Diseases

18 pages, 1785 KiB

Open AccessArticle

Labdane Diterpenoids from Leonotis ocymifolia with Selective Cytotoxic Activity Against HCC70 Breast Cancer Cell Line

by Jane Busisiwe Ncongwane, Vuyelwa Jacqueline Tembu, Comfort Mduduzi Nkambule, Douglas Kemboi, Gerda Fouche, Nyeleti Vukea and Jo-Anne de la Mare

Diseases 2025, 13(5), 140; https://doi.org/10.3390/diseases13050140 (registering DOI) - 1 May 2025

Abstract

Background: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with limited therapeutic options. Leonotis ocymifolia is a shrub widely used in traditional medicine to alleviate cancer-related symptoms. In a search to find safe and efficacious therapeutic agents from medicinal plants, [...] Read more.

Background: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with limited therapeutic options. Leonotis ocymifolia is a shrub widely used in traditional medicine to alleviate cancer-related symptoms. In a search to find safe and efficacious therapeutic agents from medicinal plants, Leonotis ocymifolia was studied to find compounds with anticancer activity against TNBC. Methods: Compounds from Leonotis ocymifolia were characterized using spectroscopic data such as IR, 1D and 2D NMR, and MS spectrometry and evaluated for cytotoxic activity against triple-negative breast cancer (HCC70), hormone receptor-positive breast cancer (MCF-7), and non-tumorigenic mammary epithelial cell lines (MCF-12A). Results: A previously unreported bis-spirolabdane, 13S-nepetaefolin (1), together with five known labdane diterpenoids, namely nepetaefolin (2), dubiin (3), nepetaefuran (4), leonotin (5), and leonotinin (6), from the genus Leonotis were isolated. Overall, the labdane diterpenoids showed selective activity toward triple-negative breast cancer cells (HCC70). Of the compounds extracted, 13S-nepetaefolin demonstrated the greatest cytotoxic activity with an IC₅₀ of 24.65 µM (SI = 1.08) against HCC70 cells; however, it was equally cytotoxic to non-tumorigenic MCF-12A breast cells (IC₅₀ of 26.55 µM), whereas its isomer (2) showed no activity. This suggests that stereochemistry might have an effect on the cytotoxic activity of the bis-spirolabdane diterpenoids. All the compounds (1–6) demonstrated adsorption, distribution, metabolism, and excretion properties (ADME), while leonotin (5) and leonotinin (6) exhibited lead-like properties and high synthetic accessibility scores. Conclusions: The findings from this study warrant further investigation of L. ocymifolia for potential triple-negative breast cancer (TNBC) therapeutic agents, including potential chemical derivatization of bis-spiro labdane diterpenoid (1) to improve selectivity to TNBC over non-cancer cells. Full article

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16 pages, 2193 KiB

Open AccessReview

Nutrition in Inflammatory Bowel Disease: Strategies to Improve Prognosis and New Therapeutic Approaches

by Nallely Bueno-Hernández, Jesús K. Yamamoto-Furusho and Viridiana Montsserrat Mendoza-Martínez

Diseases 2025, 13(5), 139; https://doi.org/10.3390/diseases13050139 (registering DOI) - 1 May 2025

Abstract

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gastrointestinal tract that significantly impacts nutritional status. Malnutrition is a frequent complication, resulting from reduced nutrient intake, malabsorption, and increased metabolic demands due to [...] Read more.

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gastrointestinal tract that significantly impacts nutritional status. Malnutrition is a frequent complication, resulting from reduced nutrient intake, malabsorption, and increased metabolic demands due to chronic inflammation. A comprehensive nutritional assessment encompassing anthropometric, biochemical, and dietary evaluations is crucial for informing personalized interventions. Several nutritional approaches have been explored to modulate inflammation and the gut microbiota, yielding promising results. The Mediterranean, anti-inflammatory, and low-FODMAP diets have shown potential benefits in symptom control. In contrast, diets high in ultra-processed foods and saturated fats are associated with worsened disease activity. Additionally, stool consistency, assessed using the Bristol Stool Scale, serves as a practical indicator for dietary adjustments, helping to regulate fiber intake and hydration strategies. When dietary modifications alone are insufficient, nutritional support becomes a critical component of IBD management. Enteral nutrition (EN) is preferred whenever possible because it maintains gut integrity and modulates immune responses. It has demonstrated efficacy in reducing postoperative complications and improving disease control. In cases where EN is not feasible, such as in intestinal obstruction, severe malabsorption, or high-output fistulas, parenteral nutrition (PN) is required. The choice between peripheral and central administration depends on treatment duration and osmolarity considerations. Despite growing evidence supporting nutritional interventions, further research is needed to establish standardized guidelines that optimize dietary and nutritional support strategies in managing IBD. Full article

