Indian Journal of Pharmacology最新文献

Abstract: Chronic obstructive pulmonary disease (COPD) remains a major global health burden, posing ongoing challenges in diagnosis and management. This systematic review examines current evidence on biomarkers relevant to COPD, emphasizing their diagnostic, prognostic, and therapeutic potential. A comprehensive search of PubMed and Scopus identified studies published from January 2019 to April 2025 involving adult COPD patients. Two independent reviewers screened observational and randomized studies, with duplicates (n = 24) removed using Mendeley and verified manually. Due to heterogeneity in methodology and outcomes, data were synthesized narratively. Risk of bias was assessed using RoB 2.0 for randomized trials and the Newcastle-Ottawa Scale for observational studies. Traditional biomarkers such as C-reactive protein and fibrinogen were consistently associated with exacerbation risk and disease severity. Interleukins-6 and -8 were elevated in frequent exacerbators, while surfactant proteins showed potential in distinguishing COPD from other chronic lung diseases. Emerging genetic and multiomics markers - such as matrix metalloproteinase-9, chitinase-3-like protein 1, and various microRNAs - demonstrated associations with disease phenotypes and treatment response. The findings highlight that while individual biomarkers offer valuable insights, a combined multimarker approach integrated with clinical parameters may enhance the precision of COPD management. This review provides clinicians and researchers with an updated perspective on the utility and limitations of current biomarkers, supporting the move toward more personalized and effective strategies in COPD care.

Abstract: Leptospirosis is one of the most widespread zoonotic diseases caused by Leptospira interrogans, characterized by mild febrile illness to severe multiorgan failure. The conventional vaccines against Leptospira have several drawbacks, including short-term immunity and serovar-based protection. The current study focuses on determining the most effective outer membrane protein (OMP) as a potential antigen using various computational approaches in providing protection against leptospirosis, as they are conserved within pathogenic serovars. Out of OmpL1, LipL21, LipL32, and LipL41, the VaxiJen analysis revealed LipL21 to be the most antigenic with a score of 0.7848. The antigenic epitopes of LipL21 were further analyzed using BCPred and MHCPred. It is conserved among all the pathogenic serovars while being absent in nonpathogenic. LipL21 had both B-cell and T-cell epitopes, suggesting that it is immunogenic. The VaxiJen score, localization of protein, Clustal Omega, and confirmational analysis of B-cell epitopes were studied for defining a better immunogenic and conserved OMP. This study holds importance as the surface proteins are a potential vaccine candidate for the development of new and effective vaccines in the prevention of leptospirosis hold. An ideal protein, which has its entire conserved immunogenic domain, would confer cross-protection against heterologous serovars. Thus, using bioinformatic approaches, we for the first time predict that LipL21 is a promising, effective vaccine candidate in providing protection against Leptospira.

Abstract: In today's fast-paced world, demand for convenient patient care is high, prompting the rise of telemedicine and digital health platforms. These platforms offer quick solutions for health management, aligning with the trend of utilizing online tools for various needs. Integrating these technologies into health care ensures top-notch facilities without disrupting busy lifestyles. This review provides a comprehensive view of their benefits, enhancing patient access and streamlining processes. The paper explores diverse applications such as electronic health records and mobile health apps, empowering patients and enabling real-time decision-making for healthcare providers. It emphasizes the role of big data analytics in managing vast health-related data. Government initiatives and regulatory frameworks are also discussed. Through case studies, the review illustrates the tangible impact of these technologies on patient outcomes and healthcare efficiency. Embracing digital health and telemedicine is crucial for pharmaceutical stakeholders to adapt to evolving patient needs and drive innovation in modern health care.

Abstract: This case report investigates mania and parkinsonism induced by olanzapine and disulfiram in a patient with substance use disorder. DSM-5 criteria were used for the diagnosis of drug-induced parkinsonism, and movement disorder severity was assessed with the Simpson-Angus Scale. After initiating olanzapine and disulfiram therapy, the patient developed extrapyramidal symptoms and manic features. Naranjo scale indicated a probable drug reaction (score = 7), while Hartwig Severity Assessment (Level 4) suggested that hospitalization was required and these reactions were nonpreventable. The case underscores the need for vigilant monitoring and tailored treatment in patients with psychiatric conditions.

