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Review Article Open Access
Folate-biopterin Crosstalk in Human Disease
Mark D. Lucock, Robert J. Leeming
Published online July 4, 2025
Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00020
Abstract
The importance of putative folate-biopterin metabolic interactions lies in the role they may play in the expression of several clinically relevant phenotypes. However, to date, [...] Read more.

The importance of putative folate-biopterin metabolic interactions lies in the role they may play in the expression of several clinically relevant phenotypes. However, to date, clinical studies on folate-biopterin interactions have been limited. The purpose of this article was to highlight the close relationship between these two cofactors, which share structural similarities and exhibit overlapping metabolic pathways. This folate-biopterin crosstalk has generated several ideas and hypotheses that are critical to advancing the biochemical understanding of several important and seemingly disparate clinical and/or biologically important phenotypes. These phenotypes include melanization/pigmentation, phenylketonuria, autism, neural tube defects, affective disorders, and vascular disease. This review provides a timely, integrated overview of this important area of biochemistry, which is under-represented in the literature and would benefit from further scientific and clinical investigation using improved metabolite-specific analytical methodologies applied to clinically relevant questions.

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Original Article Open Access
Diagnostic Performance of ATR-FTIR Spectroscopy in Discriminating Normal Breast Tissue and Breast Tumors
Samuel T. Adeleke, Christopher Igbeneghu, Sina Iyiola
Published online May 26, 2025
Cancer Screening and Prevention. doi:10.14218/CSP.2025.00004
Abstract
Histopathology is the gold standard in cancer diagnosis. However, attenuated total reflectance (ATR)-Fourier transform infrared (FTIR) spectroscopy has shown diagnostic potential [...] Read more.

Histopathology is the gold standard in cancer diagnosis. However, attenuated total reflectance (ATR)-Fourier transform infrared (FTIR) spectroscopy has shown diagnostic potential in other settings. Therefore, this study aimed to investigate the sensitivity and specificity of the ATR-FTIR spectroscopy in evaluating breast lesions.

This study was conducted on formalin-fixed, paraffin-embedded biopsy blocks received at Ladoke Akintola University of Technology Teaching Hospital between 2022 and 2023. The blocks were categorized into 10 normal (from benign breast tissue), 15 benign, and 31 malignant samples. Tissue sections of 15 µm were obtained during block trimming and floated onto FTIR slides. An additional 4 µm tissue sections were stained with hematoxylin and eosin for tumor diagnosis and to identify suitable areas on the FTIR slide. Spectrometer readings were taken within the range of 4,000–600 cm−1, 32 scans, and 16 cm−1 resolution, using the average of 10 preprocessed spectra per slide. Biomarkers were calculated by ratioing peak intensities for A1632/A1543, A1632/A2922, A1632/A1080, A1080/A1543, A1237/A1080, and A1043/A1543, which represent protein, diagnostic marker, cytoplasm-nucleus ratio, carcinogenesis marker, phosphate, and glycogen, respectively. The receiver operating characteristic curve was used to determine sensitivity, specificity, and the area under the curve (AUC).

The AUC analysis showed that cytoplasm-nucleus ratio values of 0.99 and 0.95 effectively distinguished normal from malignant tissue, and benign from malignant tissue, respectively (p < 0.0001). Additionally, protein marker (AUC = 0.73), diagnostic marker (AUC = 0.85), and cytoplasm-nucleus ratio marker (AUC = 0.94) were able to discriminate normal from benign tissue. Overall, the receiver operating characteristic analysis showed 100% sensitivity and specificity ranging from 54% to 87%. Glycogen (AUC = 1.00) exhibited 100% sensitivity in discriminating fibroadenoma from fibrocystic changes.

ATR-FTIR spectroscopy demonstrates high diagnostic accuracy in differentiating normal, benign, and malignant breast tissues using specific spectral biomarkers. Among these, the cytoplasm-nucleus ratio marker showed strong potential as a reliable spectral indicator for distinguishing various types of breast tumors. The cytoplasm-nucleus ratio marker demonstrated strong potential as a reliable spectral indicator for distinguishing various types of breast tumors.

