Archives of Medical Research最新文献

{"title":"Role of Angiotensin II in Non-Alcoholic Steatosis Development","authors":"Zimri Aziel Alvarado-Ojeda ,&nbsp;Celeste Trejo-Moreno ,&nbsp;Eduardo Ferat-Osorio ,&nbsp;Marisol Méndez-Martínez ,&nbsp;Gladis Fragoso ,&nbsp;Gabriela Rosas-Salgado","doi":"10.1016/j.arcmed.2024.102986","DOIUrl":"https://doi.org/10.1016/j.arcmed.2024.102986","url":null,"abstract":"<div><p>Fatty liver is a multifactorial disease characterized by excessive accumulation of lipids in hepatocytes (steatosis), insulin resistance, oxidative stress, and inflammation. This disease has a major public health impact because it is the first stage of a chronic and degenerative process in the liver that can lead to steatohepatitis, cirrhosis, and liver cancer. Although this disease is mainly diagnosed in patients with obesity, type 2 diabetes mellitus, and dyslipidemia, recent evidence indicates that vasoactive hormones such as angiotensin II (ANGII) not only promote endothelial dysfunction (ED) and hypertension, but also cause fatty liver, increase adipose tissue, and develop a pro-steatotic environment characterized by a low-grade systemic pro-inflammatory and pro-oxidant state, with elevated blood lipid levels. The role of ANGII in lipid accumulation has been little studied, so this review aims to summarize existing reports on the possible mechanism of action of ANGII in inducing lipid accumulation in hepatocytes.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140134398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired Ischemia-Reperfusion Responses in the Hearts of Aged Male and Female Offspring of Obese Rats","authors":"Carlos A. Ibáñez ,&nbsp;Francisco Correa ,&nbsp;Gabriela Lira-León ,&nbsp;Luis A. Reyes-Castro ,&nbsp;Francisco Javier Roldán ,&nbsp;Alejandro Silva-Palacios ,&nbsp;Mabel Buelna-Chontal ,&nbsp;Guadalupe L. Rodríguez-González ,&nbsp;Peter W. Nathanielsz ,&nbsp;Cecilia Zazueta ,&nbsp;Elena Zambrano","doi":"10.1016/j.arcmed.2024.102983","DOIUrl":"https://doi.org/10.1016/j.arcmed.2024.102983","url":null,"abstract":"<div><p>Maternal obesity predisposes offspring (F1) to cardiovascular disease. To evaluate basal heart function and ischemia-reperfusion (IR) responses in F1 males and females of obese mothers, female Wistar rats (F0) were fed chow or an obesogenic (MO) diet from weaning through pregnancy and lactation. Non-sibling F1 males and females were weaned to chow at postnatal day (PND) 21 and euthanized at PND 550. Offspring of MO mothers (MOF1) rarely survive beyond PND 650. Hearts were immediately isolated from euthanized F1s and subjected to 30 min ischemia with 20 min reperfusion. Retroperitoneal fat, serum triglycerides, glucose, insulin, and insulin resistance were measured. Baseline left ventricular developed pressure (LVDP) was lower in male and female MOF1 than in controls. After global ischemia, LVDP in control (C) male and female F1 recovered 78 and 83%, respectively, while recovery in MO male and female F1 was significantly lower at 28 and 52%, respectively. Following the IR challenge, MO hearts showed a higher functional susceptibility to reperfusion injury, resulting in lower cardiac reserve than controls in both sexes. Female hearts were more resistant to IR. Retroperitoneal fat was increased in male MOF1 vs. CF1. Circulating triglycerides and insulin resistance were increased in male and female MOF1 vs. CF1. These data show that MO programming reduces F1 cardiac reserve associated with age-related insulin resistance in a sex-specific manner.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherogenic Index as a Cardiovascular Biomarker in Mexican Workers from Marginalized Urban Areas Occupationally Exposed to Metals","authors":"Juan Carlos Fernández-Macías ,&nbsp;Laura Sherell Marín-Jauregui ,&nbsp;Karen Beatriz Méndez-Rodríguez ,&nbsp;Ana Patricia Huerta-Rodríguez ,&nbsp;Francisco Javier Pérez-Vázquez","doi":"10.1016/j.arcmed.2024.102984","DOIUrl":"https://doi.org/10.1016/j.arcmed.2024.102984","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular disease (CVD) is one of the main causes of death and disability worldwide. The etiology of CVD is often associated with multiple risk factors, with environmental factors receiving considerable attention. Individuals with precarious jobs are among the groups most affected by chronic exposure to environmental pollutants.