Frontiers in Pharmacology最新文献

{"title":"Single-versus multiple-inhaler triple therapy in patients with COPD in Spain: a retrospective cohort study comparing adherence, persistence, risk of exacerbations and economic outcomes.","authors":"M Asunción González-González, M Aránzazu Pedrosa-Naudín, Diego Fernández-Lázaro, Isabel Díaz Planelles, F Javier Álvarez, Eduardo Gutiérrez-Abejón","doi":"10.3389/fphar.2025.1642470","DOIUrl":"https://doi.org/10.3389/fphar.2025.1642470","url":null,"abstract":"<p><p>This retrospective study aimed to compare the clinical and economic outcomes of single-inhaler triple therapy (SITT) versus multiple-inhaler triple therapy (MITT) in a large cohort of COPD patients. Metrics on adherence, prevalence, and incidence of exacerbations in COPD patients treated with SITT or MITT were analyzed using pharmacy claims data integrated with the Spanish public health database. At the 12-month follow-up, patients in the SITT cohort were significantly more adherent (75.22% vs 70.1%; OR = 1.33), more persistent (64.32% vs 52.4%; HR = 1.56) and had a lower incidence of moderate exacerbations (53.53% vs 64.07%; OR = 0.65) than patients in the MITT cohort. The main predictors associated with lack of persistence were being a naïve patient (HR = 0.55) and moderate exacerbations (HR = 0.85). Furthermore, medication costs were lower for SITT (EUR 909.31 vs EUR 1025.31), demonstrating its cost-effectiveness. Our results suggest that SITT not only may improve adherence and persistence but also contributes to a relevant reduction in the risk of moderate exacerbations. Additionally, SITT offers a more cost-effective alternative for patients with moderate to severe COPD with documented exacerbations, making it a valuable strategy in real-world clinical practice.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1642470"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232288","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":"Comparative efficacy of postoperative adjuvant transcatheter arterial chemoembolization and hepatic artery infusion chemotherapy in patients with BCLC stage 0-B hepatocellular carcinoma at high risk of recurrence following radical resection.","authors":"Xu Feng, Yupei Ao, Jiarui Liu, Jue Yuan, Zhengrong Shi, Chengjia Tang","doi":"10.3389/fphar.2025.1657794","DOIUrl":"https://doi.org/10.3389/fphar.2025.1657794","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to compare the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) and postoperative adjuvant hepatic artery infusion chemotherapy (PA-HAIC) in patients with BCLC Stage 0-B Hepatocellular Carcinoma (HCC) at high risk of recurrence following radical resection.</p><p><strong>Methods: </strong>This study retrospectively evaluated HCC patients who underwent radical liver resection (LR) at two clinical centers between 1 January 2018, and 31 December 2024. The recurrence-free survival (RFS) and overall survival (OS) were compared among three groups: those who received LR alone, PA-TACE, and PA-HAIC. Propensity score matching (PSM) was applied to minimize inter-group differences and further validate the findings.</p><p><strong>Results: </strong>A total of 609 patients with high-risk recurrence following radical resection of HCC were included in this study. After PSM, both PA-TACE and PA-HAIC significantly improved median RFS (mRFS) and median OS (mOS) compared with LR alone (mRFS for the LR, PA-TACE, and PA-HAIC groups was 16.5 months, 39.0 months, and 46.0 months, respectively; mOS was 54.0 months, 68.0 months, and not reached for PA-HAIC, respectively). Furthermore, patients treated with PA-HAIC achieved superior mRFS as well as higher 1-year, 2-year, and 4-year RFS rates compared with those treated with PA-TACE. Similarly, PA-HAIC was associated with a significantly longer mOS and a higher 4-year OS rate than PA-TACE. In the construction of the RFS nomogram, the C-indexes for the training and validation cohorts were 0.802 and 0.799, respectively, demonstrating good predictive ability.</p><p><strong>Conclusion: </strong>In HCC patients with high-risk recurrence following radical resection, PA-HAIC significantly improves RFS compared to PA-TACE, but only in patients with MVI, tumor diameter ≥5 cm, or multiple tumors.