Current Pharmaceutical Design - Volume 23, Issue 16, 2017

Background: The importance of hemoproteins for life lies largely in their iron-mediated chemical properties. In the human body, there are about 4 g of iron, a precious resource preserved by sophisticated recycling mechanisms. Iron is also important for pathogen growth, so it is not surprising that immune cells developed mechanisms to reduce iron availability in cases of inflammation. In healthy conditions, macrophages degrade hemoproteins and export iron, while if inflammation develops, they retain cytoplasmic iron to reduce extracellular iron concentrations. Iron-rich macrophages possess a stronger inflammatory ability, which explains the chronic inflammatory response observed in states of iron overload. Inflammatory bowel syndromes are often characterized by intestinal blood loss and consequent anemia, but iron-supplementation therapies may exacerbate the inflammatory response. In chronically transfused patients iron overload is frequently observed; the iron can become toxic and in excess, even fatal if not treated with iron-chelating drugs. Conclusion: In the present review, we discuss the importance of iron homeostasis in states of health and inflammation, focusing on iron and iron-chelation treatment for IBD patients. Oral administration of natural ironchelating chemicals may be an effective adjuvant therapy for IBD patients, acting on numerous aspects of chronic inflammatory syndromes.

Background: Type-2 Diabetes is a long lasting disease characterized by high glucose concentration in the blood due to insulin resistance. One of the recent treatment strategies is using activators against SIRT-1, which has been in clinical trials. Hence, it is necessary to know the effects of the SIRT-1 modulators against various metabolic pathways. Methods: Many cellular processes, including insulin secretion, cell cycle, and apoptosis are imperatively regulated by a family of mediators called SIRTuins. First known mammalian sirtuin, SIRT1 is a positive regulator of insulin secretion, which triggers glucose uptake and utilization. For the past decade, a major outstanding question is whether SIRT1 activation is a safe therapy for human diseases such as diabetes? Results: This review summarizes and discusses the advances of the past decade and the challenges that will brazen out perplexity of this field. We also cover the physiological regulation of sirtuin (SIRT1) activity and how these modes of regulation may be exploited to manipulate SIRT1 activity in cells. Designing of drugs using advanced computational methods that specifically target SIRT1, and also, involvement of advanced biological methods for further understanding of sirtuin1 biology to afford new optimized treatments for diabetes and several age related human diseases. Conclusion: Hence, this review is a serial perspective of all the above topics.

Background: Thyroid hormone (T3) is essential for normal development of children enabling brain development and somatic growth. However, certain individuals are genetically predisposed with insufficient or no thyroid hormones. Such a condition is termed congenital hypothyroidism (CH). Objective: In the present review, a brief back ground about congenital hypothyroidism, factors associated with CH leading to thyroid dysgenesis and thyroid dyshormonogenesis is elaborated. Additionally, the guidelines for available treatment options, management and follow-up required for patients diagnosed with CH are discussed. Treatment options in terms of treatment initiation and dosage of hormone replacement are discussed. Conclusion: Though CH is considered as the most common neonatal metabolic disorder, it is also easily treatable compared to other metabolic or hereditary diseases. The outcome of CH treatment depends on the compliance of parents early in life and by patients themselves during later part of life.

Background: The global burden of gastrointestinal cancers, including colorectal, stomach, and esophageal cancers is rising steadily. Several therapeutic approaches have been considered for the treatment of GI carcinomas. However, none showed to halt or cure the disease. There is a need to develop effective targeted molecular therapies; mainly to overcome the adverse effects of currently used treatment regimens, as well as, to benefit a large proportion of cancer patients who do not respond well to chemotherapeutics. Methods: Epidermal growth factor receptor (EGFR) is one of the promising targets for cancer therapy. Through a cascade of events, activation of EGFR plays an important role in the homeostasis and pathogenesis of various disorders, including carcinomas of the gastrointestinal (GI) tract, ranging from oesophagitis to complex colon carcinoma. Results: The GI carcinomas are associated with aberrant EGFR expression. In this review, emphasis was made on various EFGR-associated signalling pathways, their mechanisms and role in the formation of gastrointestinal lesions. Conclusion: The current EGFR-targeting therapeutics and an outline of various novel drug delivery systems that could potentially be employed for targeting EGFR during cancer treatment were discussed. This would help medical, pharmaceutical and other life science researchers in providing broad understanding of the work previously conducted in this field.

