Ovarian Cancer

Preface

Subject Index

Mutation and DNA Repairs

Mutations are changes in the DNA sequence that can occur spontaneously or due to exposure to mutagenic agents such as chemicals, radiation, or viruses. These changes can have a wide range of effects on the organism, from no effect at all to causing genetic disorders or cancer. DNA repair mechanisms exist to correct these mutations, ensuring the integrity of the genetic material. There are several types of DNA repair mechanisms, including base excision repair, nucleotide excision repair, and mismatch repair, each designed to correct different types of DNA damage. The repair mechanisms are highly regulated and involve a complex network of proteins that detect, remove, and replace damaged DNA. Defects in DNA repair mechanisms can lead to an accumulation of mutations, increasing the risk of cancer and other diseases. For example, individuals with inherited mutations in DNA repair genes have a higher risk of developing certain types of cancer, such as breast and ovarian cancer.

Subject Index

Endophytes as an Alternative Source for Anticancer Agents

The world faces new challenges every decade in the form of calamities, pandemics, and deadly diseases. The increase in the population and limited resources has led the human race towards many ailments that are incurable, but the potency of the human brain and in collusion with natural resources can reveal the remedy to many diseases. Cancer is one of the major reasons for mortality at present, which is a global challenge. The search for new anticancer drugs is a necessity of the present day. Researchers are urged to explore alternative and new potent sources of anticancer drugs. Natural sources include plant products or some plant-derived bioactive compounds. Endophytes manifest as an acceptable source of bioactive compounds of medicinal value. Endophytes are microorganisms present asymptomatically inside the plant parts. These are known to produce several metabolites with antifungal, antiviral, antioxidant, and anticancerous activity. Some major metabolites include taxol, alkaloids, camptothecin, chromones, etc. These produced metabolites can also be manipulated for the production of novel chemotherapeutic agents. The incessant need for these anticancer drugs has escalated the search for novel natural compounds. The present chapter attempts to summarize different endophytic metabolites that serve as an alternative source for an ailment of the deadly cancer disease.

Appendix A

Defining the Moral Status of an Embryo? Or Defying the Moral Status of a Woman?

Embryonic Stem Cells (ESC) are pluripotent cells that give rise to all cell types and are used for cell replacement and regenerative therapies. However, ethical, social, and legal controversies have questioned the morality of the procedures to obtain ESC lines, and the moral status of an embryo is oscillating in the debate about the origin of life, whether it originates at the totipotent stage or at the point of syngamy. Ironically, the moral status of women is also being defied by inadequate informed consent for medical procedures and their life-threatening consequences. In response to the ESC controversy, an alternate approach of using low-grade embryos for obtaining ESC lines has been proposed. This study aims to define the moral status of an embryo, question the defined status of a woman, and find new ethical-based medical procedures to obtain ESC lines.

Abortion–The Ethical Preview

The deliberate termination of a pregnancy before a fetus can live independently is called abortion. On the other hand, the natural ending of pregnancy is called a miscarriage. This chapter describes abortion descriptively, along with its types, causative factors, risks associated with it, and the potential consequences it can have on the individual and society. It also discusses the different religious points of view on abortion and the worldwide prevalence of abortion, with special reference to Pakistan. Some organizations are also mentioned that are working to prevent it. An extensive discussion has also been carried out regarding its ethical concerns. In the ending, keeping in mind all the factors, a brief conclusion has been drawn.

In vitro Regeneration and Conservation of the Medicinal and Aromatic genus Kaempferia: An Overview

Genus Kaempferia comprises about 124 species distributed in Southeast Asia and is well known for it's diverse medicinal, nutritional and industrial values. The plants of the genus are rhizomatous, perennial, and oil-yielding plants; some are also used as spices. The essential oil obtained from the plants has a considerable market value worldwide. The rhizomes of these plants were used in traditional medicine due to the presence of diverse bioactive compounds and used to treat urinary tract infections, fever, cough, hypertension, metabolic disorder, asthma, rheumatism, epilepsy, skin diseases, etc. Seed dormancy, seasonal outgrowth and seed made through crosspollination were found to be non-viable, which are the prime limitations of ex situ conservation regarding this genus. To overcome this type of problem, in vitro tissue culture is the way to get the plants available over the year without any limitations. This chapter is based mainly on exploring those bioactive compounds containing species of the genus Kaempferia, and obtaining an alternative resource of phyto-compounds for use in pharmaceuticals and conserving them through an artificial way to get them throughout the year without exploiting the area and genotypic alteration.

Subject Index

Therapeutic Scope and Application of Mushroom-Derived Pharmacoactives in Enhancing Health

In the present era, the notion that “prevention is better than cure” has gained impetus with increased incidences of infectious and degenerative lifestyle diseases. Recent years have seen many people choosing functional food such as probiotics, plant-based nutritional supplements, and their normal dietary needs. Studies have shown significant health benefits in using these nutraceuticals as they aid in the body's general well-being. Among food varieties, edible mushrooms have also become a functional dietary food. It has been used as a source of nutrition in many parts of the world. Oriental medicine has been using mushrooms as a component in various medicinal concoctions for several decades. Today, with the advent of scientific knowhow, around 2,000 edible mushrooms have been identified; among them, 700 possess bioactive compounds. Both In vitro and In vivo studies have shown immunomodulatory effects via the regulation of innate, complement-mediated, and adaptive immunity by enhancing the active mechanisms of immune systems such as the macrophages, IL, TNF-α, IFN-γ, NO, and the complement system. The possibility of modulating these immune system players by the bioactives may pave the way to side-effect-free anticancer and immunosuppressant drugs. Recent studies have also elucidated the neuroprotective effect induced by mushroom-derived compounds through ROS scavenging and antioxidant activity. This chapter highlights the recent findings and the importance of these mushroom-derived compounds and their anti-inflammatory, anticancerous antioxidant, and immunomodulatory roles.

Multi-omics Profiles are Applicable to Human Diseases and Drug Development

Traditional medicine has been a reliable source for the discovery of molecules with therapeutic activity against human diseases of clinical interest. In the past, knowledge of traditional medicine was mainly transmitted orally and in writing. Recently, the advent of “multiomics” tools (transcriptomics, metabolomics, epigenomics, proteomics, and lipidomics, among others) has increased and merged our knowledge, both traditional knowledge and that gained with these new multiomics technologies. In this way, the development of medicines with these 'multiomics technologies' has allowed pharmaceutical advances in the discovery of new drugs. In addition, 'multiomics' technologies have made it possible to uncover new biological activities of drugs that are currently used in clinical therapy. In the same way, 'multiomics' has allowed for the development of 'personalized medicine', that is, a particular and specific treatment and/or diagnosis of a patient with respect to a disease. Therefore, 'multiomics' technologies have facilitated the discovery of new clinical therapeutics for disease, as well as allowing for the diagnosis and/or treatment of diseases in an individual and personalized way.

The Role of Age in Pediatric Tumors of the Central Nervous System

Pediatric tumors of the central nervous system (CNS) are the second most common type of solid childhood cancer. As such, they have a major effect on the rates of morbidity and mortality in children. CNS tumors originate from abnormal cells in the brain and/or spinal cord, which can be classified as either benign or malignant. They can be further subdivided into different categories based on several principal aspects, such as tumor location, histopathology, and developmental age. Among these various characteristics, age is one of the most consequential determinants for CNS tumors. Specific groups between 0 and 21 years of age, for instance, have radically divergent landscapes in terms of their tumor incidence and unique biology. Depending on the age of the child, key case features may differ like the clinical evaluation, medical diagnosis and prognosis, recommended therapy and treatment courses, anticipated responses and tolerability to treatment, and management of side effects. Effective teamwork is another crucial component for the successful management of pediatric CNS tumors. In patient-and-family-centered care, ensuring a detailed education of the children and their families, as well as their involvement in the decision-making process where appropriate, is imperative. To determine the best available options for the patient, multidisciplinary medical teams will often deliberate over all of the possible procedures. The holistic care provided by these interprofessional collaborations for this vulnerable population will depend on the age of the child, in addition to the level of patient and family participation. Evidence shows that support and counseling of the patient and their family during the entire treatment process can have a significant impact on outcomes. This chapter will review the essential diagnostic and prognostic considerations of childhood CNS tumors, with special emphasis placed on favorable therapies and treatments, including in-depth discussions around the multi-faceted responses to treatment and the management of its side effects. In particular, this content will highlight the critical role that age, and interdisciplinary healthcare teams play in comprehensive disease management.

Subject Index

Biomaterials and Mesenchymal Stem Cells

Mesenchymal stem/stromal cells are splendid cell sources for tissue engineering and regenerative medicine attributed to the unique hematopoietic-support and immunomodulatory properties as well as the multi-dimensional differentiation potential towards adipocytes, osteoblasts, and chondrocytes in vitro and in vivo. To date, MSCs have been identified from various approaches, such as perinatal tissues, and adult tissues, and even derived from human pluripotent stem cells (hPSCs). Longitudinal studies have indicated the ameliorative effect and therapeutic efficacy upon a variety of refractory and recurrent disorders such as acute-on-chronic liver failure (ACLF), acute myeloid leukemia (ACLF), premature ovarian failure (POF), and intractable wounds. To date, MSCs have been a to have various origins, including mesoderm, endoderm and ectoderm. In this chapter, we mainly focus on the concepts, and biological and therapeutic properties of MSCs, together with the standardizations for industrial transformation. Overall, the descriptions would help promote a better understanding of MSCs in disease pathogenesis and management and benefit the preclinical and clinical applications in the future.

The Role of Emerging Technologies in Smart Health Care

Numerous technological advancements like 3-D Printing, Virtual Reality (VR), Augmented Reality (AR), Artificial Intelligence (AI), Internet of Things (IoT), Drones, Robots, and Blockchain are now being inscribed for their ability to change the health care industry and make it a more automated and effective field. Various tools related to AI, like Google, DeepMind, Atomwise, Chatbot, Enlitic, Freenome, and Buoy Health, are helpful in makingthe health industry more efficient. There is another technology which is nanomicelle that can be used for effective drug delivery to treat various cancers, including breast, colon, and lung cancer. Moreover, self-assembling peptide nanoparticles that were prepared from SARSCov-1 spike (S) protein, successfully induced neutralizing antibodies against the coronavirus, subsequently preventing infection of Vero cells. Furthermore, the application of 3D printing in medicine can provide many benefits, including the customization and personalization of medical products, drugs, and equipment; cost-effectiveness; increased productivity; democratization of design and manufacturing; and enhanced collaboration. IoT enables real-time alerting, tracking, and monitoring, which permits hands-on treatment, better accuracy, apt intervention by doctors, and improves patient care delivery results. The other most promising application isblockchain in the healthcare sector for identity management, dynamic patient consent, and management of supply chains for medical supplies and pharmaceuticals. In addition, there are several case studies that describe the benefits of emerging tools, like recently the use of Emerging Technologies for the study, diagnosis, and treatment of patients with COVID-19 by using Deep Convolutional neural networks (CNN), which is a widely used deep learning architecture, enabled distinguishing between COVID-19 and other causes of pneumonia through chest X-ray image analysis.

Promising Pharmaceutical Compounds of Marine Fishes: Their Chemistry and Therapeutic Applications

This chapter deals with the bioactive potential of the different groups of marine fishes viz. cartilaginous, bony, and jawless fish species.

Promising Pharmaceutical Compounds of Marine Bryozoans: Their Chemistry and Therapeutic Applications

This chapter deals with the pharmaceutically important marine bryozoans, their promising secondary metabolites, and bioactivities. All the bioactive compounds of this marine invertebrate group are dealt with as per their chemical classes.

