Medical Pharmacology Commons^™

Tc-Ptp Enhances Cordycepin-Induced Apoptosis In Human Pancreatic Cancer Cells, Olivia Samaie, Rodrigo Vidales, Lindsey Shim, Murali M. Yallapu, Subhash C. Chauhan, Mushfiq Hassan Shaikh, Dae Joon Kim

Research Colloquium

Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy marked by early metastasis, dense desmoplastic stroma, and profound resistance to conventional therapies. Despite the development of combination regimens such as gemcitabine and FOLFIRINOX, outcomes remain dismal, with median survival under one year for metastatic cases. This underscores the urgent need for novel therapeutic approaches that target multiple pathways simultaneously. T-cell protein tyrosine phosphatase (TC-PTP) is one of nonreceptor PTPs that negatively regulates oncogenic signaling pathways, particularly STAT3 and AKT, both of which are constitutively active in many solid tumors. Cordycepin, a nucleoside analogue derived from Cordyceps militaris, has …

Systemic Vascular Dysregulation And Retinal Microvascular Alterations In Glaucoma, Amin Ibrahim, Tori Sayers, Alexa Nichols, Igor Zwir, Andrew Tsin, Lorena Flores-Hernandez, Gladys E. Maestre, Jesus D. Melgarejo

Research Colloquium

Background: Glaucoma is a multifactorial, progressive optic neuropathy, for which both mechanical and vascular mechanisms of pathogenesis have been proposed. Optical coherence tomography angiography (OCTA) enables noninvasive visualization of the choroidal and retinal vasculature and may be used to quantify vascular changes associated with glaucoma. Systemic risk factors, including variations in blood pressure (BP), whether low or elevated, have been associated with the vascular pathogenesis of glaucoma. This systematic review aims to synthesize the current evidence on the relationship between systemic vascular dysregulation and OCTA-derived retinal vascular markers in glaucomatous eyes.

Methods: Following PRISMA guidelines, we conducted a systematic search …

Synthesis, Pharmacokinetic Studies, And Metabolite Analysis Of Meridianin C In Rats Using A Validated Ultra High Performance Liquid Chromatography-Tandem Mass Spectrometry Method, Liangyu Xu, Zhaogen Wu, Karna Ramachandraiah, Guihun Jiang, Guozhe Zhang

School of Graduate Studies Faculty Publications

Introduction: Meridianin C (MC) is a marine-derived indole alkaloid that has demonstrated kinase inhibitory and anti-tumor activities. Despite its diverse biological properties, no previous reports have systematically evaluated the in vivo quantitative analysis of MC and its metabolites. Methods: In this study, MC was synthesized following a previously reported procedure with slight modifications. A sensitive, accurate, and reliable ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC–MS/MS) method was developed to simultaneously detect MC and its five major metabolites (MC-1-N-O-GluA, MC-1-N-O-SO3H, MC-2′-N-O-GluA, MC-2′-N-O-SO3H, and MC-O-GluA-didehydration) in rat plasma. Rats received a single oral dose of MC (100 mg/kg), and pharmacokinetic analysis was …

Emerging Clinical Role Of Tavapadon, A Novel Dopamine Partial Agonist, In The Treatment Of Parkinson’S Disease, Alan D. Kaye, Bennett M. Ford, Brennan M. Abbott, Kalob M. Broocks, Sofia Novacic, Sahar Shekoohi

School of Medicine Faculty Publications

Tavapadon, a novel oral dopamine-D1R/D5R partial agonist, has been studied in recent years for the treatment of late-stage development Parkinson’s disease (PD). Levodopa, a dopamine precursor that currently remains the gold-standard first-line therapy for PD motor symptoms, serves as a benchmark against emerging dopaminergic agents. By selectively activating D1-family receptors on direct-pathway medium neurons, Tavapadon differs in that it delivers levodopa-level motor benefit while avoiding its many D2R/D3R-mediated adverse effects. In placebo-controlled trials, Tavapadon produced clear, clinically meaningful gains in motor function and day-to-day activities, as captured by the Unified Parkinson’s Disease Rating Scale (UPDRS). Recent late-stage results have revealed …

Deep Learning-Driven Proteomics Analysis For Gene Annotation In The Renin-Angiotensin System, Mortaza Eivazi, Kamran Hosseini, Shahin Alipanahi, Huijing Xia, Luke Restivo, Ayushi Patel, Mahdieh Gozali, Tahereh Ebrahimi, Amy Scarborough, Vahideh Tarhriz, Eric Lazartigues

