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Systematic Review and Meta-analysis of the Impact of Metabolic Surgery on Hepatic Stiffness. 代谢手术对肝脏硬度影响的系统性回顾和元分析
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871303052240529102003
Tannaz Jamialahamdi, Matthew Kroh, Sorour Ashari, Wael Almahmeed, Ali Jangjoo, Luis E Simental-Mendía, Sepideh Salehabadi, Khalid Al-Rasadi, Amirhossein Sahebkar

Background: Bariatric surgery is one of the effective therapeutic options for people with obesity and obesity-related co-morbidities. In addition to weight-related co-morbid diseases, including diabetes, hypertension, and hypercholesterolemia, non-alcoholic fatty liver disease (NAFLD) is common in patients with morbid obesity. Bariatric surgery is one of the therapeutic options in the management of NAFLD. Hence, this review focused on the potential role of bariatric surgery on hepatic elasticity measured through shear wave elastography.

Methods: A systematic literature search was performed, and the studies regarding heterogeneity were evaluated using the random-effects model.

Results: The meta-analysis on 6 trials (3-12 months follow-up) including 350 participants showed a significant reduction of liver elasticity after surgery (WMD: -1.149, 95% CI: -1.767, -0.532, p < 0.001; I2:81.55%).

Conclusion: Bariatric surgery is associated with decreased liver elasticity. This improvement could be related to weight loss or other mechanisms of bariatric surgery.

背景:减肥手术是治疗肥胖症和肥胖相关并发症的有效方法之一。除了糖尿病、高血压和高胆固醇血症等与体重相关的并发症外,非酒精性脂肪肝在病态肥胖患者中也很常见。减肥手术是治疗非酒精性脂肪肝的方法之一。因此,本综述侧重于减肥手术对通过剪切波弹性成像测量的肝脏弹性的潜在作用:方法:进行了系统的文献检索,并使用随机效应模型对有关异质性的研究进行了评估:对包括350名参与者在内的6项试验(随访3-12个月)进行的荟萃分析表明,术后肝脏弹性显著降低(WMD:-1.149,95% CI:-1.767,-0.532,p <0.001;I2:81.55%):减肥手术与肝脏弹性下降有关。结论:减肥手术与肝脏弹性下降有关,这种改善可能与体重减轻或减肥手术的其他机制有关。
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引用次数: 0
Effect of Iron Deficiency Anemia on Blood Glucose and Insulin Resistance in Women with Type II Diabetes: A Single-group, Clinical Interventional Study. 缺铁性贫血对 II 型糖尿病女性患者血糖和胰岛素抵抗影响的单组临床干预研究。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871297808240308102327
Mahmoud Parham, Gholam Reza Tavasoli, Shahram Arsang-Jang, Mohammad Amin Habibi, Davood Olad Dameshgi, Mohammad Reza Pashaei, Sajjad Ahmadpour, Jamshid Vafaeimanesh

Aims: Iron deficiency anemia (IDA) is one of the disorders recently associated with an increase in insulin resistance (IR) and, consequently, diabetes mellitus (DM) affection by causing oxidative stress. In this study, we look at how IDA may contribute to developing type II diabetes mellitus (T2DM), controlling diabetes, and reducing IR in women with T2DM.

Methods: In this single group, clinical interventional study, we enrolled 40 women with T2DM and IDA. Before and after intervention with ferrous sulfate tablets, their blood glucose (BG) levels and IR levels were evaluated. This study was approved by the Ethics Committee of Qom University of Medical Sciences (ethics code: IR.MUQ.REC.1397.031) and registered at the Iranian Center for Clinical Trials (No. IRCT20170215032587N3). A significant level was considered p <0.05.

Result: The mean age of patients was 48.18 ± 4.6 years, with 5.3-5.8 years duration of T2DM. After the intervention, the mean fasting blood glucose (FBG) level reached 198.53 ± 48.11 to 170.93 ± 37.41, which was significant (p <0.0001). Also, hemoglobin A1C level reached from 8.49 ± 0.9 to 7.96 ± 0.58, which was significant (p <0.0001). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) demonstrating a significant reduction of IR levels after intervention with ferrous sulfate tablets (p <0.018).

Conclusions: IDA treatment in patients with T2DM can significantly reduce the BG and IR levels. To better control BG, checking iron status and its correction may provide better clinical outcomes in these patients.

