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Tropical Medicine and Infectious Disease May 2023With more than 12 million cases worldwide, leishmaniasis is one of the top 10 neglected tropical diseases. According to the WHO, there are approximately 2 million new... (Review)
Review
With more than 12 million cases worldwide, leishmaniasis is one of the top 10 neglected tropical diseases. According to the WHO, there are approximately 2 million new cases each year in foci in around 90 countries, of which 1.5 million are cutaneous leishmaniasis (CL). Cutaneous leishmaniasis (CL) is a complex cutaneous condition that is caused by a variety of species, including () , () () , () () , and () . The disease imposes a significant burden on those who are affected since it typically results in disfiguring scars and extreme social stigma. There are no vaccines or preventive treatments available, and chemotherapeutic medications, including antimonials, amphotericin B, miltefosine, paromomycin, pentamidine, and antifungal medications, have a high price tag, a significant risk of developing drug resistance, and a variety of systemic toxicities. To work around these limitations, researchers are continuously looking for brand-new medications and other forms of therapy. To avoid toxicity with systemic medication use, high cure rates have been observed using local therapy techniques such as cryotherapy, photodynamic therapy, and thermotherapy, in addition to some forms of traditional therapies, including leech and cauterization therapies. These CL therapeutic strategies are emphasized and assessed in this review to help with the process of locating the appropriate species-specific medicines with fewer side effects, lower costs, and elevated cure rates.
PubMed: 37235323
DOI: 10.3390/tropicalmed8050275 -
Anticancer Research May 2020Management strategies such as surgery and systemic therapy (androgen-deprivation therapy and chemotherapy) are considered a standard of care for patients with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/AIM
Management strategies such as surgery and systemic therapy (androgen-deprivation therapy and chemotherapy) are considered a standard of care for patients with oligometastatic prostate cancer and have shown some positive results in many patients. However, they are often accompanied by side-effects that can negatively affect patients. The aim of this study is to review the potential of stereotactic body radiation therapy (SBRT) in the management of oligometastatic prostate cancer and to compare treatment outcomes with SBRT to those under standard of care management regarding progression-free survival (PFS), androgen-deprivation therapy (ADT)-free survival and local control rate (LCR) as well as a comparison of toxicity profiles.
MATERIALS AND METHODS
MEDLINE (PubMed), EMBASE, and Clinicaltrials.gov databases were searched to identify prospective randomised controlled trials as well as retrospective studies investigating SBRT and standard of care management for oligometastatic prostate cancer. Data on treatment outcomes and toxicity profiles were extracted.
RESULTS
A total of 18 studies were included: 14 reported on the use of SBRT and four reported on the use of standard of care management. For SBRT, median PFS was 7.36-24 months. Median ADT-free survival was 12.3-39.7 months. The LCR varied, with some reports of 100% at 6 months and others of 92% at 5 years. No significant grade 3 toxicity was reported, with only five grade 3 events reported in two studies. For standard of care management, most of the studies reported 3-year PFS of 46.9-58.6%, with one study reporting a median PFS of 38.6 months. No standard of care study reported on LCR and ADT-free survival. Although different toxicity grading systems were used depending on the treatment modality, there were some reports of grade 3 events using standard of care management.
CONCLUSION
SBRT appears to be a safe and effective modality for treating oligometastatic prostate cancer, having the potential to defer palliative ADT. Although LCR is excellent compared to conventional therapies, the PFS rate is reportedly inferior to standard of care therapies. No significant grade 3 toxicity was observed with SBRT.
Topics: Combined Modality Therapy; Disease Management; Humans; Male; Neoplasm Grading; Neoplasm Metastasis; Neoplasm Staging; Prostatic Neoplasms; Radiosurgery; Treatment Outcome
PubMed: 32366385
DOI: 10.21873/anticanres.14211 -
Journal of Complementary & Integrative... Aug 2020Since antiquity, the Unani system of medicine has been participating in health care system. Usually, four modes of treatment viz. regimenal therapy, dietotherapy,... (Review)
Review
Since antiquity, the Unani system of medicine has been participating in health care system. Usually, four modes of treatment viz. regimenal therapy, dietotherapy, pharmacotherapy and surgery are applied for the treatment of diseases. Regimenal therapy is an important mode in which the morbid matter present in the body is either dispersed/excreted or its unnecessary production is blocked or its flow is restricted and the diseases are cured by natural healer of the body, consequently bring back the humoural stability. Nearly 30 regimens have been mentioned in classical Unani literature. Commonest regimenal procedures such as (venesection/phlebotomy), (cupping), (hirudotherapy/leech therapy), (purgation), (emesis), - (diuresis), (enema), (diaphoresis), (exercise), (massage), (bathing), (oiling), (irrigation), (douching/spraying), (steam/vapour application), (fomentation) etc. are usually applied for the management of various ailments. These regimenal procedures are completely based on holistic approach and are potential but needs to be explored scientifically. This review outlines the therapeutic applications of various regimens of regimenal therapy used in Unani medicine.
