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Cyclosporin for the treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN): a systematic review of observational studies and clinical trials focusing on single therapy, combination therapy, and comparative assessments. 环孢素治疗史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死(TEN):对观察性研究和临床试验的系统回顾,重点关注单一疗法、联合疗法和比较评估。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-29 DOI: 10.1007/s10787-024-01590-0
Amirhossein Nazerian, Alireza Jafarzadeh, Sadaf Salehi, Mobina Ghasemi, Azadeh Goodarzi

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, severe, and potentially life-threatening skin and mucous membrane disorders. They are characterized by widespread skin and mucosal detachment and necrosis, and are classified based on the percentage of total body surface area (TBSA) affected. Given the severe and often life-threatening nature of these conditions, the identification and implementation of effective treatments is crucial. Notably, cyclosporin has demonstrated efficacy in managing these challenging conditions.

Methods: A systematic search was carried out through the PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases until May 2024. Additionally, a manual search was conducted through the reference lists of the included studies to minimize the risk of missing reports.

Results: Overall, 17 studies involving 4761 patients were included in our analysis. The majority of the included studies suggested favorable outcomes for the use of cyclosporin in SJS/TEN patients. The use of cyclosporin was associated with improved survival rates, early arrest of disease progression, faster re-epithelialization, reduced length of hospital stays, and lower rates of multi-organ failure. However, a few studies did not find a survival advantage with cyclosporin and even reported an increased risk of mortality, as well as an increased TBSA detachment and risk of infection.

Conclusion: Most studies indicate positive outcomes with cyclosporin treatment in SJS/TEN patients. This is likely due to cyclosporin's immunomodulatory properties, which may help attenuate the severe inflammatory response associated with these conditions.

背景:史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死溶解症(TEN)是罕见、严重且可能危及生命的皮肤和粘膜疾病。它们的特征是大面积皮肤和粘膜脱落和坏死,根据受影响的体表总面积(TBSA)的百分比进行分类。鉴于这些疾病的严重性和往往危及生命的性质,确定和实施有效的治疗方法至关重要。值得注意的是,环孢素在治疗这些具有挑战性的病症方面已被证明具有疗效:通过 PubMed、Scopus、Embase、Web of Science 和 Cochrane Library 数据库进行了系统检索,检索期至 2024 年 5 月。此外,还对纳入研究的参考文献目录进行了人工检索,以尽量减少遗漏报告的风险:我们的分析共纳入了 17 项研究,涉及 4761 名患者。纳入的大多数研究表明,环孢素对SJS/TEN患者的治疗效果良好。使用环孢素可提高存活率、及早阻止疾病进展、加快上皮再生、缩短住院时间、降低多器官功能衰竭的发生率。然而,少数研究并未发现环孢素能提高生存率,甚至有报告称环孢素增加了死亡风险,并增加了TBSA脱落和感染风险:结论:大多数研究表明,环孢素治疗SJS/TEN患者的效果良好。这可能是由于环孢素具有免疫调节特性,有助于减轻与这些疾病相关的严重炎症反应。
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引用次数: 0
Exploring the role of HIF-1α on pathogenesis in Alzheimer's disease and potential therapeutic approaches. 探索 HIF-1α 在阿尔茨海默病发病机制中的作用及潜在治疗方法。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-27 DOI: 10.1007/s10787-024-01585-x
Pratyush Porel, Kanchan Bala, Khadga Raj Aran

Hypoxia-inducible factor 1α (HIF-1α) is a crucial transcription factor that regulates cellular responses to low oxygen levels (hypoxia). In Alzheimer's disease (AD), emerging evidence suggests a significant involvement of HIF-1α in disease pathogenesis. AD is characterized by the accumulation of amyloid-beta (Aβ) plaques and neurofibrillary tangles (NFTs), leading to neuronal dysfunction and cognitive decline. HIF-1α is implicated in AD through its multifaceted roles in various cellular processes. Firstly, in response to hypoxia, HIF-1α promotes the expression of genes involved in angiogenesis, which is crucial for maintaining cerebral blood flow and oxygen delivery to the brain. However, in the context of AD, dysregulated HIF-1α activation may exacerbate cerebral hypoperfusion, contributing to neuronal damage. Moreover, HIF-1α is implicated in the regulation of Aβ metabolism. It can influence the production and clearance of Aβ peptides, potentially modulating their accumulation and toxicity in the brain. Additionally, HIF-1α activation has been linked to neuroinflammation, a key feature of AD pathology. It can promote the expression of pro-inflammatory cytokines and exacerbate neuronal damage. Furthermore, HIF-1α may play a role in synaptic plasticity and neuronal survival, which are impaired in AD. Dysregulated HIF-1α signaling could disrupt these processes, contributing to cognitive decline and neurodegeneration. Overall, the involvement of HIF-1α in various aspects of AD pathophysiology highlights its potential as a therapeutic target. Modulating HIF-1α activity could offer novel strategies for mitigating neurodegeneration and preserving cognitive function in AD patients. However, further research is needed to elucidate the precise mechanisms underlying HIF-1α dysregulation in AD and to develop targeted interventions.

