Nutan R. Zanjurne1*, Omkar A. Devade2, Laxmikant M. Purane2,
Vivek K. Redasani3
¹Research Scholar, YSPM YTC, Satara, Maharashtra 415015, India.
2Department of Pharmacology, YSPM YTC, Satara Maharashtra 415015, India.
3Director and Principal, YSPM YTC, Satara Maharashtra 415015, India.
*Corresponding Author E-mail: nutanzanjurne@gmail.com
ABSTRACT:
INTRODUCTION:
Other words for cancer include neoplasms and malignant tumors. The fast formation of aberrant cells that spread beyond limits is a pertinent and important characteristic of cancer. One of the main causes of sickness and death in the globe is cancer. 5.8 million Deaths worldwide in 2015 were attributable to cancer. (WHO, 2017)1-4. Over 70% of Earth's surface is comprised of oceans, which are home to over 200,000 species of invertebrates, algae, and other animals and plants. The marine environment's vegetation and animals are important sources of novel molecular entities. Many new chemicals with biological activity have been identified from marine species over the past few decades. Numerous substances possessing cytotoxic and anticancer properties have been identified from diverse marine origins, including sponges, gorgonian coral, sea algae, sea hares, and cucumbers5. Effective therapeutic efficacy is caused by chemically active metabolites, which are abundantly provided by nature. The text reveals that a large number of medicinal anticancer agents come from marine sources and have a variety of application6. Marine bacteria are frequently hard to discover in the deep ocean, despite the fact that marine drugs are secondary metabolites can be utilized to treat a variety of infectious disorders. Molecular biology in the 1970s, and at the conclusion of the 1990s, it had advanced globally. Gene production was initiated by David Newman, the Director of the Natural Product Division at the US National Cancer Institute located in Bethesda, Maryland. They got to work on the capacity to cultivate microorganisms. The entire synthesis and structural analysis of genes was taken up by synthetic chemists. Marine Drug Discovery continues to draw newcomers despite the dearth of novel medications available on the market7. A wealth of medicinal substances that have exceptional variety and distinct chemical biodiversity have been developed by the marine environment. In 2020, cancer will be the second greatest cause of death, accounting for 10 million deaths. Scientists have worked very hard over the past few decades to understand the pathophysiology of cancer, and they have produced certain marine medications to treat the disease8. To protect themselves, marine plants and bacteria need a special chemical repertoire, and scientists studying red communication are eager to learn more about these novel substances9. The cancer group comprises over a hundred diseases that can arise practically wherever within the body. Unregulated cell proliferation combined with cancerous traits including metastasis and inversion. These chemotherapy medications have been used in the treatment of cancer for the past 30 to 40 years. These medications have the potential to alter how cells behave at various phases, which ultimately results in death10. Currently, almost 60% of medicines licensed with the purpose of treating cancer come from the marine industry. These medications have the ability to tackle cancer in multiple stages, thereby avoiding or postponing its development. Marine microorganisms, plants, and mammals have antimutagenic and anticarcinogenic properties11. 2019 marks the 50th anniversary of the development of Cytarabine, the first anticancer medication derived from marine sources. The medical and scientific community honored the 50th anniversary of Notable advancements have been made in immunotherapy and biology, as well as in the design and production of contemporary drugs. We can now achieve our goal of curing cancer thanks to this finding. Many cancers have already been successfully treated, and survival rates have been increased. Such as pediatric lymphoblastic leukemia, testicular cancer, and lymphomas. The biodiversity of the marine regions is abundant. A variety of major sources are available for the separation of drugs exhibiting the pharmacological action listed in Table 1.
Marine pharmacology:
The study of compounds with active pharmacological characteristics found in marine plant and animal species is the focus of marine pharmacology, a relatively recent field of pharmacological studies. Marine natural products are typically secondary metabolites that aren't essential to a species' growth, development, or reproduction. The superiority of natural products derived from the sea over those from the land in terms of chemical individuality has previously been established by a comparative research.
LITERATURE REVIEW:
Natural products have always been primarily sourced from terrestrial animals and plants, from human Millennium, Cytarabine (also known as ara-C cytosar-U®). The primary source of this medication is marine sponge. It inhibits the activity of DNA polymerase and has strong anticarcinogenic properties12. Conventional allopathic medicine states that there are more than 150 different forms of cancer, which can be divided into five primary categories.
