enalapril maleate + HCTZ (Vasoretic / Vaseretic / Renidur)

Scleroderma Renal Crisis and Posterior Reversible Encephalopathy Syndrome Triggered by Non-steroidal Anti-inflammatory Drugs.

Suzuki Takaya T, Ishikawa Mai M, Yamaguchi Takuya T, Miyata Masahiro M et al.

Scleroderma renal crisis (SRC) and posterior reversible encephalopathy syndrome (PRES) are rare but severe complications of systemic sclerosis (SSc). We report the case of a 44-year-old patient with SSc who developed SRC and PRES, potentially triggered by non-steroidal anti-inflammatory drugs (NSAIDs). The patient presented with impaired consciousness, renal dysfunction, hemolytic anemia, thrombocytopenia, and occipital white matter lesions on magnetic resonance imaging. Treatment included enalapril, hemodialysis, and plasma exchange. This case highlights the potential role of NSAIDs in the development of SRC, and emphasizes the importance of considering NSAIDs as a significant risk factor for SRC in patients with SSc.

Engineering adaptive self-healing biomaterials from jammed microfluidic elastomeric particles.

Kieda Jennifer J, Ramsay Kaitlyn K, Jiang Richard R, Landau Shira S et al.

Biomaterials designed for implantation must accommodate the dynamic mechanical and structural environment of the human body. Yet, current strategies for creating materials capable of adapting their shape post-implantation remain limited. In this work, we introduced a remoldable, biodegradable, and biocompatible granular scaffold composed of monodisperse poly(octamethylene maleate (anhydride) citrate) (POMaC) particles. Monodisperse POMaC droplets with controlled diameters were generated using a droplet microfluidic platform, then subsequently jammed and UV-crosslinked to form interconnected, porous, and self-healing elastomeric scaffolds. The scaffold chemical composition and crosslinking parameters directly influenced mechanical properties, stability, and permeability, enabling tunability across a range of tissue engineering applications. The granular scaffold exhibited autonomous self-healing, enhanced molecular diffusivity, and robust cell infiltration, while remaining moldable into prescribed geometries under both in vitro and in vivo conditions. Notably, following implantation, the granular scaffolds could be remolded in vivo 24 h post-implantation, allowing adaptation to a desired geometry while preserving structural integrity, promoting the recruitment of pro-reparative macrophages, and facilitating vascular ingrowth. Collectively, this work established a versatile strategy for designing adaptive implantable biomaterials capable of responding to the body's dynamic environment, with broad potential applications in regenerative medicine and tissue engineering.

Association of ACE I/D polymorphism with blood pressure response to valsartan-hydrochlorothiazide combination therapy in hypertensive patients from Khyber Pakhtunkhwa, Pakistan.

Ullah Aftab A, Rahim Abdur A, Jan Asif A, Khan Muhammad M et al.

Interindividual variability in antihypertensive response may be partly explained by genetic variation. The angiotensin-converting enzyme insertion/deletion polymorphism (ACE I/D; rs1799752) has been associated with variable response to renin-angiotensin-aldosterone system-targeting therapies, but evidence for valsartan-hydrochlorothiazide (Val-HCTZ) combination therapy remains limited, particularly in South Asian populations. In this multicenter prospective cohort study, 645 hypertensive patients from Khyber Pakhtunkhwa, Pakistan, receiving fixed-dose Val-HCTZ were enrolled; 627 were included in the final analysis after excluding 18 patients with poor adherence (<80%) followed for 3 months. ACE I/D genotyping was performed by polymerase chain reaction with confirmatory testing. The primary analysis evaluated blood pressure reduction across ACE I/D genotypes using regression models adjusted for age, sex, and body mass index. Achievement of target blood pressure (<140/90 mmHg) was analyzed as a secondary outcome. Genotype distribution was in Hardy-Weinberg equilibrium (p = 0.171). Blood pressure reduction differed across genotypes, with the most favorable response observed in DD carriers, an intermediate response in II carriers, and the least favorable response in ID carriers. In the primary analysis of continuous blood pressure reduction, ID carriers showed significantly less reduction compared to II carriers (ΔSBP: adjusted β = -11.2, 95% CI: -16.8 to -5.6, p = 0.002; ΔDBP: adjusted β = -7.4, 95% CI: -11.9 to -2.9, p = 0.004). DD carriers showed greater observed reduction compared to II carriers, but this was not statistically significant (ΔSBP: adjusted β =  +1.8, 95% CI: -4.2 to +7.8, p = 0.561; ΔDBP: adjusted β =  +0.5, 95% CI: -4.1 to +5.1, p = 0.823). In the secondary analysis, response rates were 90.6% for DD, 75.8% for II, and 40.8% for ID. ACE I/D genotype was associated with variation in blood pressure response to fixed-dose Val-HCTZ therapy in this Pakistani cohort, with the most robust finding being poorer response among ID carriers. These findings support further investigation of ACE I/D as a candidate pharmacogenetic marker in genotype-stratified and interventional studies.

Correction: Population Pharmacokinetic Analysis of Enalapril and Enalaprilat in Newly Treated Children with Heart Failure: Implications for Safe Dosing of Enalapril (LENA Studies).

Steichert Melina M, Cawello Willi W, Laeer Stephanie S, LENA Consortium