RESUMO
Objective: To observe the clinical effect of mometasone furoate cream sodium Alginate Skin Repair Mask in the treatment of atopic dermatitis (AD). By assessing the combined use of these two treatments, the study aims to address a gap in knowledge regarding the effectiveness and safety of adjuvant therapies for AD, particularly in the context of Alginate Skin Repair Mask. Methods: Eighty patients were enrolled, including 42 males and 38 females aged 20-47 years, with an average age of (32.52±5.57) years, from July 2021 to July 2022, and the patients were divided into a single group (n=40) and a combined group (n=40) by random number table method. The patients in the single group were treated with mometasone furoate cream alone, and the patients in the combination group were treated with Alginate Skin Repair Mask on the basis of the treatment of the patients in the single group. The outcome measurements included clinical treatment effect, condition change (SCORAD score), quality of life (DLQI score), adverse reactions and disease recurrence were compared between the two groups. Both groups received treatment for 1 month. After the treatment of the patients, they were followed up for a period of 3 months. Results: The total effective rate of the single group was 80.0% (32/40), and that of the combined group was 97.5% (39/40) (P < .05). After treatment, the skin lesion area score, skin lesion degree score, pruritus insomnia score, and SCORAD total score in the combined group were significantly lower than those in the single group (35.03±9.41 vs 44.03±12.04) (all P < .05). The DLQI score of the combined group after treatment was significantly lower than that of the single group (3.72±1.53 vs 6.98±2.16) (P < .05). The incidence of adverse reactions in the single group was 22.5% (9/40), and the disease recurrence rate was 32.5% (13/40), while the incidence of adverse reactions in the combination group was 2.5% (1/40). The disease recurrence rate was 7.5% (3/40), and the incidence of adverse reactions and disease recurrence rate in the combination group were significantly lower than those in the single group (7.314, 7.812). Conclusion: Mometasone furoate cream sodium Alginate Skin Repair Mask has an ideal clinical effect in the treatment of atopic dermatitis. Compared with single mometasone furoate cream, the combination of sodium Alginate Skin Repair Mask can further improve the patient's condition, improve the quality of life of the patient, and reduce the risk of adverse reactions and disease recurrence. The higher total effective rate in the combined group indicates that the addition of Alginate Skin Repair Mask to the treatment regimen resulted in improved outcomes for patients with atopic dermatitis (AD). This translates to better control of the disease, reduction in symptoms, and overall improvement in the patient's condition. However, it is important for clinicians to be aware that the use of topical glucocorticoids like mometasone furoate cream can potentially lead to adverse reactions. Some documented adverse reactions associated with long-term use of topical glucocorticoids include acne-like eruption, telangiectasia (dilation of small blood vessels), and local skin atrophy. By addressing multiple aspects of AD management, including skin barrier repair, moisturization, and inflammation control, the combination of mometasone furoate cream and Alginate Skin Repair Mask provides a more comprehensive treatment approach. This comprehensive approach may contribute to the observed reduction in recurrence rate in the combination group compared to the single group, where only mometasone furoate cream was used.
Assuntos
Alginatos , Dermatite Atópica , Furoato de Mometasona , Humanos , Furoato de Mometasona/uso terapêutico , Feminino , Masculino , Dermatite Atópica/tratamento farmacológico , Alginatos/uso terapêutico , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Creme para a Pele/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Qualidade de Vida , Resultado do TratamentoRESUMO
Post-traumatic hemorrhage, which can result from accidents or battlefield injuries, is a significant global concern due to the high prehospital mortality rate. Substantial efforts have been made to develop hemostatic agents that can effectively reduce hemorrhage in the immediate aftermath of a traumatic event. The present study investigated the potential efficacy of Ca2+ and Zn2+ supplemented sodium alginate-based dry hemostatic particles (SA-CZ DHP) to manage excessive blood loss or post-traumatic hemorrhage. SA-CZ DHP were developed, followed by their physical and biochemical characterization, cytocompatibility and hemocompatibility testing, and critical evaluation of the hemostatic potential in vitro and in vivo. The safe SA-CZ DHP showed high absorption and accelerated blood clotting kinetics with reduced coagulation time (≈70%, p < 0.0001) in whole human blood, observed with insignificant hemolysis and uninterrupted RBC morphology. SA-CZ DHP significantly reduced the mean blood loss (≈90% in SD rats tail incision), and bleeding time (≈60% in BALB/c mice tail incision) was at par with commercially available Celox hemostatic granules. In conclusion, the biocompatible SA-CZ DHP exhibited rapid and effective management of excessive blood loss. It is also pertinent to note that the developed formulation could be a cost-effective alternative to its commercial counterparts.
