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19 pages, 8640 KB  
Systematic Review
Lipidomic Signatures in Feline Disease: A PRISMA-Guided Systematic Review
by Ana Carolina Fontes, Carolina Santos Silva, Ana Carolina Matos, Isabel Ribeiro Dias, Francisco Peixoto, Maria Manuel Oliveira, Maria Rosario Domingues and Carlos Antunes Viegas
Metabolites 2026, 16(5), 330; https://doi.org/10.3390/metabo16050330 - 15 May 2026
Viewed by 577
Abstract
Background/Objectives: Lipidomics has become a key component of systems biology, enabling comprehensive characterisation of lipid species and their roles in health and disease. As regulators of membrane architecture, energy balance, inflammation, and cellular signalling, lipids offer a powerful framework for understanding metabolic [...] Read more.
Background/Objectives: Lipidomics has become a key component of systems biology, enabling comprehensive characterisation of lipid species and their roles in health and disease. As regulators of membrane architecture, energy balance, inflammation, and cellular signalling, lipids offer a powerful framework for understanding metabolic dysfunction. In veterinary medicine, however, lipidomics remains comparatively underdeveloped. In cats, lipid metabolism is central to disorders such as hepatic lipidosis, cystitis, obesity, diabetes mellitus, and chronic inflammatory enteropathies, yet available data remain limited. This systematic review synthesised current evidence on lipidomics and lipid-focused profiling in feline disease and identified lipid alterations with potential clinical relevance. Methods: Following PRISMA 2020 guidelines, PubMed, ScienceDirect, and Scopus were searched for original studies (1994–2026) evaluating lipidomics or lipid-focused profiling in cats. Eligible studies assessed lipid species, fatty acids, lipid mediators, or lipoproteins in disease or physiological states. Owing to methodological heterogeneity, findings were synthesised narratively. Results: Seventeen studies met inclusion criteria, covering hepatic, urinary, gastrointestinal, renal, neurological, oncological, metabolic, and pharmacologically modulated conditions. Recurring alterations involved lipoproteins, triglycerides, phospholipids, sphingolipids, fatty acids, and oxylipins. More consistent patterns emerged in hepatic lipidosis, where lipoprotein disturbances may aid diagnosis; in lower urinary tract disease, where PUFA-derived oxylipins differentiated bacterial from idiopathic cystitis; and in obesity, where phospholipid and triglyceride shifts reflected metabolic risk. Fatty acid remodelling in chronic enteropathies aligned with mucosal inflammation, while sphingolipid changes in neurological disease correlated with severity. Heterogeneity in analytical platforms, dietary control, and study design limited comparability. Conclusions: Feline lipidomics reveals biologically meaningful alterations with emerging diagnostic and prognostic value. Although still developing, lipid-focused approaches may enhance disease characterisation and support translational research. Larger, standardised studies and robust reference datasets are needed to validate lipid signatures for clinical implementation. Full article
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14 pages, 604 KB  
Review
The Role of Escherichia coli Autotransporters in Urinary Tract Infections and Urosepsis
by Beata Krawczyk and Paweł Wityk
Int. J. Mol. Sci. 2025, 26(19), 9760; https://doi.org/10.3390/ijms26199760 - 7 Oct 2025
Cited by 1 | Viewed by 1647
Abstract
Urinary tract infections (UTIs) caused by Uropathogenic Escherichia coli (UPEC) strains are among the most common bacterial infections in humans, causing cystitis, pyelonephritis and, in the absence of appropriate treatment, sepsis. Effective therapies and preventive strategies are still lacking, which highlights the need [...] Read more.
Urinary tract infections (UTIs) caused by Uropathogenic Escherichia coli (UPEC) strains are among the most common bacterial infections in humans, causing cystitis, pyelonephritis and, in the absence of appropriate treatment, sepsis. Effective therapies and preventive strategies are still lacking, which highlights the need to better understand UPEC virulence mechanisms. Herein, we describe the role of three groups of bacterial autotransporters (ATs): serine protease autotransporter (SPATE), trimeric autotransporter adhesins (TAA), and autotransporter adhesin AIDA-I, and their possible contribution to the induction of UTI and urosepsis. AT, depending on the type, exhibits functions such as adhesion, serum resistance, hemagglutination, protease activity, biofilm formation and toxin activity. By summarizing the molecular functions of AT proteins, our review highlights their potential as targets for novel therapeutic and preventive approaches against UTIs and urosepsis. Full article
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19 pages, 3569 KB  
Article
Bladder p75NTR-Mediated Anti-Inflammatory Response via the TLR4/TRAF6/NF-κB Axis
by Claudia Covarrubias, Abubakr H. Mossa, Laura R. Yan, Benjamin Desormeau, Philippe G. Cammisotto, H. Uri Saragovi and Lysanne Campeau
Life 2025, 15(6), 957; https://doi.org/10.3390/life15060957 - 14 Jun 2025
Viewed by 4129
Abstract
Recurrent bacterial cystitis in women can lead to interstitial cystitis or bladder pain syndrome (IC/BPS). Activation of Toll-like receptor 4 (TLR4) by LPS can upregulate signaling of the pro-inflammatory receptor p75NTR. The aim of the presented study was to assess whether [...] Read more.
