Research Article | DOI: https://doi.org/10.31579/2693-4779/333
1IMA Academy, applied pharmacologist Italy.
2Department of Hematology oncology, University of Aden, Yemen.
3Department of Medical & Health Sciences for Women, Peoples University of Medical and Health Sciences for Women, Pakistan.
4Medical laboratory Turin, Citta della salute, Italy.
5IMA Academy and IMA University president -International. Italy.
*Corresponding Author: Luisetto M, IMA Academy, Applied Pharmacologist Italy.
Citation: Luisetto M, Hamid. G.A, Mashori G.R, Cabianca L, Latyshev O.Y, (2026), When Immunodeficiency Meets Malignancy : A Case Report of Acute Lymphoblastic Leukemia in Probable Griscelli Syndrome, Clinical Research and Clinical Trials, 16(1) ; DOI :10.31579/2693-4779/333
Copyright: © 2026, Luisetto M. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 28 July 2026 | Accepted: 10 August 2026 | Published: 17 August 2026
Keywords: fluorochinolon; reverse of the fibrotic process; connective tissue deposition; mechanism of action; side effetcs; adverse event; structure activity relationship; physiology; pathology; oncology
Aim of this research is to verify the properties of ciprofloxacin and other fluorochinolon in reverse the connective tissue deposition and the fibrotic process starting from the experice of Wong et al. After a review of the scientific literature the focus is to verify if this effect is due to the antimicrobial effect of this molecule or there are other mechanims of action involved. The same the role played by the time in this process. Even if the fibrotic process was hystorically considered irreversible new evidence show other. A global conclusion is then submitter to the researcher for future investigation.
According to molecular biology and clinical research on the reversibility of scarringit is possible to verify that: Early/Dynamic Stage: In conditions like early-stage hepatic or pulmonary fibrosis, stopping the initial injury (removing toxins in the liver or exposure in the lungs) allows the body to break down excess scar tissue. Advanced/Terminal Stage: In advanced diseases like Idiopathic Pulmonary Fibrosis (IPF) or liver cirrhosis, scars mature into paucicellular lesions with highly cross-linked collagen and elastin, making them functionally irreversible.
According Neil C Henderson et al 2020
“Fibrosis can affect any organ and is responsible for up to 45% of all deaths. It has long been thought to be relentlessly progressive and irreversible, but both preclinical models and clinical trials in various organ systems have shown that fibrosis is a highly dynamic process. This has implications for therapeutic interventions that are designed to capitalize on this inherent plasticity. But despite substantial progress in our understanding of the pathobiology of fibrosis, a translational gap remains between the identification of putative antifibrotic targets and conversion of this knowledge into effective treatments in humans”
Samar A Antar et al 2023 written
“Most chronic inflammatory illnesses CII include fibrosis as a pathogenic characteristic. Extracellular matrix EM components build up in excess to cause fibrosis or scarring. The fibrotic proces FP s finally results in organ malfunction and death if it is severely progressive. Fibrosis affects nearly all tissues of the body. The fibrosis process is associated with chronic inflammation CI, metabolic homeostasis, and transforming growth factor-β1 signaling, where the balance between the oxidant and antioxidant systems appears to be a key modulator in managing these processes. Organ like the lungs, heart, kidney, liver, can be affected by fibrosis, whit an excessive accumulation of connective tissue CT. Organ malfunction is frequently caused by fibrotic tissue remodeling, which is also frequently linked to high morbidity and mortality. Long believed to be persistently progressing and irreversible, fibrosis has now been revealed to be a very dynamic process by preclinical models and clinical studies in a variety of organ systems.
Figure n 1: Fromt.A. Wynn et al wound repair and fibrosis. Epithelial and/or endothelial damage caused by various insults triggers complex interconnected wound-healing programs to quickly restore homeostasis. The coagulation pathway, which functions to stem blood loss, is triggered first, followed by acute inflammation / activation of innate immune mediators like as resident macrophages, neutrophils, dendritic cells. Epithelial and innate immune cell–derived cytokines subsequently influence the activation of the adaptive immune response. The tissue damage can directly activate the adaptive immune response. Inflammatory / immune mediators (cytokines, chemokines, free radicals) attempt to eliminate the inciting factor while activating the resident quiescent fibroblasts into myofibroblasts that orchestrate angiogenesis and production of ECM components. Failure to adequately contain or eliminate the inciting factors can exacerbate the inflammatory response and lead to a chronic wound-healing response, with continued tissue damage, repair and regeneration, resulting in fibrosis.
