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Original Article Open Access
Haiyan Zhao, Ting Wang, Luna Ge, Yuang Zhang, Ruojia Zhang, Guanhua Song, Jihong Pan, Lin Wang, Jinxiang Han
Published online January 26, 2025
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00033
Abstract
Protein disulfide isomerases (PDIs) are essential enzymes that facilitate the proper folding of proteins and maintain protein quality within the endoplasmic reticulum. Dysregulation [...] Read more.

Protein disulfide isomerases (PDIs) are essential enzymes that facilitate the proper folding of proteins and maintain protein quality within the endoplasmic reticulum. Dysregulation of PDIs has been correlated with numerous disorders, including cancer and rheumatoid arthritis (RA). E64FC26 (EFC), a small molecule that inhibits a wide range of PDI family members, has shown promise as a therapeutic agent in oncology. However, its effects on RA have not yet been studied. This research investigates the efficacy of EFC as a potential treatment for RA.

To investigate EFC’s effects on RA fibroblast-like synoviocytes, several assays were employed, including Cell Counting Kit-8 for cell viability, EdU for cell proliferation, Transwell for migration and invasion, TUNEL for apoptosis, and in vitro tube formation assays for angiogenesis. Flow cytometry was used to assess apoptosis in detail. Cytokine production was analyzed using ELISA and real-time polymerase chain reaction. In vivo, a collagen-induced arthritis model was developed in DBA mice to evaluate EFC’s effects on inflammation, disease progression, and bone damage. RNA sequencing was utilized to identify the molecular pathways influenced by EFC treatment.

EFC exhibited significant anti-inflammatory effects on RA fibroblast-like synoviocytes, reducing cell proliferation, migration, invasion, angiogenic activity, and cytokine secretion, while simultaneously promoting apoptosis. In vivo experiments using the collagen-induced arthritis mouse model showed that EFC alleviated inflammation, slowed disease progression, and preserved joint and bone integrity. RNA sequencing data suggested that EFC acts through pathways associated with inflammation and apoptosis regulation.

The findings of this research underscore EFC’s therapeutic potential in managing RA. These results pave the way for the development of inhibitors targeting the PDI family as innovative treatments for RA.

Full article
Review Article Open Access
Adeoye Bayo Olufunso, Adeyemi Funmilayo Elizabeth, Bolade Damilola Comfort, Oyeleke Ibukun Oyebimpe, Oyerinde Ayodeji Michael, Fadeyi Blessing, Olatinwo Goodness Olusayo, Ukangwa Ngozi Angela, Adeshina Halliyah Celine, Onyeyiriuche Chinecherem Chibundo, Aanu-Bakare Grace Olajumoke, Adeoye Ayodeji David, Akano Oyedayo Phillips, Adelakin Lola Adeola, Achor Cornilluis Bangsi, Ajaere Sandra Onyinyechi, Osundina Oluwaseun Babatunde, Olatinwo Mercy Olajoju, Adebayo Barakat Temitope, Olanrewaju Okikiola Olamide
Published online January 26, 2025
Future Integrative Medicine. doi:10.14218/FIM.2024.00042
Abstract
Cancer continues to pose a substantial public health problem in Nigeria, characterized by rising rates of occurrence and mortality. While there is increasing interest in using natural [...] Read more.

Cancer continues to pose a substantial public health problem in Nigeria, characterized by rising rates of occurrence and mortality. While there is increasing interest in using natural products for cancer treatment, comprehensive data on the specific bioactive compounds in these plants and how they modulate different types of cancer are still lacking. Additionally, although traditional knowledge about these food plants is rich and valuable, it has not been fully integrated with modern scientific research to create standardized treatment protocols. Scientific databases like PubMed, ScienceDirect, Google Scholar, and ResearchGate were explored to retrieve empirical data. The key plants discussed are Spondias mombin, Xanthosoma sagittifolium, Elaeis guineensis, Irvingia gabonensis, Allium cepa, Blighia sapida, Dioscorea dumetorum, Psidium guajava, and Talinum triangulare. These plants demonstrate a wide range of anticancer properties, including the ability to induce apoptosis (cell death), halt the cell cycle, inhibit angiogenesis, and regulate inflammatory responses. They contain a variety of phytochemicals, such as flavonoids, tannins, terpenoids, alkaloids, and organosulfur compounds, which contribute to their anticancer effects. For example, Spondias mombin contains flavonoids that inhibit the formation of tumors, whereas Xanthosoma sagittifolium exhibits cytotoxic effects against leukemia cells. Additionally, Elaeis guineensis exhibits antioxidant properties that counteract oxidative stress, a crucial factor in cancer progression. This review highlights the significance of these plants in developing complementary cancer therapies that can be used alongside conventional treatments. By combining traditional knowledge with contemporary scientific methods, these medicinal plants have the potential to provide innovative approaches to cancer prevention and treatment, addressing the pressing demand for safer and more efficient therapeutic alternatives.

