Current Medicinal Chemistry - Online First
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21 - 40 of 207 results
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Apolipoprotein A1 and Lipoprotein(a) as Biomarkers for the “Penumbra Freezing” in Acute Ischemic Stroke: Insights From a Case-Control and Mendelian Randomization Study
Authors: Jianyu Liu, Zhiyao Xu, Yang Wen, Xing Guo, Xiaoyang Chen, Da Liu, Linyan Li and Hua LiuAvailable online: 02 October 2025More LessIntroduction“Penumbra freezing” aims to extend vascular recanalization treatment to acute ischemic stroke (AIS) patients beyond the standard time window by preserving the ischemic penumbra. Efficient biomarkers are crucial for identifying patients eligible for AIS treatment.
MethodsThis study enrolled 141 AIS patients who exceeded the conventional treatment window. Using CT perfusion imaging, patients were categorized into “penumbra freezing” and “non-penumbra freezing” groups based on the EXTEND criteria. Multiple regression analysis assessed the association of nine baseline factors and five blood lipid indicators with “penumbra freezing.” Diagnostic accuracy was evaluated using ROC curves. Mendelian randomization (MR) analysis validated these findings using blood lipid indicators as exposures and penumbra biomarkers as outcomes.
ResultsAmong AIS patients beyond the treatment window, males exhibited better penumbra preservation (OR=0.243, 95% CI=0.072-0.813, p=0.022), while those with hyperlipidemia showed poorer preservation (OR=2.429, 95% CI=1.027-7.747, p=0.043). In the “penumbra freezing” group, ApoA1 levels were significantly lower (1.29 ± 0.03 g/L) compared to the “non-penumbra freezing” group (1.42 ± 0.06 g/L, p=0.034). Conversely, Lp(a) levels were significantly higher in the “penumbra freezing” group (304.63 ± 52.44 mg/L) than in the “non-penumbra freezing” group (110.26 ± 40.71 mg/L, p=0.034). Higher ApoA1 levels increased the likelihood of “non-penumbra freezing” beyond the time window (OR=3.206, 95% CI=1.034-9.938, p=0.044), while elevated Lp(a) levels reduced this likelihood (OR=0.075, 95% CI=0.007-0.848, p=0.036). MR analysis confirmed genetic associations of ApoA1 and Lp(a) with penumbra biomarkers.
DiscussionApoA1 and Lp(a) may be linked to ischemic penumbra status, but further validation is needed due to limitations in sample size and study methodology.
ConclusionApoA1 and Lp(a) are promising biomarkers for identifying AIS patients eligible for “penumbra freezing,” suggesting the potential to extend the treatment window.
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Mediating Effects of Plasma Metabolites in Inflammatory Protein- Lymphoma Causality: A Mendelian Randomization Study
Authors: Yueru Ji, Xiaotong Gao, Li Liu, Zhuo Wan and Weiwei QinAvailable online: 02 October 2025More LessIntroductionDiffuse large B-cell lymphoma (DLBCL) pathogenesis is poorly understood, with limited causal evidence linking circulating inflammatory proteins (CIPs) and metabolites to disease risk. Observational studies face challenges from confounding and reverse causation, while existing Mendelian Randomization (MR) analyses lack bidirectional designs and multi-omics integration.
MethodsA bidirectional two-sample MR design was applied using inverse-variance weighting (IVW). Genetic instruments for 91 CIPs derived from Olink proteomic data (14,824 participants). DLBCL genetic associations (1,050 cases; 314,193 controls) were obtained from FinnGen (R10 release). Data for 1,091 blood metabolites and 309 metabolite ratios were sourced from the GWAS Catalog.
ResultsTen CIPs exhibited causal effects on DLBCL. Risk-increasing proteins included: IL-10 (OR=1.46, 95%CI=1.05-2.03), TSLP (1.37,1.01-1.84), IL-17C (1.34,1.05-1.72), NRTN (1.30,1.02-1.66), OPG (1.29,1.01-1.66), and MCP1 (1.26,1.04-1.52). Protective proteins included: CD40 (0.82,0.67-1.00), CXCL9 (0.78,0.61-0.98), CD5 (0.77,0.61-0.97), and MCP3 (0.76,0.58-0.99). Reverse causation was absent for 7 proteins. Mediation analysis revealed 17.2% (p=0.048) of CD5’s protective effect was mediated by 1-methylhistidine.
DiscussionThese findings establish CIPs as causal factors in DLBCL pathogenesis and identify metabolite-mediated pathways as novel mechanistic links. The bidirectional design and multi-omics integration overcome key limitations of prior research, though statistical power for some mediation tests was limited by metabolite GWAS sample sizes.
