Pharmaceutical Science: Research Trends and Challenges Vol. 2

Rabbit Skin as a Source of Collagenous Biomaterials for Pharmaceutical and Biomedical Application: A Critical Appraisal of Evidence, Processing Routes and Translational Barriers

Elma Putri Primandasari — 2026-09-18

Rabbit (Oryctolagus cuniculus L.) skin is generated in large volumes as a low-value by-product of rabbit meat production, and its high type I collagen content has prompted repeated suggestions that it could serve as an alternative feedstock for collagen and gelatin used in pharmaceutical and biomedical products. The proposition is attractive because rabbit tissue is not associated with bovine spongiform encephalopathy, carries fewer cultural and religious restrictions than porcine material, and yields collagen with a denaturation temperature close to mammalian body temperature, which is a recognised weakness of marine alternatives. This review examines whether the published evidence supports that proposition. Literature was identified through structured searching of open scholarly databases and indexes, supplemented by citation tracking, and was appraised for methodological adequacy, evidence–claim alignment and translational relevance rather than being catalogued study by study. The analysis shows a distinct asymmetry. Physicochemical characterisation of rabbit skin collagen and gelatin is reasonably consistent across independent groups, demonstrating type I collagen with high subunit integrity, thermal stability near 36 °C, rapid acid gelatinisation, and gel strength comparable with or exceeding that of commercial mammalian gelatin. Biological and pharmaceutical evaluation, by contrast, is confined to a small number of electrospun dressing studies reporting cytocompatibility, antimicrobial activity and short-term systemic tolerance, with no controlled wound-healing efficacy trials, no drug-release investigations, no injectable or hydrogel formats, and no reporting of endotoxin, residual reagent or immunogenicity data using recognised biomaterial standards. Most work is framed within food science, uses single-laboratory designs without replication, and is concentrated in a few countries. Rabbit skin is therefore best described as a plausible but largely unvalidated biomaterial feedstock. Priorities include standardised medical-grade processing with documented purity, direct comparative testing against bovine, porcine and marine references, and adequately powered preclinical evaluation using biologically meaningful endpoints.

Pharmacological Management of Breast Cancer: Molecular Targets, Current Therapies, Drug Resistance, Adverse Effects, and Emerging Treatment Strategies

F. Nishvanth — 2026-09-18

Breast cancer pharmacotherapy has shifted from histology-led cytotoxic treatment towards molecularly stratified, temporally adaptive therapy. This critical narrative review evaluates the pharmacological architecture of breast cancer treatment, integrating endocrine therapy, cytotoxic chemotherapy, human epidermal growth factor receptor 2 (HER2)-directed agents, cyclin-dependent kinase 4/6 inhibitors, phosphoinositide 3-kinase–AKT–mammalian target of rapamycin pathway inhibitors, poly(ADP-ribose) polymerase inhibitors, immune checkpoint inhibitors and antibody–drug conjugates. Particular attention is given to how biomarker context, disease setting and prior selective pressure determine treatment benefit, resistance and toxicity. Literature published from January 2000 through 5 July 2026 was identified from open scholarly sources and critically appraised for methodological quality, clinical relevance, consistency and claim–source alignment. The evidence supports several robust conclusions. Endocrine therapy remains the backbone of hormone receptor-positive disease, but its effectiveness increasingly depends on rational combinations and resistance-genotype selection. HER2-targeted treatment has progressed from receptor blockade to highly active antibody–drug conjugates, with therapeutic activity extending into HER2-low and HER2-ultralow disease while creating new diagnostic and pulmonary-toxicity challenges. In triple-negative breast cancer, immunotherapy benefits biomarker- and stage-defined populations, whereas Trop-2-directed conjugates are moving earlier in the treatment course. Germline BRCA1/2 status identifies a clinically validated vulnerability to poly(ADP-ribose) polymerase inhibition. Across subtypes, resistance is not a single endpoint but an evolutionary process involving target alteration, pathway bypass, lineage plasticity, drug trafficking and payload resistance. The principal unresolved problem is therefore no longer whether targeted drugs work, but how to sequence, combine and adapt them without exhausting therapeutic index. Future progress will depend on prospective molecular monitoring, better cross-resistance models, standardised low-range HER2 assessment, central nervous system-inclusive trials and comparative strategies that measure survival, quality of life and cumulative toxicity rather than short-term tumour control alone.

