Search Results (1,195)

Ershiwei Roudoukou Wan, a traditional Tibetan medicine, is known for its sedative and tranquilizing properties. Although considerable progress has been made in characterizing its chemical constituents and pharmacological mechanisms, a comprehensive and systematic evaluation remains limited. This study integrates bibliometric analysis with a systematic literature review to summarize current research trends, clarify the chemical basis, and assess pharmacological evidence, thereby supporting rational clinical use. Publications on Ershiwei Roudoukou Wan and its component herbs were retrieved from the Web of Science database. After screening, 7869 articles were analyzed using CiteSpace to generate knowledge maps. Research hotspots centered on pharmacological activities, chemical composition, and methodological advances. Clinically, the formula has shown efficacy in conditions including heart–gallbladder syndrome, “Ninglong disease” and gynecological disorders. Analytical methods for several marker compounds have been established, and individual herbs contain diverse bioactive constituents—predominantly terpenoids, flavonoids, polysaccharides, and tannins. Pharmacological investigations highlight cardiovascular protection, immunomodulatory and anti-inflammatory effects, anticancer activity, and neuroprotection. Despite these advances, experimental studies on the complete formulation and large-scale clinical trials remain scarce. Future research should leverage advanced analytical and pharmacological techniques to elucidate the integrated mechanisms of action and promote the modernization of Tibetan medicine. Full article

Background and Objectives: The objective of this study is to ascertain the predictive criteria for steroid dependence and relapse in patients diagnosed with ulcerative colitis. Additionally, the study aims to provide data that will enable earlier transition to second-line treatment when necessary. Materials and Methods: The study included 62 patients diagnosed with ulcerative colitis between 2018 and 2023, who were followed up at the Department of Pediatric Gastroenterology, Hepatology, and Nutrition at the University of Health Sciences, Izmir Dr. Behçet Uz Children’s Hospital. Demographic data included age and gender at diagnosis, BMI, weight-for-age, and height-for-age. Laboratory parameters recorded were complete blood count, total protein, albumin, CRP, ESR, IgG, IgM, IgA, IgG subclasses, vitamin D, B12, folic acid, and ferritin levels. Results: The study included 62 patients. Thirty-two patients (51.6%) were female. In the univariate regression analysis, there was an inverse correlation between IgM levels and relapse and steroid dependence (p < 0.01, p = 0.03, respectively). Additionally, a relationship was identified between steroid dependence and hemoglobin, hematocrit, white blood cell count, neutrophil count, platelet count, and albumin levels (p = 0.01, p < 0.01, p < 0.01, p = 0.01, p < 0.01, p = 0.03, respectively). There was a significant relationship between MMES and steroid dependence (p < 0.01). MMES was found to be significant in predicting steroid dependence in patients with pancolitis (AUC: 0.75, 95% CI: [0.60–0.90], p = 0.01). Conclusions: We conclude, as for Crohn’s disease, an algorithm or a specific scoring system for ulcerative colitis is needed for the use of anti-TNF drugs as first-line treatment in pediatric ulcerative colitis. The initial severity of the disease appears to be the most important risk factor in terms of steroid dependence. Based on our study and the literature data, a scoring system incorporating parameters such as hemoglobin, hematocrit, WBC, albumin, platelet, and IgM levels, disease involvement type, initial PUCAI score, and MMES would be prudent to adopt. Full article

Peripheral nerve injuries often recover poorly. Hyaluronic acid (HA) biomaterials, with regenerative and anti-fibrotic properties, may augment repair. We performed a PRISMA-guided systematic review of PubMed, Scopus, Web of Science, and Embase (January 2000–December 2023), capturing in vitro, in vivo, and clinical investigations of HA in peripheral nerve repair; data on study context, interventions, and outcomes were extracted. Screening and extraction were performed in duplicate. Forty-eight studies met inclusion criteria. Across in vitro and in vivo models, HA-based biomaterials consistently reduced perineural fibrosis, enhanced axonal regeneration, and improved SFI, CMAP, and NCV compared with conventional repair. Several HA hydrogels and composite conduits achieved functional outcomes approaching autografts, particularly when combined with exosomes, neurotrophic factors, or mechanobiologically tuned scaffolds. Early clinical studies demonstrated safety but remain limited by size and short follow-up. Overall, HA-containing biomaterials appear anti-fibrotic, neuroprotective, and pro-regenerative, supporting their promise as adjuncts for peripheral nerve reconstruction. For this to translate into clinical practice, future work should standardize formulations and dosing, employ rigorous, clinically relevant animal models with long-term endpoints, and advance well-powered, controlled trials to test effectiveness and durability in patients. Clinically, HA platforms show promise as anti-adhesion barriers after neurolysis and as biofunctional fillers/coatings for nerve conduits, but standardized formulations and adequately powered trials are needed to define indications and dosing. Full article

