Frontiers in Medicine

Our medical research library holds 15 studies published in Frontiers in Medicine (2018–2026). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 15 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Frontiers Media S.A
• Published: 2014 to the present, Switzerland
• Language: English
• ISSN: 2296-858X (electronic)
• Its record in the NLM Catalog

2020s

• Adverse events profiles of pemetrexed: a Food and Drug Administration Adverse Event Reporting System. L. Wang, J. Su, C. Huang, et al. 2026;13:1750861. PubMed · Publisher · Free full text

  Abstract

  Background: Pemetrexed is a folate-pathway-targeting antineoplastic agent widely used in non-squamous non-small cell lung cancer (NSCLC) and malignant pleural mesothelioma. We used the US Food and Drug Administration Adverse Event Reporting System (FAERS) to characterize pemetrexed-associated adverse events to inform clinical safety monitoring.

  Methods: Pemetrexed-related reports were retrieved from the FAERS database from first quarter of 2004 through the fourth quarter of 2024. All reports were coded using the Medical Dictionary for Regulatory Activities (MedDRA) terminology. We performed descriptive analyses and disproportionality analyses using reporting odds ratio (ROR), proportional reporting ratio (PRR), empirical Bayes geometric mean (EBGM), and Bayesian confidence propagation neural network (BCPNN; information component [IC]) to identify safety signals. Statistical significance was defined as ROR >1 with the lower 95% confidence interval (CI) >1.

  Results: We identified 27,098 pemetrexed-associated reports in the FAERS database (2004-2024), in which pemetrexed was designated as the primary suspect drug. Signal detection based on these reports identified 653 significant signals of disproportionate reporting (SDR) spanning 27 System Organ Classes (SOCs). The strongest signals occurred in Blood and Lymphatic Disorders (ROR = 7.31, 95% CI = 7.16-7.47) and Endocrine disorders (ROR = 4.09, 95% CI = 3.83-4.37), the latter representing unlabeled findings. In addition, we detected previously unlisted AEs, including colitis, oral lesions, immune-mediated pancreatitis, pulmonary toxicity, lung consolidation and tubulointerstitial nephritis. Sex stratification revealed male predominance in respiratory toxicity vs. female predisposition to renal injury. A bimodal time-to-onset distribution was observed: 52.57% of AEs occurred within 0-30 days post-treatment, with a secondary peak (6.63%) at 181-360 days.

  Conclusion: This large pharmacovigilance study identifies signals of disproportionate reporting (SDRs) consistent with pemetrexed's established toxicities (e.g., myelosuppression, nephrotoxicity) and detects additional unlabeled safety signals, particularly immune-mediated endocrine, renal, and dermatologic manifestations. The bimodal onset pattern of these SDRs highlights clinically relevant monitoring windows, and observed sex- and age-related differences in SDR reporting suggest a need for individualized risk mitigation. These findings underscore the importance of vigilant surveillance for potential immune-mediated toxicities and adherence to vitamin supplementation protocols to manage hematologic risk. Prospective studies are needed to validate these reporting associations and clarify potential causality for these novel signals.

  Copyright © 2026 Wang, Su, Huang, Yang and Xu.

• Case Report: Uterine mesothelial cyst: a report of three cases and literature review. J. Huang, W. Yang, Y. Wang, et al. 2026;13:1800692. Case report PubMed · Publisher · Free full text

  Abstract

  Mesothelioma cysts are benign tumor-like lesions derived from mesothelial cells. They mainly affect the peritoneum of the pelvic and abdominal cavities, and are more commonly found in the mesentery and greater omentum, while they are less likely to occur in the uterus. The following is a report on the clinical data of 3 rare uterine mesothelial cysts that were treated at Minda Hospital of Hubei Minzu University over the past 10 years. By reviewing and analyzing the treatment processes of three patients and conducting a literature review, this study aims to explore the diagnosis and treatment methods of uterine mesothelial cysts, with the expectation of enhancing gynecologists' understanding of this disease and avoiding misdiagnosis and missed diagnoses.

  Copyright © 2026 Huang, Yang, Wang, Huang and Zhu.

