Abstract
Nasopharyngeal carcinoma (NPC) is a malignant tumor that grows from the epithelial cells of nasopharynx. NPC has the ability to modify its metabolism and leads the patient to suffer from malnutrition and cachexia, therefore aggravates the occurrence of impaired inflammatory response. Currently, available treatments for NPC are chemotherapy, radiotherapy, or chemoradiotherapy. Despite of its efficacy, these regimens have been known to elicit various inflammation-related side effects including infection, diarrhea, and mucositis. It has long been established that increased activity of inflammatory response is associated to low survival rate in both early and advanced stage of cancer. Furthermore, uncontrolled and dysregulated inflammatory response are significantly correlated with malignant progression of cancer. Considering how pivotal inflammation to malignancy progression, there is a need for effective strategies to modulate inflammatory response. Various strategies have been proposed to improve immune response in NPC patients including dietary supplementation of synbiotics. Synbiotics refers to the manipulation of both probiotics and prebiotics to provide a synergistic benefit to the host by promoting the growth of beneficial bacteria while inhibiting the growth of pathogenic bacteria. There is a growing number of evidences related to the potential of synbiotics in modulating the pro-inflammatory response and improve immune systems in a variety of conditions, including cancer. In this study, we will discuss the immunomodulatory effects of synbiotics in the nasopharyngeal carcinoma occurrences.
-
Research funding: None declared.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: Authors state no conflict of interest.
-
Informed consent: Not applicable.
-
Ethical approval: Not applicable.
References
1. Strazzulla, A, Barreca, GS, Giancotti, A, Pisani, V, Costa, C, Zicca, E, et al.. Nasopharyngeal carcinoma: review of the literature with a focus on therapeutical implications. Infez Med 2015;23:224–9.Search in Google Scholar
2. Meng, L, Wei, J, Ji, R, Wang, B, Xu, X, Xin, Y, et al.. Effect of early nutrition intervention on advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy. J Cancer 2019;10:3650. https://doi.org/10.7150/JCA.33475.Search in Google Scholar
3. Bray, F, Ferlay, J, Soerjomataram, I, Siegel, RL, Torre, LA, Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394–424. https://doi.org/10.3322/caac.21492.Search in Google Scholar PubMed
4. Lin, Y, Chuang, C, Hsieh, VC, Tsai, M, Liu, YF, Chen, XX, et al.. Unmet supportive care needs of survival patients with nasopharyngeal carcinoma. Int J Environ Res Public Health 2020;17:3519. https://doi.org/10.3390/ijerph17103519.Search in Google Scholar PubMed PubMed Central
5. Wang, C, Lin, XL, Fan, YY, Liu, YT, Zhang, XL, Lu, YK, et al.. Diet quality scores and risk of nasopharyngeal carcinoma in Chinese adults: a case-control study. Nutrients 2016;8. https://doi.org/10.3390/NU8030112.Search in Google Scholar PubMed PubMed Central
6. Chua, MLK, Wee, JTS, Hui, EP, Chan, ATC. Nasopharyngeal carcinoma. Lancet 2016;387:1012–24. https://doi.org/10.1016/S0140-6736(15)00055-0.Search in Google Scholar PubMed
7. Sanda, C, Radu, I, Popescu, B, Barbu, MA, Sarafoleanu, C, Nitipir, C. Importance of nutritional Status in treatment response of patients with nasopharyngeal carcinoma. Mod Med 2016;23:33–8.Search in Google Scholar
8. Chen, YP, Chan, ATC, Le, QT, Blanchard, P, Sun, Y, Ma, J. Nasopharyngeal carcinoma. Lancet 2019;394:64–80. https://doi.org/10.1016/S0140-6736(19)30956-0.Search in Google Scholar PubMed
