Purpose: Acute kidney injury (AKI) is a common clinical critical condition that has become a significant healthcare burden. In recent years, the relationship between AKI and mitochondria has attracted increasing attention. Protecting mitochondria or restoring their function has emerged as a novel therapeutic strategy for alleviating AKI. This study aims to analyze and summarize the current status, research trends, and hotspots in this field, providing references and directions for future research. Methods: AKI and mitochondria-related literature from the Web of Science core collection were retrieved and collected. Bibliometric and visualization analyses were conducted using Microsoft Excel 2021, bibliometric tools (VosViewer, Citespace 6.3.R1, and the bibliometrix R package), R 4.3.2, and SCImagoGraphica software. Results: A total of 2433 publications were included in this study. The number of annual publications in this field has increased year by year. China and the United States are the two most productive countries. Central South University is the most influential research institution in terms of research output, and Parikh SM, Schnellmann RG, and Dong Z are the most influential authors in this field. KIDNEY INTERNATIONAL, JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, and AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY are the most influential journals. Initially, the research focused on keywords such as oxidative stress, ischemia-reperfusion injury, apoptosis, inflammation, and autophagy. In recent years, new research hotspots have emerged, including ferroptosis, aging, mitochondrial quality control, messenger RNA, mitochondrial-targeted antioxidants, extracellular vesicles, and nanodrug delivery. Conclusion: Research on the relationship between mitochondria and AKI has broad developing prospects, and targeting mitochondrial regulation will become a focus of future AKI prevention and treatment research.
目的：急性肾损伤（AKI）是一种常见的临床危重症，已成为医疗保健的重要负担。近年来，急性肾损伤与线粒体之间的关系引起了越来越多的关注。保护线粒体或恢复其功能已成为缓解 AKI 的一种新型治疗策略。本研究旨在分析和总结该领域的研究现状、研究趋势和热点，为未来研究提供参考和方向：方法：检索并收集了 Web of Science 核心数据库中与 AKI 和线粒体相关的文献。使用 Microsoft Excel 2021、文献计量工具（VosViewer、Citespace 6.3.R1 和 bibliometrix R 软件包）、R 4.3.2 和 SCImagoGraphica 软件进行文献计量和可视化分析：本研究共收录了 2433 篇出版物。该领域的年度出版物数量逐年增加。中国和美国是发表论文最多的两个国家。就研究成果而言，中南大学是最有影响力的研究机构，Parikh SM、Schnellmann RG 和 Dong Z 是该领域最有影响力的作者。KIDNEY INTERNATIONAL》、《JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY》和《American JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY》是最有影响力的期刊。最初的研究主要集中在氧化应激、缺血再灌注损伤、细胞凋亡、炎症和自噬等关键词上。近年来，新的研究热点不断涌现，包括铁变态反应、衰老、线粒体质量控制、信使 RNA、线粒体靶向抗氧化剂、细胞外囊泡和纳米药物递送等：线粒体与 AKI 关系的研究具有广阔的发展前景，针对线粒体的调控将成为未来 AKI 预防和治疗研究的重点。
{"title":"Research Hotspots in Mitochondria-Related Studies for AKI Treatment: A Bibliometric Study","authors":"Mengfan Yang, Youqun Huang, Anqi Tang, Yu Zhang, Yu Liu, Zhenliang Fan, Mingquan Li","doi":"10.2147/dddt.s473426","DOIUrl":"https://doi.org/10.2147/dddt.s473426","url":null,"abstract":"<strong>Purpose:</strong> Acute kidney injury (AKI) is a common clinical critical condition that has become a significant healthcare burden. In recent years, the relationship between AKI and mitochondria has attracted increasing attention. Protecting mitochondria or restoring their function has emerged as a novel therapeutic strategy for alleviating AKI. This study aims to analyze and summarize the current status, research trends, and hotspots in this field, providing references and directions for future research.<br/><strong>Methods:</strong> AKI and mitochondria-related literature from the Web of Science core collection were retrieved and collected. Bibliometric and visualization analyses were conducted using Microsoft Excel 2021, bibliometric tools (VosViewer, Citespace 6.3.R1, and the bibliometrix R package), R 4.3.2, and SCImagoGraphica software.<br/><strong>Results:</strong> A total of 2433 publications were included in this study. The number of annual publications in this field has increased year by year. China and the United States are the two most productive countries. Central South University is the most influential research institution in terms of research output, and Parikh SM, Schnellmann RG, and Dong Z are the most influential authors in this field. KIDNEY INTERNATIONAL, JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, and AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY are the most influential journals. Initially, the research focused on keywords such as oxidative stress, ischemia-reperfusion injury, apoptosis, inflammation, and autophagy. In recent years, new research hotspots have emerged, including ferroptosis, aging, mitochondrial quality control, messenger RNA, mitochondrial-targeted antioxidants, extracellular vesicles, and nanodrug delivery.<br/><strong>Conclusion:</strong> Research on the relationship between mitochondria and AKI has broad developing prospects, and targeting mitochondrial regulation will become a focus of future AKI prevention and treatment research.<br/><br/><strong>Keywords:</strong> acute kidney injury, mitochondria, bibliometric analysis, visualization, VOSviewer, citespace<br/>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chunxia Yin, Taohua Lan, Yunshan Wu, Jing Cai, Haoxiang Li, Xiaolan Kuang, Lin Jiao, Xiaomin Ou, Hua Yang, Bo Liu, Weihui Lu
Purpose: This study was designed to evaluate the effect and mechanism of the Qushi Huatan (QSHT) decoction against coronary heart disease (CHD) through network pharmacology and experimental verification. Methods: In the present study, the active ingredients of the QSHT decoction were identified by ultra performance liquid chromatography/tandem mass spectrometry (UPLC/MS), then the potential ingredients and coronary heart disease targets were predicted using the SwissTarget Prediction database and the database of Genecards and OMIM database, respectively. A herb-compound-target network was constructed using Cytoscape. GO and KEGG enrichment analysis were performed using the ClusterProfiler data package of R software. Molecular docking was used to predict the core targets of QSHT against CHD. In addition, we used a myocardial infarction (MI) and high-fat diet ApoE−/− mice model to investigate the cardioprotective effects of QSHT. Western blotting and immunochemistry were used to verify the core targets and the signaling pathway. Results: A total of 68 active ingredients were found in the QSHT decoction. Network pharmacology indicated 28 targets and 147 signal pathways, including AKT1, HIF-1α, GSK-3β, TLR4 and NF-κB, those key targets were also verified by molecular docking. The results of GO and KEGG enrichment analysis showed that the targets of QSHT against CHD were largely associated with inflammatory and oxidative stress, and AKT/HIF-1α and TLR4/NF-κB pathways might be key functional pathways. In vivo, QSHT significantly improved cardiac function and attenuated fibrosis and inflammation. Furthermore, QSHT could significantly inhibit the expression of HIF-1α, TLR4, phosphorylation of AKT1, GSK-3β and NF-κB after MI in ApoE−/− mice. Conclusion: Based on network pharmacology, molecular docking and experimental verification, this study demonstrated that QSHT could improve cardiac function and attenuate cardiac fibrosis by regulating TLR4/NF-κB and AKT/HIF-1α signaling pathway in post- MI and high-fat diet ApoE−/− mice.
