Pub Date : 2020-01-01DOI: 10.2174/1872213X14666200204103714
Ronald C M Fung, Kam L Hon, Alexander K C Leung
Background: Pediatric myocarditis is rare but challenging. This overview summarized the current knowledge and recent patents on childhood myocarditis.
Methods: Clinical queries and keywords of "myocarditis" and "childhood" were used as search engine.
Results: Viral infections are the most common causes of acute myocarditis. Affected children often have a prodrome of fever, malaise, and myalgia. Clinical manifestations of acute myocarditis in children can be nonspecific. Some children may present with easy fatigability, poor appetite, vomiting, abdominal pain, exercise intolerance, respiratory distress/tachypnea, dyspnea at rest, orthopnea, chronic cough with wheezing, chest pain, unexplained tachycardia, hypotension, syncope, and hepatomegaly. Supraventricular arrhythmias, ventricular arrhythmias, and heart block may be present. A subset of patients have fulminant myocarditis and present with cardiovascular collapse, which may progress to severe cardiogenic shock, and even death. A high index of suspicion is crucial to its diagnosis and timely management. Cardiac magnetic resonance imaging is important in aiding clinical diagnosis while, endomyocardial biopsy remains the gold standard. The treatment consists of supportive therapy, ranging from supplemental oxygen and fluid restriction to mechanical circulatory support. Angiotensinconverting enzyme inhibitors, angio-tensin II receptor blockers, β-blockers, and aldosterone antagonists might be used for the treatment of heart failure while, immunosuppression treatments remain controversial. There are a few recent patents targeting prevention or treatment of viral myocarditis, including an immunogenic composition comprising a PCV-2 antigen, glutathione-S-transferase P1, neuregulins, NF-[kappa] B inhibitor, a pharmaceutical composition which contains 2-amino-2- (2- (4-octyl phenyl) - ethyl) propane 1,3-diol, a composition containing pycnojenol, Chinese herbal concoctions, and a Korean oral rapamycin. Evidence of their efficacy is still lacking.
Conclusion: This article reviews the current literature regarding etiology, clinical manifestations, diagnosis, and management of acute myocarditis in children.
背景:小儿心肌炎是一种罕见但具有挑战性的疾病。本文综述了目前关于儿童心肌炎的知识和最新专利。方法:以“心肌炎”、“儿童期”的临床查询及关键词为搜索引擎。结果:病毒性感染是急性心肌炎最常见的病因。患病儿童通常有发热、不适和肌痛的前驱症状。儿童急性心肌炎的临床表现可以是非特异性的。部分患儿可表现为易疲劳、食欲不振、呕吐、腹痛、运动不耐受、呼吸窘迫/呼吸急促、休息时呼吸困难、矫形呼吸、慢性咳嗽伴喘息、胸痛、不明原因的心动过速、低血压、晕厥和肝肿大。可能出现室上性心律失常、室性心律失常和心脏传导阻滞。一部分患者有暴发性心肌炎并表现为心血管衰竭,这可能发展为严重的心源性休克,甚至死亡。高怀疑指数对其诊断和及时治疗至关重要。心脏磁共振成像在辅助临床诊断中很重要,而心内膜活检仍然是金标准。治疗包括支持治疗,从补充氧气和液体限制到机械循环支持。血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、β阻滞剂和醛固酮拮抗剂可用于治疗心力衰竭,而免疫抑制治疗仍有争议。最近有一些针对预防或治疗病毒性心肌炎的专利,包括一种含有PCV-2抗原、谷胱甘肽- s -转移酶P1、神经调节蛋白、NF-[kappa] B抑制剂的免疫原性组合物,一种含有2-氨基-2-(2-(4-辛基苯基)-乙基)丙烷1,3-二醇的药物组合物,一种含有吡诺酚的组合物,中草药混合物,以及一种韩国口服雷帕霉素。目前仍缺乏其有效性的证据。结论:本文综述了儿童急性心肌炎的病因、临床表现、诊断和治疗方面的文献。
{"title":"Acute Myocarditis in Children: An Overview of Treatment and Recent Patents.","authors":"Ronald C M Fung, Kam L Hon, Alexander K C Leung","doi":"10.2174/1872213X14666200204103714","DOIUrl":"https://doi.org/10.2174/1872213X14666200204103714","url":null,"abstract":"<p><strong>Background: </strong>Pediatric myocarditis is rare but challenging. This overview summarized the current knowledge and recent patents on childhood myocarditis.</p><p><strong>Methods: </strong>Clinical queries and keywords of \"myocarditis\" and \"childhood\" were used as search engine.</p><p><strong>Results: </strong>Viral infections are the most common causes of acute myocarditis. Affected children often have a prodrome of fever, malaise, and myalgia. Clinical manifestations of acute myocarditis in children can be nonspecific. Some children may present with easy fatigability, poor appetite, vomiting, abdominal pain, exercise intolerance, respiratory distress/tachypnea, dyspnea at rest, orthopnea, chronic cough with wheezing, chest pain, unexplained tachycardia, hypotension, syncope, and hepatomegaly. Supraventricular arrhythmias, ventricular arrhythmias, and heart block may be present. A subset of patients have fulminant myocarditis and present with cardiovascular