Current Pharmaceutical Design - Volume 28, Issue 20, 2022

Due to the tight link between undertreated pain and agitation in dementia patients, aromatherapy can be a useful approach if an essential oil (EO) with powerful analgesic activity is used. The methodological difficulties of most aromatherapy trials have not allowed any definitive conclusion about the effectiveness of aromatherapy in dementia. The objective of the present perspective is to illustrate the long rigorous process leading from preclinical research to clinical translation of the EO of bergamot (BEO) for the management of agitation in dementia. A nanotechnology-based delivery system consisting of odorless alpha-tocopheryl stearate solid lipid nanoparticles (SLN) loaded with BEO (NanoBEO), has been proven active in acute and neuropathic pain models confirming the strong antinociceptive and anti-allodynic efficacy reported for BEO in preclinical studies. In particular, prolonged physicochemical stability of NanoBEO and titration in its main components are remarkable advantages allowing reproducible antinociceptive and anti-itch responses to be measured. Furthermore, the possibility to perform double-blind clinical trials made impossible so far because of the strong smell of essential oils used in aromatherapy. Demented patients receive limited treatment for chronic pain, particularly neuropathic. The BRAINAID (NCT04321889) trial will assess the effectiveness of NanoBEO on agitation and pain in severely demented patients to offer a safe tool able to provide relief to this fragile population. This double-blind clinical trial will be the first to assess the efficacy and safety of an engineered essential oil and will provide the rationale for the safer treatment of neuropsychiatric symptoms of dementia and pain in clinic.

Luliconazole is the first and only anti-fungal agent approved for the short-term treatment of superficial fungal infections. However, commercially available conventional topical dermal drug delivery cargo of luliconazole is associated with certain limitations, like lower skin permeation and shorter skin retention of drug. Therefore, the present review is an attempt to unravel the penetration hurdles in luliconazole topical dermal drug delivery. Moreover, we have also summarized the activity of functional nanomaterials-based drug delivery systems employed by the scientific fraternity to improve luliconazole efficacy in superficial fungal infections on a case-to-case basis. In addition, efforts have also been made to unveil the critically acclaimed mechanism of action of luliconazole against fungal cells. Under the framework of future prospects, we have analyzed the combination of luliconazole with isoquercetin using the in-silico docking technique for offering synergistic antifungal activity. Isoquercetin exhibited a good affinity for superoxide dismutase (SOD), a fungal target, owing to the formation of hydrogen bonds with Glu132, Glu133, and Arg143, in addition to a few hydrophobic interactions. On the other hand, luliconazole inhibited lanosterol-14α-demethylase, and consequently blocked ergosterol. In addition, nanotechnology and artificial neural network (ANN) derived integrated drug delivery systems may also be explored for augmenting the luliconazole therapeutic efficacy in topical fungal infections. Synergy of ANN models along with topical nanoscaled drug delivery may help to achieve critical quality attributes (CQA), leading to commercial success of luliconazole.

Background: Biomedical applications of polymersomes have been explored, including drug and gene delivery, insulin delivery, hemoglobin delivery, the delivery of anticancer agents, and various diagnostic purposes. Objectives: Polymersomes, which are self-assembled amphiphilic block copolymers, have received a lot of attention in drug delivery approaches. This review represents the methods of preparation of polymersomes, including thin-film rehydration, electroformation, double emulsion, gel-assisted rehydration, PAPYRUS method, and solvent injection methods, including various therapeutic applications of polymersomes. Methods: Data was searched from PubMed, Google Scholar, and Science Direct through searching of the following keywords: Polymersomes, methods of preparation, amphiphilic block copolymers, anticancer drug delivery. Results: Polymersomes provide both hydrophilic and hydrophobic drug delivery to a targeted site, increasing the formulation's stability and reducing the cytotoxic side effects of drugs. Conclusion: Polymersomes have the potential to be used in a variety of biological applications, including drug and gene delivery, insulin delivery, hemoglobin delivery, delivery of anticancer agents, as well as in various diagnostic purposes. Recently, polymersomes have been used more frequently because of their stability, reducing the encapsulated drug's leakage, site-specific drug delivery, and increasing the bioavailability of the drugs and different diagnostic purposes. The liposomes encapsulate only hydrophilic drugs, but polymersomes encapsulate both hydrophilic and hydrophobic drugs in their cores.

Resveratrol (RSV) is a natural polyphenolic compound known for its therapeutic activities but has limited bioavailability. The aim of our study was to explore various drug-delivering methods that are being employed to achieve target-oriented delivery and therapeutic performance of RSV. To improve the bioavailability and pharmacokinetic properties of RSV, efforts are being made to produce efficient formulations accompanying efficient drug delivery strategies. Several clinical trial studies have been conducted on RSV isomers, and the majority of studies indicated that trans-RSV had better clinical potential and therapeutic effectiveness in various types of complications such as colorectal cancer, metabolic syndrome, hypertension, obesity, neurodegenerative diseases, diabetes, hepatic disease, cardiac disorders, and breast cancer. However, multiple research studies enable us to understand various strategies that can enhance the systemic availability and efficacy of topical RSV formulations. In this article, we emphasize the hurdles of RSV delivery processes. We summarized that the micro- particulate system works efficiently for delivering liquid and solid microparticles of RSV. Another technique in which a coating encloses particles is called microencapsulation. This technique reduces the degradation of pharmaceutical compounds. Similarly, the cyclodextrin system is mainly used for poorly soluble drugs. On the other hand, the vesicular system is another micro-particulate system that can encapsulate hydrophilic and hydrophobic drugs. However, the RSV nanosponge formulations have advanced nano drug delivery systems, making it possible to use RSV for its antioxidant potential.

