Future Pharmacology doi: 10.3390/futurepharmacol6030046

Authors: Durairaj Ragu Varman Ataúlfo Martínez-Torres Manuel Enrique Gutiérrez-Alvarado Rogelio O. Arellano Daniel Reyes-Haro

Background: The cerebellum integrates sensory information to maintain balance and posture, allowing movement guidance. Perinatal damage to this brain region correlates with an increased incidence of Autism Spectrum Disorder (ASD), a major neurodevelopmental condition where poor motor performance in eye–hand coordination, balance and gait is observed. The cerebellum of ASD individuals is affected by reduced GABAergic signaling that leads to an excitatory/inhibitory imbalance. Methods: Motor coordination behavior were tested and Western blot essays performed to study the developmental expression of GABAergic signaling proteins, namely GABAA receptor (α1, α2 and β1) subunits and glutamate decarboxylase 67 (GAD67), in CD1 mice prenatally exposed to valproic acid (VPA), a preclinical model of ASD. Results: The VPA group exhibited motor coordination deficits on postnatal day 30 (P30) compared to the control. The expression profiles for the control group revealed that GABAA-α1 increased linearly, while GABAA-β1 displayed the opposite pattern and GABAA-α2 presented one peak of expression (P8). GAD67 decreased from embryonic day 16 (E16) to P8 but increased linearly after the first week of postnatal development (P8-P30). The developmental expression profile for all these proteins was disrupted by prenatal exposure to VPA. Conclusions: Motor coordination deficits correlate with a downregulated expression of GABAA (α1, α2 and β1) subunits and GAD67 through cerebellar development in individuals that were prenatally exposed to VPA.

Future Pharmacology doi: 10.3390/futurepharmacol6030045

Authors: Belma Pehlivanović Kelle Dina Lagumdžija Tarik Suljić Aida Hamzić-Mehmedbašić Jasna Kusturica Aida Kulo Ćesić

Background: Rosuvastatin, a potent lipid-lowering statin, and curcumin, a bioactive naturally occurring polyphenolic phytochemical, both show pleiotropic antioxidant and anti-inflammatory properties. In addition, curcumin shows also antimicrobial, anticancer, hypolipidemic and antifibrotic effects. From the pharmacodynamic point, rosuvastatin and curcumin target overlapping molecular pathways—suggesting possible pharmacodynamic synergy that has emerged as a promising therapeutic approach in the management of various diseases, including cardiovascular, metabolic, kidney, and inflammatory diseases. Objectives: This review aimed to systematically summarize and critically evaluate all available preclinical data concerning the combined use of rosuvastatin and curcumin, emphasizing their possible synergistic effects. Methods: A total of seven preclinical studies that investigated the combination of curcumin and rosuvastatin, three in vitro and four in vivo, conducted between 2017 and 2025, were included in the analysis. Results: While in vitro studies suggested a promising synergy in lipid-lowering, antioxidant, and anti-inflammatory effects, in vivo findings confirmed enhanced lipid-lowering effects, potential hepatoprotection and nephroprotection when two agents are co-administered. In addition to pharmacodynamic interaction, pharmacokinetic studies also revealed that curcumin may increase systemic rosuvastatin exposure by inhibiting hepatic transporters, warranting further investigation into dosing and safety of the combination. Conclusions: While current evidence supports the therapeutic potential of the combined use of rosuvastatin and curcumin, additional pharmacokinetic, mechanistic, and clinical studies are needed to fully assess its translational value.

Future Pharmacology doi: 10.3390/futurepharmacol6030044

Authors: Daria A. Kiseleva Vladislav V. Fomenko Nina I. Komarova Nariman F. Salakhutdinov Tatiana G. Tolstikova

Background/Objectives: Tryptophol and tyrosol are prominent secondary metabolites with diverse biological activities. Acetylation has been proposed as a strategy to modify the physicochemical properties of these compounds. Despite the proven neuroprotective and adaptogenic activity of tyrosol, in vivo studies, particularly concerning the anxiolytic effects of its acetylated forms, are currently limited. Materials and Methods: This study aimed to compare the behavioral effects of tryptophol, tryptophol acetate, and tyrosol acetate in mice using the chloral hydrate sleep model, the Open Field Test (OFT), and the Forced Swim Test (FST). Results: In the chloral hydrate sleep model, both tryptophol acetate and tyrosol acetate (100 mg/kg, i.g.) significantly prolonged sleep duration without affecting sleep latency, whereas none of the tested compounds induced sleep after single administration (100 mg/kg, i.p.). In the OFT, tyrosol acetate (100 mg/kg, i.g.) significantly increased exploratory activity, as reflected by increased time spent in the central zone and number/duration of verticalizations, indicating an anxiolytic-like behavioral profile. In the FST, tyrosol acetate (100 mg/kg, i.g.) significantly reduced immobility time, suggesting an effect on behavioral responses to acute inescapable stress. Conclusions: Overall, the tested compounds exhibited distinct behavioral profiles, with tyrosol acetate producing the most consistent behavioral effects across the experimental models. These findings suggest that acetylation modifies the neuropharmacological properties of naturally occurring aromatic alcohols and support further investigation of tyrosol acetate, including studies of its mechanisms of action and evaluation in additional anxiety-specific behavioral models.

Future Pharmacology doi: 10.3390/futurepharmacol6030043

Authors: Petar Taslaković Miloš N. Milosavljević Ana V. Pejčić Srđan M. Stefanović Vladimir S. Janjić Aleksandar V. Matić

Background/Objectives: Duloxetine is a serotonin–norepinephrine reuptake inhibitor used for psychiatric and chronic pain conditions. It enhances serotonergic and noradrenergic neurotransmission by inhibiting the reuptake of serotonin and norepinephrine. Acute poisoning, most commonly resulting from intentional oral ingestion, may frequently present with neurological and cardiovascular manifestations. Although duloxetine is widely prescribed, evidence regarding acute overdose remains limited, and no validated toxic duloxetine concentration threshold reliably predicts the severity of duloxetine toxicity. This systematic review aimed to synthesize published cases of duloxetine poisoning and characterize clinical manifestations, management strategies, and outcomes. Methods: We searched PubMed and Google Scholar for case reports and case series describing cases of duloxetine poisoning. We included cases of acute duloxetine poisoning with a clearly toxic ingested dose and/or analytically confirmed toxic duloxetine concentrations. Results: A total of 18 publications describing 23 patients were included in this systematic review. Duloxetine intoxication was classified as suicidal in 17 cases (73.9%), accidental in 5 cases (21.7%), and not specified in one case (4.3%). In most cases (78.3%), duloxetine overdoses involved co-ingestion of other central nervous system depressants. The most common clinical manifestation was altered mental status, ranging from somnolence, confusion, disorientation, and drowsiness to impaired consciousness, coma, or unresponsiveness in severe cases. Nearly half of the included duloxetine poisoning cases (47.8%) were fatal. Conclusions: In conclusion, acute duloxetine intoxication is most frequently associated with the co-ingestion of other central nervous system depressants, and early recognition with prompt supportive management is essential to minimize the risk of fatal outcomes.

Future Pharmacology doi: 10.3390/futurepharmacol6030042

Authors: Veronika A. Shikova Olga N. Pozharitskaya Elena V. Flisyuk Dmitry Yu. Ivkin Alexander N. Shikov

Background/Objectives: The pharmacological management of inflammation remains a clinical challenge, driving the demand for advanced topical formulations. This study utilizes a “smart-NADES” (natural deep eutectic solvent) paradigm to develop an innovative anti-inflammatory topical system. The aim was to evaluate the integrated antioxidant potential, alongside the in vitro and in vivo anti-inflammatory activities, of a novel smart-NADES licorice root extract and its hydrogel formulation. Methods: A NADES system composed of D-sorbitol and L-lactic acid (3:1) was employed for licorice root extraction. The antioxidant capacity was assessed using three independent assays and integrated via the Relative Antioxidant Capacity Index (RACI), while phytochemical interactions were quantified using the Chou–Talalai Combination Index (CI). In vitro anti-inflammatory activity was evaluated via protein stabilization capacity, and in vivo efficacy was validated using a formalin-induced paw edema model in mice. Results: The NADES extract contained glycyrrhizic acid levels of 6.3 ± 0.3 mg/g and showed strong antioxidant synergism in the DPPH assay (CI = 0.49 ± 0.07). The extract exhibited potent total antioxidant capacity (IC50 = 11.9 ± 0.6 μg/mL) with a superior RACI score (1.23). In vitro protein stabilization (IC50 = 63 ± 5 μg/mL) was comparable to diclofenac sodium. The 5% hydrogel numerically surpassed the commercial 2% diclofenac Emulgel (67.5% vs. 32.9% inhibition, respectively) at 24 h, although the direct pairwise comparison did not reach statistical significance (p = 0.186). Conclusions: The developed smart-NADES licorice hydrogel represents an effective, green formulation with pronounced topical anti-inflammatory properties, establishing a robust pharmacological rationale for advanced topical drug delivery.

Future Pharmacology doi: 10.3390/futurepharmacol6030041

Authors: Daniela Guzmán-Uribe Idania De Alba-Montero Facundo Ruiz Gabriel-Alejandro Martínez-Castañón Nereyda Niño-Martínez

Background/Objectives. The use of antibiotic pastes in the Lesion Sterilization Tissue Repair (LSTR) technique has increased due to their ability to disinfect necrotic primary teeth without mechanical instrumentation. Tri-antibiotic mixtures (TAP) and Chloramphenicol-Tetracycline-Zinc Oxide (CTZ) paste remain the most common options, although their composition and dosing lack standardization. Evidence indicates that silver and zinc oxide nanoparticles enhance antimicrobial performance by disrupting biofilms and modulating inflammatory pathways, suggesting potential benefits when incorporated into intracanal medications. This study aimed to evaluate the antimicrobial activity of a chloramphenicol–tetracycline paste modified with silver nanoparticles (SNPs) and zinc oxide nanoparticles (ZnONPs) against wild Enterococcus faecalis, comparing its MIC, MBC, and inhibition zones with those of a commercial CTZ paste. Methods. SNPs and ZnONPs (1 × 10−2 M) were synthesized and characterized using UV–Vis spectroscopy and dynamic light scattering (DLS). Two antibiotic pastes (1%) were formulated, including a nanoparticle-modified version with a 4% reduction in antibiotic content. Commercial CTZ paste was prepared according to the manufacturer’s instructions. Wild E. faecalis strains were isolated from necrotic primary teeth (N = 30). MIC, MBC, and inhibition zones were determined using microdilution and Kirby–Bauer assays. Results. AB Paste and Nanopaste showed larger inhibition zones (ZOI) than the other formulations (p < 0.001). MIC and MBC analyses showed no significant differences among antibiotic formulations and SNPs (p > 0.05). Conclusions. Both the nanoparticle-free antibiotic paste and the nanoparticle-modified paste demonstrated greater inhibitory activity than commercial pastes and Nanoparticles. Despite containing 4% less antibiotics, the Nanopaste showed equivalent efficacy, indicating that reducing the drug content does not compromise antimicrobial performance and that SNPs contribute to this effect.

Future Pharmacology doi: 10.3390/futurepharmacol6030040

Authors: Majdi Al-Alawneh Fareed Ahmad Abdallah Musa Abdallah Samir Jaoua Saïd Sif

Background: PRMT5, or protein arginine methyltransferase 5, is recognized as an epigenetic regulator that suppresses gene transcription through symmetric dimethylation of histone arginine residues, including histone H4 arginine 3 (H4R3me2s) and histone H3 arginine 8 (H3R8me2s), modifications associated with chromatin condensation and transcriptional repression. PRMT5-mediated methylation has been associated with recruitment of polycomb repressive complex 2 (PRC2) and enhancer of zeste homolog 2 (EZH2)-mediated H3K27me3 deposition, contributing to stable repression of tumor suppressor genes and apoptosis-related effectors in breast cancer. Methods: The molecular and functional impacts of PRMT5 inhibition were studied in TNBC cell lines with a pharmacological inhibitor (CMP5). Cellular responses were evaluated using a viability assay, qPCR, Western blotting, Annexin V/PI staining, and transwell migration/proliferation assays. Results: PRMT5 inhibition substantially reduced TNBC viability in a time- and dose-dependent manner. EZH2 was downregulated, whereas the tumor suppressor retinoblastoma-like protein 2 (RBL2) was induced, concomitant with low expression of Cyclin D1. These changes were accompanied by upregulation of pro-apoptotic effectors (Caspase-3, Caspase-10, death-associated protein 1 (DAP1), and BCL2-associated x protein (BAX) and repression of the pro-survival B-cell lymphoma 2 (BCL2), consistent with apoptosis-associated molecular responses. Functionally, CMP5 treatment was associated with reduced migratory behavior in TNBC cells under the experimental conditions tested. Conclusions: These findings suggest that PRMT5 inhibition by CMP5 is associated with reduced TNBC cell viability, impaired migration, increased expression of apoptosis-associated regulators and enhanced apoptotic cell death as measured by Annexin V/PI analysis in vitro. Further mechanistic and in vivo studies are required to clarify the therapeutic relevance of PRMT5 inhibition in TNBC.

Future Pharmacology doi: 10.3390/futurepharmacol6030039

Authors: Ruri Matsui Ayako Maeda-Minami Shigeo Nakamura Yasunari Mano Yoshihiko Kakinuma

Background/Objectives: The non-neuronal cardiac cholinergic system (NNCCS) is known to synthesize ACh independently of the parasympathetic nervous system, thereby regulating cardiac homeostasis, which includes sustainability of energy metabolism, anti-inflammatory and anti-ischemic properties, electrical stability, and mitochondrial calcium handling. Given these beneficial functions of NNCCS, we were prompted to search for an inducer. One such inducer is SNPiP, a novel low-molecular-weight chemical compound developed by us. SNPiP accelerates ACh synthesis in the heart via cGMP elevation and, intriguingly, enhances diastolic function, increasing cardiac output and end-systolic pressure without elevating heart rate. However, the pharmacokinetics of SNPiP remain unknown, which led us to conduct the present study. Methods and Results: We found that the half-life of SNPiP in the blood was extremely short, similar to that of a nitric oxide (NO) donor, S-nitroso-N-acetyl-DL-penicillamine. This short half-life is caused by the rapid distribution of SNPiP into organs, including the heart, kidney, and liver. In addition, once transferred into blood cells, SNPiP itself became stable and remained intact for up to 1 h. Moreover, the short half-life was partly explained by the rapid degradation of SNPiP and concomitant loss of the nitroso group in the blood. Notably, when rats were treated with SNPiP, NO levels in the heart elevated bimodally: immediately after administration and again about 12 h later, coinciding with the previous report of NNCCS upregulation and accelerated ACh synthesis with NO production. Importantly, our previous transcriptome analysis of SNPiP-treated hearts supports these findings, as it revealed upregulation of diastolic function-related genes and proteins. Conclusions: Collectively, these results clarify the pharmacokinetics of SNPiP and demonstrate that, despite a shorter half-life, SNPiP is efficiently distributed to the heart, where it confers beneficial effects through induction of NNCCS.

Future Pharmacology doi: 10.3390/futurepharmacol6030038

Authors: Erica Eugênio Lourenço Gontijo Raphael Gomes Ferreira Janne Marques da Silveira Silvia Minharro Silvio Carneiro Cunha Filho Michell Frank Alves de Oliveira Fabricio Souza Campos Gil Rodrigues dos Santos Ana Luiza Silva Guimarães Júlia Lasmar Torquato de Melo Julliana Dias Pinheiro Frederico Eugênio Jaqueline Cibene Moreira Borges João Bartholomeu Neto Vanessa Mara Chapla Renisson Neponuceno de Araújo Filho Benjamim Almeida Carneiro da Cunha Marcos Gontijo da Silva

Background: The objective of this study was to evaluate the efficacy and safety of CAR-T immunotherapy in inducing remission in patients with Acute Lymphoblastic Leukemia (ALL). Methods: The search strategy was conducted in the BVS, Embase, PubMed, and ScienceDirect databases, where 4138 studies were initially identified. Results: The final analysis resulted in the inclusion of 35 studies, all of which were incorporated into the meta-analysis, covering a cohort of 1313 patients. Statistical analysis was performed using R software (version 4.5.2), revealing a Complete Remission rate of 70.68% and a Minimal Residual Disease negativity rate of 76.68%. Tactical superiority was observed in the second-generation cells and in the dual CD19/CD22 target (82.20% CR). The risk of bias assessment using the ROBINS-I tool indicated high quality for most of the studies. The certainty of evidence according to the GRADE system was classified as moderate. Adverse events such as cytokine release syndrome (46.81%) and neurotoxicity (23.52%) were frequent but reversible. Conclusions: We thus observe that CAR-T therapy is an effective strategic bridge to bone marrow transplantation, with advances in cell persistence being fundamental for sustained cure.

Future Pharmacology doi: 10.3390/futurepharmacol6030037

Authors: Maria João Machado Ana Alves Helena Amaral Nuno M. Saraiva Paulo Costa

Neurodegenerative diseases (NDs) such as Alzheimer’s, Parkinson’s, and Huntington’s disease are progressive and currently incurable conditions characterized by the deterioration of neuronal structure and function. Its incidence is increasing, primarily driven by global aging, and it represents a significant public health concern. Traditional therapies offer only symptomatic relief and are unable to halt or reverse the underlying neurodegenerative processes. One of the key challenges in developing effective treatments is the presence of biological barriers, such as the blood–brain barrier (BBB), which limits drug delivery to the central nervous system (CNS), namely the brain. Nanotechnology has emerged as a promising tool to overcome these obstacles. Nanoparticles (NPs), due to their small size, biocompatibility, and versatility, can be engineered to cross the BBB, protect therapeutic agents from degradation, and deliver them precisely to target sites in the brain. This work explores the current advances in lipid and polymeric-based nanoparticle (LNPs and PNPs, respectively) drug delivery systems (DDS) and their application in preclinical studies for the treatment of the NDs previously mentioned. The presented studies suggest that this strategy holds great potential, offering new perspectives and emerging strategies to improve therapeutic outcomes for NDs, and promote neuroprotection of the brain.

Future Pharmacology doi: 10.3390/futurepharmacol6030036

Authors: Anastasia A. Deryabina Matvey M. Tsyganov Marina K. Ibragimova Irina A. Tsydenova Olga Y. Rybalkina Arina K. Shagabudinova Pavel E. Nikiforov Maria V. Filonova Alexey A. Churin

Xanthotoxin (8-methoxypsoralen) belongs to the group of naturally occurring furanocoumarin (furocoumarin) compounds and is a product of plant secondary metabolism. Analysis of the available literature indicates that xanthotoxin exhibits a broad spectrum of pharmacological activities, including anti-inflammatory, antioxidant, immunomodulatory, and antibacterial effects. Xanthotoxin has been shown to stimulate autophagy via inhibition of the AKT/mTOR pathway, as well as to block cell migration by modulating RIG-1 and NF-κB signaling. Moreover, its effects on JNK/MAPK, PI3K/AKT, Calcium–CaMYK/PYK2, and other signaling cascades have been confirmed. Among its most promising properties is the ability to inhibit ABC transporters, thereby preventing the reduction of chemotherapeutic agent concentrations within tumor cells and enhancing their intracellular accumulation. Thus, the aim of this study was to evaluate xanthotoxin as a potential anticancer agent. The literature review was based on publications indexed in Google Scholar, Scopus, Web of Science, and PubMed and published between 2010 and 2026. Studies describing the biological properties of xanthotoxin, its toxicity, anticancer mechanisms of action, and modulation of ABC transporters were included. This literature review summarizes the pharmacological profile of xanthotoxin, and its biological activities and therapeutic potential, as well as its antitumor effects in various cancer cell lines. The available evidence may provide a foundation for the future development of xanthotoxin as a lead compound for anticancer drug discovery.

