[The experience of community pharmacy in SARS-CoV-2 antigen detection tests programs.] / Experiencia de la farmacia comunitaria en los programas de pruebas de detección de antígenos del SARS-CoV-2.

SARS-CoV-2 infection was an unprecedented pandemic with unprecedented global health and socio-economic impact. More than 13 million cases had been confirmed in Spain by August 2022, and diagnostic testing to detect cases of infection in the country has helped to partially mitigate the spread of the virus. In 2021, the first self-testing antigen tests were marketed for dispensing in community pharmacies, and over-the-counter dispensing was allowed from July of that year. The network of community pharmacies played a key role, not only in the informed dispensing of these tests, but also in actively participating in the performance, supervision and reporting of results to the health authorities, and even in the issuing of digital certificates. A compilation has been made of all the available data on the subject, with a deadline of 13 February 2022, which is considered to be the end of the sixth wave of the epidemic in Spain. The results of the action taken by community pharmacies in twelve Autonomous Communities, which somehow participated in these initiatives by carrying out or supervising a total of 1,043,800 tests, from which 109,570 positive cases (10.5% of the total) were detected and reported to the National Health System, are presented in this article. Although the results are provisional, because many of the programmes are still ongoing, they are a clear demonstration of the potential that community pharmacies can play in Public Health work.

La infección por SARS-CoV-2 ha constituido una pandemia con un impacto sanitario y socioeconómico global sin precedentes. Con más de trece millones de casos confirmados en España hasta agosto de 2022, la realización de pruebas diagnósticas para detectar los casos de infección ha permitido atenuar parcialmente la expansión del virus. Durante 2021 se comercializaron los primeros test de antígenos para autodiagnóstico, de dispensación en farmacias comunitarias, y desde julio de ese año se permitió su dispensación sin receta médica. La red de farmacias comunitarias jugó un papel fundamental, no solo por la dispensación informada de dichos test, sino participando activamente en la realización, en la supervisión de su realización y en la notificación de resultados a las autoridades sanitarias, e incluso en la emisión de certificados digitales. Se ha realizado una recopilación de todos los datos disponibles al respecto, fijando como límite temporal la semana del 13 de febrero de 2022, por considerarse como el final de la sexta ola de la epidemia en España. El presente artículo revela los resultados derivados de la actuación de las farmacias de doce comunidades autónomas, que participaron de una forma u otra en dichas iniciativas mediante la realización o supervisión de un total de 1.043.800 pruebas, a partir de las cuales se detectaron 109.570 casos positivos (un 10,5% del total), que fueron comunicados al Sistema Nacional de Salud. Los resultados son provisionales, pues muchos de los programas continúan vigentes, pero son una muestra inequívoca del potencial que las farmacias comunitarias pueden desempeñar en tareas de Salud Pública.

Experiencia de la farmacia comunitaria en los programas de pruebas de detección de antígenos del SARS-CoV-2 / The experience of community pharmacy in SARS-CoV-2 antigen detection tests programs

FUNDAMENTOS: La infección por SARS-CoV-2 ha constituido una pandemia con un impacto sanitario y socioeconómico global sin precedentes. Con más de trece millones de casos confirmados en España hasta agosto de 2022, la realización de pruebas diagnósticas para detectar los casos de infección ha permitido atenuar parcialmente la expansión del virus. Durante 2021 se comercializaronlos primeros test de antígenos para autodiagnóstico, de dispensación en farmacias comunitarias, y desde julio de ese año se permitió su dispensación sin receta médica. La red de farmacias comunitarias jugó un papel fundamental, no solo por la dispensación informada de dichos test, sino participando activamente en la realización, en la supervisión de su realización y en la notificación de resultadosa las autoridades sanitarias, e incluso en la emisión de certificados digitales.Se ha realizado una recopilación de todos los datos disponibles al respecto, fijando como límite temporal la semana del 13 de febrero de 2022, por considerarse como el final de la sexta ola de la epidemia en España. El presente artículo revela los resultados derivados de la actuación de las farmacias de doce comunidades autónomas, que participaron de una forma u otra en dichas iniciativas mediante la realización o supervisión de un total de 1.043.800 pruebas, a partir de las cuales se detectaron 109.570 casos positivos (un 10,5% del total), que fueron comunicados al Sistema Nacional de Salud. Los resultados son provisionales, pues muchos de los programas continúan vigentes, pero son una muestra inequívoca del potencial que las farmacias comunitarias pueden desempeñar en tareas de Salud Pública.(AU)

