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[Pharmacological properties and clinical trial results of the novel calcium-sensing receptor agonist upacicalcet sodium hydrate (Upacita® intravenous injection for dialysis)]. 【新型钙敏感受体激动剂upacicalcet sodium hydrate (Upacita®透析静脉注射)的药理学特性及临床试验结果】。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.24108
Takeju Otsuki, Seigo Akari, Naomi Kashiwagi, Yoshiyuki Ono

Upacicalcet sodium hydrate (upacicalcet) is a novel small-molecule calcium-sensing receptor (CaSR) modulator with an amino acid structure, developed in Japan as a derivative from research into taste enhancement. Upacicalcet specifically targets CaSR and is thought to inhibit parathyroid hormone (PTH) secretion by activating the receptor in the presence of extracellular calcium (Ca). In nonclinical studies, upacicalcet was evaluated for its pharmacological properties, binding characteristics, and effects on ectopic calcification, parathyroid hyperplasia, and bone disorders associated with secondary hyperparathyroidism (SHPT). The results supported its mechanisms of action, binding mode, and efficacy in suppressing disease progression. In clinical trials, upacicalcet demonstrated efficacy and safety in patients with SHPT undergoing hemodialysis, as assessed in domestic Phase I/II trial (AJ1001 trial), Phase II trial (AJ1002 trial), Phase III placebo-controlled trial (AJ1004 trial), and Phase III long-term administration trial (AJ1003 trial). Upacicalcet was approved in June 2021 for the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing hemodialysis and was launched in August of the same year.

Upacicalcet sodium hydrate (Upacicalcet)是一种具有氨基酸结构的新型小分子钙敏感受体(CaSR)调节剂,是日本在味觉增强研究中开发的衍生物。Upacicalcet特异性靶向CaSR,被认为通过在细胞外钙(Ca)存在下激活受体来抑制甲状旁腺激素(PTH)的分泌。在非临床研究中,对upacicalcet的药理特性、结合特性以及对异位钙化、甲状旁腺增生和继发性甲状旁腺功能亢进(SHPT)相关骨疾病的影响进行了评估。结果支持其作用机制、结合方式和抑制疾病进展的功效。在临床试验中,upacicalcet在国内I/II期试验(AJ1001试验)、II期试验(AJ1002试验)、III期安慰剂对照试验(AJ1004试验)和III期长期给药试验(AJ1003试验)中均显示出对SHPT血液透析患者的有效性和安全性。Upacicalcet于2021年6月被批准用于治疗血液透析患者的继发性甲状旁腺功能亢进症(SHPT),并于同年8月上市。
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引用次数: 0
[A remarkable advancement in structural biology aimed at elucidating the ‍mechanism of synovial sarcoma development]. [结构生物学的一个显著进展,旨在阐明‍滑膜肉瘤发展的机制]。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.25013
Kenji Iwasaki, Satoshi Takenaka

Synovial sarcoma is a type of soft tissue sarcoma that predominantly occurs near the joints of the extremities in young adults. Its hallmark is a recurrent and pathogenic chromosomal translocation, t(X;18)(p11.2;q11.2), which results in the fusion of the SSX1 or SSX2 gene with SS18. The expressed SS18-SSX fusion protein induces abnormalities in the SWItch/Sucrose Non-Fermentable (SWI/SNF) complex, a chromatin remodeling complex. In this paper, we refer specifically to the human SWI/SNF complex as mSWI/SNF. Since 2020, significant progress has been made in elucidating the molecular mechanisms underlying the initial event in synovial sarcomagenesis, particularly in structural biology, thereby opening new possibilities for structure-based drug design (SBDD). SS18-SSX1 replaces the wild-type SS18, an essential subunit of mSWI/SNF, and in turn ejects SMARCB1, another core subunit of the complex. This aberrant mSWI/SNF complex (ssSWI/SNF) is then relocated to nucleosomes containing H2A K119Ub. H2A is one of the core histone proteins, and its 119th lysine residue is ubiquitinated to form H2A K119Ub. Chromatin domains harboring nucleosomes with this modification typically exhibit suppressed gene expression patterns. Furthermore, this region is occupied by polycomb complexes, but ssSWI/SNF competes with them, leading to gene activation, which constitutes the initial event in synovial sarcomagenesis. Given that SSX1 is normally expressed primarily in the testes, it is plausible that its ectopic expression leads to aberrant function within the chromatin remodeling complex. Ultimately, the C-terminal region of SSX1 was found to bind to the acidic patch within the nucleosome, and its structural details have been elucidated through cryo-electron microscopy.

