Medical principles and practice : international journal of the Kuwait University, Health Science Centre最新文献

{"title":"Comparative Evaluation of the Enamel Remineralization Potential and Antibacterial Activity of Pediatric Toothpastes Containing Fluoride, Hydroxyapatite, Ozone, Propolis, and Postbiotics: An in vitro Study.","authors":"Rabia Kadriye Özçiftci, Işıl S Sönmez","doi":"10.1159/mpp/adpag016","DOIUrl":"10.1159/mpp/adpag016","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the remineralization potential and antibacterial activity of 5 commercially available pediatric toothpastes with different active ingredients.</p><p><strong>Subject and methods: </strong>The evaluated toothpastes were Kids Ozon, Oral-B Pro-Kids, Dentiste Junior Postbiotics, Curasept Biosmalto, and Zubio. To assess remineralization efficacy, 48 specimens from extracted third molars were subjected to baseline microhardness testing. The samples were divided into six groups: five experimental and one negative control (n = 8). After 4 days in a demineralizing solution, microhardness was remeasured, followed by a 14-day pH-cycling protocol at 37°C with twice-daily toothpaste applications. Final microhardness values were recorded and statistically analyzed. For antibacterial assessment, the agar diffusion method was applied using Streptococcus mutans, Lactobacillus acidophilus, Enterococcus faecalis, and Candida albicans.</p><p><strong>Results: </strong>All the tested toothpastes produced statistically significant remineralization of initial enamel carious lesions (p < 0.05). The microhardness ranking after pH-cycling was as follows: Kids Ozon > Dentiste Junior Postbiotics > Curasept Biosmalto > Zubio > Oral-B Pro-Kids > negative control. However, intergroup differences weren't statistically significant (p > 0.05). All formulations showed antibacterial activity against the tested microorganisms. For S. mutans, Curasept Biosmalto had a significantly larger inhibition zone than Kids Ozon (p < 0.05). Although Curasept Biosmalto showed relatively higher antibacterial activity, differences among the other formulations were not significant (p > 0.05).</p><p><strong>Conclusion: </strong>Fluoridated and hydroxyapatite-based toothpastes exhibited comparable remineralization potential and antibacterial activity under in vitro conditions. The addition of other agents (ozone, propolis, and postbiotics) showed statistically nonsignificant improvements under the present experimental conditions.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleeve Gastrectomy Reverses Hepatic and Circulating Transcriptomic Dysregulation by Restoring Lipid and Energy Metabolism in Diet-Induced Metabolic Dysfunction-Associated Steatotic Liver Disease Rats.","authors":"Mohammad Jamal, Wayel Jasem, Mohamed Abu-Farha, Md Zubbair Malik, Salman Al-Sabah, Suleiman Al-Sabah, Carol Dsouza, Fatemah AlOtaibi, Hamad Ali, Yun Ma, Fahd Al-Mulla, Jehad Abubaker","doi":"10.1159/mpp/adpag015","DOIUrl":"10.1159/mpp/adpag015","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify key hepatic genes involved in metabolic dysfunction-associated steatotic liver disease (MASLD) pathogenesis and determine whether sleeve gastrectomy (SG) attenuates cafeteria diet-induced hepatic steatosis in a rat model.</p><p><strong>Subject and methods: </strong>Thirty-two male Sprague-Dawley rats were divided into four groups: control (lean), diet-induced obesity (DIO)-obese control, DIO-sham, and DIO-SG. Hepatic expression profiling of MASLD-associated genes was performed using RT2 Profiler polymerase chain reaction arrays. Circulating adipokines (leptin and adiponectin) and hepatic triglyceride (TG) content were also quantified.</p><p><strong>Results: </strong>SG significantly reversed obesity-induced upregulation of key lipogenic (Fasn, Srebf1, Dgat2), gluconeogenic (G6pc, Gck), and inflammatory (Nfkb1, Il1b) genes, while enhancing fatty acid oxidation and mitochondrial pathways (Cpt2, Ppargc1a, Acadl). Pathway analysis demonstrated significant modulation of peroxisome proliferator-activated receptor and adenosine monophosphate-activated protein kinase signaling, fatty acid oxidation, and insulin sensitivity networks. Circulating leptin and hepatic TG content were significantly reduced following SG, consistent with systemic metabolic improvement. The normalization of Srebf1 and Dgat2 highlights restoration of hepatic lipid homeostasis and improved insulin sensitivity.