Pub Date : 2025-01-01DOI: 10.1016/j.curtheres.2025.100811
Mahdi Keshani , Sayid Mahdi Mirghazanfari , Naseh Pahlavani , Faezeh Baniyaghoobi , Vahid Hadi , Mohammad Bagherniya , Zahra Heidari , Amirhossein Sahebkar , Mohsen Mohajeri , Saeid Hadi
Background
Severe acute respiratory syndrome coronavirus 2, the causative agent of coronavirus disease 2019 (COVID-19), is an inflammatory disease that manifests with symptoms including dry cough, fever, myalgia, and even pneumonia. Despite antiviral treatments, no definitive therapy has been proven effective. Trehala manna (TM), the edible cocoon of Larinus hedenborgi (Coleoptera: Curculionidae) weevil, as a natural product, is traditionally used to alleviate respiratory symptoms because of its antibacterial, anti-inflammatory, and antifungal properties.
Objective
The current study aimed to determine the effects of TM add-on treatment on inflammatory biomarkers and some clinical outcomes in patients with COVID-19.
Methods
The present study was a randomized controlled trial conducted on 60 patients who were randomly allocated to TM (5 g, twice a day) or a placebo for 1 week. The main outcomes of the current study include C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), blood urea nitrogen level, creatinine level, fasting blood sugar level, systolic blood pressure, and visual analog scale (VAS) score for cough, which were evaluated at both the beginning and end of the study.
Results
Our finding revealed that CRP level, ESR, blood urea nitrogen level, creatinine level, fasting blood sugar level, systolic blood pressure, and VAS score for cough were significantly reduced in the TM group after intervention (P < 0.05), and CRP level, ESR, VAS score for cough, and fever were significantly reduced in the TM group compared with the control after 7 days (P < 0.05).
Conclusions
Trehala mann is a natural remedy with potential as an adjunctive therapy for reducing inflammatory biomarkers and improving certain clinical symptoms in patients with COVID-19. No adverse effects were observed during the trial. Iranian Registry of Clinical Trials identifier: IRCT20211029052904N1.
{"title":"The Effects of Cocoons of Larinus Hedenborgi (Coleoptera: Curculionidae) Extracts on Inflammation and Clinical Outcomes in Patients With Coronavirus Disease 2019: A Double-Blinded Randomized Controlled Clinical Trial","authors":"Mahdi Keshani , Sayid Mahdi Mirghazanfari , Naseh Pahlavani , Faezeh Baniyaghoobi , Vahid Hadi , Mohammad Bagherniya , Zahra Heidari , Amirhossein Sahebkar , Mohsen Mohajeri , Saeid Hadi","doi":"10.1016/j.curtheres.2025.100811","DOIUrl":"10.1016/j.curtheres.2025.100811","url":null,"abstract":"<div><h3>Background</h3><div>Severe acute respiratory syndrome coronavirus 2, the causative agent of coronavirus disease 2019 (COVID-19), is an inflammatory disease that manifests with symptoms including dry cough, fever, myalgia, and even pneumonia. Despite antiviral treatments, no definitive therapy has been proven effective. <em>Trehala manna</em> (TM), the edible cocoon of <em>Larinus hedenborgi</em> (Coleoptera: Curculionidae) weevil, as a natural product, is traditionally used to alleviate respiratory symptoms because of its antibacterial, anti-inflammatory, and antifungal properties.</div></div><div><h3>Objective</h3><div>The current study aimed to determine the effects of TM add-on treatment on inflammatory biomarkers and some clinical outcomes in patients with COVID-19.</div></div><div><h3>Methods</h3><div>The present study was a randomized controlled trial conducted on 60 patients who were randomly allocated to TM (5 g, twice a day) or a placebo for 1 week. The main outcomes of the current study include C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), blood urea nitrogen level, creatinine level, fasting blood sugar level, systolic blood pressure, and visual analog scale (VAS) score for cough, which were evaluated at both the beginning and end of the study.</div></div><div><h3>Results</h3><div>Our finding revealed that CRP level, ESR, blood urea nitrogen level, creatinine level, fasting blood sugar level, systolic blood pressure, and VAS score for cough were significantly reduced in the TM group after intervention (<em>P</em> < 0.05), and CRP level, ESR, VAS score for cough, and fever were significantly reduced in the TM group compared with the control after 7 days (<em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div><em>Trehala mann</em> is a natural remedy with potential as an adjunctive therapy for reducing inflammatory biomarkers and improving certain clinical symptoms in patients with COVID-19. No adverse effects were observed during the trial. Iranian Registry of Clinical Trials identifier: IRCT20211029052904N1.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"103 ","pages":"Article 100811"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with metabolic disorders benefit from using anthocyanins. Nevertheless, the findings drawn from extant trials remain contentious. Thus, this meta-analysis evaluated anthocyanin's effect on inflammatory biomarkers in patients with metabolic disorders.
Materials and Methods
We comprehensively searched electronic databases, including PubMed, Scopus, Web of Science, and CENTRAL, from their inception to June 14, 2024.
Findings
A total of 11 randomized controlled clinical trials with 14 arms were analyzed. There was no significant effect of anthocyanin supplementation on interleukin (IL)-1β levels (standardized mean difference [SMD] = –0.01, 95% CI: –0.33, 0.31; P = 0.941, I2 = 62.4%, P = 0.031), tumor necrosis factor-α (TNF-α) (SMD = –0.49, 95% CI: –1.07, 0.09; P = 0.098, I2 = 94.0%, P < 0.001) and IL-6 (SMD = –0.69, 95% CI: –1.45, 0.06; P = 0.073, I2 = 95.2%, P < 0.001), respectively. A significant between-study heterogeneity was identified, which was reduced when subgrouping by sample size, dosage, and study population. However, subgroup analysis showed that it might decrease TNF-α and IL-6 in patients with hypertension, and if the intervention lasted less than 12 weeks.
Conclusions
There was no significant impact of anthocyanin supplementation on IL-1β, TNF-α, and IL-6; however, it should be noted that the intervention has a decreasing impact on individuals with hypertension. Our observed effect sizes on IL-1β, TNF-α, and IL-6 are not clinically important.