缺氧诱导因子 1α(HIF-1α)是一种重要的转录因子,可调节细胞对低氧(缺氧)的反应。在阿尔茨海默病(AD)中,新出现的证据表明,HIF-1α 在疾病发病机制中起着重要作用。阿尔茨海默病的特征是淀粉样蛋白-β(Aβ)斑块和神经纤维缠结(NFT)的积累,从而导致神经元功能障碍和认知能力下降。HIF-1α在多种细胞过程中发挥着多方面的作用,因而与AD有关联。首先,在缺氧情况下,HIF-1α会促进血管生成相关基因的表达,这对维持脑血流和脑供氧至关重要。然而,在注意力缺失症的情况下,HIF-1α激活失调可能会加剧脑灌注不足,导致神经元损伤。此外,HIF-1α 还与 Aβ 代谢的调节有关。它可以影响 Aβ 肽的产生和清除,从而可能调节其在大脑中的积累和毒性。此外,HIF-1α 的激活还与神经炎症有关,而神经炎症是注意力缺失症病理学的一个关键特征。它可以促进促炎细胞因子的表达,加剧神经元损伤。此外,HIF-1α 还可能在突触可塑性和神经元存活方面发挥作用,而这在 AD 中会受到损害。HIF-1α 信号传导失调可能会破坏这些过程,导致认知能力下降和神经变性。总之,HIF-1α参与了AD病理生理学的各个方面,这凸显了它作为治疗靶点的潜力。调节 HIF-1α 的活性可为缓解神经退行性变和保护 AD 患者的认知功能提供新的策略。然而,要阐明HIF-1α在AD中失调的确切机制并开发有针对性的干预措施,还需要进一步的研究。
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引用次数: 0
'Comprehensive review of emerging drug targets in traumatic brain injury (TBI): challenges and future scope. 全面回顾创伤性脑损伤(TBI)中的新兴药物靶点:挑战与未来空间。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI: 10.1007/s10787-024-01524-w
Rittu Banderwal, Monika Kadian, Sukant Garg, Anil Kumar

Traumatic brain injury (TBI) is a complex brain problem that causes significant morbidity and mortality among people of all age groups. The complex pathophysiology, varied symptoms, and inadequate treatment further precipitate the problem. Further, TBI produces several psychiatric problems and other related complications in post-TBI survival patients, which are often treated symptomatically or inadequately. Several approaches, including neuroprotective agents targeting several pathways of oxidative stress, neuroinflammation, cytokines, immune system GABA, glutamatergic, microglia, and astrocytes, are being tried by researchers to develop effective treatments or magic bullets to manage the condition effectively. The problem of TBI is therefore treated as a challenge among pharmaceutical scientists or researchers to develop drugs for the effective management of this problem. The goal of the present comprehensive review is to provide an overview of the several pharmacological targets, processes, and cellular pathways that researchers are focusing on, along with an update on their current state.

创伤性脑损伤(TBI)是一种复杂的脑部问题,在各个年龄段的人群中都会造成严重的发病率和死亡率。复杂的病理生理学、多样的症状和不适当的治疗进一步加剧了这一问题。此外,创伤性脑损伤后存活的患者会产生一些精神问题和其他相关并发症,而这些问题和并发症往往得不到对症治疗或治疗不当。研究人员正在尝试几种方法,包括针对氧化应激、神经炎症、细胞因子、免疫系统 GABA、谷氨酸能、小胶质细胞和星形胶质细胞等几种途径的神经保护剂,以开发有效的治疗方法或灵丹妙药来有效控制病情。因此,药物科学家或研究人员将创伤性脑损伤问题视为一项挑战,以开发有效治疗该问题的药物。本综述旨在概述研究人员正在关注的几个药理靶点、过程和细胞通路,并介绍其最新进展。
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引用次数: 0
Fixed oil from the Caatinga palm Syagrus coronata with effect on Complete Freund's Adjuvant (CFA)-induced arthritis. 对完全弗氏佐剂(CFA)诱导的关节炎有影响的卡廷加棕榈Syagrus coronata的固定油。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-10 DOI: 10.1007/s10787-024-01548-2
João Victor de Oliveira Alves, Bartira Victoria Dantas da Rocha Barbosa, Irivânia Fidelis da Silva Aguiar, Laís Ruanita Leopoldina Galvão, Rafael Jardim Ferreira, Julliano Matheus de Lima Maux, Jacinto da Costa Silva Neto, Alisson Macário de Oliveira, Thiago Henrique Napoleão, Maria Tereza Dos Santos Correia, Wêndeo Kennedy Costa, Marcia Vanusa da Silva

Syagrus coronata, a native palm tree in the Caatinga domain, produces fixed oil (ScFO) used therapeutically and dietary by Northeast Brazilian communities. This study evaluated its anti-inflammatory potential of CFA-induced arthritis and its effect on behavioral parameters. In the acute model, ScFO at 25, 50, and 100 mg/kg showed edematogenic effects similar to indomethacin at 4 mg/kg (p > 0.05). In the arthritis model, 100 mg/kg ScFO treatment was comparable to indomethacin (4 mg/kg) (p > 0.05). TNF-α and IL-1β levels were significantly reduced in ScFO-treated groups at 25, 50, and 100 mg/kg, and the indomethacin group (4 mg/kg) versus the positive control (p > 0.05). Radiographs showed severe soft-tissue swelling and bone deformities in the control group, while the 100 mg/kg ScFO group had few alterations, similar to the indomethacin group. Histopathological analysis revealed intense lymphocytic infiltration in the control group, mild diffuse lymphocytic infiltration in the indomethacin group, and mild lymphoplasmacytic infiltration with focal polymorphonuclear infiltrates in the 100 mg/kg ScFO group. Behavioral analysis showed improved exploratory stimuli in ScFO and indomethacin-treated mice compared to the positive control (p > 0.05). ScFO demonstrated anti-inflammatory effects in both acute and chronic arthritis models, reducing edema and pro-inflammatory cytokines, and improved exploratory behavior due to its analgesic properties.

