Search Results (46,258)

Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the two most prevalent neurodegenerative disorders, while the therapeutic efficacy of current drugs for both diseases remains limited, with unfavourable side effects. The fruit of Areca catechu L. (AC) is recognised as a popular chewing item across China and Southeast Asia and has been used for centuries as a traditional remedy, ranging from relieving digestive issues to depression. The neuroprotective role of AC has been underscored in previous studies; however, its mechanisms of action remain unclear. The present study aimed to investigate anti-neurodegenerative mechanisms of AC for the treatment of AD and PD. An integrated approach combining untargeted metabolite profiling, network pharmacology, bioinformatics analysis, and molecular docking was utilised. Experimental validation was performed using in vitro cell-based and in vivo models. The study revealed TNF-α, IL-1β, IL-6, CASP3, MAPK3, and AKT1 as top-ranked hub targets by which AC exerts its action on AD and PD. Enrichment analyses of these genes identified significant biological and functional pathways involved in neuroinflammation, apoptosis, and AD. Experimental validation showed that AC extracts significantly downregulated hub gene expressions in the neuroinflammatory BV-2 microglia cell model and prolonged the survival of the transgenic Caenorhabditis elegans AD model. Docking analysis suggested lucidine B, oxolucidine B, solanocapsine, evodiamine, and liquiritigenin are the principal phytocompounds underlying the neuroprotective properties of AC. The findings revealed the pharmacological mechanisms of AC and highlighted its potential value as an effective, multitargeting natural agent to address challenges in AD and PD therapies. Full article

Aim: This review summarizes the current evidence on cognitive impairment in patients with glioma, with particular emphasis on the underlying mechanisms, methods for objective assessment of cognitive deficits, and currently available therapeutic strategies. Methods: Relevant literature was identified through searches of the PubMed, Cochrane Library, and Google Scholar databases. Studies addressing the mechanisms, assessment, and management of cognitive impairment in patients with glioma published between January 2000 and February 2026 were reviewed to summarize current evidence and emerging therapeutic strategies. A structured literature search and study selection process was performed. Results: Cognitive deficits represent a heterogeneous clinical problem affecting the majority of patients diagnosed with gliomas. These impairments are multifactorial in origin, resulting both from direct infiltration of white matter by the tumor process and from the cumulative toxicity of treatment modalities, including radiotherapy, chemotherapy, corticosteroid therapy, and long-term use of antiseizure medications. Analysis of the current literature confirms that modern radiotherapy techniques (e.g., hippocampal-sparing approaches) and isocitrate dehydrogenase (IDH)-targeted therapies, such as vorasidenib, may significantly delay cognitive decline. Standardized neuropsychological batteries for the objective assessment of these disturbances remain the preferred tools recommended by the International Cognition and Cancer Task Force (ICCTF). Regarding therapeutic interventions, potential benefits have been demonstrated for supportive pharmacotherapy (including memantine), while individualized neuropsychological rehabilitation has also been shown to improve patients’ quality of life. Full article

Fibroblast growth factor receptor 2b (FGFR2b) has become an increasingly important therapeutic target in gastric and gastroesophageal junction cancer, particularly with the clinical development of FGFR2b-directed antibody therapy. However, its translation into routine treatment selection is not straightforward. FGFR2b is usually assessed as a protein biomarker by immunohistochemistry, and a positive result may reflect different biological situations depending on staining intensity, percentage of positive tumor cells, sample type and spatial distribution. In addition, FGFR2b protein expression, FGFR2 amplification, transcript-level activity and true pathway dependency are related but not interchangeable. This review examines FGFR2b-positive gastric cancer from the perspective of biomarker reliability rather than target presence alone. We discuss the biological basis of FGFR2b targeting, the reasons for variability in reported positivity rates, the implications of intratumoral and inter-lesion heterogeneity, the current clinical evidence for FGFR2b-directed and broader FGFR-targeted approaches, and the emerging challenges of safety, resistance and treatment sequencing. Particular attention is given to the gap between detecting FGFR2b and identifying tumors in which this target is sufficiently expressed, representative and biologically relevant to guide therapy. We also consider how FGFR2b should be interpreted alongside HER2, CLDN18.2, immune biomarkers and other receptor tyrosine kinase alterations. As FGFR2b-directed strategies move forward, their success will depend not only on drug efficacy, but also on standardized testing, careful reporting, and selective reassessment when disease biology changes. FGFR2b therefore offers a useful model for how protein biomarkers can be developed in gastric cancer: not as isolated positive-or-negative labels, but as clinically interpreted variables within a changing therapeutic landscape. Full article

