Human Chromosomal Q-heterochromatin Regions as a System

Review Article | DOI: https://doi.org/10.31579/2692-9406/106

Human Chromosomal Q-heterochromatin Regions as a System

  • Abyt Ibraimov 1,2*
  • Stalbek Akhunbayev 1
  • Orozali Uzakov 1

1 International Higher School of Medicine, Intergelpo str, 1F, Bishkek, Kyrgyzstan.

2 National Center of Cardiology and Internal Medicine, Togolok Moldo str,3, Bishkek, Kyrgyzstan.

*Corresponding Author: Abyt Ibraimov. International Higher School of Medicine, Intergelpo str, 1F, Bishkek, Kyrgyzstan.

Citation: Ibraimov A, Akhunbayev S and Uzakov O. (2022). Human Chromosomal Q-heterochromatin Regions as a System. Biomedical Research and Clinical Reviews. 6(4); DOI: 10.31579/2692-9406/106

Copyright: © 2022 Abyt Ibraimov, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 01 February 2022 | Accepted: 26 February 2022 | Published: 04 March 2022

Keywords: constitutive heterochromatin; chromosomal Q-heterochromatin regions; epigenetics; cell thermoregulation; genetic system

Abstract

The eukaryotic genome consists of the two forms of chromatin: euchromatin and heterochromatin. The DNA of euchromatin contains the gene portion of the genome, while heterochromatin is represented predominantly from non-coding repetitive nucleotide sequences that do not encode proteins or enzymes. In higher eukaryotes, some part of the non-coding, highly repetitive nucleotide sequences were transformed into complex forms of DNA organization as chromosomal constitutive heterochromatin regions. There are two types of constitutive heterochromatin: C- and Q-heterochromatin. C-heterochromatin is found in the chromosomes of all eukaryotic cells, while Q-heterochromatin is found in the karyotype of only three higher primates (Homo sapiens, Gorilla gorilla and Pan troglodytes).

Since the discovery of the position effect variegation phenomenon C-heterochromatin has been attributed to gene silencing effects. Dosage compensation of genes is another epigenetic gene silencing mechanism that makes it possible to equalize the level of expression of sex-linked genes in males and females. In mammals, this is done by inactivating one X chromosome in the cells of females using facultative heterochromatin, which is a heterochromatinized euchromatin. However, no epigenetic gene silencing was found in chromosomal Q-heterochromatin regions (Q-HRs). The question is discussed why human chromosomal Q-HRs does not exhibit gene silencing or other epigenetic effects and what their biological role might be.

Introduction

The two forms of chromatin were distinguished by cytological staining of cells: heterochromatin and euchromatin. Heterochromatin stained darker than euchromatin due to a denser packing and is generally localized to the periphery of the nucleus. The DNA of euchromatin contains the gene portion of the genome, while heterochromatin is represented predominantly from non-coding repetitive nucleotide sequences that do not encode proteins or enzymes. In higher eukaryotes, some part of the non-coding, highly repetitive nucleotide sequences were transformed into complex forms of DNA organization as chromosomal constitutive heterochromatin regions (HRs). There are two types of constitutive heterochromatin: C- and Q-heterochromatin. C-heterochromatin is found in the chromosomes of all eukaryotic cells, while Q-heterochromatin is found in the karyotype of only three higher primates (Homo sapiens, Gorilla gorilla and Pan troglodytes).

Position effect variegation (PEV) causes a gene to be stochastically silenced in regions where it should normally be expressed. This occurs when the gene becomes juxtaposed to C-heterochromatin in a genome translocation or insertion event. An example is variegated eye color in Drosophila caused by a translocation of the white gene into the vicinity of heterochromatin.

Dosage compensation of genes is an epigenetic mechanism that makes it possible to equalize the level of expression of sex-linked genes in males and females of those species in which sex determination is carried out using sex chromosomes. In mammals, this is done by inactivating one X chromosome in the cells of females, so that in each somatic cell of an individual of either sex, there is only one active X chromosome per diploid set of chromosomes.