目的：本研究旨在通过网络药理学和实验验证，评价曲石花潭煎膏对冠心病（CHD）的作用和机制：本研究采用超高效液相色谱/串联质谱法（UPLC/MS）对曲氏化潭煎膏的有效成分进行了鉴定，然后分别利用SwissTarget Prediction数据库、Genecards数据库和OMIM数据库预测了曲氏化潭煎膏的潜在成分和冠心病靶点。利用Cytoscape构建了草药-化合物-靶标网络。使用R软件的ClusterProfiler数据包进行了GO和KEGG富集分析。分子对接被用来预测QSHT抗心肌梗死的核心靶点。此外，我们还利用心肌梗死（MI）和高脂饮食载脂蛋白E-/-小鼠模型研究了QSHT的心脏保护作用。我们使用了 Western 印迹和免疫化学方法来验证核心靶点和信号通路：结果：在羌活水煎剂中发现了68种有效成分。网络药理学显示了28个靶点和147条信号通路，包括AKT1、HIF-1α、GSK-3β、TLR4和NF-κB。GO和KEGG富集分析结果表明，QSHT防治冠心病的靶点主要与炎症和氧化应激有关，而AKT/HIF-1α和TLR4/NF-κB通路可能是关键的功能通路。在体内，QSHT 能明显改善心脏功能，减轻纤维化和炎症反应。此外，QSHT还能明显抑制载脂蛋白E-/-小鼠心肌梗死后HIF-1α、TLR4、AKT1磷酸化、GSK-3β和NF-κB的表达：基于网络药理学、分子对接和实验验证，本研究证实瞿氏化瘀汤可通过调节TLR4/NF-κB和AKT/HIF-1α信号通路，改善心肌梗死后和高脂饮食载脂蛋白E-/-小鼠的心功能，减轻心脏纤维化。
{"title":"Integrating Network Pharmacology and Experimental Validation to Investigate the Mechanism of Qushi Huatan Decoction Against Coronary Heart Disease","authors":"Chunxia Yin, Taohua Lan, Yunshan Wu, Jing Cai, Haoxiang Li, Xiaolan Kuang, Lin Jiao, Xiaomin Ou, Hua Yang, Bo Liu, Weihui Lu","doi":"10.2147/dddt.s463054","DOIUrl":"https://doi.org/10.2147/dddt.s463054","url":null,"abstract":"<strong>Purpose:</strong> This study was designed to evaluate the effect and mechanism of the Qushi Huatan (QSHT) decoction against coronary heart disease (CHD) through network pharmacology and experimental verification.<br/><strong>Methods:</strong> In the present study, the active ingredients of the QSHT decoction were identified by ultra performance liquid chromatography/tandem mass spectrometry (UPLC/MS), then the potential ingredients and coronary heart disease targets were predicted using the SwissTarget Prediction database and the database of Genecards and OMIM database, respectively. A herb-compound-target network was constructed using Cytoscape. GO and KEGG enrichment analysis were performed using the ClusterProfiler data package of R software. Molecular docking was used to predict the core targets of QSHT against CHD. In addition, we used a myocardial infarction (MI) and high-fat diet ApoE<sup>−/−</sup> mice model to investigate the cardioprotective effects of QSHT. Western blotting and immunochemistry were used to verify the core targets and the signaling pathway.<br/><strong>Results:</strong> A total of 68 active ingredients were found in the QSHT decoction. Network pharmacology indicated 28 targets and 147 signal pathways, including AKT1, HIF-1α, GSK-3β, TLR4 and NF-κB, those key targets were also verified by molecular docking. The results of GO and KEGG enrichment analysis showed that the targets of QSHT against CHD were largely associated with inflammatory and oxidative stress, and AKT/HIF-1α and TLR4/NF-κB pathways might be key functional pathways. In vivo, QSHT significantly improved cardiac function and attenuated fibrosis and inflammation. Furthermore, QSHT could significantly inhibit the expression of HIF-1α, TLR4, phosphorylation of AKT1, GSK-3β and NF-κB after MI in ApoE<sup>−/−</sup> mice.<br/><strong>Conclusion:</strong> Based on network pharmacology, molecular docking and experimental verification, this study demonstrated that QSHT could improve cardiac function and attenuate cardiac fibrosis by regulating TLR4/NF-κB and AKT/HIF-1α signaling pathway in post- MI and high-fat diet ApoE<sup>−/−</sup> mice.<br/><br/><strong>Keywords:</strong> network pharmacology, molecular docking, Qushi Huatan decoction, coronary heart disease<br/>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siddhartha Dutta, Rima B Shah, Shubha Singhal, Sudeshna Banerjee Dutta, Sumit Bansal, Susmita Sinha, Mainul Haque
Response to Letter in regards to Metformin’s Enigma: Bridging Gaps in Research on Potential Benefits & Associated Risks - A Critical Plea for Comprehensive Investigation [Letter]
{"title":"Metformin’s Enigma: Bridging Gaps in Research on Potential Benefits & Associated Risks - A Critical Plea for Comprehensive Investigation [Response to Letter]","authors":"Siddhartha Dutta, Rima B Shah, Shubha Singhal, Sudeshna Banerjee Dutta, Sumit Bansal, Susmita Sinha, Mainul Haque","doi":"10.2147/dddt.s491638","DOIUrl":"https://doi.org/10.2147/dddt.s491638","url":null,"abstract":"Response to Letter in regards to Metformin’s Enigma: Bridging Gaps in Research on Potential Benefits & Associated Risks - A Critical Plea for Comprehensive Investigation [Letter]","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chao Zeng, Lu Li, Mengrui Wang, Jun Xiong, Wenjuan Pang, Haiyan Yu, Jiadi He, Xuguang Wang, Yingying Chen, Yanyan Sun
Objective: Ciprofol is a novel anesthetic agent, its efficacy and safety had been verified and its clinical implementation has been expanded. However, the knowledge about ciprofol in children is meager. The aim of study is to evaluate the safety and effectiveness of ciprofol in general anesthesia in children undergoing adenoidectomy and adenotonsillectomy, compared with propofol. Materials: We retrospectively analyzed data of children who underwent adenoidectomy or adenotonsillectomy with general anesthesia from June to August 2023 to evaluate the safety and effectiveness of ciprofol. The primary outcomes included hemodynamic changes during induction and postoperative complications in post-anesthesia care unit. The secondary outcomes were extubation time, pediatric anesthesia emergence delirium (PAED) score. Meanwhile, subgroup analysis was performed based on age. Results: 301 children met the inclusion criteria, 157 received ciprofol induction and 144 received propofol. Patient demographics and operation-related information were similar in the two groups. However, the dosage of dexmedetomidine in the propofol group was