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Search Results (2,907)

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Keywords = multifactorial diseases

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3 pages, 185 KB  
Editorial
Special Issue “Atherosclerosis: From Molecular Biology to Therapeutic Perspective: 6th Edition”
by Ida Perrotta
Int. J. Mol. Sci. 2026, 27(13), 5806; https://doi.org/10.3390/ijms27135806 (registering DOI) - 26 Jun 2026
Abstract
Atherosclerosis remains a leading cause of morbidity and mortality worldwide, representing a complex and multifactorial disease at the intersection of aging, metabolism, inflammation, and environmental exposures.[...] Full article
25 pages, 4951 KB  
Review
Updated Understanding of Endocrine-Disrupting Substances Involved in the Obesity Epidemic and Their Associated Etiopathogenetic Mechanisms
by Codruța Claudia Gherman Lencu, Cezara Andreea Gerdanovics, Mirela Georgiana Perne, Mircea Vasile Milaciu, Cristian Mureșanu, Geanina Maria Bud, Alexandru Gerdanovics and Teodora Gabriela Alexescu
Biomedicines 2026, 14(7), 1455; https://doi.org/10.3390/biomedicines14071455 (registering DOI) - 26 Jun 2026
Abstract
Purpose: Obesity is a chronic multifactorial disease whose increasing prevalence cannot be fully explained by excessive caloric intake and sedentary behaviour alone. This review aimed to synthesize current evidence on the role of endocrine-disrupting chemicals (EDCs), particularly obesogenic EDCs, as potential environmental contributors [...] Read more.
Purpose: Obesity is a chronic multifactorial disease whose increasing prevalence cannot be fully explained by excessive caloric intake and sedentary behaviour alone. This review aimed to synthesize current evidence on the role of endocrine-disrupting chemicals (EDCs), particularly obesogenic EDCs, as potential environmental contributors to obesity-related phenotypes, with emphasis on their main classes, etiopathogenetic mechanisms and clinical implications. Methods: A structured literature analysis was conducted using PubMed, Web of Science and additional relevant scientific reports and governmental publications. Eligible sources included original research articles, systematic reviews, meta-analyses and authoritative reports addressing endocrine disruption, obesogens, obesity, metabolic dysfunction and related molecular mechanisms. Results: The review identified several major classes of obesogenic EDCs, including organotins, bisphenols, phthalates and persistent organic pollutants. These compounds have been linked to obesity-related phenotypes through overlapping mechanisms, including disruption of adipogenesis via estrogen receptor-dependent and independent pathways, PPARγ/RXR activation, altered adipokine signalling, neuroendocrine dysregulation across developmental stages, oxidative stress and pro-inflammatory activation, genetic and epigenetic alterations, gut microbiota-mediated effects and impaired thermoregulation through brown and beige adipose tissue dysfunction. EDC-associated obesity may contribute to metabolic, endocrine, cardiovascular, hepatic and reproductive complications. Conclusion: Obesogenic EDCs should be regarded as environmental contributors to obesity that act through interconnected molecular, cellular and systemic pathways. Their biological effects support the need for further mechanistic and epidemiological research, preventive strategies, public education and regulatory measures aimed at reducing exposure. Full article
(This article belongs to the Special Issue Obesity and Obesity-Related Pathology)
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42 pages, 9359 KB  
Article
Synthesis and Anticancer Activity of New Quinazolin-4(3H)-one Derivatives: Identification of a Tumor-Selective Anticancer Agent with Potential Inhibition of TGF-βRI (ALK5)
by Nahed N. E. El-Sayed, Sami A. Al-Hussain, Marwa A. Ibrahim, Mohamed R. Elnagar, Zainab M. Almarhoon and Magdi E. A. Zaki
Pharmaceuticals 2026, 19(7), 996; https://doi.org/10.3390/ph19070996 (registering DOI) - 26 Jun 2026
Abstract
Background/Objectives: Cancer is a multifactorial disease in which drug resistance and limited selectivity remain major therapeutic challenges, highlighting the need for novel anticancer agents. As a privileged scaffold for multitarget anticancer drug discovery, quinazolin-4(3H)-one was selected for the design, synthesis, [...] Read more.
