The active metabolite of vitamin D3, 1,25-dihydroxyvitamin D3, is a secosteroid hormone that regulates calcium and bone metabolism, controls cell proliferation and differentiation, and plays an important role as an immunomodulator. Recent advances in understanding the mechanisms underlying 1,25(OH)2D3 immune actions expand the range of the therapeutic implications of 1,25(OH)2D3 and its analogs. This review will cover the current knowledge on vitamin D-mediated immunotolerance and recent advances in vitamin D-based therapies for the treatment of autoimmune disease and the prevention of graft rejection in renal transplantation. Initiation of vitamin D-based therapies at earlier stages of chronic kidney disease may impact the immune status of patients who progress to require dialysis or transplantation.

The discovery of life extension in Caenorhabditis elegans treated with anticonvulsant medications has raised the question whether these drugs are prospective anti-aging candidate compounds. The impact of these compounds on neural modulation suggests that they might influence the chronic diseases of aging as well. Lamotrigine is a commonly used anticonvulsant with a relatively good adverse-effects profile. In this study, we evaluated the interaction between the impacts of lamotrigine on mortality rate, lifespan, metabolic rate and locomotion. It has been proposed in a wide range of animal models that there is an inverse relationship between longevity, metabolic rate, and locomotion. We hypothesized that the survival benefits displayed by this compound would be associated with deleterious effects on health span, such as depression of locomotion. Using Drosophila as our model system, we found that lamotrigine decreased mortality and increased lifespan in parallel with a reduction in locomotor activity and a trend towards metabolic rate depression. Our findings underscore the view that assessing health span is critical in the pursuit of useful anti-aging compounds.

The therapeutic use of botanicals-commonly referred to as phytotherapy and herbal medicine-began thousands of years ago in medicinal practices around the world and has recently gained popularity in Western medicine. Herbal medicine is now considered an integral part of health care on a global scale. For many nations, herbal medicine is considered to be the first-line therapy; up to 50% of medicinals in China are traditional herbals, and for more than half of the children in African nations such as Nigeria and Ghana, the World Health Organization (WHO) reported that herbs are considered firstline therapy for malaria-related fevers. In the United States, a 2007 National Center for Complementary and Alternative Medicine (NCCAM) and the Centers for Disease Control and Prevention (CDC) joint survey indicated that 38% of adults use complementary and alternative medicine (CAM), with natural and herbal remedies being the most prominent modality (http://nccam.nih.gov/news/camstats/2007).

Eryngium caucasicum Trautv and Froriepia subpinnata were found in natively in the eastern parts of the south Caspian Sea coasts. Antioxidant activity of E. caucasicum Trautv and F. subpinnata were investigated employing six in vitro assay systems. IC50 for DPPH radical-scavenging activity was 0.27 ± 0.02 for E. caucasicum leaves and 0.42 ± 0.03 mg ml-1 for F. subpinnata, respectively. The extracts showed weak nitric oxide-scavenging and Fe2+ chelating ability activity. The IC50 of E. caucasicum was better than other one with IC50= 0.21 mg ml-1 in NO scaveging test. The peroxidation inhibition of E. caucasicum extract exhibited values from 93 (at 24th) to 97% (at 72nd hrs). F. subpinnata exhibited very low antioxidant activity. The activity of E. caucasicum was comparable with Vit C (p> 0.05). No extract showed good scavenging activity of H2O2. The total amount of phenolic compounds in each extracts was determined as gallic acid equivalents and total flavonoid contents were calculated as quercetin equivalents from a calibration curve. Both of them had high total phenolic and flavonoid contents.

Objective

To evaluate the impact of a therapeutic interchange from pravastatin to lovastatin on treatment outcomes, quality of life, patient satisfaction, and costs.

Study design

A prospective cohort study of 170 patients switched from pravastatin to lovastatin from September 1997 through November 1997.

Patients and methods

The therapeutic interchange program promoting lovastatin as the preferred agent went into effect June 2, 1997 after Merck & Co. was awarded the Veterans Health Administration national contract for 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Patients were switched to lovastatin by either their primary care physician during routine clinic visits or the pharmacist by mail. The following outcomes were measured before and after conversion to lovastatin: lipid values, liver function tests, National Cholesterol Education Program (NCEP) low-density cholesterol (LDL-C) goals achieved, quality of life (QOL) (measured by the Medical Outcomes Study 36-item short-form health survey [SF-36]), medication tolerance (measured with a global symptom survey), patient satisfaction, and cost-minimization analysis.

Results

Lipid values and liver function test results were similar for pravastatin and lovastatin treatment. Forty percent of patients achieved NCEP LDL-C goals before and after formulary conversion. There were no significant differences between pravastatin and lovastatin in QOL, medication tolerance, and patient satisfaction. The projected cost savings from this therapeutic interchange was approximately $211,000 annually.

Conclusion

Therapeutic interchange from pravastatin to lovastatin resulted in substantial cost savings. QOL, patient satisfaction, and achievement of NCEP LDL-C goals were maintained.