Cancer immunotherapy has gained attention as the supreme therapeutic modality for the treatment of various malignancies. Adoptive T-cell therapy (ACT) is one of the most distinctive modalities of ...this therapeutic approach, which seeks to harness the potential of combating cancer cells by using autologous or allogenic tumor-specific T-cells. However, a plethora of circumstances must be optimized to produce functional, durable, and efficient T-cells. Recently, the potential of ACT has been further realized by the introduction of novel gene-editing platforms such as the CRISPR/Cas9 system; this technique has been utilized to create T-cells furnished with recombinant T-cell receptor (TCR) or chimeric antigen receptor (CAR) that have precise tumor antigen recognition, minimal side effects and treatment-related toxicities, robust proliferation and cytotoxicity, and nominal exhaustion. Here, we aim to review and categorize the recent breakthroughs of genetically modified TCR/CAR T-cells through CRISPR/Cas9 technology and address the pearls and pitfalls of each method. In addition, we investigate the latest ongoing clinical trials that are applying CRISPR-associated TCR/CAR T-cells for the treatment of cancers.
Hydatid disease is a zoonotic infection caused primarily by the tapeworm parasite,
. It is considered an endemic disease in the Mediterranean region. In about 90% of cases, hydatid cysts are found ...in the liver and lungs; however, any other organ in the body may be affected, particularly in endemic areas. When encountering cystic lesions in these areas, the physician should always keep hydatid disease as a possible diagnosis in mind. To avoid life-threatening conditions such as anaphylactic shock or pressure effect on vital organs, timely diagnosis, and proper management are critical. When a rare site is involved, hydatid disease should be diagnosed using a combination of serologic assays and imaging modalities such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). These imaging modalities can also be used to determine the extent of the disease and assess possible complications. Here, we present a pictorial review of typical imaging manifestations of hydatid cysts in unusual sites. Being aware of these imaging features will assist physicians in making an accurate, timely diagnosis and subsequently, providing optimal management.
Despite advancements in molecular and histopathologic characterization of pediatric low-grade gliomas (pLGGs), there remains significant phenotypic heterogeneity among tumors with similar ...categorizations. We hypothesized that an unsupervised machine learning approach based on radiomic features may reveal distinct pLGG imaging subtypes.
Multi-parametric MR images (T1 pre- and post-contrast, T2, and T2 FLAIR) from 157 patients with pLGGs were collected and 881 quantitative radiomic features were extracted from tumorous region. Clustering was performed using K-means after applying principal component analysis (PCA) for feature dimensionality reduction. Molecular and demographic data was obtained from the PedCBioportal and compared between imaging subtypes.
K-means identified three distinct imaging-based subtypes. Subtypes differed in mutational frequencies of BRAF (p < 0.05) as well as the gene expression of BRAF (p<0.05). It was also found that age (p < 0.05), tumor location (p < 0.01), and tumor histology (p < 0.0001) differed significantly between the imaging subtypes.
In this exploratory work, it was found that clustering of pLGGs based on radiomic features identifies distinct, imaging-based subtypes that correlate with important molecular markers and demographic details. This finding supports the notion that incorporation of radiomic data could augment our ability to better characterize pLGGs.
Clinical management in neuro-oncology has changed to an integrative approach that incorporates molecular profiles alongside histopathology and imaging findings. While the World Health Organization ...(WHO) guideline recommends the genotyping of informative alterations as a routine clinical practice for central nervous system (CNS) tumors, the acquisition of tumor tissue in the CNS is invasive and not always possible. Liquid biopsy is a non-invasive approach that provides the opportunity to capture the complex molecular heterogeneity of the whole tumor through the detection of circulating tumor biomarkers in body fluids, such as blood or cerebrospinal fluid (CSF). Despite all of the advantages, the low abundance of tumor-derived biomarkers, particularly in CNS tumors, as well as their short half-life has limited the application of liquid biopsy in clinical practice. Thus, it is crucial to identify the factors associated with the presence of these biomarkers and explore possible strategies that can increase the shedding of these tumoral components into biological fluids. In this review, we first describe the clinical applications of liquid biopsy in CNS tumors, including its roles in the early detection of recurrence and monitoring of treatment response. We then discuss the utilization of imaging in identifying the factors that affect the detection of circulating biomarkers as well as how image-guided interventions such as focused ultrasound can help enhance the presence of tumor biomarkers through blood–brain barrier (BBB) disruption.
