Search Results (154)

Precision oncology, also known as personalized oncology or precision medicine, is the tailoring of cancer treatment to individual patients based on the specific genetic, molecular, and other unique characteristics of their tumor. The goal of precision oncology is to optimize the effectiveness of cancer treatment while minimizing toxicities and improving patient outcomes. Precision oncology recognizes that cancer is a highly heterogeneous disease and that each patient’s tumor has a distinct genetic diversity. Precision medicine individualizes therapy by using information from a patient’s tumor in the context of clinical history to determine optimal therapeutic approaches and increasing numbers of drugs target specific tumor alterations. Several targeted therapies with approved companion diagnostics are commercially available, the haves of precision oncology, where predictive biomarkers guide clinical decision-making and improve outcomes. However, many therapies still lack clear biomarkers, the have nots, posing a challenge to fully realizing the promise of precision oncology. Herein, we describe the current state of the art for breast cancer precision oncology and highlight the therapeutic agents that require a more robust biomarker. Full article

Background: Zoonotic influenza viruses pose a significant and evolving public health threat. In response to the recent rise in H5N1 cross-species transmission, the World Health Organization (WHO) R&D Blueprint for Epidemics consultations have prioritized strengthening surveillance, candidate vaccines, diagnostics, and pandemic preparedness. Serological surveillance plays a pivotal role by providing insights into the prevalence and transmission dynamics of influenza viruses. Objective: This scoping review aimed to map the global research landscape on serological surveillance of zoonotic influenza in animals and exposed humans between 2017, the date of the last WHO public health research agenda for influenza review, and 2024, as well as to identify methodological advancements. Methods: Following PRISMA-ScR guidelines, we searched PubMed for English-language peer-reviewed articles published between January 2017 and March 2024. Studies were included if they reported serological surveillance in wild or domestic animals or occupationally exposed human populations, or novel methodologies and their technical limitations and implementation challenges. Results: Out of 7490 screened records, 90 studies from 33 countries, covering 25 animal species, were included. Seroprevalence studies were in domestic poultry and swine. Surveillance in companion animals, wild mammals, and at the human–animal interface was limited. Emerging serological methods included multiplex and nanobody-based assays, though implementation barriers remain. Conclusions: The review is limited by its restriction to one database and English-language articles, lack of quality appraisal, and significant heterogeneity among the included studies. Serological surveillance is a critical but underutilized tool in zoonotic influenza monitoring. Greater integration of serological surveillance into One Health frameworks, especially in high-risk regions and populations, is needed to support early detection and pandemic preparedness. Full article

With the increase in keeping exotic companion mammals as pets, concerns about antimicrobial resistance (AMR) and its impact on animal and human health are growing. Guinea pigs, a popular pet in Hong Kong and globally, have limited studies regarding antimicrobial culture and sensitivity results. We reviewed bacteriologic and antimicrobial sensitivity results from clinically ill pet guinea pigs from 2019 to 2023 using data from the City University Veterinary Diagnostic Laboratory. Of the 234 clinical samples from 22 veterinary clinics in Hong Kong, 134 (57.3%) showed positive bacterial growth, of which 23 (17.2%) showed mixed bacterial growth. In total, 156 bacterial isolates were identified. Gram-positive bacteria (n = 104, 66.7%) were most commonly recovered, representing 25 bacterial species, most commonly Streptococcus spp., Staphylococcus spp., and Corynebacterium spp. The majority of positive samples were from the integument (43.6%) and urinary tract (33.8%). A total of 85.9% of all isolates were resistant to at least one antimicrobial agent, with over 40% of isolates exhibiting resistance to three or more antimicrobial agents, and 27.6% were multidrug resistant (resistant to at least one agent in three or more antimicrobial classes). High resistance rates were observed for penicillin (45.6%), gentamicin (43.7%), doxycycline (42.1%), and azithromycin (36.3%). In contrast, isolates were highly susceptible to ceftazidime (84.1%), chloramphenicol (82.6%), ciprofloxacin (72.7%), and marbofloxacin (72.2%). These findings highlight the high frequency of AMR in this population of clinically ill pet guinea pigs in Hong Kong and the need for informed and judicious antimicrobial use. Full article

