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Authors = Vittorio Morelli

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16 pages, 1665 KiB  
Article
Enhancing Doxorubicin Efficacy in Hepatocellular Carcinoma: The Multi-Target Role of Muscari comosum Extract
by Alessandro Pistone, Ilenia Matera, Vittorio Abruzzese, Maria Antonietta Castiglione Morelli, Martina Rosa and Angela Ostuni
Appl. Sci. 2025, 15(12), 6509; https://doi.org/10.3390/app15126509 - 10 Jun 2025
Viewed by 507
Abstract
Hepatocellular carcinoma (HCC) is still a leading cause of cancer-related mortality worldwide, characterized by poor prognosis and limited therapeutic efficacy of conventional chemotherapeutics such as doxorubicin. Phytochemicals are promising adjuvants in cancer therapy due to their multi-targeted effects. In this in vitro study, [...] Read more.
Hepatocellular carcinoma (HCC) is still a leading cause of cancer-related mortality worldwide, characterized by poor prognosis and limited therapeutic efficacy of conventional chemotherapeutics such as doxorubicin. Phytochemicals are promising adjuvants in cancer therapy due to their multi-targeted effects. In this in vitro study, we investigated the impact of a methanol–water extract (70:30 v/v, MET70) from Muscari comosum bulbs, rich in polyphenols and flavonoids, on doxorubicin-treated HepG2 human hepatoma cells. Co-treatment with MET70 increased intracellular reactive oxygen species (ROS) associated with downregulation of Nrf2 signaling, suppression of antioxidant enzymes (SOD2, GPX-1) and decreased mitochondrial UCP2 expression. MET70 modulated the inflammatory response induced by doxorubicin by decreasing TNF-α and increasing IL-6 expression. MET70 also promoted protein homeostasis through PDIA2 upregulation without exacerbating endoplasmic reticulum stress and inhibited autophagy by reducing Beclin-1 levels, contributing to increased chemosensitivity. Moreover, MET70 downregulated ABCC1 expression, suggesting a role in overcoming multidrug resistance. All these findings demonstrate that Muscari comosum extract enhances doxorubicin efficacy by targeting redox balance, inflammatory signaling, autophagy, and drug resistance, offering a promising redox-based strategy for improving HCC therapy. However, further studies should be performed in vivo. Full article
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15 pages, 370 KiB  
Review
Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)
by Marco Lorenzo Bonù, Andrea Georgopulos, Marco Ramera, Jacopo Andreuccetti, Andrea Emanuele Guerini, Anna Maria Bozzola, Vittorio Morelli, Jacopo Balduzzi, Mirsada Katica, Mariateresa Cefaratti, Lorenzo Granello, Luca Triggiani, Michela Buglione, Stefano Maria Magrini, Francesco Marampon, Michele Mondini, Silvana Parisi, Giorgia Timon, Luisa Bellu, Maria Rescigno, Stefano Arcangeli and Marta Scorsettiadd Show full author list remove Hide full author list
Curr. Issues Mol. Biol. 2025, 47(4), 265; https://doi.org/10.3390/cimb47040265 - 9 Apr 2025
Viewed by 722
Abstract
The impact of the microbiota on radiation (RT)-induced toxicity and cancer response to radiotherapy is an emerging area of interest. In this review, we summarize the available preclinical and clinical evidence concerning microbiota modulation of RT toxicity and efficacy in the main gastrointestinal [...] Read more.
The impact of the microbiota on radiation (RT)-induced toxicity and cancer response to radiotherapy is an emerging area of interest. In this review, we summarize the available preclinical and clinical evidence concerning microbiota modulation of RT toxicity and efficacy in the main gastrointestinal (GI) districts. A huge amount of data supports the clinical application of microbiota modulation, particularly through prebiotics and probiotics, to prevent or mitigate radiotherapy-induced toxicity in rectal cancer. Preclinical and clinical studies also support the observation of microbiota modulation to impact the toxicity and efficacy of treatment in esophageal cancer, hepatocellular carcinoma (HCC), and anal squamous cell carcinoma (ASCC). However, insufficient evidence remains to endorse microbiota modulation as a strategy to enhance tumor radiosensitivity in clinical practice. Well-designed studies focusing on prebiotics, probiotics, and fecal microbiota transplantation are needed across all GI sites to evaluate their potential to improve treatment efficacy, as suggested by promising preclinical findings. The impact of pre-treatment microbiota analyses should be addressed in prospective studies to verify the efficacy of patient-level tailored strategies. Additionally, the repurposing of radioprotective agents with innovative delivery systems, such as encapsulated amifostine, holds significant promise for mitigating small bowel toxicity, thereby enabling more effective RT treatment. Full article
(This article belongs to the Special Issue Understanding Cellular Radiation Responses for Radiation Therapy)
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18 pages, 5338 KiB  
Article
A Regulator Role for the ATP-Binding Cassette Subfamily C Member 6 Transporter in HepG2 Cells: Effect on the Dynamics of Cell–Cell and Cell–Matrix Interactions
by Ilenia Matera, Rocchina Miglionico, Vittorio Abruzzese, Giovanna Marchese, Giovanna Maria Ventola, Maria Antonietta Castiglione Morelli, Faustino Bisaccia and Angela Ostuni
Int. J. Mol. Sci. 2023, 24(22), 16391; https://doi.org/10.3390/ijms242216391 - 16 Nov 2023
Cited by 4 | Viewed by 2092
Abstract
There is growing evidence that various ATP-binding cassette (ABC) transporters contribute to the growth and development of tumors, but relatively little is known about how the ABC transporter family behaves in hepatocellular carcinoma (HCC), one of the most common cancers worldwide. Cellular model [...] Read more.
