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Efficacy and safety of calcineurin inhibitors (CNIs) for septic patients in ICU: a cohort study from MIMIC database 钙神经蛋白抑制剂(CNIs)对重症监护室脓毒症患者的疗效和安全性:来自 MIMIC 数据库的队列研究
IF 5.6 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-18 DOI: 10.3389/fphar.2024.1394553
ShengHui Miao, Mingkun Yang, Wen Li, Zhouxin Yang, Jing Yan
BackgroundSepsis is marked by a dysregulated immune response to infection. Calcineurin inhibitors (CNIs), commonly used as immunosuppressants, have unique properties that may help mitigate the overactive immune response in sepsis, potentially leading to better patient outcomes. This study aims to assess whether CNIs improve prognosis in septic patients and to evaluate any associated adverse reactions.MethodsWe utilized the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV 2.2) database to identify septic patients who were treated with CNIs and those who were not. Propensity score matching (PSM) was employed to balance baseline characteristics between the CNI user group and the non-user group. The primary outcome was 28-day mortality, analyzed using the Kaplan-Meier method and Cox proportional hazard regression models to examine the relationship between CNI use and patient survival.ResultsFrom the MIMIC-IV database, 22,517 septic patients were identified. After propensity score matching, a sample of 874 patients was analyzed. The CNI group exhibited a significantly lower 28-day mortality risk compared to the non-user group (HR: 0.26; 95% CI: 0.17, 0.41) in the univariate Cox hazard analysis. Kaplan-Meier survival curves also demonstrated a significantly higher 28- and 365-day survival rate for CNI users compared to non-users (log-rank test p-value = 0.001). No significant association was found between CNI use and an increased risk of new-onset infection (p = 0.144), but an association with mild hypertension (P < 0.001) and liver injury (P < 0.001) was observed.ConclusionThe use of calcineurin inhibitors was associated with reduced short- and long-term mortality in septic patients without an increased incidence of new-onset infections, hyperkalemia, severe hypertension, or acute kidney injury (AKI). However, CNI use may lead to adverse effects, such as liver injury and mild hypertension.
背景败血症的特点是对感染的免疫反应失调。钙神经蛋白抑制剂(CNIs)是常用的免疫抑制剂,其独特的性质可能有助于减轻脓毒症患者过度活跃的免疫反应,从而改善患者的预后。本研究旨在评估 CNIs 是否能改善脓毒症患者的预后,并评估任何相关的不良反应。方法我们利用重症监护医学信息市场 IV 2.2(MIMIC-IV 2.2)数据库来识别接受 CNIs 治疗和未接受 CNIs 治疗的脓毒症患者。我们采用倾向得分匹配法(PSM)来平衡CNI使用者组和非使用者组之间的基线特征。主要结果是 28 天死亡率,采用 Kaplan-Meier 法和 Cox 比例危险回归模型进行分析,以研究使用氯化萘类药物与患者存活率之间的关系。经过倾向评分匹配后,对 874 例患者进行了分析。在单变量 Cox 危险分析中,CNI 组的 28 天死亡风险明显低于非 CNI 组(HR:0.26;95% CI:0.17, 0.41)。卡普兰-梅耶生存曲线也显示,与不使用 CNI 的人群相比,CNI 使用者的 28 天和 365 天生存率明显更高(对数秩检验 p 值 = 0.001)。结论使用钙神经蛋白酶抑制剂可降低脓毒症患者的短期和长期死亡率,但不会增加新发感染、高钾血症、严重高血压或急性肾损伤(AKI)的发生率。然而,使用 CNI 可能会导致不良反应,如肝脏损伤和轻度高血压。
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引用次数: 0
Activation of AMPK/SIRT1/FOXO3a signaling by BMS-477118 (saxagliptin) mitigates chronic colitis in rats: uncovering new anti-inflammatory and antifibrotic roles BMS-477118(沙格列汀)激活 AMPK/SIRT1/FOXO3a 信号可减轻大鼠慢性结肠炎:揭示抗炎和抗纤维化的新作用
IF 5.6 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-18 DOI: 10.3389/fphar.2024.1456058
Elsayed A. Elmorsy, Mahmoud E. Youssef, Mohamed R. Abdel-Hamed, Maha M. Amer, Sahar R. Elghandour, Abdullah S. Alkhamiss, Nahla B. Mohamed, Mostafa M. Khodeir, Hossam A. Elsisi, Thamir Saad Alsaeed, Manal M. Kamal, Abousree T. Ellethy, Basem H. Elesawy, Sameh Saber