(This article belongs to the Section Gastroenterology)

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13 pages, 1684 KiB

Open AccessSystematic Review

Efficacy and Safety of Adding Ribavirin to Sofosbuvir-Based Direct-Acting Antivirals (DAAs) in Re-Treating Non-Genotype 1 Hepatitis C—A Systematic Review and Meta-Analysis

by Shahd Hamran, Amani A. Al-Rajhi, Kawthar Jasim, Majed A. Al-Theyab, Mohamed Elahtam, Mooza K. Al-Hail, Wadha Al-Fahaidi, Yaman A. Khamis, Yara Dweidri, Abdel-Naser Elzouki and Tawanda Chivese

Diseases 2025, 13(5), 138; https://doi.org/10.3390/diseases13050138 - 29 Apr 2025

Abstract

Background: There is still debate whether ribavirin should be added to direct-acting antivirals (DAAs) for the management of treatment-experienced individuals with non-genotype-1 hepatitis C. This study compared the efficacy and safety of adding ribavirin to sofosbuvir-based combinations compared to sofosbuvir-based regimens alone in [...] Read more.

Background: There is still debate whether ribavirin should be added to direct-acting antivirals (DAAs) for the management of treatment-experienced individuals with non-genotype-1 hepatitis C. This study compared the efficacy and safety of adding ribavirin to sofosbuvir-based combinations compared to sofosbuvir-based regimens alone in treating non-genotype 1 hepatitis C virus (HCV) in individuals who have been previously treated. Methods: We searched Cochrane CENTRAL, PubMed, SCOPUS, CINAHL and preprint databases from inception to September 2023 for randomized controlled trials (RCTs) that compared sofosbuvir-based regimens with ribavirin to sofosbuvir-based regimens alone in previously treated individuals with non-genotype 1 HCV infection. Data extraction and quality of study assessments were performed by two independent authors, and synthesis was performed using bias-adjusted models, heterogeneity using I2, and publication bias using funnel plots. Results: Eight RCTs compared sofosbuvir-based combinations with and without ribavirin were included. Overall, the addition of ribavirin to sofosbuvir, compared to sofosbuvir alone, did not show a benefit in achieving sustained virological response (SVR) (OR 0.91, 95% CI 0.26–3.17, I2 = 70.0%) with moderate certainty in Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence. In subgroup analysis, there was no benefit of adding ribavirin to sofosbuvir in individuals with non-genotype 1 HCV. The additional ribavirin was associated with increased adverse events (OR 2.03, 95% CI 1.58–2.6, I2 = 8.0%) and treatment discontinuation (OR 1.81, 95% CI 0.78–4.28, I2 = 0.0%). Conclusions: The moderate certainty evidence suggests that adding ribavirin to sofosbuvir-based regimens may not confer benefit in achieving SVR in previously treated individuals with non-genotype 1 HCV but increases the odds of adverse events and treatment discontinuation. More evidence is needed on the effect of additional ribavirin in achieving SVR in individuals with decompensated cirrhosis. Registration: The protocol is registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022368868). Full article

(This article belongs to the Special Issue Viral Hepatitis: Diagnosis, Treatment and Management)

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14 pages, 687 KiB

Open AccessArticle

Unmasking the Hidden Morbidity of Ocular Diseases in Primary Care Through a Collaboration with Specialists in Remote Areas: A Cross-Sectional Study from Rural Crete, Greece

by Konstantinos Chliveros, Manolis Linardakis, Ioanna Tsiligianni, Miltiadis Tsilimbaris, Ioannis Pallikaris and Christos Lionis

Diseases 2025, 13(5), 137; https://doi.org/10.3390/diseases13050137 - 29 Apr 2025

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Abstract

Background: Ocular disorders are not frequently addressed in primary care, which is more visible in remote rural settings. The aim of the study was to assess the prevalence and pattern of eye diseases in a remote rural population of Crete and to [...] Read more.