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Original Article Open Access
ATOX1 Promotes Hepatocellular Carcinoma Carcinogenesis via Activation of the c-Myb/PI3K/AKT Signaling Pathway
Qin Ouyang, Siyu Jia, Qianyu Zhu, Yanmeng Li, Huaduan Zi, Sisi Chen, Pingping He, Hengcheng Tang, Yanling Li, Anjian Xu, Bei Zhang, Xiaomin Wang, Xiaojuan Ou, Donghu Zhou, Jian Huang
Published online July 7, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00422
Abstract
Despite advancements in diagnostic and therapeutic strategies, hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality. Antioxidant-1 (ATOX1) has been [...] Read more.

Despite advancements in diagnostic and therapeutic strategies, hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality. Antioxidant-1 (ATOX1) has been implicated in oncogenic processes across various cancer types; however, its specific role in HCC remains unclear. This study aimed to investigate the function of ATOX1 and its underlying molecular mechanisms in HCC.

Immunohistochemical analysis was conducted to assess ATOX1 expression in HCC tissues. Cell Counting Kit-8, colony formation, Transwell migration, flow cytometry, and reactive oxygen species (ROS) assays were employed to evaluate the malignant behaviors of tumor cells. A xenograft mouse model was employed to assess the effects of ATOX1 knockdown on tumor growth in vivo. DCAC50 treatment was performed to inhibit the copper transport function of ATOX1. RNA sequencing was conducted to explore the potential molecular mechanisms of ATOX1 in HCC.

ATOX1 expression was significantly elevated in HCC tumor tissues. ATOX1 promoted cell proliferation, colony formation, and migration. Knockdown of ATOX1 suppressed tumor growth in vivo. Mechanistically, ATOX1 activated c-Myb, and thus enhanced the malignant phenotype of HCC cells via activation of the PI3K/AKT signaling pathway. Additionally, ATOX1 reduced intracellular copper accumulation and inhibited ROS production and apoptosis. Inhibition of ATOX1 by DCAC50 decreased cell proliferation while increasing ROS levels and apoptosis in HCC cells. Notably, acetylcysteine reversed the reduction in c-Myb expression induced by ATOX1 knockdown.

ATOX1 may promote HCC carcinogenesis through the activation of the c-Myb/PI3K/AKT pathway and the inhibition of copper accumulation and oxidative stress.

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Case Report Open Access
Colon Cancer Surgery in Jehovah’s Witnesses Patients: Case Series and Literature Review
David Díaz-Pérez, Laura Colao-García, Nuria Chavarrías-Torija, Jaime Zabala-Salinas, Ana Gallardo-Herrera, Juan Carlos Puyana, Pablo Galindo-Jara, Luis Cabezón-Gutiérrez
Published online December 30, 2024
Journal of Translational Gastroenterology. doi:10.14218/JTG.2024.00019
Abstract
The refusal of blood transfusions and blood derivatives compels surgeons to face clinical and ethical challenges. We reviewed our perioperative and long-term outcomes of Jehovah’s [...] Read more.

The refusal of blood transfusions and blood derivatives compels surgeons to face clinical and ethical challenges. We reviewed our perioperative and long-term outcomes of Jehovah’s Witnesses undergoing colon cancer surgery to evaluate the feasibility of bloodless procedures.

We retrospectively analyzed data from patients with colon cancer and Jehovah’s Witnesses who underwent surgery between January 2014 and December 2023. A protocol was systematically followed to optimize hemoglobin levels and other parameters according to the Enhanced Recovery After Surgery guidelines.

Sixteen patients underwent colon surgery, with a median age of 69 years and an equal gender distribution. Thirty-seven and a half percent had preoperative anemia and were managed by a hematologist. All procedures were performed in accordance with oncological standards. Postoperative treatment included low molecular weight heparin, and hemoglobin levels temporarily decreased postoperatively. No blood transfusions were needed during hospitalization. Two patients required surgical intervention due to postoperative hemorrhage. Complications included anastomotic dehiscence and perforation, with an overall morbidity rate of 25% and no 90-day mortality.