Ziv Paz et al 2010
“Fibrosis is a pathological process that includes scar formation and overproduction of extracellular matrix by the connective tissue as a response to tissue damage. Today, we know more about the molecular mechanism that leads to fibrosis involving different type of cells, cytokines, chemokines, and tissue enzymes. Fibrosis was considered an irreversible process, at least clinically, and is still usually treated by anti-inflammatory and immunosuppressive agents. No proven antifibrotic therapy has shown efficacy in ameliorating the clinical course of fibrotic diseases FD, but our current understanding led to the development of different drugs with promising results, like: mycophenolate mofetil, interferon, relaxin, and IV immunoglobulin.”
Figure n 2: The schematic diagram illustrates how fibrosis is triggered by persistent inflammation. TFG-β; transforming growth factor. From S.A. Antar et al.
A. Pellicoro et al 2012
“Liver fibrosis, and its end stage cirrhosis are a major cause of morbidity and mortality and therapeutic options are limited. The traditional view of liver disease as an irreversible process is obsolete and it is now evident that the development of liver fibrosis is a dynamic and potentially bidirectional process. Spontaneous resolution of scarring is seen in animal models of liver fibrosis and in human trials in which the stimuli responsible for chronic or repeated hepatic inflammation is successfully removed.
Key players in the process are hepatic stellate cells, macrophages, MMPs and their inhibitors Timps. It is evident that in advanced fibrotic liver disease AFLD, specific histological features define what is currently described as "irreversible" fibrosis. This includes the development of paucicellular scars enriched in extensively cross-linked matrix components, such as fibrillar collagen and elastin. Our work has focused on the role of macrophage metalloelastase in the turnover of elastin in reversible and irreversible models of fibrosis. We have shown that elastin turnover in liver injury and fibrosis is regulated by macrophages via Mmp-12 expression, activity and ratio to its inhibitor Timp-1. Failure of elastin degradation, together with increased deposition leads to accumulation of elastin in the fibrotic scars.”
Qing Yang Yu et al 2022
“Pulmonary fibrosis PF, a terminal pathological change in the lung, is caused by aberrant wound healing, deposition of extracellular matrix, and eventually replacement of lung parenchyma by ECM. Pulmonary fibrosis induced by acute lung injury and some diseases is reversible under treatment. While idiopathic pulmonary fibrosis is persistent and irreversible even after treatment. The known factors associated with the development of irreversible fibrosis include apoptosis resistance of (myo)fibroblasts, dysfunction of pulmonary vessel, cell mitochondria and autophagy, aberrant epithelia hyperplasia and lipid metabolism disorder.”
Figure n 3: from L.A Murtha et al Commonly secreted pro-fibrogenic growth factors, inflammatory proteins, matrix metalloproteinases, and tissue inhibitors of metalloproteinases during the fibrotic processes of myocardial infarction and idiopathic pulmonary fibrosis. Fibrotic disease is the result of a range of cellular and molecular responses activated by tissue injury. The fibrotic process is tightly regulated and involves phases: the inflammatory, proliferative, maturation phase. During the inflammatory and proliferative phases, a number of pro-fibrogenic, and inflammatory mediators are released to recruit and activate reparative mesenchymal cells like fibroblasts / myofibroblasts. These aid scar formation and maintains the structural integrity of the tissue. MMPs and TIMPs are released by fibroblasts. Their release can be mediated by chemokines, cytokines, growth factors released during the remodeling process. MMPs and TIMPs work to control the remodeling and degradation of extracellular matrix proteins at the site of injury.
