Quality of Life and Risks Associated with Systemic Anti-inflammatory Therapy versus Fluocinolone Acetonide Intraocular Implant for Intermediate Uveitis, Posterior Uveitis, or Panuveitis

Abstract Purpose The knee joint is prone to osteoarthritis (OA) due to its anatomical position, and several reports have implicated the imbalance between catabolic and anabolic processes within the joint as the main culprit, thus leading to investigations towards attenuation of these inflammatory signals for OA treatment. In this review, we have explored clinical evidence supporting the use of stromal vascular fraction (SVF), known for its anti-inflammatory characteristics for the treatment of OA. Methods Searches were made on PubMed, PMC, and Google Scholar with the keywords “adipose fraction knee regeneration, and stromal vascular fraction knee regeneration, and limiting searches within 2017–2020. Results Frequently found interventions include cultured adipose-derived stem cells (ADSCs), SVF, and the micronized/microfragmented adipose tissue-stromal vascular fraction (MAT-SVF). Clinical data reported that joints treated with SVF provided a better quality of life to patients. Currently, MAT-SVF obtained and administered at the point of care is approved by the Food and Drug Administration (FDA), but more studies including manufacturing validation, safety, and proof of pharmacological activity are needed for SVF. The mechanism of action of MAT-SVF is also not fully understood. However, the current hypothesis indicates a direct adherence and integration with the degenerative host tissue, and/or trophic effects resulting from the secretome of constituent cells. Conclusion Our review of the literature on stromal vascular fraction and related therapy use has found evidence of efficacy in results. More research and clinical patient follow-up are needed to determine the proper place of these therapies in the treatment of osteoarthritis of the knee. Lay Summary Reports have implicated the increased inflammatory proteins within the joints as the main cause of osteoarthritis (OA). This has attracted interest towards addressing these inflammatory proteins as a way of treatment for OA. The concentrated cell-packed portion of the adipose product stromal vascular fraction (SVF) from liposuction or other methods possesses anti-inflammatory effects and has been acclaimed to heal OA. Thus, we searched for clinical evidence supporting their use, for OA treatment through examining the literature. Data from various hospitals support that joints treated with SVF provided a better quality of life to patients. Currently, there is at least one version of these products that are obtained and given back to patients during a single clinic visit, approved by the FDA.

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Cannabis and Canabidinoids on the Inflammatory Bowel Diseases: Going Beyond Misuse

International Journal of Molecular Sciences ◽

10.3390/ijms21082940 ◽

2020 ◽

Vol 21 (8) ◽

pp. 2940

Author(s):

Antonelly Cassio Alves de Carvalho ◽

Gabriela Achete de Souza ◽

Samylla Vaz de Marqui ◽

Élen Landgraf Guiguer ◽

Adriano Cressoni Araújo ◽

...

Keyword(s):

Quality Of Life ◽

Inflammatory Bowel Diseases ◽

Literature Search ◽

Cannabis Sativa ◽

Antioxidant Properties ◽

Number Of Patients ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Anti Inflammatory

Inflammatory bowel diseases (IBD) are characterized by a chronic and recurrent gastrointestinal condition, including mainly ulcerative colitis (UC) and Crohn’s disease (CD). Cannabis sativa (CS) is widely used for medicinal, recreational, and religious purposes. The most studied compound of CS is tetrahydrocannabinol (THC) and cannabidiol (CBD). Besides many relevant therapeutic roles such as anti-inflammatory and antioxidant properties, there is still much controversy about the consumption of this plant since the misuse can lead to serious health problems. Because of these reasons, the aim of this review is to investigate the effects of CS on the treatment of UC and CD. The literature search was performed in PubMed/Medline, PMC, EMBASE, and Cochrane databases. The use of CS leads to the improvement of UC and CD scores and quality of life. The medical use of CS is on the rise. Although the literature shows relevant antioxidant and anti-inflammatory effects that could improve UC and CD scores, it is still not possible to establish a treatment criterion since the studies have no standardization regarding the variety and part of the plant that is used, route of administration and doses. Therefore, we suggest caution in the use of CS in the therapeutic approach of IBD until clinical trials with standardization and a relevant number of patients are performed.

