Search Results (1,622)

Background: Anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive interstitial lung disease (ILD) is associated with high mortality. While inflammatory markers have been linked to poor outcomes, clinical heterogeneity remains evident, as some patients survive despite marked hyperinflammation. Methods: We retrospectively analyzed consecutive patients with anti-MDA5 antibody-positive ILD treated at our institution between May 2017 and November 2025. In-hospital mortality was assessed in relation to clinical characteristics and laboratory markers, including peak anti-MDA5 antibody titers, ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH), and KL-6. Analyses were exploratory and hypothesis-generating. Continuous variables were compared using Mann–Whitney U tests, and categorical variables using Fisher’s exact test. Principal component analysis (PCA) and receiver operating characteristic (ROC) analyses were performed for descriptive purposes. Results: Seventeen patients were included (10 survivors and 7 non-survivors). Peak ferritin, C-reactive protein (CRP), and lactate dehydrogenase (LDH) levels were significantly higher in non-survivors, whereas peak anti-MDA5 antibody titers showed a non-significant trend toward higher values in non-survivors (p = 0.057). KL-6 levels did not differ significantly between groups. In ROC analyses, LDH and CRP showed the highest discriminative performance for in-hospital mortality, followed by ferritin, whereas KL-6 showed the lowest discriminative performance. Despite these overall trends, substantial overlap between survivors and non-survivors remained across all biomarkers. Principal component analysis (PCA) demonstrated partial separation of outcomes along an inflammation-dominant axis, but with persistent overlap, indicating marked outcome heterogeneity. Conclusions: Inflammatory biomarkers, particularly LDH, CRP, and ferritin, were associated with in-hospital mortality in anti-MDA5 antibody-associated ILD. However, persistent overlap between survivors and non-survivors suggests that single-biomarker assessment is insufficient for precise prognostication. These findings should be interpreted as hypothesis-generating and require validation in larger multicenter cohorts. Full article

X-ray crystallography is still the most widely used and versatile method for structural studies of biological macromolecules. This study concerns the application of nanogels to facilitate protein crystallization, a prerequisite for X-ray crystallography. Nanogels (NGs) are nano-sized, highly crosslinked polymeric particles that have been extensively studied for chemical catalysis and drug delivery but not for protein crystal nucleation. The efficacy of six types of nanogels (three N-isopropylacrylamide-based and three acrylamide-based) was tested, with promising results. They were subsequently functionalised with active hydroxyl groups for further testing. Both functionalised and non-functionalised nanogels were tested on model (trypsin, thaumatin, proteinase K, ferritin and catalase) and target proteins (glulisine, α-crustacyanin and acriflavine resistance protein subunit AcrB) using both manual and automated techniques. All nanogels were found to be effective in promoting protein crystallization in both screening and optimization trials, giving crystal ‘hits’ that would have otherwise been missed. Overall, the functionalised nanogels were more effective. Nanogel effects are proposed to be due to a combination of surface porosity and surface chemistry. Full article

This case-control study investigated the association between polymorphisms in the dedicator of cytokinesis 2 (DOCK2) gene and susceptibility to COVID-19 in a Mexican population. Methods: Genotyping of five single-nucleotide polymorphisms (SNPs) in the DOCK2 gene (rs9307 A/G, rs1045176 G/T, rs1045168 C/T, rs2112703 A/C, and rs2287727 A/C) was performed using TaqMan assays in 248 COVID-19 patients and 288 healthy controls. Results: No significant differences were observed in the allelic or genotypic distributions of rs1045176 G/T and rs2287727 A/C between cases and controls. However, under multiple genetic inheritance models (co-dominant, dominant, recessive, heterozygous, and additive), the rs9307 A, rs1045168 C, and rs2112703 A alleles were significantly associated with a reduced risk of COVID-19 (p < 0.05). Furthermore, sub-analyses stratified by genotype in COVID-19 patients revealed that the rs9307 AA, rs1045168 CC, and rs2112703 AA genotypes correlated with altered plasma concentrations of lactic acid dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and ferritin. Conclusions: The DOCK2 SNPs rs9307 A/G, rs1045168 C/T, and rs2112703 A/C are associated with decreased susceptibility to COVID-19 in this population and influence plasma levels of LDH, ALT, AST, and ferritin, suggesting a potential role in disease pathogenesis and severity. Full article

