Xin Gu, Jing An, Mingxue Zhang, Hongyan Zhang, Zhan Lou, Bu Wang
Background: Escitalopram oxalate (ESC) was extensively reported to improve insomnia in patients with depression/anxiety. The serotonin transporter gene (SLC6A4) was involved in regulating insomnia. However, it is still unclear whether ESC improves insomnia by regulating SLC6A4 expression. Therefore, this study aims to investigate whether ESC improves insomnia by regulating SLC6A4 based on clinical and animal experiments.
Methods: The clinical and animal experiments were involved in this study. For clinical experiments, after all 110 participants were divided into four groups, the portable sleep electroencephalogram monitor, HAMA14 scale, and HAMD24 scale were used to evaluate patients' sleep quality, anxiety, and depression. For animal experiments, after all 18 ICR male mice were randomly divided into three groups (n = 6), the sodium pentobarbital-induced sleeping test, locomotor activity test, elevated plus maze, and open field test were used to evaluate mice's sleep quality and anxiety- and depression-like behaviors. The H&E staining was used to determine pathological injuries in mice's hippocampal tissues. The ELISA kits were adopted to detect the 5-HT, NE, GABA, and Glu levels in the hypothalamus tissue and the CRH, ACTH, and CORT levels in the serum. The PubChem, DrugBank, and Therapeutic Target Database were employed to predict the potential targets of ESC. The IHC staining and Western blot were applied to assay the SLC6A4, 5-HTR1A, and 5-HTR2A expression levels in the hippocampal tissues of mice.
Results: ESC shortened the sleep latency, extended the sleep time, enhanced the sleep efficiency, and improved anxiety and depression in patients and mice. ESC mitigated the pathological injuries in mice's hippocampal tissues. ESC effectively regulated mice's neurotransmitter levels and HPA axis homeostasis, including up-regulating 5-HT and GABA, and down-regulating NE, Glu, CRH, ACTH, and CORT. Moreover, SLC6A4 was predicted as the potential target of ESC. ESC prominently inhibited SLC6A4 expression (P < 0.001) and regulated 5-HTR1A and 5-HTR2A expression (P < 0.001) in hippocampal tissues.
Conclusion: Taken together, ESC was suitable for treating insomnia in the clinic and improved insomnia by targeting SLC6A4 to regulate the HPA axis in mice.
{"title":"Escitalopram oxalate improved insomnia by targeting SLC6A4 to regulate the hypothalamic-pituitary-adrenal axis.","authors":"Xin Gu, Jing An, Mingxue Zhang, Hongyan Zhang, Zhan Lou, Bu Wang","doi":"10.1159/000550304","DOIUrl":"https://doi.org/10.1159/000550304","url":null,"abstract":"<p><strong>Background: </strong>Escitalopram oxalate (ESC) was extensively reported to improve insomnia in patients with depression/anxiety. The serotonin transporter gene (SLC6A4) was involved in regulating insomnia. However, it is still unclear whether ESC improves insomnia by regulating SLC6A4 expression. Therefore, this study aims to investigate whether ESC improves insomnia by regulating SLC6A4 based on clinical and animal experiments.</p><p><strong>Methods: </strong>The clinical and animal experiments were involved in this study. For clinical experiments, after all 110 participants were divided into four groups, the portable sleep electroencephalogram monitor, HAMA14 scale, and HAMD24 scale were used to evaluate patients' sleep quality, anxiety, and depression. For animal experiments, after all 18 ICR male mice were randomly divided into three groups (n = 6), the sodium pentobarbital-induced sleeping test, locomotor activity test, elevated plus maze, and open field test were used to evaluate mice's sleep quality and anxiety- and depression-like behaviors. The H&E staining was used to determine pathological injuries in mice's hippocampal tissues. The ELISA kits were adopted to detect the 5-HT, NE, GABA, and Glu levels in the hypothalamus tissue and the CRH, ACTH, and CORT levels in the serum. The PubChem, DrugBank, and Therapeutic Target Database were employed to predict the potential targets of ESC. The IHC staining and Western blot were applied to assay the SLC6A4, 5-HTR1A, and 5-HTR2A expression levels in the hippocampal tissues of mice.</p><p><strong>Results: </strong>ESC shortened the sleep latency, extended the sleep time, enhanced the sleep efficiency, and improved anxiety and depression in patients and mice. ESC mitigated the pathological injuries in mice's hippocampal tissues. ESC effectively regulated mice's neurotransmitter levels and HPA axis homeostasis, including up-regulating 5-HT and GABA, and down-regulating NE, Glu, CRH, ACTH, and CORT. Moreover, SLC6A4 was predicted as the potential target of ESC. ESC prominently inhibited SLC6A4 expression (P < 0.001) and regulated 5-HTR1A and 5-HTR2A expression (P < 0.001) in hippocampal tissues.</p><p><strong>Conclusion: </strong>Taken together, ESC was suitable for treating insomnia in the clinic and improved insomnia by targeting SLC6A4 to regulate the HPA axis in mice.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-20"},"PeriodicalIF":3.2,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Livia Ramos Santiago, Estéfani Alves Asevedo, Moon Nyeo Park, Trina E Tallei, Rosy Iara Maciel de Azambuja Ribeiro, Sang-Won Shin, Bonglee Kim
innovative therapeutic strategies beyond conventional treatments. The increasing interest in natural and synthetic antiproliferative compounds is driven by their ability to target oncogenic pathways implicated in tumor progression, metastasis, and drug resistance. This review explores the potential of bioactive phytochemicals and molecularly targeted therapies, particularly EGFR inhibitors, in modulating cancer cell survival, proliferation, and immune evasion. A central focus is placed on the PI3Ks/AKT, JAK/STAT, and MEK/ ERK signaling pathways, which are frequently dysregulated in therapy-resistant cancers, particularly HNC.