Topics: Leeching; Medicine, Unani
PubMed: 32853166
DOI: 10.1515/jcim-2020-0048 -
Indian Dermatology Online Journal 2023Leeches are hermaphroditic parasites of phylum Annelida and class Hirudinea. A minority of these are sanguinivorous and the cause of human morbidity. Historically,...
Leeches are hermaphroditic parasites of phylum Annelida and class Hirudinea. A minority of these are sanguinivorous and the cause of human morbidity. Historically, leeches have been used for medicinal purposes with the earliest recorded being 1500 BC. Medicinal leeches use their suction discs for locomotion, adhesion to the host, and, in the case of the anterior disc, also for blood ingestion. Dermoscopy is a new non-invasive tool that can help in the diagnosis of miscellaneous skin conditions. The new dermoscopic sign of leech bite i.e., the Mercedes Benz Logo sign which corresponds to the retractable tripartite jaw apparatus of the leech, can easily help in the quick diagnosis of the condition and referral of the patient for proper management without any delay.
PubMed: 37727570
DOI: 10.4103/idoj.idoj_414_22 -
Acta Chirurgica Belgica Dec 2023Dawali (varicose veins) is the disease of chronic dilation of veins. The veins of the legs become dilated and blue due to excessive accumulation of blood. This disease... (Review)
Review
INTRODUCTION
Dawali (varicose veins) is the disease of chronic dilation of veins. The veins of the legs become dilated and blue due to excessive accumulation of blood. This disease and the effort to identify and treat it has a very long history. The condition may have first been described in the Ebers Papyrus more than 3500 years ago. The present study deals with the turning points and progress of varicose vein surgery since ancient times, emphasizing the innovations of the scholars of the Islamic period.
METHODS
The present study is based on searching library documents and database data such as PubMed, Scopus, Science Direct, and search engines such as Google Scholar. In the end, the Prisma flow chart was drawn.
RESULTS
Besides diagnosing different varicose veins (legs, thighs, abdomen, uterus, and testes), the scholars of the Islamic period were well-versed in their prevention, etiology, and treatment. In treating varicose veins, these physicians used methods such as cleansing, phlebotomy, compression, leech therapy, and surgery, and some of them were the founders of new treatments.
CONCLUSION
The surgical treatment of varicose veins in the past was similar to modern surgical therapies. What distinguishes yesterday's varicose vein surgery from today's surgery is a more advanced tool. There is no denying the remarkable progress in using health principles, treatment techniques, and surgical instruments to facilitate surgery and reduce the disease's complications and recurrence. However, the treatment framework and foundation, such as phlebectomy and compression, were all invented and introduced in the distant past.
Topics: Female; Humans; Vascular Surgical Procedures; Varicose Veins; Leg; Treatment Outcome
PubMed: 37671628
DOI: 10.1080/00015458.2023.2254603 -
Digestive Diseases and Sciences Jul 2021Fatigue affects 50% of primary biliary cholangitis patients and is severe in approximately 20%, significantly affecting quality of life. The pathogenesis of fatigue in...
BACKGROUND
Fatigue affects 50% of primary biliary cholangitis patients and is severe in approximately 20%, significantly affecting quality of life. The pathogenesis of fatigue in primary biliary cholangitis is poorly understood. This study aimed to explore subgroups of fatigue to support targeting of selected groups in future clinical trials.
METHODS
Data were derived from the UK-PBC cohort. Participants completed the PBC-40, Hospital Anxiety and Depression Score, Epworth Sleepiness Scale, and Orthostatic Grading Scale for symptoms assessment. Fatigue and cognitive symptoms were regarded as clinically significant if they exceeded the previously defined cutoff for "moderate" symptom.