Full article
Original Article Open Access
Hayder Hatem Sultan, Amir Teimourpour, Ziba Majidi, Fariba Nabatchian
Published online January 25, 2025
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00035
Abstract
Oral contraceptive pills (OCPs) are commonly used for contraception, but their long-term effects on oxidative stress, lipid profiles, and liver function remain unclear. This study [...] Read more.

Oral contraceptive pills (OCPs) are commonly used for contraception, but their long-term effects on oxidative stress, lipid profiles, and liver function remain unclear. This study aimed to evaluate the impact of intermediate-term OCP use (Yasmin) on oxidative stress, lipid profile, and liver function, with particular emphasis on antioxidant markers, lipid metabolism, and hepatic enzyme activity, to better understand the potential metabolic and hepatic effects.

A case-control study was conducted in Maysan Governorate, Iraq, involving 150 women (100 OCP users and 50 non-users). Blood samples were collected from Al-Sadr Teaching Hospital and a specialized clinic between February and April 2023. Serum levels of antioxidants, lipids, and liver enzymes were measured using biochemical assays.

OCP users had significantly lower levels of glutathione peroxidase vitamin E and uric acid (p < 0.001) compared to non-users. Lipid profiles showed that OCP users had higher levels of triglyceride and low-density lipoprotein (p < 0.05), whereas total cholesterol was significantly higher in non-users (p < 0.05). Liver enzyme activity, including alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total serum bilirubin, did not show statistically significant differences (p > 0.05). Longer duration of OCP use was significantly negatively correlated with vitamin E levels (r = −0.67), glutathione peroxidase activity (r = −0.56), uric acid levels (r = −0.45) and high-density lipoprotein (r = −0.54). Positive correlations were found between the duration of OCP use and total cholesterol (r = 0.62), triglyceride (r = 0.58), low-density lipoprotein (r = 0.60), and liver enzymes alanine aminotransferase (r = 0.66) and aspartate aminotransferase (r = 0.64).

Intermediate-term OCP use was associated with changes in oxidative stress and lipid metabolism, potentially increasing cardiovascular and metabolic risks. Regular monitoring of these parameters is recommended for OCP users.

Full article
Review Article Open Access
Chi Zhang, Xuanran Yang, Yi Xue, Huan Li, Chuanfei Zeng, Mingkai Chen
Published online January 22, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00348
Abstract
Solute carrier (SLC) family transporters are crucial transmembrane proteins responsible for transporting various molecules, including amino acids, electrolytes, fatty acids, and [...] Read more.

Solute carrier (SLC) family transporters are crucial transmembrane proteins responsible for transporting various molecules, including amino acids, electrolytes, fatty acids, and nucleotides. To date, more than fifty SLC transporter subfamilies have been identified, many of which are linked to the progression of hepatic steatosis and fibrosis. These conditions are often caused by factors such as non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, which are major contributors to the global liver disease burden. The activity of SLC members regulates the transport of substrates across biological membranes, playing key roles in lipid synthesis and metabolism, mitochondrial function, and ferroptosis. These processes, in turn, influence the function of hepatocytes, hepatic stellate cells, and macrophages, thereby contributing to the development of hepatic steatosis and fibrosis. Additionally, some SLC transporters are involved in drug transport, acting as critical regulators of drug-induced hepatic steatosis. Beyond substrate transport, certain SLC members also exhibit additional functions. Given the pivotal role of the SLC family in hepatic steatosis and fibrosis, this review aimed to summarize the molecular mechanisms through which SLC transporters influence these conditions.

