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Pharmacology and Toxicology of Amphetamine-Type Stimulants 安非他明类兴奋剂的药理学和毒理学
Pub Date : 2023-06-08 DOI: 10.3390/futurepharmacol3020032
J. Capela, V. M. Costa
Amphetamine-type stimulants are drugs chemically related to the natural compounds ephedrine and cathinone [...]
安非他明类兴奋剂是与天然化合物麻黄碱和卡西酮在化学上相关的药物[…]
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引用次数: 1
The Landscape of IgA Nephropathy Treatment Strategy: A Pharmacological Overview IgA肾病的治疗策略:药理学综述
Pub Date : 2023-06-08 DOI: 10.3390/futurepharmacol3020033
V. Di Leo, Francesca Annese, Federica Papadia, Iris Cara, M. Giliberti, F. Sallustio, L. Gesualdo
IgA Nephropathy (IgAN) is the most common form of primary glomerulonephritis and is one of the most common causes of end-stage kidney disease (ESKD) worldwide. The immunopathogenic mechanism underlying IgAN is poorly identified. Currently, the mainstay treatment of IgAN is centered on the optimization of blood pressure and a reduction in proteinuria, using an angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blockers (ARBs). According to KDIGO, patients who persistently remain at a high risk of progressive ESKD, despite maximal supportive care, are candidates for glucocorticoid therapy. Recent discoveries regarding the pathogenesis of this disease have led to the testing of new therapeutic drugs targeting, in particular, the excessive mucosal immune reaction and the resulting systemic response as well as the complement activation and the following kidney damage and fibrosis. In this review, we examine the various therapeutic approaches to this intriguing disease.
IgA肾病(IgAN)是原发性肾小球肾炎最常见的形式,也是终末期肾脏疾病(ESKD)最常见的原因之一。IgAN的免疫致病机制尚不清楚。目前,IgAN的主要治疗集中在使用血管紧张素转换酶抑制剂(ACEi)和血管紧张素受体阻滞剂(ARBs)来优化血压和降低蛋白尿。根据KDIGO的研究,尽管有最大的支持治疗,但持续处于进展性ESKD高风险的患者是糖皮质激素治疗的候选人。最近关于该病发病机制的发现导致了新的治疗药物的测试,特别是针对过度的粘膜免疫反应和由此产生的全身反应,以及补体激活和随后的肾脏损伤和纤维化。在这篇综述中,我们研究了治疗这种有趣疾病的各种方法。
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引用次数: 0
Current Methods and Advances in the Immunotherapy Treatment of Non-Ovarian Gynaecological Cancers 非卵巢妇科肿瘤的免疫治疗方法与进展
Pub Date : 2023-06-01 DOI: 10.3390/futurepharmacol3020031
S. Adeleke, Yujia Gao, Somto Okoli, Sunyoung Choi, Hao Ding, J. Galante, C. Mikropoulos
Endometrial cancer (EC) and cervical cancer (CC) are common malignancies in women in clinical practice. More uncommon non-ovarian malignancies, such as vulval cancer (VC), are also becoming more prevalent in women of all ages. Currently, there are few comprehensive reviews on the management of these conditions, despite the recent advances in the use of immunotherapy in the management of other forms of cancer. The treatment modalities for EC, CC and VC vary; however, platinum-based chemotherapy, surgical resection and radiotherapy are the main forms of treatment. In more advanced or recurrent disease, there is a limited number of efficacious treatments, with many clinicians relying on adjuvant chemotherapy despite the increased rationale for the use of immunotherapy. With the development of the novel adoptive T-cell therapy, intra-tumoural oncolytic viral therapy and cancer vaccines, the landscape of gynaecological cancer management is changing, and it is likely that treatment efficacy and outcomes will improve dramatically. This review aims to summarise the current management of endometrial, cervical and vulval cancer and to evaluate the novel therapies under development, as well as the future of the management of non-ovarian gynaecological malignancies.