{"title":"The Effect of Anthocyanin Supplementation on Pro-Inflammatory Biomarkers in Patients With Metabolic Disorders: A Grade-Assessed Systematic Review and Meta-Analysis","authors":"Fatemeh Babaee Kiadehi MSc , Pegah Samani MSc , Sanaz Barazandeh MSc , Pedram Pam MSc , Ali Hajipour MSc , Narges Goli MSc , Ali Asadi PhD","doi":"10.1016/j.curtheres.2024.100772","DOIUrl":"10.1016/j.curtheres.2024.100772","url":null,"abstract":"<div><h3>Introduction and Aim</h3><div>Patients with metabolic disorders benefit from using anthocyanins. Nevertheless, the findings drawn from extant trials remain contentious. Thus, this meta-analysis evaluated anthocyanin's effect on inflammatory biomarkers in patients with metabolic disorders.</div></div><div><h3>Materials and Methods</h3><div>We comprehensively searched electronic databases, including PubMed, Scopus, Web of Science, and CENTRAL, from their inception to June 14, 2024.</div></div><div><h3>Findings</h3><div>A total of 11 randomized controlled clinical trials with 14 arms were analyzed. There was no significant effect of anthocyanin supplementation on interleukin (IL)-1β levels (standardized mean difference [SMD] = –0.01, 95% CI: –0.33, 0.31; <em>P</em> = 0.941, <em>I</em><sup>2</sup> = 62.4%, <em>P</em> = 0.031), tumor necrosis factor-α (TNF-α) (SMD = –0.49, 95% CI: –1.07, 0.09; <em>P</em> = 0.098, <em>I</em><sup>2</sup> = 94.0%, <em>P</em> < 0.001) and IL-6 (SMD = –0.69, 95% CI: –1.45, 0.06; <em>P</em> = 0.073, <em>I</em><sup>2</sup> = 95.2%, <em>P</em> < 0.001), respectively. A significant between-study heterogeneity was identified, which was reduced when subgrouping by sample size, dosage, and study population. However, subgroup analysis showed that it might decrease TNF-α and IL-6 in patients with hypertension, and if the intervention lasted less than 12 weeks.</div></div><div><h3>Conclusions</h3><div>There was no significant impact of anthocyanin supplementation on IL-1β, TNF-α, and IL-6; however, it should be noted that the intervention has a decreasing impact on individuals with hypertension. Our observed effect sizes on IL-1β, TNF-α, and IL-6 are not clinically important.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100772"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.curtheres.2024.100765
María José Torres PhD , Juan Carlos Ríos PhD , Alexandra Valle MSc , Sebastián Indo PhD , Kevin Brockway GV MSc , Fernanda López-Moncada PhD , Mario Faúndez PhD , Enrique A. Castellón PhD , Héctor R. Contreras PhD
Background
Leukotriene B4 (LTB4) plays a crucial role in carcinogenesis by inducing epithelial-mesenchymal transition (EMT), a process associated with tumor progression. The synthesis of LTB4 is mediated by leukotriene A4 hydrolase (LTA4H), and it binds to the receptors BLT1 and BLT2. Dysregulation in LTB4 production is linked to the development of various pathologies. Therefore, the identification or design of inhibitors of LTB4 synthesis or receptor antagonists represents an ongoing challenge. In this context, our laboratory previously demonstrated that alpha-lipoic acid (ALA) inhibits LTA4H. The objective of this study was to evaluate the effect of ALA on the expression of canonical EMT markers and the functional and tumorigenic capacities induced by LTB4 in A549 cells.
Methods
The expression of cPLA2, 5LOX, FLAP, LTA4H, BLT1, and LTB4 production in human adenocarcinomic alveolar basal epithelial A549 cells was assessed using Western blot, RT-qPCR, and ELISA, respectively. Subsequently, the expression of canonical EMT markers was evaluated by Western blot. Functional assays were performed to assess cell viability, proliferation, invasion, migration, and clonogenicity using MTT, Western blot, Transwell assays, and colony formation assays, respectively. Results were expressed as median with interquartile range (n≥3) and analyzed using the Kruskal-Wallis or Tukey multiple comparisons tests.
Results
A549 cells express key proteins involved in LTB4 synthesis and receptor binding, including LTA4H and BLT1, and ALA inhibits the production of LTB4. Additionally, LTA4H and BLT1 were detected in lung adenocarcinoma tissue samples. LTB4 was found to induce EMT, whereas ALA treatment enhanced the expression of epithelial markers and reduced the expression of mesenchymal markers. Furthermore, ALA treatment resulted in a decrease in LTB4 levels and attenuated the functional and tumorigenic capacities of A549 cells, including their viability, migration, invasion, and clonogenic potential.
Conclusions
These findings suggest that ALA may offer therapeutic potential in the context of lung cancer, as it could be integrated into conventional pharmacological therapies to enhance treatment efficacy and mitigate the adverse effects associated with chemotherapy. Further studies are warranted to confirm the clinical applicability of ALA as an adjunctive treatment in lung cancer.
