Rawiah Alsiary

Introduction: Immunotherapy with immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis has become an established treatment strategy across various malignancies. In this context, PD-L1 expression plays a key role in the clinical management of cancer patients. However, the prognostic significance of PD-L1 expression remains inconsistent across different cancer types. This study aimed to evaluate the prevalence of PD-L1 expression in three cancer types and to examine its association with key clinicopathological parameters, systemic inflammatory markers and patient outcomes. Methods: A retrospective cohort of 141 patients with lung, breast and head and neck cancers diagnosed between 2016 and 2021 was analysed. PD-L1 expression was analysed by immunohistochemistry using clone 22C3 and the scoring system for positivity was determined according to standard clinical scoring practices for each tumour type. Systemic inflammatory markers, including the platelet-to-lymphocyte ratio (PLR), were calculated from pre-treatment blood counts. Correlation and survival analyses were performed to evaluate the associations between PD-L1 expression levels, clinicopathological characteristics and prognosis. Bioinformatics analyses using GeneMania, STRING and TIMER (v.3) databases were conducted to explore functional enrichment, protein–protein interactions and immune-cell infiltration associated with PD-L1 expression. Results: PD-L1 positivity (≥1%) was observed in 56.75% of lung cancer cases, 44% of breast cancer cases and 92.85% of head and neck cancer cases. PD-L1 expression alone was not significantly associated with overall survival across the cancer cohorts. However, it was significantly associated with PLR in the lung cancer cohort (p = 0.036). Notably, low PLR was associated with improved survival in both lung cancer (p = 0.007) and breast cancer (p = 0.031). Bioinformatics analysis identified several PD-L1-interacting genes, including PD-1, CTLA4 and PTPN and demonstrated strong positive correlations between PD-L1 expression and the infiltration of CD8+ T cells, neutrophils and dendritic cells across the analysed malignancies. Conclusions: Despite its high expression in advanced solid tumours, PD-L1 showed limited prognostic value in our cancer cohort. In contrast, systemic inflammatory markers particularly PLR, emerged as a potential indicator of clinical outcome. Our data suggest that integrating PD-L1 status with systemic inflammatory markers may improve outcome prediction and help inform therapeutic decision-making in patients with advanced malignancies.

Introduction: Breast cancer (BC) is a growing global public health concern, affecting millions of women worldwide. Gulf Cooperation Council (GCC) countries are no exception to this trend. Mortality rates in GCC nations are still high despite improvements in BC treatment. This article examines the changing picture of BC incidence, prevalence, and mortality in the GCC region from 1990 to 2019 and predictions up to 2030. Material and method: Using data from the Global Burden of Disease study, we analyzed BC incidence, prevalence, and mortality rates per 100,000 individuals across different age groups and countries. Results: The study reveals a significant rise in Age-Standardized Incidence Rates (ASIR) for breast cancer among females in Saudi Arabia from 1990 to 2019, with Oman experiencing the highest increase and Kuwait the highest decrease. Bahrain also saw a significant increase in male Age-standardized death rate (ASDR), despite all other countries experiencing a decrease. Also, the data demonstrated a statistically significant positive correlation between ASIR and Human Development Index (HDI), evident across all countries. Metabolic risk and tobacco use were identified as primary contributors. A ten-year BC prediction predicts a significant increase in female cases, with Saudi Arabia expected to experience the highest rise. Conclusion: This study underscores the urgent need for improved BC awareness, early detection through screening programs, enhanced access to quality healthcare services, and the addressing of sociocultural barriers in the GCC countries.

Lower respiratory tract infections (LRIs) are the fourth leading cause of death globally, affecting all age groups and leading to over 2 million deaths annually. Saudi Arabia faces a significant burden from LRIs, affecting more than 15% of the population each year. This study aims to provide an overview of LRI mortality, etiologies, and risk factors in Saudi Arabia from 1990 to 2021. Data on LRI mortality in Saudi Arabia from 1990 to 2021 were extracted from the 2021 edition of the Global Burden of Disease (GBD) Result Tool. The analysis encompassed mortality rates across all age groups, with particular emphasis on children under five and adults over 70. Four primary etiologies influenza, respiratory syncytial virus (RSV), Streptococcus pneumoniae, and Haemophilus influenzae type b (Hib) were examined, alongside 14 associated risk factors. The total LRI deaths in Saudi Arabia decreased by 6% from 1990 to 2021, with a significant reduction observed among children under five years old (96%). In contrast, LRI mortality among adults over 70 increased by 16% during the same period. The age-standardized mortality rate decreased by 47%, with significant reductions in deaths associated with pneumococcus and RSV. However, risk factors, such as smoking and ambient particulate matter pollution, showed minimal declines or even increased mortality rates in older adults. Over the past three decades, Saudi Arabia has made significant progress in reducing LRI mortality, particularly among children under five. However, the increasing mortality rates among the elderly highlight the need for targeted interventions to address their unique vulnerabilities. Continued investment in public health infrastructure, vaccination coverage, and environmental health initiatives is essential for further reducing the burden of LRIs in Saudi Arabia.

Background Metabolic profiling of blood metabolites, particularly in plasma and serum, is vital for studying human diseases, human conditions, drug interventions and toxicology. The clinical significance of blood arises from its close ties to all human cells and facile accessibility. However, patient-specific variables such as age, sex, diet, lifestyle and health status, along with pre-analytical conditions (sample handling, storage, etc.), can significantly affect metabolomic measurements in whole blood, plasma, or serum studies. These factors, referred to as confounders, must be mitigated to reveal genuine metabolic changes due to illness or intervention onset. Review objective This review aims to aid metabolomics researchers in collecting reliable, standardized datasets for NMR-based blood (whole/serum/plasma) metabolomics. The goal is to reduce the impact of confounding factors and enhance inter-laboratory comparability, enabling more meaningful outcomes in metabolomics studies. Key concepts This review outlines the main factors affecting blood metabolite levels and offers practical suggestions for what to measure and expect, how to mitigate confounding factors, how to properly prepare, handle and store blood, plasma and serum biosamples and how to report data in targeted NMR-based metabolomics studies of blood, plasma and serum.

