Drug Design, Development and Therapy最新文献

{"title":"The Toxicity of Dimethyl Sulfoxide Combined with the Alkylating Agent MNU on Mice: Focusing on Mortality and Activity Impairment.","authors":"Weiming Yan, Qiurui He, Lin Xiao, Yuxin Xia, Xiangrong Zheng, Xiaohong Zhang","doi":"10.2147/DDDT.S521506","DOIUrl":"10.2147/DDDT.S521506","url":null,"abstract":"<p><strong>Objective: </strong>Dimethyl sulfoxide (DMSO) is known to enhance the absorption of chemicals. This study investigated the effects of DMSO in combination with the alkylating agent, N-methyl-N-nitrosourea (MNU), on the activity and mortality of mice, providing foundational data for solvent mixture use and health impact assessment.</p><p><strong>Methods: </strong>Twelve male SPF C57BL/6J mice were divided into three groups (n=4): DMSO group (D), DMSO combined with low-dose (L), and high-dose MNU group (H). Mice in D received intraperitoneal injections of pure DMSO solution at 12 mL/kg. The L or D group was injected with a DMSO solution containing 40 mg/kg or 60 mg/kg MNU at 12 mL/kg, respectively. Mice were monitored for changes in body weight, activity levels (walking, body stretching, fur condition), and mortality at various time points.</p><p><strong>Results: </strong>Pre-injection, all groups showed no statistical differences in weight or DMSO dose, while the MNU injection dose was significantly different (H>L>D). Within 2 hours post-injection, all mice except one in the D group exhibited reduced mobility, hunched posture, and lethargy. Mortality progressed rapidly, with one D and two L mice dying by 12 hours, followed by additional deaths (one D, two L, and two H mice) at 24 hours. By 36 hours, all mice in L and H groups had died, while one D mouse recovered normal activity. At the 48-hour endpoint, only one D mouse survived with normal behavior. No significant differences in weight, activity levels and mortality changes were observed in surviving mice throughout the study period.</p><p><strong>Conclusion: </strong>DMSO has certain toxicity, and when combined with alkylating agents such as MNU, it can lead to reduced activity and an increased mortality rate in mice. It is recommended to closely monitor the mice during the use of such reagents and to establish appropriate research observation protocols.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5727-5737"},"PeriodicalIF":4.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant Predictors of Azithromycin in Population Pharmacokinetic Analysis: A Systematic Review.","authors":"Runcong Zhang, Yuebin Fang, Yinhui Wang, Jing Fan, Weiming Yin, Weibin Fan, Yuetian Yu, Bin Lin","doi":"10.2147/DDDT.S519597","DOIUrl":"10.2147/DDDT.S519597","url":null,"abstract":"<p><p>Azithromycin is widely used to treat infections caused by susceptible bacteria and is the first-line treatment for mycoplasma pneumonia in pediatric patients. However, in clinical practice, large between-patient variability has been observed. Several population pharmacokinetic studies have been conducted to identify covariates and guide individualized therapy. This study evaluated published population pharmacokinetic studies and explored the significant covariates. The PubMed, Embase, and Web of science databases were systematically searched from their inception to 30 May 2024. Information on study design, characteristics, and final model parameters was extracted and compared. Time-concentration curves and forest plots were used to examine pharmacokinetic characteristics and identify covariates, respectively. Fifteen population pharmacokinetic studies were included in the review: three involved preterm neonates, two involved children, two involved pregnant/non-pregnant women, and eight involved adults. The median apparent clearance value was higher for adults (1.66 L/h/kg) than for children (1.28 L/h/kg) and preterm neonates (0.187 L/h/kg). For all populations, body weight significantly influenced the apparent clearance and distribution volume. In children, age and liver function influenced azithromycin clearance; whereas for women, clearance was reduced by 38% in case of pregnancy, non-African descent, and oral contraceptive use. Azithromycin was shown to distribute across plasma, tissues, and cells, with notable concentration differences. The azithromycin dose regimen is determined based on body weight. However, for children and women, additional predictors should be considered for individualized therapy. Further azithromycin population studies of the dose-exposure-response relationship are needed to achieve accurate dose adjustments.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5709-5725"},"PeriodicalIF":4.