Future Pharmacology doi: 10.3390/futurepharmacol6030035

Authors: Mariana Pereira Nuno Vale

Background: Prostate cancer remains one of the most prevalent malignancies worldwide, with high mortality in advanced and metastatic stages. Drug repurposing offers a cost-effective and time-efficient strategy to identify new therapeutic options. Objectives: This study aimed to apply physiologically based pharmacokinetic (PBPK) modeling to evaluate repurposed antiretroviral drugs efavirenz (EFV), etravirine (ETV), and saquinavir (SAQ) in prostate cancer, and to assess potential drug–drug interactions (DDIs) between EFV and ETV. Methods: PBPK models for EFV and SAQ were obtained and an ETV was developed and validated using literature and ADMET Predictor® data. Prostate tissue models were modified to simulate malignant conditions, and population-based simulations examined the influence of age and obesity. The GastroPlus® DDI module was applied to explore mechanistic interactions between EFV and ETV under different physiological scenarios. Results: Tumor-specific prostate tissue alterations produced minimal systemic pharmacokinetic changes but increased total drug accumulated in simulated tissue, with differences in unbound concentrations, while demographic variables such as age and weight significantly affected drug exposure, which are comorbidities in prostate cancer. Lighter individuals exhibited higher plasma concentrations across all drugs, consistent with known previously reported pharmacokinetic trends in obese individuals. DDI simulations indicated only minor changes in ETV pharmacokinetics when combined with EFV, with no clinically significant interaction detected. Conclusions: The integration of PBPK modeling, population variability, and DDI analysis highlights the potential of SAQ, EFV, and ETV as viable drugs for prostate cancer repurposing, but with a heavy focus on dosing personalization. In silico approaches provide a useful framework for early preclinical evaluation and the optimization of repurposed drugs, supporting the early evaluation of repurposed drug candidates in oncology.

Future Pharmacology doi: 10.3390/futurepharmacol6030033

Authors: Mohammad Faheem Khan Mohd Aamish Khan

Text Correction [...]

Future Pharmacology doi: 10.3390/futurepharmacol6030034

Authors: Gabriella de Souza Gomes Ribeiro Pieter Annaert Frederico Severino Martins Tania Marcourakis

Background/Objectives: In this study, we present an analysis of ayahuasca, a psychedelic preparation containing N,N-dimethyltryptamine (DMT) and β-carbolines, such as harmine (HRM), a reversible monoamine oxidase A (MAO-A) inhibitor that enables the oral bioavailability of DMT. CYP2D6 is a highly polymorphic enzyme associated with interindividual variability in drug exposure, but its influence on the pharmacokinetics of ayahuasca alkaloids remains poorly understood. Methods: Using physiologically based pharmacokinetic (PBPK) modeling, we simulated scenarios for poor (PM), normal (NM), and ultra-rapid (UM) metabolizers by adjusting CYP2D6 enzyme expression for each phenotype. Results: PMs showed increased systemic exposure to DMT (AUC +53.3%; Cmax +40.5%) and HRM (AUC +30.6%; Cmax +22.8%), while UMs exhibited reduced exposure to both compounds. Conclusions: These findings highlight the significant impact of CYP2D6 polymorphisms on the pharmacokinetics of DMT and HRM, reinforcing the value of PBPK modeling for predicting interindividual variability and potential clinical risks.

Future Pharmacology doi: 10.3390/futurepharmacol6020032

Authors: Christian S. Carnero Canales Miguel D’Agostino dos Santos Ana Carolina Cerqueira Negri Luiza Rossi Gois Subham Kumar Vishwakarma Cesar Augusto Roque-Borda Fernando Rogério Pavan

ESKAPE pathogens represent a priority clinical threat due to their multidrug-resistance, persistence in biofilms, and ability to evade antibiotic therapy. In response to these limitations, antimicrobial peptides (AMPs) have emerged as promising platforms for the development of novel anti-infective strategies. This review analyzes the potential of AMPs against ESKAPE pathogens, integrating their main classes, mechanisms of action, design strategies, and barriers to clinical translation. Natural, synthetic, and peptidomimetic AMPs are examined, along with lytic mechanisms, intracellular targets, anti-virulence effects, quorum quenching, and immunomodulation. In addition, in silico design approaches, multi-objective prediction, and molecular optimization strategies—including stereochemical modifications, cyclization, lipidation, PEGylation, and hybrid design—are discussed. Finally, their activity against ESKAPE biofilms is addressed, together with current limitations related to stability, toxicity, delivery, and preclinical validation.

Future Pharmacology doi: 10.3390/futurepharmacol6020031

Authors: Zongchang Li Sixian Zhang Shu Chen Qinke Meng Zhe Lv Zhilei Niu Jun Li Xi Chen

Background/Objectives: Osteoporosis remains a clinically important metabolic bone disorder with limited bone-forming therapeutic options. SET domain bifurcated protein 1 (SETDB1) is involved in osteogenic epigenetic regulation, but small-molecule discovery guided by SETDB1-associated structural regions remains limited. This study aimed to identify a candidate compound with in silico relevance to a SETDB1-associated ligand-bound pocket and assess its association with early osteogenic readouts. Methods: A computational–experimental workflow was used, including hierarchical molecular docking, MM-GBSA rescoring, ADMET-based prioritization, redocking validation, molecular dynamics simulations, and preliminary in vitro evaluation in MC3T3-E1 cells. Compound 271 (C271) was selected based on structure-based screening results and predicted developability-related properties. Cytocompatibility, alkaline phosphatase (ALP) activity and staining, selected molecular markers, and SETDB1–H3 molecular dynamics behavior were evaluated. Results: Redocking reproduced the reference binding mode, and molecular dynamics simulations indicated that C271 maintained a relatively persistent conformation around the predicted SETDB1-associated pocket. Comparative SETDB1–H3 simulations showed altered H3 dynamics and SETDB1–H3 contact patterns in the C271-containing system. In cell-based assays, C271 showed no appreciable cytotoxicity within the tested concentration range and was associated with increased ALP activity and staining. C271 treatment was accompanied by higher global H3K9me3 and Runx2 levels, whereas SETDB1 protein abundance remained largely unchanged. Conclusions: C271 was identified as a computationally prioritized SETDB1-related candidate compound associated with early osteogenic-associated cellular responses. The evidence supports computational plausibility and cell-level association, but does not establish direct SETDB1 engagement, SETDB1 enzymatic modulation, SETDB1-dependent causality, or late-stage osteogenic maturation/mineralization. Given the single-compound evaluation, further target-engagement, enzymatic, and functional studies are needed.

Future Pharmacology doi: 10.3390/futurepharmacol6020030

Authors: Desiree Virginia Fermin Olivares Tyler Halverson Kannayiram Alagiakrishnan

Pharmacomicrobiomics is the study of drug–microbiome interactions. It examines the dynamic relationship between the drug, the host, and the microbiome, and has become a rapidly evolving area in the realm of pharmacology and personalized medicine. Emerging evidence demonstrates that the gut microbiome can influence the pharmacodynamics and pharmacokinetics of drugs through various mechanisms, while drugs can simultaneously alter microbial composition. Treatment approaches include regular targeted pharmaceutical therapies (e.g., antibiotics, antidepressants) and alternative treatment approaches (e.g., CAM treatments such as supplements and herbs). Microbiome-based medication treatment is an alternative treatment approach that has been studied extensively in the last decade. This article reviews the current knowledge on drug–microbiome interactions across multiple therapeutic systems, including cardiovascular, central nervous system, gastrointestinal, respiratory, endocrine, oncologic, musculoskeletal, anti-infective therapies, and supplements (such as melatonin). We also highlight the various pathways by which microbes can alter the mechanisms (such as drug absorption), bioavailability, efficacy, and incidence of adverse effects, along with highlighting the clinical implications of drug-induced dysbiosis.

Future Pharmacology doi: 10.3390/futurepharmacol6020029

Authors: Marko Simic Aleksandar Kocovic Anica Petrovic Jovana Joksimovic Jovic Tijana Markovic Sandra Jovičić Milić Vladimir Jakovljevic Jovana Bradic

Background: This study investigates a novel alginate–gelatin hydrogel incorporating polyphenol-rich grape skin extract as a multifunctional therapeutic system for diabetic wound healing. The extract was obtained by ultrasound-assisted extraction and formulated into a biopolymer hydrogel designed to combine optimal moisture retention with the controlled release of bioactive compounds. Methods: A streptozotocin-induced diabetic rat model was used to evaluate wound contraction, collagen deposition, oxidative stress parameters, and systemic inflammatory markers over a 15-day period. Animals were assigned to four groups: untreated control, silver sulfadiazine (SSD), empty hydrogel (EH), and extract-loaded hydrogel (LH). Results: The LH formulation demonstrated superior wound closure, reaching 97.1% by day 15, significantly outperforming SSD and other groups. Hydroxyproline levels were markedly elevated in LH-treated tissues, indicating enhanced collagen synthesis and extracellular matrix formation. Redox analyses revealed substantial reductions in TBARS and significant increases in SOD, CAT, and GSH, confirming the strong antioxidative activity of the incorporated extract. Moreover, LH treatment produced pronounced decreases in IL-6 and TNF-α, restoring inflammatory balance and facilitating timely progression from the inflammatory to proliferative phase. Conclusions: These effects are attributed to the synergistic actions of grape skin polyphenols which exerted broad biochemical and structural benefits essential for diabetic wound repair. Overall, this sustainable, bioactive hydrogel represents a promising alternative for advanced wound care.

Future Pharmacology doi: 10.3390/futurepharmacol6020028

Authors: Natalia P. Denisenko Anastasia A. Anderzhanova Dmitriy A. Lysov Dmitriy I. Gordienko Yulia A. Meleshkina Mikhail I. Tsarev Maria V. Lukina Svetlana N. Tuchkova Ivan V. Sychev Anna S. Zhiryakova Sergey I. Markov Karin B. Mirzaev Dmitry A. Sychev

Background: Ketoprofen is one of the most commonly prescribed NSAIDs; however, its pharmacogenetics remains poorly understood. The objective was to evaluate the influence of patients’ pharmacogenetic profiles on the effectiveness of ketoprofen for postoperative pain management after total hip arthroplasty, including postoperative analgesia (pain levels, opioid consumption) and the incidence of adverse reactions during hospitalization and up to 12 months post-surgery. Methods: The study included 53 patients (31 (58.49%) women, median age 66.0 [60.0–74.0] years) undergoing total hip arthroplasty. Genotyping was performed using real-time PCR to analyze 18 single-nucleotide polymorphisms (SNPs) across the following genes: CYP2C9 (rs1799853, rs1057910), CYP2C8 (rs10509681, rs11572080), CYP3A4 (rs35599367), CYP3A5 (rs776746), UGT2B7 (rs73823859, rs7439366, rs7668282), ABCB1 (rs1045642, rs4148738, rs2032582, rs1128503), PTGS1 (rs10306135, rs12353214), PTGS2 (rs20417), C3orf20 (rs12496846), and ZNF493-ZNF429 (rs2562456). Results: We did not find significant associations between patients’ genotypes and pain levels or postoperative opioid analgesic consumption or adverse reactions when ketoprofen was used for pain management in patients undergoing total hip arthroplasty. Conclusions: Routine pharmacogenetic testing for ketoprofen is not supported by our findings.

Future Pharmacology doi: 10.3390/futurepharmacol6020027

Authors: Marina Gazdic Jankovic Dragica Pavlovic Zeljko Ivosevic Biljana Ljujic

Deposition of fibrous connective tissue within the extracellular matrix is initially an adaptive and reversible wound-healing process. However, persistent dysregulation of fibrotic signaling pathways induces irreversible cellular dysfunction, tissue degeneration and organ failure. Despite the high mortality rate associated with fibrotic diseases, there are very limited approved anti-fibrotic treatments and there is no therapeutic drug effective enough to completely invert the fibrotic process. Accordingly, new therapeutic agents that will attenuate ongoing fibrosis and, at the same time, promote regeneration of injured tissue are urgently needed. The search for new therapies has been revolutionized by recent advances in stem cell biology. Mesenchymal stem cells (MSCs) are promising candidates for the therapy of organ fibrosis because of their differentiation capabilities and immunomodulatory properties. The capacity of MSCs to suppress chronic inflammation and promote tissue repair and regeneration underlies their therapeutic effects in diseases such as liver cirrhosis, idiopathic pulmonary fibrosis, cardiac fibrosis, systemic sclerosis, and renal fibrosis. In this review, we summarize the present understanding of fibrotic disease, highlight promising research avenues, including MSC-based treatment options, and discuss the challenges involved with the clinical application of MSCs.

Future Pharmacology doi: 10.3390/futurepharmacol6020026

Authors: Farid Shagiakhmetov Inna Shamakina Viktor Kokhan Evgeny Krupitsky

Recent Phase 3 clinical trials of selective kappa-opioid (KOP) receptor antagonists aticaprant and navacaprant failed to demonstrate sufficient clinical efficacy in treatment-resistant depression (TRD). This highlights a critical gap in current strategies that target opioid-mediated hedonic suppression. We propose two hypotheses to explain these setbacks: (1) neutral antagonists are inherently ineffective in blocking constitutively active KOP receptor hyperactivation and (2) the nociceptin opioid (NOP) receptor provides functional redundancy that compensates for KOP receptor blockade. Gaining insights from paralogous compensation in drug-resistant tumors, we argue for shifting from selective opioid antagonists to dual KOP/NOP receptor blockers to meaningfully improve reward function. This concept provides a theoretical framework for overcoming clinical resistance where selective KOP targeting with neutral antagonists has failed. Thus, we advocate for the development of opioid inverse agonists (such as nor-BNI, CAS: 105618-26-6), pan-antagonists (such as AT-076, CAS: 1657028-64-2), and combinations of selective blockers.

Future Pharmacology doi: 10.3390/futurepharmacol6020025

Authors: Veselin Vasilev

Androgens regulate skeletal muscle, bone, erythropoiesis, and male reproductive function via the androgen receptor (AR), a ligand-dependent transcription factor. Pharmacologic modulation of AR has been pursued for clinical and non-medical purposes. Anabolic androgenic steroids (AAS), synthetic testosterone derivatives, act as full AR agonists, broadly activating multiple tissues. While effective in promoting muscle growth and strength, AAS cause well-known adverse effects, including hypothalamic–pituitary–gonadal (HPG) axis suppression, dyslipidemia, hepatotoxicity, cardiovascular disease, tendon injury, and neuropsychiatric disturbances. Selective androgen receptor modulators (SARMs) aim to stimulate AR in muscle and bone while minimizing androgenic effects in prostate and skin. They induce ligand-specific AR conformations, altering coactivator and corepressor recruitment, and avoiding metabolism by 5α-reductase or aromatase. Preclinical studies show favorable anabolic-to-androgenic ratios, but clinical translation is limited. Early human trials report modest lean mass gains, variable functional outcomes, and dose-dependent testosterone suppression. Emerging evidence also suggests cardiotoxicity, tendon injury, and liver toxicity, though long-term effects are unclear. Pharmacokinetically, SARMs have predictable oral absorption and moderate half-lives, enabling once-daily dosing, unlike AAS. This review compares AAS and SARMs in molecular mechanisms, pharmacokinetics, and safety. While SARMs offer partial tissue selectivity and reduced adverse effects, risks remain, and long-term safety is uncertain. Regulatory oversight is limited, and non-medical use is rising. Preclinical and clinical studies are needed to clarify whether SARMs can separate anabolic benefits from androgenic toxicity and inform safe clinical application.

Future Pharmacology doi: 10.3390/futurepharmacol6020024

Authors: Gerson Ney Hernández-Acevedo Angel Pulido-Capiz Brenda Chimal-Vega Victor García-González

Background: Endocrine therapy with tamoxifen remains a cornerstone in the treatment of estrogen receptor-positive (ER+) breast cancer; however, the emergence of resistance to its active metabolites, 4-hydroxytamoxifen (4-OHTAM) and Endoxifen, represents a major clinical limitation. Increasing evidence suggests that drug efflux transporters, redox-adaptive signaling, and translational control mechanisms may converge to promote chemoresistance. This study aimed to investigate the coordinated expression patterns of ABCC transporters, the eukaryotic initiation factor 4F (eIF4F) complex, and NRF2 signaling in tamoxifen-metabolite-resistant MCF-7 breast cancer cells. Methods: MCF-7 cell variants resistant to 4-OHTAM (Variant B) or Endoxifen (Variant C) were established through prolonged drug exposure. Cytotoxicity assays assessed cellular viability and chemoresistance. Protein expression and molecular interactions were analyzed using Western blotting and co-immunoprecipitation. Flow cytometry was employed to evaluate transporter-associated fluorescence intensity. In silico molecular docking was performed to estimate the binding affinity of tamoxifen metabolites to ABCC transporters. Results: Endoxifen-resistant cells exhibited the most pronounced chemoresistant phenotype. Analysis of ABCC transporters revealed modest but consistent increases in fluorescence intensity across resistant variants; however, these differences did not reach statistical significance. Dysregulation of the eIF4F complex was observed, with increased eIF4E and reduced eIF4A levels, suggesting altered translational control associated with resistant phenotypes. Increased NRF2 protein expression was detected in resistant variants, consistent with enhanced redox-adaptive capacity. Analysis of ABCC transporters revealed modest but consistent increases in fluorescence intensity across resistant variants; however, these differences did not reach statistical significance. Molecular docking demonstrated strong binding affinity between Endoxifen and ABCC2, supporting a potential role for transporter-mediated efflux. Conclusions: Tamoxifen-metabolite resistance in ER+ breast cancer is associated with coordinated trends in ABCC transporter-associated signals, altered eIF4F complex expression, and sustained NRF2 signaling. These findings suggest the presence of a multifactorial adaptive network that may contribute to endocrine resistance. Targeting components of this network warrants further mechanistic investigation.

Future Pharmacology doi: 10.3390/futurepharmacol6020023

Authors: Abdurahman A. Niazy

Treatment for large critical-sized bone defects and impaired fracture healing remain challenging. Clinically used protein-based osteoinductive factors, such as recombinant bone morphogenetic proteins (BMPs), can be effective; however, they are costly and limited by stability, dose-delivery issues, and safety concerns. Preclinical small molecules offer an alternative because they are chemically stable, scalable to manufacture, and readily integrated for systemic administration or localized release from scaffolds, hydrogels, cements, and implant coatings. With an emphasis on delivery formats and mechanistic themes, this review examines small molecules that have been shown to improve bone regeneration in preclinical models, contrasting those of biological origin with synthetic and repurposed compounds. Across studies, these selected compounds promote osteoblast commitment, differentiation, and matrix mineralization via BMP/Smad signaling and Wnt/beta-catenin (β-catenin) activation, often through glycogen synthase kinase-3 beta (GSK-3β) inhibition or relief of pathway antagonism or Hedgehog (Hh) pathway stimulation. Beyond osteoinduction, several candidates address issues that commonly limit repair, including angiogenesis, oxidative stress, inflammatory tone, osteoimmune regulation, and suppression of osteoclast-mediated resorption. Direct head-to-head comparisons are rare across both classes and reporting heterogeneity complicates interpretation. Key translational gaps include limited cytotoxicity and immunologic profiling, dose and release optimization, durability of benefit, and insufficient evaluation of rational combinations. More rigorous in vivo studies, including larger animal models and standardized outcome metrics, are needed to prioritize promising candidates and guide clinical development.

Future Pharmacology doi: 10.3390/futurepharmacol6020022

Authors: Victor Cardoso Jacinto da Silva Janaina Pereira Dina Toreli Edimar Cristiano Pereira Araceli Aparecida Hastreiter Beatriz Alves Thais Gascon Glaucia Raquel Luciano da Veiga Samantha Sanchez de Carvalho Fernando Luiz Affonso Fonseca

Introduction: Hereditary hemochromatosis is a genetic disorder characterized by dysregulation of iron homeostasis, resulting in excessive intestinal iron absorption and progressive iron deposition in vital organs. The hepcidin–ferroportin axis plays a central role in the pathophysiology of the disease, particularly in cases associated with mutations in the HFE gene. Persistent iron overload may lead to progressive injury in target organs and functional impairment. Methods: A brief description of the pathological basis of hereditary hemochromatosis was conducted together with a systematic review of interventional clinical trials registered on ClinicalTrials.gov. Studies with available results were included regardless of clinical phase or recruitment status. Relevant data regarding therapeutic interventions and iron metabolism parameters were extracted and descriptively analyzed. Results: Three studies met the inclusion criteria: one evaluating the hepcidin mimetic Rusfertide (PTG-300), another assessing synthetic hepcidin LJPC-401, and a third investigating the iron chelator Deferasirox. Discussion: These therapies demonstrated biological activity in modulating iron metabolism parameters; however, none proved superior to therapeutic phlebotomy, which remains the standard treatment, in terms of efficacy. Conclusions: Although emerging pharmacological therapies targeting iron metabolism show promising biological effects, current clinical evidence remains limited. Therapeutic phlebotomy continues to represent the first-line treatment for hereditary hemochromatosis, and further clinical trials are necessary to determine the potential role of these novel therapeutic approaches.