Figure n 4: From C Jun et al Mechanisms of FQ-induced AAD. FQ induces ECM remodeling via promoting MMP activation and inhibiting TIMP-1/2, P4H, Lysyl hydroxylase and LOX. FQ decreases cell proliferation and increases cell apoptosis through promoting mitochondrial dysfunction, ROS production, activation of STING. Patients with A1AT deficiency may associated with FQ-induced AAD. FQ fluoroquinolones, MMP martix metalloprotein, tissue inhibitors of matrix metalloproteinase, P4H prolyl 4-hydroxylase, LOX lysyl oxidase, ROS reactive oxygen species, STING stimulator of interferon genes, alpha-1 antitrypsin, ECM extracellular matrix, aortic aneurysm and dissection.
According C. JUN et al
“Besides their typical antibacterial activity, FQ also exhibited diverse atypical biological profiles, like anti-Alzheimer activities, anti-tumor, anti-malarial and anti-tubercular”
Mechanisms of Action Research highlights the following primary mechanisms:
And about the Metabolite Conversion: In mammals, enrofloxacin is partially metabolized into ciprofloxacin, which is the primary driver of its extracellular matrix and connective tissue effects.
Figure n. 5: From C.Y. Huang et al The model by which fluoroquinolones (FQs) inhibit matrix metalloproteinase-9 (MMP-9) production by modulating p38 and cAMP signaling. In epithelial cells, TGF-β promotes invasion and metastasis by stimulating the p38-mediated signaling cascade in concert with canonical TGF-β signaling mediated by TGF-β receptor I and TβR-II. It has been recognized that FQs exert their anti-inflammation by producing intracellular cAMP, we discovered that FQs antagonize TGF-β and phorbol 12-myristate 13-acetate (PMA)-induced MMP-9 production by suppressing phosphorylation of p38 via cAMP production or via their components.
Whit an observational point of vew various research article are reported and then analyzed related the topic under investigation.
Various figure reported help in the general meaning. An experimental case report is submitted After all this a global conculsion is provided for future study.
Results :
From literature
Letitia Wong et al
“Uropathogenic E. coli 1677 was instilled transurethrally into adult C3H/HeOuJ male mice to induce chronic prostatic inflammation CPI. Collagen was labeled whit 3 H-proline administration for 28 days post-inoculation and 3 H-hydroxyproline incorporation measured to determine stability of the newly synthesized collagen. Inflammation score was evaluated- graded using a previously established system and total collagen content TCC was measured by picrosirius red staining quantitation and hydroxyproline content. Resolution of inflammation and reversal of collagen deposition CD was assessed after treatment with antibiotic enrofloxacin for 2 weeks on day 28 post-inoculation followed by an 8-week recovery period.
Decay analysis of incorporated 3H-hydroxyproline revealed the half-life of newly synthesized collagen to be significantly shorter in infected/inflamed prostates than in controls. Treatment with enrofloxacin completely eradicated the bacterial infection and allowed resolution of the inflammation. This was followed by marked attenuation of collagen content and correlation analysis verified a positive (+) association between the resolution of inflammation and the reversal of collagen deposition. Our findings show that inflammation-induced prostatic fibrosis IIPF is at least partly reversible and suggest that fibrosis of the human prostate may be addressed therapeutically by removing the cause of the inflammation or suppressing the inflammatory response” [1].
Figure. n 6: Enrofloxacin
A.M . Bujor et al
“We demonstrated that the CIP has dual antifibrotic effects on SSc dermal and lung fibroblasts by upregulating MMP1 and downregulating CCN2 and collagen type I levels.
Tendinopathies (tendon ruptures), rare but severe complications of CIP treatment. The pathologic mechanism is poorly understood, various mechanisms were proposed: the upregulation of matrix metalloproteinases followed by type I collagen degradation, inhibition of cell proliferation by the downregulation of cyclin B and cyclin-dependent kinase 1 and the inhibition of the tenocyte migration by the downregulation of focal adhesion kinase phosphorylation.
CIP-induced collagen downregulation DR in tendon cells is the result of increased ECM degradation due to the upregulation UR of various MMPs. Fibrosis in SSc is the result of the uncontrolled deposition of ECM that is presumably due to increased synthesis and to decreased degradation of matricellular components MC. CIP may affect SSc fibrosis trought regulating the aberrant expression of MMPs, leading to increased collagen turnover. MMP1 is the only enzyme capable of initiating the breakdown of interstitial collagens IC, including collagen type I, literature indicates that this enzyme is downregulated DR in SSc cells. Our study work demonstrates that, in addition to effects on MMP1, CIP treatment may directly block collagen synthesis in SSc fibroblasts, but not in healthy controls, by upregulating Fli1 levels” [2].
