-
Journal of Glaucoma Sep 2023Repeat trabeculectomy is associated with similar postoperative intraocular pressure (IOP), a lower complication rate, and a lower need for medications when compared with... (Review)
Review
PRCIS
Repeat trabeculectomy is associated with similar postoperative intraocular pressure (IOP), a lower complication rate, and a lower need for medications when compared with Ahmed valve implantation (AVI) when performed after initially failed trabeculectomy.
OBJECTIVE
The goal of this study was to compare the efficacy of repeat trabeculectomies and AVI after an initial failed trabeculectomy.
METHODS
All studies that investigated the postoperative success of patients who underwent AVI or repeat trabeculectomy with mitomycin- C after a prior failed trabeculectomy with mitomycin- C found in PubMed, Cochrane Library, Scopus, and CINAHL were included. Mean preoperative and postoperative IOP, proportions of complete and qualified successes, and proportions of complications were extracted from each study. Meta-analyses were performed to compare the differences between the two surgical approaches. Methods of measuring complete and qualified success were too heterogeneous among the included studies to allow for meta-analysis.
RESULTS
The literature search yielded 1305 studies, and 14 studies were included in the final analysis. Mean IOP was not significantly different between the two groups preoperatively and then after 1, 2, and 3 years. Mean number of medications between the two groups was similar preoperatively. After 1 and 2 years, the mean amount of glaucoma medications in the AVI group was approximately twice that of the trabeculectomy group; however, this relationship was only significant at 1 year of follow-up ( P = 0.042). In addition, the cumulative proportion of overall and sight-threatening complications was significantly higher in the AVI group.
CONCLUSION
Repeat trabeculectomy with mitomycin- C and AVI may both be considered after failed primary trabeculectomy. However, our analysis suggests that repeat trabeculectomy may be the preferred method as it provides similar efficacy with fewer disadvantages.
Topics: Humans; Follow-Up Studies; Glaucoma Drainage Implants; Intraocular Pressure; Mitomycin; Retrospective Studies; Trabeculectomy; Treatment Outcome
PubMed: 37311016
DOI: 10.1097/IJG.0000000000002240 -
Molecules (Basel, Switzerland) May 2021This review article provides a perspective on the synthesis of alicyclic and heterocyclic ring-fused benzimidazoles, imidazo[4,5-]benzimidazoles, and... (Review)
Review
This review article provides a perspective on the synthesis of alicyclic and heterocyclic ring-fused benzimidazoles, imidazo[4,5-]benzimidazoles, and imidazo[5,4-]benzimidazoles. These heterocycles have a plethora of biological activities with the iminoquinone and quinone derivatives displaying potent bioreductive antitumor activity. Synthesis is categorized according to the cyclization reaction and mechanisms are detailed. Nitrobenzene reduction, cyclization of aryl amidines, lactams and isothiocyanates are described. Protocols include condensation, cross-dehydrogenative coupling with transition metal catalysis, annulation onto benzimidazole, often using CuI-catalysis, and radical cyclization with homolytic aromatic substitution. Many oxidative transformations are under metal-free conditions, including using thermal, photochemical, and electrochemical methods. Syntheses of diazole analogues of mitomycin C derivatives are described. Traditional oxidations of -(cycloamino)anilines using peroxides in acid via the -amino effect remain popular.
Topics: Benzimidazoles; Cyclization; Imidazoles; Mitomycin
PubMed: 34064312
DOI: 10.3390/molecules26092684 -
Journal of Ayub Medical College,... 2023Cryotherapy is a common destructive treatment modality for treating plantar warts that results in blistering and scarring. Mitomycin an antitumor drug with antiviral... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Cryotherapy is a common destructive treatment modality for treating plantar warts that results in blistering and scarring. Mitomycin an antitumor drug with antiviral property is a safe, better and a promising option for treating plantar warts. Objective was to compare efficacy of cryotherapy and mitomycin microneedling in the management of plantar warts. It was a randomized controlled trial conducted at the Skin Department CMH Abbottabad from 1st May to 31st December 2021.