Immunoglobulin Y (IgY), the major antibody class in birds, has gained increasing attention in recent years as a versatile and ethically sustainable alternative to mammalian immunoglobulins. IgY has demonstrated strong potential in diagnostics, prophylaxis, and therapy across a wide range of fields, including infectious diseases, allergy management, oral health, and food safety. Its applications in animal health—particularly in poultry, livestock, and companion animals—further underscore its relevance within the One Health framework. This review provides a comprehensive synthesis of IgY technology, starting with its physiological role in maternal immunity and the structural characteristics that distinguish it from mammalian immunoglobulin G (IgG). This review outlines current strategies for IgY production and purification. It also provides an overview of its biomedical and veterinary applications, including its use in diagnostics, prevention, and treatment—such as for SARS-CoV-2—primarily based on studies published in the past five years. The final section addresses the current limitations of IgY technology, such as variability in protocols, stability challenges, and the need for safety assessment, while highlighting the importance of harmonized guidelines to support broader implementation. With growing scientific interest, expanding clinical research, and increasing availability of commercial products, IgY is well positioned to become a valuable immunobiological tool for both human and veterinary applications. Full article

Toxoplasma gondii, a pathogen of significant concern in animal production, companion animal health, and public health, particularly affects immunocompromised individuals and pregnant women. Current diagnostic techniques employ both direct and indirect methods, with serological assays widely used for detecting T. gondii infections in humans and animals. In this study, the TIM-barrel structure of Br2 β-glucosidase was engineered to create 10 chimeric multi-epitope proteins for T. gondii serological detection. Indirect ELISA screening identified three promising candidate proteins, V4Z, SFF, and S7V-V4Z-SFF, with sensitivities ranging from 71–86% and specificities ranging from 68–76%. Among these, ELISA-V4Z achieved the highest concordance with the reference IFAT method (Kappa = 0.58, 95% CI = 0.32–0.84) and demonstrated a moderate positive predictive value (PPV, 67%) and strong negative predictive value (NPV, 90%). These results suggest that the V4Z chimeric protein demonstrated the strongest performance among the tested candidates for T. gondii detection, exhibiting the highest sensitivity and specificity along with moderate agreement with the reference IFAT. However, its overall diagnostic performance remains limited. These findings highlight the need for further refinement and validation to enhance its diagnostic potential and assess its applicability for broader serological testing. Full article

Pancreatic ductal adenocarcinoma (PDAC) presents significant challenges in diagnosis, prevention, and treatment. Predictive biomarkers offer the potential to revolutionize clinical management, particularly in the preoperative setting, but their implementation requires careful consideration of ethical implications. This scoping review analyzes the ethical landscape of using immunohistochemistry (IHC) for molecular subtyping in PDAC, focusing on its utility, accessibility, and potential impact on patient care. We conducted a systematic literature search in the PubMed, Scopus and Google Scholar databases (2015–2025) using COVIDENCE, which identified 130 references. Of these, 79 were reviewed in a full-text format, and 9 ultimately met the inclusion criteria for our analysis. IHC offers several advantages as a companion diagnostic tool. It is relatively inexpensive, widely available in most pathology laboratories, and can be readily integrated into existing clinical workflows. This contrasts with more complex molecular subtyping methods, such as gene expression profiling, which can be costly, require specialized equipment and expertise, and may not be readily accessible in all clinical settings. Furthermore, accurate analysis of gene expression requires the localized targeting of individual cells; therefore, digesting the sample for bulk analysis would be less informative than using spatial localization techniques such as IHC. Because biomarker regulation can occur at the level of transcription or translation, protein-level assessment via IHC is often more accurate than mRNA analysis. Standardized IHC protocols for biomarker assessment are therefore essential for translating the molecular subtyping of PDAC into clinically actionable treatment strategies, especially for aggressive subtypes like basal-like tumors. This readily deployable IHC-based approach can optimize therapy selection, maximizing patient benefits and minimizing exposure to ineffective and potentially toxic treatments. This review critically analyzes the ethical dimensions of this method, grounded in the principles of autonomy, beneficence, non-maleficence, and justice. The review urges the medical community to fully utilize the potential of IHC-driven molecular subtyping to improve outcomes in PDAC, while ensuring equitable and responsible access to the benefits of precision oncology for all patients. Full article

