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Pharmacokinetic profile of dexamethasone in urine and plasma after single and multiple oral administration: Relevance to doping controls 单次和多次口服地塞米松在尿和血浆中的药代动力学特征:与兴奋剂控制的相关性。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-08 DOI: 10.1016/j.ejps.2025.107405
Sergi Coll , Claudia Bressan , Núria Monfort , Ana Aldea-Perona , Marcel·lí Carbó , Rosa Ventura
Dexamethasone (DEX) is prohibited in sports competitions when administered by all injectable, oral or rectal routes, and is permitted at all times when administered by all other routes. The present work aimed to assess the urinary excretion profile of DEX after single and multiple oral administrations to verify the suitability of the new minimum reporting level (MRL) of 60 ng/mL established by the World Anti-Doping Agency to distinguish allowed and prohibited administrations. Moreover, the minimum washout period of three days established for out-of-competition treatments with oral glucocorticoids will be evaluated.
DEX was administered to healthy volunteers using two different oral treatments: single administration (4 mg, n = 8 male volunteers) and multiple administrations (2 mg/12 h for 5 days, n = 8 male volunteers). Urine and plasma samples collected before and after administration were analysed using liquid chromatography-tandem mass spectrometry. DEX and 6β‑hydroxy-DEX, were the predominant compounds detected in urine, with peak urinary excretion observed within the first 4 h post-dose. DEX concentrations exceeded the new MRL mainly within 12 h after a single dose, with one volunteer showing levels above this threshold up to 24–36 h. In the multiple-dose study, most of the DEX concentrations remained above 60 ng/mL after the second dose and throughout the dosing period and declined quickly after the final dose. Plasma DEX kinetics was defined by an open bicompartmental model with a first order oral absorption. DEX was detectable up to 48 h post-administration. In the multiple dose study, the steady-state concentrations were reached soon after the first dose, and DEX showed no evidence of accumulation. CORT levels decreased rapidly after both single and multiple administrations due to suppression of the hypothalamic-pituitary-adrenal axis. Recovery times varied among volunteers.
The MRL of 60 ng/mL proved appropriate for distinguishing permitted from prohibited use with a 3-day washout, though further studies on non-systemic routes are recommended to refine sensitivity.
地塞米松(DEX)禁止在体育比赛中通过所有注射、口服或直肠途径给药,而允许在任何时候通过所有其他途径给药。本研究旨在评估单次和多次口服给药后DEX的尿排泄情况,以验证世界反兴奋剂机构(World Anti-Doping Agency)建立的60 ng/mL最低报告水平(MRL)的适用性,以区分允许和禁止给药。此外,将评估口服糖皮质激素的非竞赛治疗的最小洗脱期为三天。对健康志愿者进行两种不同的口服治疗:单次给药(4mg, n= 8名男性志愿者)和多次给药(2mg /12h,连续5天,n= 8名男性志愿者)。用液相色谱-串联质谱法分析给药前后的尿液和血浆样本。DEX和6β-羟基DEX是尿中检测到的主要化合物,在给药后的前4小时内观察到尿排泄高峰。DEX浓度主要在单次给药后12小时内超过新的MRL,有一名志愿者在24-36小时内均高于该阈值。在多次给药研究中,大多数DEX浓度在第二次给药后和整个给药期间保持在60 ng/mL以上,并在最后一次给药后迅速下降。血浆DEX动力学定义为具有一级口服吸收的开放双室模型。给药后48小时仍可检出DEX。在多次给药的研究中,首次给药后很快就达到了稳态浓度,DEX没有出现积累的迹象。由于下丘脑-垂体-肾上腺轴的抑制,单次和多次给药后CORT水平迅速下降。志愿者的恢复时间各不相同。60 ng/mL的MRL被证明适合区分允许和禁止使用3天的洗脱期,尽管建议对非全身途径进行进一步研究以提高灵敏度。
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引用次数: 0
Update on clinical trials of intra-articular disease-modifying osteoarthritis drugs inducing cartilage regeneration 关节内疾病改善性骨关节炎药物诱导软骨再生的临床试验进展。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-08 DOI: 10.1016/j.ejps.2025.107403
Luca Morici , Ines Nikolic
Osteoarthritis is the most common degenerative joint disease affecting millions of people in the world and leading to disability. Currently, the only available treatments on the market are symptomatic therapies for pain and inflammation. There are no intra-articular drugs that can restore the cartilage matrix, also known as disease-modifying osteoarthritis drugs (DMOADs). This review focuses on all clinical trials of pro-anabolic DMOADs, which stimulate the regeneration of the cartilage matrix by inducing the differentiation of mesenchymal progenitors into chondrocytes, a process known as chondrogenesis. This review also discussed some pathways of chondrocytes, which boost the transcription of genes involved in the production of extracellular matrix components. Finally, the review also covers some implants in the commercial and clinical phases for cartilage repair.
骨关节炎是最常见的退行性关节疾病,影响着世界上数百万人,并导致残疾。目前,市场上唯一可用的治疗方法是对症治疗疼痛和炎症。目前还没有能够恢复软骨基质的关节内药物,也就是所谓的改善疾病的骨关节炎药物(DMOADs)。本文综述了促合成代谢DMOADs的所有临床试验,DMOADs通过诱导间充质祖细胞向软骨细胞的分化来刺激软骨基质的再生,这一过程被称为软骨形成。本文还讨论了促进细胞外基质成分产生相关基因转录的软骨细胞的一些途径。最后,回顾了一些在商业和临床阶段用于软骨修复的植入物。
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引用次数: 0
ASIC3–PLCG1 axis–driven macropinocytosis promotes osimertinib drug-tolerant persistence in malignant pleural effusion–associated NSCLC ASIC3-PLCG1轴驱动的巨红细胞增多症促进恶性胸腔积液相关非小细胞肺癌的奥西替尼耐药持久性
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-17 DOI: 10.1016/j.ejps.2025.107417
Wen‐Chien Huang , Chieh-Yung Wang , Ying Chen , Yi-Hsuan Lin , Chih-Ying Changchien , Chih-Feng Chian , Chen-Liang Tsai