Chromosomal Q-HRs variability in human population.

It is known that chromosomal C-heterochromatin regions (C-HRs) are present on all 46 chromosomes in the human karyotype and their complete absence even in one chromosome is extremely rare. It has been established that the C-HRs makes up 15-29% of the human genome. Unlike C-HRs, chromosomal Q-heterochromatin regions (Q-HRs) may be completely absent in the human genome without any noticeable pathological or other phenotypic manifestations for the carrier. According to some authors, individuals with a complete absence of Q-HRs make up a significant part of human populations [1-8]. There is a huge literature, including a number of reviews devoted to the study of morphology, molecular biology and methods of identification of chromosomal C- and Q-HRs in the human karyotype [6,9-16]. The main morphological manifestation of morphological variability of Q-HRs in the human karyotype is the presence, degree of fluorescence, size and location of Q-heterochromatin segments in 12 potentially Q-polymorphic loci of seven autosomes (3p11q11, 4p11q11, 13p11, 13p13, 14p11, 14p13, 15p11, 15p13, 21p11, 21p13, 22p11 and 22p13) and in the q12 segment of the Y chromosome. It should be specially emphasized that not a single individual was found in the human population in whose karyotype Q-HRs was present in all 25 potentially Q-polymorphic loci. In the human population, the number of Q-variants usually ranges from 0 to 10 [3-6,17-20].

Currently, the following quantitative characteristics of the variability of Q-heterochromatin polymorphism are used to estimate the amount of chromosomal Q-HRs in the genome of a human population: 1) the frequency of Q-HRs in 12 potentially polymorphic loci of seven autosomes, which are usually expressed as a percentage from the number of analyzed chromosomes; 2) the distribution of the numbers of Q-HRs in the population, i.e. the distribution of individuals with a different amount of Q-HRs regardless of their localization in the karyotype, which also reflects the magnitude of the variability of the amount of Q-HRs in the sample; 3) the mean number of chromosomal Q-HRs per individual in the population (m), which is determined by dividing the total amount of Q-HRs found in this sample by the number of studied chromosomes; and 4) the size of the Y chromosome, which is conventionally divided into three groups: (a) large (Y = F), (b) medium (F > Y > G) and (c) small (Y = G)  [15,21].

Suggestions on the possible biological role of the constitutive heterochromatin.

There are many hypotheses regarding the possible biological role of constitutive C-heterochromatin [9-15]. However, apart from the PEV phenomenon, almost all of the hypotheses put forward have not yet been experimentally confirmed. Once again, we specifically note that PEV was found in animals that lack chromosomal Q-HRs in the genome. In species with chromosomal Q-HRs - Homo sapiens, Pan troglodytes and Gorilla gorilla - phenomena directly or indirectly resembling PEV phenomenon have not been described.

There is still no consensus on the nature of the variability of chromosomal Q-HRs in the human genome, although all hypotheses adhere to the "selectionist" approach. Only one of these hypotheses implies that for Q-HRs, “the dose, and not the localization of Q-HRs on a particular chromosome, is of paramount importance” [8,21]. Here the term “dose" refers to the total amount of Q-heterochromatin material in an individual's genome. In other words, this hypothesis is based on the assumption that chromosomal Q-HRs do not possess locus specificity.

All other hypotheses hold the point of view that "localization is important for an individual, not the amount of Q-HRs”, that is, they are supporters of a locus-specific approach. Proponents of this approach believe that, for example, deviations from the theoretically expected Q-HRs frequencies at the population level reflect some structural and functional features of these loci and are due to either selection or non-random segregation of chromosomes carrying Q-HRs [22-24]. They suggest that Q-HRs localized on different chromosomes in the human karyotype differ in structure and biological effects. This, they believe, is evidenced by deviations in the observed frequencies of homo (+/+ or -/-) and heterozygotes (-/+) of chromosomal Q-HRs from those theoretically expected when they are checked for compliance with the Hardy-Weinberg law (for more details see [15]).