• Cystic epithelioid malignant mesothelioma of the mesentery with rapid postoperative metastasis: an unusual case report. T. Xu, X. Meng, X. Gou, et al. 2026;13:1903020. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Epithelioid malignant mesothelioma is a subtype of peritoneal mesothelioma associated with a relatively better prognosis. Herein, we report a case of epithelioid malignant mesothelioma in a 50-year-old Chinese female without a history of asbestos exposure. The tumor initially presented as a localized cystic mesenteric lesion. However, metastasis to the liver margin was detected 22 days after surgery, accompanied by rapid disease progression within one month. Gross examination revealed a cystic mass. Histologically, the tumor was consistent with epithelioid malignant mesothelioma, a rare pathological finding.

  Case Demonstration: A 50-year-old female patient was admitted with a two-month history of right lower quadrant abdominal pain and no reported asbestos exposure. Ultrasound revealed a cystic structure of undetermined nature and origin in the right lower abdomen. Contrast-enhanced magnetic resonance imaging (MRI) of the mid-to-lower abdomen demonstrated a round mass adjacent to the cecum, measuring 47 × 40 × 59 mm. On T1-weighted imaging, the lesion exhibited high signal intensity on in-phase, out-of-phase, and fat-suppressed sequences; on T2-weighted imaging, it appeared isointense to slightly hyperintense. The mass wall was unevenly thickened with irregular margins. The central area of the lesion showed no enhancement and appeared hypointense. The mass was located in the pericecal region, suggesting a cystic mesenchymal tumor. Postoperative pathological examination confirmed the diagnosis of localized epithelioid malignant mesothelioma of the mesentery. Metastasis was detected 22 days after surgery.

  Conclusions: We report this rare case of localized malignant mesothelioma to raise awareness among clinical pathologists of this entity, facilitate accurate diagnosis, and help avoid misdiagnosis.

  © 2026 Xu, Meng, Gou, Wang, Luo and Zhang.

• Familial melanoma: genetic, clinical, and dermoscopic insights and follow-up. A.E. Raika, M.E. de Las Heras Alonso, D. Sproge, et al. 2026;13:1906952. Review PubMed · Publisher · Free full text

  Abstract

  Familial melanoma accounts for approximately 5-10% of all melanoma cases. It is characterized by an earlier age of onset. Multiple primary melanomas occur in up to a fifth of patients with a positive family history, compared to 5% in sporadic cases. Pathologically, familial melanomas tend to present at thinner Breslow depths and show a higher proportion of in situ lesions compared to their sporadic counterparts, with a predilection for the lower limbs. The genetic landscape of familial melanoma is heterogeneous. CDKN2A and CDK4 mutations act through UV-dependent and cell cycle disruption pathways, while BAP1, POT1, and TERT mutations are considered UV-independent. Beyond cutaneous melanoma, germline mutations confer an increased risk for additional malignancies, including pancreatic cancer, renal cell carcinoma, mesothelioma, and neural system tumors, necessitating multidisciplinary surveillance and genetic counseling for affected families. Dermoscopically, CDKN2A mutation carriers predominantly present with superficial spreading melanoma, displaying atypical pigment networks, irregular dots and globules, regression structures, and a blue-white veil. Co-occurrence of MC1R variants may produce more subtle, structureless presentations with a lower total dermoscopy score, posing additional diagnostic challenges. Sequential digital dermoscopy and total body photography remain the cornerstones of surveillance, with follow-up every 3-6 months recommended for mutation carriers. All patients should receive structured education on photoprotection, including the use of broad-spectrum SPF50+ sunscreen and sun avoidance measures.

  Copyright © 2026 Raika, de las Heras Alonso, Sproge and Bataraga.

• IgG4-related sclerosing cholangitis: navigating diagnostic dilemmas and the challenge of relapse. X. Ren, X. Jin, L. Liu, et al. 2026;13:1732637. Review PubMed · Publisher · Free full text

  Abstract

  Background: Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC), also termed IgG4-related cholangitis (IRC), is a challenging immune-mediated biliary disease, frequently mimicking malignancies such as cholangiocarcinoma (CCA) or other sclerosing cholangitides like primary sclerosing cholangitis (PSC). Accurate diagnosis is critical to avoid unnecessary surgical interventions.

