Publications by Year: 2025

2025
Xagorari M, Marmarinos A, Doganis D, Nikita M, Magkou E, Sfetsiori AE, Baka M, Kossiva L, Pasparaki S, Soldatou A, Tsolia M, Scorilas A, Gourgiotis D, Avgeris M. NEAT1 lncRNA overexpression results in short-term progression and poor treatment outcome in childhood B-ALL. British Journal of Haematology 2025;207:2475-2485.Abstract
Childhood acute lymphoblastic leukaemia (chALL) remains the most prevalent malignancy in children and adolescents. Improving risk stratification and providing personalized prognosis and treatment remain major clinical challenges. Herein, we analysed the clinical utility of NEAT1 lncRNA for the prognosis and prediction of treatment outcome of childhood B-cell precursor ALL (chB-ALL). NEAT1_1 isoform was quantified in bone marrow samples of chB-ALL patients at diagnosis (n = 160) and at the end of induction (n = 108) of ALL-BFM protocol, and in age-matched healthy children (n = 68). Relapse and death served as clinical end-points for survival analysis. Bootstrap analysis was performed for internal validation and decision curve analysis assessed the clinical net benefit for chB-ALL prognosis. Our analysis showed that chB-ALL patients with NEAT1 overexpression at diagnosis are at significantly higher risk for progression (HR = 2.957, 95% CI: 1.122-7.790, p = 0.011) and worse survival (HR = 5.832, 95% CI: 1.259-27.01, p = 0.012), independently of clinicopathological and treatment data. Moreover, NEAT1-fitted multivariate models resulted in improved risk stratification compared to the conventional disease markers of white blood cells, bone marrow response and minimal residual disease, while decision curve analysis highlighted the superior clinical net benefit for chB-ALL prognosis. In conclusion, NEAT1 overexpression constitutes a powerful, independent predictor of poor treatment outcomes and disease progression of chB-ALL, providing refined stratification of patient's risk.
Soureas K, Malandrakis P, Papadimitriou MA, Minopoulos C, Ntanasis-Stathopoulos I, Liacos CI, Gavriatopoulou M, Kastritis E, Dimopoulos MA, Scorilas A, Avgeris M, Terpos E. Refining precision prognostics in multiple myeloma: loss of miR-221/222 cluster in CD138+ plasma cells results in short-term progression and worse treatment outcome. Blood Cancer Journal 2025;15:41.Abstract
The persistence of high relapse rates and therapy resistance continues to challenge the effective management of multiple myeloma (MM). The identification of novel MM-specific molecular markers could ameliorate risk-stratification tools and accurately identify high-risk patients towards personalized prognosis and therapy. miRNA-seq analysis of CD138+ plasma cells (n = 24) unveiled miR-221-3p and miR-222-3p (miR-221/222 cluster) as the most downregulated miRNAs in R-ISS III compared to R-ISS I/II patients. Subsequently, miR-221/222 levels were quantified by RT-qPCR in CD138+ plasma cells of our screening cohort (n = 141), assessing patients' mortality and disease progression as clinical endpoints. Internal validation was performed by bootstrap analysis, while clinical benefit was estimated by decision curve analysis. Kryukov et al. (n = 149) and Aass et al. (n = 86) served as institutional-independent validation cohorts. Loss of miR-221/222 cluster was strongly associated with patients' short-term progression and poor overall survival, which was confirmed by Kryukov et al. and Aass et al. validation cohorts. Intriguingly, miR-221/222-fitted multivariate models offered superior risk-stratification within R-ISS staging and risk-based cytogenetics. Moreover, miR-221/222 loss could effectively discriminate optimal 1st-line treatment responders with inferior treatment outcome. Our study identified the loss of miR-221/222 cluster as a powerful independent predictor of patients' post-treatment progression, ameliorating prognosis and supporting precision medicine in MM.
