This document reviews the role of STAT6 in classical Hodgkin lymphoma (cHL). It discusses how STAT6 signaling is activated in cHL cells through cytokines like IL-4 and IL-13 and promotes tumor growth and survival. STAT6 expression may also be involved in Epstein-Barr virus pathogenesis and the interaction of tumor cells with the microenvironment. Inhibition of STAT6 signaling offers a potential novel targeted therapy strategy for cHL.
Gastric Cancer and the Role of Hedgehog- Interacting Protein One as a Prognos...CrimsonpublishersCancer
Hedgehog (Hh) signaling has been linked to foregut development since its initial discovery in Drosophila. The mammalian genome expresses three (3) Hh ligands, with sonic hedgehog (Shh) level of expression is highest in the mucosa of the embryonic and adult foregut. Hedgehog signaling aberrant activation is associated with pathological consequences in a range of human cancer. Hedgehog signaling is of pivotal role in homeostasis, neoplastic transformation, and gastrointestinal cancer development. The ability to track these cell types in tumor micro-environment broadens options for the more efficient screening of subjects predisposed to eventually developing gastric cancer as well as to expand opportunities for prophylactic therapy once atrophic gastritis develops. The Hedgehog-interacting protein (HHIP) gene is an essential homolog for multiple developmental processes. However, the expression and clinical correlation of HHIP in gastric cancer (GC) has not thoroughly been investigated. There is need to explore the expression of HHIP in gastric cancer (GC) and evaluate its clinicopathological and functional correlation.
The role of natural products in regulating pyroptosisLucyPi1
Abstract In recent years, large numbers of novel cell death types have been reported such as autophagic death, paraptosis, mitosis, oncosis and pyroptosis. As a new type of proinflammatory programmed cell death, pyroptosis has attracted increasing attentions gradually, and its morphological characteristics and molecular mechanisms are significantly different from other cell death types such as necrosis and apoptosis. Many research groups have demonstrated the association between pyroptosis and various human diseases including immunological disease, cancer, atherosclerosis, infectious disease, and cardiovascular and cerebrovascular disease. Natural products are small molecules synthetized in organisms including primary and secondary metabolites. Natural products are important sources of modern innovative drugs discovery and can be used as key tools to explore the molecular mechanism of cell fate. The aim of this study is to review the molecular mechanisms and pathways of pyroptosis, and to categorize and conclude research results on the correlation between different natural products and pyroptosis in recent years. In this study, a total of 39 papers were enrolled in analyses. The molecular pathways and mechanisms of pyroptosis were clearly described. Fourteen types of natural products, their sources, effects, mechanisms and therapeutic potentials are categorized and illuminated. It is showed that a variety of natural products and pyroptosis have close correlations. They negatively or positively affect or act on different positions of pyroptosis inflammatory pathways, indicating that they may have certain potential therapeutic effects on pyroptosis-related diseases. Pyroptosis, a relatively new way of cell death, is closely associated with a variety of diseases. Natural products can have obvious effects on the process of pyroptosis as potential sources of new drugs. In-depth studies using natural products to investigate pyroptosis will help to enhance our understandings of human diseases and establish effective prevention and treatment strategies.
Flavin-Containing Dimethylaniline Monooxygenase 5 Drives Malignancies in Hepa...semualkaira
Hepatic microsomes play an important role in drug metabolism,
but the potential biological functions of hepatic microsome-containing proteins in Hepatocellular Carcinoma (HCC) remain unclear. Here, we used HCC and corresponding adjacent Non-Tumor
(NT) tissues to isolate hepatic microsomes and then performed
RNA high-throughput sequencing
Gastric Cancer and the Role of Hedgehog- Interacting Protein One as a Prognos...CrimsonpublishersCancer
Hedgehog (Hh) signaling has been linked to foregut development since its initial discovery in Drosophila. The mammalian genome expresses three (3) Hh ligands, with sonic hedgehog (Shh) level of expression is highest in the mucosa of the embryonic and adult foregut. Hedgehog signaling aberrant activation is associated with pathological consequences in a range of human cancer. Hedgehog signaling is of pivotal role in homeostasis, neoplastic transformation, and gastrointestinal cancer development. The ability to track these cell types in tumor micro-environment broadens options for the more efficient screening of subjects predisposed to eventually developing gastric cancer as well as to expand opportunities for prophylactic therapy once atrophic gastritis develops. The Hedgehog-interacting protein (HHIP) gene is an essential homolog for multiple developmental processes. However, the expression and clinical correlation of HHIP in gastric cancer (GC) has not thoroughly been investigated. There is need to explore the expression of HHIP in gastric cancer (GC) and evaluate its clinicopathological and functional correlation.