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Driven Innovations in Oncology Drug Discovery: Transforming Traditional Pipelines and Enhancing Drug Design.","authors":"Fatimah G Albani, Sahar S Alghamdi, Mohammed M Almutairi, Tariq Alqahtani","doi":"10.2147/DDDT.S509769","DOIUrl":"10.2147/DDDT.S509769","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into oncology drug discovery is redefining the traditional pipeline by accelerating discovery, optimizing drug efficacy, and minimizing toxicity. AI has enabled groundbreaking advancements in molecular modeling, simulation techniques, and the identification of novel compounds, including anti-tumor and antibodies, while elucidating mechanisms of drug toxicity. Additionally, AI has emerged as a critical tool in precision medicine, driving the formulation and release of targeted therapies and improving the development of treatments for oncology and central nervous system diseases. Furthermore, AI-assisted clinical trial designs have further optimized the recruitment and stratification of patients, reducing the time and cost of trials. Despite these advancements, challenges such as data integration, transparency, and ethical considerations persist. By synthesizing current innovations, this manuscript provides a comprehensive analysis of AI-driven approaches in drug discovery and their potential to advance oncology therapeutics and precision medicine. It examines the transformative role of AI across the drug development continuum, with a focus on its applications in computer-aided drug design (CADD), generative artificial intelligence (GAI), and high-throughput screening (HTS).</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5685-5707"},"PeriodicalIF":4.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ternary Solid Dispersions as an Alternative Approach to Enhance Pharmacological Activity.","authors":"Salma Amaliah, Diah Lia Aulifa, Amirah Mohd Gazzali, Arif Budiman","doi":"10.2147/DDDT.S533359","DOIUrl":"10.2147/DDDT.S533359","url":null,"abstract":"<p><p>Poor solubility and limited bioavailability remain significant challenges in developing oral drugs, affecting the clinical efficacy of many active pharmaceutical ingredients (APIs). Enhancing solubility has become a primary focus in improving API bioavailability. Among the most commonly employed strategies are amorphous solid dispersions (ASDs) and co-amorphous systems, collectively called binary systems. However, these systems often suffer from wettability and physicochemical limitations, which can hinder drug release. Adding a third component to form ternary solid dispersions (TSDs) significantly enhance drug release and bioavailability, ultimately improving therapeutic outcomes. While numerous studies have investigated the application of TSDs in enhancing API pharmacological activity, only limited studies have a comprehensive analysis of this approach. Therefore, this review aims to summarize and elucidate the mechanisms of TSD systems in improving pharmacological activity. The review includes available literature from Scopus, PubMed, and Google Scholar that utilizes the keywords \"ternary solid dispersion\" and \"pharmacological activity\", summarizing the importance of TSDs in therapeutic formulations for enhancing pharmacological activity. Various in vitro and in vivo studies consistently demonstrate that TSDs outperform binary systems by significantly enhancing the pharmacological effects of diverse therapeutic agents, including those with antioxidant, anti-inflammatory, anticancer, antibacterial, anticholinesterase, antihyperlipidemic, anti-hypoglycemic, anti-Alzheimer's, antidiabetic, and hepatoprotective properties. This approach holds significant promise as an alternative for the formulation of low-solubility pharmaceuticals.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5663-5684"},"PeriodicalIF":4.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide Therapy and Accelerated Sarcopenia in Older Adults with Type 2 Diabetes: A 24-Month Retrospective Cohort Study.","authors":"Qingjuan Ren, Lei Zhi, Hongfang Liu","doi":"10.2147/DDDT.S531778","DOIUrl":"10.2147/DDDT.S531778","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate changes in muscle mass and strength among older adults with type 2 diabetes who were treated with Semaglutide.