</p><p><strong>Conclusion: </strong>SG reduced hepatic fat accumulation and mitigated MASLD through broad transcriptional and metabolic reprogramming of lipid, oxidative, and inflammatory pathways. The identification of shared hepatic-whole-blood signatures together with improvements in circulating biomarkers underscores the systemic impact of SG and suggests potential translational targets for noninvasive monitoring and therapeutic intervention.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Association between Smoking and Tonsillolith Characteristics Using Cone-Beam Computed Tomography.","authors":"Ali Rasat, Sevcihan Günen Yılmaz","doi":"10.1159/mpp/adpag014","DOIUrl":"10.1159/mpp/adpag014","url":null,"abstract":"<p><strong>Objective: </strong>Tonsilloliths are calcified concretions within tonsillar crypts whose relationship with smoking remains poorly understood. This study investigated the association between smoking and tonsillolith characteristics using cone-beam computed tomography (CBCT).</p><p><strong>Subject and methods: </strong>This retrospective cross-sectional study evaluated 416 dental CBCT scans obtained between 2021 and 2023. Scans were evaluated for the presence, size, number, laterality, and anatomical localization of tonsilloliths by a single oral and maxillofacial radiologist, with a second radiologist consulted in cases of diagnostic uncertainty. Demographic characteristics and smoking status were obtained from medical records. Statistical analyses included the chi-square or Fisher's exact test, independent-samples t test or Mann-Whitney U test, and one-way ANOVA with Bonferroni post hoc correction (α = 0.05).</p><p><strong>Results: </strong>Tonsilloliths were detected in 29.6% of participants (123/416). Smoking was not significantly associated with tonsillolith prevalence, size, or number (p > 0.05). Among patients with tonsilloliths, smokers showed significantly higher frequencies of unilateral (p = 0.041) and lingual (p = 0.036) tonsilloliths than non-smokers. Age was significantly associated with both prevalence and size (p < 0.001 and p = 0.037, respectively), with higher prevalence in older groups. No significant sex differences were found.</p><p><strong>Conclusion: </strong>Smoking was not associated with the overall prevalence, size, or number of tonsilloliths, but unilateral and lingual tonsilloliths were more frequent among smokers. Age was the strongest factor associated with tonsillolith formation, exerting a greater influence than smoking. Further prospective, multicenter studies with detailed smoking exposure data are needed to validate these findings.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complication Profiles following Right-Sided Segmental Colectomy: A Comparative Retrospective Analysis of Crohn's Disease and Colon Cancer.","authors":"Jasim Alabbad, Noor Alfadhli, Nourah Almuhana, Fawaz Alnaqi","doi":"10.1159/mpp/adpag010","DOIUrl":"10.1159/mpp/adpag010","url":null,"abstract":"<p><strong>Objectives: </strong>Concerns regarding the higher incidence of postoperative complications in Crohn's disease patients may delay surgical resection. Calibrating postoperative risks specific to Crohn's disease, with the more common indication of colon cancer, is valuable for making informed surgical decisions. The primary objective of this study was to report a disease-specific postoperative complication profile. The secondary objective was to identify factors associated with significant complications (Clavien-Dindo classification grade ≥2).</p><p><strong>Subjects and methods: </strong>This retrospective study was conducted at a tertiary center from January 2010 to December 2025 on adult patients who underwent right-sided segmental colectomy for Crohn's disease or colon cancer. The data analyzed included demographics, comorbidities, laboratory findings, and perioperative clinical variables and 30-day postoperative complications.</p><p><strong>Results: </strong>A total of 230 patients met the inclusion criteria (86 with Crohn's disease and 144 with colon cancer). Patients with Crohn's disease were significantly younger and had fewer associated comorbidities. No differences were observed in the overall postoperative complications. However, among patients who developed complications, the rate of infectious complications was higher in patients with Crohn's disease compared to patients with colon cancer (72.4% vs. 46.4%, p = 0.022). Respiratory complications occurred only in patients with colon cancer. Chronic kidney disease and conversion to open surgery were found to be independently associated with significant complications on multivariate regression analysis.