Background/Objectives: Cancer is a multifactorial disease in which drug resistance and limited selectivity remain major therapeutic challenges, highlighting the need for novel anticancer agents. As a privileged scaffold for multitarget anticancer drug discovery, quinazolin-4(3H)-one was selected for the design, synthesis, and evaluation of new derivatives as potential anticancer agents, together with investigation of their mechanisms of action and molecular targets. Methods: Fifteen new quinazolin-4(3H)-one derivatives were synthesized and screened using the NCI-60 human cancer cell line panel. The mechanism of action of the most active compound was investigated through cell cycle, apoptosis, and RT-qPCR analyses. A potential molecular target was identified from transcriptomic data in the Human Protein Atlas, focusing on highly expressed cancer-implicated genes in the most responsive cell lines, followed by molecular docking, molecular dynamics simulations, and in vitro kinase studies. Safety and pharmacokinetic properties were evaluated using an MTT cytotoxicity assay in normal WI-38 fibroblasts and in silico ADME analyses. Results: Compound 3e emerged as the most active and tumor-selective derivative, exhibiting GI50 values ranging from 2.63 to 17.12 µM across 31 cancer cell lines. In A549 cells, selected as a representative responsive model, 3e (GI50 = 10.8 µM, 72 h) induced G2/M cell-cycle arrest (59.58% vs. 26.96% in control), increased early apoptosis (43.94% vs. 0.11% in control), reduced viable cells (49.71% vs. 98.66%), elevated the Bax/Bcl-2 ratio (7.91), and upregulated the expression of caspase-9 and caspase-3 by 2.5- and 4.6-fold, respectively. Integrated target identification studies and an in vitro kinase assay (IC50 = 21.34 nM) suggested TGF-βRI (ALK5) as a plausible molecular target. Compound 3e also showed low cytotoxicity toward WI-38 fibroblasts (IC50 = 88.3 µM) and favorable predicted pharmacokinetic properties; nevertheless, high plasma protein binding and potential CYP2C9 inhibition are anticipated. Conclusions: Compound 3e is a promising tumor-selective anticancer lead with potential TGF-βRI inhibitory activity. Its antiproliferative effects in A549 cells appear to be mediated through G2/M cell-cycle arrest and activation of the intrinsic apoptotic pathway, supporting further development and pharmacokinetic optimization of this scaffold for anticancer therapy. Full article
(This article belongs to the Section Medicinal Chemistry)
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17 pages, 1492 KB  
Review
The Impact of Climate-Driven Heat Stress on Bovine Mastitis: A Review of the Po Valley Dairy System
by Mario Baratta, Paolo Accornero, Silvia Miretti and Eugenio Martignani
Vet. Sci. 2026, 13(7), 623; https://doi.org/10.3390/vetsci13070623 (registering DOI) - 26 Jun 2026
Abstract
This review examines the relationship between climate-driven heat stress (HS) and bovine mastitis in the Po Valley, a key European dairy region characterized by intensive production systems and increasing climatic vulnerability. It aims to contextualize how rising temperature–humidity index (THI) levels influence animal [...] Read more.
This review examines the relationship between climate-driven heat stress (HS) and bovine mastitis in the Po Valley, a key European dairy region characterized by intensive production systems and increasing climatic vulnerability. It aims to contextualize how rising temperature–humidity index (THI) levels influence animal health and productivity. This study synthesizes the current literature on biometeorological conditions, epidemiological trends, and physiological mechanisms linking HS to mastitis. Evidence indicates that prolonged exposure to elevated THI impairs thermoregulation, disrupts endocrine and metabolic balance, and weakens immune function, thereby increasing susceptibility to intramammary infections. Epidemiological data reveal a clear seasonal pattern, with mastitis incidence peaking during summer months and a growing predominance of environmental pathogens. Additionally, HS negatively affects milk yield and quality, amplifying economic losses in dairy systems. The findings highlight that mastitis in this context is not merely an infectious disease but a multifactorial condition shaped by environmental, physiological, and management factors. Overall, this review underscores the need for integrated mitigation strategies, including improved housing, nutrition, genetic selection, and precision monitoring, to enhance resilience. In the face of ongoing climate change, adapting dairy production systems will be essential to safeguard animal welfare, maintain productivity, and ensure the long-term sustainability of the Po Valley dairy sector. Full article
(This article belongs to the Special Issue Mastitis in Dairy Animals)
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18 pages, 285 KB  
Article
Retrospective Evaluation of Anesthetic–Analgesic Protocols in Cats with and Without Transient Myocardial Thickening Following Gonadectomy
by Claire Pollak and Laura J Ruys
Animals 2026, 16(13), 1979; https://doi.org/10.3390/ani16131979 (registering DOI) - 26 Jun 2026
Abstract
Transient myocardial thickening (TMT) is considered a reversible feline cardiac disease that initially mimics hypertrophic cardiomyopathy. The exact etiopathogenesis remains unknown and is likely multifactorial. General anesthesia and surgery may contribute to the development of TMT in predisposed patients due to systemic inflammation, [...] Read more.
