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Expert Opinion on Biological Therapy Jan 2018Most male patients with non-obstructive azoospermia (NOA) have no therapeutic options outside of assisted reproductive techniques to conceive a biological child. If... (Review)
Review
INTRODUCTION
Most male patients with non-obstructive azoospermia (NOA) have no therapeutic options outside of assisted reproductive techniques to conceive a biological child. If mature sperm cannot be obtained from the testes, these patients must rely on options of donor sperm or adoption. Several techniques are in the experimental stage to provide this patient population alternatives for conceiving.
AREAS COVERED
This review discusses three of the experimental techniques for restoring fertility in men with NOA: spermatogonial stem cell transplantation, the use of adult and embryonic stem cells to develop mature gametes and gene therapy. After this discussion, the authors give their expert opinion and provide the reader with their perspectives for the future.
EXPERT OPINION
Several limitations, both technical and ethical, exist for spermatogonial stem cell transplantation, the use of stem cells and gene therapy. Well-defined reproducible protocols are necessary. Furthermore, several technical barriers exist for all protocols. And while success has been achieved in animal models, future research is still required in human models.
Topics: Azoospermia; Biological Therapy; Genetic Therapy; Humans; Male; Pluripotent Stem Cells; Spermatogenesis; Stem Cell Transplantation; Stem Cells
PubMed: 28927307
DOI: 10.1080/14712598.2018.1380622 -
South African Medical Journal =... Sep 2019The treatment of inflammatory bowel disease (IBD) is often challenging. It has a vexing and waning course with frequent relapses, despite adequate maintenance therapy.... (Review)
Review
The treatment of inflammatory bowel disease (IBD) is often challenging. It has a vexing and waning course with frequent relapses, despite adequate maintenance therapy. Biological agents have been available for the treatment of IBD for the last two decades, with impressive results. However, these drugs are costly and often have significant side-effects. Therefore, the benefit of aggressive treatment must be carefully balanced against the risk of serious adverse events. Despite good clinical outcomes, patients often request to discontinue the drugs because of cost and detrimental effects, especially the risk of malignancy. This review focuses on the benefits of biological treatment, strategies to de-escalate therapy, risk of relapse when these agents are discontinued and success with retreatment with the same or a similar biological agent.
Topics: Biological Factors; Biological Therapy; Humans; Inflammatory Bowel Diseases; Withholding Treatment
PubMed: 31635571
DOI: 10.7196/SAMJ.2019.v109i10.14074 -
Oral Surgery, Oral Medicine, Oral... Nov 2015In recent years, a new class of drugs has revolutionized the treatment of autoimmune, allergic, infectious, and many more diseases. This new class of drugs is made of 3... (Review)
Review
In recent years, a new class of drugs has revolutionized the treatment of autoimmune, allergic, infectious, and many more diseases. This new class of drugs is made of 3 groups-cytokines, monoclonal antibodies, and fusion proteins-that may target special damaged cells but not all the cells. These drugs may have side effects such as infection, hypersensitivity, hematologic disorders, cancer, hepatotoxicity, and neurologic disorders. However, there is not enough evidence or long-term studies of the mechanism of action and side effects of these drugs. Patients receiving biological therapies may need special consideration in dentistry. This paper is a review of the classification, mechanism of action, and side effects of these drugs and dental consideration for patients receiving biological therapies.
Topics: Antibodies, Monoclonal; Biological Therapy; Cytokines; Dental Care for Chronically Ill; Humans
PubMed: 26372436
DOI: 10.1016/j.oooo.2015.07.032 -
Expert Opinion on Biological Therapy Mar 2017Crohn's disease (CD) is a chronic, immune-mediated condition with a potentially disabling and destructive course. Despite growing data on when to use a therapeutic... (Review)
Review
Crohn's disease (CD) is a chronic, immune-mediated condition with a potentially disabling and destructive course. Despite growing data on when to use a therapeutic 'top-down' strategy, clinical management of this complex disorder is still challenging. Currently, the discussion of 'top-down' strategy in CD mostly includes biological therapy alone or in combination. Areas covered: This article is based on a review of existing literature regarding the use of biological therapy in a 'top-down' approach for the treatment of Crohn's disease. The authors reviewed all the major databases including MEDLINE as well as DDW and ECCO abstracts, respectively. Expert opinion: A 'top-down' therapeutic approach in Crohn's disease is strongly supported by existing data in patients with several risk factors for a severe course of disease. Moreover, there is an increasing amount of published data recommending a more individualised therapeutic strategy to identify candidates for 'top-down' treatment, based on enhanced diagnostics using biomarkers. Emerging therapeutic approaches besides existing therapy concepts using biologicals may possibly redefine the 'top-down' therapeutic strategy for Crohn's disease in the future.