Although previous studies have shown an association between parasitic infections and multiple sclerosis, the possible role of
Toxocara
infection on the etiology of multiple sclerosis has been ...overlooked. The present study aimed to investigate the seroprevalence of anti-
Toxocara
IgG antibodies among patients with multiple sclerosis compared to healthy controls. Seventy patients with prior diagnosis of multiple sclerosis were selected as cases and 70 healthy matched individuals as controls. The presence of serum anti-
Toxocara
IgG antibody was investigated by ELISA technique. The Chi square test was used to test statistically significant differences for parametric data. A total of 140 serum samples were collected and analyzed. In the case and control groups, 20 (28.6%) and 8 (11.4%) participants had positive serum anti-
Toxocara
IgG antibodies, respectively, indicating a statistically significant difference (OR 3.1; 95% CI 1.26–7.63;
p
value = 0.02). The seroprevalence rate was also higher among individuals with a history of contact with dogs (OR 2.7; 95% CI 1.17–6.37;
p
value = 0.03).The results declare that a protective role of
Toxocara canis
against the development of multiple sclerosis is unlikely.
Increasing evidence suggests that besides mutational and molecular alterations, the immune component of the tumor microenvironment also substantially impacts tumor behavior and complicates treatment ...response, particularly to immunotherapies. Although the standard method for characterizing tumor immune profile is through performing integrated genomic analysis on tissue biopsies, the dynamic change in the immune composition of the tumor microenvironment makes this approach not feasible, especially for brain tumors. Radiomics is a rapidly growing field that uses advanced imaging techniques and computational algorithms to extract numerous quantitative features from medical images. Recent advances in machine learning methods are facilitating biological validation of radiomic signatures and allowing them to "mine" for a variety of significant correlates, including genetic, immunologic, and histologic data. Radiomics has the potential to be used as a non-invasive approach to predict the presence and density of immune cells within the microenvironment, as well as to assess the expression of immune-related genes and pathways. This information can be essential for patient stratification, informing treatment decisions and predicting patients' response to immunotherapies. This is particularly important for tumors with difficult surgical access such as gliomas. In this review, we provide an overview of the glioma microenvironment, describe novel approaches for clustering patients based on their tumor immune profile, and discuss the latest progress on utilization of radiomics for immune profiling of glioma based on current literature.
Background
Nasopharyngeal cancer (NPC) is showing an increasing incidence in Iran
.
Radiation is the main treatment of this cancer. Use of new techniques such as intensity-modulated radiotherapy ...(IMRT) is on the rise. Here, we aimed to evaluate the oncological outcomes of NPC patients treated with three-dimensional conformal radiotherapy (3DCRT) for a more reliable comparison with IMRT in the future.
Results
We reviewed the medical records of 106 patients with NPC treated by definitive radiotherapy from 2007 to 2016. Patients were treated with 70 Gy in 2-Gy fractions. Twenty-one patients died during the follow-up period. Twenty-nine patients suffered from locoregional or distant recurrences. Of these, 6 recurred after 2 years of treatment completion. The 2-year and 5-year overall survival rates were 81% and 76%, respectively. The 2-year and 5-year progression-free survival rates were 72% and 63%, respectively. The 5-year locoregional recurrence and distant metastasis-free survival rates were 68% and 69%, respectively.
Conclusion
Due to high survival rates of NPC and the importance of receiving planned total dose of RT, the treatment-related toxicity and quality of life are critical considerations both for patients during active treatment and for survivors.
Computed tomography (CT) imaging has quickly found its place as a beneficial tool in the detection of coronavirus disease 2019 (COVID-19). To date, only a few studies have reported the distribution ...of lung lesions by segment. This study aimed to evaluate the lobar and segmental distribution of COVID-19 pneumonia based on patients' chest CT scan.
