The SARS-CoV-2 viral pandemic has had an immeasurable global impact, resulting in over 5 million deaths worldwide. Numerous vaccines were developed in an attempt to quell viral dissemination and reduce symptom severity among those infected. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of antinuclear autoantibodies (ANAs) with heterogenic clinical manifestations, secondary to immune complex deposition in a multitude of organ systems. There are scarcely reported cases of SLE development following COVID-19 mRNA vaccination. We present a case of a 24-year-old male without preexisting conditions or family history of autoimmune disorders, presenting with SLE following the first dose of the SARS-CoV-2 Pfizer-BioNTech mRNA vaccine.

Background: Cardiopulmonary exercise testing (CPET) is a valuable diagnostic and prognostic tool for assessing the integrated function of the cardiopulmonary and muscular systems during exercise. The initiation of a CPET program is complex, and data on early implementation in academic centers remain relatively limited. Objective: to evaluate the initial integration of CPET within a pulmonary department, focusing on patient demographics, referral indications, test performance, and factors associated with anaerobic threshold achievement. Methods: A retrospective cohort study was conducted at a single tertiary care center, including all patients who underwent their first CPET between February 2016 and December 2022. Demographic, clinical, and functional parameters were extracted. Multivariable logistic regression was used to identify variables associated with anaerobic threshold achievement, defined as a respiratory exchange ratio (RER) ≥ 1.1. Results: The cohort included 434 patients (mean age 60.3 ± 14.1 years; 54% male; mean BMI 29.2 ± 5.6 kg/m²). The most common indication for testing was dyspnea (50%). Tests were most frequently terminated due to leg discomfort (39%) and dyspnea (38.8%). Achievement of RER ≥ 1.1 was independently associated with lower BMI (aOR = 0.91; 95% CI: 0.88–0.95; p < 0.001), higher FVC % predicted (aOR = 1.02; 95% CI: 1.00–1.03; p = 0.028), and greater minute ventilation volume (aOR = 1.02; 95% CI: 1.01–1.03; p < 0.001), and it was less likely in patients referred for cardiovascular disease (aOR = 0.37; 95% CI: 0.21–0.64; p < 0.001). No consistent temporal trend in RER achievement was observed across the study period. Conclusions: CPET was most commonly utilized in response to patient-reported dyspnea, with test termination frequently driven by subjective symptoms rather than objective clinical criteria. Anaerobic threshold achievement was more strongly associated with individual physiological characteristics than with institutional experience. These findings underscore the importance of patient preparation and pulmonary functional capacity in optimizing CPET performance.

Despite the widespread utilization of Patient-Derived Xenografts (PDXs) as preclinical platforms in lung cancer research, there are concerns regarding their capability to accurately represent the tumor's clinical and molecular features across sequential passages. In this study, we established a Non-Small Cell Lung Cancer (NSCLC) PDX model in NSG-SGM3 mice and assessed clinical and preclinical factors throughout subsequent passages. Our cohort consisted of 40 NSCLC patients, which were used to successfully create 20 patient-specific PDX models in NSG-SGM3 mice. We found that the main factors that contributed to the growth of the engrafted PDX in mice were a higher grade or stage of disease, in contrast to a long duration of chemotherapy treatment which was negatively correlated with PDX propagation. Successful PDX growth was also linked to poorer prognosis and overall survival, while growth pattern variability was affected by the tumor's aggressiveness, primarily affecting the first passage. Pathology analysis showed preservation of histological type and grade; however, Whole Exome Sequence (WES) analysis revealed genomic instability in advanced passages, leading to the inconsistency of clinically relevant alterations between PDXs and biopsies. Multiple clinical and preclinical factors affect the engraftment success, growth kinetics, and tumor stability of patient-specific NSCLC PDXs; thus, their use for prolonged treatment evaluation studies remains questionable.