Topics: Animals; Biological Therapy; Crohn Disease; Databases, Factual; Humans; Risk Factors
PubMed: 28132526
DOI: 10.1080/14712598.2017.1287170 -
The Lancet. Gastroenterology &... Jan 2020Treatment strategies for inflammatory bowel disease (IBD) focus on the induction and long-term maintenance of deep remission to avoid complications of active disease and... (Review)
Review
Treatment strategies for inflammatory bowel disease (IBD) focus on the induction and long-term maintenance of deep remission to avoid complications of active disease and improve long-term outcomes. Medical therapies for IBD, notably the increasingly widespread use of biological therapy, are often effective at controlling disease, but these drugs are associated with substantial adverse events, which together with other factors-including increasing treatment costs and patient preferences-leads to concerns regarding indefinite use of medical therapy. Consequently, the need to consider the safety and feasibility of drug de-escalation once IBD remission has been achieved is clear. Here, we review the current evidence surrounding de-escalation of immunomodulator and biological therapy in Crohn's disease and ulcerative colitis. We discuss strategies for de-escalation, including the selection of patients who are appropriate for treatment de-escalation and the use of proactive drug monitoring, and review the evidence on subsequent optimal follow-up. We conclude by proposing an algorithm to guide de-escalation decisions, and highlight future perspectives, including the potential effect of emerging medication and personalised medicine for these diseases.
Topics: Biological Therapy; Drug Monitoring; Humans; Immunologic Factors; Inflammatory Bowel Diseases; Remission Induction
PubMed: 31818473
DOI: 10.1016/S2468-1253(19)30186-4 -
Polskie Archiwum Medycyny Wewnetrznej 2009Ulcerative colitis (UC), Crohn's disease (CD) and indeterminate colitis are defined as inflammatory bowel diseases (IBD). Those diseases involve disorders of numerous... (Review)
Review
Ulcerative colitis (UC), Crohn's disease (CD) and indeterminate colitis are defined as inflammatory bowel diseases (IBD). Those diseases involve disorders of numerous immunological mechanisms associated with cellular and humoral immune response. In CD cellular response is considered to be of crucial importance, and dominant cytokines include: tumor necrosis factor alpha (TNF-alpha), interferon gamma (INF-gamma) and interleukins 1beta (IL-1beta), IL-2, IL-6, IL-8, IL-12. In UC, increased expression of Th2 (responsible for humoral response) is observed. It is connected with increased production of interleukins: 4 (IL-4), IL-5, IL-6, IL-10 and TNF-alpha. Lack of balance between pro-inflammatory and anti-inflammatory cytokines is of vital importance in pathogenesis of IBD. Conventional therapy of CD and UC quite commonly fails to bring satisfactory results, therefore an interest in new therapeutic options, that is, biological therapy, gene therapy, hematopoietic stem cell transplantation, and leucapheresis, has aroused recently. Biological therapy is focused on different stages of the inflammatory process. The fundamentals of biological strategy involve neutralization of pro-inflammatory cytokines, use of anti-inflammatory cytokines and inhibition of neutrophil adhesion. Biological therapy is a promising option because it enables to withdraw corticosteroids and immunosuppressive agents or to reduce their dose. Moreover, it shortens the hospital stay, allows to avoid surgical procedures, extends the remission period and improves patients' quality of life. Currently, 2 agents, infliximab and adalimumab, are registered for the biological therapy of CD in Poland.
Topics: Adalimumab; Anti-Inflammatory Agents; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Biological Therapy; Certolizumab Pegol; Genetic Therapy; Hematopoietic Stem Cell Transplantation; Humans; Immunoglobulin Fab Fragments; Inflammatory Bowel Diseases; Infliximab; Length of Stay; Leukapheresis; Polyethylene Glycols; Quality of Life; Receptors, Tumor Necrosis Factor, Type I; Tumor Necrosis Factor Decoy Receptors
PubMed: 19341184
DOI: No ID Found -
Trends in Biotechnology Jul 2013Zinc-finger nucleases (ZFNs) and transcription activator-like effector nucleases (TALENs) comprise a powerful class of tools that are redefining the boundaries of... (Review)
Review
Zinc-finger nucleases (ZFNs) and transcription activator-like effector nucleases (TALENs) comprise a powerful class of tools that are redefining the boundaries of biological research. These chimeric nucleases are composed of programmable, sequence-specific DNA-binding modules linked to a nonspecific DNA cleavage domain. ZFNs and TALENs enable a broad range of genetic modifications by inducing DNA double-strand breaks that stimulate error-prone nonhomologous end joining or homology-directed repair at specific genomic locations. Here, we review achievements made possible by site-specific nuclease technologies and discuss applications of these reagents for genetic analysis and manipulation. In addition, we highlight the therapeutic potential of ZFNs and TALENs and discuss future prospects for the field, including the emergence of clustered regulatory interspaced short palindromic repeat (CRISPR)/Cas-based RNA-guided DNA endonucleases.