Biotization of Medicinal Plant Cultures by Endophytes: A Promising Approach to Enrich Therapeutics

Overexploitation, climate change, and pressure from invasive species are threatening the diversity of medicinal plants; a few of them are extinct or in the endangered category. The mass multiplication of some medicinal plants outside their natural habitat affected the biochemical diversity of the plants, thereby decreasing their medicinal value. Hence, micropropagation of high-yielding, elite genotypes was preferred over time to conserve the species and meet the pharmaceutical needs. Although micropropagation was promising, the diversity and quantity of bioactive compounds of the in vitro plants were not comparable to those of their counterparts in nature. The in vitro plants, challenged with a plethora of biotic and abiotic stresses, were poorly acclimatized, with abject survival. During the last few decades, the role of endophytes with their mechanisms in enhancing growth, development, and stress tolerance has been proven among field-grown plants. In consequence, the role of endophytes in micropropagation is gaining prominence to address the vulnerability, acclimatization, and enhanced bioactive compounds of tissue culture plants. This approach of the use of competent endophytes is known as biotization. This chapter brings together the current status, possibilities, and limitations of the most promising biotization of medicinal plants. Biotization of endophytes in micropropagation is a potential tool for the production of medicinal plants with enriched bioactive compounds with improved therapeutic effects.

Hormoneal Therapy

Treatments that involve the use of hormones or their antagonists are commonly referred to as hormone therapy or hormonal therapy. Oncologic hormone therapy, hormone replacement therapy (HRT), androgen replacement therapy (ART), oral contraceptive pills and gender-affirming hormone therapy are the major classes of hormonal therapy in addition to a few others. Some hormonal therapies will be discussed in detail under different chapters including oncologic hormone therapy, glucocorticoids and mineralocorticoids and insulin under antineoplastic agents, antiinflammatory steroids and antidiabetic agents, respectively. After studying this chapter, students will be able to:

• Define and classify hormonal therapy and differentiate between hormonal therapy and treatment.

• Explain all types of hormone replacement therapy including menopausal, androgens, and oral contraceptives.

• Discuss the use of androgen replacement therapy (ART) in males with low levels of testosterone due to disease or aging.

• Describe gender-affirming hormone therapy such as feminizing hormone therapy and masculinizing hormone therapy. • Identify appropriate growth hormone therapy for growth hormone deficiency.

• Demonstrate understanding of thyroid hormone replacement in hypothyroidism and antithyroid therapy in hyperthyroidism.

• Demonstrate clear guidance to the use of oral contraceptive pills for various purposes including birth control.

Animal Models for Cancer

Cancer is a complex multifactorial disease that affects many people worldwide. Animal models play an important role in deciphering cancer biology and developing new therapies. The animal models widely used in cancer research include tumor xenografts, genetically engineered mice, chemically induced models, and spontaneous tumor models. These models provide a controlled environment to study cancer progression, the interaction of cancer and the immune system, and the effectiveness of new therapies. Although animal models have several advantages, it is important to identify their limitations and use them in conjunction with other preclinical models, such as in-vitro cell culture and patient-derived xenografts, to ensure that results are transferable to humans. In this chapter, we discuss the importance of animal models in cancer research, the different types of animal models, and their advantages and disadvantages. We also provide some examples of animal models used in cancer research. Collectively, animal models have been invaluable in advancing our understanding of cancer and will continue to be important tools in the development of new therapies.

Medical Biotechnology

Medical biotechnology incorporates many of the topics that have already been discussed in this book. Right from developing new drugs to prospects of stem cell use and cloning, the possibilities are enormous.

Newer Technologies in Molecular Biology

Technical advances began with the advent of array comparative genomic hybridization and single nucleotide polymorphism arrays and are enabling researchers to identify disease-associated genetic variants by virtually scanning the entire genome. With the help of these technologies, it is now possible to screen for common genetic variants and even rare small deletions and duplications i.e., microdeletions and microduplications. This has led to a virtual explosion of gene identifications. This chapter aims to provide an overview of new technologies.

Role of Nanoparticular/Nanovesicular Systems as Biosensors

Biosensors are analytical apparatus utilized for the qualitative and quantitative detection of various biological or non-biological analytes. Early diagnosis of diseases (cancer, infectious disease), monitoring environmental pollution, and ensuring food safety are very important in terms of individual and public health. Therefore, it is also crucial to detect these markers sensitively and accurately, with cheap and simple methods, especially despite limited resources. Nanoparticles, thanks to their nano size, provide wide areas of biosensing and amplify signals. In most of the works, it was observed that the limit of detection (LOD) value decreased and the selectivity improved in biosensors prepared using nanosystems compared to conventional sensors. In this respect, the results give us hope for the use of nanosystems in biosensors. In this section, the subject of biosensors is briefly mentioned and mainly studies on the use of nanoparticular/nanovesicular systems in the field of biosensors are included.

Nanoparticle Targeting Strategies In Cancer Therapy

This review outlines major cancer targeting strategies for nanoparticle systems. Targeted therapies have superiority over conventional chemotherapy or radiotherapy methods. Nanoparticles as drug nanocarriers enable drug delivery to the tumoral regions. For targeted drug delivery, nanoparticles are designed and tailored depending on the cancer and the purpose of the targeting mechanism. In this review, nanoparticle targeting for cancer therapy was summarized into three sections: passive, active, and physical targeting. Each issue was described and discussed with recent nanoparticular studies and their findings. In addition, a combination of targeting with diagnostics and theranostics was also presented.

Metallic Nanoparticles: Synthesis and Applications in Medicine

The progress in nanoscience and advances in the fabrication, characterization, and modification of materials at the nanoscale have paved the way for the production and use of nanoparticles with different properties. Today, the chemical agents used in many therapies cannot achieve the desired effectiveness due to dose-dependent toxicity, low solubility and bioavailability, damage to non-target organs and tissues due to non-specificity, and side effects. Nanoparticle systems produced in different forms and compositions are one of the main approaches used to eliminate the negative aspects of conventional chemical agents. Among these nanoparticle systems, metallic nanoparticles represent a promising approach. During the last two decades, metallic nanoparticles (MNPs) have drawn great attention due to their optical, electrical, and physicochemical properties as well as their size-dependent properties. The large surface to volume ratio and surface reactivity of metallic nanoparticles provide great potential for combining them with different biological/chemical agents, as well as they can also be formulated as a bioactive nanoplatform alone. In this regard, the present chapter summarizes the general aspects of metallic nanoparticles, common methods for synthesis, and various applications in the biomedical field.

Lipid-Based Nanocarriers and Applications in Medicine

Lipid nanocarriers have recently arisen with a wide range of uses and research areas, with the advantages they offer in virtue of their unique properties. They are easily synthesized, scaled up, biodegradable, proper to transport many bioactive components, have a high loading capacity, and are convenient for various routes of administration (parenteral, oral, dermal, ocular, etc.). These carriers overcome the problems of bioactive substances such as low solubility, plasma half-life and bioavailability, and side effects, as well as providing controlled release, local delivery, and targeting. Lipid-based nanoparticular systems can be categorized into two basic classes, vesicular and non-vesicular. While liposomes are the most widely used vesicular structures, solid lipid nanoparticles and nano-structured lipid carriers are non-vesicular nanocarriers. These nanocarriers have many medical uses, such as cancer therapy, gene therapy, photodynamic therapy, treatment of infectious diseases and neurodegenerative diseases, vaccines, imaging, etc. It is essential that the synthesis method of lipid-based nanocarriers and the components from which they are composed are selected in accordance with the medical application area and characterization studies are carried out. In this article, liposomes, solid lipid nanoparticles and nano-structured lipid carriers will be discussed as lipid-based nanocarriers, synthesis and characterization methods will be emphasized and examples from medical applications will be given.

Bioinspired, Biomimetic Nanomedicines

Bio-inspired nanotechnology (biomimetic nanotechnology) is defined as the acquisition of nanomaterials or nanodevices and systems using the principles of biology during design or synthesis. Transferring a mechanism, an idea, or a formation from living systems to inanimate systems is an essential strategy. In this context, nanoparticles inspired by nature have many advantages, such as functionality, biocompatibility, low toxicity, diversity, and tolerability. It is known that biomimetic approaches have been used in materials science since ancient times. Today, it plays a crucial role in the development of drug delivery systems, imaging, and diagnostics in medical science. There is no doubt that interest and research in biomimetic approaches, which is an innovative approach and inspired by nature, will continue in the field of medicine and life sciences hereafter. Within the scope of this chapter, polymeric nanomedicines, monoclonal antibodies and related structures, cell and cell-membrane-derived biomimetic nanomedicines, bacteria-inspired nanomedicines, viral biomimetic nanomedicines, organelle-related nanomedicines, nanozymes, protein corona, and nanomedicine concepts and new developments will be elucidated.

Subject Index

References

Glossary

Subject Index

Phyto-nanoformulations for the Treatment of Clinical Diseases

Plant-derived drugs or formulations have always been explored because of

their lesser side effects and toxicities compared to synthetic drugs and they have been

widely used as traditional and complementary medicines for the management of many

diseases including cancer. The major challenges faced were the absorption of the plantderived

drugs, their stability, bioavailability, and transport to the intended sites inside

the body. Recent progress in nanotechnology has helped to minimize these limitations

and hence phyto-nanoformulations are slowly growing in preclinical trials as well as

clinical use. The use of various nanostructures such as nano-micelles, lipid

nanoparticles, carbon nanotubes, polymer nanoparticles, and nanoliposomes and

various types of drug delivery vehicles such as polybutylcyanoacrylate, polylactic-c-

-glycolic acid, and lactoferrin has immensely helped in increasing the effectiveness of

phytochemical drugs by increasing their stability, better pharmacokinetics and reducing

the toxicity and side effects. Phyto-nanoformulations having natural product

components such as curcumin, piperine, quercetin, berberine, scutellarin, baicalin,

stevioside, silybin, gymnemic acid, naringenin, capsicum oleoresin, emodin, and

resveratrol have been shown to improve the condition of patients diagnosed with

diseases such as neurodegenerative disorders, diabetes, infections, and cancer. Phyto

nanoformulations can also be used to treat disorders of the brain where the blood-brain

barrier is impervious to the drugs. These phyto-nanoformulations have been shown to

target several molecular cell-signaling and metabolic pathways. This chapter covers the

compositions of phyto-nanoformulations and how they have been used to control

several diseases.

Nanotechnology in Medicinal Plants

Nanoparticles have immense applications in plants from mass propagation to

phyto-drug extraction and augmentation. Alongside, nanoparticles are also manifested

as potential drug vehicles for carrying curative agents to the targeted tissues or part,

accompanying control delivery of drugs to the infected site. Advancement in

nanotechnology directed towards the transformation of metallo-drugs at the nanoscale

brings new dimensions in therapeutics from the treatment of multidrug-resistant

microbes to chemotherapies of tumors. With the nano-advancement, not only metals

and their oxides are transformed at the nanoscale but also the potential phyto agents,

proteins, and hormones are transformed into nanosized entities which change the entire

fundamentals of therapeutic and curative practices. A lot of changes in medicine, drug

delivery system and drug formulation as commenced just because of nanotechnology.

The current chapter highlights nanotech advancements in the area of medicinal plant

propagation, drug augmentation and extraction methodologies along with their

limitations and future prospects.