Background

Non-small cell lung cancer (NSCLC) frequently develops resistance to EGFR-tyrosine kinase inhibitors (TKIs), particularly in malignant pleural effusion (MPE), where a highly acidic tumor microenvironment promotes the emergence of drug-tolerant persister (DTP) cells. Building upon previous evidence that MPE acidity drives metabolic plasticity, this study investigates how acid-sensing ion channel 3 (ASIC3) coordinates PLCG1-dependent macropinocytosis to maintain osimertinib tolerance.

Methods

Primary MPE-derived NSCLC cultures underwent next-generation sequencing to define mutational heterogeneity. Acidic (pH 6.5–6.8) conditions were used to generate osimertinib-induced DTP (Osi-DTP) models. Functional assays assessed viability, invasion, colony formation, autophagy, and macropinocytosis. ASIC3 was silenced using shRNA, followed by Seahorse metabolic analysis. Transcriptomic profiling identified differentially expressed genes. ASIC3-targeted therapeutic interventions were evaluated in vitro and in xenograft models.

Results

MPE-derived NSCLC cultures showed substantial genomic diversity, including EGFR exon 19 deletion and T790M mutations. Acid-adapted Osi-DTP cells exhibited EMT-like phenotypes, reduced proliferation, elevated stemness markers, and strong activation of stress-response pathways. ASIC3 was consistently upregulated under acidic conditions and drove PLCG1-mediated macropinocytosis to support nutrient scavenging and survival. ASIC3 knockdown markedly reduced DTP cell viability, invasiveness, colony formation, autophagy, and glycolysis, while inducing a metabolic shift toward oxidative phosphorylation. In vivo, combining an ASIC3 inhibitor with osimertinib significantly delayed tumor progression and improved survival without added toxicity. Clinically, high ASIC3 expression correlated with poor overall survival and increased autophagy-associated markers.

