Treatment Modalities of Psoriasis: A Focus on requisite for Topical Nanocarrier

2020 ◽  
Vol 20 ◽  
Author(s):  
Arya Kadukkattil Ramanunny ◽  
Sheetu Wadhwa ◽  
Divya Thakur ◽  
Sachin Kumar Singh ◽  
Rajesh Kumar
Keyword(s):  
Targeted Delivery ◽  
Treatment Strategies ◽  
Topical Delivery ◽  
Therapeutic Outcome ◽  
Treatment Modalities ◽  
First Line ◽  
Comparative Review ◽  
Appropriate Therapy ◽  
Selection Of

Background and Objective: Psoriasis is an autoimmune skin disease involving cascading release of cytokines activated by the innate and acquired immune system. The increasing prevalence rate of psoriasis demands for more appropriate therapy. The existing chemical moiety is promising for the better therapeutic outcome but the selection of a proper channel for administration has to be reviewed. Hence there is a need to select the most appropriate dosage form and route of administration for improving the curative rate of psoriasis. Results: A total of 108 systematic reviews of research and review articles was carried to make the manuscript comprehensible. The role of inflammatory mediators in the pathogenesis of the disease is discussed for a better understanding of the selection of pharmacotherapy. The older and newer therapeutic moiety with its mode of administration for psoriasis treatment has been discussed. With a comparative review on topical and oral administration of first-line drugs such as methotrexate (MTX), cyclosporine (CsA), and betamethasone, its benefits-liabilities in the selected routes were accounted for. Emphasis has also been given towards advanced nanocarriers for dermatologic applications. Conclusion: For better therapeutic outcome, proper selection of drug moiety with its appropriate administration is the major requisite. With the advent of nanotechnology, the development of nanocarrier for dermatologic application has been successfully demonstrated in positioning the systemically administrated drug into topical targeted delivery. In a nutshell, to achieve successful treatment strategies towards psoriasis, there is a need to focus on the development of stable, non-toxic nanocarrier for topical delivery. Inclusion of the existing orally administered drug moiety into nanocarriers for topical delivery is proposed, in order to enhance therapeutics payload with reduced side effects which serves as a better treatment approach for relief of the psoriasis condition.

scholarly journals Endovascular Intervention for Acute Ischemic Stroke in Light of Recent Trials

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Kenan Alkhalili ◽  
Nohra Chalouhi ◽  
Stavropoula Tjoumakaris ◽  
David Hasan ◽  
Robert M. Starke ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Treatment Strategies ◽  
Endovascular Intervention ◽  
Treatment Modalities ◽  
Efficacy And Safety ◽  
The Past ◽  
Endovascular Approach

Three recently published trials, MR RESCUE, IMS III, and SYNTHESIS Expansion, evaluating the efficacy and safety of endovascular treatment of acute ischemic stroke have generated concerns about the future of endovascular approach. However, the tremendous evolution that imaging and endovascular treatment modalities have undergone over the past several years has raised doubts about the validity of these trials. In this paper, we review the role of endovascular treatment strategies in acute ischemic stroke and discuss the limitations and shortcomings that prevent generalization of the findings of recent trials. We also provide our experience in endovascular treatment of acute ischemic stroke.

scholarly journals Metformin strengthens uroepithelial immunity against E. coli infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rakesh Kumar Majhi ◽  
Soumitra Mohanty ◽  
Witchuda Kamolvit ◽  
John Kerr White ◽  
Andrea Scheffschick ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Treatment Strategies ◽  
First Line ◽  
Antidiabetic Drug ◽  
Oral Antidiabetic Drug ◽  
Bacterial Killing ◽  
E Coli ◽  
Oral Antidiabetic ◽  
Uroepithelial Cells

