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12 pages, 616 KB  
Article
The Role of Docosahexaenoic Acid in the Development of Preeclampsia and Perinatal Outcomes
by Nalan Kuruca, Senol Senturk, Ilknur Merve Ayazoglu, Medeni Arpa, Mehmet Kagıtcı, Sibel Dogan Polat and Bülent Yılmaz
Diagnostics 2026, 16(2), 305; https://doi.org/10.3390/diagnostics16020305 (registering DOI) - 17 Jan 2026
Abstract
Background/Objectives: Preeclampsia is a leading cause of maternal and perinatal morbidity worldwide, yet its underlying mechanisms remain unclear. Polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA), are essential for placental development and vascular function, but evidence on their role in preeclampsia is inconsistent. [...] Read more.
Background/Objectives: Preeclampsia is a leading cause of maternal and perinatal morbidity worldwide, yet its underlying mechanisms remain unclear. Polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA), are essential for placental development and vascular function, but evidence on their role in preeclampsia is inconsistent. This study aimed to compare serum DHA levels between women with preeclampsia and normotensive pregnant women and to examine their association with disease severity and maternal and perinatal outcomes. Methods: A total of 145 pregnant women aged 18–40 years were enrolled, including 47 with newly diagnosed preeclampsia (PE) and 98 normotensive controls. PE was defined according to the ACOG 2019 criteria. Serum DHA levels were measured using ELISA in fasting blood samples collected at the first visit. Results: Maternal serum DHA levels did not differ significantly between preeclampsia and control groups (p = 0.571); they were similar across control, mild PE, and severe PE groups. DHA showed a negative correlation with neutrophil-to-lymphocyte ratio (r = −0.305) and maternal hospitalization duration (r = −0.334). Independent predictors of PE included nulliparity (OR: 4.43), advanced age (OR: 1.14), elevated BMI (OR: 1.29), and low albumin (OR: 0.77). After adjusting for age and BMI, DHA was an independent negative predictor of IUGR (OR: 0.65). Conclusions: DHA levels: Placental and/or fetal DHA metabolism may be impaired in patients with preeclampsia. Although DHA was not associated with the development of PE, it was a negative predictor of IUGR. DHA reduces the length of maternal hospital stay through its anti-inflammatory effect. Full article
15 pages, 2495 KB  
Article
Efficacy of Transcatheter Renal Arterial Embolization to Contract Renal Size and Increase Muscle Mass in Patients with Polycystic Kidney Disease
by Che-Ming Lin, Tai-Shuan Lai, Ting-Wei Liao, Trianingsih, Ying-Hui Wu, Chun-Jung Cheng and Chih-Horng Wu
Diagnostics 2026, 16(2), 302; https://doi.org/10.3390/diagnostics16020302 (registering DOI) - 17 Jan 2026
Abstract
Background/Objectives: Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney disease (ESKD), accounting for approximately 5–10% of patients receiving dialysis worldwide. The large and numerous cysts in the liver and kidneys cause abdominal distention and poor appetite. Previous [...] Read more.
Background/Objectives: Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney disease (ESKD), accounting for approximately 5–10% of patients receiving dialysis worldwide. The large and numerous cysts in the liver and kidneys cause abdominal distention and poor appetite. Previous studies showed that renal arterial embolization (RAE) reduces total kidney volume (TKV), increases appetite, and improves quality of life. This article aims to evaluate the efficacy of RAE in increasing psoas muscle (PM) and paraspinal muscle (PS) mass in patients with polycystic kidney disease. Methods: A retrospective study was conducted from May 2016 to December 2020. Thirty-five patients with PKD and ESKD who received RAE were enrolled. The clinical data, including age, sex, body weight, abdominal circumference, and laboratory results, including albumin, creatinine, estimated glomerular filtration rate, and dialysis vintage, were collected. TKV was calculated with the ellipsoid formula method, and muscle mass was measured with bilateral PM and PS areas at the third lumbar level. The associated clinical, laboratory, and imaging data were compared before and after RAE. Results: There were 19 females and 16 males with a mean age of 59.9 for the final analysis. There were significant changes between baseline and 3-month, 6-month, 12-month after RAE, such as a decrease in TKV (4684 ± 3361 vs. 4079 ± 3456, 3675 ± 3401, 2459 ± 1706 mL, all p < 0.001), an increase in the PM area (12.6 ± 5.8 vs. 13.3 ± 5.7, 14.7 ± 6.9, 14.3 ± 7.1 cm2, all p < 0.05), but no difference in body weight, body mass index, albumin, hemoglobin, creatinine, or estimated glomerular filtration rate. The increase in the PM and PS was more obvious in the sarcopenic group than in the non-sarcopenic group in the 12-month follow-up (p = 0.001 and 0.016 vs. p = 0.205 and 0.259). Conclusions: RAE effectively reduces TKV, increases PM and PS mass, and serves as a candidate to reverse muscle loss in patients with PKD. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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18 pages, 1191 KB  
Article
Diabetic Kidney Disease Associated with Chronic Exposure to Low Doses of Environmental Cadmium
by Soisungwan Satarug, Tanaporn Khamphaya, Donrawee Waeyeng, David A. Vesey and Supabhorn Yimthiang
Stresses 2026, 6(1), 4; https://doi.org/10.3390/stresses6010004 (registering DOI) - 16 Jan 2026
Abstract
Accumulating evidence suggests that exposure to pollution from environmental cadmium (Cd) contributes to diabetic kidney disease as indicated by albuminuria and a progressive decrease in the estimated glomerular filtration rate (eGFR). This study examined the effects of Cd exposure on eGFR and the [...] Read more.