ConclusionPlasma inflammatory proteins causally influence DLBCL risk, partially mediated by metabolites. This underscores metabolite pathways as potential targets for therapeutic intervention.
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LncRNA HYMAI Promotes Endothelial Cell Autophagy via miR-19a-3p/ ATG14 to Attenuate the Progression of Coronary Atherosclerotic Disease
Authors: Shao Ouyang, Zhi-Xiang Zhou, Hui-Ting Liu, Kun Zhou, Zhong Ren, Huan Liu, Qian Xu, Zhaoyue Wang, Wenhao Xiong, Gaofeng Zeng and Zhi-Sheng JiangAvailable online: 02 October 2025More LessBackgroundCoronary atherosclerotic disease (CAD), clinically manifesting as progressive coronary atherosclerosis (As), involves endothelial cell (EC) dysfunction. HYMAI may contribute to atherogenesis by acting on ECs, but its regulation of endothelial injury and role in As pathogenesis remain unclear.
MethodsHYMAI expression was assessed via PCR array in blood samples from healthy individuals, patients with premature coronary atherosclerotic disease (PCAD), and patients with mature coronary atherosclerotic disease (MCAD) (each group consisting of 4 males and 2 females). Using male ApoE−/− and LDLR−/− mice fed with a high-fat diet (HFD) to model As, we evaluated the effects of endothelial-specific HYMAI overexpression on aortic lesions. Autophagy and apoptosis were analyzed in ox-LDL-treated human coronary artery endothelial cells (HCAECs).
ResultsHYMAI levels increased sequentially in healthy individuals, PCAD, and MCAD patients. In HFD-fed ApoE−/− and LDLR−/− mice, aortic atherosclerosis progressed with age, while HYMAI expression in aortic tissue declined. HYMAI overexpression in ECs promoted autophagy and attenuated atherosclerosis. In vitro, ox-LDL suppressed HYMAI, triggering autophagic inhibition and apoptotic activation in HCAECs. HYMAI overexpression rescued ox-LDL-impaired autophagy and suppressed apoptosis through the miR-19a-3p/ATG14 pathway. MiR-19a-3p overexpression reversed autophagic rescue and promoted apoptosis by repressing ATG14.
DiscussionHYMAI upregulation counteracts ox-LDL-treated endothelial autophagic inhibition via the miR-19a-3p/ATG14 pathway, rescuing apoptosis and attenuating As in both in vivo and in vitro settings.
ConclusionOur results demonstrated that HYMAI attenuated As progression in As mice and ox-LDL-treated HCAECs by enhancing endothelial autophagy through the miR-19a-3p/ATG14 axis. These findings establish HYMAI as a novel regulatory mechanism and provide a potential druggable target for As and CAD.
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Connexin 43: Roles in the Pathophysiology of Cardiovascular Diseases and Attractive Target for New Drugs
Authors: Yijia Wu, Yixiong Zhan, Duoduo Zha and Yisong QianAvailable online: 01 October 2025More LessConnexin43 (Cx43), encoded by the GJA1 gene, plays a crucial role in the formation of hemichannels and the assembly of gap junctions between adjacent cells, facilitating the efficient transport of ions and small molecules. Increasingly studies have revealed the regulatory roles of Cx43 in endothelial cells. Cx43 is not only implicated in the normal function of endothelial cells such as regulating the endothelial barrier, promoting endothelial angiogenesis, regulating vascular tone, and other subtle regulations, but also contributed to endothelial dysfunction, including inflammatory responses, endothelial cell death, and increased endothelial permeability. Here we provide a summary of the current understanding of Cx43 in the pathogenesis of atherosclerosis, hypertension, stroke, and diabetes. In addition, the potential therapeutic approaches targeting Cx43 are also proposed.
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Association between Serum Klotho Levels and Sarcopenia: Result from the NHANES (2011-2016)
Authors: Ting Sun, Lu Liu, Xiaoqi Xie and Li TianAvailable online: 01 October 2025More LessIntroductionKlotho is a multifunctional protein with anti-aging properties that plays a role in regulating vitamin D and phosphate metabolism. Sarcopenia is characterized by the loss of muscle mass and strength and is an important public health concern due to its negative effects on health. The aim of this study was to investigate the association between α-Klotho levels and the frequency of sarcopenia in a diverse population.
MethodsThis study analyzed data from 1,250 participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Participants were divided into four subgroups based on serum α-Klotho levels. Sarcopenia was assessed using skeletal muscle index and handgrip strength measurements. Multivariable logistic regression analysis was used to determine the association between serum α-Klotho levels and sarcopenia.