The role of natural products in regulating pyroptosisLucyPi1
Abstract In recent years, large numbers of novel cell death types have been reported such as autophagic death, paraptosis, mitosis, oncosis and pyroptosis. As a new type of proinflammatory programmed cell death, pyroptosis has attracted increasing attentions gradually, and its morphological characteristics and molecular mechanisms are significantly different from other cell death types such as necrosis and apoptosis. Many research groups have demonstrated the association between pyroptosis and various human diseases including immunological disease, cancer, atherosclerosis, infectious disease, and cardiovascular and cerebrovascular disease. Natural products are small molecules synthetized in organisms including primary and secondary metabolites. Natural products are important sources of modern innovative drugs discovery and can be used as key tools to explore the molecular mechanism of cell fate. The aim of this study is to review the molecular mechanisms and pathways of pyroptosis, and to categorize and conclude research results on the correlation between different natural products and pyroptosis in recent years. In this study, a total of 39 papers were enrolled in analyses. The molecular pathways and mechanisms of pyroptosis were clearly described. Fourteen types of natural products, their sources, effects, mechanisms and therapeutic potentials are categorized and illuminated. It is showed that a variety of natural products and pyroptosis have close correlations. They negatively or positively affect or act on different positions of pyroptosis inflammatory pathways, indicating that they may have certain potential therapeutic effects on pyroptosis-related diseases. Pyroptosis, a relatively new way of cell death, is closely associated with a variety of diseases. Natural products can have obvious effects on the process of pyroptosis as potential sources of new drugs. In-depth studies using natural products to investigate pyroptosis will help to enhance our understandings of human diseases and establish effective prevention and treatment strategies.
Flavin-Containing Dimethylaniline Monooxygenase 5 Drives Malignancies in Hepa...semualkaira
Hepatic microsomes play an important role in drug metabolism,
but the potential biological functions of hepatic microsome-containing proteins in Hepatocellular Carcinoma (HCC) remain unclear. Here, we used HCC and corresponding adjacent Non-Tumor
(NT) tissues to isolate hepatic microsomes and then performed
RNA high-throughput sequencing
Flavin-Containing Dimethylaniline Monooxygenase 5 Drives Malignancies in Hepa...semualkaira
Hepatic microsomes play an important role in drug metabolism, but the potential biological functions of hepatic microsome-con- taining proteins in Hepatocellular Carcinoma (HCC) remain un- clear. Here, we used HCC and corresponding adjacent Non-Tumor (NT) tissues to isolate hepatic microsomes and then performed RNA high-throughput sequencing. After screening, flavin-con- taining dimethylaniline monooxygenase (FMO5) showed a significantly high expression level and was associated with poor prognosis in patients with HCC.
Proteomics Exploration of Chronic Lymphocytic Leukemia_Crimson PublishersCrimsonpublishersCancer
Chronic Lymphocytic Leukemia (CLL) is an adult heme malignancy characterized by the presence of mature-appearing CD5+ B cells in the blood, bone marrow, and secondary lymphoid organs [1]. In the United States, there will be an estimate of 20,720 new cases and 3,930 deaths according to the American Cancer Society statistics. Symptoms include swollen lymph nodes, frequent infections, and fatigue which negatively impacts the quality of life of people affected [1]. CLL is heterogeneous in its progression and clinical outcomes. Factors that contribute to the heterogeneity include the immunoglobulin heavy chain (IGHV) status and chromosomal aberrations [2,3]. There are two subtypes of CLL: Unmutated(U-CLL) and Mutated CLL(M-CLL). 40% and 60% of patients are diagnosed with unmutated and mutated CLL. U-CLL is characterized by the presence of CLL cells that have less than two percent of their IGHV mutated, whereas M-CLL cells have more than two percent mutated [4]. U-CLL is the more aggressive phenotype [2]. These cells have increased responsiveness to antigens that bind the B cell receptor (BCR) versus M-CLL cells [5]. M-CLL is the more indolent phenotype. Increased BCR signaling results in increased cell survival and proliferation [5].
