Recent years have brought progress in understanding the role of the neutrophil, dispelling the dogma of homogeneous cells mainly involved in the prime defence against pathogens, shedding light on their pathogenic role in inflammatory diseases and on the importance of antineutrophil-cytoplasmic antibodies’ pathogenic role in ANCA-associated vasculitides vasculitis (AAV). Myeloperoxidase (MPO) and proteinase 3 (PR3) expressed in neutrophil granulocytes are the most common targets for ANCAs and contribute to the formation of MPO-ANCAs and PR3-ANCAs which, released to the bloodstream, become an excellent diagnostic tool for AAV. In this study, we focus on increasing the clinical and experimental evidence that supports the pathogenic role of ANCAs in AAV. Additionally, we discuss the diagnostic utility of ANCAs for disease activity and prognosis in AAV. Understanding the central role of ANCAs in AAV is crucial for advancing our knowledge of these complex disorders and developing targeted therapeutic strategies in the era of personalized medicine.

As vaccinations against the SARS-CoV-2 virus have become a crucial tool in controlling the spread of the disease, reports of rare health complications have emerged, including new-onset antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitis (AAV). We systematically reviewed new-onset AAV following COVID-19 vaccination case reports and case series published in three databases before January 2024 following PRISMA guidelines to understand the characteristics of possible causal relationships or coincidences. In total, 404 articles were screened respectively by title, abstracts, and full-texts. Thirty-four papers fulfilled the inclusion criteria and have been analyzed, covering 44 patients with new-onset AAV after COVID-19 vaccination with no prior history of COVID-19 infection. Data regarding patients’ metrics, comorbidities, vaccination characteristics, symptoms, diagnostics, treatment, and outcomes were investigated and summarized. The cohort consisted predominantly of females. AAV diagnosis was confirmed via biopsy, with renal dysfunction as a prevailing manifestation. In most cases, the first symptoms of AAV developed after the second dose; moreover, Pfizer-BioNTech was the most frequently administered vaccine among the analyzed cohort. Primary treatment involved glucocorticoid therapy, with a mostly favourable response. This systematic review aims to raise awareness among clinicians in the field regarding this rare but possible complication, to promote the prompt recognition and diagnosis of de novo ANCA-positive small-vessel vasculitis in timely association with SARS-CoV-2 vaccination.

Background: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic inflammatory disorder characterized by urothelial barrier disruption, pelvic pain, urinary urgency and frequency, and significant psychosocial burden. This condition represents a significant therapeutic challenge due to urothelial barrier dysfunction and the “washout effect,” which drastically shortens the exposure time of intravesically administered drugs. Objectives: This review aims to comprehensively analyze recent (2020–2026) advances in regenerative and nanotechnological approaches designed to overcome traditional limitations in IC/BPS treatment. Emphasis is placed on evaluating the clinical efficacy, biological mechanisms, and social impact of next-generation therapies. Methodology: A literature search was performed in PubMed, Scopus, MEDLINE, and Google Scholar for publications from 2020 to 2026 related to IC/BPS, focusing on thermosensitive hydrogels, nanocarriers, Platelet-Rich Plasma (PRP), amniotic-derived products, and gene-modulating therapies. Only peer‑reviewed preclinical and clinical research relevant to innovative IC/BPS management was analyzed. Results: Regenerative interventions, including Platelet-Rich Plasma (PRP) and Amniotic Bladder Therapy (ABT), demonstrate clinical symptom relief and improved Global Response Assessment (GRA) scores for up to 6 months. Network meta-analysis identifies PRP as highly effective for pain reduction ($SMD = -1.84$) compared to standard instillations. Advanced Drug Delivery Systems (DDS), such as thermosensitive hydrogels, extend intravesical drug residence to 5–7 days in preclinical models. Molecular precision therapies, specifically antisense Nerve Growth Factor (NGF) inhibitors and c-Jun N-terminal kinase (JNK) blockers, enable targeted intracellular modulation of neurogenic inflammation. Conclusion: The transition from palliative barrier substitution to biohybrid platforms integrating sustained drug delivery with regenerative signaling represents the current therapeutic paradigm. Future implementation requires standardized clinical protocols and large-scale randomized trials to address existing translational gaps.