ResultsThere was a significant difference in serum α-Klotho levels between patients with sarcopenia and patients without sarcopenia. In an unadjusted multivariable logistic regression model, higher α-Klotho serum levels were associated with a lower risk of sarcopenia (p < 0.05). This trend was maintained in the partially adjusted model, indicating that higher levels of α-Klotho were associated with a lower risk of sarcopenia. However, the fully adjusted model did not show significance.
DiscussionSeveral factors significantly influence the relationship between serum α-Klotho levels and sarcopenia, including sex, ethnicity, alcohol consumption, body mass index (BMI), vitamin D levels, and disease status. Our findings indicate that the risk of sarcopenia is elevated in individuals within the lowest quartile of serum α-Klotho levels. Furthermore, a negative correlation exists between α-Klotho levels and grip strength, observed in both the overall sample and the aging-related subgroup. These results highlight the necessity for further investigation into the complex interplay between α-Klotho and grip strength, particularly in the context of sarcopenia associated with renal disease.
ConclusionSerum α-Klotho levels in different populations are negatively correlated with the risk of sarcopenia, suggesting that α-Klotho may be involved in the occurrence and development of sarcopenia. Therefore, measuring α-Klotho levels in clinical practice may be a valuable diagnostic tool to identify individuals at high risk of developing sarcopenia.
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8-Hydroxyquinoline Derivatives as Drug Candidates for the Treatment of Alzheimer's Disease
Available online: 01 October 2025More LessAlzheimer's disease (AD) is the most prevalent form of dementia among older adults worldwide. Amidst several hypotheses to explain the pathobiology of the disease are biochemical indicators such as β-amyloid (Aβ) plaques; neurofibrillary tangles, caused by hyperphosphorylated tau protein; oxidative stress; metal dyshomeostasis; low levels of acetylcholine, and neuroinflammation. Considering the multifactorial nature of AD, there has been an increase in research for novel multitarget compounds, mainly utilizing molecular hybridization for drug design. In this review, we focus on the 8-hydroxyquinoline moiety, a privileged metal-binding agent with Aβ antiaggregating properties, and its derivatives, aiming to have an effect on multiple molecular targets. Furthermore, the most prominent structure-activity relationships found on the analyzed compounds, along with the most promising strategies explored by researchers, are discussed. That way, we hope to provide a comprehensive perspective on the development of anti-Alzheimer agents based on the 8-hydroxyquinoline moiety in the last decade.
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Identification of Microvascular Invasion-Related Biomarkers for Personalized Treatment of Hepatocellular Carcinoma
Authors: Wei Xiang, Xue Liu, Tingting Bao, Fei Yang, Jintao Huang, Jian Shen and Xiaoli ZhuAvailable online: 01 October 2025More LessIntroductionHepatocellular Carcinoma (HCC) exhibits high recurrence rates, particularly when accompanied by Microvascular Invasion (MVI). We identified MVI-related biomarkers and established a prognostic model for personalized HCC treatment.
MethodsData were downloaded from The Cancer Genome Atlas (TCGA) and HCCDB databases. Key radiomics features were identified using the support vector machine-recursive feature elimination (SVM-RFE) algorithm, and differential expression analysis was performed with DESeq2. This was followed by functional enrichment analysis using the clusterProfiler package. Through univariate and Lasso regression analyses, we constructed a robust RiskScore model to effectively stratify HCC patients into distinct risk groups based on the median RiskScore value. The model prediction performance was evaluated using ROC curves and Kaplan-Meier (KM) analysis. We used the CIBERSORT algorithm to characterize immune cell infiltration patterns and conducted GSEA to identify differentially activated pathways between the risk groups.
ResultsRadiomic analysis revealed four significant features strongly associated with MVI, enabling the construction of a nomogram model with robust classification performance (AUC = 0.742). Subsequent analysis identified 241 overlapping MVI-related Differentially Expressed Genes (DEGs) enriched in critical tumor proliferation and invasion pathways. A 10-gene RiskScore model was developed, demonstrating excellent prognostic discrimination in training and validation cohorts. CIBERSORT analysis revealed significant correlations between specific immune cell infiltration and the 10 genes. GSEA analysis showed significant enrichment of cell cycle regulation pathways in the high-risk group, suggesting their important role in MVI.
DiscussionThe RiskScore was established using MVI-related features for prognosis assessment in HCC.
ConclusionOur findings provided novel biomarkers and a theoretical basis for the early diagnosis and personalized treatment of HCC.
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Endothelin: A Potential Universal Systemic Biomarker
Available online: 30 September 2025More LessBackgroundEndothelins is a family of vasoconstrictive peptides known for their high potency. They are mainly synthesized and secreted by the endothelial cells lining the blood vessels in response to various stimuli. Their main physiological role is the regulation of vascular tone, affecting blood pressure and tissue perfusion.