Background/Objectives: Previous cross-sectional studies investigated the associations of low handgrip strength (HS), a primary indicator of probable sarcopenia (PS), with biomarkers related to anemia. However, existing evidence is inconsistent, and data establishing causality remain limited. The present prospective study aimed to evaluate whether serum vitamin B12, folate, homocysteine (Hcy), and ferritin levels are associated with PS risk. Methods: This study analyzed data from 1930 adults aged 45–76 years who had normal muscle quantity at baseline. Serum biomarkers were assessed at baseline and PS defined by low HS was determined at 6-year follow-up. The modified Poisson regression method was employed to calculate multivariable risk ratios (RRs) and 95% confidence intervals (CIs). Results: Among all participants, PS risk was inversely related to serum vitamin B12 levels (p = 0.06), while it was lowest in the high-normal ranges of serum Hcy (12.1–15 μmol/L) and ferritin (101–200 ng/mL) levels. The RRs (95% CIs) for PS risk were 0.73 (0.60, 0.89) and 0.75 (0.64, 0.87) for high-normal Hcy and ferritin categories, respectively, compared with the lowest category. On examining the associations of elevated Hcy and ferritin levels with PS risk, age was identified as a significant modifier for elevated Hcy levels (>15 μmol/L) (p for interaction < 0.05); a reduced risk was observed in younger participants, whereas an increased risk was noted in older participants. Conclusions: These findings suggest that high-normal ferritin levels may be optimal for alleviating PS risk, irrespective of age, and that elevated Hcy levels could be detrimental for older adults in preventing PS risk. Full article

Dysregulated iron handling—including catalytic iron and ferroptosis, hepcidin–ferroportin signaling, ferritin dynamics, and neutrophil gelatinase-associated lipocalin (NGAL)-mediated siderophore transport—has been implicated in the initiation and propagation of acute kidney injury (AKI) across ischemia–reperfusion, sepsis, and nephrotoxic contexts. To provide a SANRA-aligned narrative synthesis of mechanistic and translational evidence on iron biology in AKI, clarifying biomarker readiness and therapeutic prospects while explicitly separating preclinical from human findings. PubMed, Scopus, and Web of Science (1 January 2000 to 30 September 2025), plus appraised grey literature (guidelines/registries) using predefined criteria (authority, update recency, and methodological transparency). Narrative review with comprehensive database searches, single-reviewer screening/extraction (acknowledged as a limitation), and qualitative synthesis. Evidence is organized by pathway (catalytic iron/ferroptosis, transferrin (Tf)/transferrin receptor (/TfR), ferritin/ferritin heavy chain (FtH), hepcidin–ferroportin and NGAL) and translational domain (biomarkers and therapeutics). Statements are tagged as [Preclinical] or [Human]. [Preclinical] Robust signals support roles for catalytic iron and ferroptosis, protection by iron chelation, hepcidin modulation, heme oxygenase 1 (HO-1)/FtH induction, and apotransferrin/NGAL-based strategies. [Human] Biomarkers such as NGAL show clinical utility for kidney injury detection, whereas catalytic iron assays (labile plasma iron [LPI]/bleomycin-detectable iron [BDI]) remain investigational with limited standardization. Observational links between iron-regulatory pathways and AKI risk exist, but interventional trials are sparse; dose, timing, and safety of iron-targeted strategies in defined AKI settings remain to be established. Iron-handling pathways are compelling targets for AKI prevention/mitigation, yet high-quality human trials are limited. Priorities include standardized catalytic-iron assays, biomarker-guided enrichment, and pragmatic trials of tractable interventions (e.g., peri-contrast or cardiopulmonary bypass settings). Until such evidence accumulates, recommendations beyond standard care should be avoided. Full article

