2026-03-26
Liang Juan, Chih-Ning Cheng, Wen-Chi Chang, Huai-Hsuan Chiu, Chao-Wen Lu, Hsao-Hsun Hsu, Ching-Hua Kuo, Yu-Ju Tseng
ObjectivesMycophenolic acid (MPA) and tacrolimus (TAC) exhibit substantial pharmacokinetic variability, and volumetric absorptive microsampling (VAMS) offers a minimally invasive alternative for therapeutic drug monitoring (TDM). This study aimed to develop a VAMS-based method for MPA and TAC quantifications and systematically evaluate hematocrit (Hct)-adjusted conversion strategies.MethodsAdult transplant recipients receiving mycophenolate mofetil or mycophenolate sodium were prospectively enrolled. Paired plasma (MPA), whole-blood (TAC), and VAMS samples were analyzed using validated LC–MS/MS method for simultaneous MPA and TAC quantification. Multiple Hct-adjusted conversion approaches for MPA were compared using Passing-Bablok regression, Bland-Altman analysis, and predictive performance metrics. Clinical applicability was assessed through scenario-based AUC estimation MPA AUC estimations under different sampling schemes.ResultsLC-MS/MS method for quantifying MPA and TAC in VAMS exhibited good linearity (R2 > 0.99) and accuracy within 85–115% across validation ranges (10–20,000 ng/mL for MPA; 0.5–500 ng/mL for TAC). Formula A-ind [(VAMS/1 – individual Hct) x fbpp], where fbpp represents the MPA protein binding fraction (0.97), achieved clinical agreement in 86% of samples for the conversion of MPA concentrations between VAMS and plasma, representing the most balanced between predictive reliability and operational feasibility. TAC concentrations from VAMS correlated strongly with whole blood values without requiring Hct correction. Clinical case applications showed that rich eight-point VAMS sampling enabled more accurate AUC estimations than conventional three-point schemes, further highlighting the advantages of using VAMS for MPA TDM.ConclusionThis validated VAMS-based approach offers a minimally invasive and clinically applicable alternative to venous sampling for MPA and TAC monitoring. Incorporating individualized Hct adjustments improves predictive performance, supporting conditional integration of VAMS into routine TDM.
DOI: 10.3389/jpps.2026.161232026-03-11
Sarah Rezazi, Cherif Si-Moussa, Salah Hanini
The integration of computational intelligence into therapeutic development is increasingly important for accelerating early-stage drug discovery and improving compound prioritization. In this study, we developed an optimized neural network–based predictive framework to support the identification of bioactive compounds with analgesic potential. A dataset of 532 structurally diverse molecules described by 227 molecular descriptors was analyzed, and a stepwise feature elimination procedure reduced the descriptor set to 105 informative variables, improving model robustness and reducing redundancy. The optimized artificial neural network, trained using the Levenberg–Marquardt algorithm, achieved a correlation coefficient of 95.9% with a prediction error of 0.433%, outperforming conventional statistical approaches reported for comparable QSAR tasks. Additional analysis links key descriptor groups, including connectivity and polarity parameters, to physicochemical properties relevant to analgesic activity, improving interpretability for medicinal chemistry applications. The framework is intended to support computational screening and candidate prioritization prior to experimental validation, thereby contributing to more efficient pharmacotherapeutic discovery workflows. This work highlights how data-driven modeling can complement translational strategies aimed at accelerating drug discovery pipelines.
DOI: 10.3389/jpps.2026.161552026-03-04
Joseph Correa, Nicole K. Brogden
Asthma and allergies affect millions of people globally. Avoiding triggers and allergens is a basic management technique for all asthma subtypes (>80% of asthma patients also suffer from allergies), and pharmacological treatment is the cornerstone for acute exacerbations and ongoing maintenance. Typical treatment options for asthma include inhaled, oral, or injectable dosage forms. However, transdermal drug delivery has great potential to provide an alternative route of administration of necessary asthma and allergy therapies that have traditionally been given in other dosage forms. In Part 1 of this two-part series, we discussed the work done towards incorporating short- and long-acting β2-agonists into transdermal drug delivery systems. Here in part 2, we describe the current literature for transdermal applications of leukotriene antagonists, theophylline, and other adjunct medications that do not fall into one specific drug class. A brief overview of biologics, particularly monoclonal antibodies, and the role in asthma is also included, including some context of transdermal mAb delivery for disease states beyond asthma. Because of the relatedness of asthma and allergies, transdermal applications for allergen immunotherapy is also discussed.
DOI: 10.3389/jpps.2026.157142026-03-04
Joseph Correa, Nicole K. Brogden
Asthma and allergies are closely related conditions affecting millions of people around the world. Current treatment options cover many classes of drugs for both acute and ongoing conditions. β2-agonists, leukotriene modifiers, and corticosteroids represent some of the common types of drugs utilized in asthma management. These medications are often delivered via inhalation, oral, or parenteral methods, but each of these modalities faces challenges due to improper technique with inhalers, lessened oral bioavailability due to first-pass metabolism, and reduced compliance of injectable medicines. Transdermal drug delivery may offer a beneficial route of administration that overcomes these barriers as a painless, self-administered form that bypasses first-pass metabolism and can reduce dosing frequency with longer drug release profiles and reduced fluctuations in plasma drug levels. In this two-part mini-review series we will summarize the current literature on transdermal systems for asthma and allergy therapy. Here in Part 1, we cover β2-agonists and discuss the potential of transdermal systems for these drugs. While the body of work with transdermal β2-agonists for asthma treatment is limited, there is still evidence that transdermal systems for asthma has potential to greatly shift the field of asthma therapeutics.