{"title":"Alpha-Lipoic Acid-Mediated Inhibition of LTB4 Synthesis Suppresses Epithelial-Mesenchymal Transition, Modulating Functional and Tumorigenic Capacities in Non-Small Cell Lung Cancer A549 Cells","authors":"María José Torres PhD , Juan Carlos Ríos PhD , Alexandra Valle MSc , Sebastián Indo PhD , Kevin Brockway GV MSc , Fernanda López-Moncada PhD , Mario Faúndez PhD , Enrique A. Castellón PhD , Héctor R. Contreras PhD","doi":"10.1016/j.curtheres.2024.100765","DOIUrl":"10.1016/j.curtheres.2024.100765","url":null,"abstract":"<div><h3>Background</h3><div>Leukotriene B<sub>4</sub> (LTB<sub>4</sub>) plays a crucial role in carcinogenesis by inducing epithelial-mesenchymal transition (EMT), a process associated with tumor progression. The synthesis of LTB<sub>4</sub> is mediated by leukotriene A<sub>4</sub> hydrolase (LTA<sub>4</sub>H), and it binds to the receptors BLT<sub>1</sub> and BLT<sub>2</sub>. Dysregulation in LTB<sub>4</sub> production is linked to the development of various pathologies. Therefore, the identification or design of inhibitors of LTB<sub>4</sub> synthesis or receptor antagonists represents an ongoing challenge. In this context, our laboratory previously demonstrated that alpha-lipoic acid (ALA) inhibits LTA<sub>4</sub>H. The objective of this study was to evaluate the effect of ALA on the expression of canonical EMT markers and the functional and tumorigenic capacities induced by LTB<sub>4</sub> in A549 cells.</div></div><div><h3>Methods</h3><div>The expression of cPLA<sub>2</sub>, 5LOX, FLAP, LTA<sub>4</sub>H, BLT1, and LTB<sub>4</sub> production in human adenocarcinomic alveolar basal epithelial A549 cells was assessed using Western blot, RT-qPCR, and ELISA, respectively. Subsequently, the expression of canonical EMT markers was evaluated by Western blot. Functional assays were performed to assess cell viability, proliferation, invasion, migration, and clonogenicity using MTT, Western blot, Transwell assays, and colony formation assays, respectively. Results were expressed as median with interquartile range (n≥3) and analyzed using the Kruskal-Wallis or Tukey multiple comparisons tests.</div></div><div><h3>Results</h3><div>A549 cells express key proteins involved in LTB<sub>4</sub> synthesis and receptor binding, including LTA<sub>4</sub>H and BLT<sub>1</sub>, and ALA inhibits the production of LTB<sub>4</sub>. Additionally, LTA<sub>4</sub>H and BLT1 were detected in lung adenocarcinoma tissue samples. LTB<sub>4</sub> was found to induce EMT, whereas ALA treatment enhanced the expression of epithelial markers and reduced the expression of mesenchymal markers. Furthermore, ALA treatment resulted in a decrease in LTB<sub>4</sub> levels and attenuated the functional and tumorigenic capacities of A549 cells, including their viability, migration, invasion, and clonogenic potential.</div></div><div><h3>Conclusions</h3><div>These findings suggest that ALA may offer therapeutic potential in the context of lung cancer, as it could be integrated into conventional pharmacological therapies to enhance treatment efficacy and mitigate the adverse effects associated with chemotherapy. Further studies are warranted to confirm the clinical applicability of ALA as an adjunctive treatment in lung cancer.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100765"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.curtheres.2025.100789
Deepa Suhag , Aparna Nilesh Kodre
Background
Amaranthus is a significant source of dietary nitrates, which have been known to improve aerobic capacity and exercise performance in physically active individuals. There is a significant data gap on nonpartitive pharmacokinetics and bioequivalence studies of nitrate and nitrite from 3 species of Amaranth (A. hybridus, A. hypochondriacus, and A. tricolor).
Objective
This study aimed to assess the bioavailability of nitrates and nitrites from 3 Amaranthus species in a randomized, placebo-controlled design, thereby filling this gap.
Methods
A double-blinded, 4-way crossover study was conducted in 16 healthy participants. Each participant enrolled in the study received a single dose of 2000 mg of Amaranthus extract or a placebo. The plasma and saliva samples were collected at specific intervals over 24 hours. Nitrate and nitrite concentrations were analyzed using a validated LCMS/MS method.
Results
After the administration of amaranth extracts, both plasma and saliva samples were observed significantly higher levels of nitrate and nitrite compared with the placebo group. Pharmacokinetic variables (Cmax, AUC0-t24, and AUC0-∞) found a similar pattern for nitrite and nitrate in the 3 amaranth products but were significantly different from placebo (P < 0.05), in both plasma and saliva samples. Bioequivalence analysis confirmed significant bioequivalence among the 3 amaranth extracts for nitrite and nitrate.
Conclusions
This study concludes that the 3 species of Amaranthus—A. hybridus, A. hypochondriacus, and A. tricolor are bioequivalent in terms of plasma and saliva nitrate and nitrite levels from a single dose of 2000 mg amaranth extract and have higher bioavailability than placebo. These findings report that Amaranthus extracts could potentially act as a daily diet supplement for improving the cardiovascular and neurogenerative health of the body, particularly aging people.
{"title":"Comparison of Bioavailability of Nitrates and Nitrites in 3 Species of Amaranthus: A Randomized, Double-Blind, Placebo-Controlled, 4-Way Crossover Study in Healthy Subjects Under Fasting Conditions","authors":"Deepa Suhag , Aparna Nilesh Kodre","doi":"10.1016/j.curtheres.2025.100789","DOIUrl":"10.1016/j.curtheres.2025.100789","url":null,"abstract":"<div><h3>Background</h3><div><em>Amaranthus</em> is a significant source of dietary nitrates, which have been known to improve aerobic capacity and exercise performance in physically active individuals. There is a significant data gap on nonpartitive pharmacokinetics and bioequivalence studies of nitrate and nitrite from 3 species of Amaranth (<em>A. hybridus, A. hypochondriacus</em>, and <em>A. tricolor</em>).</div></div><div><h3>Objective</h3><div>This study aimed to assess the bioavailability of nitrates and nitrites from 3 <em>Amaranthus</em> species in a randomized, placebo-controlled design, thereby filling this gap.</div></div><div><h3>Methods</h3><div>A double-blinded, 4-way crossover study was conducted in 16 healthy participants. Each participant enrolled in the study received a single dose of 2000 mg of <em>Amaranthus</em> extract or a placebo. The plasma and saliva samples were collected at specific intervals over 24 hours. Nitrate and nitrite concentrations were analyzed using a validated LCMS/MS method.</div></div><div><h3>Results</h3><div>After the administration of amaranth extracts, both plasma and saliva samples were observed significantly higher levels of nitrate and nitrite compared with the placebo group. Pharmacokinetic variables (C<sub>max</sub>, AUC<sub>0-t24</sub>, and AUC0-∞) found a similar pattern for nitrite and nitrate in the 3 amaranth products but were significantly different from placebo (<em>P</em> < 0.05), in both plasma and saliva samples. Bioequivalence analysis confirmed significant bioequivalence among the 3 amaranth extracts for nitrite and nitrate.</div></div><div><h3>Conclusions</h3><div>This study concludes that the 3 species of <em>Amaranthus</em>—<em>A. hybridus, A. hypochondriacus</em>, and <em>A. tricolor</em> are bioequivalent in terms of plasma and saliva nitrate and nitrite levels from a single dose of 2000 mg amaranth extract and have higher bioavailability than placebo. These findings report that <em>Amaranthus</em> extracts could potentially act as a daily diet supplement for improving the cardiovascular and neurogenerative health of the body, particularly aging people.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"103 ","pages":"Article 100789"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.curtheres.2024.100766
Xiaoyan Kang MD , Ping Zhang DNP , Qing Xu MD , Zhengqun Feng MD , Bei Yin MD
Background
The escalating threat of multidrug-resistant organisms (MDROs) in intensive care unit (ICU) demands innovative management strategies to curb the rising infection rates and associated clinical challenges.