Medicinal Plants: Traditional Trends to Modern Therapeutics

Medicinal plant therapies are becoming more common, as more people seek

natural cures and health approaches devoid of synthetic chemicals' adverse effects. The

biological and pharmacological potential of plants is studied and utilized all around the

globe for various purposes including the treatment of infections and diseases owing due

to bioactive compounds in plants produced as a result of secondary metabolism. The

study of medicinal plants is helpful in clinical trials to find pharmacologically useful

chemicals, and this method has produced thousands of valued medicines. Opium,

aspirin, quinine, and digoxin are some examples. Plants possess a large number of

bioactive compounds. On the basis of their chemical structure, they are divided into

four classes: alkaloids, flavonoids, tannins, and terpenes. Plants can now be turned into

“factories” that create therapeutic proteins, vaccines, and many more products for use

in the production of biotech pharmaceuticals, medications, and therapies. This chapter

discusses the diversity and importance of medicinal plants in various sectors as well as

highlights the successful drug products produced by the said entities and their future

trends.

Exceptional Responders: Exploring the Molecular “Make-up” of Patients with Cancer Who Experienced Recovery

Patients with cancer, who have achieved an unexpectedly favorable and long-term clinical response are commonly known as exceptional responders (ER). Such patients have often experienced extraordinary responses to some oncology therapies, which have been ineffective for other individuals with similar malignancies. These unusually positive responses may be partially due to some unique genetic and molecular mechanisms, which can be further studied. This, in turn, could provide some directions to a better understanding of why the specific therapy works for only a small number of patients with cancer, but not for everybody. To further elucidate these issues, the National Cancer Institute (NCI) has been conducting various research projects to explain biological processes, which can be responsible for these remarkable responses. A recent pilot study, known as the Exceptional Responders Initiative (ERI), has evaluated the feasibility of identifying exceptional responders retrospectively, by obtaining pre-exceptional response treatment tumor tissues and analyzing them with modern molecular tools. The promising findings of this study can inspire many women with breast cancer (BC) and their medical teams. This chapter presents a synopsis of the ERI. It suggests some possibilities to adjust this concept for patients with breast cancer (BC) (e.g., advanced or metastatic triplenegative breast cancer (TNBC)).

The Way Out From the Labyrinth of Anticancer Therapies for Patients with Breast Cancer: How Can We Improve Their Cardiac Safety and Quality of Life?

Patients with Breast cancer (BC) often experience a spectrum of adverse, anticancer therapy-related symptoms, which deteriorate their quality of life (QoL). Therefore, effective strategies for BC are needed. Personalized medicine offers many therapeutic options (e.g., targeted therapies) that can be tailored to the individual needs of a given patient. This chapter aims to briefly present typical side effects of current anticancer treatments, which often reduce the QoL of patients with BC and survivors. In particular, it addresses pain (including chemotherapy (CHT)-induced peripheral neuropathy (PN) and lymphedema), depression, cognitive dysfunction, premature menopause, and CHT-induced menopause. It focuses on the adverse effects of the BC therapies, such as chemotherapy (CHT), immunotherapy (IT), and some targeted therapies. In addition, several issues related to cardiovascular toxicity induced by anticancer treatments and cardioprotective measures for women with BC are addressed. This chapter also touches on the recent advances in precision medicine and provides some future directions, aimed at fulfilling unmet needs of patients with BC. The described approaches may be helpful in planning personalized treatment, facilitating the patient’s tolerability of many available anticancer therapies, optimizing the medication selection, and improving the patient’s QoL.

Importance of Biomarker Conversions as “Road Signs” to Manage Women with Metastatic Breast Cancer: How To Use Them for Personalized Care of These Patients?

During a metastatic progression of breast cancer (BC), and upon application of various antineoplastic therapies, the initial status of biomarkers can be altered. Awareness of changes in hormone receptors (HR) and human epidermal growth factor receptor 2 (HER2) is very important, because they may have an impact on patient management. However, the procedures for monitoring these changes in women with metastatic BC still remain unclear. According to the guidelines for clinical practice from the American Society of Clinical Oncology (ASCO), the reevaluation of metastatic BC lesions, is of great importance, and it has been recommended that the biopsies of multiple metastatic lesions need to be performed. The aim of this chapter is to highlight the role of retesting receptor status in BC metastases and the impact that this approach may have on the selection of therapeutic strategies, in the individualized management plans for patients with metastatic BC. In addition, this chapter concisely presents some novel biomarkers linked with targeted therapies for metastatic BC.

Unraveling Ethnic Disparities in Triple-Negative Breast Cancer (TNBC): Exploring The Impact of Metabolic, Reproductive, Environmental, and Social Factors on the Disease Course in African-American (AA) Women Population

Triple-negative breast cancer (TNBC) is a particularly aggressive subtype of breast cancer (BC) in which the expression of the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2) is absent or very low. TNBC consists of approximately 15-30% of the invasive BC cases in the United States (US) Women with TNBC represent a heterogeneous population with regard to their ethnicity and biology including the genetic make-up metabolic or hormonal profile as well as the socioeconomic status (SES) cultural behavioral educational levels. Notably African-American (AA) women usually have a higher prevalence of TNBC and a worse prognosis compared to European-American (EA) or Non-Hispanic White (NHW) women. The goal of this chapter is to elucidate the possible interplay of inherited and acquired, often lifestyle-related risk factors which can stimulate the initiation and development of the most aggressive subtypes of TNBC in AA women compared to their EA (or NHW) counterparts. In particular this chapter explores some ethnic disparities in TNBC mainly in the example of the US where such disparities have been studied in clinical research. This chapter also focuses on differences in TNBC risk factors healthcare patterns clinical outcomes between AA and EA (or NHW) women. It briefly discusses the multi-factorial etiology of these disparities e.g genetic, hormonal, metabolic, behavioral, cultural, socio-economical and environmental. Presented short analysis of a dynamic blend of inherited and acquired variables also provides some directions for the reduction of these disparities, to improve TNBC outcomes, among women from ethnic groups, such as AA.

Radiation from Mobile Phones and Cell Towers, Risks, and Protection

Modern life is strongly associated with new technologies such as telecommunication and wireless devices. These new technologies strongly affect the way people communicate, learn, train, think and solve their problems. Today, modern cell phones not only send and receive phone calls, but they also allow people to send and receive short messages, and e-mails, share photos and videos, write, edit and share documents, play games, listen to music, watch movies, surf the Internet, find an address using GPS (Global Positioning Systems) and use a wide range of applications. Given this consideration, excessive use of smartphones is associated with growing global concerns over the health effects of radiofrequency electromagnetic fields (RF-EMF) generated by these devices. As discussed by WHO, considering the very large number of people who use mobile phones, even a small increase in the risk of adverse health effects, either cancer or other health effects, could have key public health implications. WHO believes that research about these health effects is mostly focused on potential adverse effects of mobile phones, not their base stations, because the RF-EMF levels of mobile phones are 3 orders of magnitude higher than those of base stations. Therefore, in this chapter, due to the greater likelihood of adverse health effects of handsets, we mainly focused on reviewing the current scientific evidence on health risks associated with mobile phones. However, the health effects of RF-EMF exposure on people living in the proximity of mobile base stations are also reviewed.

Drug from Marine Sampling to Factory

The marine world expresses a great scope for diverse novel scaffolds with unusual skeleton nature. Polyphenols, phycocolloids, pigments, fucoidans, peptides, pigments, and phlorotannins are the main classes of compounds provided by marine resources. Some of these structures displayed astonishing biological activities and successfully proceeded to marketed drugs for the treatment of different human diseases. There are many examples of successful commercially available marine-derived drugs such as cytarabine (Cytosar-U®) for acute myelocytic leukemia, trabectedin (Yondelis®) for ovarian cancer, Eribulin (Halaven®) for metastatic breast cancer, Ziconotide (Prialt®) for severe chronic pain, and Vidarabine (Ara-A) for viral infections. Oceans and their immense biodiversity have gifted humanity with a pathway out of the obstacles of health care. The constant need for innovation has been a great challenge for the pharmaceutical industry especially in finding new sources of active compounds. This chapter discussed the clinically approved marine-derived compounds and their impact on different diseases, focusing on those with granted approval in the last decade from 2011 to 2021. We also highlighted the underlying mechanism of actions through in vivo, in vitro, and computational in silico studies. Hopefully, this chapter will help scientists to develop a novel marine-derived drug.

Modern Nanotherapeutic Approaches in The Delivery of Phyto Pharmceuticals in Anti Cancer Research

Cancer has become one of the leading causes of human morbidity and mortality worldwide. A promising approach to tumour prevention is to eliminate cancer cells, preferably with less harm to neighbouring normal cells. Due to the disadvantages associated with current chemotherapy and radiation therapy, there is an increasing interest in developing novel delivery strategies for these natural products. Many phytochemicals show promise in cancer prevention and treatment due to their biocompatibility, low cytotoxicity, low resistance, and dynamic physiochemical properties that discriminate normal cells in the treatment of various cancer types. However, their low aqueous solubility, poor stability, unfavourable bioavailability, and low target specificity make their administration at therapeutic doses unrealistic. Recently developed nanotechnology has transformed drug delivery concepts and paved the way for the development of phytochemical-loaded nanoparticles for cancer prevention and treatment. Polymeric nanoparticles, lipid nanoparticles, carbon-based nanoparticles, and cell-derived nanoparticles can increase the stability and solubility of phytochemicals and also help in overcoming the disadvantages associated with conventional chemotherapy and phytochemicals. In the current chapter, we have mentioned the importance of nanotechnology in the delivery of phytochemicals and also added a note on the significance of delivery with current chemotherapeutics, including present challenges and future perspectives.

Cannabis in the Treatment of Various Cancers and its Current Global Scenario

Cannabis has been used as a drug for centuries, possibly much longer before it was recognised as an illegal substance. The prime psychoactive property is marked on the 9-THC compound. The cannabinoids replicate the action of endocannabinoids by stimulating receptors in the central nervous system and lymphatic system via diligent CB1 and CB2, respectively. Cannabinoids, on the other hand, are well known for their dependency, which is less severe than that of other drugs that can be abused. Cannabis' anti-tumor and anti-cancer potential was only discovered at the turn of the twentieth century. Cannabis consumption has been reported to benefit patients with cancer by suppressing nausea, curbing vomiting, elevating appetite, alleviating pain, and pacifying anxiety. Studies envisage that the up-regulation of CB receptors and their associated endogenous ligands correlates with the suppression of tumours. Patients have found cannabis to be effective in reducing side effects and relieving pain when used in conjunction with chemotherapy. Though cannabis prescription is restricted under federal laws in many countries, its lucrative efficacy profile has pushed regulators to reconsider its use in medical causes such as cancer. This chapter is an attempt to emphasise the biological role of cannabis in cancer pathophysiology

Cytotoxic Phytochemical library of Rosmarinus Officinalis

Globally, the prevalence of cancer has escalated at an alarming rate, and it has become a major health problem. The World Health Organization reported that one in six deaths is due to cancer. Despite the advantages of current chemotherapy available for cancer treatment, the development of resistance and severe side effects continuously insist cancer research focus on the discovery of new entities, especially from natural sources. In the last few decades, varieties of dietary herbs have been explored for their cytotoxic potential. Rosmarinus officinalis, a well-known culinary herb commonly known as rosemary, is not only used to enhance the flavour but also possesses medicinal values. The Rosmarinus officinalis plant extract and its essential oil are packed with different phenolic acids and terpenoids. Rosmarinus officinalis has anti-cancer, anti-proliferative, protective, anti-inflammatory, and anti-oxidant properties, according to several in vitro and in vivo studies. The antitumor activity of Rosmarinus officinalis is correlated with different molecular mechanisms such as reactive oxygen species scavenging, the on-co-suppressor gene expression, apoptosis, and immunomodulatory response regulation. So this chapter mainly focuses on the cytotoxic activities of Rosmarinus officinalis and the molecular mechanisms responsible for their anticancer activities. Also, possibilities of utilising the extracts, essential oils, and phytochemicals of Rosmarinus officinalis as potential therapeutic agents or complementary therapies with chemotherapeutic agents for cancer treatment have been discussed.