Characteristic mTOR activity in Hodgkin-lymphomas offers a potential therapeu...Enrique Moreno Gonzalez
Targeting signaling pathways is an attractive approach in many malignancies. The PI3K/Akt/mTOR pathway is activated in a number of human neoplasms, accompanied by
lower overall and/or disease free survival. mTOR kinase inhibitors have been introduced in the therapy of renal cell carcinoma and mantle cell lymphoma, and several trials are currently
underway. However, the pathological characterization of mTOR activity in lymphomas is still incomplete.
Annals of Mutagenesis is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Mutagenesis.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Mutagenesis. Annals of Mutagenesis accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of mutagenesis.
Annals of Mutagenesis strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Advances Perspectives in Syncytin-1 From Biology to Clinical Practicessuppubs1pubs1
Syncytin-1 serves as an enveloped membrane glycoprotein encoded from env gene and expressed in placenta specifically as HERV-W member product of human genome playing an essential role in cell fusion process of from trophoblast to syncytiotrophoblast during each individual pregnancy. It is widely maintained that unusual expressive levels of syncytin-1 have close relationships to obstetrical syndromes such as pre-eclampsia as a typical gestational hypertension symptom. In this review, correlations between syncytin-1 and related diseases are in detailed discussions.
Tumor metastasis is the leading cause of mortality among advanced cancer patients. Understanding its mechanisms and treatment strategies is vital for clinical application. Arginine methylation, a post-translational
modification catalyzed by protein arginine methyltransferases (PRMTs), is implicated in diverse physiological
processes and disease progressions. Previous research has demonstrated PRMTs’ involvement in tumor occurrence, progression, and metastasis. This review offers a comprehensive summary of the relationship between
PRMTs, prognosis, and metastasis in various cancers. Our focus centers on elucidating the molecular mechanisms
through which PRMTs regulate tumor metastasis. We also discuss relevant clinical trials and effective PRMT
inhibitors, including chemical compounds, long non-coding RNA (lncRNA), micro-RNA (miRNA), and nanomaterials, for treating tumor metastasis. While a few studies present conflicting results, the overall trajectory
suggests that inhibiting arginine methylation exhibits promise in curtailing tumor metastasis across various
cancers. Nonetheless, the underlying mechanisms and molecular interactions are diverse. The development of
inhibitors targeting arginine methylation, along with the progression of clinical trials, holds substantial potential
in the field of tumor metastasis, meriting sustained attention.
A 43-Year-Old Male with PCM1-JAK2 Gene Fusion Experienced T-Lymphoblastic Lym...AnonIshanvi
Myeloid/lymphoid neoplasms associated with eosinophilia and PCM1-JAK2 is a provisional entity in WHO 2016. Prior case reports have shown quite a few clinical presentations in different patients with this chromosome translocation,characterized by eosinophilia in combination with myelodysplastic/ myeloproliferative neoplasms, acute myeloid leukemia(AML) and rarely, T-lymphoblastic lymphoma(T-LBL) or B-acute
A 43-Year-Old Male with PCM1-JAK2 Gene Fusion Experienced T-Lymphoblastic Lym...NainaAnon
Myeloid/lymphoid neoplasms associated with eosinophilia and PCM1-JAK2 is a provisional entity in WHO 2016. Prior case reports have shown quite a few clinical presentations in different patients with this chromosome translocation,characterized by eosinophilia in combination with myelodysplastic/ myeloproliferative neoplasms, acute myeloid leukemia(AML) and rarely, T-lymphoblastic lymphoma(T-LBL) or B-acute...
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Lung cancer is the second common malignancy and the most aggressive cancer worldwide with late diagnosis and poor prognosis. The search for biomarkers that promote early diagnosis and improve therapeutic strategies focuses to the understanding of the mechanisms underlying cancer development and progression. The deregulation of gene expression is one of the cancer hallmarks reflected to the stability...