Objective
To assess the effectiveness of integrating the multidisciplinary team (MDT) approach with the SHEL (Software, Hardware, Environment, Liveware) model in reducing MDRO infections within ICU settings.
Methods
From January 2021 to April 2024, a prospective, randomized controlled study was conducted in the ICU of Nantong Fourth People's Hospital, enrolling 411 patients with MDRO infections. These patients were randomly assigned into 3 groups: the MDT group, the SHEL model group, and a combined group. The intervention lasted for 4 weeks, during which the effects on the MDRO detection rate, infection rate, health care staff's infection control execution scores, and the rationality of antibiotic use were assessed, aiming to determine the efficacy of each approach in managing MDROs in the ICU setting.
Results
The overall infection rate of MDROs in the ICU of our hospital from 2021 to 2024 was 60.18%, with sputum infection sources accounting for 68.37% of the total sources, making it the primary source of infection. The detection rate of MDROs in the combined group was significantly higher than that in the MDT and the SHEL groups, with the SHEL group having a higher detection rate than the MDT group (P < 0.05). The infection rate of MDROs in the combined group was significantly lower than that in both the MDT and the SHEL groups, with the SHEL group having a lower detection rate than the MDT group (P < 0.05). The implementation scores of the combination group in standard prevention, hand hygiene, antibiotic management, and isolation measures were significantly higher than those of the MDT and SHEL groups, with the SHEL group scoring higher than the MDT group (P < 0.05). The rational use of antibiotics in the combined group was also higher than in both the MDT and the SHEL groups, with the SHEL group having a higher level than the MDT group (P < 0.05).
Conclusions
The integrated MDT and SHEL model significantly reduced MDRO infections in ICU, improved health care workers' infection prevention and nursing quality, and promoted the appropriate use of antibiotics, advocating for its clinical application.
{"title":"Innovative Solutions for Multidrug-Resistant Organisms’ Infections in Intensive Care Unit: A Joint Efficacy Evaluation of Multidisciplinary Team and SHEL (Software, Hardware, Environment, Liveware) Model","authors":"Xiaoyan Kang MD , Ping Zhang DNP , Qing Xu MD , Zhengqun Feng MD , Bei Yin MD","doi":"10.1016/j.curtheres.2024.100766","DOIUrl":"10.1016/j.curtheres.2024.100766","url":null,"abstract":"<div><h3>Background</h3><div>The escalating threat of multidrug-resistant organisms (MDROs) in intensive care unit (ICU) demands innovative management strategies to curb the rising infection rates and associated clinical challenges.</div></div><div><h3>Objective</h3><div>To assess the effectiveness of integrating the multidisciplinary team (MDT) approach with the SHEL (Software, Hardware, Environment, Liveware) model in reducing MDRO infections within ICU settings.</div></div><div><h3>Methods</h3><div>From January 2021 to April 2024, a prospective, randomized controlled study was conducted in the ICU of Nantong Fourth People's Hospital, enrolling 411 patients with MDRO infections. These patients were randomly assigned into 3 groups: the MDT group, the SHEL model group, and a combined group. The intervention lasted for 4 weeks, during which the effects on the MDRO detection rate, infection rate, health care staff's infection control execution scores, and the rationality of antibiotic use were assessed, aiming to determine the efficacy of each approach in managing MDROs in the ICU setting.</div></div><div><h3>Results</h3><div>The overall infection rate of MDROs in the ICU of our hospital from 2021 to 2024 was 60.18%, with sputum infection sources accounting for 68.37% of the total sources, making it the primary source of infection. The detection rate of MDROs in the combined group was significantly higher than that in the MDT and the SHEL groups, with the SHEL group having a higher detection rate than the MDT group (<em>P</em> < 0.05). The infection rate of MDROs in the combined group was significantly lower than that in both the MDT and the SHEL groups, with the SHEL group having a lower detection rate than the MDT group (<em>P</em> < 0.05). The implementation scores of the combination group in standard prevention, hand hygiene, antibiotic management, and isolation measures were significantly higher than those of the MDT and SHEL groups, with the SHEL group scoring higher than the MDT group (<em>P</em> < 0.05). The rational use of antibiotics in the combined group was also higher than in both the MDT and the SHEL groups, with the SHEL group having a higher level than the MDT group (<em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>The integrated MDT and SHEL model significantly reduced MDRO infections in ICU, improved health care workers' infection prevention and nursing quality, and promoted the appropriate use of antibiotics, advocating for its clinical application.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100766"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.curtheres.2024.100767
Peijing Li MD , Qin Yao MD , Yuanyuan Wang MD , Xipeng Xu MD
Background
Immunosuppressive agents like cyclosporine have proven effective in some pediatric cases, although there are limited case reports considering potential risks such as secondary infections.
Objective
This study investigated the safety and efficacy of Cyclosporine A in children who did not respond to high-dose corticosteroids combined with intravenous immunoglobulin (IVIG).
Methods
We reported four pediatric patients diagnosed with toxic epidermal necrolysis (TEN) received treatment at our institution. All patients were previously healthy children with a median age of 7 years, comprising three boys and one girl (Table 1). Epidermal exfoliation and vesicular lesions ranged from 32.5% to 54.5% of the body surface area (BSA). Despite the administration of treatment comprising high-dose corticosteroids and intravenous immunoglobulin (IVIG), new cutaneous herpes continually emerged. This prompted a transition to cyclosporine treatment (3–5 mg/kg/d) administered in 1–2 oral doses.
