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Original Article Open Access
Md Ariful Amin, Uzzal Chondra, Md Morshedul Alam
Published online September 30, 2024
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Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2023.00030
Abstract
Chlorella vulgaris is a green, photosynthetic microalga in the phylum Chlorophyta. The goal of our study was to perform a bioinformatics analysis of Photosystem I P700 chlorophyll [...] Read more.

Chlorella vulgaris is a green, photosynthetic microalga in the phylum Chlorophyta. The goal of our study was to perform a bioinformatics analysis of Photosystem I P700 chlorophyll a apoprotein A2, one of its photosynthesis-related proteins, and to hunt for potent bioactive peptides.

To generate peptides and estimate the safety and efficacy of each bioactive peptide, we employed the tools BIOPEP-UWM™, PeptideRanker, DBAASP, and ToxinPred. PepDraw was used to understand the physicochemical properties and primary chemical structures of the selected bioactive peptides.

The liberated peptides exhibit up to 17 distinct bioactivities, as shown by the in silico digestion of the protein using several proteolytic enzymes. The peptides with bioactivities are listed as angiotensin-converting enzyme inhibitor, dipeptidyl peptidase IV inhibitor, dipeptidyl peptidase III inhibitor, antioxidative, renin inhibitor, glucose uptake stimulator, neuropeptide regulator (regulating stomach mucosal membrane activity and ion flow), antithrombotic, anti-amnestic, CaMPDE inhibitor, activators of ubiquitin-mediated proteolysis, alpha-glucosidase inhibitor, immunomodulating, calcium-binding, antibacterial, anti-inflammatory, and hypotensive agent. Using the Database of Antimicrobial Activity and Structure of Peptides (DBAASP) prediction method, the antibacterial activity of the released peptides was predicted, highlighting the existence of potent antibacterial peptides. An examination of their physicochemical properties revealed that most peptides are low molecular weight, mildly acidic, and moderately water-soluble. To further establish the non-toxicity profile of the released peptides (sequence length > 3), a ToxinPred analysis was performed, which revealed that most of the peptides are non-toxic. According to the allergenicity analysis, most of the top-ranked peptides are likely non-allergenic.

Thus, our study reveals a less labor-intensive method for discovering new therapeutic targets derived from C. vulgaris, which hold both pharmacological and medical significance.

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Review Article Open Access
Madhunika Agrawal, Satyam Kumar Agrawal
Published online May 28, 2024
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Gene Expression. doi:10.14218/GE.2023.00134
Abstract
Liver cancer, also identified as hepatic cell carcinoma, is the fifth most prevalent kind of malignancy globally and the fourth foremost cause of cancer-associated mortality. The [...] Read more.

Liver cancer, also identified as hepatic cell carcinoma, is the fifth most prevalent kind of malignancy globally and the fourth foremost cause of cancer-associated mortality. The development and progression of liver cancer are complex processes that involve multiple genetic and environmental factors. As the diagnosis of liver cancer is still worse, with late-stage patients facing a less than 20% 5-year survival rate, there is a critical need for the development of new and effective therapeutic approaches for liver cancer. Mitochondrial alterations and mitochondrial DNA (mtDNA) mutations have long been associated with cancer pathogenesis, including liver cancer. These alterations not only disrupt cellular bioenergetics but also deteriorate the situation by modifying tumor suppressors and oncogenic proteins. Excessive reactive oxygen species generation and flaws in mitochondrial enzymes are among the factors responsible for mitochondrial dysfunction. Additionally, perturbed microRNA levels have also been linked to mtDNA dysfunction and reactive oxygen species generation. Various pharmacological approaches to target mitochondrial dysfunction and mtDNA mutations in cancer have been proposed as potential therapeutic strategies. These approaches include targeting the electron transport chain, which is responsible for the production of adenosine triphosphate in the mitochondria, or transcriptional inhibition of various proteins involved in the mitochondrial biogenesis pathway. Overall, mtDNA is a crucial component of the cell, and alterations in mtDNA make it an attractive target for therapeutic interventions. Hence, we advocate that understanding the role of mtDNA in cancer pathogenesis is important for the development of targeted therapies for these disorders.

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Illuminating and Instructive Clinical Case Open Access
Junmin Jiang, Meifeng Shi, Shuduo Wu, Minling Cao
Published online October 30, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00287
Abstract
Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists are increasingly used in the management of type 2 diabetes mellitus and [...] Read more.

Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists are increasingly used in the management of type 2 diabetes mellitus and obesity due to their ability to stimulate insulin secretion, delay gastric emptying, and suppress appetite. The combination of GLP-1 and GIP agonists improves glycemic control and promotes weight loss. However, the introduction of these novel therapies has raised safety concerns, including the risk of cholestatic hepatitis. We report a case of a patient with obesity who was prescribed a GLP-1/GIP dual-receptor agonist as part of his treatment regimen. Importantly, both before the initiation of this therapy and during the course of treatment, the patient was not taking any other medications. Shortly after receiving four doses of the therapy, the patient developed symptoms of severe cholestatic hepatitis, including jaundice and elevated liver enzyme levels. During hospitalization, no alternative causes for the condition were identified, and a liver biopsy confirmed the diagnosis of drug-induced cholestatic hepatitis. This is the first recorded case of cholestatic hepatitis induced by a GLP-1/GIP dual agonist, and it aimed to raise global awareness of this potential side effect.

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Mini Review Open Access
John W. Wiley, Gerald A. Higgins
Published online June 28, 2024
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2024.00017
Abstract
The brain-gut axis represents a bidirectional communication network that integrates neural, hormonal, and immunological signaling between the central nervous system and the gastrointestinal [...] Read more.

The brain-gut axis represents a bidirectional communication network that integrates neural, hormonal, and immunological signaling between the central nervous system and the gastrointestinal tract. Adverse childhood experiences (ACEs) have increasingly been recognized for their profound impact on this axis, with implications for both mental and physical health outcomes. This mini-review explores the emerging field of epigenomics—specifically, how epigenetic modifications incurred by ACEs can influence the brain-gut axis and contribute to the pathophysiology of various disorders. We examine the evidence linking epigenetic mechanisms such as DNA methylation, histone modifications, and non-coding RNAs to the modulation of gene expression involved in stress responses, neurodevelopment, and immune function—all of which intersect at the brain-gut axis. Additionally, we discuss the emerging potential of the gut microbiome as both a target and mediator of epigenetic changes, further influencing brain-gut communication in the context of ACEs. The methodological and therapeutic challenges posed by these insights are significant. The reversibility of epigenetic marks and the long-term consequences of early life stress require innovative and comprehensive approaches to intervention. This underscores the need for comprehensive strategies encompassing psychosocial, pharmacological, neuromodulation, and lifestyle interventions tailored to address ACEs’ individualized and persistent effects. Future directions call for a multi-disciplinary approach and longitudinal studies to uncover the full extent of ACEs’ impact on epigenetic regulation and the brain-gut axis, with the goal of developing targeted therapies to mitigate the long-lasting effects on health.

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Review Article Open Access
Sihan Zhang, Zhipeng Yao, Na Zeng, Zheng Liu, Qidong Xia, Shaogang Wang
Published online July 25, 2024
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2023.00022
Abstract
Peroxisome proliferator-activated receptors (PPARs) participate in the fatty acid oxidation, the homeostasis of lipid and glucose metabolism, the regulation of insulin sensitivity, [...] Read more.

Peroxisome proliferator-activated receptors (PPARs) participate in the fatty acid oxidation, the homeostasis of lipid and glucose metabolism, the regulation of insulin sensitivity, and numerous metabolic processes, making them novel and important therapeutic targets for cancer treatment. However, PPARs manifest dual functions, wherein their activation and inhibition engender diverse outcomes in different types of tumors. The specificity of drugs for tumors is also a challenge when targeting PPARs. In recent years, proteolysis targeting chimeras (PROTACs) have gained significant attention in the field of cancer therapy, demonstrating potent therapeutic potential in both basic and clinical research. Furthermore, heterobifunctional molecules derived from PROTACs have ventured into domains that extend beyond protein degradation. Currently, there are no developed PPAR-targeting PROTACs. Therefore, our review delves into various aspects, including the dual roles of PPARs, known inhibitors, agonists, ligands, and co-crystal structures, and explores the feasibility and advantages of PPAR-targeting PROTACs and other heterobifunctional molecules in cancer therapy.

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Original Article Open Access
Tania Arora, Puneet Jain, Harshita Sharma, Vikash Prashar, Randeep Singh, Arti Sharma, Harish Changotra, Jyoti Parkash
Published online June 24, 2024
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Gene Expression. doi:10.14218/GE.2023.00143
Abstract
Alzheimer’s disease (AD), an enduring neurodegenerative malady, contributes significantly to dementia cases, with late-onset AD being more common than early-onset AD. Despite extensive [...] Read more.