目的:缺铁性贫血(IDA)是最近与胰岛素抵抗(IR)增加有关的疾病之一,它通过引起氧化应激而导致糖尿病(DM)。在本研究中,我们将探讨 IDA 如何有助于罹患 II 型糖尿病(T2DM)、控制糖尿病以及降低 T2DM 女性患者的 IR:在这项单组临床干预研究中,我们招募了 40 名患有 T2DM 和 IDA 的女性患者。在使用硫酸亚铁片进行干预前后,对她们的血糖(BG)水平和IR水平进行了评估。本研究已获得库姆医科大学伦理委员会批准(伦理代码:IR.MUQ.REC.1397.031),并在伊朗临床试验中心注册(编号:IRCT20170215032587N3)。结果为P:患者平均年龄为(48.18 ± 4.6)岁,T2DM 病程为 5.3-5.8 年。干预后,患者的平均空腹血糖(FBG)水平从(198.53±48.11)降至(170.93±37.41),差异有学意义(P 结论:IDA治疗T2DM患者的疗效显著:对 T2DM 患者进行 IDA 治疗可明显降低 BG 和 IR 水平。临床试验注册号:IRCT20170215032587N3。
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引用次数: 0
Primary Paraganglioma of the Prostate: A Systematic Review of the Literature for A Rare Entity. 原发性前列腺副神经节瘤:针对罕见实体瘤的系统性文献综述。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871293735240209052044
Ilias Giannakodimos, Afroditi Ziogou, Alexios Giannakodimos, Evangelia Mitakidi, Konstantinos Tzelepis, Evangelos Fragkiadis, Nikolaos Charalampakis

Background: Paragangliomas of the urinary tract are exceptionally uncommon, and sporadic case reports of primary paraganglioma of the prostate have been reported in the literature.

Methods: Systematic research in PubMed/Medline and Scopus databases concerning primary prostatic paraganglioma was performed by two independent investigators.

Results: This analysis included 25 adult males, with a mean age of 49.8 ± 22.4 years. 32% of included patients had a history of hypertension. Problems during urination (52%), blood loss (44%), either as hematuria or hemospermia, and catecholamine-related symptoms (36%) comprised the most frequently reported clinical manifestations. Digital rectal examination found a palpable nodule in 36% of patients, while prostatic specific antigen (PSA) was normal in all tested patients. Abdominal ultrasound (44%), computed tomography (44%) and magnetic resonance imaging (28%) helped to identify the primary lesion. 24-hour urine epinephrine, norepinephrine and vanillylmandelic acid (VMA) levels were elevated in 90%, 80% and 90% of included patients. Open surgical excision of the mass was performed in 40%, transurethral resection in 8%, open radical prostatectomy in 24%, transurethral resection of the prostate in 16% and robot-assisted radical prostatectomy in 4% of included patients.

Conclusion: Due to atypical clinical manifestation and scarcity of prostatic paraganglioma, urologists should be aware of this extremely rare entity.

背景:泌尿道副神经节瘤并不常见,文献中也有原发性前列腺副神经节瘤的零星病例报道:泌尿道副神经节瘤极为罕见,文献中也有原发性前列腺副神经节瘤的零星病例报道:方法:两名独立研究人员在 PubMed/Medline 和 Scopus 数据库中对原发性前列腺副神经节瘤进行了系统研究:结果:这项分析包括 25 名成年男性,平均年龄为 49.8 ± 22.4 岁。32%的患者有高血压病史。最常报告的临床表现包括排尿困难(52%)、血尿或血精(44%)以及儿茶酚胺相关症状(36%)。数字直肠检查发现 36% 的患者有可触及的结节,而所有受检患者的前列腺特异性抗原 (PSA) 均正常。腹部超声(44%)、计算机断层扫描(44%)和磁共振成像(28%)有助于确定原发病灶。90%、80%和90%的患者24小时尿液中肾上腺素、去甲肾上腺素和香草酸(VMA)水平升高。40%的患者采用开放手术切除肿块,8%的患者采用经尿道切除术,24%的患者采用开放前列腺癌根治术,16%的患者采用经尿道前列腺切除术,4%的患者采用机器人辅助前列腺癌根治术:结论:由于前列腺旁神经节瘤的临床表现不典型且数量稀少,泌尿科医生应警惕这种极为罕见的疾病。
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引用次数: 0
Comparison of the Effects of Govarcin Herbal Capsule and Metoclopramide for Alleviating Gastrointestinal Symptoms in Patients with Functional Dyspepsia: A Randomized Double-blind Clinical Trial. 比较戈伐欣草本胶囊和甲氧氯普胺缓解功能性消化不良患者胃肠道症状的效果:一项随机双盲临床试验。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871266848231120112355
Majid Asghari, Sajjad Ahmadpour, Mikaeil Molazadeh, Mohammad Mehdi Jafari, Ahmad Hormati, Mohammad Reza Pashaei, Yousef Mohammadpour, Mohammad Amin Habibi, Abolfazl Mohammadbeigi, Seyed Mahmoud Eshagh Hoseini

Background: Functional dyspepsia (FD) is felt as a discomfort or pain on the center line or upper abdomen. In this study, we aimed to compare the effects of Govarcin herbal capsule and Metoclopramide for alleviating gastrointestinal symptoms in patients with FD.

Methods: Totally, 106 patients enrolled in a double-blind, clinical trial study. The participants had FD and were divided into two groups receiving Govarcin and Metoclopramide by block randomization. The patients were treated for four weeks, taking one Govarcin capsule or Metoclopramide tablet after each meal. The rate of improvement in patients was assessed by mitigation of clinical symptoms, including epigastric pain, fullness, discomfort, nausea, vomiting and heartburn. Also, before and after intervention, we used Nepin questionnaire and ROME III. SPSS statistics 25 software was used for data analyzing.

