Arnulfo Hernán Nava-Zavala

Objective: Detangling the rheumatoid arthritis (RA) proteomic profile is of interest to improve diagnosis, RA subclassifications, and targeted treatment. We aimed at identifying serum proteins as candidate biomarkers for RA. Methods: This case-control study included participants with RA and healthy controls (HCs) paired by gender; clinical information and proteomic profiles were analyzed for the identification of candidate protein biomarkers. A statistical analysis included logistic regression and ROC curves for AUC measurement. Results: Following the screening of 176 patients, 25 RA and 25 HC patients were included in this study. The average age was 51 ± 12 years, and 90% were females. Notably, we identified five serum protein candidate biomarkers with differential expression when comparing RA to HC, consisting of testis-expressed protein 13B (p = 6.31 × 10⁻⁴), keratin type II cytoskeletal 79 (p = 1.317 × 10⁻⁴), 60 kDa heat shock protein (p = 7.594 × 10⁻⁴), pseudo uridylate synthase 7 homolog (p = 8.332 × 10⁻³), and SUN domain-containing protein 3 (p = 1.883 × 10⁻⁷). The first four proteins were predominantly observed in patients with RA, while the last was predominantly identified in the HCs. Conclusions: A distinctive serum candidate biomarker profile consistent in five proteins was identified for RA, suggesting a unique stress-related, inflammatory signature. Collectively, the profile exhibits potential, but our findings must be validated in larger cohort studies, preferably in the context of undifferentiated arthritis before a definitive model for diagnosis is established.

Lead is a neurotoxic metal. No safe blood lead level (BLL) has been identified in children; the CDC reference value was lowered to 3.5 µg/dL in 2021, while Mexico’s regulatory threshold remains at 10 µg/dL. Lead-glazed earthenware is the main documented source of pediatric exposure in Mexico. We studied children 0–15 years insured by the Mexican Social Security Institute (IMSS) in two Jalisco municipalities: Tonalá (n = 500), historically a ceramic-producing center, and Zapopan (n = 374), an urban area without this tradition. BLL was measured by graphite furnace atomic absorption spectrophotometry, and sociodemographic, environmental, occupational, and household exposure data were collected by questionnaire and analyzed with bivariate tests and multivariable models. Median BLL was 1.16 µg/dL in Tonalá and 2.08 µg/dL in Zapopan. Few children reached 5 µg/dL (3.2% and 6.4%), roughly twice as many exceeded 3.5 µg/dL (6.6% and 16.3%), and most exceeded 1 µg/dL (59.4% and 93.6%). In Zapopan, household glazed earthenware use and younger age were independently associated with a higher BLL in every model; in Tonalá, paternal professional occupation was associated with a lower BLL, an exploratory finding given its small subgroup. Widespread low-level exposure at both sites supports sustained facility-level surveillance and alignment of Mexico’s regulatory criterion with current reference values.

Acute coronary syndrome (ACS), driven by inflammation and thrombosis, remains a leading cause of morbidity globally. While traditional risk scores are useful, the prognostic value of combining inflammatory and autoimmune biomarkers remains understudied. This study aimed to evaluate the predictive role of high-sensitivity C-reactive protein (hs-CRP), platelet factor 4 (PF4), D-dimer, and antiphospholipid antibodies (anticardiolipin and anti-β2-glycoprotein I) for the development of major adverse cardiovascular events (MACE) in patients with ACS. We conducted a prospective cohort study at a tertiary referral center in Mexico. A total of 103 patients admitted with confirmed ACS were included. Blood samples were collected upon admission to measure biomarker levels. Participants were followed for 30 days. The primary outcome was the occurrence of MACE, defined as reinfarction, death, percutaneous coronary intervention, or bypass surgery. Multivariate logistic regression analysis was performed to identify independent predictors, adjusting for age, smoking, and comorbidities. MACE occurred in 51.4% of participants. Patients with adverse outcomes were significantly older and had longer hospital stays (p < 0.05). In the biomarker analysis, PF4 and hs-CRP demonstrated high sensitivity (98%) but low specificity. In the multivariate analysis, IgG anti-β2-glycoprotein I (p < 0.001) and D-dimer (p = 0.024) emerged as significant independent predictors of MACE. Conversely, IgM isotypes did not show independent predictive value. Beyond traditional risk factors, markers of coagulation (D-dimer) and autoimmunity (IgG anti-β2-glycoprotein I) are independent predictors of short-term adverse events in ACS patients. Integrating these multidomain biomarkers into clinical assessment may enhance risk stratification and prognostic accuracy.

Psoriasis is a chronic, disabling disease not only in terms of physical condition but also psychosocially, which leads to a significant increase in the burden of the disease in all aspects of daily life. This impact goes beyond the patient and affects their circle of interaction, contributing to the deterioration of mental health. The subjective experience of psoriasis has been less studied compared to objective assessments of severity. However, through qualitative research that has been conducted, it has been possible to approach the lived experience of psoriasis from a broader perspective, realistically frame it, and identify the unmet needs of patients and the barriers to accessing adequate and timely care models. Additionally, it allows the recognition of necessary elements for designing more human, fair, and appropriate care strategies. Research from the sociomedical sciences, based on qualitative analysis and contextualized in sociocultural aspects, suggests that the social phenomenon of stigma is a crucial part of what patients endure—this suffering being understood as the experience of psoriasis from the patient’s point of view. This stigma stems mainly from a lack of information about the disease among the general population and even within the medical community itself.

