budesonide (Xavin / Pulairmax / Aerosial)

Clinical remission trajectories and histopathological associations in patients with IgA nephropathy treated with targeted-release budesonide: a real-world cohort study.

He Dafeng D, Xu Jun J, Gao Bo B, Jiang Mingzhu M et al.

Targeted-release (TR) budesonide provides upstream mucosal immunomodulation in IgA nephropathy (IgAN) by targeting the gut-associated lymphoid tissue. However, the extent to which distinct downstream immune-inflammatory phenotypes and established structural chronicity shape real-world remission trajectories remains insufficiently characterized. We retrospectively analyzed 57 adults with biopsy-proven primary IgAN treated with TR-budesonide. Prespecified milestones were Very Early Response (VER) at 3 months, Early Response (ER) at 6 months, and composite clinical remission (complete or partial remission, CR/PR) over 12 months. We constructed a time-dependent prognostic nomogram using multivariable Cox modeling integrating the full Oxford MEST-C spectrum and concurrent therapies, strictly applying optimism-corrected bootstrapping (1,000 iterations) to ensure robust internal validation. Relative proteinuria reductions were broadly comparable across MEST-C strata, even among patients with substantial baseline chronicity (S1, 91.2%; T1/T2, 63.2%). Concomitant sodium-glucose cotransporter 2 inhibitor (SGLT2i) therapy independently predicted VER (OR 9.40, 95% CI 1.36-64.92; P = 0.023), consistent with an early complementary kinetic profile. Over 12 months, endocapillary hypercellularity (E1) was the only independent histopathological factor associated with composite remission (OR 2.20; P = 0.022) and was associated with a shorter time to remission (log-rank P = 0.031). The resulting optimized 3-variable nomogram demonstrated good discrimination (time-dependent AUC 0.79 at 6 months and 0.83 at 12 months) with favorable internal calibration. In routine practice, the antiproteinuric effect of TR-budesonide appears largely preserved even in patients with advanced tubulointerstitial fibrosis. Early response is strongly associated with concomitant SGLT2i therapy, while the E1 lesions was associated with a faster trajectory toward composite clinical remission within this treated cohort, identifying a potentially reversible inflammatory phenotype that warrants further validation. These findings highlight the translational value of integrating histopathological phenotyping to characterize real-world remission trajectories.

Myrtenol inhalation ameliorates lung injury induced by cigarette smoke in rats: the role of inflammation and oxidative stress.

Pardakhty Soheil S, Najafipour Hamid H, Jafari Elham E, Akbari Mohammad Mahdi MM et al.

Cigarette smoke is a major contributor to chronic lung injury through oxidative stress, inflammation, and structural damage. Myrtenol, a natural monoterpene, exhibits anti-inflammatory and antioxidant properties. This study evaluated the protective effects of inhaled myrtenol against cigarette smoke-induced lung injury in rats. Twenty male Wistar rats were divided into four groups: control, cigarette smoke (CS), CS + myrtenol (50 mg/kg via inhalation), and CS + budesonide. Rats were exposed to cigarette smoke for 4 weeks. Inflammatory markers (tumor necrosis factor alpha [TNF-α] and interleukin-10 [IL-10]) and oxidative stress parameters (malondialdehyde [MDA], total antioxidant capacity [TAC], and superoxide dismutase [SOD]) in lung tissue and bronchoalveolar lavage fluid (BALF) were measured by ELISA. Gene expression of MUC5AC and matrix metalloproteinase 21 (MMP-21) in lung tissue was assessed by real-time PCR. Serum cotinine levels were measured, and histopathology was performed using H&E staining. Myrtenol significantly mitigated CS-induced lung injury. Treatment reduced TNF-α, MDA, MUC5AC, MMP-21, and serum cotinine levels, while increasing IL-10, TAC, and SOD compared with the CS group. Histological analysis showed decreased inflammatory infiltration and improved tissue structure. Effects were comparable to those of budesonide. Inhaled myrtenol exerts potent anti-inflammatory and antioxidant effects, reduces oxidative and inflammatory markers, and protects lung structure against chronic cigarette smoke exposure. These findings suggest myrtenol as a promising therapeutic agent for smoke-related pulmonary disorders.

Octopus-inspired suction-cup microneedle patch enables intralesional SMAD7/Budesonide co-delivery to disrupt TGF-β-driven fibrotic remodeling.

Qin Xiaoyu X, Wie Wei W, Song Chuanhui C, Xu Jiale J et al.

Gastrointestinal stenosis following endoscopic intervention remains a major clinical challenge, largely driven by excessive fibrotic remodeling rather than persistent inflammation alone. Although glucocorticoids are widely used to suppress acute inflammatory responses, their therapeutic benefit is limited since the core profibrotic circuitry governed by the TGF-β/Smad signaling pathway. In fibrotic lesions throughout the gastrointestinal tract, activated myofibroblasts and dense extracellular matrix deposition increase tissue stiffness, reinforce mechanotransduction-dependent TGF-β activation, and restrict effective intralesional drug retention, thereby establishing a self-sustaining profibrotic microenvironment. To address this mechanistic barrier, we developed an octopus-inspired suction-cup microneedle patch with a mechanically decoupled architecture composed of rigid PLGA microneedles (MN) and a flexible pectin-based substrate. This design enables efficient penetration into stiffened mucosa and stable adhesion within the moist, dynamic luminal environment. The system achieves localized co-delivery of Budesonide (BUD) and SMAD7, an endogenous intracellular antagonist of TGF-β/Smad signaling. Comprehensive in vitro mechanistic studies and in vivo wound-healing models demonstrate effective intralesional retention, significant suppression of fibrotic remodeling, and promotion of mucosal regeneration. By simultaneously targeting inflammation and the core fibrotic signaling cascade, this bioinspired microneedle platform offers a mechanistically informed and clinically translatable strategy for the prevention and treatment of post-endoscopic gastrointestinal stenosis.

Comment on "Effect of Budesonide Nasal Irrigation in Patients With Chronic Rhinosinusitis With Nasal Polyps Without Prior Sinus Surgery: A Randomized, Double-Blind, Placebo-Controlled Study".

Malik Maajid Mohi Ud Din MMUD, Saraf Abhay A