Personalized and Precision Medicine Journal

Abstract Cancer is largely a disease of older people; the median age for cancer diagnosis in industrialised countries is approaching 70 years of age and is expected to increase. The morbidity and mortality rates of various tumors increase with age, and thus, malignant tumors are generally defined as aging diseases. The immune system has an ambiguous role in cancer, as it plays an important immune surveillance role in the antitumor response but is also closely associated with the initiation and progression of tumors. With aging we assist to the erosion of the immune response called immunosenescence. This deregulation particularly affects the T cell compartment of the adaptive immune response. In addition to the accumulation of genetic mutations, many researchers believe that immunosenescence may also play an important role in
the tumoral process. In the future, targeting immune senescent cells may be a novel interventional opportunity in cancer patients.

Abstract Rheumatoid arthritis (RA) is a chronic autoimmune disease of unknown etiology that results in progressive joint destruction and ultimately to disability. Currently effective biologic therapies, exist for approximately  40% of patients, but disease activity remains inadequately controlled in others. Therefore, it is crucial  to identify specific markers that predict therapeutic response in various patients, prior to the initiation of therapy.  DNA methylation , as a epigenetic factor, is increasingly being explored as a potential theranostic biomarker. It has been suggested that DNA methylation might contribute to RA development, nonetheless , with conflicting results. Epigenetic modules have provided a possible interface through which genetic and environmental risk factors  contribute to the susceptibility and pathogenesis of RA. Hence,  epigenetic regulators may provide promising drug targets to develop novel therapeutic drugs for tailored treatment of RA patients. Here we review the current knowledge regarding the role of DNA methylation in RA and indicate its potential therapeutic implications.

Abstract The pathophysiology and molecular pathways of breast cancer (BC) are still unclear, but it appears that BC is caused by the interaction between genetic susceptibility and environmental factors. Epidemiology studies have shown the increase risk of BC through polycyclic aromatic hydrocarbons (PAH) exposure. Environmental carcinogens induce disease pathways by altering the expression of specific genes that may be a consequence of epigenetic modifications. In order to understand the effects of PAHs in the BC risk, the epigenetic pathway may consider as an important key and likely play a role in BC initiation. Novel epigenetic  biomarkers and treatments hold promise  in the approch of personalized medicine. Here, we focus to review the epigenetic factors in relation to polycyclic aromatic hydrocarbons exposure that may influence BC risk.

Abstract Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder characterized by immune dysregulation and multi-organ involvement. Central to its pathogenesis is the CD154/CD40 signaling axis, which orchestrates key immunological processes, including T-B cell collaboration, dendritic cell activation, and cytokine production. Recent findings have expanded the scope of CD154 beyond its classical receptor CD40, identifying integrins as alternative receptors, thus broadening its biological impact. These discoveries underline the complexity of CD154's role in SLE and its potential as a therapeutic target. First-generation CD154/CD40-targeted therapies showed promise but were hindered by thromboembolic complications. However, second-generation therapeutics, including monoclonal antibodies, small molecules, and gene-editing technologies, exhibit improved safety and efficacy profiles. This review delves into the molecular and cellular mechanisms of CD154 in SLE, explores its emerging roles through integrin interactions, and evaluates the therapeutic advancements targeting this axis. The findings highlight CD154 as a central mediator in SLE pathogenesis and a compelling target for innovative treatment strategies.

Abstract Breast cancer is the most common cancer in women and distant site metastasis is the main cause of death in breast cancer patients. Epithelial-mesenchymal transition (EMT) is defined by the loss of epithelial characteristics and the acquisition of a mesenchymal phenotype. EMT is a vital process for large-scale cell movement during morphogenesis at the time of embryonic development. Tumor cells usurp this developmental program to execute the multi-step process of tumorigenesis and metastasis. Understanding the biological intricacies of the EMT may provide important insights that lead to the development of therapeutic targets in pre-invasive and invasive breast cancer, and could be used as biomarkers for identifying tumor subsets with greater chances of recurrence, metastasis, and therapeutic resistance leading to death. The purpose of this article is to investigate the association between EMT and breast cancer.

