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Background: Peripheral nerve regeneration relies on Schwann cell activation and neurotrophic support. Although adipose-derived stem cells (ADSCs) show therapeutic potential through paracrine mechanisms, their clinical application is often limited by donor-dependent heterogeneity in therapeutic efficacy. Accordingly, strategies to standardize and potentiate their secretory function are essential. This study investigated a safety-optimized strategy to achieve this by combining three-dimensional (3D) spheroid culture with ibudilast, a clinically approved phosphodiesterase inhibitor. Methods: Human ADSCs were cultured in 2D or 3D conditions with varying ibudilast concentrations. Safety was confirmed via CCK-8 assays, and trophic factor secretion was quantified by RT-qPCR and ELISA. To rigorously validate functional outcomes, conditioned media were applied to a dual-model system comprising immortalized rat (RSC96) and primary human Schwann cells (HSwCs), assessing migration and the expression of regeneration-associated genes. Results: Ibudilast demonstrated no cytotoxicity. While 3D culture alone enhanced secretion compared to 2D controls, the addition of ibudilast provided a synergistic boost, resulting in a 6- to 14-fold increase in NGF, VEGF, and IGF-1 levels compared to 3D spheroids alone. Notably, conditioned media from these primed spheroids significantly accelerated HSwCs migration and induced robust upregulation of myelination-related genes (specifically PMP22 and EGR2), with trophic effects sustained for up to 72 h. Conclusions: Ibudilast-primed 3D spheroids synergistically amplify the neuroregenerative secretome of ADSCs. By utilizing a repurposed, safe small molecule to overcome functional variability and maximize potency without genetic manipulation, this strategy represents a highly translatable candidate for peripheral nerve repair.

Background/Objectives: Artificial intelligence (AI) is increasingly applied to drug safety evaluation, yet evidence is dispersed across lifecycle stages and tasks. This scoping review aimed to (1) map how AI supports safety- and treatment-related decision types across the drug lifecycle, and (2) examine evaluation strategies used to assess model reliability for clinical or regulatory use. Methods: Using Arksey and O'Malley's framework, we searched a major database for studies published in the past decade that applied AI or machine learning to drug safety or medication-related decisions. After screening, we extracted data on lifecycle stage, decision type, AI methods, data sources, and evaluation strategies. A lifecycle-decision matrix was constructed to characterize application patterns. Results: AI applications were concentrated in real-world clinical care × patient-level safety prediction and post-marketing × safety surveillance, using EHRs, spontaneous reporting systems, and clinical text. Common methods included gradient boosting, deep neural networks, graph neural networks, and natural language processing models. This concentration reflects structural incentives favoring safety-oriented applications with readily available data and lower decision liability. Evidence for treatment optimization, regulatory decision modeling, and evidence synthesis was limited. Most studies used internal validation; external validation and real-world deployment were uncommon, indicating early methodological maturity and limited translational readiness. Conclusions: AI demonstrates strong potential to enhance drug safety-particularly in risk prediction and pharmacovigilance-but its use remains uneven across the lifecycle. By situating AI applications within explicit lifecycle stages and decision contexts, this review clarifies where progress has advanced, where translation has stalled, and why these gaps persist. Limited external validation and minimal real-world testing constrain clinical and regulatory adoption. These findings suggest that external validation and real-world testing may contribute to further advances in AI for drug safety.