Transient myocardial thickening (TMT) is considered a reversible feline cardiac disease that initially mimics hypertrophic cardiomyopathy. The exact etiopathogenesis remains unknown and is likely multifactorial. General anesthesia and surgery may contribute to the development of TMT in predisposed patients due to systemic inflammation, perioperative stress, surgery itself, anesthetic management, and individual susceptibility. Additionally, inadequate analgesia could result in pain, which triggers a stress response. This stress response could stimulate endogenous catecholamine release and facilitate the development of TMT. In this retrospective study, anesthetic and analgesic protocols were compared between cats with and without TMT following gonadectomy. The study group consisted of 15 cats that presented with congestive heart failure after recent anesthesia and were later suspected of or diagnosed with TMT. The control group consisted of 300 cats without TMT after gonadectomy. All cats were considered healthy prior to gonadectomy based on physical examination; no echocardiography was performed prior to anesthesia. All cats in the TMT group were anesthetized with ketamine and an alpha-2 agonist, which was medetomidine in 14/15 (93.3%) and dexmedetomidine in 1/15 (6.7%) of the cats. In the control group, all cats were anesthetized with ketamine and dexmedetomidine. The ketamine dose was significantly higher (p < 0.001) in the TMT group compared to the control group, with a median dose of 6.78 mg/kg (4.52–10.34) and 4.29 mg/kg (2.08–6.45), respectively. The doses of the alpha-2 agonist and atipamezole were not significantly different. The most commonly administered non-steroidal anti-inflammatory drug was meloxicam in 83.3% of the study group cats and 98.7% of the control group cats. The dose of meloxicam was significantly lower (p < 0.001) in the study group compared to the control group, with median doses of 0.2 mg/kg (0–0.3) and 0.29 mg/kg (0–0.38), respectively. In the control group, 93.0% of the cats received buprenorphine, and 75.0% of males received intratesticular lidocaine. None of the cats in the study group received buprenorphine or intratesticular lidocaine during the procedure. Additionally, oxygen supplementation was significantly different (p < 0.017), and lack of oxygen was associated with the development of TMT. Anesthetic protocols between the two groups were significantly different. However, it is important to note that not all observed complications can solely be attributed to anesthetic or analgesic differences; effects might also be due to different perioperative circumstances. Full article
(This article belongs to the Section Companion Animals)
29 pages, 1351 KB  
Review
Curcumin in Alzheimer’s Disease: From Mechanistic Insights to Translational Challenges and Emerging Curcuminoid Strategies
by Katarzyna Stępnik
Int. J. Mol. Sci. 2026, 27(13), 5754; https://doi.org/10.3390/ijms27135754 - 25 Jun 2026
Abstract
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder driven by complex interactions between protein aggregation, oxidative stress, neuroinflammation, and cellular dysfunction. Among plant-derived compounds, curcumin has emerged as one of the most extensively studied polyphenols due to its broad spectrum of biological activities. [...] Read more.
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder driven by complex interactions between protein aggregation, oxidative stress, neuroinflammation, and cellular dysfunction. Among plant-derived compounds, curcumin has emerged as one of the most extensively studied polyphenols due to its broad spectrum of biological activities. This review provides a critical synthesis of the mechanistic, preclinical, and clinical evidence on curcumin in AD. Experimental studies consistently demonstrate that curcumin modulates key pathogenic processes, including neuroinflammatory signaling, oxidative stress, and amyloid-β aggregation, with more limited evidence for effects on tau pathology. While in vitro studies offer detailed mechanistic insights, in vivo models provide more integrated evidence, including improvements in cognitive performance and reductions in pathological markers. Despite this strong preclinical foundation, the clinical evidence remains limited and inconsistent. Randomized controlled trials have not demonstrated clear therapeutic efficacy, with outcomes strongly influenced by formulation, bioavailability, and study design. Poor solubility, rapid metabolism, and limited brain exposure remain key translational barriers. In response, increasing attention has been directed toward formulation strategies and structurally related compounds. Emerging curcuminoids, such as bisdemethoxycurcumin (BDMC), are discussed as potential next-generation candidates. Preliminary evidence suggests that BDMC may modulate oxidative stress, autophagy, astrocyte senescence, and amyloid-related processes, although the data remain largely preclinical. Overall, curcumin represents a mechanistically rich and preclinically promising multi-target compound but with unresolved translational limitations. Future research should prioritize pharmacokinetic optimization, formulation-dependent validation, and exploration of novel curcuminoid strategies to bridge the gap between experimental findings and clinical application in AD. Full article
16 pages, 19018 KB  
Article
Neuroprotective Potential of Synaptamide in MPTP-Induced Parkinson’s Disease
by Igor Manzhulo, Yuliya Kipryushina, Ekaterina Gromova, Olga Manzhulo, Elena Milkina and Darya Ivashkevich
Pathophysiology 2026, 33(3), 42; https://doi.org/10.3390/pathophysiology33030042 - 25 Jun 2026
Abstract
Background/Objectives. Parkinson’s disease (PD) is a multifactorial neurodegenerative disorder characterized by dopaminergic neuron loss, α-synuclein pathology, neuroinflammation, and cognitive decline. Synaptamide (N-Docosahexaenoylethanolamine (DHEA)) is an endogenous lipid mediator with documented anti-inflammatory and neurogenic properties, but its effects in PD models remain unexplored. This [...] Read more.
