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ACS Nano Nov 2023Spinal cord injury (SCI) can cause permanent loss of sensory and motor function, and there is no effective clinical treatment, to date. Due to the complex pathological...
Spinal cord injury (SCI) can cause permanent loss of sensory and motor function, and there is no effective clinical treatment, to date. Due to the complex pathological process involved after injury, synergistic treatments are very urgently needed in clinical practice. We designed a nanofiber scaffold hyaluronic acid hydrogel patch to release both exosomes and methylprednisolone to the injured spinal cord in a non-invasive manner. This composite patch showed good biocompatibility in the stabilization of exosome morphology and toxicity to nerve cells. Meanwhile, the composite patch increased the proportion of M2-type macrophages and reduced neuronal apoptosis in an in vitro study. In vivo, the functional and electrophysiological performance of rats with SCI was significantly improved when the composite patch covered the surface of the hematoma. The composite patch inhibited the inflammatory response through macrophage polarization from M1 type to M2 type and increased the survival of neurons by inhibition neuronal of apoptosis after SCI. The therapeutic effects of this composite patch can be attributed to TLR4/NF-κB, MAPK, and Akt/mTOR pathways. Thus, the composite patch provides a medicine-exosomes dual-release system and may provide a non-invasive method for clinical treatment for individuals with SCI.
Topics: Rats; Animals; Methylprednisolone; Exosomes; Spinal Cord Injuries; Macrophages; Neurons; Spinal Cord
PubMed: 37948097
DOI: 10.1021/acsnano.3c08046 -
International Journal of Dermatology Jun 2017The 4th generation topical corticosteroids (TCS) have demonstrated a most favorablerisk-benefit ratio. Methylprednisolone aceponate (MPA) is a non-halogenated... (Review)
Review
BACKGROUND
The 4th generation topical corticosteroids (TCS) have demonstrated a most favorablerisk-benefit ratio. Methylprednisolone aceponate (MPA) is a non-halogenated corticosteroid with a methyl group at C6, which confers higher intrinsic activity. MPA is included in the group of potent TCS (category III/IV).
METHODS
A literature review is carried out of the clinical efficacy, pharmacokinetics, and adverse effects of MPA, especially for the treatment of atopic dermatitis (AD).
RESULTS
Several clinical studies support the use of MPA in infants and children, with minimal local or systemic adverse effects reported. The pharmacokinetic profile and the low rate of adverse effects of MPA are most suitable for the treatment of atopic dermatitis (AD), a chronic disease with frequent flaring that can involve extensive areas of the skin.
CONCLUSIONS
Most patients with AD can be easily brought into control with the use of only TCS. Achieving a complete healing of eczema is key in AD, and once the skin is clinically healthy, emollients can be used according to the physician and patient preferences. Physicians should be trained in the recognition of early or subtle manifestations of active eczema that are most suitably treated with topical TCS to achieve a most rapid and satisfactory control of the disease. If the whole area with eczema is not treated, active eczema will remain and treatment will be ineffective. Insufficient use of TCS will lead to inefficiency and frustration.
Topics: Administration, Cutaneous; Anti-Inflammatory Agents; Dermatitis, Atopic; Humans; Maintenance Chemotherapy; Methylprednisolone
PubMed: 28258632
DOI: 10.1111/ijd.13485 -
Postepy Higieny I Medycyny... Jun 2013Methylprednisolone is a synthetic glucocorticoid with a potent and long-acting anti-inflammatory, antiallergic and immunosuppressant. Its mechanism of action of... (Review)
Review
Methylprednisolone is a synthetic glucocorticoid with a potent and long-acting anti-inflammatory, antiallergic and immunosuppressant. Its mechanism of action of methylprednisolone is the result of many cellular changes. Methylprednisolone is used in many diseases, such as rheumatic diseases, autoimmune diseases, allergic, anaphylactic shock, asthma. Methylprednisolone was also used in patients with spinal cord injury, in order to minimize neurological damage. While in the above mentioned fields of medicine is undeniable role of methylprednisolone, whereas its use in the treatment of traumatic spinal cord injury within the last few years raises a lot of controversy, and in most cases, the side effects of its use outweigh the potential benefits.
Topics: Animals; Anti-Inflammatory Agents; Glucocorticoids; Humans; Methylprednisolone; Muscular Diseases; Neuroprotective Agents; Spinal Cord Injuries
PubMed: 23800640
DOI: 10.5604/17322693.1054873 -
Multiple Sclerosis (Houndmills,... Jul 1996High dose intravenous methylprednisolone treatment is effective and safe in the treatment of relapses in multiple sclerosis, but the long term effects are unclear.... (Review)
Review
High dose intravenous methylprednisolone treatment is effective and safe in the treatment of relapses in multiple sclerosis, but the long term effects are unclear. Pharmacokinetics are almost unknown, but may be very important for the understanding of the clinical and paraclinical effects. In view of what is known now, IVMP should have a prominent place in basic and clinical MS research.
Topics: Dose-Response Relationship, Drug; Forecasting; Humans; Methylprednisolone; Multiple Sclerosis; Treatment Outcome
PubMed: 9345410
DOI: 10.1177/135245859600100607 -
International Journal of Clinical... Jan 2006Methylprednisolone aceponate (MPA) has been shown to provide rapid, reliable and highly effective treatment of eczematous disorders, with an efficacy comparable to that... (Review)
Review
Methylprednisolone aceponate (MPA) has been shown to provide rapid, reliable and highly effective treatment of eczematous disorders, with an efficacy comparable to that of most reference topical corticosteroids. It also has excellent local and systemic tolerability. MPA is effective in the treatment of facial and scalp eczema and sunburn and has shown promising results in the treatment of psoriasis. Its rapid efficacy and lack of undesirable local and/or systemic side effects make MPA particularly suitable for use in children and infants. The wide range of formulations (0.1%) of MPA, including cream, ointment, fatty ointment, milk and solution, enable treatment to be tailored to the individual patient. In addition, MPA has the advantage of once-daily application compared with twice-daily treatment for other topical corticosteroids, thereby improving patient safety and promoting patient compliance but without compromising efficacy.
