Pub Date : 2023-12-25DOI: 10.37349/emed.2023.00189
Alexandre González-Rodríguez, Jesús Cobo, Mary V. Seeman
Effective clinical management of women with schizophrenia is therapeutically challenging. While there have been recent advances in the understanding of neurobiological, hormonal, and female reproductive cycle factors that play a decisive role in the development and progression of schizophrenia in women, this knowledge has not yet been fully translated into treatment practice. The aim was to apply the best evidence available to optimally treat women with schizophrenia at various periods of the lifespan. A narrative review was conducted of recent advances (2018–2023) in aspects of schizophrenia in women that demand sex-specific treatment. Sex steroids impact antipsychotic absorption, distribution, metabolism, elimination, passage through the blood-brain barrier, and blood flow rate to the brain. For these reasons, premenopausal women with schizophrenia, as compared to male age peers, require lower doses of most antipsychotic drugs and suffer comparatively more adverse events (metabolic, sexual, and cardiovascular) at similar doses. Apart from pharmacologic treatment, women have specific reproductive planning needs and need protection from sexual exploitation and domestic abuse. In addition, when pregnant, schizophrenia women show a high risk of gestational diabetes and pre-eclampsia/eclampsia that requires prevention. Prevention is also needed against long-term health hazards for their offspring. Another period of therapeutic challenge specific to women is menopause. The collected evidence points to women-specific recommendations for both biological and psychosocial treatment strategies for schizophrenia.
{"title":"Improving treatment of women with schizophrenia: a review of the recent literature","authors":"Alexandre González-Rodríguez, Jesús Cobo, Mary V. Seeman","doi":"10.37349/emed.2023.00189","DOIUrl":"https://doi.org/10.37349/emed.2023.00189","url":null,"abstract":"Effective clinical management of women with schizophrenia is therapeutically challenging. While there have been recent advances in the understanding of neurobiological, hormonal, and female reproductive cycle factors that play a decisive role in the development and progression of schizophrenia in women, this knowledge has not yet been fully translated into treatment practice. The aim was to apply the best evidence available to optimally treat women with schizophrenia at various periods of the lifespan. A narrative review was conducted of recent advances (2018–2023) in aspects of schizophrenia in women that demand sex-specific treatment. Sex steroids impact antipsychotic absorption, distribution, metabolism, elimination, passage through the blood-brain barrier, and blood flow rate to the brain. For these reasons, premenopausal women with schizophrenia, as compared to male age peers, require lower doses of most antipsychotic drugs and suffer comparatively more adverse events (metabolic, sexual, and cardiovascular) at similar doses. Apart from pharmacologic treatment, women have specific reproductive planning needs and need protection from sexual exploitation and domestic abuse. In addition, when pregnant, schizophrenia women show a high risk of gestational diabetes and pre-eclampsia/eclampsia that requires prevention. Prevention is also needed against long-term health hazards for their offspring. Another period of therapeutic challenge specific to women is menopause. The collected evidence points to women-specific recommendations for both biological and psychosocial treatment strategies for schizophrenia.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159143","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 : 2023-12-25DOI: 10.37349/emed.2023.00190
Hind Amin, Samir Shoughy
The gut microbiota comprises a complex bacterial community that resides in the intestine. Imbalances in the gut microbiota can disrupt immune homeostasis, triggering autoimmune diseases including non-infectious uveitis. Despite recent advances, the underlying mechanisms linking the microbiome and uveitis are not fully understood. This review offers a comprehensive analysis of the literature addressing microbiome’s relationship with ocular inflammation. Additionally, it explores the potential of modulating the gut microbiota as a novel therapeutic target. A literature search of published articles related to the role of ocular microbiome in non-infectious uveitis in PubMed and Scopus databases was conducted. The following keywords were used: microbiome, uveitis, and immune-mediate diseases.