This study highlights the challenges in managing patients who reject blood products during colon cancer surgeries; however, the outcomes show results comparable to those of the general population with appropriate protocols. Preoperative optimization is crucial to reduce blood loss. Treatment of postoperative hemorrhage requires a lower threshold for intervention due to limited alternatives to blood products. Despite the limitations of the study, the findings advocate for careful monitoring and intervention. Larger studies are needed to validate these findings and improve care for this group of patients.

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Original Article Open Access
Rosiglitazone Prevents the Development of Kindling by Modulating Inflammatory Cytokine Production and Brain Cell Apoptosis in Mice
Ebrahim Hesam, Sahar Fouladi, Mohammad Ali Zeyghami, Somayeh Rahimi, Sara Hosseinzadeh, Abolfazl Amini
Published online March 25, 2025
Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2024.00033
Abstract
Epileptogenesis involves complex mechanisms, including inflammation and apoptosis. Rosiglitazone, a peroxisome proliferator-activated receptor gamma agonist, possesses anti-inflammatory [...] Read more.

Epileptogenesis involves complex mechanisms, including inflammation and apoptosis. Rosiglitazone, a peroxisome proliferator-activated receptor gamma agonist, possesses anti-inflammatory and neuroprotective properties. This study investigated whether rosiglitazone can prevent pentylenetetrazole (PTZ)-induced kindling in mice by modulating inflammatory cytokines and apoptosis pathways.

Male C57BL/6 mice (n = 8 per group) were assigned to sham, control, or rosiglitazone-treated groups. Kindling was induced with intraperitoneal PTZ (40 mg/kg) every 48 h for 17 days. Rosiglitazone (0.1 mg/kg) was administered 30 m before each PTZ injection. Seizure progression was monitored, and hippocampal tissues were analyzed via immunohistochemistry and Western blotting to assess cytokine levels (interleukin (IL)-10, IL-17A, tumor necrosis factor-alpha, interferon-gamma), caspase-3 activity, and glial fibrillary acidic protein expression.

Rosiglitazone significantly delayed seizure progression, reduced seizure scores, and lowered pro-inflammatory cytokine levels (IL-17A, tumor necrosis factor-alpha, interferon-gamma) while increasing IL-10. Immunohistochemical analysis revealed fewer caspase-3-positive cells and reduced glial fibrillary acidic protein expression in the treatment group compared to controls.

Rosiglitazone exerts neuroprotective effects in PTZ-induced kindling, likely through its anti-inflammatory and anti-apoptotic actions. These findings underscore its potential as a therapeutic agent for mitigating epileptogenesis, warranting further investigation in combination therapies and clinical trials.

Full article
Mini Review Open Access
Ultrasensitive Detection of Biomarkers for Guiding Immunotherapy in Lung Cancer: A Liquid Biopsy Approach
Yongfeng Lu, Caihong Liu, Cheng Jiang, Chuan Xu
Published online December 25, 2024
Oncology Advances. doi:10.14218/OnA.2024.00030
Abstract
Liquid biopsy (LB) represents a promising strategy for the early diagnosis and treatment of lung cancer. However, relying solely on single-biomarker immunohistochemistry for predictive [...] Read more.

Liquid biopsy (LB) represents a promising strategy for the early diagnosis and treatment of lung cancer. However, relying solely on single-biomarker immunohistochemistry for predictive purposes has shown limited efficacy, often leading to suboptimal responses in certain patients. LB provides a complementary or alternative approach to immunohistochemistry by aiding in the identification of patients better suited for immunotherapy, thereby improving treatment precision. This review highlights key LB targets, including circulating tumor cells, exosomes, and small protein molecules, and explores the predictive and prognostic value of LB in immunotherapy for lung cancer and other tumors. These biomarkers play complex and multifaceted roles in liquid biopsies. Consequently, researchers have developed numerous targeted detection methods to study and identify key factors among multiple biomarkers in lung cancer and other tumor diseases. In addition, the limitations and future directions of LB are examined, aiming to advance its clinical application and support the development of personalized and precise immunotherapy. The integration of LB with artificial intelligence holds significant clinical potential for guiding immunotherapy and advancing precision medicine in lung cancer and other tumors.

