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Original Article Open Access
Xiaokang Wang, Fanci Xie, Chunhua Wang, Shangjun Zhou, Jiayu Wang, Zhijie Xu, Zhiyang Zhou
Published online August 19, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2026.00215
Abstract
Ferroptosis, an iron-dependent form of regulated cell death, serves as an important mechanism associated with cancer progression. Natural compounds, particularly alkaloids, have [...] Read more.

Ferroptosis, an iron-dependent form of regulated cell death, serves as an important mechanism associated with cancer progression. Natural compounds, particularly alkaloids, have emerged as attractive candidates for regulating ferroptotic cell death, thereby providing a promising anticancer strategy. However, the molecular mechanisms underlying their antitumor effects remain poorly understood. In this study, we aimed to investigate the antitumor effects and underlying mechanisms of natural alkaloids against HCC.

An alkaloid library was used to screen alkaloids with anti-hepatocellular carcinoma (HCC) activity. A combination of proteomic profiling, in vitro functional assays, and in vivo animal experiments was performed to explore the biological roles and molecular mechanisms of the lead compound.

Through high-throughput screening of an alkaloid library, we identified palmatine (PAL), an active component isolated from Fibraurea recisa Pierre, as a potential ferroptosis sensitizer in HCC cells. PAL treatment triggered typical ferroptotic features in HCC cells, including elevated ferrous iron, reactive oxygen species, and lipid peroxidation, along with decreased glutathione levels. Importantly, the pro-ferroptotic effect of PAL was significantly abolished by two ferroptosis inhibitors, ferrostatin-1 and deferoxamine. Mechanistically, PAL directly interacted with troponin T1 (TNNT1) to trigger its K48-linked polyubiquitination and subsequent protein degradation. Ectopic TNNT1 overexpression significantly rescued PAL-mediated ferroptosis and abrogated its tumor-suppressive effects. In vivo animal models further confirmed that PAL suppressed tumor growth by downregulating TNNT1, with a favorable safety profile.

Therefore, this study reveals a previously unrecognized role of PAL as a ferroptosis sensitizer and highlights its translational potential for anti-HCC therapy.

Full article
Study Protocol Open Access
Kathryn E. Speer, Andrew J. McKune, Nenad Naumovski
Published online July 27, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00088
Abstract
Anti-anxiety medications may cause adverse effects and can be associated with long-term health risks. Rooibos tea (Aspalathus linearis) contains polyphenolic compounds that may [...] Read more.

Anti-anxiety medications may cause adverse effects and can be associated with long-term health risks. Rooibos tea (Aspalathus linearis) contains polyphenolic compounds that may confer health benefits. This study aims to investigate the effects of green rooibos extract supplementation on anxiety levels in adults with mild-to-moderate anxiety.

This double-blind, placebo-controlled, randomized controlled trial will enroll 60 adults aged 18-65 years with mild-to-moderate anxiety. Participants will receive either green rooibos extract (19.25 mg aspalathin per capsule; n = 30) or placebo (n = 30). They will take one capsule each morning during the first week and two capsules each morning during the subsequent 7 weeks. The anxiety subscale of the 21-item Depression, Anxiety and Stress Scale will be the primary outcome and will be assessed from baseline to post-intervention. Secondary outcomes will include salivary biomarkers, heart rate variability, sleep quality, and dietary intake. Measurements will be collected at baseline, mid-intervention, and post-intervention.

The findings may help determine whether green rooibos extract supplementation is associated with reduced anxiety and improvements in related health markers in adults with mild-to-moderate anxiety.

Full article
Hypothesis Open Access
Lev Salnikov
Published online August 19, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2026.00016
Abstract
The selectivity of chemotherapy remains limited by systemic toxicity. pH-sensitive polymeric nanocarriers exploit the acidic extracellular environment of solid tumors as a drug-release [...] Read more.

