Therapeutic role

Theovent The 0x0 process Therapeutic agents Therapeutic enzymes Therapeutic lenses Therapeutic role Therbar Therm-8 Thermal analysis... 

The possibility still exists that selective COX-2 inhibitors may be used to treat cancer if the beneficial effect outweighs the side effects. They may also have a therapeutic role in treating premature labour, since labour is induced partly through the uterotonic effect of PGs synthesised by COX-2. Non-selective NSABDs such as indomethacin will also delay premature labour but they are contraindicated for this condition since they also cause early closure of the ductus arteriosus through inhibition of COX-1, which synthesises PGs maintaining patency of the ductus [5]. 

Abu J, Batuwangala M, Herbert K et al (2005) Retinoic acid and retinoid receptors potential chemopreventive and therapeutic role in cervical cancer. Lancet Oncol 6 712-720... 

CB2 receptor antagonists have received much less attention than their CBi counterparts, with only a relatively small number of compounds available and less clarity on their potential therapeutic role. A selection of the available compounds that have been shown to act as antagonists of the CB2 receptor and their suggested utilities will be covered in this section. 

Iwamura and Ueda [386] described compound (611) as a CB2 selective inverse agonist in a patent application. The potential therapeutic roles of CB2 antagonists are not clearly defined at the moment, although roles in regulation of the immune system and inflammation have been widely proposed. This patent application describes that activity of compound (611) in a mouse model of asthma, in which the compound suppressed immediate and late-phase asthmatic response and airway hyper-responsiveness. 

Niacin should be instituted at the lowest dose and gradually titrated to a maximum dose of 2 grams daily for ER and SR products and no more than 5 grams daily for IR products. FDA-approved niacin products are preferred because of product consistency. Moreover, niacin products labeled as no flush don t contain nicotinic acid and therefore have no therapeutic role in the treatment of lipid disorders.28 The time until maximum effect on lipids for niacins is generally 3 to 5 weeks. 

In conclusion, there is no doubt that IL-6 is produced massively and released to the circulation during sepsis. However, the significance of IL-6 levels and the therapeutic role of anti-IL-6 are still unclear. 

Treatment options include radiation therapy, chemotherapy, or both (combined-modality therapy). The therapeutic role of surgery is limited, regardless of stage. 

Soft fi-blockers have a particular therapeutic role to play, accounting for the amount of attention they have received. For example, a comprehensive study of ca. 80 analogues of general structure 7.64 has established the in vitro and in vivo activity of many of these compounds and confirmed that their enzymatic hydrolysis is highly sensitive to structural effects [137]. Here, the labile moiety is incorporated into the side chain, with the consequence that hydrolysis destroys the pharmacophore. 

A second line of research in this area has demonstrated an AchE inhibitory effect of withanolides in vitro. More studies are needed to assess their exact mechanisms of action and extent of utility in AD as human trials are lacking. Nevertheless, these investigations do demonstrate the potential for a therapeutic role of withanolides/withanamides in both protecting against amyloid neuronal pathology and in AchE inhibition. ... 

Coenzyme QIO (21) is one of the essential enzymes in the mitochondrial electron transport chain, participating in the aerobic respiration cycle. The role of Co-QlO as a cardioprotective substance and an antioxidant are well studied. Recently, it was found that Co-QlO is also capable of attenuating the intracellular deposition of Ap in transgenic AD mouse models. Additionally, the same group reported that Co-QlO administration also led to reduction of preexisting plaque burden in the same model. Such properties are suggestive of a potential therapeutic role for Co-QlO in AD. 

Neurodegenerative diseases are generally characterized by the death of specific neuronal populations. Many such neurons are responsive, in vitro at least, to one or more neurotrophic factor. This infers a potential therapeutic role for these molecules in the treatment of such conditions (Table 7.11). Lack of current effective therapies for the treatment of any neurodegenerative disease renders this avenue of investigation even more attractive. Target diseases include amyotrophic lateral sclerosis and peripheral neuropathies, as well as various neurodegenerative diseases of the brain, including Alzheimer s and Parkinson s. 

Historically choline, inositol and carnitine have been considered to be part of the vitamin B complex. However, for the general population there has been no demonstration of a dietary need for these agents and also for none of them has there been a therapeutic role established. Vitamins of the B family are found in many food ingredients like in yeast, in meat, in dairy products and also in eggs and grain cereals and separate vitamin B deficiencies are unlikely to occur. Excessive intake of these vitamins is eliminated in the urine because of the fact that they are water-soluble. 

In an early study, Insel et al. [1983b] compared the efficacy of CMI with that of clorgiline, a monoamine oxidase-A inhibitor, in a controlled crossover study of patients with OCD. Although CMl was effective, patients on clorgiline did not improve at all. Vallejo et al. [1992] conducted a controlled clinical trial of the efficacy of CMl and phenelzine in 30 patients with OCD. The authors reported improvement in both groups however, the lack of a placebo control and the small size of the study groups limit the applicability of these findings. Further studies on the therapeutic role of monoamine oxidase inhibitors in OCD, especially in OCD with comorbid panic disorder, are warranted. 

The PA4 peptide and an excessive amount of APP have proved to be neurotoxic. The accumulation of the pA4 peptide between synapses may be responsible for neuronal dysfunction and death (Schubert et al. 1991). PA4 could also modify the N-methyl-D-aspartate (NMDA) receptor, making possible the presence of neurotoxicity via the excitotoxin and calcium pathways [Mattson et al. 1992). Drugs that interfere with these pathways or alter calcium homeostasis have a potential therapeutic role. 

Another therapeutic role for estrogens is in the treatment of cancer. In androgen-dependent prostate carcinoma, estrogens are used therapeutically to suppress androgen formation and thus tumor growth. Estrogens are also used to treat inoperable breast cancer in men and postmenopausal women. However, antiestrogens, such as tamoxifen, have fewer side effects and are usually preferred (see section 5.8.4). 

Although steroids have been studied for many years, steroid hormones continue to be a rich area of medicinal chemistry study. Steroids continue to be evaluated for their therapeutic role in the treatment of cancer, especially malignancies whose growth characteristics are hormonally responsive. In recent years, the increased recognition of the role of steroids in the brain has resulted in ongoing projects to evaluate steroids as general anasthetics and anticonvulsants. Also, the search for compounds that bind to steroid receptors, but which are not steroidal in their molecular structure, is another important area of research. 

IFN-a2 may have a therapeutic role in both B- and T-cell lymphomas, IFN-a2 (50 X 10 units/m administered three times a week) was effective in 45% of patients with advanced cutaneous T-ceU lymphomas, with responses lasting from 3 to 25 months... 

Numerous compounds capable of antagonising the effects of histamine are available. The main therapeutic role of these drugs is in the treatment of allergic diseases involving IgE-mediated hypersensitivity, such as allergic rhinitis, hay fever, and urticaria (Table 15.2). The main Table 15.2 Clinical uses of Hlantagonists... 

Martel-Pelletier J et al Therapeutic role of dual inhibitors of 5-LOX and COX, selective and non-selective non-steroidal antiinflammatory drugs. Ann Rheum Dis 2003 62 501. [PMID 12759283]... 

In contrast to the adverse physiologies associated with bradykinin release, there is a growing body of literature that implicates bradykinin as a protective agent during periods of cardiac or renal stress [14-16]. In this regard there is substantial evidence that the cardioprotective effects afforded by ACE-inhibitor treatment are a result of metabolically preserving bradykinin and are therefore mediated by bradykinin B2 (and possibly 1) receptors [17-18]. These results point to a possible therapeutic role for a kinin receptor agonist. 

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