Conventional Drug Research Articles

Current Formulation Strategies to Design Novel Carriers for Targeted Drug Delivery and Management of Infectious Keratitis: A Comprehensive Review on the Present State of the Art

Objective: Infectious keratitis is a pernicious disease that affects the anterior segment of the eye and is one the leading causes of blindness worldwide. This disease may cause severe visual impairment or permanent vision damage if left untreated. Discussion: No doubt there are many conventional drug delivery systems to treat ocular keratitis, yet it is the fifth leading cause of blindness globally. This is the result of the eye's complex anatomy and barrier system, which restricts the total ocular contact time of the conventional formulations resulting in underdosing. The widely used traditional formulations to treat keratitis, like antibiotic eye drops and ointments, are rendered useless due to less ocular contact time and low therapeutic drug levels at the target ocular site. The main requirement of the present time is to develop novel drug delivery-backed stratagems to overcome the shortcomings of conventional formulations, which will reduce the morbidity associated with infectious keratitis and improve clinical outcomes. It is worth mentioning that there are documented incidents of Herpetic keratitis of the cornea followed by COVID-19 infection and vaccination. Conclusion: This paper is a rigorous review of all the novel drug delivery strategies to combat ocular keratitis. These future drug delivery strategies will pave the way for the present time researcher and formulation chemists to develop multi-dimensional novel formulations that are safe, patient-compliant, and surpass the ocular barriers to maintain therapeutic drug levels in ocular tissues.

Actinomycin D reduces virulence factors and biofilms against Aeromonas hydrophila.

Aeromonas hydrophila, a Gram-negative bacterium, is ubiquitously found in many aquatic habitats, causing septicemia in humans and fishes. Attributed to abuse or misuse of conventional antimicrobial drug usage, antimicrobial resistance is at an alarming rise. There is an available alternative strategy to bacterial resistance to antimicrobials, which is inhibition of virulence and pathogenicity employing quorum sensing inhibitors (QSIs). Hence, actinomycin D's effectiveness against A. hydrophila SHAe 115 as a QSI was investigated in decreasing virulence factors and preventing biofilm formation. Actinomycin D, belongs to the QSI combating Pseudomonas aeruginosa PAO1 originally isolated from an entophytic actinomycete (Streptomyces cyaneochromogenes RC1) in Areca catechu L. In the present work, further investigations were carried out to assess the effect of actinomycin D at subminimal inhibitory concentrations (sub-MICs), QS-regulated virulence factors, and biofilm inhibition strategies. Intrinsic properties encompassing inhibition of the production of protease and hemolysin and subsequent activities on biofilm formation and eradication of mature biofilm were established along with weakened swimming and swarming motilities in A. hydrophila SHAe 115. In the Tenebrio molitor survival assay, actinomycin D effectively reduced the virulence and pathogenicity of A. hydrophila, resulting in elimination of mortality. However, the hydrolysate of actinomycin D, 2-hydroxy-4,6-dimethyl-3-oxo-3H-phenoxazine-1,9-dicarboxylic acid (HDPD), had lost the QSI activity in A. hydrophila. Actinomycin D was proved as a viable QSI in lessening A. hydrophila's the virulence and pathogenicity, as evident from our research findings.

MMFA-DTA: Multimodal Feature Attention Fusion Network for Drug-Target Affinity Prediction for Drug Repurposing Against SARS-CoV-2.

The continuous emergence of novel infectious diseases poses a significant threat to global public health security, necessitating the development of small-molecule inhibitors that directly target pathogens. The RNA-dependent RNA polymerase (RdRp) and main protease (Mpro) of SARS-CoV-2 have been validated as potential key antiviral drug targets for the treatment of COVID-19. However, the conventional new drug R&D cycle takes 10-15 years, failing to meet the urgent needs during epidemics. Here, we propose a general multimodal deep learning framework for drug repurposing, MMFA-DTA, to enable rapid virtual screening of known drugs and significantly improve discovery efficiency. By extracting graph topological and sequence features from both small molecules and proteins, we design attention mechanisms to achieve dynamic fusion across modalities. Results demonstrate the superior performance of MMFA-DTA in drug-target affinity prediction over several state-of-the-art baseline methods on Davis and KIBA data sets, validating the benefits of heterogeneous information integration for representation learning and interaction modeling. Further fine-tuning on COVID-19-relevant bioactivity data enhances model predictions for critical SARS-CoV-2 enzymes. Case studies screening the FDA-approved drug library successfully identify etacrynic acid as the potential lead compound against both RdRp and Mpro. Molecular dynamics simulations further confirm the stability and binding affinity of etacrynic acid to these targets. This study proves the great potential and advantages of deep learning and drug repurposing strategies in supporting antiviral drug discovery. The proposed general and rapid response computational framework holds significance for preparedness against future public health events.

