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Géza Pethő Á, Tapolyai M, Csongrádi É, Orosz P. Management of chronic kidney disease: The current novel and forgotten therapies. J Clin Transl Endocrinol 2024; 36:100354. [PMID: 38828402 PMCID: PMC11143912 DOI: 10.1016/j.jcte.2024.100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024] Open
Abstract
Chronic kidney disease (CKD) is a progressive and incurable condition that imposes a significant burden on an aging society. Although the exact prevalence of this disease is unknown, it is estimated to affect at least 800 million people worldwide. Patients with diabetes or hypertension are at a higher risk of developing chronic kidney damage. As the kidneys play a crucial role in vital physiological processes, damage to these organs can disrupt the balance of water and electrolytes, regulation of blood pressure, elimination of toxins, and metabolism of vitamin D. Early diagnosis is paramount to prevent potential complications. Treatment options such as dietary modifications and medications can help slow disease progression. In our narrative review, we have summarized the available therapeutic options to slow the progression of chronic kidney disease. Many new drug treatments have recently become available, offering a beacon of hope and optimism in CKD management. Nonetheless, disease prevention remains the most critical step in disease management. Given the significant impact of CKD on public health, there is a pressing need for further research. With the development of new technologies and advancements in medical knowledge, we hope to find more effective diagnostic tools and treatments for CKD patients.
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Affiliation(s)
- Ákos Géza Pethő
- Faculty of Medicine, Semmelweis University, Department of Internal Medicine and Oncology, Budapest, Hungary
| | - Mihály Tapolyai
- Medicine Service, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Department of Nephrology, Szent Margit Kórhaz, Budapest, Hungary
| | - Éva Csongrádi
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Petronella Orosz
- Bethesda Children’s Hospital, 1146 Budapest, Hungary
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
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El-Shoura EAM, Abdelzaher LA, Ahmed AAN, Abdel-Wahab BA, Sharkawi SMZ, Mohamed SA, Salem EA. Reno-protective effect of nicorandil and pentoxifylline against potassium dichromate-induced acute renal injury via modulation p38MAPK/Nrf2/HO-1 and Notch1/TLR4/NF-κB signaling pathways. J Trace Elem Med Biol 2024; 85:127474. [PMID: 38788404 DOI: 10.1016/j.jtemb.2024.127474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Occupational and environmental exposure to chromium compounds such as potassium dichromate (PDC) (K2Cr2O7) has emerged as a potential aetiologic cause for renal disease through apoptotic, and inflammatory reactions. The known potent antioxidants such as nicorandil (NIC) and/or pentoxifylline (PTX) were studied for their possible nephroprotective effect in PDC-treated rats. METHODS Forty male Wistar rats were divided into five groups; control, PDC group, NIC+PDC, PTX+PDC group, and combination+PDC group. Nephrotoxicity was evaluated histopathologically and biochemically. Invasive blood pressure, renal function parameters urea, creatinine, uric acid and albumin, glomerular filtration rate markers Cys-C, Kim-1 and NGAL, inflammatory markers IL-1β, IL-6, TNF-α, TGF-β, COX-II, p38MAPK, NF-κB and TLR4, oxidative stress SOD, GSH, MDA, MPO, HO-1 and Nrf2 and apoptotic mediators Notch1 and PCNA were evaluated. Besides, renal cortical histopathology was assayed as well. RESULTS PDC led to a considerable increase in indicators for kidney injury, renal function parameters, invasive blood pressure, oxidative stress, and inflammatory markers. They were markedly reduced by coadministration of PDC with either/or NIC and PTX. The NIC and PTX combination regimen showed a more significant improvement than either medication used alone. Our results demonstrated the nephroprotective effect of NIC, PTX, and their combined regimen on PDC-induced kidney injury through suppression of oxidative stress, apoptosis, and inflammatory response. CONCLUSION Renal recovery from PDC injury was achieved through enhanced MAPK/Nrf2/HO-1 and suppressed Notch1/TLR4/NF-κB signaling pathways. This study highlights the role of NIC and PTX as effective interventions to ameliorate nephrotoxicity in patients undergoing PDC toxicity.
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Affiliation(s)
- Ehab A M El-Shoura
- Department of Clinical Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt; Department of Pharmacy Practice, Faculty of Pharmacy, Horus University, New Damietta, Egypt.
| | - Lobna A Abdelzaher
- Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed A N Ahmed
- Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Basel A Abdel-Wahab
- Department of Pharmacology, College of Pharmacy, Najran University, P.O. Box 1988, Najran, Saudi Arabia
| | - Souty M Z Sharkawi
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | | | - Esraa A Salem
- Department of Medical Physiology, Faculty of Medicine, Menoufia University, Shebeen ElKom 32511, Egypt
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Fakih-Gomez N, Porcar Plana CA, Verano-Garcia A, Muñoz-Gonzalez C, Kadouch J. Updated Filler Emergency Kit: Next-Generation Emergency Solution. Aesthetic Plast Surg 2024; 48:1174-1180. [PMID: 37957396 DOI: 10.1007/s00266-023-03722-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/17/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION The rising popularity of facial filler injections has corresponded with an increase in reported complications. While a filler emergency kit was previously introduced, advancements in the field have highlighted certain limitations, prompting the development of the updated filler emergency kit (UFEK). METHODS The authors conducted literature research up to February 2023, focusing on PubMed and open web searches for articles referred to filler emergent complications: vascular occlusion, blindness and anaphylaxis. Approximately 1200 articles were obtained from PubMed and other sources, and 45 articles were reviewed. RESULTS The developed UFEK protocol delineates specific interventions meticulously tailored to address diverse emergent scenarios linked to soft tissue fillers complications. This protocol emphasizes the urgent requirement for timely and personalized interventions. CONCLUSION The UFEK offers a standardized, comprehensive and effective approach. This work contributes to the responsible and informed progression of the field of aesthetic medicine, providing more value and safety, both for clinicians and patients. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Nabil Fakih-Gomez
- Department of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon.
| | | | - Alba Verano-Garcia
- Department of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon
| | - Cristina Muñoz-Gonzalez
- Department of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon
| | - Jonathan Kadouch
- Practice for Aesthetic Dermatology, ReSculpt Clinic, Amsterdam, The Netherlands
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Omidifar N, Gholami A, Shokripour M, Nourani MA, Mohkam M, Mousavi SM, Hashemi SA, Khorram B, Ahmadabadi AN, Dara M. Protective Effects of Xanthine Derivatives Against Arsenic Trioxide-Induced Oxidative Stress in Mouse Hepatic and Renal Tissues. Drug Res (Stuttg) 2024; 74:133-144. [PMID: 38350632 DOI: 10.1055/a-2247-5232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
In this study, the protective efficacy of pentoxifylline (PTX) as a xanthine derivative against arsenic trioxide (ATO)-induced kidney and liver damage in mice was investigated. Thirty-six mice were divided into six groups, receiving intraperitoneal injections of saline, ATO, PTX, or a combination for four weeks. Blood samples were analyzed for serum biochemistry, while hepatic tissue underwent examination for histopathological changes and assessment of oxidative stress markers and antioxidant gene expression through Real-Time PCR. ATO exposure significantly increased serum markers (creatinine, ALT, BUN, ALP, AST) and induced histopathological changes in the liver. Moreover, it elevated renal and hepatic nitric oxide (NO) and lipid peroxidation (LPO) levels, and reduced antioxidant enzyme expression (CAT, GSR, GPx, MPO, SOD), total thiol groups (TTGs), and total antioxidant capacity (TAC). Conversely, PTX treatment effectively lowered serum hepatic and renal markers, improved antioxidant markers, and induced histopathological alterations. Notably, PTX did not significantly affect renal and hepatic NO levels. These findings suggest that PTX offers therapeutic potential in mitigating liver and acute kidney injuries induced by various insults, including exposure to ATO.
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Affiliation(s)
- Navid Omidifar
- Biotechnology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Gholami
- Biotechnology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansoureh Shokripour
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Nourani
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Milad Mohkam
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Mojtaba Mousavi
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei City, Taiwan
| | - Seyyed Alireza Hashemi
- Health Policy Research Center, Health Institute, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bagher Khorram
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Nili Ahmadabadi
- Department of Pharmacology and Toxicology, Medicinal Plants and Natural Products Research Center, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan
| | - Mahintaj Dara
- Stem Cells and Transgenic Technology Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Rezaie MJ, Allahveisi A, Raoofi A, Rezaei M, Nikkhoo B, Mousavi Khaneghah A. In vitro effects of pentoxifylline and coenzyme Q10 on the sperm of oligoasthenoteratozoospermia patients. HUM FERTIL 2023; 26:908-917. [PMID: 34933649 DOI: 10.1080/14647273.2021.2017024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
The effect of in-vitro sperm incubation with Pentoxifylline (PTX) and Coenzyme Q10 (CoQ10) in Oligoasthenoteratozoospermia (OAT) patients was evaluated. Semen samples were obtained from men with Normozoospermia and men with OAT. Motile sperm from the two groups were subdivided into four subgroups: (i) without incubation with PTX + CoQ10; (ii) incubation with PTX; (iii) Incubation with CoQ10; and (iv) incubation with a combination of PTX + CoQ10. Then, sperm parameters, chromatin, DNA and membrane integrity, protamine deficiency, apoptosis, mitochondrial activity, sperm chromatin dispersion test (SCD), hypo-osmotic swelling test (HOS), chromomycin A3 (CMA3), Terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL), and diaminobenzidine (DAB) assays were evaluated, respectively. Sperm incubated with CoQ10 and a combination of CoQ10 and PTX resulted in a significant increase in the sperm parameters. Also, a significant decrease was noted with a combination of PTX and CoQ10 in normal men. There was a significant difference between CoQ10 treated and CoQ10 + PTX treated groups in comparison with the OAT group in the percentage of the DNA fragmentation, sperm apoptosis, AB+, HOS test + and sperm mitochondrial activity. Incubated sperm with CoQ10, PTX, and in combination with each other can improve sperm parameters in OAT patients.
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Affiliation(s)
- Mohammad Jafar Rezaie
- Department of Anatomical Sciences, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Azra Allahveisi
- Department of Anatomical Sciences, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amir Raoofi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
- Department of Anatomy, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Masomeh Rezaei
- Infertility Treatment Center of Besat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bahram Nikkhoo
- Department of Pathology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amin Mousavi Khaneghah
- Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
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Xu Y, Gao X, Zhu Y, Zhang Q, Qie H, Zhao H, Gao J, Wang M. Development and Validation a UPLC-MS/MS Method for Quantification of Pentoxifylline in Beagle Plasma: Application for Pharmacokinetic Study of Food Effect. Drug Des Devel Ther 2023; 17:3551-3561. [PMID: 38046282 PMCID: PMC10693274 DOI: 10.2147/dddt.s434492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/18/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose To develop an UPLC-MS/MS method for the quantitative analysis of pentoxifylline in beagle dog plasma and apply it to a pharmacokinetic study of food effect. Methods Sample separation was achieved using a Kinetex Phenyl-Hexyl column (50 × 2.1 mm, 1.7 μm) with a gradient elution program in 5.5 min after a simple protein precipitation with methanol. Using the mobile phase that made up by 0.2% formic acid and 5mM ammonium formate water (A) and methanol (B). Quantitation was carried out using the positive ionization mode with multiple reaction monitoring (MRM). A randomized, single-dose, two-period crossover study was conducted in six fasted or fed beagles that received 400 mg pentoxifylline sustained-release tablets (Brand name: Shuanling™, CSPC Pharmaceutical Group). WinNonlin® software was used to calculate pharmacokinetic parameters. Results The linear calibration range was 2-1000 ng/mL (r2> 0.99). Both intra- and inter-batch precision were less than 6.27%, and the accuracy ranged from 88.65% to 97.18%. Pentoxifylline was readily absorbed in fasted and fed dogs administered a dose of 400 mg (tmax:1.54h vs 1.83h). Compared to the fasted group, the AUC0→t and Cmax in the fed group increased by 1.71-fold and 1.30-fold, respectively. In the fasted group, the AUC0→t and Cmax values were 4684.08 h•ng/mL and 2402.33 ng/mL, respectively. In the fed group, these values were 8027.75 h•ng/mL and 3119.67 ng/mL. The difference in AUC0-t between the fed and fasted group was statistically significant. Conclusion The novel optimized UPLC-MS/MS assay is an effective tool for the determination of pentoxifylline and has been successfully applied in pharmacokinetic studies of pentoxifylline in beagle dogs. The administration of pentoxifylline sustained-release tablets with food significantly increased the area under the time curve, and it is recommended that they should be administered during or shortly after feeding.