On this occasion, Ginzburg et al. [25] specially studied the statistical side of this controversial issue. Leaving aside the question of the validity of the interpretation of the violation of the Hardy-Weinberg rule, the authors focused on the statistical procedure by which this violation can be detected. The authors showed that if the χ2 criterion is used for small samples (often the volumes did not exceed 25-200 observations), and the Hardy-Weinberg distribution hypothesis is respected, the researcher, nevertheless, will reject it more often, and, in some cases, the error of the first kind reaches a value that makes the study itself incorrect.

Thus, it can be assumed that the use of non-correspondence of the observed frequencies of homo- and heterozygotes to those theoretically expected in some samples as an argument in favor of the hypothesis of locus specificity of chromosomal Q-HRs is not justified. This method, being formal in nature, did not advance in understanding the biological role of the wide variability of Q-HRs in human populations. This idea was most clearly expressed by Jacobs [26], who noted that it is premature to assess the correspondence of the observed and expected frequencies of homo- and heterozygotes to the Hardy-Weinberg law, since existing methods for quantifying chromosomal Q-variants are far from perfect due to the continuous nature of the distribution of Q-HRs in size in human populations. Mayr [27] specifically studied this question and came to the conclusion: “They expressed this as a mathematical formula, which is a reapplication of a mathematical law, the binomial expansion. Being a strictly mathematical solution, it is not a biological law”.

Our attitude to this issue is as follows: until evidence is obtained that Q-HRs localized in 12 potentially polymorphic loci of seven pairs of autosomes and on the human Y chromosome are fundamentally different structures in molecular and/or genetic terms, the use of the Hardy-Weinberg rule remains mainly an exercise in solving some problems of applied mathematics without significant biological content. On the whole, it can be assumed that observations of supposedly deviations in the segregation of Q variants in families or a discrepancy between the observed and theoretically expected frequencies of homo- and heterozygotes in some samples do not yet require a special biological interpretation [15,28].

Our assumption about the absence of locus specificity of human chromosomal Q-HRs is based on numerous observations that with an increase or decrease in the mean number of Q-variants per individual in the population, a proportional increase or decrease in the frequency of Q-variants occurs for all Q-polymorphic loci [15,18,29]. In particular, if we arrange the studied samples according to the value of the mean number of Q-HRs per individual and perform the same operation with the frequencies of Q-variants on seven Q-polymorphic autosomes, then the distribution of populations by the frequencies of Q-variants in these autosomes will correspond to their distribution by the value of the mean numbers of Q-HRs calculated per person in the population (Table 1). A similar result was obtained by us after analyzing the data of other researchers [30-32], which revealed the existence of inter-population differences in the values of the mean number of Q-HRs [15,29,33].

Table 1: The frequency and the mean numbers of chromosomal Q-HRs in seven Q-polymorphic autosomes in native human populations living in Eurasia and Africa [15].
n = sample size; * Q-HR frequency of the chromosomes analyzed; ** Q-HR frequency as a percentage of the overall number of chromosomal Q-HRs.I – northern Mongoloids of Siberia; II – highland Mongoloids of the Pamir and Tien-Shan; II – steppe Mongoloids of Central Asia; IV – Russians; V – Indians of northern India; VI – lowland Negroids of subequatorial Africa.