The resolution of the recent COVID-19 pandemic still requires attention, since the consequences of having suffered the infection, even in mild cases, are associated with several acute and chronic pathological conditions referred to as post-COVID syndrome (PCS). PCS often manifests with pulmonary disease and, in up to 9% of cases, a more serious complication known as post-COVID-19 pulmonary fibrosis (PC19-PF), which has a similar clinical course as idiopathic pulmonary fibrosis (IPF). Generating knowledge to provide robust evidence about the clinical benefits of different therapeutic strategies to treat the pulmonary effects of PCS can provide new insights to amplify therapeutic options for these patients. We present evidence found after a scoping review, following extended PRIMSA guidelines, for the use of immunomodulators in pulmonary PCS. We start with a brief description of the immunomodulatory properties of the relevant drugs, their clinically proven efficacy for viral infections and chronic inflammatory conditions, and their use during the COVID-19 pandemic. We emphasize the need for well-designed clinical trials to improve our understanding the physiopathology of pulmonary PCS and PC19-PF and also to determine the efficacy and safety of candidate treatments.

Lipids are a broad group of hydrophobic macromolecules that play critical roles in cell physiology, specifically in metabolism, membrane synthesis and signaling, which also includes the physiology of cancer cells. Due to the metabolic changes in cancer cells, lipids are used as an important energy source and signaling intermediates, which support the progression and survival of the transformed cells. Cholesterol is also an important part of these mechanisms, since it is an essential component of lipid rafts, which act as membrane platforms for signal transduction. Apart from the metabolism and signaling implication of lipids in cancer cells, these molecules may also affect histone modifications and the tumor microenvironment, modifying gene expression, cytokines secretion and the infiltration of white blood cells in the tumor, impeding tumor detections and clearance by the immune system. Due to the preponderant role of lipids in malignant cells, enzyme lipid uptake and synthesis represent potential therapeutic targets that are being studied to provide a complete treatment that focuses on different mechanisms to kill malignant cells. This review aims to provide a metabolic explanation about the influence of lipids in the survival of cancer cells, the immune response evasion, as well as some potential therapeutic targets that regulate these processes.

Background: Gaucher disease (GD) is a rare autosomal recessive disorder caused by mutations in the GBA1 gene that lead to a deficiency in the glucocerebrosidase gene. This deficiency results in the accumulation of glucocerebrosides in macrophages, primarily affecting the liver, spleen, and bone marrow. Focusing on the Mexican population, this study aims to review GD’s epidemiology, clinical manifestations, and treatment options to enhance early diagnosis and optimize treatment outcomes. Methods: This study is a comprehensive literature review analyzing epidemiological data, clinical presentations, and current therapeutic approaches for Gaucher disease, including enzyme replacement therapy (ERT) and substrate reduction therapy (SRT). Conclusions: Early diagnosis and individualized treatment, primarily through enzyme replacement therapy, significantly improve the prognosis of patients with Gaucher disease, particularly type 1. Continued research is required to enhance therapeutic approaches for the neuropathic types and better understand the disease’s epidemiology in Mexico. These efforts will contribute to improved clinical outcomes and quality of life for patients.

Sarcopenia is defined by the presence of decreased skeletal muscle mass, strength, and functionality in older people. Multicomponent interventions represent an alternative to non-pharmacological treatment for preventing disease progression. This study aimed to evaluate the effects of a multicomponent intervention approach in women at risk of sarcopenia. Methods: A quasi-experimental pilot study of 12 weeks was conducted, with 24 sessions of dancing and resistance exercises and 12 sessions of nutritional education. The outcomes were changes in muscle mass, grip strength, gait speed, and body composition. The project was registered on Clinical Trials: NCT06038500 (14 September 2023). Results: Twelve women aged 55–75 years participated in this study; after the intervention, changes were found in the following variables: grip strength, from 18.70 (17.98–19.23) at baseline to 21.57 (20.67–23.16) kg (p = 0.002); gait speed, from 0.95 (0.81–1.18) at baseline to 1.34 (1.20–1.47) m/s (p = 0.003); and hip circumference, from 99.75 (94.75–110.37) at baseline to 97.65 (93.92–109.50) cm (p = 0.023). Other measurements that appeared without changes were appendicular skeletal muscle mass, from 21.17 (18.58–22.33) at baseline to 20.77 (18.31–22.39) kg (p = 0.875), and the appendicular skeletal muscle mass index, from 8.64 (8.08–9.35) at baseline to 8.81 (7.91–9.38) kg/m² (p = 0.875) after the intervention. Conclusions: The three-month multicomponent intervention in women at risk of sarcopenia improved their grip strength and gait speed.