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Affiliation(s)
- Yuxiang Xu
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
| | - Xiaonan Gao
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
| | - Yunfang Zhu
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
| | - Qi Zhang
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
| | - Hongxin Qie
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
| | - Haopeng Zhao
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
| | - Jinglin Gao
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
| | - Mingxia Wang
- Department of Clinical Pharmacology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People’s Republic of China
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Dąbek B, Dybiec J, Frąk W, Fularski P, Lisińska W, Radzioch E, Młynarska E, Rysz J, Franczyk B. Novel Therapeutic Approaches in the Management of Chronic Kidney Disease. Biomedicines 2023; 11:2746. [PMID: 37893119 PMCID: PMC10604464 DOI: 10.3390/biomedicines11102746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
Chronic kidney disease (CKD) is a progressive and incurable disease that impairs kidney function. Its prevalence is estimated to affect up to 800 million individuals within the general population, and patients with diabetes and hypertension are particularly at risk. This disorder disrupts the physiological mechanisms of the body, including water and electrolyte balance, blood pressure regulation, the excretion of toxins, and vitamin D metabolism. Consequently, patients are exposed to risks such as hyperkalemia, hyperphosphatemia, metabolic acidosis, and blood pressure abnormalities. These risks can be reduced by implementing appropriate diagnostic methods, followed by non-pharmacological (such as physical activity, dietary, and lifestyle adjustment) and pharmacological strategies after diagnosis. Selecting the appropriate diet and suitable pharmacological treatment is imperative in maintaining kidney function as long as possible. Drugs such as finerenone, canakinumab, and pentoxifylline hold promise for improved outcomes among CKD patients. When these interventions prove insufficient, renal replacement therapy becomes essential. This is particularly critical in preserving residual renal function while awaiting renal transplantation or for patients deemed ineligible for such a procedure. The aim of this study is to present the current state of knowledge and recent advances, providing novel insights into the treatment of chronic kidney disease.
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Affiliation(s)
- Bartłomiej Dąbek
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Jill Dybiec
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Weronika Frąk
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Piotr Fularski
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Wiktoria Lisińska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Ewa Radzioch
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
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Larocca CA, Fay CJ, Hirner JP, Meyerhardt JA, Cleary JM, Dewan AK, LeBoeuf NR. Diffuse Cutaneous Aphthosis After Combined Targeted Cancer Therapies and Responsive to Pentoxifylline. JAMA Dermatol 2023; 159:1136-1139. [PMID: 37610794 PMCID: PMC10448362 DOI: 10.1001/jamadermatol.2023.2649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/09/2023] [Indexed: 08/24/2023]
Abstract
This case series describes 3 patients who developed cutaneous aphthosis while taking an epidermal growth factor receptor inhibitor in combination with an MEK inhibitor.
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Affiliation(s)
- Cecilia A. Larocca
- Center for Cutaneous Oncology, Department of Dermatology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Christopher J. Fay
- Center for Cutaneous Oncology, Department of Dermatology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jesse P. Hirner
- Department of Dermatology, University of Missouri Health Care, Columbia
| | | | - James M. Cleary
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Anna K. Dewan
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nicole R. LeBoeuf
- Center for Cutaneous Oncology, Department of Dermatology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, Massachusetts
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Kim EY, Hussain A, Khachemoune A. Evidence-based management of keloids and hypertrophic scars in dermatology. Arch Dermatol Res 2023; 315:1487-1495. [PMID: 36504113 DOI: 10.1007/s00403-022-02509-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
While normal, controlled wound-healing results in scars that are nearly imperceptible, hypertrophic scars (HTS) and keloids are the result of an abnormal wound-healing process that can leave unsightly, difficult-to-treat lesions. While such scars are classically associated with surgical incisions, they may also result from burns or accidental trauma to the skin. Several different measures can be taken to prevent the formation of scars or treat those that have already formed. Prevention focuses on reducing inflammation during the wound-healing process, and minimizing tension in the lesion when appropriate. Treatments range from non-invasive modalities such as pressure therapy, topicals, and symptom management, to invasive methods such as injections, lasers, and even surgery. While some treatments, such as corticosteroid injections, have been used in the treatment of HTS and keloids for decades, other newer therapies have only been described in case reports or are still in early phases of clinical trials. Because optimal scar management will not be the same for every patient, further investigation of newer agents and methods is warranted and may benefit a great number of patients. This paper will review the evidence-based management of scars, including current widely used treatment options and promising newly emerging therapies.
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Affiliation(s)
- Emily Y Kim
- Georgetown University School of Medicine, Washington, DC, USA
| | - Aamir Hussain
- MedStar Washington Hospital Center/Georgetown University Dermatology Residency Program, Washington, DC, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, SUNY Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA.
- Department of Dermatology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA.
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Palafox-Mariscal LA, Ortiz-Lazareno PC, Jave-Suárez LF, Aguilar-Lemarroy A, Villaseñor-García MM, Cruz-Lozano JR, González-Martínez KL, Méndez-Clemente AS, Bravo-Cuellar A, Hernández-Flores G. Pentoxifylline Inhibits TNF-α/TGF-β1-Induced Epithelial-Mesenchymal Transition via Suppressing the NF-κB Pathway and SERPINE1 Expression in CaSki Cells. Int J Mol Sci 2023; 24:10592. [PMID: 37445768 DOI: 10.3390/ijms241310592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
Cervical cancer (CC) is one of the most common and deadly types of female cancer worldwide. Late diagnosis in CC increases the risk of tumor cells spreading to distant organs (metastasis). The epithelial-mesenchymal transition (EMT) is a fundamental process of cancer metastasis. Inflammation can lead to tumor progression, EMT induction, and metastasis. The inflammatory microenvironment is a potent inducer of EMT; inflammatory cytokines such as Tumor Necrosis Factor-alpha (TNF-α) and Transforming growth factor-beta (TGF-β1) activate transcriptional factors such as STAT3, Snail, Smad, and the Nuclear Factor kappa light-chain-enhancer of activated beta cells (NF-κΒ), which drive EMT. Anti-inflammatory compounds may be an option in the disruption of EMT. PenToXifylline (PTX) possesses potent anti-inflammatory effects by inhibiting NF-κB activity. In addition, PTX exerts an anti-fibrotic effect by decreasing Smad2/3/4. We hypothesize that PTX could exert anti-EMT effects. CaSki human cervical tumor cells were exposed to TNF-α 10 ng/mL and TGF-β1 alone or in combination for 5 days. Our results revealed that TNF-α and TGF-β1 induced N-cadherin and Vimentin, confirming the induction of EMT. Furthermore, the combination of cytokines synergized the expression of mesenchymal proteins, enhanced IκBα and p65 phosphorylation, and upregulated Serpin family E member 1 (SERPINE1) mRNA. PTX pretreatment prior to the addition of TNF-α and TGF-β1 significantly reduced N-cadherin and Vimentin levels. To our knowledge, this is the first time that this effect of PTX has been reported. Additionally, PTX reduced the phosphorylation of IκB-α and p65 and significantly decreased SERPINE1 expression, cell proliferation, migration, and invasion. In conclusion, PTX may counteract EMT in cervical cancer cells by decreasing the NF-κB and SERPINE1.
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Affiliation(s)
- Luis Arturo Palafox-Mariscal
- Doctoral Program in Biomedical Sciences Orientation Immunology, University Center for Health Science (CUCS), University of Guadalajara (UdeG), 44340 Guadalajara, Jalisco, Mexico
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
| | - Pablo Cesar Ortiz-Lazareno
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
| | - Luis Felipe Jave-Suárez
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
| | - Adriana Aguilar-Lemarroy
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
| | - María Martha Villaseñor-García
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
- Department of Pharmacobiology, University Center for Exact Sciences and Engineering (CUCEI), University of Guadalajara (UdeG), 44340 Guadalajara, Jalisco, Mexico
| | - José Roberto Cruz-Lozano
- Doctoral Program in Biomedical Sciences Orientation Immunology, University Center for Health Science (CUCS), University of Guadalajara (UdeG), 44340 Guadalajara, Jalisco, Mexico
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
| | - Karen Lilith González-Martínez
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
- Doctoral Program in Molecular Biology in Medicine, University Center for Health Science (CUCS), University of Guadalajara (UdeG), 44340 Guadalajara, Jalisco, Mexico
| | | | - Alejandro Bravo-Cuellar
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
- Department of Health Sciences, Los Altos University Center (CUALtos), University of Guadalajara (UdeG), 47620 Tepatitlan de Morelos, Jalisco, Mexico
| | - Georgina Hernández-Flores
- Immunology Division, Biomedical Research Center West (CIBO), Mexican Social Security Institute, 44340 Guadalajara, Jalisco, Mexico
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11
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Marsella R, White S, Fadok VA, Wilson D, Mueller R, Outerbridge C, Rosenkrantz W. Equine allergic skin diseases: Clinical consensus guidelines of the World Association for Veterinary Dermatology. Vet Dermatol 2023; 34:175-208. [PMID: 37154488 DOI: 10.1111/vde.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Allergic skin diseases are common in horses worldwide. The most common causes are insect bites and environmental allergens. OBJECTIVES To review the current literature and provide consensus on pathogenesis, diagnosis, treatment and prevention. MATERIALS AND METHODS The authors reviewed the literature up to November 2022. Results were presented at North America Veterinary Dermatology Forum (2021) and European Veterinary Dermatology Congress (2021). The report was available to member organisations of the World Association for Veterinary Dermatology for feedback. CONCLUSIONS AND CLINICAL RELEVANCE Insect bite hypersensitivity (IBH) is the best characterised allergic skin disease. An immunoglobulin (Ig)E response against Culicoides salivary antigens is widely documented. Genetics and environmental factors play important roles. Tests with high sensitivity and specificity are lacking, and diagnosis of IBH is based on clinical signs, seasonality and response to insect control. Eosinophils, interleukin (IL)-5 and IL-31 are explored as therapeutic targets. Presently, the most effective treatment is insect avoidance. Existing evidence does not support allergen-specific immunotherapy (ASIT) using commercially available extracts of Culicoides. Hypersensitivity to environmental allergens (atopic dermatitis) is the next most common allergy. A role for IgE is supported by serological investigation, skin test studies and positive response to ASIT. Prospective, controlled, randomised studies are limited, and treatment relies largely on glucocorticoids, antihistamines and ASIT based on retrospective studies. Foods are known triggers for urticaria, yet their role in pruritic dermatitis is unknown. Recurrent urticaria is common in horses, yet our understanding is limited and focussed on IgE and T-helper 2 cell response. Prospective, controlled studies on treatments for urticaria are lacking. Glucocorticoids and antihistamines are primary reported treatments.
