Journal of Basic and Clinical Physiology and Pharmacology最新文献

Tumor hypoxia is a critical contributor to cisplatin resistance, promoting molecular adaptations such as HIF-1α activation, reduced DNA repair capacity, metabolic reprogramming, and exosome-mediated drug efflux that collectively weaken cisplatin-induced cytotoxicity. This review integrates current evidence on these hypoxia-driven mechanisms and emphasizes how spatially heterogeneous hypoxic niches generate tumor subpopulations with distinct resistance profiles. Two therapeutic strategies show promising potential to counter this challenge: adjunct therapies that target hypoxia-related signaling and metabolic pathways, including HIF inhibitors, HDAC inhibitors, natural compounds, and metabolic modulators, and oxygenation approaches designed to reverse hypoxic stress. Notably, advances in nanotechnology-based oxygen-delivery systems provide sustained, localized reoxygenation of hypoxic regions, addressing limitations of conventional oxygen therapies. Although these interventions demonstrate strong preclinical efficacy, translation to consistent clinical benefit remains limited, partly due to inadequate hypoxia biomarkers and insufficient preclinical models that fail to replicate tumor oxygen gradients. Future progress will require biomarker-guided patient selection, optimized combination regimens, and early clinical evaluation of oxygen-delivery platforms to enhance cisplatin sensitivity and reduce hypoxia-driven chemoresistance.

Objectives: Osteoarthritis (OA) is a degenerative joint disease affecting millions worldwide, causing disability, reduced quality of life, and significant economic burden. Current clinical practices often fail to provide optimal symptom relief and functional improvement, necessitating evidence-based evaluation of integrated management strategies. This systematic literature review to identify effective integrated interventions for alleviating OA symptoms, enhancing functional outcomes, and improving patient adherence and satisfaction.

Methods: A systematic literature review was conducted following PRISMA guidelines. Peer-reviewed articles published between 2000 and 2024 were retrieved from major scientific databases, including PubMed, Science Direct, Springer Link, Elsevier, Taylor & Francis, and Google Scholar. Studies evaluating integrated or multidisciplinary approaches for OA management were included.

Results: Integrated management strategies demonstrated superior outcomes compared with isolated interventions. Pain reduction was reported in 28 out of 32 studies, with significant improvements in joint function, mobility, and quality of life. Nonpharmacological components enhanced pharmacological treatments. Patient adherence increased by 30-45 % with integrated care. Key barriers implementation included fragmented health care systems, lack of provider training, and inconsistent insurance coverage.

Conclusions: Integrated approaches to OA management provide clinically meaningful improvements in pain, function, and patient-centered outcomes. These SLR actionable insights are for optimizing OA management through holistic, patient-centered strategies. Future research should prioritize cost-effectiveness analyses and long-term outcomes of integrated models.

Concerns regarding contrast-induced acute kidney injury (CI-AKI) remain significant due to the increasing use of iodinated contrast agents (ICM) in diagnostic and medical procedures. Although the frequency of CI-AKI has decreased over the decades, it continues to be a major cause of hospital-acquired acute kidney damage, thereby elevating the risk of mortality, morbidity, and prolonged hospital stays. The complex pathophysiology of CI-AKI involves vasoconstriction, oxidative stress, renal medullary hypoxia, inflammatory responses, and direct tubular toxicity. Recent discoveries have identified ferroptosis and neutrophil extracellular traps (NETs) as additional mechanisms contributing to endothelial and tubular damage. Furthermore, microRNAs such as miR-30c, miR-21, and miR-141-3p have emerged as preliminary biomarkers and therapeutic targets due to their regulatory effects on cellular apoptosis and inflammatory pathways. Procedural controversies persist regarding the risk differences between intravenous and intra-arterial contrast administration; however, evidence suggests that patient comorbidities and procedural complexity, rather than the route of administration alone, determine the risk of CI-AKI. Risk stratification tools, such as the Mehran and ACEF scores, provide frameworks for identifying high-risk patients and guiding preventive strategies. This review integrates an understanding of the molecular pathogenesis of CI-AKI, clarifies procedural debates, and highlights emerging biomarkers and risk models.

Objectives: Chronic kidney disease (CKD) is a global health issue with significant morbidity and mortality, particularly due to cardiovascular events. Early identification and management of risk factors are crucial to prevent CKD progression and complications. CKD is heterogeneous with diverse etiologies and presentations, generalizing across populations challenging. This study aims to develop accurate predictive models for cardiovascular events in CKD patients.

Methods: Biosensors capture key parameters, including SpO₂ (Oxygen saturation), PR (Pulse rate), Pi (Perfusion index), RRp (Respiration rate), and PVi (Pleth variability index), enabling comprehensive evaluation of physiological dynamics in CKD patients. Stacked Auto-Encoders (SAEs) are applied for diagnostics. Genetic risk score (GRS) and nongenetic risk score (NGRS) models are developed using natural logarithms of odds ratios (OR) of risk factors.

Results: The models integrate properties of each factor with weighted contributions to create predictive models for CKD. A novel machine learning technique incorporates automatic machine learning (AutoML).

Conclusions: The models integrate properties of each factor with weighted contributions to create predictive models for CKD. A novel machine learning technique incorporates automatic machine learning (AutoML).

Objectives: This study compared urine output at 2 and 6 h post-furosemide and explored factors influencing diuretic efficacy in acute heart failure (AHF).

Methods: A prospective study (June-August 2023) included AHF patients (≥18 years) with NT-proBNP ≥300 pg/mL. Urinary spot sodium and urine output were measured at baseline, 2, and 6 h after 40 mg IV furosemide.

