scholarly journals A Narrative Review of Cancer-Related Fatigue (CRF) and Its Possible Pathogenesis

Cells ◽  
2019 ◽  
Vol 8 (7) ◽  
pp. 738 ◽  
Author(s):  
Songwei Yang ◽  
Shifeng Chu ◽  
Yan Gao ◽  
Qidi Ai ◽  
Yingjiao Liu ◽  
...  
Keyword(s):  
Animal Models ◽  
Cancer Patients ◽  
Molecular Mechanisms ◽  
Histopathological Examination ◽  
Treatment Options ◽  
Narrative Review ◽  
Future Research ◽  
Cancer Related Fatigue ◽  
Blood Biochemical ◽  
Long Time

Many cancer patients suffer from severe fatigue when treated with chemotherapy or radiotherapy; however, the etiology and pathogenesis of this kind of fatigue remains unknown. Fatigue is associated with cancer itself, as well as adjuvant therapies and can persist for a long time. Cancer patients present a high degree of fatigue, which dramatically affects the quality of their everyday life. There are various clinical research studies and reviews that aimed to explore the mechanisms of cancer-related fatigue (CRF). However, there are certain limitations in these studies: For example, some studies have only blood biochemical texts without histopathological examination, and there has been insufficient systemic evaluation of the dynamic changes in relevant indexes. Thus, we present this narrative review to summarize previous studies on CRF and explore promising research directions. Plenty of evidence suggests a possible association between CRF and physiological dysfunction, including skeletal muscular and mitochondrial dysfunction, peripheral immune activation and inflammation dysfunction, as well as central nervous system (CNS) disorder. Mitochondrial DNA (mtDNA), mitochondrial structure, oxidative pressure, and some active factors such as ATP play significant roles that lead to the induction of CRF. Meanwhile, several pro-inflammatory and anti-inflammatory cytokines in the peripheral system, even in the CNS, significantly contribute to the occurrence of CRF. Moreover, CNS function disorders, such as neuropeptide, neurotransmitter, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, tend to amplify the sense of fatigue in cancer patients through various signaling pathways. There have been few accurate animal models established to further explore the molecular mechanisms of CRF due to different types of cancer, adjuvant therapy schedules, living environments, and physical status. It is imperative to develop appropriate animal models that can mimic human CRF and to explore additional mechanisms using histopathological and biochemical methods. Therefore, the main purpose of this review is to analyze the possible pathogenesis of CRF and recommend future research that will clarify CRF pathogenesis and facilitate the formulation of new treatment options.

ANTI-EPILEPTIC DRUGS AND BRAIN AND BEHAVIOURAL DEVELOPMENT IN ANIMAL MODELS AND HUMANS

2010 ◽  
Vol 21 (4) ◽  
pp. 283-306
Author(s):  
NAGHME ADAB ◽  
MICHAEL F O'DONOGHUE
Keyword(s):  
Animal Models ◽  
Animal Studies ◽  
Molecular Mechanisms ◽  
Developmental Problems ◽  
Gestational Exposure ◽  
Behavioural Effects ◽  
Confounding Variables ◽  
Long Time ◽  
Behavioural Repertoire ◽  
Rule Out

Women with epilepsy constitute about 0.6% of pregnancies. The potential for major structural malformations following gestational exposure to anti-epileptic drugs (AEDs) is well known and causes concern as how best to manage epilepsy during pregnancy. In this review we focus on the structural and functional effects on the developing brain to complement other recent reviews. We do not cover neural tube defects which have been reviewed elsewhere. Suffice to say that carbamazepine, lamotrigine and, in particular, valproate exposure are associated with them. We discuss studies based on animal models as well as those that have followed-up children exposed to AEDs in-utero. Careful longitudinal human research can document the cognitive and behavioural effects, but the long time scales required and inability to rule out confounding variables, both genetic and environmental, are serious limitations. Animal studies are based on the assumption that many developmental processes are conserved between the animals used in the models (most often rodents) and humans. However, the hugely expanded cortex and cognitive and behavioural repertoire of humans implies that there are aspects that can not be well modelled. In addition, due to differences in how susceptible different species are to various teratogens, studies always need to be done in man as well. Nevertheless, an understanding of the molecular mechanisms of neuro-teratogenesis derived from animal models will help us predict which anti-epileptic drugs are likely to cause fewer neuro-developmental problems in humans.