</p><p><strong>Conclusion: </strong>Overall postoperative complications rates were comparable between Crohn's disease and colon cancer patients undergoing right-sided segmental colectomy. However, a disease-specific complication profile was noted, with a higher rate of infectious complications in Crohn's disease.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Manifestations at Diagnosis of Anti-Neutrophil Cytoplasmic Anti-body-Associated Vasculitis: Clinical İmplications from a Retrospective Cohort.","authors":"Merve Sungur Özgünen, Emre Tekgöz, Seda Çolak, Özlem Kılıç, Yusuf Uysal, Muhammet Çınar, Sedat Yılmaz","doi":"10.1159/mpp/adpag011","DOIUrl":"10.1159/mpp/adpag011","url":null,"abstract":"<p><p><p>Objective: Ocular involvement is an important source of morbidity in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and may occasionally be the initial manifestation. This study evaluated the frequency, clinical characteristics, and systemic associations of ocular involvement in patients with AAV.</p><p><strong>Methods: </strong>In this retrospective cohort study, 105 patients with AAV followed at the Division of Rheumatology, University of Health Sciences Gülhane Training and Research Hospital between November 2016 and July 2024 were analyzed. Demographic, clinical, ANCA profile, vasculitis subtype, and organ involvement data were obtained from medical records. Patients were grouped according to ocular involvement at diagnosis, and clinical and laboratory characteristics were compared.</p><p><strong>Results: </strong>Ocular involvement was identified in 22 patients (21.0%). Twenty-one patients (95.5%) had granulomatosis with polyangiitis, and 18 (81.8%) were proteinase 3 anti-neutrophil cytoplasmic antibody-positive. Episcleritis (n = 12, 54.5%) and scleritis (n = 4, 18.2%) were the most common manifestations. Less frequent findings included anterior uveitis (n = 4, 18.2%), ischemic optic neuropathy (n = 1, 4.5%), and peripheral ulcerative keratitis associated with scleritis (n = 1, 4.5%). No significant differences were observed in demographic characteristics, disease activity, ANCA subtype distribution, or systemic organ involvement between groups.</p><p><strong>Conclusion: </strong>Ocular involvement is clinically relevant in AAV at diagnosis and may represent the initial presentation of systemic vasculitis. Episcleritis and scleritis were the most common findings, whereas vision-threatening complications were uncommon. Early recognition and ophthalmology-rheumatology collaboration may facilitate timely diagnosis and management.</p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effect of Dual-Combination Antihypertensive Regimens on Reducing 24-Hour Systolic Blood Pressure Variability and Modifying Nocturnal Dipping Shifts: A Retrospective Cohort Study.","authors":"Dan Shan, Xiuxiu Yin, Wenfang Niu, Jiawei Ren, Yu-E Xing, Hongyan Chen","doi":"10.1159/mpp/adpag009","DOIUrl":"10.1159/mpp/adpag009","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective cohort study evaluated the real-world clinical effects of four dual-combination antihypertensive regimens on 24-h ambulatory blood pressure variability (BPV) and circadian rhythm modifications over a 24-week period.</p><p><strong>Methods: </strong>A total of 302 adults with primary hypertension were evaluated across parallel cohorts: an angiotensin-converting enzyme inhibitor plus calcium channel blocker group (ACEi+CCB, n = 76), an angiotensin II receptor blocker plus thiazide diuretic group (ARB+Thiazide, n = 75), a β-blocker plus thiazide group (BB+Thiazide, n = 74), and a calcium channel blocker plus β-blocker group (CCB+BB, n = 77). A 24-h systolic blood pressure (SBP) standard deviation, coefficient of variation (CV), and night-to-day SBP ratios were analyzed to assess hemodynamic variations independent of absolute blood pressure lowering.</p><p><strong>Results: </strong>While all regimens significantly reduced mean office and 24-h ambulatory blood pressure, the ACEi+CCB combination demonstrated a significantly greater reduction in the 24-h systolic CV from baseline to week 24 (from 10.35% ± 1.25% to 7.45% ± 0.92%, a relative drop of -28.0%) compared to the ARB+Thiazide (-15.1%), CCB+BB (-14.4%), and BB+Thiazide (-4.8%) cohorts (p < 0.001 after adjusting for absolute BP reduction). Additionally, the ACEi+CCB group achieved a significant downward shift in the continuous night-to-day SBP ratio from 0.96 ± 0.04 to 0.91 ± 0.03 (p < 0.001), outperforming the ARB+Thiazide and BB+Thiazide arms. Treatment compliance (92%-95%) and overall adverse event rates (7.1%-9.7%) remained comparable across all groups.