</p><p><strong>Methods: </strong>This was a retrospective cohort study comparing elderly patients with type 2 diabetes receiving Semaglutide to a matched control group. Changes in muscle mass and function over 24 months were assessed. Muscle mass was measured using the appendicular skeletal muscle mass index (ASMI), while muscle function was evaluated through grip strength and gait speed measurements. Differences between the two groups and changes before and after treatment were analyzed using the <i>t</i>-test. Additionally, multivariable linear regression models were constructed to identify clinical predictors of accelerated muscle loss during Semaglutide treatment.</p><p><strong>Results: </strong>The study involved 220 patients treated with Semaglutide and 212 control subjects. The prevalence of sarcopenia among participants was 27.7%. Semaglutide treatment significantly reduced both body mass index and muscle mass compared to controls. Notably, divergent patterns emerged in functional measures. Grip strength initially improved but then declined in men, while it continued to decrease in women. Gait speed significantly reduced in both genders. Multivariable analysis identified Semaglutide dosage, baseline ASMI, and gait speed as independent predictors of muscle loss.</p><p><strong>Conclusion: </strong>The use of Semaglutide is associated with muscle loss and functional decline in older adults with type 2 diabetes, particularly at higher doses. This effect is especially significant in patients with sarcopenia. Consequently, it is crucial to assess the risks and benefits for each elderly patient individually and to implement appropriate monitoring and interventions. The potential for nutritional supplementation and targeted exercise regimens to counteract semaglutide-associated muscle decline merits systematic investigation.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5645-5652"},"PeriodicalIF":4.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alfentanil Enhanced the Sedation of Remimazolam During Anaesthesia Induction in Patients Undergoing Urological Day Surgery: A Randomised Controlled Trial.","authors":"Yuliu Lin, Qiuling Chen, Yeqing Liao, Bing Xu, Cuiwen Zhang, Jiaxin Luo, Susu Liu, Xiaoshan Wu, Xuehai Guan","doi":"10.2147/DDDT.S508941","DOIUrl":"10.2147/DDDT.S508941","url":null,"abstract":"<p><strong>Background: </strong>Remimazolam is a novel benzodiazepine sedative agent. Combining opioids with sedatives exerts a synergistic effect. The aim is to investigate whether alfentanil enhances sedative effects of remimazolam during anaesthesia induction in patients undergoing urological day surgery.</p><p><strong>Methods: </strong>This was a single-centre, single-blinded, randomised clinical trial. The study was conducted between 1 September 2022 and 31 December 2023. We included 114 patients undergoing urological day surgery under general anaesthesia. Patients were randomly assigned to the RMZ-AF or AF-RMZ group (n=57). During induction, the RMZ-AF group received remimazolam then alfentanil, and the AF-RMZ group received alfentanil then remimazolam. Primary outcome was the time from remimazolam administration to loss of consciousness (LOC) during induction. Secondary outcomes included anaesthetic and surgical characteristics, vital signs, and adverse events.</p><p><strong>Results: </strong>The time from remimazolam administration to LOC was shorter in the AF-RMZ group compared with the RMZ-AF group (87.3 [25.7] s vs 132.3 [32.3] s, <i>P</i><0.0001). Similarly, the time from remimazolam administration to a bispectral index (BIS) ≤ 60 was shorter in the AF-RMZ group compared with the RMZ-AF group (168.2 [58.1] s vs 207.8 [61.6] s, <i>P</i>=0.0006). Although no significant difference in the total amount of remimazolam administration between groups was observed, the RMZ-AF group required a higher dose of remimazolam to achieve LOC (<i>P</i><0.0001) and to reach a BIS of ≤ 60 (<i>P</i>=0.0058). No significant differences were observed between groups in the total administration of alfentanil, ephedrine, rocuronium, or crystalloid infusion volumes. The most common adverse events were hypotension, hypertension, and tachycardia, with no significant difference between groups.</p><p><strong>Conclusion: </strong>Alfentanil enhanced remimazolam's sedative effects during anaesthesia induction in patients undergoing urological day surgery. The combination of remimazolam and alfentanil for general anaesthesia would improve efficacy, reducing the adverse effects and dosage of drug. But the potential mechanisms need further study.</p><p><strong>Clinical trial registration: </strong>The trial was registered before patient enrolment at http://www.chictr.org.cn (ChiCTR2200064130, principal investigator: Xuehai Guan; date of registration: 27 September 2022, https://www.chictr.org.cn/showproj.html?proj=179023).</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5653-5662"},"PeriodicalIF":4.