Scopus 2025
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Item Metadata only The natural history of childhood-onset nonallergic rhinitis; a long-term follow-up study(2025-06-01) Kanchanapoomi K.; Srisuwatchari W.; Pacharn P.; Visitsunthorn N.; Jirapongsananuruk O.; Kanchanapoomi K.; Mahidol UniversityBACKGROUND: Non-allergic rhinitis (NAR) is characterized by symptoms of nasal inflammation without allergic sensitization. The long-term outcome of NAR in children is poorly defined. OBJECTIVE: To determine the natural history of childhood-onset NAR and the development of allergic rhinitis (AR) in these children. METHODS: NAR patients who were followed for more than 10 years were evaluated at 3-5 years (E2) and 9-12 years (E3) after the first evaluation (E1). Nasal symptoms, disease severity, comorbidities, medication used, and aeroallergen sensitization were assessed. RESULTS: Eighty-two NAR patients (58.5% male) completed all 3 evaluations. The age at onset was 2.0 (range 2.0-4.0) years. The follow-up period was 13.6 (range 12.3-14.3) years. At E2, 37.8% of patients developed AR. At E3, the patients were classified into four groups based on results of skin prick tests in E2 and E3 (group I: NAR→NAR→NAR, 39.0%, group II: NAR→NAR→AR, 23.2%, group III: NAR→AR→NAR, 12.2% and group IV: NAR→AR→AR, 25.6%). The most common aeroallergen sensitization was house dust mite. The family history of atopy, asthma and allergic rhinitis were higher in group III and IV than other groups (p < 0.05). The atopic dermatitis, obstructive sleep apnea and adenotonsillar hypertrophy at E1 and E2 were predominantly found in group IV (p < 0.05). At E2, group III and IV patients had higher proportion of exposure to house dust, animal dander and smoking compared to other groups (p < 0.05). The overall remission rate was 14.6%. CONCLUSIONS: Children with NAR should be reevaluated periodically to determine aeroallergen sensitization for the appropriate diagnosis and management.Item Metadata only Comparative Efficacy and Safety of First-Line Treatment With Atezolizumab/Bevacizumab vs. Tyrosine-kinase Inhibitors in Patients With Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-analysis(2025-11-01) Saowapa S.; Polpichai N.; Danpanichkul P.; Bernal R.B.; Siladech P.; Tijani L.; Ng K.; Wong Y.J.; Choudhury A.; Saokaew S.; Liangpunsakul S.; Kaewdech A.; Saowapa S.; Mahidol UniversityBackground/Aims: Sorafenib, lenvatinib, and atezolizumab combined with bevacizumab (Atezo/Bev) are approved first-line treatments for unresectable hepatocellular carcinoma (uHCC). However, direct comparisons among these therapies remain limited. This study aims to compare the efficacy and safety of Atezo/Bev versus tyrosine-kinase inhibitors (TKIs) as first-line therapies for uHCC. Methods: Two independent authors conducted a literature search using electronic databases (Google Scholar, Medline, and PubMed) and manual reference list reviews up to June 2024. We included studies reporting on overall survival (OS), progression free survival (PFS) or safety data comparing Atezo/Bev versus TKI (sorafenib or lenvatinib) in patients with uHCC, irrespective of study design. Data extraction and statistical analysis were performed using RevMan 5.4. Results: We included a total of 12 studies (Ten retrospective cohort studies, one prospective study, one randomized controlled trial) involving 9952 patients (3560 received Atezo/Bev combination therapy and 6392 received TKI). Atezo/Bev significantly improved OS and PFS compared to lenvatinib (HR: 0.79, 95% CI: 0.71–0.89, P = 0.0001 for OS; HR: 0.76, 95% CI: 0.64–0.90, P = 0.002 for PFS). Atezo/Bev also improved OS in viral patients (HR: 0.72, 95% CI: 0.60–0.86, P = 0.0004), while lenvatinib improved OS (HR: 1.36, 95% CI: 1.13–1.65, P = 0.001) and PFS (HR: 1.46, 95% CI: 1.04–2.05, P = 0.03) in nonviral patients. Atezo/Bev had fewer grade ≥3 adverse events than lenvatinib (OR: 0.43, 95% CI: 0.36–0.51, P = 0.03). Atezo/Bev also demonstrated superior OS and PFS compared to sorafenib (HR: 0.68, 95% CI: 0.57–0.81, P < 0.00001 for OS; HR: 0.67, 95% CI: 0.57–0.77, P < 0.00001 for PFS). Conclusions: Atezo/Bev demonstrates better survival outcomes and safety profile compared to TKI. However, for patients with HCC of nonviral etiology, lenvatinib may be a more suitable alternative.Item Metadata only Asthma remission: A path to cure?