Accumulating evidence suggests that exposure to pollution from environmental cadmium (Cd) contributes to diabetic kidney disease as indicated by albuminuria and a progressive decrease in the estimated glomerular filtration rate (eGFR). This study examined the effects of Cd exposure on eGFR and the excretion rates of albumin (Ealb) and β2-microglobulin (Eβ2M) in 65 diabetics and 72 controls. Excretion of Cd (ECd) was a measure of exposure, while excretion of N-acetylglucosaminidase (ENAG) reflected the extent of kidney tubular cell injury. In participants with an elevated excretion of Eβ2M, the prevalence odds ratios (POR) for a reduced eGFR rose 6.4-fold, whereas the POR for albuminuria rose 4.3-fold, 4.1-fold, and 2.8-fold in those with a reduced eGFR, diabetes, and hypertension, respectively. Using covariance analysis, which adjusted for the interactions, 43% of the variation in Ealb among diabetics could be explained by female gender (η2 = 0.176), ENAG2 = 0.162), hypertension (η2 = 0.146), smoking (η2 = 0.107), and body mass index (η2 = 0.097), while the direct contribution of ECd to Ealb variability was minimal (η2 = 0.005). Results from a mediating-effect analysis imply that Cd could contribute to albuminuria and a falling eGFR through inducing tubular cell injury, leading to reduced reabsorption of albumin and β2M. Full article
(This article belongs to the Section Animal and Human Stresses)
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17 pages, 688 KB  
Article
Integration of the GRIm Score with Pathologic Immune and Stromal Markers to Develop a Combined Prognostic Model in Gastric Cancer: A Retrospective Single-Center Study
by Gökhan Öztürk, Ebru Taştekin, Canberk Topuz, Aysun Fatma Akkuş, Tayyip İlker Aydın, Sernaz Topaloğlu, Bülent Erdoğan, Muhammet Bekir Hacıoğlu and Ahmet Küçükarda
Medicina 2026, 62(1), 192; https://doi.org/10.3390/medicina62010192 - 16 Jan 2026
Abstract
Background and Objectives: The Gustave Roussy Immune (GRIm) score, reflecting systemic inflammation and nutritional status, has emerged as a simple and reproducible prognostic biomarker in various malignancies. However, its prognostic interaction with tumor microenvironmental factors remains unclear in gastric cancer. The primary [...] Read more.
Background and Objectives: The Gustave Roussy Immune (GRIm) score, reflecting systemic inflammation and nutritional status, has emerged as a simple and reproducible prognostic biomarker in various malignancies. However, its prognostic interaction with tumor microenvironmental factors remains unclear in gastric cancer. The primary aim of this study was to evaluate the prognostic value of the GRIm score in patients with resectable gastric adenocarcinoma, while the secondary aim was to determine whether integrating the GRIm score with tumor microenvironment–related pathological markers could improve prognostic stratification. Materials and Methods: This retrospective study analyzed 188 patients with resectable gastric adenocarcinoma treated at the Trakya University Faculty of Medicine between 2007 and 2018. GRIm scores were calculated from preoperative lactate dehydrogenase (LDH), albumin, and neutrophil-to-lymphocyte ratio (NLR) values. Pathologic parameters, including programmed death-ligand 1 (PD-L1) expression (combined positive score [CPS] ≥ 1 vs. <1), tumor–stroma ratio (TSR; stromal component ≥ 50% vs. <50%), and tumor-infiltrating lymphocyte (TIL) density (CD8+ ≥ 10% vs. <10%), were evaluated on surgical specimens. Survival outcomes were assessed using Kaplan–Meier and multivariate Cox analyses. Results: The study population had a mean age of 61.8 years and was predominantly male (72.3%). Patients with low GRIm scores had significantly longer disease-free survival (DFS; 24 vs. 12 months; p = 0.004) and overall survival (OS; 32 vs. 19 months; p = 0.006). In multivariate analysis, the GRIm score remained an independent predictor for both disease-free survival (p = 0.035) and overall survival (p = 0.044). Among combined models, the GRIm–TSR classification provided the most pronounced stratification (median DFS = 35 vs. 12 months; OS = 45 vs. 19 months; p = 0.014 and 0.001, respectively), retaining independent prognostic significance (hazard ratio [HR] = 1.23; p = 0.005). Integrating GRIm with PD-L1 and TIL density also improved prognostic discrimination. Conclusions: The GRIm score is a robust and cost-effective biomarker that independently predicts disease-free survival and overall survival in resectable gastric adenocarcinoma. Its combination with microenvironmental markers—PD-L1, TIL, and TSR—captures complementary biological dimensions of tumor aggressiveness, offering an integrative and clinically feasible framework for individualized risk assessment and postoperative management. Prospective multicenter validation is warranted. Full article
(This article belongs to the Section Oncology)
25 pages, 3130 KB  
Article
Effects of Zanthoxylum bungeanum Leaves on Production Performance, Egg Quality, Antioxidant Status, and Gut Health in Laying Hens
by Qiaobo Lei, Xinglai Li, Shanchuan Cao, Jianfei Zhao and Jingbo Liu
Animals 2026, 16(2), 273; https://doi.org/10.3390/ani16020273 - 16 Jan 2026
Abstract
Zanthoxylum bungeanum leaves (ZBL) are a phytogenic feed resource, but their energy value and functional effects in laying hens are not well defined. Two experiments were conducted. In Exp. 1, 96 healthy 38-week-old Roman Pink laying hens were allotted to either a control [...] Read more.
