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Original Article Open Access
Kumaran Kasianthan, Janardanan Subramonia Kumar, Kandasamy Nagarajan ArulJothi
Published online May 15, 2024
Gene Expression. doi:10.14218/GE.2023.00184
Abstract
Familial hypercholesterolemia (FH) is characterized by an elevated level (>155 mg/dL) of LDL (low-density lipoprotein)-Cholesterol in the blood circulation and is one of the [...] Read more.

Familial hypercholesterolemia (FH) is characterized by an elevated level (>155 mg/dL) of LDL (low-density lipoprotein)-Cholesterol in the blood circulation and is one of the major causes of premature atherosclerotic cardiovascular diseases. The significant genes responsible for this lipid deposition are LDL-Receptor (LDLR), Apolipoprotein B-100 (APOB), and proprotein convertase subtilisin/kexin type 9 genes (PCSK9). Other than these 3 genes, 64 gene loci have been identified as polygenic causes. The aim of the study is to analyze the other genes involved in this condition. This can be obtained using differential expression analysis of the already existing FH mRNA expression dataset.

In this study, three datasets representing the markers of monocyte, T lymphocyte, and iPSC in atherosclerosis and FH were selected from the pool of hypercholesterolemia datasets, and differential expression analysis was done using networkanalyst.ca.

The monocyte and t-lymphocytes datasets each had 743 differentially expressed genes (DEGs), while the iPSCs dataset contained 691 DEGs. RPS7, AKRIC3, PL9, and OSM are among the genes that are expressed in the majority of Gene ontology annotations.

According to the findings, genes with varied levels of expression are associated with a variety of functions, including membrane transport, ubiquitin-protein ligase activity, the COP9 signalosome complex, the mitochondrial respiratory chain, and copper metabolism. Analyzing these critical genes lays the groundwork for investigating potential therapeutic targets that could alleviate the impact of cardiovascular disease in individuals diagnosed with FH.

Full article
Review Article Open Access
Rakesh Kashyap
Published online May 15, 2024
Future Integrative Medicine. doi:10.14218/FIM.2023.00071
Abstract
Essential oils, known for their pleasant aromas, not only calm the mind and elevate the mood but also captivate the interest of researchers aiming to unveil their vast potential. [...] Read more.

Essential oils, known for their pleasant aromas, not only calm the mind and elevate the mood but also captivate the interest of researchers aiming to unveil their vast potential. Various methodologies are employed to explore the diverse capabilities of essential oils, often yielding promising and significant outcomes. This review aims to elucidate the molecular mechanisms of essential oils at the cellular level. It identifies multiple mechanisms through which essential oils exhibit their therapeutic effects across various systems. However, a comprehensive understanding of their fundamental mechanisms still necessitates extensive research. In this review, we discuss the mechanisms underlying the biological activities of essential oils, specifically their antioxidant, antimicrobial, anticarcinogenic, anti-diabetic, and anti-inflammatory properties.

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Research Letter Open Access
Review Article Open Access
Muhammed Mubarak, Rahma Rashid
Published online May 15, 2024
Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2024.00002
Abstract
During the past few years, numerous advances have been made in the characterization and categorization of renal tumors, particularly malignant tumors. During these years, new treatment [...] Read more.

During the past few years, numerous advances have been made in the characterization and categorization of renal tumors, particularly malignant tumors. During these years, new treatment approaches have also been developed, along with the emergence of new molecular data on renal tumors, paving the way for precision diagnostics and therapeutics. The World Health Organization (WHO) Classification of Tumors series for urinary and male genital tract tumors represents the major global platform for updates in the pathology of urological cancers including renal cell carcinoma. The latest WHO classification was published in 2022 and incorporates significant changes from the previous (WHO 2016) classification. The aim of this review is to describe the diagnostic updates and the major changes in the latest classification of kidney epithelial tumors and the rationale behind these changes.