significantly higher than that of the ciprofol group (p=0.001). The trends of hemodynamic shift during induction and intubation were the same in the two groups. The PAED scores on post-extubation 10min and 20min were significantly reduced in the ciprofol group (p< 0.001 and p=0.046). Moreover, in the ≤ 72 months and the > 72 months subgroups, the scores were also significantly lower in the ciprofol group on post-extubation 10min. With the score of > 10, the incidence of emergence delirium of the ciprofol group was significantly lower on post-extubation 10min and 20min in the population and the ≤ 72 months subgroups (p=0.03 and p=0.02). There were no obvious postoperative complications in both groups. Conclusion: Ciprofol exhibited advantageous characteristics in the induction of children, such as stable hemodynamics, a relatively lower incidence of postoperative delirium without apparent post-anesthesia complications. Ciprofol may emerge as a novel option for general anesthesia in pediatric patients.
Keywords: ciprofol, propofol, adenoidectomy, child, general anesthesia, delirium
{"title":"Ciprofol in Children Undergoing Adenoidectomy and Adenotonsillectomy: A Retrospective Cohort Study","authors":"Chao Zeng, Lu Li, Mengrui Wang, Jun Xiong, Wenjuan Pang, Haiyan Yu, Jiadi He, Xuguang Wang, Yingying Chen, Yanyan Sun","doi":"10.2147/dddt.s478994","DOIUrl":"https://doi.org/10.2147/dddt.s478994","url":null,"abstract":"<strong>Objective:</strong> Ciprofol is a novel anesthetic agent, its efficacy and safety had been verified and its clinical implementation has been expanded. However, the knowledge about ciprofol in children is meager. The aim of study is to evaluate the safety and effectiveness of ciprofol in general anesthesia in children undergoing adenoidectomy and adenotonsillectomy, compared with propofol.<br/><strong>Materials:</strong> We retrospectively analyzed data of children who underwent adenoidectomy or adenotonsillectomy with general anesthesia from June to August 2023 to evaluate the safety and effectiveness of ciprofol. The primary outcomes included hemodynamic changes during induction and postoperative complications in post-anesthesia care unit. The secondary outcomes were extubation time, pediatric anesthesia emergence delirium (PAED) score. Meanwhile, subgroup analysis was performed based on age.<br/><strong>Results:</strong> 301 children met the inclusion criteria, 157 received ciprofol induction and 144 received propofol. Patient demographics and operation-related information were similar in the two groups. However, the dosage of dexmedetomidine in the propofol group was significantly higher than that of the ciprofol group (<em>p</em>=0.001). The trends of hemodynamic shift during induction and intubation were the same in the two groups. The PAED scores on post-extubation 10min and 20min were significantly reduced in the ciprofol group (<em>p</em>< 0.001 and <em>p</em>=0.046). Moreover, in the ≤ 72 months and the > 72 months subgroups, the scores were also significantly lower in the ciprofol group on post-extubation 10min. With the score of > 10, the incidence of emergence delirium of the ciprofol group was significantly lower on post-extubation 10min and 20min in the population and the ≤ 72 months subgroups (<em>p</em>=0.03 and <em>p</em>=0.02). There were no obvious postoperative complications in both groups.<br/><strong>Conclusion:</strong> Ciprofol exhibited advantageous characteristics in the induction of children, such as stable hemodynamics, a relatively lower incidence of postoperative delirium without apparent post-anesthesia complications. Ciprofol may emerge as a novel option for general anesthesia in pediatric patients.<br/><br/><strong>Keywords:</strong> ciprofol, propofol, adenoidectomy, child, general anesthesia, delirium<br/>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liang Wu, Yunxia Zhu, Shengcai Zhu, Deng Zhang, Xiuping Wang, Zhen Xiao, Yanping Tan, Xiaoliang Ouyang, Chunming Li
Background: Acne vulgaris (AV), a chronic inflammatory pilosebaceous disorder, affects 80– 90% of teenagers. This study aimed to discover lipid profiles and biomarkers of the rabbit ear acne model, and investigate the mechanism of isotretinoin in treating acne at the lipid level. Methods: Untargeted lipidomic analysis using ultra-high performance liquid chromatography system (UHPLC) coupled to q-extraction plus was performed to identify skin lipid metabolites in blank control (groups C), model group (group M) and isotretinoin group (group T). Multivariate statistical analysis was used to process the lipidomics data. Results: A total of 43 lipid classes comprising 6989 lipid species were identified from the mass spectrometry data. The orthogonal partial least squares discriminant analysis (OPLS-DA) model demonstrated significant separation in skin lipidomic profiles between group M and group C. With variable influence on projection (VIP) > 1.0 and P-value < 0.05, 299 significantly different lipid metabolites were identified. These lipid metabolites consisted mainly of ceramides (Cer) (53.85%), phosphatidylethanolamines (PE) (9.03%), phosphatidylcholines (PC)(5.35%), and sphingomyelin (SM)(4.01%). Combining with AUC ≥ 0.9 as the elected criteria, Cer (d18;1_24:0), zymosterol (ZyE)(33:5), Cer (t43:1), ZyE (33:6), ZyE (24:7), and ZyE (35:6) have “high” accuracy. Isotretinoin treatment normalized 25 lipid metabolites in the acne model. Conclusion: Our findings provide new insights into the role of lipid metabolism in the pathogenesis of acne and the action mechanism of isotretinoin.
