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Review Article Open Access
Natural Killer Cell Cellular-based Therapeutic Options to Manage Acute Myeloid Leukemia: Prospects and Challenges
Ogochukwu O. Izuegbuna
Published online August 2, 2024
Oncology Advances. doi:10.14218/OnA.2024.00013
Abstract
Over the past decade, significant progress has been made in managing acute myeloid leukemia (AML). However, refractory disease and relapse continue to pose major challenges. These [...] Read more.

Over the past decade, significant progress has been made in managing acute myeloid leukemia (AML). However, refractory disease and relapse continue to pose major challenges. These issues highlight the need for innovative therapeutic options to achieve deeper remission and effectively treat refractory and relapsed diseases, thereby improving survival rates. Natural killer (NK) cell-based therapies have emerged as a promising option. NK cells, a specialized population of innate lymphoid cells, exhibit inherent anti-viral and anti-cancer capabilities. Unlike T cells, NK cells do not require prior antigen sensitization to eliminate their target cells, enhancing their potential as immunotherapeutic agents. However, NK cells often exhibit dysfunction in patients with hematological malignancies. Revitalizing these cells represent another immunotherapeutic strategy. Various NK cell-based therapies have been explored in recent decades, particularly in managing AML. These therapies include chimeric antigen receptor-NK cell therapy, bispecific and trispecific NK cell engagers (bi-specific killer cell engager (BiKEs) and tri-specific killer cell engager (TriKEs), and cytokine-induced memory-like NK cells. These therapies are also associated with fewer adverse events, such as neurotoxicity. Despite their potential for clinical cancer management, challenges such as the in vivo expansion of NK cells remain unresolved. This review summarizes the biology of NK cells and the diverse NK cell-based therapies being developed for the potential management of AML, as evidenced in preclinical studies and clinical trials.

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Review Article Open Access
Metabolic Dysregulation and Metabolite Imbalances in Acute-on-chronic Liver Failure: Impact on Immune Status
Danmei Zhang, Chunxia Shi, Yukun Wang, Jin Guo, Zuojiong Gong
Published online September 19, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00203
Abstract
Liver failure encompasses a range of severe clinical syndromes resulting from the deterioration of liver function, triggered by factors both within and outside the liver. While [...] Read more.

Liver failure encompasses a range of severe clinical syndromes resulting from the deterioration of liver function, triggered by factors both within and outside the liver. While the definition of acute-on-chronic liver failure (ACLF) may vary by region, it is universally recognized for its association with multiorgan failure, a robust inflammatory response, and high short-term mortality rates. Recent advances in metabolomics have provided insights into energy metabolism and metabolite alterations specific to ACLF. Additionally, immunometabolism is increasingly acknowledged as a pivotal mechanism in regulating immune cell functions. Therefore, understanding the energy metabolism pathways involved in ACLF and investigating how metabolite imbalances affect immune cell functionality are crucial for developing effective treatment strategies for ACLF. This review methodically examined the immune and metabolic states of ACLF patients and elucidated how alterations in metabolites impact immune functions, offering novel perspectives for immune regulation and therapeutic management of liver failure.

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Original Article Open Access
Helicobacter pylori Infection and Risk of Cardia Gastric Cancer in Asian Countries: A Systematic Review and Meta-analysis
Yinnan Zhu, Yuan Ding, Qiliu Qian, Wanyue Zhang, Qingxia Wang, Ruihua Shi
Published online September 25, 2024
Cancer Screening and Prevention. doi:10.14218/CSP.2024.00016
Abstract
The incidence of cardia gastric cancer (CGC) is rising worldwide, particularly in East Asia. There has been a debate over whether Helicobacter pylori (H. pylori) constitutes a risk [...] Read more.

The incidence of cardia gastric cancer (CGC) is rising worldwide, particularly in East Asia. There has been a debate over whether Helicobacter pylori (H. pylori) constitutes a risk factor for CGC. This study aimed to evaluate the relative risk of H. pylori infection and CGC in Asian countries.

Relevant studies examining H. pylori and CGC were searched in PubMed, Embase, and Web of Science from their inception to June 30, 2024. Either a random-effect model or a fixed-effect model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Sensitivity analyses and assessments of publication bias were performed. The stability of results was evaluated in cases where publication bias was detected.

A total of 24 studies were included in the meta-analysis. A significant association between H. pylori and CGC was observed (OR = 2.20, 95% CI 1.73–2.80). In a subgroup analysis of different countries, a significant association was observed in East Asian countries, including China (OR = 2.12, 95% CI 1.63–2.77), Japan (OR = 2.21, 95% CI 1.16–4.20), and Korea (OR = 2.36, 95% CI 1.58–3.54), but not in Iran (OR = 1.48, 95% CI 0.77–2.84). The pooled OR from five prospective cohort studies revealed a strong association between H. pylori and CGC (OR = 2.32, 95% CI 1.47–3.66).

East Asia bears a significant burden of H. pylori-related CGC. A clear association between H. pylori infection and CGC was observed in this region.