Ulcerative colitis (UC) is a debilitating chronic disease marked by persistent inflammation and intestinal fibrosis. Despite the availability of various treatments, many patients fail to achieve long-term remission, underscoring a significant unmet therapeutic need. BMS-477118, a reversible inhibitor of dipeptidyl peptidase 4 (DPP4), has demonstrated anti-inflammatory properties in preclinical and clinical studies with minimal adverse effects compared to other antidiabetic agents. However, the potential benefits of BMS-477118 in chronic UC have not yet been explored. In this study, we aimed to investigate the effects of BMS-477118 in rats subjected to chronic dextran sodium sulfate (DSS) administration. Our findings indicate that BMS-477118 activates the interconnected positive feedback loop involving AMPK, SIRT1, and FOXO3a, improving histological appearance in injured rat colons. BMS-477118 also reduced fibrotic changes associated with the chronic nature of the animal model, alleviated macroscopic damage and disease severity, and improved the colon weight-to-length ratio. Additionally, BMS-477118 prevented DSS-induced weight loss and enhanced tight junction proteins. These effects, in conjunction with reduced oxidative stress and its potential anti-inflammatory, antiapoptotic, and autophagy-inducing properties, fostered prolonged survival in rats with chronic UC. To conclude, BMS-477118 has the potential to activate the AMPK/SIRT1/FOXO3a signaling pathway in inflamed colons. These results suggest that the AMPK/SIRT1/FOXO3a pathway could be a new therapeutic target for UC. Further research is mandatory to explore the therapeutic possibilities of this pathway. Additionally, continued studies on the therapeutic potential of BMS-477118 and other DPP4 inhibitors are promising for creating new treatments for various conditions, including UC in diabetic patients.
溃疡性结肠炎(UC)是一种使人衰弱的慢性疾病,其特征是持续性炎症和肠纤维化。尽管有多种治疗方法,但许多患者无法获得长期缓解,这凸显了尚未得到满足的巨大治疗需求。BMS-477118 是二肽基肽酶 4 (DPP4) 的可逆抑制剂,在临床前和临床研究中已证明具有抗炎特性,与其他抗糖尿病药物相比,其不良反应极小。然而,BMS-477118 对慢性 UC 的潜在益处尚未得到探索。在本研究中,我们旨在调查 BMS-477118 对长期服用右旋糖酐硫酸钠(DSS)的大鼠的影响。我们的研究结果表明,BMS-477118 激活了涉及 AMPK、SIRT1 和 FOXO3a 的相互关联的正反馈回路,改善了损伤大鼠结肠的组织学外观。BMS-477118 还减少了与动物模型慢性性质相关的纤维化变化,减轻了宏观损伤和疾病严重程度,并改善了结肠重量-长度比。此外,BMS-477118 还能防止 DSS 引起的体重减轻并增强紧密连接蛋白。这些作用,加上降低氧化应激及其潜在的抗炎、抗凋亡和自噬诱导特性,延长了慢性 UC 大鼠的存活时间。总之,BMS-477118 有可能激活炎症结肠中的 AMPK/SIRT1/FOXO3a 信号通路。这些结果表明,AMPK/SIRT1/FOXO3a 通路可能是治疗 UC 的新靶点。要探索这条通路的治疗可能性,必须开展进一步的研究。此外,继续研究 BMS-477118 和其他 DPP4 抑制剂的治疗潜力有望为包括糖尿病患者的 UC 在内的各种疾病创造新的治疗方法。
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引用次数: 0
Exploring the role of Yuxuebi tablet in neuropathic pain with the method of similarity research of drug pharmacological effects based on unsupervised machine learning 基于无监督机器学习的药物药效相似性研究方法探讨玉雪碧片在神经病理性疼痛中的作用
IF 5.6 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-18 DOI: 10.3389/fphar.2024.1440542
Xiao Du, Chunhui Zhao, Yujie Xi, Pengfei Lin, Huihui Liu, Shuling Wang, Feifei Guo
IntroductionHaving multiple pharmacological effects is a characteristic of Traditional Chinese Medicine (TCM). Currently, there is a lack of suitable methods to explore and discover modern diseases suitable for TCM treatment using this characteristic. Unsupervised machine learning technology is an efficient strategy to predict the pharmacological activity of drugs. This study takes Yuxuebi Tablet (YXB) as the research object. Using the unsupervised machine learning technology of drug cell functional fingerprint similarity research, the potential pharmacological effects of YXB were discovered and verified.MethodsLC-MS combined with the in vitro intestinal absorption method was used to identify components of YXB that could