Background/Objectives. Parkinson’s disease (PD) is a multifactorial neurodegenerative disorder characterized by dopaminergic neuron loss, α-synuclein pathology, neuroinflammation, and cognitive decline. Synaptamide (N-Docosahexaenoylethanolamine (DHEA)) is an endogenous lipid mediator with documented anti-inflammatory and neurogenic properties, but its effects in PD models remain unexplored. This study aimed to evaluate the neuroprotective potential of synaptamide in a subchronic MPTP-induced mouse model of PD. Methods. Male C57BL/6 mice received MPTP (30 mg/kg/day, i.p., 5 days) with or without synaptamide (10 mg/kg/day, s.c., 13 days). Behavioral tests (open field, Y-maze, elevated plus maze, novel object recognition (NOR)) were performed, followed by immunohistochemical analysis of tyrosine hydroxylase (TH)-positive neurons in the substantia nigra, and Western blotting for α-synuclein, p-α-synuclein, TH, and IL1β in brain homogenates and serum. In vitro Neuro-2a cells were co-treated with MPP+ (100 µM) and synaptamide (0.1–10 µM) for cytotoxicity assessment (MTS assay). Results. Synaptamide (10 µM) significantly attenuated MPP+-induced cytotoxicity in Neuro-2a cells. In vivo, MPTP caused a marked loss of TH+-neurons in the substantia nigra, which was prevented by synaptamide treatment. Importantly, this subchronic MPTP model recapitulates early biochemical alterations (e.g., α-synuclein phosphorylation at Ser129) rather than mature Lewy body pathology, a limitation that should be considered when interpreting these findings. Although no motor deficits or anxiety-like behavior were observed, the NOR test revealed MPTP-induced long-term memory impairment, which was fully restored by synaptamide. Conclusions. These findings suggest that synaptamide may exert effects on pathological processes associated with PD, warranting further investigation into its potential role in combination or supportive therapy for this disease. Full article
(This article belongs to the Section Neurodegenerative Disorders)
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37 pages, 2665 KB  
Review
Omega-3 Fatty Acids and Alzheimer’s Disease: Toward a New Understanding of Neuroprotective Mechanisms and Intervention Strategies
by Giacoma Galizzi
Mar. Drugs 2026, 24(7), 224; https://doi.org/10.3390/md24070224 - 25 Jun 2026
Abstract
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder characterized by amyloid-β (Aβ) deposition, tau hyperphosphorylation, neuroinflammation, mitochondrial dysfunction, and oxidative stress. Despite recent advances, current therapies offer little benefit, and AD remains a significant challenge. Polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) [...] Read more.