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Review Article Open Access
Study on the Ideas and Methods of Bloodletting Therapy in the Treatment of Heat Stroke
Yining Li, Chengxiang Zhou, Tao Liu, Qiuling Xu
Published online September 6, 2024
Future Integrative Medicine. doi:10.14218/FIM.2023.00088S
Abstract
In recent years, global warming has led to regionally high temperatures, causing lasting and extreme impacts in some areas of China. Cases of heat stroke and even fatalities have [...] Read more.

In recent years, global warming has led to regionally high temperatures, causing lasting and extreme impacts in some areas of China. Cases of heat stroke and even fatalities have been seen in many parts of the country. Traditional Chinese medicine considers heat stroke to be a type of summerheat stroke, which belongs to the extreme heat of the Yang. Bloodletting therapy is a classical treatment in traditional Chinese medicine. Bloodletting involves puncturing certain acupoints or small epidermal veins to release a small amount of blood to dredge the channel and clear heat-fire, thus lowering a patient’s body temperature. Therefore, studying bloodletting therapy as a treatment for heat stroke has significance. Here, we analyzed the core acupoint prescriptions and the application characteristics of bloodletting therapy for the treatment of heat stroke. Our review provides a basis for the selection of acupoints and treatment methods for the clinical use of bloodletting therapy for heat stroke.

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Review Article Open Access
Mechanisms of Immune Evasion and Novel Treatments for Relapsed and Refractory Diffuse Large B-cell Lymphoma
Kamen W. Kossow, Joseph G. Bennett, Marc S. Hoffmann
Published online June 25, 2024
Oncology Advances. doi:10.14218/OnA.2024.00006
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of aggressive B-cell non-Hodgkin lymphoma. While a substantial fraction of patients are cured with frontline chemoimmunotherapy, [...] Read more.

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of aggressive B-cell non-Hodgkin lymphoma. While a substantial fraction of patients are cured with frontline chemoimmunotherapy, approximately 30% of cases subsequently relapse. DLBCL immune evasion and refractory disease can occur via several mechanisms: downregulation or loss of major histocompatibility complex expression, immune checkpoint activation, tumor microenvironment modulation, and resistance to apoptosis. Addressing these mechanisms of immune evasion in DLBCL has been a focus of ongoing research, leading to the exploration of new therapies. Here, we review the mechanisms of immune evasion and novel immunotherapy treatment strategies for DLBCL.

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Mini Review Open Access
The Current Status and Prospects of Early Diagnosis and Treatment of Esophageal Cancer in China
Yuan Ding, Lihua Ren, Yaqi Geng, Chenge Fu, Ruihua Shi
Published online June 25, 2024
Cancer Screening and Prevention. doi:10.14218/CSP.2024.00012
Abstract
Esophageal cancer is one of the most common malignant tumors in the digestive tract in China. Due to late diagnosis and rapid progression, it leads to a poor survival prognosis. [...] Read more.

Esophageal cancer is one of the most common malignant tumors in the digestive tract in China. Due to late diagnosis and rapid progression, it leads to a poor survival prognosis. Early diagnosis and treatment are crucial for improving the prognosis of esophageal cancer. Implementing simple and efficient screening methods is more in line with China’s healthcare economics and national conditions. This article mainly introduces the current status of esophageal cancer screening and new technologies for esophageal cancer screening in China, including endoscopic technology, biomarker detection, exhaled breath detection, and artificial intelligence assisted screening, and looks ahead to its future development trends.

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Guideline Open Access
Chinese Guidelines on the Management of Hepatic Encephalopathy in Cirrhosis (2024)
Xiaoyuan Xu, Huiguo Ding, Wengang Li, Ying Han, Yujuan Guan, Jinghang Xu, Yifan Han, Jidong Jia, Lai Wei, Zhongping Duan, Yuemin Nan, Hui Zhuang, Chinese Society of Hepatology, Chinese Medical Association
Published online February 17, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00484
Abstract
With progress in basic and clinical research on hepatic encephalopathy in cirrhosis worldwide, the Chinese Society of Hepatology of the Chinese Medical Association has invited experts [...] Read more.

With progress in basic and clinical research on hepatic encephalopathy in cirrhosis worldwide, the Chinese Society of Hepatology of the Chinese Medical Association has invited experts in relevant fields to revise the 2018 “Chinese Guidelines on the Management of Hepatic Encephalopathy in Cirrhosis.” The updated guidelines provide recommendations for the clinical diagnosis, treatment, and both primary and secondary prevention of hepatic encephalopathy in cirrhosis.

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Original Article Open Access
Risk of Coronary Artery Disease in Patients with Liver Cirrhosis: A Systematic Review and Meta-analysis
Chunru Gu, Liyan Dong, Lu Chai, Zhenhua Tong, Fangbo Gao, Walter Ageno, Fernando Gomes Romeiro, Xingshun Qi
Published online November 21, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00226
Abstract
Coronary artery disease (CAD) is increasingly observed in patients with liver cirrhosis. However, data on the incidence and prevalence of CAD in cirrhotic patients are heterogeneous, [...] Read more.

