In the field of pharmacological therapy, due to the high costs and other obstacles encountered in developing novel drugs, a variety of studies have recently focused on repositioning existing pharmaceutical agents. Regarding the pharmacotherapy of cancer, many possible drugs may exhibit anticancer effects owing to the vast number of biological mechanisms involved in the proliferation and survival of malignant cells. Telmisartan, a well-known inhibitor of the angiotensin II receptor used clinically as an antihypertensive, has been shown to target various signaling pathways in cancer cells, therefore exhibiting anti-proliferative, anti-apoptotic and anti-metastatic effects. Moreover, inhibitors of the angiotensin II receptor have been shown to increase the fluidity of the tumor microenvironment, thus increasing the efficacy of chemotherapy as drug delivery to the tumor is enhanced. The present review provides an insight into the different anticancer mechanisms of telmisartan, as well as recent and past studies which have tested the drug in vitro and in vivo on different types of cancers. This may provide a perspective for future clinical trials on repositioning telmisartan as an anti-cancer agent.
Introduction: Cases of myocarditis in people who were vaccinated against COVID-19 have been reported in the recent years. Nevertheless, the histopathological features and the pathomechanisms in these cases are still unclear. Hence, a scoping review of existing literature was performed to discover the histopathological features of myocarditis induced by the above-mentioned vaccine. Material and Methods: A search was performed in the PubMed, Scopus and EMBASE databases to retrieve the relevant records, involving analyses of biopsy and autopsy specimens. Baseline characteristics of the patients and the histopathological characteristics of the respective specimens were extracted and recorded. Results: Overall, 24 case reports and case series (involving a total of 54 patients) were included in this scoping review. The following signs of inflammation were present in the specimens: lymphocyte infiltration (64.8%), eosinophilic infiltration (29.6%), neutrophil infiltration (3.7%) and giant-cell formation (1.9%). Other features included myocardial tissue necrosis (20.4%), the presence of the SARS-CoV-2 spike protein (16.7%) and microthrombosis (3.7%). Conclusions: The histopathological characteristics of SARS-CoV-2 vaccine-induced myocarditis were heterogenous, the only common characteristic was the presence of lymphocyte infiltration in more than half of the cases. Studies of unreported past cases may provide further insights into the topic.
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