Human Topoisomerases and Caspases: Important Targets in Cancer Therapy

Cancer has always remained a major challenge to humanity with its rising morbidity and mortality rate making it uncontrollable. Current treatments for cancer offer limited efficacy and suffer from serious side effects. With a focus on making treatment safer and more effective, there is a need to identify novel targets and potent drugs for these targets. Recent years have witnessed significant progress in the discovery of targeted cancer therapy. On-going research in this field suggests that human topoisomerases and caspases are important molecular drug targets for anti-cancer drug development. Topoisomerases are DNA processing enzymes essentially required to maintain DNA topology during transcription, replication, recombination and chromosomal decatenation. Several new chemical classes of topoisomerase inhibitors including natural product derivatives are in clinical trials for the treatment of various human cancers. Several topoisomerase inhibitors such as topotecan, irinotecan, camptothecin, teniposide and doxorubicin are clinically approved for various cancers such as colon cancer, lung cancer, breast cancer, and many more. However, many of these inhibitors have also been associated with serious side effects during chemotherapy. Emerging data in recent years also suggests the role of topoisomerase inhibition in immunogenic cell death and activating anticancer immune responses making them potential combinatorial modalities for cancer immunotherapy. Caspases [1-12] belong to the family of cysteine-aspartic proteases responsible for the execution of cell death in apoptotic cells. Caspases play an important role in various non-lethal biological processes like cell proliferation, cell differentiation, intercellular communication, and cell migration. The dysregulation of apoptotic signalling pathways is considered one of the hallmarks of cancer. Hence the focus of cancer therapy is correcting this aberrant behaviour. Natural products such as alkaloids, flavonoids, diterpenoids, sesquiterpenes, and polyphenolics have been reported with various anticancer properties. In this chapter, we have discussed topoisomerases and the regulation of caspase functions through direct or indirect methods for anticancer drug discovery.

References

Application of d- and f- Block Elements and Their Compounds in Medicine

Application of Main Group Elements and Their Compounds in Medicine

Implications of DNA-acting Agents as Anticarcinogenic Potential in Breast Cancer Therapeutics

Breast cancer is the most prevalent neoplasm diagnosed in women worldwide. There are many factors responsible for breast cancer susceptibility. Mutation in tumor suppressor genes BRCA1 and BRCA2 predispose women to the early onset of breast cancer. The BRCA genes are involved in multiple cellular processes in response to DNA damage, including checkpoint activation, gene transcription, and DNA repair. Several DNA-acting agents act as effective anticancer used for treating cancer disease. Certain groups of chemicals are known to affect specific phases of cell division, such as, Cyclophosphamide is the most potent and successful anticancer agent that acts by alkylating the N-7position of guanine to cause crosslinking of DNA’s double helix, resulting in DNA breaks that interfere with the DNA replication and RNA transcription. This chapter deals with the classification of DNA-acting agents according to their modes of action.

Drugs and Phytochemicals Targeting Cancer

Cancer which is basically uncontrolled cell division and, thereby, the formation of tumors, has been a prominent cause of death across the world. More than 10 million people have lost their lives due to different types of cancer such as breast, lung, prostate, gastrointestinal, etc. Several pathways, including metabolic, signalling, etc., get altered to support uncontrolled cell division and their growth in case of cancer. Despite an increasing understanding of this disease over the period of time, still, specific causes could not be held responsible for the occurrence. Therefore, various different strategies mainly focused on preventing and killing cancerous cells have been explored. This chapter will primarily focus on the different drugs, including different types of chemotherapeutic agents such as DNA-alkylating agents like nitrogen mustard, cyclophosphamide, drug-peptide, drug-steroid conjugates, antimetabolites, antibiotics, etc. In addition to that, phytochemicals, which have also been investigated for their anti-cancerous activities and are under clinical trial, have also been discussed.

Fetal Tumors: Diagnosis and Management

Tumors can be formed in any organ throughout life. The fetal period is no exception to this fact, and it is important to diagnose these tumors as soon as possible to provide timely care to patients. If management is halted, tumors can cause complications in delivery, child development and even death. In this chapter, we discuss the diagnosis and management of several common fetal tumors. We also overview possible future directions in the management of tumors found during the fetal period.

Recent Synthetic and Biological Advances in Anti-Cancer Ferrocene-Analogues and Hybrids

Cancer is among the most severe risks to the global human population. The enduring crisis of drug-resistant cancer and the limited selectivity of anticancer drugs are significant roadblocks to its control and eradication, requiring the identification of new anticancer entities. The stable aromatic nature, reversible redox properties, and low toxicity of ferrocene revolutionized medicinal organometallic chemistry, providing us with bioferrocene compounds with excellent antiproliferative potential, which has been the focus of persistent efforts in recent years. Substituting the aryl/heteroaryl core for ferrocene in an organic molecule alters its molecular characteristics, including solubility, hydro-/lipophilicity, as well as bioactivities. Ferrocifen (ferrocene analogues of hydroxytamoxifen) has shown antiproliferative potential in both hormone-dependent (MCF-7) and hormone-independent (MDA-MB-231) breast cancer cells. It is now in pre-clinical trials against malignancies. These entities operate through various targets, some of which have been revealed and activated in response to product concentrations. They also react to the cancer cells by diverse mechanisms that can work in concert or in isolation, depending on signaling pathways that promote senescence or death. The behavior of ferrocene-containing hybrids with a range of anticancer targets is explained in this chapter.

Role of Artificial Intelligence in Healthcare Management

Artificial intelligence (AI) has recently become one of the most heavily debated themes in the technological world. AI is active in numerous fields and now it has lately entered the healthcare sector. In addition to biomarkers, the use of AI is increasing in a variety of applications such as genetic editing, disease prediction and diagnostics, drug development, personalized treatment, and so on. Accuracy in disease diagnostics is essential for effective and efficient treatment as well as patient safety. Artificial intelligence is a wide and varied field of data, analytics and continuously evolving insights that meet the needs of the healthcare sector as well as patients. The purpose of the many subsections in this book chapter is to shed light on how AI integrated with machine learning (ML) & Deep-learning (DL) techniques operate in various disease diagnosis domains, medication discovery, medical visualization, digital health records, and electro-medical equipment.

In silico Approaches to Tyrosine Kinase Inhibitors’ Development

Many cellular communications and cellular activities are regulated by a class of enzyme tyrosine kinases. Mutations or increased expression of these enzymes lead to many proliferative cancers as well as other non-proliferative diseases such as psoriasis, atherosclerosis and some inflammatory diseases. Hence, they are considered vital and prospective therapeutic targets. Over the past decade, considerable research work has been carried out to develop potential inhibitors against these tyrosine kinases. So far, a number of compounds have been identified successfully as tyrosine kinase inhibitors and many compounds were developed as drugs to treat tyrosine kinase-induced diseases. Behind the successful development of these inhibitors, many Computer Aided Drug Design (CADD) (in silico) approaches include molecular modelling, high throughput virtual screening against various chemical databases, and docking (both rigid and flexible method of docking). Further many studies identified the possible features which are responsible for tyrosine kinase inhibition activities for a number of series of compounds through the quantitative structure-activity/property relationship (QSAR/QSPR) process. In this review article, the structural characteristics, mechanism of action, and mode of inhibition of tyrosine kinases are discussed followed by the successful applications of a variety of in silico approaches in tyrosine kinase inhibitors development.

Recent Development and Advancement in Microneedle-Assisted Drug Delivery System Used in the Treatment of Cancer

Cancer is one of the most common and distressing diseases. Cancer-related mortality and prevalence have both grown in the last 50 years. Due to its intricacy and progressive nature, cancer remains one of the most debilitating diseases in humans, and clinical care for this lethal disease remains a challenge in the twenty-first century. New and better cancer medicines are constantly needed. Due to the rising global incidence of cancer, the development of novel alternatives to traditional medicines is unavoidable to overcome constraints, such as limited efficacy, comorbidities and high cost. Microneedle arrays (MNs) have just been introduced as an innovative, low-cost, and minimally invasive technique. MNs can safely and precisely deliver micromolecular and macromolecular pharmaceuticals, as well as nanoparticles (NPs), to tumor tissue. However, only a few lipophilic pharmacological compounds with low molecular weight and a rational Log P value were able to pass the skin barrier. Microneedles (MNs) can circumvent these constraints by piercing the body's outermost skin layer and delivering a variety of medications into the dermal layer. MN patches have been made with a variety of materials and application methods. Recently, three-dimensional (3D) printing “A touch button approach” gives the prototyping and manufacturing methods the flexibility to produce the MN patches in a one-step manner with high levels of shape complexity and duplicability.

Nanomedicine-based use of SiRNA in Cancer

People have been suffering from cancer and associated problems for many years. A great amount of improvement has occurred in the field of medical science, and it certainly has benefitted humankind to help live a happy and prosperous life. Despite all these things, cancer treatment remains a provocative question as every year cases are increasing; on the contrary, there are a lot of difficulties associated with cancer treatment. To cope with these unique and mischievous problems, nanotechnology is considered a boon. Various nanoparticle facilitates the required characteristics to deliver a specific active therapeutic agent against the cancer cells. They can be targeted and even modified to fulfill specific pharmacokinetic parameters vital for in vivo delivery of drugs along with Nano-systems. This chapter here focuses on various types of nanoparticles and nanoparticle-mediated drug delivery of certain therapeutic agents.

Cancer Pathophysiology

Cancer prevalence across the globe has increased substantially in the last two decades despite significant progress in inpatient care. Cancer, a multifactorial disease, evolved several theories to establish pathophysiological conditions. Uncontrolled proliferation, dedifferentiation and metastasis mainly describe the cancer progression, which must be characterized by cellular and molecular changes. Understanding these processes helps devise the strategy for effectively delivering the drugs to the target sites. The present review described the essential features of cancer pathophysiology and challenges to achieving drug concentration in the targeted area.

In vitro and in vivo Methods used for the Evaluation of Anticancer Secondary Metabolites

Cancer is a large group of diseases that affect the human body at all ages and causes death worldwide. Important progresses have been made in early diagnosis, prevention measures and treatment. Widespread use of secondary metabolites derived from plants has been made for the production of various effective medicines. Various natural bioactive compounds derived from medicinal plants are used as anticancer mediators to remediate cancer syndrome, but they have toxicity and side effects, and hence there is a need to explore more plant-derived cytotoxic chemical agents. Consequently, an effort has been made to evaluate various in vitro and in vivo methods that are used for assessing the efficiency of the anticancer efficacy of natural bioactive compounds derived from medicinal plants. Anticancer secondary metabolites derived from plants are efficient candidates for in vivo and in vitro anticancer activity. This chapter provides detailed information on different plant explants and extracts and various methods used to evaluate anticancer activity.

Stem Cell Models: Novel Experimental Approach for Testable Alternatives against Therapy-resistant Breast and Colon Cancer

Breast and colon cancer represent the leading causes of mortality in developed countries. The treatment options for these organ site cancers differ depending on the status of hormone/growth factor receptors in molecular subtypes that exhibit altered expression of oncogenes/tumor suppressor genes and growth factormediated molecular pathways. Conventional cytotoxic chemo-endocrine therapy traditionally includes the use of anthracyclin, taxol, cisplatin, anti-estrogens, antifolates and DNA anti-metabolites. Additionally, the use of molecular pathway-specific small molecule inhibitors represents evidence-based targeted therapy. Long-term conventional or targeted therapy using pharmacological agents is frequently associated with systemic toxicity, acquired tumor resistance and the emergence of drug-resistant cancer stem cells. These limitations are associated with the progression of the therapyresistant disease.