Full article
Review Article Open Access
M. Jesús Fernández-Aceñero, Desiré Hernández, Cristina Díaz del Arco
Published online May 15, 2024
Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2024.00007
Abstract
Gastrointestinal tract tumors, i.e., esophageal, gastric, small, and large bowel carcinomas, are some of the most frequent malignant neoplasms. The landscape of these neoplasms [...] Read more.

Gastrointestinal tract tumors, i.e., esophageal, gastric, small, and large bowel carcinomas, are some of the most frequent malignant neoplasms. The landscape of these neoplasms varies significantly. Although the incidence of esophageal carcinoma seems to be decreasing, gastroesophageal junction tumors are on the rise. The incidence of antral gastric carcinoma of the tubular type also seems to be decreasing, yet the prognosis remains largely unchanged, especially for advanced disease. Small bowel carcinomas are infrequent, but the prognosis is dismal. Colorectal carcinoma has become the second leading cause of cancer-related deaths in Western countries, and despite screening campaigns, many patients are still diagnosed with advanced or metastatic disease, leading to a poor prognosis. Unlike other tumors, breakthroughs in targeted therapies have not been so impressive in gastrointestinal tumors. Anti-HER2 drugs, immune checkpoint inhibitors, or drugs against claudin 18.2 only benefit small subsets of patients, and management in many cases is still based on conventional chemoradiation therapy. The future development of therapies for these tumors will depend on understanding the molecular basis of the disease. Many researchers are working to shed light on the molecular pathogenesis of gastrointestinal cancer. This review aims to summarize the main breakthroughs in the knowledge of the molecular basis of gastrointestinal cancers, focusing on those that could lead to significant changes in the management and prognosis of these prevalent and still lethal neoplasms.

Full article
Review Article Open Access
Abdeslam Jaafari
Published online May 14, 2024
Gene Expression. doi:10.14218/GE.2023.00039S
Abstract
Colorectal cancer (CRC) is one of the most frequent causes of cancer-related death worldwide. Chemotherapeutic agents used in CRC treatment include oxaliplatin, irinotecan, leucovorin, [...] Read more.

Colorectal cancer (CRC) is one of the most frequent causes of cancer-related death worldwide. Chemotherapeutic agents used in CRC treatment include oxaliplatin, irinotecan, leucovorin, Tegafur-Uracil, capecitabine, 5-fluorouracil, and monoclonal antibodies. The development of other effective drugs is urgently needed for CRC patients. As the epigenetics of CRC is increasingly understood, epigenetic modifiers (or epidrugs) targeting epigenetic mechanisms could play an important role in this process. During the past two decades, many studies have demonstrated that many specific genes are silenced by hypermethylation of their promoters in CRC, which means that the expression of these genes could be restored since epigenetic alterations are reversible. In fact, some molecules have been studied for their ability to inhibit DNA methyltransferases, and the results showed that silenced genes were reactivated. These molecules could be natural, such as curcumin, tea polyphenols, quercetin, and nanaomycycin A, or synthetic, such as 5-azacytidine, decitabine, procainamide, and zebularine. On the other hand, we hypothesized in this article that ten-eleven translocation inhibitors could be another class of epigenetic modifiers since they could prevent chromosomal instability through decreasing the global hypomethylation of genomic DNA. Some studies have reported that some ten-eleven translocation inhibitors exhibit anticancer effects, which supports our hypothesis. Additionally, we have proposed combinations of these epigenetic modifiers according to different parameters.

Full article
Case Series Open Access
Kenji Miki, Masayoshi Yamanishi, Satoko Mibayashi, Shinsaku Imashuku
Published online May 14, 2024
Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2023.00064
Abstract
Disseminated carcinomatosis of bone marrow (DCBM) occurs mostly in stomach cancer patients; however, characterizing tumor cells morphologically and phenotypically in the bone marrow [...] Read more.