{"title":"The role of microbiome in uveitis","authors":"Hind Amin, Samir Shoughy","doi":"10.37349/emed.2023.00190","DOIUrl":"https://doi.org/10.37349/emed.2023.00190","url":null,"abstract":"The gut microbiota comprises a complex bacterial community that resides in the intestine. Imbalances in the gut microbiota can disrupt immune homeostasis, triggering autoimmune diseases including non-infectious uveitis. Despite recent advances, the underlying mechanisms linking the microbiome and uveitis are not fully understood. This review offers a comprehensive analysis of the literature addressing microbiome’s relationship with ocular inflammation. Additionally, it explores the potential of modulating the gut microbiota as a novel therapeutic target. A literature search of published articles related to the role of ocular microbiome in non-infectious uveitis in PubMed and Scopus databases was conducted. The following keywords were used: microbiome, uveitis, and immune-mediate diseases.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158607","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 : 2023-12-25DOI: 10.37349/emed.2023.00188
Malvika Mishra, Prashant Tripathi, Pratibha Singh, Y. K. Rao, Desh Deepak Singh
Aim: The frequency of severe acute malnutrition (SAM) is the highest in India. Although it should receive more attention, severe anemia is one of the comorbidities that increases mortality in children who are severely undernourished. In SAM children, the liver function test (LFT), kidney function test (KFT), and complete blood count (CBC) are deranged, but their correlation with the prognosis is not well defined. The aim was to describe the anthropometric assessment and biochemical profile of children with SAM. Methods: This cross-sectional cohort study was performed at the Departments of Paediatrics and Biochemistry at G.S.V.M. Medical College, Kanpur, and at the Department of Biotechnology at Amity University Rajasthan, Jaipur. One hundred and six patients with SAM were enrolled; 53 were grouped as complicated SAM (Group 1) (dehydration and severe dehydration) and 53 were diagnosed as non-complicated SAM (Group 2). Results: Group II had significantly higher mean values for height, weight, mid-upper arm circumference (MUAC), head circumference, and body mass index (BMI) for age percentile compared to Group I, with P-values of 0.001. Group I had a significantly lower level of hemoglobin (8.86 g/dL ± 2.21 g/dL) compared to Group II (10.0 g/dL ± 1.83 g/dL) with a P-value of 0.003. The difference in the frequency of anemia between the groups was statistically significant, with a P-value of 0.026. Anemia significantly increased the risk of complicated SAM with an odds ratio of 2.60 [95% confidence interval (CI), 1.07–6.31, P = 0.001]. Conclusions: This study suggests that there may be a significant relationship between anemia and the development of complications in high-risk children with SAM.
目的：在印度，严重急性营养不良（SAM）的发病率最高。虽然严重贫血应该得到更多关注，但它是增加严重营养不良儿童死亡率的并发症之一。在 SAM 儿童中，肝功能测试 (LFT)、肾功能测试 (KFT) 和全血细胞计数 (CBC) 均有异常，但它们与预后的相关性尚不明确。本研究旨在描述 SAM 儿童的人体测量评估和生化特征。研究方法这项横断面队列研究在坎普尔 G.S.V.M. 医学院儿科和生物化学系以及斋浦尔拉贾斯坦邦阿米提大学生物技术系进行。共招募了 16 名 SAM 患者，其中 53 名被归为复杂 SAM（第 1 组）（脱水和严重脱水），53 名被诊断为非复杂 SAM（第 2 组）。结果显示与第一组相比，第二组的身高、体重、中上臂围（MUAC）、头围和体重指数（BMI）的平均值明显更高，P 值为 0.001。I 组的血红蛋白水平（8.86 g/dL ± 2.21 g/dL）明显低于 II 组（10.0 g/dL ± 1.83 g/dL），P 值为 0.003。组间贫血发生率的差异具有统计学意义，P 值为 0.026。贫血明显增加了并发 SAM 的风险，几率比为 2.60 [95% 置信区间 (CI)，1.07-6.31，P = 0.001]。结论本研究表明，贫血与高危 SAM 患儿并发症的发生可能存在显著关系。
{"title":"Comparison of biochemical and anthropometric parameters in complicated and uncomplicated severe acute malnutrition among children aged 6 to 59 months: a cross-sectional study","authors":"Malvika Mishra, Prashant Tripathi, Pratibha Singh, Y. K. Rao, Desh Deepak Singh","doi":"10.37349/emed.2023.00188","DOIUrl":"https://doi.org/10.37349/emed.2023.00188","url":null,"abstract":"Aim: The frequency of severe acute malnutrition (SAM) is the highest in India. Although it should receive more attention, severe anemia is one of the comorbidities that increases mortality in children who are severely undernourished. In SAM children, the liver function test (LFT), kidney function test (KFT), and complete blood count (CBC) are deranged, but their correlation with the prognosis is not well defined. The aim was to describe the anthropometric assessment and biochemical profile of children with SAM. Methods: This cross-sectional