{"title":"Phytochemicals as Emerging Antiproliferative Agents in Head and Neck Cancer: Molecular Mechanisms and Therapeutic Strategies.","authors":"Livia Ramos Santiago, Estéfani Alves Asevedo, Moon Nyeo Park, Trina E Tallei, Rosy Iara Maciel de Azambuja Ribeiro, Sang-Won Shin, Bonglee Kim","doi":"10.1159/000550172","DOIUrl":"https://doi.org/10.1159/000550172","url":null,"abstract":"<p><p>innovative therapeutic strategies beyond conventional treatments. The increasing interest in natural and synthetic antiproliferative compounds is driven by their ability to target oncogenic pathways implicated in tumor progression, metastasis, and drug resistance. This review explores the potential of bioactive phytochemicals and molecularly targeted therapies, particularly EGFR inhibitors, in modulating cancer cell survival, proliferation, and immune evasion. A central focus is placed on the PI3Ks/AKT, JAK/STAT, and MEK/ ERK signaling pathways, which are frequently dysregulated in therapy-resistant cancers, particularly HNC.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-38"},"PeriodicalIF":3.2,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Proton pump inhibitor (PPI) monotherapy is standard for artificial ulcer healing after gastric endoscopic submucosal dissection (ESD), but evidence on the efficacy of PPI combined with gastric mucosal protectants remains inconclusive.
Aim: To compare the efficacy of 10 mucosal protectants combined with PPIs through a network meta-analysis (NMA).
Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov until January 2025. Included were 20 randomized controlled trials (RCTs, n=2000) comparing PPI monotherapy versus PPI combined with protectants (e.g., rebamipide, ecabet, polaprezinc) or active controls. Primary outcomes included ulcer area reduction, healing rates (4/8 weeks), longest ulcer diameter, and bleeding risk. Frequentist random-effects models synthesized risk ratios and mean differences with 95% CIs. Consistency was evaluated using design-by-treatment interaction and node splitting. Risk of bias (RoB 2.0) was assessed at the outcome level. Certainty of evidence was graded with GRADE.
Results: Bismuth subcitrate-magnesium granules (BMG) + PPI most effectively reduced 4-week ulcer area (mean difference [MD]: -62.50 mm², 95% CI: -87.25 to -37.75 vs. PPI; SUCRA=94%). Ecabet sodium (EB) + PPI achieved the highest 8-week healing rate (risk ratio [RR]: 7.71, 95% CI: 5.52--9.91). Hydrotalcite (HT) + PPI best reduced ulcer diameter (MD: -1.87 mm), while teprenone (TN) + PPI optimally prevented bleeding (RR: -3.41, 95% CI: -5.43 to -1.38). Rebamipide + PPI showed efficacy heterogeneity, particularly in large ulcers (>40 mm).
Conclusions: PPI-based combinations likely accelerate healing versus PPI alone, but conclusions are hypothesis-generating given indirect evidence and regional concentration of trials. Combination therapy outperforms PPI monotherapy. BMG+PPI is optimal for early ulcer healing, EB+PPI for long-term healing, HT+PPI for diameter reduction, and TN+PPI for bleeding prevention. Stratified regimens by ulcer characteristics are recommended.