  Objective: This mini-review aims to synthesize the most current evidence on the pathogenesis, diagnostic pitfalls, and management strategies for IgG4-SC, with a focused discussion on overcoming diagnostic dilemmas and addressing the significant challenge of disease relapse.

  Key Findings: The pathogenesis of IgG4-SC involves a complex interplay of genetic predisposition, environmental triggers (e.g., industrial vapors, dust, gases, fumes, and asbestos), and dysregulated adaptive immunity. A distinctive CD4+ T-cell response, dominated by T-helper 2 (Th2), follicular helper T (Tfh) cells, and regulatory T cells (Tregs), drives B-cell activation, oligoclonal expansion of IgG4+ plasmablasts, and progressive fibrosis. Notably, the discovery of IgG4/IgG1 autoantibodies against annexin A11 and laminin 511-E8 has provided insight into potential direct pathogenic mechanisms. Diagnosis relies on a multimodal approach integrating clinical presentation, characteristic imaging findings, elevated serum IgG4 levels (with levels >2× ULN being suggestive, and >4× ULN being highly specific), the IgG4/IgG1 ratio (>0.24), other organ involvement (notably type 1 autoimmune pancreatitis, AIP), supportive histopathology, and a rapid response to corticosteroid therapy. Despite high initial response rates to steroids, relapse occurs in 30%-50% of patients. Maintenance therapy with steroid-sparing immunomodulators (e.g., azathioprine, mycophenolate mofetil) or B-cell depleting agents such as rituximab is often required. The anti-CD19 monoclonal antibody inebilizumab has emerged as a potent new option for maintaining remission.

  Conclusion: Maintaining a high index of clinical suspicion for IgG4-SC is essential in patients with obstructive jaundice and biliary strictures. Future efforts should focus on validating specific biomarkers (e.g., circulating plasmablasts, autoantibody profiles) and developing evidence-based protocols for long-term management to prevent fibrotic complications and reduce the relapse rate.

  Copyright © 2026 Ren, Jin, Liu and Zhang.

• Primary diffuse malignant epithelioid peritoneal mesothelioma of the greater omentum in an asbestos-naive patient: a case report. X. Gan, Y. Tuo, L. Huang, et al. 2026;13:1808853. Case report PubMed · Publisher · Free full text

  Abstract

  Background: Malignant mesothelioma is a rare malignant neoplasm of mesothelial origin, with primary involvement of the greater omentum being exceptionally uncommon. Nonspecific clinical manifestations often lead to misdiagnosis, and cases without asbestos exposure further increase diagnostic complexity.

  Case Presentation: A 71-year-old male without asbestos exposure was admitted for recurrent diarrhea (>1 year), abdominal distension (>10 days), and unintentional weight loss (5 kg in 3 months). Physical examination revealed a 20-cm firm abdominal mass, and abdominal contrast-enhanced CT showed omental-peritoneal "cake-like" thickening with massive peritoneal effusion. Laparoscopic palliative tumor resection and peritoneal effusion drainage were performed, and postoperative pathology/immunohistochemistry (CK+, CR+, CK5/6+, D2-40+, WT1+, CD20-, CDX2-) confirmed epithelioid mesothelioma of the omentum. Postoperative management included anti-infective therapy, nutritional support, and Cinobufacini Capsule-based anti-tumor treatment, with stable disease control at 3-month follow-up.

  Conclusion: Definitive diagnosis of primary greater omental malignant mesothelioma relies on pathology and immunohistochemistry. For unresectable cases, palliative surgery combined with individualized adjuvant therapy may achieve favorable short-term outcomes, highlighting the need for early clinical suspicion in patients with unexplained abdominal symptoms.

  Copyright © 2026 Gan, Tuo, Huang, Yang and Liu.