Future Pharmacology doi: 10.3390/futurepharmacol6020021

Authors: Genuína Stephanie Guimarães Carvalho Luiziana Cavalcante Costa Fernandes Crisóstomo Alice Vitoria Frota Reis Alex Bruno Matos de França Josimar O. Eloy Raquel Petrilli

Wounds, particularly chronic wounds, represent an increasing challenge for global health systems, affecting millions of people worldwide, and are often associated with persistent infections, biofilms, and multidrug-resistant microorganisms (MDRMs). In this context, the search for effective therapeutic alternatives has driven interest in photodynamic therapy (PDT), an approach in which light-excited photosensitizers promote the generation of reactive oxygen species (ROS) with antimicrobial and wound healing properties. Although first- and second-generation organic photosensitizers are widely used, they have significant limitations, including low aqueous solubility, self-aggregation, reduced photostability, and unsatisfactory ROS quantum yields. To overcome these drawbacks, various nanotechnology-based strategies have been explored. Among them, metallic nanoparticles stand out because they serve as carriers and exhibit intrinsic photosensitizing activity, high resistance to photobleaching, and remarkable extinction coefficients, which favor efficient singlet oxygen generation. Furthermore, metals such as gold and silver can enhance the performance of organic photosensitizers through a process known as metal-enhanced singlet oxygen generation, whereas others, such as copper, zinc, manganese, and magnesium, actively participate in biochemical events associated with the inflammatory and regenerative phases of wound healing. Considering these advances, this review compiles evidence published over the past five years regarding the use of metallic or metal-containing nanoparticles in PDT for acute and chronic wounds, with an emphasis on in vivo studies. In addition, we discuss the epidemiological and pathophysiological aspects of wounds and the intrinsic wound healing and antimicrobial properties of metallic compounds, thereby providing an integrated and up-to-date perspective.

Future Pharmacology doi: 10.3390/futurepharmacol6020020

Authors: Gérard Vergoten Christian Bailly

Background/Objectives. The actin-binding protein EPLIN (epithelial protein lost in neoplasm), also known as LIMA1, contributes to the maintenance of cytoskeleton structure and dynamic. This protein, which interacts with multiple partners to regulate cell adhesion and migration, has been implicated in the progression of solid tumors and in tumor metastasis. Consequently, small molecules binding to EPLIN are actively searched. EPLIN has been characterized as a molecular target for the antitumor antibiotic albacarcin V which affects the cytoskeletal structure and induces cell growth arrest. Methods. We have modeled the binding of albacarcin and naturally occurring derivatives to EPLIN conformers, in order to locate the drug-binding site and to identify additional EPLIN binders. Nineteen compounds were studied, including albacarcins V (vinyl) and M (methyl), five gilvocarcins, four ravidomycins, two chrysomycins, and six related products (including polycarcin and fucomycin). Results. The modeling analysis confirmed the capacity of albacarcin V to bind to EPLIN and identified a few better binders. In particular, ravidomycin V bearing a dimethylamino sugar unit were identified as the best binders in the series, along with the two related anticancer natural products FE35A-B. Structure-binding relationships are discussed. The drug-binding site has been localized near the central residue Asn34 in the conformationally constrained domain between the two zinc-binding regions. Conclusions. This study provides guidance to the design of EPLIN inhibitors based on the ravidomycin core structure.

Future Pharmacology doi: 10.3390/futurepharmacol6020019

Authors: Sofia Perez Lopes da Silveira Bruna Barros Aguiar Andressa Goldman Ruwel Patrícia Furtado Martins Douglas G. Lewis Helena Moura Maurício Timm Peglow Lisia Von Diemen Alexei Gil Félix Henrique Paim Kessler

Background: Addictive disorders are highly heterogeneous and frequently comorbid, limiting the clinical utility of categorical diagnoses. Transdiagnostic pharmacology seeks to address these limitations by targeting symptom dimensions and shared neurobiological processes across addictions. Methods: We conducted a theory-driven narrative review of studies indexed in MEDLINE, PubMed, LILACS, and Web of Science (October–November 2025), integrating clinical, mechanistic, and dimensional evidence. Findings were organized using the Dysregulation Phenomena of the Three Main Modes of the Predostatic Mind and the Advanced Cognitive Emotional Regulation Therapy (DREXI3/ACERT) framework, which conceptualizes addiction as dysregulation across three interacting systems—Alarm, Seeking, and Balance—and six transdiagnostic symptom dimensions, with a proposed expansion into twenty clinically observable domains (TDPM-20). Results: Pharmacological interventions consistently target neurobiological systems related to stress, reward, impulsivity, and compulsivity. Across studies, the most clinically relevant outcomes remain abstinence, reduction in substance use, and treatment retention. While these outcomes are essential, expanding outcome frameworks to incorporate dimensional and mechanistically informed measures may enhance the identification of clinically meaningful subgroups. Across studies, multiple pharmacological classes show transdiagnostic potential, but their clinical application remains variably aligned with dimensional clinical profiles. Conclusions: A dimensionally oriented approach grounded in neurobiological principles may improve alignment between clinical processes and therapeutic strategies. The DREXI3/ACERT model provides a structured framework for individualized treatment planning and research integration. This approach should be understood as complementary to, rather than a replacement for, established evidence-based treatments for specific substance use disorders, particularly in contexts where therapeutic options remain limited or insufficient. Advancing transdiagnostic pharmacology will require broader dimensional stratification, expanded outcome frameworks capable of capturing patient heterogeneity, and integrative trial designs to strengthen precision psychiatry in addictive disorders.

Future Pharmacology doi: 10.3390/futurepharmacol6020018

Authors: Subham Kumar Vishwakarma Cesar Augusto Roque-Borda Oswaldo Julio Ramirez Delgado Aditya Mishra Zidane Qriouet Achal Mishra Andréia Bagliotti Meneguin Fernando Rogério Pavan

Structure-based strategies are widely used in tuberculosis drug discovery; however, their translational impact remains limited. This review examines how structure-based virtual screening (SBVS) is applied in practice to Mycobacterium tuberculosis targets and explores why docking-derived predictions frequently fail to translate into measurable biological activity. Rather than treating docking scores as quantitative predictors of potency, representative case studies are analyzed to demonstrate that SBVS is most effective when employed as a prioritization framework integrated with appropriate target preparation, physicochemical filtering, and early experimental validation. Across diverse targets, molecular dynamics simulations emerge as a critical discriminator, enabling the identification of binding instability and false-positive hits that persist after static docking. Tuberculosis-specific constraints—including cofactor-dependent catalysis, resistance-associated mutations, membrane-rich environments, and permeability barriers—are discussed as key factors decoupling in silico affinity from whole-cell efficacy. Collectively, these observations support a workflow-oriented view of computational drug discovery in tuberculosis, in which iterative integration of structural modeling and experimental validation is required for meaningful lead identification.

Future Pharmacology doi: 10.3390/futurepharmacol6020017

Authors: Aliki Papadimitriou-Tsantarliotou Chrysostomos Avgeros Ioannis S. Vizirianakis

Background/Objectives: Ferroptosis, an iron-dependent form of regulated cell death defined by lipid peroxidation, has been extensively studied in cancer and neurodegeneration, but its contribution to erythropoiesis remains poorly understood. Methods: In this study, we investigated the expression of ferroptosis-related genes during HMBA-induced differentiation of murine erythroleukemia (MEL) cells and further assessed the effects of the ferroptosis inducer erastin in this model system. Results: HMBA treatment was accompanied by upregulation of ferroptosis-inducing genes (Atf3, Por, Tfrc, Slc11a2) and downregulation of inhibitory genes (Dhfr, Aifm2, Flvcr1, Nfe2l2, Slc3a2, Slc7a11), while Gpx4 levels increased. Erastin exposure identified 5 μM as the optimal concentration, which resulted in a significant reduction of Steap3 transcripts, an increase in Hbb expression, and an increased accumulation of differentiated cells in culture, along with mild cytotoxicity. To be noted that at the protein level, erastin induced a ~10% decrease in STEAP3 and a 1.5-fold increase in β-globin homo- or hetero-dimers. Ferroptosis markers confirmed erastin activity, with Fsp1 to be downregulated and Slc7a11, ferroportin, and the transferrin receptor upregulated. Importantly, erastin also enhanced apoptotic responses, as indicated by increased levels of active caspase-3 (~40%) and reduced cellular proliferation rate (Ki-67, ~35%), suggesting overlap between ferroptotic and apoptotic pathways. Conclusions: Collectively, these findings indicate that erastin modulates erythroid maturation by repressing Steap3 (Six-transmembrane epithelial antigen of prostate 3) and enhancing Hbb expression, yet its differentiation inducing potential is counterbalanced by concurrent apoptosis activation. Overall, our results support a role of ferroptosis in erythroid maturation by linking iron metabolism, regulated cell death, and erythropoiesis, a fact of pharmacological and therapeutic relevance too.

Future Pharmacology doi: 10.3390/futurepharmacol6010016

Authors: Viena M. Cuevas-Mancilla Pedro A. López Higinio López-Sánchez Ada M. Ríos-Cortés Abel Gil-Muñoz Rosa M. Montiel-Ruiz Manasés González-Cortazar

Background: Bacopa procumbens is a plant species with medicinal properties. Although several of these properties have already been validated, its use for treating pain remains untested. Objective: the objective was therefore to test the antinociceptive effect of two extracts (n-hexane and hydroalcoholic) and two fractions (aqueous and organic) from the most active extract, as well as to determine the chemical profile of Bacopa procumbens. Methods: analgesic activity was determined by antinociceptive activity using the formalin model in mice. Compounds were identified by high-performance liquid chromatography and gas chromatography coupled with mass spectrometry. Compared to the vehicle treatment (3% Tween 20), licking time was 22.8 s and 141.6 s lower when treated with the hexane extract (200 mg/kg); 43.4 s and 152.5 s with the hydroalcoholic extract (200 mg/kg); 27.2 s and 169 s with the organic fraction; and 5.4 s and 32 s difference with the positive control, in phases 1 and 2, respectively. Phytochemical analysis of the hexane extract allowed us to identify 2-pentadecanone, 6,10,14-trimetil- (11.70%), 6,10,14-trimethyl-, dibutyl phthalate (34.71%), and hexane-dioic acid bis(2-ethylhexyl) ester (45.15%). Conclusions: We identified arbutin (1), 5-(p-hydroxybenzoyl) shikimic acid (2), and procumgastrodin A (3) in the BpFo fraction. In conclusion, we demonstrated that the BpH extract and the BpFo fraction have anti-nociceptive properties that may be associated with compounds 2 and 3.

Future Pharmacology doi: 10.3390/futurepharmacol6010015

Authors: Andrej Vuckovski Darinka Gjorgieva Ackova

Background/Objectives: 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a highly toxic environmental contaminant whose adverse biological effects are primarily mediated through activation of the aryl hydrocarbon receptor (AhR). Upon ligand binding, AhR undergoes conformational changes that initiate nuclear translocation and transcriptional activation of xenobiotic-responsive genes, contributing to toxicity, carcinogenesis, and dysregulated immune and metabolic responses. Understanding the molecular basis of AhR activation by TCDD is therefore critical for the rational development of targeted therapeutic strategies. Methods: In this study, molecular docking simulations were employed to characterize the interaction of TCDD and selected AhR antagonists (CH223191, BAY 2416964, GNF-351) with the ligand-binding domain of AhR, with particular emphasis on the canonical PAS-B domain. Results: Docking analyses identified the PAS-B cavity (pocket C1) as the most biologically relevant binding site for high-affinity ligands, consistent with experimental evidence. Comparative docking of known AhR antagonists revealed stable binding poses characterized by hydrophobic packing, π–π interactions, and hydrogen-bonding networks that competitively block agonist access and prevent receptor activation. These findings support a competitive antagonism mechanism as a viable approach to counteract TCDD-induced AhR signaling. Conclusions: Collectively, this in silico study provides mechanistic insight into TCDD toxicity at the molecular level and highlights AhR antagonism as a promising strategy for the development of targeted therapies against dioxin-related pathologies.

Future Pharmacology doi: 10.3390/futurepharmacol6010014

Authors: Gerardo Ramírez-Rico Lucero Ruiz Mazón Magda Reyes-López Jesús Serrano Lúna Christian Avalos Gómez Rosa Isabel Higuera Piedrahita Cristal Dafne Lonngi Sosa Mireya de la Garza Cynthia González Ruíz

Antimicrobial resistance is a significant problem that has been studied in recent years. Viral diseases have generated high levels of morbidity and mortality, and recently, the world population faced a highly contagious viral disease (SARS-CoV-2), which caused millions of deaths without an effective drug capable of controlling the infectious process. As a result, various therapeutic alternatives to antimicrobials have emerged that target microorganisms, support the immune system, and reduce inflammation. Lactoferrin is a ultifunctional glycoprotein of the mammalian innate immune system that has shown various benefits, notably its antimicrobial and, primarily, its antiviral effects. No resistance or toxicity to this protein has been reported, which is why it is called a “miracle protein”. This is the first review to focus on the antiviral effects of lactoferrin in clinical trials. In addition, in vitro and in vivo studies evaluating lactoferrin against various viral etiologies are also discussed.

Future Pharmacology doi: 10.3390/futurepharmacol6010013

Authors: Michael A. Whitney Jessica L. Crisp

Background/Objectives: The identification of peripheral nerves is critical for their preservation during surgery, as accidental transection or injury can lead to significant patient morbidity. Current methods for identifying nerves typically rely on qualitative white-light visualization of anatomy, texture, and color. To improve nerve identification during surgical procedures, we developed a novel nerve imaging agent, “bevonescein,” a derivative of the peptide–dye conjugate FAM-HNP401. Methods: Variants of FAM-HNP401 were designed to be synthesized completely on solid phase to enable the efficient generation of GMP (Good Manufacturing Practice)-qualified bevonescein. We determined the nerve binding affinity for each variant, CPC-17, CPC-18, CPC-19 (bevonescein), and CPC-20, using mean fluorescent intensity measurements after binding the agents to human sural nerve sections. Results: Bevonescein (CPC-19) demonstrated significantly superior nerve binding compared to other variants and controls. Bevonescein-labeled nerves exhibited a mean fluorescent intensity of 562 ± 34.7, compared to 252 ± 41.7 for CPC-17, 344 ± 34.7 for CPC-18, and 270 ± 41.7 for CPC-20. The dye-alone control, 5-carboxyfluorescein, showed a fluorescent intensity of 168 ± 41.4. Conclusions: Bevonescein represents a first-in-class molecule that can improve the visualization of peripheral nerves during surgery, potentially reducing nerve injury and associated morbidity. It has been successfully tested in a Phase 1/2 clinical trial demonstrating safety and efficacy at a 500 mg dose and is currently in Phase 3 clinical testing.

Future Pharmacology doi: 10.3390/futurepharmacol6010012

Authors: Kartik Mittal Neha Rathi Devika Tripathi Paruvathanahalli Siddalingam Rajinikanth Prashant Pandey

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumours, driven by late diagnosis, early metastatic dissemination, and profound resistance to systemic therapies. Increasing evidence indicates that these hallmarks are not solely tumour cell intrinsic but are critically orchestrated by a complex and highly dynamic tumour microenvironment (TME) composed of pancreatic stellate cells (PSCs), cancer-associated fibroblast (CAF) subtypes, immune cells, endothelial and neuronal elements, and a dense extracellular matrix (ECM). This review provides an integrated overview of the cellular and acellular components of the PDAC TME and delineates how their reciprocal crosstalk drives desmoplasia, immune suppression, metabolic reprogramming, epithelial–mesenchymal transition (EMT), pre-metastatic niche formation, and metastatic outgrowth. Particular emphasis is placed on the context-dependent roles of stromal and immune niches in modulating drug delivery, chemoresistance, and failure of immunotherapy, highlighting why indiscriminate stromal depletion has yielded paradoxical outcomes. Building on these mechanistic insights, the review critically examines emerging therapeutic strategies targeting PSCs, CAF subsets, ECM components, myeloid and lymphoid populations, and key signalling pathways, including approaches that normalize stroma, reprogram immunity, or exploit nanocarrier-based delivery systems. Finally, a structured framework is proposed for rational TME-targeted combination regimens that integrate cytotoxic, targeted, and immunotherapeutic agents to overcome current therapeutic barriers in PDAC.

Future Pharmacology doi: 10.3390/futurepharmacol6010011

Authors: Robert B. Raffa Eugene Vortsman Joseph V. Pergolizzi Krista Casazza Morgan King

The overdose mortality landscape has shifted from predominantly opioid exposures to a polysubstance epidemic increasingly driven by illicit fentanyl and fentanyl analogs combined with other centrally active agents. Among the co-intoxicants, veterinary α2-adrenoceptor (α2AR) agonists such as xylazine have emerged as clinically confounding adulterants. Recent reports from forensic toxicology, medical examiners, and border/interdiction agencies indicate that medetomidine, a veterinary sedative racemate with the highly selective α2AR agonist enantiomer dexmedetomidine, is increasingly being detected together with fentanyl and its analogs in seized materials and postmortem assays. Prior reviews have covered these aspects. The current review synthesizes current evidence and clinical experience relevant to fentanyl + medetomidine co-exposure-induced respiratory depression—a primary cause of death. We focus on convergent µ-opioid receptor (MOR) and α2AR signaling within key physiological substrates, including respiratory rhythm-generating networks, ascending arousal pathways, chemosensory reflex control of ventilation, and autonomic cardiovascular regulation, integrating mechanistic pharmacology, respiratory and cardiovascular toxicology, emergency-room treatment, and emerging public-health implications. Available evidence supports a model in which combined MOR and α2AR activation produces additive-to-synergistic suppression of ventilation and consciousness, attenuation of hypoxic ventilatory drive and CO2 responsiveness, with marked sympatholysis manifested as bradycardia and hypotension, all of which can persist beyond presumptive opioid reversal with a MOR antagonist. We discuss the implications for prehospital and emergency care. In sum, the increasing detection of medetomidine in the illicit fentanyl supply represents an emerging and potentially high-risk co-exposure pattern that may be only partially naloxone-responsive. Lastly, we highlight potential future pharmacologic countermeasures for polysubstance overdose, such as the BK-channel antagonist ENA-001, which may address naloxone-insensitive ventilatory suppression in opioid-dominant polysubstance overdose.

Future Pharmacology doi: 10.3390/futurepharmacol6010010

Authors: Petar Z. Taslaković Miloš N. Milosavljević Vladimir Janjić Srđan Stefanović

Background/Objectives: This study aimed to investigate whether therapy with perampanel is associated with the development of psychosis or psychosis-like symptoms in patients with epilepsy. Methods: We conducted systematic electronic searches in PubMed, Google Scholar, ScienceDirect, and Scindex databases. We included articles published as case reports/case series, as well as conference abstracts and letters from the editor, if they contained enough data for analysis and quality assessment. The main inclusion criteria relate to patients who experienced psychosis or psychosis-like symptoms described by the authors during perampanel therapy or during its recent use. Results: Publications (n = 17) describing a total of 33 patients who met the inclusion criteria were included. Patient ages ranged from 11 to 70 years, and the majority of them were female (66.67%). A confirmed personal psychiatric history was identified in 60.61% of patients. The time interval between the initiation of perampanel and the onset of adverse events varied significantly across cases. The most frequently reported symptom was aggression (75.75%), followed by irritability (30.30%), while delusions or hallucinations were observed in 8 patients (24.24%). Conclusions: Clinicians should be aware that psychosis or psychosis-like symptoms may represent dose-dependent adverse effects of perampanel with a satisfactory prognosis. Identified risk factors for these developments were positive personal psychiatric history, antiseizure polytherapy at high doses, women’s gender, and focal epilepsies with secondary generalization, mainly manifested as tonic–clonic seizures. Early recognition of symptoms, followed by drug discontinuation, dose reduction, symptomatic treatment, or a combination of the mentioned strategies, is crucial for achieving better outcomes.

