Current Understanding and Translational Prospects of Tetrahedral Framework Nucleic Acids

JACS Au, Journal Year: 2025, Volume and Issue: 5(2), P. 486 - 520

Published: Feb. 10, 2025

Tetrahedral framework nucleic acids (tFNAs) represent a promising advancement in acid nanotechnology due to their unique structural properties, high biocompatibility, and multifaceted biomedical applications. Constructed through one-pot annealing method, four single-stranded DNAs self-assemble into stable, three-dimensional tetrahedral nanostructures with enhanced mechanical robustness physiological stability, resisting enzymatic degradation. Their ability permeate mammalian cells without transfection agents, coupled modifiable surfaces, positions tFNAs as versatile carriers for drug gene delivery systems. The tFNA-based platforms exhibit superior therapeutic efficacy, including antioxidative anti-inflammatory effects, alongside efficient cellular uptake tissue penetration. These features underpin role precision medicine, enabling targeted of diverse agents such synthetic compounds, peptides, acids. Additionally, demonstrate significant potential regenerative immune modulation, antibacterial strategies, oncology. By addressing challenges translational integration, stand poised accelerate the development research clinical applications, fostering novel therapies enhancing outcomes across wide spectrum diseases. This Perspective thoroughly details attributes applications critically evaluates tFNAs' potential, outlining inherent implementation exploring solutions these obstacles.

Language: Английский

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A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management

Critical Care, Journal Year: 2025, Volume and Issue: 29(1)

Published: Feb. 24, 2025

Acute respiratory distress syndrome (ARDS) is a severe complication of critical illness, characterized by bilateral lung infiltrates and hypoxemia. Its clinical pathophysiological heterogeneity poses challenges for both diagnosis treatment. This review outlines the evolution ARDS definitions, discusses underlying pathophysiology ARDS, examines implications its heterogeneity. Traditional definitions required invasive mechanical ventilation relied on arterial blood gas measurements to calculate PaO2/FiO2 ratio. Recent updates have expanded these criteria include patients receiving noninvasive support, such as high-flow nasal oxygen, adoption SpO2/FiO2 ratio an alternative While changes broaden diagnostic criteria, they also introduce additional complexity. heterogeneity—driven varying etiologies, subphenotypes, biological mechanisms—highlights limitations uniform management approach. Emerging evidence highlights presence distinct each defined unique molecular characteristics, offering pathway more precise therapeutic targeting. Advances in omics technologies—encompassing genomics, proteomics, metabolomics—are paving way precision-medicine approaches with potential revolutionize tailoring interventions individual patient profiles. paradigm shift from broad categories precise, subphenotype-driven care holds promise redefining landscape treatment and, ultimately, improving outcomes this complex, multifaceted syndrome.

Language: Английский

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Imperfect wound healing sets the stage for chronic diseases

Science, Journal Year: 2024, Volume and Issue: 386(6726)

Published: Dec. 5, 2024

Although the age of genome gave us much insight about how our organs fail with disease, it also suggested that diseases do not arise from mutations alone; rather, they develop as we age. In this Review, examine wound healing might act to ignite disease. Wound works well when are younger, repairing damage accidents, environmental assaults, and battles pathogens. Yet, accumulation tissue damage, repair process can devolve, leading inflammation, fibrosis, neoplastic signaling. We discuss healthy responses bodies misappropriate these pathways in focus predominantly on epithelial-based (lung skin) diseases, similar operate cardiac, muscle, neuronal diseases.

Language: Английский

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Macrophage pyroptosis and its crucial role in ALI/ARDS

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 14, 2025

Acute lung injury(ALI)/acute respiratory distress syndrome(ARDS) is a severe clinical syndrome characterized by high morbidity and mortality, primarily due to injury. However, the pathogenesis of ALI/ARDS remains complex issue. In recent years, role macrophage pyroptosis in injury has garnered extensive attention worldwide. This paper reviews mechanism pyroptosis, discusses its ALI/ARDS, introduces several drugs intervening measures that can regulate influence progression ALI/ARDS. By doing so, we aim enhance understanding provide novel insights for treatment.