Results
Lesions stopped progressing, and bullous lesions started epithelialization after 13–27 days of hospitalization. Cases 1 and 2 faced secondary bacterial and fungal infections, respectively, and their temperatures stabilized after administration of antibiotics. Cases 3 and 4 experienced fever again when the dosage of corticosteroids was tapered off, with no discernible evidence of infection. The patients’ temperatures normalized upon the continuation of cyclosporine therapy. Among the patients, three presented asymptomatic elevated serum amylase, one of which met the diagnostic criteria for acute pancreatitis. Two children showed mildly raised aminotransferases, with one experiencing mild coronary artery dilation, two contracted onychomadesis, and three developed corneal ulceration/keratitis and atretoblepharia, which eventually resolved after vigorous ophthalmologic treatment. None of the children had any permanent sequelae after being discharged from the hospital for six months.
Conclusions
Cyclosporine A is generally safe and effective for children who fail to respond to high-dose corticosteroids in combination with IVIG.
{"title":"Oral Cyclosporine Treatment for Four Pediatric Patients With Toxic Epidermal Necrolysis That Showed No Response to High-dose Corticosteroids in Combination With Intravenous Immunoglobulin: A Case Series","authors":"Peijing Li MD , Qin Yao MD , Yuanyuan Wang MD , Xipeng Xu MD","doi":"10.1016/j.curtheres.2024.100767","DOIUrl":"10.1016/j.curtheres.2024.100767","url":null,"abstract":"<div><h3>Background</h3><div>Immunosuppressive agents like cyclosporine have proven effective in some pediatric cases, although there are limited case reports considering potential risks such as secondary infections.</div></div><div><h3>Objective</h3><div>This study investigated the safety and efficacy of Cyclosporine A in children who did not respond to high-dose corticosteroids combined with intravenous immunoglobulin (IVIG).</div></div><div><h3>Methods</h3><div>We reported four pediatric patients diagnosed with toxic epidermal necrolysis (TEN) received treatment at our institution. All patients were previously healthy children with a median age of 7 years, comprising three boys and one girl (<span><span>Table 1</span></span>). Epidermal exfoliation and vesicular lesions ranged from 32.5% to 54.5% of the body surface area (BSA). Despite the administration of treatment comprising high-dose corticosteroids and intravenous immunoglobulin (IVIG), new cutaneous herpes continually emerged. This prompted a transition to cyclosporine treatment (3–5 mg/kg/d) administered in 1–2 oral doses.</div></div><div><h3>Results</h3><div>Lesions stopped progressing, and bullous lesions started epithelialization after 13–27 days of hospitalization. Cases 1 and 2 faced secondary bacterial and fungal infections, respectively, and their temperatures stabilized after administration of antibiotics. Cases 3 and 4 experienced fever again when the dosage of corticosteroids was tapered off, with no discernible evidence of infection. The patients’ temperatures normalized upon the continuation of cyclosporine therapy. Among the patients, three presented asymptomatic elevated serum amylase, one of which met the diagnostic criteria for acute pancreatitis. Two children showed mildly raised aminotransferases, with one experiencing mild coronary artery dilation, two contracted onychomadesis, and three developed corneal ulceration/keratitis and atretoblepharia, which eventually resolved after vigorous ophthalmologic treatment. None of the children had any permanent sequelae after being discharged from the hospital for six months.</div></div><div><h3>Conclusions</h3><div>Cyclosporine A is generally safe and effective for children who fail to respond to high-dose corticosteroids in combination with IVIG.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100767"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.curtheres.2025.100803
Ilze Dirnena-Fusini PhD , Misbah Riaz MSc , Sverre Christian Christiansen MD, PhD , Sven Magnus Carlsen MD, PhD
Background
Glucagon leads to substantial but short-lived subcutaneous vasodilation. Using micro-amounts of glucagon at the insulin injection site increases insulin absorption.
Objective
We hypothesized that a premixed solution of insulin and nanogram doses of glucagon would improve the pharmacokinetic and pharmacodynamic properties of subcutaneously injected insulin.
Methods
In this series of proof-of-concept experiments, 17 anesthetized pigs were included. Nine pigs were included in the control groups; they received a subcutaneous injection of 10 U of insulin lispro (LyumjevⓇ or HumalogⓇ). Eight pigs were included in the glucagon groups; they received 10 U of a premixed insulin (LyumjevⓇ or HumalogⓇ)/glucagon solution (5 ng glucagon/unit of insulin). Arterial blood was frequently sampled for 210 minutes to assess insulin and glucose concentrations. The impact on glucose metabolism was evaluated through euglycemic clamp investigation.
Results
When premixed insulin LyumjevⓇ/glucagon was injected, insulin Tmax decreased from 33 to 20 minutes (SE = 6.6, P = 0.08), and Cmax was 2-fold higher than that in the control group (100 mU/L vs 46 mU/L, SE = 4.8, P = 0.007). When premixed insulin HumalogⓇ/glucagon was injected, Tmax and Cmax did not change significantly (P = 0.53 and P = 0.83, respectively). Insulin AUC for the first 15 minutes increased two-fold when insulin LyumjevⓇ/glucagon was injected (946 mU×min/L vs 337 mU×min/L, SE = 196, P = 0.02). A similar trend was observed when HumalogⓇ/glucagon was injected (306 mU×min/L vs 65 mU×min/L, SE = 125), although this difference did not reach statistical significance (P = 0.102) compared with the control groups.
Conclusions
This series of proof-of-concept experiments in anesthetized pigs indicate that premixing nanogram doses of glucagon in fast-acting insulin lispro formulations may speed up the absorption of subcutaneously injected insulin.