</p></div><div><h3>Aim</h3><p>This study aimed to evaluate occupational exposure to heavy metals among individuals in precarious job settings and investigate atherogenic indices as biomarkers of cardiovascular risk.</p></div><div><h3>Methods</h3><p>A total of 137 workers participated in this cross-sectional study conducted in three work environments in San Luis Potosi, Mexico. Urine and blood samples were collected to assess metal exposure and biochemical profiles, including atherogenic indices.</p></div><div><h3>Results</h3><p>The results showed that workers in the brick sector exhibited the highest levels of metal exposure, particularly arsenic (44.06 µg/L), followed by stonecutters and garbage collectors (24.7 and 16.9 µg/L, respectively). Similarly, Castelli risk index (CRI) and the atherogenic index of plasma (AIP) were higher in brickmakers (3.883 and 0.499) compared to stonecutters (3.285 and 0.386) and garbage collectors (3.329 and 0.367).</p></div><div><h3>Conclusions</h3><p>Evidence of exposure to heavy metals was observed in the three populations, in addition to the fact that individuals with greater exposure to arsenic also exhibited higher CRI and AIP.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140122884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of High Sodium Intake on Gut Tight Junctions’ Structure and Permeability to Bacterial Toxins in a Rat Model of Chronic Kidney Disease","authors":"María de la Luz Villela-Torres ,&nbsp;María-del-Carmen Prado-Uribe ,&nbsp;Marcela Ávila Díaz ,&nbsp;Héctor Quezada Pablo ,&nbsp;Elizabeth Soria-Castro ,&nbsp;Nuria Esturau Escofet ,&nbsp;Catalina Elizabeth Flores Maldonado ,&nbsp;Ramón Paniagua","doi":"10.1016/j.arcmed.2024.102969","DOIUrl":"https://doi.org/10.1016/j.arcmed.2024.102969","url":null,"abstract":"<div><h3>Introduction</h3><p>Uremic toxicity changes the gut structure and permeability, allowing bacterial toxins to translocate from the lumen to the blood during chronic kidney failure (CKD). Clinical fluid overload and tissue edema without uremia have similar effects but have not been adequately demonstrated and analyzed in CKD.</p></div><div><h3>Aims</h3><p>To investigate the effect of sodium intake on the plasma concentration of gut-derived uremic toxins, indoxyl sulfate (IS), and p-cresyl sulfate (pCS) and the expression of genes and proteins of epithelial gut tight junctions in a rat model of CKD.</p></div><div><h3>Methods</h3><p>Sham-operated (control group, CG) and five-sixths nephrectomized (5/6Nx) Sprague-Dawley rats were randomly assigned to low (LNa), normal (NNa), or high sodium (HNa) diets., Animals were then sacrificed at 8 and 12 weeks and analyzed for IS and pCS plasma concentrations, as well as for gene and protein expression of thigh junction proteins, and transmission electron microscopy (TEM) in colon fragments.</p></div><div><h3>Results</h3><p>The HNa 5/6Nx groups had higher concentrations of IS and pCS than CG, NNa, and LNa at eight and twelve weeks. Furthermore, HNa 5/6Nx groups had reduced expression of the claudin-4 gene and protein than CG, NNa, and LNa. HNa had reduced occludin gene expression compared to CG. Occludin protein expression was more reduced in HNa than in CG, NNa, and LNa. The gut epithelial tight junctions appear dilated in HNa compared to NNa and LNa in TEM.</p></div><div><h3>Conclusion</h3><p>Dietary sodium intake and fluid overload have a significant role in gut epithelial permeability in the CKD model.