Search Results (553)

Introduction: Odontogenic infections may influence distant structures, including the eye. Their extension into the paranasal sinuses and orbital region can contribute to inflammatory and glaucomatous conditions. Case Report: A 46-year-old man was examined for a possible odontogenic source of chronic eye disease. The patient had an 18-year history of progressive vision loss in his left eye associated with Posner–Schlossmann syndrome, chronic uveitis, and episodic elevation of intraocular pressure (IOP). Imaging studies revealed the presence of a foreign body in the alveolar recess of the left maxillary sinus, as detected on panoramic radiography, cone-beam computed tomography (CBCT), and infrared thermography (IRT). Preliminary IRT examination showed marked thermal asymmetry (ΔT = 1.1 °C) between the left and right sides of the maxilla. Worsening of ocular symptoms and increased IOP despite steroid treatment prompted surgical treatment. The foreign body, identified as a root canal filling, was removed, and the chronically inflamed sinus mucosa was excised. During a follow-up visit two weeks later, the IRT examination showed a reduction in temperature difference (ΔT = 0.2 °C) and routine postoperative healing. After two months, no thermal asymmetry was found (ΔT = 0 °C), and an ophthalmological examination showed no active inflammation. Six months after the procedure, the patient remained asymptomatic, and the IRT examination revealed only minimal residual variability within the measurement tolerance (ΔT = 0.1 °C), consistent with the resolution of the sinus inflammation. Conclusions: This case highlights the value of interdisciplinary diagnostics in identifying odontogenic contributors to chronic ocular disease. Infrared thermography proved to be a helpful non-invasive adjunct for detecting and monitoring subclinical maxillary sinus inflammation. Full article

Atrial dilated cardiomyopathy with progression to atrial standstill is an ultrarare arrhythmogenic disorder characterized by complete loss of atrial electrical and mechanical activity. This condition, which may occur sporadically or in familial clusters, is associated with a markedly increased thromboembolic risk. The electrocardiographic hallmark is the absence of P waves combined with a bradycardic junctional escape rhythm. Biatrial enlargement gradually evolves into giant atria with preserved biventricular systolic function, while supraventricular arrhythmias and progressive atrial inexcitability dominate the clinical course. Valvular regurgitation frequently worsens in parallel with atrial remodelling, and patients often require permanent pacemaker implantation as well as lifelong anticoagulation. Among the few genetic determinants identified, the homozygous c.449G>A (p.Arg150Gln) mutation in the Natriuretic Peptide A gene represents one of the best characterized mechanisms. Disertori et al. first reported this pathogenic variant in 13 affected individuals from Italian families, establishing a recessive inheritance pattern. More recently, Silva et al. and Forleo et al. described additional cases, expanding the phenotypic spectrum of NPPA-related atrial cardiomyopathy. These findings confirm that homozygous carriers develop a severe atrial phenotype, whereas heterozygous relatives typically remain asymptomatic, underlining the importance of genetic testing in young patients with unexplained atrial fibrillation or standstill. Recognition of atrial cardiomyopathy as a distinct clinical entity is crucial, since early diagnosis may guide timely anticoagulation, arrhythmia management, and tailored follow-up. Broader adoption of genetic screening in patients with isolated atrial dysfunction could support precision medicine approaches, improve risk stratification, and ultimately prevent adverse outcomes in this ultrarare but highly morbid condition. Full article