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Antihypertensive Drug Use and Irrational Prescriptions Among Elderly Patients in China (2016-2023): A Nationwide Multi-Center Cross-Sectional Survey Study.","authors":"Dongsheng Hong, Weihao Chen, Shuangshuang Du, Jinshuai Ren, Duo Lv, Wenya Shan, Xiaoyang Lu, Qingwei Zhao","doi":"10.2147/DDDT.S518377","DOIUrl":"10.2147/DDDT.S518377","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertension is a common chronic condition among the elderly, and the rational use of antihypertensive medications is critical for blood pressure control. This study aimed to investigate trends in the use and irrational prescription of antihypertensive medications among elderly patients with hypertension in China from 2016 to 2023.</p><p><strong>Patients and methods: </strong>A retrospective cross-sectional design was applied to analyze the prescription of antihypertensive drugs in hypertensive patients aged 65 years and above, utilizing outpatient electronic medical record data from 78 hospitals in nine cities in China from 2016 to 2023. Antihypertensive medications were categorized into nine classes based on hypertension treatment guidelines. Annual trends in the use of these medications were analyzed using Annual Percentage Change (APC). Irrational prescriptions were defined as contraindicated medication prescriptions and inappropriate combination medication. Poisson regression models were employed to analyze trends and influencing factors for irrational prescriptions.</p><p><strong>Results: </strong>The number of patients increased from 396,408 to 542,215 during the study period. Calcium Channel Blockers had the highest usage but showed a slight decrease (APC=-3.46%, <i>P</i>=0.011), while <i>β</i>-blockers showed a slight increase (APC=1.48%, <i>P</i>=0.028). The overall proportion of first-line antihypertensive prescriptions was 97.47% but showed a slight declining trend (APC=-0.66%, <i>P</i>=0.004). The rates of inappropriate combination medication and overall irrational prescriptions decreased, while the rate of contraindicated medication prescriptions increased (<i>P</i><0.001). Factors including male gender, advanced age (≥85 years), northern regions, primary healthcare settings, and geriatrics departments were associated with higher risks of contraindicated medications.</p><p><strong>Conclusion: </strong>This study reveals the trends and patterns in antihypertensive medication use among elderly hypertensive patients in China from 2016 to 2023. While the overall use of first-line antihypertensive drugs remained high, there were differences across subgroups. The increasing rate of contraindicated medications and the identification of high-risk groups and clinical settings provide important insights for optimizing antihypertensive treatment in elderly populations.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5633-5644"},"PeriodicalIF":4.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"An Effective Solution to Accelerate the Healing of Complex Ulcers Using Recombinant Human Epidermal Growth Factor (Intralesional Application): A Review\".","authors":"Maria Teresa Cacua Sánchez, Carlos Alberto Carillo Bravo","doi":"10.2147/DDDT.S517489","DOIUrl":"10.2147/DDDT.S517489","url":null,"abstract":"<p><p>Chronic and complex ulcers of the lower limbs constitute a common, persistent, and clinically significant complication, particularly in patients with diabetes, peripheral vascular disease, and other dermatological conditions. These lesions are characterized by impaired healing, high recurrence rates, and a substantial risk of infection, amputation, and functional decline, thereby posing a considerable burden on both patients and healthcare systems. In response to this unresolved clinical need, recombinant human epidermal growth factor (rhEGF) has emerged as an innovative and effective therapeutic strategy. By stimulating cell proliferation, angiogenesis, and tissue regeneration, rhEGF reactivates essential biological processes that are typically impaired in such lesions, thereby promoting accelerated and functional wound healing. Additionally, its anti-inflammatory and antioxidant properties contribute to reducing associated complications, such as infection. Accumulated scientific evidence over recent years has strengthened the support for its clinical use, with multiple studies-including controlled trials, retrospective analyses, and systematic reviews-demonstrating consistent outcomes across various clinical settings. In practice, rhEGF has been established as a safe and effective therapeutic tool with the potential to transform the conventional management of chronic and complex ulcers, improving clinical outcomes and enhancing patients' quality of life.