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Simple Summary: Multiple myeloma is a blood cancer that progresses through distinct stages, and identifying these stages accurately is crucial for selecting effective treatments. Additionally, understanding which individuals with an asymptomatic precursor condition, known as monoclonal gammopathy of undetermined significance, are at risk of developing full-blown multiple myeloma remains a significant challenge. This study used machine learning methods to analyze gene expression data from multiple datasets, aiming to improve the accuracy of disease staging and identify individuals at higher risk of progression. By finding key patterns and pathways involved in the disease, this research offers new tools for earlier intervention and personalized care. These findings could significantly benefit the research and medical communities by improving diagnosis, enhancing patient monitoring, and opening avenues for targeted therapies. Background: The accurate staging of multiple myeloma (MM) is essential for optimizing treatment strategies, while predicting the progression of asymptomatic patients, also referred to as monoclonal gammopathy of undetermined significance (MGUS), to symptomatic MM remains a significant challenge due to limited data. This study aimed to develop machine learning models to enhance MM staging accuracy and stratify asymptomatic patients by their risk of progression. Methods: We utilized gene expression microarray datasets to develop machine learning models, combined with various data transformations. For multiple myeloma staging, models were trained on a single dataset and validated across five independent datasets, with performance evaluated using multiclass area under the curve (AUC) metrics. To predict progression in asymptomatic patients, we employed two approaches: (1) training models on a dataset comprising asymptomatic patients who either progressed or remained stable without progressing to multiple myeloma, and (2) training models on multiple datasets combining asymptomatic and multiple myeloma samples and then testing their ability to distinguish between asymptomatic and asymptomatic that progressed. We performed feature selection and enrichment analyses to identify key signaling pathways underlying disease stages and progression. Results: Multiple myeloma staging models demonstrated high efficacy, with ElasticNet achieving consistent multiclass AUC values of 0.9 across datasets and transformations, demonstrating robust generalizability. For asymptomatic progression, both modeling approaches yielded similar results, with AUC values exceeding 0.8 across datasets and algorithms (ElasticNet, Boosting, and Support Vector Machines), underscoring their potential in identifying progression risk. Enrichment analyses revealed key pathways, including PI3K-Akt, MAPK, Wnt, and mTOR, as central to MM pathogenesis. Conclusions: To the best of our knowledge, this is the first study to utilize gene expression datasets for classifying patients across different stages of multiple myeloma and to integrate multiple myeloma with asymptomatic cases to predict disease progression, offering a novel methodology with potential clinical applications in patient monitoring and early intervention. [ABSTRACT FROM AUTHOR]

In the area of drug research, several computational drug repurposing studies have highlighted candidate repurposed drugs, as well as clinical trial studies that have tested/are testing drugs in different phases. To the best of our knowledge, the aggregation of the proposed lists of drugs by previous studies has not been extensively exploited towards generating a dynamic reference matrix with enhanced resolution. To fill this knowledge gap, we performed weight-modulated majority voting of the modes of action, initial indications and targeted pathways of the drugs in a well-known repository, namely the Drug Repurposing Hub. Our method, DReAmocracy, exploits this pile of information and creates frequency tables and, finally, a disease suitability score for each drug from the selected library. As a testbed, we applied this method to a group of neurodegenerative diseases (Alzheimer's, Parkinson's, Huntington's disease and Multiple Sclerosis). A super-reference table with drug suitability scores has been created for all four neurodegenerative diseases and can be queried for any drug candidate against them. Top-scored drugs for Alzheimer's Disease include agomelatine, mirtazapine and vortioxetine; for Parkinson's Disease, they include apomorphine, pramipexole and lisuride; for Huntington's, they include chlorpromazine, fluphenazine and perphenazine; and for Multiple Sclerosis, they include zonisamide, disopyramide and priralfimide. Overall, DReAmocracy is a methodology that focuses on leveraging the existing drug-related experimental and/or computational knowledge rather than a predictive model for drug repurposing, offering a quantified aggregation of existing drug discovery results to (1) reveal trends in selected tracks of drug discovery research with increased resolution that includes modes of action, targeted pathways and initial indications for the investigated drugs and (2) score new candidate drugs for repurposing against a selected disease. [ABSTRACT FROM AUTHOR]

Prioritization or ranking of different cell types in a Single-cell RNA Sequencing (scRNA-Seq) framework can be performed in a variety of ways, some of these include: i) obtaining an indication of the proportion of cell types between the different conditions under study, ii) counting the number of differentially expressed genes (DEGs) between cell types and conditions in the experiment or, iii) prioritizing cell types based on prior knowledge about the conditions under study (i.e., a specific disease). These methods have drawbacks and limitations thus novel methods for improving cell ranking are required. Here we present a novel methodology that exploits prior knowledge in combination with expert-user information to accentuate cell types from a scRNA-seq analysis that yield the most biologically meaningful results with respect to a disease under study. Our methodology allows for ranking and prioritization of cell-types based on how well their expression profiles relate to the molecular mechanisms and drugs associated with a disease. Molecular mechanisms, as well as drugs, are incorporated as prior knowledge in a standardized, structured manner. Cell-types are then ranked/prioritized based on how well results from data-driven analysis of scRNA-seq data match the predefined prior knowledge. In additional cell-cell communication perturbations between disease and control networks are used to further prioritize/rank cell-types. Our methodology has substantial advantages to more traditional cell ranking techniques and provides an informative complementary methodology that utilizes prior knowledge in a rapid and automated manner, that has previously not been attempted by other studies. The current methodology is also implemented as an R package entitled Single Cell Ranking Analysis Toolkit (scRANK) and is available for download and installation via GitHub (https://#hub.com/aoulas/scRANK) Author summary: Single-cell RNA Sequencing (scRNA-Seq) provides an additive resolution down to the cellular level that was previously not available from traditional "Bulk" RNA sequencing experiments. However, it is often difficult to prioritize the specific cell-types which are primarily responsible for the cause of a disease. This work presents a novel methodology that utilizes predefined prior knowledge information to highlight informative cell types from a scRNA-seq analysis. Our methodology allows for ranking and prioritization of cell-types based on how well predefined prior knowledge, in the form of pathways and drugs, are mapped to the results obtained from a basic analysis of a scRNA-Seq dataset. Prior knowledge is incorporated in a standardized, structured manner, whereby a checklist is attained by querying the human disease database called MalaCards. This checklist comes in the form of pathways and drugs associated with the disease. The expert-user is prompted to "edit" the prior knowledge checklist by removing or adding terms from the list of predefined terms. Our methodology also utilizes cell-cell communication perturbations between disease and control networks to further prioritize/rank cell-types. We believe, this methodology may offer substantial advantages to existing cell prioritizing or ranking techniques and provide a rapid and automated approach that further compliments other methods of cell prioritization in a scRNA-Seq framework. [ABSTRACT FROM AUTHOR]