RESULTS
Of 2002, patients for whom full PBC-40, fatigue, and cognitive symptom domain scores were available, 1203 (60%) had significant fatigue and 730 (36%) had significant cognitive symptoms. Among the 1203 patients with significant fatigue, 663 (55%) also had significant cognitive symptoms (termed fatigue with cognitive symptoms) with a significant linear association between the fatigue and cognitive symptom severity. "Fatigue with cognitive symptoms" patients were younger and more likely to have severe fatigue. They also experienced greater social and emotional impact.
CONCLUSIONS
Fatigue in PBC is complex, and there has been no progress to date in identifying therapies able to improve it. One factor in slow progress may be the heterogeneity of patients describing fatigue complicating effective cohort selection for clinical trials. This study has identified potential discrete subgroups of fatigued patients with and without cognitive symptoms. The group of patients expressing "fatigue with cognitive symptoms" was homogenous and may represent a coherent cohort for clinical trials.
Topics: Aged; Cholagogues and Choleretics; Cohort Studies; Fatigue; Female; Humans; Liver Cirrhosis, Biliary; Male; Middle Aged; Ursodeoxycholic Acid
PubMed: 32851498
DOI: 10.1007/s10620-020-06502-0 -
Journal of the American Animal Hospital... Nov 2022The objective of this study was to report the clinical indications, outcomes, and complications associated with medicinal leech therapy (MLT) in dogs and cats. Medical...
The objective of this study was to report the clinical indications, outcomes, and complications associated with medicinal leech therapy (MLT) in dogs and cats. Medical records (2012-2016) of client-owned dogs (n = 9) and cats (n = 3) treated with MLT at one institution were retrospectively reviewed. Retrieved data included the signalment, indications, physical examination findings, laboratory results, methods of leeching, outcomes, and complications associated with MLT. Following MLT sessions, nine patients (75%) visibly showed clear improvement of the affected tissue. One patient (8%) was euthanized before complete healing owing to pulmonary parenchymal disease. Improvement or appearance of tissue following MLT was not recorded in two patients (17%). Results suggest that MLT may be a safe and effective treatment modality for venous congestion and necrosis in compromised skin flaps and wounds with success in resolving 75% of the lesions in this study. This study is suggestive of the value of MLT when more conventional treatment methods fail in dogs and cats. A data collection form was created for veterinarians to use with the goal of obtaining standardized, objective MLT data for future studies.
Topics: Cats; Dogs; Animals; Leeching; Retrospective Studies; Cat Diseases; Dog Diseases; Surgical Flaps
PubMed: 36315858
DOI: 10.5326/JAAHA-MS-7146 -
Journal of Experimental & Clinical... Sep 2020The activator protein-1 (AP-1) family of transcription factors modulate a diverse range of cellular signalling pathways into outputs which can be oncogenic or... (Review)
Review
The activator protein-1 (AP-1) family of transcription factors modulate a diverse range of cellular signalling pathways into outputs which can be oncogenic or anti-oncogenic. The transcription of relevant genes is controlled by the cellular context, and in particular by the dimeric composition of AP-1. Here, we describe the evidence linking cJun in particular to a range of cancers. This includes correlative studies of protein levels in patient tumour samples and mechanistic understanding of the role of cJun in cancer cell models. This develops an understanding of cJun as a focal point of cancer-altered signalling which has the potential for therapeutic antagonism. Significant work has produced a range of small molecules and peptides which have been summarised here and categorised according to the binding surface they target within the cJun-DNA complex. We highlight the importance of selectively targeting a single AP-1 family member to antagonise known oncogenic function and avoid antagonism of anti-oncogenic function.
Topics: Animals; Antineoplastic Agents; Humans; Molecular Targeted Therapy; Neoplasms; Proto-Oncogene Proteins c-jun
PubMed: 32917236
DOI: 10.1186/s13046-020-01686-9 -
Cells Aug 2021Vitamin D and cholesterol metabolism overlap significantly in the pathways that contribute to their biosynthesis. However, our understanding of their independent and... (Review)
Review
Vitamin D and cholesterol metabolism overlap significantly in the pathways that contribute to their biosynthesis. However, our understanding of their independent and co-regulation is limited. Cardiovascular disease is the leading cause of death globally and atherosclerosis, the pathology associated with elevated cholesterol, is the leading cause of cardiovascular disease. It is therefore important to understand vitamin D metabolism as a contributory factor. From the literature, we compile evidence of how these systems interact, relating the understanding of the molecular mechanisms involved to the results from observational studies. We also present the first systems biology pathway map of the joint cholesterol and vitamin D metabolisms made available using the Systems Biology Graphical Notation (SBGN) Markup Language (SBGNML). It is shown that the relationship between vitamin D supplementation, total cholesterol, and LDL-C status, and between latitude, vitamin D, and cholesterol status are consistent with our knowledge of molecular mechanisms. We also highlight the results that cannot be explained with our current knowledge of molecular mechanisms: (i) vitamin D supplementation mitigates the side-effects of statin therapy; (ii) statin therapy does not impact upon vitamin D status; and critically (iii) vitamin D supplementation does not improve cardiovascular outcomes, despite improving cardiovascular risk factors. For (iii), we present a hypothesis, based on observations in the literature, that describes how vitamin D regulates the balance between cellular and plasma cholesterol. Answering these questions will create significant opportunities for advancement in our understanding of cardiovascular health.