Syagrus coronata 是卡廷加地区的一种原生棕榈树,它生产的固定油(ScFO)被巴西东北部社区用于治疗和膳食。本研究评估了其对 CFA 引起的关节炎的抗炎潜力及其对行为参数的影响。在急性模型中,25、50和100毫克/千克的ScFO显示出与4毫克/千克的吲哚美辛相似的致水肿作用(p > 0.05)。在关节炎模型中,100 毫克/千克 ScFO 的治疗效果与吲哚美辛(4 毫克/千克)相当(p > 0.05)。与阳性对照组相比,ScFO治疗组(25、50和100毫克/千克)和吲哚美辛组(4毫克/千克)的TNF-α和IL-1β水平显著降低(P > 0.05)。X光片显示,对照组出现严重的软组织肿胀和骨骼畸形,而 100 毫克/千克 ScFO 组与吲哚美辛组相似,几乎没有变化。组织病理学分析表明,对照组有强烈的淋巴细胞浸润,吲哚美辛组有轻度弥漫性淋巴细胞浸润,而 100 毫克/千克 ScFO 组有轻度淋巴浆细胞浸润和局灶性多形核浸润。行为分析表明,与阳性对照组相比,ScFO 和吲哚美辛治疗组小鼠的探索刺激得到改善(p > 0.05)。ScFO 在急性和慢性关节炎模型中均表现出抗炎作用,可减少水肿和促炎细胞因子,并因其镇痛特性而改善探索行为。
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引用次数: 0
Talabostat, fibroblast activation protein inhibitor, attenuates inflammation and fibrosis in systemic sclerosis. 成纤维细胞活化蛋白抑制剂 Talabostat 可减轻系统性硬化症的炎症和纤维化。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-21 DOI: 10.1007/s10787-024-01536-6
Mehrnoosh Pashaei, Elham Farhadi, Hoda Kavosi, Elham Madreseh, Samaneh Enayati, Mahdi Mahmoudi, Aliakbar Amirzargar

Background: Systemic sclerosis (SSc) is a connective tissue disorder characterized by excessive fibrosis, where activated fibroblasts play a pivotal role in disease progression. This study aimed to investigate the potential of Talabostat, a small molecule inhibitor of dipeptidyl peptidases, in alleviating fibrosis and inflammation associated with SSc pathogenesis.

Methods: Dermal fibroblasts were obtained from skin biopsies of ten diffuse cutaneous SSc patients and healthy controls. These fibroblasts were subjected to treatment with either TGF-β alone or in combination with Talabostat. Immunofluorescence staining was conducted to evaluate FAPα and α-SMA protein levels. The expression of activated fibroblast markers (FAPα and ACAT2), pro-fibrotic (COL1A1 and COL1A2), anti-fibrotic (MMP1, MMP2, and MMP9), and inflammatory (IL-6 and TGFβ1) related genes was measured by quantitative real-time PCR. Talabostat-treated fibroblasts were assessed for their migratory capacity using a scratch assay and for their viability through MTT assay and Annexin V staining.

Results: The basal expression of COL1A1 and TGFβ1 was notably higher in healthy subjects, while MMP1 expression showed a significant increase in SSc patients. Furthermore, TGF-β stimulation led to upregulation of activated fibroblast markers, pro-fibrotic, and inflammatory-related genes in SSc-derived fibroblasts, which were attenuated upon Talabostat treatment. Interestingly, Talabostat treatment resulted in an upregulation of MMP9 expression. Moreover, Talabostat exhibited a concentration-dependent inhibition of activated fibroblast viability in both healthy and SSc fibroblasts, and suppressed fibroblast migration specifically in SSc patients.

Conclusion: In summary, Talabostat modulates fibrotic genes in SSc, thereby inhibiting myofibroblast differentiation, activation, and migration. These findings suggest promising therapeutic avenues for targeting fibrosis in SSc.