• Pseudo-Meigs'syndrome mimicking malignant pleural mesothelioma: a case report and diagnostic pitfall analysis. H. Sheng, W. Zong, Z. Song, et al. 2026;13:1849707. Case report PubMed · Publisher · Free full text

  Abstract

  Objective: To investigate the clinical characteristics, misdiagnosis causes, and preventive strategies of pseudo-Meigs' syndrome, and to improve clinicians' awareness of pelvic tumors presenting with pleural effusion and ascites.

  Methods: A 45-year-old woman presented with a 2-month history of dyspnea and a large right-sided pleural effusion with markedly elevated CYFRA 21-1 (>500 ng/mL). Thoracoscopic pleural biopsy showed atypical cells with positive Calretinin, leading to a pathology report of "suspicious for mesothelioma." The patient was diagnosed with malignant pleural mesothelioma and received two cycles of pemetrexed plus carboplatin chemotherapy. When symptoms did not improve and ascites developed, pelvic CT revealed a 7.0 × 5.5 cm ovarian mass.

  Results: Postoperative pathology confirmed bilateral ovarian borderline serous cystadenoma with focal low-grade serous carcinoma-pseudo-Meigs' syndrome. After tumor resection, the pleural effusion and ascites resolved completely, and the patient remained disease-free at 4-year follow-up.

  Conclusion: Pseudo-Meigs' syndrome can closely mimic malignant pleural mesothelioma. For any woman with unexplained pleural effusion, pelvic imaging should be performed before invasive thoracic procedures to avoid catastrophic misdiagnosis.

  Copyright © 2026 Sheng, Zong, Song and Yu.

• Case Report: Whispers of the serpent: exploring uncommon imaging features in primary hepatic malignant mesothelioma. G. Li, S. Hong, T. He, et al. 2025;12:1713971. Case report PubMed · Publisher · Free full text

  Abstract

  Primary hepatic malignant mesothelioma (PHMM) is an uncommon and aggressive neoplasm with vague clinical and radiological features, posing challenges for preoperative diagnosis. In our case, a lobulated hepatic mass demonstrated a serpiginous peripheral enhancement pattern on contrast-enhanced CT and MRI. This uncommon imaging manifestation has been sporadically documented in previous reports. By consolidating these findings, our report emphasizes serpiginous peripheral enhancement as a potential diagnostic clue for PHMM. Recognition of this pattern may aid earlier detection, improve differential diagnosis, and guide timely surgical decision-making in affected patients.

  Copyright © 2025 Li, Hong, He and Xu.

• Disease progression in patients with usual interstitial pneumonia and probable UIP patterns on computed tomography with various underlying etiologies: a retrospective cohort study. S. Yang, J. Wang, D. Sun, et al. 2023;10:1246767. PubMed · Publisher · Free full text

  Abstract

  Background: Usual interstitial pneumonia (UIP) is a pattern of interstitial pneumonia that is caused by different etiologies. This study aimed to investigate the transplant-free survival (TFS) and the decline in forced vital capacity (FVC) of the patients with UIP and probable UIP patterns on CT caused by various underlying conditions.

  Methods: A retrospective cohort study was conducted, enrolling patients with interstitial lung disease exhibiting a CT pattern consistent with UIP or probable UIP. Clinical and prognostic data of patients categorized by the etiology were compared.

  Results: A total of 591 patients were included and classified into the following groups: idiopathic pulmonary fibrosis (IPF) (n = 320), connective tissue disease (CTD)-UIP (n = 229), asbestosis-UIP (n = 28), and hypersensitivity pneumonitis (HP)-UIP (n = 14). Advanced age, elevated levels of serum cytokeratin fraction 21-1 and percentage of neutrophils in bronchoalveolar lavage were observed in all groups. IPF patients showed a more rapid decline in FVC (133.9 mL/year) compared to CTD-UIP (24.5 mL/year, p = 0.001) and asbestosis-UIP (61.0 mL/year, p = 0.008) respectively. Sub-analysis of CTD-UIP revealed that patients with rheumatoid arthritis (RA)-UIP (88.1 mL/year) or antineutrophil cytoplasmic antibody-associated vasculitis (AAV)-UIP (72.9 mL/year) experienced a faster deterioration in FVC compared to those with primary Sjögren's syndrome (pSS)-UIP (25.9 mL/year, p < 0.05). Kaplan-Meier curves showed that IPF had the poorest TFS (median 55.9 months), followed by HP-UIP (57.5 months), CTD-UIP (66.7 months), and asbestosis-UIP (TFS not reached). RA-UIP or AAV-UIP did not exhibit any prognostic advantages compared to IPF, while asbestosis-UIP and pSS-UIP showed better survival rates.