Background: Ocular disorders are not frequently addressed in primary care, which is more visible in remote rural settings. The aim of the study was to assess the prevalence and pattern of eye diseases in a remote rural population of Crete and to explore whether they represent a hidden morbidity. Materials and Methods: A community-based, cross-sectional study based on data collected through a comprehensive clinical investigation conducted by a mobile ophthalmological unit. Permanent inhabitants, aged over 40 years, living in one remote rural community located on the highest mountain of Crete, were invited to participate. The prevalence of eye diseases was measured during the comprehensive ophthalmological examination. Patients’ medical records were used to assess hidden morbidity. The National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) was applied to measure self-reported vision-targeted health status. Results: A total of 239 individuals agreed to participate; 54.9% were females (n = 151), with a mean ageof 66.13 years (±14.56). The most common diagnoses were refractory errors (59%), cataract (21.7%), glaucoma (11.7%), maculopathy (8.8%), and dry eyes (8.8%). A previously undiagnosed eye disorder was detected in 34.3% (n = 82). Total scores of NEI VFQ-25 measured quality of life were highand significantly lower in Known Cases of eye diseases compared to patients with New or Without diagnosis (76.6 vs. 84.1 and 84.6, respectively, p = 0.009). Conclusions: Our study highlighted the need for increased awareness of primary care in rural areas concerning eye disorders. Local policies should focus on implementing public health interventions and encouraging close cooperation with specialists to overcome accessibility issues. Full article

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25 pages, 5836 KiB

Open AccessSystematic Review

Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis

by Salman Muslem, Mariam AlTurani, Muhammad Bilal Maqsood and Maryam Al Qaseer

Diseases 2025, 13(5), 136; https://doi.org/10.3390/diseases13050136 - 29 Apr 2025

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Abstract

Background: While heart failure with reduced ejection fraction (HFrEF) remains a major global health burden, mesenchymal stem cell (MSC) therapy has emerged as a promising intervention designed to improve cardiac function and reduce morbidity among patients unresponsive to conventional treatments. MSC therapy has [...] Read more.

Background: While heart failure with reduced ejection fraction (HFrEF) remains a major global health burden, mesenchymal stem cell (MSC) therapy has emerged as a promising intervention designed to improve cardiac function and reduce morbidity among patients unresponsive to conventional treatments. MSC therapy has shown promise by targeting left ventricular pressure and improving wall thickness, contributing to reductions in HF-related morbidity and mortality rates. This systematic review and meta-analysis bridges a gap in current research through a focused examination of the most recent clinical trials to cohesively assess MSC therapy in HFrEF patients. Methods: We conducted a systematic review and meta-analysis of clinical trials published from 2018 onwards, which were obtained from multiple databases such as PUBMED, Scopus, EBSCO Medline, EBSCO CINAHL Science Direct, and the Cochrane Library. This review investigates the efficacy and safety outcomes of MSC therapy in patients above 18 years of age with a known diagnosis of heart failure with a reduced ejection fraction (HFrEF). The primary outcome was the change in the left ventricular ejection fraction (LVEF). Secondary outcomes encompassed several efficacy outcomes, such as Global Circumferential strain (GCS), the 6-Minute Walk Test (6MWT), Quality of Life (QoL), and major adverse cardiac events (MACE). A PRISMA flow diagram was constructed to illustrate the identification, screening, eligibility, and inclusion of studies at each stage of the review process. Results: A total of 330 studies were initially identified, but only 12 met the inclusion criteria. MSC therapy resulted in a small, non-significant improvement in LVEF (Hedges’ g = 0.096, p = 0.18) with low heterogeneity (I² = 0.5%). Only QoL showed significant improvement (Hedges’ g = −0.518, p = 0.01). No significant changes in other efficacy outcomes were observed. The therapy was not associated with an increased risk of MACE. Conclusion: While MSC therapy was safe and improved QoL for HFrEF patients, it did not significantly improve LVEF or other efficacy outcomes. Further large-scale, standardized trials are required to better understand the potential role of MSCs in heart failure (HF) therapy. Full article

(This article belongs to the Section Cardiology)

