Search Results (16,930)

Gut microbiota regulate the intestinal expression of drug-metabolizing enzymes, transporters, and barrier properties that determine oral drug absorption and disposition. This study compares germ-free Swiss Webster mice to mice colonized with fecal microbiota from a single human donor, evaluating microbiota-driven differences in colonic gene expression and P-gp protein expression, as well as small intestinal mucosal permeability. Transcriptomic analysis of colonic tissue revealed microbiota-induced upregulation of genes encoding P-gp and other drug transporters, including MCT1 and OCTN2. Immunofluorescence also indicated greater P-gp expression and apical localization in colonized mice. Gene expression of drug-metabolizing enzymes was also higher in colonized mice, including phase I enzymes (carboxylesterase 2 paralogs), phase II enzymes (UDP-glucuronosyltransferases and glutathione S-transferases), and enzymes responsible for synthesizing their co-substrates, UDP-glucuronic acid and glutathione. Small intestinal mucosal explants demonstrated lower permeability to ¹⁴C-labeled polyethylene glycol 4000 in colonized mice compared to germ-free mice. In the colon, transcriptomic analysis identified microbiota-dependent changes in genes regulating paracellular tight junctions and actomyosin contractility. These results show that human-derived gut microbiota alter gene expression in the mouse colon, identifying candidate microbiota-responsive genes relevant to oral drug absorption and disposition. Full article

Nanomedicine has yielded clinically useful platforms, including liposomes, albumin-bound nanoparticles, and lipid nanoparticles; yet, many systems translate poorly because of nonspecific biodistribution, limited target-site accumulation, inefficient cellular uptake and intracellular delivery, immune clearance, and off-target toxicity. These bottlenecks are often shaped at cell membrane interfaces, where therapeutic materials are recognized, retained, internalized, or cleared and may elicit unsafe responses. Here, we frame cell membrane biophysics as a therapeutic interface for nanomedicine. We examine how lipid organization and fluidity, mechanics, electrochemical state, glycocalyx architecture, and membrane protein identity shape recognition, adhesion, endocytosis, fusion, trafficking, immune responses, and drug release. We assess how disease-associated membrane remodeling can create candidate therapeutic entry points and delivery barriers across cancer, neurodegeneration, inflammation, infection, and vascular disease. We then analyze receptor-mediated targeting, lipid-domain-associated uptake, membrane-coated nanocarriers, engineered extracellular vesicles, and hybrid platforms, with explicit context-of-use definitions and design boundaries. Finally, we propose translational qualification through function-linked critical quality attributes, mechanism-relevant potency assays, context-matched models, in vivo pharmacology and immune safety, scalable manufacturing, and regulatory evaluation. Progress will depend less on descriptive membrane mimicry than on measurable, reproducible, and qualified membrane-dependent functions. Full article

Periprosthetic joint infection (PJI) remains one of the most serious complications of arthroplasty, largely due to the formation of microbial biofilms on implant surfaces. Biofilm-associated infections exhibit increased tolerance to antimicrobial therapy and host immune responses, making eradication difficult and often requiring repeated surgical interventions. Consequently, there is a growing need for effective local therapeutic strategies capable of delivering high concentrations of antimicrobial agents directly to the site of infection while minimizing systemic toxicity. Hydrogels have emerged as promising drug delivery platforms for the management of biofilm-associated PJI. Their biocompatibility, injectability, high water content, and tunable physicochemical properties enable controlled and localized release of therapeutic agents within the infected peri-implant environment. This narrative review summarizes recent advances in hydrogel-based approaches, including antibiotic-loaded hydrogels, systems incorporating anti-biofilm enzymes, bacteriophage-loaded formulations, and nanoparticle-enhanced platforms. It also highlights future research directions, with particular emphasis on the need for expanded clinical studies to facilitate the translation of emerging hydrogel-based therapies into clinical practice. Further development of these systems should focus on the incorporation of novel therapeutic agents into hydrogel platforms, aiming to enhance biofilm eradication and improve treatment outcomes in patients with PJI. Particular attention is given to stimuli-responsive (“smart”) hydrogels that release therapeutic payloads in response to infection-related triggers such as pH changes, with emphasis on the need for expanded clinical studies to facilitate the translation of emerging hydrogel-based therapies into clinical practice. Further development of these systems should focus on the incorporation of novel therapeutic agents into hydrogel platforms, aiming to enhance biofilm eradication and improve treatment outcomes in patients with PJI. Full article