Future Pharmacology doi: 10.3390/futurepharmacol6010009

Authors: Letícia Targino Campos Diego Romário-Silva Priscilla Vasconcelos Joanilda Paolla Raimundo e Silva Vinícius Rocha Lima Santos Larissa Almeida Sarmento Eutália Maria Veloso Antonino Joana de Freitas Santos Jozinete Pereira Pedro Luiz Rosalén Edja Costa

Background/Objectives: Galleria mellonella (G. mellonella) larvae have emerged as a valuable in vivo model for antifungal drug screening. This study aimed to determine the optimal inoculum concentrations of Candida albicans (C. albicans) in G. mellonella, as well as the appropriate fluconazole concentrations, in order to standardize a preliminary screening method for compounds with antifungal activity. Methods: Larvae were infected with four C. albicans strains, including two reference strains (ATCC® 10231 and ATCC® 90028) and two oral isolates (A1 and A2). Fluconazole toxicity was evaluated at doses of 20, 40, and 80 mg/kg over a 72 h period. In the treatment assays, larvae were infected via the left pro-leg and treated with fluconazole, administered as a single or two doses, one hour after infection. Larval viability was monitored over five days based on movement, cocoon formation, and melanization, and survival data were analyzed using Kaplan–Meier curves and the log-rank test. Results: Fluconazole showed no toxicity at the tested concentrations. Infection with up to 2 × 107 cells/mL was non-lethal for most strains, except for A2, which exhibited 50% mortality within 48 h but it was effectively controlled with a single 20 mg/kg dose of fluconazole. Infection with 2 × 108 cells/mL resulted in complete mortality within 48 h; however, a single 80 mg/kg dose significantly improved survival. Conclusions: The G. mellonella model proved to be a suitable and reproducible in vivo system for the preliminary screening of antifungal compounds. The standardized experimental conditions established in this study support its applicability for evaluating antifungal activity in early research stages. Future studies should expand this approach to different fungal species and antifungal agents, as well as explore its applicability in combination therapies.

Future Pharmacology doi: 10.3390/futurepharmacol6010008

Authors: Soung Hee Moon Young Eun Huh Hyun Jin Choi

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra (SN). Because current therapeutics have limited efficacy once PD is fully developed, it is crucial to start disease-modifying interventions during the prodromal stage of PD. In the present study, we aimed to evaluate whether intranasally delivered human umbilical cord mesenchymal stem cells (hUC-MSCs) have an efficacy in the rotenone-induced prodromal PD-like phenotype mouse model. Methods: To produce the prodromal PD mouse model, C57BL/6 mice were treated with intraperitoneal (i.p.) rotenone for 1 or 2 weeks. hUC-MSCs or PBS were delivered intranasally for 1 or 2 weeks with rotenone injection. We subsequently performed behavioral assessments to evaluate motor and non-motor features, followed by pathological analyses of the mouse brains. Results: Intranasal administration of hUC-MSCs restored motor performance and protected dopaminergic neurons in the SN of mice treated with rotenone for 2 weeks. In the 1-week rotenone mice, hUC-MSCs treatment ameliorated depressive-like behaviors and attenuated olfactory dysfunction. Furthermore, intranasal hUC-MSC treatment suppressed the accumulation of protein aggregates in the brains of mice, which is associated with enhanced autophagic function, as indicated by increased LC3B and normalization of LAMP2A protein expression. Conclusions: Our data demonstrate that intranasal administration of hUC-MSCs improves non-motor symptoms at early time points and attenuates progression to nigrostriatal loss and motor deficits in the rotenone-induced PD mouse model. These findings support the potential of a non-invasive, prodromal-stage intervention to modulate early pathological progression in PD.

Future Pharmacology doi: 10.3390/futurepharmacol6010007

Authors: Shizuo Yamada Masaki Mogi Satomi Kagota Kazumasa Shinozuka

Older adults with multiple diseases are likely to be prescribed multiple medications including anticholinergic agents, which are frequently prescribed to manage conditions such as overactive bladder and chronic obstructive pulmonary disease and Parkinson’s disease. Overactive bladder (OAB) has been the subject of increased disease awareness and is a common and significant cause of reduced quality of life, particularly in the elderly. The selective β3 adrenoceptor agonist, mirabegron was developed for the pharmacological treatment of OAB. Mirabegron has been shown to exert off-target effects on various functional proteins such as muscarinic receptors in rat tissues. This agent may relax the detrusor muscle by activating β3 adrenoceptors and also antagonizing muscarinic receptors. Mirabegron and antimuscarinics exerted additive effects on muscarinic receptor binding and relaxant responses of cholinergic contractions of the detrusor muscle. Mirabegron excreted in human urine appears to directly attenuate muscarinic receptor-mediated functions in the bladder. Combination therapy of mirabegron and solifenacin in patients with OAB may enhance not only their therapeutic effects on OAB, but also increase the risk of anticholinergic adverse effects. Therefore, the safety of concomitant use of mirabegron and other drugs such as antimuscarinics for elderly patients needs to be carefully considered.

Future Pharmacology doi: 10.3390/futurepharmacol6010006

Authors: Paraskevi Zagana Alexandra Paxinou

Since their discovery in the 1960s, liposomes have become a versatile platform for drug delivery in cancer research, capable of carrying both hydrophilic and hydrophobic drugs. Throughout the past decades, liposomes have evolved to improve stability, blood circulation time, and targeting ability, overcoming many disadvantages of early formulations. Lipid–polymer hybrid liposomes (LPHLs), a third-generation nanoparticle model, are vesicles where polymers are incorporated in or around the lipid bilayer to increase their stability, to control drug release, and to provide multifunctional capabilities. More recently, cell membrane-coated (CMC) liposomes, which consist of “core” liposomes (preformed liposomes) cloaked in natural cell membranes, have emerged as an even more innovative approach, offering superior immune evasion and highly selective targeting, which are both particularly promising for cancer therapy. Preclinical studies in cancer models demonstrate that these advanced liposomal systems improve pharmacokinetics and therapeutic outcomes. They hold significant potential for developing next-generation, personalized nanomedicines for cancer and other complex diseases. However, challenges related to large-scale production, long-term stability, and safety evaluation remain.

Future Pharmacology doi: 10.3390/futurepharmacol6010005

Authors: Ana Cabetas Antonio del Bosque María Sainz-Gil Zoraida Verde

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental condition, and pharmacogenetic studies aim to clarify interindividual variability in treatment responses and adverse effects. Despite increasing research, the field remains fragmented. This review provides a bibliometric analysis of ADHD pharmacogenetics (2005–2025), identifying its intellectual foundations, thematic structure, and global distribution. Methods: A bibliometric search was conducted in Scopus and Web of Science, retrieving 711 documents published between 2005 and July 2025. Data were analyzed with the Bibliometrix R package and Biblioshiny interface, applying bibliometric mapping, Bradford’s Law, co-word analysis, and thematic mapping. Only peer-reviewed journal articles, books, and book chapters were included to ensure scientific rigor. Results: The dataset shows a modest annual growth rate but strong impact, with an average of 29.6 citations per article. Highly cited works converge into four domains: (i) clinical guidelines and pharmacological treatments; (ii) cognitive heterogeneity and subtypes; (iii) neurodevelopmental and genetic mechanisms; (iv) environmental and health-related influences. Geographically, the United States leads with 24.8% of publications, followed by Brazil, China, and European countries. Keyword analysis reveals two main clusters: a clinical–therapeutic pole (methylphenidate, atomoxetine, child) and a genetic–molecular pole (dopamine transporter, SNPs, genotype). Conclusions: ADHD pharmacogenetics shows consolidation with strong clinical and genetic cores but limited integration of comorbidity, adult populations, and non-stimulant treatments. Future research should prioritize multi-center cohorts, multi-omic designs, and stronger international collaboration to advance precision medicine in ADHD.

Future Pharmacology doi: 10.3390/futurepharmacol6010004

Authors: Regina Yasuko Makimori Eliana Harue Endo Julia Watanabe Makimori Priscila Firmino Ribas Fernanda Vitória Leimann Odinei Hess Gonçalves Zilda Cristiani Gazim Tânia Ueda-Nakamura Celso Vataru Nakamura Benedito Prado Dias Filho

Background: Staphylococcus aureus is a clinically relevant pathogen with a strong ability to form biofilms on a wide range of surfaces, which markedly reduces the effectiveness of antimicrobial treatments and contributes to therapeutic failure. Although essential oils (EOs) represent effective and economical antimicrobial alternatives, their clinical application is limited by rapid oxidation, volatility, and potential cytotoxicity. In this context, nanoencapsulation emerges as a promising strategy to improve EO stability, control release, and reduce toxicity. In this study, Tetradenia riparia essential oil was encapsulated into poly(lactide) (PLA) nanoparticles (NP) using the nanoprecipitation method. Methods: The physicochemical properties of the nanoparticles were characterized, and their antibacterial, antibiofilm, and cytotoxic activities were evaluated. Antibiofilm and antibacterial effects against S. aureus were assessed by the broth microdilution method, while cytotoxicity was determined using a VERO cell line. Results: The nanoparticles exhibited nanometric size, spherical morphology, and homogeneous structure. Both free EO and EO-loaded nanoparticles demonstrated antibacterial and antibiofilm activity against S. aureus. Importantly, EO-loaded nanoparticles were significantly less cytotoxic than free EO. Nanoencapsulation effectively prevented rapid EO evaporation and degradation, thereby enhancing stability. The nanoparticles exhibited a zeta potential of approximately −23.1 mV, indicating adequate colloidal stability. Differential scanning calorimetry revealed a reduction in melting enthalpy from 429.63 J/g (blank nanoparticles) to 115.83 J/g for EO-loaded nanoparticles, indicating decreased polymer crystallinity and a system favorable for controlled EO release. Conclusions: Overall, these findings demonstrate that nanoencapsulation of T. riparia essential oil into PLA nanoparticles preserves antimicrobial efficacy, reduces cytotoxicity, and improves physicochemical stability, supporting the potential of this nanostructured system as a promising strategy for the treatment of S. aureus biofilm-associated infections.

Future Pharmacology doi: 10.3390/futurepharmacol6010003

Authors: Özlem Erol Polat Ferhunde Aysin Nihal Şimşek Özek Fikret Çelebi

Background: Neuroblastoma is the most common extracranial solid malignancy in infants and children. High-risk neuroblastoma patients are commonly treated with temozolomide (TMZ), which typically exhibits a poor therapeutic response. Serotonin, also known as 5-hydroxytryptamine (5-HT), plays various essential functions in the human body. In the central nervous system, it serves as a neurotransmitter. Beyond its physiological roles, 5-HT has recently been identified as a potential growth factor for several human tumors, including gliomas and carcinoid tumors. Recent literature has demonstrated that 5-HT receptor antagonists can inhibit the growth of cancer cells. Furthermore, both 5-HT receptors and their antagonists have been identified as potential anticancer agents, suggesting their significance in the development of new treatment strategies. Objectives: The primary aim of this study was to examine the effects of 5-HT and 5-HT antagonists on tumor (neuroblastoma (SH-SY5Y)) and healthy cells (microglia (HMC3)) and determine the impact of their interaction with the anticancer agent TMZ on cell proliferation/viability and migration. Methods: The study explored the interaction between 5-HT, the 5-HT antagonist granisetron (GRN), the anticancer agent TMZ, and their combinations, specifically assessing their influence on cell proliferation, viability, and migration. Results: As a result, the single and combined applications of 5-HT, TMZ, and GRN, a 5-HT antagonist, inhibited cell growth and proliferation in SH-SY5Y, causing decreased cell viability. Additionally, the combination of 5-HT and GRN increased the efficacy of TMZ. Conclusions: The study findings revealed that 5-HT and 5-HT antagonists may have therapeutic effects by exhibiting antiproliferative effects in SH-SY5Y cells at high concentrations.

Future Pharmacology doi: 10.3390/futurepharmacol6010002

Authors: Anđela Gogić Miloš Nikolić Nikola Nedeljković Nebojša Zdravković Marina Vesović Ana Živanović

The treatment of diabetes in the modern era, with its growing patient population, represents a significant challenge due to the wide range of adverse effects associated with medications that target complex biochemical processes. Consequently, researchers are investigating the hypoglycemic potential of existing drugs. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain, fever, and various inflammatory conditions. Recent studies have shown that NSAIDs, particularly salicylates, can influence glycemia through multiple mechanisms, including inhibition of gastrointestinal enzymes, blockade of KATP channels, activation of AMP-activated protein kinase (AMPK), and inhibition of NF-κB signaling, among others. Accordingly, this review explores the hypoglycemic potential of NSAIDs as well as their derivatives, and the diverse mechanisms through which these molecules may influence glucose homeostasis.

Future Pharmacology doi: 10.3390/futurepharmacol6010001

Authors: Mayara G. C. Oliveira Vanessa da Silva Eschimith Felipe T. B. Kuzniewski Andreanne G. Vasconcelos Daniel C. Moreira Marcelo P. Bemquerer Danilo Corazza Jhones N. Dias Daniel D. R. Arcanjo Peter Eaton Maria I. Muniz-Junqueira José Roberto S. A. Leite Tatiana K. S. Borges Selma A. S. Kuckelhaus

Background/Objectives: Leishmaniasis is a neglected parasitic disease with significant global impact and limited therapeutic options due to the toxicity and cost of current treatments. Antimicrobial peptides (AMPs) derived from amphibians, such as Ocellatin-PT4 and Ocellatin-PT6, have emerged as promising bioactive molecules due to their antimicrobial properties and low toxicity to mammalian cells. This study evaluated the leishmanicidal and immunomodulatory effects of Ocellatin-PT4 and Ocellatin-PT6 against Leishmania amazonensis amastigotes. Methods: Peptides were tested on axenic amastigotes and macrophages infected with amastigotes. Cytotoxicity was assessed using MTT (0.4–197 µM for Ocellatin-PT4 and 0.3–152.1 µM for Ocellatin-PT6) and vital dye exclusion assays. Reactive oxygen species (ROS), nitric oxide (NO), and lipid droplet (LD) production were quantified to assess immunomodulatory responses. Results: Ocellatin-PT4 and Ocellatin-PT6 significantly reduced the viability of free and intracellular amastigotes at concentrations ≥ 24.7 µM and ≥19 µM, respectively, without affecting J774 macrophage viability. Infected macrophages treated with the peptides showed reduced parasite load and decreased infection index (≥12.3 µM for Ocellatin-PT4 and ≥2.4 µM for Ocellatin-PT6). Both peptides modulated the oxidative stress response: they reduced ROS levels in infected macrophages while only slightly increasing NO production at higher concentrations. Additionally, lipid droplet accumulation, which was increased during infection, was downregulated by both peptides—particularly by Ocellatin-PT6. Conclusions: Ocellatin-PT4 and Ocellatin-PT6 exert leishmanicidal effects and modulate key macrophage functions without cytotoxicity. These peptides represent promising candidates for the development of novel therapies against cutaneous leishmaniasis.

Future Pharmacology doi: 10.3390/futurepharmacol5040074

Authors: Lara Marques Nuno Vale

The progress of contemporary pharmacology is deeply linked to pharmacokinetics (PK) and its quantitative exploration through PK modeling. By offering a robust mathematical framework to describe and predict drug absorption, distribution, metabolism, and excretion (ADME), PK modeling is essential for designing and optimizing safe and effective dosing regimens and for advancing personalized medicine and model-informed drug development (MIDD). The reliability of population PK (popPK) and physiologically based PK (PBPK) models depends on high-quality experimental data to estimate PK parameters. Traditional PK data sources include clinical studies, preclinical animal models, and human-derived cell lines. Although considered gold standards, these sources have significant drawbacks. Clinical trials are often restricted by ethical, logistical, and financial challenges and often include homogenous populations that fail to reflect real-world interindividual variability. Similarly, animal and cell-based models lack the physiological complexity of humans, leading to discrepancies between preclinical predictions and clinical outcomes. These constraints have stimulated interest in alternative platforms that more faithfully recapitulate human physiology and interindividual diversity. This review explores the potential of organoids as a novel or complementary source of PK-relevant data. Organoids, three-dimensional (3D) stem cell-derived structures, mimic the cellular architecture, functional heterogeneity, and physiological responses of human tissues. In particular, intestinal, liver, and kidney organoids preserve essential cellular features of ADME processes, positioning them as promising tools for integration into popPK and PBPK modeling frameworks.

Future Pharmacology doi: 10.3390/futurepharmacol5040073

Authors: Elijah Akegbe Nuno Mesquita Célia Cabral Emília Pereira Luís Fernandes Anália do Carmo Rui Tomé Dolores Pinheiro João Pinheiro-Costa Andreia M. Rosa Elisa J. Campos

Background/Objectives: Fungal keratitis (FK) is a current challenge in ophthalmology due to its association with severe visual impairment and the limitations of current antifungal therapies. We aim to evaluate the antifungal activity of essential oils (EOs) from the aromatic and medicinal plants Cymbopogon citratus and Lavandula pedunculata against selected FK pathogens collected from FK patients in two Portuguese hospitals. Methods: The antifungal activity of the EOs was tested at concentrations of 25%, 50%, 75%, and 100% for up to 7 days using the solid-phase disk diffusion in vitro assay. Results: Candida albicans was the most prevalent pathogen (28.6%), followed by Candida parapsilosis (21.4%) and Dicyma olivacea (14.2%). The other identified species were Aspergillus fumigatus and Scedosporium boydii (7.1%). Clinical diagnostic methodologies showed agreement with the molecular identification. Cymbopogon citratus EO showed higher antifungal activity than Lavandula pedunculata EO. The highest antifungal activity was observed against Aspergillus fumigatus and Scedosporium boydii (inhibition zone diameter, IZD = 90.0 mm) after 7 (Cymbopogon citratus EO) or 3 days of incubation (Lavandula pedunculata EO). While the antifungal activity of Cymbopogon citratus EO was maintained during the study (for Aspergillus fumigatus, Candida albicans, and Scedosporium boydii), the antifungal activity of Lavandula pedunculata EO decreased with time. Conclusions: Cymbopogon citratus EO and Lavandula pedunculata EO showed optimal antifungal activity against molds (Aspergillus fumigatus and Scedosporium boydii) after 3 days of incubation. Against yeasts (Candida albicans and Candida parapsilosis), the EOs showed lower activity. Our study sheds light on the development of new pharmacological strategies for FK based on EOs extracted from aromatic and medicinal plants.

Future Pharmacology doi: 10.3390/futurepharmacol5040072

Authors: Fallon dos Santos Siqueira Josiéli Demétrio Siqueira Alencar Kolinski Machado Michele Rorato Sagrillo Yuri Clemente Andrade Sokolovicz Marieli Friedrich Loreto Thiago Augusto de Lima Burgo Carlos Serpa Otávio Augusto Chaves Matiko Anraku de Campos Davi Fernando Back

Background: Rapidly growing mycobacteria (RGM) are microorganisms with variable pathogenicity, which can cause different clinical forms of mycobacterioses. They can form structured communities at the liquid-air interface and adhere to animate and inanimate solid surfaces, characterizing one of their most powerful mechanisms of resistance and survival, named biofilms. Objectives: Here, a novel series of sulfamethoxazole (SMTZ) Schiff bases were obtained by the condensation of the primary amine from SMTZ core with six different aldehydes to evaluate their antimicrobial and antibiofilm activities, as well as physicochemical and in silico characteristics. Methods: The compounds L1–L6 included: pyridoxal hydrochloride (L1), salicylaldehyde (L2), 3-methoxysalicylaldehyde (L3), 2-hydroxy-1-naphthaldehyde (L4), 3-allylsalicylaldehyde (L5), and 4-(diethylamino)salicylaldehyde (L6). MIC determination was performed against standard strains and seven clinical isolates. Time-kill assays, biofilm inhibition assays, atomic force microscopy, and peripheral blood mononuclear cell cytotoxicity assays were carried out. Density functional theory (DFT) calculations using quantum descriptors, Mulliken charges, Fukui functions, non-covalent interactions (NCI), and reduced density gradient (RDG), along with molecular docking calculations to DHS, LasR, and PqsR, supported the experimental trend. Results: The compounds L1–L6 showed a significant capacity to inhibit the growth of RGM, with MIC values in the range of 0.61 to 1.22 μg mL−1, which are significantly lower than those observed for the parent compound SMTZ, demonstrating superior antimicrobial potency. To deepen antimicrobial activity assays, L1 was chosen for further evaluations and showed a significant ability to inhibit the growth of RGM in both planktonic and biofilm forms. In addition, atomic force microscopy views great changes in topography, electrical force, and nanomechanical properties of microorganisms. The cytotoxic assays with the peripheral blood mononuclear cell model suggest that the new compound may be considered as an antimicrobial alternative, as well as a safe substance showing selectivity indexes in the range of efficacy. Conclusions: Density functional theory (DFT) calculations were performed to obtain quantum descriptors, Mulliken charges, Fukui functions, non-covalent interactions (NCI), and reduced density gradient (RDG), which, with molecular docking calculations to DHS, LasR, and PqsR, supported the experimental trend.