There is growing evidence that various ATP-binding cassette (ABC) transporters contribute to the growth and development of tumors, but relatively little is known about how the ABC transporter family behaves in hepatocellular carcinoma (HCC), one of the most common cancers worldwide. Cellular model studies have shown that ABCC6, which belongs to the ABC subfamily C (ABCC), plays a role in the cytoskeleton rearrangement and migration of HepG2 hepatocarcinoma cells, thus highlighting its role in cancer biology. Deep knowledge on the molecular mechanisms underlying the observed results could provide therapeutic insights into the tumors in which ABCC6 is modulated. In this study, differential expression levels of mRNA transcripts between ABCC6-silenced HepG2 and control groups were measured, and subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed. Real-Time PCR and Western blot analyses confirmed bioinformatics; functional studies support the molecular mechanisms underlying the observed effects. The results provide valuable information on the dysregulation of fundamental cellular processes, such as the focal adhesion pathway, which allowed us to obtain detailed information on the active role that the down-regulation of ABCC6 could play in the biology of liver tumors, as it is involved not only in cell migration but also in cell adhesion and invasion. Full article
(This article belongs to the Special Issue Purinergic Signalling in Physiology and Pathophysiology 2.0)
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12 pages, 808 KiB  
Systematic Review
Stereotactic Radiotherapy for Critically Located Pancreatic and Biliary Targets: A Review on Simultaneous Integrated Protection and Other Dose-Painting Strategies to Minimize Dose to Critical Organs at Risk
by Marco Lorenzo Bonù, Gloria Pedersoli, Jacopo Balduzzi, Mariateresa Cefaratti, Eneida Mataj, Gianluca Cossali, Lorenzo Granello, Navdeep Singh, Vittorio Morelli, Davide Tomasini, Francesco Frassine, Paola Vitali, Fabrizia Terraneo, Luca Triggiani, Michela Buglione and Stefano Maria Magrini
Radiation 2023, 3(2), 98-109; https://doi.org/10.3390/radiation3020009 - 16 May 2023
Cited by 3 | Viewed by 2596
Abstract
Background: Stereotactic Radiotherapy (SRT) in pancreatic and biliary tract cancer (PBC) suffers from proximity to any organ(s) at risk (OARs). Some strategies to manage this issue have previously been proposed, such as Simultaneous Integrated Protection (SIP), with the aim of maintaining a biological [...] Read more.