One of the most common diseases is cancer, for which the medical establishment struggles to develop effective, location-specific anti-cancer medications. Thus far in these cancer investigations, the majority of synthetic medications had unfavorable side effects. In addition, powerful and safer anti-cancer medications are produced from marine sources as opposed to synthetic ones13-20.
Table 1: Sources of Marine Natural Products in Clinical Trial
|
Sr. No. |
Sources |
% Drug |
Examples |
|
1 |
Algae |
14.3 |
Cyanobacteria [Blue-green algae] and other algaes of more than 400 novel Metabolites are bioogically active peptide and polyketide that kills cancer cell or reduce its proliferation. |
|
2 |
Fungi |
8.2 |
Higher fungi like basidiomycetes, endophytic fungi and filamentous fungi such as leptosphaerin„ leptosphaerolide and leptosphaerodione from the lignicolous fungus Leptosphaeria oraemaris [Pleosporaceae] |
|
3 |
Chordata |
- |
Didemnin B, Plitidepsin, Dehydtodidemni B |
|
4 |
Molluska |
20.4 |
Dolastatin 10, Dolastatin 15, TZT – 1027 [Auristatun PE or soblidotine], Tasidotin [ILX 651] Cematodin [LU103793] |
|
5 |
Sponges |
28.6 |
Hemiasterlin A and B, E 7974, HTI 286 |
Nowadays, everyone is paying more attention to identifying Extracts from natural sources and learning about their possible therapeutic uses. As a result, medications derived from nature that are pharmacologically strong and have minimal to no side effects are used in the food industry and in preventative medicine. They are a possible source of novel chemicals with various pharmacological properties. Traditional herbal remedies have a significant role in India's healthcare system21-27.
Fig. 1: Forms of cancer
Begins to remove the active components from terrestrial plants and animals in order to treat illnesses. As drug development advances, an increasing amount of work is being put into creating novel molecular structures for medications derived from plants and terrestrial animals that can address the growing threat to human health and life. As a result, discovering new drug sources now requires "asking for drugs from sea"28. Marine Natural Product Exploration has turned down a sizable number of medicine candidates in recent years. The majority of these compounds are still in the preclinical or early stages of clinical stages29. The anticancer, antibacterial, antifungal, anti-inflammatory, analgesic, neuroprotective properties of marine natural materials are utilized in addition to their anticancer effects30. Recently developed tiny peptide anticancer agents and their derivatives from marine species have been widely used in medical studies. Globally, about 49 active ingredients produced from marine sources or their derivatives have either been licensed for sale or have begun clinical testing. Authorities in Europe and America have approved eleven different types of marine pharmaceuticals, four of which are employed as anticancer agents: Yondelis, Adcetric, Halverson, and Cytosar-U. A valuable biological kingdom, the marine domain is a plentiful supply of new, useful proteins and peptides. Furthermore, it is becoming an increasingly important area of medication development31-33.
This review includes information on the development of marine-derived anticancer agents from sponges, tunicates, mollusks, soft corals, cyanobacteria, and marine microalgae, as well as medications with antiproliferative properties.
Marine anticancer agents:
The most complicated disease is cancer and can be treated with network drugs. The marine drug sources included in this review that are used as anticancer agents are Marizomib, Plinabulin Enapotamab vedotin, Coibamide A, Tisotumab vedotin, Plocabulin, Ladiratuzumab vedotin, AGS-16C3F, Pliotidepsin, Bryostatin, Pectenotoxin – 2, Lurbinectedin, Belantamab Mafodotin, Enfortumab vedotin, Polatuzumab vedotin, Trabectedin, Brentuximab vedotin, Eribulin Mesylate, and Cytarabine. Table No. 2 provides an overview of these.
Marizomib:
Marizomib is an actinomycete that possesses gram-positive bacteria with a high G + C ratio in its DNA34. NPI-0052, also referred to as salinosporamide A, or marizomib, is a proteasome inhibitor that is obtained from the marine actinobacterium Slinospora tropica, which is a member of the Salinosporamide family³⁵. It is a potentially effective therapeutic drug in order to treat hematologic malignancies36. Marizomib is phase I stage of development. In the clinical trial of Marizomib having relapsed or refractory multiple myeloma. The active component of marizomib is the beta lacton, and the binding of NPI-0052 is irreversible37. In clinical studies, Marizomib's molecular target belongs to the monochlorinated 20s proteasome inhibitor for cancer treatment38. Marizomib is an irreversible inhibitor that blocks the proteasome's beta-1, beta-2, and beta-5 subunits. At the moment, the US Food and Drug Administration (US-FDA) has not approved Marizomib39.
