The EPMA journal最新文献

{"title":"3PM-guided innovation in treatments of severe alcohol-associated hepatitis utilizing fecal microbiota transplantation.","authors":"Lubomir Skladany, Natalia Kubanek, Svetlana Adamcova Selcanova, Daniela Zilincanova, Daniel Havaj, Karolina Sulejova, Katarina Soltys, Lucia Messingerova, Michal Lichvar, Lukas Laffers, Michal Zilincan, Eva Honsova, Peter Liptak, Peter Banovcin, Jan Bures, Tomas Koller, Olga Golubnitschaja, Juan-Pablo Arab","doi":"10.1007/s13167-024-00381-5","DOIUrl":"10.1007/s13167-024-00381-5","url":null,"abstract":"<p><strong>Rationale: </strong>Severe alcohol-associated hepatitis (SAH) is the most critical, acute, inflammatory phenotype within the alcohol-associated liver disease (ALD) spectrum, characterized by high 30- and 90-day mortality. Since several decades, corticosteroids (CS) are the only approved pharmacotherapy offering highly limited survival benefits. Contextually, there is an evident demand for 3PM innovation in the area meeting patients' needs and improving individual outcomes. Fecal microbiota transplantation (FMT) has emerged as one of the new potential therapeutic options. In this study, we aimed to address the crucial 3PM domains in order to assess (i) the impact of FMT on mortality in SAH patients beyond CS, (ii) to identify factors associated with the outcome to be improved (iii) the prediction of futility, (iv) prevention of suboptimal individual outcomes linked to increased mortality, and (v) personalized allocation of therapy.</p><p><strong>Methods: </strong>We conducted a prospective study (NCT04758806) in adult patients with SAH who were non-responders (NR) to or non-eligible (NE) for CS between January 2018 and August 2022. The intervention consisted of five 100 ml of FMT, prepared from 30 g stool from an unrelated healthy donor and frozen at - 80 °C, administered daily to the upper gastrointestinal (GI) tract. We evaluated the impact of FMT on 30- and 90-day mortality which we compared to the control group selected by the propensity score matching and treated by the standard of care; the control group was derived from the RH7 registry of patients hospitalized at the liver unit (NCT04767945). We have also scrutinized the FMT outcome against established and potential prognostic factors for SAH - such as the model for end-stage liver disease (MELD), Maddrey Discriminant Function (MDF), acute-on-chronic liver failure (ACLF), Liver Frailty Index (LFI), hepatic venous-portal pressure gradient (HVPG) and Alcoholic Hepatitis Histologic Score (AHHS) - to see if the 3PM method assigns them a new dimension in predicting response to therapy, prevention of suboptimal individual outcomes, and personalized patient management.</p><p><strong>Results: </strong>We enrolled 44 patients with SAH (NR or NE) on an intention-to-treat basis; we analyzed 33 patients per protocol for associated factors (after an additional 11 being excluded for receiving less than 5 doses of FMT), and 31 patients by propensity score matching for corresponding individual outcomes, respectively. The mean age was 49.6 years, 11 patients (33.3%) were females. The median MELD score was 29, and ACLF of any degree had 27 patients (81.8%). FMT improved 30-day mortality (<i>p</i> = 0.0204) and non-significantly improved 90-day mortality (<i>p</i> = 0.4386). Univariate analysis identified MELD ≥ 30, MDF ≥ 90, and ACLF grade > 1 as significant predictors of 30-day mortality, (<i>p</i> = 0.031; <i>p</i> = 0.014; <i>p</i> = 0.034). Survival was not associated with baseline LFI, HVPG,","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":"15 4","pages":"677-692"},"PeriodicalIF":6.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782134","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":"Changes in the triglyceride-glucose-body mass index estimate the risk of hypertension among the middle-aged and older population: a prospective nationwide cohort study in China in the framework of predictive, preventive, and personalized medicine.","authors":"Mingzhu Zhang, Qihua Guan, Zheng Guo, Chaoqun Guan, Xiangqian Jin, Hualei Dong, Shaocan Tang, Haifeng Hou","doi":"10.1007/s13167-024-00380-6","DOIUrl":"10.1007/s13167-024-00380-6","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major modifiable cause of cardiovascular diseases and premature death worldwide. The triglyceride-glucose-body mass index (TyG-BMI), as a novel indicator, has been proposed for assessing hypertension risk. Nevertheless, a paucity of studies has explored the predictive potential of dynamic TyG-BMI for hypertension. The purpose of this study was to investigate whether cumulative TyG-BMI could better predict hypertension incidence and explore the interplay between TyG and BMI in hypertension development. From the perspective of predictive, preventive, and personalized medicine (PPPM/3PM), we assumed that dynamic monitoring of TyG-BMI level and joint assessment of TyG and BMI provide novel insights for individual risk assessment, targeted prevention, and personalized intervention of cardiovascular diseases.