Background/Objectives: Aromatase inhibitors (AIs)—specifically, letrozole, anastrozole and exemestane—represent the current gold standard for patients with estrogen-receptor-positive breast cancer (ER + BC). This narrative review highlights potential interactions between nutrients and AIs, elucidating their molecular mechanisms involved. Methods: A comprehensive search was conducted across the PubMed, ScienceDirect, Google Scholar, and Scopus databases to identify scientific publications and elucidate recommended dietary regimes for ER + BC patients treated with AIs. Results: Certain bioactive substances found in licorice, rosemary, juniper, cannabis, and citrus fruits exhibit intrinsic aromatase-inhibiting effects. Additionally, other nutrients and compounds—including honey, ginger, turmeric, sweet potatoes, pomegranates, bitter melon, dark sweet cherries, resveratrol, and vitamins D and C—contribute to treatment outcomes through their demonstrated antiproliferative properties. Certain natural compounds, such as soy, cow’s milk, sesame seeds, and sesame oil, require caution due to their potential estrogen-like effects which could diminish the anti-estrogenic efficacy of AIs. Conclusions: These considerations hold significant weight in this context, as the management of oncological patients—particularly women with ER + BC—requires an integrated perspective. Antineoplastic treatment must be supported by appropriate nutrition to enhance antitumor efficacy and improve the patient’s quality of life. The data presented herein are derived from in vitro, in silico, and animal model studies and await validation in large patient cohorts. Nevertheless, these findings pave the way for future research to elucidate these molecular phenomena in humans and to establish clinically significant conclusions for ER + BC patients. Full article

Vanillin (4-hydroxy-3-methoxybenzaldehyde) is widely recognized for its aromatic flavor and established pharmacological properties, including antioxidant, antimicrobial, anti-inflammatory, and anticancer effects. While these biological activities underpin its therapeutic potential, recent advances have expanded the application of vanillin into the field of biomaterials. In particular, vanillin’s unique chemical structure enables its use as a multifunctional building block for the development of innovative hydrogels with dynamic covalent bonding, injectability, and self-healing capabilities. Vanillin-based hydrogels have demonstrated promising applications in wound healing, drug delivery, tissue engineering, and antimicrobial platforms, combining structural support with intrinsic bioactivity. These hydrogels benefit from vanillin’s biocompatibility and functional versatility, enhancing mechanical properties and therapeutic efficacy. This review provides an overview of vanillin’s pharmacological effects, with a primary focus on the synthesis, properties, and biomedical applications of vanillin-derived hydrogels. By highlighting recent material innovations and their translational potential, we aim to position vanillin as a valuable natural compound bridging bioactivity and biomaterial science for future clinical and therapeutic advancements. Full article

