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Phytolacca dodecandra (African Soapberry) and Picrorhiza kurroa (Kutki)
Published in Azamal Husen, Herbs, Shrubs, and Trees of Potential Medicinal Benefits, 2022
K. Meenakshi, Mansi Shah, Indu Anna George
Extract of P. kurroa exhibited anti-inflammatory activity. This is due to the suppression of NF-κB mediated through the suppression of macrophage-derived cytokine signaling (Kumar et al., 2016b). The plant extract reduces edema effectively in albino rats (Kantibiswas et al., 1996). The rhizome extract reduced joint inflammation in adjuvant-induced arthritic rats (Kumar et al., 2016a). Picroliv, derived from P. kurroa rhizome, reduced dextran-sulphate-sodium-induced colitis in mice by depressing the expression of IL-1β, TNF-α, and NF-κB p65 (Zhang et al., 2012). Picrosides I, II, and IV, and picrorhizaosides D and E, and minecoside isolated from methanolic extract of rhizome showed hyaluronidase inhibitory activity as good as or better than the widely used antiallergic medicines disodium cromoglycate, ketotifenfumarate, and tranilast (Morikawa et al., 2020).
Stent thrombosis and restenosis
Published in Ever D. Grech, Practical Interventional Cardiology, 2017
S Andrew McCullough, George D Dangas
As the stent scaffold becomes progressively obstructed by neo-intimal hyperplasia, most patients experience recurrent angina, though some cases of ISR are clinically silent. Given the time frame it takes for restenosis to occur, most cases of ISR were believed to be clinically benign; however, data suggests that patients present anywhere on the spectrum of ischemia. Data in both the BMS population and DES population suggest that ISR can present as both unstable angina in up to 50%–60% of patients and as a myocardial infarction in up to 20% of patients.25 The mechanism of myocardial infarction in patients with ISR is not entirely clear. Clinically silent completely occlusive restenosis can be difficult to distinguish from an old thrombotic event, and high-grade restenosis can cause slow flow, promote thrombosis and lead to an acute coronary syndrome. It was observed in a secondary analysis of the Prevention of Restenosis with Tranilast and its Outcomes (PRESTO) trial that patients who present with an acute coronary syndrome have a higher incidence of recurrent major adverse cardiac events and binary restenosis compared with patients who present with stable angina.32
Cesarean Delivery
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
A. Dhanya Mackeen, Meike Schuster
A small RCT explored the placement of bupivacaine-soaked gelatin sponges subcutaneously and was able to demonstrate lower pain scores, narcotic use, blood pressure, and heart rate postoperatively, as well as less anxiety and depression [286, 287]. Another small RCT explored the use of topical scar gel (Contratubex) applied twice daily and showed improvement in Patient Observer Scar Assessment Scale (POSAS) scores with respect to color, stiffness, and irregularity of CD scars after 6 weeks of treatment [288]. One RCT compared the use of aloe vera gel to standard dressing and showed improved wound healing scores using the Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scale 24 hours postoperatively, but scores were equivalent 8 days postoperatively, and therefore, unnecessary, though not harmful [289]. Silicone gel or sheets have been demonstrated to improve scar healing when applied twice daily; when compared head-to-head, they appear to have similar Vancouver Scar Scale (VSS) scores, but the silicone sheets had higher Visual Analogue Scores (VAS) with respect to itching [290]. Another method investigated for improved scar cosmesis is tranilast 8% liposomal gel. When applied twice daily to the scar for 3 months, POSAS scores were lower (i.e. better) at 9 months compared to placebo [291]. Grapeseed extract ointment 5% has also been shown to improve REEDA scores at 6 and 14 days postoperatively [292]. There are no comparative trials to evaluate which of these treatments are associated with the best cosmetic outcomes. In summary, no specific recommendations can be made regarding CD incision treatment; the individual treatments are safe options that can be considered.
Investigational drugs in early phase clinical trials targeting thermotransient receptor potential (thermoTRP) channels
Published in Expert Opinion on Investigational Drugs, 2020
Asia Fernández-Carvajal, Rosario González-Muñiz, Gregorio Fernández-Ballester, Antonio Ferrer-Montiel
Tranilast has been widely used as an anti-allergic drug [100]. In a pilot study, Tranilast was found to have a protective effect against cardiomyopathy provoked by muscular dystrophy [29]. This study set the stage for the use of TRPV2 inhibition as a new therapeutic strategy for muscle dysgenesis, such as cardiomyopathy and muscular dystrophy [101]. Additionally, TRPV2 is involved in signaling pathways responsible for cancer growth/proliferation, migration/invasion, and apoptosis [22], thus representing a novel promising pharmacologic target especially in the management of aggressive cancers. In this regard, Tranilast, was found to be effective in reducing proliferation in leukemia cells and cancer-associated fibroblasts in vitro. As a consequence, it is now considered a potential candidate for further pre-clinical studies alone or in combination regimens as anti-cancer drug [102].
Investigational drugs for hyperuricemia, an update on recent developments
Published in Expert Opinion on Investigational Drugs, 2018
Tristan Pascart, Pascal Richette
Tranilast (anthranilic acid) has been developed in Japan and used for over 40 years in Asia notably for the treatment of asthma, rhinitis, and atopic dermatitis [58]. It had been suggested that tranilast has a hypouricemic effect and its mechanisms have been recently more thoroughly explored. Indeed, in an animal model, tranilast was shown to nonspecifically inhibit major transporters (URAT1, GLUT9, OAT4, and OAT10) involved in urate reabsorption in a reversible and noncompetitive manner and to not affect ABCG2 urate efflux [58]. Data presented in meetings only suggested potential anti-inflammatory effects of tranilast as well, but these results have not been published. A phase II study of the combination of allopurinol with tranilast was presented at the 2010 ACR [59] and EULAR meetings but no other results have been presented or published since then, although phase II studies of combinations of tranilast with either febuxostat and allopurinol in gout patients have been completed in 2011.
Recent approaches to gout drug discovery: an update
Published in Expert Opinion on Drug Discovery, 2020
Naoyuki Otani, Motoshi Ouchi, Hideo Kudo, Shuichi Tsuruoka, Ichiro Hisatome, Naohiko Anzai
Tranilast was originally developed in Japan as an antiallergic agent for asthma, allergic rhinitis, and atopic dermatitis. Recent studies indicate that it exerts a urate-lowering effect by inhibiting the renal transporters URAT1 and URATv1/GLUT9 [58]. Clinical trials in healthy volunteers showed a reduction in serum urate levels and reduced inflammation from urate crystals [59]. Subsequent phase II clinical trials used tranilast in combination with allopurinol for patients with moderate-to-severe gouty arthritis [60].