collapse, which may progress to severe cardiogenic shock, and even death. A high index of suspicion is crucial to its diagnosis and timely management. Cardiac magnetic resonance imaging is important in aiding clinical diagnosis while, endomyocardial biopsy remains the gold standard. The treatment consists of supportive therapy, ranging from supplemental oxygen and fluid restriction to mechanical circulatory support. Angiotensinconverting enzyme inhibitors, angio-tensin II receptor blockers, β-blockers, and aldosterone antagonists might be used for the treatment of heart failure while, immunosuppression treatments remain controversial. There are a few recent patents targeting prevention or treatment of viral myocarditis, including an immunogenic composition comprising a PCV-2 antigen, glutathione-S-transferase P1, neuregulins, NF-[kappa] B inhibitor, a pharmaceutical composition which contains 2-amino-2- (2- (4-octyl phenyl) - ethyl) propane 1,3-diol, a composition containing pycnojenol, Chinese herbal concoctions, and a Korean oral rapamycin. Evidence of their efficacy is still lacking.</p><p><strong>Conclusion: </strong>This article reviews the current literature regarding etiology, clinical manifestations, diagnosis, and management of acute myocarditis in children.</p>","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":"14 2","pages":"106-116"},"PeriodicalIF":4.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37606321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.2174/1872213X14999200728145822
Kam L Hon, David C K Luk, Alexander K C Leung, Chantel Ng, Steven K F Loo
BACKGROUND Alopecia Areata (AA) is a systemic autoimmune condition which usually starts in childhood. OBJECTIVE This article aims to review genetics, therapy, prognosis and recent patents for AA. METHODS We used clinical queries and keywords of "alopecia areata" AND "childhood" as search engine. Patents were searched using the key term "alopecia areata" in Patents.google.com and freepatentsonline.com. RESULTS Due to an immune mediated damage of the hair follicles, hair is lost from the scalp and other areas of the body temporarily or even permanently. Children with AA are generally healthy. Evidence of genetic association and increased predisposition for AA was found by studying families with affected members. Pathophysiologically, T- lymphocytes attack hair follicles and cause inflammation and destruction of the hair follicles and hair loss. In mild cases, there would be well demarcated round patchy scalp hair loss. The pathognomonic "exclamation mark hairs" may be seen at lesion periphery. In more severe cases, the hair loss may affect the whole scalp and even the whole body. The clinical course is also variable which may range from transient episodes of recurrent patchy hair loss to an indolent gradually deteriorating severe hair loss. The treatment of AA depends on factors including patients' age, extent of the hair loss, duration of disease, psychological impact, availability and side effect profile of the treatments. For localized patchy alopecia, topical application of corticosteroids and/or intralesional corticosteroids are the treatment of choice. Other topical treatments include minoxidil, anthralin, coal tar and immunotherapy. In severe resistant cases, systemic immunosuppressants may be considered. Although herbal medicine, acupuncture, complementary and alternative medicine may be tried on children in some Asian communities, the evidence to support these practices are lacking. To date, only few recent patents exist in topical treatments including Il-31, laser and herbal medications. Clinical efficacy is pending for these treatment modalities. CONCLUSIONS None of the established therapeutic options are curative. However, newer treatment modalities including excimer laser, interleukin-31 antibodies and biologics are evolving so that there may be significant advances in treatment in the near future. AA can be psychosocially devastating. It is important to assess the quality of life, degree of anxiety, social phobia and mood of the patients and their families. Psychological support is imperative for those who are adversely affected psychosocially.