Recurrent bacterial cystitis in women can lead to interstitial cystitis or bladder pain syndrome (IC/BPS). Activation of Toll-like receptor 4 (TLR4) by LPS can upregulate signaling of the pro-inflammatory receptor p75NTR. The aim of the presented study was to assess whether p75NTR antagonist THX-B can modulate LPS-mediated inflammation in bladder cells. In vitro expression and LPS-activation of p75NTR were confirmed in urothelial (URO) and smooth muscle (SMC) cells. In UROs, p75NTR antagonism abolished the LPS-elicited rise in membrane-bound and soluble TNF-α. However, it could not prevent LPS-induced rise in phosphorylated ERK nor decrease in phosphorylated p38MAPK, nor the increase in iNOS and nitric oxide (NO) content. On the other hand, in SMCs, LPS increased phosphorylation of JNK, nuclear translocation of NF-κB, and association of TRAF6 to p75NTR, outcomes prevented by p75NTR antagonism. In UROs, LPS decreased the expression of tight junction proteins, ZO-1 and occludin, with the latter rescued by p75NTR antagonism. Intraurethral instillation of LPS increased inflammation in the lamina propria, activation of JNK, and contractile activity of bladder tissue. Alternatively, intraperitoneal THX-B injections prevented LPS-induced inflammation but not enhanced muscle contraction. Our results suggest that inhibition of p75NTR could help in reducing bladder symptoms during cystitis. Full article
(This article belongs to the Section Microbiology)
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10 pages, 661 KB  
Systematic Review
Efficacy and Safety of Uro-Vaxom in Urinary Tract Infection Prevention: A Systematic Literature Review
by Silvia Volontè, Desireè De Vicari, Alice Cola, Marta Barba and Matteo Frigerio
J. Clin. Med. 2025, 14(11), 3836; https://doi.org/10.3390/jcm14113836 - 29 May 2025
Cited by 4 | Viewed by 14039
Abstract
Background/Objectives: Urinary tract infections (UTIs) are the most common bacterial infections and one of the most common diseases worldwide. These infections induce an enormous financial and economic burden. The most frequent pathogen in UTIs is Escherichia coli (E. coli), which [...] Read more.
Background/Objectives: Urinary tract infections (UTIs) are the most common bacterial infections and one of the most common diseases worldwide. These infections induce an enormous financial and economic burden. The most frequent pathogen in UTIs is Escherichia coli (E. coli), which is responsible for over 85% of cases of cystitis and over 60% of recurrent cases. Repeated antibiotic prescriptions increase the risk of bacteria developing resistance, reducing treatment efficacy and limiting long-term therapeutic options. When traditional preventive methods fail to provide protection, other strategies may be necessary. To investigate the effectiveness of vaccination with Uro-Vaxom for the prevention of UTIs based on currently available studies. Methods: Systematic literature search. Results: The available studies focus almost exclusively on the female sex. Uro-Vaxom decreased the recurrence of UTIs, was overall well tolerated, and reduced the need for antibiotic therapies. Conclusions: Uro-Vaxom is a potential effective and well-tolerated option for reducing the recurrence of UTIs in patients prone to frequent infections. Nevertheless, the retrospective nature of several studies, combined with methodological limitations and variability in study design, precluded a reliable quantitative estimation of the treatment effect. Full article
(This article belongs to the Section Nephrology & Urology)
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19 pages, 1047 KB  
Article
Antimicrobial Resistance in Companion Animals: A 30-Month Analysis on Clinical Isolates from Urinary Tract Infections in a Veterinary Hospital
by Raffaele Scarpellini, Silvia Piva, Erika Monari, Kateryna Vasylyeva, Elisabetta Mondo, Erika Esposito, Fabio Tumietto and Francesco Dondi
Animals 2025, 15(11), 1547; https://doi.org/10.3390/ani15111547 - 25 May 2025
Cited by 8 | Viewed by 4197
Abstract
Bacterial urinary tract infections (UTIs) are common in small animal practice and their inappropriate treatment contributes to the antimicrobial resistance (AMR) spreading. This study assessed bacterial prevalence, non-susceptibility percentages, antimicrobial prescription and the impact of the application of international guidelines redacted by the [...] Read more.
