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Balendra V, Rosenfeld R, Amoroso C, Castagnone C, Rossino MG, Garrone O, Ghidini M. Postbiotics as Adjuvant Therapy in Cancer Care. Nutrients 2024; 16:2400. [PMID: 39125280 PMCID: PMC11314502 DOI: 10.3390/nu16152400] [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: 06/04/2024] [Revised: 07/14/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
Postbiotics are defined as a preparation of inanimate microorganisms and/or their components that confers a health benefit to the host. They range from cell wall fragments to metabolites, bacterial lysates, extracellular vesicles, and short-chain fatty acids (SCFAs). Postbiotics may influence carcinogenesis via a variety of mechanisms. They can promote homeostatic immune responses, reduce inflammation, induce selective cytotoxicity against tumor cells, as well as the enabling the control of tumor cell proliferation and enhancing intestinal epithelial barrier function. Therefore, probiotics can serve as an adjunct strategy in anticancer treatment together with chemotherapy and immunotherapy. Up to now, the only relevant postbiotics used as interventions in oncological patients remain vitamin K molecules, with few phase-II and III trials available. In fact, postbiotics' levels are strictly dependent on the gut microbiota's composition, which may vary between individuals and can be altered under different physiological and pathological conditions. Therefore, the lack of consistent clinical evidence supporting postbiotics' efficacy is due to their poor bioavailability, short half-life, and fluctuating levels. Synbiotics, a mixture of prebiotics and probiotics, are expected to have a more homogeneous bioavailability with respect to postbiotics and may have greater potential for future development. In this review, we focus on the role of postbiotics as an adjuvant therapy in cancer treatment.
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Affiliation(s)
| | - Roberto Rosenfeld
- Oncology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (R.R.); (M.G.R.); (O.G.)
| | - Chiara Amoroso
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | | | - Maria Grazia Rossino
- Oncology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (R.R.); (M.G.R.); (O.G.)
| | - Ornella Garrone
- Oncology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (R.R.); (M.G.R.); (O.G.)
| | - Michele Ghidini
- Oncology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (R.R.); (M.G.R.); (O.G.)
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Perné MG, Sitar-Tăut AV, Orășan OH, Negrean V, Vlad CV, Alexescu TG, Milaciu MV, Ciumărnean L, Togănel RD, Petre GE, Șimon I, Crăciun A. The Usefulness of Vitamin K-Dependent Proteins in the Diagnosis of Colorectal Carcinoma. Int J Mol Sci 2024; 25:4997. [PMID: 38732222 PMCID: PMC11084444 DOI: 10.3390/ijms25094997] [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: 03/24/2024] [Revised: 04/22/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
Colorectal cancer (CRC) is one of the most common neoplasms in developed countries, with increasing incidence and mortality, even in young people. A variety of serum markers have been associated with CRC (CEA, CA 19-9), but neither should be used as a screening tool for the diagnosis or evolution staging of CRC. The sensitivity and specificity of these markers are not as good as is required, so new ones need to be found. Matrix Gla protein and PIVKA II are involved in carcinogenesis, but few studies have evaluated their usefulness in predicting the presence and severity of CRC. Two hundred patients were divided into three groups: 80 patients were included in the control group; 80 with CRC and without hepatic metastasis were included in Group 1; 40 patients with CRC and hepatic metastasis were included in Group 2. Vitamin K-dependent proteins (VKDPs) levels in plasma were determined. Patients with CRC without methastasis (Group 1) and CRC patients with methastasis (Group 2) presented significantly higher values of CEA, CA 19-9, PIVKA II (310.05 ± 38.22 vs. 430.13 ± 122.13 vs. 20.23 ± 10.90), and ucMGP (14,300.00 ± 2387.02 vs. 13,410.52 ± 2243.16 vs. 1780.31 ± 864.70) compared to control group (Group 0). Interestingly, Group 1 presented the greatest PIVKA II values. Out of all the markers, significant differences between the histological subgroups were found only for ucMGP, but only in non-metastatic CRC. Studying the discrimination capacity between the patients with CRC vs. those without, no significant differences were found between the classical tumor markers and the VKDP AUROC curves (PIVKA II and ucMGP AUROCs = 1). For the metastatic stage, the sensitivity and specificity of the VKDPs were lower in comparison with those of CA 19-9 and CEA, respectively (PIVKA II AUROC = 0.789, ucMGP AUROC = 0.608). The serum levels of these VKDPs are significantly altered in patients with colorectal carcinoma; it is possible to find additional value of these in the early stages of the disease.