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Affiliation(s)
- R Marsella
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - S White
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - V A Fadok
- Zoetis, US PET CARE, Bellaire, Texas, USA
| | - D Wilson
- School of Clinical Veterinary Sciences, University of Bristol, Bristol, UK
| | - R Mueller
- Medizinische Keleintierklinik, Zentrum für klinische Tiermedizin, LMU, Munich, Germany
| | - C Outerbridge
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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12
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Okonkwo ON, Agweye CT, Akanbi T. Neuroprotection for Nonarteritic Central Retinal Artery Occlusion: Lessons from Acute Ischemic Stroke. Clin Ophthalmol 2023; 17:1531-1543. [PMID: 37284058 PMCID: PMC10239763 DOI: 10.2147/opth.s403433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
Nonarteritic central retinal artery occlusion (NA-CRAO) is a variant of acute ischemic stroke (AIS) and is a cause of sudden severe loss of vision. There are guidelines by the American Heart Association and the American Stroke Association for the care of CRAO patients. This review explores the basis of retinal neuroprotection for CRAO and its potential for improving the outcome of NA-CRAO. Recently, there have been significant advances in research into the use of neuroprotection to treat retinal diseases, including retinal detachment, age-related macular degeneration, and inherited retinal diseases. Also, neuroprotective research in AIS has been extensive, and newer drugs tested, including Uric acid, Nerinetide, and Otaplimastat, with promising results. Progress in cerebral neuroprotection after AIS offers hope for retinal neuroprotection after CRAO; and a possibility of extrapolating research findings from AIS into CRAO. Combining neuroprotection and thrombolysis can extend the therapeutic window for NA-CRAO treatment and potentially improve outcomes. Experimented neuroprotection for CRAO includes Angiopoietin (Comp Ang1), KUS 121, Gene therapy (XIAP), and hypothermia. Efforts in the field of neuroprotection for NA-CRAO should focus on better imaging to delineate the penumbra after an acute episode of NA-CRAO (using a combination of high-definition optical coherence angiography and electrophysiology). Also, research should explore details of pathophysiologic mechanisms involved in NA-CRAO, allowing for further neuroprotective intervention, and closing the gap between preclinical and clinical neuroprotection.
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Affiliation(s)
- Ogugua Ndubuisi Okonkwo
- Department of Ophthalmology, Eye Foundation Hospital and Eye Foundation Retina Institute, Ikeja, Lagos, Nigeria
| | - Chineze Thelma Agweye
- Department of Ophthalmology, University of Calabar and University of Calabar Teaching Hospital, Cross River, Nigeria
| | - Toyin Akanbi
- Department of Ophthalmology, Eye Foundation Hospital and Eye Foundation Retina Institute, Ikeja, Lagos, Nigeria
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Khoury W, Trus R, Chen X, Baghaie L, Clark M, Szewczuk MR, El-Diasty M. Parsimonious Effect of Pentoxifylline on Angiogenesis: A Novel Pentoxifylline-Biased Adenosine G Protein-Coupled Receptor Signaling Platform. Cells 2023; 12:cells12081199. [PMID: 37190108 DOI: 10.3390/cells12081199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
Angiogenesis is the physiological process of developing new blood vessels to facilitate the delivery of oxygen and nutrients to meet the functional demands of growing tissues. It also plays a vital role in the development of neoplastic disorders. Pentoxifylline (PTX) is a vasoactive synthetic methyl xanthine derivative used for decades to manage chronic occlusive vascular disorders. Recently, it has been proposed that PTX might have an inhibitory effect on the angiogenesis process. Here, we reviewed the modulatory effects of PTX on angiogenesis and its potential benefits in the clinical setting. Twenty-two studies met the inclusion and exclusion criteria. While sixteen studies demonstrated that pentoxifylline had an antiangiogenic effect, four suggested it had a proangiogenic effect, and two other studies showed it did not affect angiogenesis. All studies were either in vivo animal studies or in vitro animal and human cell models. Our findings suggest that pentoxifylline may affect the angiogenic process in experimental models. However, there is insufficient evidence to establish its role as an anti-angiogenesis agent in the clinical setting. These gaps in our knowledge regarding how pentoxifylline is implicated in host-biased metabolically taxing angiogenic switch may be via its adenosine A2BAR G protein-coupled receptor (GPCR) mechanism. GPCR receptors reinforce the importance of research to understand the mechanistic action of these drugs on the body as promising metabolic candidates. The specific mechanisms and details of the effects of pentoxifylline on host metabolism and energy homeostasis remain to be elucidated.
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Affiliation(s)
- William Khoury
- School of Medicine, Queen's University, Kingston, ON K7L 3L4, Canada
| | - Ryan Trus
- Faculty of Arts and Science, Queen's University, Kingston, ON K7L 3N9, Canada
- School of Medicine, The Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Xingyu Chen
- School of Medicine, Queen's University, Kingston, ON K7L 3L4, Canada
| | - Leili Baghaie
- Department of Biomedical & Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Mira Clark
- Faculty of Arts and Science, Queen's University, Kingston, ON K7L 3N9, Canada
- Department of Biomedical & Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Myron R Szewczuk
- Department of Biomedical & Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Mohammad El-Diasty
- Division of Cardiac Surgery, Queen's University, Kingston, ON K7L 2V7, Canada
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Balazic E, Axler E, Konisky H, Khanna U, Kobets K. Pentoxifylline in dermatology. J Cosmet Dermatol 2023; 22:410-417. [PMID: 36208009 DOI: 10.1111/jocd.15445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pentoxifylline was initially marketed for use in patients with intermittent claudication due to chronic occlusive arterial disease of the extremities but has since been shown to have several off-label uses in dermatology. AIMS The aim of this review is to increase awareness of the several applications of pentoxifylline in the field of dermatology. METHODS A comprehensive PubMed search was conducted in May 2022 using the following phrases "dermatology" AND "pentoxifylline." Our search period spanned 34 years from 1988 to 2022. All available literature was reviewed. Reference lists of identified articles were included. Studies were excluded if they were not in English and if the study was out of scope. Eighty-one articles were included in this review. RESULTS Pentoxifylline has been used to treat various dermatological conditions including peripheral vascular disease, vasculitis and vasculopathies, chilblains, pigmented purpuric dermatosis, granuloma annulare, necrobiosis, keloids, lichen sclerosis et atrophicus, scars, radiation-induced fibrosis, vitiligo, alopecia areata, leishmaniasis, and leprosy. CONCLUSIONS Pentoxifylline's use in dermatology is growing. However, there are limited larger studies and randomized control trials on the use of pentoxifylline in dermatology and more investigation is needed to evaluate its use for many dermatologic conditions. Pentoxifylline's unique mechanism of action as well as its good tolerability, cost-effectiveness, and minimal drug interactions make it a convenient primary or adjunctive option in many dermatological conditions.
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Affiliation(s)
- Eliza Balazic
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Eden Axler
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Hailey Konisky
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Urmi Khanna
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Kseniya Kobets
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
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15
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Park DJ, Duggan E, Ho K, Dorschner RA, Dobke M, Nolan JP, Eliceiri BP. Serpin-loaded extracellular vesicles promote tissue repair in a mouse model of impaired wound healing. J Nanobiotechnology 2022; 20:474. [PMID: 36335351 PMCID: PMC9636779 DOI: 10.1186/s12951-022-01656-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/29/2022] [Indexed: 11/08/2022] Open
Abstract
Chronic metabolic diseases such as diabetes are characterized by delayed wound healing and a dysregulation of the inflammatory phase of wound repair. Our study focuses on changes in the payload of extracellular vesicles (EVs) communicating between immune cells and stromal cells in the wound bed, which regulate the rate of wound closure. Adoptive transfer of EVs from genetically defined mouse models are used here to demonstrate a functional and molecular basis for differences in the pro-reparative biological activity of diabetic (db/db) vs. wildtype EVs in wound healing. We identify several members of the Serpin family of serine protease inhibitors that are absent in db/db EVs, then we overexpress Serpin A1, F2 and G1 in EVs to evaluate their effect on wound healing in db/db mice. Serpins have an important role in regulating levels of elastase, plasmin and complement factors that coordinate immune cell signaling in full thickness wounds in a diabetic model. Here, we establish a novel therapeutic approach by engineering the payload of EVs based on proteomic analysis. Serpin-loaded EVs were used to rescue the Serpin deficiency identified by proteomics and promote wound healing in db/db mice, as well as evaluated how EVs affected extracellular matrix remodeling and the resolution of tissue injury. Therefore, we propose that the identification of EV payloads that are downregulated in diabetic wounds can be systematically analyzed for their functional activity and potential as a therapeutic, based on whether their re-expression in engineered EVs restores normal kinetics of tissue repair in chronic wounds.
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Affiliation(s)
- Dong Jun Park
- Departments of Surgery, University of California San Diego, 9500 Gilman Drive, MC 8236, La Jolla, CA, 92093-8236, USA
| | - Erika Duggan
- Scintillon Institute, 6868 Nancy Ridge, San Diego, CA, 92121, USA
| | - Kayla Ho
- Departments of Surgery, University of California San Diego, 9500 Gilman Drive, MC 8236, La Jolla, CA, 92093-8236, USA
| | - Robert A Dorschner
- Dermatology, University of California San Diego, 9500 Gilman Drive, MC 8236, La Jolla, CA, 92093-8236, USA
| | - Marek Dobke
- Departments of Surgery, University of California San Diego, 9500 Gilman Drive, MC 8236, La Jolla, CA, 92093-8236, USA
| | - John P Nolan
- Scintillon Institute, 6868 Nancy Ridge, San Diego, CA, 92121, USA
| | - Brian P Eliceiri
- Departments of Surgery, University of California San Diego, 9500 Gilman Drive, MC 8236, La Jolla, CA, 92093-8236, USA.
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16
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Cyclosporine and Pentoxifylline laden Tailored Niosomes for the effective management of Psoriasis: In-vitro Optimization, Ex-vivo and Animal Study. Int J Pharm 2022; 626:122143. [PMID: 36037986 DOI: 10.1016/j.ijpharm.2022.122143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022]
Abstract
Psoriasis is a chronic skin inflammatory auto-immune disorder. Cyclosporine is the drug of choice in severe cases of psoriasis for systemic administration. But its systemic administration leads to some serious side effects like nephrotoxicity and cardiovascular disorders. Pentoxifylline is reported to reduce such side effects of cyclosporine and also it is found useful in the management of psoriasis. In this study, Box-Behnken design was used to prepare and optimize Cyclosporine and Pentoxifylline loaded niosomes. The optimized niosomes were prepared using cholesterol and surfactant (7:3), a total of 500µmol. Ratio of Tween 80 to span 80 for the preparation of optimized niosome was 0.503 (tween80:span80), and hydration and sonication time were kept at 60 minutes and 10 minutes, respectively. Size, Poly Dispersity Index, zeta potential, and % entrapment efficiency of Pentoxifylline and cyclosporine, for optimized niosomes were found to be 179nm, 0.285, -37.5mV, 84.6%, and 75.3%, respectively. The optimized niosomes were further studied for in-vitro skin permeation and skin deposition. Though niosomes significantly influenced the permeation of both drugs, only a small amount of drug (both cyclosporine and Pentoxifylline) was permeated through the skin. In comparison with the permeation, the quantity of drug retained in the stratum corneum and viable epidermis (SC and VED) was very high. In the in-vivo studies conducted on mice induced with psoriasis using imiquimod, both the histopathology and psoriasis area severity index has shown marked improvement in the skin condition of mice treated with niosomes loaded with Pentoxifylline and cyclosporine, in comparison with the solution/suspension of individual drugs. The study shows that niosomes could be effectively used for the simultaneous delivery of cyclosporine and Pentoxifylline for the better management of psoriasis.