Background: FLT3 mutation testing is a key ancillary molecular assay for diagnosing and managing patients with acute myeloid leukemia (AML), including assessing the utility of FLT3 inhibitors during induction chemotherapy. FLT3 PCR utilizing fluorescently labeled primers and capillary electrophoresis readout is the most used technique for the rapid detection of FLT3 internal tandem duplications (ITDs) (including very small ITDs) and tyrosine kinase domain (TKD) mutations. However, capillary electrophoresis (CE) is a relatively lengthy and technically demanding result readout mode that could potentially be replaced by faster alternatives. Methods: Here, we describe the validation of a modified FLT3 PCR assay that uses the Agilent 4200 TapeStation platform for result readouts. This platform generates quantifiable electropherograms and gel images in under two minutes and at a low cost. We validated its ability to detect FLT3-ITD and -TKD mutations using 22 and 18 previously tested patient samples, respectively. Results: The TapeStation 4200 instrument is 100% sensitive, specific, and highly reproducible for post-PCR fragment analysis in detecting FLT3-ITD (greater than 15 bp in size) and TKD mutations in AML patients. Its results are nearly 100% concordant with those obtained from our previously validated NGS and PAGE methods. However, the limitation of this readout mode is its inability to reliably detect FLT3-ITDs smaller than 15 bp in size. Conclusions: Given the widespread use of TapeStation instruments in molecular diagnostics laboratories as part of next-generation sequencing (NGS) workflows, this modified assay is well-suited as a companion test for rapid NGS platforms to detect larger FLT3-ITDs, which are NGS often miscalledor under-called by the NGS bioinformatics algorithms. However, it is not suitable for use as a standalone assay, as it is unable to reliably detect very short FLT3-ITDs. Full article

Folate receptor alpha (FRα), a glycosylphosphatidylinositol-anchored glycoprotein encoded by the FOLR1 gene, plays a crucial role in folate transport during cell growth and development. While minimally expressed in most normal adult tissues, FRα is frequently overexpressed in several epithelial malignancies, particularly in high-grade serous ovarian carcinoma. An immunohistochemical (IHC) evaluation of FRα expression using the VENTANA FOLR1 (FOLR1-2.1) RxDx Assay is now approved as a companion diagnostic for selecting patients eligible for mirvetuximab soravtansine, an FRα-targeted antibody–drug conjugate. Clinical trials such as SORAYA and MIRASOL have demonstrated significant clinical benefit in platinum-resistant epithelial ovarian cancer patients with high FRα expression (≥75% of tumor cells with moderate to strong membrane staining). This review summarizes the biological significance of FRα in ovarian cancer progression, its predictive value for targeted therapy, and the technical aspects of IHC assessment, including scoring interpretation and pre-analytical variables. We also discuss heterogeneity in FRα expression across histological subtypes and tumor sites, as well as the impact of archival versus fresh tissue. Understanding FRα expression patterns across histologic subtypes and tissue samples is critical for optimizing clinical decision-making and expanding the role of FRα-targeted therapies in gynecologic oncology. Full article

Inflammatory bowel disease (IBD) in animals, a multifactorial gastrointestinal disorder marked by chronic inflammation, has increasingly been linked to Clostridioides difficile infections. Recognized for its pathogenic role in human pseudomembranous colitis, C. difficile is now emerging as a critical agent in veterinary medicine, particularly in livestock (e.g., cattle, pigs), companion animals (dogs, cats), and wildlife. Over the past five years, evidence has highlighted its association with IBD-like syndromes in animals, driven by toxin-mediated mechanisms (TcdA/TcdB), antibiotic-induced dysbiosis, and environmental spore transmission. This opinion article synthesizes recent findings on C. difficile’s zoonotic potential, diagnostic ambiguities (e.g., distinguishing colonization from active infection), and therapeutic challenges, including antibiotic resistance. We emphasize the urgent need for integrated One Health strategies to mitigate risks to animal and human health, advocating for improved surveillance, novel therapies, and interdisciplinary research. Full article