背景:系统性硬化症(SSc)是一种以过度纤维化为特征的结缔组织疾病,活化的成纤维细胞在疾病进展中起着关键作用。本研究旨在探讨二肽基肽酶小分子抑制剂 Talabostat 在缓解与 SSc 发病机制相关的纤维化和炎症方面的潜力:方法:从10名弥漫性皮肤SSc患者和健康对照者的皮肤活检组织中获取真皮成纤维细胞。这些成纤维细胞接受单独或与 Talabostat 联合使用的 TGF-β 处理。用免疫荧光染色法评估 FAPα 和 α-SMA 蛋白水平。实时定量 PCR 检测了活化成纤维细胞标志物(FAPα 和 ACAT2)、促纤维化基因(COL1A1 和 COL1A2)、抗纤维化基因(MMP1、MMP2 和 MMP9)以及炎症相关基因(IL-6 和 TGFβ1)的表达。用划痕法评估他拉泊司特处理的成纤维细胞的迁移能力,用 MTT 法和 Annexin V 染色法评估成纤维细胞的存活率:结果:COL1A1 和 TGFβ1 的基础表达在健康人中明显较高,而 MMP1 的表达在 SSc 患者中则显著增加。此外,TGF-β刺激导致SSc衍生成纤维细胞的活化成纤维细胞标志物、促纤维化基因和炎症相关基因上调,塔拉博司他治疗后,这些基因的上调有所减弱。有趣的是,他拉波司特治疗导致 MMP9 表达上调。此外,他拉波司特对健康和SSc成纤维细胞的活化成纤维细胞活力均表现出浓度依赖性抑制作用,并特别抑制了SSc患者的成纤维细胞迁移:总之,他拉波司特可调节 SSc 中的纤维化基因,从而抑制肌成纤维细胞的分化、活化和迁移。这些发现为针对 SSc 纤维化的治疗提供了前景广阔的途径。
{"title":"Talabostat, fibroblast activation protein inhibitor, attenuates inflammation and fibrosis in systemic sclerosis.","authors":"Mehrnoosh Pashaei, Elham Farhadi, Hoda Kavosi, Elham Madreseh, Samaneh Enayati, Mahdi Mahmoudi, Aliakbar Amirzargar","doi":"10.1007/s10787-024-01536-6","DOIUrl":"10.1007/s10787-024-01536-6","url":null,"abstract":"<p><strong>Background: </strong>Systemic sclerosis (SSc) is a connective tissue disorder characterized by excessive fibrosis, where activated fibroblasts play a pivotal role in disease progression. This study aimed to investigate the potential of Talabostat, a small molecule inhibitor of dipeptidyl peptidases, in alleviating fibrosis and inflammation associated with SSc pathogenesis.</p><p><strong>Methods: </strong>Dermal fibroblasts were obtained from skin biopsies of ten diffuse cutaneous SSc patients and healthy controls. These fibroblasts were subjected to treatment with either TGF-β alone or in combination with Talabostat. Immunofluorescence staining was conducted to evaluate FAPα and α-SMA protein levels. The expression of activated fibroblast markers (FAPα and ACAT2), pro-fibrotic (COL1A1 and COL1A2), anti-fibrotic (MMP1, MMP2, and MMP9), and inflammatory (IL-6 and TGFβ1) related genes was measured by quantitative real-time PCR. Talabostat-treated fibroblasts were assessed for their migratory capacity using a scratch assay and for their viability through MTT assay and Annexin V staining.</p><p><strong>Results: </strong>The basal expression of COL1A1 and TGFβ1 was notably higher in healthy subjects, while MMP1 expression showed a significant increase in SSc patients. Furthermore, TGF-β stimulation led to upregulation of activated fibroblast markers, pro-fibrotic, and inflammatory-related genes in SSc-derived fibroblasts, which were attenuated upon Talabostat treatment. Interestingly, Talabostat treatment resulted in an upregulation of MMP9 expression. Moreover, Talabostat exhibited a concentration-dependent inhibition of activated fibroblast viability in both healthy and SSc fibroblasts, and suppressed fibroblast migration specifically in SSc patients.</p><p><strong>Conclusion: </strong>In summary, Talabostat modulates fibrotic genes in SSc, thereby inhibiting myofibroblast differentiation, activation, and migration. These findings suggest promising therapeutic avenues for targeting fibrosis in SSc.</p>","PeriodicalId":13551,"journal":{"name":"Inflammopharmacology","volume":" ","pages":"3181-3193"},"PeriodicalIF":4.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pentoxifylline in patients with ulcerative colitis treated with mesalamine by modulation of IL-6/STAT3, ZO-1, and S1P pathways: a randomized controlled double-blinded study. 通过调节 IL-6/STAT3、ZO-1 和 S1P 通路对接受美沙拉秦治疗的溃疡性结肠炎患者进行五氯硝基苯胺治疗:一项随机对照双盲研究。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-27 DOI: 10.1007/s10787-024-01560-6
Mostafa M Bahaa, Sahar K Hegazy, Maha M Maher, Monir M Bahgat, Sahar M El-Haggar

Background: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that lasts a long time and has a variety of causes.

Aim: The primary aim of this study was to evaluate pentoxifylline's (PTX) essential function in patients with UC.

Methods: Fifty-two mild to moderate UC patients who matched the eligibility requirements participated in this clinical study. One gram of mesalamine (t.i.d.) and a placebo were administered to the mesalamine group (n = 26) for a duration of 24 weeks. Mesalamine 1 g t.i.d. and PTX 400 mg two times daily were administered to the PTX group (n = 26) for 24 weeks. A gastroenterologist investigated patients at the start and 6 months after the medication was given to assess disease activity index (DAI) and numeric pain rating scale (NRS). Also, interleukin-6 (IL-6), sphingosine 1 phosphate (S1P), tumor necrosis factor-alpha (TNF-α), and fecal myeloperoxidase (MPO) were measured before and after therapy. Zonula occuldin-1 (ZO-1) and signal transducer and activator of transcription factor-3 (STAT-3) expression was assessed before and after therapy as well as histological assessment. Short Form 36 Health Survey (SF-36), was assessed for each patient before and after 6 months of treatment.

Results: The PTX group showed statistically lower levels of serum SIP, TNF-α, IL-6, faecal MPO, gene expression of STAT-3, and a significant increase of ZO-1 in comparison with the mesalamine group. DAI and NRS significantly decreased whereas SF-36 significantly increased in the PTX group.

Conclusion: PTX could alleviate inflammation in patients with UC, so it might be promising adjunctive for patients with UC.

Trial registration identifier: NCT05558761.