{"title":"Childhood Alopecia Areata: An Overview of Treatment and Recent Patents.","authors":"Kam L Hon, David C K Luk, Alexander K C Leung, Chantel Ng, Steven K F Loo","doi":"10.2174/1872213X14999200728145822","DOIUrl":"https://doi.org/10.2174/1872213X14999200728145822","url":null,"abstract":"BACKGROUND\u0000Alopecia Areata (AA) is a systemic autoimmune condition which usually starts in childhood.\u0000\u0000\u0000OBJECTIVE\u0000This article aims to review genetics, therapy, prognosis and recent patents for AA.\u0000\u0000\u0000METHODS\u0000We used clinical queries and keywords of \"alopecia areata\" AND \"childhood\" as search engine. Patents were searched using the key term \"alopecia areata\" in Patents.google.com and freepatentsonline.com.\u0000\u0000\u0000RESULTS\u0000Due to an immune mediated damage of the hair follicles, hair is lost from the scalp and other areas of the body temporarily or even permanently. Children with AA are generally healthy. Evidence of genetic association and increased predisposition for AA was found by studying families with affected members. Pathophysiologically, T- lymphocytes attack hair follicles and cause inflammation and destruction of the hair follicles and hair loss. In mild cases, there would be well demarcated round patchy scalp hair loss. The pathognomonic \"exclamation mark hairs\" may be seen at lesion periphery. In more severe cases, the hair loss may affect the whole scalp and even the whole body. The clinical course is also variable which may range from transient episodes of recurrent patchy hair loss to an indolent gradually deteriorating severe hair loss. The treatment of AA depends on factors including patients' age, extent of the hair loss, duration of disease, psychological impact, availability and side effect profile of the treatments. For localized patchy alopecia, topical application of corticosteroids and/or intralesional corticosteroids are the treatment of choice. Other topical treatments include minoxidil, anthralin, coal tar and immunotherapy. In severe resistant cases, systemic immunosuppressants may be considered. Although herbal medicine, acupuncture, complementary and alternative medicine may be tried on children in some Asian communities, the evidence to support these practices are lacking. To date, only few recent patents exist in topical treatments including Il-31, laser and herbal medications. Clinical efficacy is pending for these treatment modalities.\u0000\u0000\u0000CONCLUSIONS\u0000None of the established therapeutic options are curative. However, newer treatment modalities including excimer laser, interleukin-31 antibodies and biologics are evolving so that there may be significant advances in treatment in the near future. AA can be psychosocially devastating. It is important to assess the quality of life, degree of anxiety, social phobia and mood of the patients and their families. Psychological support is imperative for those who are adversely affected psychosocially.","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":"14 2","pages":"117-132"},"PeriodicalIF":4.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38210829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.2174/1872213X14666200130095040
Deepak Meshram, Khushbo Bhardwaj, Charulata Rathod, Gail B Mahady, Kapil K Soni
Background: Leukotrienes are powerful mediators of inflammation and interact with specific receptors in target cell membrane to initiate an inflammatory response. Thus, Leukotrienes (LTs) are considered to be potent mediators of inflammatory diseases including allergic rhinitis, inflammatory bowel disease and asthma. Leukotriene B4 and the series of cysteinyl leukotrienes (C4, D4, and E4) are metabolites of arachidonic acid metabolism that cause inflammation. The cysteinyl LTs are known to increase vascular permeability, bronco-constriction and mucus secretion.
Objectives: To review the published data for leukotriene inhibitors of plant origin and the recent patents for leukotriene inhibitors, as well as their role in the management of inflammatory diseases.
Methods: Published data for leukotrienes antagonists of plant origin were searched from 1938 to 2019, without language restrictions using relevant keywords in both free text and Medical Subject Headings (MeSH terms) format. Literature and patent searches in the field of leukotriene inhibitors were carried out by using numerous scientific databases including Science Direct, PubMed, MEDLINE, Google Patents, US Patents, US Patent Applications, Abstract of Japan, German Patents, European Patents, WIPO and NAPRALERT. Finally, data from these information resources were analyzed and reported in the present study.
Results: Currently, numerous anti-histaminic medicines are available including chloropheneremine, brompheniramine, cetirizine, and clementine. Furthermore, specific leukotriene antagonists from allopathic medicines are also available including zileuton, montelukast, pranlukast and zafirlukast and are considered effective and safe medicines as compared to the first generation medicines. The present study reports leukotrienes antagonistic agents of natural products and certain recent patents that could be an alternative medicine in the management of inflammation in respiratory diseases.
Conclusion: The present study highlights recent updates on the pharmacology and patents on leukotriene antagonists in the management of inflammation respiratory diseases.