(2025-06-01) Chiewchalermsri C.; Kanjanawasee D.; Saiphoklang N.; Chirakalwasan N.; Sriprasart T.; Senavonge A.; Sanguanwong N.; Kamalaporn H.; Athipongarporn A.; Hachai S.; Boonsawat W.; Brannan J.D.; Song W.J.; Ruxrungtham K.; Poachanukoon O.; Chiewchalermsri C.; Mahidol UniversityAsthma is a chronic inflammatory airway disease characterized by variable respiratory symptoms and reversible airflow limitation. Despite significant advances in pharmacologic and immunotherapeutic treatment, definitive remission or cure remains elusive. Asthma remission is defined as a sustained absence of symptoms, exacerbations, and lung function decline, with or without ongoing therapy. In contrast, an asthma cure implies permanent disease eradication marked by lifelong symptom resolution, no need for maintenance or rescue medication, preserved lung function, and absence of airway inflammation. To date, no intervention has been proven to cure asthma. Consequently, clinical remission has emerged as a more achievable and meaningful goal in asthma management. This review summarizes recent findings on remission rates, key factors influencing asthma remission, and the impact of various therapeutic strategies-including immunotherapy and advanced biologics. We also highlight evidence underscoring the foundational role of comprehensive asthma care. Asthma should be managed within the context of a unified allergic airway disease; thus, systematic identification and treatment of coexisting conditions such as allergic rhinitis and rhinosinusitis, nasal polyps is essential, as they often exacerbate lower airway symptoms. Routine nasal irrigation, environmental control measures, and attention to modifiable lifestyle factors-such as sleep hygiene, physical activity, and weight management-are critical. When consistently implemented, these holistic approaches may significantly improve disease control and support the achievement of clinical remission. Achieving a cure for asthma remains the ultimate goal, necessitating a long-term commitment and strategically designed basic and clinical research to determine its viability.Item Metadata only Policy strategies to enhance uptake of conservative kidney management in advanced chronic kidney disease: a systematic review and meta-analysis(2025-12-01) Chawla N.; Teerawattananon Y.; Yongphiphatwong N.; Thamcharoen N.; Aryani H.; Tun Y.M.; Butani D.H.; Ngam-Prukwanit R.; Anothaisintawee T.; Chawla N.; Mahidol UniversityBackground: Conservative kidney management (CKM) is an established treatment option for patients with advanced chronic kidney disease(CKD) who are not candidates for kidney replacement therapy(KRT). Despite its benefits, CKM uptake remains low. This systematic review aims to evaluate the effectiveness of policy strategies designed to promote CKM uptake in advanced CKD patients. Methods: Relevant studies were identified through searches of Medline, Scopus, and CINAHL databases since 2000 through 24 July 2024. Observational studies or randomized controlled trials that assessed the efficacy of interventions aiming to increase CKM utilization or preference in patients with chronic kidney disease were eligible for this study. Pairwise meta-analysis using the inverse variance or DerSimonion and Laird method, was applied to estimate the efficacy of interventions across studies. Results: Seven studies were included in this systematic review. Education and training interventions which provided knowledge about CKM to patients and their families, did not significantly increased preference for CKM among CKD patients, compared to no intervention with a pooled OR of 1.05 (95% CI: 0.62–1.76; I2 = 0%). In contrast, results of two included studies found that strategies focused on reforming healthcare services, particularly through assessing patient prognosis and communicating results to nephrologists to inform decisions on KRT, significantly increased CKM utilization in patients with advanced CKD. Conclusion: Our findings suggest that educating patients and their families about CKM did not result in a statistically significant increase in CKM preference compared to no intervention. In contrast, interventions aimed at reforming healthcare services by implementing prognostication assessments into clinical practice might significantly increase CKM utilization. However, these conclusions are based on a limited number of observational studies, highlighting the need for further research to validate the effectiveness of these interventions.Item Metadata only Incidence and Risk Factors of Fungal Infections Within 3 Months Following Pediatric Liver Transplantation(2025-08-01) Phichaphop C.; Boonsathorn S.; Tanpowpong P.; Getsuwan S.; Lertudomphonwanit C.; Apiwattanakul N.; Treepongkaruna S.; Phichaphop C.; Mahidol UniversityBackground: Invasive fungal infection (IFI) remains problematic following liver transplantation (LT). Routine antifungal prophylaxis is not recommended due to a lack of consensus guidelines. This study aimed to evaluate the incidence of IFI and its associated factors among pediatric LT recipients who did not receive systemic antifungal prophylaxis during the early post-transplant period. Methods: We conducted a single-center retrospective study of children who underwent LT between January 2010 and December 2019. Data on clinical characteristics, treatment, and outcomes within 3 months following LT were collected. IFI was defined according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus with slight modifications for intraabdominal fungal infections. Potential risk factors for developing IFI