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17
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Zhang S, Liu H, Yang N, Xiong L, Wang B. Synthesis and evaluation of novel xanthine-acrylamides and xanthine-acrylates as insecticidal agents. PEST MANAGEMENT SCIENCE 2022; 78:2086-2095. [PMID: 35142104 DOI: 10.1002/ps.6834] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The design and discovery of novel pesticidal agents according to bioactive natural products is an important aspect of agrochemical innovation. New xanthine derivatives derived from natural xanthine or methylxanthines are rich resources that possess great potential to afford new active pesticidal molecules. Herein novel xanthine derivatives were designed through a strategy of combining the methylxanthine caffeine skeleton with the acrylamide or acrylate motif of cinnamic acid derivatives. RESULTS A series of novel (E)-3-(1,3,7-trimethyl-2,6-dioxo-2,3,6,7-tetrahydro-1H-purin-8-yl)acrylic acid derivatives, caffeine-(E)-acrylamides and caffeine-(E)-acrylates, were synthesized and confirmed via melting points, 1 H NMR, 13 C NMR and high-resolution mass spectrometry. A single crystal of compound I12 was obtained to illustrate the trans-configuration of the vinyl double bond. Preliminary insecticidal evaluations showed that some of the compounds had favorable insecticidal potentials against Mythimna separata Walker at 200 mg L-1 . Some of the compounds exhibited excellent insecticidal activity against Plutella xylostella L. at low test concentrations, e.g. I18 and I24 with LC50 values of 0.0435 and 0.0133 mg L-1 , respectively, were found to be more potent than the insecticide control triflumuron. The structure-activity relationship (SAR) analysis is also given in detail. CONCLUSION Compounds I12, I18, I24 and I26 generated from the integration of natural methylxanthine (caffeine) and acrylate moieties could be novel insecticidal leading compounds for further structural optimization. The SAR analysis may bring a new inspiration to the extensive and deep investigations on new xanthine derivatives in the agrochemical area.
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Affiliation(s)
- Shuyun Zhang
- State Key Laboratory of Elemento-Organic Chemistry, College of Chemistry, Nankai University, Tianjin, China
| | - Hang Liu
- State Key Laboratory of Elemento-Organic Chemistry, College of Chemistry, Nankai University, Tianjin, China
| | - Na Yang
- State Key Laboratory of Elemento-Organic Chemistry, College of Chemistry, Nankai University, Tianjin, China
| | - Lixia Xiong
- State Key Laboratory of Elemento-Organic Chemistry, College of Chemistry, Nankai University, Tianjin, China
| | - Baolei Wang
- State Key Laboratory of Elemento-Organic Chemistry, College of Chemistry, Nankai University, Tianjin, China
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18
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McLarnon SR, Wilson K, Patel B, Sun J, Sartain CL, Mejias CD, Musall JB, Sullivan JC, Wei Q, Chen JK, Hyndman KA, Marshall B, Yang H, Fogo AB, O’Connor PM. Lipopolysaccharide Pretreatment Prevents Medullary Vascular Congestion following Renal Ischemia by Limiting Early Reperfusion of the Medullary Circulation. J Am Soc Nephrol 2022; 33:769-785. [PMID: 35115326 PMCID: PMC8970460 DOI: 10.1681/asn.2021081089] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/16/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Vascular congestion of the renal medulla-trapped red blood cells in the medullary microvasculature-is a hallmark finding at autopsy in patients with ischemic acute tubular necrosis. Despite this, the pathogenesis of vascular congestion is not well defined. METHODS In this study, to investigate the pathogenesis of vascular congestion and its role in promoting renal injury, we assessed renal vascular congestion and tubular injury after ischemia reperfusion in rats pretreated with low-dose LPS or saline (control). We used laser Doppler flowmetry to determine whether pretreatment with low-dose LPS prevented vascular congestion by altering renal hemodynamics during reperfusion. RESULTS We found that vascular congestion originated during the ischemic period in the renal venous circulation. In control animals, the return of blood flow was followed by the development of congestion in the capillary plexus of the outer medulla and severe tubular injury early in reperfusion. Laser Doppler flowmetry indicated that blood flow returned rapidly to the medulla, several minutes before recovery of full cortical perfusion. In contrast, LPS pretreatment prevented both the formation of medullary congestion and its associated tubular injury. Laser Doppler flowmetry in LPS-pretreated rats suggested that limiting early reperfusion of the medulla facilitated this protective effect, because it allowed cortical perfusion to recover and clear congestion from the large cortical veins, which also drain the medulla. CONCLUSIONS Blockage of the renal venous vessels and a mismatch in the timing of cortical and medullary reperfusion results in congestion of the outer medulla's capillary plexus and promotes early tubular injury after renal ischemia. These findings indicate that hemodynamics during reperfusion contribute to the renal medulla's susceptibility to ischemic injury.
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Affiliation(s)
- Sarah R. McLarnon
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Katie Wilson
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Bansari Patel
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Jingping Sun
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Christina L. Sartain
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Christopher D. Mejias
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Jacqueline B. Musall
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Jennifer C. Sullivan
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Qingqing Wei
- Department of Cell Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Jian-Kang Chen
- Department of Cell Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Kelly A. Hyndman
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brendan Marshall
- Department of Cell Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Haichun Yang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Agnes B. Fogo
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Paul M. O’Connor
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
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Janitschke D, Lauer AA, Bachmann CM, Winkler J, Griebsch LV, Pilz SM, Theiss EL, Grimm HS, Hartmann T, Grimm MOW. Methylxanthines Induce a Change in the AD/Neurodegeneration-Linked Lipid Profile in Neuroblastoma Cells. Int J Mol Sci 2022; 23:ijms23042295. [PMID: 35216410 PMCID: PMC8875332 DOI: 10.3390/ijms23042295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/08/2021] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer's disease (AD) is characterized by an increased plaque burden and tangle accumulation in the brain accompanied by extensive lipid alterations. Methylxanthines (MTXs) are alkaloids frequently consumed by dietary intake known to interfere with the molecular mechanisms leading to AD. Besides the fact that MTX consumption is associated with changes in triglycerides and cholesterol in serum and liver, little is known about the effect of MTXs on other lipid classes, which raises the question of whether MTX can alter lipids in a way that may be relevant in AD. Here we have analyzed naturally occurring MTXs caffeine, theobromine, theophylline, and the synthetic MTXs pentoxifylline and propentofylline also used as drugs in different neuroblastoma cell lines. Our results show that lipid alterations are not limited to triglycerides and cholesterol in the liver and serum, but also include changes in sphingomyelins, ceramides, phosphatidylcholine, and plasmalogens in neuroblastoma cells. These changes comprise alterations known to be beneficial, but also adverse effects regarding AD were observed. Our results give an additional perspective of the complex link between MTX and AD, and suggest combining MTX with a lipid-altering diet compensating the adverse effects of MTX rather than using MTX alone to prevent or treat AD.
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Affiliation(s)
- Daniel Janitschke
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Anna Andrea Lauer
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Cornel Manuel Bachmann
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Jakob Winkler
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Lea Victoria Griebsch
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Sabrina Melanie Pilz
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Elena Leoni Theiss
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Heike Sabine Grimm
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
| | - Tobias Hartmann
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
- Deutsches Institut für Demenzprävention, Saarland University, 66421 Homburg, Germany
| | - Marcus Otto Walter Grimm
- Experimental Neurology, Saarland University, 66421 Homburg, Germany; (D.J.); (A.A.L.); (C.M.B.); (J.W.); (L.V.G.); (S.M.P.); (E.L.T.); (H.S.G.); (T.H.)
- Deutsches Institut für Demenzprävention, Saarland University, 66421 Homburg, Germany
- Nutrition Therapy and Counseling, Campus Rheinland, SRH University of Applied Health Science, 51377 Leverkusen, Germany
- Correspondence:
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Kupffer cells play a crucial role in monocrotaline-induced liver injury by producing TNF-α. Toxicology 2022; 468:153101. [DOI: 10.1016/j.tox.2022.153101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/17/2022]
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Yangming-Fan, Jianjun-Ge. Pentoxifylline Prevents Restenosis by Inhibiting Cell Proliferation via p38MAPK Pathway in Rat Vein Graft Model. Cell Transplant 2022; 31:9636897221122999. [PMID: 36066039 PMCID: PMC9459444 DOI: 10.1177/09636897221122999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Coronary artery bypass grafting remains the gold standard in the therapy
of advanced-stage patients. But the vein grafts are prone to
restenosis or failure. Pentoxifylline (PTX) is a methylxanthine
derivative with a function of inhibiting cell proliferation. We thus
applied PTX locally to the vein grafts to study its effect on the
inhibition of graft restenosis using a rat vein graft model.
Morphometric results showed a significant decrease in the thickness of
vein grafts intimal and medial at day 28 after the bypass operation.
Results from Western blot and immunohistochemistry showed that PTX
also significantly reduced the proliferating cell nuclear antigen
(PCNA), alpha-smooth muscle actin (α-SMA) expression, and
phosphorylation of p38 in vein grafts. These results firstly
discovered the positive role of PTX in preventing the vein grafts
restenosis and the mechanism may be inhibition of vascular smooth
muscle cells (VSMCs) proliferation via the p38MAPK pathway.
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Affiliation(s)
- Yangming-Fan
- Department of Cardiac Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jianjun-Ge
- Department of Cardiac Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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22
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Sorensen EN, Plazak ME, Dees LM, Klass WJ, Ziegler LA, Ledroux SN, Griffith BP, Feller ED. Comparison of two individualized antithrombotic protocols in HeartWare HVAD recipients. Artif Organs 2021; 46:117-127. [PMID: 34425001 DOI: 10.1111/aor.14055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/14/2021] [Accepted: 08/11/2021] [Indexed: 12/27/2022]
Abstract
We previously reported low rates of pump thrombosis and hemorrhagic stroke, but increased bleeding, under our original antithrombosis protocol (P1) in HeartWare recipients. We designed and implemented a revised protocol (P2) to reduce complexity and bleeding. Thrombelastography and PFA-100 guide antiplatelet titration. Goals for P2 were altered to decrease antiplatelet use and anticoagulation intensity. We compared the incidence and rates of gastrointestinal bleeding (GIB), embolic (eCVA) and hemorrhagic (hCVA) stroke, pump thrombosis (PT), and total bleeding (GIB+hCVA), total thrombosis (eCVA+PT), and total events between P1 and P2. Laboratory and medication data were assessed. Patients with and without hemocompatibility-related adverse events (HRAEs) were compared. The study included 123 patients (P1: 65; P2: 58). GIB rate decreased (P1: 0.66; P2 0.30 EPPY, P = .003). CVA rates and incidence were statistically similar, although hCVA incidence increased (P1: 3%; P2: 12%, P = .06). Incidence (P1: 3%; P2: 16%, P = .02) and rate (P1: 0.03; P2: 0.12 EPPY, P = .08) of PT increased. Incidence and rate of overall HRAEs and thrombotic events were similar, while bleeding rate decreased (P1: 0.69; P2: 0.40 EPPY, P = .02). Twelve-month medication burden decreased. Compared to non-HRAE patients, patients with bleeding HRAEs had more antiplatelet and pentoxifylline use, but less statin use; and lower PFAs. Patients with thrombotic HRAEs had less dual antiplatelet use, lower INRs, R-times, and PFA-ADP values. A revised antithrombotic protocol decreased GIB and overall hemorrhagic HRAE rate and medication burden. Unfortunately, PT increased. Non-HRAE and HRAE patients differed in anticoagulation and antiplatelet intensity. These differences will guide the revision of P2.
