scholarly journals Post-Operative Adhesions: A Comprehensive Review of Mechanisms

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 867
Author(s):  
Ali Fatehi Hassanabad ◽  
Anna N. Zarzycki ◽  
Kristina Jeon ◽  
Justin F. Deniset ◽  
Paul W. M. Fedak
Keyword(s):  
Clinical Trials ◽  
Healthcare Costs ◽  
Adhesion Formation ◽  
Therapeutic Options ◽  
Preclinical Research ◽  
Safety And Efficacy ◽  
Comprehensive Review ◽  
Surgical Adhesions ◽  
Consistent Basis ◽  
Almost All

Post-surgical adhesions are common in almost all surgical areas and are associated with significant rates of morbidity, mortality, and increased healthcare costs, especially when a patient requires repeat operative interventions. Many groups have studied the mechanisms driving post-surgical adhesion formation. Despite continued advancements, we are yet to identify a prevailing mechanism. It is highly likely that post-operative adhesions have a multifactorial etiology. This complex pathophysiology, coupled with our incomplete understanding of the underlying pathways, has resulted in therapeutic options that have failed to demonstrate safety and efficacy on a consistent basis. The translation of findings from basic and preclinical research into robust clinical trials has also remained elusive. Herein, we present and contextualize the latest findings surrounding mechanisms that have been implicated in post-surgical adhesion formation.

scholarly journals Current and Future Therapies for Multiple Sclerosis

Scientifica ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Alireza Minagar
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Glatiramer Acetate ◽  
Side Effect ◽  
Dimethyl Fumarate ◽  
Mechanisms Of Action ◽  
Natural Course ◽  
Safety And Efficacy ◽  
Comprehensive Review ◽  
Incurable Disease

With the introduction of interferon-β1b in 1993 as the first FDA-approved treatment for multiple sclerosis, the era of treatment of this incurable disease began, and its natural course was permanently changed. Currently, seven different treatments for patients with multiple sclerosis with different mechanisms of action and dissimilar side effect profiles exist. These medications include interferon-β1a intramuscular (Avonex), interferon-β1a subcutaneous (Rebif), interferon-β1b subcutaneous (Betaseron/Extavia), glatiramer acetate (Copaxone), natalizumab (Tysabri), fingolimod (Gilenya), teriflunomide (Aubagio), and mitoxantrone (Novantrone). In addition, a large number of clinical trials are being conducted to assess the safety and efficacy of various experimental agents in patients with multiple sclerosis, including alemtuzumab, dimethyl fumarate, laquinimod, rituximab, daclizumab, and cladribine. In this paper, the author presents a concise and comprehensive review of present and potential treatments for this incurable disease.

scholarly journals Nutraceutical Combinations in Hypercholesterolemia: Evidence from Randomized, Placebo-Controlled Clinical Trials

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3128
Author(s):  
Olga Protic ◽  
Anna Rita Bonfigli ◽  
Roberto Antonicelli
Keyword(s):  
Clinical Trials ◽  
Synergistic Effects ◽  
Lipid Lowering ◽  
Red Yeast Rice ◽  
Controlled Clinical Trials ◽  
Safety And Efficacy ◽  
Single Compound ◽  
Single Effect ◽  
Almost All ◽  
Hypercholesterolemic Subjects

There is an increasing number of nutraceutical combinations (NCs) on the market for hypercholesterolemia, although clinical trials to verify their safety and efficacy are scarce. We selected fourteen randomized, placebo-controlled clinical trials (RCTs) on different lipid-lowering NCs in hypercholesterolemic subjects. We described each compound′s mechanism of action and efficacy in the mixtures and summarized the clinical trials settings and NCs safety and efficacy results. Almost all NCs resulted efficient against hypercholesterolemia; only one reported no changes. Interestingly, red yeast rice (RYR) was present in eleven mixtures. It is not clear whether the lipid-lowering efficacy of these combinations derives mainly from the RYR component monacolin K “natural statin” single effect. Up to now, few RCTs have verified the efficacy of every single compound vs. NCs to evaluate possible additive or synergistic effects, probably due to the complexity and the high resources request. In conclusion, to manage the arising nutraceutical tide against hypercholesterolemia, it could be helpful to increase the number and robustness of clinical studies to verify the efficacy and safety of the new NCs.

scholarly journals A comprehensive review of COVID-19 treatment

2021 ◽  
Vol 38 (2) ◽  
pp. 105-115
Author(s):  
Zeinab Afshar ◽  
Arefeh Babazadeh ◽  
Mostafa Javanian ◽  
Mohammad Barary ◽  
Vasigala Rekha ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Severe Acute Respiratory Syndrome ◽  
Global Health ◽  
Clinical Efficacy ◽  
Virus Strain ◽  
Therapeutic Options ◽  
Plasma Transfusion ◽  
Comprehensive Review ◽  
Health Threat ◽  
Novel Coronavirus