Full article
Original Article Open Access
Gail A.M. Cresci, Qiang Liu, Naseer Sangwan, Darren Liu, David Grove, David Shapiro, Khaled Ali, Beatrice Cazzaniga, Luca Del Prete, Charles Miller, Koji Hashimoto, Cristiano Quintini
Published online January 22, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00352
Abstract
End-stage liver disease is associated with disruptions in gut microbiota composition and function, which may facilitate gut-to-liver bacterial translocation, impacting liver graft [...] Read more.

End-stage liver disease is associated with disruptions in gut microbiota composition and function, which may facilitate gut-to-liver bacterial translocation, impacting liver graft integrity and clinical outcomes following liver transplantation. This study aimed to assess the impact of two liver graft preservation methods on fecal microbiota and changes in fecal and breath organic acids following liver transplantation.

This single-center, non-randomized prospective pilot study enrolled liver transplant patients whose grafts were preserved using either static cold storage or ex situ normothermic machine perfusion (NMP). Fresh stool and breath samples were collected immediately before surgery and at postoperative months 3, 6, and 12. Stool microbiota was profiled via 16S rRNA gene sequencing, stool short-chain fatty acids were measured using gas chromatography/-mass spectrometry, and breath volatile organic compounds (VOCs) were analyzed with selected-ion flow-tube mass spectrometry.

Both cohorts experienced a loss of microbiota diversity and dominance by single taxa. The NMP cohort demonstrated enrichment of several beneficial gut taxa, while the static cold storage cohort showed depletion of such taxa. Various gut bacteria were found to correlate with stool short-chain fatty acids (e.g., lactic acid, butyric acid) and several VOCs.

Fecal microbiota alterations associated with end-stage liver disease do not fully normalize to a healthy control profile following liver transplantation. However, notable differences in microbiota composition and function were observed between liver graft preservation methods. Future research with larger randomized cohorts is needed to explore whether the NMP-associated shift in gut microbiota impacts clinical outcomes and if breath VOCs could serve as biomarkers of the clinical trajectory in liver transplant patients.

Full article
Original Article Open Access
Jun Zhang, Yi Jiang, Rui Zhu, Kangli Wang, Wei Li, Chenxi Wang, Xucheng Li, Xiaolong Xu, Qingquan Liu
Published online January 22, 2025
Future Integrative Medicine. doi:10.14218/FIM.2024.00040
Abstract
Sepsis involves a complex cascade of inflammatory reactions and immune system dysregulation. Neutrophils play a crucial role in modulating the anti-inflammatory response, which [...] Read more.

Sepsis involves a complex cascade of inflammatory reactions and immune system dysregulation. Neutrophils play a crucial role in modulating the anti-inflammatory response, which is vital for managing sepsis. Impaired chemotaxis of granulocytes can significantly impact the outcome of sepsis. Shenfu Decoction, by tonifying Qi and warming Yang, enhances the propelling function of Qi for promoting the chemotactic function of neutrophils. This study aimed to investigate the effects of Shenfu Decoction on the chemotactic function of neutrophils in septic mice and the underlying mechanisms.

Thirty 10-week-old specific-pathogen-free male C57BL/6J mice were randomly divided into five groups: sham operation, model, and low-, medium-, and high-dose Shenfu Decoction treatment groups (n = 6 in each group). Sepsis was induced using cecum ligation and puncture procedures. The sham-operated group served as the control. The drug was administered 6 h after surgery; the sham-operated and model groups received saline, while the treatment groups were gavaged every 12 h with the respective concentrations of Shenfu Decoction. Four hours after the last gavage, the mice were euthanized, and samples were collected to determine neutrophil counts and related indices. Primary neutrophils were extracted from the peripheral blood of septic mice and divided into blank control, sham-operated, low-dose, and high-dose groups. These cells were cultured with serum containing the respective treatments to measure neutrophil chemotactic distance, intracellular calcium ion concentration, and the expression levels of chemokine receptors and P2X1 receptors.