{"title":"Untargeted Lipidomics Analysis to Discover Lipid Profiles and Biomarkers of Rabbit Acne Model and Reveal Action Mechanism of Isotretinoin","authors":"Liang Wu, Yunxia Zhu, Shengcai Zhu, Deng Zhang, Xiuping Wang, Zhen Xiao, Yanping Tan, Xiaoliang Ouyang, Chunming Li","doi":"10.2147/dddt.s476649","DOIUrl":"https://doi.org/10.2147/dddt.s476649","url":null,"abstract":"<strong>Background:</strong> Acne vulgaris (AV), a chronic inflammatory pilosebaceous disorder, affects 80– 90% of teenagers. This study aimed to discover lipid profiles and biomarkers of the rabbit ear acne model, and investigate the mechanism of isotretinoin in treating acne at the lipid level.<br/><strong>Methods:</strong> Untargeted lipidomic analysis using ultra-high performance liquid chromatography system (UHPLC) coupled to q-extraction plus was performed to identify skin lipid metabolites in blank control (groups C), model group (group M) and isotretinoin group (group T). Multivariate statistical analysis was used to process the lipidomics data.<br/><strong>Results:</strong> A total of 43 lipid classes comprising 6989 lipid species were identified from the mass spectrometry data. The orthogonal partial least squares discriminant analysis (OPLS-DA) model demonstrated significant separation in skin lipidomic profiles between group M and group C. With variable influence on projection (VIP) > 1.0 and P-value < 0.05, 299 significantly different lipid metabolites were identified. These lipid metabolites consisted mainly of ceramides (Cer) (53.85%), phosphatidylethanolamines (PE) (9.03%), phosphatidylcholines (PC)(5.35%), and sphingomyelin (SM)(4.01%). Combining with AUC ≥ 0.9 as the elected criteria, Cer (d18;1_24:0), zymosterol (ZyE)(33:5), Cer (t43:1), ZyE (33:6), ZyE (24:7), and ZyE (35:6) have “high” accuracy. Isotretinoin treatment normalized 25 lipid metabolites in the acne model.<br/><strong>Conclusion:</strong> Our findings provide new insights into the role of lipid metabolism in the pathogenesis of acne and the action mechanism of isotretinoin.<br/><br/>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Cytomegalovirus (CMV) infection is arguably the most important infectious complication that negatively affects the outcome of solid organ transplantation. For decades, CMV management after transplantation has relied on antiviral drugs that inhibit viral DNA polymerase (ganciclovir, foscarnet, and cidofovir). However, their use has been complicated by myelosuppression, nephrotoxicity, and selection of drug-resistant viruses. During the past few years, the therapeutic armamentarium for the management of CMV in solid organ transplant recipients has expanded with the approval of letermovir for CMV prophylaxis in high-risk CMV D+/R- kidney recipients, and maribavir for the treatment of refractory and resistant CMV infection. Both drugs offer significant improvement when compared to standard anti-CMV therapies; letermovir was as efficacious for CMV prevention, whereas maribavir was more effective in treating refractory and resistant CMV infections. Both letermovir and maribavir have favorable safety profiles compared to CMV DNA polymerase inhibitors, without the risk of neutropenia and leukopenia associated with ganciclovir and renal toxicities associated with foscarnet and cidofovir. Moreover, letermovir and maribavir are orally bioavailable, which allows convenient outpatient treatment. However, letermovir and maribavir have a significant drug interaction potential in solid organ transplant recipients, resulting in higher levels of calcineurin inhibitors (cyclosporine and tacrolimus) and mTOR inhibitors (sirolimus and everolimus). Both letermovir and maribavir are CMV-specific and do not have clinical efficacy against other herpes viruses. Thus, there is a need for additional antiviral drugs to prevent herpes simplex and other herpes viruses when clinically indicated. This article provides a comprehensive review of the clinical data supporting the use of letermovir and maribavir in clinical practice. The author provides perspectives on the role of these newly approved drugs in the current management landscape of CMV infection in solid organ transplantation.