A 43-Year-Old Male with PCM1-JAK2 Gene Fusion Experienced T-Lymphoblastic Lym...daranisaha
Myeloid/lymphoid neoplasms associated with eosinophilia and PCM1-JAK2 is a provisional entity in WHO 2016. Prior case reports have shown quite a few clinical presentations in different patients with this chromosome translocation,characterized by eosinophilia in combination with myelodysplastic/ myeloproliferative neoplasms, acute myeloid leukemia(AML) and rarely,
Stereotactic Radiation Therapy of Lung Cancers and Subsequent Parenchymal Alt...daranisaha
Stereotactic body radiation therapy (SBRT) is one of the standard radical treatments in stage I nonsmall cell lung cancer (NSCLC) and an option for lung metastases. The pulmonary parenchymal CT alterations at 3, 6 and 12 months are the object of a prospective analysis in patients submitted to SBRT, to define factors affecting the different radiological alterations...
Higher Rates of Helicobacter Pylori Infection and Gastric Intestinal Metaplas...daranisaha
The rate of Helicobacter pylori (H. pylori) infection is higher in minority patients in the United States [1]. Gastric intestinal metaplasia (IM) is associated with H. pylori infection and carries an increased risk for gastric cancer over time, in particular for patients from regions of high gastric cancer incidence [2]. We aimed to compare the rates of Helicobacter pylori infection and gastric intestinal metaplasia...
Critical Role of PET-Scan in Unravelling the Dual Pathology- Review of Litera...daranisaha
Simultaneous presentation of two lymphatic haematological malignancies is extremely rare. Adequate and optimal diagnostic steps including various imaging techniques and histopathological biopsies are required unpin the exact diagnoses to be able to deliver the best management strategies...
Myelomastocytic leukemia is a very rare variant of myeloid leukemia, behaves clinically very aggressive and belongs to the group of so-called metachromatic leukemias. Metachromatic leu- kemias comprise leukemias with at least 10 to 20% tumor cells exhibiting metachromatic gran- ules: mast cell leukemia...
Cavernous Sinus Metastasis of Leiomyosarcoma with Orbital Extension along the...daranisaha
Leiomyosarcoma (LMS) metastasis in the central nervous system is extremely rare. Metastatic LMSs have been described in the orbit, meninges, and skull base, however there are no reports of LMS metastasis into the cavernous sinuswith primary origin from lower extremity and long silent disease period of 7 years..
Analysis of Treatment Option for Synchronous Liver Metastases and Colon Recta...daranisaha
Colorectal or bowel cancer is one of the major cause of cancer worldwide. Research has shown that 15 to 20 % colorectal cancer patients are also diagnosed with synchronous liver metastases (LM) at presentation and about one third eventually develop liver lesions (Leporrier, Maurel, Chiche, Bara, Segol, and Launoy, 2006; Manfredi, Lepage, Hatem, Coatmeur, Faivre, and Bou-vier, 2006)...
An Adrenal Mass in a Patient with Lynch Syndromedaranisaha
Adrenocortical cancer (ACC) is a rare malignancy (estimated annual incidence 0.7 to 2.0 cases per million individuals worldwide) with a poor prognosis. In contrast, Lynch Syndrome (LS) is a much more commonly encountered hereditary syndrome that predisposes individuals to colon cancer and multiple other malignancies...
Racial Differences in Accepting Pegfilgrastim Onpro Kit (On-Body Injector) Us...daranisaha
Neulasta Onpro kit eliminates need for additional clinic visit after chemotherapy. Given the racially diverse population in our institution, we investigated acceptance of Onpro kit among patients on chemotherapy.Single-institution, retrospective review conducted in patients with GI tumors who received Onpro kit within 1 hour of completion of systemic chemotherapy from Jan 2014 through Jan 2018...
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Proteomics Exploration of Chronic Lymphocytic Leukemia_Crimson PublishersCrimsonpublishersCancer
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Annals of Mutagenesis is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Mutagenesis.
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Advances Perspectives in Syncytin-1 From Biology to Clinical Practicessuppubs1pubs1
Syncytin-1 serves as an enveloped membrane glycoprotein encoded from env gene and expressed in placenta specifically as HERV-W member product of human genome playing an essential role in cell fusion process of from trophoblast to syncytiotrophoblast during each individual pregnancy. It is widely maintained that unusual expressive levels of syncytin-1 have close relationships to obstetrical syndromes such as pre-eclampsia as a typical gestational hypertension symptom. In this review, correlations between syncytin-1 and related diseases are in detailed discussions.