Assuntos
Hemostáticos , Camundongos , Ratos , Humanos , Animais , Hemostáticos/farmacologia , Hemostáticos/uso terapêutico , Hemostáticos/química , Alginatos/uso terapêutico , Alginatos/farmacologia , Cálcio , Zinco/uso terapêutico , Zinco/farmacologia , Ratos Sprague-Dawley , Hemorragia/tratamento farmacológico , HemostasiaRESUMO
Raft-forming systems are designed to relieve reflux symptoms by forming a physical barrier on top of the stomach. The present study aimed to evaluate the physico-chemical properties of alginate-aloe vera raft-forming systems for the first time. To achieve this goal, aloe vera was used in the proportion of 1 and 1.5 % in raft suspensions containing 5 % alginate as the main component of gel structure. Rafts were characterized by their volume, floating behavior, thickness, swelling properties, strength, resilience, reflux resistance, and acid neutralization capacity (ANC). Results showed the effectiveness of aloe vera in forming rafts that were voluminous, buoyant with greater total floating time (TFT), and stronger than formulations with no aloe vera. Furthermore, data showed that the presence of aloe vera could improve resilience time, swelling proportions, resistance to reflux under simulant conditions of movement in the stomach, and ANC values of rafts. Rafts were further characterized by oscillatory strain sweep test, differential scanning calorimetry, and Fourier transform infrared spectroscopy. Evaluation of the mechanical properties of rafts displayed a viscoelastic behavior of gels corresponding to the internal cross-linked structure of rafts. This study demonstrated that designing of alginate-aloe vera rafts can be suitable for the treatment of gastro-esophageal reflux disorders.
Assuntos
Aloe , Refluxo Gastroesofágico , Alginatos/uso terapêutico , Alginatos/química , Aloe/química , Refluxo Gastroesofágico/tratamento farmacológico , Composição de Medicamentos/métodosRESUMO
BACKGROUND: Biofilms play a role in recalcitrance and treatability of bacterial infections, but majority of known antibiotic resistance mechanisms are biofilm-independent. Biofilms of Pseudomonas aeruginosa, especially in cystic fibrosis patients infected with the alginate producing strains in their lungs, are hard to treat. Changes in growth-related bacterial metabolism in biofilm affect their antibiotic recalcitrance which could be considered for new therapies designed based on these changes. In this study, effects of nitrate, arginine, and ferrous were investigated on antibiotic recalcitrance in alginate-encapsulated P. aeruginosa strains isolated from cystic fibrosis patients in the presence of amikacin, tobramycin, and ciprofloxacin. Also, expression of an efflux pump gene, mexY, was analyzed in selected strains in the presence of amikacin and ferrous. METHODS: Clinical P. aeruginosa strains were isolated from cystic fibrosis patients and minimum inhibitory concentration of amikacin, tobramycin, and ciprofloxacin was determined against all the strains. For each antibiotic, a susceptible and a resistant or an intermediate-resistant strain were selected, encapsulated into alginate beads, and subjected to minimal biofilm eradication concentration (MBEC) test. After determining MBECs, sub-MBEC concentrations (antibiotics at concentrations one level below the determined MBEC) for each antibiotic were selected and used to study the effects of nitrate, arginine, and ferrous on antibiotic recalcitrance of encapsulated strains. Effects of ferrous and amikacin on expression of the efflux pump gene, mexY, was studied on amikacin sensitive and intermediate-resistant strains. One-way ANOVA and t test were used as the statistical tests. RESULTS: According to the results, the supplements had a dose-related effect on decreasing the number of viable cells; maximal effect was noted with ferrous, as ferrous supplementation significantly increased biofilm susceptibility to both ciprofloxacin and amikacin in all strains, and to tobramycin in a resistant strain. Also, treating an amikacin-intermediate strain with amikacin increased the expression of mexY gene, which has a role in P. aeruginosa antibiotic recalcitrance, while treating the same strain with ferrous and amikacin significantly decreased the expression of mexY gene, which was a promising result. CONCLUSIONS: Our results support the possibility of using ferrous and arginine as an adjuvant to enhance the efficacy of conventional antimicrobial therapy of P. aeruginosa infections.