and IFI-related deaths were analyzed. Results: Of the 136 patients, 42 (31%) developed 43 episodes of IFI. The median time from LT to IFI occurrence was 7.5 days (IQR: 4, 16). Among 41 fungal isolates, Candida albicans was the most common fungal infection (56%), followed by C. tropicalis (39%). The most common site was the intraabdominal (78%). Relaparotomy (OR 4.89, 95% CI: 1.8, 13.27; p = 0.002) and postoperative bacterial infections (OR 2.97, 95% CI: 1.11, 7.93; p = 0.03) were significant independent predictors of IFI. Two patients (5%) died with active IFI. Conclusions: IFI occurred in nearly one-third of LT recipients who did not receive antifungal prophylaxis during the early posttransplant period. Relaparotomy and postoperative bacterial infections were significantly associated with IFI development. These findings underscore the need for careful identification and monitoring of high-risk patients.Item Metadata only Analysis of ergot alkaloid gene expression and ergine levels in different parts of Ipomoea asarifolia(2025-01-01) Olaranont Y.; Stewart A.B.; Songnuan W.; Traiperm P.; Olaranont Y.; Mahidol UniversityBackground: Ergot alkaloids are renowned for their pharmacological significance and were historically attributed to fungal symbioses with cereal crops and grasses. Recent research uncovered a symbiotic relationship between the fungus Periglandula ipomoea and Ipomoea asarifolia (Convolvulaceae), revealing a new source for ergot alkaloid synthesis. While past studies have emphasized the storage of both the fungus and alkaloids in leaves and seeds, recent work has found they also occur in other plant parts. This study aimed to examine expression of the dmaW gene, which plays a crucial role in ergot alkaloid biosynthesis, and to quantify ergot alkaloid levels across various organs and growth stages of I. asarifolia. Results: Our findings revealed the highest levels of dmaW gene expression in young seeds and young leaves, whereas the highest ergine concentrations were found in mature leaves followed by young leaves. In light of previous studies, we propose three hypotheses to reconcile these conflicting results: the possibility of an inefficient ergot alkaloid biosynthesis pathway, the possibility that different types of ergot alkaloids are produced, and the existence of an ergot alkaloid translocation system within the plant. Furthermore, ergine concentration and ergot alkaloid biosynthesis gene expression were detected in stems, roots, and flowers, indicating that ergot alkaloids are produced and accumulated in all studied parts of I. asarifolia, rather than being solely confined to the leaves and seeds, as previously reported. Conclusions: Overall, our study reveals that ergot alkaloids are produced and accumulated in most parts of I. asarifolia, suggesting a plant-wide biosynthesis and potential transport system, challenging the previous belief that biosynthesis was confined to glandular trichomes on leaves.Item Metadata only Allergic rhinitis in remission with house dust mite subcutaneous immunotherapy(2025-06-01) Harintajinda S.; Klangkalya N.; Kanchongkittiphon W.; Rerkpattanapipat T.; Kerddonfak S.; Manuyakorn W.; Harintajinda S.; Mahidol UniversityBACKGROUND: House dust mite subcutaneous immunotherapy (HDM SCIT) is a therapeutic option for allergic rhinitis (AR) patients who are unable to properly manage symptoms with standard medications. OBJECTIVE: This study aimed to determine long-term efficacy and identify predictive factors in the clinical remission of AR patients who completed and discontinued HDM SCIT. METHODS: This study included 240 AR patients, who completed a three-year course of HDM SCIT at two tertiary hospitals and were currently being discontinued. We followed-up the patients to ask about their current symptoms and allergy medication. Clinical remission was defined by patients who no longer required daily intranasal steroid or oral antihistamine. We compared patients in clinical remission to those still taking medication. RESULTS: The enrolled patients had a median age of 21.0 (11.0-36.0) years at the time they began HDM SCIT. The clinical remission of AR was achieved in 174 (72.5%) patients. Starting HDM SCIT before the age of 15 and not having asthma were identified as significant and independent predictors of remission (aOR 4.44; 95%CI, 1.72-11.50; p-value 0.002, and 2.67, 95%CI 1.00-7.12; p-value 0.049), respectively, as determined by multivariate logistic regression analysis. There were no significant differences in HDM SCIT duration or sensitization patterns between patients in remission and those on medication after discontinuing HDM SCIT for at least one year. CONCLUSION: HDM SCIT exhibited persistent long-term efficacy after treatment discontinuation. Starting HDM SCIT before the age of 15 and without asthma comorbidity might be predictors of AR remission with HDM SCIT.Item Metadata only Full-endoscopic dural repair using drain catheter: technical note(2025-12-01) Van