Vascular endothelium balances antithrombotic and anti-inflammatory activity to control blood vessel tone under physiological conditions. However, endothelial dysfunction impairs these processes, causing a state that promotes clotting and inflammation. Eicosanoids are a major class of bioactive lipid mediators crucial for modulating endothelial and platelet function. Research has highlighted the roles of eicosanoids in vascular diseases, showing pro-inflammatory, prothrombotic, and protective activities. Specifically, prostaglandin E₂ (PGE₂) is crucial because of its major role in atherosclerosis development and progression, acting via EP receptors involved in forming, maintaining, and stabilizing atherosclerotic lesions, thereby making PGE₂-EP signalling a specific target for treating cardiovascular diseases. This review will explore the evidence on eicosanoids and the role of their receptor modulation in platelet and vascular dysfunction in atherothrombosis. The studies included in this scoping review were retrieved from PubMed, Web of Science, Cochrane, and Scopus in accordance with the Preferred Reporting Items for Scoping Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) statement and the Population Intervention Comparison Outcome Population (PICO) framework. Eight clinical studies were found, which highlighted the crucial role of eicosanoids, like prostaglandins and their receptors, in endothelial and platelet dysfunction, and also how pharmacological mechanisms affect atherothrombosis. A new therapeutic approach for cardiovascular dysfunction is indicated by the recent findings, specifically against atherothrombosis, focusing on eicosanoids, their receptors, and processes like oxidative stress. Despite this evidence, there is a lack of comprehensive research results from scientific databases; therefore, further in vitro, in vivo, and clinical studies should be promoted to validate the preliminary results. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) involves dysregulated mitochondrial dynamics. This review systematically integrates the specific mechanisms by which exercise modulates mitochondrial fusion, fission, and mass control in the liver within MASLD and metabolic dysfunction-associated steatohepatitis (MASH) models. Methods: A comprehensive search of PubMed and Web of Science identified 11 animal studies investigating exercise and mitochondrial dynamics markers. Results: MASLD generally exhibited a “pro-fission” phenotype. Exercise, particularly moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT), reversed these alterations via “pro-fusion, anti-fission” effects and restored biogenesis and mitophagy. Crucially, effects appeared to be “modality-specific” and “intensity-dependent.” Current evidence suggests that reversing severe fission and restoring inner-membrane may require a specific “intensity threshold,” with voluntary wheel running showing limited efficacy in steatohepatitis. Notably, resistance exercise seemed to display a distinct profile, effectively curbing fission but diverging in fusion/biogenesis regulation. Conclusions: Synthesizing preclinical evidence, this review suggests that exercise ameliorates hepatic mitochondrial dysregulation in MASLD and appears to exhibit characteristics of “modality specificity” and “intensity dependence.” Specifically, an “intensity threshold” may be critical for profound structural remodeling, while resistance exercise exhibits a distinct regulatory profile. Future long-term clinical trials are warranted to validate these animal-derived findings and develop stage-specific “precision exercise prescriptions” for patients. Full article

