Chronic lymphocytic leukemia (CLL) is a hematologic malignancy originating from mature B cells, where the tumor microenvironment—particularly proliferation centers (PCs)—plays a pivotal role in disease progression and treatment resistance. PCs support tumor cell survival, proliferation, and therapy resistance through intercellular communication, metabolic reprogramming, and extracellular vesicle (EV)-mediated signaling. This study investigates the mechanisms by which the CLL microenvironment, especially PCs, contributes to drug resistance and disease evolution, with a particular focus on EVs and metabolic remodeling. A comprehensive literature review was conducted to synthesize current findings in this domain.. Key findings reveal that PCs mediate resistance through multiple interconnected mechanisms, including: (1) the CXCL12/CXCR4 retention axis; (2) CD40-CD40L-induced activation of the alternative NF-κB pathway; (3) metabolic reprogramming favoring anti-apoptotic profiles; and (4) EV-mediated communication that alters stromal cell behavior. CLL-derived EVs play a critical role in reshaping the bone marrow microenvironment by transferring miRNAs and proteins that alter stromal cell function and metabolism. Additionally, this study identifies a “dual metabolic shift” in CLL cells, characterized by the simultaneous enhancement of both glycolysis and oxidative phosphorylation, which is closely linked to microenvironmental dependency. Furthermore, the research uncovers metabolic regionalization within PCs and spatiotemporal heterogeneity in EV distribution.

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The intestinal barrier is one of the body's most important defence barriers, preventing harmful substances in the intestine from crossing the intestinal mucosa into the body. Impaired intestinal barrier function is commonly seen in patients with inflammatory bowel disease (IBD) and is associated with structural and functional abnormalities in the tight junctions of intestinal epithelial cells. Modulating the expression of specific inflammatory factors can effectively reduce intestinal inflammation, promote intestinal barrier repair, and restore intestinal function. This review elucidates the role of modulating inflammatory factors in promoting intestinal barrier restoration and treating intestinal diseases. The effects of regulatory inflammatory factors on cell signaling pathways and gut microbiota were also explored. Technical references are provided for modulating inflammatory factors to restore the intestinal barrier. Finally, the limitations and deficiencies in IBD treatment with intestinal barrier damage and the challenges faced in clinical application are analysed in depth.

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In response to the limitations of existing treatment methods, the development of new treatment approaches that can delay or reverse the neurodegenerative process has become a research hotspot. Gene therapy, especially strategies based on adeno-associated virus (AAV) vectors, is emerging as a research frontier in the treatment of Parkinson's disease due to its high efficiency, low immunogenicity, long-term stable expression, and neuron tropism in the nervous system. Recent clinical trials have demonstrated significant improvements in motor function, with some approaches showing up to 36% enhancement in UPDRS scores. AAV-mediated gene therapy mainly focuses on the following therapeutic targets: dopamine pathway reconstruction, neurotrophic factor delivery, α-synuclein clearance strategies, and emerging therapeutic targets. The main purpose of this review is to evaluate the latest research progress of AAV vector gene therapy in Parkinson's disease, focusing on analyzing its potential and challenges in the preclinical and clinical translation process and proposing possible optimization paths to promote the clinical application of gene therapy.

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COVID-19 is a new disease spreading and causing harm across the world. The lack of research on adolescent immunity limits treatment options, which affects the health status of this age group and society as a whole. This article summarised recent evidence regarding immunity response in adolescents and found that the immunity duration lasts more than one year. However, other factors influencing long-term immunity remain debatable. These results could guide more reasonable vaccine policies and improve treatment plans for adolescents, leading to better control of the spreading of COVID-19.

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