</p><p><strong>Methods: </strong>Using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide cohort conducted between 2011 and 2018, the changes in TyG-BMI between 2012 and 2015 were categorized into four groups by <i>K</i>-means clustering analysis. Cumulative TyG-BMI was also divided into four levels based on quartile cutoffs. Logistic regression and restricted cubic spline analyses were performed to examine the associations of different TyG-BMI classes with hypertension. Mediating and interactive analyses were utilized to discern the mutual effects between TyG and BMI in hypertension development.</p><p><strong>Results: </strong>A total of 2891 participants were enrolled, among whom 386 (13.4%) developed hypertension during a median 36.5-month follow-up period. Logistic regression analysis revealed that, compared to participants with persistently low TyG‑BMI, an increased risk of hypertension was observed among those with a moderate (odds ratio (OR) = 1.60, 95% confidence interval (CI) 1.15 to 2.22), a higher (OR = 1.93, 95% CI 1.28 to 2.89), and the highest TyG‑BMI (OR = 2.33, 95% CI 1.35 to 4.03). A positive linear association of cumulative TyG-BMI with hypertension was discovered (<i>P</i> for non-linear = 0.343). Furthermore, TyG partially mediated the relationship between BMI and hypertension, accounting for 13.18% of the total effect. The joint effect of BMI and TyG was positively affiliated to hypertension development.</p><p><strong>Conclusions: </strong>This study demonstrated a significant positive association between dynamic TyG-BMI and hypertension among the Chinese middle-aged and older population. In the context of PPPM/3PM, long-term monitoring of TyG-BMI could assist in identifying individuals at high risk of hypertension, strengthening primary prevention efforts and facilitating prompt intervention strategies. In addition, this study revealed the mutual effect of TyG and BMI on hypertension development, which provides a novel approach for mitigating the risk of cardiovascular diseases via addressing metabolic disorders, thereby enhancing effective prev","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":"15 4","pages":"611-627"},"PeriodicalIF":6.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782141","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":"The predictive, preventive, and personalized medicine of depression: gut microbiota and inflammation.","authors":"Jialin Wu, Guosen Ou, Shiqi Wang, Yaokang Chen, Lu Xu, Li Deng, Huachong Xu, Xiaoyin Chen","doi":"10.1007/s13167-024-00379-z","DOIUrl":"10.1007/s13167-024-00379-z","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiota (GM) is closely associated with the onset of depression, in which inflammation plays an essential role. Identifying specific GM associated with depression and their mechanisms, based on the principles of predictive, preventive, and personalized medicine (PPPM), is a critical step toward achieving targeted prevention and personalized treatment for depression.</p><p><strong>Working hypothesis and methodology: </strong>We hypothesized that both gut microbiota (GM) and cytokines influence the onset of depression, with cytokines acting as mediators of GM effects on depression. To test this hypothesis, we employed univariate Mendelian Randomization (UVMR) analysis to identify GM taxa associated with depression and cytokines and to determine the potential role of the identified GM taxa on these cytokines. Subsequently, multivariate Mendelian randomization (MVMR) was used to infer the mediating role of cytokines between the identified differential genus of GM and depression. Our results indicate that immune imbalance due to intestinal dysbiosis serves as an early risk indicator for the onset of depression. This provides a basis for utilizing non-invasive stool detection of GM for early screening, timely prevention, and personalized treatment of depression. By combining non-invasive stool detection of GM with existing methods, such as psychological questionnaires, we can jointly predict and assess the risk of developing depression. Additionally, formulating personalized treatment protocols that combine probiotics and medication can help transition depression management from reactive medicine to predictive, preventive, and personalized medicine (PPPM).