Keywords: cytomegalovirus, maribavir, letermovir, ganciclovir, drug resistance, prophylaxis, treatment
摘要：巨细胞病毒（CMV）感染可以说是对实体器官移植结果产生负面影响的最重要的感染性并发症。几十年来，移植后 CMV 的治疗一直依赖于抑制病毒 DNA 聚合酶的抗病毒药物（更昔洛韦、福斯卡尼和西多福韦）。然而，由于骨髓抑制、肾毒性和耐药病毒的产生，这些药物的使用变得复杂起来。在过去几年中，用于治疗实体器官移植受者CMV的药物种类不断增加，批准了来特莫韦（letermovir）用于高危CMV D+/R-肾脏受者的CMV预防，以及马利巴韦（maribavir）用于治疗难治性和耐药性CMV感染。与标准的抗CMV疗法相比，这两种药物都有明显改善；来特莫韦在预防CMV方面同样有效，而马利巴韦在治疗难治性和耐药性CMV感染方面更为有效。与 CMV DNA 聚合酶抑制剂相比，来特莫韦和马立巴韦都具有良好的安全性，没有更昔洛韦引起的中性粒细胞减少和白细胞减少的风险，也没有福斯奈德和西多福韦引起的肾毒性。此外，来曲米韦和马立巴韦可口服，方便门诊治疗。不过，在接受实体器官移植的患者中，来特莫韦和马立巴韦可能会产生明显的药物相互作用，导致钙神经蛋白抑制剂（环孢素和他克莫司）和 mTOR 抑制剂（西罗莫司和依维莫司）的水平升高。来替莫韦和马立巴韦都是 CMV 特异性药物，对其他疱疹病毒没有临床疗效。因此，临床上需要更多的抗病毒药物来预防单纯疱疹病毒和其他疱疹病毒。本文全面回顾了支持在临床实践中使用来特莫韦和马立巴韦的临床数据。关键词：巨细胞病毒；马拉巴韦；来特莫韦；更昔洛韦；耐药性；预防；治疗
{"title":"Current Perspectives on Letermovir and Maribavir for the Management of Cytomegalovirus Infection in Solid Organ Transplant Recipients","authors":"Raymund R Razonable","doi":"10.2147/dddt.s265644","DOIUrl":"https://doi.org/10.2147/dddt.s265644","url":null,"abstract":"<strong>Abstract:</strong> Cytomegalovirus (CMV) infection is arguably the most important infectious complication that negatively affects the outcome of solid organ transplantation. For decades, CMV management after transplantation has relied on antiviral drugs that inhibit viral DNA polymerase (ganciclovir, foscarnet, and cidofovir). However, their use has been complicated by myelosuppression, nephrotoxicity, and selection of drug-resistant viruses. During the past few years, the therapeutic armamentarium for the management of CMV in solid organ transplant recipients has expanded with the approval of letermovir for CMV prophylaxis in high-risk CMV D+/R- kidney recipients, and maribavir for the treatment of refractory and resistant CMV infection. Both drugs offer significant improvement when compared to standard anti-CMV therapies; letermovir was as efficacious for CMV prevention, whereas maribavir was more effective in treating refractory and resistant CMV infections. Both letermovir and maribavir have favorable safety profiles compared to CMV DNA polymerase inhibitors, without the risk of neutropenia and leukopenia associated with ganciclovir and renal toxicities associated with foscarnet and cidofovir. Moreover, letermovir and maribavir are orally bioavailable, which allows convenient outpatient treatment. However, letermovir and maribavir have a significant drug interaction potential in solid organ transplant recipients, resulting in higher levels of calcineurin inhibitors (cyclosporine and tacrolimus) and mTOR inhibitors (sirolimus and everolimus). Both letermovir and maribavir are CMV-specific and do not have clinical efficacy against other herpes viruses. Thus, there is a need for additional antiviral drugs to prevent herpes simplex and other herpes viruses when clinically indicated. This article provides a comprehensive review of the clinical data supporting the use of letermovir and maribavir in clinical practice. The author provides perspectives on the role of these newly approved drugs in the current management landscape of CMV infection in solid organ transplantation.<br/><br/><strong>Keywords:</strong> cytomegalovirus, maribavir, letermovir, ganciclovir, drug resistance, prophylaxis, treatment<br/>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdullah R Alzahrani, Doaa I Mohamed, Hebatallah H Abo Nahas, Dalia Alaa El-Din Aly El-Waseef, Abdulmalik S Altamimi, Ibrahim H Youssef, Ibrahim Abdel Aziz Ibrahim, Soha MY Mohamed, Yasmine Gamal Sabry, Alaa H Falemban, Nasser Attia Elhawary, Ghazi A Bamagous, Mariusz Jaremko, Essa M Saied
Introduction: Pulmonary fibrosis (PF) and tissue remodeling can greatly impair pulmonary function and often lead to fatal outcomes. Methodology: In the present study, we explored a novel molecular interplay of long noncoding (Lnc) RNA CBR3-AS1/ miRNA-29/ FIZZ1 axis in moderating the inflammatory processes, immunological responses, and oxidative stress pathways in bleomycin (BLM)-induced lung fibrosis. Furthermore, we investigated the pharmacological potential of Trimetazidine (TMZ) in ameliorating lung fibrosis. Results: Our results revealed that the BLM-treated group exhibited a significant upregulation in the expression of epigenetic regulators, lncRNA CBR3-AS1 and FIZZ1, compared to the control group (P< 0.0001), along with the downregulation of miRNA-29 expression. Furthermore, Correlation analysis showed a significant positive association between lnc CBR3-AS1 and FIZZ1 (R=0.7723, p< 0.05) and a significant negative association between miRNA-29 and FIZZ1 (R=− 0.7535, p< 0.05), suggesting lnc CBR3-AS1 as an epigenetic regulator of FIZZ1 in lung fibrosis. BLM treatment significantly increased the expression of Notch, Jagged1, Smad3, TGFB1, and hydroxyproline. Interestingly, the administration of TMZ demonstrated the ability to attenuate the deterioration effects caused by BLM treatment, as indicated by biochemical and histological analyses. Our investigations revealed that the therapeutic potential of TMZ as an antifibrotic drug could be ascribed to its ability to directly target the epigenetic regulators lncRNA CBR3-AS1/ miRNA-29/ FIZZ1, which in turn resulted in the mitigation of lung fibrosis. Histological and immunohistochemical analyses further validated the potential antifibrotic effects of TMZ by mitigating the structural damage associated with fibrosis. Discussion: Taken together, our study showed for the first time the interplay between epigenetic lncRNAs CBR3-AS1 and miRNA-29 in lung fibrosis and demonstrated that FIZZ1 could be a downregulatory gene for lncRNA CBR3-AS1 and miRNA-29. Our key findings demonstrate that TMZ significantly reduces the expression of fibrotic, oxidative stress, immunomodulatory, and inflammatory markers, along with epigenetic regulators associated with lung fibrosis. This validates its potential as an effective antifibrotic agent by targeting the CBR3-AS1/miRNA-29/FIZZ1 axis.
