Current Pharmaceutical Design - Volume 31, Issue 21, 2025

Intrauterine adhesion (IUA) is a condition caused by damage to the basal uterine layer which can lead to partial or full occlusion of the uterine cavity. Although traditional treatment options have been useful in mild and moderate cases, they have been unsatisfactory in severe IUA cases. Therefore, it is essential to improve the treatment strategies of IUA. Recent studies have demonstrated that Mesenchymal stem cells (MSCs) exert their therapeutic effects via the paracrine secretion of several substances including extracellular vesicles (EV) also called exosomes. MSC-derived exosomes (MSC-Exos) do not have the limitations of MSCs including immunogenicity and tumorigenicity. However, exosomes have limitations in terms of identification, isolation, purification, and origin. The clinical application of exosomes requires quality control and increased standardization in isolation and culture serum. This review summarizes therapeutic potentials of MSC-Exos and explores their potential clinical implications as diagnostic, therapeutic targets as well as prognostic markers in managing IUA.

Thrombomodulin (TM) is a single-chain transmembrane glycoprotein with anticoagulant effects. TM has two forms: membrane type existing on the cell surface and blood type free in plasma and urine. TM functions as an anticoagulant cofactor for thrombin activation of protein C on the surface of vascular endothelial cells. Due to the excellent anti-coagulant effects in modulating the coagulation and fibrinolytic system, the recombinant human soluble TM (rhsTM) has been used for the treatment of disseminated intravascular coagulation (DIC). In addition to anti-coagulation, many studies have shown that TM can also exert anti-inflammatory and anti-tumor effects. TM has a lectin-like domain at its N-terminus that has been shown to exhibit direct anti-inflammatory functions. At the same time, due to its special structure, thrombomodulin plays an important role in vascular-related mechanistic diseases by participating in the regulation of inflammatory pathways, complement, HMGB1, etc. In this article, changes in TM expression in the body after injury, composition of TM structural domains, anticoagulant, anti-inflammatory, and antitumor effects, and related mechanisms of TM were systematically reviewed, to provide a theoretical basis and reference for the potential clinical implications of TM in treating various diseases.

Long non-coding RNAs (lncRNAs) refer to RNA molecules that exceed 200 nucleotides in length. While lncRNAs do not possess the capacity to encode proteins, they play crucial roles in gene expression, chromatin remodeling, and protein relocation. PSMA3 antisense RNA 1 (PSMA3-AS1) is a newly discovered lncRNA located on human chromosome 14q23.1. Convincing evidence shows that it acts as a tumor-promoting factor in several forms of human cancers. Moreover, high expression of PSMA3-AS1 is linked to poor clinical and pathological features and adverse prognosis in eight types of cancer. The molecular mechanisms of PSMA3-AS1 are diverse and complex. Existing evidence demonstrates that PSMA3-AS1 is activated by two transcription factors, PAX5 and YY-1, and influences cancer cell growth, metastasis, apoptosis, drug resistance, oxidative stress, and autophagy by acting as a competing endogenous RNA, activating signaling pathways, directly interacting with RNA or proteins, as well as participating in the epithelial-mesenchymal transition process. Therefore, PSMA3-AS1 holds promise as a biomarker for cancer detection and prediction, as well as a novel therapeutic target. This review explores the expression features, biological roles, potential mechanisms, and clinical significance of PSMA3-AS1 in various human cancers and provides directions for future research.

Nanogels (NGs) are presently the focus of extensive research because of their special qualities, including minimal particle size, excellent encapsulating efficacy, and minimizing the breakdown of active compounds. As a result, NGs are great candidates for drug delivery systems. Cross-linked nanoparticles (NPs) called stimulus-responsive NGs are comprised of synthetic, natural, or a combination of natural and synthetic polymers. These NPs can swell in response to large amounts of solvent, but their structural makeup prevents them from dissolving. Furthermore, in response to (i) physical stimuli like temperatures, ion strength, and magnetized or electrical fields; (ii) chemical stimuli like the pH level, molecules, or ions; (iii) biological stimuli like the enzymatic substrate or affinity ligand, they transform into a hard particle (collapsed form) from a polymer solution (swell form). Over the past decade, there has been a major advancement in the creation of “smart” NGs in applications related to therapeutics and diagnosis, involving nucleic acid and intracellular drug delivery, photodynamic/photothermal treatment, biological imaging, and its detection. The nanogels reviewed in this article rely only on temperatures, pH, light, magnetic fields, and combinations of those variables. Developing a targeted delivery vehicle will greatly benefit from the presented information, especially when used for Core-shell multi-sensitive photo-sensitive nanogels.

The increasing global prevalence of obesity (OB) calls for the development of effective treatments. Traditional Chinese Medicine (TCM) offers a promising approach by modulating gut microbiota (GM) to enhance the production of short-chain fatty acids (SCFAs). Research has demonstrated that SCFAs can regulate appetite and energy expenditure via the Central Nervous System (CNS), underscoring the role of the gut-brain axis in maintaining energy balance. A comprehensive review of the literature was conducted using databases, such as ScienceDirect, Google Scholar, and PubMed. The focus was on the impact of TCM on SCFA production and its influence on appetite regulation and energy expenditure through the CNS. This review indicates that TCM enhances the production of SCFAs, which suppress appetite and increase energy expenditure through their interaction with the CNS, particularly the gut-brain axis. TCM demonstrates promise as a therapeutic strategy for obesity by enhancing the production of SCFAs and regulating energy balance. This approach presents a novel avenue for obesity treatment through the modulation of the microbiome.