Tumor metastasis is the leading cause of mortality among advanced cancer patients. Understanding its mechanisms and treatment strategies is vital for clinical application. Arginine methylation, a post-translational
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through which PRMTs regulate tumor metastasis. We also discuss relevant clinical trials and effective PRMT
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suggests that inhibiting arginine methylation exhibits promise in curtailing tumor metastasis across various
cancers. Nonetheless, the underlying mechanisms and molecular interactions are diverse. The development of
inhibitors targeting arginine methylation, along with the progression of clinical trials, holds substantial potential
in the field of tumor metastasis, meriting sustained attention.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
STAT-6 In Hodgkin Lymphoma Pathobiology and Treatment-Review of the Literature
1. STAT-6 In Hodgkin Lymphoma Pathobiology and Treatment-
Review of The Literature
M Ioannou*
, K Baxevanidou, GK Koukoulis
Department of Pathology, University of Thessaly, Greece
Volume 1 Issue 5- 2018
Received Date: 01 Aug 2018
Accepted Date: 20 Aug 2018
Published Date: 27 Aug 2018
1. Abstract
Classical Hodgkin Lymphoma (cHL), consists of rare neoplastic Hodgkin and Reed-Sternberg
cells (HRS) residing in a prominent inflammatory background. HRS show deregulated activa-
tion of multiple signaling pathways and transcription factors. The activation of these pathways
and factors is partly mediated through interactions of HRS with various other types of cells in
the microenvironment, but also through genetic lesions. Signal transducers and activators of
transcription (STAT) are a family of transcription factors that regulate a broad range of cellu-
lar processes, such as proliferation, differentiation, and survival, in a large variety of cell types.
STAT6 pathway is activated as a response to the binding of cytokines IL-4 and IL-13 to their
receptors on the cell membrane. The ability of activated STAT6 to promote lymphoproliferation
and the requirement for STAT6 in normal cytokine-induced cell proliferation provides a strong
rationale for further study of STAT6 in cHL.
This review outlines the current evidence on the role of STAT6 in cHL. We report on the findings
concerning the involvement of STAT6 in the pathogenesis, as well as in the cross-talk between
tumor cells and their microenvironment. The dependency of HRS on micro environmental
interactions and on deregulated STAT6 signaling pathway may offer novel strategies for targeted
therapies.
Clinics of Oncology
Citation: M Ioannou, K Baxevanidou, GK Koukoulis, STAT-6 In Hodgkin Lymphoma Pathobiology and
Treatment-Review of The Literature. Clinics of Oncology. 2018; 1(5): 1-8.
United Prime Publications: http://unitedprimepub.com
*Corresponding Author (s): M Ioannou, University of Thessaly, School of Health Sci-
ences, Deprtment of Pathology, Panepistimion 3st Biopolis, 41110, Larissa, Greece, E-
mail: mioan@uth.gr
Review Type
3. Introduction
Hodgkin lymphoma (HL) was recognized in the first half of
the 19th
century by Thomas Hodgkin and Samuel Wilks [1,2].
It is one of the most common lymphomas in Western World.
Its annual incidence is 3 cases per 100.000 persons. Neoplastic
tissues usually contain a small number of scattered large mono-
nucleated and multinucleated tumor cells (designated Hodgkin
and Reed-Sternberg cells or HRS cells) residing in an abundant
heterogeneous admixture of non-neoplastic inflammatory and
accessory cells. The latter includes lymphocytes, especially Th2
cells, monocytes, granulocytes, eosinophils, mast cells and his-
tiocytes [1,3,4]. Biological and clinical studies in the last de-
cades have shown that Hodgkin lymphomas are comprised of
two disease entities: nodular lymphocyte predominant Hodgkin
lymphoma (NLPHL) and classical Hodgkin lymphoma (cHL).
Based on the consistence of the microenvironment, the lat-
ter one is divided into four subtypes: nodular sclerosis (80%),
mixed cellularity (15%), lymphocyte rich (5%) and lymphocyte
depleted (<1%) (1, 5, 6). The immunophenotypic and genetic
2. Keywords
Hodgkin lymphoma; STAT6;
Pathobiology; Therapy; Re-
view
features of the mononuclear and multinucleated cells are identi-
cal in these histological subtypes, whereas their clinical features
and association with EBV show differences.