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder characterized by amyloid-β (Aβ) deposition, tau hyperphosphorylation, neuroinflammation, mitochondrial dysfunction, and oxidative stress. Despite recent advances, current therapies offer little benefit, and AD remains a significant challenge. Polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have attracted attention for their neuroprotective effects primarily through anti-inflammatory and antioxidant properties, but also for their ability to influence membrane fluidity and neuronal function. DHA is the predominant omega-3 PUFA in nerve cell membranes and is critical for synaptic plasticity and cognitive function. Some evidence has demonstrated that marine omega-3 supplementation reduces Aβ deposition, modulates microglial activation, and prevents cognitive decline in animal models. Even with heterogeneous results, preclinical and clinical studies suggest that long-term DHA/EPA supplementation can improve cognitive function in subjects with mild cognitive impairment (MCI) and reduce neuroinflammation markers. However, individual variability and brain bioavailability pose significant challenges. This review summarizes and discusses the current knowledge on the importance of PUFAs for human health, exploring novel mechanistic hypotheses, such as the effect of omega-3 fatty acids on brain iron homeostasis, the microbiota–gut–brain axis, the glymphatic system, and miRNAs. Furthermore, it focuses on the therapeutic potential of PUFAs in the treatment of AD and proposes future directions for translational research. Full article
(This article belongs to the Special Issue Marine-Derived Novel Drugs in the Treatment of Alzheimer’s Disease)
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20 pages, 884 KB  
Review
The Role of Polyunsaturated Fatty Acids (PUFAs) in the Primary Prevention of Allergic Diseases in Children: A Position Paper of the SIAIP Primary and Secondary Prevention of Allergic Diseases and Nutraceuticals Committees
by Angela Klain, Cristiana Indolfi, Giorgio Ciprandi, Alberto Martelli, Francesco Paolo Brunese, Salvatore Cascone, Valentina Cattivera, Lorenzo Cresta, Giulio Dinardo, Cecilia Fabiano, Filippo Favuzza, Francesca Galletta, Carolina Grella, Amelia Licari, Sara Manti, Antonio Andrea Senatore, Irene Schiavetti, Chiara Trincianti, Michele Miraglia del Giudice and Gianluigi Marseglia
Nutrients 2026, 18(13), 2072; https://doi.org/10.3390/nu18132072 - 24 Jun 2026
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Abstract
Background: Type 2 inflammatory diseases are among the most common chronic inflammatory conditions in childhood and represent a growing global health burden. Increasing evidence suggests that early-life nutritional exposures may influence immune programming and allergic disease development. This Position Paper aims to summarize [...] Read more.
Background: Type 2 inflammatory diseases are among the most common chronic inflammatory conditions in childhood and represent a growing global health burden. Increasing evidence suggests that early-life nutritional exposures may influence immune programming and allergic disease development. This Position Paper aims to summarize the current evidence regarding the immunomodulatory role of polyunsaturated fatty acids (PUFAs), particularly omega-3 long-chain fatty acids, in the prevention of allergic diseases during early life. Methods: A scoping literature review and consensus process were conducted to map biological mechanisms and clinical evidence linking omega-3 PUFAs with allergic disease prevention. This document analyzed experimental, observational, and randomized controlled studies evaluating maternal prenatal/lactational omega-3 exposure. The clinical evidence was qualitatively appraised using study-design-specific Joanna Briggs Institute (JBI) Critical Appraisal Tools. Particular attention was given to immune modulation, inflammatory pathways, epithelial barrier function, gut microbiota interactions, and the ferroptosis–immune–metabolic axis. Results: Omega-3 PUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), exert immunomodulatory and anti-inflammatory effects through multiple mechanisms, including specialized pro-resolving mediator production, regulation of T-helper cell responses, cytokine modulation, maintenance of epithelial barrier integrity, and microbiota interaction. Emerging evidence also supports their involvement in oxidative stress and ferroptosis regulation. Current clinical evidence, particularly from higher-quality prenatal randomized trials and evidence syntheses, suggests that adequate maternal omega-3 intake during pregnancy and lactation may reduce the risk of respiratory allergic outcomes, especially wheezing and asthma, in selected offspring. Conclusions: Adequate omega-3 PUFA intake, such as 2 g/die, during critical windows of immune maturation may represent a valuable strategy for the primary prevention of allergic diseases. Current evidence most strongly supports supplementation during pregnancy and lactation, particularly in populations with low dietary omega-3 intake or increased allergic risk. Omega-3 supplementation should be considered within a broader multifactorial preventive approach aimed at promoting immune tolerance and reducing the future burden of allergic diseases. Full article
(This article belongs to the Section Pediatric Nutrition)
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17 pages, 2129 KB  
Article
Exploratory LC-MS/MS-Based Proteomic and Lipidomic Profiling of Plasma Samples from Premature Coronary Artery Disease Patients: A Pilot Study in a South Asian Population
by Iftikhar Ali Ch, Zahid Hasan, Zongkai Peng, Kamrul Islam, Amit Singh, Anayat Yousuf, Mohamed S. Aborahma, Ayan S. Zubair, Ali A. Rizvi, Nouraldeen Refai, Mohammad Omer Rana, Azhar A. Chaudhry, Fazal Jalil, Yasir Ali, Waseem Iqbal, Yusra Javed, Mishal Zehra, Tayyab Adeel Afzal, Ankur Kalra, Khurram Nasir, C Michael Gibson, Zhibo Yang and Nagib Ahsanadd Show full author list remove Hide full author list
Int. J. Mol. Sci. 2026, 27(13), 5684; https://doi.org/10.3390/ijms27135684 - 24 Jun 2026
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Abstract
Premature coronary artery disease (PCAD) is a growing public health concern, especially in South Asia, where traditional risk factors fail to fully explain the increasing incidence of early-onset myocardial infarction. To explore its molecular underpinnings, we conducted a pilot study analyzing plasma proteins [...] Read more.