背景：胰高血糖素导致大量但短暂的皮下血管扩张。在胰岛素注射部位使用微量胰高血糖素可以增加胰岛素的吸收。目的假设胰岛素与毫微克胰高血糖素的预混溶液可以改善皮下注射胰岛素的药动学和药效学特性。方法在这一系列的概念验证实验中，选取17头麻醉猪。9头猪作为对照组；皮下注射10u胰岛素lispro （LyumjevⓇ或HumalogⓇ）。8头猪分为胰高血糖素组；他们接受10单位胰岛素（LyumjevⓇ或HumalogⓇ）/胰高血糖素溶液（5 ng胰高血糖素/单位胰岛素）的预混合。经常抽取动脉血210分钟，以评估胰岛素和葡萄糖浓度。通过正糖钳法观察对糖代谢的影响。结果注射Lyumjev胰岛素Ⓡ/胰高血糖素预混剂后，胰岛素Tmax从33 min降低至20 min (SE = 6.6, P = 0.08)， Cmax比对照组提高2倍（100 mU/L vs 46 mU/L, SE = 4.8, P = 0.007）。注射预混合胰岛素HumalogⓇ/胰高血糖素时，Tmax和Cmax无显著变化（P = 0.53和P = 0.83）。Lyumjev胰岛素Ⓡ/胰高血糖素组前15分钟胰岛素AUC升高2倍（946 mU×min/L vs 337 mU×min/L, SE = 196, P = 0.02）。注射HumalogⓇ/胰高血糖素组也有类似的趋势（306 mU×min/L vs 65 mU×min/L, SE = 125），但与对照组相比差异无统计学意义（P = 0.102）。结论在麻醉猪身上进行的一系列概念验证实验表明，在速效胰岛素制剂中预混纳克剂量的胰高血糖素可以加速皮下注射胰岛素的吸收。
{"title":"Nano-Amounts of Glucagon Premixed With Fast-Acting Insulin Lispro: Effect on Insulin Absorption in Pigs","authors":"Ilze Dirnena-Fusini PhD , Misbah Riaz MSc , Sverre Christian Christiansen MD, PhD , Sven Magnus Carlsen MD, PhD","doi":"10.1016/j.curtheres.2025.100803","DOIUrl":"10.1016/j.curtheres.2025.100803","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon leads to substantial but short-lived subcutaneous vasodilation. Using micro-amounts of glucagon at the insulin injection site increases insulin absorption.</div></div><div><h3>Objective</h3><div>We hypothesized that a premixed solution of insulin and nanogram doses of glucagon would improve the pharmacokinetic and pharmacodynamic properties of subcutaneously injected insulin.</div></div><div><h3>Methods</h3><div>In this series of proof-of-concept experiments, 17 anesthetized pigs were included. Nine pigs were included in the control groups; they received a subcutaneous injection of 10 U of insulin lispro (Lyumjev<sup>Ⓡ</sup> or Humalog<sup>Ⓡ</sup>). Eight pigs were included in the glucagon groups; they received 10 U of a premixed insulin (Lyumjev<sup>Ⓡ</sup> or Humalog<sup>Ⓡ</sup>)/glucagon solution (5 ng glucagon/unit of insulin). Arterial blood was frequently sampled for 210 minutes to assess insulin and glucose concentrations. The impact on glucose metabolism was evaluated through euglycemic clamp investigation.</div></div><div><h3>Results</h3><div>When premixed insulin Lyumjev<sup>Ⓡ</sup>/glucagon was injected, insulin T<sub>max</sub> decreased from 33 to 20 minutes (SE = 6.6, <em>P</em> = 0.08), and C<sub>max</sub> was 2-fold higher than that in the control group (100 mU/L vs 46 mU/L, SE = 4.8, <em>P</em> = 0.007). When premixed insulin Humalog<sup>Ⓡ</sup>/glucagon was injected, T<sub>max</sub> and C<sub>max</sub> did not change significantly (<em>P</em> = 0.53 and <em>P</em> = 0.83, respectively). Insulin AUC for the first 15 minutes increased two-fold when insulin Lyumjev<sup>Ⓡ</sup>/glucagon was injected (946 mU×min/L vs 337 mU×min/L, SE = 196, <em>P</em> = 0.02). A similar trend was observed when Humalog<sup>Ⓡ</sup>/glucagon was injected (306 mU×min/L vs 65 mU×min/L, SE = 125), although this difference did not reach statistical significance (<em>P</em> = 0.102) compared with the control groups.</div></div><div><h3>Conclusions</h3><div>This series of proof-of-concept experiments in anesthetized pigs indicate that premixing nanogram doses of glucagon in fast-acting insulin lispro formulations may speed up the absorption of subcutaneously injected insulin.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"103 ","pages":"Article 100803"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The treatment of chronic pain presents a considerable difficulty, particularly due to opioid dependence, which is marked by tolerance and withdrawal symptoms. Opioids primarily target mu (μ) opioid receptors, providing pain relief while also leading to various side effects. This research aimed to examine the effectiveness of cetirizine and green tea hydroalcoholic extract (EXT) in altering morphine tolerance and improving analgesic effects.
Methods
Adult male mice were divided into nine groups. In order to investigate the analgesic tolerance, animals received morphine on 14 consecutive days. Cetirizine (5, 10, 20 mg/kg, i.p.) and EXT (50, 100, 200 mg/kg, i.p.) were given before a test dose of morphine (9 mg/kg, i.p.). The analgesic effects were evaluated by the hot plate test.
Results
Cetirizine with doses of 5, 10, 20 mg/kg, and 10 mg/kg showed a significant effect in reducing morphine tolerance 30 min (P < 0.0001) and 45 to 60 min (P < 0.0001) after test dose of morphine (9 mg/kg, i.p.) respectively. While the injection of different doses of the extract did not show any effect on tolerance to morphine. In the combined injection of these two drugs, there was no reduction in tolerance to morphine.
Conclusions
Cetirizine but not EXT reversed morphine tolerance. Furthermore, the co-administration of cetirizine and EXT did not yield any significant benefits compared to the individual treatments.