Bacterial urinary tract infections (UTIs) are common in small animal practice and their inappropriate treatment contributes to the antimicrobial resistance (AMR) spreading. This study assessed bacterial prevalence, non-susceptibility percentages, antimicrobial prescription and the impact of the application of international guidelines redacted by the International Society for Companion Animals Infectious Disease (ISCAID) in dogs and cats with UTIs evaluated at a European veterinary university hospital, over a 30-month period. A total of 729 bacterial isolates were included. The most frequently isolated bacterial species was Escherichia coli in both dogs (52.8%) and cats (45.7%). Following ISCAID guidelines, almost half of the cases were classified as upper UTIs (24.9%) or recurrent cystitis (24.8%). Multidrug resistance (MDR) percentage was 37.3% (n = 272). Over five semesters, MDR significantly decreased (p = 0.001). Additionally, a significant decrease was recorded for specimens from patients previously treated (p = 0.018) and under treatment at sampling (p < 0.001). Previous treatment with amoxicillin-clavulanate (p = 0.001), marbofloxacin (p < 0.001), enrofloxacin (p < 0.001) and piperacillin-tazobactam (p = 0.016) was linked with higher MDR rates. This study highlighted that companion animals are potential reservoirs for AMR; moreover, international guidelines applied in the daily practice guiding antimicrobial stewardship can lead to a reduction in AMR over time. Full article
(This article belongs to the Special Issue Advances in Canine and Feline Nephrology and Urology)
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16 pages, 1513 KB  
Article
Post-Transplant Cyclophosphamide-Based Prophylaxis and Its Impact on Infectious Complications and Immune Reconstitution According to Donor Type
by Beatriz Merchán-Muñoz, María Suárez-Lledó, Luis Gerardo Rodríguez-Lobato, Tommaso Francesco Aiello, Antonio Gallardo-Pizarro, Paola Charry, Joan Cid, Miquel Lozano, Alexandra Pedraza, Alexandra Martínez-Roca, Ares Guardia, Laia Guardia, Cristina Moreno, Enric Carreras, Laura Rosiñol, Carolina García-Vidal, Francesc Fernández-Avilés, Carmen Martínez, Montserrat Rovira and María Queralt Salas
Cancers 2025, 17(7), 1109; https://doi.org/10.3390/cancers17071109 - 26 Mar 2025
Cited by 3 | Viewed by 2302
Abstract
Background/Objectives: This study evaluated infectious complications and immune reconstitution in 253 adults undergoing peripheral blood allogeneic hematopoietic cell transplantation (allo-HCT) with post-transplant cyclophosphamide (PTCY)-based GVHD prophylaxis. Methods: Patients received grafts from HLA-matched donors (47.4%), mismatched unrelated donors (MMUD, 33.2%), or haploidentical donors (19.4%). [...] Read more.
