Chemotherapy-induced thrombocytopenia (CIT) is a common complication when treating malignancies with cytotoxic agents wherein carboplatin is one of the most typical agents causing CIT. Janus kinase 2 (JAK2) is one of the critical enzymes to megakaryocyte proliferation and differentiation. However, the role of the JAK2 in CIT remains unclear. In this study, we used both carboplatin-induced CIT mice and MEG-01 cell line to examine the expression of JAK2 and signal transducer and activator of transcription 3 (STAT3) pathway. Under CIT, the expression of JAK2 was significantly reduced in vivo and in vitro. More surprisingly, the JAK2/STAT3 pathway remained inactivated even when thrombopoietin (TPO) was administered. On the other hand, carboplatin could cause prominent S phase cell cycle arrest and markedly increased apoptosis in MEG-01 cells. These results showed that the thrombopoiesis might be interfered through the downregulation of JAK2/STAT3 pathway by carboplatin in CIT, and the fact that exogenous TPO supplement cannot reactivate this pathway.

Berberine exerts therapeutic effects in inflammation-associated diseases. In a lipopolysaccharide (LPS)-induced endotoxemic acute lung injury (ALI) rat model, berberine alleviated lung injury through different anti-inflammatory mechanisms; however, treatment effects on CX3CL1 expression and shedding remain to be examined. As these processes play important roles in promoting the binding of leukocytes to the endothelium, the CX3CL1/CX3CR1 axis and its related pathways may serve as potential targets for the clinical treatment of ALI. The anti-inflammatory effects of berberine were investigated in LPS-stimulated rats, human umbilical cord vein endothelial cells (HUVECs), and THP-1 monocytic cells. Cx3cl1 expression in rat pulmonary tissues was examined using immunohistochemistry. CX3CL1, CX3CR1, RELA, STAT3, and ADAM10 levels were examined using Western blotting. CX3CL1 and ADAM10 mRNA levels were examined using quantitative real-time polymerase chain reaction. Soluble fractalkine levels in LPS-stimulated rats and HUVECs were examined using the enzyme-linked immunosorbent assay. Berberine significantly mitigated the LPS-induced upregulation of fractalkine and soluble fractalkine in rats and cultured HUVECs. Berberine mitigated the LPS-induced activation of the NF-κB and STAT3 signaling pathways. In THP-1 cells, berberine mitigated the LPS-induced upregulation of CX3CR1. Furthermore, the membrane expression of ADAM10 in LPS-stimulated HUVECs was suppressed by the berberine treatment. Berberine dose-dependently inhibited the LPS-induced activation of the CX3CL1/CX3CR1 axis and fractalkine shedding through ADAM10. These findings reveal a novel molecular mechanism underlying the inhibitory effect of berberine on monocyte adherence to the endothelium during inflammation.

Aim: Sepsis greatly increases morbidity and mortality in patients with systemic lupus erythematosus (SLE). Conventional treatments, particularly glucocorticoids (GCs), raise infection risk. This retrospective cohort study aims to investigate the association of Traditional Chinese Medicine (TCM) use with sepsis incidence, mortality, and GC dependence in patients with SLE, based on data from the Chang Gung Research Database (CGRD).Methods: Patients in Taiwan with newly diagnosed SLE were enrolled from the CGRD between 2005 and 2020. They were stratified into groups based on TCM treatment post‐diagnosis. Outcomes included sepsis incidence and the dose and duration of GC usage. Data were analyzed using Cox proportional hazard models and Kaplan–Meier analysis.Results: The study included 10 846 newly diagnosed patients with SLE, of whom 1801 received at least 28 days of TCM treatment, while 8302 did not. After propensity score matching, 5403 and 1801 individuals were included in the non‐TCM and TCM groups, respectively, with no significant baseline differences in age, sex, biochemical profiles, and comorbidities between the groups. Integrative TCM usage was associated with a significantly lower risk of sepsis (adjusted hazard ratio [aHR]: 0.49; 95% confidence interval [CI]: 0.40–0.60, p < 0.001) and mortality rate (aHR 0.52, 95% CI 0.44–0.60, p < 0.001) over an 18‐year period. Additionally, the TCM group had a significantly lower daily GC dose (1.74 vs. 2.47 units/day; p = 0.02).Conclusion: TCM use was significantly associated with lower risks of sepsis and lower GC dosage in patients with SLE, suggesting its potential as an integrative therapy.

Systemic lupus erythematosus (SLE) and other systemic autoimmune rheumatic diseases (SARDs) require long-term immunosuppressive therapy, placing patients at increased risk of infection. Salmonella species are particularly concerning due to their invasiveness and potential link to autoimmune activation, notably in SLE. This study aimed to compare the risk of culture-confirmed Salmonella infection between SLE and other SARDs, based on data from the Chang Gung Research Database between 2005 and 2020. After propensity score matching, 3537 patients per group were analyzed. Patients with SLE had a higher incidence of Salmonella infection compared with those with other SARDs (0.54 vs. 0.17 per 1000 person-years), with a significantly greater cumulative incidence (log-rank p < 0.01). The adjusted hazard ratio (HR) for Salmonella infection in SLE was 2.47 (95% confidence interval (CI): 0.95–6.38), and the competing risk model confirmed a significant association (sub-distribution HR 2.58, 95% CI: 1.06–6.29, p = 0.04). Among SLE patients, lymphopenia was the only independent predictor of Salmonella infection (adjusted HR 3.98, 95% CI: 1.83–8.68, p < 0.001). Bloodstream infections were most common (70%), and serogroup D was the predominant strain (80%). These results suggest patients with SLE face higher Salmonella risk than other SARDs, especially those with lymphopenia, underscoring the need for targeted surveillance and preventive strategies.