{"title":"Reversing Morphine Induced Tolerance: Insights Into Cetirizine and Green Tea Extract Efficacy","authors":"Tahereh Eteraf-Oskouei Phd , Adel Mahmoudi Gharehbaba Phd , Solmaz Asnaashari Phd , Zahra Fazli Phd , Bohloul Habibi Asl Phd","doi":"10.1016/j.curtheres.2025.100783","DOIUrl":"10.1016/j.curtheres.2025.100783","url":null,"abstract":"<div><h3>Background</h3><div>The treatment of chronic pain presents a considerable difficulty, particularly due to opioid dependence, which is marked by tolerance and withdrawal symptoms. Opioids primarily target mu (μ) opioid receptors, providing pain relief while also leading to various side effects. This research aimed to examine the effectiveness of cetirizine and green tea hydroalcoholic extract (EXT) in altering morphine tolerance and improving analgesic effects.</div></div><div><h3>Methods</h3><div>Adult male mice were divided into nine groups. In order to investigate the analgesic tolerance, animals received morphine on 14 consecutive days. Cetirizine (5, 10, 20 mg/kg, i.p.) and EXT (50, 100, 200 mg/kg, i.p.) were given before a test dose of morphine (9 mg/kg, i.p.). The analgesic effects were evaluated by the hot plate test.</div></div><div><h3>Results</h3><div>Cetirizine with doses of 5, 10, 20 mg/kg, and 10 mg/kg showed a significant effect in reducing morphine tolerance 30 min (<em>P</em> < 0.0001) and 45 to 60 min (<em>P</em> < 0.0001) after test dose of morphine (9 mg/kg, i.p.) respectively. While the injection of different doses of the extract did not show any effect on tolerance to morphine. In the combined injection of these two drugs, there was no reduction in tolerance to morphine.</div></div><div><h3>Conclusions</h3><div>Cetirizine but not EXT reversed morphine tolerance. Furthermore, the co-administration of cetirizine and EXT did not yield any significant benefits compared to the individual treatments.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100783"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Various neuropsychological or cognitive assessments are often conducted before rehabilitation to ascertain patients’ function, disability, and environment. However, adequate assessments are not conducted for persons with dementia under the assumption that assessments would burden them. Therefore, this study investigated the perceptions of persons with dementia and their family caregivers regarding cognitive function assessments during hospital rehabilitation and reconsidered the significance of such assessments according to the opinions of those involved.
Methods
This cross-sectional observational study was conducted over a 3-month period at a hospital-based rehabilitation center. We administered a semi-structured questionnaire to 31 older persons with dementia (13 men and 18 women; mean age [± SD]: 77 [± 5.7] (range: 66–87 years); mean years of education [± SD]: 12 [± 2.3]; (range: 9–16 years); Alzheimer's disease: 15; mild cognitive impairment (MCI): 15; corticobasal degeneration: 1) and 49 family caregiver dyads (24 men and 25 women, mean age [± SD]: 67 [± 11] years; age range: 46–90 years). The data were interpreted by employing descriptive statistics, and the χ2, Fisher's exact, and Kruskal–Wallis tests.
Findings
Both groups acknowledged the value of neuropsychological assessments, with 94% (95% CI 84.9–100%) of persons with MCI/dementia and 83% (95% CI 73.3–94.0%) of their family caregivers linking them directly to enhanced treatment and care quality. Their positive attitudes were significantly associated with the belief that such evaluations are integral for personalizing and optimizing rehabilitation strategies.
Implications
Most individuals with MCI/dementia and their caregivers value detailed neuropsychological assessments for understanding rehabilitation needs, highlighting the importance of integrating comprehensive evaluations into dementia care. However, the single-center nature of our study limits generalizability. Future research with diverse participants is needed to develop scalable, inclusive rehabilitation strategies.
目的在康复前经常进行各种神经心理学或认知评估，以确定患者的功能、残疾和环境。然而，没有对痴呆症患者进行充分的评估，认为评估会给他们带来负担。因此，本研究调查了痴呆症患者及其家庭照顾者对医院康复期间认知功能评估的看法，并根据相关人员的意见重新考虑这种评估的意义。方法本横断面观察性研究在一家医院康复中心进行了为期3个月的研究。我们对31名老年痴呆症患者(13名男性和18名女性；平均年龄[±SD]: 77[±5.7]（范围：66 ~ 87岁）；平均受教育年限[±SD]: 12[±2.3]；（范围：9-16岁）；阿尔茨海默病：15人；轻度认知障碍（MCI）： 15；皮质基底变性：1例)和49例家庭照顾者(男性24例，女性25例，平均年龄[±SD]: 67[±11]岁；年龄范围：46-90岁)。采用描述性统计、χ2、Fisher精确检验和Kruskal-Wallis检验对数据进行解释。两组都承认神经心理学评估的价值，94% （95% CI 84.9-100%）的轻度认知障碍/痴呆患者和83% （95% CI 73.3-94.0%）的家庭照顾者直接将其与提高治疗和护理质量联系起来。他们的积极态度与相信这些评估是个性化和优化康复策略的组成部分显著相关。大多数MCI/痴呆患者及其护理人员重视详细的神经心理学评估，以了解康复需求，强调将综合评估纳入痴呆护理的重要性。然而，本研究的单中心性质限制了通用性。未来的研究需要不同的参与者来制定可扩展的、包容性的康复策略。
{"title":"Unlocking the Value of Neuropsychological Assessments in Rehabilitation: Perspectives from Persons with Dementia and Their Caregivers","authors":"Takako Yoshimura , Aiko Osawa , Shiinchiro Maeshima , Iikue Ueda , Koki Kawamura , Masaki Kamiya , Naoki Itoh , Hidenori Arai","doi":"10.1016/j.curtheres.2025.100781","DOIUrl":"10.1016/j.curtheres.2025.100781","url":null,"abstract":"<div><h3>Purpose</h3><div>Various neuropsychological or cognitive assessments are often conducted before rehabilitation to ascertain patients’ function, disability, and environment. However, adequate assessments are not conducted for persons with dementia under the assumption that assessments would burden them. Therefore, this study investigated the perceptions of persons with dementia and their family caregivers regarding cognitive function assessments during hospital rehabilitation and reconsidered the significance of such assessments according to the opinions of those involved.</div></div><div><h3>Methods</h3><div>This cross-sectional observational study was conducted over a 3-month period at a hospital-based rehabilitation center. We administered a semi-structured questionnaire to 31 older persons with dementia (13 men and 18 women; mean age [± SD]: 77 [± 5.7] (range: 66–87 years); mean years of education [± SD]: 12 [± 2.3]; (range: 9–16 years); Alzheimer's disease: 15; mild cognitive impairment (MCI): 15; corticobasal degeneration: 1) and 49 family caregiver dyads (24 men and 25 women, mean age [± SD]: 67 [± 11] years; age range: 46–90 years). The data were interpreted by employing descriptive statistics, and the χ<sup>2</sup>, Fisher's exact, and Kruskal–Wallis tests.