Maha E. Houssen

The majority of lung cancer cases are non-small cell lung cancer (NSCLC) which continues to be a serious global health concern. Hypoxia-inducible factor (HIF-α) pathway is a promising therapeutic target because it has a vital function in advanced non-small cell lung carcinoma. Antiangiogenic multi-kinase inhibitor, sorafenib may have a part in regulating HIF signaling in cancer. As a result, there is now more interest in employing it to target hypoxia-driven pathways in non-small cell lung cancer, especially when paired with natural bioactive products such as dauricine which is a naturally occurring alkaloid molecule targets multiple cellular pathways to provide strong anticancer effects. To examine molecular impacts of combining dauricine with sorafenib on HIF-mediated signaling pathways in human lung cancer cell lines. Cell viability was assessed using MTT assay in A549 and H1975 lung tumor cell lines. Levels of key proteins (AKT, mTORC1, HIF-1 α, ERK, VEGF, Cyclin-D1, BCL2, and E-Cadherin) were measured by ELISA.A colorimetric test was utilized to assess the activity of caspase-3, as a marker of apoptosis. qRT-PCR was employed to identify PI3K and VEGFR2 genes expression. Combination of sorafenib and dauricine significantly enhanced cytotoxicity compared to either agent alone. This combination also led to a marked reduction in VEGFR2, PI3K expression and VEGF, AKT, mTOR, HIF-1α, BCL2, ERK and E-Cadherin, and Cyclin-D1 levels. In addition, there was a significant increase in caspase-3 activity. Dauricine potentiates antitumor effects of sorafenib in human NSCLC by modulating HIF-1α-mediated pathways that are involved in several cancer hallmarks. This combination shows promise as a potential lung cancer treatment approach.

AimTo evaluate the serum levels of HMGB1, IL1 beta, and alpha-klotho in COVID-19 patients with different disease severity, investigate their association with clinicopathological parameters, and to assess HMGB1 rs1045411 polymorphism and its relation with clinical severity. Methods120 COVID-19 patients (89 critically ill, 15 severe, and 16 moderately severe) along with 80 healthy control were enrolled.The serum levels of HMGB1,IL1 beta, and alpha-klotho were determined by ELISA. The HMGB1 rs1045411 polymorphism was detected by RT- PCR. ResultsThe serum levels of HMGB1, IL1 beta, and alpha-klotho were significantly higher in critically ill COVID-19 patients compared to other groups. The HMGB1rs1045411 polymorphism revealed a significant decrease in the percentage of T/T genotypes in COVID-19 patients compared to controls. The (ROC) analysis showed moderate diagnostic potential for serum HMGB1, IL1 beta, and alpha-klotho. ConclusionThe serum HMGB1, IL1 beta, and alpha-klotho may be severity markers and promising therapeutic targets for COVID-19 patients.

Hepatocellular carcinoma (HCC) is a worldwide health issue. Epigenetic alterations play a crucial role in HCC tumorigenesis. Using epigenetic modulators for HCC treatment confers a promising therapeutic effect. The aim of this study was to explore the effect of a decitabine (DAC) and vorinostat (VOR) combination on the crosstalk between apoptosis and autophagy in the HCC HepG2 cell line at 24 h and 72 h. Median inhibitory concentrations (IC₅₀s) of VOR and DAC were assessed in the HepG2 cell line. The activity of caspase-3 was evaluated colorimetrically, and Cyclin D1(CCND1), Bcl-2, ATG5, ATG7, and P62 levels were assessed using ELISA at different time intervals (24 h and 72 h), while LC3IIB and Beclin-1gene expression were measured by using qRT-PCR. The synergistic effect of VOR and DAC was confirmed due to the observed combination indices (CIs) and dose reduction indices (DRIs). The combined treatment with both drugs inhibited the proliferation marker (CCND1), and enhanced apoptosis compared with each drug alone at 24 h and 72 h (via active caspase-3 upregulation and Bcl-2 downregulation). Moreover, the combination induced autophagy as an early event via upregulation of Beclin-1, LC3IIB, ATG5, and ATG7 gene expression. The initial induction of autophagy started to decrease after 72 h due to Beclin-1 downregulation, and there was decreased expression of LC3IIB compared with the value at 24 h. Herein, epigenetic modulation via the VOR/DAC combination showed an antitumor effect through the coordination of an autophagy–apoptosis crosstalk and promotion of autophagy-induced apoptosis, which ultimately led to the cellular death of HCC cancer cells.

Breast cancer is the main predisposing factor for female tumor-related death globally, which increases the requirement to investigate the effectiveness of new drug combination strategies. Sorafenib is a multi-kinase inhibitor mainly targeting vascular endothelial growth factor receptor (VEGFR) and Ras/Raf/ Extracellular signal-regulated kinase (ERK) pathway. Stigmasterol is a phytosterol with anticancer activity targeting different oncogenic pathways. This study aimed to examine the antitumor effects of stigmasterol and sorafenib combination against MDA-MB-231 and MCF-7 breast cancer cell lines via assessing their impact on VEGF, VEGFR-2, nuclear factor kappa B (NF-κB), Ki-67, Bcl-2, ERK, and caspase-3. Cytotoxicity was investigated using the MTT assay. VEGF, VEGFR-2, ERK, NF-κB, Bcl-2, and Ki-67 levels were assessed using the ELISA technique. VEGFR-2 gene expression was assessed using the RT-PCR technique, while caspase-3 activity was investigated using the colorimetric technique. Sorafenib and stigmasterol combination reduced the levels of NF-κB, Bcl-2, Ki-67, VEGFR-2, and VEGF-A, whereas the activity of caspase-3 was increased. In addition, MCF-7 showed more favorable results than MDA-MB-231. Stigmasterol and sorafenib combination may be a promising therapeutic regimen for breast cancer treatment through modulation of NF-κB-VEGF/BCL-2 and ERK/Caspase-3 signaling axes crosstalk.

