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Impact of advanced age on the gastric emptying of water under fasted and fed state conditions 高龄对空腹和进食状态下胃排空水量的影响
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-20 DOI: 10.1016/j.ejps.2024.106853

Although older people are the main users of oral medications, few studies are reported on the influence of advanced age on gastric emptying rate of non-caloric liquids. This study aimed at evaluating the gastric emptying of 240 ml water in healthy older and young adults in fasted and fed state conditions using the established method of salivary caffeine kinetics. The gastric emptying of water was evaluated in 12 healthy older volunteers (mean age: 73 ± 6 years) and 12 healthy younger volunteers (mean age: 25 ± 2 years) with the ingestion of a rapid disintegrating tablet containing 20 mg of 13C3-caffeine. The gastric emptying of water was assessed indirectly by calculating the AUC ratios of salivary caffeine concentrations in specific time segments. Comparison of the AUC ratios showed no statistically significant difference between young and older volunteers in both fasted and fed state conditions (p > 0.05). Advanced age itself seems to have no relevant effect on gastric emptying of water in either fasted or fed state conditions and the phenomenon of Magenstrasse appears to follow a similar pattern in healthy older adults as in healthy younger adults.

虽然老年人是口服药物的主要使用者,但有关高龄对非热量液体胃排空率影响的研究报道却很少。本研究旨在使用唾液咖啡因动力学的既定方法,评估健康老年人和年轻人在空腹和进食状态下 240 毫升水的胃排空情况。研究评估了 12 名健康老年志愿者(平均年龄:73 ± 6 岁)和 12 名健康年轻志愿者(平均年龄:25 ± 2 岁)在摄入含 20 毫克 13C3 咖啡因的快速崩解片剂后的胃排空情况。通过计算特定时间段内唾液咖啡因浓度的 AUC 比值,间接评估了水的胃排空情况。对 AUC 比率的比较显示,在空腹和进食状态下,年轻志愿者和老年志愿者之间的差异没有统计学意义(p > 0.05)。无论在空腹还是进食状态下,高龄本身似乎都不会对水的胃排空产生相关影响,健康老年人的马根氏现象似乎与健康年轻人的模式相似。
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引用次数: 0
ROS-responsive thioketal nanoparticles delivering system for targeted ulcerative colitis therapy with potent HDAC6 inhibitor, tubastatin A 利用强效 HDAC6 抑制剂 Tubastatin A 靶向治疗溃疡性结肠炎的 ROS 反应性硫代金属纳米颗粒输送系统
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-19 DOI: 10.1016/j.ejps.2024.106856

Ulcerative colitis (UC) is a common gastrointestinal problem characterized by the mucosal injury primarily affecting the large intestine. Currently available therapies are not satisfactory as evidenced by high relapse rate and adverse effects. In this study we aimed to develop an effective drug delivery system using reactive oxygen species (ROS)-responsive thioketal nanoparticles (TKNP), to deliver tubastatin A, a potent HDAC6 inhibitor, to the inflamed colon in mice with ulcerative colitis (UC). TKNPs were synthesized by step-growth polymerization from an acetal exchange reaction while TUBA-TKNP was prepared using the single emulsion solvent evaporation technique. Our developed nanoparticle showed release of tubastatin A only in presence of ROS which is found to be highly present at the site of inflamed colon. Oral administration of TUBA-TKNP resulted in the higher accumulation of tubastatin A at the inflamed colon site and decreased the inflammation as evidenced by reduced infiltration of immune cells and decreased level of pro-inflammatory cytokines in TUBA-TKNP treated mice. In summary, our results show the successful localization of tubastatin A at the site of colon inflammation through TUBA-TKNP delivery, as well as resolution of clinical features of UC in mice.