Macrolide-loaded nanofibrous inserts with polycaprolactone and cellulose acetate base for sustained ocular delivery: Pharmacokinetic study in Rabbit’s eye

The present study aimed to prepare nanofibrous inserts for sustained ocular drug delivery of Azithromycin (AZM) toward conquering the obstacles of conventional topical drug delivery. Nanofibers were fabricated by electrospinning using polycaprolactone (PCL) and cellulose acetate (CA) which are biocompatible and biodegradable polymers. Prepared nanofibers were evaluated in terms of physicochemical, morphological properties, pharmacokinetic study and ocular irritation. SEM images revealed average diameters of about 160 nm and 190 nm for CA and PCL nanofibers, respectively. These ocular drug delivery systems were strong, flexible, and stable under humid and dry conditions. Quantification was performed using microbiological assay by M. luteus as a microorganism. While PCL-based nanofibrous inserts released AZM in a two-step manner initiated by a burst release via Peppas kinetical model, CA-based inserts showed a gradual release profile without any burst release which followed the first-order model. Results showed that these inserts were non-cytotoxic and non-irritating. The nanofibers showed antibacterial efficacy against Escherichia coli and Staphylococcus aureus. In addition, according to a pharmacokinetic study in Rabbit’s Eye, a higher Cmax and lower Tmax were achieved by PCL nanofibers compared to CA-based ones. The pharmacokinetic study of nanofibers in rabbit eyes showed that all formulations were able to maintain the effective concentration of AZM for about 6 days. In conclusion, the prepared nanofibers can be effectively utilized for prolonged ocular delivery of AZM in the treatment of conjunctival infections.

In vitro Antileishmanial Activity and In Silico Molecular Modeling Studies of Novel Analogs of Dermaseptins S4 and B2.

Leishmaniasis is responsible for approximately 65,000 annual deaths. Various Leishmania species are the predominant cause of visceral, cutaneous, or mucocutaneous leishmaniasis, affecting millions worldwide. The lack of a vaccine, emergence of resistance, and undesirable side effects caused by antileishmanial medications have prompted researchers to look for novel therapeutic approaches to treat this disease. Antimicrobial peptides (AMPs) offer an alternative for promoting the discovery of new drugs. In this study, we detail the synthesis process and investigate the antileishmanial activity against Leishmania (Viannia) braziliensis for peptides belonging to the dermaseptin (DS) family and their synthetic analogs. The MTT assay was performed to investigate the cytotoxicity of these peptides on the murine macrophage cell line RAW 264.7. Subsequently, we performed molecular modeling analysis to explore the structure-function correlation of the derivatives interacting with the parasitic membrane. All examined derivatives displayed concentration-dependent antileishmanial effect at low concentrations. Their effectiveness varied according to the peptide's proprieties. Notably, peptides with higher levels of charge demonstrated the most pronounced activities. Cytotoxicity assays showed that all the tested peptides were not cytotoxic compared to the tested conventional drug. The structure-function relationships demonstrated that the charged N-terminus could be responsible for the antileishmanial effect observed on promastigotes. Collectively, these results propose that dermaseptins (DS) might offer potential as promising candidates for the development of effective antileishmanial therapies.

