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Lara VS, Silva RAD, Ferrari TP, Santos CFD, Oliveira SHPD. Losartan Plays a Fungistatic and Fungicidal Activity Against Candida albicans Biofilms: Drug Repurposing for Localized Candidosis. Assay Drug Dev Technol 2023; 21:157-165. [PMID: 37229625 DOI: 10.1089/adt.2023.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Candidosis is one of the most frequent opportunistic infections and exhibits variable clinical presentations, including oral localized forms. Drugs affecting the renin-angiotensin system targets inhibit secreted aspartic proteases from Candida albicans. The objective of the study was to evaluate whether losartan has antimicrobial action against C. albicans biofilms. Biofilms were treated with losartan or aliskiren (for comparison) for 24 h. Metabolic activity of viable cells and growth inhibition of C. albicans biofilms were assessed using XTT [2,3-Bis(2-Methoxy-4-Nitro-5-Sulfophenyl)-5-[(Phenyl-Amino)Carbonyl]-2H-Tetrazolium Hydroxide] and colony-forming unit assays, respectively. In addition, the cytotoxicity of the drugs on human cells was evaluated using the AlamarBlue assay. Both drugs decreased fungal viability at all concentrations. In addition, all concentrations of losartan inhibited the growth of C. albicans biofilm, ranging from 47% to 88.5%, whereas aliskiren showed inhibition from 1 to 10 mg/mL, which ranged from 16% to 97.6%. Furthermore, at certain concentrations, these drugs maintained the viability of human cells. Losartan and aliskiren have fungistatic and fungicidal action against C. albicans biofilms and are compatible with human cells. Therefore, these antihypertensive drugs can be repurposed to interfere with the metabolism and development of Candida biofilms, which are widely associated with clinical forms of candidosis, including oral localized forms such as denture stomatitis.
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Affiliation(s)
- Vanessa Soares Lara
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Rafaela Alves da Silva
- Integrated Research Center, Bauru School of Dentistry, University of São Paulo (USP). Bauru, Brazil
| | - Tatiane Ponteado Ferrari
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Carlos Ferreira Dos Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of Sa˜o Paulo (USP). Bauru, Brazil
| | - Sandra Helena Penha de Oliveira
- Immunopharmacology Laboratory, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry. Araçatuba, Brazil
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Ram CVS, Dalal J, Kahali D, Mohanan PP, Das MK, Guha S, Nair T, Narasimhan C, Roy DG, Abdullakutty J, Ray S, Fulwani M, Mohan JC, Gupta R, Abhyankar M, Revankar S. Management of American Heart Association/American College of Cardiology-Defined Stage 2 Hypertension by Cardiologists in India. Am J Cardiol 2022; 167:62-67. [PMID: 35034692 DOI: 10.1016/j.amjcard.2021.11.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/01/2022]
Abstract
Uncontrolled hypertension is an important cardiovascular risk factor and therefore requires effective approaches to patient management. This study assessed approaches to the management of patients with Stage 2 hypertension by cardiologists in India. This was a retrospective, multicenter, observational, case-based questionnaire study. Data on demographic characteristics, risk factors associated with Stage 2 hypertension, use of antihypertensive medications, side effects, and approaches to education for 2,540 patients were extracted from questionnaire responses provided by 508 cardiologists. The study population of patients with Stage 2 hypertension had a mean age of 55.0 years. Most of the patients (62.6%) were aged 30 to 60 years and diabetes mellitus was the most prevalent comorbidity (48.9%). Triple antihypertensive therapy was being used by 760 patients, and 634 and 1,146 patients were receiving 4 and 5 different antihypertensive medications, respectively. Telmisartan, amlodipine, chlorthalidone, hydrochlorothiazide, spironolactone, metoprolol, and prazosin were the commonly prescribed drugs. Ankle edema (27.7%) was the most frequent side effect of therapy. Pharmacotherapy was supported by patient education and lifestyle modifications for better blood pressure control. The standardized approach to the collection and assessment of these contemporary data provides useful insights into the characteristics and treatment of patients with Stage 2 hypertension in India.
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Volgman AS, Palaniappan LS, Aggarwal NT, Gupta M, Khandelwal A, Krishnan AV, Lichtman JH, Mehta LS, Patel HN, Shah KS, Shah SH, Watson KE. Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association. Circulation 2018; 138:e1-e34. [PMID: 29794080 DOI: 10.1161/cir.0000000000000580] [Citation(s) in RCA: 277] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
South Asians (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) make up one quarter of the world's population and are one of the fastest-growing ethnic groups in the United States. Although native South Asians share genetic and cultural risk factors with South Asians abroad, South Asians in the United States can differ in socioeconomic status, education, healthcare behaviors, attitudes, and health insurance, which can affect their risk and the treatment and outcomes of atherosclerotic cardiovascular disease (ASCVD). South Asians have higher proportional mortality rates from ASCVD compared with other Asian groups and non-Hispanic whites, in contrast to the finding that Asian Americans (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) aggregated as a group are at lower risk of ASCVD, largely because of the lower risk observed in East Asian populations. Literature relevant to South Asian populations regarding demographics and risk factors, health behaviors, and interventions, including physical activity, diet, medications, and community strategies, is summarized. The evidence to date is that the biology of ASCVD is complex but is no different in South Asians than in any other racial/ethnic group. A majority of the risk in South Asians can be explained by the increased prevalence of known risk factors, especially those related to insulin resistance, and no unique risk factors in this population have been found. This scientific statement focuses on how ASCVD risk factors affect the South Asian population in order to make recommendations for clinical strategies to reduce disease and for directions for future research to reduce ASCVD in this population.