溃疡性结肠炎(UC)是一种常见的胃肠道疾病,其特点是粘膜损伤,主要影响大肠。由于复发率高和不良反应多,目前可用的疗法并不令人满意。在这项研究中,我们旨在开发一种有效的给药系统,利用活性氧(ROS)反应型硫酮纳米颗粒(TKNP)将强效 HDAC6 抑制剂管他汀 A 送入溃疡性结肠炎(UC)小鼠的炎症结肠。TKNP 是通过缩醛交换反应的阶跃生长聚合反应合成的,而 TUBA-TKNP 则是通过单乳液溶剂蒸发技术制备的。我们开发的纳米粒子只有在存在 ROS 的情况下才会释放管他汀 A,而 ROS 在结肠发炎部位的存在率很高。口服 TUBA-TKNP 可使更多的管他汀 A 在结肠发炎部位积聚,并通过减少 TUBA-TKNP 治疗小鼠的免疫细胞浸润和降低促炎细胞因子水平来减轻炎症。总之,我们的研究结果表明,通过 TUBA-TKNP 递送,管他汀 A 成功地在结肠炎症部位定位,并缓解了小鼠 UC 的临床特征。
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引用次数: 0
Laponite nanoclays for the sustained delivery of therapeutic proteins 用于持续输送治疗蛋白质的皂石纳米粘土。
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-19 DOI: 10.1016/j.ejps.2024.106858

Protein therapeutics hold immense promise for treating a wide array of diseases. However, their efficacy is often compromised by rapid degradation and clearance. The synthetic smectite clay Laponite emerges as a promising candidate for their sustained delivery. Despite its unique properties allow to load and release proteins mitigating burst release and extending their effects, precise control over Laponite-protein interactions remains challenging since it depends on a complex interplay of factors whose implication is not fully understood yet. The aim of this review article is to shed light on this issue, providing a comprehensive discussion of the factors influencing protein loading and release, including the physicochemical properties of the nanoclay and proteins, pH, dispersion buffer, clay/protein concentration and Laponite degradation. Furthermore, we thoroughly revise the array of bioactive proteins that have been delivered from formulations containing the nanoclay, highlighting Laponite-polymer nanocomposite hydrogels, a promising avenue currently under extensive investigation.

蛋白质疗法在治疗各种疾病方面前景广阔。然而,由于降解和清除速度过快,它们的疗效往往大打折扣。人工合成的皂石粘土 Laponite 是一种很有前景的持续给药候选材料。尽管皂石具有独特的特性,可以装载和释放蛋白质,减轻猝发释放并延长其效果,但精确控制皂石与蛋白质之间的相互作用仍具有挑战性,因为这取决于各种因素的复杂相互作用,而这些因素的影响尚未完全明了。本综述文章旨在阐明这一问题,全面讨论影响蛋白质负载和释放的因素,包括纳米粘土和蛋白质的理化性质、pH 值、分散缓冲液、粘土/蛋白质浓度和皂石降解。此外,我们还对含有纳米粘土的制剂所释放的一系列生物活性蛋白质进行了深入研究,并重点介绍了皂石-聚合物纳米复合水凝胶这一目前正在广泛研究的前景广阔的途径。
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引用次数: 0
Ameliorating effects of the HIF-2α inhibitor PT2385 on high-altitude polycythemia HIF-2α抑制剂PT2385对高海拔多血症的改善作用
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-18 DOI: 10.1016/j.ejps.2024.106857

High-altitude polycythemia (HAPC) is a common chronic altitude disease caused by living in low-pressure and low-oxygen environment. At present, there is still no effective cure for HAPC. HIF-2α may play an important role in the development of HAPC in regulating the increased red blood cell excessively induced by HIF-EPO and the blood vessel formation induced by VEGF-VEGFR. Here, we established a rat HAPC model and treated it with the HIF-2α inhibitor PT2385. We mainly evaluated the therapeutic effect of PT2385 on HAPC rats by observing the changes in rat phenotype, tissue and organ damage, red blood cell and hemoglobin content, angiogenesis, lipid peroxidation reaction, and inflammatory factors. The results showed that PT2385 treatment improved the congestion phenotype characteristics, inhibited increased erythrocytes and hemoglobin, reduced blood vessel formation, lipid peroxidation, and inflammation, and reduced tissue and organ damage in HAPC rats. This study preliminarly explains the physiological, pathological, and immunological effects of PT2385 treatment for HAPC. It provides a new idea, a reliable experimental basis, and theoretical support for the clinical prevention and treatment of HAPC.