Plant-derived Bioactive Compounds and Their Mechanistic Roles in Combating Microbial Biofilms

Biofilms are a group of microorganisms that exist on living or non-living surfaces, embedded within extracellular matrices produced by microbial cells. They primarily cause antimicrobial resistance and treatment failure in clinical settings. Biofilms resist conventional antimicrobials because of their polymicrobial nature, ability to evade host immune detection, and increased tolerance to antimicrobial agents. Consequently, considerable attention is given to finding alternative anti-biofilm agents. Medicinal plants contain diverse biologically active compounds reported to possess antimicrobial and anti-biofilm activities. This review elucidates the mechanisms of action of plant-derived bioactive compounds (alkaloids, tannins, indoles, terpenes, and flavonoids) on in vitro microbial biofilms, shedding light on their ability to disrupt and prevent biofilm formation. Additionally, the review emphasizes current and future research directions for these phytochemicals, including synergism with conventional antibiotics and advanced drug delivery systems for treating and eradicating biofilm-associated infections.

A Comprehensive Review of Nanogel-Based Drug Delivery Systems.

Polymers can be crosslinked chemically or physically to create three-dimensional hydrogel particles with sub-micron dimensions, known as nanogels. Their customizable size, ease of manufacture, expansion potential, bio-integration, water affinity, and reactivity to various stimuli, including temperature, pH, light, and biological agents, provide them with considerable advantages over conventional drug delivery techniques. Nanogels possess properties of both hydrogels and nanoparticles and can be categorized into nanohydrogels and nano-organogels. These systems exhibit exceptional drug-loading capability, stability, biological consistency, and environmental responsiveness. Their hallmark lies in their swelling behavior, enabling substantial water absorption while maintaining structural integrity. Preparation methods involve polymer precursors or heterogeneous polymerization of monomers. Nanogels are promising for various drug administration techniques, including local anesthetics, vaccines, and transdermal drug delivery, due to their ability to encapsulate multiple bioactive ingredients, enhancing therapeutic efficacy and stability.

Natural Food Components as Biocompatible Carriers: A Novel Approach to Glioblastoma Drug Delivery.

Efficient drug delivery methods are crucial in modern pharmacotherapy to enhance treatment efficacy, minimize adverse effects, and improve patient compliance. Particularly in the context of glioblastoma treatment, there has been a recent surge in interest in using natural dietary components as innovative carriers for drug delivery. These food-derived carriers, known for their safety, biocompatibility, and multifunctional properties, offer significant potential in overcoming the limitations of conventional drug delivery systems. This article thoroughly overviews numerous natural dietary components, such as polysaccharides, proteins, and lipids, used as drug carriers. Their mechanisms of action, applications in different drug delivery systems, and specific benefits in targeting glioblastoma are examined. Additionally, the safety, biocompatibility, and regulatory considerations of employing food components in drug formulations are discussed, highlighting their viability and future prospects in the pharmaceutical field.

The effect of the liposomal form of alteplase on the effectiveness of thrombolysis in coronary arteries in acute myocardial infarction

A liposomal (Lip) formulation of tissue plasminogen activator, alteplase (AlT), has been developed. The quantitative and qualitative composition of the liposomes, as well as their physicochemical properties and proteolytic activity, have been studied in relation to the thrombolytic liposomal form. It was determined that a formulation consisting of liposomes with a phosphatidylcholine/cholesterol ratio of 1.5 : 1, and lipids/alteplase ratio of 1 : 1, is optimal for treating acute myocardial infarction (AMI) in experimental models. At different component ratios, liposomes had a negative zeta potential value greater than 30 mV, indicating their aggregative stability, even after storage for two days at 20 degrees Celsius. Liposomes derived from soy phosphatidylcholine showed greater colloidal stability with a zeta potential of approximately –57 mV and a lower hydrodynamic diameter of approximately 140 nanometers, compared to liposomes derived from egg phosphatidylcholine, which had a zeta potential around –35.4 mV and a hydrodynamic diameter around 220 nanometers. The initial content of free AlT in the liposome supernatant from egg phosphatidylcholine (Lipeg) was 15.0 ± 4.0 %. During the incubation period of 4 days, the concentration of free AlT decreased to 9.0 ± 4.5 %. In contrast, in liposomes derived from soy phosphatidylcholine (LipS), the content of free AlT increased from 11.0 ± 4.5 % to 32.5 ± 6.0 % over the same incubation period. The value of the proteolytic activity of tissue plasminogen activator (tPA) in the compositions of Lipeg(AlT) and Lips (AlT) depends on the type of phosphatidylcholine. The initial tPA activity in Lipeg (AlT) was 36.0 %, and after 1 day, it increased to 45 %. In Lips (AlT), the initial activity was 61.0 % and increased to 66 % after 1 day. When using the liposomal form of alteplase for delivery into the coronary arteries of rats with acute myocardial infarction (AMI), a more complete fibrin lysis is noted compared to animals receiving the native form of the drug. The developed system of targeted delivery of alteplase using soy liposomes has been shown to significantly improve the degree of coronary artery lumen restoration by more than 15 %, compared to the use of a conventional drug (p < 0.05).