Future Pharmacology doi: 10.3390/futurepharmacol5040071

Authors: Éverton Paredes Falcão Jeremias Justo Emídio Natália Ferreira de Sousa Karinne Kelly Gadelha Marques Janaina Esmeraldo Rocha Wellington Lima da Silva Sobrinho João Felipe Bezerra Luciana Scotti Marcus Tullius Scotti Juan Carlos Ramos Gonçalves Henrique Douglas Melo Coutinho Damião Pergentino de Sousa Ricardo Dias de Castro

Introduction: Bacterial infections, especially those caused by multidrug-resistant strains, remain a major health concern. This study investigates 4-chlorobenzyl p-coumarate, assessing its antibacterial mechanism, pharmacokinetic profile, and potential to modulate antimicrobial resistance. Methods: In silico studies were conducted, including molecular docking, molecular dynamics simulations, and pharmacokinetic predictions, alongside in vitro assays assessing efflux pump inhibition, antibiotic modulation, and bacterial DNA analysis. Results: The compound showed higher binding affinity and complex stability with the enzyme phosphatidylglycerol phosphate synthase, while also exhibiting reduced residue fluctuations and better flexibility with the NAD+-dependent DNA ligase. Molecular interactions with the efflux proteins MepA and NorA were also observed. Pharmacokinetic predictions indicated a favorable profile, including suitability for oral administration. Experimentally, the compound inhibited the MepA and NorA efflux pumps, modulated the activity of the antibiotics ciprofloxacin and norfloxacin, and reduced DNA concentration in treated cells. Conclusions: The findings suggest that the compound acts through dual mechanisms, with a prediction of activity by disrupting phosphatidylglycerol synthesis and DNA replication while inhibiting and modulating MepA and NorA efflux pumps.

Future Pharmacology doi: 10.3390/futurepharmacol5040070

Authors: Debora Emanuela Torre Carmelo Pirri

Levosimendan, a calcium-sensitizing inodilator, has emerged as a promising adjunctive therapy in patients undergoing veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Its pharmacodynamic profile, combining positive inotropy with vasodilation and mitochondrial protective effects, offers a unique therapeutic potential in the context of mechanical circulatory support. Despite growing interest, the clinical impact of Levosimendan in ECMO remains debated, with heterogeneous evidence regarding its efficacy in improving weaning success, reducing vasopressor requirements or mitigating ischemia-reperfusion injury. This narrative review aims to critically appraise the current literature on Levosimendan use in ECMO settings, exploring its mechanistic rationale, pharmacologic behavior under extracorporeal circulation and potential role in various clinical scenarios including post-cardiotomy shock and refractory cardiogenic failure. The limitations of existing studies are critically examined, underscoring the need for high-quality clinical trials to define appropriate patient selection, optimal timing of administration and dosing strategies. This review synthesizes current evidence to determine whether Levosimendan constitutes a true therapeutic asset or remains merely an adjunctive agent in the complex management of ECMO supported patients.

Future Pharmacology doi: 10.3390/futurepharmacol5040069

Authors: Aganze Gloire-Aimé Mushebenge David Ditaba Mphuthi

The global spread of Monkeypox virus (MPXV) has emerged as a major public health concern, with the 2022 outbreak underscoring the urgent need for effective antiviral therapies. Current treatment options are limited because no drugs specifically target Mpox, and existing recommendations rely on repurposed smallpox antivirals that may cause resistance. This highlights the critical need for novel therapeutic agents targeting key viral and host factors involved in MPXV pathogenesis. Medicinal plants provide a rich reservoir of bioactive compounds with potential antiviral activity, particularly in low- and middle-income countries where they play an essential role in healthcare. To address this issue, we conducted a review exploring innovative in silico approaches for natural product-based drug discovery against MPXV. Computational studies identified phytochemicals such as curcumin, punicalagin, rosmarinic acid, and quercitrin with strong affinities for key viral proteins including DNA polymerase, TMPK, DdRp, A42R, MTase, p37, and envelope proteins and favorable pharmacokinetic profiles Despite these promising findings, fragmented biological datasets, viral mutability, and limited in vitro and in vivo validation hinder clinical translation. Our analysis highlights integrating AI-driven virtual screening with experimental validation to accelerate MPXV drug discovery, providing a scalable framework for managing emerging viral threats.

Future Pharmacology doi: 10.3390/futurepharmacol5040068

Authors: Camila de Oliveira Vian Rafael Felipe De Aguiar Marcelo Augusto Germani Marinho Vitória Pereira Mackmillan Carolina Miranda Alves Jamile Lima Rodrigues Fernanda Barros de Miranda Cristiana Lima Dora Ana Paula Horn Mariana Appel Hort

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor and cognitive impairments due to dopaminergic neuron loss. The neurotoxin MPTP is commonly used to model PD, as it selectively targets these neurons. Quercetin (QU), a flavonoid with antioxidant properties, has shown neuroprotective potential, but its poor solubility limits clinical application. Nanoemulsions (NEQU) have emerged as a strategy to enhance its bioavailability and efficacy. Methods: To evaluate the neuroprotective and antioxidant effects of QU and NEQU, zebrafish larvae were exposed to MPTP (50 µM) and assessed for survival, locomotion (total distance traveled), morphological parameters, reactive oxygen species (ROS), lipid peroxidation (via MDA), and reduced glutathione (GSH) levels. Results: Only NEQU pre-treatment reversed MPTP-induced locomotor deficits. Both QU and NEQU (2.5 µM) significantly reduced ROS production and lipid peroxidation, with no effect on GSH levels. Notably, MPTP exposure led to a significant reduction in head size, an unprecedented finding in zebrafish PD models, indicating neurotoxicity. Morphometric analysis showed no change in total body length. However, MPTP significantly decreased swim bladder size and increased yolk sac size. Treatment with QU and NEQU attenuated these swim bladder alterations; no significant differences were observed in other parameters. Conclusions: These findings suggest that quercetin, particularly when nanoencapsulated, is a promising candidate for further development as a therapeutic agent to mitigate PD-related neurodegeneration.

Future Pharmacology doi: 10.3390/futurepharmacol5040067

Authors: Nirav Chandegara Shrikalp Deshpande Bhupendra Prajapati Anup Singh Dignesh Khunt

Background: Tetrabenazine, a VMAT2 inhibitor used for hyperkinetic disorders, shows considerable pharmacokinetic variability due to extensive first-pass metabolism. Standardization of clinical trial conditions, including posture, may reduce variability and improve bioequivalence assessments. Objective: The aim of this study was to determine the impact of postural restriction on the pharmacokinetics of tetrabenazine and its active metabolite, dihydrotetrabenazine (HTBZ), under controlled conditions. Methods: A randomized, open-label, four-period replicate crossover study enrolled 72 healthy fasted adults who received a single 25 mg tetrabenazine dose under two conditions: 4 h semirecumbent posture versus unrestricted movement. Plasma drug concentrations were measured across 36 h using validated LC–MS/MS method. Pharmacokinetic parameters were estimated via non-compartmental analysis and compared with Wilcoxon signed-rank tests. Results: Postural restriction significantly increased tetrabenazine exposure (AUC0–t: +16.4%, p < 0.0001) and half-life (p = 0.002), with a nonsignificant rise in Cmax. For HTBZ, Cmax decreased (−16.2%, p = 0.018), whereas AUC was unchanged. Parent-to-metabolite ratios increased by 24–29%. Replicate design analyses showed reduced intra-subject variability for tetrabenazine AUC with posture control (~24% vs. >28%). Simulation suggested that posture restriction could lower sample size requirements by 15–30% in two-period average bioequivalence trials. Conclusions: Maintaining a semirecumbent posture after dosing enhances tetrabenazine’s bioavailability, attenuates early metabolite formation, and reduces pharmacokinetic variability. Incorporating posture control into bioequivalence trial protocols may optimize study design, reduce participant exposure, and align with ICH-GCP ethical principles.

Future Pharmacology doi: 10.3390/futurepharmacol5040066

Authors: Muhammad Yasir Jinyoung Park Jongseon Choe Jin-Hee Han Eun-Taek Han Won Sun Park Wanjoo Chun

Background/Objectives: Janus kinase 2 (JAK2) is a pivotal signaling protein implicated in various hematological malignancies and inflammatory disorders, making it a compelling target for therapeutic intervention. Methods: In this study, we employed an integrative computational approach combining ligand-based screening, pharmacophore modeling, molecular docking, molecular dynamics (MD) simulations, and MM/PBSA free energy calculations to identify JAK2 inhibitors from the ChEMBL database. A comprehensive virtual screening of over 1,900,000 compounds was conducted using Tanimoto similarity and a validated pharmacophore model, resulting in the identification of 39 structurally promising candidates. Docking analyses prioritized compounds with favorable interaction energies, while MD simulations over 100 ns assessed the dynamic behavior and binding stability of top hits. Results: Four compounds, CHEMBL4169802, CHEMBL4162254, CHEMBL4286867, and CHEMBL2208033, exhibited consistently superior performance, forming stable hydrogen bonds, favorable RMSD profiles (≤0.5 nm), and strong binding interactions, including salt bridges. Notably, the binding free energies revealed ΔG values as low as −29.91 kcal/mol, surpassing that of the reference inhibitor, momelotinib (−24.17 kcal/mol). Conclusions: Among these, CHEMBL4169802 emerged as the most promising candidate due to its synergistic electrostatic and hydrophobic interactions. Collectively, our results highlight these compounds as probable, JAK2-selective inhibitors with strong potential for further biological validation and optimization.

Future Pharmacology doi: 10.3390/futurepharmacol5040065

Authors: Milena Mariano Ribeiro Luíza Siqueira Lima Nayara de Souza da Costa Meire Ellen Pereira Aline S. Fonseca Luciane R. Cavalli Quelen I. Garlet Ana Carolina Irioda Cláudia S. Oliveira

Background/Objectives: Neuroblastoma is a pediatric embryonal tumor of the autonomic nervous system, characterized by high heterogeneity. Recent research has explored the therapeutic potential of retinoic acid and selenium derivatives as antiproliferative agents. This study aims to assess the antiproliferative effects of sodium selenite and retinoic acid, as well as the conventional chemotherapeutic agents, cyclophosphamide and cisplatin, using the SH-SY5Y neuroblastoma cell line. Methods: Cells were treated with the compounds at concentrations ranging from 0 to 1000 µM for 72 h. The following assays were performed: cell viability, clonogenic assay, cell migration, cell cycle analysis, and gene expression (BCL2 and BAX). Data were analyzed using the Kruskal–Wallis test followed by Dunn’s or the Mann–Whitney test (p < 0.05). IC50 values were obtained from dose–response curves. Results: Sodium selenite (100–1000 µM) significantly reduced cell viability by more than 50% (IC50: 166 µM at 72 h). Retinoic acid (300 µM) reduced viability by 65% (IC50: 198 µM at 72 h), and cisplatin (10 µM) reduced viability by 79% (IC50: 3.4 µM at 72 h). All compounds significantly decreased colony formation. Sodium selenite and retinoic acid induced arrest in the G0/G1 phase of the cell cycle. Gene expression analysis revealed downregulation of the BCL2 gene by all compounds and upregulation of BAX only by sodium selenite at IC50 concentration. Conclusions: Sodium selenite and retinoic acid showed antiproliferative effects on neuroblastoma cells, suggesting their potential as adjuvant therapeutic agents. To reach this goal, we suggest further investigation of their mechanisms of action and evaluation of the combined strategies.

Future Pharmacology doi: 10.3390/futurepharmacol5040064

Authors: Karen Montserrat Román-Casiano Juan David Bermudes-Contreras Jorge Cornejo-Garrido Eli Amanda Delgado-Alvarado José Natividad Uribe-Soto Estela Ruiz-Baca Marcela Verónica Gutiérrez-Velázquez Rene Torres-Ricario

Background/Objectives: Fouquieria splendens Engelm. is a medicinal plant traditionally used in North America for treating metabolic disorders; however, its antihyperglycemic properties and safety profiles remain poorly studied. We investigated the phytochemical composition, oral acute toxicity, mutagenicity, and antihyperglycemic activity of the foliar ethanolic extract of F. splendens (EFS). Methods: Phytochemical analysis was performed using ultra-performance liquid chromatography–mass spectrometry. Acute toxicity and mutagenicity were evaluated following the OECD guidelines. Antihyperglycemic activity was assessed in streptozotocin-induced diabetic rats treated with EFS (200 mg/kg) alone or in combination with metformin for 30 days. Results: Eleven phenolic compounds were identified in the EFS, including ellagic acid, morin, apigenin, and luteolin 7-Oglucoside. EFS was non-mutagenic and had an LD50 of >2000 mg/kg. This treatment significantly reduced blood glucose levels and enhanced the effect of metformin in diabetic rats. Histopathological analysis showed preserved morphology in the pancreatic, hepatic, and renal tissues of the treated animals. Conclusions: EFS exhibited significant antihyperglycemic activity and a favorable safety profile, supporting its potential as a complementary phytotherapeutic agent for diabetes management. These results highlight the pharmacological value of F. splendens and promote the exploration of native plants as adjuncts for chronic disease therapy.

Future Pharmacology doi: 10.3390/futurepharmacol5040063

Authors: Mariya Ivanova Liliya Panayotova-Ovcharova Detelina Nedyalkova-Petkova Petar Petkov Georgi Boshev Evgeniya Vladeva

Peripheral nerve injuries can lead to significant functional impairments, and treatment options remain limited. Galantamine, widely used for cognitive disorders, has shown potential effects on the peripheral nervous system, making it a candidate for new therapeutic approaches. The narrative review explores the use of galantamine for peripheral nerve injuries, with a focus on transdermal and iontophoretic delivery methods. Searches in scientific databases revealed no peer-reviewed publications addressing this specific application. As a result, the review expanded to include printed and offline sources and a broader timeframe to capture earlier reports. Available evidence from Bulgaria suggests that galantamine ampules have been applied via iontophoresis for peripheral neuropathy. However, this approach is not documented in established scientific databases, and information on its safety and effectiveness is limited. Overall, research on transdermal galantamine for peripheral nerve injuries is still scarce. More studies are needed to better understand its potential benefits and to optimize safe delivery methods.

Future Pharmacology doi: 10.3390/futurepharmacol5040062

Authors: Emília Simon Noémi Miklós Sorana-Denisa Frandeș Melinda Kolcsar Zsolt Gáll

Background/Objectives: The antiseizure effects of cannabidiol (CBD) were extensively studied when used as a monotherapy. However, there is conflicting evidence regarding its use in combination with levetiracetam (LEV). Methods: This study explored the effects of chronic co-administration of CBD and LEV in a pentylenetetrazole-kindling rat model to evaluate potential antiseizure and neuropsychiatric interactions. Male and female Wistar rats (n = 48) were divided into four treatment groups: one control and three treated by receiving LEV 300 mg/kg and LEV + CBD at 10 and 60 mg/kg, respectively. Seizure parameters were assessed using the Racine scale, and behavior was evaluated using the open field (OF), novel object recognition (NOR), and social interaction (SI) tests. Results: While both combinations, LEV + CBD 10 mg/kg and 60 mg/kg, significantly reduced maximal seizure intensity, the LEV + CBD 10 mg/kg attenuated LEV’s anti-kindling effect. Additionally, only LEV + CBD 60 mg/kg reduced seizure duration compared to LEV alone (p = 0.0002). In behavioral assessments, LEV + CBD 10 mg/kg showed anxiolytic effects in the OF test by increasing central activity (p = 0.0141). In contrast, the LEV + CBD 60 mg/kg impaired social behavior in both sexes (p = 0.0019). LEV improved the cognitive performance of female rats in the NOR test (p = 0.0301), but this improvement was not observed in LEV + CBD groups. Conclusions: CBD exhibited dose-dependent effects when combined with LEV: low doses might offer anxiolytic effects but promote kindling, and high doses enhance seizure control but potentially worsen social interaction. The results support the therapeutic potential of LEV-CBD co-treatment, while highlighting the need for careful dose optimization when considering CBD as an adjunctive therapy.

Future Pharmacology doi: 10.3390/futurepharmacol5040061

Authors: Ligia-Ancuța Hui Ana-Maria Vlase Elisabeta Ioana Hirișcău Constantin Bodolea Andrei-Mihai Bălan Laurian Vlase Adina Popa

Introduction: Linezolid is a reserve antibiotic used to treat infections caused by Gram-positive bacteria with resistance genes. In critically ill patients, high intra- and interindividual variability has been observed, prompting the search for alternative methods to reduce this variability and achieve the pharmacokinetic/pharmacodynamic indices necessary for a favorable efficacy–safety balance. Aim of the study: We wished to compare the safety and effectiveness of a continuous infusion (CI) versus an intermittent infusion (II) of linezolid in patients requiring intensive care. Materials and Methods: This study, registered under the number NCT05801484), was a prospective, open-label, single-center, two-arm study. Data on hematologic safety and effectiveness were collected and compared between patients receiving CI and II, respectively, at the same daily dose of linezolid (1200 mg). Results: Twenty-nine patients from the intensive care unit were included, divided into two groups. No statistically significant difference was found in 30-day mortality between the groups, nor in the likelihood of post-treatment culture negativity. However, a significantly greater reduction in C-reactive protein levels was observed in the CI group compared to the II group. Regarding safety, at CrCl < 60 mL/min, the decrease in platelets was statistically significant in group II but not in group CI. Additionally, at the 30-day follow-up, recovery from thrombocytopenia was better in the CI group. Conclusions: Continuous infusion of linezolid proved to be non-inferior to intermittent infusion at the same daily dose in terms of effectiveness. Furthermore, a lower risk of adverse reactions was identified with continuous infusion.

Future Pharmacology doi: 10.3390/futurepharmacol5040060

Authors: Beatriz Hoffmann Sales Bianchini Geovana Martelossi-Cebinelli Jessica Aparecida Carneiro Fernanda Soares Rasquel-Oliveira Rubia Casagrande Waldiceu A. Verri

Reactive oxygen species (ROS) are formed by the incomplete reduction of oxygen and play a crucial role in both physiological function and pathological process, being controlled by enzymatic and non-enzymatic antioxidant systems. However, excessive ROS production can exceed the body’s antioxidant capacity, resulting in oxidative stress and causing cell death and oxidation of important biomolecules. In this context, the inhibition and/or modulation of ROS has been shown to be effective in reducing pain, oxidative stress, and inflammation. Among ROS, superoxide anion (O2•−) is the first free radical to be formed through the mitochondrial electron transport chain (ETC) or by specific enzymes systems, such as the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) complex. O2•− plays a significant role in the development and maintenance of pain associated with inflammatory conditions through direct or indirect activation of primary nociceptive neurons and, consequently, peripheral and central sensitization. Experimentally, potassium superoxide (KO2, a O2●− donor) is used to initiate O2●− mediated inflammatory and nociceptive responses, making it important for studying the mechanisms associated with ROS-induced pain and evaluating potential therapeutic molecules. This review addresses the production and regulation of O2•−, highlighting its biosynthesis, redox control, and its physiological and pathological roles in the development of inflammatory pain, as well as the pharmacological therapies under development aimed at its generation and/or action.

Future Pharmacology doi: 10.3390/futurepharmacol5040059

Authors: Katrin Becker Kaihui Lu

Cerebral vasospasm (CVS) following a subarachnoid hemorrhage (SAH) is a critical complication driven by imbalances between vasodilators and vasoconstrictors. This review explores the bidirectional interplay between nitric oxide (NO) and endothelin-1 (ET-1) in CVS pathogenesis. NO, a potent vasodilator mainly produced by endothelial and neuronal nitric oxide synthase (eNOS/nNOS) under normal physiological conditions, is scavenged early after SAH by hemoglobin derivatives, leading to microcirculatory dysfunction, pericyte constriction, and impaired neurovascular coupling. Conversely, ET-1 exacerbates vasoconstriction by suppressing NO synthesis via ROS-dependent eNOS uncoupling and Rho-kinase activation. The NO/ET-1 axis further influences delayed cerebral ischemia (DCI) through mechanisms like 20-HETE-mediated cGMP suppression and oxidative stress. Emerging therapies—including NO donors, NOS gene therapy, and ET-1 receptor antagonists—aim to restore this balance. Understanding these pathways offers translational potential for mitigating CVS and improving outcomes post-SAH.