{"title":"The Role of Leukotrienes Inhibitors in the Management of Chronic Inflammatory Diseases.","authors":"Deepak Meshram, Khushbo Bhardwaj, Charulata Rathod, Gail B Mahady, Kapil K Soni","doi":"10.2174/1872213X14666200130095040","DOIUrl":"https://doi.org/10.2174/1872213X14666200130095040","url":null,"abstract":"<p><strong>Background: </strong>Leukotrienes are powerful mediators of inflammation and interact with specific receptors in target cell membrane to initiate an inflammatory response. Thus, Leukotrienes (LTs) are considered to be potent mediators of inflammatory diseases including allergic rhinitis, inflammatory bowel disease and asthma. Leukotriene B4 and the series of cysteinyl leukotrienes (C4, D4, and E4) are metabolites of arachidonic acid metabolism that cause inflammation. The cysteinyl LTs are known to increase vascular permeability, bronco-constriction and mucus secretion.</p><p><strong>Objectives: </strong>To review the published data for leukotriene inhibitors of plant origin and the recent patents for leukotriene inhibitors, as well as their role in the management of inflammatory diseases.</p><p><strong>Methods: </strong>Published data for leukotrienes antagonists of plant origin were searched from 1938 to 2019, without language restrictions using relevant keywords in both free text and Medical Subject Headings (MeSH terms) format. Literature and patent searches in the field of leukotriene inhibitors were carried out by using numerous scientific databases including Science Direct, PubMed, MEDLINE, Google Patents, US Patents, US Patent Applications, Abstract of Japan, German Patents, European Patents, WIPO and NAPRALERT. Finally, data from these information resources were analyzed and reported in the present study.</p><p><strong>Results: </strong>Currently, numerous anti-histaminic medicines are available including chloropheneremine, brompheniramine, cetirizine, and clementine. Furthermore, specific leukotriene antagonists from allopathic medicines are also available including zileuton, montelukast, pranlukast and zafirlukast and are considered effective and safe medicines as compared to the first generation medicines. The present study reports leukotrienes antagonistic agents of natural products and certain recent patents that could be an alternative medicine in the management of inflammation in respiratory diseases.</p><p><strong>Conclusion: </strong>The present study highlights recent updates on the pharmacology and patents on leukotriene antagonists in the management of inflammation respiratory diseases.</p>","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":"14 1","pages":"15-31"},"PeriodicalIF":4.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37593537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.2174/1872213X14666200810152246
Alexander K C Leung, Joseph M Lam, Kin Fon Leong, Amy A M Leung, Alex H C Wong, Kam L Hon
Background: Nummular eczema may mimic diseases that present with annular configuration and the differential diagnosis is broad.
Objective: This article aimed to provide an update on the evaluation, diagnosis, and treatment of nummular eczema.
Methods: A PubMed search was performed in using the key terms "nummular eczema", "discoid eczema", OR "nummular dermatitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key terms "nummular eczema", "discoid eczema", OR "nummular dermatitis" in www.google.com/patents and www.freepatentsonline.com.
Results: Nummular eczema is characterized by sharply defined, oval or coin-shaped, erythematous, eczematous plaques. Typically, the size of the lesion varies from 1 to 10cm in diameter. The lesions are usually multiple and symmetrically distributed. Sites of predilection include the lower limbs followed by the upper limbs. The lesions are usually intensely pruritic. The diagnosis is mainly clinical based on the characteristic round to oval erythematous plaques in a patient with diffusely dry skin. Nummular eczema should be distinguished from other annular lesions. Dermoscopy can reveal additional features that can be valuable for correct diagnosis. Biopsy or laboratory tests are generally not necessary. However, a potassium hydroxide wet-mount examination of skin scrapings should be performed if tinea corporis is suspected. Because contact allergy is common with nummular eczema, patch testing should be considered in patients with chronic, recalcitrant nummular eczema. Avoidance of precipitating factors, optimal skin care, and high or ultra-high potency topical corticosteroids are the mainstay of therapy. Recent patents related to the management of nummular eczema are also discussed.
Conclusion: With proper treatment, nummular eczema can be cleared over a few weeks, although the course can be chronic and characterized by relapses and remissions. Moisturizing of the skin and avoidance of identifiable exacerbating factors, such as hot water baths and harsh soaps may reduce the frequency of recurrence. Diseases that present with annular lesions may mimic nummular eczema and the differential diagnosis is broad. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made, and appropriate treatment initiated.