DOI: 10.3389/jpps.2026.157132026-02-17
Sunbeom Kwon, Suji Jeong, Seulah Lee
DOI: 10.3389/jpps.2026.155632026-01-13
Haider Hamzah
Eco-friendly silver nanoparticles (eco-AgNPs) represent a promising convergence of green nanotechnology and precision medicine for cancer treatment. This minireview examines the therapeutic potential of silver nanoparticles (AgNPs) synthesized through eco-friendly methods using plant extracts and microorganisms. These eco-friendly AgNPs demonstrate enhanced biocompatibility and selective cytotoxicity against malignant cells. These nanoparticles target cancer through multiple mechanisms including reactive oxygen species generation, apoptosis induction, and cell cycle disruption. Selectivity is achieved through surface functionalization with targeting moieties such as antibodies and aptamers that recognize overexpressed tumor receptors. The integration of biomarker-guided design enables tumor-specific delivery by exploiting unique metabolic signatures and cellular markers characteristic of different cancer types. Furthermore, AgNP-based theranostic platforms offer simultaneous diagnostic imaging and therapeutic intervention, providing real-time assessment of treatment response and enabling personalized dosing strategies. However, clinical translation faces significant challenges including potential long-term toxicity, standardization of synthesis protocols, and regulatory approval pathways. Successful clinical implementation will require interdisciplinary collaboration to optimize nanoparticle design, establish safety profiles, and develop combination therapies that maximize therapeutic benefits while minimizing side effects. Eco-AgNPs thus offer a transformative approach to cancer treatment that combines environmental sustainability with precision targeting capabilities.
DOI: 10.3389/jpps.2025.154032026-01-06
Aashirwad Shahi, Shengyuan Zhao, Dawit Kidane
Gastric cancer remains a highly prevalent and accounts for a notable proportion of global cancer mortality. Both Intrinsic and exogenous agents can exacerbate reactive oxygen species (ROS) related oxidized DNA base lesions and single stranded DNA breaks (SSBs). Base excision repair (BER) serves as the primary defense mechanism for repairing DNA damage induced by oxidative stress. DNA polymerase beta (Pol β) plays a critical role in BER and non-homologous end joining repair pathways. The Pol β is the first perform gap-filling DNA synthesis by its polymerase activity and then cleave a 5′-deoxyribose-5-phosphate (dRP) moiety via its dRP lyase activity. Furthermore, defect in POLB promotes genetic liability of the cancer cells for different targeted and synthetic lethality-based treatment strategies. In this review, we have provided a potential example to illustrate the mechanistic insight how PARP1 inhibitor (Olaparib) induces replication associated double strand breaks in POLB deficient cells and DNA mediated innate immune signal activation that likely enhances immune based therapy. Based on our previously published data and the current recent findings, POLB status of the patient likely provide genetic indicators to stratify gastric cancer patient. Overall, in this review article, we presented a new direction to highlight the opportunity to exploit POLB genetic defect in cancer cells to enhance treatment response and to explore synergistic effect to target gastric cancer cells that harbor aberrant DNA polymerase beta function with immune based therapeutic strategy.
DOI: 10.3389/jpps.2025.153602025-12-01
Faten Alhomoud, Sakinah Alalwyat, Lama Alanzi, Farah Kais Alhomoud, Sarah Khayyat, Khalid A. Alamer, Basmah Alfageh, Mohra Aladwani, Abdullah A. Alhifany
Medication waste is a significant global concern with environmental, economic, and healthcare implications. In Saudi Arabia, approximately 25.8% of dispensed medications are wasted, resulting in an annual cost of $150 million. Re-dispensing unused medications has been proposed to reduce this waste; however, its feasibility depends on public acceptance, regulatory frameworks, and assurances of safety. This study aimed to assess the Saudi public’s willingness to accept re-dispensed medications returned unused to pharmacies and to identify factors influencing this willingness. A descriptive cross-sectional survey was conducted online across Saudi Arabia. The questionnaire, adapted from a validated tool by McRae et al. McRae et al. (Pharmacy (Basel), 2021, 9(2): 77) and translated into Arabic, explored demographics, medication practices, storage and disposal, and attitudes towards medication waste and re-dispensing. The survey was distributed via social media. Data were analyzed using SPSS version 29, including chi-squared tests and binary logistic regression. A total of 405 participants completed the survey, primarily female (64%) and aged 25–44 years (43%). About 64% reported having unused medications at home, most commonly stored in bedrooms (55.1%) and kitchens (53.6%). Disposal practices included keeping medicines for future use (62.5%), discarding them with household waste (45.7%), sharing them with others (21.5%), and returning unused medications to a pharmacy (8.4%). Approximately 60% were willing to accept re-dispensed tablets and 55% capsules, whereas fewer accepted other dosage forms. Key factors influencing acceptance included pharmacist verification of quality and integrity (79.3%), informed consent (77.3%), expiry dates (77%), and intact packaging (74.8%). Most participants (68.1%) indicated they would return unused medicines if a re-dispensing program were implemented, and half (50.6%) believed all medications, not only expensive ones, should be considered. Significant predictors of willingness included age (P < 0.001), employment status (P = 0.004), regular prescription use (P = 0.046), and concern about waste (P < 0.001). Younger participants showed higher acceptance, while employed individuals, retirees, and regular medication users were more hesitant. The findings indicate cautious yet notable public support for medication re-dispensing in Saudi Arabia, particularly for oral solid dosage forms, provided rigorous safety measures are assured. Policymakers should consider these insights to guide initiatives aimed at reducing medication waste.