高原多血症(HAPC)是一种常见的慢性高原病,由生活在低压低氧环境中引起。目前,HAPC 仍无有效的治疗方法。HIF-2α 在 HIF-EPO 诱导的红细胞过度增多和 VEGF-VEGFR 诱导的血管形成中可能起着重要的调节作用。在此,我们建立了大鼠 HAPC 模型,并用 HIF-2α 抑制剂 PT2385 对其进行治疗。我们主要通过观察大鼠表型、组织和器官损伤、红细胞和血红蛋白含量、血管生成、脂质过氧化反应和炎症因子的变化来评估 PT2385 对 HAPC 大鼠的治疗效果。结果表明,PT2385 治疗可改善 HAPC 大鼠的充血表型特征,抑制红细胞和血红蛋白的增加,减少血管形成、脂质过氧化反应和炎症反应,减轻组织和器官损伤。本研究初步解释了 PT2385 治疗 HAPC 的生理、病理和免疫学效应。它为临床预防和治疗 HAPC 提供了新的思路、可靠的实验依据和理论支持。
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引用次数: 0
Freeze-drying cycle optimization of an amorphous solid dispersion of resveratrol 白藜芦醇无定形固体分散体的冷冻干燥循环优化。
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-17 DOI: 10.1016/j.ejps.2024.106855

Resveratrol (RES) has demonstrated advantages as anti-cancer, anti-inflammatory, blood sugar-lowering agent and as cardioprotective agent, among others. Despite RES therapeutic advantages its use in pharmaceutical applications is limited by its low oral bioavailability, mainly due to its poor water solubility. Formulation of poorly water-soluble compound as solid dispersion (SD) converts a crystalline into a more soluble in water amorphous drug. Lyophilization or freeze-drying is a process in which water, an organic solvent, or a co-solvent system is frozen, followed by its removal from the sample, initially by sublimation (primary drying) and then by desorption (secondary drying). This study aimed the development and optimization of a bulk freeze-drying cycle by critical process parameters assessment in each phase to prepare a RES third-generation SD, containing Eudragit E PO as hydrophilic polymer at 1:2 ratio, and Gelucire 44/14 as surfactant at 16 % (w/w) to RES, using a tert-butanol (TBA)/Acetate buffer pH 4.5 (75:25) co-solvent system. A RES third-generation SD with good appearance, not cracked, collapsed, or melted was prepared by an optimized and robust bulk lyophilization process. A physicochemical characterization confirmed the conversion of RES to the amorphous state in the SD and formulation stability after 1 month at 40 °C/75 % RH. Increased solubility and higher dissolution rate compared with pure RES were also obtained.

白藜芦醇(RES)具有抗癌、抗炎、降血糖和保护心脏等多种优势。尽管白藜芦醇具有治疗优势,但其口服生物利用度较低,这主要是由于其水溶性较差,因此限制了其在制药领域的应用。将水溶性较差的化合物配制成固体分散体(SD),可将结晶状药物转化为更易溶于水的无定形药物。冻干或冷冻干燥是将水、有机溶剂或助溶剂系统冷冻,然后通过升华(一次干燥)和解吸(二次干燥)将其从样品中去除的过程。本研究旨在通过对每个阶段的关键工艺参数进行评估,开发和优化批量冷冻干燥循环,以制备 RES 第三代 SD,其中 Eudragit E PO 作为亲水性聚合物,与 RES 的比例为 1:2;Gelucire 44/14 作为表面活性剂,与 RES 的比例为 16%(重量比),使用叔丁醇(TBA)/醋酸盐缓冲液 pH 4.5(75:25)共溶剂系统。通过优化和稳健的散装冻干工艺,制备出了外观良好、无裂纹、无塌陷、无熔化的 RES 第三代 SD。理化表征结果表明,RES 在 SD 中转化为无定形状态,在 40⁰C/75% RH 条件下放置 1 个月后,制剂保持稳定。与纯 RES 相比,溶解度和溶解速率均有所提高。
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引用次数: 0
Preincubation-dependent inhibition of organic anion transporting polypeptide 2B1 对有机阴离子转运多肽 2b1 的预孵育抑制作用。
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-15 DOI: 10.1016/j.ejps.2024.106852

