Search Results (6,319)

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by pruritic eczematous lesions that significantly alter quality of life of patients. Dupilumab, a new biologic agent, has demonstrated efficacy and safety in the general adult population with AD. However, evidence on its use in elderly patients is limited. Objectives: The objective of this work was to systematically assess the effectiveness and safety of dupilumab in patients aged ≥60 years with AD, based on published data. Methods: A systematic review and meta-analysis were conducted following the PICO(S) framework. Articles written in English and published before 31 December 2024 that investigated patients ≥ 60 years with AD treated with dupilumab were included. Meta-analysis of the observational studies was performed using a random-effects model with subgroup and meta-regression analyses. Results: Twenty-one articles met the inclusion criteria. After 16 weeks of treatment, dupilumab significantly reduced disease severity (EASI: 21.8; 95% CI: 18.3–25.2), intensity of pruritus (P-NRS: 5.8; 95% CI: 4.2–7.3), and quality of life impairment (DLQI: 11.3; 95% CI: 6.1–16.5); all p < 0.001. Meta-regression revealed previous treatment with cyclosporin A as a predictor of a poorer response to treatment. The generalized-prurigo phenotype was associated with worse control of pruritus. The most common adverse events were conjunctivitis, injection site reactions, and facial flushing. Conclusions: Dupilumab appears to be an effective and well-tolerated treatment for AD in elderly patients. More research is warranted to evaluate its long-term effectiveness and safety in this age group. Full article

Due to their therapeutic potential and effects on cells, exosomes derived from bovine colostrum (BCE) and milk (BME) are molecules that have been at the center of recent studies. Their properties include the ability to cross biological barriers, their natural biocompatibility, and their structure, which enable them to act as stable nanocarriers. Exosomes derived from milk and colostrum stand out in cancer prevention and treatment due to these properties. BMEs can be enriched with bioactive peptides, lipids, and nucleic acids. The targeted drug delivery capacity of BMEs can be made more efficient through these enrichment processes. For example, BME enriched with an iRGD peptide and developed using hypoxia-sensitive lipids selectively transported drugs and reduced the survival rate of triple-negative breast cancer (TNBC) cells. ARV-825-CME formulations increased antitumor activity in some cancer types. The anticancer effects of exosomes are supported by these examples. In addition to their anticancer activities, exosomes also exhibit effects that maintain immune balance. BME and BCE can regulate inflammatory responses with their miRNA and protein loads. These effects of BMEs have been demonstrated in studies on colon, breast, liver, and lung cancers. The findings support the safety and scalability of these effects. However, significant challenges remain in terms of their large-scale isolation, load heterogeneity, and regulatory standardization. Consequently, BMEs represent a new generation of biogenic nanoplatforms at the intersection of nutrition, immunology, and oncology, paving the way for innovative therapeutic approaches. Full article

Atherosclerosis remains a leading cause of cardiovascular mortality despite advances in pharmacological and interventional therapies. Current treatment approaches face limitations including systemic side effects, inadequate local drug delivery, and restenosis following vascular interventions. Gel-based technologies offer unique advantages through tunable mechanical properties, controlled degradation kinetics, high drug-loading capacity, and potential for stimuli-responsive therapeutic release. This review examines gel platforms across multiple scales and applications in atherosclerosis research and intervention. First, gel-based in vitro models are discussed. These include hydrogel matrices simulating plaque microenvironments, three-dimensional cellular culture platforms, and microfluidic organ-on-chip devices. These devices incorporate physiological flow to investigate disease mechanisms under controlled conditions. Second, therapeutic strategies are addressed through macroscopic gels for localized treatment. These encompass natural polymer-based, synthetic polymer-based, and composite formulations. Applications include stent coatings, adventitial injections, and catheter-delivered depots. Natural polymers often possess intrinsic biological activities including anti-inflammatory and immunomodulatory properties that may contribute to therapeutic effects. Third, nano- and microgels for systemic delivery are examined. These include polymer-based nanogels with stimuli-responsive drug release responding to oxidative stress, pH changes, and enzymatic activity characteristic of atherosclerotic lesions. Inorganic–organic composite nanogels incorporating paramagnetic contrast agents enable theranostic applications by combining therapy with imaging-guided treatment monitoring. Current challenges include manufacturing consistency, mechanical stability under physiological flow, long-term safety assessment, and regulatory pathway definition. Future opportunities are discussed in multi-functional integration, artificial intelligence-guided design, personalized formulations, and biomimetic approaches. Gel technologies demonstrate substantial potential to advance atherosclerosis management through improved spatial and temporal control over therapeutic interventions. Full article