{"title":"Nummular Eczema: An Updated Review.","authors":"Alexander K C Leung, Joseph M Lam, Kin Fon Leong, Amy A M Leung, Alex H C Wong, Kam L Hon","doi":"10.2174/1872213X14666200810152246","DOIUrl":"https://doi.org/10.2174/1872213X14666200810152246","url":null,"abstract":"<p><strong>Background: </strong>Nummular eczema may mimic diseases that present with annular configuration and the differential diagnosis is broad.</p><p><strong>Objective: </strong>This article aimed to provide an update on the evaluation, diagnosis, and treatment of nummular eczema.</p><p><strong>Methods: </strong>A PubMed search was performed in using the key terms \"nummular eczema\", \"discoid eczema\", OR \"nummular dermatitis\". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key terms \"nummular eczema\", \"discoid eczema\", OR \"nummular dermatitis\" in www.google.com/patents and www.freepatentsonline.com.</p><p><strong>Results: </strong>Nummular eczema is characterized by sharply defined, oval or coin-shaped, erythematous, eczematous plaques. Typically, the size of the lesion varies from 1 to 10cm in diameter. The lesions are usually multiple and symmetrically distributed. Sites of predilection include the lower limbs followed by the upper limbs. The lesions are usually intensely pruritic. The diagnosis is mainly clinical based on the characteristic round to oval erythematous plaques in a patient with diffusely dry skin. Nummular eczema should be distinguished from other annular lesions. Dermoscopy can reveal additional features that can be valuable for correct diagnosis. Biopsy or laboratory tests are generally not necessary. However, a potassium hydroxide wet-mount examination of skin scrapings should be performed if tinea corporis is suspected. Because contact allergy is common with nummular eczema, patch testing should be considered in patients with chronic, recalcitrant nummular eczema. Avoidance of precipitating factors, optimal skin care, and high or ultra-high potency topical corticosteroids are the mainstay of therapy. Recent patents related to the management of nummular eczema are also discussed.</p><p><strong>Conclusion: </strong>With proper treatment, nummular eczema can be cleared over a few weeks, although the course can be chronic and characterized by relapses and remissions. Moisturizing of the skin and avoidance of identifiable exacerbating factors, such as hot water baths and harsh soaps may reduce the frequency of recurrence. Diseases that present with annular lesions may mimic nummular eczema and the differential diagnosis is broad. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made, and appropriate treatment initiated.</p>","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":"14 2","pages":"146-155"},"PeriodicalIF":4.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38248382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.2174/1872213X14666200108101548
Salome A Chime, Paul A Akpa, Cosmas C Ugwuanyi, Anthony A Attama
Background: Aspirin is a nonsteroidal anti-inflammatory drug that is very effective in the treatment of inflammation and other health conditions, however, it causes gastric irritation. Recently, researchers have developed patents (US9757529, 2019) of inhalable aspirin for rapid absorption and circumvention of gastric irritation.
Objective: The aim of this work was to formulate aspirin-loaded lipid based formulation in order to enhance oral bioavailability and inhibit gastric irritation.
Methods: This solid lipid microparticles loaded with aspirin (SLM) was formulated by a modified cold homogenization-solvent evaporation method. In vitro studies such as in vitro drug release, particle size, Encapsulation Efficiency (EE), micromeritic properties and loading capacity were carried out. Pharmacodynamics studies such as anti-inflammatory and ulcerative properties of the SLM were also carried out in Wistar rats.
Results: The results showed that aspirin entrapped SLM exhibited the highest EE of 72% and particle size range of 7.60 + 0.141µm to 20.25 + 0.070µm. Formulations had about 55% drug release at 6h in simulated intestinal fluid pH 6.8. The formulations had good flowability that could facilitate filling into hard gelatin capsule shells. The SLM exhibited 100% gastroprotection against aspirin-induced ulcers (p < 0.05). The percentage of anti-inflammatory activities also showed that aspirin-entrapped SLM had 78% oedema inhibition at 7h, while the reference had 68% inhibition at 7h.
Conclusion: Aspirin-entrapped SLM showed good sustained-release properties, enhanced antiinflammatory properties and total gastric protection from aspirin-induced ulcers and could be used as once-daily oral aspirin.