子宫内膜癌(EC)和宫颈癌(CC)是临床上常见的女性恶性肿瘤。更不常见的非卵巢恶性肿瘤,如外阴癌(VC),在所有年龄段的女性中也变得越来越普遍。目前,尽管最近在使用免疫疗法治疗其他形式的癌症方面取得了进展,但很少有关于这些疾病管理的全面综述。EC、CC和VC的治疗方式各不相同;然而,以铂为基础的化疗、手术切除和放疗是主要的治疗形式。在更晚期或复发的疾病中,有效的治疗方法数量有限,尽管使用免疫疗法的理由越来越多,但许多临床医生仍依赖于辅助化疗。随着新型过继t细胞疗法、肿瘤内溶瘤病毒疗法和癌症疫苗的发展,妇科癌症管理的前景正在发生变化,治疗效果和结果可能会显著改善。本文综述了子宫内膜癌、宫颈癌和外阴癌的治疗现状,并对正在开发的新疗法进行了评价,同时也对非卵巢妇科恶性肿瘤的治疗前景进行了展望。
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引用次数: 0
Current State of Antimicrobial Treatment of Lower Respiratory Tract Infections Due to Carbapenem-Resistant Acinetobacter baumannii 耐碳青霉烯鲍曼不动杆菌下呼吸道感染的抗菌治疗现状
Pub Date : 2023-05-16 DOI: 10.3390/futurepharmacol3020030
M. Merli, F. D’Amico, G. Travi, M. Puoti
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a worldwide non-fermenting Gram-negative bacillus responsible for potentially severe nosocomial infections, especially in critically ill patients. CRAB tends to colonize inert surfaces and epithelia, especially the respiratory tract of mechanically ventilated patients, and may then become responsible for lower respiratory tract infections, probably the more challenging infection due to the site and the multidrug-resistant phenotype which makes it difficult to establish an effective antimicrobial regimen. Despite its diffusion, data regarding the treatment of CRAB are mainly retrospective and usually heterogeneous. Current international consensus guidelines prefer the use of ampicillin/sulbactam, but the strength of recommendation and grade of evidence tend to be weak to moderate. Moreover, no specific recommendation is given for different sites of infections. The recently introduced cefiderocol still received a recommendation against its use due to the results of the first randomized clinical trial, though retrospective and observational experiences showed favourable outcomes in this setting. We reviewed the major antibacterial drugs active against CRAB and discussed their combination in lower respiratory tract infections.
耐碳青霉烯鲍曼不动杆菌(CRAB)是一种世界范围内的非发酵革兰氏阴性杆菌,可导致潜在的严重医院感染,特别是危重患者。螃蟹倾向于在惰性表面和上皮上定植,特别是机械通气患者的呼吸道,然后可能成为下呼吸道感染的原因,可能是更具挑战性的感染,由于位置和多重耐药表型,这使得难以建立有效的抗菌方案。尽管其传播广泛,但有关螃蟹治疗的数据主要是回顾性的,而且通常是异质性的。目前的国际共识指南更倾向于使用氨苄西林/舒巴坦,但推荐强度和证据等级往往较弱至中等。此外,没有针对不同感染部位给出具体建议。由于第一项随机临床试验的结果,最近推出的头孢地罗仍然受到反对使用的建议,尽管回顾性和观察性经验显示在这种情况下的有利结果。本文综述了抗螃蟹的主要抗菌药物,并讨论了它们在下呼吸道感染中的联合应用。
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引用次数: 0
Tolerability and Efficacy of Multiple Series of Intravitreal Methotrexate Injections for Complex Retinal Detachment Associated with Proliferative Vitreoretinopathy 多系列玻璃体内注射甲氨蝶呤治疗增殖性玻璃体视网膜病变所致复杂视网膜脱离的耐受性和疗效
Pub Date : 2023-04-30 DOI: 10.3390/futurepharmacol3020029
Tessnim R. Ahmad, J. Stewart
In this study, we retrospectively reviewed the outcomes of patients treated with one or more series of intravitreal methotrexate (MTX) injections as a surgical adjunct for the prevention of recurrent rhegmatogenous retinal detachment (RRD) related to proliferative vitreoretinopathy (PVR). The study subjects were patients with primary or recurrent RRD associated with grade C PVR, who received one or more series of 9 intravitreal MTX injections. Each series consisted of a single intraoperative MTX injection and then 8 weekly postoperative MTX injections as an off-label surgical adjunct for the prevention of PVR. The primary outcome was the retinal reattachment rate. The secondary outcome was the incidence of treatment-limiting side effects. A total of 14 eyes of 14 patients were identified. The median age was 61 years (range: 9–83), and 43% of the patients were female. Most patients (64%) had a prior primary surgical failure. After one MTX series, 10 eyes (72%) were attached, and 8 (57%) were free of PVR at a median follow-up of 11 months (range: 2–14). All failures after a single MTX series were successfully treated with repeat surgery and a second (n = 4) or third (n = 1) MTX series, for the final reattachment and PVR-free rates of 100%. None of the patients experienced treatment-limiting side effects. Therefore, multiple series of MTX injections can be tolerated if indicated in cases of aggressive PVR threatening the retina.