Background/Objectives: Advanced drug delivery systems (DDSs) are essential for targeted delivery, controlled release, and reduced systemic toxicity, but their clinical adoption is limited by biological barriers, manufacturing complexities, and cost. The aim of this systematic review is to critically evaluate the quantitative relationships between platform design, overcoming biological barriers, and clinical translation outcomes for DDS developed between 2016 and 2025. Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science (January 2016–April 2025) in accordance with the PRISMA 2020 guidelines. Included studies focused on experimental or clinical data for nanocarrier platforms (liposomes, lipid nanoparticles, polymer systems, biomimetic carriers, extracellular vesicles). Data on platform characteristics, interactions with barriers, pharmacokinetics, manufacturing, and clinical outcomes were extracted and synthesized in narrative form due to the significant methodological heterogeneity. Results: An analysis of 77 included studies confirms that successful clinical translation depends on matching the physicochemical properties of the carrier (size, surface chemistry, material) to specific biological barriers. Liposomes and lipid nanoparticles (LNPs) remain the most clinically validated platforms, exploiting the EPR effect and liver tropism, respectively. Key engineering solutions include stealth coatings, ligand-mediated targeting, and stimulus-responsive materials to overcome barriers such as mononuclear phagocyte system clearance, the blood–brain barrier, and mucosal barriers. Microfluidic and continuous manufacturing processes enable reproducibility, but scalability, cost, and immunogenicity (e.g., anti-PEG responses) remain key translational challenges. Engineered extracellular vesicles, biomimetic carriers, and 3D/4D-printed systems combined with AI-driven design demonstrate the potential for personalized, adaptive delivery. Conclusions: Cutting-edge DDSs have validated their clinical value, but realizing their full potential requires a holistic, patient-centered design approach integrating barrier-specific engineering, scalable manufacturing, and rigorous safety assessment from the earliest stages of development. Further progress will depend on standardizing methods for new platforms (e.g., extracellular vesicles), implementing digital and AI tools, and ensuring translational feasibility as a fundamental principle. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most prevalent chronic liver disorder among children and adolescents, mirroring the rise in pediatric obesity. The Mediterranean diet (MD) has demonstrated anti-inflammatory, antioxidant, and beneficial effects on different health outcomes across different life stages. The MD’s effect has been explored in adult MASLD, but there is limited information on the pediatric population. However, evidence on pediatric MASLD should be explored given its rising prevalence. Therefore, the aim of this review is to collect human studies assessing the effect of MD interventions on pediatric MASLD, focusing on key pathophysiological mechanisms. It also examines other interventions, including specific energy/macronutrient prescriptions, nutrition education or counseling, and physical activity components. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted using terms related to the Mediterranean diet, nutrition education, physical activity, pediatrics, and MASLD/NAFLD. Pre-determined inclusion and exclusion criteria were used to collect eligible studies to be included in the review. Study quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Screening, data extraction, and appraisal were performed independently, with discrepancies resolved through discussion, and the findings were synthesized qualitatively. Results: This review synthesizes findings from eight human studies evaluating the impact of the MD, alone or integrated with structured exercise and nutrition education, on pediatric MASLD. Interventions consistently demonstrated reductions in hepatic steatosis, liver stiffness, and fibrosis markers, alongside improvements in inflammatory cytokines, oxidative stress defenses, and liver enzymes. The MD also enhanced lipid and glycemic profiles, lowering triglycerides, total cholesterol, and insulin resistance indices. Nutrition education and family-centered approaches improved adherence, while structured, enjoyable physical activity enhanced outcomes and long-term sustainability. Conclusions: Collectively, the MD, particularly when combined with exercise and tailored education, offers a safe, effective, and comprehensive lifestyle intervention for pediatric MASLD. Nonetheless, current evidence remains limited by small sample sizes, heterogeneity in protocols, and short follow-ups. Larger, multicenter randomized trials with standardized designs are needed to establish best practices and long-term efficacy. Full article

Alopecia areata (AA) is an autoimmune-mediated nonscarring alopecia with limited therapeutic options and frequent relapses. Exosomes, nanosized extracellular vesicles secreted by various cell types, have recently emerged as potential regenerative and immunomodulatory therapies. The aim of the study is to review the clinical and preclinical evidence regarding the efficacy and safety of EV-based therapies for alopecia areata. a systematic search of PubMed, Embase, Web of Science, and Cochrane Library was performed from 2020 to 2 October 2025. Inclusion criteria were original studies (clinical, preclinical, in vivo, in vitro) investigating exosome-derived interventions for AA. Outcomes of interest were hair regrowth, immune modulation, follicular regeneration, and safety. A total of 499 records were retrieved from electronic database searches. After deduplication and application of the inclusion/exclusion criteria, 40 studies met the eligibility criteria for the review. Of these, two were clinical studies (one retrospective cohort, one case report), while the remainder comprised five animal (in vivo) studies, six in vitro studies, and sixteen mixed translational studies (in vitro/in vivo ± clinical). Experimental studies reported hair coverage improvements of 50–99% and, in one instance, 30% regrowth in totalis and 16% in partialis, with nearly complete regrowth in incipient alopecia. Clinical reports noted density increases of 9–31 hairs per cm² (e.g., from 121.7 to 146.6 hairs/cm², p < 0.001) and improvements in hair count, length, and thickness. Several studies detailed activation of the Wnt/β-catenin pathway along with enhanced dermal papilla and hair follicle stem cell function, as well as anti-inflammatory effects. Reported safety profiles were favorable; when adverse events occurred, they were limited to mild, transient local reactions with no severe systemic issues. EV-based therapy is a novel and biologically plausible approach for AA, but robust randomized controlled trials (RCTs) are lacking. Standardization of small EV sources, doses, and delivery methods is essential before clinical translation. Full article