Future Pharmacology doi: 10.3390/futurepharmacol5040058

Authors: Efstathios Pateras Ioannis S. Vizirianakis Mingrui Zhang Georgios Aivaliotis Georgios Tzimagiorgis Andigoni Malousi

Background/Objective: Predicting pharmacological response in cancer remains a key challenge in precision oncology due to intertumoral heterogeneity and the complexity of drug–gene interactions. While machine learning models using multi-omics data have shown promise in predicting pharmacological response, selecting the features with the highest predictive power critically affects model performance and biological interpretability. This study aims to compare computational and biologically informed gene selection strategies for predicting drug response in cancer cell lines and to propose a feature selection strategy that optimizes performance. Methods: Using gene expression and drug response data, we trained models on both data-driven and biologically informed gene sets based on the drug target pathways to predict IC50 values for seven anticancer drugs. Several feature selection methods were tested on gene expression profiles of cancer cell lines, including Recursive Feature Elimination (RFE) with Support Vector Regression (SVR) against gene sets derived from drug-specific pathways in KEGG and CTD databases. The predictability was comparatively analyzed using both AUC and IC50 values and further assessed on proteomics data. Results: RFE with SVR outperformed other computational methods, while pathway-based gene sets showed lower performance compared to data-driven methods. The integration of computational and biologically informed gene sets consistently improved prediction accuracy across several anticancer drugs, while the predictive value of the corresponding proteomic features was significantly lower compared with the mRNA profiles. Conclusions: Integrating biological knowledge into feature selection enhances both the accuracy and interpretability of drug response prediction models. Integrative approaches offer a more robust and generalizable framework with potential applications in biomarker discovery, drug repurposing, and personalized treatment strategies.

Future Pharmacology doi: 10.3390/futurepharmacol5040057

Authors: Lubna H. Tahtamouni Ayah Y. Almasri Marya A. Hamad Nour A. Hussein Khaled M. Saleh Salem R. Yasin Rainer Schobert Bernhard Biersack

Background/Objectives: Colorectal carcinoma (CRC) is among the most commonly diagnosed cancers in both men and women. Although CRC mortality is generally decreasing, new therapeutic options are needed for unresponsive subgroups of CRC patients. Methods: A series of known and new tyrphostin derivatives was tested for their efficacy against three CRC cell lines with varying KRAS, p53, and/or BRAF statuses. Growth inhibition, apoptosis induction, and inhibition of EGFR and VEGFR-2 were investigated. Results: Tyrphostin A9, the known RG13022-related tyrphostin 1a and its dichlorido(p-cymene)ruthenium(II) complex 1b, and the new SF5-substituted compounds 2a and 2b showed selective antiproliferative activity against KRAS-mutant HCT-116 CRC cells expressing wildtype p53, while p53-knockout HCT-116 and KRAS-wildtype BRAF/p53-mutant HT-29 CRC cells were distinctly less sensitive. In HCT-116 cells, only tyrphostin A9 increased mRNA expression of caspases 3 and 8, as well as the kinases MEK1 and MEK2, whereas 2a reduced caspase 8 mRNA levels. Tyrphostin A9 increased caspase 3 activity and induced apoptosis in HCT-116 p53-wildtype cells while simultaneously inhibiting the receptor tyrosine kinases EGFR and VEGFR-2 at low nanomolar concentrations. Conclusions: Tyrphostin A9 could be a promising therapeutic option for the treatment of KRAS-mutant CRC that expresses wildtype p53.

Future Pharmacology doi: 10.3390/futurepharmacol5040056

Authors: Karla Alejandra Avendaño-Briseño Jorge Escutia-Martínez José Pedraza-Chaverri Estefani Yaquelin Hernández-Cruz

In the original publication [1], during the revisions and restructuring of the manuscript, the following references were inadvertently removed by the authors and were not cited:103 [...]

Future Pharmacology doi: 10.3390/futurepharmacol5040055

Authors: Muhammad Yasir Jinyoung Park Eun-Taek Han Jin-Hee Han Won Sun Park Jongseon Choe Wanjoo Chun

Introduction: Tumor necrosis factor-α (TNF-α) is a key regulator of inflammatory responses, and its biological activity is dependent on proteolytic processing by the tumor necrosis factor-α-converting enzyme (TACE), also known as ADAM17. Aberrant TACE activity has been associated with various inflammatory and immune-mediated diseases, positioning it as a compelling target for therapeutic intervention. Methods: While our previous study explored TACE inhibition via repositioned FDA-approved drugs, the present study aims to examine previously untested chemical scaffolds from the Enamine compound library, seeking first-in-class TACE inhibitors. We employed an integrated in silico workflow that combined ligand-based virtual screening using a graph convolutional network (GCN) model trained on known TACE inhibitors with structure-based methodologies, including molecular docking, molecular dynamics (MD) simulations, and binding free energy calculations. Results: Several enamine-derived compounds demonstrated strong predicted inhibitory potential, favorable docking scores, and stable interactions with the TACE active site. Among them, Z1459964184, Z2242870510, and Z1450394746 emerged as lead candidates based on their highly stable 300 ns RMSD and robust hydrogen bonding profile as compared to the reference compound BMS-561392. Conclusions: This study highlights the utilization of deep learning-driven screening combined with extended 300 ns molecular simulations to identify novel small-molecule scaffolds for TACE inhibition and supports further exploration of these hits as potential anti-inflammatory therapeutics.

Future Pharmacology doi: 10.3390/futurepharmacol5030054

Authors: Natalia Nascimento Silveira Heber Eduardo Andrada Julia Mirian Paulino Naiara Cristina da Silva Boaretto Eduardo Ferreira Molina Raquel Alves dos Santos

Backgorund/Objectives: Advances in nanotechnology have enabled conventional compounds with low bioavailability to achieve their full therapeutic potential by ensuring targeted tissue delivery. In this context, polymeric nanogels have emerged as a promising option for drug delivery due to their high loading capacity and excellent in vivo stability. Objectives: Given the growing potential of nanogels in drug delivery, their cytotoxicity and genotoxicity must be evaluated to ensure safety in biotechnological applications. This study assessed the genotoxic safety of nanogels synthesized via the reaction of Jeffamine® T-5000 polyoxypropylene triamine (PPO) monomers (Huntsman Chemical, The Woodlands, TX, USA) and poly (ethylene glycol) diglycidyl ether (DPEG) in varying proportions: 1:1 (Nano11), 1:3 (Nano13), and 2:3 (Nano23) PPO/DPEG. Additionally, we determined which of the two components exhibited lower toxicity against the CHO-K1 cell line (Chinese hamster ovary). Methods: To achieve this, short- and long-term cytotoxicity experiments were conducted using the XTT colorimetric assay and clonogenic survival assay, alongside the micronucleus test and comet assay for genotoxicity analysis. Results: The cytotoxicity assays (XTT, clonogenic, and trypan blue) indicated that the nanogels did not exhibit cytotoxic effects at concentrations up to 100 μg/mL, while the genotoxicity assays revealed no evidence of DNA or chromosomal damage at these levels. Conclusions: These findings underscore the safety profile of Jeffamine® T-5000 as an effective carrier, demonstrating its compatibility with DPEG and positioning it as a highly promising and innovative solution for advanced drug delivery systems.

Future Pharmacology doi: 10.3390/futurepharmacol5030053

Authors: Juan Ostos-Hernandez Hannah Bhakta Caleb VanArragon Lanna Sirhan Danielle Orozco-Nunnelly Jeffrey Pruet

Background/Objectives: The rise of multidrug-resistant bacteria and fungi, or “superbugs”, makes the development of new antimicrobial compounds of continued importance. In this context, we have explored structural variants of the plant-derived phytocompound berberine, seeking higher antimicrobial activity and selectivity. Our prior work prepared fourteen protoberberine variants (B1–B14), and found that a partially reduced dihydro-protoberberine (B14) was significantly more active against Gram-positive bacteria. To further investigate this trend, we prepared a series of protoberberines and related dihydro-protoberberines, with the goal of better understanding the effects of the partial reduction of the protoberberine core. Methods: Protoberberines were prepared from a cyclization between glyoxal and substituted N-benzyl-phenethylamines, prepared by reductive amination. Dihydro-derivatives were obtained via NaBH4 reduction. Biological activity was assessed with a Kirby–Bauer assay to determine zones of inhibition against a panel of twelve microorganisms. Cytotoxicity was also assessed using an MTT assay against a T84 human colon carcinoma cell line. Results: The majority of the prepared compounds showed greater Gram-positive antibacterial activity compared to original berberine, and nearly all dihydro-protoberberines had improved Gram-positive antibacterial activity over their unreduced form. Additionally, the reduced variants were less active against fungi, indicating a step towards higher microbial selectivity. All variants showed greater potency against cancer cells. Conclusions: The present work highlights a significant improvement in antibacterial activity and selectivity for this set of dihydro-protoberberines over their unreduced counterparts.

Future Pharmacology doi: 10.3390/futurepharmacol5030052

Authors: Sanja Djakovic Marina Nikolic Ivan Srejovic Nikola Nedeljkovic Marko Karovic Jovana Bradic Marijana Andjic Vladimir Jakovljevic Milos Nikolic

Objectives: Our study aimed to examine the antioxidative and anti-inflammatory potential of the lyophilized aqueous leaf extract of Vitis vinifera. Methods: The antioxidant capacity of the extract was evaluated using the DPPH and FRAP assays. The in vivo phase of the study included 40 male Wistar albino rats. One half of the animals were used to induce the carrageenan model of acute inflammation, while the other half were used for examination of the extract effect on the redox state. Rats from the experimental group drank tap water containing 150 mg/kg Vitis vinifera extract for 14 days, while control animals received saline at the same volume. The molecular docking studies of polyphenols present in the leaf extract were conducted in AutoDock Vina. Results: In vitro assessment of the antioxidative capacity of the applied extract revealed significant free radical scavenging activity (IC50 value 11.63 µg/mL), along with a pronounced ferric reducing ability (0.143 at 700 nm). Moreover, animal treatment with the extract led to significant paw edema inhibition (30.34%, 35.06%, and 41.54% in the second, third, and fourth hours, respectively) and to pro-oxidative marker reduction. Additionally, Vitis vinifera extract significantly increased catalase activity and glutathione levels. The in silico results showed that rutin binds to cyclooxygenase 1 (−8.2 kcal/mol) and 2 (−8.3 kcal/mol), as well as to antioxidant enzymes (catalase: −8.6 kcal/mol, SOD: −7.4 kcal/mol), indicating its key role in mediating the biological activity of the tested extract. Conclusions: This study highlights the significant antioxidant and anti-inflammatory potential of V. vinifera lyophilized aqueous leaf extract from the Serbian market, supported by both in vivo and in silico analyses.

Future Pharmacology doi: 10.3390/futurepharmacol5030051

Authors: Luis E. Cobos-Puc María del C. Rodríguez-Salazar Sonia Y. Silva-Belmares Hilda Aguayo-Morales

Background/Objectives: Neuropsychiatric disorders such as Parkinson’s disease, depression, and Alzheimer’s disease are characterized by deficits in catecholaminergic neurotransmission. Conventional pharmacotherapies have several limitations, including poor blood–brain barrier permeability, rapid peripheral metabolism, systemic toxicity, and suboptimal brain bioavailability. This review evaluates nanoparticle-based strategies that can overcome these limitations by enhancing the delivery of catecholaminergic drugs to the central nervous system (CNS). Methods: A narrative synthesis was conducted based on a comprehensive review of research articles published by July 2025. Articles were retrieved from PubMed, Scopus, and Web of Science. The studies examined nanoformulations of catecholaminergic agents with a focus on CNS delivery, BBB penetration, toxicity, and therapeutic outcomes in neuropsychiatric disease models. Results: Evidence shows that nanoparticle platforms can stabilize drugs and extend their release time. They can also enable BBB penetration. These platforms reduce peripheral side effects and improve behavioral and neurochemical outcomes in preclinical models. Conclusions: Nanoparticles are a promising strategy for optimizing pharmacotherapy for CNS disorders associated with catecholamine deficiencies. However, more research is needed on their long-term safety, bioaccumulation, and clinical feasibility before they can be widely adopted.

Future Pharmacology doi: 10.3390/futurepharmacol5030050

Authors: Yui Iwata Aoi Mori Kana Shinogi Kanako Nishino Saori Matsuoka Yuki Kushida Yuki Satoda Akiyoshi Shimizu Fumihiro Terami Toru Nonomura Shunichi Kitajima Toshio Tanaka

Background: Zebrafish-based drug discovery systems provide significant advantages over mammalian models for high-throughput in vivo screening. Among these, the NF-κB eGFP reporter system significantly enhances drug discovery in zebrafish by enabling real-time, high-resolution monitoring of pathway activity in live organisms, thereby streamlining mechanistic studies and high-throughput screening. Methods: We developed a novel AI (Quantifish and Orange software)-based zebrafish precision individualized 96-well ZF plates (0–7 dpf) and individualized MT tanks (8 dpf–4 mpf) protocol for the transposon-mediated transgenesis of the NFκB eGFP reporter system. Results: One-cell stage embryos were administered NFκB reporter construct and Tol2 transposase mRNA via microinjection and transferred to separate wells of a 96-well ZF plate. Bright-field and fluorescence images of each well were captured at 5 dpf in the F0, F1, and F2 generations using the automated confocal high-content imager CQ1. The Quantifish software was used for the automated detection and segmentation of zebrafish larval fluorescence intensity in specific regions of interest. Quantitative data on the fluorescence intensity and distribution patterns were measured in Quantifish, and advanced statistical and machine learning methods were applied using Orange. Imaging data with eGFP expression results were assessed to evaluate the efficiency of the transgenic protocol. Discussion: This AI-enhanced precision protocol allows for high-throughput screening and quantitative analysis of NFκB reporter transgenesis in zebrafish, enabling the efficient identification and characterization of stable transgenic lines that exhibit tissue-specific expression of the NF-κB reporter, such as lines with induced expression restricted to the retina following LPS stimulation. This approach streamlines the evaluation of regulatory elements, enhances data consistency, and reduces animal use, making it a valuable tool for zebrafish drug discovery.

Future Pharmacology doi: 10.3390/futurepharmacol5030049

Authors: Karla Alejandra Avendaño-Briseño Jorge Escutia-Martínez José Pedraza-Chaverri Estefani Yaquelin Hernández-Cruz

Thallium (Tl) is a non-essential and highly toxic heavy metal capable of replacing potassium (K+) in biological systems, leading to mitochondrial dysfunction, oxidative stress, and inhibition of protein synthesis. In humans, the estimated oral lethal dose ranges from 10 to 15 mg/kg, with acute mortality rates of 6–15% and chronic neurological sequelae in up to 55% of survivors. Environmental releases of thallium of up to 5000 metric tons annually from industrial and mining activities, combined with its high oral bioavailability and nonspecific multisystemic symptoms, underscore the urgent need for more effective therapeutic strategies. This review summarizes current evidence on Tl toxicity, including its mechanisms of action, clinical manifestations, and available treatments. It emphasizes the strategic selection of biological models: simple organisms such as Caenorhabditis elegans and Drosophila melanogaster enable high-throughput screening and early biomarker detection; zebrafish (Danio rerio) provide vertebrate-level evaluation of multi-organ effects; and rodent models offer systemic toxicokinetic and therapeutic validation. Human-derived organoids and induced pluripotent stem cell (iPSC) systems recreate tissue-specific microenvironments, allowing translational assessment of mitochondrial, neuronal, and cardiac toxicity. Integrating these models within a tiered and complementary framework, alongside environmental and clinical surveillance, can accelerate the development of targeted treatments and strengthen public health responses to Tl exposure.

Future Pharmacology doi: 10.3390/futurepharmacol5030048

Authors: Mst. Afsana Mimi Md. Mahmudul Hasan

Extracellular vesicles (EVs) are mediators of intercellular communication and serve as promising tools for drug discovery and targeted therapies. These lipid bilayer-bound nanovesicles facilitate the transfer of functional proteins, RNAs, lipids, and other biomolecules between cells, thereby influencing various physiological and pathological processes. This review outlines the molecular mechanisms governing EV biogenesis and cargo sorting, emphasizing the role of key regulatory proteins in modulating selective protein packaging. We explore the critical involvement of EVs in various disease microenvironments, including cancer progression, neurodegeneration, and immunological modulation. Their ability to cross biological barriers and deliver bioactive cargo makes them desirable candidates for precise drug delivery systems, especially in neurological and oncological disorders. Moreover, this review highlights advances in engineering EVs for the delivery of RNA therapeutics, CRISPR-Cas systems, and targeted small molecules. The utility of EVs as diagnostic tools in liquid biopsies and their integration into personalized medicine and companion diagnostics are also discussed. Patient-derived EVs offer dynamic insights into disease states and enable real-time treatment stratification. Despite their potential, challenges such as scalable isolation, cargo heterogeneity, and regulatory ambiguity remain significant hurdles. Recent studies have reported novel pharmacological approaches targeting EV biogenesis, secretion, and uptake pathways, with emerging regulators showing promise as drug targets for modulating EV cargo. Future directions include the standardization of EV analytics, scalable biomanufacturing, and the classification of EV-based therapeutics under evolving regulatory frameworks. This review emphasizes the multifaceted roles of EVs and their transformative potential as therapeutic platforms and biomarker reservoirs in next-generation precision medicine.

Future Pharmacology doi: 10.3390/futurepharmacol5030047

Authors: Emmanuely de Oliveira Chaves dos Santos Pedro Luiz Rosalen Joice Graciani Josy Goldoni Lazarini Maria Ligia Rodrigues Macedo Diego Romário-Silva Mayara Aparecida Rocha Garcia Suzana Gonçalves Carvalho Paola da Mata Siqueira Mesut Ana Claudia Castelã Nascimento Prates Luis Octávio Regasini Marlus Chorilli Rafael Leonardo Xediek Consani Janaina de Cássia Orlandi Sardi

Background: Prosthetic candidiasis remains a significant clinical challenge, particularly due to the ability of Candida species to form resilient biofilms on dental prostheses, which limits the efficacy of conventional antifungal treatments. In this context, developing strategies to prevent or reduce biofilm formation is essential. Objectives This study investigates the antifungal and antibiofilm potential of a hydrogel formulation incorporating aminochalcone AM-35 as a candidate for the prevention and treatment of prosthetic candidiasis. Methods: To achieve this, experiments were conducted to determine the minimum inhibitory concentration (MIC) of aminochalcone AM-35 against Candida albicans and Candida tropicalis strains. AM-35 was incorporated into a hydrogel, which was subsequently tested on biofilms formed by these yeast species, both individually and in combination. The experimental disks were sterilized and incubated with C. albicans, C. tropicalis, and a mixture of both strains for 120 h to allow biofilm maturation. After contamination, the samples were divided into four experimental groups: Group 1: Hydrogel; Group 2: Hydrogel+AM-35; Group 3: Sodium hypochlorite (positive control); and Group 4: No treatment. The samples were then subjected to a sonication process to disaggregate the cells, which were then cultured on plates for colony-forming unit (CFU/mL) counts. The hydrogel’s toxicity was evaluated in vivo using the Galleria mellonella model. Results: The hydrogel formulation demonstrated significant antimicrobial activity, with an MIC of 7.8 μg/mL for C. albicans and 3.9 μg/mL for C. tropicalis. Treatment with the hydrogel at a concentration of 39 μg/mL resulted in a significant reduction in the formation and viability of mixed-species biofilms (p < 0.05). Additionally, the results indicated robust activity against C. albicans and C. tropicalis without presenting toxicity in the Galleria mellonella model. In conclusion, the hydrogel formulation exhibited effective antibiofilm activity, significantly reducing the microbial load. Conclusions: These findings open new possibilities for the development of alternative treatments for prosthetic candidiasis. The research suggests that the use of chalcone-based compounds may represent a promising approach in combating fungal infections in dentistry.

Future Pharmacology doi: 10.3390/futurepharmacol5030046

Authors: Brandon Fisher-Bautista Gabriela Fonseca-Camarillo Alfredo Cruz-Gregorio

There was an error in the original publication [...]