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1657794"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232044","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":"Comprehensive chemical profiling and human health risk assessment of potentially toxic heavy metals in some traditional herbal concoctions from Botswana.","authors":"Ontlametse H E Phiri, Lucia M Lepodise, Tshepo Pheko-Ofitlhile","doi":"10.3389/fphar.2025.1652817","DOIUrl":"https://doi.org/10.3389/fphar.2025.1652817","url":null,"abstract":"<p><p>Traditional herbal mixtures are still used extensively in Botswana because of their claimed therapeutic benefits, although their chemistry and safety are undocumented. Therefore, this study aims to conduct the analysis and human health risk assessment of some herbal concoctions in Botswana. The spectra of the herbal concoction samples sourced from three different street vendors were recorded at room temperature using the Fourier Transform Infrared (FT-IR) technique. The three samples exhibited comparatively similar spectral profiles, indicating that they may contain chemical compounds vibrating at similar energies. FT-IR analysis revealed the presence of characteristic functional groups which includes phenolics, alcohols, alkene, alkanes and aromatic groups some of which were identified through gas chromatography-mass spectrometry (GC-MS) analysis. GC-MS analysis of all the hexane extracts identified octane and 3-methylheptane as the major constituents. Hexadecane, tetradecane and 5-Aminovaleric acid were major compounds identified in ethyl acetate extracts. Inductively Coupled Plasma Optical Emission Spectrometer (ICP-OES) results revealed that the heavy metal concentrations of herbal concoctions that ranged between 1.00 × 10^-4 mg/kg and 2.43 × 10¹ mg/kg. The concentrations of all the heavy metals were below the acceptable limits set by World Health Organization (WHO). Trace metal concentrations of Mg, Ca, K and Na in the samples ranged from 1.31 × 10^-1 to 2.79 × 10¹ mg/kg, 4.34 × 10^-1 to 2.36 × 10² mg/kg, 1.13 to 2.26 × 10¹ mg/kg and 3.08 × 10^-1 to 5.07 × 10¹ mg/kg respectively. The human health risk analysis showed that there was no potential health risk associated with the consumption of the herbal concoctions and As concentration levels in sample A requires close scrutiny. These findings provide valuable information on the chemical composition, metal content and health risk assessment information of the herbal concoctions by informing safe usage and contributing to evidence based ethno-pharmacological research. The study provides an insight on the properties of bioactive compounds present in the herbal concoctions and emphasizes the necessity of continuous quality monitoring and chemical validation of traditional herbal mixtures to inform regulatory frameworks and public health policy.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1652817"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232036","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":"Active ingredients isolated from <i>Periplaneta americana</i> L. inhibit the inflammation of the colonic mucosa and regulate the gut microbiota in DSS-induced ulcerative colitis in mice.","authors":"Yanhuan Wang, Fa Ni, Genrui Wu, Huai Xiao, Zhibin Yang, Chenggui Zhang, Hairong Zhao, Heng Liu","doi":"10.3389/fphar.2025.1615989","DOIUrl":"https://doi.org/10.3389/fphar.2025.1615989","url":null,"abstract":"<p><strong>Introduction: </strong>Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by colonic mucosal inflammation, compromised intestinal barrier function, and gut microbiota dysbiosis. Current therapies often have significant limitations, including adverse effects, highlighting the need for safer alternatives. <i>Periplaneta americana</i> L. (PA), documented in Shennong's Herbal Classic, possesses anti-inflammatory, tissue-repairing, and immunomodulatory properties. While previous studies demonstrated efficacy of PA in rodent UC models generated using different inducers, the active components within aqueous extracts (PAW) and their comparative effects remain unclear.</p><p><strong>Materials: </strong>To address this gap, this study investigated the composition and therapeutic activity of PAW and its sequentially fractionated components based on molecular weight: PAW1 (< 3 kDa), PAW2 (3-10 kDa), and PAW3 (> 10 kDa) using membrane separation. Using a dextran sulfate sodium (DSS)-induced UC model in C57BL/6 mice, we compared the effects of unfractionated PA and its fractions (PAW1, PAW2, PAW3) on UC pathology and intestinal flora.</p><p><strong>Results: </strong>Our results demonstrate that PA, PAW1, PAW2, and PAW3 ameliorated key UC-associated pathologic features; notably, the unfractionated PA exhibited superior efficacy compared to its individual fractions. PA treatment significantly mitigated DSS-induced body weight loss, disease activity index scores, and colon shortening. It preserved intestinal mucosal integrity, evidenced by increased goblet cell numbers and elevated expression of tight junction proteins (occludin-1, ZO-1). PA treatment reduced colonic inflammation by significantly downregulating pro-inflammatory mediators (NF-κB-p65, TLR4, MyD88, TNF-α, IL-17A, IFN-γ, MPO, iNOS) and upregulating the anti-inflammatory cytokine IL-10, while IL-4 levels were also modulated. Furthermore, PA treatment attenuated intestinal dysbiosis in UC mice, characterized by an increase in beneficial bacteria (e.g., <i>Psychrobacter</i>) and a decrease in taxa like <i>Actinobacteriota</i>.