Brit J Hosp Med
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Aims/Background Epidemiological studies indicate that the involvement of the immune system in the pathogenesis of infections associated with chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung disease (ILD) remains unclear. This study aims to assess the potential causal link between infections associated with COPD, asthma, or ILD and immune system function. Methods We conducted a two-sample Mendelian randomization analysis using publicly available genome-wide association study (GWAS) datasets. ⋯ The causal effect of COPD/asthma/ILD-related infections on Immunoglobulin D (IgD) expression in IgD+ CD38br and transitional B cells was estimated to be 0.64 (95% CI: 0.49-0.83, p = 0.00091) and 0.70 (95% CI: 0.54-0.91, p = 0.00727), respectively. Additionally, COPD/asthma/ILD-related infections demonstrated a significant causal effect on several B cell and T cell subpopulations: IgD+ CD38- % B cells, IgD+ CD38- AC, CD4+ CD8dim AC, IgD+ CD38- % lymphocyte, and TD CD4+ AC, with the OR 1.54 (95% CI: 1.19-2.00, p = 0.00113), 1.56 (95% CI: 1.16-2.10, p = 0.00340), 1.60 (95% CI: 1.15-2.22, p = 0.00478), 1.47 (95% CI: 1.12-1.92, p = 0.00483) and 1.63 (95% CI: 1.14-2.34, p = 0.00725), respectively. Conclusion Our study reveals a causal association between altered circulating blood cell counts and specific immunophenotypes with the susceptibility to respiratory infections related to COPD, asthma, and ILD.
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Editorial
Finerenone: Do We Really Need an Additional Therapy in Type 2 Diabetes Mellitus and Kidney Disease?
Patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) face considerable cardiorenal morbidity and mortality despite existing therapies. Recent clinical trials demonstrate the efficacy of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, in reducing adverse renal and cardiovascular outcomes. This editorial briefly reviews the evidence and its implications for clinical practice, advocating the use of finerenone in these high-risk patients in combination with currently established treatment agents.
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Aims/Background Patients receiving kidney transplant experience immunosuppression, which increases the risk of bacterial, viral, fungal, and parasitic infections. Q fever is a potentially fatal infectious disease that affects immunocompromised renal transplant recipients and has implications in terms of severe consequences for the donor's kidney. Case Presentation A patient with acute Q fever infection following kidney transplantation was admitted to the Tsinghua Changgung Hospital in Beijing, China, in March 2021. ⋯ Comprehensive data on clinical symptoms, blood tests, chest computed tomography (CT), NGS, Immunoglobulin G (IgG) antibody titer, and therapeutic efficacy associated with Q fever infection following renal transplantation in this patient were gathered. Conclusion This is the first reported case of acute Q fever occurring in a Chinese renal transplant recipient detected using metagenomic NGS. This case underscores the need to consider acute Q fever as a possible differential diagnosis in kidney transplant recipients with fever of unknown origin.
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Editorial Review
Once-Weekly Insulin: A Breakthrough in Diabetes Management or an Unresolved Challenge?
The advent of once-weekly insulin icodec is a promising development in the care of individuals with diabetes. These once-weekly formulations aimed to improve patient adherence and quality of life for patients who find daily injection administration challenging. Insulin icodec has demonstrated comparable glycemic control to conventionally used daily basal insulins, such as insulin glargine and degludec, in the ONWARDS clinical trials. ⋯ Moreover, logistical hurdles, including production costs and supply chain complexities need to be addressed especially in low-resource settings. Future studies should evaluate the broader health impacts of weekly insulin, including cardiovascular outcomes, quality of life, and personalized dosing strategies. Making weekly insulin safe, affordable, and widely available is important to fully realize its potential in diabetes management.
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Aims/Background Lobar pneumonia is an acute inflammation with increasing incidence globally. Delayed treatment can lead to severe complications, posing life-threatening risks. Thus, it is crucial to determine effective treatment methods to improve the prognosis of children with lobar pneumonia. ⋯ However, 7 days after treatment, the CD3+, CD4+, and CD4+/CD8+ levels increased significantly in the observation group compared to the control group (p < 0.001). Additionally, there was no significant difference in the incidence of adverse reactions in both groups (p > 0.05). Conclusion Pidotimod-assisted erythromycin treatment can significantly improve the treatment efficiency in children with lobar pneumonia, improving clinical signs and symptoms and enhancing the cellular immune function without increasing the risk of adverse drug reactions.