ObjectiveThe aim of this review was to evaluate the importance of Endothelin-1 (ET-1) plasma levels as a marker in diagnosis, disease burden, or development, due to its vascular effects.
MethodsData was collected and grouped, from several studies in different organ systems, during the last thirty years, were collected. A statistical analysis was performed to reveal any similarities and differences among them.
ResultsET-1 was found to be increased in arterial and pulmonary hypertension. Plasma ET-1 was elevated in patients with heart failure, autoimmune disease, chronic kidney disease, and liver failure. In all these cases, ET-1 was increased at least twice the maximum of normal plasma concentration in healthy subjects, in a similar pattern, independently of the disease background. More importantly, plasma ET-I levels increased even more according to the severity of the disease, not necessarily in a linear manner.
DiscussionPlasma ET-1 levels appears to increase whenever a disorder or dysfunction occurs in kidney, heart, lungs, liver and pancreas. Since, remission is followed by a reduction in the already elevated levels, plasma ET-1 emerges to be an important diagnostic molecule.
ConclusionEndothelin-1 appears to increase similarly across various pathological conditions, making it a potential biomarker for overall human physiological status.
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The Potential Mechanism of Quercetin in Treating Diabetic Foot Ulcer Revealed by Network Pharmacology
Authors: Liuwen Huang, Ran Ji, Wenxing Su and Qiliang XuAvailable online: 30 September 2025More LessIntroductionTo identify the critical genes, biological mechanisms, and signaling pathways involved in the therapeutic effects of quercetin on diabetic foot ulcers using network pharmacology and molecular docking approaches.
MethodsWe identified pathological targets of diabetic foot ulcers (DFU) from GeneCards, OMIM, and TTD, and pharmacological targets of quercetin from STP, TCMSP, and PharmMapper. Intersection analysis revealed potential therapeutic targets. Core targets were determined via GO/KEGG enrichment, PPI network construction, and Cytoscape screening algorithms (Degree, Closeness, Betweenness). Molecular docking and dynamics simulations assessed quercetin-core target interactions and binding affinity.
ResultsAfter screening and intersecting the targets of quercetin and diabetic foot ulcers, 236 genes related to quercetin's anti-diabetic foot ulcer effects were identified, with six key genes emerging as critical: SRC, TP53, MAPK1, JUN, HSP90AA1, and AKT1. Enrichment analysis suggested that quercetin may modulate inflammatory imbalance(HSP90AA1), immunosuppression(JUN), and oxidative stress(SRC, TP53, MAPK1, and AKT1) during diabetic foot ulcer progression.
DiscussionThe relationship between these core targets and biological pathways in diabetic foot ulcers requires further experimental validation. Notably, molecular docking and dynamics simulation results confirmed strong binding affinity between quercetin and the core targets, supporting their potential therapeutic relevance.
ConclusionQuercetin exerts anti-diabetic foot ulcer effects by regulating SRC, TP53, MAPK1, JUN, HSP90AA1, and AKT1. These hub genes may serve as promising candidates for future therapeutic interventions in diabetic foot ulcers.
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Matricellular Proteins (MCPs) in Rheumatoid Arthritis
Authors: Asiya Kurmanova and Dieter RiethmacherAvailable online: 29 September 2025More LessRheumatoid arthritis is a chronic autoimmune disorder affecting approximately 230 per 100,000 people worldwide. It typically affects joints and bones but may involve other tissues and internal organs as well. Rheumatoid arthritis is twice as common in females compared to males and causes a significant psychological burden on patients and an economic burden on society. During the development of the disease, multiple cellular processes are involved, including the activation of JAK-STAT, MAPK, PI3K-AKT, and Wnt signaling pathways, the subsequent production of cytokines, interleukins, and matrix metalloproteinases, and the stimulation of immune cells, osteoclasts, and fibroblast-like synoviocytes. Matricellular proteins typically support the stability of the extracellular matrix and oversee cellular interactions within it. They are also thought to be involved in several pathological processes, including cancer, diabetes, immune cell recruitment, and cardiovascular diseases. Recent research evidence suggests that matricellular proteins can play both pro- and anti-inflammatory roles in rheumatoid arthritis and may also affect other processes relevant to disease propagation. In conclusion, this review highlights published research that sheds light on the roles matricellular proteins may play in rheumatoid arthritis, as well as their potential as diagnostic and therapeutic targets for the disease.