</p><p><strong>Conclusion: </strong>These findings collectively indicate that the aqueous extract of <i>Periplaneta americana</i> L. and its fractions possess significant therapeutic potential for UC treatment, with the unfractionated extract showing the most pronounced benefits via modulating inflammation, restoring barrier function, and rebalancing gut microbiota.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1615989"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232025","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":"Stability study of common vasoactive drugs diluted in five types of solutions.","authors":"Han Yang, Bingbing Xiang, Deiying Gong, Guoyan Zhao, Wensheng Zhang","doi":"10.3389/fphar.2025.1670183","DOIUrl":"https://doi.org/10.3389/fphar.2025.1670183","url":null,"abstract":"<p><strong>Background: </strong>Vasoactive drugs are widely used during the perioperative period. Different vasoactive drugs have specific recommended solutions for dilution as stated in their instructions, but non-recommended solutions are sometimes used in clinical practice. The impact of using non-recommended solutions on drug stability remains unclear. This study investigated the stability of various commonly used vasoactive drugs diluted with five commonly used solutions-0.9% sodium chloride injection, sodium lactate Ringer's injection, glucose sodium chloride injection, 5% glucose injection, and 10% glucose injection-under room temperature (24 °C ± 1 °C) without light protection.</p><p><strong>Methods: </strong>Each drug was diluted to clinically common concentrations using the five solutions mentioned above. Five samples of 100 µL each were prepared for each drug. The samples were stored at room temperature without light protection and observed at 0, 2, 4, 6, and 8 h for changes in appearance and pH. High-performance liquid chromatography (HPLC) was used to measure the drug content at each time point. The drug content at 0 h was set as 100%, and the content at other time points was calculated relative to this baseline.</p><p><strong>Results: </strong>Within 8 h, all solutions remained clear and transparent. Except for amiodarone hydrochloride, nicardipine hydrochloride, propafenone hydrochloride, and diltiazem hydrochloride, which showed significant pH changes after dilution, the pH changes of the other solutions were less than 0.1. Except for isoproterenol hydrochloride, the content of the other tested drugs showed no significant differences within 8 h.</p><p><strong>Conclusion: </strong>When diluted with the five commonly used solutions and stored at room temperature without light protection for 8 h, the tested drugs maintained stable properties.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1670183"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231939","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":"Prevalence of risk phenotypes associated with <i>CYP2C9*2, *3,</i> and <i>VKORC1 c.-1639G>A</i> genetic polymorphisms in world populations: implications in clinical practice.","authors":"Mohitosh Biswas, Murshadul Alam Murad, Maliheh Ershadian, Most Sumaiya Khatun Kali, Maw Shin Sim, Baharudin Ibrahim, Chonlaphat Sukasem","doi":"10.3389/fphar.2025.1597379","DOIUrl":"https://doi.org/10.3389/fphar.2025.1597379","url":null,"abstract":"<p><strong>Background: </strong>The safety or efficacy of drugs may be affected by the genetic variability of <i>CYP2C9</i> or <i>VKORC1.</i> Patients may be at increased risk of drug-related toxicities, for example, bleeding events, if they carry <i>CYP2C9*2</i> (rs1799853), <i>CYP2C9*3</i> (rs1057910), or <i>VKORC1 c.-1639G>A</i> (rs9923231) genetic variants.</p><p><strong>Methods: </strong>The allele frequencies of <i>CYP2C9*2, *3,</i> and <i>VKORC1 c.-1639G>A</i> were obtained from the 1000 Genomes Project Phase III in line with Fort Lauderdale principles. Predictive risk phenotypes and correlations were assigned based on the carrying of characteristic allele carriers following international pharmacogenomics (PGx)-based dosing guidelines.