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Affiliation(s)
- Erik N Sorensen
- Division of Perioperative Services, University of Maryland Medical Center, Baltimore, MD, USA
| | - Michael E Plazak
- Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA
| | - Lynn M Dees
- Division of Cardiology, Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA
| | - Wyatt J Klass
- Division of Perioperative Services, University of Maryland Medical Center, Baltimore, MD, USA
| | - Luke A Ziegler
- Procirca/University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Shannon N Ledroux
- Division of Cardiology, Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA
| | - Bartley P Griffith
- Division of Cardiac Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA
| | - Erika D Feller
- Division of Cardiology, Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA
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23
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Preparation and characterization of mucoadhesive gels containing pentoxifylline loaded nanoparticles for vaginal delivery of genital ulcer. IRANIAN POLYMER JOURNAL 2021. [DOI: 10.1007/s13726-021-00913-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Mousavinasab SR, Akhoundi-Meybodi Z, Mahmoudi L, Karimzadeh I. A randomized double-blinded placebo-controlled clinical trial on protective effects of pentoxifylline on gentamicin nephrotoxicity in infectious patients. Clin Exp Nephrol 2021; 25:844-853. [PMID: 33792832 DOI: 10.1007/s10157-021-02032-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Renal toxicity has limited gentamicin use in clinical practice. The aim of the present clinical trial was to assess the possible nephroprotective effects of pentoxifylline (PTX) against gentamicin nephrotoxicity. MATERIALS AND METHODS A multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted on patients who had the indication for systemic gentamicin for at least 7 days. Sixty people were selected and randomly assigned. For patients in the intervention and control groups, 400 mg PTX sustained release tablet and placebo were given orally three times daily, respectively. Demographic, clinical, laboratory, and therapeutic information of patients were recorded. malondialdehyde (MDA) and tumor necrosis factor-alpha (TNF-α) levels in serum were measured on days 0 and 7. RESULTS The incidence of nephrotoxicity in the placebo group was 19.6 times higher than that in the PTX group (OR = 19.6, 95%CI = 3.08-114.32; P value = 0.001). The mean ± SD time onset of ATN was 4.00 ± 2.32 and 5.58 ± 1.59 days in PTX and placebo recipients, respectively (P value < 0.001). No significant differences were observed for hypokalemia, hypomagnesemia, potassium and magnesium wasting between the two groups. The mean ± SD levels of serum MDA and TNF-α at day 7 were significantly lower in the PTX compared to those in the placebo group (P value < 0.001 for both indexes). CONCLUSION The co-administration of 400 mg PTX orally three times daily along with gentamicin was both well-tolerated and effective in preventing the nephrotoxicity of gentamicin in patients with different infectious diseases.
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Affiliation(s)
- Seyed Ruhollah Mousavinasab
- Resident of Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Akhoundi-Meybodi
- Infectionlogist Fellowship Prevention and Control of Nosocomial Infection, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Laleh Mahmoudi
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Karimzadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, 7146864685, Shiraz, Iran.
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25
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Obi ON, Lower EE, Baughman RP. Biologic and advanced immunomodulating therapeutic options for sarcoidosis: a clinical update. Expert Rev Clin Pharmacol 2021; 14:179-210. [PMID: 33487042 DOI: 10.1080/17512433.2021.1878024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Sarcoidosis is a multi-organ disease with a wide range of clinical manifestations and outcomes. A quarter of sarcoidosis patients require long-term treatment for chronic disease. In this group, corticosteroids and cytotoxic agents be insufficient to control diseaseAreas covered: Several biologic agents have been studied for treatment of chronic pulmonary and extra-pulmonary disease. A review of the available literature was performed searching PubMed and an expert opinion regarding specific therapy was developed.Expert opinion: These agents have the potential of treating patients who have progressive disease. Many of these agents have different mechanisms of action, response rates, and toxicity profiles.
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Affiliation(s)
- Ogugua Ndili Obi
- Division of Pulmonary Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Elyse E Lower
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Robert P Baughman
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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26
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Panahi-Shokouh M, Moghaddas A, Badri S, Jabalameli S, Momenzadeh M, Mehrzad V, Ashrafi F. Pentoxifylline in Prevention of Amphotericin B-induced Nephrotoxicity and Electrolyte Abnormalities. J Res Pharm Pract 2021; 9:135-139. [PMID: 33489981 PMCID: PMC7808184 DOI: 10.4103/jrpp.jrpp_20_98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/02/2020] [Indexed: 11/12/2022] Open
Abstract
Objective: Amphotericin B is an antifungal agent used to treat serious fungal infections mainly in critically ill patients. Despite its adverse effects including renal toxicity and electrolyte imbalances, amphotericin B remains one of the best choices for antifungal treatment. Information from animal studies has provided a strong scientific basis for the use of pentoxifylline as lowering nephroprotective agent. The present study was designed to evaluate the efficacy of pentoxifylline in preventing renal toxicity and electrolytes imbalances induced by amphotericin B. Methods: This study was conducted as a randomized controlled trial on 44 patients admitted to Sayyedoshohada Hospital, Isfahan, Iran, from October 2016 to August 2018. Patients were assigned to one of the two groups: Pentoxifylline, 400 mg twice a day, or matching placebo, from the 1st day of amphotericin B therapy till minimum of 7 days. All patients' information including lab data (serum and urine levels of Mg, Na, and K, serum creatinine level, blood urea nitrogen [BUN] and urinary creatinine excretion) were gathered at the time of drug initiation and during the study period. The results were analyzed by SPSS v. 20 software and Repeated measures test was used to assess the differences between groups Findings: This study did not show any significant differences between the two groups in terms of all the assessed variables, including serum and urinary levels of electrolytes, and creatinine, as well as the number of cases presented acute kidney injury during the study period. Conclusion: Despite the positive effects of pentoxifylline in preventing renal complications in previous studies, this study could not show a definitive result in salt wasting or renal damage induced by amphotericin B. So, Designing robust studies with more included samples would be valuable.
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Affiliation(s)
- Mahsa Panahi-Shokouh
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Moghaddas
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirinsadat Badri
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeedeh Jabalameli
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Momenzadeh
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Valiollah Mehrzad
- Department of Oncology/Hematology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzaneh Ashrafi
- Department of Oncology/Hematology, Isfahan University of Medical Sciences, Isfahan, Iran
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27
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Fabrication of Pentoxifylline-Loaded Hydroxyapatite/Alginate Scaffold for Bone Tissue Engineering. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2020. [DOI: 10.4028/www.scientific.net/jbbbe.47.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: Hydroxyapatite (HAP), as a common biomaterial in bone tissue engineering, can be fabricated in combination with other osteogenic agents. Pentoxifylline (PTX) is demonstrated to have positive roles in bone defect healing. Since local administration can diminish the systemic side effects of the drug, the objectives of the current in vitro study were to find the effects of PTX on the osteoblast functions for tissue engineering applications. Methods: a HAP scaffold was fabricated by casting the HAP slurry within polyurethane foam. The scaffold was enriched with 5 mg/mL PTX. Alginate (Alg) was used as drug carrier to regulate the PTX releasing rate. MG-63 osteosarcoma cells were cultured on 3D scaffolds and 2D Alg films in the presence or absence of PTX. Results: PTX did not affect the cell viability, attachment and phenotype. Also, the ultrastructure of the scaffolds was not modified by PTX enrichment. Alizarin red S staining showed that PTX has no effect on calcium deposition. Besides, Raman confocal microscopy demonstrated an increase in the organic matrix formation including proline, valine and phenylalanine deposition (represented collagen). Although PTX increased the total protein secretion, it led to a decrease in the alkaline phosphatase activity and vascular endothelial growth factor (VEGF) content. PTX reduced the hydration and degradation rates and it was released mainly at the first 24 hours of incubation. Conclusion: Based on our in vitro study, application of engineered PTX-loaded HAP scaffold in bone regeneration can act on behalf of organic matrix production, but not angiogenesis and mineralization.
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28
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Aghajani A, Kazemi T, Enayatifard R, Amiri FT, Narenji M. Investigating the skin penetration and wound healing properties of niosomal pentoxifylline cream. Eur J Pharm Sci 2020; 151:105434. [PMID: 32590122 DOI: 10.1016/j.ejps.2020.105434] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/02/2020] [Accepted: 06/22/2020] [Indexed: 12/22/2022]
Abstract
Wounds are defined as any injuries to the skin. Wounds can cause great inconvenience and health problems for the patients depending on the healing time and severity. This makes wound healing and the strategies to treat a wound or reduce their treatment time, an important concern in health care systems. Pentoxifylline (PTX) has been reported to facilitate the wound healing in systemic administration. Different cellular and immunological mechanisms have been reported and suggested regarding the promising effects of PTX. On the other hand, the topical application of PTX seems to improve its therapeutic efficiency by localizing the drug on the wound site. In this study, PTX-niosomes were prepared and characterized. Niosomes with Zavg of 150, 200, and 300 nm were incorporated into the base cold cream. In-vitro release of PTX from these formulations was obtained between 70 -100%. Ex-vivo penetration/retention studies showed that niosomal formulations (F6 and F7) increased penetration of PTX by 1.8 and 1.2 times, respectively in comparison with the PTX-conventional cream. Retention of PTX from both niosomal creams was about 2 times higher than the PTX-conventional cream. In -vivo studies on the full-thickness wound in BALB/c mice showed that PTX-niosomal creams shortened the duration of wound healing by two days compared to control groups (PTX-conventional cream, base cream, and no treatment). The final wound size in the niosomal cream-treated group was also significantly smaller than the control groups. Histological analysis of the wounds confirmed the results of in-vivo studies.
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Affiliation(s)
- Ali Aghajani
- Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
| | - Tabassom Kazemi
- Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
| | - Reza Enayatifard
- Department of pharmaceutics, Faculty of pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fereshteh Talebpour Amiri
- Department of Anatomy, Molecular and Cell Biology Research, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahsa Narenji
- Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran; Department of pharmaceutics, Faculty of pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
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29
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Pentoxifylline: An Immunomodulatory Drug for the Treatment of COVID-19. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.spl1.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rapidly spreading outbreak of the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is causing serious health concerns worldwide. It started as an epidemic in Wuhan, Hubei province, central China, and has now become a pandemic, spreading over most of the continents of the planet. The major clinical symptoms of the infection are dry cough, fever, pneumonia, respiratory failure, hypoxia, and in certain cases, even death. Alveolar damage and respiratory system failure are observed in severe cases. Initial mild infection leads to activation of the immune system in the lungs and accumulation of various inflammatory cells and molecules. At a later phase during the infection, a “cytokine storm” causes an Acute Respiratory Distress Syndrome (ARDS), leading to an increase in the production of pro-inflammatory cytokines, migration of a large number of immune cells to the site of infection, and ultimately pulmonary damage. The rapid and uncontrolled outbreak requires putative therapeutic drugs for treatment of patients suffering from COVID-19. Amongst the currently used antiviral drugs, such as hydroxychloroquine, lopinavir, remdesivir etc. we would like to present an update on another effective drug, pentoxifylline. Pentoxifylline has anti-inflammatory, immunomodulatory, anti-viral, and bronchodilatory properties. Pentoxifylline is known to reduce cytokine production, immune cell migration, and suppress certain signal transduction pathways (e.g. NF-κβ and STAT3). Thus, it minimizes inflammatory damage in the lung tissues.
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30
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Li P, Liu L, Lou B, Zhan H. Crystal structure of 3,7-dimethyl-1-(5-oxohexyl)-3,7-dihydro-1 H-purine-2,6-dione 4-hydroxybenzoic acid, C 20H 24N 4O 6. Z KRIST-NEW CRYST ST 2020. [DOI: 10.1515/ncrs-2019-0841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
C20H24N4O6, triclinic, P1̄ (no. 2), a = 8.2441(5) Å, b = 11.6409(6) Å, c = 12.0107(9) Å, α = 64.328(6)°, β = 70.778(6)°, γ = 86.678(4)°, V = 976.09(12) Å3, Z = 2, R
gt(F) = 0.0671, wR
ref(F
2) = 0.1702, T = 100 K.
