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Farberg AS, Portela D, Sharma D, Kheterpal M. Evaluation of the Tolerability of Hedgehog Pathway Inhibitors in the Treatment of Advanced Basal Cell Carcinoma: A Narrative Review of Treatment Strategies. Am J Clin Dermatol 2024; 25:779-794. [PMID: 38896403 PMCID: PMC11358199 DOI: 10.1007/s40257-024-00870-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2024] [Indexed: 06/21/2024]
Abstract
Hedgehog pathway inhibitors (HHIs) have broadened the treatment options available for patients with advanced basal cell carcinoma (BCC) for whom traditional therapeutic approaches are not feasible or effective. Sonidegib and vismodegib are oral HHIs that were approved for treatment of patients with advanced BCC after demonstrating promising efficacy in the pivotal Phase II BOLT (NCT01327053) and ERIVANCE (NCT00833417) trials, respectively. However, the incidence and types of treatment-emergent adverse events (AEs) observed with these agents may limit continuous use of HHIs and ultimately impact clinical outcomes. In this review, we summarize the safety and tolerability profiles of sonidegib and vismodegib and discuss potential management strategies for HHI class-effect AEs, including muscle spasms, creatine phosphokinase increase, alopecia, and dysgeusia. These AEs primarily occur early in treatment and can lead to treatment discontinuation. Differences in the pharmacokinetic profiles of sonidegib and vismodegib may contribute to the variability noted in times to onset and resolution of these and other AEs. Evidence suggests that protocol modifications, such as treatment interruptions and dose reductions, are effective ways to manage AEs while maintaining disease control. Nonpharmacologic and pharmacologic interventions may also be considered as part of an AE management strategy. Overall, healthcare providers and patients with advanced BCC should be aware of the HHI class-effect AEs and plan effective management strategies to avoid treatment discontinuation and optimize therapeutic response.
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Affiliation(s)
- Aaron S Farberg
- Section of Dermatology, Baylor Scott & White Health System, Dallas, TX, USA.
- Bare Dermatology, 2110 Research Row, Dallas, TX, 75235, USA.
| | | | - Divya Sharma
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Meenal Kheterpal
- Department of Dermatology, Duke Health, Duke University, Durham, NC, USA
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Wang Q, Cui C, Zhang N, Lin W, Chai S, Chow SKH, Wong RMY, Hu Y, Law SW, Cheung WH. Effects of physical exercise on neuromuscular junction degeneration during ageing: A systematic review. J Orthop Translat 2024; 46:91-102. [PMID: 38817243 PMCID: PMC11137388 DOI: 10.1016/j.jot.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 06/01/2024] Open
Abstract
The neuromuscular junction (NMJ) is a specialized chemical synapse that converts neural impulses into muscle action. Age-associated NMJ degeneration, which involves nerve terminal and postsynaptic decline, denervation, and loss of motor units, significantly contributes to muscle weakness and dysfunction. Although physical training has been shown to make substantial modifications in NMJ of both young and aged animals, the results are often influenced by methodological variables in existing studies. Moreover, there is still lack of strong consensus on the specific effects of exercise on improving the morphology and function of the ageing NMJ. Consequently, the purpose of this study was to conduct a systematic review to elucidate the effects of exercise training on NMJ compartments in the elderly. We conducted a systematic review using PubMed, Embase, and Web of Science databases, employing relevant keywords. Two independent reviewers selected studies that detailed NMJ changes during exercise in ageing, written in English, and available in full text. In total, 20 papers were included. We examined the altered adaptation of the NMJ to exercise, focusing on presynaptic and postsynaptic structures and myofibers in older animals or humans. Our findings indicated that aged NMJs exhibited different adaptive responses to physical exercise compared to younger counterparts. Endurance training, compared with resistance and voluntary exercise regimens, was found to have a more pronounced effect on NMJ structural remodeling, particularly in fast twitch muscle fibers. Physical exercise was observed to promote the formation and maintenance of acetylcholine receptor (AChR) clusters by increasing the recombinant docking protein 7 (Dok7) expression and stabilizing Agrin and lipoprotein receptor-related protein 4 (LRP4). These insights suggest that research on exercise-related therapies could potentially attenuate the progression of neuromuscular degeneration. Translational potential of this article: This systematic review provides a detailed overview of the effects of different types of physical exercise on improving NMJ in the elderly, providing scientific support for the timely intervention of muscle degeneration in the elderly by physical exercise, and providing help for the development of new therapeutic interventions in the future.