在这项研究中,我们回顾性地回顾了接受一个或多个系列玻璃体内甲氨蝶呤(MTX)注射作为手术辅助治疗的患者的结果,以预防与增殖性玻璃体视网膜病变(PVR)相关的复发性孔源性视网膜脱离(RRD)。研究对象是与C级PVR相关的原发性或复发性RRD患者,他们接受了一个或多个系列的9次玻璃体内甲氨蝶呤注射。每个系列包括术中单次注射MTX,然后每周8次注射MTX,作为预防PVR的非适应症手术辅助手段。主要结果是视网膜再附着率。次要结果是限制治疗的副作用的发生率。14例患者共鉴定14只眼。中位年龄61岁(范围:9-83岁),43%的患者为女性。大多数患者(64%)既往有原发性手术失败。在一个MTX系列后,在中位随访11个月(范围:2-14)期间,10只眼睛(72%)附着,8只(57%)无PVR。所有在单一MTX系列手术后失败的患者均通过重复手术和第二次(n = 4)或第三次(n = 1) MTX系列手术成功治疗,最终复位和无pvr率为100%。没有患者出现限制治疗的副作用。因此,在侵袭性PVR威胁视网膜的情况下,多系列MTX注射是可以耐受的。
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引用次数: 0
Production of Hydrogel-Based Curcumin-Loaded O/W Suspoemulsions 水凝胶型载姜黄素O/W悬浮液的制备
Pub Date : 2023-04-27 DOI: 10.3390/futurepharmacol3020028
Timo Bodmer, Steffen F. Hartmann, C. Keck, Martina Kleiner, K. Köhler
Curcumin is a biopharmaceutical classification system (BCS) class IV substance with many potential therapeutic effects. However, like many other BCS IV active pharmaceutical ingredients, complex formulations are needed to guarantee a sufficiently high bioavailability. A not-so-well-known delivery system is a suspoemulsion (SE). SEs are emulsions with a crystalline API in continuous or dispersed phases. This study aimed to produce curcumin-loaded o/w suspoemulsions with the particle in the oil phase for, e.g., encapsulation or triggered release effects. The particles need to be smaller than the emulsion droplet size to attain high encapsulation efficiencies (EE) in the oil phase. Sonofragmentation and bead milling were tested for their ability to produce these nanocrystals in different dispersion media. It was discovered that production in miglyol was the best fit for the needed application of the crystals in SEs. Around 85% (by volume) of the particles produced with bead milling were smaller than the droplet size of about 5 µm. In contrast, only 23% of the sonofragmentated particles were below the diameter of those droplets. This oily suspension was then used to successfully produce hydrogel-based o/w suspoemulsions. In the second part of this study, we investigated different methods for determining encapsulation efficiency, but none of the methods accurately and satisfactorily resolved the encapsulation efficiency. Finally, the suspoemulsions could not be macroscopically distinguished from one another and were physically stable. In summary, we showed that stable hydrogel-based curcumin-loaded o/w suspoemulsions could be produced.