Background: Inflammatory bowel disease (IBD) is a group of intestinal disorders characterised by chronic relapsing inflammation of the small intestine and colon. IBD manifests as either ulcerative colitis or Crohn’s disease and increases the risk of developing colorectal cancer. Methods: Here, we have reviewed current treatment regimen for IBD utilising anti-inflammatory drugs, immune system suppressors and antibiotics or a combination of these. However, these therapeutics lead to a number of adverse effects, remission or significant non-responsiveness creating an urgent need to develop potent drugs with novel mechanisms of action for IBD. Results: The inflammasome is a multiprotein complex that assembles to a key innate immune system signalling platform and is involved in the pathogenesis of inflammatory and autoimmune diseases. A number of investigations show that the NLRP3 inflammasome recognizes microbial and cell stress components and serve as a platform for caspase-1 activation and pro-inflammatory cytokine IL-1β, IL18 maturation. Although the exact aetiology of IBD is unknown, uncontrolled NLRP3 Inflammasome activation has shown to play a major role in the chronic intestinal inflammation and mature IL-1β and IL18 are consistently associated with increased colitis and colitis associated colorectal cancer development. Conclusion: In this review, we discuss the experimental NLRP3 inhibitors that have been investigated in IBD experimental models. The potential mechanism of action of these inhibitors such as inhibiting NF-ΚB activation and decreasing mitochondrial reactive oxygen species are discussed in detail. We further expand the controversial role of NLRP3 in IBD and future issues that might arise from the long term use of NLRP3 inhibitors in IBD therapy.

Background: Zinc is a critical metal ion essential for life. The biological significance of zinc is highlighted by the enormous number of proteins (approximately 10% of the human proteome) that have zinc-binding capacity. Accordingly, zinc concentrations in cells are tightly regulated by two families of zinc transporter proteins: Slc30a (ZnT) and Slc39a (Zip). ZnT and Zip are known to decrease and increase cytosolic zinc concentrations respectively. Both zinc transporters are suggested to be implicated in a number of disorders and disease states through dysfunctional zinc transport including cancer, diabetes and gastrointestinal (GI) disease. Method: The goal of this work was to identify the role of zinc transporters in GI disease/disorders. Where possible, reference will be made in the context of the function of zinc transporters and their potential role in GI disorders/ diseases with a view towards their possible therapeutic utility in the treatment of these ailments. PubMed was utilized to search for articles with the terms “zinc and GI disease”, “zinc transporters and GI disease”, “zinc and gut”, zinc transporters and gut”, and “zinc transporters and intestinal disorders”. Results: We identified a number of reviews on GI disorders/disease states associated with zinc deficiencies, but the very proteins that transport this metal ion in these systems are not well-defined. From a systematic review, we identified the following zinc transporters (Zip1, 2, 4-7, 10, 11 and 14; and ZnT1, 8 and 10) as having some functional role in the GI system and potentially could have a therapeutic role in the treatment of GI disease/disorders. Conclusion: An increasingly common health issue in our communities is disorder/disease of the GI system. Although therapies targeting these disorders are somewhat beneficial, there is a need to develop better, more efficient treatments. Despite that many gut-related disorders/disease states have been analyzed in the context of zinc deficiencies, the transport proteins that move zinc across cells are not well-defined. Zinc transporters are expressed in a range of GI tissue and cells, and their roles in the maintenance, integrity and disease processes of the GI system need to be addressed. This might open a whole new avenue of opportunities for the development of novel therapies targeting these receptors in GI disease states.