DOI: 10.3389/jpps.2025.152492025-11-27
Jean Baptiste Nyandwi, Pierre Celestin Munezero, Charles Uwambajimana, Gift Crucifix Pender, Jonathan Katandula, Théoneste Umumararungu, Jean Paul Sinumvayo, Ibrahim Eleha Suleiman, Tolessa Muleta Daba, Vedaste Kagisha, Marie Françoise Mukanyangezi, Ahmed Adebowale Adedeji
BackgroundHypoglycemia is a common yet underrecognized complication in patients with type 2 diabetes mellitus (T2DM), often linked with increased cardiovascular (CV) morbidity and mortality. Despite its clinical importance, there is a limited data on the association between hypoglycemia, CV events, and mortality among T2DM patients in Rwanda. This study investigated the occurrence of hypoglycemia and its association with CV diseases, morbidity, and mortality in T2DM patients attending two university teaching hospitals in Rwanda.MethodsA retrospective study was conducted using secondary data from 267 T2DM patients attending Kigali University Teaching Hospital (CHUK) and Butare University Teaching Hospital between 2015 and 2020. Socio-demographic and clinical data, including anti-diabetic medications, hypoglycemia episodes, CV events, and comorbidities, were extracted from medical records and analyzed using Python. Binary regression was used to determine significant predictors of hypoglycemia.ResultsHypoglycemia occurred in 112 (41.9%) patients during their hospitalization or hospital admissions. The use of insulin was significantly associated with hypoglycemia (OR = 1.590, CI: 1.100–2.290, p = 0.010). The mean age of patients who experienced hypoglycemia is 54.2 (±12.1) years. Hypoglycemia occurrence was higher in males (59.8%) group compared to females (40.2%) (p = 0.007). Cardiovascular conditions were common (73.8%), with hypertension being the most prevalent (85.4%). Insulin was the most frequently used anti-diabetic therapy (42.3%). A significant association was found between hypoglycemia and subsequent CV complications. Management of hypoglycemia predominantly involved the use of 50% dextrose solution.ConclusionHypoglycemia is a frequent and clinically significant occurrence among T2DM patients in Rwanda, particularly associated with insulin therapy and CV comorbidities. Enhanced clinical monitoring and individualized treatment regimens are essential to mitigate hypoglycemia-related complications and reduce mortality. It is important to conduct a larger studies to support the evidence based findings and address the current methodological constraints.
DOI: 10.3389/jpps.2025.148802025-11-19
Laurie Dez, Stéphane Haÿs, Gilles Leboucher, Romain Garreau, Jean-Charles Picaud, Thomas Briot
Background/objectivesOptimal nutrition in very low birth weight (VLBW) infants is associated with improved clinical outcomes. When parenteral nutrition (PN) with a marketing authorisation is not appropriate, hospital pharmacies can prepare more suitable PN preparation. This corresponds to standard preparations (i.e., available at any time with a fixed composition) or individualised ones (i.e., available after a period of prescription, preparation, and pharmaceutical control). In France, 12 standard formulas to be compounded were proposed by a national consortium in 2018. The objective of the present study was to evaluate whether individualised PN preparations ordered in our hospital are substitutable by one of the 12 standard formulas.MethodsAll PN prescriptions for VLBW infants made in 2021 in our hospital were retrospectively extracted. For each prescription, the theoretical intakes that an infant would have received if a standard preparation had been administered were calculated. Standard and individualised preparations were compared using the Mann-Whitney U test for each component. Secondly, the relative difference between the expected intakes and effectively intakes was calculated for each component.Results/DiscussionOver the study period, 1708 prescriptions were identified (corresponding to 1708 PN individualised preparations). Most infants were extremely low birth weight infants. Based on the methods of comparison, none of the 12 standard formulas fitted with targeted intakes achieved with individualised PN preparations ordered, whereas prescriptions did fit with international guidelines.ConclusionThe study highlights how it is difficult to establish nationally standard PN formulas for VLBW infants; the development of local standard formulas seems therefore relevant.
DOI: 10.3389/jpps.2025.15310