Amelioration of Cisplatin-Induced Ototoxicity in Rats by L-arginine: The Role of Nitric Oxide, Transforming Growth Factor Beta 1 and Nrf2/HO-1 Pathway

Background:

Cisplatin is an alkylating agent that inhibits DNA replication and interferes with proliferation of cancer cells. However, the major limiting factor for its use is the possible development of adverse effects, including ototoxicity. Up till now, the mechanisms of this ototoxicity remain poorly understood. However, induction of oxidative stress and activation of the inflammatory cascade were suggested as contributing factors.

Purpose:

The aim of this study was to explore the effect of L-arginine on cisplatin-induced ototoxicity in rats.

Methods:

Thirty male adult Wistar rats were divided into three equal groups as follows: control group; cisplatin group and cisplatin + L-arginine group. Auditory brainstem response (ABR), tissue oxidative stress parameters, total nitrate/nitrite, nuclear factor (erythroid-derived 2)-like 2 (Nrf2)/heme oxygenase-1 (HO-1) content, transforming growth factor beta 1 (TGF-β1), tumor necrosis factor alpha (TNF-α) and interleukin 15 (IL-15) were assessed. Also, the cochlear tissues were subjected to histopathological and electron microscopic examination.

Results:

Administration of L-arginine to cisplatin-treated rats induced significant decrease in the average ABR threshold shifts at all frequencies, tissue TGF-β1, TNF-α and IL-15 associated with significant increase in tissue antioxidant enzymes, total nitrate/nitrite and Nrf2/HO-1 content compared to cisplatin group. Also, pretreatment of cisplatin-injected rats with L-arginine induced significant improvement of the histopathological and electron microscopic picture compared to cisplatin group.

Conclusion:

L-arginine may serve as a promising therapeutic modality for amelioration of cisplatin-induced ototoxicity.

Gastric carcinoma: Insights into risk factors, methods of diagnosis, possible lines of management, and the role of primary care

Gastric carcinoma represents the second most common type of malignancy that contributes to cancer-related mortality worldwide. However, the geographic incidence of gastric carcinoma had changed over the last few decades, possibly due to increased hygiene, increased awareness of the importance of healthy nutrition, and increased rates of eradication of Helicobacter pylori infection. Gastric carcinoma consists of two pathological variants, intestinal and diffuse. Early cases of gastric carcinoma may be asymptomatic. However, advanced cases may present with significant weight loss, dysphagia, abdominal pain, vomiting, and even severe upper gastrointestinal bleeding. Patients at high risk of developing gastric carcinoma should be adequately screened at primary healthcare centers for early detection and effective management. Lines of treatment vary according to the stage of the disease but surgical resection of the tumor with regional lymphadenectomy remains the gold standard of therapy. This review sheds light on gastric carcinoma given the recent trends regarding its prevalence, risk factors, types, clinical picture, methods of diagnosis, possible lines of management, and the role of primary care.

Perceptions and Attitudes Towards Clinical Pharmacy Services and Their Impact on The Management of Cancer in Taif, Saudi Arabia

Aim:

To assess the perception and attitude of HCPs and health-related science colleges’ students regarding the clinical pharmacists’ roles and responsibilities in providing better pharmaceutical care to patients in Taif, Saudi Arabia and to detect its impact on management of cancer.

Methods:

This study was conducted in four randomly selected hospitals in Taif and three health-related science colleges in Taif University. A questionnaire was distributed to HCPs and another questionnaire to students of health-related science colleges.

Results:

Three quarters of students perceived that the clinical pharmacist is an important part of the healthcare team. Two-thirds of HCPs expressed confidence in the ability of clinical pharmacists to minimize medication errors. Although two-thirds of HCPs reported that they did not have clinical pharmacists in their institutions, there was substantial willingness among HCPs to cooperate with the clinical pharmacists. Most HCPs expressed the view that the clinical pharmacist is an important integral part of the healthcare team and has a positive impact on cancer management.

Conclusion:

HCPs and students of health-related science colleges valued the role of clinical pharmacists in healthcare delivery and management of cancer. However, new developments in clinical pharmacy services in Taif hospitals are recommended to improve perception and attitudes towards the clinical pharmacy services. Also, well-organized programs should be conducted to students of health-related science colleges to improve their perceptions and attitudes towards the clinical pharmacy services which may have a positive impact on cancer management.