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Affiliation(s)
- Peizhe Li
- College of Materials Science and Engineering, Fuzhou University , Fuzhou, 350108 , China
- Ocean College, Minjiang University , Fuzhou, 350108 , China
| | - Lei Liu
- College of Materials Science and Engineering, Fuzhou University , Fuzhou, 350108 , China
- Ocean College, Minjiang University , Fuzhou, 350108 , China
| | - Benyong Lou
- College of Materials Science and Engineering, Fuzhou University , Fuzhou, 350108 , China
- Ocean College, Minjiang University , Fuzhou, 350108 , China
| | - Hongbing Zhan
- College of Materials Science and Engineering, Fuzhou University , Fuzhou, 350108 , China
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Georgesen C, Fox LP, Harp J. Retiform purpura: Workup and therapeutic considerations in select conditions. J Am Acad Dermatol 2020; 82:799-816. [DOI: 10.1016/j.jaad.2019.07.113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/15/2019] [Accepted: 07/28/2019] [Indexed: 02/07/2023]
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Kummari E, Gibbs A, Riggs C, Fellman C, Stokes J, Thomason J, Wills R, Mackin A, Archer T. Effects of pentoxifylline on whole blood IL-2 and IFN-gamma gene expression in normal dogs. Vet Med Sci 2020; 6:19-24. [PMID: 31621209 PMCID: PMC7036308 DOI: 10.1002/vms3.204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/31/2019] [Accepted: 08/30/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Pentoxifylline (PTX) is a methylxanthine phosphodiesterase inhibitor that is used as a hemorrheologic and anti-inflammatory agent in veterinary and human medicine. In human studies, PTX has been shown to decrease T-cell production of cytokines such as IL-2 and IFN-γ. A RT-qPCR assay to measure activated T-cell gene expression of IL-2 and IFN-γ has been validated in dogs. OBJECTIVES The goal of this study was to utilize this assay to investigate the effects of PTX on in vitro cytokine gene expression in canine whole blood. METHODS Whole blood from seven healthy dogs was collected and incubated with various concentrations of PTX for 1 hr before activation. PTX concentrations spanned and exceeded blood concentrations achieved when administered at clinically relevant dosages (1, 2, 10, 50 and 200 μg/ml). Cyclosporine was used at a concentration of 500 ng/ml as a positive control. All blood samples, including untreated activated baseline samples, were then activated with phorbol myristate acetate and ionomycin for 5 hrs. RESULTS Analysis of activated whole blood by RT-qPCR revealed that there was not a significant suppression of IL-2 or IFN-γ gene expression at any concentration of PTX when evaluating ΔCt values. All samples exposed to cyclosporine showed significant changes from untreated activated baseline samples, demonstrating marked suppression as the positive control. Cytokine expression, presented as a percentage of untreated activated baseline samples, was also evaluated. After exposure to the highest concentration of PTX (200 μg/ml), median percentage cytokine expression was suppressed to just below 50% of baseline values. This concentration, however, is much higher than blood concentrations reported to be achieved at standardly used pentoxifylline doses. CONCLUSIONS PTX does not appear to significantly suppress T-cell cytokine production in samples from most dogs at clinically relevant drug concentrations. Further testing is needed to establish the full effects of PTX on the immune system in dogs.
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Affiliation(s)
- Evangel Kummari
- Department of Basic SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
| | - Andres Gibbs
- Department of Clinical SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
- Present address:
Randall Veterinary HospitalByramMSUSA
| | - Caitlin Riggs
- Department of Clinical SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
| | - Claire Fellman
- Department of Clinical SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
- Present address:
Department of Clinical SciencesTufts University200 Westboro RoadNorth GraftonMA01536USA
| | - John Stokes
- Department of Basic SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
| | - John Thomason
- Department of Clinical SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
| | - Robert Wills
- Department of Pathobiology and Population MedicineMississippi State University College of Veterinary MedicineMississippi StateMSUSA
| | - Andrew Mackin
- Department of Clinical SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
| | - Todd Archer
- Department of Clinical SciencesMississippi State University College of Veterinary MedicineMississippi StateMSUSA
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Dissard A, P. Dang N, Barthelemy I, Delbet C, Puechmaille M, Depeyre A, Pereira B, Martin F, Guillemin F, Biau J, Mirafzal S, Mom T, Gilain L, Saroul N. Efficacy of pentoxifylline–tocopherol–clodronate in mandibular osteoradionecrosis. Laryngoscope 2019; 130:E559-E566. [DOI: 10.1002/lary.28399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Alexis Dissard
- Department of Otorhinolaryngology–Head and Neck Surgery University Hospital Center Gabriel Montpied Clermont‐Ferrand France
| | - Nathalie P. Dang
- Department of Maxillofacial Surgery Clermont‐Ferrand University Hospital Center Clermont‐Ferrand France
| | - Isabelle Barthelemy
- Department of Maxillofacial Surgery Clermont‐Ferrand University Hospital Center Clermont‐Ferrand France
| | - Candice Delbet
- Department of Maxillofacial Surgery Clermont‐Ferrand University Hospital Center Clermont‐Ferrand France
| | - Mathilde Puechmaille
- Department of Otorhinolaryngology–Head and Neck Surgery University Hospital Center Gabriel Montpied Clermont‐Ferrand France
| | - Arnaud Depeyre
- Department of Maxillofacial Surgery Clermont‐Ferrand University Hospital Center Clermont‐Ferrand France
| | - Bruno Pereira
- Delegation for Clinical Research and Innovation University Hospital Center Gabriel Montpied Clermont‐Ferrand France
| | - Fanny Martin
- Department of Oncology Jean Perrin Center Clermont‐Ferrand France
| | | | - Julian Biau
- Department of Oncology Jean Perrin Center Clermont‐Ferrand France
| | - Sonia Mirafzal
- and Department of Medical Imaging University Hospital Center Gabriel Montpied Clermont‐Ferrand France
| | - Thierry Mom
- Department of Otorhinolaryngology–Head and Neck Surgery University Hospital Center Gabriel Montpied Clermont‐Ferrand France
| | - Laurent Gilain
- Department of Otorhinolaryngology–Head and Neck Surgery University Hospital Center Gabriel Montpied Clermont‐Ferrand France
| | - Nicolas Saroul
- Department of Otorhinolaryngology–Head and Neck Surgery University Hospital Center Gabriel Montpied Clermont‐Ferrand France
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Chen M, Guan B, Xu H, Yu F, Zhang T, Wu B. The Molecular Mechanism Regulating Diurnal Rhythm of Flavin-Containing Monooxygenase 5 in Mouse Liver. Drug Metab Dispos 2019; 47:1333-1342. [PMID: 31515204 DOI: 10.1124/dmd.119.088450] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/28/2019] [Indexed: 01/06/2023] Open
Abstract
Flavin-containing monooxygenase 5 (FMO5) is a phase I enzyme that plays an important role in xenobiotic metabolism. Here, we aimed to characterize diurnal rhythms of Fmo5 expression and activity in mouse liver and to investigate the potential roles of clock genes (Bmal1, Rev-erbα, and E4bp4) in the generation of diurnal rhythms. Fmo5 mRNA and protein showed robust diurnal rhythms, with peak values at zeitgeber time (ZT) 10/14 and trough values at ZT2/22 in mouse liver. Consistently, a diurnal rhythm was observed for in vitro microsomal Baeyer-Villiger oxidation of pentoxifylline (PTX), a specific reaction catalyzed by Fmo5. Pharmacokinetic studies revealed a more extensive Baeyer-Villiger oxidation of PTX at dosing time of ZT14 than at ZT2, consistent with the diurnal pattern of Fmo5 protein. Fmo5 expression was downregulated and its rhythm was blunted in Bmal1 -/- and Rev-erbα -/- mice. Positive regulation of Fmo5 by Bmal1 and Rev-erbα was confirmed in primary mouse hepatocytes and/or Hepa1-6 cells. Furthermore, Fmo5 expression was upregulated and its rhythm was attenuated in E4bp4 -/- mice. Negative regulation of Fmo5 by E4bp4 was validated using primary mouse hepatocytes. Combined luciferase reporter and chromatin immunoprecipitation assays demonstrated that Bmal1 (a known Rev-erbα activator) activated Fmo5 transcription via direct binding to an E-box (-1822/-1816 bp) in the promoter, whereas E4bp4 (a known Rev-erbα target gene) inhibited Fmo5 transcription by binding to two D-boxes (-1726/-1718 and -804/-796 bp). In conclusion, circadian clock genes control diurnal expression of Fmo5 through transcriptional actions on E-box and D-box cis-elements. SIGNIFICANCE STATEMENT: Hepatic Fmo5 displayed diurnal rhythmicities in expression and activity in mice. We uncovered the molecular mechanism by which the rhythmic Fmo5 expression was generated. Fmo5 promoter presents E-box and D-box binding elements for transcriptional actions from circadian clock proteins such as Bmal1, E4bp4, and Dbp. These findings have implications for understanding clock-controlled drug metabolism and for facilitating the practice of chronotherapeutics.
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Affiliation(s)
- Min Chen
- Research Center for Biopharmaceutics and Pharmacokinetics (M.C., H.X., FY., T.Z., B.W.) and International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE) (M.C., B.W.), College of Pharmacy, Jinan University, Guangzhou, China; and Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China (B.G.)
| | - Baozhang Guan
- Research Center for Biopharmaceutics and Pharmacokinetics (M.C., H.X., FY., T.Z., B.W.) and International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE) (M.C., B.W.), College of Pharmacy, Jinan University, Guangzhou, China; and Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China (B.G.)
| | - Haiman Xu
- Research Center for Biopharmaceutics and Pharmacokinetics (M.C., H.X., FY., T.Z., B.W.) and International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE) (M.C., B.W.), College of Pharmacy, Jinan University, Guangzhou, China; and Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China (B.G.)
| | - Fangjun Yu
- Research Center for Biopharmaceutics and Pharmacokinetics (M.C., H.X., FY., T.Z., B.W.) and International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE) (M.C., B.W.), College of Pharmacy, Jinan University, Guangzhou, China; and Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China (B.G.)
| | - Tianpeng Zhang
- Research Center for Biopharmaceutics and Pharmacokinetics (M.C., H.X., FY., T.Z., B.W.) and International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE) (M.C., B.W.), College of Pharmacy, Jinan University, Guangzhou, China; and Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China (B.G.)
| | - Baojian Wu
- Research Center for Biopharmaceutics and Pharmacokinetics (M.C., H.X., FY., T.Z., B.W.) and International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE) (M.C., B.W.), College of Pharmacy, Jinan University, Guangzhou, China; and Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China (B.G.)
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Corum O, Corum DD, Atik O, Er A, Uney K. Pharmacokinetics of pentoxifylline and its 5-hydroxyhexyl metabolite after intravenous administration of increasing doses to sheep. Am J Vet Res 2019; 80:702-708. [PMID: 31246127 DOI: 10.2460/ajvr.80.7.702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics of pentoxifylline (PTX) and its 5-hydroxyhexyl metabolite (M-I) after IV administration of increasing doses of PTX to sheep. ANIMALS 6 healthy adult Merino sheep. PROCEDURES Each sheep received 10-, 20-, and 40-mg/kg doses of PTX, IV, with a 15-day washout period between doses. Blood samples were collected before and at predetermined times after administration of each dose to determine plasma PTX and M-I concentrations by high-performance liquid chromatography. Pharmacokinetic parameters for PTX and M-I were estimated by noncompartmental analysis. RESULTS No adverse effects were observed after administration of the 10- and 20-mg/kg doses. Following administration of the 40-mg/kg dose, all sheep developed tachycardia and hypersalivation and appeared agitated for approximately 4 hours. Plasma PTX concentrations considered therapeutic in other species were achieved in all sheep after administration of all 3 doses. Pharmacokinetic parameters for PTX and M-I varied in a dose-dependent linear manner. For PTX, the mean area under the concentration-time curve (AUC), elimination half-life, and volume of distribution increased with dose and ranged from 15.67 to 94.66 h·μg/mL, 0.68 to 0.91 hours, and 0.55 to 0.66 L/kg, respectively, whereas clearance decreased with dose and ranged from 0.42 to 0.64 L/h/kg. The mean ratio of the AUC for M-I to AUC for PTX ranged from 0.38 to 0.46. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that pharmacokinetic parameters for PTX and M-I varied in a dose-dependent linear manner in healthy sheep. Further studies are warranted to determine the therapeutic threshold and optimal dosage for PTX in sheep.
