Page 113 - ITPS-8-3

INNOSC Theranostics

and Pharmacological Sciences

SHORT COMMUNICATION
In silico analysis for drug repurposing in

cholesteatoma: A novel approach to address an
unmet medical need

1
Ioannis M. Vlastos * , Mohannad Almomani 1 , John Hajiioannou 2 ,
1
Nikolaos Drimalas , and Kalliopi Gkouskou 3
1 Department of Otolaryngology-Head and Neck Surgery, Evangelismos Hospital, Athens, Greece
2 Department of Otolaryngology-Head and Neck Surgery, Medical School and University Hospital of
Thessalia, Larissa, Greece
3 Biology and Genetics Lab, School of Medicine, National and Kapodistrian University of Athens,
Athens, Greece

Abstract

Cholesteatoma presents a significant clinical challenge with limited pharmaceutical
treatment options. This paper aims to explore the potential of drug repurposing
for managing cholesteatoma through advanced bioinformatics analysis of high-
throughput genetic data. For this purpose, we conducted a systematic search of
published high-throughput genetic studies related to cholesteatoma and used
functional and literature enrichment analysis of multiple sets, a validated web-based
*Corresponding author: bioinformatics platform, for analysis. We employed common pathway enrichment
Ioannis M. Vlastos
(ivlastos@evaggelismos-hosp.gr) analysis and cross-referenced data from DrugBank and gene list automatically derived
for you drug annotations to identify potential medical treatments. Our analysis
Citation: Vlastos IM, Almomani M,
Hajiioannou J, Drimalas N, covered eight high-throughput genetic studies, with extended gene lists available
Gkouskou K. In silico analysis for for five of them. Enrichment analysis identified common pathways, including matrix
drug repurposing in cholesteatoma: metalloproteinases, interleukins, apoptosis, and the phosphoinositide 3-kinase-AKT
A novel approach to address an
unmet medical need. INNOSC pathway, shedding light on both expected and less-studied aspects of cholesteatoma
Theranostics and Pharmacological pathogenesis. In addition, the analysis proposed several medications, including anti-
Sciences. 2025;8(3):107-112. tumor necrosis factor-α (TNF-α), zinc, and marimastat, as potential treatments. In
doi: 10.36922/itps.2571
conclusion, drug repurposing is a potential cost-effective approach to address the
Received: December 29, 2023 unmet medical need for cholesteatoma management. The identified medications,
Revised: February 17, 2024 especially anti-TNFα and zinc, offer promising options. Given the limited research
funding in this field, this bioinformatic approach holds great promise, highlighting
Accepted: March 20, 2024
specific molecular pathways that hold the greatest potential to be implicated in the
Published online: April 11, 2025 pathogenesis of cholesteatoma and offering a faster route for future trials to reduce
Copyright: © 2025 Author(s). cholesteatoma recurrence.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution Keywords: Cholesteatoma; Enrichment pathways; Drug repurposing; Bioinformatics
License, permitting distribution, platform
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional Cholesteatoma, a keratinizing epithelial lesion within the middle ear, poses a significant
affiliations. clinical challenge due to the lack of pharmaceutical treatments. At present, surgical

Volume 8 Issue 3 (2025) 107 doi: 10.36922/itps.2571