Phloridzin's Diabetic Wound Healing Potential through DPP-4 Enzyme Inhibition: A Review Article.

Diabetic wound healing is a dynamic medical process that takes place in an environment within the body that is complex and contains elevated sugar levels, oxygen deprivation, and cellular oxidative stress. Phloridzin (Phlorizin) is one of the most well-known polyphenols found in apples because of its anti-inflammatory, antioxidant, antibacterial, antidiabetic, and antiseptic properties; it can also play a significant part in the healing of diabetic wounds. The study aimed to investigate the role of phloridzin as an efficient DPP-4 inhibitor with additional therapeutic effects in diabetic wound healing, as Dipeptidyl Peptidase-4 (DPP-4) expression increases in response to increases in glucose, Reactive Oxygen Species (ROS), and inflammation. Phloridzin inhibiting DPP-4 preserves Stromal cell-derived Factor-1α (SDF-1α), Insulin-like Growth Factor (IGF), and Glucagon-like Peptide-1 (GLP-1), which are possible DPP-4 substrates involved in wound healing. The accessible material from systemic searches in PubMed, Scopus, and published articles was reviewed with no period of limitation. The in silico study showed strong binding of phloridzin with DPP-4 protein (2P8S); also, in vitro DPP-4 inhibition assay has shown better inhibition by phloridzin. This study offers new research directions for examining phloridzin's capacity to withstand oxidative stress, as well as for redefining its tactical function as a powerful DPP-4 inhibitor to regulate the process involved in the healing of diabetic wounds.

Limited sampling strategies for therapeutic drug monitoring of anti-tuberculosis medications: A systematic review of their feasibility and clinical utility.

Therapeutic drug monitoring (TDM) is recommended for medications with high inter-individual variability, narrow therapeutic index drugs, possible drug-drug interactions, drug toxicity, and subtherapeutic concentrations, as well as to assess noncompliance. The area under the plasma concentration-time curve (AUC) is a significant pharmacokinetic parameter since it calculates the drug's total systematic exposure in the body. However, multiple blood samples from the patient are required to calculate the area under the curve, which is inconvenient for both the patient and the healthcare professional. To alleviate the issue, the limited sampling strategy (LSS) was devised, in which sampling is minimized while obtaining complete and precise findings to anticipate the area under the curve. One can reduce costs, labor, and discomfort for patients and healthcare workers by applying this limited sampling strategy. This article examines a systematic evaluation of all the limited sampling done in anti-tuberculosis (anti-TB) medications resulting from the literature search of several research papers. This article also briefly describes the two methodologies: Multiple regression analysis (MRA) and the Bayesian approach used to develop a limited sampling strategy model. Anti-TB medications have been found to have considerable inter-individual variability, and isoniazid has a narrow therapeutic index, both of which are criteria for therapeutic drug monitoring. To avoid multi-drug resistance and therapy failure, it is proposed that limited sampling strategy-based therapeutic drug monitoring of anti-TB medications be undertaken to generate an individualized dose regimen, particularly for individuals at high risk of treatment failure or delayed response.

Physiological and Pathophysiological Aspects of Diabetic Foot Ulcer and its Treatment Strategies.

BACKGROUND: Diabetes foot ulcers (DFU) are among the most common complications in diabetic patients, leading to amputation and psychological distress. This mini-review covers the general physiology of ulcer healing as well as the pathophysiology of DFU and its therapies. Only a few treatments have been sanctioned and numerous compounds from various pharmacological groups are now being tested at various stages for the prevention and treatment of DFUs. OBJECTIVE: The main objective of this mini-review is to give concise information on how diabetes mellitus impairs the healing of chronic ulcers by disrupting numerous biological systems of the normal healing process, resulting in diabetic foot ulceration, and the current therapeutic approaches. METHODS: A review of accessible material from systemic searches in the PubMed/Medline, Scopus, Cochrane Database of Systematic Reviews, published review articles, and Clinical Trials databases (US National Library of Medicine) with no period of limitation was conducted. RESULTS: The treatment of DFUs comprises wound dressings, use of matrix metalloproteinase inhibitors in wound dressing, antibiotics, skin substitutes, pressure off-loading growth factors and stem cells, gene therapy, topical oxygen therapy, etc. Conclusion: The majority of these treatments are aimed at treating diabetic foot ulcers and preventing diabetic wounds from becoming infected. Yet, there is no single therapy that can be advised for diabetic foot ulcer patients. Future treatment strategies should be considered an appropriate treatment option for persistent wounds.

Nrf2 Mediated Heme Oxygenase-1 Activation Contributes to Diabetic Wound Healing - an Overview.

Diabetic wound healing is a complicated procedure because hyperglycemia changes the various stages of wound healing. In type 2 diabetes mellitus (T2DM), oxidative stress is proven to be a critical factor in causing non-healing wounds and aggravating the inflammatory phase, resulting in the amputation of lower limbs in T2DM patients. This makes scientists figure out how to control oxidative stress and chronic inflammation at the molecular level. Nuclear factor erythroid 2- related factor 2 (Nrf2) releases antioxidant proteins to suppress reactive oxygen species (ROS) activation and inflammation. The current review discusses the role of Nrf2 in improving diabetic wound healing by reducing the production of ROS and thus reducing oxidative stress, as well as inhibiting nuclear factor kappa B (NF-kB) dissociation and nuclear translocation, which prevents the release of inflammatory mediators and increases antioxidant protein levels, thereby improving diabetic wound healing. As a result, the researcher will be able to find a more effective diabetic wound healing therapy.