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Sulforaphane – a Potent Immunomodulator, Widely Available, Yet Underutilized

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Review Article | DOI: https://doi.org/10.31579/2768-0487/143

Sulforaphane – a Potent Immunomodulator, Widely Available, Yet Underutilized

  • Meir Djaldetti *

Laboratory for Immunology and Hematology Research, Rabin Medical Center, Hasharon Hospital, Petah-Tiqva, School of Medicine, Tel-Aviv University, Ramat Aviv, Israel.

*Corresponding Author: Meir Djaldetti. Laboratory for Immunology and Hematology Research, Rabin Medical Center, Hasharon Hospital, Petah-Tiqva, School of Medicine, Tel-Aviv University, Ramat Aviv, Israel.

Citation: Meir Djaldetti, (2024), Sulforaphane – A Potent Immunomodulator, Widely Available, Yet Underutilized, Journal of Clinical and Laboratory Research. 7(6); DOI:10.31579/2768-0487/143

Copyright: © 2024, Meir Djaldetti. 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: 26 June 2024 | Accepted: 02 July 2024 | Published: 18 July 2024

Keywords: sulforaphane; mononuclear cells; cytokines; immunomodulation; immune response

Abstract

Vegetables play a crucial role as an important source of nutrients in global culinary traditions. Their rich content of vitamins, minerals and polyphenols makes them valuable contributors to overall human health. Broccoli, a member of the Brassica oleracea family is widely recognized for its diverse culinary uses and its beneficial impact on various health conditions, such as acute and chronic inflammation, cardiovascular diseases, diabetes and cancer. Broccoli's health-promoting qualities stem from its high polyphenol content, of which sulforaphane (SFN) is the most notable. Due to its strong antioxidant properties and ability to increase the activity of peripheral blood mononuclear cells, SFN plays a significant role in immune system modulation. It plays a catalytic role in the production of inflammatory cytokines by monocytes and polarization from M1 to M2 macrophages. Acting on lymphocytes, which are integral part of the adaptive immune system, SFN triggers the production of antibodies and cytokines, while enhancing the generation of natural killer cells. Based on in vitro and animal research it appears that there is substantial number of studies to explain the ways SFN modulates the function of the immune cells. However, although the results indicate that we have an easily available therapeutic tool for a number of serious diseases, more research is needed to elucidate the effect of SFN in humans. It is the aim of the present review to summarize the knowledge about the immune properties of SFN with expectation that the content will serve as a challenge for further research.

Introduction

Broccoli is a member of the Brassica oleracea family and has a lengthy history. Archeological evidence and seeds’ examinations imply that the countries in the Mediterranean region were the first to cultivate broccoli [1]. Its widespread in agriculture is due both to its nutritional value being a rich source of vitamins C and K, as well as most of the B group and folate [2]. Broccoli exerts beneficial activities against a wide range of illnesses such as cardiovascular and gastrointestinal diseases, diabetes, autism, rheumatoid arthritis, inflammatory and neurodegenerative conditions and a many types of cancers [3- 6]. In actuality, broccoli’s therapeutic properties stem from its thiocyanates, the most potent being sulforaphane (SFN) converted from glucoraphanin by myrosinase. It is ample documentation of SFN cytoprotective, antioxidant, anti-inflammatory and carcinopreventive effects [7]. Although SFN is highly concentrated in broccoli and its sprouts, it is also found in other cruciferous vegetables such as cauliflower and cabbage. In consumers of cruciferous vegetables SFN was able to suppress the production of pro-inflammatory cytokines by modulation of the toll-like receptor 4 (TLR4) [8]. The bioavailability, pharmacokinetics, dosage and toxicity of SFN have been extensively reviewed by Yagishita et al. [9]. The authors concluded that SFN is quickly absorbed with approximately 70% to 90

