treatment Strategies for Patients with Mitral Regurgitation: A Meta-Analysis of Randomized Controlled Trials

by Claudia Carassia, Fiorenzo Simonetti, Hector A. Alvarez Covarrubias, Bernhard Wolf, Costanza Pellegrini, Tobias Rheude, Patrick Fuchs, Ferdinand Roski, Moritz Kühlein, Edna Blum, Gjin Ndrepepa, Teresa Trenkwalder, Michael Joner, Adnan Kastrati, Salvatore Cassese and Erion Xhepa

J. Pers. Med. 2025, 15(8), 383; https://doi.org/10.3390/jpm15080383 - 16 Aug 2025

Abstract

Background: Several treatment strategies are available for patients with mitral valve regurgitation (MR). However, evidence regarding their comparative effectiveness remains limited. We sought to compare the performance of different treatment strategies for personalized treatment of patients with MR. Methods: We performed [...] Read more.

Background: Several treatment strategies are available for patients with mitral valve regurgitation (MR). However, evidence regarding their comparative effectiveness remains limited. We sought to compare the performance of different treatment strategies for personalized treatment of patients with MR. Methods: We performed a pairwise and network meta-analyses of randomized trials comparing treatment strategies for patients with MR. Patients were divided in two groups: transcatheter mitral valve repair (TMVR, including edge-to-edge repair and indirect percutaneous annuloplasty) and control (surgery or optimal medical therapy). The primary outcome of this analysis was all-cause death. Main secondary outcomes were re-hospitalization for heart failure and re-intervention. Results: A total of seven trials with 2324 participants, with mainly functional MR (TMVR, n = 1373-control, n = 951) were available for the quantitative synthesis. The median follow-up duration was 14 months. Compared to control therapy, TMVR significantly reduced all-cause death (RR 0.77, 95% CI 0.65–0.91, p = 0.002) and re-hospitalization for heart failure (RR 0.67, 95% CI 0.49–0.91, p = 0.01). Among TMVR strategies, the edge-to-edge repair with MitraClip ranked as possibly the best option to reduce all-cause death. Conclusions: In symptomatic patients with significant MR, TMVR is associated with a significant reduction of all-cause death, and re-hospitalization for heart failure, mainly in patients with functional MR. Additional comparative studies are needed to investigate the best TMVR treatment option, for patients with degenerative MR. Full article

(This article belongs to the Special Issue The Development of Echocardiography in Heart Disease)

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Graphical abstract

3 pages, 164 KiB

Open AccessReply

Reply to Fluegge, K.; Fluegge, K. Comment on “Frye et al. Air Pollution and Maximum Temperature Are Associated with Neurodevelopmental Regressive Events in Autism Spectrum Disorder. J. Pers. Med. 2022, 12, 1809”

by Richard E. Frye

J. Pers. Med. 2025, 15(8), 382; https://doi.org/10.3390/jpm15080382 - 15 Aug 2025

Abstract

I would like to thank Fluegge and Fluegge for their comments on our study which identified air pollution and maximum temperature as potential environmental factors associated with neurodevelopmental regression (NDR) in children with autism spectrum disorder (ASD) [...] Full article

(This article belongs to the Section Mechanisms of Diseases)

9 pages, 481 KiB

Open AccessComment

Comment on Frye et al. Air Pollution and Maximum Temperature Are Associated with Neurodevelopmental Regressive Events in Autism Spectrum Disorder. J. Pers. Med. 2022, 12, 1809

by Keith Fluegge and Kyle Fluegge

J. Pers. Med. 2025, 15(8), 381; https://doi.org/10.3390/jpm15080381 - 15 Aug 2025

Abstract

Frye et al. [...] Full article

(This article belongs to the Section Mechanisms of Diseases)

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12 pages, 963 KiB

Open AccessArticle

Real-World Evidence on Low-Dose Olanzapine (≤1.25 mg) for Personalized Antipsychotic Dosing

by Danbee Kang, Seongmi Moon, Ji-Hyun Baek and Juhee Cho

J. Pers. Med. 2025, 15(8), 380; https://doi.org/10.3390/jpm15080380 - 15 Aug 2025

Abstract

Background/Objectives: This cohort study aimed to elucidate the real-world treatment course of patients receiving low-dose olanzapine (<2.5 mg), to assess its efficacy, and to examine its metabolic side effects. This study was a cohort study using a clinical registry. Methods: The [...] Read more.

