“…It should be borne in mind, however, that some of these effects may be indirect, caused by binding of the ligands elsewhere in the genome. For example, the promoter of the gene encoding the catalytic subunit of telomerase, hTERT, harbors G-quadruplexes [ 52 ], and G4-stabilizing ligands have been shown to decrease levels of hTERT expression [ 53 , 54 , 55 ], which may in turn lead to telomere deprotection [ 56 , 57 ]. G4-stabilizing ligands have also been shown to have widespread effects on gene expression, including genes involved in DNA damage pathways [ 58 , 59 ], likely due either to the enrichment of G-quadruplexes in gene regulatory regions [ 60 , 61 ], in response to the genome-wide DNA damage response triggered by G4 ligands [ 62 , 63 ], or as a result of epigenetic changes affecting gene expression [ 64 , 65 ].…”