Results: Clinical symptom score changes between Govarcin and Metoclopramide patients' groups showed that there was no significant difference in any of the clinical symptom scores (except for heartburn, p-value=0.012) between the study groups. Nepean score in Govarcin group before and after treatment were 19.3±4.8 and 8.9±2.8, respectively (p-value<0.001). For Metoclopramide group, these values were 19.8±3.5 and 9.4±2.1 respectively (p-value<0.001). No significant difference was found in terms of Nepean score between the Govarcin and Metoclopramide groups (p-value=0.995).

Conclusion: Govarcin herbal capsule can be used to remedy symptoms in patients with FD. It seems that Govarcin is as effective as Metoclopramide in fighting symptoms of FD as no significant difference in efficacy has been demonstrated between them.

背景:功能性消化不良(FD)是指腹部正中线或上腹部的不适或疼痛。在这项研究中,我们探讨了高伐素草本胶囊对功能性消化不良的疗效,如果疗效显著,则可用于该病患者的治疗:方法:共有 106 名患者参加了双盲临床试验研究。方法:共有 106 名患者参加了这项双盲临床试验研究,他们都患有 FD,并被随机分为两组,分别接受高伐霉素和甲氧氯普胺治疗。患者接受为期四周的治疗,每餐后服用一粒高伐林胶囊或甲氧氯普胺片剂。通过减轻上腹痛、饱胀、不适、恶心、呕吐和烧心等临床症状来评估患者的改善率。此外,在干预前后,我们还使用了 Nepin 问卷和 ROME III。数据分析采用 SPSS 统计 25 软件:高伐林组和甲氧氯普胺组患者的临床症状评分变化显示,研究组之间的任何临床症状评分均无显著差异(烧心除外,P-vale=0.012)。高伐霉素组治疗前后的尼泊金评分分别为(19.3±4.8)分和(8.9±2.8)分(p-value):Govarcin中药胶囊可用于治疗FD患者的症状。在消除 FD 症状方面,Guarcin 似乎与甲氧氯普胺一样有效,因为两者的疗效没有明显差异。
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引用次数: 0
Vanek's Tumour as a Rare Cause of Dyspeptic Syndrome in a Patient with Primary Biliary Cholangitis: A Case Report. 范内克瘤是原发性胆汁性胆管炎患者消化不良综合征的罕见病因:病例报告。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871308542240708075537
Antonietta Gerarda Gravina, Raffaele Pellegrino, Mario Romeo, Marina Cipullo, Stefano Lucà, Iacopo Panarese, Alessandro Federico

Background: Inflammatory Fibroid Polyp (IFP), also known as Vanek's tumour, is a rare mesenchymal gastrointestinal tumour, potentially causing a wide range of clinical manifestations (even though it can be completely asymptomatic) primarily related to the location of the formation. The available evidence suggests a fundamentally non-neoplastic behaviour of IFP.

Case presentation: A 67-year-old female was presented with persistent dyspepsia despite symptomatic therapy. The patient's medical history included primary biliary cholangitis, managed with ursodeoxycholic acid, non-haemorrhagic uterine fibroids, and right knee arthrosis. Clinical examination revealed mild epigastric tenderness, and esophagogastroduodenoscopy identified a sessile mucosal formation. Histological analysis of biopsy samples revealed a gastric hyperplastic polyp, leading to a subsequent esophagogastroduodenoscopy for polypectomy. The excised specimen confirmed the diagnosis of gastric IFP. Post-polypectomy, the patient experienced progressive symptom amelioration, leading to complete resolution within three weeks.

Discussion: This case thus describes a rare cause of dyspeptic syndrome associated with the presence of a gastric IFP, promptly managed and resolved after endoscopic removal of the polyp, with no histological signs of neoplasia within the en bloc resected sample.

Conclusion: IFP is a possible and rare cause of dyspeptic syndrome. There remain significant challenges in diagnosing this rare condition, which lacks pathognomonic or specific signs and symptoms of its presence (especially when it causes symptoms). Endoscopy, when feasible, remains a cornerstone in the resective management of such lesions.

