Systemic lupus erythematosus following SARS-CoV-2 vaccination; a review of literature

From March 2020, the coronavirus disease 2019 (COVID-19) pandemic challenged public health and healthcare systems worldwide. Viral infection is one of the environmental factors that has been associated with the development, relapse, or exacerbation of systemic lupus erythematosus (SLE). SLE patients are at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of immune system dysfunction related to their disease as well as immunosuppression medications. So far, the most effective way to reduce SARS-CoV-2 infection-induced hospitalization and death is vaccination. On the other hand, SLE patients present distinct challenges related to the safety and effectiveness of SARS-CoV-2 vaccination. We have reviewed some reports on the onset or flare of SLE post-COVID-19 vaccination. Of note, the mRNA COVID-19 vaccines are associated with increased SLE disease activity, more frequently than the other types of COVID-19 vaccines

Antioxidants and cisplatin nephrotoxicity; an updated review on current knowledge

Cisplatin is a first-line antitumor drug which is applied in the therapeutic field of numerous kinds of cancers. The main dose-dependent adverse effect of cisplatin is nephrotoxicity in approximately one-third of patients, who received this drug during their treatment. Oxidative stress is one of the most significant mechanisms in cisplatin nephrotoxicity. Cisplatin-induced oxidative stress stimulates apoptosis, inflammation, mitochondrial damage within cells, and endoplasmic reticulum (ER) stress. The administration of an antioxidant in this context could be a suitable approach for preventing of cisplatin nephrotoxicity. Antioxidants are categorized into four classes: dietary antioxidants, free radical scavengers, thiol-containing compounds, and iron chelators

The association between pioglitazone consumption and incidence of bladder cancer in type II diabetic patients: a systematic review and meta-analysis of observational studies

Background: Bladder cancer is the single most prevalent urinary tract malignancy in humans with a higher risk in diabetic patients. Pioglitazone is among the conventional antidiabetic drugs. The present study thus seeks to investigate the association between the administration of pioglitazone and the incidence of bladder cancer in type II diabetic patients through a meta-analysis and systematic analysis. Materials and Methods: International databases including Web of Science, Medline/PubMed, Scopus, and Google Scholar search engine were explored. To integrate the results of studies odds ratio (OR), risk ratio (RR) or hazard ratio (HR) logarithm was extracted from each study, and the I2 index or the Cochran’s Q test were conducted to examine the heterogeneities across studies. Data analysis was carried out in STATA version14 considering a significance level of p<0.05. Results: The 15 examined studies had investigated a total of 5,353,528 patients (1,536,723 patients in case groups and 3,816,805 patients in control groups). The relative risk of bladder cancer was [RR: 1.20 (95% CI: 1.09-1.32)] in pioglitazone users. Bladder cancer risk in pioglitazone users was higher by [RR: 1.14 (95% CI: 1.03-1.25)] compared to those who had never taken pioglitazone, [RR: 1.32 (95% CI: 1.02-1.70] compared to sulfonylurea users, and [RR: 1.57 (95% CI: 1.23-2)] compared to dipeptidyl peptidase-4 (DPP-4) users. Moreover, the relative risk between pioglitazone consumption and bladder cancer was reported to be [RR: 1.27 (95% CI: 0.96-1.68)] in patients with a follow-up shorter than five years and [RR: 1.24 (95% CI: 1.09-1.41)] is patients with a follow-up of five years or longer. On the other hand, the relative risk between pioglitazone consumption and bladder cancer was [RR: 1 (95% CI: 0.69-1.45)] in 50-59 age group, [RR: 1.20 (95% CI: 1.04-1.38)] in the 60-69 age group, and [RR: 1.33 (95% CI: 1.14-1.56)] in the 70-79 age group. Conclusion: Patients who receive pioglitazone had a 20% higher risk of bladder cancer compared to those who had not taken pioglitazone or prescribed other medication such as sulfonylurea and DPP-4s. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023391151)

The association between statin administration and renal cell carcinoma; a systematic review and meta-analysis

Introduction: Renal cell carcinoma (RCC) is the most prevalent renal cancer in adults, with a rising global incidence. There has long been an ambiguity about the effect of statin administration on the incidence of RCC. The present meta-analysis aims to evaluate the relationship between statin usage and RCC. Materials and Methods: Cochrane, Web of Science, Scopus, and PubMed databases, as well as the Google Scholar search engine, were queried for relevant articles. The data were statistically analyzed by STATA 14 software. The significance level of the tests was considered P < 0.05. Results: In 15 reviewed articles, 46 735 subjects used statin, and 673 752 did not. The odds ratio (OR) between statin usage and the risk incidence of RCC was 0.86 (OR: 0.86; 95% CI: 0.63, 1.17) overall and estimated as 0.94 (OR: 0.94; 95% CI: 0.69, 1.28) in males and 0.92 (OR: 0.92; 95% CI: 0.66, 1.28) in females. The odds ratio of statin administration and the incidence risk of RCC was 0.74 (OR: 0.74; 95% CI: 0.37, 1.49) in case-control and 0.96 (OR: 0.96; 95% CI: 0.79, 1.17) in cohort studies. In addition, the impact of statin usage on overall survival (OS) in RCC was 0.65 (HR: 0.65; 95% CI: 0.53, 0.80), and this relationship was statistically significant. However, the effect of statin usage was 0.68 (HR: 0.68; 95% CI: 0.45, 1.02) on progression-free survival (PFS) and 1.24 (OR: 1.24; 95% CI: 0.66, 2.32) on disease progression (DP), and these relationships were statistically non-significant. Conclusion: The OS of RCC patients was 35% higher in statin users than in non-users. However, no relationship between statin usage and the incidence risk of RCC was found. Meta-analysis Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (CRD42023393647)