e-Health Interventions for Physical Symptom Control

2021 ◽  
pp. 550-560
Author(s):  
Robert Zachariae
Keyword(s):  
Cancer Patients ◽  
Sleep Disturbances ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Symptom Control ◽  
Physical Symptom ◽  
Convincing Evidence ◽  
Web Based ◽  
Cancer Related Fatigue ◽  
Highly Correlated

Persistent pain, fatigue, and sleep disturbances are prevalent and distressing physical and biobehavioral symptoms and late effects experienced by many cancer patients and survivors. While effective pharmacological treatment options are limited, a growing body of evidence points to the potential efficacy of nonpharmacological approaches, including psychoeducation, physical exercise, and cognitive-behavioral therapy (CBT). There are, however, considerable challenges in making such interventions available and accessible to those in need. Delivering interventions remotely using e-health solutions may be one way of overcoming these barriers. Of the available randomized controlled trials, the majority have focused on web-based interventions for cancer-related fatigue (CRF), with the most convincing evidence found for web-based CBT for insomnia (eCBT-I) and e-health-supported exercise programs. Despite few trials with cancer patients and survivors, given the evidence for the efficacy of web-based CBT-I for noncancer samples and for face-to-face-delivered CBT-I with this group, eCBT-I is a highly promising intervention for cancer-related sleep disturbances. Currently, the weakest evidence is found for pain, but it is of interest to note the preliminary findings of highly correlated improvements in co-occurring symptoms of CRF and pain, and sleep disturbance and CRF. Several questions remain to be answered, including which patients the interventions will work best for and whether there are adverse effects associated with e-health delivery. However, together with increasing internet and smartphone penetration rates, the available evidence points to the relevance of further research in e-health solutions for physical symptom management in cancer patients and survivors.

scholarly journals Spider Phobia: Neural Networks Informing Diagnosis and (Virtual/Augmented Reality-Based) Cognitive Behavioral Psychotherapy—A Narrative Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Jonas Hinze ◽  
Anne Röder ◽  
Nicole Menzie ◽  
Ulf Müller ◽  
Katharina Domschke ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Brain Regions ◽  
Current Treatment ◽  
Narrative Review ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Spider Phobia

Recent fMRI studies on specific animal phobias, particularly spider phobia (arachnophobia), have identified a large variety of specific brain regions involved in normal and disturbed fear processing. Both functional and structural brain abnormalities have been identified among phobic patients. Current research suggests that both conscious and subconscious fear processing play a crucial role in phobic disorders. Cognitive behavioral therapy has been identified as an effective treatment for specific phobias and has been associated with neuroplastic effects which can be evaluated using current neuroimaging techniques. Recent research suggests that new approaches using virtual (VR) or augmented reality (AR) tend to be similarly effective as traditional “in vivo” therapy methods and could expand treatment options for different medical or individual scenarios. This narrative review elaborates on neural structures and particularities of arachnophobia. Current treatment options are discussed and future research questions are highlighted.

scholarly journals Have We Just Scratched the Surface? A Narrative Review of Uremic Pruritus in 2020

2020 ◽  
Vol 7 ◽  
pp. 205435812095402
Author(s):  
Claire E. Martin ◽  
Sergi Clotet-Freixas ◽  
Janine F. Farragher ◽  
Gregory L. Hundemer
Keyword(s):  
Kidney Disease ◽  
Molecular Mechanisms ◽  
Case Reports ◽  
Narrative Review ◽  
Mast Cell Activation ◽  
Current Evidence ◽  
Future Research ◽  
Common Symptom ◽  
Treatment Approaches ◽  
Uremic Pruritus

