Hepatocellular carcinoma (HCC) ranks as the most prevalent of primary liver cancers and stands as the third leading cause of cancer-related deaths. Early-stage HCC can be effectively managed with available treatment modalities ranging from invasive techniques, such as liver resection and thermoablation, to systemic therapies primarily employing tyrosine kinase inhibitors. Unfortunately, these interventions take a significant toll on the body, either through physical trauma or the adverse effects of pharmacotherapy. Consequently, there is an understandable drive to develop novel HCC therapies. Adipose-derived stem cells (ADSCs) are a promising therapeutic tool. Their facile extraction process, coupled with the distinctive immunomodulatory capabilities of their secretome, make them an intriguing subject for investigation in both oncology and regenerative medicine. The factors they produce are both enzymes affecting the extracellular matrix (specifically, metalloproteinases and their inhibitors) as well as cytokines and growth factors affecting cell proliferation and invasiveness. So far, the interactions observed with various cancer cell types have not led to clear conclusions. The evidence shows both inhibitory and stimulatory effects on tumor growth. Notably, these effects appear to be dependent on the tumor type, prompting speculation regarding their potential inhibitory impact on HCC. This review briefly synthesizes findings from preclinical and clinical studies examining the effects of ADSCs on cancers, with a specific focus on HCC, and emphasizes the need for further research.

This review evaluates the use of antidepressants in older patients for the treatment of nonspecific chronic lower back pain (LBP), emphasizing age-related physiological changes and common degenerative conditions in this age group. We conducted a comprehensive search targeting studies on antidepressant use in older patients with LBP. Selective serotonin reuptake inhibitors, while effective for mood regulation, show limited benefits for LBP. Serotonin-norepinephrine reuptake inhibitors, particularly duloxetine, demonstrate potential in managing LBP, though further research is needed to confirm these findings. Tricyclic antidepressants have shown potential for pain relief, with limited evidence for LBP, but have a substantial side effect profile, including cardiotoxicity, weight gain, and severe anticholinergic effects. The evidence for trazodone in the treatment of LBP is limited. When prescribing new medications for older adults, it is crucial to carefully consider the patient's overall health, potential drug interactions, and sensitivity to side effects, ensuring that the benefits of treatment outweigh the risks. This review underscores the need for further research to understand the long-term effects and benefits of antidepressants in older patients with LBP, aiming to balance pain relief, mood stabilization, and minimized side effects.

Liver fibrosis is a regenerative mechanism, but it pathologically intensifies in the course of various diseases, leading to progressive impairment of organ function. This process involves parenchymal cells (hepatocytes) and non-parenchymal cells (Kupffer cells, stellate cells, and endothelial cells). Its classic mechanism is based on the activation of stellate cells, the main effector of fibrosis, by transforming growth factor β (TGF-β), which stimulates excessive collagen production. The role of interleukin 13 (IL-13), which enters the liver parenchyma from resident lymphoid cells, seems to be equally important. By binding to the IL-13Rα receptor on stellate cells, IL-13 initiates their activation and increases the production of type I collagen. This process is supported by the Erk1/2 pathway, which induces the expression of genes promoting extracellular matrix deposition. Due to its role as an initiator of the fibrotic cascade, IL-13 represents a promising therapeutic target for inhibiting progressive scarring. In this context, cell therapies are considered to be of great importance. Mesenchymal and epithelial stem cell secretions contain, among others, exosomes that carry paracrine mediators that can inhibit the profibrotic effects of IL-13 by modulating IL-13 signalling, limiting the development of organ scarring. However, the data on clinical applications of this molecular pathway is scarce, as there are no significant studies focusing on IL-13 influence in liver fibrosis. This review emphasizes the lack of clear clinical data linking the beneficial effects of cell therapy with modulation of the IL-13 pathway, which highlights the need for such studies.