Monocytes

Monocytes play a crucial role in the immune system by producing cytokines, antibodies, and carrying out phagocytosis [21]. They are key players of the immune system and are actively involved in both acute and chronic inflammation. In cases of inflammation, researchers have focused on the ability of monocytes to differentiate into macrophages and their transition from classically activated M1 macrophages to alternatively activated M2, related to their ability to produce pro- and anti-inflammatory cytokines respectively [22]. At non-toxic concentrations of 10 µM SFN impeded the transition of M2 to M1 macrophages, thus inhibiting inflammatory markers’ expression such as COX2, the inducible nitric oxide synthase (iNOS), CD14, CD197 and the regulator of innate immune response IL-12p70.  Furthermore, mitogen-activated protein kinases (MAPKs), which regulate various cell processes, including cell differentiation, were found to be implicated in the process of macrophage polarization. [23]. When human monocytes were treated with non-toxic concentrations of SFN it inhibited the release of pro-inflammatory cytokines IL-1β, IL-6, TNFα, and NF-kB as well as the signaling pathways (MAPK) [24]. It also inhibited the heme oxygenase inhibitor (HO), and the macrophage-activating lipopeptide 2 (MALP-2) which promote pro-inflammatory cytokine production and NF-kB activation, while increasing Nrf2 expression [25]. In the presence of SFN at concentrations of 10 and 50 µM human PBMC showed a reduced production 

of the pro-inflammatory cytokines IL-6 and IL-1β and an increased differentiation towards dendritic cells [26]. 

Macrophages

Circulating monocytes that enter the tissues differentiate into macrophages and play a dominant role in innate immune responses by functioning as phagocytes and producing cytokines. When LPS stimulated Raw 264.7 macrophages were incubated with SFN at concentrations ranging between 0-50 µM, three was a significant inhibition of pro-inflammatory cytokines and nitric oxide (NO) expression though modulation of the inflammatory enzyme iNOS and activation of Nrf2/HO-1 transduction pathway [27]. In a mouse model and in vitro hyperoxia induced macrophage dysfunction SFN was able inhibit the oxidative stress by inducing Nrf2 generation and reducing the high mobility group box 1 protein (HNGB1) [28]. Furthermore, exposure of human macrophages to 25µM of SFN for 24 hours downregulated the production of inflammatory cytokines [29]. Qin et al. [30] discovered that administering of 50 mg/kg SFN to mice after hemorrhagic shock resulted in reduced inflammatory cytokine secretion by their splenic macrophages, along with increased Nrf2 activation, indicating a shift from M1 to M2 macrophage polarization. Treatment with 5 or 10 µM of SFN preserved the mitochondrial activity and maintained a normal tricarboxylic acid (TCA) cycle in bone marrow-derived M1 macrophages stimulated with LPS, 25 ng/ml [31]. Macrophages play a pivotal role in chronic inflammation linked to obesity. Administering 0.5 mg/kg of SFN to obese mice for six weeks, and treating RAW 264.7 LPS-stimulated macrophages with 2.5-5 µM of the polyphenol, resulted in the inhibition of iNOS, COX-2 expression, NO, TNFα, IL-1β, and IL-6 production [32]. Mouse bone marrow-derived M1 and M2 macrophages stimulated with LPS and IL-4, and IL-12 respectively treated with 10 µM of SFN, showed a shift towards M2 macrophages with a decrease of IL-12, IL-6 and TNFα secretion, as well as a simultaneous increase of low ability IgFc receptors (CS16/32) percentage in M-1 cells. The levels of heme oxidase (HO-10) and Nrf2 were also elevated. Conversely, SFN raised the levels of a few cytolytic enzymes such as YM1, Fizz1 and Arg1 in M2 macrophages [33]. On mouse LPS-stimulated peritoneal macrophages, it has been demonstrated that the SFN enantiomer (R)-S induces an immunomodulatory impact manifested by suppression of pro-inflammatory cytokines and enzymes, along with ROS species production. On the other hand Nrf-2/HO axis was activated whereas the inflammasome signaling pathways were inhibited [34]. It's interesting to note that inflammasome gene expression was inhibited in adipose tissue macrophages (ATP) exclusively, but it was reduced when 40 µM of SFN, TNFα and IL-1β were incubated with macrophages derived from healthy individuals and palmitic acid-stimulated ATP [35]. Notably, several members of the Brassica oleracea family are SFN and polysaccharides producers that have the potential to immunomodulate macrophage function. Thus, Sim et al. [36] have found that sprout extract from purple head broccoli (Brassica oleracea L., var. italica) contains more SFN compared to other species of the same family and when applied to LPS-stimulated RAW 264.7 macrophages, it significantly decreased the production of the pro-inflammatory cytokines IL-1β, IL-6, IL-1, TNFα and INOS.