Purpose of review: Uremic pruritus is a highly prevalent and debilitating symptom in patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). The purpose of this review is to examine current evidence on the mechanisms and treatments of pruritus in CKD and highlight promising areas for future research. Sources of information: Published literature, including randomized controlled trials, cohort studies, case reports, and review articles, was searched for evidence pertaining to the pathophysiology and treatment of uremic pruritus. Methods: A comprehensive narrative review was conducted to explore the molecular mechanisms underlying uremic pruritus, as well as the evidence (or lack thereof) supporting pharmacological and nonpharmacological treatments for uremic pruritus. The potential role of patient sex in the pathophysiology and management of uremic pruritus is also discussed. Key findings: The pathophysiology of uremic pruritus involves a complex interplay of uremic toxins, systemic inflammation, mast cell activation, and imbalance of opioid receptors. Classic treatment strategies for uremic pruritus include optimization of dialysis parameters, amelioration of CKD-related mineral and bone disease, topical emollients and analgesics, antihistamines, the anticonvulsant medications gabapentin and pregabalin, and ultraviolet light B (UV-B) phototherapy. Strong data to support many of these classical treatments for uremic pruritus are limited. Newly evolving treatment approaches for uremic pruritus include opioid receptor modulators, neurokinin-1 inhibitors, and cannabinoids. Further studies regarding their efficacy, pharmacodynamics, and safety in the CKD and ESKD population are needed before these agents are accepted into widespread use. Additional nonpharmacological strategies aimed at treating uremic pruritus include psychotherapy, acupuncture, omega-3 fatty acids, and exercise. Finally, sex differences may exist regarding uremic pruritus, but studies directly addressing sex-specific mechanisms of uremic pruritus remain absent. Limitations: High-quality evidence in the management of uremic pruritus remains lacking. Most recommendations are based on expert opinion or studies involving small numbers of patients. In addition, our understanding of the pathophysiological mechanisms behind uremic pruritus is incomplete and continues to evolve over time. Implications: Uremic pruritus is a common symptom which reduces quality of life in CKD and ESKD. The identification of novel targeted treatment approaches may ease the burden of uremic pruritus in the future.

scholarly journals Animal Model of Severe Fever With Thrombocytopenia Syndrome Virus Infection

2022 ◽  
Vol 12 ◽  
Author(s):  
Jiawen Sun ◽  
Yuan-Qin Min ◽  
Yunjie Li ◽  
Xiulian Sun ◽  
Fei Deng ◽  
...  
Keyword(s):  
Animal Models ◽  
Molecular Mechanisms ◽  
Clinical Manifestations ◽  
Medical Problem ◽  
Future Research ◽  
Antiviral Therapies ◽  
Treatment And Prevention ◽  
Animal Infection ◽  
Life Threatening ◽  
Severe Fever

Severe fever with thrombocytopenia syndrome (SFTS), an emerging life-threatening infectious disease caused by SFTS bunyavirus (SFTSV; genus Bandavirus, family Phenuiviridae, order Bunyavirales), has been a significant medical problem. Currently, there are no licensed vaccines or specific therapeutic agents available and the viral pathogenesis remains largely unclear. Developing appropriate animal models capable of recapitulating SFTSV infection in humans is crucial for both the study of the viral pathogenic processes and the development of treatment and prevention strategies. Here, we review the current progress in animal models for SFTSV infection by summarizing susceptibility of various potential animal models to SFTSV challenge and the clinical manifestations and histopathological changes in these models. Together with exemplification of studies on SFTSV molecular mechanisms, vaccine candidates, and antiviral drugs, in which animal infection models are utilized, the strengths and limitations of the existing SFTSV animal models and some important directions for future research are also discussed. Further exploration and optimization of SFTSV animal models and the corresponding experimental methods will be undoubtedly valuable for elucidating the viral infection and pathogenesis and evaluating vaccines and antiviral therapies.

scholarly journals Cinnamomum Species: Bridging Phytochemistry Knowledge, Pharmacological Properties and Toxicological Safety for Health Benefits

2021 ◽  
Vol 12 ◽  
Author(s):  
Javad Sharifi-Rad ◽  
Abhijit Dey ◽  
Niranjan Koirala ◽  
Shabnum Shaheen ◽  
Nasreddine El Omari ◽  
...  
Keyword(s):  
Bioactive Compounds ◽  
Molecular Mechanisms ◽  
Food Additives ◽  
New Drugs ◽  
Herbal Remedies ◽  
Future Research ◽  
Neuroprotective Effects ◽  
Long Time

The genus Cinnamomum includes a number of plant species largely used as food, food additives and spices for a long time. Different traditional healing systems have used these plants as herbal remedies to cure diverse ailments. The aim of this comprehensive and updated review is to summarize the biodiversity of the genus Cinnamomum, its bioactive compounds, the mechanisms that underlie the pharmacological activities and molecular targets and toxicological safety. All the data in this review have been collected from databases and recent scientific literature including Web of Science, PubMed, ScienceDirect etc. The results showed that the bioactive compounds of Cinnamomum species possess antimicrobial, antidiabetic, antioxidant, anti-inflammatory, anticancer and neuroprotective effects. The preclinical (in vitro/in vivo) studies provided the possible molecular mechanisms of these action. As a novelty, recent clinical studies and toxicological data described in this paper support and confirm the pharmacological importance of the genus Cinnamomum. In conclusion, the obtained results from preclinical studies and clinical trials, as well as reduced side effects provide insights into future research of new drugs based on extracts and bioactive compounds from Cinnamomum plants.