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CD47-SIRPα: A Pivotal Signaling Pathway for Targeting Immunotherapy in Non-Small Cell Lung Cancer
Authors: Luying Zhang, Xueqin Wu, Mingyue Zhu, Yuli Zhou, Kun Liu, Bo Lin and Mengsen LiAvailable online: 29 September 2025More LessNon-Small Cell Lung Cancer (NSCLC) remains a major oncologic challenge with high mortality. The CD47-SIRPα pathway is critical for tumor immune escape by mediating “don't eat me” signaling. Despite progress, the specific mechanism of action of this pathway in NSCLC remains unclear, and the specific role of the CD47-signal in regulating immune escape needs to be further explored. This paper comprehensively analyzes the latest research progress on the CD47-SIRPα signaling pathway in NSCLC, as well as the challenges of CD47-SIRPα as a potential therapeutic target.
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Mechanistic Insights into the Ferroptosis-Regulating Effects of EF in the Treatment of Chronic Renal Failure
Authors: Qian Zhang, Xinran Xv, Wanchuan Zhang, Xiang Yang, Jincai Li and Tiejun LiAvailable online: 29 September 2025More LessIntroductionChronic Renal Failure (CRF) is a progressive disease that severely affects patients' quality of life, but its current treatment options remain limited. This study explores the potential mechanism of Eriobotryae Folium (EF) in treating CRF by targeting ferroptosis.
MethodsActive compounds and targets of EF were identified through multiple databases (TCMSP, SwissTargetPrediction, UniProt, GeneCards, DrugBank). Using Cytoscape and STRING, both a compound-target network and a PPI network were generated. GO and KEGG analyses were conducted to explore relevant biological functions and pathways. The binding affinity and stability between critical compounds and target proteins were investigated through molecular docking and Molecular Dynamics (MD) simulations.
ResultsEighteen active compounds and 366 targets of EF were identified, along with 1,267 CRF-related and 1,673 ferroptosis-related targets, with 40 overlapping genes. PPI analysis highlighted AKT1, EGFR, HIF1A, SRC, and ESR1 as key targets. The KEGG analysis indicated MAPK and HIF-1 pathways as major regulatory pathways. Molecular docking suggested quercetin, ellagic acid, and oleanolic acid as potential active compounds, with EGFR and SRC as promising targets. MD simulations confirmed strong and stable binding, especially for EGFR-ellagic acid (-21.38 kcal/mol) and EGFR-oleanolic acid (-24.02 kcal/mol).
DiscussionThis study suggests that EF treats CRF by targeting ferroptosis-related pathways and key proteins, such as EGFR and AKT1. MAPK and HIF-1 signaling pathways further substantiate its significant role in disease regulation.
ConclusionEF may regulate ferroptosis through multiple targets and pathways, offering potential therapeutic benefits for CRF. The findings offer foundational insights for subsequent research and therapeutic development.
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Comprehensive Pan-cancer analysis of Pyroglutamylated RFamide Peptide Receptor: Its Potential Biological Functions and Associations with Prognosis and Immunity
Authors: Quanxin Huang, Boyuan Qiu, Tiantian Lu, Mocan Qiu and Daizheng HuangAvailable online: 27 September 2025More LessIntroductionThe receptor for pyroglutamylated RF amide peptide (QRFPR) is a G protein-coupled receptor that plays a role in various physiological and pathological processes. However, a gap remains in our understanding of QRFPR's pan-cancer properties.
MethodsThis study performs an extensive pan-cancer analysis of QRFPR utilizing large-scale genomic datasets, including The Cancer Genome Atlas (TCGA). We evaluated QRFPR expression levels in multiple malignancies and examined their correlations with clinical outcomes. Additionally, we investigated associations between QRFPR expression and immune cell infiltration using bioinformatics tools.
ResultsOur results reveal significant alterations in QRFPR expression across several cancer types, particularly breast, colorectal, and prostate cancers. Elevated levels of QRFPR are linked to poor prognosis in certain malignancies, such as uterine corpus endometrial carcinoma (UCEC) and mesothelioma (MESO), and correlate with increased infiltration of immune cells, especially T cells and macrophages. Pathway enrichment analyses suggest that QRFPR may impact critical signaling pathways associated with cell growth, apoptosis, and immune regulation.
DiscussionThe observed variations in QRFPR expression across cancer types suggest its diverse roles in tumor biology. Its association with unfavorable clinical outcomes in specific cancers, as well as its link to immune cell infiltration, highlights its multifaceted impact on tumor progression and microenvironment modulation.
ConclusionOur findings underscore the potential of QRFPR as a prognostic biomarker and therapeutic target in cancer biology. Further investigations into its functional mechanisms could pave the way for precision medicine approaches in oncology.
