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Pharmacological Reviews Jan 2017Primary neurodegenerative autonomic disorders are characterized clinically by loss of autonomic regulation of blood pressure. The clinical picture is dominated by... (Review)
Review
Primary neurodegenerative autonomic disorders are characterized clinically by loss of autonomic regulation of blood pressure. The clinical picture is dominated by orthostatic hypotension, but supine hypertension is also a significant problem. Autonomic failure can result from impairment of central autonomic pathways (multiple system atrophy) or neurodegeneration of peripheral postganglionic autonomic fibers (pure autonomic failure, Parkinson's disease). Pharmacologic probes such as the ganglionic blocker trimethaphan can help us in the understanding of the underlying pathophysiology and diagnosis of these disorders. Conversely, understanding the pathophysiology is crucial in the development of effective pharmacotherapy for these patients. Autonomic failure patients provide us with an unfortunate but unique research model characterized by loss of baroreflex buffering. This greatly magnifies the effect of stimuli that would not be apparent in normal subjects. An example of this is the discovery of the osmopressor reflex: ingestion of water increases blood pressure by 30-40 mm Hg in autonomic failure patients. Animal studies indicate that the trigger of this reflex is related to hypo-osmolality in the portal circulation involving transient receptor potential vanilloid 4 receptors. Studies in autonomic failure patients have also revealed that angiotensin II can be generated through noncanonical pathways independent of plasma renin activity to contribute to hypertension. Similarly, the mineralocorticoid receptor antagonist eplerenone produces acute hypotensive effects, highlighting the presence of non-nuclear mineralocorticoid receptor pathways. These are examples of careful clinical research that integrates pathophysiology and pharmacology to advance our knowledge of human disease.
Topics: Animals; Autonomic Agents; Autonomic Nervous System; Autonomic Nervous System Diseases; Baroreflex; Blood Pressure; Cardiovascular Agents; Cardiovascular System; Ganglionic Blockers; Humans; Hypertension; Hypotension; Neurotransmitter Agents; Nitric Oxide; Renin-Angiotensin System; Supine Position; Sympathomimetics; Vasoconstrictor Agents
PubMed: 28011746
DOI: 10.1124/pr.115.012161 -
Environmental Science and Pollution... Sep 2022Asthma is a chronic inflammatory disease primarily characterized by inflammation and reversible bronchoconstriction. It is currently one of the leading causes of... (Review)
Review
Asthma is a chronic inflammatory disease primarily characterized by inflammation and reversible bronchoconstriction. It is currently one of the leading causes of morbidity and mortality in the world. Oxidative stress further complicates the pathology of the disease. The current treatment strategies for asthma mainly involve the use of anti-inflammatory agents and bronchodilators. However, long-term usage of such medications is associated with severe adverse effects and complications. Hence, there is an urgent need to develop newer, novel, and safe treatment modalities for the management of asthma. This has therefore prompted further investigations and detailed research to identify and develop novel therapeutic interventions from potent untapped resources. This review focuses on the significance of oxidative stressors that are primarily derived from both mitochondrial and non-mitochondrial sources in initiating the clinical features of asthma. The review also discusses the biological scavenging system of the body and factors that may lead to its malfunction which could result in altered states. Furthermore, the review provides a detailed insight into the therapeutic role of nutraceuticals as an effective strategy to attenuate the deleterious effects of oxidative stress and may be used in the mitigation of the cardinal features of bronchial asthma.
Topics: Asthma; Bronchodilator Agents; Dietary Supplements; Humans; Oxidation-Reduction; Oxidative Stress
PubMed: 35796922
DOI: 10.1007/s11356-022-21454-w -
Clinical Autonomic Research : Official... Dec 2020Electronic cigarettes (ECs) are the fastest growing tobacco product in the USA, and ECs, like tobacco cigarettes (TCs), have effects on the cardiovascular autonomic... (Review)
Review
PURPOSE
Electronic cigarettes (ECs) are the fastest growing tobacco product in the USA, and ECs, like tobacco cigarettes (TCs), have effects on the cardiovascular autonomic nervous system, with clinical implications. The purpose of this review was to collect and synthesize available studies that have investigated the autonomic cardiovascular effects of EC use in humans. Special attention is paid to the acute and chronic effects of ECs, the relative contributions of the nicotine versus non-nicotine constituents in EC emissions and the relative effects of ECs compared to TCs.