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Review Article Open Access
Portal Vein Thrombosis in Liver Cirrhosis: A Review of Risk Factors and Predictive Indicators
Zhicheng Yang, Yongle Zhao, Honglin Chen, Han Zhang, Maoting Tan, Xianliu Li, Lingling Tao, Hongyun Zhao
Published online July 29, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00124
Abstract
Actively identifying the risk factors and predictive indicators associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) can enable early diagnosis and treatment, which [...] Read more.

Actively identifying the risk factors and predictive indicators associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) can enable early diagnosis and treatment, which is of great significance for prolonging the survival of patients with LC. Hemodynamic disturbances, advanced LC, vascular endothelial injury, and mutations in thrombophilic genetic factors are established risk factors for PVT-LC. Venous dilatation and decreased blood flow velocity contribute to hemodynamic disturbances. The severity of LC can be assessed by the degree of portal hypertension, liver metabolic function biomarkers, and validated liver scoring systems. Iatrogenic interventions, endotoxemia, and metabolic syndrome may induce vascular endothelial injury and hypercoagulability, the latter of which can be quantified via coagulation-anticoagulation-fibrinolysis biomarkers. Mutations in thrombophilic genetic factors, such as Factor V Leiden, MTHFR C667T, and JAK2 V617F, disrupt coagulation-anticoagulation homeostasis and predispose patients to PVT-LC. This review specifically focuses on comprehensively delineating established risk factors and predictive indicators for PVT-LC, thereby providing a theoretical foundation for the construction of clinically applicable PVT predictive models to guide early interventions and improve the prognosis. Future research should further validate the associations between recently proposed risk factors and PVT-LC, while simultaneously establishing cutoff values for indicators with robust predictive value to construct a clinically applicable PVT prediction framework.

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Original Article Open Access
The Gut Microbiota in Elderly Patients with Acute Hepatitis E Infection
Miaomiao Li, Meng Shi, Changyi Ji, Luyu Wang, Ze Xiang, Ying Wang, Hongtao Wang, Mengmeng Gu, Runing Ji, Jian Wu
Published online May 26, 2025
Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00111
Abstract
Gut dysbiosis has been reported in severe liver diseases. However, information on the impact of hepatitis E virus infection on the gut microbiota, and the association between enteric [...] Read more.

Gut dysbiosis has been reported in severe liver diseases. However, information on the impact of hepatitis E virus infection on the gut microbiota, and the association between enteric microbiota disturbances and acute hepatitis E (AHE), is limited, particularly in elderly patients with AHE (AHE-elderly). Our objective was to characterize the AHE-specific microbiome in elderly patients and evaluate its association with clinical outcomes.

Fecal samples and clinical data were collected from 58 AHE-elderly patients (46 self-healing cases, 12 non-self-healing cases) and 30 elderly patients with healthy controls (hereinafter referred to as HCs-elderly). Gut microbiota composition was analyzed using 16S rRNA gene sequencing. Bioinformatic analyses, including alpha diversity and STAMP, were performed. The predictive potential of Bacteroides fragilis was assessed using statistical analysis and receiver operating characteristic curves.

Alpha diversity indices showed no significant differences in microbial diversity between the AHE-elderly and HCs-elderly groups, nor between self-healing and non-self-healing groups among AHE-elderly patients. Nevertheless, a trend toward altered species richness was observed. In the AHE-elderly group, the relative abundance of Firmicutes, Lactobacillales, and Bacilli increased significantly. Meanwhile, compared with the self-healing group, Bacteroidetes were more abundant in the non-self-healing group. At the species level, Bacteroides fragilis was the most abundant in the non-self-healing group, significantly contributing to the divergence in gut microbiota between the two groups.

