Pharmacology and therapeutic implications of current drugs for type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a global epidemic that poses a major challenge to health-care systems. Improving metabolic control to approach normal glycaemia (where practical) greatly benefits long-term prognoses and justifies early, effective, sustained and safety-conscious intervention. Improvements in the understanding of the complex pathogenesis of T2DM have underpinned the development of glucose-lowering therapies with complementary mechanisms of action, which have expanded treatment options and facilitated individualized management strategies. Over the past decade, several new classes of glucose-lowering agents have been licensed, including glucagon-like peptide 1 receptor (GLP-1R) agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors and sodium/glucose cotransporter 2 (SGLT2) inhibitors. These agents can be used individually or in combination with well-established treatments such as biguanides, sulfonylureas and thiazolidinediones. Although novel agents have potential advantages including low risk of hypoglycaemia and help with weight control, long-term safety has yet to be established. In this Review, we assess the pharmacokinetics, pharmacodynamics and safety profiles, including cardiovascular safety, of currently available therapies for management of hyperglycaemia in patients with T2DM within the context of disease pathogenesis and natural history. In addition, we briefly describe treatment algorithms for patients with T2DM and lessons from present therapies to inform the development of future therapies

Have lichenized fungi delivered promising anticancer small molecules?

This review, covering the literature from 1844 to present (end 2017), probes questions concerning small molecule metabolites derived from lichens (lichenized fungi) and their impact in terms of providing compounds with significant promise in oncology. The review gives an overview of lichenized fungi and summarizes the classes of compounds obtained as metabolites from these organisms. A definition of what characteristics an actual “promising” anticancer compound should possess is also delineated. The review reports a brief overview on human cancer and then goes into depth in listing compounds with so-called “anticancer properties” that have been isolated from lichenized fungi, according to their small molecule structural classes. Five “most promising” compounds are discussed in-depth, also considering the possibility of obtaining sufficient amounts for further investigations