RESUMO
Curcumin, as an anti-tumor agent, is not widely used in cancer treatment due to the lack of effective levels of its metabolites in cancerous tissue. Addressing the barriers to the carrier and delivery of drugs to the specific sites of therapeutic action while reducing side effects is a priority. Folate receptor expression is high in malignant and low in normal cells. Folate as a targeted ligand could selectively target cancer cells. Thus, this narrative review aimed to provide an overview of the studies that have investigated the different types of folate-modified curcumin as a carrier and deliverer and their structural properties that enhance therapeutic drug efficacy. A literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar databases. Thirty-eight preclinical studies addressing this topic were identified. The findings of the current review have shown that folate-modified nanoparticles containing curcumin as a promising therapeutic approach can be effective in improving different types of cancers. In vitro studies have shown a higher cellular uptake and cytotoxicity effect, higher cell inhibition, and anti-proliferation with a lower dosage of curcumin. In vivo studies have shown more tumor suppression and smaller tumor volume without toxicity after the administration of folate-modified nanoparticles containing curcumin. Future clinical trials are needed to confirm the beneficial effect of folate-modified curcumin as a new drug delivery platform for cancer treatment.
RESUMO
BACKGROUND: Currently, there is no accounted-for consensus and practical standard when counseling diet modification for kidney transplant recipients (KTRs). There are many differences between transplant centers regarding what KTRs are needed to follow a diet, what dietary factors and supplements are allowed, and how long KTRs should follow a modified diet. Relatively few scatter data are available for dietary factors in KTRs. Thus, we aimed to systematically review the literature on the purported dietary factors for kidney function. METHODS: A systematic literature search was performed between February and March 2022 and updated in February 2023 using PubMed, Scopus, Web of Science, and Google Scholar. We included human observational and interventional studies that evaluated a dietary factor on kidney function and graft survival in KTRs. Data were extracted, and the risk of bias was assessed using established tools relevant to the study design. RESULTS: Of the 5341 citations retrieved, seven prospective cohorts, five cross-sectional, seventeen randomized, and ten non-randomized clinical trials were included that evaluated seven purported dietary factors. Almost half of the studies (n = 22; 56%) were classified as having a low degree of bias and sufficient support. Twenty-one studies (54%) reported a positive effect on KTRs. DASH and Mediterranean diets decreased graft failure, low-sodium diet reduced blood pressure, and antioxidants improved creatinine, GFR, and graft function. Of these, only twelve studies (31%) were at low risk of bias. CONCLUSION: Some dietary factors, including DASH, Mediterranean, moderate protein, and low-sodium diet, as well as antioxidants, may be associated with improved survival and kidney function in KTRs. However, more research is needed.