{"title":"Trimetazidine Alleviates Bleomycin-Induced Pulmonary Fibrosis by Targeting the Long Noncoding RNA CBR3-AS1-Mediated miRNA-29 and Resistin-Like Molecule alpha 1: Deciphering a Novel Trifecta Role of LncRNA CBR3-AS1/miRNA-29/FIZZ1 Axis in Lung Fibrosis","authors":"Abdullah R Alzahrani, Doaa I Mohamed, Hebatallah H Abo Nahas, Dalia Alaa El-Din Aly El-Waseef, Abdulmalik S Altamimi, Ibrahim H Youssef, Ibrahim Abdel Aziz Ibrahim, Soha MY Mohamed, Yasmine Gamal Sabry, Alaa H Falemban, Nasser Attia Elhawary, Ghazi A Bamagous, Mariusz Jaremko, Essa M Saied","doi":"10.2147/dddt.s463626","DOIUrl":"https://doi.org/10.2147/dddt.s463626","url":null,"abstract":"<strong>Introduction:</strong> Pulmonary fibrosis (PF) and tissue remodeling can greatly impair pulmonary function and often lead to fatal outcomes.<br/><strong>Methodology:</strong> In the present study, we explored a novel molecular interplay of long noncoding (Lnc) RNA CBR3-AS1/ miRNA-29/ FIZZ1 axis in moderating the inflammatory processes, immunological responses, and oxidative stress pathways in bleomycin (BLM)-induced lung fibrosis. Furthermore, we investigated the pharmacological potential of Trimetazidine (TMZ) in ameliorating lung fibrosis.<br/><strong>Results:</strong> Our results revealed that the BLM-treated group exhibited a significant upregulation in the expression of epigenetic regulators, lncRNA CBR3-AS1 and FIZZ1, compared to the control group (P< 0.0001), along with the downregulation of miRNA-29 expression. Furthermore, Correlation analysis showed a significant positive association between lnc CBR3-AS1 and FIZZ1 (R=0.7723, p< 0.05) and a significant negative association between miRNA-29 and FIZZ1 (R=− 0.7535, p< 0.05), suggesting lnc CBR3-AS1 as an epigenetic regulator of FIZZ1 in lung fibrosis. BLM treatment significantly increased the expression of Notch, Jagged1, Smad3, TGFB1, and hydroxyproline. Interestingly, the administration of TMZ demonstrated the ability to attenuate the deterioration effects caused by BLM treatment, as indicated by biochemical and histological analyses. Our investigations revealed that the therapeutic potential of TMZ as an antifibrotic drug could be ascribed to its ability to directly target the epigenetic regulators lncRNA CBR3-AS1/ miRNA-29/ FIZZ1, which in turn resulted in the mitigation of lung fibrosis. Histological and immunohistochemical analyses further validated the potential antifibrotic effects of TMZ by mitigating the structural damage associated with fibrosis.<br/><strong>Discussion:</strong> Taken together, our study showed for the first time the interplay between epigenetic lncRNAs CBR3-AS1 and miRNA-29 in lung fibrosis and demonstrated that FIZZ1 could be a downregulatory gene for lncRNA CBR3-AS1 and miRNA-29. Our key findings demonstrate that TMZ significantly reduces the expression of fibrotic, oxidative stress, immunomodulatory, and inflammatory markers, along with epigenetic regulators associated with lung fibrosis. This validates its potential as an effective antifibrotic agent by targeting the CBR3-AS1/miRNA-29/FIZZ1 axis. <br/><br/><strong>Keywords:</strong> lung fibrosis, long noncoding RNA CBR3-AS1, miRNA-29, FIZZ1, trimetazidine, histopathology<br/>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04eCollection Date: 2024-01-01DOI: 10.2147/DDDT.S484531
Mei Liu, Sili Guo, Xiaohan Li, Yang Tian, Yanjie Yu, Lili Tang, Qimei Sun, Ting Zhang, Mingwei Fan, Lili Zhang, Yingjiang Xu, Jiajia An, Xiangqian Gao, Lei Han, Lei Zhang
Background: GLP-1 receptor agonists (GLP-1 RA) have been proven to treat several metabolic diseases; however, the effects of GLP-1 RA on polycystic ovary syndrome (PCOS) remain unclear. Here, we aimed to investigate whether semaglutide, a novel GLP-1 RA, could alleviate ovarian inflammation in PCOS mice.
Methods: Female C57BL/6J mice were subcutaneously injected with dehydroepiandrosterone for 21 days to establish the PCOS model. Then the mice were randomly divided into three groups: PCOS group (n = 6), S-0.42 group (semaglutide 0.42 mg/kg/w, n = 6), and S-0.84 group (semaglutide 0.84 mg/kg/w, n = 6). The remaining six mice were used as controls (NC). After 28 days of intervention, serum sex hormones and inflammatory cytokine levels were measured. Hematoxylin and eosin staining was used to observe the ovarian morphology. Immunohistochemical staining was used to detect the relative expression of CYP19A1, TNF-α, IL-6, IL-1β, and NF-κB in ovaries. CYP17A1 and StAR were detected using immunofluorescence staining. Finally, the relative expressions of AMPK, pAMPK, SIRT1, NF-κB, IκBα, pIκBα, TNF-α, IL-6, and IL-1β were measured using Western blotting.
Results: First, after intervention with semaglutide, the weight of the mice decreased, insulin resistance improved, and the estrous cycle returned to normal. Serum testosterone and IL-1β levels decreased significantly, whereas estradiol and progestin levels increased significantly. Follicular cystic dilation significantly improved. The expression of TNF-α, IL-6, IL-1β, NF-κB, CYP17A1, and StAR in the ovary was significantly downregulated, whereas CYP19A1 expression was upregulated after the intervention. Finally, we confirmed that semaglutide alleviates ovarian tissue inflammation and improves PCOS through the AMPK/SIRT1/NF-κB signaling pathway.