Obesity is characterized by low-grade systemic inflammation and alterations in gut-related immune pathways that may contribute to metabolic dysfunction. Composite biomarker indices may better capture these complex processes than individual markers, although their performance may differ across biological domains. In this cross-sectional study, 88 adults without diabetes or infection were categorized as BMI < 25 kg/m² (n = 20), BMI 25–29.9 kg/m² (n = 34), or BMI ≥ 30 kg/m² (n = 34). Circulating biomarkers reflecting systemic inflammation (high-sensitivity C-reactive protein, ferritin, interleukin-6, presepsin) and intestinal barrier-related activity (β-defensin-2, regenerating islet-derived protein 3 alpha) were measured and subsequently combined into two composite indices: the Inflammatory Load Index, derived from inflammatory markers, and the Barrier Activation Index, derived from barrier-related markers. Group differences were assessed using analysis of variance with post hoc testing. Additional analyses included effect size estimation, receiver operating characteristic (ROC) analysis, and logistic regression. Individual biomarkers showed limited differences across BMI categories. The Inflammatory Load Index differed significantly across BMI categories (p = 0.040), with higher values observed in individuals with BMI ≥ 30 kg/m² compared with those with BMI 25–29.9 kg/m² (p = 0.032; Cohen’s d = 0.80), while the Barrier Activation Index did not differ (p = 0.257). In ROC analysis, the Inflammatory Load Index discriminated BMI ≥ 30 kg/m² with an area under the curve of 0.720 (95% confidence interval 0.576–0.851), yielding 77.8% sensitivity and 67.7% specificity. Each one standard deviation increase in the index was associated with higher odds of obesity (odds ratio 2.34, 95% confidence interval 1.22–4.49; p = 0.011). In conclusion, a composite inflammatory biomarker index, but not a barrier-related index, differentiates degrees of BMI in individuals without diabetes. These findings support integrated biomarker approaches for reflecting obesity-related biological burden beyond single markers. However, these observations are based on cross-sectional data and do not imply causality. Full article

Heart failure (HF) is frequently associated with iron deficiency and anemia, negatively impacting patient outcomes. This study aimed to investigate the contribution of genetic variation in iron metabolism-related genes to biochemical and hematological phenotypes in HF. An HF population of 182 patients with functional iron deficiency (ID) and anemia was stratified by sex and heart failure subtype, including HF with reduced ejection fraction (HFrEF) and HF with non-reduced ejection fraction (HFnrEF). Genetic variants in HFE (rs1799945), SLC40A1 (rs1439816, rs2304704), and TMPRSS6 (rs855791) were evaluated. Variants in HFE and SLC40A1 were associated with differences in serum iron, ferritin, transferrin saturation, hemoglobin, and RDW. The phenotypic impact of these variants was modulated by sex and heart failure subtype, highlighting the influence of iron availability, inflammatory burden, and erythropoietic demand. In contrast, no significant associations were observed for the TMPRSS6 variant. In conclusion, genetic variation in key regulators of iron metabolism contributes to the heterogeneity of iron-related biochemical and hematological phenotypes in HF. These findings emphasize the interplay between genetic background, sex, and heart failure physiology and support the relevance of personalized approaches to iron assessment and management in heart failure. Full article

Background: Brucellosis is a globally distributed zoonotic disease characterized by highly variable clinical manifestations that may mimic systemic autoimmune and inflammatory disorders. In Europe, where the incidence of brucellosis is relatively low, limited clinical awareness may contribute to delayed diagnosis and inappropriate management. In addition to zoonotic transmission, Brucella species are a well-recognized cause of laboratory-acquired infections (LAIs) among microbiology laboratory personnel. Methods: We report a case of laboratory-acquired Brucella abortus infection in a young woman presenting with undulant fever, arthralgia, systemic inflammation, elevated ferritin levels, and antinuclear antibody (ANA) positivity. Microbiological confirmation was achieved through serological testing (ELISA), repeat blood cultures, species-specific quantitative PCR, and whole-genome sequencing (WGS) followed by core genome multilocus sequence typing (cgMLST). Results: Initial laboratory evaluation revealed elevated C-reactive protein, mildly increased ferritin levels (146 ng/mL), abnormal liver enzyme levels, and rising ANA titers (from 1:160 to 1:320), raising suspicion of a systemic autoimmune disorder and prompting consideration of corticosteroid therapy. Although the initial blood culture was negative, subsequent molecular diagnostics and repeat cultures confirmed B. abortus infection. Epidemiological investigation suggested a possible occupational exposure in a diagnostic microbiology laboratory, consistent with a laboratory-acquired infection. Genomic analysis classified the isolate as sequence type 1 (ST1) and demonstrated zero allelic differences compared with the ST1 reference strain. Targeted antimicrobial therapy resulted in complete clinical recovery, supporting an infection-triggered immune response rather than primary autoimmunity. Conclusions: Acute brucellosis should be considered in the differential diagnosis of febrile syndromes accompanied by autoimmune-like laboratory abnormalities, even in low-incidence regions. This case highlights the diagnostic challenges posed by laboratory-acquired brucellosis and underscores the importance of early microbiological investigation and strict biosafety awareness in laboratory settings. Full article