Abstract There were more than thirty-eight million HIV infections worldwide. Combination antiretroviral therapy (cART) has progressed to the point where invisible viral loads are now feasible, and HIV carriers frequently lead almost everyday lives with considerably greater average life expectancies than in the past. However, there is still no cure for the disease. Even though the ailment usually advances to a chronic state, an individual's unique course of progression may differ significantly from the average and manifest distinctively for each patient. This diversity begs whether a typical treatment strategy is appropriate for a patient.
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Abstract Artificial Intelligence (AI) is profoundly transforming healthcare, with its impact becoming increasingly evident across various medical disciplines. The most promising and novel applications of AI are found in anesthesiology, where it is enhancing patient safety, clinical decision-making, and individualized care practices. Anesthesiologists face the complex task of maintaining anesthetic stability throughout surgical procedures, where even variations in patient parameters can lead to adverse outcomes. In this context, AI is emerging as a powerful tool that enhances the precision and effectiveness of anesthetic operations.
The function of AI in anesthesiology includes several essential areas, such as improving operating room safety and tailoring medication dosages to the specific needs of individual patients. AI systems employ advanced machine learning algorithms to examine vast data from real-time physiological monitoring devices, such as heart rate, blood pressure, oxygen saturation, and respiratory rate. These devices can detect subtle changes in vital signs, providing early warnings of potential outcomes and supplying clinicians with evidence-based treatment alternatives.
Moreover, AI is substantially enhancing the personalization of anesthetic administration. By evaluating patient-specific characteristics, including demographics, medical history, and genetic predispositions, AI systems can predict optimal medication dosages, mitigating risks of under- or overdose and enhancing recovery times. Furthermore, AI-driven predictive analytics can forecast patient-specific risks, including the likelihood of adverse reactions or postoperative complications, allowing anesthesiologists to execute preventive measures.
This research aims to analyze the various ways in which AI is enhancing anesthesiology, encompassing sophisticated monitoring systems, predictive tools, and personalized treatment strategies. The advancement of AI significantly enhances anesthetic treatments, promising safer, more efficient, and highly tailored patient care in both surgical and non-surgical contexts.

Abstract 3D bioprinting is a breakthrough fabrication technology in regenerative medicine It offers great promise for fabricating hierarchical and heterogeneous tissues and organs with similar architecture as those of the natural ones. This review discusses recent advances in 3D bioprinting and the progress made for fabricating functional tissues, which have regenerative therapy applications. We cover the development of bioprinting methodologies, bioink composition and optimization, and incorporation of cellular and molecular signals for improving tissue function. An overview of the literature on key applications in skin, cartilage, bone and cardiovascular tissues is provided, including both preclinical achievements and clinical barriers/goals. In addition, we also talk about the contribution of bioprinted tissues for drug screening, disease modelling and personalized medicine. Regulatory and ethical aspects associated with the clinical translation of bioprinted tissues are also highlighted in this review. We present an up-to-date analysis of the recent literature (including studies from Nature, The Lancet, and BMC) as well as a data-rich viewpoint on 3D bioprinting to date in regenerative medicine.

