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AziziKia H, Teymourzadeh A, Kouchaki H, Nakhostin-Ansari A, Jafari Doudaran P, Ahmadinejad I, Hoveidaei A, Roshandel G. Colorectal Cancer Incidence in Iran Based on Sex, Age, and Geographical Regions: A Study of 2014-2017 and Projected Rates to 2025. Arch Iran Med 2024; 27:174-182. [PMID: 38685843 PMCID: PMC11097305 DOI: 10.34172/aim.2024.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 02/19/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND While there has been extensive research on colorectal cancer (CRC) incidence and its associated factors in Iran, a significant gap exists in studies predicting its future trends. Our study aimed to thoroughly report CRC incidence across Iran from 2014 to 2017, by sex, age, and geographical regions, and provide a projection for 2025. METHODS This retrospective study utilized data from the Iranian National Population-based Cancer Registry (INPCR). Patients with the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3) codes C18 to C21 were included. The age-standardized incidence rate (ASR), was calculated per 100000 individuals annually, and crude incidence rates were retrieved for various demographic groups and years. RESULTS Between 2014 and 2017, a total of 43580 new CRC cases (55.96% males) were registered. Men exhibited an ASR of 134.45, while women's ASR was 94.85. The highest ASRs were observed in Tehran, Qom, and Ilam (18.99, 18.26, and 18.06, respectively). Incidence rates surpassed 20 after age 50 for both genders, reaching their peak within the 80-84 age group. Adenocarcinoma was the most frequent histological type of CRC in nearly all provinces. Case numbers and ASRs are projected to continuously rise until 2025, with a predominance of male cases. CONCLUSION The anticipated increase in CRC incidence in Iran emphasizes the need for additional studies to better identify risk factors. Furthermore, implementing screening programs is recommended for individuals at a higher risk of CRC, including men, the elderly population, and those residing in regions with a notable prevalence of CRC.
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Affiliation(s)
- Hani AziziKia
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Azin Teymourzadeh
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Kouchaki
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Armin Hoveidaei
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ghafouri M, Ghasemi E, Rostami M, Rouhifard M, Rezaei N, Nasserinejad M, Danandeh K, Nakhostin-Ansari A, Ghanbari A, Borghei A, Ahmadzadeh Amiri A, Teymourzadeh A, Taylor JB, Moghadam N, Kordi R. The quality of care index for low back pain: a systematic analysis of the global burden of disease study 1990-2017. Arch Public Health 2023; 81:167. [PMID: 37700341 PMCID: PMC10496194 DOI: 10.1186/s13690-023-01183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND . Low back pain is one of the major causes of morbidity worldwide. Studies on low back pain quality of care are limited. This study aimed to evaluate the quality of care of low back pain worldwide and compare gender, age, and socioeconomic groups. METHODS . This study used GBD data from 1990 to 2017 from the Institute for Health Metrics and Evaluation (IHME) website. Extracted data included low back pain incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs). DALYs to prevalence ratio and prevalence to incidence ratio were calculated and used in the principal component analysis (PCA) to make a proxy of the quality-of-care index (QCI). Age groups, genders, and countries with different socioeconomic statuses regarding low back pain care quality from 1990 to 2017 were compared. RESULTS The proxy of QCI showed a slight decrease from 36.44 in 1990 to 35.20 in 2017. High- and upper-middle-income countries showed a decrease in the quality of care from 43.17 to 41.57 and from 36.37 to 36.00, respectively, from 1990 to 2017. On the other hand, low and low-middle-income countries improved, from a proxy of QCI of 20.99 to 27.89 and 27.74 to 29.36, respectively. CONCLUSION . Despite improvements in the quality of care for low back pain in low and lower-middle-income countries between 1990 and 2017, there is still a large gap between these countries and higher-income countries. Continued steps must be taken to reduce healthcare barriers in these countries.
