Objective To summarize the changes in the tumor microenvironment (TME) of pancreatic ductal adenocarcinoma (PDAC) in the context of immunotherapy and their impact on treatment outcomes. MethodsA systematic review of recent studies on the TME of PDAC was carried out to analyze the immune properties, intercellular interactions, and biological functions of its cellular and non-cellular components, disclose the molecular mechanisms of immunotherapy affects on the TME, explore the advancements in targeted therapy and potential biomarkers, and analyze the challenges in clinical applications and their impacts on the quality of life of patients. ResultsThe TME of PDAC exhibits highly immunosuppressive and heterogeneous characteristics, rich in diverse cells (such as pancreatic cancer cells, stellate cells, cancer-associated fibroblasts, immune cells) and non-cellular components (such as extracellular matrix). Immunotherapy is capable of regulating the immune balance in the TME and enhancing the anti-tumor response. Despite the progress made in multiple immunotherapy strategies (such as immune checkpoint inhibitors, chimeric antigen receptor cell therapy), challenges such as difficulty in selecting targets, drug resistance, and side effects still persist. Meanwhile, potential biomarkers such as programmed cell death-ligand 1, tumor-infiltrating lymphocytes, and leukemia inhibitory factor offer new directions for individualized treatment. ConclusionsThe TME of PDAC undergoes continuous changes during immunotherapy. In the future, it is requisite to integrate new technologies to deeply explore targets and biomarkers, optimize multimodal precise treatment strategies, enhance the safety and efficacy of immunotherapy, and improve the prognosis of patients.
Sepsis is a systemic inflammatory response syndrome caused by infection, with high fatality rate and complex pathogenesis. Early and accurate diagnosis is essential to improving the prognosis of patients with sepsis. This review briefly describes the basic pathogenesis of sepsis, and summarizes the current new technologies for detecting sepsis from two aspects: pathogen detection and host immune status detection, such as digital polymerase chain reaction, biosensors, fluorescent probes, single-cell RNA sequencing, and enzyme-linked immunospot assay. By comprehensively analyzing and applying these new techniques, it is helpful to improve the efficiency and accuracy of early diagnosis of sepsis and improve the clinical treatment effect of patients.