Search Results (522)

Dientamoeba fragilis is a protozoan of the human digestive tract, yet its transmission and pathogenic role remain poorly understood. This study aimed to evaluate its impact on the efficacy and safety of fecal microbiota transplantation (FMT) in treating recurrent Clostridioides difficile infection (rCDI). This longitudinal cohort study analyzed stool samples from FMT donors and recipients pre-treatment and at 2 and 8 weeks post-FMT. All samples were retrospectively tested using real-time PCR. Shotgun metagenomics was also performed on selected donor–recipient pairs to explore transmission. CDI cure rates, gastrointestinal adverse events (AEs), and serious adverse events (SAEs) were assessed prospectively. A total of 53 FMT were analyzed (179 samples), with 23 (43%) derived from D. fragilis-positive donor stool (4 of 10 donors, 40%). Four of 52 recipients (18.2%), initially negative and who received treatment from positive donors, tested positive post-FMT. Shotgun metagenomics could not definitely confirm transmission due to the lack of a good reference genome. No significant differences in efficacy, AE, or SAE were observed between FMT from D. fragilis-positive versus -negative donors, even in immunocompromised patients. No SAEs were attributed to FMT. D. fragilis may be transmitted via FMT without evidence of short-term clinical impact. Consequently, RT-PCR detection should be interpreted cautiously in the context of donor exclusion decisions. Full article

Background: This study seeks to evaluate the 23 year experience of the İnonu University Liver Transplantation Institute from a public health perspective by examining demographic patterns, etiological factors, and transplantation trends between 2002 and 2025. Aims: This analysis aims to provide insights into the epidemiological landscape of liver transplantation in Türkiye from a public health perspective. Methods: In this retrospective cross sectional study, we analyzed 4011 liver transplant procedures performed between March 2002 and March 2025. Recipient demographics, disease etiologies, donor characteristics, and patients geographic distribution were assessed to delineate regional health needs and service utilization patterns. Results: A total of 4011 patients were included. The cohort comprised 2618 males (65.3%) and 1393 females (34.7%). Recipients were classified as adult (n = 3232, 80.9%) or pediatric (n = 779, 19.1%). Among adults, infectious etiologies were the most prevalent (35.5%), followed by cryptogenic liver cirrhosis (24.7%). In contrast, pediatric patients most commonly presented with toxic etiologies (29.4%), metabolic disorders (22.6%) and bile duct diseases (15.9%). Most liver transplantations were performed using living donors (n = 3481, 86.8%), while deceased donors accounted for 530 procedures (13.2%). Additionally, 244 living donor liver transplantations were performed via liver paired exchange (LPE). Conclusions: These findings may inform resource allocation, health policy development, and the optimization of transplantation services. This center-based model offers a useful framework for characterizing regional health needs and strengthening community health, particularly through prevention, screening, and early intervention strategies for liver diseases. Full article

Background/Objectives: Blood donation is essential to health systems and represents a valuable epidemiological model for studying physiological adaptation to controlled blood loss. Regular blood donors constitute a distinct, health-screened population whose biological responses offer unique insight into mechanisms of resilience and key determinants of population health. Hypoxia-inducible factor 1-alpha (HIF-1α) is a key regulator of erythropoiesis and cellular response to hypoxia, and its modulation following blood donation may inform donor safety and the sustainability of blood donation programs. This study aimed to characterize the sociodemographic, lifestyle, and anthropometric profiles of blood donors in relation to hematopoietic biomarkers (vitamin B12 and folic acid) and to evaluate changes in serum HIF-1α concentration after donation, emphasizing the public health relevance of voluntary blood donation. Methods: A cross-sectional study was conducted among 324 voluntary blood donors (159 regular and 165 occasional). Serum HIF-1α was measured before and 30 min after donation, together with vitamin B12 and folic acid levels. Sociodemographic and lifestyle characteristics (physical activity, smoking, dietary habits) were collected through standardized questionnaires (EHIS-3, FFQ), and anthropometric parameters were assessed. Results: Regular donors were older and predominantly male, with comparable socioeconomic indicators between groups. Both regular and occasional donors showed favorable lifestyle profiles, including low smoking prevalence and moderate physical activity. Skinfold thickness was significantly greater in regular donors (p < 0.001). The main biological finding was a robust post-donation increase in HIF-1α concentrations (≈80%, p < 0.001), independent of donation frequency or lifestyle. No significant associations were found between lifestyle factors and vitamin B12 or folate levels. Conclusions: Blood donation induces a rapid elevation in HIF-1α, reflecting activation of hypoxia-responsive pathways and short-term hematopoietic adaptation. Beyond its biomedical relevance, voluntary blood donation represents a meaningful epidemiological and public health model for studying physiological resilience and the health benefits of altruistic behavior. These findings underscore the importance of donor surveillance and motivation as components of broader preventive health and health equity strategies. Full article