Preincubation with inhibitor in organic anion transporting polypeptide (OATP) in vitro assays may increase the inhibition potency of inhibitors compared to conventional inhibition assays with only short inhibitor coincubation with substrate. The decrease in IC50 may affect prediction of drug-drug interactions (DDI) involving these transporters and inhibitors. Only few drugs, however, have been assessed for the preincubation-dependent inhibition of the OATP2B1 transporter. Therefore, we studied the effect of preincubation on OATP2B1 inhibition with five known OATP2B1 inhibitors (atorvastatin, erlotinib, ezetimibe, ticagrelor and simeprevir) in HEK293 cells transiently overexpressing OATP2B1. IC50 values were determined with and without inhibitor preincubation for 20 min with three different OATP2B1 substrates (dibromofluorescein, DBF; 5-carboxyfluorescein, 5-CF; estrone sulfate). Atorvastatin, ezetimibe, and simeprevir displayed more than 2-fold lower IC50 values after preincubation with at least one of the tested substrates. Altogether, 4 out of 15 inhibitor/substrate combinations exhibited more than 2-fold potentiation of IC50 after inhibitor preincubation. In addition, preincubation by itself, without inhibitor present with the substrate, resulted in more than 50% inhibition of OATP2B1-mediated uptake of DBF and/or 5-CF by atorvastatin, ticagrelor and simeprevir. Thus, erlotinib was the only inhibitor with no indication of potentiation of inhibition by preincubation with any of the tested substrates. In conclusion, preincubation resulted in inhibitor- and substrate-dependent inhibition of OATP2B1. These results support the conclusion that to reduce the risk of false negative DDI prediction, preincubation should be considered also in OATP2B1 inhibition assays.

在有机阴离子转运多肽(OATP)体外试验中与抑制剂预孵育可提高抑制剂的抑制效力,而传统的抑制试验中抑制剂只与底物短时间孵育。IC50 的降低可能会影响涉及这些转运体和抑制剂的药物间相互作用 (DDI) 的预测。然而,只有少数药物对 OATP2B1 转运体的预孵育依赖性抑制作用进行了评估。因此,我们用五种已知的 OATP2B1 抑制剂(阿托伐他汀、厄洛替尼、依折麦布、替卡格雷和西美瑞韦)在瞬时过表达 OATP2B1 的 HEK293 细胞中研究了预孵育对 OATP2B1 抑制的影响。IC50 值是在抑制剂与三种不同的 OATP2B1 底物(二溴荧光素,DBF;5-羧基荧光素,5-CF;硫酸雌酮)预孵育 20 分钟后测定的。阿托伐他汀、依泽替米贝和西美普韦在与至少一种测试底物预孵育后,IC50 值降低了 2 倍以上。抑制剂预孵育后,15 种抑制剂/底物组合中有 4 种的 IC50 增效超过 2 倍。此外,在没有抑制剂与底物同时存在的情况下,预孵育本身会导致阿托伐他汀、替卡格雷和西美瑞韦对 OATP2B1 介导的 DBF 和/或 5-CF 吸收的抑制率超过 50%。因此,厄洛替尼是唯一一种没有迹象表明与任何测试底物预孵育会增强抑制作用的抑制剂。总之,预孵育会导致对 OATP2B1 的抑制作用依赖于抑制剂和底物。这些结果支持这样的结论,即为了降低 DDI 预测假阴性的风险,在 OATP2B1 抑制试验中也应考虑预孵育。
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引用次数: 0
Do Chinese HIV-infected adult patients with altered renal function need to adjust tenofovir disoproxil fumarate dosage? A population pharmacokinetics analysis 肾功能改变的中国成人艾滋病病毒感染者是否需要调整富马酸替诺福韦酯的剂量?群体药代动力学分析。
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-14 DOI: 10.1016/j.ejps.2024.106851

Tenofovir disoproxil fumarate (TDF), a prodrug of tenofovir (TFV), is an effective drug in treating patients infected with human immunodeficiency virus (HIV). Previous population pharmacokinetics (PPK) studies have showed the large variabilities in PK of TFV. Furthermore, limited information was known in Chinese populations. Therefore, the aim of this study was to characterize PPK of TDF in Chinese and identify factors that may affect its PK. TFV concentrations (n = 552) from 30 healthy subjects and 162 HIV-infected Chinese adult patients were pooled for PPK analysis by a nonlinear mixed-effects method. The PK of TFV was adequately described as a two-compartment model with first order absorption and elimination. The typical apparent clearance (CL/F) of TFV in 70-kg adults was 137 L/h, higher than that reported in Caucasians and Blacks (45.8–93 L/h). Estimated glomerular filtration rate was identified to be a significant factor influencing CL/F. Monte Carlo simulation showed that the exposure of standard dosing regimen of TDF 300 mg every 24 h in Chinese people with mild renal impairment (60 to 90 ml/min/1.73 m2) was close to that in individuals with normal renal function (90 mL/min). Dose adjustment is not required for patients with mild renal impairment. Our study might offer new clues for optimal dosing strategies in Chinese patients with HIV-infected.

