Milena Peruhova

Dr. Milena Peruhova

Lozenetz Hospital
orcid

Research Focus & Metrics

Academic Career Length

7Years (2020-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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Journal Article
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SLStefan Lozenov
Stefan Lozenov
Boris KrastevBoris Krastev
Boris Krastev
GNGeorgi Nikolaev
Georgi Nikolaev
Monika Peshevska-SekulovskaMonika Peshevska-Sekulovska
Monika Peshevska-Sekulovska
MPMilena Peruhova
Milena Peruhova
Tsvetelina VelikovaTsvetelina Velikova
Tsvetelina Velikova
The genetic and metabolomic abundance of the microbiome exemplifies that the microbiome comprises a more extensive set of genes than the entire human genome, which justifies the numerous metabolic and immunological interactions between the gut microbiota, macroorganisms and immune processes. These interactions have local and systemic impacts that can influence the pathological process of carcinogenesis. The latter can be promoted, enhanced or inhibited by the interactions between the microbiota and the host. This review aimed to present evidence that interactions between the host and the gut microbiota might be a significant exogenic factor for cancer predisposition. It is beyond doubt that the cross-talk between microbiota and the host cells in terms of epigenetic modifications can regulate gene expression patterns and influence cell fate in both beneficial and adverse directions for the host’s health. Furthermore, bacterial metabolites could shift pro- and anti-tumor processes in one direction or another. However, the exact mechanisms behind these interactions are elusive and require large-scale omics studies to better understand and possibly discover new therapeutic approaches for cancer.

Verified
Journal Article
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Tsvetelina VelikovaTsvetelina Velikova
Tsvetelina Velikova
Boris KrastevBoris Krastev
Boris Krastev
SLStefan Lozenov
Stefan Lozenov
RGRadostina Gencheva
Radostina Gencheva
MPMonika Peshevska-Sekulovska
Monika Peshevska-Sekulovska
MPMilena Peruhova
Milena Peruhova
The interplay between drugs and microbiota is critical for successful treatment. An accumulating amount of evidence has identified the significant impact of intestinal microbiota composition on cancer treatment response, particularly immunotherapy. The possible molecular pathways of the interaction between immune checkpoint inhibitors (ICIs) and the microbiome can be used to reverse immunotherapy tolerance in cancer by using various kinds of interventions on the intestinal bacteria. This paper aimed to review the data available on how the antibiotic-related changes in human microbiota during colorectal cancer (CRC) treatment can affect and determine ICI treatment outcomes. We also covered the data that support the potential intimate mechanisms of both local and systemic immune responses induced by changes in the intestinal microbiota. However, further better-powered studies are needed to thoroughly assess the clinical significance of antibiotic-induced alteration of the gut microbiota and its impact on CRC treatment by direct observations of patients receiving antibiotic treatment.

2 August 2024 in Gastroenterology Insights
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Tsvetelina VelikovaTsvetelina Velikova
Tsvetelina Velikova
IKIssa El Kaouri
Issa El Kaouri
KBKonstantina Bakopoulou
Konstantina Bakopoulou
MGMilena Gulinac
Milena Gulinac
KNKremena Naydenova
Kremena Naydenova
Snezhina LazovaSnezhina Lazova
Snezhina Lazova
Mucosal immunity and trained innate immunity of the gut play a pivotal role in maintaining intestinal homeostasis and defending against microbial pathogens. This review provides an overview of the mechanisms underlying mucosal immunity and the concept of trained innate immunity in the gut. We discuss the interaction between gut microbiota and the host immune system, highlighting the role of epithelial cells, dendritic cells, and innate lymphoid cells, as well as the novel concept of trained innate immunity and its role in perpetuating or attenuating gut inflammation. We also comment on the current models for investigating mucosal immunity, their limitations, and how they can be overcome. Additionally, we explore the potential therapeutic implications of modulating mucosal immunity and trained innate immunity in gastrointestinal diseases. Only by elucidating the mechanisms underlying mucosal immunity and the concept of trained innate immunity, innovative approaches to modulate immune responses and restore intestinal homeostasis in the context of gastrointestinal disorders could be implemented.

4 June 2024 in Gastroenterology Insights
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Journal Article
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MPMilena Peruhova
Milena Peruhova
Dimitrina Georgieva MitevaDimitrina Georgieva Miteva
Dimitrina Georgieva Miteva
MKMaria Kokudeva
Maria Kokudeva
SBSonya Banova
Sonya Banova
Tsvetelina VelikovaTsvetelina Velikova
Tsvetelina Velikova
The process of development, recurrence, and exacerbation of the inflammatory process depends on the cytokine levels in IBD. For that reason, many cytokine therapies have been developed for treating IBD patients. Researchers employ various techniques and methodologies for cytokine profiling to identify cytokine signatures in inflamed mucosa. These include enzyme-linked immunosorbent assays (ELISA), multiplex immunoassays, flow cytometry, and gene expression analysis techniques (i.e., microarray, RNA-seq, single-cell RNA-seq (scRNA-seq), mass cytometry (CyTOF), Luminex). Research knowledge so far can give us some insights into the cytokine milieu associated with mucosal inflammation by quantifying cytokine levels in mucosal tissues or biological fluids such as serum or stool. The review is aimed at presenting state-of-the-art techniques for cytokine profiling and the various biomarkers for follow-up and treatment.

29 March 2022 in Antibodies
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MPMilena Peruhova
Milena Peruhova
AMAntoaneta Mihova
Antoaneta Mihova
IAIskra Altankova
Iskra Altankova
Tsvetelina VelikovaTsvetelina Velikova
Tsvetelina Velikova
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder whose pathogenesis is considered multifactorial, including abnormal gut motility, visceral hyperreactivity, psychological factors, disturbances in the brain-gut axis, leaky gut, oxidative stress, etc. We aimed to investigate serum levels of specific immunoglobulin E and G to common food antigens and zonulin and to assess their use in clinical practice for patients with IBS. Material and methods. We included 23 participants, 15 with IBS (diagnosed according to the Rome IV criteria) and 8 healthy controls. We investigated serum levels of specific IgG antibodies to 24 food antigens, specific IgE antibodies to 20 food antigens, anti-celiac antibodies, fecal calprotectin and serum zonulin by ELISA. Results. Food-specific positive IgG antibodies were significantly higher in patients with IBS than in controls (p = 0.007). IgE-mediated allergic reactions were found in five patients with IBS; no one had anti-TG antibodies. One-third of IBS patients demonstrated a low degree of chronic inflammation (positive fecal calprotectin test > 50 ng/mL) without specific bacterial infection. Serum levels of zonulin in IBS patients were higher than in healthy controls (0.378 ± 0.13 vs. 0.250 ± 0.14 ng/mL, p = 0.0315). However, no correlations between clinical symptoms and zonulin levels were found. Conclusion. The mechanisms of IgG hypersensitivity and low degree inflammation in IBS and elevated zonulin may contribute to multifactor pathogenesis in IBS.

7 September 2020 in World Journal of Gastroenterology
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Journal Article
Open access
MPMilena Peruhova
Milena Peruhova
Monika Peshevska-SekulovskaMonika Peshevska-Sekulovska
Monika Peshevska-Sekulovska
VGViktoriya Georgieva
Viktoriya Georgieva
Gabriela Georgieva PanayotovaGabriela Georgieva Panayotova
Gabriela Georgieva Panayotova
DDDorian Dikov
Dorian Dikov
Surveilling Russell body Helicobacter pylori-negative gastritis: A case report and review of literature