Background/Objectives: Living donor liver transplantation (LDLT) has emerged as an alternative to deceased donor liver transplantation (DDLT) in the circumstance of scarcity of deceased grafts. This systematic review and meta-analysis aims to compare outcomes between LDLT and DDLT in adult recipients. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A systematic literature search was performed using PubMed, EMBASE, and manual reference screening of relevant articles. We included peer-reviewed cohort studies comparing LDLT and DDLT in adult patients (≥18 years), published in English since 2015. Results: A total of 17 cohort studies, published between 2015 and 2024, fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. These studies included a total of 22,514 adult liver transplant recipients, of whom 3832 (17.02%) and 18,682 (82.98%) underwent LDLT and DDLT, respectively. In comparison with DDLT, LDLT was associated with better 1-year patient survival, 5-year patient survival, and 5-year graft survival; however, these findings are based on low-certainty evidence and may be influenced by selection bias and baseline differences between cohorts. There were no significant differences between LDLT and DDLT groups in 3-year patient survival, 1-year graft survival, re-transplantation rates, biliary leakage, biliary stricture, or infection rates. Conclusions: LDLT is a valuable alternative to DDLT, particularly in regions with limited access to deceased donor organs, as it provides an excellent alternative to DDLT without compromising recipient outcomes, though further high-quality studies are needed. Full article

The immunoregulatory effects of probiotics have been widely studied, particularly in maintaining immune balance. Conventional in vitro functional screening of probiotics relies on fresh donor-derived primary immune cells, which often exhibit significant inter-individual and temporal variability, limiting reproducibility and interpretation. As an alternative, human-induced pluripotent stem cell (iPSC)-derived dendritic cells were co-cultured with five probiotic strains in the current study to evaluate their immunomodulatory interactions. To assess whether cytokines produced by probiotic-stimulated dendritic cells can influence T cell differentiation, human CD4⁺ T cells were exposed to the conditioned medium derived from co-cultures. Enzyme-linked immunosorbent assay results demonstrated that iPSC-derived dendritic cells secreted cytokines at distinct concentrations in response to different probiotic strains, suggesting that these cells can distinguish between different microbial stimuli, and supporting their use in functional probiotic screening. Among the five strains tested, Lactiplantibacillus plantarum LPA-56, Limosilactobacillus reuteri RU-23, and Lactobacillus fermentum Fem-99 induced cytokine production levels that promoted the differentiation of the human CD4⁺ T cells into regulatory T cells. These findings demonstrate that iPSC-derived dendritic cells have immunomodulatory potential, are reliable for in vitro screening of probiotics, and offer a promising strategy for selecting potent immunoregulatory probiotic candidates. Full article

Technological advancements in blood donor screening have significantly improved blood safety. However, certain testing challenges and limitations continue to face blood banks in donor screening for the hepatitis B virus, resulting in occasional cases of transfusion transmission. These cases are mostly related to donors presenting within the window period and donors with occult hepatitis B infection. There are several other challenges that professionals in transfusion medicine, infectious diseases, gastroenterology, and public health must be aware of. Maintaining the highest test sensitivity is a key parameter for enhancing blood safety, and the review describes current recommendations in this regard, along with relevant advancements. The diversity of viral genotypes and the potential for mutations affecting the surface antigen may negatively affect the performance of both serologic and nucleic acid tests. Serologic tests may also be affected by several interferences, endogenous or exogenous to the sample. A clear understanding of these challenges is necessary to create effective policies and procedures and to properly manage atypical cases. Full article