Conclusion

ASIC3 is a central regulator of acidosis-driven drug persistence in MPE-associated NSCLC, sustaining osimertinib tolerance through PLCG1-dependent macropinocytosis and metabolic reprogramming. Targeting ASIC3 restores TKI sensitivity by disrupting nutrient acquisition, autophagy, and metabolic adaptation, representing a promising therapeutic strategy to prevent or delay EGFR-TKI resistance.
背景:非小细胞肺癌(NSCLC)经常对egfr -酪氨酸激酶抑制剂(TKIs)产生耐药性,特别是在恶性胸腔积液(MPE)中,高度酸性的肿瘤微环境促进了耐药持久性(DTP)细胞的出现。基于先前关于MPE酸性驱动代谢可塑性的证据,本研究探讨了酸感离子通道3 (ASIC3)如何协调plcg1依赖性巨噬细胞作用以维持奥希替尼耐受性。方法:对原发mpe衍生的NSCLC培养物进行下一代测序以确定突变异质性。在酸性(pH 6.5-6.8)条件下制备奥西替尼诱导的DTP (osii -DTP)模型。功能分析评估活力、侵袭、菌落形成、自噬和巨噬功能。用shRNA沉默ASIC3,然后进行海马代谢分析。转录组学分析鉴定了差异表达基因。在体外和异种移植模型中评估asic3靶向治疗干预措施。结果:mpe衍生的NSCLC培养物显示出大量的基因组多样性,包括EGFR外显子19缺失和T790M突变。酸适应的osii - dtp细胞表现出emt样表型,增殖减少,茎干标记物升高,应激反应途径强烈激活。ASIC3在酸性条件下持续上调,并驱动plcg1介导的巨噬细胞作用,以支持营养清除和生存。ASIC3敲低显著降低DTP细胞活力、侵袭性、集落形成、自噬和糖酵解,同时诱导代谢向氧化磷酸化转变。在体内,ASIC3抑制剂与奥西替尼联合使用可显著延缓肿瘤进展并改善生存,且没有增加毒性。临床上,ASIC3高表达与总生存率低和自噬相关标志物增加相关。结论:ASIC3是mpe相关非小细胞肺癌中酸中毒驱动的药物持久性的中心调节因子,通过plcg1依赖性巨噬细胞和代谢重编程维持奥希替尼耐受性。靶向ASIC3通过破坏营养获取、自噬和代谢适应来恢复TKI敏感性,代表了一种有希望的预防或延迟EGFR-TKI耐药性的治疗策略。
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引用次数: 0
Mechanistic insights into semi-solid extrusion 3D printing of indomethacin-nicotinamide cocrystal-loaded oral fast-dissolving films 机械洞察半固体挤出3D打印吲哚美辛-烟酰胺共晶负载口服快速溶解膜。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-08 DOI: 10.1016/j.ejps.2025.107404
Maha F. Emam , Elina Harju , Atte Junnila , Kirsi Mikkonen , Teemu Tomberg , Clare Strachan , Anssi-Pekka Karttunen , Leena Peltonen
The growing demand for personalized medicine requires adaptable dosage forms capable of addressing challenges associated with poorly soluble drugs. Cocrystals offer a powerful strategy to enhance solubility, while semi-solid extrusion (SSE) 3D printing enables flexible, patient-tailored manufacturing. This study establishes a systematic framework for developing oral fast-dissolving films (OFDFs) incorporating indomethacin–nicotinamide (IND–NIC) cocrystals using SSE 3D printing. Critical Material Attributes (CMAs), HPMC–glycerol base, sodium starch glycolate (SSG), and varying cocrystal loadings, were systematically adjusted to evaluate their influence on key ink and film Critical Quality Attributes (CQAs).
All inks displayed desirable shear-thinning behaviour, with IND–NIC cocrystals and SSG synergistically reinforcing the structural network for reliable extrusion and shape fidelity. Solid-state analyses (XRPD, DSC, PLM, Raman microscopy) confirmed preservation of the cocrystal form throughout ink preparation, printing, and short-term storage. The 3D printed OFDFs exhibited uniform thickness, weight, and drug content with minimal variability across batches, and displayed humidity-dependent mechanical behaviour that varied with cocrystal loading.
All formulations achieved rapid drug release, exceeding 80 % IND dissolution within 30 min. Dissolution profiles were consistent across cocrystal loadings and remained statistically equivalent for films printed from inks stored for up to 2 days, as well as for the 3-day redispersed ink, confirming that the structural reinforcement required for printability does not compromise rapid release performance.
Overall, this work provides mechanistic insight into the formulation–process–performance relationships governing SSE 3D printing of cocrystal-loaded OFDFs and highlights the potential of this green, low-temperature platform for decentralized, patient-centric manufacturing of fast-dissolving dosage forms.
对个性化医疗日益增长的需求需要适应性强的剂型,能够解决与难溶性药物相关的挑战。共晶提供了强大的策略来提高溶解度,而半固态挤出(SSE) 3D打印可以实现灵活的、量身定制的制造。本研究建立了一个系统的框架,用于使用SSE 3D打印技术开发含有吲哚美辛-烟酰胺(IND-NIC)共晶的口服速溶膜(OFDFs)。系统地调整了关键材料属性(CMAs)、hpmc -甘油碱、淀粉乙醇酸钠(SSG)和不同的共晶负载,以评估它们对关键油墨和薄膜关键质量属性(cqa)的影响。所有油墨都表现出理想的剪切减薄行为,IND-NIC共晶和SSG协同增强结构网络,以实现可靠的挤压和形状保真度。固态分析(XRPD, DSC, PLM,拉曼显微镜)证实了共晶形式在油墨制备,印刷和短期储存过程中的保存。3D打印的ofdf具有均匀的厚度、重量和药物含量,批次之间的变化最小,并且显示出随共晶负载变化的湿度依赖的机械行为。所有制剂均实现药物快速释放,30分钟内IND溶出度超过80%。在不同的共晶负载下,溶解曲线是一致的,并且对于用储存了2天的油墨打印的薄膜,以及用3天的再分散油墨打印的薄膜,在统计上是相同的,这证实了印刷性所需的结构增强不会影响快速释放性能。总的来说,这项工作为控制共晶负载ofdf的SSE 3D打印的配方-工艺-性能关系提供了机制见解,并突出了这种绿色,低温平台的潜力,用于分散,以患者为中心的快速溶解剂型制造。