METHODS
The study included 60 patients with plantar warts. Each group with 30 patients. Random tables were used to determine the distribution of patients within each group. Group A received mitomycin microneedling (1u/ml) repeated every 3 weeks. Group B was prescribed liquid nitrogen cryotherapy. The freeze-thaw cycle was 20 secs and repeated every 2 weeks. Both groups were treated for 4 months duration. For analysis of data, SPSS version 21.0 was used. Efficacy was compared by the application of Chi-square test between the two groups. p<0.05 was considered statistically significant.
RESULTS
Mitomycin microneedling completely cured 76.7% of patients, while cryotherapy was effective for only 56.7%. Complete remission was observed after two to three sessions of mitomycin microneedling while average of 4 sessions of cryotherapy were required for complete remission. In general, microneedling with mitomycin had better tolerance, pain being the commonest adverse effect.
CONCLUSIONS
Plantar warts can be effectively treated with mitomycin microneedling. Treatment of plantar warts with this method is more effective, requires fewer sessions, and may take less time to complete.
Topics: Humans; Mitomycin; Cryotherapy; Warts; Antiviral Agents; Cicatrix
PubMed: 36849393
DOI: 10.55519/JAMC-01-10932 -
Current Urology Reports Sep 2016Bladder cancer is the second commonest urinary tract malignancy with 70-80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with... (Review)
Review
Bladder cancer is the second commonest urinary tract malignancy with 70-80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with high grade/G3, or CIS) represent a challenging group as they are at greater risk of recurrence and progression. Intravesical Bacilli Calmette-Guerin (BCG) is commonly used as first line therapy in this patient group but there is a current worldwide shortage. BCG has been shown to reduce recurrence in high-risk NMIBC and is more effective that other intravesical agents including mitomycin C, epirubicin, interferon-alpha and gemcitabine. Primary cystectomy offers a high change of cure in this cohort (80-90 %) and is a more radical treatment option which patients need to be counselled carefully about. Bladder thermotherapy and electromotive drug administration with mitomycin C are alternative therapies with promising short-term results although long-term follow-up data are lacking.
Topics: Antineoplastic Agents; BCG Vaccine; Cystectomy; Humans; Hyperthermia, Induced; Immunotherapy; Mitomycin; Urinary Bladder Neoplasms
PubMed: 27492610
DOI: 10.1007/s11934-016-0625-z -
Ophthalmology. Glaucoma 2021Intra-Tenon or subconjunctival injection of a solution of mitomycin C (MMC) and 1% preservative-free lidocaine (as an anesthetic) has gained popularity for its use in...
PURPOSE
Intra-Tenon or subconjunctival injection of a solution of mitomycin C (MMC) and 1% preservative-free lidocaine (as an anesthetic) has gained popularity for its use in trabeculectomy, a filtering surgery for glaucoma. To our knowledge, no studies have analyzed the impact of lidocaine on the cytotoxic effects of MMC in this setting. This study was conducted to evaluate in vitro fibroblast cytotoxicity to a solution of MMC (0.2 mg/ml) and 1% preservative-free lidocaine.
DESIGN
Experimental study.
PARTICIPANTS
Nonhuman subject research.
METHODS
Cultured human conjunctival fibroblasts were incubated in phosphate-buffered saline (PBS) (control), MMC (0.2 mg/ml), a mixture of 0.2 mg/ml MMC + 1% preservative-free lidocaine, or 1% preservative-free lidocaine. Samples were taken at 2, 5, 10, 30, and 60 minutes, and a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay with photoabsorbance testing was used to assess conjunctival cell viability.
MAIN OUTCOME MEASURE
Mean photoabsorbance.
