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Topic Review
Metformin for Preeclampsia Prophylaxis
The possibility of prophylaxis of hypertensive disorders of pregnancy (HDPs) such as preeclampsia (PE) and pregnancy-induced hypertension (PIH) is of interest due to the unpredictable course of these diseases and the risks they carry for both mother and fetus. It has been proven that their development is associated with the presence of the placenta, and the processes that initiate it begin at the time of the abnormal invasion of the trophoblast in early pregnancy. The ideal HDPs prophylaxis should alleviate the influence of risk factors and, at the same time, promote physiological trophoblast invasion and maintain the physiologic endothelium function without any harm to both mother and fetus. So far, aspirin is the only effective and recommended pharmacological agent for the prevention of HDPs in high-risk groups. Metformin is a hypoglycemic drug with a proven protective effect on the cardiovascular system. Respecting the anti-inflammatory properties of metformin and its favorable impact on the endothelium, it seems to be an interesting option for HDPs prophylaxis. 
  • 625
  • 16 Jul 2021
Topic Review
Metformin and Metabolism in Cancer Cells
Metformin has been a long-standing prescribed drug for treatment of type 2 diabetes (T2D) and its beneficial effects on virus infection, autoimmune diseases, aging and cancers are also recognized. Metformin modulates the differentiation and activation of various immune-mediated cells such as CD4+ and CD+8 T cells. The activation of adenosine 5′-monophosphate-activated protein kinase (AMPK) and mammalian target of rapamycin complex 1 (mTORC1) pathway may be involved in this process.
  • 419
  • 30 Jan 2023
Topic Review
Metformin and Insulin Resistance
Metformin is the most commonly used treatment to increase insulin sensitivity in insulin-resistant (IR) conditions such as diabetes, prediabetes, polycystic ovary syndrome, and obesity. This study explores the underlying mechanisms of the metformin's effect on IR mainly through the changes in the glucose transporter 4 (GLUT4)-mediated glucose transport.
  • 564
  • 29 Mar 2022
Topic Review
Metabolic Obesity in People with Normal Body Weight
The term Metabolic Obesity in People with Normal Body Weight (MONW) is used to describe people who, despite having a healthy body weight - usually defined by the body index (BMI), and more and more often also the percentage of adipose tissue - show metabolic disorders characteristic of obese people. 
  • 492
  • 29 Mar 2022
Topic Review
Melatonin in Cancer Treatment
Melatonin is a pleotropic molecule with numerous biological activities. Epidemiological and experimental studies have documented that melatonin could inhibit different types of cancer in vitro and in vivo.
  • 708
  • 02 Jul 2021
Topic Review
Medicinal Plants of the Himalayas
WHO recommends cancer is the leading cause of death worldwide, with nearly 10 million deaths predicted in 2020(1). The bioactivities of phytocompounds for various health benefits have been studied for decades. Synthetic drugs are being replaced by phytocompounds which have great advantages due to their effects on a wide range of target cells with lower cell cytotoxicity effects or side effects compared to synthetic anticancer compounds, which are a single-target effect for prevention and treatment of carcinoma. Various medicinal plants and their nanoparticles have anticancer activity, namely Murraya koenigii leaf extract ZnO nanoparticlets. Most modern drugs used to treat cancer originate from various medicinal plants; 50% of the anticancer drugs originate from medicinal plants. In developing countries, more than 80% of people use medicinal plants as traditional medicinal therapy and 60% of cancer patients use herbal treatment as an option to cure cancer. Currently, for high-risk breast cancer patients, tamoxifen and related compounds such as raloxifene are prescribed. The phytocompounds most studied in different research papers for the treatment of cancer (anti-proliferative activity) are curcumin, polyphenols, Withaferin A (WFA), a triterpenoid, celastrol, and berry bioactives. Vinca alkaloids, podophyllotoxin, taxanes, campothecin, homoharringtonine, saponin, isoquinoline, shatavarine IV, stigamsterola, calotropin, and shikonin phytocompounds are discussed as follows. Cancer as well as boosting the immune system.