Daele P.; Chavalparit P.; Santipas B.; Kim J.S.; Van Daele P.; Mahidol UniversityBackground: Repairing dural tears through a uniportal endoscopic approach presents significant technical challenges. This technical note describes a novel endoscopic suturing technique using standard instruments commonly available in most operating rooms. Method: We describe the instrument preparation, operative steps, and a case illustration. The dural suturing technique is performed using standard endoscopic instruments with a custom-made knot pusher adapted from a No. 8 surgical drain catheter. Conclusion: Our proposed surgical workflow and suturing technique enable effective endoscopic dural repair without the need for specialized equipment. It offers a practical solution that may reduce the need for conversion to open surgery.Item Metadata only Practical recommendations for home-nebulized corticosteroid use in children aged ≤ 5 years with asthma: A review and advisory group consensus(2025-06-01) Direkwattanachai C.; Deerojanawong J.; Aksilp C.; Jirapongsananuruk O.; Kamalaporn H.; Kamchaisatian W.; Lochindarat S.; Ngamtrakulpanit L.; Poachanukoon O.; Lao-Araya M.; Teeratakulpisarn J.; Udomittipong K.; Vangveeravong M.; Ruangnapa K.; Chatchatee P.; Direkwattanachai C.; Mahidol UniversityBACKGROUND: Despite nebulized budesonide being identified by the Global Initiative for Asthma report as a viable alternative to inhaled corticosteroids (ICS) delivered by pressurized metered-dose inhalers (pMDIs) with spacers, practical guidance on nebulized corticosteroid use in the pediatric population remains scarce. OBJECTIVE: To review the current literature and provide practical recommendations for nebulized budesonide use in children aged ≤ 5 years with a diagnosis of asthma. METHODS: A group of 15 expert pediatricians in the respiratory and allergy fields in Thailand developed Delphi consensus recommendations on nebulized budesonide use based on their clinical expertise and a review of the published literature. Studies that evaluated the efficacy (effectiveness) and/or safety of nebulized budesonide in children aged ≤ 5 years with asthma were assessed. AR patients. RESULTS: Overall, 24 clinical studies published between 1993 and 2020 met the inclusion criteria for review. Overall, results demonstrated that nebulized budesonide significantly improved symptom control and reduced exacerbations, asthma-related hospitalizations, and the requirement for oral corticosteroids compared with placebo or active controls. Nebulized budesonide was well tolerated, with no severe or drug-related adverse events reported. Following a review of the published evidence and group consensus, a treatment algorithm as per the Thai Pediatric Asthma 2020 Guidelines was proposed, based on the availability of medications in Thailand, to include nebulized budesonide as the initial treatment option alongside ICS delivered by pMDIs with spacers in children aged ≤ 5 years. CONCLUSIONS: ThNebulized budesonide is an effective and well-tolerated treatment option in children aged ≤ 5 years with asthma.Item Metadata only Dissection of Neurochemical Pathways Across Complexity and Scale(2025-07-01) Abbondanza A.; Kim N.; Lima-Filho R.A.S.; Amin A.; Anversa R.G.; Almeida F.B.; Cardozo P.L.; Carello-Collar G.; Carsana E.V.; Folarin R.O.; Guerreiro S.; Ijomone O.K.; Lawal S.K.; Matias I.; Mbagwu S.I.; Niño S.A.; Olabiyi B.F.; Olatunji S.Y.; Olasehinde T.A.; Ruankham W.; Sanchez W.N.; Soares-Cunha C.; Soto P.A.; Soto-Verdugo J.; Strogulski N.R.; Tomaszewska W.; Vieira C.; Chaves-Filho A.; Cousin M.A.; Rinken A.; Wenzel T.J.; Abbondanza A.; Mahidol UniversityThe field of Neurochemistry spent decades trying to understand how the brain works, from nano to macroscale and across diverse species. Technological advancements over the years allowed researchers to better visualize and understand the cellular processes underpinning central nervous system (CNS) function. This review provides an overview of how novel models, and tools have allowed Neurochemistry researchers to investigate new and exciting research questions. We discuss the merits and demerits of different in vivo models (e.g., Caenorhabditis elegans, Drosophila melanogaster, Ratus norvegicus, and Mus musculus) as well as in vitro models (e.g., primary cells, induced pluripotent stem cells, and immortalized cells) to study Neurochemical events. We also discuss how these models can be paired with cutting-edge genetic manipulation (e.g., CRISPR-Cas9 and engineered viral vectors) and imaging techniques, such as super-resolution microscopy and new biosensors, to study cellular processes of the CNS. These technological advancements provide new insight into Neurochemical events in physiological and pathological contexts, paving the way for the development of new treatments (e.g., cell and gene therapies or small molecules) that aim to treat neurological disorders by reverting the CNS to its homeostatic state. (Figure presented.)Item