</p><p><strong>Results: </strong>UVMR identified 15 GM taxa and 4 cytokines associated with the onset of depression. Specifically, <i>Romboutsia</i>, <i>Intestinimonas</i>, <i>Ruminococcaceae UCG011</i>, and circulating ADA, IL-18R1 were all inferred to be protective factors against the onset of depression. Conversely, <i>Lachnospiraceae FCS020 group</i>, <i>Streptococcus</i>, <i>Marvinbryantia</i>, VEGF_A, and TNFSF14 were inferred as risk factors for the onset of depression. Further, MVMR validated the mediating role of some cytokines in the effects of GM on depression.</p><p><strong>Conclusions: </strong>Our study highlights the influence of alterations in GM on depression, revealing a mediating role of inflammation. By regulating these specific GM, it is hoped that the clinical treatment of depression can be transformed from traditional medicine to PPPM. With the help of mendelian randomization (MR) method, this study provides support for the wide application of non-invasive stool detection of GM for early screening of depression in clinical and carries out precise treatment based on the screening results, targeting the supplementation of specific bacteria, correcting the immune imbalance to prevent depression, and mitigating or blocking the disease process o","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":"15 4","pages":"587-598"},"PeriodicalIF":6.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782261","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":"Body fluid multiomics in 3PM-guided ischemic stroke management: health risk assessment, targeted protection against health-to-disease transition, and cost-effective personalized approach are envisaged.","authors":"Ruofei Chen, Xiaoyan Wang, Na Li, Olga Golubnitschaja, Xianquan Zhan","doi":"10.1007/s13167-024-00376-2","DOIUrl":"10.1007/s13167-024-00376-2","url":null,"abstract":"<p><p>Because of its rapid progression and frequently poor prognosis, stroke is the third major cause of death in Europe and the first one in China. Many independent studies demonstrated sufficient space for prevention interventions in the primary care of ischemic stroke defined as the most cost-effective protection of vulnerable subpopulations against health-to-disease transition. Although several studies identified molecular patterns specific for IS in body fluids, none of these approaches has yet been incorporated into IS treatment guidelines. The advantages and disadvantages of individual body fluids are thoroughly analyzed throughout the paper. For example, multiomics based on a minimally invasive approach utilizing blood and its components is recommended for real-time monitoring, due to the particularly high level of dynamics of the blood as a body system. On the other hand, tear fluid as a more stable system is recommended for a non-invasive and patient-friendly holistic approach appropriate for health risk assessment and innovative screening programs in cost-effective IS management. This article details aspects essential to promote the practical implementation of highlighted achievements in 3PM-guided IS management.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13167-024-00376-2.</p>","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":"15 3","pages":"415-452"},"PeriodicalIF":6.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142281","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":"Hair cortisol level might be indicative for a 3PM approach towards suicide risk assessment in depression: comparative analysis of mentally stable and depressed individuals versus individuals after completing suicide.","authors":"Alexander Karabatsiakis,&nbsp;Karin de Punder,&nbsp;Juan Salinas-Manrique,&nbsp;Melanie Todt,&nbsp;Detlef E Dietrich","doi":"10.1007/s13167-022-00296-z","DOIUrl":"https://doi.org/10.1007/s13167-022-00296-z","url":null,"abstract":"<p><p>Depression and suicidal behavior are interrelated, stress-associated mental health conditions, each lacking biological verifiability. Concepts of predictive, preventive, and personalized medicine (3PM) are almost completely missing for both conditions but are of utmost importance. Prior research reported altered levels of the stress hormone cortisol in the scalp hair of depressed individuals, however, data on hair cortisol levels (HCL) for suicide completers (SC) are missing. Here, we aimed to identify differences in HCL between subject with depression (<i>n</i> = 20), SC (<i>n</i> = 45) and mentally stable control subjects (<i>n</i> = 12) to establish the usage of HCL as a new target for 3PM. HCL was measured in extracts of pulverized hair (1-cm and 3-cm hair segments) using ELISA. In 3-cm hair segments, an average increase in HCL for depressed patients (1.66 