Yeast infections are becoming an increasing public health concern, mainly due to the spread of opportunistic species and the emergence of strains resistant to commonly used antifungal drugs. Marine resources are a promising source of bioactive compounds, including polysaccharides and other biopolymers with potential antifungal applications. In this study, a sulphated polysaccharide-rich extract was obtained from the red alga Jania pedunculata var. adhaerens and chemically characterized. Its antifungal activity was compared with that of a commercial chitosan formulation against clinically relevant yeasts, including species of Candida, Cryptococcus, Clavispora, Naganishia and Trichosporon. Growth kinetics were monitored in liquid medium over 24 h, and antifungal activity was evaluated through growth rate analysis, growth inhibition at 20 h and susceptibility clustering. The sulphated polysaccharide-rich extract showed moderate but consistent growth inhibition, with the strongest effects observed at 5 mg mL⁻¹. Maximum growth inhibition reached 60.9% in Cryptococcus deuterogattii and 59.8% in Candida albicans, although no complete inhibition was observed within the tested concentration range. Chitosan showed a stronger antifungal effect, with minimal inhibitory concentration (MIC) values between 10 and 20 µg mL⁻¹ in several species and maximum inhibition values above 80% in the most susceptible yeasts. However, C. albicans showed marked resistance to chitosan, with inhibition below 12%. K-means clustering confirmed distinct susceptibility profiles between treatments, supporting a species-dependent response. Overall, these results highlight marine-derived biopolymers as promising antifungal candidates and show that chitosan and algal sulphated polysaccharides produce distinct, species-dependent antifungal profiles. Full article

Obesity is a multifactorial disorder with increasing global prevalence, highlighting the importance of identifying early-life factors that may influence long-term metabolic outcomes. While metformin is widely used to improve metabolic dysfunction in adulthood, whether neonatal exposure to this drug modifies adult responses to subsequent dietary challenges remains poorly understood. This exploratory study evaluated whether intraperitoneal metformin administration during the neonatal period alters adult metabolic responses to hyperlipidic diet (HL) exposure in Wistar rats. Following weaning and sex determination, male offspring (n = 80) were included in the study and distributed among four experimental groups, i.e., saline–normolipidic (SAL-NL), saline–high-fat (SAL-HL), metformin–normolipidic (MET-NL), and metformin–high-fat (MET-HL), with 20 animals per group. From postnatal days 1 to 12, animals received daily intraperitoneal saline or metformin (100 mg/kg/day). From days 60 to 90, animals were fed normolipidic or hyperlipidic diets. Body mass, food intake, glucose tolerance (GTT), and insulin tolerance (ITT) were assessed. Neonatal metformin exposure was associated with reduced body mass gain in MET-HL animals compared to SAL-HL, while food intake differed according to dietary condition. Metformin-treated animals also exhibited improved insulin sensitivity, reflected by higher kITT values, while no significant differences were observed in glucose tolerance. These preliminary findings suggest that neonatal metformin administration may influence adult metabolic responses to dietary challenge. Further studies are required to elucidate the mechanisms and long-term implications of this early-life intervention. Full article