Assuntos
Fibrose Cística , Infecções por Pseudomonas , Humanos , Antibacterianos/uso terapêutico , Pseudomonas aeruginosa , Amicacina/farmacologia , Nitratos/farmacologia , Nitratos/uso terapêutico , Alginatos/metabolismo , Alginatos/farmacologia , Alginatos/uso terapêutico , Arginina/farmacologia , Arginina/uso terapêutico , Fibrose Cística/microbiologia , Infecções por Pseudomonas/microbiologia , Tobramicina/farmacologia , Ciprofloxacina/farmacologia , Biofilmes , Testes de Sensibilidade MicrobianaRESUMO
To develop a new more efficient colon cancer treatment bio-vehicle, in frontier research, for the first time, an attempt has been made to design a unique colon-targeted bio-carrier containing polysaccharides along with nanoporous materials. So, at first, an imine-based covalent organic framework (COF-OH) with respectively an average pore diameter and surface area at 8.5058 nm and 208.29 m2·g-1 was fabricated. In the next step, about 41.68 % and 95.8 % of 5-fluorouracil (5-Fu) and curcumin (CUR) respectively were loaded on COF-OH, and 5-Fu + CUR@COF-OH was achieved. Due to the higher rate of drug releases in simulated stomach media, 5-Fu + CUR@COF-OH was coated with a mixture of alginate (Alg) and carboxymethyl starch (CMS) via the ionic crosslinking (Alg/CMS@(5-Fu + CUR@COF-OH)). Findings displayed that the use of polysaccharide coat reduce the drug releases in simulated gastric and improved it in simulated intestinal and colonic fluids. The beads swelled about 93.33 % under simulated gastrointestinal conditions, but this value was found higher in the simulated colonic environment and reached 326.67 %. The hemolysis rate lower than 5 %, as well as the cell viability higher than 80 %, were the main showing signs of system biocompatibility. Altogether, the results of the preliminary investigations can highlight the potential of the Alg/CMS@(5-Fu + CUR@COF-OH) for colon-specific drug delivery.
Assuntos
Neoplasias do Colo , Curcumina , Estruturas Metalorgânicas , Humanos , Alginatos/uso terapêutico , Neoplasias do Colo/tratamento farmacológico , Fluoruracila/farmacologia , Fluoruracila/uso terapêutico , Curcumina/farmacologia , Curcumina/uso terapêutico , Preparações Farmacêuticas , Excipientes , Concentração de Íons de Hidrogênio , Portadores de Fármacos/uso terapêuticoRESUMO
Benign prostatic hyperplasia (BPH) is an age-related disease of the urinary system that affects elderly men. Current treatments for BPH are associated with several adverse effects, thus highlighting the need for alternative agents. Alginate oligosaccharide (AOS), a water-soluble functional oligomer derived from brown algae, inhibits prostate cancer cell proliferation. However, the effects of AOS on BPH and the underlying molecular mechanisms remain unclear. Therefore, here, we aimed to investigate the therapeutic potential of AOS in BPH by using human benign prostatic epithelial cells (BPH-1) and a rat model of testosterone-induced BPH. Treatment with AOS inhibited in vitro and in vivo proliferation of prostatic epithelial cells and the testosterone-induced expression of androgen receptor (AR) and androgen-associated genes, such as those encoding 5α-reductase type 2 and prostate-specific antigen. Oral administration of AOS remarkably reduced the serum levels of dihydrotestosterone (DHT) and testosterone as well as the expression of proliferating cell nuclear antigen, inflammatory cytokines, and enzymes, which showed increased levels in prostatic tissues of rats with testosterone-induced BPH. Taken together, these data demonstrate that AOS suppresses testosterone-induced BPH in rats by downregulating AR and the expression of androgen-associated genes, supporting the hypothesis that AOS might be of potential use for the treatment of BPH.
Assuntos
Hiperplasia Prostática , Masculino , Ratos , Humanos , Animais , Idoso , Hiperplasia Prostática/induzido quimicamente , Hiperplasia Prostática/tratamento farmacológico , Testosterona , Androgênios/uso terapêutico , Alginatos/farmacologia , Alginatos/uso terapêutico , Ratos Sprague-Dawley , Extratos Vegetais/farmacologia , Di-HidrotestosteronaRESUMO
Dietary fiber is getting attention these days due to its tendency to improve the reproductive performance in human beings. Sodium alginate (SA) is one of the natural dietary fibers. The present study aimed to evaluate the effect of SA on serum insulin, blood sugar, lipid profile, estrogen and testosterone in polycystic (PCOS) females. A single in vivo trial was conducted on thirty adult PCOS females (25 ± 5 years old) with a body mass index (BMI) of 27.5 ± 3.5 kg m-2. Blood samples of all PCOS females were drawn for the initial biochemical analysis and considered as the negative control (NC). A complete randomized design was used to divide the NC group into three equal subgroups (n = 9) i.e. SA3: with 0.03 g; SA6: with 0.06 g per kg body weight per day of sodium alginate; the positive control (PC): metformin 500 mg day-1 for 60 days (two months). A significant reduction (p < 0.05) in the body weight, BMI, blood sugar, serum insulin, lipids and testosterone was observed, while a significant incremental effect (p < 0.05) was observed in the high-density lipoprotein level. The percentages of some physical parameters were also improved like obesity, menstrual cycle, physical activity, psychological issues and hirsutism. Therefore, the study concluded that SA exhibited therapeutic potential for weight management and the improvement of serum testosterone in PCOS females.