Background/Objectives: This cohort study aimed to elucidate the real-world treatment course of patients receiving low-dose olanzapine (<2.5 mg), to assess its efficacy, and to examine its metabolic side effects. This study was a cohort study using a clinical registry. Methods: The primary efficacy endpoint was effective medication adherence and appropriate dosing. The primary safety endpoint was the incidence of metabolic adverse events, including diabetes mellitus, dyslipidemia, cardiovascular events, and cerebrovascular events. Cox proportional hazards models were used to compare outcomes between groups. Results: A total of 9565 patients were prescribed olanzapine at Samsung Medical Center from 2002 to 2023, and 1629 (17%) were in the low-dose group. The median maintenance period for low-dose olanzapine was 142 days (IQR, 30–551 days), and 95.5% of patients received low-dose olanzapine with either gradual tapering or gradual dose escalation. During follow-up, the risk of diabetes mellitus (HR = 0.32, 95% CI = 0.17–0.62), dyslipidemia (HR = 0.59, 95% CI = 0.42–0.82), cardiovascular disease (HR = 0.88, 95% CI = 0.51–1.49), and cerebrovascular events (HR = 0.75, 95% CI = 0.41–1.36) was lower in the low-dose group than in the regular-dose group. Conclusions: Low doses of olanzapine have clinical benefits in providing appropriate dosing and a reduced incidence of metabolic side effects. These findings support personalized antipsychotic treatment strategies, particularly in populations with heightened metabolic vulnerability, by informing dose selection based on individual risk–benefit profiles. Full article

(This article belongs to the Special Issue Recent Research on Personalized Approaches to Clinical Therapeutics and Medication Safety)

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11 pages, 613 KiB

Open AccessArticle

Audiogram Shape: Does It Have a Significant Prognostic Role in Idiopathic Sudden Sensorineural Hearing Loss Outcome?

by Gabriella Cadoni, Alberta Rizzuti, Michela Sollazzo, Pasqualina Maria Picciotti and Jacopo Galli

J. Pers. Med. 2025, 15(8), 379; https://doi.org/10.3390/jpm15080379 - 15 Aug 2025

Abstract

Background/Objectives: Sudden sensorineural hearing loss (SSNHL) represents a challenging clinical entity with variable prognosis. Audiometric curve configuration has been proposed as a predictor of recovery. This study aimed to evaluate the association between audiogram morphology at onset and hearing outcome in patients with [...] Read more.

Background/Objectives: Sudden sensorineural hearing loss (SSNHL) represents a challenging clinical entity with variable prognosis. Audiometric curve configuration has been proposed as a predictor of recovery. This study aimed to evaluate the association between audiogram morphology at onset and hearing outcome in patients with idiopathic unilateral SSNHL treated with standardized therapy. Methods: We retrospectively analyzed 156 patients with idiopathic SSNHL. Hearing thresholds at key frequencies were measured at baseline and 4 weeks post-treatment. Patients were categorized into upsloping, flat, downsloping, or U-shaped audiogram subgroups. Recovery was classified into four levels. Comparisons were made across subgroups for audiometric and laboratory data using ANOVA and chi-square tests. Results: Baseline PTA values were comparable across audiogram subgroups (p = 0.12). Hearing recovery differed significantly according to audiogram configuration (chi-square, p < 0.001), with upsloping and U-shaped patterns showing the best outcomes. Flat and downsloping curves were associated with poorer recovery, lower HDL, and elevated NLR values. Conclusions: Audiogram configuration is a relevant prognostic marker in SSNHL. Patterns linked to adverse metabolic and inflammatory profiles may benefit from tailored treatment strategies in a personalized medicine framework. Full article