Disseminated carcinomatosis of bone marrow (DCBM) occurs mostly in stomach cancer patients; however, characterizing tumor cells morphologically and phenotypically in the bone marrow is not an easy task. In addition, among patients with DCBM, an unknown primary site (CUPS) is rarely noted despite standard clinical evaluation, imaging studies, and endoscopic findings. This study aimed to clarify the diagnosis/outcome of DCBM in elderly patients we have treated.

Here, we report eight DCBM cases. Once tumor clumps were noted in the bone marrow, we performed serum tumor markers, immunostaining of tumor cells in the bone marrow clot, or biopsy preparations. In addition, imaging studies (CT/MRI/ FDG PET-CT) were performed.

Of eight cases, two were diagnosed with DCBM/CUPS, whose clinical course is described in detail. The outcomes of DCBM and DCBM/CUPS, particularly in elderly patients were dismal and we could not perform comprehensive genomic profiling in these cases.

To improve the DCBM patients’ prognosis through the use of conventional morphological/phenotypical characteristics is limited. Recently, the application of comprehensive genomic profiling has been recommended. However, we encountered difficulty in applying comprehensive genomic profiling for the treatment of elderly patients with DCBM/CUPS.

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Review Article Open Access
Xin Luo, Lun-Gen Lu
Published online May 11, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00519
Abstract
Cholestatic liver disease is a group of diseases in which bile acid accumulates in the liver for various reasons, resulting in abnormal liver biochemical indicators and histological [...] Read more.

Cholestatic liver disease is a group of diseases in which bile acid accumulates in the liver for various reasons, resulting in abnormal liver biochemical indicators and histological damage. Cholestasis can be divided into intrahepatic cholestasis and extrahepatic cholestasis, which will contribute to liver damage and progress to liver fibrosis and cirrhosis. Primary biliary cholangitis (PBC) and primary sclerosing cholangitis are the two most typical cholestatic liver diseases. Ursodeoxycholic acid is currently the first-line treatment for PBC, while obeticholic acid, budesonide and fibrates have also shown good potential in the treatment of PBC. There are currently no official drugs approved to treat primary sclerosing cholangitis, and the use of ursodeoxycholic acid may have certain clinical benefits. At present, progress has been made in new treatment directions for cholestatic liver disease, including fibroblast growth factor 19, cholestyramine, S-adenosyl-L-methionine, steroid drugs, farnesoid X receptor agonists, and more. Considerable progress has been made in the management of cholestatic liver disease but there are still many opportunities and challenges. In this review, we summarized the recommended guidelines for the management of cholestatic disease and the progress of new drug research and development, in order to provide an important reference for the clinical practice of cholestatic liver disease.

Full article
Review Article Open Access
Temitope G. Olowe, Mega O. Oyovwi, Kingsley E. Nwangwa, Ejiro Peggy Ohwin, Onome B. Oghenetega
Published online May 11, 2024
Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2023.00025S
Abstract
Cyclophosphamide (CP) is a potent chemotherapeutic agent utilized in the treatment of various types of cancer. However, in addition to its efficacy in combating cancer, CP also [...] Read more.

Cyclophosphamide (CP) is a potent chemotherapeutic agent utilized in the treatment of various types of cancer. However, in addition to its efficacy in combating cancer, CP also has severe side effects, including damage to male gonadal functions. This paper aims to explore the cytotoxic properties of CP and its mechanistic impacts on male gonadal functions. The search strategy was conducted using several reviewed articles indexed in PubMed, Science Direct, EBSCO, Scopus, Cochrane Library, Sage Journals, and Google Scholar. CP is an alkylating agent that damages cancer cell DNA, inhibiting growth and division. It also affects healthy cells, leading to severe cytotoxicity. In male gonadal tissues, CP damages germ cells, Leydig cells, and Sertoli cells, causing decreased sperm count, testosterone levels, and disruption of the blood-testis barrier. The metabolism of CP in the liver generates reactive oxygen species, leading to oxidative damage and cell death. Moreover, CP also affects the hypothalamic-pituitary-gonadal axis, regulating male gonadal functions. CP disrupts the production and secretion of gonadotropin-releasing hormone, follicle-stimulating hormone, and luteinizing hormone, resulting in a decrease in testosterone levels and impaired spermatogenesis. Additionally, CP exerts its cytotoxic effects by inhibiting the proliferation and differentiation of germ cells, leading to a decrease in sperm production. It also affects Leydig cells, which are responsible for the production of testosterone, thus decreasing testosterone levels. In conclusion, CP exhibits potent cytotoxic properties that not only affect cancer cells but also severely damage male gonadal functions. The mechanisms involved in CP-induced gonadal toxicity include oxidative stress and disruption of the hypothalamic-pituitary-gonadal axis. Therefore, it is crucial to consider the potential gonadal toxicity of CP when prescribing it for cancer treatment and to closely monitor the gonadal functions of male patients receiving CP therapy.