背景:炎性纤维性息肉(IFP),又称凡内克瘤,是一种罕见的间质胃肠道肿瘤,可引起多种临床表现(即使完全无症状),主要与形成部位有关。现有证据表明,IFP 从根本上来说是一种非肿瘤性疾病:病例介绍:患者是一名 67 岁的女性,尽管接受了对症治疗,但仍出现持续性消化不良。患者的病史包括原发性胆汁性胆管炎、非出血性子宫肌瘤和右膝关节病,曾用熊去氧胆酸治疗。临床检查发现有轻度上腹压痛,食管胃十二指肠镜检查发现有无柄粘膜形成。活检样本的组织学分析显示为胃增生性息肉,因此随后进行了食管胃十二指肠镜息肉切除术。切除的标本确诊为胃 IFP。息肉切除术后,患者的症状逐渐改善,并在三周内完全缓解:本病例描述了一种罕见的消化不良综合征病因,该病因与胃息肉病变有关,在内镜下切除息肉后得到了及时处理和缓解,全切样本中没有肿瘤的组织学迹象:IFP可能是消化不良综合征的一个罕见病因。诊断这种罕见病症仍面临巨大挑战,因为它缺乏病理或特异性体征和症状(尤其是当它引起症状时)。在可行的情况下,内窥镜检查仍是此类病变切除治疗的基石。
{"title":"Vanek's Tumour as a Rare Cause of Dyspeptic Syndrome in a Patient with Primary Biliary Cholangitis: A Case Report.","authors":"Antonietta Gerarda Gravina, Raffaele Pellegrino, Mario Romeo, Marina Cipullo, Stefano Lucà, Iacopo Panarese, Alessandro Federico","doi":"10.2174/0115748871308542240708075537","DOIUrl":"10.2174/0115748871308542240708075537","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory Fibroid Polyp (IFP), also known as Vanek's tumour, is a rare mesenchymal gastrointestinal tumour, potentially causing a wide range of clinical manifestations (even though it can be completely asymptomatic) primarily related to the location of the formation. The available evidence suggests a fundamentally non-neoplastic behaviour of IFP.</p><p><strong>Case presentation: </strong>A 67-year-old female was presented with persistent dyspepsia despite symptomatic therapy. The patient's medical history included primary biliary cholangitis, managed with ursodeoxycholic acid, non-haemorrhagic uterine fibroids, and right knee arthrosis. Clinical examination revealed mild epigastric tenderness, and esophagogastroduodenoscopy identified a sessile mucosal formation. Histological analysis of biopsy samples revealed a gastric hyperplastic polyp, leading to a subsequent esophagogastroduodenoscopy for polypectomy. The excised specimen confirmed the diagnosis of gastric IFP. Post-polypectomy, the patient experienced progressive symptom amelioration, leading to complete resolution within three weeks.</p><p><strong>Discussion: </strong>This case thus describes a rare cause of dyspeptic syndrome associated with the presence of a gastric IFP, promptly managed and resolved after endoscopic removal of the polyp, with no histological signs of neoplasia within the <i>en bloc</i> resected sample.</p><p><strong>Conclusion: </strong>IFP is a possible and rare cause of dyspeptic syndrome. There remain significant challenges in diagnosing this rare condition, which lacks pathognomonic or specific signs and symptoms of its presence (especially when it causes symptoms). Endoscopy, when feasible, remains a cornerstone in the resective management of such lesions.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793323","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}
引用次数: 0
Potential Indications of Dupilumab in Th-2 Inflammatory Disease. 杜匹单抗在 Th-2 炎症性疾病中的潜在适应症
IF 1.4 Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.2174/0115748871263396231121060901
Proietti Ilaria, Skroza Nevena, Tolino Ersilia, Bernardini Nicoletta, Trovato Federica, Marco Di Fraia, Dybala Agniezska, Potenza Concetta

Dupilumab is a fully humanized IgG4 monoclonal antibody, inhibiting IL-4 and IL-13 signaling, which are the main cytokines involved in type 2 inflammatory diseases. Its introduction was a breakthrough in the treatment of moderate-to-severe atopic dermatitis, but it is also used in other inflammatory diseases, including asthma, eosinophilic esophagitis and chronic rhinosinusitis with nasal polyposis. Recent advances in the understanding of inflammatory pathways have revealed that Th2-type inflammation is involved in a wider range of diseases than previously thought. The aim of our review is to examine off-label therapeutic indications of dupilumab, including bullous dermatoses (pemphigus, bullous pemphigoid) and alopecia areata, and to investigate its potential applications in cancer patients on anti-PD1 therapy.

杜匹鲁单抗是一种全人源化的 IgG4 单克隆抗体,可抑制 IL-4 和 IL-13 信号传导,而 IL-4 和 IL-13 是参与 2 型炎症疾病的主要细胞因子。它的问世是治疗中重度特应性皮炎的一个突破,但它也被用于其他炎症性疾病,包括哮喘、嗜酸性食管炎和慢性鼻炎伴鼻息肉。最近,人们对炎症通路的认识有了新的进展,发现 Th2 型炎症参与的疾病范围比以前想象的要广。我们的综述旨在研究杜比卢单抗的标签外治疗适应症,包括牛皮癣(丘疹性荨麻疹、大丘疹性荨麻疹)和斑秃,并探讨其在接受抗PD1治疗的癌症患者中的潜在应用。
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引用次数: 0
Evaluation of Urolithin A Efficacy in Heart Failure Patients with Reduced Ejection Fraction: A Randomized, Double-blind, Crossover, Placebo-controlled Clinical Trial. 评估尿胆素 A 对射血分数降低的心力衰竭患者的疗效:一项随机、双盲、交叉、安慰剂对照临床试验。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871279354240209101604
Tannaz Jamialahmadi, Maede Hasanpour, Farveh Vakilian, Peter E Penson, Milad Iranshahy, Amirhossein Sahebkar

Background: Mitochondrial dysfunction and impaired mitophagy are integral to myocyte loss and the progression of heart failure. Urolithin A (UA), a microbiota-produced metabolite of ellagitannins and ellagic acid, is a known stimulator of mitophagy and mitochondrial biogenesis that has shown cardioprotective effects in experimental models.