Rampias T, Goutas A, Karagiannis D, Kanaki Z, Makri A, Hoxhallari L, Koukouzeli FE, Paraskevopoulou V, Tsouraki D, Paschalidis N, Avgeris M, Scorilas A, Klinakis A. KMT2C inactivation leads to PTEN downregulation and tolerance to DNA damage during cell cycle progression. NPJ Precision Oncology 2025;9:336.Abstract
Uncontrolled proliferation, resistance to apoptosis, inability to maintain genome integrity, and, recently, epigenetic reprogramming are all hallmarks of cancer. A number of gene expression and cell signaling networks control these-often-interconnected processes, while the study of their deregulation is in the forefront of cancer research for decades. Here we present data from cells and patients indicating that KMT2C, one of the most frequently mutated proteins in solid malignancies, is involved in all these processes. Its loss, a bad prognosis marker in bladder cancer, is associated with activation of the PI3K/PDK/AKT oncogenic/antiapoptotic axis, and tolerance to DNA damage during cell cycle progression. On the other hand, these cells suffer from mitotic stress that can be therapeutically exploited. Treatment with a PLK1 inhibitor showed high efficacy in vivo, and was associated with mitotic catastrophe and cellular senescence, providing evidence that targeting genes that promote mitotic progression could be a promising therapeutic approach in the subset of tumors with KMT2C loss.
Pilala KM, Panoutsopoulou K, Papadimitriou MA, Soureas K, Scorilas A, Avgeris M. Exploring the methyl-verse: Dynamic interplay of epigenome and m6A epitranscriptome. Molecular Therapy 2025;33:447-464.Abstract
The orchestration of dynamic epigenetic and epitranscriptomic modifications is pivotal for the fine-tuning of gene expression. However, these modifications are traditionally examined independently. Recent compelling studies have disclosed an interesting communication and interplay between m6A RNA methylation (m6A epitranscriptome) and epigenetic modifications, enabling the formation of feedback circuits and cooperative networks. Intriguingly, the interaction between m6A and DNA methylation machinery, coupled with the crosstalk between m6A RNA and histone modifications shape the transcriptional profile and translational efficiency. Moreover, m6A modifications interact also with non-coding RNAs, modulating their stability, abundance, and regulatory functions. In the light of these findings, m6A imprinting acts as a versatile checkpoint, linking epigenetic and epitranscriptomic layers toward a multilayer and time-dependent control of gene expression and cellular homeostasis. The scope of the present review is to decipher the m6A-coordinated circuits with DNA imprinting, chromatin architecture, and non-coding RNAs networks in normal physiology and carcinogenesis. Ultimately, we summarize the development of innovative CRISPR-dCas engineering platforms fused with m6A catalytic components (m6A writers or erasers) to achieve transcript-specific editing of m6A epitranscriptomes that can create new insights in modern RNA therapeutics.
Karaviti D, Charakida M, Dimopoulou D, Marmarinos A, Papadaki M, Maritsi D, Spyridis N, Avgeris M, Gourgiotis D, Tsolia M. Long-term Effects of SARS-CoV-2 Infection on Children's Vasculature. Pediatr Infect Dis J 2025;44:792-797.Abstract
BACKGROUND: While long coronavirus disease 2019 (COVID-19) is linked to prolonged vascular dysfunction in adults, research in children remains poor. In this study, we assessed vascular health in children infected with severe acute respiratory syndrome coronavirus 2 about 6.8 months postinfection, comparing them with healthy controls. METHODS: Two hundred twenty-three children were assessed and divided into group 1, which included children with a positive disease history and group 2, which consisted of healthy controls. Anthropometric measurements, lipid profile, biomarkers (interleukin-6, C-reactive protein, tumor necrosis factor-alpha and soluble intracellular adhesion molecule) and long COVID symptoms were assessed, along with pulse wave velocity (PWV) measurements and carotid intima-media thickness (cIMT) to evaluate aortic stiffness. RESULTS: Children in group 1 were older (mean age: 10.8 +/- 3.2 years vs. 8.5 +/- 2.8 years, P < 0.001) and had higher body mass index (20.3 +/- 5.6 kg/m 2 vs. 18.4 +/- 3.5 kg/m 2 , P < 0.001). PWV was increased in group 1 (5.02 +/- 0.7 m/s vs. 4.7 +/- 0.6, P < 0.001). However, vascular differences between the groups disappeared after adjusting for age, body mass index, and blood pressure. Soluble intracellular adhesion molecule-1 levels were elevated in children with a history of moderate/severe COVID-19 infection compared with controls (555.8 +/- 113.2 ng/mL vs. 428 +/- 42.6 ng/mL, P < 0.001). Cholesterol levels, inflammatory markers and cIMT were comparable between groups. Long COVID symptoms were reported mainly by participants of group 1 [34 (23.6%) vs. 3 (3.8%), P < 0.001]. CONCLUSIONS: This study demonstrates insights into the long-term effects of COVID-19 infection in children. Evidence of endothelial activation without structural arterial changes was found. Persistent inflammation postinfection was absent, yet approximately one-quarter of the participants experienced long COVID symptoms, indicating potential differences in the pathophysiology of postacute COVID-19 infection in childhood.