AbstractUrinary tract infection frequently caused by E. coli is one of the most common bacterial infections. Increasing antibiotic resistance jeopardizes successful treatment and alternative treatment strategies are therefore mandatory. Metformin, an oral antidiabetic drug, has been shown to activate macrophages in the protection against certain infecting microorganisms. Since epithelial cells often form the first line of defense, we here investigated the effect on uroepithelial cells during E. coli infection. Metformin upregulated the human antimicrobial peptides cathelicidin LL-37 and RNase7 via modulation of the TRPA1 channel and AMPK pathway. Interestingly, metformin stimulation enriched both LL-37 and TRPA1 in lysosomes. In addition, metformin specifically increased nitric oxide and mitochondrial, but not cytosolic ROS. Moreover, metformin also triggered mRNA expression of the proinflammatory cytokines IL1B, CXCL8 and growth factor GDF15 in human uroepithelial cells. The GDF15 peptide stimulated macrophages increased LL-37 expression, with increased bacterial killing. In conclusion, metformin stimulation strengthened the innate immunity of uroepithelial cells inducing enhanced extracellular and intracellular bacterial killing suggesting a favorable role of metformin in the host defense.

Mucosal Dendritic Cell Subsets Control HIV-1’s Viral Fitness

2020 ◽  
Vol 7 (1) ◽  
pp. 385-402
Author(s):  
Bernadien M. Nijmeijer ◽  
Catharina J.M. Langedijk ◽  
Teunis B.H. Geijtenbeek
Keyword(s):  
Dendritic Cell ◽  
Sexual Transmission ◽  
Treatment Strategies ◽  
Viral Fitness ◽  
Immunodeficiency Virus ◽  
Novel Treatment Strategies ◽  
Hiv 1 ◽  
Selection Of

Dendritic cell (DC) subsets are abundantly present in genital and intestinal mucosal tissue and are among the first innate immune cells that encounter human immunodeficiency virus type 1 (HIV-1) after sexual contact. Although DCs have specific characteristics that greatly enhance HIV-1 transmission, it is becoming evident that most DC subsets also have virus restriction mechanisms that exert selective pressure on the viruses during sexual transmission. In this review we discuss the current concepts of the immediate events following viral exposure at genital mucosal sites that lead to selection of specific HIV-1 variants called transmitted founder (TF) viruses. We highlight the importance of the TF HIV-1 phenotype and the role of different DC subsets in establishing infection. Understanding the biology of HIV-1 transmission will contribute to the design of novel treatment strategies preventing HIV-1 dissemination.

Differences in presentation and management patterns in patients with hepatocellular carcinoma (HCC): Data from HCC registry in Asia.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 229-229
Author(s):  
Pierce K. H. Chow ◽  
Lequn Li ◽  
Jiangtao Li ◽  
Fan Jia ◽  
Hee-Jee Wang ◽  
...  
Keyword(s):  
South Korea ◽  
Treatment Strategies ◽  
Cancer Staging ◽  
Treatment Modalities ◽  
First Line ◽  
Real World Data ◽  
First Line Therapy ◽  
Target Sample Size ◽  
Common Cancer ◽  
Younger Age

229 Background: HCC is the 6th most common cancer worldwide with > 70% of cases in Asia. There is limited real-world data on the diagnosis, treatment modalities, outcomes and treatment costs in HCC. Methods: The HCC Registry in Asia (AHCC08) is a multi-country longitudinal cohort study of HCC patients diagnosed between 2013 and 2019. Target sample size is 2500 from 9 geographies: China, Singapore, South Korea, Japan, Taiwan, Australia, New Zealand, Hong Kong, and Thailand. We present initial data on diagnosis, etiology, stage at presentation, and treatment modalities of HCC from China [CN] (5 centers), Singapore [SG] (3 centers), South Korea [SK] (4 centers), and Japan [JP] (2 centers). Results: 657 patients (436 CN; 102 SG; 85 SK; 34 JP) were evaluated in August 2018. Patients from China were diagnosed at a younger age, while patients from Japan were diagnosed at an older age (mean age 51 years CN; 67 years SG; 58 years SK; 68 years JP). The highest proportion of regular alcohol drinkers were from Japan (16% CN; 21% SG; 24% SK; 50% JP) and occasional drinkers from China (20% CN; 17% SG; 12% SK; 15% JP). 77% had Hepatitis B across the 5 geographies, with the highest incidence in China (93%), followed by South Korea (68%). 27% were diagnosed using AASLD/APASL imaging criteria, with the highest utilization in Singapore (66% AASLD; 80% APASL) and South Korea (64% AASLD; 20% APASL). Later-stage patients (according to Barcelona Clinic Liver Cancer staging guidelines) were more predominant in Japan (Stage C: 28% CN, 16% SG, 8% SK, 41% JP; Stage D: 0.5% CN, 0% SG, 1% SK, 3% JP). Relatively few radiofrequency ablations were carried out as the first-line therapy across the 5 geographies (2% CN; 5% SG; 2% SK; 0% JP). In China, liver resection was preferred in first-line HCC treatment (65% CN vs 28% SG, SK, and JP aggregated), followed by loco-regional (27% CN vs 7% SG, SK, and JP aggregated) and systemic therapy (2% CN vs 10% SG, SK, and JP aggregated). Conclusions: There is considerable variation in presentation and management patterns between the 5 geographies. These data will benefit policymakers, companies and clinicians in improving policies and developing treatment strategies for HCC. (ClinicalTrials.gov: NCT03233360).

