Muneeb Ullah

Background Fecal microbiota transplantation (FMT) has emerged as a therapeutic strategy for Inflammatory Bowel Disease (IBD) including ulcerative colitis (UC) and Crohn’s disease (CD). Although multiple randomized controlled trials (RCTs) have been published in recent years, evidence remains fragmented regarding safety and efficacy. This systematic review and meta-analysis evaluated the efficacy and safety of microbiome-based interventions in Inflammatory Bowel Disease (IBD). Methods A systematic search of PubMed, Cochrane CENTRAL and Embase was conducted for randomized controlled trials (RCTs) published between January 2020 and May 2025. Eligible studies compared donor FME with placebo, autologous FMT or standard therapy in adult patients with IBD. Primary outcomes were clinical remission and endoscopic improvement; secondary outcomes included maintenance of remission and adverse events. Risk of bias was assessed using the Cochrane RoB-2 tool. Meta-analyses were performed in R using the meta and meta for packages. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using common-effects and random-effects models. Results Six RCTs involving 220–230 patients were included (majority UC patients, two trials CD). For induction of clinical remission, FMT was associated with significantly higher rates vs controls (OR = 3.24, 95% CI 1.43–7.41, p = 0.005) under a common-effect model; random-effects model showed similar point estimate but wide CI overlapping unity. Endoscopic response was strongly increased with FMT (OR = 6.80, 95% CI 2.96–15.63, p < 0.0001). Serious adverse events were more common in FMT arms but not statistically significant (common-effects OR ~ 2.05, 95% CI 0.72–5.81, p = 0.18). Evidence for maintenance of remission from two trials was limited and inconsistent. Conclusion Microbiome-based therapies, particularly FMT, significantly improved clinical and endoscopic remission in IBD (especially in UC) compared with control interventions, but safety signals and maintenance efficacy remain uncertain. Larger and strictly designed UC and CD-specific RCTs are needed to confirm long-term efficacy, clarify safety and define the role of microbiome-targeted therapies in IBD management.

Background: Gut microbiome comprises a diverse microbial community, including bacteria, viruses, and fungi, which play a crucial role in human health. These microbes contribute to host well-being by producing beneficial compounds such as short-chain fatty acids and other metabolites that help maintain microbial homeostasis. Recent advancements in high-throughput sequencing techniques have identified key microbes crucial for human health and revealed that an imbalance in these communities—known as dysbiosis—can lead to various diseases, including inflammatory bowel disease (IBD), Crohn’s disease, colorectal cancer, type 2 diabetes, and liver diseases. Aim: This review aims to provide a comprehensive overview of emerging microbiome-based therapeutic strategies, including fecal microbiota transplantation (FMT), prebiotics, probiotics, next-generation probiotics, synthetic microbiome transplantation, and microbiome editing therapies, as potential interventions to restore gut microbial balance and improve health outcomes. Relevance for patients: Microbiome-based therapies have emerged as promising tools for restoring gut homeostasis and managing microbiome-associated diseases. Approaches such as FMT have shown clinical benefits in conditions such as IBD, Clostridium difficile infection, and cancer immunotherapy. Understanding these therapies may guide future personalized treatments aimed at improving patient outcomes through modulation of the gut microbiome.

Endocrine tumors are hormone-secreting tumors that pose significant challenges for diagnosis and treatment due to their complex biological processes, delayed detection, and poor response to existing therapies. Despite advancements in imaging, surgery, and medicine, tumor heterogeneity, substantial barriers, and systemic toxicity hinder therapeutic success. A novel approach utilizing nanotechnology presents theranostics capabilities for various applications, enhances bioavailability, and ensures precise drug delivery. Engineered nanoparticles (NPs), including lipid-based, polymeric, and inorganic nanocarriers, enable targeted therapy through active targeting (ligand-receptor interactions) or passive accumulation (increased permeability and retention). These nanotechnologies address drug resistance and rapid clearance, delivering treatments directly to tumors while minimizing adverse effects on healthy cells. NPs that mimic biological processes or respond to external stimuli can adapt to the evolving tumor microenvironment. This review focuses on NP-based therapy for endocrine cancer, discussing their mechanisms of action, targeted approaches, and diagnostic and therapeutic applications. The limitations of current therapies and the future prospects of NP-based therapies are explored.