Background: The global burden of cancer is expected to increase by 60% over the next two decades, largely due to population aging. The study aims to examine the association between cancer mortality-to-incidence ratios (MIR) with healthcare expenditures (HE), and human development index score for individuals 70 years old or older.Method: This is an epidemiological study using publicly available data from the Global Burden of Disease (GBD) for six over the years 1990–2019. A generalized linear model was employed to examine the association between MIR, and health expenditures and health development index score.Results: Included countries showed a statistically significant negative association between MIR and both HE, and HE, indicating that higher HDI and HE are associated with decreased MIR with the highest decrease was for China, the coefficient for HDI is −1.29 (95% CI: –1.35 to −1.24, p < 0.0001), the coefficient for HE is −0.103 (95% CI: –0.17 to −0.03, p < 0.0001). There are variations exist in MIRs between high and low health expenditure countries for each cancer type.Conclusion: The study reveals a significant impact of HE and HDI on cancer outcomes in older adults. Variations between high and low HE nations highlight potentially improved cancer outcomes in high HE countries. Considering the anticipated growth in the aging population worldwide, a rise in cancer cases is expected among older individuals. The implications are profound, suggesting an impending strain on healthcare systems, particularly in nations with a high proportion of elderly and low health expenditures.

Background: Breast cancer is the most common cancer among women worldwide. High-income countries have a greater incidence and mortality rate of breast cancer than low-income countries. As a result, raising awareness about breast cancer is crucial in increasing the chances of early detection and treatment. Social media has evolved into an essential tool for Breast Cancer Awareness Month campaigns, allowing people to share their breast cancer stories and experiences while also providing a venue for education and support. Objective: The aim of this study was to assess the level of public interest in searches linked to breast cancer among a sample of high-income nations with a sizable internet user base from 2012 to 2022. We also sought to compare the proportional search volume for breast cancer during Breast Cancer Awareness Month with that during other months of the year. Methods: Google Trends was used to retrieve data on internet user search behaviors in the context of breast cancer from 2012 to 2022. Seven countries were evaluated in this study: Australia, Canada, Ireland, New Zealand, the United Kingdom, Saudi Arabia, and the United States, in addition to global data. Breast cancer relative search volume trends were analyzed annually, monthly, and weekly from 2012 to 2022. The annual percent change (APC) was calculated for each country and worldwide. Monthly and weekly data were used to identify potential trends. Results: A fluctuating pattern in APC rates was observed, with a notable increase in 2018 and a significant decrease in 2020, particularly in Saudi Arabia. Monthly analysis revealed a consistent peak in search volume during October (Breast Cancer Awareness Month) each year. Weekly trends over a 20-year period indicated significant decreases in Australia, Canada, New Zealand, and the United States, while increases were noted in Ireland. Heatmap analysis further highlighted a consistent elevation in median search volume during October across all countries. Conclusions: These findings underscore the impact of Breast Cancer Awareness Month and suggest potential influences of governmental COVID-19 pandemic control measures in 2020 on internet search behavior.

Stem cell therapy provides a viable alternative treatment for degenerated or damaged tissue. Stem cells have been used either alone or in conjunction with an artificial scaffold. The latter provides a structural advantage by enabling the cells to thrive in three-dimensional (3D) settings, closely resembling the natural in vivo environments. Previously, we disclosed the development of a 3D scaffold made from cotton, which was conjugated with arginyl-glycyl-aspartic acid (RGD), to facilitate the growth and proliferation of mesenchymal stem cells (MSCs). This scaffold allowed the MSCs to adhere and proliferate without compromising their viability or their stem cell markers. A comprehensive analysis investigation of the molecular changes occurring in MSCs adhering to the cotton fibers will contribute to the advancement of therapy. The objective of this study is to analyze the molecular processes occurring in the growth of MSCs on a cotton-RGD conjugated-based scaffold by examining their gene expression profiles. To achieve this, we conducted an experiment where MSCs were seeded with and without the scaffold for a duration of 48 h. Subsequently, cells were collected for RNA extraction, cDNA synthesis, and whole-transcriptomic analysis performed on both populations. Our analysis revealed several upregulated and downregulated differently expressed genes in the MSCs adhering to the scaffold compared with the control cells. Through gene ontology analysis, we were able to identify enriched biological processes, molecular functions, pathways, and protein–protein interactions in these differentially expressed genes. Our data suggest that the scaffold may have the potential to enhance osteogenesis in the MSCs. Furthermore, our results indicate that the scaffold does not induce oxidative stress, inflammation, or aging in the MSCs. These findings provide valuable insights for the application of MSCs in tissue engineering and regenerative medicine.

SARS-CoV-2 causes COVID-19. COVID-19 has led to severe clinical illnesses and an unprecedented death toll. The virus induces immune inflammatory responses specifically cytokine storm in lungs. Several published reports indicated that pregnant females are less likely to develop severe symptoms compared with non-pregnant. Putative protective role of maternal blood circulating fetal mesenchymal stem cells (MSCs) has emerged and have been put forward as an explanation to alleviated symptoms. MSCs with immune-modulatory, anti-inflammatory and anti-viral roles, hold great potential for the treatment of COVID-19. MSCs could be an alternative to treat infections resulting from the SARS-CoV-2 and potential future outbreaks. This review focuses on the MSCs putative protective roles against COVID-19 in pregnant females.