times higher; <i>p</i> = .011) and SC (5.46 times higher; <i>p</i> = 1.65 × 10^-5) compared to that for controls was observed. Furthermore, the average HCL in SC was significantly increased compared to that in the depressed group (3.28 times higher; <i>p</i> = 1.4 × 10^-5). A significant correlation between HCL in the 1-cm and the 3-cm hair segments, as well as a significant association between the severity of depressive symptoms and HCL (3-cm segment) was found. To conclude, findings of increased HCL in subjects with depression compared to that in controls were replicated and an additional increase in HCL was seen in SC in comparison to patients with depression. The usage of HCL for creating effective patient stratification and predictive approach followed by the targeted prevention and personalization of medical services needs to be validated in follow-up studies.</p>","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":" ","pages":"383-395"},"PeriodicalIF":6.5,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9425778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40349845","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":"Pre-pregnancy check-up of maternal vascular status and associated phenotype is crucial for the health of mother and offspring.","authors":"Maria Evsevieva,&nbsp;Oksana Sergeeva,&nbsp;Alena Mazurakova,&nbsp;Lenka Koklesova,&nbsp;Irina Prokhorenko-Kolomoytseva,&nbsp;Evgenij Shchetinin,&nbsp;Colin Birkenbihl,&nbsp;Vincenzo Costigliola,&nbsp;Peter Kubatka,&nbsp;Olga Golubnitschaja","doi":"10.1007/s13167-022-00294-1","DOIUrl":"https://doi.org/10.1007/s13167-022-00294-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;Cardiovascular disease remains the leading cause of disease burden globally with far-reaching consequences including enormous socio-economic burden to healthcare and society at large. Cardiovascular health is decisive for reproductive function, healthy pregnancy and postpartum. During pregnancy, maternal cardiovascular system is exposed to highly increased haemodynamic stress that significantly impacts health status of the mother and offspring. Resulting from sub-optimal maternal health conditions overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and postpartum. Contextually, there are two main concepts to follow in the framework of predictive, preventive and personalised medicine, namely to develop:1. advanced screening of sub-optimal health conditions in young populations to predict and prevent individual health risks prior to planned pregnancies2. in-depth companion diagnostics during pregnancy to predict and prevent long-lasting postpartum health risks of the mother and offspring.Data collected in the current study demonstrate group-specific complications to health of the mother and offspring and clinical relevance of the related phenotyping in pre-pregnant mothers. Diagnostic approach proposed in this study revealed its great clinical utility demonstrating important synergies between cardiovascular maladaptation and connective tissue dysfunction. Co-diagnosed pre-pregnancy low BMI of the mother, connective tissue dysfunction, increased stiffness of peripheral vessels and decreased blood pressure are considered a highly specific maternal phenotype useful for innovative screening programmes in young populations to predict and prevent severe risks to health of the mother and offspring. This crucial discovery brings together systemic effects characteristic, for example, for individuals with Flammer syndrome predisposed to the phenotype-specific primary vascular dysregulation, pregnancy-associated risks, normal tension glaucoma, ischemic stroke at young age, impaired wound healing and associated disorders. Proposed maternal phenotyping is crucial to predict and effectively protect both the mother and offspring against health-to-disease transition. Pre-pregnancy check-up focused on sub-optimal health and utilising here described phenotypes is pivotal for advanced health policy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain english abstract: &lt;/strong&gt;Cardiovascular health is decisive for reproductive function and healthy pregnancy. During pregnancy, maternal cardiovascular system may demonstrate health-to-disease transition relevant for the affected mother and offspring. Overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and lifelong. Here we co-diagnosed maternal pre-pregnancy low bodyweight with systemic effects which may increase risks of pregnancy, eye and heart disorders and ischemic stroke at young age, amongst others. Innovative screening  programmes