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Sorafenib is a multi-tyrosine kinase inhibitor used to treat HCC. However, it has many side effects and induces resistance. Esculetin is a natural compound with reported anticancer activity. This study was designedto assess the chemotherapeutic effects of the sorafenib and esculetin combination on human HCC cells.Stock solutions from sorafenib and esculetin in DMSO were prepared and then diluted by DMEM to obtain the required working concentrations. HepG2 and Huh-7 cells have been selected as in vitro model of HCC.Cytotoxicity was evaluatedusing an MTT assay. We performed flow cytometry analysis and scratch assay to assess apoptosis and migration. Finally, we quantifiedvascular endothelial growth factor (VEGF), VEGFR-2, EGFR, NF-κB, and Ki-67, PI3K, p38MAPK levels through ELISA, whileHRAS and ERK2 gene expressionwere detected through RT-PCR.The sorafenib and esculetin combination exerted a potent synergistic anti-tumor effect by modulating the EGFR and VEGF-RAS/ERK/PI3K/NF-κBaxes associated with significant upregulation of the apoptotic p38MAPK/caspase-3 axis, modulation of pI3k/p38MAPK crosstalk and inhibition of the proliferation marker Ki67.This study paves the way for using esculetin as good adjuvant to sorafenib as a promising future treatment for hepatocellular carcinoma.

Purpose Colon cancer is the second most common cause of cancer-related death worldwide. Angiogenesis mediated by vascular endothelial growth factor (VEGF) plays important roles in cancer progression, and activated mitogen protein kinase (AMPK) has also been shown to exert both positive and negative effects on angiogenesis and different oncogenic signaling pathways. The multikinase inhibitor regorafenib prevents the activation of numerous kinases involved in angiogenesis, proliferation, and metastasis. All-trans retinoic acid (ATRA) has also been demonstrated to inhibit the growth and the development of different types of tumors. This study aims to assess the antitumor effects of ATRA in regorafenib-treated human colon cancer cell lines and investigate the molecular mechanism mediating these effects. Methods The levels of VEGF, AMPK, extracellular signalregulated protein kinase 1 (ERK1), and nuclear factor kappa B (NF-κB) were analyzed using enzyme-linked immunosorbent assay, and caspase-3 activity was assessed colorimetrically. Results ATRA potentiated AMPK and caspase-3 activities and reduced the levels of VEGF, ERK1, and NF-κB levels in regorafenib-treated human colon cancer cell lines. Conclusion ATRA exerted synergistic antiproliferative, antiangiogenic, and proapoptotic effects on regorafenib-treated colorectal cancer cells by modulating the AMPK/VEFG/ERK/NF-κB/caspase-3 signaling axis.

Background: Breast cancer is the most common malignancy in women worldwide. P2X7 is a transmembrane receptor expressed in breast cancer and activated by the ATP tumor microenvironment, driving cell proliferation, angiogenesis, and metastasis via different signaling pathways. The role of the P2X7 receptor, hypoxia, and autophagy in regulating tumor progression is controversial. The multikinase inhibitor regorafenib prevents the activation of numerous kinases involved in angiogenesis, proliferation, and metastasis. The present study aimed to evaluate the modulatory effect of regorafenib on the hypoxia/angiogenesis/P2X7R/autophagy axis on the MCF7 breast cancer cell line and its impact on different signaling pathways involved in breast cancer pathogenesis. Methods: The levels of VEGF, VEGFR, PI3K, NF-κB, HIF-1α, and LC3-II were analyzed using ELISA, and caspase-3 activity was also assessed colorimetrically. Phosphorylated (p)-p38 MAPK and purinergic ligand-gated ion channel 7 (P2X7) receptor protein expression levels were analyzed via Western blotting. Reverse transcription-quantitative PCR was used to determine the mRNA expression levels of Beclin 1 (BECN1), LC3-II, and sequestosome 1 (p62). Results: Regorafenib reduced MCF7 cell viability in a dose-dependent manner. Furthermore, regorafenib significantly reduced levels of PI3K, NF-κB, VEGF, VEGFR, P2X7 receptor, and p-p38 MAPK protein expression, and markedly reduced p62 mRNA expression levels. However, regorafenib significantly increased caspase-3 activity, as well as BECN1 and LC3-II mRNA expression levels. Conclusions: Regorafenib was demonstrated to possibly exhibit antitumor activity on the breast cancer cell line via modulation of the P2X7/HIF-1α/VEGF, P2X7/P38, P2X7/ERK/NF-κB, and P2X7/beclin 1 pathways.