Natural products such as dietary phytochemicals, their respective bioactive agents, botanicals, nutraceuticals and nutritional herbs are widely used in complementary and alternative medicine in women for estrogen-related issues, osteoporosis and breast diseases. Unlike conventional or targeted chemo-endocrine therapeutics, natural products, mainly due to their low systemic toxicity, may not lead to acquired tumor resistance and therefore, represent testable alternatives against therapy-resistant cancer.

These aspects emphasize a need to develop reliable experimental approaches, and specific and sensitive biomarkers that facilitate the identification of effective testable alternatives against therapy-resistant cancer.

Models for drug-resistant stem cells have been developed and characterized from the parental breast and colon carcinoma-derived cell lines, as well as from the cell lines derived from genetically predisposed colon cancer models. These stem cell models are characterized by the quantifiable expression status of select stem cell-specific cellular and molecular markers.

Mechanistically distinct natural products have documented growth-inhibitory effects on parental cell lines. Some of these agents also exhibit stem cell targeted growth inhibitory efficacy.

Recognizing clinical evidence for the role of estrogens in breast and colon cancer, future investigations include the development of tumor organoid models of therapyresistant breast and colon cancer from female patient-derived xenografts. These investigations support a scientifically robust rationale to provide clinical translatability for patient-derived preclinical data.

This chapter summarizes the evidence relevant to experimental models systems, natural products and efficacy of lead compounds as stem cell-targeted testable alternatives against breast and colon cancer. Collectively, discussed evidence and its clinical relevance support the hypothesis that natural products may benefit patients that are diagnosed for therapy resistant cancers.

Biomarkers for the Diagnosis and Surveillance of Cancer

Cancer remains one of the leading causes of death worldwide. Cancer management has been a daunting task for both health professionals and patients throughout the journey. Screening of cancer at the right time/stage remains the most critical part of the riddle. Certain molecules that characterize cancer, known as ‘biomarkers,’ come out to be the most useful in this journey. The National Institute of Health defines a biomarker as “a characteristic used to measure and evaluate objectively normal biological processes, pathogenic processes, or pharmacological responses to a therapeutic intervention”. These have proven to be often easily available agents employing minimally invasive methods. Biomarkers have played crucial roles in screening, asymptomatic and early-stage detection, monitoring of the treatment therapy and eventual follow-up to check upon a probable re-lapse or metastasis. A cancer biomarker can be any of the biomolecules such as protein, DNA, RNA, proteoglycans, immunological compounds, salivary biomarkers and endogenous peptides. With the refinement in high-throughput techniques, the list of the types of biomolecules and the number of potential biomarkers is only increasing, with volatile organic compounds from the breath (breath biopsy) adding to the list. In this chapter, we shall put effort into reviewing this otherwise very vast topic. The chapter will outline various types of biomarkers, the journey so far with clinically approved cancer biomarkers, the challenges being faced, and conclude with future perspectives.

Biomarkers as Tools for the Early Detection of Cancer

Every year, millions of people around the world lose their lives to different types of cancer, mostly in developing countries. The foremost challenge for the human race in to fight against cancer is its early detection, followed by the appropriate treatment. Currently, one of the most promising and dynamic strategies for early cancer diagnostics as well as for therapeutics, is the use of cancer biomarkers. Generally, biomarkers represent changes in the constituents or composition of cells, tissues, or body fluids, offering a means for comparable classification of diseases as well as the risk factor involved, and thereby providing information about the underlying pathogenesis of the disease. Similarly, a cancer biomarker (CB) is defined as a ‘molecular signature’ that can potentially provide valid information regarding staging as well as the mechanisms underlying the origin of cancer. Cancer biomarkers (CB) are biomolecules synthesized either by the cancer cells or by other cells of the body in response to cancer. Every cell type has its distinctive molecular signature and recognizable features, such as levels or activities of the myriad of genes, proteins, or other molecular characteristics; therefore, cancer biomarkers can facilitate the molecular definition of cancer. Endoscopy, X-rays, magnetic resonance imaging, computed tomography, invasive tissue biopsies, etc., are the traditional cancer diagnostic methods. However, the use of biomarkers as cancer screening tools have several advantages over these traditional approaches. The emergence of “omics” technologies, like metabolomics, genomics, epigenomics, proteomics, etc., has led to an increase in the number of potentially investigated biomarkers, such as DNA, RNA, miRNA, or other protein biomolecules. In this chapter, we have summarized the importance of biomarkers as powerful and dynamic tools for the early diagnosis of various types of cancers, the phases in the biomarker discovery, the criteria for the selection of biomarkers, the advantages of their preference over traditional methods, various categories of cancer biomarkers, examples of cancer biomarkers currently in use and the future prospectives.

Potential of Biomaterials Derived from Marine Algae as Anticancer Agent

Cancer is one of the most serious and common human diseases, causing millions of deaths per year worldwide. Currently, the discovery of noble therapeutic agents with a natural origin for cancer treatment is a major challenge. In this context, marine algae with wide species and phytochemical diversity will offer great scope for the discovery of new drugs. Algae with marine origin, including microalgae and macroalgae (seaweeds), constitute more than 90% of oceanic biomass. Marine algae are rich sources of pigments, lipids, carotenoids, omega-3 fatty acids, polysaccharides, vitamins and other fine chemicals. The biomaterials obtained from marine algae are important ingredients in many products, including cosmetics and drugs for treating cancer and other diseases. The in vitro and in vivo evaluations of biomolecules derived from marine algae have shown a vast range of pharmacological properties such as antioxidant, immunostimulatory and antitumor activities to control cancer. In spite of the rich source of various bioactive molecules, the marine algal flora largely remains unexplored for the discovery of active molecules against cancer to date. Hence, this review consolidates the available information on marine algae-derived anticancer molecules to provide baseline information for promoting anticancer research based on biomaterials derived from marine algae.

Molecular Mechanisms of Flavonoids Mediated Therapy and Chemoprevention of Cancer

Flavonoids derived from daily dietary source and plant products play a crucial role in the prevention and treatment of various degenerative diseases and cancer. Flavonoids are further subdivided into subclasses such as flavones, flavan-3- ols, flavonols, flavanones, isoflavones and anthocyanidins. There has been a resurgence in the research on flavonoids due to enhancement in the evidence that proves the health benefits of flavonoids. Several preclinical and epidemiological studies revealed that dietary intake of flavonoids may be found helpful in the reduction of risk of tumors like colon, breast, lung, pancreas and prostate. It also acts on the reactive oxygen species, and cellular signal transduction pathways associated with cellular proliferation, angiogenesis and apoptosis. Flavonoids are non-toxic in nature, so intensively studied the broad, vast aspect of their efficacy in biological activities that in turn promotes health benefits and also added to its availability in abundance in our daily diets, for instance, fruits, green leaves, tea, red wine and vegetables. Overall, the exciting data obtained so far elicit that dietary flavonoids have been considered a beneficial cancer preventive approach. This chapter unravels the molecular mechanisms involved in potential cancer preventive efficacy accomplished by the novel biological approach of flavonoids.

Antioxidants and Oxidative Stress as Foe and Friends in Prevention of Cancer

Cancer has become a major public health problem and is one of the leading causes of death among humans worldwide. It is characterized by the abnormal proliferation of cells due to failed normal regulatory mechanisms. Oxidative stress plays a crucial role in the pathology of many cancers and is characterized by an imbalance between the production and removal of reactive oxygen species (ROS). Under normal physiological conditions, the intracellular levels of ROS are steadily maintained to prevent cell damage, and detoxification of ROS is facilitated by various non-enzymatic and enzymatic antioxidants. These antioxidants have a widespread application in the prevention of cancer, as many endogenous and exogenous antioxidants can prevent and repair damage caused by disrupted redox status of cells during carcinogenesis. Our body can produce some of the antioxidants, but to obtain the rest of the antioxidants, it relies on external sources, primarily the diet of an individual. Also, there are certain health issues reported with the long-term usage of synthetic antioxidants. Therefore, nowadays, many nutritionists and dieticians suggest consuming food and natural products that are either rich sources of antioxidants or are supplemented with various nature-based antioxidants. This chapter seeks to explain the role of ROS in oncogenesis, understand the dynamics between oxidative damage and the antioxidants, types of antioxidants, natural sources of antioxidants, mode of action of antioxidants and the role of antioxidants in cancer prevention and treatment along with their disputable effects in cancer therapy.

Current Trends in Target-Specific Delivery of Phytomedicine: A Possible Strategy for Cancer Treatment

Cancer is a leading source of illness and mortality around the world. Despite the fact that primary cancer treatment has considerably reduced cancer mortality, the survival rate remains low due to tumour metastasis, a variety of adverse medication responses, and drug resistance. Alternative medicines, particularly herbal medications, have piqued the interest of scientists due to their high efficacy and low toxicity. However, their limited water solubility, low stability, poor absorption, and quick metabolism limit their therapeutic usefulness. Due to these constraints, the focus of phytocancer therapy has switched to tailored drug delivery systems. Nanomedicine, which involves using nanoparticles as drug delivery vehicles to boost the therapeutic benefits of phytochemicals, has a wide range of uses in cancer treatment. Many challenges in drug delivery to cancer cells can be overcome by using nanoparticulate drug carriers, including improved solubility and bioavailability, drug targeting, reducing adverse effects in non-target organs, high efficacy, low drug resistance, and high drug concentration at the tumour site. The present review entails the most recent advancements in anticancer phytodrug delivery employing nanocarrier-based technologies.

Mechanistic Insight into the Chemotherapeutic Potential of Dietary Phytochemicals

Globally, cancer is the main cause of mortality and morbidity. Unfortunately, existing medical procedures are not adequate due to a lack of appropriate therapy, adverse health effects, chemoresistance and disease recurrence. In recent years, epidemiological findings have illustrated the connection between the consumption of several phytochemical-enriched foods and nutrients, and the lower risk of different types of cancer. Natural compounds named ‘phytochemicals’, commonly found in fruits, vegetables, and whole grains, have shown convincing beneficial biological effects on human well-beings, including curing different types of cancers. Phytochemicals, which are non-nutritive chemicals present in plants, have come up as modulators of essential cellular signaling pathways exerting proven anti-cancer benefits. Dietary phytochemicals have received major interest in chemoprevention as they are thought to be safe for human use. Chemo-preventive agents restrain the growth of cancer either by impeding DNA damage, which contributes to malignancy or by preventing or restricting the division of premalignant cells through DNA damage. Phytochemicals may prevent carcinogenesis by contributing to cell cycle arrest, autophagy and apoptosis. The bioactive compounds have been reported to reverse adverse epigenetic control, including modifying DNA methylation and histone alteration, modulating the expression of miRNA, inhibiting phase I enzymes, and activation of phase II enzymes, scavenging DNA reactive agents, preventing the excessive proliferation of early, preneoplastic lesions, and suppress other properties of the cancer cells. These have all been a part of indirect yet successful and innovative approaches to cancer treatment utilizing phytochemicals.

