The potential roles of gossypol as anticancer agent: advances and future directions.

Gossypol, a polyphenolic aldehyde derived from cottonseed plants, has seen a transformation in its pharmaceutical application from a male contraceptive to a candidate for cancer therapy. This shift is supported by its recognized antitumor properties, which have prompted its investigation in the treatment of various cancers and related inflammatory conditions. This review synthesizes the current understanding of gossypol as an anticancer agent, focusing on its pharmacological mechanisms, strategies to enhance its clinical efficacy, and the status of ongoing clinical evaluations.The methodological approach to this review involved a systematic search across several scientific databases including the National Center for Biotechnology Information (NCBI), PubMed/MedLine, Google Scholar, Scopus, and TRIP. Studies were meticulously chosen to cover various aspects of gossypol, from its chemical structure and natural sources to its pharmacokinetics and confirmed anticancer efficacy. Specific MeSH terms and keywords related to gossypol's antineoplastic applications guided the search strategy.Results from selected pharmacological studies indicate that gossypol inhibits the Bcl-2 family of anti-apoptotic proteins, promoting apoptosis in tumor cells. Clinical trials, particularly phase I and II, reveal gossypol's promise as an anticancer agent, demonstrating efficacy and manageable toxicity profiles. The review identifies the development of gossypol derivatives and novel carriers as avenues to enhance therapeutic outcomes and mitigate adverse effects.Conclusively, gossypol represents a promising anticancer agent with considerable therapeutic potential. However, further research is needed to refine gossypol-based therapies, explore combination treatments, and verify their effectiveness across cancer types. The ongoing clinical trials continue to support its potential, suggesting a future where gossypol could play a significant role in cancer treatment protocols.

Natural Substances vs. Approved Drugs in the Treatment of Main Cardiovascular Disorders-Is There a Breakthrough?

Cardiovascular diseases (CVDs) are a group of diseases with a very high rate of morbidity and mortality. The clinical presentation of CVDs can vary from asymptomatic to classic symptoms such as chest pain in patients with myocardial infarction. Current therapeutics for CVDs mainly target disease symptoms. The most common CVDs are coronary artery disease, acute myocardial infarction, atrial fibrillation, chronic heart failure, arterial hypertension, and valvular heart disease. In their treatment, conventional therapies and pharmacological therapies are used. However, the use of herbal medicines in the therapy of these diseases has also been reported in the literature, resulting in a need for critical evaluation of advances related to their use. Therefore, we carried out a narrative review of pharmacological and herbal therapeutic effects reported for these diseases. Data for this comprehensive review were obtained from electronic databases such as MedLine, PubMed, Web of Science, Scopus, and Google Scholar. Conventional therapy requires an individual approach to the patients, as when patients do not respond well, this often causes allergic effects or various other unwanted effects. Nowadays, medicinal plants as therapeutics are frequently used in different parts of the world. Preclinical/clinical pharmacology studies have confirmed that some bioactive compounds may have beneficial therapeutic effects in some common CVDs. The natural products analyzed in this review are promising phytochemicals for adjuvant and complementary drug candidates in CVDs pharmacotherapy, and some of them have already been approved by the FDA. There are insufficient clinical studies to compare the effectiveness of natural products compared to approved therapeutics for the treatment of CVDs. Further long-term studies are needed to accelerate the potential of using natural products for these diseases. Despite this undoubted beneficence on CVDs, there are no strong breakthroughs supporting the implementation of natural products in clinical practice. Nevertheless, they are promising agents in the supplementation and co-therapy of CVDs.

An updated pharmacological insight into calotropin as a potential therapeutic agent in cancer.