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Exploring the Potential of Nuciferine in Diabetes Management via PTGS2 Pathway Targeting by Network Analysis and in-silico Modeling Approach
Authors: Sridevi Narayana Murthy and Thirumal MargesanAvailable online: 26 September 2025More LessIntroductionDiabetes mellitus, a chronic metabolic disorder characterized by elevated blood glucose levels, has emerged as a significant global health burden. Chronic inflammation and insulin resistance are central to the pathogenesis of non-insulin-dependent (type 2) diabetes mellitus. PTGS2 (prostaglandin-endoperoxide synthase 2) has been implicated in inflammatory pathways associated with diabetic complications, making it a potential therapeutic target.
MethodsAdvanced computational methodologies were employed to identify potential natural compounds with anti-diabetic activity. Techniques included network pharmacology to establish compound-target-pathway relationships and in silico molecular docking to evaluate binding affinity and interaction profiles of selected phytochemicals with PTGS2.
ResultsPTGS2 and its downstream prostaglandin pathways were strongly associated with diabetic inflammation and insulin resistance. Molecular docking identified Corytuberine and Nuciferine as having high binding affinities with PTGS2. Network pharmacology analysis confirmed Nuciferine’s connection to PTGS2, supporting its role as a bioactive agent targeting diabetes-related inflammatory processes.
DiscussionThe findings suggest that PTGS2 contributes to the progression of insulin resistance and chronic inflammation in type 2 diabetes. Targeting this enzyme with bioactive compounds such as Nuciferine may offer therapeutic benefits. However, translational studies and clinical trials are essential to validate these computational predictions and assess safety and efficacy in vivo.
ConclusionNuciferine exhibits promising potential in modulating PTGS2 activity and improving insulin sensitivity. Continued research and clinical validation are needed to confirm its efficacy and support the development of novel anti-diabetic therapies targeting inflammatory pathways.
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The Emerging Role of N-Acetylcysteine in Psychiatry: A Narrative Review of Available Data
Available online: 23 September 2025More LessN-acetylcysteine (NAC), a cysteine derivative with a reactive thiol group, possesses antioxidant and anti-inflammatory properties. Its redox activity plays a central role in scavenging reactive oxygen and nitrogen species and modulating cellular signaling pathways. Recent research highlights its potential role in psychiatric disorders through the modulation of oxidative stress and inflammatory pathways. This narrative review examines the efficacy of NAC in treating psychiatric conditions, including mood disorders, schizophrenia, anxiety disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), substance use disorders (SUDs), and neurodevelopmental disorders. A comprehensive search of PubMed, Scopus, Embase, PsycINFO, and Google Scholar databases was conducted for studies published between March 1, 2007, and December 30, 2024. The search utilized keywords related to NAC and psychiatric disorders. Data were critically analyzed to evaluate NAC’s therapeutic potential. Preclinical studies demonstrate NAC’s benefits in reducing oxidative stress, inflammation, and modulating neurotransmitter systems. Animal models of depression, schizophrenia, and OCD show symptom reduction through glutamatergic and antioxidant mechanisms. Clinical trials reveal NAC’s efficacy as an adjunct in treating major depressive disorder, bipolar disorder, and schizophrenia, particularly for negative and cognitive symptoms. Evidence for anxiety disorders, PTSD, and OCD is limited but suggests anxiolytic and anti-obsessive effects. In SUDs, NAC shows promise in reducing cravings and substance-seeking behavior, while preliminary findings in autism suggest improvements in irritability and hyperactivity. NAC exhibits potential as an adjunctive treatment for various psychiatric disorders due to its safety profile, low cost, and broad mechanisms of action. However, clinical results are mixed, highlighting the need for larger, well-designed trials to confirm its efficacy and define optimal dosing strategies.