cohort study was performed at the Departments of Paediatrics and Biochemistry at G.S.V.M. Medical College, Kanpur, and at the Department of Biotechnology at Amity University Rajasthan, Jaipur. One hundred and six patients with SAM were enrolled; 53 were grouped as complicated SAM (Group 1) (dehydration and severe dehydration) and 53 were diagnosed as non-complicated SAM (Group 2). Results: Group II had significantly higher mean values for height, weight, mid-upper arm circumference (MUAC), head circumference, and body mass index (BMI) for age percentile compared to Group I, with P-values of 0.001. Group I had a significantly lower level of hemoglobin (8.86 g/dL ± 2.21 g/dL) compared to Group II (10.0 g/dL ± 1.83 g/dL) with a P-value of 0.003. The difference in the frequency of anemia between the groups was statistically significant, with a P-value of 0.026. Anemia significantly increased the risk of complicated SAM with an odds ratio of 2.60 [95% confidence interval (CI), 1.07–6.31, P = 0.001]. Conclusions: This study suggests that there may be a significant relationship between anemia and the development of complications in high-risk children with SAM.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158436","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 : 2023-12-12DOI: 10.37349/emed.2023.00187
Lena B. Kim, A. Putyatina
Lung tuberculosis (TB) remains a heavy burden on public health worldwide. This review discusses mainly the mechanisms of the development of pulmonary fibrosis in an experimental TB model in mice. The involvement of individual components of the extracellular matrix, the activity of matrix metalloproteinases, and the role of their tissue inhibitors in the fibrosis development. The current TB therapy activates fibrosis along with anti-mycobacterial action. The paper describes the authors’ results of experimental use of the liposome-encapsulated dextrazid (LЕDZ) combined with isoniazid (INH) which has both antifibrotic and anti-mycobacterial effects to be considered for future treatment.
{"title":"Mechanism of lungs fibrosis in mycobacterial infection","authors":"Lena B. Kim, A. Putyatina","doi":"10.37349/emed.2023.00187","DOIUrl":"https://doi.org/10.37349/emed.2023.00187","url":null,"abstract":"Lung tuberculosis (TB) remains a heavy burden on public health worldwide. This review discusses mainly the mechanisms of the development of pulmonary fibrosis in an experimental TB model in mice. The involvement of individual components of the extracellular matrix, the activity of matrix metalloproteinases, and the role of their tissue inhibitors in the fibrosis development. The current TB therapy activates fibrosis along with anti-mycobacterial action. The paper describes the authors’ results of experimental use of the liposome-encapsulated dextrazid (LЕDZ) combined with isoniazid (INH) which has both antifibrotic and anti-mycobacterial effects to be considered for future treatment.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139007966","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 : 2023-12-11DOI: 10.37349/emed.2023.00186
Olha Denefil, S. Chorniy, S. Boitsaniuk, Nadia Manashchuk, N. Chornij, M. Levkiv, Natalia Tverdokhlib, Khrystyna Loza
Aim: The aim is to analyze the microbiome of gingival sulcus and periodontal pockets of patients with periodontal disease associated with systemic diseases. Methods: A microbiological study was conducted to analyze the microflora of the periodontal pockets in patients with different systemic pathologies and periodontal diseases. Plaque samples were collected from the gingival sulcus and periodontal pockets, and they were subsequently cultured on nutrient medium and glass plates. Results: The microbiota of the gingival sulcus and periodontal pockets in patients with associated systemic diseases in combination with periodontal disease was studied. The frequency of detecting the qualitative composition of the microbiota in the periodontal niche of patients with periodontal diseases and systemic diseases was determined. The research paper outlined groups of microorganisms isolated from periodontal pockets of patients with periodontal and systemic diseases. Conclusions: The degree of colonization by microorganisms differed slightly, while the frequency of detection of specific populations of opportunistic bacteria increased in chronic generalized periodontitis compared to chronic catarrhal gingivitis.