Language: Английский

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A Simple Nomogram for Predicting the Development of ARDS in Postoperative Patients with Gastrointestinal Perforation: A Single-Center Retrospective Study

Journal of Inflammation Research, Journal Year: 2025, Volume and Issue: Volume 18, P. 221 - 236

Published: Jan. 1, 2025

Background: Acute respiratory distress syndrome (ARDS) is a severe form of organ dysfunction and common postoperative complication. This study aims to develop predictive model for ARDS in patients with gastrointestinal perforation facilitate early detection effective prevention. Methods: In this single-center retrospective study, clinical data were collected from admitted the ICU Hebei Provincial People's Hospital October 2017 May 2024. Univariate analysis multifactorial logistic regression used determine independent risk factors developing ARDS. Nomograms developed show models, discrimination, calibration, usefulness models assessed using C-index, calibration plots, decision curve (DCA). Results: Two hundred ultimately included analysis. development cohort, 38 (27.1%) 140 ARDS, internal validation 13 (21.7%) 60 The multivariate revealed site (OR = 0.164, P 0.006), duration surgery 0.986, 0.008), BMI 1.197, 0.015), SOFA 1.443, 0.001), lactate 1.500, 0.017), albumin 0.889, 0.007) as development. area under (AUC) was 0.921 (95% CI: 0.869, 0.973) cohort 0.894 0.809, 0.978) cohort. (DCA) demonstrate that nomogram possesses good value practicability. Conclusion: Our research introduced integrates six factors, facilitating precise prediction following perforation. Keywords: perforation, acute syndrome, model,

Language: Английский

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Editorial: Case reports in intensive care medicine 2023

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: Feb. 18, 2025

Critical care medicine has undergone nearly 70 years of development and now become a relatively mature discipline primarily focused on the treatment organ failure syndromes (1). The future direction is towards translational precision medicine, which requires further clarification pathogenesis heterogeneous such as sepsis or acute respiratory distress syndrome (ARDS) from perspective sub-phenotypes to achieve precise (2,3). At same time, it encourages organization summarization medical histories for rare uncommon critical illnesses, well publication related reports provide experience relevant diseases in (4,5).Therefore, we have compiled this Research Topic "Case Reports Intensive Care Medicine", aiming an in-depth discussion fields. We are also pleased receive lot submissions, some them been successfully published after revisions. This mainly focuses following areas.Critically ill patients exhibit significant heterogeneity clinical characteristics, etiology, response, prognosis, important implications planning management (1,6,7). Specifically, critically manifests several key areas: First, etiology may include infections (such sepsis), trauma, postoperative complications, cardiovascular diseases, failure, with different etiologies leading varied pathophysiological changes needs. However, even similar diagnoses present vastly manifestations. For example, varying degrees fever, hypotension, altered consciousness, influenced by factors patient's baseline health status, age, sex, comorbidities, all affect their response illness.Second, there currently requirement stratified individual immune status assessments patients. Patients show differences system excessive inflammatory responses while others be immunosuppressed. These variations can severity outcomes. Additionally, impacts host's treatment, how respond regimen. Some improve rapidly, no obvious adverse reactions. Third, ability metabolize drugs varies among due differences, influencing both efficacy safety medications, ultimately impact patient resulting recovering conditions face higher risk mortality long-term sequelae (8).Due heterogeneity, individualized strategies tailored each specific circumstances, thereby enhancing improving prognosis.Critically often complex conditions, typically characterized multiple causes Therefore, beyond adhering broad protocols bundled approach urgent need prognosis (9). includes points:1, Accurate diagnosis etiology: Critically usually quickly accurately identifying source infection other fundamental developing plan. advanced diagnostic technologies, molecular biology tests imaging examinations.Based condition patient, characteristics pathogens, drug resistance, most appropriate antibiotics therapeutic agents should selected. considering gender, underlying allergy history.The metabolism various factors, liver kidney function hemodynamic status. adjustment dosage crucial ensure reduce monitoring vital signs, biochemical indicators, markers.With increasing prevalence drug-resistant bacteria, special attention must paid resistance issues patients, adjusting antibiotic usage timely manner avoid unnecessary use broad-spectrum antibiotics.In addition physiological require psychological support humane help cope anxiety fear associated condition.The understanding involvement families plan components treatment. Providing information helps make informed decisions.After discharge, still evaluation follow-up very identification potential issues.There currently, few guidelines specifically targeting certain genotypes diseases. case needed transition series studies, accumulating experiences.The illness complex, occur considerable heterogeneity. To pursue goal essential reasons:1, Clinical sharing: Case detail share diagnosis, processes, outcomes provides valuable references clinicians, especially when dealing cases, allowing draw others' experiences misdiagnosis delays.2, Promoting knowledge dissemination: Through reports, healthcare professionals learn about latest practices research findings. overall standards promotes application new technologies methods.Case assist recognizing newly emerging variant strains, complications. In detection these plans formulating preventive measures. summary, not only reflection practice but form academic communication. They play indispensable role promoting dissemination knowledge, skills, advancing scientific research. encourage submission hope everyone compilation content, more high-quality report manuscripts.