be absorbed by the intestinal tract of rats. Unsupervised learning hierarchical clustering was used to calculate the degree of similarity of cellular functional fingerprints between these components and 121 marketed Western drugs whose indications are diseases and symptoms that YXB is commonly used to treat. Then, based on the Library of Integrated Network-based Cellular Signatures database, pathway analysis was performed for selected Western drugs with high similarity in cellular functional fingerprints with the components of YXB to discover the potential pharmacological effects of YXB, which were validated by animal experiments.ResultsWe identified 40 intestinally absorbed components of YXB. Through predictive studies, we found that they have pharmacological effects very similar to non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. In addition, we found that they have very similar pharmacological effects to anti-neuropathic pain medications (such as gabapentin, duloxetine, and pethidine) and may inhibit the NF-κB signaling pathway and biological processes related to pain perception. Therefore, YXB may have an antinociceptive effect on neuropathic pain. Finally, we demonstrated that YXB significantly reduced neuropathic pain in a rat model of sciatic nerve chronic constriction injury (CCI). Transcriptome analysis further revealed that YXB regulates the expression of multiple genes involved in nerve injury repair, signal transduction, ion channels, and inflammatory response, with key regulatory targets including Sgk1, Sst, Isl1, and Shh.ConclusionThis study successfully identified and confirmed the previously unknown pharmacological activity of YXB against neuropathic pain through unsupervised learning prediction and experimental verification.
引言 具有多重药理作用是中药的一个特点。目前,利用这一特点探索和发现适合中医药治疗的现代疾病还缺乏合适的方法。无监督机器学习技术是预测药物药理活性的有效策略。本研究以玉雪碧片(YXB)为研究对象。方法采用LC-MS结合体外肠道吸收法鉴定玉雪碧片中可被大鼠肠道吸收的成分。采用无监督学习分层聚类法计算了这些成分与121种上市西药的细胞功能指纹相似度,这些西药的适应症是YXB常用于治疗的疾病和症状。然后,基于基于集成网络的细胞特征库,对选定的与 YXB 成分具有高度相似性的西药进行通路分析,以发现 YXB 的潜在药理作用,并通过动物实验进行验证。通过预测研究,我们发现它们的药理作用与非类固醇抗炎药(NSAIDs)和皮质类固醇非常相似。此外,我们还发现它们的药理作用与抗神经性疼痛药物(如加巴喷丁、度洛西汀和哌替啶)非常相似,并可能抑制 NF-κB 信号通路和与痛觉相关的生物过程。因此,YXB 可能对神经病理性疼痛有抗痛作用。最后,我们证明了 YXB 能显著减轻坐骨神经慢性收缩性损伤(CCI)大鼠模型的神经病理性疼痛。转录组分析进一步显示,YXB 可调控涉及神经损伤修复、信号转导、离子通道和炎症反应的多个基因的表达,其关键调控靶点包括 Sgk1、Sst、Isl1 和 Shh。
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引用次数: 0
Editorial: Global excellence in ethnopharmacology: North and South America. 社论:全球优秀民族药理学:北美和南美。
IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI: 10.3389/fphar.2024.1488930
Sol Cristians, Rachel Mata
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引用次数: 0
Editorial: Modulation of oxidative stress and inflammation via the NRF2 signaling pathway. 社论:通过 NRF2 信号通路调节氧化应激和炎症。
IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI: 10.3389/fphar.2024.1483289
Sarmistha Saha, Brigitta Buttari, Luciano Saso
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引用次数: 0
Editorial: Raising the bar: advancing therapeutic strategies for fighting communicable and noncommunicable diseases. 社论:提高标准:推进抗击传染性和非传染性疾病的治疗策略。
IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI: 10.3389/fphar.2024.1486889
Dariel Wilbert Tanoto, Jia Wen Lee, Yee Kien Chong, Rafidah Lani, Pouya Hassandarvish, Adrian Oo
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引用次数: 0
Highly active antiretroviral therapy adherence among HIV-POSITIVE women in Southern Ethiopia. 埃塞俄比亚南部感染艾滋病毒的妇女坚持接受高效抗逆转录病毒疗法的情况。
IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI: 10.3389/fphar.2024.1420979
Alemayehu Abebe Demissie, Elsie Janse van Rensburg