METHODS
Using the methodology described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, we conducted a literature search of the Ovid PubMed and Embase databases on 6 December 2019 using keywords in titles and abstracts of published literature. Acute (minutes to hours) and chronic (days or longer) changes in heart rate variability (HRV), heart rate (HR) and blood pressure (BP) were used as estimates of cardiovascular autonomic effects.
RESULTS
Nineteen studies were included in this systematic review, all of which used earlier generation EC devices. Acute EC vaping increased HR and BP less than acute TC smoking. Nicotine but not non-nicotine constituents in EC aerosol were responsible for the sympathoexcitatory effects. The results of chronic EC vaping studies were consistent with a chronic sympathoexcitatory effect as estimated by HRV, but this did not translate into chronic increases in HR or BP.
CONCLUSIONS
Electronic cigarettes are sympathoexcitatory. Cardiac sympathoexcitatory effects are less when vaping using the earlier generation ECs than when smoking TCs. Additional studies of the latest pod-like EC devices, which deliver nicotine similarly to a TC, are necessary.
Topics: Autonomic Agents; Cardiovascular System; Electronic Nicotine Delivery Systems; Humans; Nicotine; Vaping
PubMed: 32219640
DOI: 10.1007/s10286-020-00683-4 -
Respiratory Care Sep 2017
Topics: Administration, Inhalation; Bronchodilator Agents; Humans; Lung Diseases, Obstructive
PubMed: 28830986
DOI: 10.4187/respcare.05786 -
Expert Opinion on Emerging Drugs Mar 2013Autonomic dysfunction, including orthostatic hypotension (OH), sialorrhea, sexual dysfunction, urinary dysfunction and constipation is a common feature of Parkinson's... (Review)
Review
INTRODUCTION
Autonomic dysfunction, including orthostatic hypotension (OH), sialorrhea, sexual dysfunction, urinary dysfunction and constipation is a common feature of Parkinson's disease (PD). Even though its treatment has been recognized as a major unmet need in PD, there is a paucity of clinical trials to assess their treatment.
AREAS COVERED
Evidence about the efficacy and safety of available treatments for autonomic dysfunction is summarized. Potential targets for upcoming therapies are then discussed in light of what is currently known about the physiopathology of each disorder in PD. Proof-of-concept trials and circumstantial evidence about treatments for autonomic dysfunction as well as upcoming clinical trials are discussed. Finally, critical aspects of clinical trials design are considered.
EXPERT OPINION
Botulinum toxin (BTX) or glycopyrrolate might be used for sialorrhea whereas macrogol could be useful in constipation. There is preliminary evidence suggesting that fludrocortisone, domperidone, droxidopa or fipamezole may be effective for the treatment of OH. Tropicamide, clonidine or radiotherapy are under development for sialorrhea. Sildenafil may be effective for the treatment of erectile dysfunction; BTX or behavioral therapy for urinary incontinence and lubiprostone and probiotics for constipation. Sound clinical trials are needed in order to allow firm evidence-based recommendations about these treatments.
Topics: Animals; Antiparkinson Agents; Autonomic Agents; Autonomic Nervous System Diseases; Clinical Trials as Topic; Constipation; Drugs, Investigational; Humans; Hypotension, Orthostatic; Parkinson Disease; Sialorrhea; Urinary Incontinence
PubMed: 23373820
DOI: 10.1517/14728214.2013.766168 -
The British Journal of Ophthalmology Jun 1969
Topics: Eye Diseases; Humans; Mydriatics; Parasympatholytics; Sympathomimetics
PubMed: 5794962
DOI: 10.1136/bjo.53.6.428 -
Journal of the American College of... May 2019
Topics: Bronchodilator Agents; Cardiovascular Diseases; Humans; Pulmonary Disease, Chronic Obstructive
PubMed: 31047005
DOI: 10.1016/j.jacc.2018.11.068 -
Revista Brasileira de Enfermagem 2020To identify and discuss scientific evidence of the effects of ginger use on the management of chemotherapy-induced nausea and vomiting. (Review)
Review
OBJECTIVES
To identify and discuss scientific evidence of the effects of ginger use on the management of chemotherapy-induced nausea and vomiting.
METHODS
This is an integrative reviewperformed by Ganong's reference.
RESULTS
We included 24 studies, highlighting three thematic categories, namely 1) antiemetic action of ginger - nausea (13 articles; of these, nine significant) and emesis (10 studies; of these, six significant); 2) action in the control of nausea (11 articles; of these, six significant) and vomiting (8 articles; of these, three significant) in the acute phase; 3) action in the control of nausea (6 articles; of these, three significant) and vomiting (6 articles; of these, three significant) in the delayed phase. There were divergences of the methods used.
