ABSTRACT Background Patent ductus arteriosus (PDA) and patent foramen ovale (PFO) are two fetal cardiovascular shunts that normally undergo functional and anatomical closure shortly after birth. While PDA is a well‐recognized congenital defect in veterinary cardiology, the haemodynamic interaction between PDA and PFO has received little attention, particularly in neonates. Objectives To review the physiological and pathophysiological relationship between PDA and PFO and evaluate available evidence from veterinary and comparative human literature. Review Content Increased pulmonary blood flow and secondary pulmonary hypertension associated with PDA may alter right‐sided cardiac pressures and predispose affected neonates to persistent or reopened PFO, potentially resulting in interatrial shunting and cyanosis. PDA represents one of the most prevalent congenital cardiac defects encountered in canine medicine and constitutes a substantial proportion of congenital heart diseases in dogs. Conversely, PFO appears to be less frequently recognized in veterinary patients, likely because many affected animals remain clinically asymptomatic. In human medicine, persistence of the foramen ovale has been identified in approximately one‐quarter of the adult population. This narrative review summarizes the physiology and pathophysiology of ductus arteriosus and foramen ovale closure, analyses the mechanisms by which PDA can influence FO patency, and discusses relevant evidence from both veterinary and human literature. Conclusions Although no clearly documented veterinary case of concurrent PDA and PFO has been identified, comparative evidence suggests that secondary pulmonary hypertension may play an important role in this interaction. Improved understanding of this relationship may enhance diagnostic accuracy and management strategies in neonatal animals.
Amir Mohammad Barati· Veterinary Medicine and Scie...· 0 citations
Breast cancer is one of the most common malignancies worldwide and remains a leading cause of cancer-related mortality. Over the past decades, advances in multimodal treatment have significantly improved patient survival. However, disease recurrence, metastatic progression, and therapeutic resistance continue to limit long-term outcomes, underscoring the need for more effective therapies. Among emerging immunotherapeutic approaches, chimeric antigen receptor T (CAR-T) cell therapy has attracted considerable attention. CAR-T therapy has achieved remarkable success in hematologic malignancies, prompting its investigation in breast cancer. However, translating this success to solid tumors remains challenging because of fundamental biological differences between hematologic and solid malignancies. Major barriers include antigen heterogeneity, limited tumor trafficking and infiltration, an immunosuppressive tumor microenvironment, and therapy-related toxicities. Numerous preclinical and clinical studies are currently evaluating CAR-T cell therapy in solid tumors, including breast cancer. These efforts incorporate next-generation CAR designs and novel engineering strategies with the goal of reproducing the clinical success achieved in hematologic malignancies. Although the available clinical evidence is still largely limited to early-phase trials, current findings suggest that CAR-T therapy in breast cancer is feasible and generally well tolerated. Most reported adverse events have been low-grade inflammatory toxicities, whereas severe neurotoxicity and dose-limiting toxicities have been infrequent. Despite this favorable safety profile, clinical responses remain modest, with stable disease representing the most common outcome and durable objective responses being uncommon. These findings underscore the need to overcome the major biological barriers that continue to limit CAR-T cell therapy in solid tumors. This review summarizes recent advances in CAR-T cell engineering, discusses the major target antigens investigated to date, provides a comprehensive overview of the available clinical evidence, and examines the key biological and clinical challenges that must be addressed to improve future therapeutic outcomes.
Ahmad Farajzadeh, Mahmoud Mahmoudi, Soroush Yazdani et al.· International Immunopharmaco...· 0 citations