Plinabulin:
Plinabulin, which is derived from a marine fungus and belongs to the Aspergillus species, is an alkaloid. Its molecular target is the alpha-beta tubulin protein, Plinabulin, also known as NPI-2358, is undergoing phase III clinical studies and is now being utilized to treat brain tumors and lung cancer with non-small cells. It has potent anti-microtubule properties as well. Preclinical research on plinabulin demonstrates positive safety and anticancer activity profiles. It is also evaluated for safety, pharmacokinetics, and biological activity in individuals with cancer that has spread.
Enapotam 11ab vedotin:
Enapotamab vedotin is a marine anticancer medication that is used to treat endometrial, ovarian, and cervical cancer. Its molecular target is AXL – RTK /Nectin-4, which is species-specific for mollusks and bacteria; currently conducting phase II clinical trials and enapotamab vedotin, also known as HuMax-AXL, is a new ADC conjugating with a human AXL-specific IgG1 and MMAE40–43.
Coibamide A:
Displays a novel, highly effective anti-proliferative drug called coibamide A, which is derived from cyanobacterium. Coibamide A's molecular target is the lung cancer NCI-H460 clinical studies44. When used in nanomolar quantities, coibamide A had a substantial cytotoxic effect on NCI-H460 lung cancer cell lines. In addition, it resulted in dose-dependent G1 cell upregulation. It has recently been evaluated against specific 60 cell lines for human malignant tumor cells of the colon, breast, and ovary. It was also shown to be more effective against the MDA-MB-231 cell line45. One of the most popular classes of natural compounds, coibamide A directly inhibits the Sec61 protein translocan to prevent protein entry into the secretory pathway, hence causing a strong spread of cancer cells. The effect of coibamide A against human epidermal growth factor receptor [HER, ErbB] proteins in the context of lung and breast cancer cell types was assessed in the current study. Even though Coibamide A is thought to be substrate non-selective in its inhibition of the biogenesis of a wide variety of Sec61 substrate proteins46.
Tisotumab vedotin:
Tisotumab vedotin is an antibody drug combo that targets both tissue factor and monomethyl auristatin E [MMAE], an agent that disrupts microtubules. The primary cause of it is cynobacterium. The tumor development, neoangiogenesis, and metastatic potential are hypothesized to be corrected by Tissue Factor [TF], which is actively produced in solid tumors. This is achieved by local activation of coagulation and protease activated receptor – 2 [PAR-2] signaling. It has previously been demonstrated that tisotumab vedotin activates cytotoxicity through Fc-dependent and MMAE-dependent mechanisms. Furthermore, Tisotumab vedotin inhibited PAR-2 signaling in tumor cells that wereTF-positive47. Tisotumab vedotin provided patients with previously treated recurrent or metastatic cervical cancer with a reassuring anticancer efficacy and a convenient assurance profile. Since TF is typically significantly transmitted and identical with a poor prognosis, it works as a possible target in cervical cancer cases. Tisotumab vedotin is a first-in-class experimental antibody drug conjugate that targets TF and has shown encouraging results in solid tumors. This paper contains data from the Innova TV201 phase I/II study's cervical cancer cohort (NCT02001623)48. The USA has approved vedotin for the treatment of metastatic cervical cancer with disease progression occurring during or following chemotherapy, based on the results of the phase II trial49.
Ladiratuzumab vedotin:
It is a sea organism called a mollusk or cyanobacterium. Ladiratuzumab vedotin belongs to the chemical class ADC [MMAE]. Ladiratuzumab vedotin targets microtubules and LIV-1 as its molecular targets. Breast cancer is treated with it53. Investigative anti-LIV-1 antibody drug conjugate ladiratuzumab vedotin [LV] is linked to monomethyl auristatin E [MMAE] via a protease-cleavable linker. In metastatic triple negative breast cancer [TNBC], LIV-1 is highly expressed. Delivery of MMAE via LV has been shown to induce immunodeficiency cell death (ICD) and to drive anticancer action above cytotoxic cell assassination. In TNBC, LV monotherapy has finished its supportive activity54. The US FDA has not yet authorized ladiratuzumab vedoti55.
