Other Pharmacy and Pharmaceutical Sciences Commons^™

Pharmacist-Led Initiative To Increase Naloxone Prescribing For Patients On High-Dose Opioids In A General Internal Medicine Clinic, Christine E. Leduc, Hyun J. Lee, Polly D. Fraga

The Lahey Journal

Abstract

Introduction:

Opioid overdose is a pressing public health concern in the United States. In 2022, prescription opioids were involved in 15% of all opioid deaths.1 Despite CDC recommendations for prescribing naloxone to high-risk patients, primary care physicians prescribe only 1.5 naloxone prescriptions per 100 prescriptions of high-dose opioids.2,3 Strategies are needed for healthcare institutions to expand naloxone access and mitigate opioid-related harm. This pilot study assesses the impact of a pharmacist-led quality improvement patient outreach initiative on increasing naloxone prescribing for adult patients taking ≥ 50 MME per day of prescription opioids as recommended by current CDC guidelines.

Methods: …

Acute Liver Injury Likely Induced By Alpha Lipoic Acid Contained In Dietary Supplement, Simona Maksimyan, Jonathan V. Reyes, Kasim Kazbay, Farah K. Gazi

Journal of Community Hospital Internal Medicine Perspectives

The rise in use of herbal and dietary supplements, which are regulated as food rather than as drugs by the Food and Drug Association, poses the risk of unknown and potentially severe side effects. We describe the case of acute liver injury, characterized by significant elevation in AST and ALT, likely induced by the consumption of an over-the-counter supplement containing alpha lipoic acid (ALA). Our patient trusted in a “natural” alternative to Western medicine for management of neuropathy, which was ultimately detrimental to her liver. An immediate and sustained improvement in liver enzyme levels was noted with discontinuation of the …

Antimicrobial Resistance In Pediatric Infections: Current Status, Challenges, And Future Directions, Clare Dinh, Keykavous Parang

Pharmacy Faculty Articles and Research

Background/Objectives: Antimicrobial resistance in pediatric infections presents a worsening global public health challenge, with antimicrobial resistance (AMR) accounting for more than one million deaths annually and disproportionately affecting children younger than 5 years of age. Neonates and critically ill children face heightened risk owing to immature immunity, frequent healthcare exposures, and limited therapeutic options. This review synthesizes evidence on the epidemiology, mechanisms of resistance, clinical outcomes, and management of AMR across the full pediatric age range. Methods: PubMed/MEDLINE and Google Scholar were searched for literature from 2014 to 2026 using terms covering antibiotic resistance, pediatric populations, and key …

Expert Recommendations To Strengthen Chikungunya Outbreak Surveillance And Reporting For Traveler Health Protection, Daniel C. Payne, Karoun H. Bagamian, Jeffery Goad, Nathan D. Grubaugh, Michael A. Johansson, Moritz U. G. Kraemer, Eyal Leshem, Francesca F. Norman, Alfonso J. Rodríguez-Morales, Henrik Salje, Stephen Thomas, Scott C. Weaver, Lindsey A. Laytner, Rebecca Sturgis, Suzanne K. Scheele, Davidson H. Hamer

Pharmacy Faculty Articles and Research

Chikungunya, a debilitating mosquito-borne disease caused by chikungunya virus, has surged dramatically in the past two decades. Chikungunya outbreaks can intensify rapidly, with infections posing a significant endemic health burden in tropical/subtropical areas and for travelers. Health professionals require timely and accurate outbreak information to adequately protect travelers and assess chikungunya risk. However, detection is often insufficient in the areas most susceptible to outbreaks, leading to diagnostic and reporting delays. Consequently, travelers are often unaware of increased chikungunya infection risk at their destination. We assessed chikungunya surveillance and reporting resources, and we developed expert recommendations for traveler health protection. Because …

Environmental Mercury Alters Immune Pathways Linked To Autoimmune Risk In Mice Mirroring Humans, Maurgan Lee, Paul Stemmer, Randall Gill, Allen Rosenspire, Anil Aranha, Heather Gibson

Medical Student Research Symposium

Background and Purpose: Mercury is a pervasive environmental contaminant, and human epidemiologic studies have linked chronic low-level exposure to increased autoimmune disease-risk. Dysregulated lymphocyte activation and impaired signaling tolerance are central mechanisms in human autoimmunity. Protein phosphorylation governs lymphocyte differentiation and function, alterations in phosphoproteomic networks may represent a signature of immune disruption. This study evaluates how low dose mercury exposure modifies B and T cell abundance and intracellular signaling patterns in BALB/c and Diversity Outbred (DO) mice.

