Revolutionizing Drug Delivery: The Role of Nanofibers - A Review

The field of drug delivery has experienced a paradigm shift with the emergence of nanofibers as an innovative carrier system. This comprehensive review aims to delve into the multifaceted role of nanofibers in drug delivery, highlighting their unique properties and diverse applications in therapeutic interventions. Nanofibers, characterized by their high surface area-to-volume ratio and tunable properties, offer an exceptional platform for targeted and controlled drug release. Their versatile nature allows for precise engineering of size, morphology, and surface functionalities, enabling tailored drug delivery systems catering to specific therapeutic needs. This review encompasses a detailed analysis of the various fabrication techniques employed in producing nanofibers, encompassing electrospinning, self-assembly, and other advanced methodologies. Furthermore, the review presents an extensive survey of the diverse range of materials utilized in nanofiber production, such as polymers, proteins, and inorganic compounds, emphasizing their distinct advantages in drug encapsulation, protection, and release kinetics.The application spectrum of nanofibers in drug delivery is explored, spanning across various medical domains including cancer therapy, tissue engineering, wound healing, and infectious disease treatment. The review delves into recent advancements, challenges, and future prospects in this burgeoning field, underscoring the potential for nanofibers to revolutionize drug delivery strategies and improve therapeutic outcomes.In conclusion, this review underscores the pivotal role of nanofibers as a novel and promising carrier system in drug delivery, presenting a compelling case for their continued exploration and utilization in advancing medical treatments

“Nano-Herbal Innovations: Precision In Therapeutic Delivery”

Herbal nanoparticles, an innovative fusion of traditional herbal medicine and modern nanotechnology, represent a burgeoning field with vast therapeutic potential. These nanoparticles are crafted by employing various techniques like green synthesis, coacervation, or ionic gelation, utilizing natural substances derived from plants. The encapsulation of herbal extracts within nanoparticles enhances their bioavailability, stability, and targeted delivery, addressing longstanding limitations of traditional herbal medicine. The miniature size of these nanoparticles allows for easy penetration into cells, tissues, and even across physiological barriers, thereby augmenting their efficacy. Moreover, herbal nanoparticles exhibit remarkable versatility in treating diverse health conditions. Their antioxidant, anti-inflammatory, antimicrobial, and anticancer properties have been extensively studied and documented. By encapsulating compounds derived from plants, such as curcumin, resveratrol, or quercetin, within nanoparticles, their therapeutic effects are amplified manifold, fostering promising avenues for combating various diseases. Nano-sized herbal formulations shows reduced toxicity compared to their conventional ones, owing to controlled release profiles and targeted action. They hold great promise in personalized medicine, allowing for tailored therapies based on individual patient requirements. However, despite their immense potential, challenges persist in terms of large-scale production, standardization, and regulatory aspects. Further research is warranted to show their long-term safety profile and optimize their efficacy for widespread clinical applications.In conclusion, herbal nanoparticles represent a remarkable convergence of traditional herbal wisdom and cutting-edge nanotechnology. Their remarkable properties pave the way for groundbreaking advancements in healthcare, offering novel solutions for prevalent diseases while honoring the rich heritage of natural remedies. Continued exploration and refinement of these nanoparticles hold the key to unlocking their full therapeutic potential

Impact of Concurrent Posttraumatic Stress Disorder on Outcomes of Antipsychotic Augmentation for Major Depressive Disorder With a Prior Failed Treatment: VAST-D Randomized Clinical Trial.