Background/Objectives: Inflammatory bowel diseases (IBD) including ulcerative colitis and Crohn’s disease can be associated with other immune-mediated inflammatory diseases (IMIDs) and extraintestinal manifestations (EIM) including dermatological manifestations, ophthalmologic manifestations, musculoskeletal manifestations and neurological manifestations. The aim of this narrative review is to discuss the optimal management and treatment strategy of IBD with immune-mediated inflammatory disease and extraintestinal manifestations. Methods: This review is based on published studies searched in PubMed until 31 December 2025. Our search focused on systemic reviews, review articles, randomized trials, cohort studies, guidelines and case series. Results: In IBD, the presence of additional immune-mediated inflammatory diseases (IMIDs) should be considered a poor prognostic factor, prompting closer disease monitoring and earlier escalation to or optimization of advanced therapy. Therapeutic management requires careful consideration including a multidisciplinary approach and a selection of the most appropriate treatment option(s) based on the presence, severity of IBD and/or IMIDs and/or EIM. For patients with refractory disease affecting multiple organs, emerging strategies include dual biologic therapies. Conclusions: The optimal management of IBD with associated IMIDs/EIM should be multidisciplinary in close cooperation among specialists to align treatment goals and management plans. Full article

Breast cancer is a heterogeneous disease characterized by substantial molecular diversity and variable treatment outcomes across patients. Despite advances in targeted and systemic therapies, anticipating individual benefit remains a major clinical challenge. In this context, Artificial Intelligence (AI) can support precision oncology by integrating high-dimensional molecular profiles with clinical and pharmacological information. Here, we present B.R.E.A.S.T. (Breast canceR Enhanced AI-Supported Therapy), an interpretable machine learning framework designed to predict therapy outcome from tumor proteomic profiles integrated with clinical and treatment annotations. Proteomic data from The Cancer Genome Atlas (TCGA) and The Cancer Proteome Atlas (TCPA) were harmonized with outcome and therapy information, and thirteen supervised classifiers were systematically evaluated using stratified 5-fold cross-validation. Therapeutic outcome labels were operationally defined by integrating available treatment response annotations with complementary clinical outcome information. Across both cohorts, ensemble-based models consistently achieved the most stable and highest discriminative performance, supported by learning-curve analyses and consistent behavior across independent datasets. To enhance interpretability, we implemented a two-step feature selection strategy combining model-specific importance measures with a global consensus ranking, enabling the identification of a compact set of robust proteomic biomarkers associated with therapeutic outcome. Top-ranked features mapped to molecular programs relevant to breast cancer progression and treatment sensitivity, including regulators of cell survival, DNA damage response, PI3K/AKT/mTOR signaling, and invasion-related processes. Re-evaluation using only the top 30 globally ranked features preserved high predictive performance across both independent breast cancer cohorts, indicating that a parsimonious proteomic signature captures core molecular determinants of outcome. Overall, B.R.E.A.S.T. provides a robust and generalizable proteomics-driven framework for modeling outcome-associated therapeutic response patterns and supporting biologically informed biomarker discovery in breast cancer. Full article