Assuntos
Insulinas , Metformina , Síndrome do Ovário Policístico , Adulto , Alginatos/uso terapêutico , Glicemia/análise , Índice de Massa Corporal , Fibras na Dieta , Suplementos Nutricionais , Estrogênios , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Insulinas/uso terapêutico , Lipídeos , Lipoproteínas HDL , Metformina/uso terapêutico , Obesidade/tratamento farmacológico , Síndrome do Ovário Policístico/tratamento farmacológico , Testosterona , Adulto JovemRESUMO
Alginate oligosaccharides (AOS) are shown to have various biological activities of great value to medicine, food, and agriculture. However, little information is available about their beneficial effects and mechanisms on ulcerative colitis. In this study, AOS with a polymerization degree between 2 and 4 were found to possess anti-inflammatory effects in vitro and in vivo. AOS could decrease the levels of nitric oxide (NO), IL-1ß, IL-6, and TNFα, and upregulate the levels of IL-10 in both RAW 264.7 and bone-marrow-derived macrophage (BMDM) cells under lipopolysaccharide (LPS) stimulation. Additionally, oral AOS administration could significantly prevent bodyweight loss, colonic shortening, and rectal bleeding in dextran sodium sulfate (DSS)-induced colitis mice. AOS pretreatment could also reduce disease activity index scores and histopathologic scores and downregulate proinflammatory cytokine levels. Importantly, AOS administration could reverse DSS-induced AMPK deactivation and NF-κB activation in colonic tissues, as evidenced by enhanced AMPK phosphorylation and p65 phosphorylation inhibition. AOS could also upregulate AMPK phosphorylation and inhibit NF-κB activation in vitro. Moreover, 16S rRNA gene sequencing of gut microbiota indicated that supplemental doses of AOS could affect overall gut microbiota structure to a varying extent and specifically change the abundance of some bacteria. Medium-dose AOS could be superior to low- or high-dose AOS in maintaining remission in DSS-induced colitis mice. In conclusion, AOS can play a protective role in colitis through modulation of gut microbiota and the AMPK/NF-kB pathway.
Assuntos
Alginatos , Colite Ulcerativa , Colite , Microbioma Gastrointestinal , Proteínas Quinases Ativadas por AMP , Alginatos/uso terapêutico , Animais , Colite/induzido quimicamente , Colite/tratamento farmacológico , Colite/metabolismo , Colite Ulcerativa/tratamento farmacológico , Sulfato de Dextrana/efeitos adversos , Modelos Animais de Doenças , Camundongos , Camundongos Endogâmicos C57BL , NF-kappa B/metabolismo , Oligossacarídeos/uso terapêutico , RNA Ribossômico 16SRESUMO
BACKGROUND: Refractory reflux-like symptoms have a substantial impact on patients and healthcare providers. The aim of the survey was to qualitatively assess the needs and attitudes of practicing clinicians around the management of refractory reflux symptoms and refractory gastroesophageal reflux disease (rGERD). METHODS: An International Working Group for the Classification of Oesophagitis (IWGCO) steering committee invited clinicians to complete an online survey including 17 questions. KEY RESULTS: Of the 113 clinicians who completed the survey, 70% were GIs, 20% were primary care physicians, and 10% were other specialties. Functional heartburn was considered the most common reason for an incomplete response to proton pump inhibitor (PPI) therapy (82%), followed by stress/anxiety (69%). More GIs identified esophageal hypersensitivity as a cause, while more non-GIs identified esophageal dysmotility and non-reflux-related esophageal conditions. As the first step, most clinicians would order investigations (70-88%). Overall, 72% would add supplemental therapy for patients with partial response, but only 58% for those with non-response. Antacid/alginate was the most common choice overall, while non-GIs were more likely to add a prokinetic than were GIs (47.8 vs. 24.1%). Approximately 40% of clinicians would switch PPIs in patients with partial response, but only 29% would do so in non-responders. Preferences for long-term therapy were highly variable. The most common initial investigation was upper endoscopy. Choice of esophageal manometry and pH monitoring was more variable, with no clear preference for whether pH monitoring should be conducted on, or off, PPI therapy. CONCLUSIONS AND INFERENCES: The survey identified a number of challenges for clinicians, especially non-GI physicians, treating patients with refractory reflux-like symptoms or rGERD on a daily basis.