姜黄素是生物医药分类系统(BCS) IV类物质,具有多种潜在的治疗作用。然而,像许多其他BCS IV活性药物成分一样,需要复杂的配方来保证足够高的生物利用度。一种不太为人所知的递送系统是悬浮乳剂(SE)。se是具有连续相或分散相结晶API的乳剂。本研究旨在制备姜黄素负载的o/w悬浮液,其颗粒处于油相,用于包封或触发释放等效果。为了在油相中获得较高的包封效率(EE),颗粒需要小于乳状液滴的尺寸。测试了超声破碎和球磨在不同分散介质中制备这些纳米晶体的能力。研究发现,以米甘醇为原料的生产最适合该晶体在SEs中的应用。珠磨产生的颗粒中约85%(按体积计)小于约5 μ m的液滴尺寸。相比之下,只有23%的超声碎片颗粒小于这些液滴的直径。随后,该油悬浮液被成功用于生产水凝胶型o/w悬浮液乳剂。在本研究的第二部分,我们研究了不同的测定包封效率的方法,但没有一种方法能准确、满意地测定包封效率。最后,两种悬浮液在宏观上无法区分,并且具有物理稳定性。综上所述,我们证明了可以制备稳定的基于水凝胶的负载姜黄素的o/w悬浮液。
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引用次数: 0
Transplacental Treatment of Fetal Tachyarrhythmia: Current Trends and Future Perspectives 经胎盘治疗胎儿快速心律失常:当前趋势和未来展望
Pub Date : 2023-04-26 DOI: 10.3390/futurepharmacol3020027
Á. Chimenea, Carmen Vargas-Rodríguez, L. García-Díaz, G. Antiñolo
Fetal arrhythmias complicate 1% of pregnancies. Although most of them have a benign and intermittent course, sustained fetal tachyarrhythmias constitute an emerging situation, which is associated with high fetal morbidity and mortality. However, one of the major milestones in fetal therapy is the pharmacologic management of fetal arrhythmias by crossing the placental barrier. To date, there is no consensus on the first-line antiarrhythmic treatment for fetal tachyarrhythmias. The role of sotalol in therapeutic management, the use of flecainide versus digoxin as first line of treatment, the need for fetal intramuscular treatment administration, or the best treatment in case of fetal hydrops are situations whose application or management are controversial. The current paper is a scoping review of observational and experimental evidence, addressing the types of best management strategies for each type of tachyarrhythmia and the optimal pharmacological dose, considering precautions and safety elements. Finally, we will highlight new therapeutic perspectives and future diagnostic and therapeutic strategies.
胎儿心律失常导致1%的妊娠并发症。虽然它们大多数是良性的和间歇性的,但持续的胎儿快速心律失常是一种新出现的情况,它与胎儿的高发病率和死亡率有关。然而,胎儿治疗的一个重要里程碑是通过胎盘屏障对胎儿心律失常进行药理学管理。迄今为止,对于胎儿速性心律失常的一线抗心律失常治疗尚无共识。索他洛尔在治疗管理中的作用,使用氟氯胺与地高辛作为一线治疗,是否需要胎儿肌内注射治疗,或者胎儿积液时的最佳治疗方法,这些情况的应用或管理都存在争议。目前的论文是对观察和实验证据的范围审查,讨论了每种类型的速性心律失常的最佳管理策略和最佳药理学剂量,考虑到预防和安全因素。最后,我们将强调新的治疗观点和未来的诊断和治疗策略。
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引用次数: 0
Influence of Polyether Backbone PEO–PPO on the Drug Release Behavior of Polyurea Xerogels 聚醚骨架PEO-PPO对聚脲干凝胶释药行为的影响
Pub Date : 2023-04-21 DOI: 10.3390/futurepharmacol3020026
Julia G. Vargas, H. Andrada, Bruno A. Fico, Julia M Paulino, Natália N. Silveira, R. D. dos Santos, E. F. Molina
To evaluate possible structural changes and thermal stability of the polyurea unloaded and loaded with diclofenac sodium, polyurea networks based on polyetheramine containing polypropylene oxide (PPO) or polyethylene oxide (PEO) and hexamethylene diisocyanate trimer-HDI were synthesized. The formation of the network was controlled by sol-gel reactions, and the obtained materials were then characterized by different techniques (FTIR, XRD, TGA). Moreover, the amount of diclofenac released could be modulated as a function of time, studying the water absorption or swelling capacity, the cytotoxicity of the material and the amount of drug released. A choice was therefore made on the hydrophilicity of PEO- or PPO-based polyetheramine (with similar molecular weight), and the release profile was hereafter correlated with the water absorption by the PEO/PPO polyurea matrix. Links could finally be established between the release of diclofenac and the polyurea matrices properties, such as the nature of polymer (PEO/PPO) and the hydrophilicity (water uptake). Our objective here is to identify challenges and opportunities for the development of innovative functional biomaterials for health applications.