背景:溃疡性结肠炎(UC)是一种病程长、病因多的炎症性肠病(IBD)。目的:本研究的主要目的是评估喷托非韦林(PTX)在UC患者中的基本功能:52名符合条件的轻中度UC患者参与了这项临床研究。美沙拉明组(26 人)服用 1 克美沙拉明(t.i.d.)和安慰剂,疗程为 24 周。PTX组(26人)服用1克美沙拉明(t.i.d.)和400毫克PTX,每日2次,疗程24周。胃肠病学家在开始用药时和用药 6 个月后对患者进行了调查,以评估疾病活动指数(DAI)和数字疼痛评分量表(NRS)。此外,治疗前后还测量了白细胞介素-6(IL-6)、磷酸鞘磷脂 1(S1P)、肿瘤坏死因子-α(TNF-α)和粪便髓过氧化物酶(MPO)。对治疗前后的Zonula occuldin-1 (ZO-1)和信号转导及激活转录因子-3 (STAT-3)的表达进行了评估,并进行了组织学评估。在治疗前后 6 个月,对每位患者进行了简表 36 健康调查(SF-36):结果:与美沙拉秦组相比,PTX 组的血清 SIP、TNF-α、IL-6、粪便 MPO、STAT-3 基因表达水平显著降低,而 ZO-1 则显著升高。PTX组的DAI和NRS明显下降,而SF-36明显上升:结论:PTX可减轻UC患者的炎症反应,因此对UC患者来说可能是一种很有前景的辅助治疗药物:NCT05558761。
{"title":"Pentoxifylline in patients with ulcerative colitis treated with mesalamine by modulation of IL-6/STAT3, ZO-1, and S1P pathways: a randomized controlled double-blinded study.","authors":"Mostafa M Bahaa, Sahar K Hegazy, Maha M Maher, Monir M Bahgat, Sahar M El-Haggar","doi":"10.1007/s10787-024-01560-6","DOIUrl":"10.1007/s10787-024-01560-6","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that lasts a long time and has a variety of causes.</p><p><strong>Aim: </strong>The primary aim of this study was to evaluate pentoxifylline's (PTX) essential function in patients with UC.</p><p><strong>Methods: </strong>Fifty-two mild to moderate UC patients who matched the eligibility requirements participated in this clinical study. One gram of mesalamine (t.i.d.) and a placebo were administered to the mesalamine group (n = 26) for a duration of 24 weeks. Mesalamine 1 g t.i.d. and PTX 400 mg two times daily were administered to the PTX group (n = 26) for 24 weeks. A gastroenterologist investigated patients at the start and 6 months after the medication was given to assess disease activity index (DAI) and numeric pain rating scale (NRS). Also, interleukin-6 (IL-6), sphingosine 1 phosphate (S1P), tumor necrosis factor-alpha (TNF-α), and fecal myeloperoxidase (MPO) were measured before and after therapy. Zonula occuldin-1 (ZO-1) and signal transducer and activator of transcription factor-3 (STAT-3) expression was assessed before and after therapy as well as histological assessment. Short Form 36 Health Survey (SF-36), was assessed for each patient before and after 6 months of treatment.</p><p><strong>Results: </strong>The PTX group showed statistically lower levels of serum SIP, TNF-α, IL-6, faecal MPO, gene expression of STAT-3, and a significant increase of ZO-1 in comparison with the mesalamine group. DAI and NRS significantly decreased whereas SF-36 significantly increased in the PTX group.</p><p><strong>Conclusion: </strong>PTX could alleviate inflammation in patients with UC, so it might be promising adjunctive for patients with UC.</p><p><strong>Trial registration identifier: </strong>NCT05558761.</p>","PeriodicalId":13551,"journal":{"name":"Inflammopharmacology","volume":" ","pages":"3247-3258"},"PeriodicalIF":4.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Janus kinase inhibitors versus tumor necrosis factor inhibitors in rheumatoid arthritis: meta-analytical comparison of efficacy and safety. 类风湿关节炎中 Janus 激酶抑制剂与肿瘤坏死因子抑制剂的疗效和安全性荟萃分析比较。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-01 DOI: 10.1007/s10787-024-01563-3
Mahmoud Kandeel, Mohamed A Morsy, Khalid M Alkhodair, Sameer Alhojaily

Background: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by persistent inflammation leading to progressively worse disability. Janus kinase (JAK) inhibitors and tumor necrosis factor (TNF) inhibitors are pivotal in RA treatment, yet their comparative efficacy remains underexplored.

Aim: This study aimed to compare the efficacy and safety of JAK inhibitors and TNF inhibitors in treating RA using data from randomized controlled trials (RCTs).

Methods: A meta-analysis and outcomes analysis were based on results of the Health Assessment Questionnaire Disability Index (HAQ-DI), Clinical Disease Activity Index (CDAI), Visual Analogue Scale (VAS), and Patient Global Assessment Scale (PtGA) and other indices as incidences of venous thromboembolism (VTE) and malignancy.

Results: The JAK inhibitors caused a statistically significant improvement in the HAQ-DI score [MD = 0.08, 95% CI (0.03, 0.12), p = 0.0008] compared with the TNF inhibitors. However, no significant difference was observed between the two drug classes in the CDAI score [MD = - 2.03, 95% CI (- 9.27, 5.22), p = 0.58]. JAK inhibitors were associated with an increase in the VAS score [MD = 3.62, 95% CI (0.86, 6.38), p = 0.01], but there was no significant difference in the PtGA score [MD = 1.91, 95% CI (- 3.25, 7.08), p = 0.47].

Conclusion: JAK inhibitors demonstrated superior efficacy in improving the functional status and reducing the disease activity in RA patients compared with TNF inhibitors. Both drug classes exhibited comparable safety profiles for VTE and malignancies, though JAK inhibitors had a higher risk for thromboembolism.