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Neuropathic pain symptoms in inflammatory hand osteoarthritis (OA) lower quality of life and may require another approach than anti-inflammatory treatment

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.02.319 ◽

2021 ◽

Vol 29 ◽

pp. S237-S238

Author(s):

C. van der Meulen ◽

L.A. van de Stadt ◽

F.P. Kroon ◽

M.C. Kortekaas ◽

A. Boonen ◽

...

Keyword(s):

Quality Of Life ◽

Neuropathic Pain ◽

Hand Osteoarthritis ◽

Anti Inflammatory ◽

Pain Symptoms

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Systemic Anti-Inflammatory Therapy Versus Fluocinolone Acetonide

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0043 ◽

2020 ◽

pp. 263-268

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

Comparative Effectiveness ◽

Cost Effective ◽

Initial Therapy ◽

Posterior Uveitis ◽

Fluocinolone Acetonide ◽

Intermediate Uveitis ◽

Systemic Corticosteroids ◽

Active Intermediate ◽

Implant Therapy

The Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study was a randomized, partially-masked, parallel treatment, comparative effectiveness trial comparing surgically placed fluocinolone acetonide intravitreous implant to systemic corticosteroids for the treatment of intermediate uveitis, posterior uveitis, and panuveitis. Systemic and implant therapies yielded similar visual outcomes through 54 months of treatment. Given the greater cost of implant therapy for bilateral disease, and the higher risk of ocular complications in the implant arm of the trial, systemic therapy may be the preferred initial therapy for most bilateral cases of active or recently active intermediate uveitis, posterior uveitis, and panuveitis. For unilateral cases, implant therapy seemed to be reasonably cost effective.

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Astragalus polysaccharide (PG2) Ameliorates Cancer Symptom Clusters, as well as Improves Quality of Life in Patients with Metastatic Disease, through Modulation of the Inflammatory Cascade

Cancers ◽

10.3390/cancers11081054 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1054 ◽

Cited By ~ 5

Author(s):

Wen-Chien Huang ◽

Kuang-Tai Kuo ◽

Oluwaseun Adebayo Bamodu ◽

Yen-Kuang Lin ◽

Chun-Hua Wang ◽

...

Keyword(s):

Quality Of Life ◽

Growth Factor ◽

Adverse Effects ◽

Metastatic Disease ◽

Controlled Trial ◽

High Dose ◽

Advanced Stage ◽

Gm Csf ◽

Anti Inflammatory

Background: Improving patients’ quality of life (QoL) is a principal objective of all treatment in any clinical setting, including oncology practices. Cancer-associated inflammation is implicated in disease progression and worsening of patients’ QoL. Conventional anticancer therapeutics while selectively eliminating cancerous cells, are evaded by stem cell-like cells, and associated with varying degrees of adverse effects, thus reducing patients’ QoL. This necessitates novel therapeutic approaches with enhanced efficacy, minimal or no treatment-related adverse effects, and improved QoL in patients with cancer, especially those with metastatic/advance stage disease. Methods: Sequel to our team’s previous publication, the present study explores probable effects of Astragalus polysaccharides (PG2) on cancer-related inflammatory landscape and known determinants of QoL, as well as the probable link between the two to provide mechanistic insight. In an exploratory double blind randomized controlled trial using patients with metastatic disease (n = 23), we comparatively evaluated the therapeutic efficacy of high (500 mg) or low (250 mg) dose PG2 administered intravenously (i.v.), with particular focus on its suggested anti-inflammatory function and the probable effect of same on QoL indices at baseline, then at weeks 4 and 8 post-PG2 treatment. Results: All 23 patients with metastatic disease treated with either low or high PG2 experienced reduced pain, nausea, vomiting, and fatigue, as well as better appetite and sleep, culminating in improved global QoL. This was most apparent in the high dose group, with significant co-suppression of pro-inflammatory interleukin (IL)-1β, IL-4, IL-6, IL-13, IL-17, monocytes chemotactic protein (MCP)1, granulocyte-macrophage colony-stimulating factor (GM-CSF), vascular endothelial growth factor (VEGF), tumor growth factor (TGF)-β1, interferon (IFN)-γ, and immune suppressors IL-10 and IL-12. Univariate and multivariate analyses revealed that IL-1β, IL-13 and GM-CSF are independent prognosticators of improved QoL. Conclusion: This proof-of-concept study provides premier evidence of functional association between PG2 anti-inflammatory effects and improved QoL in patients with advanced stage cancers, laying the groundwork for future larger cohort blinded controlled trials to establish the efficacy of PG2 as adjuvant anticancer therapy in metastatic or advanced stage clinical settings.