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Affiliation(s)
- Mohammad Ghafouri
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Rostami
- Spine Center of Excellence, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Rouhifard
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khashayar Danandeh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Borghei
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA
| | - Ali Ahmadzadeh Amiri
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Teymourzadeh
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Jeffrey B Taylor
- Department of Physical Therapy, High Point University, 833 Montlieu Ave., High Point, NC, 27262, USA
| | - Navid Moghadam
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Spine Center of Excellence, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Spine Center of Excellence, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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AziziKia H, Didar H, Teymourzadeh A, Nakhostin-Ansari A, Jafari Doudaran P, Ferasatifar B, Hoveidaei A, Roshandel G. Uterine and Cervical Cancer in Iran: An epidemiologic analysis of the Iranian National Population-Based Cancer Registry. Arch Iran Med 2023; 26:1-7. [PMID: 37543915 PMCID: PMC10685806 DOI: 10.34172/aim.2023.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/27/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND Gynecologic cancers, including neoplasms of the cervix and uterine, are the fourth most common malignancies, causing 3.46% of deaths in women aged 15 to 59. OBJECTIVES We aimed to report the Iranian National Population-based Cancer Registry (INPCR) results for Cervical and Uterine cancers in 2017. METHODS The total population of Iran in 2017 was 80881792. INPCR collected data on cervical and uterine cancer incidence from 31 provinces of Iran. In this project, we retrospectively examined all the country's regions in terms of screening for the existence of these two cancers. The registry data bank in Iran was used. RESULTS Overall, 3481 new cervical and uterine cancer cases were registered in INPCR, including 842 cases of cervical cancer (with a crude rate of 1.04) and 2639 cases of uterine cancer (with a crude rate of 3.26). The average age-standardized incidence rate (ASR) was 0.99 for cervical cancer and 3.29 for uterine cancer. Out of 3481 new cervical and uterine cancer cases, 2887 were registered with pathological findings and 594 without pathological confirmation. In cervical cancers, the highest rate was related to squamous cell carcinoma, with 486 cases (57.72%). CONCLUSION Our results showed that Iran is a low-risk area for the incidence of cervical and uterine cancers. In this study, the highest rate of cervical cancer was related to squamous cell carcinoma, confirming previous reports. However, this rate was lower than previous studies and suggested an increase in other types of cervical cancer in Iran.
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Affiliation(s)
- Hani AziziKia
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamidreza Didar
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azin Teymourzadeh
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bahareh Ferasatifar
- Department of Chemistry, Iran University of Science and Technology, Tehran, Iran
| | - Armin Hoveidaei
- BSc in Radiotherapy Technology, Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
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Nakhostin-Ansari A, Zimet GD, Khonji MS, Aghajani F, Teymourzadeh A, Rastegar Kazerooni AA, Pirayandeh P, Aghajani R, Safari S, Khalaj K, Memari AH. Acceptance or Rejection of the COVID-19 Vaccine: A Study on Iranian People's Opinions toward the COVID-19 Vaccine. Vaccines (Basel) 2022; 10:vaccines10050670. [PMID: 35632426 PMCID: PMC9143028 DOI: 10.3390/vaccines10050670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023] Open
Abstract
We aimed to assess the Iranian people’s attitude and confidence in the COVID-19 vaccine, their concerns about the safety of vaccines, and their reasons for accepting or rejecting the COVID-19 vaccine. We conducted a web-based cross-sectional study with a mixed qualitative−quantitative approach from December 2020 to February 2021. Our questionnaire consisted of a COVID-19 vaccine attitude questionnaire, a COVID-19 vaccine confidence inventory, a modified vaccine safety scale, and questions about participants’ decision to accept or refuse the COVID-19 vaccine, and their explanations for their decisions. The research included 1928 people with an average age of 34.88 years with 1236 (64.1%) being female. A total of 1330 participants desired to have the COVID-19 vaccine (69%). Female gender, lower educational levels, following COVID-19 news through sources other than websites and social media, not following COVID-19 news, and loss of a first-degree relative due to COVID-19 were all associated with a more negative attitude toward the COVID-19 vaccine (p < 0.01). To conclude, the acceptance rate of the COVID-19 vaccine among Iranians is comparable to the international average; however, it is still unfavorable. There are serious challenges to the vaccination program in Iran, such as older adults’ lower intention to undergo the COVID-19 vaccine and misinformation.
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Affiliation(s)
- Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1417613151, Iran;
| | - Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Mohammad Saeid Khonji
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (M.S.K.); (A.T.); (R.A.); (K.K.)
| | - Faezeh Aghajani
- Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran 1417613151, Iran;
| | - Azin Teymourzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (M.S.K.); (A.T.); (R.A.); (K.K.)
| | | | - Pendar Pirayandeh
- School of Medicine, Tonekabon Islamic Azad University, Mazandaran 4684161167, Iran;
| | - Reyhaneh Aghajani
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (M.S.K.); (A.T.); (R.A.); (K.K.)
| | - Sepideh Safari
- School of Medicine, Islamic Azad University, Tehran 1949635881, Iran;
| | - Kamand Khalaj
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (M.S.K.); (A.T.); (R.A.); (K.K.)