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Kamada T, Hayashi M, Fujiwara W, Yoshikawa D, Mukaide D, Sugishita Y, Yoshinaga M, Itoh T, Yokoi H, Ishii J, Watanabe E, Ozaki Y, Izawa H. Antihypertensive efficacy and safety of the angiotensin receptor blocker azilsartan in elderly patients with hypertension. Drug Chem Toxicol 2016; 40:110-114. [PMID: 27424785 DOI: 10.1080/01480545.2016.1188301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The number of elderly patients with hypertension has been steadily increasing. However, there are limited data on the safety and efficacy of the new angiotensin type 1 receptor blocker (ARB) azilsartan in elderly patients with hypertension. We investigated the clinical efficacy and safety of azilsartan in this population. METHODS The study population comprised 56 ambulatory patients with essential hypertension. We evaluated the reduction in blood pressure and safety after 12 weeks of treatment with azilsartan in 29 hypertensive patients ≥65 years of age (aged group) in comparison with the findings in 27 patients <65 years of age (non-aged group). RESULTS Systolic blood pressure in the aged group declined significantly from 155 ± 18 mmHg at baseline to 138 ± 11 mmHg after 12 weeks of treatment with azilsartan, and that in the non-aged group also declined significantly from 152 ± 20 mmHg at baseline to 142 ± 13 mmHg after 12 weeks of treatment with azilsartan. There were no significant differences in the magnitude of change in blood pressures from pre-treatment to post-treatment with azilsartan between the non-aged and aged groups. There were no changes in clinical laboratory findings, including serum levels of creatinine, potassium, lipids, and other metabolic variables, after 12 weeks of treatment with azilsartan in both groups. CONCLUSIONS Our findings suggest that azilsartan is effective in lowering blood pressure in elderly patients and may be safe. Therefore, azilsartan could be a valuable option for treating hypertension in elderly and non-elderly patients.
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Affiliation(s)
- Tomohito Kamada
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and.,b Department of Cardiology , Fujita Health University , Toyoake , Japan
| | - Mutsuharu Hayashi
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Wakaya Fujiwara
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Daiji Yoshikawa
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Daisuke Mukaide
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Yoshinori Sugishita
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Masataka Yoshinaga
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Takehiro Itoh
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Hiroatsu Yokoi
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
| | - Junichi Ishii
- b Department of Cardiology , Fujita Health University , Toyoake , Japan
| | - Eiichi Watanabe
- b Department of Cardiology , Fujita Health University , Toyoake , Japan
| | - Yukio Ozaki
- b Department of Cardiology , Fujita Health University , Toyoake , Japan
| | - Hideo Izawa
- a Department of Cardiology , Fujita Health University, Banbuntane Hotokukai Hospital , Nagoya , Japan and
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Litscher G, Cheng WP, Cheng GY, Wang L, Zhao J, Litscher D, Gaischek I, Sheng Z, Kuang H. Acupuncture Point Laterality: Investigation of Acute Effects of Quchi (LI11) in Patients with Hypertension Using Heart Rate Variability. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:979067. [PMID: 25136375 PMCID: PMC4036712 DOI: 10.1155/2014/979067] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 04/24/2014] [Indexed: 11/17/2022]
Abstract
Hypertension is one of the major risk factors for cardiovascular disease worldwide. Over 70% of the patients use antihypertensive drugs, so nonpharmacological treatments in addition to the medication are important. Our goal was to investigate acupuncture treatment on the Quchi acupoint using heart rate (HR) and heart rate variability (HRV) and to find out whether there is a laterality in acute effects. Sixty hypertensive patients (36 female, 24 male; mean age ± SD 55.8 ± 9.7 years) were randomly assigned to two manual needle acupuncture groups (group A: left Quchi (LI11) acupoint, group B: right Quchi acupoint). There was a significant (P < 0.05) decrease in HR immediately after inserting and stimulating the needle at the left and the right Quchi acupuncture point. In contrast, total HRV increased immediately after inserting the needle, but this increase was significant only towards the end of the stimulation phase and after removing the needle. There were some differences between stimulation of the left and right Quchi acupoint, but they remained insignificant. This study provides evidence that there is a beneficial effect on heart rate variability in patients with hypertension and that there are some effects of laterality of the acupoint Quchi.
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Affiliation(s)
- Gerhard Litscher
- Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz, 8036 Graz, Austria
- Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Wei-Ping Cheng
- The First Hospital Affiliated to Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Guang-Yu Cheng
- The First Hospital Affiliated to Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Lu Wang
- Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz, 8036 Graz, Austria
- Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Jian Zhao
- Clinical Medicine of Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Daniela Litscher
- Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Ingrid Gaischek
- Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Zemin Sheng
- Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz, 8036 Graz, Austria
- Privatklinik Laßnitzhöhe, 8301 Laßnitzhöhe, Austria
| | - Haixue Kuang
- Heilongjiang University of Chinese Medicine, Harbin 150040, China
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