Assuntos
Esofagite Péptica , Refluxo Gastroesofágico , Alginatos/uso terapêutico , Antiácidos/uso terapêutico , Monitoramento do pH Esofágico , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Pessoal de Saúde , Azia/diagnóstico , Humanos , Inibidores da Bomba de Prótons/uso terapêuticoRESUMO
Pathogen transmission is a widespread threat to global human health. Vaccines are very important during the outbreak of a pandemic. Destructive fractures caused by a sudden outbreak of COVID-19 have spurred vaccine production at an unprecedented rate. The strategy of an effective vaccine delivery system is opening up novel probabilities to make more immunization. Indeed, vaccination is the most successful way to prevent deaths from infectious diseases. In order to optimal immune response production or improvement in the effectiveness of vaccines, delivery systems or adjuvants are required. Natural polymers such as chitosan, alginate, hyaluronic acid, gums, and ß-glucan with antiviral activity have good potential as adjuvant or delivery systems for vaccine formulation development and design vaccine delivery devices. According to the antiviral performance and immunomodulation of these biopolymers, they will play significant characters in the anti-COVID-19 field. In this mini-review, the recent progress in vaccine development by using biopolymers is presented which, provides a reference for their research on anti-COVID-19 drugs and vaccines.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Alginatos/uso terapêutico , Vacinas contra COVID-19/uso terapêutico , COVID-19 , Quitosana/uso terapêutico , Sistemas de Liberação de Medicamentos , Ácido Hialurônico/uso terapêutico , Gomas Vegetais/uso terapêutico , SARS-CoV-2/imunologia , beta-Glucanas/uso terapêutico , Animais , COVID-19/imunologia , COVID-19/prevenção & controle , HumanosRESUMO
Moist, breathable and antibacterial microenvironment can promote cell proliferation and migration, which is beneficial to wound healing. Here, we fabricated a novel sodium alginate-chitosan oligosaccharidezinc oxide (SA-COS-ZnO) composite hydrogel by spontaneous Schiff base reaction, using aldehydated sodium alginate (SA), chitosan oligosaccharide (COS), and zinc oxide (ZnO) nanoparticles, which can provide a moist and antibacterial environment for wound healing. The porosity and swelling degree of SA-COS-ZnO hydrogel are 80% and 150%, respectively, and its water vapor permeability is 682 g/m2/24h. The composite hydrogel showed good biocompatibility to blood cells, 3T3 cells, and 293T cells, and significant antibacterial activity against Escherichia coli, Staphylococcus aureus, Candida albicans, and Bacillus subtilis. Moreover, the hydrogel showed a promoting effect on wound healing in a rat scald model. The present study suggests that marine carbohydrates composite hydrogels are promising in wound care management.
Assuntos
Anti-Infecciosos/uso terapêutico , Hidrogéis/uso terapêutico , Polissacarídeos/uso terapêutico , Cicatrização/efeitos dos fármacos , Óxido de Zinco/uso terapêutico , Alginatos/química , Alginatos/uso terapêutico , Alginatos/toxicidade , Animais , Anti-Infecciosos/química , Anti-Infecciosos/toxicidade , Bacillus subtilis/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Linhagem Celular , Quitina/análogos & derivados , Quitina/química , Quitina/uso terapêutico , Quitina/toxicidade , Quitosana , Escherichia coli/efeitos dos fármacos , Hemólise/efeitos dos fármacos , Humanos , Hidrogéis/química , Hidrogéis/toxicidade , Masculino , Camundongos , Testes de Sensibilidade Microbiana , Nanopartículas/química , Nanopartículas/uso terapêutico , Nanopartículas/toxicidade , Oligossacarídeos , Polissacarídeos/química , Polissacarídeos/toxicidade , Porosidade , Ratos Sprague-Dawley , Staphylococcus aureus/efeitos dos fármacos , Óxido de Zinco/química , Óxido de Zinco/toxicidadeRESUMO
OBJECTIVE: Polysaccharide-based biomaterials are extensively used in wound care healing due to their unique liquid absorption, gelling properties and biocompatibility properties. They play an important role in controlling infections of highly exuding hard-to-heal wounds. The main objective of this study was to develop silver-containing polysaccharide-based tricomponent antibacterial fibres for use in these complex wounds. METHOD: The fibres were developed by coating silver-containing alginate and psyllium fibres with hydrolysed chitosan. Dope solution containing alginate, psyllium and silver carbonate was extruded into a coagulation bath containing calcium chloride and hydrolysed chitosan. The developed fibres were tested for liquid absorption, swelling and antibacterial properties against a control fibre (of alginate and psyllium). RESULTS: The developed fibres showed comparatively better liquid absorption, gelling and antibacterial properties than the control fibres. CONCLUSION: The study concluded that developed fibres could be a preferred choice for application on hard-to-heal wounds with high levels of exudate, to support infection control and faster healing.