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引用次数: 0
Comparing iron sucrose and ferric carboxymaltose interactions with murine and human macrophages: Focus on the lysosomal compartment 比较蔗糖铁和羧麦芽糖铁与小鼠和人巨噬细胞的相互作用:重点是溶酶体腔室。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-11-29 DOI: 10.1016/j.ejps.2025.107390
Mauro Sousa de Almeida , Amélie Bazzoni , Sandor Balog , Kata Dorbic , Céline Loussert-Fonta , Aura Maria Moreno-Echeverri , Jules Duruz , Jorge Larios , Anne-Marinette Cao , Amy Barton Alston , Reinaldo Digigow , Beat Flühmann , Alke Petri-Fink , Barbara Rothen-Rutishauser
Intravenous iron drugs are commonly used in the treatment of iron deficiency/iron deficiency anaemia. However, the cellular mechanisms underlying the uptake of these complexes remain poorly understood. This study examines the interaction of two iron complexes, iron sucrose and ferric-carboxymaltose, with murine J774A.1 and human M2a macrophages, focusing on their uptake and localization within lysosomal compartments at various time points: 45 min, 6 h, 24 h, and 5 days. We employed multiple analytical methods, including Prussian blue staining and transmission electron microscopy, to assess the intracellular iron complexes. In addition, the stability of the two complexes in cell culture medium and artificial lysosomal fluid was assessed by dynamic light scattering and transmission electron microscopy. A formation of larger aggregates for both complexes in cell culture medium was observed, likely due to interactions with serum proteins. The analysis in artificial lysosomal fluid revealed a slight, but not statistically significant, decrease in hydrodynamic diameter. Upon interaction with macrophages, our results demonstrate that iron sucrose is internalized more rapidly by both macrophage cell types compared to ferric carboxymaltose. Furthermore, the detection of ferric ions within intracellular and intralysosomal compartments occurs at a later time point following macrophage exposure to ferric carboxymaltose, suggesting slower internalization in comparison to iron sucrose. Our findings suggest that the two complexes remain intact upon reaching macrophages and, after internalization, are localized within intracellular vesicles, indicating endocytosis as the primary uptake mechanism. Iron sucrose was internalized more rapidly in comparison to ferric carboxymaltose by both macrophage types, whereas a decrease in metabolic activity was only observed for the J774A.1 macrophages in the presence of high iron sucrose concentration, i.e., 1mg/mL iron. These findings provide new insights into the dynamics of different iron-carbohydrate complexes on cellular uptake and may contribute to optimizing future drug designs.
静脉注射铁药物常用于治疗缺铁/缺铁性贫血。然而,摄取这些复合物的细胞机制仍然知之甚少。本研究考察了蔗糖铁和羧麦芽糖铁两种铁复合物与小鼠J774A.1和人M2a巨噬细胞的相互作用,重点研究了它们在不同时间点(45分钟、6小时、24小时和5天)在溶酶体腔室内的摄取和定位。我们采用多种分析方法,包括普鲁士蓝染色和透射电镜,以评估细胞内铁配合物。此外,通过动态光散射和透射电镜观察了这两种复合物在细胞培养基和人工溶酶体液中的稳定性。在细胞培养基中观察到两种复合物形成较大的聚集体,可能是由于与血清蛋白的相互作用。人工溶酶体液的分析显示,流体动力直径略有下降,但没有统计学意义。在与巨噬细胞相互作用后,我们的研究结果表明,与三羧基麦芽糖铁相比,蔗糖铁被两种巨噬细胞更快地内化。此外,在巨噬细胞暴露于含铁羧基麦芽糖后,细胞内和溶酶体间室中铁离子的检测发生在较晚的时间点,表明与蔗糖铁相比,铁离子的内化更慢。我们的研究结果表明,这两种复合物在到达巨噬细胞后保持完整,并在内化后定位于细胞内囊泡,表明内吞作用是主要的摄取机制。两种类型的巨噬细胞对蔗糖铁的内化速度比羧基麦芽糖铁更快,而只有在高蔗糖铁浓度(即1mg/mL铁)存在时,J774A.1巨噬细胞的代谢活性才会下降。这些发现为不同的铁-碳水化合物复合物对细胞摄取的动力学提供了新的见解,并可能有助于优化未来的药物设计。
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引用次数: 0
Synthesis, in vitro characterization and biopharmaceutical evaluation of a novel phosphate prodrug of sorafenib 新型磷酸前药索拉非尼的合成、体外表征及生物制药评价。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-04 DOI: 10.1016/j.ejps.2025.107397