</p><p><strong>Results: </strong>Intermediate and poor metabolizers were predicted to be risk phenotypes (17.8%; 95% CI 16.3%-19.3%) due to inheriting <i>CYP2C9*2</i> and <i>*3</i> genetic variants. These risk phenotypes were highest in European (35%; 95% CI 30.8%-39.2%), followed by South Asian (26.8%; 95% CI 22.9%-30.7%), American (25.9%; 95% CI 21.3%-30.5%), East Asian (6.7%; 95% CI 4.5%-8.9%), and African populations (2.1%; 95% CI 1%-3.2%). In addition, sensitive and highly sensitive responders were considered risk phenotypes (33.1%; 95% CI 31.3%-35%) when combining <i>CYP2C9*2</i> and <i>*3</i> variants with <i>VKORC1c.-1639G>A.</i> These risk phenotypes were most prevalent in East Asian (79.6%; 95% CI 76%-83.1%), followed by European (38.6%; 95% CI 34.3%-42.8%), American (30%; 95% CI 25.2%-34.8%), South Asian (25.2%; 95% CI 21.3%-29%), and African populations (1.2%; 95% CI 0.4%-2%), respectively. The prevalence of risk phenotypes in different ethnic groups was statistically significant (<i>p</i> < 0.05; 1.94 × 10^-175, <i>χ</i> ^<i>2</i> test). According to clinical annotations in the PharmGKB, the safety or efficacy of at least 29 commonly prescribed drugs is impacted by the genetic polymorphisms of <i>CYP2C9</i>/<i>VKORC1 c.-1639G>A</i> to varying degrees. The PGx label information is available for at least 23 drugs, and the Clinical Pharmacogenetics Implementation Consortium (CPIC) has already recommended PGx-based dosing guidelines for at least 11 of these medications, based on the genetic variability of <i>CYP2C9</i>/<i>VKORC1 c.-1639G>A</i>.</p><p><strong>Conclusion: </strong>To enhance the safety of at least 11 clinically significant drugs, the current study found that approximately one-fifth of the global population is at risk based on the <i>CYP2C9*2</i> and <i>*3</i> genotypes. Additionally, approximately one-third of the population is at risk when considering the combination of <i>CYP2C9</i> and <i>VKORC1 c.-1639G>A</i> genotypes. Further studies are warranted to evaluate the clinical benefits of integrating PGx-based therapies in routine practice.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1597379"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232143","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":"Therapeutic potential of natural medicines in diabetic kidney disease: restoring lipid homeostasis via lipophagy modulation.","authors":"Junwei Gao, Yunzhou Wu, Xudong Cai, Hailing Zhao, Jie Xing","doi":"10.3389/fphar.2025.1665339","DOIUrl":"https://doi.org/10.3389/fphar.2025.1665339","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD), one of the most prevalent microvascular complications of diabetes mellitus, is characterized by a complex pathogenesis in which lipid metabolism dysregulation plays a central role. Increasing evidence indicates impaired lipophagy, a selective autophagic process responsible for degrading lipid droplets, contributes substantially to renal lipid accumulation and subsequent kidney injury in DKD. Natural medicines, leveraging their multi-target and multi-pathway regulatory properties, exert considerable therapeutic potential through modulation of lipophagy and restoration of lipid homeostasis. This review synthesizes current studies on the efficacy of natural medicines in enhancing renal lipophagy and attenuating lipid-mediated kidney injury in DKD. We systematically analyze major classes of natural medicines, including flavonoids, polyphenols, terpenoids, alkaloids, and polysaccharides, and discuss their mechanisms of action through key signaling pathways such as AMPK/mTOR, PPARα/γ, and SIRT1/FoxO1. These natural medicines effectively reduce renal lipid accumulation, mitigate oxidative stress and inflammation, and alleviate pathological damage in various DKD models. Their pleiotropic effects suggest promising therapeutic avenues for DKD through the restoration of lipophagic flux and lipid homeostasis. Nonetheless, significant challenges remain, including incomplete elucidation of precise molecular mechanisms and a scarcity of robust clinical validation. Future research must prioritize the rigorous identification of natural medicines, detailed mechanistic exploration, and well-designed clinical trials to translate the potential of natural medicine-mediated lipophagy regulation into effective therapeutic strategies for DKD.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1665339"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231922","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":"Kaixin San Jiawei granule improves cognitive function and alleviates neuronal damage in Alzheimer's disease via multi-component and multi-target mechanisms.","authors":"Wei Liu, Yanan Zhao, Tingting Liu, Yilei Wang, Dongli Yin, Shengcan Zou, Chunze Zou, Zunlu Zhang, Hongwei Zhi, Yahan Wang","doi":"10.3389/fphar.2025.1650534","DOIUrl":"https://doi.org/10.3389/fphar.2025.1650534","url":null,"abstract":"<p><strong>Background: </strong>Kaixin San Jiawei Granule (KSG) is a traditional Chinese medicine formulation derived from classical prescriptions. Although it has shown promise in treating Alzheimer's disease (AD), its precise mechanisms of action remain unclear. This study aimed to systematically investigate the molecular mechanisms underlying KSG's therapeutic effects on AD through an integrative approach combining network pharmacology with experimental validation.