Zanthoxylum bungeanum leaves (ZBL) are a phytogenic feed resource, but their energy value and functional effects in laying hens are not well defined. Two experiments were conducted. In Exp. 1, 96 healthy 38-week-old Roman Pink laying hens were allotted to either a control diet or a diet containing 5% ZBL (eight replicates, six hens per replicate) to determine apparent metabolizable energy (AME) using an indicator method (7 d adaptation, 3 d collection). The AME and nitrogen-corrected AME of ZBL were 5.46 and 5.33 MJ/kg, respectively. In Exp. 2, 832 healthy 41-week-old hens were randomly assigned to diets supplemented with 0, 1%, 2%, or 3% ZBL (8 replicates, 26 hens per replicate) for 8 weeks after 1 week adaptation. Dietary ZBL at 1% to 3% did not affect production performance (p > 0.05), but increased albumen height linearly (p < 0.05) and improved yolk color at 2% and 3% (p < 0.05). ZBL increased serum albumin (p < 0.05) with a linear tendency (p = 0.065), and elevated serum IgA and IgM linearly (p < 0.05). Serum total antioxidant capacity and total superoxide dismutase were increased (p < 0.05) with significant linear and quadratic responses (p < 0.05), while serum malondialdehyde was reduced (p < 0.05). In the liver, 3% ZBL increased total antioxidant capacity (p < 0.05), hepatic catalase activity was decreased in all ZBL groups (p < 0.05), and hepatic malondialdehyde was reduced (p < 0.05). Cecal acetate increased linearly (p < 0.05), and propionate and butyrate increased with both linear and quadratic dose responses (p < 0.05). ZBL improved small intestinal morphology, especially duodenal villus height (p < 0.05). Gut microbiota was remodeled, with a marked reduction in norank_o__WCHB1-41 and increases in Ruminococcus, Pseudoflavonifractor, and several Coriobacteriales and Erysipelatoclostridiaceae taxa. Overall, ZBL provides usable energy and, at 2–3% inclusion, enhances egg quality, antioxidant status, humoral immunity, short-chain-fatty-acid production, and intestinal health without compromising laying performance. Full article
(This article belongs to the Section Animal Nutrition)
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15 pages, 280 KB  
Article
Albumin-Based Inflammatory–Nutritional Indices as Novel Biomarkers for Severity Stratification and Re-Hospitalization Risk in Hyperemesis Gravidarum: A Retrospective Case–Control Study
by Gülay Balkaş, Sümeyye Ünsal, Okan Oktar, Mustafa Can Akdogan, Murat Gözüküçük and Yusuf Üstün
Biomedicines 2026, 14(1), 197; https://doi.org/10.3390/biomedicines14010197 - 16 Jan 2026
Abstract
Background: The aim of this study was to evaluate the diagnostic and prognostic performance of albumin-based inflammatory–nutritional indices in hyperemesis gravidarum (HG) and to determine their associations with disease severity and risk of re-hospitalization. Methods: This retrospective case–control study included 246 [...] Read more.