Abstract Introduction: In this context, the use of medicinal plants as a natural and effective remedy for relieving Menstrual pain has been acknowledged in the western border region of Iran, serving as an alternative or complementary therapeutic approach. The aim of this study is to identify the medicinal plants employed in this region of Iran for the treatment of menstrual pain.
Methodology: This review study employed keywords such as medicinal plants, Iran, menstrual pain, and the provinces of West Azerbaijan, East Azerbaijan, Ardabil, Kurdistan, Kermanshah, Ilam, Khuzestan, and their cities, along with ethnobotany terms. Databases such as Google Scholar, SID, MegaIran, PubMed, and Scopus were utilized for article searches. Ethnobotanical articles related to the topic were selected for text review.
Results: Based on the ethnobotanical review, it was identified that in the cities and provinces of the western border region of Iran, medicinal plants such as fennel, wild parsley, shepherd's purse, black cumin, thyme, dandelion, rue, safflower, myrtle, European hornbeam, Kurdistan pistachio, mint, marshmallow root, male orchid, yarrow, agrimony, nettle, bitter herb, verbena, horsetail, periwinkle, marigold, saffron, wild thyme, savory, rhubarb, and eastern chamomile are commonly used for managing, controlling, and treating menstrual pain. Notably, the highest diversity of plant species was observed in the regions of Behbahan, Khuzestan, and Zrewar, Kurdistan. Leaves were the most commonly used plant part, and the Asteraceae and Lamiaceae families presented the highest number of species, indicating the rich diversity of medicinal and traditional plant applications.
Conclusion: The findings of this study demonstrate that the local communities in the western border region of Iran possess extensive knowledge regarding the use of medicinal plants for alleviating menstrual pain. Documenting and scientifically exploring this knowledge could lay the groundwork for the development of effective and natural herbal medicines in the domain of women’s health.

Abstract The discovery and production of (synthetic) antibiotics in the first half of the previous century has been one of medicine’s greatest achievements. The use of antimicrobial agents has reduced morbidity and mortality of humans and contributed substantially to human’s increased life span. The issue of antibiotic resistance has received considerable attention due to the problem of the emergence and rapid expansion of antibiotic-resistant pathogenic bacteria. Antibiotic resistance exhibited by bacteria can be intrinsic, acquired, or adaptive. Therefore, efforts to develop antibiotics and study mechanisms of resistance should be continuous, resilient and steady. In the following sections, we will focus on the molecular and biochemical mechanisms of bacterial resistance, illustrating specific situations that are often encountered in clinical practice.

Abstract Colorectal cancer (CRC) is the third most common type of cancer worldwide. It develops through a gradual accumulation of genetic and epigenetic changes, leading to the transformation of normal colonic mucosa into invasive cancer. Approximately 90% of colorectal cancer cases are sporadic without family history or genetic predisposition, while in less than 10% a causative genetic event has been identified. Since personalized medicine works on three subjects of determining disease indices in people, choosing the best therapeutic method and predicting disease relapse, it seems that regarding colorectal cancer, more researches are required in order to achieve favorable results. The recent advances in molecular biology and the genetic classification of CRC are essential to individualize these therapies and will be basic for improving the treatment in the next years. We are optimistic about the success of personalized medicine for this disease.

Abstract Prostate cancer represents a major health problem in men worldwide. Androgens are required for the growth and maintenance of the prostate. The androgen-signaling axis plays a pivotal role in the pathogenesis of prostate cancer. Clinical treatments that target steroidogenesis and the androgen receptor (AR) successfully postpone disease progression. The role of androgens and AR signaling has been well characterized in metastatic prostate cancer, where it has been shown that prostate cancer cells are exquisitely adept at maintaining functional AR signaling to drive cancer growth. This review summarizes the current information regarding the role of androgens in prostate cancer.

Abstract Background:
Multidrug-resistant (MDR) bacteria, including Acinetobacter baumannii, have increased in healthcare systems, particularly in the Middle East. This bacterium is notoriously resistant to various medications, complicating disease therapy. The proliferation of XDR bacteria and the decline of effective antibiotics threaten patient safety and healthcare efficiency.
Objectives:
This study addresses the issues associated with MDR Acinetobacter baumannii in hospitals, especially in the Middle East. It examines the bacterium's epidemiology, molecular resistance mechanisms, clinical problems, and innovative treatment approaches. The research employs novel epidemiological data, molecular insights, and enhanced infection control strategies to comprehend the evolution of this issue and its management.
Methods:
We conducted a comprehensive study by searching PubMed, Scopus, and Web of Science for research published from 2010 to 2024. The investigation identified Middle Eastern research regarding the prevalence, resistance mechanisms, clinical care, and patient outcomes of MDR Acinetobacter baumannii. This study offers a comprehensive perspective on the escalating threat posed by this disease and its ramifications for regional healthcare professionals through the integration of qualitative and quantitative data.
Results:
Carbapenem-resistant Acinetobacter baumannii is common in 60–70% of Middle Eastern intensive care units and kills 40–50%. OXA-type carbapenemases, ESBLs, MBLs, efflux pump overexpression, target site changes, and biofilm formation make the bacterium resistant. We also found novel resistance determinants including bla_OXA-235 and regulatory gene alterations like adeRS. Overcrowded hospitals, long stays, antibiotic overuse, and poor infection control aggravate this issue. However, these issues are being fixed. Modern molecular diagnosis, ultraviolet disinfection, and genetic surveillance reduce these diseases.
Conclusions:
Increasing MDR Acinetobacter baumannii prevalence in the Middle East presents a difficult challenge that requires a coordinated, multidisciplinary approach. This pathogen's hazards can be reduced by improved antimicrobial stewardship, infection control, regional surveillance, and therapeutic development.