Polymeric micelles have the potential to improve the efficacy and safety of drug delivery by improving drug solubility, enhancing bioaccumulation and reducing off-target toxicity. Despite excellent safety profiles, a major limitation with polymeric micelles is their inability to rapidly release their payload once they have reached their target, leading to the inadequate delivery of therapeutic doses. To address this limitation, we have developed a novel strategy to impart pH-responsiveness in non-responsive micelles through the co-encapsulation of oligoelectrolytes with drugs. Herein, we investigate the influence of copolymer composition and drug identity in combination with oligoelectrolyte—oligo(2-vinyl pyridine) (OVP)—loading on pH-triggered drug release from micelles and their cytotoxicity. A library of OVP-loaded micelles was prepared using conventional and well-established non-responsive block copolymers. Dynamic light scattering (DLS) was used to monitor the changes in the micelles as a function of pH. Regardless of the copolymer composition, an abrupt decrease in the hydrodynamic diameter (D_h) was observed as the pH was reduced due to OVP expulsion from the core, which was also confirmed by release studies. In general, co-encapsulation of OVP and model drugs (doxorubicin (DOX), gossypol (GP), paclitaxel (PX), and 7-ethyl-10-hydroxycamptothecin (SN38)) in the micelles provided good to excellent encapsulation efficiency percentage (EE%) values. In vitro studies revealed the pH triggered release of drugs from the OVP-loaded micelles regardless of the drug identity, which increased as the OVP loading increased. This general behaviour was observed in all cases, largely independent of the copolymer composition, albeit with subtle differences in the release profile for different drugs. Compared to their blank counterparts, the drug-loaded micelles displayed a slight increase in cytotoxicity against a panel of cancer cell lines, in a dose dependent manner. However, drug- and OVP-loaded micelles displayed a significant increase in cytotoxicity (up to 8-fold increase) that was independent of the copolymer composition. These results demonstrate the versatility of the oligoelectrolyte-mediated approach to furnish non-responsive micelles with a pH-trigger that allows the rapid release of drugs, regardless of the micelle composition or the drug identity. Full article

Audiovestibular disorders arising from the inner ear (e.g., hearing loss, tinnitus, vertigo) are widely prevalent in the United States. Yet, medical treatments targeting the underlying pathology of these disorders remain scarce. The practice of repurposing FDA-approved drugs for new therapeutic indications has become increasingly common, offering a lower risk route to treatment development with fewer barriers to implementation, as safety profiles are already established. The renin–angiotensin system (RAS) is well known for its role in blood pressure and fluid balance, and its overactivation induces acute and chronic inflammation and oxidative stress. This review discusses existing evidence and proposed otoprotective mechanisms of RAS inhibition, specifically using angiotensin II type 1 receptor blockers (ARBs), which support the repurposing of these medications as novel treatments to affect the inner ear pathologies that underlay hearing loss, tinnitus, and vertigo. Full article