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus strain that caused coronavirus disease 2019 (COVID-19). This novel coronavirus is an emerging global health threat. It caused approximately 140 million confirmed cases, with about 3 million deaths worldwide until April 18, 2021. Although there are two approved medications for this disease, remdesivir and dexamethasone, numerous studies are underway to investigate more therapeutic options. However, so far, most treatments have been supportive, and the clinical efficacy of the suggested drugs is still under consideration. The purpose of this review is to summarize the ongoing treatments, such as several antivirals, convalescent plasma transfusion, and adjunctive medications, with the intent of serving as a clinical guide for the physician and a resource for further evaluations in various clinical trials.

scholarly journals Drug Repurposing Opportunities in Pancreatic Ductal Adenocarcinoma

2021 ◽  
Vol 14 (3) ◽  
pp. 280
Author(s):  
Rita Rebelo ◽  
Bárbara Polónia ◽  
Lúcio Lara Santos ◽  
M. Helena Vasconcelos ◽  
Cristina P. R. Xavier
Keyword(s):  
Clinical Trials ◽  
Drug Development ◽  
Pancreatic Ductal Adenocarcinoma ◽  
De Novo ◽  
Drug Repurposing ◽  
Metastatic Tumor ◽  
Therapeutic Options ◽  
Ductal Adenocarcinoma ◽  
Clinical Indication ◽  
Novel Treatments

Pancreatic ductal adenocarcinoma (PDAC) is considered one of the deadliest tumors worldwide. The diagnosis is often possible only in the latter stages of the disease, with patients already presenting an advanced or metastatic tumor. It is also one of the cancers with poorest prognosis, presenting a five-year survival rate of around 5%. Treatment of PDAC is still a major challenge, with cytotoxic chemotherapy remaining the basis of systemic therapy. However, no major advances have been made recently, and therapeutic options are limited and highly toxic. Thus, novel therapeutic options are urgently needed. Drug repurposing is a strategy for the development of novel treatments using approved or investigational drugs outside the scope of the original clinical indication. Since repurposed drugs have already completed several stages of the drug development process, a broad range of data is already available. Thus, when compared with de novo drug development, drug repurposing is time-efficient, inexpensive and has less risk of failure in future clinical trials. Several repurposing candidates have been investigated in the past years for the treatment of PDAC, as single agents or in combination with conventional chemotherapy. This review gives an overview of the main drugs that have been investigated as repurposing candidates, for the potential treatment of PDAC, in preclinical studies and clinical trials.

scholarly journals Preclinical evaluation of eltrombopag in a PDX model of myelodysplastic syndromes

Leukemia ◽  
2021 ◽  
Author(s):  
Nanni Schmitt ◽  
Johann-Christoph Jann ◽  
Eva Altrock ◽  
Johanna Flach ◽  
Justine Danner ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Myelodysplastic Syndromes ◽  
Preclinical Study ◽  
Preclinical Research ◽  
Individual Level ◽  
Specific Effects ◽  
Pdx Model ◽  
Whole Exome ◽  
Thrombopoietin Receptor ◽  
Therapeutic Concepts

AbstractPreclinical research of myelodysplastic syndromes (MDSs) is hampered by a lack of feasible disease models. Previously, we have established a robust patient-derived xenograft (PDX) model for MDS. Here we demonstrate for the first time that this model is applicable as a preclinical platform to address pending clinical questions by interrogating the efficacy and safety of the thrombopoietin receptor agonist eltrombopag. Our preclinical study included n = 49 xenografts generated from n = 9 MDS patient samples. Substance efficacy was evidenced by FACS-based human platelet quantification and clonal bone marrow evolution was reconstructed by serial whole-exome sequencing of the PDX samples. In contrast to clinical trials in humans, this experimental setup allowed vehicle- and replicate-controlled analyses on a patient–individual level deciphering substance-specific effects from natural disease progression. We found that eltrombopag effectively stimulated thrombopoiesis in MDS PDX without adversely affecting the patients’ clonal composition. In conclusion, our MDS PDX model is a useful tool for testing new therapeutic concepts in MDS preceding clinical trials.

scholarly journals Citicoline in Ophthalmological Neurodegenerative Disease: A Comprehensive Review