Polymer-based three-dimensional (3D) printing has evolved from a prototyping approach toward a manufacturing strategy with emerging clinical relevance for individualized dosage forms, local drug depots, microneedle systems, microfluidic cartridges, biosensor housings and integrated theranostic platforms. Its value arises from the simultaneous control of polymer chemistry, device architecture and process history: infill, porosity, shell thickness, crosslink density, swelling, degradation and surface chemistry can be used as design variables rather than incidental manufacturing outcomes. This review critically synthesizes recent progress in polymer-enabled additive manufacturing for drug delivery and diagnostic applications, with emphasis on thermoplastic and biodegradable polymers, hydrogels, photopolymers, elastomers, conductive composites, stimuli-responsive networks and bioinks. Fused deposition modelling, hot-melt extrusion, semi-solid extrusion, vat photopolymerization, two-photon polymerization, selective laser sintering, binder jetting and inkjet/aerosol jet approaches are compared in relation to drug stability, diagnostic compatibility, feature resolution, scalability and regulatory risk. Particular attention is given to geometry-controlled release, multi-drug printlets, microneedles, implants, scaffold-based local therapy, microfluidic diagnostics, electrochemical biosensors and wearable or closed-loop systems. Translation is discussed through quality-by-design, critical material attributes, critical process parameters, process analytical technology, extractables/leachables, sterilization, point-of-care manufacturing, data integrity and clinical evidence requirements. Future advances should connect polymer–process–property relationships with clinically meaningful use cases, verified quality attributes and realistic regulatory pathways. Full article

Urothelial carcinoma (UCC) remains a clinical challenge due to its high recurrence rate and aggressive advanced-stage behavior. Driven by a high tumor mutational burden and the consistent overexpression of surface antigens, including Nectin-4, Trop-2, and HER2, UCC has become a prime target for antibody-mediated therapies. Although both immune checkpoint inhibitors (ICIs) and antibody–drug conjugates (ADCs) show significant clinical efficacy, their rational combination further enhances antitumor activity via immunogenic cell death. However, therapeutic resistance and immune evasion still limit response durability in many patients. This review provides a comprehensive overview of the molecular principles, mechanisms of action, and clinical efficacy of antibody-based UCC therapies. Additionally, we analyze biomarkers for patient selection, the mechanisms underlying resistance development, and the rationale for ADC-ICI combinations. By evaluating current challenges and unmet needs, this review aims to clarify the evolving therapeutic landscape and suggest future directions for optimizing UCC treatment. Full article

In vitro neurovascular unit (NVU) models are essential for reproducing blood–brain barrier (BBB) transport and neurovascular cell interactions. However, the literature remains fragmented: biomaterial chemistry, fabrication parameters and organ-on-a-chip architecture are commonly evaluated in isolation, while inconsistent reporting of matrix properties, processing history, cell source, flow and barrier readouts prevents head-to-head comparison and the extraction of transferable design rules. To address this gap, this review integrates biomaterials, manufacturing technologies and organ-on-a-chip engineering within a unified material–process–structure–function framework. We translate endothelial junctions, basement-membrane components and perivascular cells into experimentally actionable material requirements; compare natural, synthetic, semisynthetic and decellularized extracellular-matrix hydrogels; and examine crosslinking, peptide functionalization, stimuli responsiveness, composite-network formation and preparation methods. Findings from Transwell, microfluidic, tubular, self-assembled and 3D-bioprinted BBB systems are used to relate matrix stiffness, degradability, ligand density, permeability, device-body material and fabrication route to barrier maturation, analytical access and reproducibility. By defining matched controls and minimum reporting requirements for chemistry, mechanics, transport and processing, this review provides a practical basis for next-generation BBB models that can improve permeability and efficacy screening in drug discovery, reproduce disease- and patient-specific barrier dysfunction, and support individualized response testing with iPSC- or patient-derived cells. Full article