Premature coronary artery disease (PCAD) is a growing public health concern, especially in South Asia, where traditional risk factors fail to fully explain the increasing incidence of early-onset myocardial infarction. To explore its molecular underpinnings, we conducted a pilot study analyzing plasma proteins and lipids to identify potential biomarkers and dysregulated pathways associated with PCAD. Label-free quantitative proteomics revealed distinct molecular signatures separating PCAD patients from age- and sex-matched healthy controls. Key alterations included upregulation of GALE, immunoglobulin genes, and KIF20B, suggesting enhanced inflammatory responses and proliferative activity associated with post-myocardial infarction cellular repair. Similarly, down regulations of various proteins linked to multiple functions, such as myocardial infarction, hemoglobinopathy, complement and coagulation cascade, and fatty acid and lipoprotein transport in hepatocytes, were observed. Untargeted lipidomics further revealed significant elevations in several phosphatidylcholine species (PC 42:5, PC 40:3, and PC 42:7), highlighting disruption of highly unsaturated phospholipid metabolism. Overall, these findings indicate that PCAD is a multifactorial disorder involving metabolic, immune, and vascular dysfunction beyond conventional lipid abnormalities, underscoring the need for larger cohort studies to validate these biomarkers and uncover novel therapeutic targets. Full article
(This article belongs to the Special Issue Multi-Omics Platforms for Comprehensive Biological Insights)
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17 pages, 882 KB  
Review
Aldosterone in Diabetic Kidney Disease: From Mineralocorticoid Receptor Antagonism to Aldosterone Synthase Inhibition
by Juarez R. Braga, Joseph H. Holthoff, Luis A. Juncos, Ramakrishna Thotakura and Fatima Ayub
Int. J. Mol. Sci. 2026, 27(13), 5664; https://doi.org/10.3390/ijms27135664 - 23 Jun 2026
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Abstract
Diabetic kidney disease (DKD) represents the single most common etiology of chronic kidney disease and end stage kidney disease globally, a burden that continues to expand in direct proportion to the worldwide growth of the diabetes epidemic. The pathogenesis of DKD is multifactorial, [...] Read more.
Diabetic kidney disease (DKD) represents the single most common etiology of chronic kidney disease and end stage kidney disease globally, a burden that continues to expand in direct proportion to the worldwide growth of the diabetes epidemic. The pathogenesis of DKD is multifactorial, involving metabolic, hemodynamic, inflammatory, and fibrotic pathways. Among these, aldosterone has emerged as a key mediator of kidney injury, extending beyond its traditional role in sodium balance and blood pressure regulation. Through activation of both MR-dependent transcriptional processes and MR-independent signaling cascades, aldosterone drives a coordinated pattern of renal injury encompassing oxidative stress generation, endothelial dysfunction, podocyte damage, inflammatory cell recruitment, and progressive interstitial fibrosis. Current therapies targeting the renin–angiotensin–aldosterone system (RAAS), including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor antagonists, have significantly improved outcomes in DKD. Despite these advances, a considerable degree of residual cardiovascular and renal risk persists, attributable in part to the incomplete attenuation of aldosterone activity and the well-characterized phenomenon of aldosterone escape under sustained RAAS blockade. Aldosterone synthase inhibitors (ASIs) represent a mechanistically distinct therapeutic approach that targets aldosterone overproduction at its enzymatic source, potentially addressing both MR-dependent and independent pathways. Early clinical trials evaluating the efficacy of ASIs have demonstrated promising effects on blood pressure and albuminuria. This review summarizes the role of aldosterone in DKD pathogenesis, evaluates current therapeutic approaches, and discusses emerging evidence supporting ASIs as a potential addition to the evolving treatment landscape. Full article
23 pages, 435 KB  
Review
Obesity and Dental Caries: A State-of-the-Art Review of Shared Risk Factors, Biological Mechanisms and Current Evidence
by Inês Amaro, Anabela Paula, Ana Coelho, Carlos Miguel Marto, Mafalda Laranjo, Susana Alarico, Dírcea Rodrigues, Bárbara Oliveiros and Eunice Carrilho
Med. Sci. 2026, 14(3), 336; https://doi.org/10.3390/medsci14030336 - 23 Jun 2026
Viewed by 385
Abstract
Obesity and dental caries are highly prevalent chronic conditions with significant global health impact. Although an association between these diseases has been suggested, the nature of this relationship remains unclear. This state-of-the-art review aims to synthesize current evidence on the interplay between obesity [...] Read more.
