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Epigenome-wide analysis reveals functional modulators of drug sensitivity and post-treatment survival in chronic lymphocytic leukaemia
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Abstract<sec> <title>Background

Chronic lymphocytic leukaemia (CLL) patients display a highly variable clinical course, with progressive acquisition of drug resistance. We sought to identify aberrant epigenetic traits that are enriched following exposure to treatment that could impact patient response to therapy.

Methods

Epigenome-wide analysis of DNA methylation was performed for 20 patients at two timepoints during treatment. The prognostic significance of differentially methylated regions (DMRs) was assessed in independent cohorts of 139 and 163 patients. Their functional role in drug sensitivity was assessed in vitro.

Results

We identified 490 DMRs following exposure to therapy, of which 31 were CLL-specific and independent of changes occurring in normal B-cell development. Seventeen DMR-associated genes were identified as differentially expressed following treatment in an independent cohort. Methylation of the HOXA4, MAFB and SLCO3A1 DMRs was associated with post-treatment patient survival, with HOXA4 displaying the strongest association. Re-expression of HOXA4 in cell lines and primary CLL cells significantly increased apoptosis in response to treatment with fludarabine, ibrutinib and idelalisib.

Conclusion

Our study demonstrates enrichment for multiple CLL-specific epigenetic traits in response to chemotherapy that predict patient outcomes, and particularly implicate epigenetic silencing of HOXA4 in reducing the sensitivity of CLL cells to therapy.

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Publication Date
Wed Apr 01 2026
Journal Name
Atención Primaria
Association between smoking and chronic low back pain among medical students
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Resumen Introducción Debido a su exigente entorno académico, el dolor lumbar crónico (DLC) es un trastorno musculoesquelético común entre los estudiantes de medicina, lo cual es particularmente preocupante. El tabaquismo es un factor de riesgo conocido por causar diversos problemas de salud y se ha asociado con el DLC, pero la relación específica entre el tabaquismo y el DLC aún no ha sido bien explorada. Objetivo Este estudio tiene como objetivo investigar la asociación entre el tabaquismo y el DLC en estudiantes de medicina en Irak. Diseño Se empleó un diseño descriptivo transversal que involucró entrevistas cara a cara con 200 estudiantes de medicina de 18 años o más. Los datos sobre características demográficas, comport

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Publication Date
Thu Mar 03 2022
Journal Name
Rawal Medical Journal
Functional outcome of closed reduction of supracondylar humerus fracture with cross Kirschner wire in children
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Objective: To evaluate the functional outcome of percutaneous cross two K wires fixation for Gartland types II and III fractures of humerus. Methodology: This prospective study included80 patients with supracondylar humeral fracture, who underwent closed reduction and fixation by two crossed Kirschner wires. We included children with age < 15 years with closed fractures with Gartland types II and III, while the patient with vascular injury, open, irreducible fractures were excluded. The patients were following up for 6 months and assessed functionally by Flynn’s criteria. Results: The mean age of patients was 8.1 years. Trauma while child playing was the main mechanism of injury in 43 (59.8%) children and 46 (57.5%) fractures were of the

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Publication Date
Wed Jul 01 2020
Journal Name
Campos En Ciencias Sociales
Leadership and Post-Conflict State Rebuilding: Iraq after 2003 Case Study
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The Iraqi political and social arena has been characterized, subjectively and objectively, by the weakness of leadership building. This has led to a leadership crisis, which is reflected in the quality of the outcome of the process of rebuilding the state in Iraq. Thus, this building process has lacked the simplest requirements and conditions of success. It has suffered from a major and obvious failure: the situation in Iraq has raised conflict leaders, not constructive leaders, and this confirms the existence of a cultural crisis in the production of conscious, aware leadership compatible with democratic action. The weakness of leadership in Iraq is reflected in a series of ongoing crises that require radical solutions in accordance with l

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Patients' Knowledge and adherence to Clopidogrel Therapy post Percutaneous Coronary Intervention
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Abstract