Full article
Review Article Open Access
Natalia Todosenko, Kristina Yurova, Olga Khaziakhmatova, Maria Vulf, Maria Bograya, Pavel Ivanov, Larisa Litvinova
Published online May 8, 2024
Gene Expression. doi:10.14218/GE.2023.00202
Abstract
A key element in the pathogenesis of metabolic syndrome (MetS) is the reprogramming of hypothalamic cells at the genetic level (in the prenatal phase), which leads to neuroinflammation. [...] Read more.

A key element in the pathogenesis of metabolic syndrome (MetS) is the reprogramming of hypothalamic cells at the genetic level (in the prenatal phase), which leads to neuroinflammation. We hypothesize that alterations in the structure of hypothalamic neurons mediated by (epi)genetic alterations are directly related to impaired expression/production of neurotrophins and neurotransmitters that control the metabolism of substances in the brain and periphery, including brain-derived neurotrophic factor (BDNF). The aim of this review is to describe the molecular genetic and epigenetic role of BDNF in the development of MetS. Articles entered into the National Library of Medicine Medline database via the PubMed interface were used to create this review. We attempted to include as much literature as possible, including reviews, animal studies, cell culture studies, and clinical trials. Studies on BDNF point to its role in metabolic processes, including glucose, insulin, and cholesterol homeostasis. Evidence-based studies show that multiple genes in close proximity to BDNF are involved in the development of MetS. Studies aimed at analyzing BDNF in metabolic diseases using different biological samples will reveal clear pathophysiological links between processes in the brain and in the periphery.

Full article
Original Article Open Access
Mª Jesús Fernández-Aceñero, Salomé Merino, Desirée Hernández, Santiago Ochagavia, Melchor Saiz-Pardo, Pablo Pérez Alonso, Tomas Ganado, Jesús Vega, Cristina Díaz del Arco
Published online May 6, 2024
Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2023.00062
Abstract
Fine needle aspiration cytology (FNAC) is a cost-efficient technique for the management of thyroid nodules. Changes in the World Health Organization classification of thyroid tumors [...] Read more.

Fine needle aspiration cytology (FNAC) is a cost-efficient technique for the management of thyroid nodules. Changes in the World Health Organization classification of thyroid tumors can influence reliability of cytology. The 2023 Bethesda System for Reporting Thyroid Cytopathology has adapted cytological nomenclature to these changes. The aim of this paper was to review the management of atypia of undetermined significance (AUS) in our institution.

Retrospective review of thyroid FNAC diagnosed with AUS in a single hospital between 2014 and 2022. We analyzed the management of patients and the risk of malignancy associated with AUS.

AUS represented 7.5% of all thyroid FNAC diagnoses (273 patients). In 74.1% of the patients, FNAC was repeated, and 54.9% of the lesions were downgraded. Surgical resection of the nodule was performed in 38.2% of the patients, mostly after a repeat FNAC with upgrading. Ninety-one percent of the patients downgraded in the repeat FNAC did not undergo surgery. The risk of malignancy of the AUS category after repeat FNAC was 26.1%. AUS diagnosis was due to nuclear atypia in 32% of the patients, and we found a significant association between nuclear atypia and upgrading in repeat FNAC. Of the 96 patients who underwent surgery in our series, 42 had malignant lesions, including noninvasive follicular thyroid neoplasms with papillary-like features.