Simon Hoang Dinh , Christian Ding Fisker , Juulia Järvinen , Kati-Sisko Vellonen , Annette Bauer-Brandl , Poul Nielsen , Jarkko Rautio , Martin Brandl
Sorafenib is a multi-kinase inhibitor approved for several cancers with poor aqueous solubility, resulting in low oral bioavailability (38–49 %) despite its high permeability. As a BCS Class II compound, its absorption is solubility-/dissolution-limited. Prodrug strategies, such as phosphate esterification, can improve solubility and promote oral bioavailability upon enzymatic cleavage by intestinal alkaline phosphatase (IALP), abundantly expressed at the intestinal brush border membrane and present in the intestinal lumen. This cleavage is hypothesized to lead to a transient supersaturation of the parent drug, enhancing absorption unless (premature) precipitation prevails. Besides traditional in vitro models like Caco-2 cells, recently microdialysis-sampling has been introduced to study ALP-mediated biomimetic conversion of oral phosphate prodrugs in vitro. Microdialysis enables real-time, non-destructive sampling of molecularly dissolved drug, which allows to study the complex inter-related dynamics under (simulated) human gastrointestinal conditions.
In this study, a novel and new phosphate prodrug of sorafenib (fossorafenib) was synthesized and its physico-chemical and biopharmaceutical properties were evaluated. Fossorafenib exhibited ∼600-fold higher aqueous solubility than sorafenib in HBSS pH 7.4 and was rapidly cleaved by externally added alkaline phosphatase (ALP), yielding supersaturated sorafenib. Combined cleavage & permeability studies across Caco-2 cell monolayers demonstrated rapid bioconversion of fossorafenib in the apical compartment, with permeation of both the converted parent drug but, surprisingly, also the prodrug. Microdialysis enabled real-time monitoring of the biomimetic conversion of fossorafenib without the requirement for enzyme inactivation, thereby allowing for unprecedented mechanistic insights into the interplay between micellar solubilization and enzymatic cleavage. Microdialysis results suggest that micellar incorporation of fossorafenib into mixed micelles of bile salts and phospholipids can hinder enzymatic cleavage by intestinal ALP, thereby potentially limiting the extent of prodrug activation in the intestinal environment. Taken together with the unexpected ability of the prodrug to cross biological/biomimetic barriers, these findings suggest that fossorafenib may not follow the conventional behavior of classical phosphate-ester oral prodrugs in vivo, highlighting the need for further investigation into its unique biopharmaceutical profile.
索拉非尼(Sorafenib)是一种多激酶抑制剂,被批准用于几种水溶性差的癌症,尽管其渗透性高,但口服生物利用度低(38-49%)。作为BCS II类化合物,其吸收受溶解度/溶解性限制。前药策略,如磷酸盐酯化,可以通过肠道碱性磷酸酶(IALP)的酶切提高溶解度,促进口服生物利用度,IALP在肠刷状边界膜上大量表达,存在于肠腔中。据推测,这种解理会导致母体药物的短暂过饱和,增强吸收,除非(过早)沉淀盛行。除了Caco-2细胞等传统的体外模型外,近年来引入了微透析-采样法来研究alp介导的口服磷酸前药的体外仿生转化。微透析使分子溶解药物的实时,非破坏性采样成为可能,从而可以研究(模拟)人类胃肠道条件下复杂的相互关联动力学。本研究合成了一种新的索拉非尼磷酸盐前药(fossorafenib),并对其理化性质和生物制药性能进行了评价。在pH为7.4的HBSS中,Fossorafenib的水溶性比sorafenib高600倍,并被外部添加的碱性磷酸酶(ALP)快速裂解,产生过饱和的sorafenib。Caco-2细胞单层的裂解和通透性联合研究表明,在根尖室中,fossorafenib的生物转化速度很快,转化的母体药物都能渗透,但令人惊讶的是,前药也能渗透。微透析可以实时监测fossorafenib的仿生转化,而不需要酶失活,从而可以前所未有地深入了解胶束增溶和酶裂解之间的相互作用机制。微透析结果表明,将fossorafenib胶束掺入胆汁盐和磷脂的混合胶束中可以阻碍肠道ALP的酶裂解,从而可能限制肠道环境中药物前活化的程度。结合前体药物跨越生物/仿生屏障的意外能力,这些发现表明,fossorafenib可能不遵循经典磷酸酯口服前体药物在体内的传统行为,强调需要进一步研究其独特的生物制药特征。
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引用次数: 0
Individualized dosing strategies in breast cancer chemotherapy: Evidence for therapeutic drug monitoring-guided docetaxel treatment 乳腺癌化疗的个体化给药策略:治疗药物监测引导的多西他赛治疗的证据。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-09 DOI: 10.1016/j.ejps.2025.107407
Ya-Min Liu , Wei Huang , Yong-Zhe Tang , Hai Zhang , Sheng-Ying Qin , Jin Zhang , Jun-Wei Fan , Rui-Zhuo Ouyang , Hai-Ou Yang , Xiao-Qing Zhang