Hemophilia A (HA) is an X-linked recessive bleeding disorder that predominantly affects males but rarely manifests clinically in females. We report an unusual case of a woman with HA carrying a de novo heterozygous F8 variant, skewed X chromosome inactivation (XCI), and mosaic monosomy X without the Turner syndrome phenotype. DNA was extracted from whole blood. After excluding F8 inversions and large rearrangements, Sanger sequencing of coding regions was performed. XCI was assessed by STR analysis of the AR gene. Haplotypes were identified by fragment analysis of three polymorphic sites. Karyotyping was performed using G-banding. A heterozygous missense variant in the F8 gene, c.6545G>A (p.Arg2182His), was detected with allelic imbalance. STR analysis confirmed ~93% skewed XCI. Karyotyping revealed mosaicism: 45,X [7]/46,XX [14]. Neither parent carried the c.6545G>A variant or karyotype aberrations. We suggest that 46,XX cells carried c.6545G/A with preferential inactivation of the normal X chromosome, whereas 45,X0 cells carried the mutant allele only. The limited proportion of active normal X chromosomes led to a mild rather than severe phenotype. This case highlights complex genetic mechanisms underlying HA in females and underscores the importance of comprehensive molecular and cytogenetic testing for accurate diagnosis, clinical management, and genetic counseling. Full article

Background/Objectives: Hereditary anomalies in the TYK2 gene are the basis of a rare primary immunodeficiency, immunodeficiency-35, typified by an augmented vulnerability to mycobacterial and viral infections. Clinical overlap with chronic granulomatous disease (CGD) and other granulomatous disorders complicates diagnosis, particularly in nations where universal BCG vaccination is instituted. We present a pediatric case from Kazakhstan to broaden the clinical and molecular spectrum of TYK2-related immunodeficiency and accentuate diagnostic challenges. Methods: The proband underwent clinical assessment, immunophenotyping, and biochemical analysis during episodes of active pathology and subsequent follow-up. Whole-exome sequencing (WES) was executed, followed by confirmatory Sanger sequencing and segregation analysis in first-degree kin. Functional assays for phagocyte oxidative burst and phagocytosis were conducted to exclude CGD. Results: WES identified two rare TYK2 variants (c.209_212del, pathogenic; c.2395G>A, previously reported as pathogenic in a Chinese patient with TYK2 deficiency) and a heterozygous MEFV duplication (c.761_764dup). Paternal DNA was unavailable; therefore, allelic phase could not be formally established, but the combined genotype and phenotype are consistent with autosomal recessive TYK2 deficiency. Sanger sequencing confirmed segregation of the frameshift TYK2 variant in the mother, while the clinically healthy brother carried only the wild-type allele. The missense alteration was exclusive to the proband. Conclusions: This case exemplifies the significance of contemplating TYK2 deficiency in pediatric patients with refractory mycobacterial infections, particularly in BCG-endemic locales. Genetic validation provided a definitive diagnosis, differentiating the condition from CGD and informing patient management. To our knowledge, this constitutes one of the inaugural genetically confirmed instances of TYK2 deficiency in Central Asia, enhancing regional epidemiological comprehension and emphasizing the role of molecular diagnostics in directing treatment and vaccination policies. Full article

Background and Clinical Significance: This case report describes a 46-year-old male with no prior comorbidities who developed progressive neurological symptoms—ataxia and diplopia—shortly after the second Comirnaty (Pfizer-BioNTech) COVID-19 vaccine dose. The aim is to highlight the diagnostic challenges of central nervous system-dominant hemophagocytic lymphohistiocytosis (HLH) and its overlap with neuroinflammatory disorders. Case Presentation: Initial MRI showed demyelinating lesions in the brain and spinal cord, suggesting acute disseminated encephalomyelitis (ADEM). The patient had only transient improvement with corticosteroids and then multiple relapses with expanding CNS lesions despite cyclophosphamide, plasmapheresis, and rituximab. After 27 months, systemic features appeared, including fever, cytopenias, elevated inflammatory markers, and splenomegaly. Bone marrow analysis revealed hemophagocytosis, fulfilling HLH-2004 criteria, with an H-score of 200 supporting secondary HLH. Given consanguinity and persistent immune activation, next-generation sequencing identified two homozygous PRF1 variants—one pathogenic (p.Arg232His) and one of uncertain significance (p.Ala91Val)—consistent with autosomal recessive familial type 2 HLH. The patient underwent matched unrelated donor hematopoietic stem cell transplantation (HSCT) 11 months after HLH diagnosis, achieving initial stabilization, but ultimately died from infectious complications in March 2025 without evidence of HLH relapse. Conclusions: This case illustrates an atypical adult-onset presentation of familial HLH manifesting primarily with recurrent neuroinflammatory symptoms that initially mimicked ADEM. The diagnostic delay reflects the challenge of recognizing CNS-dominant HLH, especially in adults and in the absence of early systemic features. The identification of biallelic PRF1 variants confirmed an underlying genetic predisposition. This is the first reported case of adult-onset familial HLH presenting predominantly with neurological symptoms following COVID-19 vaccination. The case emphasizes the need to consider genetic forms of HLH in relapsing neuroinflammatory disorders and raises the hypothesis that vaccination may unmask subclinical immune dysregulation in genetically susceptible individuals Full article