Micro-RNAs (miRNAs) are short, non-coding RNA molecules regulating genes’ expression. Studies published over last years demonstrated that they play an important role in allergic diseases by regulating humoral and cellular immunity, cytokine secretion and epithelium function. Some of them seem potential non-invasive biomarkers facilitating diagnosis of the most common allergic diseases, such as allergic rhinitis (miR-21, miR-126, miR-142-3p, miR-181a, miR-221), asthma (miR-16, miR-21, miR-126, miR-146a, miR-148a, miR-221, miR-223) and atopic dermatitis (miR-24, miR-124, miR-155, miR-191, miR-223, miR-483-5p), or objectively assessing severity of inflammation and endotype of the disease. In spite of the large body of literature available, its scientific value is limited due to the small numbers of study participants, heterogeneity of populations enrolled, and diverse methodology. Some studies have revealed significant changes in miRNAs’ profile in the course of allergen immunotherapy. Tolerance induction is associated with processes controlled by miRNAs: enhanced activity of Treg cells and increased production of tolerogenic IL-10 and TGF-β. Thus, miRNAs may be candidates as biomarkers of successful immunotherapy. Finally, they are also possible therapeutic agents or targets of therapies based on antagomirs blocking their activity. However, so far no studies are available that demonstrate efficacy in overcoming delivery barriers, tissue targeting or drugs’ safety. As a consequence, despite promising results of in vitro and animal model studies, translation into human therapeutic agents is uncertain. Full article

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. Full article

Background/Objectives: Digoxin is a cardiotonic agent with a narrow therapeutic window and a high risk of toxicity. The current clinical use is based on an empirically FDA-recommended regimen which has wide dosing ranges, introducing the risk of inappropriate dosing and related adverse events. This study aims to develop a physiologically based pharmacokinetic (PBPK) model to characterize digoxin pharmacokinetics in adult and pediatric patients with heart failure, and then to evaluate the FDA-recommended regimen. Methods: The PBPK model was initially developed in healthy adults using PK-Sim^®. Then, it was translated to adults with heart failure by incorporating disease factors. Next, it was further translated to pediatrics by scaling age-related parameters. Finally, through two-step translations, the model was used to evaluate current dosing regimens to inform safety and effectiveness based on observing predicted trough concentrations at a steady state. Results: This PBPK model has strong predicting ability, where observed concentrations and key PK metrics (C_max, AUC_0-t) were within 0.5–2.0-fold of predictions in healthy adults, adults with heart failure, neonates, and infants. The model prediction work on the evaluation of recommended dosing regimens from the FDA shows that the current regimen may not achieve the lowest boundary of the therapeutic window (0.5–2 ng/mL) in neonates (0–30 days), whereas infants (1–2 months) and children (<18 years) are generally good within it. Conclusions: This PBPK model explained major physiological and pathological contributors to differences in digoxin pharmacokinetics across populations and showed good performance in pediatric extrapolation. It also pointed out the shortage of empirical dosing regimens for such a drug with a narrow therapeutic window. The model may assist in optimizing the pediatric dosing strategies of digoxin, and suggests that current neonatal dosing regimens need refinement. Full article

Ionic liquids (ILs) have emerged as multifunctional compounds with low volatility, high thermal stability, and tunable solvation capabilities, making them highly promising for biomedical applications. First explored in the late 1990s and early 2000s for enhancing the thermal stability of enzymes, antimicrobial agents, and controlled release systems, ILs have since gained significant attention in drug delivery, antimicrobial treatments, medical imaging, and biosensing. This review examines the diverse functions of ILs in contemporary therapeutics and diagnostics, highlighting their transformative capabilities in improving drug solubility, bioavailability, transdermal permeability, and pathogen inactivation. In drug delivery, ILs improve solubility of bioactive compounds, with several IL formulations achieving substantial solubility enhancements for poorly soluble drugs. Bio-ILs, in particular, show promise in enhancing drug delivery systems, such as improving transdermal permeability. ILs also exhibit significant antimicrobial and antiviral activity, offering new avenues for combating resistant pathogens. Despite their broad potential, challenges such as cytotoxicity, long-term metabolic effects, and the stability of ILs in physiological conditions persist. While much research has focused on their physicochemical properties, biological activity and in vivo studies are still underexplored. The future directions for ILs in biomedical applications include the development of bioengineered ILs and hybrid ILs, combining functional components like nanoparticles and polymers to create multifunctional materials. These ILs, derived from renewable resources, show great promise in personalized medicine and clinical applications. Further research is necessary to evaluate their pharmacokinetics, biodistribution, and long-term safety to fully realize their biomedical potential. This study emphasizes the potential of ILs to transform therapeutic and diagnostic technologies by highlighting present shortcomings and offering pathways for clinical translation, while also debating the need for continuous research to fully utilize their biomedical capabilities. Full article