Metadata only Developing a Consensus-Based Core Set of Outcome Measures for Ulnar Nerve Surgery: A Delphi Study With Focus on the Supercharged End-to-Side Anterior Interosseous Nerve to Ulnar Nerve Transfer(2025-09-01) Jiravichitchai T.; MacDermid J.; Farzad M.; Parikh P.; Pripotnev S.; Jiravichitchai T.; Mahidol UniversityPurpose: The supercharged end-to-side (SETS) anterior interosseous to ulnar nerve transfer is increasingly used to augment intrinsic muscle recovery in patients with severe ulnar neuropathy. However, there is a lack of standardized outcome measures to evaluate the effectiveness of this procedure. This study aimed to develop a consensus-based core set of outcome measures applicable to ulnar nerve surgery, with a specific focus on the SETS transfer. Methods: A two-round modified Delphi process was conducted involving 15 multidisciplinary experts in hand surgery and upper limb rehabilitation. The initial survey was informed by a comprehensive literature review and expert opinion. Participants ranked outcome domains and corresponding measurement tools based on their relevance in both clinical and research settings. Consensus was defined as ≥75% agreement. A second-round survey was conducted to refine the results and focus specifically on outcomes applicable to SETS procedures. Results: In Round 1, experts reached consensus on several key domains including motor function, functional ability, quality of life, pain, dexterity, and sensory evaluation. In Round 2, a refined core outcome set for SETS procedures was established. Lateral pinch strength and daily living function self-assessment were prioritized across both settings. Validated tools endorsed included the Patient-Rated Ulnar Nerve Evaluation, Short Form-12, visual analog scale, nine-hole peg test, and two-point discrimination. Conclusions: This Delphi study established a consensus-based core outcome set for evaluating surgical outcomes following ulnar nerve reconstruction, with specific application to SETS procedures. The proposed framework integrates patient-reported and clinician-rated measures and may support standardization in future research and clinical practice. Clinical relevance: The lack of standardized outcomes for ulnar nerve transfers limits cross-study comparisons and evidence synthesis. This study provides a structured outcome set to support consistent evaluation and improve decision making in patients undergoing SETS or related procedures.Item Metadata only Pomelo by-products: A bibliometric review on enhancing gut health and digestive function for metabolic regulation through advanced processing techniques(2025-01-01) Thilavech T.; Suantawee T.; Chusak C.; Adisakwattana S.; Thilavech T.; Mahidol UniversityPomelo (Citrus maxima or Citrus grandis) is widely cultivated for its edible pulp; however, processing generates substantial quantities of by-products, including peel, pith, sponge layer, and fruitlets, which are typically discarded as waste. Recent research highlights these by-products as abundant sources of bioactive compounds with promising health-promoting properties. This synthesis of current scientific evidence focuses on the potential of pomelo by-products to support gut health and digestive function, with particular emphasis on metabolic regulation. Key bioactive constituents identified in pomelo by-products include dietary fibers, pectins, flavonoids, and essential oils. These compounds have demonstrated the capacity to modulate gut microbiota composition by selectively promoting beneficial bacterial genera and enhancing short-chain fatty acid production. Additionally, pomelo by-products can inhibit carbohydrate-degrading enzymes such as α-glucosidase and lipid-degrading enzymes like pancreatic lipase, contributing to improved glycemic control and lipid metabolism. Furthermore, bile acid binding by pomelo by-product extracts can influence cholesterol metabolism and lipid absorption. Advanced processing technologies including super-comminution, enzymatic modification, fermentation, and pulsed electric field treatments have been investigated to enhance the release, stability, and bioavailability of these bioactive compounds, thereby improving their functional efficacy in food systems. Processing techniques are critically evaluated, highlighting their potential for sustainable upcycling of pomelo processing waste into high-value functional food ingredients and nutraceuticals. Despite encouraging preclinical evidence supporting the health benefits of pomelo by-products, further well-designed clinical trials are necessary to confirm their efficacy and safety in human populations. Overall, pomelo by-products show potential for development into sustainable and functional food ingredients that support gut health, regulate metabolic processes, and contribute to healthier dietary patterns.Item Metadata only Clinical characteristics and outcomes of children with hypertensive encephalopathy(2025-12-01) Wiraboonchai