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All Journal Universa Medicina Journal of Current Health Sciences
Chakravarthi, Srikumar
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Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Bortezomib in multiple myeloma management Iqbal, Hrishik; Islam, Mohammad Nazmul; Chakravarthi, Srikumar; Jamali, Mohammad Chand; Mahedi, Rezwan Ahmed; Afrin, Sadia; Pujita Roy; Alam, Fahadul; Reza, Md.Shajalal; Syrmos, Νikolaos
Universa Medicina Vol. 44 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.380-393

Abstract

Multiple myeloma (MM) is a hematologic malignancy characterized by the uncontrolled proliferation of plasma cells, leading to complications such as bone lesions, renal dysfunction, and immune suppression. Over the past three decades, its incidence has risen significantly, attributed to factors such as aging populations and improved diagnostic methods. Treatment strategies have evolved considerably, transitioning from alkylating agents and high-dose chemotherapy to targeted therapies, including proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs). Bortezomib, a first-in-class PI, has revolutionized MM management by inhibiting proteasome activity, thereby inducing apoptosis in malignant plasma cells. This review evaluates the efficacy, safety, and clinical applications of bortezomib, both as monotherapy and in combination with dexamethasone, IMiDs, and conventional chemotherapies. Key clinical trials, such as VISTA and SUMMIT, demonstrate its superiority over traditional regimens, improving response rates and survival outcomes. However, its use is associated with adverse effects, including peripheral neuropathy, hematologic toxicities, and gastrointestinal disturbances, necessitating dose modifications and supportive care. Emerging combinations with monoclonal antibodies and novel agents further enhance therapeutic potential, though optimal sequencing remains under investigation. Systematic literature search was performed using PubMed and Cochrane to identify relevant studies on the applications of bortezomib. The search was inclusive of all publications up to May 2025, without restriction by publication year, to ensure a thorough review of research on bortezomib. Studies focusing on multiple myeloma (MM) and the efficacy of bortezomib were prioritized. A broad set of keywords was employed reflecting the diverse applications of bortezomib in MM treatment. The search strategy was designed to capture a wide range of relevant studies. By synthesizing evidence from 77 studies, this review highlights bortezomib’s pivotal role in MM treatment while addressing challenges in toxicity management. Future research should focus on refining combination strategies and minimizing side effects to maximize long-term patient outcomes.
Oxidative Stress Induced Thrombosis and Hypercholesterolemic Condition in COVID-19 Infection Ahmed, Ashfaq; Iqbal, Hrishik; Mostaid, Md Shaki; Zannat, Afroza; Chakravarthi, Srikumar; Syrmos, Nikolaos
Journal of Current Health Sciences Vol. 6 No. 3: 2026
Publisher : Utan Kayu Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47679/jchs.2026162

Abstract

The COVID-19 pandemic, caused by SARS-CoV-2, has emerged as a global health crisis, with severe disease and mortality disproportionately affecting individuals with comorbidities such as cardiovascular disease, diabetes, obesity, and immunosuppression. These conditions are associated with elevated basal reactive oxygen species (ROS) levels, predisposing patients to oxidative stress, systemic inflammation, endothelial dysfunction, and thrombotic complications. SARS-CoV-2 infection further exacerbates ROS generation via dysregulation of the renin–angiotensin system, NADPH oxidase activation, and immune-mediated neutrophil and macrophage responses, contributing to vascular injury, cytokine storm, and acute respiratory distress syndrome (ARDS). Hypercholesterolemic patients are particularly vulnerable, as oxidized LDL (OxLDL) enhances ROS production, promotes neutrophil extracellular trap formation, and accelerates thrombosis, further compounding COVID-19 severity. COVID-19–associated coagulopathy is characterized by elevated D-dimer, von Willebrand factor, and platelet activation, reflecting systemic hypercoagulability and multiorgan involvement. Therapeutically, targeting oxidative stress represents a promising strategy. Statins exhibit cholesterol-lowering and immunomodulatory effects, potentially reducing thrombotic risk. Nrf2 activators, glutathione, and N-acetylcysteine enhance endogenous antioxidant defenses, mitigate inflammation, and preserve endothelial integrity. Micronutrients such as vitamins C, D, E, and selenium further support redox homeostasis and immune function. Collectively, in this narrative review we have shown that understanding the interplay between oxidative stress, thrombosis, hypercholesterolemia, and immune dysregulation may inform preventive and therapeutic strategies to improve outcomes in high-risk COVID-19 patients. Clinical trials are warranted to validate the efficacy of these interventions.
Co-Authors Afrin, Sadia Ahmed, Ashfaq Alam, Fahadul Iqbal, Hrishik Islam, Mohammad Nazmul Jamali, Mohammad Chand Mahedi, Rezwan Ahmed Mostaid, Md Shaki Pujita Roy Reza, Md.Shajalal Syrmos, Nikolaos Syrmos, Νikolaos Zannat, Afroza