Bone metastasis remains a major cause of morbidity in advanced cancer, driven not only by tumor–bone crosstalk but also by profound immune remodeling within the marrow. Myeloid-derived suppressor cells (MDSCs), including polymorphonuclear (PMN-MDSC) and monocytic (M-MDSC) subsets, are increasingly recognized as central effectors of this process, integrating inflammatory signals with metabolic and stromal cues to enforce immune suppression and support skeletal colonization. In this review, we synthesize current evidence that bone metastases transform the bone marrow into an “MDSC amplifier,” where vascular and endosteal niches, CXCL12-rich stromal compartments, hypoxia, and adipocyte-derived lipids collectively promote MDSC recruitment, persistence, and functional maturation. We discuss the dominant suppressive programs deployed by MDSCs in bone (e.g., arginase-1 activity, reactive oxygen/nitrogen species, and checkpoint ligand expression), and how these mechanisms converge to impair cytotoxic T-cell and NK-cell responses while fostering regulatory T-cell dominance. Importantly, because the marrow is a hematopoietic organ, bone lesions can also generate systemic consequences through myeloid spillover, providing a mechanistic basis for reduced responsiveness to immune checkpoint blockade in bone-dominant disease. We then evaluate pharmacologic strategies to target MDSCs in the context of bone metastasis, including approaches that block trafficking (e.g., CCR2/CXCR2 axes), deplete or reprogram suppressive myeloid states (e.g., STAT3-directed strategies, differentiation therapy), and disrupt bone-resorptive feedback loops (e.g., receptor activator of NF-κB ligand (RANKL) inhibition and bisphosphonates), emphasizing rational combinations and sequencing to limit marrow toxicity. Finally, we highlight emerging single-cell and spatial profiling tools that can resolve bone-specific heterogeneity in MDSCs and guide biomarker-driven, mechanism-informed therapeutic development.

Bone metastasis is often treated clinically as a late complication of advanced cancer, yet accumulating evidence indicates that it is also a spatial evolutionary process shaped by clonal selection, niche adaptation, dormancy, and reseeding. This review examines BoM through a phylogeographic framework that links tumor ancestry with anatomical location and time. We discuss how heterogeneous primary tumors generate bone-tropic subclones, how circulating tumor cells pass through dissemination bottlenecks, and how disseminated tumor cells enter perivascular and endosteal niches that either maintain dormancy or support early micrometastatic outgrowth. We then compare clonal architectures across breast, prostate, lung, and renal cell carcinomas, emphasizing both lineage-specific programs and convergent bone-adaptive states, including osteomimicry, immune evasion, metabolic plasticity, and epigenetic remodeling. Methodological platforms such as multiregion sequencing, single-cell and spatial transcriptomics, lineage tracing, and liquid biopsy are evaluated with attention to the technical limitations imposed by mineralized tissue. Finally, we consider how bone lesions may function as reservoirs for secondary dissemination and how evolutionary thinking could improve biomarker development, dormancy prediction, trial design, and therapy selection. Viewing BoM as an evolving ecosystem may help shift the field from reactive skeletal management toward earlier, biology-informed intervention.

Nail growth disorders can cause functional impairment and cosmetic concern, yet effective treatments remain limited. Minoxidil, a vasodilator widely used for androgenetic alopecia, has been proposed to enhance nail growth through its proliferative and vascular effects. This systematic review, conducted in accordance with PRISMA 2020 guidelines, evaluated the efficacy and safety of topical and oral minoxidil for promoting nail growth in healthy individuals and patients with nail disorders. Searches of PubMed, MEDLINE, Web of Science, Wiley, Google Scholar, and EBSCO identified eligible human studies reporting quantitative outcomes. Three studies (one randomized controlled trial and two non-randomized studies) were included. Topical minoxidil significantly increased nail growth compared to controls. In healthy participants, 5% topical minoxidil applied twice daily increased mean nail growth from 3.91 to 4.27 mm/month after one month (p=0.003). In onychomadesis, 5% minoxidil with vitamin E achieved an 81% clinical response after 12 months. Minoxidil also outperformed oral biotin (19% vs. 13% increase in growth). No serious adverse effects were reported. Overall, topical minoxidil appears safe and potentially effective, though larger trials are needed to confirm long-term outcomes.

Background/Objectives: Red eye is a common ocular complaint, yet population data from Saudi Arabia are limited and largely confined to specific diagnostic entities. This study assessed the proportion of adults reporting red eye and described its clinical characteristics, perceived triggers, management practices, and associated factors. Methods: A cross-sectional survey was conducted between November 2025 and March 2026 among adults aged 18 years or older in Saudi Arabia, recruited by convenience sampling through social media. A structured self-administered questionnaire captured sociodemographic, systemic, ocular, and lifestyle characteristics and, among affected participants, symptom profile, triggers, and management. The outcome was ascertained with a single screening item, accompanied by a photograph to aid recognition, asking whether participants currently had, or had previously had, red eye. Multivariable logistic regression identified independently associated factors (p < 0.05). Results: Of 1670 responses, 1627 were analysed after exclusion of duplicates and implausible anthropometric entries. Current or previous red eye was reported by 474 participants (29.1%; 95% CI: 26.9–31.4). Most reported no or only slight effect on daily life (85.4%), and 76.8% of episodes resolved within 48 h. Independently associated factors were male sex (aOR = 1.76; 95% CI: 1.23–2.52; p = 0.002), cosmetic use around the eyes (aOR = 1.74; 95% CI: 1.20–2.53; p = 0.003), allergic rhinitis or sinusitis (aOR = 1.86; 95% CI: 1.38–2.52; p < 0.001), hypertension (aOR = 1.74; 95% CI: 1.04–2.91; p = 0.035), chronic anxiety disorder (aOR = 1.67; 95% CI: 1.09–2.55; p = 0.018), and higher education. Physical activity showed a graded inverse association (aOR = 0.57; 95% CI: 0.41–0.81 for the highest category). Only 27.6% consulted a physician, and 13.3% used whitening eye drops. Conclusions: Red eye was commonly recognised but usually infrequent, brief, and minimally disabling. As the outcome was a single unvalidated self-report item not bounded in time, these findings describe reported symptom burden rather than confirmed disease.