Background: Endoplasmic reticulum is the major site for protein biosynthesis. Any perturbation in the endoplasmic reticulum will compromise its functions and reduce its efficiency in protein biosynthesis. As a result, misfolded proteins are produced and accumulated in the endoplasmic reticulum. This will result in endoplasmic reticulum stress, which reduces the quantity and quality of the functional protein synthesized from the cell. Besides that, the protein biosynthesis is also highly affected by oxidative stress. Oxidative stress is a condition where the cell has excessive exogenous and endogenous radical oxygen species overwhelming the human body’s antioxidant mechanisms. Recent researches have shown that endoplasmic reticulum stress has a strong relationship with oxidative stress and both of them can form a vicious cycle that exacerbates endoplasmic reticulum stress and oxidative stress. Endoplasmic reticulum stress and oxidative stress are harmful to human health since they can disrupt cellular homoeostasis and damage cells. Method: This work reported several studies that demonstrate that endoplasmic reticulum stress and oxidative stress have a vital role in the pathogenesis of several diseases, such as diabetes and colitis. Results: Further research is needed to develop the therapeutic strategies that resolve endoplasmic reticulum stress and oxidative stress in order to treat these diseases. Conclusion: Currently, Momordicacharantia attracts worldwide attentions due to its various beneficial effects as the functional foods and can possibly help in treating endoplasmic reticulum stress and oxidative stress.

Background: Polyphenols represent a great variety of compounds occurring in fruits, vegetables and plant-derived products. Dietary polyphenols have been found displaying several biological properties, such as anti-inflammatory, antioxidant and anti-aging activities, cardiovascular and neuro-protection, and reduction of the risk of intestinal diseases. The bio-efficacy of polyphenols is tightly linked to their bioavailability, to structural complexity and composition of food matrix in which they are present. Since most of the polyphenols are naturally stored in food matrices as glycosylated and/or variously decorated forms, they need an intestinal bio-conversion in more absorbable forms. Recent findings are highlighting the polyphenols-gut microbiota interplay in the health benefits linked to these compounds. Furthermore, the prebiotic-like activities of polyphenols on microbiota and their potential use in preventive/therapeutic strategies for gastrointestinal disorders are recently emerging. Conclusion: In this review, we will focus on the dietary flavonols, anthocyanins and stilbenes, as widely occurring polyphenols in human diet, their metabolism mediated by gut microbiota and their protective effects on inflammatory bowel diseases (IBDs).

Background: IBD is considered as one of the major public health concerns worldwide. The pathophysiology and gut microbial alteration during inflammatory bowel disease (IBD) are still not completely understood. Gut microbiota is implicated in most of the gastro-intestinal (GI) diseases including IBD. From the time of gut microbiota establishment and through aging, it undergoes a lot of changes in the composition. Methods: In a healthy state, the composition of beneficial microbes in the gut is comparatively higher and due to factors such as malnutrition, use of antibiotics and any underlying diseases allow the colonization and invasion of pathogens. Results: A careful manipulation of gut microbiota during disease conditions such as IBD is required. Probiotics are natural, safe and useful interventions for GI diseases. Conclusion: Lactic acid probiotic bacteria have shown many beneficial effects in various gastrointestinal and inflammatory disorders. This review focuses on the use of probiotics in IBD and possible mechanism of probiotics in inflammation conditions.

Hepatocellular carcinoma (HCC) is the vital cause of cancer -related death throughout the world. At present, the exact mechanism responsible for the formation of HCC and its maintenance remains suspicious. Hepatocarcinogenesis involves a multistep activity involving several genetic aberrations which result in malignant transformation of the liver cells. The prevalence and occurrence of this disease are kept on increasing and an increase in the liver transplantation cases are vital indications for it. In the past decades, significant progress has been achieved toward the better elucidation of molecular pathways of oncogenic processes. Several, cell signaling mechanisms involved in tumor pathogenesis have been identified, leading to the production of new tumor markers and to set targets for therapy, including cytokines, enzymes, proteantigens. However, more tumor markers are in need for the effective early diagnosis of the disease condition and monitor the treatment efficacy. This review updates the recent findings in key molecular markers, pathways involved, animal models and treatment strategies in HCC and the advances obtained from basic research and clinical studies.

Background: Intensive efforts have been implemented to improve the efficacy of platinum complexes especially with emerging cisplatin resistance and elevated cancer deaths. Platinum(IV) agents show better pharmacokinetics and decreased side effects compared to Platinum(II) agents. Methods: This review aims to summarize and categorize the strategies being employed to improve the efficacy of Platinum-based anticancer agents in recent years. Results: Nanoparticles and nanoplatforms offer a vast variety of strategies in targeting specific tumor types and delivering one or two lethal drugs simultaneously. Theranostic agents are being developed to achieve enhanced imaging and provide further insight into the activity of platinum containing chemotherapy. Moreover, photoactivation of Pt(IV) prodrugs specifically at the tumor site is gaining attention due to a controlled activity. A platinum agent formulated as large multi-activity complex is the most common strategy being employed. Conclusion: Platinum(IV) agents offer great potential in targeting, increasing efficacy, and decreasing toxicity of Platinum-based anticancer agents. The strategies being employed are aiming to increase specificity and targeting as well as provide more potent agents.