The selectivity of chemotherapy remains limited by systemic toxicity. pH-sensitive polymeric nanocarriers exploit the acidic extracellular environment of solid tumors as a drug-release trigger, but they respond passively to a pre-existing pH gradient that is modest and heterogeneous. We hypothesize that controlled glucose priming, temporally coordinated with nanocarrier administration, may transiently widen the tumor-to-normal extracellular pH differential sufficiently to trigger release from a sharply tuned ultra-pH-sensitive (UPS) carrier in responsive tumor regions. Historical animal studies and limited human observations report tumor-associated extracellular pH decreases of approximately 0.17–0.20 units under selected conditions, while UPS micelles can dissociate cooperatively across a window narrower than 0.25 units and have tunable transition pH thresholds (pHt). The carrier would be tuned below the baseline extracellular pH (pHe) of the target tumor (with a pHt of approximately 6.5–6.6), remaining assembled where local pHe remains above pHt until a priming-induced pH excursion crosses the threshold. The central uncertainty is the accompanying effect on tumor perfusion and carrier delivery: tumor blood flow was unchanged at 1 g/kg in one animal study and reduced by 31% at 4 g/kg, while perfusion at 2 g/kg and the net effect across the proposed 1–2 g/kg testing range remain insufficiently characterized. Human evidence is limited and heterogeneous. Recent intracellular pH imaging associated glucose-induced pH changes with the lactate-to-pyruvate ratio but not with fluorodeoxyglucose standardized uptake value; fluorodeoxyglucose positron emission tomography avidity is therefore retained only as an exploratory candidate biomarker. A previous pH-low insertion peptide (pHLIP)-modified liposomal study supports the general principle of glucose-enhanced pH-responsive delivery but uses a mechanistically distinct carrier. The present work formulates a class-level, falsifiable framework for conformational UPS polymers. The essential next step is simultaneous measurement of tumor extracellular pH, perfusion, nanocarrier accumulation, and cargo release across glucose doses and administration sequences in tumor-bearing animals. Until those variables are measured together, the strategy should be regarded as a falsifiable preclinical proposal rather than a clinically feasible protocol.

Full article
Editorial Open Access
Mengqin Guo, Ziyu Zhao, Chuanbin Wu, Zhengwei Huang
Published online July 27, 2026
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Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2025.00003e
Mini Review Open Access
Hakim Rahmoune, Nada Boutrid, Isra Benchoufi
Published online September 1, 2026
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2026.00011
Abstract
Celiac disease remains underdiagnosed despite an established diagnostic pathway, reflecting phenotypic heterogeneity, delayed recognition, and dependence on resource-intensive testing. [...] Read more.

Celiac disease remains underdiagnosed despite an established diagnostic pathway, reflecting phenotypic heterogeneity, delayed recognition, and dependence on resource-intensive testing. This narrative review synthesizes evidence on artificial intelligence and phenomics in celiac disease (CD) across four operational layers: electronic health record phenotyping, Human Phenotype Ontology-based semantic encoding, machine-learning pre-screening from routine clinical data, and deep-learning-assisted histopathology. A targeted literature search of PubMed/MEDLINE, Embase, and Google Scholar covered publications from January 2010 through December 2025, using combinations of CD/coeliac disease with artificial intelligence, machine learning, deep learning, phenomics, Human Phenotype Ontology, computable phenotype, electronic health records, and natural language processing, supplemented by targeted searches and citation chaining. We present a curated minimum viable CD phenome and discuss clinical actionability, age-specific considerations, and current pediatric validation gaps. Selected models have demonstrated promising CD detection or pre-screening performance in specific datasets, but prospective, multicenter evidence with external validation remains insufficient to establish clinical utility. Artificial intelligence should augment expert clinical care rather than replace it.

Full article
Original Article Open Access
Yang Bai, Danqi Huang, Jingyi Liu, Yibei Li, Jingbo Zhai, Tian Gan, Jiang Li
Published online September 10, 2026
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Cancer Screening and Prevention. doi:10.14218/CSP.2026.00010
Abstract
Upper gastrointestinal precancerous lesions are important targets for cancer screening and prevention. This study evaluated the diagnostic accuracy of artificial intelligence (AI)-assisted [...] Read more.

Upper gastrointestinal precancerous lesions are important targets for cancer screening and prevention. This study evaluated the diagnostic accuracy of artificial intelligence (AI)-assisted endoscopy for upper gastrointestinal precancerous lesions.

PubMed, Embase, MEDLINE, Cochrane Library, and IEEE Xplore were searched from inception to March 31, 2026. Studies reporting sensitivity and specificity, or sufficient data for their calculation, were included. Two reviewers independently extracted data. Pooled sensitivity, specificity, and the area under the receiver operating characteristic curve were estimated using a bivariate random-effects model.

Fifteen studies comprising 24 datasets and 19,578 records were included. Pooled sensitivity and specificity were 0.930 (95% confidence interval (CI): 0.886–0.958) and 0.944 (95% CI: 0.906–0.967), respectively; the diagnostic odds ratio was 223.79 (95% CI: 92.24–542.94), and the area under the receiver operating characteristic curve was 0.9661. Substantial heterogeneity was observed (bivariate I² = 73%). Among the variables formally evaluated by meta-regression, imaging modality was associated with heterogeneity (global test P = 0.005); image-enhanced endoscopy had higher sensitivity than white-light endoscopy (0.960 vs. 0.875). No significant publication bias was detected by Egger’s test (P = 0.833), Begg’s test (P = 0.641), or Deeks’ funnel plot asymmetry test (P = 0.053).