Alzheimer’s disease (AD), an enduring neurodegenerative malady, contributes significantly to dementia cases, with late-onset AD being more common than early-onset AD. Despite extensive research to diagnose and treat AD, the intricate protein network impedes the development of efficacious drugs or targets. This study endeavored to identify previously undiscovered genetic reservoirs associated with AD progression, which could be targeted as therapeutic markers.

Employing the robust tools of R-language, we dissected vast RNA sequence datasets comprising numerous samples and thousands of genes, pinpointing potential candidates implicated in AD’s trajectory. Thus, we selected the GSE203206 dataset, which includes AD patients and non-dementia controls, based on our criteria. After normalization, RNA-Seq data was compared, and log2fold change was calculated to determine the highly dysregulated genes. Further network analysis of genes and their associated miRNA was performed to determine a characteristic change in control and patient groups.

Differential expression analysis revealed 13 dysregulated genes in AD, wherein 12 were upregulated, and one was down-regulated. Furthermore, we identified hsa-miR-30-5p as a significant miRNA associated with AD, aligning with previous studies and highlighting its high involvement.

This investigation has unveiled four novel genes and a paramount miRNA implicated in AD, thus furnishing potential targets for therapeutic interventions. These discoveries pave the way for further exploration into the intricate functions and implications of these genetic entities in AD.

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Original Article Open Access
Robert Lam, Dhanpat Jain, Yanhong Deng, Eesha Acharya, Joseph K. Lim
Published online October 17, 2024
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00189
Abstract
Data regarding risk factors and long-term outcomes of U.S. patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) are limited. This study aimed [...] Read more.

Data regarding risk factors and long-term outcomes of U.S. patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) are limited. This study aimed to investigate the role of clinical and histologic risk factors on long-term outcomes in patients with MASLD.

A retrospective cohort study of 451 adults with biopsy-proven MASLD was conducted at a U.S. academic hospital from 2012 to 2020. An experienced pathologist evaluated the index liver biopsy. Patients with a prior liver transplant or alternative etiologies of chronic liver disease were excluded. The duration of the risk exposure was determined from the date of the index liver biopsy to an outcome event or the last follow-up examination. Outcome events of interest included incident liver-related events, liver decompensation, and all-cause mortality.

In the final cohort of 406 patients followed for a median of 3.7 years (interquartile range: 4.8 years), 35 patients died, 41 developed hepatic decompensation, and 70 experienced a liver-related event. Among histologic risk factors, stage 3 (adjusted Hazard ratio (aHR) 2.68, 95% confidence interval (CI) 1.18–6.11) and stage 4 (aHR 6.96, 95% CI 3.55–13.64) fibrosis were associated with incident liver-related events compared to stage 0–1 fibrosis. Stage 4 (aHR 8.46, 95% CI 3.26–21.99) fibrosis alone was associated with incident liver decompensation events compared to stage 0–1 fibrosis. Among clinical risk factors, hypertension (aHR 2.58, 95% CI 1.05–6.34) was associated with incident liver decompensation.

In a U.S. single-center cohort of patients with biopsy-proven MASLD, advanced fibrosis was the primary risk factor for incident liver decompensation and liver-related events.

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Case Report Open Access
Taha Khalid, Gavin Calpin, Alina Ahmed, Ala Yousif
Published online March 25, 2024
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Oncology Advances. doi:10.14218/OnA.2024.00002
Abstract
Cancer treatment has been revolutionized in the last 10 years. Previously, highly toxic chemotherapy regimens that attack both healthy cells and cancer cells as well as induce significant [...] Read more.

Cancer treatment has been revolutionized in the last 10 years. Previously, highly toxic chemotherapy regimens that attack both healthy cells and cancer cells as well as induce significant side effects were used. Nowadays, a more targeted approach is employed. Cancer cells are being treated at the molecular level. Patients with carcinoma of unknown primary who previously only had “broad spectrum” combination therapy as a treatment option can now have their cancer’s genome sequenced with next-generation sequencing in a matter of hours and be offered a more targeted approach. Here, we report a case of a patient with metastatic cancer of an unknown primary origin who was progressing on multiple lines of treatment. Next-generation sequencing showed that the patient had a high tumor mutational burden; therefore, he was able to access immunotherapy through a compassionate access scheme, which resulted in a near complete and sustained clinical and radiological response.