富马酸替诺福韦二吡呋酯(TDF)是替诺福韦(TFV)的原药,是治疗人类免疫缺陷病毒(HIV)感染者的有效药物。以往的人群药代动力学(PPK)研究表明,TFV的PK存在很大差异。此外,在中国人群中了解到的信息有限。因此,本研究旨在描述中国人中TDF的PPK特征,并确定可能影响其PK的因素。研究采用非线性混合效应方法,对来自30名健康受试者和162名感染艾滋病病毒的中国成年患者的TFV浓度(n = 552)进行了PPK分析。TFV的PK被充分描述为一阶吸收和消除的二室模型。在体重为70公斤的成年人中,TFV的典型表观清除率(CL/F)为137升/小时,高于白种人和黑人的表观清除率(45.8-93升/小时)。估计肾小球滤过率是影响 CL/F 的一个重要因素。蒙特卡洛模拟显示,TDF每24小时300毫克的标准剂量方案在轻度肾功能损害(60至90毫升/分钟/1.73平方米)的中国人中的暴露量与肾功能正常者(90毫升/分钟)的暴露量接近。轻度肾功能损害患者无需调整剂量。我们的研究可能会为中国艾滋病感染者的最佳用药策略提供新的线索。
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引用次数: 0
Material Compatibility and Processing Challenges in Droplet Deposition Modelling Additive Manufacturing: A Study on Pharmaceutical Excipients Polyvinylpyrrolidone/vinyl acetate (PVP/VA) and Polycaprolactone (PCL) 液滴沉积建模增材制造中的材料兼容性和加工挑战:聚乙烯吡咯烷酮/醋酸乙烯(PVP/VA)和聚己内酯(PCL)药用辅料研究。
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-10 DOI: 10.1016/j.ejps.2024.106850
Farnoosh Ebrahimi, Han Xu, Evert Fuenmayor, Ian Major

Additive manufacturing (AM) enables the production of complex, lightweight, and customized components with superior quality. Selecting the right materials considering their thermal properties, printability, and layer adhesion is crucial in melting-based AM techniques. This study investigates Droplet Deposition Modelling (DDM), an innovative material extrusion process that utilizes thermoplastic granules. DDM is distinguished by its shorter manufacturing times and a wider range of materials, setting it apart from traditional material extrusion methods such as fused filament fabrication. We investigated the printability and part quality in DDM using two common pharmaceutical excipients: Polyvinylpyrrolidone/vinyl acetate 6:4 (PVP/VA), which is highly brittle, and Polycaprolactone (PCL), known for its low solubility and role in controlled drug release. Different ratios of PVP/VA and PCL were compounded via hot melt extrusion (HME) and used in DDM to study the impact of ingredient content on printability and part quality, employing geometrical models to assess material compatibility and printability. The study revealed that increasing PVP/VA content leads to higher viscosity, reduced flowability, and uneven deposition, with formulations of 80% and 100% PVP/VA showing poor processability. In contrast, formulations with 60% and 40% PVP/VA exhibited smooth processing and compatibility with DDM. We identified processing temperature and Drop Aspect Ratio (DAR) as key factors influencing material printability and part quality. Elevated processing temperatures and reduced DAR were found to increase interface temperatures, reduce diffusion, and potentially cause the 'elephant feet' issue. Additionally, smaller droplet sizes and material characteristics, such as higher interfacial tension in PCL, could lead to coalescence. Our findings highlight the complexities in optimizing DDM processing parameters and material blends, underscoring the need for careful formulation design to achieve high-quality 3D printed products.