The Role of Stem Cell Factor in Hyperpigmented Skin Lesions

BACKGROUND

Skin hyperpigmentation usually results from an increased number, or activity, of melanocytes. The degree of pigmentation of skin depends on the amount and type of melanin, degree of skin vascularity, presence of carotene, and thickness of the stratum corneum. Common causes of hyperpigmentation include post-inflammatory hyperpigmentation, melasma, solar lentigines, ephelides (freckles), and café-au-lait macules. Some skin tumors can be hyperpigmented as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma (MM). Stem cell factor (SCF) is a growth factor and its interaction with its receptor, c-kit, is well known to be critical to the survival of melanocytes.

METHODS

This study was carried out on 60 patients complaining of hyperpigmented skin lesions (20 melasma, 20 solar lentigines, and 20 freckles) and 36 patients with skin tumors (14 BCC, 12 SCC, and 10 MM). Punch skin biopsies were taken from the previous lesions. Immunohistochemical staining of these samples was done using the stem cell factor (SCF).

RESULTS

There was positive expression of SCF in all cases of melasma, solar lentigines and freckles with significant increase in the intensity of expression in the lesional areas than the non-lesional ones (P=0.004). There was also a statistically significant increase in the expression of SCF in BCC and melanoma tumor cells.

CONCLUSION

SCF has a great role in skin hyperpigmented disorders and this can be used as a target for the developing of new antipigmentary lines of treatment by inhibiting SCF. SCF can also be involved in the emergence of some skin tumors.

Pre-treatment with Empagliflozin ameliorates Cisplatin induced acute kidney injury by suppressing apoptosis

Dose-limiting nephrotoxicity restricts Cisplatin use in high therapeutic doses. Empagliflozin showed a reno-protective effect in diabetic nephropathy. We investigated if Empagliflozin can ameliorate Cisplatin nephrotoxicity whether used prophylactically or therapeutically. Forty male Wistar rats were divided into 5 groups: (1) control; (2) Cisplatin-induced nephrotoxicity by single intraperitoneal dose; (3) Empagliflozin was given for 10 days before a single dose of Cisplatin; (4) a single dose of Cisplatin followed by Empagliflozin for 10 days; (5) received Empagliflozin only. Regular assessment of weight was done, biochemical evaluation for serum urea, creatinine, uric acid, albumin, and glucose was performed, kidney tissue nerve growth factor-β (NGF-β) and oxidative stress parameters were measured, kidneys were evaluated histopathologically and immunostained for caspase 3. Cisplatin significantly reduced body weight, NGF-β, and reduced glutathione, elevated urea, creatinine, and malondialdehyde with no effect on other serum biochemical parameters. Histopathologically, there was high acute tubular necrosis (ATN) score with strong immunostaining of caspase 3. The use of Empagliflozin significantly reduced urea and creatinine in both prophylactic and therapeutic, reduced ATN score in the prophylactic group associated with minimal staining of caspase 3 and elevated reduced glutathione. In conclusion, prophylactic Empagliflozin protected against Cisplatin-induced acute kidney injury mainly via anti-apoptotic effect.

Dipeptidyl peptidase-4 inhibitors: Anti-diabetic drugs with potential effects on cancer

Dipeptidyl peptidase (DPP- 4) inhibitors belong to the oral antidiabetic drugs. They are used for the treatment of Type 2 Diabetes mellitus. DPP-4 is an enzyme which puts down the action of hormone, incretin. Incretins belong to the group of hypoglycaemic gastrointestinal hormones. Some studies show that DPP-4 inhibitors causes cancer and some study show that they have anticancer property. This review sheds light on the role of the different types of DPP-4 inhibitors in cancer therapy.

The role of silent helicobacter pylori infection in intragastric ulcers induced by balloon insertion used for management of obesity

BACKGROUND

Obesity represents one of the common medical disorders that carries a high risk of morbidity and mortality. Insertion of intragastric balloon is one of the recently introduced lines of treatment of obesity. It allows patients to sense abdominal fullness and reduce their food intake. However, gastric ulceration may be a serious adverse effect that may be associated with intragastric balloon insertion.

AIM

To assess the role of silent helicobacter pylori infection in intragastric balloon-induced ulcers and to explore the possible methods for amelioration of this effect.