Metformin protects renal tubular cells; mechanisms and new concepts

Context: The prevalence of diabetes markedly increased in recent decades. It is well accepted that the risk of morbidity and fatality increases in patients with type 2 diabetes (T2DM). Evidence Acquisition: An electronic search was performed to detect suitable studies, with keywords of metformin, prediabetes, diabetes Mellitus, Gentamicin and lactic acidosis. Results: Metformin (biguanide) is widely used as the first pharmacological option in pre-diabetic subjects and patients with T2DM. Low-cost, long-term effect, low risk of hypoglycemia, and ease in utilization are considered as significant benefits of metformin compared with other therapies. Numerous studies have explored that medicinal intervention particularly metformin administration not only can decrease high blood glucose in patients with T2DM but also can avoid or postpone the beginning of clinical T2DM in pre-diabetic cases. Protective effect of metformin on renal cells by different mechanisms is described here. Gentamicin is an important factor that affects kidney function and structure. Nephrotoxicity is one of the serious side effects of gentamicin (an aminoglycoside antibiotic). Numerous investigation showed the protective effect of metformin against the gentamicin nephrotoxicity. On the other hand, lactic acidosis is known as an uncommon but serious side effect of metformin that should be mentioned. Signs of lactic acidosis are defined by plasma lactate levels higher than 5 mmol/L and pH smaller than 7.4. Conclusions: Different small series and large experimental investigations have discovered the association between metformin and lactic acidosis summarized here

A rare testicular tumor with elevated alkaline phosphatase

Background: The majority of Leydig cell tumors (LCTs) are found in males, usually when they have 5–10 years of age. Children typically present with precocious puberty due to excessive testosterone secreted by the tumor, one-third of female patients present a recent history of progressive masculinization. Alkaline phosphatase is normally at low levels. Case Presentation: A 30-year-old male referred to the hospital with a complaint of fever, chills, nausea and weight loss, and history of diabetes mellitus type 1. In the physical examination of testis, no abnormal findings were revealed. Scrotal ultrasonography demonstrated a small (7.5 ×4.8 mm) mass which seemed to be very vascular and suggestive of neoplastic lesion. Echogenicity of the head of the right epididymis was heterogeneous and the small cyst of about 4.5 mm was present on it. Left testis had normal size and no space occupying lesion in it. The hormonal test revealed high levels of alkaline phosphatase, ferritin, FSH and LH, normal level of testosterone, LDH, β-HCG and α-feto-protein. Immunohistochemistry results revealed negative CD30, alpha-fetoprotein and CK results, but calretinin, vimentin and S-100 were positive in tumor cells. Conclusions: LCTs are rare testicular tumors arising from male gonadal interstitium and very rare in adulthood. Because this tumor consists of immature embryonic tissues it can be accompanied by an elevation in alkaline phosphatase level

Nivolumab plus ipilimumab combination therapy in cancer: Current evidence to date

Immune checkpoint inhibitors (ICIs) have revolutionized cancer immunotherapy, yielding significant antitumor responses across multiple cancer types. Combination ICI therapy with anti-CTLA-4 and anti-PD-1 antibodies outperforms either antibody alone in terms of clinical efficacy. As a consequence, the U.S. Food and Drug Administration (FDA) approved ipilimumab (anti-CTLA-4) plus nivolumab (anti-PD-1) as the first-ever approved therapies for combined ICI in patients with metastatic melanoma. Despite the success of ICIs, treatment with checkpoint inhibitor combinations poses significant clinical challenges, such as increased rates of immune-related adverse events (irAEs) and drug resistance. Thus, identifying optimal prognostic biomarkers could help to monitor the safety and efficacy of ICIs and identify patients who may benefit the most from these treatments. In this review, we will first go over the fundamentals of the CTLA-4 and PD-1 pathways, as well as the mechanisms of ICI resistance. The results of clinical findings that evaluated the combination of ipilimumab and nivolumab are then summarized to support future research in the field of combination therapy. Finally, the irAEs associated with combined ICI therapy, as well as the underlying biomarkers involved in their management, are discussed

Medical plants for lung cancer: an overview of current knowledge

Lung cancer is an uncontrolled cell growth in lung tissue, with changes in the cellular, epigenetic and genetic alterations, oncogenes activation and clonal evolution of malignant cells. The most critical risk factor for lung cancer is cigarette smoking (80-85%). Other reasons for lung cancer (15-20%) include genetic factors, exposure to secondhand smoke, air pollution, radiation, hazardous gases and foreign chemical agents. The most widely used strategies in lung cancer treatment are chemotherapy, radiotherapy and surgery. However, there are various adverse effects, such as significant toxicity, limited efficiency and multidrug resistance. Plants and plant-derived products have proven to have a role in lung cancer therapy and prevention through sensitizing conventional factors, extending patient survival time, avoiding adverse effects of chemotherapy, promoting physiological improvement and ameliorating quality of life in pulmonary malignancy cases. For this review article, we searched Web of Science, EBSCO, Scopus, PubMed/Medline, DOAJ (Directory of Open Access Journals), Embase, and Google Scholar, using various keywords. There are several natural product molecules with anticancer properties through many molecular mechanisms, including, inducing apoptosis, inhibition of angiogenesis and metastasis, reversion of multidrug resistance and also targeting reactive oxygen species signaling. Some phytochemical compounds are discussed as anticancer agents for lung cancer