Calotropin is a pharmacologically active compound isolated from milkweed plants like Calotropis procera, Calotropis gigantea, and Asclepias currasavica that belong to the Asclepiadaceae family. All of these plants are recognised as medical traditional plants used in Asian countries. Calotropin is identified as a highly potent cardenolide that has a similar chemical structure to cardiac glycosides (such as digoxin and digitoxin). During the last few years, cytotoxic and antitumor effects of cardenolides glycosides have been reported more frequently. Among cardenolides, calotropin is identified as the most promising agent. In this updated and comprehensive review, we aimed to analyze and discuss the specific mechanisms and molecular targets of calotropin in cancer treatment to open new perspectives for the adjuvant treatment of different types of cancer. The effects of calotropin on cancer have been extensively studied in preclinical pharmacological studies in vitro using cancer cell lines and in vivo in experimental animal models that have targeted antitumor mechanisms and anticancer signaling pathways. The analyzed information from the specialized literature was obtained from scientific databases until December 2022, mainly from PubMed/MedLine, Google Scholar, Scopus, Web of Science, and Science Direct databases using specific MeSH search terms. The results of our analysis demonstrate that calotropin can be a potential chemotherapeutic/chemopreventive adjunctive agent in cancer pharmacotherapeutic management.

Ethnopharmacological-Based Validation of Polyalthia suberosa Leaf Extract in Neurological, Hyperalgesic, and Hyperactive Gut Disorders Using Animal Models.

Polyalthia suberosa (Roxb.) is a plant used to cure coughs, dysentery, fevers, joint aches, rheumatic pain, inflammation, and a variety of skin diseases. The aim of the study was to evaluate the ethyl acetate extract of Polyalthia suberosa (P. suberosa) leaves and their effects on mice for neuropharmacological, analgesic, and antidiarrheal activities. For neurological studies, the hole cross, hole board, open field, and thiopental sodium-induced sleep duration measurement methodologies were used. The castor oil-induced diarrhea inhibition test was used to assess antidiarrheal action, and the acetic acid-induced writhing inhibition test was used to determine analgesic effectiveness. The extract was given in doses of 250 and 500 mg kg-1 body weight. As a standard drug, diazepam at a dosage of 3 mg kg-1 was used. The extract was also given to groups, and sleep time was measured and recorded. The onset of the anxiolytic effect of the extract at both doses was found to be significant (p < 0.001), and sleep time increased to 273 minutes. For assessing analgesic activity, the extract along with standard diclofenac was administered and found to be 55.02 percent and 64.33 percent, respectively, for the extracts, and diclofenac was found to be 67.44 percent (p < 0.001). For antidiarrheal activity, it was compared with the standard drug, loperamide. The decrease for plant extracts was 50.07 percent and 70.06 percent at 250 mg kg-1 and 500 mg kg-1, respectively, whereas it was 85.01 percent for loperamide (3 mg kg-1) (p < 0.00). In this study, it was found that ethyl acetate extract of Polyalthia suberosa leaves had strong CNS depressant, analgesic, and antidiarrheal activities, which indicates that it may be used in contemporary medicine.

Resveratrol and Reproductive Health.

Resveratrol (RSV), a plant-derived polyphenol, demonstrates broad-spectrum health benefits, including anti-proliferative, anti-inflammatory, antidiabetic, anti-ischemic and antioxidant effects. The aim of this review is to give an important heads-up regarding the influence of RSV as a phytoestrogen, RSV effects on most common pregnancy-related complications, as well as its impact on the embryogenesis, spermatogenesis, and women's reproductive health. Considering the important implications of RSV on human reproductive health, this overview could provide a groundwork, encouraging more detailed research at the clinical level.

Potassium channels on smooth muscle as a molecular target for plant-derived Resveratrol.

Resveratrol (3,5,4'-trihydroxy-trans-stilbene) is a phytoalexin present in a variety of plant species. Resveratrol has a wide spectrum of pharmacologic properties, and it exhibits versatile biological effects on different human and animal models. The studies have shown that potassium (K) channels can be potential targets in the mechanism of resveratrol action. K channels play a crucial role in maintaining membrane potential. Inhibition of K channels causes membrane depolarization and then contraction of smooth muscles, while the activation leads to membrane hyperpolarization and subsequently, relaxation. Five diverse types of K channels have been identified in smooth muscle cells in different tissue: ATP-sensitive K channels (KATP), voltage-dependent K channels (Kv), Ca2+ - and voltage-dependent K channels (BKCa), inward rectifier K channels (Kir), and tandem two-pore K channels (K2P). The expression and activity of K channels altered in many types of diseases. Aberrant function or expression of K channels can be underlying in pathologies such as cardiac arrhythmia, diabetes mellitus, hypertension, preterm birth, preeclampsia, and various types of cancer. Modulation of K channel activity by molecular approaches and selective drug development may be a novel treatment modality for these dysfunctions in the future. The plant-derived non-toxic polyphenols, such as resveratrol, can alter K channel activity and lead to the desired outcome. This review presents the basic properties, physiological, pathophysiological functions of K channels, and pharmacological roles of resveratrol on the major types of K channels that have been determined in smooth muscle cells.