Methods: A randomized, double-blind, placebo-controlled 2×2 crossover trial was conducted on 10 patients with HF with reduced ejection fraction (HFrEF). The trial design involved two 4- week intervention periods of UA (500 mg BID) and placebo, separated by a 2-week washout phase. The patients underwent two-dimensional echocardiogram examination as well as blood sampling at the beginning and end of each period.

Results: All patients completed the study. The results failed to reveal any significant effect of UA supplementation on echocardiographic measures (LVEF, LVEDD, LVESV, and TAPSE). Plasma concentrations of pro-BNP, glucose, and CRP (p >0.05) were also not altered. Serum HDL-C levels were increased with UA compared with placebo (+6.46 ± 2.33 mg/dL, p =0.026), whereas other lipid indices (LDL-C, triglycerides, total cholesterol, and VLDL-C) remained unchanged (p >0.05).

Conclusion: The results of the present study do not support any positive effect of UA supplementation in improving echocardiographic and biochemical indices of HFrEF. Further studies with higher doses of UA and longer supplementation duration are encouraged to be conducted.

背景:线粒体功能障碍和线粒体吞噬功能受损是心肌细胞损失和心力衰竭进展不可或缺的因素。尿囊素 A(UA)是鞣花丹宁酸和鞣花酸的微生物代谢产物,是一种已知的有丝分裂和线粒体生物生成刺激物,在实验模型中显示出心脏保护作用:对 10 名射血分数降低的心房颤动(HFrEF)患者进行了随机、双盲、安慰剂对照 2×2 交叉试验。试验设计包括 UA(500 毫克,每日一次)和安慰剂两个为期 4 周的干预期,中间有 2 周的冲洗期。患者在每个阶段的开始和结束时接受二维超声心动图检查和血液采样:结果:所有患者都完成了研究。结果显示,补充 UA 对超声心动图指标(LVEF、LVEDD、LVESV 和 TAPSE)无明显影响。血浆中 Pro-BNP、葡萄糖和 CRP 的浓度(P >0.05)也未发生变化。与安慰剂相比,UA 增加了血清 HDL-C 水平(+6.46±2.33 mg/dL,p =0.026),而其他血脂指标(LDL-C、甘油三酯、总胆固醇和 VLDL-C)保持不变(p >0.05):结论:本研究结果不支持补充尿酸对改善 HFrEF 的超声心动图和生化指标有任何积极作用。临床试验注册号:IRCT20210216050375N1。
{"title":"Evaluation of Urolithin A Efficacy in Heart Failure Patients with Reduced Ejection Fraction: A Randomized, Double-blind, Crossover, Placebo-controlled Clinical Trial.","authors":"Tannaz Jamialahmadi, Maede Hasanpour, Farveh Vakilian, Peter E Penson, Milad Iranshahy, Amirhossein Sahebkar","doi":"10.2174/0115748871279354240209101604","DOIUrl":"10.2174/0115748871279354240209101604","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial dysfunction and impaired mitophagy are integral to myocyte loss and the progression of heart failure. Urolithin A (UA), a microbiota-produced metabolite of ellagitannins and ellagic acid, is a known stimulator of mitophagy and mitochondrial biogenesis that has shown cardioprotective effects in experimental models.</p><p><strong>Methods: </strong>A randomized, double-blind, placebo-controlled 2×2 crossover trial was conducted on 10 patients with HF with reduced ejection fraction (HFrEF). The trial design involved two 4- week intervention periods of UA (500 mg BID) and placebo, separated by a 2-week washout phase. The patients underwent two-dimensional echocardiogram examination as well as blood sampling at the beginning and end of each period.</p><p><strong>Results: </strong>All patients completed the study. The results failed to reveal any significant effect of UA supplementation on echocardiographic measures (LVEF, LVEDD, LVESV, and TAPSE). Plasma concentrations of pro-BNP, glucose, and CRP (p >0.05) were also not altered. Serum HDL-C levels were increased with UA compared with placebo (+6.46 ± 2.33 mg/dL, p =0.026), whereas other lipid indices (LDL-C, triglycerides, total cholesterol, and VLDL-C) remained unchanged (p >0.05).</p><p><strong>Conclusion: </strong>The results of the present study do not support any positive effect of UA supplementation in improving echocardiographic and biochemical indices of HFrEF. Further studies with higher doses of UA and longer supplementation duration are encouraged to be conducted.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983666","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}
引用次数: 0
The Effects and Safety of Silymarin on β-thalassemia in Children and Adolescents: A Systematic Review based on Clinical Trial Studies. 水飞蓟素对儿童和青少年β地中海贫血症的影响和安全性:基于临床试验研究的系统回顾。
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871305325240511122602
Nasim Rahimi-Dehkordi, Saeid Heidari-Soureshjani, Catherine M T Sherwin

Background: β-thalassemia imposes significant complications on affected patients. Silymarin, a natural flavonoid complex, has potential therapeutic properties.