Background: Stereotactic Radiotherapy (SRT) in pancreatic and biliary tract cancer (PBC) suffers from proximity to any organ(s) at risk (OARs). Some strategies to manage this issue have previously been proposed, such as Simultaneous Integrated Protection (SIP), with the aim of maintaining a biological effective dose prescription while reducing toxicities. We performed a systematic review of the literature about SRT techniques applied in patients with tumor in proximity to OARs, with the aim of testing safety and efficacy. Methods: using PRISMA guidelines, we selected studies from a pool of more than 25,000 articles published from 2010 to 30 January 2023 that explored the use of SRT to deliver targeted treatment for PBC. We then selected the ones referring to decreases in prescription doses (for SRT only) in the area of overlap between planning target volume (PTV) and OARs. Local control (LC) and toxicities being detailed were exclusion criteria for articles. Results: 9 studies were included in our review, considering 368 patients. One-year LC probability ranges between 67% and 98.3% were reported. Late G3 toxicities ranged between 0% and 5.3%, while G4-G5 late toxicities were both reported as 0.3%. Conclusion: prioritizing critical OAR constraints limits severe toxicities while preserving LC in PBC SRT. Improving in-study reporting is essential to confirm these promising results. Full article
(This article belongs to the Topic Innovative Radiation Therapies)
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16 pages, 893 KiB  
Review
The Role of miRNA in the Management of Localized and Advanced Renal Masses, a Narrative Review of the Literature
by Luigi Napolitano, Luca Orecchia, Carlo Giulioni, Umberto Carbonara, Giovanni Tavella, Leonardo Lizzio, Deborah Fimognari, Antonio De Palma, Alberto Gheza, Antonio Andrea Grosso, Ugo Falagario, Stefano Parodi, Vittorio Fasulo, Federico Romantini, Giuseppe Rosiello, Silvia Viganò, Salvatore Rabito, Tommaso Ceccato, Mirko Pinelli, Graziano Felici, Francesco De Vita, Francesco Prata, Francesco Dibitetto, Matteo Tedde, Federico Piramide, Fabio Traunero, Mario De Michele, Michele Morelli, Pietro Piazza and Rocco Simone Flammiaadd Show full author list remove Hide full author list
Appl. Sci. 2023, 13(1), 275; https://doi.org/10.3390/app13010275 - 26 Dec 2022
Cited by 11 | Viewed by 2645
Abstract
Renal cell carcinoma (RCC) is the most common form of kidney cancer with 403,262 diagnoses and 170,000 deaths worldwide in 2018. Although partial or radical nephrectomy can be considered a successful treatment in early-stage or localized RCC, in advanced-stage disease, there is a [...] Read more.
Renal cell carcinoma (RCC) is the most common form of kidney cancer with 403,262 diagnoses and 170,000 deaths worldwide in 2018. Although partial or radical nephrectomy can be considered a successful treatment in early-stage or localized RCC, in advanced-stage disease, there is a high risk of metastasis or recurrence with a significantly poorer prognosis. Metastatic RCC is generally resistant to both chemotherapy and radiotherapy, and, despite several novel therapeutic agents, disease progression and mortality rates remain high. It is necessary to identify new diagnostic and therapeutic strategies for the management of this cancer. Knowledge of microRNA (miRNA) has consistently increased in the last year. miRNAs play an important role in several biological processes, such as cell proliferation, differentiation, and cell death. Due to this, miRNAs have been identified as an important key in different diseases, especially in cancer, and several studies show miRNAs as attractive tools and targets for novel therapeutic approaches. Recently several miRNAs (including miR-22, miR-203, miR-301 and miR-193a-3p) have been linked to dysregulated molecular pathways involved with the proliferation of cancerous cells and resistance to therapeutic agents. In the present study, recent data from studies assessing the application of miRNAs as biomarkers, therapeutic targets, or modulators of response to treatment modalities in RCC patients are analyzed. Full article
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12 pages, 1471 KiB  
Article
Sex-Related Differences in Oxidative, Platelet, and Vascular Function in Chronic Users of Heat-not-Burn vs. Traditional Combustion Cigarettes
by Leonardo Schirone, Lorenzo Loffredo, Roberto Carnevale, Simona Battaglia, Roberta Marti, Stefano Pizzolo, Simona Bartimoccia, Cristina Nocella, Vittoria Cammisotto, Wael Saade, Alessandra Tanzilli, Sebastiano Sciarretta, Isotta Chimenti, Elena De Falco, Elena Cavarretta, Vittorio Picchio, Mariangela Peruzzi, Antonino Marullo, Fabio Miraldi, Francesco Violi, Andrea Morelli, Giuseppe Biondi-Zoccai and Giacomo Fratiadd Show full author list remove Hide full author list
Antioxidants 2022, 11(7), 1237; https://doi.org/10.3390/antiox11071237 - 24 Jun 2022
Cited by 4 | Viewed by 2814
Abstract
Smoking is still a major cardiovascular risk factor, despite many public awareness campaigns and dedicated interventions. Recently, modified risk products (MRP), e.g., heat-not-burn cigarettes (HNBCs), have been introduced as surrogates of traditional combustion cigarettes (TCCs). Although these products are promoted as healthier than [...] Read more.