Vector-borne parasites might be transmitted through transfusion, notably Plasmodium spp. and Trypanosoma cruzi. Prevention strategies include blood donor screening, deferral, and blood unit treatment by pathogen inactivation methods. At the end of 2015, in line with European guidelines, Italian legislation introduced a questionnaire to identify donors at risk and their screening by serological methods. In early 2016, the Laboratory of Parasitology at Pisa University Hospital started the serological analysis of donors at risk, referring to Transfusion Services located in northwestern Tuscany. The aim of the present study was to describe the prevalence of seropositive donors observed during 8 years of screening. Donors at risk of transmitting malaria were screened by ELISA (Enzyme Linked Immunosorbent Assay). The DRG ELISA kit was employed until 2020, when it was substituted by the Euroimmun ELISA kit based on the results of a comparative evaluation of available commercial kits. Seropositive donors were offered the possibility of Plasmodium DNA testing by Loop-Mediated AMPlification (LAMP) to exclude current infection. Donors at risk of transmitting Chagas disease were screened by ICT employing recombinant antigen until 2021, when it was substituted by ELISA employing lysate antigen because of its higher accuracy. Seropositive donors were further tested by CLIA, and WB was performed in case of discordant results, according to WHO guidelines for diagnosis of chronic Chagas disease. A total of 3754 donors were tested for anti-Plasmodium antibodies, revealing a 6.8% (95% CI = 6.1–7.7%) seroprevalence. Seropositivity was higher among donors from Sub-Saharan Africa (42.9%; 95% CI = 36.1–49.9%) and Southeast Asia (10.6%; 95% CI = 6.7–16.4%). A lower seropositivity was observed when employing Euroimmun ELISA (4.8; 95% CI = 3.8–5.9%) than DRG ELISA (8.2%; 95% CI = 7.1–9.3%). Seropositivity dropped to 3.6% (95% CI = 2.4–5.6) in 2020, likely because of travel restrictions during the COVID-19 pandemic. None of the tested seropositive donors (n = 20) tested positive for Plasmodium DNA LAMP testing. A high proportion of seroreversion was observed after one year of testing. Among 4285 donors tested for anti-T. cruzi antibodies seroprevalence was 0.7% (95% CI = 0.5–1.1%), a higher value than what was observed in a recent national survey. All seropositive donors were born in Europe or Latin America. Seropositivity was apparently lower with ELISA (0.5%, 95% CI = 0.2–1.2%) than ICT (0.8%, 95% CI = 0.6–1.2%), possibly due to ELISA’s higher specificity, although the difference is not significant. No confirmed cases of chronic Chagas disease were identified. The study emphasizes the importance of defining the serological test employed for screening and the need to confirm seropositive results with further testing. The high seroreversion observed in the study suggests repeating seropositive donor screening after a year to minimize deferral and blood unit loss. Full article

