RESUMEN
Dental caries (tooth decay) is the most prevalent human disease caused by oral biofilms, affecting nearly half of the global population despite increased use of fluoride, the mainstay anticaries (tooth-enamel protective) agent. Recently, an FDA-approved iron oxide nanozyme formulation (ferumoxytol, Fer) has been shown to disrupt caries-causing biofilms with high specificity via catalytic activation of hydrogen peroxide, but it is incapable of interfering with enamel acid demineralization. Here, we find notable synergy when Fer is combined with stannous fluoride (SnF 2 ), markedly inhibiting both biofilm accumulation and enamel damage more effectively than either alone. Unexpectedly, our data show that SnF 2 enhances the catalytic activity of Fer, significantly increasing reactive oxygen species (ROS) generation and antibiofilm activity. We discover that the stability of SnF 2 (unstable in water) is markedly enhanced when mixed with Fer in aqueous solutions without any additives. Further analyses reveal that Sn 2+ is bound by carboxylate groups in the carboxymethyl-dextran coating of Fer, thus stabilizing SnF 2 and boosting the catalytic activity. Notably, Fer in combination with SnF 2 is exceptionally effective in controlling dental caries in vivo , preventing enamel demineralization and cavitation altogether without adverse effects on the host tissues or causing changes in the oral microbiome diversity. The efficacy of SnF 2 is also enhanced when combined with Fer, showing comparable therapeutic effects at four times lower fluoride concentration. Enamel ultrastructure examination shows that fluoride, iron, and tin are detected in the outer layers of the enamel forming a polyion-rich film, indicating co-delivery onto the tooth surface. Overall, our results reveal a unique therapeutic synergism using approved agents that target complementary biological and physicochemical traits, while providing facile SnF 2 stabilization, to prevent a widespread oral disease more effectively with reduced fluoride exposure.
RESUMEN
INTRODUCTION: Hypothyroidism is an endocrine condition. The signs and symptoms of Hypothyroidism match with the descriptions of several conditions like Vataja Shotha, Rasa Pradoshaja Vikara or a disorder Agni. In the current study two different dosage forms i.e., Vardhamana (Increasing & Decreasing pattern) and fixed Dosage to evaluate its efficacy on Primary Hypothyroidism. MATERIALS AND METHODS: 40 patients randomized into two groups Escalating and Fixed were administered Vardhamana Pippali in two dosage forms for 19 days. Serum T3, T4, and TSH were assessed at baseline and on the 20th day along with the assessment of clinical score through Zulewskis's clinical score for measuring tissue hypothyroidism. The total pippali administered in both groups was 69 g. RESULTS: The mean levels of TSH were 9.52 ± 3.97 mIU/ml, 10 ± 6.02 mIU/ml, and 10.21 ± 8.49 mIU/ml at baseline, 20th day and 40th day respectively in group A. In group B it was 9.21 ± 3.72 mIU/ml, 8.23 ± 4.62 mIU/ml, and 9.15 ± 4.67 mIU/ml at baseline, 20th day and 40th day respectively. The mean Zulewski's clinical score was 3.67 ± 1.49, 2.28 ± 1.32, and 2.06 ± 1.25 at baseline, 20th day, and 40th day respectively in Escalating group. In Fixed group it was 3.83 ± 1.20, 2.50 ± 1.42, and 3.44 ± 1.33 at baseline, 20th day, and 40th day respectively. DISCUSSION: Zulewski's clinical scores were statically non-significant in both the groups on the 20th-day respectively, suggesting minimal efficacy of the interventions. But subjects administered with Vardhamana Pippali exhibited better long-lasting effects suggesting sustained effects of the drug. CONCLUSION: Pippali is efficacious in reducing the signs and symptoms of Primary Hypothyroidism and also has a positive impact on the Thyroid profile but is more effective when administered in Vardhamana dosage compared to fixed dose.