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Affiliation(s)
- Qianjin Wang
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Can Cui
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Ning Zhang
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Wujian Lin
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Senlin Chai
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Simon Kwoon-Ho Chow
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Ronald Man Yeung Wong
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Yong Hu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Sheung Wai Law
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Wing-Hoi Cheung
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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Rota Graziosi E, François S, Nasser F, Gauthier M, Oger M, Favier AL, Drouet M, Jullien N, Riccobono D. Comparison of Three Antagonists of Hedgehog Pathway to Promote Skeletal Muscle Regeneration after High Dose Irradiation. Radiat Res 2024; 201:429-439. [PMID: 38253061 DOI: 10.1667/rade-23-00140.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/01/2023] [Indexed: 01/24/2024]
Abstract
The current geopolitical context has brought the radiological nuclear risk to the forefront of concerns. High-dose localized radiation exposure leads to the development of a musculocutaneous radiation syndrome affecting the skin and subcutaneous muscles. Despite the implementation of a gold standard treatment based on an invasive surgical procedure coupled with autologous cell therapy, a muscular defect frequently persists. Targeting the modulation of the Hedgehog (Hh) signaling pathway appears to be a promising therapeutic approach. Activation of this pathway enhances cell survival and promotes proliferation after irradiation, while inhibition by Cyclopamine facilitates differentiation. In this study, we compared the effects of three antagonists of Hh, Cyclopamine (CA), Vismodegib (VDG) and Sonidegib (SDG) on differentiation. A stable cell line of murine myoblasts, C2C12, was exposed to X-ray radiation (5 Gy) and treated with CA, VDG or SDG. Analysis of proliferation, survival (apoptosis), morphology, myogenesis genes expression and proteins production were performed. According to the results, VDG does not have a significant impact on C2C12 cells. SDG increases the expression/production of differentiation markers to a similar extent as CA, while morphologically, SDG proves to be more effective than CA. To conclude, SDG can be used in the same way as CA but already has a marketing authorization with an indication against basal cell cancers, facilitating their use in vivo. This proof of concept demonstrates that SDG represents a promising alternative to CA to promotes differentiation of murine myoblasts. Future studies on isolated and cultured satellite cells and in vivo will test this proof of concept.
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Affiliation(s)
- Emmanuelle Rota Graziosi
- IRBA, French Armed Forces Biomedical Research Institute, Radiobiology unit, Brétigny-sur-Orge, France
| | - Sabine François
- IRBA, French Armed Forces Biomedical Research Institute, Radiobiology unit, Brétigny-sur-Orge, France
- INSERM, UMR1296, Radiations: Defense, Health, Environment, Lyon and Brétigny-sur-Orge, France
| | - Farah Nasser
- IRBA, French Armed Forces Biomedical Research Institute, Radiobiology unit, Brétigny-sur-Orge, France
| | - Michel Gauthier
- IRBA, French Armed Forces Biomedical Research Institute, Radiobiology unit, Brétigny-sur-Orge, France
| | - Myriam Oger
- IRBA, French Armed Forces Biomedical Research Institute, Imagery Unit, Department of Platforms and Technology Research, Brétigny-sur-Orge, France
| | - Anne-Laure Favier
- IRBA, French Armed Forces Biomedical Research Institute, Imagery Unit, Department of Platforms and Technology Research, Brétigny-sur-Orge, France
| | - Michel Drouet
- INSERM, UMR1296, Radiations: Defense, Health, Environment, Lyon and Brétigny-sur-Orge, France
- IRBA, French Armed Forces Biomedical Research Institute, Radiations Bioeffects Department, Brétigny-sur-Orge, France
| | - Nicolas Jullien
- IRBA, French Armed Forces Biomedical Research Institute, Radiobiology unit, Brétigny-sur-Orge, France
| | - Diane Riccobono
- INSERM, UMR1296, Radiations: Defense, Health, Environment, Lyon and Brétigny-sur-Orge, France
- IRBA, French Armed Forces Biomedical Research Institute, Radiations Bioeffects Department, Brétigny-sur-Orge, France
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LEOW LJ, HOWARD V. Clinical Clearance Following Improvement of Histologic Subtype of Basal Cell Carcinoma with Sonidegib. Acta Derm Venereol 2022; 102:adv00809. [PMID: 36281813 PMCID: PMC9811294 DOI: 10.2340/actadv.v102.2740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Liang Joo LEOW
- Aesthetic Dermatology, 69 Burton Street, Darlinghurst NSW 2010, Sydney,Department of Dermatology, St Vincent’s Private Hospital, Sydney, Australia
| | - Vicki HOWARD
- School of Medicine, University of Notre Dame Australia, Sydney, Australia
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