  Conclusion: Patients with UIP caused by different underlying conditions share certain common features, but the trajectories of disease progression and survival outcomes differ.

  Copyright © 2023 Yang, Wang, Sun, Wang, Xue and Ye.

• Prognostic significance of inflammation-related and electrolyte laboratory variables in patients with malignant pleural mesothelioma. Y. Zhang, J. Li, S. Zhang. 2023;10:1099685. PubMed · Publisher · Free full text

  Abstract

  Objective: Malignant pleural mesothelioma (MPM) is a kind of pleural cancer characterized by low incidence but high invasiveness. There is heterogeneity in survival among patients with MPM. Inflammation-related and electrolyte laboratory variables were previously reported as potential predictors of survival. We evaluated the relationship between overall survival and pre-treatment biomarkers.

  Materials And Methods: Patients diagnosed with MPM in Beijing Chaoyang Hospital for more than 10 years were screened for this study. All basic, clinical, radiologic and laboratory variables were collected. The COX univariable and multivariable analysis were used to explore prognostic related risk factors.

  Results: Ninety patients with MPM were included. The median follow-up of all patients was 57 months [interquartile range (IQR): 27-100 months]. The median survival time was 24 months (IQR: 12-52 months). Univariate survival analyses indicated that age, Eastern Cooperative Oncology Group Performance Status, treatment, erythrocyte sedimentation rate, calcium, lymphocyte, hemoglobin, platelet-to-lymphocyte ratio (PLR), and monocyte-to-white blood cell ratio (MWR) were significantly related to survival. Multivariable analysis demonstrated that age [hazard ratio (HR), 2.548; 95% confidence interval (CI) 1.145-5.666; p = 0.022], calcium (HR, 0.480; 95% CI 0.270-0.855; p = 0.013), PLR (HR, 2.152; 95% CI 1.163-3.981; p = 0.015), and MWR (HR, 3.360; 95% CI 1.830-6.170; p < 0.001) might have a significant impact on the prognosis.

  Conclusion: Calcium, MWR, and PLR might be related to the prognosis of MPM patients. Analyzing the relationship between the results of inflammation-related and electrolyte laboratory variables in peripheral blood and prognosis could help clinicians evaluate the situation of patients.

  Copyright © 2023 Zhang, Li and Zhang.

• Dissecting and Reconstructing Matrix in Malignant Mesothelioma Through Histocell-Histochemistry Gradients for Clinical Applications. M.L. Balancin, C.M. Baldavira, T.G. Prieto, et al. 2022;9:871202. PubMed · Publisher · Free full text

  Abstract

  Background: Malignant pleural mesotheliomas (MM) are known for their heterogenous histology and clinical behavior. MM histology reveals three major tumor cell populations: epithelioid, sarcomatoid, and biphasic. Using a dissecting approach, we showed that histochemical gradients help us better understand tumor heterogeneity and reconsider its histologic classifications. We also showed that this method to characterize MM tumor cell populations provides a better understanding of the underlying mechanisms for invasion and disease progression.

  Methods: In a cohort of 87 patients with surgically excised MM, we used hematoxylin and eosin to characterize tumor cell populations and Movat's pentachrome staining to dissect the ECM matrisome. Next, we developed a computerized semi-assisted protocol to quantify and reconstruct the ECM in 3D and examined the clinical association between the matricellular factors and patient outcome.

  Results: Epithelioid cells had a higher matrix composition of elastin and fibrin, whereas, in the sarcomatoid type, hyaluronic acid and total collagen were most prevalent. The 3D reconstruction exposed the collagen I and III that form channels surrounding the neoplastic cell blocks. The estimated volume of the two collagen fractions was 14% of the total volume, consistent with the median estimated area of total collagen (12.05 mm2) for epithelioid MM.