| | - Amir Hossein Memari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1417613151, Iran;
- Correspondence: ; Tel.: +98-92-1575-2817; Fax: +98-21-8800-3539
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Ghafouri M, Teymourzadeh A, Nakhostin-Ansari A, Sepanlou SG, Dalvand S, Moradpour F, Bavarsad AH, Boogar SS, Dehghan M, Ostadrahimi A, Aghazadeh-Attari J, Kahnooji M, Hosseinipour A, Gohari A, Hosseini SV, Mirzaei M, Khorram A, Shahmoradi M, Pourfarzi F, Moosazadeh M, Mansour-Ghanaei F, Marioryad H, Najafi F, Genevay S, Moghadam N, Kordi R. Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study. Ann Med Surg (Lond) 2022; 74:103243. [PMID: 35145656 PMCID: PMC8801351 DOI: 10.1016/j.amsu.2022.103243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 12/19/2022] Open
Abstract
Background and objectives Low back pain (LBP) is a common health condition in populations. Limited large-scale population-based studies evaluated the prevalence and predictors of LBP in developing countries. This study aimed to evaluate the prevalence and factors associated with LBP among the Iranian population. Methods We used baseline information from the Prospective Epidemiological Research Studies in Iran (PERSIAN), including individuals from 16 provinces of Iran. LBP was defined as the history of back pain interfering with daily activities for more than one week during an individual's lifetime. Various factors hypothesized to affect LBP, such as age, sex, marital status, educational status, ethnicity, living area, employment status, history of smoking, body mass index (BMI), physical activity, sleep duration, wealth score, history of joint pain, and history of morning stiffness in the joints were evaluated. Results In total, 163770 Iranians with a mean age of 49.37 (SD = 9.15) were included in this study, 44.8% of whom were male. The prevalence of LBP was 25.2% among participants. After adjusting for confounders, the female gender [OR:1.244(1.02–1.50)], middle and older ages [OR:1.23(1.10–1.33) and OR:1.13(1.07–1.42), respectively], being overweight or obese [OR:1.13(1.07–1.19) and OR:1.21(1.16–1.27), respectively], former and current smokers (OR:1.25(1.16–1.36) and OR:1.28(1.17–1.39), respectively], low physical activity [OR:1.07(1.01–1.14)], and short sleep duration [OR: 1.09(1.02–1.17)] were significantly associated with LBP. Conclusion In this large-scale study, we found the lifetime prevalence of LBP to be lower among the Iranian population in comparison to the global prevalence of LBP; further studies are warranted to evaluate the causality of risk factors on LBP. The lifetime prevalence of low back pain in the Iranian population is 25.2%. Our survey includes 163770 people from 16 Iranian provinces. We used PERSIAN Cohort data which is the largest study conducted in Iran population. For analysis, we used both unadjusted and adjusted logistic regression models.
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Affiliation(s)
- Mohammad Ghafouri
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Teymourzadeh
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf G. Sepanlou
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Dalvand
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | | | - Morteza Dehghan
- Department of Orthopedics, School of Medicine, And Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Aghazadeh-Attari
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahmood Kahnooji
- Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Hosseinipour
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Gohari
- Department of Clinical Biochemistry and Nutrition, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Masoud Mirzaei
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Khorram
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehdi Shahmoradi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Stephane Genevay
- Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Navid Moghadam
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author.
| | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Toosi R, Teymourzadeh A, Mahmoudi H, Balighi K, Daneshpazhooh M. Correlation of anti-γ/ε nicotinic acetylcholine receptor antibody levels with anti-desmoglein 1,3 antibody levels and disease severity in pemphigus vulgaris. Clin Exp Dermatol 2021; 46:1230-1235. [PMID: 33713456 DOI: 10.1111/ced.14645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/29/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND A role for nondesmoglein antigens in the pathogenesis of pemphigus vulgaris (PV) has been suggested in several studies. Acetylcholine receptors (AchR), are one of the most important groups of these antigens. However, the exact role of both antimuscarinic (m) and nicotinic (n) AchR antibodies (Abs) is still controversial. AIM To evaluate anti-desmoglein (Dsg)1, Dsg 3 and anti-γ/ε nAchR Abs values in patients with PV before and 3 months after rituximab (RTX) treatment, and to assess their correlation with disease severity. METHODS In total, 75 patients with PV (26 men, 49 women) who were planned to receive RTX were enrolled. Disease activity was assessed by using the Pemphigus Disease Area Index (PDAI). Using ELISA, anti-Dsg1,3 and anti-γ/ε nAchR Abs were determined at baseline and 3 months after RTX treatment. RESULTS At baseline, 53.33% patients had positive values for anti-Dsg1, 89.33% for anti-Dsg3 and 13.33% for anti-γ/ε nAchR Abs. All patients with positive anti-γ/ε nAchR Abs had the mucocutaneous phenotype. PDAI, anti-Dsg1,3 and anti-γ/ε nAchR values were dramatically decreased 3 months after RTX infusion (P < 0.001). There was a significant positive correlation between disease activity and anti-γ/ε nAchR values at baseline (P = 0.04), whereas no significant correlation was observed between anti-Dsg1,3 and anti-γ/ε nAchR values at baseline and 3 months after RTX infusion. CONCLUSION The reduction in anti-γ/ε nAchR Abs with clinical improvement in this study may suggest a synergic role for anti-γ/ε nAchR Abs with anti-Dsg1,3 Abs, or it could be an epiphenomenon.