Assuntos
Alginatos/uso terapêutico , Antibacterianos/uso terapêutico , Quitosana/uso terapêutico , Polissacarídeos/uso terapêutico , Psyllium/uso terapêutico , Prata/uso terapêutico , Cicatrização/efeitos dos fármacos , Bandagens , HumanosRESUMO
Gastroesophageal reflux disease (GERD) is a common disorder, and empirical proton pump inhibitor (PPI) treatment is often the first step of management; however, up to 40% of patients remain symptomatic despite PPI treatment. Refractory reflux refers to continued symptoms despite an adequate trial of PPI, and management remains challenging. The differential diagnosis is important; other oesophageal (e.g. eosinophilic oesophagitis) and gastroduodenal disorders (e.g. functional dyspepsia) should be ruled out, as this changes management. A combination of clinical assessment, endoscopic evaluation and in selected cases oesophageal function testing can help characterize patients with refractory reflux symptoms into oesophageal phenotypes so appropriate therapy can be more optimally targeted. Medical options then may include adding a H2 receptor antagonist, alginates, baclofen or antidepressant therapy, and there is emerging evidence for bile acid sequestrants and diaphragmatic breathing. The demonstration of a temporal association of symptoms with reflux events on pH-impedance testing (reflux hypersensitivity) serves to focus the management on modulating oesophageal perception and reducing the reflux burden, or identifies those with no obvious pathophysiologic abnormalities (functional heartburn). Anti-reflux surgery based on randomized controlled trial evidence has a role in reflux hypersensitivity or continued pathological acid reflux despite PPI in carefully considered, fully worked up cases that have failed medical therapy; approximately two of three cases will respond but there is a small risk of complications. In patients with persistent volume reflux despite medical therapy, given the lack of alternatives, anti-reflux surgery is a consideration. Promising newer approaches include endoscopic techniques. This review aims to summarize current diagnostic approaches and critically evaluates the evidence for the efficacy of available treatments.
Assuntos
Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Alginatos/uso terapêutico , Antidepressivos/uso terapêutico , Baclofeno/uso terapêutico , Ácidos e Sais Biliares/metabolismo , Exercícios Respiratórios , Diagnóstico Diferencial , Endoscopia Gastrointestinal , Refluxo Gastroesofágico/fisiopatologia , Fármacos Gastrointestinais/uso terapêutico , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Humanos , Concentração de Íons de Hidrogênio , Relaxantes Musculares Centrais/uso terapêutico , Fenótipo , Inibidores da Bomba de Prótons/uso terapêuticoRESUMO
OBJECTIVE: Laryngopharyngeal reflux (LPR) and associated symptoms can be refractory to treatment with acid suppressing medication. We investigated the role and evidence for complementary and alternative medicine (CAM) for LPR in this systematic review. REVIEW METHODS: Complementary and alternative treatment was defined in this systematic review as any non-acid suppressing medication, treatment, or therapy. A literature search was performed by two authors in consultation with a medical librarian using controlled vocabulary for "complementary and alternative medicine" and "laryngopharyngeal reflux" in the databases PubMed and EMBASE, with supplemental searches with Google Scholar. RESULTS: Twenty articles were included in this review for the modalities: alginate, diet modification, prokinetics, respiratory retraining, voice therapy, rikkunshito (RKT), hypnotherapy, and sleep positioning. The studies were analyzed for bias based on the Cochrane criteria for RCTs and Methodological Index for non-RCT (MINORS) criteria for all other studies. For each modality a level of evidence was assigned to the current body of evidence using the GRADE approach. CONCLUSION: There is mixed evidence with a high degree of bias and heterogeneity between studies for the modalities presented in the paper. Based on this review, an anti-reflux diet is recommended for all patients and there is some low-quality evidence to support alkaline water. For patients with predominant vocal symptoms there is evidence that supports voice therapy. There is insufficient evidence to recommend prokinetics at this time. For patients with predominant globus symptoms, alginate, RKT, and relaxation strategies may be used in conjunction with acid suppressing medications for symptom relief.
Assuntos
Alginatos/uso terapêutico , Exercícios Respiratórios , Terapias Complementares , Dietoterapia , Medicamentos de Ervas Chinesas/uso terapêutico , Hipnose , Refluxo Laringofaríngeo/terapia , Treinamento da Voz , Viés , Humanos , Postura , SonoRESUMO
Gut microbiota plays an important role in the high-fat diet (HFD)-induced obesity and related metabolic syndrome (MetS). Our previous study has demonstrated that unsaturated alginate oligosaccharides (UAOS) degraded by alginate lyase possess significant anti-obesity effects in HFD-fed mice. Herein, we further established that UAOS could significantly ameliorate obesity-related metabolic abnormalities, including hyperlipidemia, insulin resistance and low-grade inflammation. Particularly, the beneficial effect of UAOS on these metabolic abnormalities could be significantly reversed by antibiotic supplementation. Subsequently, the microbiological analysis has revealed that UAOS treatment can modulate the overall composition of the gut microbiota, which is highly associated with metabolic parameters. UAOS supplementation can partially reverse the gut dysbiosis induced by HFD-diet or antibiotics. Specifically, UAOS treatment selectively increased the relative abundance of beneficial intestinal bacteria (e.g. Lactobacillus and Akkermansia genus) and decreased the abundance of inflammogenic bacteria (e.g. Bacteroides and Parabacteroides). These results suggest that UAOS can attenuate the HFD-induced obesity and related abnormalities through modulating gut microbiota, indicating that UAOS can act as potent prebiotic agents in treating obesity and related metabolic diseases.