South African Rheumatism and Arthritis Association 2024 guidelines for the use of biologic and targeted synthetic disease-modifying antirheumatic drugs.

Biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) target a specific pathway of the immune system, and are usually prescribed after failure of conventional synthetic disease-modifying antirheumatic drug therapy. The choice of b/tsDMARD depends on the disease profile and comorbidities, patient preference, registered indications of the drugs, and risks associated with therapy. It is recommended that b/tsDMARDs for immune-mediated inflammatory rheumatic diseases are prescribed by a rheumatologist, and all patients must be included in the South African Rheumatism and Arthritis Association biologic registry. Knowledge of and vigilance for adverse events, particularly infections, associated with b/ts DMARD therapies are of paramount importance.

Investigation of Folate-Functionalized Magnetic-Gold Nanoparticles Based Targeted Drug Delivery for Liver: In Vitro, In Vivo and Docking Studies.

Magnetic nanoparticles used for targeted drug administration present a promising approach in cancer treatment owing to its notable advantages, such as targeted and enhanced encapsulation ability and improved bio protection compared with conventional drug delivery methods. Au shell-iron core nanoparticles (Fe3O4@Au) were manufactured by a chemical process, coated with dextran to encapsulate curcumin, and functionalized for precision drug delivery using folic acid to combat liver cancer. Dynamic light scattering, scanning electron microscopy, transmission electron microscopy, vibrational spectroscopy, and magnetometry were applied to assess the synthesis of the Fe3O4@Au-DEX-CU-FA compound. The mean size, zeta potential, and polydispersity of Fe3O4@Au-DEX-CU-FA were 63.3 ± 2.33 nm, -68.3 ± 1.78 mV, and 0.041 ± 0.008, respectively. Molecular docking models were created to examine the relationship between Fe3O4@Au-CU and BCL-XL, BAK, and to identify potential binding sites. The loading efficiency and release profile tests examined the medication delivery system's ability. MTT assay was subsequently utilized to determine the optimal dosage and therapeutic efficacy of Fe3O4@Au-DEX-CU-FA on cancer SNU-449 and healthy THLE-2 cell lines. Flow cytometry demonstrated that Fe3O4@Au-DEX-CU-FA effectively induced cancer cell death. Fe3O4@Au-DEX-FA showed a regulated release profile of free curcumin at 37 °C and pH values of 7.4 and 5.4. Real-time PCR revealed increased BAK expression and decreased BCL-XL expression. Nude tumor-bearing mice were used for in vivo experiments. Fe3O4@Au-DEX-CU-FA treatment dramatically reduced the swelling size compared with free CU and control treatments. It also resulted in a longer lifespan, expanded splenocyte proliferation, increased IFN-γ levels, and decreased IL-4 levels. The regular cells showed no cytotoxic effect compared with the cancer type, confirming that Fe3O4@Au-DEX-CU-FA maintained its potent anticancer actions. The data suggests that Fe3O4@Au-DEX-CU-FA possesses a promising potential as a therapeutic agent for combating tumors.