The totality of the data presented below shows the validity of the assumption that there is no locus specificity of chromosomal Q-HRs: a) despite the fact that there are 25 loci in the human karyotype in which may be chromosomal Q-HRs, in fact, the maximum number of Q-variants does not exceed ten [1,2,6]; b) in human populations, the number of Q-HRs usually ranges from 0 to 10 without visible pathological or other phenotypic manifestations [6]; c) the distribution of Q-variants in the samples has always been close to the normal distribution [18,21,34 ]; d) at the population level, the distribution of Q-HRs on seven Q-polymorphic autosomes is uneven: the largest number of Q-variants was found on chromosomes 3 and 13 (more than 50%), the remaining Q-HRs were more or less evenly distributed on the remaining five autosomes [29,34] (see Table 1); e) human populations do not differ from each other in the relative content (“portion”) of Q-HRs on seven autosomes: the portion of Q-variants on autosomes 3, 4, 13, 14, 15, 21, and 22 were on average, 25.5 %, 3.5 %, 30.7 %, 8.6 %, 12 %, 10.6 %, and 9.1%, respectively [29,33] (see Table 1); f) the quantitative content of Q-HRs in the genome of a human population is best determined by the mean number of Q-variants per individual (m) in the sample [1-6,8,21,34]; g) significant differences were found between the samples in the quantitative content of chromosomal Q-HRs, and it turned out that these differences are related to the climatic and geographical features of the place of permanent residence of the studied populations, and not to their racial and ethnic composition [3-6,18-21,34]; h) changes in the mean number of Q-HRs in the genome of populations tend to decrease from low to high geographical latitudes and from low to high altitudes [3-6,15]; i) both a decrease and an increase in the value of m is accompanied by a narrowing or expansion of the range of variability of Q-variants [29,33]; j) in different age groups, the values of m differ — the largest number of Q-variants are present in the genome of newborns, and the smallest in individuals from older age groups [30,36]; k) individuals who adapted to hypoxic hypoxia at high altitudes (mountaineers) and the extreme climate of the Far North of Siberia had an extremely low amount of chromosomal Q-HRs in the karyotype [3-6,18-21,34]; l) Q-HR on the Y chromosome, being the largest block of Q-heterochromatin in the human karyotype "restricts" the amount of Q-HRs on autosomes, namely, in samples of men with large Q-HR sizes on the Y chromosome, the m value is significantly lower and vice versa [37]; m) there is some evolutionarily fixed mechanism that compensates for the low content of Q-heterochromatin in the female genome due to the absence of a Y chromosome in their karyotype by increasing the amount of Q-HRs on their autosomes [38]; and, finally, n) individuals in the human population differ from each other in the level of thermal conductivity of their bodies, and these differences are related to the amount of chromosomal Q-HRs in their genome [39].

Thus, more than half a century of experience in studying chromosomal Q-HRs shows that this type of constitutive heterochromatin has not demonstrated effects even remotely resembling PEV, gene silencing or other known epigenetic processes. This is directly evidenced, at least, by the fact that even the complete absence or maximum amount of Q-heterochromatin in the human karyotype has no visible phenotypic manifestation, so that they could be used to judge the effect of Q-HRs on the functioning of genes. On the other hand, chromosomal Q-HRs at the level of human populations behave so regularly that their behavior can be predicted.

Human chromosomal Q-HRs as a system.

Now let's consider an approach in which human chromosomal Q-HRs are considered as a single structural and functional system, where their total amount (dosage) in the genome is of primary importance, and not localization on one or another chromosome in the karyotype. If it concerns a concrete person, then an important criterion for assessing the variability of Q-variants should be their total number (from 0 to 10) in the karyotype; when it comes to a population, then the mean number of Q-HRs per individual in the population is crucial [15,18].

Usually, by "system” it is customary to mean a certain totality, which in some way can be distinguished from real or imaginary elements of the surrounding world [40]. In biology, consider a particular set as a system if: 1) each of its elements is indivisible (not in the physical sense, but conditionally); 2) it interacts with the surrounding world as a whole; and 3) quantitative relations are established between the elements of the selected set, and in its evolution, correspondences are preserved between the elements, that is, there is some ordering.

The indivisibility of chromosomal Q-HRs located in 12 polymorphic loci of seven pairs of autosomes and Y chromosomes is evidenced by the specificity of cytochemical staining methods (Q-staining) used to detect them [41]. The second requirement meets such facts: an increase or decrease in the frequency of human chromosomal Q-HRs occurs simultaneously across all Q-polymorphic loci in proportion to their initial frequencies in the population, regardless of gender, age, racial and ethnic characteristics or climatic and geographical features of their places of permanent residence. If the elements of the proposed system should interact with the surrounding world as a whole, then a proportional decrease or increase in the number of Q-variants for all Q-polymorphic autosomes in the genome of a population, depending on the characteristics of the ecological environment of their habitat, may indicate in favor of considering chromosomal Q-HRs as a single structural and functional system (see also Table 1) [15,18,33].