Background: 8-Quinolinol and its derivatives are drawing significant attention across various disciplines due to their remarkable versatility. These compounds are well-known for their exceptional chelating ability, forming stable metal complexes via their nitrogen and oxygen electron donor atoms. This main characteristic determines their broad utility. Biological activity can also be explained by the chelating capacity, which allows 8-quinolinol to bind to essential metal ions such as Fe, Zn, Cu, and others. This chelation disrupts metal-dependent biological processes in target cells or organisms, leading to a range of effects, including antimicrobial, anticancer, antifungal, and neuroprotective activities. On the other hand, the biological activity of pyrazole derivatives is attributed to their heterocyclic structure, which allows for interactions with biological targets that can lead to enzyme inhibition, receptor antagonism, radical scavenging, and other effects. Objective: This work aimed to synthesize and characterize novel diazene compounds derived from 8-quinolinol or 2-methyl-8-quinolinol and pyrazole amines, and to evaluate their antimicrobial and anticancer activities. Methods: The compounds have been synthesized by coupling diazonium salts obtained from the diazotization of heterocyclic amines with 8-quinolinol and its derivative, 2-methyl-8-quinolinol. The careful selection of reaction conditions enabled the synthesis of high-purity products. The compounds were characterized by 1D and 2D NMR, FT-IR spectroscopy, UV-Vis spectroscopy, and LC-HRMS analysis. The biological activity of the newly synthesized compounds was evaluated following the protocols of EU-OPENSCREEN, a European Research Infrastructure Consortium (ERIC) initiative dedicated to supporting early drug discovery. Results: By combining diazonium salts obtained from 3-methyl-1H-pyrazol-5-amine and ethyl 5-amino-3-methyl-1H-pyrazole-4-carboxylate with the aforementioned coupling agents, four novel 8-quinolinol derivatives were synthesized. The further hydrolysis of the ethoxy carbonyl functional group allowed its conversion to a carboxylic functional group, thus expanding the series of new compounds to six members. Several compounds from the series have proven to be biologically active against several human pathogenic microorganisms and the Hep-G2 cancer cell line. Conclusions: The combination of two well-known biologically active scaffolds through a classic diazo coupling reaction allowed the synthesis of novel biologically active compounds, which showed promising results as possible antifungal and anticancer agents. These results represent a foundation for future studies, which will include a broader biological screening and in vivo studies. Full article

This study applied a guided culturomics workflow to isolate and characterize gut-associated yeasts as probiotic candidates. Culture conditions were optimized using Dixon agar and Modified Schädler Agar with a moderate antibiotic cocktail (colistin, chloramphenicol, vancomycin) to suppress bacteria without impairing yeast growth, combined with incubation at 37 °C under anaerobic conditions to mimic the intestinal environment. From three healthy donors, 305 isolates were recovered (MSA: 193; Dixon: 112). After excluding pseudohyphal morphotypes and PCR positive Candida isolates, 127 non-Candida strains remained. Safety screening (hemolysis, DNase, coagulase) reduced the pool to 26 safe isolates. Simulated gastrointestinal stress tests showed that 20 out of 26 exhibited at least 50 percent survival under pH 2.0 or 0.5% bile salts. Functional assays revealed strain-specific antimicrobial activity against Staphylococcus aureus, Escherichia coli including O157:H7 and Salmonella species, with several isolates (Y6, Y22, Y42, Y48, Y55, Y56, Y73, Y105, Y127) showing broad and strong inhibition. Two isolates Y44 and Y55 further demonstrated robust bile and acid tolerance (>50% survivability) in both conditions. All isolates displayed intracellular but not extracellular bile salt hydrolase activity, indicating a viability dependent cholesterol lowering potential. Overall, the workflow minimized bacterial interference while enriching for safe and functional yeasts. Full article

At the beginning of the COVID-19 pandemic, SARS-CoV-2-positive donors were not considered eligible for organ donation. The Italian National Transplant Centre has gradually introduced measures to prevent donor-to-recipient transmission of SARS-CoV-2 infection through organ transplantation. The current national screening protocol for deceased SARS-CoV-2-positive donors recommends molecular testing of donor lower respiratory tract (LRT) samples, graft biopsies and organ perfusion fluids. The aim of the study is to describe the 3-year experience of protocol application in a northern region of Italy. From 1 January 2022 to 31 January 2025, a total of 132 samples were analyzed (29 liver biopsies, 35 kidney biopsies, 68 perfusion fluids) from 40 organ donors with an active or resolved SARS-CoV-2 infection. SARS-CoV-2 PCR on LRT samples was positive in 26/40 (65%) donors, negative in 11/40 (27.5%) cases and in the remaining 3 (7.5%) the PCR result was unknown. Overall, 65 organs were transplanted into 60 recipients. All processed graft biopsies and organ perfusion fluid samples tested negative for SARS-CoV-2 RNA. Our data suggest that the utilization of non-lung donors with resolved or active SARS-CoV-2 infections who died of other causes appears justified and safe. Full article