Methods: BALB/c and DO mice were exposed to low dose HgCl2 in their water for two weeks or provided standard water controls. …

Level Of Comfort And Barriers To Pediatric Vaccination Among Pharmacy-Based Immunizers In California, Laressa Bethishou, Karl Hess, Richard Beuttler, Jeffery Goad

Pharmacy Faculty Articles and Research

Background

Pharmacists are increasingly recognized as accessible immunizers, yet pediatric vaccination rates in community pharmacies remain lower than those for adults, likely due to unique barriers. This study aimed to assess the comfort level of pharmacy-based immunizers in California with administering vaccines to pediatric patients and to identify barriers limiting their participation in pediatric immunization.

Methods

An IRB-approved, cross-sectional survey was distributed electronically to pharmacists, student pharmacists, and pharmacy technicians administering vaccines in California community pharmacies between November 2022 and February 2023. The survey measured comfort with vaccinating pediatric age groups, perceived barriers, and collected demographic data. Data analysis included …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Addition Of Prg4 To Optimize The Anti‑Adhesive Properties Of Tissue Barrier Sepraflm®, Ava J. Marks, Khaled A. Elsaid, Ling X. Zhang, Timmy Lin, Janette Baird, Tannin A. Schmidt, Gregory D. Jay

Pharmacy Faculty Articles and Research

Purpose

Postsurgical adhesion remains a significant clinical challenge. Seprafilm^® is widely used as a barrier to reduce adhesion formation, however its efficacy may be inconsistent. Recombinant human proteoglycan-4 (rhPRG4), a surface-active, anti-inflammatory glycoprotein found in synovial fluid inhibits cell and protein adhesion. This study investigated whether coating Seprafilm with rhPRG4 could enhance its anti-adhesive potential.

Methods

Macrophages (J774), human fibroblast-like synoviocytes (HFLS), and melanoma (A375) cells were cultured on tissue culture wells treated with rhPRG4 or bovine submaxillary mucin (BSM) to determine optimal seeding density. Seprafilm sheets were coated with rhPRG4 or BSM (0.78–200 µg/mL). Cell adhesion was quantified …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

2025 Novel Drug Approvals, Katherine Ghattas Pharmd, Amanda Rawa Pharmd

Transformative Medicine

The year 2025 marked another strong chapter in pharmaceutical innovation, with multiple novel therapies gaining approval from the U.S. Food and Drug Administration (FDA). These approvals reflect continued progress in addressing unmet medical needs across a wide range of disease states. This article reviews the FDA’s 2025 novel drug approvals, spotlighting a few therapeutic advancements and emerging trends. A comprehensive table of all approved agents is provided, along with a focused discussion of four particularly impactful therapies: donidalorsen (Dawnzera), taletrectinib (Ibtrozi), delgocitinib (Anzupgo), gepotidacin (Blujepa), etripamil (Cardamyst). Each of these agents represents a step forward in its respective field and …

Cbx6-Ca9 Axis: An Epigenetic-Metabolic Vulnerability In Glioblastoma, Keykavous Parang

Pharmacy Faculty Articles and Research

Glioblastoma (GBM) remains one of the most therapeutically recalcitrant malignancies, with median survival rarely exceeding 15 months despite maximal therapy.¹ The hypoxic tumor microenvironment drives treatment resistance through epigenetic and metabolic adaptations.²

In this issue of Molecular Therapy Oncology, the study by Wang et al.³ demonstrates a novel regulatory axis between CBX6 (chromobox 6), a polycomb group protein, and CA9 (carbonic anhydrase 9), revealing how hypoxia-driven epigenetic reprogramming promotes tumor progression and identifying a mechanistically linked pathway for therapeutic intervention in GBM.

The study by Wang et al.3 advances our understanding of how the tumor microenvironment …

Receptor-Mediated Drug Delivery: Redefining Targeted Drug Conjugates In Oncology, Keon Niles Jafari, Charlene Chai, Shelby Kim, Kamaljit Kaur

Pharmacy Faculty Articles and Research

Targeted drug delivery (TDD), specifically through targeting ligand–drug conjugates, has reshaped oncology by enabling selective delivery of cytotoxic payloads to cancer cells while minimizing uptake by normal tissues. A key approach relies on exploiting overexpressed cell surface receptors (CSRs) to enable selective uptake of drug conjugates via receptor-mediated endocytosis. This review delineates four clinically validated CSRs (HER2, Trop-2, Nectin-4, and SSTR2) with several FDA-approved drug conjugates. Furthermore, emerging CSRs (EGFR, DLL3, and keratin 1) that may support next-generation TDD platforms for cancer treatment are also highlighted. We discuss how CSR type, density on cancer cells, and its mechanism of endocytosis, …

Neonatal Sepsis: Empiric Treatment And Monitoring Of Gentamicin Troughs In The Nicu, Aleese Palfreyman

Annual Research Symposium

No abstract provided.

