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Endometriosis as a Systemic and Complex Disease: Toward Phenotype-Based Classification and Personalized Therapy
(MDPI AG, 2026-01-16)
Daniel Simancas-Racines
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Emilia Jiménez Flores
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Martha Montalvan
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Raquel Horowitz
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Valeria Araujo
Endometriosis is traditionally conceptualized as a pelvic lesion–centered disease; however, mounting evidence indicates it is a chronic, systemic, and multifactorial inflammatory disorder. This review examines the molecular dialog between ectopic endometrial tissue, the immune system, and peripheral organs, highlighting mechanisms that underlie disease chronicity, symptom variability, and therapeutic resistance. Ectopic endometrium exhibits distinct transcriptomic and epigenetic signatures, disrupted hormonal signaling, and a pro-inflammatory microenvironment characterized by inflammatory mediators, prostaglandins, and matrix metalloproteinases. Immune-endometrial crosstalk fosters immune evasion through altered cytokine profiles, extracellular vesicles, immune checkpoint molecules, and immunomodulatory microRNAs, enabling lesion persistence. Beyond the pelvis, systemic low-grade inflammation, circulating cytokines, and microRNAs reflect a molecular spillover that contributes to chronic pain, fatigue, hypothalamic–pituitary–adrenal axis dysregulation, and emerging gut–endometrium interactions. Furthermore, circulating biomarkers—including microRNAs, lncRNAs, extracellular vesicles, and proteomic signatures—offer potential for early diagnosis, patient stratification, and monitoring of therapeutic responses. Conventional hormonal therapies demonstrate limited efficacy, whereas novel molecular targets and delivery systems, including angiogenesis inhibitors, immune modulators, epigenetic regulators, and nanotherapeutics, show promise for precision intervention. A systems medicine framework, integrating multi-omics analyses and network-based approaches, supports reconceptualizing endometriosis as a systemic inflammatory condition with gynecologic manifestations. This perspective emphasizes the need for interdisciplinary collaboration to advance diagnostics, therapeutics, and individualized patient care, ultimately moving beyond a lesion-centered paradigm toward a molecularly informed, holistic understanding of endometriosis.
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Heavy Metal-Contaminated Soils and Gastric Cancer Risk: Molecular Insights and the Relevance of a One Health Perspective
(MDPI AG, 2025-11-27)
Claudia Reytor-González
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LEYVA RICARDO, SONIA EMILIA
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Yasniel Sánchez Suárez
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Vianey Ariadna Burboa Charis
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Emilia Jiménez-Flores
Heavy metal contamination in agricultural soils has emerged as a critical environmental and public health issue associated with increased gastric cancer incidence worldwide. Among the most concerning pollutants are cadmium, arsenic, and lead, which persist in the environment and enter the human body primarily through the soil–plant–food chain. This review integrates environmental, molecular, and epidemiological evidence to explain how these metals alter gastric mucosal biology and promote carcinogenesis. Mechanistically, cadmium, arsenic, and lead trigger oxidative stress, mitochondrial dysfunction, DNA damage, and epigenetic reprogramming, resulting in genomic instability, resistance to programmed cell death, and the transformation of epithelial cells into invasive phenotypes. These molecular disruptions interact with Helicobacter pylori infection, microbial imbalance, chronic inflammation, and hypoxia-driven remodeling of the gastric stroma, all of which enhance angiogenesis and tumor progression. Advanced experimental platforms, such as gastric organoids, immune co-cultures, and humanized animal models, are improving the understanding of these complex interactions. Adopting a One Health perspective reveals the continuity between environmental contamination, agricultural production, and human disease, underscoring the importance of integrative monitoring systems that combine soil and crop analysis with molecular biomarkers in exposed populations. Strengthening this interdisciplinary approach is essential to design preventive strategies, guide remediation policies, and protect human, animals, and environmental health.
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Assessing the impact of a business intelligence program on the employability and well-being of low-income women: a quasi-experimental study protocol
(Frontiers Media SA, 2025-11-13)
Marco Faytong-Haro
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Alonso Quijano-Ruiz
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Daniel Sanchez-Pazmiño
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Patricio Alvarez-Muñoz
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Jose Diaz-Montenegro
Women are underrepresented globally in the field of data analytics, particularly in underdeveloped countries. We present a protocol to assess the impact of the New Dimensions program, a data analytics and business intelligence course sequence that aims to address this gender gap by providing free business intelligence training to disadvantaged women in Ecuador. The program offers both technical (Business Intelligence) and soft skills training, including Excel, Power BI, SQL, GitHub, R, Tableau, statistics, Python, and workshops on empowerment, employability, and public speech. The purpose of this quasi-experimental study is to assess the impact of this training program on employability and other well-being outcomes of the participants. A total of 80 individuals will be part in the study, of which 70 will be selected to participate in the program, 50 will receive both hard and soft skills training, and 20 only soft skills training. Ten individuals will form part of the control group with no intervention. The study design involves a nonrandomized control group composed of rejected applicants. Data will be collected through an online application form and a computer-based exam. The outcome measures are participants' labor market outcomes, income, food security, and economic stratification, among others. This protocol will prospectively evaluate the program's potential effectiveness; findings will inform future, larger randomized studies focused on employability and well-being in underrepresented groups.