Background: The aim of this study was to evaluate the diagnostic and prognostic performance of albumin-based inflammatory–nutritional indices in hyperemesis gravidarum (HG) and to determine their associations with disease severity and risk of re-hospitalization. Methods: This retrospective case–control study included 246 women with HG and 246 gestational-age-matched healthy pregnant controls at 6–16 weeks of gestation. Disease severity was classified as mild, moderate, or severe using the Pregnancy-Unique Quantification of Emesis (24 h scale) (PUQE-24) score. A comprehensive panel of albumin-based inflammatory indices—including C-reactive protein-to-albumin ratio (CAR), fibrinogen-to-albumin ratio (FAR), neutrophil-to-albumin ratio (NAR), leukocyte-to-albumin ratio (LAR), neutrophil percentage-to-albumin ratio (NPAR), monocyte-to-albumin ratio (MAR), hemoglobin–albumin–lymphocyte–platelet (HALP) score, modified HALP (m-HALP) score, prognostic nutritional index (PNI) score, systemic immune-inflammation index-to-albumin (SII/Alb), and systemic inflammatory response index-to-albumin (SIRI/Alb)—was calculated from routine complete blood count and serum biochemistry results obtained at diagnosis. Receiver operating characteristic analysis, along with univariate and multivariate logistic regression models, was performed to evaluate diagnostic performance and identify predictors of severe HG and re-hospitalization. Results: Albumin-based indices exhibited severity-associated alterations, with an overall trend toward worsening immuno-nutritional status across increasing HG severity. Among these, m-HALP score demonstrated the strongest inverse correlations with PUQE-24 score, ketonuria grade, length of hospital stay, and re-hospitalization risk (r = −0.74 to −0.52; all p < 0.001) and achieved the highest discriminative accuracy for both severe HG (AUC 0.864, 95% CI 0.836–0.892, p < 0.001) and re-hospitalization (AUC 0.722, 95% CI 0.675–0.766, p < 0.001). In multivariable analysis, higher HALP, m-HALP, and PNI were independently associated with a lower likelihood of severe HG. For re-hospitalization, higher m-HALP and HALP were independently associated with a lower risk, whereas higher NPAR, higher ketonuria grade, and higher PUQE-24 score were independently associated with an increased risk of re-hospitalization. Conclusions: Albumin-based indices, particularly m-HALP, demonstrated robust diagnostic and prognostic performance in HG compared with conventional biomarkers. These readily available, cost-neutral composite biomarkers enable objective severity stratification and accurate identification of patients at elevated risk of recurrent hospitalization, offering immediate potential to guide personalized, evidence-based clinical management. Full article
(This article belongs to the Special Issue New Insights in Reproductive Health and Disease)
15 pages, 6332 KB  
Article
Glycation Product Synthesized in Anhydrous Conditions Mimics an Epitope in Epithelial and Mesenchymal Tissues
by Monika Czech, Elżbieta Gamian, Agata Kochman, Marta Woźniak, Emilia Jaskuła, Piotr Ziółkowski and Andrzej Gamian
Biomedicines 2026, 14(1), 196; https://doi.org/10.3390/biomedicines14010196 - 16 Jan 2026
Abstract
Background: Advanced glycation end-products (AGEs) are formed and deposited in tissues, contributing to various disorders, including diabetes, other metabolic diseases, and aging. A new epitope, AGE10, was identified in human and animal tissues using a monoclonal antibody raised against synthetic melibiose-derived glycation [...] Read more.
Background: Advanced glycation end-products (AGEs) are formed and deposited in tissues, contributing to various disorders, including diabetes, other metabolic diseases, and aging. A new epitope, AGE10, was identified in human and animal tissues using a monoclonal antibody raised against synthetic melibiose-derived glycation end-products (MAGE), which were synthesized under anhydrous conditions with bovine serum albumin or myoglobin. The biology of the AGE10 epitope, particularly its role in diseases and in cancer tissues, is not well understood. Methods: The study was aimed at investigating the immunohistochemical recognition of AGE10 with the MoAb-anti-MAGE antibody. Results: Data obtained show that AGE10 is recognized in striated muscles but not in tumors of muscular origin. AGE10 is also stained in both normal and cancerous salivary glands and in adenomas of the large intestine. The staining is cytoplasmic. Discussion: Our approach may provide a methodology for cell biology research; AGE10 may be related to an advanced lipoxidation end-product; further investigation of MAGE may clarify disease mechanisms, support the development of novel therapeutic strategies. Conclusions: The key finding is that antibodies recognize mainly the epitope in epithelial and some mesenchymal tissues. Thus, the potential for AGE10 as a diagnostic marker is limited. The implications concern the biology of this epitope, the unique tissue distribution, and a role in cellular metabolism. Full article
(This article belongs to the Section Cell Biology and Pathology)
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11 pages, 448 KB  
Article
The Value of HALP Score in Predicting Adverse In-Hospital Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement
by Ömer Faruk Çiçek, Mustafa Çetin and Ali Palice
Diagnostics 2026, 16(2), 276; https://doi.org/10.3390/diagnostics16020276 - 15 Jan 2026
Viewed by 37
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is widely used in patients with severe aortic stenosis. The HALP (hemoglobin, albumin, lymphocyte, and platelet) score is an easily obtainable composite index that reflects nutritional status and systemic inflammation. Methods: In this single-center retrospective [...] Read more.