Topics: Anti-Inflammatory Agents; Dermatitis; Dermatologic Agents; Eczema; Facial Dermatoses; Humans; Methylprednisolone; Psoriasis; Scalp Dermatoses; Sunburn; Treatment Outcome
PubMed: 16409433
DOI: 10.1111/j.1368-5031.2005.00754.x -
The Canadian Journal of Neurological... Aug 2002A systematic review of the evidence pertaining to methylprednisolone infusion following acute spinal cord injury was conducted in order to address the persistent... (Review)
Review
BACKGROUND
A systematic review of the evidence pertaining to methylprednisolone infusion following acute spinal cord injury was conducted in order to address the persistent confusion about the utility of this treatment.
METHODS
A committee of neurosurgical and orthopedic spine specialists, emergency physicians and physiatrists engaged in active clinical practice conducted an electronic database search for articles about acute spinal cord injuries and steroids, from January 1, 1966 to April 2001, that was supplemented by a manual search of reference lists, requests for unpublished additional information, translations of foreign language references and study protocols from the author of a Cochrane systematic review and Pharmacia Inc. The evidence was graded and recommendations were developed by consensus.
RESULTS
One hundred and fifty-seven citations that specifically addressed spinal cord injuries and methylprednisolone were retrieved and 64 reviewed. Recommendations were based on one Cochrane systematic review, six Level I clinical studies and seven Level II clinical studies that addressed changes in neurological function and complications following methylprednisolone therapy.
CONCLUSIONS
There is insufficient evidence to support the use of high-dose methylprednisolone within eight hours following an acute closed spinal cord injury as a treatment standard or as a guideline for treatment. Methylprednisolone, prescribed as a bolus intravenous infusion of 30 mg per kilogram of body weight over fifteen minutes within eight hours of closed spinal cord injury, followed 45 minutes later by an infusion of 5.4 mg per kilogram of body weight per hour for 23 hours, is only a treatment option for which there is weak clinical evidence (Level I- to II-1). There is insufficient evidence to support extending methylprednisolone infusion beyond 23 hours if chosen as a treatment option.
Topics: Acute Disease; Anti-Inflammatory Agents; Drug Administration Schedule; Evidence-Based Medicine; Humans; Injections, Intravenous; Methylprednisolone; Spinal Cord Injuries
PubMed: 12195611
DOI: 10.1017/s0317167100001992 -
Pediatric Hematology and Oncology 1993
Review
Topics: Anaphylaxis; Heart Arrest; Humans; Methylprednisolone
PubMed: 8217535
DOI: 10.3109/08880019309029486 -
Journal of Cardiothoracic and Vascular... Apr 2005
Review
Topics: Anti-Inflammatory Agents; Cardiopulmonary Bypass; Clinical Trials as Topic; Humans; Inflammation; Lung Diseases; Methylprednisolone; Neuroprotective Agents; Postoperative Complications
PubMed: 15868540
DOI: 10.1053/j.jvca.2005.02.008 -
Annals of the Rheumatic Diseases Apr 1990
Review
Topics: Arthritis, Rheumatoid; Drug Administration Schedule; Humans; Methylprednisolone
PubMed: 2187419
DOI: 10.1136/ard.49.4.265 -
Musculoskeletal Care Mar 2017Intra-articular (IA) corticosteroid injections are a common approach in the management of osteoarthritis (OA) of the knee. The effectiveness of injections and particular... (Review)
Review
Intra-articular (IA) corticosteroid injections are a common approach in the management of osteoarthritis (OA) of the knee. The effectiveness of injections and particular injection products is often discussed and debated in clinical arenas. The following therapeutic review examines the evidence for intra-articular methylprednisolone acetate (MPA) injections in the management of OA knee. A review of research evidence, published guidelines and clinical literature was undertaken following an electronic database and relevant literature search. The review found that there is limited evidence which indicates that a single dose intra-articular MPA injection can provide short to medium term benefits for pain, with less evidence for beneficial effects on function or stiffness. There is heterogeneity across studies and until recently, most studies had only short to medium term follow-up periods, thus limiting the evidence available on longer term benefit. There was also evidence indicating equivalent overall efficacy of MPA to that of other corticosteroid products. Most guideline recommendations concerning IA injections for OA knee have drawn on evidence from pooled data for several corticosteroid products. The review also found there was limited reporting of the incidence of adverse events in most studies. Overall, MPA shows efficacy for symptom relief in OA knee. At an individual management level, evidence for a limited duration of effect needs consideration in injections decisions. Furthermore, consensus across clinical guidelines suggests that the management of OA knee should be individualized to a person's clinical history, degree of disability, risk factors, quality of life and personal preferences, whereby injecting involves a shared decision and forms part of a multimodal approach. Copyright © 2016 John Wiley & Sons Ltd.
Topics: Animals; Anti-Inflammatory Agents; Humans; Injections, Intra-Articular; Methylprednisolone; Methylprednisolone Acetate; Osteoarthritis, Knee; Treatment Outcome
PubMed: 27297608
DOI: 10.1002/msc.1144