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Affiliation(s)
- Mirela-Georgiana Perné
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Adela-Viviana Sitar-Tăut
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Olga Hilda Orășan
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Vasile Negrean
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Călin Vasile Vlad
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Teodora-Gabriela Alexescu
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Mircea Vasile Milaciu
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Lorena Ciumărnean
- 4th Department–Internal Medicine, 4th Medical Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Răzvan Dan Togănel
- 6th Department–Surgery, 4th Surgery Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Gabriel Emil Petre
- 6th Department–Surgery, 4th Surgery Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Ioan Șimon
- 6th Department–Surgery, 4th Surgery Discipline, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Republicii Street, Nr. 18, 400015 Cluj-Napoca, Romania
| | - Alexandra Crăciun
- 2nd Department–Molecular Sciences, Discipline of Medical Biochemistry, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Pasteur Street, Nr. 6, 400349 Cluj-Napoca, Romania
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Yan F, Eshak ES, Arafa A, Tamakoshi A, Iso H. Vitamin K Intake and Risk of Lung Cancer: The Japan Collaborative Cohort Study. J Epidemiol 2023; 33:536-542. [PMID: 35871570 PMCID: PMC10483107 DOI: 10.2188/jea.je20220063] [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: 03/07/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Limited reports from prospective human studies investigated the possible role of vitamin K in the development of lung cancer although vitamin K's anticarcinogenic activities were verified from several in vitro and in vivo studies. We investigated the associations between total vitamin K intake from food and the development of lung cancer based on this large prospective cohort study. METHODS A validated food frequency questionnaire was used to examine vitamin K intake among 42,166 (16,341 men and 25,825 women) at the Japan Collaborative Cohort Study's baseline (1988-1990). Hazard ratios (HRs) and 95% confidence intervals (CIs) of incident lung cancer were calculated using the Cox proportional hazard regression method based on vitamin K consumption quartiles. RESULTS 430 cases (308 males and 122 women) of lung cancer were documented during a total of 564,127 person-years of follow-up (median follow-up, 14.6 years). Vitamin K consumption was shown to be inversely related to lung cancer risk; the multivariable hazard ratio [HR] for the highest versus lowest quartiles was 0.67 (95% confidence interval [CI], 0.46-0.96; P for trend = 0.010). This relationship appears to be stronger in males (HR 0.62; 95% CI, 0.40-0.96; P for trend = 0.016) than in females (HR 0.82; 95% CI, 0.42-1.61; P for trend = 0.39) (P for interaction = 0.012), and in ever smokers (HR 0.57; 95% CI, 0.36-0.91; P for trend = 0.006) than in never smokers (HR 0.79; 95% CI, 0.40-1.55; P for trend = 0.37) (P for interaction = 0.30). The individuals' age, body mass index, or alcohol consumption status had no effect on the observed connection. CONCLUSION Vitamin K consumption reduces the risk of lung cancer. More research is needed to clarify the molecular processes behind this connection.