Background/Objectives: Understanding blood group antigen distribution is essential for transfusion safety and preventing alloimmunization in transfused patients. The ABO, RH1, and Kell blood group systems are among the most clinically significant due to their high immunogenic potential and their role in hemolytic transfusion reactions and hemolytic disease of the newborn. Despite their clinical significance, data on the phenotypic frequency of these samples in southern Chile are limited. This study aimed to identify the distribution of ABO, RH1, and Kell blood group systems among blood donors at the Centro de Sangre Concepción, adding regional data to the national transfusion medicine records. Methods: A retrospective, descriptive analysis was conducted using data from 59,318 blood donations collected in 2024 by the Concepción Blood Center, part of the Southern Transfusion Medicine Macronetwork in Chile. Blood typing for the ABO, RH1, and Kell antigen (KEL1) typing was performed in accordance with national regulations established by the Ministry of Health (MINSAL). Results: Blood group O was the most frequent (61.3%), followed by A (27.8%), B (9.0%), and AB (1.9%). RH1 positivity was observed in 94.47% of donors, and Kell positivity in 4.24%. The distribution of Kell phenotypes was comparable between men (4.38%) and women (4.11%), with the highest frequency in donors aged 27–52 years. Conclusions: The phenotypic distribution observed reflects national patterns and shows the genetic makeup of southern Chile. The low but important prevalence of Kell-positive donors emphasizes the need for systematic Kell antigen screening to prevent alloimmunization and improve transfusion safety. Full article

Background and Objectives: Transfusion-transmitted infections (TTIs) impose a considerable healthcare burden globally. Despite rigorous screening protocols, these infections can still be present among apparently healthy blood donors, potentially compromising the safety of transfusion recipients. Understanding the frequency of TTIs among blood donors is crucial for ensuring a healthy blood supply and gaining insights into the epidemiology of these infections within a community. Materials and Methods: The main objective of this study is to determine the frequency of TTIs among healthy blood donors, aged 18 to 60 years, at King Abdulaziz Hospital in Makkah City, Saudi Arabia. Data was collected retrospectively at the blood bank center from 1 January 2023, to 31 December 2023. Results: There were 8831 blood donors included. Saudi participants emerged as the dominant nationality, comprising 57% of the total sample (5036 out of 8831 donors). The prevalence of TTIs among blood donors varied according to the individual markers used. The overall TTI reactivity rates were low. Anti-HBc was the most common TTI-positive marker (7.5%), followed by syphilis (0.5%), HBV NAT (0.3%), HBsAg, and anti-HCV (0.3%). On the other hand, the lowest TTI-positive markers were HIV-1/-P2 and HTLV-1/-2 (0.04%). In Saudi participants, the most prevalent TTI marker was anti-HBc with a rate of 5.8% (293 out of 5036), followed by HBsAg (0.3%), syphilis (0.3%), and HBV NAT (0.2%). Conclusions: The present study found that HBV outperformed other TTI markers compared to the regional reports. However, in our research and the earlier reports, the rates of seropositive patients were noticeably low for HIV, HTLV, and malaria, while the rate for syphilis was higher, particularly among non-Saudi donors. NAT assays are crucial for screening blood donations for TTIs, which can help the early detection of infections and significantly reduce serological window periods. For a precise estimation of the frequency of TTIs, large prospective multicenter studies from various regions of the KSA are required. Full article

Polyextremophilic microbial communities of Baikal Rift Zone hot springs have been studied fragmentarily, and these studies have typically focused on either phototrophic microbial mats or on the whole microbial community from one or a few sites. In our work, we conducted the first large-scale screening of microbial communities from seven hot spring groups in the Baikal Rift Zone, using metabarcoding of the V3-V4 regions of the 16S rRNA gene. Analysis of alpha and beta diversity, as well as co-occurrence network analysis, revealed that the microbial diversity of the studied springs is highly dependent on temperature values. This approach allowed classifying microbial communities into four distinct groups, characterized by significantly different taxa representing the key functional roles of primary producers, heterotrophic consumers, and terminal destructors of organic matter. Sulfate-reducing bacteria constituted a major metabolic group driving the final stage of organic matter mineralization. Moreover, the presence of alkalithermophilic dissimilatory iron reducers, whose existence was debatable, was proved in the studied samples by cultural methods. The phylotypes that gained an advantage on selective media with synthesized ferrihydrite and hydrogen or acetate added as an electron donor belonged to the genus Parvivirga of the order Anaerosomatales and several unknown representatives of the phylum Bacillota. Full article