Dendritic cells

Dendritic cells, together with macrophages, are an essential part of the innate immune system [37]. Furthermore, as antigen-presenting cells being specialized in activating the elements of the adaptive system they are actively involved in inflammatory responses and cancer cell development [38]. Their origin, development and relation to T cell immune responses have been reviewed by Puhr et al. [39].  Similar to macrophages and monocytes, dendritic cells react quickly to SFN. By reducing the expression of the activating markers CD80, CD83 and CD86, that are potent regulators of the T cells immune function, SFN restrains Th2 proliferation and decreases the secretion of the pro-inflammatory cytokines IL-9 and IL-12 [40]. 

Mouse bone marrow derived dendritic cells exposed to 0.3 µM of SFN showed inhibited TLR4-induced IL-12 and IL-23 cytokine generation by regulating the activity of TLR4-induced NF-kB factor. In addition, there was a significant hindrance to the development of Th1 and Th17 cells [41]. Similarly, SFN-treated porcine monocyte-derived dendritic cells demonstrated a controlled activity of TLR4-induced NF-kB transcription factor and suppressed histone deacetylases (HDACs) 6 and 10 [42,43]. Additional mechanisms by which SFN stimulates dendritic cells to increase T-cell activation include modulation of the regulatory proteins Janus kinase/transcription activator 3 (JAK/STAT3) leading to downregulation of the anti-apoptotic receptor B1-H1 and microRNA-signaling. Furthermore, SFN improved the activity of the dendritic cells by affecting their co-stimulatory molecules CD80 and CD83 [37]. Notably, as demonstrated in mice with induced colitis, broccoli-derived nanoparticles may also have an anti-inflammatory impact by activating dendritic cell adenosine monophosphate-activated protein kinase (AMPK) [44]. Results on the function of SFN on the immune activity of dendritic cells indicate that there is a challenge to mobilize them in the prevention of inflammatory processes and the immune defense. 

The effect of SFN on lymphocytes

Being members of the antigen-presenting cells (APC), lymphocytes play a crucial role in the adaptive immune response. According to Checker et al. [45] treating mitogen stimulated T and B cells with SFN reduced their proliferation and upregulation as well as their ability to produce IL-2, IL-4, IL-6 and IFNγ cytokines. Furthermore, SFN stimulated the production of phosphoinositide kinase/protein kinase/glycogen synthase kinase 3β (PI3K/Akt/GSK-3β) expression leading to Nrf-2 activation.  Human T cells are readily affected by SFN expressed by an increase in ROS species, suppression of the transcription factor RORyt and the T helper 17 (Th17) cells that are specialized in IL-17 and IL-22 secretion [46]. Mice with induced airway inflammation showed down-regulation of Th17 capacity to secrete pro-inflammatory cytokines overturned by Nrf2 activation after treatment with SFN. In addition, the corticosteroid resistance was inverted [47]. Activation of Nrf2 was the main cause for the beneficial effect of SFN when it was used in vitro and when given intragastric to mice with trichloroethylene-mediated necrotizing enterocolitis (NEC). At a dose of 20 mg/kg., it improved the colitis and the survival rate of the animals [48]. In another study with NEC mice the reduced the proportion of the helper Th17 to regulatory T cells (Th17/Treg cells’ ratio) and the levels of TLR4 and NF-kB, TNFα and IL-6 were decreased after treatment with SFN. Additionally, by controlling the PI3K/Akt/GSK-3β signaling pathway, both in vivo and in vitro, SFN reduced apoptosis [49]. 

The Th17/Treg cells’ ratio was observed to be downregulated in mice with B hepatitis following administration of 100 µM of SFN for 4 weeks [50] and in BTBR mice with idiopathic autism-like symptoms [51]. Notably it was found that SFN lessens the toxicity caused by cadmium. Compared to 69

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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!

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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".

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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.

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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.

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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.

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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.

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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.

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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.

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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”.

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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.

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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.

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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.

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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.

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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.

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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.

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Dr Maria Dolores Gomez Barriga

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¨.

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

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Dr Marcelo Flavio Gomes Jardim Filho

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!”

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Zsuzsanna Bene