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  • ISSN: 2578-3351
    Early Online
    Volume 1, Issue 2
    Mini Review
    Antonella Riva*, Federico Franceschi, Stefano Togni, Roberto Eggenhoffner, and Luca Giacomelli
    Osteopenia, or low bone density, is a chronic condition characterized by decreased calcification, density, and mass of bones, which represents a major health issue. Nutrition plays a key role in the prevention and management of this condition. Among different nutritional supplementation, curcumin is characterized by a wide spectrum of pharmacological activities, also with potential reference to the management of osteopenia. This review discusses current evidence supporting the use of curcumin supplementation in osteopenia. In multiple experimental studies on osteopenia models, curcumin reduced osteoclasts activity and promoted the action of osteoblasts, thus contributing to restore the physiological balance between these two cell populations which underlies the onset of osteopenia.
    However, curcumin in its native form presents poor pharmacokinetic properties which greatly limit the effectiveness of this supplementation in daily practice. To address this limitation, our group has developed Meriva®, a phytosome-based technology which ensures optimal pharmacokinetic and allows curcumin to exert its multiple effects. On these bases, we studied Meriva® also in the management of osteopenia in otherwise healthy subjects, showing improved bone health parameters already after few weeks of administration and without any side effect.
    These clinical findings represented the first evidence supporting the use of curcumin in the phytosome-form for the management of bone loss. Although larger studies are needed to further explore the effectiveness of curcumin in this condition, we believe that Meriva®, in combination with an appropriate lifestyle, may play a key role in the prevention and management of osteopenia in otherwise healthy subjects.
    Review Article
    Choudhry VP*
    Aplastic anemia which was once considered as rare and invariably fatal disease. Over the years the understanding of its pathophysiology, its relationship with constitutional bone marrow failure syndrome and evolution to myelodysplastic syndrome and leukemia has improved. Evolution of standard immunotherapy and bone marrow transplantation has dramatically improved the survival of patients over the years. The optimum immunotherapy with antithymocyte globulin and cyclosporine has been developed and patients who failed even to second course of immunotherapy were also subjected to bone marrow transplantation. These strategies have achieved and improved the event free but significant numbers of cases were refractory to these treatments.
    Initial studies of thrombopoietin-MPL system revealed their activity to increase the number of committed progenitor cells along with their proliferation in all three lineages. Peptide agonists such as eltrombopag can bind to MPL region to initiate lineage responses. Initially it was shown to induce significant stimulus to increase platelets in patients of chronic idiopathic thrombocytopenic purpura. Subsequent clinical trials have revealed that eltrombopag induced erythropoietic stimulus even in patients of refractory aplastic anemia and resulted in improved event free and overall survivals. In the present manuscript the role of eltrombopag along with standard immunotherapy has been briefly reviewed in aplastic anemia.
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