AI-assisted endoscopy shows high diagnostic accuracy for upper gastrointestinal precancerous lesions. Multicenter prospective studies are needed for validation.

Full article
Original Article Open Access
David S. Lee, Daniel H. Wilentz, Melissa Duarte, Ifeoma Onwubiko, Julio C. Poveda, Elizabeth A. Montgomery
Published online September 3, 2026
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00041
Abstract
Anal canal melanoma (ACM) is a rare, aggressive malignancy with an ominous prognosis. However, its associated factors are largely unknown. Therefore, we investigated potential independent [...] Read more.

Anal canal melanoma (ACM) is a rare, aggressive malignancy with an ominous prognosis. However, its associated factors are largely unknown. Therefore, we investigated potential independent associations of sex and self-reported race with ACM and physiological anal canal pigmentation.

Two case-control cohorts from a single institution in Miami, Florida, were evaluated. The biopsy cohort comprised 117 sequential patients evaluated prospectively for melanocytic cells/pigment and anal intraepithelial neoplasia (AIN)/squamous intraepithelial lesion (SIL) in anal transitional zone biopsies between January 2021 and August 2022. The melanoma cohort consisted of 28 patients diagnosed with ACM between January 2003 and August 2021 and 116 of the patients in the pigmentation cohort. Multivariable logistic regression analysis was conducted to examine independent factor associations.

In the biopsy cohort, anal transitional melanocytic cells/pigment were identified in 48% (26/54) of Black patients compared to 17% (10/59) of White patients. Multivariable analysis demonstrated that White race was inversely associated with mucosal pigmentation (odds ratio (OR) = 0.19, 95% confidence interval (CI): 0.08–0.48, P < 0.001). Conversely, White race was associated with ACM (OR = 6.25, 95% CI: 2.07–18.81, P = 0.001). Male sex was also inversely associated with ACM (OR = 0.18, 95% CI: 0.07–0.47, P < 0.001). No significant correlations were observed between mucosal pigmentation and AIN/SIL or human immunodeficiency virus status.

Anal transitional zone pigmentation is more prevalent in self-reported Black individuals but is not associated with neoplastic squamous cell precursors. White (versus Black) individuals and female (versus male) individuals both have a significant association with ACM.

Full article
Review Article Open Access
Guantong Li, Dayan Sun, Dingding Wang, Shuangshuang Li, Kaiyun Hua, Yichao Gu, Yanan Zhang, Yong Zhao, Junmin Liao, Jinshi Huang
Published online August 26, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2026.00352
Abstract
Biliary atresia (BA) is the leading cause of pediatric obstructive cholestasis and a major indication for liver transplantation in infants. Organoid models are increasingly used [...] Read more.

Biliary atresia (BA) is the leading cause of pediatric obstructive cholestasis and a major indication for liver transplantation in infants. Organoid models are increasingly used to investigate BA pathogenesis and therapeutic responses, but incomplete methodological and clinical reporting may limit cross-study comparison and translational interpretation. This study aimed to map the landscape of BA-related organoid research, identify major reporting gaps, and propose Biliary Atresia Minimum Reporting Standard (BA-MRS) as a preliminary framework for improving reporting completeness.

PubMed, Scopus, and Web of Science Core Collection were searched on March 8, 2026, in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and the 2024 Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. Reporting completeness was assessed using a 36-item BA-MRS across six domains, scored as fully reported, partially reported, not reported, or not applicable.

Twenty-six studies published between 2020 and 2026 were included. Fibrosis and epithelial–mesenchymal transition were the most frequently studied themes, whereas only one study linked organoid findings to post-Kasai outcomes. BA case/model definition, ethics approval, and differentiation protocols were fully reported in all applicable studies (100%). In contrast, contamination monitoring (3.8%), core biliary function assays (34.6%), and clinical outcome linkage (26.3%) were poorly reported. Culture System and Sample Acquisition showed the lowest domain-level fully reported rates (58.1% and 63.2%, respectively).

BA organoid research has progressed beyond early model development, but reporting remains insufficient for robust comparison, reproducibility, and clinically meaningful interpretation. BA-MRS may serve as a preliminary framework for improving standardized reporting in future studies.

Full article
Opinion Open Access
Ebrahim Piri, AmirAli Jafarnezhadgero, Makwan JabarAli
Published online August 26, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2026.00020
Editorial Open Access
Yuriy L. Orlov, Monica R. Bequet, Peter V. Shegai, Dania M. Vazquez, Anton V. Snegovoy, Julio R. Fernández, Inna A. Apolikhina, Daria V. Bagdasarova, Alexander N. Kuznetsov, Oleg I. Apolikhin, Marta Ayala Avila, Andrey D. Kaprin
Published online July 29, 2026
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Gene Expression. doi:10.14218/GE.2025.00081
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