BACKGROUND: SARS-CoV-2 infection was an unprecedented pandemic with unprecedented global health and socio-economic impact. More than 13 million cases had been confirmed in Spain by August 2022, and diagnostic testing to detect cases of infection in the country has helped to partially mitigate the spread of the virus. In 2021, the first self-testing antigen tests were marketed for dispensing in community pharmacies, and over-the-counter dispensing was allowed from July of that year. The network of communitypharmacies played a key role, not only in the informed dispensing of these tests, but also in actively participating in the performance, supervision and reporting of results to the health authorities, and even in the issuing of digital certificates. A compilation has been made of all the available data on the subject, with a deadline of 13 February 2022, which is considered to be the end of the sixth wave of the epidemic in Spain. The results of the action taken by community pharmacies in twelve Autonomous Communities, which somehow participated in these initiatives by carrying out or supervising a total of 1,043,800 tests, from which 109,570 positive cases (10.5% of the total) were detected and reported to the National Health System, are presented in this article. Although the results are provisional, because many of the programmes are still ongoing, they are a clear demonstration of the potential that community pharmacies can play in Public Health work.(AU)

Current knowledge on Parmelia genus: Ecological interest, phytochemistry, biological activities and therapeutic potential.

Parmelia Acharius is one of the most representative genera within Parmeliaceae family which is the largest and the most widespread family of lichen-forming fungi. Parmelia lichens present a medium to large foliose thallus and they are distributed from the Artic to the Antartic continents, being more concentrated in temperate regions. According to its current description, the genus encompasses up to 41 different species and it is phylogenetically located within the Parmelioid clade (the largest group in the family). Interestingly, some of its species are among the most common epiphytic lichens in Europe such as Parmelia sulcata Taylor and Parmelia saxatilis (L.) Ach. The present work aims at providing a complete overview of the existing knowledge on the genus, from general concepts such as taxonomy and phylogeny, to their ecological relevance and biological interest for pharmaceutical uses. As reported, Parmelia lichens arise as valuable tools for biomonitoring environmental pollution due to their capacity to bioaccumulate metal elements and its response to acid rain. Moreover, they produce a wide array of specialized products/metabolites including depsides, depsidones, triterpenes and dibenzofurans, which have been suggested to exert promising pharmacological activities, mainly antimicrobial, antioxidant and cytotoxic activities. Herein, we discuss past and recent data regarding to the phytochemical characterization of more than 15 species. Even though the knowledge is still scarce in comparsion to other groups of organisms such as higher plants and other non-lichenized fungi. Reviewed works suggest that Parmelia lichens are worthy of further research for determining their actual possibilities as sources of bioactive compounds with potential therapeutic applications.

Evaluation of the adaptogenic potential exerted by ginsenosides Rb1 and Rg1 against oxidative stress-mediated neurotoxicity in an in vitro neuronal model.