School of Medicine Faculty Publications

The renin-angiotensin system (RAS) is central to cardiovascular diseases such as hypertension and cardiomyopathy, yet the functions of many RAS genes remain unclear. This study developed a multi-label deep learning model to systematically annotate RAS gene functions and elucidate their roles in biological pathways. A total of 39,463 RAS-related publications from PubMed and PMC were processed into text format. Feature matrices were generated using TF-IDF and token processing, followed by dimensionality reduction via Principal Component Analysis (PCA). A Multi-Layer Perceptron (MLP) was applied for multi-label classification, with performance evaluated using Precision, F1-Score, Ranking Loss, and ROC-AUC metrics. The model outperformed …

Subtype-Specific Her3 Enrichment In Basal-Like Breast Cancer Is Regulated Via The Gata2/Gata3–Foxa1 Axis, Congcong Tan, Hui Lyu, Sanbao Ruan, Yakun Wu, Margaret E. Larsen, Shou Ching Tang, Bolin Liu

School of Medicine Faculty Publications

Basal-like breast cancer (BLBC) is a major subtype of triple-negative breast cancer (TNBC), characterized by aggressive behavior, limited treatment options, and poor prognosis. While HER3 overexpression is frequently observed in TNBC and associated with poor outcomes, its subtype-specific expression and therapeutic potential remain unclear. Here, we demonstrated that HER3 signaling is selectively hyperactivated in BLBC compared to claudin-low breast cancer (CLBC) using transcriptomic profiling. Histone deacetylase inhibitors (HDACi), Romidepsin and Panobinostat, exerted potent antitumor effects on BLBC by selectively downregulating HER3 expression. HER3 levels were positively correlated with FOXA1, a key transcriptional activator. Mechanistically, we identified GATA2 and GATA3 as …

A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel

HCA Healthcare Journal of Medicine

Constipation is a common condition among geriatric patients with different presenting symptoms and potential serious complications. Additionally, the condition causes a significant burden on our healthcare system. Here, we summarized recommendations from several societies, including the American College of Gastroenterology, American Geriatrics Society, and American Academy of Family Physicians to provide guidance on managing constipation with geriatric patients. Our aim was to emphasize the importance of prevention of constipation in this population and methods to do so. We also give recommendations on how to manage constipation when it does develop and how to manage it across different healthcare settings. These …

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 …

Hydrogen Sulfide Deficiency And Therapeutic Targeting In Cardiometabolic Hfpef: Evidence For Synergistic Benefit With Glp-1/Glucagon Agonism, Jake E. Doiron, Mahmoud H. Elbatreek, Huijing Xia, Xiaoman Yu, Natalie D. Gehred, Tatiana Gromova, Jingshu Chen, Ian H. Driver, Naoto Muraoka, Martin Jensen, Smitha Shambhu, W. H.Wilson Tang, Kyle B. Lapenna, Thomas E. Sharp, Traci T. Goodchild, Ming Xian, Shi Xu, Heather Quiriarte, Timothy D. Allerton, Alexia Zagouras, Jennifer Wilcox, Sanjiv J. Shah, Josef Pfeilschifter, Karl Friedrich Beck, Thomas M. Vondriska, Zhen Li, David J. Lefer

School of Graduate Studies Faculty Publications

Heart failure with preserved ejection fraction (HFpEF) presents significant treatment challenges. We assessed hydrogen sulfide (H2S) bioavailability in HFpEF patients and 2 animal models: the "2-hit" L-NAME + high-fat diet mouse model and ZSF1 obese rats. H2S levels were significantly reduced in patients and both models, linked to decreased cystathionine-γ-lyase expression and increased sulfide quinone oxidoreductase. Cystathionine-γ-lyase knockout worsened HFpEF, whereas pharmacological supplementation with an H2S donor improved diastolic function and reduced cardiac fibrosis. H2S supplement synergized with GLP-1/glucagon agonist and ameliorated HFpEF. These findings suggest that enhancing H2S bioavailability may provide a novel therapeutic strategy for HFpEF.

Nuak Kinases: Signaling Mechanisms And Therapeutic Applications, Nicole M. Cullen, Peter Rosston, Bakhtawar Tufail, Anne E. D'Armond, Ayushi Patel, Dara H. Khosravi, Bridgette M. Collins-Burow, Van T. Hoang, Elizabeth C. Martin, David H. Drewry, Matthew E. Burow, Suresh K. Alahari

School of Medicine Faculty Publications

The novel (nua) kinases 1 and 2 are two of 12 AMP-activated protein–related kinases whose signaling pathways are involved in cancer progression, as well as neurologic, fibrotic, and inflammatory diseases. Currently, there are 80 Food and Drug Administration-approved kinase inhibitors which target roughly 24 of the 500+ known human kinases, leaving most kinases underexplored, including NUAK1 and NUAK2. Thus, there is a critical need for selective inhibition of NUAK1 and NUAK2 signaling. Here, we review the protein structure, known upstream regulators and downstream targets, and expression profiles of NUAK1 and NUAK2 in cancerous compared to noncancerous tissue. We also delineate …