{"title":"Analysis of microbiocenosis of a gingival sulcus and periodontal pockets of patients with periodontal diseases associated with systemic pathology","authors":"Olha Denefil, S. Chorniy, S. Boitsaniuk, Nadia Manashchuk, N. Chornij, M. Levkiv, Natalia Tverdokhlib, Khrystyna Loza","doi":"10.37349/emed.2023.00186","DOIUrl":"https://doi.org/10.37349/emed.2023.00186","url":null,"abstract":"Aim: The aim is to analyze the microbiome of gingival sulcus and periodontal pockets of patients with periodontal disease associated with systemic diseases.\u0000Methods: A microbiological study was conducted to analyze the microflora of the periodontal pockets in patients with different systemic pathologies and periodontal diseases. Plaque samples were collected from the gingival sulcus and periodontal pockets, and they were subsequently cultured on nutrient medium and glass plates.\u0000Results: The microbiota of the gingival sulcus and periodontal pockets in patients with associated systemic diseases in combination with periodontal disease was studied. The frequency of detecting the qualitative composition of the microbiota in the periodontal niche of patients with periodontal diseases and systemic diseases was determined. The research paper outlined groups of microorganisms isolated from periodontal pockets of patients with periodontal and systemic diseases.\u0000Conclusions: The degree of colonization by microorganisms differed slightly, while the frequency of detection of specific populations of opportunistic bacteria increased in chronic generalized periodontitis compared to chronic catarrhal gingivitis.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138980234","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 : 2023-12-08DOI: 10.37349/emed.2023.00185
Jaykrishan Prasad, A. Shah, N. Dhalla
Protein kinases, a family of enzymes responsible for regulating various cellular processes, have been implicated in the development and progression of various heart diseases, making them attractive therapeutic targets. This review focuses on the role of protein kinases induced phosphorylation and protein phosphatase-induced dephosphorylation in cardiovascular disorders, including heart failure, ischemic heart disease, arrhythmias, hypertension, and diabetic cardiomyopathy. This paper explores the potential of novel kinase-targeted therapies and emerging technologies for the prevention and treatment of these conditions. It also discusses the involvement of protein kinase A (PKA), protein kinase C (PKC), phosphoinositide 3-kinases (PI3Ks), mitogen-activated protein kinases (MAPKs), and Ca2+/calmodulin-dependent protein kinase II (CaMKII) in heart dysfunction and alterations in their function that contribute to their respective cardiac disorders. Furthermore, this article presents a comprehensive overview of protein kinases in cardiac disorders and the potential of innovative kinase-targeted therapies, advanced technologies, and multidisciplinary approaches for the effective prevention and treatment of cardiovascular diseases, ultimately aiming to improve patient outcomes and quality of life.
{"title":"Involvement of protein kinases associated signal transduction mechanisms in cardiac diseases","authors":"Jaykrishan Prasad, A. Shah, N. Dhalla","doi":"10.37349/emed.2023.00185","DOIUrl":"https://doi.org/10.37349/emed.2023.00185","url":null,"abstract":"Protein kinases, a family of enzymes responsible for regulating various cellular processes, have been implicated in the development and progression of various heart diseases, making them attractive therapeutic targets. This review focuses on the role of protein kinases induced phosphorylation and protein phosphatase-induced dephosphorylation in cardiovascular disorders, including heart failure, ischemic heart disease, arrhythmias, hypertension, and diabetic cardiomyopathy. This paper explores the potential of novel kinase-targeted therapies and emerging technologies for the prevention and treatment of these conditions. It also discusses the involvement of protein kinase A (PKA), protein kinase C (PKC), phosphoinositide 3-kinases (PI3Ks), mitogen-activated protein kinases (MAPKs), and Ca2+/calmodulin-dependent protein kinase II (CaMKII) in heart dysfunction and alterations in their function that contribute to their respective cardiac disorders. Furthermore, this article presents a comprehensive overview of protein kinases in cardiac disorders and the potential of innovative kinase-targeted therapies, advanced technologies, and multidisciplinary approaches for the effective prevention and treatment of cardiovascular diseases, ultimately aiming to improve patient outcomes and quality of life.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589412","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 : 2023-12-06DOI: 10.37349/emed.2023.00183
A. A. H. S. AL-Janabi, Ruaa Kadhim Mohammed Jawad, Abdul Razzak Kalaf Hassan
Aim: Estrogen has an important role in the colonization of Candida through the presence of estrogen receptors (ERs). These ERs are usually used to categorize breast cancer into two types, positive and negative ER breast cancers. The effect of variation in the type of ER and estrogen levels on the biodiversity of Candida in the vagina was investigated. Methods: A case-control study, consisting of three groups of 30 patients with ER-positive, 29 with ER-negative breast cancer, and 30 healthy individuals, was carried out. The diversity and counting of Candida spp. in the vagina and estrogen levels were identified in all subjects. Results: The growth of Candida spp. was high in the vagina of patients with ER-positive breast cancer when estrogen was at normal levels. Otherwise, its growth was enhanced by high levels of estrogen in patients with ER-negative breast cancer. Conclusions: Estrogen levels have no effect on the vaginal content of Candida spp. in patients with ER-positive breast cancer, unlike those with ER-negative breast cancer. The principal recommendation from this study is that vaginal candidiasis and estrogen levels should be checked in patients with ER-negative breast cancer.