Unlocking Hope: Mirtazapine's Promise In Obsessive-Compulsive Disorder Treatment, Rebecca K. Hicks, Iram Kingson, Jordan Gaal, Suzanne Holroyd

Marshall Journal of Medicine

Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). While selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are first-line treatments for OCD, a significant proportion of patients remain refractory to these interventions. Mirtazapine, an atypical antidepressant with unique pharmacological properties, has emerged as a potential adjunctive therapy for treatment-resistant OCD. This review synthesizes existing evidence regarding the efficacy and safety profile of mirtazapine in OCD management. We analyze clinical trials, observational studies, and case reports, distinguishing high- vs. low-quality evidence, and discuss mechanisms underlying mirtazapine's therapeutic effects. Additionally, …

Fda Approval Of The Eversense 365 Continuous Glucose Monitoring System: A New Era In Long-Term Glucose Monitoring, Kiley Devoll, Alexander Defranco, Kennedy Kosikowski, Anna Spalvieri, Macy Davis, Connor Dains, Brenna Hissong, Emily Eddy

Pharmacy and Wellness Review

Eversense 365 is an implantable continuous glucose monitoring (CGM) system designed to provide accurate glucose measurements for up to 365 days. Current clinical guidelines recommend CGM use for patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), with evidence demonstrating benefit in patients with T2DM regardless of concurrent insulin use. Healthcare providers play a key role in patient education and are well-positioned to support the adoption of long-term CGM technologies, including Eversense 365. The safety and efficacy of the 365-day CGM have been evaluated across a series of clinical trials, which demonstrate clinically meaningful improvements in …

Grover's Disease: A Review Of The Current Treatment Options, Dustin Ross, Dmsc, Mph, Pa-C

Lynchburg Journal of Medical Science

Grover’s disease, also known as transient acantholytic dermatosis, is an uncommon dermatologic condition characterized by pruritic papulovesicular eruptions that predominantly affect the trunk of older adults. Although the disease is often self-limited, it may significantly impair quality of life. This review summarizes treatment options and emerging therapies for Grover’s disease reported in the literature since 2019. A comprehensive search of PubMed and MEDLINE identified 1,068 records, of which thirteen publications met inclusion criteria, including one systematic review, one narrative review, one nonrandomized controlled study, nine case reports, and one fact sheet, representing a total of 337 patients. The literature demonstrates …

Evaluation Of Peptides And Peptide–Doxorubicin Conjugates Designed And Synthesized For Targeting Triple-Negative Breast Cancer Via Cell-Surface Receptors, Shih-Jing (Jane) Yao

Pharmaceutical Sciences (PhD) Dissertations

A significant problem faced in oncology is the lack of chemotherapeutic agents that are tumor site-specific, resulting in reduced therapeutic efficacy and unintended infliction of harm to surrounding healthy tissues and cells that often lead to serious side effects. Current strategies being explored to circumvent this issue aim to refine delivery of  chemotherapeutic agents specifically to tumor sites, which may be achieved via conjugation of these agents to biomarker-specific ligands. This forms the foundation of ligand-targeted drug delivery. Among different breast cancers, treatment of the triple-negative breast cancer (TNBC) subtype has been particularly challenging, largely due to the absence of …

The Effects Of Antidepressant Medications On Sleep Quality In Dominican University Of California Students, Natalie L. Davis, Kenna Wohlford, Stephanie Lee

Physician Assistant Studies | Graduate Research Papers

We spend approximately one third of our life time sleeping or attempting to sleep. The quality of our sleep is equally, if not more important than the amount of sleep we get. This study assesses the effects that medications, specifically antidepressants, can have on sleep quality in Dominican University of California students. 118 participants completed a Qualtrics survey including questions regarding stress, sleep quality, medication lists, and demographics. This study utilized the Pittsburgh Sleep Quality Index (PSQI) to quantify participants’ sleep quality as the outcome. Participant stress levels were assessed with a Likert scale question asking for stress levels on …

Proteome-Based Identification And Validation Of Nxpe3 In Childhood Acute Lymphoblastic Leukaemia, Najia Tabassum, Yamna Khurshid, Basir Syed, Aftab Ahmad, Sadia Muhammad, Rehan Imad, Talat Mirza