Background

Docetaxel is a first-line chemotherapy drug for breast cancer and is traditionally dosed based on body surface area (BSA). However, this method often leads to significant inter-patient variability and a high incidence of adverse drug reactions (ADRs). Therapeutic drug monitoring (TDM) offers a personalized dosing approach that may improve drug safety and efficacy. This study aimed to evaluate the clinical and pharmacoeconomic benefits of TDM-guided dosing compared to traditional BSA-based dosing in breast cancer patients receiving docetaxel-based chemotherapy.

Methods

A randomized controlled study was conducted at the Department of Breast Surgery, IPMCH, from October 2022 to July 2024. A total of 208 breast cancer patients were enrolled and randomly assigned to two groups: the BSA group (n = 104) and the TDM-guided pharmacokinetics (PK) group (n = 104). Adverse drug reactions—including hematological, gastrointestinal, skin, neurotoxic, and cardiotoxic events—were monitored and compared between groups. Liver function markers (ALT, AST, ALP) and pharmacoeconomic data (treatment-related costs) were also assessed. Statistical analyses included univariate and interaction models to evaluate the impact of dosing strategy on ADRs and costs.

Results

Patients in the TDM-guided PK group exhibited significantly lower levels of ALT, AST, and ALP, indicating reduced hepatic toxicity. Gastrointestinal ADRs—including nausea, diarrhea, and constipation—were less frequent and less severe in the PK group compared to the BSA group. Overall, the incidence and severity of ADRs were markedly reduced in the PK group. Pharmacoeconomic analysis demonstrated consistently lower treatment-related costs in the PK group. Both univariate and interaction analyses confirmed the clinical and economic benefits of TDM-guided dosing.