Allium Species: A Remarkable Repertoire of Nutraceuticals with Anti-cancer Properties

Cancer - the name evokes fear and anxiety. Researchers are working tirelessly to bring hope to countless patients by developing prevention and treatment strategies. One approach is dietary modulation - which is documented to reduce the risk of cancer and increase the benefit of anti-cancer therapy. Allium species are a part of the daily diet in most parts of the world. Important members of this genus - chives, garlic, onions, and shallots add flavour and nutrition to food. These are prized for their organosulphur compounds and flavonoid content which are responsible for their diverse pharmacological activities. Traditional and scientific literature shows that dietary intake of Allium species prevents and aids the treatment of different cancers. In this review, based on an extensive search of available databases, the role of Allium species as nutraceuticals for cancer management was examined to ascertain the truth in the popular claims. Preclinical and clinical investigations show that consumption of the Allium members as a part of the diet and also the functional components (e.g., allicin, diallyl disulphide, diallyl trisulphide, ajoene, S-allyl cysteine, S-allyl mercaptocysteine, tuberoside M, onionin A, fisetin, quercetin, etc.) reduce risk of cancer and have significant antitumor activities. These act by varied mechanisms, including inhibition of gene expression, promotion of apoptosis of cancer cells, antiproliferative activity, and anti-oxidant and anti-inflammatory effects. It is emphasised that standardization of Allium products, their efficacy, dosage, safety profiles and interactions should be ascertained to corroborate their use. This article highlights the importance of Allium species for their prophylactic, therapeutic and immune-boosting ability in cancer management.

Chromosome X

X Chromosome is the sex chromosome that is found in many organisms. Both males and females, including mammalians, have X Chromosomes. Females have XX sets of chromosomes, and males have XY sets of chromosomes. X Chromosome aids in identifying the sex of the organism. The Human X chromosome contains approximately 1500 genes. These genes may undergo some genetic alterations and eventually lead to complex diseases. Genetic mutations in some of the genes of the X chromosome are associated with cancer. Some specific mutations are observed in human cancer cells. This chapter specifically relayed on X chromosomal genes that are associated with different types of cancer and gave information on the location of the gene in the X chromosome. Moreover, the function of the specific gene and information regarding how many types of cancers were associated with a particular gene, has also been provided.

Chromosome 22

When the collection of human Chromosome 22 was first suggested in 1999, it became the most extended, non-stop stretch of DNA ever decoded and assembled. Chromosome 22 became the first of the 23 human chromosomes to decode due to its minimal length and affiliation with numerous diseases. Chromosome 22 involves several genes that contribute to cancer genetics in one way or the other. The contribution of chromosome 22 in abnormalities is evident through somatic translocations, germline and somatic, and in certain cases, overexpression of genes. One famous example is the Philadelphia translocation, particularly in chronic myeloid leukemia cells. Various gene contributions about types of cancer such as Acute Myeloid Leukemia, colorectal, lung, breast cancer and many more have been reported in studies related to chromosome 22. This chapter takes a run-through of important targeted studies of a gene that facilitates itself as a part of cancer genetics.

Chromosome 21

The significance of human chromosome 21 is that the trisomy of human chromosome 21 causes Down syndrome in children. There are about 235 protein-coding genes on chromosome 21. Mutations like translocation in human chromosome 21 cause different conditions such as partial monosomy 21, core binding factor acute myeloid leukemia, ring chromosome 21, and other types of cancers such as acute lymphoblastic leukemia. Mutation in the DSCAM gene causes mental retardation and facial deformities in down syndrome. The human chromosome 21 also comprises the APP gene, where the expression of the gene causes Alzheimer's disease. The genes that are involved in causing Down syndrome and Alzheimer's diseases are also involved in cancer. This chapter discusses 63 genes of human chromosome 21 that are involved in different types of cancer.

Chromosome 20

Over the years, many scientists and doctors have been treating the deadly disease of cancer but are not able to find a permanent treatment for this disease. Also, sometimes it becomes very difficult to understand the mechanisms and causes of cancer as it is a very complex disease that involves many biological processes. Due to the redundancy in our biological system, cancer progression becomes very easy, thus making it difficult to cure. To find the root cause of this disease, we should know what genetic alterations are undergoing, which is causing cancer to progress, and know who is participating in these alterations, like proteins, signaling pathways, or genes. Cancer is caused due to various reasons; it can be due to genetics but mostly due to carcinogens, causing mutations in the genes, thereby making them an oncogene. The Proto-oncogenes are those genes that usually assist the growth of tumor cells. The alteration, mutation, or increased copy number of a particular gene may turn into a proto-oncogene which could end up completely activated or turned on. Many Tumor-causing alterations or mutations related to oncogenes are usually acquired and not inherited. These tumor-causing mutations often actuate oncogenes via chromosomal rearrangement, or alterations in the chromosome, which sequestrates one gene after another, thereby permitting the first gene to prompt the alternative. Search which genes are involved in different cancer types would help scientists proceed with new methods for finding a cure for this disease. This article will depict which genes and their location on which chromosomes, specifically on chromosome 20, are related to different types of cancer.

Chromosome 19

Gene is considered discrete coding units that contain the information for individual proteins. These lot of genes were combined and named DNA which is tightly coiled many times over the histone protein to form Chromosomes. Humans have got 23pairs of chromosomes, including the sex chromosome. The current study is about the major genes and their functions that are present in chromosome 19. There are approximately 1500 genes present in this chromosome, and changes in chromosome 19 are identified in many cancers. Dislocation of the chromosome, a mutation in genes that are present in a chromosome (rearrangements, deletions, or duplications) of DNA in the chromosome, epigenetic modification, and lifestyle changes are some of the chromosomal abnormalities that are responsible for cancer-causing. These changes will trigger the growth of normal cells and induce cancer cell proliferation, migration, invasion, angiogenesis, and metastasis. The signaling pathways like PI3K/AKT, JAK/STAT, NF-κB, and TGF-β are responsible for the various cellular functions with the result of autocrine, juxtacrine, intracrine, paracrine, or endocrine. When the dysregulation of these signaling pathways leads to cancer progression and metastasis. Prostate cancer, breast cancer, gastric cancer, pancreatic cancer, colon cancer, gastric cancer, lung cancer, leukemia, and cervical cancer are the major cancers that are caused because of mutation that occurs in chromosome 19.

Chromosome 18

Cancer is an abnormal or unusual growth of cells in the body with invasive and migrating potential. It leads to loss of function, weakens the immune system, and is the second leading cause of death worldwide. This makes it important to eliminate the disease. Genetic predisposition imposes a high relative risk for several kinds of cancer. Inherited genetic mutations are responsible for causing 5 to 10 percent of all cancers. Scientists have investigated mutations in specific genes with more than 50 hereditary cancer syndromes. For this, chromosome 18 was explored for its genes associated with cancer and this study unveiled 30 genes involved in causing cancer. Of these, the genes DCC, EPB41L3, MBD1 PHLPP1, and RBBP8 were the potential tumor suppressors. This chromosome consists of the target genes of the transforming growth factor-beta (TGF-β) signaling pathway. The SMAD family genes (SMAD4, SMAD7, and SMAD2) are encoded by this chromosome, of which SMAD4 acts as a tumor suppressor. SERPINB5 and TCF-4 were the potential oncogenes. The enzyme coded by TYMS was a potential therapeutic target for chemotherapy. Several fusion genes of this chromosome (SS18-SSX2B, SS18-SSX2, and SS18-SSX4) have been identified to cause cancer. Therefore, this chapter provides a summary of the genes in chromosome 18 that are involved in the initiation and proliferation of cancer and provides an insight into the potential biomarkers and therapeutic targets for clinical application to develop a cancer-free world.

Chromosome 17

Cancer is a disease in which the body's cells divide disorderly and are likely to spread to other organs. It has always been one of the world's top causes of death. A growing population, low mortality rate, and lifestyle changes lead to an increase in the number of cancer cases. It can be caused by genetic or environmental factors or a combination of both. The risk of cancer increases with age as the body loses its ability to eliminate the damaged cells. Cancer-causing genes can be inherited or acquired due to exposure to carcinogens. Cancers are inherited when a mutation occurs in the germ cells. The carcinogens can alter the DNA of a normal gene (a proto-oncogene) converting it into a cancerous oncogene. Genes that slow cell division, fix DNA errors, or undergo programmed cell death (apoptosis) are tumor suppressor genes. Tumor suppressor genes that don't function properly can cause cells to develop out of control, leading to cancer. Cancer expresses itself differently in each individual, making it challenging to identify and treat. Studying the types of genetic mutations, as well as the genes, proteins, and signaling pathways involved in cancer formation will help better understand the underlying cause of cancer. Identifying which genes are expressed in various cancer types will enable scientists to develop novel techniques for curing the disease. This chapter will explain how different cancer types are linked to specific genes and their locations on chromosome 17.

Chromosome 16

Cancer is a heterogeneous disorder with invasive and metastatic potential. It is a deadly disorder affecting 1 in 6 people worldwide. Hence, it is important to eliminate the disease. Genetic alterations remain an underlying cause of cancer, and several gene mutations were involved in causing different types of cancer. Recently, researchers have been investigating the role of genetic mutations in causing cancer. For this reason, the genes associated with chromosome 16 were investigated for their role in causing cancer. This study revealed 70 genes associated with cancer. Of which, the cadherin genes (CDH11, CDH13, and CDH1), AXIN-1, ANKRD11, BANP, CYLD, CBFA2T3, IR8, MVP, MT1F, NQO1 and PYCARD was the tumor suppressor, and the gene MSLN is the potential oncogene. CBFB and MYH11 are well-known fusion genes associated with this chromosome. Loss of heterogeneity was noted in the q arm of this chromosome. The chromosome translocations, t (16;16) (16) (p13q22), t (16;21) (21) (p11;q22), t (12;16) (q13; p13; p11), t(16;21) (p11;q22) and t(7;16) (q33; p11) led to the development of acute myeloid leukemia, leukemia, and sarcoma. Several other genes associated with chromosome 16 responsible for cancer initiation and proliferation are summarized in this chapter. A novel insight into the genetic biomarkers and therapeutic targets has been provided to develop potential therapeutic strategies against cancer.

Chromosome 15

The genomic alteration at chromosome 15 has been widely recognized as the utmost significant and prevalent alteration in several cancers, including non-small-cell lung cancer, breast cancer, ovarian cancer, prostate cancer, gastrointestinal cancer, acute lymphoblastic leukemia, colorectal carcinoma, hepatocellular carcinoma, myeloma, pituitary adenomas, etc. Emerging reports suggest that the abnormalities of prime genes in chromosome 15 have drastic effects on tumor development and progression, and can be candidate biomarkers of disease prognosis, disease progression, and response to treatment. The translocations involving chromosome 15 and other chromosomes have been found in tumors, including mucoepidermoid carcinomas, mixed-lineage leukemia, colorectal cancer, pancreatic cancer, sarcoma, lung adenocarcinoma, melanoma, brain cancer, cholangiocarcinoma, spitz tumor, congenital mesoblastic nephroma, papillary thyroid cancer, pontine glioma tumors, and acute promyelocytic leukemia. The tumor suppressor genes such as C15orf65, CSK, CRABP1, DAPK2, FES, GREM1, KNSTRN, NEDD4-1, NTRK3, PML, SPRED1, TPM1, and TCF12 under chromosome 15 play a crucial role by enhancing cellular growth, proliferation, migration, invasion, metastasis, cellular differentiation, and development in various cancer, including colorectal cancer, acute promyelocytic leukemia, myeloid leukemia, breast cancer, thyroid carcinoma, glioblastoma, intrahepatic cholangiocarcinoma, chondrosarcoma, cartilaginous cancer, Squamous cell carcinoma, non- small-cell lung carcinomas, mucosal melanoma, and oral squamous cell carcinoma. Chapter 15 discusses the significance of each important gene under chromosome 15 in mediating oncogenesis. The elevated or attenuated expression levels of these cardinal genes can either act as an oncogene or a tumor suppressor. Thus, shedding light on these genes would be a game changer in the field of cancer genetics and theragnostic.