{"title":"Impact of the type of breast cancer on the biodiversity of the vaginal Candida represented by estrogen receptor and its levels","authors":"A. A. H. S. AL-Janabi, Ruaa Kadhim Mohammed Jawad, Abdul Razzak Kalaf Hassan","doi":"10.37349/emed.2023.00183","DOIUrl":"https://doi.org/10.37349/emed.2023.00183","url":null,"abstract":"Aim: Estrogen has an important role in the colonization of Candida through the presence of estrogen receptors (ERs). These ERs are usually used to categorize breast cancer into two types, positive and negative ER breast cancers. The effect of variation in the type of ER and estrogen levels on the biodiversity of Candida in the vagina was investigated.\u0000Methods: A case-control study, consisting of three groups of 30 patients with ER-positive, 29 with ER-negative breast cancer, and 30 healthy individuals, was carried out. The diversity and counting of Candida spp. in the vagina and estrogen levels were identified in all subjects.\u0000Results: The growth of Candida spp. was high in the vagina of patients with ER-positive breast cancer when estrogen was at normal levels. Otherwise, its growth was enhanced by high levels of estrogen in patients with ER-negative breast cancer.\u0000Conclusions: Estrogen levels have no effect on the vaginal content of Candida spp. in patients with ER-positive breast cancer, unlike those with ER-negative breast cancer. The principal recommendation from this study is that vaginal candidiasis and estrogen levels should be checked in patients with ER-negative breast cancer.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138595575","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 : 2023-12-06DOI: 10.37349/emed.2023.00182
Gerhard Nahler
Amazingly, almost 50 years after the first demonstration of anticancer effects of cannabinoids in vitro and in vivo, well-designed clinical trials that definitively prove tumour-inhibiting effects in man are still missing. Whereas a large number of preclinical studies exist that describe tumour-inhibiting effects of cannabinoids, alone or in combination, but also in the form of medical cannabis or natural extracts in vitro, the number of in vivo studies is still limited. Even more limited are well-documented experiences in man. Most animal studies and experience with cannabinoids in man concern brain tumours. This review summarises the effects of phytocannabinoids in brain, breast, colorectal, head and neck, haematological, liver, lung, pancreatic, ovarian, prostate, and skin cancers in animal models and, if available, in patients. The large majority of animal studies demonstrate tumour-inhibiting effects of cannabinoids, thus confirming in vitro data. Experiences in cancer patients are almost exclusively limited to individual case reports and case series without a control group. Many questions are currently unanswered such as the role of pure cannabinoids compared to combinations, cannabinoids as the eventual sole cancer therapy, optimal dosages, or duration of treatment. Pure cannabidiol (CBD) seems to be superior to pure delta-9-tetrahydrocannabinol (THC) in experimental settings. The role of medical cannabis or extracts is less clear as they vary in their phytochemical composition. In conclusion, cannabis/cannabinoids may slow the progression of tumours. However, the hope that cannabinoids could eventually cure cancer as often spread in social media, is, at present, wishful thinking. Above all, well-designed clinical trials paired with long-term follow-up of cancer patients are needed.