Background/Objectives: This study evaluated infectious complications and immune reconstitution in 253 adults undergoing peripheral blood allogeneic hematopoietic cell transplantation (allo-HCT) with post-transplant cyclophosphamide (PTCY)-based GVHD prophylaxis. Methods: Patients received grafts from HLA-matched donors (47.4%), mismatched unrelated donors (MMUD, 33.2%), or haploidentical donors (19.4%). Results: The estimated 2-year non-relapse mortality (NRM) was 11.8%, 26.4%, and 22.4%, respectively (p = 0.0528). The cumulative incidence (Cum.Inc) of acute and chronic GVHD, immunosuppression duration, and post-transplant outcomes were similar across donor types. The day +30 Cum.Inc of bacterial bloodstream infections (BSI) tended to be higher in HLA-matched transplants (49.2%, p = 0.073), while HHV-6 reactivation showed a trend toward higher frequency in haploidentical transplants (22.4%, p = 0.068). Cytomegalovirus (CMV) reactivation occurred between days +30 and +100, with the highest Cum.Inc in MMUD (59.5%, p = 0.033). BK virus-associated hemorrhagic cystitis showed a trend toward higher incidence in MMUD (22.3%, p = 0.056). Respiratory and fungal infections were most frequent in the first 100 days, with comparable rates across donor types. By day +180, most patients achieved immune reconstitution, with normalization of CD4+ T cells, CD8+ T cells, and IgG levels, independent of donor type. Conclusions: Patients undergoing allo-HCT with PTCY-based prophylaxis experience a high infectious density rate early post-transplant, which decreases after 6 months as immune reconstitution progresses, regardless of donor type. Full article
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12 pages, 1583 KB  
Article
The Role of Stratified Cumulative Antibiograms in the (Choice of Appropriate Antibiotics in Urinary Tract Infection) Management of Urinary Tract Infections
by Vaclava Adamkova, Michaela Matouskova, Vanda Gabriela Adamkova, Michal Huptych and Marcela Fontana
Pathogens 2025, 14(2), 141; https://doi.org/10.3390/pathogens14020141 - 3 Feb 2025
Cited by 3 | Viewed by 2690
Abstract
Urinary tract infections (UTIs) are one of the most common bacterial diseases both in communities and in hospitalized patients, and at the same, time they are one of the most common indications for the use of antibiotics. UTI guidelines are generally available nationally [...] Read more.
Urinary tract infections (UTIs) are one of the most common bacterial diseases both in communities and in hospitalized patients, and at the same, time they are one of the most common indications for the use of antibiotics. UTI guidelines are generally available nationally or internationally, but they do not address all aspects of UTI treatment for different patient cohorts, age, gender, or comorbidities. The aim of the study was to point out the importance of stratified cumulative antibiograms at the level of individual health care facilities and the significant differences between epidemiological data, not only at the national level, but also at the local level. Our study analyses data from 383 patients with UTIs from a hospital department, General University Hospital (GUH), and 272 patients from an outpatient medical facility, Urocentrum (UC). This analysis focuses on the most common UTI causative agent, Escherichia coli, its representation as the causative agent of UTI in patients with complicated acute cystitis (N30), and its representation in complicated acute cystitis in patients with prostate cancer (C61). In addition to the frequency of occurrence, a sub-analysis of the incidence of resistance of E. coli to commonly used antibiotics by age, gender, diagnosis, and medical facility was performed. Results: The most common causative agent of UTI was E. coli. In patients with N30, it was 70% in GUH and 54% in UC, but in oncological patients with UTI, it was only 39% and 35%, respectively. In patients with UTI in C61, there was a significant difference in susceptibility of E. coli between individual health care facilities. Lower resistance was found in UC opposite to GUH isolates in ampicillin, with 29.8% vs. 65%, p = 0.001; amoxicillin/clavulanic acid, with 8.5% vs. 30%, p = 0.01; with 2.1% vs. 17.5% in pivmecillinam, p = 0.01; with 10.6% vs. 37.5% in co-trimoxazole, p = 0.003; and ciprofloxacin, with 10.6% vs. 30%, p = 0.04. The study shows significant differences in the sensitivity of urinary E. coli isolates in patients in relation to age, gender, medical devices, and the presence of comorbidities. Full article
(This article belongs to the Special Issue Hospital-Associated Infections and Antibiotic Resistance)
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11 pages, 893 KB  
Article
Persistent Elevation in Urinary Neutrophil Gelatinase-Associated Lipocalin Levels Can Be a Predictor of Urinary Tract Infection Recurrence or Persistence in Women
by Min-Ching Liu, Yuan-Hong Jiang, Jia-Fong Jhang, Tien-Lin Chang, Chia-Cheng Yang and Hann-Chorng Kuo
Int. J. Mol. Sci. 2024, 25(23), 12670; https://doi.org/10.3390/ijms252312670 - 26 Nov 2024
Cited by 1 | Viewed by 1819
Abstract
Women commonly experience urinary tract infection (UTI) recurrence. However, there is no effective tool for predicting recurrent UTI after the first UTI episode. Hence, this study aimed to investigate potential urinary inflammatory biomarkers and specific biomarkers for predicting UTI recurrence or persistence after [...] Read more.