Background: Transcatheter aortic valve replacement (TAVR) is widely used in patients with severe aortic stenosis. The HALP (hemoglobin, albumin, lymphocyte, and platelet) score is an easily obtainable composite index that reflects nutritional status and systemic inflammation. Methods: In this single-center retrospective study, 140 patients who underwent TAVR between 1 April 2021, and 31 October 2024, were included. Patients were stratified according to the median HALP score (32.65) into low (<32.65)- and high (≥32.65)-HALP groups. In-hospital outcomes were mortality, bleeding requiring transfusion of >5 units of red blood cells, acute kidney injury (AKI), need for mechanical ventilation >24 h, and length of hospital stay. Associations between the HALP score and clinical outcomes were evaluated using multivariable regression analyses, and the discriminatory performance of HALP was assessed using receiver operating characteristic (ROC) curves. Results: Patients with low HALP scores had higher rates of in-hospital mortality (11.4% vs. 4.2%; p = 0.002), bleeding (28.6% vs. 5.7%; p < 0.001), AKI (11.4% vs. 2.9%; p < 0.001), and need for mechanical ventilation >24 h (25.7% vs. 14.4%; p = 0.002), as well as longer hospital stay (4.82 ± 1.50 vs. 3.62 ± 1.94 days; p = 0.001) compared with the high-HALP group. In multivariable models, a lower HALP score remained independently associated with all adverse in-hospital outcomes. ROC analysis showed good discriminatory ability of the HALP score for mortality (area under the curve [AUC] = 0.816; cut-off = 20.16), bleeding (AUC = 0.798; cut-off = 24.94), AKI (AUC = 0.737; cut-off = 26.21), and need for mechanical ventilation (AUC = 0.735; cut-off = 27.36). Conclusions: The HALP score is independently associated with adverse in-hospital clinical outcomes in patients undergoing TAVR and may serve as a simple and practical tool for early risk stratification in this population. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
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32 pages, 510 KB  
Review
Perioperative Blood Biomarkers of Infectious and Non-Infectious Postoperative Pulmonary Complications: A Narrative Review
by Simona Gigliotti, Giuseppe Guerriero, Giuseppe Mazza, Eugenio Garofalo, Grazia Pavia, Angela Amaddeo, Antonia Rizzuto, Nadia Marascio, Angela Quirino, Federico Longhini and Giovanni Matera
J. Clin. Med. 2026, 15(2), 699; https://doi.org/10.3390/jcm15020699 - 15 Jan 2026
Viewed by 52
Abstract
Background/Objectives: Postoperative pulmonary complications (PPCs) remain frequent and increase morbidity, mortality, and resource use. Preoperative risk scores (ARISCAT, NSQIP-derived calculators) use mostly static variables and may miss the dynamic perioperative host response preceding respiratory deterioration or infection. We address the gap in clinically [...] Read more.
Background/Objectives: Postoperative pulmonary complications (PPCs) remain frequent and increase morbidity, mortality, and resource use. Preoperative risk scores (ARISCAT, NSQIP-derived calculators) use mostly static variables and may miss the dynamic perioperative host response preceding respiratory deterioration or infection. We address the gap in clinically interpretable syntheses of perioperative blood biomarker trajectories that distinguish infectious from non-infectious PPCs and clarify bedside-ready versus exploratory markers. Methods: We conducted a narrative review with a structured Medline search (inception to 1 November 2025) plus reference screening. We included English-language adult surgical studies (observational or interventional) evaluating perioperative blood biomarkers in relation to PPCs or postoperative pulmonary infection; case reports, editorials, and reviews were excluded. No formal risk-of-bias assessment or quantitative meta-analysis was performed. Results: Across 298 cited publications, serial patterns of routinely available biomarkers (C-reactive protein, procalcitonin, lactate, albumin, and leukocyte-derived indices) were most consistently associated with PPC risk and helped separate expected postoperative inflammation from evolving infection when interpreted longitudinally rather than as single values. Mechanistic biomarkers (cytokines/immune-function assays, endothelial injury and coagulation/fibrinolysis markers, oxidative stress indicators) add biological insight but are limited by assay availability, heterogeneous sampling windows, and absent standardized cut-offs. Omics signatures and machine learning models combining biomarker kinetics with clinical variables are promising but require prospective, transportable validation. Conclusions: Key barriers to implementation include biological variability, non-specificity across postoperative syndromes, heterogeneous sampling windows, and lack of standardized cut-offs. Integrating multimarker panels into validated, dynamic predictive frameworks represents a promising direction for perioperative precision medicine. Full article
(This article belongs to the Section Anesthesiology)
22 pages, 3229 KB  
Article
Antitumor Activity of All-Trans Retinoic Acid and Curcumin-Loaded BSA Nanoparticles Against U87 Glioblastoma Cells
by Ceyda Sonmez, Aleyna Baltacioglu, Julide Coskun, Gulen Melike Demirbolat, Ozgul Gok and Aysel Ozpinar
Life 2026, 16(1), 131; https://doi.org/10.3390/life16010131 - 15 Jan 2026
Viewed by 140
Abstract
Glioblastoma (GBM) is a highly aggressive brain tumor characterized by invasive growth, intrinsic drug resistance, and the presence of the blood–brain barrier. All of these features make treatment extremely challenging and underscore the need for developing effective combination strategies and advanced drug delivery [...] Read more.