BACKGROUND: Ginseng (Panax sp.) is a drug with multiple pharmacological actions that has been largely used in traditional medicines for the treatment of many health problems. In the therapy of neurodegenerative disorders, it has been employed due to its capacity to strengthen mental processes by enhancing cognitive performance and psychological function. Current work aimed at evaluating the adaptogenic potential of Rb1 and Rg1 against oxidative-stress mediated degeneration in a model of nervous cells. METHODS: Oxidative stress and mitochondrial dysfunction were achieved by exposing SH-SY5Y cells to the mitochondrial complex I inhibitor rotenone. The cytoprotective activity of pre-treatments with ginsenosides Rb1 and Rg1 against rotenone was assessed by determining biochemical markers regarding oxidative stress (ROS scavenging, glutathione and lipid peroxidation levels, SOD activity and Nrf2 activation) and apoptosis-related alterations (mitochondrial membrane potential, calcium levels, aconitase activity and pro/antiapoptotic proteins). Their capacity to cross the blood brain barrier was also estimated. RESULTS: At their optimal doses, ginsenosides Rb1 and Rg1 significantly ameliorated redox status within the cells; they reduced ROS and TBARS levels and improved the glutathione system, as well as they enhanced SOD activity and Nrf2 pathway activation. They protected neuronal cells against MMP loss, calcium homeostasis disruption and aconitase inhibition. Consequently, apoptotic cell death was attenuated by the pre-treatment with ginsenosides, as evidenced by the reduction in caspase-3 and Bax, and the increase in Bcl-2 expressions; also, lower levels of cytochrome C were found in the cytosol. Poor BBB permeation was demonstrated for both ginsenosides. CONCLUSIONS: In conclusion, ginsenosides Rb1 and Rg1 exhibit neuroprotective potential which is achieved, at least in part, via mitochondrial protection and the plausible involvement of Nrf2 pathway activation. Our results contribute to validate the traditional use of ginseng for cognitive-enhancing purposes and provide basis to encourage further research on the potential of ginsenosides in the treatment of neurodegenerative diseases.

Ginsenosides Rd and Re co-treatments improve rotenone-induced oxidative stress and mitochondrial impairment in SH-SY5Y neuroblastoma cells.

Oxidative stress and mitochondrial dysfunction play key roles in Parkinson's disease (PD) initiation and progression. Ginsenosides are major compounds of Ginseng species and they are responsible for pharmacological activity. The aim of this study was to investigate the potential neuroprotective effects and mechanism of the major ginsenosides Rd and Re in rotenone-induced oxidative stress model in human neuroblastoma SH-SY5Y cells. Co-treatments with both ginsenosides inhibited the increased intracellular ROS production and by-products lipid peroxidation accumulation caused by rotenone. Moreover, these ginsenosides upregulated SOD and aconitase enzymes activities, and glutathione system; these antioxidant properties are related to Nrf2 induction and radical scavenger effect. Additionally, the results showed that both Rd and Re attenuated the extent of depolarization of mitochondrial membrane potential and restored calcium levels. Furthermore, these compounds prevented apoptosis by modulating Bax and Bcl-2 proteins and inhibiting cytochrome c release and caspase-3 activation. The ginsenoside Rd resulted to be more active than ginsenoside Re. These findings highlighted the efficacy of these compounds as neuroprotectant compounds for PD prevention and treatment through reducing oxidative stress, improving mitochondrial integrity and functions, and inhibiting apoptosis.

Protective effects of lichen metabolites evernic and usnic acids against redox impairment-mediated cytotoxicity in central nervous system-like cells.

Lichens species produce unique secondary metabolites that attract increasing pharmacological interest, including their redox modulatory activities. Current work evaluated for the first time the in vitro cytoprotective properties, based on the antioxidant activities, of the Parmeliaceae lichens Evernia prunastri and Usnea ghattensis and the mechanism of action of their major phenolic constituents: the evernic and usnic acids, respectively. In two models of central nervous system-like cells (U373-MG and SH-SY5Y cell lines), exogenous H2O2 induced oxidative stress-mediated cytotoxicity. We first assessed their radical scavenging capacities (ORAC and DPPH tests) and the phenolic content of the extracts. At the optimal concentrations, pretreatments with evernic acid displayed significant protection against H2O2-induced cytotoxic damage in both models. It reversed the alterations in oxidative stress markers (including ROS generation, glutathione system and lipid peroxidation levels) and cellular apoptosis (caspase-3 activity). Such effects were in part mediated by a notable enhancement of the expression of intracellular phase-II antioxidant enzymes; a plausible involvement of the Nrf2 cytoprotective pathway is suggested. Usnic acid exerted similar effects, to some extent more moderate. Results suggest that lichen polyketides evernic and usnic acids merit further research as promising antioxidant candidates in the therapy of oxidative stress-related diseases, including the neurodegenerative disorders.