为了评价双氯芬酸钠负载和卸载后聚脲的结构变化和热稳定性,合成了含聚环氧聚丙烯(PPO)或聚环氧聚乙烯(PEO)的聚醚胺和六亚甲基二异氰酸酯三聚体hdi的聚脲网络。该网络的形成受溶胶-凝胶反应控制,然后用不同的技术(FTIR, XRD, TGA)对所得材料进行了表征。此外,双氯芬酸的释放量可以作为时间的函数进行调节,研究材料的吸水或溶胀能力、细胞毒性和药物释放量。因此,对PEO-或PPO-基聚醚胺(分子量相近)的亲水性进行了选择,并将其释放曲线与PEO/PPO聚脲基质的吸水性进行了相关性研究。最终可以建立双氯芬酸释放与聚脲基质性质之间的联系,例如聚合物的性质(PEO/PPO)和亲水性(吸水)。我们的目标是确定发展创新功能生物材料的挑战和机遇,用于健康应用。
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引用次数: 0
Antidepressant Effect of Alpha Lipoic Acid in Rats Exposed to Chronic Unpredictable Mild Stress: Putative Role of Neurotransmitters and 5HT3 Receptor α硫辛酸对慢性不可预测轻度应激大鼠的抗抑郁作用:神经递质和5HT3受体的推测作用
Pub Date : 2023-04-17 DOI: 10.3390/futurepharmacol3020025
Likhit Akotkar, Urmila Aswar, R. Patil, Dileep Kumar, M. Aswar, Jyoti Pandey, S. Gurav
Depression is a neuropsychiatric disorder characterized by altered emotion and cognition. Alpha lipoic acid (ALA) is a potent natural antioxidant and exhibits neuroprotective effects. However, its antidepressant activity and its mechanism of action in rats exposed to chronic unpredictable mild stress (CUMS) need to be evaluated. The rats were divided into six groups. Group, I vehicle control (without stress), II- CUMS, III- fluoxetine (FLX) (50 mg/kg p.o.), IV, V, and VI were treated with ALA (50, 100, 200 mg/kg, p.o.), respectively. All the groups, except I, were subjected to CUMS + treatments from day 1 to day 42. Body weight and behavioral parameters like sucrose preference test (SPT), Morris water maze (MWM), resident intruder test (RIT), and marble-burying test (MBT) were performed on day 0, day 21, and day 42, and forced swim test (FST) on last day 42 and 43 only. The rats were further sacrificed for biochemical and histopathological evaluation. ALA significantly improved behavioral function, increased antioxidant strength, reduced lipid peroxidation, restored monoamines, and protected CA3 neurons. Further, docking studies revealed strong binding of ALA on the 5HT3 receptor. The study demonstrates that ALA might be exhibiting antidepressant effects in part by restoring monoamines and modulating the 5HT3 receptor.