A critical yet frequently overlooked factor is the tumor’s metabolic profile. Diabetes and chronic moderate hyperglycemia are known risk factors for triple-negative breast cancer (TNBC) that do not respond to hormonal therapy. So, identifying novel therapeutic targets and developing more effective treatments is needed. One of the key pathways involved in the aggressive nature of TNBC is the Toll-like receptor 4 (TLR4) signaling cascade. To this end, curcumin (CUR) has shown effects consistent with modulating inflammatory stress by inhibiting TLR4/MD-2. This study evaluated CUR at concentrations observed in the bloodstream (0.025–25 ng/mL) in MDA-MB-231 TNBC cells under different glucose conditions (normal, moderate, and severe hyperglycemia) and inflammatory states (LPS-induced), using cell viability assays and molecular docking. A zinc complex (Zn–CUR) was also used. Results were validated through cell viability assays. Under severe hyperglycemia, CUR unexpectedly increased cell viability in a dose-dependent manner, while Zn–CUR had no activity across all glucose levels. In LPS-induced inflammation, CUR exhibited a biphasic, dose-dependent response, being protective at mid-level doses but cytotoxic at higher doses, whereas Zn–CUR showed more consistent effects, consistent with modulation of inflammatory stress. Molecular docking suggests that Zn–CUR binds more stably within the MD-2 hydrophobic pocket than CUR, particularly when bound to LPS, with binding energies of −8.7 and −8.3 kcal/mol, respectively. However, better in silico affinity did not always translate into improved cellular effects. These findings indicate that metabolic context significantly influences CUR’s biological activity and that forming a zinc complex offers a safer, more reliable profile. This positions Zn–CUR as a candidate warranting further investigation for TNBC, particularly in the context of hyperglycemia. Full article

Background/ Objectives: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and decreased tear secretion, largely driven by chronic ocular surface inflammation. Although current therapies primarily target inflammation and tear film stabilization, their clinical efficacy is often limited by insufficient ocular surface retention. In this study, we explored a drug repositioning strategy for DED by developing a nanocrystalline formulation of troxipide (TRO), a gastric mucosal protective agent with cytoprotective properties. Methods and Results: A TRO nanosuspension (TRO-NPs) was successfully prepared by wet bead milling, yielding particles with a mean diameter of approximately 100 nm. Physicochemical characterization revealed that the crystalline structure, solubility, viscosity, pH, and osmolarity of the nanosuspension were comparable with those of the conventional TRO microsuspension (TRO-MPs). In contrast, the TRO-NPs exhibited markedly improved dispersion stability, maintaining particle suspension for at least 1 month after preparation. Repeated topical instillation of the TRO-NPs did not induce corneal toxicity or inflammation in rabbits, and resulted in significantly higher drug retention in the tear fluid than that observed for the TRO-MPs. Furthermore, in an N-acetylcysteine-induced rabbit dry eye model, repetitive instillation of the TRO-NPs significantly increased tear volume and mucin levels, leading to improved tear film stability. Conclusions: These findings demonstrate that nanosuspension-based formulations can enhance ocular surface retention and therapeutic efficacy of TRO. TRO-NPs therefore represent a promising nanomedicine-based repositioned therapy for the treatment of DED. Full article

Recent studies indicate that ferroptosis shows unique advantages in oncotherapy, particularly in reversing multidrug resistance (MDR). Despite current therapeutic advancements, the treatment of high-incidence malignancies with dismal prognoses continues to face challenges, including limited clinical efficacy, significant side effects, and drug resistance. In recent years, Chinese herbal medicine (CHM) has gained increasing attention in anti-tumor therapy. CHM bioactive components are highly effective in inducing tumor cell ferroptosis, inhibiting tumor proliferation and migration, and reversing drug resistance. Additionally, some components can protect normal cells and improve the tumor microenvironment. This review systematically summarizes the regulatory roles of various CHM bioactive components in ferroptosis across common human cancers. We further analyze the underlying molecular mechanisms, focusing on the modulation of key regulatory targets (e.g., GPX4, SLC7A11, and Nrf2) and critical signaling cascades (e.g., PI3K/AKT/mTOR and p53). Furthermore, the differential effects of bioactive compounds from CHM on common tumors were evaluated, alongside their potential in combination therapy. This review provides a theoretical foundation for the development of novel anticancer drugs targeting ferroptosis regulation and offers new perspectives for the clinical application of CHM in oncology. Full article