  Conclusion: Differential patterns in matricellular phenotypes in MM could be used in translational studies to improve patient outcome. More importantly, our data raise the possibility that cancer cells can use the matrisome for disease expansion and could be effectively targeted by anti-collagen, anti-elastin, and/or anti-hyaluronic acid therapies.

  Copyright © 2022 Balancin, Baldavira, Prieto, Machado-Rugolo, Farhat, Assato, Velosa, Teodoro, Ab'Saber, Takagaki and Capelozzi.

• Inhibition of IL-12 heterodimers impairs TLR9-mediated prevention of early mouse plasmacytoma cell growth. M.F. Mandour, P.P. Soe, A.S. Castonguay, et al. 2022;9:1057252. PubMed · Publisher · Free full text

  Abstract

  Introduction: Natural prevention of cancer development depends on an efficient immunosurveillance that may be modulated by environmental factors, including infections. Innate lymphoid cytotoxic cells have been shown to play a major role in this immunosurveillance. Interleukin-12 (IL-12) has been suggested to be a key factor in the activation of innate cytotoxic cells after infection, leading to the enhancement of cancer immunosurveillance.

  Methods: The aim of this work was to analyze in mouse experimental models by which mechanisms the interaction between infectious agent molecules and the early innate responses could enhance early inhibition of cancer growth and especially to assess the role of IL-12 by using novel antibodies specific for IL-12 heterodimers.

  Results: Ligation of toll-like receptor (TLR)9 by CpG-protected mice against plasmacytoma TEPC.1033.C2 cell early growth. This protection mediated by innate cytolytic cells was strictly dependent on IL-12 and partly on gamma-interferon. Moreover, the protective effect of CpG stimulation, and to a lesser extent of TLR3 and TLR7/8, and the role of IL-12 in this protection were confirmed in a model of early mesothelioma AB1 cell growth.

  Discussion: These results suggest that modulation of the mouse immune microenvironment by ligation of innate receptors deeply modifies the efficiency of cancer immunosurveillance through the secretion of IL-12, which may at least partly explain the inhibitory effect of previous infections on the prevalence of some cancers.

  Copyright © 2023 Mandour, Soe, Castonguay, Van Snick and Coutelier.

• Marital status as an independent prognostic factor for patients of malignant pleural mesothelioma. S. Pan, N. Yan, Y. Zhao, et al. 2022;9:955619. PubMed · Publisher · Free full text

  Abstract

  Objectives: The prognostic impact of marital status on malignant pleural mesothelioma (MPM) is not investigated. This paper probes into the relationship between the prognosis of MPM and marital status.

  Materials And Methods: The Surveillance, Epidemiology, and End Results (SEER) database of American had been applied to choose eligible patients over the 2004-2015 periods. Moreover, cancer-specific survival (CSS) and overall survival (OS) of unmarried and married groups were compared.

  Results: A total of 3,997 patients in total had been identified, including 2,735 (68.43%) married patients. In comparison to unmarried patients, married ones tended to be younger, male, white, and received active treatment (surgery, chemotherapy, or radiotherapy). In addition, the 1, 3, and 5-year CSS rates were 44.40, 12.09, and 6.88% in married patients, while 35.75, 12.12, and 6.37% in unmarried group (p = 0.0014). At the same time, the 1, 3, and 5-year OS rates were 41.84, 10.56, and 5.91% in married patients, while 33.67, 10.44, and 4.93%, respectively, in the unmarried group (p < 0.0001). As revealed by the multivariate analysis results, the marital status was an independent favorable prognostic factor, in which the married groups showed better CSS [hazard ratio (HR): 0.870; 95% confidence interval (CI): 0.808-0.938; p < 0.001] as well as OS (HR: 0.871; 95% CI: 0.810-0.936; p < 0.001). According to the results of subgroup analysis, the CSS and OS survival of married groups were better than the unmarried groups in almost all the subgroups.

  Conclusion: Marital status is an independent favorable prognostic indicator of MPM. Poor prognosis in unmarried patients is likely to be related to insufficient treatments and socioeconomic and psychosocial factors.