FINAL CONSIDERATIONS
This complementary therapy has low cost and easy access, but no statistical confirmation of its effectiveness in the management of nausea and vomiting in cancer patients was found.
Topics: Antiemetics; Drug Therapy; Female; Zingiber officinale; Humans; Male; Middle Aged; Nausea; Vomiting
PubMed: 32236378
DOI: 10.1590/0034-7167-2018-0903 -
BioMed Research International 2018Natural products with antispasmodic activity have been used in traditional medicine to alleviate different illnesses since the remote past. We searched the literature... (Review)
Review
Natural products with antispasmodic activity have been used in traditional medicine to alleviate different illnesses since the remote past. We searched the literature and compiled the antispasmodic activity of 248 natural compounds isolated from terrestrial plants. In this review, we summarized all the natural products reported with antispasmodic activity until the end of 2017. We also provided chemical information about their extraction as well as the model used to test their activities. Results showed that members of the Lamiaceae and Asteraceae families had the highest number of isolated compounds with antispasmodic activity. Moreover, monoterpenoids, flavonoids, triterpenes, and alkaloids were the chemical groups with the highest number of antispasmodic compounds. Lastly, a structural comparison of natural versus synthetic compounds was discussed.
Topics: Animals; Asteraceae; Humans; Lamiaceae; Parasympatholytics; Structure-Activity Relationship
PubMed: 30402474
DOI: 10.1155/2018/3819714 -
Medicina (Kaunas, Lithuania) Apr 2020: This is the first study to investigate the effect of high-flow oxygen therapy, using a normobaric chamber on cognitive, biochemical (oxidative stress parameters and...
: This is the first study to investigate the effect of high-flow oxygen therapy, using a normobaric chamber on cognitive, biochemical (oxidative stress parameters and the level of neurotrophins), cardiovascular and autonomic functioning. : 17 healthy volunteers, eight males and nine females, with a mean age of 37.5 years, were examined. The experimental study involved ten two-hour exposures in a normobaric chamber with a total pressure of 1500 hPa (32–40 kPa partial pressure of oxygen, 0.7–2 kPa of carbon dioxide and 0.4–0.5 kPa of hydrogen). Cognitive function was assessed by using Trail Making Test parts A, B and difference in results of these tests (TMT A, TMT B and TMT B-A); California Verbal Learning Test (CVLT); Digit symbol substitution test (DSST); and Digit Span (DS). Fatigue (Fatigue Severity Scale (FSS)), cardiovascular, autonomic and baroreceptor functioning (Task Force Monitor) and biochemical parameters were measured before and after intervention. : After 10 sessions in the normobaric chamber, significant decreases in weight, caused mainly by body fat % decrease (24.86 vs. 23.93%, = 0.04 were observed. TMT part A and B results improved ( = 0.0007 and = 0.001, respectively). In contrast, there was no statistically significant influence on TMT B-A. Moreover, decrease in the number of symbols left after a one-minute test in DSST was noted ( = 0.0001). The mean number of words correctly recalled in the CVLT Long Delay Free Recall test improved ( = 0.002), and a reduction in fatigue was observed ( = 0.001). Biochemical tests showed a reduction in levels of malondialdehyde ( < 0.001), with increased levels of Cu Zn superoxide dismutase ( < 0.001), Neurotrophin 4 ( = 0.0001) and brain-derived neurotrophic factor (p = 0.001). A significant increase in nitric oxide synthase 2 (Z = 2.29, = 0.02) and Club cell secretory protein ( = 0.015) was also noted. Baroreceptor function was significantly improved after normobaric exposures ( = 0.003). Significant effect of normobaric exposures and BDNF in CVLT Long Delay Free Recall was noted. : This study demonstrates that 10 exposures in a normobaric chamber have a positive impact on visual information and set-shifting processing speed and increase auditory-verbal short-term memory, neurotrophic levels and baroreceptor function. A response of the respiratory tract to oxidative stress was also noted. There is a need to rigorously examine the safety of normobaric therapy. Further studies should be carried out with physician examination, both pre and post treatment.
Topics: Adult; Autonomic Agents; Cognition; Female; Healthy Volunteers; Humans; Hyperoxia; Male; Middle Aged; Neuropsychological Tests; Oxygen; Poland
PubMed: 32290164
DOI: 10.3390/medicina56040172