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Shareef LG, Fawzi Al-Hussainy A, Majeed Hameed S. COVID-19 vaccination hesitancy among Iraqi general population between beliefs and barriers: An observational study. F1000Res 2022; 11:334. [PMID: 35529280 PMCID: PMC9046899 DOI: 10.12688/f1000research.110545.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Vaccine apprehension poses a serious threat to global health. While there has been a tremendous global effort to create a vaccine against coronavirus disease 2019 (COVID-19), little is known about its reception in Iraq. Therefore, we sought to examine COVID-19 vaccine acceptance, hesitation, and related elements in the Iraqi population. Methods: Between the 19th of May and the 22nd of September 2021, a descriptive, cross-sectional web-based survey was conducted employing a quantitative approach. Respondents from both sexes aged 18 years and above who live in Iraq and agreed to participate were included. An anonymized online structured questionnaire was designed based on data from prior research on vaccine hesitation in general, and COVID-19 vaccination reluctance specifically. Results: A total of 1221 eligible participants from various regions in Iraq actively participated in the short web-based questionnaire. The overall acceptance rate of the COVID-19 vaccine was 56.2%, with a greater acceptance rate among younger male participants (p<0.05). Marital status had no significant association (p=0.834). Urbanization influenced the acceptance rate significantly (p=0.002). The barriers to receiving the COVID-19 vaccine were exemplified by the vaccine not being evaluated for a sufficient period in 51.4% of the responses, as well as concerns about future side effects in 76.6% of the responses and a lack of efficacy in 55.7% of the responses. The Pfizer-BioNTech vaccine received 39.6% preference and participants confidence, followed by the Oxford/AstraZeneca vaccine at 18.1% and the Sinopharm vaccine at 14.6%. Conclusions: COVID-19 vaccination apprehension was discovered in almost half of the study population. Lack of understanding about vaccination eligibility, anxiety about adverse events and vaccine efficacy, and distrust in the government were independently predictive of vaccine hesitation.
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Muzammil K, Sabah Ghnim Z, Saeed Gataa I, Fawzi Al-Hussainy A, Ali Soud N, Adil M, Ali Shallan M, Yasamineh S. NRF2-mediated regulation of lipid pathways in viral infection. Mol Aspects Med 2024; 97:101279. [PMID: 38772081 DOI: 10.1016/j.mam.2024.101279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/14/2024] [Accepted: 05/15/2024] [Indexed: 05/23/2024]
Abstract
The first line of defense against viral infection of the host cell is the cellular lipid membrane, which is also a crucial first site of contact for viruses. Lipids may sometimes be used as viral receptors by viruses. For effective infection, viruses significantly depend on lipid rafts during the majority of the viral life cycle. It has been discovered that different viruses employ different lipid raft modification methods for attachment, internalization, membrane fusion, genome replication, assembly, and release. To preserve cellular homeostasis, cells have potent antioxidant, detoxifying, and cytoprotective capabilities. Nuclear factor erythroid 2-related factor 2 (NRF2), widely expressed in many tissues and cell types, is one crucial component controlling electrophilic and oxidative stress (OS). NRF2 has recently been given novel tasks, including controlling inflammation and antiviral interferon (IFN) responses. The activation of NRF2 has two effects: it may both promote and prevent the development of viral diseases. NRF2 may also alter the host's metabolism and innate immunity during viral infection. However, its primary function in viral infections is to regulate reactive oxygen species (ROS). In several research, the impact of NRF2 on lipid metabolism has been examined. NRF2 is also involved in the control of lipids during viral infection. We evaluated NRF2's function in controlling viral and lipid infections in this research. We also looked at how lipids function in viral infections. Finally, we investigated the role of NRF2 in lipid modulation during viral infections.
