Current Pharmaceutical Design - Online First

Diabetic nephropathy (DN) is increasing worldwide in parallel with type 2 diabetes mellitus. Identifying diagnostic biomarkers for DN at an early stage is crucial due to the considerable societal and economic burden associated with diabetes mellitus (DM) and its risk factors. In the past, early indicators of microvascular problems, such as microalbuminuria (MA), have been used to predict the possibility of developing advanced chronic kidney disease (CKD). However, because of the incapacity of MA to appropriately estimate DN, particularly, non-albuminuric DN, additional markers have been suggested for recognizing the early renal abnormalities and structural lesions, even before MA. This study aims to assess the existing and future biomarkers used to diagnose or predict early DN. This review provides comprehensive insight into diagnostic approaches for early detection of CKD, addressing the following areas: (i) markers of glomerular damage, (ii) markers of tubular damage, (iii) oxidative stress biomarkers, (iv) inflammatory biomarkers and (v) futuristic biomarkers such as micro-ribonucleic acids (miRNAs), proteomics, metabolomics and genomics and gut microbiota. Early detection of DN may lead to improvement in clinical management and quality of life, emphasizing the importance of identifying a specific and reliable predictive biomarker. Emerging serum and urinary biomarkers offer promise for early DN diagnosis, potentially reducing prevalence and preventing progression to end-stage renal disease (ESRD). Further advancements in miRNAs, proteomics, metabolomics genomics and gut microbiota offer prospects for even earlier and more precise DN diagnosis.

Saffron, derived from the Crocus sativus plant, has been revered for centuries for its culinary, medicinal, and cultural significance. This review provides a comprehensive overview of saffron's chemical constituents and phytochemistry, elucidating its rich profile of bioactive compounds. Emphasis is placed on exploring the bio-accessibility, bioavailability, and bioactivity of saffron's phytochemicals, laying the foundation for understanding its pharmaceutical significance. The pharmaceutical importance of saffron and its phytochemicals is thoroughly examined, focusing on their diverse therapeutic properties. These include anticancer, antidiabetic, antioxidant, antimicrobial, anti-inflammatory, antinociceptive, anticonvulsant, antidepressant, learning and memory enhancement, cardiovascular, and antihypertensive properties. Such multifaceted pharmacological activities underscore saffron's potential as a valuable medicinal resource. Clinical studies investigating the efficacy and safety of saffron in various health conditions are synthesized, providing insights into its clinical applications. Moreover, toxicity assessments in animal models, encompassing acute, subacute, subchronic, and developmental toxicity, are discussed to delineate the safety profile of saffron and its bioactive constituents. Finally, recent advances and future perspectives in saffron research are highlighted, underscoring emerging trends and potential avenues for further exploration. This review serves as a comprehensive resource for researchers, clinicians, and stakeholders interested in harnessing the therapeutic potential of saffron while ensuring its safe and effective utilization in healthcare settings.

The oral route of drug administration is often preferred by patients and healthcare providers due to its convenience, ease of use, non-invasiveness, and patient acceptance. However, traditional oral dosage forms have several limitations, including low bioavailability, limited drug loading capacity, and stability and storage issues, particularly with solutions and suspensions. Over the years, researchers have dedicated considerable effort to developing novel oral drug delivery systems to overcome these limitations. This review discusses various challenges associated with oral drug delivery systems, including biological, pharmaceutical, and physicochemical barriers. It also explores common delivery approaches, such as gastroretentive drug delivery, small intestine drug delivery, and colon-targeting drug delivery systems. Additionally, numerous strategies aimed at improving oral drug delivery efficiency are reviewed, including solid dispersion, absorption enhancers, lipid-based formulations, nanoparticles, polymer-based nanocarriers, liposomal formulations, microencapsulation, and micellar formulations. Furthermore, innovative approaches like orally disintegrating tablets (ODT), orally disintegrating films (ODF), layered tablets, micro particulates, self-nano emulsifying formulations (SNEF), and controlled release dosage forms are explored for their potential in enhancing oral drug delivery efficiency and promoting patients’ compliance. Overall, this review highlights significant progress in addressing challenges in the pharmaceutical industry and clinical settings, offering novel approaches for the development of effective oral drug delivery systems.