Glioblastoma (GBM) is a highly aggressive brain tumor characterized by invasive growth, intrinsic drug resistance, and the presence of the blood–brain barrier. All of these features make treatment extremely challenging and underscore the need for developing effective combination strategies and advanced drug delivery systems. This study aimed to develop a bovine serum albumin (BSA) nanoparticle (NP)-based delivery system to overcome the poor bioavailability and pharmacokinetic limitations of two potent anti-tumor agents, all-trans retinoic acid (ATRA) and curcumin (CURC), and to evaluate their antitumor activity in U87-MG GBM cells. Drug-free and ATRA/CURC-loaded BSA-NPs were synthesized using an optimized desolvation method and characterized in terms of particle size, polydispersity index, morphology, drug encapsulation efficiency, and release behavior. The cytotoxic, anti-migratory, and pro-apoptotic effects of the NPs on U87-MG GBM cells were assessed using real-time proliferation and migration assays and Annexin V/PI staining followed by flow cytometry. Collectively, the findings indicated that the co-delivery of ATRA and CURC using BSA-NPs showed enhanced antiproliferative, antimigratory, and pro-apoptotic effects. With its controlled release profile, high loading capacity, and favorable nanoscale dimensions, the ATRA-CURC-BSA–NP system represents a promising nanoplatform for GBM therapy that warrants further in vivo investigation. To the best of our knowledge, this is the first study demonstrating the inhibition of glioblastoma cell growth through the co-delivery of all-trans retinoic acid and curcumin using a bovine serum albumin-based nanoparticle system. Full article
(This article belongs to the Section Pharmaceutical Science)
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12 pages, 926 KB  
Article
Association Between Muscle Quality and GNRI in Patients with Type 2 Diabetes
by Shinta Yamamoto, Yoshitaka Hashimoto, Fuyuko Takahashi, Moe Murai, Nozomi Yoshioka, Yuto Saijo, Chihiro Munekawa, Hanako Nakajima, Noriyuki Kitagawa, Takafumi Osaka, Ryosuke Sakai, Hiroshi Okada, Naoko Nakanishi, Saori Majima, Emi Ushigome, Masahide Hamaguchi and Michiaki Fukui
Nutrients 2026, 18(2), 275; https://doi.org/10.3390/nu18020275 - 15 Jan 2026
Viewed by 62
Abstract
Background: Type 2 diabetes (T2D) has been linked to impairments in skeletal muscle performance, encompassing reductions in both muscle strength and muscle quality. While malnutrition is a known modifiable factor contributing to muscle quality deterioration, its specific relationship with the Geriatric Nutritional Risk [...] Read more.
Background: Type 2 diabetes (T2D) has been linked to impairments in skeletal muscle performance, encompassing reductions in both muscle strength and muscle quality. While malnutrition is a known modifiable factor contributing to muscle quality deterioration, its specific relationship with the Geriatric Nutritional Risk Index (GNRI) in T2D remains underexplored. Using data from 743 participants in the KAMOGAWA-A cohort, this cross-sectional study evaluated the association between muscle quality and GNRI in individuals with type 2 diabetes. Methods: Muscle quality was defined as handgrip strength divided by arm lean mass. GNRI was calculated using serum albumin and body mass index. Multiple linear regression models were used to assess associations between GNRI and muscle quality. To account for BMI-related dependency in muscle quality measurements, we derived BMI-adjusted GNRI residuals and performed the same regression analysis to evaluate the stability of the observed relationship beyond BMI-induced confounding. Results: In the overall population, GNRI was inversely associated with muscle quality (β = −0.17, p < 0.001). Conversely, residual GNRI demonstrated a significant positive association with muscle quality (β = 0.13, p < 0.001), especially among men, individuals under 65 years of age, and across all BMI categories. Stratified analyses suggested that the strength and direction of associations varied by age, sex, and glycemic control status. Conclusions: The GNRI showed an inverse correlation with muscle quality, whereas residual GNRI showed a consistent positive relationship. These findings suggest that improving nutritional status may support muscle function in T2D, but BMI confounds the interpretation of GNRI in this context. Full article
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16 pages, 10722 KB  
Article
Mesenchymal Stem Cell-Derived Exosomes miR-143-3p Attenuates Diabetic Kidney Disease by Enhancing Podocyte Autophagy via Bcl-2/Beclin1 Pathway
by Wenze Song, Jiao Wang, Lulu Guan, Yun Zou, Jiarong Liu, Wen Chen, Jixiong Xu and Wei Cai
Biomedicines 2026, 14(1), 184; https://doi.org/10.3390/biomedicines14010184 - 14 Jan 2026
Viewed by 173
Abstract
Objective: Diabetic kidney disease (DKD) is characterized by podocyte injury and impaired autophagy. Bone marrow mesenchymal stem cell-derived exosomes (BMSC-Exos) exhibit therapeutic potential for DKD, yet their mechanisms remain unclear. This study investigated whether BMSC-Exos restore podocyte autophagy via the miR-143-3p/Bcl-2/Beclin1 axis [...] Read more.