We evaluated the interplay between systemic total antioxidant capacity (TAC), oxidative stress (OS) (lipid hydroperoxides), inflammation, iron status, and oral contraception (OC) use in 182 healthy 23-year-old women (76 OC-users, and 106 non-OC-users). In all women, blood TAC (FORD units) values were significantly inversely associated with OS (FORT units), high-sensitivity C-reactive protein (hsCRP), and transferrin; and positively associated with transferrin saturation (TfS%). No significant associations were observed for hemoglobin, hematocrit, red blood cells, serum iron, soluble transferrin receptor (sTfR), sTfR/log(ferritin) ratio (sTfR-F index), ferritin, folate, uric acid, or creatinine. OS hydroperoxides were positively associated with hsCRP and transferrin, and inversely associated with TfS%. sTfR was positively correlated with hydroperoxides in non-OC-users and with folate in all women and non-OC-users, but was not associated with hsCRP in any group. The combined abnormal condition of low TAC and elevated OS (n = 71) was significantly more frequent among OC-users (OR = 39.0), women with hsCRP ≥ 3 mg L⁻¹ (OR = 10.1), transferrin ≥ 330 mg dL⁻¹ (OR = 6.58), and smokers (OR = 3.76). OC use modulated the TAC/OS balance and inflammation. Low TAC and elevated OS may impact health status. Enhanced TAC/OS knowledge may increase awareness of effects of OC use among fertile-age women. Ferritin was independent of TAC/OS status and OC use, supporting its reliability as an iron biomarker. Full article

Background/Objectives: This study aimed to investigate the impact of allergic diseases (AD) or obstructive sleep apnea (OSA) risk, as a host factor, on the development of severe Mycoplasma pneumoniae Pneumonia (SMPP) in children by analyzing the clinical data of pediatric patients with Mycoplasma pneumoniae Pneumonia (MPP). Methods: This retrospective study enrolled children hospitalized with Mycoplasma pneumoniae pneumonia (MPP) at Shanghai Ninth People’s Hospital from November 2024 to November 2025. Patients were classified into severe (SMPP) and mild (MMPP) groups. Demographic, clinical, laboratory, and questionnaire data were collected and compared between groups. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of SMPP and construct a nomogram. The model was validated for discrimination, calibration, and clinical utility using ROC curves, calibration plots, and decision curve analysis, with internal validation by bootstrap resampling. Results: Among the 150 enrolled children with MPP, 35 (23.3%) were classified as severe (SMPP) and 115 (76.7%) as mild (MMPP). Patients with SMPP exhibited significantly higher frequencies of allergic diseases, prolonged fever and steroid use, elevated inflammatory markers (CRP, LDH, D-dimer, ferritin, ALT), and higher PSQ and RQLQ scores (all p < 0.05). Disease severity was positively correlated with these clinical, laboratory, and questionnaire-based parameters. Multivariate logistic regression identified allergic diseases, PSQ score, LDH, and ferritin as independent predictors of SMPP. A nomogram incorporating these four factors demonstrated good predictive performance, with an internally validated C-index of 0.827, satisfactory calibration (Hosmer–Lemeshow p = 0.116), and clinical utility within a 0–25% threshold probability range on decision curve analysis. Conclusions: Children with MPP and comorbid AD or OSA risk are more likely to develop SMPP. Among children aged 6–12 years, RQLQ score is positively correlated with the severity of MPP. AD, PSQ score, LDH, and ferritin are independent risk factors for SMPP. Clinicians should be alert to the development of SMPP when children with MPP present with a history of AD, PSQ score >3.5, LDH >327.50 U/L, or ferritin >120.05 ng/mL. The visual nomogram model constructed by combining these risk factors demonstrates improved predictive performance for SMPP, with high predictive efficacy and accuracy. It has great clinical value and can be used for individualized risk assessment and early intervention. However, our proposed nomogram requires external validation prior to broader implementation. Full article