滑膜肉瘤是一种软组织肉瘤,主要发生在年轻人的四肢关节附近。其标志是复发性和致病性染色体易位,t(X;18)(p11.2;q11.2),导致SSX1或SSX2基因与SS18融合。表达的SS18-SSX融合蛋白诱导SWItch/蔗糖不可发酵复合物(SWI/SNF)异常,这是一种染色质重塑复合物。在本文中,我们将人类SWI/SNF复合体具体称为mSWI/SNF。自2020年以来,在阐明滑膜肉瘤形成初始事件的分子机制方面取得了重大进展,特别是在结构生物学方面,从而为基于结构的药物设计(SBDD)开辟了新的可能性。SS18- ssx1取代了野生型SS18,这是mSWI/SNF的一个重要亚基,反过来又排斥了该复合体的另一个核心亚基SMARCB1。然后,这种异常的mSWI/SNF复合物(ssSWI/SNF)被重新定位到含有H2A K119Ub的核小体中。H2A是核心组蛋白之一,其第119个赖氨酸残基泛素化形成H2A K119Ub。具有这种修饰的核小体的染色质结构域通常表现出抑制的基因表达模式。此外,该区域被多梳复合体占据,但ssSWI/SNF与它们竞争,导致基因激活,这构成了滑膜肉瘤形成的初始事件。考虑到SSX1通常主要在睾丸中表达,它的异位表达可能导致染色质重塑复合体中的异常功能。最终,SSX1的c端区域被发现与核小体内的酸性斑块结合,其结构细节已通过冷冻电子显微镜被阐明。
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引用次数: 0
[Nationwide survey of practice after COVID-19 pandemic conducted in medical schools]. [新冠肺炎大流行后全国医学院实践情况调查]。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.25010
Masaki Mogi, Shung Liu
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引用次数: 0
[Physiologically-based pharmacokinetic model analysis of antipsychotic risperidone and its active metabolite paliperidone in perinatal period]. [抗精神病药物利培酮及其活性代谢物帕利哌酮在围产期的生理药代动力学模型分析]。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.24065
Ikuko Yano

Pregnancy can affect the absorption, distribution, metabolism, and excretion of several drugs due to pregnancy-induced physiological changes. Risperidone, a second-generation antipsychotic, is prescribed to pregnant women when the benefits outweigh the risks to the fetus. Serum concentrations of risperidone and its active metabolite paliperidone in a pregnant woman as well as her newborn were measured, and physiologically-based pharmacokinetic (PBPK) models of both drugs were developed. The effects of pregnancy on pharmacokinetic parameters of both drugs were quantitively assessed by the developed PBPK model. As a result, serum concentrations of risperidone and paliperidone decrease in the pregnant status and abruptly recover to the non-pregnant level after delivery mainly due to cytochrome P450 (CYP) 2D6 activity changes, and therefore, close and careful monitoring of clinical symptoms should be considered during pregnancy and after delivery. In the 10 different models for estimating the renal function of children, the Flanders metadata equation showed the lowest absolute bias and the greatest precision in predicting paliperidone serum concentration in the neonate. PBPK model-informed approach could help with the precision dosing in special populations, such as pregnant women and neonates.

由于妊娠引起的生理变化,妊娠可影响几种药物的吸收、分布、代谢和排泄。利培酮是一种第二代抗精神病药物,当其益处大于对胎儿的风险时,孕妇才会服用。测定一名孕妇及其新生儿血清利培酮及其活性代谢物帕利培酮的浓度,建立两种药物的生理药代动力学(PBPK)模型。采用建立的PBPK模型定量评估妊娠对两种药物药代动力学参数的影响。因此,利培酮和帕利培酮的血清浓度在妊娠状态下降,分娩后又突然恢复到非妊娠水平,这主要是由于细胞色素P450 (CYP) 2D6活性的改变,因此在妊娠期间和分娩后应密切、仔细监测临床症状。在10种不同的儿童肾功能预测模型中,Flanders元数据方程在预测新生儿帕利哌酮血清浓度方面的绝对偏差最小,精度最高。基于PBPK模型的方法有助于孕妇和新生儿等特殊人群的精确给药。
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引用次数: 0
Pub Date : 2025-01-01 DOI: 10.1254/fpj.25027
Ichiro Kawahata
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引用次数: 0
[Roles of extracellular vesicles in allergen-specific immunotherapy]. [细胞外囊泡在过敏原特异性免疫治疗中的作用]。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.25007
Masaya Matsuda, Takeshi Nabe