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10 pages, 638 KiB

Open AccessArticle

Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis

by Elisa Mikus, Mariafrancesca Fiorentino, Diego Sangiorgi, Antonino Costantino, Simone Calvi, Elena Tenti, Elena Tremoli, Alberto Tripodi and Carlo Savini

Diseases 2025, 13(5), 135; https://doi.org/10.3390/diseases13050135 - 28 Apr 2025

Viewed by 106

Abstract

Background: This study evaluates the outcomes of isolated mitral valve surgery for infective endocarditis performed via conventional full sternotomy or minimally invasive right minithoracotomy. While minimally invasive surgery (MIS) is well-established for elective mitral procedures, its role in infective endocarditis remains less explored [...] Read more.

Background: This study evaluates the outcomes of isolated mitral valve surgery for infective endocarditis performed via conventional full sternotomy or minimally invasive right minithoracotomy. While minimally invasive surgery (MIS) is well-established for elective mitral procedures, its role in infective endocarditis remains less explored due to the complexity of the disease. Methods: A retrospective analysis of 134 patients who underwent isolated mitral valve surgery for infective endocarditis between January 2010 and March 2024 was conducted. Patients were divided into two groups based on the surgical approach: full sternotomy (n = 94) and MIS via right minithoracotomy (n = 40). Variables analyzed included preoperative characteristics, intraoperative details, and postoperative outcomes, such as mortality, complications, and hospital stay duration. Given significant baseline differences, inverse probability weighting was applied for comparability. Results: Mitral valve replacement was performed in 77% of cases. After adjustment, the MIS group demonstrated shorter intensive care unit stays (p = 0.018), with no significant differences in in-hospital mortality (p = 0.145) or total hospitalization length (p = 0.151). Conclusions: Minimally invasive mitral valve surgery is a safe and effective alternative to sternotomy in infective endocarditis, offering comparable outcomes with shorter ICU stays. Further research is needed to refine patient selection and validate these findings. Full article

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30 pages, 2473 KiB

Open AccessReview

Sarcopenia in Rheumatic Diseases: A Hidden Issue of Concern

by Eleni C. Pardali, Markos Klonizakis, Dimitrios G. Goulis, Sousana K. Papadopoulou, Christos Cholevas, Constantinos Giaginis, Christina Tsigalou, Dimitrios P. Bogdanos and Maria G. Grammatikopoulou

Diseases 2025, 13(5), 134; https://doi.org/10.3390/diseases13050134 - 26 Apr 2025

Viewed by 278

Abstract

Sarcopenia is characterized by a loss of muscle mass and function, with significant implications for the physical performance of the affected people. Although commonly associated with aging, disease-related sarcopenia is of great clinical importance, particularly as it impacts disease progression and outcomes. Individuals [...] Read more.

Sarcopenia is characterized by a loss of muscle mass and function, with significant implications for the physical performance of the affected people. Although commonly associated with aging, disease-related sarcopenia is of great clinical importance, particularly as it impacts disease progression and outcomes. Individuals with rheumatic diseases (RDs), including rheumatoid arthritis, systemic sclerosis, spondyloarthritides, systemic lupus erythematosus, fibromyalgia, myositis, or vasculitis, exhibit a high prevalence of sarcopenia, which exacerbates their clinical symptoms and contributes to poorer disease outcomes. Chronic inflammation influences muscle tissue degradation, causing a decline in physical performance. Apart from the apparent clinical manifestations, patients with RDs also use pharmacological treatments that negatively impact muscle mass further, increasing the risk of sarcopenia. Nutrition (diet and dietary supplements) and exercise interventions have been recommended as protective measures for sarcopenia as they may mitigate its adverse events. The present narrative review seeks to explore the methods used to assess sarcopenia in patients with RDs, its prevalence among them, and the challenges faced by the affected individuals, while critically assessing the appropriateness and limitations of current sarcopenia assessment tools in the context of RDs. Full article

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15 pages, 1141 KiB

Open AccessCase Report

Clinical Heterogeneity of Early-Onset Autoimmune Gastritis: From the Evidence to a Pediatric Tailored Algorithm

by Ivan Taietti, Martina Votto, Riccardo Castagnoli, Mirko Bertozzi, Maria De Filippo, Antonio Di Sabatino, Ombretta Luinetti, Alessandro Raffaele, Alessandro Vanoli, Marco Vincenzo Lenti, Gian Luigi Marseglia and Amelia Licari

Diseases 2025, 13(5), 133; https://doi.org/10.3390/diseases13050133 - 25 Apr 2025

Viewed by 244

Abstract

Autoimmune gastritis (AIG) is an uncommon and often underestimated condition in children, characterized by chronic stomach inflammation leading to the destruction of oxyntic glands with subsequent atrophic and metaplastic changes. This condition is associated with hypo-/achlorhydria, impairing iron and vitamin B12 absorption. The [...] Read more.