For millennia, Cannabis sativa has served diverse roles, from medicinal applications to recreational use. Despite its extensive historical use, only a fraction of its components have been explored until recent times. The therapeutic potential of Cannabis and its constituents has garnered attention, with suggestions for treating various conditions such as Parkinson's disease, epilepsy, Alzheimer's disease, and other Neurological disorders. Recent research, particularly on animal experimental models, has unveiled the neuroprotective properties of cannabis. This neuroprotective effect is orchestrated through numerous G protein-coupled receptors (GPCRs) and the two cannabinoid receptors, CB1 and CB2. While the capacity of cannabinoids to safeguard neurons is evident, a significant challenge lies in determining the optimal cannabinoid receptor agonist and its application in clinical trials. The intricate interplay of cannabinoids with the endocannabinoid system, involving CB1 and CB2 receptors, underscores the need for precise understanding and targeted approaches. Unravelling the molecular intricacies of this interaction is vital to harness the therapeutic potential of cannabinoids effectively. As the exploration of cannabis components accelerates, there is a growing awareness of the need for nuanced strategies in utilizing cannabinoid receptor agonists in clinical settings. The evolving landscape of cannabis research presents exciting possibilities for developing targeted interventions that capitalize on the neuroprotective benefits of cannabinoids while navigating the complexities of receptor specificity and clinical applicability.

Oral thin films are changing the way drugs are delivered, making drug administration more convenient and patient-friendly. This review delves into the fascinating possibilities of natural polymers in thin film design. We consider the benefits of biocompatible polymers produced from chitosan, gelatin, and pullulan. Their intrinsic biodegradability and safety make them excellent for use with a wide range of patients. Additionally, the research investigates novel strategies for creating these distinctive drug delivery systems. We look beyond standard solvent casting techniques, hot melt extrusion methods, rolling methods, etc. These technologies provide exact control over film qualities, allowing for tailored medication delivery and increased patient compliance. This review seeks to bridge the gap between natural polymers and cutting-edge fabrication processes. By investigating this combination, we pave the road for the development of next-generation oral thin films that are more efficacious, patient-acceptable, and environmentally-friendly.

Implementing lifestyle interventions as a primary prevention strategy is a cost-effective approach to reducing the occurrence of cancer, which is a significant contributor to illness and death globally. Recent advanced studies have uncovered the crucial role of nutrients in safeguarding women's health and preventing disorders. Genistein is an abundant isoflavonoid found in soybeans. Genistein functions as a chemotherapeutic drug against various forms of cancer, primarily by modifying apoptosis, the cell cycle, and angiogenesis and suppressing metastasis. Furthermore, Genistein has demonstrated diverse outcomes in women, contingent upon their physiological characteristics, such as being in the early or postmenopausal stages. The primary categories of gynecologic cancers are cervical, ovarian, uterine, vaginal, and vulvar cancers. Understanding the precise mechanism by which Genistein acts on ovarian cancer could contribute to the advancement of anti-breast cancer treatments, particularly in situations where no specific targeted therapies are currently known or accessible. Additional investigation into the molecular action of Genistein has the potential to facilitate the development of a plant-derived cancer medication that has fewer harmful effects. This research could also help overcome drug resistance and prevent the occurrence of ovarian cancers.

Oxidative stress is a biological stress response produced by the destruction of redox equilibrium in aerobic metabolism in organisms, which is closely related to the occurrence of many diseases. Mesenchymal stem cells (MSCs) have been found to improve oxidative stress injury in a variety of diseases, including arthritis, chronic obstructive pulmonary disease, asthma, multiple sclerosis, focal segmental glomerulosclerosis, diabetic nephropathy, ischemia-reperfusion injury, hepatic fibrosis, myocardial infarction, diabetes, inflammatory bowel disease, etc. The antioxidant stress capacity of MSCs may be a breakthrough in the treatment of these diseases. This review found that MSCs have the ability to resist oxidative stress, which may be achieved through MSCs involvement in mediating the Nrf2, MAPK, NF-κB, AMPK, PI3K/AKT and Wnt/b-catenin signaling pathways.