快速成型制造(AM)可以生产复杂、轻质和定制化的优质部件。考虑到材料的热性能、可印刷性和层粘附性,选择合适的材料对基于熔融的 AM 技术至关重要。本研究调查了液滴沉积建模(DDM),这是一种利用热塑性颗粒的创新材料挤压工艺。DDM 的特点是制造时间更短,材料范围更广,有别于熔融长丝制造等传统材料挤出方法。我们使用两种常见的药用辅料对 DDM 的可印刷性和零件质量进行了研究:聚乙烯吡咯烷酮/醋酸乙烯酯 6:4 (PVP/VA)(脆性高)和聚己内酯 (PCL)(溶解度低,可控制药物释放)。通过热熔挤压(HME)将不同比例的 PVP/VA 和 PCL 混合物用于 DDM,研究成分含量对可印刷性和零件质量的影响,并采用几何模型评估材料的兼容性和可印刷性。研究结果表明,PVP/VA 含量的增加会导致粘度升高、流动性降低和沉积不均匀,PVP/VA 含量为 80% 和 100% 的配方加工性较差。相比之下,PVP/VA 含量分别为 60% 和 40% 的配方则可顺利加工并与 DDM 兼容。我们发现加工温度和液滴纵横比(DAR)是影响材料可印刷性和零件质量的关键因素。我们发现,加工温度升高和 DAR 降低会增加界面温度、减少扩散并可能导致 "象脚 "问题。此外,较小的液滴尺寸和材料特性(如 PCL 较高的界面张力)也可能导致凝聚。我们的研究结果凸显了优化 DDM 加工参数和混合材料的复杂性,强调了精心设计配方以实现高质量 3D 打印产品的必要性。
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引用次数: 0
Mechanistic insights into carvedilol's potential protection against doxorubicin-induced cardiotoxicity 卡维地洛对多柔比星诱发的心脏毒性潜在保护作用的机理认识
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-09 DOI: 10.1016/j.ejps.2024.106849
Elsayed A. Elmorsy , Sameh Saber , Rabab S. Hamad , Mustafa Ahmed Abdel-Reheim , Attalla F. El-kott , Mohammed A. AlShehri , Kareem Morsy , Sally Negm , Mahmoud E. Youssef

Doxorubicin (DOX) is an anthracycline chemotherapy drug widely employed in the treatment of various cancers, known for its potent antineoplastic properties but often associated with dose-dependent cardiotoxicity, limiting its clinical use. This review explores the complex molecular details that determine the heart-protective effectiveness of carvedilol in relation to cardiotoxicity caused by DOX. The harmful effects of DOX on heart cells could include oxidative stress, DNA damage, iron imbalance, disruption of autophagy, calcium imbalance, apoptosis, dysregulation of topoisomerase 2-beta, arrhythmogenicity, and inflammatory responses. This review carefully reveals how carvedilol serves as a strong protective mechanism, strategically reducing each aspect of cardiac damage caused by DOX. Carvedilol's antioxidant capabilities involve neutralizing free radicals and adjusting crucial antioxidant enzymes. It skillfully manages iron balance, controls autophagy, and restores the calcium balance essential for cellular stability. Moreover, the anti-apoptotic effects of carvedilol are outlined through the adjustment of Bcl-2 family proteins and activation of the Akt signaling pathway. The medication also controls topoisomerase 2-beta and reduces the renin-angiotensin-aldosterone system, together offering a thorough defense against cardiotoxicity induced by DOX. These findings not only provide detailed understanding into the molecular mechanisms that coordinate heart protection by carvedilol but also offer considerable potential for the creation of targeted treatment strategies intended to relieve cardiotoxicity caused by chemotherapy.