9. Pan, JJ, Ng, WT, Zong, JF, Chan, LLK, Sullivan, BO, Lin, SJ, et al.. Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer 2016;122:546–58. https://doi.org/10.1002/CNCR.29795.Search in Google Scholar
10. Zhang, B, Li, MM, Chen, WH, Zhao, JF, Chen, WQ, Dong, YH, et al.. Association of chemoradiotherapy regimens and survival among patients with nasopharyngeal carcinoma A systematic review and meta-analysis. JAMA Netw Open 2019;2:e1913619. https://doi.org/10.1001/jamanetworkopen.2019.13619.Search in Google Scholar PubMed PubMed Central
11. Muscaritoli, M, Arends, J, Bachmann, P, Baracos, V, Barthelemy, N, Bertz, H, et al.. ESPEN Guideline ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017;36:11–48. https://doi.org/10.1016/j.clnu.2016.07.015.Search in Google Scholar PubMed
12. Ramos Chaves, M, Boléo‐Tomé, C, Monteiro‐Grillo, I, Camilo, M, Ravasco, P. The diversity of nutritional Status in cancer: new insights. Oncol 2010;15:523–30. https://doi.org/10.1634/theoncologist.2009-0283.Search in Google Scholar PubMed PubMed Central
13. Fearon, K, Strasser, F, Anker, SD, Bosaeus, I, Bruera, E, Fainsinger, RL, et al.. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011;12:489–95. https://doi.org/10.1016/S1470-204570218-7.Search in Google Scholar
14. Wie, GA, Cho, YA, Kim, SY, Kim, SM, Bae, JM, Joung, H. Prevalence and risk factors of malnutrition among cancer patients according to tumor location and stage in the National Cancer Center in Korea. Nutrition 2010;26:263–8. https://doi.org/10.1016/J.NUT.2009.04.013.Search in Google Scholar
15. Longo, VD, Fontana, L. Calorie restriction and cancer prevention: metabolic and molecular mechanisms. Trends Pharmacol Sci 2010;31:89–98. https://doi.org/10.1016/J.TIPS.2009.11.004.Search in Google Scholar PubMed PubMed Central
16. Li, G, Gao, J, Liu, Z, Tao, YL, Xu, QB, Tu, ZW, et al.. Influence of pretreatment ideal body weight percentile and albumin on prognosis of nasopharyngeal carcinoma : long-term outcomes of 512 patients from a single institution. Head Neck 2014;36:660–6. https://doi.org/10.1002/hed.23357.Search in Google Scholar PubMed
17. Lee, AWM, Lin, JC, Ng, WT. Current management of nasopharyngeal cancer. Semin Radiat Oncol 2012;22:233–44. https://doi.org/10.1016/j.semradonc.2012.03.008.Search in Google Scholar PubMed
18. Baujat, B, Audry, H, Bourhis, J, Chan, ATC. Onat, H, Chua, DTT, et al.. Chemotherapy in locally advanced nasopharyngeal carcinoma : an Individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys 2006;64:47–56. https://doi.org/10.1016/j.ijrobp.2005.06.037.Search in Google Scholar PubMed
19. Tsao, SW, Yip, YL, Tsang, CM, Pang, PS, Lau, VMY, Zhang, G, et al.. Etiological factors of nasopharyngeal carcinoma. Oral Oncol. 2014;50:330–8. https://doi.org/10.1016/j.oraloncology.2014.02.006.Search in Google Scholar PubMed
20. George, J, Cannon, T, Lai, V, Richey, L, Zanation, A, Hayes, N, et al.. Basic science review cancer cahexia syndrome in head and neck cancer patiens: Part II. Pathophysiology. Head Neck 2007;29:497–507. https://doi.org/10.1002/hed.20630.Search in Google Scholar PubMed
21. Bourke, CD, Berkley, JA, Prendergast, AJ. Immune dysfunction as a cause and consequence of malnutrition. Trends Immunol 2016;37:386. https://doi.org/10.1016/J.IT.2016.04.003.Search in Google Scholar PubMed PubMed Central