In Ebstein-Barr virus (EBV) positive cases evidence suggest its
role in the pathogenesis of HRS cells [5,7-11]. The prevalence of
EBV in HRS cells varies according to the histological subtype and
epidemiologic factors. The highest frequency is found in mixed
cellularity classical HL and the lower incidence in nodular scle-
rosis classical HL (WHO 2008). EBV is found in 40% of cases in
Western world, however may be seen in up to 90% of cases in
Central and South Africa [5].
Classical HL is a monoclonal lymphoid neoplasm derived (in
most instances from B cells). Despite their derivation from ger-
minal center B cells, HRS have lost much of the B-cell specific
expression program and have acquired B-cell inappropriate gene
products. In addition, deregulated transcription factors in classi-
cal HL promote proliferation and abrogate apoptosis in the neo
plastic cells. Multiple signaling pathways, mainly including nu-
3. deregulation of lineage-specific transcription factors such as E2A
[5], and the Interferon regulating factor (IRF)5 that, together with
NF-κB activation, determine the inflammatory phenotype of HRS
cells [57]. HRS cells express CD30 and CD40, two members of the
tumor necrosis factor (TNF)/nerve growth factor (NGF) receptor
family, and in the majority of cases CD15 (75–85%) and IRF4 [5].
The JAK/STAT signaling pathway represents another key pathway
in pathogenesis of HL. STAT3, STAT5 and STAT6 are activated
and expressed at high level in HL [21, 58]. Given that the activa-
tion of docking domains for STAT monomers is due the activation
of JAK/STAT pathway, the expression of STATs and especially of
STAT6 in HRS cells might represent a possible biomarker of JAK/
STAT activation in tissue specimens. Clinicopathological studies
correlating clinical data and molecular results with immunohisto-
chemical expression of STAT6 protein, could further investigate
this possibility.
Epstein–Barr virus (EBV) is causally associated with approxi-
mately one third of HL cases in socioeconomically developed
countries, while in pediatric HL in Central and South America,
the association can be up to 90% [59]. In patients with AIDS,
EBV-infected HRS cells are present in nearly all cases [60]. Differ-
ent studies have shown that Epstein-BarrVirus contributes to the
transformation of its precursors, as well as the survival and pro-
liferation of the malignant HRS cells [4,5,7]. The EBV+ HRS cells
typically show an EBV latency II gene expression profile, meaning
expression of the viral proteins EBV nuclear antigen 1 (EBNA1)
and latent membrane proteins 1 and 2a (LMP1 and LMP2a) [61].
The EBV-encoded LMP-1 is a viral mimic of the CD40 recep-
tor, and by constitutive signaling it activates potently the nuclear
factorκB, c-Jun N-terminal kinase, and phosphatidylinositol 3-ki-
nase pathways.LMP-1 has been reported as a viral oncoprotein
promoting tumor growth but also apoptotic resistance and im-
mune modulation [9,62,63]. Recently, demonstrated that the in-
duction of LMP-1 by IL-4 and IL-13 is mediated by STAT6 and a
newly defined high-affinity STAT6-binding site in the LMP-1 pro-
moter in HL-derived, EBV-converted KMH2-EBV cell lines [10].
This evidence strongly supports the role of STAT6 in the patho-
genesis of EBV-positive cHL. Furthermore, it indicates that inhi-
bition of the interactions between the cytokines and its specific
receptor or inhibition of the STAT6 signaling pathway might have
beneficial effects in the EBV-positive cases by down-regulating the
expression of LMP-1.
In respect to tumor growth, it has been proved that survival and
proliferation of HRS cells is dependent on STAT3 and STAT6 acti-
vation, since rescission of their activation by neutralizing antibod-
ies, JAK/STAT blockers or siRNAs against STAT3 and STAT6 re-
duced proliferation and induced cell death in vitro [14, 25, 64]. In
addition. pointed out the association between antibody-mediated
neutralization of IL-13, reduced STAT6 phosphorylation and de-
creased HL cell proliferation [19].
Interestingly, Baus et al. [55] demonstrated that knockdown of
STAT6, by using constantly expressed shRNAs against STAT6 by
lentiviral transduction, induced apoptotic cell death in the cHL
cell lines L428 and L1236cHL. In the latter study, the values of
the G1 and G2 cell populations were not affected, suggesting that
STAT6 has a strong effect on cell survival and does not provoke
cell-cycle arrest.