(This article belongs to the Section Personalized Therapy and Drug Delivery)

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12 pages, 827 KiB

Open AccessArticle

Effect of High Altitude on Small Pulmonary Vein and Artery Volume in the COPDGene Cohort: Towards Better Understanding of Lung Physiology and Pulmonary Disease

by Anastasia K. A. L. Kwee, Esther Pompe, Leticia Gallardo Estrella, Jean-Paul Charbonnier, Stephen M. Humphries, Harm A. W. M. Tiddens, James D. Crapo, Richard Casaburi, Pim A. de Jong, David A. Lynch and Firdaus A. A. Mohamed Hoesein

J. Pers. Med. 2025, 15(8), 377; https://doi.org/10.3390/jpm15080377 - 15 Aug 2025

Abstract

Background: To personalize the care for persons with smoking-related lung disease, a thorough understanding of its etiology is essential. The role of pulmonary vessels remains poorly understood. Living at high altitude provides a natural model to investigate the effects of low oxygen levels [...] Read more.

Background: To personalize the care for persons with smoking-related lung disease, a thorough understanding of its etiology is essential. The role of pulmonary vessels remains poorly understood. Living at high altitude provides a natural model to investigate the effects of low oxygen levels on pulmonary vessels. This study aims to evaluate the relationship between living at high altitudes and small pulmonary vein and artery volumes. We hypothesize that small vein and artery volumes were independently associated with living at high altitude. Methods: We quantified small pulmonary vein and artery dimensions (ᴓ < 1 mm) on computed tomography (CT) down to 0.2 mm in diameter and normalized the dimensions by body surface area. In 8931 current and former smokers participating in the COPDGene study, we used multivariate regression models corrected for clinical and technical confounders. Results: 1262 residents (14.1%) were defined as high-altitude residents (~1600 m, Denver, CO, USA). Compared to lower-altitude residents, the high-altitude residents had a higher age (62.0 ± 9.1 vs. 59.6 ± 9.0 years), more pack-years smoked (46.8 vs. 44.1) and a lower FEV₁% predicted (64.6 ± 32.4% vs. 76.8 ± 25.2%). Both mean small artery volume (4.09 ± 0.89 mL/m² vs. 3.85 ± 0.90 mL/m²) and mean small vein volume (2.96 ± 0.53 mL/m² vs. 2.67 ± 0.53 mL/m²) were higher in high-altitude residents. Multivariate linear regression showed that, in those without COPD, high-altitude residents have a higher small vein volume (0.129 mL/m², p < 0.001) and higher small artery volume (0.170 mL/m², p = 0.001) compared to lower-altitude residents. There was no significant association in residents with COPD. Conclusions: In current and former smokers without COPD, higher small pulmonary vein and artery volumes were associated with living at high altitude, independent of lung disease or technical CT parameters. A potential cause includes vascular remodeling due to an elevated need for blood oxygen transport, which becomes concealed when COPD develops. Full article

(This article belongs to the Section Epidemiology)

15 pages, 1023 KiB

Open AccessArticle

Personalized Diagnosis and Functional Impact of Vestibular Migraine in Women Aged 20–50: Cross-Sectional Analysis from Neurotology Clinic

by Khalid A. Alahmari and Sarah Alshehri

J. Pers. Med. 2025, 15(8), 378; https://doi.org/10.3390/jpm15080378 - 14 Aug 2025

Abstract

Background/Objectives: Vestibular migraine is a frequently underdiagnosed cause of dizziness in adult females, often overlapping clinically with other vestibular and neurological conditions. Despite its recognition in diagnostic criteria, limited data exist on its prevalence and functional impact in women presenting with dizziness [...] Read more.

