According to the type of surgery and the definition of PPCs, the incidence of PPCs has been reported to range from 5 to 33%. It is quite certain that postoperative pulmonary complications (PPCs) result in more morbidity and mortality, as well as prolong hospital stays. Secondary endpoints will be serum IL-6, TNF-α, procalcitonin (PCT) kinetics during and after surgery, incidence of PPCs, organ dysfunction, length of in-hospital stay, and hospital expense. Primary endpoints will be postoperative atelectasis measured by chest electrical impedance tomography (EIT) and intraoperative oxygen index. Standard lung-protective ventilation methods such as low tidal volumes (7 ml/kg, predicted body weight, PBW), a fraction of inspired oxygen ≥ 0.5, and recruitment maneuvers (RM) will be applied during and after operation in both groups. A PEEP of 5 cmH 2O will be used in PEEP5 group, whereas an individualized PEEP value determined by a Cstat-directed PEEP titration procedure will be applied in the iPEEP group. They will be randomly assigned to control group (PEEP5 group) and iPEEP group. A total number of 80 obese patients with body mass index ≥ 32.5 kg/m 2 scheduled for laparoscopic gastric volume reduction and at medium to high risk for PPCs will be enrolled. This study is a single-center, two-arm, prospective, randomized control trial. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. All rights reserved.Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Therefore, this platform may lay a solid foundation for the design and preparation of personalized therapeutic vaccines based on neoantigen peptides.Īntigen delivery Cancer vaccine Cytotoxic T-Lymphocyte (CTL) Virus-like particle (VLP).Ĭopyright © 2021 Elsevier Ltd. Compared with other chemically synthesized nanomaterials, VLPs have obvious advantages as vaccine carriers due to their clear chemical composition, fixed spatial structure, excellent biocompatibility, and relatively high potential for clinical translation. Mouse tumor model experiments showed that VLP-OVA T could significantly inhibit tumor growth by increasing the proportions of CD4 + T cells, CD8 + T cells and effector memory T cells (T EM cells) and lowering the proportion of myeloid-derived suppressor cells (MDSCs) among tumor-infiltrating lymphocytes and splenocytes. Subsequent experiments showed that VLP-OVA B induced an antibody titer against the peptide antigen as high as 5.0 × 10 5 and that VLP-OVA T induced highly effective cross-presentation and then strongly activated a T epitope-specific CTL response. The B and T epitopes (OVA B peptide and OVA T peptide) of ovalbumin (OVA) were used here as model antigens and fused individually at the C terminus of the coat protein (CP), which allowed display on the surface of P22 particles to form two types of vaccine particles (VLP-OVA B and VLP-OVA T). In this study, virus-like particles (VLPs) derived from the phage P22 were adopted to load peptide antigens on the surface, to test whether VLP technology can be used as a platform for efficient peptide antigen delivery by therapeutic cancer vaccines. However, addressing the needs to quickly and efficiently elicit a high-intensity immune response against neoantigen peptides, especially to induce an effective cytotoxic lymphocyte (CTL) reaction, remain challenges in this field. As a new strategy for cancer immunotherapy, therapeutic cancer vaccines have been greatly improved in recent years.
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