Background/Objectives: Late diagnosis hampers effective treatment of non-small cell lung cancer (NSCLC). This study evaluated whether circulating microRNAs (miRs), miR-155 and miR-3196, measured in liquid biopsy peripheral blood mononuclear cells (PBMCs), can serve as potential non-invasive biomarkers for NSCLC diagnosis, patient stratification, therapy monitoring, and prognosis. Methods: RNA was isolated from PBMCs of 136 NSCLC patients and 64 healthy donors. RT–qPCR quantified miR expression in PBMCs after predefined QC filtering: miR-155-3p (NSCLC n = 63; controls n = 28), miR-3196 (NSCLC n = 55; controls n = 28), and miR-155-5p (NSCLC n = 23; controls n = 12). Diagnostic performance was assessed using receiver operating characteristic (ROC) analyses, reporting area under the curve (AUC), and threshold-dependent sensitivity/specificity. Survival was analyzed with Kaplan–Meier/Cox methods. Associations with clinicopathological variables (stage, metastasis, smoking, EGFR, and KRAS status), treatment response (chemotherapy, immunotherapy, TKIs), and survival outcomes were examined. Results: miR-155-3p was upregulated in NSCLC, whereas miR-3196 was downregulated relative to controls; AUCs were 0.881 and 0.784, respectively. At high-sensitivity operating points, specificity was lower (≈29–30%), consistent with PBMC miRs reflecting both immune activation and tumor burden. In adenocarcinoma, miR-155-3p was associated with advanced stage, metastatic disease and smoking history. miR-3196 aligned with features of metastatic progression. During systemic therapy (chemotherapy, immunotherapy, TKIs), circulating levels of both miRs tended to normalize. Notably, normalization of miR-155-3p levels was associated with improved overall survival, supporting its prognostic value and utility for treatment monitoring. Conclusions: Circulating miR-155-3p and miR-3196 in PBMCs are promising screening/monitoring non-invasive candidates rather than stand-alone NSCLC diagnostics at current thresholds. Combining these miRs with additional biomarkers and/or clinical covariates and tuning decision thresholds may enhance specificity for diagnostic use. While preliminary, these findings warrant validation in large, prospective studies with standardized protocols to enable clinical implementation. Full article

Background/Objectives: Serological and molecular screening for Hepatitis B virus (HBV) has been essential in reducing the risk of transfusion-transmitted infection, particularly in regions of high endemicity. This retrospective study aimed to analyze the epidemiological profile and laboratory outcomes of 259 blood donors deemed ineligible after initial reactive or inconclusive screening for HBV markers. Methods: Donors were summoned for revaluation at the HEMOPA Foundation, in Belém, Pará, between February 2015 and July 2016. Demographic data, risk factors, and results for HBsAg, anti-HBc, anti-HBs, and HBV DNA obtained at the donation and return time points were collected. Results: The mean age was 37 ± 11.25 years, with a predominance of males (56.8%) and first-time donors (76%). At the return time point, 63.7% presented a profile indicative of resolved HBV infection and 3.5% of active infection, 6.6% were susceptible to HBV infection, and 1.9% presented vaccine-induced HBV immunity. Cases of Occult Hepatitis B Infection (OBI, 0.4%) and Window Period (WP, 0.4%) were also identified. Conclusions: The findings reveal a high prevalence of resolved HBV infection among ineligible donors, particularly first-time donors, and reinforce the importance of combined serological and molecular screening, as well as the need for vaccination and health education strategies for at-risk populations. As a public blood bank located in the Amazon region, we highlight that local epidemiological specificities must be considered in the formulation of public health policies that are sensitive to the regional context. Full article