Topic Review
Antisclerostin Effect on Osseointegration and Bone
Sclerostin is a glycoprotein encoded in humans by the SOST gene. It is located on chromosome 17q12-q21, with a C-terminal cysteine knot-like (CTCK) domain. It has a similar sequence also to DAN (Differential screening-selected gene Aberrative in Neuroblastoma), an antagonist’s family of the bone morphogenetic protein (BMP). Sclerostin is primarily produced and secreted by osteocytes. Moreover, it is a negative key regulator of osteoblastic functions. It inhibits osteoblast differentiation and bone formation by inhibiting the Wnt signaling pathway after binding with LRP5 and 6 (Wnt-coreceptor). This canonical Wnt signaling (Wnt/β-catenin pathway) is essential in bone healing. It promotes pre-osteoblast proliferation and osteo-induction, enhances survival of all cells of the osteoblast lineage, inhibits differentiation of mesenchymal stem cells (MSCs) into chondrocytes and adipocytes and controls osteoclast maturation by regulating RANKL levels in osteoblast receptors.
  • 290
  • 15 Feb 2023
Topic Review
Antisense Oligonucleotide for Chronic Kidney Disease
Chronic kidney disease (CKD) is a global public health issue that places an increasing burden on the healthcare systems of both the developed and developing countries. CKD is a progressive and irreversible condition, affecting approximately 10% of the population worldwide. Patients that have progressed to end-stage renal disease (ESRD) require expensive renal replacement therapy, i.e., dialysis or kidney transplantation. Current CKD therapy largely relies on the use of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs). However, these treatments by no means halt the progression of CKD to ESRD. Therefore, the development of new therapies is urgently needed. Antisense oligonucleotide (ASO) has recently attracted considerable interest as a drug development platform. Thus far, eight ASO-based drugs have been granted approval by the US Food and Drug Administration for the treatment of various diseases.
  • 555
  • 17 Jan 2022
Topic Review
Antisense Oligonucleotide-Mediated Splice Switching
Antisense oligonucleotides (AOs) have been developed to inhibit the production of alternatively spliced carcinogenic isoforms through splice modulation or mRNA degradation. AOs can also be used to induce splice switching, where the expression of an oncogenic protein can be inhibited by the induction of a premature stop codon. In general, AOs are modified chemically to increase their stability and binding affinity. One of the major concerns with AOs is efficient delivery. Strategies for the delivery of AOs are constantly being evolved to facilitate the entry of AOs into cells. 
  • 623
  • 25 Nov 2021
Topic Review
Antiseptic Agents for Chronic Wounds
Chronic wounds are wounds failing to proceed through the normal phases of healing in an orderly and timely manner. The definition of time without complete or partial healing differs across countries, ranging from 4 weeks to 3 months. In many parts of the world, antiseptic agents remain non-indicated in chronic wound care. In the current context of bacterial resistance to antibiotics and the development of new-generation antiseptic agents, wound antisepsis represents an asset for the prevention of wound infection.
  • 557
  • 28 Mar 2022
Topic Review
Antisocial Disorders
Transdiagnostic causal variables have been identified that have allowed understanding the origin and maintenance of psychopathologies in parsimonious explanatory models of antisocial disorders. However, it is necessary to systematize the information published in the last decade. The main findings indicated that at a structural level there is a general psychopathological factor (psychopathy or externalizing), non-emotional callousness and impulsivity from behavioral inhibition and activation systems, and negative affect traits as base structures. In the emotional level, the study found a risk component from emotional dysregulation and experiential avoidance. In the cognitive level, a key role of anger-rumination and violent ideation as explanatory variables of antisocial disorders. We concluded that the interaction of these identified variables makes it possible to generate an evidence-based transdiagnostic model.
  • 1.1K
  • 30 Oct 2020
Topic Review
Antithrombotic Therapy Following Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) is expanding towards a low-risk patient category as a result of technical advances and operators’ improved skills. However, the post-TAVR antithrombotic regimen remains challenging. Single antiplatelet therapy appears to be the best compromise when there is no compelling indication for chronic oral anticoagulation. Whether it should be aspirin or clopidogrel is not established. There is no supportive evidence to use oral anticoagulation when there is no established indication for oral anticoagulation other than the TAVR procedure. The gap in evidence as to whether DOACs should be preferred over VKA remains when there is an indication for oral anticoagulation (OAC) use. It seems that DOACs are not the same and randomized trials are awaited. Likewise, whether oral anticoagulant therapy should be continued or interrupted during the procedure remains unclear.
  • 519
  • 17 Jun 2022
Topic Review
Antithrombotic Therapy in Patients with AF Undergoing PCI
The antithrombotic management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) poses numerous challenges. Triple antithrombotic therapy (TAT), which combines dual antiplatelet therapy (DAPT) with oral anticoagulation (OAC), provides anti-ischemic protection but increases the risk of bleeding. Therefore, TAT is generally limited to a short phase (1 week) after PCI, followed by aspirin withdrawal and continuation of 6–12 months of dual antithrombotic therapy (DAT), comprising OAC plus clopidogrel, followed by OAC alone.
  • 276
  • 27 Dec 2023
Topic Review
Antithrombotic Therapy in Polyvascular Disease
Patients presenting with atherosclerosis involving more than one vascular bed, such as those with peripheral artery disease (PAD) and concomitant coronary artery disease (CAD), constitute a particularly vulnerable group characterized by enhanced residual long-term risk for major adverse cardiac events (MACE), as well as major adverse limb events (MALE). Antithrombotic therapy is the mainstay of secondary prevention in both patients with PAD or CAD; however, the optimal intensity of such therapy is still a topic of debate, particularly in the post-acute and long-term setting.
  • 329
  • 31 Aug 2023
Topic Review
Antithrombotic Therapy in the Prevention of Stroke
 Ischemic stroke is a leading cause of death and disability throughout the world. Antithrombotic therapy, which includes both antiplatelet and anticoagulant agents, is a primary medication of choice for the secondary prevention of stroke. However, the choices vary with the need to incorporate evolving, newer information into the clinical scenario. There is also the need to factor in co-morbid medical conditions as well as the cost ramifications for a particular patient as well as compliance with the regimen. 
  • 461
  • 12 Jan 2022
Topic Review
Antithrombotic Therapy with Acute Coronary Syndromes
Cardiovascular disease constitutes one of the leading causes of death worldwide. The incidence of acute coronary syndromes (ACS) is especially high in the elderly, who constitute up to one-third of patients. Age also associates with an increased risk of recurrent ischemic events and death. Antithrombotic therapy represents the main component of treatment in the setting of ACS. The focus is on antiplatelet therapy, but balancing the benefit in terms of reducing ischemic events with the bleeding risk is still complicated. In combination with aspirin, oral P2Y12 receptor inhibitors (clopidogrel, prasugrel, and ticagrelor) have been widely implemented as a first-line treatment strategy in patients with ACS and those undergoing percutaneous coronary intervention (PCI). However, the management of ACS in the elderly has turned out to be challenging, since compared with clopidogrel, prasugrel and ticagrelor involve an increased risk of bleeding, potentially offsetting their ischemic clinical benefit among more vulnerable patients.
  • 584
  • 07 Jun 2022
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