Pathophysiological peculiarities of cancer-associated thrombosis specifying opportunities of therapy with direct oral anticoagulants

2019 ◽  
Author(s):  
Е.В. Ройтман
Keyword(s):  
Cancer Patients ◽  
Molecular Mechanisms ◽  
Randomized Clinical Trials ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Individual Treatment ◽  
Pharmacological Interactions ◽  
Venous Thromboembolic ◽  
Long Time ◽  
Cancer Associated Thrombosis

Тромбоз является второй по значимости причиной смертности у онкологических больных. Однако молекулярные механизмы, повышающие предрасположенность онкологических больных к тромбоэмболическим событиям, изучены достаточно плохо. На сегодняшний день рассматривают два основных пути, приводящих к развитию тромбоза. Прямая активация гемокоагуляции и тромбоцитов осуществляется факторами, продуцируемыми или высвобождаемыми из раковых клеток (тканевой фактор, подопланин, тромбоцитарные агонисты, фосфатидилсерин, раковый прокоагулянт и ингибитор активации плазминогена1). В механизме непрямой активации гемокоагуляции участвуют воспалительные цитокины из опухолевых клеток, активирующие тромбоциты, стимуляция нейтрофилов и высвобождение нейтрофильных внеклеточных ловушек. В результате этого происходит выраженная активация тромбоцитов, отложение фибрина и захват эритроцитов, усугубляющие образование сгустков. Наличие нескольких путей тромбообразования у онкологических пациентов снижает эффективность антитромботической терапии. Долгое время для снижения риска венозных тромбоэмболических осложнений (ВТЭО) стандартом дефакто были и пока еще остаются низкомолекулярные гепарины (НМГ). Однако появилось достаточно доказательств из различных рандомизированных клинических исследований в отношении использования пероральных антикоагулянтов прямого действия (ПОАК) для лечения ракассоциированных тромбозов, в том числе с учетом удобства их применения. Рекомендации предлагают применение конкретных ПОАК (ривароксабан и эдоксабан) для онкологических больных с диагнозом ВТЭО, низким риском кровотечений и отсутствием медикаментозных взаимодействий с текущей системной терапией. Наибольшее количество из имеющихся исследований проведено по препарату ривароксабан. Это позволяет составить соответствующий портрет пациента, необходимый для составления индивидуальной схемы лечения ВТЭО ривариксабаном и/или НМГ. Thrombosis is the second leading cause of death in cancer patients. Molecular mechanisms that increase thrombogenicity in cancer patients have been poorly studied. At present two main ways to thrombosis are considered: (1) direct mechanisms through the fact that cancer cells expressed on or released several factors such as tissue factor, podoplanin, platelet agonists, phosphatidylserine, cancer procoagulant and plasminogen activation inhibitor1 (2) indirect mechanism activating hemocoagulation involves inflammatory cytokines from tumor cells, activating platelets, neutrophil stimulation and release neutrophil extracellular traps. As a result there is a pronounced activation of platelets, fibrin deposition and capture of erythrocytes that aggravates clot formation. Acting jointly these two ways lead to reduced effectiveness of antithrombotic therapy in cancer patients. Low molecular weight heparins (LMWH) have been the de facto standard for reducing risk of venous thromboembolic complications (VTE) for a long time and they are still considered that. However a lot of evidence from various randomized clinical trials are appeared about direct oral anticoagulants (DOAC) using for the treatment of cancerassociated thrombosis including topics on the convenience of their administration. Recent guidelines suggest the use of certain DOAC (rivaroxaban and edoxaban) in cancer patients with VTE in cases of low risk of bleeding and the lack of pharmacological interactions with current systemic therapy. Most of the available studies have been conducted with rivaroxaban. That allows to draw sonamed portrait of patient in order to build up individual treatment of VTE with rivaroxaban and/or with LMWH.