Objective: This systematic review aims to comprehensively evaluate the literature on the mechanistic effects of Silymarin on β-thalassemia outcomes in children and adolescents.

Methods: A systematic search of electronic databases, including MEDLINE/PubMed, Embase, Scopus, Cochrane Library, and Web of Science (WOS), was done to identify relevant clinical trials before January 2024. Various data were extracted, including study characteristics, outcomes measured (hematological parameters, oxidative stress markers, iron metabolism, and other outcomes), proposed mechanisms, and safety.

Results: By iron chelation effects, Silymarin can reduce reactive oxygen species (ROS) production, increase intracellular antioxidant enzyme glutathione (GSH), and insert antioxidant effects. It also attenuated inflammation through reduced tumor necrosis factor-alpha (TNF-α), transforming growth factor-β1 (TGF-β1), interferon-gamma (IFNγ), C-reactive protein (CRP), interleukin 6 (IL-6), IL-17, and IL-23 levels and increase in IL-4 and IL-10 levels. By reducing iron overload conditions, Silymarin indicates modulatory effects on immune abnormalities, inhibits red blood cell (RBC) hemolysis, increases RBC count, and minimizes the need for a transfusion. Moreover, it reduces myocardial and hepatic siderosis, improves liver function tests, and modifies abnormal enzymes, particularly for aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin, and total protein levels. Silymarin also reduces iron overload, increases antioxidant and anti-inflammatory capacity in cardiomyocytes, and reveals antioxidant effects.

Conclusion: Silymarin indicates promising effects on various aspects of children and adolescents with β-thalassemia and has no serious side effects on the investigated dosage.

背景:β-地中海贫血给患者带来了严重的并发症。水飞蓟素是一种天然类黄酮复合物,具有潜在的治疗作用:本系统综述旨在全面评估有关水飞蓟素对β地中海贫血症儿童和青少年预后的机理影响的文献:对电子数据库(包括 MEDLINE/PubMed、Embase、Scopus、Cochrane Library 和 Web of Science (WOS))进行系统检索,以确定 2024 年 1 月之前的相关临床试验。提取了各种数据,包括研究特点、测量结果(血液学参数、氧化应激标志物、铁代谢和其他结果)、拟议机制和安全性:通过铁螯合作用,水飞蓟素能减少活性氧(ROS)的产生,增加细胞内抗氧化酶谷胱甘肽(GSH),并起到抗氧化作用。水飞蓟素还能降低肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、γ干扰素(IFNγ)、C反应蛋白(CRP)、白细胞介素6(IL-6)、IL-17和IL-23的水平,增加IL-4和IL-10的水平,从而减轻炎症反应。水飞蓟素能减轻铁超载状况,从而对免疫异常产生调节作用,抑制红细胞(RBC)溶血,增加 RBC 数量,最大限度地减少输血需求。此外,水飞蓟素还能减轻心肌和肝脏淤血,改善肝功能检测,调节异常酶,尤其是天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)、总胆红素和总蛋白水平。水飞蓟素还能减轻铁超载,提高心肌细胞的抗氧化和抗炎能力,并显示出抗氧化作用:结论:水飞蓟素对患有β地中海贫血症的儿童和青少年的各个方面都有良好的影响,并且在研究剂量下没有严重的副作用。
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引用次数: 0
Multisystem Inflammatory Syndrome in Children (MIS-C) in a Low-income Country: What Treatment Should be Adopted in Case of a Lack of Immunoglobulin? 低收入国家的儿童多系统炎症综合征(MIS-C):缺乏免疫球蛋白时应采取何种治疗方法?
IF 1.4 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-01-01 DOI: 10.2174/0115748871257131231204114803
Babakhouya Abdeladim, Bouhmidi Massilia, Elouali Aziza, Elhaddar Zohair, Ghanam Ayad, Rkain Maria

Introduction: In multisystem inflammatory syndrome (MIS-C), children typically present high-grade fever, gastrointestinal symptoms, Kawasaki-like symptoms, and even a toxic shock-like syndrome days to weeks after recovering from SARS-CoV-2 infection. It is important to raise awareness of this condition in order to have early diagnosis and immediate treatment of patients. We have, herein, reported 44 cases of MIS-C with various risk factors and symptoms. Furthermore, we have emphasized the efficacy of experience in treating children with MIS-C with high-dose corticosteroids as an alternative to immunoglobulin in low-income countries.