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Affiliation(s)
- R Toosi
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - A Teymourzadeh
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - H Mahmoudi
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - K Balighi
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - M Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
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Farahmand L, Mansouri S, Jafarbeik-Iravani N, Teymourzadeh A, Majidzadeh-A K. Stemness Phenotype in Tamoxifen Resistant Breast Cancer Cells May be Induced by Interactions Between Receptor Tyrosine Kinases and ERα-66. Recent Pat Anticancer Drug Discov 2018; 13:302-307. [PMID: 29512469 DOI: 10.2174/1574892813666180305164634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 02/24/2018] [Accepted: 02/26/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tamoxifen is widely administered for patients with estrogen receptor-positive breast cancer. Despite many patients benefiting from Tamoxifen as an effective anti-hormonal agent in adjuvant therapy, a noticeable number of patients tend to develop resistance. OBJECTIVE The aim of this study was to shed light upon the molecular mechanisms associated with Tamoxifen resistance which can help improve current treatment strategies available for stimulating responsiveness and combating resistance. METHODS Relevant articles were obtained from PubMed and google scholar, nearly all dated from 2010 to 2017. Articles were screened to select the ones meeting the objective. The molecular interactions in the resistant network were extracted from the appropriate articles. RESULTS The mechanisms of developing Tamoxifen resistance were briefly outlined. Overactivation of Receptor Tyrosine Kinases (RTKs) pathways, commonly known as alternative growth cascades, is one of the main players in acquired cancer cell stemness, which can induce unrestricted proliferation in the presence of Tamoxifen. There are seven recent patents including 6291496B1 as an anti-HER2, 8143226B2 as an inhibitor of RTK phosphorylation, 9062308B2 as an anti-HOXB7, Lapatinib functioning as an anti-EGFR/HER2, Everolimus as an inhibitor of mTOR, Exemestane as an aromatase inhibitor and Perifosine as an AKT inhibitor. CONCLUSION Altogether, it seems that tumor cells express a stemness phenotype which tends to override anti-hormonal adjuvant therapies. Since RTKs are overactivated and overexpressed in such cells, specialized targeted therapies suppressing RTKs would be a novel and effective way in restoring Tamoxifen sensitivity in resistant breast cancer tumor cells.
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Affiliation(s)
- Leila Farahmand
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Sepideh Mansouri
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Narges Jafarbeik-Iravani
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Azin Teymourzadeh
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Keivan Majidzadeh-A
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.,Tasnim Biotechnology Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
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Mansouri S, Farahmand L, Teymourzadeh A, Majidzadeh-A K. Clinical Evidence on the Magnitude of Change in Growth Pathway Activity in Relation to Tamoxifen Resistance is Required. Curr Cancer Drug Targets 2018; 18:668-676. [DOI: 10.2174/1568009617666170808110820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/12/2017] [Accepted: 06/19/2017] [Indexed: 11/22/2022]
Abstract
Background:
Despite prolonged disease-free survival and overall survival rates in Estrogen
Receptor (ER)-positive patients undergoing adjuvant treatment, Tamoxifen therapy tends to fail
due to eventual acquisition of resistance.
Objective:
Although numerous studies have emphasized the Role of Receptor Tyrosine Kinases
(RTKs) in the development of Tamoxifen resistance, inadequate clinical evidence is available regarding
the alteration of biomarker expression during acquired resistance, thus undermining the validity
of the findings.
Results:
Results of two meta-analyses investigating the effect of HER2 status on the prognosis of
Tamoxifen-receiving patients have demonstrated that despite HER2-negative patients having longer
disease-free survival; there is no difference in overhaul survival between the two groups. Furthermore,
due to the intricate molecular interactions among estrogen receptors including ERα36, ERα66,
and also RTKs, it is not surprising that RTK suppression does not restore Tamoxifen sensitivity. In
considering such a complex network, we speculate that by the time HER2/EGFR is suppressed via
targeted therapies, activation of ERα66 and ERα36 initiate molecular signaling pathways downstream
of RTKs, thereby enhancing cell proliferation even in the presence of both Tamoxifen and
RTK inhibitors.
Conclusion:
Although clinical findings regarding the molecular pathways downstream of RTKs
have been thoroughly discussed in this review, further clinical studies are required in determining a
consistency between preclinical and clinical findings. Discovering the best targets in preventing tumor
progression requires thorough comprehension of estrogen-dependent and estrogen-independent
pathways during Tamoxifen resistance development. Indeed, exploring additional clinically-proven
targets would allow for better characterized treatments being available for breast cancer patients.
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Affiliation(s)
- Sepideh Mansouri
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Leila Farahmand
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Azin Teymourzadeh
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Keivan Majidzadeh-A
- Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
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