22. Gorenc, M, Kozjek, NR, Strojan, P. Malnutrition and cachexia in patients with head and neck cancer treated with (chemo)radiotherapy. Reports Pract Oncol Radiother 2015;20:249–58. https://doi.org/10.1016/j.rpor.2015.03.001.Search in Google Scholar PubMed PubMed Central
23. Bahareh Bakhshaie, P. Dysphagia–Pathophysiology of swallowing dysfunction, symptoms, diagnosis and treatment. J Otolaryngol Rhinol 2019;5:1–4. https://doi.org/10.23937/2572-4193.1510063.Search in Google Scholar
24. Ezeoke, CC, Morley, JE. Pathophysiology of anorexia in the cancer cachexia syndrome. J Cachexia Sarcopenia Muscle 2015;6:287–302. https://doi.org/10.1002/jcsm.12059.Search in Google Scholar PubMed PubMed Central
25. Paulsen, Ø, Laird, B, Aass, N, Lea, T, Fayers, P, Kaasa, S, et al.. The relationship between pro-inflammatory cytokines and pain, appetite and fatigue in patients with advanced cancer. PLoS One 2017;12. https://doi.org/10.1371/JOURNAL.PONE.0177620.Search in Google Scholar
26. Schrezenmeir, J, de Vrese, M. Probiotics, prebiotics, and synbiotics - approaching a definition. Am J Clin Nutr 2001;73:361S–4S.10.1093/ajcn/73.2.361sSearch in Google Scholar PubMed
27. Flaherty, SO, Saulnier, DM, Pot, B, Versalovic, J. How can probiotics and prebiotics impact mucosal immunity? Gut Microb 2010;1:293–300. https://doi.org/10.4161/gmic.1.5.12924.Search in Google Scholar PubMed PubMed Central
28. Hill, C, Guarner, F, Reid, G, Gibson, GR, Merenstein, DJ, Pot, B, et al.. Expert consensus document: the international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 2014;11:506–14. https://doi.org/10.1038/nrgastro.2014.66.Search in Google Scholar PubMed
29. Shu, Z, Li, P, Yu, B, Huang, S, Chen, Y. The effectiveness of probiotics in prevention and treatment of cancer therapy-induced oral mucositis: a systematic review and meta-analysis. Oral Oncol 2020;102:104559. https://doi.org/10.1016/j.oraloncology.2019.104559.Search in Google Scholar PubMed
30. Sotoudegan, F, Daniali, M, Hassani, S, Nikfar, S, Abdollahi, M. Reappraisal of probiotics’ safety in human. Food Chem Toxicol. 2019;129:22–9. https://doi.org/10.1016/j.fct.2019.04.032.Search in Google Scholar PubMed
31. Patel, S, Goyal, A. Evolving roles of probiotics in cancer prophylaxis and therapy. Probiotics Antimicro Prot 2013;5:59–67. https://doi.org/10.1007/s12602-012-9124-9.Search in Google Scholar PubMed
32. Hou, J, Zheng, HM, Li, P, Liu, HY, Zhou, HW, Yang, XJ. Distinct shifts in the oral microbiota are associated with the progression and aggravation of mucositis during radiotherapy. Radiother Oncol 2018;129:44–51. https://doi.org/10.1016/j.radonc.2018.04.023.Search in Google Scholar PubMed
33. Mego, M, Holec, V, Drgona, L, Hainova, K, Ciernikova, S, Zajac, V. Probiotic bacteria in cancer patients undergoing chemotherapy and radiation therapy. Complement Ther Med 2013;21:712–23. https://doi.org/10.1016/j.ctim.2013.08.018.Search in Google Scholar PubMed
34. Österlund, P, Ruotsalainen, T, Korpela, R, Saxelin, M, Ollus, A, Valta, P, et al.. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer 2007;97:1028–34. https://doi.org/10.1038/sj.bjc.6603990.Search in Google Scholar PubMed PubMed Central
35. Ciorba, MA, Hallemeier, CL, Stenson, WF, Parikh, PJ. Probiotics to prevent gastrointestinal toxicity from cancer therapy: an interpretive review and call to action. Curr Opin Support Palliat Care. 2015;9:157–62. https://doi.org/10.1097/SPC.0000000000000134.Probiotics.Search in Google Scholar
36. Urbancsek, H, Kazar, T, Mezes, I, Neumann, K. Results of a double-blind, randomized study to evaluate the efficacy and safety of Antibiophilus in patients with radiation-induced diarrhoea. Eur J Gastroenterol Hepatol. 2001;13:391–6.10.1097/00042737-200104000-00015Search in Google Scholar PubMed