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Affiliation(s)
- Fangyu Yan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ehab S. Eshak
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Minia, Egypt
- Advanced Clinical Epidemiology, Medical Data Science, Osaka University Graduate School of Medicine, Osaka, Japan
- Public Health, School of Health, Calvin University, Michigan, USA
| | - Ahmed Arafa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Akiko Tamakoshi
- Department of Public Health, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - the JACC Study Group
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Minia, Egypt
- Advanced Clinical Epidemiology, Medical Data Science, Osaka University Graduate School of Medicine, Osaka, Japan
- Public Health, School of Health, Calvin University, Michigan, USA
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Department of Public Health, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Ziglioli F, Patera A, Isgrò G, Campobasso D, Guarino G, Maestroni U. Impact of modifiable lifestyle risk factors for prostate cancer prevention: a review of the literature. Front Oncol 2023; 13:1203791. [PMID: 37746271 PMCID: PMC10515617 DOI: 10.3389/fonc.2023.1203791] [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] [Received: 04/11/2023] [Accepted: 07/06/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Although prostate cancer (PCa) is one of the most common cancers among men, the impact of modifiable risk and protective factors is still being debated. This review aims to qualitatively summarize the most recent studies related to potential healthy lifestyle factors affecting the development of PCa. Methods for data acquisition The literature focusing on modifiable risk factors for prostate cancer was reviewed. Medline and Embase via the Ovid database were searched, and all relevant and inherent articles were analyzed. Non-eligible publications, such as review articles, editorials, comments, guidelines, or case reports, were excluded. Synthesis of the evidence obtained from data analysis This review confirms that there is strong evidence that being overweight or obese increases the risk of advanced prostate cancer (assessed by body mass index (BMI), waist circumference, and waist-hip ratio), particularly considering central adiposity and ethnicity as contributing factors. The possible contribution of smoking still seems not entirely clear, while alcohol seems to affect PCa prevention in patients taking 5α-reductase inhibitors (5-ARIs). Dietary fibers may have anti-inflammatory properties and improve insulin sensitivity by reducing IGF bioactivity. In particular, dietary fiber intake like insoluble and legume fibers may be inversely associated with prostate cancer risk. Also, hyperglycemia and hyperinsulinemia, with untreated diabetic fasting blood glucose levels, could be modifiable prostate cancer risk factors. In two studies, aspirin was associated with a lower risk of lethal PCa and overall mortality. Concerning the role of vitamins, despite conflicting and divergent results, serum retinol concentration seems to be associated with an increased risk of prostate cancer and high-grade prostate cancer. Some studies resulted in disagreement about the role of selenium and vitamin E. We found inconsistent and controversial findings about the association between vitamin D and prostate cancer risk. Conclusion Far from being conclusive evidence, our findings confirm some strong evidence already found in the previous literature and highlight the need to clarify the role of some risk factors whose role is not yet completely known. This effort would facilitate the cultural and social change that may allow the shift from the treatment of prostate cancer when diagnosed to the real efforts needed for systematic prevention.
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Affiliation(s)
| | - Annalisa Patera
- Department of Urology, University Hospital of Parma, Parma, Italy
| | - Gianmarco Isgrò
- Department of Urology, James Cook University Hospital, Middlesbrough, United Kingdom
| | | | - Giulio Guarino
- Department of Urology, University Hospital of Parma, Parma, Italy
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Role of Vitamin K in Selected Malignant Neoplasms in Women. Nutrients 2022; 14:nu14163401. [PMID: 36014904 PMCID: PMC9413298 DOI: 10.3390/nu14163401] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 12/13/2022] Open
Abstract
The main function of vitamin K in the human organism is its activity in the blood clotting cascade. Epidemiological studies suggest that reduced intake of vitamin K may contribute to an increased risk of geriatric diseases such as atherosclerosis, dementia, osteoporosis, and osteoarthritis. A growing number of studies also indicate that vitamin K may be involved not only in preventing the development of certain cancers but it may also support classical cancer chemotherapy. This review article summarizes the results of studies on the anticancer effects of vitamin K on selected female malignancies, i.e., breast, cervical, and ovarian cancer, published over the past 20 years. The promising effects of vitamin K on cancer cells observed so far indicate its great potential, but also the need for expansion of our knowledge in this area by conducting extensive research, including clinical trials.