Background/Objectives: Nutritional supplementation has been proposed as a potential adjunct strategy in myopia prevention and control through antioxidative, anti-inflammatory, and extracellular matrix-regulating mechanisms. This systematic review aimed to evaluate randomized controlled trial (RCT) evidence on the effects of carotenoids, anthocyanins, polyunsaturated fatty acids, and combined nutraceutical formulations on refractive outcomes, axial length, macular pigment optical density (MPOD), visual function, and symptoms of visual fatigue. Methods: The review was registered in PROSPERO (CRD420251149727) and conducted in accordance with PRISMA 2020 and AMSTAR-2 guidelines. PubMed, Web of Science, and Scopus were searched up to 5 August 2025. Eligible studies were RCTs involving individuals with myopia or at risk of myopia, comparing nutritional supplementation with placebo or active controls. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. Results: Nine RCTs were included. Carotenoids such as crocetin, lutein, zeaxanthin, and astaxanthin produced modest benefits, including improved MPOD, reduced visual fatigue, and—in one pediatric trial—slightly less axial elongation. Anthocyanin-rich extracts improved mesopic contrast sensitivity and subjective asthenopia. A combined carotenoid–polyphenol formulation enhanced accommodative facility. However, no consistent clinically meaningful reduction in myopia progression was observed. Trials were generally small, heterogeneous, and short in duration. Conclusions: Nutritional supplementation may improve visual function and retinal antioxidant status but lacks strong evidence for slowing myopia progression. Larger, long-term RCTs are needed before recommending supplementation for routine myopia management. Full article

Background: Short-chain fatty acids (SCFAs), the main microbial fermentation products in the colon, have immunometabolic and anti-neoplastic properties. Alterations in fecal SCFA profiles have been proposed as potential non-invasive biomarkers for colorectal cancer (CRC), but previous findings remain inconsistent. This systematic review and meta-analysis aimed to determine whether fecal acetate, propionate, and butyrate concentrations differ between patients with CRC and healthy individuals. Methods: A comprehensive search of PubMed, Web of Science and Cochrane Library was conducted on 18 September 2025. Eligible studies were observational, included adults with histologically confirmed CRC and healthy controls, and reported fecal concentrations of at least one SCFA quantified using validated analytical methods. Two independent reviewers performed study screening, data extraction, and risk-of-bias assessment. Random-effects models were applied to calculate pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Thirteen studies met inclusion criteria for qualitative synthesis, and four (141 CRC cases, 98 controls) were eligible for meta-analysis. Compared with healthy controls, patients with CRC had significantly lower fecal acetate (pooled SMD −0.37; 95% CI −0.63 to −0.10; p = 0.006; I² = 0%) and butyrate (pooled SMD −0.59; 95% CI −1.10 to −0.07; p = 0.026; I² = 64.4%), whereas propionate did not differ significantly (pooled SMD −0.02; 95% CI −0.85 to 0.82; p = 0.971; I² = 89%). Conclusions: CRC is associated with reduced fecal butyrate and, to a lesser extent, acetate, suggesting impaired microbial fermentation. Propionate shows no consistent difference. SCFA profiling currently lacks sufficient standardization and validation for clinical application. Future harmonized, longitudinal studies integrating diet, microbiome, and metabolomic data are warranted to confirm SCFAs as reproducible biomarkers of CRC. Full article

