• Title/Summary/Keyword: Clinical unmet need

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Ginsenosides: potential therapeutic source for fibrosis-associated human diseases

  • Li, Xiaobing;Mo, Nan;Li, Zhenzhen
    • Journal of Ginseng Research
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    • v.44 no.3
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    • pp.386-398
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    • 2020
  • Tissue fibrosis is an eventual pathologic change of numerous chronic illnesses, which is characterized by resident fibroblasts differentiation into myofibroblasts during inflammation, coupled with excessive extracellular matrix deposition in tissues, ultimately leading to failure of normal organ function. Now, there are many mechanistic insights into the pathogenesis of tissue fibrosis, which facilitate the discovery of effective antifibrotic drugs. Moreover, many chronic diseases remain a significant clinical unmet need. For the past five years, many research works have undoubtedly addressed the functional dependency of ginsenosides in different types of fibrosis and the successful remission in various animal models treated with ginsenosides. Caveolin-1, interleukin, thrombospondin-1 (TSP-1), liver X receptors (LXRs), Nrf2, microRNA-27b, PPARδ-STAT3, liver kinase B1 (LKB1)-AMPK, and TGF-β1/Smads are potential therapy targeting using ginsenosides. Ginsenosides can play a targeting role and suppress chronic inflammatory response, collagen deposition, and epitheliale-mesenchymal transition (EMT), as well as myofibroblast activation to attenuate fibrosis. In this report, our aim was to focus on the therapeutic prospects of ginsenosides in fibrosis-related human diseases making use of results acquired from various animal models. These findings should provide important therapeutic clues and strategies for the exploration of new drugs for fibrosis treatment.

Perceived Competency, Frequency, Training Needs in Physical Assessment among Registered Nurses

  • Oh, Heeyoung;Lee, Jiyeon;Kim, Eun Kyung
    • Korean Journal of Adult Nursing
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    • v.24 no.6
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    • pp.627-634
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    • 2012
  • Purpose: The purpose of this study was to identify registered nurses learning needs about physical assessment. Specifically, what are the perceived competency, frequency of skill use and the unmet training needs. Methods: The study was an exploratory survey study. The sample was 104 registered nurses. Data were collected through three instruments: The Perceived Competency in Physical Assessment Scale, the Frequency of Physical Assessment Scale, and the Training Needs of Physical Assessment Scale which incorporated 30 core Physical Assessment skills. Descriptive statistics, t-test, and Pearson's correlation coefficient were used to analyze the data. Results: Auscultation of heart and lung sounds and inspection of the spine were rated by the subjects as physical assessment skills they feel least competent and also were less frequently performed. The most competent area for physical assessment was neurological system. The respiratory and abdominal system was identified as two systems that more education would be needed. Nurses with less than one year of working experience reported needing more training. Nurses with more than five years of clinical work experience performed physical assessment more frequently than nurses with less than five year of work experience. The perceived competency was positively related to the frequency of physical assessment. Conclusion: Continuing education is necessary to further train registered nurses regarding physical assessment skills and the program needs to be focused on the area which nurses are less competent for and have high training need.

Chronicles of EGFR Tyrosine Kinase Inhibitors: Targeting EGFR C797S Containing Triple Mutations

  • Duggirala, Krishna Babu;Lee, Yujin;Lee, Kwangho
    • Biomolecules & Therapeutics
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    • v.30 no.1
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    • pp.19-27
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    • 2022
  • Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase widely expressed in many cancers such as non-small cell lung cancer (NSCLC), pancreatic cancer, breast cancer, and head and neck cancer. Mutations such as L858R in exon 21, exon 19 truncation (Del19), exon 20 insertions, and others are responsible for aberrant activation of EGFR in NSCLC. First-generation EGFR tyrosine kinase inhibitors (TKIs) such as gefitinib and erlotinib have clinical benefits for EGFR-sensitive (L858R and Del19) NSCLC patients. However, after 10-12 months of treatment with these inhibitors, a secondary T790M mutation at the gatekeeper position in the kinase domain of EGFR was identified, which limited the clinical benefits. Second-generation EGFR irreversible inhibitors (afatinib and dacomitinib) were developed to overcome this T790M mutation. However, their lack of selectivity toward wild-type EGFR compromised their clinical benefits due to serious adverse events. Recently developed third-generation irreversible EGFR TKIs (osimertinib and lazertinib) are selective toward driving mutations and the T790M mutation, while sparing wild-type EGFR activity. The latest studies have concluded that their efficacy was also compromised by additional acquired mutations, including C797S, the key residue cysteine that forms covalent bonds with irreversible inhibitors. Because second- and third-generation EGFR TKIs are irreversible inhibitors, they are not effective against C797S containing EGFR triple mutations (Del19/T790M/C797S and L858R/T790M/C797S). Therefore, there is an urgent unmet medical need to develop next-generation EGFR TKIs that selectively inhibit EGFR triple mutations via a non-irreversible mechanism.