{"title":"A Network Meta-Analysis of Pharmacological Treatments for Gastric Mucosal Protection in Artificial Ulcers Following Endoscopic Submucosal Dissection (ESD) of the Stomach.","authors":"Zhiqun Chen, Sanhui Zhan, Haiyang Yu","doi":"10.1159/000550164","DOIUrl":"https://doi.org/10.1159/000550164","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitor (PPI) monotherapy is standard for artificial ulcer healing after gastric endoscopic submucosal dissection (ESD), but evidence on the efficacy of PPI combined with gastric mucosal protectants remains inconclusive.</p><p><strong>Aim: </strong>To compare the efficacy of 10 mucosal protectants combined with PPIs through a network meta-analysis (NMA).</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov until January 2025. Included were 20 randomized controlled trials (RCTs, n=2000) comparing PPI monotherapy versus PPI combined with protectants (e.g., rebamipide, ecabet, polaprezinc) or active controls. Primary outcomes included ulcer area reduction, healing rates (4/8 weeks), longest ulcer diameter, and bleeding risk. Frequentist random-effects models synthesized risk ratios and mean differences with 95% CIs. Consistency was evaluated using design-by-treatment interaction and node splitting. Risk of bias (RoB 2.0) was assessed at the outcome level. Certainty of evidence was graded with GRADE.</p><p><strong>Results: </strong>Bismuth subcitrate-magnesium granules (BMG) + PPI most effectively reduced 4-week ulcer area (mean difference [MD]: -62.50 mm², 95% CI: -87.25 to -37.75 vs. PPI; SUCRA=94%). Ecabet sodium (EB) + PPI achieved the highest 8-week healing rate (risk ratio [RR]: 7.71, 95% CI: 5.52--9.91). Hydrotalcite (HT) + PPI best reduced ulcer diameter (MD: -1.87 mm), while teprenone (TN) + PPI optimally prevented bleeding (RR: -3.41, 95% CI: -5.43 to -1.38). Rebamipide + PPI showed efficacy heterogeneity, particularly in large ulcers (>40 mm).</p><p><strong>Conclusions: </strong>PPI-based combinations likely accelerate healing versus PPI alone, but conclusions are hypothesis-generating given indirect evidence and regional concentration of trials. Combination therapy outperforms PPI monotherapy. BMG+PPI is optimal for early ulcer healing, EB+PPI for long-term healing, HT+PPI for diameter reduction, and TN+PPI for bleeding prevention. Stratified regimens by ulcer characteristics are recommended.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-19"},"PeriodicalIF":3.2,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adriána Papiež, Pavel Suk, Radka Baránková, Pavlína Hančlová, Vladimír Šrámek, Klára Odehnalová
Introduction: The administration of medication through feeding tubes (FT) represents a critical aspect of routine nursing practice. Although guidelines recommend the separate administration of medications to minimize potential interactions, it is common practice in the clinical settings for medications to be combined and administered simultaneously. Since there is a lack of data on this topic, this study assesses the stability of drugs crushed and mixed in water solution concurrently for administration through FT.
Methods: The drug compatibility was evaluated in vitro by monitoring the changes in drug content in water solution over time and identifying potential degradation products using a high-performance liquid chromatography system.
Results: The majority of drugs (acetylsalicylic acid, clopidogrel, atorvastatin, furosemide, and prasugrel) maintained their stability during the entire preparation process. The only medication that showed degradation over time was pantoprazole (especially when combined with acetylsalicylic acid and clopidogrel), which was attributed to the acidic environment. The remaining drugs (acetylsalicylic acid, clopidogrel, atorvastatin, furosemide, and prasugrel) maintained their stability during the entire preparation process.
Conclusion: This study proves that most drugs can be prepared and administered simultaneously, with the exception of acid-labile drugs, which undergo significant degradation in acidic solutions.