The above data suggest that STAT6 promotes the neoplastic pro-
liferation and consequently it might represent a possible thera-
peutic target.
5.2 Stat6 and Hl Microenvironment
Unlike any other neoplasm, the tumor in cHL is made predomi-
nantly of the non-neoplastic HRS cells rather than the neoplastic
HRS cells, which often constitute no more than 1-3% of the entire
mass [12]. CD4+ T cell lymphocytes are the most abundant cell
type in cHL, clustering around the RS cells [48], and the overpro-
duction of helper T cell type 2 (Th2) cytokines and chemokines
such as interleukin (IL)-13, IL5 and eotaxin [14] is reported in
most cases. The great number of cytokines produced in cHL by
HRS cells promote neoplastic cell growth and survival. At the
same time, the secreted molecules are implicated in the reactions
between the cells of microenvironment and trigger an abnormal
immune response to the HRS cells while support them to over-
come the antitumor activity of cytotoxic T and NK cells [8]. This
is highlighted by expression or secretion of PD-1 ligand, galec-
tin-1 and IL-13 which directly interfere with the functional activ-
ity of T cells, primarily polarize specific T cell subsets towards a
regulatory phenotype, or prevent an effective Th1-response [65-
68].
Early studies reported that IL-13 and IL-13R (alpha)1, the IL-
13-specific receptor chain, are frequently expressed by HL-de-
rived cell lines as well as by HRS cells from biopsy material of
tissues involved by HL. Furthermore, antibody-mediated neu-
tralization of IL-13 in cultures of HL-derived cell lines resulted in
a dose-dependent inhibition of proliferation, and it was associ-
ated with increased apoptosis and with significant decreases in
both cellular proliferation and levels of phosphorylated STAT6 of
HL cell lines [13, 14, 69].
These data support the hypothesis that STAT6 is involved in
cellular interactions that modify the tumor microenvironment
which, on the other hand, regulate the immune response against
tumor cells. Since HRS survival seems to be mostly due the acti-
vated proliferating and proinflammatory cytokine secreting cells
[8, 70], the IL-13/STAT6 signaling, involved in micoenvironmen-
Volume 1 Issue 5 -2018 Review Type
United Prime Publications: http://unitedprimepub.com 3
4. tal interactions, may be an additional target for new therapeutic
approaches.
5.3. Stat6 and Therapy of Hl
The majority of patients with HL are treated with a combination
of multi-drug chemotherapy and radiotherapy. Despite relative
success of therapy, approximately 20% of patients will not be
cured with the current available therapy and the disease will re-
lapse [26]. Moreover, 30-35% of patients with high-risk prognos-
tic features will not be treated [71]. Additionally, patients recur-
ring after autologous and/or allogenic stem cell transplantation
are regarded incurable and are considered to have a median sur-
vival <3 years [72]. Hence, the development of novel therapeutic
agents are needed for patients with refractory or relapsed disease.
Novel therapeutic strategies focus on the special and unique
pathology and microenvironment, the deregulated signaling
pathways, as well as the induction of anti-HRS cell immunity by
modulating the microenvironment. Among the latter, the im-
mune checkpoint inhibitors (e.g. programmed cell death 1/PD-1,
PD1-Ligand/PDL-1) have been proved a breakthrough therapy
for advanced HL [66, 73, 74].
The JAK/STAT pathway is activated in HL as a result of genomic
amplification of JAK2 and/or inactivating mutations in an in-
hibitor of JAK activity, SOCS1 (75). A proof of the therapeutic
potential of JAK inhibitors has been proved by a phase I study
of the JAK inhibitor SB1518, a selective inhibitor of JAK2 and
FLT3. In this study, 14 out of the 34 patients had cHL. Of these
14 patients, 6 patients had a steady disease with the treatment
[31]. Have also supported the positive effects of SB1518, a novel
macrocyclic pyrimidine-based JAK2 inhibitor for the treatment
of HL. More specifically, SB1518 aims the JAK/STAT pathway by
inhibiting tyrosine phosphorylation on JAK2 (Y221) and down-
stream STATs. Hence, SB1518 has probably an anti-proliferative
effect on lymphoid cell lines, driven by mutant or wild type JAK-
2 or FLT3. The latter results from cell cycle arrest and induction
of apoptosis [31].