背景:类风湿性关节炎(RA)是一种慢性全身性自身免疫性疾病,其特征是持续性炎症导致残疾程度逐渐加重。Janus激酶(JAK)抑制剂和肿瘤坏死因子(TNF)抑制剂在RA治疗中起着关键作用,但它们的疗效比较仍未得到充分探讨。目的:本研究旨在利用随机对照试验(RCTs)的数据,比较JAK抑制剂和TNF抑制剂治疗RA的疗效和安全性:方法:根据健康评估问卷残疾指数(HAQ-DI)、临床疾病活动指数(CDAI)、视觉模拟量表(VAS)和患者总体评估量表(PtGA)的结果以及静脉血栓栓塞(VTE)和恶性肿瘤的发病率等其他指标进行荟萃分析和结果分析:与 TNF 抑制剂相比,JAK 抑制剂能显著改善 HAQ-DI 评分[MD = 0.08,95% CI (0.03,0.12),P = 0.0008]。然而,两类药物的CDAI评分无明显差异[MD = - 2.03,95% CI (- 9.27, 5.22),p = 0.58]。JAK抑制剂与VAS评分的增加有关[MD = 3.62,95% CI (0.86,6.38),p = 0.01],但在PtGA评分方面没有显著差异[MD = 1.91,95% CI (- 3.25,7.08),p = 0.47]:结论:与 TNF 抑制剂相比,JAK 抑制剂在改善 RA 患者的功能状态和减少疾病活动方面表现出更优越的疗效。虽然JAK抑制剂发生血栓栓塞的风险较高,但两类药物对VTE和恶性肿瘤的安全性相当。
{"title":"Janus kinase inhibitors versus tumor necrosis factor inhibitors in rheumatoid arthritis: meta-analytical comparison of efficacy and safety.","authors":"Mahmoud Kandeel, Mohamed A Morsy, Khalid M Alkhodair, Sameer Alhojaily","doi":"10.1007/s10787-024-01563-3","DOIUrl":"10.1007/s10787-024-01563-3","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by persistent inflammation leading to progressively worse disability. Janus kinase (JAK) inhibitors and tumor necrosis factor (TNF) inhibitors are pivotal in RA treatment, yet their comparative efficacy remains underexplored.</p><p><strong>Aim: </strong>This study aimed to compare the efficacy and safety of JAK inhibitors and TNF inhibitors in treating RA using data from randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A meta-analysis and outcomes analysis were based on results of the Health Assessment Questionnaire Disability Index (HAQ-DI), Clinical Disease Activity Index (CDAI), Visual Analogue Scale (VAS), and Patient Global Assessment Scale (PtGA) and other indices as incidences of venous thromboembolism (VTE) and malignancy.</p><p><strong>Results: </strong>The JAK inhibitors caused a statistically significant improvement in the HAQ-DI score [MD = 0.08, 95% CI (0.03, 0.12), p = 0.0008] compared with the TNF inhibitors. However, no significant difference was observed between the two drug classes in the CDAI score [MD = - 2.03, 95% CI (- 9.27, 5.22), p = 0.58]. JAK inhibitors were associated with an increase in the VAS score [MD = 3.62, 95% CI (0.86, 6.38), p = 0.01], but there was no significant difference in the PtGA score [MD = 1.91, 95% CI (- 3.25, 7.08), p = 0.47].</p><p><strong>Conclusion: </strong>JAK inhibitors demonstrated superior efficacy in improving the functional status and reducing the disease activity in RA patients compared with TNF inhibitors. Both drug classes exhibited comparable safety profiles for VTE and malignancies, though JAK inhibitors had a higher risk for thromboembolism.</p>","PeriodicalId":13551,"journal":{"name":"Inflammopharmacology","volume":" ","pages":"3229-3246"},"PeriodicalIF":4.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gingerol nanoparticles attenuate complete Freund adjuvant-induced arthritis in rats via targeting the RANKL/OPG signaling pathway. 姜酚纳米颗粒通过靶向 RANKL/OPG 信号通路减轻完全弗氏佐剂诱导的大鼠关节炎。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI: 10.1007/s10787-024-01537-5
Rida Siddique, Faqir Muhammad, Muhammad Naeem Faisal, Bushra Akhtar, Ammara Saleem, Shaneel Kousar, Ali Sharif, Muhammad Saeed, Safwan Muhammad

Rheumatoid arthritis (RA) is characterized by inflammatory joint pathology leading to the degradation of articular bone and cartilage, primarily triggered by synovial inflammation, resulting in joint discomfort. The metacarpophalangeal and proximal interphalangeal joints are predominantly affected. Treatment typically involves a combination of biological and synthetic disease-modifying antirheumatic drugs (DAMARDs) alongside steroid therapy. The application of nanomedicine has been instrumental in enhancing treatment efficacy by facilitating controlled release of pharmacologically active compounds, thus augmenting bioavailability and enabling targeted drug delivery. Gingerol, a constituent of ginger, possesses multifaceted properties. including anti-inflammatory, anti-oxidant, antidiabetic, and antipyretic effects. In this study, gingerol-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs), coated with chitosan, were administered orally to rats over a period of 21 days to address RA induced by complete Freund adjuvant (CFA). The rats were segregated into four experimental groups. Upon completion of the treatment regimen, blood samples were collected for the assessment of cyclooxygenase-2 (COX-2), RA factor, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Subsequent gene expression analysis was conducted to evaluate the levels of interleukin-4 (IL-4), interleukin-17a (IL-17a), IL-6, interferon-gamma (INF-γ), TNF-α, interleukin-1 beta (IL-1β), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-B ligand (RANKL). Statistical analyses utilizing one-way ANOVA followed by Tukey tests were applied to the data. The gene expression profiling revealed significant disparities in mRNA levels of IL-1β, IL-6, IL-4, IL-17a, RANKL, INF-γ, and TNF-α between the CFA-induced arthritis group and the control group. Consequently, it was inferred that gingerol-loaded PLGA NPs coated with chitosan exhibited heightened therapeutic efficacy in addressing CFA-induced arthritis in rats.