Language: Английский

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Sevoflurane Sedation in Acute Respiratory Distress Syndrome

JAMA, Journal Year: 2025, Volume and Issue: unknown

Published: March 18, 2025

Language: Английский

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Endothelial ENaC as a repressor of oxidative stress and a guardian of lung capillary barrier function in bacterial and viral pneumonia

Frontiers in Physiology, Journal Year: 2025, Volume and Issue: 16

Published: April 7, 2025

The endothelium represents a crucial regulator of vascular homeostasis. Since endothelial cells mainly rely on glycolysis rather than oxidative phosphorylation for their ATP generation, this allows capillaries to transport the maximum amount oxygen oxygen-starved tissues, where it can be used energy generation. However, occasionally high levels and reactive species (ROS) in blood vessels requires balancing act between pro- anti-oxidative mechanisms endothelium. When balance is disturbed by excessive stress, as occur bacterial viral pneumonia, barrier function compromised. This review will discuss some recently discovered barrier-protective during mediated through reduction stress lung epithelial sodium channel (ENaC).

Language: Английский

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Rib-Indexed POCUS versus Chest X-Ray for Lung Recruitment Assessment in Ventilated Neonates with Moderate-Severe ARDS on Pulmonary Surfactant Therapy: a prospective observational study

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: April 22, 2025

Background Neonatal acute respiratory distress syndrome (NARDS) is associated with high morbidity and mortality. Current lung recruitment assessment methods, such as chest X-ray (CXR) computed tomography (CT), involve ionizing radiation, limiting serial use in neonates. This study evaluated the feasibility of rib-indexed point-of-care ultrasound (POCUS) a radiation-free alternative for monitoring mechanically ventilated neonates moderate-to-severe NARDS receiving pulmonary surfactant (PS) therapy. Methods A prospective observational was conducted tertiary neonatal intensive care unit (NICU) from September 2023 to 2024. Thirty-five were enrolled. Lung assessed via anterior‒posterior approach POCUS CXR before 6 hours after PS therapy combined prone ventilation. Results Posterior demonstrated concordance (ICC: 0.957 preintervention, 0.955 postintervention; kappa: 0.942–0.946), whereas anterior showed low consistency 0.132–0.114; −0.029 − 0.047) despite moderate Spearman correlations (0.673–0.913). Subgroup analyses revealed no significant associations between physiological parameter changes clinical outcomes [mechanical ventilation duration, extracorporeal membrane oxygenation (ECMO) criteria, mortality]. Interoperator reliability excellent. Conclusions Rib-indexed posterior reliable, modality real-time NARDS, demonstrating noninferiority CXR. Notably, our first propose innovative Doppler ultrasound-guided vascular landmark identification assist rib localization protocol addresses critical limitations conventional imaging, offering safer dynamic care. Future multicentre studies integrating CT validation are warranted confirm broader applicability. Trial Registration: The trial prospectively registered Chinese Clinical Trial Registry (ChiCTR2300074652) on August 11, 2023.

Language: Английский

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Friend or foe: the role of platelets in acute lung injury

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: May 14, 2025

Lung diseases, including acute lung injury (ALI) and respiratory distress syndrome (ARDS), are associated with various etiological factors characterized by high mortality rates. Current treatment strategies primarily focus on lung-protective ventilation careful fluid management. Despite over 50 years of basic clinical research, effective options remain limited, the search for novel continues. Traditionally, platelets have been viewed as contributors to blood coagulation; however, recent research has revealed their significant role in inflammation immune regulation. While relationship between platelet count ALI/ARDS remained unclear, emerging studies highlight "dual role" these conditions. On one hand, interact neutrophils form neutrophil extracellular traps (NETs), promoting thrombosis exacerbating inflammation. other also play a protective modulating inflammation, regulatory T cell (Treg) activity, assisting alveolar macrophage reprogramming. This dual functionality important implications pathogenesis resolution ALI/ARDS. review examines multifaceted roles ALI/ARDS, focusing immunomodulatory effects, platelet-neutrophil interaction, critical involvement platelet-Treg complexes shaping inflammatory environment ALI.

Language: Английский

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