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P028 The anti-inflammatory effects of a poly-probiotic on the oral mucosa

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.157 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S145-S146

Author(s):

E Marlina ◽

B Hirani ◽

V Mercadante ◽

M Shephard ◽

S Kishida ◽

...

Keyword(s):

Quality Of Life ◽

Wound Healing ◽

Oral Mucosa ◽

Inflammatory Cytokine ◽

Cytokine Production ◽

Healthy Controls ◽

E Coli ◽

Live Bacteria ◽

Anti Inflammatory

Abstract Background Probiotics have previously showed evidence of being efficacious in inducing and maintaining remission in post-operative recurrent pouchitis. The potential mechanism of action of probiotics has been attributed to their ability to reduce pro-inflammatory cytokine production, both within the mucosal tissue and systemically. We present our study which characterises the anti-inflammatory effects of probiotics on the oral epithelium and in the treatment of oral lichen planus (OLP), a chronic inflammatory disease of the oral mucosa. Methods VSL#3 (VSL#3-ACTIVE batch 703093 Exp date 04/2019) is a highly concentrated (450 billion live bacteria per sachet) poly-probiotic food supplement that contains eight different strains of live bacteria. The mouth ordinary epithelium cell line (MOE-1a) was stimulated with VSL#3 plus or minus the pro-inflammatory bacteria E. coli. The resultant effects on cytokine production and wound healing were measured using ELISA and live cell imaging. Wound closure was calculated using ImageJ software. OLP patients (n = 80) and healthy controls (n = 44) were recruited from UCLH Eastman Dental Hospital (Ethics 17/LO/0475) and saliva and blood samples tested for CXCL10 levels using an ELISA. OLP patients with active disease (n = 30) were recruited into a double-blind placebo-controlled proof-of-concept trial investigating the potential benefit of VSL#3 in the treatment of clinical symptoms (NCT03052179). Patients consumed two sachets twice daily for 30 days with a 30-day follow-up. Clinical questionnaires, saliva and peripheral blood were collected on days 0, 30 and 60. A daily quality of life and compliance diary was used by all participants. Results The addition of VSL#3 to MOE1a cells stimulated with E. coli resulted in a significant reduction in pro-inflammatory cytokine secretion and an acceleration in wound healing. OLP patients were found to have an elevation in the pro-inflammatory chemokine CXCL10 both locally (saliva) and systemically (serum) compared with healthy controls. Finally, the clinical trial demonstrated that VSL#3 was tolerated and safe for patients with OLP. Although there is no statistical evidence, descriptive results suggest that VSL#3 can confer some beneficial effects on patients with active OLP. We noted a reduction in the number of sites of disease activity and an improvement in quality of life in the VSL#3 group compared with placebo. Corticosteroid usage was also reduced in the VSL#3 group. Conclusion VSL#3 has the ability to improve oral epithelial wound healing and reduce pro-inflammatory cytokines secretion in vitro. In OLP, the consumption of VSL#3 seems to provide some clinical benefits, but due to the study size a more substantial multi-centre trial is necessary to confirm these observations.

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