Biological and Pharmacological Effects of Gamma-oryzanol: An Updated Review of the Molecular Mechanisms

BACKGROUND

Gamma-oryzanol (γ-oryzanol) is one of the rice bran oil (RBO) compounds, known as a principal food source throughout the world. In recent numerous experimental studies, γ-oryzanol has been revealed to have several useful pharmacological properties, such as anti-oxidant, anti-inflammatory, anti-cancer, anti-diabetic, ameliorating unpleasant menopausal symptoms, cholesterol-lowering, improving plasma lipid pattern, etc. Methods: In this study, we reviewed the scientific literature published up until 2020, which has evaluated the biological and pharmacological activity of gamma-oryzanol. This review summarizes the published data found in PubMed, Science Direct, and Scopus.

RESULTS AND CONCLUSION

The present review attempts to summarize the most related articles about the pharmacological and therapeutic potential from recent studies on γ-oryzanol to gain insights into design further studies to achieve new evidence that confirm the observed effects.

Absolute Blood Eosinophil Counts to Guide Inhaled Corticosteroids Therapy Among Patients with COPD: Systematic Review and Meta-analysis

INTRODUCTION

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019 recommends the use of absolute blood eosinophil count as a guide for the escalation and de-escalation of inhaled corticosteroids (ICS) in the pharmacological management of patients with chronic obstructive pulmonary disease (COPD). We evaluated the risk of moderate or severe exacerbations among patients escalating and de-escalating ICS therapy by absolute blood eosinophil thresholds in this systematic review.

METHODS

Through a comprehensive literature search of Pubmed/MEDLINE, EMBASE, and clinical trial sites up to April 2019, we identified relevant studies. We used generic inverse variance method with fixed-effects estimates to compare the risk of moderate or severe exacerbations among COPD patients with elevated blood eosinophil counts exposed to inhaled corticosteroids (ICS) versus non-ICS treatments groups expressed as risk ratios.

RESULTS

Ten studies (8 randomised control trials and 2 observational studies) were included, with a total of 85,059 COPD patients. In our pooled analysis, we found an overall reduction in risk of moderate or severe exacerbations in patients with absolute blood eosinophil thresholds ranging from ≥ 100 to ≥ 340 cells/µL among patients escalating ICS (RR, 0.77, 95% CI, 0.73-0.81). For studies evaluating the effects of de-escalation of ICS on moderate to severe exacerbations using blood eosinophil thresholds of ≥ 300 to ≥ 340 cells/µL had an increased risk of moderate or severe exacerbations following the de-escalation of ICS (RR, 1.66, 95% CI, 1.31-2.10).

CONCLUSION

This study confirms the validity of the recommended absolute blood eosinophil count thresholds for the escalation and de-escalation of ICS among COPD patients. However, this recommendation is for COPD patients with prior exacerbations rather than among newly diagnosed COPD patients as observed in this study. COPD patients with current or past history of asthma represent a unique phenotypic group which should be further evaluated.