37. Lescheid, DW. Probiotics as regulators of inflammation: a review. Funct Foods Heal Dis 2014;4:299–311. https://doi.org/10.31989/ffhd.v4i7.2.Search in Google Scholar
38. Ciorba, MA, Riehl, TE, Rao, MS, Moon, C, Ee, X, Nava, GM, et al.. Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner. Gut. 2012;61:829–38. https://doi.org/10.1136/gutjnl-2011-300367.Search in Google Scholar PubMed PubMed Central
39. Mack, DR, Ahrne, S, Hyde, L, Wei, S, Hollingsworth, MA. Extracellular MUC3 mucin secretion follows adherence of Lactobacillus strains to intestinal epithelial cells in vitro. Gut. 2003;52:827–34. http://gut.bmj.com/content/52/6/827.full.pdf+html.10.1136/gut.52.6.827Search in Google Scholar PubMed PubMed Central
40. Rodrigues, ACP, Cara, DC, Fretez, SHGG, Cunha, FQ, Vieira, EC, Nicoli, JR, et al.. Saccharomyces boulardii stimulates sIgA production and the phagocytic system of gnotobiotic mice. J Appl Microbiol 2000;89:404–14. https://doi.org/10.1046/j.1365-2672.2000.01128.x.Search in Google Scholar PubMed
41. Donato, KA, Gareau, MG, Wang, YJJ, Sherman, PM. Lactobacillus rhamnosus GG attenuates interferon-γ and tumour necrosis factor-α-induced barrier dysfunction and pro-inflammatory signalling. Microbiology 2010;156:3288–97. https://doi.org/10.1099/mic.0.040139-0.Search in Google Scholar PubMed
42. Johansson, MA, Björkander, S, Forsberg, MM, Qazi, KM, Celades, MS, Bittmann, J, et al.. Probiotic lactobacilli modulate Staphylococcus aureus-induced activation of conventional and unconventional T cells and NK cells. Front Immunol 2016;7. https://doi.org/10.3389/fimmu.2016.00273.Search in Google Scholar PubMed PubMed Central
43. Yadav, H, Lee, JH, Lloyd, J, Walter, P, Rane, SG. Beneficial metabolic effects of a probiotic via butyrate-induced GLP-1 hormone secretion. J Biol Chem 2013;288:25088–97. https://doi.org/10.1074/jbc.M113.452516.Search in Google Scholar PubMed PubMed Central
44. Moens, F, Van den Abbeele, P, Basit, AW, Dodoo, C, Chatterjee, R, SMith, B, et al.. A four-strain probiotic exerts positive immunomodulatory effects by enhancing colonic butyrate production in vitro. Int J Pharm 2019;555:1–10. https://doi.org/10.1016/j.ijpharm.2018.11.020.Search in Google Scholar PubMed
45. He, J, Luo, X, Jin, D, Wang, Y, Zhang, T. Identification, recombinant expression, and characterization of LGH2, a novel antimicrobial peptide of Lactobacillus casei HZ1. Molecules 2018;23:1–18. https://doi.org/10.3390/molecules23092246.Search in Google Scholar PubMed PubMed Central
46. Schlee, M, Harder, J, Köten, B, Stange, EF, Wehkamp, J, Fellermann, K. Probiotic lactobacilli and VSL#3 induce enterocyte β-defensin 2. Clin Exp Immunol 2008;151:528–35. https://doi.org/10.1111/j.1365-2249.2007.03587.x.Search in Google Scholar PubMed PubMed Central
47. Lee, JH, Lee, B, Lee, HS, Bae, EA, Lee, H, Ahn, YT, et al.. Lactobacillus suntoryeus inhibits pro-inflammatory cytokine expression and TLR-4-linked NF-κB activation in experimental colitis. Int J Color Dis 2008 242. 2008;24:231–7. https://doi.org/10.1007/S00384-008-0618-6.Search in Google Scholar PubMed
48. Benson, KF, Redman, KA, Carter, SG, Keller, D, Farmer, S, Endres, JR, et al.. Probiotic metabolites from Bacillus coagulans GanedenBC30TM support maturation of antigen-presenting cells in vitro. World J Gastroenterol 2012;18:1875–83. https://doi.org/10.3748/wjg.v18.i16.1875.Search in Google Scholar PubMed PubMed Central