Background: Adherence to Highly Active Antiretroviral Therapy (HAART) medication is the major predictor of HIV/AIDS treatment success. Poor adherence to HAART creates the risk of transmitting HIV, deteriorating health conditions, treatment failure, increased occurrences of drug-resistant HIV, morbidity and mortality. The objective of the study was to explore and describe factors influencing HAART adherence among HIV-positive women in Southern Ethiopia.

Methods: A hospital-based descriptive cross-sectional survey was used among 220 randomly selected respondents. Data was collected with a structured interview guide after each respondent had given consent to take part in the study. The collected data was entered into and analyzed by using the Statistical Package for Social Sciences (SPSS) software program version 27.

Results: The level of self-reported adherence (measured by dose) to HAART in the past 30 days was found to be 82.7%. In multivariate analysis, the divorced/separated HIV-positive women had poor adherence to their HAART medication as compared to those who were married [AOR: 2.94, 95% CI: (1.02-8.44)]. Respondents who used reminders in their medication were 75% less likely to be poorly adherent to their HAART medication than those who did not use reminders [AOR: 0.25, 95% CI: (0.06-0.97)]. Those who self-reported depression, perceived stigma, and low perceived susceptibility had poor adherence to their HAART than those who did not report depression, perceived stigma, and low perceived susceptibility [AOR:2.34, 95% CI: (1.01-5.42)], [AOR:2.37, 95% CI: (1.06-5.34)], and [AOR: 4.1, 95% CI: (1.53-11.1)] respectively. HIV-positive women who self-reported low perceived severity were poorly adherent to HAART than those who self-reported high perceived severity [AOR: 2.92, 95% CI: (1.14-7.47)].

Conclusion: Factors including being divorced/separated, not using reminders, depression, perceived stigma, perceived susceptibility, and perceived severity negatively impact HIV-positive women's adherence to HAART.

