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Chiaki Yoshioka, Yoshimasa Ito, Noriaki Nagai
Cilostazol (CLZ), an anti-platelet agent, is primarily used following the onset of cerebral infarction. However, as CLZ is only marginally soluble in water, a strategy for patients with serious secondary conditions, such as impaired consciousness or aphagia, is required. In the present study, topical formulations containing CLZ nanocrystals (CLZnano ) were designed to enhance percutaneous absorption. In addition, the mechanism of penetration of CLZnano through rat skin was investigated. A topical formulation containing CLZ nanoparticles (CLZnano gel patch) was prepared using a combination of recrystallization and ball milling of an aqueous gel...
April 2018: Experimental and Therapeutic Medicine
Farzin Fakhry, Hugo Jp Fokkenrood, Sandra Spronk, Joep Aw Teijink, Ellen V Rouwet, M G Myriam Hunink
BACKGROUND: Intermittent claudication (IC) is the classic symptomatic form of peripheral arterial disease affecting an estimated 4.5% of the general population aged 40 years and older. Patients with IC experience limitations in their ambulatory function resulting in functional disability and impaired quality of life (QoL). Endovascular revascularisation has been proposed as an effective treatment for patients with IC and is increasingly performed. OBJECTIVES: The main objective of this systematic review is to summarise the (added) effects of endovascular revascularisation on functional performance and QoL in the management of IC...
March 8, 2018: Cochrane Database of Systematic Reviews
Hisato Shima, Manabu Tashiro, Satoshi Yamada, Motokazu Matsuura, Kazuyoshi Okada, Toshio Doi, Jun Minakuchi, Shu Kawashima
BACKGROUND: Cilostazol is an antiplatelet drug that is widely prescribed for the prevention of secondary stroke. Adverse reactions to cilostazol include headaches, palpitations, and diarrhea. Little is known about the nephrotoxicity of cilostazol, such as acute kidney injury. We report a biopsy-proven case of diffuse tubulointerstitial nephritis induced by cilostazol. CASE PRESENTATION: A 69-year-old woman prescribed cilostazol was hospitalized for acute kidney injury...
March 5, 2018: BMC Nephrology
Slobodan Tanaskovic, Djordje Radak, Nikola Aleksic, Branko Calija, Vera Maravic-Stojkovic, Dragoslav Nenezic, Nenad Ilijevski, Petar Popov, Goran Vucurevic, Srdjan Babic, Predrag Matic, Predrag Gajin, Dragan Vasic, Zoran Rancic
BACKGROUND: Inflammation is one of the mechanisms that leads to carotid restenosis (CR). The aim of this study was to examine the influence of increased values of inflammation markers (high-sensitivity C-reactive protein [hs-CRP], C3 complement, and fibrinogen) on CR development after eversion carotid endarterectomy (CEA). METHODS: A consecutive 300 patients were included in the study, in which eversion CEA was performed between March 1 and August 1, 2010. Demographic data, atherosclerosis risk factors, comorbidities, and ultrasound plaque characteristics were listed in relation to potential risk factors for CR...
March 1, 2018: Journal of Vascular Surgery
Mervat Z Mohamed, Heba M Hafez, Nagwa M Zenhom, Hanaa Hassanein Mohammed
AIMS: Male infertility prevalence is higher in diabetic patients. Those patients exhibit testicular oxidative damage due to sustained hyperglycemia and inflammation. The study has investigated the efficacy of cilostazol, a phosphodiesterase 3 inhibitor, on testicular damage of diabetic rats. MAIN METHODS: Streptozotocin-induced diabetes in rats was used as a model. Six control male rats and 24 diabetic male rats were divided into the following: diabetic, cilostazol at low dose, cilostazol at high dose, and sildenafil treated rat groups...
February 26, 2018: Life Sciences
Vasiliki Tsigkou, Gerasimos Siasos, Kleanthis Rovos, Niki Tripyla, Dimitris Tousoulis
Peripheral artery disease (PAD) is one of the most important causes of cardiovascular morbidity and mortality and its prevalence is alarmingly increasing in modern societies. PAD shares common characteristics with the other atherosclerotic diseases but involves specifically the arteries of the lower extremities. Apart from the changes in lifestyle, antiplatelet agents are the hallmark of the treatment and improve the symptoms as well as the progression of the disease. Aspirin is the cornerstone of treatment and is administrated in doses ranging from 75 to 325mg daily...
February 19, 2018: Current Opinion in Pharmacology
Shinsuke Mii, Atsushi Guntani, Eisuke Kawakubo, Kiyoshi Tanaka, Ryoichi Kyuragi
BACKGROUND: Few reports have described the effects of medication on the wound healing of ischemic ulcers after revascularization. This study was conducted to investigate the effects of cilostazol on wound healing in patients who underwent infrainguinal bypass for ischemic tissue loss. METHODS: Two hundred and sixty-three limbs undergoing de novo infrainguinal bypass for tissue loss from January 2004 to December 2015 were divided into two groups based on whether or not cilostazol was administered after surgery...