Conclusion

TDM-guided docetaxel dosing significantly reduced ADRs and improved cost efficiency in breast cancer chemotherapy. These findings support the implementation of TDM as a superior strategy to traditional BSA-based dosing, with potential to enhance both patient safety and healthcare resource utilization.
背景:多西他赛是乳腺癌的一线化疗药物,传统上是基于体表面积(BSA)给药。然而,这种方法往往会导致显著的患者间差异和高发生率的药物不良反应(adr)。治疗药物监测(TDM)提供了一种个性化的给药方法,可以提高药物的安全性和有效性。本研究旨在评估在接受多西他赛化疗的乳腺癌患者中,tdm引导给药与传统bsa为基础的给药相比的临床和药物经济效益。方法:于2022年10月至2024年7月在IPMCH乳房外科进行随机对照研究。共纳入208例乳腺癌患者,随机分为两组:BSA组(n=104)和tdm引导药代动力学组(n=104)。监测药物不良反应,包括血液学、胃肠道、皮肤、神经毒性和心脏毒性事件,并比较两组之间的差异。还评估了肝功能指标(ALT、AST、ALP)和药物经济学数据(治疗相关费用)。统计分析包括单变量和相互作用模型,以评估给药策略对不良反应和成本的影响。结果:tdm引导下的PK组患者ALT、AST、ALP水平明显降低,表明肝毒性降低。与BSA组相比,PK组的胃肠道不良反应(包括恶心、腹泻和便秘)发生频率和严重程度较低。总的来说,PK组不良反应的发生率和严重程度明显降低。药物经济学分析表明,PK组的治疗相关费用始终较低。单变量分析和相互作用分析都证实了tdm引导给药的临床和经济效益。结论:tdm引导下多西紫杉醇给药可显著降低乳腺癌化疗不良反应,提高成本效益。这些发现支持TDM作为一种优于传统bsa给药策略的实施,具有提高患者安全和医疗资源利用的潜力。
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引用次数: 0
Dual-functionalized mesoporous silica nanoparticles for topical axitinib delivery to the posterior eye segment 双功能化介孔二氧化硅纳米颗粒用于局部阿西替尼后眼段输送。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI: 10.1016/j.ejps.2025.107398
Li Xu , Zih-An Chen , Cheng-Hsun Wu , Yi-Ping Chen , Si-Han Wu , Chung-Yuan Mou , Ching-Li Tseng , Yueh Chien , Hardy Wai-Hong Chan , Tien-Chun Yang , Shih-Hwa Chiou
Topical drug delivery to the posterior eye segment remains a significant challenge due to ocular anatomical barriers, particularly in diseases such as wet age-related macular degeneration (AMD), where treatment typically relies on frequent intravitreal (IVT) injections of anti-angiogenic agents. In this study, we present a non-invasive eye drop formulation of axitinib (AXT), a potent vascular endothelial growth factor receptor (VEGFR) inhibitor, encapsulated within 25-nm dual-functionalized mesoporous silica nanoparticles (AXT@dual-MSNs) engineered for efficient retinal delivery. The nanoparticles feature sulfonate-functionalized mesopores that enhanced AXT loading and solubilization, along with a PEGylated/quaternary ammonium-modified surface that improved colloidal stability and favored intramesopore drug confinement. Following topical administration, AXT@dual-MSNs achieved retinal accumulation via the conjunctiva-sclera-choroid pathway, effectively bypassing the corneal route. A pharmacokinetic analysis confirmed rapid, transscleral delivery of AXT with therapeutically relevant concentrations in the retina. In a laser-induced choroidal neovascularization (CNV) mouse model, a well-established surrogate for wet AMD, AXT@dual-MSN eyedrops significantly suppressed neovascular lesion formation, outperforming free-drug eyedrops and IVT AXT injection. Notably, the formulation exhibited excellent ocular tolerance, with no evidence of local toxicity or contralateral eye exposure. This work introduces a novel nanocarrier system capable of overcoming the longstanding delivery barrier to the posterior eye segment via eyedrops, offering a safe, effective, and clinically translatable alternative to IVT injections. The modular design of AXT@dual-MSNs also holds promise for expanding topical access to other hydrophobic or labile therapeutics targeting retinal diseases.
由于眼部解剖障碍,局部药物递送到眼后段仍然是一个重大挑战,特别是在湿性年龄相关性黄斑变性(AMD)等疾病中,治疗通常依赖于频繁的玻璃体内(IVT)注射抗血管生成药物。在这项研究中,我们提出了一种非侵入性滴眼液制剂阿西替尼(axitinib, AXT),一种有效的血管内皮生长因子受体(VEGFR)抑制剂,包裹在25纳米双功能化介孔二氧化硅纳米颗粒(AXT@dual-MSNs)中,用于有效的视网膜递送。纳米颗粒具有磺酸功能化的介孔,增强了AXT的负载和增溶性,同时具有聚乙二醇化/季铵修饰的表面,提高了胶体稳定性,有利于孔内药物约束。在局部给药后,AXT@dual-MSNs通过结膜-巩膜-脉络膜途径实现视网膜积聚,有效绕过角膜途径。药代动力学分析证实快速,经巩膜传递AXT与治疗相关的浓度在视网膜。在激光诱导脉络膜新生血管(CNV)小鼠模型中,AXT@dual-MSN滴眼液显著抑制新生血管病变的形成,优于无药滴眼液和IVT AXT注射。值得注意的是,该配方表现出良好的眼部耐受性,没有局部毒性或对侧眼睛暴露的证据。这项工作介绍了一种新的纳米载体系统,能够克服长期以来通过滴眼液进入后眼段的输送障碍,提供了一种安全、有效和临床可翻译的IVT注射替代方案。AXT@dual-MSNs的模块化设计也有望扩大局部访问其他疏水或不稳定的治疗针对视网膜疾病。
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引用次数: 0
A novel microbubble delivery platform with high payload of paclitaxel upon focused ultrasound for enhanced glioblastoma treatment 聚焦超声下高负荷紫杉醇微泡输送平台增强胶质母细胞瘤治疗。
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-12 DOI: 10.1016/j.ejps.2025.107415
Yudie Yan , Kihwan Hwang , Jungmin Lee , Kyung Mi Nam , Soyeon Shin , Been Yoon , Zhen Zhang , Myoung-Hwan Park , Chae-Yong Kim