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140122885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GEMIN4 Variants: Risk Profiling, Bioinformatics, and Dynamic Simulations Uncover Susceptibility to Bladder Carcinoma","authors":"Abdallah S. Mohamed ,&nbsp;Afrah F. Salama ,&nbsp;Magdy A. Sabaa ,&nbsp;Eman Toraih ,&nbsp;Rami M. Elshazli","doi":"10.1016/j.arcmed.2024.102970","DOIUrl":"https://doi.org/10.1016/j.arcmed.2024.102970","url":null,"abstract":"<div><h3>Background</h3><p>The relationship between GEMIN4 genetic variants and cancer, especially bladder carcinoma (BLCA), has been explored without conclusive results. This study aims to elucidate the link between GEMIN4 polymorphisms and BLCA susceptibility through genetic analyses, bioinformatics, and molecular dynamics (MD) simulations.</p></div><div><h3>Methods</h3><p>A cohort of 249 participants (121 BLCA patients and 128 unrelated controls) was enrolled. PCR was employed for allelic discrimination of GEMIN4 variants, followed by subgroup stratification, haplotype analyses, structural prediction using the AlphaFold2 prediction tool, subsequent MD simulations, structural analysis, and residue interaction mapping using Desmond, UCSF ChimeraX, and Cytoscape softwares.</p></div><div><h3>Results</h3><p>The rs.2740348*G variant demonstrated a protective role against BLCA in allelic (OR = 0.55, <em>p</em> = 0.002) and recessive (OR = 0.54, <em>p</em> = 0.017) models, whereas the rs.7813*T variant increased BLCA risk under the recessive model (OR = 1.90, <em>p</em> = 0.019). Haplotype analysis revealed a significant association between GEMIN4 haplotype (rs.2740348*C/rs.7813*T) with increased BLCA risk (OR = 2.01, <em>p</em> = 0.004). Univariate analysis revealed associations of the variants with albumin levels and absolute neutrophil count in BLCA patients. Pathogenicity evaluation categorized p.Gln450Glu as neutral and p.Arg1033Cys as deleterious. MD simulations revealed structural alterations and conformational shifts in the GEMIN4 protein induced by the Glu450 and Cys1033 mutations.</p></div><div><h3>Conclusions</h3><p>The study highlights the dual role of GEMIN4 variants in BLCA susceptibility, with rs.2740348 conferring protection and rs.7813 increasing risk. The Glu450 residue positively impacted protein stability, while Cys1033 had a detrimental effect on protein function. These findings underscore the significance of GEMIN4 variants in BLCA susceptibility and pave the way for future diagnostic and therapeutic initiatives.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0188440924000237/pdfft?md5=eceb7a893ea57109bcba414cf6da3e02&pid=1-s2.0-S0188440924000237-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139942481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Vitamin D Status in Healthy Young Adults from Mexico City","authors":"Alva Belen Morales-Villar ,&nbsp;Jorge Maldonado-Hernández ,&nbsp;Nelson Eduardo Álvarez-Licona ,&nbsp;Mónica Ivette Piña-Aguero ,&nbsp;Salvador Villalpando-Hernández ,&nbsp;Ricardo Martín Robledo-Pérez ,&nbsp;Ismael Díaz-Rangel ,&nbsp;María de Lourdes Barbosa-Cortés ,&nbsp;Benjamín-Armando Núñez-García","doi":"10.1016/j.arcmed.2024.102968","DOIUrl":"https://doi.org/10.1016/j.arcmed.2024.102968","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Vitamin D deficiency is a global health problem. The determinants of this deficiency have not been evaluated in developing countries such as Mexico. Thus, this study aimed to determine vitamin D intake and sun exposure and its relationship with plasma concentrations of 25-hydroxyvitamin D -25(OH)D- in young adults from Mexico City.</p></div><div><h3>Methods</h3><p>One hundred fifty five urban adult subjects were enrolled during 2017 and 2018. Sociodemographic, anthropometric, and clinical data, vitamin D intake, and sun exposure habits were collected. Plasma concentrations of 25(OH)D were also determined.</p></div><div><h3>Results</h3><p>The proportion of vitamin D deficiency was significantly higher in women than in men (65.7 vs. 43.4%, <em>p</em> = 0.012). The overall median dietary vitamin D intake was 112 IU/d (less than 20% of the recommended daily intake; RDI). 25-hydroxyvitamin D correlated directly with vitamin D intake, sun exposure score, waist-to-hip ratio, and age; an inverse significant association was found with body fat percentage. A multiple regression analysis was performed; simultaneous and significant (<em>p</em> &lt;0.01) effects of sun exposure score, dietary vitamin D, the season of the year (spring-summer vs. fall-winter), and age were observed on 25(OH)D levels.