Future Pharmacology doi: 10.3390/futurepharmacol5030045

Authors: Ewa Zwierzyńska Bogusława Pietrzak

Background: Ethanol intake leads to cognitive deficits. Recent research demonstrated that a dysregulation of synaptic vesicle glycoprotein 2A (SV2A) expression seems to be linked to anxiety and memory disorders. Levetiracetam and brivaracetam are two antiseizure drugs that affect the SV2A protein. This study aimed to assess the impact of these drugs on associative learning and anxiety-like behaviors in ethanol-treated rats. Methods: Adult male Wistar rats (n = 64) were given brivaracetam or levetiracetam via i.g. for three weeks at doses of 300 mg/kg or 6 mg/kg, respectively. Ethanol was administered as a 20% solution twice a day, via i.g., at a morning dose of 1.5 g/kg b.w. and an afternoon dose of 3.5 g/kg b.w. Additionally, 5% ethanol was available ad libitum between 4:00 p.m. and 8:00 a.m. Associative learning was evaluated using the passive avoidance test during the alcohol administration period, as well as the contextual fear conditioning and cued fear conditioning tests during the withdrawal period. The level of anxiety was determined using the elevated plus maze test in withdrawal rats. Results: Ethanol consumption resulted in impaired associative memory, and its withdrawal was linked to increased anxiety levels. Levetiracetam enhanced memory performance in the passive avoidance test, but brivaracetam disturbed memory associated with unpleasant stimuli in the contextual fear conditioning. Additionally, withdrawal-induced disturbance of locomotor activity persisted, particularly in animals receiving levetiracetam in the elevated plus maze. Conclusions: Levetiracetam appears to provide certain beneficial effects, whereas brivaracetam may worsen memory disturbances in rats.

Future Pharmacology doi: 10.3390/futurepharmacol5030044

Authors: Edith Dube Grace Emily Okuthe

Bacterial diseases are a major constraint to aquaculture productivity, driving extensive antibiotic use and raising concerns over antimicrobial resistance, environmental contamination, and food safety. Curcumin, a polyphenolic compound from Curcuma longa, exhibits broad-spectrum antimicrobial and immunomodulatory activities but is limited by poor water solubility, instability, and low bioavailability. This review was conducted through a literature search of Scopus, PubMed, Web of Science, and Google Scholar using targeted keywords, including curcumin nanoparticles, antibacterial, aquatic pathogens, nanotechnology, synthesis, and disease control. Titles and abstracts were screened for relevance, followed by full-text evaluation of selected studies. Key findings were critically analyzed and incorporated into the review. Findings from the literature indicate that curcumin nanoparticles, synthesized via milling, anti-solvent precipitation, ionic gelation, emulsification, spray drying, and metal/polymer nanocomposite formation, exhibit enhanced antibacterial activity against aquatic pathogens, including Aeromonas hydrophila, Vibrio parahaemolyticus, Escherichia coli, and Staphylococcus aureus. Optimally engineered curcumin nanoparticles (<100 nm, being mostly spherical, highly negatively charged) can penetrate bacterial membranes, disrupt biofilms, lower minimum inhibitory concentrations, and improve in vivo fish survival. Practical applications include dietary supplementation to boost fish immunity and growth, water disinfection to reduce pathogen loads, immersion therapy for external infections, and antimicrobial coatings for aquaculture equipment and surfaces, resulting in reduced infections and outbreaks, reduced mortality, improved water quality, and decreased antibiotic dependence. In conclusion, curcumin nanoparticles and curcumin-based nanocomposites present a versatile, eco-friendly approach to sustainable aquaculture disease management. However, further field-scale validation, safety assessment, and cost-effective production methods are necessary to enable commercial adoption.

Future Pharmacology doi: 10.3390/futurepharmacol5030043

Authors: Damianos-Ioannis Zervanos Eleftheria Galatou Androulla N. Miliotou Nikoleta F. Theodoroula Nikolaos Grigoriadis Ioannis S. Vizirianakis

Background/Objectives: Advances in understanding immune checkpoint pathways and tumor immune biology have enabled the development of immune checkpoint inhibitors (ICIs), particularly targeting the PD-1/PD-L1 axis, which has transformed cancer immunotherapy. While they have shown remarkable success in various cancer types, including melanoma, non-small cell lung cancer, and gastrointestinal malignancies, variability in patient response, immune-related adverse events (irAEs), and resistance mechanisms remain significant. This review aims to evaluate clinical pharmacology, mechanisms of action, resistance pathways, and pharmacogenomic influences shaping interindividual responses to ICIs. Methods: This comprehensive review synthesizes current literature on FDA-approved ICIs, exploring their clinical use, underlying biological mechanisms, and emerging pharmacogenomic data. It also assesses key biomarkers such as tumor mutational burden (TMB), microsatellite instability (MSI), HLA diversity, and epigenetic factors influencing ICI efficacy and safety. Results: We outline key mechanisms contributing to ICI resistance, including T cell dysfunction, altered antigen presentation, and immunosuppressive tumor microenvironment components. Furthermore, we highlight promising pharmacogenomic findings, including single-nucleotide polymorphisms (SNPs) in PD-1/PD-L1 and immune-regulatory genes, offering predictive and prognostic utility. Variability in PD-L1 expression and the role of epigenetic modifications are also addressed as challenges in treatment optimization. Conclusions: Interindividual variability in ICI response underscores the need for biomarker-driven strategies. By integrating pharmacogenomic insights with clinical pharmacology, future approaches may support more personalized and effective use of ICIs. Combination therapies and novel modalities hold promise for overcoming resistance, enhancing therapeutic efficacy, and enabling precision oncology.

Future Pharmacology doi: 10.3390/futurepharmacol5030042

Authors: Giuseppe Marano Francesco Maria Lisci Gianluca Boggio Ester Maria Marzo Francesca Abate Greta Sfratta Gianandrea Traversi Osvaldo Mazza Roberto Pola Gabriele Sani Eleonora Gaetani Marianna Mazza

Background: Bipolar disorder (BD) is a chronic and disabling psychiatric condition characterized by recurring episodes of mania, hypomania, and depression. Despite the availability of mood stabilizers, antipsychotics, and antidepressants, long-term management remains challenging due to incomplete symptom control, adverse effects, and high relapse rates. Methods: This paper is a narrative review aimed at synthesizing emerging trends and future directions in the pharmacological treatment of BD. Results: Future pharmacotherapy for BD is likely to shift toward precision medicine, leveraging advances in genetics, biomarkers, and neuroimaging to guide personalized treatment strategies. Novel drug development will also target previously underexplored mechanisms, such as inflammation, mitochondrial dysfunction, circadian rhythm disturbances, and glutamatergic dysregulation. Physiological endophenotypes, such as immune-metabolic profiles, circadian rhythms, and stress reactivity, are emerging as promising translational tools for tailoring treatment and reducing associated somatic comorbidity and mortality. Recognition of the heterogeneous longitudinal trajectories of BD, including chronic mixed states, long depressive episodes, or intermittent manic phases, has underscored the value of clinical staging models to inform both pharmacological strategies and biomarker research. Disrupted circadian rhythms and associated chronotypes further support the development of individualized chronotherapeutic interventions. Emerging chronotherapeutic approaches based on individual biological rhythms, along with innovative monitoring strategies such as saliva-based lithium sensors, are reshaping the future landscape. Anti-inflammatory agents, neurosteroids, and compounds modulating oxidative stress are emerging as promising candidates. Additionally, medications targeting specific biological pathways implicated in bipolar pathophysiology, such as N-methyl-D-aspartate (NMDA) receptor modulators, phosphodiesterase inhibitors, and neuropeptides, are under investigation. Conclusions: Advances in pharmacogenomics will enable clinicians to predict individual responses and tolerability, minimizing trial-and-error prescribing. The future landscape may also incorporate digital therapeutics, combining pharmacotherapy with remote monitoring and data-driven adjustments. Ultimately, integrating innovative drug therapies with personalized approaches has the potential to enhance efficacy, reduce adverse effects, and improve long-term outcomes for individuals with bipolar disorder, ushering in a new era of precision psychiatry.

Future Pharmacology doi: 10.3390/futurepharmacol5030041

Authors: Adnan Memić Turdimuhammad Abdullah

Theranostic materials, which combine therapeutic and diagnostic capabilities, represent a promising advancement in cancer treatment by improving both the precision and personalization of therapies. Recently, metal peroxides (MePOs) have attracted significant interest from researchers for their potential use in both cancer diagnosis and therapy. This review provides an overview of recent developments in the application of MePOs for innovative cancer treatment strategies. The unique properties of MePOs, such as oxygen generation, are highlighted for their potential to improve therapeutic outcomes, especially in hypoxic tumor microenvironments. Initially, methods for MePO synthesis are briefly discussed, including hydrolyzation–precipitation, reversed-phase microemulsion, and sonochemical techniques, emphasizing the role of surfactants in regulating the particle size and enhancing bioactivity. Next, we discuss the main therapeutic approaches where MePOs have shown promise. These applications include chemotherapy, photodynamic therapy (PDT), immunotherapy, and radiation therapy. Overall, we focus on integrating MePOs into theranostic platforms to enhance cancer treatment and enable diagnostic imaging for improved clinical outcomes. Finally, we discuss potential future research directions that could lead to clinical translation and the development of advanced medicines.

Future Pharmacology doi: 10.3390/futurepharmacol5030040

Authors: Hironori Tsuchiya Maki Mizogami

Although it is more than a century since it was first marketed, acetaminophen remains one of the most popular analgesic agents. In addition, acetaminophen has recently been applied to multimodal analgesia in combination with non-steroidal anti-inflammatory drugs, and its consumption significantly increased during the pandemic of coronavirus disease 2019 as well as diclofenac and ibuprofen. However, the detailed mode of analgesic action of acetaminophen is still unclear. In the present study, we comprehensively discuss conventional, recognized, and postulated mechanisms of analgesic acetaminophen and highlight the current mechanistic concepts while comparing with diclofenac and ibuprofen. Acetaminophen inhibits cyclooxygenase with selectivity for cyclooxygenase-2, which is higher than that of ibuprofen but lower than that of diclofenac. In contrast to diclofenac and ibuprofen, however, anti-inflammatory effects of acetaminophen depend on the extracellular conditions of inflamed tissues. Since the discovery of cyclooxygenase-3 in the canine brain, acetaminophen had been hypothesized to inhibit such a cyclooxygenase-1 variant selectively. However, this hypothesis was abandoned because cyclooxygenase-3 was revealed not to be physiologically and clinically relevant to humans. Recent studies suggest that acetaminophen is deacetylated to 4-aminophenol in the liver and after crossing the blood–brain barrier, it is metabolically converted into N-(4-hydroxyphenyl)arachidonoylamide. This metabolite exhibits bioactivities by targeting transient receptor potential vanilloid 1 channel, cannabinoid receptor 1, Cav3.2 calcium channel, anandamide, and cyclooxygenase, mediating acetaminophen analgesia. These targets may be partly associated with diclofenac and ibuprofen. The perspective of acetaminophen as a prodrug will be crucial for a future strategy to develop analgesics with higher tolerability and activity.

Future Pharmacology doi: 10.3390/futurepharmacol5030039

Authors: Andrea Rodríguez-Lopez Eva González-Iglesias Jesús Novalbos Susana Almenara Francisco Abad-Santos

Background: Inflammatory bowel disease (IBD) is defined as recurrent inflammatory bowel disorders, the most common of which are Crohn’s disease (CD) and ulcerative colitis (UC). Tumor necrosis factor inhibitors (anti-TNFs), primarily adalimumab (ADA), infliximab (IFX), ustekinumab (UST), and vedolizumab (VLZ), are used to treat moderate-to-severe cases of IBD in patients who either do not tolerate or fail to respond to conventional therapies. However, about one-third of patients are primary non-responders to these treatments, and an additional 30% lose response over time. Several studies have investigated the role of genetic variability in explaining these differences in treatment response among patients. The aim of this study was to design an array of 60 single-nucleotide variants (SNVs) to validate the biomarkers described in the literature in a population of more than 400 IBD patients treated with biological drugs. Method: The primary focus of this study was the most recent reviews published in PubMed, with all relevant SNVs selected for the array design. Subsequently, studies presenting original data on the association between variants and the response to biological treatment were identified. Results: A total of 55.9% of SNVs have been studied in CD, 18.6% have been in UC, and 25.4% have been studied in both pathologies. A total of 44.1% of SNVs have been observed to influence the response to IFX, 16.9% influence the response to ADA, and 37.3% influence the response to both IFX and ADA; however, only one study (1.7%) reported an influence on the response to UST and none reported an influence on the response to VLZ. Conclusions: An array comprising 38 genes and 59 SNVs has been designed to be used to validate biomarkers associated with responses to biologic drug treatments in IBD.

Future Pharmacology doi: 10.3390/futurepharmacol5030038

Authors: Eduarda Ribeiro Nuno Vale

Cancer remains a leading cause of mortality worldwide, necessitating innovative therapeutic strategies. Drug repurposing offers a cost-effective approach to cancer treatment by identifying new anticancer applications for existing drugs. Terbutaline, a β2-adrenergic receptor agonist, and Milrinone, a phosphodiesterase-3 inhibitor, are traditionally used as positive inotropic agents but have shown potential anticancer effects. This review explores their mechanisms of action in cancer, focusing on their roles in modulating cyclic adenosine monophosphate (cAMP) levels, oxidative stress, and the tumor microenvironment. Terbutaline influences β2-adrenergic signaling, impacting cell proliferation, angiogenesis, and immune evasion. Milrinone, through PDE3 inhibition, elevates cAMP, promoting apoptosis and reducing tumor growth. Both agents exhibit anti-inflammatory and anti-angiogenic properties, suggesting their potential as adjuvant therapies in oncology. Despite promising preclinical data, clinical validation is required to confirm their efficacy and safety in cancer patients. This review highlights the therapeutic promise of repurposing Terbutaline and Milrinone, emphasizing the need for further research to optimize their application in cancer therapy.

Future Pharmacology doi: 10.3390/futurepharmacol5030037

Authors: Brandon Fisher-Bautista Gabriela Fonseca-Camarillo Alfredo Cruz-Gregorio

Recently, a number of new genes (NFE2L2, HFE, HMOX, HIF-1α, ALOX5, GPX4, PTGS2, and IL-6) have been recognized as playing a role in ferroptosis and genetic predisposition to cardiovascular diseases (CVDs). Identifying these novel genes may facilitate the discovery of therapeutic agents and improve the clinical evaluation of phenotypes and prognoses in CVD patients. In the future, it will be crucial to develop genetic markers that correlate with clinical outcomes for individuals with CVDs. This review highlights recent developments in ferroptosis research while interpreting how genetic factors may contribute to the pathogenesis of CVDs. Understanding this relationship could be invaluable for predicting disease progression in individual patients, informing suitable medical interventions, and facilitating early diagnosis and treatment. Furthermore, we examine the possible uses of these disorders in diagnosis and the various treatment strategies, along with the associated challenges and existing limitations.

Future Pharmacology doi: 10.3390/futurepharmacol5030036

Authors: Marlene Große Martin Burchardt Pedro Caetano Pinto

The success of checkpoint inhibitors in improving cancer patient survival has demonstrated the therapeutic potential of immunotherapies. This advancement has reshaped oncology treatment and driven interest in harnessing immune modulation for a wider range of diseases. However, developing drugs that modulate immune activity presents unique challenges. A major limitation in preclinical research is the inefficiency of testing human-specific immune targets in animal models, which often fail to translate to clinical outcomes. Additionally, conventional in vitro systems lack immune reactivity due to their static and monocellular nature, limiting their predictive value. Advanced in vitro models can bridge this gap by offering increasingly relevant human physiology for testing drug efficacy and safety, along with absorption, distribution, metabolism, and excretion (ADME). In particular, immune-competent spheroids, organoids, and organs-on-a-chip (OoC) have emerged as promising tools. Although still in their infancy, these microphysiological systems (MPSs) have demonstrated the feasibility of replicating immune responses ex vivo, providing a new avenue for studying immune-targeting drugs with higher translational potential. In this review, we explore recent advances in immune-competent organoid and OoC models, highlighting their capabilities and limitations. We provide a perspective on their applications for cancer drug testing, discussing how these systems could refine preclinical immuno-oncology research and accelerate the development of next-generation immunotherapies.

Future Pharmacology doi: 10.3390/futurepharmacol5030035

Authors: Milka Malešević Branko Jovčić

Biofilm-associated infections caused by Gram-negative bacteria, especially multidrug-resistant strains, frequently occur in intensive care units and represent a major therapeutic challenge. The economic burden of biofilm-associated infections is considerable, making the search for new treatment approaches a focal point for policymakers and scientific funding bodies. Biofilm formation is regulated by quorum sensing (QS), a population density-dependent communication mechanism between cells mediated by small diffusible signaling molecules. QS modulates various intracellular processes, and some features of QS are common to all Gram-negative bacteria. While there are differences in the QS regulatory networks of different Gram-negative bacterial species, a common feature of most Gram-negative bacteria is the ability of N-acylhomoserine lactones (AHL) as inducers to diffuse across the bacterial membrane and interact with receptors located either in the cytoplasm or on the inner membrane. Targeting QS by inhibiting the synthesis, transport, or perception of signaling molecules using small molecules, quorum quenching enzymes, antibodies, combinatorial therapies, or nanoparticles is a promising strategy to combat virulence. In-depth knowledge of biofilm biology, antibiotic susceptibility, and penetration mechanisms, as well as a deep understanding of anti-QS agents, will contribute to the development of antimicrobial therapies to combat biofilm infections. Advancing antimicrobial therapies against biofilm infections requires a deep understanding of biofilm biology, antibiotic susceptibility, penetration mechanisms, and anti-QS strategies. This can be achieved through in vivo and clinical studies, supported by state-of-the-art tools such as machine learning and artificial intelligence.

Future Pharmacology doi: 10.3390/futurepharmacol5030034

Authors: S. M. Sohag Sharmin Nur Toma Md. Al-Imran Imon Maiweilan Maihemuti Famim Ahmed Mst. Afsana Mimi Imran Mahmud Md. Mahmudul Hasan

The tumor microenvironment (TME) is crucial for the onset, development, and resistance to treatment of lung cancer. The tumor microenvironment consisting of a complex array of immune cells, fibroblasts, endothelial cells, extracellular matrix elements, and signaling molecules, facilitates tumor growth and spread while inhibiting the body’s antitumor immune response. In lung cancer, tumor-associated macrophages, cancer-associated fibroblasts, mast cells, and dendritic cells interact through cytokines, chemokines, growth factors, and matrix metalloproteinases to create an immunosuppressive and proangiogenic milieu. Hypoxic conditions within the TME further enhance cancer cell adaptability through hypoxia-inducible factors (HIFs), promoting epithelial–mesenchymal transition, immune evasion, and metastasis. Moreover, miRNAs have emerged as key regulators of gene expression within the TME, offering novel insights into tumor behavior and potential therapeutic targets. Targeting dynamic interactions within the TME, particularly through the modulation of immune responses, angiogenesis, and stromal remodeling, offers promising avenues for precision pharmacological approaches. This review covers the current understanding of the lung TME, highlighting its impact on cancer pathophysiology and treatment strategies. Understanding and therapeutically reprogramming the TME may pave the way for personalized and more effective interventions for lung cancer treatment.

Future Pharmacology doi: 10.3390/futurepharmacol5030033

Authors: Giovanni Gori Ferdinando De Negri Anna Fioravanti Francesca De Feo Catia Castiglioni Elisabetta Fini

Objective: This study evaluated the systemic bioavailability of L-thyroxine (L-T4) in healthy women following repeated cutaneous application of a new gel formulation containing L-T4 and escin. Plasma concentrations of free triiodothyronine (FT3), reverse triiodothyronine (rT3), and thyroid-stimulating hormone (TSH) were also assessed, along with local and systemic tolerability. Methods: Thirty healthy women participated in a single-group, open-label trial. L-thyroxine gel was applied at 20 g/day for the first 2 days and 10 g/day for the following 26 days (equivalent to 20 mg/day and 10 mg/day of L-T4, respectively). Blood samples were collected at Baseline, 5 and 24 h after the first application, and on Days 14, 28 (End of Treatment, EOT), and 42 (End of Study, EOS). Tolerability and safety were monitored throughout. Results: Plasma FT4 concentrations remained stable throughout the study, with no clinically significant changes from Baseline (1.13 ± 0.15 ng/dL) to EOT (1.11 ± 0.13 ng/dL). FT3 and TSH levels also remained within physiological ranges, with only a transient, non-clinically relevant decrease observed 5 h after the first application. No changes in rT3 concentrations were detected at any time point. No serious adverse events were reported. Conclusions: This study confirms that repeated application of L-thyroxine/escin gel over 28 days (total exposure of 300 g) does not affect systemic thyroid hormone levels and is well tolerated in healthy women. These findings support the hypothesis that intact skin acts as an effective barrier to transdermal L-T4 absorption.