METHODS

Thirty patients were divided into 2 equal groups; one of them received triple therapy for helicobacter pylori eradication and the other group received placebo treatment. Then, they underwent intragastric balloon insertion. After removal of the balloon, gastroscopy was performed to evaluate the gastric mucosal lesions, if present.

RESULTS

There was significant decrease in the incidence of gastric erosions and ulcerations in the group that received triple therapy for helicobacter pylori eradication compared to the group that received placebo treatment.

CONCLUSION

Eradication of silent helicobacter pylori infection may represent a promising hope to decrease the incidence and improve symptoms of gastric erosions and ulceration that may be associated with intragastric balloon insertion.

Sleep disorders in adolescents and young adults: Insights into types, relationship to obesity and high altitude and possible lines of management

A sleep disorder is a medical disorder of the sleep pattern of a person that may be serious enough to interfere with normal physical, mental and emotional functioning. Disruptions in sleep can be caused by a variety of causes, from teeth grinding to night terrors. Sleep disorders are usually prevalent among adolescents and young adults, possibly due to factors related to life style, dietary habits, hormonal and emotional disturbances. Other factors that may precipitate sleep disorders include environmental, psychological and genetic factors. Sleep disorders may lead to serious psychological and mood disorders and may even affect the immune system. Management of sleep disorders depends on amelioration of the precipitating factors and the use of certain drugs that may help to restore the normal sleep-wake cycle. This review sheds light on sleep disorders in adolescents and young adults regarding their types, etiology, dangers and possible lines of management.

Sleep disorders in a sample of students in Taif University, Saudi Arabia: The role of obesity, insulin resistance, anemia and high altitude

AIM

The aim of this study was to assess the incidence of sleep disorders and excessive daytime sleepiness (EDS) among Taif University students and to explore the precipitating factors of these disorders.

METHODS

This study was carried out on 1066 students in Taif University of both sexes aging from 18 to 25 years. All included individuals were subjected to full history taking and thorough clinical examination, with special concern on anthropometric measurements (weight, height, waist-to-hip ratio and body mass index). Also, fasting blood glucose, fasting serum insulin, homeostatic model assessment (HOMA) index and blood hemoglobin levels were measured. Sleep disorders were assessed using sleep disturbances scale and the Epworth sleepiness scale.

RESULTS

The overall incidence of sleep disorders and EDS was 31.33% and 15.29% respectively with statistically significant prevalence in females than males. There was significant positive correlation between sleep disturbances scale and Epworth sleepiness scale on one hand and body weight, body mass index, waist-to-hip ratio, the height of the residence place above the sea level, fasting and post-prandial blood glucose, fasting serum insulin and HOMA index on the other hand. Also, there was significant negative correlation between sleep disturbances scale and Epworth sleepiness scale on one hand and blood hemoglobin levels on the other hand.

CONCLUSION

Sleep disorders and EDS in Taif University students were precipitated by high altitude, anemia, obesity and glucose intolerance. Control of these factors may have a positive impact on the incidence of sleep disorders and EDS in this age group.

Ameliorative potential of acupressure on gestational diabetes mellitus: A randomized controlled trial

Background and aim Gestational diabetes mellitus (GDM) poses a threat to the mother and child. The aim of this study was to examine the effect of acupressure on the glycemic control and insulin requirement of GDM females. Materials and methods Thirty GDM female patients were randomized to either the study group (SG; n=15), which was treated with acupressure and the standard antenatal care, or the control group (CG; n=15), which was treated with the standard antenatal care. Fasting and 2-h post-prandial blood glucose levels, requirement for insulin and insulin resistance were measured at 24 and 36 weeks' gestation (WG). Also, neonatal outcomes were registered at delivery. Results The pre intervention showed no statistically significant differences between SG and CG for baseline characteristics of participants (p>0.05). Within group analyses, after 12 weeks intervention had shown that 75 g oral glucose tolerance test (OGTT), insulin resistance, number of required insulin and measure of utilized insulin were significantly reduced (p<0.05), with significant increase in body mass index (BMI) (p<0.05) in both groups. All outcome measures were not significantly changed (p>0.05) between both groups at 24 and 36 WG. No significant differences (p>0.05) in pregnancy and neonatal outcomes between both groups at labor. Conclusions Acupressure may help to reduce gestational diabetes or insulin treatment for overweight female patients with GDM.