The prevalence of allergic diseases has been increasing, and sensitization to allergens such as cedar pollen and house dust mites has become a social issue. Allergic inflammation is primarily driven by type 2 inflammation, which is mediated by interleukin (IL)-4, IL-5, and IL-13 produced by Th2 cells and group 2 innate lymphoid cells (ILC2s). Recent studies have suggested that extracellular vesicle (EV) also plays critical roles in the pathogenesis of allergic diseases. EVs are lipid bilayer-enclosed particles containing proteins, mRNA, and microRNA (miRNA), which function as carriers of cytokines, antigens, and miRNAs, thereby activating Th2 cells and ILC2s and contributing to the progression of various inflammatory diseases. In contrast, we demonstrated that EVs contributed to the regression of allergic disease: EVs derived from the serum of allergen immunotherapy-treated mice exhibited suppression of ILC2 activation. Given their dual roles in both promoting and suppressing immune responses, EVs are emerging as promising targets and tools for novel treatment strategies. Understanding the immunomodulatory mechanisms mediated by EVs will be a crucial step toward developing safer and more effective therapies for allergic diseases. This review provides an overview of the role of EVs in allergic inflammation and highlights our recent findings on how allergen immunotherapy influences the properties and functions of EVs, thereby contributing to the regulation of immune responses and alleviation of allergic symptoms.

过敏性疾病的发病率不断上升,对雪松花粉和屋尘螨等过敏原的致敏已成为一个社会问题。过敏性炎症主要由2型炎症驱动,2型炎症由Th2细胞和2组先天淋巴样细胞(ILC2s)产生的白细胞介素(IL)-4、IL-5和IL-13介导。最近的研究表明,细胞外囊泡(EV)在变应性疾病的发病机制中也起着重要作用。EVs是含有蛋白质、mRNA和microRNA (miRNA)的脂质双层封闭颗粒,作为细胞因子、抗原和miRNA的载体,激活Th2细胞和ILC2s,参与各种炎症性疾病的进展。相反,我们证明了ev有助于过敏性疾病的消退:来自过敏原免疫治疗小鼠血清的ev抑制了ILC2的激活。鉴于其在促进和抑制免疫反应中的双重作用,ev正在成为新的治疗策略的有希望的靶点和工具。了解ev介导的免疫调节机制将是开发更安全、更有效的过敏性疾病治疗方法的关键一步。本文综述了ev在变应性炎症中的作用,并重点介绍了我们最近在过敏原免疫治疗如何影响ev的性质和功能,从而有助于调节免疫反应和减轻过敏症状方面的发现。
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引用次数: 0
[Role of TRPV2 in mediating and maintaining stress resilience of the heart]. TRPV2在介导和维持心脏应激恢复能力中的作用。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.25058
Yuki Katanosaka

The heart has adynamic compensatory mechanism for hemodynamic stress. This adaptive response to stress depends on cardiac resilience. However, the details of the molecular mechanisms underlying cardiac resilience and the mechanisms by which it is acquired remain unclear. In this review, we focus on TRPV2, a candidate molecule for mechanical stress sensors in cardiomyocytes, and its role in cardiac growth and maturation and in the adult heart using drug-induced TRPV2-deficient mice. TRPV2-mediated activation of the transcription factors SRF and MEF2c is an important pathway that regulates structural and functional maturation of cardiomyocytes. TRPV2 is also an essential factor for the maintenance of the intercalated discs, a site of structural and functional contact between neighboring cardiomyocytes. The increased contractile function of individual cardiomyocytes and the maturation of structural and functional contacts between cells are feedback as mechanical stress, suggesting that the heart develops hemodynamic resilience. In addition, hearts deficient in TRPV2 from an early age developed heart failure due to a failure of adaptive response to the hemodynamic load produced by long-term administration of phenylephrine. These findings suggest that TRPV2 mediates stress resilience in mouse cardiomyocytes. In contrast, these TRPV2-deficient hearts did not show structural or functional changes in response to pressure-overload induced by transverse aortic constriction. These suggest that TRPV2 acts as a mechanotransduction key molecule in the adult mouse heart in response to hemodynamic loading. Advances in this area are expected to provide more options for strategies to treat heart failure conditions.