Figure n 7: form Bujor et al Schematic diagram showing the proposed mechanism of action for the antifibrotic effects of ciprofloxacin.
S. A. LeMaire et al 2020
“CIP treatment in WT Fbn1þ/þ mice reduced the level of LOX, a protein critical for cross-linking and stabilizing elastin and collagen” [3].
Enríquez-Casillas Rubén et al
“Scleroderma is an autoimmune connective AC tissue disorder that is characterized by microvascular injury, excessive fibrosis of the skin, and distinctive visceral changes that can involve the lungs, heart, kidneys and GI. Our results suggest that the administration OS of CIP for 6 months reduces the severity of symptoms affecting the skin of patients with systemic scleroderma SS, and does so without important secondary effects” [4].
Hannah Blau et al
“Both MXF and CIP are fluoroquinolones, possessing a cyclopropyl moiety at the position N1 of the quinolone core structure, appears to be associated with their immunomodulatory effects compared with other quinolones. MXF possesses a -CHO group on carbon 8 and a bulky C7 side chain, which differentiate it chemically from other fluoroquinolones, including CIP, and may be associated with MXF's wider antibacterial spectrum as well as increased tissue penetrance. These structural features and the higher concentration of MXF compared with CIP within cells may explain the enhanced immunomodulation by MXF shown in this study.
New therapies that downregulate DR the massive neutrophilic inflammation within CF airways as well as other inflammatory lung diseases ILD are urgently needed. Therapeutic targeting of the production of IL-8, IL-6, and other inflammatory proteins may most effectively be achieved by inhibiting key intracellular signaling molecules. Our work demonstrates that MXF, and to some extent CIP, function in this way and might be new modalities to prevent progressive destruction of lung parenchyma in these diseases “[5].
Figure n 8: from H Blau et al IL-8 secretion by IB3 [a cystic fibrosis (CF) bronchial cell line] and C38 cells stimulated with TNF-α. A: effect of TNF-α stimulation. IL-8 secretion by IB3 and C38 cells cultured in Lab. of Human Carcinogenesis basal medium #8 (LHC-8), serum-starved for 24 h, and incubated with 50 ng/ml TNF-α for a further 48 h. Results are expressed as means ± SE of 8 experiments performed in duplicate. *P < 0>
Figure n 9: from Resti Yudhawati et al Structure of fluoroquinolones with and without cyclopropyl moiety.
J H Yoon et al
“The use of FQs is not without risk: Tendonitis and spontaneous tendon rupture have been reported. We have studied the effects of enrofloxacin, used in domestic animals, on tendon cell cultures established from equine superficial digital flexor tendons. Effects on cell proliferation and morphology were studied using cell counting and scanning electron microscopy. Monosaccharide content and composition was determined by CG – MS analysis. Western and Northern blot were utilized to evaluate the synthesis and expression of 2 proteoglycans, biglycan and decorin. Our data demonstrate that enrofloxacin inhibits the cell proliferation, induces morphological changes, decreases total monosacharide content and alters small proteoglycan synthesis at the glycosylation level in equine tendon cell cultures. These effects are more pronounced in the juvenile tendon cells than in adult equine tendon cells. We hypothesize that morphological changes and inhibition of cell proliferation are a result of impaired production of biglycan and decorin, proteoglycans involved in fibrillogenesis of collagen, the most important structural component of the tendon of enrofloxacin-treated tendon cells” [6].
Kaveh Khazaeel et al,
“Enrofloxacin increases apoptosis in chondrocytes and decreases their numbers. Enrofloxacin use in growing lambs even at recommended therapeutic dose is not completely safe on articular cartilage. Higher doses of enrofloxacin induce severe changes in lamb articular cartilage” [7].
Diva Baggio et al
“Serious adverse effects are rare but significant, and include tendinopathy, aortopathy, neuropathy, arrhythmia, hypoglycaemia and hyperglycaemia. Prescribers should be aware of the risk factors for fluoroquinolone FQs toxicity including patients over 60 years and patients with comorbidities or interacting drugs” [8].
