PMID- 33527053
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210203
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 12
DP  - 2020 Dec 30
TI  - Can Pioglitazone Safeguard Patients of Lichen Planus Against Homocysteine Induced 
      Accelerated Cardiovascular Aging and Reduced Myocardial Performance: A Systematic 
      Review.
PG  - e12372
LID - 10.7759/cureus.12372 [doi]
LID - e12372
AB  - Lichen planus (L.P.) is a long-standing mucocutaneous inflammatory condition. A 
      less familiar but essential illness association is increased arterial stiffness, 
      endothelial dysfunction, and advanced atherosclerosis. Enhanced cardiac 
      reconditioning and reduced performance of the heart have been suggested. 
      Thiazolidinediones were commenced to manage hyperglycemia in diabetes mellitus. 
      Recently, the class attained popularity after its action on vascular physiology 
      was discovered. With this review, we attempted to explore whether an antidiabetic 
      drug, pioglitazone (PIO), a peroxisome proliferator‑activated receptor gamma (PPAR 
      gamma) agonist, can defend patients of lichen planus against increased arterial 
      stiffness and cardiac changes. We methodically screened numerous databases using 
      focused words and phrases for relevant articles. After a comprehensive 
      exploration, we applied the inclusion and exclusion criteria and performed a 
      quality appraisal. Items retained were exhaustively studied. High homocysteine 
      (HHcy) levels in lichen planus play a significant role in modifying the arteries 
      and leading to their dysfunction. Not only does homocysteine affect the precursor 
      cells, but it also increases the free radical damage. Arterial damage and 
      upraised resistance encountered by the heart reduce its performance. After an 
      exhaustive analysis, in our opinion, pioglitazone works in various miscellaneous 
      ways to mitigate the homocysteine mediated changes. Early inclusion of the drug 
      in managing patients with lichen planus seems promising in minimizing the harmful 
      effects of high homocysteine. Evaluating the risk-benefit ratio, we believe that 
      a trial of pioglitazone could be given to patients without underlying cardiac 
      conditions.
CI  - Copyright (c) 2020, Balani et al.
FAU - Balani, Prachi
AU  - Balani P
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Lopez, Angel R
AU  - Lopez AR
AD  - Psychiatry, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Nobleza, Chelsea Mae N
AU  - Nobleza CMN
AD  - Neurology, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Siddiqui, Mariah
AU  - Siddiqui M
AD  - Neurology, St. George's University, True Blue, GRD.
AD  - Neurology, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Shah, Parth V
AU  - Shah PV
AD  - Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Khan, Safeera
AU  - Khan S
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20201230
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7842239
OTO - NOTNLM
OT  - arterial aging
OT  - arterial stiffness
OT  - cardiac remodelling
OT  - homoscysteine
OT  - left ventricle
OT  - lichen planus
OT  - microcirculaiton and inflammation
OT  - myocardial performance index
OT  - pioglitazone
OT  - thiazolidinediones
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/02/03 06:00
MHDA- 2021/02/03 06:01
PMCR- 2020/12/30
CRDT- 2021/02/02 06:10
PHST- 2021/02/02 06:10 [entrez]
PHST- 2021/02/03 06:00 [pubmed]
PHST- 2021/02/03 06:01 [medline]
PHST- 2020/12/30 00:00 [pmc-release]
AID - 10.7759/cureus.12372 [doi]
PST - epublish
SO  - Cureus. 2020 Dec 30;12(12):e12372. doi: 10.7759/cureus.12372.