RESULTS
Mean photoabsorbance across all time intervals was 0.680 for solutions incubated in PBS, 0.642 for MMC, 0.612 for MMC + 1% preservative-free lidocaine, and 0.605 for 1% preservative-free lidocaine. A 2-way analysis of variance analyzing solution, time, and solution-time interaction on photoabsorbance showed that PBS was least cytotoxic and an optimal control for this study. Tukey post hoc comparisons showed that MMC was more cytotoxic than PBS (P < 0.001). However, both MMC + 1% preservative-free lidocaine and 1% preservative-free lidocaine were more cytotoxic than MMC and PBS (P < 0.01 for all). No significant differences in cytotoxicity comparing lidocaine-containing solutions were observed.
CONCLUSIONS
In this in vitro study, we found an increase in cytotoxicity when MMC (0.2 mg/ml) was combined with 1% preservative-free lidocaine. We note that lidocaine did not inhibit MMC cytotoxicity and exhibited a significant cytotoxic effect on its own.
Topics: Glaucoma; Humans; Lidocaine; Mitomycin; Tetrazolium Salts; Trabeculectomy
PubMed: 33080409
DOI: 10.1016/j.ogla.2020.10.011 -
Bioorganic Chemistry Jun 2022While interstrand crosslinks (ICLs) have been considered as one type of DNA damage in the past, there is mounting evidence suggesting that these highly cytotoxic lesions...
While interstrand crosslinks (ICLs) have been considered as one type of DNA damage in the past, there is mounting evidence suggesting that these highly cytotoxic lesions are processed differently by the cellular machinery depending upon the ICL structure. In this study, we examined the crosslinking ability of three mitomycins, the structure of the ICLs they produce and the cytotoxicity of the drugs toward three different cell lines. The drugs are: mitomycin C (1), decarbamoylmitomycin C (2), and a mitomycin-conjugate (3) whose mitosane moiety is linked to a N-methylpyrrole carboxamide. We found that, overall, both MC and compound 3 show strong similarities regarding their alkylation of DNA, while DMC alkylating behavior is markedly different. To gain further insight into the mode of action of these drugs, we performed high throughput gene expression and gene ontology analysis to identify gene expression and cellular pathways most impacted by each drug treatment in MCF-7 cell lines. We observed that the novel mitomycin derivative (3) specifically causes changes in the expression of genes encoding proteins involved in cell integrity and tissue structure. Further analysis using bioinformatics (IPA) indicated that the new derivative (3) displays a stronger downregulation of major signaling networks that regulate the cell cycle, DNA damage response and cell proliferation when compared to MC and DMC. Collectively, these findings demonstrate that cytotoxic mechanisms of all three drugs are complex and are not solely related to their crosslinking abilities or the structure of the ICLs they produce.
Topics: Alkylation; DNA; DNA Adducts; DNA Damage; Humans; Mitomycin; Mitomycins
PubMed: 35349830
DOI: 10.1016/j.bioorg.2022.105744 -
Pediatric Nephrology (Berlin, Germany) Feb 2018Refinement of immunosuppressive strategies has led to further improvement of kidney graft survival in recent years. Currently, the main limitations to long-term graft... (Review)
Review
Refinement of immunosuppressive strategies has led to further improvement of kidney graft survival in recent years. Currently, the main limitations to long-term graft survival are life-threatening side effects of immunosuppression and chronic allograft injury, emphasizing the need for innovative immunosuppressive regimens that resolve this therapeutic dilemma. Several cell therapeutic approaches to immunosuppression and donor-specific unresponsiveness have been tested in early phase I and phase II clinical trials in kidney transplantation. The aim of this overview is to summarize current cell therapeutic approaches to immunosuppression in clinical kidney transplantation with a focus on myeloid suppressor cell therapy by mitomycin C-induced cells (MICs). MICs show great promise as a therapeutic agent to achieve the rapid and durable establishment of donor-unresponsiveness in living-donor kidney transplantation. Cell-based therapeutic approaches may eventually revolutionize immunosuppression in kidney transplantation in the near future.