Foutadakis S, Soureas K, Roupakia E, Besta S, Avgeris M, Kolettas E. Identification of Oncogene-Induced Senescence-Associated MicroRNAs. Methods Mol Biol 2025;2906:189-213.Abstract
Cellular senescence, a state of permanent cell cycle arrest, recapitulates the aging process at the cellular level. It can be triggered by intrinsic or extrinsic factors including telomere shortening (replicative senescence) and in response to various types of stresses such as oncogenic stress (oncogene-induced senescence, OIS). Senescence has been detected in vitro and in premalignant lesions in mice and humans expressing mutant oncogenes. MicroRNAs (miRNAs) are short noncoding RNAs that regulate gene expression at the posttranscriptional level, and have been involved in both replicative senescence and OIS. Several methods have been used to identify miRNAs and compare their expression in normal versus oncogene-induced senescent cells, as well as to analyze their role and their targets in senescence. Here, we describe several methods that can be employed to identify miRNAs in cells undergoing OIS, including miRNA-sequencing, RT-qPCR-based detection and quantification of miRNAs and Nanostring miRNA analysis (nCounter miRNA Expression Assay). Moreover, we perform a meta-analysis of studies employing the above methodologies, pinpoint miRNAs with consistent expression changes across senescence models, and predict their target genes and the pathways in which they partake.
Damianaki A, Marmarinos A, Avgeris M, Gourgiotis D, Vlachopapadopoulou EA, Charakida M, Tsolia M, Kossiva L. Lifestyle and Biochemical Parameters That May Hamper Immune Responses in Pediatric Patients After Immunization with the BNT162b2 mRNA COVID-19 Vaccine. Diseases 2025;13Abstract
BACKGROUND: The aim of this study was to evaluate whether increased body mass index (BMI) and biochemical and lifestyle parameters linked to obesity and smoke exposure disrupt immune responses of children and adolescents following vaccination with the mRNA BNT162b2 vaccine. METHODS: A prospective, single-center, cohort study was conducted. Participants were assigned to receive two doses of the mRNA vaccine. Anti-SARS-CoV-2 IgG and neutralizing antibodies (AB) were measured before vaccination (T0) and 14 days after the second dose (T1). BMI and biochemical parameters were evaluated at T0. A questionnaire on lifestyle characteristics was filled in. RESULTS: IgG optical density (OD) ratio at T1 was lower in the overweight-obese group regardless of COVID-19 disease positive history [p = 0.028 for the seronegative group, p = 0.032 for the seropositive group]. Neutralizing AB were lower in overweight-obese participants in the seronegative group at T1 [p = 0.008]. HDL, fasting glucose/insulin ratio (FGIR), C-reactive protein (CRP), HBA1c, uric acid, and smoke exposure were significantly correlated with BMI [p = 0.006, p < 0.001, p < 0.001, p = 0.006, p = 0.009, p < 0.001, respectively]. The main biochemical parameters that were inversely correlated with IgG and neutralizing AB titers at T1 were uric acid [p = 0.018, p = 0.002], FGIR [p = 0.001, p = 0.008] and HBA1C [p = 0.027, p = 0.038], while smoke exposure negatively affected the humoral immune responses at T0 in the convalescent group [p = 0.004, p = 0.005]. CONCLUSIONS: Current data suggests that uric acid, insulin resistance (IR), and smoke exposure could adversely affect the immune responses in overweight-obese vaccinated children, highlighting the need for actions to enhance the protection of this particular subgroup.