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Hsu CY, Allela OQB, Hussein AM, Mustafa MA, Kaur M, Alaraj M, Al-Hussainy AF, Radi UK, Ubaid M, Idan AH, Alsaikhan F, Narmani A, Farhood B. Recent advances in polysaccharide-based drug delivery systems for cancer therapy: a comprehensive review. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2024; 52:564-586. [PMID: 39639430 DOI: 10.1080/21691401.2024.2436350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 11/13/2024] [Accepted: 11/25/2024] [Indexed: 12/07/2024]
Abstract
Cancer has a high rate of incidence and mortality throughout the world. Although several conventional approaches have been developed for the treatment of cancer, such as surgery, chemotherapy, radiotherapy and thermal therapy, they have remarkable disadvantages which result in inefficient treatment of cancer. For example, immunogenicity, prolonged treatment, non-specificity, metastasis and high cost of treatment, are considered as the major drawbacks of chemotherapy. Therefore, there is a fundamental requirement for the development of breakthrough technologies for cancer suppression. Polysaccharide-based drug delivery systems (DDSs) are the most reliable drug carriers for cancer therapy. Polysaccharides, as a kind of practical biomaterials, are divided into several types, including chitosan, alginates, dextran, hyaluronic acid, cyclodextrin, pectin, etc. Polysaccharides are extracted from different natural resources (like herbal, marine, microorganisms, etc.). The potential features of polysaccharides have made them reliable candidates for therapeutics delivery to cancer sites; the simple purification, ease of modification and functionalization, hydrophilicity, serum stability, appropriate drug loading capacity, biocompatibility, bioavailability, biodegradability and stimuli-responsive and sustained drug release manner are considerable aspects of these biopolymers. This review highlights the practical applications of polysaccharides-based DDSs in pharmaceutical science and cancer therapy.
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Saadh MJ, Ahmed HH, Al-Hussainy AF, Kaur I, Kumar A, Chahar M, Saini S, Taher WM, Alwan M, Jawad MJ, Darvishi M, Alsaikhan F. Bile's Hidden Weapon: Modulating the Microbiome and Tumor Microenvironment. Curr Microbiol 2024; 82:25. [PMID: 39614901 DOI: 10.1007/s00284-024-04004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Accepted: 11/20/2024] [Indexed: 12/07/2024]
Abstract
The human gut microbiome is a dynamic and intricate ecosystem, composed of trillions of microorganisms that play a pivotal role in maintaining overall health and well-being. However, the gut microbiome is constantly exposed to various environmental factors, including the bile produced by the liver, which can significantly impact its composition and function. Bile acids, secreted by the liver and stored in the gallbladder, modulate the gut microbiome, influencing its composition and function. This altered microbiome profile can, in turn, impact the tumor microenvironment (TME), promoting an immunosuppressive environment that favors tumor growth and metastasis. Furthermore, changes in the gut microbiome can also influence the production of bile acids and other metabolites that directly affect cancer cells and their behavior. Moreover, bile acids have been shown to shape the microbiome and increase antibiotic resistance, underscoring the need for targeted interventions. This review provides a comprehensive overview of the intricate relationships between bile, the gut microbiome, and the TME, highlighting the mechanisms by which this interplay drives cancer progression and resistance to therapy. Understanding these complex interactions is crucial for developing novel therapeutic strategies that target the gut-bile-TME axis and improve patient outcomes.
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Saadh MJ, Ahmed HH, Chandra M, Al-Hussainy AF, Hamid JA, Mishra A, Taher WM, Alwan M, Jawad MJ, Al-Nuaimi AMA, Alsaikhan F, Farhood B, Akhavan-Sigari R. Therapeutic effects of quercetin in oral cancer therapy: a systematic review of preclinical evidence focused on oxidative damage, apoptosis and anti-metastasis. Cancer Cell Int 2025; 25:66. [PMID: 39994659 PMCID: PMC11854426 DOI: 10.1186/s12935-025-03694-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 02/13/2025] [Indexed: 02/26/2025] Open
Abstract
OBJECTIVE Oral malignancies are among the common head and neck cancers. Various therapeutic modalities are used for targeting oral cancers. It was shown that quercetin (a flavonoid) has an anti-cancer effect on different cancers. In the current study, the anti-cancer potentials of quercetin against oral cancer cells were summarized. METHODS The current systematic review was conducted in accordance with the PRISMA guideline for the identification of relevant studies in various electronic databases up to April 2023. After reviewing and screening 193 articles, 18 were chosen for this study based on our inclusion and exclusion criteria. RESULTS It was shown that quercetin significantly reduced cancer cell proliferation, cell viability, tumor volume, invasion, metastasis and migration. This anti-cancer agent induced oxidative stress and apoptosis in the cancer cells. Quercetin treatment could also induce some biochemical alterations in the cancer cells. CONCLUSION According to the results, it can be mentioned that quercetin administration has an anti-cancer effect against oral cancer cells. This agent exerts its anticancer effects via reduced cell viability and different mechanisms, including induce oxidative damage, apoptosis, and reduced invasion and metastasis. However, suggesting the use of quercetin as a therapeutic agent of oral cancer patients requires further clinical studies due to its poor absorption rates, and the exact molecular mechanisms are still not well understood.