背景:坚持接受高活性抗逆转录病毒疗法(HAART)药物治疗是预测艾滋病毒/艾滋病治疗成功与否的主要因素。如果不能坚持接受高活性抗逆转录病毒疗法(HAART)治疗,就有可能导致艾滋病病毒传播、健康状况恶化、治疗失败、耐药艾滋病病毒发生率增加、发病率和死亡率上升。本研究旨在探讨和描述影响埃塞俄比亚南部艾滋病毒呈阳性妇女坚持接受 HAART 治疗的因素:方法:对随机抽取的 220 名受访者进行了医院描述性横断面调查。在每位受访者同意参与研究后,采用结构化访谈指南收集数据。收集到的数据通过社会科学统计软件包(SPSS)软件程序 27 版进行输入和分析:受访者自我报告的过去 30 天内坚持服用 HAART(按剂量计算)的比例为 82.7%。在多变量分析中,与已婚妇女相比,离婚/分居的 HIV 阳性妇女对 HAART 药物治疗的依从性较差[AOR:2.94,95% CI:(1.02-8.44)]。在服药过程中使用提醒功能的受访者与未使用提醒功能的受访者相比,HAART 服药依从性差的可能性降低了 75%[AOR:0.25,95% CI:(0.06-0.97)]。与未报告抑郁、耻辱感和易感性低的人群相比,自我报告抑郁、耻辱感和易感性低的人群的 HAART 服药依从性较差[AOR:2.34,95% CI:(1.01-5.42)]、[AOR:2.37,95% CI:(1.06-5.34)]和[AOR:4.1,95% CI:(1.53-11.1)]。与自述严重程度高的女性相比,自述严重程度低的女性对 HAART 的依从性较差[AOR:2.92,95% CI:(1.14-7.47)]:结论:包括离婚/分居、不使用提醒器、抑郁、认为耻辱感、认为易感性和认为严重性在内的因素会对 HIV 阳性女性坚持接受 HAART 治疗产生负面影响。
{"title":"Highly active antiretroviral therapy adherence among HIV-POSITIVE women in Southern Ethiopia.","authors":"Alemayehu Abebe Demissie, Elsie Janse van Rensburg","doi":"10.3389/fphar.2024.1420979","DOIUrl":"10.3389/fphar.2024.1420979","url":null,"abstract":"<p><strong>Background: </strong>Adherence to Highly Active Antiretroviral Therapy (HAART) medication is the major predictor of HIV/AIDS treatment success. Poor adherence to HAART creates the risk of transmitting HIV, deteriorating health conditions, treatment failure, increased occurrences of drug-resistant HIV, morbidity and mortality. The objective of the study was to explore and describe factors influencing HAART adherence among HIV-positive women in Southern Ethiopia.</p><p><strong>Methods: </strong>A hospital-based descriptive cross-sectional survey was used among 220 randomly selected respondents. Data was collected with a structured interview guide after each respondent had given consent to take part in the study. The collected data was entered into and analyzed by using the Statistical Package for Social Sciences (SPSS) software program version 27.</p><p><strong>Results: </strong>The level of self-reported adherence (measured by dose) to HAART in the past 30 days was found to be 82.7%. In multivariate analysis, the divorced/separated HIV-positive women had poor adherence to their HAART medication as compared to those who were married [AOR: 2.94, 95% CI: (1.02-8.44)]. Respondents who used reminders in their medication were 75% less likely to be poorly adherent to their HAART medication than those who did not use reminders [AOR: 0.25, 95% CI: (0.06-0.97)]. Those who self-reported depression, perceived stigma, and low perceived susceptibility had poor adherence to their HAART than those who did not report depression, perceived stigma, and low perceived susceptibility [AOR:2.34, 95% CI: (1.01-5.42)], [AOR:2.37, 95% CI: (1.06-5.34)], and [AOR: 4.1, 95% CI: (1.53-11.1)] respectively. HIV-positive women who self-reported low perceived severity were poorly adherent to HAART than those who self-reported high perceived severity [AOR: 2.92, 95% CI: (1.14-7.47)].</p><p><strong>Conclusion: </strong>Factors including being divorced/separated, not using reminders, depression, perceived stigma, perceived susceptibility, and perceived severity negatively impact HIV-positive women's adherence to HAART.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344702","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}
引用次数: 0
Integrated analyses reveal IDO1 as a prognostic biomarker coexpressed with PD-1 on tumor-associated macrophages in esophageal squamous cell carcinoma. 综合分析表明,IDO1与PD-1共同表达于食管鳞状细胞癌的肿瘤相关巨噬细胞上,是一种预后生物标记物。
IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI: 10.3389/fphar.2024.1466779
Yaojun Peng, Lingxiong Wang, Juan Yang, Qiyan Wu, Xiaoxuan Sun, Jinying Zhang, Yanju Yu, Liping Zhang, Jie Gao, Qing Zhou, Haiyan Zhu, Fan Yin

Background: Inhibition of indolamine-2,3-dioxygenase 1 (IDO1) has been proposed as a promising strategy for cancer immunotherapy; however, it has failed in clinical trials. Macrophages in the tumor microenvironment (TME) contribute to immune escape and serve as potential therapeutic targets. This study investigated the expression pattern of IDO1 in TME and its impact on prognosis and therapeutic response of patients with esophageal squamous cell carcinoma (ESCC).