NIR-driven intense UV upconversion films for non-contact high-efficiency prevention of bacterial infections

Bacterial infections on wounds imposes a significant limitation to the wound healing. Although the conventional drug antibacterial dressing is employed for hindering bacterial infection, the inevitable microbial resistance and secondary damage severely limit the quality and speed of wound healing. Herein, the NIR-driven intense UV upconversion (UC) BaLu2F8:80%Yb3+/0.5%Tm3+ microcrystals are, for the first time, designed and fabricated into solid sterilization film to protect the wounds from infections. Equipped with excessive Yb3+ sensitizers, the emission of Yb3+/Tm3+ co-doped monoclinic BaLu2F8 matrix achieve a 175-fold enhancement at the UV band. The UV UC microcrystals was further fabricated into a NIR-to-UV sterilization film with a diameter of 1.5 cm and a thickness of 150 μm using solution casting method, which can efficiently destroy 97 % of E. coli with a NIR irradiation of 5 minutes. Due to the outstanding penetrability of NIR irradiation, the sterilization film under 4 layers gauze dressing can be activated to produce UV photons. The in-vivo mouse tests demonstrate the well-designed NIR-to-UV sterilization film can speed up the wound healing by high-efficient inhibiting E. coli infection under the irradiation of 980 nm NIR laser. The non-contact NIR-driven UV sterilization film require no more drugs and dressing exchange, thus entirely eliminating the effect of microbial resistance and secondary damage from conventional drug dressing. Our work provides a new alternative for constructing highly-efficiency sterilization dressing through the utilization of NIR-to-UV optical conversion materials.

Evaluating the efficacy of whole genome sequencing in predicting susceptibility profiles for first-line antituberculosis drugs

ObjectivesThis study aimed to examine the efficacy of whole genome sequencing (WGS) in accurately predicting susceptibility profiles, potentially eliminating the need for conventional phenotypic drug susceptibility testing (pDST) for first-line antituberculosis drugs in routine tuberculosis diagnosis. MethodsOver the period of 2017 to 2020, 1114 Mycobacterium tuberculosis complex isolates were collected with drug susceptibility testing conducted using the MGIT960 system and WGS performed for predicting drug resistance profiles. In addition, we implemented a new algorithm with an updated WGS workflow, omitting pan-susceptible strains from pDST. ResultsResults showed that out of 1075 analysed isolates, WGS-based genotypic sensitivity predictions for isoniazid, rifampicin, ethambutol, and pyrazinamide were 100% (95% CI, 99.6–100%), 100% (95% CI, 99.62–100%), 99.8% (95% CI, 99.26–99.94%), and 100% (95% CI, 99.63–100%), respectively. In contrast, the WGS-based genotypic resistance prediction, was 98.85% (95% CI, 93.77–99.79%) for isoniazid, 94.74% (95% CI, 82.71–98.54%) for rifampicin, 86.96% (95% CI, 67.87–95.46%) for ethambutol, and 75.7% (95% CI, 59.9–86.63%) for pyrazinamide. Moreover, WGS enabled the implementation of a new testing algorithm that made it unnecessary to perform pDST in 954 of all 1075 samples (88.7%) and in 890 of 901 pan-susceptible samples (98.8%). DiscussionIntegrating WGS into tuberculosis management offers significant potential to replace phenotypic drug susceptibility testing, especially for problematic drugs like pyrazinamide and ethambutol, potentially improving treatment outcomes.

Enzyme-Responsive Micelles with High Drug-Loading Capacity for Antitumor Therapy.

To overcome the poor targeting of conventional chemotherapeutic drugs and the defects of low drug-loading capacity of conventional drug delivery systems, novel drug delivery systems with high drug-loading capacity are developed. Herein, the high drug-loaded mPEG79-GFLGDDD-DOX copolymer is first synthesized via an amide reaction, which can bond multiplex DOX. After PEGylation, the drug can resist the adsorption of proteins in the plasma in blood circulation, avoid being rapidly cleared out of the body, and prolong the circulation time of the drug in the blood, which is conducive to the enrichment of micelles in tumor tissues through the EPR effect. In tumor tissues, the peptide Glycine- Phenylalanine- Leucine- Glycine (GFLG) is recognized and sheared by overexpressed cathepsin B, which stripped the outer layer of methoxy polyethylene glycol (mPEG) and made it more readily available for uptake by tumor cells. After entering the tumor cells, the bonded DOX and the physically encapsulated DOX in the micelles played a synergistic role, realizing the killing of tumor cells, thus effectively enhancing the therapeutic effect on tumors. The findings in this work suggest that a high drug-loading drug delivery system has great potential in the clinical treatment of tumors.