  Copyright © 2022 Pan, Yan, Zhao and Li.

• Chest Imaging in the Diagnosis and Management of Pulmonary Tuberculosis: The Complementary Role of Thoraci Ultrasound. G. Rea, M. Sperandeo, R. Lieto, et al. 2021;8:753821. PubMed · Publisher · Free full text

  Abstract

  Tuberculosis (TB) is a severe infectious disease that still represents a major cause of mortality and morbidity worldwide. For these reasons, clinicians and radiologists should use all the available diagnostic tools in the assessment of the disease in order to provide precise indications about starting an anti-tubercular treatment and reduce risk of TB transmission and complications especially in developing countries where the disease is still endemic. As TB mycobacteria are mainly transmitted through respiratory droplets, the pulmonary parenchyma is usually the first site of infection. As a result, chest imaging plays a central role in the diagnostic process. Thoracic ultrasound (TUS) is a portable, non-invasive, radiation-free, and cost-contained technology which could be easily available in resource-limited settings. This perspective article focuses on the potential role of TUS in the diagnosis and management of patients with pulmonary TB. Unfortunately, there are still insufficient evidence and too contrasting data to judge TUS as an appropriate diagnostic method for the screening of the disease. Despite this, TUS may have a useful role in identifying pleural and anterior pericardial effusions or in the identification of abscesses of the anterior chest wall and paraspinal collections in low- and middle-income settings. In addition, TUS seems to have a milestone role in guiding minimally invasive interventional procedures, such as placement of chest tubes, drainage of loculated collections, thoracentesis and pericardiocentesis, and percutaneous biopsy of subpleural pulmonary consolidations or pleural plaques.

  Copyright © 2021 Rea, Sperandeo, Lieto, Bocchino, Quarato, Feragalli, Valente, Scioscia, Giuffreda, Foschino Barbaro and Lacedonia.

2010s

• The Regulatory Status Adopted by Lymph Node Dendritic Cells and T Cells During Healthy Aging Is Maintained During Cancer and May Contribute to Reduced Responses to Immunotherapy. J.K. Gardner, C. Jackaman, C.D.S. Mamotte, et al. 2018;5:337. PubMed · Publisher · Free full text

  Abstract

  Aging is associated with an increased incidence of cancer. One contributing factor could be modulation of immune cells responsible for anti-tumor responses, such as dendritic cells (DCs) and T cells. These immunological changes may also impact the efficacy of cancer immunotherapies in the elderly. The effects of healthy aging on DCs and T cells, and their impact on anti-mesothelioma immune responses, had not been reported. This study examined DCs and T cells in young (2-5 months; equivalent to 16-26 human years) and elderly (20-24 months; equivalent to 60-70 human years) healthy and mesothelioma-bearing C57BL/6J mice. During healthy aging, elderly lymph nodes adopted a regulatory profile, characterized by: (i) increased plasmacytoid DCs, (ii) increased expression of the adenosine-producing enzyme CD73 on CD11c+ cells, and (iii) increased expression of multiple regulatory markers (including CD73, the adenosine A2B receptor, CTLA-4, PD-1, ICOS, LAG-3, and IL-10) on CD8+ and CD4+ T cells, compared to lymph nodes from young mice. Although mesotheliomas grew faster in elderly mice, the increased regulatory status observed in healthy elderly lymph node DCs and T cells was not further exacerbated. However, elderly tumor-bearing mice demonstrated reduced MHC-I, MHC-II and CD80 on CD11c+ cells, and decreased IFN-γ by CD8+ and CD4+ T cells within tumors, compared to young counterparts, implying loss of function. An agonist CD40 antibody based immunotherapy was less efficient at promoting tumor regression in elderly mice, which may be due to: (i) failure of elderly CD8+ T cells to up-regulate perforin, and (ii) increased expression of multiple regulatory markers on CD11c+ cells and T cells in elderly tumor-draining lymph nodes (including CD73, PD-1, ICOS, LAG-3, and TGF-β). Our findings suggest that checkpoint blockade may improve responses to immunotherapy in elderly hosts with mesothelioma, and warrants further investigation.

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