{"title":"The stability of drugs commonly used in intensive care units co-administered via feeding tube and its dependence on pH: An in vitro study.","authors":"Adriána Papiež, Pavel Suk, Radka Baránková, Pavlína Hančlová, Vladimír Šrámek, Klára Odehnalová","doi":"10.1159/000550187","DOIUrl":"https://doi.org/10.1159/000550187","url":null,"abstract":"<p><strong>Introduction: </strong>The administration of medication through feeding tubes (FT) represents a critical aspect of routine nursing practice. Although guidelines recommend the separate administration of medications to minimize potential interactions, it is common practice in the clinical settings for medications to be combined and administered simultaneously. Since there is a lack of data on this topic, this study assesses the stability of drugs crushed and mixed in water solution concurrently for administration through FT.</p><p><strong>Methods: </strong>The drug compatibility was evaluated in vitro by monitoring the changes in drug content in water solution over time and identifying potential degradation products using a high-performance liquid chromatography system.</p><p><strong>Results: </strong>The majority of drugs (acetylsalicylic acid, clopidogrel, atorvastatin, furosemide, and prasugrel) maintained their stability during the entire preparation process. The only medication that showed degradation over time was pantoprazole (especially when combined with acetylsalicylic acid and clopidogrel), which was attributed to the acidic environment. The remaining drugs (acetylsalicylic acid, clopidogrel, atorvastatin, furosemide, and prasugrel) maintained their stability during the entire preparation process.</p><p><strong>Conclusion: </strong>This study proves that most drugs can be prepared and administered simultaneously, with the exception of acid-labile drugs, which undergo significant degradation in acidic solutions.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle V Green, Jessie L Reed, Cameron D Zielinski, Jeffrey D Neighbors
Introduction: High-risk neuroblastoma is a difficult to treat cancer with high rates of recurrence and treatment resistance, likely driven by a population of cancer stem cells. Multiple previous studies have suggested that the use of mevalonate pathway inhibitors, such as statins and bisphosphonates, may have anticancer activity against high-risk tumors.
Methods: We aimed to observe the use of mevalonate pathway inhibitors against the cancer stem cell population of high-risk neuroblastoma cell lines SH-SY5Y, SK-N-AS, and SK-N-BE(2)-C using spheroid-based assays.
Results: We observed significant reductions in spheroid formation capability, stem cell frequency, and stemness properties of these neuroblastoma cancer stem cells with fluvastatin and zoledronate treatment.
Conclusion: Treatment with mevalonate pathway inhibitors leads to reduced neuroblastoma cancer stem cell function through reductions in protein geranylgeranylation.
{"title":"Inhibition of the Mevalonate Pathway Targets Neuroblastoma Stem Cells.","authors":"Michelle V Green, Jessie L Reed, Cameron D Zielinski, Jeffrey D Neighbors","doi":"10.1159/000549949","DOIUrl":"https://doi.org/10.1159/000549949","url":null,"abstract":"<p><strong>Introduction: </strong>High-risk neuroblastoma is a difficult to treat cancer with high rates of recurrence and treatment resistance, likely driven by a population of cancer stem cells. Multiple previous studies have suggested that the use of mevalonate pathway inhibitors, such as statins and bisphosphonates, may have anticancer activity against high-risk tumors.</p><p><strong>Methods: </strong>We aimed to observe the use of mevalonate pathway inhibitors against the cancer stem cell population of high-risk neuroblastoma cell lines SH-SY5Y, SK-N-AS, and SK-N-BE(2)-C using spheroid-based assays.</p><p><strong>Results: </strong>We observed significant reductions in spheroid formation capability, stem cell frequency, and stemness properties of these neuroblastoma cancer stem cells with fluvastatin and zoledronate treatment.</p><p><strong>Conclusion: </strong>Treatment with mevalonate pathway inhibitors leads to reduced neuroblastoma cancer stem cell function through reductions in protein geranylgeranylation.</p><p><strong>Key words: </strong>neuroblastoma, mevalonate, statin, bisphosphonate, spheroids, spheres, cancer stem cells.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-28"},"PeriodicalIF":3.2,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article "Tanshinone IIA Affects Autophagy and Apoptosis of Glioma Cells by Inhibiting Phosphatidylinositol 3-Kinase/Akt/Mammalian Target of Rapamycin Signaling Pathway" [Pharmacology. 2017;99(3-4):188-195. https://doi.org/10.1159/000452340] by Lijuan Ding, Shudong Wang, Weiyao Wang, Peng Lv, Donghai Zhao, Feier Chen, Tianjiao Meng, Lihua Dong and Ling Qi has been retracted by the Publisher and the Editor.After the publication of this article, concerns were raised about the integrity of some of the data presented. Specifically, similar features appear between the two panels "FITC-A 740 Y-P" and "FITC-A Mixed" in Figure 3b of the article. In addition, panels in Figure 3b of this article are the same as panels in Figure 3 of another article by different authors, published subsequently in a different journal [1], specifically:Figure 3b panel "FITC-A Tan IIA" is the same as Figure 3c of [1].Figure 3b panel "FITC-A 740 Y-P" is the same as Figure 3a of [1].Figure 3b panel "FITC-A Mixed" is the same as Figure 3b of [1].The authors did not respond to requests to comment on the concerns and provide the raw data within the given timeframe despite multiple attempts of contact. We contacted the authors' institution to request an investigation. However, we did not receive a response. Given the severity of the concerns raised, this article is being retracted. The authors have not responded to our correspondence regarding this retraction despite multiple attempts of contact.