The clinical management of AUS patients includes repeat FNAC, which is strongly correlated with the risk of malignancy. Nuclear atypia seems to be more predictive of malignancy than architectural patterns.

Full article
Original Article Open Access
Yachao Tao, Yonghong Wang, Menglan Wang, Hong Tang, Enqiang Chen
Published online April 30, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2023.00557
Abstract
Acute liver failure (ALF) is a life-threatening clinical problem with limited treatment options. Administration of human umbilical cord mesenchymal stem cells (hUC-MSCs) may be [...] Read more.

Acute liver failure (ALF) is a life-threatening clinical problem with limited treatment options. Administration of human umbilical cord mesenchymal stem cells (hUC-MSCs) may be a promising approach for ALF. This study aimed to explore the role of hUC-MSCs in the treatment of ALF and the underlying mechanisms.

A mouse model of ALF was induced by lipopolysaccharide and d-galactosamine administration. The therapeutic effects of hUC-MSCs were evaluated by assessing serum enzyme activity, histological appearance, and cell apoptosis in liver tissues. The apoptosis rate was analyzed in AML12 cells. The levels of inflammatory cytokines and the phenotype of RAW264.7 cells co-cultured with hUC-MSCs were detected. The C-Jun N-terminal kinase/nuclear factor-kappa B signaling pathway was studied.

The hUC-MSCs treatment decreased the levels of serum alanine aminotransferase and aspartate aminotransferase, reduced pathological damage, alleviated hepatocyte apoptosis, and reduced mortality in vivo. The hUC-MSCs co-culture reduced the apoptosis rate of AML12 cells in vitro. Moreover, lipopolysaccharide-stimulated RAW264.7 cells had higher levels of tumor necrosis factor-α, interleukin-6, and interleukin-1β and showed more CD86-positive cells, whereas the hUC-MSCs co-culture reduced the levels of the three inflammatory cytokines and increased the ratio of CD206-positive cells. The hUC-MSCs treatment inhibited the activation of phosphorylated (p)-C-Jun N-terminal kinase and p-nuclear factor-kappa B not only in liver tissues but also in AML12 and RAW264.7 cells co-cultured with hUC-MSCs.

hUC-MSCs could alleviate ALF by regulating hepatocyte apoptosis and macrophage polarization, thus hUC-MSC-based cell therapy may be an alternative option for patients with ALF.

Full article
Original Article Open Access
Pei-Zhong Liu, Peng-Chong Du, Ai-Meng Zhang, Qing-Qing Liu, Da-Wei Wang, Rong-Yuan Yang, Qing Liu
Published online April 30, 2024
Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2023.00033
Abstract
Restenosis is a serious complication for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). In this prospective clinical study, we aimed [...] Read more.

Restenosis is a serious complication for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). In this prospective clinical study, we aimed to investigate the effects of Radix Salviae decoction (RSD) on coronary stenosis and restenosis in CHD patients.

We conducted this study at Guangdong Hospital of Traditional Chinese Medicine (registration No. BF2022-052) and enrolled 60 patients diagnosed with CHD for PCI surgery. The patients were divided into a control group and an RSD treatment group of 30 cases each. The primary outcome was restenosis after PCI, and the secondary outcome was newly increased stenosis (neostenosis).

Fifty-eight of the 60 enrolled patients completed follow-up and were included in the final analysis, with 28 in the control and 30 in the RSD group. A baseline comparison of stenosis location, stenosis degree, and the number of vessels in stenosis before PCI showed comparable results (p > 0.05). Comparison of implanted stents showed similar features in stent diameter and stent length during PCI between the two groups (p > 0.05). For the primary outcome, there was no significant difference in restenosis percentage (p > 0.05) or the number of vessels in restenosis (p > 0.05) of the three arteries between groups. For the secondary outcome, neither the number of nonculprit vessels in neostenosis after PCI nor the percentage of neostenosis of the three arteries showed significant differences between groups (p > 0.05). Although multifactor logistic regression analysis for the incidence of restenosis did not find any statistically significant factors (p > 0.05), the diagnosis of MI/angina (p = 0.031), average stent length (p = 0.010), and alanine transaminase (p = 0.027) were found to be significantly associated with neostenosis occurrence. Safety index measurement indicated that RSD had a good safety profile in clinical treatment.