Pregnancy-induced hypertension decreases Kv1.3 potassium channel expression and function in human umbilical vein smooth muscle.

Voltage-gated potassium (Kv) channels are the largest superfamily of potassium (K) channels. A variety of Kv channels are expressed in the vascular smooth muscle cells (SMC). Studies have shown that gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) cause various changes in the human umbilical vein (HUV). Recently, we have shown that 4-AP, a nonspecific Kv1-4 channel inhibitor, significantly decreases vasorelaxation induced by K channel opener pinacidil in vascular SMCs of the HUVs from normal pregnancies, but not in GDM and PIH. The goal of this study was to provide more detailed insight in the Kv channel subtypes involved in pinacidil-induced vasodilation of HUVs, as well as to investigate potential alterations of their function and expression during GDM and PIH. Margatoxin, a specific blocker of Kv1.2 and Kv1.3 channels, significantly antagonized pinacidil-induced vasorelaxation in normal pregnancy, while in HUVs from GDM and PIH that was not the case, indicating damage of Kv1.2 and Kv1.3 channel function. Immunohistochemistry and Western blot revealed similar expression of Kv1.2 channels in all groups. The expression of Kv1.3 subunit was significantly decreased in PIH, while it remained unchanged in GDM compared to normal pregnancy. Phrixotoxin, specific blocker of Kv4.2 and Kv4.3 channels, did not antagonize response to pinacidil in any of the groups. The major novel findings show that margatoxin antagonized pinacidil-induced relaxation in normal pregnancy, but not in GDM and PIH. Decreased expression of Kv1.3 channels in HUV during PIH may be important pathophysiological mechanism contributing to an increased risk of adverse pregnancy outcomes.

The influence of climate change on human cardiovascular function.

Climate change is considered to have great impact on human health. The heat waves have been associated with excess morbidity and mortality of cardiovascular diseases (CVD) across various populations and geographic locations. Important role in the heat-induced cardiovascular damage has endothelial dysfunction. It has been noticed that hot weather can impair tone and structure of the blood vessels via interfering with variety of biological factors such as nitric oxide synthesize, cytokine production and systemic inflammation. Also, due to dehydration and increased blood viscosity, by promoting thrombogenesis, heat has important impact on patients with atherosclerosis. During chronic exposure to the cold or hot weather cardiovascular function can be decreased, leading to a higher risk of developing heart attack, malignant cardiac arrhythmias, thromboembolic diseases and heat-induced sepsis like shock. It has been shown that changes in the ambient temperature through increasing blood pressure, blood viscosity, and heart rate, contribute to the cardiovascular mortality. The majority of deaths due to heat waves especially affect individuals with preexisting chronic CVD. This population can experience a decline in the health status, since extreme ambient temperature affects pharmacokinetic parameters of many cardiovascular drugs. Increased mortality from ischemic or hemorrhagic stroke can also be related to extreme temperature variations. On a cellular level, higher ambient temperature can limit storage of ATP and O2 increase amount of free radicals and toxic substances and induce neuronal apoptotic signal transduction, which all can lead to a stroke. Preserving cardiovascular function in context of extreme climate changing tends to be particularly challenging.

Effect of gestational diabetes mellitus and pregnancy-induced hypertension on human umbilical vein smooth muscle KATP channels.

Gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) can jeopardize mother and/or fetus. Vascular ATP-sensitive potassium (KATP) channels most likely participate in the processes of diabetes and hypertension. The aim of this research was to examine whether GDM and PIH cause changes in the expression and function of KATP channels in vascular smooth muscle of human umbilical vein (HUV). Western blot and immunohistochemistry detected significantly decreased expression of Kir6.1 subunit of KATP channels in GDM and PIH, while the expression of SUR2B was unchanged. In GDM, a K+ channel opener, pinacidil caused reduced relaxation of the endothelium-denuded HUVs compared to normal pregnancy. However, its effects in HUVs from PIH subjects were similar to normal pregnancy. In all groups KATP channel blocker glibenclamide antagonized the relaxation of HUV induced by pinacidil without change in the maximal relaxations indicating additional KATP channel-independent mechanisms of pinacidil action. Iberiotoxin, a selective antagonist of large-conductance calcium-activated potassium channels, inhibited the relaxant effect of pinacidil in PIH, but not in normal pregnancy and GDM. Experiments performed in K+-rich solution confirmed the existence of K+-independent effects of pinacidil, which also appear to be impaired in GDM and PIH. Thus, the expression of KATP channels is decreased in GDM and PIH. In GDM, vasorelaxant response of HUV to pinacidil is reduced, while in PIH it remains unchanged. It is very likely that KATP channels modulation and more detailed insight in KATP channel-independent actions of pinacidil may be precious in the therapy of pathological pregnancies.

Differences in antimicrobial consumption, prescribing and isolation rate of multidrug resistant Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii on surgical and medical wards.

In order to provide guidance data for clinically rational use of an antibiotics consuption, prescribing and prevalence of multidrug resistant (MDR) Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were monitored on the surgical (S) and medical (M) wards of the University Hospital Center "Dr. Dragisa Misovic-Dedinje" (Belgrade, Serbia), in the study period from 2012 to 2015. Appropriateness of antimicrobial use was evaluated using the Global-Prevalence Survey method designed by the University of Antwerp. The percentages of MDR pathogens relative to the total number of isolates of K. pneumoniae and P. aeruginosa were higher on the S (86.2% and 49.1%) than on the M (63.2% and 36.9%) wards. The percentage of MDR A. baumannii was not different between S (93.7%) and M (79.5%) wards. An overall antibiotics consumption (defined daily doses/100 bed-days) during study was 369.7 and 261.5 on the S and M wards, respectively. A total of 225 prescriptions of antimicrobials were evaluated in138 adults admitted to wards on the day of the survey. The percentage of antimicrobials prescribed for prophylaxis on the M and S wards were 0% and 25%, respectively. Therapies were more frequently empiric (S, 86.8% and M, 80%). The percentages of medical errors on the S and M wards were 74.6% and 27.3%, respectively. The quality indicators for antibiotic prescribing on the S and M wards were as follows: the incorrect choice of antimicrobials (35.6% vs. 20.0%), inappropriate dose interval (70.6% vs. 16.9%) or duration of therapy (72.5% vs. 23.1%), a non-documented stop/review data (73.6% vs. 16.9%) and divergence from guidelines (71.9% vs. 23.1%). Treatment based on biomarkers was more common on the M wards as compared to the S wards. The increasing prevalence of MDR pathogens, a very high consumption and incorrect prescribing of antimicrobials need special attention, particularly on the S wards.

Phenylpropiophenone derivatives as potential anticancer agents: synthesis, biological evaluation and quantitative structure-activity relationship study.

Series of twelve chalcone and propafenone derivatives has been synthesized and evaluated for anticancer activities against HeLa, Fem-X, PC-3, MCF-7, LS174 and K562 cell lines. The 2D-QSAR and 3D-QSAR studies were performed for all compounds with cytotoxic activities against each cancer cell line. Partial least squares (PLS) regression has been applied for selection of the most relevant molecular descriptors and QSAR models building. Predictive potentials of the created 2D-QSAR and 3D-QSAR models for each cell line were compared, by use of leave-one-out cross-validation and external validation, and optimal QSAR models for each cancer cell line were selected. The QSAR studies have selected the most significant molecular descriptors and pharmacophores of the chalcone and propafenone derivatives and proposed structures of novel chalcone and propafenone derivatives with enhanced anticancer activity on the HeLa, Fem-X, PC-3, MCF-7, LS174 and K562 cells.

Effect of wine polyphenol resveratrol on the contractions elicited electrically or by norepinephrine in the rat portal vein.