Background: Test descriptions from major diagnostic manufacturers do not include ferritin reference intervals (RIs) for individuals aged 60 and older. The absence of older adults-specific RIs contrasts with the widespread use of serum ferritin testing in older adults. We aimed to establish and verify RIs using two common analytical methods. Methods: For this study, 1467 older adults were prospectively enrolled and monitored for morbidity and mortality, and exclusion criteria were applied. Ferritin was measured using chemiluminescent microparticle immunoassay (CMIA) and transferred to an electrochemiluminescence immunoassay (ECLIA) using method comparison. RIs were evaluated using a direct method with a prospective observational study based on healthy individuals according to the Clinical and Laboratory Standards Institute (CLSI) 28-A3c guideline and compared with RIs obtained using an indirect approach based on data obtained in clinical routine outpatients, where normal and abnormal values are supposed to be statistically differentiated to determine RIs. When applied within a countrywide population-based setting in Liechtenstein, the impact of novel RIs on the frequency of abnormal values was analyzed. Results: A total of 386 men and 532 women were included in the direct RI determination. Women (W) had significantly lower ferritin levels than men (M), while age over the age of 60 years had no significant association with ferritin in men and women. RIs were 23–241 ng/mL (W) and 19–396 ng/mL (M) for CMIA and 27–293 ng/mL (W) and 23–480 ng/mL (M) for ECLIA. These RIs are higher than those mentioned in the test descriptions in both tests. In comparison, the indirect method for both assays showed comparably lower reference limits, whereas upper reference limits were only approximately similar. The prevalence of high abnormal ferritin levels was considerably lower with this study’s RIs compared with manufacturer RIs. Conclusions: Employing older adults-specific RIs in clinical routine seems to be advisable. This reduces the frequency of abnormal high values in comparison with the widely applied practice of extrapolating RIs obtained from younger age groups to older adults and therefore leads to fewer follow-up investigations. Full article

Fish oil (FO) has been shown to confer beneficial effects on hepatic diseases in both humans and animals. This study aimed to investigate whether dietary fish oil (FO) supplementation alleviates deoxynivalenol (DON)-induced liver injury by modulating the ferroptosis signaling pathway in weaned piglets. Twenty-four weaned piglets were allocated to a 2 × 2 factorial design, with the main factors consisting of dietary treatment (5% corn oil or 5% FO supplementation) and DON exposure (basal diet or diet contaminated with 4 mg/kg DON). After 21 days of dietary treatment, piglets were euthanized for collection of blood and liver samples. Dietary FO significantly attenuated DON-induced hepatic structural damage and inflammatory infiltration. Specifically, FO supplementation reduced the activities of aspartate transaminase (AST) and alkaline phosphatase (ALP), as well as the AST/alanine aminotransferase (ALT) ratio following DON exposure. Dietary FO also decreased malondialdehyde (MDA) concentrations in both the liver and serum, lowered hepatic 4-hydroxynonenal (4-HNE) level and Fe²⁺ content, and increased hepatic glutathione (GSH) content. Moreover, dietary FO ameliorated ultrastructural liver damage induced by DON. Furthermore, DON significantly downregulated the mRNA levels of multiple genes associated with iron metabolism and ferroptosis, including heat shock protein beta-1 (HSPB1), acyl-CoA synthetase long chain family member 4 (ACSL4), and arachidonate 15-lipoxygenase (ALOX15), and upregulated the mRNA levels of transferrin (TF), ferritin heavy chain (FTH), solute carrier family 7 member 11 (SLC7A11), and transferrin receptor 1 (TFR1). Dietary FO counteracted these alterations by decreasing the mRNA of SLC7A11, TFR1, FTH, and TF after DON exposure. Finally, FO significantly decreased the protein expression of SLC7A11, iron-responsive element-binding protein 2 (IREB2), and FHT1 and increased the GPX4 protein expression following DON exposure. These findings suggest that FO may ameliorate DON-induced liver injury in weaned piglets, possibly through suppressing the ferroptosis signaling pathway. Full article