Marinesco–Sjögren syndrome (MSS) is a rare autosomal recessive neuromuscular disorder marked by ataxia, muscle weakness, cataracts, and often intellectual and skeletal abnormalities. It is commonly caused by loss-of-function variants in the SIL1 gene, which impair binding immunoglobulin protein (BiP) function, leading to protein misfolding and activation of the unfolded protein response. In a 2-year-old patient with typical MSS symptoms, we identified a previously unreported c.1024G>A (p.E342K) variant in SIL1 via whole-exome sequencing. The pathogenicity of this Sil1 variant was supported by evidence of structural changes revealed through in silico predictions, circular dichroism, and native gel electrophoresis. Patient-derived fibroblasts exhibited reduced Sil1 protein levels, likely due to misfolding and degradation, which was partially rescued by proteasome inhibition. Proteomics revealed a profile similar to known MSS cases and a distinctive MSS transcriptional signature. Ultrastructural analysis confirmed typical MSS features, such as autophagic vacuoles and lipid droplets. Although the p.E342K phenotype appears milder than the reference pathogenic variant R111X, our findings support the reclassification of this novel variant as pathogenic, in accordance with the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) 2015 guidelines and the refinements proposed by the Clinical Genome Resource Sequence Variant Interpretation (ClinGen SVI) recommendations. Furthermore, the overall evidence also provides important insights into the genotype–phenotype correlation and the underlying pathogenic mechanism of the p.E342K variant. Full article

During the Great Recession, labor markets often exhibit a slow unemployment recovery and persistent outward shifts in the Beveridge curve, which suggests a decline in the efficiency of the job-matching process. While it is often explained by worker search intensity, we argue that the direction of search behavior also matters by proposing a stylized theoretical model based on the Free Energy Principle. Through modeling agents who actively divide their effort between applying for jobs and learning about the market’s new state, our framework shows that agents endogenously shift effort from applications to learning when their uncertainty is high. Building on this micro-foundation, we design a macroeconomic model where matching efficiency is no longer an external parameter but is instead governed by two cognitive factors: the share of unemployed workers with misaligned beliefs and the average learning effort of the informed. Simulation results show that a structural shock will divert effort to learning and depress matching by creating widespread uncertainty, and the subsequent slow recovery is governed by the realignment of collective beliefs. Our work provides a cognitive explanation for this observed persistence of unemployment and the shift of the Beveridge curve. Full article