We investigated the effects of resveratrol on rat portal vein (RPV) contractility without endothelium. Contractions were produced by electrical field stimulation of perivascular nerves (EFS), norepinephrine (NE), adenosine 5'-triphosphate (ATP), high K(+) solution and by calcium chloride (CaCl2 ) in Ca(2+) -free and high K(+) , Ca(2+) -free solution. The EFS-evoked contractions were more sensitive to resveratrol and to NS1619-selective openers of big calcium-sensitive (BKCa ) channels, than NE-evoked contractions. Effects of resveratrol on the ATP-evoked contractions were weak. Blockers of BKCa channels partly inhibited the effect of resveratrol only in EFS-contracted preparations. Western blotting showed that RPV expressed KCa 1.1 protein. Inhibitors of ATP- and voltage-sensitive K(+) channels did not modify the effects of resveratrol. None of the antagonists of K(+) channels affected the resveratrol inhibition of NE-evoked contractions and effect of high concentrations of resveratrol on the EFS-evoked contractions. Resveratrol more potently inhibited CaCl2 than potassium chloride contractions of RPV. Thus, BKCa channels partly mediate the inhibitory effect of resveratrol on the neurogenic contractions of RPV. The smooth muscle Ca(2+) channels and/or Ca(2+) mobilizing through cells might be involved in the effects of resveratrol on the contractility of RPV. Our results are important for better understanding the impact of resveratrol on the portal circulation.

Anthropological aspect of death in dialyzed patients.

The aim of this article is to compare the incidence of thanatophobia in dialysed patients having Balkan endemic nephropathy (BEN) with a control group (N18) members where some of them have chronic renal failure (CRF), but not (BEN). We examined thanatophobia on a sample of 753 dialysed patients with chronic renal failure (CRF) in Bosnia and Herzegovina (B&H) during the period from 1st January 2000 to 31st December 2006. The first group is a cohort consisted of 348 patients with Balkan endemic nephropathy (BEN), and the control group consisted of 405 randomly selected patients with different diagnoses of CRF (N18). The measurement instruments used were: General data list, Eysenck's Personality Questionnaire (EPQ), Beck's Anxiety Inventory (BAI), Hamilton's Depression Rating Scale (HDRS), and Mini-Mental State Examination (MMSE). Univariante and multivariante statistical analyses were carried out. From the multivariante analysis, the highest correlations with thanatophobia were found in these variables: avoidance of dialysis in BEN group: R=0.985, OR=0.358, CI=0.483-0.728 (95%), and in control group: R=0.550, OR=0.935, CI=0.615-0.830 (95%), age, years on dialysis, education, pervasive fear with statistical significance P=0.001. BEN group differentiates from control group: BAI-total (R=1.110, OR=0.578 (95%), CI=0.770-0.890, P=0.001), HDRS-total (R=0.995, OR=1.290 (95%), CI=1.180-1.920 P=0.001. BEN group have lower scores than the control group in MMSE-total: (R=0.430, OR=0.023 (95%), CI=0.034-2.850, P=0.001) which represents the organic part of anxiety. Thanatophobia is present in both groups, but it is more frequent in the BEN (11.70%) than in control group (7.50%). We found that thanatophobia occurs before dialysis, and that it is structured as a pervasive fear of death and is associated with endemia, years spent on dialysis, and avoidance of dialysis.

Somatisation disorder in nephrologic patients.