First-Line and Combination Therapeutics for Major Depressive Disorder

Depression ◽  
2019 ◽  
pp. 183-196
Author(s):  
Manish K. Jha
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Symptom Severity ◽  
Severe Depression ◽  
Severity Of Illness ◽  
Treatment Modalities ◽  
First Line ◽  
Major Depressive ◽  
Ongoing Research ◽  
Selection Of

Major depressive disorder (MDD) affects one in five adults during their lifetime. Patients with MDD and their clinicians have a multitude of options to select for management of this chronic and/or recurrent condition. Selection of treatment modalities may be guided by the severity of illness. Nonpharmacologic treatments such as psychotherapy or exercise may be considered for those with mild symptom severity, with pharmacologic treatment reserved for those with moderate or higher symptom severity. Severe or very severe depression may warrant the combination of both pharmacologic and psychotherapeutic treatments. In patients who fail to improve adequately with one or more first-line treatments, augmentation with second-generation antipsychotics should be considered. There currently are no objective markers to guide the selection of one first-line treatment over other. Exciting ongoing research in the field of depression may inform new methods to personalize treatment selection and potentially lead to the development of mechanistically novel antidepressants.

scholarly journals The Role of Metabolism in Tumor Immune Evasion: Novel Approaches to Improve Immunotherapy

Biomedicines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 361
Author(s):  
Alberto Cruz-Bermúdez ◽  
Raquel Laza-Briviesca ◽  
Marta Casarrubios ◽  
Belén Sierra-Rodero ◽  
Mariano Provencio
Keyword(s):  
Tumor Cells ◽  
Immune Evasion ◽  
Building Materials ◽  
Cell Types ◽  
First Line ◽  
Tumor Immune Evasion ◽  
Novel Approaches ◽  
Metabolic Properties ◽  
Selection Of

The tumor microenvironment exhibits altered metabolic properties as a consequence of the needs of tumor cells, the natural selection of the most adapted clones, and the selfish relationship with other cell types. Beyond its role in supporting uncontrolled tumor growth, through energy and building materials obtention, metabolism is a key element controlling tumor immune evasion. Immunotherapy has revolutionized the treatment of cancer, being the first line of treatment for multiple types of malignancies. However, many patients either do not benefit from immunotherapy or eventually relapse. In this review we overview the immunoediting process with a focus on the metabolism-related elements that are responsible for increased immune evasion, either through reduced immunogenicity or increased resistance of tumor cells to the apoptotic action of immune cells. Finally, we describe the main molecules to modulate these immune evasion processes through the control of the metabolic microenvironment as well as their clinical developmental status.

scholarly journals The chemotherapeutic drug methotrexate selects for antibiotic resistance

2020 ◽  
Author(s):  
Jónína S. Gudmundsdóttir ◽  
Elizabeth G. A. Fredheim ◽  
Catharina I. M. Koumans ◽  
Joachim Hegstad ◽  
Po-Cheng Tang ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibacterial Properties ◽  
Treatment Strategies ◽  
Bacterial Populations ◽  
E Coli ◽  
Resistance Evolution ◽  
Selective Pressures ◽  
Methotrexate Chemotherapy ◽  
Selection Of