Women commonly experience urinary tract infection (UTI) recurrence. However, there is no effective tool for predicting recurrent UTI after the first UTI episode. Hence, this study aimed to investigate potential urinary inflammatory biomarkers and specific biomarkers for predicting UTI recurrence or persistence after antibiotic treatment in women. Forty women who had a history of recurrent UTI within 1 year after the initial episode and acute bacterial cystitis were treated with broad-spectrum antibiotics for 1 week. To measure inflammatory biomarker levels, urine samples were collected at the baseline and after 1 week, 1 month, and 3 months. The levels of urinary pro-inflammatory proteins such as neutrophil gelatinase-associated lipocalin (NGAL), nerve growth factor, CXC-motif chemokine ligand (CXCL)-1, interleukin-8, CXCL-10, monocyte chemoattractant protein-1, and tumor necrosis factor-alpha were measured using commercial kits. Seven healthy age-matched women were included as controls. The changes in urinary biomarker levels at the baseline and various time points were compared between women with and without UTI recurrence within 1 month or within 3 months after the initial antibiotic therapy. At the baseline, patients with a higher urinary white blood cell count had a significantly higher NGAL level than the controls and those with a low white blood cell count. Of the 40 patients with a history of recurrent UTI, 12 presented with UTI persistence or recurrence within 1 month and 19 within 3 months after the initial antibiotic treatment. Among the 28 patients without UTI recurrence at 1 month after treatment, 7 had UTI recurrence within 3 months. Compared with patients without UTI recurrence, those with UTI recurrence had significantly higher urinary NGAL levels at 1 week, 1 month, and 3 months after the initial treatment. This study concludes that persistent elevation in urinary NGAL levels after the initial antibiotic treatment indicated persistent bladder inflammation. Further, it could be a predictor of UTI persistence or recurrence within 1 or 3 months after the initial antibiotic treatment. Patients with a history of recurrent UTI and high urinary NGAL levels after antibiotic treatment might require a longer treatment duration to completely eradicate or prevent UTI recurrence. Full article
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13 pages, 580 KB  
Article
Antimicrobial Resistance of Escherichia coli for Uncomplicated Cystitis: Korean Antimicrobial Resistance Monitoring System
by Seong Hyeon Yu, Seung Il Jung, Seung-Ju Lee, Mi-Mi Oh, Jin Bong Choi, Chang Il Choi, Yeon Joo Kim, Dong Jin Park, Sangrak Bae, Seung Ki Min and KAUTII Investigators
Antibiotics 2024, 13(11), 1075; https://doi.org/10.3390/antibiotics13111075 - 12 Nov 2024
Cited by 4 | Viewed by 4645 | Correction
Abstract
Objectives: Uncomplicated cystitis is a leading form of bacterial UTI; the most common causative bacterium worldwide is Escherichia coli. This internet-based, prospective, multicenter, and national observational study aimed to report the antimicrobial resistance of E. coli in patients with uncomplicated cystitis through [...] Read more.
Objectives: Uncomplicated cystitis is a leading form of bacterial UTI; the most common causative bacterium worldwide is Escherichia coli. This internet-based, prospective, multicenter, and national observational study aimed to report the antimicrobial resistance of E. coli in patients with uncomplicated cystitis through the use of the Korean Antimicrobial Resistance Monitoring System (KARMS) in 2023. Results: Data for a total of 654 patients were retrieved from the KARMS database. The mean (standard deviation) patient age was 55.9 (18.3) years. The numbers of postmenopausal women and patients with recurrent cystitis were 381 (59.4%) and 78 (11.9%), respectively. Regarding antimicrobial susceptibility, 96.8% were susceptible to fosfomycin, 98.9% to nitrofurantoin, 50.9% to ciprofloxacin, and 82.4% to cefotaxime. Extended-spectrum beta-lactamase positivity was 14.4% (89/616), and was significantly higher in tertiary hospitals (24.6%, p < 0.001) and recurrent cystitis (27.6%, p < 0.001). Fluoroquinolone resistance was significantly higher in tertiary hospitals (57.8%, p < 0.001), postmenopausal women (54.2%, p < 0.001), and recurrent cystitis (70.3%, p < 0.001). In addition, postmenopausal status (95% confidence interval [CI]: 1.44–3.17, odds ratio [OR] 2.13, p < 0.001), recurrent cystitis (95% CI: 1.40–4.66, OR 2.56, p = 0.002) and tertiary hospitals (95% CI: 1.00–2.93, OR 1.71, p = 0.049) were associated with significantly increased fluoroquinolone resistance. Methods: Any female patient diagnosed with clinical uncomplicated cystitis and microbiologically proven E. coli infection in 2023 was eligible for this study. Patient data were obtained from the web-based KARMS database. The antimicrobial susceptibility of E. coli was analyzed according to clinical factors, including hospital region, hospital type, menopause status, and recurrence status. Conclusions: The antimicrobial resistance of E. coli in patients with uncomplicated cystitis in the Republic of Korea has reached a serious level, especially in fluoroquinolone resistance. Therefore, major efforts should be made to reduce antimicrobial resistance. Full article
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15 pages, 1235 KB  
Review
The Pathomechanism and Current Treatments for Chronic Interstitial Cystitis and Bladder Pain Syndrome
by Wan-Ru Yu, Jia-Fong Jhang, Yuan-Hong Jiang and Hann-Chorng Kuo
Biomedicines 2024, 12(9), 2051; https://doi.org/10.3390/biomedicines12092051 - 10 Sep 2024
Cited by 21 | Viewed by 13454
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and debilitating condition characterized by symptoms such as bladder pain, frequent urination, and nocturia. Pain is typically perceived in the lower abdomen, pelvic floor, or urethra, causing significant discomfort and impacting quality of life. Due [...] Read more.