Autoimmune gastritis (AIG) is an uncommon and often underestimated condition in children, characterized by chronic stomach inflammation leading to the destruction of oxyntic glands with subsequent atrophic and metaplastic changes. This condition is associated with hypo-/achlorhydria, impairing iron and vitamin B12 absorption. The pathogenesis involves the activation of helper type 1 CD4+/CD25-T-cells against parietal cells. Clinical manifestations in children are not specific and include abdominal pain, bloating, nausea, vomiting, and iron deficiency anemia (IDA). The disease is also linked to an increased risk of pernicious anemia, intestinal-type gastric cancer, and type I neuroendocrine tumors. AIG is often diagnosed through the presence of autoantibodies in the serum, such as parietal cell (APCA) and intrinsic factor (IF) antibodies. However, therapeutic recommendations for pediatric AIG are currently lacking. We aim to present two clinical cases of pediatric-onset AIG, highlighting the heterogeneous clinical manifestations and the challenges in diagnosis with the support of an updated literature review. A 9-year-old girl presented with refractory IDA, initial hypogammaglobulinemia, and a 12-year-old boy was initially diagnosed with eosinophilic esophagitis. Both cases underline the importance of considering AIG in children with chronic gastrointestinal symptoms and gastric atrophy. Diagnostic workup, including endoscopy and serological tests, is crucial for accurate identification. A better understanding of this condition is imperative for timely intervention and regular monitoring, given the potential long-term complications, including the risk of malignancy. These cases contribute to expanding the clinical spectrum of pediatric AIG and highlight the necessity for comprehensive evaluation and management in affected children. Full article

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16 pages, 2859 KiB

Open AccessArticle

Beneficial Effects of White Grape Pomace in Experimental Dexamethasone-Induced Hypertension

by Raluca Maria Pop, Paul-Mihai Boarescu, Corina Ioana Bocsan, Mădălina Luciana Gherman, Veronica Sanda Chedea, Elena-Mihaela Jianu, Ștefan Horia Roșian, Ioana Boarescu, Floricuța Ranga, Maria Doinița Muntean, Maria Comșa, Sebastian Armean, Ana Uifălean, Alina Elena Pârvu and Anca Dana Buzoianu

Diseases 2025, 13(5), 132; https://doi.org/10.3390/diseases13050132 - 24 Apr 2025

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Abstract

Background: Grape pomace (GP), a by-product of winemaking, is a rich source of bioactive polyphenols known for their antioxidant and anti-inflammatory properties. While the cardiovascular benefits of red grape pomace have received significant scientific attention, the therapeutic potential of white grape pomace remains [...] Read more.

Background: Grape pomace (GP), a by-product of winemaking, is a rich source of bioactive polyphenols known for their antioxidant and anti-inflammatory properties. While the cardiovascular benefits of red grape pomace have received significant scientific attention, the therapeutic potential of white grape pomace remains largely unexplored, particularly in glucocorticoid-induced hypertension. Given the rising prevalence of hypertension and the oxidative-inflammatory mechanisms underlying its progression, this study investigates the effects of white GP on blood pressure regulation, oxidative stress, and pro-inflammatory cytokine expression in an experimental model of dexamethasone (DEXA)-induced hypertension (HTN). By focusing on white GP, this research addresses a significant gap in current knowledge and proposes a novel, sustainable approach to managing hypertension through valorising winemaking by-products. Methods: The first concentration used, GP1, was 795 mg polyphenols/kg bw, while the second concentration, GP2, was 397.5 mg polyphenols/kg bw. Results: White GP polyphenols extract in the DEXA_GP1 group had reduced systolic and diastolic blood pressure. The extract with a higher content of polyphenols (GP1) prevented the elevation of serum levels of total oxidative stress (TOS), malondialdehyde (MDA), and oxidative stress index (OSI), while the extract with a lower content of polyphenols (GP2) slightly reduced serum levels of MDA. Both concentrations of GP increased serum levels of NO and Total Thiols, significantly higher (p < 0.05) than in the group treated with lisinopril. The serum levels of tumour necrosis factor-alpha (TNF-α) increased in all groups where HTN was induced. Both doses of GP extract prevented the elevation of TNF-α. Heart tissue levels of the studied cytokines (TNF-α, interleukin (IL)-1β, and IL-6 were not influenced (p > 0.05) by either the HTN induction or the treatment administered. Conclusions: These findings suggest that grape pomace may serve as a promising nutraceutical intervention for hypertension management, particularly in conditions associated with oxidative stress. Full article