scholarly journals Natural Products for the Management and Prevention of Breast Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-23 ◽  
Author(s):  
Sarmistha Mitra ◽  
Raju Dash
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Treatment Strategies ◽  
Chemical Compounds ◽  
Future Research ◽  
Breast Cancer Patients ◽  
Cancer Breast ◽  
Cancerous Cell ◽  
Long Time ◽  
Prevention Of Breast Cancer

Among all types of cancer, breast cancer is one of the most challenging diseases, which is responsible for a large number of cancer related deaths. Hormonal therapy, surgery, chemotherapy, and radiotherapy have been used as treatment of breast cancer, for a very long time. Due to severe side effects and multidrug resistance, these treatment approaches become increasingly ineffective. However, adoption of complementary treatment approach can be a big solution for this situation, as it is evident that compounds derived from natural source have a great deal of anticancer activity. Natural compounds can fight against aggressiveness of breast cancer, inhibit cancerous cell proliferation, and modulate cancer related pathways. A large number of research works are now focusing on the natural and dietary compounds and trying to find out new and more effective treatment strategies for the breast cancer patients. In this review, we discussed some significant natural chemical compounds with their mechanisms of actions, which can be very effective against the breast cancer and can be more potent by their proper modifications and further clinical research. Future research focusing on the natural anti-breast-cancer agents can open a new horizon in breast cancer treatment, which will play a great role in enhancing the survival rate of breast cancer patients.

scholarly journals The Microenvironmental Effect in the Progression, Metastasis, and Dormancy of Breast Cancer: A Model System within Bone Marrow

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Bobby Y. Reddy ◽  
Philip K. Lim ◽  
Kimberly Silverio ◽  
Shyam A. Patel ◽  
Brian Wong Won ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Cancer Progression ◽  
Breast Cancer Cells ◽  
Molecular Mechanisms ◽  
Cancer Metastasis ◽  
Treatment Options ◽  
The United States ◽  
Breast Cancer Metastasis ◽  
Future Research

Despite diagnostic advances, breast cancer remains the most prevalent cancer among women in the United States. The armamentarium of treatment options for metastatic disease is limited and mostly ineffective with regards to eradicating cancer. However, there have been novel findings in the recent literature that substantiate the function of the microenvironment in breast cancer progression and the support of metastasis to tertiary sites such as bone marrow. The uncovered significance of the microenvironment in the pathophysiology of breast cancer metastasis has served to challenge previously widespread theories and introduce new perspectives for the future research to eradicate breast cancer. This paper delineates the current understanding of the molecular mechanisms involved in the interactions between breast cancer cells and the microenvironment in progression, metastasis, and dormancy. The information, in addition to other mechanisms described in bone marrow, is discussed in the paper.

scholarly journals The Experiences of Cancer-Related Fatigue among Adult Cancer Patients: A Systematic Review

Jurnal NERS ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. 35
Author(s):  
I Komang Leo Triandana Arizona ◽  
Tintin Sukartini ◽  
Ferry Efendi ◽  
Primalova Septiavy Estiadewi ◽  
Ni Putu Dian Ayu Anggraeni
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cancer Patients ◽  
Future Research ◽  
Subjective Feeling ◽  
Structured Interviews ◽  
Cancer Related Fatigue ◽  
Patient Reported ◽  
The Impact

Introduction: Cancer-related fatigue (CRF) is one of the symptoms commonly experienced and it is a subjective feeling felt by cancer patients. The aim of this systematic review was to summarize how fatigue has been described from the perspective of adult cancer patients, the impact of fatigue on their quality of life, what the patient reported as contributing factors and potential coping strategies to reduce fatigue.Methods: A systematic review is in line with PRISMA guidelines. Five databases were systematically searched (Scopus, PubMed, Springerlink, ProQuest and Science Direct) from January 2009 to February 2019 for qualitative studies describing the experience of adult cancer patients using a predefined search strategy and any relevant keywords.Results: In total, 13 out of 4692 studies were included. The ages of the included patient cancer ranged from 26 to 84 years. The majority of studies used in-depth interviews and semi-structured interviews to elicit the participant’s experiences of fatigue. Four themes were identified: the perception of cancer-related fatigue, the etiology of cancer fatigue, impact and coping strategies.Conclusion: Fatigue is impactful on quality of life from the perspective of cancer patients. Future research should focus on the prospective exploration of the impact of fatigue on woman's and men's health and identifying approaches to reduce fatigue. 

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