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Review Article Open Access
Dante J. Marciani
Published online July 25, 2024
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00002
Abstract
Like other drugs, adjuvants are ligands with distinct structures that interact with specific cell receptors, modulating the immune response. This definition excludes formulations [...] Read more.

Like other drugs, adjuvants are ligands with distinct structures that interact with specific cell receptors, modulating the immune response. This definition excludes formulations and delivery systems. New adjuvants may be discovered using methods based on a ligand and its receptor’s structural and functional traits, a process known as rational drug design. This strategy requires detailed information about both the receptors and their ligands. Such information is obtained using techniques like X-ray crystallography and 2D-nuclear magnetic resonance (NMR) to establish the spatial interactions between a ligand’s functional groups and its receptor. This data is necessary to establish reliable structure-activity relationships, which, when applied to computer-aided drug design, facilitate the creation of better adjuvants as an empirical strategy. Since Quillaja saponin adjuvants likely act separately on innate and adaptive immune cells via specific functional groups and unidentified cell receptors, it is crucial to identify these receptors. This task may be achieved using bioorthogonal chemistry and proteomic methods to identify and isolate the receptors. Initially focusing on those unidentified receptors where chemical modifications of these glycosides, such as the aldehyde group and fucose residue, cause drastic changes in adjuvanticity. The isolated receptor(s) can then be characterized by X-ray crystallography and/or 2D-NMR; this information can be applied to computer-aided drug design to rationally design new derivatives. This methodology will prevent the proposition of dubious structure-activity relationships based on incomplete immunological data, unknown receptors, and unsuspected physical factors, providing essential information for designing new adjuvants and elucidating these compounds’ mechanisms of action.

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Original Article Open Access
Ming Ruan, Jingjing Zhang, Wei Zhang, Changsheng Sheng, Rongsheng Wang, Jingyan Tian, Weirong Zhu, Huailin Gao
Published online June 25, 2024
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Future Integrative Medicine. doi:10.14218/FIM.2023.00106
Abstract
Patients with corona virus disease 2019 (COVID-19) face not only physical strains but also significant psychological stress, highlighting the importance of addressing their mental [...] Read more.

Patients with corona virus disease 2019 (COVID-19) face not only physical strains but also significant psychological stress, highlighting the importance of addressing their mental health concerns. This study aimed to evaluate the impact of Lianhua Qingwen on the psychological well-being of asymptomatic and mildly symptomatic COVID-19 patients, providing empirical evidence to guide clinical practices.

Conducted in eight shelter hospitals in Shanghai, the study employed a cluster randomization method to allocate patients equally into either the Lianhua Qingwen group or the control group. The Lianhua Qingwen group received oral doses of four capsules or one packet of granules three times daily for 14 days. In contrast, the control group received standardized treatment according to the diagnostic and treatment plan, excluding Lianhua Qingwen. Mental health was assessed using the Self-rating Depression Scale and Self-rating Anxiety Scale, with symptom reporting on the 7th and 14th days, accompanied by nucleic acid test result screenshots. A follow-up investigation on new disease occurrence was conducted six months post-discharge.

Among the 2,652 valid questionnaire respondents, the Lianhua Qingwen group accounted for 1,665 cases, characterized by a higher proportion of females (32.7% vs. 26.9%), younger age (44.8 vs. 46.2 years), lower percentages of asymptomatic infections (27.6% vs. 38.5%), higher baseline Patient Health Questionnaire-9 scores (2.7 vs. 1.9), and higher Generalized Anxiety Disorder 7 scores (1.9 vs. 1.4). Further multivariate logistic regression analysis explored factors influencing the alleviation of depressive and anxiety symptoms during follow-up, revealing that Lianhua Qingwen use was an independent factor in reducing anxiety (odds ratio = 1.37, 95% confidence interval 1.14–1.65, p = 0.001) and depression (odds ratio = 1.42, 95% confidence interval 1.19–1.69, p < 0.0001). Lianhua Qingwen increased the likelihood of reducing anxiety by 37% and depression by 42%.

Lianhua Qingwen significantly alleviated anxiety and depression symptoms in COVID-19 patients, suggesting its potential therapeutic efficacy in mitigating these conditions.

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