Background. Dystroglycanopathies (DGPs) constitute a set of recessive, neuromuscular congenital dystrophies that result from impaired glycosylation of dystroglycan (DG). These disorders typically course with CNS alterations, which, alongside gradual muscular dystrophy, may include brain malformations, intellectual disability and a panoply of ocular defects. In this process, the protein products of 22 genes, collectively dubbed DGP-associated genes, directly or indirectly participate sequentially along a complex, branched biosynthetic pathway. POMGNT2 and POMGNT1 are two enzymes whose catalytic activity consists of transferring the same substrate, a molecule of N-acetylglucosamine (GlcNAc) to a common substrate, the O-mannosylated α subunit of DG. Despite their presumptive role in retinal homeostasis, there are currently no reports describing their expression pattern or function in this tissue. Purpose. This work focuses on POMGNT2 and POMGNT1 expression in the mammalian retina, and on the characterization of their distribution across retinal layers, and in the 661W photoreceptor cell line. Methods. The expression of POMGNT2 protein in different mammalian species’ retinas, including those of mice, rats, cows and monkeys, was assessed by immunoblotting. Additionally, POMGNT2 and POMGNT1 distribution profiles were analyzed using immunofluorescence confocal microscopy in retinal sections of monkeys and mice, and in 661W cultured cells. Results. Expression of POMGNT2 was detected in the neural retina of all species studied, being present in both cytoplasmic and nuclear fractions of the monkey and mouse, and in 661W cells. In the cytoplasm, POMGNT2 was concentrated in the endoplasmic reticulum (ER) and/or Golgi complex, depending on the species and cell type, whereas POMGNT1 accumulated only in the Golgi complex in both monkey and mouse retinas. Additionally, both proteins were present in the nucleus of the 661W cells, concentrating in the euchromatin and heterochromatin, as well as in nuclear PML and Cajal bodies, and nuclear speckles. Conclusions. Our results are indicative that POMGNT2 and POMGNT1 participate in the synthesis of O-mannosyl glycans added to α-dystroglycan in the ER and/or Golgi complex in the cytoplasm of mammalian retinal cells. Also, they could play a role in the modulation of gene expression at the mRNA level, which remains to be established, in a number of nuclear compartments in transformed retinal neurons. Full article

Economic development and its sustainability are influenced not only by material, human, financial, and intellectual factors, but also by psychological factors. In particular, the levels of business expectations, trust, and confidence significantly affect the resilience of the economy, especially in crucial sectors such as industry and, more specifically, industrial production. Based on political, economic, social, and legal stability, businesses are likely to assess their opportunities more optimistically and realistically. This, in turn, enables them to look confidently toward the future and provides a foundation for investing in further development. Conversely, a decline in business expectations and confidence can slow socio-economic development, potentially leading to recession or depression. The purpose of the article is to identify the association between business confidence (Impact of the Business Confidence Indicator, IBCI) and the level of industrial production (Industrial Production Index, IPI), as a crucial aspect of ensuring sustainable economic development. A correlation–regression analysis conducted using Ukraine as a case study—a country candidate for EU accession—and statistical data from the State Statistics Service of Ukraine (SSSU) for the period from 1 February 2022 to 1 September 2024 demonstrated that there is a stable, positive, and strong relationship between IBCI and IPI levels (r = 0.7; D = 0.49). The constructed linear correlation model indicates that, with other factors held constant, a one-percentage-point increase in positive business expectations may lead to a 2.23-point rise in the industrial production activity of enterprises in Ukraine’s manufacturing sector. Furthermore, approximately 49.0% of the variation in industrial production levels is likely explained by changes in business expectations. Verification of the constructed regression equation and assessment of its parameters indicate that it is statistically reliable and consistent with real economic processes. Specifically, the Fisher coefficient (F = 5.30) exceeds the critical (tabular) value (Ft = 2.04), with Se = 0.45 and C_95% = 1.96; the causality test based on the Granger methodology revealed the presence of a causal relationship, indicating that the IBCI influences the IPI. The obtained statistical results for the applied models and tests are as follows: MDF (p < 0.05), KPSS (p > 0.10), Durbin–Watson ≈ 2.0, Breusch–Godfrey (p = 0.32), White (p = 0.41), ARCH (p = 0.27), and SER (p = 0.36). The constructed correlation–regression equation also allowed forecasting based on trend line modeling—how IPI levels will change depending on business confidence. According to the forecast, the IPI in Ukraine at the beginning of 2030 is expected to increase by 63.48 percentage points compared to the beginning of 2024, reaching 153.6%. Full article