Assuntos
Alginatos/uso terapêutico , Obesidade/tratamento farmacológico , Oligossacarídeos/uso terapêutico , Alginatos/administração & dosagem , Alginatos/farmacologia , Animais , Dieta Hiperlipídica , Modelos Animais de Doenças , Microbioma Gastrointestinal/efeitos dos fármacos , Resistência à Insulina , Camundongos , Camundongos Endogâmicos C57BL , Oligossacarídeos/administração & dosagem , Oligossacarídeos/farmacologia , Organismos Livres de Patógenos EspecíficosRESUMO
Honey is an ancient natural wound-healing agent and has been reintroduced to modern clinical wound care as it has various bioactivities. In this study, honey was incorporated into an alginate/PVA-based electrospun nanofibrous membrane to develop an efficient wound dressing material. The morphology and chemical composition of the nanofibrous membrane were observed by scanning electron microscopy and characterized via Fourier transform infrared spectroscopy, respectively, demonstrating that honey was successfully introduced to the nanofibers. The nanofibrous membranes with increasing honey content showed enhanced antioxidant activity, suggesting the ability to control the overproduction of reactive oxygen species. Disc diffusion assay and dynamic contact assay proved the antibacterial activity of the honey loaded nanofibers towards Gram-positive bacterium (Staphylococcus aureus) and Gram-negative bacterium (Escherichia coli). The cytotoxicity assay illustrated the non-cytotoxicity and biocompatibility of the nanofibrous membranes. Therefore, the developed honey/alginate/PVA nanofibrous membranes are promising for wound dressings.
Assuntos
Alginatos , Antibacterianos , Antioxidantes , Mel , Membranas/química , Nanofibras , Alginatos/química , Alginatos/uso terapêutico , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Antioxidantes/química , Antioxidantes/farmacologia , Apiterapia , Escherichia coli/efeitos dos fármacos , Humanos , Camundongos , Células NIH 3T3 , Nanofibras/química , Nanofibras/uso terapêutico , Nanofibras/toxicidade , Curativos Oclusivos , Espécies Reativas de Oxigênio/metabolismo , Staphylococcus aureus/efeitos dos fármacos , CicatrizaçãoRESUMO
Melanoma is one of the most malignant and aggressive types of cancer worldwide. Fibroblast growth factor 2 (FGF2) is one of the critical regulators of melanoma angiogenesis and metastasis; thus, it might be an effective anti-cancer strategy to explore FGF2-targeting drug candidates from existing drugs. In this study, we evaluate the effect of the marine drug propylene glycol alginate sodium sulfate (PSS) on FGF2-mediated angiogenesis and invasion. The data shows that FGF2 selectively bound to PSS with high affinity. PSS inhibited FGF2-mediated angiogenesis in a rat aortic ring model and suppressed FGF2-mediated invasion, but not the migration of murine melanoma B16-F10 cells. The further mechanism study indicates that PSS decreased the expression of activated matrix metalloproteinase 2 (MMP-2) and matrix metalloproteinase 9 (MMP-9), and also suppressed their activity. In addition, PSS was found to decrease the level of Vimentin in B16-F10 cells, which is known to participate in the epithelial-mesenchymal transition. Notably, PSS did not elicit any changes in cancer cell viability. Based on the results above, we conclude that PSS might be a potential drug to regulate the tumor microenvironment in order to facilitate the recovery of melanoma patients.
Assuntos
Alginatos/farmacologia , Fator 2 de Crescimento de Fibroblastos/metabolismo , Melanoma Experimental/tratamento farmacológico , Neovascularização Patológica/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Alginatos/uso terapêutico , Animais , Aorta/efeitos dos fármacos , Organismos Aquáticos/química , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Embrião de Galinha , Membrana Corioalantoide , Avaliação Pré-Clínica de Medicamentos , Transição Epitelial-Mesenquimal , Humanos , Laminaria/química , Melanoma Experimental/irrigação sanguínea , Melanoma Experimental/patologia , Camundongos , Invasividade Neoplásica/patologia , Invasividade Neoplásica/prevenção & controle , Neovascularização Patológica/patologia , Neovascularização Fisiológica/efeitos dos fármacos , Técnicas de Cultura de Órgãos , Ratos , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/patologia , Microambiente Tumoral/efeitos dos fármacosRESUMO
BACKGROUND: Impaired wound healing is a debilitating complication of diabetes that leads to significant morbidity, particularly foot ulcers. The risk of developing diabetic foot ulcers for diabetic patients is 15% over their lifetime and approximately 85% of limb amputations is caused by non-healing ulcers. Unhealed, gangrenous wounds destroy the structural integrity of the skin, which acts as a protective barrier that prevents the invasion of external noxious agents into the body. Vicenin-2 (VCN-2) has been reported to contain prospective anti-oxidant and anti-inflammatory properties that enhance cell proliferation and migration. Sodium Alginate (SA) is a natural polysaccharide that possesses gel forming properties and has biodegradable and biocompatible characteristics. Therefore, the objective of this study is to evaluate the effect of SA wound dressings containing VCN-2 on diabetic wounds. METHODS: Wounds were inflicted in type-1 diabetic-streptozotocin (STZ) induced male Sprague Dawley rats. Subsequently, relevant groups were topically treated with the indicated concentrations (12.5, 25 and 50 µM) of VCN-2 hydrocolloid film over the study duration (14 days). The control group was treated with vehicle dressing (blank or allantoin). Wounded tissues and blood serum were collected on 0, 7 and 14 days prior to sacrifice. Appropriate wound assessments such as histological tests, nitric oxide assays, enzyme-linked immunosorbent assays (ELISA) and immunoblotting assays were conducted to confirm wound healing efficacy in the in vivo model. One-way Analysis of Variance (ANOVA) was used for statistical analysis. RESULTS: Results showed that hydrocolloid film was recapitulated with VCN-2 enhanced diabetic wound healing in a dose-dependent manner. VCN-2 reduced pro-inflammatory cytokines (IL-1ß, IL-6 and TNF-α), mediators (iNOS and COX-2), and nitric oxide (NO) via the NF-κB pathway. Data suggests that the VCN-2 film facilitated healing in hyperglycemic conditions by releasing growth factors such as (VEGF and TGF-ß) to enhance cell proliferation, migration, and wound contraction via the VEGF and TGF-ß mechanism pathways. CONCLUSIONS: This study's findings suggest that VCN-2 may possess wound healing potential since topical treatment with VCN-2 hydrocolloid films effectively enhanced wound healing in hyperglycemic conditions.