Future Pharmacology doi: 10.3390/futurepharmacol5030032

Authors: Xolani H. Makhoba Sergii Krysenko

Bacterial natural ecological niches are characterized by variations in the availability of nutrients, resulting in a complex metabolism. Their impressive ability to adapt to changeable nutrient conditions is possible through the utilization of large amounts of substrates. Recent discoveries in bacterial metabolism have suggested the importance of polyamine metabolism in bacteria, particularly in those of the order Actinomycetales, in enabling them to survive in their natural habitats. This makes such enzymes promising targets to inhibit their growth. Since the polyamine metabolisms of soil bacteria of the genus Streptomyces and the human pathogenic Mycobacteria are surprisingly similar, target-based drug development in Streptomyces and Mycobacterium spp. is an alternative approach to the classical search for antibiotics. The recent development of drugs to treat epidemic diseases like tuberculosis (TB) has gained attention due to the occurrence of multidrug-resistant strains. In addition, drug repurposing plays a crucial role in the treatment of various complex diseases, such as malaria. With that notion, the treatment of TB could also benefit from this approach. For example, molecular chaperones, proteins that help other proteins to fold properly, are found in almost all living organisms, including the causative agents of TB. Therefore, targeting these molecules could help in the treatment of TB. We aim to summarize our knowledge of the nitrogen and carbon metabolism of the two closely related actinobacterial genera, Streptomyces and Mycobacterium, and of the identification of new potential drug targets.

Future Pharmacology doi: 10.3390/futurepharmacol5030031

Authors: Mizuho Sumitani Takamichi Kogure Hiroaki Abe Rikuhei Tsuchida Reo Inoue Masahiko Sumitani

Background and Aim: Neuropathic pain leads to a significant deterioration in health-related quality of life (HRQOL). Treating neuromusculoskeletal pain is especially important to prevent and improve physical frailty and the locomotive syndrome. Varied pharmacotherapies could be applicable for neuropathic pain patients, but evidence has been limited for a wide range of neuropathic pain conditions with different etiologies. The aim of this review was to highlight mirogabalin, a novel calcium channel α2δ ligand which was first approved in Japan, and which is effective for various types of neuropathic pain diseases. Methods: We conducted a narrative review of the recent evidence that mirogabalin has significant analgesic potency for varied types of neuropathic pain conditions. Futher, this review highlighted specific advantages over other calcium channel ligands. Results: Analgesic potency of mirogabalin could cover peripheral neuropathic pain conditions including post-herpetic neuralgia, diabetic peripheral neuropathy, cauda equina syndrome caused by lumbar spinal stenosis, radiculopathy caused by cervical spondylosis, and also central neuropathic pain conditions like spinal cord injury. Mirogabalin consistently demonstrated daytime sleepiness and dizziness as adverse effects, but most of these were mild. Conclusions: Mirogabalin is recommended as the first-line drug against most molecular mechanisms that cause neuropathic pain regardless of whether they have a peripheral or central origin. Mirogabalin demonstrates relatively less daytime sleepiness, making it age-friendly in the current global situation where population aging is accelerated. Considering the epidemic of ‘opiophobia’ in Japan and other countries, pharmacotherapy using mirogabalin could treat neuropathic pain associated with cancer and its treatment (e.g., chemotherapy-induced peripheral neuropathy), as well as non-cancer etiologies worldwide.

Future Pharmacology doi: 10.3390/futurepharmacol5020030

Authors: Isabella M. Sturgeon Youssef M. Roman

Osteoarthritis (OA) is a multifactorial, degenerative joint disease that significantly impairs mobility and quality of life, especially among older adults. The growing aging population and increasing obesity rates are expected to increase the incidence and prevalence of OA. In the absence of Disease-Modifying Antirheumatic Drugs (DMARDs) for OA, current treatment strategies largely focus on symptom relief rather than disease modification. These symptomatic treatments often fail to account for the substantial inter-individual variability in drug response. Pharmacogenomics (PGx), the study of how genetic variation influences drug response, offers a promising approach to personalize OA therapy. This review explores the clinical and pharmacogenomic considerations of commonly used OA medications—acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), duloxetine, and tramadol—focusing on gene–drug interactions that influence efficacy, safety, and metabolism. Evidence-based recommendations from the Clinical Pharmacogenetics Implementation Consortium guidelines are discussed, where applicable, to highlight actionable genetic variants in very important pharmacogenes such as CYP2D6, CYP2C9, and other important drug-metabolizing encoding genes such as CYP2E1 and UGT1A6. While PGx data are not currently embedded in OA clinical treatment guidelines, their integration into clinical practice may enhance therapeutic outcomes and minimize adverse drug events. This review underscores the potential of PGx as a clinical tool in OA pain management, paving the way toward truly personalized medicine.

Future Pharmacology doi: 10.3390/futurepharmacol5020029

Authors: Xue Wu Yuxin Guo Congjie Dai Chao Zhao

Algal polysaccharides are a kind of bioactive compound with diverse pharmacological applications, yet their structure–activity relationships and therapeutic potential in chronic disease management remain systematically underexplored. This review comprehensively analyzes the structural characteristics of brown, red, and green algal polysaccharides, revealing how specific structural features—such as glycosidic linkage patterns and sulfate group positioning—dictate their biological activities. We also demonstrated their multifaceted roles in diabetes, cancer, and cardiovascular diseases through distinct mechanisms, including gut microbiota modulation via short-chain fatty acid production, antioxidant enzyme activation, and targeted inhibition of pathological signaling pathways like mTOR and JAK-STAT3. The work further evaluates extraction methodologies, highlighting the advantages of emerging techniques such as enzyme-assisted and ultrasonic extraction for preserving bioactive integrity. By integrating fundamental research with practical applications in functional foods, this synthesis provides critical insights for harnessing algal polysaccharides in precision nutrition and sustainable biomedicine, while identifying key challenges in standardization and environmental safety that warrant future investigation.

Future Pharmacology doi: 10.3390/futurepharmacol5020028

Authors: Mounia Chroho Latifa Bouissane Christian Bailly

Background/Objectives: The plant species Erophaca baetica (L.) Boiss. (synonym: Astragalus lusitanicus Lam.) is found essentially around the Mediterranean basin, with Morocco as its ancestral territory. The foliage of E. baetica is toxic to small ruminants, and for this reason the plant is often eliminated by farmers, despite its ecological and medicinal potential. The phytochemicals at the origin of the toxicity of E. baetica are not precisely known, but several potentially toxic products have been identified. In particular, aliphatic nitro compounds are present in the aerial parts of the plant, such as 3-nitro-propionic acid (NPA) and its precursor 3-nitro-propanol (NPOH) which are most likely at the origin of the plant toxicity. Results: The present review provides a detailed analysis of the nitrotoxins isolated from E. baetica and their mechanism of action. The covalent targeting of metabolic enzymes such as isocitrate lyase and succinate dehydrogenase by NPA is discussed. The mitochondrial chain blocker NPA is most likely responsible for the brain toxicity of E. baetica, but the presence of other potentially toxic chemicals—such as lusitoxamine and lusitoxamide—is also discussed. Conclusions: This review shed light on the widespread but little-known Mediterranean plant E. baetica and the phytochemicals responsible for the plant’s toxicity.

Future Pharmacology doi: 10.3390/futurepharmacol5020027

Authors: Daniel P. Radin Rok Cerne Jodi L. Smith Jeffrey M. Witkin Arnold Lippa

Background: Ampakines are a family of molecules that enhance the functioning of AMPA-glutamate receptors (AMPAR). High-impact ampakines completely offset receptor desensitization and enhance agonist binding affinity, while low-impact ampakines only modestly affect receptor desensitization and do not alter agonist binding affinity. Nonetheless, little is known about AMPAR recovery following ampakine treatment. Methods: Herein, we study the effects of ampakines on AMPAR recovery and the interaction between high- and low-impact ampakines. Results: The high-impact ampakine CX729 did not induce any current in the absence of glutamate, but it dramatically increased glutamate-induced steady-state inward currents. Recoveries from the enhancement were significantly slower than those for the low-impact ampakine CX516, as was also seen on miniature synaptic currents. Electrophysiological interaction studies suggest that high- and low-impact ampakines may have different binding sites. We further investigated the induction of the potentiated response by measuring glutamate-induced responses after transient applications of CX729 or CX729 plus glutamate. Under both circumstances, subsequent application of glutamate yielded comparably potentiated responses. Furthermore, the recovery time was not different if saline was substituted for glutamate during the recovery period. Conclusions: These observations show that AMPAR potentiation by CX729 does not require the simultaneous presence of glutamate, nor is the slow reversal of the effects of the ampakine altered by subsequent receptor activation. Hence, the slow recovery from the effects of these select ampakines on the AMPAR may be the result of slow dissociation kinetics. We posit that the slow recovery of AMPAR from high-impact ampakines may contribute to the seizurogenic effects of this drug class and that high-impact ampakines that allow for more rapid AMPAR recovery may be safer and more clinically viable candidates.

Future Pharmacology doi: 10.3390/futurepharmacol5020026

Authors: Bradley S. Wahle Peter Pushko Katie Albanese Dylan M. Johnson Irina Tretyakova Igor S. Lukashevich Thomas Rudge

(1) Background: Mopeia–Lassa reassortant ML29 virus is an investigational, reassortant virus vaccine for the prevention of Lassa fever caused by Lassa virus (LASV). (2) Methods: The vaccine virus ML29-SF was prepared in Vero cells using a serum-free culture medium under Good Manufacturing Practice. A 2-week repeat dose toxicity study was performed in guinea pigs under Good Laboratory Practice (GLP) regulations to assess the local and systemic toxicological effects. (3) Results: Following an intramuscular (IM) or subcutaneous (SC) injection of 104 PFU of ML29-SF LASV vaccine at the start of the study, with a second dose 15 days later, no toxicological response attributable to the vaccine was observed. Vaccine-related effects were not observed in any in-life or post-mortem parameter evaluated, including clinical observations, injection site observations, body temperature, body weight, food consumption, ophthalmology, immunology, hematology, clinical chemistry, gross anatomical pathology, organ weights, and histopathology. An immunogenic response, as measured by the elicitation of IgG antibodies against major LASV immunogens, nucleocapsid and glycoprotein precursor, was observed in all vaccine-treated animals prior to the booster dose (Study Day 15) which endured through the end of the study (Study Day 42). There was no evidence of viral shedding in any vaccinated animal. (4) Conclusions: Overall, this single-dose vaccine was locally and systemically well tolerated even after a two-dose repeat administration, confirming the high level of safety of ML29-SF vaccination and supporting the future evaluation of this LASV vaccine, including in clinical trials.

Future Pharmacology doi: 10.3390/futurepharmacol5020025

Authors: Dishary Sharmin Kamal P. Pandey Lalit K. Golani Sepideh Rezvanian Md Yeunus Mian Janet L. Fisher Arnold Lippa James M. Cook Daniel P. Radin Jodi L. Smith Jeffrey M. Witkin Hana Shafique Rok Cerne

Background: The GABAA receptor (GABAAR) potentiator, KRM-II-81, is being developed as a novel antiseizure medication with reduced potential for sedation, tolerance development, and abuse liability. Although KRM-II-81 has been shown to provide antiseizure protection against a broad array of seizure induction paradigms, seizures induced by viral vectors have not been previously studied. GABAARs with specific α subunit compositions have been studied in relation to the reduced side-effect liability of KRM-II-81; however, the role of β subunit composition has yet to be determined. Methods: In the present study, KRM-II-81 was studied against handling-induced seizures in Theiler’s murine encephalomyelitis virus (TMEV)-infected mice. Results: An intracerebral infusion of TMEV on day 0 increased the cumulative seizure burden in mice when assessed for handling-induced seizures on days 3–7. KRM-II-81 (15 mg/kg, p.o., bid) nearly completely suppressed seizures in TMEV-infected mice over the course of daily treatments. The number of the most severe seizures (stage 5, tonic/clonic seizures) in the mice was suppressed to zero by KRM-II-81. Although the selectivity of KRM-II-81 for GABAAR α2/3 receptor subtypes might imbue KRM-II-81 with a reduced side-effect liability, other mechanisms are possible, and the potentiation of β1-containing GABAARs has been implicated in inducing sedation. The role of β subunit composition has yet to be determined for KRM-II-81. In electrophysiological studies with cells transfected with αxβ1γ2 or αxβ3γ2, KRM-II-81 preferentially potentiated GABA responses in cells containing β3 subunits in α2/3-containing GABAARs. Conclusions: The present findings confirm the robust antiseizure activity of KRM-II-81, now extended to a virus-induction model, and suggest a possible role of reduced β1-potentiation in the low side-effect profile of KRM-II-81.

Future Pharmacology doi: 10.3390/futurepharmacol5020024

Authors: Antonio Ruiz-Gonzalez

The pharmaceutical industry faces mounting pressure to reduce its environmental impact while maintaining innovation in drug development. Artificial intelligence (AI) has emerged as a transformative tool across healthcare and drug discovery, yet its potential to drive sustainability by improving molecular design remains underexplored. This review critically examines the applications of AI in molecular design that can support in advancing greener pharmaceutical practices across the entire drug life cycle—from design and synthesis to waste management and solvent optimisation. We explore how AI-driven models are being used to personalise dosing, reduce pharmaceutical waste, and design biodegradable drugs with enhanced environmental compatibility. Significant advances have also been made in the predictive modelling of pharmacokinetics, drug–polymer interactions, and polymer biodegradability. AI’s role in the synthesis of active pharmaceutical compounds, including catalysts, enzymes, solvents, and synthesis pathways, is also examined. We highlight recent breakthroughs in protein engineering, biocatalyst stability, and heterogeneous catalyst screening using generative and language models. This review also explores opportunities and limitations in the field. Despite progress, several limitations constrain impact. Many AI models are trained on small or inconsistent datasets or rely on computationally intensive inputs that limit scalability. Moreover, a lack of standardised performance metrics and life cycle assessments prevents the robust evaluation of AI’s true environmental benefits. In particular, the environmental impact of AI-driven molecules and synthesis pathways remains poorly quantified due to limited data on emissions, waste, and energy usage at the compound level. Finally, a summary of challenges and future directions in the field is provided.

Future Pharmacology doi: 10.3390/futurepharmacol5020023

Authors: Richard H. Lima Yan R. Robles Isabelle M. Oliva Anna L. O. Santos Júlia G. Teixeira Maria A. S. C. Chellegatti Niege A. J. C. Furtado Carlos H. G. Martins Viviani Nardini Antônio E. M. Crotti

Background/Objectives: Dental caries and candidiasis are major health problems worldwide. Dental caries is caused by cariogenic bacteria, especially those belonging to the Streptococcus genus, whereas candidiasis is caused by Candida species. In this study, the antimicrobial activity of a series of synthetic N-methyl-4-piperidone-derived monoketone curcuminoids (MKCs) against Candida albicans, C. krusei, and a representative panel of cariogenic bacteria was assessed. Methods: Fifteen MKCs were synthesized using an environmentally friendly base-catalyzed Claisen–Schmidt condensation between an aromatic aldehyde (R-PhCHO) and N-methyl-4-piperidone ethanol using NaOH as the catalyst. These compounds were evaluated for their antibacterial activity against a representative panel of cariogenic bacteria, along with their antifungal activity against Candida krusei and C. albicans. The antimicrobial activity was determined based on the Minimum Inhibitory Concentration (MIC) values. Results: Most of the compounds were obtained in about 2 h in yields ranging from 40 to 70%. None of the compounds displayed antifungal activity, even at 100 μg/mL, the highest tested concentration. Similarly, none of the compounds were active against Enterococcus faecalis. On the other hand, compounds 1 (R = H), 10 (R = 3,4,5-OMe), and 13 (R = 3-F) displayed moderate activity against Streptococcus mutans (13), S. salivarus (1), L. paracasei (1 and 10), S. mitis (1, 10, and 13), S. sanguinis (1, 10, and 13), and S. sobrinus (13), with MIC values of 250 μg/mL and 500 μg/mL. The presence of the N-methyl-4-piperidone ring was found to boost the antibacterial activity as compared to the corresponding acetone-derived MKCs. Moreover, the antibacterial activity of compounds 10 and 13 was associated with the presence and position of the fluor atom and the methoxy groups at the aromatic ring. Conclusions: This study contributed to a better understanding of the antimicrobial activity of MKCs, whose data in the literature are still scarce.

Future Pharmacology doi: 10.3390/futurepharmacol5020022

Authors: Fernanda Barros de Miranda Lucia Emanueli Schimith Dennis Guilherme da Costa Silva Camila de Oliveira Vian Diele Bopsin da Luz Rafael Felipe de Aguiar Crístian Yan Montana da Rocha Anna Maria Siebel Jean Pierre Oses Mariana Appel Hort

Background/Objectives: Epilepsy is a common neurological condition characterized by the occurrence of a seizure. It affects around 50 million individuals worldwide, and despite the large quantity of anti-seizure medications available, 30% of epileptic patients still suffer from seizures. Therefore, it is necessary to find new therapeutic options. Interestingly, polydatin has shown promising effects on epilepsy treatment due to its antioxidant and anti-inflammatory properties. Thus, this study aimed to evaluate the effects of polydatin (200, 300, and 400 µM) on a pentylenetetrazol (PTZ)-induced seizure model in wild-type zebrafish (Danio rerio) larvae. Methods: Seizure-like behavior, cell death, reactive species (RS) production, and lipid peroxidation were analyzed. Results: Pre-treatment with polydatin at 200 and 300 µM did not have a significant impact on seizure occurrence and the behavior of animals exposed to PTZ. Diazepam decreased seizure occurrence and increased the latency to achieve each seizure stage. Exposure to PTZ increased the swimming activity, and this effect was suppressed by diazepam but not by polydatin. PTZ exposure increased the RS production, which was significantly attenuated by polydatin at 400 µM and DMSO. Cell death and lipid peroxidation were not changed when compared to the experimental groups. Conclusions: Only the experimental positive control (diazepam) showed anti-seizure effects. Therefore, we failed to observe any anti-seizure effects of polydatin using a zebrafish experimental model. However, we cannot rule out its effects in other experimental models and different treatment protocols.

Future Pharmacology doi: 10.3390/futurepharmacol5020021

Authors: Eugene Jamot Ndebia Gabriel Tchuente Kamsu

Background/Objectives: Limitations of conventional treatments for esophageal cancer, which include poor solubility, drug resistance, and undesirable side effects, make it imperative to explore new therapeutic approaches to slow the progression of this disease. This study aims to assess the potential of terpene compounds as anti-cancer agents for esophageal squamous cell carcinoma (ESCC). Methods: This work was carried out following the PRISMA 2020 guidelines to ensure rigorous methodology. Results: A systematic analysis of 34 compounds revealed various mechanisms of action, such as induction of oxidative stress and modulation of apoptotic pathways. The results also show that several compounds, including (1Z,3R,4S,5E,7Z)-1-bromo-3,4,8-trichloro-7-(dichloromethyl)-3-methylocta-1,5,7-triene, dehydrocostus lactone, (3R,4S)-3,4,6,7-tetrachloro-3,7-dimethyl-octene-1-ene, acetyl-macrocalin B, jesridonin, longikaurin A, sphaerococcenol A, DS2, rabdocoestin B, ingenol C, ingenol-3,20-dibenzonate, JDA-202, xerophilusin B, betulinic acid, euphol, and (20S) ginsenoside Rh2, with IC50s below 10 µM, show promising efficacy both in vitro and in vivo, sometimes surpassing certain conventional treatments. Conclusions: However, despite these encouraging prospects, limitations remain, notably a lack of in vivo data and clearly defined mechanisms of action for certain compounds. These challenges require further research to validate their safety and efficacy, facilitating their development as viable therapeutic options for ESCC.