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and debilitating condition characterized by symptoms such as bladder pain, frequent urination, and nocturia. Pain is typically perceived in the lower abdomen, pelvic floor, or urethra, causing significant discomfort and impacting quality of life. Due to the similarity of its symptoms with those of overactive bladder and acute bacterial cystitis, patients often face misdiagnosis and delayed appropriate treatment. Hunner’s (HIC) and non-Hunner’s IC (NHIC), each with distinct clinical presentations, urothelial dysfunction, chronic inflammation, and central sensitization and thus multimodal symptomatic treatment approaches, may be the most common pathogeneses of IC/BPS. Treatment of IC/BPS should involve identifying the different clinical phenotypes and underlying pathophysiology causing clinical symptoms and developing strategies tailored to the patient’s needs. This review discusses the roles of urine biomarkers, bladder inflammation, and glycosaminoglycans in the pathogenesis of IC/BPS. Various bladder treatment modalities are explored, including glycosaminoglycan replenishment, botulinum toxin A injection, platelet-rich plasma injection, low-energy shock waves, immunosuppression, and low-dose oral prednisolone. Pelvic floor muscle physiotherapy and bladder therapy combined with psychiatric consultation can help alleviate psychological stress and enhance the quality of life of patients with IC/BPS. Elucidating the pathological mechanisms and exploring diverse treatment options would help advance the care of individuals suffering from this challenging bladder condition. Full article
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15 pages, 1422 KB  
Article
Reduced Dose of Post-Transplant Cyclophosphamide with Tacrolimus for the Prevention of Graft-versus-Host Disease in HLA-Matched Donor Peripheral Blood Stem Cell Transplants: A Prospective Pilot Study
by Alex Juárez, María Queralt Salas, Alexandra Pedraza, María Suárez-Lledó, Luís Gerardo Rodríguez-Lobato, María Teresa Solano, Anna Serrahima, Meritxell Nomdedeu, Joan Cid, Miquel Lozano, Paola Charry, Jordi Arcarons, Noemí Llobet, Laura Rosiñol, Francesc Fernández-Avilés, Montserrat Rovira and Carmen Martínez
Cancers 2024, 16(14), 2567; https://doi.org/10.3390/cancers16142567 - 17 Jul 2024
Cited by 15 | Viewed by 4190
Abstract
PTCY 50 mg/kg/day on days +3/+4 is an excellent strategy to prevent GVHD. However, its use is associated with adverse outcomes such as delayed engraftment, increased risk of infection, and cardiac complications. This pilot study evaluates the efficacy and toxicity of a reduced [...] Read more.