Brentuximab vedotin:
It is an antibody-drug conjugate [ADC] of the antimitotically active monomethyl auristatin E [MMAE], a synthetic analog of dolastatin-10, generated by cynobacteria that live in symbiosis with the sea hare Dolabella auricularia. The monoclonal antibody brentuximab is CD30-specific. In 2011, brentuximab vedotin was initially authorized for the treatment of anaplastic large T-cell systemic malignant lymphomas and Hodgkins lymphomas, one year after eribulin mesylate's approval. It inhibits tubulin polymerization [MMAE] and binds to CD30 [antibody]. Adcetris®, also known as benuximab vedotin, received approval in 2012 to treat Hodgkin’s lymphoma, a cancer form identified by elevated expression of CD⁵⁹.
Trabectidin:
In 2015, trabectidine [ET-743, Yondelis] was initially authorized for the management of ovarian cancer and soft tissue sarcoma. The natural alkaloid was first isolated from marine tunicates and, in contrast to earlier marine medications like trabectedine [Yondelis], exerts its anticancer properties through a variety of methods. It first attaches itself to the DNA double strand's minor groove. Furthermore, by disrupting microtubules and thus interfering with the late S and G2 phases of the cell cycle, it can result in cell cycle arrest. Additionally, it has the ability to cause RNA polymerase ll [RNA Pll] to degrade. By blocking the release of cytokines, it can also modify the tumor microenvironment through a variety of powerful anticancer mechanisms.
Eribulin mesylate:
The Food and Drug Administration [FDA] first approved the spongimal macrolide Eribulin mesylate, also known as Halavenas, in 2010 for the treatment of metastatic breast cancer. In 2016, the FDA approved it as the second line of treatment for liposarcoma therapy60. Epibulin has demonstrated anticancer effect in preclinical tests on a variety of cancer types, including small cell lung cancer, ovarian cancer, pancreatic cancer, colon cancer, melanoma, and non-small cell lung cancer (NSCLC). Eribulin prevents the spread of tumors by promoting the mesenchymal-epithelial transition (MET) and blocking the epithelial-mesenchymal transition (EMT). It is an artificial variation of the marine chemical halichondrin B. This medicine functions as a microtube-targeted non-taxane one. By attaching to tubulins and microtubules in the interphase, eribulin mesylate can suppress the dynamics of centromeres and stop mitosis, which in turn causes cancer cells to undergo apoptosis and proliferate less⁶¹.
Plitidepsin:
The ascidian depsipeptide Plitidepsin [dehydrodidemnin B, Aplidin] was first approved in Australia in 2018 for the treatment of leukemia, multiple myeloma, and lymphoma. It is a naturally occurring compound that is isolated from Aplidium albican and has strong antitumor activity with low toxicity. The mechanism of Plitidepsin was achieved by targeting eukaryotic elongation factor 1A2 [eEF1A2] and subsequently inducing apoptosis in cancer cells. eEF1A2, the target of plitidepsin, is one of the two isoforms of eukaryotic elongation factor 1 [eEF1A], a protein elongation factor. During translation, aminoacyl tRNA recruitment to the ribosome can be mediated by eEF1A, an elongation factor protein. In prostate, ovarian, pancreatic, multiple myeloma, and plasmacytoma cancers, it causes cell death to demonstrate its anticancer properties. Plitidepsin can also stop the cell cycle and continuously activate the Racl/JNK pathway, in addition to causing apoptosis through G1 and G2/M arresting62.
Polatuzumab vedotin:
In 2019, the FDA authorized polatuzumab vedotin as a medication for the treatment of B-cell lymphomas, chronic lymphocytic leukemia, and non-Hodgkin lymphomas63. This antibody-drug combination, or ADC, is made up of the monomethyl auristatin E [MMAE], a peptide toxin of symbiotic marine cynobacteria, coupled with polatuzumab, a monoclonal antibody specific to CD76b. The monomethyl auristatin E [MMAE] is specifically delivered to cancer cells by the antibody. Once the proteolytic ADC cleaves and releases the MMAE molecule, tubulin polymerization is inhibited, which ultimately results in the death of the cancer cells64.