The relative abundance of Bacteroidetes significantly distinguished AHE-elderly patients from healthy controls and could more accurately predict recovery outcomes in elderly AHE patients. These findings suggest new strategies for preventing and managing AHE recurrence in the elderly patients.

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Case Report Open Access
Clinical Response to Sequential HAIC and TAE Combined with Tislelizumab and Lenvatinib Treatment for Hepatocellular Carcinoma Involving Lung Metastases: A Case Report
Jian-Rong Li, Da-Long Yang, Jia-Yong Su, Cai-Yi Dong, Wen-Yang Li, Xiu-Qiong Long, Xiao-Shan Qin, Bin-Yan Gu, Liang Ma, Jian-Hong Zhong
Published online May 28, 2025
Journal of Translational Gastroenterology. doi:10.14218/JTG.2025.00008
Abstract
Lung metastasis is common in hepatocellular carcinoma (HCC) and is typically associated with a poor prognosis. In this report, we present a case of advanced HCC in a 46-year-old [...] Read more.

Lung metastasis is common in hepatocellular carcinoma (HCC) and is typically associated with a poor prognosis. In this report, we present a case of advanced HCC in a 46-year-old Chinese male with lung metastases. The patient received two cycles of sequential hepatic arterial infusion chemotherapy and transarterial embolization in combination with lenvatinib (a tyrosine kinase inhibitor) and tislelizumab (a programmed cell death protein 1 immune checkpoint inhibitor). After three months of treatment, the intrahepatic tumors showed a partial response, while the bilateral lung metastases exhibited a complete response. Concurrently, levels of alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II decreased to normal levels. Systemic treatment with lenvatinib and tislelizumab was continued for 10 months. This case underscores the potential of combination therapies for advanced HCC with lung metastases and provides a novel perspective on a therapeutic approach involving sequential hepatic arterial infusion chemotherapy and transarterial embolization with immune checkpoint and tyrosine kinase inhibitors.

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Original Article Open Access
TNIP1 Knockdown Induces the Growth Arrest and Apoptosis of Breast Cancer Cells by Activating the NF-κB Pathway
Qiuhua Li, Shengpeng Chen, Yubin Zhou, Zhan Shi, Zhaozhe Liu
Published online December 25, 2024
Oncology Advances. doi:10.14218/OnA.2024.00022
Abstract
Breast cancer is one of the leading causes of mortality among women worldwide. Tumor necrosis factor α-induced protein 3-interacting protein 1 (TNIP1) is a ubiquitin-binding protein [...] Read more.

Breast cancer is one of the leading causes of mortality among women worldwide. Tumor necrosis factor α-induced protein 3-interacting protein 1 (TNIP1) is a ubiquitin-binding protein that is widely expressed, but its function in breast cancer cells remains unknown. This study aimed to elucidate the molecular mechanism of TNIP1 regulation in the proliferation and apoptosis of breast cancer cells.

A colony formation assay was conducted on MCF-7 and T47D cells stably transfected with TNIP1/cyclin G1 (CCNG1) short hairpin RNAs. Quantitative polymerase chain reaction was performed to assess the relative abundances of TNIP1, CCNG1, and cyclin D1 (CCND1) messenger RNAs. Immunoprecipitation and immunoblotting were used to detect the expression of TNIP1, CCNG1, CCND1, and related proteins. A dual-luciferase reporter assay was employed to explore the molecular mechanism of TNIP1 in signal transduction. Caspase activity in MCF-7 and T47D cells transfected with TNIP1 short hairpin RNAs was measured using the Caspase-Glo 3/7 assay.

Ablation of TNIP1 induced growth arrest in breast cancer cells. TNIP1 directly interacted with CCNG1, and TNIP1 knockdown increased the ubiquitination of CCNG1. CCNG1 knockdown also induced growth arrest in MCF-7 and T47D cells. Furthermore, TNIP1 knockdown activated the NF-κB pathway and induced apoptosis in these cells.

TNIP1 regulates the proliferation and apoptosis of breast cancer cells, suggesting that TNIP1 may serve as a potential biomarker for breast cancer.

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