Current pharmaceutical design
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Pentraxins are a family of evolutionarily conserved multifunctional pattern-recognition proteins characterized by a cyclic multimeric structure. Based on the primary structure of the subunit, the pentraxins are divided into two groups: short pentraxins and long pentraxins. C-reactive protein (CRP) and serum amyloid P-component (SAP) are the two short pentraxins. ⋯ In addition, PTX3 is essential in female fertility by acting as a nodal point for the assembly of the cumulus oophorus hyaluronan-rich extracellular matrix. Here we will concisely review the general properties of PTX3 in the context of the pentraxin superfamily and discuss recent data suggesting that PTX3 plays a cardiovascular protective effect. PTX3 may represent a new marker in vascular pathology which correlates with the risk of developing vascular events.
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Coronary heart disease (CHD) is the leading cause of death among elderly patients and >80% of all coronary deaths occur in patients >65 years. Cerebrovascular events are also associated with older age. Since elevated cholesterol concentrations are a risk factor for cardiovascular disease, lipid-lowering drugs, especially statins, are in widespread use for prevention. ⋯ Their prescription should not be denied to patients for reasons of age alone. Other lipid-lowering drugs play only a minor role in cardiovascular disease (CVD) event prevention because convincing outcome studies are largely missing. A primary prevention statin trial in the very elderly is urgently needed.
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Recent research has uncovered neurobiological and behavioral similarities between substance dependence and excess consumption of highly processed foods. These findings have led to the theory that food addiction may play a role in obesity and disordered eating. The inclusion of validated food addiction measures in clinical research, such as the Yale Food Addiction Scale, will add to the understanding of the clinical utility of this concept. Further exploring the food-addiction construct may also lead to a better clinical understanding of obesity and eating disorders and suggest future avenues for more effectively treating these problems.
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Insomnia is a highly prevalent condition, and due to ongoing demand from patients suffering with this condition, new pharmacological treatments are actively being sought. As our neurophysiological understanding of insomnia grows, so too do the available treatment options. A significant advance in the treatment of insomnia came with the development of the nonbenzodiazepine hypnotic medications, zolpidem, zaleplon and eszopiclone. ⋯ Serotonin antagonists and inverse agonists have been investigated; however, a recent trial with APD125 was discontinued due to lack of efficacy. Sodium oxybate has been used off-label for insomnia by some providers, although data supporting its use are limited. While the sleep-promoting effects of GABA(A) (nonbenzodiazepines and benzodiazepines) enhancement is well-established, newer research examining other mechanisms of action suggest that agents which modulate the histaminergic, serotonergic, melontonergic, and hypocretin/orexin and perhaps GABA-B systems show promise.
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The contemporary American food environment makes energy-dense, nutrient-poor foods and beverages the "default" option for most consumers. Economic interventions like taxes can shift the relative prices of unhealthy foods to nudge consumers towards healthier options. Beverages with added sugar are a good starting point for food taxation; they constitute over 10 percent of caloric intake nationwide and provide little or no nutritional value. ⋯ Current estimates predict that a tax that raised the cost of SSBs by 20 percent could lead to an average reduction of 3.8 pounds per year for adults, causing the prevalence of obesity to decline from 33 to 30 percent. SSB taxes would also generate considerable revenue for public health and obesity prevention programs. Although the beverage industry is fighting such taxes with massive lobbying and public relations campaigns, support for the policies is increasing, especially when revenue is earmarked for obesity prevention.