Background: Treatment-resistant depression (TRD) is associated with substantial functional impairment, suicide risk, and health-care costs. Ketamine and its S-enantiomer, esketamine, have emerged as rapid-acting glutamatergic treatment options for TRD. Aim: This review aims to synthesize current evidence on the different ketamine administration routes for TRD, with a focus on acute and maintenance efficacy, dosing strategies, safety, infrastructure needs, and positioning within stepped-care algorithms. Methods: A narrative review of randomized controlled trials, meta-analyses, systematic reviews, and long-term open-label studies was performed. Outcomes were grouped by route and examined for (1) antidepressant response, (2) adverse-event profile, (3) required clinical resources, and (4) integration with other treatments such as electroconvulsive therapy and psychotherapy. Results: Ketamine and esketamine can be administered via intravenous (IV), intranasal (IN), oral, subcutaneous (SC), and intramuscular (IM) routes. IV racemic ketamine shows the strongest and fastest antidepressant effect but demands infusion-suite equipment and monitoring for transient hypertension and dissociation. FDA-approved IN esketamine offers robust long-term data but requires administration under supervised in-clinic administration and blood pressure monitoring. According to the reviewed studies, IV and IN routes remain the best-supported options for achieving a rapid response. Oral, sublingual and extended-release formulations provide easier access and lower cost, but have reduced bioavailability, modest effect sizes, and higher diversion risk. These routes of administration may be useful for maintenance treatment in resource-constrained settings. SC and IM injections achieve ~90 % bioavailability with minimal infrastructure, yet evidence is limited to small series. Conclusion: The optimal ketamine route is context-dependent, and requires balancing efficacy, safety, cost, and health-system capacity. Future research should include direct comparative trials and extended safety monitoring to better define the long-term efficacy, tolerability, and optimal clinical use of different ketamine administration routes.

Background: Anorexia nervosa (AN) is a severe psychiatric disorder associated with the highest mortality rate among mental illnesses. Up to 20% of patients develop Severe and Enduring Anorexia Nervosa (SE-AN), a life-threatening condition resistant to conventional psychotherapy and nutritional rehabilitation. In the absence of effective pharmacotherapy, Deep Brain Stimulation (DBS) has emerged as a potential neurosurgical intervention targeting dysfunctional circuits involved in cognitive control, reward processing, and emotion regulation. Objectives: This review evaluates the current application of DBS in treatment-refractory AN, focusing on neuroanatomical targets, clinical efficacy, safety, and methodological, technological, and ethical challenges. Methodology: A comprehensive literature search was conducted in PubMed, Scopus, ScienceDirect, Embase, and Google Scholar. Studies published between 2022 and 2026 were considered, with reference lists manually screened for additional relevant evidence. Results: DBS may improve BMI, psychiatric symptoms, and quality of life in patients with SE-AN. Although the subcallosal cingulate cortex (SCC) and nucleus accumbens (NAcc) remain the principal targets, recent approaches increasingly emphasize phenotype-driven and connectome-guided neuromodulation. Emerging closed-loop, AI-assisted, and wireless technologies may further improve stimulation precision and reduce hardware-related complications. Conclusions: DBS represents a promising harm-reduction approach for treatment-refractory SE-AN. However, limited evidence, surgical risks, and ethical concerns regarding informed consent in severely malnourished patients warrant its use only as a last-resort intervention. Robust randomized multicenter trials are needed to establish its long-term safety and target-specific efficacy.

Aim: This narrative review evaluates the current evidence on the impact of high-intensity focused ultrasound (HIFU), including MR-guided (MRgFUS) and ultrasound-guided (USgHIFU) techniques, on ovarian reserve in women treated for adenomyosis, with particular emphasis on anti-Müllerian hormone (AMH) level. Methods: narrative review included evidence from prospective and retrospective studies, randomized trials, and original research in patients with adenomyosis, identified through searches of PubMed/MEDLINE, Embase, Web of Science, and Google Scholar. Results: available studies consistently demonstrate that this treatment does not result in significant changes in AMH concentrations, irrespective of the method used, suggesting preservation of ovarian reserve. Conclusion: In contrast to more invasive treatment options, such as uterine artery embolization or hysterectomy, HIFU acts locally, minimizing the risk of damage to ovarian tissue and vascular supply. This enables the preservation of fertility, which is particularly important for women desiring future childbearing. However, the available evidence is limited by small sample sizes, heterogeneous study populations, and short follow-up periods. Further large-scale, prospective studies with long-term follow-up are needed to confirm the sustained safety of HIFU and its impact on reproductive outcomes.