49. Grabig, A, Paclik, D, Guzy, C, Dankof, A, Baumgart, DC, Erckenbrecht, J, et al.. Escherichia coli strain Nissle 1917 ameliorates experimental colitis via toll-like receptor 2- and toll-like receptor 4-dependent pathways. Infect Immun. 2006;74:4075–82. https://doi.org/10.1128/IAI.01449-05.Search in Google Scholar PubMed PubMed Central
50. Jeon, SG, Kayama, H, Ueda, Y, Takahashi, T, Asahara, T, Tsuji, H, et al.. Probiotic Bifidobacterium breve induces IL-10-producing Tr1 cells in the colon. PLoS Pathog 2012;8:1–15. https://doi.org/10.1371/journal.ppat.1002714.Search in Google Scholar PubMed PubMed Central
51. Zhou, X, Liu, H, Zhang, J, et al.. Protective effect of Lactobacillus fermentum CQPC04 on dextran sulfate sodium–induced colitis in mice is associated with modulation of the nuclear factor-κB signaling pathway. J Dairy Sci. 2019;102:9570–85. https://doi.org/10.3168/jds.2019-16840.Search in Google Scholar PubMed
52. Pathmakanthan, S, Li, CKF, Cowie, J, Hawkey, CJ. Lactobacillus plantarum 299: beneficial in vitro immunomodulation in cells extracted from inflamed human colon. J Gastroenterol Hepatol 2004;19:166–73. https://doi.org/10.1111/j.1440-1746.2004.03181.x.Search in Google Scholar PubMed
53. Pujari, R, Banerjee, G. Impact of prebiotics on immune response: from the bench to the clinic. Immunol Cell Biol. 2021;99:255–73. https://doi.org/10.1111/imcb.12409.Search in Google Scholar PubMed
54. Davani-Davari, D, Negahdaripour, M, Karimzadeh, I, Seifan, M, Mohkam, M, Masoumi, SJ, et al.. Prebiotics: definition, types, sources, mechanisms, and clinical applications. Foods 2019;8:1–27. https://doi.org/10.3390/foods8030092.Search in Google Scholar PubMed PubMed Central
55. Patel, S, Goyal, A. The current trends and future perspectives of prebiotics research: a review. 3 Biotech 2012;2:115–25. https://doi.org/10.1007/s13205-012-0044-x.Search in Google Scholar
56. Pham, VT, Seifert, N, Richard, N, Raederstorff, D, Steinert, RE, Prudence, K, et al.. The effects of fermentation products of prebiotic fibres on gut barrier and immune functions in vitro. PeerJ 2018;2018. https://doi.org/10.7717/peerj.5288.Search in Google Scholar PubMed PubMed Central
57. Bourke, CD, Berkley, JA, Prendergast, AJ. Immune dysfunction as a cause and consequence of malnutrition. Trends Immunol 2016;37:386–98. https://doi.org/10.1016/j.it.2016.04.003.Search in Google Scholar PubMed PubMed Central
58. Shirai, T, Suzuki, Y, Kamikado, K, Koga, Y, Aoki, R. Kestose, a prebiotic fructooligosaccharide, enhances intercellular tight junction recovery via a rho-associated kinase-dependent mechanism in intestinal Caco-2 cells. Int J Probiotics Prebiotics 2013:8:53–60.Search in Google Scholar
59. Hansen, CHF, Larsen, CS, Petersson, HO, Zachariassen, LF, Vegge, A, Lauridsen, C, et al.. Targeting gut microbiota and barrier function with prebiotics to alleviate autoimmune manifestations in NOD mice. Diabetologia 2019;62:1689–700. https://doi.org/10.1007/s00125-019-4910-5.Search in Google Scholar PubMed
60. Everard, A, Lazarevic, V, Derrien, M, Girard, M, Muccioli, GG, Neyrinck, AM, et al.. Responses of gut microbiota and glucose and lipid metabolism to prebiotics in genetic obese and diet-induced leptin-resistant mice. Diabetes. 2011;60:2775–86. https://doi.org/10.2337/db11-0227.Search in Google Scholar PubMed PubMed Central
61. Ho, J, Reimer, RA, Doulla, M, Huang, C. Effect of prebiotic intake on gut microbiota, intestinal permeability and glycemic control in children with type 1 diabetes: study protocol for a randomized controlled trial. Trials 2016;17:1–8. https://doi.org/10.1186/s13063-016-1486-y.Search in Google Scholar PubMed PubMed Central
