RESUMO
Background: Assessment of awareness and knowledge of the general population regarding Monkeypox is rarely investigated on a global level. The World Health Organization (WHO) reported a lack of knowledge about monkeypox as one of the main challenges facing authorities in implementing effective preventive strategies. This study aims to assess the awareness and knowledge of the general adult population about Monkeypox disease. Subjects and Methods: An online population-based cross-sectional study was carried out in Jeddah, Saudi Arabia, among a snowball sample of adult persons (>18 years old). A self-administered online Arabic and English questionnaires was utilized in this study. It consists of three main parts: sociodemographic characteristics of the patients, perception towards Monkeypox disease and assessment of the knowledge about Monkeypox disease through 23 multiple-choice questions with "Yes", "No" and "don't know" responses. Results: A total of 387 adults were included in the study. Females represented 72.6% of them. Almost two-thirds (63.8%) aged between 26 and 45 years. More than half (55.6%) of the participants believed that monkeypox will affect social and economic life like the COVID-19 pandemic while 30.7% considered Monkeypox as a conspiracy or bioterrorism. Overall, almost half (50.4%) of the participants expressed excellent level of knowledge, whereas only 4.4% had poor level of knowledge. The highest level of excellent knowledge about Monkeypox disease was observed among participants in the age group 26-45 years (55.1%), whereas the lowest was observed among those in the age group 46-60 years (39.7%), P = 0.001. More educated participants (university/postgraduates) were more knowledgeable about Monkeypox disease as 53.5% of them had excellent level of knowledge compared to 33.3% of those below secondary school educational level, P = 0.047. Conclusion: The knowledge of the general population about Monkeypox is acceptable. However, defective knowledge was observed regarding the fact that Monkeypox is not a new infection that appeared in the year 2022 as well as about the availability of a monkeypox vaccine in Saudi Arabia. Therefore, it is recommended to organize educational activities about the disease for general population targeted mainly lower educated and elderly subjects.
RESUMO
Active cancer-associated fibroblasts (CAFs) are major components of the tumor microenvironment, which promote carcinogenesis and modulate response to therapy. Therefore, targeting these cells or reducing their paracrine pro-carcinogenic effects could be of great therapeutic value. To this end, we sought to investigate the effect of eugenol, a natural phenolic molecule, on active breast CAFs. We have shown that decitabine (5-Aza-2'-deoxycytidine, DAC) and eugenol inhibit the expression of the DNA methyltransferase genes DNMT1 and DNMT3A at both the protein and mRNA levels in breast CAF cells. While the effect of eugenol was persistent, DAC had only a transient inhibitory effect on the mRNA level of both DNMT genes. Furthermore, eugenol and DAC suppressed the invasive/migratory and proliferative potential of CAF cells as well as their paracrine pro-carcinogenic effects both in vitro and in humanized orthotopic tumor xenografts. Interestingly, these inhibitory effects of decitabine and eugenol were mediated through E2F1 downregulation. Indeed, ectopic expression of E2F1 upregulated both genes and attenuated the effects of eugenol. Additionally, we provide clear evidence that eugenol, like DAC, strongly modulates the methylation pattern in active CAF cells, through methylating several oncogenes and demethylating various important tumor suppressor genes, which affected their mRNA expression levels. Importantly, the E2F1 promoter was also hypermethylated and the gene downregulated in response to eugenol. Together, these findings show that the active features of breast CAF cells can be normalized through eugenol-dependent targeting of DNMT1/DNMT3A and the consequent modulation in gene methylation.