多柔比星(DOX)是一种广泛用于治疗各种癌症的蒽环类化疗药物,以其强大的抗肿瘤特性而闻名,但往往伴有剂量依赖性心脏毒性,限制了其临床应用。本综述探讨了决定卡维地洛对 DOX 引起的心脏毒性的心脏保护作用的复杂分子细节。DOX 对心脏细胞的有害影响可能包括氧化应激、DNA 损伤、铁失衡、自噬破坏、钙失衡、细胞凋亡、拓扑异构酶 2-beta 失调、致心律失常和炎症反应。本综述仔细揭示了卡维地洛如何作为一种强有力的保护机制,战略性地减少 DOX 对心脏造成的各方面损伤。卡维地洛的抗氧化能力包括中和自由基和调整重要的抗氧化酶。它还能巧妙地管理铁平衡、控制自噬和恢复细胞稳定所必需的钙平衡。此外,卡维地洛的抗凋亡作用是通过调整 Bcl-2 家族蛋白和激活 Akt 信号通路来实现的。卡维地洛还能控制拓扑异构酶2-β,减少肾素-血管紧张素-醛固酮系统,从而彻底抵御DOX诱导的心脏毒性。这些发现不仅让人们详细了解了协调卡维地洛保护心脏的分子机制,还为制定旨在缓解化疗引起的心脏毒性的靶向治疗策略提供了巨大的潜力。
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引用次数: 0
Exploring the thermally-controlled fentanyl transdermal therapy to provide constant drug delivery by physics-based digital twins 探索热控芬太尼透皮疗法,通过基于物理的数字双胞胎提供持续给药。
IF 4.3 3区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-08 DOI: 10.1016/j.ejps.2024.106848

Transdermal drug delivery is suitable for low-molecular-weight drugs with specific lipophilicity, like fentanyl, which is widely used for cancer-induced pain management. However, fentanyl's transdermal therapy displays high intra-individual variability. Factors like skin characteristics at application sites and ambient temperature contribute to this variation. In this study, we developed a physics-based digital twin of the human body to cope with this variability and propose better adapted setups. This twin includes an in-silico skin model for drug penetration, a pharmacokinetic model, and a pharmacodynamic model. Based on the results of our simulations, applying the patch on the flank (side abdominal area) showed a 15.3 % higher maximum fentanyl concentration in the plasma than on the chest. Additionally, the time to reach this maximum concentration when delivered through the flank was 19.8 h, which was 10.3 h earlier than via the upper arm. Finally, this variation led to an 18 % lower minimum pain intensity for delivery via the flank than the chest. Moreover, the impact of seasonal changes on ambient temperature and skin temperature by considering the activity level was investigated. Based on our result, the fentanyl uptake flux by capillaries increased by up to 11.8 % from an inactive state in winter to an active state in summer. We also evaluated the effect of controlling fentanyl delivery by adjusting the temperature of the patch to alleviate the pain to reach a mild pain intensity (rated three on the VAS scale). By implementing this strategy, the average pain intensity decreased by 1.1 points, and the standard deviation for fentanyl concentration in plasma and average pain intensity reduced by 37.5 % and 33.3 %, respectively. Therefore, our digital twin demonstrated the efficacy of controlled drug release through temperature regulation, ensuring the therapy toward the intended target outcome and reducing therapy outcome variability. This holds promise as a potentially useful tool for physicians.

透皮给药适用于具有特定亲脂性的低分子量药物,如芬太尼,它被广泛用于癌症引起的疼痛治疗。然而,芬太尼的透皮疗法显示出较高的个体内变异性。使用部位的皮肤特征和环境温度等因素都会导致这种差异。在这项研究中,我们开发了一个基于物理学的人体数字孪生体,以应对这种变异性,并提出更好的适应性设置。这个孪生体包括一个用于药物渗透的皮肤模型、一个药代动力学模型和一个药效学模型。根据我们的模拟结果,将贴片贴在侧腹部位,血浆中芬太尼的最大浓度比贴在胸部高出 15.3%。此外,从侧腹给药达到最大浓度的时间为 19.8 小时,比从上臂给药提前了 10.3 小时。最后,这种变化导致经腹部给药的最低疼痛强度比胸部低 18%。此外,通过考虑活动水平,研究了季节变化对环境温度和皮肤温度的影响。根据我们的结果,从冬季的非活跃状态到夏季的活跃状态,毛细血管对芬太尼的吸收通量最多增加了 11.8%。我们还评估了通过调节贴片温度来控制芬太尼给药的效果,以减轻疼痛,使疼痛强度达到轻度(在 VAS 量表中评定为 3 级)。通过实施这一策略,平均疼痛强度降低了 1.1 分,血浆中芬太尼浓度的标准偏差和平均疼痛强度分别降低了 37.5% 和 33.3%。因此,我们的数字孪生证明了通过温度调节控制药物释放的有效性,确保了治疗达到预期的目标结果,并降低了治疗结果的变异性。这有望成为医生的一种有用工具。
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European Journal of Pharmaceutical Sciences
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