</p></div><div><h3>Conclusion</h3><p>High rates of vitamin D deficiency and insufficiency were observed in young adults from Mexico City. According to the RDI of this vitamin, its consumption, assessed by a 24 h multi-step nutritional questionnaire, was significantly low. A linear multiple regression model identified several predictors of plasma 25(OH)D concentrations. This multiple regression model was statistically validated.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repositioning FDA-Approved Drug Against Chagas Disease and Cutaneous Leishmaniosis by Structure-Based Virtual Screening","authors":"Alfredo Juarez-Saldivar ,&nbsp;Rogelio Gómez-Escobedo ,&nbsp;Gerardo Corral-Ruiz ,&nbsp;Karla Fabiola Chacón-Vargas ,&nbsp;Vanessa Horta-Montaño ,&nbsp;Luvia Sanchez-Torres ,&nbsp;Lenci k. Vazquez-Jimenez ,&nbsp;Benjamín Nogueda-Torres ,&nbsp;Gildardo Rivera","doi":"10.1016/j.arcmed.2024.102958","DOIUrl":"10.1016/j.arcmed.2024.102958","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Chagas disease and </span>cutaneous leishmaniasis, two parasitic diseases caused by </span><span><em>Trypanosoma cruzi</em></span> (<em>T. cruzi</em>) and <span><em>Leishmania mexicana</em></span> (<em>L. mexicana</em><span>), respectively, have a major global impact. Current pharmacological treatments for these diseases are limited and can cause severe side effects; thus, there is a need for new antiprotozoal drugs.</span></p></div><div><h3>Methods</h3><p><span><span>Using molecular docking, this work describes a structure-based virtual screening of an FDA-approved </span>drug library against </span><em>Trypanosoma cruzi</em> and <em>Leishmania mexicana</em><span><span> glycolytic enzyme </span>triosephosphate isomerase<span> (TIM), which is highly conserved in these parasites. The selected compounds with potential dual inhibitory activity were tested </span></span><em>in vitro</em> to confirm their biological activity.</p></div><div><h3>Results</h3><p><span>The study showed that five compounds: nilotinib<span><span>, chlorhexidine, </span>protriptyline<span>, cyproheptadine, and montelukast, were more active against </span></span></span><em>T. cruzi</em><span><span>, than the reference drugs, nifurtimox and </span>benznidazole while chlorhexidine and protriptyline were the most active against </span><em>L. mexicana</em>.</p></div><div><h3>Conclusions</h3><p>The analysis of these compounds and their structural characteristics may provide the basis for the development of new antiprotozoal agents.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139578727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De Novo Vitiligo Following Covid-19 Infection and Vaccination: A Door Open to Future Events?","authors":"RAFFAELLA MORMILE","doi":"10.1016/j.arcmed.2024.102961","DOIUrl":"10.1016/j.arcmed.2024.102961","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139645641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Prevalence and Severity of Retinopathy of Prematurity over the Last Four Decades (1985–2021): A Systematic Review and Meta-Analysis","authors":"Heladia García ,&nbsp;Miguel Angel Villasis-Keever ,&nbsp;Georgina Zavala-Vargas ,&nbsp;Juan Carlos Bravo-Ortiz ,&nbsp;Ayari Pérez-Méndez ,&nbsp;Alberto Escamilla-Núñez","doi":"10.1016/j.arcmed.2024.102967","DOIUrl":"10.1016/j.arcmed.2024.102967","url":null,"abstract":"<div><h3>Background</h3><p>Retinopathy of prematurity (ROP) is a vasoproliferative disease of the retina that occurs in premature infants. The prevalence of ROP reported so far is inconsistent.</p></div><div><h3>Aim</h3><p>To conduct a systematic review to describe the trend of ROP prevalence between 1985 and 2021, and to determine the influence of countries’ economic conditions on ROP prevalence.