Compared with the sham-operated group, the total number of colonies and the number of neutrophils in the peritoneal lavage fluid were increased in the model group (P < 0.05). In the treatment groups, the number of neutrophils in the peritoneal lavage fluid was significantly increased (P < 0.05), while the number of neutrophils in the blood was decreased. Compared with the blank control group, the neutrophil chemotaxis distance was significantly prolonged in the sham-operated group. Additionally, the expression levels of P2X1 and FPR1 receptors were decreased, the expression levels of CXCR1 and CXCR2 receptors were increased (P < 0.05), and the calcium ion concentration was decreased (P > 0.05). Compared with the sham-operated group, the treatment groups exhibited a prolonged neutrophil chemotaxis distance, significantly decreased expression levels of P2X1 and FPR1 receptors, significantly increased expression levels of CXCR1 and CXCR2 receptors (P < 0.05), and significantly decreased calcium ion concentrations (P < 0.05). These effects were positively correlated with the Shenfu Decoction dosage.

Shenfu Decoction can improve the chemotactic function of neutrophils, possibly through the downregulation of P2X1 receptor expression. Its effects are positively correlated with the dosage.

Full article
Review Article Open Access
Dylan W. Purkiss, Iris E. Lee, Dan Xu, Jun Wang
Published online January 21, 2025
Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2024.00043
Abstract
Large granular lymphocytic leukemias (LGLLs), including T-cell LGLL and natural kill (NK)-cell LGLL variants, are rare lymphoproliferative disorders characterized by the chronic [...] Read more.

Large granular lymphocytic leukemias (LGLLs), including T-cell LGLL and natural kill (NK)-cell LGLL variants, are rare lymphoproliferative disorders characterized by the chronic proliferation of cytotoxic lymphocytes. Despite recent advancements, challenges remain in distinguishing these entities from one another and from related disorders, such as T-cell prolymphocytic leukemia, adult T-cell leukemia/lymphoma, Sézary syndrome, and aggressive NK-cell leukemia, owing to overlapping clinical and morphologic features. This article aims to review the role of molecular and immunophenotypic markers in guiding diagnosis and prognosis of LGLLs, with brief review of their clinical and morphologic features by synthesizing current advances in molecular pathogenesis, immunophenotypic profiling, and updated World Health Organization (WHO) classification criteria in order to enhance diagnostic precision, improve prognostic assessment, and inform personalized treatment strategies for these challenging disorders.

Literature was searched through Pubmed and the recently published 5th WHO classification criteria. Articles were reviewed and analyzed with emphasis on recent molecular and cytogenetic insights.

A total of 106 publications were reviewed, and the recent molecular insights—focusing on those concerning STAT3 mutations in T-cell LGLL and TET2 mutations in NK-cell LGLL which have refined diagnostic frameworks, though gaps persist in understanding their clinical relevance and variability.

By providing a comparative analysis of large granular lymphocytic leukemias and their differential diagnoses in cooperation of the current advances in molecular pathogenesis, immunophenotypic profiling, and updated WHO classification criteria, this work aimed to enhance diagnostic precision, improve prognostic assessment, and inform personalized treatment strategies for these challenging LGLLs.

Full article
Review Article Open Access
Lei Wang, Deqiang Lei, Nan Tang, Haijun Wang, Hongyang Zhao, Yingchun Zhou
Published online January 21, 2025
Neurosurgical Subspecialties. doi:10.14218/NSSS.2024.00006
Abstract
Chiari malformation type I (CMI) is a congenital neurological disorder characterized by the herniation of the cerebellar tonsils through the foramen magnum, which impairs cerebrospinal [...] Read more.

Chiari malformation type I (CMI) is a congenital neurological disorder characterized by the herniation of the cerebellar tonsils through the foramen magnum, which impairs cerebrospinal fluid circulation at the craniocervical junction. The primary hypothesis regarding its pathogenesis involves a mismatch between the posterior cranial fossa volume and the developing nervous tissue, leading to crowding and subsequent herniation. CMI presents a wide range of clinical manifestations, including cerebrospinal fluid-related symptoms, brainstem and cranial nerve compression, and spinal cord dysfunction, typically diagnosed through magnetic resonance imaging. The surgical treatment of adult CMI remains controversial due to its heterogeneous manifestations and the lack of standardized surgical protocols. Posterior fossa decompression (PFD), with or without duraplasty (hereinafter referred to as PFDD), remains the most common intervention. In this review, we focus on the following aspects to provide an overview of the current surgical strategies: 1. Surgical indications; 2. The extent of bony decompression in PFD; 3. Choosing between PFD, PFDD, and the dura-splitting technique; 4. Atlantoaxial fixation; 5. Techniques for intradural procedures; 6. Timing and approach for syrinx shunting. Additionally, emerging surgical innovations, such as endoscopic techniques, offer promising avenues for treatment.