Obesity and dental caries are highly prevalent chronic conditions with significant global health impact. Although an association between these diseases has been suggested, the nature of this relationship remains unclear. This state-of-the-art review aims to synthesize current evidence on the interplay between obesity and dental caries, focusing on shared risk factors, salivary alterations and underlying biological mechanisms. Evidence indicates that obesity and dental caries share common behavioral and socioeconomic determinants, namely unhealthy dietary patterns with high intake of free sugars, poor oral hygiene habits and social disadvantage. Salivary alterations observed in obesity may also create a more cariogenic oral environment. Additionally, inflammatory mediators, oxidative stress markers and changes in the oral microbiome suggest biologically plausible links between both conditions. However, current data does not support a direct causal relationship, but rather a complex multifactorial interaction between obesity and dental caries driven by shared risk factors and modifiable behaviors. Preventive strategies should adopt an integrated approach targeting shared determinants, particularly diet, oral hygiene habits and socioeconomic status. Nevertheless, the predominance of cross-sectional evidence limits causal inference, highlighting the need for longitudinal studies that simultaneously assess obesity and dental caries, and that address salivary biomarkers using standardized methodologies across different age groups to clarify underlying mechanisms and assess their clinical relevance. Full article
(This article belongs to the Special Issue Obesity, Meta-Inflammation and Non-Communicable Disease Pathogenesis)
33 pages, 4245 KB  
Review
Phytochemistry, Bioavailability, and Molecular Mechanisms Underlying Multitarget Anticancer Activity of Aloe vera
by Nimra Haroon, Adnan Amjad, Muhammad Maaz, Ahmad Mujtaba Noman, Nimra Anees, Zafarullah Muhammad, Mohibullah Shah and Waleed Al Abdulmonem
Nutrients 2026, 18(12), 2034; https://doi.org/10.3390/nu18122034 - 22 Jun 2026
Viewed by 316
Abstract
Background/Objectives: Cancer, a multifactorial disease with uncontrolled cell growth, oxidative stress, inflammation, genomic instability, and molecular signaling pathways, is a global health concern, leading to the ~20 million newly diagnosed cases annually. Although conventional therapy has been shown to enhance the survival [...] Read more.
Background/Objectives: Cancer, a multifactorial disease with uncontrolled cell growth, oxidative stress, inflammation, genomic instability, and molecular signaling pathways, is a global health concern, leading to the ~20 million newly diagnosed cases annually. Although conventional therapy has been shown to enhance the survival rates of cancer patients, its clinical efficacy is limited by certain side effects that occur as a result of treatment, thus necessitating the exploration of plant-derived bioactive compounds for their potential as safer and alternative supportive therapeutic agents. Aloe vera, known as the plant of immortality, comprises phytochemicals, such as anthraquinones (aloe-emodin, emodin, and aloin), polysaccharides (acemannan), flavonoids, and phenolic acids, which contribute to the pharmacological effect of the compound. Methods: This review summarizes the anticancer potential of Aloe vera, and the data were retrieved from databases, such as PubMed, Google Scholar, ScienceDirect, Web of Science, and Wiley Online Library, during the time period of 2015 to 2025. Results: The literature revealed that Aloe vera and its bioactive compounds have dose-dependent cytotoxic and anti-proliferative properties against hepatocellular, cervical, colorectal, lung, breast, prostate, and hematological cancers, which are significantly mediated by apoptosis and pyroptosis induction, reactive oxygen species (ROS) production, mitochondrial dysfunction, inhibition of angiogenesis and metastasis, and the modulation of key signaling pathways, particularly PI3K/Akt, MAPK, NF-кB, p53, and Wnt/β-catenin. Furthermore, anthraquinones, including Aloe-emodin, demonstrate potent anticancer effects at micro-molar doses, and polysaccharides increase immune reactions and provide tumor immunity. Conclusions: Conclusively, Aloe vera is a promising multi-target natural compound, particularly efficient in the treatment of cancer. However, despite significant therapeutic potential, more research on pharmacokinetics, standard dose, and controlled clinical trials of Aloe vera is required to validate clinical applicability. Full article
(This article belongs to the Section Phytochemicals and Human Health)
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30 pages, 511 KB  
Review
Beyond the Intestinal Mucosa in Long-Standing Inflammatory Bowel Disease: Consequences of Chronic Inflammation and Endoscopic Approaches to Diagnosis and Management
by Sabina Gabriela Luca, Oana Cristina Petrea, Cristina Muzica, Ana Maria Singeap, Ana Maria Buzuleac, Adriana Dunca, Alexandru Sebastian Cotleț, Simona Stefania Juncu and Anca Trifan
Medicina 2026, 62(6), 1208; https://doi.org/10.3390/medicina62061208 - 22 Jun 2026
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Abstract
Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC), chronic immune-mediated conditions of the gastrointestinal tract characterized by alternating periods of disease activity and remission with a complex multifactorial pathogenesis. Persistent intestinal inflammation in IBD is a key driver of [...] Read more.
Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC), chronic immune-mediated conditions of the gastrointestinal tract characterized by alternating periods of disease activity and remission with a complex multifactorial pathogenesis. Persistent intestinal inflammation in IBD is a key driver of disease progression and is strongly associated with the development of complications such as dysplasia, colorectal cancer (CRC), intestinal strictures, and fistulas. It may also result in changes in anorectal function, identifiable and classifiable using high-resolution anorectal manometry. Histologic and endoscopic assessments are essential for the evaluation of intestinal inflammation. Cumulative inflammatory burden (CIB) is an important concept that quantifies inflammatory exposure in IBD over time by integrating the severity and duration of histologic inflammation across the disease course, highlighting the importance of long-term inflammatory activity in the development of CRC. Histologic healing may be an important therapeutic target in IBD to reduce the risk of long-term complications. In parallel, emerging precision medicine approaches aim to improve risk stratification and enable early, individualized interventions to reduce disease-related outcomes. Endoscopy also plays a fundamental role in monitoring high-risk patients and guiding treatment decisions. This review aims to characterize the main intestinal complications extending beyond the mucosa that are associated with cumulative chronic inflammation in patients with IBD, including dysplasia, CRC, strictures, fistulas, and anorectal dysfunction in an era increasingly focused on achieving complete mucosal healing. Particular attention is drawn to the significant role of persistent histologic and endoscopic inflammation in disease progression and development of complications, highlighting the specific features and associated risk factors of these disease-related outcomes. Throughout, this review emphasizes the fundamental role of endoscopy in the timely detection, monitoring, and therapeutic management of IBD-related complications, thereby reinforcing its role in comprehensive patient care. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Treatment of Inflammatory Bowel Disease (IBD))
30 pages, 4590 KB  
Review
Building Disease Models for Endometriosis: iPSCs as Game-Changers
by Khalisa H. Kahar, Bushra E-Anjum, Fazlina Nordin, Angela Min Hwei Ng, Nor Haslinda Abd Aziz, Izyan Mohd Idris, Gee Jun Tye and Wan Safwani Wan Kamarul Zaman
Int. J. Mol. Sci. 2026, 27(12), 5614; https://doi.org/10.3390/ijms27125614 - 22 Jun 2026
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Abstract
This review aims to evaluate the potential of endometriosis models, especially patient-derived iPSC models, to gain deeper insights into the disease, thereby advancing our understanding and treatment of endometriosis. This comprehensive narrative review utilized a structured search of the PubMed, Scopus, and Web [...] Read more.
This review aims to evaluate the potential of endometriosis models, especially patient-derived iPSC models, to gain deeper insights into the disease, thereby advancing our understanding and treatment of endometriosis. This comprehensive narrative review utilized a structured search of the PubMed, Scopus, and Web of Science databases, primarily covering literature published between January 2000 and May 2025. An expansive search strategy was employed to capture the full breadth of the field using keywords such as “endometriosis,” “induced pluripotent stem cells (iPSCs),” “patient-derived organoids,” “disease modeling,” and “epigenetics” without restrictive filtering, ensuring the integration of both foundational theories and emerging biotechnological advances. In total, over 170 peer-reviewed publications were analyzed, ranging from landmark genomic meta-analyses that have identified significant risk loci to state-of-the-art 3D-culture systems for modeling patient-specific endometrial disease. By synthesizing these diverse sources, the review bridges the gap between traditional anatomical classifications and modern molecular modeling to evaluate the potential of iPSC platforms for personalized medicine and therapeutic discovery. Endometriosis is a multifactorial gynecological condition that affects 176 million women worldwide and can significantly impair quality of life. It occurs when endometrium-like tissue grows outside the uterus, responsive to ovarian hormones, causing inflammation, pain, and discomfort, and leading to fibrotic tissue. World Health Organization estimates indicate that 6–10% of women suffer from this disorder, which can cause infertility and increase the risk of developing various types of cancer and autoimmune disorders. The use of patient-derived iPSC models serves to gain deeper insights into the disease by mimicking the endometrial tissue or lesions observed in affected individuals, thereby advancing our understanding and treatment of endometriosis. Full article
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