Methods: RNA sequencing data from 95 patients with ESCC from The Cancer Genome Atlas (TCGA) database were used to explore the prognostic value of IDO1. Bioinformatics tools were used to estimate scores for stromal and immune cells in tumour tissues, abundance of eight immune cell types in TME, and sensitivity of chemotherapeutic drugs and immune checkpoint (IC) blockage. The results were validated using digitalized immunohistochemistry and multiplexed immunofluorescence in ESCC tissue samples obtained from our clinical center.

Results: TCGA and validation data suggested that high expression of IDO1 was associated with poor patient survival, and IDO1 was an independent prognostic factor. IDO1 expression positively correlated with macrophages in TME and PDCD1 within diverse IC genes. Single-cell RNA sequencing data analysis and multiplexed immunofluorescence verified the coexpression of IDO1 and PD-1 in tumor-associated macrophages (TAMs). Patients with high IDO1 expression showed increased sensitivity to various chemotherapeutic drugs, while were more likely to resist IC blockage.

Conclusion: This study identifies IDO1 as an independent prognostic indicator of OS in patients with ESCC, reveals a compelling connection of IDO1, PD-1, and TAMs, and explores the sensitivity of patients with high IDO1 expression to chemotherapeutic drugs and their resistance to IC blockade. These findings open new avenues for potential targets in ESCC immunotherapy.

背景:抑制吲哚胺-2,3-二氧合酶 1(IDO1)被认为是一种很有前景的癌症免疫疗法,但在临床试验中却以失败告终。肿瘤微环境(TME)中的巨噬细胞有助于免疫逃逸,是潜在的治疗靶点。本研究调查了IDO1在TME中的表达模式及其对食管鳞状细胞癌(ESCC)患者预后和治疗反应的影响:方法:利用癌症基因组图谱(TCGA)数据库中95例ESCC患者的RNA测序数据探讨IDO1的预后价值。生物信息学工具用于估算肿瘤组织中基质细胞和免疫细胞的得分、TME中八种免疫细胞类型的丰度以及化疗药物和免疫检查点(IC)阻断的敏感性。我们使用数字化免疫组化技术和多重免疫荧光技术对临床中心获得的 ESCC 组织样本进行了验证:结果:TCGA和验证数据表明,IDO1的高表达与患者生存率低有关,并且IDO1是一个独立的预后因素。IDO1的表达与TME中的巨噬细胞和不同IC基因中的PDCD1呈正相关。单细胞RNA测序数据分析和多重免疫荧光验证了IDO1和PD-1在肿瘤相关巨噬细胞(TAMs)中的共表达。IDO1高表达的患者对各种化疗药物的敏感性增加,同时更容易抵抗IC阻断:本研究发现,IDO1是ESCC患者OS的独立预后指标,揭示了IDO1、PD-1和TAMs之间令人信服的联系,并探讨了IDO1高表达患者对化疗药物的敏感性及其对IC阻断的耐受性。这些发现为 ESCC 免疫疗法的潜在靶点开辟了新的途径。
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引用次数: 0
Rhabdomyolysis associated with concomitant use of colchicine and statins in the real world: identifying the likelihood of drug-drug interactions through the FDA adverse event reporting system. 现实世界中与同时服用秋水仙碱和他汀类药物相关的横纹肌溶解症:通过美国食品及药物管理局不良事件报告系统识别药物相互作用的可能性。
IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI: 10.3389/fphar.2024.1445324
Sha Zhang, Ming-Ming Yan, Hui Zhao, Xiao-Yan Qiu, Deqiu Zhu

Background: Currently, there remains substantial controversy in research regarding whether the concomitant use of colchicine and statins increases the occurrence of rhabdomyolysis, warranting further substantiation.

Objective: This study aimed to identify the likelihood drug-drug interactions (DDIs) for the co-administration of colchicine and statins resulting in rhabdomyolysis.