foc","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":" ","pages":"351-366"},"PeriodicalIF":6.5,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40349847","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":"Sleep apnea predicts cardiovascular death in patients with Marfan syndrome: a cohort study.","authors":"Nele Gessler,&nbsp;Peter Wohlmuth,&nbsp;Omar Anwar,&nbsp;Eike Sebastian Debus,&nbsp;Christian Eickholt,&nbsp;Melanie A Gunawardene,&nbsp;Samer Hakmi,&nbsp;Kathrin Heitmann,&nbsp;Meike Rybczynski,&nbsp;Helke Schueler,&nbsp;Sara Sheikhzadeh,&nbsp;Eike Tigges,&nbsp;Gunther H Wiest,&nbsp;Stephan Willems,&nbsp;Ekaterina Adam,&nbsp;Yskert von Kodolitsch","doi":"10.1007/s13167-022-00291-4","DOIUrl":"https://doi.org/10.1007/s13167-022-00291-4","url":null,"abstract":"<p><strong>Background: </strong>Surgical replacement of the aortic root is the only intervention that can prevent aortic dissection and cardiovascular death in Marfan syndrome (MFS). However, in some individuals, MFS also causes sleep apnea. If sleep apnea predicts cardiovascular death, a new target for predictive, preventive, and personalized medicine (PPPM) may emerge for those individuals with MFS who have sleep apnea.</p><p><strong>Methods: </strong>This is an investigator-initiated study with long-term follow-up data of 105 individuals with MFS. All individuals were screened for sleep apnea regardless of symptoms. Cardiovascular death served as a primary endpoint, and aortic events as a secondary outcome.</p><p><strong>Results: </strong>Sleep apnea with an apnea-hypopnea index (AHI) > 5/h was observed in 21.0% (22/105) with mild sleep apnea in 13% (14/105) and moderate to severe sleep apnea in 7.6% (8/105). After a median follow-up of 7.76 years (interquartile range: 6.84, 8.41), 10% (10/105) had died, with cardiovascular cause of death in 80% (8/10). After adjusting for age and body mass index (BMI), the AHI score emerged as an independent risk factor for cardiovascular death (hazard ratio 1.712, 95% confidence interval [1.061-2.761], <i>p</i> = 0.0276). The secondary outcome of aortic events occurred in 33% (35/105). There was no effect of the AHI score on aortic events after adjusting for age and BMI (hazard ratio 0.965, 95% confidence interval [0.617-1.509]), possibly due to a high number of patients with prior aortic surgery.</p><p><strong>Interpretation: </strong>Sleep apnea is emerging as an independent predictor of cardiovascular death in MFS. It seems mandatory to screen all individuals with MFS for sleep apnea and to include these individuals, with both MFS and sleep apnea, in further studies to evaluate the impact of preventive measures with regard to cardiovascular death.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13167-022-00291-4.</p>","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":" ","pages":"451-460"},"PeriodicalIF":6.5,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40349846","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":"Anti-prostate cancer protection and therapy in the framework of predictive, preventive and personalised medicine - comprehensive effects of phytochemicals in primary, secondary and tertiary care.","authors":"Alena Mazurakova,&nbsp;Marek Samec,&nbsp;Lenka Koklesova,&nbsp;Kamil Biringer,&nbsp;Erik Kudela,&nbsp;Raghad Khalid Al-Ishaq,&nbsp;Martin Pec,&nbsp;Frank A Giordano,&nbsp;Dietrich Büsselberg,&nbsp;Peter Kubatka,&nbsp;Olga Golubnitschaja","doi":"10.1007/s13167-022-00288-z","DOIUrl":"https://doi.org/10.1007/s13167-022-00288-z","url":null,"abstract":"<p><p>According to the GLOBOCAN 2020, prostate cancer (PCa) is the most often diagnosed male cancer in 112 countries and the leading cancer-related death in 48 countries. Moreover, PCa incidence permanently increases in adolescents and young adults. Also, the rates of metastasising PCa continuously grow up in young populations. Corresponding socio-economic burden is enormous: PCa treatment costs increase more rapidly than for any other cancer. In order to reverse current trends in exploding PCa cases and treatment costs, pragmatic decisions should be made, in favour of advanced populational screening programmes and effective anti-PCa protection at the level of the health-to-disease transition (sub-optimal health conditions) demonstrating the highest cost-efficacy of treatments. For doing this, the paradigm change from reactive treatments of the clinically manifested PCa to the predictive approach and personalised prevention is essential. Phytochemicals are associated with potent anti-cancer activity targeting each stage of carcinogenesis including cell apoptosis and proliferation, cancer invasiveness and metastatic disease. For example, their positive effects are demonstrated for stabilising and restoring mitochondrial health quality, which if compromised