Chromosome 14

Cancer genetics has focused on several mutational events within a tumor cell for many years. Recently, the study on cancer genetics has been widened by concentrating on the importance of intercellular communication and epigenetic events causing tumor progression and development. The translocation of genetic material betwixt chromosome 14 and other chromosomes may engender the formation of various types of tumors. Recent studies emphasize that these chief translocations between two chromosomes may disrupt the genes crucial for controlling cell growth and cell division. The translocations involving chromosome-14 and other chromosomes have been found in tumors including acute myeloid Leukemia, acute lymphoblastic leukemia, acute bilineal leukemia, follicular lymphoma, small cell lung cancer, non-Hodgkin’s lymphoma, Burkitt lymphoma and multiple myeloma. The tumor suppressor genes, such as ARID4A, ARID4B, BCL11B, BMP4, CCNB1IP1, CEBPE, DICER1, DLK1, ESR2, FOXN3, HIF1A, MAX, MEG3, NDRG2 and TTF-1/NKX2-1 under chromosome 14, play a hypercritical role by enhancing cellular differentiation, migration, proliferation, metastasis, invasion, cellular growth, and development in several tumors, including breast cancer, pancreatic tumor, osteosarcoma, lung cancer, endocrine tumor, T-ALL, cystic nephroma, Hodgkin lymphoma, pleuropulmonary blastomas, Sertoli Leydig ovarian tumors and rhabdomyosarcoma. Chapter 14 meticulously discusses the importance of each predominant gene under chromosome 14 in mediating tumorigenesis. In cancer genetics, these cardinal genes play a crucial role by acting as an oncogene or a tumor suppressor in several cancers. Thus, targeting these tumor-causing genes would provide a breakthrough in cancer biology and oncology when concerned with future perspectives.

Application of Carbonaceous Quantum Dots in Biomedical

Numerous research fields, including chemistry, electronics, and medical sciences, have concentrated on the production and use of novel functional nanomaterials. Carbon, a component of all organic life forms, is essential for the creation of nanomaterials. The modern carbon-based family component known as carbonaceous quantum dots (CQD) was unintentionally discovered in 2004 while single-walled carbon nanotubes were being purified. Additionally, CQDs have exceptional qualities like outstanding photoluminescence and minimal toxic effects. Outstanding in vitro andin vivo biomedical implications of CQDs include drug/gene delivery, biosensor biotherapy, and theragnostic evolution. Also, CQDs can pass through specific body sites of endothelial inflammation (epithelium of the intestinal tract, liver, for example), tumors or penetrate capillaries due to their small size. For the same reason, nanoparticles are more suitable for intravenous administration than microparticles and also prevent particle aggregation and bypass emboli or thrombi formation. This chapter describes the most contemporary applications of CQDs in diverse biomedical fields. We hope it will provide incalculable insights to inspire discoveries on CQD and delineate a road map toward a broader range of bio applications.

A Comprehensive Review on Anticancer and Antitumor Potentials of Indigenous Plants Found in North East India

Cancer is a malign disease that accounts for about 9.6 million deaths around the world and is the second largest leading cause of death after cardiovascular disease. Chemotherapeutic drugs administered to treat cancer show great potency but falter, causing many severe side effects. Hence, the paradigm of cancer drug research has shifted towards plant and plant-derived natural compounds as they are reported to deliver maximal effectiveness with lesser side effects. Indigenous plants and their derivatives have been an integral part of ethnomedicine in India. The traditional knowledge of utilizing medicinal plants has been used to treat numerous metabolic disorders and diseases since immemorial. Indigenous plants have also been shown to possess high potency in the treatment of cancer as well. The natural landscape of northeast India has some of the most diverse and unique plant species, which have been traditionally used in ethnomedicine and have been studied for their anticancer and antitumor potentials. The aim of the present review is to highlight some of the natural and indigenous plant species of Northeast India that have been reported to have anticancer and anti-tumor effects identified either in-vivo or in-vitro.

Immunological Significance of Steroids and Implications for Immune Related Diseases

This book chapter compiles a general idea of steroids and their overall biological significance in immunity and immune-associated diseases. Steroids chemically comprise a group of cyclical organic compounds constituted by seventeen carbon atoms that consist of four fused rings called sterane, and cyclopentanoperhydrophenanthrene. The four-ringed structures are mainly synthesized by mitochondria and smooth endoplasmic reticulum through the cyclization of thirty-carbon chain squalene into lanosterol or cycloartenol. Steroid hormones differ only in number of oxygen and carbon atoms, but all are derived from cholesterol. The biological significance of steroids and their derivatives range from energy metabolism, and body growth to the control of reproductive activities. However, deficiency or malfunctioning of steroids can lead to direct effects on body salt/sugar levels, sexual differentiation and immunity. As far as immune responses are concerned, a lot of research works have emerged which show the importance of steroids in immune regulation, and in extreme cases, they are also known to result in immune-related diseases. Most of these effects are mediated by the influence of steroids on gene expression in cells and this could in turn prove to be novel drug targets as well. We have made an attempt in this chapter to update and highlight the role of steroids in immune regulation and immune-related diseases, which we hope would open up therapeutic options for diseases.

A Comprehensive Overview of Estrogen: Physiological and Pathological Insights

Estrogens (estrone, estriol, and estradiol) are a class of steroidal hormones produced by developing ovarian follicles. These hormones induce various cyclic events in the uterine endothelium and vaginal epithelium and make the female body competent for conception and ultimately for motherly care. While estrogen is primarily produced by ovaries from cholesterol, the non-reproductive tissues including the brain, liver, and heart also produce a considerable amount of it. Apart from its important role in controlling sexual behavior and reproductive function, estrogen also functions in the regulation of various physiological functions including reproduction, skin physiology, cardiovascular health, skeletal homeostasis, bone integrity, electrolyte balance, cognition, and behavior. These biological functions are regulated by diffusion through the plasma membrane in vitro signaling through specific binding to nuclear receptors such as estrogen receptors (ERα and ERβ) or binding to cell membrane receptors such as GPR30 and ER-X. The signaling mechanism can be genomic (change in gene expression) or non-genomic (activation of various signaling cascades). Disruption in estrogen functioning has a pivotal role in the pathogenesis of many diseases such as osteoporosis, insulin resistance, neurodegenerative disease, obesity, and endometriosis. Also, dysregulation in the levels of estrogen has been linked to the development of many cancers such as breast cancer, etc. This chapter aims to summarize the complete insight of estrogen by providing a clear understanding of its synthesis, receptor binding, signaling, regulation of physiological functions, and role in various diseases.

Biological Significance of Steroids

Steroids display varied biological functions and play a crucial role in the fascinating fields of biology, chemistry, and medicine.Steroids encompass wideranging natural products which are abundantly encountered in eukaryotic organisms. These exhibit a pivotal role in regulating the cellular functions of animals, plants, and fungi. Furthermore, they act as chemical messengers in the human body and get secreted in the systemic circulation and extracellular fluids, where they regulate metabolic, immune, and reproductive functions. Steroids are the fundamental components of cell membranes and serve primarily as signalling molecules. This chapter gives a comprehensive overview of physiologically active steroids in various organisms.The biological activities of various steroid classes have been discussed in detail. Glucocorticoids are a class of steroid hormones that regulate the metabolic processes involving the formation of glucose from amino acids and fatty acid deposition of glycogen in the liver. Another important group of hormones, called mineralocorticoids, helps in balancing water and electrolyte content in the body and primarily affects the kidney. The principal class of steroids viz. the sex hormones are essentially crucial for the development and maintenance of reproductive function and cause stimulation of secondary sexual characteristics in humans. To summarize, steroids stabilize and regulate the structure and functions of cellular membranes and play a crucial role in regulating growth and development.

An Overview of Natural Steroid Sources and their Therapeutic Profile

Natural steroids are organic compounds that play important physiological roles in various organisms. They are the key components of a cell, which act as important signalling molecules engaging in stress response, metabolic activities, reproduction, inflammation, and behavioural uniformities. Naturally, the human body embraces a cluster of steroids in the form of biological hormones, namely, sex hormones, adrenal cortical hormones and bile acids. Steroidal derivatives can imitate human hormones and exhibit their activities by boosting enzymes that the body lacks. Clinically, it is evident that the distribution of synthetic steroids is high in pharmaceutical use for hormonal anomalies, but they provide adverse side effects over long term usage. Steroids work as immunosuppressants to control many autoimmune disorders concerned with inflammation, but they also reduce the activity of the immune system, which is the body’s natural defence against infection and illness. Replacement of natural steroids sourced from herbal plants, marine invertebrates, bacteria, algae, and fungi has a medicinal value that aids in the treatment of various ailments. Apart from hormonal functions, bio-derived steroids also display a safe and copious pharmacological profile for anti-oxidant, anti-inflammatory, anti-carcinogenic, anti-neoplastic, neuroprotective, and cardioprotective activities. This chapter discusses the prevalence of various naturally available steroids in different entities and their suitable applications in various fields.

Terpenes, Terpenoids and Steroids: Properties, Biosynthesis and Functions

Terpenes belong to the largest class of secondary metabolites consisting of five carbon isoprene units which are assembled through innumerable patterns generating diverse structural motifs. Terpenes are linear or cyclic hydrocarbons, whereas terpenoids are oxygen-containing terpene analogues found in all living organisms. Steroids are a subclass of terpenoids that are biosynthesized from terpene precursors. Terpenes, terpenoids and steroids are all derived from five-carbon isoprene units assembled and arranged in different ways generating thousands of structurally varied molecules. Terpenes and terpenoids are widely explored as biomaterials and biofuels while steroids are used as drugs to increase protein synthesis in animals besides their anti-inflammatory, anticancer and other properties. In this chapter, we discuss the properties, functions and biosynthesis of terpenes and terpenoids in general and steroids in particular to better understand their functions and prospective applications.

Biosynthesis of Nanomaterials via Plant Extracts

Nanoparticles (NPs) have become a hot research material in many fields, such as catalysis, sensing, clinical diagnosis, medical treatment, antimicrobial agents, and environmental remediation, due to their small size, high surface area, high reactivity, and unique optical, electrical, and thermodynamic properties. The type, morphology, size, and surface function modification of NPs determine their performance and application scope. The development of green, simple, and controllable NP synthesis methods is an important research direction at present. The biosynthesis of NPs is a kind of green synthesis method that uses organisms or biomolecules to reduce NP precursors. The reaction conditions are mild, the energy consumption is low, and there is no need for expensive equipment or harmful chemicals. It has been developed into an important branch of nanobiotic technology. This chapter summarizes the latest progress in the synthesis of NPs from different plant tissue extracts. It also summarizes the biosynthesis mechanism and application of NPs, analyzes the main problems faced by the biosynthesis method, and prospects its future research direction.

Subject Index

Chromosome 12

Chromosome 12 spans about 134 million DNA building blocks and represents approximately 4.5 percent of the total cellular DNA. Gene dysregulation from chromosome 12 has triggered a cell to transform into a cancerous cell. Different types of genes are present in chromosome 12 that cause colon cancer, ovarian cancer, prostate cancer, ampulla of Vater cancer (Vater cancer), etc. These genes play their role in the development and the progression of cancer into metastasis, Epithelial to mesenchymal transition, and overall cancer growth. In this chapter, we have enlisted the genes responsible for cancer and their short introduction.

Chromosome 11

Over the years, many scientists and doctors have been treating the deadly cancer disease but cannot find a permanent treatment for this disease. Also, sometimes it becomes tough to understand the mechanisms and causes of cancer as it is a very complex disease that involves many biological processes. Due to the redundancy in our biological system, cancer progression becomes very easy, thus making it difficult to cure. To find the root cause of this disease, we should know what genetic alterations are causing cancer progress and who is participating in these alterations, like proteins, signaling pathways, or genes. Cancer is caused due to various reasons; it can be due to genetics but primarily due to carcinogens, causing mutations in the genes, thereby making them an oncogene. The Proto-oncogenes are those genes that usually assist the growth of tumor cells. The alteration, mutation, or increased copy number of a particular gene may turn into a proto-oncogene, which could end up completely activated or turned on. Many Tumor-causing alterations or mutations related to oncogenes are usually acquired and not inherited. These tumor-causing mutations often actuate oncogenes via chromosomal rearrangement or changes in the chromosome, which sequestrates one gene after another, thereby permitting the first gene to prompt the alternative. Search which genes are involved in different cancer types would help scientists proceed with new methods for finding a cure for this disease. This article will depict which genes and their location on which chromosomes, specifically on chromosome 11, are related to different types of cancer.

