Kermanshah University of Medical Sciences

Parasitic infections pose a significant global health burden, particularly in regions with limited medical resources and poor sanitation. These infections often have detrimental effects on the human body, including disruptions to the hematopoietic system, the intricate network responsible for blood cell production. Parasites such as Plasmodium, Schistosoma, and Leishmania are notorious for causing blood disorders such as anemia, thrombocytopenia, and leukopenia. Understanding the intricate interactions between parasites and the hematopoietic system is crucial for developing effective diagnostic, therapeutic, and preventive strategies. This review explores the multifaceted effects of parasitic infections on hematological parameters. The mechanisms are explored by which parasites can disrupt red blood cell production, leading to various types of anemia. Additionally, we examined the effects of parasites on platelet counts and white blood cell populations, highlighting the potential for both thrombocytopenia and leukocytosis. Furthermore, the role of parasites is examined in inducing coagulation disorders and the implications for clinical management. By understanding the complex interplay between parasites and the hematopoietic system, healthcare professionals can develop more targeted and effective interventions to address the significant health challenges posed by parasitic infections.

Obstructive sleep apnea (OSA), marked by recurrent upper airway obstruction during sleep, poses significant risks due to its association with cardiovascular diseases. This study systematically analyzed the link between circulating vascular cell adhesion molecule-1 (VCAM-1) levels and OSA, highlighting its role as a biomarker of endothelial dysfunction and its potential connection to cardiovascular disease.

The databases searched for the meta-analysis included PubMed/Medline, Scopus, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI), up to March 22, 2025. Effect sizes were calculated using the standard mean difference (SMD) with 95% confidence intervals (CIs), and advanced statistical techniques such as subgroup, meta-regression, and sensitivity analyses were employed to ensure the robustness of findings. Additional assessments included publication bias tests and trial sequential analysis to confirm adequate sample size and reliability.

Of 406 identified records, 19 articles (28 studies) met inclusion criteria, revealing significantly higher VCAM-1 levels in OSA patients (SMD=1.90, 95% CI: 1.45-2.35; P<0.00001). Subgroup analyses consistently showed elevated VCAM-1 level, with variations across ethnicity and OSA severity, while sensitivity analysis confirmed robustness despite high heterogeneity (I²=94%). Publication bias and trial sequential analysis highlighted reliability but emphasized cautious interpretation of results.

VCAM-1 shows potential as a biomarker for OSA, indicating systemic inflammation and endothelial dysfunction linked to cardiovascular risks. Its utility in early detection and treatment development is promising, but further research is needed to validate findings across populations and explore its connection to OSA-related comorbidities for innovative therapies.

While cell-based scaffolds represent a promising approach in tissue regeneration, limitations such as poor cell survival, immunogenicity, and scalability have prompted the development of cell-free therapies. Exosomes (EXOs), nanosized extracellular vesicles derived from mesenchymal stem cells (MSCs), have emerged as pivotal therapeutic agents for skin wound healing. These vesicles overcome challenges in chronic and acute wound management by promoting functional skin restoration through intricate modulation of angiogenesis, immunoregulation, extracellular matrix (ECM) remodeling, and re-epithelialization. This review provides a detailed analysis of MSC and EXO biology, highlighting how MSC source influences EXO cargo and function. We discuss the integration of EXOs into advanced biomaterial scaffolds, including 3D-bioprinted hydrogels and electrospun nanofibers, which enhance EXO retention and sustain release at the wound site. The review critically evaluates the mechanisms through which EXOs activate key signaling pathways (PI3K/Akt, TGF-β/Smad) to coordinate healing. Furthermore, we summarize current preclinical and clinical trials, available commercial products, and the significant challenges-including EXO heterogeneity, isolation standardization, and regulatory hurdles-that must be addressed to realize the clinical potential of EXO-based therapies. By synthesizing current knowledge and future perspectives, this review aims to advance the design of novel, effective cell-free scaffolds for reparative medicine.