INTRODUCTION: Nephrologic patients have somatisation disorder that can be primary disorder when fear is dominant or secondary disorder in the frame of other organic and mental disorders. AIM: To evaluate, somatisaton disorder is more offten accompanied with microalbuminuria (MA) in patients with suspected endemic nephropathy than in patients with some other nephrologic disorder, in Bosnia and Herzegovina (B&H) during period from January the 1st of 2000 to December the 31st of 2006. METHOD: Somatisation disorders were proved in patients with microalbuminuria (MA) in nephropathic group (n = 200), and they were compared to the patients with MA in other nephrologic disorders (n = 200). The study took place from January, the 1st of 2000 to December, the 31st of 2006, and it was a multicentric, longitudinal, comparative study in B&H. Patients were questioned using: B&H Renal register questionnaire adapted for this study and psychological tests: Eysenck's Personality Questionnaire (EPQ), Beck Anxiety Inventory (BAI), and Hamilton Depression Rating Scale (HDRS). Statistical analysis was done using descriptive methods and multivariate logistic model. RESULTS: In nephropathic group (t = 23.103, P = 0.001) somatisation disorder F45.0 was found in 10.50%, while it was found in 7.00% patients in control group. On multivariate model, somatisation disorder in nephropathic group F45.0 was -4.00%, r = 0.950, OR = 0.875 (95%), CI = 0.710-0.820; undifferentiated disorder -4.00%, hypochondria -3.50%, disfunction of VNS -1.50%, pain disorder -1.00% and 0.50% of other disorders life in house, village and renal heredity. Somatisation disorder in control group was 2.50%, r = 0.815, OR = 0.985 (95%), CI = 0.710-0.920, P = 0.001, undifferentiated disorder -2.50%, disfunction of VNS -2.00%, pain -1.50%, and -1.00% hypochondria with migration, living in flat and town. CONCLUSION: Majority of the patients tested on microalbuminuria had somatisation of fear, and nephropathic somatisation disorder F45.0 was found in 10.50% comparing to 7.00% of controls, comfirming somatisation of anxiety in nephrologic patients. Somatisation was proved using sociodemographic and variables of anxiety, depressivness and cognitive disturbance.

The effect of potassium channel opener pinacidil on the non-pregnant rat uterus.

The effects of the K(+) channel opener, pinacidil on the spontaneous rhythmic contractions and contractions provoked by electrical field stimulation (50 Hz) or by oxytocin were investigated in the isolated uterus of the non-pregnant rat in oestrus. Pinacidil produced more potent inhibition of oxytocin-elicited contractions than of spontaneous rhythmic contractions or electrical field stimulation-induced contractions. Glibenclamide, a selective blocker of adenosine triphosphate (ATP)-sensitive K(+) (K(ATP)) channels, antagonized the pinacidil-induced inhibition of contractions elicited by oxytocin in a competitive manner. However, the pinacidil-induced inhibition of electrical field stimulation-elicited contractions and spontaneous rhythmic contractions was antagonized non-competitively by glibenclamide. In the uterine strips pre-contracted with 80 mM K(+), the pinacidil-induced maximal relaxation was not affected. The present data show that pinacidil exhibits potent relaxant properties in the rat non-pregnant uterus in oestrus and therefore should be taken into account as a possible agent for treatment of dysmenorrhoea. Based on glibenclamide affinity, it appears that the inhibitory response to pinacidil involves K(ATP )channels. We need further investigations to explain why the interaction between glibenclamide and pinacidil in this experimental model depends on the nature of contractions. The ability of pinacidil to completely relax the rat non-pregnant uterus pre-contracted with K(+)-rich solution suggests that K(+) channel-independent mechanism(s) also play a part in its relaxant effect.

Depersonalization in Balkan endemic nephropathy.

UNLABELLED: Aim of the study was to confirm depersonalization/derealization in patients with Balkan endemic nephropathy in comparison with other patients on dialysis in Bosnia and Herzegovina within the period 01.01.2000 -31-12-2006. years. METHOD: Examined were 753 out of 2770 dialyzed patients and they were divided into two groups: those with Balkan endemic nephropathy--BEN group (N+348) and the control group of other diseases N18. Patients were followed-up form 01.01.2000 to 31.12. 2006. when the study was made. It is comparative, cross-sectional study and Questionnaire from the renal Registry of B&H adapted to the mental health and psychological tests--Eizenck's personality characteristics test, Hamilton Depression Rating scale (HDRS) and Mini Mental State evaluation were used. RESULTS: Depersonalization was in BEN group present in 3.50% of cases (chi2 = 70.880, df = 2 p < 0.001), a derealization in 3.75% (chi2 = 117.678, df = 2, p < 0.002) and depersonalization/ derealization in 1.19% of them (chi2 = 218.457, df = 2, p < 0.002). Regression analysis was: y = -0.93x + 14.818, a CI = 95% for Fisher's (Z = -0.995462 to -0.26481). CanFanc r2 = 0.86, P = 0.002 za 87.5% for depersonalization prediction in HRF. CONCLUSION: In patients on dialyzed treatment in BaH depersonalization sui generis was found in group BEN 3.50% of cases, derealization in 3.57% of them and in group N18 depersonalization in 3.32% of them and possibility to predict depersonalization is 87.50%.