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Cancer Stem Cell-targeted Antibody-drug Conjugates for Cancer Immunotherapy
Available online: 11 September 2025More LessCancer stem cells (CSCs) participate in cancer initiation, metastasis, and therapy tolerance, presenting a formidable challenge in cancer treatment. Antibody-drug conjugates (ADCs) have been established as a potential strategy for selectively targeting and eradicating CSCs, thereby overcoming resistance mechanisms and preventing tumor recurrence. ADCs integrate a monoclonal antibody specific to CSC surface markers, such as CD44, CD133, EpCAM, and ALDH1, with a potent cytotoxic payload linked by a stable chemical linker. Upon antigen binding, ADCs undergo receptor-mediated internalization, leading to intracellular payload release and CSC apoptosis. Recent advances in ADC technology have enhanced selectivity and efficacy while minimizing off-target toxicity. Preclinical studies demonstrate that CSC-targeted ADCs, including CD133- and CD44-directed therapies, effectively deplete CSC populations in glioblastoma, breast, colorectal, and lung cancers. EpCAM-targeted ADCs have also shown efficacy in epithelial tumors with potential synergy in combination immunotherapies. Moreover, emerging approaches, such as bispecific antibodies and optimized linker chemistry, further refine CSC-targeted ADCs for clinical applications. Despite these advancements, challenges remain, including CSC heterogeneity, immune evasion, and limitations in biomarker specificity. Addressing these hurdles requires continued innovation in ADC engineering, novel payloads, and combinatory strategies with immune checkpoint inhibitors or CAR-T cell therapies. While clinical evaluations are still in the early phases, preliminary trials underscore the potential of CSC-targeted ADCs in revolutionizing precision oncology. This review explores the mechanisms, recent developments, and prospects of CSC-targeted ADCs, highlighting their transformative potential in cancer immunotherapy.
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The Impact of IGFBP6 Knockdown on Cholesterol Metabolism in Breast Cancer Cells
Available online: 11 September 2025More LessIntroductionCholesterol plays a key role in maintaining tumor cell homeostasis. Reduced IGFBP6 expression is associated with an increased risk of breast cancer recurrence. Previous studies showed that IGFBP6 knockdown decreases cholesterol levels in the MDA-MB-231 cell line. This study aimed to investigate how IGFBP6 influences genes involved in cholesterol metabolism.
MethodsWe used MDA-MB-231 breast cancer cells with IGFBP6 knockdown. Transcriptomic and proteomic analyses were performed, with selected gene expression validated by RT-PCR. Correlations between IGFBP6 and cholesterol-related genes were evaluated using public RNA-seq datasets.
ResultsIGFBP6 knockdown in MDA-MB-231 cells resulted in a threefold decrease in low-density lipoprotein receptor (LDLR) expression and a twofold reduction in LDLR adaptor protein (LDLRAP1) mRNA levels, both responsible for exogenous cholesterol uptake. Meanwhile, PCSK9 expression increased 11-fold (p-adj = 1.4E-93), further limiting uptake. Despite the upregulation of genes involved in endogenous cholesterol synthesis (HMGCS1, HMGCR, FDFT1, SQLE, DHCR24), total cholesterol content in knockdown cells decreased, leading to activation of the sterol-dependent transcription factor SREBF1 (OR = 6.44; p-adj = 0.036). Correlation analysis revealed a significant association between IGFBP6 expression and cholesterol synthesis genes in basal-like breast cancer.
DiscussionThe altered expression profile of multiple cholesterol metabolism-related genes with known prognostic value aligns with a transcriptional program typical of poor-outcome basal-like tumors. These findings support the role of IGFBP6 as a regulator of lipid metabolism and a potential biomarker for therapeutic stratification.
ConclusionThe results of this study indicate that the reduction in cholesterol levels observed in breast cancer cells following IGFBP6 knockdown is primarily due to decreased exogenous uptake. These findings highlight the role of IGFBP6 in regulating cholesterol metabolism and further explain its clinical significance in predicting breast cancer recurrence and progression.
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Harnessing Vitamin C: Unveiling Its Potential in Cancer Prevention and Treatment
Authors: Antara Roy, Dilip K. Maiti and Bimal Krishna BanikAvailable online: 11 September 2025More LessThe strong antioxidant vitamin C has been researched for its potential use in the prevention and treatment of cancer. Scavenging free radicals and lowering oxidative stress, which is essential in carcinogenesis, helps to protect cells. Excessive levels of vitamin C can produce hydrogen peroxide and selectively kill cancer cells in the tumor microenvironment by exerting pro-oxidant effects. Normal cells might be spared, indicating a possible window for treatment. Additionally, vitamin C affects important cellular functions that contribute to the development of tumors, including angiogenesis, inflammation, immune response modulation, and epigenetic regulation. Sensitizing tumor cells or shielding healthy tissue from harm caused by treatment may increase the effectiveness of traditional cancer treatments. Recent clinical investigations have revisited the use of high-dose intravenous vitamin C in both monotherapy and combination regimens. While some trials report improvements in quality of life, reduced chemotherapy side effects, and extended survival in specific cancer types, robust evidence of a consistent anticancer effect remains lacking due to variability in study design, cancer type, dosing protocols, and patient populations. Nonetheless, these studies have renewed interest in understanding the pharmacodynamics and clinical utility of vitamin C in oncology. Vitamin C should be considered an investigational approach rather than a standard component of cancer therapy. This review provides a comprehensive overview of the biochemical properties of Vitamin C, its anticancer mechanisms, experimental evidence, clinical data, controversies, and future directions.