Abstract Personalized medicine is the clinical treatment of diseases that is tailored to the physiologic, molecular genetics and lifestyle characteristics of the patient.
Personalized medicine can be considered as a new approach to face diseases and develop traditional methods for their diagnosis and treatment. This novel field of medicine has the potential of changing identification and management of health problems strategies. Corona virus disease 2019 (COVID-19) is an infectious disease that affects the lungs of patients. This novel outbreak was first reported on 31 December 2019 in Wuhan, the capital of Hubei province of China, and it had many effects on people's lives all over the world in various economic, social and health fields until now. Since the start of the pandemic Covid-19, the World Health Organization (WHO) has expressed concern about the public health emergency. Although the disease has mild symptoms and similar to a common cold in most people, in some cases it can lead to pneumonia, acute respiratory distress syndrome, multi-organ dysfunction, and even death. Therefore, due to the different effects of this disease in individuals and even families, the role of personalized medicine becomes more significant and sensitive. Considering the rapid spread and global crisis of Covid-19, recent research has focused more on the control and treatment of the virus. The main goal of this paper is the investigation of different effects of the virus on patients and study of the personalized medicine roles in the control and treatment of the disease.

Abstract Precision medicine is a medical approach that involves customizing therapy for an individual by using extensive biological and external data. The rapid progress in the disciplines of molecular biology, gene sequencing, machine learning, and related technologies has facilitated the use of precision medicine. This approach utilizes the wealth of comprehensive information obtained from these advancements to improve the decision-making process in clinical treatment for individuals, particularly in real-time scenarios during the progression of a disease. Diabetes mellitus is a significant worldwide health issue, requiring the implementation of novel strategies to enhance patient outcomes. The efficacy of conventional treatment options that use a uniform approach has been shown to be limited in effectively addressing the heterogeneous character of the illness. In recent times, personalized medicine has surfaced as a revolutionary resolution, customizing treatment strategies in accordance with an individual's health attributes, lifestyle choices, and genetic composition. This review underscores the significance of genetic screening in forecasting susceptibility to diabetes and treatment response, while also emphasizing the potential of pharmacogenomics to optimize medication selection.

Abstract Cancer is a catastrophic illness with a significant worldwide fatality rate, anticipated to rise in the next years. Contemporary treatment modalities, including chemotherapy and radiation therapy, include constraints such as adverse effects, inconsistent efficacy, elevated expenses, and restricted accessibility. Bacteriophages have arisen as multifaceted instruments in bioengineering, with significant promise in tissue engineering, vaccine formulation, and immunotherapy. Bacteriophages are being used extensively in several fields of biotechnology and medicine, with cancer treatment being the most compelling application. Numerous studies are increasingly validating the effectiveness and safety of phage-based vectors as systemic delivery vehicles for therapeutic genes and medicines in cancer treatment. Moreover, the genetic composition of phages may be used for the creation of innovative DNA vaccines and antigen display systems, since they provide a highly structured and repeated presentation of antigens to immune cells. Bacteriophages have created novel opportunities for the precise targeting of certain molecular determinants in cancer cells. Phages may serve as anticancer agents and as carriers for imaging compounds and medicines. This article introduces bacteriophage and examines the performance of bacteriophages and bacteriophage engineering in targeted cancer treatment.