B.; Khongkhatithum C.; Nimkarn N.; Chantarogh S.; Saisawat P.; Tangnararatchakit K.; Pirojsakul K.; Wiraboonchai B.; Mahidol UniversityBackground: Hypertensive encephalopathy (HE) is characterized by a severe increase in blood pressure, leading to neurological symptoms such as severe headache, seizure, and mental status change. Prompt medical treatment is crucial, often leading to full recovery without long-term neurological deficits. However, untreated cases can result in serious complications. This study aimed to describe the clinical characteristics and outcomes of children who developed HE. Materials and methods: A retrospective review of medical records in patients aged < 18 years diagnosed with HE in Ramathibodi Hospital was conducted. Data were collected, including demographics, underlying conditions, clinical presentations, blood pressure levels during HE, medications used, diagnostic investigations, and outcomes. Patients with pre-existing neurological symptoms or incomplete data were excluded. Data between the groups with kidney diseases and non-kidney diseases were compared. Results: Fifty-three patients (26 males) were included with a mean age of 8.9 ± 4 years and a median follow-up time of 47.8 months. Kidney disease (51%) was the most common cause of hypertension. Patients with kidney disease were older (10.3 vs. 7.5 years, p = 0.01), had a shorter duration between the diagnosis of underlying conditions and development of HE (70 vs. 457 days, p = 0.04), and a larger proportion of females (66.7% vs. 34.6%, p = 0.02). Neither clinical manifestations, such as generalized tonic-clonic seizures, headaches, and mental status changes, nor survival were different between the kidney and non-kidney groups. Five patients who developed recurrent episodes of HE had the underlying diseases involving endothelial injuries, such as small vessel vasculitis, and were on calcineurin inhibitors after hematopoietic stem cell transplantation (HSCT). Conclusions: Patients with kidney diseases were older and developed HE earlier, but there was no difference in survival between the kidney and non-kidney groups. Recurrent episodes of HE were detected in patients with small vessel vasculitis or taking calcineurin inhibitors after HSCT, prompting the pediatricians to be vigilant for blood pressure control in these patients.Item Metadata only Compound D from Zingiber cassumunar Roxb. attenuated type 2 inflammatory cytokine-induced tight junction disruption in airway epithelial cells(2025-06-01) Poachanukoon O.; Termworasin P.; Tharabenjasin P.; Dechatiwongse Na Ayudhya T.; Moonwiriyakit A.; Poachanukoon O.; Mahidol UniversityBACKGROUND: Barrier disruption in the airway mucosae has been implicated in allergic type 2 inflammatory diseases such as allergic rhinitis and asthma. Zingiber cassumunar Roxb. has long been used in traditional medicine to treat allergic diseases. The active compound, namely compound D, has proven anti-inflammatory benefits. However, the effect of compound D on allergic inflammation remains unclear. OBJECTIVE: This study aimed to investigate the protective effects of compound D on allergic inflammation-induced barrier disruption. METHODS: Type 2 cytokine (IL-4 and IL-13)-exposed 16HBE human bronchial epithelial cells were treated with compound D. After 24, 48, and 72 h, cytotoxicity, epithelial integrity, and tight junction (TJ) disruption were determined by viability assays, transepithelial electrical resistance measurement, and immunofluorescence staining, respectively. Moreover, the mechanism of action of compound D was investigated by western blotting. RESULTS: Compound D (100 and 200 µM) prevented IL-4/IL-13-induced barrier disruption at 24 and 48 h with no effect on cell viability. Compound D rescued the localization of ZO-1 to pericellular areas, and the barrier-protective effect of compound D was mediated by inhibiting STAT6 signaling. CONCLUSIONS: Compound D can suppress IL-4/IL-13-induced epithelial inflammation and TJ disruption through STAT6 inhibition. The agent is a promising candidate for therapeutic or adjunctive treatment of type 2 inflammation-associated diseases, including asthma.Item Metadata only Communicating Risk Alleles in Kidney Genes: Lessons from APOL1 and New Discoveries of Risk Alleles(2025-01-01) Caliskan Y.; Iltis A.; Wongboonsin J.; Lentine K.L.; Caliskan Y.; Mahidol UniversityEffective communication of genetic risk alleles, particularly APOL1 renal risk variants, is essential for enhancing patient comprehension, guiding clinical decision-making, and ensuring equitable health care. This review explores the communication and implications of risk alleles in kidney-related genes, emphasizing the need for genetic training for nephrologists, expanded genetic counseling services, and multidisciplinary collaboration to optimize test interpretation and patient-centered care. Increasing ancestral diversity in genetic databases remains critical for refining risk assessments and