Conclusion: Semaglutide alleviates ovarian inflammation via the AMPK/SIRT1/NF‑κB signaling pathway in PCOS mice.
{"title":"Semaglutide Alleviates Ovary Inflammation via the AMPK/SIRT1/NF‑κB Signaling Pathway in Polycystic Ovary Syndrome Mice.","authors":"Mei Liu, Sili Guo, Xiaohan Li, Yang Tian, Yanjie Yu, Lili Tang, Qimei Sun, Ting Zhang, Mingwei Fan, Lili Zhang, Yingjiang Xu, Jiajia An, Xiangqian Gao, Lei Han, Lei Zhang","doi":"10.2147/DDDT.S484531","DOIUrl":"10.2147/DDDT.S484531","url":null,"abstract":"<p><strong>Background: </strong>GLP-1 receptor agonists (GLP-1 RA) have been proven to treat several metabolic diseases; however, the effects of GLP-1 RA on polycystic ovary syndrome (PCOS) remain unclear. Here, we aimed to investigate whether semaglutide, a novel GLP-1 RA, could alleviate ovarian inflammation in PCOS mice.</p><p><strong>Methods: </strong>Female C57BL/6J mice were subcutaneously injected with dehydroepiandrosterone for 21 days to establish the PCOS model. Then the mice were randomly divided into three groups: PCOS group (n = 6), S-0.42 group (semaglutide 0.42 mg/kg/w, n = 6), and S-0.84 group (semaglutide 0.84 mg/kg/w, n = 6). The remaining six mice were used as controls (NC). After 28 days of intervention, serum sex hormones and inflammatory cytokine levels were measured. Hematoxylin and eosin staining was used to observe the ovarian morphology. Immunohistochemical staining was used to detect the relative expression of CYP19A1, TNF-α, IL-6, IL-1β, and NF-κB in ovaries. CYP17A1 and StAR were detected using immunofluorescence staining. Finally, the relative expressions of AMPK, pAMPK, SIRT1, NF-κB, IκBα, pIκBα, TNF-α, IL-6, and IL-1β were measured using Western blotting.</p><p><strong>Results: </strong>First, after intervention with semaglutide, the weight of the mice decreased, insulin resistance improved, and the estrous cycle returned to normal. Serum testosterone and IL-1β levels decreased significantly, whereas estradiol and progestin levels increased significantly. Follicular cystic dilation significantly improved. The expression of TNF-α, IL-6, IL-1β, NF-κB, CYP17A1, and StAR in the ovary was significantly downregulated, whereas CYP19A1 expression was upregulated after the intervention. Finally, we confirmed that semaglutide alleviates ovarian tissue inflammation and improves PCOS through the AMPK/SIRT1/NF-κB signaling pathway.</p><p><strong>Conclusion: </strong>Semaglutide alleviates ovarian inflammation via the AMPK/SIRT1/NF‑κB signaling pathway in PCOS mice.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04eCollection Date: 2024-01-01DOI: 10.2147/DDDT.S261119
Panayotis K Vlachakis, Panagiotis Theofilis, Stergios Soulaidopoulos, Emilia Lazarou, Konstantinos Tsioufis, George Lazaros
Recurrent pericarditis (RP) has been traditionally regarded as a "nightmare" for both clinicians and patients. Until approximately a decade ago, available treatments were thin on the ground with non-steroidal anti-inflammatory medications, glucocorticoids, colchicine, and classical immunosuppressants being the only options. The first important step in the tale of RP was the advent of colchicine in clinical practice, which has been shown to halve the rate of first and subsequent pericarditis recurrences. The second major breakthrough advance in this setting was the introduction of interleukin-1 inhibitors based on the recently unveiled autoinflammatory nature of pericarditis. At present, anti-interleukin-1 inhibitors available for clinical use in patients with refractory RP include anakinra and rilonacept, with the latter having obtained FDA approval for this indication. Apart from the remarkable efficacy and good safety profile which is a common feature of all anti-interleukin-1 compounds, rilonacept has the advantage of weekly administration (instead of daily compared to anakinra) which is important in terms of adherence to treatment and improved quality of life albeit at the expense of a higher cost. This review aims to summarize the available evidence on the role of rilonacept in the treatment of RP and the reduction of the recurrences risk.
复发性心包炎（RP）历来被视为临床医生和患者的 "噩梦"。大约十年前，非甾体抗炎药物、糖皮质激素、秋水仙碱和传统免疫抑制剂还是唯一的选择。临床实践证明，秋水仙碱可将首次和随后的心包炎复发率降低一半。在这一领域取得的第二个重大突破是，根据最近揭示的心包炎自身炎症性质，引入了白细胞介素-1 抑制剂。目前，可用于难治性 RP 患者临床治疗的抗白细胞介素-1 抑制剂包括 anakinra 和 rilonacept，后者已获得 FDA 批准用于这一适应症。除了所有抗白细胞介素-1化合物都具有的显著疗效和良好的安全性外，利龙赛普还具有每周给药（而不是像阿纳金拉那样每天给药）的优点，这对于坚持治疗和提高生活质量非常重要，尽管代价是较高的费用。本综述旨在总结有关利龙赛普在治疗 RP 和降低复发风险方面作用的现有证据。
{"title":"Clinical Utility of Rilonacept for the Treatment of Recurrent Pericarditis: Design, Development, and Place in Therapy.","authors":"Panayotis K Vlachakis, Panagiotis Theofilis, Stergios Soulaidopoulos, Emilia Lazarou, Konstantinos Tsioufis, George Lazaros","doi":"10.2147/DDDT.S261119","DOIUrl":"10.2147/DDDT.S261119","url":null,"abstract":"<p><p>Recurrent pericarditis (RP) has been traditionally regarded as a \"nightmare\" for both clinicians and patients. Until approximately a decade ago, available treatments were thin on the ground with non-steroidal anti-inflammatory medications, glucocorticoids, colchicine, and classical immunosuppressants being the only options. The first important step in the tale of RP was the advent of colchicine in clinical practice, which has been shown to halve the rate of first and subsequent pericarditis recurrences. The second major breakthrough advance in this setting was the introduction of interleukin-1 inhibitors based on the recently unveiled autoinflammatory nature of pericarditis. At present, anti-interleukin-1 inhibitors available for clinical use in patients with refractory RP include anakinra and rilonacept, with the latter having obtained FDA approval for this indication. Apart from the remarkable efficacy and good safety profile which is a common feature of all anti-interleukin-1 compounds, rilonacept has the advantage of weekly administration (instead of daily compared to anakinra) which is important in terms of adherence to treatment and improved quality of life albeit at the expense of a higher cost. This review aims to summarize the available evidence on the role of rilonacept in the treatment of RP and the reduction of the recurrences risk.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Ciprofol is a new intravenous sedative / anesthetic drug. In recent years, many clinical studies have also confirmed the sedative effect of ciprofol. However, more clinical research is still needed on its clinical application characteristics in special populations.