Objective: Diabetic kidney disease (DKD) is characterized by podocyte injury and impaired autophagy. Bone marrow mesenchymal stem cell-derived exosomes (BMSC-Exos) exhibit therapeutic potential for DKD, yet their mechanisms remain unclear. This study investigated whether BMSC-Exos restore podocyte autophagy via the miR-143-3p/Bcl-2/Beclin1 axis to delay DKD progression. Methods: A high-glucose (HG)-induced podocyte injury model was established using mouse podocytes (MPC5). Autophagy-related proteins (Beclin1, Bcl-2, LC3) and the injury marker desmin were analyzed by Western blot and immunofluorescence (IF). High-throughput sequencing identified BMSC-Exos-enriched miRNAs, with the miR-143-3p/Bcl-2 targeting relationship validated by dual-luciferase reporter assays. BMSCs transfected with miR-143-3p mimic or inhibitor were used to assess exosomes effects on autophagy and podocin expression. In vivo, DKD mice received tail vein injections of modified BMSC-Exos, followed by evaluation of physiological parameters, biochemical indices, and renal histopathology. Results: BMSC-Exos were successfully isolated and characterized. Fluorescence microscopy confirmed exosomes internalization by HG-treated MPC5 cells. BMSC-Exos upregulated Beclin1 and LC3-II while downregulating Bcl-2 and desmin, indicating enhanced autophagy. High-throughput sequencing revealed miR-143-3p enrichment in BMSC-Exos, and Bcl-2 was confirmed as a direct target of miR-143-3p. Exosomes from miR-143-3p mimic-transfected BMSCs further promoted autophagy and podocin expression. In DKD mice, BMSC-Exos reduced blood glucose, urinary albumin-to-creatinine ratio (UACR), and ameliorated renal damage, whereas miR-143-3p inhibition attenuated these effects. Conclusions: BMSC-Exos deliver miR-143-3p to target Bcl-2, thereby activating Beclin1-mediated autophagy and ameliorating DKD. This study elucidates a novel autophagy regulatory mechanism supporting BMSC-Exos as a cell-free therapy for DKD. Full article
(This article belongs to the Section Cell Biology and Pathology)
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11 pages, 352 KB  
Article
The Role of the CALLY Index in 30-Day Mortality Prediction for Acute Mesenteric Ischemia: A Retrospective Cohort Study
by Yeliz Simsek, Akkan Avci, Ahmet Burak Urfalioglu, Erdem Aksay, Adnan Kuvvetli, Ramazan Guven, Begum Seyda Avci, Saliha Dilek Oztoprak Hacioglu and Mustafa Oguz Tugcan
Medicina 2026, 62(1), 167; https://doi.org/10.3390/medicina62010167 - 14 Jan 2026
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Abstract
Background and Objectives: Acute mesenteric ischemia (AMI) lacks reliable prognostic biomarkers, and the prognostic performance of the C-reactive protein–albumin–lymphocyte (CALLY) index in this population has not been previously evaluated. This study aimed to assess the predictive value of the CALLY index for 30-day [...] Read more.