TP53 is the most frequently altered tumor-suppressor gene in human cancer, yet efforts to therapeutically target p53 have yielded limited and inconsistent clinical success. We argue that this gap reflects not a lack of druggable biology, but an oversimplified conceptual framework that treats p53 as a binary wild-type versus mutant entity. Here, we synthesize emerging evidence supporting a model in which p53 operates across a spectrum of functional states defined by mutation class, allelic burden, isoform composition, aggregation propensity, post-translational regulation, and cellular context. These states shape distinct biological outputs, including transcriptional activity, dominant-negative and gain-of-function effects, immune modulation, and checkpoint dependency, which collectively determine therapeutic vulnerability. We review current strategies targeting the p53 pathway, including mutant p53 reactivation, targeted degradation, anti-aggregation approaches, immune-directed therapies, restoration of wild-type pathway activity, gene replacement, and synthetic lethal targeting of DNA damage response dependencies. Clinical and preclinical evidence highlights key limitations of each approach, including stoichiometric constraints, mutation specificity, context-dependent efficacy, and adaptive resistance. Notably, emerging evidence from preclinical and correlative clinical studies suggests that therapeutic outcomes may be more closely associated with p53 functional state than with TP53 mutation status alone. We further emphasize the emerging roles of p53 isoforms and the tumor immune microenvironment as critical modifiers of p53 activity and determinants of treatment response. Collectively, these insights support a paradigm shift toward mechanism-matched, biomarker-stratified strategies that align therapeutic modality with the operative p53 network. Future progress will depend on integrating multi-parameter diagnostics with rational combination therapies to fully exploit p53 as a central vulnerability in cancer. Full article

Background: Enterococcus faecalis is one of the most frequent causes of catheter-associated urinary tract infections, largely due to its ability to form biofilms on indwelling urinary catheter surfaces, which enhance bacterial persistence and antimicrobial tolerance. Sub-minimum inhibitory concentrations (sub-MICs) of antimicrobials frequently occur in clinical settings, and growing evidence suggests that such suboptimal exposures can induce bacterial biofilm formation. We hypothesized that exposure to sub-MICs of amoxicillin, ciprofloxacin, and nitrofurantoin, antimicrobials commonly employed in the treatment of urinary tract infections, would enhance the biofilm-forming capacity of E. faecalis strains. Objective: To investigate the effects of sub-MICs of amoxicillin, ciprofloxacin, and nitrofurantoin on biofilm formation and biofilm-associated gene expression. The study focused on key biofilm-related genes, including those encoding aggregation substance protein (asa1), collagen adhesin (ace), E. faecalis surface protein (esp), gelatinase (gelE), cytolysin activator A (cylA), endocarditis antigen A (efaA), and the endocarditis- and biofilm-associated pili subunit A (ebpA) in E. faecalis. Methods: Two strains, E. faecalis ATCC 29212 and strain 54, were exposed to 1/8× and 1/4× MIC of amoxicillin, ciprofloxacin, and nitrofurantoin in either artificial urine medium (AUM) or tryptone soya broth (TSB). Bacterial growth kinetics were monitored by optical density measurements, while biofilm formation was quantified using a microtiter plate biofilm assay. The expression of biofilm-associated genes was analyzed using quantitative reverse transcription PCR (RT-qPCR) at 24 and 48 h following exposure to sub-MICs of amoxicillin under flow conditions mimicking the urinary tract milieu. Results: Exposure to sub-MICs of the three antimicrobials did not significantly affect bacterial growth in either strain or culture medium. Sub-MICs of amoxicillin significantly enhanced biofilm formation, with the most pronounced effect observed at 1/4× MIC in both AUM and TSB. In contrast, ciprofloxacin and nitrofurantoin exerted inhibitory effects on biofilm formation across both media. Gene expression analysis demonstrated time- and strain-dependent responses to amoxicillin exposure. E. faecalis ATCC 29212 exhibited a moderate, coordinated upregulation of adhesion- and biofilm-associated genes, particularly at 48 h. By comparison, E. faecalis strain 54 showed a stronger and more dynamic transcriptional response, characterized by early and sustained induction of key biofilm-related genes, including esp and gelE, as well as a pronounced late upregulation of ebpA. Conclusions: These findings emphasize the importance of maintaining therapeutically effective antimicrobial concentrations, as sub-inhibitory amoxicillin exposure may promote biofilm-associated persistence and potentially compromise treatment efficacy. Full article