{"title":"Anti-Inflammatory and Gastroprotective Properties of Aspirin - Entrapped Solid Lipid Microparticles.","authors":"Salome A Chime, Paul A Akpa, Cosmas C Ugwuanyi, Anthony A Attama","doi":"10.2174/1872213X14666200108101548","DOIUrl":"https://doi.org/10.2174/1872213X14666200108101548","url":null,"abstract":"<p><strong>Background: </strong>Aspirin is a nonsteroidal anti-inflammatory drug that is very effective in the treatment of inflammation and other health conditions, however, it causes gastric irritation. Recently, researchers have developed patents (US9757529, 2019) of inhalable aspirin for rapid absorption and circumvention of gastric irritation.</p><p><strong>Objective: </strong>The aim of this work was to formulate aspirin-loaded lipid based formulation in order to enhance oral bioavailability and inhibit gastric irritation.</p><p><strong>Methods: </strong>This solid lipid microparticles loaded with aspirin (SLM) was formulated by a modified cold homogenization-solvent evaporation method. In vitro studies such as in vitro drug release, particle size, Encapsulation Efficiency (EE), micromeritic properties and loading capacity were carried out. Pharmacodynamics studies such as anti-inflammatory and ulcerative properties of the SLM were also carried out in Wistar rats.</p><p><strong>Results: </strong>The results showed that aspirin entrapped SLM exhibited the highest EE of 72% and particle size range of 7.60 + 0.141µm to 20.25 + 0.070µm. Formulations had about 55% drug release at 6h in simulated intestinal fluid pH 6.8. The formulations had good flowability that could facilitate filling into hard gelatin capsule shells. The SLM exhibited 100% gastroprotection against aspirin-induced ulcers (p < 0.05). The percentage of anti-inflammatory activities also showed that aspirin-entrapped SLM had 78% oedema inhibition at 7h, while the reference had 68% inhibition at 7h.</p><p><strong>Conclusion: </strong>Aspirin-entrapped SLM showed good sustained-release properties, enhanced antiinflammatory properties and total gastric protection from aspirin-induced ulcers and could be used as once-daily oral aspirin.</p>","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":"14 1","pages":"78-88"},"PeriodicalIF":4.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1872213X14666200108101548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37521533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.2174/1872213X14666200705235757
Alexander K C Leung, Amy A M Leung, Alex H C Wong, Kam L Hon
Background: Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide.
Objective: This article aimed to provide an update on the evaluation, diagnosis, and treatment of ascariasis.
Methods: A PubMed search was conducted in February 2020 in Clinical Queries using the key terms "ascariasis" OR "Ascaris lumbricoides". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 10 years. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key term "ascariasis" OR "Ascaris lumbricoides" in www.freepatentsonline.com.
Results: Ascaris lumbricoides is transmitted through the ingestion of embryonated eggs from fecal- contaminated material. Ascariasis has high endemicity in tropical and subtropical areas. Predisposing factors include poverty, poor sanitation, inadequate sewage disposal, and poor personal hygiene. The prevalence is greatest in children younger than 5 years of age. The majority of patients with intestinal ascariasis are asymptomatic. For those with symptoms, anorexia, nausea, bloating, abdominal discomfort, recurrent abdominal pain, abdominal distension, and intermittent diarrhea are not uncommon. Other clinical manifestations vary widely, depending on the underlying complications. Complications include Löeffler syndrome, intestinal obstruction, biliary colic, recurrent pyogenic cholangitis, cholecystitis, acalculous cholecystitis, obstructive jaundice, cholelithiasis, pancreatitis, and malnutrition. The diagnosis is best established by microscopic examination of fecal smears or following concentration techniques for the characteristic ova. Patients with A. lumbricoides infection warrant anthelminthic treatment, even if they are asymptomatic, to prevent complications from migration of the parasite. Albendazole and mebendazole are the drugs of choice for children and nonpregnant individuals with ascariasis. Pregnant women with ascariasis should be treated with pyrantel pamoate. Recent patents related to the management of ascariasis are also discussed.
Conclusion: The average cure rate with anthelminthic treatment is over 95%. Unfortunately, most treated patients in endemic areas become re-infected within months. Health education, personal hygiene, improved sanitary conditions, proper disposal of human excreta, and discontinuing the use of human fecal matter as a fertilizer are effective long-term preventive measures. Targeting deworming treatment and mass anthelminthic treatment should be considered in regions where A. lumbricoides is prevalent.