Coronary artery disease (CAD) is increasingly observed in patients with liver cirrhosis. However, data on the incidence and prevalence of CAD in cirrhotic patients are heterogeneous, and the association remains uncertain. In this study, we aimed to conduct a systematic review and meta-analysis to address these issues.

PubMed, EMBASE, and Cochrane Library databases were searched. Incidence, prevalence, and factors associated with CAD were pooled using a random-effects model. Risk ratio (RR) and odds ratio (OR), with their 95% confidence interval (CI), were calculated to evaluate differences in CAD incidence and prevalence between patients with and without liver cirrhosis.

Fifty-one studies were included. The pooled incidences of CAD, acute coronary syndromes, and myocardial infarction (MI) were 2.28%, 2.02%, and 1.80%, respectively. Liver cirrhosis was not significantly associated with CAD incidence (RR = 0.77; 95% CI = 0.46–1.28) or MI (RR = 0.87; 95% CI = 0.49–1.57). The pooled prevalence of CAD, acute coronary syndromes, and MI was 18.87%, 12.54%, and 6.12%, respectively. Liver cirrhosis was not significantly associated with CAD prevalence (OR = 1.29; 95% CI = 0.83–2.01) or MI (OR = 0.58; 95% CI = 0.28–1.22). Non-alcoholic steatohepatitis, hepatitis C virus, advanced age, male sex, diabetes mellitus, hypertension, hyperlipidemia, smoking history, and family history of CAD were significantly associated with CAD in cirrhotic patients.

CAD is common in cirrhotic patients, but cirrhosis itself may not be associated with an increased CAD risk. In addition to traditional risk factors, non-alcoholic steatohepatitis and hepatitis C virus infection are also associated with CAD presence in cirrhotic patients.

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Review Article Open Access
Systematic Evaluation of Guidelines for the Diagnosis and Treatment of Hepatitis E Virus Infection
Ting Gu, Cai-Ying Zheng, Yan-Qin Deng, Xiao-Feng Yang, Wei-Min Bao, Ying-Mei Tang
Published online June 28, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00508
Abstract
The hepatitis E virus (HEV) is a zoonotic disease, and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised [...] Read more.

The hepatitis E virus (HEV) is a zoonotic disease, and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised individuals. Over the past decade, guidelines for diagnosing and treating HEV infection have been developed. This study aimed to systematically assess the quality of current guidelines for diagnosing and treating HEV infection, and we analyzed the differences in guideline quality and primary recommendations and explored possible reasons for these differences.

Guidelines published between 2013 and 2022 were searched, and studies were identified using selection criteria. The study assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation tool, extracted the primary recommendations in the guidelines, determined the highest level of evidence supporting the recommendations, and reclassified the evidence using the Oxford Centre for Evidence-Based Medicine grading system.

Seven guidelines were included in the final analysis. The quality of the guidelines varied widely. The discrepancies may have been caused by the lack of external experts, the failure to consider influencing factors in guideline application, and the lack of consideration of the public’s opinion. Analysis of the heterogeneity in primary recommendations revealed differences in algorithms for managing chronic HEV infection, the dosage of ribavirin, and a low level of evidence supporting the primary recommendations.

Guideline quality and primary recommendations vary considerably. Refinement by guideline developers and researchers would facilitate updating and applying guidelines for diagnosing and treating HEV infection.

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Systematic Review Open Access
Rose Hip as a Possible Herbal Remedy for Weight Loss: A Systematic Review
Ida Sofie Bjerregård Petersen, Kaj Winther
Published online June 25, 2024
Future Integrative Medicine. doi:10.14218/FIM.2024.00006
Abstract
Several studies have suggested that rose hip extracts have anti-obesity potential. Conventional medicines treating obesity are followed by multiple adverse side effects and is very [...] Read more.

Several studies have suggested that rose hip extracts have anti-obesity potential. Conventional medicines treating obesity are followed by multiple adverse side effects and is very cost full to society. This makes the investigation of herbal remedies with anti-obesity effects potential highly relevant. This systematic review aims to shed light on the results of existing literature reports on the correlation between the intake of rose hip extracts and anti-obesity effects.

A systematic literature search of PubMed and Web of Science was made to localize relevant experimental literature. Nine articles met the inclusion criteria, including one in vitro study, seven in vivo animal studies, and one human trial with pre-obese subjects. All nine articles are objectively reviewed in this systematic review.

Eight out of nine articles, including the article on humans, presented significant anti-obesity effects. Though some limitations of the studies were found, including the human trial, seven possible metabolic mechanisms are suggested as the underlying cause of the significant effects.

Based on the findings of this review, rose hip extracts containing tiliroside found in the seeds have the potential to become a new herbal remedy with anti-obesity effects. Nevertheless, more research is needed to assess the effectiveness and optimal dosage of the rose hip treatment and to elucidate the underlying mechanisms of the effects.

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