PTCY 50 mg/kg/day on days +3/+4 is an excellent strategy to prevent GVHD. However, its use is associated with adverse outcomes such as delayed engraftment, increased risk of infection, and cardiac complications. This pilot study evaluates the efficacy and toxicity of a reduced dose of PTCY (40 mg/kg/day) combined with tacrolimus in 22 peripheral blood HLA-matched alloHSCT patients. At day +100, the cumulative incidences of grade II–IV and III–IV acute GVHD were 18.2% and 4.5%, respectively. No grade IV acute GVHD or steroid-refractory disease was observed. The cumulative incidences of all-grade and moderate-severe chronic GVHD at 1-year were 11.4% and 6.4%, respectively. No patient died from transplant-related complications. Two-year OS and RFS were 77.1% and 58.3%, respectively. All patients engrafted, with neutrophil and platelet recovery occurring at a median of 15 (IQR 14–16) and 16 days (IQR 12–23), respectively. The cumulative incidences of bloodstream bacterial infections, polyomavirus BK hemorrhagic cystitis, HHV6 reactivation, CMV reactivation, and fungal infections were 13.6%, 9.1%, 9.1%, 4.6%, and 6%, respectively. Only one early cardiac event was observed. These results suggest that PTCY 40 mg/kg/day on a +3/+4 schedule provides adequate immunosuppression to allow for engraftment and prevent clinically significant GVHD with a low toxicity profile. Full article
(This article belongs to the Special Issue Immunotherapy and Transplantation in the Era of Transplant Oncology)
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13 pages, 988 KB  
Article
In Vitro Antibacterial Activities of Fosfomycin against Escherichia coli Isolates from Canine Urinary Tract Infection
by Nattha Jariyapamornkoon, Suphachai Nuanualsuwan and Nipattra Suanpairintr
Animals 2024, 14(13), 1916; https://doi.org/10.3390/ani14131916 - 28 Jun 2024
Cited by 4 | Viewed by 2660
Abstract
Fosfomycin is a bactericidal drug recommended as an alternative treatment for canine bacterial cystitis, particularly in cases involving multidrug-resistant (MDR) infections when no other options are available. In this study, minimum inhibitory concentration (MIC) and mutant prevention concentration (MPC) of fosfomycin were determined [...] Read more.
Fosfomycin is a bactericidal drug recommended as an alternative treatment for canine bacterial cystitis, particularly in cases involving multidrug-resistant (MDR) infections when no other options are available. In this study, minimum inhibitory concentration (MIC) and mutant prevention concentration (MPC) of fosfomycin were determined against 79 clinical E. coli isolates using the agar dilution method. The susceptibility rate of E. coli to fosfomycin was 86.06%, with MIC50 and MIC90 values of 4 mg/L and 96 mg/L, respectively. MPC50 and MPC90 values were 64 mg/L and 192 mg/L. Using pharmacokinetic (PK) data from dogs given a single 80 mg/kg oral dose of fosfomycin, the area under the curve per MIC50 (AUC0–24/MIC50) was 85.79 with time above MIC50 (T > MIC50) exceeding 50%. In urine, the AUC0–24/MIC50 was 10,694.78, and the AUC0–24/MPC90 was 222.81, with T > MPC90 extending beyond 24 h. Therefore, fosfomycin exhibited significant antibacterial activity against canine uropathogenic E. coli, including MDR strains, at concentrations below the susceptible MIC breakpoint. However, the high MPC values, especially the MPC90, indicate the critical importance of performing susceptibility testing for fosfomycin and maintaining ongoing resistance monitoring. Full article
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12 pages, 1668 KB  
Article
MV140 Mucosal Vaccine Induces Targeted Immune Response for Enhanced Clearance of Uropathogenic E. coli in Experimental Urinary Tract Infection
by Paula Saz-Leal, Marianne Morris Ligon, Carmen María Diez-Rivero, Diego García-Ayuso, Soumitra Mohanty, Marcos Viñuela, Irene Real-Arévalo, Laura Conejero, Annelie Brauner, José Luis Subiza and Indira Uppugunduri Mysorekar
Vaccines 2024, 12(5), 535; https://doi.org/10.3390/vaccines12050535 - 14 May 2024
Cited by 9 | Viewed by 4628
Abstract
MV140 is an inactivated whole-cell bacterial mucosal vaccine with proven clinical efficacy against recurrent urinary tract infections (UTIs). These infections are primarily caused by uropathogenic E. coli (UPEC) strains, which are unique in their virulence factors and remarkably diverse. MV140 contains a non-UPEC [...] Read more.