Immunopathogenic Crosstalk Between Cancer And The Kidney: A Central Role For Macrophages As Potential Mediators., Dana Hammouri

Electronic Theses and Dissertations

Cisplatin remains a mainstay in the treatment of solid tumors, yet its therapeutic efficacy is frequently compromised by dose-limiting nephrotoxicity. Approximately 30% of patients receiving cisplatin develop acute kidney injury (AKI), which increases the risk of chronic kidney disease (CKD), a leading cause of morbidity and mortality. Despite extensive preclinical efforts, no FDA-approved therapy currently exists to prevent or treat cisplatin-induced nephrotoxicity (CIN). This in part is due to the reliance of preclinical studies on non-cancer animal models that fail to capture the complex physiological alterations associated with malignancy. To address this limitation, we developed a clinically relevant model in …

Complications And Management Of Idiopathic Multicentric Castleman Disease, Kavanya Feustel, Jacob W. Keeling, Olivia Makos, Dmitriy Scherbak

HCA Healthcare Journal of Medicine

Background

The pathophysiology of idiopathic multicentric Castleman disease (iMCD) is poorly understood compared to the other subtypes of MCD, which has contributed to limited treatment options and poor prognosis for iMCD patients. The pathogenesis of iMCD is thought to be mediated in part by dysregulation of interleukin (IL)-6.

Case Presentation

We present a case report of a 39-year-old Caucasian man with siltuximab-refractory iMCD. He presented with severe lower extremity lymphedema and wounds. His disease progressed through standard-of-care siltuximab. Due to his severe disease-related morbidity, he contracted recurrent infections, often complicated by sepsis. Ultimately, he required a left lower extremity amputation. …

Targeting Obesity: The Role Of Glp-1 Receptor Agonists In Achieving Sustainable Weight Loss, Brad Vamplew

Lynchburg Journal of Medical Science

This review critically evaluates the effectiveness of glucagon-like peptide-1 receptor agonist pharmacotherapy in managing obesity. Obesity is a health epidemic that affects 100 million Americans, and it puts individuals at higher risk for numerous health comorbidities over a lifetime. A comprehensive literature review was completed by utilizing PubMed and its clinical queries function to locate relevant research. The research information was narrowed down with a focus on obesity management and glucagon-like peptide-1 receptor agonists for therapy. Numerous current clinical studies and trials were incorporated into this review. Many clinical trials substantiated the benefits of this pharmacotherapy for the management of …

Concurrent Use Of Skeletal Muscle Relaxants And Nsaids In Low Back Pain Management: A Critical Review Of Current Evidence And Future Directions, Rupesh A. Saindane, Nilima A. Thombre

The Thai Journal of Pharmaceutical Sciences

Low back pain (LBP) represents a leading cause of non-fatal disability globally. Its high prevalence and disabling nature highlight the urgent need for effective management strategies. The exact cause of LBP still remains unclear, and thus, its treatment remains symptomatic. LBP is commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs). These agents are frequently used in combination to target both inflammation and muscle spasms. However, the clinical guidelines vary widely on the recommendation for the use of such combination therapy. The present review evaluates evidence from randomized clinical trials and systematic reviews on the concurrent use …

Topical Lifitegrast Therapy For Dry Eye Disease, Lama Assi, Salim C. Lutfallah, Tsz Wing Yim, Su Hsun Liu, Sharon J. Duffy, Jayne Weiss

School of Medicine Faculty Publications

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effectiveness and safety of topical lifitegrast therapy alone or in combination with artificial tears, compared with a placebo, artificial tears alone, or no treatment for dry eye disease.

Comparative Impact Of Thiazides Vs. Dihydropyridines On Heart Failure Risk In Hypertensive Patients: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Safaa M. Alsanosi, Yosra Z. Alhindi

Saudi Toxicology Journal

Background: Uncontrolled hypertension (HTN) is a progressive condition that significantly elevates the risk of heart failure (HF). The selection of antihypertensive agents plays a critical role in modulating HF risk. Thiazide diuretics and dihydropyridine calcium channel blockers (DHPs) are frequently utilized in clinical practice, yet their comparative long-term cardiovascular outcomes, particularly regarding HF incidence, remain underexplored. Methods: A systematic literature review was undertaken, drawing four key databases—MEDLINE, EMBASE, Web of Science, and Cochrane—covering the period from 1994 to October 2024. The scope was limited to randomized controlled trials (RCTs) evaluating thiazides or DHPs, with a minimum of 100 participants diagnosed …

Renal Denervation Improves Cardiac Function And Exercise Duration In A Miniswine Model Of Heart Failure With Preserved Ejection Fraction, David J. Lefer, Thomas E. Sharp, Amy L. Scarborough, Amelia G. Haydel, Sanjiv J. Shah, Zhen Li, Traci T. Goodchild