Results: Among 32 patients, 26 (81.25 %) had satisfactory urine output, and 30 (93.75 %) met the target urinary sodium concentration at 2 h. No significant difference in mean urine output was found between the 2 and 6 h intervals (267 ± 189 mL vs. 298 ± 149 mL, p=0.099). Urine output correlated strongly with urinary sodium concentration (p < 0.001, R²=0.683). Serum creatinine was a significant predictor of urine output (p=0.007).

Conclusions: The comparable urine output at 2 and 6 h suggests that a 2 h assessment may be sufficient to evaluate diuretic response and guide dose adjustments in AHF.

Objectives: Diabetes mellitus is a chronic metabolic condition marked by high blood sugar levels. As a primary treatment for type 2 diabetes (T2DM), metformin has demonstrated positive effects on antioxidant and anti-inflammatory biomarkers in newly diagnosed patients.

Methods: This was a prospective observational study. Blood samples were collected three times to analyse biomarkers. The study involved newly diagnosed T2DM patients who provided written informed consent. The assessments included plasma lipid peroxidation, superoxide dismutase (SOD), catalase, and Malondialdehyde (MDA) levels. Additionally, interleukin-6 (IL-6) was measured to evaluate inflammation.

Results: HbA1c levels significantly decreased at the 6-month follow-up. Analysis showed a reduction in SOD levels at each visit, with a statistically significant difference between the first and second follow-ups (p=0.03028). MDA levels also decreased at each visit, with a statistically significant difference between the first and second follow-ups (p<0.05). Catalase levels increased at each visit, but only between the first and second follow-ups (p=0.03124). IL-6 levels decreased at each visit, with a statistically significant difference between the first and second follow-ups (p<0.05).

Conclusions: Metformin reduces oxidative stress and inflammation in patients with type 2 diabetes, aiding in protecting cells and tissues.

Objectives: Hypothyroidism is common among females of reproductive age group. The prevalence is 10.95 % of which 3.47 % are unaware of the condition and its effect on lung function. To study the pulmonary function among hypothyroid females of reproductive age group and to identify the respiratory disease pattern and also to correlate free T3, T4 and TSH Levels with pulmonary function test parameters.

Methods: This is a case control study, comprised of 156 participants divided into two groups (n₁ and n₂). Group 1 consisted of normal healthy female controls and group 2 consisted of hypothyroid female patients of age group 18-45 years. After recording anthropometric variables, vital signs and BMI, spirometry was performed and following parameters, FVC, FEV1, FEV1/FVC, PEF, PIF and FEF_25-75 % were assessed and analyzed. Statistical analysis and correlation was done.

Results: Hypothyroid patients showed a statistically significant decline in FEV1, FEV1/FVC%. Rho and Pearson's correlation showed a positive correlation between free T4 and FEV1, FEV1/FVC%, PIF, FEF_25-75 %, with FEF_25-75 % statistically significant. TSH showed a negative correlation with FVC, PEF and PIF with PEF statistically significant.

Conclusions: Our study shows that patients with hypothyroidism are more prone to develop obstructive pattern of lung disease, with a decline in small airway and large airway function.

Objectives: Evaluate associations between serum copper (Cu), rubidium (Rb), selenium (Se), strontium (Sr), and zinc (Zn) and psychophysical health in adults from Italy's Sarno River Basin within the 2025 PREVES-STOP program.

Methods: Adults aged 30-65 completed validated questionnaires plus clinical evaluation and blood sampling. Elements were quantified by collision/reaction-cell inductively coupled plasma mass spectrometry (ICP-MS). Associations were evaluated using Spearman and partial Spearman correlations.

Results: Significant associations included Zn and Rb associated with lower odds (odds ratio, OR) of severe fatigue - Recognizing and Estimating Signs of Tiredness (REST): Zn OR=0.38, 95 % confidence interval (CI) 0.21-0.68, q=0.02; Rb OR=0.33, 95 % CI 0.15-0.71, q=0.03 - while Sr was associated with higher well-being - the World Health Organization-5 Well-Being Index (WHO-5) OR=1.36, 95 % CI 1.12-1.65, q=0.02.

Conclusions: Findings support broader trace-element panels to inform psychophysical and cardiometabolic risk beyond classical toxic metals, complementing prior PREVES-STOP evidence on lead (Pb) and cadmium (Cd). Further investigation is warranted.

Objectives: To assess the efficacy and safety of Flower Pollen Extract with Vitamins (PEV) in improving urinary and sexual function in men diagnosed with chronic prostatitis (CP).

Methods: A retrospective controlled study was conducted involving 145 men with CP. Participants were divided into two groups: the intervention group received PEV (n=71) and the control group received ibuprofen (n=74). Clinical and functional outcomes were evaluated at baseline and at 1, 3, and 12 months post-treatment.

Results: Both groups exhibited comparable baseline characteristics. At 3 months, the PEV group demonstrated significantly greater improvement in IPSS (9.4 ± 2.7 vs. 10.3 ± 2.6, p=0.04), NIH-CPSI (11.5 ± 3.7 vs. 13.6 ± 4.2, p=0.002), and IIEF-5 (19.8 ± 3.6 vs. 17.7 ± 3.3, p<0.001). These benefits were maintained and further enhanced at 12 months, with mean IPSS 7.6 ± 2.1, NIH-CPSI 6.5 ± 2.4, and IIEF-5 21.6 ± 3.3 in the PEV group (all p<0.005). No significant differences were observed in Qmax.

Conclusions: Long-term PEV therapy significantly improves urinary and sexual function in men with CP compared with ibuprofen treatment, demonstrating sustained, time-dependent efficacy and excellent safety.