In vitro neuroprotective potential of lichen metabolite fumarprotocetraric acid via intracellular redox modulation.

The lichen-forming fungi Cetraria islandica has been largely used in folk medicines, and it has recently showed promising in vitro antioxidant effects in glial-like cells. Current work aimed at investigating the neuroprotective potential of its major isolated secondary metabolite: the depsidone fumarprotocetraric acid (FUM). H2O2 was used herein to induce oxidative stress (OS)-mediated cytotoxicity in two models of neurons and astrocytes cells (SH-SY5Y and U373-MG cell lines). We found that a pre-treatment with FUM significantly enhanced cell viability compared to H2O2-treated cells, and we selected the optimal concentrations in each model (1 and 25µg/ml, respectively) for assessing its cytoprotective mechanisms. FUM, which exerted effective peroxyl radical scavenging effect in the chemical oxygen radical antioxidant capacity (ORAC) assay, alleviated the alterations in OS markers provoked by H2O2. It attenuated intracellular ROS formation, lipid peroxidation and GSH depletion. At mitochondrial level, FUM prevented from the dissipation of mitochondrial membrane potential and the increase in mitochondrial calcium, implying a protective role against oxidative damage in mitochondrial membrane. Similarly, FUM pre-treatment diminished H2O2-induced apoptosis, as evidenced by the reduction in caspase-3 activity and expression; inmunoblot analysis also revealed a decrease in Bax and an increase in Bcl-2 proteins levels. Furthermore, FUM up-regulated the expression of the antioxidant enzymes catalase, superoxide dismutase-1, and hemeoxigenase-1. These findings and the activation of Nrf2 binding activity in nuclear extracts suggest a plausible involvement of Nrf2 signaling pathway in the cytoprotection by FUM. In conclusion, FUM emerges as a potential drug candidate in the therapy of OS-related diseases, such as the neurodegenerative disorders.

Antioxidant potential of lichen species and their secondary metabolites. A systematic review.

CONTEXT: Pharmacological interest of lichens lies in their capacity to produce bioactive secondary metabolites, being most of them phenolic compounds with reactive hydroxyl groups that confer antioxidant potential through various mechanisms. Increasing incidence and impact of oxidative stress-related diseases (i.e., neurodegenerative disorders) has encouraged the search of new pharmacological strategies to face them. Lichens appear to be a promising source of phenolic compounds in the discovery of natural products exerting antioxidant activity. OBJECTIVE: The present review thoroughly discusses the available knowledge on antioxidant properties of lichens, including both in vitro and in vivo studies and the parameters assessed so far on lichen constituents. METHODS: Literature survey was performed by using as main databases PubMed, Google Scholar, Scopus, Science Direct, and Recent Literature on Lichens. We reviewed 98 highlighted research articles without date restriction. RESULTS: Current report collects data related to antioxidant activities of more than 75 lichen species (from 18 botanical families) and 65 isolated metabolites. Much information comes from in vitro investigations, such as chemical assays evaluating radical scavenging properties, lipid peroxidation inhibition, and reducing power of lichen species and compounds; similarly, research on cellular substrates and animal models generally measures antioxidant enzymes levels and other antioxidant markers, such as glutathione levels or tissue peroxidation. CONCLUSION: Since consistent evidence demonstrated the contribution of oxidative stress on the development and progression of several human diseases, reviewed data suggest that some lichen compounds are worthy of further investigation and better understanding of their antioxidant and neuroprotective potentials.

