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Alternative Tumor-Targeting Strategies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
A formulation of paclitaxel bound to albumin, nabTM-paclitaxel (AbraxaneTM) was developed by Abraxis BioScience Inc (previously VivoRx Inc) which was acquired by Celgene Inc in 2010. The product was approved by the FDA (US) and EMA (EU) in 2005 and 2008, respectively, for the treatment of breast cancer in patients not responding to other treatments, or in patients who had relapsed after other treatments. As this albumin-based formulation is free of Cremophor EL and ethanol, the risk of hypersensitivity reactions is significantly lowered, obviating the need for premedication to reduce this risk. Albumin is a naturally occurring protein in mammals including humans, one function of which is to carry water-insoluble molecules such as certain nutrients, hormones, and vitamins in the bloodstream. It is also known to selectively accumulate in tumor tissues through the EPR effect.
Total Calories and Protein Intake
Published in Luke R. Bucci, Nutrition Applied to Injury Rehabilitation and Sports Medicine, 2020
Biochemical indices of protein status have been useful in hospitalized settings. However, the utility of biochemical measurements in outpatient settings is of considerably less value. Table 6 lists some serum proteins used for assessment of protein status. Usually, decreases in serum levels (signifying protein deficiency) are not seen until protein malnutrition is severe. However, the advantage of serum protein levels is the short-term nature of serum protein half-lives. Thus, rapid changes in protein status may be determined or assessed in a serial manner. Since serum albumin is usually included in chemistry profiles of serum, and lymphocyte counts are now becoming routine for complete blood counts, routine laboratory tests offer two biochemical methods of protein assessment. Thus, screening for protein deficiency is relatively low cost to impractical research methods (nitrogen balance, 3-methylhistidine excretion).
Geriatric hair and scalp disorders
Published in Robert A. Norman, Geriatric Dermatology, 2020
The causes of telogen effluvium are different in the postmenopausal female and older male patient (Table 2). The incidence increases for events associated more with aging, such as acute25 and chronic illnesses, surgery and the use of medications for all manner of conditions26. Figure 7 shows regrowing hair after telogen effluvium following surgery. Note that a dark background helps to visualize the tips of the regrowing hair. Insufficient thetary protein may pose a problem in the elderly when issues of ill health, deficiencies of self-care and social isolation may become manifest27. Telogen effluvium may result when thyroid replacement requirements decrease in the postmenopausal female. Hair shedding may be the first symptom of changing thyroid status28–50. Iron deficiency is not as prevalent as the chronic iron losses due to menstruation cease (unpublished data, Roberts JL). Zinc deficiency and essential free fatty acid deficiency, common in the 1970s and 1980s in patients on total parenteral nutrition, has been largely eliminated in the West as knowledge about nutrition requirements has improved31–33. Fewer older individuals undergo the stresses of rapid weight loss due to intentional ‘crash theting’ but may suffer unintentional weight loss due to various illnesses. Chronic illnesses and dietary deficiencies can both result in lowered serum albumin.
Utilization of interpretable machine learning model to forecast the risk of major adverse kidney events in elderly patients in critical care
Published in Renal Failure, 2023
Lin Wang, Shao-Bin Duan, Ping Yan, Xiao-Qin Luo, Ning-Ya Zhang
Furthermore, we found that a significant increase in non-hepatic AST was associated with mortality, which may reflect skeletal muscle damage, myocardial damage, or hematological diseases [43]. Our analysis also showed that low levels of albumin related to a high risk of MAKE30. Albumin is a protein that is mainly produced by the liver and circulates in the blood plasma. It has various functions, such as maintaining fluid balance, transporting hormones and drugs, and modulating immune responses. Low albumin levels might indicate liver dysfunction, kidney dysfunction, inflammation, or infections, which are all potential risk factors for adverse kidney events [14,44,45]. Therefore, albumin levels can reflect the overall health status of elderly ICU patients and their susceptibility to MAKE30. Albumin levels might also be used as a biomarker to monitor the response to interventions and the prognosis of elderly ICU patients with AKI. These findings emphasize the importance of considering various physiological factors in predicting adverse renal outcomes in critically ill elderly patients and may have implications for clinical decision-making and risk stratification.
Shedding light on experimental intra-articular drugs for treating knee osteoarthritis
Published in Expert Opinion on Investigational Drugs, 2023
Yang Zhao, Qianhua Ou, Yu Cai, Guangfeng Ruan, Yan Zhang, Changhai Ding
Human serum albumin has long been safely administered as a 5% solution in treatment for shock, burns, and plasma volume expansion [127]. The low molecular weight fraction of 5% human serum albumin (LMWF −5A), with aspartyl-alanyl diketopiperazine considered as its active component, has been shown to have multiple anti-inflammatory and immune modulating effects [52,128]. In the context of KOA, LMWF − 5A is reported to trigger anti-inflammatory signaling in synovial fibroblasts, and this may be a primary component of its therapeutic mode of action in relieving OA pain [53]. Despite the unclear preclinical evidence, it has been investigated as an IA drug for pain control. A phase 2 clinical trial demonstrated that a single IA injection of LMWF − 5A was safe and effective in improving the pain of moderate to severe KOA over 12 weeks [54]. More recently, a study investigated the safety and efficacy of multiple (3 biweekly) IA injections of LMWF − 5A in KOA and reported that repeated IA injections of LMWF − 5A are safe and are effective in relieving pain in KOA through 20 weeks [55]. Considering the lack of highly acknowledged results and underlying mechanism of LMWF − 5A, we still need more rigorous evidence to properly assess its therapeutic potential.
Hypothesis of using albumin to improve drug efficacy in cancers accompanied by hypoalbuminemia
Published in Xenobiotica, 2021
Soghra Bagheri, Ali A. Saboury
Albumin is the main natural plasma protein produced by the liver (Peters 1996), which has several important physiological functions including maintaining colloidal osmotic pressure, binding a wide range of compounds, and providing major plasma antioxidant activity. Therefore, the strong correlation between blood albumin concentration and health is not unexpected, and in fact, its concentration is directly related to mortality risk (Levitt and Levitt 2016). Albumin production rate is 9-14 g/day and its half-life is about 19 days (Peters 1996). Decreased albumin level occurs in conditions such as malnutrition, liver dysfunction, sepsis, infection, trauma, or major surgery (Gatta et al. 2012; Ñamendys-Silva et al. 2011). The normal concentration of albumin in the blood is about 35-50 g/L, which its decrease from this interval is called hypoalbuminemia (Vincent et al. 2003). Hypoalbuminemia can occur due to decreased energy source, impaired synthesis by the liver, increased albumin loss, or increased tissue catabolism (Franch-Arcas 2001).