Although the addition of Radix Salviae decoction for a short period did not significantly change restenosis and neostenosis after PCI, the diagnosis of MI/angina, average stent length and aspartate aminotransferase levels were significantly associated with neostenosis occurrence. This pilot research will help to design future studies in investigating RSD effects on stenosis.

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Review Article Open Access
Huisen Hu, Yonglei Zhao, Chengbin He, Lujie Qian, Pintong Huang
Published online April 30, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00018
Abstract
Hepatocellular carcinoma (HCC) is a prominent contributor to cancer-related mortality worldwide. Early detection and diagnosis of liver cancer can significantly improve its prognosis [...] Read more.

Hepatocellular carcinoma (HCC) is a prominent contributor to cancer-related mortality worldwide. Early detection and diagnosis of liver cancer can significantly improve its prognosis and patient survival. Ultrasound technology, serving has undergone substantial advances as the primary method of HCC surveillance and has broadened its scope in recent years for effective management of HCC. This article is a comprehensive overview of ultrasound technology in the treatment of HCC, encompassing early detection, diagnosis, staging, treatment evaluation, and prognostic assessment. In addition, the authors summarized the application of contrast-enhanced ultrasound in the diagnosis of HCC and assessment of prognosis. Finally, the authors discussed further directions in this field by emphasizing overcoming existing obstacles and integrating cutting-edge technologies.

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Original Article Open Access
Xiaoquan Liu, Xiuqing Pang, Zhiping Wan, Jinhua Zhao, Zhiliang Gao, Hong Deng
Published online April 30, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00051
Abstract
Hepatitis B virus (HBV) infection is a major risk factor for cirrhosis and liver cancer, and its treatment continues to be difficult. We previously demonstrated that a dopamine [...] Read more.

Hepatitis B virus (HBV) infection is a major risk factor for cirrhosis and liver cancer, and its treatment continues to be difficult. We previously demonstrated that a dopamine analog inhibited the packaging of pregenomic RNA into capsids. The present study aimed to determine the effect of dopamine on the expressions of hepatitis B virus surface and e antigens (HBsAg and HBeAg, respectively) and to elucidate the underlying mechanism.

We used dopamine-treated HBV-infected HepG2.2.15 and NTCP-G2 cells to monitor HBsAg and HBeAg expression levels. We analyzed interferon-stimulated gene 15 (ISG15) expression in dopamine-treated cells. We knocked down ISG15 and then monitored HBsAg and HBeAg expression levels. We analyzed the expression of Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway factors in dopamine-treated cells. We used dopamine hydrochloride-treated adeno-associated virus/HBV-infected mouse model to evaluate HBV DNA, HBsAg, and HBeAg expression. HBV virus was collected from HepAD38.7 cell culture medium.

Dopamine inhibited HBsAg and HBeAg expression and upregulated ISG15 expression in HepG2.2.15 and HepG2-NTCP cell lines. ISG15 knockdown increased HBsAg and HBeAg expression in HepG2.2.15 cells. Dopamine-treated cells activated the JAK/STAT pathway, which upregulated ISG15 expression. In the adeno-associated virus-HBV murine infection model, dopamine downregulated HBsAg and HBeAg expression and activated the JAK-STAT/ISG15 axis.

Dopamine inhibits the expression of HBsAg and HBeAg by activating the JAK/STAT pathway and upregulating ISG15 expression.