The therapy of various diseases by the drugs entrapped in calixarene derivatives is gaining attraction of researchers nowadays. Calixarenes are macrocyclic nano-baskets which belong to cavitands class of host-guest chemistry. They are the marvelous hosts with distinct hydrophobic three dimensional cavities to entrap and encapsulate biologically active guest drugs. Calixarene and its derivatives develop inclusion complexes with various types of drugs and vitamins for their sustained/targeted release. Calixarene and its derivatives are used as carriers for anti-cancer, anti-convulsant, anti-hypertensive, anthelmentic, anti-inflammatory, antimicrobial and antipsychotic drugs. They are the important biocompatible receptors to improve solubility, chemical reactivity and decrease cytotoxicity of poorly soluble drugs in supramolecular chemistry. This review focuses on the calixarene and its derivatives as the state-of-the-art in host-guest interactions for important drugs. We have also critically evaluated calixarenes for the development of prodrugs.

Glial cells are integrated part of neurovascular unit of blood brain barrier (BBB). They undergo mitosis and mainly classified as astrocytes, oligodendrocytes, microglia, ependymal cells and nerve glial antigen 2 cells. Being a most versatile glial cell, astrocytes provide structural support to neurons, maintain brain homeostasis, take part in neuronal communication, and perform some housekeeping functions. Oligodendrocytes myelinate the neuronal axons for proper transmission of nerve impulse and microglia are brain immune cells. Multiple sclerosis is a prototype glia mediated disease that manifests demyelination. Fingolimod is already being marketed for this disease, while guanabenz and ibudilast are facing clinical trials. Many researches revealed the role of glial cells in Alzheimer's disease, in which riluzole (a glutamate modulator already in market for amyotrophic lateral sclerosis-ALS) was found to be effective. Q-cells® are glial cell-based therapeutic agent to treat ALS that only produce astrocytes and oligodendrocytes, when transplanted in vivo. hIL13-PE is a gene based therapeutic agent that has been smartly designed for the treatment of glioma. Although for CNS diseases, drugs are available, still it is not easy to extract satisfactory therapeutic effect of most of the drugs due to the presence of BBB. This barrier can be overcome by implanting a drug reservoir in brain parenchyma (wafer), by judicious selection of drug delivery system (nanoparticulate system), or by using an alternative route of administration (intranasal route). This review revolves around cellular and drug based modulation of glial cells to achieve maximum therapeutic benefit for some of the CNS diseases.

Background: Targeted delivery of small interfering RNA (siRNA) to the specific tumor tissues and cells is the key challenge in the development of RNA interference as a therapeutic application. Methods: To target breast cancer, we developed a cationic nanoparticle as a therapeutic delivery system. The successful synthesis of the magnetic nanoparticles modified by polyaspartate (PAA) and polyethyleneimine (PEI) was confirmed using fourier transform infrared (FT-IR) measurements. The designed nanoparticle has been characterized evaluating its size and charge before and after nanoplex formation with siRNA. Results: The designed nanoparticle could effectively form nanoplex with siRNA in 2:1 w/w ratio. Survivin siRNA was used to suppress the antiapoptotic gene, survivin, in MCF-7 cells. According to the importance of combinational therapy, Mitoxantrone (MTX) was used as a chemotherapeutic agent as well. The multifunctional nanoparticles have been successfully entered into about 63% of the MCF-7 cells shown via microscopic and flowcytometric methods. This effective cellular uptake led to the cell apoptosis. Down regulation of survivin was determined in mRNA and protein levels using Real Time PCR and western blotting, respectively. Conclusion: Gathering all obtained data, it was concluded that Fe3O4-PAA-PEI nanoparticles can deliver siRNA effectively into the cytoplasm of the MCF-7 breast cancer cells and induce apoptosis.