{"title":"Retraction Statement.","authors":"","doi":"10.1159/000549042","DOIUrl":"10.1159/000549042","url":null,"abstract":"<p><p>The article \"Tanshinone IIA Affects Autophagy and Apoptosis of Glioma Cells by Inhibiting Phosphatidylinositol 3-Kinase/Akt/Mammalian Target of Rapamycin Signaling Pathway\" [Pharmacology. 2017;99(3-4):188-195. https://doi.org/10.1159/000452340] by Lijuan Ding, Shudong Wang, Weiyao Wang, Peng Lv, Donghai Zhao, Feier Chen, Tianjiao Meng, Lihua Dong and Ling Qi has been retracted by the Publisher and the Editor.After the publication of this article, concerns were raised about the integrity of some of the data presented. Specifically, similar features appear between the two panels \"FITC-A 740 Y-P\" and \"FITC-A Mixed\" in Figure 3b of the article. In addition, panels in Figure 3b of this article are the same as panels in Figure 3 of another article by different authors, published subsequently in a different journal [1], specifically:Figure 3b panel \"FITC-A Tan IIA\" is the same as Figure 3c of [1].Figure 3b panel \"FITC-A 740 Y-P\" is the same as Figure 3a of [1].Figure 3b panel \"FITC-A Mixed\" is the same as Figure 3b of [1].The authors did not respond to requests to comment on the concerns and provide the raw data within the given timeframe despite multiple attempts of contact. We contacted the authors' institution to request an investigation. However, we did not receive a response. Given the severity of the concerns raised, this article is being retracted. The authors have not responded to our correspondence regarding this retraction despite multiple attempts of contact.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1"},"PeriodicalIF":3.2,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Colorectal cancer (CRC) is one of the most common malignancies worldwide, and the liver is its main site of distant metastasis. Colorectal cancer liver metastasis (CRLM) is a major cause of CRC-related death. Current treatments, including surgery, chemotherapy, and immunotherapy, have limited efficacy and often cause substantial side effects.
Summary: This review examines the emerging role of traditional Chinese medicine (TCM) in managing CRLM, focusing on its ability to modulate the tumor microenvironment (TME) by inhibiting epithelial-mesenchymal transition, suppressing angiogenesis, and reversing immune evasion. TCM provides a holistic, multi-targeted approach, but most supporting evidence comes from preclinical studies in cell and animal models, with limited clinical validation.
Key messages: TCM shows promise for targeting the CRLM-related TME. Most evidence is preclinical; well-designed clinical trials are urgently needed. Standardization, pharmacokinetics, and regulatory issues remain major barriers to clinical application.
背景:结直肠癌(CRC)是一种主要的全球恶性肿瘤,肝脏是远处转移的主要部位。结直肠癌肝转移(CRLM)是结直肠癌患者死亡的主要原因。新出现的证据强调了CRLM机制的复杂性,其中肿瘤微环境(TME)在驱动转移和培养治疗耐药性中起着核心作用。目前的西方医学策略(化疗、靶向治疗、免疫治疗、手术)对疾病的控制有限,往往伴有不良反应,缺乏针对CRLM的有效的特异性药物干预。摘要:本文系统地评价了中医在整体和辨证原则指导下治疗CRLM的潜力。通过对PubMed、Web of Science、Embase、CNKI和万方数据库的文献分析,我们发现中药干预措施(方剂、中药对、植物化学物质)通过多种机制调节TME来发挥治疗作用。这些包括抑制细胞外基质(ECM)重塑,抑制缺氧诱导的血管生成和逆转免疫逃避。关键信息:中药对CRLM具有独特的多组分、多靶点、多途径优势,具有很好的互补策略。未来的高质量研究,特别是精心设计的临床试验,对于验证疗效,进一步了解机制,并将中医药的潜力转化为对CRLM患者有临床意义的益处至关重要。
{"title":"Traditional Chinese Medicine in the Management of Colorectal Cancer Liver Metastasis: Mechanisms, Challenges, and Perspectives.","authors":"Nan Li, Likun Liu, Xixing Wang, Shulan Hao","doi":"10.1159/000549133","DOIUrl":"10.1159/000549133","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is one of the most common malignancies worldwide, and the liver is its main site of distant metastasis. Colorectal cancer liver metastasis (CRLM) is a major cause of CRC-related death. Current treatments, including surgery, chemotherapy, and immunotherapy, have limited efficacy and often cause substantial side effects.</p><p><strong>Summary: </strong>This review examines the emerging role of traditional Chinese medicine (TCM) in managing CRLM, focusing on its ability to modulate the tumor microenvironment (TME) by inhibiting epithelial-mesenchymal transition, suppressing angiogenesis, and reversing immune evasion. TCM provides a holistic, multi-targeted approach, but most supporting evidence comes from preclinical studies in cell and animal models, with limited clinical validation.</p><p><strong>Key messages: </strong>TCM shows promise for targeting the CRLM-related TME. Most evidence is preclinical; well-designed clinical trials are urgently needed. Standardization, pharmacokinetics, and regulatory issues remain major barriers to clinical application.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-17"},"PeriodicalIF":3.2,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to unveil the impact of optimal pulse technology (OPT) combined with tobramycin and dexamethasone eye ointment on the ocular surface disease index (OSDI) and related outcomes in patients with blepharokeratoconjunctivitis (BKC).