  • 429
  • 22 Aug 2022
Topic Review
Medical Uses of N-Acetylcysteine
N-acetylcysteine (NAC), a plant antioxidant naturally found in onion, is a precursor to glutathione. It has been used as a drug since the 1960s and is listed on the World Health Organization (WHO) Model List of Essential Medicines as an antidote in poisonings. There are numerous other uses or proposed uses in medicine that are still in preclinical and clinical investigations. NAC is also used in food supplements and cosmetics. Despite its abundant use, there are projections that the NAC global market will grow in the next five years; therefore, the purpose of this work is to provide a balanced view of further uses of NAC as a dietary supplement. Although NAC is considered a safe substance, the results among clinical trials are sometimes controversial or incomplete, like for many other antioxidants. More clinical trials are underway that will improve our understanding of NAC applicability.
  • 523
  • 16 Aug 2021
Topic Review
Medical Insights of Hemodiafiltration
Hemodiafiltration, a dialysis method that was implemented in clinics many years ago and that combines the two main principles of hemodialysis and hemofiltration—diffusion and convection—has had a positive impact on mortality rates, especially when delivered in a high-volume mode as a surrogate for a high convective dose. The achievement of high substitution volumes during dialysis treatments does not only depend on patient characteristics but also on the dialyzer (membrane) and the adequately equipped hemodiafiltration machine. 
  • 328
  • 07 Feb 2023
Topic Review
Mechanistic Basis for Autophagy in Diabetic Kidney Disease
Diabetic kidney disease (DKD), or diabetic nephropathy (DN), is a common but severe complication in diabetic patients. The disorder mainly consists of persistent proteinuria with progressive worsening of renal function, and can ultimately cause irreversible kidney damage. Studies have provided new insights into the connection between autophagy, a physiological metabolic process known to maintain cellular homeostasis, and the pathophysiological pathways of DKD. Typically, autophagic activity plays a role in DKD progression mainly by promoting an inflammatory response to tissue damage, while both overactivated and downregulated autophagy worsen disease outcomes in different stages of DKD. 
  • 182
  • 13 Dec 2023
Topic Review
Mechanisms of Kidney Damage in Acute Hepatic Porphyrias
Porphyrias are a group of rare disorders originating from an enzyme dysfunction in the pathway of heme biosynthesis. Depending on the specific enzyme involved, porphyrias manifest under drastically different clinical pictures. The most dramatic presentation of the four congenital acute hepatic porphyrias (AHPs: acute intermittent porphyria—AIP, ALAD deficiency, hereditary coproporphyria—HCP, and porphyria variegata—VP) consists of potentially life-threatening neurovisceral attacks, for which givosiran, a novel and effective siRNA-based therapeutic, has recently been licensed. Nonetheless, the clinical manifestations of acute porphyrias are multifaceted and do not limit themselves to acute attacks. In particular, porphyria-associated kidney disease (PAKD) is a distinct, long-term degenerating condition with specific pathological and clinical features, for which a satisfactory treatment is not available yet. In PAKD, chronic tubule-interstitial damage has been most commonly reported, though other pathologic features (e.g., chronic fibrous intimal hyperplasia) are consistent findings. Given the relevant role of the kidney in porphyrin metabolism, the mechanisms possibly intervening in causing renal damage in AHPs are different: among others, δ-aminolevulinic acid (ALA)-induced oxidative damage on mitochondria, intracellular toxic aggregation of porphyrins in proximal tubular cells, and derangements in the delicate microcirculatory balances of the kidney might be implicated. The presence of a variant of the human peptide transporter 2 (PEPT2), with a greater affinity to its substrates (including ALA), might confer a greater susceptibility to kidney damage in patients with AHPs. Furthermore, a possible effect of givosiran in worsening kidney function has been observed. In sum, the diagnostic workup of AHPs should always include a baseline evaluation of renal function, and periodic monitoring of the progression of kidney disease in patients with AHPs is strongly recommended.
  • 617
  • 07 Feb 2022
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