Background/Objectives: Colorectal cancer (CRC) remains a major cause of cancer-related mortality worldwide, largely owing to metastasis, recurrence, and resistance to conventional therapies. Natural-product-derived compounds represent an important source of anticancer drug candidates. This study investigated the anticancer activity of purified narciclasine, which was tentatively annotated as a major detected constituent of Lycoris sanguinea extract, and examined its association with HELLS-associated DNA damage responses in CRC cells. Methods: Human CRC cell lines HT29 and HCT116 were used to evaluate the cytotoxic and mechanistic effects of L. sanguinea extract and narciclasine. Cell viability, clonogenic growth, apoptosis, mitochondrial membrane potential, cell cycle distribution, migration, and invasion were assessed. Western blotting was performed to analyze apoptosis-, cell cycle-, epithelial–mesenchymal transition (EMT)-, and DNA damage-related proteins. UPLC-QTOF/MS analysis was used to identify major phytochemical constituents. HELLS knockdown and γ-H2AX immunofluorescence staining were conducted to examine the involvement of HELLS in narciclasine-associated DNA damage and apoptosis. Results: L. sanguinea extract reduced CRC cell viability, suppressed clonogenic growth, induced mitochondrial dysfunction and caspase-dependent apoptosis, and promoted G2/M cell cycle arrest with decreased cyclin B1 and increased p53/p21 expression. The extract also inhibited migration and invasion, accompanied by reduced β-catenin, N-cadherin, vimentin, slug, and snail expression and increased E-cadherin expression. UPLC-QTOF/MS tentatively annotated narciclasine as a major detected constituent. Purified narciclasine recapitulated several anticancer effects of the extract, accompanied by HELLS downregulation, increased γ-H2AX accumulation, reduced cyclin B1 expression, and enhanced PARP and caspase-3 cleavage. HELLS knockdown further sensitized CRC cells to narciclasine-associated γ-H2AX accumulation, G2/M arrest-associated signaling, and apoptosis. Conclusions: Narciclasine treatment was associated with HELLS downregulation, DNA damage-associated signaling, G2/M cell cycle arrest-associated changes, EMT suppression, and apoptosis in CRC cells. These findings suggest that narciclasine is a promising natural-product-derived lead compound for further preclinical evaluation in HELLS-associated CRC vulnerabilities. Full article

Treat-to-target management in inflammatory bowel disease (IBD) combines symptoms, fecal and serum biomarkers, endoscopy, histology, and cross-sectional imaging, but these measures frequently diverge. Discordance may reflect analytical variation, timing, disease location, phenotype, comorbidity, or partially non-overlapping biological processes. We performed a critical narrative review using a structured PubMed/MEDLINE search, supplemented by citation chaining and publisher searches. Guidelines, systematic reviews, diagnostic studies, cohorts, randomized trials, and selected mechanistic studies were prioritized. Fecal calprotectin (FC) and lactoferrin primarily reflect intestinal neutrophilic inflammation, whereas C-reactive protein (CRP) and related serum indices reflect a nonlocalizing systemic response. The fecal immunochemical test (FIT) detects gastrointestinal bleeding, and leucine-rich alpha-2 glycoprotein (LRG) remains promising but insufficiently standardized. We distinguish five biological biomarker domains—namely, fecal–neutrophil; serum–systemic; epithelial/barrier; restitution/resolution; and fibrosis/extracellular matrix (ECM) remodeling—from symptoms and clinical indices, pharmacologic measurements, and phenotype-directed reference assessments. Circulating barrier, repair, and matrix-turnover markers remain investigational. Reactive therapeutic drug monitoring (TDM) for anti-tumor necrosis factor (anti-TNF) agents has the most mature evidence. Vedolizumab and ustekinumab show exposure–response associations, but actionable thresholds are unvalidated, and clinical TDM is not established for newer biologics or oral small molecules. After objective confirmation of disease activity, the framework may support phenotype-directed therapeutic decisions but is not a validated algorithm. Clinically important disagreement should prompt assessment of sampling, assay, timing, infection, medication-related confounding, and pretest probability before phenotype-directed endoscopy, histology, imaging, or reactive TDM is selected. A single discordant result should neither trigger treatment escalation nor exclude active or structural disease. Full article