Background and aim: Celiac disease (CD) is a systemic autoimmune disorder triggered by gluten ingestion, and the only effective treatment is strict adherence to a gluten-free diet (GFD). Many factors, including limited dietary diversity and poor adherence, are associated with an increased risk of specific micronutrient deficiencies and malnutrition. This study aims to evaluate the relationship between adherence to GFD, celiac antibody levels, micronutrient levels, and nutritional status in children with CD. Methods: This retrospective study was conducted on 402 children aged 2–18 years with a diagnosis of CD confirmed positive by anti-tTG IgA and duodenal biopsy, all of whom had been on GFD for at least six months. Demographic, anthropometric, clinical, serological, and biochemical data (including hemogram, serum iron, ferritin, vitamin D, folate, and B12 levels), and GFD adherence were collected from medical records. Results: Most individuals are girls (64.9%), with a mean age of 10.6 ± 4.20 years. Chronic malnutrition was observed in 29.4% of patients. Acute malnutrition was identified in 27.8% of children, and wasting was observed in 6.7%. Iron deficiency anemia was the most frequently encountered micronutrient deficiency among the patients (23.9%). The prevalence of stunting was significantly higher among individuals with positive tTG-IgA levels and poor adherence to the GFD. Conclusions: Poor adherence to the GFD and positive tTG-IgA levels were associated with higher rates of stunting, underlining the need for individualized dietary follow-up and regular monitoring of both nutritional status and serological response in children with CD. Full article

Background: Iron overload and its associated complications are major concerns in patients with transfusion-dependent β-thalassaemia (TDT). Iron chelation is an important part of TDT therapy with monotherapy or dual iron chelation being the most commonly used strategies. Evidence regarding the efficacy and safety of triple iron chelation therapy remains limited. Case presentation: We present the case of a 21-year-old immigrant from the Middle East with TDT and a history of irregular transfusion management without chelation therapy, leading to clinically significant iron overload. She was successfully treated with the combination of deferoxamine, deferasirox and deferiprone over a course of 8 years. Triple chelation therapy led to sustained reductions in serum ferritin levels and improvement in hepatic and cardiac iron burden on follow-up MRI, with good tolerability. Conclusions: This case highlights the potential role of triple iron chelation therapy as a therapeutic strategy in TDT patients with severe iron overload. Further studies are needed to establish optimal dosing, eligible patients and long-term safety. Full article

The responsiveness of the stress axis is fundamental for maintaining health and sustaining productive performance; however, the effect of modulating this stress axis with bovine appeasing substance and its effects on biochemical, immunological, oxidative parameters and uterine involution have not been determined, which are the objectives of this experiment. To elucidate these questions, Holstein cows, from the prepartum to lactation period in a cross-ventilation system, received an application of a bovine appeasing substance (treated group) and a 0.9% saline solution (control group) at the time of calving, and blood samples were collected on calving day and on days 3, 7, 14 and 21 postpartum for analysis. Modulation of the stress axis by bovine appeasing substance increased magnesium levels on days 7 and 14 postpartum, with a reduction in fructosamine levels on days 3, 7, 14, and 21 postpartum. A reduction in ferritin levels, an acute-phase protein, and a reduction in interleukin 1 beta and interleukin 6 were also observed, demonstrating an anti-inflammatory effect in cows of the treated group. Creatine kinase activity decreased on day 21 postpartum in cows treated with bovine appeasing substances. An increase in cholinesterase activity on day 7 and a marked decrease on day 21 postpartum in treated cows were observed compared to the control. This was accompanied by a reduction in beta-hydroxybutyrate levels on day 7 and a reduction in reactive oxygen species levels on day 14 in animals of the treated group, indicating modulation of ketogenesis and reduced oxidation through an anti-inflammatory effect. Mean uterine thickness was also affected by the bovine appeasing substance, with a lower mean thickness on day 21 postpartum in treated cows. Modulation of the stress axis by the bovine appeasing substance reduces inflammation, improving energy dynamics and reducing oxidation, thus facilitating tissue repair associated with postpartum uterine involution in dairy cows. Full article