This was a retrospective study performed on 63 Iranian adult patients with a final diagnosis of COVID-19. All patients had undergone chest CT scan on admission. Demographic data and imaging profile, including segmental distribution, were evaluated. Moreover, a scoring scale was designed to assess the severity of ground-glass opacification (GGO). The relationship of GGO score with age, sex, and symptoms at presentation was investigated.
Among included patients, mean age of patients was 54.2 ±14.9 (range: 26 - 81) years old and 60.3% were male. Overall, the right lower lobe (87.3%) and the left lower lobe (85.7%) were more frequently involved. Specifically, predominant involvement was seen in the posterior segment of the left lower lobe (82.5%). The most common findings were peripheral GGO and consolidation, which were observed in 92.1% and 42.9% of patients, respectively. According to the self-designed GGO scoring scale, about half of the patients presented with mild GGO on admission. GGO score was found to be equally distributed among different sex and age categories; however, the presence of dyspnea on admission was significantly associated with a higher GGO score (p= 0.022). Cavitation, reticulation, calcification, bronchiectasis, tree-in-bud appearance and nodules were not identified in any of the cases.
COVID-19 mainly affects the lower lobes of the lungs. GGO and consolidation in the lung periphery is the imaging hallmark in patients with COVID-19 infection. Absence of bronchiectasis, solitary nodules, cavitation, calcifications, tree-in-bud appearance, and reversed halo-sign indicates that these features are not common findings, at least in the earlier stages.
A possible diagnosis of RDD should be kept in mind when encountering a patient with raised plasma creatinine levels and renal mass. Timely diagnosis and management of RDD will help prevent future ...kidney loss.
A possible diagnosis of RDD should be kept in mind when encountering a patient with raised plasma creatinine levels and renal mass. Timely diagnosis and management of RDD will help prevent future kidney loss.
Kidney transplant improves patients' survival and quality of life. Worldwide, concern about the equality of access to the renal transplant wait-list is increasing. In Iran, patients have the choice ...to be placed on either the living or deceased-donor transplant wait-list.
This was a prospective study performed on 416 kidney transplant recipients (n = 217 (52.2%) from living donors and n = 199 (47.8%) from deceased donors). Subjects were recruited from four referral kidney transplant centers across Tehran, Iran, during 2016-2017. The primary outcome was to identify the psycho-socioeconomic factors influencing the selection of type of donor (living versus deceased). Secondary objective was to compare the outcomes associated with each type of transplant. The impact of psycho-socioeconomic variables on selecting type of donor was evaluated by using multiple logistic regression and the effect of surgical and non-surgical variables on the early post-transplant creatinine trend was assessed by univariate repeated measure ANOVA.
Based on standardized coefficients, the main predictors for selecting living donor were academic educational level (adjusted OR = 3.25, 95% CI: 1.176-9.005, p = 0.023), psychological status based on general health questionnaire (GHQ) (adjusted OR = 2.46, 95% CI: 1.105-5.489, p = 0.028), and lower monthly income (adjusted OR = 2.20, 95% CI: 1.242-3.916, p = 0.007). The waiting time was substantially shorter in patients who received kidneys from living donors (p < 0.001). The early post-transplant creatinine trend was more desirable in recipients of living donors (β = 0.80, 95% CI: 0.16-1.44, p-value = 0.014), patients with an ICU stay of fewer than five days (β = - 0.583, 95% CI: - 0.643- -0.522, p-value = < 0.001), and those with less dialysis duration time (β = 0.016, 95% CI: 0.004-0.028, p-value = 0.012). Post-operative surgical outcomes were not different across the two groups of recipients (p = 0.08), however, medical complications occurred considerably less in the living-donor group (p = 0.04).
Kidney transplant from living donors was associated with shorter transplant wait-list period and better early outcome, however, inequality of access to living donors was observed. Patients with higher socioeconomic status and higher level of education and those suffering from anxiety and sleep disorders were significantly more likely to select living donors.
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