Chromosome 10

Chromosome 10 contains various genes that are significantly involved in tumorigenesis. These genes described herein that play roles in cancer comprise receptor tyrosine kinases (FGFR2), proto-oncogenes (FRAT1, RET), tumor suppressor genes (PTEN, KLF6), and also genes involved in signal transduction (MAPK8), gene fusions (CCDC6, KIF5B, VTI1A), developmental processes (GATA3, NODAL), Epithelial- Mesenchymal transition (ZEB1, VIM) and epigenetic regulation (MLLT10). This chapter provides a compilation of many such genes from Chromosome 10 that are associated with cancer, with vivid delineations of the underlying molecular mechanisms of each gene in its contribution to cancer initiation, progression and metastasis. Genes that are insufficiently investigated but implicated in tumorigenesis have also been described in this chapter.

Chromosome 9

Chromosome 9 represents approximately 4.5 percent of the total DNA in cells, and it’s a submetacentric type of chromosome. Chromosomal abnormalities in chromosome 9 have been reported in different kinds of cancer, for example, deletion of the long-q arm, a fusion of ABL1 with BCR results in the ABL1-BCR fusion gene, etc. Bladder cancer, chronic myeloid leukemia, etc., are several cancer types resulting from genetic changes in the genes present in chromosome 9. Dysregulation of the tumor suppressor genes or activation of the oncogene from chromosome 9 has supported the normal cell’s transformation. Here, we have listed a few top genes reappearing themselves as causative agent for cancer development in cancer and types of cancer.

Chromosome 8

Chromosome 8 spans more than 146 million DNA base pairs, and represents between 4.5 and 5 percent of the total DNA in cells. Sixteen percent of these genes and their mutations have been identified to play a role in cancer development. Cancer is a genetic disease at the somatic cell level. Multiple gene mutations usually precede them throughout one’s life. Oncogenes such as Myc, Lyn, Atad2, etc., from chromosome 8 promoted cancer cell proliferation, invasion, and migration. The increased expression of these proteins can transform a normal cell into a cancer cell. Chromosome 8 also houses multiple tumor suppressor genes, such as Dlc1, E2f5, Gata4, Ido1, etc. These proteins, when expressed, reduce the chances of tumor initiation within cells. Thus, mutations leading to the reduced expression of these genes are associated with multiple cancers. Mutation of other functional genes like Ank1, Ctsb, Ext1, Il7, etc., has also been implicated in various cancers for their role in increasing the invasive nature of cancers by regulating angiogenesis and facilitating cancer metastasis. Cancers can also stem from the translocational mutations of genes in chromosome 8. This chapter explains essential cancer genes, genetic mutations, and gene variations that can cause an increased risk of cancer and its progression.

Chromosome 7

Chromosome 7 consists of 159 million base pairs, and around 950 genes, representing at least 5 percent of the entire DNA in a cell. Various genes that regulate cell division and cellular growth are present in Chromosome 7. Aberrations in these genes can therefore lead to tumorigenesis. Lymphomas and Leukemia have been frequently correlated with abnormalities on chromosome 7. Aberrations in chromosome 7, such as aneusomy in prostate cancer, gene amplifications in gastric cancer, and chromosomal gain in glioblastoma, are some of the starkly real ramifications of genetic abnormalities on chromosome 7. Numerous essential genes from Chromosome 7, including ABCB5, BRAF, CDK6, EGFR, ETV1, EZH2, IL6, and TWIST1, involved in cancer have been explained in this chapter.

Chromosome 6

Chromosome 6 is among the 23 pairs of chromosomes in humans and it spans about 170 million base pairs. Several cancer genes have been identified to have a role in cancer development. Cancer is also a genetic disease caused due to changes in the genes that control cell function, such as cell division and cell growth. Most of these cancer genes either act as tumor suppressors or possess an oncogenic potential. Oncogenes like ROS1, MYB, HMGA1, etc., induce tumorigenesis by playing a role in DNA repair, replication, transcriptional regulation, and mRNA splicing. When these genes are highly expressed, they result in the transformation of normal cells to malignant cells; on the other side, tumor suppressor genes like IGF2R, AIM1, IRF4, etc., reduce tumorigenicity and invasive potential. Thus, reduced expression of these genes due to loss of heterozygosity, deletion or any epigenetic modifications can induce tumor formation. Also, some genes can either suppress or induce tumor formation given the cellular location and condition, such as CCN2, TNF, etc. Along with these, different types of structural abnormalities can be observed on chromosome 6, such as chromosomal translocation, deletion, duplication, and inversion. These abnormalities on both p and q arms have been known to contribute to the growth and spread of cancer by impacting the expression of cancer genes. Aberrant expression of the genes can also be influenced by fusions, missense mutations, non-missense mutations, silent mutations, frame-shift deletions, and insertion at the molecular level. Some genes can maintain stem-cell-like properties by regulating the expression of cell surface markers like Oct4, Nanog, Sox4, etc. This chapter explains important cancer genes, genetic mutations, and gene variations that can influence the risk of having cancer and induces cancer formation.

Chromosome 5

Chromosome 5 presents an extensive collection of genes, and includes several cancer-associated ones. The contribution of chromosome 5 in abnormalities is evident through somatic translocations, germline, somatic, and, in some instances, expression of genes. Various syndromes are associated with chromosome 5, such as 5q minus syndrome, leading to the development of acute myeloid leukemia, PDGFRBassociated chronic eosinophilic leukemia contributing to acute myeloid leukemia, and myelodysplastic syndromes. Studies propose that a few genes on chromosome 5 play important roles withinside the increase and department of cells. When chromosome segments are deleted, as in a few instances of AML and MDS, those crucial genes are missing. Without those genes, cells can develop and divide too speedy and in an out-o- -control way. Researchers are trying to perceive the genes on chromosome five that might be associated with AML and MDS.

Chromosome 4

Chromosome 4 represents around 6 percent of the total DNA in the cell with 191 million DNA base pairs. Genetic changes in chromosome 4, such as somatic mutation, and chromosomal rearrangement like translocation, gene deletion, etc., have been reported to develop several types of cancer. This includes leukemias, multiple myeloma, oesophageal squamous cell carcinoma, prostate cancer, breast cancer, bladder cancer, etc. In this chapter, we have listed genes residing in chromosome 4, which further frequently support cancer development, progression, and metastasis.

Chromosome 3

Myriad genes in the genome have been implicated in cancer. However, a focused compilation of genes from the same chromosome would provide a valuable detailed yet succinct catalog for researchers, advantageous in quickly understanding the leading roles played by these genes in cancer. This chapter fulfills the above aim of furnishing a pocket dictionary- like a concise yet meticulous explanation of many genes from Chromosome 3, describing these genes’ functional essentialities in various cancers. Such a judicious collection of genes from a single chromosome is probably the first of its kind. The multiple inputs in this chapter from Chromosome 3 include oncogenes (BCL6, RAF1), tumor suppressor genes (SRGAP3, FHIT), transcription factors (FOXP1, MITF), fusion genes (MECOM), and many other types. With approximately 1085 genes spanning 198 million base pairs, Chromosome 3 constitutes 6.5% of the total DNA.

Chromosome 2

The human chromosome 2 was formed by a head-to-head fusion mutation caused by two chromosomes of our ancestors. The gorilla and chimpanzee contain 48 chromosomes in contrast to 46 chromosomes in humans. Ten million years ago, the two chromosomes of apes underwent telomere-to-telomere fusion that gave rise to human chromosome 2. Apart from the exciting history, the human chromosome 2 is involved in various genetic conditions caused due to chromosomal deletions and duplications, leading to SATB2 (Special AT-rich sequence-binding protein 2)-associated syndrome, MBD5 (Methyl-CpG-binding domain 5)-associated neurodevelopmental disorder, 2q37 deletion syndrome, partial trisomy 2, myelodysplastic syndrome as well as cancer. These mutations cause different human abnormalities, such as craniofacial anomalies, cleft palate, genitourinary tract anomalies, microcephaly, hypotonia, heart defects, anemia, and myeloid malignancies. This chapter discusses 50 genes of human chromosome 2 involved in various cancer types.

Chromosome 1

Chromosome 1 is the largest human chromosome, constituting approximately 249 million base pairs. Chromosome 1 is the largest metacentric chromosome, with “p” and “q” arms of the chromosome almost similar in length. Chromosome 1 abnormalities or inclusion of any mutations leads to developmental defects, mental, psychological, cancer, etc., among the most common diseases. 1/10th of the genes in chromosome 1 have been reported its involvement in cancer growth and development. These cancer genes result from chromosomal rearrangement, fusion genes, somatic mutations, point mutation, gene insertion, gene deletion, and many more. Some of these cancer-causing genes appear to be involved in cancer more often, and other novel genes are also enlisted in this chapter.

Prebiotics and Postbiotics for Anticancer Immunity

Cancer remains a daunting task for clinicians and scientists. Many scientists across the globe are toiling in their labs to find an effective and safe treatment modality for cancer. Although significant stride has been achieved in the field of cancer treatment, and millions of precious lives have been saved using available therapeutic strategies, viz. chemotherapy, radiation therapy, biologics and surgical intervention. However, the search for the panacea for cancer is still not over, and new dimensions are being constantly explored. Maneuvering the immune system for controlling and treating cancer is a new fascinating field, and rigorous researches are underway. The importance of anticancer immunity as a promising treatment approach has been recognised even by the Nobel Prize Authority and James P. Allison and Tasuku Honjo were jointly awarded the 2018 Nobel Prize in Physiology or Medicine for their revolutionary research in cancer immunotherapy. This chapter discusses the different aspects of immune system response vis a vis cancer development and strategies to manipulate the immune system through prebiotics and postbiotics to control and cure the different types of cancer. Prebiotics and postbiotics are being explored extensively for their role in modifying disease progression and control of cancer. Prebiotics and postbiotics are considered safe alternatives to manipulate the immune system in order to get therapeutic benefits for cancer.

Probiotics as Potential Remedy for Restoration of Gut Microbiome and Mitigation of Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the most frequent endocrine disorder currently plaguing women. There are many factors associated with high androgenicity in the female body. Dysbiosis of gut microbiota may be one of the primary reasons that initiate PCOS. Emerging evidence suggests that some plastics, pesticides, synthetic fertilizers, electronic waste, food additives, and artificial hormones that release endocrine-disrupting chemicals (EDCs) cause microbial Dysbiosis. It is reported that the permeability of the gut is increased due to an increase of some Gram-negative bacteria. It helps to promote the lipopolysaccharides (LPS) from the gut lumen to enter the systemic circulation resulting in inflammation. Due to inflammation, insulin receptors' impaired activity may result in insulin resistance (IR), which could be a possible pathogenic factor in PCOS development. Good bacteria produce short-chain fatty acids (SCFAs), and these SCFAs have been reported to increase the development of Mucin-2 (MUC-2) mucin in colonic mucosal cells and prevent the passage of bacteria. Probiotic supplementation for PCOS patients enhances many biochemical pathways with beneficial effects on changing the colonic bacterial balance. This way of applying probiotics in the modulation of the gut microbiome could be a potential therapy for PCOS.