{"title":"Human Ascariasis: An Updated Review.","authors":"Alexander K C Leung, Amy A M Leung, Alex H C Wong, Kam L Hon","doi":"10.2174/1872213X14666200705235757","DOIUrl":"https://doi.org/10.2174/1872213X14666200705235757","url":null,"abstract":"<p><strong>Background: </strong>Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide.</p><p><strong>Objective: </strong>This article aimed to provide an update on the evaluation, diagnosis, and treatment of ascariasis.</p><p><strong>Methods: </strong>A PubMed search was conducted in February 2020 in Clinical Queries using the key terms \"ascariasis\" OR \"Ascaris lumbricoides\". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 10 years. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key term \"ascariasis\" OR \"Ascaris lumbricoides\" in www.freepatentsonline.com.</p><p><strong>Results: </strong>Ascaris lumbricoides is transmitted through the ingestion of embryonated eggs from fecal- contaminated material. Ascariasis has high endemicity in tropical and subtropical areas. Predisposing factors include poverty, poor sanitation, inadequate sewage disposal, and poor personal hygiene. The prevalence is greatest in children younger than 5 years of age. The majority of patients with intestinal ascariasis are asymptomatic. For those with symptoms, anorexia, nausea, bloating, abdominal discomfort, recurrent abdominal pain, abdominal distension, and intermittent diarrhea are not uncommon. Other clinical manifestations vary widely, depending on the underlying complications. Complications include Löeffler syndrome, intestinal obstruction, biliary colic, recurrent pyogenic cholangitis, cholecystitis, acalculous cholecystitis, obstructive jaundice, cholelithiasis, pancreatitis, and malnutrition. The diagnosis is best established by microscopic examination of fecal smears or following concentration techniques for the characteristic ova. Patients with A. lumbricoides infection warrant anthelminthic treatment, even if they are asymptomatic, to prevent complications from migration of the parasite. Albendazole and mebendazole are the drugs of choice for children and nonpregnant individuals with ascariasis. Pregnant women with ascariasis should be treated with pyrantel pamoate. Recent patents related to the management of ascariasis are also discussed.</p><p><strong>Conclusion: </strong>The average cure rate with anthelminthic treatment is over 95%. Unfortunately, most treated patients in endemic areas become re-infected within months. Health education, personal hygiene, improved sanitary conditions, proper disposal of human excreta, and discontinuing the use of human fecal matter as a fertilizer are effective long-term preventive measures. Targeting deworming treatment and mass anthelminthic treatment should be considered in regions where A. lumbricoides is prevalent.</p>","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":"14 2","pages":"133-145"},"PeriodicalIF":4.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38128398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-30DOI: 10.2174/1872213X13666190724112644
O. Giacinto, U. Satriano, A. Nenna, C. Spadaccio, M. Lusini, C. Mastroianni, F. Nappi, M. Chello
BACKGROUND Endothelial injury occurring during cardiopulmonary bypass is a major contributing factor in the development of organ dysfunction, which leads to many of the postoperative complications occurring during cardiac surgery. OBJECTIVE This narrative review aims to summarize the main mechanisms of cardiopulmonary bypass - related disease, evaluating the unfavorable events leading to tissue injury, with a description of current pharmacologic and non-pharmacologic mechanisms to reduce CPB-related injury. METHODS A Medline/Pubmed/Scopus search was conducted using clinical queries with the key terms "cardiac surgery", "cardiopulmonary bypass", "inflammation" and "endothelial injury", and related MeSH terms, until July 2019. The search strategy included meta-analyses, randomized controlled trials, clinical trials, reviews and pertinent references. Patents were searched using the same key terms from https://patents.google.com/, www.uspto.gov, and www.freepatentsonline.com. RESULTS In this review we discuss the current knowledge of the mechanisms of vascular endothelial cell injury, the acute inflammatory response, and the regulatory factors that control the extent of vascular injury during extracorporeal circulation, summarizing the main target of anti-inflammatory pharmacologic and non-pharmacologic strategies. CONCLUSION Inflammatory response and endothelial dysfunction following cardiopulmonary bypass are the price to pay for the benefits offered during cardiac surgery procedures. Counteracting the detrimental effect of extracorporeal circulation appears to be crucial to improve clinical outcomes in pediatric and adult cardiac surgery. The intrinsic complexity and the tight interplay of the factors involved might require a holistic approach against inflammation and endothelial response.
{"title":"Inflammatory Response and Endothelial Dysfunction Following Cardiopulmonary Bypass: Pathophysiology and Pharmacological Targets.","authors":"O. Giacinto, U. Satriano, A. Nenna, C. Spadaccio, M. Lusini, C. Mastroianni, F. Nappi, M. Chello","doi":"10.2174/1872213X13666190724112644","DOIUrl":"https://doi.org/10.2174/1872213X13666190724112644","url":null,"abstract":"BACKGROUND\u0000Endothelial injury occurring during cardiopulmonary bypass is a major contributing factor in the development of organ dysfunction, which leads to many of the postoperative complications occurring during cardiac surgery.\u0000\u0000\u0000OBJECTIVE\u0000This narrative review aims to summarize the main mechanisms of cardiopulmonary bypass - related disease, evaluating the unfavorable events leading to tissue injury, with a description of current pharmacologic and non-pharmacologic mechanisms to reduce CPB-related injury.