2021 ◽  
Vol 14 (3) ◽  
pp. 281
Author(s):  
Francesco Oddone ◽  
Luca Rossetti ◽  
Mariacristina Parravano ◽  
Diego Sbardella ◽  
Massimo Coletta ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Diabetic Retinopathy ◽  
Neurodegenerative Diseases ◽  
Brain Ischemia ◽  
Metabolic Pathways ◽  
Randomized Clinical Trials ◽  
Mitochondrial Dynamics ◽  
Ischemic Optic Neuropathy ◽  
Comprehensive Review ◽  
Dopaminergic Transmission

Cytidine 5’-diphosphocholine has been widely studied in systemic neurodegenerative diseases, like Alzheimer’s disease, Parkinson’s disease, and brain ischemia. The rationale for the use of citicoline in ophthalmological neurodegenerative diseases, including glaucoma, anterior ischemic optic neuropathy, and diabetic retinopathy, is founded on its multifactorial mechanism of action and the involvement in several metabolic pathways, including phospholipid homeostasis, mitochondrial dynamics, as well as cholinergic and dopaminergic transmission, all being involved in the complexity of the visual transmission. This narrative review is aimed at reporting both pre-clinical data regarding the involvement of citicoline in such metabolic pathways (including new insights about its role in the intracellular proteostasis through an interaction with the proteasome) and its effects on clinical psychophysical, electrophysiological, and morphological outcomes following its use in ophthalmological neurodegenerative diseases (including the results of the most recent prospective randomized clinical trials).

scholarly journals Antiviral, Antibacterial, Antifungal, and Antiparasitic Properties of Propolis: A Review

Foods ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 1360
Author(s):  
Felix Zulhendri ◽  
Kavita Chandrasekaran ◽  
Magdalena Kowacz ◽  
Munir Ravalia ◽  
Krishna Kripal ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Antioxidant Status ◽  
Energy Production ◽  
Mechanisms Of Action ◽  
Host Cells ◽  
Physical Barrier ◽  
Inflammatory Signaling ◽  
Replication Process ◽  
Comprehensive Review ◽  
Cellular Organelles

Propolis is a complex phytocompound made from resinous and balsamic material harvested by bees from flowers, branches, pollen, and tree exudates.Humans have used propolis therapeutically for centuries. The aim of this article is to provide comprehensive review of the antiviral, antibacterial, antifungal, and antiparasitic properties of propolis. The mechanisms of action of propolis are discussed. There are two distinct impacts with regards to antimicrobial and anti-parasitic properties of propolis, on the pathogens and on the host. With regards to the pathogens, propolis acts by disrupting the ability of the pathogens to invade the host cells by forming a physical barrier and inhibiting enzymes and proteins needed for invasion into the host cells. Propolis also inhibits the replication process of the pathogens. Moreover, propolis inhibits the metabolic processes of the pathogens by disrupting cellular organelles and components responsible for energy production. With regard to the host, propolis functions as an immunomodulator. It upregulates the innate immunity and modulates the inflammatory signaling pathways. Propolis also helps maintain the host’s cellular antioxidant status. More importantly, a small number of human clinical trials have demonstrated the efficacy and the safety of propolis as an adjuvant therapy for pathogenic infections.

scholarly journals Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies

Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1027
Author(s):  
Ali Fatehi Hassanabad ◽  
Anna N. Zarzycki ◽  
Kristina Jeon ◽  
Jameson A. Dundas ◽  
Vishnu Vasanthan ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Financial Burden ◽  
Adhesion Formation ◽  
Length Of Hospital Stay ◽  
Engineering Research ◽  
Surgical Adhesions ◽  
Preventative Strategy ◽  
Underlying Mechanisms ◽  
And Personalized Medicine ◽  
Tissue Engineering Research

Post-operative adhesions affect patients undergoing all types of surgeries. They are associated with serious complications, including higher risk of morbidity and mortality. Given increased hospitalization, longer operative times, and longer length of hospital stay, post-surgical adhesions also pose a great financial burden. Although our knowledge of some of the underlying mechanisms driving adhesion formation has significantly improved over the past two decades, literature has yet to fully explain the pathogenesis and etiology of post-surgical adhesions. As a result, finding an ideal preventative strategy and leveraging appropriate tissue engineering strategies has proven to be difficult. Different products have been developed and enjoyed various levels of success along the translational tissue engineering research spectrum, but their clinical translation has been limited. Herein, we comprehensively review the agents and products that have been developed to mitigate post-operative adhesion formation. We also assess emerging strategies that aid in facilitating precision and personalized medicine to improve outcomes for patients and our healthcare system.

scholarly journals “Nanomaterials of curcumin-hyaluronic acid”: their various methods of formulations, clinical and therapeutic applications, present gap, and future directions

