Basic & Clinical Pharmacology & Toxicology最新文献

This study aimed to evaluate the effectiveness of pharmacist-led medication reviews in reducing the anticholinergic burden of hospitalised patients with cardiovascular diseases (CVDs), to identify which anticholinergic medications were most frequently prescribed or discontinued during hospitalisation and to investigate factors associated with an elevated anticholinergic burden via secondary analysis of the INFAR study. An uncontrolled before-and-after design was used, and medication reviews were performed for all patients so that the anticholinergic burden of medications prescribed to older adults during their hospital stay could be examined. The mean age of the 319 patients was 68.9 years (±6.2), and upon hospital admission, 40.4% were classified as having a high anticholinergic burden, decreasing to 22.6% at discharge. Multivariate analysis at admission indicated that polypharmacy (PR = 2.00; 95% CI = 1.47–2.72) and potentially inappropriate medication (PR = 4.47; 95% CI = 2.10–9.53) were independently associated with a higher anticholinergic burden; however, only inappropriate medication was significantly associated with a high burden (PR = 2.39; 95% CI = 1.54–3.71) at discharge. The results indicate that a clinical pharmacist-led medication review may reduce the anticholinergic burden in older adults with CVD, highlighting the importance of such a review in promoting safer prescribing practices during hospitalisation.

Cardiovascular diseases (CVDs) remain a leading global cause of mortality, necessitating novel therapeutic strategies to address myocardial injury, adverse remodelling and impaired cardiomyocyte regeneration. Exosomes, nanoscale extracellular vesicles secreted by nearly all cell types, have emerged as pivotal mediators of intercellular communication, influencing cardiac physiology and pathology through their cargo of nucleic acids, proteins and lipids. These vesicles participate actively in processes such as cytoprotection, angiogenesis, apoptosis regulation and immune modulation, which are critical for cardiac repair and regeneration. Recent preclinical and clinical studies highlight the promising regenerative capabilities of exosomes, especially those derived from stem cells and immune cells, positioning them as innovative therapeutic tools and diagnostic biomarkers in CVD management. Despite their potential advantages over traditional cell therapies, including lower immunogenicity and enhanced targeting, several hurdles remain before exosomes can be routinely applied in clinical practice. Challenges include the lack of standardized isolation and characterization protocols, heterogeneity of exosome populations, inefficient cargo loading methods, off-target biodistribution and safety concerns related to immune response and infectious risk. Ongoing research aims to overcome these obstacles to realize exosomes' full potential in cardiovascular regenerative medicine, with diagnostic applications currently representing a nearer-term goal.

Propyl gallate (PG), a long-standing synthetic antioxidant, is integral to the food, cosmetic and pharmaceutical industries for its established effectiveness in inhibiting lipid peroxidation. This review synthesizes the evolving scientific narrative of PG, reframing it from a simple preservative to a multifaceted bioactive compound and metabolic precursor. It details PG's physicochemical properties, chain-breaking antioxidant mechanism and applications in advanced active packaging. A central focus is its metabolic fate: PG is rapidly and extensively hydrolyzed to gallic acid (GA) upon ingestion. This transformation is critical, as the systemic biological activities and toxicological profile are largely attributable to its metabolites, positioning PG as a pro-drug. This metabolic context clarifies the historical discrepancy between in vitro genotoxicity, driven by reactive oxygen species (ROS) generation, and its general lack of in vivo genotoxicity. The review examines PG's dual bioactivity, where its pro-oxidant potential underlies promising anti-cancer effects via the induction of apoptosis in various cancer cell lines and restores antibiotic efficacy against resistant bacteria. By summarizing current toxicological data, including its role as a contact allergen, this work highlights the urgent need for future research designed to precisely differentiate the in vivo activities of PG from GA, enabling a more nuanced understanding of its complex and often paradoxical biological role.