is strongly associated with sub-optimal health conditions and strong predisposition to aggressive PCa sub-types. Further, phytochemicals significantly enhance response of cancer cells to anti-cancer therapies including radio- and chemotherapy. Evident plant-based mitigation of negative side-effects frequently observed for conventional anti-cancer therapies has been reported. Finally, dual anti-cancer and anti-viral effects of phytochemicals such as these of silibinin have been demonstrated as being highly relevant for improved PCa management at the level of secondary and tertiary care, for example, under pandemic conditions, since PCa-affected individuals per evidence are highly vulnerable towards COVID-19 infection. Here, we present a comprehensive data analysis towards clinically relevant anti-cancer effects of phytochemicals to be considered for personalised anti-PCa protection in primary care as well as for an advanced disease management at the level of secondary and tertiary care in the framework of predictive, preventive and personalised medicine.</p>","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":" ","pages":"461-486"},"PeriodicalIF":6.5,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9263437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40584874","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":"Metagenomic analysis of the microbiome of the upper reproductive tract: combating ovarian cancer through predictive, preventive, and personalized medicine.","authors":"Xu Qin,&nbsp;Jianglin Zhou,&nbsp;Zizhuo Wang,&nbsp;Chenzhao Feng,&nbsp;Junpeng Fan,&nbsp;Jia Huang,&nbsp;Dianxing Hu,&nbsp;Babak Baban,&nbsp;Shengqi Wang,&nbsp;Ding Ma,&nbsp;Chaoyang Sun,&nbsp;Zhe Zhou,&nbsp;Gang Chen","doi":"10.1007/s13167-022-00286-1","DOIUrl":"https://doi.org/10.1007/s13167-022-00286-1","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated whether ovarian cancer could alter the genital microbiota in a specific way with clinical values. Furthermore, we proposed how such changes could be envisioned in a paradigm of predictive, preventive, and personalized medicine (PPPM).</p><p><strong>Methods: </strong>The samples were collected using cotton swabs from the cervical, uterine cavity, fallopian tubes, and ovaries of patients subjected to the surgical procedures for the malignant/benign lesions. All samples were then analyzed by metagenomic shotgun sequencing. The distribution patterns and characteristics of the microbiota in the reproductive tract of subjects were analyzed and were interpreted in relation to the clinical outcomes of the subjects.</p><p><strong>Results: </strong>While the ovarian cancer was able to alter the genital microbiota, the bacteria were the dominant microorganisms in all samples across all cohorts in the study (median 99%). The microbiota of the upper female reproductive tract were mainly from the cervical, identified by low bacterial biomass and high bacterial diversity. Ovarian cancer had a distinct microbiota signature. The tubal ligation affects its microbial distribution. There were no different species on the surface of platinum-sensitive ovarian tissues compared to samples from platinum-resistant patients.</p><p><strong>Conclusion: </strong>The ovarian cancer-induced changes in microbiota magnify the potential of microbiota as a biotherapeutic modality in the treatment of ovarian cancer in this study and very likely for several malignancies and other conditions. Our findings demonstrated, for the first time, that microbiota could be dissected and applied in more specific fashion based on a predictive, preventive, and personalized medicine (PPPM) model in the treatment of ovarian cancer. Utilizing microbiota portfolio in a PPPM system in ovarian cancer would provide a unique opportunity to a clinically intelligent and novel approach in the treatment of ovarian cancer as well as several other conditions and malignancies.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13167-022-00286-1.</p>","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":" ","pages":"487-498"},"PeriodicalIF":6.5,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40405877","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":"Tangled quest of post-COVID-19 infection-caused neuropathology and what 3P nano-bio-medicine can solve?","authors":"N. Hamdy, Fatma H. Shaker, X. Zhan, Emad B. Basalious","doi":"10.1007/s13167-022-00285-2","DOIUrl":"https://doi.org/10.1007/s13167-022-00285-2","url":null,"abstract":"","PeriodicalId":94358,"journal":{"name":"The EPMA journal","volume":"36 1","pages":"261 - 284"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73682315","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}