Regarding the third requirement, it should be noted that: a) the proportion of Q-HRs variants in 12 Q-polymorphic loci of seven pairs of autosomes in human populations, expressed as a percentage of the number of Q-variants are always comparable, regardless of the average values of the number of Q-HRs in the samples [15,29,33]; b) even in those populations where the value of the average number of Q-HRs is very low, Q-heterochromatin does not disappear on autosomes that differ with low frequency, and moreover, the contribution of Q-highly polymorphic and Q-low polymorphic chromosomes in the total pool of Q-HRs in the samples remains comparable [3-6,18-21,34]; c) the distribution of Q-variants in the population is always close to the normal distribution [15,29]. All this testifies in favor of the point of view that chromosomal Q-HRs behaves at the level of human populations as a single self-sustaining structural and functional system [15,21,29].

When asked why chromosomal Q-HRs behave as a single genetic system and, contrary to theoretical expectations, do not show any signs of epigenetic effects, we would answer as follows. The consistency in the behavior of human chromosomal Q-HRs at the population level is due to their special biological role. We believe that chromosomal Q-HRs, together with C-HRs, are involved in thermoregulation at the cell level, the essence of which is that they, as part of a dense layer of condensed chromatin (CC), contribute to the dissipation of excess heat from the interphase nucleus.

DNAs of human chromosomal constitutive HRs are not involved in the production of proteins, enzymes, or RNAs, and their main biological effect is the dense packing (compactization) of the CC layer around the interphase nucleus. This CC layer, being the densest structure in the interphase cell, must have a high thermal conductivity in order to facilitate more efficient removal of excess heat from the nucleus.

The phenotypic manifestation of the biological effect of constitutive chromosomal HRs is the level of thermal conductivity of the human body, which has received experimental confirmation. In particular, our studies indicate that the phenotypic effect (the level of heat conductivity of the human body) of Q-HRs depends on their amount in the individual's genome, and not on the peculiarity of their localization on one or another chromosome in its karyotype. Apparently, the total number of human chromosomal Q-HRs in the genome of populations is under the control of natural selection, the pressure of which is determined by the climatic and geographical features of the environment where the population permanently lives (for details see [15,39,41]).

Conclusion

The eukaryotic genome consists of the two forms of chromatin: euchromatin and heterochromatin. The DNA of euchromatin contains the gene portion of the genome, while heterochromatin is represented predominantly from non-coding repetitive nucleotide sequences. There are two types of constitutive heterochromatin: C- and Q-heterochromatin. C-heterochromatin is found in the chromosomes of all eukaryotic cells, while Q-heterochromatin is found in the karyotype of only three higher primates (Homo sapiens, Gorilla gorilla and Pan troglodytes).

Since the discovery of the position effect variegation phenomenon C-heterochromatin has been attributed to gene silencing effects. Dosage compensation of genes is another epigenetic gene silencing mechanism that makes it possible to equalize the level of expression of sex-linked genes in males and females. However, no epigenetic gene silencing was found in chromosomal Q-heterochromatin regions (Q-HRs).

Our studies indicate that chromosomal Q-HRs behave as a single genetic system and do not show any signs of epigenetic processes. We believe that the systemic nature in the behavior of human chromosomal Q-HRs at the population level is associated with their special biological role. Apparently, chromosomal Q-HRs together with C-HRs are involved in thermoregulation at the cell level, the essence of which is that they, as part of a dense layer of condensed chromatin, contribute to the dissipation of excess heat from the interphase nucleus with all the ensuing consequences.

Acknowledgements

I apologize to that author whose work is not cited or is cited only through reviews.  The reason for this is only the space limitations of the publication.

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

img

Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

img

Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

img

Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

img

Dr Maria Dolores Gomez Barriga