\u0000\u0000\u0000METHODS\u0000A Medline/Pubmed/Scopus search was conducted using clinical queries with the key terms \"cardiac surgery\", \"cardiopulmonary bypass\", \"inflammation\" and \"endothelial injury\", and related MeSH terms, until July 2019. The search strategy included meta-analyses, randomized controlled trials, clinical trials, reviews and pertinent references. Patents were searched using the same key terms from https://patents.google.com/, www.uspto.gov, and www.freepatentsonline.com.\u0000\u0000\u0000RESULTS\u0000In this review we discuss the current knowledge of the mechanisms of vascular endothelial cell injury, the acute inflammatory response, and the regulatory factors that control the extent of vascular injury during extracorporeal circulation, summarizing the main target of anti-inflammatory pharmacologic and non-pharmacologic strategies.\u0000\u0000\u0000CONCLUSION\u0000Inflammatory response and endothelial dysfunction following cardiopulmonary bypass are the price to pay for the benefits offered during cardiac surgery procedures. Counteracting the detrimental effect of extracorporeal circulation appears to be crucial to improve clinical outcomes in pediatric and adult cardiac surgery. The intrinsic complexity and the tight interplay of the factors involved might require a holistic approach against inflammation and endothelial response.","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1872213X13666190724112644","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46294718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-30DOI: 10.2174/1872213X13666190919162414
G. Calogiuri, L. H. Garvey, E. Nettis, P. Romita, E. Di Leo, R. Caruso, L. Butani, C. Foti
BACKGROUND Antifungal azoles are the first-line agents used to treat topical and, above all, systemic mycosis. The latter could be life-threating infections in immunocompromised patients. Chemotherapeutic antibiotics, including antifungal azoles, may induce hypersensitivity reactions; however, such immunologic adverse reactions have not been as well defined and carefully investigated. OBJECTIVE To provide an update on the evaluation and diagnosis of skin allergy to azole antifungal agents. METHODS This is a systematic review performed on PubMed and Google Schoolbarusing the key term "allergy, hypersensitivity, anaphylaxis, immediate-type reaction, delayed-type reaction, ketoconazole, fluconazole, posaconazole, voriconazole, itravuconazole, triazoles, imidazoles, antifungals, antimycotics"The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews and case reports. RESULTS One hundred twenty-four articles matched our search terms. The most common adverse events reported were T-cell mediateddelayed-type hypersensitivity reactions, such as fixed drug eruptions,localized, generalized and exhantematous dermatitis, Steven Johnson syndrome, toxic epidermal necrolysis and acute generalizedexhanthematouspustulosis. Rarely a drug rash, eosinophilia systemic symptoms has been described Also immediate-type reactions such as urticaria-angioedema or anaphylaxis have been reported following administration of antifungal imidazoles, although not so frequently. CONCLUSION Despite their widespread use, triazoles seem to induce rare cutaneous hypersensitivity reactions, but the pathomechanisms, risk factors, diagnostic and management strategies, including skin tests and challenge tests, are little known and poorly investigated.
{"title":"Skin Allergy to Azole Antifungal Agents for Systemic Use: A Review of the Literature.","authors":"G. Calogiuri, L. H. Garvey, E. Nettis, P. Romita, E. Di Leo, R. Caruso, L. Butani, C. Foti","doi":"10.2174/1872213X13666190919162414","DOIUrl":"https://doi.org/10.2174/1872213X13666190919162414","url":null,"abstract":"BACKGROUND\u0000Antifungal azoles are the first-line agents used to treat topical and, above all, systemic mycosis. The latter could be life-threating infections in immunocompromised patients. Chemotherapeutic antibiotics, including antifungal azoles, may induce hypersensitivity reactions; however, such immunologic adverse reactions have not been as well defined and carefully investigated.\u0000\u0000\u0000OBJECTIVE\u0000To provide an update on the evaluation and diagnosis of skin allergy to azole antifungal agents.\u0000\u0000\u0000METHODS\u0000This is a systematic review performed on PubMed and Google Schoolbarusing the key term \"allergy, hypersensitivity, anaphylaxis, immediate-type reaction, delayed-type reaction, ketoconazole, fluconazole, posaconazole, voriconazole, itravuconazole, triazoles, imidazoles, antifungals, antimycotics\"The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews and case reports.\u0000\u0000\u0000RESULTS\u0000One hundred twenty-four articles matched our search terms. The most common adverse events reported were T-cell mediateddelayed-type hypersensitivity reactions, such as fixed drug eruptions,localized, generalized and exhantematous dermatitis, Steven Johnson syndrome, toxic epidermal necrolysis and acute generalizedexhanthematouspustulosis. Rarely a drug rash, eosinophilia systemic symptoms has been described Also immediate-type reactions such as urticaria-angioedema or anaphylaxis have been reported following administration of antifungal imidazoles, although not so frequently.\u0000\u0000\u0000CONCLUSION\u0000Despite their widespread use, triazoles seem to induce rare cutaneous hypersensitivity reactions, but the pathomechanisms, risk factors, diagnostic and management strategies, including skin tests and challenge tests, are little known and poorly investigated.","PeriodicalId":20960,"journal":{"name":"Recent patents on inflammation & allergy drug discovery","volume":"1 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1872213X13666190919162414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41974838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}