To determine whether concurrent posttraumatic stress disorder (PTSD) should affect whether to augment or switch medications when major depressive disorder (MDD) has not responded to a prior antidepressant trial. Patients at 35 Veterans Health Administration medical centers from December 2012 to May 2015 with nonpsychotic MDD (N = 1,522) and a suboptimal response to adequate antidepressant treatment were randomly assigned to 3 "next step" treatments: switching to bupropion, augmenting the current antidepressant with bupropion, and augmenting with the antipsychotic aripiprazole. Blinded ratings with the 16-item Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C₁₆) determined remission and response by 12 weeks and relapse after remission. Survival analyses compared treatment effects in patients with concurrent PTSD diagnosed with the Mini-International Neuropsychiatric Interview (n = 717, 47.1%) and those without PTSD (n = 805, 52.9%). Patients diagnosed with PTSD showed more severe depressive symptoms at baseline and were less likely to achieve either remission or response by 12 weeks. Augmentation with aripiprazole was associated with greater likelihood of achieving response (68.4%) than switching to bupropion (57.7%) in patients with PTSD (relative risk [RR] = 1.26; 95% CI, 1.01-1.59) as well as in patients without PTSD (RR = 1.29; 95% CI, 1.05-1.97) (78.9% response with aripiprazole augmentation vs 66.9% with switching to bupropion). Treatment comparisons with the group receiving augmentation with bupropion were not significant. There was no significant interaction between treatment group and PTSD on remission (P = .70), response (P = .98), or relapse (P = .15). Although PTSD was associated with poorer overall outcomes, the presence of concurrent PTSD among Veterans in this trial did not affect the comparative effectiveness of medications on response, remission, or relapse after initial remission. ClinicalTrials.gov identifier: NCT01421342

Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST-D Randomized Clinical Trial.

ImportanceLess than one-third of patients with major depressive disorder (MDD) achieve remission with their first antidepressant.ObjectiveTo determine the relative effectiveness and safety of 3 common alternate treatments for MDD.Design, setting, and participantsFrom December 2012 to May 2015, 1522 patients at 35 US Veterans Health Administration medical centers who were diagnosed with nonpsychotic MDD, unresponsive to at least 1 antidepressant course meeting minimal standards for treatment dose and duration, participated in the study. Patients were randomly assigned (1:1:1) to 1 of 3 treatments and evaluated for up to 36 weeks.InterventionsSwitch to a different antidepressant, bupropion (switch group, n = 511); augment current treatment with bupropion (augment-bupropion group, n = 506); or augment with an atypical antipsychotic, aripiprazole (augment-aripiprazole group, n = 505) for 12 weeks (acute treatment phase) and up to 36 weeks for longer-term follow-up (continuation phase).Main outcomes and measuresThe primary outcome was remission during the acute treatment phase (16-item Quick Inventory of Depressive Symptomatology-Clinician Rated [QIDS-C16] score ≤5 at 2 consecutive visits). Secondary outcomes included response (≥50% reduction in QIDS-C16 score or improvement on the Clinical Global Impression Improvement scale), relapse, and adverse effects.ResultsAmong 1522 randomized patients (mean age, 54.4 years; men, 1296 [85.2%]), 1137 (74.7%) completed the acute treatment phase. Remission rates at 12 weeks were 22.3% (n = 114) for the switch group, 26.9% (n = 136)for the augment-bupropion group, and 28.9% (n = 146) for the augment-aripiprazole group. The augment-aripiprazole group exceeded the switch group in remission (relative risk [RR], 1.30 [95% CI, 1.05-1.60]; P = .02), but other remission comparisons were not significant. Response was greater for the augment-aripiprazole group (74.3%) than for either the switch group (62.4%; RR, 1.19 [95% CI, 1.09-1.29]) or the augment-bupropion group (65.6%; RR, 1.13 [95% CI, 1.04-1.23]). No significant treatment differences were observed for relapse. Anxiety was more frequent in the 2 bupropion groups (24.3% in the switch group [n = 124] vs 16.6% in the augment-aripiprazole group [n = 84]; and 22.5% in augment-bupropion group [n = 114]). Adverse effects more frequent in the augment-aripiprazole group included somnolence, akathisia, and weight gain.Conclusions and relevanceAmong a predominantly male population with major depressive disorder unresponsive to antidepressant treatment, augmentation with aripiprazole resulted in a statistically significant but only modestly increased likelihood of remission during 12 weeks of treatment compared with switching to bupropion monotherapy. Given the small effect size and adverse effects associated with aripiprazole, further analysis including cost-effectiveness is needed to understand the net utility of this approach.Trial registrationclinicaltrials.gov Identifier: NCT01421342