Wang C, et al. Allergy Asthma Immunol Res. 2022 Nov;14(6):604-652. https://doi.org/10.4168/aair.2022.14.6.604

Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is an extremely rare and poor-prognosis malignancy, which has recently been noted as a subtype of lung tumors. We presented a case of SMARCA4-UT in a 50-year-old man with progressively worsening respiratory failure. The tumor was the first reported to involve pulmonary artery, and 90% of tumor cells expressed programmed cell death ligand 1 (PD-L1). High tumor mutational burden (TMB, 23.93/Mb) and mutations in SMARCA4 were detected. It is the first reported case to receive Tislelizumab monotherapy with considerable improvement in clinical condition and no adverse events. As a result of our case, we highlight the importance of recognizing SMARCA4-UT as an individual entity, as well as the efficacy of immune checkpoint inhibitor therapy, particularly in patients with high levels of TMB and PD-L1 expression.

Background: The red cell distribution width to albumin ratio (RAR), a newly identified biomarker of inflammation, has been linked to a variety of inflammatory diseases. Asthma, a major burden on global health, is an inflammatory airway disease that is profoundly affected by inflammation. This study primarily sought to examine the influence of RAR on the risk of developing asthma.Methods: Data from 1999 to 2020 was gathered from the NHANES database. The impact of RAR on asthma risk and their non-linear relationship were clarified by multivariate logit and restricted cubic spline (RCS) analyses. Subgroup and interaction analyses collectively formed the sensitivity analysis for this study.Results: This study was based on an analysis of 54,161 individuals. RAR has been identified as an independent risk factor for asthma, according to logit analysis. The moderate and high RAR groups had a 16% [95% confidence interval (CI): 1.06–1.27] and 43% (95% CI: 1.30–1.58) higher risk, respectively, compared to the lowest group. Every 0.5 unit increase in RAR almost doubled the risk of asthma [odds ratio (OR): 1.82, 95% CI: 1.55–2.12]. There was no non-linear relationship between RAR and asthma risk, based on RCS analysis. Combining subgroup and interaction analyses results, all subgroups in this study showed consistent trends with the overall population.Conclusion: Notably, this article, the first to examine the relationship between RAR and asthma risk, unveiled a positive linear correlation between them. With an increase in RAR, whether analyzed as a categorical or continuous variable, asthma risk significantly increases. This finding was beneficial for clinicians to anticipate and assess the onset of asthma through stratified or dynamic management. Given RAR’s numerous advantages, its application in clinical settings held considerable promise.

To explore the effects of chronic intermittent hypoxia (CIH), which mimics sleep apnea syndrome, on the cardiac renin angiotensin system (RAS), and to investigate the cardiac protection of an angiotensin receptor blocker (ARB)telmisartan (TERT) against CIH. 32 healthy male C57B6J mice were randomly divided into CIH, ARB, blank and air control groups. CIH lasted for 12 weeks. Cardiac angiotensin converting enzyme (ACE), angiotensin converting enzyme 2 (ACE 2) and angiotensin II (Ang II) were evaluated by immunohistochemistry. Myocardial apoptosis were assessed by TUNEL assay and myocardial cell ultrastructure were observed under transmission electron microscope. Cardiac ACE expression was higher in the CIH group than in blank and air control groups, which was decreased with TERT treatment. TERT treatment elevated the expression of cardiac ACE 2 and Ang II compared with CIH group. Myocardial cell and capillary endothelial cell apoptosis, mitochondrial injury were most severe in CIH groups, which were mitigated with TERT treatment. CIH changes the expression of cardiac ACE, ACE2 and Ang II, which may cause myocardial damage. TERT protects mice from CIH-linked cardiac damage via modulating the activity of RAS in the hearts.