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Tsunoda RH, Serrano-Recalde EC, Arruda RPD, Oliveira BMM, Pinto SCC, Celeghini ECC. Effects of pentoxifylline supplementation to semen extender on post-breeding inflammation response assessed by endometrial cytology and vascular perfusion in mares. Anim Reprod Sci 2019; 208:106128. [PMID: 31405471 DOI: 10.1016/j.anireprosci.2019.106128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/11/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
The aim was to evaluate effects of addition of pentoxifylline to skimmed milk semen extender on uterine inflammatory response. Thirty-six estrous cycles of 15 mares were randomly divided into five groups for artificial insemination (AI): Control: mimicking the AI procedure (n = 7); Extender: deposition of skimmed milk based extender (n = 7); Extender + PTX: skimmed milk based extender plus pentoxifylline (7.18 mM; n = 8); Semen: semen diluted with extender without pentoxifylline (n = 7), and Semen + PTX: semen diluted with extender containing pentoxifylline (n = 7). Mares in estrus were examined by trans-rectal palpation and using ultrasonography, and ovulation was induced. Uterine hemodynamics were assessed immediately before ovulation induction (T-30), immediately before AI (T0), 2 (T2), 6 (T6), 12 (T12), 24 (T24) and 48 (T48) h after AI. Endometrial samples were collected 6 h after AI, and slides were stained and examined to determine percentage of PMN. Pentoxifylline had no additional effect on vascular perfusion. There was a major inflammatory response with pentoxifylline treatment that was greater than that of the control group. In the group treated with Extender + PTX, there were more PMN (57.98 ± 9.42%) than in the group treated with Extender (20.20 ± 6.63%) and in the Semen + PTX group more PMN (82.84 ± 5.71%) than in the Semen-treated group (47.83 ± 10.61%). These findings indicate the addition of pentoxifylline does not stimulate blood flow; however, it induces a greater immune defense response because more neutrophils migrate to the uterine lumen.
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Affiliation(s)
- Roberta Harue Tsunoda
- Laboratory of Teaching and Research in Pathology of Reproduction, Center of Biotechnology in Animal Reproduction, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science of the University of São Paulo, Pirassununga, SP, Brazil
| | - Elena Carolina Serrano-Recalde
- Laboratory of Teaching and Research in Pathology of Reproduction, Center of Biotechnology in Animal Reproduction, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science of the University of São Paulo, Pirassununga, SP, Brazil
| | - Rubens Paes de Arruda
- Laboratory of Semen Biotechnology and Andrology, Center of Biotechnology in Animal Reproduction, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, SP, Brazil
| | - Bruna Marcele Martins Oliveira
- Laboratory of Teaching and Research in Pathology of Reproduction, Center of Biotechnology in Animal Reproduction, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science of the University of São Paulo, Pirassununga, SP, Brazil
| | - Sâmara Cristine Costa Pinto
- Laboratory of Teaching and Research in Pathology of Reproduction, Center of Biotechnology in Animal Reproduction, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science of the University of São Paulo, Pirassununga, SP, Brazil
| | - Eneiva Carla Carvalho Celeghini
- Laboratory of Teaching and Research in Pathology of Reproduction, Center of Biotechnology in Animal Reproduction, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science of the University of São Paulo, Pirassununga, SP, Brazil.
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Gou S, Del Rio-Sancho S, Singhal M, Laubach HJ, Kalia YN. Er:YAG fractional laser ablation for cutaneous co-delivery of pentoxifylline and d-α-tocopherol succinate: A new approach for topical treatment of radiation-induced skin fibrosis. Eur J Pharm Sci 2019; 135:22-31. [PMID: 31078643 DOI: 10.1016/j.ejps.2019.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 11/30/2022]
Abstract
Radiation induced fibrosis is a common side-effect after radiotherapy. Pentoxifylline is reported to reverse radiation injuries when used in conjunction with D-α-tocopherol. However, pentoxifylline has a short half-life, limited oral bioavailability, and induces several systemic adverse effects. The objective of this study was to investigate the feasibility of using Er:YAG fractional laser ablation to enable simultaneous cutaneous delivery of pentoxifylline and D- α -tocopherol succinate from poly(lactide-co-glycolide) microparticles prepared using the freeze-fracture technique. In vitro release experiments demonstrated the different release profiles of the two molecules, which were influenced by their very different lipophilicities and aqueous solubilities. Experiments were then performed to investigate the effect of laser fluence on pore depth and so determine the pore volume available to host the topically applied microparticles. Application of the pentoxifylline and D-α-tocopherol succinate containing microparticles, prepared with RESOMER® RG 502H, to laser porated skin for 48 h, resulted in simultaneous delivery of pentoxifylline (69.63 ± 6.41 μg/cm2; delivery efficiency 46.4%) and D-α-tocopherol succinate (33.25 ± 8.91 μg/cm2; delivery efficiency 22.2%). After deposition into the micropores, the poly(lactide-co-glycolide) microparticles containing pentoxifylline and D-α-tocopherol succinate could serve as an intraepidermal depot to enable sustained drug delivery after micropore closure and thereby reduce the need for repeated microporation.
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Affiliation(s)
- Si Gou
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, 1211 Geneva, Switzerland
| | - Sergio Del Rio-Sancho
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, 1211 Geneva, Switzerland
| | - Mayank Singhal
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, 1211 Geneva, Switzerland
| | - Hans-Joachim Laubach
- Division of Dermatology, Geneva University Hospital, 1205 Geneva, Switzerland; Centre Laser MD, 8 Rue de Londres, 67000 Strasbourg, France
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, 1211 Geneva, Switzerland.
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Murkamilov IT, Aitbaev KA, Fomin VV, Murkamilova ZA, Bayzhigitova AA. Pentoxifylline and nephroprotection: effects on renal dysfunction and cardiovascular risks. TERAPEVT ARKH 2019; 91:95-100. [PMID: 31090379 DOI: 10.26442/00403660.2019.01.000037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Generalized data on nephroprotective efficacy of pentoxifylline in chronic kidney disease (CKD) are presented. The potential of this drug in treating people suffering from CKD and cardiovascular diseases (CVD) with a high risk of developing the terminal stage of renal dysfunction is considered. Antiproteinuric, antifibrotic and anti-inflammatory effects of pentoxifylline significantly reduce the risk of progression of CKD and joining of CVD in the future. Efficacy in preventing the onset of the uremic stage of CKD, safety andapplicability at all stages of renal dysfunction development make pentoxifylline a very appealing drug not only for nephrologists but also for physicians. Keywords: chronic kidney disease, progression, pentoxifylline, nephroprotection, cardiovascular diseases.
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Affiliation(s)
- I T Murkamilov
- Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek, Kyrgyzstan.,Kyrgyz Russian Slavic University named after the First President of Russia B.N. Yeltsin, Bishkek, Kyrgyzstan
| | - K A Aitbaev
- Scientific Research Institute of Molecular Biology and Medicine, Bishkek, Kyrgyzstan
| | - V V Fomin
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian
| | | | - A A Bayzhigitova
- National Hospital under the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
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Yucel B, Coruh A, Deniz K. Salvaging the Zone of Stasis in Burns by Pentoxifylline: An Experimental Study in Rats. J Burn Care Res 2019; 40:211-219. [DOI: 10.1093/jbcr/irz005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Bora Yucel
- Department of Plastic Reconstructive and Aesthetic Surgery, Ministry of Health, Elmali State Hospital, Elmali/Antalya, Turkey
| | - Atilla Coruh
- Medical Faculty, Department of Plastic Surgery, Erciyes University, Kayseri, Turkey
| | - Kemal Deniz
- Medical Faculty, Department of Pathology, Erciyes University, Kayseri, Turkey
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Singh N, Shreshtha AK, Thakur M, Patra S. Xanthine scaffold: scope and potential in drug development. Heliyon 2018; 4:e00829. [PMID: 30302410 PMCID: PMC6174542 DOI: 10.1016/j.heliyon.2018.e00829] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 02/07/2023] Open
Abstract
Medicinal plants have been the basis for discovery of various important marketed drugs. Xanthine is one such lead molecule. Xanthines in various forms (caffeine, theophylline, theobromine, etc) are abode in tea, coffee, cocoa, chocolate etc. giving them popular recognition. These compounds are best known for their diverse pharmaceutical applications as cyclic nucleotide phosphodiesterase inhibition, antagonization of adenosine receptor, anti-inflammatory, anti-microbial, anti-oxidant and anti-tumor activities. These properties incentivize to use xanthine as scaffold to develop new derivatives. Chemical synthesis contributes greater diversity in xanthine based derivatisation. With highlighting the existing challenges in chemical synthesis, the present review focuses the probable solution to fill existing lacuna. The review summarizes the available knowledge of xanthine based drugs development along with exploring new xanthine led chemical synthesis path for bringing diversification in xanthine based research. The main objective of this review is to explore the immense potential of xanthine as scaffold in drug development.
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Affiliation(s)
- Nivedita Singh
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | | | - M.S. Thakur
- Fermentation Technology and Bioengineering Department, Central Food Technological Research Institute, Mysore, India
| | - Sanjukta Patra
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
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Uney K, Tras B, Corum O, Yildiz R, Maden M. Pharmacokinetics of pentoxifylline and its 5-hydroxyhexyl metabolite following intravenous administration in cattle. Trop Anim Health Prod 2018; 51:435-441. [DOI: 10.1007/s11250-018-1710-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
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Salmaninejad A, Gowhari A, Hosseini S, Aslani S, Yousefi M, Bahrami T, Ebrahimi M, Nesaei A, Zal M. Genetics and immunodysfunction underlying Behçet's disease and immunomodulant treatment approaches. J Immunotoxicol 2018; 14:137-151. [PMID: 28693405 DOI: 10.1080/1547691x.2017.1346008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Behçet's disease (BD) is a chronic autoimmune condition primarily prevalent in populations along the Mediterranean Sea. The exact etiology of BD has not been fully explained yet, but the disease occurrence is associated with a genetic factor, human leukocyte antigen (HLA)-B51 antigen. Among the various immunodysfunctions that are found in BD, patients are increased neutrophil motility and superoxide production, as well as elevated production of tumor necrosis factor (TNF)-α and decreased production of interleukin (IL)-10. Elevated levels of inflammatory cytokines like IL-1 and IL-17 in BD have been found associated with aberrant expression of microRNA. Gene polymorphisms in BD patients have been observed in molecules involved in responses to pathogens that can ultimately modulate the host antimicrobial response. Moreover, several single nucleotide polymorphisms (SNPs) have been reported in genes encoding chemokines and adhesion molecules; many of these changes manifest as increases in vascular inflammation and vascular damage. Lastly, genetic and epigenetic changes have been suggested as involved in the pathogenesis of BD. Modifications in DNA methylation have been found in BD patient monocytes and lymphocytes, leading to adverse function of these cells. This review presents a comprehensive compilation of the literature with regard to the immunodysfunction underlying BD, as well as of the genetics, newly described clinical specifications and novel treatment strategies using immunomodulants based on the current understanding of BD.