类风湿性关节炎(RA)的特点是关节炎症性病变导致关节骨和软骨退化,主要由滑膜炎症引发,从而引起关节不适。主要受影响的是掌指关节和近端指间关节。治疗方法通常是在类固醇治疗的同时,联合使用生物和合成的改善病情抗风湿药物(DAMARDs)。纳米药物的应用有助于药理活性化合物的控制释放,从而提高生物利用率并实现靶向给药,从而提高治疗效果。姜酚是生姜的一种成分,具有多方面的特性,包括抗炎、抗氧化、抗糖尿病和解热作用。在这项研究中,大鼠口服了21天的涂有壳聚糖的姜酚负载聚(乳酸-共聚-乙醇酸)(PLGA)纳米粒子(NPs),以应对完全弗氏佐剂(CFA)诱导的RA。大鼠被分为四个实验组。治疗方案结束后,收集血液样本以评估环氧化酶-2(COX-2)、RA因子、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)。随后进行了基因表达分析,以评估白细胞介素-4(IL-4)、白细胞介素-17a(IL-17a)、IL-6、γ干扰素(INF-γ)、TNF-α、白细胞介素-1β(IL-1β)、骨保护素(OPG)和核因子卡巴-B配体受体激活剂(RANKL)的水平。数据采用单因素方差分析和 Tukey 检验进行统计分析。基因表达谱分析显示,CFA诱导的关节炎组与对照组之间的IL-1β、IL-6、IL-4、IL-17a、RANKL、INF-γ和TNF-α的mRNA水平存在显著差异。因此,可以推断壳聚糖包覆的姜酚载药 PLGA NPs 在治疗 CFA 诱导的大鼠关节炎方面具有更高的疗效。
{"title":"Gingerol nanoparticles attenuate complete Freund adjuvant-induced arthritis in rats via targeting the RANKL/OPG signaling pathway.","authors":"Rida Siddique, Faqir Muhammad, Muhammad Naeem Faisal, Bushra Akhtar, Ammara Saleem, Shaneel Kousar, Ali Sharif, Muhammad Saeed, Safwan Muhammad","doi":"10.1007/s10787-024-01537-5","DOIUrl":"10.1007/s10787-024-01537-5","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is characterized by inflammatory joint pathology leading to the degradation of articular bone and cartilage, primarily triggered by synovial inflammation, resulting in joint discomfort. The metacarpophalangeal and proximal interphalangeal joints are predominantly affected. Treatment typically involves a combination of biological and synthetic disease-modifying antirheumatic drugs (DAMARDs) alongside steroid therapy. The application of nanomedicine has been instrumental in enhancing treatment efficacy by facilitating controlled release of pharmacologically active compounds, thus augmenting bioavailability and enabling targeted drug delivery. Gingerol, a constituent of ginger, possesses multifaceted properties. including anti-inflammatory, anti-oxidant, antidiabetic, and antipyretic effects. In this study, gingerol-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs), coated with chitosan, were administered orally to rats over a period of 21 days to address RA induced by complete Freund adjuvant (CFA). The rats were segregated into four experimental groups. Upon completion of the treatment regimen, blood samples were collected for the assessment of cyclooxygenase-2 (COX-2), RA factor, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Subsequent gene expression analysis was conducted to evaluate the levels of interleukin-4 (IL-4), interleukin-17a (IL-17a), IL-6, interferon-gamma (INF-γ), TNF-α, interleukin-1 beta (IL-1β), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-B ligand (RANKL). Statistical analyses utilizing one-way ANOVA followed by Tukey tests were applied to the data. The gene expression profiling revealed significant disparities in mRNA levels of IL-1β, IL-6, IL-4, IL-17a, RANKL, INF-γ, and TNF-α between the CFA-induced arthritis group and the control group. Consequently, it was inferred that gingerol-loaded PLGA NPs coated with chitosan exhibited heightened therapeutic efficacy in addressing CFA-induced arthritis in rats.</p>","PeriodicalId":13551,"journal":{"name":"Inflammopharmacology","volume":" ","pages":"3311-3326"},"PeriodicalIF":4.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recent advances in COVID-19-induced liver injury: causes, diagnosis, and management. COVID-19诱发肝损伤的最新进展:原因、诊断和处理。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-10 DOI: 10.1007/s10787-024-01535-7
Samar A Antar, Nada A Ashour, Amir O Hamouda, Ayman M Noreddin, Ahmed A Al-Karmalawy

Since the start of the pandemic, considerable advancements have been made in our understanding of the effects of SARS-CoV-2 infection and the associated COVID-19 on the hepatic system. There is a broad range of clinical symptoms for COVID-19. It affects multiple systems and has a dominant lung illness depending on complications. The progression of COVID-19 in people with pre-existing chronic liver disease (CLD) has also been studied in large multinational groups. Notably, SARS-CoV-2 infection is associated with a higher risk of hepatic decompensation and death in patients with cirrhosis. In this review, the source, composition, mechanisms, transmission characteristics, clinical characteristics, therapy, and prevention of SARS-CoV-2 were clarified and discussed, as well as the evolution and variations of the virus. This review briefly discusses the causes and effects of SARS-CoV-2 infection in patients with CLD. As part of COVID-19, In addition, we assess the potential of liver biochemistry as a diagnostic tool examine the data on direct viral infection of liver cells, and investigate potential pathways driving SARS-CoV-2-related liver damage. Finally, we explore how the pandemic has had a significant impact on patient behaviors and hepatology services, which may increase the prevalence and severity of liver disease in the future. The topics encompassed in this review encompass the intricate relationships between SARS-CoV-2, liver health, and broader health management strategies, providing valuable insights for both current clinical practice and future research directions.