Recent Advances in Prodrug Approach over Conventional Drug Therapy

Background: Prodrugs represent a strategically designed category of medicinal compounds aimed at optimizing drug pharmacokinetics. By modifying the pharmacological action of the drug within a prodrug, subsequent enzymatic bioconversion in the human body facilitates the release of the active drug. This strategy has been highly effective, as demonstrated by the substantial number of prodrugs found in commercial pharmaceutical products. Prodrugs have emerged as a recognized strategy for augmenting the physical, chemical, biological, or pharmacokinetic attributes of pharmacologically active molecules in the realm of drug research and development. Objective: This systematic review intended to offer insights into the recent developments in the prodrug approach used in drug research and development, with a focus on highlighting its effectiveness. The objective was to illustrate the diverse applications of prodrugs and their impact on enhancing drug properties and therapeutic outcomes. Area covered: This review is centered on the most recent developments in the prodrug approach used for drug development and research. The prodrug concept has a wide range of practical uses, some of which are illustrated in this review article. These illustrations are categorized based on the intention behind their creation. Results: Prodrugs have been designed to address challenges, such as poor water solubility and low bioavailability. Strategies, like using neutral or charged promoieties, have been reported to be successful in enhancing solubility. For permeability and bioavailability, prodrugs have been employed to mask polar groups, enabling better absorption. Prolonged half-life prodrugs have been developed to extend drug action, while tissue-targeted delivery prodrugs have shown promise in enhancing drug delivery to specific sites. Conclusion: Prodrug design offers promising strategies to optimize drug delivery and efficacy. Despite challenges, ongoing clinical trials and research efforts indicate the potential of prodrugs in improving therapeutic outcomes. Addressing formulation challenges and understanding pharmacokinetic variability are essential for successful prodrug development.

Detection of multidrug-resistance in Mycobacterium tuberculosis by phenotype- and molecular-based assays

BackgroundThe whole-genome sequencing (WGS) is becoming an increasingly effective tool for rapid and accurate detection of drug resistance in Mycobacterium tuberculosis complex (MTBC). This approach, however, has still been poorly evaluated on strains from Central and Eastern European countries. The purpose of this study was to assess the performance of WGS against conventional drug susceptibility testing (DST) for the detection of multi-drug resistant (MDR) phenotypes among MTBC clinical strains from Poland and Lithuania.MethodsThe study included 208 MTBC strains (130 MDR; 78 drug susceptible), recovered from as many tuberculosis patients in Lithuania and Poland between 2018 and 2021. Resistance to rifampicin (RIF) and isoniazid (INH) was assessed by Critical Concentration (CC) and Minimum Inhibitory Concentration (MIC) DST as well as molecular-based techniques, including line-probe assay (LPA) and WGS. The analysis of WGS results was performed using bioinformatic pipeline- and software-based tools.ResultsThe results obtained with the CC DST were more congruent with those by LPA compared to pipeline-based WGS. Software-based tools showed excellent concordance with pipeline-based analysis in prediction of RIF/INH resistance. The RIF-resistant strains demonstrated a relatively homogenous MIC distribution with the mode at the highest tested MIC value. The most frequent RIF-resistance conferring mutation was rpoB S450L. The mode MIC for INH was two-fold higher among double katG and inhA mutants than among single katG mutants. The overall rate of discordant results between all methods was calculated at 5.3%. Three strains had discordant results by both genotypic methods (LPA and pipeline-based WGS), one strain by LPA only, three strains by MIC DST, two strains by both MIC DST and pipeline-based WGS, and the remaining two strains showed discordant results with all three methods, compared to CC DST.ConclusionsConsidering MIC DST results, current CCs of the first-line anti-TB drugs might be inappropriately high and may need to be revised. Both molecular methods demonstrated 100% specificity, while pipeline-based WGS had slightly lower sensitivity for RIF and INH than LPA, compared to CC DST.