Background and Objectives: Acute mesenteric ischemia (AMI) lacks reliable prognostic biomarkers, and the prognostic performance of the C-reactive protein–albumin–lymphocyte (CALLY) index in this population has not been previously evaluated. This study aimed to assess the predictive value of the CALLY index for 30-day mortality in patients presenting to the emergency department (ED) with AMI. Materials and Methods: This retrospective cohort study included patients aged ≥18 years who presented to the ED with AMI over a 4-year period. Demographic and clinical data were collected. The CALLY index, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and CRP-to-lactate ratio were calculated. The primary outcome was 30-day mortality. Univariate and multivariate logistic regression analyses were performed to identify predictors of mortality. A receiver operating characteristic (ROC) curve analysis was used to assess predictive performance. A p-value < 0.05 was considered statistically significant. Results: A total of 111 patients were included (mean age, 69.2 ± 11.8 years; 52.3% male). The most common comorbidities were hypertension and coronary artery disease (45% each). The 30-day mortality rate was 55.9%. In a univariate analysis, lower CALLY index values were associated with higher mortality (p = 0.011). However, the CALLY index did not remain independently associated with mortality in multivariate logistic regression analysis (p = 0.773). The ROC analysis indicated that the CALLY index had a modest but statistically significant ability to predict 30-day mortality (AUC = 0.64, 95% CI: 0.54–0.74, p = 0.011). At a cut-off value of 0.0015, the CALLY index showed a sensitivity of 55% and a specificity of 77%. Conclusions: The CALLY index had modest predictive value for 30-day mortality in patients with AMI. Full article
(This article belongs to the Section Surgery)
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12 pages, 890 KB  
Article
Prognostic Significance of C-PLAN Index in Patients Treated with Immunotherapy for Non-Small-Cell Lung Cancer
by Ayse Nuransoy Cengiz, Oktay Bozkurt, Muhammet Cengiz, Metin Ozkan, Mevlude Inanc, Umut Kefeli, Devrim Cabuk, Mustafa Erman, Saadettin Kilickap, Tolga Koseci, Duygu Bayir, Deniz Can Guven, Muslih Urun, Ramazan Cosar, Teoman Sakalar, Nargiz Majidova, Emel Mutlu Ozkan, Cengiz Akosman, Mustafa Ersoy, Elif Sahin, Pervin Can Sanci, Canan Yildiz, Erdem Kolemen, Gözde Agdas, Erkam Kocaaslan, Ezgi Turkoğlu, Sedat Yildirim, Berrak Mermit Ercek, Anıl Karakayali, Hayati Arvas, Mehmet Mutlu Kidi, Sedat Biter, Havva Yesil Cinkir, Latif Karahan and Aslihan Ezgi Apaydin Rollasadd Show full author list remove Hide full author list
J. Clin. Med. 2026, 15(2), 642; https://doi.org/10.3390/jcm15020642 - 13 Jan 2026
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Abstract
Background/Objectives: Non-small-cell lung cancer (NSCLC) is a common disease with a high mortality rate and is often treated with immunotherapies; however, prognostic markers are required to identify patients who are most likely to benefit from these treatments. Therefore, we designed this study to [...] Read more.
Background/Objectives: Non-small-cell lung cancer (NSCLC) is a common disease with a high mortality rate and is often treated with immunotherapies; however, prognostic markers are required to identify patients who are most likely to benefit from these treatments. Therefore, we designed this study to assess the prognostic significance of the C-PLAN index, which includes performance status (PS) and C-reactive protein (CRP). Methods: A total of 560 patients were included in this multicenter study. Patients had been diagnosed with NSCLC and had received nivolumab therapy. The C-PLAN index, defined in 2022, is a score derived from the combination of PS, CRP, lactate dehydrogenase (LDH), albumin, and neutrophil–lymphocyte ratio (NLR). Patients were classified into good-, moderate-, and poor-prognosis groups according to the C-PLAN score. Results: The median metastatic overall survival was 25 months in the group with a C-PLAN score < 2 and 6 months in the group with a C-PLAN score ≥ 2 (p < 0.001). The median metastatic progression-free survival was 11 months in the group with a C-PLAN score < 2 and 3 months in the group with a C-PLAN score ≥ 2. Conclusion: This is the first comprehensive study demonstrating that the C-PLAN index can be used for prognostic purposes in immunotherapy. This score, which can be easily, economically, and practically calculated in outpatient clinics, can predict patient prognosis and determine who should receive longer durations of immunotherapy. Full article
(This article belongs to the Section Oncology)
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13 pages, 256 KB  
Article
A Cross-Sectional Study of Sex-Specific Associations of Renin and Electrolytes on the Development of Hypertension
by Seong Beom Cho
J. Clin. Med. 2026, 15(2), 643; https://doi.org/10.3390/jcm15020643 - 13 Jan 2026
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Abstract
Background/Objectives: Blood renin and electrolyte levels are associated with blood pressure and hypertension. While sex-specific effects of such factors have been investigated, exact comparisons of the factors between the sexes have been scarce. Methods: Using cohort data from the Korean Genome [...] Read more.
Background/Objectives: Blood renin and electrolyte levels are associated with blood pressure and hypertension. While sex-specific effects of such factors have been investigated, exact comparisons of the factors between the sexes have been scarce. Methods: Using cohort data from the Korean Genome and Environmental Study (KoGES), the study population that did not receive any interventions for blood pressure was determined. Blood levels of renin and electrolytes, including sodium, potassium, chloride, and calcium, were used to test their relationship with hypertension and blood pressure. Confounding variables, including age, body mass index (BMI), waist-to-hip ratio, family history of hypertension, alcohol consumption, smoking, blood urea nitrogen, creatinine, protein, and albumin levels, were used for adjustment in the multiple regression analysis. Results: In the single-variable analysis, sodium levels were significantly higher in the female population, and showed strong associations in the multiple regression analysis. Blood potassium levels showed no significant sex-specific differences. Among these factors, renin showed the greatest significance in both the total population and sex-specific groups. Moreover, in the development of hypertension, the effect size of renin was significantly different between sexes. Additionally, BMI tended to show stronger associations in females. Conclusions: This study identified sex-specific differential effects of renin and other electrolytes that are important in the pathophysiology of blood pressure. These findings provide clues for the more precise management of hypertension. Full article
(This article belongs to the Section Cardiovascular Medicine)
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