Topics: Animals; Cardiovascular Diseases; Cholesterol; Cholesterol, LDL; Dyslipidemias; Heart Disease Risk Factors; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Models, Biological; Prognosis; Risk Assessment; Systems Biology; Vitamin D; Vitamin D Deficiency
PubMed: 34440777
DOI: 10.3390/cells10082007 -
Journal of Ethnopharmacology Apr 2024Leech, as a traditional Chinese medicine for the treatment of blood circulation and blood stasis, was also widely used to cure pulmonary fibrosis in China. In clinical...
ETHNOPHARMACOLOGICAL RELEVANCE
Leech, as a traditional Chinese medicine for the treatment of blood circulation and blood stasis, was also widely used to cure pulmonary fibrosis in China. In clinical practice, some traditional Chinese medicine preparation such as Shui Zhi Xuan Bi Hua Xian Tang and Shui Zhi Tong Luo Capsule composed of leech, could improve the clinical symptoms and pulmonary function in patients with idiopathic pulmonary fibrosis (IPF). However, the material basis of the leech in the treatment of IPF were not yet clear.
AIM OF THE STUDY
Screen out the components of leech that have the anti-pulmonary fibrosis effects, and further explore the therapeutic mechanism of the active components.
MATERIALS AND METHODS
In this study, the different molecular weight components of leech extract samples were prepared using the semi-permeable membranes with different pore sizes. The therapeutic effects of the leech extract groups with molecular weight greater than 10 KDa (>10 KDa group), between 3 KDa and 10 KDa (3-10 KDa group), and less than 3 KDa (<3 KDa group) on pulmonary fibrosis were firstly investigated by cell proliferation and cytotoxicity assay (MTT), cell wound healing assay, immunofluorescence staining (IF) and Western blot (WB) assay through the TGF-β1-induced fibroblast cell model. Then bleomycin-induced pulmonary fibrosis (BML-induced PF) mouse model was constructed to investigate the pharmacological activities of the active component group of leech extract in vivo. Pathological changes of the mouse lung were observed by hematoxylin-eosin staining (H&E) and Masson's trichrome staining (Masson). The hydroxyproline (HYP) content of lung tissues was quantified by HYP detection kit. The levels of extracellular matrix-related fibronectin (FN) and collagen type Ⅰ (Collagen Ⅰ), pyruvate kinase M2 (PKM2) monomer and Smad7 protein were determined via WB method. PKM2 and Smad7 protein were further characterized by IF assays.
RESULTS
Using TGF-β1-induced HFL1 cell line as a PF cell model, the in vitro results demonstrated that the >10 KDa group could significantly inhibited the cell proliferation and migration, downregulated the expression level of cytoskeletal protein vimentin and α-smooth muscle actin (α-SMA), and reduced the deposition of FN and Collagen Ⅰ. In the BML-induced PF mouse model, the >10 KDa group significantly reduced the content of HYP, downregulated the expression levels of FN and Collagen Ⅰ in lung tissues, and delayed the pathological changes of lung tissue structure. The results of WB and IF assays further indicated that the >10 KDa group could up-regulate the expression level of PKM2 monomer and Smad7 protein in the cellular level, thereby delaying the progression of pulmonary fibrosis.
CONCLUSIONS
Our study revealed that the >10 KDa group was the main material basis of the leech extract that inhibited pulmonary fibrosis through TGF-β1/Smad3 signaling pathway.
Topics: Mice; Animals; Humans; Transforming Growth Factor beta1; Smad7 Protein; Idiopathic Pulmonary Fibrosis; Collagen Type I; Bleomycin; Disease Models, Animal; Signal Transduction
PubMed: 38228229
DOI: 10.1016/j.jep.2024.117737