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Shareef LG, Khalid SS, Raheem MF, Al-Hussainy AF, Al-Khayyat NS, Al Arajy AZ, Noori MM, Qasim MA, Jasim HH. Population-Level Interest in Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss Using Google Trends Statistics in a 12-Month Retrospective Analysis: An Infodemiology and Infoveillance Study. Cureus 2024; 16:e71569. [PMID: 39553073 PMCID: PMC11564366 DOI: 10.7759/cureus.71569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2024] [Indexed: 11/19/2024] Open
Abstract
Obesity is an exacerbated public health challenge, increasing the risk of several diseases and mortality while deteriorating the quality of life. There is significant dedication to exploring obesity therapies using glucagon-like peptide-1 (GLP-1) agonists, which have shown efficacy in reducing the number of deaths and complications associated with type 2 diabetes. This research aimed to examine the recent search popularity of GLP-1 agonists using Google Trends at both national (in Iraq) and global levels. To quantify relative search volume (RSV), the total search query activity has been transformed to a percentage scale ranging from 0% to 100%. The word "Ozempic" was chosen because of its extensive coverage in social media and web/print publications pertaining to this subject matter. A comparative search was performed targeting the phrases "Wegovy," "Saxenda," and "Mounjaro" to identify a novel combination GLP-1 agonist from August 2023 to August 2024. The present study demonstrated a statistically significant difference in the RSV among the four drugs (P < 0.0001) nationally and globally. In Iraq, the highest RSV for Ozempic was documented in Duhok, followed by Sulaymaniyah and Erbil. A comparable RSV profile has been noted for Saxenda, while substantial interest in Wegovy is seen in Ninawa. Meanwhile, globally, the highest RSV for Ozempic was recorded in Canada, the United States of America, and Australia. A distinct RSV profile has been observed for Saxenda, with heightened search interest recorded in Latin America, Poland, Sweden, and Australia. By contrast, Mounjaro received search interest primarily in Greenland and the United States, while Mounjaro search interest was noted in Canada, the United States, and Australia. This study demonstrates a significant and growing public interest in GLP-1 agonists, namely, Ozempic, Saxenda, Wegovy, and Mounjaro. As the use of GLP-1 agonists for weight loss becomes more common, more knowledge, understanding, and continuous scientific research will make it more convenient to obtain the best patient outcomes.
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Asadiof F, Zamanpour M, Al-Hussainy AF, Shalal AAAH, Ubaid M, Aluquaily ZH, Hashemian SH. Neurocognitive Deficits in Individuals at Ultra-High-Risk for Psychosis: An Overview of Systematic Reviews. IRANIAN JOURNAL OF PSYCHIATRY 2025; 20:111-125. [PMID: 40093530 PMCID: PMC11904743 DOI: 10.18502/ijps.v20i1.17405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Revised: 11/30/2024] [Accepted: 12/04/2024] [Indexed: 03/19/2025]
Abstract
Objective: Identifying individuals at ultra-high risk for psychosis (UHRP) is crucial for early intervention and prevention strategies. Neurocognitive deficits have been increasingly recognized as potential predictors of psychosis onset. This overview aims to consolidate current evidence and elucidate the role of neurocognitive predictors in identifying UHRP individuals. Method : we systematically searched three scientific databases, i.e., PubMed, Scopus, and Google Scholar using predefined keywords related to predictive neurocognitive markers and ultra-high risk psychosis. By following the PRISMA procedure, we included all relevant systematic-reviews and meta-analyses in our data-synthesis. Results: Neurocognitive deficits, including impairments in working memory, attentional control, verbal learning, and executive functions, have been consistently identified as predictors of psychosis conversion in individuals at UHRP. Structural and functional neuroimaging studies have further revealed aberrant brain connectivity, reduced gray matter volume, and altered neural activation patterns in key brain regions to be involved in psychosis. Moreover, the combination of neurocognitive and clinical risk factors has been shown to enhance the accuracy of predicting psychosis onset and inform personalized intervention strategies. Conclusion: Neurocognitive deficits serve as valuable predictors of the risk of psychosis in individuals with UHRP, offering insights into the underlying neurobiological mechanisms and potential targets for early intervention. Future research should focus on refining predictive models, elucidating the neurodevelopmental trajectories, and evaluating the efficacy of targeted interventions in mitigating the psychosis risk.