Platelet-rich plasma (PRP) is an autologous blood-derived concentrate increasingly utilized in regenerative medicine for its ability to accelerate healing and tissue repair. PRP is broadly classified by leukocyte content, fibrin architecture, and platelet concentration, with classification systems developed to standardize characterization. Preparation methods, including single- or double-spin centrifugation and buffy coat techniques, influence the final composition of PRP, determining the relative proportions of platelets, leukocytes, plasma proteins, and extracellular vesicles. These components act synergistically, with platelets releasing growth factors (e.g., VEGF, PDGF, TGF-β) that stimulate angiogenesis and matrix synthesis, leukocytes providing immunomodulation, plasma proteins facilitating scaffolding, and exosomes regulating intercellular signaling. Mechanistically, PRP enhances tissue repair through four key pathways: platelet adhesion molecules promote hemostasis and cell recruitment; immunomodulation reduces pro-inflammatory cytokines and favors M2 macrophage polarization; angiogenesis supports vascular remodeling and nutrient delivery; and serotonin-mediated pathways contribute to analgesia. These processes establish a regenerative microenvironment that supports both structural repair and functional recovery. Clinically, PRP has been applied across multiple specialties. In orthopedics, it promotes tendon, cartilage, and bone healing in conditions such as tendinopathy and osteoarthritis. In dermatology, PRP enhances skin rejuvenation, scar remodeling, and hair restoration. Gynecology has adopted PRP for ovarian rejuvenation, endometrial repair, and vulvovaginal atrophy. In dentistry and oral surgery, PRP accelerates wound closure and osseointegration, while chronic wound care benefits from its angiogenic and anti-inflammatory effects. PRP has also favored gingival recession coverage, regeneration of intrabony periodontal defects, and sinus grafting. Although preparation heterogeneity remains a challenge, PRP offers a versatile, biologically active therapy with expanding clinical utility. Full article

Background: Crisponi/cold-induced sweating syndrome (CS/CISS) is a rare autosomal recessive disorder characterized by severe neonatal manifestations including paroxysmal muscle contractions, tendency for hyperthermia, and feeding and swallowing difficulties with high neonatal mortality. Pathogenic variants in the Cytokine Receptor-Like Factor 1 (CRLF1) gene have been associated with CS/CISS. These variants result in a loss of function of the encoded protein, which disrupts the formation of a functional heterodimer with Cardiotrophin-Like Cytokine Factor 1 (CLCF1). This complex is essential for the development of autonomic and sensory nervous systems, as well as for bone remodeling. We report two patients affected by CS harboring pathogenic variants in the CRLF1 gene. Methods—case reports: The first patient was diagnosed postnatally, presenting with non-epileptic paroxysmal events characterized by opisthotonus and orofacial contractions. He survived beyond infancy, later developing scoliosis and persistent episodes of hyperthermia. In the second patient, a prenatal ultrasound at 20 weeks of gestation revealed bilateral camptodactyly, also referred to as the ‘horn’s sign’, raising early suspicion of CS. The diagnosis was subsequently confirmed both clinically and genetically. After birth, the infant developed severe dysphagia, apnea, and paroxysmal events not associated with epileptiform activity on EEG. Sanger sequencing identified a homozygous c.708_709delinsT frameshift variant in the CRLF1 gene. The patient died at 30 days of age due to respiratory failure. Results and conclusions: With this manuscript, we aim to further delineate the phenotypic spectrum of this rare condition and propose the ‘horn’s sign’ as a targeted prenatal marker for early diagnosis in populations with known founder mutations or familial risk factors. Full article

Mucopolysaccharidosis IVA (MPS IVA) is a lysosomal storage disease with an autosomal recessive trait caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) enzyme, which leads to the accumulation of chondroitin-6-sulfate and keratan sulfate, primarily in cartilage and its extracellular matrix, resulting in a direct impact on cartilage and bone development, as well as subsequent systemic skeletal dysplasia. ERT and HSCT are current treatment options, but they have a limited effect on bone lesions. In this article, we investigated liver-specific AAV8 vectors with a thyroxine-binding globulin promoter in the MPS IVA murine model to evaluate the long-term (24 weeks in males and 48 weeks in females) effects of gene therapy on biochemical markers and bone pathology. Both treated groups showed GALNS enzyme activity at supraphysiological levels in plasma and in various tissues, including the liver, heart, spleen, and bone. Keratan sulfate in both groups was normalized in plasma, liver, and bone (male mice). Pathological analyses revealed a decrease in vacuolated cells in the heart muscle and valves and improvement in bone pathology in treated male mice. However, the therapeutic impact was less pronounced in treated female mice. Overall, male mice indicated a substantial improvement in biochemical parameters and pathology compared to female mice. Full article