</p><p><strong>Methods: </strong>An <i>in vivo</i> AD model was established in male KM mice via intraperitoneal injection of scopolamine. Cognitive function was assessed using the Morris water maze, and hippocampal levels of acetylcholine (ACh), acetylcholinesterase (AChE), glutathione peroxidase (GSH-Px), and reactive oxygen species (ROS) were measured using ELISA. <i>In vitro</i>, PC12 cells were exposed to Aβ_25-35 to induce apoptosis. Immunofluorescence staining, Western blotting, and qPCR were used to assess the expression of amyloid-beta (Aβ), apoptosis-related protein caspase-3, and inflammatory cytokines (TNF-α, IL-1β). Active components of KSG and their potential targets and pathways were identified using mass spectrometry and network pharmacology, while partial validation was performed using molecular docking and Western blotting.</p><p><strong>Results: </strong><i>In vivo</i>, KSG significantly alleviated scopolamine-induced cognitive deficits in mice. Treatment increased hippocampal levels of ACh and GSH-Px while reducing AChE and ROS. <i>In vitro</i>, KSG mitigated Aβ_25-35-induced cytotoxicity in PC12 cells, decreased Aβ accumulation, and downregulated the expression of TNF-α and IL-1β. However, KSG had no significant effect on telomerase activity, telomere length, or the expression of the telomere-associated protein POT1. Mass spectrometry and network pharmacology analyses identified genistein, quercetin, and apigenin as key active compounds with TP53, AKT1, PTGS2, and CNR2 identified as core targets. Molecular docking validation confirmed the favorable binding activity between them. The calcium signaling, PI3K-Akt, and MAPK pathways emerged as the primary enriched pathways.</p><p><strong>Conclusion: </strong>KSG improves cognitive function and attenuates Aβ-induced neuronal damage in AD through multi-component, multi-target synergistic mechanisms. These effects appear to be mediated by modulation of the cholinergic system, inhibition of oxidative stress and inflammation, and suppression of neuronal apoptosis. These findings provide a theoretical basis and experimental support for developing novel AD therapies based on traditional Chinese medicine.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1650534"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232149","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":"Efficacy and safety of Traditional Chinese Medicine in alleviating symptoms associated with myocardial bridge: a systematic review and meta-analysis.","authors":"Jiaqi Ren, Teng Feng, Xize Wu, Qiuying Wu, Yuxi Huang, Yue Li, Kaifeng Yu, Lihong Gong","doi":"10.3389/fphar.2025.1619617","DOIUrl":"https://doi.org/10.3389/fphar.2025.1619617","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;With the advancement of technology, the detection rate of myocardial bridge (MB) has gradually increased and attracted attention. However, management options for symptomatic MB are limited, and Traditional Chinese Medicine (TCM) has emerged as a potential complementary approach for managing symptoms in MB patients. This study conducted a meta-analysis by pooling data from clinical randomized controlled trials (RCTs) to assess the efficacy and safety of TCM in alleviating symptoms in patients with MB.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;RCTs of TCM for MB were searched in PubMed, Embase, Web of Science, Cochrane Library, CBM, Wanfang, VIP, and CNKI databases from their inception to 1 April 2025. Patients diagnosed with MB &lt;i&gt;via&lt;/i&gt; angiography were included in the study. The intervention group received either TCM alone (TCM-alone) or TCM combined with biomedicine (TCM + BM), while the control group received conventional biomedicine alone. Two investigators independently screened the literature according to the inclusion and exclusion criteria. The risk of bias in the included studies was assessed using Stata/MP 18.0 software. A meta-analysis was then conducted using RevMan 5.4.1 software to evaluate outcomes such as angina efficacy, electrocardiogram efficacy, TCM syndrome score efficacy, and the Seattle Angina Scale (SAQ). Subgroup analysis was performed according to the treatment regimen and duration of the intervention group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 