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MicroRNAs (miRNAs) have been shown to be promising biomarkers in predicting cancer prognosis. However, inappropriate or poorly optimized processing and modeling of miRNA expression data can negatively affect prediction performance. Here, we propose a holistic solution for miRNA biomarker selection and prediction model building. This work introduces the use of a neural network cascade, a cascaded constitution of small artificial neural network units, for evaluating miRNA expression and patient outcome. A miRNA microarray dataset of nasopharyngeal carcinoma was retrieved from Gene Expression Omnibus to illustrate the methodology. Results indicated a nonlinear relationship between miRNA expression and patient death risk, implying that direct comparison of expression values is inappropriate. However, this method performs transformation of miRNA expression values into a miRNA score, which linearly measures death risk. Spearman correlation was calculated between miRNA scores and survival status for each miRNA. Finally, a nine-miRNA signature was optimized to predict death risk after nasopharyngeal carcinoma by establishing a neural network cascade consisting of 13 artificial neural network units. Area under the ROC was 0.951 for the internal validation set and had a prediction accuracy of 83% for the external validation set. In particular, the established neural network cascade was found to have strong immunity against noise interference that disturbs miRNA expression values. This study provides an efficient and easy-to-use method that aims to maximize clinical application of miRNAs in prognostic risk assessment of patients with cancer. [ABSTRACT FROM AUTHOR]

Cardiotoxicity is an aggravating side effect of many clinical antineoplastic agents such as arsenic trioxide (As2O3), which is the first-line treatment for acute promyelocytic leukemia (APL). Clinically, drug combination strategies are widely applied for complex disease management. Here, an optimized, cardiac-friendly therapeutic strategy for APL was investigated using a combination of As2O3 and genistein or resveratrol. Potential combinations were explored with respect to their effects on mitochondrial membrane potential, reactive oxygen species, superoxide dismutase activity, autophagy, and apoptosis in both NB4 cells and neonatal rat left ventricular myocytes. All experiments consistently suggested that 5 µM resveratrol remarkably alleviates As2O3-induced cardiotoxicity. To achieve an equivalent effect, a 10-fold dosage of genistein was required, thus highlighting the dose advantage of resveratrol, as poor bioavailability is a common concern for its clinical application. Co-administration of resveratrol substantially amplified the anticancer effect of As2O3 in NB4 cells. Furthermore, resveratrol exacerbated oxidative stress, mitochondrial damage, and apoptosis, thereby reflecting its full range of synergism with As2O3. Addition of 5 µM resveratrol to the single drug formula of As2O3 also further increased the expression of LC3, a marker of cellular autophagy activity, indicating an involvement of autophagy-mediated tumor cell death in the synergistic action. Our results suggest a possible application of an As2O3 and resveratrol combination to treat APL in order to achieve superior therapeutics effects and prevent cardiotoxicity. [ABSTRACT FROM AUTHOR]

Typically, most nephropathies can be categorized as complex human diseases in which the cumulative effect of multiple minor genes, combined with environmental and lifestyle factors, determines the disease phenotype. Thus, multi-target drugs would be more likely to facilitate comprehensive renoprotection than single-target agents. In this study, functional chemical-protein association analysis was performed to retrieve multi-target drugs of high pathway wideness from the STITCH 3.1 database. Pathway wideness of a drug evaluated the efficiency of regulation of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways in quantity. We identified nine experimentally validated renoprotectants that exerted remarkable impact on KEGG pathways by targeting a limited number of proteins. We selected curcumin as an illustrative compound to display the advantage of multi-pathway drugs on renoprotection. We compared curcumin with hemin, an agonist of heme oxygenase-1 (HO-1), which significantly affects only one KEGG pathway, porphyrin and chlorophyll metabolism (adjusted p = 1.5×10−5). At the same concentration (10 µM), both curcumin and hemin equivalently mitigated oxidative stress in H2O2-treated glomerular mesangial cells. The benefit of using hemin was derived from its agonistic effect on HO-1, providing relief from oxidative stress. Selective inhibition of HO-1 completely blocked the action of hemin but not that of curcumin, suggesting simultaneous multi-pathway intervention by curcumin. Curcumin also increased cellular autophagy levels, enhancing its protective effect; however, hemin had no effects. Based on the fact that the dysregulation of multiple pathways is implicated in the etiology of complex diseases, we proposed a feasible method for identifying multi-pathway drugs from compounds with validated targets. Our efforts will help identify multi-pathway agents capable of providing comprehensive protection against renal injuries. [ABSTRACT FROM AUTHOR]