</p><p><strong>Conclusion: </strong>Dual therapies show class-dependent effects on BPV and circadian rhythm; ACEi+CCB most effectively reduces 24-h systolic fluctuations.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic Insights into the Analgesic Action of Acetaminophen: Its Bioactive Metabolite Induces Peripheral Analgesia in Addition to Central Analgesia.","authors":"Hironori Tsuchiya, Yoshiaki Takai, Maki Mizogami","doi":"10.1159/mpp/adpag006","DOIUrl":"10.1159/mpp/adpag006","url":null,"abstract":"<p><p>The molecular target and detailed mechanism of analgesic acetaminophen are still not fully understood despite being commonly used for many years. Through a literature search, the present study aimed to characterize the cyclooxygenase (COX) inhibitory properties of acetaminophen in comparison with nonsteroidal anti-inflammatory drugs (NSAIDs) and to gain novel mechanistic insights into its analgesic action, especially focusing on the peripheral mechanisms. Comparative characterization indicated that acetaminophen is relatively selective for COX-2 but less potent to inhibit COX than NSAIDs. This narrative review suggests that acetaminophen is very likely to be a prodrug, which is metabolically converted into bioactive N-arachidonoylphenolamine, AM404, by fatty acid amide hydrolase-mediated conjugation of acetaminophen metabolite 4-aminophenol with arachidonic acid not only in the central nervous system but also in the peripheral nervous system. It is considered that AM404 activates transient receptor potential vanilloid 1 and cannabinoid type 1 receptor distributed in the brain and spinal cord to induce analgesia centrally. In addition, it is speculated that AM404 produced in trigeminal ganglion neurons, dorsal root ganglion neurons, and primary sensory neurons inhibits nociceptive voltage-gated sodium channels through the local anesthetic binding site to suppress pain signaling and inhibits COX-2 to prevent the biosynthesis of prostaglandins responsible for nociception, thereby inducing peripheral analgesia. We propose the mechanistic hypothesis for the analgesic effects of acetaminophen to integrate central and peripheral action of its bioactive entity AM404, which should provide the pharmacological rationale for the use of acetaminophen to relieve postoperative and inflammatory pain and its application to multimodal analgesia.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal Vascular Malperfusion: A Comprehensive 10-Year Retrospective Single-Center Cohort Analysis.","authors":"Salah Alwaheeb","doi":"10.1159/mpp/adpag004","DOIUrl":"10.1159/mpp/adpag004","url":null,"abstract":"<p><strong>Background: </strong>Fetal vascular malperfusion (FVM) represents a significant cause of adverse perinatal outcomes, yet population-specific patterns remain understudied in Middle Eastern populations. This study characterizes FVM patterns and clinical correlates in Kuwait over a 10-year period.</p><p><strong>Methods: </strong>Retrospective analysis of 180 histologically confirmed FVM cases from the Maternity Hospital, Kuwait (2014-2024). Cases were classified by FVM grade, associated pathology, and clinical parameters.</p><p><strong>Results: </strong>High-grade FVM predominated (80.0%, 144/180). Distinct trimester-specific patterns emerged: the second trimester showed the highest inflammatory pathology (18.6%), while maternal vascular malperfusion occurred exclusively in third trimester pregnancies (10.7%). Maternal age analysis revealed an unexpected peak risk in the 30-34 years group (88.3% high-grade FVM). Twin pregnancies demonstrated significantly higher pathological burden (88.9% vs. 79.5% in singletons, p = 0.041).</p><p><strong>Conclusions: </strong>This study reveals distinct FVM patterns in Middle Eastern populations, including unique age-related risks and trimester-specific pathological profiles. These findings support population-specific approaches to FVM assessment and management.