Skin cancer is the most commonly occurring malignancy globally, especially in light-skinned individuals and ultraviolet (UV) radiation has been identified as its main etiological factor. Although the mutagenic action of UV-induced DNA damage has been clearly demonstrated, recent evidence has underscored chronic inflammation as an important contributor to skin carcinogenesis. Chronic inflammation contributes to tumour initiation and growth by triggering several signalling cascades, with the nuclear factor-kappa B (NF-kB) being a key mediator. NF-kB is a transcription factor that regulates gene expression in immunity, cell survival, inflammation and resistance to apoptosis. This narrative review discusses the dual role of NF-kB in skin cancer pathogenesis, addressing its tumour-supportive and tumour-suppressive functions under specific conditions drawing on publications indexed in PubMed, Scopus and Web of Science from January 2010 to June 2025. The review examines the relationship between chronic inflammation and transformation of normal cells into cancerous cells, focusing specifically on how NF-kB signalling influences the tumour microenvironment via key cellular pathways, including PI3K/AKT, Wnt/β-catenin and MAPK. This article further addresses preclinical and clinical attempts to therapeutically modulate the NF-kB pathway via small molecule inhibitors, anti-inflammatory agents, monoclonal antibodies and natural products. This manuscript reviews the various experimental models, ie, 2D cultures, 3D skin organoids and humanised mouse models, utilised to analyse inflammation-cancer crosstalk to improve translational applicability. Thus, this review emphasises the need for precise modulation of the NF-kB signalling pathway to develop novel therapeutics for skin cancer treatment.
Background/Aim: Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults. Anti-phospholipase A2 receptor (anti-PLA2R) antibodies and PLA2R1 variants are associated with primary MN, but data from Iraq are limited. This study compared biochemical parameters, serum anti-PLA2R levels and PLA2R1 variants in Iraqi patients with MN and healthy controls.Methods: Laboratory measurements were reported for 50 patients with MN undergoing maintenance haemodialysis and 50 apparently healthy controls. Patient samples were collected before dialysis at Al-Kindy Teaching Hospital, Baghdad, Iraq. Complete blood count and biochemical parameters were measured using automated analysers and serum anti-PLA2R levels were measured by sandwich enzyme-linked immunosorbent assay. DNA from 25 patients and 25 controls was analysed by polymerase chain reaction and sequencing.Results: Patients had lower serum albumin, calcium, iron and haemoglobin and higher creatinine, urea, alkaline phosphatase, phosphate, ferritin, biliru-bin and anti-PLA2R levels (all p < 0.05). Anti-PLA2R levels differed between groups (p < 0.001), with an area under the receiver operating characteristic curve of 1.000, but were not significantly correlated with creatinine (r = -0.12, p = 0.411). The 33,988 (G>A) variant had a reported odds ratio (OR) of 6.78 (p = 0.041), while 34,046 (G>A) had an OR of 0.07 (p < 0.001). No significant asso-ciation was found at 33,861 or 34,254. In the multivariable model, anti-PLA2R level had the largest reported OR (17.6; p < 0.001).Conclusion: Serum anti-PLA2R levels showed strong discrimination be-tween patients and healthy controls in this dataset. Associations with selected PLA2R1 variants warrant further investigation before clinical or causal conclu-sions are drawn.
Background/Aim: Poor glycaemic control remains a persistent challenge in patients with type 2 diabetes mellitus (T2DM), particularly within primary healthcare settings in Indonesia. Medication adherence is a key modifiable factor that may influence glycaemic outcomes. This study aimed to evaluate the correlation between glycated haemoglobin (HbA1c) levels and medication adherence among type 2 diabetes mellitus (T2DM) patients participating in the PROLANIS. Methods: This observational study examined the relationship between adherence to oral antidiabetic drugs (OADs) and glycaemic control in patients with T2DM enrolled in the PROLANIS programme at Gending Primary Healthcare Centre, East Java. Fifty adult patients were enrolled in December 2024. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8) and glycaemic control was defined as HbA1c ≤ 7.0 %. Results: High adherence was significantly associated with better glycaemic control (p = 0.011). Patients with high adherence were over six times more likely to improve glycaemic status (OR = 6.69, 95 % CI: 1.32-34.5). ANCOVA revealed that adherence independently predicted change in HbA1c (p < 0.001, η²p = 0.478), while age and baseline HbA1c were non-significant covariates. A strong negative correlation was observed between MMAS-8 scores and HbA1c (r = -0.483, p < 0.001). Conclusion: High OAD adherence was independently associated with improved glycaemic control among T2DM patients in a primary care setting. Interventions targeting medication adherence could enhance the effectiveness of community-based chronic disease management programmes such as PROLANIS.
Background/Aim: Self-efficacy is a key psychosocial determinant influencing individuals' ability to perform effective self-management behaviours in type 2 diabetes mellitus (T2DM). The rapid expansion of digital health interventions has introduced new approaches to support diabetes self-care; however, the magnitude of its impact on self-efficacy has not been clearly established. This systematic review and meta-analysis were conducted to examine the effectiveness of digital health interventions in improving self-efficacy among adults with T2DM. Methods: A systematic search was undertaken across Scopus, PubMed/MEDLINE and EBSCO to identify randomised controlled trials published between 2017 and 2024. Eligible studies included adults with T2DM who received digital health interventions and reported self-efficacy outcomes. Quantitative data were pooled using a random-effects meta-analytic approach, with standardised mean differences (SMDs) and 95 % confidence intervals (CIs) calculated. Methodological quality was assessed using the Cochrane Risk of Bias 2 tool. Results: Eight randomised controlled trials involving 817 participants were included in the meta-analysis. Digital health interventions demonstrated a statistically significant improvement in self-efficacy compared with control conditions (SMD = 1.38; 95 % CI: 0.77-2.00; p < 0.00001). Considerable heterogeneity was observed (I² = 93 %). The high heterogeneity observed may be attributed to variations in intervention design, duration and outcome measurement across studies. Leave-one-out sensitivity analysis confirmed that the pooled effect was robust and not driven by any single study. Conclusion: Digital health interventions were effective in enhancing self-efficacy among adults with T2DM. Despite substantial heterogeneity, these findings support digital strategies as complementary components of diabetes self-management. Further research employing standardised self-efficacy measures and follow-up periods is warranted to strengthen the evidence base.
Natural polyphenols are promising candidates for the treatment of chronic inflammatory disorders because they possess several antioxidant and anti-inflammatory properties within the diverse class of phytochemicals. However, their low bioavailability, poor water solubility, limited stability and rapid metabolism hinder clinical application. To address these limitations, nanotechnology-based delivery systems such as solid lipid nanoparticles, nanosuspensions, liposomes and polymeric nanoparticles have been developed. These systems can improve the bioavailability, stability and targeted tissue distribution of polyphenols. Such nanoformulations may enhance the pharmacokinetic profile and anti-inflammatory potential of polyphenols via inhibition of pro-inflammatory cytokines and modulation of anti-inflammatory signalling pathways (including MAPK and NF-κB). Preclinical research indicates that nanoencapsulated polyphenols such as quercetin, catechins, resveratrol and curcumin are more efficacious in reducing inflammation and accelerating tissue healing than their free forms in vitro and in animal models. The combination of natural polyphenols with nanotechnology-based delivery technologies may provide a promising direction for anti-inflammatory therapy. This review article highlights the anti-inflammatory properties of natural polyphenols and explores how nanoformulation approaches can mitigate issues related to poor bioavailability, instability and rapid metabolism.