自大流行开始以来,我们对 SARS-CoV-2 感染和相关 COVID-19 对肝脏系统的影响的了解取得了长足的进步。COVID-19 的临床症状范围很广。它影响多个系统,根据并发症的不同,主要表现为肺部疾病。在大型跨国团体中,也对 COVID-19 在原有慢性肝病(CLD)患者中的进展情况进行了研究。值得注意的是,SARS-CoV-2 感染与肝硬化患者肝功能失代偿和死亡的风险较高有关。本综述阐明并讨论了 SARS-CoV-2 的来源、组成、机制、传播特点、临床特点、治疗和预防,以及病毒的演变和变异。本综述简要讨论了 CLD 患者感染 SARS-CoV-2 的原因和影响。作为 COVID-19 的一部分,我们还评估了肝脏生化作为诊断工具的潜力,研究了病毒直接感染肝细胞的数据,并探讨了驱动 SARS-CoV-2 相关肝损伤的潜在途径。最后,我们探讨了大流行病如何对患者行为和肝病服务产生重大影响,这可能会增加未来肝病的患病率和严重程度。本综述的主题涵盖了 SARS-CoV-2、肝脏健康和更广泛的健康管理策略之间错综复杂的关系,为当前的临床实践和未来的研究方向提供了宝贵的见解。
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引用次数: 0
Review on the role of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway in diabetes: mechanistic insights and therapeutic implications. 核苷酸结合寡聚化域类受体蛋白 3 (NLRP3) 炎症小体通路在糖尿病中的作用综述:机理认识和治疗意义。
IF 4.6 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-19 DOI: 10.1007/s10787-024-01556-2
Abhishek Satheesan, Janardanan Kumar, Kakithakara Vajravelu Leela, Ria Murugesan, Venkata Chaithanya, Matcha Angelin

This review explores the pivotal role of the nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3) inflammasome in the pathogenesis of diabetes and its complications, highlighting the therapeutic potential of various oral hypoglycemic drugs targeting this pathway. NLRP3 inflammasome activation, triggered by metabolic stressors like hyperglycemia, hyperlipidemia, and free fatty acids (FFAs), leads to the release of pro-inflammatory cytokines interleukin-1β and interleukin-18, driving insulin resistance, pancreatic β-cell dysfunction, and systemic inflammation. These processes contribute to diabetic complications such as nephropathy, neuropathy, retinopathy, and cardiovascular diseases (CVD). Here we discuss the various transcriptional, epigenetic, and gut microbiome mediated regulation of NLRP3 activation in diabetes. Different classes of oral hypoglycemic drugs modulate NLRP3 inflammasome activity through various mechanisms: sulfonylureas inhibit NLRP3 activation and reduce inflammatory cytokine levels; sodium-glucose co-transporter 2 inhibitors (SGLT2i) suppress inflammasome activity by reducing oxidative stress and modulating intracellular signaling pathways; dipeptidyl peptidase-4 inhibitors mitigate inflammasome activation, protecting against renal and vascular complications; glucagon-like peptide-1 receptor agonists attenuate NLRP3 activity, reducing inflammation and improving metabolic outcomes; alpha-glucosidase inhibitors and thiazolidinediones exhibit anti-inflammatory properties by directly inhibiting NLRP3 activation. Agents that specifically target NLRP3 and inhibit their activation have been identified recently such as MCC950, Anakinra, CY-09, and many more. Targeting the NLRP3 inflammasome, thus, presents a promising strategy for managing diabetes and its complications, with oral hypoglycemic drugs offering dual benefits of glycemic control and inflammation reduction. Further research into the specific mechanisms and long-term effects of these drugs on NLRP3 inflammasome activity is warranted.

这篇综述探讨了核苷酸结合寡聚化结构域(NOD)样受体蛋白3(NLRP3)炎性体在糖尿病及其并发症的发病机制中的关键作用,并重点介绍了针对这一途径的各种口服降糖药物的治疗潜力。NLRP3炎性体在高血糖、高脂血症和游离脂肪酸(FFAs)等代谢应激因素的触发下被激活,导致促炎细胞因子白细胞介素-1β和白细胞介素-18的释放,引发胰岛素抵抗、胰岛β细胞功能障碍和全身炎症。这些过程会导致糖尿病并发症,如肾病、神经病变、视网膜病变和心血管疾病(CVD)。在此,我们将讨论糖尿病患者 NLRP3 激活的各种转录、表观遗传和肠道微生物组介导的调控。不同类别的口服降糖药通过不同机制调节 NLRP3 炎性体的活性:磺脲类药物可抑制 NLRP3 的激活并降低炎性细胞因子的水平;钠-葡萄糖协同转运体 2 抑制剂(SGLT2i)可通过减少氧化应激和调节细胞内信号通路来抑制炎性体的活性;二肽基肽酶-4 抑制剂可减轻炎性体的激活,从而防止肾脏和血管并发症的发生;胰高血糖素样肽-1 受体激动剂可减轻 NLRP3 的活性,从而减轻炎症并改善代谢结果;α-葡萄糖苷酶抑制剂和噻唑烷二酮类药物通过直接抑制 NLRP3 的活化而具有抗炎特性。最近还发现了特异性靶向 NLRP3 并抑制其活化的药物,如 MCC950、Anakinra、CY-09 等。因此,靶向 NLRP3 炎性体是治疗糖尿病及其并发症的一种很有前景的策略,口服降糖药物具有控制血糖和减少炎症的双重功效。我们需要进一步研究这些药物对 NLRP3 炎症小体活性的具体机制和长期影响。
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引用次数: 0
期刊
Inflammopharmacology
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