Metastatic colorectal cancer (mCRC) remains one of the leading causes of cancer deaths worldwide. Mutations of the RAS and BRAF genes and the location of the primary tumor determine the choice of systemic therapy. Panitumumab—a fully human anti-EGFR monoclonal antibody—is well-established in the treatment of patients with wild-type RAS and BRAF and left-sided tumor localization. The aim of this review is to summarize the role and potential of targeted therapies for colorectal cancer with monoclonal antibodies such as panitumumab or cetuximab, to provide current evidence on the position of panitumumab in the treatment of mCRC, and to discuss biomarkers and qualification strategies for targeted therapy, including the role of ctDNA in disease monitoring and rechallenge. The work is based on a narrative review of literature from the PubMed, Scopus, Web of Science and Google Scholar databases, including publications available until May 2026. The efficacy of panitumumab was confirmed in phase III studies: first-line (PRIME: prolongation of OS by 5.6 months) and second-line treatment. A key condition for eligibility is complete RAS and BRAF genotyping, assessment of MSI/dMMR status, HER2 amplification, and tumor location. ctDNA analysis enables monitoring of tumor clonal evolution and qualification for rechallenge—the CHRONOS study showed 30% objective responses with liquid biopsy-based selection. Associations with BRAF/MEK and KRAS G12C inhibitors and modulation of the immune microenvironment via the CCL5/CCR5 axis remain promising directions. Panitumumab occupies an important position in the treatment of patients with mCRC, but increasingly precise molecular stratification and dynamic monitoring of disease with ctDNA are becoming the basis for the effective and rational use of the drug. Unlike reviews that selectively focus on individual aspects of anti-EGFR therapy, the following work integrates all aspects: from molecular biology and biomarkers used to qualify patients to clinical data on panitumumab and new strategies in the fight against mCRC. Further development of next-generation sequencing methods and standardization of ctDNA panels will be crucial for the widespread deployment of targeted therapies in everyday clinical practice. The role of panitumumab is well established in appropriately selected patients with RAS wild-type, particularly left-sided, metastatic colorectal cancer (mCRC). Combining panitumumab with immune checkpoint inhibitors warrants further investigation, particularly in patients with MSS/pMMR mCRC. The observed activity of panitumumab in combination with nivolumab and ipilimumab provides a rationale for further clinical evaluation and monitoring. Full article

Introduction: Despite the growing spectrum of modern drugs for the treatment of juvenile idiopathic arthritis (JIA), patients with a refractory, progressive course of the disease remain a clinical challenge. B-cell-depleting therapy has demonstrated efficacy in adult rheumatoid arthritis and several pediatric rheumatic diseases, encouraging us to evaluate rituximab (RTX) for children with refractory JIA. Objective: This study aimed to assess the long-term efficacy and safety of rituximab therapy in children with refractory juvenile idiopathic arthritis. Methods: This retrospective, single-center, observational study included 106 patients with JIA who had failed previous therapy. The efficacy and safety of the therapy were evaluated at baseline and at 3, 6, 12, 24, 36, and 48 months post-initial rituximab infusion using the American College of Rheumatology Pediatric Criteria (ACRpedi 30/50/70/90), C. Wallace criteria for inactive disease/remission, and the JADAS71 activity index until patient completion or withdrawal from the study. The primary endpoint was achieving an ACRpedi50 response by 3 months, and the secondary endpoint was achieving inactive disease status according to C. Wallace criteria by 6 months of follow-up. Results: An ACRpedi50 response was achieved in 78/100 (78%) patients by month 3 of rituximab therapy, and inactive disease status was reached in 48/93 (52%) patients by month 6. More than half of the patients demonstrate inactive disease or remission at each observation point. During rituximab therapy, oral glucocorticoids were discontinued in 18/57 (32%) patients, and 28/57 (49%) patients were able to halve their corticosteroid dose (p = 0.03). Rituximab demonstrated an acceptable safety profile, with a total of 351 adverse events (non-serious AEs: 304/351, 87%) and a serious AE rate of 0.8 per 100 patient-years. Conclusions: Rituximab can reduce disease activity and lower the dose of oral glucocorticoids in patients with refractory JIA, serving as a viable therapeutic option with an acceptable safety profile. Full article