Smoking is still a major cardiovascular risk factor, despite many public awareness campaigns and dedicated interventions. Recently, modified risk products (MRP), e.g., heat-not-burn cigarettes (HNBCs), have been introduced as surrogates of traditional combustion cigarettes (TCCs). Although these products are promoted as healthier than TCCs, few studies have been conducted to assess it. This work is a sex-focused sub-study of a prospective observational study in which apparently healthy chronic TCC smokers were age-matched with regular HNBC users. Blood samples were collected for biochemical assays and blood pressure and flow-mediated dilation (FMD) were measured. Out of 60 subjects, 33 (55%) were women, and 27 (45%) men, with 11 (33%) vs. 9 (33%) non-smokers, respectively, 10 (30%) vs. 10 (37%) TCC smokers, and 12 (36%) vs. 8 (30%) HNBC smokers (p = 0.946). Bivariate and multivariable analyses showed no statistically significant between-sex differences in NO, H2O2, sCD40L, sNox2-dp, sP-selectin, platelet aggregation, cotinine or FMD, overall, in non-smokers, in TCC smokers, or in HNBC smokers (all p > 0.05). HNBCs appeared safer than TCCs when focusing on Nox2-dp (p = 0.026) and sP-selectin (p = 0.050) but had similar levels of the other measured markers. In conclusion, HNBCs have similar detrimental effects on women and men’s oxidative stress (H2O2: p = 0.49; sNox2-dp: p = 0.31) and platelet activation (sP-selectin: p = 0.33; platelet aggregation p = 0.87). Full article
(This article belongs to the Special Issue Cigarette Smoking: Associated Oxidative Stress and Health Hazards)
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12 pages, 3365 KiB  
Review
Structural and Functional Characterization of the ABCC6 Transporter in Hepatic Cells: Role on PXE, Cancer Therapy and Drug Resistance
by Faustino Bisaccia, Prashant Koshal, Vittorio Abruzzese, Maria Antonietta Castiglione Morelli and Angela Ostuni
Int. J. Mol. Sci. 2021, 22(6), 2858; https://doi.org/10.3390/ijms22062858 - 11 Mar 2021
Cited by 13 | Viewed by 4988
Abstract
Pseudoxanthoma elasticum (PXE) is a complex autosomal recessive disease caused by mutations of ABCC6 transporter and characterized by ectopic mineralization of soft connective tissues. Compared to the other ABC transporters, very few studies are available to explain the structural components and working of [...] Read more.
Pseudoxanthoma elasticum (PXE) is a complex autosomal recessive disease caused by mutations of ABCC6 transporter and characterized by ectopic mineralization of soft connective tissues. Compared to the other ABC transporters, very few studies are available to explain the structural components and working of a full ABCC6 transporter, which may provide some idea about its physiological role in humans. Some studies suggest that mutations of ABCC6 in the liver lead to a decrease in some circulating factor and indicate that PXE is a metabolic disease. It has been reported that ABCC6 mediates the efflux of ATP, which is hydrolyzed in PPi and AMP; in the extracellular milieu, PPi gives potent anti-mineralization effect, whereas AMP is hydrolyzed to Pi and adenosine which affects some cellular properties by modulating the purinergic pathway. Structural and functional studies have demonstrated that silencing or inhibition of ABCC6 with probenecid changed the expression of several genes and proteins such as NT5E and TNAP, as well as Lamin, and CDK1, which are involved in cell motility and cell cycle. Furthermore, a change in cytoskeleton rearrangement and decreased motility of HepG2 cells makes ABCC6 a potential target for anti-cancer therapy. Collectively, these findings suggested that ABCC6 transporter performs functions that modify both the external and internal compartments of the cells. Full article
(This article belongs to the Special Issue ABC Transporters in Human Diseases)
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20 pages, 11909 KiB  
Article
The Aryl Hydrocarbon Receptor Is Expressed in Thyroid Carcinoma and Appears to Mediate Epithelial-Mesenchymal-Transition
by Sonia Moretti, Nicole Nucci, Elisa Menicali, Silvia Morelli, Vittorio Bini, Renato Colella, Martina Mandarano, Angelo Sidoni and Efisio Puxeddu
Cancers 2020, 12(1), 145; https://doi.org/10.3390/cancers12010145 - 7 Jan 2020
Cited by 35 | Viewed by 4995
Abstract
Aryl hydrocarbon receptor (AhR) is expected to promote initiation, progression and invasion of cancer cells regulating proliferation, differentiation, gene expression, inflammation, cell motility and migration. Furthermore, an immunosuppressant function of AhR has been recognized. This study evaluated AhR expression and its role in [...] Read more.