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20 pages, 2316 KiB

Open AccessArticle

Desmocollin-3 and Bladder Cancer

by Chandreshwar P. Shukla, Nayan K. Jain, Michael A. O’Donnell, Kapil V. Vachhani, Rashmi Patel, Janki Patel, Rajiv Modi, Arpit Dheeraj, Jee Min Lee, Annah Rolig, Sanjay V. Malhotra and Bakulesh Khamar

Diseases 2025, 13(5), 131; https://doi.org/10.3390/diseases13050131 - 23 Apr 2025

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Abstract

Background: Desmocollin3, a transmembrane protein, is expressed in the basal/suprabasal layer of normal stratified epithelium. DSC3 gene expression is described in muscle-invasive bladder cancer (MIBC). DSC3-protein-expressing recurrent non-muscle-invasive bladder cancer (NMIBC) had a durable response to CADI-03, a DSC3-specific active immunotherapy. Methods: We [...] Read more.

Background: Desmocollin3, a transmembrane protein, is expressed in the basal/suprabasal layer of normal stratified epithelium. DSC3 gene expression is described in muscle-invasive bladder cancer (MIBC). DSC3-protein-expressing recurrent non-muscle-invasive bladder cancer (NMIBC) had a durable response to CADI-03, a DSC3-specific active immunotherapy. Methods: We evaluated DSC3 protein expression and its correlation with tumor-infiltrating immune cells in bladder cancer. DSC3 gene expression and its correlation with 208 immune encoding genes, treatment outcome, and survival were evaluated using the “ARRAYEXPRESS” and “TCGA” datasets. Immune genes were grouped as tumor-controlling immune genes (TCIGs) and tumor-promoting immune genes (TPIGs) as per their functions. Results & conclusions: NMIBC had higher DSC3 expression compared to MIBC. More immune genes were correlated with DSC3 in MIBC (21) compared to NMIBC (11). Amongst the TCIGs, six in NMIBC and one in MIBC had a negative correlation while two in NMIBC and nine in MIBC had a positive correlation with DSC3. Amongst the TPIGs, nine in NMIBC and five in MIBC had a negative correlation. Seven TPIGs had a positive correlation with DSC3 in MIBC and none in NMIBC. Of the T cell exhaustion markers, none were correlated with DSC3 in MIBC. Among NMIBC, CTLA4 and TIGIT were the only markers of exhaustion that demonstrated a negative correlation with DSC3. DSC3 expression was also higher in p53 mutant compared to wild p53, non-papillary MIBC compared to papillary MIBC, and in basal, squamous molecular subtype compared to luminal MIBC. MIBC with lower DSC3 expression had better outcomes (response, survival) compared to those with higher DSC3 expression. Full article

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11 pages, 576 KiB

Open AccessArticle

Prevalence of Chronic Obstructive Pulmonary Disease and Asthma in the Community of Pathumthani, Thailand

by Narongkorn Saiphoklang, Pitchayapa Ruchiwit, Apichart Kanitsap, Pichaya Tantiyavarong, Pasitpon Vatcharavongvan, Srimuang Palungrit, Kanyada Leelasittikul, Apiwat Pugongchai and Orapan Poachanukoon

Diseases 2025, 13(5), 130; https://doi.org/10.3390/diseases13050130 - 23 Apr 2025

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Abstract

Background: Airway diseases, particularly asthma and chronic obstructive pulmonary disease (COPD), pose significant respiratory problems. The prevalence and risk factors of these diseases among community dwellers vary geographically and because of underdiagnosis. This study aims to determine the prevalence and factors associated [...] Read more.

