Jia-Yan Chen

(1) Background: Recent studies suggest a potential link between gut microbiomes (GMs) and inflammatory diseases, but the role of GMs in lichen sclerosus (LS) remains unclear. This study aims to investigate the causal relationship between GMs and LS, focusing on key GM taxa. (2) Methods: We utilized GWAS summary statistics for 211 GM taxa and their association with 2,445 LS patients and 353,088 healthy controls, employing Mendelian randomization (MR). GWAS data for GM taxa came from the MiBioGen consortium, and for LS from the FinnGen consortium. The primary analytical tools included the inverse-variance weighted (IVW) method, weighted MR, simple mode, weighted median, and MR-Egger methods. Sensitivity analyses included leave-one-out analysis, MR-Egger intercept test, MR-PRESSO global test, and Cochrane’s Q-test. A reverse MR analysis was conducted on bacteria identified in the forward MR study. (3) Results: We identified one strong causal relationship: order Burkholderiales [odds ratio (OR) = 0.420, 95% confidence interval (CI): 0.230 - 0.765, p = 0.005], and three nominally significant relationships: phylum Cyanobacteria (OR = 0.585, 95% CI: 0.373 - 0.919, p = 0.020), class Betaproteobacteria (OR = 0.403, 95% CI: 0.189 - 0.857, p = 0.018), and genus Butyrivibrio (OR = 0.678, 95% CI: 0.507 - 0.907, p = 0.009). Moreover, this MR analysis was not impacted by horizontal pleiotropy, according to the MR-Egger intercept test and MR-PRESSO global test (p > 0.05). Remarkably, the reliability of our results was confirmed by leave-one-out analysis. Reverse MR analysis showed no significant causal relationship between LS and GM. (4) Conclusions: This MR study identifies specific gut flora linked to a lower risk of LS, offering new insights for disease treatment and prevention. Future research should incorporate metagenomics sequencing of extensive microbiome GWAS datasets.

Prostate cancer (PCa) is a widespread malignancy with global significance, which substantially affects cancer-related mortality. Its spectrum varies widely, from slow-progressing cases to aggressive or even lethal forms. Effective patient stratification into risk groups is crucial to therapeutic decisions and clinical trials. This review examines a wide range of diagnostic and prognostic biomarkers, several of which are integrated into clinical guidelines, such as the PHI, the 4K score, PCA3, Decipher, and Prolaris. It also explores the emergence of novel biomarkers supported by robust preclinical evidence, including urinary miRNAs and isoprostanes. Genetic alterations frequently identified in PCa, including BRCA1/BRCA2, ETS gene fusions, and AR changes, are also discussed, offering insights into risk assessment and precision treatment strategies. By evaluating the latest developments and applications of PCa biomarkers, this review contributes to an enhanced understanding of their role in disease management.

Background: Stereotactic ablative body radiotherapy (SABR) is one of the treatment options for oligometastatic renal cell carcinoma (RCC) but is limited by a lack of data to evaluate high-dose SABR to all/multiple sites. Objective: This study retrospectively investigated the efficacy and prognostic factors of high-dose SABR for oligometastatic RCC patients. Design, setting, and participants: Patients with oligometastatic RCC on systemic therapy were retrospectively collected. Intervention(s): All patients were treated with SABR (40–50 Gy/5 fractions) for small tumors or partial-SABR (tumor center boosted with 6–8 Gy/3–5 fractions with 50–60 Gy/20–25 fractions to the whole tumor volume) for bulky tumors or tumors adjacent to critical organs. Outcome measurements and statistical analysis: Progression-free survival (PFS) and overall survival (OS) were calculated. Results and limitations: In total, 35 patients were enrolled, of which 88.5% had intermediate- or high-risk disease, with 60% on second- to fourth-line systemic therapy. The median follow-up time was 17 months. The median PFS and OS times were 11.3 and 29.7 months, respectively. Univariate analysis showed that an OS benefit was found in patients who received radiation before tyrosine kinase inhibitor (TKI) failure (p = 0.006) and where there was a short time interval (p = 0.046). Similar results were also found in PFS in patients who received radiation before TKI failure (p = 0.049) or within eight months (p = 0.047). There were certain differences in PFS (p = 0.033) between patients receiving radiotherapy with all lesions and those with selected tumors. In multivariate analysis, OS benefits were found in patients who received radiotherapy before TKI failure (p = 0.028). The limitations of this study include its retrospective design and the small patient cohort. Conclusions: The early use of high-dose SABR to multi-lesions may improve survival. Partial-SABR for bulky lesions close to critical organs could be safely and effectively applied under certain circumstances.