Mud loach (Misgurnus mizolepis) is a freshwater fish widely farmed in inland aquaculture owing to its nutritional value. However, failure to distinguish Chinese from Korean mud loach negatively affects the distribution economy and food safety regulation. Untargeted profiling was previously used to determine the origin of mud loaches, and N-acetylhistidine and anserine were selected as biomarker candidates. However, their quantitative verification and practical applicability for origin discrimination have not been thoroughly investigated. In this study, mud loaches of different geographical origins were analyzed using liquid chromatography-ultraviolet and liquid chromatography-tandem mass spectrometry to quantify the two metabolites, followed by statistical and receiver operating characteristic (ROC) analyses to evaluate their discriminative performance. Compared with Korean mud loaches, Chinese mud loaches showed significantly higher concentrations of both metabolites. The area under the curve values for N-acetylhistidine and anserine were 0.88 and 0.89, respectively, reflecting high sensitivity and specificity for discriminating between Korean and Chinese mud loaches. Cutoff values were established for reliably distinguishing the geographical origin of mud loaches. The established approach based on N-acetylhistidine and anserine can be used to determine the geographical origin of mud loach. Full article

Background and Objectives: Hysteroscopy has become the “gold standard” in assessing uterine cavity abnormalities, and currently it can be performed in an “office setting”. Although office hysteroscopy has a better level of comfort than operative hysteroscopy, pain is a common concern. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used for pre-procedure analgesia, but they may cause gastrointestinal side effects. Paracetamol offers to be a safer alternative, but its efficacy in this setting is limited. This study aimed to compare the efficacy and safety of oral paracetamol with oral ketoprofen for pain management during office hysteroscopy. Materials and Methods: Double-blind, parallel-group, randomized controlled trial conducted at a single hysteroscopy center in Jakarta, Indonesia, over a 2-year period. Sixty women undergoing office hysteroscopy were randomized (1:1) to receive paracetamol 1000 mg orally or ketoprofen 100 mg orally 1 h before the procedure. Results: All participants completed the trial and were included in the analysis. The median visual analog score (VAS) during the procedure was 2 (range 0–8) in the paracetamol group versus 3 (range 0–6) in the ketoprofen group (p = 0.266). Median cramping scores 30 min post-procedure in the paracetamol group were 0 (range 0–5) vs. 0 (range 0–4) in the ketoprofen group, respectively (p = 0.499). Side effects occurred in 3 participants (10%) in the ketoprofen group and none of the paracetamol group. Comfort scores were high in both groups (median 9/10). No vagal reflexes were observed. Conclusions: Oral 1000 mg paracetamol was as effective as oral 100 mg ketoprofen for pain management during and after office hysteroscopy, with fewer side effects. Paracetamol may be a safe and cost-effective alternative for pre-procedure analgesia in office hysteroscopy. Full article

Type 2 diabetes mellitus (T2DM) involves chronic hyperglycemia, insulin resistance, low-grade inflammation, and oxidative stress that drive cardiometabolic and renal damage despite current therapies. Sodium–glucose cotransporter (SGLT) inhibitors have reshaped the treatment landscape, but residual risk and safety concerns highlight the need for new agents that combine glucose-lowering efficacy with redox–inflammatory modulation. LASSBio-1986 is a synthetic N-acylhydrazone (NAH) derivative designed as a gliflozin-like scaffold with the potential to interact with SGLT1/2 while also influencing oxidative and inflammatory pathways. Here, we integrated in silico and in vivo approaches to characterize LASSBio-1986 as a multifunctional antidiabetic lead in murine models of glucose dysregulation. PASS and target class prediction suggested a broad activity spectrum and highlighted transporter- and stress-related pathways. Molecular docking indicated high-affinity binding to both SGLT1 and SGLT2, with a modest energetic preference for SGLT2, and ADME/Tox predictions supported favorable oral drug-likeness. In vivo, intraperitoneal LASSBio-1986 improved oral glucose tolerance and reduced glycemic excursions in an acute glucose challenge model in C57BL/6 mice, while enhancing hepatic and skeletal muscle glycogen stores. In a dexamethasone-induced insulin-resistance model, LASSBio-1986 improved insulin sensitivity, favorably modulated serum lipids, attenuated thiobarbituric acid-reactive substances (TBARS), restored reduced glutathione (GSH) levels, and rebalanced pro- and anti-inflammatory cytokines in metabolic tissues, with efficacy broadly comparable to dapagliflozin. These convergent findings support LASSBio-1986 as a preclinical, multimodal lead that targets SGLT-dependent glucose handling while mitigating oxidative and inflammatory stress in models relevant to T2DM. Chronic disease models, formal toxicology, and pharmacokinetic studies, particularly with oral dosing, will be essential to define its translational potential. Full article