62. Ho, J, Nicolucci, AC, Virtanen, H, Schick, A, Meddings, J, Reimer, RA, et al.. Effect of prebiotic on microbiota, intestinal permeability, and glycemic control in children with type 1 diabetes. J Clin Endocrinol Metab 2019;104:4427–40. https://doi.org/10.1210/jc.2019-00481.Search in Google Scholar PubMed
63. Johnson, JR, Wing, S. External versus internal triggering of substorms: an information-theoretical approach. Geophys Res Lett. 2014;41:5748–54. https://doi.org/10.1002/2014GL060928.Search in Google Scholar
64. Mazzoni, A, Segal, DM. Controlling the Toll road to dendritic cell polarization. J Leukoc Biol 2004;75:721–30. https://doi.org/10.1189/jlb.1003482.Search in Google Scholar PubMed
65. Nastasi, C, Fredholm, S, Willerslev-Olsen, A, Hansen, M, Bonefeld, CM, Geisler, C, et al.. Butyrate and propionate inhibit antigen-specific CD8+ T cell activation by suppressing IL-12 production by antigen-presenting cells. Sci Rep 2017;7:1–10. https://doi.org/10.1038/s41598-017-15099-w.Search in Google Scholar PubMed PubMed Central
66. Nastasi, C, Candela, M, Bonefeld, CM, Geisler, C, Hansen, M, Krejsgaard, T, et al.. The effect of short-chain fatty acids on human monocyte-derived dendritic cells. Sci Rep. 2015;5:1–10. https://doi.org/10.1038/srep16148.Search in Google Scholar PubMed PubMed Central
67. Singh, N, Thangaraju, M, Prasad, PD, Martin, PM, Lambert, NA, Boettger, T, et al.. Blockade of dendritic cell development by bacterial fermentation products butyrate and propionate through a transporter (Slc5a8)-dependent inhibition of histone deacetylases. J Biol Chem 2010;285:27601–8. https://doi.org/10.1074/jbc.M110.102947.Search in Google Scholar PubMed PubMed Central
68. Vogt, L, Meyer, D, Pullens, G, F Marijke, Smelt, M, Venema, K, et al.. Immunological properties of inulin-type fructans. Crit Rev Food Sci Nutr 2015;55:414–36. https://doi.org/10.1080/10408398.2012.656772.Search in Google Scholar PubMed
69. Trushina, EN, Martynova, EA, Nikitiuk, DB, Mustafina, OK, Ba_ıgarin, EK. The influence of dietary inulin and oligofructose on the cell-mediated and humoral immunity in rats. Vopr Pitan 2005;74:22–7.Search in Google Scholar
70. Chang, PV, Hao, L, Offermanns, S, Medzhitov, R. The microbial metabolite butyrate regulates intestinal macrophage function via histone deacetylase inhibition. Proc Natl Acad Sci USA 2014;111:2247–52. https://doi.org/10.1073/pnas.1322269111.Search in Google Scholar PubMed PubMed Central
71. Tan, J, McKenzie, C, Vuillermin, PJ, Goverse, G, Vinuesa, CG, Mebius, RE, et al.. Dietary Fiber and bacterial SCFA Enhance oral Tolerance and Protect against food allergy through diverse cellular pathways. Cell Rep 2016;15:2809–24. https://doi.org/10.1016/j.celrep.2016.05.047.Search in Google Scholar PubMed
© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Investigating periprostatic adipose tissue as a driving force of prostate cancer progression: a new source of information for the advancement of targeted therapy in metastatic prostate cancer
- Reviews
- Pathophysiological effects of cadmium(II) on human health-a critical review
- The role of synbiotics in improving inflammatory status in nasopharyngeal carcinoma patients
- Anti-ageing effects of FDA-approved medicines: a focused review
- Diagnosis and management of uterine fibroids: current trends and future strategies
- Importance of moderate-to-vigorous physical activity during the COVID-19 pandemic: a systematic review and meta-analysis