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Affiliation(s)
- Arash Salmaninejad
- a Drug Applied Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran.,c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Arezoo Gowhari
- d Department of Immunology, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Seyedmojtaba Hosseini
- b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Saeed Aslani
- c Rheumatology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Meysam Yousefi
- b Medical Genetics Research Center, Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Tayyeb Bahrami
- e Genetics Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Masoume Ebrahimi
- f Department of Biology, Faculty of Sciences , University of Guilan , Rasht , Iran
| | - Abolfazl Nesaei
- g Department of Basic Sciences , Gonabad University of Medical Sciences , Gonabad , Iran
| | - Masoud Zal
- h Department of Medical Genetics , Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Ventin F, Cincurá C, Machado PRL. Safety and efficacy of miltefosine monotherapy and pentoxifylline associated with pentavalent antimony in treating mucosal leishmaniasis. Expert Rev Anti Infect Ther 2018; 16:219-225. [PMID: 29411659 DOI: 10.1080/14787210.2018.1436967] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Mucosal Leishmaniasis (ML) is a difficult to treat and severe form of Leishmaniasis. In general, more than 40% of subjects with ML have therapeutic failure upon the use of pentavalent antimony (Sbv) at 20mg/kg/day during 30 days. Additionally, Sbv is a toxic drug that requires parenteral administration, and many patients will need several courses to be cured. In cases that cannot be treated or cured by Sbv, the alternative is amphotericin B, another toxic and parenteral drug. As a consequence, many ML patients will be cured only after years of disease and may present several morbidities due to the aggressiveness of the disease or toxicity related to the treatment. Areas covered: We aimed to review clinical trials with Miltefosine or Sbv associated with pentoxifylline in the treatment of ML. Expert commentary: There are few studies to define more effective and safer therapy in mucosal disease caused by Leishmania, with an urgent need to supporting and funding well designed trials. Miltefosine monotherapy, as well as pentoxifylline combined with Sbv are promising therapeutic approaches to increase the cure rate of this neglected disease.
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Affiliation(s)
- Fernanda Ventin
- a Serviço de Imunologia , Complexo Hospitalar Universitário Professor Edgard Santos , Salvador , Brazil
| | - Carolina Cincurá
- a Serviço de Imunologia , Complexo Hospitalar Universitário Professor Edgard Santos , Salvador , Brazil
| | - Paulo Roberto Lima Machado
- a Serviço de Imunologia , Complexo Hospitalar Universitário Professor Edgard Santos , Salvador , Brazil.,b Serviço de Imunologia , National Institute of Science and Technology in Tropical Diseases (INCT-DT), CNPq/MCT , Salvador , Brazil
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Namdar H, Zohori R, Aslanabadi N, Entezari-Maleki T. Effect of Pentoxifylline in Ameliorating Myocardial Injury in Patients With Myocardial Infarction Undergoing Thrombolytic Therapy: A Pilot Randomized Clinical Trial. J Clin Pharmacol 2017; 57:1338-1344. [PMID: 28513852 DOI: 10.1002/jcph.926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 03/22/2017] [Indexed: 11/11/2022]
Abstract
Cell death following acute myocardial infarction (MI) is the hallmark pathology of cardiovascular disease, leading to considerable mortality and morbidity. Platelet and neutrophil activation and inflammatory cytokines, prominently TNF-α, play an important role in the development of cell death. Because pentoxifylline inhibits platelet and neutrophil activation and reduces TNF-α, this study was performed to assess the potential benefit of pentoxifylline in the reduction of myocardial injury following acute MI. In this randomized clinical trial, 98 patients with acute MI were randomly divided into 2 groups. The intervention group received an oral dose of 1200 mg of pentoxifylline immediately before thrombolytic therapy (TLT). All patients received the same standard protocol for treatment of MI. Cardiac enzymes were checked over 48 hours. ST resolution was measured over 90 minutes. Then all patients were followed up for a 1-month period to assess major adverse cardiac effects (MACEs). There were no significant differences in peak levels of CPK (P = .18) and CK-MB (P = .33) between the 2 groups, whereas peak level of troponin I was significantly lower in the pentoxifylline group (16.8 ± 10.4 vs 21.3 ± 11.6; P = .048). No significant change between the groups was observed in biomarkers levels, ST segment resolution, cardiac ejection fraction, and MACEs. The results showed that pentoxifylline significantly reduced the peak value of troponin I in patients with acute MI receiving TLT. No significant change was observed in the other studied parameters. Further outcome-based studies are needed to show the clinical relevance of differences between the groups in troponin peak.
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Affiliation(s)
- Hossein Namdar
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rasoul Zohori
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Aslanabadi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taher Entezari-Maleki
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Current Status of Targeted Radioprotection and Radiation Injury Mitigation and Treatment Agents: A Critical Review of the Literature. Int J Radiat Oncol Biol Phys 2017; 98:662-682. [PMID: 28581409 DOI: 10.1016/j.ijrobp.2017.02.211] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 01/17/2023]
Abstract
As more cancer patients survive their disease, concerns about radiation therapy-induced side effects have increased. The concept of radioprotection and radiation injury mitigation and treatment offers the possibility to enhance the therapeutic ratio of radiation therapy by limiting radiation therapy-induced normal tissue injury without compromising its antitumor effect. Advances in the understanding of the underlying mechanisms of radiation toxicity have stimulated radiation oncologists to target these pathways across different organ systems. These generalized radiation injury mechanisms include production of free radicals such as superoxides, activation of inflammatory pathways, and vascular endothelial dysfunction leading to tissue hypoxia. There is a significant body of literature evaluating the effectiveness of various treatments in preventing, mitigating, or treating radiation-induced normal tissue injury. Whereas some reviews have focused on a specific disease site or agent, this critical review focuses on a mechanistic classification of activity and assesses multiple agents across different disease sites. The classification of agents used herein further offers a useful framework to organize the multitude of treatments that have been studied. Many commonly available treatments have demonstrated benefit in prevention, mitigation, and/or treatment of radiation toxicity and warrant further investigation. These drug-based approaches to radioprotection and radiation injury mitigation and treatment represent an important method of making radiation therapy safer.
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Abstract
Chronic radiation dermatitis is a late side effect of skin irradiation, which may deteriorate patients’ quality of life. There is a lack of precise data about its incidence; however, several risk factors may predispose to the development of this condition. It includes radiotherapy dose, fractionation, technique, concurrent systemic therapy, comorbidities, and personal and genetic factors. Chronic radiation dermatitis is mostly caused by the imbalance of proinflammatory and profibrotic cytokines. Clinical manifestation includes changes in skin appearance, wounds, ulcerations, necrosis, fibrosis, and secondary cancers. The most severe complication of irradiation is extensive radiation-induced fibrosis (RIF). RIF can manifest in many ways, such as skin induration and retraction, lymphedema or restriction of joint motion. Diagnosis of chronic radiation dermatitis is usually made by clinical examination. In case of unclear clinical manifestation, a biopsy and histopathological examination are recommended to exclude secondary malignancy. The most effective prophylaxis of chronic radiation dermatitis is the use of proper radiation therapy techniques to avoid unnecessary irradiation of healthy skin. Treatment of chronic radiation dermatitis is demanding. The majority of the interventions are based only on clinical practice. Telangiectasia may be treated with pulse dye laser therapy. Chronic postirradiation wounds need special dressings. In case of necrosis or severe ulceration, surgical intervention may be considered. Management of RIF should be complex. Available methods are rehabilitative care, pharmacotherapy, hyperbaric oxygen therapy, and laser therapy. Future challenges include the assessment of late skin toxicity in modern irradiation techniques. Special attention should be paid on genomics and radiomics that allow scientists and clinicians to select patients who are at risk of the development of chronic radiation dermatitis. Novel treatment methods and clinical trials are strongly needed to provide more efficacious therapies.
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Affiliation(s)
- Mateusz Spałek
- Department of Radiotherapy I, The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
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Pal R, Chaudhary MJ, Tiwari PC, Nath R, Babu S, Pant KK. Pharmacological studies on the anti-inflammatory and immunomodulatory role of pentoxifylline and its interaction with nitric oxide (NO) in experimental arthritis in rats. Inflammopharmacology 2016; 24:221-231. [PMID: 27671331 DOI: 10.1007/s10787-016-0281-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/06/2016] [Indexed: 12/20/2022]
Abstract
AIM Present study was designed to evaluate protective effects of pentoxifylline and its potentiation with low dose of nitric oxide (NO) modulators in adjuvant-induced experimental arthritis in rats. METHOD Wistar rats (200-300 g, n = 8 per group) of both sexes were used in the study. On day "0" experimental arthritis was induced by injecting 0.2 ml of Complete Freund's adjuvant (CFA) in sub-planter region of right hind paw of animals. Pentoxifylline treatment alone and in combination with NO modulators was given (i.p.) from day 14 to 28. Various arthritic parameters were recorded and blood and joint synovial fluid was collected for biochemical analysis. RESULTS CFA inoculation significantly increases (1) arthritic index (2) ankle diameter (3) paw volume (4) histopathology score (5) serum TNF-α, IL-6, IL-1β and synovial TNF-α levels (p < 0.001) (6) serum Th1 and Th2 cytokine levels g) MDA levels in rat paw tissue homogenates (7) serum NF-κB levels. Significant decrease in serum IL-10 levels and SOD activity was observed in rats after CFA inoculation. Decrease in body weight and suppressed general quality of life of CFA inoculated rats was also observed. These CFA-induced arthritic changes were significantly reversed by pentoxifylline alone and in combination with low dose of NO modulators (p < 0.05). CONCLUSION These results are suggestive of protective effects of pentoxifylline and its potentiation in combination with low dose of NO modulators. These results may provide new pharmacological therapy for management of rheumatoid arthritis (RA).
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Affiliation(s)
- Rishi Pal
- Department of Pharmacology & Therapeutics, King George's Medical University, Lucknow, UP, 226003, India.
| | - Manju J Chaudhary
- Department of Physiology, Government Medical College, Tirwa Road, Kannauj, UP, India
| | - Prafulla Chandra Tiwari
- Department of Pharmacology & Therapeutics, King George's Medical University, Lucknow, UP, 226003, India
| | - Rajendra Nath
- Department of Pharmacology & Therapeutics, King George's Medical University, Lucknow, UP, 226003, India
| | - Suresh Babu
- Department of Pathology, King George's Medical University, Lucknow, UP, 226003, India
| | - Kamlesh Kumar Pant
- Department of Pharmacology & Therapeutics, King George's Medical University, Lucknow, UP, 226003, India
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Abstract
Ionizing radiation is an important treatment modality for a variety of malignant conditions. However, development of radiation-induced skin changes is a significant adverse effect of radiation therapy (RT). Cutaneous repercussions of RT vary considerably in severity, course, and prognosis. When they do occur, cutaneous changes to RT are commonly graded as acute, consequential-late, or chronic. Acute reactions can have severe sequelae that impact quality of life as well as cancer treatment. Thus, dermatologists should be informed about these adverse reactions, know how to assess their severity and be able to determine course of management. The majority of measures currently available to prevent these acute reactions are proper skin hygiene and topical steroids, which limit the severity and decrease symptoms. Once acute cutaneous reactions develop, they are treated according to their severity. Treatments are similar to those used in prevention, but incorporate wound care management that maintains a moist environment to hasten recovery. Chronic changes are a unique subset of adverse reactions to RT that may develop months to years following treatment. Chronic radiation dermatitis is often permanent, progressive, and potentially irreversible with substantial impact on quality of life. Here, we also review the etiology, clinical manifestations, pathogenesis, prevention, and management of late-stage cutaneous reactions to radiotherapy, including chronic radiation dermatitis and radiation-induced fibrosis.
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