Full article
Mini Review Open Access
Fernando Bessone, Geraldine L. Hillotte, Norberto Tamagnone, Daiana Arnedillo, Marcelo G. Roma
Published online January 21, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00325
Abstract
Drug-induced liver injury (DILI) is a harmful reaction to medications, herbs, and dietary supplements that results in liver dysfunction. Based on the distinct clinical patterns [...] Read more.

Drug-induced liver injury (DILI) is a harmful reaction to medications, herbs, and dietary supplements that results in liver dysfunction. Based on the distinct clinical patterns of liver damage, DILI can be categorized into hepatocellular, cholestatic, and mixed types. Hepatocellular DILI is linked to inflammation, apoptosis, and necrosis, while cholestatic DILI is commonly associated with bile plugs and, in rare cases, ductopenia. Ursodeoxycholic acid (UDCA) is the therapeutic agent most widely used for the treatment of cholestatic hepatopathies of diverse etiologies and has been mainly used as a supportive treatment in cholestatic DILI. In this review, we presented a more structured and systematic framework for the potential application of this hepatoprotective agent across a broader range of DILI scenarios. A MEDLINE search of the literature from 1995 to the present retrieved 41 preliminary clinical studies suggesting that UDCA may offer curative and preventive benefits for hepatocellular DILI as well. This aligns with preclinical studies in rodents, showing beneficial effects of UDCA in experimental DILI irrespective of the clinical patterns of injury involved. This could be due to the broad range of potentially beneficial effects of UDCA, which may address the various types of liver damage with different causes and mechanisms seen in all forms of DILI. UDCA’s beneficial properties include anticholestatic, antioxidant, anti-inflammatory, anti-apoptotic, anti-necrotic, mitochondrial protective, endoplasmic reticulum stress-relieving, and immunomodulatory effects. Controlled studies with systematic use of standardized causality assessments are eagerly awaited to properly validate the use of UDCA in DILI. Meanwhile, we hope this article helps clarify and systematize the use of this versatile and safe hepatoprotective medication for different types of liver toxicity.

Full article
Original Article Open Access
Yaqun Zhang, Huimin Shi, Lin Wang, Jihong Pan
Published online January 20, 2025
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00036
Abstract
Rheumatoid arthritis (RA) is an inflammatory arthritis characterized by chronic joint inflammation, cartilage degradation, and bone erosion. ELK3 is a transcriptional repressor [...] Read more.

Rheumatoid arthritis (RA) is an inflammatory arthritis characterized by chronic joint inflammation, cartilage degradation, and bone erosion. ELK3 is a transcriptional repressor that can affect cell proliferation, migration, invasion, apoptosis, and other cellular processes. The study aimed to clarify the effect of ELK3 in the biological activity and ferroptosis phenotype of RA fibroblast-like synoviocytes (FLS), and to reveal its molecular mechanism in regulating ferroptosis in RA FLS.

We investigated the impact of ELK3 on the biological activity and ferroptosis phenotype of RA FLS using real-time quantitative polymerase chain reaction, immunohistochemistry, Transwell assay, CCK-8 assay, and ferroptosis-related indicator kit. The molecular mechanism of ELK3 in RA FLS was further explored using Western blot, chromatin immunoprecipitation polymerase chain reaction, and other experiments.

ELK3 was highly expressed in RA. Silencing ELK3 inhibited the invasion and proliferation of RA FLS (both p < 0.05). After silencing ELK3 in imidazole ketone erastin-induced RA FLS, intracellular reactive oxygen species, lipid peroxidation levels, ferrous ion content, 4-Hydroxynonenal levels, and Malondialdehyde concentrations all increased. Additionally, ELK3 affects ferroptosis in RA FLS by regulating kelch-like ECH-associated protein 1 (p < 0.05).

Silencing ELK3 leads to decreased invasion and proliferation of RA FLS, affecting their biological activity. ELK3 inhibits ferroptosis by suppressing its transcriptional activity through binding to the kelch-like ECH-associated protein 1 promoter. This suggests that ELK3 may be a potential target for RA therapy.

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