18 publications were included, containing 1,224 participants, with 613 in the intervention group and 611 in the control group. Meta-analysis results showed that TCM significantly improved angina efficacy [RR = 1.30, 95% CI (1.21, 1.40), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001], reduced angina attack frequency [MD = -0.96 episodes per week, 95% CI (-1.32, -0.59), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001], improved electrocardiogram efficacy [RR = 1.31, 95% CI (1.20, 1.42), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001], enhanced TCM syndrome scores [RR = 1.45, 95% CI (1.28, 1.64), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001], and reduced physical limitation [MD = 5.95, 95% CI (2.25, 9.64), &lt;i&gt;P =&lt;/i&gt; 0.002], angina stability [MD = 12.10, 95% CI (7.37, 16.83), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001], angina frequency [MD = 11.29, 95% CI (6.93, 15.64), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001], treatment satisfaction [MD = 23.44, 95% CI (19.26, 27.61), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001], and disease perception [MD = 10.69, 95% CI (5.66, 15.72), &lt;i&gt;P&lt;/i&gt; &lt; 0.0001] scores in the SAQ, as well as Self-rating Anxiety Scale (SAS) [MD = -12.83, 95% CI (-13.95, -11.71), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001] and Self-rating Depression Scale (SDS) [MD = -6.97, 95% CI (-8.41, -5.52), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001] scores, and did not increase adverse reactions [RR = 0.82, 95% CI (0.51, 1.34), &lt;i&gt;P&lt;/i&gt; = 0.43]. Subgroup analysis results indicated that, compared with the control group, both the TCM-alone [RR = 1.22, 95% CI (1.11, 1.34), &lt;i&gt;P&lt;/i&gt; &lt; 0.0001] and TCM + BM [RR = 1.38, 95% CI (1.24, 1.55), &lt;i&gt;P&lt;/i&gt; &lt; 0.00001] groups improved angina ef","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1619617"},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232053","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":"Retrospective evaluation of resident pharmacists' services in a liver intensive care unit: a single-center experience.","authors":"Huijie Meng, Zhaoshuai Ji, Zhenyu Zhang, Yuanyuan Liu, Fang Li, Jing Tang, Guangmeng Nie","doi":"10.3389/fphar.2025.1583818","DOIUrl":"https://doi.org/10.3389/fphar.2025.1583818","url":null,"abstract":"<p><strong>Background: </strong>The engagement of clinical pharmacists in ward-based care remains limited in our hospital. This study explores a novel pharmacist working model (resident pharmacists) and evaluates its effectiveness to provide evidence for optimizing pharmaceutical services in intensive care units (ICUs).</p><p><strong>Methods: </strong>From February 2024 to January 2025, resident pharmacists were embedded within the Liver ICU as part of a pilot program, delivering multidisciplinary pharmaceutical services including clinical care, teaching, research, and management. Specialized interventions targeting pediatric and infectious disease populations were implemented based on departmental needs. A retrospective analysis was conducted over 12 months to assess the impact of resident pharmacists on pharmaceutical indicators, service quality, and staff satisfaction; key outcome measures included cost reduction, prescribing appropriateness, and antibiotic use metrics.</p><p><strong>Results: </strong>All pharmaceutical management metrics met institutional standards in 2024-2025, including Antibiotic Use Density (AUD; 112.30 vs. threshold 120.47), antimicrobial usage rate (78.68% vs. 88.54%), and proton pump inhibitor prescription rationality (100%). Pharmacists conducted 78 clinical consultations (65.38% multidisciplinary), addressed 132 medication inquiries, developed two clinical guidelines, and achieved full satisfaction scores from medical staff. The average drug cost per patient decreased by 20.05% (RMB 28,806 vs. 36,028 in 2023), with drug cost proportion declining from 30.85% to 23.59%.</p><p><strong>Conclusion: </strong>By deeply participating in various aspects of drug use in the wards, including medical work, management, scientific research cooperation, continuing medical education, resident pharmacists provided more high-quality pharmaceutical services and promote the improvement of pharmaceutical quality control indicators. Resident pharmacists have become important members of the medical team responsible for medication safety and optimizing treatment plans.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1583818"},"PeriodicalIF":4.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232265","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}