Furthermore, JAK inhibitors can lead on propitious immuno-
modulary effects. Derenzini et al. [76] showed that AZD1480,
JAK 1/2 inhibitor exhibited immunomodulary effects at low con-
centrations by down regulating the expression of Th2 cytokines
and chemokines (Il-13 and TRAC), as well as STAT3-mediated
reduced expression of PD-L1 and PD-L2, which take part in im-
mune escape mechanisms in HL. In addition. Demonstrated that
JAK2 inhibition by the selective inhibitor, fedratinibdecreased
phosphorylation of JAK2, STAT1, STAT3, and STAT6 and re-
duced the expression of additional downstream targets, includ-
ing PD-L1, Interestingly, the phosphorylation of STAT 1, 3 and 6
was inhibited by chemical JAK2 blockade in a 9p24.1 copy num-
ber-dependent manner in cHL cell lines [20].
Recently presented a JAK 1 /2 inhibitor, ruxolintinib, which re-
duced the phosphorylation of STAT3 and STAT6, as well as the
expression of c-Myc in the HL cell line HDLM-2. These results
were amplified when ruxolintinib was combined with the Bcl-2/
Bcl-xL inhibitor, Navitoclax, or with anti-CD30 toxin conjugate,
brentuximab vedotin (BV). The combination of ruxolitinib with
Navitoclax or BV alone prolonged survival period but did not
cure HDML-2 tumor-bearing mice. On the other, BV combined
with ruxolitinib and/or with Navitoclax led to sustained com-
plete remission in this model of HL. The studies above propose
future use of the combination of BV with ruxolitinib in patients
with HL [77].
The significance of STAT6 inhibition in HL therapy has been
reported. The authors demonstrated a direct antiproliferative ef-
fect of histone deacetylase (HDAC) inhibitor vorinostat on HRS
which was associated with cell cycle arrest and apoptosis and an
immune mediated effect by altering cytokine and chemokines
secretion in the microenvironment due to inhibition of STAT6
phosphorylation [78]. Furthermore demonstrated that the pan-
deacetylase inhibitor panobinostat has potent antiproliferative
activity against Hodgkin lymphoma-derived cell lines. At the
molecular level, panobinostat activated the caspase pathway, in-
hibited STAT5 and STAT6 phosphorylation, and down-regulated
hypoxia-inducible factor 1 α and its downstream targets, glucose
transporter 1 (GLUT1) and vascular endothelial growth factor.
In respect to STAT6 signaling, have shown that specific block-
ing of the IL-4 and IL-13-mediated STAT-6 activation by an IL-4
binding fusion protein APG598 or an IL-4R antagonist APG201
(R121D/Y124D) make HL cells more prone to apoptotic effect
by chemotherapeutic drugs such as Mitomycin C, 5-Fluoracil,
Etoposide, Doxorubicin and Plaxicatel. This outcome is based
on the inhibition of STAT-6 mediated elevation of expression of
the anti-apoptotic Bcl-2 family protein Bcl-xL. Thus, the IL-4/
Il-13-STAT6-Bcl-xL pathway may be a crucial target for HL
treatment [25]. In addition, Demonstrated that treatment of two
IL-13-responsive HL-derived cell lines, with Soluble interleukin-
13Ralpha2 decoy receptor, resulted in the inhibition of cell prolif-
eration, and down-regulated the phosphorylation of STAT6 [24].
All the data investigating the correlation of STAT6 with cHL and
its prognosis are summarized in Table 1.
Volume 1 Issue 5 -2018 Review Type
United Prime Publications: http://unitedprimepub.com 4
5. 6. Conclusion
In conclusion, although the complexity of interactions between
HRS cells and their microenvironment and their functional role
during malignant transformation is not completely understood,
however, emerging data indicate that STAT6 is involved in cHL
pathogenesis and growth, through interplay with cellular signal
transduction pathways. Experimental results following disrup-
tion of microenviromental interactions by STAT6 inhibition gen-
erate optimism for novel therapeutic strategies for HL, possibly
including drugs that block specifically the STAT6 signaling path-
way and particularly the STAT6 protein.
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