Figure n. 10: From D. Daneman et al 2015
Figure n. 11: from F Puoci et al 2012 Insertion of CFX into collagen chain. The covalent incorporation of CFX into collagen chains was confirmed by performing FT-IR and UV-Vis analyses and the amount of CFX bound per gram of polymeric conjugate was 25 mg.
Yuki Enoki et al
“A similar inhibition in a H2O2/UV system and PMA-stimulated neutrophils was observed in the case of LVFX, indicating that LVFX is capable of scavenging OH radicals” [9].
Jun, C., Fang, B.
“Matok et al. revealed that there was a significant association between FQ exposure and an increased risk of arrhythmia (85% increase) and CV (71% increase). In 2018, FDA issued several “black box warnings” against FQ with the latest safety announcement warning about an increased risk of ruptures in the aorta blood vessel in certain patients. FQ may interfere with ECM integrity in the aortas. Dysregulation of ECM homeostasis disrupted ECM integrity and impaired biomechanical strength, which finally triggered progressive aortic weakening, dissection, or rupture. According to studies, enzymatic degradation of ECM by MMPs and vascular remodeling constituted the most prominent characters of AA. TIMPs may inhibit the development of AA. Evidence confirmed that FQ reduced collagen production in tenocytes and fibroblasts. Researches showed that CIP suppressed TIMP-1 expression but enhanced MMP expression in the cornea, in tendon cells and tissues, in fibroblasts, which finally promoted MMP activation and tissue destruction. It was suggested that CIP greatly up-regulated MMP activity more than twofold in cultured human aortic smooth muscle cells. Human aortic fibroblasts exposed to FQ showed an increased capacity for ECM dysregulation by reducing the expression of collagen and endogenous protease inhibitors protein. They demonstrated collagen degradation and decreased TIMPs activity in human aortic fibroblasts cultured with 2 days FQ. A recent study confirmed that CIP significantly increased the incidence of AAD (79%) in mice. Specifically, in the mouse model of AAD that CIP exposure reduced the expression of LOX, a critical enzyme in the assembly and stabilization of elastic fibers and collagen.CIP us enhanced MMP expression and activity as well as elastic fiber fragmentation in the aortas. In cultured smooth muscle cells, CIP markedly down-regulated LOX levels and activity while up-regulated MMP levels. FQ is considered to be powerful iron chelators. Prolyl 4-hydroxylase and lysyl hydroxylase are iron-dependent enzymes, which play central roles in the post-translational modification of collagen. These enzymes promote collagen maturation through hydroxylation of proline and lysine residues to induce collagen cross-linking, which is essential for the tensile strength of collagen fibers. Badal et al. The effect of FQ on the inhibition of cell proliferation and induction of cell apoptosis may lead to aortic destruction. Evidence showed that FQ inhibited cell proliferation in various cells, including tenocytes, osteoblasts and chondrocytes, and induced cell apoptosis in various cells, like tenocytes and lens epithelial cells. Mechanically, as a DNA topoisomerase inhibitor, CIP induced nuclear and mitochondrial DNA damage and the the release of DNA, which finally promoted mitochondrial dysfunction, reactive oxygen species production, activation of stimulator of interferon genes, the cytosolic DNA sensor and cell death “[10].
Figure n: 12: from A. Menon et al 2013 Immunofluorescence analysis of the actin cytoskeleton in tenocytes untreated and treated with CPX. Representative immunofluorescence photomicrographs of microfilament distribution, evidenced by rhodamine-phalloidin labeling, in CT (a) and tenocytes after 10 μg/ml (b), 20 μg/ml (c) and 50 μg/ml CPX (d). DAPI was used for nuclear staining. Original magnification: 40×.
Aura Rusu et al
“Underlying Mechanisms of Aortic Aneurysm and Aortic Dissection The mechanism of FQ-induced ruptures or tears in the aorta blood vessel remains to be clarified. One proposed mechanism claim that FQs upregulate cell matrix metalloproteinases. Consequently, collagen fibrils (types I and III) will be reduced. FQs may interfere with extracellular matrix (collagen and elastic fibers) integrity in the aortas. Disrupted extracellular matrix integrity correlated with impaired biomechanical strength triggers progressive aortic degradation until dissection or rupture. It was reported that FQs decrease collagen production in mouse tympanic membrane fibroblasts (CIP) and tenocytes (human-derived tendon cells). Many studies have shown that CIP enhanced MMPs expression, which mediates collagen and elastic fiber degradation. CIP was associated with collagen degradation and decreased the inhibitors of the matrix metalloproteins expression” [11].