Ameliorative potential of sitagliptin and/or resveratrol on experimentally-induced clear cell renal cell carcinoma

The aim of this study was to assess the effect of sitagliptin with or without resveratrol on carcinogen-induced clear cell renal cell carcinoma. Sixty male Wistar rats were divided into 6 equal groups as follows: control; clear cell renal cell carcinoma group; clear cell renal cell carcinoma+sitagliptin group; clear cell renal cell carcinoma+resveratrol group; clear cell renal cell carcinoma+carboxymethyl cellulose group and clear cell renal cell carcinoma+sitagliptin+resveratrol group. Blood urea, serum creatinine, creatinine clearance, urinary N-acetyl beta-d-glucosaminidase (NAG), gamma glutamyl transpeptidase (GGT) and urinary albumin excretion rate (UAER) were determined. Renal tissue antioxidant enzymes, lactate dehydrogenase (LDH), nuclear factor (erythroid-derived 2)-like 2 (Nrf2), heme oxygenase-1 (HO-1), transforming growth factor beta-1 (TGF-β1), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and signal transducers and activators of transcription-3 (STAT3) were determined. Parts of the kidneys were subjected to histopathological and immunohistochemical examination for nuclear factor kappa B (p65). Sitagliptin and/or resveratrol induced significant improvement of the renal functions with significant increase in tissue antioxidant defenses and Nrf2/HO-1 content associated with significant decrease in tissue LDH, TGF-β1, TNF-α, IL-6 and STAT3 and alleviated the histopathological and immunohistochemical changes compared to the untreated clear cell renal cell carcinoma group. These effects were significant in sitagliptin/resveratrol combination group compared to the use of each of these drugs alone. In conclusion, sitagliptin/resveratrol combination might represent a beneficial therapeutic modality for amelioration of experimentally-induced clear cell renal cell carcinoma.

Ameliorative Effect of Coenzyme Q10 and/or Candesartan on Carboplatin-Induced Nephrotoxicity: Roles of Apoptosis, Transforming Growth Factor-Β1, Nuclear Factor Kappa-B And The Nrf2/HO-1 Pathway

Background:

Carboplatin is a drug that is used for treatment of many types of cancer. However, it may produce serious nephrotoxicity. Candesartan is angiotensin II receptor antagonist employed mainly for control of hypertension. Coenzyme Q10 (CoQ10) is a fat-soluble substance which was proven to have potent antioxidant and anti-inflammatory properties.

Aim:

Our aim was to study the effects of candesartan and/or CoQ10 on carboplatin-induced nephrotoxicity in mice.

Methods:

Sixty mice were divided into 6 equal groups: Control untreated; carboplatin; carboplatin + candesartan; carboplatin + CoQ10; carboplatin + carboxymethyl cellulose; and carboplatin + candesartan + CoQ10 group. Kidney weight/body weight ratio, blood urea, serum creatinine, creatinine clearance, urinary N-acetyl beta-D-glucosaminidase (NAG), gamma glutamyl transpeptidase (GGT) and the urinary albumin excretion rate (UAER) were determined. Renal tissue catalase (CAT), glutathione reductase (GR), nuclear factor (erythroid-derived 2)-like 2 (Nrf2), heme oxygenase-1 (HO-1), transforming growth factor beta-1 (TGF-β1), tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were also determined, along with mitochondrial complex I activity. In addition, portions of the kidney were subjected to histopathological and immunohistochemical examination.

Results:

Candesartan and/or CoQ10 induced significant improvement of renal and mitochondrial functions with significant increase in tissue CAT, GR, Nrf2 and HO-1 content associated with significant decrease in the kidney weight/body weight ratio, tissue TGF-β1, TNF-α and IL-6 and alleviation of the histopathological and immunohistochemical changes as compared to carboplatin alone group. These effects were more significant in candesartan/CoQ10 combination group compared to either candesartan or CoQ10 alone.

Conclusion:

Candesartan/CoQ10 combination might represent a beneficial therapeutic modality for amelioration of carboplatin-induced nephrotoxicity.

RETRACTED: Ameliorative potential of linagliptin and/or calcipotriol on bleomycin-induced lung fibrosis: In vivo and in vitro study

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted due to the authors’ plagiarism of text and images from the work of Eman Said Abd-Elkhalek, Hatem Abdel-Rahman Salem, Ghada Mohamed SuddeK, Marwa Ahmed Zaghloul and Ramy Ahmed Abdel-Salam, Faculties of Pharmacy and Medicine, Mansoura University, Mansoura, Egypt.