The oral route is the most preferred delivery route for drug administration due to its advantages, such as lower cost, improved patient compliance, no need for trained personnel, and less severity of drug reactions in general. The major problem with new molecules in the drug discovery pipeline is poor solubility and dissolution rate that ultimately results in low oral bioavailability. Numerous techniques are available for solubility and bioavailability (BA) enhancement, but out of all, solid dispersion (SD) is proven to be the most feasible due to fewer issues in manufacturing, processing, storage, and transportation. In the past few years, SD has been extensively applied to reinforce the common issues of insoluble drugs. Currently, many hydrophobic and hydrophilic polymers are used to prepare either immediate release or controlled release SDs. Therefore, the biological behavior of the SDs is contingent upon the use of appropriate polymeric carriers and methods of preparation. The exploration of novel carriers and methodologies in SD technology leads to improved BA and therapeutic effectiveness. Moreover, the clinical applicability of SD-based formulations has been increased with the discovery of novel polymeric carriers. In this review, emphasis is laid down on the present status of recent generations of SDs (i.e., surfactant and controlled release polymer-based SD) and their application in modifying the physical properties of the drug and modulation of pharmacological response in different ailments.

Background: Beta-adrenergic (β-AR) receptor blockers (BBs) are an essential class of drugs as they have numerous indications. On the other hand, they have numerous unwanted effects that decrease the compliance, adherence, and persistence of this very useful group of drugs. Objective: The paper aims to analyze the possibility that an unnoticed side effect may contribute to a less favorable pharmacologic profile of BBs, e.g., a diminished reaction to a sudden fall in BP. Methods: We searched two medical databases for abstracts and citations (Medline and SCOPUS). Moreover, we searched the internet for drug prescription leaflets (of the individual BBs). Results: Whichever cause of stress is considered, the somatic manifestations of stress will be (partially) masked if a patient takes BB. Stress-induced hypercatecholaminemia acts on β-AR of cardiomyocytes; it increases heart rate and contractility, effects suppressed by BBs. The answers of the organism to hypoglycemia and hypotension share the main mechanisms such as sympathetic nervous system activation and hypercatecholaminemia. Thus, there is a striking analogy: BBs can cover up symptoms of both hypoglycemia (which is widely known) and of hypotension (which is not recognized). It is widely known that BBs can cause hypotension. However, they can also complicate recovery by spoiling the defense mechanisms in hypotension as they interfere with the crucial compensatory reflex to increase blood pressure in hypotension. Conclusion: Beta blockers can cause hypotension, mask it, and make recovery more difficult. This is clinically important and deserves to be more investigated and probably to be stated as a warning.

The foremost common natural polymers are carbohydrate-based polymers or polysaccharides, having a long chain of monosaccharide or disaccharide units linked together via glycosidic linkage to form a complex structure. There are several uses of carbohydrate-based polymers in the biomedical sector due to their attractive features, including less toxicity, biocompatibility, biodegradability, high reactivity, availability, and relative inexpensiveness. The aim of our study was to explore the synthetic approaches for the preparation of numerous carbohydrate-based polyurethanes (PUs) and their wide range of pharmaceutical and biomedical applications. The data summarized in this study show that the addition of carbohydrates in the structural skeleton of PUs not only improves their suitability but also affects their applicability for use in biological applications. Carbohydrate- based units are incorporated into the PUs, which is the most convenient method for the synthesis of novel biocompatible and biodegradable carbohydrate-based PUs for use in various biomedical applications.

Background: As a member of long non-coding RNAs (lncRNAs), maternally expressed gene 8 (MEG8) has been found involving in the progression of a variety of cancers and playing a regulatory role. Therefore, MEG8 may turn into a new therapeutic target for cancer in the future. The purpose of this review is to illustrate the molecular mechanism and physiological function of MEG8 in various cancers. Methods: We retrieved and analyzed related articles about MEG8, lncRNAs, and cancers, and then summarize the pathophysiological mechanisms of MEG8 in cancer development. Results: LncRNA MEG8 participates in various cancers progression, thus influencing the proliferation, migration, and invasion of cancers. However, the expression of MEG8 is abnormally upregulated in non-small cell lung cancer (NSCLC), pancreatic cancer (PC), liver cancer (HCC), pituitary adenoma (PA) and hemangioma (HA), and inhibited in colorectal cancer (CRC), ovarian cancer (OC) and giant cell tumor (GCT), suggesting its clinical value in cancer therapy. Conclusion: LncRNA MEG8 is expected to be a new therapeutic target or biomarker for a wide range of cancers in the future.