Methods: We conducted a targeted survey of MIS-C from early May 2020 to October 2022 on 44 children and adolescents with characteristics of multisystem inflammatory syndrome admitted to the pediatric department of the university hospital center in Oujda, Morocco, to which patients diagnosed with MIS-C were referred. The case definition included six criteria: serious illness leading to hospitalization, age under 18 years, fever of at least 24 hours, laboratory evidence of inflammation, multi-organ involvement, biological inflammatory syndrome, and evidence of coronavirus infection based on polymerase chain reaction, antibody testing or exposure to people with COVID-19 in the past month. The criteria used to diagnose myocarditis were impaired left ventricular function, central mitral leak, and elevation of BNP or pro-BNP. Coronary involvement was assessed by the z-score and the criteria for its presence was a z-score equal to or greater than 2.5.

Results: Our study included 44 children and adolescents with MIS-C in our hospital, with male predominance (79%) and a median age of six years. Cardiovascular involvement was present in 91%, mucocutaneous in 78%, gastrointestinal in 70%, hematologic in 84%, and respiratory in 2% of patients. Coronary abnormalities (z-score ≥ 2.5) were documented in 21 cases (48%). Glucocorticoids were frequently used in comparison to immunoglobulin, which were uncommonly available and expensive.

Conclusion: The therapeutic protocol that was adopted was high doses of short-term prednisone (Cortancyl) at 4mg/kg/day for 4 days. Favorable outcome was noted in all patients over a 2-year period.

导言:在多系统炎症综合征(MIS-C)中,儿童通常在感染 SARS-CoV-2 后数天至数周内出现高烧、胃肠道症状、川崎样症状,甚至出现中毒性休克样综合征。提高人们对这种疾病的认识非常重要,以便及早诊断和及时治疗患者。我们在此报告了 44 例 MIS-C 病例,这些病例具有不同的危险因素和症状。此外,我们还强调了在低收入国家用大剂量皮质类固醇替代免疫球蛋白治疗 MIS-C 儿童的疗效:从 2020 年 5 月初到 2022 年 10 月,我们对摩洛哥乌季达大学医院中心儿科收治的 44 名具有多系统炎症综合征特征的儿童和青少年进行了一次有针对性的 MIS-C 调查。病例定义包括六项标准:导致住院的严重疾病、18 岁以下、发热至少 24 小时、炎症的实验室证据、多器官受累、生物炎症综合征、基于聚合酶链反应的冠状病毒感染证据、抗体检测或在过去一个月中接触过 COVID-19 患者。诊断心肌炎的标准是左心室功能受损、二尖瓣中央漏、BNP 或 Pro-BNP 升高。冠状动脉受累通过z-score进行评估,z-score等于或大于2.5为冠状动脉受累的标准:我们的研究纳入了本院 44 名患有 MIS-C 的儿童和青少年,其中男性占多数(79%),中位年龄为 6 岁。91%的患者受累于心血管,78%受累于粘膜,70%受累于胃肠道,84%受累于血液系统,2%受累于呼吸系统。有 21 例(48%)患者出现冠状动脉异常(z 评分≥ 2.5)。与免疫球蛋白相比,糖皮质激素被频繁使用,但免疫球蛋白并不常见且价格昂贵:结论:采用的治疗方案是大剂量短期泼尼松(Cortancyl),剂量为 4 毫克/千克/天,持续 4 天。所有患者在两年内均取得了良好的疗效。
{"title":"Multisystem Inflammatory Syndrome in Children (MIS-C) in a Low-income Country: What Treatment Should be Adopted in Case of a Lack of Immunoglobulin?","authors":"Babakhouya Abdeladim, Bouhmidi Massilia, Elouali Aziza, Elhaddar Zohair, Ghanam Ayad, Rkain Maria","doi":"10.2174/0115748871257131231204114803","DOIUrl":"10.2174/0115748871257131231204114803","url":null,"abstract":"<p><strong>Introduction: </strong>In multisystem inflammatory syndrome (MIS-C), children typically present high-grade fever, gastrointestinal symptoms, Kawasaki-like symptoms, and even a toxic shock-like syndrome days to weeks after recovering from SARS-CoV-2 infection. It is important to raise awareness of this condition in order to have early diagnosis and immediate treatment of patients. We have, herein, reported 44 cases of MIS-C with various risk factors and symptoms. Furthermore, we have emphasized the efficacy of experience in treating children with MIS-C with high-dose corticosteroids as an alternative to immunoglobulin in low-income countries.</p><p><strong>Methods: </strong>We conducted a targeted survey of MIS-C from early May 2020 to October 2022 on 44 children and adolescents with characteristics of multisystem inflammatory syndrome admitted to the pediatric department of the university hospital center in Oujda, Morocco, to which patients diagnosed with MIS-C were referred. The case definition included six criteria: serious illness leading to hospitalization, age under 18 years, fever of at least 24 hours, laboratory evidence of inflammation, multi-organ involvement, biological inflammatory syndrome, and evidence of coronavirus infection based on polymerase chain reaction, antibody testing or exposure to people with COVID-19 in the past month. The criteria used to diagnose myocarditis were impaired left ventricular function, central mitral leak, and elevation of BNP or pro-BNP. Coronary involvement was assessed by the z-score and the criteria for its presence was a z-score equal to or greater than 2.5.</p><p><strong>Results: </strong>Our study included 44 children and adolescents with MIS-C in our hospital, with male predominance (79%) and a median age of six years. Cardiovascular involvement was present in 91%, mucocutaneous in 78%, gastrointestinal in 70%, hematologic in 84%, and respiratory in 2% of patients. Coronary abnormalities (z-score ≥ 2.5) were documented in 21 cases (48%). Glucocorticoids were frequently used in comparison to immunoglobulin, which were uncommonly available and expensive.</p><p><strong>Conclusion: </strong>The therapeutic protocol that was adopted was high doses of short-term prednisone (Cortancyl) at 4mg/kg/day for 4 days. Favorable outcome was noted in all patients over a 2-year period.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049252","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}
引用次数: 0
A Review of Clinical Trials of Cancer and Its Treatment as a Vaccine. 癌症及其疫苗治疗的临床试验综述
IF 1.9 Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 DOI: 10.2174/0115748871260733231031081921
Chandani Chandarana, Anuradha Tiwari