Chronic and infected wounds continue to pose significant clinical challenges due to microbial infections, biofilm development, inflammation, and poor tissue regeneration. Traditional antibiotics medications often show low efficacy and lack stability. The demand for new therapeutic approaches is increasing due to bacterial resistance. Metal-based nanozymes have intrinsic enzyme-like catalytic activity and emerged as a promising class of antibacterial agents for wound-healing applications. The functionalization with metals such as silver (Ag), copper (Cu), iron (Fe), manganese (Mn), cerium (Ce), platinum (Pt) and gold (Au) enhances peroxidase (POD)-, oxidase (OXD)-, and catalase (CAT)-like biomimetic activities. This improvement enables efficient reactive oxygen species (ROS) production, biofilm inhibition, and microenvironment-responsive antibacterial activity. These metal-nanozymes also alter the immune response, increase angiogenesis, and promote extracellular matrix remodeling when combined with metals and also polysaccharides. This review summarizes recent advances in metal-incorporated antibacterial nanozymes including their design, catalytic mechanisms, structure-activity relationships, and integration into hydrogels, films, and fibers for wound healing. Key challenges such as biosafety, metal ion release, the inflammatory balance, and clinical translation are critically discussed. Emerging directions such as single-atom nanozymes, cascade enzyme systems, and stimuli-responsive platforms are highlighted as promising routes for next-generation wound therapeutics. Overall, this review underscores the clinical potential of metal-functionalized nanozymes for infected wound management; however, concerns regarding ion leakage and long-term safety persist emphasizing the need for controlled designs and biocompatible systems to enable safe translation.

(1) Background: This study evaluates the anticancer potential of a newly synthesized azomethine-based compound, 6,6',5,8-Dioxa-2,11-diazadodeca-1,11-diene-1,12-diyl)bis(4-bromo-2-methoxyphenol) (B-134-0), against osteosarcoma (SAOS-2) cells, focusing on its effects on apoptosis and DNA-damage-related gene expression. (2) Methods: B-134-0 was synthesized via condensation and tested at eight concentrations (0.5-100 μg/mL) for 24, 48, and 72 h. Cytotoxicity was assessed through MTT assay, and gene expression levels of TP53, RAD51, BRCA2, CASP2, MYC, MDM2, CDKN1A, ERCC1, ATR, and PRKDC were quantified through qPCR using the ΔΔ_Ct method. Molecular docking and DFT analyses were performed to explore structural stability and protein interactions. (3) Results: B-134-0 exhibited strong time-dependent cytotoxicity (IC₅₀: 71.58, 54.36, and 12.59 μg/mL at 24, 48, and 72 h, respectively) and significantly modulated the expression of cell cycle and DNA-repair-associated genes. The compound notably downregulated TP53, RAD51, CASP2, MYC, and MDM2, while CDKN1A and BRCA2 showed relative upregulation, indicating activation of the DNA damage response. Docking results revealed strong binding affinity with BRCA2 and CDKN1A, consistent with experimental findings. (4) Conclusions: These results indicate that B-134-0 exhibits potent anticancer activity by modulating DDR and apoptosis pathways, with strong molecular stability, suggesting its promise as a therapeutic candidate for osteosarcoma.

Background/Objectives: As the prevalence of depression and the use of antidepressants have risen steadily in the last decade, new treatment options are needed. Aloysia gratissima var. gratissima ethanol extract has previously shown antidepressant-like activity, and the present study was conducted to identify the active fraction and clarify the possible mechanisms of action. Methods: Tail suspension (TST) and forced swimming (FST) behavioral tests were performed, and possible mechanisms of action were elucidated using serotonergic, dopaminergic, adrenergic, and GABAergic system antagonists. UPLC-DAD-MS analyses were performed to identify compounds in active fractions, and molecular docking studies were carried out to determine the binding affinities of these compounds to serotonergic and dopaminergic receptors (5-HT_1A, 5-HT_2A, 5-HT₃, and D₂R). Results: Ethyl acetate and butanol fractions were found to decrease immobility time in FST. The reduction in immobility time during the FST caused by the ethyl acetate fraction was reversed by pretreating mice with WAY100635 (5-HT_1A antagonist), ketanserin (a 5-HT_2A antagonist, ondansetron (5-HT₃ antagonist), or haloperidol (D₂ antagonist). UPLC-DAD-MS analysis revealed a similar composition for the ethyl acetate and butanol fractions of A. gratissima var. gratissima. Pharmacokinetic predictions suggest that only a few of the identified compounds have the potential to permeate the blood-brain barrier, and molecular docking simulations showed that compounds such as 13-oxooctadecadienoic acid, ferulic acid, and coumaric acid have binding affinities to the druggable site of serotonergic and dopaminergic receptors. Conclusions: These results suggest that the Agg ethyl acetate fraction possesses antidepressant-like activities, altering dopaminergic and serotonergic system functions. Computational simulations also suggest that some of the identified compounds have binding affinities to the 5-HT_1A, 5-HT_2A, 5-HT₃, and D₂R receptors.