Methods: Ninety-six BKC patients treated at our hospital from September 2022 to September 2023 were divided into a control group (n = 48) and an observation group (n = 48) by a random number table. Both groups received fluorometholone and sodium hyaluronate eye drops. The control group additionally applied tobramycin and dexamethasone eye ointment to the lid margin twice daily, while the observation group underwent OPT on this basis. The clinical efficacy and safety, OSDI, conjunctival hyperemia score, lid margin alteration score, meibomian gland yield secretory score (MGYSS), Demodex mite count, and tear break-up time (TBUT) were compared between the two groups before treatment and at 4 and 8 weeks post-treatment. Additionally, the National Eye Institute Visual Function Questionnaire-25 (NEIVFQ-25) scores were assessed before and after treatment.
Results: The total effective rate in the observation group was 100.00% (48/48) at 8 weeks post-treatment, higher than 89.58% (43/48) in the control group (P < 0.05). The OSDI, conjunctival hyperemia score, lid margin alteration scores, MGYSS, and Demodex mite count all decreased in both groups at 4 and 8 weeks post-treatment compared to baseline, with greater improvements in the observation group(P < 0.05). TBUT and NEIVFQ-25 scores increased in both groups at 8 weeks post-treatment compared to baseline, with the observation group achieving better outcomes than the control group (P < 0.05).
Conclusion: The addition of OPT to standard therapy for BKC is safe and provides superior short-term efficacy. It can alleviate lid margin inflammation, improve ocular surface symptoms, and enhance visual-related quality of life.
{"title":"Optimal pulse technology combined with tobramycin and dexamethasone eye ointment in the treatment of blepharokeratoconjunctivitis: an impact on ocular surface disease index.","authors":"Jing Yuan, Biyue Tu, Zhen Zhao, Yanxia Tong","doi":"10.1159/000548649","DOIUrl":"https://doi.org/10.1159/000548649","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to unveil the impact of optimal pulse technology (OPT) combined with tobramycin and dexamethasone eye ointment on the ocular surface disease index (OSDI) and related outcomes in patients with blepharokeratoconjunctivitis (BKC).</p><p><strong>Methods: </strong>Ninety-six BKC patients treated at our hospital from September 2022 to September 2023 were divided into a control group (n = 48) and an observation group (n = 48) by a random number table. Both groups received fluorometholone and sodium hyaluronate eye drops. The control group additionally applied tobramycin and dexamethasone eye ointment to the lid margin twice daily, while the observation group underwent OPT on this basis. The clinical efficacy and safety, OSDI, conjunctival hyperemia score, lid margin alteration score, meibomian gland yield secretory score (MGYSS), Demodex mite count, and tear break-up time (TBUT) were compared between the two groups before treatment and at 4 and 8 weeks post-treatment. Additionally, the National Eye Institute Visual Function Questionnaire-25 (NEIVFQ-25) scores were assessed before and after treatment.</p><p><strong>Results: </strong>The total effective rate in the observation group was 100.00% (48/48) at 8 weeks post-treatment, higher than 89.58% (43/48) in the control group (P < 0.05). The OSDI, conjunctival hyperemia score, lid margin alteration scores, MGYSS, and Demodex mite count all decreased in both groups at 4 and 8 weeks post-treatment compared to baseline, with greater improvements in the observation group(P < 0.05). TBUT and NEIVFQ-25 scores increased in both groups at 8 weeks post-treatment compared to baseline, with the observation group achieving better outcomes than the control group (P < 0.05).</p><p><strong>Conclusion: </strong>The addition of OPT to standard therapy for BKC is safe and provides superior short-term efficacy. It can alleviate lid margin inflammation, improve ocular surface symptoms, and enhance visual-related quality of life.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-17"},"PeriodicalIF":3.2,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Alpha-linolenic acid (ALA) is a well-known n-3 polyunsaturated fatty acid. Our previous study showed that ALA inhibits coronary contractions induced by U46619 (a thromboxane A2 analog) and prostaglandin F2α (PGF2α) in pigs by antagonizing prostanoid TP receptors. In this study, we investigated the inhibitory effects of ALA on pig basilar artery contractions and explored the underlying mechanisms.