Neuroprotective activity and cytotoxic potential of two Parmeliaceae lichens: Identification of active compounds.

BACKGROUND: Lichens are symbiotic organisms capable of producing unique secondary metabolites, whose pharmacological activities are attracting much interest. PURPOSE: The present study aimed to investigate the in vitro neuroprotective effects and anticancer potential of methanol extracts of two Parmeliaceae lichens: Cetraria islandica and Vulpicida canadensis. The chemical composition of the two lichens was also determined. METHODS: Neuroprotective activity was studied with respect to the antioxidant properties of the extracts; radical scavenging tests (ORAC and DPPH assays) were performed and oxidative stress markers (intracellular ROS production, caspase-3 activity, MDA and glutathione levels) were assessed in a hydrogen peroxide-induced oxidative stress model in astrocytes. Cytotoxic activity was tested against human HepG2 (hepatocellular carcinoma) and MCF-7 (breast adenocarcinoma) cell lines. RESULTS: Cell viability studies identified a single concentration for each extract that was subsequently used to measure oxidative stress markers. Lichen extracts were able to reverse the oxidative damage caused by hydrogen peroxide, thus promoting astrocyte survival. Both lichen extracts also had anticancer activity in the cell lines, with IC50 values of 19.51-181.05 µg/ml. The extracts had a high total phenolic content, and the main constituents identified by HPLC were fumarprotocetraric acid in Cetraria islandica, and usnic, pinastric and vulpinic acids in Vulpicida canadensis. The biological activities of the lichen extracts can be attributed to these secondary metabolites. CONCLUSION: The lichen species studied are promising sources of natural compounds with neuroprotective activity and cytotoxic potential, and warrant further research.

Mitochondria-Targeted Protective Compounds in Parkinson's and Alzheimer's Diseases.

Mitochondria are cytoplasmic organelles that regulate both metabolic and apoptotic signaling pathways; their most highlighted functions include cellular energy generation in the form of adenosine triphosphate (ATP), regulation of cellular calcium homeostasis, balance between ROS production and detoxification, mediation of apoptosis cell death, and synthesis and metabolism of various key molecules. Consistent evidence suggests that mitochondrial failure is associated with early events in the pathogenesis of ageing-related neurodegenerative disorders including Parkinson's disease and Alzheimer's disease. Mitochondria-targeted protective compounds that prevent or minimize mitochondrial dysfunction constitute potential therapeutic strategies in the prevention and treatment of these central nervous system diseases. This paper provides an overview of the involvement of mitochondrial dysfunction in Parkinson's and Alzheimer's diseases, with particular attention to in vitro and in vivo studies on promising endogenous and exogenous mitochondria-targeted protective compounds.

Potential neuroprotective activity of Ginseng in Parkinson's disease: a review.

Parkinson's disease is a chronic, multifactorial and progressive neurologic condition that affects around six million people worldwide, normally over 60 years of age, and is characterized by neurodegeneration of dopaminergic neurons in the substantia nigra. The species of the genus Panax, popularly named as "Ginseng", are widely used as herbal remedies for their multiple beneficial effects, including their neurotherapeutic efficacies as protectors against major neurodegenerative diseases. The current review aims to report major findings and current knowledge on Ginseng and its major constituents as potential neuroprotective agents against Parkinson's disease, focusing on its mechanisms of action and molecular targets. For that purpose, it includes all research works published in MEDLINE/PubMed within the last decade by utilizing the following combination of the keywords: "Ginseng, ginsenosides, neuroprotection and Parkinson's disease". As reported, most of the studies have been carried out on isolated compounds rather than extracts. The major ginsenosides investigated as neuroprotector agents for Parkinson's disease are Rb1, Rg1, Rd and Re. Other minor components such as Notoginsenoside R2 and Pseudoginsenoside-F11 have also attracted remarkable interest as promising antiparkinson agents. These compounds exert their neuroprotective activity through different mechanisms including, among others, inhibition of oxidative stress and neuroinflammation, decrease in toxins-induced apoptosis and nigral iron levels, and regulation of N-methyl-D-aspartate receptor channel activity.