Immunogenetic Determinants of Pemphigus Vulgaris: A Critical Appraisal of Oral Disease Expression, Rituximab Response and Predictive Biomarker Development

Emily-Alice Russu — 2026-09-18

Pemphigus vulgaris is a rare autoantibody-mediated blistering disease in which the oral mucosa is usually the first and the most persistent site of involvement. Susceptibility is strongly influenced by inherited variation, most conspicuously within the human leucocyte antigen class II region, and a second tier of non-antigen-presenting loci that act on keratinocyte survival, immune checkpoint signalling and antibody production. The therapeutic landscape has been reshaped by anti-CD20 B-cell depletion, which now holds first-line status for moderate to severe disease, yet a substantial minority of patients relapse early, fail to achieve corticosteroid-free remission, or require repeated cycles. This review examines whether the accumulated genetic and immunogenetic evidence supports a move from population-level association towards individual-level prediction of oral disease expression and of response to rituximab. Literature was identified through structured searching of general and biomedical scholarly indexes, supplemented by citation tracking of trials, consensus documents and prior reviews, and appraised for design adequacy, sample size, ancestral representation, replication and outcome definition. The synthesis indicates that class II associations are robust and mechanistically coherent at the level of peptide-binding chemistry, but that allele frequencies, protective effects and haplotypic context vary sufficiently between populations to limit transportability of any single risk model. Non-antigen-presenting loci show smaller and less consistently replicated effects, with the strongest functional evidence attaching to a promoter variant that raises epidermal expression of a pro-apoptotic transcription factor. Prediction of rituximab outcome currently rests on immunological rather than germline markers, principally residual desmoglein-specific autoantibody, autoantibody subclass diversity, the depth and duration of B-cell depletion and lymphocyte subset dynamics; pharmacogenetic candidates, notably Fc gamma receptor polymorphism, remain unvalidated in this disease. Oral-specific outcome measurement is heterogeneous, which weakens the link between genotype and the phenotype that matters most to patients. Ancestrally diverse, prospectively phenotyped cohorts with harmonised oral scoring are the principal requirement for progress.

Artificial Intelligence and Telemedicine in Rural Health Care: A Critical Narrative Review of Evidence, Access Outcomes and Implementation Constraints

Rini Sasanti Handayani — 2026-09-18

Rural populations continue to experience reduced availability of clinicians, longer travel distances to diagnostic services and slower entry into specialist pathways than urban populations. Telemedicine has been promoted for three decades as a partial correction to this asymmetry, and artificial intelligence is now proposed as the component that will make remote care scalable by automating interpretation, triage and prioritisation. This critical narrative review examines whether the convergence of artificial intelligence and telemedicine has demonstrably improved access to health care in rural settings, and where the supporting evidence remains weakest. Literature was identified through open scholarly indexes, citation registries and institutional repositories, with searching completed on 3 July 2026, and was appraised for design adequacy, representativeness, outcome relevance and transferability rather than being catalogued descriptively. Four clinical domains dominate the evidence base: retinal screening, chest radiography for tuberculosis, obstetric ultrasound and asynchronous dermatology. Within these domains, diagnostic performance under controlled conditions is frequently strong and, for gestational age estimation and retinal grading, is comparable with or better than the conventional reference pathway. The evidence supporting improvements in access itself is substantially thinner. Most studies report accuracy rather than referral completion, time to treatment or population coverage, and prospective evaluations conducted under routine rural conditions have sometimes shown performance well below that reported in retrospective validation. Economic analyses are few, are concentrated in a small number of health systems, and generally model screening rather than the complete care pathway. Trust among rural service users is conditional and closely tied to continued clinician involvement. Persistent constraints include connectivity limitations that favour asynchronous and on-device designs, unrepresentative training data, fragmented regulation of cross-jurisdictional care, and the absence of downstream capacity to absorb the additional demand that effective case-finding generates. The field requires pragmatic trials with access outcomes, transparent external validation in rural cohorts, and economic evaluation of whole pathways rather than isolated diagnostic steps.