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From meal to malfunction: exploring molecular pathways, biomarkers and interventions in postprandial cardiometabolic health
(Frontiers Media SA, 2025-10-29)
Claudia Reytor-González
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Cevallos-fernández Emilia Luciana
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JÁCOME VILLACRÉS, MARÍA BELÉN
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Daniel Simancas-Racines
Cardiometabolic diseases—including type 2 diabetes, cardiovascular disease, and metabolic dysfunction–associated steatotic liver disease—are increasingly driven by near-continuous after-meal exposure to glucose and lipid surges that traditional fasting tests often miss. This review prioritizes human studies from 2020 to 2025 and uses earlier work only as foundational anchors; non-English reports were excluded and preclinical findings are cited solely for mechanistic context. Evidence converges on six processes that amplify risk within hours after eating: impaired insulin signaling, delayed clearance of dietary lipids, mitochondrial and oxidative stress, loss of endothelial nitric oxide, inflammasome-mediated inflammation, and microbiome–hormone interactions. Dynamic, after-meal markers and simple composites such as the triglyceride–glucose index outperform fasting measures for identifying risk and guiding care. Practical strategies to shorten the “damage window” include Mediterranean-style meals with low glycemic index swaps and unsaturated fats, earlier distribution of daily energy and early time-restricted eating, a small pre-meal protein portion, and brief post-meal walking. Fast-acting medicines—glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide receptor agonists, rapid-acting insulin analogues, sodium–glucose cotransporter 2 inhibitors taken before meals, and proprotein convertase subtilisin/kexin type 9 inhibitors—further blunt peaks, while continuous glucose monitoring with algorithmic feedback enables timing-aware, person-specific adjustments. A tiered workflow—screen, stratify, and personalize—reframes prevention and treatment around after-meal physiology, with particular relevance to settings where resources are limited.
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Unlocking the potential: very-low-energy ketogenic therapy in obesity-related disorders
(Informa UK Limited, 2025-01-16)
Daniel Simancas-Racines
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Claudia Reytor-González
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ZAMBRANO ESPINOSA, ANA KARINA
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Giuseppe Annunziata
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Angelo Michele Carella
The Very Low-Energy Ketogenic Therapy (VLEKT) is a structured, multi-phase dietary regimen characterized by a carbohydrate intake of less than 50 g/day and a daily caloric intake of fewer than 800 kcal, which induces ketosis and facilitates significant weight loss. Evidence suggests that this nutritional therapy can improve glycemic control, lipid profiles, and blood pressure, making it a promising option for managing type 2 diabetes (T2D) and reducing cardiovascular risk. These benefits are achieved through reductions in triglycerides and low-density lipoprotein cholesterol (LDL-c), alongside increases in high-density lipoprotein cholesterol (HDL-c). However, the effects of the VLEKT on lipid metabolism remain controversial. The review emphasizes the urgent need for further research to validate the long-term safety and efficacy of the VLEKT. It also highlights the critical role of personalized dietary plans, supervised by healthcare professionals, to optimize health outcomes and address individual patient needs.
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Mediterranean diet and breast cancer: A narrative review
(Medwave Estudios Limitada, 2025-03-04)
Claudia Reytor-González
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ZAMBRANO ESPINOSA, ANA KARINA
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Evelyn Frias-Toral
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Martín Campuzano-Donoso
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Daniel Simancas-Racines
Breast cancer is the second most common neoplasm and the deadliest among women worldwide. Its incidence varies according to human development and is associated with several risk factors, including age, genetic factors, obesity, and dietary habits. Recent research has revealed a significant influence of dietary habits on the onset and progression of this disease, which is why this review aims to comprehensively analyze the available literature to understand better the role played by the mediterranean diet in the development and management of breast cancer. The mediterranean diet has anti-inflammatory and antioxidant effects, may influence gene regulation, and produce hormonal and intestinal microbiota changes, resulting in improved quality of life for breast cancer patients by alleviating symptoms such as pain, inflammation, and reducing the risk and mortality from this disease. Evidence suggests that greater adherence to the mediterranean diet reduces the risk of breast cancer, as well as an improvement in patients' quality of life and mortality. These findings underscore its potential relevance in the context of dietary patterns associated with breast cancer prevention and management, which could inform considerations for public health policies. Further research is needed to confirm these observations and to understand the underlying mechanisms better.

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