Bakhtin V.M. et al
“The complexing activity of levofloxacin and moxifloxacin was similar to that of EDTA and was greater than that of citrate ionsand glycine. FQ may compete with bioorganic ligands for magnesium ions. High complexing activity of FQ may lead to serious adverse reactions caused by intracellular Mg2+ deficiency” [12].
Figure n. 13: Form Agnieszka Cuprys et al 2018 Fluoroquinolones metal complexation and its environmental impacts.
Figure. n 14: From D.M Walden. Computed structures and predicted free energies of binding (∆Gbind) between N-protonated cationic CIP and (A) aluminum hydrate, (B) magnesium hydrate, and (C) calcium hydrate. Structural images generated using CYLView.
Experimental hypotesys part
Two group of patients with hystory of chronic prostatitis and documented reduced urinary flux: 20 patients group A nd 20 in the gruop B. Before to start this test, it must to be measured the all patient basal urofluxometry. The group A must to be treated with ciprofloxacin for 15 days at usual posology. Gre group B must to be treated with Suslfametoxazole and trimetoprimfor 15 days at usual posology. To all of this patient must to be added oral antinflamatory therapy. After this period must to be tested all patient with uorofluxometry. If increased flux in the group A this can suggest more efficacy in reverse the Bladder neck- urethra fibrosis related the chronic prostatitis. (hypotesis).
In medicine hystory the fibrotic process was considered as irreversible with many implications in various severe condition affecting also relevant organs. The fibrotic process if in acute seem reversible in chronic phases it can become more irreversible. Various flurochinolon show in literature efficacy in reverse some fibrotic process with deposition of connective tissue. Betwen the MOA there is a reduction of infalmatory process linked to infection.
The MOA of the fluorochinolon in reverse the fibrotic process imply modify in various moleculas signal systems.
1)Downregulation of Dnmt1, 2) Upregulation of Fli1, 3) MMP1 Activation, 4) MMP-9 Suppression. Ciprofloxacin exerts paradoxical, tissue-dependent effects on Matrix Metalloproteinase-9 (MMP-9). It has been shown to downregulate MMP-9 in certain cancer cells (inhibiting migration), yet upregulate MMP-9 in connective tissues (contributing to tendon injury and aortic aneurysms) 5) Upregulation of Collagen Repressors, 6) Connective Tissue Growth Factor Reduction 7) ions ecomplexing activity
“Besides their typical antibacterial activity, FQ also exhibited diverse atypical biological profiles, like anti-Alzheimer activities, anti-tumor, anti-malarial and anti-tubercular” See C. Jun et al Of great interest the efficacy in Influenza Virus-Induced Lung Injury [9] so not only antibacteric effect.
In literature it is clear the florochinolon show a toxic class effect. [9] and this ADR can be a driver to address the reseach: tendom rupture, aorta rupture. In oral therapy is wwll knowed the risk of serious tendinopaty since also rupture. (Achilles tendon) Fundamental in this filed are the animal model, and preclinical studies even if the clinical trial can be the right instrument to verify the efficacy in humans as antifibrotic molecule.
After seeing all reported it is crucial to verify if the class effect in reverse fibrotic process is related only to the antibacterial properites that contribute to reduce local infections or there is another mechanism of action not related to the antimicrobial effect.
Tha fact that the fibrotic process was hystorically considered as irreversible make this article interesting to continue the research in this field. Finally, because this effects in some fibtoric processi is is needed to label these drugs like Some fluorochinolon as antifibrotic? It is so recomended to perform clinical trial for evaluate this new condition a part from the In vitro sudy or in animal model.
Conflict of interest: No.
Ethical consideration: all international ethical rules were followed in this work.
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I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My Testimonial Covering as fellowing: Lin-Show Chin. 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.
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
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.
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.
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.
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.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
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.
“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”.
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.
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.
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.
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.
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.
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.
"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".
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!
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