Background: Airway diseases, particularly asthma and chronic obstructive pulmonary disease (COPD), pose significant respiratory problems. The prevalence and risk factors of these diseases among community dwellers vary geographically and because of underdiagnosis. This study aims to determine the prevalence and factors associated with these diseases in a provincial-metropolitan area in Thailand. Methods: A cross-sectional study was conducted between April 2023 and November 2023 on individuals aged 18 years or older residing in Pathumthani, Thailand. Data on demographics, pre-existing diseases, respiratory symptoms, and pulmonary functions assessed by spirometry, including forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and bronchodilator responsiveness (BDR), were collected. COPD was defined as having respiratory symptoms, a risk factor, and post-bronchodilator FEV₁/FVC < 70%. Asthma was defined as having respiratory symptoms and a positive bronchodilator responsiveness. Results: A total of 1014 subjects (71.7% female) were included, with a mean age of 56.6 years. The smoking history was 10.4% (13.4 pack-years). Common symptoms included cough (18.4%), sputum production (14.5%), and dyspnea (10.0%). COPD was found in 8.3%, while asthma was found in 10.3%. Logistic regression analysis indicated that these diseases were significantly associated with older age (odds ratio [OR] 1.023; 95% confidence interval [CI] 1.007–1.039 for every 1-year increase in age), smoking (OR 2.247; 95% CI 1.068–4.728), heart disease (OR 2.709; 95% CI 1.250–5.873), wheezing (OR 3.128; 95% CI 1.109–8.824), runny nose (OR 1.911; 95% CI 1.050–3.477), and previous treatment for dyspnea (OR 6.749, 95% CI 3.670–12.409). Conclusions: COPD and asthma were relatively prevalent in our study. Being elderly, smoking, having heart disease, and experiencing any respiratory symptoms with a history of treatment are crucial indicators for these airway diseases. Pulmonary function testing might be needed for active surveillance to detect these respiratory diseases in the community. Full article

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24 pages, 1185 KiB

Open AccessReview

Current and Emerging Parenteral and Peroral Medications for Weight Loss: A Narrative Review

by Abdullah Al Lawati, Ayman Alhabsi, Rhieya Rahul, Maria-Luisa Savino, Hamed Alwahaibi, Srijit Das and Hanan Al Lawati

Diseases 2025, 13(5), 129; https://doi.org/10.3390/diseases13050129 - 22 Apr 2025

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Abstract

Obesity is a growing global health challenge, necessitating effective treatment options beyond lifestyle interventions. This narrative review explores established and emerging pharmacotherapies for weight management, including parenteral agents like Liraglutide, Semaglutide, Setmelanotide, and Tirzepatide, as well as peroral medications such as Phentermine, Phentermine/Topiramate, [...] Read more.

Obesity is a growing global health challenge, necessitating effective treatment options beyond lifestyle interventions. This narrative review explores established and emerging pharmacotherapies for weight management, including parenteral agents like Liraglutide, Semaglutide, Setmelanotide, and Tirzepatide, as well as peroral medications such as Phentermine, Phentermine/Topiramate, Bupropion/Naltrexone, Orlistat, and Metformin. Newer treatments like Cagrilintide and Bimagrumab show promise for enhancing weight loss outcomes. Parenteral GLP-1 receptor agonists demonstrate superior efficacy compared to traditional peroral medications, with gastrointestinal side effects being the most common. Artificial intelligence presents intriguing opportunities to enhance weight loss strategies; however, its integration into clinical practice remains investigational and requires rigorous clinical validation. While current anti-obesity medications deliver significant benefits, future research must determine the efficacy, safety, and cost-effectiveness of AI-driven approaches. This includes exploring how AI can complement combination therapies and tailor personalized interventions, thereby grounding its potential benefits in robust clinical evidence. Future directions will focus on integrating AI into clinical trials to refine and personalize obesity management strategies. Full article

(This article belongs to the Special Issue Body Composition, Energy Expenditure and Lifestyle During Obesity Management)

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9 pages, 796 KiB

Open AccessArticle

Ultrasound Relationship of Plantar Fat and Predislocation Syndrome

by Ana María Rayo Pérez, Rafael Rayo Martín, Rafael Rayo Rosado, Joao Miguel Costa Martiniano and Raquel García-de-la-Peña

Diseases 2025, 13(5), 128; https://doi.org/10.3390/diseases13050128 - 22 Apr 2025

Viewed by 125

Abstract

Background: Plantar fat plays a crucial role in protecting and cushioning the metatarsals. Its degeneration is a risk factor for the development of metatarsalgia and, consequently, predislocation syndrome. Objectives: To evaluate the relationship between plantar fat thickness and predislocation syndrome in an adult [...] Read more.