Topics: Biological Therapy; Clustered Regularly Interspaced Short Palindromic Repeats; Deoxyribonucleases; Genetic Engineering; Molecular Biology; Recombinant Proteins; Zinc Fingers
PubMed: 23664777
DOI: 10.1016/j.tibtech.2013.04.004 -
Expert Opinion on Biological Therapy Apr 2007Colon and rectal cancer remain the second most common cause of cancer death in the US. Advances in the past 10 years have resulted in improved outcomes for patients. In... (Review)
Review
Colon and rectal cancer remain the second most common cause of cancer death in the US. Advances in the past 10 years have resulted in improved outcomes for patients. In addition to newer chemotherapeutics agents, the so-called 'targeted' or 'biological' therapies have improved survival in patients with metastatic disease. This review aims to summarize the mechanistic basis for the usefulness of these agents, the key clinical trials demonstrating their efficacy, and the studies now initiated with the hope of further incorporating their use in treating colon and rectal cancer.
Topics: Angiogenesis Inhibitors; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Bevacizumab; Biological Therapy; Cetuximab; Chemotherapy, Adjuvant; Colorectal Neoplasms; Fluorouracil; Humans; Phthalazines; Protein Kinase Inhibitors; Pyridines; Randomized Controlled Trials as Topic; Vascular Endothelial Growth Factor A
PubMed: 17373902
DOI: 10.1517/14712598.7.4.509 -
Journal of Infection in Developing... Feb 2014The emergence of multiple drug-resistant bacteria has prompted interest in alternatives to conventional antimicrobials. One of the possible replacement options for... (Review)
Review
The emergence of multiple drug-resistant bacteria has prompted interest in alternatives to conventional antimicrobials. One of the possible replacement options for antibiotics is the use of bacteriophages as antimicrobial agents. Phage therapy is an important alternative to antibiotics in the current era of drug-resistant pathogens. Bacteriophages have played an important role in the expansion of molecular biology and have been used as antibacterial agents since 1966. In this review, we describe a brief history of bacteriophages and clinical studies on their use in bacterial disease prophylaxis and therapy. We discuss the advantages and disadvantages of bacteriophages as therapeutic agents in this regard.
Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Bacteriophages; Biological Therapy; Disease Models, Animal; Drug Resistance, Multiple, Bacterial; Humans; United States
PubMed: 24518621
DOI: 10.3855/jidc.3573 -
International Journal of Dermatology Mar 2020The anecdotic evidence of the benefits from biologic agents for psoriasis is extensive. However, data on the efficacy of biologic agents for pustular psoriasis are...
BACKGROUND
The anecdotic evidence of the benefits from biologic agents for psoriasis is extensive. However, data on the efficacy of biologic agents for pustular psoriasis are limited.
METHODS
To update the data on the efficacy and safety of biologic agents for the management of pustular psoriasis. A systematic review of published data regarding biologic therapies on PubMED database, used in the management of pustular psoriasis from 2012 was undertaken.
RESULTS
A total of 209 articles were identified, and 43 articles were selected for inclusion. TNF-α inhibitors were used in 205 patients, and 86 patients received ustekinumab, secukinumab, brodalumab, ixekizumab and IL-1 inhibitors. Overall response was favorable for most modalities. No serious adverse events were reported. Inconsistent measures of treatment response and study variability limited the overall evaluation of data.
CONCLUSIONS
Infliximab and ustekinumab have the most evidence of efficacy and safety for the treatment of pustular psoriasis. Recent evidence supports the use of IL-17 antagonists. Prospective controlled and comparative trials are needed to further explore the efficacy and safety of biologic agents in order to establish objective recommendations for the management of this challenging condition.
Topics: Antibodies, Monoclonal; Biological Products; Biological Therapy; Dermatologic Agents; Humans; Psoriasis
PubMed: 31612467
DOI: 10.1111/ijd.14671