Systemic arterial hypertension (SAH), characterised by a persistent increase in BP beyond the reference values for the species, is a concerning and detrimental clinical condition. The aim of this manuscript is to present the state of the art on SAH in companion animals, including the different types of hypertension, diagnostic and therapeutic approaches, and the factors associated with its occurrence, such as the role of stress. It also discusses the benefits and challenges related to the measurement process. SAH is categorised into types based on the underlying cause: situational, secondary, and idiopathic (the least frequently observed). The situational type occurs when stress is the primary factor, such as during veterinary visits, contact with other animals, or in cases of ‘white coat syndrome’. If the stressor is removed, BP values tend to normalise. The most common type of SAH is the secondary form, which is associated with an underlying condition, such as renal, cardiac, endocrine, or neurological diseases, or a combination of these. Diagnosing SAH is a challenging task for many veterinarians due to factors related to handling the animal, managing the equipment, and interpreting the results. Consequently, many professionals either take inaccurate measurements or misinterpret the results, often prescribing antihypertensive medications prematurely or unnecessarily. Despite being a well-standardised and well-documented process, challenges persist. Treatment often involves antihypertensive drugs, either alone or in combination, alongside management of the underlying causes, when present. Therefore, BP values should be obtained correctly, with clinical-therapeutic decisions carefully aligned with the factors that may influence them. Full article

This retrospective study investigated the clinical presentation, diagnostic findings, and treatment outcomes in 419 backyard (pet) chickens admitted to the Service for Avian and Reptiles at the University of Veterinary Medicine Vienna from 1 May 2009 to 30 April 2019. The median age of the chickens was 1.5 years, with 83.8% being female. The majority (80.0%) presented with individual clinical issues, while 20.0% were diagnosed with flock diseases. The most common admission causes included unspecific clinical signs (57.3%), respiratory tract issues (18.4%), and locomotor problems (16.2%). Diagnostic imaging modalities such as ultrasonography, radiography, and CT scans revealed pathologies, including ascites, salpingitis, and skeletal system abnormalities. Parasitological examinations found a high rate of coccidia, Capillaria, and Ascaridia, while microbiological analysis identified Escherichia coli and Pasteurella multocida as common bacterial pathogens. The most prevalent diseases were upper respiratory tract infections (13.8%), egg peritonitis (9.9%), and soft tissue trauma (9.4%). Treatment outcomes showed that 67.5% survived to discharge, while 32.2% died or were euthanized. Surgical interventions were performed in 25.3% of cases, with the most common surgeries being salpingohysterectomy and wound debridement. This study highlights the wide range of health issues faced by pet chickens and emphasizes the importance of accurate diagnosis and targeted treatment in avian veterinary care. It also underscores the role of various diagnostic tools, such as imaging, pathogen detection, and histopathology, in addressing the health challenges of backyard chickens. Full article

Rapid and accurate detection of the causes of gastrointestinal diseases in farmed and companion animals is crucial for advancing livestock farming and safeguarding public health safety. Diseases caused by pathogenic bacteria infections often result in the overrepresentation of pathogens in the gut microbiota; however, gut microbiota dysbiosis without obvious pathogen overrepresentation can also lead to disorders such as inflammatory bowel disease (IBD). Traditional cultivation-based diagnostic methods are time-consuming and ineffective in identifying microbiota dysbiosis-associated diseases. In this study, we developed a sample-to-answer MinION full-length 16S rDNA sequencing analysis pipeline, accompanied by detailed bioinformatics scripts, for the rapid diagnosis of animal gastrointestinal diseases. The pipeline enables the detection of pathogens and microbiota dysbiosis-associated diseases in approximately six hours. The pipeline showed high sensitivity and specificity, as evident by the analysis of artificially contaminated samples, and accurately diagnosed bacterial infections in five cases, including chicken, duckling, and piglet samples from their respective farms, as well as a companion cat, outperforming traditional methods. It also rapidly identified IBD in five companion animals. The findings highlight the potential application of our developed sample-to-answer analysis pipeline in pathogen detection and the diagnosis of gut microbiota dysbiosis-related diseases in animals, thereby improving livestock health and public safety. Full article