Background: Interleukin-6 (IL-6) is a key inflammatory cytokine implicated in atherosclerotic plaque progression and carotid vulnerability. Although elevated IL-6 levels have been linked to cerebrovascular risk, its prognostic value in patients undergoing carotid endarterectomy (CEA) remains undefined. This systematic review aimed to investigate the available evidence on the relationship between IL-6 levels, surgical outcomes and mechanistic evidence in CEA patients. Materials and Methods: The review followed the PRISMA statement and AMSTAR-2 critical appraisal guidelines, with the protocol registered on PROSPERO (CRD420251120023). PubMed/MEDLINE, Scopus, and Web of Science were systematically searched up to July 2025 using the terms “interleukin-6” and “carotid endarterectomy”. Original studies in humans assessing IL-6 in relation to clinical outcomes after CEA or mechanistic evidence were included without language or date restrictions. Study quality was evaluated using the Cochrane Risk of Bias 2 and NHLBI tools, and evidence certainty was appraised using the GRADE framework. Given the heterogeneity of studies, only a qualitative synthesis was performed. Results: From 1232 records identified, 13 studies encompassing 1396 patients met the inclusion criteria. Most were prospective observational cohorts, with a mean participant age of 68.52 years and 81.16% male predominance. Perioperative stroke and mortality rates were uniformly low (≤2%), consistent with contemporary registry data. Across studies, elevated IL-6 levels—whether systemic or plaque-derived—were consistently associated with symptomatic carotid disease, plaque vulnerability, and adverse long-term outcomes. However, not all studies presented quantitative data on IL-6 levels, limiting the ability to draw definitive prognostic conclusions. Conclusions: Current evidence supports a mechanistic link between IL-6–mediated inflammation and carotid plaque instability, yet robust clinical validation in surgical populations is lacking. Future large-scale, prospective studies incorporating IL-6 measurement are warranted to establish its prognostic utility, guide anti-inflammatory therapeutic strategies, and refine postoperative risk stratification in patients undergoing CEA. Full article

Type 2 diabetes mellitus (T2DM) is a widespread metabolic disorder characterized by insulin resistance and pancreatic β-cell dysfunction, posing a substantial global health challenge. This review systematically summarizes the therapeutic potential of berberine, a natural isoquinoline alkaloid, in the management of T2DM. Berberine’s pharmacological activities are discussed from multiple perspectives, including enhancing insulin sensitivity and regulating glucose metabolism—encompassing glycogen synthesis, gluconeogenesis, and glucose transport. The review also highlights berberine’s anti-inflammatory, antioxidant, and epigenetic enzyme-targeting actions and its involvement in key T2DM-related signaling pathways such as AKT, AMPK, and GLUTs. These findings collectively elucidate the multi-targeted and multi-pathway molecular mechanisms underlying berberine’s efficacy against T2DM. Additionally, the review covers the pharmacological activities and molecular mechanisms of berberine in treating T2DM complications—including diabetic nephropathy, retinopathy, cardiomyopathy, neuropathy, and diabetic foot ulcers—as well as its clinical and preclinical applications and the synergistic benefits of combination therapy with agents such as metformin, ginsenoside Rb1, and probiotics. By systematically reviewing the literature retrieved from PubMed and Web of Science up to 2025, this article provides a comprehensive summary of current research, offering a theoretical foundation for the clinical use of berberine in T2DM therapy. Full article

Background: Chronic diseases are leading causes of morbidity and mortality worldwide and their prevalence is increasing due to aging and lifestyle factors. A central element in their pathophysiology is chronic low-grade inflammation, linking metabolic, cardiovascular, neurodegenerative, and proliferative disorders. In this context, Opuntia dillenii, a cactus species traditionally used in folk medicine, has attracted considerable scientific interest due to its promising nutraceutical potential. Methods: This systematic review was conducted through a PRISMA-guided literature search using PubMed, Scopus, and Web of Science, identifying 45 studies that analyze the phytochemical composition and biological activity of O. dillenii. Results: The compounds highlighted include betalains, polyphenols, flavonoids, and polysaccharides that exhibit potent anti-inflammatory and analgesic effects by modulating key inflammatory mediators. In addition, O. dillenii demonstrates antiproliferative activity, inducing apoptosis and inhibiting tumor growth in various in vivo models, suggesting a potential role in cancer prevention and as a complementary therapy. The cactus also exhibits antiatherogenic and hypotensive effects, as well as hypolipidemic and antidiabetic properties by improving lipid profiles, reducing serum cholesterol and triglycerides, and enhancing insulin sensitivity. Furthermore, its protective actions against tissue damage extend its therapeutic potential. Antimicrobial properties have also been reported, reinforcing its value as a functional food. Conclusions: Taken together, the evidence supports the use of O. dillenii as a versatile nutraceutical resource with a low toxicity profile, capable of contributing to the prevention and treatment of various chronic inflammatory and metabolic diseases. Nevertheless, human clinical trials are needed to validate these findings and explore their full therapeutic utility. Full article