Background/Objectives: Vestibular migraine is a frequently underdiagnosed cause of dizziness in adult females, often overlapping clinically with other vestibular and neurological conditions. Despite its recognition in diagnostic criteria, limited data exist on its prevalence and functional impact in women presenting with dizziness in clinical settings. This study assesses the frequency and diagnostic rate of vestibular migraine among females aged 20–50 years presenting with dizziness and evaluates its impact on quality of life and work productivity. Methods: A cross-sectional study was conducted, which included 196 female patients reporting dizziness who were evaluated. Vestibular migraine was diagnosed using ICHD-3 criteria. Functional impact was assessed using the Dizziness Handicap Inventory (DHI) and Work Productivity and Activity Impairment (WPAI) questionnaire. Group comparisons and regression analyses were conducted using SPSS version 24. Results: Vestibular migraine was diagnosed in 84 participants, yielding a prevalence rate of 42.86% (95% CI: 36.13–49.86%). Compared to non-migraine participants, those with vestibular migraine had longer dizziness duration (37.62 ± 11.34 vs. 24.58 ± 10.49 min, p = 0.032), higher DHI (58.34 ± 15.62 vs. 32.76 ± 14.83, p < 0.001) and WPAI scores (42.19 ± 13.45 vs. 23.47 ± 12.90, p < 0.001), and more missed workdays. Regression analysis identified vestibular migraine, poor sleep, anxiety/depression, and BMI as significant predictors of work impairment. Conclusions: Vestibular migraine is a prevalent and functionally disabling condition among women with dizziness, underscoring the importance of systematic diagnosis and multidisciplinary management. Full article

(This article belongs to the Special Issue Clinical Diagnosis and Treatment in Otorhinolaryngology)

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15 pages, 1728 KiB

Open AccessReview

MicroRNAs in Liver Cirrhosis: Diagnostic and Therapeutic Perspectives—A Comprehensive Review

by Cristian Ichim, Adrian Boicean, Paula Anderco, Samuel Bogdan Todor, Adrian Hașegan, Sabrina Bîrsan and Victoria Bîrluțiu

J. Pers. Med. 2025, 15(8), 376; https://doi.org/10.3390/jpm15080376 - 14 Aug 2025

Abstract

Liver cirrhosis represents the end-stage of chronic hepatic injury, arising from a diverse range of etiologies including viral hepatitis, alcohol abuse and non-alcoholic fatty liver disease. A key driver of cirrhosis is hepatic fibrogenesis, a multifaceted process involving hepatic stellate cell activation, inflammatory [...] Read more.

Liver cirrhosis represents the end-stage of chronic hepatic injury, arising from a diverse range of etiologies including viral hepatitis, alcohol abuse and non-alcoholic fatty liver disease. A key driver of cirrhosis is hepatic fibrogenesis, a multifaceted process involving hepatic stellate cell activation, inflammatory signaling and extracellular matrix accumulation. MicroRNAs (miRNAs), a class of small non-coding RNAs, have emerged as pivotal regulators in this context, modulating gene expression networks that govern inflammation, fibrosis and hepatocarcinogenesis. This review synthesizes current evidence on the role of miRNAs in liver cirrhosis, emphasizing specific miRNAs such as miR-21, miR-122, miR-125, miR-146 and miR-155. These miRNAs influence pathways involving TGF-β, NF-κB and PI3K/Akt signaling, contributing to either fibrogenic progression or its suppression. The unique expression profiles and stability of miRNAs in biological fluids position them as promising non-invasive biomarkers for cirrhosis diagnosis and monitoring. Moreover, therapeutic modulation of miRNA activity through mimics or inhibitors holds future potential, though delivery and safety challenges remain. Advancing our understanding of miRNA-mediated regulation in cirrhosis could transform current diagnostic and therapeutic strategies, enabling more precise and personalized liver disease management. Full article

(This article belongs to the Section Disease Biomarker)

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