Currently, the increased incidence of invasive fungal infections globally is posing a significant challenge to public health. Due to drug resistance issues, the clinical efficacy of existing antifungal drugs is seriously insufficient, while new drug development progresses slowly. Consequently, there is an urgent need to discover and develop novel antifungal therapeutics. Natural products have the characteristics of wide sources and few adverse reactions and are one of the sources for developing antifungal drugs. Numerous studies have shown that many compounds isolated from plants and traditional Chinese medicine have antifungal activity and diverse antifungal mechanisms. Thymol, a monoterpene phenol compound from thyme (Lamiaceae), has multiple biological functions such as antibacterial, antioxidant, and anti-inflammatory. Recent research has found that thymol has strong antifungal activity, and its molecular mechanisms involve cell membrane rupture, interference with cell wall synthesis, disruption of mitochondrial function and energy metabolism, inhibition of biofilm, inhibition of virulence factor expression, inhibition of key enzymes, and induction of cell apoptosis. This review aimed to summarize the antifungal activity of thymol and the underlying molecular mechanisms, safety, and potential clinical applications. Emerging technologies in thymol delivery systems and future research directions are also discussed. The comprehensive analysis aims to provide a detailed understanding of fungal infections and the role of thymol in antifungal treatment, offering insights for further research and clinical practice. Full article

Drug-resistant bacteria cause millions of global infections each year, and the development of alternative antimicrobial drugs has become a serious undertaking. Currently, peptides with antimicrobial activity represent potential candidates for new antibiotic discovery as they are less likely to cause drug resistance in bacteria. In this study, bifunctional peptides with potent trypsin-inhibitory activity and antimicrobial activity were obtained by rational computation-based structural modifications to a novel Bowman–Birk-type inhibitor (BBI) peptide. The analogues not only displayed potent bacterial killing ability against two drug-resistant bacteria strains of E. coli but also an excellent safety profile, as assessed by low haemolytic activity and low anti-proliferation activity on HaCaT cells. Throughout the molecular dynamics simulations, the peptides exhibited stable adsorption onto the mixed POPE/POPG membrane; most amino acid residues of the AMPs remained bound to the membrane surface, with a few amino acid residues partially penetrating the membrane interior. This showed that the electrostatic interactions were the dominant driving force mediating the peptide–membrane associations. In addition, the tested peptides displayed a degree of stability in the presence of salt ions, serum, and trypsin. These modified peptides thus possess potential as clinical antibacterial agents, and the strategies used in structural modification may also provide a different path to developing new antimicrobial peptides. Full article

The objective of this review is to provide an in-depth overview of the current state of research on microneedles for drug delivery, with emphasis on composite systems, particularly those based on hyaluronic acid (HA) and zinc oxide as composite systems. The review discusses the advantages, challenges, and future directions associated with the use of these materials for microneedle-based drug delivery. Hyaluronic acid, which is naturally found in human tissue, has been shown to enhance drug permeation and improve skin hydration, while ZnO has provided high mechanical durability and prevented microbial and bacterial growth. The use of dissolvable microneedles is a viable substitute for traditional drug delivery methods such as oral or intravenous administration. Ongoing research is being conducted to further improve the performance, safety, and effectiveness of microneedles for various drug delivery applications. Full article