February 15, 2018: Annals of Vascular Surgery
Naoki Saji, Shigenobu Tone, Kenta Murotani, Yoshiki Yagita, Kazumi Kimura, Takashi Sakurai
BACKGROUND: The mechanism of progressive neurological deficit in patients with recent small subcortical infarcts has not yet been clarified. Inflammatory biomarkers and the use of cilostazol may be associated with this phenomenon. METHODS: Between May 2013 and April 2014, we evaluated consecutive first-ever patients with stroke due to recent small subcortical infarcts within 48 hours of onset. We divided patients into 2 groups according to the use of antiplatelet agents (cilostazol with or without aspirin versus aspirin alone)...
February 14, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Laura Alemanno, Isabella Massimi, Vanessa Klaus, Maria Luisa Guarino, Teresa Maltese, Luigi Frati, Dominick J Angiolillo, Fabio M Pulcinelli
Platelet multidrug resistance protein 4 (MRP4) plays a modulating role on platelet activation. Platelet function and thrombus formation are impaired in MRP4 knockout mice models, and, among aspirin-treated patients, high on-aspirin residual platelet reactivity (HARPR) positively correlates with MRP4 levels. To better understand the effects of MRP4 on platelet function, the aim of this investigation was to assess the impact of cilostazol-induced inhibition of MRP4-mediated transport and assess aspirin-induced antiplatelet effects and rates of HARPR in human subjects...
March 2018: Thrombosis and Haemostasis
Ayaka Haruta-Tsukamoto, Hideki Funahashi, Yu Miyahara, Tomoko Matsuo, Toshikazu Nishimori, Yasushi Ishida
Thalamic pain is severe and treatment-resistant; however, there are few available options for improving thalamic pain. This study demonstrated that thalamic pain was alleviated by administration of cilostazol, suggesting that cilostazol may be a candidate for treating thalamic pain.
February 2018: Clinical Case Reports
Ryoko Umebayashi, Haruhito A Uchida, Yuki Kakio, Venkateswaran Subramanian, Alan Daugherty, Jun Wada
OBJECTIVE: Abdominal aortic aneurysm (AAA) is a permanent dilation of the abdominal aorta associated with rupture, which frequently results in fatal consequences. AAA tissue is commonly characterized by localized structural deterioration accompanied with inflammation and profound accumulation of leukocytes, although the specific function of these cells is unknown. Cilostazol, a phosphodiesterase III inhibitor, is commonly used for patients with peripheral vascular disease or stroke because of its anti-inflammatory effect, which is vasoprotective effects through its anti-inflammatory effect...
February 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Tsukasa Kamakura, Mitsuru Wada, Kohei Ishibashi, Yuko Y Inoue, Koji Miyamoto, Hideo Okamura, Satoshi Nagase, Takashi Noda, Takeshi Aiba, Satoshi Yasuda, Wataru Shimizu, Shiro Kamakura, Kengo Kusano
BACKGROUND: Previously described patients with early repolarization syndrome (ERS) may have experienced silent coronary artery spasm (CAS) because the diagnosis of CAS was mainly based on symptoms or coronary angiography findings, without performing a spasm provocation test. This study investigated the significance of CAS diagnosis and evaluated the incidence of silent CAS in patients with possible ERS (ie, idiopathic ventricular fibrillation [VF] and inferolateral J wave). METHODS AND RESULTS: The study included 34 patients with idiopathic VF and inferolateral J wave...
February 7, 2018: Journal of the American Heart Association
Shireen A Hedya, Marwa M Safar, Ashraf K Bahgat
Nuclear receptor related 1 (Nurr1) orphan receptor has emerged as a promising contender in ameliorating Parkinson's disease; thus, finding a suitable activator of Nurr1 receptor is an attracting target for treating PD. Cilostazol, a phosphodiesterase-3 inhibitor, recently showed a favorable neuroprotective activity in multiple devastating central disorders, yet the possible antiparkinsonian activity of the drug has not been fully elucidated. Thus, the aim of this study is to explore the neuroprotective effect of cilostazol in rotenone-induced PD model in rats...
February 10, 2018: Molecular Neurobiology
Lorenzo Valerio, Jawaad Sheriff, Phat L Tran, William Brengle, Alberto Redaelli, Gianfranco B Fiore, Federico Pappalardo, Danny Bluestein, Marvin J Slepian
INTRODUCTION: Continuous flow ventricular assist devices (cfVADs) continue to be limited by thrombotic complications associated with disruptive flow patterns and supraphysiologic shear stresses. Patients are prescribed complex antiplatelet therapies, which do not fully prevent recurrent thromboembolic events. This is partially due to limited data on antiplatelet efficacy under cfVAD-associated shear conditions. MATERIALS AND METHODS: We investigated the efficacy of antiplatelet drugs directly acting on three pathways: (1) cyclooxygenase (aspirin), (2) phosphodiesterase (dipyridamole, pentoxifylline, cilostazol), and (3) glycoprotein IIb-IIIa (eptifibatide)...