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Afzal M, Kazmi I, Al-Abbasi FA, Alshehri S, Ghoneim MM, Imam SS, Nadeem MS, Al-Zahrani MH, Alzarea SI, Alquraini A. Current Overview on Therapeutic Potential of Vitamin D in Inflammatory Lung Diseases. Biomedicines 2021; 9:1843. [PMID: 34944659 PMCID: PMC8698997 DOI: 10.3390/biomedicines9121843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
Inflammatory lung disorders (ILDs) are one of the world's major reasons for fatalities and sickness, impacting millions of individuals of all ages and constituting a severe and pervasive health hazard. Asthma, lung cancer, bronchiectasis, pulmonary fibrosis acute respiratory distress syndrome, and COPD all include inflammation as a significant component. Microbe invasions, as well as the damage and even death of host cells, can cause and sustain inflammation. To counteract the negative consequences of irritants, the airways are equipped with cellular and host defense immunological systems that block the cellular entrance of these irritants or eliminate them from airway regions by triggering the immune system. Failure to activate the host defense system will trigger chronic inflammatory cataracts, leading to permanent lung damage. This damage makes the lungs more susceptible to various respiratory diseases. There are certain restrictions of the available therapy for lung illnesses. Vitamins are nutritional molecules that are required for optimal health but are not produced by the human body. Cholecalciferol (Vitamin D) is classified as a vitamin, although it is a hormone. Vitamin D is thought to perform a function in bone and calcium homeostasis. Recent research has found that vitamin D can perform a variety of cellular processes, including cellular proliferation; differentiation; wound repair; healing; and regulatory systems, such as the immune response, immunological, and inflammation. The actions of vitamin D on inflammatory cells are dissected in this review, as well as their clinical significance in respiratory illnesses.
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Affiliation(s)
- Muhammad Afzal
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka 72341, Saudi Arabia; (M.A.); (S.I.A.)
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Fahad A. Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.); (S.S.I.)
| | - Mohammed M. Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia;
| | - Syed Sarim Imam
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.); (S.S.I.)
| | - Muhammad Shahid Nadeem
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Maryam Hassan Al-Zahrani
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (F.A.A.-A.); (M.S.N.); (M.H.A.-Z.)
| | - Sami I. Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka 72341, Saudi Arabia; (M.A.); (S.I.A.)
| | - Ali Alquraini
- Department of Pharmaceutical Chemistry, Faculty of Clinical Pharmacy, Al Baha University, Al Baha 65779, Saudi Arabia;
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Wang K, Wu Q, Li Z, Reger MK, Xiong Y, Zhong G, Li Q, Zhang X, Li H, Foukakis T, Xiang T, Zhang J, Ren G. Vitamin K intake and breast cancer incidence and death: results from a prospective cohort study. Clin Nutr 2020; 40:3370-3378. [PMID: 33277073 DOI: 10.1016/j.clnu.2020.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/20/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Vitamin K prevents growth and metastasis of certain cancers, but there is little evidence regarding the association between dietary vitamin K and breast cancer incidence and death. We sought to examine whether intakes of total vitamin K, phylloquinone (vitamin K1) and menaquinones (MKs) (vitamin K2) may influence risks of breast cancer incidence and death in the US population. METHODS Herein, 2286 breast cancer cases and 207 breast cancer deaths were identified during 702,748 person-years of follow-up. Cox regression and competing risk regression were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by dietary vitamin K intake quintile (Q) for risk of breast cancer incidence and mortality. RESULTS After adjustment for confounders, the total MK intake was associated with an increased risk of breast cancer (HR Q5 vs Q1, 1.26; 95% CI, 1.05 to 1.52; Ptrend, 0.01) and death from breast cancer (HR Q5 vs Q1, 1.71; 95% CI, 0.97 to 3.01; Ptrend, 0.04). Non-linear positive dose-response associations with risks of breast cancer incidence and death were found for total MKs intake (Pnon-linearity<0.05). No statistically significant associations were observed between the intake of total vitamin K and phylloquinone and breast cancer. CONCLUSIONS The present study suggests that total MK intake was associated with an altered risk of the occurrence and death of breast cancer in the general US population. If our findings are replicated in other epidemiological studies, reducing dietary intake of menaquinones may offer a novel strategy for breast cancer prevention.