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5615-5631"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic Insights into Flavonoid Subclasses as Cardioprotective Agents Against Doxorubicin-Induced Cardiotoxicity: A Comprehensive Review.","authors":"Wei Shang, Xin-Hui Li, Lang-Hong Zeng, Zhi Li, Yu Hu, Hui-Min Wen, Feng-Jun Cao, Guo-Xing Wan","doi":"10.2147/DDDT.S535517","DOIUrl":"10.2147/DDDT.S535517","url":null,"abstract":"<p><p>Doxorubicin (DOX) is an anthracycline chemotherapeutic agent widely used for treating various malignancies due to its remarkable efficacy. However, the dose-limiting cardiotoxicity induced by DOX remains a critical clinical concern with limited therapeutic strategy. Several molecular mechanisms underlying the pathogenesis of doxorubicin-induced cardiotoxicity (DIC) have been proposed, including oxidative stress, dysregulation of Top2β, mitochondrial damage, imbalance of calcium homeostasis, ferroptosis, and inflammatory responses. Increasing studies have posed the promise of the natural products flavonoids against DIC attributed to its advantages in antioxidant activity as well as anti-cancer properties. This paper reviews relevant publications to date and comprehensively summarizes the evidence from preclinical and clinical studies in support of the cardioprotective effect of seven flavonoids subclasses against DIC, including flavones with 18 compounds, flavonols with 11 compounds, isoflavones with 7 compounds, flavanones with 6 compounds, chalcones with 3 compounds, flavanols with 2 compounds and anthocyanins with 2 compounds. Specially, several lines of evidence have also demonstrated the anti-cancer property of flavonoids in addition to the cardioprotective property. This review synthesizes comprehensive mechanistic and translational insights to inform future preclinical and clinical investigations aiming at integrating flavonoid-based interventions into oncotherapeutic regimens. The accumulated evidence underscores flavonoids as promising candidates for DIC as well as adjuvant cancer therapy.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5553-5596"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Traditional Chinese Medicine for Managing Diminished Ovarian Reserve: Mechanisms and Clinical Insights.","authors":"Yonghui Liu, Mingchan Wei, Yasheng Deng, Yanping Fan, Yiqing Zheng, Zhaobing Ni, Jiang Lin","doi":"10.2147/DDDT.S505689","DOIUrl":"10.2147/DDDT.S505689","url":null,"abstract":"<p><p>Diminished Ovarian Reserve (DOR) is characterised by a decrease in the number and quality of oocytes, accompanied by biological markers such as a decrease in anti-Müllerian hormone (AMH), a decrease in the sinus follicle count (AFC), and an increase in follicle stimulating hormone (FSH). In response to the limitations of modern medical treatments, traditional Chinese medicine (TCM) has demonstrated unique advantages in the treatment of DOR. In this paper, we systematically reviewed the literature in the past decade to analyse the scientific content of TCM intervention in DOR from the dimensions of molecular mechanism and clinical application. It was found that single components (paeoniflorin, <i>Epimedium</i> glycosides, etc.), TCM pairs (<i>Cuscuta chinensis-Sambucus nigra and Semencuspidatae</i>-<i>Epimedium</i>), TCM combinations (Liuweidihuangwan, Haifuyuyuyuitang, <i>Angelica sinensis-Paeonia lactiflora</i>, etc.), and a variety of acupuncture therapies can improve the ovarian function through a multi-targeted modulation mechanism: ① regulating the signalling pathways, such as PI3K/AKT, to promote the development of the follicle; ②regulating the hypothalamic-pituitary-ovarian axis balance hormone levels; ③enhance anti-oxidative stress through Nrf2/HO-1/NLRP3 signalling; ④inhibit the expression of granulosa cell apoptosis-related factors (Bax/Caspase-3). Clinical data showed that TCM interventions significantly increased AMH levels, increased AFC and decreased FSH levels in patients. The study confirms that TCM exerts therapeutic advantages through multi-component synergistic effects, from improving the ovarian microenvironment, regulating reproductive endocrinology, delaying follicular atresia, etc. which provides a theoretical basis and practical reference for the integrated treatment of DOR. It is suggested that standardised clinical studies should be carried out to establish an evaluation system for the efficacy of TCM and to promote the development of precise treatment options.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5597-5614"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}