minimizing uncertainty in result interpretation. Additionally, addressing concerns regarding genetic discrimination through legal protections is necessary to promote ethical use of genetic information. Collaborating with experts in risk communication and engaging community members, as exemplified by the APOLLO Consortium's Community Advisory Council, will aid in integrating genetic and nongenetic risk factors to improve health outcomes. Moving forward, research efforts must focus on elucidating APOL1-associated disease mechanisms, refining risk stratification, and developing targeted therapeutics. Implementing innovative communication strategies, including culturally competent counseling, digital education tools, and standardized decision aids, will be vital in making genetic information both accessible and actionable. By addressing these challenges, the medical community can fully leverage genetic testing to advance personalized medicine, improve patient outcomes, and reduce disparities in kidney disease care.Item Metadata only Corrigendum to “Sublethal infection of C3H/HeNJ against Leptospira interrogans serovar Pomona” [Acta Tropica 238 (2023) 106701] (Acta Tropica (2023) 238, (S0001706X2200393X), (10.1016/j.actatropica.2022.106701))(2025-01-01) Krangvichian P.; Nakornpakdee Y.; Sangjun N.; Komanee P.; Techawiwattanaboon T.; Patarakul K.; Krangvichian P.; Mahidol UniversityThe authors have identified an error in the reporting of the Institutional Animal Care and Use Committee (IACUC) approval number. The originally published version incorrectly listed the number as ARC 2/2563. The correct statement should read: The protocols for animal manipulation were approved by the Institutional Animal Care and Use Committee (IACUC) of AFRIMS (approval number: ARAC 2/63). The authors and the Publisher regret the error that appeared in their paper.Item Metadata only Cleanse, Control and Calm: 3C for Simpler Self-care for Atopic Dermatitis(2025-01-01) Wananukul S.; Limpongsanurak W.; Wisuthsarewong W.; Nitiyarom R.; Chatproedprai S.; Wananukul S.; Mahidol UniversityAtopic dermatitis (AD) is a common, chronic inflammatory skin condition affecting a substantial number of individuals globally. Managing AD is a common challenge not only for patients but also for primary care practitioners (PCPs), as they are frequently called to help/care for patients who are seeking relief from its distressing symptoms. This paper presents a concise guide to an eczema self-care routine, which may serve as a valuable resource for PCPs seeking to improve long-term AD management in their patients. We discuss the importance of addressing skin barrier dysfunction and highlight using emollients with active ingredients as fundamental components of AD care. Additionally, we introduce an easy-to-follow 3C (Cleanse, Control, Calm) approach to daily AD self-care that strengthens skin barrier function, supports steroid-sparing, and helps break the cycle of symptomatic treatment. By equipping PCPs with up-to-date knowledge of AD pathophysiology and evidence-based management strategies, this guide seeks to enhance the quality of care provided by PCPs, thereby improving the well-being of individuals living with AD.Item Metadata only Development of multiplex recombinase polymerase amplification for the rapid detection of five carbapenemase (blaKPC, blaNDM, blaOXA-48-like, blaIMP, and blaVIM) and 10 mcr (mcr-1 to mcr-10) genes in blood cultures(2025-10-01) Tullayaprayouch K.; Phuadraksa T.; Luk-In S.; Pornsuwan S.; Changkhundi P.; Wichit S.; Yainoy S.; Tullayaprayouch K.; Mahidol UniversityThe emergence of plasmid-encoded carbapenemase and mobile colistin resistance (mcr) genes poses a significant challenge in controlling the spread of multidrug-resistant Gram-negative bacteria. Addressing this issue requires the development of rapid, accurate, and cost-effective tools for gene detection. For the first time, this study reports three multiplex recombinase polymerase amplification (RPA) assays, each designed to detect five resistance genes: carbapenemase (blaKPC, blaNDM, blaOXA-48-like, blaIMP, and blaVIM), mcr-1 to mcr-5, and mcr-6 to mcr-10. Using agarose gel electrophoresis, all 15 target genes were successfully amplified by the three assays, demonstrating the potential of these assays for integration with rapid reporting platforms. To increase their applicability, the assays were combined with SYBRⓇ Green I for visual identification of all 15 target genes and with lateral flow immunoassays (LFIAs) for detection of two carbapenemase (blaNDM and blaOXA-48-like) and two mcr genes (mcr-1 and mcr-3) genes. Specificity testing showed that RPA-SYBRⓇ Green I and RPA-LFIAs produced no cross-reactivity among the target genes. The limit of detection for RPA-SYBRⓇ Green I, for all genes, ranged from 2 × 100 to 2 × 102 CFU/reaction, and for RPA-LFIAs from 2 × 100 to 2 × 103 CFU/reaction. The developed RPA-SYBRⓇ Green I and RPA-LFIAs successfully detected 15 and four target