Background: Cutaneous wound infections caused by methicillin-resistant Staphylococcus aureus (MRSA) pose serious threats to public health. Nitric oxide (NO), an endogenous gaseous molecule with antibacterial and wound-healing properties, is a promising next-generation antimicrobial agent with a minimal risk of resistance. However, conventional S-nitrosoglutathione (GSNO)-loaded formulations suffer from GSNO leakage, which could compromise the treatment effect or induce systemic side effects. Although conjugation strategies have been introduced to mitigate this issue, there is still a lack of GSNO-conjugated systems that simultaneously achieve high NO loading and sustained NO release while avoiding harsh external stimuli and complex multistep synthetic processes. Objectives: This research aims to develop a high NO-loading system produced through a simple synthetic process that provides sustained NO release without harsh external stimuli while preventing GSNO leakage for effective treatment of MRSA-infected wounds. Methods: We developed cellulose-based GSNO conjugates via a simple EDC/NHS-mediated covalent coupling to TEMPO-oxidized nanocellulose (NC-GSNO). Results: The NC-GSNO hydrogel achieved high NO loading, minimal leakage, and sustained NO release for more than three days. This controlled NO delivery promoted enhanced wound healing in MRSA-infected models. Conclusions: These findings demonstrate that the NC-GSNO hydrogel is a promising platform for controlled NO delivery and the effective treatment of MRSA-infected wounds.

Background Ulcerative colitis (UC) is a chronic inflammatory condition affecting the large intestine that can progress to colorectal cancer if left untreated. Different therapeutic approaches are used for its treatment and cyclosporine is one of them. It has been investigated as a rescue treatment option in cases when patients are unresponsive to steroidal therapy. However, its efficacy and safety remain uncertain. This study aims to conduct a comprehensive analysis of clinical evidence on cyclosporine safety and efficacy for the treatment of UC. Methods Electronic databases, Cochrane Library, and PubMed were searched from 1998 till December 2024 to screen the relevant studies. A systematic approach was followed to pool and analyze the studies following the PICOS framework (population, intervention, comparison, outcome, and study design). Data was extracted systematically and analyzed using Comprehensive Meta-analysis software (CMA version 3), with the risk of bias evaluated using the RoB-2 tool, heterogeneity measured using I² statistic, and Publication bias was evaluated using funnel plots and Egger’s test. Results Out of 27 studies initially identified, 6 studies meeting the eligibility criteria were included in the final analysis. The risk of bias was high in four studies for all the outcomes except for colectomy rates. Heterogeneity between studies was not significant for all outcomes. Analysis results demonstrated that there was no statistically significant difference between the clinical response (OR = 1.290, 95%CI 0.552–3.012, P = 0.557), colectomy rates (OR = 1.171, 95%CI 0.776–1.767, P = 0.452), and serious adverse events (OR = 0.592, 95%CI 0.313–1.120, P = 0.107) of cyclosporine in comparison with control group. Conclusion There is no statistically significant difference between cyclosporine compared to the control group in improving clinical outcomes for patients with ulcerative colitis. Future studies with larger sample sizes can explore its role with combination therapy in targeted patient sub-groups.

The transition from three-dimensional (3D) to four-dimensional (4D)-bioprinting marks a significant advancement in tissue engineering and drug delivery. 4D-bioprinting offers the potential to more accurately mimic the adaptive qualities of living tissues due to its dynamic flexibility. Structures created with 4D-bioprinting can change shape in response to internal and external stimuli. This article reviews the background, key concepts, techniques, and applications of 4D-bioprinting, focusing on its role in tissue scaffolding and drug delivery. We discuss the limitations of traditional 3D-bioprinting in providing customized and sustained medication release. Shape memory polymers and hydrogels are examples of new responsive materials enabled by 4D-bioprinting that can enhance drug administration. Additionally, we provide a thorough analysis of various biopolymers used in drug delivery systems, including cellulose, collagen, alginate, and chitosan. The use of biopolymers in 4D-printing significantly increases material responsiveness, allowing them to react to stimuli such as temperature, light, and humidity. This capability enables complex designs with programmable shape and function changes. The expansion and contraction of hydrogels in response to temperature changes offer a practical method for controlled drug release. 4D-bioprinting has the potential to address significant challenges in tissue regeneration and medication administration, spurring ongoing research in this technology. By providing precise control over cell positioning and biomaterial integration, traditional 3D-bioprinting has evolved into 4D-bioprinting, enhancing the development of tissue constructs. 4D-bioprinting represents a paradigm shift in tissue engineering and biomaterials, offering enhanced possibilities for creating responsive, adaptive structures that address clinical needs. Researchers can leverage the unique properties of biopolymers within the 4D-printing framework to develop innovative approaches for tissue regeneration and drug delivery, leading to advanced treatments in regenerative medicine. One potential future application is in vivo tissue regeneration using bioprinted structures that can enhance the body’s natural healing capabilities.