Assuntos
Alginatos , Apigenina , Curativos Hidrocoloides , Pé Diabético/tratamento farmacológico , Glucosídeos , Cicatrização/efeitos dos fármacos , Alginatos/administração & dosagem , Alginatos/uso terapêutico , Animais , Apigenina/administração & dosagem , Apigenina/farmacologia , Apigenina/uso terapêutico , Modelos Animais de Doenças , Glucosídeos/administração & dosagem , Glucosídeos/farmacologia , Glucosídeos/uso terapêutico , Masculino , Ratos , Ratos Sprague-DawleyRESUMO
The present study focuses on the preparation of nanoparticles-loaded ionic cross-linked films for the topical delivery of cefazolin. The aim of the study was to prepare a dosage form which can provide local effect of cefazolin along with sustained delivery at the site of application. Cefazolin was loaded into chitosan nanoparticles to mask the burst release of the drug and they were optimized based on particle size, PDI, % EE and zeta potential. Finally, the prepared nanoparticles were loaded into the films comprising of sodium alginate and pectin which were then subjected to cross-linking via calcium chloride to improve the mechanical strength of the hydrogel films upon exposure to wound fluid. The films were assessed for physical and mechanical properties, swelling behavior, water transmission rate, mucoadhesion, FTIR, DSC, percent inhibition assay and in vitro release profile. Optimized formulation with Cefazolin nanoparticles in the size range of 227â¯nm and 0.5% CL films showed significantly better results (pâ¯<â¯0.05) as compared to the films with increased cross-linker concentration. Therefore, 0.5% CL films were considered more suitable for the treatment of infections when applied as wound dressing.
Assuntos
Bandagens , Cefazolina/química , Quitosana/química , Cicatrização/efeitos dos fármacos , Alginatos/química , Alginatos/uso terapêutico , Cloreto de Cálcio , Cefazolina/uso terapêutico , Quitosana/uso terapêutico , Composição de Medicamentos , Humanos , Hidrogel de Polietilenoglicol-Dimetacrilato/química , Hidrogel de Polietilenoglicol-Dimetacrilato/uso terapêutico , Fenômenos Mecânicos , Nanopartículas/química , Nanopartículas/uso terapêutico , Pectinas/química , Pectinas/uso terapêutico , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
Alginate hydrogel beads have been extensively investigated as drug delivery systems due to promising gastric environment stability. In the present study, alginate hydrogel beads were prepared with Ca2+ or Fe3+ to serve as the loading vehicles for egg yolk low density lipoprotein (LDL)/pectin nanogels. Scanning electron microscope was carried out to confirm the successful incorporation of nanogels into the beads. The FT-IR spectra and swelling ratio analyses proved that incorporation of nanogels did not affect the physicochemical properties of the hydrogel beads. The developed hydrogel beads exhibited pH dependent release of curcumin pre-encapsulated in nanogels, with significant retention of curcumin in gastric condition compared to curcumin encapsulated in nanogels or alginate beads alone. Hydrogel beads prepared with low viscous alginate and Ca2+ showed limited swelling property and more sustained release of curcumin in simulated gastrointestinal conditions, compared to the beads prepared with high viscous alginate and Fe3+. Gradual dissociation of nanogels from the beads during incubation in simulated intestinal fluid was studied with transmission electron microscope. Our study demonstrated the promising potential of alginate beads as a carrier to protect LDL-based nanogels from destabilization in gastric condition, thus expanding their applications as oral delivery system.