Objective: The aim of this study was to compare the clinical effects of ciprofol and propofol in general anesthesia induction of elderly patients.
Methods: 60 elderly (aged ≥ 75 years) patients underwent hip fracture surgery were randomly into two groups of a 1:1 ratio. Group C (ciprofol group): 0.3mg/kg ciprofol was infused. Group P (propofol group): 1.5mg/kg propofol was infused. The observation period was from the infusion of test drug to 5 min after endotracheal intubation. The primary outcomes included the incidence of severe hypotension and hypotension during the observation period. The secondary outcomes were as follows: the success rate of general anesthesia induction, the number of additional sedation, the time of loss of consciousness (LOC), Δ MAP, Δ HR, adverse events and the frequency of vasoactive drugs used.
Results: Finally, 60 subjects completed the study. Compared with Group P, the incidence of severe hypotension in Group C was lower (26.7% vs 53.3%, P = 0.035), the incidence of hypotension was also lower (36.7% vs 63.3%, P = 0.037), Δ MAP in Group C was significantly lower (31.4 ± 11.4 vs 39.6 ± 15.7, P = 0.025), the frequency of ephedrine used and the incidence of injection pain in Group C were also significantly lower.
Conclusion: Ciprofol showed similar efficacy to propofol when used for general anesthesia induction in elderly patients underwent hip fracture surgery and could maintain more stable blood pressure.
背景介绍环丙酚是一种新型静脉镇静/麻醉药物。近年来，许多临床研究也证实了环丙酚的镇静作用。然而，关于其在特殊人群中的临床应用特点，仍需要更多的临床研究：方法：将 60 名接受髋部骨折手术的老年患者（年龄≥ 75 岁）按照 1:1 的比例随机分为两组。C组（ciprofol组）：注入 0.3mg/kg 环丙酚。P组（丙泊酚组）：注入 1.5mg/kg 异丙酚。观察时间为输注试验药物至气管插管后 5 分钟。主要结果包括严重低血压和观察期间低血压的发生率。次要结果如下：全身麻醉诱导成功率、追加镇静次数、意识丧失时间（LOC）、ΔMAP、ΔHR、不良事件和使用血管活性药物的频率：最后，60 名受试者完成了研究。与 P 组相比，C 组严重低血压的发生率较低（26.7% vs 53.3%，P = 0.035），低血压的发生率也较低（36.7% vs 63.3%，P = 0.037），C 组的Δ MAP 显著较低（31.4 ± 11.4 vs 39.6 ± 15.7，P = 0.025），C 组使用麻黄碱的频率和注射疼痛的发生率也显著较低：结论：在对老年髋部骨折手术患者进行全身麻醉诱导时，异丙酚的疗效与丙泊酚相似，且能维持更稳定的血压。
{"title":"Efficacy and Safety of General Anesthesia Induction with Ciprofol in Hip Fracture Surgery of Elderly Patients: A Randomized Controlled Trial.","authors":"Yan-Fei Lu, Ji-Min Wu, Hai-Yan Lan, Qiao-Min Xu, Shu-Qi Shi, Gong-Chen Duan","doi":"10.2147/DDDT.S475176","DOIUrl":"10.2147/DDDT.S475176","url":null,"abstract":"<p><strong>Background: </strong>Ciprofol is a new intravenous sedative / anesthetic drug. In recent years, many clinical studies have also confirmed the sedative effect of ciprofol. However, more clinical research is still needed on its clinical application characteristics in special populations.</p><p><strong>Objective: </strong>The aim of this study was to compare the clinical effects of ciprofol and propofol in general anesthesia induction of elderly patients.</p><p><strong>Methods: </strong>60 elderly (aged ≥ 75 years) patients underwent hip fracture surgery were randomly into two groups of a 1:1 ratio. Group C (ciprofol group): 0.3mg/kg ciprofol was infused. Group P (propofol group): 1.5mg/kg propofol was infused. The observation period was from the infusion of test drug to 5 min after endotracheal intubation. The primary outcomes included the incidence of severe hypotension and hypotension during the observation period. The secondary outcomes were as follows: the success rate of general anesthesia induction, the number of additional sedation, the time of loss of consciousness (LOC), Δ MAP, Δ HR, adverse events and the frequency of vasoactive drugs used.</p><p><strong>Results: </strong>Finally, 60 subjects completed the study. Compared with Group P, the incidence of severe hypotension in Group C was lower (26.7% vs 53.3%, <i>P</i> = 0.035), the incidence of hypotension was also lower (36.7% vs 63.3%, <i>P</i> = 0.037), Δ MAP in Group C was significantly lower (31.4 ± 11.4 vs 39.6 ± 15.7, <i>P</i> = 0.025), the frequency of ephedrine used and the incidence of injection pain in Group C were also significantly lower.</p><p><strong>Conclusion: </strong>Ciprofol showed similar efficacy to propofol when used for general anesthesia induction in elderly patients underwent hip fracture surgery and could maintain more stable blood pressure.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号