Methods: The effects of ALA on contractions of pig basilar arteries were assessed. The effects of K+ channel inhibitors on ALA-mediated attenuation were also evaluated.
Results: ALA inhibited TP receptor-mediated contractions induced by U46619 and PGF2α in a concentration-dependent manner. It shifted the U46619 concentration-response curve to the right and reduced the maximal contraction. The slope of the regression line in the Schild plot analysis exceeded unity, although the difference was not statistically significant. ALA also inhibited PGF2α-induced contractions (in the presence of SQ 29,548, a TP receptor antagonist) and endothelin-1-induced contractions, without affecting those induced by high-KCl. Among the tested K+ channel inhibitors, Ba2+, an inhibitor of inwardly rectifying K+ (Kir) channels, most potently attenuated ALA's inhibitory effect on PGF2α-induced contractions in the presence of SQ 29,548.
Conclusion: These findings indicate that ALA potently inhibits contractions induced by potentially spasmogenic substances in the pig cerebral artery. The inhibitory mechanisms likely involve both antagonism of prostanoid TP receptors and activation of Kir channels.
{"title":"Alpha-Linolenic Acid Inhibits Contraction of Pig Basilar Arteries through Prostanoid TP Receptor Antagonistic Action and Activation of K<sub>ir</sub> Channels.","authors":"Kento Yoshioka, Haruki Kimura, Keigo Osa, Ayu Kato, Sakika Ichihara, Yuka Saito, Daichi Ito, Ikuya Kogure, Keisuke Obara, Yoshio Tanaka","doi":"10.1159/000548780","DOIUrl":"10.1159/000548780","url":null,"abstract":"<p><strong>Introduction: </strong>Alpha-linolenic acid (ALA) is a well-known n-3 polyunsaturated fatty acid. Our previous study showed that ALA inhibits coronary contractions induced by U46619 (a thromboxane A<sub>2</sub> analog) and prostaglandin F<sub>2α</sub> (PGF<sub>2α</sub>) in pigs by antagonizing prostanoid TP receptors. In this study, we investigated the inhibitory effects of ALA on pig basilar artery contractions and explored the underlying mechanisms.</p><p><strong>Methods: </strong>The effects of ALA on contractions of pig basilar arteries were assessed. The effects of K+ channel inhibitors on ALA-mediated attenuation were also evaluated.</p><p><strong>Results: </strong>ALA inhibited TP receptor-mediated contractions induced by U46619 and PGF<sub>2α</sub> in a concentration-dependent manner. It shifted the U46619 concentration-response curve to the right and reduced the maximal contraction. The slope of the regression line in the Schild plot analysis exceeded unity, although the difference was not statistically significant. ALA also inhibited PGF<sub>2α</sub>-induced contractions (in the presence of SQ 29,548, a TP receptor antagonist) and endothelin-1-induced contractions, without affecting those induced by high-KCl. Among the tested K+ channel inhibitors, Ba2+, an inhibitor of inwardly rectifying K+ (K<sub>ir</sub>) channels, most potently attenuated ALA's inhibitory effect on PGF<sub>2α</sub>-induced contractions in the presence of SQ 29,548.</p><p><strong>Conclusion: </strong>These findings indicate that ALA potently inhibits contractions induced by potentially spasmogenic substances in the pig cerebral artery. The inhibitory mechanisms likely involve both antagonism of prostanoid TP receptors and activation of K<sub>ir</sub> channels.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Muscular dystrophy (MD) refers to a group of genetic disorders leading to progressive weakness and degeneration of skeletal muscle. Among them, Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are the most common types. Histone deacetylase inhibitors (i.e., givinostat) is a recently approved therapy for DMD. In this systematic review, we aimed to evaluate givinostat in MD patients regarding safety and efficacy.
Methods: A systematic review was performed according to the PRISMA guidelines by searching through Medline, Embase, Cochrane Library, and Web of Science. Only randomized control trials comparing givinostat vs. placebo or other therapies are included. The primary outcomes were motor function alteration and histopathologic muscle changes and the secondary outcomes were the adverse reactions.