The FDA approved the use of enfortumab vedotin, an antibody-drug combination [ADC], to treat metastatic urothelial carcinoma by targeting the extracellular adhesion protein nectar-4. On the surface of numerous epithelial malignancies, including pancreatic, bladder, lung, and breast tumors, it is abundantly expressed. When nectin-4 is coupled to monomethyl auristatin E [MMAE], a chemotherapeutic microtubule disrupting drug, enfortumab vedotin can specifically target nectin-4-positive cells and subsequently cause cell death via MMAE65.
A non-cleavable maleimido caproyl [mc] linker makes AGS-16C3F an MMAF. Extracellular nucleotides are catalyzed at the ENPP3 cell surface, where they increase tumor invasion and contribute to the pathophysiology of cancer. AGS-16C3F has a strong affinity for the molecular target, ENPP3, which is seen on the surface of renal, hepatocellular, and chronic nucleogenous leukemia cells, according to preclinical trial data67. Furthermore, anticancer activity is noted. On the other hand, 84 patients who had previously received treatment for metastatic renal cell carcinoma (mRCC) responded well to axitinib with AGS-16C3F in phase-II trials68. After determining that AGS-16C3F was well tolerated and had clinical activity at a dose of 1.8 mg/kg every three weeks, the study's conclusion was that phase-II trials should use this dose. The discontinuation of AGS-16C3F was due to the combination of axitinib and AGS-16C3F failing to meet its primary and secondary goals69-70.
Method No.1: Hydrolysis: Pectenotoxin-2 is hydrolyzed to yield the seco acid molecule pectenotoxin-2. Following further acylation, this molecule yields 37-O-acyl PTX-2SA, 33-O-acyl PTX-2SA, and 11-O-acyl PTX-2SA.
Method No. 2: Oxidation: Pectenotoxin-2 is oxidized step-by-step to produce pectenotoxin-1, an alcohol. This chemical is then oxidized again to produce pectenotoxin-3, an aldehyde molecule, which is oxidized even further to produce pectenotoxin-6, a carboxylic acid. Targeted Organs: Pectenotoxin-2 has been reported to exhibit specific toxicity towards P53 mutant and P53 null tumors, including highly chemoresistant variants, in addition to other actin-disrupting drugs.
|
Sr. No. |
Compound name |
Marine Organism |
Chemical class |
Molecular Target |
Cancer Type |
Phases |
|
1 |
Marizomib |
Actinobacteria |
Beta- lactone |
20s Proteasome inhibitor |
Myeloma |
Phase l |
|
2 |
Plinabulin |
Fungus |
Alkaloid |
Alpha-beta tubulin protein |
Small cell lung cancer, Brain tumors. |
Phase ll |
|
3 |
Enapotamab vedotin |
Mollusk/ Cyanobacterium |
ADC [MMAE] |
AXL-RTK/ Nactin-4 |
Ovarian cancer, Cervical cancer, Endometrial cancer. |
Phase l/ll |
|
4 |
Coibamide A |
Cyanobacterium |
Anti- proliferative depsipeptide |
Sec61 substrate protein |
Lung cancer, Breast cancer, Ovarian Malignant tumor. |
Phase l |
|
5 |
Tisotumab Vedotin |
Mollusk/ Cyanobacterium |
ADC[MMAE] |
Tissue factor |
Metastatic cervical cancer. |
Phase ll |
|
6 |
Plocabulin |
Sponge |
Polyketide |
Microtubule inhibitor, Minor groove of DNA. |
Solid tumors |
Phase l |
|
7 |
Ladiratuzumab vedotin |
Mollusk/ Cyanob acterium |
ADC[MMAE] |
Microtubules |
Breast Cancer |
Phase l |
|
8 |
Cytarabine |
Sponge |
Nucleoside |
DNA Polymerase |
Leukemia |
Phase l |
|
9 |
Eribulin |
Sponge |
Macrolide |
Microtubules |
Metastatic Breast cancer |
Phase ll |
|
10 |
Brentuximab Vedotin |
Mollusk/ Cyanobacterium |
ADC[MMAE] |
CD30, Microtubules |
Anaplastic large T-cell systemic Malignant lymphoma, Hodgkin”s Disease |
Phase ll and l |
|
11 |
Trabectidine |
Tunicate |
Alkaloid |
Minor groove of DNA |
Soft tissue sarcoma and Ovarian cancer |
Phase ll |
|
12 |
Plitidepsin |
Tunicate |
Desipeptide |
eEF1A2 |
Multiple Myeloma, Leukemia, Lymphoma. |
Phase ll/lll |
|
13 |
Polatuzumab Vedotin |
Mollusk/ Cyanob acterium |
ADC[MMAF] |
CD76b, Microtubules |
Non-hodgkins lymphoma, Chroniclymphocyti leukemia, Lymphoma. |
Phase lll |
|
14 |
Enfortumab Vedotin |
Mollusk/ Cyanob acterium |
ADC[MMAE] |
Nectin-4 |
Metastatic Urothelial Cancer |
Phase l /ll |
|
15 |
Ags 16 C3F |
Sponge |
ADC[MMAF] |
ENPP3 |
Tumor |
Phase ll |