Pharmacy Faculty Articles and Research

Background: Childhood acute lymphoblastic leukaemia (cALL) tends to metastasize to central nervous system. Treatment with antileukemic agents against CNS leukaemia is an essential component for cure in ALL. Hence, it is essential to identify biomarkers for CNS infiltration. Proteomics, supported by mass spectrometry, is the platform for exploring biomarkers in various biological samples, contributing to translational research. Objectives: This study aimed to identify the plasma proteome profile of children across different risk groups of cALL. Neurexophilin and PC-esterase family, member 3 (NXPE3), was validated. The protein-protein interactions (PPI) of NXPE3 were evaluated with bioinformatics analyses. Methods: Plasma …

Implementing A Standardized App-Led Multidisciplinary Medication Review And Reconciliation To Improve Medication Safety Before Systemic Cancer Therapy: An Ambulatory Oncology Quality Improvement Initiative, Sarah R. Hines

DNP Projects

Background

Adult patients initiating systemic cancer therapy frequently present with pre-existing polypharmacy related to chronic comorbidities and cancer-related symptom management. The addition of anticancer therapies and supportive care medications further increases medication burden and the risk of medication-related harm. Although national organizations and institutional policies recommend comprehensive medication review before treatment initiation, implementation remains inconsistent in ambulatory oncology practice.

Purpose

To implement and evaluate a standardized Advanced Practice Provider (APP)-led multidisciplinary medication review and reconciliation process designed to identify medication medication-related safety risks before initiation of systemic cancer therapy in adult oncology patients receiving care in an ambulatory infusion center. …

Selenium Nanoparticles As Versatile Delivery Tools, Amir Nasrolahi Shirazi, Rajesh Vadlapatla, Ajoy Koomer, Kyle Yep, Keykavous Parang

Pharmacy Faculty Articles and Research

Selenium nanoparticles (SeNPs) have emerged as promising metal-based nanoparticles for drug delivery due to their unique physicochemical properties, intrinsic bioactivity, and biocompatibility. SeNPs offer a lower toxicity, higher bioavailability, and flexibility to be customized for surface chemistry compared to traditional selenium compounds. Advances in synthetic strategies, including chemical reduction, green biosynthesis, and surface functionalization with polymers, peptides, or ligands, have improved their stability, targeting capability, and circulation time. SeNP-based systems have demonstrated unique anticancer, antimicrobial, and anti-inflammatory activities, as they can function as drug carriers and active therapeutic agents. The surface of SeNPs has been functionalized with ligands such as …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Evaluating Perceptions Of Clinical Sports Pharmacists: Insights From An Orthopedic Clinic Survey, Brandon K. Welch, Sara Panella, Michael Swartzon, Eli Friedman, Samantha Cossin

Nursing & Health Sciences Research Journal

Introduction: Athletes have unique pharmaceutical needs due to injury risk, supplement use, and anti-doping regulations. Despite this, pharmacists remain underutilized in sports medicine. This quality improvement project evaluated clinician and staff perceptions of clinical sports pharmacists at Baptist Health, a large healthcare system in South Florida.

Methods: A 12-question REDCap survey was distributed to 19 staff and clinicians— including physicians, athletic trainers, and medical assistants—across five Baptist Health Orthopedic and Sports Medicine clinics. Responses were measured using a Likert scale and analyzed using descriptive statistics and thematic analysis.

Results: The survey achieved a 100% response rate. Most participants had over …

Swollen Lymph Node Metastasis In Gastric Cancer: A Forgotten Prognostic Signal In Need Of Clinical Action, Keykavous Parang, Amir Nasrolahi Shirazi

Pharmacy Faculty Articles and Research

Gastric cancer (GC) remains a leading cause of cancer mortality. While the extent of nodal involvement is a well-known prognostic factor, the specific entity of swollen lymph node metastasis (SLNM), bulky nodal tumor deposits detectable radiologically or pathologically, has received little attention in staging. Recent data from a study by Cui et al demonstrated that SLNM is an independent predictor of very poor survival in GC. Through robust data and rigorous propensity-matched analyses, SLNM emerged not merely as an anatomical finding but as an independent predictor of poor prognosis, even among patients undergoing curative resection. As precision oncology advances, the …

Inflammation And Detection: Rethinking The Biomarker Landscape In Gastric Cancer, Keykavous Parang, Koosha Paydary