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Review Article Open Access
Le Li, Zhen-Zhen Li, Li-Xin Pan, Jia-Yong Su, Shan Huang, Liang Ma, Jian-Hong Zhong
Published online April 24, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00030
Abstract
Most patients with hepatocellular carcinoma (HCC) have a poor prognosis. Hepatectomy and local ablation are the main curative treatments for HCC. Nevertheless, the recurrence rate [...] Read more.

Most patients with hepatocellular carcinoma (HCC) have a poor prognosis. Hepatectomy and local ablation are the main curative treatments for HCC. Nevertheless, the recurrence rate after hepatectomy or ablation is up to 70%, which seriously affects patient prognosis. Several adjuvant therapies have been explored to reduce postoperative recurrence. However, although a variety of adjuvant therapies have been shown to reduce the recurrence rate and improve overall survival, a standard consensus of national HCC guidelines for adjuvant treatment is lacking. Therefore, there are significant differences in the recommendations for adjuvant therapy for HCC between the Eastern and Western guidelines. A variety of adjuvant treatment methods, such as antiviral therapy, transarterial chemoembolization or traditional Chinese medicine, are recommended by the Chinese HCC guidelines. However, Western guidelines make few recommendations other than antiviral therapy. Adjuvant immune checkpoint inhibitors are recommended only in the recently updated American Association for the Study of Liver Diseases guidelines. This review summarized the existing adjuvant therapy options after curative hepatectomy or ablation and discusses several important dilemmas of adjuvant treatments.

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Original Article Open Access
Prasanna Kumar Selvam, Santhosh Mudipalli Elavarasu, Hrituraj Dey, Karthick Vasudevan, George Priya Doss
Published online April 23, 2024
Gene Expression. doi:10.14218/GE.2023.00107
Abstract
Antimicrobial resistance (AMR) poses a significant threat to public health in the 21st century, with bacteria such as Campylobacter jejuni (C. jejuni) exhibiting multidrug resistance [...] Read more.

Antimicrobial resistance (AMR) poses a significant threat to public health in the 21st century, with bacteria such as Campylobacter jejuni (C. jejuni) exhibiting multidrug resistance due to the presence of AMR genes. Understanding the evolutionary patterns and functional relationships of these genes is crucial for addressing this issue effectively.

We conducted phylogenetic analysis to examine the evolution of AMR genes in C. jejuni. Additionally, we constructed and analyzed a gene interaction network comprising 39 functional relationships. Clustering analysis was employed to identify interconnected clusters associated with AMR processes. Functional enrichment analysis was performed to explore the involvement of cellular components, molecular functions, and biological processes.

Our analysis revealed two interconnected clusters (C1 and C2) closely associated with AMR processes. Furthermore, genes encoding ribosomal proteins (rplE, rplV, rplG, rplK, rplA, rplJ, rpsE, rplB, rpsL, and rpmA) were identified as hub genes within the gene interaction network. These genes interact frequently with their functional counterparts, indicating their significance in AMR mechanisms. Enriched Kyoto Encyclopedia of Genes and Genomes pathway analysis highlighted the importance of the ribosome pathway in understanding antibiotic resistance mechanisms in C. jejuni.

The findings of this study enhance our understanding of the molecular mechanisms underlying AMR in C. jejuni. By elucidating the evolutionary patterns, gene interactions, and pathway enrichment, our study provides valuable insights that may contribute to the development of novel treatments for illnesses caused by this pathogen.

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Review Article Open Access
Mehdi Koushki, Masoumeh Farahani, Negin Parsamanesh, Hossein Chiti, Mohammad Javad Fridoni, Somayeh Chahkandi, Nasrin Amiri-Dashatan, Mostafa Rezaei-Tavirani
Published online April 22, 2024
Gene Expression. doi:10.14218/GE.2023.00126
Abstract
Environmental factors such as heavy metals can influence the gene expression profiles that can lead to diseases. MicroRNAs (miRNAs) are primary regulatory molecules related to health [...] Read more.