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tanzeel Rehman Charan ◽  
Muhammad Aqeel Bhutto ◽  
Mihr Ali Bhutto ◽  
Azhar Ali Tunio ◽  
Ghulam Murtaza Khuhro ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hyaluronic Acid ◽  
Future Research ◽  
Main Body ◽  
Future Directions ◽  
Research Directions ◽  
Safety And Efficacy ◽  
Therapeutic Applications ◽  
Future Research Directions ◽  
Neural Disorders

Abstract Background Nanomaterials of curcumin with hyaluronic acid have gained a lot of attention for potential therapeutic applications of curcumin and hyaluronic acid with or without other additional drugs. Overall studies of curcumin and hyaluronic acid show that nanomaterials of curcumin with hyaluronic acid accelerate the efficacy of curcumin in the treatment of various disorders like arthritis, cancer, hepatic fibrosis, neural disorders, wound healing, and skin regeneration, it is largely due to the combined effect of hyaluronic acid and curcumin. However, due to limited clinical trials and experiments on humans and animals, there is a substantial gap in research for the safety and efficacy of nanomaterials of curcumin-hyaluronic acid in the treatment of curcumin and hyaluronic acid targeted diseases and disorders. Main body of the abstract In this current review, we have first described various reported synthetic nanomaterials of curcumin-hyaluronic acid, then in the next section, we have described various fields, disorders, and diseases where these are being applied and in the final section of this review, we discussed the research gap, and future research directions needed to propose the fabricated nanocurcumin-hyaluronic acid biomaterials. Short conclusion There are substantial gaps in research for the safety and efficacy of nanomaterials of curcumin with hyaluronic acid due to limited available data of clinical trials and experiments of nanocurcumin-hyaluronic acid biomaterials on humans and animals. So, it entirely requires serious and committed efforts through the well-organized system of practical and clinical trials which provide results, data, and detections that lead to the formulation of the best drug from curcumin with hyaluronic acid for the treatment of curcumin and hyaluronic acid targeted diseases and disorders.

Preclinical investigations revealed possibilities for Salmonella tumor treatment. Bacteria can also be coupled to nanomaterials enabling drug-loading, photocatalytic and/or magnetic properties, using the bacteria's net negative charge

2021 ◽  
Author(s):  
Moataz Dowaidar
Keyword(s):  
Clinical Trials ◽  
Cancer Therapy ◽  
Cancer Treatment ◽  
Negative Charge ◽  
Human Cancer ◽  
Drug Loading ◽  
Tumor Therapy ◽  
Preclinical Research ◽  
Immunodeficient Mice ◽  
Virulence Attenuation

Except in human clinical trials, preclinical tests showed the potential of Salmonella bacteria for tumor therapy. There are still various challenges to tackle before salmonella bacteria may be employed to treat human cancer. Due to its pathogenic nature, attenuation is essential to minimize the host's harmful effects of bacterial infection. Loss of anticancer efficacy from bacterial virulence attenuation can be compensated by giving therapeutic payloads to microorganisms. Bacteria can also be linked to micro-or nanomaterials with diverse properties, such as drug-loaded, photocatalytic and/or magnetic-sensing nanoparticles, using the net negative charge of the bacteria. Combining bacteria-mediated cancer treatment with other medicines that have been clinically shown to be helpful but have limits may provide surprising therapeutic results. Recently, this strategy has received attention and is underway. The use of live germs for cancer treatment has not yet been approved for human clinical trials. The non-invasive oral form of administration benefits from safety, making it more suitable for clinical cancer patients.Infection of live germs through systemic means, on the other hand, involves toxicity risk. Although Salmonella bacteria can be genetically manipulated with high tumor targeting, harm to normal tissues can not be excluded when medications with nonspecific toxicity are administered. It is preferred if the action of selected drugs may be restricted to the tumor site rather than healthy tissues, thereby boosting cancer therapy safety. In recent years, many regulatory mechanisms have been developed to manage pharmaceutical distribution through live bacterial vectors. Engineered salmonella can accumulate 1000 times greater than normal tissue density in the tumor. The QS-regulated mechanism, which initiates gene expression when bacterial density exceeds a particular threshold level, also promises Salmonella bacteria for targeted medication delivery. Nanovesicle structures of Salmonella bacteria can also be used as biocompatible nanocarriers to deliver functional medicinal chemicals in cancer therapy. Surface-modified nanovesicles preferably attach to tumor cells and are swallowed by receptor-mediated endocytosis before being destroyed to release packed drugs. The xenograft methodology, which comprises the implantation of cultivated tumor cell lines into immunodeficient mice, has often been used in preclinical research revealing favorable results about the anticancer effects of genetically engineered salmonella.

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