</div></div><div><h3>Findings</h3><div>Both groups acknowledged the value of neuropsychological assessments, with 94% (95% CI 84.9–100%) of persons with MCI/dementia and 83% (95% CI 73.3–94.0%) of their family caregivers linking them directly to enhanced treatment and care quality. Their positive attitudes were significantly associated with the belief that such evaluations are integral for personalizing and optimizing rehabilitation strategies.</div></div><div><h3>Implications</h3><div>Most individuals with MCI/dementia and their caregivers value detailed neuropsychological assessments for understanding rehabilitation needs, highlighting the importance of integrating comprehensive evaluations into dementia care. However, the single-center nature of our study limits generalizability. Future research with diverse participants is needed to develop scalable, inclusive rehabilitation strategies.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100781"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.curtheres.2025.100786
Chris Lievens OD, MS, PhD, FNAP, FAAO , Andrew D. Pucker OD, PhD, FAAO , Quentin Franklin BS , Stephen M. Montaquila OD, FAAO , Brad Giedd OD, MS, FAAO , Gina Wesley OD, MS, FAAO , Morgan Bromley PhD , Zackarias Coker MS , John Meyers MS , Marta Vianya-Estopa PhD
Background
Perfluorohexyloctane (PFHO) acts to prevent the evaporation of the tear film. It has the potential to limit friction related issues between the eye lid margin and the ocular surface. Prior to the present work, this had not yet been evaluated.
Objective
To examine the potential of using perfluorohexyloctane for reducing the signs and symptoms of lid wiper epitheliopathy (LWE).
Methods
Data were collected at 4 visits spanning 2 months. Patients who had symptomatic dry eye and a LWE score of ≥1.0 on the Korb LWE scale were recruited. Participants were randomized to PFHO 4 times a day or no treatment. Lid wiper epitheliopathy was graded at each visit with the Korb and photographic LWE (PLWE) scales. Symptoms were assessed using the Standard Patient Evaluation of Eye Dryness questionnaire and visual analog scales (0–100).
Results
A total of 52 participants were enrolled (mean ± SD age, 49.7 ± 15.7 years; 79% female). Right eyes in the treatment group were significantly more likely to show an improvement of ≥0.5-units in PLWE scores at 2 months than the no treatment group (P = 0.04), but no left eye differences were noted. Korb and PLWE scores were significantly better in the treatment group compared with the no treatment group starting at 2 weeks and remained so for the duration of the study (all P < 0.001). Standard Patient Evaluation of Eye Dryness scores and dry eye symptoms were significantly better in the treatment than in the no treatment group at the 2-month visit (all P ≤ 0.01).
Conclusions
Perfluorohexyloctane significantly reduced LWE and improved dry eye symptoms compared with no treatment, suggesting that PFHO may enhance ocular lubrication and reduce friction-related damage. Masked, randomized, trials are still needed to compare PFHO to other treatments in participants with LWE to support generalizability of results. ClinicalTrials.gov study NCT06671041.
{"title":"Investigating the Effect of Reducing the Signs and Symptoms of Lid Wiper Epitheliopathy in Patients With Dry Eye Disease With Perfluorohexyloctane","authors":"Chris Lievens OD, MS, PhD, FNAP, FAAO , Andrew D. Pucker OD, PhD, FAAO , Quentin Franklin BS , Stephen M. Montaquila OD, FAAO , Brad Giedd OD, MS, FAAO , Gina Wesley OD, MS, FAAO , Morgan Bromley PhD , Zackarias Coker MS , John Meyers MS , Marta Vianya-Estopa PhD","doi":"10.1016/j.curtheres.2025.100786","DOIUrl":"10.1016/j.curtheres.2025.100786","url":null,"abstract":"<div><h3>Background</h3><div>Perfluorohexyloctane (PFHO) acts to prevent the evaporation of the tear film. It has the potential to limit friction related issues between the eye lid margin and the ocular surface. Prior to the present work, this had not yet been evaluated.</div></div><div><h3>Objective</h3><div>To examine the potential of using perfluorohexyloctane for reducing the signs and symptoms of lid wiper epitheliopathy (LWE).</div></div><div><h3>Methods</h3><div>Data were collected at 4 visits spanning 2 months. Patients who had symptomatic dry eye and a LWE score of ≥1.0 on the Korb LWE scale were recruited. Participants were randomized to PFHO 4 times a day or no treatment. Lid wiper epitheliopathy was graded at each visit with the Korb and photographic LWE (PLWE) scales. Symptoms were assessed using the Standard Patient Evaluation of Eye Dryness questionnaire and visual analog scales (0–100).</div></div><div><h3>Results</h3><div>A total of 52 participants were enrolled (mean ± SD age, 49.7 ± 15.7 years; 79% female). Right eyes in the treatment group were significantly more likely to show an improvement of ≥0.5-units in PLWE scores at 2 months than the no treatment group (<em>P</em> = 0.04), but no left eye differences were noted. Korb and PLWE scores were significantly better in the treatment group compared with the no treatment group starting at 2 weeks and remained so for the duration of the study (all <em>P</em> < 0.001). Standard Patient Evaluation of Eye Dryness scores and dry eye symptoms were significantly better in the treatment than in the no treatment group at the 2-month visit (all <em>P</em> ≤ 0.01).</div></div><div><h3>Conclusions</h3><div>Perfluorohexyloctane significantly reduced LWE and improved dry eye symptoms compared with no treatment, suggesting that PFHO may enhance ocular lubrication and reduce friction-related damage. Masked, randomized, trials are still needed to compare PFHO to other treatments in participants with LWE to support generalizability of results. ClinicalTrials.gov study NCT06671041.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100786"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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