genes, from positive haemoculture bottles. These assays offer a promising approach for point-of-care testing. Providing a valuable tool for antimicrobial resistance surveillance and timely guidance for effective antibiotic intervention.Item Metadata only Improved Survival in Vascular Pythiosis With Surgery and Azithromycin, Doxycycline, and Itraconazole Therapy: A Phase II Multicenter, Open-Label, Single-Arm Trial(2025-06-15) Torvorapanit P.; Worasilchai N.; Manothummetha K.; Srisurapanont K.; Thongkam A.; Langsiri N.; Leksuwankun S.; Meejun T.; Thanakitcharu J.; Lerttiendamrong B.; Susaengrat N.; Chuleerarux N.; Siriyakorn N.; Watcharasuwanseree S.; Suparatanachatpun P.; Chayangsu S.; Khemla S.; Kajeekul R.; Wattanasoontornsakul W.; Bansong R.; Sakulkonkij P.; Wongkamhla T.; Diewsurin J.; Laohasakprasit K.; Kongsakpaisal P.; Chayapum P.; Chindamporn A.; Plongla R.; Permpalung N.; Torvorapanit P.; Mahidol UniversityBackground Vascular pythiosis, caused by Pythium insidiosum, is a life-threatening disease with high mortality rate in patients with residual disease post-surgery. This study evaluated the effectiveness of a combination therapy of surgery, azithromycin, doxycycline, and itraconazole. Methods In this open-label, Phase II multicenter trial, 51 patients were enrolled. Patients were categorized based on residual disease post-surgery (unresectable lesions, incomplete resection, or persistent symptoms). Patients with residual disease received azithromycin (500 mg daily), doxycycline (100 mg twice daily), and itraconazole (200 mg thrice daily) until beta-d-glucan (BDG) levels were negative (<80 pg/mL) for 3 months. Those without residual disease received the same regimen for 6 months. Outcomes included all-cause mortality at 6 months, adverse events, changes in BDG levels over time, and factors associated with residual disease and mortality. Results At 6 months, the all-cause mortality rate was 15.7%. Mortality in patients with residual disease was 31.5% compared to 6.25% for those without (P =. 04). Lesions above the popliteal artery were a significant predictor of residual disease (incidence rate ratio [IRR] 3.20, 95% confidence interval [CI]: 1.08-11.70). BDG levels decreased over time (odds ratio [OR] 0.82, 95% CI:. 77-.88 per week, P <. 001) but remained higher in the residual disease group (OR 4.29, 95% CI: 1.55-11.92) Conclusions The combination therapy of surgery, azithromycin, doxycycline, and itraconazole improves survival in patients with vascular pythiosis, including those with residual disease. This regimen is well tolerated and should be considered a standard of care, with further research needed for long-term outcomes.Item Metadata only Ensitrelvir for the Treatment of Nonhospitalized Adults with COVID-19: Results from the SCORPIO-HR, Phase 3, Randomized, Double-blind, Placebo-Controlled Trial(2025-06-15) Luetkemeyer A.F.; Chew K.W.; Lacey S.; Hughes M.D.; Harrison L.J.; Daar E.S.; Eron J.; Fletcher C.V.; Greninger A.L.; Hessinger D.; Li J.Z.; Mailhot D.; Wohl D.; Chayakulkeeree M.; Mendoza J.L.A.; Elistratova P.; Makinde O.; Morgan G.; Portsmouth S.; Uehara T.; Smith D.; Currier J.S.; Luetkemeyer A.F.; Mahidol UniversityBackground Ensitrelvir, a severe acute respiratory syndrome coronavirus-2 main protease inhibitor, has demonstrated clinical and virologic efficacy in previous studies. Methods In this global phase 3 trial, nonhospitalized adults with mild-to-moderate coronavirus disease 2019 (COVID-19) and symptom onset within 5 days were randomized (1:1) to receive once-daily ensitrelvir (375 mg day 1, 125 mg days 2-5) or blinded matching placebo. The primary endpoint was the restricted mean time to sustained (≥2 days) resolution of 15 COVID-19 symptoms, recorded in participant daily diaries, through day 29 in participants starting treatment within 3 days after symptom onset. Virologic efficacy and safety were assessed. Results Of 2093 participants, 1888 started treatment within 3 days after symptom onset. Mean time to symptom resolution was 12.5 and 13.1 days with ensitrelvir and placebo, respectively (difference, -0.6 days; 95% confidence interval, -1.38 to 0.19; P =. 14). On day 4, ensitrelvir reduced least-squares mean RNA by 0.72 log10 copies/mL more than placebo (95% confidence interval, 0.55-0.90). Among those with positive viral cultures at enrollment, 274/287 (95.5%) ensitrelvir-treated versus 210/280 (75.0%) placebo-treated participants had negative cultures on day 4. RNA rebound was similar (<1.5%) between groups. The proportion of participants with ≥1 adverse event was similar with ensitrelvir (61.5%) and placebo (60.6%). No treatment-related serious adverse events or deaths occurred. Three (0.3%) ensitrelvir-treated and 1 (0.1%) placebo-treated participants had COVID-19-related hospitalizations by day 29. Conclusions Despite the evidence of antiviral activity with ensitrelvir, this trial did not demonstrate a significant difference in time to sustained symptom resolution.