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[18F]FDG PET/CT versus Bone Scintigraphy for the Diagnosis of Bone Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis
Authors: Xinmin Wang, Yufei Xu and Jing JingAvailable online: 09 September 2025More LessIntroductionBreast cancer has become the most commonly diagnosed cancer in women worldwide, with advanced cases often leading to bone metastases that significantly affect prognosis and quality of life. This meta-analysis and systematic review aims to evaluate and compare the diagnostic performance of [18F]FDG PET/CT and bone scintigraphy for detecting bone metastases in breast cancer patients.
MethodsA systematic search was conducted across PubMed, Embase, Web of Science, and Scopus for studies published up to February 2025. Relevant articles were identified using a combination of subject-specific and free-text keywords, including “breast cancer,” “positron emission tomography,” “bone scintigraphy,” and “bone metastasis.” Studies assessing the diagnostic utility of [18F]FDG PET/CT and bone scintigraphy in detecting bone metastases were included. A bivariate random-effects model was used to calculate pooled estimates of sensitivity, specificity, and diagnostic accuracy with 95% confidence intervals (CIs). Potential sources of heterogeneity were explored using meta-regression analysis. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was applied to evaluate the methodological quality of the included studies.
ResultsA total of 1407 publications were initially retrieved, and 13 studies involving 892 patients met the inclusion criteria. The pooled diagnostic performance for [18F]FDG PET/CT demonstrated a sensitivity of 0.91 (95% CI: 0.81-0.96) and a specificity of 0.98 (95% CI: 0.93-1.00), with an area under the curve (AUC) of 0.99 (95% CI: 0.97-0.99). In comparison, bone scintigraphy showed a sensitivity of 0.82 (95% CI: 0.72-0.89), specificity of 0.81 (95% CI: 0.73-0.87), and an AUC of 0.88 (95% CI: 0.85-0.91). Despite its higher diagnostic accuracy, PET/CT exhibited notable heterogeneity across studies, potentially influenced by differences in patient populations and imaging interpretation criteria.
DiscussionOur meta-analysis demonstrated the superior diagnostic performance of [18F]FDG PET/CT over bone scintigraphy, likely attributable to its enhanced sensitivity for osteolytic lesions and integrated anatomical-functional imaging. Nevertheless, considerable inter-study heterogeneity and incomplete clinical data reporting limit the generalizability and robustness, warranting further standardized prospective investigations.
ConclusionThe findings suggest that [18F]FDG PET/CT offers superior diagnostic accuracy compared to bone scintigraphy for detecting bone metastases in breast cancer patients. However, its clinical application requires further validation through large-scale, prospective studies. Additionally, considerations such as cost-effectiveness and accessibility must be addressed before widespread clinical adoption.
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New Indazole Derivatives as Potential Scaffolds for the Development of Anticancer, Antiviral, and Anti-tuberculosis Chemotherapeutic Compounds
Available online: 05 September 2025More LessIntroductionChemotherapy remains essential despite advances in immunotherapy, radiotherapy, and biological therapy. However, the wide range of chemical drugs is limited by a narrow therapeutic index, low selectivity, and the development of resistance. In this regard, new high-efficiency drugs are in extremely high demand. The indazole moiety, a scaffold found in many biologically active compounds, was selected for use in new drug design.
MethodsSix new indazole derivatives were synthesized via Suzuki-Miyaura coupling starting from bromoindazole. Their antiviral (against influenza A and SARS-CoV-2), antibacterial (against M. tuberculosis), and antiproliferative activities (against neuroblastoma, glioma, leukemia cell lines) were evaluated in vitro. Acute toxicity was assessed in mice of both sexes via single intragastric administration, with toxicometric parameters and pathomorphological changes studied.
Results6-(1H-pyrazol-4-yl)-1H-indazole (8) suppressed the reproduction of the influenza virus at non-toxic doses to the MDCK cells and showed cytotoxicity against cancer cell lines, with an IC50 between 4 and 14 µM. However, it exhibited significant acute toxicity in mice (LD50 40 mg/kg), causing systemic organ damage.
DiscussionDerivative 8 demonstrated promising antiviral and antiproliferative activities but exhibited considerable acute toxicity in vivo. The antiviral efficacy, although lower than oseltamivir, is meaningful and justifies further optimization and investigation. Its antibacterial activity against M. tuberculosis adds to its potential as a multifunctional agent.
ConclusionWhile derivative 8 has shown potential as an antiviral and anticancer agent, its high toxicity highlights the need for further studies to define a safe and effective therapeutic window. Overall, the indazole scaffold remains a valuable platform for the development of new therapeutic compounds.
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