School of Medicine Faculty Publications

Aims: Overactivity of the sympathetic nervous system is a common underlying mechanism in development and progression of several heart failure with preserved ejection fraction (HFpEF) comorbidities. Decreasing renal sympathetic nerve activity using catheter-based renal denervation (RDN) systems have shown efficacy in treating resistant hypertension and cardiac dysfunction in heart failure with reduced ejection fraction. The purpose of this study was to determine if modulation of renal sympathetic nerve activity by RDN improves cardiac function and exercise tolerance in a clinically-relevant minipig model of cardiometabolic HFpEF. Methods and results: Multiple HFpEF comorbidities were induced in adult female Göttingen minipigs by mineralocorticoid …

Current Paradigm And Futuristic Vision On New-Onset Diabetes And Pancreatic Cancer Research, Russell Moreland Iii, Abigail Arredondo, Anupam Dhasmana, Swati Dhasmana, Shabia Shabir, Asfia Siddiqua, Bonny Bannerjee, Murali Yallapu, Stephen Behrman, Subhash Chauhan, Sheema Khan

School of Medicine Publications

New-onset diabetes (NOD) has emerged as a potential early indicator of pancreatic cancer (PC), necessitating a refined clinical approach for risk assessment and early detection. This study discusses critical gaps in understanding the NOD-PC relationship and proposes a multifaceted approach to enhance early detection and risk assessment. We present a comprehensive clinical workflow for evaluating NOD patients, incorporating biomarker discovery, genetic screening, and AI-driven imaging to improve PC risk stratification. While existing models consider metabolic factors, they often overlook germline genetic predispositions that may influence disease development. We propose integrating germline genetic testing to identify individuals carrying pathogenic variants in …

Reducing Surgery For Pediatric Posttonsillectomy Hemorrhage Using Tranexamic Acid: A Quality Improvement Initiative, Laura A. Petrauskas, Janavi Sethurathnam, Ansley J. Kunnath, Rahul K. Sharma, John Ceremsak, Ryan H. Belcher, James D. Phillips, Jay A. Werkhaven, Amy S. Whigham, Lyndy J. Wilcox, Christopher T. Wootten, Frank W. Virgin, Jason S. Park

School of Medicine Faculty Publications

Objective: Evaluate the use of tranexamic acid (TXA) and observation as a management option for pediatric patients presenting with posttonsillectomy hemorrhage (PTH). Study Design: Retrospective analysis of a prospectively implemented quality improvement initiative with a historical control comparison group. Setting: Tertiary children's hospital. Methods: Patients < 18 years of age who underwent adenotonsillectomy (AT) and returned to the Emergency Department for PTH were included. Patients who were stable without large volume or active bleeding were given intravenous TXA and admitted for overnight observation. Data were compared in a before-and-after analysis: preprotocol (April 2022 to March 2023) versus postprotocol (April 2023 to March 2024). For cost-effectiveness analysis, we analyzed aggregated claims data from a commercial claims database. Results: Preprotocol 1800 adenotonsillectomies were performed, and 40 procedures were performed for control of hemorrhage (2.2 per 100 AT). Postprotocol 2356 adenotonsillectomies were performed, and 30 procedures were performed to control hemorrhage (1.3 per 100 AT) showing a significant reduction in return to the operating room (relative risk [RR] = 0.59, 95% confidence interval [CI] [0.358, 0.916], P-value.020). There were no reported adverse events attributable to TXA. An estimated 21 surgeries were avoided, and 26 additional patients were observed in the hospital during the postprotocol period, for an estimated net cost savings of $174,970. Conclusion: The implementation of a standardized TXA protocol significantly reduced the need for return to the operating room for PTH in pediatric patients, without complications and with net cost savings to the health care system.

Fda Approval Of Cobenfy: A New Therapeutic Option For Schizophrenia, Brenna Hissong, Penlope Mazivanhanga, Alexander Defranco, Linda Azap, Haley Brown, Megan Rizo, Joshua Honaker, Samantha Mccord, Lindsey Ferraro

Pharmacy and Wellness Review

Schizophrenia is a complex illness characterized by behavioral, emotional, and cognitive dysfunctions. Common symptoms include hallucinations, delusions, cognitive decline, and social withdrawal. The disorder is related to structural brain abnormalities, neurotransmitter imbalances, and a combination of genetic and environmental elements, and affects about 24 million individuals globally. Currently, two medication classes are most commonly used to treat schizophrenia. These medications are first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs). Due to the side effect profiles that both medication classes carry, research is being conducted for new drug classes.

Cobenfy (xanomeline/trospium chloride), also known investigationally as KarXT, is a new class of …