Pharmacy Faculty Articles and Research

Gastric carcinoma is a leading cause of cancer-related mortality worldwide, yet reliable noninvasive biomarkers for its early detection remain limited. As research continues to elucidate the inflammatory underpinnings of tumor initiation and progression, it has become increasingly clear that pro-inflammatory cytokines may hold promise as diagnostic adjuncts. Serum cytokines such as interleukin (IL)-1β, IL-6, IL-8, and interferon-gamma have been frequently reported as elevated in gastric cancer patients compared to healthy individuals. These molecules, known for their roles in modulating tumor-promoting inflammation, angiogenesis, and immune evasion, may serve as accessible indicators of disease presence or progression. Several studies have shown that …

The 9th Annual Lafora Science Symposium: A Rare Epilepsy Community Makes Progress Towards Clinical Readiness, Meredith I. Williams, Katherine J. Donahue, Pascual Sanz, Souad Messahel, Jose M. Serratosa, Jordi Duran, Roberto Michelucci, Lorenzo Muccioli, Antonio Delgado-Escueta, Viet-Hong Nguyen, Berge A. Minassian, Matthew S. Gentry

Pharmacy Faculty Articles and Research

Lafora disease (LD) is a fatal childhood progressive myoclonus epilepsy and glycogen storage disease that is caused by recessive mutations in either EPM2A or EPM2B. The hallmarks of LD are cytoplasmic, aberrant glycogen-like aggregates, called Lafora bodies (LBs), that drive disease progression. The 9th Annual Lafora Science Symposium was held in San Diego, California and brought together over 70 researchers, clinicians, academic trainees, and friends and family members of patients with LD and 80 attendees joined virtually. This symposium focused primarily on international collaborations for therapeutic development and biomarker identification and strategies for preparing the Lafora community for upcoming …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Use Of Naltrexone For Treating Binge Eating And Food Obsession Related To Trauma: A Case Report And Literature Review, Rebecca K. Hicks, Iram Kingson, Jordan Gaal, Suzanne Holroyd

Marshall Journal of Medicine

Impulse-control disorders, including those related to eating behaviors, are complex conditions with limited pharmacologic treatment options. While naltrexone is primarily used for opioid and alcohol dependence, emerging research suggests it may also be effective in managing a variety of impulse-driven conditions. As a pure opioid antagonist, naltrexone’s mechanism of action involves the inhibition of opioid receptors on dopaminergic neurons involved in the reward pathway of the brain, thereby reducing the reinforcing effects of substances such as alcohol and opioids. Research suggests that through this mechanism of action, naltrexone shows promise in treating impulsive behaviors also driven by the reward pathway, …

Combination Of Irreversible Electroporation And Clostridium Novyi-Nt Bacterial Therapy For Colorectal Liver Metastasis, Zigeng Zhang, Guangbo Yu, Qiaoming Hou, Farideh Amirrad, Sha Webster, Surya M. Nauli, Jianhua Yu, Vahid Yaghmai, Aydin Eresen, Zhuoli Zhang

Pharmacy Faculty Articles and Research

Colorectal liver metastasis (CRLM) poses a significant challenge in oncology due to its high incidence and poor prognosis in unresectable cases. Current treatments, including surgical resection, systemic chemotherapy, and liver-directed therapies, often fail to effectively target hypoxic tumor regions, which are inherently more resistant to these interventions. This review examines the potential of a novel therapeutic strategy combining irreversible electroporation (IRE) ablation and Clostridium novyi-nontoxic (C. novyi-NT) bacterial therapy. IRE is a non-thermal tumor ablation technique that uses high-voltage electric pulses to create permanent nanopores in cell membranes, leading to cell death while preserving surrounding structures, and …

Targeting Neuronal Nitric Oxide Synthase (Nnos) As A Novel Approach To Enhancing The Anti-Melanoma Activity Of Immune Checkpoint Inhibitors, Anika R. Patel, Shirley Tong, Kate Alison Lozada, Amardeep Awasthi, Richard B. Silverman, Jennifer Totonchy, Sun Yang

Pharmacy Faculty Articles and Research

Background and Objectives: Neuronal nitric oxide synthase (nNOS) overexpressed in melanoma plays a critical role in disease progression. Our previous studies demonstrated that nNOS inhibitors exhibited potent anti-melanoma activity and regulated PD-L1 expressions in the presence of interferon-gamma (IFN-γ). However, the role of nNOS in the melanoma immune response has not been well defined. Methods: Changes in gene expression profiles after nNOS inhibitor treatment were determined by transcriptomic analysis. A melanoma mouse model was used to determine the effects of nNOS inhibition on peripheral T cells and the in vivo anti-tumor activity of combining nNOS inhibitors with immune …