A Personal Perspective and Our Role in Korean Oriental Medicine (한의학(韓醫學)의 전망(展望)과 우리의 역할(役割))

  • Kang Shun-Su
    • Herbal Formula Science
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    • v.10 no.2
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    • pp.1-4
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    • 2002
  • The development of Korean Oriental medicine is based upon the accumulation of experience and knowledge gathered over the centuries. The approaches taken are holistic and empirical. There is a need to understand their actions at molecular levels with more rational, objective and scientific studies. Today it appears that Chronic and age-associated diceases may be multifactorial and hence more complex. A different approach may be required. One claimed usage of Korean Oriental medicine is for the treatment and prevention of chronic and age-associated illnesses. Some of the botanical formulas used for this purpose were discovered thousands of years ago and continue to be used today. There are indications that these formulas may indeed be helpful in the treatment or prevention of chronic diseases. This multi-component medicine could not only be very useful meeting the unmet clinical needs but for defining a more synergistic therapy that supports and maintains the bodies natural curative abilities. The potential usefulness of Korean Oriental medicine embodies the belief of maintaining healthy homeostasis of the body through the proper balance of a mixture of chemical at different organs or tissues. This concept is different from western medicine and implies that multiple compounds may act on multiple mechanisms of action to maintain the balance of the complex web of biology. This is very important in view of sciences current direction to integrate fragmented information to develop future medicines. The western and eastern approaches to human health and disease are complementary to each other. The best approach in developing future medicines is to integrate both approaches.

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Prevalence of feline calicivirus and the distribution of serum neutralizing antibody against isolate strains in cats of Hangzhou, China

  • Zheng, Mengjie;Li, Zesheng;Fu, Xinyu;Lv, Qian;Yang, Yang;Shi, Fushan
    • Journal of Veterinary Science
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    • v.22 no.5
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    • pp.73.1-73.11
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    • 2021
  • Background: Feline calicivirus (FCV) is a common pathogen of felids, and FCV vaccination is regularly practiced. The genetic variability and antigenic diversity of FCV hinder the effective control and prevention of infection by vaccination. Improved knowledge of the epidemiological characteristics of FCV should assist in the development of more effective vaccines. Objectives: This study aims to determine the prevalence of FCV in a population of cats with FCV-suspected clinical signs in Hangzhou and to demonstrate the antigenic and genetic relationships between vaccine status and representative isolated FCV strains. Methods: Cats (n = 516) from Hangzhou were investigated between 2018 and 2020. The association between risk factors and FCV infection was assessed. Phylogenetic analyses based on a capsid coding sequence were performed to identify the genetic relationships between strains. In vitro virus neutralization tests were used to assess antibody levels against isolated FCV strains in client-owned cats. Results: The FCV-positive rate of the examined cats was 43.0%. Risk factors significantly associated with FCV infection were vaccination status and oral symptoms. Phylogenetic analysis revealed a radial phylogeny with no evidence of temporal or countrywide clusters. There was a significant difference in the distribution of serum antibody titers between vaccinated and unvaccinated cats. Conclusions: This study revealed a high prevalence and genetic diversity of FCV in Hangzhou. The results indicate that the efficacy of FCV vaccination is unsatisfactory. More comprehensive and refined vaccination protocols are an urgent and unmet need.

Antiviral Activity of Plant-derived Natural Products against Influenza Viruses (식물 유래 천연물의 인플루엔자에 대한 항바이러스 활성)

  • Kim, Seonjeong;Kim, Yewon;Kim, Ju Won;Hwang, Yu-bin;Kim, Seong Hyeon;Jang, Yo Han
    • Journal of Life Science
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    • v.32 no.5
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    • pp.375-390
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    • 2022
  • Influenza viruses are zoonotic respiratory pathogens, and influenza infections have caused a substantial burden on public health systems and the livestock industry. Although currently approved seasonal influenza vaccines have shown potent protection efficacy against antigenically well-matched strains, there are considerable unmet needs for the efficient control of viral infections. Enormous efforts have been made to develop broadly protective universal influenza vaccines to tackle the huge levels of genetic diversity and variability of influenza viruses. In addition, antiviral drugs have been considered important interventions for the treatment of viral infections. The viral neuraminidase inhibitor oseltamivir is the most widely used antiviral medication to treat influenza A and influenza B viruses. However, unsatisfactory clinical outcomes resulting from side effects and the emergence of resistant variants have led to greater attention being paid to plants as a natural resource for anti-influenza drugs. In particular, the recent COVID-19 pandemic has underpinned the need for safe and effective antiviral drugs with a broad spectrum of antiviral activity to prevent the rapid spread of viruses among humans. This review outlines the results of the antiviral activities of various natural products isolated from plants against influenza viruses. Special focus is paid to the virucidal effects and the immune-enhancing effects of antiviral natural products, since the products have broad applications as inactivating agents for the preparation of inactivated vaccines and vaccine adjuvants.