心脏对血流动力学应激具有动态代偿机制。这种对压力的适应性反应取决于心脏的恢复能力。然而,心脏恢复力的分子机制及其获得机制的细节仍不清楚。在这篇综述中,我们重点研究了心肌细胞中机械应力传感器的候选分子TRPV2,以及它在心脏生长和成熟以及药物诱导的TRPV2缺陷小鼠成年心脏中的作用。trpv2介导的转录因子SRF和MEF2c的激活是调控心肌细胞结构和功能成熟的重要途径。TRPV2也是维持间插椎间盘的重要因素,间插椎间盘是邻近心肌细胞之间结构和功能接触的部位。单个心肌细胞收缩功能的增强以及细胞间结构和功能接触的成熟作为机械应力反馈,表明心脏发展了血流动力学弹性。此外,早期TRPV2缺乏的心脏由于对长期服用苯肾上腺素产生的血流动力学负荷的适应性反应失败而发生心力衰竭。这些发现表明,TRPV2介导小鼠心肌细胞的应激恢复能力。相比之下,这些trpv2缺陷的心脏在横向主动脉收缩引起的压力过载时没有表现出结构或功能变化。这些表明,TRPV2在成年小鼠心脏对血流动力学负荷的反应中起着机械转导的关键分子作用。这一领域的进展有望为治疗心力衰竭的策略提供更多选择。
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引用次数: 0
Pub Date : 2025-01-01 DOI: 10.1254/fpj.24087
Eiichi Taira
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引用次数: 0
[Drug discovery using iPS cells and in silico model]. [利用iPS细胞和计算机模型发现药物]。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.24046
Yuya Fujiwara, Yoshinori Yoshida

Human induced pluripotent stem cells derived cardiomyocytes (hiPSC-CMs) can recapitulate the properties of human cardiomyocyte and exhibit disease phenotypes in vitro, attributable to their healthy- or patient-specific genetic backgrounds. Therefore, hiPSC-CMs are a crucial tool for developing therapeutic agents for cardiovascular diseases, and regenerative medicine using hiPSC-CMs is expected to be an alternative therapy to heart transplantation. Moreover, the development of organoid models has been advanced to replicate the complex structure of heart tissue in vitro, thereby effectively facilitating drug discovery. On the other hand, current methods for advancing drug discovery using hiPSC-CMs face limitations, including the difficulty of quantifying characteristics such as cell structure and predicting the risk and efficacy of candidate drug in clinical practice. In the field of regenerative medicine, challenges include quality control and the verification of safety of transplanted cells in human. In silico model, including artificial intelligence (AI) and simulation, have been developed in the field of drug discovery using hiPSC-CMs. These advancements encompass phenotype scoring via AI and risk prediction through simulations. This review outlines the current status and challenges of drug discovery using hiPSC-CMs and in silico model, based on the published reports.

人类诱导多能干细胞衍生的心肌细胞(hiPSC-CMs)可以概括人类心肌细胞的特性,并在体外表现出疾病表型,这可归因于其健康或患者特异性的遗传背景。因此,hiPSC-CMs是开发心血管疾病治疗剂的重要工具,使用hiPSC-CMs的再生医学有望成为心脏移植的替代疗法。此外,类器官模型的发展已经取得了进展,可以在体外复制心脏组织的复杂结构,从而有效地促进药物的发现。另一方面,目前利用hiPSC-CMs推进药物发现的方法面临局限性,包括难以量化细胞结构等特征,以及难以预测临床实践中候选药物的风险和疗效。在再生医学领域,面临的挑战包括人体移植细胞的质量控制和安全性验证。利用hiPSC-CMs在药物发现领域开发了包括人工智能(AI)和仿真在内的计算机模型。这些进步包括通过人工智能进行表型评分和通过模拟进行风险预测。本文以已发表的报告为基础,概述了利用hiPSC-CMs和硅模型进行药物发现的现状和挑战。
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引用次数: 0
[The 75th Regional Meeting (Kita Area)]. [第75届区域会议(北区)]。
Pub Date : 2025-01-01 DOI: 10.1254/fpj.S24087
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引用次数: 0
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Folia Pharmacologica Japonica
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