Background: Cancer and infectious diseases are one of the greatest challenges of modern medicine. An unhealthy lifestyle, poor drug use, or drug misuse contribute to the rise in morbidity and mortality brought on by these illnesses. The inadequacies of the medications now being used to treat these disorders, along with the growing issue of drug resistance, have compelled researchers to look for novel compounds with therapeutic promise. The number of infections and diseases has significantly abated due to vaccine development and use over time, which is described in detail. Several novel vaccines can now be produced by manipulating Deoxyribonucleic acid (DNA), Ribonucleic acid (RNA), Messenger Ribonucleic acid (mRNA), proteins, viral vector Recombinant, and other molecules due to advances in genetic engineering and our understanding of the immune defense.

Objective: The main topic of discussion is cancer-based vaccinations, which were developed less than a decade ago but have already been used to treat a wide range of both life-threatening and deadly diseases. It contains clinical studies for cancer vaccines against kidney, liver, prostate, cervix, and certain RNA-based cancer vaccines against breast and bladder cancer.

Results: Numerous studies using various DNA and RNA-based methods have been conducted on the basis of cancer, with 9-10 diseases related to DNA and 8-9 diseases associated with RNA. Some of these studies have been completed, while others have been eliminated due to a lack of research; further studies are ongoing regarding the same.

Conclusion: This brief discussion of vaccines and their varieties with examples also discusses vaccine clinical trials in relation to cancer diseases in this DNA and RNA-based cancer vaccine that has had successful clinical trials like the cervical cancer drug VGX-3100, the kidney cancer drug Pembrolizumab, MGN-1601, the prostate cancer drug pTVG-HP with rhGM-CSF, the melanoma cancer drug proteasome siRNA, and the lung cancer drug FRAME-001.

背景:癌症和传染病是现代医学面临的最大挑战之一。不健康的生活方式、不良的药物使用或药物滥用导致这些疾病引起的发病率和死亡率上升。目前用于治疗这些疾病的药物的不足,以及日益严重的耐药性问题,迫使研究人员寻找具有治疗前景的新化合物。随着时间的推移,由于疫苗的发展和使用,感染和疾病的数量已大大减少,这一点将得到详细说明。由于基因工程的进步和我们对免疫防御的理解,现在可以通过操纵脱氧核糖核酸(DNA)、核糖核酸(RNA)、信使核糖核酸(mRNA)、蛋白质、病毒载体重组和其他分子来生产几种新型疫苗。目的:讨论的主要话题是基于癌症的疫苗接种,这是在不到10年前开发的,但已经被用于治疗各种危及生命和致命的疾病。它包含针对肾癌、肝癌、前列腺癌、宫颈癌的癌症疫苗的临床研究,以及针对乳腺癌和膀胱癌的某些基于rna的癌症疫苗。结果:以癌症为基础,利用各种DNA和RNA为基础的方法进行了大量的研究,其中9-10种疾病与DNA相关,8-9种疾病与RNA相关。其中一些研究已经完成,而另一些则由于缺乏研究而被取消;有关这方面的进一步研究正在进行中。结论:本文对疫苗及其品种进行了简短的讨论,并举例讨论了这种基于DNA和rna的癌症疫苗与癌症疾病相关的疫苗临床试验,该疫苗已成功地进行了临床试验,如宫颈癌药物VGX-3100,肾癌药物Pembrolizumab, MGN-1601,前列腺癌药物pTVG-HP与rhGM-CSF,黑色素瘤药物蛋白酶体siRNA,肺癌药物FRAME-001。
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引用次数: 0
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