Abstract One of the key molecular mechanisms contributing to the metastatic progression is epithelial to mesenchymal transition (EMT), which drives invasion and migration of various cancer including breast cancer.During tumorigenesis, changes in EMT regulatory pathways lead to a loss of cellular adhesions, changes in the polarization of the cell and cytoskeleton, detachment, migration, intra-vasation, and survival in the vascular system; extravasation, and finally, metastasis.EMT is largely mediated by a core set of EMT-activating transcription factors. The master regulators of the EMT include many pathways, however the primary mediators of the EMT include signaling through TGF-, Notch and Wnt.  The role of EMT in breast cancer has  been demonstrated via numerous in vitro studies in  normal and malignant mammary epithelial cells and via in vivo studies using mouse models of breast cancers. Studying the regulatory pathways of the EMT process can be used as a tool for cancer monitoring ,treatment and possible direct targets for new-combination anticancer personalized medicine.

Abstract Humans are continuously exposed to a wide of carcinogenic and mutagenic stimuli, including environmental toxins, radiation and viruses as well as other infections. Tumor metastasis is responsible for approximately 9% of all cancer related deaths. The tumor microenvironment (TME) contains many distinct cell types, including endothelial cells and their precursors, pericytes, smooth muscle cells, fibroblasts, carcinoma-associated fibroblasts, myofibroblasts, neutrophils, eosinophils, basophils, mast cells, T and B lymphocytes, natural killer cells and antigen presenting cells (APC) such as macrophages and dendritic cells. Recent evidence has shown that stromal tissue is much more than a passive bystander in the development and progression of cancers. None the lese,the clinical therapy for many types of human cancers has mainly focused on the malignant cancer cell itself, and have made great achievements, yet cancer therapy still remains a great challenge. This review highlights the evidence for the crucial role of the tumor microenvironment in tumor progression and metastasis.

Abstract The enormous genetic variety of the viral population harbored by the patient and the large volume of therapeutic alternatives characterize HIV therapy. Each patient and period has its viral population. The enormous number of therapy possibilities makes selecting an ideal or near-optimal therapy challenging, especially among therapy-experienced patients. Over the last decade, computer-based medication selection that measures viral resistance to pharmaceuticals has become a norm for HIV patients. We explore the qualities of available systems and the field's viewpoints.

Abstract Rheumatic inflammatory diseases, besides affecting joints and other bodily systems, are linked to heightened mortality and morbidity. Cardiovascular reasons are among the most prevalent mortality factors in individuals with these disorders, attributable to the disease's etiology and pathophysiology, chronic inflammation, and the pharmacological treatments employed. Although rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis, and gout exhibit distinct pathophysiology and symptoms, persistent inflammation remains their shared pathophysiological characteristic. Metabolic syndrome has recently been linked to several of these disorders. The investigation of metabolic syndrome in inflammatory rheumatic diseases is significant for multiple reasons, including its correlation with cardiovascular disease onset, the emergence of a pre-inflammatory condition, treatment selection, and associated monitoring. This review article initially explores the significance of metabolic syndrome in rheumatic diseases, followed by a detailed analysis of each condition individually. This study concludes, through a review of previous studies, that abdominal obesity in rheumatoid arthritis and lupus patients, abdominal obesity and hypertension in psoriatic arthritis patients, and hypertriglyceridemia and hypertension in gout are significant elements of metabolic syndrome warranting increased focus.

Abstract This review synthesizes and elaborates on current studies examining the neurotoxic effects of microplastics, emphasizing their mechanisms of entry into the central nervous system and their possible involvement in the development of neurodegenerative disorders. The pervasive presence of microplastics in the environment has heightened concerns about their accumulation in biological systems, particularly their capacity to traverse biological boundaries and engage with neuronal tissues. This article seeks to synthesize and critically evaluate the existing scientific literature on microplastic neuroinvasion, concentrating on the mechanisms through which these particles penetrate the blood-brain barrier (BBB) specifically via transcellular, paracellular, or Trojan horse pathways—and their ensuing effects on neuronal homeostasis.