Gaucher disease (GD) is an autosomal recessive metabolic disorder caused by pathogenic variants in the GBA1 gene, which encodes the lysosomal hydrolase β-glucocerebrosidase (GCase). The pathogenic defects result in a misfolded protein, which can trigger endoplasmic reticulum stress and an unfolded protein response within the affected cells. The reduced enzyme activity leads to accumulation of its substrates, glucosylceramide (GlcCer) and glucosylsphingosine (GlcSph), within lysosomes or macrophages and with prominent disease manifestations in reticuloendothelial tissues such as liver, spleen and bone marrow. GCase defects alter both the mitochondria and the lysosome. In the lysosome, reduced GCase activity leads to glycosphingolipid build-up, disrupting lysosomal function and autophagy, thereby activating α-synuclein accumulation. GCase can also be imported into the mitochondria, where it fosters the integrity and function of mitochondrial respiratory chain (MRC) complex I. Thus, the reduced GCase activity impairs the normal mitochondrial function and increases oxidative stress in this organelle, which may contribute to cell death. However, further studies are required to confirm this mechanism of MRC dysfunction. In this review we have systematically evaluated the evidence for oxidative stress in individuals affected by GD, as well as the currently available therapies and adjunctive therapies. Therapies targeting oxidative stress may prove useful as adjuvant treatments for GD. Full article

Concerns about potential negative impacts of human activity on macrofungal diversity are spreading globally, yet research on this topic remains scarce. This study focuses on forest grazing (silvopasture), a popular economic practice whose impacts on macrofungal diversity are underexplored. Through investigation and comparison of macrofungal diversity and selected environmental factors in three types of subtropical forests (secondary mixed forests, dense-tree plantations and sparse-tree plantations) before and after two years of grazing at an intensity of 10 goats per hectare in South China, three key findings emerged: (1) Macrofungal alpha-diversity increased significantly after grazing, associated with an increase in large plant remains and a decrease in litterfall thickness; (2) dominance was monopolized by few taxa before grazing but became more balanced among a number of taxa after grazing; and (3) dominance of endemic taxa decreased in two of the three types of forests after grazing. Such findings suggest that grazing may create additional niches through foraging, trampling and excretion by livestock and thus recruit diverse macrofungi but may also lead to homogenization of fungal florae across regions and thus result in recessive beta-diversity loss. As this study heavily relies on taxonomy, allied updates for ambiguous taxa recognized in analyses are additionally proposed. Full article

Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the CFTR gene, which encodes a cAMP-activated chloride channel essential for epithelial function. Beyond its canonical role, evidence suggests CFTR also influences mitochondrial function. Previous studies have identified CFTR- and Cl-dependent genes, including MTND4 and CISD1, which are downregulated in CF cells and play a critical role in mitochondrial function. CF cells exhibit altered mitochondrial complex I (mCx-I) activity and impaired electron transport chain function, although the underlying mechanisms remain unclear. In this study, the impact of the CFTR modulators lumacaftor (VX-809) and ivacaftor (VX-770) on mitochondrial morphology and function was investigated in heterozygous ΔF508/W1282X CF IB3-1 cells. Combined treatment with VX-809 (10 μM, CFTR corrector) and VX-770 (0.1 μM, CFTR potentiator) induced a fragmented mitochondrial morphology in both CF and CF expressing wt-CFTR cells, without affecting cell viability or mitochondrial membrane potential (ΔΨm). While individual treatments differentially modulated ROS production and ΔΨm, these effects were not statistically significant under combined treatment. These results highlight a previously unrecognized role for CFTR modulators in shaping mitochondrial morphology. A better understanding of these effects may reveal novel mechanisms underlying the regulation of mitochondrial structure and function. Full article