抑郁症是一种以情绪和认知改变为特征的神经精神疾病。α硫辛酸(ALA)是一种有效的天然抗氧化剂,具有神经保护作用。然而,其抗抑郁活性及其对慢性不可预测轻度应激(CUMS)大鼠的作用机制有待进一步研究。老鼠被分成六组。ⅰ组对照(无应激)、ⅱ组- CUMS、ⅲ组-氟西汀(FLX) (50 mg/kg, p.o)、ⅳ组、ⅴ组和ⅵ组分别用ALA(50、100、200 mg/kg, p.o)处理。除1组外,其余各组均于第1天至第42天进行CUMS +处理。在第0天、第21天、第42天分别进行体重、蔗糖偏好试验(SPT)、Morris水迷宫试验(MWM)、常驻闯入者试验(RIT)和大理石掩埋试验(MBT),最后42天和第43天分别进行强迫游泳试验(FST)。处死大鼠进行生化和组织病理学评价。ALA显著改善行为功能,增强抗氧化能力,减少脂质过氧化,恢复单胺,保护CA3神经元。此外,对接研究显示ALA与5HT3受体的强结合。该研究表明,ALA可能通过恢复单胺和调节5HT3受体而表现出抗抑郁作用。
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引用次数: 0
Bempedoic Acid and Statins in Lipid-Lowering Strategy: Which Came First, the Egg or the Chicken? 苯二甲酸和他汀类药物降脂策略:哪个先有蛋还是先有鸡?
Pub Date : 2023-04-10 DOI: 10.3390/futurepharmacol3020024
F. Natale, R. Molinari, Rosa Franzese, N. Mollo, G. Cimmino
The goal in cardiovascular prevention is the reduction of morbidity and mortality through the promotion of healthy lifestyles in the general population. The management of modifiable risk factors with pharmacological and non-pharmacological interventions, based on the individual risk is the first strategy suggested by the current guidelines. Several epidemiological studies have clearly shown the direct correlation between high levels of low-density lipoprotein cholesterol (LDL-C) and incidence of cardiovascular diseases. On the other hand, numerous randomized clinical studies have reported a huge benefit in terms of major cardiovascular events achievable by the reduction of LDL-C, thus supporting the notion that “the lower is better”. Among the lipid-lowering strategies, statins are the drugs of choice in cardiovascular prevention, at both primary and secondary level. To achieve the ambitious targets suggested by the current guidelines, other lipid-lowering therapies are currently available in addition to statins, such as ezetimibe the inhibitors of the PCSK9. Pharmacological research has recently led to the development of a new drug, the bempedoic acid, which further enrich the available therapies. This drug also acts on the biosynthesis of cholesterol but at upstream level than statins. From the biochemical point of view, it has the potential to be considered before the statin with consequent titration of statins to achieve the desirable LDL-C target. In the present review, the biochemical and pharmacological characteristics of bempedoic acid are discussed. An overview of the clinical data that support its use in the management of the cardiovascular patient and its allocation in the lipid-lowering scenario will be also provided.
预防心血管疾病的目标是通过在一般人群中提倡健康的生活方式来降低发病率和死亡率。基于个体风险,采用药物和非药物干预措施管理可改变的风险因素是当前指南建议的第一种策略。一些流行病学研究清楚地表明,低密度脂蛋白胆固醇(LDL-C)的高水平与心血管疾病的发病率之间存在直接关联。另一方面,大量随机临床研究报告了LDL-C降低对主要心血管事件的巨大益处,从而支持了“越低越好”的观点。在降脂策略中,他汀类药物是心血管预防的首选药物,无论是一级还是二级。为了实现当前指南所建议的宏伟目标,除了他汀类药物之外,目前还可以使用其他降脂疗法,例如PCSK9抑制剂依zetimibe。最近的药理学研究导致了一种新药的开发,它进一步丰富了现有的治疗方法。这种药物也作用于胆固醇的生物合成,但作用水平比他汀类药物高。从生化的角度来看,在服用他汀类药物之前,有可能考虑到这一点,随后他汀类药物的滴定,以达到理想的LDL-C目标。本文综述了苯二甲酸的生物化学和药理特性。本文还将概述支持其在心血管患者管理中的应用及其在降脂方案中的分配的临床数据。
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引用次数: 0
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Future Pharmacology
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