Environmental factors such as heavy metals can influence the gene expression profiles that can lead to diseases. MicroRNAs (miRNAs) are primary regulatory molecules related to health and disease that are sensitive to environmental factors. Several studies have shown an association between environmental exposure to toxic metals such as cadmium (Cd) and disease risk. Growing knowledge has shown that heavy metal toxicity can manifest through miRNAs. Therefore, dysregulated miRNAs are proposed as potential biomarkers for monitoring chronic metal exposure. This review aimed to evaluate the effect of Cd on changes in miRNA expression. The databases of PubMed, Web of Science (ISI), Scopus, and Google Scholar were systematically searched for all previous relevant articles from 2000 up to 2022. The following medical subject headings were used: (microRNAs OR miRs) AND (Heavy Metals OR Cadmium OR Cd) AND (miRs profile OR miRs Expression). Searched articles were divided into the categories of in vitro, in vivo, and human studies. MiRNAs, widely used for biomarker discovery in Cd-induced diseases, are still being researched to use these genes for reliable biomarker discovery in addition to current diagnostic and prognostic approaches. As the functional effects of miRNAs are by their target proteins, it is important to analyze the expression levels of multiple potential target proteins to fully understand the role and mechanism of miRNAs in Cd-induced diseases. Therefore, further investigations are required to understand the regulatory mechanisms of miRNAs and to obtain novel biomarkers, and these findings will be used to develop early diagnostic approaches as well as new preventive methods and treatment options for Cd-induced diseases.

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Original Article Open Access
Xiaokang Wang, Xianjing Hu, Chunxiao Ye, Jingqian Zhao, Shing Cheng Tan, Liangbin Zhou, Chenyu Zhao, Kit Hang Wu, Xixiao Yang, Jinbin Wei, Maoxun Yang
Published online April 19, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00024
Abstract
Voriconazole (VRC), a widely used antifungal drug, often causes hepatotoxicity, which presents a significant clinical challenge. Previous studies demonstrated that Astragalus polysaccharide [...] Read more.

Voriconazole (VRC), a widely used antifungal drug, often causes hepatotoxicity, which presents a significant clinical challenge. Previous studies demonstrated that Astragalus polysaccharide (APS) can regulate VRC metabolism, thereby potentially mitigating its hepatotoxic effects. In this study, we aimed to explore the mechanism by which APS regulates VRC metabolism.

First, we assessed the association of abnormal VRC metabolism with hepatotoxicity using the Roussel Uclaf Causality Assessment Method scale. Second, we conducted a series of basic experiments to verify the promotive effect of APS on VRC metabolism. Various in vitro and in vivo assays, including cytokine profiling, immunohistochemistry, quantitative polymerase chain reaction, metabolite analysis, and drug concentration measurements, were performed using a lipopolysaccharide-induced rat inflammation model. Finally, experiments such as intestinal biodiversity analysis, intestinal clearance assessments, and Bifidobacterium bifidum replenishment were performed to examine the ability of B. bifidum to regulate the expression of the VRC-metabolizing enzyme CYP2C19 through the gut–liver axis.

The results indicated that APS does not have a direct effect on hepatocytes. However, the assessment of gut microbiota function revealed that APS significantly increases the abundance of B. bifidum, which could lead to an anti-inflammatory response in the liver and indirectly enhance VRC metabolism. The dual-luciferase reporter gene assay revealed that APS can hinder the secretion of pro-inflammatory mediators and reduce the inhibitory effect on CYP2C19 transcription through the nuclear factor-κB signaling pathway.

The study offers valuable insights into the mechanism by which APS alleviates VRC-induced liver damage, highlighting its immunomodulatory influence on hepatic tissues and its indirect regulatory control of VRC-metabolizing enzymes within hepatocytes.

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Research Letter Open Access
Liming Zhou, Xiaobin Zeng, Xiaofang Wei, Wanying Shen, Jie Yao, Weigang Wu, Lanlan Ge, Boping Zhou
Published online April 16, 2024
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00031
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