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Shareef LG, Fawzi Al-Hussainy A, Majeed Hameed S. COVID-19 vaccination hesitancy among Iraqi general population between beliefs and barriers: An observational study. F1000Res 2022; 11:334. [PMID: 35529280 PMCID: PMC9046899 DOI: 10.12688/f1000research.110545.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 08/18/2023] Open
Abstract
Background: Vaccine apprehension poses a serious threat to global health. While there has been a tremendous global effort to create a vaccine against coronavirus disease 2019 (COVID-19), little is known about its reception in Iraq. Therefore, we sought to examine COVID-19 vaccine acceptance, hesitation, and related elements in the Iraqi population. Methods: Between the 19th of May and the 22nd of September 2021, a descriptive, cross-sectional web-based survey was conducted employing a quantitative approach. Respondents from both sexes aged 18 years and above who live in Iraq and agreed to participate were included. An anonymized online structured questionnaire was designed based on data from prior research on vaccine hesitation in general, and COVID-19 vaccination reluctance specifically. Results: A total of 1221 eligible participants from various regions in Iraq actively participated in the short web-based questionnaire. The overall acceptance rate of the COVID-19 vaccine was 56.2%, with a greater acceptance rate among younger male participants (p<0.05). Marital status had no significant association (p=0.834). Urbanization influenced the acceptance rate significantly (p=0.002). The barriers to receiving the COVID-19 vaccine were exemplified by the vaccine not being evaluated for a sufficient period in 51.4% of the responses, as well as concerns about future side effects in 76.6% of the responses and a lack of efficacy in 55.7% of the responses. The Pfizer-BioNTech vaccine received 39.6% preference and participants confidence, followed by the Oxford/AstraZeneca vaccine at 18.1% and the Sinopharm vaccine at 14.6%. Conclusions: COVID-19 vaccination apprehension was discovered in almost half of the study population. Lack of understanding about vaccination eligibility, anxiety about adverse events and vaccine efficacy, and distrust in the government were independently predictive of vaccine hesitation.
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Li J, Ahmed HH, Hussein AM, Kaur M, Jameel MK, Kaur H, Tillaeva U, Al-Hussainy AF, Sameer HN, Hameed HG, Idan AH, Alsaikhan F, Narmani A, Farhood B. Advances in polysaccharide-based materials for biomedical and pharmaceutical applications: A comprehensive review. Arch Pharm (Weinheim) 2025; 358:e2400854. [PMID: 39651831 DOI: 10.1002/ardp.202400854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 11/14/2024] [Accepted: 11/18/2024] [Indexed: 12/18/2024]
Abstract
Polysaccharides, the most abundant biopolymers in nature, have attracted the attention of researchers and clinicians due to its practicality in biomedical and pharmaceutical sciences. These biomaterials have high bioavailability and play structural and functional roles in living organisms. Polysaccharides are classified into several groups based on their origin, including plant polysaccharides and marine polysaccharides (like chitosan, hyaluronic acid, dextran, alginates, etc.) with specific applications. These biopolymers possess unique physicochemical (such as surface functional groups, solubility, and stability), mechanical (like mechanical strength and tensile), and biomedical (such as antioxidant activity, biocompatibility, biodegradability, renewability, and non-immunogenicity) characteristics which have made them excellent platforms for a wide variety of biomedical and pharmaceutical applications. Ease of extraction and different preparation approaches are mentioned as other potential properties of polysaccharides that further improved their practicality in biomedical sciences. They have high drug/bioactive encapsulation capacity and sustained/controlled release manner in in vivo microenvironments. The anti-inflammatory and immunomodulation, stimuli-responsive drug/bioactive release, and passive and active drug/bioactive delivery are considered the potential features of these biopolymers in pharmaceutical sciences. Polysaccharides have indicated practical applications in biomedical sciences, including biosensors, tissue engineering, implantation, wound healing, vascular grafting, and vaccines. This review highlights the advances of polysaccharide-based materials in biomedical and pharmaceutical sciences.
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Saadh MJ, Hussein WS, Al-Hussainy AF, Bishoyi AK, Rekha MM, Kundlas M, Kavitha V, Aminov Z, Taher SG, Alwan M, Jawad M, Mushtaq H. Circular RNAs: driving forces behind chemoresistance and immune evasion in bladder cancer. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025:10.1007/s00210-025-04032-y. [PMID: 40131386 DOI: 10.1007/s00210-025-04032-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/08/2025] [Accepted: 03/06/2025] [Indexed: 03/27/2025]
Abstract
Bladder cancer (BCa) is characterized by recurring relapses and the emergence of chemoresistance, especially against standard treatments like cisplatin and gemcitabine. Despite its significance, the molecular mechanisms underlying chemoresistance in BCa remain elusive. Recent studies have revealed that circular RNAs (circRNAs) are pivotal regulators of cancer progression and chemoresistance. Through their function as miRNA sponges and protein sequesters, circRNAs modulate the expression of key genes, ultimately driving either drug resistance or sensitivity in BCa. The complex interplay between circRNAs and chemoresistance suggests that they may represent promising therapeutic targets for overcoming treatment resistance in patients with BCa. This review aims to summarize the current understanding of circRNAs' regulatory roles in chemoresistance and provide insights into their potential as therapeutic targets, particularly in the context of cisplatin and gemcitabine resistance. Furthermore, we explore how chemoresistance can also impact tumor immune evasion, thereby affecting the tumor microenvironment. Our findings may pave the way for the advancement of innovative treatment approaches for bladder cancer.