Cannabidiol (CBD) is one of the most studied compounds of Cannabis sativa and has attracted significant interest due to its therapeutic and beneficial properties, which have been confirmed in numerous preclinical and clinical studies over the last few years. A great advantage of CBD over the other widely known Cannabis sativa ingredient, Δ-9-tetrahydrocannabinol (THC), is that CBD does not exert intoxicating and psychoactive effects, making it an attractive candidate for therapeutic applications in neurological disorders. CBD has been shown to exert antioxidant, analgesic, anti-inflammatory, and neuroprotective effects, with therapeutic potential for various neurological conditions. To date, the only drug that consists solely of highly purified CBD is Epidiolex, which is used in the management of severe forms of epilepsy such as Dravet syndrome and Lennox-Gastaut syndrome. Another legal medication containing CBD (albeit with the addition of THC) is Sativex, used to alleviate spasticity in multiple sclerosis. Besides epilepsy, preclinical data suggest that CBD alone may be potentially beneficial in treating chronic pain, multiple sclerosis, Alzheimer's and Parkinson's diseases, or stroke. The safety profile of CBD is generally considered favorable, as the most commonly reported adverse effects are mild (e.g., somnolence, diarrhea). However, much attention should be paid as CBD-driven drug-drug interactions have been reported. This review article aims to assess the outcomes of preclinical and clinical research on CBD's effects in various neurological conditions while also addressing potential risks and concerns related to its use.

Background: Colorectal and pancreatic cancers remain therapeutically challenging, with limitations in efficacy and limitations due to toxicity from conventional antimetabolites such as 5-fluorouracil (5-FU), methotrexate (MTX), and gemcitabine (GEM). Steroidal conjugation offers an approach to enhance selectivity and toxicokinetics. Methods: Five novel hybrid homo-aza (lactam) steroidal antimetabolites (GE23, CS18, CS23, KA44, MV16) were synthesized and tested against three pancreatic and four colorectal carcinoma cell lines with distinct molecular characteristics. Antiproliferative activity (MTT), apoptosis (Annexin V/PI), and cell cycle effects were assessed. Thymidylate synthase (TS) and dihydrofolate reductase (DHFR) inhibition was examined via molecular docking, Western blot, and enzymatic assays. Correlations between docking binding scores (DBS) and biological data were analyzed, and effects were compared with reference drugs (5-FU, MTX, GEM). Results: CS23, CS18, and KA44 exhibited the most potent cytostatic activity (mean GI₅₀ 10-80 µM). CS23 also induced high cytocidal effects, strong apoptosis (40% at 72 h), and G1/S arrest. Moreover, docking predicted the high binding affinity of CS23 for both TS (-11.2 kcal/mol) and DHFR (-11.5 kcal/mol), which was validated by Western blot and enzymatic inhibition (IC₅₀ ≈ 20 nM). Correlation analyses showed significant relationships between hybrid steroidal antimetabolites' cytostatic efficacy and DBS for TS (r = -0.75) and DHFR (r = -0.76), and combined DBS values predicted growth inhibition (r = -0.81, p < 0.01). No simple, universal correlation with single mutations of KRAS, BRAF, PI3K, or TP53 was found. Conclusions: Lactam steroidal antimetabolite hybrids, particularly CS23, act as dual TS/DHFR inhibitors, inducing apoptosis and cell cycle arrest with improved selectivity. Their strong in silico-in vitro concordance provides a compelling preclinical rationale for further evaluation of steroidal antimetabolites as next-generation therapeutics for resistant gastrointestinal malignancies.