Methods: A disproportionality analysis was conducted by using data sourced from the US Food and Drug Administration Adverse Event Reporting System (FAERS) to detect rhabdomyolysis signals associated with the combined use of colchicine and statins. The association between (colchicine/statins/colchicine and statins) and rhabdomyolysis were evaluated using information component (IC). DDI signals were calculated based on the Ω shrinkage measure and Bayesian confidence propagation neural network (BCPNN) method. Furthermore, stratification was performed based on colchicine and individual statins agents.

Results: In total, 11,119 reports of rhabdomyolysis were identified in the FAERS database, 255 (2.29%) involved both colchicine and statins. Our analysis showed potential DDI signals of rhabdomyolysis (Ω025 = 1.17) among individuals concurrent use of colchicine and statins. Moreover, further drug-specific analysis suggests DDI signals in the colchicine-atorvastatin pair (Ω025 = 1.12), and colchicine-rosuvastatin pair (Ω025 = 1.05), along with a higher proportion of rhabdomyolysis (IC025 = 5.20) and (IC025 = 4.26), respectively.

Conclusion: The findings suggest that concomitant use of colchicine and statins may increase the risk of rhabdomyolysis, particularly when combined with atorvastatin or rosuvastatin. Therefore, healthcare professionals should pay special attention to life-threatening AE such as rhabdomyolysis, when co-prescribing colchicine statins.

背景:目前,关于同时使用秋水仙碱和他汀类药物是否会增加横纹肌溶解症发生率的研究仍存在很大争议,需要进一步证实:本研究旨在确定同时服用秋水仙碱和他汀类药物导致横纹肌溶解症的药物相互作用(DDI)的可能性:方法: 利用美国食品药品管理局不良事件报告系统(FAERS)中的数据进行了比例失调分析,以检测与联合使用秋水仙碱和他汀类药物相关的横纹肌溶解信号。使用信息成分(IC)评估(秋水仙碱/他汀类药物/秋水仙碱和他汀类药物)与横纹肌溶解症之间的关联。DDI信号是根据Ω收缩测量和贝叶斯信心传播神经网络(BCPN)方法计算得出的。此外,还根据秋水仙碱和单个他汀类药物进行了分层:结果:FAERS数据库共发现11119例横纹肌溶解症报告,其中255例(2.29%)同时涉及秋水仙碱和他汀类药物。我们的分析表明,在同时使用秋水仙碱和他汀类药物的人群中存在横纹肌溶解症的潜在DDI信号(Ω025 = 1.17)。此外,进一步的药物特异性分析表明,在秋水仙碱-阿伐他汀配伍(Ω025 = 1.12)和秋水仙碱-罗伐他汀配伍(Ω025 = 1.05)中存在DDI信号,同时横纹肌溶解的比例较高(IC025 = 5.20)和(IC025 = 4.26):研究结果表明,同时服用秋水仙碱和他汀类药物可能会增加横纹肌溶解症的风险,尤其是与阿托伐他汀或罗苏伐他汀合用时。因此,医护人员在联合处方秋水仙碱他汀类药物时,应特别注意横纹肌溶解等危及生命的不良反应。
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引用次数: 0
The identification of potent dual-target monopolar spindle 1 (MPS1) and histone deacetylase 8 (HDAC8) inhibitors through pharmacophore modeling, molecular docking, molecular dynamics simulations, and biological evaluation. 通过药效学建模、分子对接、分子动力学模拟和生物学评价,确定强效的双靶点单纺锤体 1 (MPS1) 和组蛋白去乙酰化酶 8 (HDAC8) 抑制剂。
IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI: 10.3389/fphar.2024.1454523
Huilian Hua, Lixia Guan, Bo Pan, Junyi Gao, Yifei Geng, Miao-Miao Niu, Zhiqin Li, Jindong Li

Background: Overexpression of monopolar spindle 1 (MPS1) and histone deacetylase 8 (HDAC8) is associated with the proliferation of liver cancer cells, so simultaneous inhibition of both MPS1 and HDAC8 could offer a promising therapeutic approach for the treatment of liver cancer. Dual-targeted MPS1/HDAC8 inhibitors have not been reported.