</p></div><div><h3>Methods</h3><p>We searched PubMed, Embase, and Google Scholar for studies published between January 1985 and December 2021 using the following MeSH terms: “retinopathy of prematurity”, “ROP”, “incidence”, and “prevalence”. Two independent reviewers examined the articles to select studies that met the selection criteria and performed data extraction and study quality assessment. For the meta-analysis, the pooled prevalence was calculated using a random-effects model and R software.</p></div><div><h3>Results</h3><p>Of 5,250 titles and abstracts, 139 original studies met the inclusion criteria; a total of 121,618 premature infants were included in these studies. The pooled prevalence of ROP was 31.9% (95% confidence interval [CI] 29.0–34.8) and that of severe ROP was 7.5% (6.5–8.7). In general, no significant differences in prevalence were found over the four decades; however, we found a higher prevalence in premature infants ≤28 weeks of gestational age. In addition, the highest ROP prevalence was found in lower-middle-income countries with high mortality rates. In contrast, the highest severe ROP prevalence was found in high-income countries.</p></div><div><h3>Conclusion</h3><p>ROP remains a common cause of morbidity in premature infants worldwide. Therefore, it seems necessary to maintain early identification strategies for patients at higher risk, particularly in low- and middle-income countries.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intranasal Versus Intravenous Dexamethasone to Treat Hospitalized COVID-19 Patients: A Randomized Multicenter Clinical Trial","authors":"Graciela Cárdenas ,&nbsp;María Chávez-Canales ,&nbsp;Ana María Espinosa ,&nbsp;Antonio Jordán-Ríos ,&nbsp;Daniel Anica Malagon ,&nbsp;Manlio Fabio Márquez Murillo ,&nbsp;Laura Victoria Torres Araujo ,&nbsp;Ricardo Leopoldo Barajas Campos ,&nbsp;Rosa María Wong-Chew ,&nbsp;Luis Esteban Ramirez González ,&nbsp;Karent Ibet Cresencio ,&nbsp;Enrique García Velázquez ,&nbsp;Mariana Rodriguez de la Cerda ,&nbsp;Yoana Leyva ,&nbsp;Joselin Hernández-Ruiz ,&nbsp;María Luisa Hernández-Medel ,&nbsp;Mireya León-Hernández ,&nbsp;Karen Medina Quero ,&nbsp;Anahí Sánchez Monciváis ,&nbsp;Eduardo Beltrán Sarmiento ,&nbsp;Edda Sciutto","doi":"10.1016/j.arcmed.2024.102960","DOIUrl":"10.1016/j.arcmed.2024.102960","url":null,"abstract":"<div><h3>Background</h3><p><span><span><span>SARS-CoV2 induces flu-like symptoms that can rapidly progress to severe acute lung injury<span> and even death. The virus<span> also invades the central nervous system (CNS), causing </span></span></span>neuroinflammation and death from central failure. Intravenous (IV) or oral </span>dexamethasone (DXM) reduced 28 d mortality </span>in patients who required supplemental oxygen compared to those who received conventional care alone. Through these routes, DMX fails to reach therapeutic levels in the CNS. In contrast, the intranasal (IN) route produces therapeutic levels of DXM in the CNS, even at low doses, with similar systemic bioavailability.</p></div><div><h3>Aims</h3><p>To compare IN vs. IV DXM treatment in hospitalized patients with COVID-19.</p></div><div><h3>Methods</h3><p>A controlled, multicenter, open-label trial. Patients with COVID-19 (69) were randomly assigned to receive IN-DXM (0.12 mg/kg for three days, followed by 0.6 mg/kg for up to seven days) or IV-DXM (6 mg/d for 10 d). The primary outcome was clinical improvement, as defined by the National Early Warning Score (NEWS) ordinal scale. The secondary outcome was death at 28 d between IV and IN patients. Effects of both treatments on biochemical and immunoinflammatory profiles were also recorded.</p></div><div><h3>Results</h3><p>Initially, no significant differences in clinical severity, biometrics, and immunoinflammatory parameters were found between both groups. The NEWS-2 score was reduced, in 23 IN-DXM treated patients, with no significant variations in the 46 IV-DXM treated ones. Ten IV-DXM-treated patients and only one IN-DXM patient died.</p></div><div><h3>Conclusions</h3><p>IN-DMX reduced NEWS-2 and mortality more efficiently than IV-DXM, suggesting that IN is a more efficient route of DXM administration.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":7.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139578663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}