Background: Spironolactone is the main addition for triple therapy for resistant hypertension, which has been proven by previous studies about how effective the drug is on reducing blood pressure. Renal denervation (RDN) is a catheter-based ablation procedure designed to treat resistant hypertension (RH). Both of these interventions are considered the main choices on treating resistant hypertension, however the use of spironolactone and renal denervation to decrease blood pressure in individuals with resistant hypertension has not before been compared in a systematic study. Methods: We performed the present systematic review according to preferred items in the 2020 PRISMA. A systematic search was conducted through Pubmed, Sciencedirect, Scopus, and Web of Science selecting randomized control study until July 2022 Results and Discussion: Our search yielded 987 studies of which we included 6 studies for the final analysis. A total of 224 patients were treated with spironolactone and 211 patients treated with RDN, however 1 study performed RDN combined with PVI. From the 6 studies included in this review, it has been found that spironolactone has a better lowering effect on both 24-hour and office blood pressure. Conclusion: Spironolactone is more effective than renal denervation in reducing blood pressure in patients with resistant hypertension.
Glioblastoma is one of the most malignant brain tumors that have a low survival rate compared to other cancers. The hallmark of tumor metastasis is controlled by a process called epithelial-mesenchymal transition (EMT). The EMT can also be affected by a protein called Zinc finger E-box-binding homeobox 1 encoded by the ZEB1 gene. Studies have found that this gene is expressed by the primary glioblastomas. This gene is localized in the invasion front of the tumor which also has fewer N-cadherin expression, another protein associated with the EMT process. The lower the N-cadherin expression, the less cell-cell connections and the greater the cell mobility, which means increased invasiveness. Therefore, redistributing the N-cadherin expression, such as by using the ROBO1, is a promising way to control the glioblastoma invasion. Coincidentally, the ROBO1 expression can be controlled by the expression of the ZEB1 gene. There is also a paralog of the ZEB1 gene, namely the ZEB2 gene which plays a role in Transforming growth factor beta (TGF-β) signaling pathways, which is positively correlated with aggressiveness of the cancers. In fact, studies have found that higher expression of the ZEB2 gene is correlated with lower survival rate of glioblastoma patients.
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