Results: A total of 188 records were identified, and after screening, two clinical trials met the inclusion criteria. In DMD patients, givinostat significantly slowed disease progression, improving four-stair climb times (p = 0.037) and reducing muscle fat infiltration. In BMD patients, fibrosis progression was not significantly different (p = 0.8282), but MRI showed reduced muscle fat replacement. Common adverse events included diarrhoea, thrombocytopenia, and hypertriglyceridemia, leading to dose reductions, though no new safety signals or treatment-related deaths were observed.
Conclusion: Givinostat seems to be effective in slowing disease progression in DMD but has little benefit in BMD. Its safety profile requires rigorous monitoring. Efficacy difference might be explained by the pathophysiology of the disease and the progression rate. Larger and longer follow-up trials are warranted to confirm longer term benefits and to optimize dosing strategies. Givinostat offers potential as a disease-modifying therapy for DMD but requires further investigation to establish its role in BMD.
简介:肌营养不良症(MD)是指一组导致骨骼肌进行性无力和变性的遗传性疾病。其中,杜氏肌营养不良症(DMD)和贝克尔肌营养不良症(BMD)是最常见的类型。组蛋白去乙酰化酶(HDAC)抑制剂Givinostat)是最近批准的治疗DMD的药物。在这篇系统综述中,我们旨在评估吉维诺他在MD患者中的安全性和有效性。方法:根据PRISMA指南,检索Medline、Embase、Cochrane Library和Web of Science进行系统评价。仅包括比较吉维司他与安慰剂或其他治疗的随机对照试验。主要结果是运动功能改变和组织病理学肌肉改变,次要结果是不良反应。结果:共纳入188份文献,经筛选,有2项临床试验符合纳入标准。在DMD患者中,Givinostat显著减缓疾病进展,改善4次爬楼梯次数(p=0.037),减少肌肉脂肪浸润。在BMD患者中,纤维化进展无显著差异(p=0.8282),但MRI显示肌肉脂肪替代减少。常见的不良事件包括腹泻、血小板减少和高甘油三酯血症,导致剂量减少,但没有观察到新的安全性信号或治疗相关死亡。讨论:吉维司他似乎在减缓DMD的疾病进展方面有效,但在BMD方面几乎没有益处。它的安全状况需要严格监控。疗效差异可能与疾病的病理生理及进展速度有关。有必要进行更大规模和更长时间的随访试验,以确认长期益处并优化给药策略。结论:吉维司他作为一种潜在的DMD疾病改善疗法,但需要进一步研究以确定其在BMD中的作用。
{"title":"Safety and Efficacy of Givinostat for Patients with Muscular Dystrophy: A Systematic Review.","authors":"Prasanjit Das, Bisweswar Ojha, Alapan Das, Bhairav Kumar Pathak, Kaushik Mukhopadhyay","doi":"10.1159/000547936","DOIUrl":"10.1159/000547936","url":null,"abstract":"<p><strong>Introduction: </strong>Muscular dystrophy (MD) refers to a group of genetic disorders leading to progressive weakness and degeneration of skeletal muscle. Among them, Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are the most common types. Histone deacetylase inhibitors (i.e., givinostat) is a recently approved therapy for DMD. In this systematic review, we aimed to evaluate givinostat in MD patients regarding safety and efficacy.</p><p><strong>Methods: </strong>A systematic review was performed according to the PRISMA guidelines by searching through Medline, Embase, Cochrane Library, and Web of Science. Only randomized control trials comparing givinostat vs. placebo or other therapies are included. The primary outcomes were motor function alteration and histopathologic muscle changes and the secondary outcomes were the adverse reactions.</p><p><strong>Results: </strong>A total of 188 records were identified, and after screening, two clinical trials met the inclusion criteria. In DMD patients, givinostat significantly slowed disease progression, improving four-stair climb times (p = 0.037) and reducing muscle fat infiltration. In BMD patients, fibrosis progression was not significantly different (p = 0.8282), but MRI showed reduced muscle fat replacement. Common adverse events included diarrhoea, thrombocytopenia, and hypertriglyceridemia, leading to dose reductions, though no new safety signals or treatment-related deaths were observed.</p><p><strong>Conclusion: </strong>Givinostat seems to be effective in slowing disease progression in DMD but has little benefit in BMD. Its safety profile requires rigorous monitoring. Efficacy difference might be explained by the pathophysiology of the disease and the progression rate. Larger and longer follow-up trials are warranted to confirm longer term benefits and to optimize dosing strategies. Givinostat offers potential as a disease-modifying therapy for DMD but requires further investigation to establish its role in BMD.</p>","PeriodicalId":20209,"journal":{"name":"Pharmacology","volume":" ","pages":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}