Drug resistance remains a significant barrier to achieving durable treatment responses. Traditionally, resistance has been attributed to genetic alterations and clonal selection. However, accumulating evidence suggests that early adaptation to therapy is often mediated by non-genetic state transitions. In this review, we propose a conceptual framework in which resistance emerges through therapy-driven molecular evolution in bladder cancer, characterized by three interconnected axes: non-genetic plasticity, metabolic reorganization, and tumor microenvironment remodeling. Using the Gemcitabine-Resistant Cell (GRC) model as a temporal reference system, we describe a stepwise transition from drug-sensitive states dominated by proliferation to survival-optimized resistant states through a growth–survival trade-off. Early adaptive phases are marked by the attenuation of cell-cycle and glycolytic programs, increased epigenetic flexibility, and metabolic rewiring involving mitochondrial and lipid-associated pathways. Later phases involve the reinforcement of resistance through extracellular matrix remodeling, developmental and stress-response signaling, and immunometabolic interactions within the tumor microenvironment, including adenosine- and lipid-associated mediators. Projecting the GRC score onto a clinical bladder cancer cohort further suggests that these evolutionary patterns may also be reflected in patient tumors. Overall, this framework supports a temporally structured view of chemoresistance and highlights opportunities to therapeutically target transitional adaptive states before resistance becomes stabilized. Full article

Epigenetics regulates gene activity without altering the underlying DNA sequences. Numerous studies have highlighted the importance of epigenetics in diverse physiological processes, including cell growth, differentiation, and tissue development. Increasingly, epigenetic modifications are recognized for their involvement in various diseases, notably corneal disorders. Corneal fibrosis, a common consequence of ocular injury or infection, significantly contributes to visual impairment and blindness worldwide. Recent evidence indicates that epigenetic changes regulate key processes in corneal pathogenesis, such as inflammation, wound healing, extracellular matrix remodeling, fibrosis, and neovascularization. These findings underscore the potential of developing novel therapeutic strategies that specifically target epigenetic mechanisms to treat or mitigate corneal pathology. Nevertheless, bringing epigenetic therapies into clinical practice remains challenging given the complexity of epigenetic regulation. Future research leveraging multi-omics technologies and specific gene manipulation will be essential to elucidate the mechanisms underlying epigenetic regulation in corneal diseases and to identify specific therapeutic targets. Such advancements will drive the development of effective, clinically relevant treatments for corneal fibrosis and related disorders. Full article