Aryl hydrocarbon receptor (AhR) is expected to promote initiation, progression and invasion of cancer cells regulating proliferation, differentiation, gene expression, inflammation, cell motility and migration. Furthermore, an immunosuppressant function of AhR has been recognized. This study evaluated AhR expression and its role in thyroid cancer progression. AhR expression was assessed by qPCR in 107 thyroid cancer samples (90 PTCs, 11 MTCs, 6 ATCs), and by immunohistochemistry in 41 PTCs. To estimate receptor activation, the expression of target genes CYP1A1 and CYP1B1 was measured. AhR functional effects were evaluated in kynurenine-stimulated FTC-133 and BcPap cell lines by analyzing the expression of genes involved in EMT and cell motility. AhR mRNA expression resulted significantly higher in all the analyzed thyroid cancer samples compared to normal thyroid and a statistically significant correlation with CYP1B1 was detected. Kynurenine-stimulated FTC-133 and BcPap showed the activation of a specific AhR-driven EMT program characterized by E-cadherin decrease and SLUG, N-cadherin and fibronectin increase, resulting in boost of cell motility and invasion. This study confirmed the importance of the IDO1-Kyn-AhR pathway in thyroid cancer tumorigenesis, suggesting an AhR pivotal role in mediating an immunosuppressive microenvironment and favoring the acquisition of a mesenchymal phenotype that could promote invasiveness and metastasis. Full article
(This article belongs to the Special Issue Thyroid Cancer)
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13 pages, 2531 KiB  
Article
Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors
by Matteo Santoni, Daniel Y. Heng, Sergio Bracarda, Giuseppe Procopio, Michele Milella, Camillo Porta, Marc R. Matrana, Giacomo Cartenì, Simon J. Crabb, Ugo De Giorgi, Umberto Basso, Cristina Masini, Fabio Calabrò, Maria Giuseppa Vitale, Daniele Santini, Francesco Massari, Luca Galli, Giuseppe Fornarini, Riccardo Ricotta, Sebastiano Buti, Paolo Zucali, Orazio Caffo, Franco Morelli, Francesco Carrozza, Angelo Martignetti, Alain Gelibter, Roberto Iacovelli, Alessandra Mosca, Francesco Atzori, Nuno Vau, Lorena Incorvaia, Cinzia Ortega, Marina Scarpelli, Antonio Lopez-Beltran, Liang Cheng, Vittorio Paolucci, Jeffrey Graham, Erin Pierce, Sarah Scagliarini, Pierangela Sepe, Elena Verzoni, Sara Merler, Mimma Rizzo, Giulia Sorgentoni, Alessandro Conti, Francesco Piva, Alessia Cimadamore, Rodolfo Montironi and Nicola Battelliadd Show full author list remove Hide full author list
Cancers 2020, 12(1), 84; https://doi.org/10.3390/cancers12010084 - 30 Dec 2019
Cited by 24 | Viewed by 5519
Abstract
Cabozantinib is approved for the treatment of renal cell carcinoma (RCC). However, prognostic factors are still lacking in this context. The aim of this study was to evaluate prognostic factors in RCC patients treated with second- or third-line cabozantinib. A multicenter retrospective real-world [...] Read more.
Cabozantinib is approved for the treatment of renal cell carcinoma (RCC). However, prognostic factors are still lacking in this context. The aim of this study was to evaluate prognostic factors in RCC patients treated with second- or third-line cabozantinib. A multicenter retrospective real-world study was conducted, involving 32 worldwide centers. A total of 237 patients with histologically confirmed clear-cell and non-clear-cell RCC who received cabozantinib as second- or third-line therapy for metastatic disease were included. We analyzed overall survival (OS), progression-free survival (PFS) and time-to-strategy failure (TTSF) using Kaplan–Meier curves. Cox proportional models were used at univariate and multivariate analyses.The median PFS and OS of cabozantinib were 7.76 months (95% CI 6.51–10.88) and 11.57 months (95% CI 10.90–not reached (NR)) as second-line and 11.38 months (95% CI 5.79–NR) and NR (95% CI 11.51–NR) as third-line therapy. The median TTSF and OS were 11.57 and 15.52 months with the sequence of cabozantinib–nivolumab and 25.64 months and NR with nivolumab–cabozantinib, respectively. The difference between these two sequences was statistically significant only in good-risk patients. In the second-line setting, hemoglobin (Hb) levels (HR= 2.39; 95% CI 1.24–4.60, p = 0.009) and IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) group (HR = 1.72, 95% CI 1.04–2.87, p = 0.037) were associated with PFS while ECOG-PS (HR = 2.33; 95%CI, 1.16–4.69, p = 0.018) and Hb levels (HR = 3.12; 95%CI 1.18–8.26, p = 0.023) correlated with OS at multivariate analysis, while in the third-line setting, only Hb levels (HR = 2.72; 95%CI 1.04–7.09, p = 0.042) were associated with OS. Results are limited by the retrospective nature of the study.This real-world study provides evidence on the presence of prognostic factors in RCC patients receiving cabozantinib. Full article
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