Background: The close relationship between humans and petsraises health concerns due to the potential transmission of antimicrobial-resistant (AMR) bacteria and genes. Bacterial otitis is an emerging health problem in dogs, given its widespread prevalence and impact on animal welfare. Early detection of resistance is vital in veterinary medicine to anticipate future treatment challenges. Objective: This study aimed to determine the prevalence of AMR bacteria involved in 12,498 cases of otitis in dogs from the Iberian Peninsula and the evolution of AMR patterns over an 11-year period. Methods: Data was provided by the Veterinary Medicine Department of a large private diagnostic laboratory in Barcelona. Antimicrobial susceptibility testing was performed using the standard disk diffusion method and minimum inhibitory concentration (MIC) testing. Results: The frequency of the principal bacterial agents was 35% Staphylococcus spp. (principally S. pseudointermedius), 20% Pseudomonas spp. (P. aeruginosa), 13% Streptococcus spp. (S. canis), and 11% Enterobacterales (Escherichia coli and Proteus mirabilis). Antimicrobial susceptibility testing revealed P. aeruginosa (among Gram-negatives) and Enterococcus faecalis (among Gram-positives) as the species with the highest AMR to multiple antimicrobial classes throughout the years. According to the frequency and time evolution of multidrug resistance (MDR), Gram-negative bacteria like P. mirabilis (33%) and E. coli (25%) presented higher MDR rates compared to Gram-positive strains like Corynebacterium (7%) and Enterococcus (5%). The AMR evolution also showed an increase in resistance patterns in Proteus spp. to doxycycline and Streptococcus spp. to amikacin. Conclusions: This information can be useful for clinicians, particularly in this region, to make rational antimicrobial use decisions, especially when empirical treatment is common in companion animal veterinary medicine. In summary, improving treatment guidelines is a key strategy for safeguarding both animal and human health, reinforcing the One Health approach. Full article

Polymerase chain reaction (PCR) chips are advanced, microfluidic platforms that have revolutionized biomarker discovery and validation because of their high sensitivity, specificity, and throughput levels. These chips miniaturize traditional PCR processes for the speed and precision of nucleic acid biomarker detection relevant to advancing drug development. Biomarkers, which are useful in helping to explain disease mechanisms, patient stratification, and therapeutic monitoring, are hard to identify and validate due to the complexity of biological systems and the limitations of traditional techniques. The challenges to which PCR chips respond include high-throughput capabilities coupled with real-time quantitative analysis, enabling researchers to identify novel biomarkers with greater accuracy and reproducibility. More recent design improvements of PCR chips have further expanded their functionality to also include digital and multiplex PCR technologies. Digital PCR chips are ideal for quantifying rare biomarkers, which is essential in oncology and infectious disease research. In contrast, multiplex PCR chips enable simultaneous analysis of multiple targets, therefore simplifying biomarker validation. Furthermore, single-cell PCR chips have made it possible to detect biomarkers at unprecedented resolution, hence revealing heterogeneity within cell populations. PCR chips are transforming drug development, enabling target identification, patient stratification, and therapeutic efficacy assessment. They play a major role in the development of companion diagnostics and, therefore, pave the way for personalized medicine, ensuring that the right patient receives the right treatment. While this tremendously promising technology has exhibited many challenges regarding its scalability, integration with other omics technologies, and conformity with regulatory requirements, many still prevail. Future breakthroughs in chip manufacturing, the integration of artificial intelligence, and multi-omics applications will further expand PCR chip capabilities. PCR chips will not only be important for the acceleration of drug discovery and development but also in raising the bar in improving patient outcomes and, hence, global health care as these technologies continue to mature. Full article

Background: New safety concerns about targeted anticancer agents (TAAs) often emerge in the first few years after their initial regulatory approval. Our aim was to determine whether new serious and potentially fatal adverse drug reactions (ADRs) continue to emerge in the updated drug labels of TAAs several years after their initial regulatory approval and whether their emergence can be predicted. Methods: The updated drug labels of TAAs approved by the U.S. Food and Drug Administration before July 2013 were analyzed. Serious and potentially fatal ADRs were identified in the Warnings & Precautions (WPs) and Boxed Warnings (BWs) sections of the updated drug labels. Generalized linear mixed models were used to examine the associations between the number of adverse drug reactions and time, drug type (small molecules vs. monoclonal antibodies), and the availability of companion diagnostics for biomarkers. Results: Among 37 eligible TAAs, 25 (68%) were small molecules and 11 (30%) had available companion diagnostics for the biomarkers. Time was a significant predictor of new WPs (p ˂ 0.001) and BWs (p = 0.008). The updated drug labels of the small molecules received significantly more new WPs (p = 0.042) as compared to monoclonal antibodies. The availability of the companion diagnostics for the biomarkers did not have an impact on the emergence of new ADRs. Conclusions: New serious ADRs of TAAs continue to emerge in updated drug labels several years after their initial regulatory approval. Oncologists, regulators, and payers should be aware of the changing risk–benefit ratios of approved TAAs. Full article