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Affiliation(s)
- Kang Wang
- Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China; Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Oncology-Pathology, Karolinska Institutet, 17164, Stockholm, Sweden
| | - Qianxue Wu
- Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China
| | - Zhuyue Li
- West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Michael K Reger
- College of Health Professions Ferris State University, 200 Ferris Drive, VFS 300B, Big Rapids, MI, 49307, USA
| | - Yongfu Xiong
- The First Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637007, China
| | - Guochao Zhong
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Li
- Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China
| | - Xiang Zhang
- Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China
| | - Hongyuan Li
- Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China
| | - Theodoros Foukakis
- Department of Oncology-Pathology, Karolinska Institutet, 17164, Stockholm, Sweden; Breast Center, Theme Cancer, Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Tingxiu Xiang
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Jianjun Zhang
- Department of Epidemiology, Fairbanks School of Public Health Melvin and Bren Simon Comprehensive Cancer Center Indiana University, 1050 Wishard Boulevard, RG5118, Indianapolis, IN, 46202, USA.
| | - Guosheng Ren
- Department of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China; Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Kucera R, Pecen L, Topolcan O, Dahal AR, Costigliola V, Giordano FA, Golubnitschaja O. Prostate cancer management: long-term beliefs, epidemic developments in the early twenty-first century and 3PM dimensional solutions. EPMA J 2020; 11:399-418. [PMID: 32843909 PMCID: PMC7429585 DOI: 10.1007/s13167-020-00214-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 12/20/2022]
Abstract
In the early twenty-first century, societies around the world are facing the paradoxal epidemic development of PCa as a non-communicable disease. PCa is the most frequently diagnosed cancer for men in several countries such as the USA. Permanently improving diagnostics and treatments in the PCa management causes an impressive divergence between, on one hand, permanently increasing numbers of diagnosed PCa cases and, on the other hand, stable or even slightly decreasing mortality rates. Still, aspects listed below are waiting for innovate solutions in the context of predictive approaches, targeted prevention and personalisation of medical care (PPPM / 3PM).A.PCa belongs to the cancer types with the highest incidence worldwide. Corresponding economic burden is enormous. Moreover, the costs of treating PCa are currently increasing more quickly than those of any other cancer. Implementing individualised patient profiles and adapted treatment algorithms would make currently too heterogeneous landscape of PCa treatment costs more transparent providing clear "road map" for the cost saving.B.PCa is a systemic multi-factorial disease. Consequently, predictive diagnostics by liquid biopsy analysis is instrumental for the disease prediction, targeted prevention and curative treatments at early stages.C.The incidence of metastasising PCa is rapidly increasing particularly in younger populations. Exemplified by trends observed in the USA, prognosis is that the annual burden will increase by over 40% in 2025. To this end, one of the evident deficits is the reactive character of medical services currently provided to populations. Innovative screening programmes might be useful to identify persons in suboptimal health conditions before the clinical onset of metastasising PCa. Strong predisposition to systemic hypoxic conditions and ischemic lesions (e.g. characteristic for individuals with Flammer syndrome phenotype) and low-grade inflammation might be indicative for specific phenotyping and genotyping in metastasising PCa screening and disease management. Predictive liquid biopsy tests for CTC enumeration and their molecular characterisation are considered to be useful for secondary prevention of metastatic disease in PCa patients.D.Particular rapidly increasing PCa incidence rates are characteristic for adolescents and young adults aged 15-40 years. Patients with early onset prostate cancer pose unique challenges; multi-factorial risks for these trends are proposed. Consequently, multi-level diagnostics including phenotyping and multi-omics are considered to be the most appropriate tool for the risk assessment, prediction and prognosis. Accumulating evidence suggests that early onset prostate cancer is a distinct phenotype from both aetiological and clinical perspectives deserving particular attention from view point of 3P medical approaches.
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Affiliation(s)
- Radek Kucera
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine, Pilsen, Czech Republic
| | - Ladislav Pecen
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine, Pilsen, Czech Republic
| | - Ondrej Topolcan
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine, Pilsen, Czech Republic
| | - Anshu Raj Dahal
- Center of Molecular Biotechnology, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | | | - Frank A. Giordano
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
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