Marked interindividual variability in drug response remains a major challenge in clinical pharmacology and cannot be fully explained by host genetics alone. Increasing evidence indicates that the gut microbiota constitutes an additional determinant of drug efficacy and toxicity through bidirectional interactions with pharmacological therapies. This recognition has led to the emergence of pharmacomicrobiomics, a field that investigates how microbial communities influence drug disposition and response, and how drugs, in turn, alter the microbiome. Microbiome-mediated effects on drug efficacy and toxicity have been described across several therapeutic areas, including oncology, multiple sclerosis, and type 2 diabetes mellitus. Although these findings are promising, most mechanistic evidence derives from preclinical and animal studies, with relatively limited validation in controlled clinical trials. Strategies to modulate the gut microbiota, including prebiotics, probiotics, and faecal microbiota transplantation, have shown preliminary promise in optimising drug efficacy and reducing adverse effects, although methodological heterogeneity and incomplete mechanistic understanding limit their current clinical application. The identification of robust microbiome-derived biomarkers and the integration of multi-omics approaches, particularly metabolomics, are expected to accelerate the translation of pharmacomicrobiomics into precision medicine. This review summarises current evidence regarding microbiome–drug interactions, the mechanisms underlying microbiome-mediated modulation of pharmacokinetics and pharmacodynamics, emerging therapeutic strategies, and the challenges that remain before pharmacomicrobiomics can be implemented in clinical practice. Full article

The development of nanoparticle (NP)-based drug delivery systems that combine passive tumor targeting, physiological stability, and therapeutic efficacy remains a key challenge in cancer nanomedicine. Here, we report a pH-responsive peptide-functionalized poly(lactic-co-glycolic acid) (PLGA) NP system designed for cancer targeting. The PLGA core is coated with a short glutamic acid–lysine–histidine–phenylalanine x3 (EKHFFF) peptide shell, enabling tunable surface charge modulation around its isoelectric point and promoting environmental responsiveness. Physicochemical characterization confirms spherical NPs (~70–75 nm) with good colloidal stability, serum compatibility, and ion-dependent stability in physiological conditions. The peptide coating also provides pH-dependent modulation of the zeta potential. Evaluation of the NPs in ovarian cancer (OvCA) models, including immortalized and patient-derived cell lines (PDCLs), demonstrates efficient uptake across OvCA cell lines, with significantly enhanced internalization in PDCLs compared to immortalized cells. The EKHFFF nanoparticle (EKHFFF NP) induced minimal reactive oxygen species and nitric oxide production in macrophages, indicating low immunogenicity and favorable biocompatibility. Upon platinum loading (EKHFFF-Pt NP), the system exhibits potent cytotoxicity in both platinum-sensitive and platinum-resistant OvCA cell lines, outperforming carboplatin and showing comparable or improved efficacy relative to cisplatin in several cell lines. In vivo studies further demonstrate preferential tumor accumulation, sustained intratumoral retention, and measurable systemic circulation with a half-life of approximately 35 min. Full article

Peptide therapeutics occupy a unique position between small organic compounds and large protein biomolecules, combining high specificity, strong pharmacological efficacy, and favourable safety profiles. Consequently, they have emerged as important therapeutic agents for a wide range of diseases, including metabolic and oncological disorders. However, oral administration of peptide drugs remains a major challenge due to extensive enzymatic degradation, low intestinal permeability, mucus entrapment, and presystemic metabolism within the gastrointestinal tract. This review provides a comprehensive overview of contemporary strategies for improving oral peptide delivery, with special emphasis on emerging pharmaceutical formulation technologies, bioinspired delivery systems and ingestible device-assisted approaches. A qualitative literature search was conducted using major scientific databases and included relevant publications available up to May 2026. The analysis identified the main barriers responsible for low oral bioavailability of peptide drugs, as well as promising approaches to overcoming these obstacles, including peptide modification, enzyme inhibition, permeation enhancement, mucolytic strategies, and advanced carrier systems. Special attention is given to multifunctional carrier systems, ingestible medical devices and bile acid-inspired technologies as emerging directions in oral peptide delivery. The convergence of pharmaceutical sciences, bioinspired formulation strategies and biomedical engineering is expected to accelerate the clinical translation of oral peptide formulations and enable their therapeutic potential to be fully exploited. Full article