Objectives: To assess patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention, and to find out the relationship between patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention

Methodology: A descriptive design was carried out at Al- Nasiriyah Heart Center in Thi-Qar Governorate for the period between May 19th, 2022 to October 25th, 2022. A non-probability sampling was used among (50) patients after their Percutaneous Coronary Intervention. The study instrument that used to collect data was composed of three parts namely: sociodemographic charac

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Publication Date
Tue Oct 01 2024
Journal Name
Results In Chemistry
Microwave synthesis, density functional theory study and antiproliferative activity of the novel spiropyrazole derivatives
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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Al-nahrain University-science
Global Stability of Harmful Phytoplankton and Herbivorous Zooplankton with Holling Type IV Functional Response
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In this paper harmful phytoplankton and herbivorous zooplankton model with Hollimg type IV functional response is proposed and analyzed. The local stability analysis of the system is carried out. The global dynamics of the system is investigated with the help of the Lyapunov function. Finally, the analytical obtained results are supported with numerical simulation.

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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Search for Identity in Michael Ondaatje's Post colonial Novel In the Skin of a Lion
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In his post colonial novel, In the Skin of a lion, the Canadian/Sri Lankan writer,
Michael Ondaatje is so interested in the term "Post colonialism" because he wants to show
that the term doesn't only refer to a period of time that comes after colonialism. In other
words, post colonialism is not only referred to as a literal description of formerly colonial
societies. He deals with the termas a literary genre and an academic construct that describes
the global conditions of a man after a period of colonialism. He shows that post colonialism is
a theory that tries to examine and explore the different styles and faces of European authority
to control the colonized. Ondaatje's attempt through such term is to unmask Europ

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Publication Date
Fri Aug 01 2025
Journal Name
Al-kindy College Medical Journal
The Impact of Personalized Medicine on Enhancing Quality of Life in Chronic Diseases Management
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Personalized Medicine represents a recent revolution in healthcare practice, focusing on tailoring different therapies to be precise for a specific individual; this is aided by exploring the number of genetic predispositions and lifestyle choices that fit each individual. In this article, the authors utilize and gather recent literature and opinions to discuss the impact of personalized medicine on chronic disease management and patient quality of life. Additional attention is paid to limits and possible ethical issues. Chronic diseases such as Hypertension, Diabetes, and chronic kidney diseases adversely affect multiple health indicators, including Quality of Life (QoL) and well-being. This will have additional impacts on physical

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Development and in vitro Evaluation of Bioadhesive Vaginal Tablet using Econazole Nitrate as a Model Drug
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         In this study, a bioadhesive dosage form of eoconazole nitrate for vaginal delivery was designed using a combination of bioadhesive polymers: Carbopol 941 p and sodium carboxymethylcellulose or methylcellulose in different ratios. The bioadhesive strength was evaluated by measuring the force required to detach the tablet from sheep vaginal mucosal membrane. It was found that the bioadhesive force was directly proportional to Carbopol 941 p content in the different formulae. The formulae were tested for their swelling behavior using agar gel plate method. The results showed that formulae containing a combination of Carbopol 941 p and sodium carboxymethylcellulose had greater swelling index

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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Journal Of Science
Study of Some Hormonal and Biochemical Parameters among Patients with Chronic Liver Diseases
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It has been revealed previously that chronic liver disease (CLD) may be associated to hormonal fluctuations. The current study, therefore, aimed to evaluate some hormones in CLD patients compared with non-CLD individuals. This case control study was conducted at Gastroenterology and Hepatology Teaching Hospital, Medical city, Baghdad, Iraq during December 2021 to May 2022. One hundred and twenty male patients with CLD (age:14-75 years) and 120 control males (age: 24-70 years) were involved in this study. Serum samples were taken from all individuals and were then analysed for many tests which included hormones (Cortisol, testosterone, prolactin, insulin  and thyroid stimulating hormone TSH); biochemical analysis (Prothrombin time

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