We investigate the physiological and molecular reactions triggered by microplastics, encompassing oxidative stress induction, mitochondrial failure, neuroinflammation, and synaptic disruption. These pathogenic processes may facilitate the onset and advancement of several neurodegenerative disorders, including Alzheimer’s disease, by intensifying amyloid-beta aggregation, tau phosphorylation, and neuroimmune activation. Additionally, we examine the burgeoning epidemiological and experimental evidence associating microplastic exposure with cognitive deterioration and neuronal impairment.

This review offers a thorough analysis of microplastic neurotoxicity by evaluating both in vitro and in vivo studies, with the objective of elucidating the potential neurological hazards associated with these environmental contaminants. We emphasize significant deficiencies in existing research and propose future avenues, encompassing enhanced detection techniques, public health initiatives, and efforts to reduce human exposure to microplastics.

Abstract Severe Acute Respiratory Syndrome
Coronavirus 2 (SARS-CoV-2), is a severe infection with respiratory and systemic
manifestations. This infectious disease has a complex course and manifests itself with
various clinical presentations, ranging from asymptomatic infection to a severe clinical
course. These variations in severity have raised the question of whether the genetic or
epigenetic variations have a role in COVID-19 susceptibility or severity, and that these
factors can be used to predict the disease course. A whole-genome sequencing performed
on 95 samples of SARS-CoV-2 identified 116 unique mutations, most of which were
missense and synonymous. Moreover, some studies have reported a relationship between
the COVID-19 severity and the genes ACE and TMPRSS2. The present review provides
an overview of different genes that have been found to be implicated or related to the
susceptibility to COVID-19 or its severity.

Abstract Multiple sclerosis (MS) is a disease of the central nervous system characterized by inflammation, demyelination, and neuronal damage. Epstein–Barr virus (EBV) is a human DNA herpesvirus infecting more than 90% of the world's population. EBV is the etiological agent of infectious mononucleosis (Pfeiffer's disease). Major predisposing factors for MS are certain tissue types (e.g., HLA DRB1*15:01), vitamin D deficiency, smoking, obesity, and infection with Epstein-Barr virus (EBV). This review summarizes current knowledge on the association between EBV and MS.

Abstract The COVID-19 outbreak offers an unmatched chance to take advantage of personalized medicine's benefits for the protection, detection, medication, monitoring, and administration of a fresh public health crisis. Antibiotics, which were formerly regarded as miracle cures and among the most difficult life-saving discoveries of the twentieth century, are now posing a hazard to society as a result of overuse and abuse. Antimicrobial resistance (AMR) is a widespread issue that is becoming worse, and the current COVID-19 pandemic might make things even worse. It has been shown that a significant portion of Covid-19 patients gets secondary microbiological infections. The medical industry is now facing difficulties because of this. As a result, several non-antibiotic techniques have been sought, and their processes have been examined, to slow the spread of AMR.

Abstract In this article, the features of DNA-functionalized goldnanoparticles (GNRs), including the size-dependent color, the amount of conjugated DNA, and the fluorescence quenchers will be described. DNA and aptamer conjugated GNRs can be applied for producing the colorimetric and fluorescent biosensors to detect all types of disease markers including DNA, RNA, protein and other small molecular metabolites.
The early phase of this work is performed in clean buffers and serum samples. DNA-conjugated GNRs delivery into the cells is recently used for intracellular diagnosis in personalized medicine. Simultaneously, DNA-functionalized GNRs can be used to deliver the antisense DNA for gene therapy applications.
With targeting both diagnosis and treatment applications, DNA- functionalized GNRs can be used as a suitable approach to reach theranostics purposes (diagnosis and treatment in a simultaneous manner).