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlations of Free Beta-Human Chorionic Gonadotropin/Pregnancy-Associated Plasma Protein A Ratio, Pregnancy Characteristics, and Placental Pathology in Fetal Growth Restriction.","authors":"István Dankó, András Tankó, Edit Kelemen, Béla Temesváry, Gábor Cserni","doi":"10.1159/mpp/adpag002","DOIUrl":"10.1159/mpp/adpag002","url":null,"abstract":"<p><p><p>Objective: We evaluated the clinicopathological correlations of maternal serum free beta-human chorionic gonadotropin (FBHCG)/pregnancy-associated plasma protein A (PAPP-A) multiple of the median ratio measured between 11 + 0 and 13 + 6 weeks of gestation, pregnancy characteristics, and placental histopathology in pregnancies affected by fetal growth restriction (FGR).</p><p><strong>Subjects and methods: </strong>We investigated 69 pregnancies complicated with FGR. Different indicators of FGR, placental villous capillarization, placental weight to birth weight ratio, and placental histopathological entities were correlated with FBHCG/PAPP-A ratio.</p><p><strong>Results: </strong>Complication of FGR with preeclampsia (p < 0.001) and birth weight below the 2nd percentile (p < 0.001) were significantly more common when the FBHCG/PAPP-A ratio was higher. Placental weight to birth weight ratio was significantly lower (<1:8) in cases of higher FBHCG/PAPP-A ratio. Distal villous hypoplasia (DVH), avascular villi (AV), and chorangiosis were more prevalent in cases with a higher FBHCG/PAPP-A ratio; however, villous capillarization, onset of FGR, oligohydramnios, and preterm birth did not have an association with it.</p><p><strong>Conclusion: </strong>In FGR, a higher FBHCG/PAPP-A ratio could be an early indicator of placental villous underdevelopment, which is further supported by the fact that higher prevalence of DVH and AV was described in cases with a higher FBHCG/PAPP-A ratio. We conclude that this ratio could be an early marker of potential placental dysfunction (and consecutive FGR later in pregnancy), rendering it a helpful marker as early as the end of the first trimester for identifying pregnancies that warrant close monitoring throughout gestation.</p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aquaporin 5 and Nuclear Factor Erythroid 2-Related Factor 2 Upregulation in Tumor and Stroma Is Associated with Poor Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer.","authors":"Ilija Guteša, Sanda Bubanović, Tonči Vodopić, Monika Mlinarić, Krešimir Grgat, Ana Čipak Gašparović","doi":"10.1159/mpp/adpag003","DOIUrl":"10.1159/mpp/adpag003","url":null,"abstract":"<p><p><p>Objective: Breast cancer remains a leading cause of global mortality in women, with therapy resistance posing a major challenge to successful treatment. Chemotherapy-induced oxidative stress can trigger adaptive survival mechanisms through the antioxidative transcription factor NRF2 and membrane pores known as peroxiporins. Peroxiporins regulate cellular redox homeostasis by controlling the flux of H₂O₂, potentially driving the development of chemoresistance in aggressive subtypes. This study investigated the expression of peroxiporins, AQP3 and AQP5, and the antioxidative transcription factor NRF2, before and after chemotherapy to determine their role in chemotherapy resistance in HER2-positive and triple-negative breast cancer.</p><p><strong>Subjects and methods: </strong>In this retrospective study, we analyzed the expressions of AQP3, AQP5, and NRF2 by immunohistochemical staining in paired clinical biopsy samples of HER2-positive (N = 75) and triple-negative (N = 56) breast cancer patients. We evaluated target protein expression across both tumor and surrounding stroma within these tissue samples.</p><p><strong>Results: </strong>Chemotherapy significantly increased AQP5 and NRF2 expression in both tumor cells and stroma across both subtypes. However, when stratified by therapy response, significant upregulation of AQP5 and nuclear NRF2 was observed only in the pathological incomplete response group. In contrast, patients achieving a complete response showed no significant changes in protein expression post-therapy.</p><p><strong>Conclusion: </strong>Chemotherapy is associated with increased AQP5 expression and NRF2 nuclear translocation within both tumor cells and stroma. These post-therapy molecular changes are significantly associated with a lack of pathological complete response, suggesting that AQP5 and NRF2 may be involved in resistance to chemotherapy in HER2-positive and TNBC.</p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}