AbstractUnderstanding drivers of antibiotic resistance evolution is fundamental for designing optimal treatment strategies and interventions to reduce the spread of antibiotic resistance. Various cytotoxic drugs used in cancer chemotherapy have antibacterial properties, but how bacterial populations are affected by these selective pressures is unknown. Here we test the hypothesis that the widely used cytotoxic drug methotrexate affects the evolution and selection of antibiotic resistance through the same mechanisms as the antibiotic trimethoprim. We show that methotrexate can select for trimethoprim resistance determinants located on the chromosome or a plasmid in clinical strains of Escherichia coli. Additionally, methotrexate can co-select for virtually any antibiotic resistance determinant when present together with trimethoprim resistance on a multidrug-resistance clinical plasmid. These selective effects occur at concentrations 40- to >320-fold below the methotrexate minimal inhibitory concentration for E. coli, suggesting a selective role of methotrexate chemotherapy for antibiotic resistance in patients that strongly depend on effective antibiotic treatment.

scholarly journals The role of rational immunotherapy for renal cell carcinoma

2003 ◽  
Vol 11 (1) ◽  
pp. 17-19
Author(s):  
Svetlana Salma
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Combined Therapy ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Rational Approach ◽  
Selection Of Patients ◽  
Selection Of

Metastases to distant organs are the principal cause of death from renal cell carcinoma (RCC). No commonly accepted therapy is available for disseminated RCC at present. The rationale for immunotherapy of RCC is based on the fact that there is no other therapy for advanced cases. Biologic therapies are the only current treatment modalities that have produced promising therapeutic results in metastatic RCC (mRCC). Therapy with cytokines usually has typical and sometimes severe side effects. Response rates and toxicity were higher with combined therapy. The administration of cytokines that augment the function of the immune system can be accomplished safely and without toxicity, provided a rational approach is used. The toxic effects that are frequently observed with combined therapy emphasize the need for careful selection of patients.

scholarly journals Tortura e violenze contro gli immigrati in Marocco

2019 ◽  
Author(s):  
Rabi Ouenniche ◽  
Zineb Saaid
Keyword(s):  
International Migration ◽  
First Line ◽  
European Continent ◽  
Migration Policies ◽  
European Governance ◽  
Sub Saharan ◽  
Selection Of

In the context of the European ‘governance’ of international migration, the so-called countries of transit end up being the first line of Europe’s borders, acting as laboratories for experimenting with the radical tightening of migration policies and as centers for the selection of immigrants who may reach the European continent. Morocco, that in recent years has also become a country of immigration and transit, is a symbol of this process, in which it plays the role of patroller of the European borders. This essay examines the phenomenon of torture and violence against sub-Saharan migrants in Morocco, focusing on the events of summer of 2018, without forgetting the historical roots of racism in the country and considering the role Morocco aims at playing in the region.

PD-L1 ≥ 50% lung cancer refractory to PD-1 inhibition: the role of salvage chemo-immunotherapy combination

Immunotherapy ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 363-369
Author(s):  
Francesco Gelsomino ◽  
Francesco Facchinetti ◽  
Monia Sisi ◽  
Teresa Zielli ◽  
Marcello Tiseo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Performance Status ◽  
Treatment Strategies ◽  
Tumor Burden ◽  
First Line ◽  
Radiological Response ◽  
Novel Treatment Strategies ◽  
Line Setting ◽  
Nsclc Patients

Novel treatment strategies incorporating PD-1/PD-L1 inhibitors in the first-line setting of advanced non-small-cell lung cancer (NSCLC) provided relevant improvements in survival outcomes. Among NSCLC patients with PD-L1 tumor proportion score ≥50%, identifying the ones to be addressed to pembrolizumab monotherapy or chemo-immunotherapy combinations is a matter of debate, taking into account the risks of overtreatment and toxicity. Here we report the clinical stories of four NSCLC patients with PD-L1 tumor proportion score ≥50% and good performance status, sharing high tumor burden including serosal involvement. After having rapidly progressed on first-line PD-1/PD-L1 inhibitors, they achieved major clinical and radiological response to pembrolizumab-chemotherapy combination. These cases prove the feasibility and effectiveness of salvage chemo-immunotherapy in pembrolizumab-refractory NSCLC patients.

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