Background: Plantar fat plays a crucial role in protecting and cushioning the metatarsals. Its degeneration is a risk factor for the development of metatarsalgia and, consequently, predislocation syndrome. Objectives: To evaluate the relationship between plantar fat thickness and predislocation syndrome in an adult population, and to determine a possible association between a decrease in forefoot plantar fat and the presence of symptoms. Material and Methods: A retrospective observational study was conducted, including records of patients who visited the podiatry clinic between December 2022 and December 2023. Fifty complete records were selected, divided into two groups, one healthy and one pathological, aged between 18 and 70 years. An ultrasound examination of the plantar area of the second metatarsophalangeal joint was performed to assess the thickness of the fat and plantar plate. Results: The analysis of the 50 records, divided into healthy and pathological groups, reveals significant differences in the thickness of plantar fat and the plantar plate between the two groups. Subjects with predislocation syndrome have a significantly lower plantar fat thickness (0.566 cm) compared to the healthy group (0.941 cm) and also show a greater thickness of the plantar plate (0.359 cm vs. 0.244 cm). Statistical tests confirm these differences with high significance (p < 0.001). The ROC curve shows that plantar fat thickness is a good predictor of predislocation syndrome, with an area under the curve (AUC) of 0.923, emphasizing the utility of this measure in identifying the condition. Conclusions: Preliminary studies suggest that a reduction in plantar fat increases the predisposition to develop predislocation syndrome at the level of the second metatarsophalangeal joint. Full article

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20 pages, 2553 KiB

Open AccessSystematic Review

A Closer Look at the Dermatological Profile of GLP-1 Agonists

by Calista Persson, Allison Eaton and Harvey N. Mayrovitz

Diseases 2025, 13(5), 127; https://doi.org/10.3390/diseases13050127 - 22 Apr 2025

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Abstract

Background/objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used in treating type 2 diabetes and obesity, offering established metabolic and cardiovascular benefits. Emerging evidence suggests these agents also exert direct dermatologic effects. This systematic review categorizes these effects and explores their role in [...] Read more.

Background/objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used in treating type 2 diabetes and obesity, offering established metabolic and cardiovascular benefits. Emerging evidence suggests these agents also exert direct dermatologic effects. This systematic review categorizes these effects and explores their role in inflammatory skin diseases. Methods: A comprehensive literature search was performed across EMBASE, PubMed, Web of Science, and Google Scholar for studies published from 2014 to 2025. Inclusion criteria were English-language, peer-reviewed original research involving human subjects that linked GLP-1RAs to dermatologic effects. Animal and in vitro studies were excluded. PRISMA guidelines were followed. Results: Fifty-one studies met inclusion criteria. Thirty-four reported adverse effects, including hypersensitivity, injection-site reactions, pruritus, urticaria, angioedema, and immune-mediated conditions like bullous pemphigoid. Seventeen studies described beneficial outcomes, such as improvements in psoriasis, reduced hidradenitis suppurativa flares, enhanced wound healing, anti-aging potential, and decreased inflammation. GLP-1RAs showed cytokine modulation in psoriasis, though their role in hidradenitis suppurativa remains uncertain. Cosmetic concerns, such as “Ozempic Face” due to rapid weight loss, were also noted. Conclusions: GLP-1RAs have a broad spectrum of dermatologic effects, from immunomodulatory benefits to adverse cutaneous reactions. Their impact on inflammatory skin disorders suggests a novel therapeutic avenue. However, adverse reactions and aesthetic changes warrant vigilance. Future research should focus on mechanistic studies, long-term safety, and identifying biomarkers to predict dermatologic responses, ultimately guiding personalized treatment approaches. Full article

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Diseases, Volume 13, Issue 5 (May 2025) – 14 articles

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