Mechanisms of primary and acquired resistance are responsible for treatment failure with the Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors (EGFR-TKIs) in the majority of patients with advanced Non-Small-Cell Lung Cancer (NSCLC) carrying EGFR-activating mutations. MicroRNAs (miRNAs) are important modulators of EGFR signaling in lung cancer. Recent studies suggested the role of miR-23c as a tumor suppressor or oncogenic miRNA in different tumor types. However, the role of miR-23c in NSCLC carrying EGFR mutations and its involvement in resistance to EGFR-TKIs has not been explored yet. We found that miR-23c was strongly downregulated in H1975 and HCC827-Gefitinib-Resistant (GR) NSCLC cell lines with intrinsic and acquired resistance to gefitinib, respectively, as compared to gefitinib-sensitive cell lines. Moreover, we demonstrated that miR-23c mimic inhibited proliferation, migration, invasion, and epithelial–mesenchymal transition of resistant cells and that Interleukin-6 Receptor (IL-6R) is a direct target of miR-23c in H1975 and HCC827-GR cell lines. Importantly, miR-23c mimic re-sensitized NSCLC-resistant cells to gefitinib, whereas the combination of miR-23c mimic with a neutralizing IL-6R antibody potentiated the sensitivity to the drug. Collectively, our data demonstrated that miR-23c acts as a tumor suppressor in NSCLC cell lines carrying EGFR mutations and that the axis miR-23c/IL-6R might represent a potential target for the development of therapeutic approaches to overcome resistance to gefitinib. Full article

Background: Ready-to-use therapeutic foods (RUTFs) have been developed to treat severe acute malnutrition (SAM) in children by promoting rapid weight gain, but the long-term effects have been overlooked. Incorporating prebiotic rice bran into RUTF can enhance balanced weight gain. We hypothesized that children receiving RUTF + rice bran would exhibit increased fat-free mass (FFM) and reduced body fat percentage and abdominal adiposity. Methods: A double-blinded randomized controlled trial (ClinicalTrials.gov:NCT05319717) involving 200 children with different degrees of acute malnutrition compared the effectiveness of RUTF with or without rice bran. Children received treatment for 8 weeks, with another 8 weeks of follow-up. Anthropometry, including skinfolds, was collected every 4 weeks. Results: Compliance was similar in both groups (~21%). Children aged 6 to 23 months receiving RUTF + rice bran gained more FFM than those receiving RUTF alone (p = 0.05 at week 8). Over the 8-week treatment, the fat mass index increased in children receiving RUTF (p = 0.02), but not in those receiving RUTF + rice bran (p = 0.48), although the increase in body fat percentage was similar (p = 0.23). The ratio of abdominal to peripheral skinfolds decreased in both groups during treatment but increased during follow-up, though the difference was not statistically significant. In children aged 24 to 59 months, no significant differences in body composition were observed. The fat-free mass index increased in both groups during treatment but declined afterwards, with significant changes noted in the RUTF + rice bran group. Conclusions: The addition of rice bran to RUTF affected body composition changes during treatment only in younger children, where more lean mass was gained and fat mass gain was limited. Differences in intestinal microbiome maturity might underlie this age difference. Full article

Atopic dermatitis (AD) is among the most common chronic inflammatory diseases. Due to the heterogeneous presentation of AD, patient response to treatment may differ considerably. Therefore, there is a pressing need for biomarkers associated with response to biological therapies. Thus, we aimed to identify blood-based candidate biomarkers associated with response in patients treated with dupilumab. The present study applied a multi-stage integrative analytical framework combining transcriptomic profiling, functional enrichment, co-expression network analysis, and genomic variant analysis to identify potential biomarkers. Eighteen dupilumab-naïve patients were enrolled in the transcriptomic analysis, with blood samples collected at baseline and after 16–18 weeks of therapy; five patients were identified as non-responders. Additionally, genotyping was performed in 34 patients. We identified a set of candidate genes (RPL18A, RPS28, FAU, MASTL, AURKA, TAF2, BUB1B, and RNF135) and genomic variants that may reflect underlying biological mechanisms influencing therapeutic response. However, given the limited sample size, these findings should be considered exploratory and hypothesis-generating. Finally, our study identified exploratory candidate genes potentially associated with variability in dupilumab treatment response. Moreover, our study represents an incremental contribution to existing knowledge, opening avenues for research that may ultimately lead to personalized medicine. Full article