Antioxidant and cytoprotective potentials of Parmeliaceae lichens and identification of active compounds / Potencial antioxidante y citoprotector de líquenes parmeliáceos e identificación de compuestos activos

Lichens, symbiotic organisms with special features, are able to synthesize exclusive secondary metabolites that are attracting increasing interest in their pharmacological activities. Present study aimed to perform an initial screening of the antioxidant capacities of 29 lichens from Parmeliaceae family, and the cytoprotective potential of the most promising species in a model of central nervous system-like cells. Also, another goal was to determine the main chemical constituents of the promising lichens. After molecular identification of all lichen specimens by PCR techniques regarding the molecular marker ITS rDNA, antioxidant activity was measured in terms of free radical scavenging properties through ORAC assay. Methanol extracts of the three species with highest ORAC values (Cetrelia braunsiana (Cb), Parmotrema saccatilobum (Ps) and Usnea ghattensis (Ug)) were analyzed for phytochemical characterization through TLC and HPLC methods. We identified alectoronic acid as major metabolite in Cb, protocetraric acid in Ps and usnic, stictic and constictic acids in Ug. Concerning cytoprotective properties, their extracts were tested on human neuroblastoma cell line SH-SY5Y. Protection against H2O2- induced oxidative stress in such neuron- like model was assessed by cell viability assays, thus determining their optimal concentrations. Then, their effect on oxidative stress markers, such as intracellular ROS formation, glutathione levels and caspase-3 activity, were evaluated. In general, lichens extracts were able to reverse the oxidative damage caused by H2O2, and promoted neurons survival. Results obtained in this study imply that these lichen species might be used as promising sources for natural compounds with potential neuroprotective activity, suggesting future research avenues

Los líquenes son organismos simbióticos de especiales características capaces de sintetizar metabolitos secundarios únicos, con un creciente interés por sus propiedades farmacológicas. El presente estudio persiguió realizar un cribado de la actividad antioxidante de 29 especies liquénicas de la familia Parmeliaceae, y el potencial citoprotector de los más interesantes en un modelo neuronal. Otro objetivo consistió en derminar los principales constituyentes de dichas especies. Tras la identificación molecular de todos los especímenes por técnicas de PCR, la actividad antioxidante se evaluó por la capacidad captadora de radicales libres en el ensayo ORAC. Se analizaron por TLC y HPLC los extractos metanólicos de las tres especies con mayor valor ORAC (Cetrelia braunsiana (Cb), Parmotrema saccatilobum (Ps) and Usnea ghattensis (Ug)) y se identificaron como principales metabolitos el ácido alectorónico en Cb, el ácido protocetrárico en Ps y los ácidos úsnico, estíctico y constíctico en Ug. Estos tres extractos se probaron en células de neuroblastoma humano (línea celular SH- SY5Y). Se testó la citoprotección contra el estrés oxidativo inducido por H2O2 mediante ensayos de viabilidad celular, estableciendo las concentraciones óptimas. Posteriormente, se valoraron sus efectos en marcadores de estrés oxidativo, como la formación intracelular de especies reactivas de oxígeno, los niveles de glutatión y la actividad de la enzima caspasa-3. En general, los extractos liquénicos revirtieron el daño oxidativo causado por H2O2, promoviendo la supervivencia neuronal. Los resultados obtenidos de este estudio apuntan que las especies estudiadas pueden ser prometedoras fuentes de productos naturales con potencial actividad neuroprotecora, sugiriendo futuras líneas de investigación