December 5, 2017: Thrombosis Research
Yi-Da Tang, Wenyao Wang, Min Yang, Kuo Zhang, Jing Chen, Shubin Qiao, Hongbing Yan, Yongjian Wu, Xiaohong Huang, Bo Xu, Runlin Gao, Yuejin Yang
Background -Patients undergoing percutaneous coronary intervention (PCI) react differently to antiplatelet drugs. Those with low responsiveness to clopidogrel have a higher risk of cardiac ischemic events. The goal of this study is to conduct a head-to-head comparison of the safety and effectiveness of intensified antiplatelet therapies (either double-dose clopidogrel [DOUBLE] or adjunctive cilostazol [TRIPLE]) and conventional strategy (STANDARD) in post-PCI patients. Methods -In this single-center, randomized, controlled trial, we used thromboelastography (TEG), a platelet function test, to select 1078 PCI patients at high thrombotic risk and compared the intensified antiplatelet therapies with standard antiplatelet therapy...
February 2, 2018: Circulation
Dagmar F Hernandez-Suarez, Hector Núñez-Medina, Stuart A Scott, Angel Lopez-Candales, Jose M Wiley, Mario J Garcia, Kyle Melin, Karid Nieves-Borrero, Christina Rodriguez-Ruiz, Lorraine Marshall, Jorge Duconge
BACKGROUND: Antiplatelet therapy with clopidogrel is recommended to reduce cardiovascular events in patients with peripheral artery disease (PAD); however, clopidogrel efficacy has not been adequately studied in this patient population. Therefore, we aimed to determine the effects of cilostazol therapy on platelet reactivity among PAD patients on clopidogrel. METHODS: We performed a cross-sectional pilot study of 46 Puerto Rican patients diagnosed with PAD. The cohort was divided based on use of clopidogrel and cilostazol (n=24) or clopidogrel alone (n=22)...
February 6, 2018: Drug Metabolism and Personalized Therapy
Katrine Falkenberg, Bára Óladóttir Á Dunga, Song Guo, Messoud Ashina, Jes Olesen
BACKGROUND: Cilostazol is an inhibitor of phosphodiesterase 3 and thus causes accumulation of cAMP. It induces migraine-like attacks in migraine patients. Whether the cilostazol model responds to sumatriptan in migraine patients and therefore is valid for testing of future anti-migraine medications has never been investigated. METHODS: In a cross-over study, 30 patients received cilostazol (200 mg p.o.) on two separate days each day followed by oral self-administered placebo or sumatriptan 50 mg...
February 2, 2018: Journal of Headache and Pain
Ryouhei Komaki, Takehiro Ueda, Yukio Tsuji, Toko Miyawaki, Sentaro Kusuhara, Shigeo Hara, Tatsushi Toda
A 40-year-old woman with renal dysfunction for 2 years was admitted to our hospital suffering from a headache. Family history revealed that her mother had a headache, renal dysfunction, and brain infarction in younger age. She had a retinal hemorrhage, a retinal atrophy, pitting edema in her lower extremities. Her neurological findings were unremarkable. Brain imaging showed multiple white matter lesions accompanied with calcifications and slightly enhancement. Kidney biopsy showed the thrombotic microangiopathy, Gene analysis demonstrated a causative mutation in three-prime repair exonuclease-1 (TREX1) gene, c...
January 31, 2018: Rinshō Shinkeigaku, Clinical Neurology
Chiaki Yoshioka, Yoshimasa Ito, Noriaki Nagai
Cilostazol (CLZ) is an anti-platelet agent that is generally used after the onset of cerebral infarction. However, CLZ is a poorly water-soluble drug and a strategy for increasing its bioavailability is required. In the present study, novel oral formulations were designed containing CLZ solid nanoparticles to improve bioavailability. The present study investigated the therapeutic effect of the oral formulations containing CLZ nanoparticles on ischemic stroke using a cerebral ischemia/reperfusion-induced injury model (MCAO/reperfusion mice)...
January 2018: Experimental and Therapeutic Medicine
Marek Rychter, Anna Baranowska-Korczyc, Bartłomiej Milanowski, Marcin Jarek, Barbara M Maciejewska, Emerson L Coy, Janina Lulek
PURPOSE: The study discusses the value of electrospun cilostazol-loaded (CIL) polymer structures for potential vascular implant applications. METHODS: Biodegradable polycaprolactone (PCL) fibers were produced by electrospinning on a rotating drum collector. Three different concentrations of CIL: 6.25%, 12.50% and 18.75% based on the amount of polymer, were incorporated into the fibers. The fibers were characterized by their size, shape and orientation. Materials characterization was carried out by Fourier Transformed Infrared spectroscopy (FTIR), Raman spectroscopy, differential scanning calorimetry (DSC) and X-ray diffraction (XRD)...
January 16, 2018: Pharmaceutical Research
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