Topics: Humans; Immunosuppression Therapy; Kidney Transplantation; Mitomycin; Myeloid-Derived Suppressor Cells; Nucleic Acid Synthesis Inhibitors; Transplantation Tolerance
PubMed: 28229281
DOI: 10.1007/s00467-017-3599-2 -
Chest Mar 2021
Topics: Humans; Mitomycin; Neoplasms; Pulmonary Veno-Occlusive Disease
PubMed: 33678275
DOI: 10.1016/j.chest.2020.10.060 -
Journal of Bronchology & Interventional... Jul 2023Therapeutic options for managing laryngotracheal stenosis (LTS) are limited. Endoscopy is a minimally invasive approach to treating LTS, but carries a high risk of... (Review)
Review Meta-Analysis
BACKGROUND
Therapeutic options for managing laryngotracheal stenosis (LTS) are limited. Endoscopy is a minimally invasive approach to treating LTS, but carries a high risk of stenosis recurrence. Mitomycin C (MMC) is often used as an adjunct therapy to delay the time to symptomatic recurrence of LTS. This review synthesizes the current literature on the topic of MMC as an adjunct treatment strategy for LTS.
METHODS
A focused literature search was carried out from PubMed on June 12, 2022 using the terms "mitomycin c AND stenosis" in all fields with no date limitations. Evidence-based recommendations relevant to the clinical application of MMC as an adjunct therapy for LTS were formulated. Three questions were addressed: 1) efficacy of MMC, 2) single versus multiple application(s) of MMC, and 3) safety of MMC. The evidence rating and recommendation strength were guided by the GRADE system.
RESULTS
Twenty-nine studies were reviewed. The efficacy of MMC as an adjunct therapy for LTS varied across studies. Randomized controlled trials have not shown an outcome difference with MMC use, although methodologic flaws including underpowering were noted. A meta-analysis of observational studies with a comparator arm found the unadjusted probability of remaining symptom-free for > 1 year is greater with versus without MMC application (73% vs. 35%). Single versus multiple application(s) of MMC resulted in similar restenosis rates at long-term follow-up. Complications related to MMC use are rarely reported using conventional doses (0.4 mg/mL). Overall, the quality of evidence was low and the recommendation for intervention was weak.
CONCLUSION
The role for MMC as an adjunct therapy in LTS is uncertain. While safe in its application, the efficacy of MMC in reducing stenosis recurrence remains a matter of debate. Large, prospective studies are needed to inform future recommendations.
Topics: Humans; Mitomycin; Constriction, Pathologic; Treatment Outcome; Laryngostenosis; Tracheal Stenosis
PubMed: 37271867
DOI: 10.1097/LBR.0000000000000933 -
Journal of Oral and Maxillofacial... Feb 2017Keloids are difficult to remove successfully and there is no universally accepted treatment. After surgical excision of the keloid, there are various management methods... (Review)
Review
PURPOSE
Keloids are difficult to remove successfully and there is no universally accepted treatment. After surgical excision of the keloid, there are various management methods for prevention of keloid recurrence, such as intralesional injection, radiation, and topical agents. A few studies have compared topical agents with other treatments. The aim of this study was to investigate effective topical agents for the prevention of recurrent keloid after surgical excision.
MATERIALS AND METHODS
Eligible articles were sought using core databases, including Medline, Embase, and Cochrane databases, up to April 2016. The predictor variables were mitomycin C (MC) and imiquimod cream treatment after keloid excision. The outcome variable was keloid recurrence rate.
RESULTS
The search strategy identified 120 publications. After screening, 9 articles were selected for review. Articles were divided into 2 groups: MC and imiquimod cream. The recurrence rate after surgical excision in the MC group was estimated to be 16.5%, and that in the imiquimod cream group was estimated to be 24.7%.
CONCLUSION
If intralesional injection or radiation is not available, then MC or imiquimod 5% cream could be an effective alternative in preventing keloid recurrence.
Topics: Administration, Cutaneous; Aminoquinolines; Dermatologic Agents; Humans; Imiquimod; Keloid; Mitomycin; Recurrence; Treatment Outcome
PubMed: 27865791
DOI: 10.1016/j.joms.2016.10.009