{"title":"Treatment of malignant diseases with phytocannabinoids: promising observations in animal models and patients","authors":"Gerhard Nahler","doi":"10.37349/emed.2023.00182","DOIUrl":"https://doi.org/10.37349/emed.2023.00182","url":null,"abstract":"Amazingly, almost 50 years after the first demonstration of anticancer effects of cannabinoids in vitro and in vivo, well-designed clinical trials that definitively prove tumour-inhibiting effects in man are still missing. Whereas a large number of preclinical studies exist that describe tumour-inhibiting effects of cannabinoids, alone or in combination, but also in the form of medical cannabis or natural extracts in vitro, the number of in vivo studies is still limited. Even more limited are well-documented experiences in man. Most animal studies and experience with cannabinoids in man concern brain tumours. This review summarises the effects of phytocannabinoids in brain, breast, colorectal, head and neck, haematological, liver, lung, pancreatic, ovarian, prostate, and skin cancers in animal models and, if available, in patients. The large majority of animal studies demonstrate tumour-inhibiting effects of cannabinoids, thus confirming in vitro data. Experiences in cancer patients are almost exclusively limited to individual case reports and case series without a control group. Many questions are currently unanswered such as the role of pure cannabinoids compared to combinations, cannabinoids as the eventual sole cancer therapy, optimal dosages, or duration of treatment. Pure cannabidiol (CBD) seems to be superior to pure delta-9-tetrahydrocannabinol (THC) in experimental settings. The role of medical cannabis or extracts is less clear as they vary in their phytochemical composition. In conclusion, cannabis/cannabinoids may slow the progression of tumours. However, the hope that cannabinoids could eventually cure cancer as often spread in social media, is, at present, wishful thinking. Above all, well-designed clinical trials paired with long-term follow-up of cancer patients are needed.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138596507","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}
Progeroid syndromes are characterized by clinical signs of premature ageing, which may contain several diseases such as Werner syndrome, Bloom syndrome, Rothmund-Thomson syndrome, Hutchinson-Gilford progeria syndrome, and Cockayne syndrome. These disorders may also exhibit some pathological involvements reminiscent of primary mitochondrial diseases. Emerging evidence has linked mitochondria even to physiological ageing. In addition, alterations in the maintenance pathway of mitochondria have been also deliberated as relevant in age-related diseases. In particular, mitophagy and its regulatory pathway might be key process for the homeostasis of mitochondria. Therefore, chronic DNA damage and/or the activation of poly[adenosine diphosphate (ADP)-ribose] polymerase 1 (PARP1) could be a threat to the mitochondrial alterations. The PARP1 is an enzyme responding to the DNA damage, which might be also involved in the mitophagy. Interestingly, the PARP1 has been reported to play an important role in the longevity of lifespan, which has attracted growing attention with the social development. This review may provide a rationalized overview of the involvement of mitochondrial oxidative stresses in genetically defined accelerated ageing, progeroid syndromes, physiological ageing, and/or age-related diseases for the innovative therapeutic approaches.
{"title":"Roles of poly(ADP-ribose) polymerase 1 and mitophagy in progeroid syndromes as well as physiological ageing","authors":"Naoko Suga, Yuka Ikeda, Sayuri Yoshikawa, Satoru Matsuda","doi":"10.37349/emed.2023.00180","DOIUrl":"https://doi.org/10.37349/emed.2023.00180","url":null,"abstract":"Progeroid syndromes are characterized by clinical signs of premature ageing, which may contain several diseases such as Werner syndrome, Bloom syndrome, Rothmund-Thomson syndrome, Hutchinson-Gilford progeria syndrome, and Cockayne syndrome. These disorders may also exhibit some pathological involvements reminiscent of primary mitochondrial diseases. Emerging evidence has linked mitochondria even to physiological ageing. In addition, alterations in the maintenance pathway of mitochondria have been also deliberated as relevant in age-related diseases. In particular, mitophagy and its regulatory pathway might be key process for the homeostasis of mitochondria. Therefore, chronic DNA damage and/or the activation of poly[adenosine diphosphate (ADP)-ribose] polymerase 1 (PARP1) could be a threat to the mitochondrial alterations. The PARP1 is an enzyme responding to the DNA damage, which might be also involved in the mitophagy. Interestingly, the PARP1 has been reported to play an important role in the longevity of lifespan, which has attracted growing attention with the social development. This review may provide a rationalized overview of the involvement of mitochondrial oxidative stresses in genetically defined accelerated ageing, progeroid syndromes, physiological ageing, and/or age-related diseases for the innovative therapeutic approaches.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135928765","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 : 2023-10-31DOI: 10.37349/emed.2023.00179
Cassandra L. Taylor, Schuyler A. Pruyn
Since the early 1970s, the U.S. Food and Drug Administration (FDA) has received over 800 investigational new drug applications (INDs) for, and pre-INDs pertaining to, research of cannabis or cannabis-derived products. The current data show that applications for research of these products submitted by both academic researchers and commercial developers focus on four major clinical areas: addiction and pain medicine (53%), neurology (19%), immunology and inflammation (14%), and psychiatry (9%). The product types studied have expanded greatly in recent years and include a wide variety of topical, inhalable, injectable, and oral products. In this article, the authors present a breakdown of cannabis and cannabis-derived applications received by the FDA over the past 50 years. The authors also provide a summary of their experience and challenges in reviewing applications for research of cannabis and cannabis-derived products, as well as recommendations for those interested in studying cannabis and cannabis-derived products in human clinical trials. This perspective article includes a discussion on important IND criteria, the pre-IND consultation program, drug master files (DMFs), and various guidance documents and resources. Lastly, the authors provide their perspective for the future of cannabis drug development.
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