RESUMO
Selective delivery of therapeutic agents into solid tumors has been a major challenge impeding the achievement of long-term disease remission and cure. The need to develop alternative drug delivery routes to achieve higher drug concentration in tumor tissue, reduce unwanted off-target side effects and thus achieve greater therapeutic efficacy, has resulted in an explosive body of research. Bifidobacterium spp. are anaerobic, nonpathogenic, Gram-positive bacteria, commensal to the human gut that are a possible anticancer drug-delivery vehicle. In this review, we describe Bifidobacterium's microbiology, current clinical applications, overview of the preclinical work investigating Bifidobacterium's potential to deliver anticancer therapy, and review the different strategies used up to date. Finally, we discuss both current challenges and future prospects.
Assuntos
Bifidobacterium/fisiologia , Sistemas de Liberação de Medicamentos/métodos , Imunoterapia/métodos , Oncologia/métodos , Neoplasias/terapia , Medicina de Precisão/métodos , Animais , Antineoplásicos/administração & dosagem , Ensaios Clínicos como Assunto , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Genes Reporter/genética , Terapia Genética/métodos , Vetores Genéticos/administração & dosagem , Vetores Genéticos/genética , Humanos , Oncologia/tendências , Neoplasias/genética , Neoplasias/imunologia , Plasmídeos/genética , Medicina de Precisão/tendências , Probióticos/administração & dosagem , Resultado do TratamentoRESUMO
All-trans-retinoic acid represents a major progress that has made acute promyelocytic leukemia the most curable subtype of acute myeloid leukemia in adults. Although all-trans-retinoic acid is usually well tolerated, some patients develop the retinoic acid syndrome, characterized by unexplained fever, weight gain, respiratory distress, interstitial pulmonary infiltrates, pleural and pericardial effusions, episodic hypotension, and acute renal failure. Further studies of growth factor expression and modulation of adhesion molecules are warranted to provide further insights into the pathogenesis of the syndrome and may lead to its prevention.
Assuntos
Antineoplásicos/efeitos adversos , Leucemia Promielocítica Aguda/tratamento farmacológico , Tretinoína/efeitos adversos , Antineoplásicos/uso terapêutico , Humanos , Pessoa de Meia-Idade , Síndrome , Tretinoína/uso terapêuticoRESUMO
Infective endocarditis (IE) is becoming a disease of the elderly because of the aging process and increased use of intravascular devices. If undetected, IE has a poor prognosis. Previous guidelines had become cumbersome, and with unintended consequences, ie, excess antibiotic use, potential risk for acquisition of multiple-drug-resistant organisms and adverse drug reactions. The newest American Heart Association guideline severely restricts antibiotic prophylaxis, recommending it only for cardiac conditions with the greatest risks for complications and for dental procedures that involve perforation of oral mucosa, manipulation of gingival tissue or periapical region of the teeth. Routine prophylaxis for genitourinary and gastrointestinal procedures is no longer recommended.