The review emphasizes the finding of unique chemical structures and characteristics, as well as anticancer properties, in marine creatures. The issue of cytotoxicities and activity prevention of tumor development and associated chemicals that trigger apoptosis was addressed. The goal has been achieved by researching the marine population that contains bioactive compounds that have anticancer properties. A key component of anticancer drugs is the diversity of biological materials from the marine environment, which essentially complements the marine real. The development of novel anticancer medicines derived from marine species plays a major role in increasing our understanding of the therapeutic agents developed from these organisms that target different stages of the carcinoma process. This background suggested that these anticancer drugs function through both therapeutic and preventative intervention. At the clinical level, there is an alliance of experts in medicine, chemistry, toxicology, biology, and "omics" who work together in the early stages and purposefully rely on national and international funding sources for science. They also have open access to data from earlier research project. It seems sense that marine items could offer a platform for bettering cancer treatment approaches. Even yet, more thorough investigation is necessary to overcome the majority of typical obstacles in chemical utility. Essentially, active metabolites produced from sponges should be utilized in conjunction with cutting-edge technologies to open up new application domains that will have a significant impact on biotechnology. As drug research advances, it becomes increasingly difficult to obtain novel active metabolites from terrestrial sources, which is insufficient to keep up with the growing hazard to human health and well-being.
Natural products that are produced by enzymatic processes are provided with three-dimensional structural characteristics that enable them to combine with binding sites and exhibit both significant specificity and distinctive variety. Many viewpoints regarding how to improve natural product discovery programs in light of the increased number of pharmaceuticals made from natural materials that are reaching the market. These natural remedies have been utilized to treat human ailments and have laid a solid foundation for modern pharmaceuticals. Due to their ability to expand knowledge and their clinical significance in cancer pharmacology, these chemotherapeutic medicines have had a profound impact on the pharmacy community.
Given that cancer is one of the most serious illnesses, one may wonder, "Why are we looking forward to anticancer drugs from the deep of ocean?" which begs the question of whether finding novel marine anticancer substances is possible. The ongoing advancements in deep sea mining, extraction, and separation technologies offer fresh prospects and optimism for the discovery of marine anticancer drugs. Since a millennium ago, humans have begun to extract the active molecular component of marine substances from terrestrial sources. With increased exploration, the realm of marine flora and fauna is becoming a fascinating place to examine in order to find new anticancer leads.
CONCLUSIONS:
The current review study provides brief information of marine medications that may be used to treat different neoplastic disorders and be clinically beneficial. These medications work in different ways to treat cancer; they either destroy cancer cells or stop them from proliferating. Therefore, these biomolecules prove useful as a futuristic means of accessing combinational treatment for cancer using medications derived from marine sources. These medications can also be used in further medical research to treat other physical ailments. This review sheds light on a few anti-cancer agents that can also be assessed for their anti-cancer effects, marking a revolutionary development in cancer treatment.
ACKNOWLEDGEMENT:
The author would like to acknowledge Dr. V. K. Redasani, Principal and Director, YSPM’S YTC College of Pharmacy, Satara, for encouragement and guidance.
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Received on 25.04.2024 Revised on 06.06.2024 Accepted on 19.07.2024 Published on 07.12.2024 Available online on December 30, 2024 Res.J. Pharmacology and Pharmacodynamics.2024;16(4):306-314. DOI: 10.52711/2321-5836.2024.00053 ©A and V Publications All right reserved
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