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Zairov RR, Syed A, Tawfiq MM, Al-Hussainy AF, Mansoor AS, Radi UK, Idan AH, Bahair H, Al-Shwaiman HA, Subramaniam M, Wong LS, Janani BJ, Sinyashin OG. Preparation of amorphous Nd/Dy-based metal organic framework@MXene for solar driven selective photocatalytic and serving as sensor for fluorescence quenching detection, and biological activity. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2025; 327:125406. [PMID: 39547150 DOI: 10.1016/j.saa.2024.125406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 10/20/2024] [Accepted: 11/05/2024] [Indexed: 11/17/2024]
Abstract
The development of a new Neodymium/Dysprosium metal-organic framework, referred to as Nd/Dy-BTC MOF, based on benzene-1,2,4-tricarboxylic acid, has been achieved through an in situ growth process on 2D transition metal carbides (MXene) surfaces. This synthesis was conducted via a solvothermal method utilizing a solvent mixture of water, ethanol, and dimethylformamide. The primary objective of this research is to investigate the framework's efficacy as a photocatalyst for the degradation of anionic dye, as well as its potential for sensing certain explosives. The Nd/Dy-MOF@MXene has been characterized by various analysis techniques. The prepared Nd/Dy-MOF@MXene was utilized as catalyst in selective degradation of methyl orange dye. The study examined the influence of pH and catalyst concentration, revealing that the catalyst achieves peak efficiency of 93.55% when exposed to sunlight in an acidic medium. The reusability of the catalyst shows the highest efficient photocatalyst after four cycles of reusability. The detection of explosives, specifically 2,4,6-trinitrophenol, through photoluminescence techniques has been conducted, utilizing the Stern-Volmer equation to evaluate the quenching efficiency. The findings indicated remarkable efficiency and selectivity of Nd/Dy-MOF@MXene for 2,4,6-trinitrophenol, achieving a quenching efficiency of 91%. Furthermore, the reusability tests demonstrated that Nd/Dy-MOF@MXene exhibits outstanding recyclability, maintaining performance over five cycles. The antibacterial activity of Nd/Dy-MOF@MXene was investigated against Gram-positive and Gram-negative strains due to indication of medicine properties of Nd/Dy-MOF@MXene. These results paves a way for manufacturing innnovation in near future.
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Vakilzadehian N, Moradi Y, Allela OQB, Al-Hussainy AF, Al-Nuaimi AMA, al-hussein RKA, Jawad MJ, Gandomkar H, Moradi S. Non-coding RNA in the Regulation of Gastric Cancer Tumorigenesis: Focus on microRNAs and Exosomal microRNAs. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2024; 13:417-435. [PMID: 39895920 PMCID: PMC11786126 DOI: 10.22088/ijmcm.bums.13.4.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Accepted: 10/13/2024] [Indexed: 02/04/2025]
Abstract
Gastric cancer has become the leading type of cancer on an international scale, with metastatic cancer being the leading cause of mortality associated with this illness. Consequently, methods for early detection have been established, mainly through the use of non-invasive biomarkers present in different bodily fluids. Exosomes are distinct extracellular vehicles that transport cellular signals over long distances via diverse contents. They may be readily seen in bodily fluids due to their secretion by gastric cancer cells or cells in the gastric cancer-tumor microenvironment. Given this context, multiple biological and functional features of human tumors, especially gastric cancer, are intricately connected to exosomal non-coding RNAs (ncRNAs). Exosomal microRNAs play a crucial role in several stages of gastric cancer progression, facilitating the transfer of genetic information between cancer cells and other cells. This process regulates tumor angiogenesis, growth, metastasis, immunological responses, and medication resistance. They engage with several regulatory complexes that have different enzymatic activities. These complexes then alter the chromatin landscapes, including changes to nucleosomes, DNA methylation, and alterations to histones. This research delves into the essential regulatory mechanisms of exosomes in gastric cancer. Furthermore, the existing understanding of the functions of exosomal miRNAs in this context was evaluated, aiming to confirm their potential significance in identifying biomarkers, elucidating their roles in immune evasion and drug resistance, and ultimately evaluating therapeutic strategies.
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