Abstract: Palliative care is a multidisciplinary approach aimed at improving the quality of life (QoL) and alleviating sufferings of people with serious and terminal illnesses. The present health system understands that palliative and rehabilitative services offer care to patients when cure is not possible. The concept is relatively new for most Indian graduates due to little emphasis on palliative care in the medical curriculum in India. Although palliative care has been incorporated in Universal Health Coverage in India and now also in the new competency-based medical curriculum in various subjects, including pharmacology, by the National Medical Commission, it is seldom emphasized to medical undergraduates in a structured, separate chapter. Like many other countries, it largely lacks implementation due to a lack of information and emphasis in standard textbooks. Palliative care is considered to be part of the primary healthcare system, and our budding physicians are supposed to be empowered with the prescription skills in palliative care. In the Indian scenario, this is being adopted newly in the medical training of primary care with the new medical education system. Pharmacology plays an important role in understanding the use of palliative care medicines. Palliative care pharmacology includes the use of various medications that target specific symptoms or conditions, for example, opioids such as morphine, fentanyl, and oxycodone for severe pain, antiemetics to alleviate nausea and vomiting, and benzodiazepines to manage anxiety and agitation. Most of the drugs prescribed in palliative care are usually covered in pharmacology textbooks, but in a "piecemeal." However, an explicit chapter on palliative care with the relevant pharmacology helps the young medicos to get sensitized to the drugs and acquire the requisite prescription skills early on the same go. "Strength, weakness, opportunity, and threat analysis" is a tool for strategic planning to assess the intrinsic and extrinsic factors, as well as the existing and upcoming potential of an initiative. Palliative care, which is relatively a new concept for MBBS teaching in India, is still at a primitive stage and needs more emphasis to provide definite advantages with the changing needs of society. Here, in a fresh perspective, through this fact-based analysis we looked at competitive position of 'Pharmacology' discipline to provide the early exposure of 'palliative care' to the MBBS students through a new chapter. We also explored its current relevance and future potential. In addition, we analyzed the internal and external factors influencing this approach, including its strengths, weaknesses, opportunities, and threats.

Abstract: Carbamazepine is widely used drug for various neurological psychiatric disorders. Aplastic anemia is its rare serious adverse effect which possess high mortality rate. This is a retrospective case study where aplastic anemia due to carbamazepine was reported. We enquired the case details and on doing the causality assessment by World Health Organization scale, concluded it as a "certain" type of Adverse Drug Reaction (ADR) induced by carbamazepine. A 44-year-old male was taking carbamazepine prescribed for epilepsy for 2 years. For the last 4-5 months, he started having generalized weakness, easy fatiguability, shortness of breath on exertion, and pedal edema. Investigating it, further he was diagnosed with carbamazepine-induced aplastic anemia. Routine blood investigations, bone marrow findings, etiological confirmation done by treating physicians, and reporting of ADRs by pharmacologists through pharmacovigilance program may provide World Health Organization to release drug alerts so as to warrant the future use of culprit drugs.

Abstract: Antifungal drug resistance is an escalating global health concern that threatens the effective treatment of fungal infections in both clinical and environmental settings. This review synthesizes developments, focusing on molecular and physiological mechanisms of resistance, key contributing factors, and associated therapeutic limitations. Through selected international case studies over the past 5 years (2020-2025), we illustrate the clinical and ecological consequences of resistant fungal pathogens and emphasize the need for coordinated global responses. We also discuss integrated strategies to mitigate this threat, including strengthened surveillance systems, optimized antifungal stewardship, and advancements in diagnostic tools and therapeutic innovation. By consolidating recent insights and identifying critical research gaps, this review aims to inform future investigations and guide policy frameworks to combat antifungal resistance worldwide.

Objective: The inflammation-responsive NLRP3 inflammasome and nuclear factor-kappa B (NF-κB) dependent signaling pathways are critically connected with inflammatory conditions and disorders such as colorectal cancer (CRC). Where phytochemicals may be added as preventive natural supplements to control CRC. In this study, we investigated whether astilbin (AST) interacted with anti-inflammatory NLRP3 and NF-κB-dependent molecular events in CRC.

Background: The network of growth signaling redox-sensitive transcription factor NF-κB interacting with the NLRP3 inflammasome in CRC progression needed targeted research. AST is a flavonol reported for anti-inflammatory, immune-suppressive, and antioxidant properties, which are sought to assess CRC growth inhibition through NF-κB and NLRP3.

Methods: AST was applied to HCT116 and HT-29 cells of human origin to examine cell survival, apoptosis, progression, and DNA fragmentation to determine the analysis of gene and protein expression and molecular mechanisms.

Results: AST inhibits the proliferation of HCT116 and HT29, and both cell lines depend on IC50 values of 128 and 144 events. AST caused induction of apoptosis in CRC cells via intrinsic mechanism involving caspase-9 and caspase-3 activation and caused arrest of the G2/M phase cell cycle. AST (100 μm) inhibited colony formation abilities to 54% and wound healing to 62% in both cell lines. In the azoxymethane/dextran sodium sulfate (AOM/DSS)-induced colitis-associated colon cancer mice, the total tumor count was reduced from 14 to 4.3 by the AST 20 mg/kg group, significantly reducing the large tumor count. AST (20 mg/kg) suppressed the colonic inflammation as shown by decreased expression of NF-κB (1.8-fold) and NLRP3 (1.5-fold) against the control (1.0-fold). AST restored colon length and histopathological changes caused by AOM/DSS. AST inhibited the production of COX-2, INOS, and pro-inflammatory cytokines and chemokines, especially interleukin-6 (IL-6), IL-1β, and IL-10, by approximately 50% at 20 mg/kg. AST suppressed intestinal tissue ASC and IL-1β NLRP3 and NF-kB by approximately 1.3 times compared to control.

Conclusions: AST inhibited colorectal carcinoma growth by blocking the expression of NLRP3 and NF-κB and inducing an apoptotic cascade and suppressing iNOS-COX2 and IL-1β as regulators of inflammation and growth signal. This study advocates the application of phytopharmaceutical supplements for the management of colorectal carcinoma.