MV140 is an inactivated whole-cell bacterial mucosal vaccine with proven clinical efficacy against recurrent urinary tract infections (UTIs). These infections are primarily caused by uropathogenic E. coli (UPEC) strains, which are unique in their virulence factors and remarkably diverse. MV140 contains a non-UPEC strain, suggesting that it may induce an immune response against different UPEC-induced UTIs in patients. To verify this, we experimentally evaluated the cellular and humoral responses to UTI89, a prototypical UPEC strain, in mice vaccinated with MV140, as well as the degree of protection achieved in a UPEC UTI89 model of acute cystitis. The results show that both cellular (Th1/Th17) and antibody (IgG/IgA) responses to UTI89 were induced in MV140-immunized mice. MV140 vaccination resulted in an early increased clearance of UTI89 viable bacteria in the bladder and urine following transurethral infection. This was accompanied by a highly significant increase in CD4+ T cells in the bladder and an increase in urinary neutrophils. Collectively, our results support that MV140 induces cross-reactive humoral and cellular immune responses and cross-protection against UPEC strains. Full article
(This article belongs to the Special Issue Bacterial Vaccine: Mucosal Immunity and Implications)
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16 pages, 3584 KB  
Study Protocol
Chronic E. Coli Drug-Resistant Cystitis Treated with a Sequence of Modulated Extremely Low-Frequency Electromagnetic Fields: A Randomized Study of 148 Cases
by Ivan D’Agostino and F. Marelli
J. Clin. Med. 2024, 13(9), 2639; https://doi.org/10.3390/jcm13092639 - 30 Apr 2024
Cited by 1 | Viewed by 2273
Abstract
(1) Background: This study investigated the effects of sequenced electromagnetic fields, modulated at extremely low frequencies and intensities, in the treatment of drug-resistant Escherichia coli (E. coli)-induced chronic bacterial cystitis. (2) Methods: A total of 148 female participants, aged 18 to [...] Read more.
(1) Background: This study investigated the effects of sequenced electromagnetic fields, modulated at extremely low frequencies and intensities, in the treatment of drug-resistant Escherichia coli (E. coli)-induced chronic bacterial cystitis. (2) Methods: A total of 148 female participants, aged 18 to 80 years diagnosed with chronic bacterial cystitis caused by drug-resistant E. coli, were recruited for this study. Participants were randomly assigned to two groups: an experimental group (n = 74) with osteopathic palpation and assessment treated with a sequence of electromagnetic fields, and a control group (n = 74) receiving a placebo treatment. Both groups were assessed at this study’s outset, 4 weeks after eight applications, and at 12 weeks for symptomatic presentation and laboratory parameters. (3) Results: After 4 weeks of treatment, a significant difference was observed between the two groups regarding D-DIMER levels, IL-6 levels, erythrocyte levels, leukocyte levels, and E. coli levels (p < 0.001). By the 12th week, the experimental group continued to exhibit a significant reduction in the examined parameters compared to the control group (p < 0.001). Additionally, the treatment did not induce any side effects in the patients in the experimental group. (4) Conclusions: Treatment with coherently sequenced electromagnetic fields, modulated at an extremely low frequency and intensity, not only appears to provide an effective alternative for the symptoms of chronic bacterial cystitis caused by drug-resistant E. coli but also demonstrates a potent antibacterial effect. Full article
(This article belongs to the Section Nephrology & Urology)
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Review
A Bird’s-Eye View of the Pathophysiologic Role of the Human Urobiota in Health and Disease: Can We Modulate It?
by Emilio Jirillo, Raffaele Palmirotta, Marica Colella and Luigi Santacroce
Pathophysiology 2024, 31(1), 52-67; https://doi.org/10.3390/pathophysiology31010005 - 1 Feb 2024
Cited by 7 | Viewed by 3860
Abstract
For a long time, urine has been considered sterile in physiological conditions, thanks to the particular structure of the urinary tract and the production of uromodulin or Tamm–Horsfall protein (THP) by it. More recently, thanks to the development and use of new technologies, [...] Read more.
For a long time, urine has been considered sterile in physiological conditions, thanks to the particular structure of the urinary tract and the production of uromodulin or Tamm–Horsfall protein (THP) by it. More recently, thanks to the development and use of new technologies, i.e., next-generation sequencing and expanded urine culture, the identification of a microbial community in the urine, the so-called urobiota, became possible. Major phyla detected in the urine are represented by Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. Particularly, the female urobiota is largely represented by Lactobacillus spp., which are very active against urinary pathogenic Escherichia (E.) coli (UPEC) strains via the generation of lactic acid and hydrogen peroxide. Gut dysbiosis accounts for recurrent urinary tract infections (UTIs), so-called gut–bladder axis syndrome with the formation of intracellular bacterial communities in the course of acute cystitis. However, other chronic urinary tract infections are caused by bacterial strains of intestinal derivation. Monomicrobial and polymicrobial infections account for the outcome of acute and chronic UTIs, even including prostatitis and chronic pelvic pain. E. coli isolates have been shown to be more invasive and resistant to antibiotics. Probiotics, fecal microbial transplantation, phage therapy, antimicrobial peptides, and immune-mediated therapies, even including vaccines for the treatment of UTIs, will be described. Full article
(This article belongs to the Topic Human Anatomy and Pathophysiology, 2nd Volume)
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