Methods: A combined approach of pharmacophore modeling and molecular docking was used to identify potent dual-target inhibitors of MPS1 and HDAC8. Enzyme inhibition assays were performed to evaluate the optimal compound with the strongest inhibitory activity against MPS1 and HDAC8. The selectivity of MPH-5 for MPS1 and HDAC8 was assessed on a panel of 68 kinases and other histone deacetylases. Subsequently, molecular dynamics (MD) simulation verified the binding stability of the optimal compound to MPS1 and HDAC8. Ultimately, in vitro cellular assays and in vivo antitumor assays evaluated the antitumor efficacy of the most promising compound for the treatment of hepatocellular carcinoma.

Results: Six dual-target compounds (MPHs 1-6) of both MPS1 and HDAC8 were identified from the database using a combined virtual screening protocol. Notably, MPH-5 showed nanomolar inhibitory effect on both MPS1 (IC50 = 4.52 ± 0.21 nM) and HDAC8 (IC50 = 6.07 ± 0.37 nM). MD simulation indicated that MPH-5 stably binds to both MPS1 and HDAC8. Importantly, cellular assays revealed that MPH-5 exhibited significant antiproliferative activity against human liver cancer cells, especially HepG2 cells. Moreover, MPH-5 exhibited low toxicity and high efficacy against tumor cells, and it overcomes drug resistance to some extent. In addition, MPH-5 may exert its antitumor effects by downregulating MPS1-driven phosphorylation of histone H3 and upregulating HDAC8-mediated K62 acetylation of PKM2. Furthermore, MPH-5 showed potent inhibition of HepG2 xenograft tumor growth in mice with no apparent toxicity and presented favorable pharmacokinetics.

Conclusion: The study suggests that MPH-5 is a potent, selective, high-efficacy, and low-toxicity antitumor candidate for the treatment of hepatocellular carcinoma.

研究背景单极纺锤体1(MPS1)和组蛋白去乙酰化酶8(HDAC8)的过度表达与肝癌细胞的增殖有关,因此同时抑制MPS1和HDAC8可为肝癌的治疗提供一种有前景的治疗方法。目前还没有关于 MPS1/HDAC8 双靶向抑制剂的报道:方法:采用药效学建模和分子对接相结合的方法来鉴定 MPS1 和 HDAC8 的强效双靶点抑制剂。进行了酶抑制实验,以评估对 MPS1 和 HDAC8 具有最强抑制活性的最佳化合物。在一组 68 种激酶和其他组蛋白去乙酰化酶中评估了 MPH-5 对 MPS1 和 HDAC8 的选择性。随后,分子动力学(MD)模拟验证了最佳化合物与 MPS1 和 HDAC8 的结合稳定性。最后,体外细胞实验和体内抗肿瘤实验评估了最有希望治疗肝细胞癌的化合物的抗肿瘤疗效:结果:采用联合虚拟筛选方案,从数据库中鉴定出六种同时针对MPS1和HDAC8的双靶点化合物(MPH 1-6)。值得注意的是,MPH-5 对 MPS1(IC50 = 4.52 ± 0.21 nM)和 HDAC8(IC50 = 6.07 ± 0.37 nM)均有纳摩尔级的抑制作用。MD 模拟表明,MPH-5 可与 MPS1 和 HDAC8 稳定结合。重要的是,细胞实验表明,MPH-5 对人类肝癌细胞,尤其是 HepG2 细胞具有显著的抗增殖活性。此外,MPH-5 对肿瘤细胞具有低毒性和高效性,并在一定程度上克服了耐药性。此外,MPH-5可能通过下调MPS1驱动的组蛋白H3磷酸化和上调HDAC8介导的PKM2的K62乙酰化而发挥抗肿瘤作用。此外,MPH-5还能有效抑制小鼠HepG2异种移植瘤的生长,且无明显毒性,药代动力学良好:该研究表明,MPH-5 是一种强效、选择性、高效、低毒的抗肿瘤候选药物,可用于治疗肝细胞癌。
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Frontiers in Pharmacology
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