- Original Articles
- Healthcare workers’ knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia in Hodeida, Yemen
- Comparison of cardiac autonomic function across complete glycaemic spectrum
- Prognostic value of heart rate variability in acute coronary syndrome
- Insights into the protective capacity of human dental pulp stem cells and its secretome in cisplatin-induced nephrotoxicity: effects on oxidative stress and histological changes
- Caffeine impairs anticonvulsant effects of levetiracetam in the maximal electroshock seizure threshold test in mice
- Antioxidant activity in off and on-pump coronary artery bypass grafting and valve replacement surgery
- A drug utilisation pattern in non-dialysis patients of diabetic nephropathy in a government-run tertiary care hospital in South-Asia
- Inguinal lymphadenectomy in penile cancer patients: a comparison between open and video endoscopic approach in a multicenter setting
- A randomized controlled trial to evaluate the efficacy of electrical vestibular nerve stimulation (VeNS), compared to a sham control for the management of sleep in young adults
- Short Communication
- The role of Bruton’s kinase inhibitors (BTKi) in accelerated Chronic Lymphocytic Leukemia (a-CLL): a case of successful response to acalabrutinib
- Letter to the Editor
- A hypothesis that Notopterol may be effective in COVID-19 via JAK/STAT and other signaling pathways
Articles in the same Issue
- Frontmatter
- Editorial
- Investigating periprostatic adipose tissue as a driving force of prostate cancer progression: a new source of information for the advancement of targeted therapy in metastatic prostate cancer
- Reviews
- Pathophysiological effects of cadmium(II) on human health-a critical review
- The role of synbiotics in improving inflammatory status in nasopharyngeal carcinoma patients
- Anti-ageing effects of FDA-approved medicines: a focused review
- Diagnosis and management of uterine fibroids: current trends and future strategies
- Importance of moderate-to-vigorous physical activity during the COVID-19 pandemic: a systematic review and meta-analysis
- Original Articles
- Healthcare workers’ knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia in Hodeida, Yemen
- Comparison of cardiac autonomic function across complete glycaemic spectrum
- Prognostic value of heart rate variability in acute coronary syndrome
- Insights into the protective capacity of human dental pulp stem cells and its secretome in cisplatin-induced nephrotoxicity: effects on oxidative stress and histological changes
- Caffeine impairs anticonvulsant effects of levetiracetam in the maximal electroshock seizure threshold test in mice
- Antioxidant activity in off and on-pump coronary artery bypass grafting and valve replacement surgery
- A drug utilisation pattern in non-dialysis patients of diabetic nephropathy in a government-run tertiary care hospital in South-Asia
- Inguinal lymphadenectomy in penile cancer patients: a comparison between open and video endoscopic approach in a multicenter setting
- A randomized controlled trial to evaluate the efficacy of electrical vestibular nerve stimulation (VeNS), compared to a sham control for the management of sleep in young adults
- Short Communication
- The role of Bruton’s kinase inhibitors (BTKi) in accelerated Chronic Lymphocytic Leukemia (a-CLL): a case of successful response to acalabrutinib
- Letter to the Editor
- A hypothesis that Notopterol may be effective in COVID-19 via JAK/STAT and other signaling pathways