Background and Objective: Chronic refractory wounds not only persist and delay healing, causing physical and mental suffering to patients and reducing their quality of life but also impose a heavy burden on their families and society. Recombinant human acidic fibroblast growth factor (rh-aFGF), approved in China for decades, is a growth factor with multiple biological effects which can promote the healing of various wounds. It is crucial to develop an rh-aFGF expert consensus for standardizing the clinical application of aFGF and enhancing its clinical value. Methods: The literature related to rh-aFGF, including clinical trials, experimental research, and reviews, was collected and selected from PubMed, Web of Science, Medline, CNKI, and the Wangfang database. The expert recommendations were formed by a combination of clinical research quality, use of the Delphi questionnaire, and consensus reached during meetings involving experts. Results: A total of 12 consensus recommendations for clinical application of rh-aFGF on chronic refractory wounds (CRWs) were successfully formulated, of which seven strong, four moderate, and one weak recommendations were suitable for various clinical sets. The recommendations include specifications for duration of rh-aFGF treatment, dosage, types of wounds, and its combination with other products and dressings. Conclusions: rh-aFGF has vital clinical value for healing chronic wounds. This consensus provides clinicians with a reference to guide the application not only of rh-aFGF but also of other growth factor drugs with similar mechanisms for CRWs.

Background/Objectives: Osteoporosis is a metabolic bone disease characterized by reduced bone mass and impaired bone microarchitecture. It has become a major clinical challenge due to the limitations of current therapeutic approaches. Isoimperatorin (ISO), a naturally occurring and biologically active furanocoumarin extracted from various traditional herbals, exhibits therapeutic potential in combating osteoporosis. However, toxicity limits its application. Methods: In vivo, compound B15 was evaluated in an Ovariectomy (OVX) mice model, where treatment was associated with changes in bone microarchitecture parameters, modulation of serum bone metabolism markers, and alterations in the histopathological features of bone tissue. Results: In this study, a new series of furanocoumarin derivatives was designed and synthesized for the treatment of osteoporosis. Compared with ISO, compound B15 has less toxicity and better ability to inhibit osteoclast formation in vitro. Compound B15 could decelerate the progression of osteoporosis in ovariectomized mice. It is worth mentioning that the expression of estradiol in the serum of mice with excised ovaries was significantly increased by compound B15. Conclusions: These results imply that the novel furanocoumarin derivative B15 is a promising therapeutic option for osteoporosis.

Background/Objectives: Cervical dysplasia, a precursor to cervical cancer, represents a significant global health challenge, particularly in regions like Central America, Africa, and Southeast Asia. Current management approaches rely on surgical or ablative interventions, which can lead to complications, for example, preterm birth and cervical insufficiency. Therefore, developing non-invasive, localized therapeutic alternatives is of great clinical interest. Curcumin is a natural compound that suppresses the progression of cervical cancer, but it has poor oral bioavailability and high clearance. Methods: We incorporated curcumin into solid lipid nanoparticles, which were then loaded into rapidly dissolving films. These films show the sustained release profile of curcumin at the localized vaginal site, demonstrating release kinetics consistent with the Korsmeyer-Peppas model. Results: The curcumin solid lipid nanoparticles yielded a size of 341 nm and a polydispersity index of 0.373, and the zeta potential was -23.4 mV. The encapsulation efficiency of curcumin solid lipid nanoparticles was 77.27% using a validated HPLC method. FTIR analysis supported successful incorporation of curcumin into the lipid matrix. A Box-Behnken Design of Experiments optimized the key film formulation parameters and yielded a film with a tensile strength of 2.8 mPa, disintegration time of 3 min, folding endurance of 263, film thickness of 0.426 mm and a pH of 4.0. Conclusions: In vitro assays in human cervical carcinoma cells demonstrated enhanced mortality and autophagosome formation by the curcumin solid lipid nanoparticles when compared to free curcumin. Surface expression of MHC I, MHCII, CD40 and CD80 in peripheral dendritic cells was significantly higher in the curcumin solid lipid nanoparticles than in free curcumin. Results show that solid lipid nanoparticles loaded with curcumin effectively stimulate and activate dendritic cells, supporting immune cell activation outside the tumor microenvironment. The proposed pain-free self-administration strategies will lead to increased patient compliance.