Effective chemotherapy for glioblastoma (GBM) is severely limited by the impermeability of the blood-brain barrier (BBB). Although paclitaxel (PTX) demonstrates potent anti-glioma activity in vitro, its poor BBB penetration precludes its clinical use for GBM. We developed a novel PTX-loaded microbubble (PTX@MB) platform designed for targeted drug delivery to gliomas via low-intensity focused ultrasound (LIFU). PTX@MB were fabricated using a perfluorocarbon (PFC) liquid core stabilized by F-127, and their physicochemical properties were characterized. In vitro anti-tumor effects were evaluated using U87MG cells in both 2D culture and 3D spheroid models. For in vivo assessment, an orthotopic U87MG glioma mouse model was utilized. Following intravenous administration of PTX@MB, LIFU was applied to the tumor region to induce localized drug release and transient BBB disruption. Therapeutic outcomes were evaluated by MRI, survival analysis, and histopathology. The fabricated PTX@MB were spherical, with a high drug encapsulation efficiency of 89.1 ± 0.5 %, and exhibited ultrasound-responsive drug release. In vitro, the combination of PTX@MB and ultrasound exposure demonstrated dose-dependent cytotoxicity and significant inhibition of U87MG spheroid growth. In the orthotopic mouse model, the PTX@MB + LIFU treatment significantly suppressed tumor progression and prolonged median survival compared to the control group. The PTX@MB + LIFU system significantly reduced tumor burden without notable systemic toxicity. This ultrasound-responsive platform enables targeted PTX delivery across the BBB and offers a promising, non-invasive strategy for site-specific chemotherapy in neuro-oncology.
胶质母细胞瘤(GBM)的有效化疗受到血脑屏障(BBB)的不渗透性的严重限制。尽管紫杉醇(PTX)在体外显示出强大的抗胶质瘤活性,但其血脑屏障渗透性差妨碍了其在GBM中的临床应用。我们开发了一种新型的ptx负载微泡(PTX@MB)平台,设计用于通过低强度聚焦超声(LIFU)靶向给药胶质瘤。采用F-127稳定的全氟碳(PFC)液芯制备了PTX@MB,并对其物理化学性质进行了表征。用U87MG细胞在二维培养和三维球体模型中评估其体外抗肿瘤作用。为了进行体内评估,使用了原位U87MG胶质瘤小鼠模型。静脉给药PTX@MB后,将LIFU应用于肿瘤区域,诱导局部药物释放和短暂血脑屏障破坏。通过MRI、生存分析和组织病理学评估治疗结果。制备的PTX@MB为球形,包封率为89.1 ± 0.5%,具有超声响应性释药。在体外,PTX@MB联合超声暴露显示出剂量依赖性的细胞毒性,并显著抑制U87MG球体的生长。在原位小鼠模型中,与对照组相比,PTX@MB + LIFU治疗显著抑制肿瘤进展并延长中位生存期。PTX@MB + LIFU系统显著降低肿瘤负荷,无明显的全身毒性。该超声响应平台可实现PTX通过血脑屏障的靶向递送,为神经肿瘤学的部位特异性化疗提供了一种有前途的非侵入性策略。
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引用次数: 0
Nortriptyline-targeted siRNA-loaded liposomes: Design, affinity, biodistribution, and bioactivity in a murine Herpes Simplex Virus 1 corneal infection model 去甲替林靶向sirna负载脂质体:小鼠单纯疱疹病毒1型角膜感染模型的设计、亲和力、生物分布和生物活性
IF 4.7 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI: 10.1016/j.ejps.2025.107388
Doaa Jbara-Agbaria , Neethi C Thathapudi , Marc Groleau , Majd Agbaria , Marie-Claude Robert , Natalia Callai Da Silva , Sebastien Talbot , Janet Laganiere , May Griffith , Gershon Golomb
Herpes simplex virus type 1 (HSV1) establishes latency in the trigeminal ganglia and reactivates to cause recurrent infections and severe complications, including herpes simplex keratitis (HSK), the leading cause of infectious corneal blindness in developed countries. We developed and characterized a targeted siRNA delivery system designed to suppress HSV1 by silencing the immediate-early gene ICP0, which encodes a protein essential for lytic infection and viral reactivation. To enhance neuronal accumulation, siRNA-loaded liposomes were decorated with nortriptyline (NTP), a ligand with high affinity for neuronal cells, including those in the trigeminal ganglia. The liposomes were optimized to exhibit nanoscale size, low polydispersity, neutral surface charge, high siRNA loading, spherical morphology, and long-term shelf stability. Studies in cell lines confirmed efficient internalization with good tolerability, and targeted liposomes showed enhanced binding to differentiated PC‑12 neuronal cells, competitively inhibited by free NTP, supporting their targeting specificity. Following retro-orbital administration in mice, NTP-targeted siHSV1 liposomes preferentially accumulated in the trigeminal ganglia. Antiviral efficacy was further assessed by topical application of siHSV1‑loaded liposomes within a biocompatible hydrogel in a murine HSV1 corneal perforation model of HSK. In the corneal limbus, targeted liposomes produced a significant reduction in viral load, whereas in the contralateral trigeminal ganglia, they significantly reduced viral load with a pronounced trend toward decreased ICP0 expression. These results demonstrate the feasibility of using NTP-mediated targeting ligand and support the potential of this delivery platform for treating latent HSV1, warranting further optimization for improved therapeutic efficacy.
1型单纯疱疹病毒(HSV1)在三叉神经节中潜伏,并重新激活,引起复发性感染和严重并发症,包括单纯疱疹角膜炎(HSK),这是发达国家感染性角膜失明的主要原因。我们开发并表征了一种靶向siRNA递送系统,该系统通过沉默直接早期基因ICP0来抑制HSV1, ICP0编码一种裂解感染和病毒再激活所必需的蛋白质。为了促进神经元的积累,用去甲替林(NTP)修饰装载sirna的脂质体,去甲替林是一种对神经细胞(包括三叉神经节细胞)具有高亲和力的配体。优化后的脂质体具有纳米级尺寸、低多分散性、中性表面电荷、高siRNA负载、球形形态和长期货架稳定性。细胞系研究证实了有效的内化和良好的耐受性,靶向脂质体与分化的PC‑12神经元细胞的结合增强,被游离NTP竞争性抑制,支持其靶向特异性。在小鼠眼眶后给药后,ntp靶向siHSV1脂质体优先积聚在三叉神经节。通过在生物相容性水凝胶中局部应用负载siHSV1的脂质体,在HSK小鼠HSV1角膜穿孔模型中进一步评估抗病毒效果。在角膜边缘,靶向脂质体显著降低了病毒载量,而在对侧三叉神经节,它们显著降低了病毒载量,并显著降低了ICP0的表达。这些结果证明了使用ntp介导的靶向配体的可行性,并支持该递送平台治疗潜伏性HSV1的潜力,需要进一步优化以提高治疗效果。
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引用次数: 0
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European Journal of Pharmaceutical Sciences
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