Three-dimensional (3D) bioprinting using biocompatible polymers has emerged as a revolutionary technique in tissue engineering and regenerative medicine. These biopolymers mimic the extracellular matrix (ECM) and enhance cellular behavior. The current review presents recent advancements in additive manufacturing processes including Stereolithography (SLA), Fused Filament Fabrication (FFF), Selective Laser Sintering (SLS), and inkjet printing. It also explores the fundamentals of 3D printing and the properties of biocompatible polymers for 3D bioprinting. By mixing biopolymers, enhancing rheological characteristics, and adding bioactive components, further advancements have been made for organ transplantation, drug development, and tissue engineering. As research progresses, the potential for 3D bioprinting to fundamentally transform the healthcare system is becoming obvious and clear. However, the therapeutic potential of printed structures is hindered by issues such as material anisotropy, poor mechanical properties, and the need for more biocompatible and biodegradable architectures. Future research should concentrate on optimizing the 3D bioprinting process using sophisticated computational techniques, systematically examining the characteristics of biopolymers, customizing bioinks for different cell types, and exploring sustainable materials.

The persistent inflammation of the intestinal mucosa is the main characteristic of inflammatory bowel disease (IBD), a lifelong illness that affects people of both genders. The exact etiology is still undefined while previously it was attributed to genetic components. Later, it was investigated that the environment has an equal effect on the development of IBD encompassing both Crohn’s disease (CD) and Ulcerative colitis (UC). Among environmental risk factors linked to IBD, diet, notably the transition toward the Western diet, is the most noticeable element that contributes to IBD. This comprehensive overview summarizes the present literature on the role of food and food groups in IBD nutrition and management. Increased consumption of sugar, fats, and/or proteins, decreased consumption of fruits and vegetables, and increased use of emulsifiers or other binding compounds are among the most significant candidates that lead to inflammation in the intestines of healthy individuals. Furthermore, low dietary habits, including selective malnutrition, obesity, and sarcopenia, are linked with poor clinical results, treatment responsiveness, and, as a result, quality of life. Therefore, the trend in the management of IBD has shifted toward dietary therapies and strategies like Specific Carbohydrate Diet (SCD), the Mediterranean diet (MD), Enteral Nutrition (EN), Crohn’s disease exclusion diet (CDED), Inflammatory bowel disease-Anti-inflammatory diet (IBD-AID), and others are reported to have had a positive association with reducing the underlying IBD symptoms and remission of intestinal homeostasis.

Carbon dots (CDs) are a class of carbon-based nanomaterials undergoing rapid development with broad potential applications across diverse biomedical fields. These materials are highly attractive for diagnostics, therapeutics, and nanomedicine due to their remarkable optical and physicochemical properties, including photoluminescence, biocompatibility, and aqueous dispersibility. CDs can be synthesized using various techniques, ranging from top-down to bottom-up approaches. Among these, biogenic synthesis, utilizing natural sources and waste materials, presents an eco-friendly and sustainable alternative. CDs have exhibited considerable promise in diagnostics, especially with bioimaging and biosensing, providing both high sensitivity and precise identification. CDs are presently being investigated in the pharmaceutical sector for their potential applications in cancer and infection treatment, as well as in photodynamic and thermal therapies. The advancement of CD composites, through enhanced functionality and broader application, facilitates novel research in nanomedicine. This article highlights the advantages of CDs, focusing on their structural properties, classification, and versatility in synthesis methods. Furthermore, the safety and toxicity profiles of CDs are critically analyzed. In conclusion, the innocuity, adaptability, and multifunctionality of CDs position them as a cornerstone in the advancement of nanotechnology and biomedical applications. With their broad applicability and promising potential, CDs stand poised to drive significant innovation across diagnostics, therapeutics, and other domains, heralding a new era in nanomedicine and sustainable material development.