Metal-Organic Frameworks for Overcoming the Blood-Brain Barrier in the Treatment of Brain Diseases: A Review.

The blood-brain barrier (BBB) plays a vital role in safeguarding the central nervous system by selectively controlling the movement of substances between the bloodstream and the brain, presenting a substantial obstacle for the administration of therapeutic agents to the brain. Recent breakthroughs in nanoparticle-based delivery systems, particularly metal-organic frameworks (MOFs), provide promising solutions for addressing the BBB. MOFs have become valuable tools in delivering medications to the brain with their ability to efficiently load drugs, release them over time, and modify their surface properties. This review focuses on the recent advancements in molecular-based approaches for treating brain disorders, such as glioblastoma multiforme, stroke, Parkinson's disease, and Alzheimer's disease. This paper highlights the significant impact of MOFs in overcoming the shortcomings of conventional brain drug delivery techniques and provides valuable insights for future research in the field of neurotherapeutics.

Flaxseed (Linum usitatissimum) mucilage: A versatile stimuli–responsive functional biomaterial for pharmaceuticals and healthcare

The present review is novel as it discusses the main findings of researchers on the topic and their implications, as well as highlights the emerging research in this particular area and its future prospective. The seeds of Flax (Linum usitatissimum) extrude mucilage (FSM) that has a diverse and wide range of applications, especially in the food industry and as a pharmaceutical ingredient. FSM has been blended with several food and dairy products to improve gelling ability, optical properties, taste, and user compliance. The FSM is recognized as a foaming, encapsulating, emulsifying, suspending, film–forming, and gelling agent for several pharmaceutical preparations and healthcare materials. Owing to stimuli (pH) –responsive swelling–deswelling characteristics, high swelling indices at different physiological pHs of the human body, and biocompatibility, FSM is considered a smart material for intelligent, targeted, and controlled drug delivery applications through conventional and advanced drug delivery systems. FSM has been modified through carboxymethylation, acetylation, copolymerization, and electrostatic complexation to get the desired properties for pharma, food, and healthcare products. The present review is therefore devoted to the isolation techniques, structural characterization, highly valuable properties for food and pharmaceutical industries, preclinical and clinical trials, pharmacological aspects, biomedical attributes, and patents of FSM.

Transcoronary guidewire ablation with radiofrequency in a porcine animal model.

Transcoronary ablation of septal hypertrophy (TASH) and surgical myectomy are the recommended treatment options for patients with hypertrophic obstructive cardiomyopathy refractory (HOCM) when conventional drug treatment is not sufficient. We describe the application of radiofrequency (RF) energy via coronary guidewires in an animal model for selective occlusion of coronary side branches that mimics the principle of TASH. Transcoronary guidewire ablation of coronary vessels was performed in 5 adult pigs under general anaesthesia in an animal cathlab after successful bench testing of the ablation settings. After assessing transcoronary pacing parameters, RF energy was delivered via coronary guidewires insulated by coating or by a monorail balloon and positioned in different coronary side branches. Occlusion or patency of the specific coronary side branch was documented by coronary angiography after RF delivery. After the transcoronary RF ablation, the intended occlusion of the coronary vessel (thrombolysis in myocardial infarction [TIMI]-0 or TIMI-1 flow) could be verified by angiography in 82% of the septal branches attempted and 79% of the epicardial branches. The mean ablation duration was 10.3 seconds at 20-W power with an initial impedance of 176 ± 31 Ώ. No unintended occlusion of the main vessels occurred in any case. RF ablation via coronary guidewires is a feasible method for inducing an acute occlusion of coronary vessels and may change the interventional therapy of HOCM if the current limitations of this technique are overcome.

Treatment of early oligoarticular psoriatic arthritis with apremilast: primary outcomes at week 16 from the FOREMOST randomised controlled trial

ObjectivesOligoarticular psoriatic arthritis (PsA) is frequent but rarely studied. The objective was to assess the efficacy of apremilast in early oligoarticular PsA.MethodsFOREMOST (NCT03747939) was a phase 4 multicentre, randomised, double-blind,...